bluuebunny/crossref_metadata_2025 huggingface dataset:
Near-infrared spectroscopy of embedded protostars in the massive metal-poor star-forming region NGC 346
Authors: Jones O C , Reiter M , Sanchez-Janssen R , Evans C J , Robertson C S , Meixner M , Ochsendorf B
Published: September 2022

We present medium-resolution (R ∼ 4000) YJ-, H-, and K-band spectroscopy of candidate young stellar objects (YSOs) in NGC 346, the most active star-formation region in the metal-poor (Z = 1/5 Z⊙) Small Magellanic Cloud. The spectra were obtained with the KMOS (K-Band Multi-Object Spectrograph) integral field instrument on the Very Large Telescope. From our initial sample of 18 candidate high-mass YSOs previously identified from mid-IR photometry and radiative transfer model fits to their spectral energy distributions, approximately half were resolved into multiple components by our integral-field data. In total, we detect 30 continuum sources and extract reliable spectra for 12 of these objects. The spectra show various features including hydrogen recombination lines, and lines from H2, He i, and [Fe ii], which are indicative of accretion, discs, and outflowing material in massive YSOs. We spectroscopically confirm the youthful nature of nine YSO candidates, and identify two others as OB stars. All of the confirmed YSOs have Br γ in emission, but no emission is seen from the CO bandhead, despite other disc tracers present in the spectra. He i 1.083 $\mu$m emission is also detected at appreciably higher rates than for the Galaxy.
WISDOM Project – XIII. Feeding molecular gas to the supermassive black hole in the starburst AGN-host galaxy Fairall 49
Authors: Lelli Federico , Davis Timothy A , Bureau Martin , Cappellari Michele , Liu Lijie , Ruffa Ilaria , Smith Mark D , Williams Thomas G
Published: September 2022

The mm-Wave Interferometric Survey of Dark Object Masses (WISDOM) is probing supermassive black holes (SMBHs) in galaxies across the Hubble sequence via molecular gas dynamics. We present the first WISDOM study of a luminous infrared galaxy with an active galactic nuclei (AGNs): Fairall 49. We use new ALMA observations of the CO(2 − 1) line with a spatial resolution of ∼80 pc together with ancillary HST imaging. We reach the following results: (1) The CO kinematics are well described by a regularly rotating gas disc with a radial inflow motion, suggesting weak feedback on the cold gas from both AGN and starburst activity; (2) The dynamically inferred SMBH mass is 1.6 ± 0.4(rnd) ± 0.8(sys) × 108 M⊙ assuming that we have accurately subtracted the AGN and starburst light contributions, which have a luminosity of ∼109 L⊙; (3) The SMBH mass agrees with the SMBH−stellar mass relation but is ∼50 times higher than previous estimates from X-ray variability; (4) The dynamically inferred molecular gas mass is 30 times smaller than that inferred from adopting the Galactic CO-to-H2 conversion factor (XCO) for thermalized gas, suggesting low values of XCO; (5) the molecular gas inflow rate increases steadily with radius and may be as high as ∼5 M⊙ yr−1. This work highlights the potential of using high-resolution CO data to estimate, in addition to SMBH masses, the XCO factor, and gas inflow rates in nearby galaxies.
Spherically symmetric accretion on to a compact object through a standing shock: the effects of general relativity in the Schwarzschild geometry
Authors: Kundu Suman Kumar , Coughlin Eric R
Published: September 2022

A core-collapse supernova is generated by the passage of a shock wave through the envelope of a massive star, where the shock wave is initially launched from the ‘bounce’ of the neutron star formed during the collapse of the stellar core. Instead of successfully exploding the star, however, numerical investigations of core-collapse supernovae find that this shock tends to ‘stall’ at small radii (≲10 neutron star radii), with stellar material accreting on to the central object through the standing shock. Here, we present time-steady, adiabatic solutions for the density, pressure, and velocity of the shocked fluid that accretes on to the compact object through the stalled shock, and we include the effects of general relativity in the Schwarzschild metric. Similar to previous works that were carried out in the Newtonian limit, we find that the gas ‘settles’ interior to the stalled shock; in the relativistic regime analysed here, the velocity asymptotically approaches zero near the Schwarzschild radius. These solutions can represent accretion on to a material surface if the radius of the compact object is outside of its event horizon, such as a neutron star; we also discuss the possibility that these solutions can approximately represent the accretion of gas on to a newly formed black hole following a core-collapse event. Our findings and solutions are particularly relevant in weak and failed supernovae, where the shock is pushed to small radii and relativistic effects are large.
Gravitational-wave bursts from spin-precessing black holes in binary systems
Authors: Zhang Chen , Han Wen-Biao , Yang Shu-Cheng
Published: September 2022

Gravitational waves from precessing binary black holes exhibit new features that are absent in non-precessionary systems. All current waveform models take into account only the modulation of the signal due to precession. In this letter, we find that this effect has its own signature, by gravitational emission of a short and transient signal, or burst. The frequency of the burst is comparable to that of the late stage of the inspiral. We show that under certain conditions, this signal is strong enough to be detected by Advanced LIGO. For third-generation detectors like the Einstein telescope, the calculated signal-to-noise ratio can reach higher values. Measurements of precession would provide valuable insights into the intrinsic structure of black holes, and therefore into astrophysical binary formation mechanisms.
Effects of conjugated linoleic acid and exercise on body composition and obesity: a systematic review and meta-analysis
Authors: Liang Chun-Wei , Cheng Hsiao-Yi , Lee Yu-Hao , Liou Tsan-Hon , Liao Chun-De , Huang Shih-Wei
Published: September 2022

Context

Conjugated linoleic acid (CLA) has been reported to have anti-obesity and antidiabetic effects. However, the benefits of CLA combined with exercise remain unclear, and studies report conflicting results.

Objective

A systematic review and meta-analysis were performed to investigate the synergistic effect of CLA and exercise on body composition, exercise-related indices, insulin resistance, and lipid profiles; and of the safety of CLA supplements.

Data sources

In October 2021, the PubMed, Embase, and Cochrane Library databases were searched for reports on clinical trials of the combined intervention of CLA and exercise.

Data extraction

A total of 18 randomized controlled trials and 2 crossover trials were included. The methodological quality assessment was performed using the revised Cochrane risk-of-bias tool. Pooled effect sizes were reported as standardized mean difference (SMD) for continuous data and risk ratio for dichotomous data with their corresponding 95% confidence intervals (CIs). Heterogeneity was tested using the I2 statistic.

Data analysis

The combination of CLA and exercise resulted in significantly decreased body fat (SMD, –0.42 [95%CI, –0.70, –0.14]; P = 0.003; I2 = 65) and insulin resistance (SMD, –0.25 [95%CI, –0.44, –0.06]; P = 0.01; I2 = 0) than did exercise alone. In subgroup analysis, the following factors were associated with significant outcomes: (1) body mass index ≥25 kg/m2; (2) female sex; (3) follow-up time >4 weeks; and (4) intervention duration >4 weeks. Nevertheless, supplementation with CLA during exercise programs was not effective for body-weight control, exercise performance enhancement, or lipid-profile improvement. CLA in combination with exercise did not result in a higher risk of adverse events (risk ratio, 1.32 [95%CI, 0.94–1.84]; P > 0.05; I2 = 0).

Conclusion

CLA combined with exercise is generally safe and can lower body fat and insulin resistance but does not reduce body weight, enhance exercise performance, or improve lipid profiles.
Metafilm Music in Jean-Luc Godard's Cinema
Authors: Baumgartner Michael
Published: September 2022

This monograph explores the underresearched use of music in Jean-Luc Godard’s films and video essays from the early 1960s to the late 1990s. While Godard is largely hailed as a leading innovator of visual montage, unique storytelling style, and groundbreaking cinematography, his achievements as a leading pioneer in sculpting complex soundtracks altering the familiar relationship between sound and image have been mainly overlooked. On these soundtracks, music assumes the unique role of metafilm music. Metafilm music self-consciously refers to its own role as film music and disrupts the primary function of film music as an essential filmic device creating cinematic illusion. The concept of metafilm music describes how Godard thinks with film music about film music. Metafilm music manifests itself in Godard’s work in four distinct manners: as fragmentized musical cues; as the same fragment verbatim repeated several times; as extrapolated, short excerpts from classical or popular music; and as music making as a model for filmmaking. With a detailed analysis of these parameters, the book explores fragmented and repeated music as Godard’s critique of the leitmotif technique. Godard further self-reflexively investigates genre-specific music in musical comedies, films noir, and melodramas, as well as prototypical film music as arguably its own musical genre. His last foray into metafilm music entails music making as a metaphor for filmmaking. By thinking with music about the function of film music, Godard has created throughout his career multilayered soundtracks that challenge the conventional norms of film music and sound.
Subtyping of major SARS-CoV-2 variants reveals different transmission dynamics based on 10 million genomes
Authors: Yang Hsin-Chou , Wang Jen-Hung , Yang Chih-Ting , Lin Yin-Chun , Hsieh Han-Ni , Chen Po-Wen , Liao Hsiao-Chi , Chen Chun-houh , Liao James C
Published: September 2022

SARS-CoV-2 continues to evolve, causing waves of the pandemic. Up to May 2022, 10 million genome sequences have accumulated, which are classified into five major variants of concern. With the growing number of sequenced genomes, analysis of the big dataset has become increasingly challenging. Here we developed systematic approaches based on sets of correlated single nucleotide variations (SNVs) for comprehensive subtyping and pattern recognition of transmission dynamics. The approach outperformed single-SNV and spike-centric scans. Moreover, the derived subtypes elucidate the relationship of signature SNVs and transmission dynamics. We found that different subtypes of the same variant, including Delta and Omicron exhibited distinct temporal trajectories. For example, some Delta and Omicron subtypes did not spread rapidly, while others did. We identified sets of characteristic SNVs that appeared to enhance transmission or decrease efficacy of antibodies for some subtypes. We also identified a set of SNVs that appeared to suppress transmission or increase viral sensitivity to antibodies. For the Omicron variant, the dominant type in the world, we identified the subtypes with enhanced and suppressed transmission in an analysis of eight million genomes as of March 2022 and further confirmed the findings in a later analysis of ten million genomes as of May 2022. While the “enhancer” SNVs exhibited an enriched presence on the spike protein, the “suppressor” SNVs are mainly elsewhere. Disruption of the SNV correlation largely destroyed the enhancer-suppressor phenomena. These results suggest the importance of fine subtyping of variants, and point to potential complex interactions among SNVs.
Predicting lymphoma in Sjögren’s syndrome and the pathogenetic role of parotid microenvironment through precise parotid swelling recording
Authors: De Vita Salvatore , Isola Miriam , Baldini Chiara , Goules Andreas V , Chatzis Loukas G , Quartuccio Luca , Zabotti Alen , Giovannini Ivan , Donati Valentina , Ferro Francesco , Rizzo Maria Teresa , Manfrè Valeria , Pegolo Enrico , Voulgarelis Michael , Zaja Francesco , Fanin Renato , Masaoutis Christos , Rontogianni Dimitra , Fotiadis Dimitrios I , Ponzoni Maurilio , Tzioufas Athanasios G
Published: September 2022

Objective

Parotid swelling (PSW) is a major predictor of non-Hodgkin’s lymphoma (NHL) in primary SS (pSS). However, since detailed information on the time of onset and duration of PSW is scarce, this was investigated to verify whether it may lead to further improved prediction. NHL localization was concomitantly studied to evaluate the role of the parotid gland microenvironment in pSS-related lymphomagenesis.

Methods

A multicentre study was conducted among patients with pSS who developed B cell NHL during follow-up and matched controls that did not develop NHL. The study focused on the history of salivary gland and lachrymal gland swelling, evaluated in detail at different times and for different durations, and on the localization of NHL at onset.

Results

PSW was significantly more frequent among the cases: at the time of first referred pSS symptoms before diagnosis, at diagnosis and from pSS diagnosis to NHL. The duration of PSW was evaluated starting from pSS diagnosis, and the NHL risk increased from PSW of 2–12 months to >12 months. NHL was prevalently localized in the parotid glands of the cases.

Conclusion

A more precise clinical recording of PSW can improve lymphoma prediction in pSS. PSW as a very early symptom is a predictor, and a longer duration of PSW is associated with a higher risk of NHL. Since lymphoma usually localizes in the parotid glands, and not in the other salivary or lachrymal glands, the parotid microenvironment appears to be involved in the whole history of pSS and related lymphomagenesis.
A panel of plasma microRNAs improves the assessment of surrogate markers of cardiovascular disease in rheumatoid arthritis patients
Authors: Llop Didac , Ibarretxe Daiana , Plana Núria , Rosales Roser , Taverner Delia , Masana Lluís , Vallvé Joan Carles , Paredes Silvia
Published: September 2022

Objective

Patients with RA present increased risk of cardiovascular (CV) disease compared with the general population. Moreover, CV risk factors that have a causal relationship with atherosclerosis do not seem to fully explain the accelerated process that they exhibit. We evaluated the association of a 10 microRNAs panel with surrogate markers of subclinical arteriosclerosis [carotid intima-media thickness (cIMT), carotid plaque presence (cPP), pulse wave velocity (PWV) and distensibility] in a cohort of RA patients.

Material and methods

A total of 199 patients with RA were included. Surrogate markers of arteriosclerosis were measured with My Lab 60 X-Vision sonographer. MicroRNAs were extracted from plasma and quantified with qPCR. Multivariate models and classification methods were performed.

Results

Multivariate models showed that microRNAs-24 (β = 15.48), 125a (β = 9.93), 132 (β = 11.52), 146 (β = 15.12), 191 (β = 13.25) and 223 (β = 13.30) were associated with cIMT globally. MicroRNA-24 [odds ratio (OR) = 0.41], 146 (OR = 0.36) and Let7a (OR = 0.23) were associated with cPP in men. Including the microRNAs in a partial least square discriminant analysis model properly classified men with and without cPP. MicroRNA-96 (β = –0.28) was associated with PWV in male patients. Finally, several miRNAs were also associated with cIMT, cPP and arterial stiffness in the high DAS28 group and in the earlier tertile groups of disease duration.

Conclusion

Plasmatic expression of microRNA-24, 96, 103, 125a, 132, 146, 191, 223 and Let7a were associated with surrogate markers of CV disease and could be predictors of CV risk in patients with RA.
A Gendered and Racialized Educational Hierarchy: Disparities in Elementary School Teachers’ Perceptions of Student Behavior
Authors: Pyne Jaymes , Musto Michela
Published: September 2022

This paper uses an intersectional framework to account for the degree to which race, when intersecting gender, relates to teachers’ evaluations of US elementary school children over time. Drawing on longitudinal data from the 2011 Early Childhood Longitudinal Study-Kindergarten cohort, we employ growth curve modeling to study descriptive trends in teacher perceptions of student behavior from kindergarten through fifth grade. We find that educators’ perceptions of White, Asian American, and Latinx girls increase over time, while their perceptions of Black girls remain flat. Meanwhile, a different longitudinal trend emerges among boys. Although teachers’ views of Black boys decrease over time, their views of other boys increase to the levels of Black girls, or higher, by the end of fifth grade. This analysis reveals how teachers’ perceptions coalesce into an emerging hierarchy that—by the end of fifth grade—most sharply contrasts the behavior of Asian American girls and Black boys. Our intersectional approach and the theoretical framework informing it underscore the limits to considering how educators distinguish students by gender or race alone. Together, gender and race more fully account for differences in how educators perceive student behavior over time.
Insights into the catalytic and regulatory mechanisms of dihydroflavonol 4-reductase, a key enzyme of anthocyanin synthesis in Zanthoxylum bungeanum
Authors: Aiguo Zhao , Ruiwen Ding , Cheng Wang , Cheng Chen , Dongmei Wang
Published: September 2022

Accumulation of anthocyanins largely determines the fruit color, and dihydroflavonol 4-reductase (DFR) is a key enzyme involved in the formation of anthocyanins. However, the catalytic and regulatory mechanisms of DFR are unclear. In this study, the gene encoding DFR from Zanthoxylum bungeanum Maxim. was cloned and ZbDFR was analyzed in detail. The ZbDFR accepted dihydrokaempferol, dihydroquercetin and dihydromyricetin as substrates. Flavonols such as myricetin, quercetin and kaempferol significantly inhibited the activity of ZbDFR, while quercitrin and isoquercitrin slightly increased the activity. Quercetin was a competitive inhibitor at low concentrations, and it had a combined effect of competitive and noncompetitive inhibition at high concentrations, which was consistent with ZbDFR having two inhibitor binding sites. In addition, the content of different types of flavonoids in Z. bungeanum peel at green, semi-red and red stage was analyzed, and the in vivo results could be explained by the regulation of ZbDFR activity in vitro. Site-directed mutagenesis combined with enzyme activity experiments showed that Ser128, Tyr163, Phe164 and Lys167 are the key catalytic amino acid residues. The Ser128, Tyr163 and Lys167 were crucial for the hydrogen transfer reaction, and mutation of these amino acids resulted in the loss of all or most of the activity. Phe164 was found to be important for the regulation of ZbDFR by flavonols. Accordingly, ZbDFR is a node at which flavonoids regulate the synthesis of anthocyanins and proanthocyanins.
Radiological and Long-Term Functional Outcomes of Displaced Distal Clavicle Fractures
Authors: Srinivasan Ananth , Haque Aziz , Kheiran Amin , Singh Harvinder Pal
Published: September 2022

Objectives:

To investigate radiological and long-term functional outcomes in modified Neer 2a, 2b, and 5 distal clavicle fractures.

Design:

Retrospective cohort study.

Setting:

A single university teaching hospital.

Patients/Participants:

One hundred fifteen patients sustaining displaced distal clavicle fractures between January 01, 2010 and December 12, 2017.

Intervention:

Operative versus nonoperative management.

Main Outcome Measurements:

Radiographs were reviewed for fracture management and union. A customised questionnaire consisting of QuickDASH (Disabilities of the Arm, Shoulder and Hand), work, sports/performing arts, global satisfaction, and complication modules was used to determine functional outcome.

Results:

One hundred fifteen patients were included [mean age of 49 (18–89) years]. Thirty-three (29%) underwent early fixation (<6 weeks from injury) and were younger (37 vs. 53 years, P < 0.0001). Radiographs were available for 96 patients. Nonunion rate was 55% (53/96), and majority had undergone initial nonoperative management (49 vs. 4, P < 0.00001). Eleven patients with symptomatic nonunion were deemed appropriate for delayed fixation with all cases uniting. Of the operatively managed patients, 27% (12/44) underwent metalwork removal. There were no differences in functional outcome between operative versus nonoperative and union versus nonunion patient groups at a mean follow-up of 79 months (P > 0.05).

Conclusion:

Functional outcome and patient satisfaction at long-term follow-up were similar regardless of operative fixation or radiological union. Nonunion in displaced distal clavicle fractures seemed to cause minimal functional deficit in most elderly sedentary individuals, or the outcome measures were not sensitive enough to capture these differences. An individualized approach should be adopted, with less active, comorbid, and elderly patients counseled regarding the minimal functional improvement of surgery and risk of reoperation.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Advocating for Equitable Healthcare for the Undocumented Immigrant
Authors: Knight Natalie
Published: September 2022

Despite the healthcare community's increased efforts to reduce health disparities in the United States, undocumented immigrants (UIs) remain one of the highest at-risk populations. Health and public policies, societal and healthcare worker bias, and fear of deportation are among barriers to healthcare access, resulting in increasingly poor health and health outcomes. Christian nurses, guided by biblical principles and the American Nurses Association's Code of Ethics for Nurses, can advocate for UIs' healthcare needs by supporting and promoting more inclusive institutional and government policies.
Finding Your Calling
Authors: Petersen Cheryl L. , Munk Dennis D. , Dalton Daniel
Published: September 2022

The aim of this study was to assess if an evidence-based educational program focused on vocation and calling could improve undergraduate nursing students' sense of meaning in life and sense of calling/vocation. Using a mixed-methods, quasi-experimental design, a statistically significant increase occurred in sense of meaning in life and calling/vocation. Qualitative responses revealed growth in self-knowledge, importance of individual pathways, and recognition of nursing as one's calling. Courses on calling may encourage nursing students to commit to nursing as a calling.
Piloting a Faith-Based Hypertension Self-Care Program in a Church Setting
Authors: Alen Josiya , Forehand Jeffery , Miller Barbara
Published: September 2022

Health promotion strategies offered in a faith-based setting can be effective in influencing positive self-care behaviors related to hypertension. Faith-based organizations are ideal places to reach vulnerable populations to improve blood pressure management and make a lasting impact. The purpose of this pilot study was to provide a 4-week management program to improve hypertension self-care among a congregation of African Americans. Results revealed improvements among participants related to self-care as well as lowered blood pressure readings.
Considerations in Limiting Abortion
Authors: Hammons Kati E.
Published: September 2022

In May 2021, Texas passed Senate Bill Eight, the Texas Heartbeat Act. The act bans physicians from performing an abortion after a fetal heartbeat is detected and bans nonmedical people from aiding or abetting an abortion in such situations. The act has significant social, economic, political, and ethical impacts for women with unintended pregnancies, for the state of Texas, and for nurses and other providers. A Christian perspective is offered regarding life, abortion, and the need to provide special care and support for women in crisis pregnancies.
Pain interference in young adulthood and work participation
Authors: Pooleri Anand , Yeduri Rishita , Horne Gabrielle , Frech Adrianne , Tumin Dmitry
Published: September 2022

Chronic pain is associated with reduced work participation, but longitudinal data on the work impact of chronic pain are limited. We used data from the National Longitudinal Survey of Youth-1997 cohort to analyze how pain interference in early adulthood was associated with subsequent exit from the labor force in a longitudinal survey. Pain interference at age 29 and employment status were self-reported at subsequent biennial interviews. Exit from the labor force, return to employment, and development of new health-related work limitations after age 29 were analyzed using survival analysis methods. Among 5819 respondents, 10% and 3% endorsed “a little” or “a lot” of pain interference at age 29, respectively. During follow-up (median of 26 months until censoring or labor force exit), 43% of respondents had exited the labor force at least once and 10% developed a new work-related health limitation. The highest pain interference group (compared with no pain interference) had higher hazard of labor force exit (hazard ratio: 1.26; 95% confidence interval: 1.01-1.57; P = 0.044) and of developing new health-related work limitations (hazard ratio: 2.45; 95% confidence interval: 1.64-3.67; P < 0.001), with similar results for the group experiencing “a little” pain interference at age 29. In this nationally representative cohort, any level of pain interference reported at age 29 was found to predict increased hazards of subsequent labor force exit and health-related work limitation. Early identification and treatment of pain problems among young workers can help reduce burdens of future unemployment and disability.
Cochlear Implantation Outcomes in Patients With Retrocochlear Pathology: A Systematic Review and Pooled Analysis
Authors: Schlacter Jamie A. , Kay-Rivest Emily , Nicholson Joseph , Santacatterina Michele , Zhang Yan , Jethanamest Daniel , Friedmann David R. , McMenomey Sean O. , Roland J. Thomas
Published: September 2022

Objective

To review the current literature regarding cochlear implantation in patients with retrocochlear pathologies and extract speech perception scores between 6 months and 1 year after surgery.

Databases Reviewed

PubMed/MEDLINE, Embase and Cochrane CENTRAL via Ovid, CINAHL Complete via Ebsco, and Web of Science.

Methods

The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Search strategies included keywords and subject headings to maximize retrieval and reflect cochlear implants and retrocochlear pathologies. Patients with previously resected vestibular schwannoma (VS) were excluded.

Results

There were 2,524 abstracts screened against inclusion criteria, and 53 studies were included, with individual data available for 171 adult patients. Pathologies included were either observed or irradiated VS (previously operated tumors were excluded) (n = 99, 57.9%), superficial siderosis (n = 39, 22.8%), neurosarcoidosis (n = 11, 6.4%), and previous central nervous system or skull base radiation (n = 22, 12.9%). Mean (standard deviation) postoperative consonant-nucleus-consonant (CNC) word scores were 45.4% (24.2) for observed VS, 44.4% (20.8) for irradiated VS, 43.6% (21.0) for superficial siderosis, 89.5% (3.0) for neurosarcoidosis, and 30.0% (30.2) in patients with previous central nervous system or skull base irradiation. Irradiated compared with observed VS had similar postoperative CNC word scores (effect size, 0.06; p = 0.71). Age, sex, maximal tumor dimension, and neurofibromatosis type 2 status did not significantly impact cochlear implant performance in patients with VS. Eighty-two percent of patients with reported device usage were daily users, and overall, 82% of cases benefitted from cochlear implantation.

Conclusion

Cochlear implantation in patients with concomitant retrocochlear pathology generally results in improved speech discrimination scores sustained over time.
A Five-Year Update on the Profile of Adults Undergoing Cochlear Implant Evaluation and Surgery—Are We Doing Better?
Authors: Patro Ankita , Lindquist Nathan R. , Tawfik Kareem O. , O’Malley Matthew R. , Bennett Marc L. , Haynes David S. , Gifford René H. , Holder Jourdan T. , Perkins Elizabeth L.
Published: September 2022

Objective

To characterize the influence of expanding indications on the profile of adults undergoing cochlear implantation (CI) at a high-volume CI center.

Study Design

Retrospective review.

Setting

Tertiary referral center.

Patients

774 adults undergoing CI evaluation from August 2015 to August 2020.

Main Outcome Measures

Demographics; audiometry; speech recognition; speech, spatial, and qualities of hearing scale (SSQ-12).

Results

Of 745 (96.3%) patients qualifying for implantation, 642 (86.6%) pursued surgery. Median age at evaluation was 69 years; 56.3% were men; 88.2% were Caucasian. Median distance to our center was 95 miles. The majority (51.8%) had public insurance (Medicare, Medicaid), followed by private (47.8%) and military (0.4%). Mean PTA, CNC, and AzBio in quiet and noise for the ear to be implanted were 85.2 dB HL, 15.0%, and 19.2% and 3.5%, respectively. Hybrid/EAS criteria were met by 138 (18.5%) CI candidates, and 436 (77.0%) unilateral CI recipients had aidable contralateral hearing for bimodal hearing configurations. Younger age (odds ratio [OR], 0.96; 95% confidence interval, 0.93–0.99) and non-Caucasian race (OR, 6.95; 95% confidence interval, 3.22–14.98) predicted candidacy. Likelihood of surgery increased for Caucasian (OR, 8.08; 95% confidence interval, 4.85–13.47) and married (OR, 2.28; 95% confidence interval, 1.50–3.47) patients and decreased for those with public insurance (OR, 0.45; 95% confidence interval, 0.29–0.69). A lower SSQ-12 score predicted both candidacy and surgery.

Conclusion

Despite expansions in criteria, speech understanding remained extremely low at CI evaluation. Younger age and non-Caucasian race predicted candidacy, and Caucasian, married patients with private insurance and lower SSQ scores were more likely to pursue surgery.
A case report of upper tibial gout stones resulting in bone destruction
Authors: Ji Jinke , Lou Caili , Ma Hongbao , Liu Jian , Wang Linan , Ren Zhibo , Yang Zongqiang , Shi Jiandang , Niu Ningkui
Published: September 2022

Rationale:

Gout is caused by the deposition of monosodium urate crystals caused by purine metabolism disorder or uric acid excretion disorder, which could be manifested as hyperuricemia, arthritis, tophus, and even renal dysfunction and other important organ damage. Gout stones to originate from crystals formed by urate and occur to joints, ears, olecranon bursa, fingers, and tendons. Bone destruction of gout stones is rare in clinic, and is easily misdiagnosed as bone tumor, and gout stones in the upper tibia is even rarer.

Patient concerns:

A 25-year-old male patient presented with right upper tibia pain for 2 weeks without obvious cause and had no history of alcoholism or hyper purine diet.

Diagnosis:

Right tibia and fibula anteroposterior and lateral radiographs showed that a round like low-density shadow at the upper end of the right tibia. CT showed bone destruction and neoplastic lesions at the right tibial tubercle. MRI showed bone destruction at the upper end of the right tibia with local oval abnormal signal, which were considered the neoplastic lesions. However, postoperative pathological diagnosis suggested gout calculi.

Interventions:

After examination, the patient underwent surgical treatment, curettage and bone graft fusion. Long-term oral administration of uric acid lowering drug allopurinol tablets 50 mg/time, twice/day, potassium sodium hydrogen citrate particles 2.5 g/time, 3 times/day.

Outcomes:

The patient took allopurinol tablets 50 mg/time, 2 times/day and Sodium Hydrogen Citrate Granules 2.5 g/time, 3 times/day for a long time after operation. As a result, the focus on gout stones was cured. Three months after operation, the bone graft healed well, the incision healed well, and the uric acid was 397 µmol/ L, which achieved satisfactory clinical efficacy.

Conclusion:

Tibial gout stones is rare in clinic. When hyperuricemia patients have tibial bone destruction and consider bone tumor, it should be differentiated from gout stones. The blood uric acid value should be controlled to the normal range before operation, and the drug therapy of decreasing uric acid should be continued after operation.
Electronic Connectivity Among US Hospitals Treating Shared Patients
Authors: Everson Jordan , Adler-Milstein Julia
Published: September 2022

Background:

Increasing electronic health information exchange (HIE) between provider organizations is a top policy priority that has been pursued by establishing varied types of networks.

Objectives:

To measure electronic connectivity enabled by these networks, including community, electronic health record vendor, and national HIE networks, across US hospitals weighted by the volume of shared patients and identify characteristics that predict connectivity.

Research Design:

Cross-sectional analysis of 1721 hospitals comprising 16,344 hospital pairs and 6,492,232 shared patients from 2018 CareSet Labs HOP data and national hospital surveys.

Subjects:

Pairs of US acute care hospitals that delivered care to 11 or more of the same fee-for-service Medicare beneficiaries in 2018.

Measures:

Whether a patient was treated by a pair of hospitals connected through participation in the same HIE network (“connected hospitals”) or not connected because the hospitals participated in different networks, only 1 participated, or both did not participate.

Results:

Sixty-four percent of shared patients were treated by connected hospitals. Of the remaining shared patients, 14% were treated by hospital pairs that participated in different HIE networks, 21% by pairs in which only 1 hospital participated in an HIE network, and 2% by pairs in which neither participated. Patients treated by pairs with at least 1 for-profit hospital, and by pairs located in competitive markets, were less likely to be treated by connected hospitals.

Conclusions:

While the majority of shared patients received care from connected hospitals, remaining gaps could be filled by connecting HIE networks to each other and by incentivizing certain types of hospitals that may not participate because of competitive concerns.
Peristomal Complications
Authors: Merkert Jessica L.
Published: September 2022

Patients with new ostomies are being discharged from the hospital without enough hands-on training for ostomy care. Maintaining healthy peristomal skin is one of the greatest challenges for patients with an ostomy. Unfortunately, peristomal complications are very common and affect quality of life. It is important that home healthcare clinicians maintain competency in ostomy care, so they have the knowledge and skills necessary to prevent and treat peristomal complications. This article focuses on peristomal skin assessment as well as prevention and treatment of common peristomal complications.
Development of a Berg Balance Scale Short-Form Using a Machine Learning Approach in Patients With Stroke
Authors: Wang Inga , Li Pei-Chi , Lee Shih-Chieh , Lee Ya-Chen , Wang Chun-Hou , Hsieh Ching-Lin
Published: September 2022

Background and Purpose:

The Berg Balance Scale (BBS) is frequently used in routine clinical care and research settings and has good psychometric properties. This study was conducted to develop a short form of the BBS using a machine learning approach (BBS-ML).

Methods:

Data of 408 individuals poststroke were extracted from a published database. The initial (ie, 4-, 5-, 6-, 7-, and 8-item) versions were constructed by selecting top-ranked items based on the feature selection algorithm in the artificial neural network model. The final version of the BBS-ML was chosen by selecting the short form that used a smaller number of items to achieve a higher predictive powerR2, a lower 95% limit of agreement (LoA), and an adequate possible scoring point (PSP). An independent sample of 226 persons with stroke was used for external validation.

Results:

TheR2values for the initial 4-, 5-, 6-, 7-, and 8-item short forms were 0.93, 0.95, 0.97, 0.97, and 0.97, respectively. The 95% LoAs were 14.2, 12.2, 9.7, 9.6, and 8.9, respectively. The PSPs were 25, 35, 34, 35, and 36, respectively. The 6-item version was selected as the final BBS-ML. Preliminary external validation supported its performance in an independent sample of persons with stroke (R2= 0.99, LoA = 10.6, PSP = 37).

Discussion and Conclusions:

The BBS-ML seems to be a promising short-form alternative to improve administrative efficiency. Future research is needed to examine the psychometric properties and clinical usage of the 6-item BBS-ML in various settings and samples.

Video Abstract availablefor more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A402).
CARDIOVASCULAR MORTALITY POST BURN INJURY
Authors: Paratz Jennifer D , Warren Jacelle , Paratz Elizabeth , Watt Kerrianne , Corte-Real Vidal , Muller Michael J , Cameron Cate M.
Published: September 2022

BACKGROUND

Burn injury is responsible for both acute and ongoing inflammation, resulting in systematic changes impacting the cardiovascular, hepatobiliary, endocrine and metabolic systems but there is minimal investigation into long term clinical outcomes. This study aimed to investigate mortality due to cardiovascular causes long-term post burn injury.

METHODS

This was a retrospective cohort study linking a burns unit database with mortality outcomes from a Registry of Births, Deaths and Marriages. Data was extracted from the Australian Institute of Health and Welfare and stratified into three age groups: 15-44, 45-64 and 65+ years. Mortality Rate Ratios (MRR) and 95% CI were calculated to compare the burns cohort mortality incidence rates with the national mortality incidence rates the three age-groups. Logistic regression was used to identify demographic and clinical factors associated with cardiovascular mortality.

RESULTS

A total of 4134 individuals in the database were analysed according to demographic and clinical variables. The 20-year age-standardised cardiovascular mortality rate for the burns cohort was significantly higher compared to the Australian population (250.6 per 100,000 person-years (PYs) v 207.9 per 100,000 PYs) (MRR = 1.21, 95%CI 1.001-1.45). Cardiovascular mortality was significantly higher in males aged 15-44 and 45-64 years (respectively) in the burns cohort than in the age-matched Australian population (MRR = 8.48, 95%CI 3.47-13.49), and (MRR = 1.75, 95%CI 1.07-2.44) respectively. Those who died of cardiovascular disease were more frequently intubated post-burn injury (p = 0.01), admitted to intensive care (p < 0.0001), and had pre-existing comorbid physical conditions (60.9% v 15.0%, p < 0.0001).

CONCLUSION

Survivors from burn injury, especially young males are at increased long-term risk of death from cardiovascular disease. Increased screening and counselling pertaining to lifestyle factors should be standard management post burn injury. Longitudinal observation of physiological changes, investigation of mechanistic factors and investigation of interventional strategies should be instituted.

LEVEL OF EVIDENCE

Retrospective cohort study Level IV

TYPE OF STUDY

Epidemiological
Glucose and fructose directly stimulate brain-derived neurotrophic factor gene expression in microglia
Authors: Aldhshan Muhammad S. , Jhanji Gursagar , Mizuno Tooru M.
Published: September 2022

Brain-derived neurotrophic factor (BDNF) is expressed in both hypothalamic neurons and microglia, and plays a critical role in the regulation of metabolism. Although hypothalamic expression of BDNF is regulated by metabolic signals such as nutrients and hormones, it remains unknown whether these signals differentially regulate BDNF expression in different cell types. The present study aimed to determine whether glucose and fructose regulate BDNF expression in microglia via the specific glucose transporter. To determine the effect of glucose and fructose on Bdnf mRNA and protein expression, murine microglial cell line SIM-A9 cells were exposed to the maintenance concentration of glucose (17.5 mmol/l), high glucose (25 mmol/l), or fructose (7.5 mmol/l) for 40 min to 24 h. To determine whether the blockade of glucose transporter 5 (GLUT5) negates the effect of glucose on Bdnf mRNA expression, cells were exposed to 25 mmol/l glucose in the presence or absence of the GLUT5 inhibitor for 4 h. Levels of Bdnf mRNA and protein were measured by real-time PCR and ELISA, respectively. High glucose caused a significant increase in both pan-Bdnf and long-form Bdnf (L-Bdnf) mRNA as well as protein levels when compared with the maintenance concentration of glucose in a time-dependent manner. Fructose treatment also increased L-Bdnf mRNA expression. Pharmacological blockade of GLUT5 did not affect glucose-induced Bdnf mRNA expression. These findings suggest that glucose and fructose directly stimulate Bdnf mRNA expression in microglia and these responses may mediate the metabolic actions of glucose and fructose.
Leupeptin accelerates recovery after sciatic transection and repair, but not crush injuries in rats
Authors: Gurevich Mikhail , Iocolano Kari , Achonu Justice U. , Badalamente Marie A. , Hurst Lawrence C. , Komatsu David E.
Published: September 2022

We aimed to explore previously reported discrepancies in success with leupeptin by comparing outcomes of two types of injury: transection and crush. Male rats were randomized into vehicle and leupeptin treatment groups (n = 6/transection group; n = 10/crush group). Leupeptin (12 mg/kg) was administered via intramuscular injection into the gastrocnemius muscle twice a week for the duration of the study. Rats were monitored on a weekly basis for electromyographic function and gait for 8 weeks. A total of 83.3% of the rats that were treated with leupeptin began to recover electromyographic activity 1 week after transection, versus 0% that were treated with leupeptin after crush (P < 0.0001). Rats that were treated with leupeptin also had less functional debilitation, as indicated by a greater sciatic functional index at five of the eight time-points after transection versus one of eight after crush (P ≤ 0.05). Leupeptin aids in the rate of recovery after transection and repair but not crush injuries. These findings suggest there may be differences in pathology and recovery associated with these two types of peripheral nerve injury.
Sorbitol non-fermenting Escherichia coli and E. coli O157: prevalence and antimicrobial resistance profile of strains in slaughtered food animals in Southeast Nigeria
Authors: Anyanwu Madubuike U. , Ugwu Ifeoma C. , Okorie-Kanu Onyinye J. , Ngwu Maria I. , Kwabugge Yakubu A. , Aneke Chioma I. , Chah Kennedy F.
Published: September 2022

Antimicrobial resistance (AMR) is one of the greatest global health challenges. Reliable monitoring of AMR in bacteria in food animals is critical in order to devise mitigation strategies and empiric treatment of infections associated with the organisms. The aim of this study was to isolate sorbitol non-fermenting (SN-F)

Escherichia coli

from food animals (broiler chickens, cattle and pigs) slaughtered at Ikpa Market, Nsukka, Enugu State, Southeast Nigeria, detect

E. coli

O157 and determine the in vitro antimicrobial resistance profile of the

E. coli

strains. A total of 388 faecal samples were collected from randomly selected broiler chickens (n=155), cattle (n=129) and pigs (n=104). Isolation of SN-F

E. coli

was done using tryptic soy broth and cefixime- and potassium tellurite-supplemented sorbitol MacConkey agar (CT-SMAC). SN-F

E. coli

strains were confirmed biochemically and

E. coli

O157 detected serologically using specific

E. coli

O157 latex agglutination test kit. The antimicrobial resistance profile of all strains was established using the disc diffusion method. Overall, 52 (13.4 %) SN-F

E. coli

strains were recovered from the broiler chickens (n=31), cattle (n=12) and pigs (n=9). A significant association (χ2=9.70; P <0.05) was observed between the prevalence of SN-F

E. coli

and animal species.

E. coli

O157 was detected in two of the samples, representing 0.51% of the 388 samples processed. All the

E. coli

strains were resistant to at least one antimicrobial agent tested and 76% were multidrug resistant (MDR). The mean multiple antibiotic resistance indices (MARI) for isolates from chickens, cattle and pig were 0.32, 0.18 and 0.23, respectively. This study showed that a considerable percentage of food animals slaughtered in Nsukka Southeastern Nigeria are potential reservoirs of multiple-drug-resistant SN-F E. coli, including

E. coli

O157 that could spread to humans and the environment.
Genomic analysis of the progenitor strains of Staphylococcus aureus RN6390

Authors: Garrett Stephen R. , Mariano Giuseppina , Palmer Tracy
Published: September 2022

RN6390 is a commonly used laboratory strain of  Staphylococcus aureus  derived from NCTC8325. In this study, we sequenced the RN6390 genome and compared it to available genome sequences for NCTC8325. We confirmed that three prophages,  F 11,  F 12 and  F 13, which are present in NCTC8325 are absent from the genome of RN6390, consistent with the successive curing events leading to the generation of this strain. However, we noted that a separate prophage is present in RN6390 that is not found in NCTC8325. Two separate genome sequences have been deposited for the parental strain, NCTC8325. Analysis revealed several differences between these sequences, in particular, between the copy number of  esaG  genes, which encode immunity proteins to the type VII secreted anti-bacterial toxin, EsaD. Single nucleotide polymorphisms were also detected in ribosomal RNA genes and genes encoding microbial surface components recognizing adhesive matrix molecules (MSCRAMM) between the two NCTC8325 sequences. Comparing each NCTC8325 sequence to other strains in the RN6390 lineage confirmed that sequence assembly errors in the earlier NCTC8325 sequence are the most likely explanation for most of the differences observed.
Bayesian nowcasting with Laplacian-P-splines
Authors: Sumalinab Bryan , Gressani Oswaldo , Hens Niel , Faes Christel
Published: September 2022

During an epidemic, the daily number of reported infected cases, deaths or hospitalizations is often lower than the actual number due to reporting delays. Nowcasting aims to estimate the cases that have not yet been reported and combine it with the already reported cases to obtain an estimate of the daily cases. In this paper, we present a fast and flexible Bayesian approach to do nowcasting by combining P-splines and Laplace approximations. The main benefit of Laplacian-P-splines (LPS) is the flexibility and faster computation time compared to Markov chain Monte Carlo (MCMC) algorithms that are often used for Bayesian inference. In addition, it is natural to quantify the prediction uncertainty with LPS in the Bayesian framework, and hence prediction intervals are easily obtained. Model performance is assessed through simulations and the method is applied to COVID-19 mortality and incidence cases in Belgium.