bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Performance of Different Types of Radiation Protection Gloves: A Cross-sectional Study
Authors: Yasuda Mitsuyoshi , Manabu Syoji , Fuji Tomoki , Seino Noritaka , Watanabe Hiroyuki , Sato Hisaya , Kato Kyoichi
Published: September 2023

Radiation exposure of a practitioner’s fingers is a problem in interventional radiology, and radiation protection gloves (protective gloves) can help reduce such exposure. Several types of protective gloves are commercially available from various manufacturers. In the present study, we compared the protective effects and usability of four types of protective gloves. To investigate the radiation protection effect, we placed normal surgical gloves and the four types of protective gloves on phantom hands with thermoluminescent dosimeters (TLD) attached to the fingertips and the dorsum and palms of the hands. Next, they were irradiated with x rays, and the radiation dose was measured and compared using the TLDs. In terms of usability, 42 medical staff members completed a questionnaire that included seven items, such as finger movability, tactile sensation, grip, and overall satisfaction, which were scored on a 5-point scale. Consequently, the protective effects differed between the gloves, and radiation exposure was lower by 30% to 60% with these gloves compared with surgical gloves. In terms of usability, a difference of 2 to 4 points was noted between the gloves for each questionnaire item. These results suggest that radiation protective gloves can protect the surgeon's fingers from radiation exposure without reducing work efficiency by selecting gloves according to the surgical procedure.
Late recurrence of corneal dystrophy treated with phototherapeutic keratectomy combined with epikeratophakia using double lenticules
Authors: Sun Bingqing , Zhang Zhe , Xia Fei , Zhao Yu , Fu Dan , Xu Haipeng , Zhou Xingtao , Zhao Jing
Published: September 2023

Phototherapeutic keratectomy (PTK) combined with epikeratophakia (EP) using double lenticules through small-incision lenticule extraction (SMILE) after late recurrence was used in a patient with Reis-Bückler corneal dystrophy (RBCD) who underwent bilateral PTK 9.5 years previously. Opacity recurred at 4 years, with PTK + EP being performed using SMILE-derived lenticules, and at 5.5 years with an uncorrected visual acuity of 20/100 and disrupted counting fingers in the right and left eyes. PTK + EP in the right eye and PTK on the original lenticule in the left eye were performed. Manifest refraction was −4.25/−2.5 × 155 with a corrected distance visual acuity (CDVA) of 20/20 and −3.50/−0.75 × 140 with a CDVA of 20/20 in the right and left eyes, respectively, 2 months postoperatively. Lenticules remained transparent and well-attached to the corneal stroma, and the corneal epithelium reshaped successfully. The feasibility of repeated PTK + EP in patients with multiple RBCD recurrences was demonstrated, delaying the need for corneal transplantation.
Psychosocial Factors Associated With Time to Recovery After Concussion in Adolescent Ice Hockey Players
Authors: Luszawski Caroline A. , Plourde Vickie , Sick Stacy R. , Galarneau Jean-Michel , Eliason Paul H. , Brooks Brian L. , Mrazik Martin , Debert Chantel T. , Lebrun Constance , Babul Shelina , Hagel Brent E. , Dukelow Sean P. , Schneider Kathryn J. , Emery Carolyn A. , Yeates Keith Owen
Published: September 2023

Objective:

To investigate the association between psychosocial factors and physician clearance to return to play (RTP) in youth ice hockey players after sport-related concussion.

Design:

Prospective cohort study, Safe to Play (2013-2018).

Setting:

Youth hockey leagues in Alberta and British Columbia, Canada.

Participants:

Three hundred fifty-three ice hockey players (aged 11-18 years) who sustained a total of 397 physician-diagnosed concussions.

Independent Variables:

Psychosocial variables.

Main Outcome Measures:

Players and parents completed psychosocial questionnaires preinjury. Players with a suspected concussion were referred for a study physician visit, during which they completed the Sport Concussion Assessment Tool (SCAT3/SCAT5) and single question ratings of distress and expectations of recovery. Time to recovery (TTR) was measured as days between concussion and physician clearance to RTP. Accelerated failure time models estimated the association of psychosocial factors with TTR, summarized with time ratios (TRs). Covariates included age, sex, body checking policy, days from concussion to the initial physician visit, and symptom severity at the initial physician visit.

Results:

Self-report of increased peer-related problems on the Strengths and Difficulties Questionnaire (TR, 1.10 [95% CI, 1.02-1.19]), higher ratings of distress about concussion outcomes by participants (TR, 1.06 [95% CI, 1.01-1.11]) and parents (TR, 1.05 [95% CI, 1.01-1.09]), and higher parent ratings of distress about their child's well-being at the time of injury (TR, 1.06 [95% CI, 1.02-1.09]) were associated with longer recovery.

Conclusions:

Greater pre-existing peer-related problems and acute distress about concussion outcomes and youth well-being predicted longer TTR. Treatment targeting these psychosocial factors after concussion may promote recovery.
Newborn screening for severe combined immunodeficiency and inborn errors of immunity
Authors: Lev Atar , Somech Raz , Somekh Ido
Published: September 2023

Purpose of review

Severe combined immune deficiency (SCID) is the most devastating genetic disease of the immune system with an unfavorable outcome unless diagnosed early in life. Newborn screening (NBS) programs play a crucial role in facilitating early diagnoses and timely interventions for affected infants.

Recent findings

SCID marked the pioneering inborn error of immunity (IEI) to undergo NBS, a milestone achieved 15 years ago through the enumeration of T-cell receptor excision circles (TRECs) extracted from Guthrie cards. This breakthrough has revolutionized our approach to SCID, enabling not only presymptomatic identification and prompt treatments (including hematopoietic stem cell transplantation), but also enhancing our comprehension of the global epidemiology of SCID.

NBS is continuing to evolve with the advent of novel diagnostic technologies and treatments. Following the successful implementation of SCID-NBS programs, a call for the early identification of additional IEIs is the next step, encompassing a broader spectrum of IEIs, facilitating early diagnoses, and preventing morbidity and mortality.
Prophylactic Antibiotics to Prevent Cholangitis in Children with Biliary Atresia After Kasai Portoenterostomy: A Meta-Analysis
Authors: Alatas Fatima Safira , Lazarus Glen , Junaidi Michelle Clarissa , Oswari Hanifah
Published: September 2023

Objectives:

A connection between the bowel and bile ducts after the Kasai hepatoportoenterostomy (HPE) procedure poses a risk of ascending cholangitis. There were only a few evidence-based consensuses on the benefits of prophylactic antibiotics. This study aims to assess the value of prophylactic antibiotics in reducing the risk of cholangitis following the Kasai HPE procedure.

Methods:

Meta-analysis is performed using random-effects model from the search result of 5 online databases (PubMed, Google Scholar, EBSCO MEDLINE, ClinicalTrials.gov, and EuropePMC) from inception to October 27, 2021. The keywords used were “antibiotic,” “antimicrobial,” “Kasai,” “portoenterostomy,” “biliary atresia,” and “bile duct atresia.” Cochrane Risk of Bias tool and Newcastle-Ottawa Scale is used to assess the risk of bias. The outcomes are incidence of cholangitis and native liver survival.

Results:

Six studies consisting of 4 cohorts and 2 cross-sectional studies were extracted. A total of 714 patients reported different cholangitis incidence after prophylactic antibiotics administration post-Kasai HPE. The incidence of cholangitis following Kasai HPE was not statistically significant among participants. There is conflicting evidence on the efficacy of antibiotics in prolonging native liver survival.

Conclusions:

The existing evidence does not support the administration of prophylactic antibiotics in preventing cholangitis after Kasai HPE among biliary atresia patients. Additionally, their roles in native liver survival are still inconclusive. The fact that there were heterogeneous method and antibiotic usage between existing studies must also be highlighted for better design in future studies.
Refeeding Syndrome in Pediatric Age, An Unknown Disease: A Narrative Review
Authors: Corsello Antonio , Trovato Chiara Maria , Dipasquale Valeria , Bolasco Giulia , Labriola Flavio , Gottrand Frédéric , Verduci Elvira , Diamanti Antonella , Romano Claudio
Published: September 2023

Refeeding syndrome (RS) is characterized by electrolyte imbalances that can occur in malnourished and abruptly refed patients. Typical features of RS are hypophosphatemia, hypokalemia, hypomagnesemia, and thiamine deficiency. It is a potentially life-threatening condition that can affect both adults and children, although there is scarce evidence in the pediatric literature. The sudden increase in food intake causes a shift in the body’s metabolism and electrolyte balance, leading to symptoms such as weakness, seizures, and even heart failure. A proper management with progressive increase in nutrients is essential to prevent the onset of this condition and ensure the best possible outcomes. Moreover, an estimated incidence of up to 7.4% has been observed in pediatric intensive care unit patients receiving nutritional support, alone or as an adjunct. To prevent RS, it is important to carefully monitor feeding resumption, particularly in severely malnourished individuals. A proper strategy should start with small amounts of low-calorie fluids and gradually increasing the calorie content and amount of food over several days. Close monitoring of electrolyte levels is critical and prophylactic use of dietary supplements such as thiamine may be required to correct any imbalances that may occur. In this narrative review, we aim to provide a comprehensive understanding of RS in pediatric clinical practice and provide a possible management algorithm.
Efficacy of One Dose of Laxative on Postoperative Constipation Following Total Knee Arthroplasty
Authors: Gonzalez Kathleen , Sanchez Karen , Mauch Katelyn , Burchill Christian N. , Bena James F. , Morrison Shannon L. , Distelhorst Karen S.
Published: September 2023

Postoperative constipation is a common problem among orthopaedic surgical patients leading to discomfort, increased length of stay, and other complications. The primary purpose of this study was to determine the effectiveness of polyethylene glycol compared with docusate sodium for the prevention of constipation, after total knee arthroplasty. The secondary purpose was to examine the effectiveness of polyethylene glycol on pain and strain with bowel movement. A two-group nonequivalent cohort design was used to evaluate the effect of one 17-g dose of polyethylene glycol by mouth on postoperative day 1 compared with usual care with docusate sodium 100 mg starting the day of surgery and continued twice daily at home. There was no significant difference in the rate of constipation between the two cohorts in the 3 days after surgery. There was no difference in reported pain and strain. Future research should focus on the use of pharmacologic and nursing interventions together for prevention of postoperative constipation in patients with arthroplasty surgery.
Validation of a Reduced Set of High-Performance Triggers for Identifying Patient Safety Incidents with Harm in Primary Care: TriggerPrim Project
Authors: Garzón González Gerardo , Alonso Safont Tamara , Conejos Míquel Dolores , Castelo Jurado Marta , Aguado Arroyo Oscar , Jurado Balbuena Juan José , Villanueva Sanz Cristina , Zamarrón Fraile Ester , Luaces Gayán Arancha , Cañada Dorado Asunción , Martínez Patiño Dolores , Magán Tapia Purificación , Barberá Martín Aurora , Toribio Vicente María José , Drake Canela Mercedes , Mediavilla Herrera Inmaculada
Published: September 2023

Objective

The aim of the study was to construct and validate a reduced set of high-performance triggers for identifying adverse events (AEs) via electronic medical records (EMRs) review in primary care (PC).

Methods

This was a cross-sectional descriptive study for validating a diagnostic test. The study included all 262 PC centers of Madrid region (Spain). Patients were older than 18 years who attended their PC center over the last quarter of 2018. The randomized sample was n = 1797. Main measurements were as follows: (a) presence of each of 19 specific computer-identified triggers in the EMR and (b) occurrence of an AE. To collect data, EMR review was conducted by 3 doctor-nurse teams. Triggers with statistically significant odds ratios for identifying AEs were selected for the final set after adjusting for age and sex using logistic regression.

Results

The sensitivity (SS) and specificity (SP) for the selected triggers were: ≥3 appointments in a week at the PC center (SS = 32.3% [95% confidence interval {CI}, 22.8%–41.8%]; SP = 92.8% [95% CI, 91.6%–94.0%]); hospital admission (SS = 19.4% [95% CI, 11.4%–27.4%]; SP = 97.2% [95% CI, 96.4%–98.0%]); hospital emergency department visit (SS = 31.2% [95% CI, 21.8%–40.6%]; SP = 90.8% [95% CI, 89.4%–92.2%]); major opioids prescription (SS = 2.2% [95% CI, 0.0%–5.2%]; SP = 99.8% [95% CI, 99.6%–100%]); and chronic benzodiazepine treatment in patients 75 years or older (SS = 14.0% [95% CI, 6.9%–21.1%]; SP = 95.5% [95% CI, 94.5%–96.5%]).

The following values were obtained in the validation of this trigger set (the occurrence of at least one of these triggers in the EMR): SS = 60.2% (95% CI, 50.2%–70.1%), SP = 80.8% (95% CI, 78.8%–82.6%), positive predictive value = 14.6% (95% CI, 11.0%–18.1%), negative predictive value = 97.4% (95% CI, 96.5%–98.2%), positive likelihood ratio = 3.13 (95% CI, 2.3–4.2), and negative likelihood ratio = 0.49 (95% CI, 0.3–0.7).

Conclusions

The set containing the 5 selected triggers almost triples the efficiency of EMR review in detecting AEs. This suggests that this set is easily implementable and of great utility in risk-management practice.
Energy expenditure during typical household and community activities of daily living in persons with lower limb amputation: A pilot study
Authors: Mellema Mirjam , Gjøvaag Terje
Published: September 2023

Introduction:

Knowledge about the energy expenditure of typical activities of daily living (ADL) in persons with lower limb amputation (LLA) is lacking. This study investigated the following: (1) oxygen consumption per unit distance (V̇O2; mL·kg−1·min−1), (2) proportion utilization of peak oxygen consumption (%V̇O2peak), (3) oxygen cost (energy cost; mL·kg−1·m−1), and (4) perceived exertion (rating of perceived exertion) of ADL in persons with LLA and able-bodied controls.

Methods:

Participants (21 with LLA/12 controls) performed 2 household ADL experiments: in-house walking and vacuuming and 3 community ADL experiments: marked shopping, fast walking, and stair negotiation. V̇O2peak was assessed with arm crank ergometry, and ambulatory activity was monitored for 7 days with a StepWatch.

Results:

Participants with LLA performed in-house walking, marked shopping, vacuuming, and stair negotiation at a similar V̇O2 as controls, while their self-selected walking speed (WS) was significantly lower. Participants with LLA had significantly higher %V̇O2peak than controls during in-house walking and reported a significantly higher rating of perceived exertion for vacuuming and marked shopping. The highest possible WS of participants with LLA during fast walking was significantly lower than that of controls, but V̇O2 was also significantly lower, indicating a limited capacity to walk at higher WS. Participants with LLA had a significantly lower daily step count, significantly lower-proportion high-intensity ambulation, but significantly higher-proportion low-intensity ambulation than controls, indicating that persons with LLA also walked at lower WS in daily life.

Conclusions:

The results indicate that persons with LLA have increased physical and perceived effort during performance of ADL compared with persons without amputation, which has consequences for community participation, and hence independence and quality of life.
The Tennessee Center for AIDS Research HIV Research Training Program for Minority High School and Undergraduate Students: Development, Implementation, and Early Outcomes
Authors: Koethe John R. , Eeds Angela , Stewart LaMonica V. , Haas David W. , Hildreth James E. K. , Mallal Simon , Wanjalla Celestine , Perkins Jessica , Ahonkhai Aima , Dong Xinhong , Berhanu Rebecca , Dash Chandravanu
Published: September 2023

Background:

The Southern region of the United States has the highest HIV incidence, and new infections disproportionately affect Black Americans. The Tennessee Center for AIDS Research (CFAR) Diversity, Equity, and Inclusion Pathway Initiative (CDEIPI) program supports the training of individuals from groups underrepresented in medicine and science in multiple areas of research to increase the pool of HIV-focused investigators at early educational and career stages.

Setting:

The Tennessee CFAR is a partnership between Vanderbilt University Medical Center, Meharry Medical College (one of the oldest historically Black medical colleges), Tennessee Department of Health, and Nashville Community AIDS Resources, Education and Services (a sophisticated community service organization, which emphasizes research training responsive to regional and national priorities).

Methods:

The Tennessee CFAR CDEIPI program leverages existing Vanderbilt University Medical Center and Meharry Medical College structured biomedical training programs for high school and undergraduate students to provide an intensive, mentored, HIV research experience augmented by CFAR resources situating this training within the broader history, scientific breadth, and societal and political aspects of the HIV epidemic.

Results:

The first year of the Tennessee CFAR CDEIPI program trained 3 high school and 3 undergraduate students from underrepresented in medicine and science backgrounds in basic, clinical/translational, and community-focused research projects with a diverse group of 9 mentors. All students completed the program, and evaluations yielded positive feedback regarding mentoring quality and effectiveness, and continued interest in HIV-related research.

Conclusions:

The Tennessee CFAR CDEIPI program will continue to build upon experience from the first year to further contribute to national efforts to increase diversity in HIV-related research.
Addressing Stigma by Increasing Empathy Toward Vulnerable Populations in Preprofessional Trainees: Impacts of the Generation Tomorrow Summer Health Disparities Scholars Program
Authors: Antoine Denis G. , Manogue Sean , Blue Jasmine , Irvin Risha , Irvin Nathan
Published: September 2023

Background:

Creating empathetic health care professionals is critical to addressing the health equity challenges of today, particularly because it relates to vulnerable populations.

Methods:

To assess the impact of the Johns Hopkins Center for AIDS Research Generation Tomorrow Summer Health Disparities Scholars (GTSHDS) program on students' empathy toward individuals living with substance use disorder and differential impact on empathy related to the COVID-19 pandemic, the Attitudes towards Mental Illness Questionnaire (AMIQ), an assessment of stigmatizing attitudes, was administered. Preprogram and postprogram participation AMIQ survey data were compared using paired t tests to explore changes within the program year. Unpaired t tests were used to characterize differences between the mean scores across the 2 student cohorts.

Results:

Both GTSHDS cohorts displayed postprogram increase in empathy. Mean 2019 cohort AMIQ scores shifting from −1.4 (SD 2.01) to −0.8 (SD 2.35) (P = 0.54), and the 2022 cohort shifting from −3.67 (SD 2.01) to −3 (SD 1.61) (P = 0.79). On average, individual scores improved by 2.2 (SD 1.65) points in the 2019 cohort and 2.4 (SD 1.86) points in the 2022 cohort (P = 0.83). Although these were not statistically significant, they suggested a trend toward more empathy.

Conclusions:

Preliminary data suggest that programs such as GTSHDS that expose students to various aspects of health care principles can prepare future health care professionals in a manner that may reduce health care disparities. Future research with larger population sizes is needed to understand the impacts of the curriculum on empathy and related concepts to achieving health equity.
Pathways and Intersections: Multifaceted Approaches to Engage Individuals From Underrepresented and Marginalized Communities in HIV Research and Career Development
Authors: Irie Whitney C. , Chitneni Pooja , Glynn Tiffany R. , Allen Wanda , Chai Peter R. , Engelman Alan N. , Hurtado Rocio , Li Jonathan Z. , Li Peng , Lockman Shahin , Marcus Julia L. , Ogunshola Funsho J. , Rönn Minttu M. , Haberer Jessica , Ghebremichael Musie , Ciaranello Andrea ,   For the Harvard University Center for AIDS Research Diversity, Equity, and Inclusion Working Group
Published: September 2023

Background:

The underrepresentation of historically marginalized groups in the HIV research workforce is a barrier to reaching national Ending the Epidemic goals.

Setting:

The Harvard University Center for AIDS Research (HU CFAR) Diversity Equity and Inclusion Working Group (DEI WG) uses a multifaceted approach to enhance the field's diversity.

Methods:

We established a DEI WG to improve the recruitment, inclusion, and retention of underrepresented minorities (URMs) in HIV research. We use community-based, participatory processes to establish and expand education and outreach programs about HIV care and research to better connect the HU CFAR to communities affected by HIV. This article reports on the development of the WG in July 2022, progress in its first year, and future plans.

Results:

We have built a network of >50 investigators across the university for monthly meetings; partnered with existing research pathway programs for high school, undergraduate, and graduate students, directly supporting 7 new trainees and linking CFAR investigators to additional mentorship opportunities; and created 2-year Scholar Awards for 5 URM investigators in HIV. Planned work includes needs assessments for early-stage investigators to understand factors contributing to inclusion and retention and new pathway and outreach programming being developed with community partner minority-serving institutions.

Conclusions:

The HU CFAR DEI WG strives to ensure that individuals from underrepresented, marginalized, and minoritized communities have an opportunity to contribute to HIV research and that research is informed by the needs of the communities affected by the epidemic. An intersectional approach should be incorporated into HIV research pathway initiatives.
Centers for AIDS Research (CFAR) Diversity, Equity, and Inclusion Pathway Initiative (CDEIPI): Developing Career Pathways for Early-Stage Scholars From Racial and Ethnic Groups Underrepresented in HIV Science and Medicine
Authors: CDEIPI Consortium
Published: September 2023

Background:

There is an urgent need to increase diversity among scientific investigators in the HIV research field to be more reflective of communities highly affected by the HIV epidemic. Thus, it is critical to promote the inclusion and advancement of early-stage scholars from racial and ethnic groups underrepresented in HIV science and medicine.

Methods:

To widen the HIV research career pathway for early-stage scholars from underrepresented minority groups, the National Institutes of Health supported the development of the Centers for AIDS Research (CFAR) Diversity, Equity, and Inclusion Pathway Initiative (CDEIPI). This program was created through partnerships between CFARs and Historically Black Colleges and Universities and other Minority Serving Institutions throughout the United States.

Results:

Seventeen CFARs and more than 20 Historically Black Colleges and Universities and Minority Serving Institutions have participated in this initiative to date. Programs were designed for the high school (8), undergraduate (13), post baccalaureate (2), graduate (12), and postdoctoral (4) levels. Various pedagogical approaches were used including didactic seminar series, intensive multiday workshops, summer residential programs, and mentored research internship opportunities. During the first 18 months of the initiative, 257 student scholars participated in CDEIPI programs including 150 high school, 73 undergraduate, 3 post baccalaureate, 27 graduate, and 4 postdoctoral students.

Conclusion:

Numerous student scholars from a wide range of educational levels, geographic backgrounds, and racial and ethnic minority groups have engaged in CDEIPI programs. Timely and comprehensive program evaluation data will be critical to support a long-term commitment to this unique training initiative.
An Internship Approach to Strengthen the Pathway for Historically Underrepresented Groups in Health Sciences Research: The North Carolina Diversity and Inclusion Pathway Program
Authors: Robinson Seronda A. , Menezes Prema , Zinck Matthew , McCrimmon Jordyn , Okumu Eunice , Ford R. Uriah , Esposito Maria , Sivaraman Vijay , Chi Benjamin H.
Published: September 2023

Background:

To increase engagement of historically underrepresented groups in health sciences research, we created the North Carolina Diversity and Inclusion Pathway Program (NC-DIPP). This year-long, paid internship provides undergraduate and graduate students from 2 historically Black colleges and universities an opportunity to gain real-world experience under the mentorship of expert faculty.

Methods:

To evaluate the early experiences with the NC-DIPP program, we conducted semi-structured interviews with interns and program leaders. Faculty mentors completed an online questionnaire to describe their experiences to date. A thematic approach was used to analyze the findings.

Results:

In March–April 2023, 7 of 8 interns (88%), 6 of 11 mentors (54%), and 4 of 4 program leaders (100%) participated in various evaluation components. Overall, respondents agreed about the importance of programs like NC-DIPP, which further engage historically underrepresented groups in the health sciences. Interns had positive feedback about the internship, including real-world work experience, connections to experienced mentors, and early career planning. On a scale of 1 (poor) to 10 (excellent), interns rated their experience as a median of 8.3 (range: 4.5–10.0). Mentors had favorable but slightly lower scores (median: 7.0, range: 5.0–8.0). Areas for improvement were noted, including clearer expectations, improved logistical support, and central engagement of interns across projects.

Conclusions:

This early evaluation of NC-DIPP was generally favorable across all stakeholder groups. By providing a long-term experience in health science research, such programs can contribute to work experience, career planning, and professional networking.
Advancements in Diffusion MRI Tractography for Neurosurgery
Authors: Kamagata Koji , Andica Christina , Uchida Wataru , Takabayashi Kaito , Saito Yuya , Lukies Matthew , Hagiwara Akifumi , Fujita Shohei , Akashi Toshiaki , Wada Akihiko , Hori Masaaki , Kamiya Kouhei , Zalesky Andrew , Aoki Shigeki
Published: September 2023

Diffusion magnetic resonance imaging tractography is a noninvasive technique that enables the visualization and quantification of white matter tracts within the brain. It is extensively used in preoperative planning for brain tumors, epilepsy, and functional neurosurgical procedures such as deep brain stimulation. Over the past 25 years, significant advancements have been made in imaging acquisition, fiber direction estimation, and tracking methods, resulting in considerable improvements in tractography accuracy. The technique enables the mapping of functionally critical pathways around surgical sites to avoid permanent functional disability. When the limitations are adequately acknowledged and considered, tractography can serve as a valuable tool to safeguard critical white matter tracts and provides insight regarding changes in normal white matter and structural connectivity of the whole brain beyond local lesions. In functional neurosurgical procedures such as deep brain stimulation, it plays a significant role in optimizing stimulation sites and parameters to maximize therapeutic efficacy and can be used as a direct target for therapy. These insights can aid in patient risk stratification and prognosis. This article aims to discuss state-of-the-art tractography methodologies and their applications in preoperative planning and highlight the challenges and new prospects for the use of tractography in daily clinical practice.
Tree diversity increases forest temperature buffering
Authors: Schnabel Florian , Beugnon Rémy , Yang Bo , Richter Ronny , Eisenhauer Nico , Huang Yuanyuan , Liu Xiaojuan , Wirth Christian , Cesarz Simone , Fichtner Andreas , Perles-Garcia Maria D. , Hähn Georg J. A. , Härdtle Werner , Kunz Matthias , Izaguirre Nadia C. Castro , Niklaus Pascal A. , von Oheimb Goddert , Schmid Bernhard , Trogisch Stefan , Wendisch Manfred , Ma Keping , Bruelheide Helge
Published: September 2023

Global warming is increasing the frequency and intensity of climate extremes. Forests may buffer such extreme events by creating their own microclimate below their canopy via cooling hot and insulating against cold macroclimate air temperatures. This buffering capacity of forests may be increased by tree diversity and may itself maintain forest functioning and biodiversity. However, despite its relevance for many ecosystem processes, the effect of tree diversity on temperature buffering is largely unexplored. Here, we show that tree species richness consistently increases forest temperature buffering across daily, monthly, and annual scales over six years. This finding is based on data from a large-scale tree diversity experiment covering a species richness gradient of 1 to 24 tree species. We found that species richness strengthened both components of forest temperature buffering: the attenuation of hot and of cold macroclimate air temperatures, with the cooling effect being more pronounced. The buffering effect of tree species richness was mediated by canopy density and structural diversity, assessed as leaf area index and stand structural complexity index, respectively. Safeguarding and planting diverse forests may thus mitigate negative effects of global warming and climate extremes on ecosystem functions and communities below the tree canopy.
Chemogenetic activation of target neurons expressing insect Ionotropic Receptors in the mammalian central nervous system by systemic administration of ligand precursors
Authors: Iguchi Yoshio , Fukabori Ryoji , Kato Shigeki , Takahashi Kazumi , Eifuku Satoshi , Maejima Yuko , Shimomura Kenju , Mizuma Hiroshi , Mawatari Aya , Cui Hisashi Yilong , Onoe Hirotaka , Hikishima Keigo , Osanai Makoto , Nishijo Takuma , Momiyama Toshihiko , Benton Richard , Kobayashi Kazuto
Published: September 2023

The IR-mediated neuronal activation (IRNA) technology allows stimulation of neurons in the brain that heterologously-express members of the insect chemosensory IR repertoire in response to their cognate ligands. In the current protocol, a ligand against the complex consisting of IR84a and IR8a subunits, phenylacetic acid (PhAc), is locally injected into a brain region, because of a low efficiency of PhAc for the delivery into the brain across the blood-brain barrier. To circumvent this invasive injection, here we developed a strategy for activation of target neurons in the brain through peripheral administration with a precursor of PhAc, methyl ester of PhAc (PhAcM), which is efficiently transferred into the brain and converted to the mature ligand by endogenous esterase activities. Peripheral administration of with PhAcM activated IR84a/IR8a-expressing neurons in the locus coeruleus of mice and increased the release of neurotransmitters in their nerve terminal regions. (S)-2-phenylpropionic acid ((S)-PhPr) was newly identified as a ligand for IR84a/IR8a, and peripheral administration with the methyl ester of PhPr with the S-configuration [(S)-PhPrM] caused similar effects on the target neurons. In addition, cell-type specific expression of IR84a/IR8a complex in the striatum of rats was unilaterally induced with a viral vector based on the Cre-loxP system. Peripheral administration with PhAcM or (S)-PhPrM stimulated the neurotransmitter release in the ipsilateral terminal regions of the vector-injected striatum, and PhAcM administration resulted in rotational behavior.

Finally, we demonstrated that the metabolites of the peripherally administered-radiolabeled (S)-PhPrM accumulated in the IR84a/IR8a-expressing region in the striatum of the vector-injected rats. These results demonstrate that the systemic IRNA technique provides a powerful strategy for remote manipulation of diverse types of target neurons in the mammalian central nervous system.
The interplay between oxidative stress and inflammation supports autistic-related behaviors in mice
Authors: Pangrazzi Luca , Cerilli Enrica , Balasco Luigi , Tobia Caterina , Dall‘O’ Ginevra Matilde , Chelini Gabriele , Perini Samuel , Filosi Michele , Ravizza Teresa , Vezzani Annamaria , Provenzano Giovanni , Pastore Anna , Weinberger Birgit , Domenici Enrico , Bozzi Yuri
Published: September 2023

Autism Spectrum Disorder (ASD) is a highly prevalent neurodevelopmental condition characterized by social communication deficits and repetitive/restricted behaviors. Several studies showed that inflammation may contribute to ASD. Here we used RT-qPCR, RNA sequencing, immunohistochemistry, and flow cytometry to show that pro-inflammatory molecules were increased in the cerebellum and periphery of mice lackingCntnap2(Cntnap2−/−), a robust model of ASD. In parallel, oxidative stress was present in the cerebellum of mutant animals. Systemic treatment with N-acetyl-cysteine (NAC) rescued cerebellar oxidative stress and inflammation as well as motor and social impairments inCntnap2−/−mice. This was accompanied by improved function of microglia cells in NAC-treated mutant animals. Intriguingly, social deficits, cerebellar inflammation and microglia dysfunction were induced by NAC inCntnap2+/+animals. Our findings therefore suggest that the interplay between oxidative stress and inflammation may support ASD-related behaviors in mice.
Multilevel regulation of NF-κB signaling by NSD2 suppressesKras-driven pancreatic tumorigenesis
Authors: Feng Wenxin , Niu Ningning , Lu Ping , Rao Hanyu , Chen Zhuo , Zhang Wei , Ma Chunxiao , Liu Changwei , Xu Yue , Gao Wei-Qiang , Xue Jing , Li Li
Published: September 2023

Pancreatic ductal adenocarcinoma (PDAC) is a clinically challenging cancer with a dismal overall prognosis. NSD2 is an H3K36-specific di-methyltransferase which has been reported to play a crucial role in promoting tumorigenesis. Here, we demonstrate that NSD2 acts as a putative tumor suppressor inKras-driven pancreatic tumorigenesis. Low level of NSD2 indicates aggressive feature of PDAC. NSD2 restrains the mice from inflammation andKras-induced ductal metaplasia, while NSD2 loss facilitates pancreatic tumorigenesis. Mechanistically, NSD2-mediated H3K36me2 promotes the expression of IκBα, which inhibits the phosphorylation of p65 and NF-κB nuclear translocation. More importantly, NSD2 interacts with the DNA binding domain of p65, attenuating NF-κB transcriptional activity. Furthermore, inhibition of NF-κB signaling relieves the symptoms ofNsd2-deficient mice. Together, our study reveals the important tumor suppressor role of NSD2 and multiple mechanisms by which NSD2 suppresses both p65 phosphorylation and downstream transcriptional activity during pancreatic tumorigenesis. This study contributes to understanding the pathogenesis of pancreatic tumorigenesis and identifies a novel negative regulator of NF-κB signaling.
Differential cortical and subcortical visual processing with eyes shut
Authors: Cicero Nicholas G. , Klimova Michaela , Lewis Laura D. , Ling Sam
Published: September 2023

Closing our eyes largely shuts down our ability to see. That said, our eyelids still pass some light, allowing our visual system to coarsely process information about visual scenes, such as changes in luminance. However, the specific impact of eye closure on processing within the early visual system remains largely unknown. To understand how visual processing is modulated when eyes are shut, we used functional magnetic resonance imaging (fMRI) to measure responses to a flickering visual stimulus at high (100%) and low (10%) temporal contrasts, while participants viewed the stimuli with their eyes open or closed. Interestingly, we discovered that eye closure produced a qualitatively distinct pattern of effects across the visual thalamus and visual cortex. We found that with eyes open, low temporal contrast stimuli produced smaller responses, across the lateral geniculate nucleus (LGN), primary (V1) and extrastriate visual cortex (V2). However, with eyes closed, we discovered that the LGN and V1 maintained similar BOLD responses as the eyes open condition, despite the suppressed visual input through the eyelid. In contrast, V2 and V3 had strongly attenuated BOLD response when eyes were closed, regardless of temporal contrast. Our findings reveal a qualitative distinct pattern of visual processing when the eyes are closed – one that is not simply an overall attenuation, but rather reflects distinct responses across visual thalamocortical networks, wherein the earliest stages of processing preserves information about stimuli but is then gated off downstream in visual cortex.

Significance statement

When we close our eyes, not all information is blocked out. Coarse luminance information is still accessible for processing by the visual system, even when our eyes are closed. Using functional magnetic resonance imaging (fMRI), we examined whether eyelid closure plays a unique role in visual processing. We discovered that while the thalamus and primary visual cortex (V1) show equivalent luminance-dependent responses both when the eyes are open and closed, extrastriate cortex exhibited a qualitatively distinct pattern of responses. Specifically, eye closure attenuated luminance responses in extrastriate cortices, but responses were preserved in LGN and V1. This pattern suggests that during brain states where the eyes are closed, visual information is still accessible to the very earliest stages of visual processing, but that downstream visual processing areas appear to become blind to this information.
A reproducible approach for the use of aptamer libraries for the identification of Aptamarkers for brain amyloid deposition based on plasma analysis
Authors: Meehan Cathal , Lecocq Soizic , Penner Gregory
Published: September 2023

An approach for the agnostic identification and validation of aptamers for the prediction of a medical state from plasma analysis is presented in application to a key risk factor for Alzheimer’s disease. brain amyloid deposition. This method involved the use of a newly designed aptamer library with sixteen random nucleotides interspersed with fixed sequences called a Neomer library. The Neomer library approach enables the direct application of the same starting library on multiple plasma samples. without the requirement for pre-enrichment associated with the traditional approach. Eight aptamers were identified as a result of the selection process and screened across 390 plasma samples by qPCR assay. Results from both processes were analysed using multiple machine learning algorithms from the Scikit-learn package along with clinical variables including cognitive status. age and sex to create predictive models. An Extra Trees Classifier model provided the highest predictive power. The Neomer approach resulted in a sensitivity of 0.88. specificity of 0.76. and AUC of 0.79. The only clinical variables that were included in the model were age and sex. We conclude that the Neomer approach represents a clear improvement for the agnostic identification of aptamers (Aptamarkers) that bind to unknown biomarkers of a medical state.
United States influenza 2022-2023 season characteristics as inferred from wastewater solids, influenza hospitalization and syndromic data
Authors: Schoen Mary E. , Bidwell Amanda L. , Wolfe Marlene K. , Boehm Alexandria B.
Published: September 2023

Influenza A virus (IAV) causes significant morbidity and mortality in the United States and has pandemic potential. Identifying IAV epidemic patterns is essential to inform the timing of vaccines and non-pharmaceutical interventions. In a prospective, longitudinal study design, we measured IAV RNA in wastewater settled solids at 163 wastewater treatment plants across 33 states to characterize the 2022-2023 influenza season at the state, health and human services (HHS) regional, and national scales. Influenza season onset, offset, duration, peak, and intensity using IAV RNA in wastewater were compared with those determined using laboratory-confirmed influenza hospitalization rates and outpatient visits for influenza-like illness (ILI). The onset for HHS regions as determined by IAV RNA in wastewater roughly corresponded with those determined using ILI when the annual geometric mean of IAV RNA concentration was used as baseline (i.e., the threshold that triggers onset), although offsets between the two differed. IAV RNA in wastewater provided early warning of onset, compared to the ILI estimate, when the baseline was set at twice the limit of IAV RNA detection in wastewater. Peak when determined by IAV RNA in wastewater generally preceded peak determined by IAV hospitalization rate by two weeks or less. Wastewater settled solids data is an IAV-specific indicator that can be used to augment clinical surveillance for seasonal influenza epidemic timing and intensity.

Abstract Figure
Randomised study of a new inline respiratory function monitor (Juno) to improve mask seal and delivered ventilation with neonatal manikins
Authors: Tracy Mark , Hinder Murray , Morakeas Stephanie , Lowe Krista , Priyadarshi Archana , Crott Matthew , Boustred Matthew , Culcer Mihaela
Published: September 2023

Background

Respiratory function monitors (RFM) have been used extensively in manikin and infant studies yet have not become the standard of training. We report the outcomes of a new portable, lightweight resuscitation monitor (Juno) designed to show mask leak and deflation tidal volume to assist in positive pressure ventilation (PPV) competency training using manikins.

Methods

Two leak-free manikins (Preterm and Term) were used. Participants provided positive pressure ventilation to manikins using two randomized devices self-inflating bag (SIB) and T-piece resuscitator (TPR) with Juno display initially blinded then unblinded in four 90-second paired sequences, aiming for adequate chest wall rise and target minimal mask leak with appropriate target delivered volume when using the monitor.

Results

49 experienced neonatal staff delivered 15,569 inflations to the term manikin and 14,580 inflations to the preterm. Comparing blinded to unblinded RFM display there were significant reductions in all groups in the number of inflations out of target range volumes (Preterm: SIB 22.6% to 6.6%, TPR: 7.1% to 4.2% and Term: SIB 54.8% to 37.8%, TPR 67.2 to 63.8%). The percentage of mask leak inflations >60% was reduced in Preterm: SIB 20.7% to 7.2%, TPR 23.4% to 7.4% and in Term: SIB 8.7% to 3.6%, TPR 23.5% to 6.2%).

Conclusions

Using the Juno monitor during simulated resuscitation significantly improved mask leak and delivered ventilation amongst otherwise experienced staff, using both preterm and term manikins. The Juno is a novel RFM that may assist in teaching and self-assessment of resuscitation technique.

Key messages

What is already known on this topic

Mask leak is common, can be large in magnitude and produce ineffective ventilation.

Excessive tidal volumes may injure vulnerable preterm lungs and brain.

The optimum use of RFMs used in manikin training is not determined.

What this study adds

Mask leaks in excess of 60 % significantly reduces delivered tidal volumes.

Optimising mask seal reduces high leak inflations in manikin models.

Optimising mask seal alone with TPR improves targeted volume delivery in manikin models.

How this study might affect research, practice or policy

Inline RFM monitors with simple GUI can improve the delivery of resuscitation training at all levels of skill.

Further research to guide policy how often to train to retain skills is needed.

Further research will determine the effectiveness of this RFM as a tool for self-directed learning in rural or remote settings.
Pleiotropic Genetic Effects between Multiple Sclerosis and Musculoskeletal Traits
Authors: Jeong Sohyun , Tsai Ming-Ju , Shen Changbing , Hsu Yi-Hsiang
Published: September 2023

Background

Musculoskeletal disorders were commonly reported in patients with multiple sclerosis. However, the underlying etiology linking Multiple Sclerosis (MS) and musculoskeletal disorders is not well studied. With large-scale Genome-Wide Association Studies (GWAS) publicly available, we conducted genetic correlation analysis to identify shared pleiotropic genetic effects between MS and musculoskeletal traits. We also conducted Mendelian Randomization (MR) to estimate the causal relation between MS and increased risks of musculoskeletal disorders.

Methods

Linkage Disequilibrium Score Regression (LDSR) analysis was performed to estimate heritability and genetic correlation. Univariable, multivariable, and bidirectional MR analyses were conducted to estimate the causal relation. These analyses were done by utilizing the recent GWAS summary statistics of MS, fracture, frailty, falls, and several musculoskeletal risk factors, including bone mineral density, lean mass, grip strengths, and vitamin D.

Results

LDSR analysis showed a moderate genetic correlation of MS with falls (RG=0.10,p=0.01) but not with fracture and frailty. Genetic variants (rs13191659) inLINC00240gene which is associated with iron status biomarkers was found to be associated with both MS and falls. In MR analyses after excluding outlier SNPs with potential pleiotropic effects and correcting for multiple testing, MS presented no causal association with fracture and frailty but a minimal association with falls. Falls showed causally increased risks of fracture and frailty.

Conclusion

Our study suggests a potential genetic correlation with shared pleiotropic genetic effects between MS and falls. However, we didn’t find evidence to support the causal relation between MS and increased risks of falls, fracture, and frailty.