bluuebunny/crossref_metadata_2025 huggingface dataset:
Adhesive capsulitis following COVID-19 vaccination: A case series
Authors: Ghosh Srutarshi , Pandey Sanjay Kumar , Biswas Anurug , Pandey Jyoti
Published: February 2023

Of the many bizarre complications of administration of the COVID 19 vaccine, adhesive capsulitis is almost unheard-of, although Shoulder Injury following Vaccine Administration (SIRVA), which by definition has symptom onset within 48 hours and is caused by faulty injection technique, has been rarely reported. Nine cases of adhesive capsulitis, five males and four females with a mean age of 48.7 ± 12.7 years, presenting within one month of intramuscular Covishield™ vaccine on the ipsilateral deltoid and fulfilling the standard UK FROST Multicenter Study diagnostic criteria are reported. The mean time interval from vaccination till symptom onset was 12.3 ± 3.1 days, and mean symptom duration was 9.4 ± 2.4 weeks. Conventional treatment with Non-Steroidal Anti Inflammatory Drugs, followed by intra-articular steroid injection coupled with suprascapular nerve steroid block improved the pain score and range of movement in 8 weeks. The exact pathogenesis remains an enigma, although mechanisms such as local spread via deltoid muscle microvasculature, nerves, or SIRVA causing secondary adhesive capsulitis have been hypothesized. While adhesive capsulitis is a very common diagnosis in the physiatric outpatient setting, the possible association with Covishield™ vaccination, the Indian version of the Oxford AstraZeneca recombinant ChAdOx1 nCoV-19 vaccine, is almost absent in existing literature and hence likely to be missed by clinicians, which necessitates this report.
The PRINCOVID retrospective study – a predictive model of pressure injuries for critical COVID-19 patients
Authors: Teixeira-Vaz Ana , Rocha José Afonso , Oliveira Mafalda , Almeida e Reis David , Simões Moreira Tiago , Silva Ana Isabel , Paiva José Artur
Published: February 2023

Objective

To characterize pressure injuries (PI), identify risk factors, and develop a predictive model for PI at intensive care unit (ICU) admission for critical COVID-19 patients.

Design

Retrospective analysis of a consecutive sample of patients admitted to ICU between May/2020 and September/2021. Inclusion criteria encompassed the diagnosis of Acute Respiratory Distress Syndrome due to SARS-CoV-2, requiring invasive mechanical ventilation >48 h. Several predictors were evaluated: socio-demographic characteristics, comorbidities, clinical and laboratory findings at ICU admission. The primary outcome was the presence of PI.

Results

205 patients were included, mostly males (73%) with a mean age of 62 years old. PI prevalence was 58%. On multivariable analysis, male gender, hypertension, hemoglobin, and albumin at ICU admission were independently associated with PI, constituting the PRINCOVID model. The model reached an AUC-ROC of 0.71, surpassing the Braden Scale(p = 0.0015). The PRINCOVID score ranges from 0-15, with two risk groups: “at-risk”(≤7 points) and “high-risk”(>7 points).

Conclusions

This study proposes PRINCOVID as a multivariable model for developing PI in critical COVID-19 patients. Based on four parameters (gender, hypertension, hemoglobin and albumin at ICU admission), this model fairly predicts the development of PI. The PRINCOVID score allows patients’ classification into two groups, facilitating early identification of high-risk patients.
Secondary Breast Reconstruction in Irradiated Patients - Prospective Trial Comparing DIEP to Brava Expansion + Fat Transplantation
Authors: Begic Anadi , Tolli Jukka , Hegard Wenche , Stark Birgit
Published: February 2023

Background:

Autologous tissue reconstruction of the breast is preferable after irradiation. Fat transplantation is a possible alternative. The aim of this prospective trial was to compare outcomes of deep inferior epigastric perforator (DIEP) flaps to BRAVA® expansion + fat grafting, after mastectomy and irradiation.

Methods:

Patients were recruited among the candidates for delayed breast reconstruction after mastectomy and irradiation and were given the same information on both methods. Twenty-six patients underwent DIEP reconstructions and 31 patients had multiple fat grafting sessions after BRAVA® external tissue expansion. Outcomes were evaluated using Breast-Q questionnaire and Telemark Breast Score (TBS).

Results:

Twenty-four of 31 patients in the fat graft group completed the study. Six to nine operative sessions were required to gain a mean volume of about 490 ml. The mean total operation time was 11.5 hours. Four patients in this group developed a new primary or metastatic cancer disease during the study. Twenty-four of 26 patients in the DIEP-group completed the study. The mean total operation time was 8 hours. The mean volume of the reconstructed breast was 523 ml. TBS scores showed similar improvements in both groups at short terms of 3 months in Brava and 6 in DIEP group.

Conclusion:

Supplementary surgical procedures are often needed in breast reconstruction after mastectomy with irradiation using Brava external expansion + fat grafting. Even though the aesthetic results evaluated by surgeons were comparable, patients were more satisfied with outcomes after DIEP reconstructions compared to BRAVA® + fat grafting.
The Male Eyebrow and Eyelid: An Anthropometric Analysis of Caucasian Professional Models.”
Authors: Pietruski Piotr , Majak Marcin
Published: February 2023

Background:

Surgical lift of eyebrows is one of the most efficient facial rejuvenation methods. Although the popularity of those procedures seems to be increasing among men, little is known about esthetically pleasant male eyebrow shape and position.

Methods:

Semi-automatic photogrammetric analysis of three-hundred professional Caucasian male models of assumed age of 18-39 years old was performed. The assessment was conducted in two sessions, using A.I.D. software. A set of linear, angular, and surface area morphometric parameters of the periorbital region was measured.

Results:

A total of six-hundred periorbital regions were quantitatively evaluated. Statistical analysis showed high inter-rater reliability for all three types of measurements. The mean width of the eyebrow was found to be 47.28 + 4.55 mm. The male eyebrow was flat and low-located, overlying the orbital rim. The apex was located at the lateral two-thirds of the brow's width. The vertical distance between the eyebrow's peak and the hairline was 51.3 ± 7.15 mm. In addition, an Averaged Body Contours (ABC) was generated using the A.I.D. software, enabling graphical summarization of facial outline and periorbital contours of all analyzed subjects in the form of a single figure.

Conclusions:

Based on the esthetical preferences of several leading modeling agencies, a concept of the ideal eyebrow for Caucasian males was created. The collected morphometric data on the periorbital region may guide the surgical rejuvenation attempts of achieving youthful and natural brow contours. It may also aid its reconstruction using hair transplant techniques.
Carbon dioxide laser transconjunctival lower blepharoplasty: an objective and quantitative comparison to monopolar electrosurgery
Authors: Chen Chia-Fang , Mao Shih-Hsuan , Yen Cheng-I , Yang Shih-Yi , Hsiao Yen-Chang , Yang Jui-Yung , Chang Shu-Yin , Chuang Shiow-Shuh , Chen Hung-Chang
Published: February 2023

Background:

The ability of simultaneous cutting and hemostasis with low lateral thermal injury makes CO2 laser a useful tool in blepharoplasty. Monopolar electrosurgery is another commonly used cutting tool that improves the quality of hemostasis and cutting speed. This study aimed to objectively and quantitatively assess the intraoperative and postoperative outcomes of transconjunctival lower blepharoplasty using either a CO2 laser or monopolar electrosurgery.

Methods:

Between August 2018 and March 2021, 78 patients who underwent transconjunctival lower blepharoplasty were randomly assigned to the CO2 laser group or monopolar electrosurgery group. Patient related parameters were recorded. Periorbital bruises were objectively and quantitatively assessed using the ecchymosis evaluation score. Analyses were performed using the independent sample t-test, the Mann-Whitney U test, the chi-square test, and the Fisher exact test.

Results:

Sex, age, local anesthesia injection volume, and fat removal volume were not different between the groups. Patients’ subjective intraoperative heat sensation was significantly higher in the monopolar electrosurgery group than in the CO2 laser group. The CO2 laser group had a significantly lower incidence of postoperative chemosis than the monopolar electrosurgery group. All patients had uncomplicated wound healing, except three (7.89%) patients in the monopolar electrosurgery group who developed conjunctival granuloma. Operation time, intraoperative pain sensation, intraoperative blood pressure, postoperative ecchymosis, conjunctivitis, and patients’ esthetic satisfaction did not differ between the groups.

Conclusion:

Our findings revealed that CO2 laser is a useful technique for reducing intraoperative heat sensation and postoperative chemosis and may prevent conjunctival wound complications.
Microsievert Wide-Volume Versus Spiral Computed Tomography Using an Automatic Exposure Control System in the Diagnosis of Foreign Body Aspiration in Children
Authors: Sade Recep , Aydın Yener , Pirimoglu Berhan , Yalcin Ahmet , Abbasguliyev Hasan , Keskin Halil , Polat Gökhan , Ulas Ali Bilal , Daharli Coskun , Eroglu Atila
Published: February 2023

Background

Foreign body aspiration (FBA) in childhood is a life-threatening condition that necessitates prompt management to prevent devastating complications. Different imaging methods are used in the diagnosis of FBA.

Objective

The aim of this study was to compare the diagnostic value and dose of microsievert wide-volume computed tomography (μSv-WV-CT) with multidetector computed tomography using an automatic exposure control system (MDCT-AEC) in children with FBA.

Material and Methods

In this single-center cross-sectional study, 102 cases diagnosed with FBA between September 2013 and September 2021 were retrospectively evaluated. The patients were divided into 2 groups according to the diagnostic modality used: group A, μSv-WV-CT (2016–2021) and group B, MDCT-AEC (2013–2021). The diagnostic performance and radiation dose of the 2 groups were statistically compared.

Results

The diagnostic performance (sensitivity, specificity, positive predictive value, negative predictive value, and accuracy) of the 2 groups was similar. The mean effective radiation dose of group A was 34.89 ± 0.01 μSv, which was significantly lower than that of group B (179.75 ± 114.88 μSv) (P < 0.001).

Conclusion

In children with suspected FBA, μSv-WV-CT at a lower radiation dose had similar diagnostic performance to MDCT-AEC.
Complex Fibroadenoma Mimicking Breast Cancer on 68Ga-FAPI-04 and 18F-FDG PET/CT
Authors: Alçin Göksel , Tatar Gamze , Menengiç Koç Melisa Seray , Arslan Esra , Ergül Nurhan , Çermik Tevfik Fikret
Published: February 2023

A 47-year-old woman had complaint of palpable swelling in the left breast for the last 3 weeks. 18F-FDG PET/CT for staging of concomitant invasive carcinoma in the right breast and 68Ga-labeled fibroblast activation protein inhibitor 04 PET/CT imaging in an ongoing study were performed. Increased radiopharmaceutical uptake was observed in both PET/CT imaging in complex fibroadenoma located in the left breast.
Peptide Receptor Radionuclide Therapy in Patients With Advanced Progressive Medullary Thyroid Cancer
Authors: Liu Qingxing , Kulkarni Harshad R. , Zhao Tianzhi , Schuchardt Christiane , Chen Xiaoyuan , Zhu Zhaohui , Zhang Jingjing , Baum Richard P.
Published: February 2023

Purpose

Progressive metastatic medullary thyroid carcinoma (MTC) is often characterized by rapid disease progression and poor prognosis, with only few therapeutic options available. Peptide receptor radionuclide therapy (PRRT) has demonstrated remarkable success in the management of gastroenteropancreatic neuroendocrine tumors and has also been suggested to treat MTC. However, evidence on its effectiveness and long-term outcome for this indication is still limited. The objective of this study was to assess the safety and efficacy of PRRT in patients with advanced, progressive MTC and to determine survival. Potential predictors of survival were also evaluated.

Methods

From September 2003 to June 2019, 28 patients (15 men and 13 women; mean age, 49 ± 14 years) with progressive, somatostatin receptor–positive advanced MTC received PRRT with 177Lu- or 90Y-labeled somatostatin analogs at Zentralklinik Bad Berka, Germany. Toxicity was graded according to Common Terminology Criteria for Adverse Events version 5.0. Treatment response was evaluated according to RECIST (Response Evaluation Criteria in Solid Tumors) 1.1, as well as molecular imaging criteria (European Organisation for Research and Treatment of Cancer). Kaplan-Meier analysis was used to calculate progression-free survival (PFS) and overall survival (OS), defined from the start of PRRT. Univariate and multivariate Cox regression analyses were performed to identify parameters associated with PFS and OS.

Results

Seventy-seven cycles of PRRT were administered (mean cumulative administered activity, 16.0 ± 7.8 GBq). No acute or long-term grade 3/4 toxicity was recorded with a follow-up of 3 to 140 months, except for 1 patient (4%) who suffered from grade 3 anemia (possibly related to disease progression). According to the RECIST criteria, the disease control rate after 3 to 4 months of PRRT was 56% (partial remission, 12%; stable disease, 44%). The disease control rate (72%) was higher by molecular response evaluation. Median OS and PFS were 63.7 and 10.1 months, respectively. The annual OS rates were 84% at 1 year, 65% at 3 years, 57% at 5 years, and 18% at 10 years. The annual PFS rates were 42% at 1 year, 21% at 2 years, and 13% at 5 years. Patients with bone metastases had poorer OS and PFS than those without metastases (median OS, 58.7 vs 92.3 months [P = 0.035; hazard ratio, 2.7; 95% confidence interval, 0.92–7.84]; median PFS, 8.5 vs 12.8 months [P = 0.592; hazard ratio, 1.2; 95% confidence interval, 0.56–2.76]).

Conclusions

Peptide receptor radionuclide therapy was well tolerated and effective in patients with advanced, aggressive MTC. Bone metastasis was an independent adverse prognostic factor for OS.
Defining a Taxonomical Map for Craniosynostoses: An Integrated Nomenclature for Interdisciplinary Workflow and Problem Mapping in Craniosynostoses Management: A Feasibility Study
Authors: Udayakumaran Suhas , Panikar Dilip , Subhash Pramod
Published: February 2023

Craniosynostoses is a complex clinical and management challenge. This is further complicated by varying phenotypes and specific challenges. Most complex craniosynostoses are approached and managed the same way despite the clinical variability. The goals for craniofacial surgery are common, but the nomenclature based on phenotype, genotype, sutural involvement, or syndromic nature does not shed light on the management workflow. The descriptive diagnosis and terminologies do not highlight the priorities and the operational issues, and most specialists dealing with these conditions remain in their field of tunnelled vision. In this article, the authors propose a concept of categorization based on initial patient presentation. In addition, the etiology and the treatment status, if available, are incorporated along with the presentation. The utility of our proposed categorization is to create a goal-based universal language among various specialists involved.
Overview of Corneal Transplantation for the Nonophthalmologist
Authors: Zhou Yujia , Wang Theodore , Tuli Sonal S. , Steigleman Walter A. , Shah Ankit A.
Published: February 2023

Corneal transplant is a procedure that aims to replace dysfunctional corneal tissue with a transparent graft and is one of the most widely performed transplant surgeries, but its public and professional awareness is low outside of ophthalmology. Corneal tissue consists of 5 major layers that serve to maintain its structural integrity and refractive shape: the epithelium, Bowman’s layer, the stroma, Descemet’s membrane, and the endothelium. Failure or irreversible damage to any layer of the cornea may be an indication for corneal transplant, and variants of this procedure may be full thickness or selectively lamellar. Complications related to corneal transplantation may occur anywhere from during surgery to years afterward, including rejection, dehiscence, cataract, and glaucoma. Complications should be managed by an ophthalmologist, but other physicians should be aware of prophylactic medications. Topical immunosuppressants and steroids are effective for preventing and treating rejection episodes, whereas there is little evidence to support the use of systemic immunosuppression. Eye protection is recommended for any corneal transplant recipient. Physicians should counsel patients on corneal donation, especially if outside the United States, where donor tissue is in short supply.
Testing bird-driven diurnal trade-offs of the moon moth's anti-bat tail
Authors: Rubin Juliette J. , Martin Nich W. , Sieving Kathryn E. , Kawahara Akito Y.
Published: February 2023

Traits are often caught in a dynamic tension of countervailing evolutionary pressures. Trade-offs can be imposed by predators evolutionarily curtailing the conspicuousness of a sexually selected trait, or acting in opposition to another natural selection pressure, for instance, a different predator with a divergent hunting strategy. Some moon moths (Saturniidae) have long hindwing tails that thwart echolocating bat attacks at night, allowing the moth to escape. These long tails may come at a cost, however, if they make the moth's roosting form more conspicuous to visually foraging predators during the day. To test this potential trade-off, we offered wild-caught Carolina wrens (Thryothorus ludovicianus) pastry dough models with realActias lunawings that were either intact or had tails experimentally removed. We video recorded wrens foraging on models and found that moth models with tails did not experience increased detection and attack by birds. Thus, this elaborate trait, while obvious to human observers, does not seem to come at a cost of increased avian predator attention. The evolution of long hindwing tails, likely driven by echolocating predators at night, does not seem to be limited by opposing diurnal constraints. This study demonstrates the importance of testing presumed trade-offs and provides hypotheses for future testing.
Alan Baker. 19 August 1939—4 February 2018
Authors: Masser FRS David
Published: February 2023

Alan Baker single-handedly transformed several areas of number theory. He achieved a major breakthrough in transcendence and applied it to obtain a new and important large class of transcendental numbers, opening the way to the subsequent discovery of several other such classes. He developed quantitative versions and applied them to the effective solutions of many classical diophantine equations as well as the first effective improvement on the 1844 result by Joseph Liouville (ForMemRS 1850) on diophantine approximation and the resolution of the celebrated Gauss Conjectures of 1801 on class numbers, not only
h 
= 1 but also
h 
= 2, of imaginary quadratic fields. He started the study of extensions to elliptic curves, opening the way to later generalizations to abelian varieties and commutative group varieties and in turn their applications to old and new problems in diophantine geometry.

In 1970 he was awarded the Fields Medal at the International Congress in Nice on the basis of his outstanding work on linear forms in logarithms and its consequences. He received many other honours, including the prestigious University of Cambridge Adams Prize, and he was made an honorary fellow of University College London, a foreign fellow of the Indian Academy of Science, a foreign fellow of the National Academy of Sciences India, an honorary member of the Hungarian Academy of Sciences and a fellow of the American Mathematical Society.
Network regulation meets substrate modification chemistry
Authors: Ramesh Vaidhiswaran , Suwanmajo Thapanar , Krishnan J.
Published: February 2023

Biochemical networks are at the heart of cellular information processing. These networks contain distinct facets: (i) processing of information from the environment via cascades/pathways along with network regulation and (ii) modification of substrates in different ways, to confer protein functionality, stability and processing. While many studies focus on these factors individually, how they interact and the consequences for cellular systems behaviour are poorly understood. We develop a systems framework for this purpose by examining the interplay of network regulation (canonical feedback and feed-forward circuits) and multisite modification, as an exemplar of substrate modification. Using computational, analytical and semi-analytical approaches, we reveal distinct and unexpected ways in which the substrate modification and network levels combine and the emergent behaviour arising therefrom. This has important consequences for dissecting the behaviour of specific signalling networks, tracing the origins of systems behaviour, inference of networks from data, robustness/evolvability and multi-level engineering of biomolecular networks. Overall, we repeatedly demonstrate how focusing on only one level (say network regulation) can lead to profoundly misleading conclusions about all these aspects, and reveal a number of important consequences for experimental/theoretical/data-driven interrogations of cellular signalling systems.
Optimization of institutional incentives for cooperation in structured populations
Authors: Wang Shengxian , Chen Xiaojie , Xiao Zhilong , Szolnoki Attila , Vasconcelos Vítor V.
Published: February 2023

The application of incentives, such as reward and punishment, is a frequently applied way for promoting cooperation among interacting individuals in structured populations. However, how to properly use the incentives is still a challenging problem for incentive-providing institutions. In particular, since the implementation of incentive is costly, to explore the optimal incentive protocol, which ensures the desired collective goal at a minimal cost, is worthy of study. In this work, we consider the positive and negative incentives for a structured population of individuals whose conflicting interactions are characterized by a Prisoner’s Dilemma game. We establish an index function for quantifying the cumulative cost during the process of incentive implementation, and theoretically derive the optimal positive and negative incentive protocols for cooperation on regular networks. We find that both types of optimal incentive protocols are identical and time-invariant. Moreover, we compare the optimal rewarding and punishing schemes concerning implementation cost and provide a rigorous basis for the usage of incentives in the game-theoretical framework. We further perform computer simulations to support our theoretical results and explore their robustness for different types of population structures, including regular, random, small-world and scale-free networks.
Would I lie to you? Party affiliation is more important than Brexit in processing political misinformation
Authors: Prike Toby , Reason Robert , Ecker Ullrich K. H. , Swire-Thompson Briony , Lewandowsky Stephan
Published: February 2023

In recent years, the UK has become divided along two key dimensions: party affiliation and Brexit position. We explored how division along these two dimensions interacts with the correction of political misinformation. Participants saw accurate and inaccurate statements (either balanced or mostly inaccurate) from two politicians from opposing parties but the same Brexit position (Experiment 1), or the same party but opposing Brexit positions (Experiment 2). Replicating previous work, fact-checking statements led participants to update their beliefs, increasing belief after fact affirmations and decreasing belief for corrected misinformation, even for politically aligned material. After receiving fact-checks participants had reduced voting intentions and more negative feelings towards party-aligned politicians (likely due to low baseline support for opposing party politicians). For Brexit alignment, the opposite was found: participants reduced their voting intentions and feelings for opposing (but not aligned) politicians following the fact-checks. These changes occurred regardless of the proportion of inaccurate statements, potentially indicating participants expect politicians to be accurate more than half the time. Finally, although we found division based on both party and Brexit alignment, effects were much stronger for party alignment, highlighting that even though new divisions have emerged in UK politics, the old divides remain dominant.
Chronic corticosterone deteriorates latrine and nesting behaviours in mice
Authors: Nomoto Kensaku , Kansaku Kenji
Published: February 2023

Self-care behaviours are actions that help maintain good health and surroundings. For example, appropriate toileting, sleeping in the bed, and bathing and washing are among self-care behaviours in humans. Animals also perform similar self-care behaviours such as latrine, nesting and self-grooming. Studies have shown that chronic stress disrupts nesting and self-grooming behaviours. However, the effect of chronic stress on latrine behaviour, preferential, repeated defecation at specific locations, has not yet been clarified. This study aimed to investigate the influence of chronic corticosterone administration on latrine and nesting behaviours in mice. The variation in defecation location was quantified as the degree of the latrine behaviour by using Shannon entropy. The nest quality was scored based on shape. The study showed that mice exposed to chronic corticosterone had scattered defecation sites and lower nest quality compared to the control group. Furthermore, results showed that more scattered defecation behaviour was associated with lower nest quality at an individual level. Additionally, the deterioration of these self-care behaviours was associated with depression-like behaviours such as less open field activity and increased immobility time during the tail suspension test. These results suggest that chronic corticosterone deteriorates self-care behaviours such as latrine and nesting in mice.
The influence of elastic ankle exoskeletons on lower limb mechanical energetics during unexpected perturbations
Authors: Williamson James L. , Lichtwark Glen A. , Sawicki Gregory S. , Dick Taylor J. M.
Published: February 2023

Passive elastic ankle exoskeletons have been used to augment locomotor performance during walking, running and hopping. In this study, we aimed to determine how these passive devices influence lower limb joint and whole-body mechanical energetics to maintain stable upright hopping during rapid, unexpected perturbations. We recorded lower limb kinematics and kinetics while participants hopped with exoskeleton assistance (0, 76 and 91 Nm rad
−1
) on elevated platforms (15 and 20 cm) which were rapidly removed at an unknown time. Given that springs cannot generate nor dissipate energy, we hypothesized that passive ankle exoskeletons would reduce stability during an unexpected perturbation. Our results demonstrate that passive exoskeletons lead to a brief period of instability during unexpected perturbations — characterized by increased hop height. However, users rapidly stabilize via a distal-to-proximal redistribution of joint work such that the knee performs an increased energy dissipation role and stability is regained within one hop cycle. Together, these results demonstrate that despite the inability of elastic exoskeletons to directly dissipate mechanical energy, humans can still effectively dissipate the additional energy of a perturbation, regain stability and recover from a rapid unexpected vertical perturbation to maintain upright hopping.
Resting disparity in quoll semelparity: examining the sex-linked behaviours of wild roaming northern quolls (Dasyurus hallucatus) during breeding season
Authors: Gaschk Joshua L. , Del Simone Kaylah , Wilson Robbie S. , Clemente Christofer J.
Published: February 2023

Semelparity is a breeding strategy whereby an individual invests large amounts of resources into a single breeding season, leading to the death of the individual. Male northern quolls (Dasyurus hallucatus) are the largest known mammal to experience a post-breeding die-off; however, the cause of their death is unknown, dissimilar from causes in other semelparous dasyurids. To identify potential differences between male northern quolls that breed once, and females that can breed for up to four seasons, the behaviours, activity budgets, speeds and distances travelled were examined. Northern quolls were captured on Groote Eylandt off the coast of the Northern Territory, Australia, and were fitted with accelerometers. A machine learning algorithm (Self-organizing Map) was trained on more than 76 h of recorded footage of quoll behaviours and used to predict behaviours in 42 days of data from wild roaming quolls (7M : 6F). Male northern quolls were more active (male 1.27 g,s.d. = 0.41; female 1.18 g, s.d. = 0.36), spent more time walking (13.09% male: 8.93% female) and engaged in less lying/resting behaviour than female northern quolls (7.67% male: 23.65% female). Reduced resting behaviour among males could explain the post-breeding death as the deterioration in appearance reflects that reported for sleep-deprived rodents.
Temperature and nutrients drive eco-phenotypic dynamics in a microbial food web
Authors: Han Ze-Yi , Wieczynski Daniel J. , Yammine Andrea , Gibert Jean P.
Published: February 2023

Anthropogenic increases in temperature and nutrient loads will likely impact food web structure and stability. Although their independent effects have been reasonably well studied, their joint effects—particularly on coupled ecological and phenotypic dynamics—remain poorly understood. Here we experimentally manipulated temperature and nutrient levels in microbial food webs and used time-series analysis to quantify the strength of reciprocal effects between ecological and phenotypic dynamics across trophic levels. We found that (1) joint—often interactive—effects of temperature and nutrients on ecological dynamics are more common at higher trophic levels, (2) temperature and nutrients interact to shift the relative strength of top-down versus bottom-up control, and (3) rapid phenotypic change mediates observed ecological responses to changes in temperature and nutrients. Our results uncover how feedback between ecological and phenotypic dynamics mediate food web responses to environmental change. This suggests important but previously unknown ways that temperature and nutrients might jointly control the rapid eco-phenotypic feedback that determine food web dynamics in a changing world.
Clinical gait analysis using video-based pose estimation: multiple perspectives, clinical populations, and measuring change
Authors: Stenum Jan , Hsu Melody M. , Pantelyat Alexander Y. , Roemmich Ryan T.
Published: February 2023

Gait dysfunction is common in many clinical populations and often has a profound and deleterious impact on independence and quality of life. Gait analysis is a foundational component of rehabilitation because it is critical to identify and understand the specific deficits that should be targeted prior to the initiation of treatment. Unfortunately, current state-of-the-art approaches to gait analysis (e.g., marker-based motion capture systems, instrumented gait mats) are largely inaccessible due to prohibitive costs of time, money, and effort required to perform the assessments. Here, we demonstrate the ability to perform quantitative gait analyses in multiple clinical populations using only simple videos recorded using household devices (tablets). We report four primary advances: 1) a novel, versatile workflow that leverages an open-source human pose estimation algorithm (OpenPose) to perform gait analyses using videos recorded from multiple different perspectives (e.g., frontal, sagittal), 2) validation of this workflow in three different populations of participants (adults without gait impairment, persons post-stroke, and persons with Parkinson’s disease) via comparison to ground-truth three-dimensional motion capture, 3) demonstration of the ability to capture clinically relevant, condition-specific gait parameters, and 4) tracking of within-participant changes in gait, as is required to measure progress in rehabilitation and recovery. Importantly, our workflow has been made freely available and does not require prior gait analysis expertise. The ability to perform quantitative gait analyses in nearly any setting using only household devices and computer vision offers significant potential for dramatic improvement in the accessibility of clinical gait analysis across different patient populations.
Bayesian network structure for predicting two-year survival in patients diagnosed with non small cell lung cancer
Authors: Osong Biche , Dekker Andre , Wee Leonard , van Soest Johan , Bermejo Inigo
Published: February 2023

Purpose

The aim of this study was to develop and internally validate a clinically plausible Bayesian network structure to predict two-year survival in patients diagnosed with non-small cell lung cancer (NSCLC) and primarily treated with (chemo) radiation therapy by combining expert knowledge and a learning algorithm.

Summary of background

The incidence of lung cancer has been increasing. Healthcare providers are trying to acquire more knowledge of the disease’s biology to treat their patients better. However, the information available is more than humans can efficiently process. Predictive models such as Bayesian networks, which can intricately represent causal relations between variables, are suitable structures to model this information. However, commonly known methods for developing Bayesian network structures are limited in healthcare.

Patients and Methods

545 NSCLC patients treated primarily with (chemo) radiation therapy from Maastro clinic in the Netherlands between 2010 to 2013 were considered to develop this Bayesian network structure. All continuous variables were discretized before analysis. Patients with missing survival status and variables with more than 25% missing information were excluded. The causal relationships (arcs) between variables in the data were determined using the hill-climbing algorithm with domain experts’ restrictions. The learning algorithm was run on a number of bootstrapped samples (B=400) and for the final structure, we kept the arcs present in at least 70% of the learned structures. Performance was assessed by computing the area under the curve (AUC) values and producing calibration plots based on a 5-fold cross-validation. In addition, an adapted pre-specified expert structure was compared with a structure developed from the method in this study.

Results

Tumor load was included in the main structure due to its high percentage (37%) of missingness and lack of added value. The final cohort used to develop the structure was reduced to 499, excluding 46 (8.4%) patients with missing survival status. The resulting structure’s mean AUC and confidence interval to predict two-year survival was 0.614 (0.499 - 0.730). The AUC of the compared structures was only slightly above the chance level, but the structure based on the method in this study was clinically more plausible.

Conclusion

The results of this study show that Bayesian network structures which combine expert knowledge with a rigorous structure learning algorithm produce a clinically plausible structure with optimal performance.
Ethical Issues in Residency Education Related to the COVID-19 Pandemic: A Narrative Inquiry Study
Authors: Kassam Aliya , Page Stacey , Lauzon Julie , Hay Rebecca , Coret Marian , Mitchell Ian
Published: February 2023

Background

Amidst the pandemic, residency programs were faced with new challenges to provide care and educate junior doctors (resident physicians). We sought to understand both the positive and negative experiences of first-year residents during COVID-19, as well as to describe potential ethical issues from their stories.

Method

We used narrative inquiry (NI) methodology and applied a semi-structured interview guide that included questions pertaining to ethical principles as well as both positive and negative aspects of the pandemic. Sampling was purposive. Interviews were audio-recorded and transcribed. Three members of the research team coded transcripts in duplicate to elicit themes. A composite story with threads was constructed. Discrepancies were resolved through discussion to attain consensus.

Results

Eleven residents participated from Internal Medicine (n=2), Family Medicine (n=2), Ophthalmology (n=1), General Surgery (n=1), Pediatrics (n=1), Diagnostic Radiology (n=1), Public Health (n=1), Psychiatry (n=1), Emergency Medicine (n=1). Resident stories had three common themes in which ethical issues were described: 1)Intersecting healthcare and medical education systems, 2)Public health and the public good, 3)Health systems planning/healthcare delivery.

Discussion

The pandemic exacerbated the lack of autonomy experienced by resident physicians. The notion of public health and the public good at times eclipsed individual wellbeing for residents and patients alike.

Conclusion

Efforts to understand how resident physicians can be engaged in their own education as well as how they can navigate public health crises with respect to ethical principles could benefit both residency education and healthcare delivery.
Low seroprevalence of Ebola virus in health care providers in an endemic region (Tshuapa province) of the Democratic Republic of the Congo
Authors: Zola Matuvanga Trésor , Mariën Joachim , Larivière Ynke , Osangir Bernard , Milolo Solange , Meta Rachel , Esanga Emmanuel , Maketa Vivi , Matangila Junior , Mitashi Patrick , Ahuka Mundeke Steve , Muhindo-Mavoko Hypolite , Muyembe Tamfum Jean-Jacques , Van Damme Pierre , Van geertruyden Jean-Pierre
Published: February 2023

Introduction

A serosurvey among health care providers (HCPs) and frontliners of an area previously affected by Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) was conducted to assess the seroreactivity to Ebola virus antigens.

Methods

Serum samples were collected in a cohort of HCPs and frontliners (n=698) participants in the EBL2007 vaccine trial (December 2019 to October 2022). Specimens seroreactive for EBOV were confirmed using either the Filovirus Animal Nonclinical Group (FANG) ELISA or a Luminex multiplex assay.

Results

The seroreactivity to at least two EBOV-Mayinga (m) antigens was found in 10 (1.4%: 95% CI, 0.7-2.6) samples for GP-EBOV-m + VP40-EBOV-m, and 2 (0.3%: 95% CI, 0.0 - 1.0) samples for VP40-EBOV-m + NP-EBOV-m using the Luminex assay. Seroreactivity to GP-EBOV-Kikwit (k) was observed in 59 (8.5%: 95%CI, 6.5-10.9) samples using FANG ELISA.

Conclusion

In contrast to previous serosurveys, a low seroprevalence was found in the HCP and frontline population participating in the EBL2007 Ebola vaccine trial in Boende, DRC. This underscores the high need for standardized antibody assays and cutoffs in EBOV serosurveys to avoid the broad range of reported EBOV seroprevalence rates in EBOV endemic areas.
Microevolution and phylogenomic characterization with perspectives in the 2022-2023 outbreak of child Respiratory Syncytial Virus type A
Authors: Majaz Sidra , Ahmad Ashfaq , Saeed Aamir , Noureen Shumaila , Nouroz Faisal , Amin Amr , Xie Yingqiu
Published: February 2023

A communal respiratory syncytial virus (RSV) causes mild to severe illness, predominantly in older adults, or people with certain chronic medical conditions, and in particular, in young children. Symptoms may include runny nose, cough, fever, and difficulty breathing. In most cases, the infection is mild and resolves on its own, but in some cases, it can lead to more serious illness such as bronchiolitis or pneumonia. The RSV genome codes for ten proteins, NS1, NS2, N, P, M, SH, G, F, M2 and L. We aimed to identify the RSV geographical distribution and transmission pattern using site parsimonious frequencies, and investigate hotspot regions across the complete RSV genomes. These results indicated that RSV strains circulating in South and North America are not mixed to the European samples, however, genomes reported from Australia are the direct decedents of European samples. Samples reported from the United Kingdom were found diverse. Further, this report provides a comprehensive mutational analysis of all the individual RSV genes and in particular the 32 hotspot substituting regions circulating across the globe in RSV type A samples. This is the first comprehensive analysis of RSV type A that features mutational frequencies across the whole genome providing more clues for epidemiological control and drug development.
Host-microbe interactions mediate doramectin-promoted metabolic reprogramming of CD8+T-cells and amplify antitumor immunity
Authors: Taghinezhad-S Sedigheh , Mohseni Amir Hossein , Jiang Wen , Casolaro Vincenzo , Bermúdez-Humarán Luis G. , McAllister Florencia , Lv Zhongwei , Li Dan
Published: February 2023

The intestinal microbiota and its metabolites influence the host metabolic environment and CD8+T-cell function. Metabolic changes in T-cells are thought to enhance the antitumor immune response. Here, we show that doramectin (DOR), a macrocyclic lactone (ML) of the avermectin (AVM) family, can modify CD8+T-cell metabolism to increase and accelerate effector function. However, the functional capability of DOR depends mainly on the accessibility of gut microbiota. Using metagenomic and metabolomic techniques, we describe for the first time the interplay between gut microbiota and host metabolism involved in metabolic reprogramming of CD8+-T cells following DOR administration. Interestingly, we found that, after DOR administration, Firmicutes phylum not only impact DOR transport and absorption, but also boost amino acid levels in CD8+T-cells, consistent with increased production of tumor necrosis factor alpha (TNF-α) and, in particular, interferon gamma (IFN-γ), which together play an important role in antitumor immunity. In contrast, the dysbiotic microbial community may abrogate the anticancer efficacy of DOR and lead to enhanced tumor growth and decreased survival. This finding likely supports the view that the presence of certain bacteria in the gut governs extra-intestinal immune responses and may be associated with metabolic adaptations necessary for efficient function of CD8+T-cells upon DOR administration.
Extracellular communication between brain cells through functional transfer of Cre mRNA
Authors: Rufino-Ramos David , Leandro Kevin , Perdigão Pedro R.L. , O’Brien Killian , Pinto Maria Manuel , Santana Magda M. , van Solinge Thomas S , Mahjoum Shadi , Breakefield Xandra O , Breyne Koen , Pereira de Almeida Luís
Published: February 2023

1

In the central nervous system (CNS), the crosstalk between neural cells is mediated by extracellular mechanisms, including brain-derived extracellular vesicles (bdEVs).

To study endogenous communication across the brain and periphery, we explored Cre-mediated DNA recombination to permanently record the functional uptake of bdEVs cargo overtime. To elucidate functional cargo transfer within the brain at physiological levels, we promoted the continuous secretion of physiological levels of neural bdEVs containing Cre mRNA from a localized region in the brain byin situlentiviral transduction of the striatum of Flox-tdTomato Ai9 mice reporter of Cre activity. Our approach efficiently detected in vivo transfer of functional events mediated by physiological levels of endogenous bdEVs throughout the brain. Remarkably, a spatial gradient of persistent tdTomato expression was observed along the whole brain exhibiting an increment of more than 10-fold over 4 months. Moreover, bdEVs containing Cre mRNA were detected in the bloodstream and extracted from brain tissue to further confirm their functional delivery of Cre mRNA in a novel and highly sensitive Nanoluc reporter system.

Overall, we report a sensitive method to track bdEVs transfer at physiological levels which will shed light on the role of bdEVs in neural communication within the brain and beyond.
MEG frequency tagging reveals a grid-like code during covert attentional movements
Authors: Giari Giuliano , Vignali Lorenzo , Xu Yangwen , Bottini Roberto
Published: February 2023

Grid cells in the entorhinal cortex map regular environments with a 60° periodicity, encoding body- and eye-movements’ direction during spatial exploration. Recent evidence in monkeys suggests that grid cells firing is elicited by spatial attention even without eye movements. We investigated whether movements of covert attention can elicit grid-like responses in humans by concurrently recording MEG and eye-tracker. To obtain a measure of grid-like signal non-invasively, we developed a new paradigm based on frequency tagging. While keeping central fixation, participants were presented visually with sequences of linearly-spaced trajectories (15° or 30° in different conditions) formed by static lines or moving dots in separate sessions. Trajectories appeared sequentially on the screen at a fixed rate (6 Hz), allowing different spatial periodicities (e.g., 90°, 60°, 45°) to have corresponding temporal periodicities (e.g., 1, 1.5, 2 Hz), thus resulting in distinct spectral responses in the MEG signal.

Analyses of inter-trial coherence evidenced a higher steady-state response for the frequency corresponding to 60° periodicity compared to control periodicities. This effect was localized in medial-temporal sources and not in control regions. Moreover, in a control experiment using a recurrent sequence of letters featuring the same temporal periodicity but lacking spatial structure, the 60° effect did not emerge, suggesting its dependency on spatial movements of attention. We report the first evidence, in humans, that grid-like signals in the medial-temporal lobe can be elicited by covert attentional movements. Moreover, we propose a new neuroimaging paradigm based on frequency tagging to study grid-like activity non-invasively.