bluuebunny/crossref_metadata_2025 huggingface dataset:
The Twin Peaks of the Export Intensity Distribution
Authors: Defever Fabrice , Riaño Alejandro
Published: February 2022

Received wisdom suggests that most exporters sell most of their output domestically. We show, however, that the distribution of export intensity varies substantially across countries and is often bimodal, displaying “twin peaks”—that is, large shares of both low- and high-intensity exporters coexisting alongside each other within a country. We reconcile this new stylized fact with an otherwise standard model of trade in which firms face firm-destination-specific revenue shifters that follow a lognormal distribution with sufficiently high dispersion. We structurally estimate the model and show that differences in countries’ size relative to the rest of the world can account for most of the observed cross-country variation in the distribution of export intensity in our data. While policies that incentivize firms to export a high share of their output account for a substantial share of the variation in the dispersion of firm-destination revenue shifters, they cannot fully account for the widespread prevalence of twin peaks around the world.
The predictive value of self-reported allergies for reoperation after index hip arthroscopy
Authors: Srikumar Syian , Feingold Jacob D , Swartwout Erica L , Roberts Sacha A , Ranawat Anil S
Published: February 2022

The purpose of this study is to compare the rate of reoperation after index hip arthroscopy for symptomatic femoroacetabular impingement in patients with, and without, at least one self-reported allergy. Data were collected prospectively in 1468 patients whose records were retrospectively reviewed. After the application of inclusion and exclusion criteria, two cohorts were formed: (i) a study cohort (n = 261) composed of patients with a self-reported allergy and (ii) a control cohort. (n = 666). The allergy cohort had a significantly larger [P < 0.001] reoperation rate (24.1% [63/261]) compared to the control cohort (9.6% [64/66]). Univariate analysis (UVA) and multivariate analysis (MVA) were then performed to better understand the implications of allergy status on the arthroscopic outcome. On UVA the presence of an allergy increased the odds of reoperation after index hip arthroscopy by 2.99 [OR (95% CI): 2.99 (2.04, 4.39); P < 0.001] and for each additional allergy a patient reported, their odds of subsequent surgery increased by 1.27 per allergy [OR (95% CI): 1.27 (1.15, 1.39); P < 0.001]. However, on the MVA, allergy status was not an independent risk factor for reoperation. These findings suggest that allergy status is associated with a higher reoperation rate, however, allergy status alone cannot prognosticate the risk of subsequent surgery. Therefore, allergy status and its association with future surgery after hip arthroscopy should be considered in the context of multiple patient-specific factors that influence the surgical outcome. An understanding of this association enables patient-centered care and will strengthen the physician–patient relationship.
Factors associated with overall survival after recurrence in patients with ER-positive/HER2-negative postmenopausal breast cancer: an ad hoc analysis of the JBCRG-C06 Safari study
Authors: Kawaguchi Hidetoshi , Yamamoto Yutaka , Saji Shigehira , Masuda Norikazu , Nakayama Takahiro , Aogi Kenjiro , Anan Keisei , Ito Yoshinori , Ohtani Shoichiro , Sato Nobuaki , Takano Toshimi , Tokunaga Eriko , Nakamura Seigo , Hasegawa Yoshie , Hattori Masaya , Fujisawa Tomomi , Morita Satoshi , Yamaguchi Miki , Yamashita Hiroko , Yamashita Toshinari , Yotsumoto Daisuke , Toi Masakazu , Ohno Shinji
Published: February 2022

Background

The Safari study (UMIN000015168) was a retrospective, multicenter study in which 1072 consecutive cases of estrogen receptor-positive advanced breast cancer treated using 500 mg fulvestrant were registered. We previously reported the relationship between the patient factors and overall survival after the diagnosis using the same cases and the same factors for the analysis of time to treatment failure in patients with estrogen receptor-positive advanced breast cancer. The current study is an ad hoc analysis that focused on the relationship between the patient factors and overall survival after recurrence by adding factors generally associated with overall survival after recurrence.

Methods

The overall survival after recurrence in patients with estrogen receptor-positive human epidermal growth factor receptor 2 negative recurrent breast cancer was analyzed via univariate and multivariate analyses with a Cox proportional hazards model.

Results

A total of 598 cases were used for the analysis of overall survival after recurrence. Multivariate analysis revealed that favorable overall survival (median, 6.4 years) was significantly correlated with long time from recurrence to fulvestrant use (≥3 years), low nuclear or histological grade (G3 vs. G1), long time to treatment failure of initial palliative endocrine therapy (≥12 months) and long time to initial palliative chemotherapy (≥2 years).

Conclusion

The results of this study indicate that sequential endocrine monotherapy may be a useful treatment option for patients with estrogen receptor-positive/human epidermal growth factor receptor 2 negative recurrent breast cancer who have been successfully treated with initial long-term palliative endocrine therapy.
Novel and Broadly Applicable Microsatellite Markers in Identified Chromosomes of the Philippine Dengue Mosquitoes, Aedes aegypti (Diptera: Culicidae)
Authors: Labiros Dinesse A , Catalig Antonio Mari P , Ymbong Rhoniel Ryan J , Sakuntabhai Anavaj , Lluisma Arturo O , Edillo Frances E
Published: February 2022

Dengue is the leading arboviral infection in the Philippines. Its endemicity in the country is due to the presence of its primary mosquito vector, Aedes aegypti (L.). This species has limited microsatellite markers. This study characterized microsatellite markers screened in silico from intergenic regions of the updated reference genome of Ae. aegypti from Liverpool, U.K. Criteria for good markers are: polymorphic, inherited in a Mendelian codominant manner, no null alleles, selectively neutral, randomly associated, and broadly applicable across different regions. Genotypes were scored using ABI Peak Scanner and were screened for the presence of null alleles. Hardy-Weinberg equilibrium, linkage disequilibrium, and robustness of the markers were determined by GENEPOP using Ae. aegypti samples from selected highland and lowland sites (n = 30 each) in the Philippines and outgroups (Thailand and Vietnam). Mendelian codominant inheritance was examined using F1 offspring of Ae. aegypti family (n = 30 each) derived from samples collected from Cebu city highlands and Maramag, Bukidnon. From the 63 randomly selected markers, nine were polymorphic. Two markers (Aaeg1-3D of chromosome 1 and Aaeg3-4C of chromosome 3) satisfied all criteria, hence, are good broadly useful microsatellite markers. Two other markers (Aaeg2-2E of chromosome 2 and Aaeg3-2A of chromosome 3) met all criteria but deviated from Mendelian codominant inheritance. These new markers of the Philippine Ae. aegypti with their chromosomal locations relative to the other published markers are presented, and will ultimately be useful in a variety of population genetic studies of Ae. aegypti to protect the public health.
Modeling Geographic Uncertainty in Current and Future Habitat for Potential Populations of Ixodes pacificus (Acari: Ixodidae) in Alaska
Authors: Witmer Frank D W , Nawrocki Timm W , Hahn Micah
Published: February 2022

Ixodes pacificus Cooley & Kohls is the primary vector of Lyme disease spirochetes to humans in the western United States. Although not native to Alaska, this tick species has recently been found on domestic animals in the state. Ixodes pacificus has a known native range within the western contiguous United States and southwest Canada; therefore, it is not clear if introduced individuals can successfully survive and reproduce in the high-latitude climate of Alaska. To identify areas of suitable habitat within Alaska for I. pacificus, we used model parameters from two existing sets of ensemble habitat distribution models calibrated in the contiguous United States. To match the model input covariates, we calculated climatic and land cover covariates for the present (1980–2014) and future (2070–2100) climatologies in Alaska. The present-day habitat suitability maps suggest that the climate and land cover in Southeast Alaska and portions of Southcentral Alaska could support the establishment of I. pacificus populations. Future forecasts suggest an increase in suitable habitat with considerable uncertainty for many areas of the state. Repeated introductions of this non-native tick to Alaska increase the likelihood that resident populations could become established.
The Fauna, Diversity, and Bionomics of Culicinae (Diptera: Culicidae) in Hormozgan Province, Southern Iran
Authors: Jaberhashemi Seyed-Aghil , Azari-Hamidian Shahyad , Soltani Aboozar , Azizi Kourosh , Dorzaban Hedayat , Norouzi Mojtaba , Daghighi Elaheh
Published: February 2022

Hormozgan Province is one of the important foci of malaria in Iran. In addition to malaria pathogens, mosquitoes also transmit the pathogens that cause dirofilariasis and West Nile fever in the province. Also, the threat of emerging aedine-borne viruses that cause infections, such as Chikungunya, dengue, and Zika, is noticeable. There is little information about the fauna and bionomics of Culicinae in the province. The present investigation aimed to study the fauna, diversity, and bionomics of culicines. The study was conducted from September 2016 to April 2017 in four counties of Bandar Abbas, Bandar Khamir, Bashagard, and Jask. In total, 3,236 larvae and 1,901 adults including 16 culicine species were collected. The larvae of Culiseta longiareolata (Macquart) (25.65%), Culex pipiens Linnaeus (16.62%), and Cx. quinquefasciatus Say (16.16%) were most abundant and Cx. hortensis Ficalbi (0.09%) was least abundant. Among adults, Cx. laticinctus Edwards (33.19%), Cx. quinquefasciatus (31.09%), and Cx. pipiens (11.99%) were the most prevalent species and Cs. longiareolata (0.47%), Aedes caballus (Theobald) (0.90%), and Cx. bitaeniorhynchus Giles (0.90%) were the least prevalent species. The pairwise similarities of fauna of the counties and different collecting methods and diversity indices were investigated. More ecological data, especially on host preference, seasonality, and larval habitat characteristics, are needed as a basic knowledge for any intervention measures using integrated vector management.
3D reconstructed brain images reveal the possibility of the ogg1 gene to suppress the irradiation-induced apoptosis in embryonic brain in medaka (Oryzias latipes)
Authors: Yasuda Takako , Li Duolin , Sha Erge , Kakimoto Fumitaka , Mitani Hiroshi , Yamamoto Hiroshi , Ishikawa-Fujiwara Tomoko , Todo Takeshi , Oda Shoji
Published: February 2022

The accumulation of oxidative DNA lesions in neurons is associated with neurodegenerative disorders and diseases. Ogg1 (8-oxoG DNA glycosylase-1) is a primary repair enzyme to excise 7,8-dihydro-8-oxoguanine (8-oxoG), the most frequent mutagenic base lesion produced by oxidative DNA damage. We have developed ogg1-deficient medaka by screening with a high resolution melting (HRM) assay in Targeting-Induced Local Lesions In Genomes (TILLING) library. In this study, we identified that ogg1-deficient embryos have smaller brains than wild-type during the period of embryogenesis and larvae under normal conditions. To reveal the function of ogg1 when brain injury occurs during embryogenesis, we examined the induction of apoptosis in brains after exposure to gamma-rays with 10 Gy (137Cs, 7.3 Gy/min.) at 24 h post-irradiation both in wild-type and ogg1-deficient embryos. By acridine orange (AO) assay, clustered apoptosis in irradiated ogg1-deficient embryonic brains were distributed in a similar manner to those of irradiated wild-type embryos. To evaluate possible differences of gamma-ray induced apoptosis in both types of embryonic brains, we constructed 3D images of the whole brain based on serial histological sections. This analysis identified that the clustered apoptotic volume was about 3 times higher in brain of irradiated ogg1-deficient embryos (n = 3) compared to wild-type embryos (n = 3) (P = 0.04), suggesting that irradiation-induced apoptosis in medaka embryonic brain can be suppressed in the presence of functional ogg1. Collectively, reconstruction of 3D images can be a powerful approach to reveal slight differences in apoptosis induction post-irradiation.
Consistency Between Thyrotropin Receptor Antibody (TRAb) and Thyroid-Stimulating Antibody (TSAb) Levels in Patients with Graves Disease
Authors: Huang Youyuan , Jin Bo , Huang Yucheng , Dong Aimei
Published: February 2022

Objective

To investigate the consistency between thyrotropin receptor antibody (TRAb) and thyroid-stimulating antibody (TSAb) levels in patients with Graves disease (GD).

Methods

We performed a cross-sectional observational study to recruit eligible patients with GD who visited the outpatient endocrinology clinic for the purpose of evaluating the consistency between their TRAb and TSAb levels. Our cohort included 28 men and 99 women.

Results

The median levels of TRAb and TSAb were 5.65 IU/L and 3.76 IU/L, respectively, in the enrolled patients with GD. The levels of TRAb (5.03 vs 8.42 IU/L; P = .008) and TSAb (2.69 vs 5.37 IU/L; P = .008) in patients with adequate thyroid regulation were all lower than those in patients with inadequate thyroid regulation.

Conclusions

Although TRAb is closely related to TSAb, we observed high heterogeneity of TRAb due to relatively low consistency between the levels of the 2 antibodies.
Direct visualization of pre-protamine 2 detects protamine assembly failures and predicts ICSI success
Authors: Rezaei-Gazik Maryam , Vargas Alexandra , Amiri-Yekta Amir , Vitte Anne-Laure , Akbari Arvand , Barral Sophie , Esmaeili Vahid , Chuffart Florent , Sadighi-Gilani Mohammad Ali , Couté Yohann , Eftekhari-Yazdi Poopak , Khochbin Saadi , Rousseaux Sophie , Totonchi Mehdi
Published: February 2022

Histone-to-protamine transition is an essential step in the generation of fully functional spermatozoa in various mammalian species. In human and mouse, one of the two protamine-encoding genes produces a precursor pre-protamine 2 (pre-PRM2) protein, which is then processed and assembled. Here, we design an original approach based on the generation of pre-PRM2-specific antibodies to visualize the unprocessed pre-PRM2 by microscopy, flow cytometry and immunoblotting. Using mouse models with characterized failures in histone-to-protamine replacement, we show that pre-PRM2 retention is tightly linked to impaired nucleosome disassembly. Additionally, in elongating/condensing spermatids, we observe that pre-PRM2 and transition protein are co-expressed spatiotemporally, and their physical interaction suggests that these proteins act simultaneously rather than successively during histone replacement. By using our anti-human pre-PRM2 antibody, we also measured pre-PRM2 retention rates in the spermatozoa from 49 men of a series of infertile couples undergoing ICSI, which shed new light on the debated relation between pre-PRM2 retention and sperm parameters. Finally, by monitoring 2-pronuclei embryo formation following ICSI, we evaluated the fertilization ability of the sperm in these 49 patients. Our results suggest that the extent of pre-PRM2 retention in sperm, rather than pre-PRM2 accumulation per se, is associated with fertilization failure. Hence, anti-pre-PRM2 antibodies are valuable tools that could be used in routine monitoring of sperm parameters in fertility clinics, as well as in experimental research programmes to better understand the obscure process of histone-to-protamine transition.
Calcific tendinitis of the shoulder induced by an mRNA vaccine for COVID-19: A case report
Authors: Nakajima Koji , Miyata Akira , Kato So , Oshima Yasushi , Tanaka Sakae
Published: February 2022

Coronavirus disease 2019 (COVID-19) vaccines have been widely used and have been shown to be effective in combating the pandemic. However, various side effects have been reported following vaccination. For instance, a condition called ‘shoulder injury related to vaccine administration’ (SIRVA) is characterized by shoulder pain and limited range of motion after intramuscular injection of a vaccine into the deltoid muscle of the shoulder. Despite an increase in SIRVA cases, the exact incidence of the disease is unclear, and there are a few reports of SIRVA about the COVID-19 vaccine. Here, we report a rare case of an 83-year-old woman who was diagnosed with calcification in her left shoulder 1 year ago and developed calcific tendinitis after receiving an mRNA vaccine for COVID-19 (Pfizer-BioNTech). Radiographs showed calcification of the supraspinatus tendon, and magnetic resonance images showed continuous inflammatory findings from the subdeltoid bursa to the subacromial bursa. We treated the patient with celecoxib and acetaminophen, and she recovered after about 2 months. In order to prevent SIRVA, the presence of shoulder joint disease should be carefully asked during a pre-vaccination assessment. The puncture point should be chosen with the median point of the deltoid muscle or the anterior–posterior axillary line as landmarks because the more cephalad the puncture position, the greater the chance of causing SIRVA.
Tobacco Couponing: A Systematic Review of Exposures and Effects on Tobacco Initiation and Cessation
Authors: Liber Alex C , Sánchez-Romero Luz María , Cadham Christopher J , Yuan Zhe , Li Yameng , Oh Hayoung , Cook Steven , Warner Kenneth E , Henriksen Lisa , Mistry Ritesh , Meza Rafael , Fleischer Nancy L , Levy David T
Published: February 2022

Introduction

Tobacco couponing continues to be part of contemporary tobacco marketing in the United States. We performed a systematic review of the evidence of tobacco product coupon receipt and redemption to inform regulation.

Aims and Methods

We searched EMBASE OVID and Medline databases for observational (cross-sectional and longitudinal) studies that examined the prevalence of tobacco coupon receipt and coupon redemption across different subpopulations, as well as studies of the association between coupon receipt and redemption with tobacco initiation and cessation at follow-up. We extracted unadjusted and adjusted odds ratios for the associations between coupon exposure (receipt, redemption) and tobacco use outcomes (initiation, cessation) and assessed each studies’ potential risk of bias.

Results

Twenty-seven studies met the criteria for inclusion. Of 60 observations extracted, 37 measured coupon receipt, nine measured coupon redemption, eight assessed tobacco use initiation, and six assessed cessation. Tobacco product coupon receipt and redemption tended to be more prevalent among younger adults, women, lower education individuals, members of sexual and gender minorities, and more frequent tobacco users. Coupon receipt at baseline was associated with greater initiation. Coupon receipt and redemption at baseline were associated with lower cessation at follow-up among tobacco users. Results in high-quality studies did not generally differ from all studies.

Conclusions

Tobacco product coupon receipt and redemption are often more prevalent among price-sensitive subpopulations. Most concerning, our results suggest coupon receipt may be associated with higher tobacco initiation and lower tobacco cessation. Couponing thereby increases the toll of tobacco use and could prove to be a viable public health policy intervention point.

Implications

A systematic review was conducted of the scientific literature about the receipt, redemption, and effects on tobacco initiation and cessation of tobacco product couponing. This review found that tobacco coupons are more often received by price-sensitive persons and these coupons serve to increase tobacco initiation and decrease tobacco cessation. Policy efforts to address these consequences may help curb tobacco’s harms and address health inequities.
Predictors of Treatment Success After Periprosthetic Joint Infection: 24-Month Follow up From a Multicenter Prospective Observational Cohort Study of 653 Patients
Authors: Davis Joshua S , Metcalf Sarah , Clark Benjamin , Robinson J Owen , Huggan Paul , Luey Chris , McBride Stephen , Aboltins Craig , Nelson Renjy , Campbell David , Solomon L Bogdan , Schneider Kellie , Loewenthal Mark R , Yates Piers , Athan Eugene , Cooper Darcie , Rad Babak , Allworth Tony , Reid Alistair , Read Kerry , Leung Peter , Sud Archana , Nagendra Vana , Chean Roy , Lemoh Chris , Mutalima Nora , Tran Ton , Grimwade Kate , Sehu Marjoree , Looke David , Torda Adrienne , Aung Thi , Graves Steven , Paterson David L , Manning Laurens
Published: February 2022

Background

Periprosthetic joint infection (PJI) is a devastating condition and there is a lack of evidence to guide its management. We hypothesized that treatment success is independently associated with modifiable variables in surgical and antibiotic management.

Methods

The is a prospective, observational study at 27 hospitals across Australia and New Zealand. Newly diagnosed large joint PJIs were eligible. Data were collected at baseline and at 3, 12, and 24 months. The main outcome measures at 24 months were clinical cure (defined as all of the following: alive, absence of clinical or microbiological evidence of infection, and not requiring ongoing antibiotic therapy) and treatment success (clinical cure plus index prosthesis still in place).

Results

Twenty-four-month outcome data were available for 653 patients. Overall, 449 patients (69%) experienced clinical cure and 350 (54%) had treatment success. The most common treatment strategy was debridement and implant retention (DAIR), with success rates highest in early postimplant infections (119 of 160, 74%) and lower in late acute (132 of 267, 49%) and chronic (63 of 142, 44%) infections. Selected comorbidities, knee joint, and Staphylococcus aureus infections were independently associated with treatment failure, but antibiotic choice and duration (including rifampicin use) and extent of debridement were not.

Conclusions

Treatment success in PJI is associated with (1) selecting the appropriate treatment strategy and (2) nonmodifiable patient and infection factors. Interdisciplinary decision making that matches an individual patient to an appropriate management strategy is a critical step for PJI management. Randomized controlled trials are needed to determine the role of rifampicin in patients managed with DAIR and the optimal surgical strategy for late-acute PJI.
Controlling trapping, overgrazing and invasive vegetation is key to saving Java’s last population of the Black-winged Myna
Authors: Squires Thomas M , Collar Nigel J , Devenish Christian , Owen Andrew , Pratiwi Arif , Winarni Nurul L , Marsden Stuart J
Published: February 2022

The Black-winged Myna (Acridotheres melanopterus) is an Endangered passerine endemic to the islands of Java and Bali, Indonesia. Illegal trapping to supply the cage-bird trade has led to its near-total extinction, with the global population estimated to number fewer than 100 individuals. We estimated the current range and population size of the species at Baluran National Park, which supports Java’s last known population, and used species distribution modeling to evaluate potential suitability of currently unoccupied areas across the park to identify priorities for management intervention. We estimate that the Black-winged Myna population numbers 179 individuals (95% CI: 111–288; density: 14.3 ± 3.5 individuals km–2) and that its current range is 12.3 km2. Our model indicated that some 72 km2 of the park (30% of total area) has potentially suitable habitat for the species, and we infer that the principal cause for the disparity between its current and potential range is trapping, compounded by savanna loss and degradation due to illegal domestic cattle grazing and the spread of invasive thorny acacia (Vachellia nilotica). The partial clearance of acacia in recent years appears to have assisted a modest population recovery by the myna. Its further population growth and range expansion in Baluran will depend on effective management of illegal poaching, further clearance of acacia, and easing domestic cattle grazing pressure on areas of savanna, particularly through engagement with communities living inside the park. Any actions that increase the size of the Black-winged Myna population are likely to benefit other threatened savanna-dependent wildlife in the park, notably banteng (Bos javanicus) and Green Peafowl (Pavo muticus). While our models and recommendations may be applicable to other protected areas in Java, and indeed other threatened myna species, trapping and habitat change may have site-specific dimensions, especially outside of protected areas, and thus demand local bespoke solutions.
Photosystem I light-harvesting proteins regulate photosynthetic electron transfer and hydrogen production
Authors: Ho Thi Thu Hoai , Schwier Chris , Elman Tamar , Fleuter Vera , Zinzius Karen , Scholz Martin , Yacoby Iftach , Buchert Felix , Hippler Michael
Published: February 2022

Linear electron flow (LEF) and cyclic electron flow (CEF) compete for light-driven electrons transferred from the acceptor side of photosystem I (PSI). Under anoxic conditions, such highly reducing electrons also could be used for hydrogen (H2) production via electron transfer between ferredoxin and hydrogenase in the green alga Chlamydomonas reinhardtii. Partitioning between LEF and CEF is regulated through PROTON-GRADIENT REGULATION5 (PGR5). There is evidence that partitioning of electrons also could be mediated via PSI remodeling processes. This plasticity is linked to the dynamics of PSI-associated light-harvesting proteins (LHCAs) LHCA2 and LHCA9. These two unique light-harvesting proteins are distinct from all other LHCAs because they are loosely bound at the PSAL pole. Here, we investigated photosynthetic electron transfer and H2 production in single, double, and triple mutants deficient in PGR5, LHCA2, and LHCA9. Our data indicate that lhca2 and lhca9 mutants are efficient in photosynthetic electron transfer, that LHCA2 impacts the pgr5 phenotype, and that pgr5/lhca2 is a potent H2 photo-producer. In addition, pgr5/lhca2 and pgr5/lhca9 mutants displayed substantially different H2 photo-production kinetics. This indicates that the absence of LHCA2 or LHCA9 impacts H2 photo-production independently, despite both being attached at the PSAL pole, pointing to distinct regulatory capacities.
Order Flows and Financial Investor Impacts in Commodity Futures Markets
Authors: Ready Mark J , Ready Robert C
Published: February 2022

Using intraday data, we document statistically strong, but temporary, impacts of commodity index trade flows on commodity futures prices. We also examine the previously documented positive returns around the issuance of commodity-linked notes and find that these returns are an order of magnitude too large to be caused by the small trades necessary to hedge the notes. We provide new evidence that they are instead the result of endogenous issuance. Our results provide novel support for commodity financialization but highlight the importance of measuring the magnitude of financial investment, since even large financial flows have economically modest impacts on prices.
A multicentric validation study of a novel home sleep apnea test based on peripheral arterial tonometry
Authors: Van Pee Bart , Massie Frederik , Vits Steven , Dreesen Pauline , Klerkx Susie , Bijwadia Jagdeep , Verbraecken Johan , Bergmann Jeroen
Published: February 2022

Study Objectives

This paper reports on the multicentric validation of a novel FDA-cleared home sleep apnea test based on peripheral arterial tonometry (PAT HSAT).

Methods

One hundred sixty-seven participants suspected of having obstructive sleep apnea (OSA) were included in a multicentric cohort. All patients underwent simultaneous polysomnography (PSG) and PAT HSAT, and all PSG data were independently double scored using both the recommended 1A rule for hypopnea, requiring a 3% desaturation or arousal (3% Rule), and the acceptable 1B rule for hypopnea, requiring a 4% desaturation (4% Rule). The double-scoring of PSG enabled a comparison of the agreement between PAT HSAT and PSG to the inter-rater agreement of PSG. Clinical endpoint parameters were selected to evaluate the device’s ability to determine the OSA severity category. Finally, a correction for near-boundary apnea–hypopnea index values was proposed to adequately handle the inter-rater variability of the PSG benchmark.

Results

For both the 3% and the 4% Rules, most endpoint parameters showed a close agreement with PSG. The 4-way OSA severity categorization accuracy of PAT HSAT was strong, but nevertheless lower than the inter-rater agreement of PSG (70% vs 77% for the 3% Rule and 78% vs 81% for the 4% Rule).

Conclusions

This paper reported on a multitude of robust endpoint parameters, in particular OSA severity categorization accuracies, while also benchmarking clinical performances against double-scored PSG. This study demonstrated strong agreement of PAT HSAT with PSG. The results of this study also suggest that different brands of PAT HSAT may have distinct clinical performance characteristics.
Preventing postpartum insomnia by targeting maternal versus infant sleep: a protocol for a randomized controlled trial (the Study for Mother-Infant Sleep “SMILE”)
Authors: Quin Nina , Tikotzky Liat , Stafford Lesley , Fisher Jane , Bei Bei
Published: February 2022

Symptoms of insomnia are common during the perinatal periods and are linked to adverse parent/infant outcomes. Theories on insomnia development (e.g. 3P model) suggest that significant sleep disruption (e.g. nighttime infant care) can precipitate, while unhelpful sleep-related cognitions/behaviors can perpetuate parental insomnia symptoms. This study aims to examine how two interventions, one addressing infant sleep as the precipitator, the other targeting maternal sleep-related cognitions/behaviors as the perpetuator, might prevent postpartum insomnia. Participants are 114 nulliparous females 26 to 32 weeks gestation, with self-reported insomnia symptoms (Insomnia Severity Index scores ≥ 8). Participants are randomized to one of three conditions and receive: (1) a “responsive bassinet” used until 6 months postpartum, designed to boost/consolidate infant sleep and target infant sleep as a precipitator of insomnia, (2) therapist-assisted cognitive behavioral therapy for insomnia, addressing unhelpful sleep-related cognitions/behaviors as perpetuators of insomnia, or (3) a sleep hygiene booklet (control condition). The primary outcome is maternal insomnia symptoms. Secondary outcomes include maternal sleep duration/quality, mental health (e.g. depression, anxiety), and wellbeing-related variables (e.g. sleep-related impairment). Outcomes are assessed using validated instruments at 26–32 and 35–36 weeks’ gestation, and 2, 6, and 12 months postpartum. This study adopts an early-intervention approach and longitudinally compares two distinct approaches to prevent postpartum insomnia in an at-risk population. If interventions are efficacious, findings will demonstrate how interventions targeting different mechanisms mitigate insomnia symptoms in perinatal populations. This will provide empirical evidence for future development of multi-component sleep intervention to improve mother-infant wellbeing.

Clinical Trial Registration: The Study for Mother-Infant Sleep (The SMILE Project): reducing postpartum insomnia using an infant sleep intervention and a maternal sleep intervention in first-time mothers. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377927, Australian New Zealand Clinical Trials Registry: ACTRN12619001166167.
Space–time risk cluster and time trends of congenital syphilis in Brazil: an ecological study
Authors: Dalazen Chaiane Emília , de Souza Albert Schiaveto , Ribeiro Caique Jordan Nunes , Marques dos Santos Marquiony , Probst Livia Fernandes , Theobald Melina Raquel , De-Carli Alessandro Diogo
Published: February 2022

Background

Congenital syphilis (CS) is a problem of great concern for public health, especially in Brazil. The aim of this study was to analyse the time trends and the space–time dynamics of morbidity and mortality from CS in Brazil.

Methods

An ecological and time series study, which included all cases and deaths from CS recorded in a national Brazilian database from 2013 to 2019 was performed. Time trends in CS incidence and mortality were assessed using segmented linear regression. Univariate global and local Moran indices and space–time scan statistics were used in the space and space–time analyses.

Results

A total of 183 171 cases and 2401 deaths from CS were recorded in Brazil, with the highest number of cases being observed in the Southeast Region (n=82 612 [45.1%]). Only 21.1% of pregnant mothers with syphilis received adequate treatment. There was an upward trend in CS rates among mothers ages 20–29 y (average annual percent change [AAPC] 1.4 [95% confidence interval {CI} 1.0 to 1.7]) and with <8 y of schooling (AAPC 6.6 [95% CI 5.3 to 7.9]). The primary space–time cluster involved 338 municipalities in the Southeast Region (relative risk 3.06, p<0.001) and occurred between 2017 and 2019.

Conclusions

To reduce the trends in CS rates, it is necessary to develop actions to improve the quality of prenatal care and expand early diagnosis and adequate treatment of syphilis in pregnant women and their sexual partners, especially in groups with upward trends (mothers ages 20–29 y and <8 y of schooling) and living in higher-risk regions (Southeast, North and Northeast).
Civil Resistance and Violence against the Movement
Authors: Chenoweth Erica
Published: February 2022

This chapter looks at myths and realities of civil resistance against brutal opponents. It
examines the ways in which civil resistance campaigns have succeeded in spite of episodes of
extreme brutality and the options available to movements fighting against racist regimes. It
explains why many people do not believe that civil resistance defeats a truly brutal opponent
and that only violence can overturn a tyrant who's willing to turn to mass slaughter,
imprisonment, torture, and other immoral and inhumane means to stay in power. The chapter argues
that where nonviolent civil resistance campaigns succeeded, it was only because the opponent was
not willing or able to use massive violence against them. That's a common argument about the
1989 Chinese student protests in Tiananmen Square, in which pro-democracy activists were
brutally crushed by the Chinese Army.
The History of Gender
Authors: Erickson-Schroth Laura , Davis Benjamin
Published: February 2022

This chapter traces the history of gender. Most people
believe that gender equality is a product of modern times and that the gap between the sexes has
decreased due to technology, advocacy, and contemporary social demands. People typically think
about early humans as hunter-gatherers and assume that because of the natural capacity for male
bodies to be physically stronger and more robust than female bodies, men were the ones primarily
responsible for the livelihood and sustainability of a group. As such, people have inferred that
men were likely leaders within groups and the ones with the most power; they assume that women’s
roles as gatherers were less critical than their male counterparts and thus less valued.
However, we are learning that gender roles in early human communities were probably far more
egalitarian than what we originally thought. This chapter also delves into evolutionary
psychology and distinguishes between patriarchy and matriarchy. It then looks at gender
diversity and provides a history of transgender people prior to and during colonization, as well
as after the founding of the United States. Finally, the chapter describes what trans activism
looks like in the 21st century.
Gender, Medicine, and Psychology
Authors: Erickson-Schroth Laura , Davis Benjamin
Published: February 2022

This chapter focuses on the medical and psychological
aspects of gender, beginning with a discussion on gender development. An unspoken assumption in
much of the gender development work to date is the alignment of bodily sex with gender identity.
Children who do not develop in accordance with societal expectations have historically been
pathologized as not having achieved a critical developmental milestone. Only recently has
transgender identity begun to be considered a valid developmental trajectory. Historically,
transgender children have presented with heightened levels of depression and anxiety, among
other signifiers of distress, including poor school performance and poor social integration.
However, recent studies have shown that transgender children match their cisgender peer groups
when raised in affirmed settings. The chapter then defines gender dysphoria, which is
characterized by significant distress or difficulty functioning related to an incongruence
between assigned sex and experienced gender identity. It also traces the history of treatment
for transgender people, including medical and surgical interventions. Finally, the chapter
considers the role gender has played over time in the diagnosis and treatment of mental health
concerns.
Contextualizing Gender
Authors: Erickson-Schroth Laura , Davis Benjamin
Published: February 2022

This chapter examines feminism and gender studies. It
begins by distinguishing the different “waves” of feminism. The first wave is usually described
as lasting from the Seneca Falls Convention in 1848 until women’s suffrage in 1920; the second,
as the 1960s and 1970s; and the third, as beginning in the 1980s or 1990s and lasting until
today. During the 1960s and 1970s, women achieved massive successes, including abortion rights
and sexual harassment laws. Support of transgender people improved with the arrival of third
wave feminism. The chapter then explains the concepts of intersectionality, misogyny, and toxic
masculinity. It also describes queer theory, trans studies, and transfeminism. From the time the
phrase “queer theory” was introduced in 1990, queer theorists have ventured into a diverse array
of subjects, including LGBTQ history, social construction of identities, and literary theory.
Like queer theory, trans studies emerged out of a recognized need for new voices within academic
worlds.
Identification and Mapping of bs8, a Novel Locus Conferring Resistance to Bacterial Spot Caused by Xanthomonas gardneri
Authors: Sharma Anuj , Minsavage Gerald V. , Gill Upinder S. , Hutton Samuel F. , Jones Jeffrey B.
Published: February 2022

Although cultivars possessing recessive resistance alleles provide effective control of bacterial spot of pepper (Capsicum annuum), the deployed resistance gene, bs5, is ineffective against Xanthomonas gardneri, one of the pathogenic species. Resistance against X. gardneri was identified in C. annuum accession PI 163192, and this study sought to characterize this novel resistance and to map the resistance gene(s) to the pepper genome. We crossed PI 163192 with the susceptible cultivar Early Calwonder (ECW) to develop resistant near-isogenic lines (NILs) of ECW, designated ECW80R. The novel resistance in ECW80R was determined to be quantitative, recessively inherited, and non-hypersensitive-response causing, and inhibits lesion expansion and chlorosis. Presence of the resistance in NILs decreased the in planta bacterial population by ninefold compared with ECW. Bulked segregant analysis of resistant and susceptible individuals from an F2 population using whole genome single nucleotide polymorphisms identified a major resistance locus within an approximate 6-Mbp interval on the subtelomeric region of chromosome 11. We developed markers spanning this region and used these to genotype backcross F2 populations, which further delimited the resistance locus within a 2.3-Mbp interval. The novel resistance locus has been designated bs8. ECW80R and the linked markers developed in this study should prove useful for breeders seeking to advance this resistance into commercially relevant germplasm and for pyramiding bs8 with other resistance alleles such as bs5 and bs6. The allele bs8 will help prolong the durability of bacterial spot resistance in pepper and improve resistance to multiple species of Xanthomonas.
Do Continuous Peripheral Nerve Blocks Decrease Home Opioid Use Following Anterior Cruciate Ligament Reconstruction in Children and Adolescents? The Envelope Please
Authors: Schlechter John A. , Gornick Bryn R. , Harrah Tanner , Sherman Benjamin
Published: February 2022

Background:

Levels of opioid misuse and addiction among children and adolescents have reached alarming proportions. Exposure to opioids after surgery for anterior cruciate ligament reconstruction (ACLR), which is commonly performed in young athletes, increases this risk. This study was designed to evaluate whether continuous peripheral nerve block (CPNB) with placement of an elastomeric reservoir ball, compared with single-shot peripheral nerve block (SPNB), would decrease the need for home opioid analgesia and improve pain control after ACLR in children and adolescents.

Methods:

Prospectively collected data from a consecutive cohort that underwent ACLR by a single surgeon were retrospectively reviewed. Patients who received ACLR with 72-hour CPNB were assigned to Group 1. Patients who received ACLR with SPNB were assigned to Group 2. Postoperative pain management included cryotherapy, oral acetaminophen, and ibuprofen. A prescription for 10 doses of hydrocodone/acetaminophen (5/325 mg) was provided in a sealed envelope with instructions that the prescription should only be used in the case of uncontrolled pain. Reports of no opioid use were corroborated by the unopened envelope and unfilled prescription.

Results:

One hundred and ninety-six patients were enrolled in the study (SPNB=114 patients, CPNB=82 patients). Average age was 15±1.5 years (115 female). A total of 138 patients (70%) did not need home opioid analgesia after surgery. Of the 58 patients (30%) that did there were 35 (30.7%) in the SPNB group and 23 (28.0%) in the CPNB group (P=0.659). There were no differences between groups in demographics, operative data, or visual analog scale scores on any postoperative day.

Conclusion:

The findings of this study demonstrate equivalent pain control and opioid consumption in children and adolescents undergoing ACLR treated with either a CPNB or a SPNB. At-home opioid analgesia use can be negated after ACLR in 70% of children and adolescents. For the patients in this study who required opioids, average use was only 2 pills of 5 mg hydrocodone/325 mg acetaminophen, with no child using more than 10 pills.

Level of Evidence:

Level II—therapeutic.
Factors Associated With Brain Tissue Oxygenation Changes After RBC Transfusion in Acute Brain Injury Patients
Authors: Gouvêa Bogossian Elisa , Rass Verena , Lindner Anna , Iaquaniello Carolina , Miroz John Paul , Cavalcante dos Santos Elaine , Njimi Hassane , Creteur Jacques , Oddo Mauro , Helbok Raimund , Taccone Fabio Silvio
Published: February 2022

OBJECTIVES:

Anemia is common after acute brain injury and can be associated with brain tissue hypoxia. RBC transfusion (RBCT) can improve brain oxygenation; however, predictors of such improvement remain unknown. We aimed to identify the factors associated with PbtO2 increase (greater than 20% from baseline value) after RBCT, using a generalized mixed model.

DESIGN:

This is a multicentric retrospective cohort study (2012–2020).

SETTING:

This study was conducted in three European ICUs of University Hospitals located in Belgium, Switzerland, and Austria.

PATIENTS:

All patients with acute brain injury who were monitored with brain tissue oxygenation (PbtO2) catheters and received at least one RBCT.

INTERVENTION:

Patients received at least one RBCT. PbtO2 was recorded before, 1 hour, and 2 hours after RBCT.

MEASUREMENTS AND MAIN RESULTS:

We included 69 patients receiving a total of 109 RBCTs after a median of 9 days (5–13 d) after injury. Baseline hemoglobin (Hb) and PbtO2 were 7.9 g/dL [7.3–8.7 g/dL] and 21 mm Hg (16–26 mm Hg), respectively; 2 hours after RBCT, the median absolute Hb and PbtO2 increases from baseline were 1.2 g/dL [0.8–1.8 g/dL] (p = 0.001) and 3 mm Hg (0–6 mm Hg) (p = 0.001). A 20% increase in PbtO2 after RBCT was observed in 45 transfusions (41%). High heart rate (HR) and low PbtO2 at baseline were independently associated with a 20% increase in PbtO2 after RBCT. Baseline PbtO2 had an area under receiver operator characteristic of 0.73 (95% CI, 0.64–0.83) to predict PbtO2 increase; a PbtO2 of 20 mm Hg had a sensitivity of 58% and a specificity of 73% to predict PbtO2 increase after RBCT.

CONCLUSIONS:

Lower PbtO2 values and high HR at baseline could predict a significant increase in brain oxygenation after RBCT.
Relative Hypoglycemia and Lower Hemoglobin A1c-Adjusted Time in Band Are Strongly Associated With Increased Mortality in Critically Ill Patients
Authors: Krinsley James S. , Rule Peter R. , Roberts Gregory W. , Brownlee Michael , Preiser Jean-Charles , Chaudry Sherose , Dionne Krista D. , Heluey Camilla , Umpierrez Guillermo E. , Hirsch Irl B.
Published: February 2022

Objectives:

To determine the associations of relative hypoglycemia and hemoglobin A1c-adjusted time in blood glucose (BG) band (HA-TIB) with mortality in critically ill patients.

Design:

Retrospective cohort investigation.

Setting:

University-affiliated adult medical-surgical ICU.

Patients:

Three thousand six hundred fifty-five patients with at least four BG tests and hemoglobin A1c (HbA1c) level admitted between September 14, 2014, and November 30, 2019.

Interventions:

None.

Measurements and Main Results:

Patients were stratified for HbA1c bands of <6.5%; 6.5–7.9%; greater than or equal to 8.0% with optimal affiliated glucose target ranges of 70–140, 140–180, and 180–250 mg/dL, respectively. HA-TIB, a new glycemic metric, defined the HbA1c-adjusted time in band. Relative hypoglycemia was defined as BG 70–110 mg/dL for patients with HbA1c ≥ 8.0%. Further stratification included diabetes status-no diabetes (NO-DM, n = 2,616) and preadmission treatment with or without insulin (DM-INS, n = 352; DM-No-INS, n = 687, respectively). Severity-adjusted mortality was calculated as the observed:expected mortality ratio (O:EMR), using the Acute Physiology and Chronic Health Evaluation IV prediction of mortality. Among NO-DM, mortality and O:EMR, decreased with higher TIB 70–140 mg/dL (p < 0.0001) and were lowest with TIB 90–100%. O:EMR was lower for HA-TIB greater than or equal to 50% than less than 50% and among all DM-No-INS but for DM-INS only those with HbA1 greater than or equal to 8.0%.

Among all patients with hba1c greater than or equal to 8.0% And no bg less than 70 mg/dl, mortality was 18.0% For patients with relative hypoglycemia (bg, 70–110 mg/dl) (p < 0.0001) And was 0.0%, 12.9%, 13.0%, And 34.8% For patients with 0, 0.1–2.9, 3.0–11.9, And greater than or equal to 12.0 Hours of relative hypoglycemia (p < 0.0001).

Conclusions:

These findings have considerable bearing on interpretation of previous trials of intensive insulin therapy in the critically ill. Moreover, they suggest that BG values in the 70–110 range may be deleterious for patients with HbA1c greater than or equal to 8.0% and that the appropriate target for BG should be individualized to HbA1c levels. These conclusions need to be tested in randomized trials.