bluuebunny/crossref_metadata_2025 huggingface dataset:
CEBPB is required for NRF2-mediated drug resistance in NRF2-activated non-small cell lung cancer cells
Authors: Okazaki Keito , Anzawa Hayato , Katsuoka Fumiki , Kinoshita Kengo , Sekine Hiroki , Motohashi Hozumi
Published: February 2022

NRF2 is a transcription activator that plays a key role in cytoprotection against oxidative stress. Although increased NRF2 activity is principally beneficial for our health, NRF2 activation in cancer cells is detrimental, as it drives their malignant progression. We previously found that CCAAT/enhancer-binding protein B (CEBPB) cooperates with NRF2 in NRF2-activated lung cancer and enhances tumour-initiating activity by promoting NOTCH3 expression. However, the general contribution of CEBPB in lung cancer is rather controversial, probably because the role of CEBPB depends on cooperating transcription factors in each cellular context. To understand how NRF2 shapes the function of CEBPB in NRF2-activated lung cancers and its biological consequence, we comprehensively explored NRF2-CEBPB–coregulated genes and found that genes involved in drug metabolism and detoxification were characteristically enriched. Indeed, CEBPB and NRF2 cooperatively contribute to the drug resistance. We also found that CEBPB is directly regulated by NRF2, which is likely to be advantageous for the coexpression and cooperative function of NRF2 and CEBPB. These results suggest that drug resistance of NRF2-activated lung cancers is achieved by the cooperative function of NRF2 and CEBPB.
Sexual dimorphism and rare intersex individuals in Cretaceous (Maastrichtian)DakoticancerRathbun, 1917 (Decapoda: Brachyura: Dakoticancroida)
Authors: Jones Annmarie R , Schweitzer Carrie E , Feldmann Rodney M
Published: February 2022

Several hundred specimens of the crab Dakoticancer overanusRathbun, 1917 represent a normal size-distributed adult population, with a skewed sex ratio of 21% females to 79% males. Sexual dimorphism is clearly developed in the shape of the sternum and pleon as well as overall carapace size. The Dakoticancer Assemblage displays a variety of intersex conditions, including gonopores (vulvae) on the coxa of the fourth pereiopod and female spermatheca associated with male sternal morphology. Gonopores on the coxae of the fourth pereiopods have been reported for shrimps, clawed lobsters, and palinurid lobsters, but not for brachyurans. Understanding the occurrence of intersex specimens within an extinct species of an extinct section is extremely difficult, as there seem to be no modern analogs concerning gonopores on the fourth pereiopod in Brachyura. The low percentage of affected individuals, about 1%, suggests developmental or genetic conditions were most likely responsible for the intersex individuals. The absence of such individuals in another large collection of a species of the same genus, of more or less the same geologic age, suggests that the factors leading to intersexuality in the Dakoticancer overanus population were endemic to that population.
Rural–Urban Disparities in Cancer Outcomes: Opportunities for Future Research
Authors: Bhatia Smita , Landier Wendy , Paskett Electra D , Peters Katherine B , Merrill Janette K , Phillips Jonathan , Osarogiagbon Raymond U
Published: February 2022

Cancer care disparities among rural populations are increasingly documented and may be worsening, likely because of the impact of rurality on access to state-of-the-art cancer prevention, diagnosis, and treatment services, as well as higher rates of risk factors such as smoking and obesity. In 2018, the American Society of Clinical Oncology undertook an initiative to understand and address factors contributing to rural cancer care disparities. A key pillar of this initiative was to identify knowledge gaps and promote the research needed to understand the magnitude of difference in outcomes in rural vs nonrural settings, the drivers of those differences, and interventions to address them. The purpose of this review is to describe continued knowledge gaps and areas of priority research to address them. We conducted a comprehensive literature review by searching the PubMed (Medline), Embase, Web of Science, and Cochrane Library databases for studies published in English between 1971 and 2021 and restricted to primary reports from populations in the United States and abstracted data to synthesize current evidence and identify continued gaps in knowledge. Our review identified continuing gaps in the literature regarding the underlying causes of rural–urban disparities in cancer outcomes. Rapid advances in cancer care will worsen existing disparities in outcomes for rural patients without directed effort to understand and address barriers to high-quality care in these areas. Research should be prioritized to address ongoing knowledge gaps about the drivers of rurality-based disparities and preventative and corrective interventions.
Slipstreaming for Public Sector Reform: How Enterprising Public Sector Leaders Navigate Institutional Inertia
Authors: Rahman Shibaab , Teicher Julian , Cox Julie Wolfram , Alam Quamrul
Published: February 2022

We situate public sector leaders as actors who deal with competing institutional demands, and examine how public sector leaders can facilitate reform implementation in the face of institutional inertia in a transitional setting, Bangladesh public administration. Based on 32 interviews with current and former Bangladeshi civil servants and local public administration experts supported by secondary analysis of government documents, our evidence shows that public sector leaders operating within multiple logics are agentic in contributing to reform. However, these leaders also become constrained by institutional pressures that threaten their legitimacy and may face sanctions for pursuing local changes. Although public sector leaders typically engage in resistance to reform, our evidence shows that public sector leaders can create enterprising avenues of change, adeptly exercising agency and utilizing existing institutional logics as a conduit to introducing a new institutional order. Our principal contribution is to identify slipstreaming as a means by which institutional actors negotiate institutional logics and facilitate change despite institutional inertia.
Transcriptome shock in interspecific F1 allotriploid hybrids between Brassica species
Authors: Quan Chengtao , Chen Guoting , Li Sijia , Jia Zhibo , Yu Pugang , Tu Jinxing , Shen Jinxiong , Yi Bin , Fu Tingdong , Dai Cheng , Ma Chaozhi
Published: February 2022

Interspecific hybridization drives the evolution of angiosperms and can be used to introduce novel alleles for important traits or to activate heterosis in crop breeding. Hybridization brings together gene expression networks from two different species, potentially causing global alterations of gene expression in the F1 plants which is called ‘transcriptome shock’. Here, we explored such a transcriptome shock in allotriploid Brassica hybrids. We generated interspecific F1 allotriploid hybrids between the allotetraploid species Brassica napus and three accessions of the diploid species Brassica rapa. RNA-seq of the F1 hybrids and the parental plants revealed that 26.34–30.89% of genes were differentially expressed between the parents. We also analyzed expression level dominance and homoeolog expression bias between the parents and the F1 hybrids. The expression-level dominance biases of the Ar, An, and Cn subgenomes was genotype and stage dependent, whereas significant homoeolog expression bias was observed among three subgenomes from different parents. Furthermore, more genes were involved in trans regulation than in cis regulation in allotriploid F1 hybrids. Our findings provide new insights into the transcriptomic responses of cross-species hybrids and hybrids showing heterosis, as well as a new method for promoting the breeding of desirable traits in polyploid Brassica species.
Selection for early shoot vigour in wheat increases root hair length but reduces epidermal cell size of roots and leaves
Authors: Hendriks Pieter-Willem , Ryan Peter R , Hands Philip , Rolland Vivien , Gurusinghe Saliya , Weston Leslie A , Rebetzke Greg J , Delhaize Emmanuel
Published: February 2022

Six cycles of recurrent selection for early shoot vigour in wheat resulted in significant increases in leaf width and shoot biomass. Here, in replicated controlled-environment studies, the effect of early shoot vigour on root biomass, rhizosheath size, root hair length, and cell size in the roots and leaves was examined across different cycles of selection. Increased shoot vigour was associated with greater root biomass, larger rhizosheath size, and longer root hairs. Our findings demonstrate that rhizosheath size was a reliable surrogate for root hair length in this germplasm. Examination of the root epidermis revealed that the ‘cell body’ of the trichoblasts (hair-forming cells) and the atrichoblasts (non-hair-forming cells) decreased in size as shoot vigour increased. Therefore, in higher vigour germplasm, longer root hairs emerged from smaller trichoblasts so that total trichoblast volume (root hair plus cell body) was generally similar regardless of shoot vigour. Similarly, the sizes of the four main cell types on the leaf epidermis became progressively smaller as shoot vigour increased, which also increased stomatal density. The relationship between shoot vigour and root traits is considered, and the potential contribution of below-ground root traits to performance and competitiveness of high vigour germplasm is discussed.
Modelling efficient team structures in biology
Authors: Sikimić Vlasta , Herud-Sikimić Ole
Published: February 2022

We used agent-based modelling to highlight the advantages and disadvantages of several management styles in biology, ranging from centralized to egalitarian ones. In egalitarian groups, all team members are connected with each other, while in centralized ones, they are only connected with the principal investigator. Our model incorporated time constraints, which negatively influenced weakly connected groups such as centralized ones. Moreover, our results show that egalitarian groups outperform others if the questions addressed are relatively simple or when the communication among agents is limited. Complex epistemic spaces are explored best by centralized groups. They outperform other team structures because the individual members can develop their own ideas with less interference of the opinions of others. The optimal ratio between time spent on experimentation and dissemination varies between different organizational structures. Furthermore, if the evidence is shared only after a relevant degree of certainty is reached, all investigated groups epistemically profit. We discovered that the introduction of seminars to the model changes the epistemic performance in favour of weakly connected teams. Finally, the abilities of the principal investigator do not seem to outperform cognitive diversity, as group performances were not strongly influenced by the increase of her abilities.
MOBSTER – VI. The crucial influence of rotation on the radio magnetospheres of hot stars
Authors: Shultz M E , Owocki S P , ud-Doula A , Biswas A , Bohlender D , Chandra P , Das B , David-Uraz A , Khalack V , Kochukhov O , Landstreet J D , Leto P , Monin D , Neiner C , Rivinius Th , Wade G A
Published: February 2022

Numerous magnetic hot stars exhibit gyrosynchrotron radio emission. The source electrons were previously thought to be accelerated to relativistic velocities in the current sheet formed in the middle magnetosphere by the wind opening magnetic field lines. However, a lack of dependence of radio luminosity on the wind power, and a strong dependence on rotation, has recently challenged this paradigm. We have collected all radio measurements of magnetic early-type stars available in the literature. When constraints on the magnetic field and/or the rotational period are not available, we have determined these using previously unpublished spectropolarimetric and photometric data. The result is the largest sample of magnetic stars with radio observations that has yet been analysed: 131 stars with rotational and magnetic constraints, of which 50 are radio-bright. We confirm an obvious dependence of gyrosynchrotron radiation on rotation, and furthermore find that accounting for rotation neatly separates stars with and without detected radio emission. There is a close correlation between H α emission strength and radio luminosity. These factors suggest that radio emission may be explained by the same mechanism responsible for H α emission from centrifugal magnetospheres, i.e. centrifugal breakout (CBO), however, while the H α-emitting magnetosphere probes the cool plasma before breakout, radio emission is a consequence of electrons accelerated in centrifugally driven magnetic reconnection.
Jets in magnetically arrested hot accretion flows: geometry, power, and black hole spin-down
Authors: Narayan Ramesh , Chael Andrew , Chatterjee Koushik , Ricarte Angelo , Curd Brandon
Published: February 2022

We present the results of nine simulations of radiatively inefficient magnetically arrested discs (MADs) across different values of the black hole spin parameter a*: −0.9, −0.7, −0.5, −0.3, 0, 0.3, 0.5, 0.7, and 0.9. Each simulation was run up to $t \gtrsim 100\, 000\, GM/c^3$ to ensure disc inflow equilibrium out to large radii. We find that the saturated magnetic flux level, and consequently also jet power, of MAD discs depends strongly on the black hole spin, confirming previous results. Prograde discs saturate at a much higher relative magnetic flux and have more powerful jets than their retrograde counterparts. MADs with spinning black holes naturally launch jets with generalized parabolic profiles whose widths vary as a power of distance from the black hole. For distances up to 100GM/c2, the power-law index is k ≈ 0.27–0.42. There is a strong correlation between the disc–jet geometry and the dimensionless magnetic flux, resulting in prograde systems displaying thinner equatorial accretion flows near the black hole and wider jets, compared to retrograde systems. Prograde and retrograde MADs also exhibit different trends in disc variability: accretion rate variability increases with increasing spin for a* > 0 and remains almost constant for a* ≲ 0, while magnetic flux variability shows the opposite trend. Jets in the MAD state remove more angular momentum from black holes than is accreted, effectively spinning down the black hole. If powerful jets from MAD systems in Nature are persistent, this loss of angular momentum will notably reduce the black hole spin over cosmic time.
The main perturbing objects on the orbits of (616) Prometheus and (617) Pandora
Authors: Gomes-Júnior A R , Santana T , Winter O C , Sfair R
Published: February 2022

The dynamical evolution of the Prometheus and Pandora pair of satellites is chaotic, with a short 3.3 yr Lyapunov time. It is known that the anti-alignment of the apses line of Prometheus and Pandora, which occurs every 6.2 yr, is a critical configuration that amplifies their chaotic dynamical evolution. However, the mutual interaction between Prometheus and Pandora is not enough to explain the longitudinal lags observed by the Hubble Space Telescope. The main goal of the current work is to identify the main contributors to the chaotic dynamical evolution of the Prometheus–Pandora pair beyond themselves. Therefore, in this work, we first explore the sensibility of this dynamical system to understand it numerically and then build numerical experiments to reach our goals. We identify that almost all major satellites of the Saturn system play a significant role in the evolution of Prometheus’s and Pandora’s orbits.
The interplay of supercoiling and thymine dimers in DNA
Authors: Lim Wilber , Randisi Ferdinando , Doye Jonathan P K , Louis Ard A
Published: February 2022

Thymine dimers are a major mutagenic photoproduct induced by UV radiation. While they have been the subject of extensive theoretical and experimental investigations, questions of how DNA supercoiling affects local defect properties, or, conversely, how the presence of such defects changes global supercoiled structure, are largely unexplored. Here, we introduce a model of thymine dimers in the oxDNA forcefield, parametrized by comparison to melting experiments and structural measurements of the thymine dimer induced bend angle. We performed extensive molecular dynamics simulations of double-stranded DNA as a function of external twist and force. Compared to undamaged DNA, the presence of a thymine dimer lowers the supercoiling densities at which plectonemes and bubbles occur. For biologically relevant supercoiling densities and forces, thymine dimers can preferentially segregate to the tips of the plectonemes, where they enhance the probability of a localized tip-bubble. This mechanism increases the probability of highly bent and denatured states at the thymine dimer site, which may facilitate repair enzyme binding. Thymine dimer-induced tip-bubbles also pin plectonemes, which may help repair enzymes to locate damage. We hypothesize that the interplay of supercoiling and local defects plays an important role for a wider set of DNA damage repair systems.
The Conditional Relationship of Psychological Needs to Ideology
Authors: Ollerenshaw Trent , Johnston Christopher D
Published: February 2022

We offer novel tests of hypotheses regarding the conditional relationship of psychological needs to political ideology. Using five personality measures and a large national sample, our findings affirm that political engagement plays an important moderating role in the relationship between needs for certainty and security and political identification, values, and policy preferences. We find that needs for certainty and security are strongly associated with right-wing political identification and cultural values and policy preferences, particularly among politically engaged citizens. In the economic domain, however, we find that needs for certainty and security are typically associated with left-wing values and policy preferences among politically unengaged citizens. It is only among politically engaged citizens that such needs are associated with right-wing economic values and policy preferences. Our findings confirm the importance of heterogeneity across both ideological domain and political engagement for how psychological needs translate into political ideology in the American mass public.
Do Ex-Bankers Benefit Nonfinancial Firms? Evidence from Job Transitions
Authors: Chernykh Lucy , Mityakov Sergey
Published: February 2022

We document the beneficial impact of human capital transfer from banks to nonfinancial firms: firms hiring ex-bankers have higher asset and employment growth and easier access to bank loans. Using a unique employee-employer-matched data set from Russia and exogenous variation in ex-bankers’ supply due to bank-branch-network restructurings, we establish the causal interpretation of these patterns. We also show that ex-bankers’ human capital consists of bank-specific and banking industry expertise (with the latter being acquired through interbank connections). Firms recognize the value of ex-bankers, who receive significant salary bonuses when a new bank loan is issued to the firm (JEL G21, G32, J24).

Received August 17, 2020; editorial decision January 5, 2022; by editor: Isil Erel. Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
RETENTION OF ORGANICALLY BOUND DEUTERIUM IN GRASS PLANTS EXPOSED TO HEAVY WATER VAPOUR AT DIFFERENT GROWTH STAGES
Authors: Tani Takashi , Nagai Masaru
Published: February 2022

Potted timothy grass plants were exposed to heavy water (HDO) vapour at seven different periods during the third growth of harvestable shoots (the part 5-cm above the ground surface), and the concentration of non-exchangeable organically bound deuterium (NE-OBD) was measured in harvestable shoots, stubbles and roots at the third harvest. The excess concentration of NE-OBD was obtained as an increase in the concentration of NE-OBD against the background level. On average, this value was 1.8- to 2.6-fold higher in the harvestable shoots than in the stubble for plants exposed to HDO vapour during the period when the harvestable shoots grew faster than the stubble. Our results suggest that the separation of harvestable shoots and stubble, both of which are generally combined as one part in studies on the metabolism of organically bound tritium (OBT) in grass, could contribute to a realistic evaluation of OBT transfer from timothy to livestock.
South–south technology transfer: the case of pharmaceutical know-how in Kenya, Tanzania and Uganda
Authors: Chorev Nitsan
Published: February 2022

Technological capabilities that are necessary for industrial development are often learned from others. But where does technology come from and through which channels? This article identifies a change in the source of pharmaceutical know-how in East Africa, from the global north to the global south. This shift in the countries from which know-how arrived coincided with a shift in the channels through which know-how was transferred, from channels that enhance individual capabilities to channels that enhance firm capabilities. What impact do such changes have on local production? I show that these changes not only led to increased inclusion—it became possible for nascent entrepreneurs with lesser resources to enter the sector—but also to increased internal differentiation. I also suggest that foreign direct investment functions as a countervailing force that reverses locally owned industrialization. Understanding sources and channels of technology transfer, and their impact, is an important contribution to the study of technology transfer and of industrial development more generally.
Towards a unified theory of market prices: turning to pricing in practice
Authors: Bååth Jonas
Published: February 2022

This article proceeds from the question: how do prices in markets work? In socio-economic theories, I find two answers to this question. The structural-coordinative approach explains prices as outcomes—coordinative effects of pricing scripts installed by exogenous, institutionalized social structures. The performative-epistemological approach explains prices as market devices—endogenous performative-epistemological tools of marketization. While not necessarily antithetical, the two theories define market knowledge, pricing and price in distinct ways. Drawing on ethnographic fieldwork from the Swedish meat industry, this article examines the merits of the two aforementioned theories and the prospects for unifying them. The conclusion presents an empirically grounded proposal for such a unification, emphasizing that prices, in practice, simultaneously express embedding social structures and mobilize marketization. A unified theory of market prices allows for identifying and analysing the recursive relation of social structures and performed episteme in pricing; how prices both express and realize market organization.
A Case of Phenibut Directed Detoxification Leading to Toxicity During the COVID-19 Pandemic
Authors: Peterkin Alyssa F. , Abraham Rohit , Harris Miriam T. H.
Published: February 2022

Background

Phenibut is a non-Food and Drug Administration-approved gamma-aminobutyric acid analog marketed in the United States as an anxiolytic, cognitive enhancer, and alcohol withdrawal treatment through online supplement vendors. In this case report, we describe a woman’s self-directed detoxification with phenibut used to manage withdrawal symptoms from fentanyl and benzodiazepines in March 2020 during the height of the COVID-19 pandemic.

Case

A 38-year-old woman with severe opioid, benzodiazepine, gabapentin, stimulant use disorders developed altered mental status after oral phenibut ingestion intended to help self-manage opioid and benzodiazepine withdrawal. She chose self-directed detoxification as she feared COVID-19 exposure in detoxification facilities. Her altered mental status drove her to jump out a third-story window causing multiple spinal fractures. After a long hospitalization, she self-directed her discharge home due to concerns about COVID-19. Her premature discharge disrupted opioid and benzodiazepine use disorder treatment plans.

Conclusion

This case highlights the risks of phenibut use for selfdirected detoxification. With COVID-19 related changes in the drug supply, people may be more likely to use online pharmaceuticals, therefore, substance use assessments should inquire about the online acquisition of new psychoactive drugs. Public health messaging regarding the risks of infectious disease transmission in addiction care settings is needed to guide addiction treatment choices among people who use substances.
Discordance Between Self-reported and Biologically Tested Exposure to Fentanyl Among People at Risk of Opioid Overdose
Authors: Park Ju Nyeong , Urquhart Glenna , Morris Miles , Dahal Rejwi , Rouhani Saba , Sherman Susan G.
Published: February 2022

Drug overdose remains a leading cause of death in the US, and the majority of opioid overdose fatalities involve fentanyl. This study aims to measure the degree of concordance between self-reported and biologically tested exposure to fentanyl. We conducted a cross-sectional analysis using survey and urinalysis data collected between 2019 and 2020 from Anne Arundel County, Maryland. Among urinalysis participants (n =113), 30% reported daily fentanyl use, and among this group, only 54% had a fentanyl-positive result. Cohen Kappa between self-reported and biologically detected fentanyl use was 0.26, indicating minimal agreement between the 2 markers. Limitations to interpreting self-reported and urinalysis data are discussed in this report.
Hyperoxia and Antioxidants for Myocardial Injury in Noncardiac Surgery: A 2 × 2 Factorial, Blinded, Randomized Clinical Trial
Authors: Holse Cecilie , Aasvang Eske K. , Vester-Andersen Morten , Rasmussen Lars S. , Wetterslev Jørn , Christensen Robin , Jorgensen Lars N. , Pedersen Sofie S. , Loft Frederik C. , Troensegaard Hannibal , Mørkenborg Marie-Louise , Stisen Zara R. , Rünitz Kim , Eiberg Jonas P. , Hansted Anna K. , Meyhoff Christian S. ,   for the VIXIE Trial Group
Published: February 2022

Background

Hyperoxia and oxidative stress may be associated with increased risk of myocardial injury. The authors hypothesized that a perioperative inspiratory oxygen fraction of 0.80 versus 0.30 would increase the degree of myocardial injury within the first 3 days of surgery, and that an antioxidant intervention would reduce degree of myocardial injury versus placebo.

Methods

A 2 × 2 factorial, randomized, blinded, multicenter trial enrolled patients older than 45 yr who had cardiovascular risk factors undergoing major noncardiac surgery. Factorial randomization allocated patients to one of two oxygen interventions from intubation and at 2 h after surgery, as well as antioxidant intervention or matching placebo. Antioxidants were 3 g IV vitamin C and 100 mg/kg N-acetylcysteine. The primary outcome was the degree of myocardial injury assessed by the area under the curve for high-sensitive troponin within the first 3 postoperative days.

Results

The authors randomized 600 participants from April 2018 to January 2020 and analyzed 576 patients for the primary outcome. Baseline and intraoperative characteristics did not differ between groups. The primary outcome was 35 ng · day/l (19 to 58) in the 80% oxygen group; 35 ng · day/l (17 to 56) in the 30% oxygen group; 35 ng · day/l (19 to 54) in the antioxidants group; and 33 ng · day/l (18 to 57) in the placebo group. The median difference between oxygen groups was 1.5 ng · day/l (95% CI, −2.5 to 5.3; P = 0.202) and −0.5 ng · day/l (95% CI, −4.5 to 3.0; P = 0.228) between antioxidant groups. Mortality at 30 days occurred in 9 of 576 patients (1.6%; odds ratio, 2.01 [95% CI, 0.50 to 8.1]; P = 0.329 for the 80% vs. 30% oxygen groups; and odds ratio, 0.79 [95% CI, 0.214 to 2.99]; P = 0.732 for the antioxidants vs. placebo groups).

Conclusions

Perioperative interventions with high inspiratory oxygen fraction and antioxidants did not change the degree of myocardial injury within the first 3 days of surgery. This implies safety with 80% oxygen and no cardiovascular benefits of vitamin C and N-acetylcysteine in major noncardiac surgery.

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What We Already Know about This Topic

What This Article Tells Us That Is New
Anesthesia Considerations in Infective Endocarditis
Authors: Hermanns Henning , Eberl Susanne , Terwindt Lotte E. , Mastenbroek Thierry C. B. , Bauer Wolfgang O. , van der Vaart Thomas W. , Preckel Benedikt
Published: February 2022

The management of infective endocarditis is complex and inherently requires multidisciplinary cooperation. About half of all patients diagnosed with infective endocarditis will meet the criteria to undergo cardiac surgery, which regularly takes place in urgent or emergency settings. The pathophysiology and clinical presentation of infective endocarditis make it a unique disorder within cardiac surgery that warrants a thorough understanding of specific characteristics in the perioperative period. This includes, among others, echocardiography, coagulation, bleeding management, or treatment of organ dysfunction. In this narrative review article, the authors summarize the current knowledge on infective endocarditis relevant for the clinical anesthesiologist in perioperative management of respective patients. Furthermore, the authors advocate for the anesthesiologist to become a structural member of the endocarditis team.
Frequency and Types of Healthcare Encounters in the Week Preceding a Sepsis Hospitalization: A Systematic Review
Authors: Flannery Alexander H. , Venn Chad M. , Gusovsky Amanda , Henderson Stephanie , Kiser Adam S. , Prescott Hallie C. , Rhee Chanu , Delcher Chris , Morris Peter E.
Published: February 2022

OBJECTIVES:

Early recognition and treatment are critical to improving sepsis outcomes. We sought to identify the frequency and types of encounters that patients have with the healthcare system in the week prior to a sepsis hospitalization.

DATA SOURCES:

PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, and the Cochrane Library.

STUDY SELECTION:

Observational cohort studies of patients hospitalized with sepsis or septic shock that were assessed for an outpatient or emergency department encounter with the healthcare system in the week prior to hospital admission.

DATA EXTRACTION:

The primary outcome was the proportion of patients with a healthcare encounter in the time period assessed (up to 1 week) prior to a hospitalization with sepsis.

DATA SYNTHESIS:

Six retrospective observational studies encompassing 6,785,728 sepsis admissions were included for evaluation, ranging from a 263-patient single-center cohort to a large database evaluating 6,731,827 sepsis admissions. The average (unweighted) proportion of patients having an encounter with the healthcare system in the week prior to a sepsis hospitalization was 32.7% and ranged from 10.3% to 52.9%. These encounters commonly involved presentation or potential symptoms of infectious diseases, antibiotic prescriptions, and appeared to increase in frequency closer to a sepsis hospitalization admission. No consistent factors were identified that distinguished a healthcare encounter as more or less likely to precede a sepsis hospitalization in the subsequent week.

CONCLUSIONS:

Patients that present to the hospital with sepsis are frequently evaluated in the healthcare system in the week prior to admission. Further research is necessary to understand if these encounters offer earlier opportunities for intervention to prevent the transition from infection to sepsis, whether they merely reflect the comorbidities of sepsis patients with a high baseline rate of healthcare encounters, or the declining trajectory of a patient’s overall health in response to infection.
Nurse–Client Engagement
Authors: Woods Katie
Published: February 2022

Engaging clients is central to nurses' work across all practice settings. This concept analysis seeks to better understand engagement as seen by the participants. Data from 15 qualitative studies conducted between 1982 and 2020 illustrate engagement from the perspective of nurse and client. Five defining attributes emerged: genuine concern and hopeful persistence, authenticity, trusting, time, and mutuality. The purpose of this concept analysis is to make the process of engagement visible, quantifiable, and valid.
Lichen Planus Pemphigoides Associated With PD-1 and PD-L1 Inhibitors: A Case Series and Review of the Literature
Authors: Boyle Margaret M. , Ashi Shaymaa , Puiu Tudor , Reimer Danielle , Sokumbi Olayemi , Soltani Keyoumars , Onajin Oluwakemi
Published: February 2022

Immune checkpoint inhibitors are increasingly being used in the treatment of various solid organ and hematologic malignancies. Dermatologic toxicities associated with programmed cell death protein-1 (PD-1) and programmed death ligand-1 (PD-L1) therapy have been widely reported in the literature. It is important for clinicians to be aware of these toxicities to ensure prompt recognition and treatment. Herein, we present the clinical, histopathologic, and immunofluorescence findings of 3 patients diagnosed with lichen planus pemphigoides (LPP) after treatment with anti-PD-1 inhibitors. We also reviewed the literature and summarize 7 previously reported cases of LPP associated with anti-PD-1 and anti-PD-L1 inhibitors. LPP was diagnosed at a median time of 24.4 weeks (range: 4–78 weeks) after initiation of immunotherapy. Clinical findings included papules, plaques, erosions, vesicles, and bullae on the trunk and extremities. Oral involvement was present in half the cases. Histopathologic features of immunotherapy-induced LPP included lichenoid or vacuolar interface dermatitis, the presence of eosinophils, and subepidermal bullae. Direct immunofluorescence demonstrated linear deposition of immunoglobulin G (IgG) or C3. Indirect immunofluorescence demonstrated linear IgG along basement membrane zone on monkey esophagus in 2 cases and linear IgG on the epidermal side of salt split skin in 3 cases. Serum anti-BP180 was elevated in all cases in which enzyme-linked immunosorbent assay was performed.
Unusual Late Complication of Latissimus Dorsi Free Flap Donor Site: Elastofibroma Dorsi
Authors: Cavadas Pedro C. , Almoguera-Martinez Alejandro , Idriss Hassan
Published: February 2022

In existing literature about elastofibroma dorsi (ED), no cases reported ED arising after latissimus dorsi flap harvest. Concretely, we present a patient who developed an ED at latissimus dorsi free flap donor site 10 years after harvesting. After our research, we found the occurrence of ED after thoracotomy surgery, stressing the importance of previous local trauma. Latissimus dorsi flap harvest is also a local traumatic episode, although its association with ED has not been previously reported. Thus, ED should be considered in the differential diagnosis of deep soft tissue lumps after latissimus dorsi harvest.
Spontaneous Partial Regression of Bilateral Grade III Corneal Dermoids Associated With Fetal Valproate Spectrum Disorder
Authors: Kiratli Hayyam , Colak Dilan , Koç İrem
Published: February 2022

Purpose:

The purpose of this study was to describe a rare case of a child with bilateral central corneal dermoids (grade III) in association with fetal valproate spectrum disorder (FVSD) and to report the spontaneous regression of these tumors.

Methods:

Clinical records of a 14-month-old child whose mother took sodium valproate all along her pregnancy were retrospectively reviewed. The diagnosis of FVSD was made based on phenotypic features and associated congenital malformations. Facial features included trigonocephaly, flat nose bridge and small upturned nose, cleft palate and lip, and micrognathia. Systemic anomalies included bilateral radial defects and club hands, pes equinovarus, hypospadias, secundum atrial septal defect, patent ductus arteriosus, and aortic insufficiency. Cytogenetic studies were normal.

Results:

Ocular findings included bilateral central corneal dermoids sparing the limbus and peripheral cornea, bilateral aphakia, absence of left anterior chamber, and bilateral mass-like vitreal opacities. A computed tomography scan suggested minimal left microphthalmia. Owing to the high-risk category for general anesthesia and prioritization of other severe systemic anomalies, no ocular surgical intervention was performed. Over 5 years of follow-up, spontaneous partial regression of the corneal tumors was observed.

Conclusions:

The development of bilateral grade III corneal dermoids in a child with FVSD may be more than fortuitous and enlarges the list of ocular anomalies associated with FVSD. Corneal dermoids may regress spontaneously.
Long-Term Follow-Up of Corneal Endothelial Cell Changes After Iris-Fixated Phakic Intraocular Lens Explantation
Authors: Kim Tae Young , Moon In Hee , Park Sung Eun , Ji Yong Woo , Lee Hyung Keun
Published: February 2022

Purpose:

The purpose of this study was to evaluate long-term corneal endothelial cell changes and visual outcomes after iris-fixated phakic intraocular lens (pIOL) explantation in patients with endothelial damage and to investigate potential predictors of endothelial injury.

Methods:

Consecutive patients undergoing pIOL explantation with corneal endothelial cell density (ECD) <2000 cells/mm2 at the time of the procedure were retrospectively reviewed in a single tertiary center. All patients were treated between April 2016 and October 2020 at a high-volume referral-based tertiary hospital. The primary outcome was the change in corneal endothelial parameters, including ECD, over long-term follow-up. Secondary outcomes included changes in corrected distance visual acuity and analysis of prognostic factors.

Results:

This study included 44 eyes from 28 patients with an average age of 42.5 ± 7.8 years (range: 27–63). Mean ECD before explantation was 1375.4 ± 468.2 cells/mm2 (range: 622–1996), and the average duration of follow-up after explantation was 20.5 months (6–58.2). Two years after explantation, ECD had significantly decreased by more than 25% to 1019.6 ± 368.6 (608–1689; P < 0.01). However, there was no significant change in corrected distance visual acuity (20/23–20/22, P = 0.59). Longer operation duration (odds ratio, 1.004; P = 0.04) was the only significant factor weakly associated with postoperative decreases in ECD.

Conclusions:

Although ECD continuously decreased despite pIOL explantation on a long-term follow-up, patients did not experience any discomfort or showed decreases in visual acuity. Therefore, a careful follow-up is required for possible endothelial injury after pIOL explantation.
An Approach to the Simultaneous Detection of Multiple Biomarkers for the Early Diagnosis of Liver Cancer Using Quantum Dot Nanoprobes
Authors: Cheng Ningtao , Fu Jing
Published: February 2022

Biomarker-based early diagnosis of liver cancer is of high clinical value for reducing the mortality rate. However, it has been challenging to establish early detection methods with a single biomarker such as alpha-fetoprotein (AFP) because of limited diagnostic sensitivity and specificity. Therefore, developing multiplexed biomarker detection assays is crucially important for early diagnosis. Yet, simultaneous detection methods involving three or more biomarkers have been scarce. Here we suggest employing the serological biomarker panel of glypican-3 (GPC3), dickkopf-1 (DKK1), and AFP for liver cancer detection. We present a rapid simultaneous detection approach for the biomarker panel labeled with three fluorescent quantum dot nanoprobes (emission wavelengths at 565 nm, 605 nm, and 655 nm). As a proof-of-concept, simultaneous fluorescence detection of the biomarker panel was demonstrated using mixed reference samples containing human recombinant GPC3, DKK1, and AFP antigens. Our simultaneous detection approach conferred a linear range of 0.625-2.5 ng•mL-1 for the entire biomarker panel, which merits further clinical validation for the simultaneous and accurate determination of the biomarker panel in human serum samples.
The Knowledge on HCV: From the Discovery to the Elimination
Authors: Guan Jun , Ren Yanli , Wang Jing , Zhu Haihong
Published: February 2022

From being described as “non-A, non-B” hepatitis in 1975 and being identified in 1989, to the emergence of direct-acting antiviral drugs (DAAs), knowledge on hepatitis C virus (HCV) has achieved a qualitative leap in recent decades. Although more than 95% of HCV patients can be cured by DAAs, the high detection rate, high treatment cost, and relative high recurrence rate for some subtypes (eg, type 3b) make it still a public health problem worldwide. Due to the widespread availability of DAAs, vaccine research has received relatively little attention. The purpose of this review is to look back to the discovery of the HCV, its life cycle, innate and adaptive immune responses, and the evolution of treatment options for HCV.
Practice and Prospect: HIV-1 Molecular Network-Based Studies in China
Authors: Qiu Yu , Zhao Bin , Han Xiaoxu , Zhong Ping
Published: February 2022

Identification of human immunodeficiency virus (HIV) transmission networks is a critical step in the public health response; however, it is challenging to achieve this through traditional epidemiological surveys alone. The molecular network approach can provide more accurate information for understanding HIV outbreaks and bring targeted interventions into reality. Based on the current global development of the concept of the molecular network, Chinese scientists have in recent years explored the applications of molecular networks for understanding the HIV-1 transmission trends, for identifying the population acquiring priority interventions, and for evaluating the targeted intervention effectiveness. In this review, we focus on research progress by Chinese scientists in the field of molecular networks and put forward some suggestions for future research of molecular networks.
Basal Cell Carcinoma Excision Guided by Dermoscopy: A Retrospective Study in Macau
Authors: Coelho Ricardo , Cheong Si Leong
Published: February 2022

Objective:

Dermoscopic evaluation of tumor margins may help to accurately detect lateral borders before surgical excision. The purpose of this study was to comprehensively evaluate the usefulness of dermoscopically detecting basal cell carcinoma tumor margins before surgical excision.

Methods:

The authors retrospectively analyzed the outcomes of 60 basal cell carcinomas that were excised after undergoing dermoscopic evaluation of the margins from 2016 to 2018 in a single center in Macau SAR, China. Descriptive statistical analysis was carried out by using frequencies and percentages.

Results:

All treated tumors were completely excised, although five had safety margins of <1 mm. No re-excisions were performed and during a medium follow-up period of 31 months, none of the 60 tumors showed any evidence of recurrence.

Conclusions:

Our data suggest that the preoperative dermoscopic evaluation of tumor margins increases the chances of successful and complete tumor excision, while preserving healthy adjacent tissue. Further studies comparing dermoscopy-assisted versus conventional excision are needed to better evaluate the value of this technique.
Methods of Capturing Process Outcomes in Quality Improvement Trials: A Systematic Review
Authors: Radisic Gorjana , de la Perrelle Lenore , Laver Kate
Published: February 2022

Healthcare quality can be measured by studying structure, processes, and outcomes. This study examines how trialists capture process outcomes in implementation trials to provide guidance for researchers and health professionals. Electronic databases were searched, and two researchers performed the title, abstract, and full-text selection. Only implementation studies involving nonpharmacological approaches were included. Data were extracted by one reviewer and checked for accuracy and completeness by a second reviewer. Study quality was independently assessed by two reviewers. Of the 3,186 articles screened, 24 studies matched our inclusion criteria. Most studies were cluster randomized control trials, followed by interrupted time series studies and stepped wedge studies. The population in the studies was diverse and settings included hospitals, community centers, residential aged care facilities, and primary care. The reporting of process measures across the included studies varied, and there was limited information about the mechanisms of data collection procedures. Nineteen studies extracted information about processes from electronic medical records, patient records, or chart reviews. The remaining five studies used staff surveys. Challenges remain in the practical aspect of data collection for measuring process outcomes, particularly outside of hospital settings or where processes are hard to capture in patient records.
Patulous Eustachian Tube Patients With Oculopharyngeal Muscular Dystrophy
Authors: Ishigakii Kento , Ikeda Ryoukichi , Suzuki Jun , Hirano-Kawamoto Ai , Ohta Jun , Kato Kengo , Izumi Rumiko , Suzuki Naoki , Aoki Masashi , Kawase Tetsuaki , Katori Yukio
Published: February 2022

Objectives:

To describe cases of patulous Eustachian tube (PET) or patent ET conditions in oculopharyngeal muscular dystrophy (OPMD).

Patients:

Four cases of PET or patent ET conditions with OPMD.

Main Outcome Measures:

Clinical case records, objective ET function tests (tubo-tympano-aerodynamic graphy and sonotubometry), and swallowing function (videoendoscopic examination and Food Intake Level Scale) were analyzed.

Results:

Two cases of definite PET, one case of possible PET, and one case lacking aural symptoms with findings of patent ET. All patients have ptosis, and three cases have dysphagia. Body mass index indicated that three cases were underweight. Magnetic resonance imaging in case 4 showed atrophy and fat replacement of palatine and masticatory muscles.

Conclusions:

It is important to consider PET or patent ET conditions when OPMD patients describe aural symptoms.
Incidence and Timing of Thrombocytopenia in Patients Receiving Impella Ventricular Assist Device Support
Authors: Shuster Mareena , Konopka Chelsea I. , Verlinden Nathan J.
Published: February 2022

Impella devices are used in patients with cardiogenic shock or during high-risk percutaneous coronary intervention. Although thrombocytopenia is a known complication in patients receiving Impella support, the incidence and timing of thrombocytopenia remain unknown in this patient population. We retrospectively reviewed adult patients with a left-sided Impella device inserted for more than 24 hours between February 2016 and December 2019. A total of 349 patients were reviewed, and 99 patients were included. Baseline characteristics were similar between patients with thrombocytopenia and those without thrombocytopenia with the exception of median duration of Impella support, which was longer in patients with thrombocytopenia (3.7 vs. 2.1 days; p < 0.001). Thrombocytopenia occurred in 70 patients (70.7%) after Impella implantation. Median time to onset of thrombocytopenia after Impella placement was 2 days with platelet nadirs occurring after 4 days. Thrombocytopenia was mild in our study with 73% of patients having platelet nadirs above 50,000/mL. Duration of Impella support (odds ratio [OR] per day: 1.31; 95% confidence interval [CI]: 1.06–1.56; p = 0.017) and aspirin use (OR: 9.7; 95% CI: 1.46–64.5; p = 0.019) were independent predictors of thrombocytopenia. Thrombocytopenia is common in patients after Impella implantation but is not associated with adverse outcomes.