bluuebunny/crossref_metadata_2025 huggingface dataset:
Biosynthesis of fragrance 2-phenylethanol from sugars by Pseudomonas putida
Authors: Godoy Patricia , Udaondo Zulema , Duque Estrella , Ramos Juan L.
Published: April 2024

Background

Petrochemicals contribute to environmental issues, with concerns ranging from energy consumption and carbon emission to pollution. In contrast, microbial biorefineries offer eco-friendly alternatives. The solvent-tolerant Pseudomonasputida DOT-T1E serves as a suitable host for producing aromatic compounds, specifically l-phenylalanine and its derivative, 2-phenylethanol (2-PE), which find widespread applications in various industries.

Results

This study focuses on enhancing 2-PE production in two l-phenylalanine overproducing strains of DOT-T1E, namely CM12-5 and CM12-5Δgcd (xylABE), which grow with glucose and glucose-xylose, respectively. To synthesize 2-PE from l-phenylalanine, these strains were transformed with plasmid pPE-1, bearing the Ehrlich pathway genes, and it was found higher 2-PE production with glucose (about 50–60 ppm) than with xylose (< 3 ppm). To understand the limiting factors, we tested the addition of phenylalanine and intermediates from the Ehrlich and shikimate pathways. The results identified intracellular l-phenylalanine as a key limiting factor for 2-PE production. To overcame this limitation, a chorismate mutase/prephenate dehydratase variant—insentive to feedback inhibition by aromatic amino acids—was introduced in the producing strains. This led to increased l-phenylalanine production and subsequently produced more 2-PE (100 ppm). Random mutagenesis of the strains also produced strains with higher l-phenylalanine titers and increased 2-PE production (up to 120 ppm). The improvements resulted from preventing dead-end product accumulation from shikimate and limiting the catabolism of potential pathway intermediates in the Ehrlich pathway. The study explored agricultural waste substrates, such as corn stover, sugarcane straw and corn-syrup as potential C sources. The best results were obtained using 2G substrates at 3% (between 82 and 100 ppm 2-PE), with glucose being the preferred sugar for 2-PE production among the monomeric sugars in these substrates.

Conclusions

The findings of this study offer strategies to enhance phenylalanine production, a key substrate for the synthesis of aromatic compounds. The ability of P.putida DOT-T1E to thrive with various C-sources and its tolerance to substrates, products, and potential toxicants in industrial wastes, are highlighted. The study identified and overcome possible bottlenecks for 2-PE production. Ultimately, the strains have potential to become efficient microbial platforms for synthesizing 2-PE from agro-industrial waste materials.
Leveraging new methods for comprehensive characterization of mitochondrial DNA in esophageal squamous cell carcinoma
Authors: Zhuang Xuehan , Ye Rui , Zhou Yong , Cheng Matthew Yibo , Cui Heyang , Wang Longlong , Zhang Shuangping , Wang Shubin , Cui Yongping , Zhang Weimin
Published: April 2024

Background

Mitochondria play essential roles in tumorigenesis; however, little is known about the contribution of mitochondrial DNA (mtDNA) to esophageal squamous cell carcinoma (ESCC). Whole-genome sequencing (WGS) is by far the most efficient technology to fully characterize the molecular features of mtDNA; however, due to the high redundancy and heterogeneity of mtDNA in regular WGS data, methods for mtDNA analysis are far from satisfactory.

Methods

Here, we developed a likelihood-based method dMTLV to identify low-heteroplasmic mtDNA variants. In addition, we described fNUMT, which can simultaneously detect non-reference nuclear sequences of mitochondrial origin (non-ref NUMTs) and their derived artifacts. Using these new methods, we explored the contribution of mtDNA to ESCC utilizing the multi-omics data of 663 paired tumor-normal samples.

Results

dMTLV outperformed the existing methods in sensitivity without sacrificing specificity. The verification using Nanopore long-read sequencing data showed that fNUMT has superior specificity and more accurate breakpoint identification than the current methods.

Leveraging the new method, we identified a significant association between the ESCC overall survival and the ratio of mtDNA copy number of paired tumor-normal samples, which could be potentially explained by the differential expression of genes enriched in pathways related to metabolism, DNA damage repair, and cell cycle checkpoint. Additionally, we observed that the expression of CBWD1 was downregulated by the non-ref NUMTs inserted into its intron region, which might provide precursor conditions for the tumor cells to adapt to a hypoxic environment. Moreover, we identified a strong positive relationship between the number of mtDNA truncating mutations and the contribution of signatures linked to tumorigenesis and treatment response.

Conclusions

Our new frameworks promote the characterization of mtDNA features, which enables the elucidation of the landscapes and roles of mtDNA in ESCC essential for extending the current understanding of ESCC etiology. dMTLV and fNUMT are freely available from https://github.com/sunnyzxh/dMTLV and https://github.com/sunnyzxh/fNUMT, respectively.
Race-specific coregulatory and transcriptomic profiles associated with DNA methylation and androgen receptor in prostate cancer
Authors: Ramakrishnan Swathi , Cortes-Gomez Eduardo , Athans Sarah R. , Attwood Kristopher M. , Rosario Spencer R. , Kim Se Jin , Mager Donald E. , Isenhart Emily G. , Hu Qiang , Wang Jianmin , Woloszynska Anna
Published: April 2024

Background

Prostate cancer is a significant health concern, particularly among African American (AA) men who exhibit higher incidence and mortality compared to European American (EA) men. Understanding the molecular mechanisms underlying these disparities is imperative for enhancing clinical management and achieving better outcomes.

Methods

Employing a multi-omics approach, we analyzed prostate cancer in both AA and EA men. Using Illumina methylation arrays and RNA sequencing, we investigated DNA methylation and gene expression in tumor and non-tumor prostate tissues. Additionally, Boolean analysis was utilized to unravel complex networks contributing to racial disparities in prostate cancer.

Results

When comparing tumor and adjacent non-tumor prostate tissues, we found that DNA hypermethylated regions are enriched for PRC2/H3K27me3 pathways and EZH2/SUZ12 cofactors. Olfactory/ribosomal pathways and distinct cofactors, including CTCF and KMT2A, were enriched in DNA hypomethylated regions in prostate tumors from AA men. We identified race-specific inverse associations of DNA methylation with expression of several androgen receptor (AR) associated genes, including theGATAfamily of transcription factors andTRIM63. This suggests that race-specific dysregulation of the AR signaling pathway exists in prostate cancer. To investigate the effect of AR inhibition on race-specific gene expression changes, we generated in-silico patient-specific prostate cancer Boolean networks. Our simulations revealed prolonged AR inhibition causes significant dysregulation of TGF-β, IDH1, and cell cycle pathways specifically in AA prostate cancer. We further quantified global gene expression changes, which revealed differential expression of genes related to microtubules, immune function, and TMPRSS2-fusion pathways, specifically in prostate tumors of AA men. Enrichment of these pathways significantly correlated with an altered risk of disease progression in a race-specific manner.

Conclusions

Our study reveals unique signaling networks underlying prostate cancer biology in AA and EA men, offering potential insights for clinical management strategies tailored to specific racial groups. Targeting AR and associated pathways could be particularly beneficial in addressing the disparities observed in prostate cancer outcomes in the context of AA and EA men. Further investigation into these identified pathways may lead to the development of personalized therapeutic approaches to improve outcomes for prostate cancer patients across different racial backgrounds.
A comparison of various insulin resistance indices and the possibility of hypertension in military adults: CHIEF study
Authors: Huang Wei-Che , Tsai Kun-Zhe , Yang Kai-Ti , Chen Han-Hsing , Kwon Younghoon , Lin Gen-Min
Published: April 2024

Background

Insulin resistance is associated with the development of hypertension, whereas there were rare studies comparing various non-insulin based insulin resistance (NI-IR) indices for the possibility of hypertension among young and middle-aged adults.

Methods

This cross-sectional study included a total of 4,080 military personnel, aged 18–50 years, without antihypertensive medications therapy in 2014. All subjects received annual health examinations for blood pressure (BP) measurements. Stage I isolated diastolic hypertension (IDH) and isolated systolic hypertension (ISH) and combined hypertension were respectively defined as systolic BP (SBP) < 130 mmHg/diastolic BP (DBP) 80–89 mmHg, SBP 130–139 mmHg/DBP < 80 mmHg, and SBP 130–139 mmHg/DBP 80–89 mmHg. The cut-off values of stage II hypertension for SBP and DBP were 140–159 mmHg and 90–99 mmHg, respectively. Four NI-IR indices included the serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio, TyG index, Metabolic Score for IR (METS-IR) and ZJU index which were defined according to their specific formula. Multiple logistic regression analysis with adjustments for age, sex, anthropometrics, substance use, kidney function, serum uric acid, atherogenic cholesterols and physical activity was performed to determine the associations.

Results

There were 1,024 subjects with hypertension (25.1%) in which 739 were stage I hypertension, and 285 were stage II hypertension. For total hypertension, there were an association with TyG and METS-IR indices [odds ratios (ORs) and 95% confidence intervals: 1.432 (1.215–1.688) and 1.553 (1.040–2.321), respectively]. For hypertension subtypes, TyG index was positively associated with overall, stage I, and stage II ISH [ORs: 1.447 (1.149–1.823), 1.317 (1.029–1.687), and 2.011 (1.351–2.994), respectively], while TG/HDL-C, METS-IR and ZJU indices were merely associated with stage II ISH [ORs: 1.053 (1.006–1.103), 3.001 (1.171–7.696) and 1.009 (1.000-1.017), respectively]. In addition, TyG and METS-IR indices were positively associated with stage II IDH [ORs: 1.813 (1.207–2.721) and 2.85 (1.080–7.520), respectively], and TyG index was also associated with combined hypertension [OR: 1.425 (1.007–1.833)].

Conclusion

Among young and middle-aged adults, insulin resistance assessed by the four NI-IR indices was positively associated with stage II ISH, while only TyG index had a significant association for both stage II IDH and combined hypertension.
Brain 18 F-FDG PET reveals cortico-subcortical hypermetabolic dysfunction in juvenile neuropsychiatric systemic lupus erythematosus
Authors: Rodrigo Sebastian , Costi Stefania , Ellul Pierre , Aubart Melodie , Boddaert Nathalie , Auvin Stephane , Elmaleh Monique , Ntorkou Alexandra , Bader-Meunier Brigitte , Lebon Vincent , Melki Isabelle , Chiron Catherine
Published: April 2024

Background

In juvenile systemic lupus erythematosus (j-SLE) with neuropsychiatric (NP) symptoms, there is a lack of diagnostic biomarkers. Thus, we study whether PET-FDG may identify any metabolic dysfunction in j-NPSLE.

Methods

A total of 19 18FDG-PET exams were consecutively performed using PET-MRI system in 11 non-sedated patients presenting with j-NPSLE (11-18y) for less than 18 months (m) and without any significant lesion at MRI. Psychiatric symptoms were scored from 0 (none) to 3 (severe) at PET time. PET images were visually analyzed and voxel-based analyses of cerebral glucose metabolism were performed using statistical parametric mapping (spm) with an age-matched control group, at threshold set > 50 voxels using both p < 0.001 uncorrected (unc.) and p < 0.05 corrected family wise error (FWE).

Results

Patients exhibited mainly psychiatric symptoms, with diffuse inflammatory j-NPSLE. First PET (n = 11) was performed at a mean of 15y of age, second/third PET (n = 7/n = 1) 6 to 19 m later. PET individual analysis detected focal bilateral anomalies in 13/19 exams visually but 19/19 using spm (unc.), mostly hypermetabolic areas (18/19). A total of 15% of hypermetabolic areas identified by spm had been missed visually. PET group analysis (n = 19) did not identify any hypometabolic area, but a large bilateral cortico-subcortical hypermetabolic pattern including, by statistical decreasing order (unc.), thalamus, subthalamic brainstem, cerebellum (vermis and cortex), basal ganglia, visual, temporal and frontal cortices. Mostly the subcortical hypermetabolism survived to FWE analysis, being most intense and extensive (51% of total volume) in thalamus and subthalamus brainstem. Hypermetabolism was strictly subcortical in the most severe NP subgroup (n = 8, scores 2–3) whereas it also extended to cerebral cortex, mostly visual, in the less severe subgroup (n = 11, scores 0–1), but difference was not significant. Longitudinal visual analysis was inconclusive due to clinical heterogeneity.

Conclusions

j-NPSLE patients showed a robust bilateral cortico-subcortical hypermetabolic network, focused subcortically, particularly in thalamus, proportionally to psychiatric features severity. Further studies with larger, but homogeneous, cohorts are needed to determine the sensitivity and specificity of this dysfunctional pattern as a potential biomarker in diffuse inflammatory j-NPSLE with normal brain MRI.
Arab male physicians’ perceptions about their own smoking behaviors: a qualitative study
Authors: Obeid Samira , Idilbi Nasra , Agbarya Abed , Admi Hanna
Published: April 2024

Background

Smoking remains the leading preventable cause of disease, disability, and death worldwide. Although physicians have high levels of health literacy with awareness of the consequences of smoking and their essential role in smoking cessation of patients, some physicians continue to smoke. Rates of smoking among Arab male physicians are high. This study aimed to gain insights into Arab male physician’s perceptions of their own smoking behaviors and their professional role in health promotion.

Methods

Using purposive sampling, we recruited 25 Arab male physicians working in hospital and community clinic settings who currently smoke. Semi-structured, hour-long, interviews were held during January—June 2022. We then performed a thematic analysis of the interview data.

Results

The analysis revealed three categories, two sub-categories, and 15 emerging themes. The category ‘Antecedents: prior to becoming a physician’ revealed the themes: smoking experience during adolescence; social and ethnic culture; stress during medical studies; and on & off periods of quitting smoking. The category ‘Physicians’ perception of smoking’ was sorted into two sub-categories: (1) Personal aspects, including the themes ‘relaxation from stress’, ‘self-compensation’, ‘addiction’, and ‘enjoyable experience’, and (2) Professional aspects, including the themes ‘lack of knowledge about cessation’, ‘inadequate workplace support’, ‘motivation to consult patients’, and ‘awareness of their role as primary care physicians’. The category’Impacts’ revealed the themes ‘personal health and well-being’, ‘professional competence’, and ‘professional image in public’.

Conclusions

This study provides an in-depth understanding of the personal, socio-cultural, and professional aspects of the phenomenon of Arab male smoking physicians from their perspective. Based on this information, we recommend developing programs that support and empower all physicians to cope better with their personal and professional stress as well as instituting programs that will provide all physicians with specific knowledge and skills related to smoking cessation. These programs should improve the ability of physicians to serve as positive role models for their patients for preventing and ceasing smoking, thus enhancing the image of the medical profession and, most importantly, improving the health of the public.
The discrete analogue of high-order differential operator and its application to finding coefficients of optimal quadrature formulas
Authors: Shadimetov K. M. , Davronov J. R.
Published: April 2024

The discrete analog of the differential operator plays a significant role in constructing interpolation, quadrature, and cubature formulas. In this work, we consider a discrete analog $D_{m}(h\beta )$

D
m

(
h
β
)
of the differential operator $\frac{d^{2m}}{dx^{2m}}+1$

d

2
m

d

x

2
m

+
1
designed specifically for even natural numbers m. The operator’s effectiveness in constructing an optimal quadrature formula in the $L_{2}^{(2,0)}(0,1)$

L
2

(
2
,
0
)

(
0
,
1
)
space is demonstrated. The errors of the optimal quadrature formula in the $W_{2}^{(2,1)}(0,1)$

W
2

(
2
,
1
)

(
0
,
1
)
space and in the $L_{2}^{(2,0)}(0,1)$

L
2

(
2
,
0
)

(
0
,
1
)
space are compared numerically. The numerical results indicate that the optimal quadrature formula constructed in this work has a smaller error than the one constructed in the $W_{2}^{(2,1)}(0,1)$

W
2

(
2
,
1
)

(
0
,
1
)
space.
Cost of start-up activities to implement a community-level opioid overdose reduction intervention in the HEALing Communities Study
Authors: Montoya Iván D. , Watson Colleen , Aldridge Arnie , Ryan Danielle , Murphy Sean M. , Amuchi Brenda , McCollister Kathryn E. , Schackman Bruce R. , Bush Joshua L. , Speer Drew , Harlow Kristin , Orme Stephen , Zarkin Gary A. , Castry Mathieu , Seiber Eric E. , Barocas Joshua A. , Linas Benjamin P. , Starbird Laura E.
Published: April 2024

Background

Communities That HEAL (CTH) is a novel, data-driven community-engaged intervention designed to reduce opioid overdose deaths by increasing community engagement, adoption of an integrated set of evidence-based practices, and delivering a communications campaign across healthcare, behavioral-health, criminal-legal, and other community-based settings. The implementation of such a complex initiative requires up-front investments of time and other expenditures (i.e., start-up costs). Despite the importance of these start-up costs in investment decisions to stakeholders, they are typically excluded from cost-effectiveness analyses. The objective of this study is to report a detailed analysis of CTH start-up costs pre-intervention implementation and to describe the relevance of these data for stakeholders to determine implementation feasibility.

Methods

This study is guided by the community perspective, reflecting the investments that a real-world community would need to incur to implement the CTH intervention. We adopted an activity-based costing approach, in which resources related to hiring, training, purchasing, and community dashboard creation were identified through macro- and micro-costing techniques from 34 communities with high rates of fatal opioid overdoses, across four states—Kentucky, Massachusetts, New York, and Ohio. Resources were identified and assigned a unit cost using administrative and semi-structured-interview data. All cost estimates were reported in 2019 dollars.

Results

State-level average and median start-up cost (representing 8–10 communities per state) were $268,657 and $175,683, respectively. Hiring and training represented 40%, equipment and infrastructure costs represented 24%, and dashboard creation represented 36% of the total average start-up cost. Comparatively, hiring and training represented 49%, purchasing costs represented 18%, and dashboard creation represented 34% of the total median start-up cost.

Conclusion

We identified three distinct CTH hiring models that affected start-up costs: hospital-academic (Massachusetts), university-academic (Kentucky and Ohio), and community-leveraged (New York). Hiring, training, and purchasing start-up costs were lowest in New York due to existing local infrastructure. Community-based implementation similar to the New York model may have lower start-up costs due to leveraging of existing infrastructure, relationships, and support from local health departments.
Triglyceride-glucose-waist circumference index predicts the incidence of cardiovascular disease in Korean populations: competing risk analysis of an 18-year prospective study
Authors: Ahn Sung Ho , Lee Hye Sun , Lee Jun-Hyuk
Published: April 2024

Background

The triglyceride and glucose-waist circumference (TyG-WC) index demonstrated a strong association with insulin resistance, especially in Asian population. However, evidence on the association between TyG-WC index and the occurrence of cardiovascular disease (CVD) is limited. This study aimed to verify association between the TyG-WC index and the occurrence of CVD by considering all-cause mortality as a competing risk.

Methods

The study included 7482 participants divided into four groups based on the TyG-WC index quartiles. Kaplan–Meier curves illustrated cumulative incidence rates of CVD and all-cause mortality during the follow-up period. Log-rank tests determined group differences. The Cox proportional hazard spline curve demonstrates the dose-dependent relationship between the TyG-WC index and incident CVD. Modified Cox regression (Fine and Gray) estimated hazard ratios (HRs) with 95% CIs for incident CVD, treating death as a competing risk. Death event after incident CVD was excluded from the death count.

Results

During the median 15.94 year of follow-up period, a total of 691 (9.24%) new-onset CVD cases and 562 (7.51%) all-cause mortality cases were confirmed. Cox proportional hazard spline curves suggested that TyG-WC index exhibited a dose-dependent positive correlation with incident CVD. The cumulative incidence rate of CVD was significantly higher in the groups with higher TyG-WC index quartiles in Kaplan–Meier curves. The adjusted HR (95% CI) for incident CVD in Q2–Q4, compared with Q1, was 1.47 (1.12–1.93), 1.91 (1.44–2.54) and 2.24 (1.63–3.07), respectively. There was no significant association between TyG-WC index and all-cause mortality. Specifically, angina and stroke were significantly associated with the TyG-WC index, in contrast to myocardial infarction and peripheral artery disease.

Conclusions

The TyG-WC index was positively associated with incident CVD even considering all-cause mortality as a competing risk. Therefore, TyG-WC index may be a valuable marker for predicting the occurrence of CVD.
Dietary fasting and time-restricted eating in Huntington’s disease: therapeutic potential and underlying mechanisms
Authors: Wells Russell G. , Neilson Lee E. , McHill Andrew W. , Hiller Amie L.
Published: April 2024

Huntington's disease (HD) is a devastating neurodegenerative disorder caused by aggregation of the mutant huntingtin (mHTT) protein, resulting from a CAG repeat expansion in the huntingtin gene HTT. HD is characterized by a variety of debilitating symptoms including involuntary movements, cognitive impairment, and psychiatric disturbances. Despite considerable efforts, effective disease-modifying treatments for HD remain elusive, necessitating exploration of novel therapeutic approaches, including lifestyle modifications that could delay symptom onset and disease progression. Recent studies suggest that time-restricted eating (TRE), a form of intermittent fasting involving daily caloric intake within a limited time window, may hold promise in the treatment of neurodegenerative diseases, including HD. TRE has been shown to improve mitochondrial function, upregulate autophagy, reduce oxidative stress, regulate the sleep–wake cycle, and enhance cognitive function. In this review, we explore the potential therapeutic role of TRE in HD, focusing on its underlying physiological mechanisms. We discuss how TRE might enhance the clearance of mHTT, recover striatal brain-derived neurotrophic factor levels, improve mitochondrial function and stress-response pathways, and synchronize circadian rhythm activity. Understanding these mechanisms is critical for the development of targeted lifestyle interventions to mitigate HD pathology and improve patient outcomes. While the potential benefits of TRE in HD animal models are encouraging, future comprehensive clinical trials will be necessary to evaluate its safety, feasibility, and efficacy in persons with HD.
Detecting oracle bone inscriptions via pseudo-category labels
Authors: Fu Xinran , Zhou Rixin , Yang Xi , Li Chuntao
Published: April 2024

Oracle bone inscriptions (OBIs) are the earliest Chinese characters and reserve abundant historical information. OBIs are detected by locating their positions in digital images. This has been a foundational task in modern archeological studies. Due to the development of deep neural networks(DNNs) in computer vision, detecting OBIs can be implemented by a more concise method instead of designing complicated hand-crafted features. However, existing models cannot perform well when noise areas are similar to some inscriptions. In this work, we present a simple but effective pseudo-label-based architecture for OBIs detection. Different from previous approaches, our method performs OBIs detection with the employment of information from multilabel annotations rather than single location information. We append a plug-and-play module that predicts the pseudo-label of an inscription after the backbone network for learning the particular structure prior to each inscription and brings this information to the backbone network by means of feature fusion. We make remarkable improvements on different backbone networks when using the proposed method on an OBIs detection dataset. The quantitative and qualitative results show that the proposed model can detect OBIs well and is an effective tool for assisting in the discovery and recognition of ancient writing.
Impact of scatter correction on personalized dosimetry in selective internal radiotherapy using 166Ho-PLLA: a single-center study including Monte-Carlo simulation, phantom and patient imaging
Authors: Collette Benoît , Mannie-Corbisier Marie , Bucalau Ana-Maria , Pauly Nicolas , Verset Gontran , Moreno-Reyes Rodrigo , Flamen Patrick , Trotta Nicola
Published: April 2024

Background

Developments in transarterial radioembolization led to the conception of new microspheres loaded with holmium-166 (166Ho). However, due to the complexity of the scatter components in 166Ho single photon emission computed tomography (SPECT), questions about image quality and dosimetry are emerging. The aims of this work are to investigate the scatter components and correction methods to propose a suitable solution, and to evaluate the impact on image quality and dosimetry including Monte-Carlo (MC) simulations, phantom, and patient data.

Methods

Dual energy window (DEW) and triple energy window (TEW) methods were investigated for scatter correction purposes and compared using Contrast Recovery Coefficients (CRC) and Contrast to Noise Ratios (CNR). First, MC simulations were carried out to assess all the scatter components in the energy windows used, also to confirm the choice of the parameter needed for the DEW method. Then, MC simulations of acquisitions of a Jaszczak phantom were conducted with conditions mimicking an ideal scatter correction. These simulated projections can be reconstructed and compared with real acquisitions corrected by both methods and then reconstructed. Finally, both methods were applied on patient data and their impact on personalized dosimetry was evaluated.

Results

MC simulations confirmed the use of k = 1 for the DEW method. These simulations also confirmed the complexity of scatter components in the main energy window used with a high energy gamma rays component of about half of the total counts detected, together with a negligible X rays component and a negligible presence of fluorescence. CRC and CNR analyses, realized on simulated scatter-free projections of the phantom and on scatter corrected acquisitions of the same phantom, suggested an increased efficiency of the TEW method, even at the price of higher level of noise. Finally, these methods, applied on patient data, showed significant differences in terms of non-tumoral liver absorbed dose, non-tumoral liver fraction under 50 Gy, tumor absorbed dose, and tumor fraction above 150 Gy.

Conclusions

This study demonstrated the impact of scatter correction on personalized dosimetry on patient data. The use of a TEW method is proposed for scatter correction in 166Ho SPECT imaging.
An 8-mm port site hernia after robotic-assisted ileocecal resection: a case report
Authors: Ahn Changgi , Shibutani Masatsune , Kitayama Kishu , Kasashima Hiroaki , Miki Yuichiro , Yoshii Mami , Fukuoka Tatsunari , Tamura Tatsuro , Toyokawa Takahiro , Lee Shigeru , Maeda Kiyoshi
Published: April 2024

Background

Robotic-assisted surgery is steadily becoming more prominent. The majority of reports regarding port site hernias (PSHs) have involved laparoscopic procedures. Currently, it is common to suture the fascia at port sites that are 10 mm or larger; however, the closure of 5-mm port sites is not considered mandatory. The da Vinci® surgical system (Intuitive Surgical Inc., Sunnyvale, CA, USA) utilizes a distinctive 8-mm port. We report a case of an early-onset PSH at an 8-mm port site after robotic-assisted ileocecal resection.

Case presentation

A 74-year-old male patient with a body mass index of 19.7 kg/m2 was diagnosed with cecal cancer and underwent robotic-assisted ileocecal resection. A 3-cm midline incision was made at the umbilicus for insufflation. Under laparoscopic visualization, three ports (12 mm, 8 mm, and 8 mm) were inserted in the lower abdomen. An 8-mm port was inserted in the left subcostal region, and a 5-mm port was inserted in the left lateral abdomen. The procedure was performed without significant intraoperative complications. The fascia was closed only at the umbilicus and 12-mm port site; the fascia at the 8-mm port sites was not closed. The patient was initially discharged without complications; however, on postoperative day 11, the patient was urgently hospitalized again because of PSH incarceration. After manual reduction, the fascia was sutured closed under local anesthesia. The hernial defect was small and barely allowed the insertion of a little finger. There was no evidence of compression or significant damage to the fascia. On postoperative day 27, the patient was discharged after experiencing good recovery.

Conclusions

Robotic-assisted colectomy could contribute to the risk of PSHs because of its surgical characteristics. Although routine closure of the fascia at 8-mm port sites is not mandatory, it may be beneficial in certain cases.
Nominal Differences in Acute Symptom Presentation and Recovery Duration of Sport-Related Concussion Between Male and Female Collegiate Athletes in the PAC-12
Authors: Konstantinides Niki A. , Murphy Sean M. , Whelan Bridget M. , Harmon Kimberly G. , Poddar Sourav K. , Hernández Theresa D. , Rowe Rachel K.
Published: April 2024

Background

Sport-related concussion (SRC) is a heterogenous injury that often presents with varied symptoms and impairment. Recently, research has focused on identifying subtypes, or clinical profiles of concussion to be used in assessing and treating athletes with SRC. The purpose of this study was to investigate sex differences in clinical profiles, recovery duration, and initial symptom severity after SRC in a cohort of collegiate athletes in the Pacific-12 Conference (Pac-12).

Methods

This prospective cohort study examined post-SRC symptoms, recovery, and return-to-play times using data from the Pac-12 CARE Affiliated Program and Pac-12 Health Analytics Program. Clinical profiles reported by student-athletes were defined by the number (> 50%) of specific symptoms frequently reported for each profile. Generalized linear mixed models were used to examine associations among sex, clinical profiles, time-to-recovery, and return-to-play times.

Results

479 concussion incidents met inclusion criteria. The probabilities of initial presentation of each clinical profile, initial injury severity scores, and recovery times within a profile did not differ between sexes (p = 0.33–0.98). However, both males and females had > 0.75 probabilities of exhibiting cognitive and ocular profiles. Initial injury severity score was a strong nonlinear predictor of initial number of clinical profiles (p < 0.0001), which did not differ between sexes. The number of clinical profiles was also a nonlinear predictor of time-to-recovery (p = 0.03) and return-to-play times (p < 0.0001).

Conclusions

Initial symptom severity was strongly predictive of the number of acute clinical profiles experienced post-SRC. As the number of clinical profiles increased, time-to-recovery and time to return-to-play also increased. Factors other than sex may be better associated with acute symptom presentation post-concussion as no sex differences were found in reported clinical profiles or recovery. Understanding the number and type of clinical profiles experienced post-SRC may help inform concussion diagnostics and management.
Prevalence and predictors associated with modern contraceptive method utilization among women in the nomadic community of Ethiopia: a cross-sectional study
Authors: Gebrerufael Gebru Gebremeskel , Hagos Bsrat Tesfay
Published: April 2024

Background

Ethiopia is one of the countries in sub-Saharan Africa with the lowest prevalence of the use of modern contraceptive methods. On the frequency and determinants of modern contraceptive method in the Ethiopian women who live a nomadic lifestyle, there is, however, scant research. Therefore, the purpose of this study was to evaluate the factors that influence how often women in Ethiopia’s nomadic tribes use modern contraceptive method.

Methods

In the nomadic community of Ethiopia, a community-based retrospective cross-sectional study was carried out between January 18 and June 27, 2016. From the 15,683 nationally representative datasets on the 2016 Ethiopian Demography and Health Survey, a sample of 3,415 women from nomadic communities was chosen. To determine factors linked to modern contraceptive method usage within the nomadic group, a multivariable logistic regression model analysis was considered.

Result

In the nomadic population of Ethiopia, 10% (95% CI (9.10, 11.1)) of respondents reported using modern contraceptive method overall. The most popular way to use modern contraceptive method was through injection (73.5%). In the multivariable logistic regression model analysis, secondary and above-educated husbands (AOR = 1.6, 95% CI (1.01, 2.24)) and primarily educated husbands (AOR = 1.4, 95% CI (1.027, 2.0)), rich (AOR = 1.6, 95% CI (1.03, 2.74)) and middle wealth index (AOR = 1.58, 95% CI (1.25, 2.38)), public health place of delivery (AOR = 2.5, 95% CI (1.55, 3.0)), being a working husband (AOR = 3.8, 95% CI (1.96, 4.22)), and respondents working (AOR = 1.5, 95% CI (1.04, 1.79)) were positively critical risk predictors associated with modern contraceptive method usages. Compared to the Somali region, women living in the Afar (AOR = 2.58, 95% CI (1.68, 3.95)) and Benshangul-Gumuz (AOR = 3.40, 95% CI (2.22, 5.21)) regions had higher use of modern contraceptive method.

Conclusion

In Ethiopia, modern contraceptive method usage is still quite uncommon among women who live in nomadic communities. Therefore, in order to increase modern contraceptive method service utilization and improve the wealth index of households, two key strategies, government professionals and concerned body service providers should pay special attention to educational opportunities for husbands and give valuable and effective counseling information during child delivery for women.
On the portrayal of indigenous peoples in English language teaching coursebooks used in Chile: a critical visual literacy/socio-semiotic study
Authors: Véliz-Campos Mauricio , Roa Felipe , Veliz Leonardo
Published: April 2024

This research critically examines the multifaceted role of English as a foreign language (EFL) coursebooks beyond mere language learning objectives. Specifically, the study focuses on how these coursebooks often project universal cultural values that, though seemingly bland, can perpetuate power dynamics leading to various forms of inequality. Drawing on a qualitative methodology that amalgamates socio-semiotic analysis and critical visual literacy, the investigation scrutinizes the portrayal of indigenous peoples within 12 EFL coursebooks used in state-run and subsidized schools across Chile. Furthermore, the research explores the viewpoints and attitudes of seven EFL teachers towards the visual representations of indigenous peoples compared to non-indigenous individuals depicted in the same coursebooks. The findings suggest that indigenous peoples are often depicted as stereotypical remnants of the past, oversimplifying their intricate cultural attributes and presenting them as disconnected from contemporary society. Moreover, the study identifies the failure of coursebook publishers in acknowledging the richness and diversity of indigenous cultures, thereby perpetuating cultural stereotypes and contributing to the process of otherising, which reinforces a sense of separation between the majority (“us”) and the indigenous minority (“them”).
Fabricating patient-specific 3D printed drill guides to treat femoral head avascular necrosis
Authors: Bell Cameron , Feizi Alborz , Roytman Gregory R. , Ramji Alim F. , Tommasini Steven M. , Wiznia Daniel H.
Published: April 2024

Background

Femoral head avascular necrosis (AVN), or death of femoral head tissue due to a lack of blood supply, is a leading cause of total hip replacement for non-geriatric patients. Core decompression (CD) is an effective treatment to re-establish blood flow for patients with AVN. Techniques aimed at improving its efficacy are an area of active research. We propose the use of 3D printed drill guides to accurately guide therapeutic devices for CD.

Methods

Using femur sawbones, image processing software, and 3D modeling software, we created a custom-built device with pre-determined drill trajectories and tested the feasibility of the 3D printed drill guides for CD. A fellowship trained orthopedic surgeon used the drill guide to position an 8 ga, 230 mm long decompression device in the three synthetic femurs. CT scans were taken of the sawbones with the drill guide and decompression device. CT scans were processed in the 3D modeling software. Descriptive statistics measuring the angular and needle-tip deviation were compared to the original virtually planned model.

Results

Compared to the original 3D model, the trials had a mean displacement of 1.440 ± 1.03 mm and a mean angle deviation of 1.093 ± 0.749º.

Conclusions

The drill guides were demonstrated to accurately guide the decompression device along its predetermined drill trajectory. Accuracy was assessed by comparing values to literature-reported values and considered AVN lesion size. This study demonstrates the potential use of 3D printing technology to improve the efficacy of CD techniques.
Preoperative weight loss before total hip arthroplasty negatively impacts postoperative outcomes
Authors: Schmerler Jessica , Hussain Nauman , Kurian Shyam J. , Khanuja Harpal S. , Oni Julius K. , Hegde Vishal
Published: April 2024

Background

Obesity adversely impacts outcomes of total hip arthroplasty (THA), leading surgeons to impose body mass index cutoffs for patient eligibility and encourage preoperative weight loss. This study aimed to determine if preoperative weight loss impacts outcomes of THA in the general patient population and if it mitigates poor outcomes in obese patients.

Methods

Patients who underwent THA from 2013–2020 were identified in the National Surgical Quality Improvement Program (NSQIP) database. Patients were stratified by weight loss of >10% of body weight over the preceding 6 months. We used multivariable linear and logistic regression models, adjusted for age, sex, race/ethnicity, and comorbidities, to examine the effect of significant preoperative weight loss on 30-day outcomes after THA in the general and obese patient populations.

Results

In the overall population, patients who lost significant weight preoperatively had significantly increased length of stay, were more likely to have a non-home discharge, return to the operating room, or be readmitted, and were more likely to experience numerous medical complications. In the obese population, patients who lost significant weight preoperatively had significantly increased length of stay and were more likely to require a transfusion or experience any medical complication.

Discussion

Rapid significant preoperative weight loss is not associated with improved postoperative outcomes after THA in the obese population and is associated with worse outcomes in the general population. Arthroplasty surgeons should balance these risks with the risks of obesity when advising patients about preoperative weight loss prior to THA.

Level of evidence

III.
Evaluating the accuracy and relevance of ChatGPT responses to frequently asked questions regarding total knee replacement
Authors: Zhang Siyuan , Liau Zi Qiang Glen , Tan Kian Loong Melvin , Chua Wei Liang
Published: April 2024

Background

Chat Generative Pretrained Transformer (ChatGPT), a generative artificial intelligence chatbot, may have broad applications in healthcare delivery and patient education due to its ability to provide human-like responses to a wide range of patient queries. However, there is limited evidence regarding its ability to provide reliable and useful information on orthopaedic procedures. This study seeks to evaluate the accuracy and relevance of responses provided by ChatGPT to frequently asked questions (FAQs) regarding total knee replacement (TKR).

Methods

A list of 50 clinically-relevant FAQs regarding TKR was collated. Each question was individually entered as a prompt to ChatGPT (version 3.5), and the first response generated was recorded. Responses were then reviewed by two independent orthopaedic surgeons and graded on a Likert scale for their factual accuracy and relevance. These responses were then classified into accurate versus inaccurate and relevant versus irrelevant responses using preset thresholds on the Likert scale.

Results

Most responses were accurate, while all responses were relevant. Of the 50 FAQs, 44/50 (88%) of ChatGPT responses were classified as accurate, achieving a mean Likert grade of 4.6/5 for factual accuracy. On the other hand, 50/50 (100%) of responses were classified as relevant, achieving a mean Likert grade of 4.9/5 for relevance.

Conclusion

ChatGPT performed well in providing accurate and relevant responses to FAQs regarding TKR, demonstrating great potential as a tool for patient education. However, it is not infallible and can occasionally provide inaccurate medical information. Patients and clinicians intending to utilize this technology should be mindful of its limitations and ensure adequate supervision and verification of information provided.
Effectiveness of the application of an educational program based on the Theory of Planned Behavior (TPB) in adopting preventive behaviors among mothers who have thalassemia children in Iran: a randomized controlled trial
Authors: Zareban Iraj , Oudi-Akbari Zahra , Jadgal Mohammad Saeed , Ansari Hossein , Hosseinzehi Zamani Jamshid
Published: April 2024

Background

Thalassemia is one of the most common chronic diseases, which cause many problems for the patients, families, and health system. The aim of this study was to evaluate the effectiveness of the application of an educational program based on the Theory of Planned Behavior in adopting preventive behaviors from thalassemia.

Methods

This randomized controlled trial study was associated with the participation of 160 mothers of children suffering from thalassemia major, who were divided into two groups including intervention and control. Demographic information, knowledge, and data related to the constructs of the Theory of Planned Behavior were collected. Data were analyzed using SPSS16 software and descriptive and analytical tests.

Results

The mean scores of perceived behavioral control, behavioral intention, and behavior in the intervention group in the pre-intervention phase were 9.83 ± 1.45, 9.1 ± 21.32, and 2.1 ± 18.42, respectively. The stage after the intervention was increased to 12.00 ± 0.00, 11.51 ± 0.59, and 5 ± 0.37.95, respectively, and the difference of the means in the two stages was significant (Pvalue < 0.0001). But no significant change was observed in the control group (Pvalue > 0.05).

Conclusion

The results of the study showed the effect of the training intervention based on the Theory of Planned Behavior on the promotion of preventive behaviors in mothers of children suffering from thalassemia major.
Investigating the effect of serum level of uric acid on the immunogenicity of hepatitis B vaccination in dialysis patients
Authors: Golestani Nasibe , Shamspour Najmeh , Azmandian Jalal , Ahmadipour Habibeh , zarei Mahdi Karamipour
Published: April 2024

Introduction

HBV infection is a significant concern in dialysis patients, influenced by various factors. This study aims to investigate the impact of serum uric acid levels on the immunogenicity of hepatitis Bvaccination in dialysis patients.

Method

A cross-sectional study was conducted, involving 125 hemodialysis patients. Prior to dialysis, assessments were made for uric acid, vitamin D, HBsAg, andHBsAb. Patients were divided into two groups based on uric acid levels: high level (≥ 6.5 mg/dl) and low level (< 6.5 mg/dl). Each group received three doses of a high-dose hepatitis B vaccine (40 mcg) at 0, 1, and 6 months. After 8 weeks of the 3rd dose of the vaccine, the anti-hepatitis B antibody titer (HBsAb) was measured and recorded. Data were analyzed using SPSS version 22.

Results

Among patients with high uric acid, 30 (26.8%) had low HBsAb and 82 (73.2%) had high HBsAb (> 10). In patients with low uric acid, 1 (7.7%) had low HBsAb and 12 (92.3%) had high HBsAb (> 10). There was no statistically significant difference inHBsAb between the two groups. The immune response of HBsAb and uric acid did not show significance based on demographic variables and laboratory results.

Conclusion

This study found no correlation between uric acid levels and the immunogenicity of hepatitis B vaccination in hemodialysis patients. However, it is important to note that the group with low serum uric acid was very small compared to the other group and this may have influenced these results. Further studies with larger patient populations are needed to provide more conclusive evidence in this area.