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Alexander Chern

and 3 more

Purpose: Transcanal endoscopic ear surgery (TEES) avoids a postauricular incision, which has been shown to minimize pain and numbness. Our objective is to assess how much patients value minimizing pain and numbness relative to other postoperative otologic outcomes. Methods: Cross-sectional anonymous surveys were distributed to otolaryngology clinic patients in a tertiary care center. Patients were instructed to rate how much they value various outcomes when undergoing hypothetical ear surgery on a scale of 0 (not important) to 10 (very important). Linear regression was used to analyze demographic predictors of valued outcomes. Results: 102 patients responded (response rate 75%, 50% male). 51% presented for otologic complaints; other represented subspecialties included head & neck surgery, facial plastic surgery and rhinology. 10% of survey respondents were Spanish-speaking. Outcomes of highest importance included hearing (mean 9.3; SD 1.9), staff friendliness (8.9; 1.8), numbness (8.3; 2.4), and pain (8.1; 2.5). Outcomes of moderate importance included time spent under anesthesia (7.0; 3.2), scar visibility (6.3; 3.5), incision size (5.5; 3.4), incision hidden in the ear canal (5.4, 3.9), and surgery cost to the hospital (5.1; 3.9). In linear regression analysis, increasing age was associated with decreased value placed on size of incision (β=-0.06, p<0.001) and visibility of scar (β=-0.07, p<0.001). Conclusion: Patients placed very high value on minimizing pain and numbness after ear surgery, nearly as much as a good hearing outcome. This has implications for patient-driven interest in TEES, which has been previously shown to reduce pain and numbness compared to the postauricular approach.

Daniel Balleza

and 1 more

The transient receptor potential (TRP) superfamily of cation channels is divided into several subfamilies. The TRPV (vanilloid) subfamily is composed of proteins that undergo a closed-to-open gating transition in response to various physical and chemical stimuli, including heat transfer phenomena. TRPV1, the prototypical member of these thermo-TRP channels, is activated under physiological conditions by noxious high temperatures (>42°C), and by pungent chemicals including capsaicin and resiniferatoxin . Like TRPV1, TRPV2 is also activated at >52°C as well as 2-aminoethoxydiphenyl borate and cannabidiol. On the other hand, the main stimulus for Kv channels is the potential difference across the membrane. Notwithstanding these differences in their activation temperatures, ligand- or voltage-dependence, the gating mechanisms of these channels exhibit conformational transition pathways in common. Understanding these conformational changes in terms of the sequence determinants underlying these structural transitions helps to reveal residues with great functional relevance. This work examines the side-chain flexibility in regions undergoing peculiar helical transitions. We found that α-to-π helical transitions are associated with patterns of local rigidity whereas α-to-3 10 transitions are mainly associated with high local flexibility profiles. We also study the relationship between flexibility and protein order, both in these dynamic regions and in the rest of the transmembrane domains of these proteins. Our analysis shows that flexibility and protein disorder are two complementary parameters that could reveal conformational heterogeneity and the dynamic behavior of specific segments.

Antonio R. Vieira

and 14 more

In regions of the world where anthrax is endemic, humans are at risk of infection from contact with infected animals and contaminated animal products. The World Health Organization proposed recommendations, based on then current evidence, for personal protective equipment (PPE) use when performing clinical, laboratory, and field work activities involving collection and handling of specimens from humans, animals, and environments potentially contaminated with Bacillus anthracis. However, it is often unclear how these recommendations apply under field settings in low-resource countries, leading to inadequate protection and subsequent exposures of veterinary, medical, and public health professionals investigating anthrax outbreaks. To illustrate how existing recommendations can be applied to reduce the risk of exposures in endemic regions with limited resources, while balancing access to PPE, CDC subject matter experts (field epidemiologists working on anthrax outbreak response, control and capacity building activities around the globe) reviewed current recommendations, existing data from human anthrax case reports and anthrax prevention studies, and discussed professional judgment based on years of personal field experiences. To develop a risk assessment for exposures to naturally occurring anthrax, the group evaluated exposure mechanisms in settings such as the laboratory, clinical practice (animal and human), environmental specimen collection, and foodborne exposures, and provided examples of simplified anthrax-exposure risk characterization scenarios and illustrations of post-exposure prophylaxis (PEP) practices. Although these practice-informed examples and risk exposure scenarios are most applicable in endemic regions with limited resources, they may be applied anywhere that B. anthracis occurs naturally, to assess whether PEP and monitoring are indicated.

Mishchenko A.V.

and 6 more

Our intention in writing this paper is to conduct a retrospective epidemiological analysis of foot and mouth disease (hereinafter referred to as FMD) outbreaks reported in livestock in the Russian Federation from 1991 to 2020. The paper provides space-time patterns of FMD outbreaks and describes risk factors, FMD prevention and control strategies. 97 FMD outbreaks caused by A, O and Asia-1 serotypes were reported in cattle, small ruminants and pigs in the Russian Federation in the study period. These outbreaks were mainly concentrated along the Russian-Chinese border. The analysis reveals a high incidence rate of A and O serotypes, which accounted for 79% of all outbreaks, as well as a trend towards forming time-space clusters in 2005 and in 2013-2019. Sufficient data were collected to identify 9 statistically significant time-space clusters formed by FMD outbreaks: 3 clusters (the FMDV serotype A) lasted 27 - 62 days, 4 clusters (the FMDV serotype O) lasted 6 - 27 days, one cluster (the FMDV serotype Asia-1) lasted 125 days, and a mixed cluster composed of A and O serotypes that lasted 552 days. Risk factors associated with pathogen introduction were underestimated and it undermined biosecurity and biosafety when keeping and moving animals. It has been argued that the underestimation of risk factors is the major cause of outbreaks. Due to it, direct and indirect contacts with carriers, including wild migrating [cloven-hoofed animal](, became possible. Based on the work carried out we have come to the conclusion that developing cross-border cooperation is urgently needed to prevent and control FMD.

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Shaomin Shi

and 5 more

Solar-induced chlorophyll fluorescence (SIF) has been used to estimate leaf-level net CO 2 assimilation by a mechanistic light reaction (MLR-SIF) equation. However, the application of this model would be limited by the challenging measurement and estimation of input parameters (e.g. fraction of open PSII reaction centres, q L). We modified the MLR-SIF model by replacing q L by the easily obtained parameters (non-photochemical quenching [NPQ]) to facilitate its application. We employed synchronous measurements of gas exchanges, ChlF parameters and SIF for Leymus chinensis, Populus tomentosa Carrières and Ulmus pumila var. sabulosa under the soil–water deficit and rehydration process to test the robustness of the modified MLR-SIF model. Our results demonstrated that for L. chinensis the net photosynthesis rate dynamics under severe soil–water stress and saturated water condition were effectively captured by the modified MLR-SIF model ( R 2 = 0.75–0.92, RMSE = 1.11–3.56) . For P. tomentosa Carrières and U. pumila var. sabulosa, the net photosynthesis rates were predicted by the modified MLR-SIF model with good accuracy ( R 2 = 0.86, RMSE = 9.44; R 2 = 0.88, RMSE = 4.16) across the water deficit and rehydration condition . However, the electron transport rate estimated by the modified MLR-SIF model uncoupled with the photosynthetic capacity ( r 2 = -0.13) and lowered the net photosynthesis rate simulation precision ( R 2 = 0.35, RMSE = 3.41) for L. chinensis under mild drought stress and saturated light intensities. The electron transport rate estimated by the modified MLR-SIF model downregulated the photosynthetic capacity for P. tomentosa Carrières ( r 2 = 0.32) and U. pumila var. sabulosa ( r 2 = 0.22) under mild drought stress. The shift of the Rubisco and RUBP limited state cross-points, the dynamic photosynthesis parameters across the plant species and the alternative electron sinks under soil–water deficit and rehydration process influenced the simulation precision of the modified MLR-SIF model. Our modified MLR-SIF model provided a basis for understanding and inferring the photosynthetic rate by SIF and NPQ under water stress.

Raju Nagaraju

and 3 more

Introduction: Studies suggest that chronic lead (Pb) exposure may induce Deoxyribonucleic acid (DNA) damage. However, there is no synthesised evidence in this regard. We systematically reviewed existing literature and synthesised evidence on the association between chronic Pb exposure and markers of genotoxicity. Methods: Observational studies reporting biomarkers of DNA damage among occupationally Pb-exposed and unexposed controls were systematically searched from PubMed, Scopus and Embase databases from inception to January 2022. The markers included were micronucleus frequency (MN), chromosomal aberrations, comet assay, and 8-hydroxy-deoxyguanosine. During the execution review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Mean differences in the biological markers of DNA damage between Pb-exposed and control groups were pooled using the random-effects model. The heterogeneity was assessed using the Cochran- Q test and I 2 statistic. Results: The review included forty-five studies comparing markers of DNA damage between Pb-exposed and unexposed. The primary studies utilised buccal and/or peripheral leukocytes for evaluating the DNA damage. The pooled quantitative results revealed a significantly higher DNA damage characterised by increased levels of MN and SCE frequency, chromosomal aberrations, and oxidative DNA damage (comet assay and 8-OHdG) among Pb-exposed than the unexposed. However, studies included in the review exhibited high levels of heterogeneity between the studies. Conclusion: Chronic Pb exposure is associated with DNA damage. However, high-quality, multicentered studies are required to strengthen present observations and further understand the Pb’s role in inducing DNA damage.

Omar Sharaf

and 4 more

Background: Dysphagia following cardiac surgery is common and associated with adverse outcomes. Among patients receiving left ventricular assist device (LVAD), we evaluated the impact of fiberoptic endoscopic evaluation of swallowing (FEES) on outcomes. Methods: A single-center pilot study was conducted in adults (≥18 years of age) undergoing durable LVAD (February 2019-January 2020). Six patients were prospectively enrolled, evaluated, and underwent FEES within 72 hours of extubation—they were compared to 12 control patients. Demographic, surgical, and postoperative outcomes were collected. Unpaired two-sided t-tests and Fisher’s Exact tests were performed. Results: Baseline characteristics were similar between groups. Intraoperative criteria including duration of transesophageal echo (314 ± 86 min) and surgery (301 ± 74 min) did not differ. Mean time of intubation was comparable (57.3 vs. 68.7 hours, p=0.77). In the entire cohort, 30-day, 1-year, 2-year, and 3-year mortality were 0%, 5.6%, 5.6%, and 16.7%, respectively. Sixty-seven percent of the patients that underwent FEES had inefficient swallowing function. The FEES group trended to a shorter hospital length of stay (LOS) (29.1 vs. 46.6 days, p=0.098), post-implantation LOS (25.3 vs 30.7 days, p=0.46), and lower incidence of postoperative pneumonia (16.7% vs. 50%, p=0.32) and sepsis (0% vs. 33.3%, p=0.25). Conclusions: FEES did not impact 30-day, 1-year, 2-year, or 3-year mortality. Patients who underwent FEES trended toward shorter LOS, and lower postoperative pneumonia and sepsis rates, though not statistically significant. A higher incidence of dysphagia among patients undergoing FEES despite comparable baseline risk factors with controls suggests FEES may detect subclinical dysphagia.

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