bluuebunny/crossref_metadata_2025 huggingface dataset:
Marijuana’s Impact On Implant-based Breast Reconstruction: A Retrospective Cohort Study
Authors: Al-Saghir Tala , Hall Jamie , Diffley Michael , Tang Amy , Teitelbaum Abigail , Tepper Donna G. , Darian Vigen , Evangelista Maristella , Atisha Dunya
Published: August 2024

Background:

Studies have shown that chronic marijuana use is associated with increased vascular inflammation, endothelial damage, myocardial infarctions, strokes, arteritis, and cardiomyopathies; however, cannabis’s effect on wound healing in immediate direct-to-implant (DTI) breast reconstruction is unknown. With the increasing prevalence of marijuana use, it is imperative to understand its effects on surgical outcomes.

Methods:

We performed a retrospective cohort study of consecutive patients in a quaternary-care breast cancer center undergoing immediate DTI reconstruction. Patient demographics, operative details, and surgical complications were extracted through chart review. Active cannabis use was defined as use within 12 weeks of operation. Univariate and multivariable analyses were performed.

Results:

In total, 243 consecutive patients underwent immediate DTI reconstruction, and 12 reported active cannabis use. There were no significant differences in patient demographics, cancer treatment, or operative details. Active marijuana users demonstrated higher rates of cellulitis treated with IV antibiotics (P = 0.004), explantation for infection (P = 0.004), emergency department visits (P = 0.028), readmission (P = 0.037), takeback to the operating room in 90 days (P < 0.001), and overall major complications (P < 0.001). Multivariable analysis demonstrated that active marijuana users were more likely to experience cellulitis treated with IV antibiotics [odds ratio (OR) = 3.55, P = 0.024], takeback to the OR within 90 days of operation (OR = 4.75, P = 0.001), and major complications (OR = 2.26, P = 0.048).

Conclusions:

The consumption of cannabis in the perioperative setting is associated with increased rates of complications in patients undergoing immediate DTI reconstruction; however, an analysis with a larger patient population is needed to conclude that abstinence from its use should be highly encouraged.
Research Progress on the Mechanism of Chinese Herbal Compounds Treating Benign Prostatic Hyperplasia by Regulating Inflammatory Response
Authors: Ma Dongyue , Yang Jiutian , Zhao Ziwei , Wang Hao , Du Guanchao , Yu Wenxiao , Wang Fu
Published: August 2024

Benign prostatic hyperplasia (BPH) is one of the most common benign diseases in middle-aged and elderly men. Its main clinical manifestations are frequent urination, urgent urination, weak urine flow, other lower urinary tract symptoms, serious urinary retention, and urinary incontinence. Chinese herbal compounds are widely used in the clinical treatment of BPH with good efficacy and safety, reflecting the advantages of multi-target and multi-approach traditional Chinese medicine (TCM) treatment. There is usually a high level of inflammation in the affected area of BPH, and its persistence affects the whole body, causing multiple complications and accelerating the development of the disease. Inflammation can directly stimulate the proliferation of prostate cells and drive other pathological mechanisms to jointly promote the development of diseases, such as participating in oxidative stress, driving growth factor synthesis, destroying the imbalance between apoptosis and proliferation, and promoting fibrosis. To more fully elucidate the mechanism of action of Chinese herbal compounds in the treatment of BPH, this paper reviews the literature in recent years, beginning with basic research on the intervention of Chinese herbal compounds in BPH inflammation, to provide further ideas for relevant research on the prevention and treatment of BPH inflammation by TCM.
Gray matter volume of limbic brain structures during the development of chronic back pain: a longitudinal cohort study
Authors: Neumann Nicola , Domin Martin , Lotze Martin
Published: August 2024

This study set out to investigate in a population-based longitudinal cohort, whether chronification of back pain (BP) is related to structural gray matter changes in corticolimbic brain structures. Gray matter volume (GMV) was measured in participants with chronic BP (CBP, n = 168) and controls without chronic pain (n = 323) at 2 time points with an interval of 7 years (baseline t1, follow-up t2). Over this time period, participants with CBP showed an increase of GMV in the left ventral striatum, whereas controls showed a decrease. By contrast, participants with CBP had a GMV decrease in the left parahippocampal gyrus. Within the CBP group, pain duration was negatively associated with GMV in the left caudate. Those with emerging CBP had less GMV in the right entorhinal area, right amygdala, and left medial frontal cortex. Additional variables differing between those who had BP at t1 and later developed CBP or not were pain intensity, body mass index, and depression score. In sum, these findings are in accordance with the notion that limbic brain properties are both predisposing risk factors and drivers of brain reorganization during the development of CBP.
Real-world use of spesolimab for the treatment of generalized pustular psoriasis: reports from four cases
Authors: Anderson Meagen , Christianson Ellie , Hopper Sara Keeney , Pansch Leigh-Ann
Published: August 2024

Generalized pustular psoriasis (GPP) is a rare, chronic, autoinflammatory skin disease characterized by painful widespread pustular eruptions. Patients with GPP experience a substantial physical, social, and emotional burden, with significant impacts on their quality of life. Historically, treatment for GPP in the United States mainly involved off-label use of therapies approved to treat plaque psoriasis. Dysregulation of the interleukin-36 (IL-36) pathway appears to play a key role in the pathophysiology of GPP. Spesolimab is a first-in-class humanized monoclonal antibody that binds specifically to the IL-36 receptor and antagonizes IL-36 signaling. In September 2022, spesolimab was approved by the U.S. Food and Drug Administration for the treatment of GPP flares in adults and was subsequently approved for GPP flare treatment in other countries across the world. Here, we describe 4 cases from our respective clinical practices, in which individuals with GPP were treated successfully with spesolimab. These cases demonstrate the difficulties experienced by patients with GPP regarding the disease burden and its effect on patients’ lives. These cases also illustrate some of the challenges that health care professionals may face when seeking to initiate spesolimab treatment, as well as highlighting the need for wider awareness of both the impact and severity of GPP and of the efficacy of spesolimab in GPP treatment.
Systemic assessment of manual circular stapler versus powered circular stapler for anastomosis in rectal cancer: a large-scale Chinese multicenter prospective cohort study
Authors: Chen Yikuan , Zhang Ruijia , Fan Juan , Luo Dakui , Gu Weijin , Liu Fangqi , Zhang Wei , Lin Guole , Wang Quan , Li Xinxiang
Published: August 2024

Mechanical anastomosis in rectal cancer surgery offers several advantages but is plagued by complications like leaks and strictures. Variations in surgeons’ experiences affect outcomes, but powered circular anastomosis has emerged as a promising solution, ensuring uniform staple formation, and reducing manual manipulation. This multicenter, randomized, parallel-controlled study in China compared IntoCare’s powered circular staplers (ICS) with manual circular staplers (MCS) in 382 patients (195 ICS, 187 MCS). Both groups had comparable anastomotic leakage rates. ICS significantly reduced anastomosis time while maintaining similar safety profiles. Postoperative recovery and complication rates were closely matched. The use of ICS in rectal cancer surgeries effectively reduces anastomosis time without compromising safety, offering a promising innovation to enhance the efficacy of rectal cancer surgeries while maintaining patient safety.
Bridging therapy versus direct endovascular thrombectomy in patients with established large infarct: a prospective cohort study
Authors: Sun Wenzhe , Ma Jinfu , Xu Xu , Zhao Yuan , Huang Jiacheng , Guo Changwei , Zhang Lingyu , Yu Nizhen , Yue Chengsong , Zi Wenjie , Zhu Minzhen , He Jinzhao
Published: August 2024

Background:

Whether patients with large core infarctions should undergo intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT) is currently a subject of controversy. The study aimed to investigate the association of prior use of IVT with outcomes of EVT patients with large core infarctions.

Materials and methods:

This prospective cohort included patients with acute large vessel occlusion and Alberta Stroke Program Early Computed Tomography Score (ASPECTS) of 0-5 from 38 stroke centers across China between November 2021 and February 2023. The primary outcome was defined as favorable functional outcomes, which is 90-day modified Rankin Scale (mRS) scores ranging from 0 to 3. Procedural outcomes included measures of successful and effective recanalization. Safety outcomes included the incidence of any intracranial hemorrhage (ICH), symptomatic ICH, and 90-day mortality.

Results:

Of 490 patients, 122 (24.5%) were treated with IVT before EVT. Bridging therapy and its transfer modes showed no association with any of the measured outcomes. Compared to direct EVT, bridging therapy was associated with a decreased risk of symptomatic ICH in very elderly patients and a decreased risk of any ICH in patients with admission NIHSS scores of 20 or higher. Additionally, early stroke severity may alter the odds of any ICH in patients with bridging therapy versus direct EVT (inverse probability weighting adjusted P value for interaction=0.003 and 0.007, respectively).

Conclusion:

In large core infarction patients with high admission NIHSS or very elderly age, bridging therapy appears to have some advantages over direct EVT in reducing the risk of ICH.
Revolutionizing patient education with GPT-4o: a new approach to preventing surgical site infections in total hip arthroplasty
Authors: Zhao Bin , Zhang Weiwen , Zhou Qianqian , Zhang Qi , Du Jianer , Jin Yi , Weng Xiaojian
Published: August 2024

Total hip arthroplasty (THA) is a common surgical procedure known for its generally positive outcomes, but it also comes with the risk of surgical site infections (SSIs), which can result in significant complications and higher healthcare costs. Effective patient education plays a vital role in reducing these risks, as well-informed patients are more likely to take preventive measures and identify early signs of complications. The advent of advanced language models like GPT-4o has opened new avenues for patient education, potentially revolutionizing the way information is delivered and understood. This research letter explores the utility of GPT-4o in enhancing patient education specifically related to SSIs following THA. The capabilities of GPT-4o include offering tailored educational materials, providing 24/7 availability, facilitating humanized interactive learning, and supporting multilingual education. These features significantly improve patient understanding, engagement, and adherence to preventive measures, enhancing the overall quality of healthcare services. However, challenges such as equitable access, language and cultural barriers, and data privacy must be addressed. Utilizing GPT-4o’s advanced AI capabilities can revolutionize patient education, thereby decreasing the incidence of SSIs and enhancing postoperative recovery for THA patients.
Hepatic arterial infusion chemotherapy-based conversion hepatectomy in responders versus nonresponders with hepatocellular carcinoma: a multicenter cohort study
Authors: Deng Min , Zhong Chong , Li Dong , Guan Renguo , Lee Carol , Chen Huanwei , Qin Wei , Cai Hao , Guo Rongping , Chen Zubing
Published: August 2024

Background:

Hepatic arterial infusion chemotherapy (HAIC) has shown satisfactory therapeutic efficacy in unresectable hepatocellular carcinoma (HCC) and is regarded as an important conversion treatment. However, limited information is available regarding the optimal timing of HAIC-based conversion hepatectomy. This study aims to determine the optimal timing for HAIC-based conversion surgery in patients with HCC.

Methods:

Data from a retrospective cohort of patients who underwent HAIC-based conversion hepatectomy were reviewed. Oncological outcomes, surgical information, and risk factors were comparatively analyzed.

Results:

In total, 424 patients with HCC who underwent HAIC-based conversion hepatectomy were included and were divided into responder (n=312) and nonresponder (n=112) groups. The overall survival (OS) and recurrence-free survival (RFS) rates of both the whole responder cohort and patients who achieved a response after 4–6 cycles of HAIC were significantly better than those of the nonresponder cohort. Higher OS and RFS were observed in responders than in nonresponders with advanced-stage HCC. Patients in the responder group had a shorter occlusion duration and less intraoperative blood loss than those in the nonresponder group. There were no significant differences in other surgical information or postoperative complications between the two groups. Tumor response, differentiation, postoperative alpha-fetoprotein level, postoperative protein induced by vitamin K absence or antagonist-II level, age, microvascular invasion, pre-HAIC neutrophil-to-lymphocyte ratio, and preoperative systemic inflammatory response index were independent risk factors for poor long-term survival.

Conclusions:

Conversion surgery should be considered when tumor response is achieved. Our findings may be useful in guiding surgeons and patients in decision-making regarding HAIC-based conversion hepatectomy.
Alopecia patterns and trichoscopic findings in patients with autosomal recessive congenital ichthyosis
Authors: Zaouak Anissa , Jouini Wafa , Abdessalem Ghaith , Abdelhak Sonia , Hammami Houda , Charfeddine Cherine , Fenniche Samy
Published: August 2024

Background:

Autosomal recessive congenital ichthyosis (ARCI) is a rare genodermatosis categorized among nonsyndromic ichthyoses. While ARCI patients often manifest hair abnormalities, their impact on the quality of life remains underreported in the literature.

Objective:

This study aims to comprehensively characterize the clinical and trichoscopic findings of alopecia in ARCI patients.

Methods:

A prospective study spanning from January 2019 to December 2021 (3 years) was conducted at the Dermatology Department of Habib Thameur Hospital, Tunis, Tunisia. Clinical and trichoscopic examinations were performed on the hair of the participants, with molecular studies conducted on 15 patients.

Results:

The study included 30 patients, predominantly female (male/female = 0.58), with a mean age of 20 years. Twenty-eight patients were born from consanguineous marriages. Lamellar ichthyosis was observed in 22 cases, while congenital ichthyosiform erythroderma and bathing suit ichthyosis were each present in 4 cases. The ARCI severity score, assessed using the Visual Index For Ichthyosis Severity scale, had a mean value of 15 (4–28). Alopecia emerged as a prominent finding in 11 patients, presenting as hairline recession (13%), multiple patchy alopecia (27%), and alopecia of the eyebrows (13%). Trichoscopic findings included interfollicular and perifollicular scaling, perifollicular lamellar hyperkeratosis, peripilar casts, interfollicular erythema, loss of hair openings, predominance of single hair follicles, broken hair, vellus hair, anisotrichosis, pili torti, dystrophic hair, and comma hair. Several trichoscopic findings showed statistically significant associations with the severity of ARCI.

Limitations:

In our study, we only included 30 patients due to the rarity of this genodermatosis.

Conclusion:

Contrary to previous perceptions, alopecia is a notable finding in ARCI, particularly in patients with a severe form. This study provides a detailed characterization of alopecia in ARCI, shedding light on its prevalence and associated trichoscopic features, thereby enhancing our understanding of this dermatological condition.
Conductive Hearing Loss Associates With Dementia, and Middle Ear Reconstruction Mitigates This Association: A Multinational Database Study
Authors: Urdang Zachary D. , Jain Amiti , Li Marwin , Haupt Thomas L. , Wilcox Thomas O. , Chiffer Rebecca C. , Gurgel Richard K.
Published: August 2024

Objective

To test the hypothesis that conductive hearing loss (CHL) is associated with dementia, and that middle ear reconstruction (MER) associates with improved outcomes for these measures in a multinational electronic health records database.

Study Design

Retrospective cohort study with propensity-score matching (PSM).

Setting

TriNetX is a research database representing about 110 million patients from the United States, Taiwan, Brazil, and India.

Patients

Subjects older than 50 years with no HL and any CHL (ICD-10: H90.0–2). Subjects of any age with and without any MER (CPT: 1010174).

Main Outcome Measures

Odds ratios (ORs) and hazard ratios with 95% confidence intervals (95% CIs) for incident dementia (ICD-10: F01, F03, G30).

Results

Of 103,609 patients older than 50 years experiencing any CHL, 2.74% developed dementia compared with 1.22% of 38,216,019 patients with no HL (OR, 95% CI: 2.29, 2.20–2.37). Of patients experiencing CHL, there were 39,850 who received MER. The average age was 31.3 years, with 51% female patients. A total of 343,876 control patients with CHL were identified; 39,900 patients remained in each cohort after 1:1 PSM for HL- and dementia-related risk factors. Matched risk for developing dementia among MER recipients was 0.33% compared with 0.58% in controls (OR: 0.58, 0.46–0.72).

Conclusions

CHL increases the odds for dementia, and MER improves the odds for incident dementia. This study represents the first population study on the topic of CHL, MER, and dementia.
A clinical validation of AViTA home blood pressure monitor for atrial fibrillation detection in adults
Authors: Chiu Fu-Chun , Huang I-Chih
Published: August 2024

Background

Atrial fibrillation (AF) is a stroke and heart complication risk but is often overlooked due to subtle symptoms. The accessibility of sphygmomanometers that can detect AF, may play crucial roles in identifying asymptomatic patients. AViTA BPM63B is an automatic blood pressure (BP) monitor for atrial fibrillation detection. This study validated the performance of BPM63B for AF detection using two novel algorithms of time-domain analysis and frequency-domain analysis which evaluate multiple statistics.

Methods

The study included 100 participants, with 47 participants being male (47%) and ages ranging from 24 to 89 years (mean ± SD: 59 ± 17 years). Each participant received three consecutive readings from the subject device and a 12-lead ECG assessment. The pulse wave data from subject device was analyzed using the two algorithms. The atrial fibrillation status thus determined was compared to the ECG results interpreted by a physician.

Results

Among the 100 participants, 52 patients had chronic atrial fibrillation, along with 48 outpatients exhibiting sinus rhythm or non-atrial fibrillation arrhythmias. Using the time-domain analysis method for atrial fibrillation detection, we achieved a sensitivity of 94.8% [95% confidence interval (CI), 90.08–97.75%] and a specificity of 98.6% (95% CI, 95.07–99.83%). Similarly, utilizing the frequency-domain analysis method resulted in a sensitivity of 91.6% (95% CI, 86.08–95.46%) and specificity of 94.4% (95% CI, 89.35–97.57%).

Conclusions

These findings suggest that AViTA BPM63B, which integrates two novel algorithms for atrial fibrillation diagnosis, demonstrates high sensitivity and specificity. Utilizing the AViTA BPM63B for BP monitoring could aid in the early detection of atrial fibrillation among outpatients in cardiology clinics.
Efficacy and safety of mavacamten for the treatment of hypertrophic cardiomyopathy: an updated systematic review and meta-analysis of randomized controlled trials
Authors: Almansouri Naiela Ennaji , Nadeem Bukhari Syed Ali Uzair , Qureshi Muhammad Hassan , Idrees Muhammad , Riaz Chaudhry Zaid , Asghar Arshman Rauf , Habib Ayesha , Ikram Jibran , Ehsan Muhammad , Rehman Wajeeh Ur , Cheema Huzaifa Ahmad , Ayyan Muhammad , Kandel Kamal , Iqbal Sana , Pasha Ahmed , Patel Keyoor , Sabouni Mouhammad Amr
Published: August 2024

The efficacy and safety profile of mavacamten, a cardiac myosin inhibitor for the treatment of hypertrophic cardiomyopathy (HCM) is not well-established, prompting the need for an updated meta-analysis. The authors conducted an extensive search across multiple electronic databases, including Embase, MEDLINE (via Pubmed), and CENTRAL, to identify randomized controlled trials (RCTs) assessing the efficacy and safety of mavacamten in HCM. Review Manager 5.4 (Revman) was employed to pool risk ratios (RR) and mean differences (MD). Our literature search yielded 4 RCTs with a total of 503 patients. Mavacamten was found to be associated with higher rates of greater than or equal to 1 New York Heart Association (NYHA) class improvement (RR 2.20, 95% CI: 1.48–3.28; I2=51%) and change from baseline in the Kansas City Cardiomyopathy Questionnaire- Clinical Summary Score (KCCQ-CSS) (MD 7.50, 95% CI: 3.44–11.55; I2 =50%). Mavacamten was also associated with improved resting left ventricular outflow tract (LVOT) gradient (MD −38.33, 95% CI: −49.38 to −27.28; I2 =75%), Valsalva LVOT gradient (MD −48.08, 95% CI: −62.21 to −33.96; I2 =78%), post-exercise LVOT gradient (MD −37.1, 95% CI: −44.37 to −29.84; I2 =0%), LVMI (MD −16.91, 95% CI: −28.29 to −5.54; I2 =88%), and lower rates of septal reduction therapy (SRT) (RR 0.30, 95% CI: 0.22–0.40; I2 =0%). There were no significant differences between mavacamten and placebo regarding the composite functional outcome, greater than or equal to 1 treatment-emergent adverse event, greater than or equal to 1 serious adverse event, and atrial fibrillation. The authors; findings suggest that mavacamten contributes to improvements in NYHA class, KCCQ-CSS scores, and LVOT gradients while reducing the incidence of SRT in patients with HCM.
Supervised Group-Based Exercise for Preventing Falls Among Older Adults in the Community
Authors: Zhou Jianhong , Yu Ming , Zheng Yali , Zhou Xiaoyue
Published: August 2024

Background:

Supervised group exercise may have greater health benefits than no exercise or exercise alone.

Purpose:

The purpose of this systematic review and meta-analysis was to investigate the effectiveness of supervised group-based exercise on the risk of falls among community-dwelling older adults compared to no exercise or exercise alone.

Methods:

Four databases were searched up to March 1, 2024 for eligible randomized controlled trials.

Results:

Seventeen randomized controlled trials were eligible for this meta-analysis. Meta-analyses showed that compared with no exercise, supervised group-based exercise had a significant effect on preventing falls, injurious falls, and fall-related fractures. Compared with exercise alone, supervised group-based exercise significantly reduced falls and injurious falls.

Conclusions:

Moderate-quality evidence suggests that compared with no exercise or exercise alone, supervised group-based exercise is more effective at preventing falls among community-dwelling older adults.
Brightfield Multiplex Immunohistochemistry Assay for PD-L1 Evaluation in Challenging Melanoma Samples
Authors: Ugolini Filippo , Tinunin Luca , Nozzoli Filippo , Simi Sara , Di Gangi Dario , Baroni Gianna , Antonini Pietro , Szumera-Ciećkiewicz Anna , Massi Daniela
Published: August 2024

Targeting the PD1/PD-L1 immune checkpoint pathway has rapidly become a therapeutic strategy for melanoma patients. Indeed, the quantification of PD-L1 expression by immunohistochemistry (IHC) in melanoma samples is already required, in some contexts, to allow access to anti-PD-1/PD-L1 immunotherapy. Despite a rising demand for PD-L1 testing, paralleling increasing cumulative experience in its assessment and quantification, it is fair to recognize that PD-L1 evaluation in melanoma samples still presents some critical issues. The aim of this technical report is to develop and validate a multiplex double staining protocol for PD-L1/SOX10 in Ventana Benchmark Ultra for routine practice. Our results show that double labeling provides the necessary tools to identify PD-L1+ melanoma cells clearly. The simultaneous visualization of 2 different proteins targets allows the topographical relationship between the 2 labeling to be evaluated within the context of the tissue morphology. Future studies are needed to test this technique’s real-world applicability and effectiveness in implementing interpathologist agreement.
p53 Abnormal (Copy Number High) Endometrioid Endometrial Carcinoma Has a Prognosis Indistinguishable From Serous Carcinoma
Authors: Vaziri Fard Elmira , Imboden Sara , Rau Tilman , Epstein Elisabeth , Petta Tirzah Braz , Walia Saloni , Carlson Joseph W.
Published: August 2024

Among the 4 molecular subgroups of endometrial carcinoma, the p53 abnormal (copy number high) subgroup has the worst prognosis; however, the histologic characteristics of this subgroup are not well established. Also, it is not well established whether low-grade tumors can belong to the p53 abnormal molecular subgroup and if so, what is the prognostic significance of the p53-mutated molecular subgroup in low-grade tumors. In the current study, we included 146 p53-mutated endometrial carcinomas and performed molecular subgrouping either based on a combination of immunohistochemical studies for p53 and MMR protein expression and POLE mutation testing (81 cases) or based on array-based and sequencing-based technologies (65 cases). We excluded cases that belonged to the POLE mutant or MSI molecular subgroups and only studied p53 abnormal (molecular subgroup) endometrial carcinomas (125 cases). In 71 cases, the molecular subgroup was determined by a combination of immunohistochemical studies and POLE mutation testing, and in 54 cases by array-based and sequencing-based methods. We reviewed 1 to 2 representative digital slides from each case and recorded the morphologic characteristics as well as clinical, treatment, and survival follow-up data. Overall, 47 cases were classified as endometrioid carcinoma, 55 serous carcinoma, and 23 other histotypes. Eight cases were FIGO 1, 21 were FIGO 2, and 91 were FIGO 3. A significant proportion of the cases (24.2%) were histologically classified as low-grade (FIGO 1 or 2) endometrioid carcinoma. There was no morphologic characteristic that showed prognostic implication. There was no significant difference in survival among different histotypes (P=0.60). There was no significant difference in survival among low-grade endometrioid (FIGO 1 or 2) versus high-grade (FIGO 3) tumors (P=0.98). Early-stage (stage I), low-grade tumors showed no significant survival advantage over early-stage, high-grade tumors (P=0.16) and this was more evident in FIGO 2 tumors. Although not statistically significant, the FIGO 2 tumors showed a trend toward worse survival than FIGO 3 tumors. Among the cases with available treatment data, more patients with early-stage high-grade tumors received adjuvant treatment, compared to patients with early-stage low-grade tumors, possibly explaining this trend (P=0.03). In conclusion, the findings of our study suggest that low-grade p53 abnormal endometrioid endometrial carcinomas (especially FIGO 2 tumors) have an aggressive course, with a prognosis similar to high-grade tumors. Furthermore, our study suggests that patients who had early-stage low-grade p53 abnormal disease might have been undertreated because of the “low-grade” histotype.
Centrally administered growth hormone secretagogue receptor antagonist DLys decreases alcohol intake and preference in male mice
Authors: Richardson Rani S. , Gomez Juan L. , Vendruscolo Leandro F. , Leggio Lorenzo , Ryabinin Andrey E.
Published: August 2024

Alcohol use disorder (AUD) is a highly prevalent public health problem. The ghrelin system has been identified as a potential target for therapeutic intervention for AUD. Previous work showed that systemic administration of the growth hormone secretagogue receptor (GHSR) antagonist DLys reduced alcohol intake and preference in male mice. Yet, it is unclear whether central or peripheral GHSRs mediated these effects. We hypothesized that alcohol consumption is driven by central GHSRs and addressed this hypothesis by testing the effects of central administration of DLys. Male C57BL/6J mice consumed alcohol in a two-bottle choice procedure (10% ethanol versus water). DLys (2 nmol) was administered intracerebroventricularly for 7 days to examine alcohol intake and preference. DLys decreased alcohol intake and preference but had no effect on food intake. The effects on alcohol intake and preference persisted after several administrations, indicating lack of tolerance to DLys’ effects. These results suggest that central administration of DLys is sufficient to reduce alcohol drinking and that DLys remains effective after several administrations when given intracerebroventricularly. Moreover, this work suggests that the effects of intracerebroventricularly administered DLys are specific to alcohol and do not generalize to other calorie-driven behaviors.
Subcortical white matter differences according to presence of disorders of consciousness in hypoxic-ischemic brain injury: a tract-based spatial statistics study
Authors: Jang Sung Ho , Kwon Hyeok Gyu
Published: August 2024

We investigated differences in subcortical white matter according to the presence disorders of consciousness (DOC) in patients with hypoxic-ischemic brain injury (HI-BI), using tract-based spatial statistics (TBSS). Thirty-two consecutive patients with HI-BI were recruited. The patients were assigned in group A [preserved consciousness (Glasgow Coma Scale: 15 and Coma Recovery Scale-revised (CRS-R): 23, 9 patients)] or group B [DOC present (Glasgow Coma Scale <15 and CRS-R < 23, 20 patients)]. Voxel-wise statistical analysis of fractional anisotropy data was performed by using TBSS as implemented in the FMRIB Software Library. We calculated mean fractional anisotropy values across the white matter skeleton and within 48 regions of interest (ROIs) based on intersections between the skeleton and the probabilistic Johns Hopkins University white matter atlases. Among the 48 ROIs examined, the fractional anisotropy values of two ROIs (the left superior corona radiata, and left tapetum) were significantly lower in group B than in group A (P < 0.05). No significant differences were observed, however, in the other 46 ROIs (P > 0.05). Our results suggest that abnormalities of the superior corona radiata and tapetum may be critical for DOC presence in patients with HI-BI.
Graduated Autonomy of Laparoscopic Liver Resection Based on Liver Resection Complexity: a Western and Eastern Bi-Institution Study for Learning Curve
Authors: Mazzotta Alessandro D , Kawaguchi Yoshikuni , Ito Kyoij , Abe Satoru , Diab Samer , Tribillon Ecoline , Gayet Brice , Hasegawa Kiyoshi , Soubrane Olivier
Published: August 2024

BACKGROUND:

Laparoscopic liver resection (LLR) requires a high degree of expertise in both hepatobiliary and minimally invasive surgery. Our group previously reportwed a 3-level LLR complexity classification based on intrapostoperative outcomes: grade I (low), grade II (intermediate), and grade III (high). We evaluated the learning curve effect in each complexity grade to assess the experience needed for a surgeon to safely progress through the grades.

STUDY DESIGN:

Patients who underwent LLR during 1994 to 2020 at the Institut Mutualiste Montsouris and the University of Tokyo during 2008 to 2023 were included in the study. The learning curve for operating time was evaluated using the standardized (cumulative sum) analysis for each complexity grade.

RESULTS:

A total of 503 patients (grade I, 198; grade II, 87; and grade III, 218) at the Institut Mutualiste Montsouris and 221 patients (grade I, 135; grade II, 57; and grade III, 29) at the University of Tokyo met the inclusion criteria. The cumulative sum analysis showed that the deviation of operating time was found up to 40 cases for grade I resections, 30 cases for grade II resections, and 50 cases for grade III resections. By dividing cohorts based on these numbers for each group and each institution and labeling these cases as the prelearning groups and the remaining as the postlearning group, surgical outcomes and postoperative complications were generally improved in the postlearning groups in both institutions.

CONCLUSIONS:

A gradual progression in LLR per complexity grade as follow: 40 cases of low grade I procedures before starting intermediate complexity grade II procedures, and 30 cases of intermediate complexity grade II procedures before starting high complexity grade III procedures may ensure a safe implementation of high complexity LLR procedures.
Reconstructing blood flow in data-poor regimes: a vasculature network kernel for Gaussian process regression
Authors: Ashtiani Shaghayegh Z. , Sarabian Mohammad , Laksari Kaveh , Babaee Hessam
Published: August 2024

Blood flow reconstruction in the vasculature is important for many clinical applications. However, in clinical settings, the available data are often quite limited. For instance, transcranial Doppler ultrasound is a non-invasive clinical tool that is commonly used in clinical settings to measure blood velocity waveforms at several locations. This amount of data is grossly insufficient for training machine learning surrogate models, such as deep neural networks or Gaussian process regression. In this work, we propose a Gaussian process regression approach based on empirical kernels constructed by data generated from physics-based simulations—enabling near-real-time reconstruction of blood flow in data-poor regimes. We introduce a novel methodology to reconstruct the kernel within the vascular network. The proposed kernel encodes both spatiotemporal and vessel-to-vessel correlations, thus enabling blood flow reconstruction in vessels that lack direct measurements. We demonstrate that any prediction made with the proposed kernel satisfies the conservation of mass principle. The kernel is constructed by running stochastic one-dimensional blood flow simulations, where the stochasticity captures the epistemic uncertainties, such as lack of knowledge about boundary conditions and uncertainties in vasculature geometries. We demonstrate the performance of the model on three test cases, namely, a simple Y-shaped bifurcation, abdominal aorta and the circle of Willis in the brain.
Effects of Virtual Online Physical Education on Physical Fitness: Insights from a Gender Perspective in a Chinese University
Authors: Ao-wei Zhang , Gong Shijun
Published: August 2024

Background

With rapid advancements in Artificial Intelligence (AI) and Virtual Online (VO) technologies in the field of education, Virtual Online Physical Education (VPE) as a novel instructional mode is gradually gaining traction. However, systematic research on the specific impacts of online physical education on the physical fitness of university students, particularly within the context of Chinese students, remains scarce.

Objective

This study aims to explore the effects of Virtual Online Physical Education on the physical fitness of university students, focusing on assessing its impacts on Body Mass Index (BMI), lung capacity, aerobic capacity, flexibility, explosive strength, and muscular strength, while analyzing gender differences.

Methods

A total of 17,000 undergraduate students from a university in southern China were involved in an 8-month Virtual Online Physical Education intervention. Paired-sample t-tests were employed to analyze changes in physical fitness data before and after the intervention, with stratified analysis by gender.

Results

Following the intervention, students showed a significant increase in BMI (p < 0.05) and a significant decrease in lung capacity (p < 0.01). Aerobic capacity improved significantly in male students (p < 0.05) but declined in female students (p < 0.05). Flexibility and explosive strength improved significantly in all students (p < 0.01), while muscular strength (sit-ups for females and pull-ups for males) slightly decreased (p < 0.05). Gender analysis revealed that females exhibited more significant improvements in flexibility and explosive strength, whereas males demonstrated better enhancement in aerobic capacity.

Conclusion

This study reveals the potential and limitations of Virtual Online Physical Education in enhancing the physical fitness of university students, particularly highlighting significant gender differences. While VPE excels in promoting flexibility and explosive strength, its effectiveness in managing BMI and improving cardiorespiratory function is limited. Future research and practices should focus on personalized training program designs and further explore how new technologies can enhance the effectiveness of Virtual Online physical education to comprehensively promote students’ physical fitness.
What keeps male amateur rugby union players committed to the game despite high risk of injury? A qualitative study
Authors: Lane Samuel Jake , Ayre Colin
Published: August 2024

Objectives

Rugby Union is a popular sport worldwide characterised by high intensity full contact match play. Injuries are common during matches and training. While musculoskeletal injury is expected in such a sport, there is emerging research evidence and increased public awareness of neurodegenerative disease risks. The objectives of the present study are to explore reasons for continued participation despite high risk of injury, gain understanding of perceived importance of participation and insight into why players may play with chronic injury.

Design

10 male amateur rugby union players in Gloucestershire and Yorkshire aged 30±5.75 with 20±6.93 years of playing experience participated in semi-structured interviews with subsequent thematic analysis of transcripts.

Results

4 major themes of identity, community, risk acceptance, and uniqueness of rugby were identified. None of the players reported plans to reduce participation in rugby.

Conclusions

Despite risks of injury there were no plans to reduce participation amongst players interviewed. Benefits gained from rugby are abundant and meaningful to players. Understanding these beliefs is helpful for medical staff supporting players, especially through injury. Overall, commitment to amateur rugby union remains strong despite new knowledge of the long-term risks involved. The findings show that amateur rugby union remains a popular sport with benefits extending beyond physical activity.

Highlights

There are 4 key themes regarding commitment to participation in male amateur rugby union despite risk of injury, regardless of new insights of potential long term injury risk and available injury epidemiology data

Current players remain firmly committed to playing citing more benefits than negatives.

Knowledge of risks is limited in the playing population recruited. This is significant as it highlights an issue that needs to be addressed regarding players ability to make an informed choice about their involvement in the game.
Cell-free screening, production and animal testing of a STI-related chlamydial major outer membrane protein supported in Nanolipoproteins
Authors: Mohagheghi Mariam , Abisoye-Ogunniyan Abisola , Evans Angela C. , Peterson Alex , Bude Greg , Hoang-Phou Steven , Vannest Byron Dillon , Hall Dominique , Rasley Amy , Fischer Nicholas , He Wei , Robinson Beverly , Pal Sukumar , Slepenkin Anatoli , de la Maza Luis , Coleman Matthew A.
Published: August 2024

Vaccine development against Chlamydia, a prevalent sexually transmitted infection (STI), is imperative due to its global public health impact. However, significant challenges arise in the production of effective subunit vaccine based on recombinant protein antigens, particularly with membrane proteins like the Major Outer Membrane Protein (MOMP). Cell-free protein synthesis (CFPS) technology is an attractive method to address these challenges as a method of high-throughput membrane protein and protein complex production coupled with nanolipoprotein particles (NLPs). NLPs provides a supporting scaffold while allowing easy adjuvant addition during formulation. Over the last decade we have been working toward production and characterization of MOMP-NLP complexes for vaccine testing. The work presented here highlights the expression and biophysical analyses, including transmission electron microscopy (TEM) and dynamic light scattering (DLS), confirm formation and functionality of MOMP-NLP complexes for use in animal studies. Moreover, immunization studies in preclinical models compare the past and present protective efficacy of MOMP-NLP formulations, particularly when co-adjuvanted with CpG and FSL1. Ex vivo assessments further highlight the immunomodulatory effects of MOMP-NLP vaccinations, emphasizing their potential in eliciting robust immune responses. However, further research is warranted to further optimize vaccine formulations, validate efficacy againstChlamydia trachomatis, and better understand underlying mechanisms of immune response.
Offshore Wind and Aerofauna: Avoidance Remains the Best Bet Amid Limited Mitigation Evidence
Authors: Gulka Julia , Knapp Steve , Soccorsi Anna , Avery-Gomm Stephanie , Knaga Paul , Williams Kathryn A.
Published: August 2024

Offshore wind energy (OSW) development is a vital strategy for reducing global reliance on fossil fuels but also poses environmental challenges that require mitigation. A diversity of approaches exist for mitigating (e.g., avoiding, minimizing, or compensating for) the effects of OSW development on aerofauna (birds and bats), but little is known about the effectiveness of many of these approaches. To address this knowledge gap, we reviewed the scientific and gray literature to evaluate the evidence base for proposed mitigation approaches for OSW and aerofauna. Given limited data from the OSW sector, we included studies from other industries where relevant (e.g., terrestrial wind energy, offshore oil and gas industry, other maritime and terrestrial industries). Of a total of 211 mitigation approaches relevant to OSW that were described in 183 source documents, most approaches focused on minimization, with far fewer addressing avoidance or compensation. Sixty-one percent (128 approaches) had no evidence of being tested in the reviewed literature. Of the 83 mitigation approaches that were field tested or implemented, we found evidence of effectiveness for only 41 approaches. This included approaches tested and implemented in other industry contexts; however, specific to the OSW sector, we found evidence of effectiveness for only 10 approaches. Consequently, 86% of all the mitigation approaches identified in this review lacked any evidence of effectiveness. For birds, minimization approaches related to lighting (e.g., reducing artificial light, avoiding white and steady-burning lights) were the most tested and effective methods for reducing maladaptive attraction and collisions. For bats, minimization approaches involving adjustments to turbine operations (e.g., curtailment and feathering of turbine blades) were most tested and effective methods for reducing collisions. Given the limited evidence of effectiveness for most approaches, dedicated testing of mitigation measures is urgently needed to mitigate the environmental challenges posed by the OSW industry. Until such evidence becomes available, avoidance of effects (via careful siting of industrial activity and related measures) remains the single best available option for mitigating impacts to aerofauna. To fully address the effects of OSW development on aerofauna, compensation and offset strategies should also be further explored.
Social 'envirotyping' the ABCD study contextualizes dissociable brain organization and diverging outcomes
Authors: Merritt Haily , Koch Mary Kate , Jo Youngheun , Chumin Evgeny J , Betzel Richard F
Published: August 2024

The environment, especially social features, plays a key role in shaping the development of the brain, notably during adolescence. To better understand variation in brain-environment coupling and its associated outcomes, we identified ''envirotypes,'' or different patterns of social environment experience, in the Adolescent Brain Cognitive Development Study by hierarchically clustering subjects. Two focal clusters, which accounted for 89.3% of all participants, differed significantly on eight out of nine youth-report social environment quality measures, representing almost perfect complements. We then applied tools from network neuroscience to show different envirotypes are associated with different patterns of whole brain functional connectivity. Differences were distributed across the brain but were especially prominent in Default and Somatomotor Hand systems for these focal clusters. Finally, we examined how social envirotypes change over development and how these patterns of change are associated with a suite of outcomes. The resulting dynamic envirotypes differed along dimensions of stability and quality, but outcomes diverged based on stability. Specifically, the stable, high quality envirotype was most easily distinguished from the improving envirotype, while the unstable envirotype was associated with the worst outcomes. Altogether, our findings represent significant contributions to both social developmental neuroscience and network neuroscience, emphasizing the variability and dynamicity of brain-environment coupling and its consequences.