bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards a phenomenological understanding of neural networks: data
Authors: Tovey Samuel , Krippendorf Sven , Nikolaou Konstantin , Holm Christian
Published: August 2023

A theory of neural networks (NNs) built upon collective variables would provide scientists with the tools to better understand the learning process at every stage. In this work, we introduce two such variables, the entropy and the trace of the empirical neural tangent kernel (NTK) built on the training data passed to the model. We empirically analyze the NN performance in the context of these variables and find that there exists correlation between the starting entropy, the trace of the NTK, and the generalization of the model computed after training is complete. This framework is then applied to the problem of optimal data selection for the training of NNs. To this end, random network distillation (RND) is used as a means of selecting training data which is then compared with random selection of data. It is shown that not only does RND select data-sets capable of outperforming random selection, but that the collective variables associated with the RND data-sets are larger than those of the randomly selected sets. The results of this investigation provide a stable ground from which the selection of data for NN training can be driven by this phenomenological framework.
Recommendations for cradle-to-gate environmental product declarations (EPD) in ‘Buy Clean’ procurement based on CDOT’s experience
Authors: Senseney Christopher T , Harvey John , Butt Ali A , Meijer Joep
Published: August 2023

The use of environmental product declarations (EPDs) in procurement of construction materials has been of increasing interest to government agencies, and adoption in the United States has been driven in part by ‘Buy Clean’ legislation. Buy Clean encompasses green procurement policies that promote the purchase of construction materials and products with lower environmental impacts, considering the life-cycle impacts associated with those materials. Most EPDs for transportation infrastructure construction materials are ‘cradle-to-gate’, or representative of the material production stage of a product and not the entire life cycle; however, these EPDs can allow meaningful quantitative comparisons of environmental and sustainability indicators and serve as a mechanism for measuring improvements in environmental impacts during the production of materials. This paper describes how cradle-to-gate EPDs are used, presents a case study of initial implementation of an EPD policy by the Colorado Department of Transportation, and provides recommendations to address some of the challenges that agencies and stakeholders can face when developing or participating in new EPD programs. It is desired that the recommendations and case study presented in this paper will help provide pathways to agencies for the successful enactment of Buy Clean policies and enable mitigation of actual or perceived barriers to program implementation.
DPSP: a multimodal deep learning framework for polypharmacy side effects prediction
Authors: Masumshah Raziyeh , Eslahchi Changiz
Published: August 2023

Motivation

Because unanticipated drug–drug interactions (DDIs) can result in severe bodily harm, identifying the adverse effects of polypharmacy is one of the most important tasks in human health. Over the past few decades, computational methods for predicting the adverse effects of polypharmacy have been developed.

Results

This article presents DPSP, a framework for predicting polypharmacy side effects based on the construction of novel drug features and the application of a deep neural network to predict DDIs. In the first step, a variety of drug information is evaluated, and a feature extraction method and the Jaccard similarity are used to determine similarities between two drugs. By combining these similarities, a novel feature vector is generated for each drug. In the second step, the method predicts DDIs for specific DDI events using a multimodal framework and drug feature vectors. On three benchmark datasets, the performance of DPSP is measured by comparing its results to those of several well-known methods, such as GNN–DDI, MSTE, MDF–SA–DDI, NNPS, DDIMDL, DNN, DeepDDI, KNN, LR, and RF. DPSP outperforms these classification methods based on a variety of classification metrics. The results indicate that the use of diverse drug information is effective and efficient for identifying DDI adverse effects.

Availability and implementation

The source code and datasets are available at https://github.com/raziyehmasumshah/DPSP.
Quantifying microplastic ingestion, degradation and excretion in insects using fluorescent plastics
Authors: Ritchie Marshall W , Cheslock Alexandra , Bourdages Madelaine P T , Hamilton Bonnie M , Provencher Jennifer F , Allison Jane E , MacMillan Heath A
Published: August 2023

Plastic pollution is a growing threat to our natural environment. Plastic waste/pollution results from high emissions of both macro (>5 mm) and microplastics (MPs; <5 mm) as well as environmental fractioning of macroplastics into MPs. MPs have been shown to have a range of negative impacts on biota. Harmonized methods to accurately measure and count MPs from animal samples are limited, but what methods exist are not ideal for a controlled laboratory environment where plastic ingestion, degradation and elimination can be quantified and related to molecular, physiological and organismal traits. Here, we propose a complete method for isolating and quantifying fluorescent MPs by combining several previously reported approaches into one comprehensive workflow. We combine tissue dissection, organic material digestion, sample filtering and automated imaging techniques to show how fluorescently labelled MPs provided to insects (e.g. in their diet) in a laboratory setting can be isolated, identified and quantified. As a proof of concept, we fed crickets (Gryllodes sigillatus) a diet of 2.5% (w/w) fluorescently labelled plastics and isolated and quantified plastic particles within the gut and frass.
The fast-food effect: costs of being a generalist in a human-dominated landscape
Authors: Guerrero-Sanchez Sergio , Frias Liesbeth , Saimin Silvester , Orozco-terWengel Pablo , Goossens Benoit
Published: August 2023

Agricultural expansion in Southeast Asia has converted most natural landscapes into mosaics of forest interspersed with plantations, dominated by the presence of generalist species that benefit from resource predictability. Dietary shifts, however, can result in metabolic alterations and the exposure of new parasites that can impact animal fitness and population survival. Our study focuses on the Asian water monitor lizard (Varanus salvator), one of the largest predators in the Asian wetlands, as a model species to understand the health consequences of living in a human-dominated landscape in Sabah, Malaysian Borneo. We evaluated the effects of dietary diversity on the metabolism of monitor lizards and the impact on the composition of their parasite communities in an oil palm-dominated landscape. Our results showed that (1) rodent-dominated diets were associated with high levels of lipids, proteins and electrolytes, akin to a fast-food-based diet of little representativeness of the full nutritional requirements, but highly available, and (2) lizards feeding on diverse diets hosted more diverse parasite communities, however, at overall lower parasite prevalence. Furthermore, we observed that the effect of diet on lipid concentration differed depending on the size of individual home ranges, suggesting that sedentarism plays an important role in the accumulation of cholesterol and triglycerides. Parasite communities were also affected by a homogeneous dietary behaviour, as well as by habitat type. Dietary diversity had a negative effect on both parasite richness and prevalence in plantations, but not in forested areas. Our study indicates that human-dominated landscapes can pose a negative effect on generalist species and hints to the unforeseen health consequences for more vulnerable taxa using the same landscapes. Thus, it highlights the potential role of such a widely distributed generalist as model species to monitor physiological effects in the ecosystem in an oil palm-dominated landscape.
Responses to saltwater exposure vary across species, populations and life stages in anuran amphibians
Authors: Albecker Molly A , McCoy Michael W
Published: August 2023

To predict the impacts of environmental change on species, we must first understand the factors that limit the present-day ranges of species. Most anuran amphibians cannot survive at elevated salinities, which may drive their distribution in coastal locations. Previous research showed that coastal Hyla cinerea are locally adapted to brackish habitats in North Carolina, USA. Although Hyla squirella and Hyla chrysoscelis both inhabit coastal wetlands nearby, they have not been observed in saline habitats. We take advantage of naturally occurring microgeographic variation in coastal wetland occupancy exhibited by these congeneric tree frog species to explore how salt exposure affects oviposition site choice, hatching success, early tadpole survival, plasma osmolality and tadpole body condition across coastal and inland locations. We observed higher survival among coastal H. cinerea tadpoles than inland H. cinerea, which corroborates previous findings. But contrary to expectations, coastal H. cinerea had lower survival than H. squirella and H. chrysoscelis, indicating that all three species may be able to persist in saline wetlands. We also observed differences in tadpole plasma osmolality across species, locations and salinities, but these differences were not associated with survival rates in salt water. Instead, coastal occupancy may be affected by stage-specific processes like higher probability of total clutch loss as shown by inland H. chrysoscelis or maladaptive egg deposition patterns as shown by inland H. squirella. Although we expected salt water to be the primary filter driving species distributions along a coastal salinity gradient, it is likely that the factors dictating anuran ranges along the coast involve stage-, species- and location-specific processes that are mediated by ecological processes and life history traits.
Structures on the ventricular side of the prosthetic valve in extremely late mitral paravalvular leak: a case report
Authors: Nakajima Hiroyuki , Tokunaga Chiho , Yoshitake Akihiro , Takazawa Akitoshi
Published: August 2023

Background

Mechanisms of paravalvular leak (PVL) after mitral valve replacement have not been fully delineated. Herein, we report a case of structures on the ventricular side of the mitral valve in a patient with an extremely late PVL.

Case summary

A 68-year-old female underwent aortic and mitral valve replacement with a mechanical valve 29 years ago. She was in good health for 28 years. However, exertional dyspnoea appeared 8 months ago. She was admitted to our hospital for congestive heart failure and haemolytic anaemia. Echocardiography showed severe regurgitation due to PVL of the mitral valve. The fluoroscopy showed that a circular calcification was found below the mitral prosthesis. The operation was performed through a median sternotomy. After the aortic cross-clamp, the aortic mechanical valve was removed. The ventricular side of the mitral valve was inspected with the endoscope through the aortic annulus before manoeuvers were performed in the mitral valve. A gap was seen between the prosthetic valve and annular tissue and subvalvular calcification. A bioprosthetic valve was placed with a modified collar-reinforcement technique using a xenopericardium strip. The postoperative course was uneventful. PVL and haemolysis completely disappeared.

Discussion

The ventricular side of the prosthetic valve could be observed before the mitral valve was removed. Not only the protruding circular calcification and displacement of the prosthetic valve to the atrial side but also the loss of adhesion and adhesive nature of the annular tissue played a definitive role in the late PVL occurrence and recurrence after percutaneous or surgical repair.
Dramatic recovery of left ventricular dysfunction in a patient with pseudoaldosteronism, hypokalaemia, and rhabdomyolysis: a case report
Authors: Ito Shinya , Hasebe Masashi , Inoko Moriaki
Published: August 2023

Background

Excessive liquorice ingestion sometimes causes pseudoaldosteronism. The association between liquorice-induced pseudoaldosteronism and acute heart failure has not been well described.

Case summary

An 89-year-old woman was referred to the hospital due to muscle weakness with rhabdomyolysis and severe hypokalaemia. The electrocardiogram in the emergency department revealed pulseless ventricular tachycardia, thus, emergent defibrillation was delivered. Laboratory findings revealed severe hypokalaemia with metabolic alkalosis. Plasma renin activity and serum aldosterone were highly suppressed. Her medications included herbal medicines containing a great amount of liquorice. The patient was diagnosed with pseudoaldosteronism caused by liquorice over-ingestion. She developed acute pulmonary oedema with unexpected left ventricular (LV) dysfunction after the peak out of creatine kinase. She was managed with acute heart failure therapy, as well as optimal medical therapy. She accidentally developed an acute embolic stroke but fully recovered due to emergent thrombolytic therapy. Cardiac magnetic resonance imaging revealed banding late gadolinium enhancement in the basal-mid segments, which was inconsistent with takotsubo cardiomyopathy. As time passed, LV function unexpectedly improved, and congestive heart failure was completely compensated.

Discussion

Liquorice contains glycyrrhetinic acid that inhibits 11βHSD2. This invites the over-activation of mineralocorticoid receptors by cortisol in the kidneys and eventually causes hypokalaemia and hypertension. Acute heart failure caused by excessive liquorice ingestion is scarcely described. The triggering factors for LV dysfunction and acute congestive heart failure remain unclear. Rhabdomyolysis could affect massive catecholamine release and cause LV dysfunction.
Integrating rapid assessment, variable probability sampling, and machine learning to improve accuracy and consistency in mapping local spatial distribution of plant species richness
Authors: Perng Bo-Hao , Lam Tzeng Yih , Su Sheng-Hsin , Md Sabri Mohamad Danial Bin , Burslem David , Cardenas Dairon , Duque Álvaro , Ediriweera Sisira , Gunatilleke Nimal , Novotny Vojtech , O’Brien Michael J , Reynolds Glen
Published: August 2023

Conserving plant diversity is integral to sustainable forest management. This study aims at diversifying tools to map spatial distribution of species richness. We develop a sampling strategy of using rapid assessments by local communities to gather prior information on species richness distribution to drive census cell selection by sampling with covariate designs. An artificial neural network model is built to predict the spatial patterns. Accuracy and consistency of rapid assessment factors, sample selection methods, and sampling intensity of census cells were tested in a simulation study with seven 25–50-ha census plots in the tropics and subtropics. Results showed that identifying more plant individuals in a rapid assessment improved accuracy and consistency, while transect was comparable to or slightly better than nearest-neighbor assessment, but knowing more species had little effects. Results of sampling with covariate designs depended on covariates. The covariate Ifreq, inverse of the frequency of the rapidly assessed species richness strata, was the best choice. List sampling and local pivotal method with Ifreq increased accuracy by 0.7%–1.6% and consistency by 7.6%–12.0% for 5% to 20% sampling intensity. This study recommends a rapid assessment method of selecting 20 individuals at every 20-m interval along a transect. Knowing at least half of the species in a forest that are abundant is sufficient. Local pivotal method is recommended at 5% sampling intensity or less. This study presents a methodology to directly involve local communities in probability-based forest resource assessment to support decision-making in forest management.
Social Isolation and Worsening Health Behaviors Among Older Adults During the COVID-19 Pandemic
Authors: Choi Kyung Won , Waite Linda J , Finch Laura E , Kotwal Ashwin A
Published: August 2023

Objectives

We examine the relationship between social isolation, poor health behaviors, and the perceived worsening of older adults’ health behaviors following the coronavirus outbreak. We assess the extent to which psychological pathways mediate the relationship between social isolation and worsening health behaviors.

Methods

Drawing on data from the National Social Life Health and Aging Project Round 3 (2015) and its coronavirus immune disease 2019 (COVID-19) substudy (2020; N = 2,549), we use generalized linear models to explore how indicators of social isolation during the COVID-19 pandemic—infrequent in-person contact with friends and family in 2020 and decreased in-person contact with friends and family since COVID-19 started—are associated with (1) poor health behaviors (low physical activity, drinks per week, smoking, and poor sleep) in 2020 and (2) perceived worsening of health behaviors (reports of decreased physical activity, increased drinking and smoking, and feeling less rested) since the pandemic started.

Results

Infrequent in-person contact was not associated with poor health behaviors. Decreases in in-person contact, on the other hand, were associated with worsening health behaviors. Older adults who reported decreases in in-person contact were more likely to perceive a decrease in physical activity, an increase in drinking, and feeling less rested. Emotional well-being, particularly loneliness compared to anxiety or depressive feelings, partially mediated the relationship between perceived worsening of health behaviors and a decrease in in-person contact with friends, and to a lesser extent, with family.

Discussion

Our study suggests that in-person contact may play a distinct role in shaping older adults’ well-being during the pandemic.
Modelling player ratings in One Day International cricket using the Modified Duckworth-Lewis method
Authors: Asif Muhammad , Yousaf Muhammad
Published: August 2023

Accepted by: Phil Scarf

We present a player rating system for One-Day International (ODI) cricket using the Modified Duckworth-Lewis model. We used ball-by-ball data of 1764 uninterrupted One-Day International (ODI) matches played from January 2004 to June 2021 to estimate model parameters. The proposed method is then used to rate players who appeared in the ICC Men’s World Cup 2019. The method is novel because the rating depends on the state of the match, so that pressure and non-pressure situations are accounted for. The method also considers a pitch effect (high or low run scoring). Moreover, the batsman performance can be compared to all-rounder and bowling performances. The results rate Shakib Al Hassan of Bangladesh as the tournament’s best player, followed by R.G. Sharma (India) and J.J. Roy (England).
PFKFB3-Meditated Glycolysis via the Reactive Oxygen Species–Hypoxic Inducible Factor 1α Axis Contributes to Inflammation and Proliferation ofStaphylococcus aureusin Epithelial Cells
Authors: Gao Xing , Wang Zhenglei , Xu Yuanyuan , Feng Shiyuan , Fu Shaodong , Luo Zhenhua , Miao Jinfeng
Published: August 2023

Mastitis caused by antibiotic-resistant strains of Staphylococcus aureus is a significant concern in the livestock industry due to the economic losses it incurs. Regulating immunometabolism has emerged as a promising approach for preventing bacterial inflammation. To investigate the possibility of alleviating inflammation caused by S aureus infection by regulating host glycolysis, we subjected the murine mammary epithelial cell line (EpH4-Ev) to S aureus challenge. Our study revealed that S aureus can colonize EpH4-Ev cells and promote inflammation through hypoxic inducible factor 1α (HIF1α)–driven glycolysis. Notably, the activation of HIF1α was found to be dependent on the production of reactive oxygen species (ROS). By inhibiting PFKFB3, a key regulator in the host glycolytic pathway, we successfully modulated HIF1α-triggered metabolic reprogramming by reducing ROS production in S aureus–induced mastitis. Our findings suggest that there is a high potential for the development of novel anti-inflammatory therapies that safely inhibit the glycolytic rate-limiting enzyme PFKFB3.
Cash Transfers and Social Capital: Evidence from a Randomized Controlled Trial in Malawi
Authors: Mesfin Hiwot , Cecchi Francesco
Published: August 2023

We examine the social capital implications of conditional and unconditional cash transfer (CCT) programs in Malawi, randomly assigning adolescent women and their households to either program or to a control group. Our results show that cash transfers have a positive aggregate effect on social capital, proxied by trust and gift giving. They also show positive intention-to-treat effects on both trust and gift giving in the short run but a negative spillover effect on gift giving in the long run. Moreover, we find that CCTs have greater positive effects on trust than the unconditional cash transfers (UCT). Further analyses reveal that adolescents with initial reciprocal beliefs drive the increase in trust. These results contribute to the current debate on whether CCTs or UCTs are better policy tools, adding the important ‘externality’ of social capital formation.
Long-term multiwavelength monitoring and reverberation mapping of NGC 2617 during a changing-look event
Authors: Oknyansky V L , Brotherton M S , Tsygankov S S , Dodin A V , Tatarnikov A M , Du P , Bao D -W , Burlak M A , Ikonnikova N P , Lipunov V M , Gorbovskoy E S , Metlov V G , Belinski A A , Shatsky N I , Zheltouhov S G , Maslennikova N A , Wang J -M , Zhai S , Fang F -N , Fu Y -X , Bai H -R , Kasper D , Huseynov N A , McLane J N , Maithil J , Zastrocky T E , Olson K A , Chen X , Chelouche D , Oknyansky R S , Buckley D A H , Tyurina N V , Kuznetsov A S , Rebolo R L , Zhao B -X
Published: August 2023

We present the results of photometric and spectroscopic monitoring campaigns of the changing look AGN NGC 2617 carried out from 2016 until 2022 and covering the wavelength range from the X-ray to the near-IR. The facilities included the telescopes of the SAI MSU, MASTER Global Robotic Net, the 2.3-m WIRO telescope, Swift, and others. We found significant variability at all wavelengths and, specifically, in the intensities and profiles of the broad Balmer lines. We measured time delays of ∼6 d (∼8 d) in the responses of the Hβ (Hα) line to continuum variations. We found the X-ray variations to correlate well with the UV and optical (with a small time delay of a few days for longer wavelengths). The K-band lagged the B band by 14 ± 4 d during the last three seasons, which is significantly shorter than the delays reported previously by the 2016 and 2017–2019 campaigns. Near-IR variability arises from two different emission regions: the outer part of the accretion disc and a more distant dust component. The HK-band variability is governed primarily by dust. The Balmer decrement of the broad-line components is inversely correlated with the UV flux. The change of the object’s type from Sy1 to Sy1.8 was recorded over a period of ∼8 yr. We interpret these changes as a combination of two factors: changes in the accretion rate and dust recovery along the line of sight.
astrophot: fitting everything everywhere all at once in astronomical images
Authors: Stone Connor J , Courteau Stéphane , Cuillandre Jean-Charles , Hezaveh Yashar , Perreault-Levasseur Laurence , Arora Nikhil
Published: August 2023

We present astrophot, a fast, powerful, and user-friendly python based astronomical image photometry solver. astrophot incorporates automatic differentiation and graphics processing unit (GPU), or parallel central processing unit (CPU), acceleration, powered by the machine learning library pytorch. Everything: astrophot can fit models for sky, stars, galaxies, point spread functions (PSFs), and more in a principled χ2 forward optimization, recovering Bayesian posterior information and covariance of all parameters. Everywhere: astrophot can optimize forward models on CPU or GPU; across images that are large, multiband, multi-epoch, rotated, dithered, and more. All at once: The models are optimized together, thus handling overlapping objects and including the covariance between parameters (including PSF and galaxy parameters). A number of optimization algorithms are available including Levenberg–Marquardt, Gradient descent, and No-U-Turn Markov chain Monte Carlo sampling. With an object-oriented user interface, astrophot makes it easy to quickly extract detailed information from complex astronomical data for individual images or large survey programs. This paper outlines novel features of the astrophot code and compares it to other popular astronomical image modelling software. astrophot is open-source, fully python based, and freely accessible at https://github.com/Autostronomy/AstroPhot .
Association between individual resilience and depression or anxiety among general adult population during COVID-19: a systematic review
Authors: Yap Mei Chen , Wu Fei , Huang Xulei , Tang Lingli , Su Kehan , Tong Xin , Kwok Sze Chai , Wu Chenkai , Wang Shan , He Zhengting , Yan Lijing L
Published: August 2023

Background

The coronavirus disease (COVID-19) pandemic exacerbated depression and anxiety worldwide. Resilience is important to maintain mental health during uncertain times, but limited study has systematically reviewed its association with depression or anxiety with an emphasis on the general population.

Methods

We searched PubMed and Embase for quantitative or mixed-methods studies on the general adult population published between 1 January 2020 and 31 April 2022 (PROSPERO ID: CRD 42022340935). National Institute of the Health quality assessment tools was used to assess the risk of bias. We qualitatively synthesized findings by outcome and study design.

Results

A total of 2945 studies were screened and 35 studies were included in the narrative analysis (5 on depression, 9 on anxiety, and 21 on both). Overall, 21 studies identified statistically significant inverse associations between resilience and depression, while 24 studies found statistically significant inverse associations between resilience and anxiety. Eight studies reported no statistically significant relationships between resilience with depression or anxiety.

Conclusions

Resilience was found to be inversely associated with depression and anxiety during the COVID-19 pandemic. The findings highlight the importance of resilience-enhancing intervention in migrating the global mental health burden from outbreaks of infectious diseases.
Wheat Stem Rust Surveillance Reveals Two New Races of Puccinia graminis f. sp. tritici in South Africa During 2016 to 2020
Authors: Terefe Tarekegn G. , Boshoff Willem H. P. , Park Robert F. , Pretorius Zacharias A. , Visser Botma
Published: August 2023

Stem rust, caused by Puccinia graminis f. sp. tritici (Pgt), is an important disease of wheat in South Africa (SA) and is primarily controlled using resistant cultivars. Understanding virulence diversity of Pgt is essential for successful breeding of resistant cultivars. Samples of infected wheat stems were collected across the major wheat-growing regions of SA from 2016 to 2020 to determine the pathogenic variability of Pgt isolates. Seven races were identified from 517 isolates pathotyped. The most frequently found races were 2SA104 (BPGSC + Sr9h,27,Kw) (35% frequency) and 2SA88 (TTKSF + Sr8b) (33%). Race 2SA42 (PTKSK + Sr8b), which was found in 2017, and 2SA5 (BFGSF + Sr9h), identified in 2017, are new races. The Ug99 variant race 2SA42 is similar in its virulence to 2SA107 (PTKST + Sr8b) except for avirulence to Sr24 and virulence to Sr8155B1. Race 2SA5 is closely related in its virulence to existing races that commonly infect triticale. Certain races showed limited geographical distribution. Races 2SA5, 2SA105, and 2SA108 were found only in the Western Cape, whereas 2SA107 and 2SA42 were detected only in the Free State province. The new and existing races were compared using microsatellite (SSR) marker analysis and their virulence on commercial cultivars was also determined. Seedling response of 113 wheat entries against the new races, using 2SA88, 2SA88+9h, 2SA106, and 2SA107 as controls, revealed 2SA107 as the most virulent (67 entries susceptible), followed by 2SA42 (64), 2SA106 (60), 2SA88+9h (59), 2SA88 (25), and 2SA5 (17). Thus, 2SA5 may not pose a significant threat to local wheat production. SSR genotyping revealed that 2SA5 is genetically distinct from all other SA Pgt races.
A Novel Method to Determine the Maximum Output of Individual Patients for an Active Transcutaneous Bone Conduction Implant Using Clinical Routine Data
Authors: Ghoncheh Mohammad , Busch Susan , Lenarz Thomas , Maier Hannes
Published: August 2023

Objectives:

The maximum output provided by a bone conduction (BC) device is one of the main factors that determines the success when treating patients with conductive or mixed hearing loss. Different approaches such as sound pressure measurements using a probe microphone in the external auditory canal or a surface microphone on the forehead have been previously introduced to determine the maximum output of active transcutaneous BC devices that are not directly accessible after implantation. Here, we introduce a method to determine the maximum output hearing level (MOHL) of a transcutaneous active BC device using patients’ audiometric data.

Design:

We determined the maximum output in terms of hearing level MOHL (dB HL) of the Bonebridge using the audiometric and direct BC threshold of the patient together with corresponding force levels at hearing threshold and the maximum force output of the device. Seventy-one patients implanted with the Bonebridge between 2011 and 2020 (average age 45 ± 19 years ranging from 5 to 84 years) were included in this study. The analyses of MOHLs were performed by (1) dividing patients into two groups with better or worse average audiometric BC threshold (0.5, 1, 2, 4 kHz), on the ipsilateral side or (2) by separating the MOHLs based on better or worse frequency-by-frequency specific audiometric BC thresholds on the ipsilateral (implanted) side.

Results:

When using a frequency-by-frequency analysis obtained average ipsilateral MOHLs were in the range between 51 and 73 dB HL for frequencies from 0.5 to 6 kHz in the group with better audiometric BC threshold on the ipsilateral ears. The average contralateral MOHLs in the group with better contralateral hearing were in the range from 43 to 67 dB HL. The variability of the data was approximately 6 to 11 dB (SDs) across measured frequencies (0.5 to 6 kHz). The average MOHLs were 4 to 8 dB higher across frequencies in the group with better audiometric BC threshold on the ipsilateral ears than in the group with better audiometric BC threshold on the contralateral ears. The differences between groups were significant across measured frequencies (t test; p < 0.05).

Conclusions:

Our proposed method demonstrates that the individual frequency-specific MOHL on the ipsilateral and contralateral side of individual patients with a transcutaneous BC device can be determined mainly using direct and audiometric BC threshold data of the patients from clinical routine. The average MOHL of the implant was found 4 to 8 dB higher on the ipsilateral (implanted) side than on the contralateral side.
MicroRNAs in idiopathic inflammatory myopathies: state-of-the-art and future perspectives
Authors: Pettorossi Federico , Gasparotto Michela , Ghirardello Anna , Franco Chiara , Ceolotto Giulio , Giannella Alessandra , Iaccarino Luca , Zanatta Elisabetta , Doria Andrea , Gatto Mariele
Published: August 2023

Purpose of review

Idiopathic inflammatory myopathies (IIMs) are a group of rare autoimmune disorders characterized by muscle weakness and inflammation. MicroRNAs (miRNAs) are the main class of small noncoding RNAs regulating a wide range of physiological and pathological processes and play a role in mediating autoimmunity and inflammation. In this review, we summarize the latest knowledge on the role of miRNAs in systemic autoimmune diseases with particular focus on IIMs.

Recent findings

Study on miRNA expression in IIMs is helping in understanding the pathogenetic basis of the disease at a tissue and systemic level. Several miRNAs, even with a muscle-specific expression (myomiRs), have been shown to be involved in immune and nonimmune mechanisms of myofiber damage. MiRNAs modulate and orchestrate the local inflammatory infiltrate and could be used as potential biomarkers as they correlate with disease activity and response to therapy.

IIMs comprise different clinical phenotypes and still little is known about the molecular signature of each subset. Further research about miRNA profiling will provide additional insights in the disease characterization with an expected impact on the therapeutic strategies.
Differentiating Radiation Necrosis and Metastatic Progression in Brain Tumors Using Radiomics and Machine Learning
Authors: Salari Elahheh , Elsamaloty Haitham , Ray Aniruddha , Hadziahmetovic Mersiha , Parsai E. Ishmael
Published: August 2023

Objectives:

Distinguishing between radiation necrosis (RN) and metastatic progression is extremely challenging due to their similarity in conventional imaging. This is crucial from a therapeutic point of view as this determines the outcome of the treatment. This study aims to establish an automated technique to differentiate RN from brain metastasis progression using radiomics with machine learning.

Methods:

Eighty-six patients with brain metastasis after they underwent stereotactic radiosurgery as primary treatment were selected. Discrete wavelets transform, Laplacian-of-Gaussian, Gradient, and Square were applied to magnetic resonance post-contrast T1-weighted images to extract radiomics features. After feature selection, dataset was randomly split into train/test (80%/20%) datasets. Random forest classification, logistic regression, and support vector classification were trained and subsequently validated using test set. The classification performance was measured by area under the curve (AUC) value of receiver operating characteristic curve, accuracy, sensitivity, and specificity.

Results:

The best performance was achieved using random forest classification with a Gradient filter (AUC=0.910±0.047, accuracy 0.8±0.071, sensitivity=0.796±0.055, specificity=0.922±0.059). For, support vector classification the best result obtains using wavelet_HHH with a high AUC of 0.890±0.89, accuracy of 0.777±0.062, sensitivity=0.701±0.084, and specificity=0.85±0.112. Logistic regression using wavelet_HHH provides a poor result with AUC=0.882±0.051, accuracy of 0.753±0.08, sensitivity=0.717±0.208, and specificity=0.816±0.123.

Conclusion:

This type of machine-learning approach can help accurately distinguish RN from recurrence in magnetic resonance imaging, without the need for biopsy. This has the potential to improve the therapeutic outcome.
Another Day, Another 82 Cents: A National Survey Assessing Gender-based Wage Differences in Board-certified Plastic Surgeons
Authors: Raborn Layne N. , Gokun Yevgeniya , Molina Bianca J. , Janse Sarah , Schoenbrunner Anna R. , Janis Jeffrey E.
Published: August 2023

Background:

Of 7461 actively practicing United States American Board of Plastic Surgery certified plastic surgeons, only 17% are women. In relation to this small number, gender inequities within the field have been the source of national discussions. Our study assessed the status of the gender-based wage-gap in plastic surgery and sought to identify possible causes.

Methods:

An anonymous 43-question survey was distributed to 2981 members of the American Society of Plastic Surgeons in 2021. Male and female responses were compared; an analysis also considering board-certification year was performed. Chi-square and Fisher exact tests were used for bivariate analysis. Continuous variables were compared with two-sample t tests and Wilcoxon rank sum tests.

Results:

Ten percent of contacted American Society of Plastic Surgeons members responded to our survey. Of the 288 respondents, 111 (38.5%) were women, and 177 (61.5%) were men. Men were more likely to have salaries over $400K USD per year (P < 0.0001). Earlier certification year was associated with pay greater than $400K per year (P = 0.0235) but was insignificant once stratified by gender (women: P = 0.2392, men: P = 0.7268). Earlier certification year was associated with production-based and self-determined wages (P = 0.0097), whereas later board-certification year was associated with nonnegotiable salaries (P < 0.0001).

Conclusions:

Women are significantly less likely to make salaries comparable to those of male plastic surgeons, related to shorter careers on average. An increase in female representation and career duration within the field is needed to improve the current wage-gap.
Botulinum Toxins and Lip Repositioning Surgery with Repeated Botulinum Toxin Injection: A Combined Approach for Gummy Smile Treatment
Authors: Adel Noury
Published: August 2023

This study was conducted to evaluate the longevity and efficacy of neurotoxin injection before lip repositioning surgery in addition to reinjection of two sustaining doses along three different postoperative intervals (2, 4, and 8 months). This experimental study included 10 female patients who had a gummy smile resulting from upper lip hypermobility or short upper lip. Preoperative measurements were taken during spontaneous smiling: the interlabial distance and the amount of gingival exposure. IncoBotulinum Toxin A was injected into the elevator muscles of the upper lip followed by performing the lip repositioning surgery after 2 weeks of IncoBotulinum Toxin A injection. IncoBotulinum Toxin A was then reinjected at three different postoperative intervals (2, 4, and 8 months). All patients were followed up at 14 days, 4 months, 8 months, and 12 months. Postoperative measurements at 14 days follow-up showed a significant reduction in the amount of gum exposure and in the interlabial distance during smiling. Both changes remained stable up to 1 year, despite the minimal relapse that was observed; all the patients reported a high degree of satisfaction. Combining neurotoxins before and after the lip repositioning surgery may provide long-lasting results up to 1 year and better stability for the success rate of the surgery, where the use of each approach alone (IncoBotulinum Toxin A alone/surgery alone) may offer a temporary improvement.
SUBRETINAL FLUID ASSOCIATED WITH PEMIGATINIB THERAPY FOR CHOLANGIOCARCINOMA: A CASE REPORT AND LITERATURE REVIEW
Authors: Caranfa Jonathan T. , Mellen Phoebe , Liang Michelle C.
Published: August 2023

Purpose:

To describe the retinal findings associated with pemigatinib, an oral competitive inhibitor of fibroblast growth factor receptor approved for the treatment of cholangiocarcinoma.

Methods:

A case report is presented, and a literature review was performed, revealing only two prior reported cases of pemigatinib-mediated subretinal fluid.

Results:

A 72-year-old woman presented with transient visual symptoms while on pemigatinib for the treatment of cholangiocarcinoma. Optical coherence tomography revealed subfoveal subretinal fluid bilaterally that resolved during a drug holiday; however, it fluctuated throughout her treatment course. She remained on pemigatinib for 10 months without other ocular sequelae.

Conclusion:

This is one of the few reported cases of pemigatinib-related retinopathy, which further supports the self-limited and benign nature of subretinal fluid associated with fibroblast growth factor receptor inhibitors.
Student Experiences of a Home-Based Acute Care Curriculum
Authors: Trojanowski Suzanne , Sherman Erica , Huang Min Hui
Published: August 2023

Background/Purpose:

The COVID-19 pandemic disrupted physical therapy education beginning in March 2020. Acute care physical therapy is complex and has substantive psychomotor skills and safety demands. Students can experience significant challenges during acute care clinical education experiences (CEE); therefore, assessment of the effect of curricular adjustments on preparation for clinical experiences is paramount. Students can experience significant challenges during acute care CEE. Educational programs continue to assess the effect of pandemic dictated altered modes of delivery of laboratory-based courses on student outcomes. The purpose of this qualitative case report is to explore students' experiences of an online delivery mode of an acute care course and their perception of its ability to prepare the student for an acute care CEE.

Case Description:

Interviews were completed with physical therapist students after their terminal acute care CEE. Qualitative analysis was approached from an interpretive epistemological perspective and a phenomenological approach was used to explore students' experience in participating in an online delivery mode to gain the required skills to be effective during acute care physical therapist practice. Data analysis was completed using a thematic analysis approach.

Outcomes:

Seven students participated in qualitative interviews after their acute care educational experience. Qualitative results revealed 3 main themes: (1) Course Design, (2) Fidelity, and (3) Learner Characteristics as contributors to feelings of preparedness when transitioning from the classroom to an acute care CEE.

Discussion and Conclusion:

Despite COVID-19 disruptions to traditional in-person education delivery of an acute care laboratory-based course, a unique at-home delivery of acute care curriculum led to students reporting sufficient skill development to participate in an acute care CEE. Aspects of the unique course that students reported facilitated their learning were skill repetition and fidelity to clinical practice embedded in laboratory activities. Results can be used to intentionally design coursework to aide in building student confidence and preparation for acute care CEE.
Cocaine-induced pyoderma gangrenosum with negative anti-neutrophil cytoplasmic antibodies: A case report
Authors: Lim Rachel K. , Negbenebor Nicole A. , Lin Erica M. , Ragi Sara D. , Robinson-Bostom Leslie , Massoud Cathy M.
Published: August 2023

Introduction:

Cutaneous pyoderma gangrenosum (PG) is an ulcerating autoinflammatory neutrophilic dermatosis often associated with inflammatory bowel disease, hematologic diseases, or arthritis. PG secondary to systemic medications is less commonly reported. PG is a diagnosis of exclusion that requires investigation of other causes of cutaneous ulcers prior to final diagnosis.

Case presentation:

We herein describe a case of cocaine-induced PG with atypical features (recurrent ulcerations limited to the lower extremities and perinuclear anti-neutrophil cytoplasmic antibody negativity) following years of abstinence from cocaine.

Discussion:

PG is a rare autoinflammatory neutrophilic dermatosis and a diagnosis of exclusion because of its nonspecific clinical presentation. Drug-induced PG is less common but presents an opportunity to further research the pathogenesis of PG.

Conclusion:

This unusual case reinforces that drug-induced PG may have non-classical features and may serve as an indicator of past or present substance abuse, allowing for patient education and counseling.
Pembrolizumab-induced erosive lichenoid reaction in a patient with metastatic lung adenocarcinoma: A case report
Authors: Venturi Federico , Melotti Barbara , Lambertini Martina , Alessandrini Aurora , Ardizzoni Andrea , Dika Emi
Published: August 2023

Introduction:

Immune-related adverse events induced by immune checkpoint inhibitors are quite common. Cutaneous lichenoid immune-related adverse events are among the most frequent. However, oral lichenoid adverse reactions are extremely rare.

We herein describe a patient who was treated with pembrolizumab for metastatic lung cancer and developed an erosive oral lichenoid reaction induced by immunotherapy.

Case presentation:

An 87-year-old man treated with pembrolizumab for metastatic lung adenocarcinoma (stage IVa based on AJCC 2018) developed multifocal erosions of the oral mucosa mainly located on the buccal mucosa, palate, and inner portion of the lips with multiple small, irregular, hyperkeratotic areas. Histopathological examination showed epithelial necrosis and a dense band-like layer of an inflammatory infiltrate of lymphocytes and histiocytes within the upper dermis. Direct immunofluorescence was negative for both IgG and C3. A diagnosis of erosive oral lichenoid reaction of the mucosa induced by immunotherapy was established. Given the severity of the condition, pembrolizumab treatment was withheld and concomitant topical and systemic steroids were started. After 1 month, the drug-related toxicity was ameliorated and immunotherapy was re-introduced.

Discussion:

Only one other case of pembrolizumab-induced erosive lichen planus of the oral mucosa has been described to date. Previously reported drug-induced lichenoid rashes were mainly localized on the skin. Clinically, the main differential diagnoses of lichenoid erosive lesions are bullous immune-related disorders and should be excluded. In our patient, histological examination combined with negative results of both direct immunofluorescence and enzyme-linked immunosorbent assays confirmed the diagnosis of erosive lichenoid drug reaction.

Conclusion:

Clinicians should be aware of lichenoid involvement of the oral mucosa because related pain and food intake difficulties may seriously compromise treatment compliance. Prompt treatment of oral drug-related reactions may prevent interruption of immunotherapy and improve patients’ quality of life.
Techniques of staging laparoscopy and peritoneal fluid assessment in gastric cancer: a systematic review
Authors: Rawicz-Pruszyński Karol , Erodotou Maria , Pelc Zuzanna , Sędłak Katarzyna , Polkowski Wojciech , Pawlik Timothy M , Wijnhoven Bas P.L.
Published: August 2023

Background:

Staging laparoscopy for gastric cancer is recommended to assess the tumor’s locoregional extension and exclude peritoneal disease. As there is no consensus on optimizing the procedure’s diagnostic accuracy, we aimed to systematically review the literature on operative techniques, followed by peritoneal lavage fluid assessment in gastric cancer patients. Specifically, we sought to indicate the most common characteristics of the procedure and cytological evaluation.

Methods:

This study was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The protocol for this systematic review was registered on PROSPERO database (CRD: 42022306746). On September 2022, a search was carried out using Embase, Medline ALL, Cochrane Central Register of Controlled Trials and Web of Science Core Collection.

Results:

The search identified 1632 studies on staging laparoscopy and 2190 studies on peritoneal fluid assessment. Some 212 studies were included. Open Hasson was the method of choice in accessing the peritoneal cavity in 65% of the studies, followed by establishing a pneumoperitoneum at 10-12mmHg in 52% of reports. Most frequently, the patient was positioned supine (70%), while a 30° scope and three ports were used to assess the peritoneal cavity clockwise (72%, 77%, and 85%, respectively). Right and left upper abdomen quadrants were the predominant area of laparoscopic exploration (both 65%), followed by primary tumor region (54%), liver and pelvis (both 30%), small bowel and spleen (19% and 17%, respectively). Regions of peritoneal lavage and aspiration were limited to pelvis (50%), followed by right and left upper abdomen quadrants (37.5% and 50%, respectively). No studies compared different methods of operative techniques or analysis of ascites/fluid.

Conclusions:

This study indicates a high heterogeneity in the technique of staging laparoscopy and peritoneal fluid assessment in gastric cancer patients. Further research and initiatives to reach a consensus on the standardization of the procedure are warranted.