bluuebunny/crossref_metadata_2025 huggingface dataset:
Night-to-night variability in obstructive sleep apnea severity, the physiological endotypes, and the frequency of flow limitation
Authors: Hynes Daniel J , Mann Dwayne L , Landry Shane A , Joosten Simon A , Edwards Bradley A , Hamilton Garun S
Published: December 2024

Study Objectives

There is substantial night-to-night variability (NtNV) in obstructive sleep apnea (OSA) severity in some individuals; however, predictors for this remain incompletely understood. This study aims to quantify the degree of NtNV in the apnea–hypopnea index (AHI), hypoxic burden, airflow limitation, and OSA endotypes; to determine if a relationship exists between the degree of NtNV in AHI and in endotype expression; to assess whether the degree of flow-limited breathing is predictive of the degree of NtNV of the AHI.

Methods

Seventy-one patients with OSA underwent 2 polysomnograms (PSGs). OSA endotypes, hypoxic burden, and flow limitation frequency were extracted from PSG data. Intraindividual agreement was assessed and associations with the NtNV of the AHI were calculated. Patients were grouped into High Variability vs Low Variability based on the degree of difference in AHI between each night.

Results

Despite wide limits of agreement, at the group level most PSG and endotype variables were not statistically different between first and second night. Flow limitation frequency was 7.7% (2.1–13, p < 0.01) higher on the second night compared to baseline. There were weak linear associations between NtNV of endotypes and NtNV of the AHI. In subgroup analysis, there was greater difference between nights for Vactive (5%eupnea, p = 0.01), Vpassive (3.1%eupnea, p = 0.03), Vcomp (3.2%eupnea, p = 0.01), and arousal threshold (4.1%eupnea, p = 0.04) in the High-Variability compared to the Low-Variability group.

Conclusions

There is high NtNV in AHI, OSA endotypes, and flow limitation in some individuals; however, no strong linear relationship exists between these changes.

Clinical Trials

Combined Upper-airway and Breathing Control Therapies for Obstructive Sleep Apnea (https://clinicaltrials.gov/study/NCT03189173?term=NCT03189173&rank=1, NCT03189173). Pharmacological Intervention for Symptomatic Mild Sleep Disordered Breathing (https://clinicaltrials.gov/study/NCT04611750?term=NCT04611750&rank=1, NCT04611750). Combination Pharmacological Interventions for Multiple Mechanisms of Obstructive Sleep Apnea (https://clinicaltrials.gov/study/NCT03892772?term=NCT03892772&rank=1, NCT03892772).
Chemogenetic activation of astrocytes modulates sleep–wakefulness states in a brain region-dependent manner
Authors: Kurogi Yuta , Sanagi Tomomi , Ono Daisuke , Tsunematsu Tomomi
Published: December 2024

Study Objectives

Astrocytes change their intracellular calcium (Ca2+) concentration during sleep/wakefulness states in mice. Furthermore, the Ca2+ dynamics in astrocytes vary depending on the brain region. However, it remains unclear whether alterations in astrocyte activity can affect sleep–wake states and cortical oscillations in a brain region-dependent manner.

Methods

Astrocyte activity was artificially manipulated in mice using chemogenetics. Astrocytes in the hippocampus and pons, which are 2 brain regions previously classified into different clusters based on their Ca2+ dynamics during sleep–wakefulness, were focused on to compare whether there are differences in the effects of astrocytes from different brain regions.

Results

The chemogenetic activation of astrocytes in the hippocampus significantly decreased the total time of wakefulness and increased the total time of sleep. This had little effect on cortical oscillations in all sleep–wakefulness states. On the other hand, the activation of astrocytes in the pons substantially suppressed rapid eye movement (REM) sleep in association with a decreased number of REM episodes, indicating strong inhibition of REM onset. Regarding cortical oscillations, the delta wave component during non-REM sleep was significantly enhanced.

Conclusions

These results suggest that astrocytes modulate sleep–wakefulness states and cortical oscillations. Furthermore, the role of astrocytes in sleep–wakefulness states appears to vary among brain regions.
Cyclophosphamide-induced multiple organ dysfunctions: unravelling of dose dependent toxic impact on biochemistry and histology
Authors: Sahu Asim Amitabh , Mukherjee Ankita , Nirala Satendra Kumar , Bhadauria Monika
Published: December 2024

Background: Cyclophosphamide, an immunosuppressive alkylating agent, has been used against breast cancer, lymphoma and myeloid leukemia. Despite various therapeutic uses, its toxic impacts on multiple organs remains to be fully elucidated. Aim: This study aimed to investigate dose dependent toxic impact of cyclophosphamide on liver, kidney, brain and testis emphasizing serum and tissue biochemical and histological alterations. Materials and methods: Experimental design consisted of five groups of albino rats. Group 1–5 were administered vehicle for five consecutive days. On 6th day, group 1 received vehicle only and termed as control; group 2–5 received cyclophosphamide through intraperitoneal route at the rate of 50, 100, 150 and 200 mg/kg dose, respectively. After 24 h of the last administration, rats were euthanised; serum and tissue biochemistry; histology, sperm count and its motility were performed. Results: Serological, biochemical and histological indices exhibited dose dependent deviations from their regular status as a marker of toxicity in liver, kidney, brain and testis. Tukey’s HSD post hoc test revealed maximum damage in multiple organs with 200 mg/kg dose of cyclophosphamide.
Acute Effects of Videoconference-Delivered Exercise Sessions on Energy and Fatigue in Individuals Surviving Cancer
Authors: Gomes Emma L. , Crisafio Mary E. , Khatun Mosammat Sonia , Nabeen A.H.M. Musfiqur Rahman , Nguyen Huong Thao , Hess Ann M. , Leach Heather J.
Published: December 2024

Purpose: High cancer-related fatigue (CRF) and low energy are commonly reported by survivors of cancer both during and following treatment(s) and can be alleviated by regular exercise. However, the immediate or “acute” effects of exercise for improving CRF and energy among survivors of cancer is not well understood. This study examined changes in CRF and energy from immediately before to immediately after exercise sessions during an 8-week videoconference exercise program. Methods: Videoconference exercise sessions were held 1× per week and consisted of light to moderate intensity aerobic and resistance exercise. Energy and CRF were self-reported immediately before and after each exercise session using a visual analog scale (0 = low, 10 = high). Separate linear mixed models were used for CRF and energy, with time (pre/post), treatment status (ie, receiving chemotherapy at the time of the program) and time × treatment interaction included as fixed effects. Results: Participants (N = 55) were M = 59 ± 9.94 years old, 96% female, with ovarian (61.8%), breast (30%), or other (7.2%) cancer, and 27% were receiving chemotherapy. There was a main effect of time for CRF [F(1, 380) = 18.96, P < .01; MΔ = − 0.63 ± −0.04], and for energy [F(1,380) = 93.91, P < .01; MΔ = 1.16 ± .001], but no effect of treatment status. Conclusion: Regardless of treatment status, CRF and energy improved from immediately before to after exercise sessions during an 8-week videoconference exercise program. Future research is needed to determine how to leverage the positive, acute effects of exercise to enhance exercise motivation and adherence, and to understand how exercise intensity may impact CRF and energy immediately following exercise.
Toward Precision in Nutrition Therapy
Authors: Stoppe Christian , Hill Aileen , Christopher Kenneth B. , Kristof Arnold S.
Published: December 2024

Precision in critical care nutrition is paramount, as it focuses nutrition interventions on those patients most likely to benefit, or those who might potentially be harmed. Critical care nutrition must therefore be tailored to individual metabolic needs as determined by factors that control the capacity for tissue homeostasis and anabolic responses. This ideally involves the accurate and timely assessment of macronutrient and micronutrient requirements, a careful evaluation of metabolic response mechanisms and the identification of circumstances that might interfere with the productive utilization of dietary substrates. Specific surrogate markers of metabolic response, such as blood glucose levels, urea levels, or nitrogen balance, might be used to evaluate the metabolic readiness for nutrition and to establish the timing, nature, and clinical effectiveness of nutrition interventions. Despite the pressing need to further develop more targeted approaches in critically ill patients, indices of immediate metabolic responses that correlate with favorable clinical outcomes are lacking. In addition, the development of precision approaches might address timely adjustments in protein, energy, or micronutrient supplementation based on evolving clinical conditions. Here, we review why precision tools are needed in critical care nutrition, our progress thus far, as well as promising approaches and technologies by which multidisciplinary healthcare teams can improve quality of care and clinical outcomes by individualizing nutrition interventions.
Primary Cutaneous Anaplastic Large Cell Lymphoma With Rare Extracutaneous Disseminated Disease: A Case Report
Authors: Dougher Meaghan C. , Cartron Alexander , Scott Jennifer , Bayerl Michael G. , Helm Matthew
Published: December 2024

Primary cutaneous anaplastic large cell lymphoma (pcALCL) is a CD30+ lymphoproliferative disorder with generally favorable outcomes and infrequent extracutaneous spread, usually limited to local lymph nodes. However, there may be extensive histologic overlap with more aggressive CD30+ lymphomas, such as large cell transformation of mycosis fungoides or secondary skin involvement by anaplastic lymphoma kinase (ALK)-negative anaplastic large cell lymphoma. Definitive diagnosis relies on clinicopathologic correlation. We report on a 26-year-old woman who presented to our institution with progressive lower extremity wounds for several months, previously treated with antibiotics and vacuum-assisted closure dressings. Consultation with dermatology and 2 separate biopsies eventually led to the diagnosis of pcALCL. Subsequent imaging revealed stage IV disease with innumerable intensely fluorodeoxyglucose (FDG)-avid subcutaneous, intramuscular, and visceral foci, but paucity of lymph node involvement. The patient's condition deteriorated, and she died during her hospitalization. This case reviews the clinicopathologic findings of pcALCL, emphasizes the importance of clinicopathologic correlation in differentiating between CD30+ lymphoproliferative disorders, highlights the extremely rare phenomenon of systemic intramuscular and visceral disseminated disease occurring in pcALCL, and discusses implications for prognosis.
Identification of a Fetal De Novo Splice Variant in ARCN1 Associated With Growth and Skeletal Abnormalities
Authors: He Wencong , Yang Zejun , Cui Jianjian , Ma Ruilin , Tao Hui , Li Yanan , Zhao Yin
Published: December 2024

Objective:

To report a fetus with ARCN1-related syndrome caused by a novel de novo heterozygous variant, highlighting the importance of early genetic diagnosis in prenatal care.

Methods:

The clinical and genetic data of a fetus with a complex combination of clinical signs and a novel de novo heterozygous variant were collected and have been summarized in this study. The potential pathogenic variant was identified throughout the whole exome sequencing and the effects of candidate variants were further validated by a minigene splicing assay.

Results:

Prenatal systematic ultrasound detected fetal growth restriction. Genetic analysis identified a novel de novo heterozygous variant within the ARCN1 gene—c.1241+5G>A—located in intron 8. In vitro minigene splicing assays demonstrated that the variant led to two abnormal transcripts. The longer transcript retained 189 base pairs of intron 8, resulting in a truncated protein of 414 amino acids (p.Ser415*). The shorter transcript involved exon 8 skippings, producing a truncated protein of 407 amino acids (p.Ile378Serfs*31).

Conclusion:

A novel de novo heterozygous variant of the ARCN1 gene, namely NM_001655.5: c.1241+5G>A, was discovered and identified in a fetus with rhizomelic short stature, microretrognathia, and developmental delays.
Misleading Renal Function Evaluation Leading to Severe Methotrexate-Induced Toxicity
Authors: Launay Manon , Vogrig Manon , Damin-Pernik Marlene , Marotte Hubert , Perinel-Ragey Sophie
Published: December 2024

Low-dose methotrexate has been proposed as therapy for patients with severely disabling psoriasis and psoriatic arthritis. However, it can be associated with severe toxicity, such as pancytopenia, characterized by anemia (hemoglobin level <13 g/dL in men), thrombocytopenia (platelet count <150 × 109/L), and neutropenia or agranulocytosis (neutrophil count <1.5 × 109/L and 0.5 × 109/L, respectively). Here, we report a challenging clinical scenario characterized by pancytopenia and acute renal failure to inform clinicians about potential drug–drug interactions and subclinical renal insufficiency.
Menopause symptom burden and management across rural, suburban, and urban settings in a US population
Authors: Dwyer Erin R. , Maki Pauline M. , Katz Ronit , Mallampalli Monica P. , Reed Susan D.
Published: December 2024

Objective

The aim of this study was to compare menopause experience in rural, suburban, and urban-residing women.

Methods

A 2019 online survey of US females queried respondents on menopause symptoms, resources, and treatments. Those ≥45 years of age and in late menopause transition or postmenopause were included in the analysis. Late menopause transition and postmenopause subgroups were stratified by rural, suburban, and urban residence, and age-weighted proportions for menopause symptoms and treatments were calculated and compared using chi-square tests.

Results

A total of 1,531 respondents, 45% (n = 686) late menopause transition, mean age of 50.7 (SD 3.9) and 55% (n = 845) postmenopause, and mean age of 65.1 (SD 8.5) were included. More prevalent symptoms in late menopause transition rural residents were as follows: muscle aches and pains (urban: 49%, suburban: 49%, rural: 65%, P = 0.003), and panic attacks (urban: 18%, suburban: 24%, rural: 30%, P = 0.04). More prevalent symptoms in postmenopause rural residents were as follows: mood swings (urban: 18%, suburban: 14%, rural: 23%, P = 0.02), urinary incontinence (urban: 19%, suburban: 14%, rural: 23%, P = 0.02), and vaginal dryness (urban: 22%, suburban: 29%, rural: 37%, P = 0.004). Vasomotor symptom prevalence was high (71% late menopause transition, 20% postmeopause), but current menopause hormone therapy use was low (11% late menopause transition, 11% postmenopause) and did not differ by residence, despite differences in menopausal resources used.

Conclusions

Rural women may experience greater burden of psychological and somatic menopause symptoms but not vasomotor symptoms. Overall low rates of menopause hormone therapy use suggest a need for education regarding hormone therapy, tailored to residential groups who rely on different resources on healthy aging.
Validation and expansion of Baveno VII criteria for cACLD and CSPH based on liver stiffness and platelet count: Correlation with risk of hepatic decompensation and death
Authors: Vutien Philip , Barnard Giustini Abbey , Kim Nicole J. , Moon Andrew M. , Hsu Chun-Nan , Mezzacappa Catherine , Borgerding Joleen A. , Johnson Kay M. , VoPham Trang , Berry Kristin , Beste Lauren A. , Kaplan David E. , Taddei Tamar H. , Ioannou George N.
Published: December 2024

Background and Aims:

Recently proposed “Rule-of-Five” criteria define compensated advanced chronic liver disease (cACLD) and clinically significant portal hypertension (CSPH) using liver stiffness (LS) and platelet count. We aimed to validate these criteria by determining whether they are associated with risk of adverse outcomes.

Approach and Results:

Patients without prior hepatic decompensation or HCC who underwent LS and platelet measurements (n = 17,076) were categorized as follows: no cACLD (LS: 2.5–9.9 kPa); probable cACLD (LS: 10–14.9 kPa); certain cACLD-no CSPH (LS: 15–19.9 kPa and platelets ≥110,000/µL or LS 20–24.9 kPa and platelets ≥150,000/µL); probable CSPH (LS 15–19.9 kPa and platelets <110,000/µL or LS 20–24.9 and platelets <150,000/µL); and certain CSPH (LS ≥25 kPa), which we further subdivided into 25–49.9 and 50–75 kPa.

During a median follow-up of 2.82 years, each increase in the “Rule-of-Five” category was associated linearly with higher risks of death (HR: 1.22, 95% CI: 1.18–1.25) and decompensation (HR: 1.52, 95% CI: 1.46–1.58). Compared to patients with LS 25–49.9 kPa, those with LS 50–75 kPa (“critical” CSPH) had approximately double the risk of decompensation (11.24 vs. 4.20 per 100 patient-years) and death (9.85 vs. 6.98 per 100 patient-years).

Conclusions:

The Baveno VII “Rule-of-Five” criteria provide a valid system for stratifying risks of death and hepatic decompensation and should be used routinely in patients with chronic liver disease. Among patients with CSPH (LS ≥25 kPa), the subgroup with LS 50–75 kPa (“critical” CSPH) has approximately double the risk of death and hepatic decompensation than LS 25–49.9 kPa.
Clinical Course and Prognostic Factors in Non-Neovascular Age-Related Macular Degeneration with Subretinal Fluid
Authors: Lee Chang Hwan , Bae Kunho , Yoon Chang Ki , Park Un Chul , Park Kyu Hyung , Lee Eun Kyoung
Published: December 2024

Purpose:

To investigate the clinical course and prognostic factors of age-related macular degeneration (AMD) without macular neovascularization (MNV) in patients presenting with pigment epithelial detachment (PED) and the associated subretinal fluid (SRF).

Methods:

Morphological characteristics of spectral-domain optical coherence tomography images were analyzed to determine anatomic outcomes. Factors associated with the progression to late AMD, defined as complete retinal pigment epithelium and outer retinal atrophy (cRORA) or MNV, were investigated.

Results:

Fifty eyes of 41 patients were included in this study. The most common SRF location was the angle of the PED (56%), and there was a significant decrease in SRF thickness and PED height and width over the follow-up period. Eleven (22%) eyes developed cRORA, and seven (14%) eyes developed MNV during a mean period of 52.1 months. Multivariate analysis revealed that hyperreflective foci and MNV in the fellow eye were associated with the development of cRORA, and higher PED height was a significant factor associated with the development of MNV.

Conclusions:

In patients with AMD, SRF can be accompanied by PED in the absence of MNV. Notably, patients with this characteristic entity can progress to late AMD, including cRORA and MNV, in a significant proportion of cases.
Hydroxychloroquine retinopathy in a 23-year-old male
Authors: Bousquet Elodie , Santina Ahmad , Somisetty Swathi , Morales Veronica Romero , Holland Gary N , Sarraf David
Published: December 2024

Purpose:

To report a case of hydroxychloroquine (HCQ) retinopathy after long-term exposure in a 23-year-old male.

Methods:

Multimodal imaging including fundus photography, fundus autofluorescence (FAF), spectral domain optical coherence tomography (SD-OCT), and en face OCT were performed, in addition to functional testing with full-field electroretinography (ERG) and Humphrey visual field (HVF).

Results:

A 23-year-old man with a history of juvenile systemic lupus erythematosus and HCQ treatment for 13 years at a dosage of 200 mg/d (cumulative dose: 949 grams) presented to the retinal clinic (DS). Although fundus photography and FAF were unremarkable, SD-OCT and en face OCT showed paracentral ellipsoid zone loss with thinning of the outer nuclear layer, OS greater than OD consistent with HCQ retinopathy. HVF 10-2 showed possible nasal loss OU. Genetic testing revealed heterozygous mutations in the CNGA1 and CRX genes but full-field ERG was unremarkable without evidence of a cone dystrophy. Family history was negative for genetic disease.

Conclusion:

This report highlights a case of HCQ retinopathy in a young patient who started treatment at the age of 10 years. There are currently no specific guidelines for the screening of pediatric patients, and studies evaluating the effect of HCQ on children are lacking. Whether the genetic carrier status rendered the patient more susceptible to the toxic effect of HCQ remains to be determined.
Fast Fourier Transform in Assessing the Effect of Parkinson Disease Progression on Sympathetic Oscillation
Authors: Abrol Daksh , Satyam Kumar , Aggarwal Yogender
Published: December 2024

The complex relationship between sympathetic oscillation and the progression of Parkinson disease (PD) is still under active investigation. This study examines the influence of PD on sympathetic activity by examining heart rate variability derived from electrocardiogram recordings. The peak frequency within the low-frequency band of heart rate variability, which is primarily associated with sympathetic modulation, was extracted and compared across various phases of PD severity. As PD advanced, the results revealed a significant and progressive decline in peak frequency, indicating a reduction in sympathetic responsiveness. This observation corresponds with the recognized autonomic dysfunction that accompanies PD progression. Furthermore, a significant negative correlation was observed between peak frequency and disease severity, suggesting its potential utility as a biomarker for monitoring PD advancement and treatment efficacy. The findings emphasize the clinical relevance of autonomic dysfunction in PD and highlight the potential of peak frequency analysis as an effective method for adding to the diagnosis, prognosis, and management of this complex neurodegenerative disorder.
Experiences of Nurse Educators Using Virtual Games in Nursing Education: A Qualitative Study
Authors: ORDU Yadigar , CALIŞKAN Nurcan
Published: December 2024

Background

Virtual games developed for educational purposes have an important place in the education of nursing students.

Purpose

This study was designed to investigate the experiences of nurse educators regarding the use of virtual games in nursing education.

Methods

A descriptive qualitative design was used in this research, which was conducted between June and August 2022. The participants included 18 nurse educators, all of whom were working in the nursing department at several universities in Turkey and selected using purposeful sampling. The data were collected using the Educator Information Form and the Semi-Structured Interview Form. The participants were contacted by e-mail. Participant interviews, which took approximately 30–45 minutes to complete, were conducted online via Zoom. The interviews were recorded with participant approval and then transcribed verbatim. Braun and Clarke's method and MAXQDA 2022 software were used to analyze the data.

Results

Five themes were identified: (a) opinions of the nurse educators, (b) feedback received by nurse educators from students, (c) nurse educator experiences, (d) nurse educator suggestions for the use of virtual games, and (e) nurse educator suggestions for virtual game developers.

Conclusions/Implications for Practice

The participants expressed support for using virtual games in nursing education; received both positive and negative related feedback from students; reported positive and negative experiences with these games; made suggestions for gaming methods and dissemination; and offered related planning, professional support, and other recommendations to game developers. The use of games in nursing education should be expanded, training programs should be organized for nurse educators considering game development, and similar studies should be conducted on larger study samples. The findings provide important information to nurse educators who are considering developing virtual games. The experiences of nurse educators regarding the use of virtual games are quite interesting, and the number of nurse educators involved in developing these games is quite low.
Development and Usability of an Adjustable Prosthesis for Aquatic Therapy
Authors: Atkins Anna , Hoppe-Ludwig Shenan , Guminiak Walter , Hendricksen Monica , Miller Laura
Published: December 2024

Introduction

During aquatic therapy, without a prosthesis, individuals with lower-limb difference are limited in navigating stairs or ladders, performing gait training, balance, and strengthening exercises. A noncustom prosthesis for individuals with transtibial limb difference in aquatic therapy, consisting of interchangeable sockets and pylons, does not exist. Dilatancy has not been applied within a socket to provide an accommodative shape for multiple users.

Objectives

This study explores the development and usability of an adjustable prosthesis, utilizing dilatancy, for aquatic therapy.

Study Design

The design of this study is developmental.

Methods

Participants underwent an informed written consent process (IRB STU00219525). Three individuals (1 male, 55 years; and 2 female, 47 and 22 years) with unilateral transtibial amputations were recruited. A set of interchangeable adjustable sockets and pylons were developed. Utilizing dilatant properties, small particles under vacuum were assessed for their ability to provide a rigid, lightweight, and remoldable pouch within the socket. Participants trialed the prosthesis during two fittings and three aquatic therapy sessions. Upon completion, participants and treating therapists completed the System Usability Scale. Survey results were converted to a 100-point scale. Time to don the prosthesis was recorded, and socket comfort scores at the final session were averaged.

Results

The System Usability Scale indicated that the prosthesis was usable for aquatic therapy. Participant scores were 97.5, 95, and 87.5, and therapist’s scores were 92.5 and 85 of a total possible 100. Average socket comfort scores were 10, 9, and 7.6/10. Times to don the prosthesis were 5:45, 5:32, and 4:10 (minutes:seconds).

Conclusions

This system functioned successfully as a noncustom prosthesis for multiple users in aquatic therapy from the participant and therapists’ perspective.

Clinical Relevance

The novelty of this system is utilizing a prosthesis for multiple users, improving the rehabilitation capabilities during aquatic therapy.
Home dialysis: there's no place like home
Authors: Wallach Jeffrey D. , Medaura Juan A. , Stern Leonard
Published: December 2024

Purpose of review

The rapid rise in incidence and prevalence of end-stage kidney disease (ESKD) over the past 50 years was matched by a drop-off in use of home dialysis and a proliferation of in-center hemodialysis across the United States. There is renewed interest in improving access to home dialysis modalities for patients with ESKD. The aim of this review is to update kidney care providers with clinical outcome data and new guidelines that promote patient-centered choices, and to address barriers to home dialysis uptake and continued use.

Recent findings

Recent literature, including changing practice guidelines for prescribing home dialysis and examining the goals of treatment from the patient and caregiver perspectives will be reviewed. We will examine the impact of newer care models to promote home dialysis for incident ESKD patients. Assisted home dialysis, home dialysis in a nursing home and the impact of new payment models rewarding home dialysis providers will be examined.

This concise review of recent pertinent literature should give the dialysis provider confidence in advising their patients on the benefits of home dialysis, a glimpse into the future landscape for home dialysis, and hopefully transform kidney care providers into unbiased patient advocates.
Complications after low-velocity ballistic femur fractures: a series of 104 patients at a level 1 trauma center
Authors: Fram Brianna R. , Chintalapudi Nainisha , Davis Jana , Yu Ziqing , Seymour Rachel B. , Karunakar Madhav A. ,   Evidence-Based Musculoskeletal Injury and Trauma Collective
Published: December 2024

Objectives:

To report outcomes and risk factors of complications following low-velocity ballistic fractures of the femur.

Design:

Retrospective case series.

Setting:

Academic Level I trauma center.

Patients/Participants:

Retrospective series of 104 patients aged 18+ years presenting with low-velocity civilian ballistic femur fractures from 2011 to 2020 (OTA/AO types 31–33).

Intervention:

Treatment following ballistic femur fracture.

Main Outcome Measurements:

All cause complications.

Results:

Our cohort experienced a 39% complication rate and 19% reoperation rate, including 3 deep surgical site infections, 15 hardware failures, and 12 nonunions. All-cause complications did not differ significantly between OTA/AO or Gustilo classifications (P = 0.56, P = 0.94). Skin and muscle management, arterial injury, amount of contamination, or muscle loss did not differ significantly between those with and without complication. Factors not associated with increased complications included time to initial antibiotics, time from injury, operative time, duration of prophylactic antibiotics, and hospital length of stay. However, all of these factors were based on our typical clinical care routine within the standard of care and were not purposefully varied.

Conclusions:

We did not find any modifiable or nonmodifiable factors that increased risk of complication in our sample. We found that time to prophylactic antibiotics or time to operative debridement was within quality standards and was not associated with increased risk of complications. Our complication rate was similar to previous reports. While we found lower rates of vascular complications than previous reports and 0 cases of compartment syndrome, complication rates in our sample were driven by nonunion and implant failure. These continue to be challenging injuries with high rates of complications.

Level of Evidence:

IV.
Entirely Exophytic HPV-associated Endocervical Adenocarcinoma: A Rare But Potentially Aggressive Neoplastic Phenomenon
Authors: Zyla Roman E. , Talia Karen L. , Hodgson Anjelica
Published: December 2024

A subset of human papillomavirus (HPV)-associated endocervical adenocarcinoma (EA) displays exclusively exophytic growth, with or without a classic villoglandular appearance. Given that increased depth and extent of destructive stromal invasion are associated with poorer prognosis for HPV-associated EA, it is believed that exclusively exophytic tumors are associated with a relatively indolent clinical course. There is, however, a paucity of data regarding the behavior of these neoplasms. We assembled a cohort of 73 patients with entirely resected cervix-confined HPV-associated EA treated with primary operative therapy. The tumors were classified based on architecture and presence/extent of stromal invasion, and histopathologic parameters, including the International Federation of Gynecology and Obstetrics (FIGO) 2018 substage and lymphovascular invasion (LVI). Clinical outcomes including local recurrence, metastasis, and death were evaluated. Of 73 tumors, 4 (6%) demonstrated exclusively exophytic growth (0.4–2.2 cm in maximal dimension). All lacked LVI as well as nodal involvement. None of the 4 patients with exclusively exophytic tumors received adjuvant therapy. Two of the 4 (50%), however, experienced recurrence and both patients eventually died of causes related to EA. Of the remaining 69 cases with a component of nonexophytic growth, <6% of patients experienced tumor recurrence. Our study has found that, in at least a subset of cases, exclusively exophytic HPV-associated EA is associated with adverse outcomes. Additional studies are needed to substantiate these findings and to identify additional features (pathologic, molecular, etc.) that may aid in identifying those patients who could benefit from more aggressive treatment.
Local and energy-resolved topological invariants for Floquet systems
Authors: Ghosh Arnob Kumar , Arouca Rodrigo , Black-Schaffer Annica M.
Published: December 2024

Periodically driven systems offer a perfect breeding ground for out-of-equilibrium engineering of topological boundary states at zero energy (0 mode), as well as finite energy (π mode), with the latter having no static analog. The Floquet operator and the effective Floquet Hamiltonian, which encapsulate the stroboscopic features of the driven system, capture both spectral and localization properties of the 0 and π modes but sometimes fail to provide complete topological characterization, especially when 0 and π modes coexist. In this work, we utilize the spectral localizer, a powerful local probe that can provide numerically efficient, spatially local, and energy-resolved topological characterization. In particular, we apply the spectral localizer to the effective Floquet Hamiltonian for driven one- and two-dimensional topological systems with no or limited symmetries and are able to assign topological invariants, or local markers, that characterize the 0- and the π-boundary modes individually and unambiguously. Due to the spatial resolution, we also demonstrate that the extracted topological invariants are suitable for studying driven disordered systems and can even capture disorder-induced phase transitions.

Published by the American Physical Society
2024
Mirror resonances in
Be9
and
B9
within an
α+α+N
model
Authors: Odsuren Myagmarjav , Myo Takayuki , Kikuchi Yuma , Katō Kiyoshi
Published: December 2024

Using an α+α+N three-body model, we describe the ground and excited unbound states above the three-body threshold of A=9 mirror nuclei. We investigate the energy levels of low-lying and highly excited resonances below ≈10MeV excitation energy of Be9 and B9 mirror nuclei with the complex-scaling method. The same number of solutions are found for both mirror nuclei, namely, thirteen resonances, 3/21−4−, 5/21−3−, 1/21−3−, 7/21,2−, and 9/2−, including the ground state for odd parity states, and eight resonances 5/21,2+, 3/21,2+, 7/21,2+, and

9

/

2

1

,

2

+

, for even-parity states with the exception of the low-lying 1/2+ state. These results are compared with experimentally observed and other theoretically calculated results. The band structures of odd and even parity states for both Be9 and B9 mirror nuclei are discussed in relation to the effect of the Coulomb energy difference.

Published by the American Physical Society
2024
Transverse momentum dependent PDFs in chiral effective theory
Authors: Copeland Marston , Mehen Thomas
Published: December 2024

We develop a theoretical framework to match transverse momentum dependent parton distribution functions (TMD PDFs) onto chiral effective theory operators. In this framework the TMD PDF is expressed as a convolution of TMD hadronic distribution functions, which describe fluctuations of initial states into intermediate hadrons in chiral perturbation theory, and short distance matching coefficients, which are the TMD PDFs of intermediate hadrons in the chiral limit. The various limits of the matching condition are explored and an operator product expansion is applied to the high energy TMD matching coefficients, allowing them to be written in terms of the collinear valence PDFs of intermediate hadrons. As an example, we calculate the isovector TMD hadronic distribution functions for the proton at leading order in the chiral expansion.

Published by the American Physical Society
2024
ϕp
amplitudes from the positive tropical Grassmannian: Triangulations of extended diagrams
Authors: Giménez Umbert Bruno , Yeats Karen
Published: December 2024

The global Schwinger formula, introduced by Cachazo and Early as a single integral over the positive tropical Grassmannian, provides a way to uncover properties of scattering amplitudes which are hard to see in their standard Feynman diagram formulation. In a recent work, Cachazo and one of the authors extended the global Schwinger formula to general ϕp theories. When p=4, it was conjectured that the integral decomposes as a sum over cones which are in bijection with noncrossing chord diagrams, and further that these can be obtained by finding the zeroes of a piecewise linear function, H(x). In this note we give a proof of this conjecture. We also present a purely combinatorial way of computing ϕp amplitudes by triangulating a trivial extended version of noncrossing (p−2)-chord diagrams, called extended diagrams, and present a proof of the bijection between triangulated extended diagrams and Feynman diagrams when p=4. This is reminiscent of recent constructions using Stokes polytopes and accordiohedra. However, the ϕp amplitude is now partitioned by a new collection of objects, each of which characterizes a polyhedral cone in the positive tropical Grassmannian in the form of an associahedron or of an intersection of two associahedra. Moreover, we comment on the bijection between extended diagrams and double-ordered biadjoint scalar amplitudes. We also conjecture the form of the general piecewise linear function, Hϕp(x), whose zeroes generate the regions in which the ϕp global Schwinger formula decomposes into.

Published by the American Physical Society
2024
Effective many-body interactions in reduced-dimensionality spaces through neural network models
Authors: Liang Senwei , Kowalski Karol , Yang Chao , Bauman Nicholas P.
Published: December 2024

Accurately describing properties of challenging problems in physical sciences often requires complex mathematical models that are unmanageable to tackle head on. Therefore, developing reduced-dimensionality representations that encapsulate complex correlation effects in many-body systems is crucial to advance the understanding of these complicated problems. However, a numerical evaluation of these predictive models can still be associated with a significant computational overhead. To address this challenge, in this paper we discuss a combined framework that integrates recent advances in the development of active-space representations of coupled cluster (CC) downfolded Hamiltonians with neural network approaches. The primary objective of this effort is to train neural networks to eliminate the computationally expensive steps required for evaluating hundreds or thousands of Hugenholtz diagrams, which correspond to multidimensional tensor contractions necessary for evaluating a many-body form of downfolded effective Hamiltonians. Using small molecular systems (the H2O and HF molecules) as examples, we demonstrate that training neural networks employing effective Hamiltonians for a few nuclear geometries of molecules can accurately interpolate or extrapolate their forms to other geometrical configurations characterized by different intensities of correlation effects. We also discuss differences between effective interactions that define CC downfolded Hamiltonians with those of bare Hamiltonians defined by Coulomb interactions in the active spaces.

Published by the American Physical Society
2024
Approximate
t
-Designs in Generic Circuit Architectures
Authors: Belkin Daniel , Allen James , Ghosh Soumik , Kang Christopher , Lin Sophia , Sud James , Chong Frederic T. , Fefferman Bill , Clark Bryan K.
Published: December 2024

Unitary t-designs are distributions on the unitary group whose first t moments appear maximally random. Previous work has established several upper bounds on the depths at which certain specific random quantum circuit ensembles approximate t-designs. Here we show that these bounds can be extended to any fixed architecture of Haar-random two-site gates. This is accomplished by relating the spectral gaps of such architectures to those of one-dimensional brickwork architectures. Our bound depends on the details of the architecture only via the typical number of layers needed for a block of the circuit to form a connected graph over the sites. When this quantity is bounded, the circuit forms an approximate t-design in at most linear depth. We give numerical evidence for a stronger bound that depends only on the number of connected blocks into which the architecture can be divided. We also give an implicit bound for nondeterministic architectures in terms of properties of the corresponding distribution over fixed architectures.

Published by the American Physical Society
2024
Review and experimental comparison of speckle-tracking algorithms for X-ray phase contrast imaging
Authors: Celestre Rafael , Quénot Laurène , Ninham Christopher , Brun Emmanuel , Fardin Luca
Published: December 2024

X-ray speckles have been used in a wide range of experiments, including imaging (and tomography), wavefront sensing, spatial coherence measurements, X-ray photon correlation spectroscopy and ptychography. In this review and experimental comparison, we focus on using X-ray near-field speckle grains as wavefront markers and numerical methods for retrieving the phase information they contain. We present the most common tracking methods, introducing the existing algorithms with their specifications and comparing their performances under various experimental conditions. This comparison includes applications to different types of samples: phantoms for quantitative analysis and complex samples for assessing image quality. Our goal is to unify concepts from several speckle tracking methods using consistent terminology and equation formalism, while keeping the discussion didactic and accessible to a broad audience.
3DCryoHolder: a new open access 3D printable system to store and transport silicon nitride membranes under cryogenic conditions for spectromicroscopy at low temperature
Authors: Dominguez-Alfaro Antonio , Sanchez-Cano Carlos
Published: December 2024

Data acquisition under cryogenic conditions allows one to avoid unwanted damage caused by beam irradiation. This is particularly important for the study of biological samples at hard X-ray, micro- or nano-probe beamlines, which focus synchrotron radiation to small beam sizes with extremely high flux densities. Sample preparation methods for cryopreserved specimens have been adapted from electron microscopy, and include the use of silicon nitride membranes as they are easy to handle and possess low X-ray absorption. Yet, currently there are no commercially available methods for the storage and transport of silicon nitride membranes under cryogenic conditions. Here, we introduce and provide the design files of 3DCryoHolder, a system that can be 3D printed in-house for the correct storage and transport of multiple silicon nitride membranes under cryogenic conditions, and is compatible with all commercial plunge-freezing instruments.
Crown ether inclusion compound 3,4-difluoroanilinium di(methanesulfonyl)amidate–18-crown-6 (1/1) clathrate
Authors: Zhang Yao , Wang Yan-Juan , Tang Yuan-Yuan , Chen Xiao-Gang
Published: December 2024

In recent years, molecular-based ferroelectric materials have attracted widespread research interest due to their excellent performance. Among them, host–guest-type crown ether inclusion compounds composed of organic ammonium cations, crown ether molecules and corresponding anions have become a star component in the design of molecular-based ferroelectric materials because they are prone to order–disorder phase transitions. Many anions have been studied extensively as counter-ions, such as bis(trifluoromethanesulfonyl)amidate (TFSA−), PF6
− and [FeCl4]−. However, crown ether inclusion compounds with di(methanesulfonyl)amidate (DMSA) as the anion have been rarely investigated. Here, we converted TFSA to DMSA to obtain 3,4-difluoroanilinium di(methanesulfonyl)amidate–18-crown-6 (1/1), C6H6F2N+·C2H6NO4S2
−·C12H24O6 or [(3,4-DFA)(18-crown-6)][DMSA]. At both 100 and 300 K, the crystal falls into the space group P21/c. The 3,4-DFA cation forms three well-defined N—H...O hydrogen bonds, positioned at the perching position of the crown ether ring. In contrast to the distinct packing configuration observed in the [(3,4-DFA)(18-crown-6)][TFSA] crystals, where TFSA exhibits a disordered structure, the [(3,4-DFA)(18-crown-6)][DMSA] complex features a staggered arrangement, with DMSA existing in an ordered fashion.
Exploring the nexus between usage motivation and behavioral intention in metaverse hospitality and tourism: moderation and mediation insights
Authors: Wu Qi , Wang Junhui
Published: December 2024

Purpose

This study aims to examine the relationship between metaverse usage motivations and metaverse behavioral intention through Self-Determination Theory.

Design/methodology/approach

This study analyzed a sample of 501 South Korean individuals aged 18 and older who had prior experience using the metaverse, using a moderated mediation model.

Findings

The results indicate a significant direct effect between metaverse usage motivation and tourist behavioral intention, with tourist satisfaction significantly mediating this relationship. In addition, the authenticity and flow of metaverse tourism also have significant moderating effects on the model.

Originality/value

These insights can inform targeted marketing strategies, guiding the future development of metaverse tourism and hospitality.
Capitalist messiahs fighting small-mindedness: hegemonic startup masculinity in a semi-peripheral context
Authors: Virágh Enikő Anna
Published: December 2024

Purpose

The aim of this study is to explore the constructions of startup masculinity as a cultural ideal in the specific context of Hungary, a semi-peripheral country in Central and Eastern Europe. Drawing on Connell’s concept of hegemonic masculinity, the paper examines how the construction of startup masculinity, considered hegemonic in a given space and time, subordinates “others”.

Design/methodology/approach

The study employs a critical discourse analysis of 143 media articles published in the Hungarian print and online Forbes magazine. It builds upon the concepts and theoretical models of hegemonic masculinity, entrepreneurial masculine identities, discursive identity construction and semi-peripherality.

Findings

The study highlights two key findings. Firstly, it reveals that the normative figure of the successful startup founder is not gender-neutral but discursively constructed as masculine, thereby excluding women. Secondly, it emphasises the hierarchical relationship between hegemonic startup masculinity and other masculinities rooted in the semi-peripheral, specifically Hungarian context, which are subordinated in the discourse. Thus, it discursively reproduces not only the hierarchical gendered relations in society, but the symbolical hierarchical relations between the core and the semi-periphery as well.

Originality/value

By examining hegemonic startup masculinity as a subordinating concept within a particular entrepreneurial and geographical context and by illuminating the significance of semi-peripheral locationality in hegemony construction, this paper contributes to both the understanding of masculinity in entrepreneurship literature and the decolonisation of masculinity studies.