bluuebunny/crossref_metadata_2025 huggingface dataset:
Peopling a new colony: Henry Jordan, land orders, and Queensland immigration, 1861–7
Authors: Morgan Kenneth
Published: January 2021

This article analyses the first years of the land order system of immigration that dominated Queensland’s settlement as a colony. Queensland issued land orders worth £30 per adult to fare-paying British and Irish immigrants who were mechanics, agriculturalists and people with modest amounts of capital. This form of immigration was facilitated through the work of an Emigration Commissioner – later an Agent-General – based in the British Isles. Henry Jordan held these positions in the period 1861–6. The article argues that land orders only partly met their intended outcomes, but that Jordan’s activities were essential for the scheme’s limited success.
Projected HIV and Bacterial Sexually Transmitted Infection Incidence Following COVID-19–Related Sexual Distancing and Clinical Service Interruption
Authors: Jenness Samuel M , Le Guillou Adrien , Chandra Christina , Mann Laura M , Sanchez Travis , Westreich Daniel , Marcus Julia L
Published: January 2021

Background

The global COVID-19 pandemic has the potential to indirectly impact transmission dynamics and prevention of HIV and other sexually transmitted infections (STI). It is unknown what combined impact reductions in sexual activity and interruptions in HIV/STI services will have on HIV/STI epidemic trajectories.

Methods

We adapted a model of HIV, gonorrhea, and chlamydia for a population of approximately 103 000 men who have sex with men (MSM) in the Atlanta area. Model scenarios varied the timing, overlap, and relative extent of COVID-19–related sexual distancing and service interruption within 4 service categories (HIV screening, preexposure prophylaxis, antiretroviral therapy, and STI treatment).

Results

A 50% relative decrease in sexual partnerships and interruption of all clinical services, both lasting 18 months, would generally offset each other for HIV (total 5-year population impact for Atlanta MSM, −227 cases), but have net protective effect for STIs (−23 800 cases). If distancing lasted only 3 months but service interruption lasted 18 months, the total 5-year population impact would be an additional 890 HIV cases and 57 500 STI cases.

Conclusions

Immediate action to limit the impact of service interruptions is needed to address the indirect effects of the global COVID-19 pandemic on the HIV/STI epidemic.
Connecting International Relations and Public Administration: Toward A Joint Research Agenda for the Study of International Bureaucracy
Authors: Fleischer Julia , Reiners Nina
Published: January 2021

The recent debate on administrative bodies in international organizations has brought forward multiple theoretical perspectives, analytical frameworks, and methodological approaches. Despite these efforts to advance knowledge on these actors, the research program on international public administrations (IPAs) has missed out on two important opportunities: reflection on scholarship in international relations (IR) and public administration and synergies between these disciplinary perspectives. Against this backdrop, the essay is a discussion of the literature on IPAs in IR and public administration. We found influence, authority, and autonomy of international bureaucracies have been widely addressed and helped to better understand the agency of such non-state actors in global policy-making. Less attention has been given to the crucial macro-level context of politics for administrative bodies, despite the importance in IR and public administration scholarship. We propose a focus on agency and politics as future avenues for a comprehensive, joint research agenda for international bureaucracies.
Navigating Multiple Identities: Decentering International Relations
Authors: Thakur Monika
Published: January 2021

The article argues that academics navigate and occupy various localities, spaces, and identities, which allows them to be self-reflexive in understanding the inherent challenges in diversifying the discipline. Using personal narratives as a methodological and theoretical tool, this article situates plural experiences and contexts of a woman of color, working in precarity in academia. The intersection of multiple identities reveals various sites of privilege and oppression, and inclusion and exclusion. Unsettling and dismantling binaries and identities reveal complex entanglements and connections that provide more nuanced understandings of IR. This article further discusses ways the discipline of IR has excluded diverse theoretical and empirical knowledges and regions, including critical approaches and the Global South. This disciplinary exclusion and erasure is reproduced in everyday academic practice and can serve as an entry point to understand why diverse communities are underrepresented in IR. Further, academia is not immune from the functions of power and social and economic hierarchies in society, and those hierarchies are manifested in various forms of asymmetry observable in academia, especially toward diverse communities and academics working in precarity.
EUCAST rapid antimicrobial susceptibility testing (RAST): analytical performance and impact on patient management
Authors: Berinson Benjamin , Olearo Flaminia , Both Anna , Brossmann Nicole , Christner Martin , Aepfelbacher Martin , Rohde Holger
Published: January 2021

Background

The emergence of antibiotic-resistant species calls for fast and reliable phenotypic susceptibility testing to adapt clinical management as fast as possible.

Objectives

We assessed the real-life performance of EUCAST rapid antimicrobial susceptibility testing (RAST) and analysed its impact on patient management.

Methods

RAST was performed on clinical blood cultures containing Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa or Acinetobacter baumannii complex. Categorical agreement with VITEK2 was analysed. A pre-post quasi-experimental observational study was designed to compare antibiotic treatment in sepsis patients in the RAST patient group (n = 51) and a historical control cohort (n = 54).

Results

In total, 436 isolates, corresponding to 2314 disc diameters, were measured; 18.4% of these measurements were in the area of technical uncertainty. For the 81.6% categorical results, which could be compared, 94.7% were in agreement, whereas 5.3% of the results were not. In the RAST group, optimal therapy was initiated on the same day as blood culture positivity, while this was the case in the historical group after 24 h. In six cases, RAST allowed for rapid antibiotic escalation. The 30 day mortality rate was lower in the RAST group, although this was not statistically significant.

Conclusions

RAST provides a reliable tool to improve clinical management of sepsis patients by providing rapid phenotypic susceptibility data. While not necessarily being an instrument for de-escalation, especially in areas of low prevalence, early detection allows for timely coverage of resistant isolates. Thus, RAST significantly adds to successful antibiotic stewardship programmes.
Negotiating Peace with Your Enemy: The Problem of Costly Concessions
Authors: Sticher Valerie
Published: January 2021

Why do some parties fail to settle conflict, even after long periods of fighting? Bargaining theory explains this through imperfect information, commitment problems, war entrepreneurs, and indivisible stakes. Integrating insights from social psychology into bargaining theory, this article proposes an additional bargaining obstacle. Conflict party members not only care about their in-group's welfare, but also want to avoid rewarding their opponent through concessions. A mutually acceptable agreement always contains concessions, yet when concessions are unpopular with key constituents, they are costly for leaders to make. This may result in a situation where leaders would prefer to settle but still decide to continue the war. Modifying a standard bargaining setup to account for this dilemma, the article demonstrates the difficulties of settling a conflict when out-group preferences are salient. It shows how events that increase the saliency of out-group preferences, such as major ceasefire violations, lead to a drop in public support for negotiations. The problem of costly concessions renders the search for a mutually acceptable agreement a delicate balancing act, particularly if constituents are isolated from the costs of war and political competitors mobilize around unpopular concessions.
Ancylostoma ceylanicum as the second most frequent hookworm species isolated in France in travellers returning from tropical areas
Authors: Gerber Victor , Le Govic Yohann , Ramade Cécile , Chemla Cathy , Hamane Samia , Desoubeaux Guillaume , Durieux Marie-Fleur , Degeilh Brigitte , Abou-Bacar Ahmed , Pfaff Alexander W , Candolfi Ermanno , Greigert Valentin , Brunet Julie
Published: January 2021

Ancylostoma ceylanicum is the second most common hookworm species infecting humans in Southeast Asia and Oceania. We performed a 3 years multicenter study to assess its frequency in hookworm infecting patients returning from tropical areas to France and found that A. ceylanicum was the second most frequent hookworm species isolated.
‘Short-Spanned Living Creatures’: Evolutionary Perspectives in Rhoda Broughton’s Not Wisely, but Too Well (1867)
Authors: Green James Aaron
Published: January 2021

In Geological Evidences of the Antiquity of Man (1863), Charles Lyell appraised the distinct contribution made by his protégé, Charles Darwin (On the Origin of Species (1859)), to evolutionary theory: ‘Progression … is not a necessary accompaniment of variation and natural selection [… Darwin’s theory accounts] equally well for what is called degradation, or a retrogressive movement towards a simple structure’. In Rhoda Broughton’s first novel, Not Wisely, but Too Well (1867), written contemporaneously with Lyell’s book, the Crystal Palace at Sydenham prompts precisely this sort of Darwinian ambivalence to progress; but whether British civilization ‘advance[s] or retreat[s]’, her narrator adds that this prophesized state ‘will not be in our days’ – its realization exceeds the single lifespan. This article argues that Not Wisely, but Too Well is attentive to the irreconcilability of Darwinism to the Victorian ‘idea of progress’: Broughton’s novel, distinctly from its peers, raises the retrogressive and nihilistic potentials of Darwin’s theory and purposes them to reflect on the status of the individual in mid-century Britain.
There Is No Role for Damage Control Orthopedics Within the Golden Hour
Authors: Dunn John C , Elster Eric A , Blair James A , Remick Kyle N , Potter Benjamin K , Nesti Leon J
Published: January 2021

Introduction

Trauma systems within the United States have adapted the “golden hour” principle to guide prehospital planning with the goal to deliver the injured to the trauma facility in under 60 minutes. In an effort to reduce preventable prehospital death, in 2009, Secretary of Defense Robert M. Gates mandated that prehospital transport of injured combat casualties must be less than 60 minutes. The U.S. Military has implemented a 60-minute timeline for the transport of battlefield causalities to medical teams to include Forward Surgical Teams and Forward Resuscitative Surgical Teams. The inclusion of orthopedic surgeons on Forward Surgical Teams has been extrapolated from the concept of damage control orthopedics (DCO). However, it is not clear if orthopedic surgeons have yielded a demonstrable benefit in morbidity or mortality reduction. The purpose of this article is to investigate the function of orthopedic surgeons during the military “golden hour.”

Materials and Methods

The English literature was reviewed for evidence supporting the use of orthopedic surgeons within the golden hour. Literature was reviewed in light of the 2009 golden hour mandate by Secretary Gates as well as those papers which highlighted the utility of DCO within the golden hour.

Results

Evidence for orthopedic surgery within the “golden hour” or in the current conflicts when the United States enjoys air superiority was not identified.

Conclusions

Within the military context, DCO, specifically pertaining to fracture fixation, should not be considered an element of golden hour planning and thus orthopedic surgeons are best utilized at more centralized Role 3 facility locations. The focus within the first hour after injury on the battlefield should be maintained on rapid and effective prehospital care combined with timely evacuation, as these are the most critical factors to reducing mortality.
Identifying Patterns and Predictors of Prescription Opioid Use After Total Joint Arthroplasty
Authors: Chaudhary Muhammad Ali , Dalton Michael K , Koehlmoos Tracey P , Schoenfeld Andrew J , Goralnick Eric
Published: January 2021

Introduction

Total hip arthroplasty and total knee arthroplasty account for over 1 million procedures annually. Opioids are the mainstay of postoperative pain management for these patients. In this context, the objective of this study was to determine patterns of use and factors associated with early discontinuation of opioids after total joint arthroplasty (TJA).

Methods

TRICARE claims data (2006-2014) were queried for adult (18-64 years) patients who underwent total hip arthroplasty or total knee arthroplasty. Prescription opioid use was identified from 6 months before and 6 months after surgical intervention. Prior opioid use was categorized as naïve, exposed (with non-sustained use), and sustained (6 month continuous use before surgery). Cox proportional-hazards models were used to identify factors associated with opioid discontinuation following TJA.

Results

Among the 29,767 patients included in the study, 15,271 (51.3%) had prior opioid exposure and 3,740 (12.5%) were sustained opioid users. At 6 months after the surgical intervention, 3,171 (10.6%) continued opioid use, 3.3% were among opioid naïve, 10.2% among exposed, and 33.3% among sustained users. In risk-adjusted models, prior opioid exposure (hazards ratio: 0.65, 95% CI: 0.62-0.67) and sustained prior use (hazards ratio: 0.33, 95% CI: 0.31-0.35) were the strongest predictors of lower likelihood of opioid discontinuation. Lower socio-economic status, depression, and anxiety were also strong predictors.

Conclusion

Prior opioid exposure was strongly associated with continued opioid dependence after TJA. Although one-third of prior sustained users continued use after surgery, approximately 10% of previously exposed patients became sustained users, making them the prime candidates for targeted interventions to reduce the likelihood of sustained opioid use after TJA.
The Atacama Cosmology Telescope: SZ-based masses and dust emission from IR-selected cluster candidates in the SHELA survey
Authors: Fuzia Brittany J , Kawinwanichakij Lalitwadee , Mehrtens Nicola , Aiola Simone , Battaglia Nicholas , Ciardullo Robin , Devlin Mark , Finkelstein Steven L , Gralla Megan , Hilton Matt , Huffenberger Kevin M , Hughes John P , Jogee Shardha , Maldonado Felipe A , Page Lyman A , Papovich Casey , Partridge Bruce , Rykoff Eli , Sehgal Neelima , Sifón Cristóbal , Staggs Suzanne T , Wollack Edward
Published: January 2021

We examine the stacked thermal Sunyaev–Zel’dovich (SZ) signals for a sample of galaxy group and cluster candidates from the 24 deg2 infrared Spitzer-HETDEX Exploratory Large Area (SHELA) survey. We identify the objects in combination with optical data using the redMaPPer algorithm, and divide them into three richness bins (λ in 10–20, 20–30, and 30–76 with average photometric redshifts of 0.80, 0.73, and 0.70, respectively). All richness bins show evidence for dust emission, which we fit using stacked profiles from Herschel Stripe 82 data. We fit for synchrotron emission using stacked profiles created by binning source fluxes from NRAO VLA Sky Survey data. We can confidently detect the SZ decrement only in the highest richness bin, finding MSZ,500  = $8.7^{+1.7}_{-1.3} \times 10^{13}\, \mathrm{ M}_\odot$. Neglecting the correction for dust and synchrotron depresses the inferred mass by 26 per cent, indicating a partial fill-in of the SZ decrement from dust and synchrotron emission. We compare our corrected SZ masses to two redMaPPer mass–richness scaling relations and find that the SZ mass is lower than predicted by the richness. For the lower richness bins, mass bias factors as low as 1 − b = 0.6 are not enough to bring the mass limits into agreement. We discuss possible explanations for this discrepancy. The SHELA richnesses may differ from previous richness measurements due to the inclusion of infrared data in redMaPPer. To connect the SZ signal to the mass, we use a universal gas pressure profile that is calibrated to massive clusters at low redshift. It may not be applicable to our lower mass, higher redshift sample.
GASTON: Galactic Star Formation with NIKA2 – evidence for the mass growth of star-forming clumps
Authors: Rigby A J , Peretto N , Adam R , Ade P , Anderson M , André P , Andrianasolo A , Aussel H , Bacmann A , Beelen A , Benoît A , Berta S , Bourrion O , Bracco A , Calvo M , Catalano A , De Petris M , Désert F-X , Doyle S , Driessen E F C , García P , Gomez A , Goupy J , Kéruzoré F , Kramer C , Ladjelate B , Lagache G , Leclercq S , Lestrade J-F , Macías-Pérez J F , Mauskopf P , Mayet F , Monfardini A , Perotto L , Pisano G , Ponthieu N , Revéret V , Ristorcelli I , Ritacco A , Romero C , Roussel H , Ruppin F , Schuster K , Shu S , Sievers A , Tucker C , Watkins E J
Published: January 2021

Determining the mechanism by which high-mass stars are formed is essential for our understanding of the energy budget and chemical evolution of galaxies. By using the New IRAM KIDs Array 2 (NIKA2) camera on the Institut de Radio Astronomie Millimétrique (IRAM) 30-m telescope, we have conducted high-sensitivity and large-scale mapping of a fraction of the Galactic plane (GP) in order to search for signatures of the transition between the high- and low-mass star-forming modes. Here, we present the first results from the Galactic Star Formation with NIKA2 (GASTON) project, a Large Programme at the IRAM 30-m telescope that is mapping ≈2 deg2 of the inner GP, centred on ℓ = 23${_{.}^{\circ}}$9, b = 0${_{.}^{\circ}}$05, as well as targets in Taurus and Ophiuchus in 1.15- and 2.00-mm continuum wavebands. In this paper, we present the first of the GASTON GP data taken, and present initial science results. We conduct an extraction of structures from the 1.15-mm maps using a dendrogram analysis and, by comparison to the compact source catalogues from Herschel survey data, we identify a population of 321 previously undetected clumps. Approximately 80 per cent of these new clumps are 70-μm-quiet, and may be considered as starless candidates. We find that this new population of clumps are less massive and cooler, on average, than clumps that have already been identified. Further, by classifying the full sample of clumps based upon their infrared-bright fraction – an indicator of evolutionary stage – we find evidence for clump mass growth, supporting models of clump-fed high-mass star formation.
Nigraha: Machine-learning-based pipeline to identify and evaluate planet candidates from TESS
Authors: Rao Sriram , Mahabal Ashish , Rao Niyanth , Raghavendra Cauligi
Published: January 2021

The Transiting Exoplanet Survey Satellite (TESS) has now been operational for a little over two years, covering the Northern and the Southern hemispheres once. The TESS team processes the downlinked data using the Science Processing Operations Center (SPOC) pipeline and Quick Look pipeline (QLP) to generate alerts for follow-up. Combined with other efforts from the community, over 2000 planet candidates have been found of which tens have been confirmed as planets. We present our pipeline, Nigraha, that is complementary to these approaches. Nigraha uses a combination of transit finding, supervised machine learning, and detailed vetting to identify with high confidence a few planet candidates that were missed by prior searches. In particular, we identify high signal-to-noise ratio shallow transits that may represent more Earth-like planets. In the spirit of open data exploration, we provide details of our pipeline, release our supervised machine learning model and code as open source, and make public the 38 candidates we have found in seven sectors. The model can easily be run on other sectors as is. As part of future work, we outline ways to increase the yield by strengthening some of the steps where we have been conservative and discarded objects for lack of a datum or two.
Improving estimates of the growth rate using galaxy–velocity correlations: a simulation study
Authors: Turner Ryan J , Blake Chris , Ruggeri Rossana
Published: January 2021

We present an improved framework for estimating the growth rate of large-scale structure, using measurements of the galaxy–velocity cross-correlation in configuration space. We consider standard estimators of the velocity autocorrelation function, ψ1 and ψ2, the two-point galaxy correlation function, ξgg, and introduce a new estimator of the galaxy–velocity cross-correlation function, ψ3. By including pair counts measured from random catalogues of velocities and positions sampled from distributions characteristic of the true data, we find that the variance in the galaxy–velocity cross-correlation function is significantly reduced. Applying a covariance analysis and χ2 minimization procedure to these statistics, we determine estimates and errors for the normalized growth rate fσ8 and the parameter β = f/b, where b is the galaxy bias factor. We test this framework on mock hemisphere data sets for redshift z < 0.1 with realistic velocity noise constructed from the l-picola simulation code, and find that we are able to recover the fiducial value of fσ8 from the joint combination of ψ1 + ψ2 + ψ3 + ξgg, with 15 per cent accuracy from individual mocks. We also recover the fiducial fσ8 to within 1σ regardless of the combination of correlation statistics used. When we consider all four statistics together we find that the statistical uncertainty in our measurement of the growth rate is reduced by $59{{\ \rm per\ cent}}$ compared to the same analysis only considering ψ2, by $53{{\ \rm per\ cent}}$ compared to the same analysis only considering ψ1, and by $52{{\ \rm per\ cent}}$ compared to the same analysis jointly considering ψ1 and ψ2.
UOCS – III. UVIT catalogue of open clusters with machine learning-based membership using Gaia EDR3 astrometry
Authors: Jadhav Vikrant V , Pennock Clara M , Subramaniam Annapurni , Sagar Ram , Nayak Prasanta Kumar
Published: January 2021

We present a study of six open clusters (Berkeley 67, King 2, NGC 2420, NGC 2477, NGC 2682, and NGC 6940), using the Ultra Violet Imaging Telescope (UVIT) aboard ASTROSAT and Gaia EDR3. We used combinations of astrometric, photometric, and systematic parameters to train and supervise a machine-learning algorithm along with a Gaussian mixture model for the determination of cluster membership. This technique is robust, reproducible, and versatile in various cluster environments. In this study, the Gaia EDR3 membership catalogues are provided along with classification of the stars as members, candidates, and field in the six clusters. We could detect 200–2500 additional members using our method with respect to previous studies, which helped estimate mean space velocities, distances, number of members and core radii. UVIT photometric catalogues, which include blue stragglers, main-sequence, and red giants are also provided. From UV–Optical colour–magnitude diagrams, we found that majority of the sources in NGC 2682 and a few in NGC 2420, NGC 2477, and NGC 6940 showed excess UV flux. NGC 2682 images have 10 white dwarf detection in far-UV. The far-UV and near-UV images of the massive cluster NGC 2477 have 92 and 576 members, respectively, which will be useful to study the UV properties of stars in the extended turn-off and in various evolutionary stages from main sequence to red clump. Future studies will carry out panchromatic and spectroscopic analysis of noteworthy members detected in this study.
Deep learning for medical image analysis: a brief introduction
Authors: Wiestler Benedikt , Menze Bjoern
Published: January 2021

Advances in deep learning have led to the development of neural network algorithms which today rival human performance in vision tasks, such as image classification or segmentation. Translation of these techniques into clinical science has also significantly advanced image analysis in neuro-oncology. This has created a need in the neuro-oncology community for understanding the mechanisms behind neural networks and deep learning, as close interaction of computer scientists and neuro-oncology researchers as well as realistic expectations about the possibilities (and limitations) of the current state-of-the-art is pivotal for successful translation of deep learning techniques into practice. In this review, we will briefly introduce the building blocks of neural networks with a particular focus on convolutional neural networks. We will explain why these networks excel at identifying relevant features and how they learn to associate these imaging features with (clinical) features of interest, such as genotype, or how they automatically segment structures of interest in the image volume. We will also discuss challenges for the more widespread use of these algorithms.
SARS-CoV-2 Infections and Serologic Responses Among Military Personnel Deployed on the USNS COMFORT to New York City During the COVID-19 Pandemic
Authors: Lalani Tahaniyat , Lee Tida K , Laing Eric D , Ritter Andrew , Cooper Elizabeth , Lee Melissa , Baker Matthew , Baldino Tyler , Mcadoo Terrance , Phogat Shreshta , Samuels Emily , Nguyen Huy , Broder Christopher C , Epsi Nusrat , Richard Stephanie A , Warkentien Tyler E , Millar Eugene V , Burgess Timothy , Kronmann Karl C
Published: January 2021

Background

Coronavirus disease 2019 (COVID-19) presents a unique challenge to United States Navy hospital ships. The aim of this study was to determine the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among US Navy personnel deployed on the USNS COMFORT to augment the inpatient health care capacity in New York City.

Methods

This was a cross-sectional study conducted on USNS COMFORT crewmembers returning to Norfolk, Virginia, following deployment. Participants completed an electronic questionnaire and provided a serum sample at Day 14 post-deployment. Polymerase chain reaction (PCR) results from testing of symptomatic crewmembers during deployment and Day 0 and Day 14 post-deployment screening swabs conducted on all crewmembers, per military order, were abstracted. SARS-CoV-2 infection was defined as a positive SARS-CoV-2 spike glycoprotein immunoglobulin G antibody or PCR result.

Results

Of the ship’s total complement of 1200 crewmembers, 450 were enrolled: 432 (96.0%) completed the questionnaire and provided a serum sample. The median age of participants (interquartile range) was 30 (24–39) years, 50.8% were female, 58.6% were White, and 14.0% were Black; 80.1% had a clinical role during deployment. The cumulative prevalence of SARS-CoV-2 infection was 3.01% (13/432; 95% CI, 1.61%–5.09%). Twelve of 13 infections occurred in health care providers, and 8 of 13 were asymptomatic. The antibody profile of infected crewmembers varied by suspected timing of infection.

Conclusions

We observed a low prevalence of SARS-CoV-2 infection among USNS COMFORT crewmembers despite the inherent risk of a shipboard deployment to an area with high rates of community transmission. Our findings suggest that early infection control measures mitigated the spread of SARS-CoV-2 among crewmembers.
Technical Note: Extreme Lateral Supracerebellar Approach for Resection of Superior Cerebellar Peduncle Arteriovenous Malformations
Authors: Klironomos Georgios , Chiluwal Amrit K , Dehdashti Amir R
Published: January 2021

BACKGROUND

The surgical approaches to the region of the cerebello-mesencephalic sulcus and superior cerebellar peduncle (SCP) remain a neurosurgical challenge.

OBJECTIVE

To present the use of the extreme lateral supracerebellar infratentorial (SC-IT) approach to treat arteriovenous malformations (AVMs) of the SCP, which is a different entity compared to brainstem AVMs

METHODS

We treated 4 patients with SCP AVMs in the last 5 yr at our institution. The mean age was 49.7 yr. The average nidus size was 2.12 cm. Of those, 3 patients presented with hemorrhage and 1 with headache and tinnitus. Extreme lateral SC-IT approach was used in all cases.

RESULTS

Complete resection was achieved in all cases as verified with postoperative angiogram. In 1 case, intraoperative rupture with intraventricular hemorrhage was encountered, and the patient required temporary external ventricular drainage. There was no permanent complication or neurological deficit. The modified Rankin Scale (at discharge or follow-up) was less than 2 in all cases.

CONCLUSION

The AVMs located primarily in the SCP are distinct compared to brainstem AVMs, and their management should be different. Extreme lateral SC-IT approach should be considered as a viable alternative surgical approach for resection of these AVMs, and excellent surgical results can be achieved.
Safety and Efficacy of Perioperative Intravenous Meloxicam for Moderate-to-Severe Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial
Authors: Berkowitz Richard D , Steinfeld Richard , Sah Alexander P , Mack Randall J , McCallum Stewart W , Du Wei , Black Libby K , Freyer Alex , Coyle Erin
Published: January 2021

Objective

To evaluate the effect of perioperative meloxicam IV 30 mg on opioid consumption in primary total knee arthroplasty (TKA).

Design

Multicenter, randomized, double-blind, placebo-controlled trial.

Subjects

In total, 181 adults undergoing elective primary TKA.

Methods

Subjects received meloxicam 30 mg or placebo via an IV bolus every 24 hours, the first dose administered prior to surgery as part of a multimodal pain management protocol. The primary efficacy parameter was total opioid use from end of surgery through 24 hours.

Results

Meloxicam IV was associated with less opioid use versus placebo during the 24 hours after surgery (18.9 ± 1.32 vs 27.7 ± 1.37 mg IV morphine equivalent dose; P < 0.001) and was superior to placebo on secondary endpoints, including summed pain intensity (first dose to 24 hours postdosing, first dose to first assisted ambulation, and first dose to discharge) and opioid use (48–72 hrs., 0–48 hrs., 0–72 hrs., hour 0 to end of treatment, and the first 24 hours after discharge). Adverse events (AEs) were reported for 69.9% and 92.0% of the meloxicam IV and placebo groups, respectively; the most common AEs were nausea (40% vs. 59%), vomiting (16% vs 22%), hypotension (14% vs 15%), pruritus (15% vs 11%), and constipation (11% vs 13%).

Conclusions

Perioperative meloxicam IV 30 mg as part of a multimodal analgesic regimen for elective primary TKA reduced opioid consumption in the 24-hour period after surgery versus placebo and was associated with a lower incidence of AEs typically associated with opioid use.
COVID-19 and shielding: experiences of UK patients with lupus and related diseases
Authors: Sloan Melanie , Gordon Caroline , Lever Elliott , Harwood Rupert , Bosley Michael A , Pilling Mark , Brimicombe James , Naughton Felix , Blane Moira , Walia Chanpreet , D’Cruz David
Published: January 2021

Objective

The shielding guidance in the UK for the clinically extremely vulnerable (CEV) commenced on 23 March 2020 in response to the coronavirus disease 2019 (COVID-19) pandemic. The purpose of this study was to explore the impact of the pandemic and shielding on patients with lupus and related systemic autoimmune rheumatic diseases (SARDs).

Methods

This was a mixed-methods cohort study (n = 111) including pre-lockdown baseline surveys (March 2020), follow-up surveys (June 2020) and in-depth interviews during July 2020 (n = 25).

Results

Most participants had a high level of anxiety regarding their mortality risk from COVID-19 and supported the concept of shielding. Shielding allocations and communications were perceived as inconsistently applied and delivered. More than half of those not classified as CEV reported feeling abandoned, at increased risk and with no support. Shielding communications increased feelings of being ‘cared about’, but also increased fear, and the ‘vulnerable’ labelling was perceived by some to damage social and self-identity. More than 80% of those classified as CEV stated that the classification and subsequent communications had changed their social-mixing behaviour. Despite many negative impacts of COVID-19 and shielding/lockdown being identified, including isolation, fear and reduced medical care, the quantitative data during the pandemic showed increases in most measures of wellbeing (which was low at both time points) from pre-lockdown, including reductions in the impact of fatigue and pain (P-values < 0.001).

Conclusion

Shielding classifications and communications were, in general, viewed positively, although they were perceived as inconsistently delivered and anxiety-provoking by some participants. More frequent positively framed communication and wellbeing support could benefit all SARD patients. Slower-paced lockdown lifestyles might confer health/wellbeing benefits for some people with chronic diseases.
Neuroanesthesiology Update
Authors: Pasternak Jeffrey J.
Published: January 2021

This review summarizes the literature published in 2020 that is relevant to the perioperative care of neurosurgical patients and patients with neurological diseases as well as critically ill patients with neurological diseases. Broad topics include general perioperative neuroscientific considerations, stroke, traumatic brain injury, monitoring, anesthetic neurotoxicity, and perioperative disorders of cognitive function.
Hepatitis B Virus Reactivation in Cancer Patients Treated With Immune Checkpoint Inhibitors
Authors: Burns Ethan A. , Muhsen Ibrahim N. , Anand Kartik , Xu Jiaqiong , Umoru Godsfavour , Arain Abeer N. , Abdelrahim Maen
Published: January 2021

There have been unique adverse events reported with targeted blockade of programmed death-1 (PD-1), programmed death-ligand-1 (PD-L1), and cytotoxic T-lymphocyte-associated protein-4 (CTLA4), including immune mediated toxicities. Recently, there have been reports of hepatitis B reactivation (HBVr) occurring with PD-1/PD-L1 inhibitors, which may result in treatment delays, interruptions, or discontinuation. This retrospective literature review and analysis of the Food and Drug Administration’s (FDA) Adverse Events Reporting System (FAERS) queried reported cases of “Hepatitis B reactivation” reported with the PD-1/PD-L1 inhibitors “Pembrolizumab,” “Atezolizumab,” “Nivolumab,” “Durvalumab,” “Avelumab,” and “Ipilimumab” from initial FDA approval to June 30, 2020. Disproportionality signal analysis was determined by calculating a reporting odds ratio (ROR) and 95% confidence intervals (CI). The ROR was considered significant when the lower and upper limits of the 95% CI were >1 and confirmed by the Fisher exact test (P<0.05). Pembrolizumab had a strong signal associated with HBVr, with a ROR of 2.32 (95% CI: 1.11–4.28) (P=0.013) and was the only statistically significant finding. There were no reports of HBVr with Ipilimumab or Avelumab. Additional prospective studies should be conducted to validate the findings of this retrospective pharmacovigilance analysis to determine the risk of HBVr in patients receiving immune checkpoint inhibitors.
Use of the Subfascial Plane for Gender-affirming Breast Augmentation: A Case Series
Authors: Mehra Geetika , Kaufman-Goldberg Tal , Meshulam-Derazon Sagit , Boskey Elizabeth R. , Ganor Oren
Published: January 2021

Background:

Transgender women seeking gender-affirming breast augmentation often present with differences in preoperative chest measurements and contours in comparison with cisgender women. These include a more robust pectoralis muscle and limited glandular tissue, raising important considerations in determining the optimal anatomical plane for implantation. Abundant literature has described advantages and drawbacks of the available planes for breast augmentation in cisgender women. Certain drawbacks may be more pronounced for transgender women, given their distinct anatomy. The subfascial plane offers lower complication rates than the subglandular plane when using smooth implants, and avoids implant animation and displacement associated with the subpectoral plane. To our knowledge, existing studies have not yet addressed this discussion in the transfeminine population. The goal of this article is to highlight potential benefits of the subfascial plane for gender-affirming breast augmentation, utilizing a case series of 3 transfeminine patients, and to review the literature on surgical techniques and outcomes in this population.

Methods:

A retrospective chart review of patients presenting to a single surgeon for gender-affirming breast augmentation in 2019 was performed. A narrative literature review on surgical techniques and outcomes for gender-affirming breast augmentation was conducted.

Results:

Three cases of gender-affirming breast augmentation using subfascial implant placement are described. From the literature search, 12 articles inclusive of 802 transfeminine patients were identified.

Conclusions:

The subfascial plane represents an option for implant placement in gender-affirming breast augmentation that merits further investigation. There is a need for more research comparing surgical techniques and outcomes in the transfeminine population.
Combined Phialemonium curvatum and Acanthamoeba Keratitis: The Importance of Early Diagnosis and Specific Therapy
Authors: Roszkowska Anna M. , Severo Alice A. , Biondo Carmelo , Postorino Elisa I. , Inferrera Leandro , Aragona Pasquale
Published: January 2021

Purpose:

To report the clinical and confocal findings of a unique case of combined Phialemonium curvatum and Acanthamoeba keratitis and to highlight the role of the prompt diagnosis and specific medical treatment in preserving visual function.

Methods:

A case report and literature review.

Results:

A 54-year-old woman presented with a 3-day history of visual impairment, photophobia, and ocular pain in her right eye. Her best corrected visual acuity was 0.4 Logarithm of the Minimum Angle of Resolution scale, and the slit-lamp examination showed whitish corneal stromal infiltrate with satellite lesions. In vivo confocal microscopy evidenced Acanthamoeba cysts and fungal hyphae that resulted P. curvatum in the culture examination. The intensive medical treatment was started with topical 0.02% polyhexamethylene biguanide, voriconazole 1%, and moxifloxacin hydrochloride 0.5%. Progressive improvement of clinical and confocal pictures was registered with a complete recovery of visual function after 1 month.

Conclusions:

This is the first case report of combined P. curvatum and Acanthamoeba keratitis. The fast diagnosis with in vivo confocal microscopy allowed early and intensive specific treatment with recovery of corneal infection.
Anticancer effects of dietary administration of secoisolariciresinol diglucoside in a patient of gastrointestinal stromal tumor: a case report
Authors: Wu Hao , Wang Yao , Chen Jia-Tao , Wang Li-Ping , Liu Gui-Rong , Liu Shu-Lin
Published: January 2021

Introduction:

Gastrointestinal stromal tumor (GIST) is among the leading malignancies of the digestive system. GIST is not susceptible to chemotherapies and is prone to recurrence or metastasis after surgical operation. Secoisolariciresinol diglucoside (SDG) was suggested to have potential anticancer effects, but no clinical evidence had been available. Here we report successful treatment of a postoperative GIST case with dietary SDG.

Presentation of Case:

The patient was a 58-year-old man. He had GIST and received resection of small intestinal lesions 1 year before. He was diagnosed with postoperation of GIST and presented with high level of serum carbohydrate antigen 72-4 (CA72-4). The patient was then treated with dietary administration of SDG with his voluntary acceptance for 5 months, and underwent 2 serum CA72-4 measurements during this period. CA72-4 level of the patient was restored to normal range after treatment with dietary SDG for 1 month. There was no aberrant CA72-4 level, recurrence or metastasis after the treatment with dietary SDG.

Discussion:

This is to our knowledge the first report on application of dietary SDG on a postoperative GIST patient with aberrant level of serum CA72-4. SDG can be transformed into active substances with antitumor effects by human gut bacteria. Dietary SDG might inhibit tumorigenicity and malignant behavior of GIST cells.

Conclusion:

The excellent effects suggest dietary SDG to be a potential therapy for GIST, especially against recurrence or metastasis.
Ultraviolet Induced Skin Inflammation
Authors: Zhao Hai-Chao , Xiao Ta , Chen Yu-Jie
Published: January 2021

Ultraviolet (UV) induced skin inflammation (UISI) is associated with many skin disorders. However, the mechanism by which UV causes skin inflammation remains unclear. Studies evaluating UISI in vivo have mainly been conducted using mouse models. Current investigations indicate that the classic inflammatory pathways involving nuclear factor kappa B and Toll-like receptor contribute to the regulation of UISI. However, more novel signaling factors have been identified as being involved in this process, including interleukin 22 receptor-α, cluster of differentiation 28 and cluster of differentiation 1d, serum amyloid A1, estrogen, melatonin, peroxisome proliferator activated receptors β/δ, isocitrate dehydrogenase 2, and transglutaminase 2. In addition, the gene mutation of fermitin family member 1 and selenium deficiency are reported to affect the phenotype of UISI. Although the actual roles of UISI in UV-related skin diseases need to be clarified, recent studies have reported the potent contribution of UISI to photocarcinogesis. To clarify the process and modulation of UISI, the special profiles of cytokines and inflammatory mediators and the core regulatory pathways should be identified clearly. These investigations would be promoted rapidly, accompanied by the conduction of high-quality clinical research on patients with UV-related skin disease and the construction of precise animal models of UISI.
Muscle Damage and Overreaching During Wildland Firefighter Critical Training
Authors: Christison Katherine S. , Gurney Shae C. , Sol Joseph A. , Williamson-Reisdorph Cassie M. , Quindry Tiffany S. , Quindry John C. , Dumke Charles L.
Published: January 2021

Objective:

To document the effects of wildland firefighter (WLFF) critical training (CT) on physiologic markers of muscle damage and acute overreaching.

Methods:

Eighteen male and three female WLFFs were studied during an 11-day CT. Upper-body (US), lower-body (LS) muscle soreness and body weight (BW) were collected daily. Blood was collected on days 1, 4, 8, and 11 to measure creatine kinase (CK), lactate dehydrogenase (LDH), cortisol, and testosterone. Skinfolds were taken on days 1 and 11 to estimate body fat (BF) and lean body weight (LBW).

Results:

CT resulted in a significant depression in BF and elevation in LBW, while main effects of time were seen in US, LS, CK, LDH, cortisol, and testosterone/cortisol ratio (P < 0.05).

Conclusion:

These data suggest WLFFs undergo significant physiological stressors resulting in muscle soreness, damage, and possible overreaching during CT.
Temporal Trends and Regionalization of Acute Mastoiditis Management in the United States
Authors: Fujiwara Rance J.T. , Alonso Jose E. , Ishiyama Akira
Published: January 2021

Objective:

To describe demographics and to analyze temporal trends in the inpatient management of acute mastoiditis admissions.

Study Design:

Cross-sectional analysis.

Setting:

National Inpatient Sample, 2002–2014.

Patients:

26,072 nonelective inpatient admissions with primary diagnosis of acute mastoiditis

Intervention:

Myringotomy, mastoidectomy, or no procedure.

Main Outcome Measures:

We described the patient- and hospital-level demographics of acute mastoiditis admissions and the frequency of complications. We evaluated the percentage of patients requiring surgical management. Binary logistic regression was performed to determine whether there was a significant increase in the percentage of patients treated at academic institutions.

Results:

The majority of patients were ≤40 years old (64.9%) and Elixhauser comorbidity index ≥4 (57.4%); 23.3% (SE 0.8%) presented with complications associated with acute mastoiditis, the most common of which was a subperiosteal abscess (11.5%, SE 0.7%). Among all admissions, 30.9% (SE 1.1%) underwent myringotomy, 13.8% (SE 0.8%) required both myringotomy and mastoidectomy. On multivariate analysis, there was a statistically significant increase in the percentage of mastoiditis admissions to teaching hospitals for all admissions (OR 1.55 [CI 1.22–1.97], p < 0.001) and even more evident for cases with associated complications (OR 1.85 [CI 1.21–2.83], p = 0.004).

Conclusions and Relevance:

A sizeable percentage of patients with acute mastoiditis present with complications which may require surgical intervention. From 2002 to 2014, inpatient care of acute mastoiditis became increasingly regionalized to teaching hospitals, suggestive of increased specialization within certain facilities. This trend may have significant impacts on the cost and subsequent quality of care provided to these patients.
Imaging and surgical predictive factors for postoperative hemorrhage after partial nephrectomy and clinical results of trans-arterial embolization
Authors: Qin Caipeng , Zhi Xin , Wang Fei , Li Qing , Gao Jian , Liu Shijun , Xu Tao
Published: January 2021

Partial nephrectomy (PN) has been established as the standard treatment for T1 renal tumors, and postoperative hemorrhage due to vascular complications is a rare but potentially life-threatening complication reported after PN. Thus, this study evaluated the imaging and surgical factors associated with postoperative hemorrhage after PN and the clinical results of trans-arterial embolization. A retrospective review of the institutional PN database was performed from May 2012 to January 2019, revealing that we performed 810 PN procedures at our institution. In total, 12 patients were referred to the interventional radiology department for vascular complications after the procedure. Patients with and without transarterial embolization (TAE) were age- and sex-matched with 56 patients. Preoperative imaging characteristics and operative details were considered. Univariable and multivariable analyses were used to test their eventual association with the occurrence of hemorrhage. Furthermore, renal functions at diagnosis, after operation or embolization for TAE cases, and at the last follow-up were recorded. A diagnosis of hemorrhage was made at a median of 4 (range, 0–25) days after surgery. The majority of patients (50%) presented with gross hematuria. T test revealed higher renal tumor-parenchyma contact area (TPA) (P = .0407), Length-A (P = .0136), Length-P (P = .0267), operation time (P = .0214) and estimated blood loss (P = .0043) in patients with hemorrhage than in controls. Binary logistic regression analysis identified TPA (P = .048) and estimated blood loss (P = .042) as independent predictors for postoperative hemorrhage with an area under the ROC curve of 0.705 (64% sensitivity and 79% specificity). In conclusion, the occurrence of hemorrhage after PN was associated with a larger TPA and more estimated blood loss during the procedure. In patients who underwent selective TAE, renal function remained comparable with that of controls.