bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic cholecystectomy: post-operative bile and chyle leaks. A case report
Authors: Philip Dwight , Garcia Maxine , Anika Maisha , Avila Azalia , Seaver Christopher
Published: September 2023

One week after an elective laparoscopic cholecystectomy at an outside hospital, a 56-year-old male presented to the emergency department with right-sided abdominal pain. Computerized tomography (CT) revealed a complex fluid collection in the gallbladder fossa. The patient underwent drain placement and received broad-spectrum intravenous antibiotics. Drain output was suspicious for a chyle leak, which was confirmed by elevated fluid triglyceride levels. Magnetic resonance cholangiopancreatography (MRCP) and hepatobiliary iminodiacetic acid (HIDA) analysis showed evidence of a concurrent bile leak. After starting a low fat, high protein diet and octreotide, a common bile duct sphincterotomy with plastic stent placement was performed. The patient’s symptoms and drain output proceeded to improve. The cause of the chyle leak is unclear. However, with consideration of the patient’s concurrent bile leak, an injury to the right major lymphatic drainage pathway and adjacent bile duct is suspected.
Massive stone or is it glass: a curious case of porcelain gallbladder
Authors: Kendric Tan Jun Guang , Wijesuriya Ruwan
Published: September 2023

Usage of computed tomography (CT) scans has increased exponentially over the past decade. This is associated with the rise in incidental findings and having to manage clinical scenarios previously never encountered in the pre-CT scan era. Once such finding is a porcelain gallbladder, specifically gallbladder wall calcification. We report one such case of a porcelain gallbladder mimic and propose some suggestions on the decision-making process when managing an incidentally discovered calcified gallbladder.
Diagnosis of invasive pulmonary aspergillosis by lateral flow assay of galactomannan in bronchoalveolar lavage fluid: a meta-analysis of diagnostic performance
Authors: Cai Yingli , Liang Jun , Lu Guangsheng , Zhan Yankun , Meng Jianwei , Liu Zhusheng , Shao Yiming
Published: September 2023

The performance of lateral flow assay (LFA) in diagnosing invasive pulmonary aspergillosis (IPA) has not been well demonstrated. To address this, we conducted a meta-analysis assessing the overall accuracy of LFA in diagnosing IPA using bronchoalveolar lavage fluid (BALF). Over a systematical search and assessment of bias risk, we calculated the pooled specificity, sensitivity, and area under the receiver operating curve (AUC) to assess the diagnostic performance. Our meta-analysis included 11 studies. The combined total sensitivity and specificity for diagnosing IPA were 0.78 (95% confidence interval (CI): 0.71, 0.83) and 0.87 (95% CI: 0.81, 0.91), respectively. The AUC was 0.86 (95% CI: 0.82, 0.89). Our results demonstrate that LFA using galactomannan in BALF exhibits high sensitivity and specificity for diagnosing IPA.
Schistosomiasis: The Disease That Saved Taiwan
Authors: Turner Matthew D , Sapp Jason
Published: September 2023

From 1949 to 1950, an acute epidemic of schistosomiasis struck several elite units of the People’s Liberation Army during the Chinese Civil War that were preparing for an amphibious invasion of Taiwan. The crucial delay brought by the sudden outbreak of the disease may have cost communist forces control of the strategic island, changing the geopolitical calculus of the Pacific in the decades since.
-1 Programmed ribosomal frameshifting in Class 2 umbravirus-like RNAs uses multiple long-distance interactions to shift between active and inactive structures and destabilize the frameshift stimulating element
Authors: Mikkelsen Anna A , Gao Feng , Carino Elizabeth , Bera Sayanta , Simon Anne E
Published: September 2023

Plus-strand RNA viruses frequently employ -1 programmed ribosomal frameshifting (-1 PRF) to maximize their coding capacity. Ribosomes can frameshift at a slippery sequence if progression is impeded by a frameshift stimulating element (FSE), which is generally a stable, complex, dynamic structure with multiple conformations that contribute to the efficiency of -1 PRF. As FSE are usually analyzed separate from the viral genome, little is known about cis-acting long-distance interactions. Using full-length genomic RNA of umbravirus-like (ula)RNA citrus yellow vein associated virus (CY1) and translation in wheat germ extracts, six tertiary interactions were found associated with the CY1 FSE that span nearly three-quarters of the 2.7 kb genomic RNA. All six tertiary interactions are conserved in other Class 2 ulaRNAs and two are conserved in all ulaRNAs. Two sets of interactions comprise local and distal pseudoknots that involve overlapping FSE nucleotides and thus are structurally incompatible, suggesting that Class 2 FSEs assume multiple conformations. Importantly, two long-distance interactions connect with sequences on opposite sides of the critical FSE central stem, which would unzip the stem and destabilize the FSE. These latter interactions could allow a frameshifting ribosome to translate through a structurally disrupted upstream FSE that no longer blocks ribosome progression.
Severe recurrent hyponatremia in a 72-year-old patient with undiagnosed partially empty Sella syndrome—a case report
Authors: Dahal Agnimshwor , Chauhan Bhim , Gyawali Jeevan , Thapa Astha , Dhungel Prakash , Yadav Saroj
Published: September 2023

Hyponatremia is one of the most common electrolyte abnormalities encountered in medical practice and is caused by multiple conditions. SIADH is the most common cause of hyponatremia, however, careful workup must be performed on all patients as mere supplementation may cause recurrent hyponatremia and serious side effects. Adrenal insufficiency is a principal culprit that mimics the clinical picture of SIADH and tends to worsen when treated in the line of SIADH. In addition, individuals may have various comorbidities, such as hypothyroidism in our case, which can also cause hyponatremia, making it difficult to determine precise etiology. We present a case of a 72-year-old man with recurrent hyponatremia, who was subsequently diagnosed as partially empty sella syndrome. Given the temporal relationship between the use of corticosteroids and the improvement of his symptoms, low cortisol and ACTH levels, adrenal insufficiency was most likely the cause of the hyponatremia in our patient.
Sugar-Sick Yet Healthy: Changing Concepts of Disease in the Dutch Diabetics Association (1945–1970)
Authors: Haalboom Floor
Published: September 2023

Using the journal of the Dutch Diabetics Association (Nederlandse Vereniging van Suikerzieken), the article provides insight into the role of an early patient organisation in conceptualising the chronic disease diabetes and its management in the Netherlands between 1945 and 1970. The dual aims of discipline (steered by health professionals) and independence (steered by diabetics) were reconciled through the concept of balance during the 1940s and 1950s. Organised diabetics played a particularly large role, and independence got particular emphasis as a consequence. This made it possible for organised patients to reconfigure their disease and identity in terms of social health in relation to labour, family and society in the post-war reconstruction period. In the late 1960s, this social concept transformed into a personal concept of health in which the concept of balance lost its prominence, despite a short intermezzo of medicalisation in the early 1960s.
Sleep and circadian influences on blood alcohol concentration
Authors: Miller Mary Beth , Cofresí Roberto U , McCarthy Denis M , Carskadon Mary A
Published: September 2023

Study Objectives

Anecdotally, adults reach higher levels of subjective intoxication on days they are fatigued or sleep-deprived, but sleep is not typically discussed as a predictor of blood alcohol concentration (BAC) in clinical settings. To inform clinical work and future research, this perspective reviews data examining the impact of sleep (process S) and circadian (process C) factors on indicators of BAC in humans and animal models.

Methods

Literature searches of medical and psychological databases were conducted to identify articles that manipulated sleep/circadian factors and reported effects on indicators of alcohol pharmacology (e.g. BAC, alcohol metabolism).

Results

Of the 86 full-text articles reviewed, 21 met inclusion criteria. Studies included manipulations of time of day, circadian phase (evidence for process C), and time in bed (evidence for process S). Evidence for time-of-day effects on alcohol pharmacology was most compelling. Studies also provided evidence for circadian phase effects, but failed to find support for time-in-bed effects. Although results were not uniform across studies, most evidence from human and animal models indicates that peak BACs occur toward the beginning of the biological day, with some studies indicating slower alcohol elimination rates at this time.

Conclusions

Circadian factors likely influence alcohol pharmacokinetics, perhaps due to altered elimination of alcohol from the body. This means that individuals may reach higher BACs if they drink during the morning (when, for most people, circadian alerting is low) versus other times of the day. Alcohol prevention and intervention efforts should highlight sleep/circadian health as a potential contributor to alcohol-related harm.
Sleep-inducing effect of Rhynchophylline in EphA4 knockout mice
Authors: Ballester Roig Maria Neus , Mongrain Valérie
Published: September 2023

We have recently demonstrated that the alkaloid rhynchophylline (RHY; purified from Uncaria plants) induces sleep and modifies electrocorticographic (ECoG) activity throughout the 24-h day in a vigilance state-dependent manner in wild-type mice. We here asked whether this alkaloid impacts wake/sleep variables in the absence of the cell adhesion protein EPHA4, via ECoG recording in EphA4 knockout (KO) mice submitted to the same RHY treatment contemporaneously to the wild-type mice (littermates). We uncover that RHY decreases time spent awake and increases time spent in slow wave sleep in EphA4 KO mice and alters the 24-h time course of ECoG activity during wakefulness and sleep states. These observations are similar to the reported effects of RHY in wild-type littermate animals, which strongly supports that RHY-driven sleep alterations are not dependent on the presence of EPHA4.
Patient perspectives on a proposed pharmacy-based colorectal cancer screening program
Authors: Ferrari Renée M , Atkins Dana L , Wangen Mary , Rohweder Catherine L , Waters Austin R , Correa Sara , Richmond Jennifer , van Rensburg Dillon , Ittes Annika , Odebunmi Olufeyisayo , Issaka Rachel B , Ceballos Rachel , Shah Parth D , Wheeler Stephanie B , Brenner Alison T
Published: September 2023

Colorectal cancer (CRC) is a common and preventable cancer. CRC screening is underutilized, particularly within medically underserved communities. Most interventions aimed at increasing CRC screening are delivered through primary care clinics. Pharmacies are more accessible than traditional primary care settings and may be ideally suited for delivering CRC screening and increasing access. Fecal immunochemical test is an at-home, stool-based CRC screening test that could be distributed through pharmacies. The purpose of our study was to assess patient perspectives on receiving fecal immunochemical test-based CRC screening through pharmacies. We conducted semi-structured interviews with participants residing in North Carolina and Washington. Interviews explored acceptability and intervention design preferences for a pharmacy-based CRC screening program. The interview guide was informed by Andersen’s Healthcare Utilization Model and the Theoretical Domains Framework. Interviews were conducted at the University of North Carolina at Chapel Hill and Fred Hutchinson Cancer Research Center, audio-recorded, and transcribed. Patients perceived a pharmacy-based CRC screening program to be highly acceptable, citing factors such as ease of pharmacy access and avoiding co-pays for an office visit. Some concerns about privacy and coordination with patients’ primary care provider tempered acceptability. Trust and positive relationships with providers and pharmacists as well as seamless care across the CRC screening continuum also were viewed as important. Patients viewed pharmacy-based CRC screening as an acceptable option for CRC screening. To improve programmatic success, it will be important to ensure privacy, determine how communication between the pharmacy and the patient’s provider will take place, and establish closed-loop care, particularly for patients with abnormal results.
Exogenous chelating agents influence growth, physiological characteristics and cell ultrastructure of Robinia pseudoacacia seedlings under lead–cadmium stress
Authors: Zhou Jian , Qi Anguo , Wang Ting , Zhang Songyan , Liu Jinxiu , Lu Yabo
Published: September 2023

Heavy metal pollution of soil, especially by lead (Pb) and cadmium (Cd), is a serious problem worldwide. The application of safe chelating agents, combined with the growing of tolerant trees, constitutes an approach for phytoremediation of heavy-metal-contaminated soil. This study aimed to determine whether the two safe chelators, tetrasodium glutamate diacetate (GLDA) and citric acid (CA), could improve the phytoremediation capacity of black locust (Robinia pseudoacacia L.) in a Pb–Cd-contaminated soil and to find the key factors affecting the biomass accumulation of stressed black locust. In Pb- and Cd-stressed black locust plants, medium- and high-concentration GLDA treatment inhibited the growth, chlorophyll synthesis and maximum photochemical efficiency (Fv/Fm), promoted the absorption of Pb and Cd ions and resulted in the shrinkage of chloroplasts and starch grains when compared with those in Pb- and Cd-stressed plants that were not treated with GLDA. The effects of CA on plant growth, ion absorption, chlorophyll content, chlorophyll fluorescence and organelle size were significantly weaker than those of GLDA. The effect of both agents on Cd absorption was greater than that on Pb absorption in all treatments. The levels of chlorophyll a and plant tissue Cd and rates of starch metabolism were identified as the key factors affecting plant biomass accumulation in GLDA and CA treatments. In the future, GLDA can be combined with functional bacteria and/or growth promoters to promote the growth of Pb- and Cd-stressed plants and to further improve the soil restoration efficiency following pollution by heavy metals. Application of CA combined with the growing of black locust plants has great potential for restoring the Cd-polluted soil. These findings also provide insights into the practical use of GLDA and CA in phytoremediation by R. pseudoacacia and the tolerant mechanisms of R. pseudoacacia to Pb–Cd-contaminated soil.
Irisin ameliorates diabetic kidney disease by restoring autophagy in podocytes
Authors: Lai Weiyan , Luo Dan , Li Yin , Li Yuanqing , Wang Qianqian , Hu Zhaoyong , Ye Zengchun , Peng Hui
Published: September 2023

Many studies have highlighted the importance of moderate exercise. While it can attenuate diabetic kidney disease, its mechanism has remained unclear. The level of myokine irisin in plasma increases during exercise. We found that irisin was decreased in diabetic patients and was closely related to renal function, proteinuria, and podocyte autophagy injury. Muscle‐specific overexpression of PGC‐1α (mPGC‐1α) in a mouse model is known to increase plasma irisin levels. The mPGC‐1α mice were crossed with db/m mice to obtain db/db mPGC‐1α+ mice in the present study. Compared to db/db mice without mPGC‐1α, plasma irisin was increased, and albuminuria and glomerular pathological damage were both alleviated in db/db mPGC‐1α+ mice. Impaired autophagy in podocytes was restored as well. Irisin inhibited the activation of the PI3K/AKT/mTOR signaling pathway in cultured human podocytes and improved damaged autophagy induced by high glucose levels. Then, db/db mice were treated with recombinant irisin, which had similar beneficial effects on the kidney as those in db/db mPGC‐1α+ mice, with alleviated glomerular injury and albuminuria. Moreover, the autophagy in podocytes was also significantly restored. These results suggest that irisin secreted by skeletal muscles protects the kidney from diabetes mellitus damage. It also restores autophagy in podocytes by inhibiting the abnormal activation of the PI3K/AKT/mTOR signaling pathway. Thus, irisin may become a new drug for the prevention and treatment of diabetic nephropathy.
Cerebral Blood Flow Assessed with Phase-contrast Magnetic Resonance Imaging during Blood Pressure Changes with Noradrenaline and Labetalol: A Trial in Healthy Volunteers
Authors: Birnefeld Johan , Petersson Karl , Wåhlin Anders , Eklund Anders , Birnefeld Elin , Qvarlander Sara , Haney Michael , Malm Jan , Zarrinkoob Laleh
Published: September 2023

Background

Adequate cerebral perfusion is central during general anesthesia. However, perfusion is not readily measured bedside. Clinicians currently rely mainly on mean arterial pressure (MAP) as a surrogate, even though the relationship between blood pressure and cerebral blood flow is not well understood. The aim of this study was to apply phase-contrast magnetic resonance imaging to characterize blood flow responses in healthy volunteers to commonly used pharmacologic agents that increase or decrease arterial blood pressure.

Methods

Eighteen healthy volunteers aged 30 to 50 yr were investigated with phase-contrast magnetic resonance imaging. Intra-arterial blood pressure monitoring was used. First, intravenous noradrenaline was administered to a target MAP of 20% above baseline. After a wash-out period, intravenous labetalol was given to a target MAP of 15% below baseline. Cerebral blood flow was measured using phase-contrast magnetic resonance imaging and defined as the sum of flow in the internal carotid arteries and vertebral arteries. Cardiac output (CO) was defined as the flow in the ascending aorta.

Results

Baseline median cerebral blood flow was 772 ml/min (interquartile range, 674 to 871), and CO was 5,874 ml/min (5,199 to 6,355). The median dose of noradrenaline was 0.17 µg · kg−1 · h−1 (0.14 to 0.22). During noradrenaline infusion, cerebral blood flow decreased to 705 ml/min (606 to 748; P = 0.001), and CO decreased to 4,995 ml/min (4,705 to 5,635; P = 0.01). A median dose of labetalol was 120 mg (118 to 150). After labetalol boluses, cerebral blood flow was unchanged at 769 ml/min (734 to 900; P = 0.68). CO increased to 6,413 ml/min (6,056 to 7,464; P = 0.03).

Conclusions

In healthy, awake subjects, increasing MAP using intravenous noradrenaline decreased cerebral blood flow and CO. These data do not support inducing hypertension with noradrenaline to increase cerebral blood flow. Cerebral blood flow was unchanged when decreasing MAP using labetalol.

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Nail Plate Constructs are Associated with Decreased Rates of Reoperation in Complex Distal Femur Fractures
Authors: Roszman Alexander , Cone Ryan , Chodaba Yvonne , Cichos Kyle , McGwin Gerald , Spitler Clay
Published: September 2023

Objectives:

To determine if nail plate constructs have lower rates of reoperation to promote bone healing than lateral locking plates in the treatment of distal femur fractures.

Design:

Retrospective Cohort

Setting:

Single Level 1 trauma center

Patients/Participants: 312 consecutive patients treated operatively for native distal femur fractures (OTA/AO 33A or 33C)

Intervention:

Reduction and fixation of distal femur fractures with either a lateral locked plate (LLP) or a nail plus plate construct (NPC)

Main Outcome Measures:

reoperation to promote bone healing at any time after definitive fixation

Results:

279 fractures were treated with LLP and were compared with and 33 fractures treated with NPC constructs. Patient demographics, injury severity score (ISS), and frequency utilization of each construct between different types of OTA/AO classified distal femur fractures were similar. The reoperation rate to promote bone healing was 18.7% (51/273) for LLPs, and 3% (1/33) for NPC constructs. There was no significant difference in surgical site infection (SSI) (p = 0.67).

Conclusions:

Utilization of NPC technique demonstrated a significant decrease in rates of reoperation to promote bone healing compared to LLP alone in the treatment of OTA/AO 33A and 33C distal femur fractures. Augmented fixation with NPCs should be considered to treat complex distal femur fractures as it is associated with lower rates of reoperation to promote bone healing in comparison to LLP.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Anticholinergic Burden and Xerostomia in Critical Care Settings
Authors: Chung Joohyun , Tjia Jennifer , Zhang Ning , O'Connor Brendan T.
Published: September 2023

Background

Although previous studies have established the association of medications with anticholinergic adverse effects and xerostomia, anticholinergic burden and xerostomia in critical care settings are poorly characterized. The objective of this study was to determine the impact of medication burdens associated with anticholinergic adverse effects, particularly the occurrence of xerostomia (dry mouth) in a critical care setting. In addition, this study explored the correlation between the timing of the first instance of xerostomia and the administration timing of medication known to have anticholinergic adverse effects.

Methods

A retrospective case-control study was used with the MIMIC (Medical Information Mart for Intensive Care) III database. The MIMIC-III clinical database is a publicly available, deidentified, health-related database with more than 40 000 patients in critical care units from 2001 to 2012. Cases of xerostomia (n = 1344) were selected from clinical notes reporting “dry mouth,” “xerostomia,” or evidence of pharmacological treatment for xerostomia; control (n = 4032) was selected using the propensity analysis with 1:3 matching on covariates (eg, age, sex, race, ethnicity, and length of stay). The anticholinergic burden was quantified as the cumulative effect of anticholinergic activities using the Anticholinergic Burden Scale.

Results

Anticholinergic burden significantly differed between xerostomia patients and control subjects (P = .04). The length of stay was a statistically significant factor in xerostomia. The probability of developing the symptom of xerostomia within 24 hours was .95 (95%) for patients of xerostomia.

Conclusions

Anticholinergic Burden Scale is associated with xerostomia in the critical care setting, particularly within 24 hours after admission. It is crucial to carefully evaluate alternative options for medications that may have potential anticholinergic adverse effects. This evaluation should include assessing the balance between the benefits and harms, considering the probability of withdrawal reactions, and prioritizing deprescribing whenever feasible within the initial 24-hour period.
Beyond genome-wide association studies: Investigating the role of noncoding regulatory elements in primary sclerosing cholangitis
Authors: Pratt Henry E. , Wu Tong , Elhajjajy Shaimae , Zhou Jeffrey , Fitzgerald Kate , Fazzio Tom , Weng Zhiping , Pratt Daniel S.
Published: September 2023

Background:

Genome-wide association studies (GWAS) have identified 30 risk loci for primary sclerosing cholangitis (PSC). Variants within these loci are found predominantly in noncoding regions of DNA making their mechanisms of conferring risk hard to define. Epigenomic studies have shown noncoding variants broadly impact regulatory element activity. The possible association of noncoding PSC variants with regulatory element activity has not been studied. We aimed to (1) determine if the noncoding risk variants in PSC impact regulatory element function and (2) if so, assess the role these regulatory elements have in explaining the genetic risk for PSC.

Methods:

Available epigenomic datasets were integrated to build a comprehensive atlas of cell type–specific regulatory elements, emphasizing PSC-relevant cell types. RNA-seq and ATAC-seq were performed on peripheral CD4+ T cells from 10 PSC patients and 11 healthy controls. Computational techniques were used to (1) study the enrichment of PSC-risk variants within regulatory elements, (2) correlate risk genotype with differences in regulatory element activity, and (3) identify regulatory elements differentially active and genes differentially expressed between PSC patients and controls.

Results:

Noncoding PSC-risk variants are strongly enriched within immune-specific enhancers, particularly ones involved in T-cell response to antigenic stimulation. In total, 250 genes and >10,000 regulatory elements were identified that are differentially active between patients and controls.

Conclusions:

Mechanistic effects are proposed for variants at 6 PSC-risk loci where genotype was linked with differential T-cell regulatory element activity. Regulatory elements are shown to play a key role in PSC pathophysiology.
Antihyperalgesic properties of gut microbiota: Parabacteroides distasonis as a new probiotic strategy to alleviate chronic abdominal pain
Authors: Gervason Sandie , Meleine Mathieu , Lolignier Stéphane , Meynier Maëva , Daugey Valentine , Birer Aurélien , Aissouni Youssef , Berthon Jean-Yves , Ardid Denis , Filaire Edith , Carvalho Frédéric Antonio
Published: September 2023

The potential role of gut microbiota in pain modulation is arousing an emerging interest since recent years. This study investigated neuromodulatory properties of gut microbiota to identify next-generation probiotics to propose alternative therapies for visceral pain management. Neuromodulation ability of 10 bacterial strains isolated from a healthy donor was assessed both on ND7/23 immortalized cell line and primary neuronal cells from rat dorsal root ganglia. This screening highlighted the neuroinhibitory property ofParabacteroides distasonis(F1-2) strain, supported both by its intracellular content and membrane fraction, which was further investigated in visceral pain mouse models. Oral administration of F1-2 resulted in a significant decrease of colonic hypersensitivity (CHS) in dextran sulfate sodium (0.5%) model associated with low-grade inflammation and a significant decrease of CHS inCitrobacter rodentiumpostinfectious models. No effect of F1-2 oral administration on CHS was observed in a neonatal maternal separation stress model. Antihyperalgesic effect unlikely involved modulation of inflammatory processes or restoration of intestinal barrier. Exploration of direct dialogue mechanisms between this strain and nervous system, assessed by calcium imaging experiments, revealed that F1-2 interacts directly with nociceptors by reducing activation level on capsaicin, inflammatory soup, and bradykinin stimulations. Our study provides new insights about bacteria–host interaction and placesP distasonisas a potential therapeutic strategy in the treatment of visceral pain observed in leaky gut–associated pathologies.
The Clinical Utility of Antroduodenal Manometry in the Evaluation of Children with Upper Gastrointestinal Symptoms
Authors: Arbizu Ricardo A. , Trauernicht Sean , Pinillos Sergio , Nurko Samuel , Rodriguez Leonel
Published: September 2023

Objectives:

Antroduodenal manometry (ADM) measures antral and small bowel motility and is clinically used to evaluate upper gastrointestinal (UGI) symptoms. We aimed to evaluate its utility in guiding treatment, predicting response, and association with clinical findings.

Methods:

Retrospective review of 200 children undergoing ADM. ADM interpretation and parameters were compared to outcomes (response to first therapy after ADM and overall response), predominant symptom (group A, abdominal distention and/or vomiting and group B, abdominal pain and/or nausea), etiology (idiopathic or with known comorbidity), and ADM indication [suspected chronic intestinal pseudo-obstruction (CIPO) or unexplained UGI symptoms].

Results:

We found an association between a normal intestinal phase III of the migrating motor complex (MMC) and idiopathic etiology, group B symptoms and unexplained UGI symptoms. No variable was associated with initial successful response. However, normal small bowel phase III of the MMC and idiopathic etiology were associated with overall successful response to treatment (including feeding tolerance and weaning of parenteral nutrition). No antral ADM parameter was associated with outcomes or other comparisons. The time to overall successful treatment response was significantly shorter in patients with a normal ADM and presence of a normal phase III of the MMC.

Conclusions:

The presence of the phase III of the MMC was the single ADM parameter predictive of overall treatment response, also associated to group B symptoms and idiopathic etiology. Our findings suggest that small bowel ADM parameters are more useful to predict outcomes and ADM should be performed primarily in patients presenting with abdominal distention and/or vomiting and those being evaluated for CIPO.
Bladder stone formation due to neglected double J stent: a case report
Authors: Jawad Ali , Hamdar Hussein , Nahle Ali Alakbar , Taher Hussein , Ahmad Ali Faisal , Ahmed Adnan
Published: September 2023

Introduction and importance:

Double J (DJ) stents are commonly used in genitourinary procedures, but they can lead to complications including infection, hematuria, encrustation, and stone formation. The longer the duration of encrustation, the greater the risk of complications and renal dysfunction. Forgotten stents pose challenges for patients and can require endourological or open surgical procedures.

Case presentation:

A 40-year-old man with hypertension and coronary artery disease had a forgotten DJ stent for 3 years, causing suprapubic pain and dysuria. Kidney, ureter, and bladder (KUB) revealed a coiled DJ stent with a large bladder stone and encrustation, and an open cystolithotomy was successfully performed. Recovery was uneventful, and the patient was discharged without complication.

Clinical discussion:

Ureteral stents, including the DJ stent, are commonly used for urological conditions but can cause complications if retained beyond the intended timeframe. Optimal timing for stent removal is crucial, and patients’ healthcare knowledge and adherence are critical to preventing retention. KUB X-ray can evaluate stent encrustation and bladder stones. Cystoscopy is the typical approach for stent removal, but supplementary interventions may be necessary. Open surgery was recommended for removing a large bladder stone and encrusted stent in this case.

Conclusion:

Timely removal of DJ stents is crucial to avoid complications. Extended retention can cause problems such as encrustation and stone formation. Patient education and adherence are essential to prevent retention and forgetfulness. This case report highlights the importance of careful management of patients with DJ stents for optimal outcomes and prevention of complications.
Nonfluent Variant Primary Progressive Aphasia on FDG, 11C-PIB, and 18F-APN-1607 PET Imaging
Authors: Li Lingchao , Ji Bin , Zhao Min , Bai Lin , Chen Bin
Published: September 2023

A 61-year-old right-handed man presented with decreased cognitive function, short-term memory, fluent speech disorders, and grammatical errors for 1 year. The patient underwent PET imaging with 11C-PIB, 18F-FDG, and 18F-APN-1607. The 11C-PIB PET showed no amyloid accumulation; the 18F-FDG PET showed hypometabolism in the bilateral frontal lobe, temporal lobe, and midbrain; and the 18F-APN-1607 PET showed tau accumulation in the brainstem, basal ganglia, and left inferior frontal gyrus. These findings suggested a diagnosis of nonfluent variant primary progressive aphasia. This case emphasizes the value of combined imaging of glucose metabolism, Aβ, and tau PET in the diagnosis of nonfluent variant primary progressive aphasia.
Assessing the effectiveness of online emotion recognition training in healthy volunteers
Authors: Reed Zoe E. , Suddell Steph , Eastwood Andy , Thomas Lilian , Dwyer Imogen , Penton-Voak Ian S. , Jarrold Christopher , Munafò Marcus R. , Attwood Angela S.
Published: September 2023

Facial emotion recognition (ER) difficulties are associated with mental health and neurodevelopmental conditions, including autism and poorer social functioning. ER interventions may therefore have clinical potential. We investigated the efficacy of ER training (ERT). We conducted three online studies with healthy volunteers completing one ERT session. Studies 1 and 2 included active and control/sham training groups and tested the efficacy of (i) four-emotion ERT (angry, happy, sad and scared) (
n
= 101), and (ii) six-emotion ERT (adding disgusted and surprised) (
n
= 109). Study 3 tested generalizability of ERT to non-trained stimuli with groups trained and tested on the same stimuli, or different stimuli (
n
= 120). Training effects on total correct hits were estimated using linear mixed effects models. We did not observe clear evidence of improvement in study 1 but note the effect was in the direction of improvement (
b
= 0.02, 95% confidence interval (CI) = −0.02 to 0.07). Study 2 indicated greater total hits following training (
b
= 0.07, 95% CI = 0.03–0.12). Study 3 demonstrated similar improvement across groups (
b
= −0.01, 95% CI = −0.05 to 0.02). Our results indicate improved ER (as measured by our task), which generalizes to different facial stimulus sets. Future studies should further explore generalizability, longer-term effects and ERT in populations with known ER difficulties.
Three-candidate election strategy
Authors: Brody Dorje C. , Yuasa Tomooki
Published: September 2023

The probability of a given candidate winning a future election is worked out in closed form as a function of (i) the current support rates for each candidate, (ii) the relative positioning of the candidates within the political spectrum, (iii) the time left to the election, and (iv) the rate at which noisy information is revealed to the electorate from now to the election day, when there are three or more candidates. It is shown, in particular, that the optimal strategy for controlling information can be intricate and non-trivial, in contrast to a two-candidate race. A surprising finding is that for a candidate taking the centre ground in an electoral competition among a polarized electorate, certain strategies are fatal in that the resulting winning probability for that candidate vanishes identically.
ZooMS confirms geometric morphometrics species identification of ancient sheep and goat
Authors: Jeanjean Marine , McGrath Krista , Valenzuela-Lamas Silvia , Nieto-Espinet Ariadna , Schafberg Renate , Parés-Casanova Pere Miquel , Jiménez-Manchón Sergio , Guintard Claude , Tekkouk Faiza , Ridouh Rania , Mureau Cyprien , Evin Allowen
Published: September 2023

Geometric morphometrics can effectively distinguish isolated third lower molars of present-day sheep and goat, but its applicability to archaeological specimens has yet to be established. Using a modern reference collection of 743 sheep and goats and a two-dimensional landmark-based geometric morphometric (GMM) protocol, this study aimed to morphometrically identify 109 archaeological specimens, used as case studies, dating from the Late Neolithic to the modern period/era. These morphometric identifications were then compared to molecular identifications via collagen peptide mass fingerprinting, known as Zooarcheology by Mass Spectrometry (ZooMS). ZooMS confirmed the morphometric identifications for 104 specimens, with the five misidentified specimens all morphometrically identified as goat. Modern sheep and goats have larger teeth and distinct shapes compared to their archaeological counterparts, suggesting strong differences between archaeological and modern specimens potentially linked with recent breed improvement or geographical origin of the specimens. In addition, for both species, some of the archaeological dental morphologies do not match with any of our modern references. This study validates the applicability of geometric morphometrics for identifying isolated archaeological sheep and goat teeth. It represents a stepping stone for future, non-destructive, bioarchaeological studies of the two species.
Reduced strength and increased variability of extinction selectivity during mass extinctions
Authors: Monarrez Pedro M. , Heim Noel A. , Payne Jonathan L.
Published: September 2023

Two of the traits most often observed to correlate with extinction risk in marine animals are geographical range and body size. However, the relative effects of these two traits on extinction risk have not been investigated systematically for either background times or during mass extinctions. To close this knowledge gap, we measure and compare extinction selectivity of geographical range and body size of genera within five classes of benthic marine animals across the Phanerozoic using capture–mark–recapture models. During background intervals, narrow geographical range is strongly associated with greater extinction probability, whereas smaller body size is more weakly associated with greater extinction probability. During mass extinctions, the association between geographical range and extinction probability is reduced in every class and fully eliminated in some, whereas the association between body size and extinction probability varies in strength and direction across classes. While geographical range is universally the stronger predictor of survival during background intervals, variation among classes during mass extinction suggests a fundamental shift in extinction processes during these global catastrophes.
Linguistic law-like compression strategies emerge to maximize coding efficiency in marmoset vocal communication
Authors: Risueno-Segovia Cristina , Dohmen Deniz , Gultekin Yasemin B. , Pomberger Thomas , Hage Steffen R.
Published: September 2023

Human language follows statistical regularities or linguistic laws. For instance, Zipf's law of brevity states that the more frequently a word is used, the shorter it tends to be. All human languages adhere to this word structure. However, it is unclear whether Zipf's law emerged de novo in humans or whether it also exists in the non-linguistic vocal systems of our primate ancestors. Using a vocal conditioning paradigm, we examined the capacity of marmoset monkeys to efficiently encode vocalizations. We observed that marmosets adopted vocal compression strategies at three levels: (i) increasing call rate, (ii) decreasing call duration and (iii) increasing the proportion of short calls. Our results demonstrate that marmosets, when able to freely choose what to vocalize, exhibit vocal statistical regularities consistent with Zipf's law of brevity that go beyond their context-specific natural vocal behaviour. This suggests that linguistic laws emerged in non-linguistic vocal systems in the primate lineage.
Fault logic and data-driven model for operation reliability analysis of the flap deflection angle
Authors: Liu Wan-Yi , Feng Yun-Wen , Teng Da , Lu Cheng , Chen Jun-Yu
Published: September 2023

To effectively perform the reliability analysis of the flap deflection angle, the reliability analysis framework is developed by introducing fault logic and a data-driven model. Herein, the fault logic analysis is used to study the fault mechanism and filter out the characteristic fault parameters that can be used to collect input data for data-driven modelling; the data-driven modelling is employed to establish a reliability analysis model with a small amount of input data. Under this proposed framework, the improved dung beetle optimization algorithm for back propagation (IDBO-BP) method is developed to perform the reliability modelling of the flap deflection angle. To validate the effectiveness of the proposed framework, we study the fault logic of flap symmetry and establish a surrogate model of flap deflection based on the fault parameters and the IDBO-BP algorithm. According to the predicted results of the flap deflection angle, the reliability model based on the fault mechanism can reflect the actual flap motion. At the same time, the proposed IDBO-BP algorithm has excellent modelling and simulation property by comparing with other optimization algorithms. Thus, the efforts of this study provide a new solution to the problem of reliable analysis with uncertain fault parameters.

This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 1)'.
A time variant uncertainty propagation method for high-dimensional dynamic structural system via K–L expansion and Bayesian deep neural network
Authors: Liu Jingfei , Jiang Chao , Liu Haibo , Li Guijie
Published: September 2023

In this paper, a time variant uncertainty propagation (TUP) method for dynamic structural system with high-dimensional input variables is proposed. Firstly, an arbitrary stochastic process simulation (ASPS) method based on Karhunen–Loève (K–L) expansion and numerical integration is developed, expressing the stochastic process as the combination of its marginal distributions and eigen functions at several discrete time points. Secondly, the iterative sorting method is implemented to the statistic samples of marginal distributions for matching the constraints of covariance function. Since marginal distributions are directly used to express the stochastic process, the proposed ASPS is suitable for stationary or non-stationary stochastic processes with arbitrary marginal distributions. Thirdly, the high-dimensional TUP problem is converted into several high-dimensional static uncertainty propagation (UP) problems after implementing ASPS. Then, the Bayesian deep neural network based UP method is used to compute the marginal distributions as well as the eigen functions of dynamic system response, the high-dimensional TUP problem can thus be solved. Finally, several numerical examples are used to validate the effectiveness of the proposed method.

This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 1)'.
Assessment of Potential Adverse Events Following the 2022–2023 Seasonal Influenza Vaccines Among U.S. Adults Aged 65 Years and Older
Authors: Shi Xiangyu (Chianti) , Gruber Joann F. , Ondari Michelle , Lloyd Patricia C. , Duenas Pablo Freyria , Clarke Tainya C. , Nadimpalli Gita , Cho Sylvia , Feinberg Laurie , Hu Mao , Chillarige Yoganand , Kelman Jeffrey A. , Forshee Richard A. , Anderson Steven A. , Shoaibi Azadeh
Published: September 2023

Background

While safety of influenza vaccines is well-established, some studies have suggested potential associations between influenza vaccines and certain adverse events (AEs). This study examined the safety of the 2022–2023 influenza vaccines among U.S. adults≥65 years.

Methods

A self-controlled case series compared incidence rates of anaphylaxis, encephalitis/encephalomyelitis, Guillain Barré-Syndrome (GBS), and transverse myelitis following 2022–2023 seasonal influenza vaccinations (i.e., any, high-dose or adjuvanted) in risk and control intervals among Medicare beneficiaries≥65 years. We used conditional Poisson regression to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) adjusted for event-dependent observation time, seasonality, and outcome misclassification. For AEs with any statistically significant associations, we stratified results by concomitant vaccination status.

Results

Among 12.7 million vaccine recipients, we observed 76 anaphylaxis, 276 encephalitis/encephalomyelitis, 134 GBS and 75 transverse myelitis cases. Only rates of anaphylaxis were elevated in risk compared to control intervals. With all adjustments, an elevated, but non-statistically significant, anaphylaxis rate was observed following any (IRR: 2.40, 95% CI: 0.96–6.03), high-dose (IRR: 2.31, 95% CI: 0.67–7.91), and adjuvanted (IRR: 3.28, 95% CI: 0.71–15.08) influenza vaccination; anaphylaxis IRRs were 2.54 (95% CI: 0.49–13.05) and 1.64 (95% CI: 0.38–7.05) for those with and without concomitant vaccination, respectively.

Conclusions

Rates of encephalitis/encephalomyelitis, GBS, or transverse myelitis were not elevated following 2022–2023 seasonal influenza vaccinations among U.S. adults≥65 years. There was an increased rate of anaphylaxis following influenza vaccination that may have been influenced by concomitant vaccination.
Factors associated with delayed umbilical cord clamping in public health facilities in Debremarkos town, northwest Ethiopia
Authors: Workineh Betel Bogale , Cherkose Endeshaw Admasu , Kassie Belayneh Ayanaw
Published: September 2023

Background

Delayed cord clamping is a proven intervention to improve both maternal and neonatal health and nutrition. World Health Organization recommends not clamping the umbilical cord before 1 minute of delivery. However, little is known about the timing of umbilical cord clamping, and associated factors in Ethiopia.

Objective

To assess the timing of umbilical cord clamping and associated factors among women who gave birth at public health institutions in Debremarkos town, 2022/23.

Methods

A facility-based cross-sectional study was conducted from December 01, 2022, to January 30, 2023, among women selected using systematic random sampling. Data was collected through observation and review of medical records using a checklist. The data was entered to Epi-data version 4.6.0.4 and analyzed by STATA 14. Descriptive statistics, bivariable and multivariable logistic regression models were fitted.

Result

A study of 388(91.73% response rate) women-newborn pairs found that 206(53.09%) newborns received delayed umbilical cord clamping, with mean and median clamping times of 67.87 ± 39.86 SD and 60s, respectively. In the multivariable analysis, giving birth at the hospital (AOR = 2.47, 95% CI: 1.21-5.03), attended by medical interns (AOR = 2.47, 95% CI: 1.29-5.41), receiving uterotonic for AMTSL at or after 60 seconds of giving birth (AOR = 10.36, 95% CI: 6.02-17.84), Rh-negative mothers (AOR = 3.91, 95% CI: 1.40-10.95), and multiparity (AOR = 0.54, 95% CI: 0.32-0.93) were significantly associated with delayed umbilical cord clamp.

Conclusion

In this study, half of the newborns had delayed umbilical cord clamping. However, the result is still unsatisfactory, as the recommendations for delayed cord clamping extend to all newborns who do not require intensive care. Therefore, considering the proven benefit of delayed umbilical cord clamping, obstetric care providers should adhere to clinical guidelines for this proven intervention.