bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapeutic Hypothermia for Neonatal Encephalopathy in Low- and Middle-Income Countries: A Meta-Analysis
Authors: Bellos Ioannis , Devi Usha , Pandita Aakash
Published: March 2022

Background: Perinatal asphyxia and hypoxic-ischemic encephalopathy (HIE) represent substantial sources of neonatal morbidity and mortality in low- and middle-income countries (LMICs), leading to high rates of adverse long-term neurological outcomes. Methods: A systematic review with meta-analysis of randomized controlled trials in LMICs was conducted. PubMed, Scopus, Web of Science, CENTRAL, ClinicalTrials.gov, and Google Scholar were searched from inception to August 20, 2021. The population of the study consisted of neonates with gestational age ≥34 weeks and HIE. The main endpoints were overall mortality and the composite outcome of death or severe disability. The certainty of evidence was evaluated with the GRADE approach. Results: Ten studies were included comprising 1,293 neonates. Some concerns of bias were raised due to the nonblinded nature of the intervention. The risk of death was similar between the two groups (risk ratio [RR]: 0.78, 95% confidence interval [CI]: 0.52–1.18). No significant differences were observed in the composite outcome of death or severe disability between the two groups (RR: 0.78, 95% CI: 0.56–1.10, very low quality of evidence). Furthermore, no significant differences were observed in the endpoints of sepsis, shock, acute kidney injury, major arrhythmia, and length of hospital stay. Therapeutic hypothermia was associated with significantly higher risk of thrombocytopenia (RR: 2.13, 95% CI: 1.34–3.38) and clinically significant hemorrhage (RR: 1.57, 95% CI: 1.25–1.97). Conclusion: Therapeutic hypothermia probably results in little to no difference in clinical outcomes among neonates with HIE in LMICs. Further large-scale research targeting proper patient selection is needed to elucidate the utility of therapeutic hypothermia in resource-limited settings. Protocol Registration: The protocol of the study has been prospectively registered by Prospero, CRD42021272284.
Assessment of the Association between Genetic Polymorphisms in the CHI3L1 Gene and Asthma Risk
Authors: Huang Qiu-Pin , Xie Zheng-Fu , Huang Jian
Published: March 2022

Background: Chitinase 3-like 1 (CHI3L1) is an important factor involved in the development of asthma. This meta-analysis assessed the association of the CHI3L1 polymorphisms rs4950928, rs10399931, rs883125, rs880633, and rs10399805 with asthma risk. Methods: The literature searches were conducted in PubMed, Web of Science, Wanfang, and China National Knowledge Infrastructure up until September 4, 2021, for relevant studies. Sixteen publications with 18 studies involving 5,005 asthma patients and 9,725 controls were included in this meta-analysis. Results: The meta-analyses showed that among East-Asian subjects, increased asthma risk was associated with CHI3L1 rs4950928 (GG + CG vs. CC: odds ratio [OR] = 1.43, 95% confidence interval [CI]: 1.09–1.88, p = 0.011; GG vs. CG + CC: OR = 1.64, 95% CI: 1.20–2.26, p = 0.002; GG vs. CC: OR = 1.97, 95% CI: 1.41–2.75, p = 0.000; and G vs. C: OR = 1.36, 95% CI: 1.12–1.66, p = 0.002) and rs883125 (G vs. C: OR = 1.42, 95% CI: 1.01–1.99, p = 0.043), whereas CHI3L1 rs10399931 was associated with reduced asthma risk (TT vs. CT + CC: OR = 0.79, 95% CI: 0.64–0.99, p = 0.038; TT vs. CC: OR = 0.77, 95% CI: 0.61–0.98, p = 0.030). In addition, we found an association between CHI3L1 rs4950928 and asthma risk in adult subjects but not children, while CHI3L1 rs883125 was associated with asthma risk in children. Conclusion: The CHI3L1 polymorphisms rs4950928, rs10399931, and rs883125 are important genetic factors for asthma among East-Asian subjects.
Pseudoaneurysm Complicating Proximal Humeral Exostosis: A Case Report of a Missed Diagnosis on Computed Tomography Angiographic Examination
Authors: Khanfour Ashraf A. , Gaweesh Ahmed S. , Gaweesh Tamer Y.
Published: March 2022

Vascular complications of osteochondromas of the humerus are extremely rare. Only 9 cases with pseudoaneurysms of the brachial artery complicating osteochondromas of the humerus were reported in 7 English articles. The computed tomography (CT) angiographic examination of all of them were positive for the diagnosis of the pseudoaneurysm. Up to our knowledge, this is the first case report in which the CT angiography misdiagnosed such lesion. In this article, we described a case with a pseudoaneurysm complicating a proximal humeral exostosis in a 27-year-old male patient with a known history of hereditary multiple osteochondromas since childhood that was unanticipatedly misdiagnosed by the CT angiographic imaging modality. The participating authors tried to infer reasoned possibilities behind this unreported phenomenon before.
Infected Biloma after Endoscopic Ultrasound-Guided Fine-Needle Aspiration
Authors: Aourarh Benayad , Adioui Tarik , Benhamdane Ahlame , Berrag Sanaa , Tamzaourte Mouna , Aourarh Aziz , Belkouchi Lina , Saouab Rachida
Published: March 2022

Biloma is a severe complication that can result from bile duct disruption or hepatic trauma. It can occur after biliary surgery such as cholecystectomy or an endoscopic retrograde cholangiopancreatography manipulation and endoscopic biliary sphincterotomy. We present the case of a 59-year-old man admitted for jaundice, with pain in his right flank and fever, 10 days after an endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for an ill-defined pancreatic lesion, associated with an infected biloma. Severe complications can occur after an EUS-FNA; therefore, this diagnosis should not be neglected after the intervention in symptomatic patients, to ensure an early and proper treatment.
Accuracy of Pulmonary Nodule Sampling Using Robotic Assisted Bronchoscopy with Shape Sensing, Fluoroscopy, and Radial Endobronchial Ultrasound (The ACCURACY Study)
Authors: Thiboutot Jeffrey , Argento A. Christine , Akulian Jason , Lee Hans J. , DeMaio Andrew , Kapp Christopher M. , Wahidi Momen M. , Yarmus Lonny
Published: March 2022

Background: Despite recent advances in guided bronchoscopy, the yield of bronchoscopic biopsy of a peripheral pulmonary nodule (PPN) remains highly variable. Objective: The aim of the study was to evaluate which features of robotic assisted bronchoscopy (RAB) contribute to a successful biopsy in a cadaver model. Methods: A preclinical, prospective, single-blinded trial using a ventilated human cadaveric model assessed the successful puncture of implanted pulmonary nodules using various localization techniques with RAB. The different approaches included positioning the robotic catheter at predefined distances from the target nodule (<10 mm, 10–20 mm, 20–30 mm), bronchoscopist correction of divergence between the software virtual map and bronchoscopic view if observed, and impact of fluoroscopy and radial endobronchial ultrasound (rEBUS). The primary endpoint was a central target hit (defined as an inner 2/3 target puncture) verified by cone-beam computed tomography. Results: Thirty-eight RAB procedures were performed to target 16 PPNs. Median nodule size was 16.2 mm. All targets were located in the outer 1/3 of the lung with a bronchus sign in 31.3%. Central target hit rates were improved when the robotic catheter tip was closer to the nodule (<10 mm 68%, 10–20 mm 66%, 20–30 mm 11%, p < 0.001). Multivariable analysis confirmed the strongest predictor of a central target hit was robotic catheter distance to nodule (OR 0.89 per increase in 1 mm, p < 0.001), independent of the presence of a bronchus sign, divergence or concentric rEBUS view. Conclusions: Utilizing a RAB platform, closer proximity of the robotic catheter to the target nodule results in an increase in peripheral nodule biopsy success.
Single-Port Laparoscopic Duodenojejunostomy Employing Semi-Kocherization for a Young Female with Superior Mesenteric Artery Syndrome
Authors: Umemura Akira , Nitta Hiroyuki , Katagiri Hirokatsu , Kanno Shoji , Takeda Daiki , Nagase Hayato , Amano Satoshi , Kikuchi Koji , Yamada Naoto , Sasaki Akira
Published: March 2022

Single-port laparoscopic duodenojejunostomy employing semi-Kocherization performed for a patient with superior mesenteric artery (SMA) syndrome is presented in this report. A 24-year-old woman missed meals due to work pressure, and her body weight decreased from 42 kg to 27 kg within 6 months. After this severe weight loss, she suffered from postprandial abdominal pain. An enhanced computed tomography revealed that the aortomesenteric angle was 11° (narrow), and the distance was short at 4.5 mm. Duodenography also revealed dilatation of the proximal duodenum. These findings led to a diagnosis of SMA syndrome, and we performed single-port laparoscopic duodenojejunostomy. We first dissected the fusion between the duodenum and transverse mesocolon, such as Kocherization, enough to mobilize the duodenum; this procedure was termed semi-Kocherization. A gauze was placed in the dissected space for a landmark from the transverse mesocolon side. We confirmed the gauze at the duodenum’s lateral side, then opened the transverse mesocolon, and pulled the duodenum out. We performed side-to-side duodenojejunostomy. The postoperative course was unremarkable, and she gained 4 kg within 2 months of discharge. Semi-Kocherization is shown to be an effective technique to increase duodenal mobility for performing anastomosis, and single-port laparoscopic surgery can reduce wounds and increase cosmesis.
Associations of Peripheral Neuropathy Defined by Monofilament Insensitivity with Mild Cognitive Impairment and Dementia in Older Adults
Authors: Hicks Caitlin W. , Wang Dan , Schneider Andrea L.C. , Johansen Michelle C. , Gottesman Rebecca F. , Matsushita Kunihiro , Coresh Josef , Windham B. Gwen , Selvin Elizabeth
Published: March 2022

Introduction: The aim of this study was to assess the association of peripheral neuropathy (PN) as defined by monofilament insensitivity with mild cognitive impairment (MCI) and dementia in older adults with and without diabetes. Methods: We conducted a cross-sectional analysis of 3,362 Black and White participants in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) who underwent monofilament testing at visit 6 (2016–2017, age 71–94 years). Participants’ cognitive status was classified by an adjudication committee as cognitively normal, MCI, or dementia after completing a comprehensive battery of neurocognitive assessments. We used logistic regression to evaluate the association of PN with MCI or dementia overall and stratified by diabetes status after adjusting for traditional dementia risk factors. We also compared age-adjusted brain MRI measures among a subset (N = 1,095) of participants with versus without PN. Results: Overall, the prevalence of MCI (21.9% vs. 16.7%) and dementia (7.8% vs. 3.9%) were higher among participants with versus without PN (both p < 0.05). After adjustment, PN was positively associated with MCI or dementia in the overall study population (OR 1.45, 95% CI 1.23, 1.73). Results were similar by diabetes status (diabetes: OR 1.38, 95% CI 1.03–1.87; no diabetes: OR 1.48, 95% CI 1.20–1.83; p-for-interaction = 0.46). Age-adjusted total and lobar brain volumes were significantly lower in participants with versus without PN (both, p < 0.05). Discussion/Conclusions: PN as defined by monofilament insensitivity was associated with cognitive status independent of vascular risk factors and regardless of diabetes status. Our findings support a connection between PN and cognitive impairment, even in the absence of diabetes.
The Network Structure of ICD-11 Disorders Specifically Associated with Stress: Adjustment Disorder, Prolonged Grief Disorder, Posttraumatic Stress Disorder, and Complex Posttraumatic Stress Disorder
Authors: Karatzias Thanos , Knefel Matthias , Maercker Andreas , Cloitre Marylene , Reed Geoffrey , Bryant Richard A. , Ben-Ezra Menachem , Kazlauskas Evaldas , Jowett Sally , Shevlin Mark , Hyland Philip
Published: March 2022

Introduction: The ICD-11 includes a new grouping for “disorders specifically associated with stress” that contains revised descriptions of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) and new diagnoses in the form of complex PTSD (CPTSD) and prolonged grief disorder (PGD). These disorders are similar in that they each require a life event for the diagnosis; however, they have not yet been assessed together for validity within the same sample. We set out to test the distinctiveness of the four main ICD-11 stress disorders using a network analysis approach. Methods: A population-based, cross-sectional design. A nationally representative sample of adults from the Republic of Ireland aged 18 years and older (N = 1,020) completed standardized measures of PTSD, CPTSD, AjD, and PGD. A network analysis was conducted at the symptom level. Outcome measures included the International Trauma Questionnaire, the Inventory of Complicated Grief, and the International Adjustment Disorder Questionnaire. Results: Consistent with the taxonomic structure of the ICD-11, our results showed that although the four conditions clustered independently at the disorder level, the specific symptoms of PTSD, CPTSD, PGD, and AjD clustered together very strongly but more strongly than with symptoms of the other disorders. The majority (61%) of the variation in each symptom could be explained by its neighboring symptoms. The strongest transdiagnostically connecting symptom was “startle response.” Discussion/Conclusion: Mental health professionals caring for people who have experienced a range of stressors and traumatic life events can be confident in diagnosing these conditions that have clear diagnostic boundaries. Interventions addressing stress-associated disorders should be based on diagnostic assessment to ensure close fit between symptoms and treatment.
Delayed Fluoroquinolone-Induced Tibialis Anterior Rupture: Review and Case Report on Achilles and Tibialis Anterior Atraumatic Rupture with Operative Technique
Authors: Prevost Matthew , Szabo Edward , Ramirez Mario , Heiken Matthew
Published: March 2022

Tendinopathy is a well-defined adverse effect of fluoroquinolone (FQ) antibiotics with complete tendon rupture being the most serious consequence. The most described FQ-associated tendinopathies are of the Achilles tendon with an onset ranging between 2 h after initial FQ administration to 6 months after completing FQ treatment. We herein report the case of a 50-year-old diabetic woman who suffered from a right Achilles tendon rupture and contralateral nontraumatic tibialis anterior (TA) tendon rupture 11 and 25 months following FQ administration, respectively. Operative management of both injuries identified degenerative changes consistent with FQ treatment. This case is unusual in its involvement of an uncommon tendon in an atypical timeframe. Notably, only one other reported case of FQ-associated TA tendon rupture was identified.
Brolucizumab 12- and 16-Week Fixed Dosing Potential in Neovascular AMD: A post hoc Evaluation of Data from the HAWK and HARRIER Trials
Authors: Singer Michael , Khanani Arshad M. , Wolf Armin , Flores Rita , Chhablani Jay , B Guruprasad , Clemens Andreas , Gedif Kinfemichael , Liu Xiaoxi , Mulyukov Zufar , Querques Giuseppe
Published: March 2022

Introduction: This post hoc analysis applies a fixed dosing stratification approach to patient-level brolucizumab data from the phase III HAWK and HARRIER trials to determine the proportion of patients who would have been assigned to fixed dosing regimens with treatment intervals of 8, 12, or 16 weeks (q8w, q12w, or q16w) based on the presence/absence of disease activity (DA) following the loading phase. The analysis also simulates central subfield thickness (CSFT) data to estimate the anatomical outcomes if the patients had been thus assigned. Of note, the limitations of this analysis include the post hoc nature of the work and the inability to directly compare HAWK and HARRIER with TENAYA and LUCERNE due to the differences in design. Design: This study was a post hoc modelling analysis of patient-level data. Methods: Using patient-level data from HAWK and HARRIER, patients (n = 730) were allocated to a fixed q16w, q12w, or q8w regimen based on assessment of DA at weeks 16 and 20. Two definitions of DA were used: DA 1, based on a phase II study of faricimab, and DA 2, a definition derived from common clinical consideration including visual acuity and anatomical changes. CSFT simulations were performed using a pharmacokinetic/pharmacodynamic model describing CSFT response to anti-VEGF treatment. Outcome measures were modelled patient allocation to fixed regimens and mean CSFT reduction. Results: Using DA definitions 1 and 2, respectively, 78% and 76% of patients in the brolucizumab arm were allocated to a greater than or equal to q12w regimen, and 56% and 52% were allocated to a q16w regimen. Mean reduction in CSFT was similar between the two study drugs with both DA definition assumptions. Conclusions: This analysis demonstrates the potential durability of action and effectiveness of brolucizumab.
Myeloid Neoplasm with PCM1-PDGFRB Transcript Responded to Low-Dose Imatinib: One Case Report with Literature Review
Authors: Wang Zhe , Wan Li , Lin Dong , Li Cheng-Wen , Tian Zheng , Mi Ying-Chang
Published: March 2022

Through an RNA-seq analysis of an adult patient with unclassifiable myelodysplastic/myeloproliferative neoplasms (MDS/MPN-U), we identified a rare PDGFRB fusion partner gene, PCM1. Conventional chromosome karyotype analysis showed abnormal clones of t(5;8)(q32;p22), and fluorescence in situ hybridization (FISH) confirmed rearrangement of the PDGFRB gene. Reverse transcription PCR (RT-PCR) and Sanger sequencing further confirmed that exon 30 of the PCM1 gene was fused with exon 11 of PDGFRB in frame, and the fusion event was accompanied by a 14 bp deletion of exon 11 of PDGFRB. After low-dose imatinib treatment, the patient achieved complete molecular remission. This study not only broadens the understanding of myeloid/lymphoid neoplasms with PDGFRB rearrangement but also reflects the vital role of RNA-seq in identifying PDGFRB rearrangements.
Differences in the Intestinal Microbiome Associated with Diarrhea during Lenvatinib Treatment for Hepatocellular Carcinoma
Authors: Inukai Yosuke , Yamamoto Kenta , Honda Takashi , Ito Takanori , Imai Norihiro , Ishizu Yoji , Nakamura Masanao , Kawashima Hiroki , Ishigami Masatoshi
Published: March 2022

Introduction: Lenvatinib has been widely used for the treatment of advanced hepatocellular carcinoma (HCC). Some adverse events, including diarrhea, have been reported for lenvatinib. Diarrhea may be associated with the changes in the intestinal microbiome; however, the underlying mechanism has not been elucidated. Aim: In this study, we aimed to investigate the relationship between the intestinal microbiome and diarrhea caused by lenvatinib via analysis of fecal samples collected before treatment. Methods: A total of 21 patients with advanced HCC who were treated with lenvatinib were enrolled. Fecal samples were collected from patients. The patients were divided into diarrhea (n = 8) and nondiarrhea groups (n = 12). We compared the characteristics of patients, incidence of adverse events, composition of the intestinal microbiome, and enrichment of functional pathways between both groups using QIIME2 and PICRUSt2. Results: The median age of the two groups was 73 years. The nondiarrhea group comprised a relatively higher number of male patients than the diarrhea group; however, there were no significant differences in patient characteristics between both groups. The proportion of the microbiome was similar, and alpha and beta diversities were not significantly different between both groups. The relative abundance of order Bacteroidales, including Parabacteroides and Prevotella, was higher in the diarrhea group than in the nondiarrhea group. PICRUSt2 analysis showed some metabolic pathways, including butanoate (butyrate) metabolism, were enriched in the nondiarrhea group when compared with those in the diarrhea group. Conclusion: Differences in the intestinal microbiomes and their functions may influence the incidence of diarrhea during lenvatinib treatment.
Effect of FFP2/3 Masks on Voice Range Profile Measurement and Voice Acoustics in Routine Voice Diagnostics
Authors: Ho Guan-Yuh , Kansy Ines Kristina , Klavacs Katharina Anna , Leonhard Matthias , Schneider-Stickler Berit
Published: March 2022

Introduction: Voice diagnostics including voice range profile (VRP) measurement and acoustic voice analysis is essential in laryngology and phoniatrics. Due to COVID-19 pandemic, wearing of 2 or 3 filtering face piece (FFP2/3) masks is recommended when high-risk aerosol-generating procedures like singing and speaking are being performed. Goal of this study was to compare VRP parameters when performed without and with FFP2/3 masks. Further, formant analysis for sustained vowels, singer’s formant, and analysis of reading standard text samples were performed without/with FFP2/3 masks. Methods: Twenty subjects (6 males and 14 females) were enrolled in this study with an average age of 36 ± 16 years (mean ± SD). Fourteen patients were rated as euphonic/not hoarse and 6 patients as mildly hoarse. All subjects underwent the VRP measurements, vowel, and text recordings without/with FFP2/3 mask using the software DiVAS by XION medical (Berlin, Germany). Voice range of singing voice, equivalent of voice extension measure (eVEM), fundamental frequency (F0), sound pressure level (SPL) of soft speaking and shouting were calculated and analyzed. Maximum phonation time (MPT) and jitter-% were included for Dysphonia Severity Index (DSI) measurement. Analyses of singer’s formant were performed. Spectral analyses of sustained vowels /a:/, /i:/, and /u:/ (first = F1 and second = F2 formants), intensity of long-term average spectrum, and alpha-ratio were calculated using the freeware praat. Results: For all subjects, the mean values of routine voice parameters without/with mask were analyzed: no significant differences were found in results of singing voice range, eVEM, SPL, and frequency of soft speaking/shouting, except significantly lower mean SPL of shouting with FFP2/3 mask, in particular that of the female subjects (p = 0.002). Results of MPT, jitter, and DSI without/with FFP2/3 mask showed no significant differences. Further mean values analyzed without/with mask were ratio singer’s formant/loud singing, with lower ratio with FFP2/3 mask (p = 0.001), and F1 and F2 of /a:/, /i:/, /u:/, with no significant differences of the results, with the exception of F2 of /i:/ with lower value with FFP2/3 mask (p = 0.005). With the exceptions mentioned, the t test revealed no significant differences for each of the routine parameters tested in the recordings without and with wearing a FFP2/3 mask. Conclusion: It can be concluded that VRP measurements including DSI performed with FFP2/3 masks provide reliable data in clinical routine with respect to voice condition/constitution. Spectral analyses of sustained vowel, text, and singer’s formant will be affected by wearing FFP2/3 masks.
Evaluating the Response of Palbociclib on Progression-Free Survival in Hormone Receptor-Positive Metastatic Breast Cancer
Authors: Shikdar Sufana , Hall Spencer , Taylor Brandon , de los Angeles Jennifer , Tahirkheli Mashal , Zhao Daniel , Razaq Wajeeha
Published: March 2022

Background: In patients with hormone receptor-positive metastatic breast cancer, palbociclib has been shown to improve overall survival and progression-free survival (PFS) when combined with endocrine therapy. Dose modification of palbociclib is effective in the management of adverse events. Despite variable clinical response, no predictive biomarkers of efficacy to palbociclib have been identified in metastatic breast cancer. In our study, we aimed to assess the PFS of metastatic breast cancer patients who received dose-reduced palbociclib and compare the results in the non-dose-reduced group. We also evaluated the clinical significance of progesterone receptor (PR) and Ki67 as predictive biomarkers of palbociclib. Methods: Seventy-six palbociclib-treated metastatic breast cancer patients were included in our study. PFS was compared between dose-reduced and non-dose-reduced groups. PR expression and Ki67 status were assessed by immunohistochemistry. Kaplan-Meier method and log-rank test were used to analyze PFS. Results: Of the 76 patients, 40 (52.6%) experienced dose reduction (DR). Statistical analysis of the results revealed that there were no statistically significant differences observed between dose-reduced (16.5 months) versus non-dose-reduced (17.7 months) patients in PFS (p = 0.5493). For patients with Ki67 ≥14%, PFS was 15.2 months (95% CI: 10.2–22.2 months; p = 0.3024). In patients with PR ≥20%, median PFS was 25.0 months (lower 95% CI: 16.8 months; p = 0.0069). Conclusion: Our study indicated that DR of palbociclib is frequently required but does not appear to affect PFS. PR expression was suggested to be a significant predictive factor for palbociclib responsiveness.
Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications
Authors: Singh Trisha , Khan Hilal , Gamble David T. , Scally Caroline , Newby David E. , Dawson Dana
Published: March 2022

Takotsubo syndrome is a condition characterized by acute transient left ventricular systolic dysfunction, which at presentation can be challenging to distinguish from acute myocardial infarction. Although previously thought to be a benign, self-limiting condition, recent studies have confirmed that patients with takotsubo syndrome have persistent subtle ongoing cardiac dysfunction, and many continue to have limiting symptoms despite restoration of left ventricular ejection fraction. Moreover, these patients have a substantial burden of morbidity and mortality, as well, with high rates of subsequent major adverse cardiovascular events that approach those of patients with acute coronary syndrome. The mechanisms behind this condition remain elusive. Despite substantial research, the medical community continues to have an incomplete understanding of its underlying pathogenesis and pathophysiology. Catecholamine-induced myocardial injury is the most established and well-known theory, but this does not explain all the clinical features and presentations of the condition, and numerous other pathways and abnormalities are emerging. Because of the poor understanding of its underlying pathophysiology, there is a lack of evidence-based interventions to treat the acute episode, to avoid recurrences, and to prevent major adverse cardiovascular events. This highlights the need for further research to gain a better understanding of the underlying pathophysiology to inform appropriate randomized controlled trials of interventions targeting the causative pathways. Only then can evidence-based management strategies be established to improve clinical outcomes of this potentially lethal condition.
Outcomes in Obese vs Non-Obese Injured Patients at a Level 1 Trauma Center and Bariatric Surgery Center of Excellence
Authors: Petrone Patrizio , Joseph D’Andrea K. , Baltazar Gerard , Akerman Meredith , Howell Raelina S. , Brathwaite Collin E. M.
Published: March 2022

Background

We hypothesized that the outcomes of trauma patients with a body mass index (BMI) equal to or greater than 30 compared to patients with BMI less than 30 would not differ at a level 1 trauma center that is also a Metabolic and Bariatric Surgery Center of Excellence in the Metabolic and Bariatric Surgery Accreditation Quality Improvement Program (MBSAQIP).

Study Design

Patients equal to and greater than 18 years old treated between 1/1/2018 and 12/31/2020 were included. Demographics, BMI, comorbidities, and outcomes (hospital-LOS, ICU-LOS, blood products used, and mortality) were compared between 2 groups: obese (BMI ≥30) vs non-obese (BMI <30).

Results

Of the 4192 patients identified, 3821 met the inclusion criteria; 3019 patients had a BMI <30, and 802 had a BMI ≥30. There was a statistically significant difference between the 2 groups with respect to gender (females: 57% vs 47%, P < .0001) and age (median: 80 [IQR: 63-88] vs 69 [IQR: 55-81], P < .0001). When adjusted for age, sex, DM, dementia, ISS, and ICU admission, there was no statistically significant difference in hospital-LOS (4.30 [95% CI: 4.10, 4.52] vs 4.48 [95% CI: 4.18, 4.79]) or mortality. No statistical differences were seen between the 2 groups in blood product use.

Conclusions

Obesity did not correlate with poorer outcomes at an ACS-verified level 1 Trauma Center and Bariatric Surgery Center of Excellence. Further studies are needed to determine whether outcomes vary at hospitals without both designations.
Imaging Sin and the Passage to Holiness: René Girard, Ecclesial Vision, and the Spiritual Reshaping of Desires
Authors: McLaughlin Brett
Published: March 2022

In his 2018 book, Stumbling in Holiness, Brian Flanagan presents the knotty ecclesiological dialogue over the purity of the Church-body. There is a continuing inducement to evade acknowledgment of a sinful dimension in the body of the Church. Sometimes Christians forswear that gravely sinful people are actually members. The converse, cynical perspective turns up as well. This present article advances Girardian theological anthropology and the ecclesiology of the Halfway House as a pathway forward. The Church and church members have a situatedness in sinful culture, generating desires and cultivating conflict. The Cross exposes the destructiveness of such desires; Jesus calls for Christians to imitate his renunciation of worldly aspiration. James Alison’s vision of the Church as Halfway House fosters the notion of Christians as people undergoing forgiveness. Girardian ecclesial vision results in the spirituality of the reshaping of desires, inspired by Jesus’ bestowal of friendship and love in John 15.
Understanding the capacity of key actors and their role in the seed potato systems: The case of Eritrea
Authors: Ghebreagziabiher Fitsumberhan Ghebremeskel , Griffin Denis , Burke John , Gorman Monica
Published: March 2022

Understanding the combined effects of the biophysical, socioeconomic, and institutional components of a seed system can help to improve the effectiveness of seed system interventions. This study examined whether and how institutional factors are contributing to the inadequate supply of quality seed potato in Eritrea and identified where and how bottlenecks within the seed systems might improve the efficacy of seed potato interventions. The research methodology included semi-structured interviews with seed potato system actors, focus group discussions with farmers and local experts, a review of seed potato intervention program reports, farm visit reports, and other literature. The study identified some structural system failures that block the effective functioning of the seed potato intervention. The study recommendations include (i) investment in climate-smart technologies (such as water harvesting structures and new varieties) as well as for electricity supply in the high grades seed production center (ii) shifting the traditional supply-driven approach to a demand driven approach for greater participation of the actors in the seed potato intervention (iii) strengthening the human skill of the actors for greater interaction and collaboration between the different government actors and (iv) developing local strategies to encourage decentralized service provision systems. In the longer term, consideration should be given to greater private sector participation in sourcing and supply of seed and other inputs, even as a pilot-scale activity.
Semantic Versus Orthographic Preferences in Aphasia: Behavioral Evidence
Authors: DeMetropolis Susan M. , Goldfarb Robert
Published: March 2022

In this study, we compared the orthographic and semantic preferences of healthy adults and age and gender matched adults with aphasia, an acquired language disorder. Previous research in word retrieval and word associations has addressed semantic and phonological connections, but it has not as often included analyses of orthographic skills. We matched (on age and gender) 10 neurotypical adults and 11 older adults with aphasia and administered to both groups a lexical discrimination task requiring them to select, from 18 choices, those words that were most different from three words (daughter, laughter, son). Among the choices were foil words (e.g., daughter), orthographic similarities (laughter) and semantic similarities (son). Results revealed that individuals with aphasia focused on orthographic differences, while healthy adults chose semantic differences. Further studies should further explore this orthographic focus to develop treatment strategies, using behavioral and objective measures, for word-finding deficits in aphasia.
The growing movement to create full-service community schools: A conversation with Mavis Sanders and Claudia Galindo
Authors: Heller Rafael
Published: March 2022

Claudia Gallindo and Mavis Sanders describe what they’ve learned from their research about how full-service community schools connect with families and communities. These schools acknowledge that students have needs that go beyond that need and attempt to address those needs and serve as a hub for the community. The current movement goes beyond providing services to include community members in their decision making. They discuss examples of what specific schools are doing and some of the challenges they face.
Creating a safe community: The transition project
Authors: Verdone Bailey , Farag Antony
Published: March 2022

Currently, research surrounding transition programs for students entering high school focuses on academic achievement outcomes. However, the prevalence of school shootings in predominantly white, suburban communities shows that students in these often academically competitive schools may need support to help them become more connected to the school community. Antony Farag and Bailey Verdone describe how the Transition Project at Westfield High School in New Jersey, launched soon after the 1999 shooting at Columbine High School, has helped the school build a community of trust, beginning when students enter the school in 9th grade. The program links 9th graders with 11th- and 12th-grade who lead them in discussions about community building. The program has become an integral part of the school, receiving support from teachers, administrators, and the local community.
Under The Law: Banning books: Unlawful censorship, or within a school’s discretion?
Authors: Kim Robert
Published: March 2022

The American Library Association reported an “unprecedented spike” in the number of book removal requests in the final months of 2021, and most of these challenges focus on books about people from marginalized communities. Robert Kim asks whether such removals violate the First Amendment and explores how much discretion court have granted school officials in removing books from schools. Cases tend to hinge on the motivations behind such removals and bar officials from removing books because they express viewpoints officials and community members find objectionable while allowing the removal of books that are vulgar, not age-appropriate, or not educationally suitable.
‘Stop Measuring Black Kids with a White Stick’: Translanguaging for Classroom Assessment
Authors: Steele Carly , Dovchin Sender , Oliver Rhonda
Published: March 2022

In this conceptual paper, we explore the opportunities and challenges that translanguaging may provide for students from Australian Aboriginal backgrounds and their teachers. We use examples taken from Australian Aboriginal students who may speak Standard Australian English, Australian Aboriginal English, creoles (Kriol being the common one across the north of Australia) and traditional languages (e.g. Kija, Martu). We begin by examining the concept of translanguaging and show how Australian Aboriginal students can move fluidly between their various linguistic resources, dialects and repertoires to make meaning, express their thoughts, understandings and feelings, create their identities, and do so in often playful and creative ways. The principles of fair and valid assessment are explored and the role that translanguaging can fulfil for assessment purposes is considered. We also document some of the social, cultural and linguistic biases that underpin aspects of assessment, and make suggestions for improvement. In particular, we examine how teachers could approach assessment so that students with Aboriginal backgrounds are able to draw on their full linguistic repertoire and, in this way, address the issues surrounding discriminatory assessment practices that are founded on monolingual mindsets. We also take up the gauntlet to ‘stop measuring black kids with a white stick’ and seek positive and embracing ways for all students with Aboriginal backgrounds to engage in assessment practices.
Waiting for Tindaya: Modern ruins and indigenous futures in Fuerteventura
Authors: Marrero-Guillamón Isaac
Published: March 2022

Since the mid-1990s, the mountain of Tindaya (Fuerteventura, Canary Islands, Spain) has been in limbo. Despite being listed as a Natural and Cultural Asset by virtue of its environmental singularity and indigenous engravings, the conservation plans have never been implemented. Instead, the state institutions designated it as the location for artist Eduardo Chillida’s Monument to Tolerance (a huge, bare cubic cave to be dug in its interior) – a controversial project that remains suspended, neither in construction nor abandoned. To complicate matters, the mountain also features three quarries, and speculation over the mining rights associated with them resulted in a long series of trials and appeals. Tindaya is therefore a site of truncated futures, fragments of which are still to be found in and around the mountain. This article works with these material traces as a way of activating the mountain’s role in a plurality of strategies of anticipation, from the economic and cultural superabundance ascribed to Chillida’s project by the state to the indigenous rituals and offerings that took place in the mountain. It is argued that Tindaya stands today as an unintended monument to the ruins of a modernity envisaged in the language of economic development and artistic abstraction, but also represents the possibility of enacting other, minoritarian futures, connected to the poorly understood indigenous lifeworlds attached to the mountain and its surroundings. The critique of the former is accompanied by the cultivation of the latter through an exercise in speculative ethnography.
Treatment of venous malformations with tumescent-assisted sclero-embolic and ablative lasers (SEALs): Safe and effective long-term outcomes
Authors: Kang Mina , Connor David E , Parsi Kurosh
Published: March 2022

Background

Perivascular infiltration of tumescent anaesthesia (TA) is an essential element of endovenous thermal ablative procedures employed to treat superficial venous disease. In addition to anaesthesia, TA is administered to achieve vessel wall approximation and to protect surrounding structures from thermal damage. However, its role in the treatment of venous malformations (VMs) has not been established.

Objectives

To assess the safety and efficacy of tumescent-assisted thermal and chemical ablative methods in the treatment of VMs.

Methods

Adult and paediatric patients presenting with VMs were treated using a combination of endovenous laser ablation, foam embolo-sclerotherapy and liquid embolisation using n-BCA. All procedures were ultrasound-guided. Treatment outcomes were assessed in early and late follow-ups. To assess the efficacy of TA in achieving vessel wall approximation, cross-sectional lesional diameters were measured by ultrasound, before and after the administration of TA during endovenous procedures.

Results

In a 12 month period, 22 patients recruited in the study presented with 27 VMs which included 23 extra-truncular lesions (16 subcutaneous and seven intramuscular) and four truncular anomalies. On average the subcutaneous lesions measured 5.5 mm (1.9–24.5 mm) in diameter, intramuscular lesions measured 9.2 mm (5.9–15.1 mm) and truncular anomalies measured 4.9 mm (1.2–12 mm) in diameter. Perivascular infiltration of TA resulted in a significant reduction in vessel calibre (90% reduction on average). Intramuscular VMs were less compressible with TA (69.2% reduction) compared to subcutaneous lesions (98% reduction). Truncular anomalies such as the embryonic marginal vein achieved complete approximation (100% reduction). Procedures were safely tolerated with no major complications such as thromboembolism, stroke, nerve damage or tissue necrosis. Most patients had significant clinical as well as ultrasonographic improvement.

Conclusion

Tumescent-assisted endovenous laser ablation and foam sclerotherapy provides safe and effective outcomes in patients with a variety of VMs.
Joint search of optimal topology and trajectory for planar linkages
Authors: Pan Zherong , Liu Min , Gao Xifeng , Manocha Dinesh
Published: March 2022

We present an algorithm to compute planar linkage topology and geometry, given a user-specified end-effector trajectory. Planar linkage structures convert rotational or prismatic motions of a single actuator into an arbitrarily complex periodic motion, which is an important component when building low-cost, modular robots, mechanical toys, and foldable structures in our daily lives (chairs, bikes, and shelves). The design of such structures requires trial and error even for experienced engineers. Our research provides semi-automatic methods for exploring novel designs given high-level specifications and constraints. We formulate this problem as a non-smooth numerical optimization with quadratic objective functions and non-convex quadratic constraints involving mixed-integer decision variables (MIQCQP). We propose and compare three approximate algorithms to solve this problem: mixed-integer conic-programming (MICP), mixed-integer nonlinear programming (MINLP), and simulated annealing (SA). We evaluated these algorithms searching for planar linkages involving 10 − 14 rigid links. Our results show that the best performance can be achieved by combining MICP and MINLP, leading to a hybrid algorithm capable of finding the planar linkages within a couple of hours on a desktop machine, which significantly outperforms the SA baseline in terms of optimality. We highlight the effectiveness of our optimized planar linkages by using them as legs of a walking robot.
Silver nanoparticles modify the hypothalamic–pituitary–interrenal axis and block cortisol response to an acute stress in zebrafish, Danio rerio
Authors: Arab-Bafrani Zahra , Zabihi Erfan , Hoseini Seyyed Morteza , Sepehri Hamid , Khalili Mohsen
Published: March 2022

The present study aimed at assessing the effects of exposure to silver nanoparticle (AgNP) and a subsequent acute stress on the expression of various genes involved in the hypothalamus–pituitary–interrenal (HPI) axis in zebrafish, Danio rerio. The fish were exposed to 0 (Control), 0.1 (LC), 0.4 (MC), and 1.2 (HC) mg Ag/L (as AgNP) over a 2-week period, followed by an acute air exposure stress. The whole body cortisol and the expression of selected genes in the fish brain and kidney were analyzed, before and after the acute stress. The results showed that AgNP increased basal cortisol levels and the expression of corticotropin releasing factor, prohormone convertase 1, pro-opiomelanocortin, and melanocortin 2 receptor; however, it suppressed/inhibited whole body cortisol, brain corticotropin releasing factor responses, pro-opiomelanocortin, and the kidney melanocortin 2 receptor responses to the acute stress. AgNP down-regulated the expression of the steroidogenic acute regulatory protein, but it intensified the gene expression in response to the acute stress. Before the acute stress, LC treatment exhibited an up-regulation in Cytochrome P450-11A-1 expression, but MC and HC treatments induced down-regulation. After the acute stress, the AgNP-exposed fish exhibited decreased Cytochrome P450-11A-1 expressions, compared with the Control. Exposure to AgNP significantly increased Cytochrome P450-11B expression. However, after the acute stress, LC treatment exhibited an up-regulation, but MC and HC treatments exhibited down-regulation in the Cytochrome P450-11B gene expression. In conclusion, AgNP suppressed cortisol response to stress, which appears to be a consequence of alterations in the HPI axis at the transcriptomic levels.
Parametric Tracking of Electrical Current Components Using Gradient Descent Algorithm
Authors: Frini Marouane , Choqueuse Vincent , Auger François
Published: March 2022

In the last few years, Motor Current Signature Analysis (MCSA) has proven to be an effective method for electrical machines condition monitoring. Indeed, compared to vibration and temperature analysis, current measurement proves to be a convenient and non-invasive alternative. Moreover, it has proven to be a reliable method since many mechanical and electrical faults manifest as side-band spectral components generated around the fundamental frequency component of the motor’s current. These components are called interharmonics and they are a major focus of fault detection using MCSA. However, the main drawback of this approach is that the interference of other more prevalent components such as the fundamental and noise components can obstruct the effect of interharmonics in the spectrum and may therefore affect fault detection accuracy. Thus, we propose in this paper an alternative approach that aims to decompose the different current components using a model based on a Vandermonde matrix, in order to monitor each component independently. Then, the tracking of each distinct component in time and spectral domains is implemented. This is achieved by estimating their respective relevant parameters using the Gradient Descent algorithm. This method has been favorably compared to an existing estimation algorithm (MUSIC) and its efficiency has been validated. The results of this work prove to be promising and establish the parametric tracking of the electrical current components using the Gradient Descent algorithm as a reliable monitoring approach.
Learning About the Self: Motives for Coherence and Positivity Constrain Learning From Self-Relevant Social Feedback
Authors: Elder Jacob , Davis Tyler , Hughes Brent L.
Published: March 2022

People learn about themselves from social feedback, but desires for coherence and positivity constrain how feedback is incorporated into the self-concept. We developed a network-based model of the self-concept and embedded it in a reinforcement-learning framework to provide a computational account of how motivations shape self-learning from feedback. Participants ( N = 46 adult university students) received feedback while evaluating themselves on traits drawn from a causal network of trait semantics. Network-defined communities were assigned different likelihoods of positive feedback. Participants learned from positive feedback but dismissed negative feedback, as reflected by asymmetries in computational parameters that represent the incorporation of positive versus negative outcomes. Furthermore, participants were constrained in how they incorporated feedback: Self-evaluations changed less for traits that have more implications and are thus more important to the coherence of the network. We provide a computational explanation of how motives for coherence and positivity jointly constrain learning about the self from feedback, an explanation that makes testable predictions for future clinical research.