bluuebunny/crossref_metadata_2025 huggingface dataset:
New Technologies and the Future Governance of Bank Run Risk
Authors: Krogstrup Signe , Sangill Thomas
Published: February 2024

The banking turmoil in March 2023 and the associated public interventions to prevent or reduce the risk of a systemic fallout underscore the fact that despite banking systems being in a much better shape in many countries relative to the position prior to the global financial crisis, some bank run risk remains. In fact, bank run risk may be increasing. As fintech and new technologies transform banking, uninsured deposits may become near-perfectly mobile, making bank runs all but inevitable if the governance of the financial system is not appropriately adapted. In this article we discuss how digitalization and new technologies can affect bank run risk and we look at approaches to adapting governance to containing related systemic vulnerabilities in the banking system. We also briefly consider how central bank digital currencies could fit into future frameworks. We conclude that there is no silver bullet, but that adjusting frameworks will become necessary if bank deposit mobility increases.
Tracking and classification performances in the bio-inspired asymmetric and symmetric networks
Authors: Ishii Naohiro , Iwata Kazunori , Matsuo Tokuro
Published: February 2024

Machine learning, deep learning and neural networks are extensively applied for the development of many fields. Though their technologies are improved greatly, they are often said to be opaque in terms of explainability. Their explainable neural functions will be essential to realization in the networks. In this paper, it is shown that the bio-inspired networks are useful for the explanation of tracking and classification of features. First, the asymmetric network with nonlinear functions is created based on the bio-inspired retinal network. They have orthogonal properties useful for the tracking of features compared with the conventional symmetric networks, which is also proposed on the biological functions.

Next, the analysis for the independence of the subspaces between the Fourier bases and the asymmetric network bases is performed. It was that the asymmetric networks have better performances in the classification compared with the symmetric ones. Further, the layered asymmetric networks generate the higher dimensional orthogonal bases that improve the classification accuracies by the replacements of bases. Finally, we classified Reuters collections data applying the explainable processing steps, which consist of the linear discriminations and the sparse coding with nearest neighbor relation for classification.
Food bioactive peptides: functionality beyond bitterness
Authors: Tagliamonte Silvia , Oliviero Veronica , Vitaglione Paola
Published: February 2024

Bitter taste is an aversive taste because it is unconsciously associated with toxic compounds. However, a considerable variability in bitter sensitivity exists in those who have the genetic polymorphism for bitter taste receptors (TAS2Rs). Besides the oral cavity, TAS2Rs are present in many body tissues, including the gastrointestinal tract; therefore, they are crucial players both in the gustatory/hedonic system and in the homeostatic system, triggering numerous biological responses, including adipogenesis, carcinogenesis, or immunity. Bitter-tasting compounds are widely distributed in plant and animal foods and belong to many chemical classes. In this study, the evidence was reviewed on bitter peptides, considering the food sources, their formation in food under different processing and storage conditions and in the gastrointestinal tract during digestion, as well as their biological activities. Bitterness associated with peptides is due to the presence of hydrophobic amino acids in the C-terminus. The current literature mainly explores the enzymes and hydrolysis conditions, with the aim of reducing the formation of bitter peptides in hydrolysate preparation or food. Few studies highlight the bioactivity (namely, antihypertensive, antidiabetic, antioxidant, or immunity boosting), besides the bitterness. However, encapsulation of bitter peptides has been tentatively used to develop antihypertensive and antidiabetic supplements. In the era of personalized nutrition and precision medicine, the evidence available suggests the opportunity to use bitter bioactive peptides as functional ingredients in food. Such types of food may modulate a plethora of physiological mechanisms by targeting TAS2Rs in the gastrointestinal tract, thus modulating appetite sensations or gastrointestinal motility and discomfort according to individual nutritional needs and goals. More studies are needed to optimize the technological strategies to target TAS2Rs by bitter bioactive peptides, improve their stability in food, and validate the biological efficacy through well-designed in vivo studies.
Effect of Cultivar and Temperature on Disease Development of Macrophomina Root Rot in Strawberry
Authors: Wang Yu-Chen , Mansouripour Seyed Mojtaba , Hewavitharana Shashika S. , Holmes Gerald J.
Published: February 2024

Root rot, or charcoal rot, caused by the soilborne fungus Macrophomina phaseolina, is a significant disease affecting strawberry production worldwide. Field trials were conducted for five seasons (2016–2017 to 2020–2021) to evaluate strawberry host plant resistance to Macrophomina root rot (MRR) in California. A wide range of plant resistance to MRR was observed. Because low disease severity occurred in the fifth season, a summary of the first to fourth seasons showed that ‘Osceola’ was highly resistant, whereas ‘Festival’, ‘Sweet Ann’, and ‘Ruby June’ were highly susceptible. Disease severity varied over the seasons for specific cultivars, as did the average final mortality for all cultivars. Models were built to investigate the relationship between environmental variables and final disease mortality among the seasons. Strong positive associations were found between the soil temperature during the first month after planting ( R2 = 0.79, P < 0.0001) or air temperature mid-season ( R2 = 0.79, P < 0.0001) and the final disease mortality of eight cultivars. We concluded that the soil temperature during the early stage of plant development and the mid-season air temperature are important factors in disease development for MRR. Screening new strawberry cultivars and elite breeding lines against MRR should be ongoing as part of a standard process for determining the susceptibility of currently grown and potentially new cultivars.
HDAC2 counteracts vascular calcification by activating autophagy in chronic kidney disease
Authors: Zhou Guangyu , Liu Pai , Zhang Chen , Huang Qun , Zhao Zixia , Wu Si , Li Detian , Liu Hongbo
Published: February 2024

Vascular calcification is a major risk factor for cardiovascular disease mortality, with a significant prevalence in chronic kidney disease (CKD). Pharmacological inhibition of histone acetyltransferase has been proven to protect against from vascular calcification. However, the role of Histone Deacetylase 2 (HDAC2) and molecular mechanisms in vascular calcification of CKD remains unknown. An in vivo model of CKD was established using mouse fed with a high adenine and phosphate diet, and an in vitro model was produced using human aortic vascular smooth muscle cells (VSMCs) stimulated with β‐glycerophosphate (β‐GP). HDAC2 expression was found to be reduced in medial artery of CKD mice and β‐GP‐induced VSMCs. Overexpression of HDAC2 attenuated OPN and OCN upregulation, α‐SMA and SM22α downregulation, and calcium deposition in aortas of CKD. The in vitro results also demonstrated that β‐GP‐induced osteogenic differentiation was inhibited by HDAC2. Furthermore, we found that HDAC2 overexpression caused an increase in LC3II/I, a decrease in p62, and an induction of autophagic flux. Inhibition of autophagy using its specific inhibitor 3‐MA blocked HDAC2's protective effect on osteogenic differentiation in β‐GP‐treated VSMCs. Taken together, these results suggest that HDAC2 may protect against vascular calcification by the activation of autophagy, laying out a novel insight for the molecular mechanism in vascular calcification of CKD.
Case Series of Individuals Treated With Naltrexone During Pregnancy for Opioid and/or Alcohol Use Disorder
Authors: Wachman Elisha M. , Saia Kelley , Bressler Jonathan , Werler Martha , Carter Ginny , Jones Hendree E.
Published: February 2024

Objective

There is a lack of knowledge about the relative safety and efficacy of naltrexone for the treatment of pregnant individuals with opioid and/or alcohol use disorder, including the range of outcomes, in both the pregnant individual and the infant, over the course of peripartum period. Our objective was to describe these outcomes in a cohort of pregnant individuals on naltrexone.

Methods

In this prospective case series, 7 pregnant individuals with opioid use disorder (OUD) or alcohol use disorder (AUD) treated with naltrexone were followed from pregnancy through 12 months after delivery. Clinical treatment protocols and outcomes related to safety and efficacy during pregnancy, delivery, and the postpartum period are described.

Results

There were 4 pregnant individuals with OUD and 3 with AUD, of which 3 were managed with oral and 4 with extended-release naltrexone. The mean gestational age at study enrollment was 21.7 (SD, 12) weeks. Of the 7 participants, there was no return to nonprescribed opioid use and 2 who experienced a return to alcohol use over the course of the study. All individuals delivered vaginally at a mean of 37 weeks gestation without any peripartum pain difficulties. Five of the individuals (71.4%) remained on naltrexone 12 months after delivery. There were no reported fetal anomalies and one preterm delivery. None of the infants developed neonatal opioid withdrawal syndrome.

Conclusions

For pregnant individuals with OUD or AUD treated with naltrexone, there were low rates of return to nonprescribed use and reassuring pregnant person and infant outcomes to 12 months postpartum.
Effect of Different Local Antibiotic Regimens on Prevention of Postoperative Infection in Clean Surgical Wounds: A Systematic Review and Network Meta-analysis
Authors: Pan Hai Bang , Cui Yan , Wu Zhi Hang , Meng Ying , Wang Tian Ming , Fu Qi , Chen Qian , Chen Quan Xin , Wang Bo
Published: February 2024

OBJECTIVE

To compare the efficacy of several local antibiotic regimens in preventing surgical site infection (SSI) in clean surgical wounds.

DATA SOURCES

The authors searched CNKI (China National Knowledge Infrastructure), the VIP (VIP information resource integration service platform), Wanfang Data knowledge service platform (WANFANG), SinoMed, Cochrane Library, EMBASE, and PubMed.

STUDY SELECTION

A total of 20 randomized controlled trials published between January 1, 2000 and April 1, 2021 were included in this meta-analysis.

DATA EXTRACTION

Authors extracted the name of the first author, publication date, country, type of surgery, follow-up time, mean age of participants, sample size of each group, interventions, outcome indicators, and study type from each article.

DATA SYNTHESIS

The overall effectiveness of eight local managements in reducing the incidence of the SSI effect were compared through the SUCRA (surface under the cumulative ranking curve) probabilities. The results of a network meta-analysis demonstrated that gentamicin ointment (odds ratio [OR], 0.16; 95% CI, 0.04–0.60), mupirocin ointment (OR, 0.44; 95% CI, 0.21–0.94), and gentamicin soaking of the graft (OR, 0.63; 95% CI, 0.44–0.91) significantly reduced the incidence of SSI compared with control. Further, vancomycin soaking of the graft (86.7%) ranked first, followed by gentamicin ointment (81.1%), gentamicin irrigation (79.9%), mupirocin ointment (56.8%), triple antibiotic ointment (47.8%), gentamicin soaking of the graft (42.3%), and vancomycin powder (22.1%); ampicillin powder (17.8%) was the least effective drug.

CONCLUSIONS

The findings indicate that local antibiotics combined with conventional antibiotics in the wound before wound closure are effective in reducing the incidence of SSI in clean surgical wounds. Vancomycin inoculation of the graft exhibited the best effect.
Rapidly Progressive and Debilitating Epithelioid Hemangioendothelioma: An Atypical Presentation of a Rare Malignant Cutaneous Vascular Neoplasm
Authors: Dash Siddhartha , Behera Biswanath , Viswan Parvathy , Garg Kunal , Sethy Madhusmita , Ayyanar Pavithra
Published: February 2024

Epithelioid hemangioendothelioma (EHE) is a rare vascular malignant tumor that comprises less than 1% of all vascular tumors. Cutaneous involvement in EHE can occur either by spreading from underlying bone or rarely could be limited to the skin and mostly presents as solitary well-circumscribed mass to an ill-defined infiltrative lesion. We present a case of rapidly progressive and debilitating EHE presenting multiple vascular papules and nodules. Histopathology showed an ill-circumscribed nodular proliferation of epithelioid and spindled cells in the dermis that extended into the subcutaneous tissue. The tumor cells had moderate eosinophilic cytoplasm, vesicular chromatin, and prominent nucleoli. In addition, they showed evidence of lumen formation and intracytoplasmic vacuoles. Brisk mitosis was noted. On immunohistochemistry, the cells were strongly positive for CD31, CD34, and ERG (ETS [erythroblast transformation-specific]-related gene). MIB-1 labeling index was more than 75% in the highest proliferating areas. A high degree of clinical suspicion and immunopathological examination is recommended for early diagnosis of this rare condition before it becomes function or life-threatening.
Association between ambient temperature and genitourinary emergency ambulance dispatches in Japan: A nationwide case-crossover study
Authors: Mano Yasuko , Yuan Lei , Ng Chris Fook Sheng , Hashizume Masahiro
Published: February 2024

Background:

Although the effects of temperature on genitourinary morbidity and mortality have been investigated in several countries, it remains largely unexplored in Japan. We investigated the association between ambient temperature and genitourinary emergency ambulance dispatches (EADs) in Japan and the modifying roles of sex, age, and illness severity.

Methods:

We conducted a time-stratified case-crossover study with conditional quasi-Poisson regression to estimate the association between mean temperature and genitourinary EADs in all prefectures of Japan between 2015 and 2019. A mixed-effects meta-analysis was used to pool the association at the country level. Subgroup analyses were performed to explore differences in associations stratified by sex, age, and illness severity.

Results:

We found an increased risk of genitourinary EAD associated with higher temperatures. The cumulative relative risk (RR) at the 99th temperature percentile compared with that at the 1st percentile was 1.74 (95% confidence interval (CI) = [1.60, 1.89]). We observed higher heat-related RRs in males (RR = 1.89; 95% CI = [1.73, 2.07]) than females (RR = 1.56; 95% CI = [1.37, 1.76]), and in the younger (RR = 2.13; 95% CI = [1.86, 2.45]) than elderly (RR = 1.39; 95% CI = [1.22, 1.58]). We found a significant association for those with mild or moderate cases (RR = 1.77; 95% CI = [1.62, 1.93]), but not for severe or life-threatening cases (RR = 1.20; 95% CI = [0.80, 1.82]).

Conclusion:

Our study revealed heat effects on genitourinary EADs in Japan. Men, youth, and mild-moderate illnesses were particularly vulnerable subgroups. These findings underscore the need for preventative measures aimed at mitigating the impact of temperature on genitourinary emergencies.
The Feasibility of Chest Wall Resection and Reconstruction during an Operation in Breast Cancer, Phyllodes Tumor, and Osteoradionecrosis
Authors: Chirappapha Prakasit , Adireklarpwong Lakkana , Lertsithichai Panuwat , Sukarayothin Thongchai , Suvikapakornkul Ronnarat , Leesombatpaiboon Monchai , Wasuthit Yodying , Kiranantawat Kidakorn , Cherntanomwong Piya
Published: February 2024

Background:

The effectiveness and safety of chest wall surgery for various breast conditions remain unclear. Previous studies have reported a high risk of morbidity. We hypothesized that the limited chest wall resection can be performed under safe and good technique and aim to identify the extent of safe surgery.

Methods:

A retrospective study analyzed patients who underwent chest wall resection for chest wall recurrence breast cancer, locally advanced breast cancer, phyllodes, fibromatosis breast tumor, and osteoradionecrosis from January 1, 2008, to April 10, 2023. The primary objectives were the extent of safe chest wall surgery and performance status postoperatively.

Results:

Thirteen chest wall resections with an average of two to three ribs removed were performed. Patients who had two or more rib resections underwent mesh stabilization; nevertheless, paradoxical chest without deteriorating oxygenation remained. Anterolateral thigh-free flap, pedicled-TRAM or latissimus dorsi flap, pectoralis major myocutaneous flap, and local fasciocutaneous bilateral advancement flap were performed on five, four, three, and one patient, respectively. Patients with a maximum of three ribs removed had an ECOG score of 0–1 postoperatively. Hematoma and wound dehiscence affected two patients. In a small series of chest wall recurrence cases (N  = 7), R0 resection had better disease-free survival of 13 months.

Conclusions:

The procedure of chest wall resection and reconstruction can be performed safely with a maximum of three ribs removed, using mesh and myocutaneous flaps in two or more rib resections. Further studies with larger sample sizes will provide better understanding.
From past to present to future: Terlipressin and hepatorenal syndrome-acute kidney injury
Authors: Allegretti Andrew S. , Patidar Kavish R. , Ma Ann T. , Cullaro Giuseppe
Published: February 2024

Hepatorenal syndrome (HRS) is a rare and highly morbid form of kidney injury unique to patients with decompensated cirrhosis. HRS is a physiologic consequence of portal hypertension, leading to a functional kidney injury that can be reversed by restoring effective circulating volume and renal perfusion. While liver transplantation is the only definitive “cure” for HRS, medical management with vasoconstrictors and i.v. albumin is a cornerstone of supportive care. Terlipressin, a V1a receptor agonist that acts on the splanchnic circulation, has been used for many years outside the United States for the treatment of HRS. However, its recent Food and Drug Administration approval has generated new interest in this population, as a new base of prescribers now work to incorporate the drug into clinical practice. In this article, we review HRS pathophysiology and diagnostic criteria, the clinical use of terlipressin and alternative therapies, and identify areas of future research in the space of HRS and kidney injury in cirrhosis.
Physician selection for hospital integration: Theoretical considerations and empirical findings
Authors: Alinezhad Farbod , Post Brady , Young Gary J.
Published: February 2024

Background

The U.S. health care system has seen an increase in hospital-physician integration, with hospitals acquiring increasing numbers of physician practices. This shift has been linked to higher costs without significant improvements in quality.

Purpose

This study sought to identify the characteristics of physicians who transitioned from independent practice to hospital integration.

Methodology/Approach

We used physician variables, including quality scores, medical school rankings, years of experience, experience treating socially or medically complex patients, practice style, and location, as well as health care market and county-level variables to understand these determinants using a fixed-effects logistic regression model.

Results

A total of 101,746 physicians representing 66 clinical specialties satisfied our inclusion criteria, of which 3,656 became hospital-integrated between 2018 and 2020. The integrating physicians were generally less experienced, had lower quality scores, and generated less revenue per Medicare patient. Their patients, on average, had higher comorbidity scores, were more likely to be dually eligible, and resided in counties with higher poverty rates.

Conclusion

Our findings indicate that the physicians most likely to become hospital integrated are those facing reimbursement pressures due to a complex case mix and the associated challenges of performing well on the quality metrics. We also found some support for the anticompetitive aspects of hospital–physician integration. Our results suggest that hospitals are integrating with a relatively less experienced physician workforce but one that is perhaps more capable of treating clinically and socioeconomically complex patients.

Practice Implications

Hospitals interested in using physician integration strategically to improve care quality should put more emphasis on physician quality. Such an approach has the potential to increase efficiency without sacrificing quality of care.
Comparison of the efficacy and safety of pegylated liposomal doxorubicin and epirubicin in neoadjuvant chemotherapy for HER2-negative breast cancer: a real-world case–control study
Authors: Yang Lixian , Zhang Shiyu , Zheng Lei , Pu Pengpeng , Li Xiaowei , Jia Lining
Published: February 2024

Purpose:

The purpose of this study was to assess the effectiveness and side effects of pegylated liposomal doxorubicin (PLD) and epirubicin in neoadjuvant treatment for HER2-negative breast cancer.

Patients and methods:

The authors performed a retrospective analysis of 107 patients diagnosed with HER2-negative breast cancer who underwent TA (PLD 35 mg/m2, docetaxel 75 mg/m2) or TE (epirubicin 100 mg/m2, docetaxel 75 mg/m2) neoadjuvant chemotherapy (NAC) from January 2021 to December 2022. PLD was administered in 57 instances, while epirubicin was used in 50 cases. The clinicopathological features, chemotherapy effects, and adverse responses of these individuals were examined, and logistic regression was applied to determine the parameters defining the effectiveness of NAC.

Results:

The clinicopathological characteristics of the PLD and epirubicin groups were consistent, and there was no statistical difference. Also, there was no statistical difference in the efficacy of NAC between the two groups. Leukopenia, hair loss, digestive tract responses, and irregular electrocardiograms were dramatically decreased in the PLD group compared to the epirubicin group. However, hand-foot syndrome and hypersensitivity were significantly increased, with statistical relevance.

Conclusion:

PLD has the same efficacy as traditional epirubicin in NAC for HER2-negative breast cancer.
Updates on respiratory syncytial virus prophylaxis: the past, present and future
Authors: Coates Anne , Sadreameli Christy
Published: February 2024

Purpose of review

Human respiratory syncytial virus (RSV) causes acute respiratory infection in individuals of all age groups. It is the most common pathogen identified in infants and young children with acute lower respiratory infection. Although most infants and young children experience mild, cold-like symptoms, some infants develop severe lower respiratory tract disease such as pneumonia and bronchiolitis that may result in an emergency department visit or hospitalization.

Recent findings

In the United States, hospitalization rates have risen during the last decades, and while premature infants with chronic lung disease and congenital heart disease are at increased risk for severe presentations, the majority of hospitalizations occur in previously healthy infants. Until recently, RSV prophylaxis was only available for former preterm infants and those with certain underlying medical conditions.

The need for preventive interventions against RSV is crucial. This paper will provide a review of the vaccine development, the spectrum of RSV prophylaxis, current challenges associated with the cost, insurance coverage and equitable distribution of targeted therapies.
The Signal Intensity Ratio of Pancreas to Spleen in Magnetic Resonance Imaging Can Predict Nonalcoholic Fatty Liver Disease After Pancreaticoduodenectomy
Authors: Tsunematsu Masashi , Haruki Koichiro , Shirai Yoshihiro , Onda Shinji , Furukawa Kenei , Okui Norimitsu , Abe Kyohei , Sakamoto Taro , Gocho Takeshi , Ikegami Toru
Published: February 2024

Objectives

Signal intensity ratio of pancreas to spleen (SI ratiop/s) on fat-suppressed T1-weighted images of magnetic resonance imaging has been associated with pancreatic exocrine function. We here investigated the predictive value of the SI ratiop/s for the development of nonalcoholic fatty liver disease (NAFLD) after pancreaticoduodenectomy (PD).

Materials and Methods

This study comprised 208 patients who underwent PD. NAFLD was defined as a liver-to-spleen attenuation ratio of <0.9 calculated by a computed tomography 1 year after surgery. SI ratiop/s was calculated by dividing the average pancreas SI by the spleen SI. We retrospectively investigated the association of clinical variables including the SI ratiop/s and NAFLD by univariate and multivariate analyses.

Results

NAFLD after 1 year was developed in 27 patients (13%). In multivariate analysis, the SI ratiop/s < 1 (P < 0.001) was an independent predictor of incidence of NAFLD. The SI ratiop/s < 1 was associated with low amylase level of the pancreatic juice (P < 0.001) and progressed pancreatic fibrosis (P = 0.017). According to the receiver operating characteristics curve, the SI ratiop/s had better prognostic ability of NAFLD than the remnant pancreas volume.

Conclusions

The SI ratiop/s is useful to predict NAFLD development after PD. Moreover, the SI ratiop/s can be a surrogate marker, which represents exocrine function of the pancreas.
An Elemental Diet Reduces Chylous Ascites of Patients Undergoing Pancreatoduodenectomy in the Setting of Early Enteral Feeding
Authors: Matsumura Masaru , Mise Yoshihiro , Takemura Nobuyuki , Ono Yoshihiro , Sato Takafumi , Ito Hiromichi , Inoue Yosuke , Takahashi Yu , Saiura Akio
Published: February 2024

Objectives

The elemental diet (ED) is a formula to support nutritional status without increasing chylous burden. This study evaluates the efficacy of early ED feeding after pancreatoduodenectomy (PD).

Materials and Methods

A prospective phase II study of consecutive patients who underwent PD with early ED feeding was conducted. Patient backgrounds, surgical outcomes, and ED feeding tolerability were compared with a historical cohort of 74 PD patients with early enteral feeding of a low residue diet (LRD).

Results

The ED group comprised 104 patients. No patient in the ED group discontinued enteral feeding because of chylous ascites (CAs), whereas 17.6% of the LRD group experienced refractory CAs that disrupted further enteral feeding. The CAs rate was significantly decreased in the ED group compared with the LRD group (3.9% and 48.7%, respectively; P < 0.001). There was no significant difference in the incidence of major complications (ED: 17.3%, LRD: 18.9%; P = 0.844). Postoperative prognostic nutritional index was similar between the 2 groups (P = 0.764). In multivariate analysis, enteral feeding formula, and sex were independent risk factors for CAs (LRD: P < 0.001, odds ratio, 22.87; female: P = 0.019, odds ratio, 2.78).

Conclusions

An ED reduces postoperative CAs of patients undergoing PD in the setting of early enteral feeding.
Neuro-ophthalmic manifestations in traumatic brain injury: a hospital-based study from Nepal
Authors: Gurung Jamuna , Karn Mitesh , Gurung Prakash Kumar , Sapkota Shabal
Published: February 2024

Objective:

Neuro-ophthalmic manifestations occur frequently in patients with a traumatic head injury which are often ignored, leading to late presentation with permanent visual disability and visual field defects. This study aimed to find the various neuro-ophthalmic manifestations of traumatic brain injury and correlate them with the neurological status and neuro-imaging abnormality.

Methods:

A hospital-based cross-sectional study was carried out among patients admitted to our center with a diagnosis of traumatic brain injury for a period of six months from August 2020 to January 2021. Glasgow Coma Score was used to grade the severity of the head injury. Detailed ophthalmological examinations were documented in predesigned proforma. Descriptive statistics were used to describe the outcomes.

Results:

A total of 377 head injury patients underwent neuro-ophthalmic examination- 271 (71.9%) were males and 106 (28.1%) were females. The mean age in our study population was 38.6  16.8 years, their age ranging from 3 to 85 years. Time from injury to ophthalmologic examination ranged from 30 minutes to 12 days post-injury, the mean duration being 24.2  34 hours. Road traffic accidents were the most common cause of head injury, with 203 cases (53.8%). 38 (10.1%) patients had neuro-ophthalmic manifestations- 16 (42.0%) had afferent pathway deficits and 22 (57.9%) had efferent pathway deficits. The most frequently encountered neuro-ophthalmic abnormality was optic neuropathy in 14 (36.8%) followed by trochlear, oculomotor, abducens nerve, and chiasmal injury. The presence of brain contusion was associated with traumatic optic neuropathy while skull fractures were associated with trochlear nerve palsy, these associations being statistically significant (P<0.05).

Conclusion:

Neuro-imaging abnormalities, particularly brain contusions and skull fractures were significantly associated with neuro-ophthalmic deficits.
“A Case Report of Uncommon Giant Epidermal Inclusion Cyst Found in the Thyroid Gland.”
Authors: Mousa Hana , Aljassem Razan
Published: February 2024

Introduction and importance:

This case report describes a rare occurrence of an epidermal inclusion cyst (EIC) being found in the thyroid gland and highlights the importance of considering uncommon entities like EIC in the differential diagnosis of thyroid lesions.

Case presentation:

A 68-year-old male presented with a large, painless swelling in the anterior neck, causing dysphagia and dysphonia. Imaging and cytology confirmed a benign Epidermal Inclusion Cyst involving the left lobe of the thyroid, which was successfully removed via hemithyroidectomy, resulting in resolution of symptoms.

Clinical discussion:

Epidermoid inclusion cysts are rare in the thyroid gland, with only sixteen reported cases worldwide. The cyst was diagnosed through ultrasound-guided fine needle aspiration and confirmed by surgical pathology. Treatment involves complete removal of the cyst and its capsule, which was successfully performed in this case under local anesthesia with sedation due to the patient’s medical history of COPD.

Conclusion:

it is important to consider the possibility of EIC when benign squamous cells are detected in a thyroid aspirate without any follicular cells. In such cases, hemithyroidectomy can be a successful management strategy.
Effects of breastfeeding in postoperative complication in pediatric and adolescent population- a systematic review
Authors: Ghosh Bikona , Sripathi Samhrutha , Nuthalapati Bhargav Sai , Dwivedi Ayush , Pandey Ayush , Sarkar Prianka
Published: February 2024

Introduction:

Surgical complications in younger patients can lead to infections, delayed healing, prolonged hospital stays, and other negative outcomes, significantly affecting their recovery. This study explores the potential impact of breastfeeding on mitigating these complications, aiming to enhance our understanding of postoperative care for pediatric and adolescent patients.

Methodology:

We conducted a systematic search on databases such as PubMed, Scopus, Web of Science, and EMBASE, using relevant MESH keywords, adhering to the “Preferred Reporting Items for Systematic Reviews and Meta-analysis” methodology. Quality assessments were performed, and studies scoring above 70% were included for standardized data incorporation. Data extraction followed Cochrane Consumers and Communication Review group’s guidelines. Bias and ethical criteria were considered and provided valuable evidence to answer the research question.

Results:

Among 402 initially reviewed articles, six met inclusion criteria: 3 observational cohort studies, 2 systematic reviews, and 1 randomized controlled trial. The selected literature consistently demonstrates a significant reduction in postoperative infection rates and improved outcomes. Breastfeeding shortened postoperative hospital stays, accelerated recovery, and enhanced nutritional status, potentially reducing healthcare resource utilization and patient financial burden. Lower mortality and morbidity rates were also observed.

Conclusion:

This systematic review provides compelling evidence of breastfeeding’s positive impact on surgical outcomes in the pediatric population. While our findings support the benefits of breastfeeding in this age group, further large-scale, multi-center research is needed to provide stronger evidence for guiding clinical practices.
Recurrent fibroepithelial vaginal polyp in a two-year-old girl: A case report and review of the literature
Authors: Shehadeh Mohammad Hakam , Abualrub Ahmad , Malhes Waleed , Msarweh Amar , Amro Wael
Published: February 2024

Introduction and Importance:

Fibroepithelial vaginal polyps (FEPV) are rare mucosal polypoid lesions primarily found in adult women. However, FEPV in pediatric patients, especially beyond the neonatal period, is exceedingly uncommon. Documenting cases improves diagnosis and management. FEPV can mimic malignancy, posing challenges for interpretation. Early detection, treatment, and follow-up are crucial for optimal outcomes.

Case presentation:

We present the case of a two-year-old girl with a recurrent FEPV. The patient had a painless, reddish, smooth, soft, rubbery polypoid vaginal mass measuring 2.3 × 1.5 cm. Physical examination revealed no concurrent systemic issues. Surgical excision of the polyps confirmed them as fibroepithelial polyps. Despite previous excisions, the polyps recurred within a month. The patient’s postoperative recovery was uneventful, and subsequent follow-up showed no recurrence.

Clinical discussion:

FEPV presents as mucosal polypoid lesions with a connective tissue core covered by benign squamous epithelium. It is rare before menarche and after menopause. Although the pathophysiology remains unclear, hormonal factors and local injuries may contribute. FEPV is usually asymptomatic but may cause pressure, obstruction, bleeding, or discharge. Differential diagnosis includes vaginal connective tissue malignancies. The diagnosis was confirmed by surgical excision and histopathology. Complete excision is crucial for preventing recurrence.

Conclusion:

This case report highlights recurrent FEPV in a two-year-old girl. Despite previous excisions, polyps recurred, emphasizing the need for complete excision. Documenting cases will enhance our understanding. Further research is needed to elucidate the pathogenesis of pediatric FEPV. Early detection, treatment, and follow-up are essential for optimal management.
Association of an In-Hospital Desirability of Outcomes Ranking Scale With Postdischarge Health-Related Quality of Life: A Secondary Analysis of the Life After Pediatric Sepsis Evaluation*
Authors: Logan Grace E. , Banks Russell K. , Reeder Ron , Miller Kristen , Mourani Peter M. , Bennett Tellen D. , Bourque Stephanie L. , Meert Kathleen L. , Zimmerman Jerry , Maddux Aline B.
Published: February 2024

OBJECTIVES:

To develop a desirability of outcome ranking (DOOR) scale for use in children with septic shock and determine its correlation with a decrease in 3-month postadmission health-related quality of life (HRQL) or death.

DESIGN:

Secondary analysis of the Life After Pediatric Sepsis Evaluation prospective study.

SETTING:

Twelve U.S. PICUs, 2013–2017.

PATIENTS:

Children (1 mo–18 yr) with septic shock.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We applied a 7-point pediatric critical care (PCC) DOOR scale: 7: death; 6: extracorporeal life support; 5: supported by life-sustaining therapies (continuous renal replacement therapy, vasoactive, or invasive ventilation); 4: hospitalized with or 3: without organ dysfunction; 2: discharged with or 1: without new morbidity to patients by assigning the highest applicable score on specific days post-PICU admission. We analyzed Spearman rank-order correlations (95% CIs) between proximal outcomes (PCC-DOOR scale on days 7, 14, and 21, ventilator-free days, cumulative 28-day Pediatric Logistic Organ Dysfunction-2 (PELOD-2) scores, and PICU-free days) and 3-month decrease in HRQL or death. HRQL was measured by Pediatric Quality of Life Inventory 4.0 or Functional Status II-R for patients with developmental delay. Patients who died were assigned the worst possible HRQL score. PCC-DOOR scores were applied to 385 patients, median age 6 years (interquartile range 2, 13) and 177 (46%) with a complex chronic condition(s). Three-month outcomes were available for 245 patients (64%) and 42 patients (17%) died. PCC-DOOR scale on days 7, 14, and 21 demonstrated fair correlation with the primary outcome (–0.42 [–0.52, –0.31], –0.47 [–0.56, –0.36], and –0.52 [–0.61, –0.42]), similar to the correlations for cumulative 28-day PELOD-2 scores (–0.51 [–0.59, –0.41]), ventilator-free days (0.43 [0.32, 0.53]), and PICU-free days (0.46 [0.35, 0.55]).

CONCLUSIONS:

The PCC-DOOR scale is a feasible, practical outcome for pediatric sepsis trials and demonstrates fair correlation with decrease in HRQL or death at 3 months.
Lipidomic Analysis of Microfat and Nanofat Reveals Different Lipid Mediator Compositions
Authors: Grünherz Lisanne , Kollarik Sedef , Sanchez-Macedo Nadia , McLuckie Michelle , Lindenblatt Nicole
Published: February 2024

Background:

Microfat and nanofat are commonly used in various surgical procedures, from skin rejuvenation to scar correction, to contribute to tissue regeneration. Microfat contains mainly adipocytes and is well suited for tissue augmentation, and nanofat is rich in lipids, adipose-derived stem cells, microvascular fragments, and growth factors, making it attractive for aesthetic use. The authors have previously demonstrated that the mechanical processing of microfat into nanofat significantly changes its proteomic profile. Considering that mechanical fractionation leads to adipocyte disruption and lipid release, they aimed to analyze their lipidomic profiles for their regenerative properties.

Methods:

Microfat and nanofat samples were isolated from 14 healthy patients. Lipidomic profiling was performed by liquid chromatography tandem mass spectrometry. The resulting data were compared against the Human Metabolome and LIPID MAPS Structure Database. MetaboAnalyst was used to analyze metabolic pathways and lipids of interest.

Results:

From 2388 mass-to-charge ratio features, metabolic pathway enrichment analysis of microfat and nanofat samples revealed 109 pathways that were significantly enriched. Microfat samples revealed higher-intensity levels of sphingosines, different eicosanoids, and fat-soluble vitamins. Increased levels of coumaric acids and prostacyclin were found in nanofat.

Conclusions:

This is the first study to analyze the lipidomic profiles of microfat and nanofat, providing evidence that mechanical emulsification of microfat into nanofat leads to changes in their lipid profiles. From 109 biological pathways, antiinflammatory, antifibrotic, and antimelanogenic lipid mediators were particularly enriched in nanofat samples when compared with microfat. Although further studies are necessary for a deeper understanding of the composition of these specific lipid mediators in nanofat samples, the authors propose that they might contribute to its regenerative effects on tissue.

Clinical Relevance Statement:

Profiling the unique lipid mediators in nanofat and microfat enhances our understanding of their different therapeutic effects and allows us to link these specific mediators to antiinflammatory, pro-regenerative, or healing properties. Ultimately, this insight can advance personalized therapeutic strategies, where a specific type of fat is selected based on its optimal therapeutic effect.
Causality Assessment Between Idiopathic Inflammatory Myopathies and Lung Cancer
Authors: Li Hui , Xu Yingying , Guo Qin , Zhang Tiantian , Zhou Shufen , Wang Qianqian , Tian Ye , Cheng Yuanxiong , Guo Chengshan
Published: February 2024

Background

Although observational studies have revealed associations between idiopathic inflammatory myopathies (IIMs) and lung cancer (LC), they have not established a causal relationship between these 2 conditions.

Methods

We used a 2-sample Mendelian randomization approach to examine the bidirectional causal associations between IIMs and LC, using single-nucleotide polymorphisms selected from high-quality genome-wide association studies in the FinnGen database. Sensitivity analyses were conducted to assess potential heterogeneity and pleiotropy impacts on the Mendelian randomization results.

Results

Our analysis demonstrated a positive causal effect of genetically increased IIM risk on LC (odds ratio, 1.114; 95% confidence interval, 1.057–1.173; p = 5.63 × 10−5), particularly on the lung squamous cell carcinoma subtype (odds ratio, 1.168, 95% confidence interval, 1.049–1.300, p = 0.00451), but not on lung adenocarcinoma or small cell lung cancer. No causal effect of LC on IIMs was identified. Sensitivity analyses indicated that horizontal pleiotropy was unlikely to influence causality, and leave-one-out analysis confirmed that the observed associations were not driven by a single-nucleotide polymorphism.

Conclusion

Our findings offer compelling evidence of a positive causal relationship between IIMs and LC, particularly with regard to lung squamous cell carcinoma, in the European population. Conversely, there is no evidence of LC causing IIMs. We recommend that LC diagnosis consider the specific characteristics of IIMs.
IR76b-expressing neurons in
Drosophila melanogaster
are necessary for associative reward learning of an amino acid mixture
Authors: Toshima Naoko , Schleyer Michael
Published: February 2024

Learning where to find nutrients while at the same time avoiding toxic food is essential for survival of any animal. Using
Drosophila melanogaster
larvae as a study case, we investigate the role of gustatory sensory neurons expressing IR76b for associative learning of amino acids, the building blocks of proteins. We found surprising complexity in the neuronal underpinnings of sensing amino acids, and a functional division of sensory neurons. We found that the IR76b receptor is dispensable for amino acid learning, whereas the neurons expressing IR76b are specifically required for the rewarding but not the punishing effect of amino acids. This unexpected dissociation in neuronal processing of amino acids for different behavioural functions provides a study case for functional divisions of labour in gustatory systems.
Accelerated simulation methodologies for computational vascular flow modelling
Authors: MacRaild Michael , Sarrami-Foroushani Ali , Lassila Toni , Frangi Alejandro F.
Published: February 2024

Vascular flow modelling can improve our understanding of vascular pathologies and aid in developing safe and effective medical devices. Vascular flow models typically involve solving the nonlinear Navier–Stokes equations in complex anatomies and using physiological boundary conditions, often presenting a multi-physics and multi-scale computational problem to be solved. This leads to highly complex and expensive models that require excessive computational time. This review explores accelerated simulation methodologies, specifically focusing on computational vascular flow modelling. We review reduced order modelling (ROM) techniques like zero-/one-dimensional and modal decomposition-based ROMs and machine learning (ML) methods including ML-augmented ROMs, ML-based ROMs and physics-informed ML models. We discuss the applicability of each method to vascular flow acceleration and the effectiveness of the method in addressing domain-specific challenges. When available, we provide statistics on accuracy and speed-up factors for various applications related to vascular flow simulation acceleration. Our findings indicate that each type of model has strengths and limitations depending on the context. To accelerate real-world vascular flow problems, we propose future research on developing multi-scale acceleration methods capable of handling the significant geometric variability inherent to such problems.
Glycolytic oscillations under periodic drivings
Authors: Kim Pureun , Hyeon Changbong
Published: February 2024

In many living organisms displaying circadian rhythms, the intake of energy often occurs in a periodic manner. Glycolysis is a prototypical biochemical reaction that exhibits a self-sustained oscillation under continuous injection of glucose. Here we study the effect of periodic injection of glucose on the glycolytic oscillation from a dynamical systems perspective. In particular, we employ Goldbeter’s allosteric model of phosphofructokinase as a model system for glycolytic oscillations, and explore the effect of periodic substrate influx of varying frequencies and amplitudes by building the phase diagrams of Lyapunov exponents and oscillatory periods. When the frequency of driving is tuned around the harmonic and sub/super-harmonic conditions of the natural frequency, the system is entrained to a frequency-locked state, forming an entrainment band that broadens with an increasing amplitude of driving. On the other hand, if the amplitude is substantial, the system may transition, albeit infrequent, to a chaotic state which defies prediction of dynamical behaviour. Our study offers in-depth understandings into the controllability of glycolytic oscillation as well as explaining physical underpinnings that enable the synchronous oscillations among a dense population of cells.
A Japanese Christian physicist defends evolution: Kimura Shunkichi's appropriation of British discourses in his philosophical scrutiny of science
Authors: Okamoto Takuji
Published: February 2024

Between 1889 and 1891, the Christian physicist Kimura Shunkichi strove to persuade his non-religious pupils at the First Higher Middle School that nature was harmonious, while encouraging his fellow Christians to enhance their belief by assimilating the accomplishments of contemporary science, especially the theory of evolution. The arguments of British scientists regarding the relationship between science and religion, particularly those after 1859, emerged as a substantial resource for Kimura's endeavour to convince his distinct audiences. Kimura astutely appropriated the discourses of various British scientists—ranging from the eighth Duke of Argyll to John Tyndall—in his physics course for humanities pupils and his lecture on evolution at a church in Yokohama, to effectively address the sensitivities of each group. Consequently, Kimura's lectures and publications during this period reveal a previously unknown connection between the acceptance of evolutionism in Japan and the contemporary British debates, underscoring the meticulous approach he adopted in employing these resources both in a national educational institution and within the church.