bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring the operational performance of an artificial intelligence–based blood tube-labeling robot, NESLI
Authors: Demirci Ferhat
Published: August 2024

Objectives

Laboratory testing, crucial for medical diagnosis, has 3 phases: preanalytical, analytical, and postanalytical. This study set out to demonstrate whether automating tube labeling through artificial intelligence (AI) support enhances efficiency, reduces errors, and improves outpatient phlebotomy services.

Methods

The NESLI tube-labeling robot (Labenko Informatics), which uses AI models for tube selection and handling, was used for the experiments. The study evaluated the NESLI robot’s operational performance, including labelling time, technical problems, tube handling success, and critical stock alerts. The robot’s label readability was also tested on various laboratory devices. This research will contribute to the field’s understanding of the potential impact of automated tube-labeling systems on laboratory processes in the preanalytical phase.

Results

NESLI demonstrated high performance in labeling processes, achieving a success rate of 99.2% in labeling parameters and a success rate of 100% in other areas. For nonlabeling parameters, the average labeling time per tube was measured at 8.96 seconds, with a 100% success rate in tube handling and critical stock warnings. Technical issues were promptly resolved, affirming the NESLI robot’s effectiveness and reliability in automating the tube-labeling processes.

Conclusions

Robotic systems using AI, such as NESLI, have the potential to increase process efficiency and reduce errors in the preanalytical phase of laboratory testing. Integration of such systems into comprehensive information systems is crucial for optimizing phlebotomy services and ensuring timely and accurate diagnostics.
Association of anticoagulant choice with death in the primary treatment of noncancer venous thromboembolism: Medicare 2011-2018
Authors: Walker Rob F , Zakai Neil A , Maclehose Richard F , Norby Faye L , Alonso Alvaro , Lutsey Pamela L
Published: August 2024

Direct oral anticoagulants (DOACs; namely, rivaroxaban and apixaban) and warfarin are approved for venous thromboembolism (VTE) treatment. Few direct comparisons exist of DOACs on risk of death among patients with VTE, and for patients with concomitant conditions (eg, kidney disease, liver disease), clinical guidelines are unclear. We evaluated 6-month all-cause mortality by anticoagulant prescribed for primary treatment of VTE. Using data from a 20% sample of Medicare beneficiaries, we created a propensity score–matched analytic data set of 47 860 beneficiaries with noncancer incident VTE. We used Cox regression to estimate adjusted hazard ratios (HRs) of OACs with 6-month mortality, and tested interactions by liver and kidney disease. There were 3422 deaths over 6 months of follow-up. In adjusted models, patients prescribed rivaroxaban (HR = 0.82; 95% CI, 0.76-0.90) had lower mortality rates than those prescribed warfarin. There was no association when comparing apixaban with warfarin (HR = 0.96; 95% CI, 0.87-1.07). In head-to-head comparisons of apixaban and rivaroxaban, the HR was 1.14 (95% CI, 1.01-1.28). Findings were similar among patients with liver and kidney disease. Overall, risk of death was similar by OAC prescribed. Though it is possible residual confounding remained, there was some suggestion of lower risk with rivaroxaban than warfarin. Treatment with DOACs appears safe among patients with VTE who have concomitant kidney or liver disease.

This article is part of a Special Collection on Pharmacoepidemiology.
Healthcare workers’ experiences protecting themselves and their families during the COVID-19 pandemic in 2020–2021
Authors: Ceballos Diana M , Vasquez Diana , Ceballos Lina M , Noguchi Julia E , Levy Jonathan I , Green Jennifer Greif , Baker William E , Schechter-Perkins Elissa M , Leibler Jessica H
Published: August 2024

We characterized experiences and strategies used by frontline healthcare workers to prevent severe-acute-respiratory-syndrome-related coronavirus transmission at work and to household members during the coronavirus disease pandemic. Alongside an online questionnaire (n = 234), remote semi-structured interviews (n = 23: 15 clinicians, 8 non-clinicians) were conducted in 2021. Mitigation challenges and facilitators were identified from data to represent experiences as a process considering the before, during, and after work shifts. Journey mapping was utilized to visually describe how healthcare workers experienced the stages of the work environment, leaving work, commuting home, and the home environment, and strategies implemented to stay safe. Major facilitators included the uptake of coronavirus disease vaccines and testing, information regarding virus transmission, and adequate personal protective equipment. The most critical challenges identified included a lack of designated areas for end-of-day disinfection, changing rooms, showers, and lockers in the leaving work stage. Psychosocial and environmental factors must be considered in future hospital pandemic preparations.
ModDotPlot—rapid and interactive visualization of tandem repeats
Authors: Sweeten Alexander P , Schatz Michael C , Phillippy Adam M
Published: August 2024

Motivation

A common method for analyzing genomic repeats is to produce a sequence similarity matrix visualized via a dot plot. Innovative approaches such as StainedGlass have improved upon this classic visualization by rendering dot plots as a heatmap of sequence identity, enabling researchers to better visualize multi-megabase tandem repeat arrays within centromeres and other heterochromatic regions of the genome. However, computing the similarity estimates for heatmaps requires high computational overhead and can suffer from decreasing accuracy.

Results

In this work, we introduce ModDotPlot, an interactive and alignment-free dot plot viewer. By approximating average nucleotide identity via a k-mer-based containment index, ModDotPlot produces accurate plots orders of magnitude faster than StainedGlass. We accomplish this through the use of a hierarchical modimizer scheme that can visualize the full 128 Mb genome of Arabidopsis thaliana in under 5 min on a laptop. ModDotPlot is bundled with a graphical user interface supporting real-time interactive navigation of entire chromosomes.

Availability and implementation

ModDotPlot is available at https://github.com/marbl/ModDotPlot.
When advanced MRI is not about naming musculoskeletal lesions
Authors: Martín-Noguerol Teodoro , Casado-Verdugo Oscar L , Vilanova Joan C , Luna Antonio
Published: August 2024

Nowadays, the use of advanced MRI sequences such as diffusion-weighted imaging or perfusion-weighted imaging in the field of musculoskeletal radiology remains limited compared to other anatomical regions and subspecialties. Several reasons underpin this, primarily technical challenges, and a longstanding reliance on conventional and morphological evaluations of soft tissue and bone lesions. Experienced radiologists often assert that these advanced sequences do not offer added diagnostic value, claiming that a morphological approach suffices. However, in our opinion, the role of these advanced MRI sequences extends beyond merely naming an MSK lesion. In this commentary, we elucidate how these sequences can aid radiologists in various scenarios, from determining patient prognosis and tracking treatment progress to enhancing clinical-radiological correlations or guiding less experienced radiologists in evaluating soft tissues or bone tumours.
Intratumoral vitamin D signaling and lethal prostate cancer
Authors: Vaselkiv Jane B , Shui Irene M , Grob Sydney T , Ericsson Caroline I , Giovannucci Isabel , Peng Cheng , Finn Stephen P , Mucci Lorelei A , Penney Kathryn L , Stopsack Konrad H
Published: August 2024

High circulating vitamin D levels and supplementation may lower prostate cancer mortality. To probe for direct effects of vitamin D signaling in the primary tumor, we assessed how activation of intratumoral vitamin D signaling in prostate cancer is associated with lethal prostate cancer during long-term follow-up. Among 404 participants with primary prostate cancer in the Health Professionals Follow-up Study and the Physicians’ Health Study, we defined a gene score of expected activated intratumoral vitamin D signaling consisting of transcriptionally upregulated (CYP27A1, CYP2R1, RXRA, RXRB, and VDR) and downregulated genes (CYP24A1 and DHCR7). We contrasted vitamin D signaling in tumors that progressed to lethal disease (metastases/prostate cancer-specific death, n = 119) over up to three decades of follow-up with indolent tumors that remained nonmetastatic for >8 years post-diagnosis (n = 285). The gene score was downregulated in tumor tissue compared with tumor-adjacent histologically normal tissue of the same men. Higher vitamin D gene scores were inversely associated with lethal prostate cancer (odds ratio for highest versus lowest quartile: 0.46, 95% confidence interval: 0.21–0.99) in a dose–response fashion and after adjusting for clinical and pathologic factors. This association appeared strongest among men with high predicted plasma 25-hydroxyvitamin D3 and men with body mass index ≥25 kg/m2. Findings were replicated with broader gene sets. These data support the hypothesis that active intratumoral vitamin D signaling is associated with better prostate cancer outcomes and provide further rationale for testing how vitamin D-related interventions after diagnosis could improve prostate cancer survival through effects on the tumor.
Epidemiology, survival and risk of subsequent primary malignancies in patients with digital papillary adenocarcinoma: a retrospective study of 213 patients in the Surveillance, Epidemiology, and End Results Program
Authors: Joshi Tejas P , Kimyai-Asadi Arash
Published: August 2024

Digital papillary adenocarcinoma (DPAc) is a rare and aggressive cutaneous malignancy of sweat gland derivation. We conducted a retrospective study of 213 patients with DPAc using the 17 registries of the Surveillance, Epidemiology, and End Results (SEER) Program. We estimated the incidence of DPAc to be 0.11 per million persons per year, with the incidence rising over the past two decades. Our study shows DPAc to most commonly affect White men, typically in their forties to sixties. We noted a 5-year disease-specific survival of 98.3% and 5-year overall survival of 95.7%. We also showed advanced age to be associated with more aggressive disease and identified tumour size as an independent risk factor affecting disease-specific survival. Our results also suggest that patients with DPAc have an elevated risk of developing subsequent primary malignancies, with men being at increased risk of developing lung/bronchial neoplasms and women being at increased risk of developing breast cancer.
Expression of STAT3, IL27p28 and IL12p35 is deregulated and linked to autoimmune markers in chronic spontaneous urticaria
Authors: Rastgoo Sahar , Mohammadi Mojgan , Maurer Marcus , Atabaki Mahdi , Tavakkol-Afshari Jalil , Khoshkhui Maryam
Published: August 2024

Background

Chronic spontaneous urticaria (CSU) is a common inflammatory disorder characterized by weals, angio-oedema, or both, for more than 6 weeks. Autoimmunity is held to be one of the most frequent causes, but little is known about the expression and relevance of autoimmunity-driving genes in CSU, such as STAT3, STAT1, IL27p28 (IL30) and IL12p35 (IL12A).

Objectives

To investigate patients with CSU and the expression of STAT3, STAT1, IL27p28 and IL12p35, and possible links to clinical features.

Methods

We enrolled 26 patients with CSU and 19 healthy controls (HCs) and determined their expression levels of STAT3, STAT1, IL27p28 and IL12p35 by quantitative real-time polymerase chain reaction. Patients were assessed for total IgE and IgG-anti-thyroid peroxidase (TPO), markers of autoimmune CSU.

Results

Patients with CSU showed significantly higher expression of STAT3 but not STAT1: 17 (65%) and 10 (38%) of the 26 had elevated STAT3 expression and STAT3/STAT1 ratios, respectively, as compared with only 1 (5%) of the 19 HCs. High STAT3 expression and STAT3/STAT1 ratios were linked to low IgE and elevated IgG-anti-TPO. As compared with HCs, patients with CSU had markedly lower and correlated IL27p28 and IL12p35 mRNA expression levels. Low IL27p28 and IL12p35 expression levels were linked to higher STAT3/STAT1 ratios and low IgE.

Conclusions

STAT3 upregulation and higher STAT3/STAT1 ratios, along with IL27p28 and IL12p35 downregulation, clusters with features of autoimmune CSU. The role of STAT3 as a potential pathogenic driver of autoimmune CSU and target of treatment should be explored further.
Hospital-Acquired and Ventilator-Associated Pneumonia Early After Lung Transplantation: A Prospective Study on Incidence, Pathogen Origin, and Outcome
Authors: Walti Laura N , Ng Chun Fai , Mohiuddin Qasim , Bitterman Roni , Alsaeed Mohammed , Klement William , Martinu Tereza , Sidhu Aman , Mazzulli Tony , Donahoe Laura , Keshavjee Shaf , del Sorbo Lorenzo , Husain Shahid
Published: August 2024

Background

Hospital-acquired (HAP) and ventilator-associated pneumonia (VAP) are important complications early (<30 days) after lung transplantation (LT). However, current incidence, associated factors, and outcomes are not well reported.

Methods

LT recipients transplanted at our institution (July 2019–January 2020 and October 2021–November 2022) were prospectively included. We assessed incidence and presentation of pneumonia and evaluated the impact of associated factors using regression models. We also evaluated molecular relatedness of respiratory pathogens collected peri-transplant and at pneumonia occurrence using pulsed-field gel electrophoresis (PFGE).

Results

In the first 30 days post-LT, 25/270 (9.3%) recipients were diagnosed with pneumonia (68% [17/25] VAP; 32% [8/25] HAP). Median time to pneumonia was 11 days (IQR, 7–13); 49% (132/270) of donor and 16% (44/270) of recipient respiratory peri-transplant cultures were positive. However, pathogens associated with pneumonia were not genetically related to either donor or recipient cultures at transplant, as determined by PFGE. Diagnosed pulmonary hypertension (HR, 4.42; 95% CI, 1.62–12.08) and immunosuppression use (HR, 2.87; 95% CI, 1.30–6.56) were pre-transplant factors associated with pneumonia. Pneumonia occurrence was associated with longer hospital stay (HR, 5.44; 95% CI, 2.22–13.37) and VAP with longer ICU stay (HR, 4.31; 95% CI, 1.73–10.75) within the first 30 days post-transplantation; 30- and 90-day mortality were similar.

Conclusions

Prospectively assessed early pneumonia incidence occurred in ∼10% of LT. Populations at increased risk for pneumonia occurrence include LT with pre-transplant pulmonary hypertension and pre-transplant immunosuppression. Pneumonia was associated with increased healthcare use, highlighting the need for further improvements by preferentially targeting higher-risk patients.
Integrase Strand Transfer Inhibitor–Related Changes in Body Mass Index and Risk of Diabetes: A Prospective Study From the RESPOND Cohort Consortium
Authors: Rupasinghe Dhanushi , Bansi-Matharu Loveleen , Law Matthew , Zangerle Robert , Rauch Andri , Tarr Philip E , Greenberg Lauren , Neesgaard Bastian , Jaschinski Nadine , De Wit Stéphane , Wit Ferdinand , d'Arminio Monforte Antonella , Fontas Eric , Castagna Antonella , Stecher Melanie , Florence Eric , Begovac Josip , Mussini Cristina , Sönnerborg Anders , Abutidze Akaki , Groh Ana , Vannappagari Vani , Cohen Cal , Young Lital , Hosein Sean , Ryom Lene , Petoumenos Kathy
Published: August 2024

Background

With integrase strand transfer inhibitor (INSTI) use associated with increased body mass index (BMI) and BMI increases associated with higher diabetes mellitus (DM) risk, we explored the relationships between INSTI/non-INSTI regimens, BMI changes, and DM risk.

Methods

RESPOND participants were included if they had CD4, human immunodeficiency virus (HIV) RNA, and ≥2 BMI measurements during follow-up. Those with prior DM were excluded. DM was defined as a random blood glucose ≥11.1 mmol/L, hemoglobin A1c ≥6.5%/48 mmol/mol, use of antidiabetic medication, or site-reported clinical diagnosis. Poisson regression was used to assess the association between natural log (ln) of time-updated BMI and current INSTI/non-INSTI and their interactions on DM risk.

Results

Among 20 865 people with HIV included, most were male (74%) and White (73%). Baseline median age was 45 years (interquartile range [IQR], 37–52), with a median BMI of 24 kg/m2 (IQR, 22–26). There were 785 DM diagnoses with a crude rate of 0.73 (95% confidence interval [CI], .68–.78)/100 person-years of follow-up. ln(BMI) was strongly associated with DM (adjusted incidence rate ratio [aIRR], 16.54 per log increase; 95% CI, 11.33–24.13; P < .001). Current INSTI use was associated with increased DM risk (IRR, 1.58; 95% CI, 1.37–1.82; P < .001) in univariate analyses and only partially attenuated when adjusted for variables including ln(BMI) (aIRR, 1.48; 95% CI, 1.29–1.71; P < .001). There were no interactions between ln(BMI), INSTI, and non-INSTI use and DM (P = .130).

Conclusions

In RESPOND, compared with non-INSTIs, current use of INSTIs was associated with an increased DM risk, which partially attenuated when adjusted for BMI changes and other variables.
Changes of intracardiac flow dynamics measured by HyperDoppler in patients with aortic stenosis
Authors: Sabatino Jolanda , Leo Isabella , Strangio Antonio , La Bella Sabrina , De Sarro Rosalba , Montemurro Vincenzo , Pedrizzetti Gianni , Troilo Fabio , Maglione Marco , Torella Daniele , Di Salvo Giovanni , De Rosa Salvatore
Published: August 2024

Aims

Assessment of intracardiac flow dynamics has recently acquired significance due to the development of new measurement methods based on echocardiography. Recent studies have demonstrated that cardiac abnormalities are associated with changes in intracardiac vortical flows. Yet, no previous study assessed the impact of aortic stenosis (AS) on intracardiac vortices. This study aims to explore the clinical potential of additional information provided by quantifying intracardiac flow dynamics in patients with AS.

Methods and results

One hundred and twenty patients with severe AS, sixty patients with concentric ventricular remodelling (VR), and hundred controls (CTRL) were prospectively included and underwent non-invasive evaluation of intracardiac flow dynamics. In addition to standard echocardiography, fluid dynamics were assessed by means of HyperDoppler. Vortex depth (P < 0.001), vortex length (P = 0.003), vortex intensity (P < 0.001), and vortex area (P = 0.049) were significantly increased in AS compared with CTRL. In addition, mean energy dissipation was significantly higher in AS compared with CTRL (P < 0.001) and VR (P = 0.002). At receiver operating characteristic analysis, vortex depth showed the best discrimination capacity for AS (P < 0.001).

Conclusion

Changes in fluid dynamics–based HyperDoppler indices can be reliably assessed in patients with AS. Significant changes in vortex depth and intensity can selectively differentiate AS from both concentric remodelling and healthy CTRLs, suggesting that the assessment of intracardiac flow dynamics may provide complementary information to standard echocardiography to better characterize patients’ subsets.
Post-discharge pharmacotherapy in people with atrial fibrillation hospitalized for acute myocardial infarction: an Australian cohort study 2018–22
Authors: Deakin Claire T , Costa Juliana de Oliveira , Brieger David , Lin Jialing , Schaffer Andrea L , Kidd Michael , Pearson Sallie-Anne , Falster Michael O
Published: August 2024

Background

Dual antiplatelet therapy with P2Y12 inhibitors (P2Y12i) and aspirin following acute myocardial infarction (AMI) prevents future ischaemic events. People with atrial fibrillation (AF) also require oral anticoagulants (OAC), increasing bleeding risk. Guidelines recommend post-discharge prescribing of direct OAC with clopidogrel and discontinuation of P2Y12i after 12 months, but little is known about use in clinical practice.

Aim

To describe post-discharge use of OACs and P2Y12i in people with AF and a history of OAC use hospitalized for AMI.

Methods and results

We identified 1330 people hospitalized for AMI with a diagnosis of AF and history of OAC use in New South Wales, Australia, July 2018–June 2020. We identified three aspects of post-discharge antithrombotic medicine use with possible safety implications: (1) not being dispensed OACs; (2) dispensing OAC and P2Y12i combinations associated with increased bleeding (involving warfarin, ticagrelor, or prasugrel); and (3) P2Y12i use longer than 12 months.

After discharge, 74.3% of people were dispensed an OAC, 45.4% were dispensed a P2Y12i, and 35.8% were dispensed both. People with comorbid heart failure or cancer were less likely to receive OACs. Only 11.2% of people who dispensed both an OAC and P2Y12i received combinations associated with increased bleeding; this was more common among people with chronic kidney disease or prior warfarin or statin use. A total of 44.6% of people dispensed both medicines continued P2Y12i for over 12 months; this was more common in people who received a revascularization or lived in areas of social disadvantage.

Conclusion

We identified potential gaps in pharmacotherapy, including underuse of recommended therapies at discharge, use of combinations associated with increased bleeding, and P2Y12i use beyond 12 months. Prescribing vigilance across both hospital and community care is required.
General anaesthesia compared to conscious sedation for first-time atrial fibrillation catheter ablation—a Danish nationwide cohort study
Authors: Riis-Vestergaard Lise Da , Tønnesen Jacob , Ruwald Martin H , Zörner Christopher R , Middelfart Charlotte , Hein Regitze , Johannessen Arne , Hansen Jim , Worck Rene Husted , Gislason Gunnar , Hansen Morten Lock
Published: August 2024

Aims

Catheter ablation (CA) is a well-established treatment option for atrial fibrillation (AF), where sedation and analgesia are pivotal for patient comfort and lesion formation. The impact of anaesthesia type on AF recurrence rates remains uncertain. This study aimed to examine AF recurrence rates depending on conscious sedation (CS) vs. general anaesthesia (GA) during CA.

Methods and results

Utilizing nationwide data from the Danish healthcare registries, we conducted this cohort study involving adults (≥18 years) undergoing first-time CA for AF between 2010 and 2018. Patients were categorized by anaesthesia type (CS or GA), with the primary endpoint being AF recurrence, defined by a composite endpoint of either antiarrhythmic drug (AAD) prescriptions, AF-related hospital admissions, electrical cardioversions, or AF re-ablation. The impact of anaesthesia type was evaluated using multivariable Cox proportional hazards analysis. The study cohort comprised 7957 (6421 CS and 1536 GA) patients. Persistent AF, hypertension, and heart failure, as well as use of AAD, were more prevalent in the GA group. Cumulative incidences of recurrent AF were higher in the CS group at 1 (46% vs. 37%) and at 5 (68% vs. 63%) years. Multivariate analysis revealed CS as significantly associated with increased risk of AF recurrence at 5-year follow-up [hazard ratio 1.26 (95% confidence interval 1.15–1.38)], consistent across paroxysmal and persistent AF subtypes.

Conclusion

This nationwide cohort study suggests a higher risk of AF recurrence with CS during CA compared to GA. These results advocate for considering GA as the preferred anaesthesia type for improved CA outcomes.
Draft Genome of Akame (Lates Japonicus) Reveals Possible Genetic Mechanisms for Long-Term Persistence and Adaptive Evolution with Low Genetic Diversity
Authors: Hashiguchi Yasuyuki , Mishina Tappei , Takeshima Hirohiko , Nakayama Kouji , Tanoue Hideaki , Takeshita Naohiko , Takahashi Hiroshi
Published: August 2024

It is known that some endangered species have persisted for thousands of years despite their very small effective population sizes and low levels of genetic polymorphisms. To understand the genetic mechanisms of long-term persistence in threatened species, we determined the whole genome sequences of akame (Lates japonicus), which has survived for a long time with extremely low genetic variations. Genome-wide heterozygosity in akame was estimated to be 3.3 to 3.4 × 10−4/bp, one of the smallest values in teleost fishes. Analysis of demographic history revealed that the effective population size in akame was around 1,000 from 30,000 years ago to the recent past. The relatively high ratio of nonsynonymous to synonymous heterozygosity in akame indicated an increased genetic load. However, a detailed analysis of genetic diversity in the akame genome revealed that multiple genomic regions, including genes involved in immunity, synaptic development, and olfactory sensory systems, have retained relatively high nucleotide polymorphisms. This implies that the akame genome has preserved the functional genetic variations by balancing selection, to avoid a reduction in viability and loss of adaptive potential. Analysis of synonymous and nonsynonymous nucleotide substitution rates has detected signs of positive selection in many akame genes, suggesting adaptive evolution to temperate waters after the speciation of akame and its close relative, barramundi (Lates calcarifer). Our results indicate that the functional genetic diversity likely contributed to the long-term persistence of this species by avoiding the harmful effects of the population size reduction.
Aiming for transformations in power: lessons from intersectoral CBPR with public housing tenants (Québec, Canada)
Authors: Radziszewski Stephanie , Houle Janie , Montiel Corentin , Fontan Jean-Marc , Torres Juan , Frohlich Katherine L , Boivin Antoine , Coulombe Simon , Gaudreau Hélène
Published: August 2024

Intersectoral collaborations are recommended as effective strategies to reduce health inequalities. People most affected by health inequalities, as are people living in poverty, remain generally absent from such intersectoral collaborations. Community-based participatory research (CBPR) projects can be leveraged to better understand how to involve people with lived experience to support both individual and community empowerment. In this paper, we offer a critical reflection on a CBPR project conducted in public housing in Québec, Canada, that aimed to develop intersectoral collaboration between tenants and senior executives from four sectors (housing, health, city and community organizations). This single qualitative case study design consisted of fieldwork documents, observations and semi-structured interviews. Using the Emancipatory Power Framework (EPF) and the Limiting Power Framework (LPF), we describe examples of types of power and resistance shown by the tenants, the intersectoral partners and the research team. The discussion presents lessons learned through the study, including the importance for research teams to reflect on their own power, especially when aiming to reduce health inequalities. The paper concludes by describing the limitations of the analyses conducted through the EPF–LPF frameworks and suggestions to increase the transformative power of future studies.
Repeated large declines in the Barents Sea capelin population are associated with different ecosystem conditions
Authors: Olsen Tora , Stige Leif Christian , Dupont Nicolas , Durant Joël M , Langangen Øystein
Published: August 2024

Although fluctuations in the biomass of small pelagic fish are strong and rapid, they are largely investigated as individual events or generalized to what is common across several species and populations. The Barents Sea capelin population, which experienced four large decreases in biomass between 1980 and 2016, can be used to compare the similarity of causes and sequence of events leading up to large biomass decline in the same population. Here, we used an age-structured state-space model to investigate the possible contributions from somatic growth, food availability, temperature, predation by Atlantic cod, herring interactions, and/or fisheries on the capelin biomass declines. We recalculated total biomass while perturbing these effects and assessed the change in total biomass. We did not find a single, common cause for the dramatic biomass declines. Although median biomass increased in several of the scenarios, a large decline in total biomass was mostly retained. Atlantic cod predation and food availability influenced adult capelin biomass. Food availability mainly impacted the first period, while the importance of Atlantic cod predation increased from the first period to the third period. Reducing larval mortality from herring interactions or temperature did not suppress the biomass declines. Recruitment failures were maintained due to a combination of process errors and uncertainty in the effect of spawning biomass, and thus fisheries, on age 0 abundance. The impact of each perturbation depended on the specific ecosystem context at the time of the biomass decline.
Algorithmic Aspects of Immersibility and Embeddability
Authors: Manin Fedor , Weinberger Shmuel
Published: August 2024

We analyze an algorithmic question about immersion theory: for which $m$, $n$, and $CAT=\textbf{Diff}$ or $\textbf{PL}$ is the question of whether an $m$-dimensional $CAT$-manifold is immersible in $\mathbb{R}^{n}$ decidable? We show that PL immersibility is decidable in all cases except for codimension 2, whereas smooth immersibility is decidable in all odd codimensions and undecidable in many even codimensions. As a corollary, we show that the smooth embeddability of an $m$-manifold with boundary in $\mathbb{R}^{n}$ is undecidable when $n-m$ is even and $11m \geq 10n+1$.
Measles: What Goes Around, Comes Around
Authors: Moss William J , Griffin Diane E
Published: August 2024

Measles cases are increasing globally and in the United States because of low routine measles vaccine coverage and disruptions to immunization services during the coronavirus disease 2019 (COVID-19) pandemic. To achieve and sustain measles elimination requires maintaining high coverage with 2 doses of measles vaccine, addressing vaccine hesitancy and misinformation, strong political commitment, and the necessary financial resources.
Geopolitical Narratives of Withdrawal and the Counter-Narrative of Women's Rights Activism in Afghanistan
Authors: True Jacqui , Akbari Farkhondeh
Published: August 2024

Gendered narratives are political narratives that frequently frame decisions to go to war or broker peace. Such geopolitical narratives both enable the protection of women's rights and violate them. Women's rights, specifically, have been used as a rhetorical device by security policymakers to persuade people of the urgency and legitimacy of foreign intervention or withdrawal. We explore how gendered, geopolitical narratives work to construct understandings of political reality and delimit foreign policy options, and how counter-narratives contest them, transforming the available policy options. Drawing on narrative analysis frameworks, we examine the shifting narratives invoking “Afghan women” that facilitated the change in US policy on Afghanistan between 2018 and 2021 and the consequent return of the Taliban. In response to the US withdrawal, we investigate the counter-narrative of Afghan women that emphasizes universal human rights, inclusive peace, and international recognition of the situation of “gender apartheid.” We argue that counter-narratives supported by political strategies are an effective instrument for empowering marginalized women and legitimizing their activism that protests the continuation of war against women despite the end of military war.
Feasibility and Accuracy of Ultrasound-Guided Core Needle Biopsy for Nipple Lesions: A Pilot Study
Authors: O’Brien Sophia R , Medrano Damien , Birnbaum Julia , McDonald Elizabeth S , Conant Emily F , Weinstein Susan P , Fayanju Oluwadamilola M , Zuckerman Samantha P , Edmonds Christine E
Published: August 2024

Background

Due to the superficial location, suspicious findings of the nipple-areolar complex (NAC) are not amenable to stereotactic or MRI-guided sampling and have historically necessitated surgical biopsy or skin-punch biopsy. There are limited reports of US-guided core biopsy of the nipple (US-CBN).

Objective

We report our nearly 3-year pilot experience with US-CBN at an academic breast imaging center.

Methods

An institutional review board–exempt and HIPAA-compliant retrospective review was performed. We assessed patient demographics, breast imaging characteristics, procedural data, pathology, and outcomes.

Results

Nine female patients aged 27 to 64 underwent US-CBN from January 2021 to October 2023. Initial imaging abnormalities included abnormal MRI enhancement, mammographic calcifications, and sonographic masses. After initial or second-look US, all imaging findings had sonographic correlates for biopsy specimens, the majority of which were sonographic masses (8/9). US-CBN was performed by 6 breast radiologists using a variety of devices. All biopsy specimen results were concordant with sonographic abnormalities, although 1 was considered discordant from the initial abnormality seen on MRI. There were no complications, and discomfort during the procedure was well-treated. Two patients (22%, 2/9) were diagnosed with malignancy.

Conclusion

This pilot study demonstrated that US-CBN can be performed by a breast radiologist for definitive diagnosis of suspicious nipple abnormalities seen on breast imaging, avoiding surgery, and maintaining nipple integrity. In our population, 22% (2/9) of US-CBNs revealed malignancy.
Acellular Dermal Matrix: Imaging Features With Histopathology Correlation
Authors: Dhami Alysha , Rutland Cooper D , Momeni Arash , Waheed Uzma
Published: August 2024

Acellular dermal matrix (ADM) is an immunologically inert graft, typically from cadaveric skin, often used in postmastectomy breast reconstruction. Created from decellularized dermal tissues that have been treated to remove DNA and antigenic donor cells (leaving extracellular matrix), ADM is often used as a structural scaffold or sling to reinforce and support the structure and position of a breast implant during postoperative integration in implant-based breast reconstruction; ADM can also be used to fill cosmetic defects. Advantages of ADM use include improved cosmesis and reduced capsular contracture rates. On US, ADM can be seen as a subtle band with variable echogenicity adjacent to the implant. When folded on itself or redundant, ADM may present as a palpable oval mass with indistinct or circumscribed margins and variable echogenicity. On mammography, ADM can be seen as a circumscribed oval equal density mass when redundant and folded on itself; a layered appearance may be evident on tomosynthesis. On MRI, presence and absence of enhancement have been documented. Imaging findings likely vary depending on the degree of host tissue remodeling and incorporation, and when biopsied, histopathologically, ADM may be difficult to distinguish from scarring. Successful imaging diagnosis of ADM is aided by clinical knowledge of the intraoperative use and configuration of ADM, which may help differentiate ADM from new or recurrent malignancy and avoid unnecessary biopsy.
Life history parameters of Ectropis grisescens (Lepidoptera: Geometridae) in different Wolbachia infection states
Authors: Li Qiangkun , Ji Ruijie , Zi Huabin , Sun Wanpeng , Zhang Yong , Wu Xinyu , Long Yanhua , Yang Yunqiu
Published: August 2024

Wolbachia, a prevalent intracellular symbiotic bacterium in insects, plays a significant role in insect biology. Ectropis grisescens (Warren; Lepidoptera: Geometridae) is a devastating chewing pest distributed in tea plantations throughout China. However, it is unclear how Wolbachia titers affect the fitness and reproduction of E. grisescens. In this study, the impacts of 3 different infection lines, naturally Wolbachia-infected, Wolbachia-uninfected, and Wolbachia transinfected, regarding the life history traits of E. grisescens, were evaluated using the age-stage, 2-sex life table. Wolbachia infection shortened preadult duration and preoviposition periods and increased the fecundity, net reproductive rate, and finite rate of increase. Meanwhile, population projection indicated that E. grisescens population size with Wolbachia infection can increase faster than without. These results indicate that Wolbachia plays a regulatory role in the fitness of E. grisescens. It is also noted that the life history parameters of E. grisescens may positively correlate with Wolbachia titers. These findings could aid in pest management in tea gardens.
Removal of circulating mitochondrial N-formyl peptides via immobilized antibody therapy restores sepsis-induced neutrophil dysfunction
Authors: Kwon Woon Yong , Jung Yoon Sun , Suh Gil Joon , Kim Sung Hee , Lee Areum , Kim Jeong Yeon , Kim Hayoung , Park Heesu , Shin Jieun , Kim Taegyun , Kim Kyung Su , Itagaki Kiyoshi , Hauser Carl J
Published: August 2024

During recovery from septic shock, circulating mitochondrial N-formyl peptides predispose to secondary infection by occupying formyl peptide receptor 1 on the neutrophil (polymorphonuclear leukocyte) membrane, suppressing cytosolic calcium ([Ca2+]i)-dependent responses to secondarily encountered bacteria. However, no study has yet investigated therapeutic clearance of circulating mitochondrial N-formyl peptides in clinical settings. Thus, we studied how to remove mitochondrial N-formyl peptides from septic-shock plasma and whether such removal could preserve cell-surface formyl peptide receptor 1 and restore sepsis-induced polymorphonuclear leukocyte dysfunction by normalizing [Ca2+]i flux. In in vitro model systems, mitochondrial N-formyl peptide removal rescued polymorphonuclear leukocyte formyl peptide receptor 1-mediated [Ca2+]i flux and chemotaxis that had been suppressed by prior mitochondrial N-formyl peptide exposure. However, polymorphonuclear leukocyte functional recovery occurred in a stepwise fashion over 30 to 90 min. Intracellular Ca2+-calmodulin appears to contribute to this delay. In ex vivo model, systems using blood samples obtained from patients with septic shock, antimitochondrial N-formyl peptide antibodies alone failed to eliminate mitochondrial N-formyl peptides from septic-shock plasma or inhibit mitochondrial N-formyl peptide activity. We therefore created a beads-based antimitochondrial N-formyl peptide antibody cocktail by combining protein A/sepharose with antibodies specific for the most potent human mitochondrial N-formyl peptide chemoattractants. The beads-based antimitochondrial N-formyl peptide antibody cocktail treatment successfully removed those active mitochondrial N-formyl peptides from septic-shock plasma. Furthermore, the beads-based antimitochondrial N-formyl peptide antibody cocktail treatment significantly restored chemotactic and bactericidal dysfunction of polymorphonuclear leukocytes obtained from patients with septic shock who developed secondary infections. By clearing circulating mitochondrial N-formyl peptides, the immobilized antimitochondrial N-formyl peptide antibody therapy prevented mitochondrial N-formyl peptide interactions with surface formyl peptide receptor 1, thereby restoring [Ca2+]i-dependent polymorphonuclear leukocyte antimicrobial function in clinical septic-shock environments. This approach may help prevent the development of secondary, nosocomial infections in patients recovering from septic shock.
Physical activity and cognition: longitudinal findings from the Thinking and Living with Cancer Study
Authors: Artese Ashley L , Zhou Xingtao , Tometich Danielle B , Small Brent J , Ahles Tim A , Ahn Jaeil , Bethea Traci N , Breen Elizabeth C , Cohen Harvey J , Extermann Martine , Graham Deena , Isaacs Claudine , Jim Heather S L , McDonald Brenna C , Nakamura Zev M , Patel Sunita K , Rentscher Kelly E , Root James C , Saykin Andrew J , Van Dyk Kathleen , Zhai Wanting , Carroll Judith E , Mandelblatt Jeanne
Published: August 2024

Background

Physical activity can improve cognition; however, little is known regarding the relationships between longitudinal objectively measured physical activity, cognition, and inflammation in older breast cancer survivors.

Methods

Older (aged 60 years and older) breast cancer survivors (n = 216) and frequency-matched noncancer control participants (n = 216) were assessed at baseline (presystemic therapy for survivors) and annually for up to 5 years. Assessments included hip-worn actigraphs worn for 7 days, neuropsychological tests, the Functional Assessment of Cancer Therapy-Cognitive Function perceived cognitive impairment subscale, and circulating levels of C-reactive protein and interleukin-6. Data were analyzed using linear mixed-effect, random-effect contemporaneous fluctuation, and multilevel mediation models, considering covariates; a P value less than .05 (2-sided) was considered statistically significant.

Results

Survivors had fewer minutes of moderate-to-vigorous physical activity than controls at 36-, 48-, and 60-month time points (P < .03). Fewer survivors met aerobic physical activity guidelines at 36 months than control participants (17.7% vs 33.0%, P = .030). When guidelines were met (vs not), Functional Assessment of Cancer Therapy-Cognitive Function perceived cognitive impairment scores were 2.1 (1.0) (P = .034) points higher. Higher moderate-to-vigorous physical activity and meeting aerobic guidelines were not related to objective neuropsychological performance. Moderate-to-vigorous physical activity was inversely associated with C-reactive protein and interleukin-6 (P < .001), but inflammation did not mediate physical activity effects on perceived cognition.

Conclusions

Older breast cancer survivors were less physically active than older noncancer controls, especially farther from baseline. Meeting aerobic guidelines was associated with better perceived cognition in survivors. Survivorship care should consider physical activity monitoring and referral to rehabilitation and supervised exercise programs to promote physical activity and improve recovery in older survivors.
Tobacco–cannabis co-use among cancer patients and survivors: findings from 2 US cancer centers
Authors: Smith Danielle M , Kaye Jesse T , Walters Kyle J , Schlienz Nicolas J , Hyland Andrew J , Ashare Rebecca L , Tomko Rachel L , Dahne Jennifer , McRae-Clark Aimee L , McClure Erin A
Published: August 2024

Background

Cannabis use is prevalent among cancer patients and survivors and may provide some therapeutic benefits for this population. However, benefits may be attenuated when cannabis is co-used with tobacco, which is associated with more severe tobacco and cannabis use and adverse outcomes in noncancer populations. We compared cannabis use, primary mode of use, and therapeutic and/or nontherapeutic use among 3 groups of patients and survivors based on cigarette smoking status.

Methods

Survey data was collected from patients and survivors with cancer (n = 1732) at 2 US National Cancer Institute–designated cancer centers in states with varying cannabis regulatory policy. Prevalence of cannabis use (prior to diagnosis, after diagnosis, before treatment, after treatment), primary mode of use, and therapeutic and/or nontherapeutic use were assessed by cigarette smoking status (current, former, never) within and across centers using weighted bivariate analyses and multivariable logistic regression, controlling for demographic and clinical variables.

Results

Current cigarette use was associated with greater rates of cannabis use prior to diagnosis, after diagnosis, during treatment, and after treatment within each center (all P < .001) and in pooled analyses across centers (all P < .001). Primary mode of use, knowledge of cannabis products, and therapeutic and/or nontherapeutic use also statistically differed by tobacco status and study site.

Conclusions

Results illustrate the importance of conducting assessments for both tobacco and cannabis use among cancer patients during and after cancer treatment, regardless of the cannabis regulatory environment. Given previous data indicating harms from co-use and continued tobacco use during cancer treatment, this issue introduces new priorities for cancer care delivery and research.
Improving instrumental variable estimators with poststratification
Authors: Pashley Nicole E , Keele Luke , Miratrix Luke W
Published: August 2024

Experiments studying get-out-the-vote (GOTV) efforts estimate causal effects of various mobilization efforts on voter turnout. However, there is often substantial noncompliance in these studies. A usual approach is to use an instrumental variable (IV) analysis to estimate impacts for compliers, here being those actually contacted by the investigators. Unfortunately, popular IV estimators can be unstable in studies with a small fraction of compliers. We explore poststratifying the data (e.g. taking a weighted average of IV estimates within each stratum) using variables that predict complier status (and, potentially, the outcome) to mitigate this. We present the benefits of poststratification in terms of bias, variance, and improved standard error estimates, and provide a finite-sample asymptotic variance formula. We also compare the performance of different IV approaches and discuss the advantages of our design-based poststratification approach over incorporating compliance-predictive covariates into the two-stage least squares (2SLS) estimator. In the end, we show that covariates predictive of compliance can increase precision, but only if one is willing to make a bias-variance trade-off by down-weighting or dropping strata with few compliers. By contrast, standard approaches such as 2SLS fail to use such information. We finally examine the benefits of our approach in two GOTV applications.
Modified multiple papilla full flap combined with tunneling and de-epithelialized gingival graft to manage severe gingival recession in mandibular incisors: literature review and case report
Authors: Dong Ta Quan , Van Vo Nhan , Le Bui Hanh My , Quoc Tran Trung Dang , Hoang Viet
Published: August 2024

Gingival recession is a common condition in adults, causing esthetic issues or tooth sensitivity in patients. Gingival recession in the lower incisors area after orthodontic treatment is often difficult to predict, due to anatomical factors such as thin phenotype, shallow vestibular depth, and low frenum attachment. A young male patient presented to the clinic with severe Cairo Class I gingival recession at tooth 41 after 2 years of orthodontic treatment. Surgery combining tunneling technique and multiple papilla full thickness flap was performed to treat the patient after endodontic treatment. The clinical case was followed up to monitor gingival margin recovery one year post-surgery. The clinical case introduces a treatment method for severe localized gingival recession in the lower anterior region of a single tooth.
Reconstructive management of a patient with Tessier number 10 cleft
Authors: Sơn Trần Thiết , Nhật Phạm Kiến , Nghĩa Phan Tuấn , Dung Phạm Thị Việt , Thuý Tạ Thị Hồng , Pellerin Phillipe
Published: August 2024

Tessier number 10 cleft is one of the rarest facial clefts. Surgical treatment of this type of cleft is challenging due to the complexity of periorbital and temporal soft tissue deformities. A 23-year-old male patient presented with typical facial deformities of Tessier number 10 cleft. The surgical procedure involved using a free anterolateral thigh flap to reconstruct the eye socket, while the superficial temporal artery pedicle scalp flap was used to reconstruct the eyebrow deformity. The patient had no complications and 16 months after surgery, the patient had good aesthetic results. A hair-bearing scalp flap with a pedicle of the frontal branch of the superficial temporal artery combined with an anterolateral thigh-free flap can effectively resolve most soft tissue deformities of Tessier number 10 cleft and reconstruct the orbital socket in a single surgery. At the same time, it augments the soft tissue of the frontotemporal area and provides good aesthetic results.