bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent trends in the elucidation of complex triterpene biosynthetic pathways in horticultural trees
Authors: Dinday Sandeep
Published: October 2024

Triterpene (C30 isoprene compounds) represents the most structurally diverse class of natural products and has been extensively exploited in the food, medicine, and industrial sectors. Decades of research on medicinal triterpene biosynthetic pathways have revealed their roles in stress tolerance and shaping microbiota. However, the biological function and mechanism of triterpenes are not fully identified. Even this scientific window narrows down for horticultural trees. The lack of knowledge and a scalable production system limits the discovery of triterpene pathways. Recent synthetic biology research revealed several important biosynthetic pathways that define their roles and address many societal sustainability challenges. Here, I review the chemical diversity and biosynthetic enzymes involved in triterpene biosynthesis of horticultural trees. This review also outlines the integrated Design-Build-Test-Learn (DBTL) pipelines for the discovery, characterization, and optimization of triterpene biosynthetic pathways. Further, these DBTL components share many fundamental and technical difficulties, highlighting opportunities for interdisciplinary collaboration between researchers worldwide. This advancement opens up unprecedented opportunities for the bioengineering of triterpene compounds toward development and scaleup processes.
Statistically optimal firstorder algorithms: a proof via orthogonalization
Authors: Montanari Andrea , Wu Yuchen
Published: October 2024

We consider a class of statistical estimation problems in which we are given a random data matrix ${\boldsymbol{X}}\in{\mathbb{R}}^{n\times d}$ (and possibly some labels ${\boldsymbol{y}}\in{\mathbb{R}}^{n}$) and would like to estimate a coefficient vector ${\boldsymbol{\theta }}\in{\mathbb{R}}^{d}$ (or possibly a constant number of such vectors). Special cases include low-rank matrix estimation and regularized estimation in generalized linear models (e.g. sparse regression). Firstorder methods proceed by iteratively multiplying current estimates by ${\boldsymbol{X}}$ or its transpose. Examples include gradient descent or its accelerated variants. Under the assumption that the data matrix ${\boldsymbol{X}}$ is standard Gaussian, Celentano, Montanari, Wu (2020, Conference on Learning Theory, pp. 1078–1141. PMLR) proved that for any constant number of iterations (matrix vector multiplications), the optimal firstorder algorithm is a specific approximate message passing algorithm (known as ‘Bayes AMP’). The error of this estimator can be characterized in the high-dimensional asymptotics $n,d\to \infty $, $n/d\to \delta $, and provides a lower bound to the estimation error of any firstorder algorithm. Here we present a simpler proof of the same result, and generalize it to broader classes of data distributions and of firstorder algorithms, including algorithms with non-separable nonlinearities. Most importantly, the new proof is simpler, does not require to construct an equivalent tree-structured estimation problem, and is therefore susceptible of a broader range of applications.
Human Rights Promotion and Democratic Allies
Authors: Kudo Yasuki
Published: October 2024

Abstracts

Do military alliances promote human rights? Scholars and practitioners generally believe they do not because states form alliances largely to advance their strategic interests and thus are not interested in members' domestic policies. I claim that some states may care about their allies' human rights practices. Specifically, democracies are concerned that alliance relationships with rights-abusing governments harm their reputation, and thus urge their allies to improve human rights. However, this rights-promoting motivation is constrained because democracies also need to preserve alliance partnerships with governments that may rely on repression for their internal security. Empirical analyses of alliance relationships between democracies and autocracies provide support for this argument. Autocracies with a powerful democratic ally implement relatively advanced human rights protection; however, this association becomes weaker as the risk of domestic conflict becomes higher. These findings suggest the importance of considering democratic allies in the international promotion of human rights.
Perceptions and attitudes toward artificial intelligence among frontline physicians and physicians’ assistants in Kansas: a cross-sectional survey
Authors: Dean Tanner B , Seecheran Rajeev , Badgett Robert G , Zackula Rosey , Symons John
Published: October 2024

Objective

This survey aims to understand frontline healthcare professionals’ perceptions of artificial intelligence (AI) in healthcare and assess how AI familiarity influences these perceptions.

Materials and Methods

We conducted a survey from February to March 2023 of physicians and physician assistants registered with the Kansas State Board of Healing Arts. Participants rated their perceptions toward AI-related domains and constructs on a 5-point Likert scale, with higher scores indicating stronger agreement. Two sub-groups were created for analysis to assess the impact of participants’ familiarity and experience with AI on the survey results.

Results

From 532 respondents, key concerns were Perceived Communication Barriers (median = 4.0, IQR = 2.8-4.8), Unregulated Standards (median = 4.0, IQR = 3.6-4.8), and Liability Issues (median = 4.0, IQR = 3.5-4.8). Lower levels of agreement were noted for Trust in AI Mechanisms (median = 3.0, IQR = 2.2-3.4), Perceived Risks of AI (median = 3.2, IQR = 2.6-4.0), and Privacy Concerns (median = 3.3, IQR = 2.3-4.0). Positive correlations existed between Intention to use AI and Perceived Benefits (r = 0.825) and Trust in AI Mechanisms (r = 0.777). Perceived risk negatively correlated with Intention to Use AI (r = −0.718). There was no difference in perceptions between AI experienced and AI naïve subgroups.

Discussion

The findings suggest that perceptions of benefits, trust, risks, communication barriers, regulation, and liability issues influence healthcare professionals’ intention to use AI, regardless of their AI familiarity.

Conclusion

The study highlights key factors affecting AI adoption in healthcare from the frontline healthcare professionals’ perspective. These insights can guide strategies for successful AI implementation in healthcare.
Genomics of historical museum collections clarifies species diversity in Cuban hutias (Capromys)
Authors: Henriksen Rasmus Amund , Woods Roseina , Barnes Ian , Kennerley Rosalind J , Borroto-Páez Rafael , Brace Selina , Turvey Samuel T
Published: October 2024

Specimen-based taxonomic research is essential for understanding diversity and setting management frameworks for threatened mammal faunas, and ancient DNA techniques are increasingly used to extract information from taxonomically relevant historical specimens. The largest survivors of the depleted Caribbean mammal fauna are hutias in the genus Capromys, which is usually interpreted as containing a single species, C. pilorides. Previous studies have demonstrated genetic differentiation of Capromys populations across Cuba, but infrageneric species diversity and nomenclature remain unclear. We conducted ancient DNA analysis of historical Capromys samples using cytochrome b and complete mitogenome data sets, and including the 19th-century holotypes of 2 species now considered synonyms, C. fournieri and C. geayi. Our analyses identify distinct western and central/eastern Capromys clades that diverged 1.75 Mya based upon mitogenome data. These clades are separated by the Havana–Matanzas Channel, which represented a barrier to dispersal throughout the Neogene–Quaternary. Divergence date comparisons with other hutia species provide support for interpreting divergence between Capromys populations as species-level differentiation. Although we were unable to yield amplifiable DNA from the C. fournieri holotype, our analyses confidently assign the C. geayi holotype to the western Capromys clade. We therefore recognize 2 extant Capromys species: C. geayi (western Cuba) and C. pilorides (central/eastern Cuba and Cayman Islands).
Transcriptomic markers of biological aging in breast cancer survivors: a longitudinal study
Authors: Carroll Judith E , Crespi Catherine M , Cole Steve , Ganz Patricia A , Petersen Laura , Bower Julienne E
Published: October 2024

Background

The purpose of this study was to examine the impact of breast cancer therapy on biological aging as measured by expression of genes for cellular senescence (p16INK4a, SenMayo), DNA damage response, and proinflammatory senescence-associated secretory phenotype.

Methods

This longitudinal, observational study evaluated women diagnosed with breast cancer (stage 0-III) prior to radiation therapy (RT) and/or chemotherapy (CT) and at repeated visits out to 2 years. Peripheral blood mononuclear cell gene expression was assessed using RNA sequencing on quality-verified RNA. Longitudinal data were analyzed using mixed linear models and a zero-inflated 2-part model.

Results

Women (mean age = 55.5 years) receiving CT with or without RT (n = 73) had higher odds (odds ratio = 2.97, 95% confidence interval = 1.52 to 5.8) of having detectable p16INK4a following treatment compared with RT (n = 76) or surgery alone (n = 37). The proportion of women expressing 16INK4a over the follow-up period increased in all treatment groups (P < .001), with no interaction by treatment. All groups also increased over time in DNA damage response (P < .001), SenMayo (P < .001), and senescence-associated secretory phenotype (P < .001). Groups differed in the pattern of increase over time with statistically significant quadratic time by group differences for CT with or without RT compared with RT alone for DNA damage response (P = .05), SenMayo (P = .006), and the senescence-associated secretory phenotype (P = .02).

Conclusions

Results revealed activation of genes associated with biological aging in women with breast cancer from diagnosis through early survivorship, including DNA damage response, cell senescence, and the inflammatory secretome. Increases were evident across cancer treatments, although women receiving CT showed sustained increases, whereas RT exhibited slowing at later time points. Overall, findings suggest that women treated for breast cancer are aging within their immune cells.
Symbolic Communication and Cross-Domain Deterrence
Authors: Gurantz Ron
Published: October 2024

New military technologies in space and cyberspace have led to an interest in cross-domain deterrence, the threat of one type of attack to deter an attack of a different type. However, fundamental questions remain unanswered. Previous studies do not explain why threats often default to in-domain or “in-kind” retaliations or why cross-domain threats often lack credibility. In this article, I argue that “in-kind” retaliation is essentially a symbolic act. In its resemblance or relationship to the original attack, it communicates its purpose as a retaliation for that attack. I also argue that cross-domain threats can sometimes be imbued with the same symbolic meaning and be redefined as an “in-kind” response, and I explore mechanisms through which this can be done.
A dissipative extension to ideal hydrodynamics
Authors: Hatton Marcus John , Hawke Ian
Published: October 2024

We present a formulation of special relativistic dissipative hydrodynamics (SRDHD) derived from the well-established Müller–Israel–Stewart (MIS) formalism using an expansion in deviations from ideal behaviour. By re-summing the non-ideal terms, our approach extends the Euler equations of motion for an ideal fluid through a series of additional source terms that capture the effects of bulk viscosity, shear viscosity, and heat flux. For efficiency these additional terms are built from purely spatial derivatives of the primitive fluid variables. The series expansion is parametrized by the dissipation strength and time-scale coefficients, and is therefore rapidly convergent near the ideal limit. We show, using numerical simulations, that our model reproduces the dissipative fluid behaviour of other formulations. As our formulation is designed to avoid the numerical stiffness issues that arise in the traditional MIS formalism for fast relaxation time-scales, it is roughly an order of magnitude faster than standard methods near the ideal limit.
scATAcat: cell-type annotation for scATAC-seq data
Authors: Altay Aybuge , Vingron Martin
Published: October 2024

Cells whose accessibility landscape has been profiled with scATAC-seq cannot readily be annotated to a particular cell type. In fact, annotating cell-types in scATAC-seq data is a challenging task since, unlike in scRNA-seq data, we lack knowledge of ‘marker regions’ which could be used for cell-type annotation. Current annotation methods typically translate accessibility to expression space and rely on gene expression patterns. We propose a novel approach, scATAcat, that leverages characterized bulk ATAC-seq data as prototypes to annotate scATAC-seq data. To mitigate the inherent sparsity of single-cell data, we aggregate cells that belong to the same cluster and create pseudobulk. To demonstrate the feasibility of our approach we collected a number of datasets with respective annotations to quantify the results and evaluate performance for scATAcat. scATAcat is available as a python package at https://github.com/aybugealtay/scATAcat.
TrajectoryGeometry suggests cell fate decisions can involve branches rather than bifurcations
Authors: Laddach Anna , Pachnis Vassilis , Shapiro Michael
Published: October 2024

Differentiation of multipotential progenitor cells is a key process in the development of any multi-cellular organism and often continues throughout its life. It is often assumed that a bi-potential progenitor develops along a (relatively) straight trajectory until it reaches a decision point where the trajectory bifurcates. At this point one of two directions is chosen, each direction representing the unfolding of a new transcriptional programme. However, we have lacked quantitative means for testing this model. Accordingly, we have developed the R package TrajectoryGeometry. Applying this to published data we find several examples where, rather than bifurcate, developmental pathways branch. That is, the bipotential progenitor develops along a relatively straight trajectory leading to one of its potential fates. A second relatively straight trajectory branches off from this towards the other potential fate. In this sense only cells that branch off to follow the second trajectory make a ‘decision’. Our methods give precise descriptions of the genes and cellular pathways involved in these trajectories. We speculate that branching may be the more common behaviour and may have advantages from a control-theoretic viewpoint.
Burden of Illness Associated With Respiratory Syncytial Virus, Influenza, and Coronavirus Disease 2019 in Infants and Young Children in Ontario, Canada, 2018–2023: A Population-Based Canadian Immunization Research Network Study
Authors: Jorgensen Sarah C J , Hernandez Alejandro , Buchan Sarah A , Fitzpatrick Tiffany , Guttmann Astrid , Morris Shaun K , Kwong Jeffrey C
Published: October 2024

Background

As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transitions to endemicity and respiratory syncytial virus (RSV) and influenza reestablish their seasonal circulation patterns, understanding their comparative burden on infants and children can guide health system responses and funding priorities.

Methods

This was a population-based cohort study of children aged <5 years in Ontario, Canada, from September 2018 to August 2023 using linked health administrative databases.

Results

Seasonal cohorts comprised 731 838 to 763 660 children. RSV- and influenza-related hospital admission rates immediately decreased in March 2020. In 2021–2022, RSV-related admissions rebounded but remained 8%–11% lower than prepandemic seasons, whereas 2022–2023 RSV-related admissions increased 105%–113% versus prepandemic seasons and peak admissions occurred in November versus December. Influenza did not rebound until 2022–2023, when admissions were 28%–37% higher than prepandemic seasons. Coronavirus disease 2019 (COVID-19)–related admissions remained low until 2021–2022 and were lower than RSV-related admissions across all age groups during prepandemic and pandemic seasons. By contrast, 2021–2022 COVID-19-related admissions exceeded prepandemic influenza-related admissions by 30%–40% but decreased by 45% in 2022–2023 and were lower than prepandemic influenza-related admissions, except among infants aged <12 months who remained at highest risk. There was no distinct seasonal pattern for COVID-19–related admissions during the study.

Conclusions

RSV remains a major cause of childhood hospitalization. Although COVID-19 appears to be receding, its disease burden as it transitions to endemicity remains to be established. The unprecedented peaks in RSV-related hospital admissions during 2022–2023, together with the return of influenza and ongoing SARS-CoV-2 transmission, underscore the need to strengthen systems for real-time surveillance and to proactively prepare for critical healthcare scenarios.
Microphase iron particle growth promoted by solar wind implantation in lunar soils
Authors: Lu Xuejin , Chen Jian , Cao Haijun , Fu Xiaohui , Zeng Xiaojia , Qiao Le , Liu Chengbao , Zhang Guang , Zhang Peng , Ling Zongcheng
Published: October 2024

Lunar soils record the history and spectral changes resulting from the space-weathering process. The solar wind and micrometeoroids are the main space-weathering agents leading to darkening (decreasing albedo) and reddening (increasing reflectance with longer wavelength) of visible and near-infrared spectra. Nevertheless, their relative contributions are not well constrained and understood. In this study, we examine the near-infrared spectral variation as a function of lunar latitude and chemical composition using remote spectroscopic analysis of mare basalts and swirl regions. The results indicate that the reflectance of lunar mature soils darkens and the spectral slope flattens (reddening effect saturation) in areas of enhanced solar wind flux. We propose a previously unrecognized stage of space weathering (the post-mature stage), in which solar wind implantation may contribute to the growth and coarsening of metallic iron particles into larger microphase iron. This space-weathering mechanism is dominated by the solar wind and has important implications for understanding the alteration processes of airless bodies across our solar system.
T2 MRI visible perivascular spaces in Parkinson’s disease: clinical significance and association with polysomnography measured sleep
Authors: Meinhold Lena , Gennari Antonio G , Baumann-Vogel Heide , Werth Esther , Schreiner Simon J , Ineichen Christian , Baumann Christian R , O’Gorman Tuura Ruth
Published: October 2024

Poor sleep quality might contribute to the risk and progression of neurodegenerative disorders via deficient cerebral waste clearance functions during sleep. In this retrospective cross-sectional study, we explore the link between enlarged perivascular spaces (PVS), a putative marker of sleep-dependent glymphatic clearance, with sleep quality and motor symptoms in patients with Parkinson’s disease (PD). T2-weighted magnetic resonance imaging (MRI) images of 20 patients and 17 healthy control participants were estimated visually for PVS in the basal ganglia (BG) and centrum semiovale (CSO). The patient group additionally underwent a single-night polysomnography. Readouts included polysomnographic sleep features and slow-wave activity (SWA), a quantitative EEG marker of sleep depth. Associations between PVS counts, PD symptoms (MDS-UPDRS scores), and sleep parameters were evaluated using correlation and regression analyses. Intra- and inter-rater reproducibility was assessed with weighted Cohen`s kappa coefficient. BG and CSO PVS counts in both patients and controls did not differ significantly between groups. In patients, PVS in both brain regions was negatively associated with SWA (1–2 Hz; BG: r(15) = −.58, padj = .015 and CSO: r(15) = −.6, padj = .015). Basal ganglia PVS counts were positively associated with motor symptoms of daily living (IRR = 1.05, CI [1.01, 1.09], p = .007, padj = .026) and antidepressant use (IRR = 1.37, CI [1.05, 1.80], p = .021, padj = .043) after controlling for age. Centrum Semiovale PVS counts in patients were positively associated with a diagnosis of REM sleep behavior disorder (IRR = 1.39, CI [1.06, 1.84], p = .018, padj = .11). These results add to evidence that sleep deterioration may play a role in impairing glymphatic clearance via altered perivascular function, potentially contributing to disease severity in PD patients.
Selective depletion of kisspeptin neurons in the hypothalamic arcuate nucleus in early juvenile life reduces pubertal LH secretion and delays puberty onset in mice
Authors: Coutinho Eulalia A. , Esparza Lourdes A. , Steffen Paige H. , Liaw Reanna , Bolleddu Shreyana , Kauffman Alexander S.
Published: October 2024

Puberty is the critical developmental transition to reproductive capability driven by the activation of gonadotropin‐releasing hormone (GnRH) neurons. The complex neural mechanisms underlying pubertal activation of GnRH secretion still remain unknown, yet likely include kisspeptin neurons. However, kisspeptin neurons reside in several hypothalamic areas and the specific kisspeptin population timing pubertal onset remains undetermined. To investigate this, we strategically capitalized on the differential ontological expression of the Kiss1 gene in different hypothalamic nuclei to selectively ablate just arcuate kisspeptin neurons (aka KNDy neurons) during the early juvenile period, well before puberty, while sparing RP3V kisspeptin neurons. Both male and female transgenic mice with a majority of their KNDy neurons ablated (KNDyABL) by diphtheria toxin treatment in juvenile life demonstrated significantly delayed puberty onset and lower peripubertal LH secretion than controls. In adulthood, KNDyABL mice demonstrated normal in vivo LH pulse frequency with lower basal and peak LH levels, suggesting that only a small subset of KNDy neurons is sufficient for normal GnRH pulse timing but more KNDy cells are needed to secrete normal LH concentrations. Unlike prior KNDy ablation studies in rats, there was no alteration in the occurrence or magnitude of estradiol‐induced LH surges in KNDyABL female mice, indicating that a complete KNDy neuronal population is not essential for normal LH surge generation. This study teases apart the contributions of different kisspeptin neural populations to the control of puberty onset, demonstrating that a majority of KNDy neurons in the arcuate nucleus are necessary for the proper timing of puberty in both sexes.
Targeting KRAS in gynecological malignancies
Authors: Peng Yuanyuan , Yang Qing
Published: October 2024

Cervical, endometrial, and ovarian cancers stand prominently as the leading gynecological malignancies of the female reproductive system. The conventional therapeutic modalities for gynecological malignancies have predominantly encompassed surgery, chemotherapy, and radiotherapy. However, efficacy of these approaches remains limited in cases of relapse or drug resistance. KRAS is one of the most frequently mutated oncogenes in human cancers. The KRAS gene encodes a small guanosine triphosphatase protein that acts as a molecular switch for crucial intracellular signaling pathways. KRAS mutations are deeply involved in the occurrence and development of gynecological malignancies. The present review aims to expound upon the role of oncogenic KRAS as a biomarker, elucidating various therapeutic approaches under investigation targeting the KRAS pathway in gynecological tumors.
Masking Effects Caused by Contralateral Distractors in Participants With Versus Without Listening Difficulties
Authors: Kawase Tetsuaki , Obuchi Chie , Suzuki Jun , Katori Yukio , Sakamoto Shuichi
Published: October 2024

Objectives:

To examine the effects of distractor sounds presented to the contralateral ear on speech intelligibility in patients with listening difficulties without apparent peripheral pathology and in control participants.

Design:

This study examined and analyzed 15 control participants (age range, 22 to 30 years) without any complaints of listening difficulties and 15 patients (age range, 15 to 33 years) diagnosed as having listening difficulties without apparent peripheral pathology in the outpatient clinic of the Department of Otolaryngology-Head and Neck Surgery, Tohoku University Hospital. Speech intelligibility for 50 Japanese monosyllables presented to the right ear was examined under the following three different conditions: “without contralateral sound,” “with continuous white noise in the contralateral ear,” and “with music stimuli in the contralateral ear.”

Results:

The results indicated the following: (1) speech intelligibility was significantly worse in the patient group with contralateral music stimuli and noise stimuli; (2) speech intelligibility was significantly worse with contralateral music stimuli than with contralateral noise stimuli in the patient group; (3) there was no significant difference in speech intelligibility among three contralateral masking conditions (without contra-stimuli, with contra-noise, and with contra-music) in the control group, although average and median values of speech intelligibility tended to be worse with contralateral music stimuli than without contralateral stimuli.

Conclusions:

Significantly larger masking effects due to a contralateral distractor sound observed in patients with listening difficulties without apparent peripheral pathology may suggest the possible involvement of masking mechanisms other than the energetic masking mechanism occurring in the periphery in these patients. In addition, it was also shown that the masking effect is more pronounced with real environmental sounds, that is, music with lyrics, than with continuous steady noise, which is often used as a masker for speech-in-noise testing in clinical trials. In other words, it should be noted that a speech-in-noise test using such steady noise may underestimate the degree of listening problems of patients with listening difficulties in their daily lives, and a speech-in-noise test using a masker such as music and/or speech sounds could make listening problems more obvious in patients with listening difficulties.
The Effect of Night-time versus Full-time Bracing on the Sagittal Profile in Adolescent Idiopathic Scoliosis
Authors: Heegaard Martin , Ragborg Lærke , McIntosh Amy L. , Johnson Megan E. , Gehrchen Martin , Sucato Daniel J , Dahl Benny , Ohrt-Nissen Søren
Published: October 2024

Study Design.

Retrospective multicenter cohort study

Objective.

To investigate the impact of night-time bracing (NTB) and full-time bracing (FTB) on the sagittal profile in adolescent idiopathic scoliosis (AIS) patients.

Summary of background data.

Recent studies have shown that FTB in AIS patients may induce hypokyphosis. Whether this effect differs between NTB and FTB is unknown.

Methods.

We included skeletally immature AIS patients with main curves ranging from 20-45° treated with either NTB or FTB. The two cohorts were propensity-score matched on Risser stage, age, major curve size, and kyphosis at brace initiation. Coronal and sagittal radiographic parameters were gathered at the initiation and completion of brace treatment.

Results.

Two-hundred fifty-seven patients were eligible for inclusion. The matched cohorts included 62 patients in each group. During bracing, the thoracic kyphosis increased from 31±11° to 35±13° in the NTB group compared to a decrease from 30±12° to 28±13° in the FTB group (P=0.011). Eight percent were hypokyphotic (<20°) after bracing in the NTB group compared to 24% in the FTB group (P=0.015). Pelvic incidence, sacral slope, and pelvic tilt were not significantly different between the groups. In the coronal plane, curve progression >50° was seen in 50% in the NTB group and 31% in FTB (P=0.028).

Conclusion.

We saw a small increase in thoracic kyphosis in the NTB group vs. a small decrease in the FTB group. Eight percent in the NTB group vs 24% in the FTB group showed substantial hypokyphosis after bracing. The impact of minor changes in thoracic kyphosis remains uncertain; however, a threefold difference in the occurrence of hypokyphosis is notable and merits further attention.
New Assessment Method for Upper Limb Function in Patients With Cervical Spondylotic Myelopathy
Authors: Yamada Shohei , Izumi Teiyu , Inokuchi Akihiko , Hamada Takahiro , Imamura Ryuta , Nakamura Kimitaka , Shirasaki Keigo , Yamashita Michinaga , Imasato Yusuke , Tsukahara Kohei , Watanabe Yutaka , Terada Kazumasa , Arizono Takeshi
Published: October 2024

Study Design.

Retrospective cohort study.

Objective.

Although there are several methods available to assess upper limb function in patients with cervical spondylotic myelopathy, few methods can evaluate the degree of upper limb functional impairment in activities of daily living.

Summary of Background Data.

We devised and evaluated the utility of a new assessment method called the 10 Coins Test, which is based on daily movements.

Materials and Methods.

The study included 39 patients who underwent spinal surgery for cervical spondylotic myelopathy and who were followed up for 1 year postoperatively. The mean age was 65.2±11.5 years, with 31 (79.5%) male and 8 (20.5%) female patients. The 10 Coins Test is a simple examination that measures the time it takes to pick up and move 10 coins forward. Patient satisfaction with surgery was evaluated on a 5-point scale. We compared the 10 Coins Test results, patient satisfaction, and Japanese Orthopaedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ) results before and after surgery.

Results.

The mean time to perform the 10 Coins Test was 27.4 seconds for the dominant hand and 24.5 seconds for the nondominant hand preoperatively. In the control group, the average time was 14.6 seconds for the dominant hand and 15.0 seconds for the nondominant hand. The cut-off value was 16.2 seconds. There was a significant difference in the 10 Coins Test time and satisfaction for both hands at 1 week postoperatively compared with preoperatively. The JOACMEQ upper limb motor function showed a significant improvement 3 months postoperatively compared with preoperatively. The 10 Coins Test result was correlated with satisfaction and the JOACMEQ upper limb motor function.

Conclusion.

The 10 Coins Test allows for the quantitative evaluation of complex movements. It is convenient and highly useful for assessing upper limb function in patients with cervical spondylotic myelopathy.
Evaluating the positive predictive value of code-based identification of cirrhosis and its complications utilizing GPT-4
Authors: Far Aryana T. , Bastani Asal , Lee Albert , Gologorskaya Oksana , Huang Chiung-Yu , Pletcher Mark J. , Lai Jennifer C. , Ge Jin
Published: October 2024

Background and Aims:

Diagnosis code classification is a common method for cohort identification in cirrhosis research, but it is often inaccurate and augmented by labor-intensive chart review. Natural language processing using large language models (LLMs) is a potentially more accurate method. To assess LLMs’ potential for cirrhosis cohort identification, we compared code-based versus LLM-based classification with chart review as a “gold standard.”

Approach and Results:

We extracted and conducted a limited chart review of 3788 discharge summaries of cirrhosis admissions. We engineered zero-shot prompts using a Generative Pre-trained Transformer 4 to determine whether cirrhosis and its complications were active hospitalization problems. We calculated positive predictive values (PPVs) of LLM-based classification versus limited chart review and PPVs of code-based versus LLM-based classification as a “silver standard” in all 3788 summaries. Compared to gold standard chart review, code-based classification achieved PPVs of 82.2% for identifying cirrhosis, 41.7% for HE, 72.8% for ascites, 59.8% for gastrointestinal bleeding, and 48.8% for spontaneous bacterial peritonitis. Compared to the chart review, Generative Pre-trained Transformer 4 achieved 87.8%–98.8% accuracies for identifying cirrhosis and its complications. Using LLM as a silver standard, code-based classification achieved PPVs of 79.8% for identifying cirrhosis, 53.9% for HE, 55.3% for ascites, 67.6% for gastrointestinal bleeding, and 65.5% for spontaneous bacterial peritonitis.

Conclusions:

LLM-based classification was highly accurate versus manual chart review in identifying cirrhosis and its complications. This allowed us to assess the performance of code-based classification at scale using LLMs as a silver standard. These results suggest LLMs could augment or replace code-based cohort classification and raise questions regarding the necessity of chart review.
Umbilical Amniotic Tissue Graft as an Alternative Approach for Eyelid Reconstruction After Necrotizing Fasciitis Debridement
Authors: Mirzania Delaram , Zhao Zhenyang , Kim Denise S. , Aakalu Vinay K. , Nelson Christine C.
Published: October 2024

A 54-year-old female with myelodysplastic syndrome on chemotherapy presented with 10 days of periocular erythema and edema worsening on oral antibiotics. Computed Tomography scan showed periorbital soft tissue swelling without postseptal extension or abscess. Intravenous broad-spectrum antibiotics were administered. However, she developed necrosis of the upper eyelid requiring aggressive debridement. Nine days after debridement, the defect measuring 5.5 × 3 cm was covered using an umbilical amniotic tissue graft (AmnioGuard, BioTissue, Miami, FL). At postoperative week 4, 5-fluorouracil was injected to prevent the shortening of anterior lamella. At postoperative week 20, the graft had dissolved and been replaced by regenerated skin. Final eyelid exam demonstrated normal eyelid elevation and minimal lagophthalmos. Herein, we present a case of umbilical amniotic membrane as a substrate graft to support the healing of the eyelid defect by secondary intention.
Thickness of the Orbital Septum in Comparison to Periorbita and Periosteum
Authors: Kakizaki Hirohiko , Vaidya Aric , Naito Munekazu , Takahashi Yasuhiro
Published: October 2024

Purpose:

To examine the thickness of the orbital septum in comparison to that of the periorbita and the periosteum of the frontal bone.

Methods:

Histological evaluation of 11 tissues around the upper arcus marginalis, including the orbital septum, periorbita, and periosteum of the frontal bone (5 right, 6 left) from 11 Japanese cadavers (age range: 63–91-year-old, average: 77.1, male: 5 cases and female: 6 cases) was performed. The specimens were fixed in 10% formalin and stained with Masson’s trichrome. The thickness was measured at the 2 mm points from the center of the merging area of these 3 tissues (arcus marginalis). Statistical analyses in 3 groups were performed first with a one-way ANOVA and then with Tukey’s multiple comparison test. Differences in ages or sexes were compared with the Mann–Whitney U test. The significance level was set at 0.05.

Results:

The orbital septum showed similar thickness with the periosteum of the frontal bone (p = 0.784), but was thicker than the periorbita (p = 0.021). The periosteum of the frontal bone was found to be thicker than the periorbita (p = 0.004). Differences between ages (p = 0.315) or sexes (p = 0.126) did not show statistical significance.

Conclusion:

The thickness of the orbital septum was similar to the periosteum of the frontal bone, but was thicker than the periorbita at the 2 mm points from the center of the arcus marginalis. These showed some variation in each case, though. Ages or sexes did not influence the septum thickness after 60 years of age.
Occupational Electronic Health Records
Authors: Fazen Louis E. , Martin Bill E. , Isakari Marcia , Kowalski-McGraw Michele , McLellan Robert K. , Ahsan Raj , Berenji Manijeh
Published: October 2024

Objective

Occupational and environmental medicine (OEM) clinicians require specialized electronic health records (EHRs) to address the privacy, data governance, interoperability, and medical surveillance concerns that are specific to occupational health.

Methods

The American College of Occupational and Environmental Medicine (ACOEM) Section of Health Informatics evaluated clinical workflow concerns, assessed health information requirements, and developed informatics recommendations through iterative consultation with ACOEM members.

Results

The ACOEM presents 10 recommendations that specialized occupational EHR systems (OEHRs) should meet to serve the information needs and practice requirements of OEM clinicians. Common challenges in OEM practice and potential informatics solutions are used to illustrate each recommendation.

Conclusions

The recommendations serve as a framework for occupational health clinicians to consider in their adoption of OEHRs and provide software engineers a set of requirements to facilitate the development and improvement of OEHRs.
Mapping the scientific landscape and evolution of the International Journal of Surgery: a scientometric analysis (2004–2024)
Authors: Li Chong , Hu Jing , He Anqi , He Chengqi , Zhuang Weihua
Published: October 2024

Aim:

The purpose of this study was to analyze the publication characteristics and development of the International Journal of Surgery (IJS) over its 20-year history.

Methods:

This study included articles published in IJS during the 20 years from 2004 to 2024. The data were analyzed using the Citespace, VOS viewer, and the ‘Bibliometrix’ package in R software. The authors studied the dynamics and trend patterns of IJS literature production through descriptive bibliometrics and identified the most prolific authors, publications, institutions, and countries. Bibliometric maps were utilized to visualize published articles’ content and identify the most prolific research terms and topics in IJS, as well as their evolution over time.

Results:

A total of 5964 publications in the IJS from 2004 to 2023 and 356 publications in 2024 were included in the analysis. The study revealed a positive trend in literature production, although the number of articles published in IJS has slightly decreased recently. The most productive country was China (n=1211), the most productive institution was Sichuan University (n=151), and the most prolific author was Wang Yang (n=87). The top 15 most cited articles focus primarily on research reporting standard guidelines for surgical studies. Research published in IJS mainly targeted middle-aged and older adults, emphasizing postoperative complications and treatment outcomes. The future research focus in IJS might center on integrating artificial intelligence and deep learning technologies to revolutionize surgical research and practice.

Conclusions:

The International Journal of Surgery significantly contributes to advances in surgical research. IJS prioritized enhancing patient outcomes and advancing surgical techniques, focusing on middle-aged and older adults, postoperative complications, and treatment outcomes. The journal emphasized robust evidence through retrospective, controlled, and cohort surgical studies. Integrating artificial intelligence and deep learning represented a significant frontier poised to revolutionize surgical care, shaping the future landscape of research and practice.
Innovative approaches in stem cell therapy: revolutionizing cancer treatment and advancing neurobiology – a comprehensive review
Authors: Banerjee Dhrupad , Bhattacharya Arghya , Puri Abhijeet , Munde Shubham , Mukerjee Nobendu , Mohite Popat , Kazmi Syeda W. , Sharma Abhishek , Alqahtani Taha , Shmrany Humood Al
Published: October 2024

Stem cell therapy represents a transformative frontier in medical science, offering promising avenues for revolutionizing cancer treatment and advancing our understanding of neurobiology. This review explores innovative approaches in stem cell therapy that have the potential to reshape clinical practices and therapeutic outcomes in cancer and neurodegenerative diseases. In this dynamic and intriguing realm of cancer research, recent years witnessed a surge in attention toward understanding the intricate role of mesenchymal stem cells (MSCs). These cells, capable of either suppressing or promoting tumors across diverse experimental models, have been a focal point in the exploration of exosome-based therapies. Exosomes released by MSCs have played a pivotal role, in unraveling the nuances of paracrine signaling and its profound impact on cancer development. Recent studies have revealed the complex nature of MSC-derived exosomes, showcasing both protumor and antitumor effects. Despite their multifaceted involvement in tumor growth, these exosomes show significant promise in influencing both tumor development and chemosensitivity, acting as a pivotal factor that increases stem cells’ potential for medicinal use. Endogenous MSCs, primarily originating from the bone marrow, exhibited a unique migratory response to damaged tissue sites. The genetic modification of stem cells, including MSCs, opened avenues for the precise delivery of therapeutic payloads in the milieu around the tumor (TME). Stem cell therapy offers groundbreaking potential for treating neurodegenerative and autoimmune disorders by regenerating damaged tissues and modulating immune responses. This approach aims to restore lost function and promote healing through targeted cellular interventions. In this review, we explored the molecular complexities of cancer and the potential for breakthroughs in personalized and targeted therapies. This analysis offers hope for transformative advancements in both cancer treatment and neurodegenerative disorders, highlighting the promise of precision medicine in addressing these challenging conditions.
New drugs on the horizon for acute kidney injury
Authors: Mourisse Louis , Pickkers Peter
Published: October 2024

Purpose of review

Acute kidney injury (AKI) is a frequent and serious complication in critically ill patients. Currently, no effective therapy to prevent or treat AKI is available. This review highlights recently published developments on pharmacological treatments that aim to prevent AKI or to alleviate the severity of AKI in critical ill patients.

Recent findings

Studies on pharmacological interventions aimed to improve hemodynamics, renal perfusion, to mediate inflammation-associated renal damage and to reduce oxidative stress are presented, including several observational studies and randomized trials focused on the potential renal protective effects in relevant patient populations. Different existing and novel compounds are being investigated for the effects on renal endpoints and several show potential to prevent or alleviate the occurrence of AKI. It is now ac

knowledged that different underlying pathophysiological processes are relevant in the development of AKI. Recognition of these sub-endotypes of AKI and knowledge of the therapeutic target of different compounds is of paramount importance to select the right patient for the right treatment at the right time.

The discovery of reno-protective therapies is hampered by the timely detection and recognition of the overriding mechanism of AKI. Nevertheless, several compounds are under investigation, which hold promise for a future treatment.
Gaps in HIV Pre-exposure Prophylaxis Acceptance: Findings from an Outpatient HIV Testing Service in Italy
Authors: Raccagni Angelo Roberto , Passini Flavia , Diotallevi Sara , Lolatto Riccardo , Bruzzesi Elena , Piromalli Girolamo , Candela Caterina , Castagna Antonella , Nozza Silvia
Published: October 2024

Background:

The aim of this study is to assess the acceptability of HIV pre-exposure prophylaxis (PrEP) among individuals eligible for prophylaxis.

Setting:

Retrospective study of individuals receiving their first HIV test at the Infectious Diseases Unit of IRCCS San Raffaele Scientific Institute, Milan, Italy.

Methods:

People i) who received their first HIV test (baseline date) between January 2018 (availability of PrEP in Italy) and December 2023 (data lock), ii) with an indication for PrEP based on condomless sex were included; those already on PrEP were excluded. Individuals with a negative HIV test result were offered PrEP counselling and prescription according to guidelines. Characteristics of people who accepted or declined HIV PrEP were compared using Mann-Whitney or Chi-square tests, as appropriate.

Results:

A total of 2627 people were tested for HIV: 175 (6.6%) were diagnosed with HIV. Of the 2452 people with negative HIV test results, 2165 (88.3%) were men; median age was 34.3 years (interquartile range, IQR=28.7-42.4). Sexually transmitted infections (STIs) were detected in 478/2452 (19.5%), most commonly gonorrhoea (206/2452, 8.4%). Overall, 982/2452 (40.0%) people accepted PrEP, including only three women. Non-acceptance was higher among women (p<0.001) and non-Caucasians (p<0.001). Of those who did not accept PrEP, 260 (17.7%) were diagnosed with at least one STI at the time of HIV testing.

Conclusion:

Low PrEP acceptance was observed, particularly among women and people of non-Caucasian origin. Non-acceptance of PrEP was also observed among individuals diagnosed with an STI.
Assessing Use and Familiarity of Enhanced Recovery After Surgery Elements in Pediatric Orthognathic Surgery
Authors: Vallurupalli Medha , Fligor Jennifer , Shah Nikhil D. , Pham Lee , Pfaff Miles J. , Vyas Raj M.
Published: October 2024

Enhanced recovery after surgery (ERAS) protocols have informed perioperative care across multiple surgical specialties, optimizing patient outcomes through surgical stress management and accelerated recovery. This study evaluates the familiarity and adoption of ERAS elements among craniofacial and oral and maxillofacial surgeons in pediatric orthognathic surgery, a field where a formal ERAS protocol has not been established. A closed-ended survey of 102 surgeons was conducted to assess familiarity with and utilization of 14 ERAS elements. The survey garnered a 40.2% response rate, with 41 surgeons participating. The majority of respondents (68.3%) specialized in craniofacial (CF) surgery, and their annual pediatric orthognathic surgery caseload varied widely. Key findings revealed that 7 ERAS elements were widely adopted, including hypothermia prevention, normovolemia maintenance, intraoperative tranexamic acid use, and minimized opioid use for postoperative pain control. However, elements such as liposomal bupivacaine and postoperative goal-directed fluid therapy were less utilized, primarily due to limited availability or knowledge. Surgeons demonstrated high familiarity with elements like jaw immobilization and minimizing opioid use but showed knowledge gaps in areas such as preoperative nutritional screening and goal-directed fluid therapy. These insights underline the need for further education and the development of a standardized ERAS protocol tailored for pediatric orthognathic surgery. The study underscores the importance of multidisciplinary collaboration and comprehensive preoperative education in implementing ERAS protocols. This study serves as a foundation for future research into optimizing perioperative care for pediatric patients undergoing orthognathic surgery.