bluuebunny/crossref_metadata_2025 huggingface dataset:
Energy requirements of growing small ruminants raised for meat production in contrasting climatic regions: a meta-analysis
Authors: Souza V C , Bougouin A , Archimede H , Adegbola A , Kebreab E
Published: January 2025

The objective of this meta-regression was to evaluate the influence of ruminant species, sex, and climatic regions on the metabolizable energy (ME) requirements for maintenance (MEm) and weight gain (MEg) in growing small ruminants raised for meat production across different climatic regions. Data included 655 and 337 treatment means from 173 and 99 studies on sheep and goats, respectively. Metabolizable energy intake (MEI; MJ/kg^0.75) was regressed against average daily gain (ADG; g/kg^0.75), with the study included as a random effect. The analysis found that MEm was not affected by species (P = 0.50), but MEg (MJ/g ADG) was significantly different between species (P = 0.02), with sheep requiring 0.032 (± 0.002) and goats 0.026 (± 0.002) MJ/g ADG. Sex did not affect MEm in either species (P ≥ 0.32). However, in goats, intact males had a greater MEg (P = 0.02) than females (0.030 ± 0.003 vs. 0.013 ± 0.006 MJ/g ADG). MEm was lower (P = 0.03) in small ruminants raised in subtropical regions (0.497 ± 0.046 MJ/kg^0.75) compared to those in semi-arid (0.600 ± 0.038 MJ/kg^0.75) and tended to be lower than those in arid regions (0.529 ± 0.050 MJ/kg^0.75). However, these differences disappeared when adjusting for maturity, diet composition, digestibility, or altitude. MEg was significantly higher (P < 0.05) in animals raised in arid regions (0.032 ± 0.006 MJ/g ADG) compared to those in Mediterranean (0.009 ± 0.004 MJ/g ADG) or semi-arid regions (0.009 ± 0.004 MJ/g ADG) after adjusting for diet composition and digestibility. Similarly, ruminants in Mediterranean regions had lower MEg (0.019 ± 0.004 and 0.009 ± 0.004 MJ/g ADG) than those in tropical regions (0.033 ± 0.002 and 0.024 ± 0.002 MJ/g ADG), respectively after adjusting for maturity, diet composition, and digestibility. MEg in semi-arid regions was consistently lower than in tropical regions, regardless of the covariates tested. For predictive purposes, the global model exhibited the best accuracy (CCC = 0.57 and RSR = 0.79), comparable to the model derived specifically for the tropical region (CCC = 0.58 and RSR = 0.80). This meta-analysis provides a comprehensive evaluation of species-specific differences in ME requirements in small ruminants while recognizing the challenges posed by confounding effects and climatic variability inherent in global datasets. The analysis suggests that animals raised in tropical conditions may have lower MEm than current feeding systems that use data from temperate climates.
Dispersal of Colletotrichum acutatum Sensu Lato Conidia from Infected Citrus and Strawberry Under Simulated Rainfall and Different Laminar and Turbulent Wind Speeds
Authors: Gama Andre B. , Gasparoto Maria Cândida de Godoy , Poole Gavin H. , Bock Clive H. , Gottwald Timothy R. , Amorim Lilian , Peres Natalia A. , Dewdney Megan M.
Published: January 2025

Species of the Colletotrichum acutatum complex cause postbloom fruit drop of citrus and anthracnose fruit rot of strawberries. C. acutatum produces acervuli in diseased citrus flowers and strawberry fruit, surviving asymptomatically on vegetative tissues. Previous studies have suggested that dispersal mechanisms other than windblown rain may be involved in dispersal of conidia of C. acutatum sensu lato. Our hypothesis is that wind alone may play a role in dispersal, especially for inoculum surviving on vegetative tissue. Our objectives were to study the dispersal pattern of C. acutatum sensu lato from strawberry fruit and leaves, and citrus flowers and leaves by placing semi-selective media at known distances away from inoculum sources in laminar flow and turbulent wind tunnels. The number of C. acutatum sensu lato colony-forming units (CFU) on each plate was correlated to the distance from inoculum sources. Conidia were dispersed up to 15 meters in wind speeds greater than 10 meters per second but observed dispersal patterns were not described by the models we tested. A negative exponential model adequately described the dispersal gradient of inoculum downwind, particularly for the dispersal gradient in turbulent wind. Dispersal in rain splash and wind was limited to short distances. Our data describes how conidia spread from inoculum sources, and for the first time describes how dispersal of C. acutatum sensu lato secondary conidia occurs from citrus and strawberry leaves. Knowledge of the dispersal of conidia of C. acutatum sensu lato can provide valuable information on epidemic development, and thus approaches for disease management.
Whole blood exchange ameliorates acute hemolytic anemia by reducing inflammation and oxidative stress in rats
Authors: Pei Siya , Wang Yanjie , Yao Run , Zhang Zhimin , Yin Wenyu , Li Ning
Published: January 2025

Hemolytic anemia (HA) is characterized by massive destruction of red blood cells (RBCs) and insufficient oxygen supply, which can lead to shock, organ failure, even death. Recent studies have preliminarily demonstrated the therapeutic effectiveness of whole blood exchange (WBE) in the management of acute hemolytic anemia and exhibited potential for reducing the duration of corticosteroid treatment, while the underlying mechanism of WBE therapy was not investigated in preclinical study. Hence, we investigate the therapeutic mechanisms of WBE in HA through established continued WBE therapy in rats creatively. This study aims to examine the mechanism of WBE on phenylhydrazine hydrochloride‐induced hemolytic anemia in SD rats to aid the development of therapeutics for drug‐induced hemolytic anemia (DIHA). Research results demonstrated the efficacy of WBE therapy in reducing mortality and ameliorating anemia in DIHA, as evidenced by significant improvements in representative hematological parameters such as RBCs, hemoglobin, and lactate dehydrogenase levels. Additionally, WBE indicated the ability to suppress oxidative stress and inflammation, and it mitigated organ damage and biochemical function by stabilizing hepatic ferroportin levels and decreasing organ iron content. These results highlighted the effectiveness of WBE as an innovative treatment for HA, furnishing evidence to prioritize it over traditional blood transfusion for severe anemias.
Salvianolic acid A promotes bone‐fracture healing via balancing osteoblast and osteoclast differentiation
Authors: Cao Binhao , Wu Xiaoyong , Zhou Chengwei , Chen Hongyu , Xue Deting , Pan Zhijun
Published: January 2025

Nonunion is a significant complication in fracture management for surgeons. Salvianolic acid A (SAA), derived from the traditional Chinese plant Salviae miltiorrhizae Bunge (Danshen), exhibits notable anti‐inflammatory and antioxidant properties. Although studies have demonstrated its ability to promote osteogenic differentiation, the exact mechanism of action remains unclear. This study investigated the effects of various SAA concentrations on the osteogenic differentiation of mouse‐derived bone marrow mesenchymal stem cells (mBMSCs) and the osteoclastic differentiation of bone marrow‐derived macrophages. Our findings indicate that SAA promotes the osteogenic differentiation of mBMSCs in a concentration‐dependent manner, primarily by inhibiting the Notch1 signaling pathway. Notably, the administration of two Notch1 agonists (Jagged‐1 and VPA) inhibited the effects of SAA on osteogenic differentiation. Additionally, SAA facilitated the autophagic degradation of NICD1, further enhancing osteogenic differentiation. Furthermore, SAA also dose‐dependently inhibited the osteoclastic differentiation of bone marrow‐derived macrophages, which is linked to its suppression of NF‐κB signaling pathways. In a fracture model, SAA demonstrated a capacity to promote healing. In conclusion, SAA enhances bone fracture healing by balancing osteoblast and osteoclast differentiation.
Xuefu Zhuyu Decoction improves hyperlipidemia through the MAPK/NF‐κB and MAPK/PPARα/CPT‐1A signaling pathway
Authors: Han Jiajun , Miao Yuyang , Song Linze , Zhou Xianfeng , Liu Yan , Wang Lin , Zhu Kai , Ma He , Ma Yan , Li Qingjie , Han Dong
Published: January 2025

Xuefu Zhuyu Decoction (XZD) is widely used in the treatment of cardiovascular diseases. The purpose of this study was to explore the pharmacological effects and molecular mechanisms of XZD in improving hyperlipidemia and to provide a theoretical framework for clinical application. In this study, the signaling pathways regulated by XZD in improving hyperlipidemia were predicted by network pharmacology. Molecular docking was used to verify the affinity between the components in XZD and the target. Furthermore, a hyperlipidemic model in rats was constructed through feeding a high‐fat diet. The effect of XZD on hyperlipidemia was verified by histopathological staining, Elisa, and western blot. The results found that the XZD improved dyslipidemia and inflammatory factor disorders, and inhibited liver function damage, pathological damage, and oxidative stress damage in hyperlipidemic rats. The findings from molecular docking and network pharmacology suggested that the mechanism of XZD improving hyperlipidemia may be closely related to the MAPK, NF‐κB, and PPAR pathways. This study demonstrated that the XZD inhibited liver lipid metabolism disorder and inflammatory response by regulating the MAPK/NF‐κB and MAPK/PPARα/CPT‐1A pathway, significantly improved liver histopathological damage and oxidative stress injury, and played a protective role in hyperlipidemic rats.
Analysis of the Top Articles and Authors of the Journal of Orthopaedic Trauma and Bibliometric Comparison of Impact Factors of Orthopaedic Surgery Journals
Authors: Box McKenna W. , Puga Troy , Marsh Laurel , Beal Wrangler , Chandrasekaran Vinay , Riehl John T.
Published: January 2025

OBJECTIVES:

To determine the top 100 cited authors and the top 20 articles in the Journal of Orthopaedic Trauma (JOT) and compare its impact factor to orthopaedic and non-orthopaedic surgery literature.

DESIGN:

Review

METHODS:

The Web of Science database was used to determine the top 100 cited authors and top 20 cited articles that originated in JOT from 1995 to the present. The total number of citations for each article and author in first, last, and any author position for publications in JOT, and the location of training and current place of work for each author were gathered. Each author's total number of citations as first author was tallied to determine the top 100 JOT first authors. The Journal Citation Reports database was searched to determine the impact factor (IF) of multiple orthopaedic and non-orthopaedic journals from 1997 to 2023. Yearly IF and yearly IF percent growth were calculated.

RESULTS:

The number of citations for the top 20 cited articles in JOT ranged from 302 to 787. Of the top 100 JOT first authors by citation number, 93 were orthopaedic surgeons. 65% of these completed a residency in the United States, 61% worked in the United States, and of the authors that work in the United States, 70.5% practice in an academic setting. From 1997 to 2023, JOT's mean yearly IF was 1.6, and the mean yearly IF percent growth was 6.1%. The mean IF for included comparison orthopaedic subspecialty journals was 2.3, with 5.6% mean yearly IF percent growth. JOT’s median IF was 1.8 and was second to Injury (IF 1.9) within orthopaedic trauma journals evaluated.

CONCLUSIONS:

This bibliometric analysis shows that JOT's most cited authors are primarily U.S.-trained orthopaedic surgeons in academic environments. JOT has consistently experienced annual growth in its impact factor throughout its almost 30-year history and has one of the highest impact factors of measured orthopaedic trauma journals.

LEVEL OF EVIDENCE:

IV
Diagnosis, Classifications and Treatment of Os Odontoideum
Authors: Alves Oscar L. , Lee June Ho , Kitumba Djamel , Lucas Agnaldo , Baeesa Saleh , Ben Ali Said , Sampaio Francisco , Uriza Gustavo , Gepp Ricardo , Zileli Mehmet , Botelho Ricardo , Klekamp Jörg , Goel Atul
Published: January 2025

Study Design.

A systematic literature review and consensus using Delphi method.

Objective.

The aim was to formulate consensus recommendations regarding the natural history, diagnosis, classification and optimal treatment of Os Odontoideum with global applicability.

Summary of background.

Os odontoideum (OO) is a rare anomaly of the cranio-vertebral junction (CVJ). Due to the paucity of literature, there is still considerable debate about the clinical management of OO.

Material and Method.

Using PubMed, the authors reviewed the literature on OO published from 2011 to 2022. Using the Delphi method, a panel expert spine surgeons and members of the WFNS Spine Committee analyzed the strength of the published literature, elaborated and voted statements concerning diagnosis and management.

Result.

The diagnosis may be established incidentally. Symptoms may manifest as neck discomfort or encompass occipital-cervical pain, myelopathy, or vertebrobasilar ischemia. Diagnosis is usually made with plain radiographs and CT can. Dynamic x-rays identify C1-C2 instability whereas MRI assess spinal cord integrity and compression. Asymptomatic cases lacking radiologic instability are generally handled through regular observation and serial imaging, until predictors of neurological deterioration necessitate surgical intervention. In the event of atlantoaxial instability or neurological dysfunction, surgical intervention with instrumentation and fusion is required to maintain stability. In irreducible cases, C1-2 joint manipulation and distraction permits re-alignment and deformity correction avoiding decompression, either from anterior or posterior.

Conclusion.

The management guidelines for asymptomatic OO are still a grey zone as our understanding of the natural history is still vague. Therefore, we need more large-center studies to investigate this condition further. Whenever symptomatic, unstable or asymptomatic presenting with risk factors, OO is better managed with atlanto-axial fusion avoiding occipital inclusion in the construct. In irreducible OO, C1-2 joint manipulation and distraction is preferred to decompression.
Career Planning and Maintaining Well-being in Academic Plastic Surgery
Authors: Egan Katie , Aryanpour Zain , Kokosis George , Viennas Lambros K.
Published: January 2025

Success in academic plastic surgery is based on the traditional pillars of promotion: clinical excellence, teaching, research, leadership, and service to the university and community. The time commitment and workload for career advancement are highly demanding and, therefore, well-being is essential to avoid burnout. A congruent healthy work environment that meets institutional goals and surgeons’ objectives can be established through inclusive, transparent, strategic, and operational planning. In this Special Topic article, we will review the requisites and challenges to promotion in academic plastic surgery and will discuss longitudinal strategies for well-being during the early, middle, and late academic career.
Short-term starvation boosts anti-PD-L1 therapy by reshaping tumor-associated macrophages in hepatocellular carcinoma
Authors: Cheng Kun , Cai Ning , Yang Xing , Li Danfeng , Jinghan Zhu , Yang Hui Yuan , Liu Sha , Ning Deng , Liang Huifang , Zhao Jianping , Zhang Zhanguo , Zhang Wanguang
Published: January 2025

Background and Aims:

Immune checkpoint inhibitors (ICIs) have revolutionized systemic hepatocellular carcinoma (HCC) treatment. Nevertheless, numerous patients are refractory to ICIs therapy. It is currently unknown whether diet therapies such as short-term starvation (STS) combined with ICIs can be used to treat HCC. This study aimed to investigate whether STS could sensitize HCC tumors to immunotherapy.

Approach and Results:

STS was found to attenuate tumor progression by inducing tumor-associated macrophages (TAMs) to switch to an antitumoral phenotype, enhancing phagocytosis of tumor cells, and stimulating subsequent anti-tumor immunity of CD8+ T cells as demonstrated in three HCC mouse models, NCG mice, and Rag2-KO mice. Furthermore, STS combined with anti-PD1/L1 suppressed tumor progression, while the efficacy of anti-programmed cell death 1 ligand 1 (PD-L1) was improved when combined with STS. Mechanistically, TAM-derived exosomal PD-L1 (exoPD-L1) impairs the efficacy of anti-PD-1/L1. STS attenuates exoPD-L1 secretion from TAM by regulating the fructose diphosphatase 1 (FBP1) /Akt/Rab27a axis. Modulating FBP1/Akt/Rab27a axis potentiates the anti-PD-L1 response using two liposomal delivery systems and macrophage adoptive transfer.

Conclusions:

This study describes the immunomodulatory effects of STS and provides a rationale for its application as an adjuvant in HCC immunotherapy.
Clinical outcomes and care for spontaneous bacterial peritonitis: A national cohort study
Authors: Serper Marina , Tang Helen , Zhang Siqi , McCullough Alexandra , Kaplan David E. , Taddei Tamar H. , Mahmud Nadim
Published: January 2025

Background & Aims:

SBP leads to high rates acute kidney injury (AKI) -hepatorenal syndrome and mortality. Population-based studies on contemporary SBP epidemiology are needed to inform care. In a large, national cohort of patients diagnosed with SBP and confirmed by ascitic fluid criteria, we characterized ascitic fluid characteristics, in-hospital and 12-month mortality, AKI, and recurrent SBP.

Approach & Results:

We investigated how individual and bundled quality measures for SBP associated with outcomes after multi-level adjustment for health-system, patient clinical factors and quality measures. Individual and bundled quality metrics were inpatient antibiotics within 48 hours, intravenous albumin, repeat paracentesis within 48 hours, recognition of SBP, and prophylactic antibiotics upon discharge. Among 4,330 patients with newly diagnosed SBP, in-hospital mortality was 15.5% and 12-month mortality was 56.6%. The incidence of Stage 1 AKI was 26.6%, 15.7% for Stage 2, and 22.8% for Stage 3. The cumulative incidence of recurrent SBP was 10.3%. Guideline-recommended albumin was the only individual metric associated with reduced in-hospital mortality (HR 0.73, 95%CI 0.59 - 0.91). Receipt of a higher number of metrics from the SBP bundle was associated with progressively lower 12-month post-discharge mortality: patients who received 3, 4, and 5 SBP bundle components had 20%, 38%, and 56% lower hazard of mortality, respectively, relative to those receiving 2 or fewer (all p<0.001). The SBP bundle was associated with lower incidence of Stage 3 versus Stage 0-2 AKI (OR 0.66, 95%CI 0.51-0.86).

Conclusion:

Prospective implementation of evidence-based SBP bundles may improve care outcomes and mortality in SBP.
Acute encephalopathy without hyperammonemia has a different presentation than overt HE and displays a similarly severe prognosis
Authors: Desplats Victor , Haudebourg Luc , Verger Nicolas , Assaraf Julie , Mouri Sarah , Bouzbib Charlotte , Bonnefont-Rousselot Dominique , Alkouri Rana , Sakka Mehdi , Sultanik Philippe , Leproux Apolline , Weiss Nicolas , Rudler Marika , Thabut Dominique
Published: January 2025

Background and Aims:

In cirrhosis, some patients display acute encephalopathy without hyperammonemia (NonHep E) which is not considered as overt hepatic encephalopathy (OHE). We aimed to assess the prevalence and characteristics of NonHep E and OHE in patients with cirrhosis displaying acute encephalopathy, assess their respective prognosis and compare it to other causes of acute decompensation with/without hyperammonemia.

Approach and Results:

We conducted a retrolective analysis from a prospective cohort of patients hospitalized for acute decompensation. Hyperammonemia was defined by NH3 >50 µmol/L. Patients were divided into 4 groups: OHE (encephalopathy and NH3 >50 µmol/L: group 1), NonHep E (encephalopathy and NH3≤50 µmol/L, group 2), and 2 control groups with acute decompensation/without encephalopathy (NH3≤50 µmol/L [group 3] or NH3>50 µmol/L [group 4]). Five hundred thirty patients were included (168 group 1, 76 group 2, 125 group 3, and 161 group 4). Overall, 168/244 (69%) of patients with acute encephalopathy displayed OHE, and 76/244 (31%) NonHep E. NonHep E patients were significantly more exposed to medications than patients with OHE. One-year transplant-free survival was 60.4%. In multivariable analysis, compared to patients with normal ammonemia and without encephalopathy, OHE was independently associated with a lower 1-year transplant-free survival (1.58 [95% CI: 1.14–2.18, p=0.006]). Patients with OHE did not display a higher risk of death or transplantation than NonHep E patients (HR: 1.27, 95% CI: 0.91–1.77, p=0.161).

Conclusions:

NonHep E accounts for one-third of admissions for acute encephalopathy and displays as severe a prognosis as OHE. OHE is independently associated with lower transplant-free survival at 1 year.
Metabolic syndrome and associated components among police officers: A 7 and 12-year longitudinal analysis.
Authors: Violanti John M. , Fekedulegn Desta , Mnatsakanova Anna , Gu Ja K , Samantha Service , Allison Penelope , Hartley Tara A.
Published: January 2025

Objective

This study estimated risk of metabolic syndrome (MetSyn) and its components among police officers including differences by sex.

Methods

Police officers were examined at baseline and two follow-up examinations after 7 and 12 years. MetSyn was defined using the 2005 guidelines from AHA/NHLBI. Risk for incident MetSyn and its components at follow-up exams and risk ratios in males compared to females were estimated using modified Poisson regression.

Results

The 7 (n = 276) - and 12- (n = 191) year incidence of MetSyn was 20.4% and 22.2%, respectively. MetSyn components with lowest and highest incidence were reduced HDL cholesterol and abdominal obesity. The 7-year risk of developing glucose intolerance was two-fold higher in males compared to females.

Conclusion

Longitudinal analysis of incidence of MetSyn and its components is important for understanding future cardiovascular disease (CVD) morbidity and mortality.
The influence of familiarity between the surgeon and their assistant on patient outcomes: a prospective observational cohort study
Authors: Stelzl Daniel R. , Polazzi Stephanie , Lifante Jean-Christophe , Dey Tanujit , Duclos Antoine
Published: January 2025

Background:

The inverse relationship between increased surgical team familiarity and reduced operative time is established, but its effect on patient outcomes remains uncertain.

Materials and methods:

A prospective cohort study including operations by attending surgeons between 1 November 2020 and 31 December 2021 across fourteen surgical departments from four French university hospitals. Surgical team familiarity was measured as the cumulative number of previous operations performed by the same dyad of attending and assisting surgeons. Composite of adverse events within 30 days of surgery encompassed major surgical complication, unplanned reoperation, extended ICU stay, and death. We used multivariable generally estimated equations to model the association between patient outcomes and surgical team familiarity, using a logarithmic function. The model considered the clustering of operations within surgeons.

Results:

Our analysis included 8546 operations by 1109 surgical team dyads, involving 45 attending surgeons and 369 assisting surgeons. We observed a significant inverse association between surgical team familiarity and composite adverse events odds ratio [OR] 0.92 (95% confidence interval [95% CI] 0.87–0.98), major surgical complications OR 0.93 (95% CI 0.88–0.99), and unplanned reoperations OR 0.88 (95% CI 0.78–0.99), with non-significant trends observed for extended ICU stays OR 0.88 (95% CI 0.75–1.04) and deaths OR 0.87 (95% CI 0.74–1.03). Within the first 15 collaborations, this was illustrated by a reduction in the occurrence of composite adverse events from 23.0% (95% CI 22.1%–24.0%) to 16.5% (95% CI 14.1%–18.8%), major surgical complications from 21.3% (95% CI 20.3%–22.2%) to 15.3% (95% CI 13.0%–17.5%), unplanned reoperations from 8.8% (95% CI 8.6%–9.1%) to 5.2% (95%CI 4.2%–6.1%), extended ICU stays from 4.3% (95% CI 4.1%–4.5%) to 3.1% (95% CI 2.0%–4.1%), and deaths from 2.3% (95% CI 2.1%–2.5%) to 1.4% (95% CI 0.9%–1.8%).

Conclusions and relevance:

This study emphasizes that heightened familiarity among surgical teams is associated with a significant reduction in major adverse events. Building stable operating room teams should be a management priority to enhance patient outcomes.
Incidence, risk factors and endoscopic retrieval of proximally migrated pancreatic stents: 25 years of experience in a high-volume center – a case controlled study
Authors: Cai Yi-Li , Wang Fan , Zhang Jie , Liu Miao , Guo Rui-Xi , Yang Ting , Li Zhao-Shen , Hu Liang-Hao
Published: January 2025

Background and aim:

Proximal migration is one of the complications after pancreatic stenting. This study aims to determine the incidence, risk factors and endoscopic treatment of proximally migrated pancreatic stents.

Methods:

A retrospective search of all the endoscopic retrograde cholangiopancreatography (ERCP) records was conducted from 1997 to 2022 in our tertiary center. Proximal migration of the pancreatic stent was defined as when the stent shifted completely into the pancreatic duct and the distal end of the stent was no longer visible at the duodenal papilla.

Results:

A total of 9017 pancreatic duct stentings of 6083 patients were performed. The proximal migration rate was 0.2% (17/9017). Three predictive factors for proximal migration were identified: pancreatic duct stones (OR, 0.107), residual pancreatic duct stones (OR, 8.290) and straight-shape stent (OR, 4.725). After including 19 patients transferred from other hospitals, 46 ERCPs were performed to retrieve the proximally migrated stents in 36 patients. The success rate of endoscopic removal was 80.6% (29/36). 1 (2.8%) patient was referred to surgery, and 6 patients had new pancreatic stents placed for conservative treatment. 21.7% (10/46) cases developed post-ERCP pancreatitis and 2.2% (1/46) developed infection.

Conclusions:

Proximal migration of pancreatic stents is less common, but deserves more attention. Endoscopy is efficient in retrieving proximally migrated stents. In patients with residual pancreatic duct stones and straight stent, the risk of proximal migration is significantly increased.
How Do People Living With Cancer Navigate Health Systems?
Authors: Hennessey Emma , Kirkegaard Amy , Ball Lauren
Published: January 2025

Background

Cancer and its physiological and psychological effects are well defined, but how these factors impact health system navigation for people living with cancer (PLWC) is lacking.

Objective

To develop a theory explaining how PLWC navigate health systems to meet their health and well-being needs.

Methods

This study used multi–grounded theory to explain how PLWC navigate health systems to meet their needs. Individuals more than 6 months postdiagnosis participated in semistructured interviews. The theory was grounded with the Health Beliefs Model and Socioecological Model to generate a candidate theory.

Results

Eighteen participants were interviewed (n = 12 female); the most prominent cancer type was breast (50%). The theory comprised 5 components describing how PLWC navigate health services: (1) “being on the journey” referenced a core care team and differing utilization over time; (2) “adjusting to a new identity” addressed feeling lost and isolated and a desire to be around people who have experienced cancer; (3) “assimilating knowledge” included knowledge about cancer, timing, and source of information; (4) “navigating the health system” found health-seeking attitudes and behaviors dictated whether services were accessed; and (5) “policy environment” acknowledged how policy set the context within which all theory components exist.

Conclusions

The candidate theory depicts core factors influencing how PWLC navigate health and well-being services over their cancer journey and into survivorship.

Implications for Practice

The theory identifies factors that influence access to healthcare, including trust and knowledge, which can form the basis of navigational initiatives and programs.
Robotic Nipple Sparing Mastectomy and Breast Reconstruction with Profunda Artery Perforator Flaps
Authors: Haddock Nicholas T. , Teotia Sumeet S. , Farr Deborah
Published: January 2025

The single port robotic nipple sparing mastectomy (SPrNSM) was recently introduced. This approach is safe and has led to favorable outcomes in relation to cosmetic result, patient satisfaction, and breast sensation. The typical reconstruction with all robotic nipple sparing mastectomies is implant based; however, this is not always what a patient desires. We present autologous tissue reconstruction with PAP flaps following SPrNSM using the same axillary incision. A retrospective review of all patients treated with a PAP flap for breast reconstruction and SPrNSM at our institution from July 2022 to May 2023 was performed. Six patients underwent SPrNSM with PAP flap breast reconstruction (three delayed immediate and three immediate reconstruction). Three patients underwent subsequent revision with fat grafting. Breast reconstruction following robotic nipple sparing mastectomy has typically been performed with implants. We present a series of patients treated with PAP flaps for autologous reconstruction utilizing the same remote axillary incision as used in SPrNSM.
3D Segmentation of Whole Lung and Metastatic Lung Nodules Using Adaptive Region Growing and Shape-based Morphology
Authors: Baidya Kayal Esha , Ganguly Shuvadeep , Sasi Archana , Dheeksha DS , Saini Manish , Sharma Swetambri , Gupta Shivansh , Sharma Nikhil , Rangarajan Krithika , Bakhshi Sameer , Kandasamy Devasenathipathy , Mehndiratta Amit
Published: January 2025

Objective:

Early diagnosis of primary and metastatic lung nodules is critical for effective therapeutic planning. Manual delineation of lung nodules is not time-efficient and is prone to human error as well as interobserver and intraobserver variability. This study aimed to address the unmet need for an open-source computer-aided detection (CAD) system for 3D segmentation of lung and metastatic lung nodules along with radiomic feature extraction.

Methods:

The proposed adaptive region-growing-based lung nodule segmentation (RGLNS) tool was developed in-house, requiring only manual input to select a seed point within the nodule on computed tomography (CT) images. A total of 230 CT scans from 100 patients with sarcomas were screened. Lung nodules were present in 200 CT scans, which were further analyzed. The accuracy of the lung and nodule segmentation was evaluated qualitatively using a 5-point Likert scale (uninterpretable: 1; poor: 2; fair: 3; good: 4; excellent: 5) and quantitatively using the Dice coefficient and Jaccard index.

Results:

A total of 200 CT scans comprising 12,000 CT slices were analyzed, among which 786 lung nodules were identified. Quantitative lung segmentation accuracies (n=2400 slices) yielded a Dice coefficient of 0.92±0.06 and a Jaccard index of 0.85±0.05. Qualitative scores (n=9600 slices) for lung boundary correction (4.56±1.18) and inclusion of pulmonary vessels (4.75±0.72) were rated as good to excellent. Quantitative nodule segmentation (n=142 nodules) accuracies were as follows: dice coefficient=0.92±0.03, 0.88±0.04, 0.86±0.03, 0.85±0.03, 084±0.04 and Jaccard index=0.84±0.03, 0.81±0.04, 0.78±0.04, 0.78±0.02, 0.76±0.04 for solitary (n=73), juxtapleural (n=32), juxtavascular (n=28), fissure-attached (n=6), and ground-glass (n=6) nodules, respectively. Qualitative scores (n=644 nodules) for nodule-boundary were good to excellent [solitary (n=342): 4.97±0.15; juxtapleural (n=155): 4.45±0.60; juxtavascular (n=127): 4.40±0.65; fissure-attached (n=9): 4.40±0.70; ground-glass (n=11): 4.25±0.75] and for exclusion of pulmonary vessels/pleura from nodules were good [juxtapleural (n=155): 4.10±0.66; juxtavascular (n=127): 4.08±0.64; fissure-attached (n=9): 4.30±0.67].

Conclusions:

The proposed semiautomated CAD system, RGLNS, requiring minimal manual input, demonstrated robust, and promising segmentation results for the whole lung and various types of metastatic lung nodules.
Head-to-Head Comparison Between [68Ga]Ga-DOTA.SA.FAPi And [18F]F-FDG PET/CT Imaging in Patients With Sarcoma
Authors: Sakir Mohammad , Ballal Sanjana , Rastogi Sameer , Yadav Madhav Prasad , Roesch Frank , Chandekar Kunal , GB Priyanka , Tripathi Madhavi , Dhiman Ayan , Taggar Mehul , Martin Marcel , Bal Chandrasekhar
Published: January 2025

Purpose

This study aimed to compare the diagnostic efficacy of [68Ga]Ga-DOTA.SA.FAPi and [18F]F-FDG PET/CT for detecting primary and metastatic lesions in sarcoma patients.

Materials and Methods

The analysis included both patient-based and lesion-based comparisons of PET/CT scans in individuals with histologically confirmed sarcoma.

Results

A total of 23 sarcoma patients (mean age 43.0 ± 16.5 years; range: 21–76 years) underwent both [18F]F-FDG and [68Ga]Ga-DOTA.SA.FAPi PET/CT scans. Histological distribution included 30% synovial sarcoma, 13% liposarcoma, and 21.7% leiomyosarcoma, with 70% of patients presenting with distant metastases. Detection rates for primary tumors were similar between [68Ga]Ga-DOTA.SA.FAPi and [18F]F-FDG PET/CT (85.7% vs 100%, P = 0.149). Lymph node detection rates were also comparable (80% vs 100%, P = 0.146). Lesion-based analysis revealed that [68Ga]Ga-DOTA.SA.FAPi detected 220 lesions (83% efficiency) compared with 249 lesions (94% efficiency) for [18F]F-FDG (P < 0.0001). Notably, [68Ga]Ga-DOTA.SA.FAPi demonstrated superior detection of liver (54 vs 38 lesions, P < 0.0001) and bone metastases (125 vs 102 lesions, P < 0.0001).

Conclusion

Our study shows that although [18F]F-FDG PET/CT offers superior overall lesion detection efficiency, [68Ga]Ga-DOTA.SA.FAPi PET/CT excels in identifying specific metastatic sites, particularly in bone and liver. These findings highlight the complementary roles of both imaging modalities in sarcoma evaluation.
Three-step Approach for Facial Reconstruction After Injectable Silicon: Surgical Excision, Fat Grafting, and Hyaluronic Acid Filler
Authors: Arcuri Francesco , Ardito Emanuela , Baldelli Ilaria , Laganà Francesco , Bianchi Bernardo
Published: January 2025

Introduction:

In facial cosmetic surgery, injectable liquid silicone has been used to augment the cheek and the lips and to camouflage facial wrinkles. However, complications started to arise in 1964 as postoperative silicone granuloma formation. The purpose of this study is to introduce our experience in facial reconstruction after injectable silicon oil with a sequential 3-step approach: transoral surgical excision, full-face fat grafting, and hyaluronic acid filler.

Methods:

A retrospective study was conducted for all patients affected by facial granulomatosis due to liquid silicone injection who underwent surgical treatment between January 2018 and June 2020 at the Unit of Maxillo-Facial Surgery at the Hospital “Policlinico San Martino” (Genoa, Italy).

Results:

Three female patients completed the entire surgical pathway. The mean age of the patients at the time of surgery was 58.7 years (range, 52–65 y). There was no clinical recurrence of the facial deformity during a mean follow-up of 14 months. Apart from the standard postoperative discomforts such as bruising, edema, and pain, the authors did not observe major complications.

Conclusions:

Our 3-step approach is a safe and viable option that can be offered to motivated patients affected by granulomatous facial reactions.

Level of Evidence-Based Medicine (EBM):

Level 3
The Association Between Vitamin D Status With Inflammatory Markers and Clinical Features in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease
Authors: Pishdadian Abbas , Amirkhizi Farshad , Zaersabet Zahra , Hamedi-Shahraki Soudabeh
Published: January 2025

This cross-sectional study assessed the association of vitamin D status with inflammatory markers and clinical features in 122 patients with metabolic dysfunction-associated steatotic liver disease (MASLD) who attended the polyclinics in Tabriz, Iran. The diagnosis of MASLD among participants was ultrasonography. The mean serum levels of interleukin-6 (P = .028), tumor necrosis factor-α (P = .036), and alanine aminotransferase (ALT) (P = .005) were significantly higher in the patients with vitamin D insufficiency than those with vitamin D sufficiency. Vitamin D insufficiency in patients with MASLD was found to be related to higher inflammation and severity of liver steatosis.
Partner fidelity, not geography, drives co-diversification of gut microbiota with hominids
Authors: Moeller Andrew H.
Published: January 2025

Bacterial strains that inhabit the gastrointestinal tracts of hominids have diversified in parallel (co-diversified) with their host species. The extent to which co-diversification has been mediated by partner fidelity between strains and hosts or by geographical distance between hosts is not clear due to a lack of strain-level data from clades of hosts with unconfounded phylogenetic relationships and geographical distributions. Here, I tested these competing hypotheses through meta-analyses of 7121 gut bacterial genomes assembled from wild-living ape species and subspecies sampled throughout their ranges in equatorial Africa. Across the gut bacterial phylogeny, strain diversification was more strongly associated with host phylogeny than with geography. In total, approximately 14% of the branch length of the gut bacterial phylogeny showed significant evidence of co-diversification independent of geography, whereas only approximately 4% showed significant evidence of diversification associated with geography independent of host phylogeny. Geographically co-occurring heterospecific hosts (
Pan
and
Gorilla
) universally maintained distinct co-diversified bacterial strains. Strains whose diversification was associated with geography independent of host phylogeny included clades of Proteobacteria known to adopt free-living lifestyles (e.g.
Escherichia
). These results show that co-diversification of gut bacterial strains with hominids has been driven primarily by fidelity of strains to host lineages rather than geography.
Cooperative bots exhibit nuanced effects on cooperation across strategic frameworks
Authors: Si Zehua , He Zhixue , Shen Chen , Tanimoto Jun
Published: January 2025

The positive impact of cooperative bots on cooperation within evolutionary game theory is well-documented. However, prior studies predominantly use discrete strategic frameworks with deterministic actions. This article explores continuous and mixed strategic approaches. Continuous strategies use intermediate probabilities for varying degrees of cooperation and focus on expected payoffs, while mixed strategies calculate immediate payoffs from actions taken within these probabilities. Using the prisoner’s dilemma game, this study examines the effects of cooperative bots on human cooperation in both well-mixed and structured populations across these strategic approaches. Our findings reveal that cooperative bots significantly enhance cooperation in both population types under weak imitation scenarios, where players are less concerned with material gains. Conversely, under strong imitation scenarios, cooperative bots do not alter the defective equilibrium in well-mixed populations but have varied impacts in structured populations. Specifically, they disrupt cooperation under discrete and continuous strategies but facilitate it under mixed strategies. These results highlight the nuanced effects of cooperative bots within different strategic frameworks and underscore the need for careful deployment, as their effectiveness is highly sensitive to how humans update their actions and their chosen strategic approach.
Photobioreactor design utilizing procedural three-dimensional modelling and ray tracing
Authors: Riihiaho Kimmo A. , Lind Leevi , Calderini Marco L. , Halonen Vilho , Pölönen Ilkka , Salmi Pauliina
Published: January 2025

The design of photobioreactors for microalgae cultivation aims to achieve an architecture that allows the most efficient photosynthetic growth. The availability of light at wavelengths that are important for photosynthesis is therefore particularly crucial for reactor design. While testing different reactor types in practice is expensive, simulations could effectively limit the range of material and reactor design options. In this study, procedural three-dimensional modelling together with ray tracing was used to create virtual models of a conventional glass photobioreactor lit from the outside and a steel photobioreactor with embedded light sources. The measured transmittance and reflectance of
Chlorella vulgaris
culture were used as a basis for light interaction simulation, and spectral images of the same species were used to validate the simulation results. This type of simulation could have the potential for comparing different reactor architectures, geometries and light attenuation to facilitate the transition to large-scale cultivation. Our results show that the proposed simulator is usable in photobioreactor geometry design as well as in the estimation of available illumination on wavelengths where microalgae have strong absorption peaks, but the handling of light scattering still needs improvement. To the authors’ best knowledge, this is the first attempt, not focused on a specific use case, to build a general photobioreactor design tool capable of estimating hyperspectral light attenuation in microalgae suspension. All software code and used datasets are made available for the reader as open source.
Multicellular PID control for robust regulation of biological processes
Authors: Martinelli Vittoria , Fiore Davide , Salzano Davide , di Bernardo Mario
Published: January 2025

This article presents the first implementation of a proportional-integral-derivative (PID) biomolecular controller within a consortium of different cell populations, aimed at robust regulation of biological processes. By leveraging the modularity and cooperative dynamics of multiple engineered cell populations, we develop a comprehensive
in silico
analysis of the performance and robustness of P, PD, PI and PID control architectures. Our theoretical findings, validated through
in silico
experiments using the BSim agent-based simulation platform for bacterial populations, demonstrate the robustness and effectiveness of our multicellular PID control strategy. This innovative approach addresses critical limitations in current control methods, offering significant potential for applications in metabolic engineering, therapeutic contexts and industrial biotechnology. Future work will focus on experimental validation
in vivo
and further refinement of the control models.
Spatiotemporal variation in size-dependent growth rates in small isolated populations of Arctic charr (
Salvelinus alpinus
)
Authors: Mittell Elizabeth A. , Leblanc Camille A. , Kristjánsson Bjarni K. , Ferguson Moira M. , Räsänen Katja , Morrissey Michael B.
Published: January 2025

As a key life-history trait, growth rates are often used to measure individual performance and to inform parameters in demographic models. Furthermore, intraspecific trait variation generates diversity in nature. Therefore, partitioning out and understanding drivers of spatiotemporal variation in growth rate is of fundamental interest in ecology and evolution. However, this has rarely been attempted owing to the amount of individual-level data required through both time and space, and issues with missing data in important covariates. Here, we implemented a Bayesian state-space model using individual-level data from 20 populations of Arctic charr (
Salvelinus alpinus
) across 15 capture occasions, which allowed us to: (i) integrate over the uncertainty of missing recapture records; (ii) robustly estimate size-dependence; and (iii) include a covariate (water temperature) that contained missing data. Interestingly, although there was substantial spatial, temporal and spatiotemporal variation in growth rate, this was only weakly associated with variation in water temperature and almost entirely independent of size, suggesting that spatiotemporal variation in other environmental conditions affected individuals across sizes similarly. This fine-scale spatiotemporal variation emphasizes the importance of local conditions and highlights the potential for spatiotemporal variation in a size-dependent life-history trait, even when environmental conditions are apparently very similar.
A machine learning approach to predicting dynamical observables from network structure
Authors: Rodrigues Francisco A. , Peron Thomas , Connaughton Colm , Kurths Jürgen , Moreno Yamir
Published: January 2025

Estimating the outcome of a given dynamical process from structural features is a key unsolved challenge in network science. This goal is hampered by difficulties associated with nonlinearities, correlations and feedbacks between the structure and dynamics of complex systems. In this work, we develop an approach based on machine learning algorithms that provides an important step towards understanding the relationship between the structure and dynamics of networks. In particular, it allows us to estimate from the network structure the outbreak size of a disease starting from a single node, as well as the degree of synchronicity of a system made up of Kuramoto oscillators. We show which topological features of the network are key for this estimation and provide a ranking of the importance of network metrics with much higher accuracy than previously done. For epidemic propagation, the k-core plays a fundamental role, while for synchronization, the betweenness centrality and accessibility are the measures most related to the state of an oscillator. For all the networks, we find that random forests can predict the outbreak size or synchronization state with high accuracy, indicating that the network structure plays a fundamental role in the spreading process. Our approach is general and can be applied to almost any dynamic process running on complex networks. Also, our work is an important step towards applying machine learning methods to unravel dynamical patterns that emerge in complex networked systems.
Latitudinal cline of ocean dependence in a diadromous fish
Authors: Goto Akihiko , Kuroki Mari , Morita Kentaro
Published: January 2025

Diadromous fishes exhibit latitudinal clines of ocean dependency at inter- and intra-species levels. A pattern of ocean dependence at high latitudes and river dependence at low latitudes is explained by relative aquatic productivity. Such latitudinal productivity clines may induce geographical variations in life-history diversity within migratory phenotypes. We hypothesized that the lifetime ocean dependency of a regional migratory salmonid would display a latitudinal cline that increased at higher latitudes. Freshwater growth rate decreased with higher latitudes, whereas marine growth rate was independent of latitude. The percentage of adult weight gain at sea was higher at higher latitudes. Relative weight gain (ln(ocean weight gain/freshwater weight gain)) decreased to zero at lower latitudes, indicating no growth benefit of going to sea at the southern distribution limit. These latitudinal variations in life history within salmonid migrants are consistent with the intra- and interspecific patterns and provide insight into the origin of diadromous migration but raise the question of whether the current definition of anadromy may be insufficient to fully capture the complexity and continuum of river-ocean migrations.