bluuebunny/crossref_metadata_2025 huggingface dataset:
Perturbations highlight importance of social history in parakeet rank dynamics
Authors: van der Marel Annemarie , Francis Xavier , O’Connell Claire L , Estien Cesar O , Carminito Chelsea , Moore Virginia Darby , Lormand Nickolas , Kluever Bryan M , Hobson Elizabeth A
Published: March 2023

Dominance hierarchies can provide many benefits to individuals, such as access to resources or mates, depending on their ranks. In some species, rank can emerge as a product of a group’s history of social interactions. However, it can be difficult to determine whether social history is critical to rank in observation-based studies. Here, we investigated rank dynamics in three captive groups of monk parakeets (Myiopsitta monachus). We used experimental social perturbations to test whether social history shapes rank emergence in these groups. Using targeted removals and reintroductions, we tested whether differently ranked individuals could re-take their ranks in hierarchies after reintroduction following their removal period from the group. We performed perturbations that consisted of an 8-day removal and an 8-day reintroduction period of 15 differently ranked focal birds. We found that no focal birds could regain their previous rank immediately following reintroduction and that the top-ranked birds showed greater relative rank loss than middle/low-ranked birds. We also found that morphology, specifically bodyweight, was unassociated with rank. Combined with previous results, this experiment supports the hypothesis that rank in monk parakeet dominance hierarchies is more likely to be an emergent outcome of past interactions and memory rather than based on individual characteristics. Gaining a better understanding of how individuals achieve and maintain rank can give insight into the role of cognition on rank acquisition, as rank position can have significant biological effects on individuals in hierarchically structured groups.
Retracted: New-onset alopecia areata during inclisiran therapy
Authors: Correia Catarina , Vieitez-Frade Joana , Filipe Paulo
Published: March 2023

This article has been retracted. Please see: https://doi.org/10.1093/ced/llad447
Spontaneous resolution of lentigo maligna: a case report
Authors: Daruish Maged , Patalay Rakesh , Calonje Eduardo
Published: March 2023

A 64-year-old man with a known history of psoriasis was under regular clinical and reflectance confocal microscopy follow-up for a biopsy-proven lentigo maligna on his right forehead. Five years after the initial diagnosis the lesion gradually disappeared with no concurrent effective treatment. Spontaneous resolution is reported in various skin tumours but to our knowledge, this phenomenon has not been previously described in lentigo maligna.
A bilateral periocular acneiform eruption
Authors: Ceresnie Marissa S , Owji Shayan , Seale Lauren , Friedman Ben J , Veenstra Jesse
Published: March 2023

We present the case of a 47-year-old man who had an acneiform eruption on his bilateral eyelids and periocular skin. We discuss the key clinical and histopathologic features needed to diagnose this condition.
Diagnostic markers and potential therapeutic agents for Sjögren’s syndrome screened through multiple machine learning and molecular docking
Authors: Zhou Liqing , Wang Haojie , Zhang He , Wang Fei , Wang Wenjing , Cao Qiong , Wei Zhihao , Zhou Haitao , Xin Shiyong , Zhang Jianguo , Shi Xiaofei
Published: March 2023

Primary Sjögren’s syndrome (pSS) is a chronic inflammatory autoimmune disease, which mainly damages patients’ exocrine glands. Sensitive early diagnostic indicators and effective treatments for pSS are lacking. Using machine learning methods to find diagnostic markers and effective therapeutic ways for pSS is of great significance. In our study, first, 1643 differentially expressed genes (DEGs; 737 were upregulated and 906 were downregulated) were ultimately screened out and analyzed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes based on the datasets from the Gene Expression Omnibus. Then, support vector machine, least absolute shrinkage and selection operator regression, random forest, and weighted correlation network analysis were used to screen out feature genes from DEGs. Subsequently, the intersection of the feature genes was taken to screen 10 genes as hub genes. Meanwhile, the analysis of the diagnostic efficiency of 10 hub genes showed their good diagnostic value for pSS, which was validated through immunohistochemistry on the paraffin sections of the labial gland. Subsequently, a multi-factor regulatory network and correlation analysis of hub genes were performed, and the results showed that ELAVL1 and IGF1R were positively correlated with each other but both negatively correlated with the other seven hub genes. Moreover, several meaningful results were detected through the immune infiltration landscape. Finally, we used molecular docking to screen potential therapeutic compounds of pSS based on the hub genes. We found that the small molecules DB08006, DB08036, and DB15308 had good docking scores with ELAVL1 and IGF1R simultaneously. Our study might provide effective diagnostic biomarkers and new therapeutic ideas for pSS.
Individual differences in neural event segmentation of continuous experiences
Authors: Sava-Segal Clara , Richards Chandler , Leung Megan , Finn Emily S
Published: March 2023

Event segmentation is a spontaneous part of perception, important for processing continuous information and organizing it into memory. Although neural and behavioral event segmentation show a degree of inter-subject consistency, meaningful individual variability exists atop these shared patterns. Here we characterized individual differences in the location of neural event boundaries across four short movies that evoked variable interpretations. Event boundary alignment across subjects followed a posterior-to-anterior gradient that was tightly correlated with the rate of segmentation: slower-segmenting regions that integrate information over longer time periods showed more individual variability in boundary locations. This relationship held irrespective of the stimulus, but the degree to which boundaries in particular regions were shared versus idiosyncratic depended on certain aspects of movie content. Furthermore, this variability was behaviorally significant in that similarity of neural boundary locations during movie-watching predicted similarity in how the movie was ultimately remembered and appraised. In particular, we identified a subset of regions in which neural boundary locations are both aligned with behavioral boundaries during encoding and predictive of stimulus interpretation, suggesting that event segmentation may be a mechanism by which narratives generate variable memories and appraisals of stimuli.
Keynesian expectations, epistemic authority and pluralism in economics: placebo and nocebo effects in normal and abnormal times
Authors: Russell Ellen D
Published: March 2023

Prominent economists may provide expert guidance to assist the public in forming expectations. Using both Keynes’ theory of conventional expectations formation and lay epistemology, this article argues that prominent economists may have sufficient ‘epistemic authority’ to encourage a self-fulfilling ‘placebo/nocebo effect’, meaning that widely and confidently-held expectations congruent with prominent economists’ guidance encourage economic behaviours that promote the economic outcomes predicted by these economists. This article examines the peripherality of pluralism in the economics discipline as supporting these self-fulfilling dynamics insofar as it: (i) contributes to the public’s capacity to identify and attribute epistemic authority to prominent economists, (ii) encourages sufficient convergence of prominent economists’ expectational guidance that the public can adopt coherent and confident expectations based on this guidance and (iii) facilitates the public dissemination of this expectational guidance. The conclusion considers Keynesian ‘abnormal times’ (such as a Minskian expectational scenario) that may discredit the epistemic authority of prominent economists (and perhaps expert economic knowledge in general) and considers some implications of these circumstances for disciplinary pluralism.
Performance of a consensus-based algorithm for diagnosing anastomotic leak after minimally invasive esophagectomy for esophageal cancer
Authors: Lemmens Jobbe , Klarenbeek Bastiaan , Verstegen Moniek , van Workum Frans , Hannink Gerjon , Ubels Sander , Rosman Camiel
Published: March 2023

Anastomotic leak (AL) is a common and severe complication after esophagectomy. This study aimed to assess the performance of a consensus-based algorithm for diagnosing AL after minimally invasive esophagectomy. This study used data of the ICAN trial, a multicenter randomized clinical trial comparing cervical and intrathoracic anastomosis, in which a predefined diagnostic algorithm was used to guide diagnosing AL. The algorithm identified patients suspected of AL based on clinical signs, blood C-reactive protein (cut-off value 200 mg/L), and/or drain amylase (cut-off value 200 IU/L). Suspicion of AL prompted evaluation with contrast swallow computed tomography and/or endoscopy to confirm AL. Primary outcome measure was algorithm performance in terms of sensitivity, specificity, and positive and negative predictive values (PPV, NPV), respectively. AL was defined according to the definition of the Esophagectomy Complications Consensus Group. 245 patients were included, and 125 (51%) patients were suspected of AL. The algorithm had a sensitivity of 62% (95% confidence interval [CI]: 46–75), a specificity of 97% (95% CI: 89–100), and a PPV and NPV of 94% (95% CI: 79–99) and 77% (95% CI: 66–86), respectively, on initial assessment. Repeated assessment in 19 patients with persisting suspicion of AL despite negative or inconclusive initial assessment had a sensitivity of 100% (95% CI: 77–100). The algorithm showed poor performance because the low sensitivity indicates the inability of the algorithm to confirm AL on initial assessment. Repeated assessment using the algorithm was needed to confirm remaining leaks.
Effect of treatment with dental space maintainers after the early extraction of the second primary molar: a systematic review
Authors: Tabatabai Tuka , Kjellberg Heidrun
Published: March 2023

Background

Early loss of second primary molars may lead to different malocclusions, mainly caused by the mesial migration of the first permanent molar. To prevent space loss in the dental arch, different types of space maintainers (SM) are used.

Objectives

The main objective of this systematic review is to examine the evidence in the literature regarding the effect of SM, including the clinical effect, risk of developing caries and periodontal disease, patient satisfaction, and cost-effectiveness after the premature loss of the second primary molar in children.

Search methods

The present systematic review was made according to PRISMA. The literature search was performed using four databases (last search 30/8/2022): PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Scopus, and Web of Science.

Selection criteria

The studies included were randomized controlled trials, economic evaluations, and non-randomized clinical studies with a defined control group.

Data collection and analysis

Data collected by the two authors were in regard to reports, studies, participants, research designs, and interventions. The assessment of the risk of bias was made using the ROBINSON-I tool.

Results

The search yielded 1058 articles after the removal of duplicates. Two studies were included in the final review with a moderate risk of bias, and measured space changes in the dental arch and the periodontal status of patients treated with SM. The main results indicate that treatment with SM can preserve arch length, but also cause an increase in plaque accumulation and other periodontal parameters. However, there is an overall lack of scientific evidence regarding the effect of the treatment.

Limitations

No studies that fulfilled the eligibility criteria were found on cost-effectiveness, risk of caries development, and patient satisfaction.

Conclusions

The scientific evidence is lacking regarding the clinical effect, cost effect, and side-effects such as caries and periodontal disease when using SM in children with a premature loss of the second primary molar.

Registration

PROSPERO Registration (CRD 42021290130).
Reversal agents for current and forthcoming direct oral anticoagulants
Authors: van Es Nick , De Caterina Raffaele , Weitz Jeffrey I
Published: March 2023

Over the past 20 years, there has been a shift from vitamin K antagonists to direct oral anticoagulants (DOACs), which include the thrombin inhibitor dabigatran and the factor Xa inhibitors apixaban, edoxaban, and rivaroxaban. Although DOACs are associated with less serious bleeding than vitamin K antagonists, bleeding still occurs with DOACs, particularly in the elderly and in those with comorbidities. Reversal of the anticoagulant effects of the DOACs may be needed in patients with serious bleeding and in those requiring urgent surgery or intervention. Reversal can be effected with specific agents, such as idarucizumab for dabigatran and andexanet alfa for apixaban, edoxaban, and rivaroxaban, or with non-specific agents, such as prothrombin complex concentrates, activated prothrombin complex concentrate, and recombinant activated factor VII. This paper (i) provides an update on when and how to reverse the DOACs, (ii) describes new reversal agents under development, and (iii) provides a strategic framework for the reversal of the factor XI inhibitors currently under investigation in phase three clinical trials.
General practitioners’ views on cardiovascular prevention for ethnic minorities—a qualitative study in the Netherlands
Authors: van Apeldoorn Joshua A N , Roozekrans Alet K , Harskamp Ralf E , Richard Edo , Agyemang Charles , Moll van Charante Eric P
Published: March 2023

Objectives

While ethnic minorities in Europe are disproportionally affected by cardiovascular disease (CVD), little is known about how general practitioners (GPs) perceive differences in risk or care needs across ethnic minority groups. Therefore, we explored GPs’ views on whether ethnicity influences cardiovascular risk, whether a culturally sensitive approach is warranted, on potential barriers in the provision of such care, and to find potential opportunities to improve cardiovascular prevention for these groups.

Methods

We conducted a qualitative study by interviewing GPs practising in The Netherlands. The interviews were semistructured, audio-recorded, and analysed by 2 researchers using thematic analysis.

Results

We interviewed 24 Dutch GPs (50% male). GPs’ views on the impact of ethnicity on CVD risk varied widely, yet it was generally recognized as a relevant factor in cardiovascular prevention for most minority groups, prompting earlier case-finding of high-risk patients. While GPs were aware of sociocultural differences, they emphasized an individualized approach. Perceived limitations were language barriers and unfamiliarity with sociocultural customs, leading to a need for continuing medical education on culturally sensitive care and reimbursement of telephone interpreting services.

Conclusion

Dutch GPs have differing views on the role of ethnicity in evaluating and treating cardiovascular risk. Despite these differences, they emphasized the importance of a personalized and culturally sensitive approach during patient consultations and expressed a need for continuing medical education. Additional research on how ethnicity influences CVD risk may strengthen cardiovascular prevention in increasingly diverse primary care populations.
Experiences and influences of online health information-seeking about statin use in patients with high cardiovascular risk: a qualitative study
Authors: Lim Hooi Min , Ng Chirk Jenn , Dunn Adam G , Abdullah Adina
Published: March 2023

Objectives

Online health information (OHI) has been shown to influence patients’ health decisions and behaviours. OHI about statins has created confusion among healthcare professionals and the public. This study explored the views and experiences of patients with high cardiovascular risk on OHI-seeking about statins and how OHI influenced their decision.

Design

This was a qualitative study using semi-structured in-depth interviews. An interpretive description approach with thematic analysis was used for data analysis.

Setting

An urban primary care clinic in Kuala Lumpur, Malaysia.

Participants

Patients aged 18 years and above who had high cardiovascular risk and sought OHI on statins were recruited.

Results

A total of 20 participants were interviewed. The age of the participants ranged from 38 to 74 years. Twelve (60%) participants took statins for primary cardiovascular disease prevention. The duration of statin use ranged from 2 weeks to 30 years. Six themes emerged from the data analysis: (i) seeking OHI throughout the disease trajectory, (ii) active and passive approaches to seeking OHI, (iii) types of OHI, (iv) views about statin-related OHI, (v) influence of OHI on patients’ health decisions, and (vi) patient–doctor communication about OHI.

Conclusion

This study highlights the changing information needs throughout patient journeys, suggesting the opportunity to provide needs-oriented OHI to patients. Unintentional passive exposure to OHI appears to have an influence on patients’ adherence to statins. The quality of patient–doctor communication in relation to OHI-seeking behaviour remains a critical factor in patient decision-making.
Improving a solar collector's efficiency by selecting the composition of the working fluid used
Authors: Alshuraiaan Bader
Published: March 2023

The study's purpose was to determine the efficiency, as well as the energy and exergy analysis of the vacuum tube solar collector when using a mixture of water with Fe3O4 nanoparticles and multiwall carbon nanotubes in the selected percentage ratio as the working fluid. By varying the concentration of Fe3O4 nanoparticles in the working fluid from 0.05 to 0.15 wt.%, it was found that the maximum efficiency is achieved at a Fe3O4 content equal to 0.1 wt.%. At this concentration, the ratio of Fe3O4 and multiwall carbon nanotubes in the mixture varied from 4:1 to 1:4. It was found that the Fe3O4/multiwall carbon nanotubes ratio (1:4) can increase the efficiency of the solar collector up to 84%. Exergy analysis performed showed that water without the addition of nanoparticles Fe3O4 and multiwall carbon nanotubes was characterized by the maximum values of exergy destruction and entropy generation at any level of solar radiation, and water with the addition of nanoparticles Fe3O4/multiwall carbon nanotubes in a ratio of 1:4 was characterized by the minimum values of exergy destruction and entropy generation.
Absent Mothers: A Folkloric Reading of the Exclusionary Practices of Writing IR's Canonical History
Authors: Starnes Kathryn
Published: March 2023

Women's exclusion from the international relations (IR) canon has been widely documented, and many have undertaken to systematically address these exclusions. However, consideration of how women's exclusion is written into canonical texts is less well explored. This paper draws on folkloric approaches to understanding canon constitution to perform a close reading of disciplinary history texts. This paper considers these texts in parallel to Cinderella stories to understand the absence of “founding mothers” and illuminate how women's exclusion has been written into the canon as a natural absence. This paper builds on the growing literature about women's exclusion to document the specific ways in which how we write can reiterate exclusions within the canon. This is relevant to understanding these historical practices of exclusion and to reconsidering how we write the contemporary IR canon.
What Do We Learn about War and Peace from Women International Thinkers?
Authors: Sluga Glenda
Published: March 2023

The aim of this essay is to ask what can we learn about war and peace from women international thinkers? As I will show, new and old historical evidence of women thinkers points us in directions that suggest, first, the privations women regularly faced in order to make their arguments against the background of actual war, addressing both the more conventional “women's” topic of peace and the often masculinized controversies of the nature of violence. This same history sounds out the range and changing (gendered) registers of international thought, including the diminished tones of peace as a defining objective. Then there are the diverse locations of specifically women's international thought, from manifestos to pamphlets and newspaper articles to published tomes. These lead us to the intersecting political and intellectual networks of activism and influence that colored the intertextual referentiality that thinking generated. Finally, I will argue that the evidence at hand, and the related examples it connects to, underscores the broad transnational European settings of the texts that specifically address war and peace. It even suggests, as I suggest, that the borders of that transnationalism extended not only across the Atlantic, but also through the entangled continental political histories of Western Europe and Russia. In the twenty-first century, these contours of the history of women's international thought remain relevant, not least because they pose the question for us, what difference have women thinkers made?
A red giant orbiting a black hole
Authors: El-Badry Kareem , Rix Hans-Walter , Cendes Yvette , Rodriguez Antonio C , Conroy Charlie , Quataert Eliot , Hawkins Keith , Zari Eleonora , Hobson Melissa , Breivik Katelyn , Rau Arne , Berger Edo , Shahaf Sahar , Seeburger Rhys , Burdge Kevin B , Latham David W , Buchhave Lars A , Bieryla Allyson , Bashi Dolev , Mazeh Tsevi , Faigler Simchon
Published: March 2023

We report spectroscopic and photometric follow-up of a dormant black hole (BH) candidate from Gaia DR3. The system, which we call Gaia BH2, contains a ∼1 M⊙ red giant and a dark companion with mass $M_2 = 8.9\pm 0.3\, {\rm M}_{\odot }$ that is very likely a BH. The orbital period, Porb = 1277 d, is much longer than that of any previously studied BH binary. Our radial velocity (RV) follow-up over a 7-month period spans >90 per cent of the orbit’s RV range and is in excellent agreement with the Gaia solution. UV imaging and high-resolution optical spectra rule out plausible luminous companions that could explain the orbit. The star is a bright (G = 12.3), slightly metal-poor ($\rm [Fe/H]=-0.22$) low-luminosity giant ($T_{\rm eff}=4600\, \rm K$; $R = 7.8\, R_{\odot }$; $\log \left[g/\left({\rm cm\, s^{-2}}\right)\right] = 2.6$). The binary’s orbit is moderately eccentric (e = 0.52). The giant is enhanced in α-elements, with $\rm [\alpha /Fe] = +0.26$, but the system’s Galactocentric orbit is typical of the thin disc. We obtained X-ray and radio non-detections of the source near periastron, which support BH accretion models in which the net accretion rate at the horizon is much lower than the Bondi–Hoyle–Lyttleton rate. At a distance of 1.16 kpc, Gaia BH2 is the second-nearest known BH, after Gaia BH1. Its orbit – like that of Gaia BH1 – seems too wide to have formed through common envelope evolution. Gaia BH1 and BH2 have orbital periods at opposite edges of the Gaia DR3 sensitivity curve, perhaps hinting at a bimodal intrinsic period distribution for wide BH binaries. Dormant BH binaries like Gaia BH1 and Gaia BH2 significantly outnumber their close, X-ray bright cousins, but their formation pathways remain uncertain.
On the role of dust and mass-loss in the extended main sequence turnoff of star clusters: the case of NGC 1783
Authors: D’Antona F , Dell’Agli F , Tailo M , Milone A P , Ventura P , Vesperini E , Cordoni G , Dotter A , Marino A F
Published: March 2023

The colour–magnitude diagram (CMD) morphology of the ‘extended’ main sequence turnoff (eMSTO) and upper main sequence (MS) of the intermediate age (≲ 2 Gyr) Large Magellanic Cloud Cluster NGC 1783 shows the presence of a small group of UV-dim stars, that, in the ultraviolet Hubble Space Telescope filters, are located at colours on the red side of the typical ‘fan’ shape displayed by the eMSTO. We model the UV-dim stars by assuming that some of the stars which would intrinsically be located on the left side of the eMSTO are obscured by a ring of dust due to grain condensation at the periphery of the excretion disc expelled when they spin at the high rotation rates typical of stars in the Be stage. A reasonably low optical depth at 10μ is necessary to model the UV-dim group. Introduction of dust in the interpretation of the eMSTO may require a substantial re-evaluation of previous conclusions concerning the role of age and/or rotation spreads in the MC clusters: the entire eMSTO can be populated by dusty stars, and the reddest UV-dim stars simply represents the tail of the distribution with both maximum obscuration and the dust ring seen along the line of sight. The model stars having higher rotational projected velocity (vsin  i) are predicted to be preferentially redder than the slowly rotating stars. The mass-loss responsible for the dust may also cause the non-monotonic distribution of stars in the upper main sequence, with two peaks and gaps showing up in the UV CMD.
The temporal transcriptomic signature of cartilage formation
Authors: Takács Roland , Vágó Judit , Póliska Szilárd , Pushparaj Peter Natesan , Ducza László , Kovács Patrik , Jin Eun-Jung , Barrett-Jolley Richard , Zákány Róza , Matta Csaba
Published: March 2023

Chondrogenesis is a multistep process, in which cartilage progenitor cells generate a tissue with distinct structural and functional properties. Although several approaches to cartilage regeneration rely on the differentiation of implanted progenitor cells, the temporal transcriptomic landscape of in vitro chondrogenesis in different models has not been reported. Using RNA sequencing, we examined differences in gene expression patterns during cartilage formation in micromass cultures of embryonic limb bud-derived progenitors. Principal component and trajectory analyses revealed a progressively different and distinct transcriptome during chondrogenesis. Differentially expressed genes (DEGs), based on pairwise comparisons of samples from consecutive days were classified into clusters and analysed. We confirmed the involvement of the top DEGs in chondrogenic differentiation using pathway analysis and identified several chondrogenesis-associated transcription factors and collagen subtypes that were not previously linked to cartilage formation. Transient gene silencing of ATOH8 or EBF1 on day 0 attenuated chondrogenesis by deregulating the expression of key osteochondrogenic marker genes in micromass cultures. These results provide detailed insight into the molecular mechanism of chondrogenesis in primary micromass cultures and present a comprehensive dataset of the temporal transcriptomic landscape of chondrogenesis, which may serve as a platform for new molecular approaches in cartilage tissue engineering.
CircularSTAR3D: a stack-based RNA 3D structural alignment tool for circular matching
Authors: Chen Xiaoli , Zhang Shaojie
Published: March 2023

The functions of non-coding RNAs usually depend on their 3D structures. Therefore, comparing RNA 3D structures is critical in analyzing their functions. We noticed an interesting phenomenon that two non-coding RNAs may share similar substructures when rotating their sequence order. To the best of our knowledge, no existing RNA 3D structural alignment tools can detect this type of matching. In this article, we defined the RNA 3D structure circular matching problem and developed a software tool named CircularSTAR3D to solve this problem. CircularSTAR3D first uses the conserved stacks (consecutive base pairs with similar 3D structures) in the input RNAs to identify the circular matched internal loops and multiloops. Then it performs a local extension iteratively to obtain the whole circular matched substructures. The computational experiments conducted on a non-redundant RNA structure dataset show that circular matching is ubiquitous. Furthermore, we demonstrated the utility of CircularSTAR3D by detecting the conserved substructures missed by regular alignment tools, including structural motifs and conserved structures between riboswitches and ribozymes from different classes. We anticipate CircularSTAR3D to be a valuable supplement to the existing RNA 3D structural analysis techniques.
Transcription factor clusters enable target search but do not contribute to target gene activation
Authors: Meeussen Joseph V W , Pomp Wim , Brouwer Ineke , de Jonge Wim J , Patel Heta P , Lenstra Tineke L
Published: March 2023

Many transcription factors (TFs) localize in nuclear clusters of locally increased concentrations, but how TF clustering is regulated and how it influences gene expression is not well understood. Here, we use quantitative microscopy in living cells to study the regulation and function of clustering of the budding yeast TF Gal4 in its endogenous context. Our results show that Gal4 forms clusters that overlap with the GAL loci. Cluster number, density and size are regulated in different growth conditions by the Gal4-inhibitor Gal80 and Gal4 concentration. Gal4 truncation mutants reveal that Gal4 clustering is facilitated by, but does not completely depend on DNA binding and intrinsically disordered regions. Moreover, we discover that clustering acts as a double-edged sword: self-interactions aid TF recruitment to target genes, but recruited Gal4 molecules that are not DNA-bound do not contribute to, and may even inhibit, transcription activation. We propose that cells need to balance the different effects of TF clustering on target search and transcription activation to facilitate proper gene expression.
Proxying economic activity with daytime satellite imagery: Filling data gaps across time and space
Authors: Lehnert Patrick , Niederberger Michael , Backes-Gellner Uschi , Bettinger Eric
Published: March 2023

This paper develops a novel procedure for proxying economic activity with daytime satellite imagery across time periods and spatial units, for which reliable data on economic activity are otherwise not available. In developing this unique proxy, we apply machine-learning techniques to a historical time series of daytime satellite imagery dating back to 1984. Compared to satellite data on night light intensity, another common economic proxy, our proxy more precisely predicts economic activity at smaller regional levels and over longer time horizons. We demonstrate our measure’s usefulness for the example of Germany, where East German data on economic activity are unavailable for detailed regional levels and historical time series. Our procedure is generalizable to any region in the world, and it has great potential for analyzing historical economic developments, evaluating local policy reforms, and controlling for economic activity at highly disaggregated regional levels in econometric applications.
Article III of the OAU Refugee Convention in Context: the Emergence of Subversion in the African Inter-State System
Authors: Odinkalu Chidi Anselm
Published: March 2023

On the face of the Organisation of African Unity (OAU) Convention Governing the Specific Aspects of Refugee Problems in Africa, the refugee problem in Africa is explicitly a multi-dimensional humanitarian, political, and security challenge. Linking the problem of refugees in Africa to the challenge of coexistence among then newly independent African States, Article III of the OAU Convention prohibits subversion by refugees. This study examines the evolution of this prohibition in the context of the history of post-colonial transition and authoritarianism which birthed it, and whose consequences are far from extinguished; suggesting that this context provides greater clarity to the scope and function of the prohibition as an obligation founded in a duty of friendly relations owed by African states to one another. Despite this, the language of the prohibition in the OAU Convention nevertheless lends it to sovereign self-help in a global context of rising authoritarian rule.
Retailoring training programmes in anaesthesia and intensive care after the coronavirus disease 2019 outbreak
Authors: Pereda Elvira , De Hert Stefan , El Tahan Mohamed , Romero Carolina S.
Published: March 2023

Purpose of review

In this review, we want to collect all the adaptations that anaesthesiology training has faced because of the health crisis and social distancing measures resulting from coronavirus 2019 disease (COVID-19). We reviewed new teaching tools launched during the COVID-19 outbreak worldwide and particularly those implemented by the European Society of Anaesthesiology and Intensive Care (ESAIC) and the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC).

Recent findings

Globally, COVID-19 has interrupted health services and all aspects of training programmes. These unprecedented changes have led to teaching and trainee support innovation tools, focusing on online learning and simulation programmes. Airway management, critical care and regional anaesthesia, have been enhanced during the pandemic, while there were major obstacles in paediatrics, obstetrics and pain medicine.

The COVID-19 pandemic has altered profoundly the functioning of health systems worldwide. Anaesthesiologists and trainees have fought on the front lines of the battle against COVID-19. As a result, training in anaesthesiology during the last 2 years has focused on managing patients in intensive care. New training programmes have been designed to continue teaching residents of this speciality, focusing on e-learning and advanced simulation. It is necessary to present a review describing the impact that this turbulent period has had on the different subsections of anaesthesiology and to review the innovative measures that have been implemented to address these possible deficits in education and training.
Optimization of procedural sedation and analgesia during atrial fibrillation ablation
Authors: Homberg Marloes C. , Bouman Esther A.C. , Joosten Bert A.J.
Published: March 2023

Purpose of review

This mini-review is aimed to provide an overview and discuss procedural sedation and analgesia for atrial fibrillation (AF) ablation with focus at qualification of staff, patient evaluation, monitoring, medication and postprocedural care.

Recent findings

Sleep-disordered breathing is highly prevalent in patients with AF. Impact of often used STOP-BANG questionnaire to detect sleep-disordered breathing in AF patients is limited due to its restricted validity. Dexmedetomidine is a commonly used drug in sedation, but is shown not to be superior to propofol in sedation during AF-ablation. Alternatively use of remimazolam has characteristics that makes it a promising drug for minimal to moderate sedation for AF-ablation. High flow nasal oxygen (HFNO) has shown to reduce the risk of desaturation in adults receiving procedural sedation and analgesia.

An optimal sedation strategy during AF ablation should be based on AF patient characteristics, the level of sedation needed, the procedure (duration and type of ablation) and the education and experience of the sedation provider. Patient evaluation and post procedural care are part of sedation care. More personalized care based on use of various sedation strategies and types of drugs as related to the type of AF-ablation is the way to further optimize care.
Etiology and management of hypofibrinogenemia in trauma
Authors: Nathwani Rajen , Proumen Adrian , Blaine Kevin P.
Published: March 2023

Purpose of review

Fibrin polymerization is essential for stable clot formation in trauma, and hypofibrinogenemia reduces hemostasis in trauma. This review considers fibrinogen biology, the changes that fibrinogen undergoes after major trauma, and current evidence for lab testing and treatment.

Recent findings

Fibrinogen is a polypeptide that is converted to fibrin by the action of thrombin. During trauma, fibrinogen levels are consumed and reduce within the first few hours because of consumption, dilution, and fibrinolysis. Fibrinogen levels usually rebound within 48 h of injury and can contribute to thrombotic events. The Clauss fibrinogen assay is the gold standard test for fibrinogen levels, although viscoelastic hemostatic assays are often used when a lab delay is anticipated. An evidence-based threshold for fibrinogen replacement is not well established in the literature, but expert opinion recommends maintaining a level above 150 mg/dl.

Hypofibrinogenemia is an important cause of nonanatomic bleeding in trauma. Despite multiple pathologic causes, the cornerstone of treatment remains fibrinogen replacement with cryoprecipitate or fibrinogen concentrates.
Anesthesia for pediatric magnetic resonance imaging: a review of practices and current pathways
Authors: Guimarães Ferreira Fonseca Lucas , Garbin Marta , Bertolizio Gianluca
Published: March 2023

Purpose of review

Magnetic resonance imaging (MRI) is an ever-expanding investigation modality in children. This review aims to present current strategies to perform MRI in pediatrics efficiently and safely. The latest evidence on approaches, safety and costs of MRI with no sedation or with sedation provided by anesthesiologists and non-anesthesiologists are outlined and discussed.

Recent findings

MRI under sedation provided by either anesthesiologists or non-anesthesiologists has a low incidence of minor adverse events and rarely severe complications. Propofol infusion with or without dexmedetomidine appears the ideal anesthetic, as it allows spontaneous breathing and fast turnover. Intranasal dexmedetomidine is safe and the most effective medication when a nonintravenous route is employed.

New scanning techniques and patient's preparation methods can increase the chances to successfully perform MRI with no sedation by shortening sequences, reducing artifacts, and improving child's cooperation.

MRI under sedation can be considered safe. Proper patient selection, clear decision-making and medico-legal pathways are particularly necessary for nurse-only sedated scans. Nonsedated MRIs are feasible and cost-effective but require optimal scanning techniques and patient's preparation to be successful. Further research should be focused on identifying the most effective modalities to perform MRI without sedation and clarify protocols for the nurse-only sedations.

Anesthesia service will likely remain pivotal for complex and critically ill patients and to provide assistance in case of adverse events.
The Effects of Early Mobilization on Acquired Weakness in Intensive Care Units
Authors: Rosa Debora , Negro Alessandra , Marcomini Ilaria , Pendoni Roberta , Albabesi Beatrice , Pennino Giovanni , Terzoni Stefano , Destrebecq Anne , Villa Giulia
Published: March 2023

Background

Intensive care unit (ICU)–acquired weakness (ICUAW) is defined as a clinical syndrome of neuromuscular weakness, and a consequence of critical illness, unrelated to any other etiology. It is associated with difficult weaning from the ventilator, prolonged ICU stay, increased mortality, and other important long-term outcomes. Early mobilization is defined as any active exercise in which patients use their muscle strength actively or passively within the first 2 to 5 days of critical illness. Early mobilization can be safely initiated from the first day of admission to the ICU during mechanical ventilation.

Objectives

The purpose of this review is to describe the effects of early mobilization on complications from ICUAW.

Method

This was a literature review. Inclusion criteria were as follows: observational studies and randomized controlled trials conducted with adult patients (aged ≥18 years) admitted to the ICU were included. Studies selected were published in the last 11 years (2010-2021).

Results

Ten articles were included. Early mobilization reduces muscle atrophy, ventilation, length of hospital stay, and ventilator-associated pneumonia and improves patients' responses to inflammation and hyperglycemia.

Discussion

Early mobilization appears to have a significant impact on the prevention of ICUAW and appears to be safe and feasible. The results of this review could be useful for improving the provision of efficient and effective tailored care for ICU patients.
The burden of liver cirrhosis and underlying etiologies: results from the Global Burden of Disease Study 2019
Authors: Lan Yan , Wang Hao , Weng Haoda , Xu Xianbin , Yu Xia , Tu Huilan , Gong Kai , Yao Junjie , Ye Shaoheng , Shi Yu , Sheng Jifang
Published: March 2023

Background:

Liver cirrhosis is a major health concern. Herein, we aimed to estimate the incidence, prevalence, and mortality of liver cirrhosis caused by specific etiologies for 204 countries and territories.

Materials and Methods:

The data were retrieved from the Global Burden of Disease Study 2019. The age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized death rate, and estimated annual percentage changes were used to estimate the trends in incidence, prevalence, and mortality of liver cirrhosis by sex, region, country, and etiology between 2009 and 2019.

Results:

From 2009 to 2019, the incident cases of liver cirrhosis increased by 16.7%, from 1.8 million (95% uncertainty interval: 1.5–2.1) to 2.1 million (1.7–2.5), and the prevalent cases increased from 1378.3 million (1275.1–1498.8) to 1691.0 million (1560.9–1845.5). Liver cirrhosis contributed to nearly 1.5 million (1.4–1.6) deaths in 2019, nearly 0.2 million more than in 2009. However, the age-standardized death rate fell from 20.71 (19.79–21.65) per 100,000 population in 2009 to 18.00 (16.80–19.31) per 100,000 population in 2019. In terms of sex, males showed higher ASIR, ASPR, and age-standardized death rate than females. Among the etiologies, the ASIR and ASPR of NAFLD increased markedly, and there was also a modest increase in ASIR and ASPR for HCV and alcohol use. In contrast, the ASIR and ASPR of HBV decreased considerably.

Conclusions:

Our finding suggests an increasing burden of liver cirrhosis worldwide but a declining attributed death. A high prevalence and still rising trend of NAFLD and alcohol use-etiology were found in patients with cirrhosis globally, although variation was found between regions/countries. These data indicate that efforts to reduce the associated burden need to be improved.
HIGH-RESOLUTION IMAGING OF THE OUTER RETINA IN TYPE 2 ACUTE MACULAR NEURORETINOPATHY
Authors: Doble Nathan , Wells-Gray Elaine M. , Ohr Matthew P. , Choi Stacey S.
Published: March 2023

Purpose:

The purpose of this study was to investigate the outer retinal changes in a patient with type 2 acute macular neuroretinopathy (AMN).

Methods:

A 35-year-old White woman complaining of a unilateral blind spot was imaged using various retinal imaging modalities including clinical optical coherence tomography (OCT), OCT-angiography, fundus fluorescein angiography, and adaptive optics (AO).

Results:

Fundus examination revealed multiple paracentral reddish brown petaloid lesions in the symptomatic left eye, while the other eye was unremarkable. Clinical OCT showed areas of hyperreflectance at the outer plexiform layer/outer nuclear layer complex with a disrupted inner/outer segment junction, which are characteristic features of type 2 AMN. AO imaging further revealed either shortening or absence of cone outer segments within the AMN lesions attributing to the darker features observed in the en face images from fundus photography and scanning laser ophthalmoscopy.

Conclusion:

The AO findings indicate that the petaloid lesions in type 2 AMN are caused by a combination of the shortening and absence of the outer segment in individual cone photoreceptors.
Leveraging Community Resources and Local Expertise to Build a Safe Learning Environment for K-12 Students During COVID-19: A Field Experience
Authors: Masterson Evelyn , Chung Sarita , Shen Renata , Singh Bindiya , Savoia Elena , Rajabiun Serena
Published: March 2023

Objective:

To share the experiences of stakeholders in a school district's response to the COVID-19 pandemic, especially related to supporting the district in the reopening process and sharing key decision points, challenges, facilitators, and overall lessons learned that may be applied to future emergencies.

Design:

A descriptive study of participants' experience that included (1) a content analysis of policy documents and recommendations that were developed and published by key stakeholders and (2) interviews with stakeholders in the school system that were coded to identify patterns and themes.

Setting:

Remote interviews conducted over Zoom. Participants live or work in Brookline, Massachusetts.

Participants:

Fifteen qualitative interviews were conducted with school committee members, principals, members of school leadership, school nurses, school staff, parents, advisory panel members, and physicians collaborating with the school district.

Main Outcome Measures:

Whether patterns and themes related to challenges, solutions, and recommendations for future management of public health emergencies in the district could be identified.

Results:

Challenges experienced during a school district's response included staffing burdens, changing scopes of services, the difficulty of successfully enforcing social distancing, addressing staff and family fears, meeting informational needs, and limited resources. Multiple interviewees shared that they felt there should have been a greater emphasis on mental health in the district's response. Successes of the response included the creation and implementation of a consistent communications system, recruiting volunteers and mobilizing the community to address critical needs, and effective technology expansion and usage in schools.

Conclusions:

Leadership and community collaboration were essential to the response to the COVID-19 pandemic in addition to strategies used to enhance coordination and communication and relay information across the community.
Patient-Specific Implants for Correction of Midfacial Aging
Authors: Wang Xin , Chen Xiaoping , Zhao Qiming , Zhou Zhuying , Wu Sihan , Chen Yue , Wang Xiaowei , Huang Xiaoxiang , Long Xiaohui
Published: March 2023

The nasolabial folds (NLFs) may be shallowed with the use of nostril base augmentation. This study aimed to design and customize patient-specific implants (PSIs) with computer-aided design/computer-aided manufacturing (CAD/CAM) to correct NLF deepening caused by midfacial aging. The patient’s head computed tomography data obtained and were used for reconstruction. The PSIs were customized by CAD/CAM techniques, which were implanted into a nasal base for shallow NLFs caused by midfacial aging. Preoperative and postoperative photos and a wrinkle severity rating scale were used to evaluate the changes in NLFs. Also, the global esthetic improvement scale was used to investigate the surgical satisfaction of patients. Eleven patients (22 NLFs) received PSIs in the nasal base (22 implants). The customized PSI matched well with premaxilla, reducing the difficulty of operation. After 3 to 12 months of follow-up, PSI was stable without foreign body reaction or inflammatory reaction. Postoperative wrinkle severity rating scale scores showed that NLF severity was reduced in all patients, with a significant esthetic improvement compared with preoperatively (P < 0.01). The global esthetic improvement scale showed an extremely satisfied improved NLF in 27.27% of patients, much improved in 63.63%, and improved in 9.90% (2/22), and none reported change or poor NLF. Patient satisfaction with their midface appearance differed significantly before and after surgery (P < 0.01). Individualized PSI designed with high precision and matching degree by CAD and prepared using CAM could be applied to overcome the limitations of noncustomized implants.