bluuebunny/crossref_metadata_2025 huggingface dataset:
GPU accelerated Monte Carlo scoring of positron emitting isotopes produced during proton therapy for PET verification
Authors: McNamara Keegan , Schiavi Angelo , Borys Damian , Brzezinski Karol , Gajewski Jan , Kopeć Renata , Rucinski Antoni , Skóra Tomasz , Makkar Shubhangi , Hrbacek Jan , Weber Damien C , Lomax Antony J , Winterhalter Carla
Published: November 2022

Objective. Verification of delivered proton therapy treatments is essential for reaping the many benefits of the modality, with the most widely proposed in vivo verification technique being the imaging of positron emitting isotopes generated in the patient during treatment using positron emission tomography (PET). The purpose of this work is to reduce the computational resources and time required for simulation of patient activation during proton therapy using the GPU accelerated Monte Carlo code FRED, and to validate the predicted activity against the widely used Monte Carlo code GATE. Approach. We implement a continuous scoring approach for the production of positron emitting isotopes within FRED version 5.59.9. We simulate treatment plans delivered to 95 head and neck patients at Centrum Cyklotronowe Bronowice using this GPU implementation, and verify the accuracy using the Monte Carlo toolkit GATE version 9.0. Main results. We report an average reduction in computational time by a factor of 50 when using a local system with 2 GPUs as opposed to a large compute cluster utilising between 200 to 700 CPU threads, enabling simulation of patient activity within an average of 2.9 min as opposed to 146 min. All simulated plans are in good agreement across the two Monte Carlo codes. The two codes agree within a maximum of 0.95σ on a voxel-by-voxel basis for the prediction of 7 different isotopes across 472 simulated fields delivered to 95 patients, with the average deviation over all fields being 6.4 × 10−3
σ. Significance. The implementation of activation calculations in the GPU accelerated Monte Carlo code FRED provides fast and reliable simulation of patient activation following proton therapy, allowing for research and development of clinical applications of range verification for this treatment modality using PET to proceed at a rapid pace.
Influence of toroidal rotation on nonlinear evolution of tearing mode in tokamak plasmas
Authors: Ren Zhenghao , Wang Feng , Cai Huishan , Liu Jinyuan
Published: November 2022

The nonlinear evolution of the tearing mode instability with toroidal rotation is investigated using a three-dimensional toroidal geometry magnetohydrodynamic code (M3D). It is found that toroidal rotation plays a significantly stable role in reducing the width of magnetic island, which is independent of the direction of toroidal rotation. Compared with the stabilizing effect in the linear phase, the stabilizing effect of toroidal rotation is much stronger in the nonlinear phase. The magnetic island is almost suppressed by large enough rotation, even though the linear growth rate is weakly reduced in the linear phase. It is observed that the flow shear has a stabilizing effect, which is significant when the rotation frequency is large. However, it is shown that the magnitude of rotation plays a dominant role in stabilizing the magnetic island when the rotation frequency is small. The Coriolis force, rather than the centrifugal force, is found to play a dominant role in stabilizing the tearing mode in the nonlinear phase. When

m

/

n
=
3

/

2

and

m

/

n
=
2

/

1

tearing modes exist simultaneously, the sheared toroidal rotation is shown to effectively suppress the overlap of magnetic islands and field stochasticity caused by the coupling of neighboring islands.
A phase-shift-periodic parallel boundary condition for low-magnetic-shear scenarios
Authors: St-Onge D A , Barnes M , Parra F I
Published: November 2022

We formulate a generalized periodic boundary condition as a limit of the standard twist-and-shift parallel boundary condition that is suitable for simulations of plasmas with low magnetic shear. This is done by applying a phase shift in the binormal direction when crossing the parallel boundary. While this phase shift can be set to zero without loss of generality in the local flux-tube limit when employing the twist-and-shift boundary condition, we show that this is not the most general case when employing periodic parallel boundaries, and may not even be the most desirable. A non-zero phase shift can be used to avoid the convective cells that plague simulations of the three-dimensional Hasegawa–Wakatani system, and is shown to have measurable effects in periodic low-magnetic-shear gyrokinetic simulations. We propose a numerical program where a sampling of periodic simulations at random pseudo-irrational flux surfaces are used to determine physical observables in a statistical sense. This approach can serve as an alternative to applying the twist-and-shift boundary condition to low-magnetic-shear scenarios, which, while more straightforward, can be computationally demanding.
Optimization of beam shaping and error quantification of calibration approach using E-FISHG based electric field measurements
Authors: Nakamura Shin , Sato Masahiro , Fujii Takashi , Kumada Akiko
Published: November 2022

Electric-field measurement based on the electric-field-induced second-harmonic generation (E-FISHG) method is a promising tool for a noncontact field measurement in plasmas and gases. For the E-FISHG method, a probing laser beam is focused at the measurement target by a lens, and the signals integrated along the laser path are acquired. Although the signal is frequently calibrated under uniform electric fields, the yielded value is erroneous if one does not consider the difference in the electric-field-profiles between the calibration and measurement. In this paper, we review the calibration and measurement targets of relevant studies, assess the error in the conventional method for the streamer discharge measurement, and give guidelines on which calibration approach to use depending on the electric field profile to be measured. Our approach uses cylindrical-to-cylindrical electrodes and multipoint measurement corresponding to the target length along the optical path, gas, and pressure.
Broadband Spectral Properties of MAXI J1348–630 using AstroSat Observations
Authors: Mall Gitika , Vadakkumthani Jithesh , Misra Ranjeev
Published: November 2022

We present broadband X-ray spectral analysis of the black hole X-ray binary MAXI J1348–630, performed using five AstroSat observations. The source was in the soft spectral state for the first three observations and in the hard state for the last two. The three soft state spectra were modeled using a relativistic thin accretion disk with reflection features and thermal Comptonization. Joint fitting of the soft state spectra constrained the spin parameter of the black hole a
* > 0.97 and the disk inclination angle i =

32.9

−
0.6

+
4.1

degrees. The bright and faint hard states had bolometric flux a factor of ∼6 and ∼10 less than that of the soft state respectively. Their spectra were fitted using the same model except that the inner disk radius was not assumed to be at the last stable orbit. However, the estimated values do not indicate large truncation radii and the inferred accretion rate in the disk was an order of magnitude lower than that of the soft state. Along with earlier reported temporal analysis, AstroSat data provide a comprehensive picture of the evolution of the source.
Error-related potential-based shared autonomy via deep recurrent reinforcement learning
Authors: Wang Xiaofei , Chen Hsiang-Ting , Lin Chin-Teng
Published: November 2022

Objective. Error-related potential (ErrP)-based brain–computer interfaces (BCIs) have received a considerable amount of attention in the human–robot interaction community. In contrast to traditional BCI, which requires continuous and explicit commands from an operator, ErrP-based BCI leverages the ErrP, which is evoked when an operator observes unexpected behaviours from the robot counterpart. This paper proposes a novel shared autonomy model for ErrP-based human–robot interaction. Approach. We incorporate ErrP information provided by a BCI as useful observations for an agent and formulate the shared autonomy problem as a partially observable Markov decision process. A recurrent neural network-based actor-critic model is used to address the uncertainty in the ErrP signal. We evaluate the proposed framework in a simulated human-in-the-loop robot navigation task with both simulated users and real users. Main results. The results show that the proposed ErrP-based shared autonomy model enables an autonomous robot to complete navigation tasks more efficiently. In a simulation with 70% ErrP accuracy, agents completed the task 14.1% faster than in the no ErrP condition, while with real users, agents completed the navigation task 14.9% faster. Significance. The evaluation results confirmed that the shared autonomy via deep recurrent reinforcement learning is an effective way to deal with uncertain human feedback in a complex human–robot interaction task.
Theory of triangulene two-dimensional crystals
Authors: Ortiz R , Catarina G , Fernández-Rossier J
Published: November 2022

Equilateral triangle-shaped graphene nanoislands with a lateral dimension of n benzene rings are known as

[n]

triangulenes. Individual

[n]

triangulenes are open-shell molecules, with single-particle electronic spectra that host n − 1 half-filled zero modes and a many-body ground state with spin

S
=
(
n
−
1
)

/

2

. The on-surface synthesis of triangulenes has been demonstrated for

n
=
3
,
4
,
5
,
7

and the observation of a Haldane symmetry-protected topological phase has been reported in chains of [3]triangulenes. Here, we provide a unified theory for the electronic properties of a family of two-dimensional honeycomb lattices whose unit cell contains a pair of triangulenes with dimensions

n
a

,

n
b

. Combining density functional theory and tight-binding calculations, we find a wealth of half-filled narrow bands, including a graphene-like spectrum (for

n
a

=

n
b

=
2

), spin-1 Dirac electrons (for

n
a

=
2
,

n
b

=
3

),

p

x
,
y

-orbital physics (for

n
a

=

n
b

=
3

), as well as a gapped system with flat valence and conduction bands (for

n
a

=

n
b

=
4

). All these results are rationalized with a class of effective Hamiltonians acting on the subspace of the zero-energy states that generalize the graphene honeycomb model to the case of fermions with an internal pseudospin degree of freedom with C
3 symmetry.
Quantum correlations in molecules: from quantum resourcing to chemical bonding
Authors: Ding Lexin , Knecht Stefan , Zimborás Zoltán , Schilling Christian
Published: November 2022

The second quantum revolution is all about exploiting the quantum nature of atoms and molecules to execute quantum information processing tasks. To boost this growing endeavor and by anticipating the key role of quantum chemistry therein, our work establishes a framework for systematically exploring, quantifying and dissecting correlation effects in molecules. By utilizing the geometric picture of quantum states we compare—on a unified basis and in an operationally meaningful way—total, quantum and classical correlation and entanglement in molecular ground states. To unlock and maximize the quantum informational resourcefulness of molecules an orbital optimization scheme is developed, leading to a paradigm-shifting insight: a single covalent bond equates to the entanglement

2
ln
(
2
)

. This novel and more versatile perspective on electronic structure suggests a generalization of valence bond theory, overcoming deficiencies of modern chemical bonding theories.
The Willmore energy and the magnitude of Euclidean domains
Authors: Gimperlein Heiko , Goffeng Magnus
Published: November 2022

We study the geometric significance of Leinster’s notion of magnitude for a compact metric space. For a smooth, compact domainXXin an odd-dimensional Euclidean space, we show that the asymptotic expansion of the functionMX(R)=Mag(R⋅X)\mathcal {M}_X(R) = \mathrm {Mag}(R\cdot X)atR=∞R = \inftydetermines the Willmore energy of the boundary∂X\partial X. This disproves the Leinster-Willerton conjecture for a compact convex body in odd dimensions.
PScL-2LSAESM: bioimage-based prediction of protein subcellular localization by integrating heterogeneous features with the two-level SAE-SM and mean ensemble method
Authors: Ullah Matee , Hadi Fazal , Song Jiangning , Yu Dong-Jun
Published: November 2022

Motivation

Over the past decades, a variety of in silico methods have been developed to predict protein subcellular localization within cells. However, a common and major challenge in the design and development of such methods is how to effectively utilize the heterogeneous feature sets extracted from bioimages. In this regards, limited efforts have been undertaken.

Results

We propose a new two-level stacked autoencoder network (termed 2L-SAE-SM) to improve its performance by integrating the heterogeneous feature sets. In particular, in the first level of 2L-SAE-SM, each optimal heterogeneous feature set is fed to train our designed stacked autoencoder network (SAE-SM). All the trained SAE-SMs in the first level can output the decision sets based on their respective optimal heterogeneous feature sets, known as ‘intermediate decision’ sets. Such intermediate decision sets are then ensembled using the mean ensemble method to generate the ‘intermediate feature’ set for the second-level SAE-SM. Using the proposed framework, we further develop a novel predictor, referred to as PScL-2LSAESM, to characterize image-based protein subcellular localization. Extensive benchmarking experiments on the latest benchmark training and independent test datasets collected from the human protein atlas databank demonstrate the effectiveness of the proposed 2L-SAE-SM framework for the integration of heterogeneous feature sets. Moreover, performance comparison of the proposed PScL-2LSAESM with current state-of-the-art methods further illustrates that PScL-2LSAESM clearly outperforms the existing state-of-the-art methods for the task of protein subcellular localization.

Availability and implementation

https://github.com/csbio-njust-edu/PScL-2LSAESM.

Supplementary information

Supplementary data are available at Bioinformatics online.
CONFERD-HP: recommendations for reporting COmpeteNcy FramEwoRk Development in health professions
Authors: Batt Alan M , Tavares Walter , Horsley Tanya , Rich Jessica V , Williams Brett ,   CONFERD-HP Collaborators, Beck Eleanor , Czabanowska Katarzyna , Fitzgerald Gerard , Halcomb Elizabeth , Hauer Karen , Hsu Deborah , Köhler Tamara , Landzaat Lindy H , Morrison Laura J , Palermo Claire , Pessoa Eneline A H , Sullivan Gail , Tackett Sean , Tonkin Emma , Touger-Decker Riva , Wilkinson Tim
Published: November 2022

Background

Competency frameworks outline the perceived knowledge, skills, attitudes, and other attributes required for professional practice. These frameworks have gained in popularity, in part for their ability to inform health professions education, assessment, professional mobility, and other activities. Previous research has highlighted inadequate reporting related to their development which may then jeopardize their defensibility and utility.

Methods

This study aimed to develop a set of minimum reporting criteria for developers and authors of competency frameworks in an effort to improve transparency, clarity, interpretability and appraisal of the developmental process, and its outputs. Following guidance from the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network, an expert panel was assembled, and a knowledge synthesis, a Delphi study, and workshops were conducted using individuals with experience developing competency frameworks, to identify and achieve consensus on the essential items for a competency framework development reporting guideline.

Results

An initial checklist was developed by the 35-member expert panel and the research team. Following the steps listed above, a final reporting guideline including 20 essential items across five sections (title and abstract; framework development; development process; testing; and funding/conflicts of interest) was developed.

Conclusion

The COmpeteNcy FramEwoRk Development in Health Professions (CONFERD-HP) reporting guideline permits a greater understanding of relevant terminology, core concepts, and key items to report for competency framework development in the health professions.
Reformulating scale-free network via strong dependency
Authors: Kim Tae Yoon , Park Cheolyong , Ha Jeongcheol , Hwang Sun Young , Park Inho
Published: November 2022

In this article, we study the mechanism of generating a scale-free network using strong dependency between nodes. It is found that dependency should be aided by two key factors, namely, the reduced structure of network connections and small zero inflation. Our finding provides key conditions bridging the gap between the two groups having different opinions on scale-free networks. These groups include a camp of network scientists that consider scale-free networks as ideal objects in the large-size limit and the others that consider them as concrete objects in the real world.
Disrupting circadian control of peripheral myogenic reactivity mitigates cardiac injury following myocardial infarction
Authors: Kroetsch Jeffrey T , Lidington Darcy , Alibhai Faisal J , Reitz Cristine J , Zhang Hangjun , Dinh Danny D , Hanchard Julia , Khatua Tarak N , Heximer Scott P , Martino Tami A , Bolz Steffen-Sebastian
Published: November 2022

Aims

Circadian rhythms orchestrate important functions in the cardiovascular system: the contribution of microvascular rhythms to cardiovascular disease progression/severity is unknown. This study hypothesized that (i) myogenic reactivity in skeletal muscle resistance arteries is rhythmic and (ii) disrupting this rhythmicity would alter cardiac injury post-myocardial infarction (MI).

Methods and results

Cremaster skeletal muscle resistance arteries were isolated and assessed using standard pressure myography. Circadian rhythmicity was globally disrupted with the ClockΔ19/Δ19 mutation or discretely through smooth muscle cell-specific Bmal1 deletion (Sm-Bmal1 KO). Cardiac structure and function were determined by echocardiographic, hemodynamic and histological assessments. Myogenic reactivity in cremaster muscle resistance arteries is rhythmic. This rhythm is putatively mediated by the circadian modulation of a mechanosensitive signalosome incorporating tumour necrosis factor and casein kinase 1. Following left anterior descending coronary artery ligation, myogenic responsiveness is locked at the circadian maximum, although circadian molecular clock gene expression cycles normally. Disrupting the molecular clock abolishes myogenic rhythmicity: myogenic tone is suspended at the circadian minimum and is no longer augmented by MI. The reduced myogenic tone in ClockΔ19/Δ19 mice and Sm-Bmal1 KO mice associates with reduced total peripheral resistance (TPR), improved cardiac function and reduced infarct expansion post-MI.

Conclusions

Augmented microvascular constriction aggravates cardiac injury post-MI. Following MI, skeletal muscle resistance artery myogenic reactivity increases specifically within the rest phase, when TPR would normally decline. Disrupting the circadian clock interrupts the MI-induced augmentation in myogenic reactivity: therapeutics targeting the molecular clock, therefore, may be useful for improving MI outcomes.
Modified Collard technique is more effective than circular stapled for cervical esophagogastric anastomosis in prevention of anastomotic stricture: a propensity score-matched study
Authors: Takeoka Tomohira , Miyata Hiroshi , Sugimura Keijiro , Kanemura Takashi , Sugase Takahito , Yamamoto Masaaki , Shinno Naoki , Hara Hisashi , Fujii Yoshiaki , Mukai Yosuke , Asukai Kei , Mikamori Manabu , Hasegawa Shinichiro , Akita Hirofumi , Haraguchi Naotsugu , Nishimura Junichi , Wada Hiroshi , Matsuda Chu , Omori Takeshi , Yasui Masayoshi , Ohue Masayuki , Yano Masahiko
Published: November 2022

The anastomotic technique after esophagectomy is of great interest in the prevention of anastomotic complications that adversely affect postoperative recovery. This study aimed to compare the clinical outcomes of modified Collard (MC) and circular stapled (CS) anastomoses after esophagectomy. A total of 504 consecutive patients with thoracic esophageal cancer who underwent esophagectomy and cervical esophagogastric CS or MC anastomosis from January 2013 to December 2019 were enrolled. Out of 504 patients, 134 and 370 underwent CS and MC anastomoses. The frequency of anastomotic leakage and stricture was significantly lesser in the MC group than in the CS group (3.0 vs. 10.5%, P = 0.0014 and 11.1 vs. 34.3%, P < 0.001, respectively). CS anastomosis was an independent risk factor for anastomotic stricture (odds ratio, 4.89; P < 0.001). Oral intake was significantly higher in the group without anastomotic stricture than in the group with anastomotic stricture at 2, 3, and 6 months postoperatively (P < 0.001, P = 0.013, and P < 0.001, respectively). The percentage body weight loss (%BWL) was −12.2% in the group with anastomotic stricture and −7.5% in the group without anastomotic stricture at 3 months postoperatively (P = 0.0012). Anastomotic stricture was an independent factor associated with %BWL (odds ratio, 4.86; P = 0.010). Propensity score-matched analysis, which included 88 pairs of patients, confirmed a significantly lower anastomotic stricture rate in the MC group than in the CS group (10.2 vs. 35.2%, P < 0.001). MC anastomosis is better than CS anastomosis for reducing the frequency of anastomotic stricture, which may be useful for maintaining early postoperative nutritional status.
A case report of acute heart failure and cardiogenic shock caused by catastrophic antiphospholipid syndrome and lupus myocarditis
Authors: Lai Ashton C , Feinman Jason , Oates Connor , Parikh Aditya
Published: November 2022

Background

Catastrophic antiphospholipid syndrome and lupus myocarditis are two rare life-threatening conditions.

Case summary

We present a case of a 47-year-old woman admitted in profound cardiogenic shock due to catastrophic antiphospholipid syndrome and lupus myocarditis requiring advanced heart failure therapies, including early mechanical circulatory support. She improved with steroids, immunoglobulins, mycophenolate, and eculizumab.

Discussion

This case highlights the importance of early identification of cardiogenic shock secondary to catastrophic antiphospholipid syndrome and lupus myocarditis, the arrhythmogenic complications of myocarditis, and the subsequent management of the disease progression with mechanical and medical support.
Erroneous diagnosis of COVID-19 mRNA vaccine–associated acute myocarditis due to false-positive high-sensitive troponin I assay: a case report
Authors: Suan Vivian Goh Yi , Hawkins Robert , Yew Min Sen
Published: November 2022

Background

Coronavirus disease 2019 (COVID-19) mRNA vaccine–associated acute myocarditis has been well described, and the demonstration of elevated high-sensitivity cardiac troponin (hs-cTn) is crucial for its diagnosis. However, falsely elevated hs-cTn can occasionally occur, leading to incorrect diagnosis. Here, we report the case of a patient who was given an erroneous diagnosis of COVID-19 mRNA vaccine–associated acute myocarditis due to falsely elevated hs-cTn, likely from assay interference.

Case summary

A 29-year-old Chinese male presented with 3 months of chest pain, dyspnoea, and palpitations starting a few days after his second dose of mRNA-1273 (Moderna) vaccine. High-sensitivity cardiac troponin I was elevated at presentation, which rose further 4 h later. The provisional diagnosis was acute myocarditis after a computed tomography coronary angiogram showed normal coronaries. Cardiac magnetic resonance was also negative for myocardial inflammation. The hs-cTn I levels fluctuated but remained elevated on outpatient serial testing, despite no new symptoms or clinical events. A paired serum sample showed elevated hs-cTn I but normal hs-cTn T, confirming a diagnosis of false-positive hs-cTn I. Further investigations, including blood tests before and after a subsequent uneventful mRNA-1273 booster vaccination, were performed to investigate for assay interference.

Discussion

Widespread COVID-19 mRNA vaccination has resulted in an awareness of vaccine-related acute myocarditis and a more thorough evaluation of post-vaccination cardiac symptoms. Although false-positive hs-cTn rarely occurs, extensive testing will inevitably result in a significant number of patients with falsely elevated hs-cTn. Clinicians should exclude this possibility and consider using alternative hs-cTn assay when investigation results and clinical presentation appear discordant.
Development and validation of a dynamic deep learning algorithm using electrocardiogram to predict dyskalaemias in patients with multiple visits
Authors: Lou Yu-Sheng , Lin Chin-Sheng , Fang Wen-Hui , Lee Chia-Cheng , Wang Chih-Hung , Lin Chin
Published: November 2022

Aims

Deep learning models (DLMs) have shown superiority in electrocardiogram (ECG) analysis and have been applied to diagnose dyskalaemias. However, no study has explored the performance of DLM-enabled ECG in continuous follow-up scenarios. Therefore, we proposed a dynamic revision of DLM-enabled ECG to use personal pre-annotated ECGs to enhance the accuracy in patients with multiple visits.

Methods and results

We retrospectively collected 168 450 ECGs with corresponding serum potassium (K+) levels from 103 091 patients as development samples. In the internal/external validation sets, the numbers of ECGs with corresponding K+ were 37 246/47 604 from 13 555/20 058 patients. Our dynamic revision method showed better performance than the traditional direct prediction for diagnosing hypokalaemia [area under the receiver operating characteristic curve (AUC) = 0.730/0.720–0.788/0.778] and hyperkalaemia (AUC = 0.884/0.888–0.915/0.908) in patients with multiple visits.

Conclusion

Our method has shown a distinguishable improvement in DLMs for diagnosing dyskalaemias in patients with multiple visits, and we also proved its application in ejection fraction prediction, which could further improve daily clinical practice.
Association between phonocardiography and echocardiography in heart failure patients with preserved ejection fraction
Authors: Luo Hongxing , Weerts Jerremy , Bekkers Anja , Achten Anouk , Lievens Sien , Smeets Kimberly , van Empel Vanessa , Delhaas Tammo , Prinzen Frits W
Published: November 2022

Aims

Heart failure with preserved ejection fraction (HFpEF) is associated with stiffened myocardium and elevated filling pressure that may be captured by heart sound (HS). We investigated the relationship between phonocardiography (PCG) and echocardiography in symptomatic patients suspected of HFpEF.

Methods and results

Consecutive symptomatic patients with sinus rhythm and left ventricular ejection fraction >45% were enrolled. Echocardiography was performed to evaluate the patients’ diastolic function, accompanied by PCG measurements. Phonocardiography features including HS amplitude, frequency, and timing intervals were calculated, and their abilities to differentiate the ratio between early mitral inflow velocity and early diastolic mitral annular velocity (E/e′) were investigated. Of 45 patients, variable ratio matching was applied to obtain two groups of patients with similar characteristics but different E/e′. Patients with a higher E/e′ showed higher first and second HS frequencies and more fourth HS and longer systolic time intervals. The interval from QRS onset to first HS was the best feature for the prediction of E/e′ > 9 [area under the curve (AUC): 0.72 (0.51–0.88)] in the matched patients. In comparison, N-terminal pro-brain natriuretic peptide (NT-proBNP) showed an AUC of 0.67 (0.46–0.85), a value not better than any PCG feature (P > 0.05).

Conclusion

Phonocardiography features stratify E/e′ in symptomatic patients suspected of HFpEF with a diagnostic performance similar to NT-proBNP. Heart sound may serve as a simple non-invasive tool for evaluating HFpEF patients.
Is School-Based Financial Education Effective? Immediate and Long-Lasting Impacts on High School Students
Authors: Frisancho Veronica
Published: November 2022

Relying on a large-scale experiment in Peru, this study evaluates the effects of an in-class intervention on financial literacy and financial behaviour. As soon as the programme is over, treated students record significant financial literacy gains that do not hinder their academic performance. The programme also leads to immediate changes in downstream financial behaviour as measured by financial autonomy and financial savviness. Credit bureau records gathered three years later show that early improvements in financial literacy translate into limited, but positive long-lasting changes in financial behaviour. The treatment did not affect students’ credit or repayment behaviour on the extensive margin, but, among those few with outstanding loans, it reduced arrears by 20%.
Sound reasons for unsound sleep: Comparative support for the sentinel hypothesis in industrial and nonindustrial groups
Authors: McKinnon Leela , Shattuck Eric C , Samson David R
Published: November 2022

Background and objectives

Sleep is a vulnerable state in which individuals are more susceptible to threat, which may have led to evolved mechanisms for increasing safety. The sentinel hypothesis proposes that brief awakenings during sleep may be a strategy for detecting and responding to environmental threats. Observations of sleep segmentation and group sentinelization in hunter-gatherer and small-scale communities support this hypothesis, but to date it has not been tested in comparisons with industrial populations characterized by more secure sleep environments.

Methodology

Here, we compare wake after sleep onset (WASO), a quantitative measure of nighttime awakenings, between two nonindustrial and two industrial populations: Hadza hunter-gatherers (n = 33), Malagasy small-scale agriculturalists (n = 38), and Hispanic (n = 1,531) and non-Hispanic White (NHW) (n = 347) Americans. We compared nighttime awakenings between these groups using actigraphically-measured sleep data. We fit linear models to assess whether WASO varies across groups, controlling for sex and age.

Results

We found that WASO varies significantly by group membership and is highest in Hadza (2.44 h) and Malagasy (1.93 h) and lowest in non-Hispanic Whites (0.69 h). Hispanics demonstrate intermediate WASO (0.86 h), which is significantly more than NHW participants. After performing supplementary analysis within the Hispanic sample, we found that WASO is significantly and positively associated with increased perception of neighborhood violence.

Conclusions and implications

Consistent with principles central to evolutionary medicine, we propose that evolved mechanisms to increase vigilance during sleep may now be mismatched with relatively safer environments, and in part responsible for driving poor sleep health.
Skeletal Muscle Nuclei in Mice are not Post-mitotic
Authors: Borowik Agnieszka K , Davidyan Arik , Peelor Frederick F , Voloviceva Evelina , Doidge Stephen M , Bubak Matthew P , Mobley Christopher B , McCarthy John J , Dupont-Versteegden Esther E , Miller Benjamin F
Published: November 2022

The skeletal muscle research field generally accepts that nuclei in skeletal muscle fibers (ie, myonuclei) are post-mitotic and unable to proliferate. Because our deuterium oxide (D2O) labeling studies showed DNA synthesis in skeletal muscle tissue, we hypothesized that resident myonuclei can replicate in vivo. To test this hypothesis, we used a mouse model that temporally labeled myonuclei with GFP followed by D2O labeling during normal cage activity, functional overload, and with satellite cell ablation. During normal cage activity, we observed deuterium enrichment into myonuclear DNA in 7 out of 7 plantaris (PLA), 6 out of 6 tibialis anterior (TA), 5 out of 7 gastrocnemius (GAST), and 7 out of 7 quadriceps (QUAD). The average fractional synthesis rates (FSR) of DNA in myonuclei were: 0.0202 ± 0.0093 in PLA, 0.0239 ± 0.0040 in TA, 0.0076 ± 0. 0058 in GAST, and 0.0138 ± 0.0039 in QUAD, while there was no replication in myonuclei from EDL. These FSR values were largely reproduced in the overload and satellite cell ablation conditions, although there were higher synthesis rates in the overloaded PLA muscle. We further provided evidence that myonuclear replication is through endoreplication, which results in polyploidy. These novel findings contradict the dogma that skeletal muscle nuclei are post-mitotic and open potential avenues to harness the intrinsic replicative ability of myonuclei for muscle maintenance and growth.
Does the division of the inferior pulmonary ligament in upper lobectomy result in improved short-term clinical outcomes and long-term survival?
Authors: Wang Yi-Feng , Deng Han-Yu , Huang Weijia , Zhou Qinghua
Published: November 2022

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was ‘Does the division of the inferior pulmonary ligament (IPL) in upper lobectomy result in improved short-term clinical outcomes and long-term survival?’. Altogether 43 papers were found using the reported search, of which 6 studies represented the best evidence to answer the clinical question, including a previous best evidence topic study, a meta-analysis and 4 retrospective cohort studies. The author, journal, date and country of publication, patient group studied, study type and relevant outcomes and results of these papers are tabulated. Most of the enrolled studies reported that there is no significant difference between the division groups and the preservation groups in terms of drainage time, drainage volume, postoperative dead space and complications. While 3 cohort studies revealed unfavoured postoperative pulmonary function in the division groups, including lung volume, forced vital capacity and forced expiratory volume in 1 s. The previous meta-analysis and a recent cohort study also found that the division of IPL might lead to increased bronchus angle change or torsion. Moreover, 2 cohort studies found that the division of IPL could not improve the long-term survival of patients undergoing upper lobectomy. Current evidence showed that dividing the IPL could not result in clinical benefits but might lead to decreased pulmonary function instead. Therefore, we recommended not dissecting the IPL routinely during upper lobectomy.
Impact of the physical therapy–managed spinal orthoses program on cost of care in the hospital setting: a retrospective interrupted time-series study
Authors: Willey Sue , Lenk James , Waters Linda , French Charles Joseph , Cayce Jonathan Mathew
Published: November 2022

Background

The physical therapy (PT) department at a level 1 trauma center identified vendor delivery delays of off-the-shelf (OTS) spinal orthoses that delayed patient mobilization.

Objective

This study aimed to identify improvements in mobilization times, discharge times and reduction in the cost of care after centralizing the management of orthoses within the therapy department.

Method

The centralized management of OTS spinal orthoses included stocking three adjustable lumbosacral and thoraco-lumbosacral orthosis sizes and ensuring that all personnel received training to appropriately fit the orthoses to patients. This study evaluates the impact of the centralized program by using a retrospective interrupted time-series design to compare outcomes before and after program implementation. Outcome measurements included orthosis delivery delay, time to orthosis delivery, time to mobilization by physical therapist, length of stay (LOS) and cost of care. Segmented linear regression, Wilcoxon rank-sum test and Fisher's exact tests compared outcome measures before and after implementing the centralized program.

Results

The PT-managed program eliminated orthosis delivery delays noted during the vendor program (42 vs. 0; P < 0.001), resulting in an overall 13.97-h reduction in time to mobilization (P < 0.001). Program cost savings equated to $2,023.40 per patient (P < 0.001). Sub-group analysis of patients without complications and treated conservatively showed a significant reduction in LOS (15.36 h; P = 0.009) in addition to time to mobilization reductions.

Conclusion

The PT-managed program significantly improved the quality of care for patients who required a spinal orthosis by mobilizing patients as soon as possible, allowing timely discharge. The program also resulted in overall patient and hospital cost savings.
Evaluation of the intention to use the electronic medical record (EMR) by health professionals in healthcare facilities of Libreville and Owendo in Gabon
Authors: Moukoumbi Lipenguet Gaëtan , Ngoungou Edgard-Brice , Roberts Tamara , Ibinga Euloge , Amani Gnamien Prudence , Engohang-Ndong Jean , Wittwer Jérôme
Published: November 2022

Introduction

Health systems in several countries have integrated information and communication technologies into their operations. Electronic medical records (EMRs) are at the core of patient care. The working of these EMRs requires their acceptance and use by medical and paramedical personnel. The objective of this study was to empirically evaluate the intention of health professionals to use these EMRs.

Materials and Methods

A questionnaire on the intention of health professionals to use the EMR was developed following a Likert scale. The survey was done via in-person interviews of health professionals in major health facilities in the cities of Libreville and Owendo in Gabon. The technology acceptance model (TAM) was tested using a step-down logistic regression analysis to identify the main factors explaining the intention of health professionals to use the EMR.

Results

A total of 218 health professionals responded to the questionnaire. Thirty-eight percent (38%) of respondents were male. The average age was 41.33 years (±8.98 years) and the average length of service at work in the system was 12.02 years (±8.47 years). The integrated model showed that the intention to use the EMR was significantly associated with the perceived usefulness, the subjective standard, and experience. No socio-demographic variables explained the intention to use the EMR.

Conclusion

The perceived ease, familiarity with the computer, and motivation are not associated with the intention to use the EMR. Actions should be taken to raise awareness and train health professionals to motivate them to accept and use EMRs in their medical practices.
Validation of MICA Legionella for Enumeration of Legionella pneumophila in Sanitary Waters and Cooling Tower Waters: AOAC Performance Tested MethodSM 032201
Authors: Passot Fanny , Peslier Sabine , Benzinger M Joseph , Blackburn Jonathan , Thompson Wesley , Bastin Benjamin , Dumont Audrey , Dukan Sam
Published: November 2022

Background

Frequent testing for Legionella concentration in water is required by most health risk monitoring organizations worldwide. Domestic hot water and cooling tower water networks must be regularly controlled to prevent Legionnaires’ disease, a potentially deadly lung infection. MICA Legionella is the fastest culture-based detection method for all serogroups of Legionella pneumophila, with automatic enumeration in 48 h and no need for confirmation.

Objective

This study compares the performance and robustness of MICA Legionella with the reference method ISO 11731:2017 for the enumeration of culturable L. pneumophila.

Methods

MICA Legionella and ISO 11731:2017 results were compared for domestic hot water and cooling tower water. Inclusivity and exclusivity were tested on reference and environmental strains. Ruggedness, lot-to-lot consistency, and stability of the reagents kit were also studied.

Results

Enumeration of L. pneumophila by MICA Legionella was statistically equivalent to ISO 11731:2017 in both matrixes. In cooling tower waters, MICA Legionella showed better sensitivity than ISO 11731:2017. It presented a 94% sensitivity and a 97% specificity.

Conclusion

MICA Legionella is a highly sensitive and specific method for culturable L. pneumophila enumeration. It presents, in 48 hours, equivalent or better results than ISO 11731:2017. Its protocol is robust to variations. Its reagents kit is stable for up to 18 months.

Highlights

MICA Legionella is a robust and reliable method for the enumeration of culturable L. pneumophila in domestic and cooling tower water. It reduces significantly the number of sample pretreatments required in ISO 11731:2017. Automatic identification and enumeration of L. pneumophila microcolonies eliminates the requirement to have skilled analysts and limits the results variability. It also greatly reduces the time to results to 48 h instead of 7–10 days with ISO 11731:2017 while providing statistically equivalent results.
Stability-Indicating RP-HPLC Method Development and Validation for Eltrombopag Olamine in the Presence of Impurities and Degradation Products. Robustness by Design of Expert Software
Authors: Dandabattina Rajeshwari , Subramanian Velusamy B , Merugu Karuna Sree , SharathBabu Haridasyam , Katari Naresh Kumar , Kowtharapu Leela Prasad
Published: November 2022

Background

A simple and reliable HPLC method for determining impurities in eltrombopag olamine (ELO) film-coated tablets is not available. At the same time, there is no official monograph reported. The proposed research is targeted at the development of a stability-indicating method for determining impurities in ELO film-coated tablets and drug substances.

Objective

To develop and validate a simple and effective HPLC method for determining impurities in ELO film-coated tablets and drug substances.

Methods

All the impurities were separated using a reverse phase (RP)-HPLC system equipped with a Zorbax SB-Phenyl 150 mm × 4.6 mm, 3.5 µm, column with UV detection at 230 nm and a flow rate of 1.2 mL/min. The column temperature was maintained at 45°C.

Results

The proposed method was validated as per current regulatory guidelines. The coefficient of correlation was found to be >0.999 for all impurities. The LOD and LOQ for ELO and all specified impurities were determined. The precision and accuracy were obtained for ELO and its related impurities. Intra- and inter-day RSD values were between 1.22 and 2.04%, and impurity recovery varied between 93.80 and 103.69%. The stability of standard and sample solutions was established for 24 h.

Conclusions

As per recent guidelines, a stability-indicating method has been developed to determine the impurities in ELO film-coated tablets and drug substances. QbD-based robustness was performed and proved that the method was robust.

Highlights

The proposed article is the first RP-HPLC method for determining impurities in ELO film-coated tablets and drug substances. The quality by design (QbD) concept was utilized to verify the method performance.
Frequency, barriers, outcomes, and consequences of reporting sexual harassment in clinical oncology
Authors: Graff Stephanie L , Subbiah Ishwaria M , Markham Merry Jennifer , Matt-Amaral Laurie B , Close Julia L , Griffith Kent A , Jagsi Reshma
Published: November 2022

Sexual harassment is increasingly recognized as widely prevalent in medicine. Broad efforts at the organizational and society level are working to address this inequity, but many of these efforts rely on reporting to eradicate problematic behaviors and shift culture. We examined, among oncologists experiencing sexual harassment, the frequency of reporting, as well as barriers, outcomes, and consequences of reporting. Among 271 survey respondents, 217 reported sexual harassment from peers or superiors or from patients or families. Most harassed oncologists (n = 148, 68%) did not report the event to authority because of concerns about future negative consequences for themselves. Among the minority who reported harassment (n = 31, 14%), 52% felt their concerns were not taken seriously and 55% reported no action was taken as a result of their report. Furthermore, 52% experienced retaliatory behavior. Addressing these findings may help to inform the change necessary to create an antiharassment culture in oncology.
Well leg compartment syndrome due to the lithotomy position in orthopedic surgery: a report of two cases and a review of the literature
Authors: Ntontis Zisis , Trygonis Nikolaos , Bitados Panagiotis , Tsatsoulas Chrysostomos , Pappa Eirini , Samartzidis Kosmas , Stavrakakis Ioannis
Published: November 2022

The well leg compartment syndrome (WLCS) is a complication that can occur because of the lithotomy surgical position. Although it is a very rare entity, it can lead to a permanent disability if not properly treated. Very few cases have been described in the literature as a result of orthopedic surgery. We present two cases of WLCS that developed because of the lithotomy position. The first case concerns a patient who sustained a left floating knee and developed a compartment syndrome of the right uninjured calf during surgery. A good outcome has been achieved after early fasciotomies. The second case is about a patient who developed a compartment syndrome of the right buttock after a left unicompartmental knee replacement. This patient was treated conservatively because of delayed diagnosis. A brief literature review regarding the WLCS in orthopedic surgery is also conducted.
Vitamin B12 levels in children and adolescents on plant-based diets: a systematic review and meta-analysis
Authors: Jensen Christopher F
Published: November 2022

Context

The popularity of plant-based diets, characterized by a partial or complete exclusion of animal products, has increased significantly over the last 10 years. The exclusion of animal products removes the most common sources of vitamin B12, which can lead to vitamin B12 deficiency and result in irreversible damage, such as growth stunting.

Objective

This aim of this systematic review and meta-analysis was to qualitatively evaluate all studies on this subject and to quantify the potential difference in vitamin B12 levels in healthy children and adolescents aged 5 to 18 years.

Data Sources

PubMed and Embase databases were searched for relevant studies investigating vitamin B12 levels in healthy children and adolescents aged 5 to 18 years on plant-based diets.

Data Extraction

Studies were assessed qualitatively with the AXIS tool and quantitatively with Stata 16.0 software.

Data Analysis

Overall, children and adolescents on plant-based diets had a significantly lower vitamin B12 level than omnivorous children and adolescents (−97 pmol/L; 95%CI, −187 to −7; I2 = 98.5%), a difference that remained statistically significant after adjusting for methodological confounders. After subgroup analyses, this effect was not statistically significant for children and adolescents on vegetarian diets but remained significant in children and adolescents on vegan or macrobiotic diets. Moreover, total vitamin B12 intake nullified the mean difference in vitamin B12 levels.

Conclusion

Despite high heterogeneity across studies, these results indicate that children and adolescents on plant-based diets, especially those on vegan and macrobiotic diets, may be at risk of developing vitamin B12 deficiency.