bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from Multiplex Tissue Imaging Harmonization: A Multicenter Experience from CIMAC-CIDC Immuno-Oncology Biomarkers Network
Authors: Akturk Guray , Parra Edwin R. , Gjini Evisa , Lako Ana , Lee J. Jack , Neuberg Donna , Zhang Jiexin , Yao Shen , Laface Ilaria , Rogic Anita , Chen Pei-Hsuan , Sanchez-Espiridion Beatriz , Valle Diane M. Del , Moravec Radim , Kinders Robert , Hudgens Courtney , Wu Catherine , Wistuba Ignacio I. , Thurin Magdalena , Hewitt Stephen M. , Rodig Scott , Gnjatic Sacha , Tetzlaff Michael T.
Published: October 2024

AbstractPurpose:
The Cancer Immune Monitoring and Analysis Centers – Cancer Immunologic Data Commons (CIMAC-CIDC) network supported by the NCI Cancer Moonshot initiative was established to provide correlative analyses for clinical trials in cancer immunotherapy, using state-of-the-art technology. Fundamental to this initiative is implementation of multiplex IHC assays to define the composition and distribution of immune infiltrates within tumors in the context of their potential role as biomarkers. A critical unanswered question involves the relative fidelity of such assays to reliably quantify tumor-associated immune cells across different platforms.
Experimental Design:
Three CIMAC sites compared across their laboratories: (i) image analysis algorithms, (ii) image acquisition platforms, (iii) multiplex staining protocols. Two distinct high-dimensional approaches were employed: multiplexed IHC consecutive staining on single slide (MICSSS) and multiplexed immunofluorescence (mIF). To eliminate variables potentially impacting assay performance, we completed a multistep harmonization process, first comparing assay performance using independent protocols followed by the integration of laboratory-specific protocols and finally, validating this harmonized approach in an independent set of tissues.
Results:
Data generated at the final validation step showed an intersite Spearman correlation coefficient (r) of ≥0.85 for each marker within and across tissue types, with an overall low average coefficient of variation ≤0.1.
Conclusions:
Our results support interchangeability of protocols and platforms to deliver robust, and comparable data using similar tissue specimens and confirm that CIMAC-CIDC analyses may therefore be used with confidence for statistical associations with clinical outcomes largely independent of site, antibody selection, protocol, and platform across different sites.
Deep Learning and Minimally Invasive Endoscopy: Panendoscopic Detection of Pleomorphic Lesions
Authors: Mascarenhas Miguel , Mendes Francisco , Ribeiro Tiago , Afonso João , Marílio Cardoso Pedro , Martins Miguel , Cardoso Hélder , Andrade Patrícia , Ferreira João , Mascarenhas Saraiva Miguel , Macedo Guilherme
Published: October 2024

Introduction: Capsule endoscopy (CE) is a minimally invasive exam suitable of panendoscopic evaluation of the gastrointestinal (GI) tract. Nevertheless, CE is time-consuming with suboptimal diagnostic yield in the upper GI tract. Convolutional neural networks (CNN) are human brain architecture-based models suitable for image analysis. However, there is no study about their role in capsule panendoscopy. Methods: Our group developed an artificial intelligence (AI) model for panendoscopic automatic detection of pleomorphic lesions (namely vascular lesions, protuberant lesions, hematic residues, ulcers, and erosions). 355,110 images (6,977 esophageal, 12,918 gastric, 258,443 small bowel, 76,772 colonic) from eight different CE and colon CE (CCE) devices were divided into a training and validation dataset in a patient split design. The model classification was compared to three CE experts’ classification. The model’s performance was evaluated by its sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under the precision-recall curve. Results: The binary esophagus CNN had a diagnostic accuracy for pleomorphic lesions of 83.6%. The binary gastric CNN identified pleomorphic lesions with a 96.6% accuracy. The undenary small bowel CNN distinguished pleomorphic lesions with different hemorrhagic potentials with 97.6% accuracy. The trinary colonic CNN (detection and differentiation of normal mucosa, pleomorphic lesions, and hematic residues) had 94.9% global accuracy. Discussion/Conclusion: We developed the first AI model for panendoscopic automatic detection of pleomorphic lesions in both CE and CCE from multiple brands, solving a critical interoperability technological challenge. Deep learning-based tools may change the landscape of minimally invasive capsule panendoscopy.
Trends and Most-Cited Articles on Hemispheric Surgery: A Bibliometric Analysis and Historical Review
Authors: Basalamah Ali A. , Saleh Tariq , Albloushi Monirah , Alotaibi Faisal
Published: October 2024

Introduction: Hemispheric surgery is a multistep, highly effective, and radical surgical procedure in the treatment of drug-resistant epilepsy due to extensive unilateral hemispheric disease. The procedure ranges from a resective procedure (hemispherectomy) to disconnection (hemispherotomy) and has developed substantially over the last century from morbid to elegant, minimally invasive, and routinely practiced procedures. Bearing in mind the numerous articles that have been published on hemispherectomy and hemispherotomy, we aimed to highlight the top 100 cited and impactful articles to create familiarity with the topic. We anticipate that this will be a helpful guide for clinicians and academics navigating the literature on this subject. Methods: A Scopus title-based search on the top 100 most-cited articles on “hemispherectomy” and “hemispherotomy” was performed in September 2023 with no restrictions. The top 100 most-cited articles were then retrieved. The article title, first author, first author’s specialty, country of origin, first author’s institution at the time of publication, journal of publication, year of publication, citation count, and citations per year were collected. The Google Scholar database citation count for each paper was added for correlation and comprehensive coverage. Results: The top 100 most-cited articles were cited 92 times per paper on average. The publication dates ranged from 1949 to 2016. The most frequently cited article “Clinical outcomes of hemispherectomy for epilepsy in childhood and adolescence” with 307 citations was published by A.M. Devlin et al. (2003) in the journal Brain. The USA was the highest publishing country (41 articles). The highest-publishing journal was Neurology. The most prolific first authors were A. Smith, J. Schramm, and J. Villemure, each with four publications. The institution with the most contributions was McGill University and its affiliated Health Centers, with nine publications in total. Neurosurgery was the most common specialty among the first authors. Most of the included studies were cohort studies or case series. Conclusion: We identified the top 100 cited articles on hemispherectomy and hemispherotomy using the Scopus database and supplemented our results with Google Scholar. We highlighted the most prominent authors, institutions, countries, journals, and study designs and illuminated the historical development of hemispherectomy and hemispherotomy procedures, in addition to landmark and currently trending papers.
Evaluating the Safety of Stent-Assisted Endovascular Treatment for Unruptured Cerebral Aneurysms in Older Adults: Emphasizing the Role of Antiplatelet Therapy
Authors: Fujii Shoko , Fujita Kyohei , Hirai Sakyo , Takahashi Satoru , Matsubara Hirofumi , Shoda Kenji , Ishii Akira , Sakamoto Makoto , Nakagawa Ichiro , Higashi Toshio , Yoshimura Shinichi , Sumita Kazutaka , Enomoto Yukiko
Published: October 2024

Introduction: This study aimed to compare the outcomes and safety in patients aged ≥75 years and those aged <75 years who underwent stent-assisted endovascular treatment for unruptured cerebral aneurysms, specifically focusing on perioperative antiplatelet therapy (APT). Methods: This multicenter retrospective study comprised patients who underwent stent-assisted coiling (SAC) or flow diverter stent (FDS) placement for unruptured cerebral aneurysms. The primary outcome was defined as the composite outcomes of perioperative thromboembolic events, bleeding events, or death. Results: Among 632 patients, 533 (84.3%) were aged <75 years and 99 (15.6%) were aged ≥75 years. No significant differences were observed in the dual APT duration. The primary outcome occurred in 14.3% of patients aged <75 years and in 14.1% of those aged ≥75 years, with no significant difference (p = 1.0). The composites of the primary outcome, including thromboembolic events, bleeding events, and death differed insignificantly. Similar findings were observed when the primary outcomes for SAC (12.7% vs. 11.5%, p = 0.95) and FDS (17.5% vs. 18.4%, p = 1.0) were analyzed. The 30-day, 1-year, and 2-year cumulative event-free survival rates for the primary outcome were 89.5, 87.2%, and 85.2%, respectively, in patients aged <75 years, and 90.9%, 88.7%, and 87.0%, respectively, in those aged ≥75 years. These trends were similar (log-rank test, p = 0.92). Conclusion: No significant differences were observed in the rates of the primary outcomes between patients aged <75 years and those aged ≥75 years. Therefore, refraining from stent-assisted treatment for unruptured aneurysms based solely on age might be inappropriate.
Changes and Influencing Factors of Corneal Endothelial Cells and Central Corneal Thickness after Pediatric Cataract Surgery
Authors: Shi Jingyi , Wang Dandan , Xie Yang , Lu Ziyi , Zhang Ruiwen , Dou Renhui , Xie Mengjuan , Chen Ruru , Zhao Yun-e
Published: October 2024

Introduction: This study aimed to examine the impact of cataract surgery on the corneal endothelium and central corneal thickness (CCT) in pediatric patients, and to identify the factors associated with corneal alterations. Methods: This retrospective study included consecutive children undergoing bilateral or unilateral cataract surgery and intraocular lens implantation at the Eye Hospital of Wenzhou Medical University, with or without posterior capsulorhexis and anterior vitrectomy, and an age-matched normal control group. This study aimed to assess whether changes in corneal parameters, including CCT, corneal endothelial cell density (CD), average cell area (AVE), standard deviation of size (SD), coefficient of variation (CV), percentage of hexagonal cells (6A) before and after surgery, and endothelial cell loss (ECL) differed among the bilateral cataract, unilateral cataract, and control groups. Furthermore, the potential effects of anterior vitrectomy, axial length, preoperative anterior chamber depth, surgical duration, horizontal corneal diameter, intraoperative pupil diameter (PD), and the number of corneal sutures on corneal endothelial parameters and CCT were investigated. Results: A total of 107 eyes from 107 children were included in the study. In the bilateral cataract group, CD significantly decreased, AVE and CCT significantly increased, and ECL was significantly higher than in the control group. The unilateral cataract group also exhibited a significant increase in CCT. Additionally, the number of corneal sutures was negatively correlated with CD, and PD was negatively correlated with CV in the unilateral cataract group. Conclusion: Cataract surgery in pediatric patients results in increased CCT, reduced CD, and morphological changes in corneal cells. A greater number of corneal sutures and a smaller PD increased the risk of CD reduction and elevated CV in the unilateral cataract group, underscoring the need for ophthalmologists to minimize corneal damage in these children.
Real-Time Imaging Assessment of Stress-Induced Vascular Inflammation Using Heartbeat-Synchronized Motion Compensation
Authors: Jang Minseok A. , Song Joon Woo , Kim Ryeong Hyun , Kang Dong Oh , Kang Ungyo , Kim Hyun Jung , Kim Jin Hyuk , Park Eun Jin , Park Ye Hee , Lee Bo-Hyung , Kim Chi Kyung , Park Kyeongsoon , Kim Jin Won , Yoo Hongki
Published: October 2024

BACKGROUND:

Chronic mental stress accelerates atherosclerosis through complicated neuroimmune pathways, needing for advanced imaging techniques to delineate underlying cellular mechanisms. While histopathology, ex vivo imaging, and snapshots of in vivo images offer promising evidence, they lack the ability to capture real-time visualization of blood cell dynamics within pulsatile arteries in longitudinal studies.

METHODS:

An electrically tunable lens was implemented in intravital optical microscopy, synchronizing the focal plane with heartbeats to follow artery movements. ApoE
−/−
mice underwent 2 weeks of restraint stress before baseline imaging followed by 2 weeks of stress exposure in the longitudinal imaging, while nonstressed mice remained undisturbed. The progression of vascular inflammation was assessed in the carotid arteries through intravital imaging and histological analyses.

RESULTS:

A 4-fold reduction of motion artifact, assessed by interframe SD, and an effective temporal resolution of 25.2 Hz were achieved in beating murine carotid arteries. Longitudinal intravital imaging showed chronic stress led to a 6.09-fold (
P
=0.017) increase in myeloid cell infiltration compared with nonstressed mice. After 3 weeks, we observed that chronic stress intensified vascular inflammation, increasing adhered myeloid cells by 2.45-fold (
P
=0.031), while no significant changes were noted in nonstressed mice. Microcirculation imaging revealed increased circulating, rolling, and adhered cells in stressed mice’s venules. Histological analysis of the carotid arteries confirmed the in vivo findings that stress augmented plaque area, myeloid cell and macrophage accumulation, and necrotic core volume while reducing fibrous cap thickness indicating accelerated plaque formation. We visualized the 3-dimensional structure of the carotid artery and 4-dimensional dynamics of the venules in the cremaster muscle.

CONCLUSIONS:

Dynamic focusing motion compensation intravital microscopy enabled subcellular resolution in vivo imaging of blood cell dynamics in beating arteries under chronic restraint stress in real time. This novel technique emphasizes the importance of advanced in vivo imaging for understanding cardiovascular disease.
Tangled Physics: Knots Strain Intuitive Physical Reasoning
Authors: Croom Sholei , Firestone Chaz
Published: October 2024

Whereas decades of research have cataloged striking errors in physical reasoning, a resurgence of interest in intuitive physics has revealed humans’ remarkable ability to successfully predict the unfolding of physical scenes. A leading interpretation intended to resolve these opposing results is that physical reasoning recruits a general-purpose mechanism that reliably models physical scenarios (explaining recent successes), but overly contrived tasks or impoverished and ecologically invalid stimuli can produce poor performance (accounting for earlier failures). But might there be tasks that persistently strain physical understanding, even in naturalistic contexts? Here, we explore this question by introducing a new intuitive physics task: evaluating the strength of knots and tangles. Knots are ubiquitous across cultures and time-periods, and evaluating them correctly often spells the difference between safety and peril. Despite this, 5 experiments show that observers fail to discern even very large differences in strength between knots. In a series of two-alternative forced-choice tasks, observers viewed a variety of simple “bends” (knots joining two pieces of thread) and decided which would require more force to undo. Though the strength of these knots is well-documented, observers’ judgments completely failed to reflect these distinctions, across naturalistic photographs (E1), idealized renderings (E2), dynamic videos (E3), and even when accompanied by schematic diagrams of the knots’ structures (E4). Moreover, these failures persisted despite accurate identification of the topological differences between the knots (E5); in other words, even when observers correctly perceived the underlying structure of the knot, they failed to correctly judge its strength. These results expose a blindspot in physical reasoning, placing new constraints on general-purpose theories of scene understanding.
L2CEval: Evaluating Language-to-Code Generation Capabilities of Large Language Models
Authors: Ni Ansong , Yin Pengcheng , Zhao Yilun , Riddell Martin , Feng Troy , Shen Rui , Yin Stephen , Liu Ye , Yavuz Semih , Xiong Caiming , Joty Shafiq , Zhou Yingbo , Radev Dragomir , Cohan Arman , Cohan Arman
Published: October 2024

Recently, large language models (LLMs), especially those that are pretrained on code, have demonstrated strong capabilities in generating programs from natural language inputs. Despite promising results, there is a notable lack of a comprehensive evaluation of these models’ language-to-code generation capabilities. Existing studies often focus on specific tasks, model architectures, or learning paradigms, leading to a fragmented understanding of the overall landscape. In this work, we present L2CEval, a systematic evaluation of the language-to-code generation capabilities of LLMs on 7 tasks across the domain spectrum of semantic parsing, math reasoning, and Python programming, analyzing the factors that potentially affect their performance, such as model size, pretraining data, instruction tuning, and different prompting methods. In addition, we assess confidence calibration, and conduct human evaluations to identify typical failures across different tasks and models. L2CEval offers a comprehensive understanding of the capabilities and limitations of LLMs in language-to-code generation. We release the evaluation framework1 and all model outputs, hoping to lay the groundwork for further future research.

All future evaluations (e.g., LLaMA-3, StarCoder2, etc) will be updated on the project website: https://l2c-eval.github.io/.
Aristotle on the Perfections of Virtuous Action
Authors: Fernandez Patricio A.
Published: October 2024

In Nicomachean Ethics 2.4 Aristotle distinguishes between virtuous action and acting virtuously: a virtuous action counts as virtuously performed if done with knowledge, chosen for its own sake, and from a stable character. Since the ‘same’ action can be performed virtuously or non-virtuously, interpreters have concluded that these ‘agential conditions’ are indifferent incidental features with no bearing on the virtuous character of the action. I propose that they are instead ‘perfections,’ i.e., constitutive features of virtuous action as such, admitting of degrees. Unlike the alternative interpretation, my proposal fully harmonizes with three important Aristotelian doctrines: that action from virtue is prior to action merely in conformity with virtue; that character virtue is a perfection of human beings; and that practical life is not properly characterized in transitive, productive terms. My proposal still allows for a generic sense of ‘sameness’ in which the ‘same’ action may be virtuously or non-virtuously performed.
Imagining NAASR: Pasts and Futures
Authors: Martin Craig
Published: October 2024

What kind of institution has the North American Association for the Study of Religion (NAASR) been in the past? What might it become in the future? In this 2024 presidential address, Craig Martin reflects on the history of the institution, considers the shared interests and intellectual investments that have drawn people to it over the last two scholarly generations, and suggests a vision for the future which respects the past while simultaneously moving us forward.
To Consume or to Commune
Authors: Padgett Isaiah C.
Published: October 2024

This article investigates how the text of Ruth 2.8-16 might serve to enrich the continued development of Pentecostal economic ethics. The sheer dominance of capitalistic modes of the consumption of resources and the commodification of persons have prompted an ongoing interest in developing Pentecostal theological responses to this issue. While the influence of Prosperity Pentecostalism continues as one such response, the growing desire to articulate alternative theological critiques requires attention to the breadth of Scripture that speaks to these concerns. As such, this article will attempt to demonstrate how the initial interaction between Ruth and Boaz in Ruth 2.8-16 reflects a counter to modern notions of consumption and commodification. It will be argued that this interaction demonstrates both God’s ultimate ownership of creation and the necessity of inviting the other into community, both of which have profound implications for Pentecostal economic ethics.
‘Were Not Our Hearts Burning Within Us?’ (Luke 24:32): Dysregulated Passions, Righteous Fervour and an Emotional Regime Change in the Roman Empire
Authors: Schellenberg Ryan S.
Published: October 2024

Idioms describing specific emotional states with reference to hot or cold body temperatures are ubiquitous across cultural groups and appear to reflect the interpretive affordances of basic physiological processes. Thus high-arousal emotions tend to be associated with heat and low-arousal emotions with cold. Nonetheless, these associations are not universal but are shaped by cultural history. The description in the Gospel of Luke of the disciples’ ‘burning hearts’ provides an illuminating case study. Although often read by modern interpreters as a transparent metaphor for elation or excitement, ancient usage points in a decidedly different direction, reflecting a prevailing moral and medical assumption in the Greco-Roman world that the dysregulation of the body’s innate heat is a symptom of affective and physical disorder. If Luke’s phrase nonetheless depicts desirable feelings, it would appear to be a harbinger of a new chapter in the history of emotions wherein certain ‘hot feelings’ might be understood not as unregulated passions but rather righteous fervour.
Enhancing black soldier fly larval production from sugarcane bagasse through hydrothermal, enzymatic, and microbial treatment
Authors: Bothma M. , Teke G.M. , Pieterse E. , Diedericks D. , Van Rensburg E. , Görgens J.F. , Den Haan R.
Published: October 2024

In response to the urgent demand for environmentally responsible waste management alternatives, insects such as the black soldier fly (BSF) could be cultivated for the bioconversion of rich organic waste into biomass contents rich in fat and protein. Agricultural residues such as sugarcane bagasse is a renewable biomass source that has the potential to augment the inadequate quantity of suitable organic wastes currently available for insect feeding. However, this recalcitrant lignocellulosic material requires pretreatment to improve its digestibility by BSF larvae (BSFL). Hence, in this study, sugarcane bagasse (SB) was steam pretreated followed by biological treatments (enzymatic hydrolysis, microbial bioprocessing and a combination of both) with each feedstock subsequently tested in BSFL rearing trials. From the results it is clear that a combination of thermal and biological pre-treatments was essential to liberate sugar monomers for BSFL utilisation. Lignocellulose treatment using microbes without enzymes was not feasible for BSFL rearing due to limited in-situ cellulase enzyme production. However, enzymatic hydrolysis combined with microbial biotreatment of steam pre-treated bagasse led to a high bioconversion rate (13.4%), and associated increases in crude protein (33%) and fat (28%) contents of the larvae, which implied that this combined treatment was beneficial to BSFL rearing. These findings suggested that BSFL could be raised on lignocellulosic residues, while increases in protein and fat yields may be achieved through further process optimisation.
Interannual Variation of Global Surface Potential Vorticity Forcing in Boreal January and Its Link with Long-Persisting Droughts in Southwest China
Authors: Ma Tingting , Wu Guoxiong , Liu Yimin , Mao Jiangyu , Bao Wen
Published: October 2024

An increasing number of studies have recognized the essential influence of surface potential vorticity (PV) forcing on atmospheric circulation. In this study, we investigated the temporal characteristics of global surface PV forcing in January and its associated climate anomalies. The global surface PV forcing exhibited a pronounced decreasing trend, implying reduced forcing on atmospheric PV. Its interannual component was accompanied by cold winters on the Eurasian and North American continents and long-persisting droughts in southwest China (SWC), consistent with the coexistence of these extreme events. Based on the global surface PV forcing index, the mechanism underlying long-persisting droughts, which lasted from October to January, was investigated. The formation mechanisms of persistent drought varied monthly. Specifically, the occurrence of drought in October was closely related to Rossby wave activity over Eurasia, which enhanced the anomalous anticyclone over the Tibetan Plateau and subsequently induced air descent over SWC. In contrast, drought in November and December could be ascribed to La Niña events in the central Pacific, which facilitated subsidence over SWC through local meridional circulation anomalies. Distinct from other months, the combined effects of La Niña events and circulation anomalies over northern Eurasia caused the drought in January. The former reduced precipitation over southern SWC, whereas the latter influenced precipitation over central SWC. The present study provides novel insights into simultaneous extreme events in the Northern Hemisphere.

Significance Statement

Long-persisting droughts in southwest China (SWC) usually coexist with cold winters in the Eurasian and North American continents. Here, we suggested that the coexistence of these extremes was closely linked to interannual variability in global surface potential vorticity forcing. Based on this relationship, the mechanism underlying long-persisting droughts in SWC, lasting from October to January, was investigated. The formation of these droughts could be ascribed to Rossby wave activity over Eurasia in October and to La Niña events in the central Pacific in November and December. The drought in January was ascribed to the combined effects of La Niña and circulation anomalies over northern Eurasia. This study provides a broader view for understanding extremes that occurred simultaneously in the Northern Hemisphere.
Delayed Impact of Biomass Burning in the Indochinese Peninsula on the Bay of Bengal Monsoon
Authors: Yang Sixiao , Ji Zhenming
Published: October 2024

The Indochinese Peninsula experiences a dry season with extensive biomass burning peaking from March to April. As the monsoon arrives, rainfall significantly removes aerosols through deposition, ending the emission season. However, the biomass burning aerosols exert an influence on the atmospheric circulation prior to the monsoon onset. This study employed statistical methods and a regional atmosphere–chemistry model [WRF Model coupled with chemistry (WRF-Chem)] to investigate the delayed impact of biomass burning from the Indochinese Peninsula on the monsoon onset. The results indicate that the cold sea surface temperature anomaly caused by the aerosols during the emission season can be stored in the ocean and inhibit convective activities over the adjacent sea regions in the postemission season, suppressing the southwestward cross-equatorial flow over the southern Bay of Bengal. This suppression delays the westward extension and northward shift of the upper-level South Asian high pressure system, along with its divergence and subsidence effects, thereby postponing the breakdown and retreat of the subtropical high-pressure belt. Simultaneously, the cold sea temperature also suppresses the development of a warm pool in the southeastern Bay of Bengal, which is associated with the generation of a monsoon onset vortex. Consequently, the onset of the Bay of Bengal monsoon is delayed. Due to the decreasing delayed effects of aerosols over time and the counteractive warming from the accelerated abnormal anticyclonic circulation in the upper-level Bay of Bengal, which results in accelerated disappearance of the cold signal in sea surface, the delayed influence of aerosols diminishes gradually after the onset of the Bay of Bengal monsoon until it disappears.

Significance Statement

This study explores the correlation between spring biomass burning in the Indochinese Peninsula and the onset of the Bay of Bengal and South China Sea monsoons. The research reveals that biomass burning during the emission season might postpone the initiation of the Bay of Bengal monsoon, while it has minimal influence on the South China Sea monsoon. By employing sensitivity experiments using models, the study elucidates the underlying mechanisms responsible for these observed effects.
Familial hypercholesterolaemia with high triglycerides: A diagnostic challenge
Authors: Ahmed Suha , Elgizouli Marwa , Kilpatrick Eric S , Morris Timothy J
Published: October 2024

Combined or mixed hyperlipidaemia is characterised by hypercholesterolaemia together with high triglyceride concentrations. It is found in approximately 1 in 100 people in the United Kingdom. Most cases are secondary to an underlying condition such as the metabolic syndrome, diabetes mellitus (especially poorly controlled) or individuals with a high alcohol intake. Mixed hyperlipidaemia is also a feature of some primary hyperlipidaemia conditions such familial combined hyperlipidaemia (FCH) or type III hyperlipidaemia (dysbetalipoproteinaemia). One differential diagnosis for mixed hyperlipidaemia that can easily be overlooked is a patient with an underlying diagnosis of familial hypercholesterolaemia (FH) who also has a hypertriglyceridaemia due to any other cause. Those patients may have very high total and low-density lipoprotein cholesterol concentrations (LDL-C) with a moderately elevated triglyceride concentration. In this article, we report 4 cases of familial hypercholesterolaemia, confirmed by genetic testing, in patients initially presenting with hypertriglyceridaemia in addition to high total cholesterol and LDL-C. This article discusses the diagnostic challenges associated with this presentation and highlights the key role of directly measuring LDL-C to aid diagnosis in these specific situations.
Mobilizing Critical Occupational Therapy Praxis to Promote Structural Justice, Equity, and Rights
Authors: Restall Gayle
Published: October 2024

[Formula: see text]

Background. Societal structures and systems compel occupational therapists, at times, to behave in ways that perpetuate injustices. Justice theorists have described how Global North social structures have created the conditions for oppression of some groups while enabling additional groups to have unearned privileges. Mobilizing critical occupational therapy praxis is an essential response. Purpose. This lecture addresses three questions: why should occupational therapists integrate structural justice, equity, and rights into their everyday practices?; what gives occupational therapy the potential to be a structural justice-, equity-, and rights-oriented profession?; and, how can occupational therapy mobilize critical praxis that will promote structural justice, equity, and rights? Key issues. Occupational therapy's embeddedness in structures of injustice and therapists’ obligations to integrate justice, equity, and rights into their everyday practices are increasingly evident. A focus on occupational participation, growing critical consciousness, socially transformative practices, and capacity for collective action position occupational therapy to be a structural justice-oriented profession. Critical reflexivity and reflection; justice-, equity-, and rights-based lenses; and acts of resistance and disobedience to oppressive systems can help mobilize critical praxis. Implications. Occupational therapists have individual and collective opportunities for exercising the moral imagination and moral courage to mobilize critical occupational therapy praxis.
Quality of Life in Adolescent Athletes With Sport-Related Concussion Prescribed Heart Rate-Targeted Aerobic Exercise Within 10 Days of Injury
Authors: Bogdanowicz Ian , Plante Kyle , Leddy John , Master Christina , Haider Mohammad
Published: October 2024

Individualized aerobic exercise treatment prescribed within 10 days of injury facilitates recovery in adolescents after sport-related concussion (SRC) and reduces incidence of persisting post-concussive symptoms (PPCSs) beyond 4 weeks. The effect of aerobic exercise treatment on quality of life symptoms is, however, unknown. This planned secondary aim of a published randomized controlled trial found that while adolescents prescribed aerobic exercise recovered faster, there was no difference on the Pediatric Quality of Life (PedsQL) questionnaire scores during the 4-week intervention period. Nevertheless, adolescents who experienced PPCS reported significantly worse initial visit (within 10 days of injury) symptoms on the PedsQL than those who recovered within 4 weeks. Higher scores on the PedsQL correlated with greater initial visit concussion symptom burden and more abnormalities on a concussion-relevant visio-vestibular examination. Thus, the PedsQL captures the clinical severity of concussion and is prognostic of risk for delayed recovery when administered early after SRC in adolescents.
Recent Advances in Intraoral Scanners
Authors: Eggmann F. , Blatz M.B.
Published: October 2024

Intraoral scanners (IOSs) have emerged as a cornerstone technology in digital dentistry. This article examines the recent advancements and multifaceted applications of IOSs, highlighting their benefits in patient care and addressing their current limitations. The IOS market has seen a competitive surge. Modern IOSs, featuring continuous image capture and advanced software for seamless image stitching, have made the scanning process more efficient. Patient comfort with IOS procedures is favorable, mitigating the discomfort associated with conventional impression taking. There has been a shift toward open data interfaces, notably enhancing interoperability. However, the integration of IOSs into large dental institutions is slow, facing challenges such as compatibility with existing health record systems and extensive data storage management. IOSs now extend beyond their use in computer-aided design and manufacturing, with software solutions transforming them into platforms for diagnostics, patient communication, and treatment planning. Several IOSs are equipped with tools for caries detection, employing fluorescence technologies or near-infrared imaging to identify carious lesions. IOSs facilitate quantitative monitoring of tooth wear and soft-tissue dimensions. For precise tooth segmentation in intraoral scans, essential for orthodontic applications, developers are leveraging innovative deep neural network–based approaches. The clinical performance of restorations fabricated based on intraoral scans has proven to be comparable to those obtained using conventional impressions, substantiating the reliability of IOSs in restorative dentistry. In oral and maxillofacial surgery, IOSs enhance airway safety during impression taking and aid in treating conditions such as cleft lip and palate, among other congenital craniofacial disorders, across diverse age groups. While IOSs have improved various aspects of dental care, ongoing enhancements in usability, diagnostic accuracy, and image segmentation are crucial to exploit the potential of this technology in optimizing patient care.
Periodontitis and Diabetes Differentially Affect Inflammation in Obesity
Authors: SantaCruz-Calvo S. , Saraswat S. , Hasturk H. , Dawson D.R. , Zhang X.D. , Nikolajczyk B.S.
Published: October 2024

Periodontitis (PD) potentiates systemic inflammatory diseases and fuels a feed-forward loop of pathogenic inflammation in obesity and type 2 diabetes (T2D). Published work in this area often conflates obesity with obesity-associated T2D; thus, it remains unclear whether PD similarly affects the inflammatory profiles of these 2 distinct systemic diseases. We collected peripheral blood mononuclear cells (PBMCs) from cross-sectionally recruited subjects to estimate the ability of PD to affect cytokine production in human obesity and/or T2D. We analyzed 2 major sources of systemic inflammation: T cells and myeloid cells. Bioplex quantitated cytokines secreted by PBMCs stimulated with T cell– or myeloid-targeting activators, and we combinatorially analyzed outcomes using partial least squares discriminant analysis. Our data show that PD significantly shifts peripheral T cell– and myeloid-generated inflammation in obesity. PD also changed myeloid- but not T cell–generated inflammation in T2D. T2D changed inflammation in samples from subjects with PD, and PD changed inflammation in samples from subjects with T2D, consistent with the bidirectional relationship of inflammation between these 2 conditions. PBMCs from T2D subjects with stage IV PD produced lower amounts of T cell and myeloid cytokines compared with PBMCs from T2D subjects with stage II to III PD. We conclude that PD and T2D affect systemic inflammation through overlapping but nonidentical mechanisms in obesity, indicating that characterizing both oral and metabolic status (beyond obesity) is critical for identifying mechanisms linking PD to systemic diseases such as obesity and T2D. The finding that stage IV PD cells generate fewer cytokines in T2D provides an explanation for the paradoxical findings that the immune system can appear activated or suppressed in PD, given that many studies do not report PD stage. Finally, our data indicate that a focus on multiple cellular sources of cytokines will be imperative to clinically address the systemic effects of PD in people with obesity.
Evaluation of alternative joining methods in softshell fabric types
Authors: Boz Serkan , Oral Oksan , Dirgar Esra
Published: October 2024

Parameters such as high performance, durability and comfort are very important in protective and sports clothing produced to increase the technical or functional properties of clothing products, as well as aesthetic and decorative features. Fabrics that provide comfort to the user by regulating body temperature, protect against harsh weather conditions, and are waterproof and windproof, as well as breathable, are used for these purposes. One of the most important fabrics with these features is the fabric called ‘softshell’. Softshell is a fabric specially created to release moisture and regulate body temperature. Therefore, the outer layer of the softshell is not waterproof, but water-repellent, ensuring that it remains dry and protective while a person is wearing it. Creating a three-dimensional product from a two-dimensional fabric with these features is achieved through the sewing process. As traditional methods are used in the sewing process, an alternative joining method called ‘ultrasonic joining’ can also be used. While alternative joining methods provide joining without sewing thread, these methods do not create holes in the fabric surfaces since there is no sewing needle. Joining processes with thermal, laser and ultrasound energy are based on the principle of melting, fusing and cooling the joined surfaces. In this study, it was aimed to analyze the change in the physical properties of different softshell fabrics as a result of joining them with classical and innovative sewing/joining methods. In this context, lockstitch, lockstitch & tape welding, ultrasonic welding, and ultrasonic welding & tape welding are applied to the softshell, ripstop softshell and Lycra softshell fabrics used in the market. The thickness, air permeability, seam strength and elongation at break properties of the bonded fabrics were examined. Within the scope of this study, obtaining successful results in softshell fabric types, which is one of the bulky fabrics, contributes to the idea that the usage area of ultrasonic welding will expand day by day.
Applying Evidential Pluralism to Justify Legal Responses to Online Fake News
Authors: Trofimov Alexandra
Published: October 2024

The aim of this paper is to argue that Evidential Pluralism ought to be used to evaluate the impact of online fake news. To support this, I show how an application of Evidential Pluralism can overcome difficulties in assessing the impact of online fake news. The significance of this is twofold. Firstly, the application of Evidential Pluralism enables an evidence-based justification for legal interventions aimed at tackling online fake news. Secondly, the application of Evidential Pluralism to the problem of online fake news provides a case study example to motivate a new methodology for evidence-based law, called EBL+.
Bridging the Past, or Breaking From It? Leader Continuity Rhetoric and Nontarget Employee Diversity Initiative Support
Authors: Kukula Anastasia , Reinwald Max , Kanitz Rouven , Hoegl Martin
Published: October 2024

Organizations launch diversity initiatives to promote diversity within their ranks, improve the work experiences of underrepresented groups, and satisfy growing demands for diversity in workplace settings. While typically welcomed by the target group, diversity initiatives can be compromised when employees who are not the initiative’s targets—for example, men in the case of gender diversity initiatives—withhold their support. Particularly organizations that are mostly composed of nontargets may thus struggle with a lack of support for their diversity initiatives. To understand how organizations can successfully implement diversity initiatives while preserving nontarget support, we take an uncertainty management perspective and examine the interactive effects of diversity practice type (identity-conscious vs. identity-blind) and leader continuity rhetoric (high vs. low vision of continuity) on nontarget support. In Study 1, using data from a 2 × 2 between-person field experiment in a firefighter organization, we find that framing the initiative under a vision of high (vs. low) continuity preserves nontargets’ anticipatory distributive justice in the face of identity-conscious (vs. identity-blind) practices and thereby promotes initiative support. Study 2, a vignette experiment, replicates our findings and shows that other justice dimensions above and beyond distributive justice appear secondary in this context. Our work has important implications for managing the initiation phase of diversity initiatives in organizations primarily composed of nontargets in a way that fosters nontargets’ perceived justice and support.
Historical Cohort Differences in Views on Aging in the US: A Trend Toward Longer Midlife but Older Felt Age
Authors: Ennis Stephanie K. , Gehring Moritz , Wurm Susanne
Published: October 2024

This study compared equal age groups from two cohorts from the Midlife in the United States (MIDUS) study surveyed at different times to characterize societal changes in measures of subjective age and age threshold. Two successive MIDUS cohorts were utilized (1995–1996 and 2011–2014; age range 25–74). Outcomes included subjective age (felt age and desired age) and age threshold. Following multiple imputations of missing data and balancing methods, weighted linear regression measured associations between subjective age outcomes and cohort, sex, and chronological age. Individuals of the later MIDUS cohort reported older felt age and younger desired age in middle age groups (35–64 years old). An increase in age threshold was observed only in older age groups (65+). Possible underlying historical changes in health and societal age stereotypes are explored to explain the observed trend toward older felt age and age threshold, but a younger desired age.
Veno-arterial extracorporeal membrane oxygenation as bridge for fluid resuscitation in a patient with acute respiratory failure and circulatory shock two years post lung transplantation
Authors: Segura Ana , Bobba Christopher , Rackauskas Mindaugas , Gries Cynthia , Emtiazjoo Amir M , Maybauer Marc O
Published: October 2024

Background

The use of extracorporeal membrane oxygenation (ECMO) continues to evolve and is recognized as an important adjunct as a bridge to recovery or a bridge to transplant. We wanted to share our experience of using veno-arterial (VA) ECMO as an adjunct to lung recovery and an aide for fluid resuscitation.

Case description

We present the case of a 77-year-old man with a history of previous single lung transplant who had acute respiratory decompensation and cardiovascular collapse secondary to CMV pneumonia and septic shock. He was cannulated for VA ECMO, treated for CMV pneumonia and resuscitated with 5 L of albumin 5% and antibiotics, within 12 hours of cannulation. He required two days of VA ECMO and was ultimately decannulated and discharged to a rehabilitation facility on hospital day 73.

Conclusion

This case emphasizes the challenging clinical scenario of fluid resuscitation in a lung transplant patient. With adequate patient selection, a multidisciplinary team and the use of VA ECMO, success can be achieved.
Effectiveness of rigid plate fixation for sternal closure in patients with a high risk of deep sternal wound infection
Authors: Nakamura Hiromasa , Miura Yujiro , Yoshida Keisuke , Edo Naoki , Saito Ren , Orihashi Kazumasa
Published: October 2024

Objective

Median sternotomy is a standard approach in cardiovascular surgery, and wire fixation is commonly used for sternal closure. However, postoperative intermittent stress on the sternum can lead to sternal breakdown, potentially resulting in deep sternal wound infection (DSWI). Sternal closure with rigid plate fixation was recently reported to be effective for preventing DSWI and promoting sternal healing. We investigated the effectiveness of a rigid plate fixation system in patients at a high risk of developing DSWI.

Methods

This retrospective observational study evaluated the incidence of DSWI and the progression of postoperative sternal fusion observed on computed tomography. Forty-eight patients at a high risk of DSWI who underwent sternal closure with a rigid plate fixation system between 2020 and 2023 were assessed.

Results

Among the 48 patients, 1 (2.1%) developed DSWI requiring surgical treatment. Sternal fusion improved over time, with significant progression observed during the follow-up period compared with the early postoperative period. Additionally, patients who did not show sternal fusion in the early postoperative period showed progressive fusion during follow-up.

Conclusions

The rigid plate fixation system prevents sternal displacement and may be beneficial in preventing DSWI by maintaining and promoting sternal fusion in high-risk patients.
Biomarkers of insulin sensitivity/resistance
Authors: Kosmas Constantine E , Sourlas Andreas , Oikonomakis Konstantinos , Zoumi Eleni-Angeliki , Papadimitriou Aikaterini , Kostara Christina E
Published: October 2024

In recent years, remarkable advancements in elucidating the intricate molecular underpinnings of type 2 diabetes mellitus (T2D) have been achieved. Insulin resistance (IR) has been unequivocally acknowledged as the driving pathogenetic mechanism of T2D, preceding disease onset by several years. Nonetheless, diagnostic tools for ascertaining IR are lacking in current clinical practice, representing a critical unmet need; use of the hyperinsulinemic-euglycemic glucose clamp, widely accepted as the gold standard method for evaluating IR at present, is cumbersome in a clinical setting. Thus, the development of well-validated, reliable, and affordable biomarkers of IR has attracted considerable attention from the research community. The biomarkers under investigation can be divided into two major categories: (1) indices or ratios, comprising parameters obtained from a basic or comprehensive metabolic panel and/or derived from anthropometric measurements, and (2) circulating molecules implicated in pathophysiological processes associated with IR. Furthermore, numerous novel biomarkers, including markers of β-cell dysfunction, radiographic quantification of excess visceral adipose tissue, T2D prediction models, certain microRNAs and metabolomic biomarkers, have also provided promising preliminary results. This narrative review aims to present current evidence pertaining to the most notable and exciting biomarkers of IR that are under rigorous evaluation.