bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of internal limiting membrane peeling on the inner retinal layers in patients without macular pathology
Authors: Belkin Avner , Harel Gal , Shtayer Chen , Bercovich Or , Rubowitz Alexander
Published: January 2024

Background:

To examine the effect of internal limiting membrane (ILM) peeling on the inner retinal layers in patients without macular pathology.

Methods:

A prospective nonrandomized trial of patients undergoing pars plana vitrectomy with ILM peeling for pathology outside of the macula was performed. Optical coherence tomography (OCT) including macular ganglion cell layer (GCL), inner plexiform layer (IPL) and peripapillary retinal nerve fiber layer imaging was performed prior to surgery, 1,3 and 6 months post-operatively and at the end of follow up (ranges between 4-17 months). Patients with any macular pathology on OCT prior to surgery were excluded. The main outcome measure was change in thickness of the GCL and IPL.

Results:

Ten patients who underwent pars plana vitrectomy with ILM peeling for macula-on retinal detachment were included in the analysis. The mean age was 55 years and the mean follow up was 10.8 months. All patients completed at least 2 post-operative follow up visits that included an OCT as per the protocol (range 2-6 months). There was an immediate reduction in the global (G), infero-temporal (IT), supero-temporal (ST) and superior (S) GCL thickness at the first follow up as compared to the pre-operative state (P=0.028, P=0.027, P=0.026 and P=0.027 respectively). From the first follow up visit onward until the final follow up the thinning persisted, though there was no further statistically significant thinning.

Conclusion:

Peeling of the ILM causes significant GCL thinning in maculae without pathology prior to surgery. At up to 17 months of follow up, this effect seems to be immediate and non-progressive.
Does Bevacizumab Improve Outcomes After Ahmed Glaucoma Valve Implantation for Refractory Glaucoma?: A Meta-Analysis
Authors: Tran Luke , Vo Joanne , Bell Katharina , Perera Shamira , Crowston Jonathan
Published: January 2024

Précis:

Mean intraocular pressure (IOP), complete and overall success, mean IOP-lowering medications, incidence of hypertensive phase, and complications were found to be comparable between patients undergoing Ahmed glaucoma valve implantation (AGVI) with adjunctive bevacizumab versus AGVI alone.

Objective:

This meta-analysis aims to assess how adjunctive bevacizumab impacts the surgical outcomes of AGVI compared with AGVI alone in all subtypes of refractory glaucoma.

Methods:

A systematic search of databases for relevant randomized controlled trials (RCTs) was performed in March 2023. Primary outcomes included mean IOP and success rates. Secondary outcomes were mean IOP-lowering medications, incidence of hypertensive phase, and complications. Qualitative assessment, meta-analysis, subgroup analyses, and sensitivity analysis were performed.

Results:

Five RCTs comprising 203 eyes were included in the quantitative analysis. Initial meta-analysis showed a strong yet nonsignificant trend (all P > 0.05) favoring adjunctive bevacizumab in all outcomes of interest. Significant heterogeneity was observed for mean IOP and success outcomes at all time points (all I
2 > 50%). Subgroup analysis of the administration route revealed a reduced incidence of hyphaema in the intravitreal bevacizumab subgroup (odds ratio: 0.10; 95% CI: 0.02 to 0.59; P = 0.01) with significant heterogeneity persisting in the intravitreal bevacizumab subgroup for all measures (all I
2 > 50%). Post hoc sensitivity analysis of studies without concurrent pan-retinal photocoagulation for mean IOP and success outcomes demonstrated more conservative effect sizes with a corresponding decrease in heterogeneity for all measures (all I
2 < 30%).

Conclusion:

Published studies investigating the role of adjunctive bevacizumab show a strong trend to improve outcomes but contain a relatively small number of participants. This analysis underpins the need for an adequately powered RCT to explore the role of anti-vascular endothelial growth factor agents in AGVI surgery.
Pilot Study of a Software Application to Identify Trauma Registry Inconsistencies
Authors: Roden-Foreman Jacob W. , Garlow Laura , Riordan Kathleen M. , Edlund Susie , Suarez Valerie
Published: January 2024

BACKGROUND:

Trauma registries are essential to the functioning of modern trauma centers, and high-quality data are necessary to identify patient care issues, develop evidence-based practice, and more. However, institutional experience suggested existing methods to evaluate data quality were insufficient.

OBJECTIVE:

This study aims to compare a new software application developed at our trauma center to our existing trauma registry platform on the ability to identify registry inconsistencies (i.e., potential data quality issues).

METHODS:

We conducted a pilot retrospective cohort study of patients from September 2019 to August 2020 who underwent chart review during a Level I verification visit and had been audited several times for accuracy. Registry records were processed by both validation systems, and registry inconsistencies were recorded.

RESULTS:

In registry data for 63 patients, the new software found 225 registry inconsistencies, and the registry systems found 153 inconsistencies. The most frequent inconsistencies identified by the new software were missing or unknown procedure start times, with 18/63 (28.6%) patients affected and prehospital supplemental oxygen being blank, with 29/53 (54.7%) patients with prehospital care affected. None of the 10 most common inconsistencies detected with the registry systems were true issues.

CONCLUSIONS:

This study found the new software application identified 47% more inconsistencies than the standard registry systems, and none of the most frequent inconsistencies detected with the registry systems were true issues pertinent to institutional practice. Centers should consider additional methods to identify registry inconsistencies as existing processes appear insufficient.
Preliminary discussion on the mechanism of active components of Radix Aconiti kusnezoffii in the treatment of migraine based on network pharmacology
Authors: Wu Siqinbilige , Baolechaolu  , Hongmei  , Huhemuren  , Bai Changxi , Gao Jingxian
Published: January 2024

To investigate the mechanism of action of Cao Wu in the treatment of migraine from the perspective of network pharmacology. The Swiss Target Prediction Database and CTD database were used to predict the target information of Cao Wu. Human Genome Database gene cards were used to find migraine-related target genes. The target protein interaction network and the “active ingredient-target” network were obtained by combining Cytoscape 3.7.1 software and R language. Enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes pathway and gene function analysis (GO) were performed using the R language to preliminarily explore the multiple pharmacological mechanisms of Radix Aconiti kusnezoffii. Forty-three indicators were identified. A total of 176 migraine targets were identified through the genecards database and OMIM database. Radix Aconiti kusnezoffii targets were compared with migraine targets and 12 overlapping targets were extracted. The protein interaction network of the overlapping targets was analyzed to identify the key targets for the drug to affect the disease. In addition, Kyoto Encyclopedia of Genes and Genomes pathway and go function enrichment analyses were performed on the overlapping targets to explore the therapeutic mechanism of migraine. The treatment of migraine with herbal woo is characterized by multi-component, multi-target, and multi-channel, which exerts complex network regulation through the interaction between different targets, providing a new idea and basis for further exploring the mechanism of action of herbal woo in the treatment of migraine.
Evidence-based evaluation of adjuvant therapy with Chinese medicine for cerebral small vessel disease: A systematic review and meta-analysis
Authors: Xu Yaqian , Chen Bowei , Yi Jian , Liu Baiyan
Published: January 2024

Background:

As the population ages, the prevalence of cerebral small vessel disease (CSVD) steadily increases, resulting in a significant economic burden on society. In East Asian nations, Chinese medicine has been used extensively to teat CSVD and has been reported to improve the cognitive function of patients. The present study aimed to comprehensively assess the efficacy and safety of Chinese medicine as adjuvant therapy for CSVD.

Methods:

A literature search of the CNKI, Wanfang, VIP, SinoMed, Medline, Cochrane Library, and ChiCTR databases were searched for RCTs investigating the use of TCM as an adjuvant in the treatment of CSVD, published up to July 27, 2023, was performed. Based on the Cochrane Collaboration Network bias risk assessment criteria, Review Manager version 5.3 was used to perform a meta-analysis.

Results:

Meta-analysis of 27 RCTs, including 2554 subjects, revealed that the majority of the RCTs exhibited risk for ambiguous bias. The findings demonstrated that the use of Chinese medicine as an adjuvant treatment for CSVD effectively enhanced the cognitive function, as evidenced by improvements in the MMSE score (mean difference (MD) = 2.42, 95% confidence interval (CI) [1.79,3.17], P < .00001), MoCA score (MD = 2.39, 95% CI [1.78,2.99], P < .00001) and ADL score (MD = 4.13, 95% CI [1.74,6.51], P = .0007). Furthermore, the study also demonstrated the advantages of Chinese medicine adjuvant therapy in enhancing the Chinese medicine syndrome score (MD = −2.57, 95% CI [−3.31, −1.83], P < .00001), CRP (MD = −1.35, 95% CI [−2.27, −0.43], P = .004), Hcy (MD = −3.44,95% CI [−4.05, −2.83], P < .00001), and blood flow velocity (CBV) (MD = 1.37,95% CI [0.24,2.50], P = .02). Moreover, there was no statistical difference in the incidence of adverse reactions between the 2 groups.

Conclusion:

Findings of the present study indicate that the Chinese medicine, as an adjuvant to conventional treatment, appeared to be efficacious in enhancing cognitive function, reducing Chinese medicine syndrome score, improving blood biochemical markers, and improving cerebral blood flow perfusion in patients with CSVD, without any notable adverse reactions. However, it is imperative to validate these conclusions in future high-quality investigations.
Effects of stepped speech rehabilitation and psychological intervention on speech disorders and cognitive function in Parkinson disease patients
Authors: Wang Liping , Qi Chengyan , Gu Minmin , Yan Min , Qi Qinde
Published: January 2024

To examine the impact of stepwise speech rehabilitation exercise therapy in the treatment of patients with Parkinson speech problems under psychological intervention on clinical results and cognitive functioning. Parkinson speech disorder patients who met the inclusion criteria were selected and divided into a control group and an observation group for training respectively. The control group used conventional nursing methods, including training in orofacial movement, vocalization, pitch, volume and breath control. The observation group used stepwise speech rehabilitation exercise intervention combined with psychotherapy nursing programme. In the statistical analysis, independent sample t-test and chi-square test were used to test the significance of the data processing methods. In the statistical analysis of baseline functional level (P > .05). The difference was not statistically significant. After 7 weeks of training, the mFDA level and speech intelligibility increased in both the observation and control groups. From the situation analysis of “modified drinking test” and the comparison of UPDRS-I scores, it can be seen that dysphagia and Parkinson dysphasia were reduced in both groups after training. The observation group spontaneous speech dimension was greater than the control group by around 0.07 in the aphasia comparison. Both groups displayed an upward trend in their MMSE and Montreal Cognitive Assessment (MoCA) when measuring cognitive function; the evaluation of P300, constructive function, and quality of life revealed this. The observation group P300 potential score was 0.13 points higher than that of the control group. The therapeutic training of stepped speech rehabilitation exercise care combined with psychological intervention has significant nursing effects on patients with Parkinson disease speech disorders, and the patients’ cognitive functions have been effectively improved.
New diagnostic strategy for multiple myeloma: A review
Authors: Xu Ligong , Wu Shuang
Published: January 2024

Multiple myeloma (MM) is the second most prevalent hematological malignancy and is distinguished by the aberrant proliferation of monoclonal plasma cells inside the bone marrow and production of M-protein. This condition frequently results in bone deterioration, acute kidney damage, anemia, and hypercalcemia. However, the clinical manifestations and accompanying symptoms of MM vary and may change as the condition evolves. Therefore, diagnosis of MM is difficult. At present, the confirmation of MM diagnosis necessitates the use of bone marrow biopsy, a procedure that is both invasive and challenging for assessing dynamic alterations in the disease. The integration of laboratory testing technologies with imaging technology has the potential to enhance the diagnostic effectiveness and provide a thorough evaluation of disease progression and prognosis in patients with MM. All the examination methods have advantages and disadvantages. Therefore, diagnosis is determined by the application of clinical characteristics, serological tests, and imaging investigations.
Effects of stem cell factor in follicular fluid and granulosa cells on oocyte maturity and clinical pregnancy
Authors: Wang Xu , Zhou Lixiang , Xu Anli , NIMA Dunzhu , Dong Zhaomei
Published: January 2024

Stem cell factor (SCF) is implicated in cell growth, proliferation, differentiation, migration, and apoptosis. SCF in follicular fluid (FF) and granulosa cells (GCs) plays a key role in oocyte maturation and clinical pregnancy; however, the exact mechanism is unclear. We aimed to investigate SCF potential in predicting oocyte maturity and clinical pregnancy. We collected 60 FF and 60 GCs samples from different patients with infertility. Real-time polymerase chain reaction and cellular immunofluorescence analyses were used to quantitatively and qualitatively determine SCF concentration in GCs; enzyme-linked immunosorbent assay was used to determine SCF concentration in FF. GC and FF SCF concentrations were positively correlated with metaphase (M)II oocyte proportion and clinical pregnancy (R = 0.280, 0.735 vs R = 0.257, 0.354). SCF concentrations in GCs were significantly higher in the clinical pregnancy group than in the nonclinical pregnancy group. Immunofluorescence analysis showed that SCF expression was higher in the clinical pregnancy and high-MII -oocyte proportion groups. Receiver operating characteristic curve analysis showed that combined SCF and serum anti-Müllerian hormone levels could predict oocyte maturity and clinical pregnancy better than either of these factors alone. SCF concentration in GCs and FF can serve as a predictor of oocyte maturity and clinical pregnancy.
The efficacy of newly proposed gastric open peroral endoscopic myotomy (GO-POEM) in preventing post-endoscopic submucosal dissection stenosis: A comparison with non-GO-POEM group
Authors: Cho Bong Ju , Lee Won Dong , Song Jae Sun , Yang Min A. , Kim Byung Sun , Yang Sung Yeol , Jung Gum Mo , Kim Ji Woong , Cho Yong Keun , Cho Jin Woong
Published: January 2024

Extensive endoscopic submucosal dissection (ESD) for gastric adenoma or early cancer can lead to post-ESD stenosis. This may cause a decrease in quality of life and an increase in medical issues. Therefore, this study examined the safety and effectiveness of gastric open peroral endoscopic myotomy (GO-POEM) in preventing stenosis following ESD. A retrospective investigation was carried out on 31 patients who underwent gastric ESD for > 75% of the lumen in the antrum or pylorus at the Presbyterian Medical Center in Korea between December 2004 and October 2022. The patients were divided into GO-POEM (n = 11) and non-GO-POEM groups (n = 20). The average age of the 31 patients was 73.23 years, and 18 were male. There were no differences in age, sex, location, gross findings, or procedure time between the 2 groups. In the GO-POEM group, only 1 patient (9 %) developed stenosis, compared to 11 patients (55 %) in the control group (P = .02). Multivariate analysis showed that the GO-POEM group had a significantly lower risk of post-ESD stenosis (P < .05). Stenosis symptoms resolved with a single endoscopic balloon dilatation (EBD) in 1 patient in the GO-POEM group. In contrast, 5 of 11 patients with stenosis in the non-GO-POEM group required a median of 2 EBD sessions (range, 1–8). GO-POEM may be an effective and reliable method for preventing stenosis post extensive gastric ESD. Further investigations are necessary to establish its efficacy and safety.
Ultrasound assessment of the brachial plexus nerve root cross-sectional areas in asymptomatic patients with type 2 diabetes
Authors: Kotb Mamdouh Ali , Bedewi Mohamed A. , Almalki Daifallah Mohamed , AlAseeri Ali Abdullah , Sandougah Kholoud J. , Soliman Steven B. , Aldossary Nasser M. , Aboulela Wael Hamed
Published: January 2024

Type 2 diabetes mellitus (T2D) is one of the most common metabolic diseases and is often associated with cervical radiculoplexus neuropathies. Magnetic resonance imaging is the modality of choice for evaluating the brachial plexus, however, the use of ultrasound for its evaluation has increased and has been shown to be an additional reliable method. We aimed to compare the cross-sectional areas of the C5, C6, and C7 nerve roots of the brachial plexus, at the interscalene groove, in asymptomatic patients with T2D to that of an asymptomatic control cohort without T2D. A total of 25 asymptomatic patients with T2D were recruited from outpatient clinics. A total of 18 asymptomatic subjects without T2D were also recruited from hospital staff volunteers to form the control cohort. High-resolution ultrasound imaging of the bilateral C5, C6, and C7 nerve roots of the brachial plexus was performed in the short axis, at the level of the interscalene grooves. The nerve root cross-sectional areas were recorded and compared. In the patients with T2D, HbA1c and fasting blood glucose (FBG) levels were obtained as well as the duration of T2D in years and correlated with cross-sectional areas. The cross-sectional areas of C6 and C7 were significantly smaller in the T2D cohort. Additionally, HbA1c, and FBG levels as well as the duration of T2D were negatively correlated with the C5, C6, and C7 cross-sectional areas. Our study demonstrated smaller brachial plexus nerve root cross-sectional areas in asymptomatic patients with T2D which negatively correlated with HbA1c, and FBG levels as well as the duration of T2D.
Effects of blue-light-filtering intraocular lenses on contrast sensitivity in patients with glaucoma
Authors: Kitnarong Naris , Udomwech Lunla , Chongthurakit Nisarate , Phongsuphan Theerajate , Petchyim Sakaorat
Published: January 2024

To compare the effects of blue-light-filtering intraocular lenses (BF-IOLs) and conventional ultraviolet-blocking intraocular lenses (UVB-IOLs) on contrast sensitivity in patients with concurrent cataracts and glaucoma. This prospective randomized comparative interventional study enrolled glaucomatous patients with concurrent cataracts scheduled for cataract surgery with IOL implantation at Siriraj Hospital, Bangkok, Thailand, between October 2016 and March 2018. The patients were randomly assigned to receive BF-IOLs or UVB-IOLs. A functional vision analyzer measured contrast sensitivity at spatial frequencies of 1.5, 3.0, 6.0, 12.0, and 18.0 cycles per degree (CPD). The contrast sensitivity values of the 2 patient groups were compared at 2 months postoperatively. The study enrolled 42 eyes (21 with primary angle-closure glaucoma and 21 with primary open-angle glaucoma) of 32 patients. Twenty eyes received BF-IOLs, and 22 received UVB-IOLs. Postoperative logarithmic contrast sensitivity (log contrast sensitivity) significantly improved at each spatial frequency in both groups, except for 1.5 CPD. The median postoperative log contrast sensitivity values for the spatial frequencies of 1.5, 3.0, 6.0, 12.0, and 18.0 CPD for the BF-IOL group were 1.6, 1.9, 1.8, 1.4, and 0.6, respectively, compared to 1.4, 1.8, 1.7, 1.2, and 0.8 for the UVB-IOL group. However, the 2 groups had no significant differences in log contrast sensitivity values at each spatial frequency (P = .20, .37, .30, .28, and .68, respectively). Cataract surgery with IOL implantation improved contrast sensitivity in glaucomatous patients. The BF-IOLs and UVB-IOLs showed no statistically significant difference in the postoperative contrast sensitivity achieved at each spatial frequency.
3D printing-assisted total hip arthroplasty and internal fixation for the treatment of fresh acetabular fracture and femoral head necrosis: A case report
Authors: Chen Yong , Zhang Bin
Published: January 2024

Rationale:

Posterior wall comminuted fractures of the acetabulum are typically caused by high-energy trauma, and the complex anatomical structure of the acetabulum makes their treatment challenging. However, reports of the treatment of fresh acetabular fractures combined with femoral head necrosis are extremely rare.

Patient concerns:

A 57-year-old male, injured in a car accident, presented with right hip pain and limited mobility. At the age of 50, the patient was diagnosed with avascular necrosis of the right femoral head, experiencing right hip pain and a limp while walking, for which conservative treatment was initiated.

Diagnosis:

The patient was clinically diagnosed with fresh comminuted posterior wall acetabular fracture and late-stage femoral head necrosis.

Interventions:

We applied 3D printing technology and computer-assisted virtual surgical techniques for preoperative planning, simulated fracture reduction, and designed personalized bone plates and screws for fixation of the posterior wall of the acetabulum. A single-stage total hip arthroplasty was performed to treat femoral head necrosis.

Outcomes:

He began walking with the assistance of a walker 1 month after surgery, and at 6 months post-surgery, the acetabular posterior wall fracture had effectively healed, allowing the patient to return to work.

Lessons:

The application of 3D printing technology in acetabular internal fixation and total hip arthroplasty is helpful for fracture assessment, facilitates smooth surgery, promotes fracture reduction and healing, restores hip joint function, and ensures a high level of safety.
A Review of an Interfacility Transport Program Pediatric Stroke Clinical Practice Guideline
Authors: Arends Grace , Perry Elizabeth , Sherman Ashley , Flint Jennifer
Published: January 2024

Background

Pediatric acute ischemic stroke is a rare diagnosis that requires timely recognition and definitive management to prevent morbidity and mortality. Children often present to primary care offices, urgent care clinics, and adult emergency departments for evaluation of symptoms that may be signs and symptoms of stroke. Currently, there are no published prehospital or transport protocols specific to pediatric acute ischemic stroke. The Children's Mercy Hospital Critical Care Transport Team (CMCCT) created a pediatric-specific clinical practice guideline (CPG) for suspected acute ischemic stroke.

Methods

This retrospective, descriptive study reports pediatric patients aged younger than 18 years who met criteria for the pediatric stroke CPG and required interfacility transport by CMCCT over a 4- year period. Large vessel occlusion (LVO) scores used in adults were calculated retrospectively.

Results

Seventeen patients met inclusion criteria. Four (24%) of 17 had radiographic evidence of acute thrombus, 3 of whom received alteplase and/or endovascular clot retrieval. Median age of confirmed stroke was 83 months (interquartile range, 65–148) compared with 177 months for nonstroke (interquartile range, 169–191), P = 0.126. The most common presenting symptom was hemiplegia in the confirmed stroke group. The confirmed stroke group scored significantly lower on the Glasgow Coma Scale (median of 8 vs 15, P = 0.014), significantly higher on the Los Angeles Motor Scale LVO score (median 4 vs 0, P = 0.021), and significantly higher on the Rapid Arterial Occlusion Evaluation LVO (median 4 vs 0, P = 0.036).

Conclusions

To our knowledge, the CMCCT CPG is the first pediatric transport protocol aimed at recognition and management of pediatric stroke described in the literature. Retrospective calculation of LVO scores show that they may be helpful in application to pediatric patients.
Subfascial Mini–Muscle Release Dual-Plane Technique: A Modified Procedure for Breast Augmentation
Authors: Xia Zenan , Xie Jiangmiao , Zhang Wenchao , Wang Xiaojun , Zheng Yongjian , Zeng Ang
Published: January 2024

Background:

Each breast augmentation technique has advantages and indications, and the quest for the perfect implant pocket plane is ongoing. An ideal dual plane should meet 3 requirements: adequate implant coverage, optimal control of breast shape, and maximal muscle preservation. The authors report a modified procedure for breast augmentation: the subfascial mini–muscle release dual-plane technique.

Methods:

From an inframammary or periareolar approach, the implant pocket is dissected in a subfascial plane up to the pectoralis major muscle. The muscle is split 3 cm above the lateral margin, and then pocket dissection proceeds in the submuscular plane. A small portion of the costal origin is divided inferomedially to create a dual plane.

Results:

This study included a total of 178 patients with hypoplasia or breast atrophy, among whom 34 had breast ptosis and 20 had tubular breast deformity. The median follow-up period was 20 months. The average implant volume was 268.8 mL, and a smooth implant was used in 85.4% of cases. There was 1 case of hematoma, 2 cases of wound-healing issues, 2 cases of rippling, 2 cases of grade III or IV capsular contracture, 5 cases of implant malposition, and 12 cases of mild muscle contraction–associated deformity. Revision procedures were performed on 2 patients.

Conclusions:

The subfascial mini–muscle release dual-plane technique is an easy method of breast augmentation, and it is especially indicated for ptotic breasts and tubular breast deformities. This technique combines the advantages of traditional dual-plane and muscle-splitting techniques, yielding a satisfactory aesthetic outcome.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Therapeutic, IV.
Optimized, Person-Centered Workflow Design for a High-Throughput Breast MRI Screening Facility—A Simulation Study
Authors: Kočo Lejla , Balkenende Luuk , Appelman Linda , Moman Maaike R. , Sponsel Aljoscha , Schimanski Markus , Prokop Mathias , Mann Ritse M.
Published: January 2024

Objectives

This project aims to model an optimal scanning environment for breast magnetic resonance imaging (MRI) screening based on real-life data to identify to what extent the logistics of breast MRI can be optimized.

Materials and Methods

A novel concept for a breast MRI screening facility was developed considering layout of the building, workflow steps, used resources, and MRI protocols. The envisioned screening facility is person centered and aims for an efficient workflow-oriented design. Real-life data, collected from existing breast MRI screening workflows, during 62 scans in 3 different hospitals, were imported into a 3D simulation software for designing and testing new concepts. The model provided several realistic, virtual, logistical pathways for MRI screening and their outcome measures: throughput, waiting times, and other relevant variables.

Results

The total average appointment time in the baseline scenario was 25:54 minutes, with 19:06 minutes of MRI room occupation. Simulated improvements consisted of optimizing processes and resources, facility layout, and scanning protocol. In the simulation, time spent in the MRI room was reduced by introducing an optimized facility layout, dockable tables, and adoption of an abbreviated MRI scanning protocol. The total average appointment time was reduced to 19:36 minutes, and in this scenario, the MRI room was occupied for 06:21 minutes. In the most promising scenario, screening of about 68 people per day (10 hours) on a single MRI scanner could be feasible, compared with 36 people per day in the baseline scenario.

Conclusions

This study suggests that by optimizing workflow MRI for breast screening total appointment duration and MRI occupation can be reduced. A throughput of up to 6 people per hour may be achieved, compared with 3 people per hour in the current setup.
Using the Operating Room Black Box to Assess Surgical Team Member Adaptation Under Uncertainty
Authors: Incze Taylor , Pinkney Sonia J. , Li Cherryl , Hameed Usmaan , Hallbeck M. Susan , Grantcharov Teodor P. , Trbovich Patricia L.
Published: January 2024

Objective:

Identify how surgical team members uniquely contribute to teamwork and adapt their teamwork skills during instances of uncertainty.

Summary/Background Data:

The importance of surgical teamwork in preventing patient harm is well documented. Yet, little is known about how key roles (nurse, anesthesiologist, surgeon, medical trainee) uniquely contribute to teamwork during instances of uncertainty, particularly when adapting to and rectifying an intraoperative adverse event (IAE).

Methods:

Audio-visual data of 23 laparoscopic cases from a large community teaching hospital were prospectively captured using OR Black Box®. Human factors researchers retrospectively coded videos for teamwork skills (backup behaviour, coordination, psychological safety, situation assessment, team decision making, leadership) by team role under two conditions of uncertainty: associated with an IAE versus no IAE. Surgeons identified IAEs.

Results:

1015 instances of teamwork skills were observed. Nurses adapted to IAEs by expressing more backup behaviour skills (5.3x increase; 13.9 instances/h during an IAE vs. 2.2 instances/h when no IAE) while surgeons and medical trainees expressed more phycological safety skills (surgeons:3.6x increase; 30.0 instances/h vs. 6.6 instances/h and trainees 6.6x increase; 31.2 instances/h vs. 4.1 instances/h). All roles expressed less situation assessment skills during an IAE versus no IAE.

Conclusions:

ORBB enabled the assessment of critically important details about how team members uniquely contribute during instances of uncertainty. Some teamwork skills were amplified, while others dampened, when dealing with IAEs. Knowledge of how each role contributes to teamwork and adapts to IAEs should be used to inform the design of tailored interventions to strengthen interprofessional teamwork.
WIV, a protein domain found in a wide number of arthropod viruses, which probably facilitates infection
Authors: Karlin David G.
Published: January 2024

The most powerful approach to detect distant homologues of a protein is based on structure prediction and comparison. Yet this approach is still inapplicable to many viral proteins. Therefore, we applied a powerful sequence-based procedure to identify distant homologues of viral proteins. It relies on three principles: (1) traces of sequence similarity can persist beyond the significance cutoff of homology detection programmes; (2) candidate homologues can be identified among proteins with weak sequence similarity to the query by using ‘contextual’ information, e.g. taxonomy or type of host infected; (3) these candidate homologues can be validated using highly sensitive profile–profile comparison. As a test case, this approach was applied to a protein without known homologues, encoded by ORF4 of Lake Sinai viruses (which infect bees). We discovered that the ORF4 protein contains a domain that has homologues in proteins from >20 taxa of viruses infecting arthropods. We called this domain ‘widespread, intriguing, versatile’ (WIV), because it is found in proteins with a wide variety of functions and within varied domain contexts. For example, WIV is found in the NSs protein of tospoviruses, a global threat to food security, which infect plants as well as their arthropod vectors; in the RNA2 ORF1-encoded protein of chronic bee paralysis virus, a widespread virus of bees; and in various proteins of cypoviruses, which infect the silkworm Bombyx mori. Structural modelling with AlphaFold indicated that the WIV domain has a previously unknown fold, and bibliographical evidence suggests that it facilitates infection of arthropods.
Blinking as a measurement of group vigilance in red deerCervus elaphusand fallow deerDama dama
Authors: Howard Thomas R. , Rands Sean A.
Published: January 2024

The group vigilance hypothesis suggests animals within a group have a lower overall vigilance level than solitary individuals due to the collective responsibility of predator detection. Previous methods of studying vigilance have used head position as a proxy to indicate a state of vigilance, but it has been suggested that this method is too ambiguous, and the observer cannot accurately ascertain the exact behavioural state of the focal animal. Here, we consider blinking as a proxy for vigilance, as the eye-closure during a blink momentarily reduces the animal’s information about the environment, increasing the risk of unanticipated predator attack. We videoed semi-captive herds of red deerCervus elaphusand fallow deerDama dama, and quantified their blinking behaviour using behavioural logging software. We show that blink rate decreased with increasing group size in both species, suggesting that blinking may be tied with social vigilance rather than anti-predator vigilance. Similarly, the length of the inter-blink interval increased with increasing group size in red deer. Male red deer blinked less than females, and had longer inter-blink intervals, which suggests that blinking may be related to sex-specific behaviour. We discuss the suitability of blinking measures for assessing vigilance behaviour.
Large DNA viruses in early diverging fungal genomes are relics of past and present infections
Authors: Myers Jillian M. , Schulz Frederik , Rahimlou Saleh , Amses Kevin R. , Simmons D. Rabern , Stajich Jason E. , James Timothy Y.
Published: January 2024

Giant viruses of the phylum Nucleocytoviricota have captured researchers’ attention due to their increasingly recognized impacts on eukaryotic genome evolution. Their origins are hypothesized to predate or coincide with the diversification of eukaryotes and their natural hosts span the eukaryotic tree of life. But surprisingly, giant viruses have not been found in the fungal kingdom, though recent metagenomic work suggests a putative association. Here we show that early-diverging fungal lineages maintain both “viral fossils” and host active infections by giant viruses, which form a monophyletic clade that we nameMycodnaviridae. Viral genomes described here span up to 350kb and encode over 300 genes, including many genes characteristic of giant viruses. Interestingly, we observed variation in infection status among the isolates including apparent active infection and transcriptionally-suppressed states, suggestive that viral activation may be constrained to certain life stages of the host. Our experimental findings add to the scant few natural virus-host systems available in culture for the study of giant viruses. These viruses have likely shaped the early evolution of these fungal lineages and should prove a useful model for their study.
E protein control of NKγδT cell development through both generation and function of the stereotypic Vγ1Vδ6.3 TCR
Authors: Mihai Ariana , Lee Sang-Yun , Shinton Susan , Parker Mitchell I. , Contreras Alejandra V. , Zhang Baojun , Rhodes Michele , Dunbrack Roland L. , Zúñiga-Pflücker Juan-Carlos , Ciofani Maria , Zhuang Yuan , Wiest David L.
Published: January 2024

T cell receptor (TCR) signals regulate important developmental transitions through induction of the E protein antagonist, Id3; however, Id3-deficiency produces paradoxical effects on γδ T cell subsets. Here, we show here that Id3-deficiency attenuates the development of Vγ3-expressing γδ T cells, while markedly enhancing the development of Vγ1Vδ6.3-expressing NKγδT cells. Id3-deficiency does so by regulating both the generation of the stereotypic Vγ1Vδ6.3 TCR expressed by NKγδT cells and its capacity to support development. Indeed, we determined that theTrav15segment, which encodes the Vδ6.3 TCR subunit, is directly bound by E proteins that control its expression. Moreover, once expressed, the resulting Vγ1Vδ6.3 TCR in capable of specifying the innate-like NKγδT cell fate in a cell-autonomous and developmentally-unrestricted manner that is restrained by the Id3/E axis. Together, these data indicate that the paradoxical behavior of NKγδT cells in the Id3-deficient setting is entirely determined by its stereotypic Vγ1Vδ6.3 TCR complex.
Post-zygotic reproductive isolation is not correlated with chromosome number in plants
Authors: Finch Geoffrey S , Yang Yang , Barker Michael S
Published: January 2024

The evolution of chromosome numbers is an important but not fully understood aspect of eukaryotic evolution. Although we understand the types of karyotypic changes that can lead to chromosome gain and loss, we still do not understand why chromosome numbers in many plants and animals have an average ofn= 9. A recent hypothesis proposed that chromosome number reduction following whole genome duplication (WGD) in angiosperms is driven by an interaction between chromosome number and the strength of reproductive isolation among populations. Chromosome number is expected to determine the maximum number of independently assorting Bateson-Dobzhansky-Muller incompatibilities (BDMIs). Selection against restricted gene flow among populations would result in selection for reduced chromosome number. Here we test for an interaction between chromosome number and post-zygotic reproductive isolation across a broad sample of land plants. We additionally tested for the indirect effects of WGD in generating post-zygotic reproductive isolation. Such an effect is expected if reproductive isolation is driven largely by reciprocal gene loss of WGD-derived paralogs. We found no correlation between post-zygotic reproductive isolation and chromosome number, WGD age, or degree of fractionation, suggesting that the accumulation of genic incompatibilities is likely not a major driver of post-WGD chromosome number reduction.
A complex mechanism translating variation of a simple genetic architecture into alternative life-histories
Authors: Verta Jukka-Pekka , Moustakas-Verho Jacqueline E. , Donner Iikki , Frapin Morgane , Ruokolainen Annukka , Debes Paul V. , Erkinaro Jaakko , Primmer Craig R.
Published: January 2024

Linking genes to traits is a central goal in biology. Despite progress in discovering genes associated with trait differences, a poor understanding of the functional mechanisms underlying genetic associations leaves us critically far from connecting genetic and phenotypic variation. This knowledge-gap is particularly large in multifaceted phenotypes of ecological relevance such as life-history traits. Using a multiomic dissection of the genotype-phenotype association in a large-effect maturation age gene - the transcription cofactorvestigial-like 3(vgll3) - in Atlantic salmon (Salmo salar), we show thatvgll3mediates concerted changes of distinct molecular phenotypes associated with puberty in male gonads.Vgll3genotype conferringearlymaturity upregulates key genes controlling androgen production, cellular energy and adiposity, and TGF-β signaling, among others, thereby increasing the likelihood of earlier pubertal initiation. Genotype-dependent developmental trajectories are produced through VGLL3 interaction with distinct transcription factors, thus coordinating differential activation of regulatory pathways. These results reveal a genetically simple, yet functionally complex, architecture underlying alternative life-histories where variation in a single major effect gene produces pleiotropic variation in a spectrum of cellular traits. Our results further suggest that evolution in correlated phenotypes such as exemplified by alternative life history strategies may be mediated by a surprisingly simple genetic architecture.
Simultaneous generation of osteoblasts and adipocytes by a bivalent differentiation medium from bone marrow stromal/stem cells (BMSCs)
Authors: Qiu Dawei , Liu Dong , Chen Jia , Huang Jingwen , Yang Yong , Wei Wanyi , Luo Ziwei
Published: January 2024

Bone marrow stromal/stem cells (BMSCs) are primitive and heterogeneous cells that can be differentiated into osteoblasts, adipocytes and other subsets. Their bone-fat lineage commitment is responsible for the homeostasis of bone marrow microenvironment. However, there are little effective methods and evidence to simultaneously evaluate the lineage commitment of BMSCs. Here we provide a mixed osteo-adipogenic (OA) differentiation medium that could enable BMSCs differentiation into osteoblasts and adipocytes in vitro, and establish a method for simultaneous assessment of bone-fat lineage allocation of BMSCs based on the Alizarin red S and Oil red O staining, which have been used for detection of specific mineralized nodules and lipid droplets, respectively. This assay provides a specifically simple but effective and low-cost method to visualize the osteogenesis and adipogenesis of BMSCs, and evaluate the differentiation efficiency of lineage allocation of BMSCs.
Maternal Care Leads to the Evolution of Long, Slow Lives
Authors: Zipple Matthew N , Reeve H Kern , Peniston Jimmy H
Published: January 2024

Animals, and mammals in particular, vary widely in their “pace of life,” with some species living long lives and reproducing infrequently (slow life histories) and others living short lives and reproducing often (fast life histories). These species also vary in the importance of maternal care in offspring fitness: in some species, offspring are fully independent of their mothers following a brief period of nutritional input, while others display a long period of continued dependence on mothers well after nutritional dependence. Here we hypothesize that these two axes of variation are causally related to each other, such that extended dependence of offspring on maternal presence leads to the evolution of longer lives at the expense of reproduction. We use a combination of deterministic modeling and stochastic agent-based modeling to explore how empirically-observed links between maternal survival and offspring fitness are likely to shape the evolution of mortality and fertility. Each of our modelling approaches leads to the same conclusion: when maternal survival has strong impacts on the survival of offspring and grandoffspring, populations evolve longer lives with less frequent reproduction. Our results suggest the slow life histories of humans and other primates as well as other long-lived, highly social animals such as hyenas, whales, and elephants, are partially the result of the strong maternal care that these animals display. We have designed our models to be readily parameterized with demographic data that is routinely collected by long-term researchers, which will facilitate more thorough testing of our hypothesis.

Significance Statement

Humans and other primates live longer lives and reproduce less often than other mammals of similar body mass. What is the cause of these long lives? Here we add to existing hypotheses, including the Mother and Grandmother hypotheses, by arguing that these increased lifespans are partially explained by the intense maternal care that many primates express. Using a combination of deterministic and stochastic modeling approaches, informed by empirical data, we show that stronger connections between maternal survival and offspring fitness leads to selection for longer lives and slower reproduction. Our models suggest that the importance of the mother-offspring relationship, which defines much of human and non-human primate lives, lies at the core of the evolution of our long lives.
Step selection analysis with non-linear and random effects in mgcv
Authors: Klappstein Natasha , Michelot Théo , Fieberg John , Pedersen Eric , Field Chris , Flemming Joanna Mills
Published: January 2024

Step selection analysis is used to jointly describe animal movement patterns and habitat preferences. Recent work has extended this framework to model inter-individual differences, account for unexplained structure in animals’ space use, and capture temporally-varying patterns of movement and habitat selection.In this paper, we formulate step selection functions with penalised smooths (similar to generalised additive models) to unify new and existing extensions, and conveniently implement the models in the popular, open-sourcemgcvR package. We explore non-linear patterns of movement and habitat selection, and use the equivalence between penalised smoothing splines and random effects to implement individual-level and spatial random effects. This framework can also be used to fit varying-coefficient models to account for temporally or spatially-heterogeneous patterns of selection (e.g., resulting from behavioural variation), or any other non-linear interactions between drivers of the animal’s movement decisions. We provide the necessary technical details to understand several key special cases of smooths and their implementation inmgcv, showcase the ecological relevance using two illustrative examples, and provide R code (available athttps://github.com/NJKlappstein/smoothSSF) to facilitate the adoption of these methods. This paper is a broad overview of how smooth effects can be applied to increase the flexibility and biological realism of step selection analysis.
SRCompiler: Translating Stella dynamic models to open-source R scripts
Authors: Morales Enrique , Bordehore Cesar , Pastor Héctor M. , García-García David
Published: January 2024

Stella Architect (iSee Systems) offers an object-oriented environment that facilitates the development of dynamic models. Stella, however, does not support some of the advanced mathematical tools that can be found in mathematical software such as R. Moreover, R is open source, contains numerous libraries and resources, and is used by a large community. However, building dynamic systems, which typically use a large number of differential or difference equations, are more difficult to build in R. To take advantage of both Stella and R, we have developed the SRCompiler (Stella-R Compiler), which is a translator that exports models built in Stella into R scripts. In 2012, a translator from Stella to R was developed based on plain text treatment for Stella, but it had some limitations such as scalability and error handling. Nevertheless, our approach is more versatile, scalable and expandable since it is based on compiler design, defines a formal language, and uses the latest Stella version (v. Architect).In this paper, a classical predator-prey model has been modelled in Stella to show an applied example. Following the translation of the Stella model into R, all the parameters of the model (6 in total) have been optimised to fit model output to the Hudson Bay Company’s hare-lynx time series hunting data (1847-1935).

Software availability

Name of software: SRCompiler

SRCompiler Developers: Pastor Héctor.M, Morales Enrique

Web page:https://github.com/hmpp91/SRCompiler

Available: 2021

Program language: C++

Program size: 197 KB

Availability and cost: Open source