bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Soft Law’, Informal Lawmaking and ‘New Institutions’ in the Global Counter-Terrorism Architecture
Authors: Ní Aoláin Fionnuala
Published: September 2021

This article assesses the increasingly important and diverse role undertaken by a range of ‘soft-law’ counter-terrorism instruments since September 2001. It starts from the proposition that states increasingly use soft-law standards to regulate in the counter-terrorism, countering violent extremism and preventing violent extremism arenas. The article identifies a broad range of soft-law instruments and assesses their normative and practical importance for states. In parallel, the analysis identifies and maps a range of new institutions and entities producing such norms, paying particular attention to their membership, legal basis, terms of reference and working methods. The role and importance of these new institutions is broadly addressed. The article argues that soft-law production in counter-terrorism has weakened human rights protections across the globe and provided cover for sustained rights violations in multiple national contexts. As a result, human rights norms are not meaningfully included in the creation and implementation of these norms. The article pays particular attention to the lack of pathways for human rights standards to be meaningfully integrated, accounted for and benchmarked in the creation of counter-terrorism soft law. It identifies the ways in which new institutions have inter alia been established precisely to avoid the normative and institutional application of these standards to the counter-terrorism norm creation process. The article starts to trace the movement of some ‘soft-law’ norms to hard-law standards, illustrating the dense relationship between ‘hard’ and ‘soft’ law in the counter-terrorism arena.
Taking care of the ordinary in extraordinary times—delayed routine care means more morbidity and pre-mature mortality
Authors: Cuschieri Sarah , Mamo Julian
Published: September 2021

Individuals with chronic diseases are more susceptible to its grave complications and negative outcomes if infected by COVID-19. Furthermore, mandatory isolation and cancellations of routine healthcare services led to the disruption of the screening and management plans for chronic diseases. Fear of attending health services as well as disruptions to public transport are other factors increasing health risks among persons with chronic conditions during the pandemic. Ensuring access to universal healthcare services, increasing use of digital services, targeted interventions to risk groups are examples of measures that need to be taken when reviewing health systems preparedness for future pandemics and other disasters.
Population Structure, Genetic Connectivity, and Signatures of Local Adaptation of the Giant Black Tiger Shrimp (Penaeus monodon) throughout the Indo-Pacific Region
Authors: Vu Nga T T , Zenger Kyall R , Silva Catarina N S , Guppy Jarrod L , Jerry Dean R
Published: September 2021

The giant black tiger shrimp (Penaeus monodon) is native to the Indo-Pacific and is the second most farmed penaeid shrimp species globally. Understanding genetic structure, connectivity, and local adaptation among Indo-Pacific black tiger shrimp populations is important for informing sustainable fisheries management and aquaculture breeding programs. Population genetic and outlier detection analyses were undertaken using 10,593 genome-wide single nucleotide polymorphisms (SNPs) from 16 geographically disparate Indo-Pacific P. monodon populations. Levels of genetic diversity were highest for Southeast Asian populations and were lowest for Western Indian Ocean (WIO) populations. Both neutral (n = 9,930) and outlier (n = 663) loci datasets revealed a pattern of strong genetic structure of P. monodon corresponding with broad geographical regions and clear genetic breaks among samples within regions. Neutral loci revealed seven genetic clusters and the separation of Fiji and WIO clusters from all other clusters, whereas outlier loci revealed six genetic clusters and high genetic differentiation among populations. The neutral loci dataset estimated five migration events that indicated migration to Southeast Asia from the WIO, with partial connectivity to populations in both oceans. We also identified 26 putatively adaptive SNPs that exhibited significant Pearson correlation (P < 0.05) between minor allele frequency and maximum or minimum sea surface temperature. Matched transcriptome contig annotations suggest putatively adaptive SNPs involvement in cellular and metabolic processes, pigmentation, immune response, and currently unknown functions. This study provides novel genome-level insights that have direct implications for P. monodon aquaculture and fishery management practices.
Should Gatekeepers Be Allowed to Combine Data? Ideas for Art. 5(a) of the Draft Digital Markets Act
Authors: Podszun Rupprecht
Published: September 2021

Should digital gatekeepers be allowed to gather data from users and combine data from different sources? That is one of the key substantive questions of the Digital Markets Act (DMA). It is currently addressed in Art. 5(a) of the draft DMA. There are two problems with the current wording: first, it is not specific enough to work as a self-executable provision; secondly, it could happen that users are nudged into giving consent easily so that the gatekeepers can continue to expand their sets of personal data, without users having a ‘real’ say and with third parties losing out in competition. In this contribution, I analyse this problem. My suggestion is to resort to a ‘rating solution’: qualified entities, e.g. trusted data intermediaries, should rate, certify or label the data options offered by the gatekeepers and serve as ‘data guides’ for consumers. I also look at other policy options.
Gig Work as a Manifestation of Short- Termism: Crafting a Sustainable Regulatory Agenda
Authors: Novitz Tonia
Published: September 2021

Commercial platforms were once lauded as a facet of the sustainable ‘sharing economy’. Today, the short-termism associated with ‘gig work’ is widely condemned as an obstacle to sustainable development. This article begins by examining what is meant by ‘sustainability’, including how we might interpret and apply the Sustainable Development Goals adopted by the United Nations and endorsed by the International Labour Organization. The second substantive part of the article analyses contemporary practices associated with intermittent and insecure platform work which have been identified globally, with reference to longer term and inter-related economic, environmental and social effects. The third part reflects on how appreciation of these effects could shape a future reform agenda oriented towards sustainable development. It is argued that recognition of the desirability of sustainability could enhance the case for holistic legal reform, promoting collective solidarity and action across geographical and temporal borders, while traversing doctrinal boundaries, to make gig work (as we now know it) a thing of the past.
Pharmacokinetics and placental transfer of dolutegravir in pregnancy
Authors: Ikumi Nadia M. , Anumba Dilly , Matjila Mushi
Published: September 2021

Dolutegravir is currently recommended by the WHO as the preferred first-line treatment for all people with HIV, including pregnant women. Estimates indicate that, by 2024, nearly 22 million adults in low- and middle-income countries will have transitioned to dolutegravir-based ART. It is therefore critical that there is a clear appreciation and understanding of the risks that may be associated with in utero exposure to dolutegravir. In this review we consolidate data from studies on dolutegravir and the placenta. The studies have largely focused on the pharmacokinetics and placental transfer of dolutegravir in pregnancy. These include studies on transplacental transfer of dolutegravir, ex vivo placenta perfusion models, physiologically based pharmacokinetic (PBPK) models and animal studies. The data available clearly demonstrate that placental transfer of dolutegravir occurs in moderate to high concentrations. Intracellular placental dolutegravir has been demonstrated in the placental villous tissue. There are limited data suggesting that pregnancy is associated with decreased maternal dolutegravir levels. In addition, PBPK models have great potential in predicting the passage of drugs through the placenta and further contributing towards the elucidation of fetal exposure. The animal studies available demonstrate that in utero dolutegravir exposure can be associated with neural tube defects. Taking into consideration that antiretroviral exposure may be associated with poor placental development or function and increased risk of adverse effects to the fetus, it is crucially important that these risks are evaluated, especially with the rapid scale up of dolutegravir-based ART into national treatment programmes.
The Ideal Donor Site Dressing: A Comparison of a Chitosan-Based Gelling Dressing to Traditional Dressings
Authors: Uke Nkemjika , Singh Simran , Sorensen Grant E , Frost Joshua , Venable Amanda , Burge Bailey , Terziyski Ilina , Payberah Ebrahim , Griswold John
Published: September 2021

Donor site wound management is critical in split-thickness skin graft surgeries. These sites typically recover in 7 to 14 days due to the dermal-imbedded keratinocytes that promote skin regeneration. An ideal donor site dressing can help to mitigate pain, reduce infection risk, promote hemostasis, and accelerate healing times. Additionally, this dressing would be easy to apply in the operating room, easily managed, and cost-effective. Chitosan-based gelling dressings (CBGD) possess many of these qualities that make an ideal donor site dressing. We conducted a retrospective chart review of patients who received CBGD as part of their postoperative wound care plan. We collected data on infections, hemostasis, dressing failure, and hospital course over a 14-month period where CBGD was used as the donor site dressing. One hundred and fourteen patients were evaluated. We found an infection rate of 7%, a bleed-through rate of 1.8%, and a re-application rate of 9.6%. The average CBGD cost per patient was $75.15. CBGD has acceptable infection rates, and pain scores as traditional donor site dressings. However, it possesses several qualities of a suitable donor site dressing notably swift healing rates, impressive hemostatic property, and low cost. Our study supports the idea that CBGD is a suitable donor site dressing for split-thickness skin graft surgeries.
Outcomes in Ventilated Burn Patients With Acute Respiratory Distress Syndrome: An Evaluation of Early High-PEEP Strategy Using Berlin Criteria
Authors: Perry Travis L , Pinette William , Miner Jason , Lesch Heather , Denny Brittany , Parikh Priti
Published: September 2021

Acute respiratory distress syndrome (ARDS) remains a formidable sequela, complication, and mortality risk in patients with large burns with or without inhalation injury. Alveolar recruitment using higher Positive end expiratory pressures (PEEP) after the onset of ARDS has been tried with varying success. Studies have identified benefits for several rescue maneuvers in ARDS patients with refractory hypoxemia. A prophylactic strategy utilizing an early recruitment maneuver, however, has not, to our knowledge, been explored in ventilated burn patients. This study was designed to evaluate the natural progression and clinical outcomes of ARDS severity (mild, moderate, and severe) using Berlin criteria in ventilated burn patients treated with an early high-PEEP ventilator strategy. A single-center retrospective review of burn patients who were mechanically ventilated for greater than 48 hours utilizing an early high-PEEP >10 mmHg (10.36) ventilator strategy was performed at the Level 1 trauma and regional burn center in Wright State University. ARDS severity was defined according to the Berlin criteria and then compared to published results of ARDS severity, clinical outcomes, and mortality. Demographic data, as well as respiratory and clinical outcomes, were evaluated. Eighty-three patients met inclusion criteria and were evaluated. Utilizing the Berlin definition as a benchmark, 42.1% of patients met ARDS criteria on admission, and most patients (85.5%) developed ARDS within the first seven days: 28 (34%) mild, 32 (38.6%) moderate, and 11 (13.3%) severe ARDS. The mean percent total body surface area was 24.6 + 22.1, with 68.7% of patients diagnosed with inhalation injury. The highest incidence of ARDS was 57.8% on day 2 of admission. Most cases remained in the mild to moderate ARDS category with severe ARDS (2.4%) being less common by hospital day 7. Overall, 30-day in-hospital and inhalation injury mortality rates were 9.6% and 15.8%, respectively. No correlation was observed between plateau pressures (22.8), mean arterial pressures (84.4), or vasopressor requirements; and oxygen requirements down trended quickly over the first 24 to 48 hours. In our study, implementing prophylactic, immediate high-PEEP in mechanically ventilated burn patients was associated with trends toward decreased severity and rapid resolution of ARDS in the first week following burn injury. This correlated with low 30-day in-hospital mortality in this population. This short and less severe course suggests that early high-PEEP support may be a viable protective strategy in the treatment of ventilated burn patients with ARDS.
Enhanced esterase activity during the degradation of dibutyl phthalate by Fusarium species in liquid fermentation
Authors: González-Márquez Angel , Volke-Sepulveda Tania , Díaz Rubén , Sánchez Carmen
Published: September 2021

Dibutyl phthalate (DBP) is one of the most abundantly produced and used plasticizers and is incorporated into plastic to make it more flexible and malleable. DBP has been found to be an environmental contaminant and reported as an endocrine disruptor. Therefore, it is crucial to develop ecofriendly alternatives to eliminate phthalate pollution. In the present research, the growth of F. culmorum and F. oxysporum in the presence of DBP was studied in liquid fermentation. The esterase activity, specific growth rate, and growth and enzymatic yield parameters were determined in DBP-supplemented media (1,500 or 2,000 mg/L) and in control medium (lacking DBP). These results show that in general, for both Fusarium species, the highest esterase activities, specific growth rates, and yield parameters were observed in media supplemented with DBP. It was observed that 1,500 and 2,000 mg of DBP/L did not inhibit F. culmorum or F. oxysporum growth and that DBP induced esterase production in both fungi. These organisms have much to offer in the mitigation of environmental pollution caused by the endocrine disruptor DBP. This study reports, for the first time, esterase production during the degradation of high concentrations (i.e., 1,500 and 2,000 mg/L) of DBP by F. culmorum F. oxysporum.
A 54 Gy in three fractions of stereotactic body radiotherapy using CyberKnife for T1b-2aN0M0 pathologically confirmed non-small cell lung cancer
Authors: Abe Takanori , Ryuno Yasuhiro , Iino Misaki , Saito Satoshi , Aoshika Tomomi , Ohta Tomohiro , Igari Mitsunobu , Hirai Ryuta , Kumazaki Yu , Kaira Kyoichi , Kagamu Hiroshi , Ishida Hironori , Noda Shin-ei , Kato Shingo
Published: September 2021

Objective

Optimal dose-fractionation regimen of stereotactic body radiotherapy for peripheral early-stage non-small cell lung cancer remains unclear. We retrospectively investigated outcomes of stereotactic body radiotherapy using CyberKnife at 54 Gy in three fractions in 26 patients (median age: 76 years) with pathologically confirmed T1b–T2aN0M0 non-small cell lung cancer.

Methods

A 54 Gy in three fractions was prescribed to cover the 99% of gross tumor volume. We estimated cumulative local control, progression-free survival and overall survival rates (Kaplan–Meier method), and toxicity (Common Toxicity Criteria for Adverse Events, version 5.0).

Results

All the tumors were located at peripheral area of lung. Mean distance from chest wall to tumor was 6.5 mm (range: 0–32 mm). The patients’ pathological diagnoses were: adenocarcinoma: n = 18, squamous cell carcinoma: n = 7 and non-small cell carcinoma: n = 1. Their stages were T1b: n = 9, T1c: n = 14 and T2a: n = 3. Median follow-up was 24 months (range: 6–54). Cumulative 2-year effect rates were local control: 100%, progression-free survival 70% and overall survival: 92%. Twenty patients developed grade one radiation pneumonitis, but grade 2 or greater radiation pneumonitis was not observed.

Conclusions

We found CyberKnife-stereotactic body radiotherapy for pathologically confirmed T1b–T2aN0M0 non-small cell lung cancer to be effective and safe. However, these results should be validated with a larger patient cohort and prospective follow-up monitoring.
Soil calcium content as the driving factor for vegetative structure and soil microbial function diverging across a fire chronosequence of the boreal forests in northeast China
Authors: Zhou Zhiyong , Shen Ying , Wang Bo , Zhang Huan
Published: September 2021

The role of biophysical variables in constructing community structure changes with the time since fire. The major objective of this study is to verify the transition stage and its underlying variables for the postfire forest and soil microbial function in the boreal forested area of China. A 50-year fire chronosequence was presented, and biomass of forbs, shrubs and woody plants was separately weighted to assess their contribution to the whole community with the year since fire (YSF). Simultaneously, soil biophysical properties were measured for stands in different time periods after fire. Soil microbial functions, i.e. growth efficiency (GE) and carbon use efficiency (CUE), were calculated based on ecoenzymatic and soil nutrient stoichiometry. In terms of vegetative structure, forbs’ proportion decreased from 75% to 1.5%, but the proportion of woody plants increased from 0.04% to 70% across this fire chronosequence. GE and CUE of soil microorganisms averaged 0.242 and 0.236 and were significantly higher in 9, 15 and 31 YSF than in 2 and 3 YSF. Soil metal content was significantly increased at the late stage of this fire chronosequence, and soil calcium content showed a positive correlation with woody plant biomass and a negative correlation with soil microbial function. Overall, the present work highlights that the time period of 15 and 31 YSF is a hallmark stage for aboveground vegetative structure and soil microbial function to change in different trends and that the calcium content may partly account for these two divergent trajectories.
Rare cases requiring emergency procedures while harvesting a free forearm flap: report of two cases
Authors: Hihara Masakatsu , Hikiami Rina , Mitsui Toshihito , Kakudo Natsuko , Kuro Atsuyuki , Kusumoto Kenji
Published: September 2021

The free forearm flap is considered safe to harvest and is still extremely useful for reconstruction after head and neck tumor resection. We experienced two uncommon cases, in which an emergency procedure was required during reconstructive surgery after resection of head and neck cancer. Case 1 suffered persistent hand blood flow insufficiency long after the flap was placed in the oral cavity. Case 2 had an anomalous cutaneous vein of the forearm that was a drainage vein of the flap. For risk management during free flap surgery, preparing multiple venous transplant options in advance is fundamental.
Military Exposures Predict Mental Health Symptoms in Explosives Personnel but Not Always as Expected
Authors: Barczak-Scarboro Nikki E , Hernández Lisa M , Taylor Marcus K
Published: September 2021

Objective

The aim of this study was to determine the unique and combined associations of various military stress exposures with positive and negative mental health symptoms in active duty service members.

Materials and Methods

We investigated 87 male U.S. Navy Explosive Ordnance Disposal (EOD) technicians (age M ± SE, range 33.7 ± 0.6, 22-47 years). Those who endorsed a positive traumatic brain injury diagnosis were excluded to eliminate the confounding effects on mental health symptoms. Using a survey platform on a computer tablet, EOD technicians self-reported combat exposure, deployment frequency (total number of deployments), blast exposure (vehicle crash/blast or 50-m blast involvement), depression, anxiety, posttraumatic stress, perceived stress, and life satisfaction during an in-person laboratory session.

Results

When controlling for other military stressors, EOD technicians with previous involvement in a vehicle crash/blast endorsed worse mental health than their nonexposed counterparts. The interactions of vehicle crash/blast with deployment frequency and combat exposure had moderate effect sizes, and combat and deployment exposures demonstrated protective, rather than catalytic, effects on negative mental health scores.

Conclusions

Military stressors may adversely influence self-reported symptoms of negative mental health, but deployment experience and combat exposure may confer stress inoculation.
The SAMI galaxy survey: Mass and environment as independent drivers of galaxy dynamics
Authors: van de Sande Jesse , Croom Scott M , Bland-Hawthorn Joss , Cortese Luca , Scott Nicholas , Lagos Claudia D P , D’Eugenio Francesco , Bryant Julia J , Brough Sarah , Catinella Barbara , Foster Caroline , Groves Brent , Harborne Katherine E , López-Sánchez Ángel R , McDermid Richard , Medling Anne , Owers Matt S , Richards Samuel N , Sweet Sarah M , Vaughan Sam P
Published: September 2021

The kinematic morphology–density relation of galaxies is normally attributed to a changing distribution of galaxy stellar masses with the local environment. However, earlier studies were largely focused on slow rotators; the dynamical properties of the overall population in relation to environment have received less attention. We use the SAMI Galaxy Survey to investigate the dynamical properties of ∼1800 early and late-type galaxies with log (M⋆/M⊙) > 9.5 as a function of mean environmental overdensity (Σ5) and their rank within a group or cluster. By classifying galaxies into fast and slow rotators, at fixed stellar mass above log (M⋆/M⊙) > 10.5, we detect a higher fraction (∼3.4σ) of slow rotators for group and cluster centrals and satellites as compared to isolated-central galaxies. We find similar results when using Σ5 as a tracer for environment. Focusing on the fast-rotator population, we also detect a significant correlation between galaxy kinematics and their stellar mass as well as the environment they are in. Specifically, by using inclination-corrected or intrinsic $\lambda _{R_{\rm {e}}}$ values, we find that, at fixed mass, satellite galaxies on average have the lowest $\lambda _{\, R_{\rm {e}},\rm {intr}}$, isolated-central galaxies have the highest $\lambda _{\, R_{\rm {e}},\rm {intr}}$, and group and cluster centrals lie in between. Similarly, galaxies in high-density environments have lower mean $\lambda _{\, R_{\rm {e}},\rm {intr}}$ values as compared to galaxies at low environmental density. However, at fixed Σ5, the mean $\lambda _{\, R_{\rm {e}},\rm {intr}}$ differences for low and high-mass galaxies are of similar magnitude as when varying Σ5 ($\Delta \lambda _{\, R_{\rm {e}},\rm {intr}} \sim 0.05$, with σrandom = 0.025, and σsyst < 0.03). Our results demonstrate that after stellar mass, environment plays a significant role in the creation of slow rotators, while for fast rotators we also detect an independent, albeit smaller, impact of mass and environment on their kinematic properties.
Temperature-dependent direct photodissociation cross sections and rates of AlCl
Authors: Qin Zhi , Bai Tianrui , Liu Linhua
Published: September 2021

The photodissociation process of aluminium monochloride (AlCl) plays an important role in modelling the chemistry of the circumstellar envelope. In this work, direct photodissociation cross sections of AlCl have been computed for transitions from the ground X1Σ+ state to six low-lying excited electronic states by using ab initio potential energy curves and transition dipole moments, which are obtained by the internally contracted multireference configuration-interaction method with Davidson correction and the aug-cc-pV6Z basis set. State-resolved cross sections for transitions from 38 958 rovibrational levels (υ″ ≤ 100, J″ ≤ 400) of the ground X1Σ+ state have been obtained for photon wavelengths from 500 Å to the dissociation threshold. Photodissociation cross sections in local thermal equilibrium are evaluated for gas temperatures from 500 to 10 000 K. Using the computed cross sections, temperature-dependent photodissociation rates of AlCl in the interstellar and blackbody radiation fields are determined. The results can be applied to the investigation of the chemical evolution of Al in the envelope of carbon-rich and oxygen-rich stars.
An accurate comprehensive approach to substructure – II. Stripped subhaloes
Authors: Salvador-Solé Eduard , Manrique Alberto , Botella Ignacio
Published: September 2021

In Salvador-Solé, Manrique & Botella (Paper I), we used the ConflUent System of Peak trajectories (CUSP) formalism to derive from first principles and no single free parameter the accurate abundance and radial distribution of both diffuse dark matter (dDM) and subhaloes accreted on to haloes and their progenitors at all previous times. Here we use those results as initial conditions for the monitoring of the evolution of subhaloes and dDM within the host haloes. Specifically, neglecting dynamical friction, we accurately calculate the effects of repetitive tidal stripping and heating on subhaloes as they orbit inside the host halo and infer the amount of dDM and subsubhaloes they release into the intrahalo medium. We then calculate the expected abundance and radial distribution of stripped subhaloes and dDM. This derivation clarifies the role of halo concentration in substructure and unravels the origin of some key features found in simulations including the dependence of substructure on halo mass. In addition, it unveils the specific effects of dynamical friction on substructure. The results derived here are for purely accreting haloes. In Salvador-Solé et al. (Paper III), we complete the study by addressing the case of low-mass subhaloes, unaffected by dynamical friction, in ordinary haloes having suffered major mergers.
eIF3j facilitates loading of release factors into the ribosome
Authors: Egorova Tatiana , Biziaev Nikita , Shuvalov Alexey , Sokolova Elizaveta , Mukba Sabina , Evmenov Konstantin , Zotova Maria , Kushchenko Artem , Shuvalova Ekaterina , Alkalaeva Elena
Published: September 2021

eIF3j is one of the eukaryotic translation factors originally reported as the labile subunit of the eukaryotic translation initiation factor eIF3. The yeast homolog of this protein, Hcr1, has been implicated in stringent AUG recognition as well as in controlling translation termination and stop codon readthrough. Using a reconstituted mammalian in vitro translation system, we showed that the human protein eIF3j is also important for translation termination. We showed that eIF3j stimulates peptidyl-tRNA hydrolysis induced by a complex of eukaryotic release factors, eRF1-eRF3. Moreover, in combination with the initiation factor eIF3, which also stimulates peptide release, eIF3j activity in translation termination increases. We found that eIF3j interacts with the pre-termination ribosomal complex, and eRF3 destabilises this interaction. In the solution, these proteins bind to each other and to other participants of translation termination, eRF1 and PABP, in the presence of GTP. Using a toe-printing assay, we determined the stage at which eIF3j functions – binding of release factors to the A-site of the ribosome before GTP hydrolysis. Based on these data, we assumed that human eIF3j is involved in the regulation of translation termination by loading release factors into the ribosome.
Fluoroscopy-Guided High-Intensity Focused Ultrasound Neurotomy of the Lumbar Zygapophyseal Joints: A Clinical Pilot Study
Authors: Perez Jordi , Gofeld Michael , Leblang Suzanne , Hananel Arik , Aginsky Ron , Chen Johnny , Aubry Jean-Francois , Shir Yoram
Published: September 2021

Objective

To investigate the safety and feasibility of a fluoroscopy-guided, high-intensity focused ultrasound system for zygapophyseal joint denervation as a treatment for chronic low back pain.

Methods

The clinical pilot study was performed on 10 participants diagnosed with lumbar zygapophyseal joint syndrome. Each participant had a documented positive response to a diagnostic block or a previous, clinically beneficial radiofrequency ablation. For a descriptive study, the primary outcome was the safety question. All device- or procedure-related adverse events were collected. Secondary outcome variables included the average numeric rating scale for pain, the Roland-Morris Disability Questionnaire, the Brief Pain Inventory, the Patient Global Impression of Change, the morphine equivalent dose, and the finding of the neurological examination.

Results

All participants tolerated the procedure well with no significant device- or procedure-related adverse events; there was one episode of transient pain during the procedure. The average numeric rating scale score for pain decreased from 6.2 at baseline to 2.1 (n = 10) after 1 month, 4.9 (n = 9) after 3 months, 3.0 (n = 8) after 6 months, and 3.0 (n = 6) after 12 months. The ratio of participants who were considered a treatment success was 90% at 1 month, 50% at 3 months, 60% at 6 months, and 40% at 12 months.

Conclusions

The first clinical pilot study using a noninvasive, fluoroscopy-guided, high-intensity focused ultrasound lumbar zygapophyseal neurotomy resulted in no significant device- or procedure-related adverse events and achieved clinical success comparable with that of routine radiofrequency ablation.
Samuel Johnson, Gregory Sharpe, and the Authorship of Some Remarks on the Progress of Learning (1746)
Authors: Lock Frederick P
Published: September 2021

Samuel Johnson wrote far more than he acknowledged or than his contemporaries could identify. Modern scholars have proposed many additions to the canon. Among the most recent of these is Some Remarks on the Progress of Learning (1746), a pamphlet ostensibly written to promote a new edition of Mario di Calasio’s concordance to the Hebrew Bible, then in preparation by William Romaine. The evidence adduced for Johnson’s authorship is partly circumstantial (his connections with the book trade) and partly internal (phrases and features of style that sound Johnsonian). No external evidence connects Johnson with the pamphlet. This article questions the attribution, arguing that neither the circumstantial nor the internal evidence is convincing. Further, the substance of the pamphlet itself, its politics, its religion (especially its view of the Reformation), and most of all its enthusiastic promotion of the study of Hebrew, are quite un-Johnsonian, and indeed contradict his known views. It therefore proposes a more credible candidate, Gregory Sharpe (1713–1771), an ‘enlightened’ cleric and a known enthusiast for Hebrew, and in support, cites parallels with his writings.
Development of an environmental contextual factor item set relevant to global functioning and health in patients with axial spondyloarthritis
Authors: Kiltz Uta , Boonen Annelies , van der Heijde Désirée , Bautista-Molano Wilson , Burgos Vargas Ruben , Chiowchanwisawakit Praveena , El-Zorkany Bassel , Gaydukova Inna , Geher Pal , Gossec Laure , Gilio Michele , Grazio Simeon , Gu Jieruo , Khan Muhammad Asim , Kim Tae-Jong , Maksymowych Walter P , Marzo-Ortega Helena , Navarro-Compán Victoria , Ozgocmen Salih , Patrikos Dimos , Pimentel-Santos Fernando Manuel , Reveille John , Schirmer Michael , Stebbings Simon , Van den Bosch Filip , Weber Ulrich , Braun Juergen
Published: September 2021

Objective

To describe the development of an Environmental contextual factors (EF) Item Set (EFIS) accompanying the disease specific Assessment of SpondyloArthritis international Society Health Index (ASAS HI).

Method

First, a candidate item pool was developed by linking items from existing questionnaires to 13 EF previously selected for the International Classification of Functioning, Disability and Health (ICF) /ASAS Core Set. Second, using data from two international surveys, which contained the EF item pool as well as the items from the ASAS HI, the number of EF items was reduced based on the correlation between the item and the ASAS HI sum score combined with expert opinion. Third, the final English EFIS was translated into 15 languages and cross-culturally validated.

Results

The initial item pool contained 53 EF addressing four ICF EF chapters: products and technology (e1), support and relationship (e3), attitudes (e4) and health services (e5). Based on 1754 responses of axial spondyloarthritis patients in an international survey, 44 of 53 initial items were removed based on low correlations to the ASAS HI or redundancy combined with expert opinion. Nine items of the initial item pool (range correlation 0.21–0.49) form the final EFIS. The EFIS was translated into 15 languages and field tested in 24 countries.

Conclusions

An EFIS is available complementing the ASAS HI and helps to interpret the ASAS HI results by gaining an understanding of the interaction between a health condition and contextual factors. The EFIS emphasizes the importance of support and relationships, as well as attitudes of the patient and health services in relation to self-reported health.
Effects of biologics on reducing the risks of total knee replacement and total hip replacement in rheumatoid arthritis
Authors: Chang Yu-Sheng , Chen Jin-Hua , Lin Tzu-Min , Hsu Hui-Ching , Chen Wei-Sheng , Lin Sheng-Hong , Kuo Pei-I , Lin Yi-Chun , Chang Chi-Ching
Published: September 2021

Objectives

RA damages the joints and increases the risks of total knee replacement (TKR) and total hip replacement (THR). However, the benefits of biologics in preventing TKR or THR remain unclear.

Methods

This retrospective nationwide study used the 2000–2013 claims-based National Health Insurance dataset. Biologics are reimbursed for refractory cases. The risks of TKR and THR in the biologic cohort were compared with those of an age- and sex-matched csDMARD cohort. A multivariate Cox regression model was used to investigate the benefits of bDMARDs for TKR and THR.

Results

TKR was performed in 5979 biologic cases and 11 958 matched controls, of which 249 (4.16%) and 871 (7.28%) cases received TKR, respectively. THR was performed in 6245 biologic cases and 12 490 matched controls, of which 159 (2.55%) and 516 (4.13%) cases had THR, respectively. The biologic cohort had significantly lower incidence rates of TKR (11.73 vs 16.33/1000 person-years, P < 0.001) and THR (7.09 vs 9.16/1000 person-years, P < 0.001). After adjustment for confounding factors, the regular bDMARD subgroup (average dose >0.95 defined daily dose/day) had significantly lower risks of TKR (aHR: 0.55, 95% CI: 0.38, 0.81) and THR (aHR: 0.63, 95% CI: 0.40, 0.98). Those without MTX use, with steroid use, with biologic switch, and overlapping antiphospholipid syndrome had significantly higher risks of TKR and THR.

Conclusions

Compared with the csDMARD cohort, the risks of TKR and THR in the bDMARD cohort were the same as those in the low-to-moderate dose subgroups and significantly lower in those with regular bDMARD use.
Comparison of the immediate effects of prefabricated soft medical insoles and custom-molded rigid medical insoles on plantar pressure distribution in athletes with flexible flatfoot: a prospective study
Authors: Razavi Khorasani Seyede Gelare , Bagherzadeh Cham Masumeh , Sharifnezhad Ali , Saeedi Hassan , Farahmand Behshid
Published: September 2021

Background:

The aims of this quasi-experimental study were to compare the effect of prefabricated soft medical insoles and custom-molded rigid medical insoles on plantar pressure distribution in athletes with flexible flatfoot.

Methods:

Eighteen amateur athletes with flexible flatfoot participated in this study. All participants received custom-molded rigid medical insoles and prefabricated soft medical insoles. Mean peak pressure (kPa), maximum force (N), and contact area (cm2) were calculated for the heel, medial and lateral midfoot, first metatarsal head, second and third metatarsal heads, fourth and fifth metatarsal heads, hallux, and other toe area using the Pedar-X system (Novel GmbH, Munich, Germany) immediately.

Results:

The use of both prefabricated and custom-molded insoles significantly reduced the mean pressure and force in the heel, second and third metatarsophalangeal joints (MTP2,3), the fourth and fifth metatarsophalangeal joints (MTP4,5), and increased the pressure in the medial midfoot compared to the shoe (P<0.001). No significant difference was observed between the two insoles (P>0.05). The contact area increased significantly in the medial midfoot (P<0.001) and MTP2,3 (P=0.02) and decreased in the hallux (P<0.001) and other toes (P=0.01) using both insoles compared to only shoes.

Conclusions:

The results showed that the use of a medical insole in athletes with flexible flatfoot could alter athletics’ plantar pressures immediately. Since both insoles had a similar effect on the distribution of plantar pressures, it seems that the prefabricated soft medical insole is a more suitable option for daily use in athletes to prevent injury because of its availability and cost-effectiveness.

Level of Evidence:

Level II.
Simplified Antibiotic-Coated Plating for Infected Nonunion, Fracture-Related Infection, and Single-Stage Prophylactic Fixation
Authors: Medda Suman , Hsu Joseph R.
Published: September 2021

Antibiotic-coated implants are increasing in prevalence in the treatment of fracture-related infections. Coated plates may be desirable in certain anatomic locations or to augment nail fixation. We describe a simple, reproducible technique for the fabrication of antibiotic-coated plates and our initial results of a small case series.
In-Hospital Morbidity and Mortality With Delays in Femoral Shaft Fracture Fixation
Authors: Obey Mitchel R. , Clever David C. , Bechtold Daniel A. , Stwalley Dustin , McAndrew Christopher M. , Berkes Marschall B. , Wolinsky Philip R. , Miller Anna N.
Published: September 2021

Objectives:

To investigate trends in the timing of femur fracture fixation in trauma centers in the United States, identify predictors for delayed treatment, and analyze the association of timing of fixation with in-hospital morbidity and mortality using data from the National Trauma Data Bank.

Methods:

Patients with femoral shaft fractures treated from 2007 to 2015 were identified from the National Trauma Data Bank and grouped by timing of femur fixation: <24, 24–48 hours, and >48 hours after hospital presentation. The primary outcome measure was in-hospital postoperative mortality rate. Secondary outcomes included complication rates, hospital length of stay (LOS), days spent in the intensive care unit LOS (ICU LOS), and days on a ventilator.

Results:

Among the 108,825 unilateral femoral shaft fractures identified, 74.2% was fixed within 24 hours, 16.5% between 24 and 48 hours, and 9.4% >48 hours. The mortality rate was 1.6% overall for the group. When fixation was delayed >48 hours, patients were at risk of significantly higher mortality rate [odds ratio (OR) 3.60; 95% confidence interval (CI), 3.13–4.14], longer LOS (OR 2.14; CI 2.06–2.22), longer intensive care unit LOS (OR 3.92; CI 3.66–4.20), more days on a ventilator (OR 5.38; CI 4.89–5.91), and more postoperative complications (OR 2.05; CI 1.94–2.17; P < 0.0001).

Conclusions:

Our study confirms that delayed fixation of femoral shaft fractures is associated with increased patient morbidity and mortality. Patients who underwent fixation >48 hours after presentation were at the greatest risk of increased morbidity and mortality. Although some patients require optimization/resuscitation before fracture fixation, efforts should be made to expedite operative fixation.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Use of Thromboelastography in the Evaluation and Management of Patients With Traumatic Brain Injury: A Systematic Review and Meta-Analysis
Authors: Cannon Jeremy W. , Dias João D. , Kumar Monisha A. , Walsh Mark , Thomas Scott G. , Cotton Bryan A. , Schuster James M. , Evans Susan L. , Schreiber Martin A. , Adam Elisabeth H. , Zacharowski Kai , Hartmann Jan , Schöchl Herbert , Kaplan Lewis J.
Published: September 2021

OBJECTIVES:

Traumatic brain injury is associated with coagulopathy that increases mortality risk. Viscoelastic hemostatic assays such as thromboelastography (Haemonetics SA, Signy, Switzerland) provide rapid coagulopathy assessment and may be particularly useful for goal-directed treatment of traumatic brain injury patients. We conducted a systematic review to assess thromboelastography in the evaluation and management of coagulopathy in traumatic brain injury patients.

DATA SOURCES:

MEDLINE, PubMed Central, Embase, and CENTRAL.

STUDY SELECTION:

Clinical studies of adult patients with traumatic brain injury (isolated or polytrauma) who were assessed by either standard thromboelastography or thromboelastography with platelet mapping plus either conventional coagulation assays or platelet function assays from January 1999 to June 2021.

DATA EXTRACTION:

Demographics, injury mechanism and severity, diagnostic, laboratory data, therapies, and outcome data were extracted for analysis and comparison.

DATA SYNTHESIS:

Database search revealed 1,169 sources; eight additional articles were identified by the authors. After review, 31 publications were used for qualitative analysis, and of these, 16 were used for quantitative analysis. Qualitative and quantitative analysis found unique patterns of thromboelastography and thromboelastography with platelet mapping parameters in traumatic brain injury patients. Patterns were distinct compared with healthy controls, nontraumatic brain injury trauma patients, and traumatic brain injury subpopulations including those with severe traumatic brain injury or penetrating traumatic brain injury. Abnormal thromboelastography K-time and adenosine diphosphate % inhibition on thromboelastography with platelet mapping are associated with decreased survival after traumatic brain injury. Subgroup meta-analysis of severe traumatic brain injury patients from two randomized controlled trials demonstrated improved survival when using a viscoelastic hemostatic assay-guided resuscitation strategy (odds ratio, 0.39; 95% CI, 0.17–0.91; p = 0.030).

CONCLUSIONS:

Thromboelastography and thromboelastography with platelet mapping characterize coagulopathy patterns in traumatic brain injury patients. Abnormal thromboelastography profiles are associated with poor outcomes. Conversely, treatment protocols designed to normalize abnormal parameters may be associated with improved traumatic brain injury patient outcomes. Current quality of evidence in this population is low; so future efforts should evaluate viscoelastic hemostatic assay-guided hemostatic resuscitation in larger numbers of traumatic brain injury patients with specific focus on those with traumatic brain injury-associated coagulopathy.
Integrated bioinformatics analysis reveals correlations of high TRIM59 expression with worse prognosis and immune infiltrates in lung adenocarcinoma
Authors: Yang Lingge , Wu Yuan , You Liangkun , Xie Binbin , Lou Jun , Han Weidong , Wang Kai
Published: September 2021

Objective:

Most patients with advanced lung cancer have a poor prognosis. Recent studies have identified TRIM59 as a novel molecule that serves as a prognostic factor for the progression of non-small cell lung cancer. In the present study, we investigated the role of TRIM59 in predicting the prognosis of lung adenocarcinoma (LUAD) as well as the correlation between TRIM59 expression and immune infiltrates.

Methods:

We analyzed TRIM59 expression in normal and tumor tissues based on RNA-sequencing datasets from The Cancer Genome Atlas and Genotype-Tissue Expression databases. Forty-seven cases of LUAD tissues and their matching adjacent tissues were collected, and TRIM59 expression in tissue samples was demonstrated by immunohistochemistry. All tissue specimens were obtained under the approval of the Medical Ethics Committee of the Second Affiliated Hospital of Zhejiang University School of Medicine (approval No. IR2019001101; approved on April 3, 2019). The immune cell scores were calculated using the CIBERSORT database. The Tumor Immune Estimation Resource database was used to analyze the correlation between TRIM59 and immune cell activities.

Results:

TRIM59 was up-regulated in most cancer types. High TRIM59 expression predicted a worse prognosis in patients with LUAD (overall survival,
P
= 0.00096; disease-specific survival,
P
= 0.00056; disease-free interval,
P
= 0.0009; progression-free interval,
P
= 0.0012). Moreover, TRIM59 was highly expressed in patients with LUAD who had a poorer prognosis. TRIM59 also showed a significant correlation with the ESTIMATE score (
P
= 0.04) and stromal score (
P
= 0.005) in patients with LUAD. Notably, a significant correlation between TRIM59 and the tumor mutation burden was found in LUAD but in no other cancer types (
P
< 0.001). Further investigation showed that TRIM59 had a significant correlation with gene markers on neutrophils and dendritic cells.

Conclusion:

TRIM59 is a potential prognosticator in LUAD and may be correlated with immune cell identification, immune cell infiltration, and immunotherapy checkpoints in LUAD.
The bi-directional role of the gut–brain axis in inflammatory and other gastrointestinal diseases
Authors: Mogilevski Tamara
Published: September 2021

Purpose of review

There is a growing body of evidence implicating the role of the gut–brain axis in a multitude of inflammatory and non-inflammatory gastrointestinal disorders. The interaction between the gut and the brain is bidirectional and its therapeutic manipulation is gaining traction as the new frontier in the management of gastrointestinal disorders. This review summarizes the recent literature on this subject and serves as a reference for future research directions.

Recent findings

Recent studies have shown that the gut–brain axis, through its main communicator – the vagal nerve – plays a multimodal role in manipulating gastrointestinal physiology. This is evident systemically via the cholinergic anti-inflammatory pathway, through its effect on intestinal barrier function and also locally on intestinal epithelial and immune cells. Vagal nerve stimulation and faecal microbiota transplantation are two ways by which therapeutic manipulation has been attempted with success.

There has been exceptional progress in our understanding of the gut–brain axis in recent literature. Its role in the modulation of a multitude of gastrointestinal disorders is becoming clear. Preclinical findings are sufficient for this research to proceed to clinical trials in order to harness its clinical therapeutic potential for the care of patients.