bluuebunny/crossref_metadata_2025 huggingface dataset:
Achievement of ESC/EAS LDL-C treatment goals after an acute coronary syndrome with statin and alirocumab
Authors: Landmesser Ulf , McGinniss Jennifer , Steg Ph Gabriel , Bhatt Deepak L , Bittner Vera A , Diaz Rafael , Dilic Mirza , Goodman Shaun G , Jukema J Wouter , Loy Megan , Pećin Ivan , Pordy Robert , Poulsen Steen H , Szarek Michael , White Harvey D , Schwartz Gregory G ,   for the ODYSSEY OUTCOMES Investigators
Published: June 2022

Aims

European guidelines set low-density lipoprotein cholesterol (LDL-C) treatment goals <1.4 mmol/L after acute coronary syndrome (ACS), and <1.0 mmol/L for patients with recurrent cardiovascular events ≤2 years. Many ACS patients do not achieve these goals on statin alone. We examined actual goal achievement with alirocumab and projected achievement with ezetimibe, either added to optimized statin therapy.

Methods and results

The ODYSSEY OUTCOMES trial (NCT01663402) compared alirocumab with placebo in 18 924 patients with recent ACS and hyperlipidaemia despite high-intensity or maximum-tolerated statin therapy. This subanalysis comprised 17 589 patients with LDL-C ≥1.4 mmol/L at baseline who did not receive ezetimibe treatment. High-intensity statin treatment was used in 88.8%. Median (interquartile range) baseline LDL-C was 2.3 (1.9−2.7) mmol/L. With alirocumab, 94.6% of patients achieved LDL-C <1.4 mmol/L at ≥1 post-baseline measurement vs. 17.3% with placebo. Among 2236 patients with a previous cardiovascular event within 2 years (before the qualifying ACS), 85.2% vs. 3.5%, respectively, achieved LDL-C <1.0 mmol/L. Among patients not treated with ezetimibe, we projected that its use would have achieved LDL-C <1.4 and <1.0 mmol/L in 10.6 and 0%, respectively, at baseline (assuming 18 ± 3% reduction of LDL-C).

Conclusion

Among patients with recent ACS and LDL-C ≥1.4 mmol/L despite optimized statin therapy, the addition of alirocumab allowed 94.6% to achieve the 2019 European guideline LDL-C goal <1.4 mmol/L, and 85.2% of those with recurrent cardiovascular events to achieve <1.0 mmol/L. In contrast, the addition of ezetimibe to optimized statin therapy was projected to achieve LDL-C <1.4 mmol/L in only 10.6% of patients at baseline.
Self-reported daytime napping, daytime sleepiness, and other sleep phenotypes in the development of cardiometabolic diseases: a Mendelian randomization study
Authors: Jia Yiming , Guo Daoxia , Sun Lulu , Shi Mengyao , Zhang Kaixin , Yang Pinni , Zang Yuhan , Wang Yu , Liu Fanghua , Zhang Yonghong , Zhu Zhengbao
Published: June 2022

Aims

Sleep disorders are associated with an increased risk of cardiometabolic diseases in observational studies, but the causality remains unclear. In this study, we leveraged two-sample Mendelian randomization (MR) analyses to assess the causal associations of self-reported daytime napping, daytime sleepiness, and other sleep phenotypes with cardiometabolic diseases including ischaemic stroke (IS), coronary artery disease (CAD), heart failure (HF), and Type 2 diabetes mellitus (T2DM).

Methods and results

We selected genetic variants as instrumental variables for self-reported daytime napping, daytime sleepiness, morning person, insomnia, short sleep duration, and long sleep duration from European-descent genome-wide association studies (GWASs). Summary statistics for cardiometabolic diseases originated from four different GWASs with a total of 2 500 086 participants. We used the inverse-variance weighted method to explore the role of self-reported sleep phenotypes on the aetiology of cardiometabolic diseases in the main analyses, followed by several sensitivity analyses for robustness validation. Genetically predicted self-reported daytime napping [T2DM: OR, 1.56 (95% confidence interval, 1.21–2.02)], insomnia [IS: OR, 1.07 (1.04–1.11)]; CAD: OR, 1.13 (1.08–1.17); HF: OR, 1.10 (1.07–1.14); T2DM: OR, 1.16 (1.11–1.22); and short sleep duration [CAD: OR, 1.37 (1.21–1.55)] were causally associated with an elevated risk of cardiometabolic diseases. Moreover, genetically determined self-reported daytime sleepiness [CAD: OR, 2.05 (1.18–3.57); HF: OR, 1.82 (1.15–2.87)] and morning person [HF: 1.06 OR, (1.01–1.11)] had potential detrimental effect on cardiometabolic risks.

Conclusion

Self-reported daytime napping, insomnia, and short sleep duration had causal roles in the development of cardiometabolic diseases, while self-reported daytime sleepiness and morning person was the potential risk factor for cardiometabolic diseases.
Evaluating Trade-Offs between Using Regional and Site-Specific Allometric Models to Predict Growing Stock Volume of Subtropical Atlantic Forests
Authors: Oliveira Laio Zimermann , Vibrans Alexander Christian
Published: June 2022

Choosing models to predict volume for individual trees is a relevant step in estimating growing stock volume. When large-area estimates are needed, models should ideally be constructed based on observations acquired across the population. However, due to multiple constraints, models are often constructed using samples collected at one or in a few sites. Therefore, this study aimed to evaluate trade-offs between using models based on a regional dataset (RD) and a model based on a local dataset (LD) and to assess the effects of such models on large-scale estimates of stem volume (V) per unit area. Regional and local V datasets and inventory data acquired throughout the subtropical Brazilian Atlantic Forest were employed. When used to predict V for trees of the RD (n = 1,192), the local model (LM), based on 419 tree observations, presented a mean systematic percentage error (MSPE) of +11%. In turn, when the regional model (RM) (n = 1,192) was used to predict V for trees of the LD (n = 419), it yielded an MSPE of –3%. The estimated mean V ha–1 using the LM was 9.4% greater than the estimated mean using the RM. Moreover, less precise estimates were attained using the LM.
Determination of mechanical properties of Zanthoxylum armatum using the discrete element method
Authors: Zhang Jian , Zhou Hong , Luo Fan , Wan Long , Li Chengsong , Wang Lihong
Published: June 2022

Using the discrete element method to investigate the behavior of particles is a crucial strategy in the research and development of novel equipment. Green pepper (Zanthoxylum armatum) is a globally renewable plant-derived medicinal and food homologous commodity with a wide range of uses and great demand, but the mechanical properties needed to develop its processing equipment are scarce. Thus, this case study aimed to systematically explore the necessary input parameters to model green pepper, and to provide new insights for the guidance of future industrial applications worldwide. On the basis of the experimental measured physical properties, the contact properties of green pepper on zinc-coated steel were first calibrated and then used to determine the contact properties between particles. The differences between the experimental and simulation results were analyzed for selection and verification of the contact properties accurately. Difference analysis confirmed that the coefficient of restitution, coefficient of static friction and coefficient of rolling friction for contact between the particle and zinc-coated steel have values of 0.392, 0.650, and 0.168, and those coefficients for particle-to-particle contact have values of 0.199, 0.710, and 0.184, respectively. Discoveries in this work may contribute to the research and development of production equipment for green pepper.
Temporal Analysis of Gene Expression and Isoform Switching in Brown Bears (Ursus arctos)
Authors: Perry Blair W , Armstrong Ellie E , Robbins Charles T , Jansen Heiko T , Kelley Joanna L
Published: June 2022

Hibernation in brown bears is an annual process involving multiple physiologically distinct seasons—hibernation, active, and hyperphagia. While recent studies have characterized broad patterns of differential gene regulation and isoform usage between hibernation and active seasons, patterns of gene and isoform expression during hyperphagia remain relatively poorly understood. The hyperphagia stage occurs between active and hibernation seasons and involves the accumulation of large fat reserves in preparation for hibernation. Here, we use time-series analyses of gene expression and isoform usage to interrogate transcriptomic regulation associated with all three seasons. We identify a large number of genes with significant differential isoform usage (DIU) across seasons and show that these patterns of isoform usage are largely tissue-specific. We also show that DIU and differential gene-level expression responses are generally non-overlapping, with only a small subset of multi-isoform genes showing evidence of both gene-level expression changes and changes in isoform usage across seasons. Additionally, we investigate nuanced regulation of candidate genes involved in the insulin signaling pathway and find evidence of hyperphagia-specific gene expression and isoform regulation that may enhance fat accumulation during hyperphagia. Our findings highlight the value of using temporal analyses of both gene- and isoform-level gene expression when interrogating complex physiological phenotypes and provide new insight into the mechanisms underlying seasonal changes in bear physiology.
Is shorter always better? The pros and cons of treating Gram-negative bloodstream infections with 7 days of antibiotics
Authors: Yahav Dafna , Paul Mical , Van Nieuwkoop Cees , Huttner Angela
Published: June 2022

Accumulating evidence from randomized controlled trials (RCTs) supports 7 days treatment for uncomplicated Gram-negative bacteraemia. However, some patient populations were not well represented in these RCTs, including critically ill patients, immunocompromised patients and those with MDR bacteria. In this debate document, we discuss the pros and cons for treating patients with Gram-negative bacteraemia with a 7 day antibiotic course. We surmise that the patients who were not well represented in the RCTs are probably those who have most to lose from the drawbacks of prolonged antibiotic courses, including adverse events, superinfections and resistance development. Treatment durations among these patients can be managed individually, with C-reactive protein or procalcitonin guidance or by clinical measures, and with care to discontinue antibiotics as soon as the patient recovers clinically from the infection.
Superinfections caused by carbapenem-resistant Enterobacterales in hospitalized patients with COVID-19: a multicentre observational study from Italy (CREVID Study)
Authors: Falcone Marco , Suardi Lorenzo Roberto , Tiseo Giusy , Galfo Valentina , Occhineri Sara , Verdenelli Stefano , Ceccarelli Giancarlo , Poli Melita , Merli Marco , Bavaro Davide , Carretta Anna , Nunnari Giuseppe , Venanzi Rullo Emmanuele , Trecarichi Enrico Maria , Papalini Chiara , Franco Antonina , Del Vecchio Rosa Fontana , Bianco Vincenzo , Punzi Rodolfo , Francisci Daniela , Rubino Raffaella , Torti Carlo , Puoti Massimo , Carbonara Sergio , Cascio Antonio , Saracino Annalisa , Santantonio Teresa , Venditti Mario , Menichetti Francesco
Published: June 2022

Objectives

To describe clinical characteristics and outcomes of COVID-19 patients who developed secondary infections due to carbapenem-resistant Enterobacterales (CRE).

Methods

Retrospective observational study including COVID-19 patients admitted to 12 Italian hospitals from March to December 2020 who developed a superinfection by CRE. Superinfection was defined as the occurrence of documented bacterial infection >48 h from admission. Patients with polymicrobial infections were excluded. Demographic, clinical characteristics and outcome were collected. Isolates were classified as KPC, metallo-β-lactamase (MBL) and OXA-48-producing CRE. A Cox regression analysis was performed to identify factors independently associated with 30 day mortality.

Results

Overall, 123 patients (median age 66 years, IQR 59–75) were included. The majority of infections occurred in the ICU (81, 65.9%), while 42 (34.1%) in medical wards. The most common types of infection were bloodstream infections (BSI) (n = 64, 52%), followed by urinary-tract infections (UTI) (n = 28, 22.8%), hospital-acquired/ventilator-associated pneumonia (HAP/VAP) (n = 28, 22.8%), intra-abdominal infections (n = 2, 1.6%) and skin infections (n = 1, 0.8%). Sixty-three (51.2%) infections were caused by KPC-, 54 (43.9%) by MBL-, and 6 (4.8%) by OXA-48-producing CRE. Thirty-day mortality was 33.3% (41/123). On Cox regression analysis, HAP/VAP compared with UTI (HR 7.23, 95% CI 2.09–24.97, P = 0.004), BSI compared with UTI (HR 3.96, 95% CI, 1.33–11.77, P = 0.004), lymphopenia on admission (HR 3, 95% CI 1.44–6.26, P = 0.003) and age (HR 1.05, 95% CI 1.02–1.08, P = 0.002) were predictors of 30 day mortality.

Conclusions

Superinfections by CRE were associated with high risk of 30 day mortality in patients with COVID-19. HAP/VAP was the strongest predictor of death in these patients.
Impact of housing environment and management on pre-/post-weaning piglet productivity
Authors: Ramirez Brett C , Hayes Morgan D , Condotta Isabella C F S , Leonard Suzanne M
Published: June 2022

The complex environment surrounding young pigs reared in intensive housing systems directly influences their productivity and livelihood. Much of the seminal literature utilized housing and husbandry practices that have since drastically evolved through advances in genetic potential, nutrition, health, and technology. This review focuses on the environmental interaction and responses of pigs during the first 8 wk of life, separated into pre-weaning (creep areas) and post-weaning (nursery or wean-finish) phases. Further, a perspective on instrumentation and precision technologies for animal-based (physiological and behavioral) and environmental measures documents current approaches and future possibilities. A warm microclimate for piglets during the early days of life, especially the first 12 h, is critical. While caretaker interventions can mitigate the extent of hypothermia, low birth weight remains a dominant risk factor for mortality. Post-weaning, the thermoregulation capabilities have improved, but subsequent transportation, nutritional, and social stressors enhance the requisite need for a warm, low draft environment with the proper flooring. A better understanding of the individual environmental factors that affect young pigs as well as the creation of comprehensive environment indices or improved, non-contact sensing technology is needed to better evaluate and manage piglet environments. Such enhanced understanding and evaluation of pig–environment interaction could lead to innovative environmental control and husbandry interventions to foster healthy and productive pigs.
Review: Physiology and nutrition of late gestating and transition sows
Authors: Theil Peter Kappel , Farmer Chantal , Feyera Takele
Published: June 2022

The physiology during late gestation and the transition period to lactation changes dramatically in the sow, especially during the latter period. Understanding the physiological processes and how they change dynamically as the sow approaches farrowing, nest building, giving birth to piglets, and producing colostrum is important because these processes greatly affect sow productivity. Glucose originating from assimilated starch accounts for the majority of dietary energy, and around farrowing, various organs and peripheral tissues compete for plasma glucose, which may become depleted. Indeed, physical activity increases shortly prior to farrowing, leading to glucose use by muscles. Approximately ½ to 1 d later, glucose is also needed for uterine contractions to expel the piglets and for the mammary gland to produce lactose and fat for colostrum. At farrowing, the sow appears to prioritize glucose to the mammary gland above the uterus, whereby insufficient dietary energy may compromise the farrowing process. At this time, energy metabolism in the uterus shifts dramatically from relying mainly on the oxidation of glucogenic energy substrates (primarily glucose) to ketogenic energy supplied from triglycerides. The rapid growth of mammary tissue occurs in the last third of gestation, and it accelerates as the sow approaches farrowing. In the last 1 to 2 wk prepartum, some fat may be produced in the mammary glands and stored to be secreted in either colostrum or transient milk. During the first 6 h after the onset of farrowing, the uptake of glucose and lactate by the mammary glands roughly doubles. Lactate is supplying approximately 15% of the glucogenic carbon taken up by the mammary glands and originates from the strong uterine contractions. Thereafter, the mammary uptake of glucose and lactate declines, which suggests that the amount of colostrum secreted starts to decrease at that time. Optimal nutrition of sows during late gestation and the transition period should focus on mammary development, farrowing performance, and colostrum production. The birth weight of piglets seems to be only slightly responsive to maternal nutrition in gilts; on the other hand, sows will counterbalance insufficient feed or nutrient intake by increasing mobilization of their body reserves. Ensuring sufficient energy to sows around farrowing is crucial and may be achieved via adequate feed supply, at least three daily meals, high dietary fiber content, and extra supplementation of energy.
Genetic aspects of piglet survival and related traits: a review
Authors: Knol Egbert F , van der Spek Dianne , Zak Louisa J
Published: June 2022

In livestock, mortality in general, and mortality of the young, is societal worries and is economically relevant for farm efficiency. Genetic change is cumulative; if it exists for survival of the young and genetic merit can be estimated with sufficient accuracy, it can help alleviate the pressure of mortality. Lack of survival is a moving target; livestock production is in continuous change and labor shortage is a given. There is now ample evidence of clear genetic variance and of models able to provide genomic predictions with enough accuracy for selection response. Underlying traits such as birth weight, uniformity in birth weight, gestation length, number of teats, and farrowing duration all show genetic variation and support selection for survival or, alternatively, be selected for on their own merit.
Functional Reconstruction for Severe Heat Press Injury of the Proper Digits Using Immediate Preserved Subdermal Vascular Network Skin Graft: A Case Report
Authors: Hihara Masakatsu , Kakudo Natsuko , Mitsui Toshihito , Kuro Atsuyuki , Kusumoto Kenji
Published: June 2022

The patient was a 57-year-old woman who suffered third-degree burns to the dorsal side of her left fingers (non-dominant hand) when it was caught in a press machine heated to 200°C while she was cleaning clothes. At 20 hours after the injury, the necrotic tissue was excised and covered with a preserved subdermal vascular network (PSVN) skin graft, which allowed the patient to regain a very good hand function. Even for severe heat press injuries of the hand, the combination of immediate surgical intervention, a thick skin graft with PSVN, and early rehabilitation from the first postoperative week leads to good functional and cosmetic reconstruction outcomes.
Exploring the Insecticidal Potential of Gaseous and Aqueous Ozone to Control Spotted-Wing Drosophila,Drosophila suzukii(Diptera: Drosophilidae)
Authors: Savage Benjamin A , Masten Susan , Chung Henry , Grieshop Matthew
Published: June 2022

Over the last decade, numerous companies have marketed aqueous ozone sprayers for insect and disease management, but little to no data has been published on their efficacy. Thus, we evaluated the potential of both gaseous and aqueous ozone as a potential preharvest insecticide against the adult life stage of the invasive fruit pest, spotted-wing drosophila, Drosophila suzukii (Matsumura). Gaseous ozone was applied at two dosages, 14,600 and 30,100 ppmv, for varying durations and the respective concentration-time (CT) exposure responses were modeled for sex-specific mortalities recorded at 0, 24, 48, and 72 h following treatment. We found that gaseous ozone primarily caused mortality immediately following exposure, with slight increases 72 h following ozone treatments. The female and male lethal concentration-time (LCT) 50 estimates were significantly different at 0, 24, 48, and 72 h after 30,100 ppmv treatments, where males observed an increased mortality response. However, the LCT 99 estimates confidence intervals (95%) of adult female and male D. suzukii were similar at 0, 24, 48, and 72 h after 14,600 or 30,100 ppmv ozone treatments. In contrast, ozone dissolved in distilled water at 18.52 ppm (mg/L) did not provide any mortality after total immersion of subjects for 30 s. While gaseous ozone may have some utility as a fumigant for D. suzukii in closed vessels where concentrations could be maintained, we did not identify any insecticidal potential for ozone dissolved in aqueous solution when simulating a preharvest treatment under optimal laboratory conditions.
A Near-Deterministic Mutational Hotspot in Pseudomonas fluorescens Is Constructed by Multiple Interacting Genomic Features
Authors: Shepherd M J , Horton J S , Taylor T B
Published: June 2022

Mutation—whilst stochastic—is frequently biased toward certain loci. When combined with selection, this results in highly repeatable and predictable evolutionary outcomes. Immotile variants of the bacterium Pseudomonas fluorescens (SBW25) possess a “mutational hotspot” that facilitates repeated occurrences of an identical de novo single nucleotide polymorphism when re-evolving motility, where ≥95% independent lines fix the mutation ntrB A289C. Identifying hotspots of similar potency in other genes and genomic backgrounds would prove valuable for predictive evolutionary models but to do so we must understand the genomic features that enable such a hotspot to form. Here, we reveal that genomic location, local nucleotide sequence, gene strandedness, and presence of mismatch repair proteins operate in combination to facilitate the formation of this mutational hotspot. Our study therefore provides a framework for utilizing genomic features to predict and identify hotspot positions capable of enforcing near-deterministic evolution.
The retrograde signaling regulator ANAC017 recruits the MKK9–MPK3/6, ethylene, and auxin signaling pathways to balance mitochondrial dysfunction with growth
Authors: He Cunman , Liew Lim Chee , Yin Lingling , Lewsey Mathew G , Whelan James , Berkowitz Oliver
Published: June 2022

In plant cells, mitochondria are ideally positioned to sense and balance changes in energy metabolism in response to changing environmental conditions. Retrograde signaling from mitochondria to the nucleus is crucial for adjusting the required transcriptional responses. We show that ANAC017, the master regulator of mitochondrial stress, directly recruits a signaling cascade involving the plant hormones ethylene and auxin as well as the MAP KINASE KINASE (MKK) 9–MAP KINASE (MPK) 3/6 pathway in Arabidopsis thaliana. Chromatin immunoprecipitation followed by sequencing and overexpression demonstrated that ANAC017 directly regulates several genes of the ethylene and auxin pathways, including MKK9, 1-AMINO-CYCLOPROPANE-1-CARBOXYLATE SYNTHASE 2, and YUCCA 5, in addition to genes encoding transcription factors regulating plant growth and stress responses such as BASIC REGION/LEUCINE ZIPPER MOTIF (bZIP) 60, bZIP53, ANAC081/ATAF2, and RADICAL-INDUCED CELL DEATH1. A time-resolved RNA-seq experiment established that ethylene signaling precedes the stimulation of auxin signaling in the mitochondrial stress response, with a large part of the transcriptional regulation dependent on ETHYLENE-INSENSITIVE 3. These results were confirmed by mutant analyses. Our findings identify the molecular components controlled by ANAC017, which integrates the primary stress responses to mitochondrial dysfunction with whole plant growth via the activation of regulatory and partly antagonistic feedback loops.
Perceptions and Experiences of Individuals With Neck Pain: A Systematic Critical Review of Qualitative Studies With Meta-Summary and Meta-Synthesis
Authors: Falsiroli Maistrello Luca , Zanconato Laura , Palese Alvisa , Geri Tommaso , Turolla Andrea , Gianola Silvia , Dell’Isola Andrea , Rossettini Giacomo
Published: June 2022

Objective

This study aimed at exploring the perspectives and experiences of individuals with neck pain by synthesizing all available qualitative studies.

Methods

A systematic, qualitative meta-summary and meta-synthesis was conducted following the 5-step methodology proposed by Sandelowski and Barroso. A systematic search of 9 electronic databases was conducted in May 2021. Methodological quality was assessed using the Critical Appraisal Skills Programme tool.

Results

Nine studies were included in the meta-synthesis for a total of 103 participants (73 women). Eleven categories were identified as belonging to 3 main themes: physical (“My neck has gone wrong”); psychological (“I am worried about my recovery”); and social (“Pain limits my life”). In the physical theme, the categories with the highest frequency were symptoms (67%) followed by body perception (44%). The psychological theme frequencies from highest to lowest were psychological consequences (100%), coping strategies (100%), mindset (67%), expectations from health care professionals (44%), and gender influence (22%). In the social theme, frequencies from highest to lowest were social relationships (56%), work, and activities of daily living and physical activity (44%, respectively).

Conclusion

An individual’s experience with neck pain is a multidimensional phenomenon in which physical, psychological, and social dimensions influence each other. These findings suggested that health care professionals should be aware of recognizing and evaluating all of the individual’s experiences to offer a truly patient-centered care pathway.

Impact

This qualitative meta-synthesis responded to a call to action to explore perspectives and experiences of individuals with neck pain. These findings can provide crucial guidance for clinicians as they plan and implement evidence-based recommendations for neck pain.
Plastid development of albino viviparous propagules in the woody mangrove species of Kandelia obovata
Authors: Hao Saiqi , Hu Wei , Ye Congting , Shen Yingjia , Li Qingshun Q
Published: June 2022

The process of plastids developing into chloroplasts is critical for plants to survive. However, this process in woody plants is less understood. Kandelia obovata Sheue, Liu & Yong is a viviparous mangrove species; the seeds germinate on the maternal tree, and the hypocotyls continue to develop into mature propagules. We identified rare albino propagules through field observation among normal green and brown ones. Toward unveiling the propagule plastid development mechanism, albino propagule leaves only have etioplasts, low photosynthesis rates, and drastically reduced chlorophyll a/b and carotenoid contents, but with increased superoxide dismutase activities. To identify candidate genes controlling propagule plastid development, a genome-wide association study (GWAS) was performed between the albino and green propagules. Twenty-five significant single nucleotide polymorphisms (SNPs) were associated with albino propagule plastid development, the most significant SNPs being located on chromosomes 1 and 5. Significant differentially expressed genes were identified in porphyrin and chlorophyll metabolisms, carotenoid and flavonoid biosynthesis by combining transcriptome and GWAS data. In particular, KoDELLAs, encoding a transcription factor and KoCHS, encoding chalcone synthase, may be essential to regulate the albino propagules plastid development through weakened chlorophyll and flavonoid biosynthesis pathways while promoting chlorophyll degradation. Our results provide insights into genetic mechanisms regulating propagule plastid development in woody plants.
Limited acclimation of leaf traits and leaf temperatures in a subtropical urban heat island
Authors: Kullberg Alyssa T , Feeley Kenneth J
Published: June 2022

The consequences of rising temperatures for trees will vary between species based on their abilities to acclimate their leaf thermoregulatory traits and photosynthetic thermal tolerances. We tested the hypotheses that adult trees in warmer growing conditions (i) acclimate their thermoregulatory traits to regulate leaf temperatures, (ii) acclimate their thermal tolerances such that tolerances are positively correlated with leaf temperature and (iii) that species with broader thermal niche breadths have greater acclimatory abilities. To test these hypotheses, we measured leaf traits and thermal tolerances of seven focal tree species across steep thermal gradients in Miami’s urban heat island. We found that some functional traits varied significantly across air temperatures within species. For example, leaf thickness increased with maximum air temperature in three species, and leaf mass per area and leaf reflectance both increased with air temperature in one species. Only one species was marginally more homeothermic than expected by chance due to acclimation of its thermoregulatory traits, but this acclimation was insufficient to offset elevated air temperatures. Thermal tolerances acclimated to higher maximum air temperatures in two species. As a result of limited acclimation, leaf thermal safety margins (TSMs) were narrower for trees in hotter areas. We found some support for our hypothesis that species with broader thermal niches are better at acclimating to maintain more stable TSMs across the temperature gradients. These findings suggest that trees have limited abilities to acclimate to high temperatures and that thermal niche specialists may be at a heightened risk of thermal stress as global temperatures continue to rise.
Low temperature and short daylength interact to affect the leaf senescence of two temperate tree species
Authors: Wang Huanjiong , Gao Chengxi , Ge Quansheng
Published: June 2022

Temperature and photoperiod are two major environmental cues shaping the leaf senescence of temperate tree species. However, how the control of leaf senescence is split between photoperiod and temperature is unknown for many ecologically important species. Here, we conducted a growth chamber experiment to test the effects of temperature (6, 9, 18 and 21°C) and photoperiod (8 and 16 h daylength) on leaf senescence of two temperate tree species (Quercus mongolica Fisch. and Larix principis-rupprechtii Mayr.) distributed in montane forest of China. The results showed that low temperature (LT) alone could induce leaf senescence of both species under long daylength (LD) conditions, but the leaf senescence of L. principis-rupprechtii was more sensitive to the decrease in temperature than that of Q. mongolica under the LD condition. Short daylength (SD) alone could only induce the leaf senescence of L. principis-rupprechtii, suggesting that the photoperiod sensitivity varies between species. SD could accelerate the LT-induced senescence, but the effect of SD reduced with the decrease in temperature. Based on these findings, we developed a new autumn phenology model by incorporating interspecific differences in the photoperiod sensitivity of leaf senescence. Compared with the three existing process-based autumn phenology models, the new model was more robust in simulating the experimental data. When employing these models to available long-term phenological data, our new model also performed best in reproducing the observed leaf senescence date of two closely related species (Quercus robur L. and Larix decidua Mill.). These results enhance our understanding of how LT and SD control leaf senescence. The prediction of the climate change impacts on forest carbon uptake could be improved by incorporating this new autumn phenological model into the terrestrial biosphere models.
Coexisting Iron Deficiency Anemia and Thalassemia Traits in Infants: Implication for an Anemia Screening Program
Authors: Boonrusmee Sasivara , Thongkhao Arunwan , Wongchanchailert Malai , Mo-Suwan Ladda , Sangsupawanich Pasuree
Published: June 2022

Objectives

To study the prevalence of anemia among healthy infants, and outcomes of giving a therapeutic trial of iron to anemic infants in thalassemia-endemic area.

Methods

A cross sectional study was conducted in 6–9-month-old, full-term healthy infants who attended the well child clinics at 2 tertiary care centers in southern Thailand. Complete blood count and serum ferritin were performed in every infant, and hemoglobin typing was performed only in anemic cases. All anemic infants were given a therapeutic trial of iron and categorized into either; iron responder (hemoglobin increased ≥ 1 g/dL) or iron non-responder (hemoglobin increased <1 g/dL) groups after one month of the therapeutic trial. Mean levels of hematological parameters, including the Mentzer index, were compared within the groups.

Results

A total of 620 infants were included in the study. From this, 230 infants (37%) were anemic for which iron deficiency contributed for 80% of the etiology. The iron responder group showed significant improvement in hematological parameters after a trial of iron, while there was no improvement in the iron non-responder group. Among iron responders, there were 31 out of 186 infants (16.6%) who had coexisting abnormal hemoglobin typing, and their post-treatment complete blood count still showed a mean corpuscular volume < 70, with a Mentzer index < 13.

Conclusion

Iron deficiency remains a major cause of anemia among infants, and a therapeutic trial of iron is beneficial in this age group, even though thalassemia trait/hemoglobinopathy can co-exist.
A Single Proximal Interlocking Bolt May Be Sufficient for Retrograde Nailing of Extra-articular Femur Fractures
Authors: Campbell Sean T. , Dhillon Ekamjeet , Sliepka Joseph , Higgins Alexander , DeBaun Malcolm R. , Goodnough Lawrence Henry , Agel Julie , Barei David P.
Published: June 2022

Objective:

To evaluate whether a single proximal interlocking bolt was sufficient during the treatment of extra-articular femur fractures with retrograde medullary nailing.

Design:

Retrospective comparative study.

Setting:

Academic Level 1 trauma center.

Patients:

The study included 136 patients with extra-articular femur fractures treated with retrograde medullary nailing who met inclusion and follow-up criteria.

Intervention:

The intervention included surgical treatment for a femur fracture with retrograde medullary nailing, with comparisons made between those treated with a single proximal interlocking (1 IL) bolt and those treated with 2 proximal interlocking bolts (2 IL).

Main Outcome Measurement:

The main outcome measurements were as follows: (1) rate of nonunion and (2) rate of catastrophic implant failure.

Results:

There was no difference in the rate of nonunion requiring surgical intervention between the 2 groups. There were no catastrophic failures in either group.

Conclusions:

A single proximal interlocking bolt may be sufficient when using retrograde nailing for the treatment of extra-articular femur fractures.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Degree of Postoperative Curve Correction Decreases Risks of Postoperative Pneumonia in Patients Undergoing Both Fusion and Growth-friendly Surgical Treatment of Neuromuscular Scoliosis
Authors: Levine Sonya B. , Fields Michael W. , Boby Afrain Z. , Matsumoto Hiroko , Skaggs Kira F. , Roye Benjamin D. , Vitale Michael G.
Published: June 2022

Introduction:

Due to a combination of poor respiratory muscle control and mechanical lung compression secondary to spine and chest wall deformities, patients with neuromuscular (NM) early-onset scoliosis (EOS) are at a high risk for pulmonary complications including pneumonia. The purpose of this study is to examine the effect of surgical intervention on the prevalence and risk of postoperative pneumonia in patients with NM EOS.

Methods:

In this retrospective cohort study, pediatric (18 y old and below) patients with NM EOS undergoing index fusion or growth-friendly instrumentation from 2000 to 2018 were identified. Patients were then categorized into 2 groups: those with ≥50% curve correction and those with <50% curve correction of the coronal deformity at the first postoperative visit. The primary outcome of interest was postoperative pneumonia occurring between 3 weeks and 2 years postoperatively. Manual chart review was supplemented with phone call surveys to ensure all occurrences of preoperative/postoperative pneumonia (ie, in-institution and out-of-institution visits) were accounted for.

Results:

A total of 35 patients (31% female, age at surgery: 10.3±4.3 y) with NM EOS met inclusion criteria. Twenty-three (66%) patients experienced at least 1 case of preoperative pneumonia. Twenty-six (74%) patients had ≥50% and 9 (26%) patients had <50% immediate postoperative curve correction. In total, 12 (34%) patients experienced at least 1 case of postoperative pneumonia (7 in-institution, 5 out-of-institution). Seven (27%) patients with ≥50% curve correction versus 5 (56%) with <50% curve correction experienced postoperative pneumonia. Relative risk regression demonstrated that patients with <50% curve correction had increased risk of postoperative pneumonia by 2.1 times compared with patients with ≥50% curve correction (95% confidence interval: 0.9; 4.9, P=0.099).

Conclusion:

The prevalence of preoperative and postoperative pneumonia is high in patients with NM EOS. This study presents preliminary evidence suggesting that percent curve correction is associated with the occurrence of postoperative pneumonia in patients with NM EOS undergoing surgical correction.
Benign Breast Disease
Authors: Pleasant Versha
Published: June 2022

Benign breast disease presents commonly in routine gynecologic care. Presenting symptoms such as breast mass, nipple discharge, or breast pain may raise concern for malignancy. Once breast cancer is ruled out, gynecologists must identify and appropriately treat benign breast disease. While most benign lesions can be managed conservatively, high-risk breast lesions can increase the future risk of breast cancer and may require additional screening imaging and surgical excision. Pharmacologic therapy may also have a role in certain conditions. Gynecologists should be proficient in the identification and management of benign breast disease.
Content validity of patient-reported outcome measures for patients with chronic pain: considering the patient's perspective
Authors: Hickey Michael , Barry Daniel , Redito John , Anand Natasha , Bianchi Nancy , Reneman Michiel , Escorpizo Reuben
Published: June 2022

Understanding chronic pain and disability requires a consideration of the lived experience of the patient. There is limited evaluation of the content validity of patient-reported outcome measures (PROMs) in chronic pain using a comprehensive biopsychosocial view of the patient's experience. To address this gap, this study aimed to evaluate the content validity of PROMs for patients with chronic pain. A literature review was performed to identify PROMs for patients with chronic pain. Concepts from PROMs were linked to the International Classification of Functioning, Disability, and Health (ICF); the ICF Core Set for Chronic Widespread Pain; and the International Classification of Diseases-11 Functioning Properties of Chronic Pain (FP). Concepts were compared with published “attributes'' of chronic pain. 62 PROMs (1336 items total) were identified and linked to 560 unique second-level ICF categories. The greatest number of items across PROMs were represented in the activities and participation category (44% of all total items), followed by body functions (41%), environmental factors (9%), personal factors (5%), and body structures (0.3%). There was a 41% to 78% match with the Core Set for Chronic Widespread Pain and the International Classification of Diseases-11 FP, respectively. 20% of items reflected the pain-experience attributes with the most items reflecting the concept of “control over pain.” Content validity analysis suggests chronic widespread pain patient-reported outcome measures poorly address attributes of living with chronic pain that matter most to patients. Future development or refinement should consider a more comprehensive view of the patients' lived experience.
Jean Riolan the Younger (1580 – 1657) and the Trepanation of the Mastoid Process: More Than a Suggestion?
Authors: Mudry Albert
Published: June 2022

Introduction

The Parisian anatomist Jean Riolan the Younger (1580 – 1657) is usually associated with the first proposal to surgically open the mastoid for certain ear pathologies with varying degrees of accuracy. The purpose of this historical research is to go back to the original texts and try to understand what probably prompted Riolan the Younger to suggest the surgical opening of the mastoid, thus paying him the correct tribute and restoring him to his rightful place in the history of mastoid surgery.

Methodology

Review of the published secondary literature on the history of the surgical opening of the mastoid, completed by a detailed study of most of the original works written by Riolan the Younger.

Results

The study of Riolan the Younger’s original texts shows that he suggested the perforation of the mastoid process for three different clinical situations: whistling in the ear, deafness at birth, and deafness related to a blockage of the eustachian tube. These three suggestions were made between 1629 and 1649. No one before him had made such suggestions. This study also shows that Riolan the Younger did not propose to open the mastoid process in case of ear infection.

Conclusion

Riolan the Younger must be considered as the true initiator of this surgery and thus must take its proper place in any history of surgical opening of the mastoid.
An ESPGHAN Position Paper on the Use of Low-FODMAP Diet in Pediatric Gastroenterology
Authors: Thomassen R.A. , Luque V. , Assa A. , Borrelli O. , Broekaert I. , Dolinsek J. , Martin-de-Carpi J. , Mas E. , Miele E. , Norsa L. , Ribes-Koninckx C. , Saccomani M. Deganello , Thomson M. , Tzivinikos C. , Verduci E. , Bronsky J. , Haiden N. , Köglmeier J. , de Koning B. , Benninga M.A.
Published: June 2022

Excluding oligo-, di-, monosaccharides and polyols (FODMAPs) from the diet is increasingly being used to treat children with gastrointestinal complaints. The aim of this position paper is to review the available evidence on the safety and efficacy of its use in children and provideexpert guidance regarding practical aspects in case its use is considered. Members of the Gastroenterology Committee, the Nutrition Committee and the Allied Health Professionals Committee of the European Society for Pediatric Gastroenterology Hepatology and Nutrition contributed to this position paper. Clinical questions regarding initiation, introduction, duration, weaning, monitoring, professional guidance, safety and risks of the diet are addressed. A systematic literature search was performed from 2005 to May 2021 using PubMed, MEDLINE and Cochrane Database of Systematic Reviews. In the absence of evidence, recommendations reflect the expert opinion of the authors. The systematic literature search revealed that the low-FODMAP diet has not been comprehensively studied in children. Indications and contraindications of the use of the diet in different pediatric gastroenterological conditions are discussed and practical recommendations are formulated. There is scarce evidence to support the use of a low-FODMAP diet in children with Irritable Bowel Syndrome and no evidence to recommend its use in other gastrointestinal diseases and complaints in children. Awareness of how and when to use the diet is crucial, as a restrictive diet may impact nutritional adequacy and/or promote distorted eating in vulnerable subjects. The present article provides practical safety tips to be applied when the low-FODMAP diet is considered in children.
Taking Leave During Residency
Authors: McDeavitt James T. , Appelbaum Nital P. , Raddatz Mikaela M. , Driscoll Sherilyn W. , Kinney Carolyn L.
Published: June 2022

There is limited literature examining the reasons physical medicine and rehabilitation residents take an extended leave of absence during residency and the impact of leave on board examination performance. Such information could better inform leave policies, help guide residency program directors, and potentially destigmatize taking leave. Study objectives were to describe the characteristics of physical medicine and rehabilitation residents who take leave during residency, compare differences in part I (written) and part II (oral) certification examination performance, and determine the prevalence of delays in taking board examinations. Study methodology was a retrospective analysis of deidentified information from the American Board of Physical Medicine and Rehabilitation database between 2008 and 2020. Results indicated four reasons for extended leave of absence: medical, parental, academic/remediation, and unspecified personal reasons. Residents who took an extended leave of absence for medical or parental reasons had similar or better odds of passing their part I and part II examinations compared with those without leave. Residents who took leave for academic/remediation concerns or unspecified personal reasons had lower odds of passing their board examinations. Examination delays for those taking parental or personal health leaves did not affect board pass rates. Further investigation is needed to identify how to support residents on academic/remediation and unspecified leaves during training.
Key Findings From Peer-Reviewed Published Research by the American Board of Physical Medicine and Rehabilitation in Review
Authors: Sabharwal Sunil , Kinney Carolyn L. , Raddatz Mikaela M. , Driscoll Sherilyn W. , Francisco Gerard E. , Robinson Lawrence R.
Published: June 2022

Recognizing the dearth of published research on board certification in physical medicine and rehabilitation and its subspecialties, the American Board of Physical Medicine and Rehabilitation has increased efforts to conduct and disseminate research in this area. This report summarizes key findings of peer-reviewed studies published by American Board of Physical Medicine and Rehabilitation staff and leadership in the past 6 yrs, including those conducted in partnership with other entities. The reported studies are organized in three main categories: initial certification, continuing certification, and subspecialty certification in physical medicine and rehabilitation. Related findings are further grouped into subsections that include psychometric evaluation of certification examinations, association of candidate characteristics with certification performance, relationship of certification performance to other measures, and candidate reaction and feedback. Collectively, the summarized results provide evidence that the board certification process is reliable, statistically valid, and predictive of the risk of disciplinary action in subsequent years. These studies also describe facets of our specialty including degree of subspecialization, burnout, and how people maintain certification over time. We hope that physical medicine and rehabilitation trainees, diplomates, institutions, programs, and other stakeholders find this information useful and look forward to continuing research in these and other areas in the spirit of constant evidence-based improvement and feedback to our specialty.