bluuebunny/crossref_metadata_2025 huggingface dataset:
Unraveling immune heterogeneity across pan-cancer and deep insights in lung adenocarcinoma based on alternative splicing
Authors: Wang Yuquan , Guo Erliang , Zou Min , Lv Chen , Cui Yanrui , Zhai Songmei , Sang Shaocong , Xiong Kai , Yang Xiuqi , Zhuang Shuping , Gu Yunyan , Liang Haihai
Published: May 2024

Alternative splicing (AS) participates in tumor development and tumor microenvironment formation. However, the landscape of immune-infiltrating AS events in pan-cancer and mechanisms of AS in lung adenocarcinoma (LUAD) have not been comprehensively characterized. We systematically profiled the immune-infiltrating AS event landscape of pan-cancer using data from The Cancer Genome Atlas, analyzing both commonalities and specific characteristics among different cancer types. We found that AS events tend to occur specifically in one cancer type rather than in multiple cancer types. AS events were used to classify 512 LUAD samples into 2 subtypes by unsupervised clustering: the aberrant splicing subtype and the immune-infiltrating subtype. The 2 subtypes showed significant differences in clinicopathology, prognosis, transcriptomics, genomics, and immune microenvironment. We constructed a classification signature comprising 10 genes involved in 14 AS events using logistic regression. The robustness of the signature was validated in 3 independent datasets using survival analysis. To explore AS mechanisms in LUAD, we constructed subtype-specific coexpression networks using Pearson correlation analysis. AS event of AKT3 regulated by splicing factor ENOX1 was associated with poor prognosis in LUAD. Overall, we outline AS events associated with immune infiltration in pan-cancer, and this study provides insights into AS mechanisms in LUAD patient classification.
Machine Learning-Enabled Image Classification for Automated Electron Microscopy
Authors: Day Alexandra L , Wahl Carolin B , Gupta Vishu , dos Reis Roberto , Liao Wei-keng , Mirkin Chad A , Dravid Vinayak P , Choudhary Alok , Agrawal Ankit
Published: May 2024

Traditionally, materials discovery has been driven more by evidence and intuition than by systematic design. However, the advent of “big data” and an exponential increase in computational power have reshaped the landscape. Today, we use simulations, artificial intelligence (AI), and machine learning (ML) to predict materials characteristics, which dramatically accelerates the discovery of novel materials. For instance, combinatorial megalibraries, where millions of distinct nanoparticles are created on a single chip, have spurred the need for automated characterization tools. This paper presents an ML model specifically developed to perform real-time binary classification of grayscale high-angle annular dark-field images of nanoparticles sourced from these megalibraries. Given the high costs associated with downstream processing errors, a primary requirement for our model was to minimize false positives while maintaining efficacy on unseen images. We elaborate on the computational challenges and our solutions, including managing memory constraints, optimizing training time, and utilizing Neural Architecture Search tools. The final model outperformed our expectations, achieving over 95% precision and a weighted F-score of more than 90% on our test data set. This paper discusses the development, challenges, and successful outcomes of this significant advancement in the application of AI and ML to materials discovery.
A closer look at the host-galaxy environment of high-velocity Type Ia supernovae
Authors: Lin Han-Tang , Pan Yen-Chen , Abdurro’uf
Published: May 2024

Recent studies suggested that the ejecta velocity of Type Ia supernova (SN Ia) is a promising indicator in distinguishing the progenitor systems and explosion mechanisms. By classifying the SNe Ia based on their ejecta velocities, studies found that SNe Ia with high $\mathrm{Si}\, {\rm{\small II}}\, \lambda 6355$ velocities (HV SNe Ia; $v \gtrsim 12\,000$ km s−1) tend to be physically different from their normal-velocity counterparts (NV SNe Ia). In this work, we revisit the low-z sample studied in previous work and closely look into the spatially resolved environment local to the site of SN explosion. Our results reveal a possible trend (at 2.4σ significance) that HV SNe Ia are likely associated with older stellar populations than NV SNe Ia. While the trend is inconclusive, the local host-galaxy sample studied in this work is likely skewed towards massive galaxies, limiting the parameter space that we would like to investigate from the original parent sample. Nevertheless, our results do not rule out the possibility that parameters other than the host-galaxy age (such as metallicity) could be the underlying factors driving the differences between HV and NV SNe Ia due to the limitation of our data set.
A survey for radio emission from white dwarfs in the VLA Sky Survey
Authors: Pelisoli Ingrid , Chomiuk Laura , Strader Jay , Marsh T R , Aydi Elias , Dage Kristen C , Kyer Rebecca , Molina Isabella , Panurach Teresa , Urquhart Ryan , Maccarone Thomas J , Rich R Michael , Rodriguez Antonio C , Breedt E , Brown A J , Dhillon V S , Dyer M J , Gaensicke Boris T , Garbutt J A , Green M J , Kennedy M R , Kerry P , Littlefair S P , Munday James , Parsons S G
Published: May 2024

Radio emission has been detected from tens of white dwarfs, in particular in accreting systems. Additionally, radio emission has been predicted as a possible outcome of a planetary system around a white dwarf. We searched for 3 GHz radio continuum emission in 846 000 candidate white dwarfs previously identified in Gaia using the Very Large Array Sky Survey (VLASS) Epoch 1 Quick Look Catalogue. We identified 13 candidate white dwarfs with a counterpart in VLASS within 2 arcsec. Five of those were found not to be white dwarfs in follow-up or archival spectroscopy, whereas seven others were found to be chance alignments with a background source in higher resolution optical or radio images. The remaining source, WDJ204259.71+152108.06, is found to be a white dwarf and M-dwarf binary with an orbital period of 4.1 d and long-term stochastic optical variability, as well as luminous radio and X-ray emission. For this binary, we find no direct evidence of a background contaminant, and a chance alignment probability of only ≈2 per cent. However, other evidence points to the possibility of an unfortunate chance alignment with a background radio and X-ray emitting quasar, including an unusually poor Gaia DR3 astrometric solution for this source. With at most one possible radio emitting white dwarf found, we conclude that strong (≳1–3 mJy) radio emission from white dwarfs in the 3 GHz band is virtually non-existent outside of interacting binaries.
Towards automatic detection and classification of swimming pectinids behaviour: first developments on great scallops (Pecten maximus)
Authors: Chauvaud Arthur , Reynaud Sarah , Mars Jérôme , Retailleau Elie , Chauvaud Laurent , Jolivet Aurélie , Mathias Delphine , Chauvaud Sylvain
Published: May 2024

Over the past decades, valvometric techniques have been commonly used to record valve opening activities of bivalves. Various relationships with environmental variations have been elucidated through different types of metrics extracted from valvometric signals (e.g. valve opening, cyclicity, specific behaviours). Although automated data processing methods exist, many specific behaviours are still annotated manually. This study proposes an algorithm to detect and classify the behaviours performed by the great scallop (Pecten maximus) in two categories: jump-like (JL) behaviours and other behaviours (OBs). These two categories differ in the shape of their valvometric signal, JL being movements of high amplitudes associated with ‘displacement movements’ (rotation, swimming, jumping, flipping) and OB grouping all other movements of lower amplitudes (‘common movements’), such as partial closures, which are produced routinely. This algorithm has been developed and tested on 10 scallop valve opening time series recorded using fully autonomous valvometers based on the Hall effect principle. The algorithm detected 93.65% ± 5.5 of manually annotated behaviours produced by scallops, with a false detection rate of less than 6.3% ± 5.5. Classification performances vary according to the type of behaviour. JL behaviours and OBs were well classified at 83.72% ± 23.09 and 98.92% ± 1.80, respectively. Analysis of the algorithm's outputs, highlighting potential daily trends in the production of certain behaviours, shows their relevance for acquiring information on the biology of scallops. By providing an efficient and flexible detection and classification method, this study is a first step towards the automation of bivalve behaviour detection. This study also highlights the importance of simultaneously using Hall sensors and accelerometers to accurately classify the complex behaviours of mobile bivalves such as P. maximus.
Mediterranean Diet and Mental Health in Children and Adolescents: A Systematic Review
Authors: Camprodon-Boadas Patricia , Gil-Dominguez Aitana , De la Serna Elena , Sugranyes Gisela , Lázaro Iolanda , Baeza Immaculada
Published: May 2024

Context

Childhood and adolescence are periods of critical importance in the development of mental health disorders. The Mediterranean diet (MD) has been linked to multiple positive health outcomes, including reduced incidence of mental health disorders and fewer psychiatric symptoms.

Objective

This study aimed to investigate the association between adherence to an MD and mental health outcomes in children and adolescents.

Methods

A systematic literature review was conducted of original research that explored the relationship between psychiatric symptoms or disorders and adherence to an MD. The literature search was conducted on PubMed, Scopus, Web of Science, MEDES, Dialnet, and Latindex from inception to November 2022, and the Newcastle-Ottawa Scale was used to evaluate the quality of studies.

Results

A total of 13 studies (6 cross-sectional, 4 case-control, 2 randomized clinical trials, and 1 longitudinal cohort) out of 450 met the inclusion criteria. A total of 3058 children or adolescents with a mean age range from 8.6 to 16.2 years were included. Among the reviewed studies, 5 (71.42%) of those looking at attention-deficit/hyperactivity disorder, 4 (80%) examining depression, and 2 (50%) assessing anxiety found a significant protective association. Seven articles (53.84%) were found to be of high quality and 6 (46.15%) of moderate quality.

Conclusion

Adherence to an MD could be a protective factor for mental health in child and adolescent populations. This suggests that promoting an MD could help prevent the onset of clinical psychiatric symptoms, reduce symptom severity, and improve prognosis in young patients.

Systematic Review Registration

PROSPERO registration no. CRD42021276316.
Micromorphological and Chemical Characterization of Drimys winteri Leaf Surfaces: The Secondary Alcohols Forming Epicuticular Wax Crystals Are Accompanied by Alkanediol, Alkanetriol and Ketol Derivatives
Authors: Zhang Zhonghang , Mistry Dwiti , Jetter Reinhard
Published: May 2024

The cuticle is a hydrophobic coating of most aerial plant surfaces crucial for limiting non-stomatal water loss. Plant cuticles consist of the lipid polyester cutin and associated waxes with compositions varying widely between plant species and organs. Here, we aimed to provide a comparative analysis of the dark-glossy adaxial and pale-glaucous abaxial sides of Drimys winteri (Winteraceae) leaves. Scanning electron microscopy showed nanotubular wax crystals lining the entire abaxial side of the leaf (including stomatal pores), while the adaxial side had patches of mixed platelet/tubule crystals and smooth areas between them. Consecutive treatments for wax removal and cutin depolymerization revealed that the waxes were deposited on a cutin network with micron-scale cavities across the entire abaxial surface including the stomata pores, and on a microscopically smooth cutin surface on the adaxial side of the leaf. Gas chromatography coupled to mass spectrometry and flame ionization detection showed that the wax mixtures on both sides of the leaf were complex mixtures of very-long-chain compounds dominated by the secondary alcohol nonacosan-10-ol and alkanediols with one hydroxyl on C-10. It is therefore very likely that the characteristic tubular wax crystals of both leaf sides are formed by these alcohols and diols. Further secondary alcohols and alkanediols, as well as ketols and alkanetriols with one functional group on C-10, were identified based on mass spectral fragmentation patterns. The similarities between all these mid-chain-functionalized compounds suggest that they are derived from nonacosan-10-ol via regio-specific hydroxylation reactions, likely catalyzed by three P450-dependent monooxygenases with different regio-specificities.
Identification and characteristics of patients with potential difficult-to-treat psoriatic arthritis: exploratory analyses of the Greek PsA registry
Authors: Vassilakis Konstantinos D , Papagoras Charalampos , Fytanidis Nikolaos , Gazi Sousana , Mole Evangelia , Krikelis Michael , Voulgari Paraskevi V , Kaltsonoudis Evripidis , Koletsos Nikolaos , Boumpas Dimitrios , Katsimpri Pelagia , Katsifis-Nezis Dimitrios , Dimitroulas Theodoros , Kougkas Nikolaos , Boutel Maria , Sfikakis Petros P , Tektonidou Maria G , Gialouri Chrysoula , Bogdanos Dimitrios , Simopoulou Theodora , Koutsianas Christos , Mavrea Evgenia , Katsifis Gkikas , Kottas Konstantinos , Konsta Maria , Tziafalia Matthoula , Kataxaki Evangelia , Kalavri Eleni , Klavdianou Kalliopi , Grika Eleftheria P , Sfontouris Charalampos , Daoussis Dimitrios , Iliopoulos George , Bournazos Ilias , Karokis Dimitrios , Georganas Konstantinos , Patrikos Dimos , Vassilopoulos Dimitrios , Fragoulis George E
Published: May 2024

Objective

To present the characteristics of patients with potential difficult-to-treat (D2T) PsA.

Methods

We used data from the Greek multicentre registry of PsA patients. D2T PsA was defined as follows: patients with at least 6 months’ disease duration, who have failed to at least one conventional synthetic DMARD and at least two biologic DMARDs/targeted synthetic DMARDs with a different mechanism of action and have either at least moderate disease activity (MODA) defined as DAPSA (Disease Activity index in PSoriatic Arthritis) >14, and/or are not at minimal disease activity (MDA). Demographic and clinical characteristics were compared between D2T and non-D2T PsA patients. In two sensitivity analyses, patients classified as D2T solely according to the MODA or MDA criterion were examined separately.

Results

Among 467 patients included, 77 (16.5%) were considered D2T and 390 non-D2T PsA. Compared with non-D2T, patients with D2T PsA presented more commonly with extensive psoriasis (P < 0.0001) and were more likely to have higher BMI (P = 0.023) and a history of IBD (P = 0.026). In the MODA and MDA sensitivity analyses, 7.5% and 12.5% of patients were considered D2T, respectively. In both sensitivity analyses, extensive psoriasis was again identified as an independent variable for D2T PsA (P = 0.001 and P = 0.008, respectively). Moreover, female gender (P = 0.034) in the MODA analysis and axial disease (P = 0.040) in the MDA analysis were independent variables for D2T PsA.

Conclusion

Despite the availability of therapies, D2T PsA is common in real-life cohorts of patients with PsA and extensive psoriasis. High BMI, female gender, axial disease and history of IBD were also associated with D2T PsA.
Peer-led stay interviews to connect employees and develop retention strategies
Authors: Warren Nina , Gale Lisa , Rettew Stephanie , Peterson Cynthia , Sorensen Sara , Glassman Emily L.
Published: May 2024

Stay interviews can strengthen employee engagement and increase retention. This quality improvement project aimed to determine nurses' motivations for staying on their current unit by conducting peer-led stay interviews. Participants responded positively to the stay interview process.
Effect of Remimazolam on Emergence Delirium in Children Undergoing Laparoscopic Surgery: A Double-blinded Randomized Trial
Authors: Cai Yu-Hang , Zhong John Wei , Ma Hong-Yu , Szmuk Peter , Wang Cheng-Yu , Wang Zhen , Zhang Xu-Lin , Dong Le-Qi , Liu Hua-Cheng
Published: May 2024

Background

Preventing emergence delirium is a clinical goal for pediatric anesthesia, yet there is no consensus on its prevention. This study investigated the hypothesis that a continuous infusion or a single bolus of remimazolam can reduce the incidence of emergence delirium in children.

Methods

A total of 120 children aged 1 to 6 yr were randomly and equally allocated into three groups: group RC, which received a continuous infusion of remimazolam at 1 mg · kg−1 · h−1; group RB, which received a single bolus of remimazolam at 0.2 mg · kg−1 at the beginning of wound closure; and group C, which received a continuous infusion of saline at 1 ml · kg−1 · h−1 and a single bolus of saline at 0.2 ml · kg−1 at the beginning of sutures. The primary outcome was the incidence of emergence delirium assessed by the Pediatric Anesthesia Emergence Delirium scale. Secondary outcomes included the number of rescue propofol administrations in the postanesthesia care unit, recovery time, and adverse events.

Results

Emergence delirium was observed in 14 of 40 (35%) patients in group C, 2 of 40 (5%) patients in group RC (vs. group C, P = 0.001; risk ratio, 95% CI: 0.14, 0.04 to 0.59), and 3 of 39 (7.7%) patients in group RB (vs. group C, P = 0.003; risk ratio, 95% CI: 0.22, 0.07 to 0.71). Ten of 40 patients in group C, 2 of 40 patients in group RC (vs. group C, P = 0.012; risk ratio, 95% CI: 0.20, 0.05 to 0.86), and 2 of 39 patients in group RB (vs. group C, P = 0.014; risk ratio, 95% CI: 0.21, 0.05 to 0.88) needed rescue propofol. No differences in the recovery time and adverse effects were detected.

Conclusions

Both continuous infusion and single bolus administration of remimazolam can effectively reduce the occurrence of emergence delirium in children.

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Determinants and Practice Variability of Oxygen Administration during Surgery in the United States: A Retrospective Cohort Study
Authors: Billings Frederic T. , McIlroy David R. , Shotwell Matthew S. , Lopez Marcos G. , Vaughn Michelle T. , Morse Jennifer L. , Hennessey Cassandra J. , Wanderer Jonathan P. , Semler Matthew W. , Rice Todd W. , Wunsch Hannah , Kheterpal Sachin
Published: May 2024

Background

The best approaches to supplemental oxygen administration during surgery remain unclear, which may contribute to variation in practice. This study aimed to assess determinants of oxygen administration and its variability during surgery.

Methods

Using multivariable linear mixed-effects regression, the study measured the associations between intraoperative fraction of inspired oxygen and patient, procedure, medical center, anesthesiologist, and in-room anesthesia provider factors in surgical cases of 120 min or longer in adult patients who received general anesthesia with tracheal intubation and were admitted to the hospital after surgery between January 2016 and January 2019 at 42 medical centers across the United States participating in the Multicenter Perioperative Outcomes Group data registry.

Results

The sample included 367,841 cases (median [25th, 75th] age, 59 [47, 69] yr; 51.1% women; 26.1% treated with nitrous oxide) managed by 3,836 anesthesiologists and 15,381 in-room anesthesia providers. Median (25th, 75th) fraction of inspired oxygen was 0.55 (0.48, 0.61), with 6.9% of cases less than 0.40 and 8.7% greater than 0.90. Numerous patient and procedure factors were statistically associated with increased inspired oxygen, notably advanced American Society of Anesthesiologists classification, heart disease, emergency surgery, and cardiac surgery, but most factors had little clinical significance (less than 1% inspired oxygen change). Overall, patient factors only explained 3.5% (95% CI, 3.5 to 3.5%) of the variability in oxygen administration, and procedure factors 4.4% (95% CI, 4.2 to 4.6%). Anesthesiologist explained 7.7% (95% CI, 7.2 to 8.2%) of the variability in oxygen administration, in-room anesthesia provider 8.1% (95% CI, 7.8 to 8.4%), medical center 23.3% (95% CI, 22.4 to 24.2%), and 53.0% (95% CI, 52.4 to 53.6%) was unexplained.

Conclusions

Among adults undergoing surgery with anesthesia and tracheal intubation, supplemental oxygen administration was variable and appeared arbitrary. Most patient and procedure factors had statistical but minor clinical associations with oxygen administration. Medical center and anesthesia provider explained significantly more variability in oxygen administration than patient or procedure factors.

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Semaglutide in Heart Failure With Preserved Ejection Fraction: Exploring Recent Evidence in Therapeutic Potential for the Obese Population
Authors: Kusayev Josef , Levy Yisrael , Weininger David , Frishman William H. , Aronow Wilbert S.
Published: May 2024

Heart failure with preserved ejection fraction (HFpEF) is an increasingly prevalent condition, particularly among the aging population in the United States, and is associated with significant challenges due to its complex pathophysiology and limited therapeutic options. Historically, few pharmacological therapies have successfully mitigated HFpEF, making the emergence of effective treatments particularly significant. This review evaluates recent evidence on the therapeutic potential of semaglutide for managing HFpEF, especially in the obese population. Results from the STEP-HFpEF and STEP-HFpEF DM trials demonstrate that semaglutide, a glucagon-like peptide-1 receptor agonist originally developed for type 2 diabetes but now also approved for obesity treatment, significantly improves clinical outcomes such as symptom scores, body weight, exercise capacity, and inflammation markers in the obese population suffering from HFpEF. These improvements are attributed to both the weight loss induced by semaglutide and its direct effects on the congestive pathophysiology of HFpEF. The efficacy of semaglutide offers new hope for addressing a condition that has long lacked effective pharmacological interventions.
Infantile Hemangiomas Lose Vascular Endothelial Cadherin During Involution: Potential Role in Cell Death?
Authors: Clapp Averill , Modiri Omeed , Schonning Michael , Wu June K.
Published: May 2024

Background:

Infantile hemangiomas (IHs) are benign endothelial cell (EC) tumors that undergo a predictable natural history, with rapid proliferation, stabilization, and involution. However, mechanisms regulating these transitions are not well understood. We have observed loss of vascular endothelial cadherin (VECAD) in involuting/involuted IHs. VECAD plays a critical role in angiogenesis, cell cycle progression, and EC survival. We hypothesize that loss of VECAD is associated with apoptosis occurring during IH involution.

Methods:

Resected IH samples were clinically categorized as proliferating (n = 4), stable (n = 4), or involuting/involuted (n = 5). Neonatal dermal tissues were used as controls (n = 5). Immunohistochemistry was conducted on sectioned specimens using antibodies against EC markers VECAD and CD31. Apoptosis was assessed with terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay.

Results:

CD31 signal intensity in proliferating, stable, and involuting/involuted IH ECs was unchanged relative to each other and to control ECs. VECAD signal significantly and progressively diminished as IHs progressed from proliferation to involution. Involuting/involuted IHs had significantly reduced VECAD expression compared with control ECs (P < 0.0001), proliferating IHs (P < 0.0001), and stable IHs (P < 0.001). As expected, the number of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling-positive ECs was significantly higher in involuting/involuted IHs (P < 0.05) relative to control ECs and proliferating IHs.

Conclusions:

Loss of VECAD expression in IH endothelium corresponded to IH involution and increased apoptosis. It is unclear whether loss of VECAD is causative of IH involution; further studies are needed to elucidate the role of VECAD function in EC survival.
Effects of Optical Zone Variation of High-Addition Multifocal Contact Lenses on the Global Flash Multifocal Electroretinography
Authors: Boily Laurence , Michaud Langis , Garon Marie-Lou , Marcotte Rémy
Published: May 2024

Objectives:

To evaluate the retinal response to myopic defocus after the wear of soft multifocal contact lenses with high addition through electroretinography.

Methods:

Twenty-seven participants meeting inclusion criteria were enrolled. Tropicamide 1% drops (2) were instilled. Participants were then fitted with three different contact lenses: a single-vision spherical lens (SE +3.00 D), L1, serving as a control, and two soft multifocal lens designs (SE +3.00 D/add +10 D), one with a central distance zone of 4.0 mm (L2) and one with a central distance zone of 7.0 mm (L3). A global flash multifocal electroretinography was performed. Direct component (DC) amplitude, DC peak time, induced component (IC) amplitude, and IC peak time were recorded. Waveforms were grouped into five concentric areas, covering from 0° to 24° of retinal eccentricity. Differences of L2/L3 versus L1 were analyzed with t tests. Finally, correlations were calculated between the percentage of defocus in the pupil area versus the electroretinography results.

Results:

Results show that the DC amplitude, caused mainly by photoreceptors and bipolar cells, is not influenced by the design of the lenses. The IC amplitude, however, is significantly decreased when the lens with a smaller optical zone (L2) is worn. This significant difference only concerns the ring 5, which corresponds to a retinal eccentricity of 15.7° to 24.0°.

Conclusion:

Soft multifocal lens designs influence the peripheral retinal reaction to defocus. A larger treatment zone seems to significantly impact the retinal response to defocus between 15.7° and 24.0° of eccentricity from the macula.
Preparing porcine lens to mimic human lens capsule
Authors: Pei Yajing , Han Shaofeng , Lu Mingfeng , Yang Yang , Ma Ke
Published: May 2024

Purpose:

To develop a chemical method that makes porcine lens anterior capsule resemble human lens anterior capsule in tear force and perforating force.

Setting:

Beijing Tongren Hospital, Beijing, China.

Design:

Experimental study.

Methods:

Porcine eyes were divided into groups, and reagents (0.9% physiological saline, 0.1% sodium hypochlorite, 0.3% sodium hypochlorite, and 0.5% sodium hypochlorite) were injected into the anterior chamber, respectively, recorded as Groups A, B, C, and D, respectively. A senior physician collected each group of anterior capsules after performing continuous circular capsulorhexis and assessing the anterior capsule's tearing and perforation forces. An additional group, which consisted of human lens anterior capsules taken in the operating room from patients with cataract, recorded as Group E. A tensile system was used to measure each sample's tensile force.

Results:

A significant difference was found between Group A and any other group in maximum tensile force and average tensile force in both transverse and longitudinal directions. No significant difference was found between any 2 groups from Group B to Group E. According to the surgeon's assessment, the tear force characteristic of the porcine lens anterior capsule treated with 0.1%, 0.3%, and 0.5% sodium hypochlorite solution was similar to that of the human lens anterior capsule.

Conclusions:

Porcine lens capsule treated using this method can be used for training of new surgeons. The porcine lens anterior capsule treated with 0.5% sodium hypochlorite, which results showed most resembled human lens anterior capsule, can be used for robotic training.
Small Patients but a Heavy Lift
Authors: Dye M. Eva , Runyan Patti , Scott Theresa A. , Dietrich Mary S. , Hatch L. Dupree , France Daniel , Alrifai Mhd Wael
Published: May 2024

Objective:

This study explored the association between workload and the level of burnout reported by clinicians in our neonatal intensive care unit (NICU). A qualitative analysis was used to identify specific factors that contributed to workload and modulated clinician workload in the NICU.

Study Design:

We conducted a study utilizing postshift surveys to explore workload of 42 NICU advanced practice providers and physicians over a 6-month period. We used multinomial logistic regression models to determine associations between workload and burnout. We used a descriptive qualitative design with an inductive thematic analysis to analyze qualitative data.

Results:

Clinicians reported feelings of burnout on nearly half of their shifts (44%), and higher levels of workload during a shift were associated with report of a burnout symptom. Our study identified 7 themes related to workload in the NICU. Two themes focused on contributors to workload, 3 themes focused on modulators of workload, and the final 2 themes represented mixed experiences of clinicians’ workload.

Conclusion:

We found an association between burnout and increased workload. Clinicians in our study described common contributors to workload and actions to reduce workload. Decreasing workload and burnout along with improving clinician well-being requires a multifaceted approach on unit and systems levels.
The Relationship Between Restrictive Regulation of Midwives, Practice Environment, and Professional Burnout
Authors: Thumm E. Brie , Schaeffer Ann , Michel Alexandra , McFarland A. Kristienne , Long Maryann H. , Giano Zachary
Published: May 2024

Purpose:

The purpose of the study was to investigate the relationship between state regulation of the midwifery workforce, practice environment, and burnout.

Background:

Burnout threatens the US midwifery workforce, with over 40% of certified nurse-midwives meeting criteria. Burnout can lead to poorer physical and mental health and withdrawal from the workforce. Burnout in midwives has been associated with lack of control and autonomy. In the United States, midwives' autonomy is restricted through state-level regulation that limits scope of practice and professional independence.

Methods:

A mixed-methods study was conducted using an explanatory sequential approach. Quantitative and qualitative data were collected by online surveys and analyzed in a 2-stage process, followed by data integration.

Results:

State regulation was not found to be independently associated with burnout (n = 248; P = .250); however, mediation analysis showed a significant association between state regulation, practice environment, and burnout. Qualitative analysis mirrored the importance of practice environment and expanded on its features.

Conclusion:

For midwives, unrestrictive practice regulation may not translate to burnout prevention without supportive practice environments.

Implications for practice and research:

Interventions should focus on promoting job flexibility, realistic demands, and professional values. While midwives' commitment to patients and the profession can help bolster the workforce, it can also amplify negative experiences of the practice environment.
Nurses’ Job Burnout and Resilience in Neonatal Intensive Care Units
Authors: Al-Harrasi Samhaa , Sabei Sulaiman Al , Omari Omar Al , Abrawi Umaima Al
Published: May 2024

Purpose:

To assess the relationship between job burnout and resilience among nurses working in neonatal intensive care units (NICUs) in Oman.

Background:

NICUs induce a significant amount of stress that predisposes nurses to a substantial degree of burnout. Resilience can play a role in reducing the effects of job burnout. A limited number of studies have examined job burnout and resilience among NICU nurses.

Methods:

A cross-sectional survey design was utilized. The Maslach Burnout Inventory was used to assess burnout, and the Brief Resilience Scale was used to assess perceptions of resilience. Pearson correlation was used to assess the relationship between job burnout and resilience.

Results:

A total of 173 staff nurses participated. Participants reported low levels of emotional exhaustion and depersonalization but moderate levels on the personal accomplishment subscale. Nurses reported moderate levels of resilience. Emotional exhaustion and depersonalization were negatively correlated with resilience, while personal accomplishment was positively correlated with resilience.

Conclusion:

This study demonstrated that enhancing resilience can reduce the effect of burnout among NICU nurses.

Implications for Practice and Research:

Enhancing levels of resilience among NICU nurses, in addition to providing adequate managerial support and good collegial relations, is essential to reduce their perceived job burnout.
ACNM’s Commentary on the Midwifery Workforce in the US
Authors: Clarke Heather , Jefferson Karen
Published: May 2024

The American College of Nurse-Midwives (ACNM) represents certified nurse-midwives (CNMs) and certified midwives (CMs) who are graduate-prepared advanced practice providers. They attend educational programs accredited by the American Commission for Midwifery Education (ACME) and are certified by the American Midwifery Certification Board (AMCB). Their scope of practice as defined by ACNM includes primary care, reproductive services beginning with menarche through menopause, gender-affirming services, contraception, abortion, prenatal, birth, postpartum, and care of the newborn. CNMs/CMs attend 10.9% of US births, but other high-income countries have the reverse proportion of midwives to obstetricians. The CNM/CM workforce is growing, but retirements and attrition slow the growth. Research demonstrates good outcomes from care provided by midwives, and ACNM’s primary goal is to expand the midwifery workforce and increase consumer access to midwifery care to mitigate the persistent rise in maternal mortality and morbidity. Barriers to workforce expansion include restricted practice at the state level, inability to expand the number of seats in education programs due to lack of clinical preceptors, and a lack of diversity in the workforce. Strategies to address these barriers may allow the workforce to grow, increasing access to high-quality, equitable sexual and reproductive care for people in the United States.
Advancements in hepatocellular carcinoma management: the role of 18F-FDG PET-CT in diagnosing portal vein tumor thrombosis
Authors: Mititelu Raluca , Mitoi Alexandru , Mazilu Catalin , Jinga Mariana , Radu Florentina Ionita , Bucurica Ana , Mititelu Teodora , Bucurica Sandica
Published: May 2024

Portal vein thrombosis, a relatively frequent complication associated with hepatocellular carcinoma (HCC) and liver cirrhosis, is recognized as a significant global health concern. This is mainly due to these conditions’ high prevalence and potentially severe outcomes. The aim of our study was to conduct a comprehensive literature review to evaluate the efficacy, accuracy, and clinical implications of 18F-FDG PET-CT in diagnosing and managing portal vein tumor thrombosis (PVTT) in patients with HCC. HCC, which accounts for 80% of liver malignancies, ranks as the fourth most prevalent cancer globally and is a significant contributor to cancer-related mortality. The majority of HCC patients are diagnosed at an advanced stage, leading to a deterioration in patient outcomes. Involvement of the portal vein is also a significant negative factor. This review analyzes the application of 18F-FDG PET-CT in the detection and management of PVTT in patients with HCC, with an emphasis on the importance of the maximum standardized uptake value as an essential diagnostic and prognostic marker. 18F-FDG PET-CT is invaluable for detecting recurrence and guiding management strategies, particularly in patients with high-grade HCC, and plays a pivotal role in differentiating malignant portal vein thrombi from their benign counterparts.
Advances in preclinical approaches for intravesical therapy of bladder cancer
Authors: Obireddy Sreekanth Reddy , Lai Wing-Fu
Published: May 2024

Purpose of review

The purpose of this review is to explore new strategies to treat bladder cancer. This article addresses challenges and opportunities in intravesical therapy of bladder cancer.

Recent findings

The review examines the latest advances in the development of preclinical approaches for intravesical therapy of bladder cancer. It discusses strategies to improve drug delivery efficiency by using synthesized diverse carriers. Immunotherapy with protein aggregate magnesium-ammonium phospholinoleate-palmitoleate anhydride has been shown to be more effective than intravesical Bacillus Calmette-Guerin. Novel drug delivery systems such the urinary drug-disposing strategy and intravesical nanoparticle formulations improve the drug delivery efficiency while minimizing adverse reactions. Innovative imaging techniques using near-infrared fluorescence probes and multifunctional nano-transformers enable real-time detection and targeted therapy in bladder cancer treatment.

Treatment of bladder cancer is clinically challenging. However, recent progress in drug delivery technologies shows promise. Optimizing these technologies helps improve patient outcomes, and facilitates clinical translation of different treatment modalities.
Histology of Bronchiolar Tumor Spread Through Air Spaces
Authors: Takahara Taishi , Satou Akira , Tsuyuki Takuji , Ito Takanori , Taniguchi Natsuki , Yamamoto Yuki , Ohashi Akiko , Takahashi Emiko , Kadota Kyuichi , Tsuzuki Toyonori
Published: May 2024

The clinical significance of lung tumor spread through air spaces (STAS) has been extensively studied, and is recognized as a unique pattern of invasion. Previous studies of STAS have focused primarily on STAS in alveolar spaces, whereas STAS in the bronchiolar spaces (bronchiolar STAS) has been described in only a few case reports only. Here, we examined 306 cases of primary lung adenocarcinoma and found that bronchiolar STAS was present in 18%. Bronchiolar STAS was associated with an inferior prognosis, more advanced stage, and higher histologic grade. No significant difference in clinicopathological factors or prognosis was observed between cases with bronchiolar STAS and those with alveolar STAS alone. Notably, bronchiolar STAS often occurred simultaneously with alveolar STAS and endobronchial spread of adenocarcinoma, particularly when bronchiolar STAS was present outside the main tumor. We also identified cases where bronchiolar STAS and endobronchial spread of adenocarcinoma occurred simultaneously in the same bronchi or bronchioles located outside the main tumor, as well as cases with bronchiolar STAS adjacent to intrapulmonary metastatic nodules. Our results highlight the significant role of bronchiolar STAS in the aerogenous spread of adenocarcinoma cells. Bronchiolar STAS can be regarded as a histologic variant of alveolar STAS. This study also supports the idea that STAS is not a tissue processing artifact, but a true biological process with clinical implications, offering histologic evidence of aerogenous spread in lung adenocarcinoma.
Melorheostosis With Uniform Rib Thickening
Authors: Ariga Akane , Funauchi Yuki , Sato Shingo , Kunieda Junko , Yoshii Toshitaka
Published: May 2024

A 16-year-old girl presented with left chest pain. Radiography and CT revealed localized abnormal calcification in the left sixth rib and sixth thoracic vertebra. Bone scintigraphy confirmed abnormal uptake of 99mTc in the same area. An open biopsy of the sixth rib was performed, leading to the diagnosis of melorheostosis. This case showed uniformly thickened calcification throughout the rib, unlike the typical “dripping candle wax” radiography finding associated with melorheostosis. This case implies the importance of open biopsy for diagnostic confirmation in cases with atypical imaging features.
Early Experience with EndoRobotic Submucosal Dissection (ERSD)
Authors: Alipouriani Ali , Ozgur Ilker , Bhatt Amit , Steele Scott R. , Sommovilla Joshua , Gorgun Emre
Published: May 2024

Objective:

To evaluate the safety and feasibility of single-port endorobotic submucosal dissection (ERSD) using the Da Vinci SP platform for the management of rectal neoplasms.

Summary Background Data:

Endoscopic submucosal dissection (ESD) offers a potential organ-sparing treatment for advanced colorectal neoplasms but demands high technical skill and a steep learning curve. Advances in semiflexible robotic platforms, such as the Da Vinci SP, promise to simplify this procedure, potentially offering improved outcomes for patients with benign rectal neoplasms.

Methods:

A retrospective analysis of 28 patients who underwent ERSD using the Da Vinci SP platform between 2020 and 2023 was performed. Patient demographics, lesion characteristics, procedure details, outcomes, and complications were reviewed. The primary endpoint was successful en-bloc resection.

Results:

The cohort had a median age of 60.5 years and a median BMI of 28.2 kg/m², predominantly male(67.8%) with ASA categories 2 or 3(82%). Lesions had a median size of 38 mm and were located a median of 9 cm from the anal verge. The median procedure time was 87.5 minutes. En-bloc resection was achieved in all cases(100%), with no intraoperative complications or mortality. One patient experienced urinary retention, and one had late bleeding requiring blood transfusion. Pathology outcomes included 46.4% tubulovillous adenomas, 21.4% adenocarcinomas, and high-grade dysplasia in 53.6% of patients.

Conclusion:

Single-port ERSD using the Da Vinci SP platform is safe and feasible for the management of colorectal neoplasia, ensuring a high rate of en-bloc resection. It potentially offers advantages over conventional ESD, including shorter dissection times, although further studies are necessary for a definitive comparison.
A Transformer Approach for Cognitive Impairment Classification and Prediction
Authors: Liu Houjun , Weakley Alyssa M. , Zhang Jiawei , Liu Xin
Published: May 2024

Introduction:

Early classification and prediction of Alzheimer disease (AD) and amnestic mild cognitive impairment (aMCI) with noninvasive approaches is a long-standing challenge. This challenge is further exacerbated by the sparsity of data needed for modeling. Deep learning methods offer a novel method to help address these challenging multiclass classification and prediction problems.

Methods:

We analyzed 3 target feature-sets from the National Alzheimer’s Coordinating Center (NACC) dataset: (1) neuropsychological (cognitive) data; (2) patient health history data; and (3) the combination of both sets. We used a masked Transformer-encoder without further feature selection to classify the samples on cognitive status (no cognitive impairment, aMCI, AD)—dynamically ignoring unavailable features. We then fine-tuned the model to predict the participants’ future diagnosis in 1 to 3 years. We analyzed the sensitivity of the model to input features via Feature Permutation Importance.

Results:

We demonstrated (1) the masked Transformer-encoder was able to perform prediction with sparse input data; (2) high multiclass current cognitive status classification accuracy (87% control, 79% aMCI, 89% AD); (3) acceptable results for 1- to 3-year multiclass future cognitive status prediction (83% control, 77% aMCI, 91% AD).

Conclusion:

The flexibility of our methods in handling inconsistent data provides a new venue for the analysis of cognitive status data.
ROK or MLCK inhibition restricts Dengue virus replication in endothelial cells
Authors: Nichols Gena , Spengler Andrea , Voss Thomas G.
Published: May 2024

Dengue virus (DV), a member of the Flaviviridae family, has been demonstrated to induce changes to the actin cytoskeleton to promote efficient viral entry and replication. These cytoskeletal alterations continue throughout infection, and disruption of the cytoskeleton has been shown to decrease the release of infectious virions. However, few studies have assessed the contribution of actin alterations to Dengue-induced vascular leak in endothelial cells. A number of cellular kinases control the assembly and rearrangement of actin filaments, including Rho-activated kinase (ROK) and Myosin Light Chain kinase (MLCK). To determine whether the observed changes to the actin cytoskeleton during Dengue viral infection contribute to the loss of endothelial cell barrier function, the roles of the cellular kinases ROK and MLCK were evaluated during DV infection. Inhibition of ROK and MLCK during infection prevented the formation of DV-induced actin stress fibers. While kinase inhibition did not prevent virus-induced changes in monolayer permeability, specific inhibition of either kinase resulted in a significant decrease in virus yield indicating that ROK/MLCK-mediated cytoskeletal alterations play a role in virus replication and biogenesis that do not affect vascular integrity in Dengue virus infection in vitro. Further investigation revealed that ROK or MLCK inhibition decreased virus spread through the culture, but only MLCK inhibition decreased viral protein synthesis and genome replication. Taken together, these results identify a critical role for both ROK and MLCK activity in the efficient replication of Dengue virus in endothelial cells, potentially affecting the assembly or budding of mature
Efficient and accurate mixed model association tool for single-cell eQTL analysis
Authors: Zhou Wei , Cuomo Anna S.E. , Xue Angli , Kanai Masahiro , Chau Grant , Krishna Chirag , Xavier Ramnik J. , MacArthur Daniel G. , Powell Joseph E. , Daly Mark J. , Neale Benjamin M.
Published: May 2024

Understanding the genetic basis of gene expression can help us understand the molecular underpinnings of human traits and disease. Expression quantitative trait locus (eQTL) mapping can help in studying this relationship but have been shown to be very cell-type specific, motivating the use of single-cell RNA sequencing and single-cell eQTLs to obtain a more granular view of genetic regulation. Current methods for single-cell eQTL mapping either rely on the “pseudobulk” approach and traditional pipelines for bulk transcriptomics or do not scale well to large datasets. Here, we propose SAIGE-QTL, a robust and scalable tool that can directly map eQTLs using single-cell profiles without needing aggregation at the pseudobulk level. Additionally, SAIGE-QTL allows for testing the effects of less frequent/rare genetic variation through set-based tests, which is traditionally excluded from eQTL mapping studies. We evaluate the performance of SAIGE-QTL on both real and simulated data and demonstrate the improved power for eQTL mapping over existing pipelines.