bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Continuous Sedatives in the Burn ICU on Delirium and Coma
Authors: Falksen Jessica A , Young Sierra R , Lee Jin A
Published: October 2023

Lighter sedation targets over the past decade have resulted in improved outcomes for critically ill populations. Although guidelines exist for the general ICU population, these recommendations often exclude the burn population. The purpose of this study is to assess the impact of the initial continuous sedative on coma- and delirium-free days in critically ill patients with burns. This retrospective cohort study evaluated adult patients admitted to a burn intensive care unit at an academic medical center between January 2010 and September 2019. Patients were enrolled into 3 groups based on the depth of initial continuous sedation received (deep, light, or analgosedation). Intubated patients were randomly assessed for inclusion from the National V6 Burn Registry. Patients were included if they received a continuous sedative infusion for at least 48 h. A total of 107 patients were included in the study with 36, 41, and 30 patients receiving deep, light, and analgosedation, respectively. The primary outcome of coma- and delirium-free days was significantly different between sedation types with the most days free in analgosedation and the fewest in deep sedation (8 versus 3 days; P = 0.024). The composite primary outcome was divided into secondary outcomes of coma-free days and delirium-free days, with coma-free days being different (P = 0.00008). Other secondary outcomes of length of stay in the intensive care unit and hospital, time on mechanical ventilation, and survival to discharge were not statistically significant; however, a trend toward higher mortality in deep sedation was noted.
Dose–responses of seven species of cerambycid beetles to synthesized pheromones in field experiments
Authors: Grommes Anna C , Millar Jocelyn G , Hanks Lawrence M
Published: October 2023

Adult male cerambycid beetles of the subfamilies Cerambycinae and Lamiinae emit aggregation-sex pheromones that attract both sexes, and these chemicals can be utilized for quarantine surveillance for related exotic species which produce the same or similar pheromones. Here, we assess how attraction of 7 cerambycid species to pheromone-baited traps was influenced by the release rates of synthesized pheromones from polyethylene sachet emitters. Compounds tested included racemic 3-hydroxyhexan-2-one, the (R)-enantiomer of which is the sole or major pheromone component of numerous cerambycine species, and 2 compounds that are pheromone components of many lamiine species: (E)-6,10-dimethyl-5,9-undecadien-2-yl acetate (fuscumol acetate) and 6-methylhept-5-en-2-ol (sulcatol). We confirmed release rates of these compounds could be manipulated by varying the doses loaded into emitters. Various doses and concentrations, ranging from very dilute to the neat compounds, were then tested in field trials. Several species were most strongly attracted to the highest dose of a tested compound, one species to an intermediate dose, while another species was equally attracted regardless of dose. Our results demonstrate the importance of characterizing dose–response relationships for cerambycid species targeted by pheromone-based trapping.
Hilling as a cultural control strategy for soybean gall midge (Diptera: Cecidomyiidae)
Authors: McMechan Anthony Justin , Schroeder de Souza Joana , Umezu Natasha , Gupta Pragya , Inveninato Carmona Gabriela
Published: October 2023

Soybean gall midge, Resseliella maxima Gagné, was recently identified as a new species causing significant injury to soybean and is currently found in 164 counties across 7 midwestern states (NE, IA, SD, MN, MO, ND, and KS). Infestation of soybean begins in late spring, when adults emerge from last year’s soybean field. Infestation of a new soybean crop depends on the presence of fissures which start to form at the base of the soybean plant around the V2 stage. Field observations indicate that these fissures are only present below the cotyledonary nodes or in the area within 3–5 cm above the soil surface. To determine the importance of these fissures for R. maxima infestation and plant injury, hilling or the movement of the soil to cover the base of soybean plants at the V2–V3 stage was compared with the standard practice (no-hilling). Field studies were conducted at 3 sites in east-central Nebraska during the 2021 growing season. The results showed a significant reduction in the frequency of infested plants, larval number per plant, and plant injury for hilled compared to no-hill treatment. This reduction in the presence of larvae and plant injury corresponded with a significantly greater yield for hilled compared to the no-hill treatment. These results highlight the importance of fissures on soybean for R. maxima adult infestation as well as the potential for hilling to be used as a management strategy for R. maxima.
Constructive aspects of Riemann’s permutation theorem for series
Authors: Berger J , Bridges Douglas , Diener Hannes , Schwichtenberg Helmet
Published: October 2023

The notions of permutable and weak-permutable convergence of a series $\sum _{n=1}^{\infty }a_{n}$ of real numbers are introduced. Classically, these two notions are equivalent, and, by Riemann’s two main theorems on the convergence of series, a convergent series is permutably convergent if and only if it is absolutely convergent. Working within Bishop-style constructive mathematics, we prove that Ishihara’s principle BD- $\mathbb {N}$ implies that every permutably convergent series is absolutely convergent. Since there are models of constructive mathematics in which the Riemann permutation theorem for series holds but BD- $\mathbb{N}$ does not, the best we can hope for as a partial converse to our first theorem is that the absolute convergence of series with a permutability property classically equivalent to that of Riemann implies BD- $\mathbb {N}$ . We show that this is the case when the property is weak-permutable convergence.
Epistemic injustice in educational policy: an account of structural contributory injustice
Authors: Bogia Megan L
Published: October 2023

In this paper, I introduce a special case of epistemic injustice that I call ‘structural contributory injustice’. This conception aims to capture some dimensions of how policy—separately from individual agential interactions—can generate epistemic injustice at a group level. I first locate the case within Kristie Dotson’s original conception of contributory injustice. I then consider one potential case of structural contributory injustice—namely, the policy problem of significant financial risk burden on students considering university in the USA. Finally, I consider potential policy reforms in response to this injustice.
Trends in anti-neuropathic medications turnover in Iraq
Authors: Al-Shammaa Zainab M , Aladul Mohammed I , Essa Narmin S
Published: October 2023

Objectives

Neuropathic pain (NP) is a type of chronic pain. Numerous diseases and/or lesions are associated with the development of NP, and diabetes mellitus is the most prevalent cause. Several classes of medications were recommended and/or approved as anti-neuropathic medications. This study aimed to examine the trends in the turnover of anti-neuropathic medications in Iraq.

Methods

This was a retrospective analysis of the turnover of selected anti-neuropathic medications in the Iraqi market derived from Advanced Marketing Statistics between 2017 and 2021. The sales units were converted to defined daily doses. Regression analysis and correlation analysis were used to compare the turnover of the medications.

Key findings

The overall volume of turnover of anti-neuropathic medications increased between 2017 and 2021. The anti-neuropathic market domination was shifted from carbamazepine to pregabalin, in which the average increase in pregabalin turnover of 60% [95% CI (confidence interval) 37.6–82.5] quarterly to achieve 42% of the market share (highest sales) by 2021. The overall expenditure on anti-neuropathic medications increased steadily over the study period.

Conclusions

The market of anti-neuropathic medications’ domination was shifted from the older antiepileptic drug (AED) (carbamazepine) to the newer AED (pregabalin). The availability and affordability of less expensive generic versions of these agents, together with the better safety profiles of the newer agents were the main driver for this shift. This indeed allowed Iraqi physicians to adhere to the latest international guidelines.
Causal inference with a functional outcome
Authors: Ecker Kreske , de Luna Xavier , Schelin Lina
Published: October 2023

This article presents methods to study the causal effect of a binary treatment on a functional outcome with observational data. We define a Functional Average Treatment Effect (FATE) and develop an outcome regression estimator. We show how to obtain valid inference on the FATE using simultaneous confidence bands, which cover the FATE with a given probability over the entire domain. Simulation experiments illustrate how the simultaneous confidence bands take the multiple comparison problem into account. Finally, we use the methods to infer the effect of early adult location on subsequent income development for one Swedish birth cohort.
Using CHIRON spectroscopy to test the hypothesis of a precessing orbit for the WN4 star EZ CMa
Authors: Barclay Krister D G , Rosu Sophie , Richardson Noel D , Chené André-Nicolas , St-Louis Nicole , Ignace Richard , Moffat Anthony F J
Published: October 2023

The bright WN4 star EZ CMa exhibits a 3.77 d periodicity in photometry, spectroscopy, and polarimetry, but the variations in the measurements are not strictly phase-locked, exhibiting changes in reference times, amplitudes, and the shape of the variability happening over times as short as a few weeks. Recently, 137 d of contiguous, variable photometry from BRITE-constellation was interpreted as caused either by large-scale dense wind structures modulated by rotation, or by a fast-precessing binary having a slightly shorter 3.626 d orbital period and a fast apsidal motion rate of $1315^\circ \, \text{yr}^{-1}$. We aim at testing the latter hypothesis through analysis of spectroscopy and focus on the N v λ 4945 line. We derive an orbital solution for the system and reject the 3.626 d period to represent the variations in the radial velocities of EZ CMa. An orbital solution with an orbital period of 3.77 d was obtained but at the cost of an extremely high and thus improbable apsidal motion rate. Our best orbital solution yields a period of 3.751 ± 0.001 d with no apsidal motion. We place our results in the context of other variability studies and system properties. While we cannot fully reject the precessing binary model, we find that the corotating interaction region (CIR) hypothesis is better supported by these and other data through qualitative models of CIRs.
Proteometabolomics of initial and recurrent glioblastoma highlights an increased immune cell signature with altered lipid metabolism
Authors: Cosenza-Contreras Miguel , Schäfer Agnes , Sing Justin , Cook Lena , Stillger Maren N , Chen Chia-Yi , Villacorta Hidalgo Jose , Pinter Niko , Meyer Larissa , Werner Tilman , Bug Darleen , Haberl Zeno , Kübeck Oliver , Zhao Kai , Stei Susanne , Gafencu Anca Violeta , Ionita Radu , Brehar Felix M , Ferrer-Lozano Jaime , Ribas Gloria , Cerdá-Alberich Leo , Martí-Bonmatí Luis , Nimsky Christopher , Van Straaten Alexis , Biniossek Martin L , Föll Melanie , Cabezas-Wallscheid Nina , Büscher Jörg , Röst Hannes , Arnoux Armelle , Bartsch Jörg W , Schilling Oliver
Published: October 2023

Background

There is an urgent need to better understand the mechanisms associated with the development, progression, and onset of recurrence after initial surgery in glioblastoma (GBM). The use of integrative phenotype-focused -omics technologies such as proteomics and lipidomics provides an unbiased approach to explore the molecular evolution of the tumor and its associated environment.

Methods

We assembled a cohort of patient-matched initial (iGBM) and recurrent (rGBM) specimens of resected GBM. Proteome and metabolome composition were determined by mass spectrometry-based techniques. We performed neutrophil-GBM cell coculture experiments to evaluate the behavior of rGBM-enriched proteins in the tumor microenvironment. ELISA-based quantitation of candidate proteins was performed to test the association of their plasma concentrations in iGBM with the onset of recurrence.

Results

Proteomic profiles reflect increased immune cell infiltration and extracellular matrix reorganization in rGBM. ASAH1, SYMN, and GPNMB were highly enriched proteins in rGBM. Lipidomics indicates the downregulation of ceramides in rGBM. Cell analyses suggest a role for ASAH1 in neutrophils and its localization in extracellular traps. Plasma concentrations of ASAH1 and SYNM show an association with time to recurrence.

Conclusions

We describe the potential importance of ASAH1 in tumor progression and development of rGBM via metabolic rearrangement and showcase the feedback from the tumor microenvironment to plasma proteome profiles. We report the potential of ASAH1 and SYNM as plasma markers of rGBM progression. The published datasets can be considered as a resource for further functional and biomarker studies involving additional -omics technologies.
Geoengineering: proactive measures to tackle climate change
Authors: Zhu He
Published: October 2023

As of 20 August, 2023, extensive parts of northern China including the capital city of Beijing had experienced arguably the hottest summer in recent years, recording consecutive days of high temperatures at or near 40°C. Against this backdrop, National Science Review (NSR) organized a web forum on a climate-related topic that needs more exposure to Chinese public and researchers alike: geoengineering. Compared to commonly-known methods to address climate change such as emission reduction, geoengineering proposes to take much more proactive measures such as injecting aerosol into the stratosphere to increase solar reflection, implementing iron fertilization in the ocean to promote microbial growth, and capturing and liquifying CO2 and injecting it directly into exhausted oil fields. The forum was hosted by Prof. Tong Zhu of Peking University with four panelists. Together, they introduced the scientific backgrounds and implementations of these proactive measures and discussed the pros and cons anticipated by researchers so far.

Fei Chai (柴扉)

Professor, College of Ocean and Earth Sciences, Xiamen University

Zhijun Jin (金之钧)

Professor, SONOPEC Petroleum Exploration and Production Research Institute; Dean, Institute of Energy, Peking University; Dean, Peking University Ordos Research Institute of Energy

Shawchen Liu (刘绍臣)

Professor, Institute for Environmental and Climate Research, Jinan University

Jianhua Xu (徐建华)

Associate Professor, Department of Environmental Management, College of Environmental Sciences and Engineering and Institute for Global Health and Development, Peking University

Tong Zhu (朱彤) (Chair)

Professor, College of Environmental Sciences and Engineering, Peking University
Procalcitonin Monitoring and Antibiotic Duration in Presumed Lower Respiratory Tract Infections: A Propensity Score–Matched Cohort Across the Veterans Health Administration
Authors: Heren Jamie E , Lund Brian C , Alexander Bruce , Livorsi Daniel J
Published: October 2023

Background

Randomized controlled trials have shown that procalcitonin-guided algorithms can reduce antibiotic duration for lower respiratory tract infections (LRTIs). The goal of this study was to compare antibiotic duration for LRTIs with and without procalcitonin testing in real-life practice.

Methods

This retrospective cohort study included all acute care hospital admissions for presumed LRTIs between 1/2018 and 12/2021 at 81 Veterans Affairs facilities with on-site procalcitonin testing. The exposure was procalcitonin testing; the primary outcome was antibiotic duration. We used 1:1 nearest-neighbor propensity score matching to estimate the difference in outcome between procalcitonin-tested and nontested patients.

Results

A total of 35 610 patients with LRTIs were included (6015 [16.9%] with procalcitonin testing; 29 595 [83.1%] without testing). In tested patients, the median number of procalcitonin levels checked (interquartile range) was 2 (1–3). The mean antibiotic duration was 10.0 days in the procalcitonin group compared with 8.3 days in nontested patients (unadjusted difference, 1.7 days; P < .0001). After propensity score matching with 3903 pairs, antibiotic duration remained greater in the procalcitonin group (9.6 days vs 9.2 days; P < .0001). In a subgroup analysis of 2241 tested patients with a procalcitonin value at the standard threshold for antibiotic discontinuation, antibiotic duration was shorter in tested vs nontested patients, with a mean difference of 0.1 days (P < .01).

Conclusions

In this retrospective propensity-matched cohort of patients with presumed LRTIs across a geographically diverse group of hospitals, patients who underwent procalcitonin testing did not have a meaningful reduction in antibiotic duration compared with those who were not tested. Poor implementation of procalcitonin testing may have undermined its effectiveness.
Intentional Dental Modification
Authors: Burnett Scott E. , Tiesler Vera , Tremblay Kenneth , Willman John C.
Published: October 2023

Teeth have long been a focus of body modification as a visible and durable medium for communication with others through tooth removal (ablation), or alteration of tooth appearance by imbedding inlays, dyeing or painting the tooth crown, or shaping the occlusal or labial surfaces or both. One or more of these techniques for modification of the dentition have been employed on every populated continent at some point for the past twenty thousand years. Given the geographic and temporal distribution of intentional dental modification, the immense variability in such practices cannot be surprising. This chapter provides an overview of the primary types of intentional dental modification and discusses their classification and identification. It also reviews the geographic and temporal distribution of intentional dental modification worldwide and discusses the cultural significance and implications of these practices.
Archaeological Science and the Identification of Tattooing Tools
Authors: Deter-Wolf Aaron , Gillreath-Brown Andrew
Published: October 2023

The growing popularity of tattooing in modern culture is accompanied by an increased interest in the practice’s deep past and in identifying evidence of tattooing in archaeological and museum collections. Until recently, most identifications of tattooing artifacts were based on intuition rather than sound cultural comparisons or definitive, replicable data. Recent advances in archaeological science and efforts to contextualize tattooing as a global practice have provided new frameworks for successful artifact identification. This chapter assesses the methods that have been used to identify the material remains of tattooing tools in the archaeological record, ranging from the instincts of investigators to microwear studies, and shows the need for rigorous and comprehensive analyses in studying and discovering tattoo tools, in both the archaeological record and curated collections.
Internal Applications and Puzzles of the Applicability of Mathematics
Authors: Marshall Douglas Bertrand
Published: October 2023

Just as mathematics helps us to represent and reason about the natural world, in its internal applications one branch of mathematics helps us to represent and reason about the subject matter of another. Recognition of the close analogy between internal and external applications of mathematics can help resolve two persistent philosophical puzzles concerning its applicability: a platonist puzzle arising from the abstractness of mathematical objects; and an empiricist puzzle arising from mathematical propositions’ lack of empirical factual content. In order to see how this is the case, we will examine what it is to apply mathematics internally and describe examples.
The nuclear pore Y-complex functions as a platform for transcriptional regulation of FLOWERING LOCUS C in Arabidopsis
Authors: Huang Penghui , Zhang Xiaomei , Cheng Zhiyuan , Wang Xu , Miao Yuchen , Huang Guowen , Fu Yong-Fu , Feng Xianzhong
Published: October 2023

The nuclear pore complex (NPC) has multiple functions beyond the nucleo-cytoplasmic transport of large molecules. Subnuclear compartmentalization of chromatin is critical for gene expression in animals and yeast. However, the mechanism by which the NPC regulates gene expression is poorly understood in plants. Here we report that the Y-complex (Nup107–160 complex, a subcomplex of the NPC) self-maintains its nucleoporin homeostasis and modulates FLOWERING LOCUS C (FLC) transcription via changing histone modifications at this locus. We show that Y-complex nucleoporins are intimately associated with FLC chromatin through their interactions with histone H2A at the nuclear membrane. Fluorescence in situ hybridization assays revealed that Nup96, a Y-complex nucleoporin, enhances FLC positioning at the nuclear periphery. Nup96 interacted with HISTONE DEACETYLASE 6 (HDA6), a key repressor of FLC expression via histone modification, at the nuclear membrane to attenuate HDA6-catalyzed deposition at the FLC locus and change histone modifications. Moreover, we demonstrate that Y-complex nucleoporins interact with RNA polymerase II to increase its occupancy at the FLC locus, facilitating transcription. Collectively, our findings identify an attractive mechanism for the Y-complex in regulating FLC expression via tethering the locus at the nuclear periphery and altering its histone modification.
The systemic impact of deplatforming on social media
Authors: Mekacher Amin , Falkenberg Max , Baronchelli Andrea
Published: October 2023

Deplatforming, or banning malicious accounts from social media, is a key tool for moderating online harms. However, the consequences of deplatforming for the wider social media ecosystem have been largely overlooked so far, due to the difficulty of tracking banned users. Here, we address this gap by studying the ban-induced platform migration from Twitter to Gettr. With a matched dataset of 15M Gettr posts and 12M Twitter tweets, we show that users active on both platforms post similar content as users active on Gettr but banned from Twitter, but the latter have higher retention and are 5 times more active. Our results suggest that increased Gettr use is not associated with a substantial increase in user toxicity over time. In fact, we reveal that matched users are more toxic on Twitter, where they can engage in abusive cross-ideological interactions, than Gettr. Our analysis shows that the matched cohort are ideologically aligned with the far-right, and that the ability to interact with political opponents may be part of Twitter’s appeal to these users. Finally, we identify structural changes in the Gettr network preceding the 2023 Brasília insurrections, highlighting the risks that poorly regulated social media platforms may pose to democratic life.
Interferon ɛ restricts Zika virus infection in the female reproductive tract
Authors: Xu Chuan , Wang Annie , Ebraham Laith , Sullivan Liam , Tasker Carley , Pizutelli Vanessa , Couret Jennifer , Hernandez Cyril , Kolli Priyanka , Deb Pratik Q , Fritzky Luke , Subbian Selvakumar , Gao Nan , Lo Yungtai , Salvatore Mirella , Rivera Amariliz , Lemenze Alexander , Fitzgerald-Bocarsly Patricia , Tyagi Sanjay , Lu Wuyuan , Beaulieu Aimee , Chang Theresa L
Published: October 2023

Interferon ɛ (IFNɛ) is a unique type I IFN that has been implicated in host defense against sexually transmitted infections. Zika virus (ZIKV), an emerging pathogen, can infect the female reproductive tract (FRT) and cause devastating diseases, particularly in pregnant women. How IFNɛ contributes to protection against ZIKV infection in vivo is unknown. In this study, we show that IFNɛ plays a critical role in host protection against vaginal ZIKV infection in mice. We found that IFNɛ was expressed not only by epithelial cells in the FRT but also by immune and stromal cells at baseline or after exposure to viruses or specific Toll-like receptor (TLR) agonists. IFNɛ-deficient mice exhibited abnormalities in the epithelial border and underlying tissue in the cervicovaginal tract, and these defects were associated with increased susceptibility to vaginal but not subcutaneous ZIKV infection. IFNɛ deficiency resulted in an increase in magnitude, duration, and depth of ZIKV infection in the FRT. Critically, intravaginal administration of recombinant IFNɛ protected Ifnɛ−/− mice and highly susceptible Ifnar1−/− mice against vaginal ZIKV infection, indicating that IFNɛ was sufficient to provide protection even in the absence of signals from other type I IFNs and in an IFNAR1-independent manner. Our findings reveal a potentially critical role for IFNɛ in mediating protection against the transmission of ZIKV in the context of sexual contact.
Group Responsibility and Historicism
Authors: Collins Stephanie , de Haan Niels
Published: October 2023

In this paper, we focus on the moral responsibility of organized groups in light of historicism. Historicism is the view that any morally responsible agent must satisfy certain historical conditions, such as not having been manipulated. We set out four examples involving morally responsible organized groups that pose problems for existing accounts of historicism. We then pose a trilemma: one can reject group responsibility, reject historicism, or revise historicism. We pursue the third option. We formulate a Manipulation Condition and a Guarding Condition as addendums to historicism that are necessary to accommodate our cases of group responsibility.
Byakangelicol suppresses TiPs-stimulated osteoclastogenesis and bone destruction via COX-2/NF-κB signaling pathway
Authors: Wang Zhidong , Tao Huaqiang , Chu Miao , Yu Lei , Yang Peng , Wang Qiufei , Lu Jun , Yang Huilin , Wang Zhenheng , Zhang Hailin , Geng Dechun
Published: October 2023

Aseptic loosening (AL) is considered a significant cause of prosthesis revision after arthroplasty and a crucial factor in the longevity of an artificial joint prosthesis. The development of AL is primarily attributed to a series of biological reactions, such as peri-prosthetic osteolysis (PPO) induced by wear particles around the prosthesis. Chronic inflammation of the peri-prosthetic border tissue and hyperactivation of osteoclasts are key factors in this process, which are induced by metallic wear particles like Ti particles (TiPs). In our in vitro study, we observed that TiPs significantly enhanced the expression of inflammation-related genes, including COX-2, IL-1β and IL-6. Through screening a traditional Chinese medicine database, we identified byakangelicol, a traditional Chinese medicine molecule that targets COX-2. Our results demonstrated that byakangelicol effectively inhibited TiPs-stimulated osteoclast activation. Mechanistically, we found that byakangelicol suppressed the expression of COX-2 and related pro-inflammatory factors by modulating macrophage polarization status and NF-κB signaling pathway. The in vivo results also demonstrated that byakangelicol effectively inhibited the expression of inflammation-related factors, thereby significantly alleviating TiPs-induced cranial osteolysis. These findings suggested that byakangelicol could potentially be a promising therapeutic approach for preventing PPO.
The pros and cons of using automated sleep scoring in sleep research
Authors: Rayan Abdelrahman , Szabo Anna B , Genzel Lisa
Published: October 2023

Sleep scoring plays a pivotal role both in sleep research and in clinical practice. Traditionally, this process has relied on manual scoring by human experts, but it is marred by time constraints, and inconsistencies between different scorers. Consequently, the quest for more efficient and reliable approaches has sparked a great interest in the realm of automatic sleep-scoring methods. In this article, we provide an exploration of the merits and drawbacks of automatic sleep scoring, alongside the pressing challenges and critical considerations that demand attention in this evolving field.
Efficacy of Iminoctadine Trialbesilate and Trifloxystrobin in Inhibiting and Controlling Pear Powdery Mildew (Phyllactinia pyri) in Hebei Province, China
Authors: Bi Qiuyan , Lu Fen , Wu Jie , Han Xiuying , Wang Wenqiao , Zhao Jianjiang
Published: October 2023

Pear powdery mildew (PPM), caused by Phyllactinia pyri, is one of the most serious diseases affecting production in the Hebei pear-growing region of China. Iminoctadine trialbesilate and trifloxystrobin are known to have broad-spectrum activity against a wide range of plant pathogens, including P. pyri. A total of 105 P. pyri strains were isolated from 11 cities in Hebei Province from 2017 to 2019. Iminoctadine trialbesilate and trifloxystrobin significantly inhibited P. pyri growth. Microscopic observation showed that P. pyri mycelia had different degrees of desiccation and that the conidial cell contents had been released. The sensitivities of 60 P. pyri strains to iminoctadine trialbesilate and trifloxystrobin were determined in vitro, and the average EC50 values were 0.5773 ± 0.0014 and 1.2038 ± 0.0010 μg/ml, respectively. The average EC50 values for 85 and 75% of the strains with continuous single peak frequency distributions were 0.4534 ± 0.0012 and 0.8124 ± 0.0039 μg/ml, respectively. These data could be used as the baseline sensitivities of P. pyri to these two fungicides. The maximum difference multiples of the sensitivities of P. pyri strains from the different cities to iminoctadine trialbesilate and trifloxystrobin were 13.5- and 17.2-fold, respectively. Cluster analysis showed that there was no significant correlation between P. pyri sensitivity and geographical origin. The field efficacies in controlling PPM were higher than 85%. These findings can improve how we monitor iminoctadine trialbesilate and trifloxystrobin resistance and improve application efficiency.
Taking Mental Health Seriously
Authors: Perez Nicole Beaulieu , Melkus Gail D'Eramo
Published: October 2023

The authors recommend a more proactive approach.
Nurse Reimbursement
Authors: Fink Jennifer
Published: October 2023

A pathway to better valuing nursing care and addressing shortages
Sample Size Planning in Quantitative Nursing Research
Authors: Curtis Alexa Colgrove , Keeler Courtney
Published: October 2023

Editor's note: This is the 18th article in a series on clinical research by nurses. The series is designed to be used as a resource for nurses to understand the concepts and principles essential to research. Each column will present the concepts that underpin evidence-based practice—from research design to data interpretation. To see all the articles in the series, go to https://links.lww.com/AJN/A204.
Is It Time to Say Goodbye to BMI? A Commentary
Authors: Russell Holly Ann
Published: October 2023

The linkage between weight and health is complicated and our current body of evidence is inconsistent. We cannot have a discussion about weight without understanding the larger context of our antifat society and the influence of the diet industrial complex. Weight bias and a focus on weight in health care produce known harms. Additionally, clinicians often recommend losing weight without a nuanced discussion of the evidence showing that most people are unlikely to be successful with sustained weight loss. In this piece, I argue that using our precious time with patients and health care dollars to focus on health behaviors with indisputable evidence such as increasing physical activity and promoting smoking cessation is a more effective use of resources and more closely aligns with our ethical obligation to “do no harm.”
Changes in straylight after cataract surgery
Authors: Reus Nicolaas J. , van den Berg Thomas J.T.P.
Published: October 2023

Purpose:

To investigate straylight in the immediate postoperative period after cataract surgery.

Setting:

Amphia Hospital, Breda, the Netherlands.

Design:

Prospective, comparative, single-arm, single-center, single-surgeon study.

Methods:

Patients underwent cataract surgery on both eyes. 1 eye was randomly selected for implantation with a Clareon CNA0T0 intraocular lens (IOL); the fellow eye received a Vivinex XY1 IOL. Straylight was measured with the C-Quant straylight meter.

Results:

25 patients were included. Preoperatively, 1 day, 1 week, 1 month, and 3 months postoperatively, eyes with a CNA0T0 IOL had straylight levels (mean ± SD) of 1.48 ± 0.23, 1.26 ± 0.20, 1.06 ± 0.19, 1.11 ± 0.25, and 1.09 ± 0.20 log(s), respectively. For eyes with an XY1 IOL, these values were 1.48 ± 0.21, 1.41 ± 0.41, 1.10 ± 0.20, 1.13 ± 0.20, and 1.16 ± 0.20 log(s), respectively. From 1 week postoperatively, straylight values did not change (1 week vs 3 months:P= .40 andP= .14 and 1 month vs 3 months:P= .74 andP= .50 for CNA0T0 and XY1, respectively). The Pearson correlation coefficient for straylight values between the 2 eyes of individual subjects was 0.80 at 3 months.

Conclusions:

Straylight levels can be considered stable 1 week after cataract surgery. We believe it is safe to use straylight measurements 1 month postoperatively for clinical trials. Straylight is highly correlated between the 2 eyes of an individual postoperatively.
Agreement between youth and caregiver report of pain and functioning in pediatric sickle cell disease: PedsQL sickle cell disease module
Authors: Alberts Nicole M. , Gilbert Alexandra , Kang Guolian , Okhomina Victoria I. , Flynn Jessica S. , Hodges Jason , Hankins Jane S. , Klosky James L.
Published: October 2023

Pain is a primary symptom of sickle cell disease (SCD) and is often severe and chronic. To treat SCD-related pain, proper assessment of SCD pain among youth, including the degree of concordance or agreement between youth and caregiver reports of pain, is essential but has not yet been adequately evaluated. In this study, 525 youth with SCD and their parents were evaluated as part of the Sickle Cell Clinical Research and Intervention Program (SCCRIP) to examine pain rating concordance and predictors of concordance. Youth and parents completed the Pediatric Quality of Life Inventory Sickle Cell Disease module (PedsQL-SCD) to measure pain, pain interference, and pain-related constructs. Disease, clinical, and demographic variables were obtained from the SCCRIP database. Intraclass correlations demonstrated moderate-to-poor consistency between youth and caregiver reports of pain and pain interference (ICCs range from 0.17 to 0.54). Analysis of covariance and regression models found that patient age, frequency of hospitalizations and emergency department (ED) visits, economic hardship, and fetal hemoglobin levels were significantly associated with varying pain-rating agreement levels among parent proxy and child self-report pain. Concordance of pain assessments among youth with SCD and their caregivers using the PedsQL-SCD Module was moderate at best, corroborating prior research. Youth factors predicting discordance among pain-related factors included increased ED visits, older age, and female sex. Collectively, these results bolster the use of integrated pain assessments to reduce parent–child discrepancies, thereby improving the adequacy of SCD-related pain assessment and treatment.
Prevalence and effects of acute myocardial infarction on hospital outcomes among COVID-19 patients
Authors: Chan Kelvin , Conroy Abigail , Khosla Atulya , Rubens Muni , Saxena Anshul , Ramamoorthy Venkataraghavan , Roy Mukesh , Appunni Sandeep , Doke Mayur , Ahmed Md Ashfaq , Zhang Zhenwei , McGranaghan Peter , Chaparro Sandra , Jimenez Javier
Published: October 2023

Background

Acute myocardial infarction (AMI) is one of the most lethal complications of COVID-19 hospitalization. In this study, we looked for the occurrence of AMI and its effects on hospital outcomes among COVID-19 patients.

Methods

Data from the 2020 California State Inpatient Database was used retrospectively. All COVID-19 hospitalizations with age ≥ 18 years were included in the analyses. Adverse hospital outcomes included in-hospital mortality, prolonged length of stay (LOS), vasopressor use, mechanical ventilation, and ICU admission. Prolonged LOS was defined as any hospital LOS ≥ 75th percentile. Multivariate logistic regression analyses were used to understand the strength of associations after adjusting for cofactors.

Results

Our analysis had 94 114 COVID-19 hospitalizations, and 1548 (1.6%) had AMI. Mortality (43.2% vs. 10.8%, P < 0.001), prolonged LOS (39.9% vs. 28.2%, P < 0.001), vasopressor use (7.8% vs. 2.1%, P < 0.001), mechanical ventilation (35.0% vs. 9.7%, P < 0.001), and ICU admission (33.0% vs. 9.4%, P < 0.001) were significantly higher among COVID-19 hospitalizations with AMI. The odds of adverse outcomes such as mortality (aOR 3.90, 95% CI: 3.48–4.36), prolonged LOS (aOR 1.23, 95% CI: 1.10–1.37), vasopressor use (aOR 3.71, 95% CI: 3.30–4.17), mechanical ventilation (aOR 2.71, 95% CI: 2.21–3.32), and ICU admission (aOR 3.51, 95% CI: 3.12–3.96) were significantly more among COVID-19 hospitalizations with AMI.

Conclusion

Despite the very low prevalence of AMI among COVID-19 hospitalizations, the study showed a substantially greater risk of adverse hospital outcomes and mortality. COVID-19 patients with AMI should be aggressively treated to improve hospital outcomes.
Addressing disparities in technology use among patients with type 1 diabetes: a review
Authors: Kanbour Sarah , Everett Estelle
Published: October 2023

Purpose of review

The benefits of continuous glucose monitors (CGMs) and insulin pumps in the management of type 1 diabetes (T1D) are widely recognized. However, glaring disparities in access exist, particularly in marginalized and economically disadvantaged groups that stand to benefit significantly from diabetes technology use. We will review recent data describing drivers of these disparities and approaches to address the disparities.

Recent findings

Several qualitative studies were published in recent years that have investigated the drivers of disparities reported over the past decades. These studies report that in addition to typical barriers seen in the diabetes technology, marginalized patients have unique challenges that make insulin pumps and CGMs less accessible.

Barriers to technology use in these groups include stigmatization, lack of support, financial constraints, provider biases, stringent insurance policies, and clinic infrastructure. To address inequities, multifaceted strategies across community, healthcare, and provider sectors are essential. Key initiatives include enhancing public awareness, refining health policies, ensuring access to high-quality care, and emphasizing patient-centered approaches. The equitable use of technology can narrow the gap in T1D outcomes. The social and economic implications of suboptimal T1D management further underscore the urgency of these efforts for both improved health outcomes and cost-efficient care.
Hospital-Acquired Venous Thromboembolism and Invasive Mechanical Ventilation: A Report From the Children’s Hospital Acquired Thrombosis Consortium
Authors: Sochet Anthony A. , Jaffray Julie , Branchford Brian R. , Havlicek Elizabeth E. , Mosha Maua , Amankwah Ernest K. , Ignjatovic Vera , Faustino E. Vincent S. , Goldenberg Neil A.
Published: October 2023

OBJECTIVES:

To determine if the duration of invasive mechanical ventilation (IMV) was associated with hospital-acquired venous thromboembolism (HA-VTE) among critically ill children.

DESIGN:

A multicenter, matched case-control study as a secondary analysis of Children’s Hospital Acquired Thrombosis (CHAT) Consortium registry.

SETTING:

PICUs within U.S. CHAT Consortium participating centers.

PATIENTS:

Children younger than 21 years old admitted to a PICU receiving IMV for greater than or equal to 1 day duration from January 2012 to March 2022 were included for study. Cases with HA-VTE were matched 1:2 to controls without HA-VTE by patient age groups: younger than 1, 1–12, and older than 12 years.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The primary outcome was IMV duration in days. Descriptive data included demographics, anthropometrics, HA-VTE characteristics (i.e., type, location, and timing), central venous catheterization data, thromboprophylaxis practices, and Braden Q mobility scores. Descriptive, comparative, and associative (multivariate conditional logistic regression for HA-VTE) statistics were employed. A total of 152 cases were matched to 304 controls. Cases with HA-VTE were diagnosed at a median of 7 days (interquartile range [IQR], 3–16 d) after IMV. The HA-VTE were limb deep venous thromboses in 130 of 152 (85.5%) and frequently central venous catheterization-related (111/152, 73%). Cases with HA-VTE experienced a longer length of stay (median, 34 d [IQR, 18–62 d] vs. 11.5 d [IQR, 6–21 d]; p < 0.001) and IMV duration (median, 7 d [IQR, 4–15 d] vs. 4 d [IQR, 1–7 d]; p < 0.001) as compared with controls. In a multivariate logistic model, greater IMV duration (adjusted odds ratio, 1.09; 95% CI, 1.01–1.17; p = 0.023) was independently associated with HA-VTE.

CONCLUSIONS:

Among critically ill children undergoing IMV, HA-VTE was associated with greater IMV duration. If prospectively validated, IMV duration should be included as part of prothrombotic risk stratification and future pediatric thromboprophylaxis trials.
Organ Dysfunction in Children With Blood Culture-Proven Sepsis: Comparative Performance of Four Scores in a National Cohort Study
Authors: Schlapbach Luregn J. , Goertz Sabrina , Hagenbuch Niels , Aubert Blandine , Papis Sebastien , Giannoni Eric , Posfay-Barbe Klara M. , Stocker Martin , Heininger Ulrich , Bernhard-Stirnemann Sara , Niederer-Loher Anita , Kahlert Christian R. , Natalucci Giancarlo , Relly Christa , Riedel Thomas , Aebi Christoph , Berger Christoph , Agyeman Philipp K. A. ,   for the Swiss Pediatric Sepsis Study Group
Published: October 2023

OBJECTIVES:

Previous studies applying Sepsis-3 criteria to children were based on retrospective analyses of PICU cohorts. We aimed to compare organ dysfunction criteria in children with blood culture-proven sepsis, including emergency department, PICU, and ward patients, and to assess relevance of organ dysfunctions for mortality prediction.

DESIGN:

We have carried out a nonprespecified, secondary analysis of a prospective dataset collected from September 2011 to December 2015.

SETTING:

Emergency departments, wards, and PICUs in 10 tertiary children’s hospitals in Switzerland.

PATIENTS:

Children younger than 17 years old with blood culture-proven sepsis. We excluded preterm infants and term infants younger than 7 days old.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We compared the 2005 International Pediatric Sepsis Consensus Conference (IPSCC), Pediatric Logistic Organ Dysfunction-2 (PELOD-2), pediatric Sequential Organ Failure Assessment (pSOFA), and Pediatric Organ Dysfunction Information Update Mandate (PODIUM) scores, measured at blood culture sampling, to predict 30-day mortality. We analyzed 877 sepsis episodes in 807 children, with a 30-day mortality of 4.3%. Percentage with organ dysfunction ranged from 32.7% (IPSCC) to 55.3% (pSOFA). In adjusted analyses, the accuracy for identification of 30-day mortality was area under the curve (AUC) 0.87 (95% CI, 0.82–0.92) for IPSCC, 0.83 (0.76–0.89) for PELOD-2, 0.85 (0.78–0.92) for pSOFA, and 0.85 (0.78–0.91) for PODIUM. When restricting scores to neurologic, respiratory, and cardiovascular dysfunction, the adjusted AUC was 0.89 (0.84–0.94) for IPSCC, 0.85 (0.79–0.91) for PELOD-2, 0.87 (0.81–0.93) for pSOFA, and 0.88 (0.83–0.93) for PODIUM.

CONCLUSIONS:

IPSCC, PELOD-2, pSOFA, and PODIUM performed similarly to predict 30-day mortality. Simplified scores restricted to neurologic, respiratory, and cardiovascular dysfunction yielded comparable performance.
Skeletal Fluorosis
Authors: Gerges Maria M. , Ngo Victoria T. , Tu Jonathan , Colletti Patrick M. , Wassef Heidi
Published: October 2023

A 27-year-old man with polysubstance abuse including methamphetamine, fentanyl, and 1.5 years of electronics compressed gas duster inhalation presented following an assault. Radiologic imaging performed for suspected fractures revealed periosteal reaction, cortical thickening with increased bone density, and ligament and tendon ossification, which were not present on imaging obtained 3 years before presentation. A bone scan was subsequently performed revealing a metabolic superscan with cortical irregularity. Further investigation revealed skeletal fluorosis from electronics compressed gas duster inhalation. Skeletal fluorosis may be considered when these osseous findings are encountered.
α2-ADRENORECEPTOR ANTAGONIST AMELIORATES SEPSIS-ASSOCIATED PULMONARY FIBROSIS BY SUPPRESSING NOREPINEPHRINE-MEDIATED FIBROBLAST DIFFERENTIATION VIA INHIBITING PKC ACTIVATION
Authors: Su Xingyu , Lu Fan , Chen Yihua , Wang Miao , Tang Guoqing , Lin Wan , Liu Yingwen , Wang Huadong , Yin Haiyan , Wang Yiyang
Published: October 2023

Pulmonary fibrosis is an important factor affecting the prognosis of severe septic patients with acute lung injury. The objective of this study was to explore the effect of norepinephrine (NE) and α2-adrenoreceptor (AR) on sepsis-associated pulmonary fibrosis and the mechanism underlying these effects. We found pulmonary fibrotic changes, and increased NE production and α2A-AR expression in the pulmonary tissue of mice subjected to cecal ligation and puncture surgery. Reserpine and yohimbine alleviated pulmonary fibrosis in mice with sepsis by exhausting NE derived from the lung's adrenergic nerve and blocking α2-AR, respectively. There was no significant difference in the expression of the three α1-AR subtypes. The effect of NE on promoting pulmonary fibroblast differentiationin vitrowas suppressed by yohimbine. Both the protein and mRNA expression levels of α2A-AR were increased in pulmonary fibroblasts treated with LPS. Clonidine, a selective α2-AR agonist, enhanced LPS-induced differentiation in pulmonary fibroblasts, as indicated by the increase in α-smooth muscle actin and collagen I/III, which was mitigated by inhibiting PKC and p38. Furtherin vivoresults indicated that yohimbine alleviated pulmonary fibrosis and inhibited the phosphorylation of PKC, p38, and Smad2/3 in lung tissue of mice exposed to LPS for 4 weeks. Clonidine showed the opposite effect to yohimbine, which aggravated LPS-induced pulmonary fibrosis. These findings demonstrated that the sepsis-induced increase in NE promoted fibroblast differentiation via activating α2-AR. Blockage of α2-AR effectively ameliorated sepsis-associated pulmonary fibrosis by abolishing NE-induced lung fibroblast differentiation and inhibiting the PKC-p38-Smad2/3 pathway.