bluuebunny/crossref_metadata_2025 huggingface dataset:
An unusual case of colonic duplication cyst in an adult with dysplasia
Authors: Shanmugalingam Aswin , Duxbury Hayley , Choi Joseph Do Woong , Kwik Charlotte , P’Ng Chow Heok , Kim Lauren , Pathma-Nathan Nimalan
Published: February 2023

Duplication cysts are rare benign congenital malformations typically identified in children by the age of 2 years. We report a rare case of colonic duplication cyst with dysplasia in an adult. A 32-year-old male was diagnosed with non-specific abdominal symptoms. Abdominopelvic computed tomography scan demonstrated a submucosal cystic lesion in the right colon. He underwent laparoscopic right hemicolectomy. Histopathology showed colonic duplication cyst with low grade dysplasia. He is due for a surveillance colonoscopy in 3 years. Duplication cyst in an adult colon with dysplasia is extremely rare. They are usually present in the terminal ileum. They have non-specific abdominal symptoms or can be asymptomatic. They are often identified incidentally or intraoperatively. Imaging may demonstrate a cystic lesion. Histopathology is required for definitive diagnosis. There are no guidelines or consensus on managing duplication cysts in adults. We recommend an oncological resection of the involved colon. Surveillance with routine colonoscopy is advisable.
On Negation with the Bipartite Constructions ʿĒB-(V/V:)Š and MĀ-(V/V:)Š in Šrūgi Arabic
Authors: Hassan Qasim
Published: February 2023

The split of the gǝlǝt dialects into Šrūgi and non-Šrūgi types was first introduced by the author in three studies. Here a correlation was observed between the geographic distribution of the gǝlǝt dialects and the sectarian affiliation of their speakers (Hassan 2020: 167, 2021a: 52, 2021b: 195 n. 1). The term Šrūgi refers to all gǝlǝt dialects over-whelmingly spoken by the Shīʿa population in southern Iraq and the Middle Euphrates Area, whereas the term non-Šrūgi denotes the gǝlǝt dialects of the Sunna population in the northern and western parts of the country. Accordingly, the term Šrūgi appears to be broader in scope than the traditional ‘southern Iraq’, which refers to only the southern part of the Šrūgi area. Research on negation in Šrūgi Arabic in general and on the bipartite negative constructions ʿēb-(v/v:)š and mā-(v/v:)š in particular, has thus far been very scant. In the published literature, only the single negative particles ʿēb and mā- and the split morpheme mā-(v/v:)š have been discussed, but no mention has been made of the bipartite construction ʿēb-(v/v:)š. What is more, the single negator ʿēb and the bipartite construction mā-(v/v:)š have usually been considered, although in passing, exclusive marshland features, a view that has unnecessarily been adopted in subsequent related contributions on negation in Šrūgi Arabic. However, recent research conducted by the author has shown the wide distribution of these constructions, mā-(v/v:)š in particular, in the Šrūgi area, in fact establishing an isogloss between the Šrūgi and the non-Šrūgi dialectal areas. The goal of this paper is to add new information to our knowledge of negation with the bipartite constructions ʿēb-(v/v:)š and mā-(v/v:)š in Šrūgi Arabic, showing at the same time that both constructions are not recent innovations, but their distribution has not been reported until now.
Mass derivation of planets K2-21b and K2-21c from transit timing variations
Authors: El Moutamid Maryame , Stevenson Kevin B , Quarles Billy , Lewis Nikole K , Petigura Erik , Fabrycky Daniel , Bean Jacob L , Dragomir Diana , Sotzen Kristin S , Werner Michael W
Published: February 2023

While various indirect methods are used to detect exoplanets, one of the most effective and accurate methods is the transit method, which measures the brightness of a given star for periodic dips when an exoplanet is passing in front of the parent star. For systems with multiple transiting planets, the gravitational perturbations between planets affect their transit times. The difference in transit times allows a measurement of the planet masses and orbital eccentricities. These parameters help speculating on the formation, evolution, and stability of the system. Using transit timing variations (TTVs), we measure the masses and eccentricities of two planets orbiting K2-21, a relatively bright K7 dwarf star. These two planets exhibit measurable TTVs, have orbital periods of about 9.32 and 15.50 d, respectively, and a period ratio of about 1.66, which is relatively near to the 5:3 mean motion resonance. We report that the inner and outer planets in the K2-21 system have properties consistent with the presence of a hydrogen- and helium-dominated atmosphere, as we estimate their masses to be $1.59^{+0.52}_{-0.44}$ and $3.88^{+1.22}_{-1.07}\, \mathrm{ M}_\oplus$ and densities of $0.22^{+0.05}_{-0.04}$ and $0.34^{+0.08}_{-0.06}\, \rho _\oplus$, respectively (M⊕ and ρ⊕ are the mass and density of the Earth, respectively). Our results show that the inner planet is less dense than the outer planet; one more counterintuitive exoplanetary system such as Kepler-105, LTT 1445, TOI-175, and Kepler-279 systems.
Dynamical tides in Jupiter and other rotationally flattened planets and stars with stable stratification
Authors: Dewberry Janosz W
Published: February 2023

We develop a numerical method for directly computing the dissipative dynamical tidal response of rapidly rotating, oblate stars and gaseous planets with realistic internal structures. Applying these calculations to neutrally and stably stratified polytropes, we identify the most relevant resonances in models with rotation rates up to nearly the mass-shedding limit. We then compute the dynamical tidal response for Jupiter interior models including both stably stratified and convective regions. These calculations show that resonances involving mixed waves with both gravito-inertial and purely inertial character are capable of explaining a discrepancy between observations and hydrostatic calculations of Jupiter’s response to tidal forcing by Io. This result contrasts with recent work that excluded Jupiter’s rotational flattening, and opens the door to resonances involving a wider range of internal oscillation modes than previously considered.
A Gaian habitable zone
Authors: Arthur Rudy , Nicholson Arwen
Published: February 2023

When searching for inhabited exoplanets, understanding the boundaries of the habitable zone around the parent star is the key. If life can strongly influence its global environment, then we would expect the boundaries of the habitable zone to be influenced by the presence of life. Here, using a simple abstract model of ‘tangled-ecology’ where life can influence a global parameter, labelled as temperature, we investigate the boundaries of the habitable zone of our model system. As with other models of life-climate interactions, the species act to regulate the temperature. However, the system can also experience ‘punctuations’, where the system’s state jumps between different equilibria. Despite this, an ensemble of systems still tends to sustain or even improve conditions for life on average, a feature we call Entropic Gaia. The mechanism behind this is sequential selection with memory which is discussed in detail. With this modelling framework we investigate questions about how Gaia can affect and ultimately extend the habitable zone to what we call the Gaian habitable zone. This generates concrete predictions for the size of the habitable zone around stars, suggests directions for future work on the simulation of exoplanets and provides insight into the Gaian bottleneck hypothesis and the habitability/inhabitance paradox.
The non-explosive stellar merging origin of the ultra-massive carbon-rich white dwarfs
Authors: Kawka Adela , Ferrario Lilia , Vennes Stéphane
Published: February 2023

We have investigated the origin of a sub-class of carbon-polluted white dwarfs (DQ) originally identified as the “hot DQ” white dwarfs. These objects are relatively hot ($10\, 000\lesssim T_{\rm eff}\lesssim 25\, 000$ K), have markedly higher carbon abundance (C-enriched), are more massive (M ≳ 0.8 M⊙) than ordinary DQs (M ∼ 0.6 M⊙), and display high space velocities. Hence, despite their young appearance their kinematic properties are those of an old white dwarf population. The way out of this dilemma is to assume that they formed via the merging of two white dwarfs. In this paper, we examine the observed characteristics of this population of “C-enriched” DQ white dwarfs and confirm that nearly half of the 63 known objects have kinematic properties consistent with those of the Galactic thick disc or halo. We have also conducted population synthesis studies and found that the merging hypothesis is indeed compatible with observations. Studies of this sub-class of white dwarfs have important implications for our understanding of Type Ia Supernovae (SNeIa), commonly used to determine the expansion history of the Universe, since the same formation channel applies to both kinds of objects. Hence, probing the properties of these white dwarfs that failed to explode may yield important constraints to the modelling of the mechanisms leading to a thermonuclear runaway.
Anisotropic electron transport in the nuclear pasta phase
Authors: Pelicer M R , Antonelli M , Menezes D P , Gulminelli F
Published: February 2023

The presence of nuclear pasta is expected to modify the transport properties in the mantle of neutron stars. The non-spherical geometry of the pasta nuclear clusters leads to anisotropies in the collision frequencies, impacting the thermal and electrical conductivity. We derive analytical expressions for the anisotropic collision frequencies using the Boltzmann equation in the relaxation time approximation. The average parallel, perpendicular, and Hall electrical conductivities are computed in the high-temperature regime above crustal melting, considering incoherent elastic electron-pasta scattering and randomly oriented pasta structures. Numerical values are obtained at different densities and temperatures by using the Indiana University–Florida State University (IUFSU) parametrization of the non-linear Walecka model to determine the crustal structure. We find that the anisotropy of the collision frequencies grows with the length of the pasta structures and, independently of the magnetic field, the presence of rod and slab phases decreases the conductivity by more than one order of magnitude. Our numerical results indicate that, even if the pasta structures might survive above the crustal melting point, no strong anisotropies are to be expected in the conduction properties in this temperature regime, even in the presence of a very high magnetic field.
Revisiting secondary CMB distortions due to kinetic Sunyaev–Zel’dovich effect from quasar bubbles before reionization
Authors: Acharya Sandeep Kumar , Majumdar Subhabrata
Published: February 2023

We discuss the secondary cosmic microwave background (CMB) anisotropy due to kinetic Sunyaev–Zel’dovich (kSZ) effect from ionized bubbles around individual quasars prior to the reionization of the Universe. The bubbles create local ionization modulations which move with the large-scale structure linear bulk flow and act as sources for kSZ. We improve upon previous calculations of this effect, using a halo model based description of quasar abundance, and find that the kSZ distortion power spectrum, Cℓ, from the bubbles to be sub-dominant to kSZ from patchy reionization driven by galaxies. However, the shape of the two Cℓ’s are very different with the quasar bubble Cℓ having a peak at ℓ ≈ 500–700 whereas the Cℓ due to patchy reionization flattening out at ℓ > 1000 thus making it plausible to separate the two using Cℓ template-fitting in a future survey like CMB-HD. Next, we look at the imprint of a single quasar bubble on the CMB and show that it can be detected in a high-resolution, ambitious effort like CMB-HD. A detection of a high redshift quasar bubble in the CMB would carry complimentary information to its detection in H i or Lyman-α and a joint analysis can be used to break parameter degeneracies.
Genomics of Secondarily Temperate Adaptation in the Only Non-Antarctic Icefish
Authors: Rivera-Colón Angel G , Rayamajhi Niraj , Minhas Bushra Fazal , Madrigal Giovanni , Bilyk Kevin T , Yoon Veronica , Hüne Mathias , Gregory Susan , Cheng C H Christina , Catchen Julian M
Published: February 2023

White-blooded Antarctic icefishes, a family within the adaptive radiation of Antarctic notothenioid fishes, are an example of extreme biological specialization to both the chronic cold of the Southern Ocean and life without hemoglobin. As a result, icefishes display derived physiology that limits them to the cold and highly oxygenated Antarctic waters. Against these constraints, remarkably one species, the pike icefish Champsocephalus esox, successfully colonized temperate South American waters. To study the genetic mechanisms underlying secondarily temperate adaptation in icefishes, we generated chromosome-level genome assemblies of both C. esox and its Antarctic sister species, Champsocephalus gunnari. The C. esox genome is similar in structure and organization to that of its Antarctic congener; however, we observe evidence of chromosomal rearrangements coinciding with regions of elevated genetic divergence in pike icefish populations. We also find several key biological pathways under selection, including genes related to mitochondria and vision, highlighting candidates behind temperate adaptation in C. esox. Substantial antifreeze glycoprotein (AFGP) pseudogenization has occurred in the pike icefish, likely due to relaxed selection following ancestral escape from Antarctica. The canonical AFGP locus organization is conserved in C. esox and C. gunnari, but both show a translocation of two AFGP copies to a separate locus, previously unobserved in cryonotothenioids. Altogether, the study of this secondarily temperate species provides an insight into the mechanisms underlying adaptation to ecologically disparate environments in this otherwise highly specialized group.
Cognitive outcomes after multimodal treatment in adult glioma patients: A meta-analysis
Authors: De Roeck Laurien , Gillebert Céline R , van Aert Robbie C M , Vanmeenen Amber , Klein Martin , Taphoorn Martin J B , Gehring Karin , Lambrecht Maarten , Sleurs Charlotte
Published: February 2023

Background

Cognitive functioning is increasingly assessed as a secondary outcome in neuro-oncological trials. However, which cognitive domains or tests to assess, remains debatable. In this meta-analysis, we aimed to elucidate the longer-term test-specific cognitive outcomes in adult glioma patients.

Methods

A systematic search yielded 7098 articles for screening. To investigate cognitive changes in glioma patients and differences between patients and controls 1-year follow-up, random-effects meta-analyses were conducted per cognitive test, separately for studies with a longitudinal and cross-sectional design. A meta-regression analysis with a moderator for interval testing (additional cognitive testing between baseline and 1-year posttreatment) was performed to investigate the impact of practice in longitudinal designs.

Results

Eighty-three studies were reviewed, of which 37 were analyzed in the meta-analysis, involving 4078 patients. In longitudinal designs, semantic fluency was the most sensitive test to detect cognitive decline over time. Cognitive performance on mini-mental state exam (MMSE), digit span forward, phonemic and semantic fluency declined over time in patients who had no interval testing. In cross-sectional studies, patients performed worse than controls on the MMSE, digit span backward, semantic fluency, Stroop speed interference task, trail-making test B, and finger tapping.

Conclusions

Cognitive performance of glioma patients 1 year after treatment is significantly lower compared to the norm, with specific tests potentially being more sensitive. Cognitive decline over time occurs as well, but can easily be overlooked in longitudinal designs due to practice effects (as a result of interval testing). It is warranted to sufficiently correct for practice effects in future longitudinal trials.
Assessing the added value of apparent diffusion coefficient, cerebral blood volume, and radiomic magnetic resonance features for differentiation of pseudoprogression versus true tumor progression in patients with glioblastoma
Authors: Leone Riccardo , Meredig Hagen , Foltyn-Dumitru Martha , Sahm Felix , Hamelmann Stefan , Kurz Felix , Kessler Tobias , Bonekamp David , Schlemmer Heinz-Peter , Bo Hansen Mikkel , Wick Wolfgang , Bendszus Martin , Vollmuth Philipp , Brugnara Gianluca
Published: February 2023

Background

Pseudoprogression (PsPD) is a major diagnostic challenge in the follow-up of patients with glioblastoma (GB) after chemoradiotherapy (CRT). Conventional imaging signs and parameters derived from diffusion and perfusion-MRI have yet to prove their reliability in clinical practice for an accurate differential diagnosis. Here, we tested these parameters and combined them with radiomic features (RFs), clinical data, and MGMT promoter methylation status using machine- and deep-learning (DL) models to distinguish PsPD from Progressive disease.

Methods

In a single-center analysis, 105 patients with GB who developed a suspected imaging PsPD in the first 7 months after standard CRT were identified retrospectively. Imaging data included standard MRI anatomical sequences, apparent diffusion coefficient (ADC), and normalized relative cerebral blood volume (nrCBV) maps. Median values (ADC, nrCBV) and RFs (all sequences) were calculated from DL-based tumor segmentations. Generalized linear models with LASSO feature-selection and DL models were built integrating clinical data, MGMT methylation status, median ADC and nrCBV values and RFs.

Results

A model based on clinical data and MGMT methylation status yielded an areas under the receiver operating characteristic curve (AUC) = 0.69 (95% CI 0.55–0.83) for detecting PsPD, and the addition of median ADC and nrCBV values resulted in a nonsignificant increase in performance (AUC = 0.71, 95% CI 0.57–0.85, P = .416). Combining clinical/MGMT information with RFs derived from ADC, nrCBV, and from all available sequences both resulted in significantly (both P < .005) lower model performances, with AUC = 0.52 (0.38–0.66) and AUC = 0.54 (0.40–0.68), respectively. DL imaging models resulted in AUCs ≤ 0.56.

Conclusion

Currently available imaging biomarkers could not reliably differentiate PsPD from true tumor progression in patients with glioblastoma; larger collaborative efforts are needed to build more reliable models.
Balamuthia mandrillarisEncephalitis Presenting as a Symptomatic Focal Hypodensity in an Immunocompromised Patient
Authors: Sakusic Amra , Chen Baibing , McPhearson Kimberly , Badi Mohammed , Freeman William D , Huang Josephine F , Siegel Jason L , Jentoft Mark E , Oring Justin M , Verdecia Jorge , Meschia James F
Published: February 2023

We present the case of a 61-year-old woman with a history of orthotopic heart transplant who was hospitalized with new-onset headache. Magnetic resonance imaging (MRI) of the brain revealed T2 hyperintense signal involving the left occipital lobe with leptomeningeal enhancement and mild vasogenic edema. Initial neurologic examination was normal; however, after 7 days she developed imbalance, visual disturbances, night sweats, bradyphrenia, alexia without agraphia, and right hemianopsia. Brain MRI showed enlargement of the left occipital mass and worsening edema. Stereotactic needle biopsy showed nondiagnostic necrosis. The patient continued to deteriorate despite dexamethasone. Cerebrospinal fluid (CSF) suggested infection, and cytomegalovirus CSF polymerase chain reaction (PCR) was positive. The patient received vancomycin, imipenem, and ganciclovir. After obtaining a positive serum beta-D-glucan (Fungitell), amphotericin was added. Despite best medical efforts, the patient died. Postmortem broad-range PCR sequencing of the brain tissue was positive for rare amoeba Balamuthia mandrillaris.
An ancestral role for 3-KETOACYL-COA SYNTHASE3 as a negative regulator of plant cuticular wax synthesis
Authors: Huang Haodong , Yang Xianpeng , Zheng Minglü , Chen Zexi , Yang Zhuo , Wu Pan , Jenks Matthew A , Wang Guangchao , Feng Tao , Liu Li , Yang Pingfang , Lü Shiyou , Zhao Huayan
Published: February 2023

The plant cuticle, a structure primarily composed of wax and cutin, forms a continuous coating over most aerial plant surfaces. The cuticle plays important roles in plant tolerance to environmental stress, including stress imposed by drought. Some members of the 3-KETOACYL-COA SYNTHASE (KCS) family are known to act as metabolic enzymes involved in cuticular wax production. Here we report that Arabidopsis (Arabidopsis thaliana) KCS3, which was previously shown to lack canonical catalytic activity, instead functions as a negative regulator of wax metabolism by reducing the enzymatic activity of KCS6, a key KCS involved in wax production. We demonstrate that the role of KCS3 in regulating KCS6 activity involves physical interactions between specific subunits of the fatty acid elongation complex and is essential for maintaining wax homeostasis. We also show that the role of the KCS3–KCS6 module in regulating wax synthesis is highly conserved across diverse plant taxa from Arabidopsis to the moss Physcomitrium patens, pointing to a critical ancient and basal function of this module in finely regulating wax synthesis.
MicroRNA156ab regulates apple plant growth and drought tolerance by targeting transcription factor MsSPL13
Authors: Feng Chen , Zhang Xiang , Du Bingyang , Xiao Yuqin , Wang Yanyan , Sun Yueting , Zhou Xin , Wang Chao , Liu Yang , Li Tian-Hong
Published: February 2023

Drought stress substantially reduces the productivity of apple plants and severely restricts the development of apple industry. Malus sieversii, wild apples with excellent drought resistance, is a valuable wild resource for a rootstock improvement of cultivated apple (Malus domestica). miRNAs and their targets play essential roles in plant growth and stress responses, but their roles in drought stress responses in apple are unknown. Here, we demonstrate that microRNA156ab is upregulated in M. sieversii in response to drought stress. Overexpressing msi-miR156ab promoted auxin accumulation, maintained the growth of apple plants, and increased plant resistance to osmotic stress. Antioxidant enzyme activities and proline contents were also increased in miR156ab-OE transgenic apple lines, which improved drought resistance. The squamosa promoter binding protein-like transcription factor MsSPL13 is the target of msi-miR156ab, as demonstrated by 5′-RACE and dual luciferase assays. Heterologous expression of MsSPL13 decreased auxin contents and inhibited growth in Arabidopsis (Arabidopsis thaliana) under normal and stress conditions. The activities of antioxidant enzymes were also suppressed in MsSPL13-OE transgenic Arabidopsis, reducing drought resistance. We showed that MsSPL13 regulates the expression of the auxin-related genes MsYUCCA5, PIN-FORMED7 (MsPIN7), and Gretchen Hagen3-5 (MsGH3-5) by binding to the GTAC cis-elements in their promoters, thereby regulating auxin metabolism. Finally, we demonstrated that the miR156ab-SPL13 module is involved in mediating the difference in auxin metabolism and stress responses between M. sieversii and M26 (M. domestica) rootstocks. Overall, these findings reveal that the miR156ab-SPL13 module enhances drought stress tolerance in apples by regulating auxin metabolism and antioxidant enzyme activities.
Expression of the wheat multipathogen resistance hexose transporter Lr67res is associated with anion fluxes
Authors: Milne Ricky J , Dibley Katherine E , Bose Jayakumar , Ashton Anthony R , Ryan Peter R , Tyerman Stephen D , Lagudah Evans S
Published: February 2023

Many disease resistance genes in wheat (Triticum aestivum L.) confer strong resistance to specific pathogen races or strains, and only a small number of genes confer multipathogen resistance. The Leaf rust resistance 67 (Lr67) gene fits into the latter category as it confers partial resistance to multiple biotrophic fungal pathogens in wheat and encodes a Sugar Transport Protein 13 (STP13) family hexose-proton symporter variant. Two mutations (G144R, V387L) in the resistant variant, Lr67res, differentiate it from the susceptible Lr67sus variant. The molecular function of the Lr67res protein is not understood, and this study aimed to broaden our knowledge on this topic. Biophysical analysis of the wheat Lr67sus and Lr67res protein variants was performed using Xenopus laevis oocytes as a heterologous expression system. Oocytes injected with Lr67sus displayed properties typically associated with proton-coupled sugar transport proteins—glucose-dependent inward currents, a Km of 110 ± 10 µM glucose, and a substrate selectivity permitting the transport of pentoses and hexoses. By contrast, Lr67res induced much larger sugar-independent inward currents in oocytes, implicating an alternative function. Since Lr67res is a mutated hexose-proton symporter, the possibility of protons underlying these currents was investigated but rejected. Instead, currents in Lr67res oocytes appeared to be dominated by anions. This conclusion was supported by electrophysiology and 36Cl− uptake studies and the similarities with oocytes expressing the known chloride channel from Torpedo marmorata, TmClC-0. This study provides insights into the function of an important disease resistance gene in wheat, which can be used to determine how this gene variant underpins disease resistance in planta.
The biogenesis and regulation of the plant oxidative phosphorylation system
Authors: Ghifari Abi S , Saha Saurabh , Murcha Monika W
Published: February 2023

Mitochondria are central organelles for respiration in plants. At the heart of this process is oxidative phosphorylation (OXPHOS) system, which generates ATP required for cellular energetic needs. OXPHOS complexes comprise of multiple subunits that originated from both mitochondrial and nuclear genome, which requires careful orchestration of expression, translation, import, and assembly. Constant exposure to reactive oxygen species due to redox activity also renders OXPHOS subunits to be more prone to oxidative damage, which requires coordination of disassembly and degradation. In this review, we highlight the composition, assembly, and activity of OXPHOS complexes in plants based on recent biochemical and structural studies. We also discuss how plants regulate the biogenesis and turnover of OXPHOS subunits and the importance of OXPHOS in overall plant respiration. Further studies in determining the regulation of biogenesis and activity of OXPHOS will advances the field, especially in understanding plant respiration and its role to plant growth and development.
A tactile pain evaluation scale for persons with visual deficiencies
Authors: Pickering Gisèle , Morel Véronique , Goubayon Jonathan , Touron Ambre , Leray Vincent , Pereira Bruno
Published: February 2023

Objective

Pain evaluation scales often rely on the sense of sight. There is so far no pain assessment scale designed specifically for persons with visual impairment.

Design

This study aims to validate a tactile pain evaluation scale, Visiodol (Copyright Prof Pickering), in blind or visually impaired persons, by correlation with a numeric pain scale.

Setting

The study took place at University Hospital Clermont-Ferrand, France.

Methods

Pain intensity for a range of thermal stimuli (Pathway Medoc) was evaluated with Visiodol and a numeric pain scale. Secondary outcomes, including pain thresholds, catastrophizing, emotion, and quality of life, were compared in persons who were blind or visually impaired and in sighted persons. Lin’s concordance correlation coefficient was estimated. Weighted Cohen’s κ accounted for degrees of disagreement between scales with 95% confidence intervals (95% CI).

Subjects

Sixteen healthy sighted and 21 healthy nonsighted volunteers (n = 13 congenital, n = 8 acquired) were included.

Results

Lin’s correlation coefficient for repeated data was 0.967 (95% CI, 0.956–0.978; P < 0.001) for visually impaired participants, with a good agreement at each temperature plateau. A weighted Cohen’s κ of 0.90 (95% CI, 0.84–0.92) and 92.9% percentage of agreement for visually impaired participants were satisfactory. Pain perception, psychological components, and quality of life were more impaired in persons who were blind or visually impaired than in sighted persons.

Conclusions

This study validates Visiodol, a tactile scale for persons who are blind or visually impaired, and addresses health care inequalities in the context of pain evaluation. Visiodol will now be tested in a larger population of patients to give the millions of persons worldwide who are blind or visually impaired an option for pain intensity evaluation in clinical situations.

Trial registration

French National Agency for the Safety of Medicines and Healthcare Products (2018-A03370-55) and www.ClinicalTrials.gov (NCT03968991).
Curved domain-wall fermion and its anomaly inflow
Authors: Aoki Shoto , Fukaya Hidenori
Published: February 2023

We investigate the effect of a U(1) gauge field on lattice fermion systems with a curved domain-wall mass term. In the same way as the conventional flat domain-wall fermion, the chiral edge modes appear localized at the wall, whose Dirac operator contains the induced gravitational potential as well as the U(1) vector potential. In the case of anS1 domain-wall fermion on a two-dimensional flat lattice, we find a competition between the Aharonov–Bohm(AB) effect and a gravitational gap in the Dirac eigenvalue spectrum, which leads to an anomaly inthe time-reversal (T) symmetry. Our numerical result shows a good consistency with the Atiyah–Patodi–Singer index theorem on a disk inside the S1 domain wall, which describes the cancellation of the T anomaly between the bulk and edge. When the U(1) flux is squeezed inside one plaquette, and the AB phase takes a quantized value π mod $2\pi \mathbb {Z}$, the anomaly inflow drastically changes: the strong flux creates another domain wall around the flux to make the two zero modes coexist. This phenomenon is also observed in the S2 domain-wall fermion in the presence of a magnetic monopole. We find that the domain-wall creation around the monopole microscopically explains the Witten effect.
CanVasc consensus recommendations for the use of avacopan in antineutrophil cytoplasm antibody-associated vasculitis: 2022 addendum
Authors: Turgeon David , Bakowsky Volodko , Baldwin Corisande , Cabral David A , Clements-Baker Marie , Clifford Alison , Cohen Tervaert Jan Willem , Dehghan Natasha , Ennis Daniel , Famorca Leilani , Fifi-Mah Aurore , Girard Louis-Philippe , Lefebvre Frédéric , Liang Patrick , Makhzoum Jean-Paul , Massicotte-Azarniouch David , Mendel Arielle , Milman Nataliya , Reich Heather N , Robinson David B , Ross Carolyn , Rumsey Dax G , Soowamber Medha , Towheed Tanveer E , Trudeau Judith , Twilt Marinka , Yacyshyn Elaine , Yardimci Gozde K , Khalidi Nader , Barra Lillian , Pagnoux Christian
Published: February 2023

Objective

In 2020, the Canadian Vasculitis Research Network (CanVasc) published their updated recommendations for the management of ANCA-associated vasculitides (AAV). The current addendum provides further recommendations regarding the use of avacopan in AAV based on a review of newly available evidence.

Methods

An updated systematic literature review on avacopan (formerly, CCX168) using Medline, Embase, and the Cochrane Library was performed for publications up to September 2022. New recommendations were developed and categorized according to the EULAR grading levels, as done for previous CanVasc recommendations. A modified Delphi procedure and videoconferences were used to reach ≥80% consensus on the inclusion, wording and grading of each recommendation.

Results

Three new recommendations were developed. They focus on avacopan therapy indication and duration, as well as timely glucocorticoid tapering.

Conclusion

These 2022 addended recommendations provide rheumatologists, nephrologists and other specialists caring for patients with AAV with guidance for the use of avacopan, based on current evidence and consensus from Canadian experts.
“You Know, the Church Has Never Agreed on Everything”: Analyzing the Prophetic and Pragmatic Voice in Clergy Sermons
Authors: Krull Laura M , Gilliland Claire Chipman
Published: February 2023

Clergy have regular opportunities to take a prophetic stance on social issues in their weekly sermons, but they are also responsible for maintaining organizational stability. How do they respond to controversial denominational decisions? We collected sermons from the United Methodist Church (UMC) clergy following the 2019 UMC decision to maintain their prohibition against same sex marriage and lesbian, gay, bisexual, transgender, and queer (LGBTQ) ordination. Our qualitative analysis of a sample of 447 sermons reveals three strategies clergy use to respond to the UMC decision: prophetic engagement, unifying discussion, and detached acknowledgment. Further, we show that different strategies are likely tied to the pastor’s perception of the attitudes of their attendees. Some clergy are willing to use a constrained prophetic voice in support of LGBTQ people, but most balance their comments with pragmatic efforts to minimize conflict. As a result, a more inclusive religious voice is present, but it may be muted by congregational concerns.
Elevated PD-L1 Expression and Microsatellite Instability in Elderly Patients With Gastric Cancer
Authors: Chen Tien-Hua , Chen Ming-Huang , Hung Yi-Ping , Chiang Nai-Jung , Huang Kuo-Hung , Lin Yi-Hsiang , Lin Ryan Weihsiang , Chao Yee , Li Anna Fen-Yau , Yu Hung-Yuan , Hwang Hsuen-En , Yeh Yi-Chen , Wang Yu-Chao , Fang Wen-Liang
Published: February 2023

Immunotherapy in combination with chemotherapy is the current treatment of choice for frontline programmed cell death ligand 1 (PD-L1)–positive gastric cancer. However, the best treatment strategy remains an unmet medical need for elderly or fragile patients with gastric cancer. Previous studies have revealed that PD-L1 expression, Epstein-Barr virus association, and microsatellite instability-high (MSI-H) are the potential predictive biomarkers for immunotherapy use in gastric cancer. In this study, we showed that PD-L1 expression, tumor mutation burden, and the proportion of MSI-H were significantly elevated in elderly patients with gastric cancer who were older than 70 years compared with patients younger than 70 years from analysis of The Cancer Genome Atlas gastric adenocarcinoma cohort [≥70/<70: MSI-H: 26.8%/15.0%, P=0.003; tumor mutation burden: 6.7/5.1 Mut/Mb, P=0.0004; PD-L1 mRNA: 5.6/3.9 counts per million mapped reads, P=0.005]. In our real-world study, 416 gastric cancer patients were analyzed and showed similar results (≥70/<70: MSI-H: 12.5%/6.6%, P=0.041; combined positive score ≥1: 38.1%/21.5%, P<0.001). We also evaluated 16 elderly patients with gastric cancer treated with immunotherapy and revealed an objective response of 43.8%, a median overall survival of 14.8 months, and a median progression-free survival of 7.0 months. Our research showed that a durable clinical response could be expected when treating elderly patients with gastric cancer with immunotherapy, and this approach is worth further study.
Acute and Chronic Demyelinating Neuropathies After COVID-19 Vaccination: A Report of 4 Cases
Authors: Dennis Erin , Hartman Elizabeth , Cortes-Penfield Nicolas , Piccione Ezequiel , Thaisetthawatkul Pariwat
Published: February 2023

Objectives:

To report demyelinating neuropathies after COVID-19 vaccination.

Methods:

Case report.

Results:

Four cases of demyelinating neuropathies after COVID-19 vaccination were identified at the University of Nebraska Medical Center from May to September 2021. Three were male and 1 was a female, ages 26–64 years. Three cases received Pfizer-BioNTech vaccine and 1 Johnson & Johnson. Symptom onset ranged from 2 to 21 days after vaccination. Two cases had progressive limb weakness, 3 had facial diplegia, and all had sensory symptoms and areflexia. The diagnosis was acute inflammatory demyelinating polyneuropathy in 1 case and chronic inflammatory demyelinating polyradiculoneuropathy in 3. All cases received treatment with intravenous immunoglobulin, with significant improvement in 3 of 4 who had a long-term outpatient follow-up.

Conclusions:

Continued identification and reporting of cases of demyelinating neuropathies after COVID-19 vaccination is essential to determine whether a causative association is present.
Landscape of Guillain–Barré Syndrome Interventional Clinical Trials
Authors: Saleh Mustafa , Boukhdoud Mona , Boukhdoud Hayam , Al Zein Mohammad , Salameh Pascale
Published: February 2023

Introduction:

Guillain–Barré syndrome (GBS) is an immune-mediated polyradiculoneuropathy that remains a debilitating disease despite medical treatment. Numerous challenges still exist, including the development of disease-modifying therapies that can improve prognosis, particularly in patients with poor prognostic outcomes. In this study, we explored clinical trials related to GBS, analyzed the trial characteristics, suggested some ideas for improvement, and discussed recent advances.

Methods:

On December 30, 2021, the authors searched ClinicalTrials.gov for all interventional and therapeutic clinical trials related to GBS, without any restrictions on the date or location. Trial characteristics including trial duration, location, phase, sample size, and publications were retrieved and analyzed.

Results:

Twenty-one trials fulfilled the selection criteria. Clinical trials were conducted in 11 different countries, most of them occurring in Asia. On average, the trial duration across the phases was around 2 years. About two-thirds of trials were completed, and 39% of trials were in the early phases (1 and 2). Only 24% of all trials and 60% of completed trials have publications in this study.

Conclusions:

The study revealed a low number of trials, lack of geographic diversity, scanty enrollment of patients, and paucity of clinical trial duration and publications regarding GBS clinical trials. Optimization of GBS trials is fundamental to achieving effective therapies for this disease.
Is Orthokeratology Treatment Zone Decentration Effective and Safe in Controlling Myopic Progression?
Authors: Chu Mengqi , Zhao Yingying , Hu Peike , Chen Duya , Yu Yinhui , Ni Hailong
Published: February 2023

Objective:

To compare the myopia control efficacy and safety of decentered versus centered positioning of orthokeratology.

Methods:

This is a retrospective intrasubject study, including 46 children with myopia (25 boys, 21 girls; age 11.12±0.33 years) treated for 1 year with OK decentration in one eye (group D) and central location in the other (Group C). Axial length was measured before and at 6 months and 12 months after the initial lens wear, respectively. Corneal topography was measured at baseline and at 1-month after lens wear. The corneal topography obtained from the 1-month visit was used to quantify treatment zone decentration (TZD) for each subject. Cycloplegic refraction was required for all children before fitting the orthokeratology lenses.

Results:

No differences were found between the groups in the biological ocular parameters (P≥0.05 for all). The axial elongation in group D and group C differed after 6 and 12 months (P<0.001 for all). Similar corneal staining rates (P=0.06) were noted during follow-up in groups D (n=20; 7.24%) and C (n=10; 3.62%), all of grade I. The uncorrected visual acuity (UCVA) in group D and C differed after 1, 6, and 12 months (P=0.002, 0.010, 0.044), except 3 months (P=0.146). Group D (n=32; 17.39%) was more likely to have glare or ghosting (chi-squared test, P<0.001) than group C (n=12; 6.52%) during follow-up visits. Axial elongation was significantly associated with baseline spherical equivalent (SE) in group C (P=0.019). In group D, axial elongation was significantly associated with SE and TZD (P<0.05 for all).

Conclusions:

This intrasubject study showed that when the UCVA was acceptable and there were no apparent complications, orthokeratology decentration may be beneficial in controlling the progression of myopia. Axial elongation became slower in children with a higher SE and a larger TZD, because TZD ranged from 0.5 mm to 1.5 mm.
Potential environmental effect of reducing the variation of disposable materials used for cataract surgery
Authors: Winklmair Nicolas , Kieselbach Gerhard , Bopp Julian , Amon Michael , Findl Oliver
Published: February 2023

Purpose:

To analyze the cataract package variability in 1 country, Austria.

Setting:

Austrian Departments of Ophthalmology.

Design:

Cross-sectional study.

Methods:

The cataract package components of 3 different Austrian hospitals were weighed and life cycle assessment on each product performed. This data was then extrapolated to the sales figures of the main Austrian cataract package suppliers to estimate the carbon footprint of all cataract packages used in Austria in 2021.

Results:

There were 55 different cataract package compositions in use with an average weight of 0.7 kg. These compositions differ significantly in weight and composition considering that the smallest package was 57% lighter than the largest package. The size of the surgical drapes also showed considerable variation, with a difference of up to 71%. This is substantial, considering that drapes and covers account for about 53% of the package weight.

Conclusions:

There was a considerable variation in package composition and product size, which could provide opportunities to save carbon dioxide emissions in cataract surgery. If all Austrian eye departments were to reduce the material quantities and drape sizes to the lower third of the cataract packages used in the Austria in 2021, cataract package associated CO2 emissions could be reduced by 34%.
A global update of mpox (monkeypox) in children
Authors: Sam-Agudu Nadia A. , Martyn-Dickens Charles , Ewa Atana U.
Published: February 2023

Purpose of review

Human mpox disease (formerly monkeypox) was first diagnosed in an infant in the Democratic Republic of the Congo in 1970. Mpox was rarely reported outside West and Central Africa until the global outbreak in May 2022. On 23 July 2022, the WHO declared mpox a public health emergency of international concern. These developments warrant a global update on pediatric mpox.

Recent findings

Mpox epidemiology in endemic African countries has changed from predominantly affecting children under 10 years to adults 20–40 years old. This shift also applies to the global outbreak, where 18–44-year-old adult men who have sex with men are disproportionately affected. Furthermore, the proportion of children affected in the global outbreak is less than 2%, while children under 18 years constitute nearly 40% of cases in African countries. The highest mortality rates remain among both children and adults in African countries.

Mpox epidemiology has shifted to adults and is affecting relatively few children in the current global outbreak. However, infants, immunocompromised children and African children are still at high risk of severe disease. Mpox vaccines and therapeutic interventions should be accessible to at-risk and affected children globally, especially to those living in endemic African countries.
Update on Covid-19: vaccines, timing of transplant after COVID-19 infection and use of positive donors
Authors: Boutin Catherine-Audrey , Alamri Maha , Ison Michael G.
Published: February 2023

Purpose of review

SARS-CoV-2 resulted in a global pandemic that had a chilling effect on transplantation early in the pandemic and continues to result in significant morbidity and mortality of transplant recipients. Over the past 2.5 years, our understanding of the clinical utility of vaccination and mAbs to prevent COVID-19 in solid organ transplant (SOT) recipients has been studied. Likewise, approach to donors and candidates with SARS-CoV-2 has been better understood. This review will attempt to summarize our current understanding of these important COVID-19 topics.

Recent findings

Vaccination against SARS-CoV-2 is effective in reducing the risk of severe disease and death among transplant patients. Unfortunately, humoral and, to a lesser extent, cellular immune response to existing COVID-19 vaccines is reduced in SOT recipients compared with healthy controls. Additional doses of vaccine are required to optimize protection of this population and still may be insufficient in those who are highly immunosuppressed, those receiving belatacept, rituximab and other B-cell active mAbs. Until recently, mAbs were options for the prevention of SARS-CoV-2 but are markedly less effective with recent omicron variants. SARS-CoV-2-infected donors can generally be used for nonlung, nonsmall bowel transplants unless they have died of acute severe COVID-19 or COVID-19-associated clotting disorders.

Our transplant recipients require a three-dose mRNA or adenovirus-vector and one dose of mRNA vaccine to be optimally protected initially; they then need to receive a bivalent booster 2+ months after completing their initial series. Most nonlung, nonsmall bowel donors with SARS-CoV-2 can be utilized as organ donors.
Local administration of vancomycin powder in orthopaedic fracture surgery: current practice and trends
Authors: Marchand Lucas S. , Sprague Sheila , O'Hara Nathan N. , Li Chuan Silvia , O'Toole Robert V. , Joshi Manjari , Viskontas Darius , Romeo Nicholas , Hymes Robert A. , Obremskey William T. , Higgins Thomas F. , Potter Gorden D. , Bergin Patrick F. , Gage Mark , Gary Joshua L. , Bhandari Mohit , Slobogean Gerard P. ,   PREP-IT Investigators
Published: February 2023

Objectives:

Surgical site infections in orthopaedic trauma are a significant problem with meaningful patient and health care system–level consequences. Direct application of antibiotics to the surgical field has many potential benefits in reducing surgical site infections. However, to date, the data regarding the local administration of antibiotics have been mixed. This study reports on the variability of prophylactic vancomycin powder use in orthopaedic trauma cases across 28 centers.

Methods:

Intrawound topical antibiotic powder use was prospectively collected within three multicenter fracture fixation trials. Fracture location, Gustilo classification, recruiting center, and surgeon information were collected. Differences in practice patterns across recruiting center and injury characteristics were tested using chi-square statistic and logistic regression. Additional stratified analyses by recruiting center and individual surgeon were performed.

Results:

A total of 4941 fractures were treated, and vancomycin powder was used in 1547 patients (31%) overall. Local administration of vancomycin powder was more frequent in open fractures 38.8% (738/1901) compared with closed fractures 26.6% (809/3040) (P < 0.001). However, the severity of the open fracture type did not affect the rate at which vancomycin powder was used (P = 0.11). Vancomycin powder use varied substantially across the clinical sites (P < 0.001). At the surgeon level, 75.0% used vancomycin powder in less than one-quarter of their cases.

Conclusions:

Prophylactic intrawound vancomycin powder remains controversial with varied support throughout the literature. This study demonstrates wide variability in its use across institutions, fracture types, and surgeons. This study highlights the opportunity for increased practice standardization for infection prophylaxis interventions.

Level of Evidence:

Prognostic—III.