bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Bronchoscopic Spray Cryotherapy and Ultra-low Temperature on Physical Properties of Metallic and Silicone Airway Stents
Authors: Sharma Deepankar , Kang Le , Shepherd Ray W.
Published: March 2022

Background:

Bronchoscopic spray cryotherapy (SCT) is utilized in the field of interventional pulmonology for treating benign and malignant airway stenosis as a standard tool to maintain airway patency. Stent-related complications include tumor overgrowth, granulation tissue, and epithelialization. Thermal ablation can have a limited role in such scenarios due to the risk of airway fire and damage to the existing stent. SCT is a potential therapy using ultra-low temperatures that can allow stents to remain in place during treatment. However, there has been no study demonstrating the safety of SCT on the integrity and physical properties of tracheobronchial stents. We report the results of the first study demonstrating the safety of SCT utilized to treat stent-associated granulation or malignant airway disease. The aim of this study was to demonstrate the effects of SCT on the physical properties of airway stents in an ex vivo environment.

Methods:

Various types of airway stents were subjected to multiple intervals of SCT for up to 30 seconds, and then the cycle was repeated 3 times. After every cycle, we compressed the stents to 60% of their original size, and compression and expansion force data was collected immediately after, at 3-minute and 5-minute intervals, and compared with the baseline readings.

Results:

There was no significant change in the association between diameter and compression/expansion force, including any derangement in returning to the original diameter or any physical damage to any of the stents even after 3 prolonged SCT sessions of 30 seconds.

Conclusion:

Our study provides the first evidence that the use of SCT in conjunction with existing silicone/metal stents is feasible and does not cause any physical damage to the stents or alters their ability to maintain the original diameter.
Economic Evaluation
Authors: Smith David H. , O’Keeffe-Rosetti Maureen , Leo Michael C. , Mayhew Meghan , Benes Lindsay , Bonifay Allison , Deyo Richard A. , Elder Charles R. , Keefe Francis J. , McMullen Carmit , Owen-Smith Ashli , Trinacty Connie M. , Vollmer William M. , DeBar Lynn
Published: March 2022

Background:

Chronic pain is prevalent and costly; cost-effective nonpharmacological approaches that reduce pain and improve patient functioning are needed.

Objective:

Report the incremental cost-effectiveness ratio (ICER), compared with usual care, of cognitive behavioral therapy aimed at improving functioning and pain among patients with chronic pain on long-term opioid treatment.

Design:

Economic evaluation conducted alongside a pragmatic cluster randomized trial.

Subjects:

Adults with chronic pain on long-term opioid treatment (N=814).

Intervention:

A cognitive behavioral therapy intervention teaching pain self-management skills in 12 weekly, 90-minute groups delivered by an interdisciplinary team (behaviorists, nurses) with additional support from physical therapists, and pharmacists.

Outcome Measures:

Cost per quality adjusted life year (QALY) gained, and cost per additional responder (≥30% improvement on standard scale assessment of Pain, Enjoyment, General Activity, and Sleep). Costs were estimated as-delivered, and replication.

Results:

Per patient intervention replication costs were $2145 ($2574 as-delivered). Those costs were completely offset by lower medical care costs; inclusive of the intervention, total medical care over follow-up was $1841 lower for intervention patients. Intervention group patients also had greater QALY and responder gains than did controls. Supplemental analyses using pain-related medical care costs revealed ICERs of $35,000, and $53,000 per QALY (for replication, and as-delivered intervention costs, respectively); the ICER when excluding patients with outlier follow-up costs was $106,000.

Limitations:

Limited to 1-year follow-up; identification of pain-related utilization potentially incomplete.

Conclusion:

The intervention was the optimal choice at commonly accepted levels of willingness-to-pay for QALY gains; this finding was robust to sensitivity analyses.
Racial Disparities in the Emergency Department Evaluation of Adolescent Girls
Authors: Polhemus Samuel , Pickett Michelle L. , Liu Xuerong (Joy) , Fraser Raphael , Ferguson Catherine C. , Drendel Amy L.
Published: March 2022

Objective

Racial disparities and differences exist in emergency care. Obtaining a sexual history is standard of care for adolescents with abdominal pain. Testing for sexually transmitted infections (STIs) and pregnancy should be based on historical findings. The objective of this study was to determine whether differential care was provided to adolescent female patients with abdominal pain based on patient race or healthcare provider characteristics by evaluating the documentation of sexual history, STI testing, and pregnancy testing.

Methods

This was a retrospective chart review of female patients between the ages of 14 and 18 years with abdominal pain presenting to a pediatric emergency department. Patient and provider characteristics, sexual history documentation, STI, and pregnancy testing were abstracted. Data were analyzed using χ2 test and logistic regression model.

Results

Eight hundred eighty-six encounters were included in the analysis. Median patient age was 16 years (range, 14–18 years); 359 (40.5%) were non-White. Differential care was provided. Non-White patients compared with White patients were more likely to have a documented sexual history (59.9% vs 44.0%, P < 0.001), STI testing (24.8% vs 7.8%, P < 0.001), and pregnancy testing (76.6% vs 66.2%, P < 0.001). Among sexually active female patients, the racial disparity for STI testing persisted (P = 0.010). Provider type and sex did not result in differences in sexual history documentation, STI, or pregnancy testing for non-White compared with White patients (P > 0.05).

Conclusions

Differential care was provided to non-White adolescents with abdominal pain compared with White adolescents. They were more likely to have a documented sexual history, STI testing, and pregnancy testing. Healthcare provider characteristics did not impact patient care. This racial disparity resulted in better medical care for non-White adolescents, but this may be the consequence of underlying implicit bias.
De-escalation of High-flow Respiratory Support for Children Admitted with Bronchiolitis: A Quality Improvement Initiative
Authors: Hoefert Jennifer A. , Molina Adolfo L. , Gardner Hannah M. , Miller Kevin H. , Wu Chang L. , Grizzle Karisa , Miller Kylee N. , Orr Mary M.
Published: March 2022

Introduction:

Bronchiolitis is the most common cause for hospitalization in the first year of life, with hypoxemia and acute respiratory failure as major determinants leading to hospitalization. In addition, the lack of existing guidelines for weaning and discontinuing supplemental oxygen, including high-flow nasal cannula, may contribute to prolonged hospitalization and increased resource utilization.

Methods:

This single-center quality improvement initiative assessed the effect of implementing a standardized care process for weaning and discontinuing high-flow oxygen for patients hospitalized with bronchiolitis. Patients aged 1–24 months with bronchiolitis admitted to the general wards or ICU step-down unit from February 1, 2018, and January 31, 2020 were included in the study. Primary outcomes included length of stay and time on supplemental oxygen, with time on high-flow oxygen and length of time in ICU step-down unit as secondary outcomes. Balancing measures included transfer rate to Pediatric Intensive Care Unit, intubation rate, 7- and 30-day readmission rates, and 7- and 30-day ED visits after discharge.

Results:

Following the standardized care process implementation, the mean length of stay decreased from 60.7 hours to 46.7 hours (P < 0.01). In addition, the mean time on any supplemental oxygen decreased by 47% (P < 0.01), the mean time on high-flow oxygen decreased by 45% (P < 0.01), and the mean time in the ICU step-down unit decreased by 27% (P =< 0.01). Balancing measures remained unchanged with no statistically significant differences.

Conclusion:

Implementing a standardized care process for weaning and discontinuing high-flow oxygen may reduce the length of stay and resource utilization for patients hospitalized with bronchiolitis.
Schmorl Node Can Cause Increased 68Ga-FAPI Activity on PET/CT
Authors: Wu Junhao , Tang Wenxin , Wang Yingwei , Gong Weidong , Zhang Chunyin
Published: March 2022

68Ga-FAPI is a newly developed tumor imaging agent with promising clinical applications. However, benign lesions may also show increased FAPI activity. We accidentally discovered that Schmorl node expressed FAPI activity in a patient with sweat gland cancer. Thus, greater awareness is needed that Schmorl nodes are a potential reason for false-positive uptake on 68Ga-FAPI PET/CT.
Uncommon Metastases From Occult Breast Cancer Revealed by 18F-FDG and 68Ga-FAPI PET/CT
Authors: Xu Weizhi , Meng Tinghua , Shang Qihang , Pang Yizhen , Chen Haojun
Published: March 2022

Metastases to gastrointestinal tract from breast cancer are very rare and can be diagnostically challenging. In this case, we reported 18F-FDG and 68Ga-FAPI PET/CT findings in a 54-year-old women with such uncommon metastases from breast cancer. Although the primary tumor of breast cancer remained radiologically occult, 68Ga-FAPI PET/CT showed a far better tumor-to-background ratio than 18F-FDG PET/CT for detecting the metastatic lesions, especially for detecting the retroperitoneal lymph node and rectal metastases.
Synthesis of genetic association studies on autism spectrum disorders using a genetic model-free approach
Authors: Mpoulimari Ioanna , Zintzaras Elias
Published: March 2022

Background

Autism spectrum disorder (ASD) is a clinically and genetically heterogeneous group of neurodevelopmental disorders. Despite the extensive efforts of scientists, the etiology of ASD is far from completely elucidated. In an effort to enlighten the genetic architecture of ASDs, a meta-analysis of all available genetic association studies (GAS) was conducted.

Methods

We searched in the Human Genome Epidemiology Navigator (HuGE Navigator) and PubMed for available case–control GAS of ASDs. The threshold for meta-analysis was two studies per genetic variant. The association between genotype distribution and ASDs was examined using the generalized linear odds ratio (ORG). For variants with available allele frequencies, the examined model was the allele contrast.

Results

Overall, 57 candidate genes and 128 polymorphisms were investigated in 159 articles. In total 28 genetic polymorphisms have been shown to be associated with ASDs, that are harbored in 19 genes. Statistically significant results were revealed for the variants of the following genes adenosine deaminase (ADA), bone marrow stromal cell antigen-1 (CD157/BST1), Dopamine receptor D1 (DRD1), engrailed homolog 2 (EN2), met proto-oncogene (MET), methylenetetrahydrofolate reductase (MTHFR), solute carrier family 6 member 4 (SLC6A4), Synaptosomal-associated protein, 25kDa (SNAP-25) and vitamin D receptor (VDR). In the allele contrast model of cases versus healthy controls, significant associations were observed for Adrenoceptor Alpha 1B (ADRA1B), acetyl serotonin O - methyltransferase (ASMT), complement component 4B (C4B), dopamine receptor D3 (DRD3), met proto-oncogene (MET), neuroligin 4, X-linked (NLGN4), neurexin 1 (NRXN1), oxytocin receptor (OXTR), Serine/Threonine-Protein Kinase PFTAIRE-1 (PFTK1), Reelin (RELN) and Ras-like without CAAX 2 (RIT2).

Conclusion

These significant findings provide further evidence for genetic factors’ implication in ASDs offering new perspectives in means of prevention and prognosis.
Embedding entropy: a nonlinear measure of dynamical causality
Authors: Shi Jifan , Chen Luonan , Aihara Kazuyuki
Published: March 2022

Research on concepts and computational methods of causality has a long history, and there are various concepts of causality as well as corresponding computing algorithms based on measured data. Here, by considering causes and effects from a dynamical perspective, we present a unified mathematical framework for the so-called dynamical causality (DC), which can detect causal interactions over time; notably, this framework covers Granger causality, transfer entropy, embedding causality and their conditional versions. Based on this framework, we further propose a causality criterion called embedding entropy (EE) to measure the DC between two variables. Moreover, its conditional version, conditional embedding entropy (cEE), is also derived for detecting conditional/direct causality. The significant advantages of EE and cEE are that they can be employed for solving not only nonlinear causal inference but also the non-separability problem, and they can reduce the scale bias in numerical calculation. The performance and robustness of EE and cEE were demonstrated through numerical simulations, and causal inference on various real-world datasets validated their effectiveness.
What are the limits of universality?
Authors: Halberstam Noah , Hutchcroft Tom
Published: March 2022

It is a central prediction of renormalization group theory that the critical behaviours of many statistical mechanics models on Euclidean lattices depend only on the dimension and not on the specific choice of lattice. We investigate the extent to which this universality continues to hold beyond the Euclidean setting, taking as case studies Bernoulli bond percolation and lattice trees. We present strong numerical evidence that the critical exponents governing these models on transitive graphs of polynomial volume growth depend only on the volume-growth dimension of the graph and not on any other large-scale features of the geometry. For example, our results strongly suggest that percolation, which has upper-critical dimension 6, has the same critical exponents onZ4and the Heisenberg group despite the distinct large-scale geometries of these two lattices preventing the relevant percolation models from sharing a common scaling limit. On the other hand, we also show that no such universality should be expected to hold on fractals, even if one allows the exponents to depend on a large number of standard fractal dimensions. Indeed, we give natural examples of two fractals which share Hausdorff, spectral, topological and topological Hausdorff dimensions but exhibit distinct numerical values of the percolation Fisher exponentτ. This gives strong evidence against a conjecture of Balankinet al.(2018Phys. Lett. A382, 12–19 (doi:10.1016/j.physleta.2017.10.035)).
Waves in the Earth’s core. I. Mildly diffusive torsional oscillations
Authors: Luo Jiawen , Jackson Andrew
Published: March 2022

Axisymmetric oscillations of fluid in a rapidly rotating whole sphere immersed in a magnetic field can be supported by the elastic tension of the magnetic field lines. This special class of Alfvén waves is largely geostrophic (invariant along the rotation axis) and describes a set of normal modes that has been extensively studied in the ideal, lossless case, a limit in which regular solutions do not exist when the background magnetic field is axisymmetric. We study the geophysically relevant limit with parameters such that magnetic diffusion plays a realistic role appropriate to the Earth’s core, by choosing a Lundquist numberLuappropriately. We demonstrate for the first time the existence of normal modes in the presence of an axisymmetric background field, and obtain eigenfrequencies and decay rates that lead us to deduce quality factorsQfor these modes for two simple background fields of dipole and quadrupole parity. Two scaling behaviours ofQare seen depending on the background field and normal modes’ frequency, one scaling asLu1/2and another asLu, so that likelyQ>10in the core of the Earth. A one-dimensional theory is presented that is able to capture the frequencies of oscillation quite accurately.
Host preferences inhibit transmission from potential superspreader host species
Authors: Hopkins Skylar R. , McGregor Cari M. , Belden Lisa K. , Wojdak Jeremy M.
Published: March 2022

Host species that are particularly abundant, infectious and/or infected tend to contribute disproportionately to symbiont (parasite or mutualist) maintenance in multi-host systems. Therefore, in a facultative multi-host system where two host species had high densities, high symbiont infestation intensities and high infestation prevalence, we expected interspecific transmission rates to be high. Instead, we found that interspecific symbiont transmission rates to caged sentinel hosts were an order of magnitude lower than intraspecific transmission rates in the wild. Using laboratory experiments to decompose transmission rates, we found that opportunities for interspecific transmission were frequent, where interspecific and intraspecific contact rate functions were statistically indistinguishable. However, most interspecific contacts did not lead to transmission events owing to a previously unrecognized transmission barrier: strong host preferences. During laboratory choice experiments, the symbiont preferred staying on or dispersing to its current host species, even though the oligochaete symbiont is a globally distributed host generalist that can survive and reproduce on many snail host species. These surprising results suggest that when managing symbiont transmission, identifying key host species is still important, but it may be equally important to identify and manage transmission barriers that keep potential superspreader host species in check.
Neuron-specific transcriptomic signatures indicate neuroinflammation and altered neuronal activity in ASD temporal cortex
Authors: Zhang Pan , Omanska Alicja , Ander Bradley P. , Gandal Michael J. , Stamova Boryana , Schumann Cynthia M.
Published: March 2022

Autism spectrum disorder (ASD) is a highly heterogeneous disorder, yet transcriptomic profiling of bulk brain tissue has identified substantial convergence among dysregulated genes and pathways in ASD. However, this approach lacks cell-specific resolution. We performed comprehensive transcriptomic analyses on bulk tissue and laser-capture microdissected (LCM) neurons of 59 postmortem human brains (27 ASD and 32 matched controls) in the superior temporal gyrus (STG) ranging from 2-73 years of age. In bulk tissue, synaptic signaling, heat shock protein-related pathways and RNA splicing were significantly altered in ASD. There was age-dependent dysregulation of genes involved in GABA (GAD1 and GAD2) and glutamate (SLC38A1) signaling pathways. In LCM neurons, AP-1 mediated neuroinflammation and insulin/IGF-1 signaling pathways were upregulated in ASD, while mitochondrial function, ribosome and spliceosome components were downregulated. GABA synthesizing enzymes GAD1 and GAD2 were both downregulated in ASD neurons. Alterations in small nucleolar RNAs (snoRNAs) associated with splicing events suggested interplay between snoRNA dysregulation and splicing disruption in neurons of individuals with ASD. Our findings supported the fundamental hypothesis of altered neuronal communication in ASD, demonstrated that inflammation was elevated at least in part in ASD neurons, and may reveal windows of opportunity for biotherapeutics to target the trajectory of gene expression and clinical manifestation of ASD throughout the human lifespan.
A moderated-mediation model of individual learning and commitment: part I
Authors: Somaskandan Karthikeyan , Arulandu Savarimuthu , Parayitam Satyanarayana
Published: March 2022

Purpose

This study aims to develop a conceptual model linking the relationship between individual learning, organizational learning and organizational commitment. A multi-layered conceptual model involving three dimensions of organizational commitment: normative, affective and continuance, and individual and organizational learning is presented.

Design/methodology/approach

The two well-known theories – organizational learning theory and organizational commitment theory – have been combined to systematically explain the importance of the interaction of variables benefitting both individuals and organizations. As learning involves change, a climate of organizational learning would foster connectivity of structure, people and process. At the same time, when an individual expands his learning and gets necessary skills, it is more likely they get connected to the organization and increase their level of commitment. In this study, the authors develop a conceptual model, and the authors apply this to the health-care industry and provide the results in the second paper.

Findings

The authors postulate that (i) individual learning will be positively related to organizational learning and continuance commitment; (ii) organizational learning will be positively related to continuance commitment; and (iii) organizational learning mediates the relationship between individual learning and continuance commitment. Furthermore, they also postulate that (i) normative commitment and affective commitment moderate the relationship between organizational learning and continuance commitment; and (ii) three-way interaction between organizational learning, normative commitment and affective commitment will strengthen continuance commitment of employees.

Research limitations/implications

The conceptual model can be applied to organizations from any industry. In the second part, the authors would test the model to the health-care industry and provide the results.

Practical implications

This study contributes to both practicing managers and the literature on organizational learning and organizational commitment. The study suggests that managers in work organizations need to promote a climate for enhancing learning so that employees remain committed to completing their job and contributing to organizational effectiveness. The results of this study highlight the importance of all three dimensions of organizational commitment: affective, normative and continuance.

Originality/value

This study provides new insights in understanding complex interactions between three dimensions of commitment in contributing to organizational performance. To the best of the authors’ knowledge, the multilayered model showing three-way interactions between the three dimensions of organizational commitment is the first of its kind and is a novel idea.
Targeting mitochondrial proteases for therapy of acute myeloid leukaemia
Authors: Xiang Xinrong , Bao Rui , Wu Yu , Luo Youfu
Published: March 2022

Targeting cancer metabolism has emerged as an attractive approach to improve therapeutic regimens in acute myeloid leukaemia (AML). Mitochondrial proteases are closely related to cancer metabolism, but their biological functions have not been well characterized in AML. According to different categories, we comprehensively review the role of mitochondrial proteases in AML. This review highlights some ‘powerful’ mitochondrial protease targets, including their biological function, chemical modulators, and applicative prospect in AML.
Bronchial inflammation biomarker patterns link humoral immunodeficiency with bronchiectasis‐related small airway dysfunction
Authors: Zissler Ulrich M. , Thron Aljoscha , Eckrich Jonas , Bakhtiar Shahrzad , Schubert Ralf , Zielen Stefan
Published: March 2022

Background

The progression of chronic destructive lung disease in patients with humoral immunodeficiency (ID) and concomitant development of bronchiectasis is difficult to prevent. Lung function tests in these patients typically show bronchial obstruction of the small airways in combination with increased air trapping in the distal airways, which is consistent with small airway dysfunction.

Objective

The objective was to assess the grade of chronic lower airway inflammation and small airway dysfunction from induced sputum and the corresponding local pro‐inflammatory mediator pattern to discriminate patients affected by bronchiectasis‐related Small Airway Dysfunction (SAD).

Methods

In a prospective design, 22 patients with ID (14 CVID, 3 XLA, 3 hyper‐IgM syndrome, 1 hyper‐IgE syndrome and low IgG levels due to treatment with rituximab and 1 SCID after BMT and persistent humoral defect) and 21 healthy controls were examined. Lung function, Fraction Expiratory Nitric Oxide (FeNO) and pro‐inflammatory cytokine levels were compared in subsets of patients with (ID + BE) and without bronchiectasis (ID) pre‐stratified using high‐resolution computed tomography (HRCT) scans and control subjects.

Results

Analysis of induced sputum showed significantly increased total cell counts and severe neutrophilic inflammation in ID. The concomitant SAD revealed higher total cell numbers compared to ID. Bronchial inflammation in ID is clearly mirrored by pro‐inflammatory mediators IL‐1β, IL‐6 and CXCL‐8, whilst TNF‐α revealed a correlation with lung function parameters altered in the context of bronchiectasis‐related Small Airway Dysfunction.

Conclusions

In spite of immunoglobulin substitution, bronchial inflammation was dominated by neutrophils and was highly increased in patients with ID + BE. Notably, the pro‐inflammatory cytokines in patients with ID were significantly increased in induced sputum. The context‐dependent cytokine pattern in relation to the presence of concomitant bronchiectasis associated with SAD in ID patients could be helpful in delimiting ID patient subgroups and individualizing therapeutic approaches.
‘You need to understand the extent of the bubble we grew up in’: The religio‐cultural aspects of sibling's sexual dynamics—Perspectives of Orthodox Jewish adults
Authors: Marmor Amitai , Gemara Netanel , Lusky‐Weisrose Efrat , Tener Dafna
Published: March 2022

The term ‘sibling sexual dynamics’ (SSD) describes (in this study) a continuum of childhood sexual behaviours that are inconsistent with age‐appropriate curiosity and can include abuse (SSA). The present qualitative study, based on 20 semi‐structured interviews, conducts an analysis via constructivist grounded theory on the perspectives of adults who, as children in the Orthodox Jewish community, experienced sexual interactions with one or more of their siblings. Ultimately, the goal is to deepen the understanding of the religio‐cultural aspects of SSD in this cultural context. The findings reveal three main themes: (1) taboos, both those relating to intrafamilial sexual encounters and the religious taboo around sexuality in general; (2) family hierarchic dynamics, including gender‐based hierarchies; and (3) religious prohibition, a concept that the participants perceive as influencing their modes of thought and logic. The study highlights the need for practitioners to attend to the double ambiguity arising from the sibling and religious contexts. Additionally, we suggest that distinguishing between religious and interpretative socio‐cultural factors may provide practitioners with a path to create a dialogue with clients, individuals and religious leaders within the community around issues that may constitute risk for sibling sexual acts and abuse.
Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID‐19: A systematic review and meta‐analysis
Authors: Kim Do Hyun , Kim Sung Won , Kang Minju , Hwang Se Hwan
Published: March 2022

Objectives

The aim of this study was to assess the effect of topical steroids on acute‐onset olfactory dysfunction in patients infected with COVID‐19.

Design and Setting

Systematic review and meta‐analysis of cohort studies.

Participants

Patients infected with COVID‐19.

Main outcome measures

PubMed, Embase, the Web of Science, SCOPUS, Cochrane database and Google Scholar were searched for articles up to September 2021. We analysed studies comparing the improvement of olfactory dysfunction between topical steroid treatment and control groups (placebo or no treatment). In addition, we performed a subgroup analysis by study type.

Results

The improvement of olfactory score at 2 (standardised mean difference [SMD] = 0.7272, 95% confidence interval = [0.3851, 1.0692], p < .0001, I2 = 62.1%) and 4 weeks post‐treatment (SMD = 1.0440 [0.6777, 1.4102], p < .0001, I2 = 61.2%) was statistically greater in the treatment than control group. However, there was no significant difference (odds ratio [OR] = 1.4345 [0.9525, 2.1604], p = .0842, I2 = 45.4%) in the incidence of fully recovery from anosmia/hyposmia between the treatment and control groups. In subgroup analysis, there were no significant differences in the improvement of olfactory score at 4 weeks post‐treatment (OR = 0.6177 [0.1309, 1.1045] vs. 0.1720 [0.8002, 1.5438], p = .0761) or the incidence of full recovery from anosmia/hyposmia (OR = 1.8478 [0.6092, 5.6053] vs. 1.3784 [0.8872, 2.1414], p = .8038) between randomised and non‐randomised controlled trials.

Conclusions

Although this meta‐analysis found that topical steroids improved the acute‐onset olfactory dysfunction caused by COVID‐19, there was no difference in the rate of full olfactory recovery between treated and control patients.
Is elevation a strong environmental filter? Combining taxonomy, functional traits and phylogeny of butterflies in a tropical mountain
Authors: Henriques Nathália Ribeiro , Lourenço Giselle Martins , Diniz Écio Souza , Cornelissen Tatiana
Published: March 2022

Environmental filters select species that tolerate and respond to habitat conditions similarly. By combining taxonomy, functional traits and phylogeny, we aimed to understand the spatial distribution of a tropical butterfly community, evaluating whether elevation acts as an environmental filter strong enough to select flight‐related traits.

Frugivorous and nectarivorous butterflies were sampled with nets at seven altitudinal bands (800–1400 m) in four sampling periods. We tested seven flight‐related traits (wing length, width, and area; thorax volume; wing:thorax ratio [WTR]length, WTRwidthand WTRarea) and incorporated the effects of phylogeny in the relationships among these traits and with elevation.

Butterfly diversity decreased with increased elevation, and four traits exhibited larger values at higher elevations: wing length, width, area and WTRarea.This suggests that butterflies tended to have smaller wings and robust bodies at lower elevations, and larger wings with slender bodies at higher elevations, possibly related to flight speed or wind conditions. Although the phylogenetic relatedness did not exert significant weight in the traits and elevation, we found indication of phylogenetic conservatism of wing area and WTR.

Butterflies in mountains experience a strong selection by several environmental filters related to flight performance, and our study demonstrated a robust relationship between elevation, flight‐related traits and species distribution. These relationships occurred regardless of phylogenetic relatedness, but most traits are conserved and exhibit resemblance in the phylogenetic lineages of these species. These findings suggest an influence of a widespread filter promoted by the elevational gradient with convergent trait evolution.
Adapting a conceptual framework to engage diverse stakeholders in genomic/precision medicine research
Authors: Watson Karriem S. , Cohn Elizabeth G. , Fair Alecia , Menon Usha , Szalacha Laura A. , Carpenter Selena M. , Wilkins Consuelo H.
Published: March 2022

Introduction

Genomic/precision medicine offers a remarkable opportunity to improve health and address health disparities. Genomic medicine is the study of genes and their interaction with health. Precision medicine is an approach to disease prevention and treatment that considers individual variability in genes, environment and lifestyle. Conclusions from studies lacking diversity may hinder generalizability as genomic variation occurs within and between populations. Historical factors, such as medical mistrust, ethical issues related to decision making, and data sharing pose complex challenges that may further widen inequities in genomic/precision medicine if not appropriately addressed. Although few biomedical studies integrate priorities of community partners into their conceptual framework, effective implementation of genomic/precision medicine research calls for the involvement of diverse stakeholders to expand traditional unidirectional models of engagement in clinical research towards authentic bidirectional collaboration.

Methods

A multipronged approach was used integrating an evidence‐based literature review and best practices in developing and evaluating the engagement of diverse stakeholders in genomic and precision medicine research. This was combined with expert consensus building to adapt a conceptual model from a community engagement framework to addressing genomics to be scalable to engagement science, which is challenging to genomic/precision medicine research.

Results

The final enhanced conceptual framework is composed of four overarching dimensions now inclusive of domains in trust, exploitation, discrimination, privacy risk, stigmatization, prior harms/injustices, failure to recognize coexisting governments, intersectionality and research transformation. This conceptual framework proposes effective participant research engagement strategies for upstream relationship building, distinct from downstream recruitment strategies in which the goal is enrolment.

Conclusion

To further shape the evolution of genomic/precision medicine research, it is important to leverage existing partnerships, engage participants beyond recruitment and embrace diverse perspectives.

Patient or Public Contribution

In preparation of this manuscript, the perspectives of the community partners on the impact of engaging in genomic/precision medicine research beyond research participation were integrated into this conceptual framework from various guided listening sessions held in diverse communities.
Triplet pregnancy with hydatidiform mole: A report of two cases with literature review
Authors: Sheng Qing‐Jing , Wang Yu‐Mei , Wang Bei‐Ying , Shuai Wen , He Xiao‐Ying
Published: March 2022

Aim

We present two cases of triplet pregnancy with complete hydatidiform mole (CHM) in contrasting outcomes and discuss the complications of mothers and outcomes of fetuses through a literature review, raising an important issue on the management of this special pregnancy.

Methods

We share our manage experience for two cases of triplet pregnancy with CHM and retrospectively analyze 18 similar pregnancies reported previously with different pregnancy outcomes.

Results

In our cases, one case receiving Clomiphene ovulation induction delivered two live fetuses by cesarean section at 30+ weeks without GTN (gestational trophoblastic neoplasia), unfortunately, the other case following ICSI‐ET terminated the pregnancy in the setting of complications at 18+ weeks without GTN. No severe complications were detected during pregnancy and no pGTD was developed after delivery in neither of the pregnant.

Conclusions

Co‐existing complete hydatidiform mole in multiple pregnancies may become more common owing to the spreading use of ART. The decision for whether continue pregnancy depending on the personalized conditions including the complications of the pregnancy, the outcomes of the fetuses, the gestational age for delivery, and the potential progression of persistent gestational trophoblastic disease (pGTD). Furthermore, close monitor is necessary for the pregnant with triplet pregnancy with CHM who want to continue pregnancy.
Dry heating, moist heating, and microwave irradiation of cold‐climate‐adapted barley grain—Effects on ruminant‐relevant carbohydrate and molecular structural spectral profiles
Authors: Feng Xin , Prates Luciana L. , Rodríguez Espinosa María E. , Peng Quanhui , Zhang Huihua , Zhang Weixian , Yu Peiqiang
Published: March 2022

Different feed processing techniques affect barley digestibility and nutrient utilization in ruminants. To our knowledge, there are few studies on the interactive relationship between carbohydrate molecular structure profiles of cool‐season‐adapted barley grain and nutritional characteristics for ruminants. The objectives of this study were: (1) to investigate the effect of different technological processing methods on carbohydrate chemical profiles, Cornell Net Carbohydrate and Protein System—carbohydrate subfractions, ruminal and intestinal carbohydrate digestion of barley grain in dairy cows; (2) to study the effect of heat processing on carbohydrate molecular structure of barley grain using advanced molecular spectroscopy; and (3) to associate processing‐induced changes in carbohydrate molecular structure with changes in carbohydrate metabolic profiles in dairy cows. Barley grain samples collected from Crop Research Field in Western Canada underwent four different processing treatments: control, dry heating (120°C for 60 min in an air‐ventilated oven), moist heating (120°C for 60 min in an autoclave), and microwave irradiation (900 W and 2450 MHz for 5 min in a microwave). The heating conditions used in the current study induced some changes in rumen‐degradable and ‐undegradable digestible fibre (CB3) fraction. Intestinally digestible CB3 was decreased after moist heating. Moist heating decreased starch digestibility compared to the other three treatments. The processing‐induced carbohydrate molecular structure changes, which was revealed by advanced vibrational molecular spectroscopic technique (attenuated total reflectance‐Fourier transform infrared), could be used to predict carbohydrate nutritional value.
Health‐care resource use and costs associated with diabetic and idiopathic gastroparesis: A claims analysis of the first 3 years following the diagnosis of gastroparesis
Authors: Chen Yaozhu J. , Tang Wenxi , Ionescu‐Ittu Raluca , Ayyagari Rajeev , Wu Eric , Huh Susanna Y. , Parkman Henry P.
Published: March 2022

Background

Due to limited treatment options, many patients with diabetic gastroparesis (DG) or idiopathic gastroparesis (IG) experience inadequate symptom control resulting in increased health‐care resource utilization (HRU) and associated costs. We compared all‐cause HRU and health‐care costs over the 3 years after patients’ first gastroparesis diagnosis with that of matched controls without gastroparesis.

Methods

Newly diagnosed adults with DG or IG were identified in Optum's de‐identified Clinformatics® Data Mart Database (Q1‐2007 to Q1‐2019). Patients with DG/IG were matched 1:1 to controls using a mixed approach of exact matching and propensity score matching. The index date was the first gastroparesis diagnosis for cases or randomly selected for controls. All‐cause HRU and direct health‐care costs per person‐year (PPY) were compared between DG/IG cases and controls in Years 1–3 post‐index.

Key Results

Demographics and comorbidities were balanced between patients with gastroparesis (n = 18,015 [DG]; n = 14,305 [IG]) and controls. In each of the Years 1–3 post‐index, patients with DG or IG had significantly higher annual HRU and costs versus controls (mean total cost differences PPY: DG Year 1 $34,885, Year 2 $28,071, Year 3 $25,606; IG Year 1 $23,176, Year 2 $16,627, Year 3 $14,396) (all p < 0.05). Across all 3 years, DG/IG cohorts had approximately twice the costs of controls. HRU and costs were highest in Year 1 post‐index for both DG and IG.

Conclusions & Inferences

The economic burden of gastroparesis remains high several years after diagnosis, emphasizing the need for chronic treatment to effectively manage symptoms and consequently reduce the burden of this disorder.
Feasibility and safety of left atrial posterior wall isolation with a new Cryoballoon technology in patients with persistent atrial fibrillation
Authors: Bisignani Antonio , Pannone Luigi , Miraglia Vincenzo , Sieira Juan , Iacopino Saverio , Bala Gezim , Ströker Erwin , Overeinder Ingrid , Almorad Alexandre , Gauthey Anaïs , Monaco Cinzia , Paparella Gaetano , Osório Thiago Guimarães , Sorgente Antonio , Jordaens Luc , Brugada Pedro , Chierchia Gian‐Battista , Asmundis Carlo de
Published: March 2022

Background

Left atrial posterior wall isolation (LAPWI) is often performed in addition to pulmonary vein isolation (PVI) in the setting of persistent atrial fibrillation (AF) ablation.

The aim of this study was to evaluate the feasibility and safety of a new cryoballoon ablation system in achieving PVI + LAPWI isolation.

Methods

The study was a prospective, non‐randomized, single center study. Forty consecutive patients, undergoing PVI + LAPWI with the novel POLARx™, were compared to 40 consecutive patients who underwent the same procedure with the established Arctic Front Advance PRO™.

Results

Acute isolation was achieved in all PVs in both groups and left posterior wall isolation (LAPWI) was achieved in 38 patients (95%) in the POLARx group and in 36 patients (90%) in Arctic Front group. Procedural outcomes were similar between both groups, except for lower temperatures during cryoenergy in the POLARx group, for both pulmonary vein isolation (PVI) and LAPWI.

Conclusion

LAPWI + PVI with the novel POLARx™ Cryoballoon is feasible and safe; the results are comparable with the Arctic Front Advance PRO™ system.
Overthrow the Orthodoxy! Replies to Hill, Titus, and Sosa
Authors: Gupta Anil
Published: March 2022

I respond to three sets of questions and objections to the account of empirical reason I offer in my book Conscious Experience: A Logical Inquiry. (i) In response to doubts expressed by Christopher Hill, I outline the case against Simple Representationalism, the view that experience confers an epistemic status on certain perceptual judgments and that it does so in virtue of its content. (ii) In response to objections of Lisa Titus (née Miracchi) and Hill, I show that the account is not too liberal in its attributions of rationality to transitions, beliefs, and views. (iii) In response to questions raised by David Sosa, I explain why qualities do not constitute appearances and why the account offered of hallucinations is not overly restrictive.
Three‐dimensional imaging of intramural perineural invasion in colorectal cancer: Three‐dimensional reconstruction approach with multiple immunohistochemically stained sections
Authors: Miyashita Yu , Ikeda Tetsuo , Shinto Eiji , Okano Shinji , Korehisa Shotaro , Shimazaki Hideyuki , Oki Eiji , Ueno Hideki , Oda Yoshinao , Mori Masaki
Published: March 2022

Perineural invasion (PNI) at Auerbach's plexus in colorectal cancer (CRC), known as intramural PNI, is associated with adverse prognostic outcomes. This study aimed to characterize the three‐dimensional (3D) architecture of CRC with intramural PNI and to evaluate the morphological features of tumor invasion around nerve tissue. Serial tissue sections from two cases of CRC were stained with cytokeratin AE1/AE3 and an anti‐S‐100 protein antibody. 3D models were reconstructed by scanning the virtual slides. In one case, intramural PNI was observed at the horizontal invasive front. The 3D reconstruction model showed tumor cells that appeared to infiltrate along the nervous meshwork, the structure of which was preserved. In the other case, intramural PNI was observed both at and behind the horizontal invasive front, and the 3D reconstruction model showed that the tumor cells appeared to be involved with nerve cells at the focal part of the horizontal invasive front. However, the nervous meshwork structure was not well identified in cancer‐involved areas. This is the first study to characterize the 3D structure of tumor invasion around nerve tissue in CRC, demonstrating the morphological features of intramural PNI in CRC.
Elucidating the role of network topology dynamics on the coil-stretch transition hysteresis in extensional flow of entangled polymer melts
Authors: Boudaghi Mahdi , Nafar Seddashti M. Hadi , Edwards Brian J. , Khomami Bamin
Published: March 2022

Dissipative particle dynamics (DPD) simulations are performed on coarse-grained replicas of linear, monodisperse entangled polyethylene melts C1000H2002 and C3000H6002 undergoing both steady-state and transient planar elongational flow (PEF). The fidelity of the DPD simulations is verified by direct comparison of flow topological and rheological properties of a 334-particle chain liquid against the united-atom C1000H2002 liquid, simulated using nonequilibrium molecular dynamics (NEMD). These DPD simulations demonstrate that a flow-induced coil-stretch transition (CST) and its associated hysteresis caused by configurational microphase separation, as observed in previous NEMD simulations of PEF, can be replicated using a more computationally efficient coarse-grained system. Results indicate that the breadth of the CST hysteresis loop is enlarged for the longer molecule liquid relative to the shorter one. Furthermore, relaxation simulations reveal that reducing the applied flow Deborah number (De) from a high value corresponding to a homogeneous phase of highly stretched molecules to a De within the biphasic region results in a two-stage relaxation process. There is a fast initial stratification of the kinetically trapped highly stretched chains into regions of highly extended and less extended chains, which displays similar behavior to a system undergoing a spinodal decomposition caused by spatial configurational free energy fluctuations. After a short induction period of apparently random duration, the less extended chain regions experience a stochastic nucleation event that induces configurational relaxation to domains composed of coiled molecules over a much longer time scale, leaving the more highly extended chains in surrounding sheetlike domains. The time scales of these two relaxation processes are of the same order of magnitude as the Rouse and disengagement times of the equilibrium liquids.
In Vivo Knee Kinematics in Patients With Arthrofibrosis After Anterior Cruciate Ligament Reconstruction
Authors: Zhang Ling , Wang Cong , Tsai Tsung-Yuan , Wang Shao-bai , Fan Shuai , Cai Bin
Published: March 2022

Context: Arthrofibrosis after anterior cruciate ligament (ACL) reconstruction can be detrimental to the knee joint function and patient outcomes. However, the effects of arthrofibrosis on the in vivo tibiofemoral and patellofemoral joint kinematics after ACL reconstruction remain unclear. Objective: The objective of this study was to quantify the in vivo knee kinematics during a dynamic lunge task in the knee with arthrofibrosis after ACL reconstruction. Methods: Eleven patients with arthrofibrosis in one knee after ACL reconstruction participated in this study. Computed tomography and dual fluoroscopic imaging were used to evaluate in vivo kinematics of affected and contralateral knees during a lunge task. Differences in 6 degrees of freedom tibiofemoral kinematics and patellar tracking between limbs were assessed via repeated-measures analysis of variance. Results: Internal tibial rotation (5.2° vs 7.5°, respectively; P < .001) and inferior patellar shift (24.6 mm vs 28.9 mm, respectively; P < .001) were significantly lower in the arthrofibrotic knee compared with the contralateral knee from 15° to 75° of knee flexion. The patella in the arthrofibrotic knee significantly less flexed by 9.1° (P = .009) throughout the measured ROM and less laterally tilted by 3° (P = .017) compared with the contralateral knee from 30° to 75° of knee flexion. Conclusions: A significant superior shift and medial tilt of the patella were found in the affected knee compared with those in the contralateral knee during the dynamic lunge. Decreased internal tibial rotation and patellar flexion were found in knees with arthrofibrosis following ACL reconstruction; whether these kinematic changes are caused by arthrofibrosis need further investigation.