bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-forgiveness is associated with increased volumes of fusiform gyrus in healthy individuals
Authors: Kim Hyun-Ju , Seo Junghwa , Bang Minji , Lee Sang-Hyuk
Published: April 2023

Self-forgiveness (SF) involves a process through which negative moral emotions directed at the self are replaced by benevolence and acceptance. Lower SF scores can be associated with less self-compassion, higher psychological distress, and lower life dissatisfaction. However, neural correlates of SF have not been investigated yet. We enrolled a total of 79 healthy individuals. The Self-Forgiveness Scale (SFS), Self-Compassion Scale (SCS), Connor-Davidson Resilience Scale (CD-RISC), Beck Depression Inventory-II (BDI-II), and Beck Anxiety Inventory (BAI) were evaluated. Voxel-wise correlational analyses showed a significant positive correlation between the total SFS scores and gray matter volumes (GMVs) in the fusiform gyrus (FG). In addition, the GMVs in the FG were significantly positively associated with the total SCS and CD-RISC scores and negatively correlated with the total BDI-II and BAI scores. These findings suggest that the FG related to the mirror neuron system might be a neural correlate of SF. Furthermore, its increased volumes of FG in healthy individuals can be associated with the capacity to overcome stressful life events.
Effects of adding poly-histidine tag on stability, antimicrobial activity and safety of recombinant buforin I expressed in periplasmic space of Escherichia coli
Authors: Roshanak Sahar , Yarabbi Hanieh , Shahidi Fakhri , Tabatabaei Yazdi Farideh , Movaffagh Jebraeil , Javadmanesh Ali
Published: April 2023

The lack of cost-effective methods for producing antimicrobial peptides has made it impossible to use their high potential as a new and powerful class of antimicrobial agents. In recent years, extensive research has been conducted to decrease the cost of recombinant proteins production through microorganisms, transgenic animals, and plants. Well-known genetic and physiological characteristics, short-term proliferation, and ease of manipulation make E. coli expression system a valuable host for recombinant proteins production. Expression in periplasmic space is recommended to reduce the inherently destructive behavior of antimicrobial peptides against the expressing microorganism and to decline susceptibility to proteolytic degradation. In this study, a pET-based expression system was used to express buforin I at E. coli periplasmic space, and its antimicrobial, hemolytic, and cell toxicity activities as well as structural stability were evaluated. The hemolysis activity and cytotoxicity of His-tagged buforin I were negligible and its antimicrobial activity did not show a significant difference compared to synthetic buforin I. In addition, in silico investigating of stability of native and His-tagged buforin I showed that RMSF, RMSD and Rg curves had followed a similar trend during 150 ns simulation. Furthermore, evaluating the modelled structures, FTIR and X-ray methods of both peptides indicated an insignificant structural difference. It was concluded that the recombinant buforin I could be a viable alternative to some currently used antibiotics by successfully expressing it in the pET-based expression system.
Human visual explanations mitigate bias in AI-based assessment of surgeon skills
Authors: Kiyasseh Dani , Laca Jasper , Haque Taseen F. , Otiato Maxwell , Miles Brian J. , Wagner Christian , Donoho Daniel A. , Trinh Quoc-Dien , Anandkumar Animashree , Hung Andrew J.
Published: April 2023

Artificial intelligence (AI) systems can now reliably assess surgeon skills through videos of intraoperative surgical activity. With such systems informing future high-stakes decisions such as whether to credential surgeons and grant them the privilege to operate on patients, it is critical that they treat all surgeons fairly. However, it remains an open question whether surgical AI systems exhibit bias against surgeon sub-cohorts, and, if so, whether such bias can be mitigated. Here, we examine and mitigate the bias exhibited by a family of surgical AI systems—SAIS—deployed on videos of robotic surgeries from three geographically-diverse hospitals (USA and EU). We show that SAIS exhibits an underskilling bias, erroneously downgrading surgical performance, and an overskilling bias, erroneously upgrading surgical performance, at different rates across surgeon sub-cohorts. To mitigate such bias, we leverage a strategy —TWIX—which teaches an AI system to provide a visual explanation for its skill assessment that otherwise would have been provided by human experts. We show that whereas baseline strategies inconsistently mitigate algorithmic bias, TWIX can effectively mitigate the underskilling and overskilling bias while simultaneously improving the performance of these AI systems across hospitals. We discovered that these findings carry over to the training environment where we assess medical students’ skills today. Our study is a critical prerequisite to the eventual implementation of AI-augmented global surgeon credentialing programs, ensuring that all surgeons are treated fairly.
Recent progress on lanthanide-based long persistent phosphors: an overview
Authors: Vaidyanathan Sivakumar
Published: April 2023

Persistent phosphors are highly explored materials due to their diverse applications (including anti-counterfeiting, information and data storage, photocatalysis, sensing, and bioimaging).
Full-crystalline monolithic EU-1 zeolite: sustainable synthesis and its applications in the hydroisomerization of ethylbenzene with meta-xylene
Authors: Liang Guanghua , Chen Jianyi , Dou Tao , Wu Zhijie , Li Xiaofeng , Liu Yuanshuai
Published: April 2023

A novel strategy for the effective production of monolithic EU-1 zeolite as an active component of catalyst in C8 hydroisomerization.
Elucidating the exceptional halide ion etching of bimetallic Ag–Cu oxides for efficient adsorption and porous nanostructure formation
Authors: Zhang Meng , Liu Fuzhu , Yang Hongliang , Xu Zhanglian , Wang Junjie , Gong Yutong
Published: April 2023

The unique etching of Ag–Cu oxides by halide ions is demonstrated for the first time, which enables innovative applications of Ag–Cu oxides for the efficient iodide removal and the preparation of porous CuO with excellent glucose biosensing.
Experimental and simulation study of REEV charging and discharging strategy considering battery temperature
Authors: He Liange , Gu Zihan , Zhang Yan , Jing Haodong , Li Pengpai
Published: April 2023

An APU (Auxiliary Power Unit) control strategy C considering battery SOC (State of Charge), vehicle power, and battery temperature is proposed to meet the cooling requirements of the battery and the cabin.
Photocatalytic ability of visible-light-responsive hybrid ZrO2 particles
Authors: Zarubica Aleksandra , Sredojević Dušan , Ljupković Radomir , Randjelović Marjan , Murafa Natalija , Stoiljković Milovan , Lazić Vesna , Nedeljković Jovan M.
Published: April 2023

The interfacial charge transfer (ICT) complex formation between zirconium dioxide (ZrO2), the material absorbing below 250 nm, and 5-aminosalicylic acid (5-ASA) leads to the formation of visible-light-absorbing inorganic–organic hybrids.
Atomically dispersed Fe–Zn dual-site nanozymes with synergistic catalytic effects for the simultaneous detection of Cr(vi) and 8-hydroxyquinoline
Authors: Feng Min , Chen Xiaofang , Liu Yuhang , Zhao Yan , Karmaker Pran Gopal , Liu Jia , Wang Ya , Yang Xiupei
Published: April 2023

A schematic diagram of high-sensitivity colorimetric detection of Cr(vi) and 8-HQ based on MWCN/FeZn-NC single-atom nanozymes.
Phosphorene hydrogel conduits as “neurotrophin reservoirs” for promoting regeneration of peripheral nerves
Authors: Hui Tiankun , Wang Chen , Yu Liangmin , Zhou Chuanli , Qiu Meng
Published: April 2023

Multifunctional black phosphorus (BP) hydrogel nerve growth conduits (NGCs) loaded with neuregulin 1 (Nrg1) were fabricated to support peripheral-nerve regeneration.
Energy focusing reinforced narrowband ultraviolet-B mechanoluminescence for bright-field stress visualization
Authors: Yang Xiuxia , Chen Dongxun , Liang Yanjie , Zhou Su , Xu Ju , Liu Lin , Lin Hang , Xiong Yan , Cheng Yao , Wang Yuansheng
Published: April 2023

Narrowband ultraviolet-B (NB-UVB) ML materials with visible-blind features have been developed for the first time to enable bright-field visualization of stress-sensing, where a sensitization strategy is employed to reinforce NB-UVB ML emission.
Accuracy of Naming Error Profiles Elicited From Adaptive Short Forms of the Philadelphia Naming Test
Authors: Swiderski Alexander M. , Hula William D. , Fergadiotis Gerasimos
Published: April 2023

Purpose:

The purpose of this study was to evaluate whether a short-form computerized adaptive testing (CAT) version of the Philadelphia Naming Test (PNT) provides error profiles and model-based estimates of semantic and phonological processing that agree with the full test.

Method:

Twenty-four persons with aphasia took the PNT-CAT and the full version of the PNT (hereinafter referred to as the “full PNT”) at least 2 weeks apart. The PNT-CAT proceeded in two stages: (a) the PNT-CAT30, in which 30 items were selected to match the evolving ability estimate with the goal of producing a 50% error rate, and (b) the PNT-CAT60, in which an additional 30 items were selected to produce a 75% error rate. Agreement was evaluated in terms of the root-mean-square deviation of the response-type proportions and, for individual response types, in terms of agreement coefficients and bias. We also evaluated agreement and bias for estimates of semantic and phonological processing derived from the semantic–phonological interactive two-step model (SP model) of word production.

Results:

The results suggested that agreement was poorest for semantic, formal, mixed, and unrelated errors, all of which were underestimated by the short forms. Better agreement was observed for correct and nonword responses. SP model weights estimated by the short forms demonstrated no substantial bias but generally inadequate agreement with the full PNT, which itself showed acceptable test–retest reliability for SP model weights and all response types except for formal errors.

Discussion:

Results suggest that the PNT-CAT30 and the PNT-CAT60 are generally inadequate for generating naming error profiles or model-derived estimates of semantic and phonological processing ability. Post hoc analyses suggested that increasing the number of stimuli available in the CAT item bank may improve the utility of adaptive short forms for generating error profiles, but the underlying theory also suggests that there are limitations to this approach based on a unidimensional measurement model.

Supplemental Material:

https://doi.org/10.23641/asha.22320814
Does Kinesiophobia Affect Spatiotemporal Parameters in Patients with
Ankylosing Spondylitis?
Authors: Deniz Gulnihal , Bilek Furkan , Yentur Songul Baglan , Akgol Gurkan
Published: April 2023

Aim We aimed to examine the effect of kinesiophobia on functional
capacity, disease activity, quality of life and spatiotemporal parameters of
patients with AS by comparing AS patients with healthy controls.

Material and method Our study included 46 patients with ankylosing
spondylitis (AS) and 45 healthy controls (HC). Bath Ankylosing Spondylitis
Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI),
Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing
Spondylitis Disease Activity Index (BASDAI), Tampa Kinesiophobia Scale (TKS)
scores, Timed Up and Go (TUG) test, maximum plantar pressure and spatiotemporal
parameters (total weight transfer, step cycle duration, double-support phase,
swing phase, step length, foot angle and cadence) were evaluated.

Results Ninety-one individuals (46 AS, 45 HC)
(age/sex/BMI) were included in our study. Statistically
significant differences were seen between AS and HC groups in TUG, cadence, TKS,
maximum pressure, step cycle duration, swing phase, step length, double-support
phase, and foot angle measurements (p<0.05). Significant positive
correlations existed between TKS and BASMI, BASDAI, BASFI, ASoQ, TUG and foot
angle (p<0.05) in AS. Substantial negative correlations were found
between TKS and maximum pressure, cadence and swing phase values
(p<0.05) in AS.

Conclusion Our study is the first in the literature to measure
spatiotemporal parameters between patients with AS and HC and evaluate their
relationship with kinesiophobia, which was done to the best of our knowledge. We
found that patients with AS changed their gait phases by developing a unique
pattern and created a more cautious and safe gait model to provide balance and
stability. Our study revealed a statistically significant relationship between
kinesiophobia and disease activity, functional status, quality of life, cadence,
maximum plantar pressure, swing phase, and foot angle. The detailed data we
obtained in our study will shed light on gait analysis and research on
kinesiophobia in patients with AS. Kinesiophobia should be evaluated in routine
gait rehabilitation protocols applied to individuals with AS, and treatment
protocols for kinesiophobia should be added if necessary.
Gibt es entitätsspezifische Kriterien für den Beginn der spezialisierten Palliativversorgung für nicht heilbare Krebserkrankungen? Ein Scoping Review
Authors: Gahr Susanne , Brunner Sarah , Heckel Maria , Ostgathe Christoph
Published: April 2023

Hintergrund/Ziel Patienten mit nicht heilbaren Krebserkrankungen eine spezialisierte Palliativversorgung zum richtigen Zeitpunkt anzubieten, stellt eine Herausforderung dar. Ziel des Scoping Reviews war, geeignete entitätsspezifische Kriterien zu finden.

Methode Im Februar 2020 wurde in den Online-Datenbanken PubMed und Scopus ein Scoping Review durchgeführt. Ziel der Literatursuche war die Identifikation von englisch- und deutschsprachigen Originalarbeiten, die zwischen 2009 und Februar 2020 veröffentlicht wurden und Hinweise darauf geben, welche entitätsspezifischen und entitätsunabhängigen Kriterien nicht heilbarer Krebserkrankungen herangezogen werden, um betroffene Patienten zeitgerecht in die spezialisierte Palliativversorgung zu integrieren. Insgesamt wurden 13 relevante Artikel identifiziert. Der Methode des Scoping Reviews entsprechend, wurde auf eine formale Bewertung der methodischen Qualität der eingeschlossenen Literatur verzichtet.

Ergebnisse Unter den relevanten Publikationen waren 6 Reviews und 7 Originalarbeiten. In keiner der analysierten Publikationen wurden explizit charakteristische Kriterien zu spezifischen Krebsentitäten angeführt. Für die Integration in eine spezialisierte Palliativversorgung wurden unabhängig der Krebsentität als Kriterien Unheilbarkeit/fortgeschrittenes Tumorleiden, Lebensqualität, belastende Symptome, ECOG-Status, psychosoziale Bedürfnisse, Komorbiditäten, tumorassoziierte Komplikationen, Behandlungsentscheidung/keine Behandlungsmöglichkeiten und begrenzte Lebenszeitprognose herangezogen oder vorgeschlagen. Die Erhebung der Kriterien erfolgte mittels Instrumenten, für die keine konkreten Kennwerte angegeben waren, die eine zur Einbindung in spezialisierte Palliativversorgung relevante Ausprägung der Kriterien detektieren könnten.

Schlussfolgerung Für den Zeitpunkt einer zeitgerechten Integration der spezialisierten Palliativversorgung bei nicht heilbaren Krebserkrankungen gibt es bislang keine entitätsspezifischen Kriterien und Kennwerte. Aus der Analyse lässt sich jedoch ableiten, dass entitätsunabhängig alle Patienten mit einer nicht heilbaren bzw. fortgeschrittenen Krebserkrankung, die unter Verminderung/Verlust ihrer Lebensqualität und einer komplexen Symptomlast, v.a. Depressionen und Schmerzen leiden, das Angebot einer spezialisierten Palliativversorgung erhalten sollten. Kriterien generell als Kennwerte festzulegen und konsekutiv einen Messwert bzw. Cut-off-Wert zu definieren, könnte eine Möglichkeit sein, über z.B. ein Scoringsystem eine zeitgerechte Integration der Palliativmedizin zu erleichtern. Unklar ist bislang, welche Kombinationen von Erhebungsinstrumenten oder Screeningtools der Erfassung einer zeitgerechten Integration dienen könnten.
Conversion of α-Diazoketones into 1-Bromo-2-alkyl- or 2-arylpent-4-en-2-ols using Tin-Mediated Allylation/Propargylation
Authors: Biswas Swapan Kumar , Joyasawal Sipak
Published: April 2023

High-yielding and mild conditions are used to prepare of 1-bromo-2-alkyl- or 2-arylpent-4-en-2-ols/1-bromo-2-alkyl- or 2-arylpent-4-yn-2-ols from α-diazoketones. The reaction involves allylation/propargylation with successive bromide insertion using in situ generated allyltin bromide/or propargyltin bromide from activated tin metal and allyl/or propargyl bromide.
Descriptive and Surgical Analysis of 196 Cases of Traumatic Maxillofacial Fractures: An experience of 6 years
Authors: Mashalkar Narendra S. , Shetty Naren , Ellur Sunderraj
Published: April 2023

Objectives

To analyze the etiology, anatomical pattern, and management of upper, midface, and lower face fractures pertaining to our demography and compare our results with other regions and worldwide.

Material and Methods

A 6-year retrospective record analysis from 2013 to 2018 of eligible patients’ data was recorded with a prepared proforma. Demographic parameters including age, sex, etiology, anatomical site, closed or open, displaced or un displaced fracture, type of treatment, associated with head injury, and implants used were evaluated.

Inclusion criteria were all patients with facial bone fractures irrespective of age and gender.

Exclusion criteria were patients with pure soft tissue injury of the face and with facial burns.

Results

Most were involved with multiple facial bone fractures. Out of 196, 72 patients (pts) had involvement of mandible fractures, 79 had involvement of the maxilla, 65 zygoma, 68 nasal bone, 42 orbital wall, 21 frontal bone with processes, and 7 NOE involvement. The most frequent etiologic factor was detected to be road traffic accidents (RTA; 162 ,83%), due to falling (24, 12%), and assault (10, 5%).

In total, 173 were male (88%) and the rest 23 were female (12%). The mean age was found to be 29 years. Twelve patients (6.1%) were less than 14 years of age. Most RTAs had occurred in young adults from 16 to 30 years of age group. We analyzed individual bone fracture involvement and compared it with other geographical locations.

Conclusions

Most facial fractures are combined involving multiple bones in young adults with RTA as the most common etiology. There was a balance seen in managing the facial fractures between conservative and operative methods. These data provide us the information in evaluation of the preventive measures to be taken and give the direction of focusing the clinical and research priority in the future.
Importance of and Approach to Taking a History of Exposures to Occupational Respiratory Hazards
Authors: Weissman David N. , Radonovich Lewis J.
Published: April 2023

Occupational respiratory diseases are caused by exposure to respiratory hazards at work. It is important to document those exposures and whether they are causing or exacerbating disease because these determinations can have important impacts on diagnosis, treatment, job restrictions, and eligibility for benefits. Without investigation, it is easy to miss clinically relevant exposures, especially in those with chronic diseases that can have work and nonwork causes. The first and most important step in identifying exposures to respiratory hazards at work is to take an appropriate history. For efficiency, this is a two-step process. An initial quick screening history is done by asking only a few questions. Follow-up questions are asked if there are positive responses to the screening questions or if an occupational etiology is suspected based on the clinical presentation. Electronic health records have promise for facilitating this process. Follow-up to the screening history may include additional questions, evaluating additional sources of information about workplace exposures, and medical testing. Radiographic findings or tests conducted on noninvasive samples or lung tissue can be used as biomarkers. Online resources can be used to learn more about exposures associated with occupations and industries and to see if investigations evaluating exposures were performed in the patient's own workplace. It is important to adhere to the patient's wishes about contacting the employer. With patient consent, the employer can be an important source of information about exposures and, if a problem exists, has an important role in taking corrective action. Consultation for challenging cases is available from a variety of professional and governmental entities. If a clinician identifies a significant public health issue, such as an occupational disease outbreak, it is important to notify relevant public health authorities so that steps can be taken to prevent additional exposures and appropriately care for those already exposed.
Evaluation of Changes in Leukocyte Surface Markers in the Early Diagnosis of Late-Onset Neonatal Sepsis
Authors: Korkmaz Seven Efsun , Aydemir Cumhur , Tekin Ishak Ozel
Published: April 2023

Objective This study aimed to evaluate the cluster of differentiation (CD)64, CD16, CD11b, CD63 human leukocyte antigen-DR (HLA-DR), and CD62L leukocyte surface marker abnormalities using flow cytometry in the early diagnosis of late-onset neonatal sepsis.

Methods Forty-four neonates were included in this study. Of them, 22 neonates with clinical late-onset neonatal sepsis were included in the study group, and the remaining 22 neonates without sepsis were considered the control group. Complete sepsis screening was performed. Additionally, monocyte and neutrophil surfaces marker were examined using flow cytometry.

Results The expression of the leukocyte surface markers CD16 and CD64 on monocytes and neutrophils was significantly higher in the study group than in the control group (p < 0.05), while the CD63, CD62L, CD11b, and HLA-DR levels were similar to those in the control group (p > 0.05). Furthermore, receiver operating characteristic curve analysis indicated that neutrophil CD64 (nCD64) is a diagnostic marker for neonatal sepsis, with an area under the curve of 0.901. The CD64 and CD16, which are the respective leukocyte surface markers on neutrophils and monocytes, are useful tests in the early diagnosis of late-onset neonatal sepsis.

Conclusion In addition to acute phase proteins, cell surface antigens such as CD16 and more specifically CD64 should be used in routine investigations for the early diagnosis of late-onset neonatal sepsis. Such use in combination with acute phase reactants can improve diagnostic accuracy.
Collostructional analysis on Chinese modal verb construction neng bu neng + VP
Authors: Shan Weijia , Lin Zhengjun
Published: April 2023

This paper aims to investigate the meanings of Chinese neng (modal verb) bu
(negative word) neng (modal verb) + VP construction and explores the meaning motivations behind them. The present
paper employs the method of collostructional analysis, R software and BLCU Corpus Center1
(BCC) are used to process the linguistic data. It is found that the prototypical meaning of the target construction is “let
something (not) happen or let someone (not) do something” with the sense of negotiation and interaction and its extensional
meanings include “getting an expected result”, “continuation”, “obtaining”, “specific actions containing causation, motion,
communication, vision, life, and mental activities”. The meaning motivations of the construction lie in the force experience of
human from his/her interaction with the outside world, and in the semantic interaction of its constituent words
neng and bu.
Energy resolution of the LZ detector for high-energy electronic recoils
Authors: Pereira G. , Silva C. , Solovov V.N.
Published: April 2023

The LUX-ZEPLIN (LZ) detector is a dual-phase liquid xenon time projection chamber (TPC) installed at the Sanford Underground Research Facility (Lead, South Dakota) at a depth of 1478 meters. Although the main objective of LZ is the direct detection of dark matter, its low background environment allows for the search of other rare processes, such as the neutrinoless double beta decay of xenon isotopes 134Xe and 136Xe with the respective Q-values of 826 keV and 2458 keV. The sensitivity of the detector to these decays is directly determined by the energy resolution, which, in turn, is degraded by non-uniformities in detector response. In this work, we present a novel method to correct, in the data, the non-uniformity of the light collected by an array of photosensors in a scintillation detector. This method is based on the knowledge of the light response functions of individual photosensors. With these techniques, we report, at a very early phase of the detector operations, a state-of-the-art energy resolution (σ/μ) of (0.67 ± 0.01)% at 2614 keV for the fiducial volume of 5.6 tonnes of liquid xenon.
Surface plasmon enhanced fluorescence: self-consistent classical treatment in the quasi-static limit
Authors: Genov Dentcho A
Published: April 2023

The problem of enhanced molecular emission in close proximity to dielectric and metallic interfaces is of great importance for many physical and biological applications. Here we present an exact treatment of the problem from the view point of classical electromagnetism. Self-consistent analytical theory of the surface enhanced fluorescence (SEF) is developed for configurations consisting of an emitter in proximity to core–shell metal-dielectric nanoparticles. The dependence of the fluorescence enhancement on the excitation laser and fluorescence frequencies and distance of the emitter to the nanoparticle interface are studied. The developed theory predicts enhanced fluorescence at intermediate distances as well as emission quenching into non-radiative surface plasmon (SP) modes dominating the response for short distances. The conditions for optimal emission enhancement for two core–shell configurations are determined and a comparison to published experimental data is performed showing a good correspondence between theory and experiment. The developed model can be applied toward analyzes and optimizations of various applications related to SP enhance fluorescence spectroscopy.
Newton–Okounkov polytopes of flag varieties and marked chain-order polytopes
Authors: Fujita Naoki
Published: April 2023

Marked chain-order polytopes are convex polytopes constructed from a marked poset. They give a discrete family relating a marked order polytope with a marked chain polytope. In this paper, we consider the Gelfand–Tsetlin poset of type

A
A

, and realize the associated marked chain-order polytopes as Newton–Okounkov bodies of the flag variety. Our realization connects previous realizations of Gelfand–Tsetlin polytopes and Feigin–Fourier–Littelmann–Vinberg polytopes as Newton–Okounkov bodies in a uniform way. As an application, we prove that the flag variety degenerates into the irreducible normal projective toric variety corresponding to a marked chain-order polytope. We also construct a specific basis of an irreducible highest weight representation. The basis is naturally parametrized by the set of lattice points in a marked chain-order polytope.
A Reexamination ofIn Vitro Fertilization
Authors: Muñoz Michael G
Published: April 2023

For the sake of consistency with settled principles from other theological and ethical questions, there is a need for a Christian reexamination of in vitro fertilization (IVF). Both Old and New Testaments demonstrate that human personal life begins at conception or fertilization. Additionally, the Bible teaches that human beings are persons in the image of God from the very beginning of their existence. Thus, it can be concluded that the embryos created via IVF are persons in God’s image. Applying this to the destruction and freezing of embryos, several limitations or restrictions present themselves—embryos should not be purposefully destroyed or wasted, all embryos ought to be implanted, and embryos should not be frozen. Ultimately, however, due to the immense quantity of embryo wastage, it is concluded that Christians should avoid this form of assisted reproductive technology and consider it a pro-life issue.
Kidney injury molecule 1 (KIM-1): a potential biomarker of acute kidney injury and tubulointerstitial injury in patients with ANCA-glomerulonephritis
Authors: Brilland Benoît , Boud'hors Charlotte , Wacrenier Samuel , Blanchard Simon , Cayon Jérôme , Blanchet Odile , Piccoli Giorgina Barbara , Henry Nicolas , Djema Assia , Coindre Jean-Philippe , Jeannin Pascale , Delneste Yves , Copin Marie-Christine , Augusto Jean-François
Published: April 2023

Background

Kidney injury molecule 1 (KIM-1) is a transmembrane glycoprotein expressed by proximal tubular cells, recognized as an early, sensitive and specific urinary biomarker for kidney injury. Blood KIM-1 was recently associated with the severity of acute and chronic kidney damage but its value in antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis with glomerulonephritis (ANCA-GN) has not been studied. Thus, we analyzed its expression at ANCA-GN diagnosis and its relationship with clinical presentation, kidney histopathology and early outcomes.

Methods

We assessed KIM-1 levels and other pro-inflammatory molecules (C-reactive protein, interleukin-6, tumor necrosis factor α, monocyte chemoattractant protein-1 and pentraxin 3) at ANCA-GN diagnosis and after 6 months in patients included in the Maine-Anjou registry, which gathers data patients from four French Nephrology Centers diagnosed since January 2000.

Results

Blood KIM-1 levels were assessed in 54 patients. Levels were elevated at diagnosis and decreased after induction remission therapy. KIM-1 was associated with the severity of renal injury at diagnosis and the need for kidney replacement therapy. In opposition to other pro-inflammatory molecules, KIM-1 correlated with the amount of acute tubular necrosis and interstitial fibrosis/tubular atrophy (IF/TA) on kidney biopsy, but not with interstitial infiltrate or with glomerular involvement. In multivariable analysis, elevated KIM-1 predicted initial estimated glomerular filtration rate (β = –19, 95% CI –31, –7.6, P = .002).

Conclusion

KIM-1 appears as a potential biomarker for acute kidney injury and for tubulointerstitial injury in ANCA-GN. Whether KIM-1 is only a surrogate marker or is a key immune player in ANCA-GN pathogenesis remain to be determined.
Intra-cardiac tumour and bicuspid aortic valve in a patient with neurofibromatosis type 1—rare associations: a case report
Authors: MacLeod Claire , Mangion Kenneth , Roditi Giles , Ahmad Faheem
Published: April 2023

Background

Neurofibromatosis (NF) is an autosomal dominant neurocutaneous disease with multi-system involvement. Three cardiovascular associations are recognized but infrequently reported: congenital heart disease, vasculopathy, and hypertension. Cardiac outflow tract pathology, pulmonary stenosis, and aortic co-arctation have been described in the literature with varying frequency. The incidence of intra-cardiac tumour is exceeding rare.

Case summary

A 53-year-old man presented to the neurosurgical team with myelopathy secondary to cord compression arising from multiple cervical neurofibromas secondary to NF-1. Further cardiac evaluation with echocardiography and cardiac MRI uncovered the presence of both a bicuspid aortic valve (with mild aortic stenosis and moderate aortic regurgitation) and a concurrent intra-cardiac tumour of the mitral papillary muscle; a combined finding which was not reported previously. Serial evaluation confirmed stable disease with no major progression over time.

Discussion

Our case highlights the importance of recognizing cardiovascular manifestations of NF-1 and instituting appropriate screening and surveillance strategies. Targeted non-invasive imaging strategies may be more suited for this purpose over routine clinical examination alone.
Ulster Unionist Political Thought in the Era of the Northern Ireland Troubles, 1968–1998
Authors: Corthorn Paul
Published: April 2023

This article examines Ulster Unionist political thought, in its widest sense, against the backdrop of the Northern Ireland Troubles. During this period, Ulster Unionists sought to resist nationalist and republican arguments for the unification of Ireland and to articulate their position to supporters and wider audiences. As Direct Rule from London followed the suspension of the unionist-dominated Northern Ireland parliament at Stormont in 1972 and its abolition the following year, internal unionist debate intensified over the constitutional future of Northern Ireland. Defining Ulster Unionism broadly, at a time when its organisational forms were proliferating, the article considers the Ulster Unionist Party and its offshoot Vanguard, as well as the Democratic Unionist Party and the paramilitary organisations, the Ulster Volunteer Force and the Ulster Defence Association, and their affiliated political bodies. The article analyses, in turn, the four competing unionist visions of the future: a return to majority-rule devolution; independence; closer integration with Great Britain; and power-sharing devolution. Not attempting a detailed consideration of the policy proposals, the article instead explores the connections forged between Ulster Unionist political ideas, some of them of long pedigree, and wider debates. It shows that, at a time of considerable change for the United Kingdom, Ulster Unionist argument reflected—much more than is currently understood, and sometimes in a pronounced form—a wide range of interconnected contemporary British disputes. These not only concerned the constitution, nationality and sovereignty, but also permissiveness, political parties, decline, the end of empire, Thatcherism and European integration.
Genotypic Diversity of Childhood Rhinovirus Infections
Authors: Schmit Kathryn M , DeMuri Gregory P , Eickhoff Jens C , Bochkov Yury , Gern James E , Wald Ellen R
Published: April 2023

Our objective was to describe the distribution of rhinovirus (RV) by species and type in both symptomatic and asymptomatic children in a prospective study over multiple years. A large and diverse distribution of RV types was seen among children with and without symptoms. RV-A and RV-C were predominant at all visits.
Case report: a rare case of gastroduodenal intussusception caused by GIST in an elderly patient and literature review
Authors: Singh Khushboo , Hlayhel Ahmad , Kulkarni Sayali , Christian Derick
Published: April 2023

Gastroduodenal intussusception is a rare phenomenon in adults and is caused by gastrointestinal stromal tumors (GIST) in the majority of the documented cases. It commonly presents with abdominal pain, vomiting and melena. GIST is the most common gastrointestinal mesenchymal tumor in gastric and non-gastric locations. It is characterized classically by KIT or PGDFRA expression, and immunohistochemical analysis is the mainstay of diagnosis. Surgical resection provides definitive treatment in 70% of the cases. Here, we present a rare case of gastroduodenal intussusception caused by GIST in an elderly patient.
An Exploration of Accessibility to Trauma-Focused Education and Knowledge Among Music Therapists
Authors: Beach Christopher
Published: April 2023

A substantial number of children and adults in American society have been exposed to violence, marginalization, prejudice, or other traumatic experiences. Thus, it is imperative that those in helping professions have adequate training and resources to recognize and respond to the signs, symptoms, and risks of trauma. Like other helping professionals, music therapists are increasingly called to recognize the impact trauma can have on the communities they serve, but little is known about music therapists’ knowledge and awareness of trauma concepts. A survey was distributed to all board-certified music therapists in the United States that sought to examine the accessibility of educational and professional trainings related to trauma, as well as self-perceived competency in working with service users who have experienced trauma. Of the 8,602 emails distributed (CBMT), 958 different responses were returned, 945 of which consented to participate for a 10.9% response rate. Results indicated a substantial interest in trauma work among music therapists (88.04%); however, almost half of respondents (48.86%) have indicated a lack of access to these trainings for any given reason, leading to limited self-perceived competency in trauma work. This limitation in self-perceived competency in trauma work might exist due to a lack of consistent education and training provided to music therapists, regardless of the mode of education. By not addressing this gap in the profession, harm might be done to those who utilize music therapy services. A breakdown of conglomerate music therapist trauma-specific knowledge is provided, along with identified areas of trauma-concept interest.
Patient and Process Outcomes among Pediatric Patients Undergoing Appendectomy during the COVID-19 Pandemic: An International Retrospective Cohort Study
Authors: Matava Clyde T. , Tighe Nathaniel T. G. , Baertschiger Reto , Wilder Robert T. , Correll Lynnie , Staffa Steven J. , Zurakowski David , Kato Meredith A. , Meier Petra M. , Raman Vidya , Reddy Srijaya K. , Roque Remigio A. , Peterson Melissa Brooks , Zhong John , Edala Thejovathi , Greer Timothy J. , von Ungern-Sternberg Britta S. , Cravero Joseph , Simpao Allan F. ,   for the PEACOC Collaborators
Published: April 2023

Background

COVID-19 forced healthcare systems to make unprecedented changes in clinical care processes. The authors hypothesized that the COVID-19 pandemic adversely impacted timely access to care, perioperative processes, and clinical outcomes for pediatric patients undergoing primary appendectomy.

Methods

A retrospective, international, multicenter study was conducted using matched cohorts within participating centers of the international PEdiatric Anesthesia COVID-19 Collaborative (PEACOC). Patients younger than 18 yr old were matched using age, American Society of Anesthesiologists Physical Status, and sex. The primary outcome was the difference in hospital length of stay of patients undergoing primary appendectomy during a 2-month period early in the COVID-19 pandemic (April to May 2020) compared with prepandemic (April to May 2019). Secondary outcomes included time to appendectomy and the incidence of complicated appendicitis.

Results

A total of 3,351 cases from 28 institutions were available with 1,684 cases in the prepandemic cohort matched to 1,618 in the pandemic cohort. Hospital length of stay was statistically significantly different between the two groups: 29 h (interquartile range: 18 to 79) in the pandemic cohort versus 28 h (interquartile range: 18 to 67) in the prepandemic cohort (adjusted coefficient, 1 [95% CI, 0.39 to 1.61]; P < 0.001), but this difference was small. Eight centers demonstrated a statistically significantly longer hospital length of stay in the pandemic period than in the prepandemic period, while 13 were shorter and 7 did not observe a statistically significant difference. During the pandemic period, there was a greater occurrence of complicated appendicitis, prepandemic 313 (18.6%) versus pandemic 389 (24.1%), an absolute difference of 5.5% (adjusted odds ratio, 1.32 [95% CI, 1.1 to 1.59]; P = 0.003). Preoperative SARS-CoV-2 testing was associated with significantly longer time-to-appendectomy, 720 min (interquartile range: 430 to 1,112) with testing versus 414 min (interquartile range: 231 to 770) without testing, adjusted coefficient, 306 min (95% CI, 241 to 371; P < 0.001), and longer hospital length of stay, 31 h (interquartile range: 20 to 83) with testing versus 24 h (interquartile range: 14 to 68) without testing, adjusted coefficient, 7.0 (95% CI, 2.7 to 11.3; P = 0.002).

Conclusions

For children undergoing appendectomy, the COVID-19 pandemic did not significantly impact hospital length of stay.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
The Response of the Infant to the Father's Voice
Authors: Jasin Lisa R. , Newnam Katherine M.
Published: April 2023

Background:

Premature infants are at increased risk for language delays. The auditory system hears sounds at 25 weeks' gestation; therefore, infants in the neonatal intensive care unit (NICU) may miss crucial language exposure during the period when neural pathways for language processing are developing. Supporting the synergistic relationship between fathers and newborns promotes connections through early language to strengthen engagement and promote infant neurodevelopment.

Purpose:

To determine what is known about preterm infants' response to the male voice.

Data Sources:

Three databases and forward searching of reference lists were used to locate articles addressing the clinical question: “What strategies can be used in the NICU to support purposeful language development?”

Study Selection:

Empiric, primary research studies were included if they were published in English without date restriction.

Data Extraction:

The authors evaluated each study's quality using a validated 16-item assessment tool (QATSDD) developed for studies with diverse designs; data were extracted and organized following Garrard's Matrix Method.

Results:

The aim of this evidence-based review is to report the way an infant responds to the paternal voice. Findings promote a better understanding of individual infant response to paternal voice, including conversational turns and engagement behaviors. Although informative, this review highlights a clear gap in the evidence, supporting standardized methodology.

Implications for Practice and Research:

Fathers should be encouraged to communicate vocally early and often to facilitate bonding in the NICU. Encouraged future study of father–infant communication to support bonding, relationship building, and neurodevelopmental outcomes is paramount.
Treatment Refractory Soft Tissue Myoepithelial Carcinoma With an ARID1A Mutation
Authors: Ashcroft Cody R. , Penney Scott W. , Whiteway Susan L.
Published: April 2023

Soft tissue myoepithelial carcinoma is a rare tumor first reported in the salivary gland. There is considerable tumor heterogeneity between pathology findings, tumor aggressiveness, and response to treatment. Recent molecular testing has identified recurrent genetic changes with PLAG mutations in salivary gland primary tumors and loss of SMARCB1 and EWSR1/FUS gene changes in myoepithelial carcinoma. SMARCB1 is a component of the switch/sucrose nonfermentable (SWI/SNF) complex, an essential cellular regulator. ARID1A is another SWI/SNF complex subunit and is a potent oncogenic driver in other tumor types. In this case, we describe the case of an adolescent/young adult patient with treatment refractory soft tissue myoepithelial carcinoma and a previously unreported ARID1A mutation.
Interrater reliability of chart-based assessment of functional impairment after pediatric injury using the functional status scale
Authors: Melhado Caroline G. , Kao Emily , Hogan-Schlientz Jacqueline , Crane Debbie , Shui Amy M. , Stephens Caroline Q. , Evans Lauren , Burd Randall S. , Jensen Aaron R.
Published: April 2023

BACKGROUND

Functional impairment has been proposed as an alternative outcome for quality improvement in pediatric trauma. The functional status scale (FSS) has been used in studies of injured children, but has only been validated with resource-intensive in-person assessment. Implementation with retrospective chart-based FSS assessment would offer a simplified and scalable alternative. The purpose of this study was to evaluate interrater reliability of retrospective FSS assessment and to identify factors associated with unreliable assessment.

METHODS

A retrospective cohort of admissions to a Level I pediatric trauma center between July 2020 and June 2021 was analyzed. Two physicians and two nurse registrars reviewed charts to obtain measures of six FSS domains (mental status, sensory functioning, communication, motor functioning, feeding, and respiratory status) at discharge. Functional impairment was categorized by total FSS scores as good (6,7), mild impairment (8,9), moderate impairment (10–15), severe impairment (16–21), or very severe impairment (>21). Interrater reliability was assessed using intraclass correlation (ICC). Predictors of rater disagreement were evaluated using multivariable logistic regression.

RESULTS

The cohort included 443 children with a mean age of 7.4 years (standard deviation, 5.4 years) and median Injury Severity Score of 9 (interquartile range, 5–12). The median time per chart to assess FSS was 2 minutes (interquartile range, 1–2). Thirty-seven patients (8%) had functional impairment at discharge. Interrater reliability was excellent for total FSS score (ICC = 0.87) and good for FSS impairment categorization (ICC = 0.80). Rater disagreement of functional impairment categorization occurred in 14% of cases overall. Higher level of functional impairment and use of therapies (occupational and speech language therapy) were independently associated with more frequent rater disagreement.

CONCLUSION

Chart-based FSS assessment is feasible and reliable, but may require more detailed review for patients with higher level of impairment that require allied health therapy. Validation of chart-based assessment is needed before widespread implementation.

LEVEL OF EVIDENCE

Prognostic/Epidemiological, Level III.
Utility of computed tomography reconstructed thoracolumbar spinal imaging in blunt trauma
Authors: Swarup Abhishek , Amro Chris , Choron Rachel L. , Cong Alexander , Park John , Butts Christopher A. , Goswami Julie , Teichman Amanda L.
Published: April 2023

OBJECTIVES

Fractures of the thoracolumbar (TL) spine are common and may cause neurologic damage, pain, and reduced quality of life. Computed tomography (CT) TL reconstructions from CT chest, abdomen, and pelvis (CAP) are used to identify TL fractures; however, their benefit over CAP imaging is unclear. We hypothesized that reformatted TL images do not identify additional clinically significant injuries or change outcomes.

METHODS

Retrospective data were collected 2016 to 2021 from trauma patients at a level 1 trauma center. All patients 18 years or older with TL fractures on CT CAP with/without CT TL reformats were included. Clinically significant TL fractures were defined as requiring operative fixation, brace, or spinal rehabilitation. A binary classification model was created to assess the diagnostic utility of CTCAP compared with CTTL in predicting clinically significant fractures in patients who underwent CT CAP/TL.

RESULTS

There were 828 patients with TL fractures, 634 had both CT CAP/CT TL (CAPTL) and 194 CTCAP only (CAP). There were 134 clinically significant TL fractures (16%) (14 [7.2%] CT CAP vs. 120 [18.9%] CT CAPTL, p < 0.001). There were no differences among unstable fractures, fractures on magnetic resonance imaging (MRI) only, mortality, or neurologic deficits on discharge between CAPTL and CAP (p > 0.05). Among clinically significant fractures, CAPTL was not associated with increased MRI utilization, surgery, spinal brace, or spinal cord rehabilitation (p > 0.05). Among clinically insignificant fractures, CAPTL was associated with increased MRIs, length of stay (LOS), and intensive care unit LOS (p < 0.05). CAPTL was also an independent predictor of increased MRIs (odds ratio, 5.79; 95% confidence interval, 2.29–14.65; p < 0.01) and spine consultation (odds ratio, 2.39; 95% confidence interval, 1.64–3.67; p < 0.01). More CT CAP/TL were performed in those with clinically significant fractures; however, CTCAP was equivalent to CTTL for detection of fractures (p > 0.05).

CONCLUSION

CTCAP alone is sufficient to identify clinically significant TL fractures. While the addition of TL reformatted imaging minimizes missed injuries, it is associated with increased hospital LOS and MRI resource utilization. Therefore, careful consideration is needed for appropriate CT TL patient selection.

LEVEL OF EVIDENCE

Therapeutic/Care Management; Level IV.