bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional modulation of lysophosphatidic acid type 2 G‐protein coupled receptor facilitates alveolar bone formation
Authors: Kim Tae‐Young , Kim Anna , Aryal Yam Prasad , Sung Shijin , Pokharel Elina , Neupane Sanjiv , Choi So‐Young , Ha Jung‐Hong , Jung Jae‐Kwang , Yamamoto Hitoshi , An Chang‐Hyeon , Suh Jo‐Young , Sohn Wern‐Joo , Lee Youngkyun , Jang Il‐Ho , Norman Derek D. , Tigyi Gabor J. , An Seo‐Young , Kim Jae‐Young
Published: December 2023

Lipid biosynthesis is recently studied its functions in a range of cellular physiology including differentiation and regeneration. However, it still remains to be elucidated in its precise function. To reveal this, we evaluated the roles of lysophosphatidic acid (LPA) signaling in alveolar bone formation using the LPA type 2 receptor (LPAR2) antagonist AMG‐35 (Amgen Compound 35) using tooth loss without periodontal disease model which would be caused by trauma and usually requires a dental implant to restore masticatory function. In this study, in vitro cell culture experiments in osteoblasts and periodontal ligament fibroblasts revealed cell type‐specific responses, with AMG‐35 modulating osteogenic differentiation in osteoblasts in vitro. To confirm the in vivo results, we employed a mouse model of tooth loss without periodontal disease. Five to 10 days after tooth extraction, AMG‐35 facilitated bone formation in the tooth root socket as measured by immunohistochemistry for differentiation markers KI67, Osteocalcin, Periostin, RUNX2, transforming growth factor beta 1 (TGF‐β1) and SMAD2/3. The increased expression and the localization of these proteins suggest that AMG‐35 elicits osteoblast differentiation through TGF‐β1 and SMAD2/3 signaling. These results indicate that LPAR2/TGF‐β1/SMAD2/3 represents a new signaling pathway in alveolar bone formation and that local application of AMG‐35 in traumatic tooth loss can be used to facilitate bone regeneration and healing for further clinical treatment.
Extracellular matrix viscoelasticity regulates TGFβ1‐induced epithelial‐mesenchymal transition and apoptosis via integrin linked kinase
Authors: Sacco Jessica L. , Vaneman Zachary T. , Gomez Esther W.
Published: December 2023

Transforming growth factor (TGF)‐β1 is a multifunctional cytokine that plays important roles in health and disease. Previous studies have revealed that TGFβ1 activation, signaling, and downstream cell responses including epithelial‐mesenchymal transition (EMT) and apoptosis are regulated by the elasticity or stiffness of the extracellular matrix. However, tissues within the body are not purely elastic, rather they are viscoelastic. How matrix viscoelasticity impacts cell fate decisions downstream of TGFβ1 remains unknown. Here, we synthesized polyacrylamide hydrogels that mimic the viscoelastic properties of breast tumor tissue. We found that increasing matrix viscous dissipation reduces TGFβ1‐induced cell spreading, F‐actin stress fiber formation, and EMT‐associated gene expression changes, and promotes TGFβ1‐induced apoptosis in mammary epithelial cells. Furthermore, TGFβ1‐induced expression of integrin linked kinase (ILK) and colocalization of ILK with vinculin at cell adhesions is attenuated in mammary epithelial cells cultured on viscoelastic substrata in comparison to cells cultured on nearly elastic substrata. Overexpression of ILK promotes TGFβ1‐induced EMT and reduces apoptosis in cells cultured on viscoelastic substrata, suggesting that ILK plays an important role in regulating cell fate downstream of TGFβ1 in response to matrix viscoelasticity.
AdipoRon reduces TGFβ1‐mediated collagen deposition in vitro and alleviates knee stiffness in vivo
Authors: Dudakovic Amel , Limberg Afton K. , Bothun Cole E. , Dilger Oliver B. , Bayram Banu , Bettencourt Jacob W. , Salmons Harold I. , Thaler Roman , Karczewski Daniel C. , Owen Aaron R. , Iyer Varun G. , Payne Ashley N. , Carstens Mason F. , van Wijnen Andre J. , Berry Daniel J. , Sanchez‐Sotelo Joaquin , Morrey Mark E. , Abdel Matthew P.
Published: December 2023

Arthrofibrosis, which causes joint motion restrictions, is a common complication following total knee arthroplasty (TKA). Key features associated with arthrofibrosis include myofibroblast activation, knee stiffness, and excessive scar tissue formation. We previously demonstrated that adiponectin levels are suppressed within the knee tissues of patients affected by arthrofibrosis and showed that AdipoRon, an adiponectin receptor agonist, exhibited anti‐fibrotic properties in human mesenchymal stem cells. In this study, the therapeutic potential of AdipoRon was evaluated on TGFβ1‐mediated myofibroblast differentiation of primary human knee fibroblasts and in a mouse model of knee stiffness. Picrosirius red staining revealed that AdipoRon reduced TGFβ1‐induced collagen deposition in primary knee fibroblasts derived from patients undergoing primary TKA and revision TKA for arthrofibrosis. AdipoRon also reduced mRNA and protein levels of ACTA2, a key myofibroblast marker. RNA‐seq analysis corroborated the anti‐myofibrogenic effects of AdipoRon. In our knee stiffness mouse model, 6 weeks of knee immobilization, to induce a knee contracture, in conjunction with daily vehicle (DMSO) or AdipoRon (1, 5, and 25 mg/kg) via intraperitoneal injections were well tolerated based on animal behavior and weight measurements. Biomechanical testing demonstrated that passive extension angles (PEAs) of experimental knees were similar between vehicle and AdipoRon treatment groups in mice evaluated immediately following immobilization. Interestingly, relative to vehicle‐treated mice, 5 mg/kg AdipoRon therapy improved the PEA of the experimental knees in mice that underwent 4 weeks of knee remobilization following the immobilization and therapy. Together, these studies revealed that AdipoRon may be an effective therapeutic modality for arthrofibrosis.
Problematic mobile phone use as impulsive choice: Development and empirical verification of a reinforcer‐pathology model
Authors: Hayashi Yusuke
Published: December 2023

Problematic mobile phone use is characterized by its “impulsive” nature; users engage in it despite their negative attitude toward it. From a behavioral‐economic perspective, this attitude–behavior discrepancy is generated by competing contingencies that involve smaller‐sooner social reinforcers associated with mobile phone use and larger‐later prosocial reinforcers potentially compromised by phone use. Based on this conceptualization, the reinforcer‐pathology model of problematic mobile phone use is proposed, which posits that such phone use stems from excessive delay discounting of the social and prosocial reinforcers and/or excessive demand for the social reinforcers. A secondary data analysis of previously published studies was conducted, with the novel addition of principal component analysis and hierarchical cluster analysis of these data. The results generated evidence that supports the reinforcer‐pathology model proposed in this article. Based on the theoretical analyses and accumulated empirical evidence, theory‐driven prevention and intervention strategies for problematic mobile phone use are proposed. Overall, the reinforcer‐pathology model of problematic mobile phone use provides a comprehensive framework for understanding and addressing this growing issue.
Questionnaire survey of Japanese board‐certified expert hepatobiliary and pancreatic surgeons and instructors on the surgical indications for hepatocellular carcinoma
Authors: Akahoshi Keiichi , Shindoh Junichi , Tanabe Minoru , Watanabe Shuichi , Takamizawa Hayato , Eguchi Susumu , Endo Itaru , Kubo Shoji , Taketomi Akinobu , Nagano Hiroaki , Nakamura Masafumi , Hasegawa Kiyoshi , Hatano Etsuro , Yoshizumi Tomoharu , Kokudo Norihiro
Published: December 2023

Background

Recent advancements in systemic therapy for hepatocellular carcinoma (HCC) necessitate the establishment of resectability criteria for advanced HCC.

Methods

A questionnaire survey sought to clarify the perspectives of Japanese expert hepatobiliary surgeons regarding surgical indications for HCC. Thirty‐one questions were used to determine when surgery is strongly recommended (resectable: R) or not recommended (unresectable: UR).

Results

A total of 351 responses were obtained. While 64.7% of the respondents considered solitary tumors as being R, irrespective of size, opinions diverged on the upper limit of the number of tumors/tumor size for R: (1) up to three nodules with no size limit (27.9%), (2) up to three nodules ≤5 cm in diameter each (21.4%) and (3) up to three nodules ≤3 cm in diameter each (19.4%). Vp1, Vp2, Vp3, and Vp4 were considered as being R by 90.9%, 70.7%, 39.0%, and 8.0% of respondents, respectively. Half of the respondents indicated they would consider resection even for cases with extrahepatic spread under limited conditions.

Conclusions

The current views of Japanese expert surgeons on the resectability criteria for HCC were clarified for the first time. The findings could serve as a basis for preparing expert consensus statements on the resectability criteria for HCC.
Are owls technically capable of making a full head turn?
Authors: Panyutina Aleksandra A. , Kuznetsov Alexander N.
Published: December 2023

The three‐dimensional configuration of the neck that produces extreme head turn in owls was studied using the Joint Coordinate System. The limits of planar axial rotation (AR), lateral, and sagittal bending in each vertebral joint were measured. They are not extraordinary among birds, except probably for the extended ability for AR. The vertebral joint angles involved in the 360° head turn do not generally exceed the limits of planar mobility. Rotation in one plane does not expand the range of motion in the other, with one probable exception being extended dorsal bending in the middle of the neck. Therefore, the extreme 360° head turn can be presented as a simple combination of the three planar motions in the neck joints. Surprisingly, certain joints are always laterally bent or axially rotated to the opposite side than the head was turned. This allows keeping the anterior part of the neck parallel to the thoracic spine, which probably helps preserve the ability for peering head motions throughout the full head turn. The potential ability of one‐joint muscles of the owl neck, the mm. intertransversarii, to ensure the 360° head turn was addressed. It was shown that the 360° head turn does not require these muscles to shorten beyond the known contraction limit of striated vertebrate muscles. Shortening by 50% or less is enough for the mm. intertransversarii in the middle neck region for the 360° head turn. This study has broad implications for further research on vertebral mobility and function in a variety of tetrapods, providing a new method for CT scan‐based measurement of intervertebral angles.
Identifying Minimal Hepatic Encephalopathy: A New Perspective from Magnetic Resonance Imaging
Authors: Wang Yisong , Yang Longtao , Shang Youlan , Huang Yijie , Ju Chao , Zheng Hairong , Zhao Wei , Liu Jun
Published: December 2023

Type C hepatic encephalopathy (HE) is a condition characterized by brain dysfunction caused by liver insufficiency and/or portal‐systemic blood shunting, which manifests as a broad spectrum of neurological or psychiatric abnormalities, ranging from minimal HE (MHE), detectable only by neuropsychological or neurophysiological assessment, to coma. Though MHE is the subclinical phase of HE, it is highly prevalent in cirrhotic patients and strongly associated with poor quality of life, high risk of overt HE, and mortality. It is, therefore, critical to identify MHE at the earliest and timely intervene, thereby minimizing the subsequent complications and costs. However, proper and sensitive diagnosis of MHE is hampered by its unnoticeable symptoms and the absence of standard diagnostic criteria. A variety of neuropsychological or neurophysiological tests have been performed to diagnose MHE. However, these tests are nonspecific and susceptible to multiple factors (eg, aging, education), thereby limiting their application in clinical practice. Thus, developing an objective, effective, and noninvasive method is imperative to help detect MHE. Magnetic resonance imaging (MRI), a noninvasive technique which can produce many objective biomarkers by different imaging sequences (eg, Magnetic resonance spectroscopy, DWI, rs‐MRI, and arterial spin labeling), has recently shown the ability to screen MHE from NHE (non‐HE) patients accurately. As advanced MRI techniques continue to emerge, more minor changes in the brain could be captured, providing new means for early diagnosis and quantitative assessment of MHE. In addition, the advancement of artificial intelligence in medical imaging also presents the potential to mine more effective diagnostic biomarkers and further improves the predictive efficiency of MHE. Taken together, advanced MRI techniques may provide a new perspective for us to identify MHE in the future.

Level of Evidence

3

Technical Efficacy

Stage 2
Systematic review on management of high‐output enterostomy in children: An urgent call for evidence
Authors: Stoop Thomas F. , van Bodegraven Eduard A. , ten Haaft Britte H. E. A. , van Etten‐Jamaludin Faridi S. , van Zundert Suzanne M. C. , Lambe Cécile , Tabbers Merit M. , Gorter Ramon R.
Published: December 2023

Objectives/Background

High‐output stoma is one of the most common major morbidities in young children with an enterostomy that could lead to intestinal failure. Management of high‐output enterostomy in children is mostly based on personal experience. This systematic review aims to clarify the evidence‐based therapeutic approach of high‐output enterostomy in children.

Methods

A systematic review was performed using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published until March 20, 2023, following the 2020 Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. The study population comprised children (i.e., age <18 years) with high‐output enterostomy (i.e., jejuno‐, ileo‐, and/or colostomy), regardless of underlying aetiology. Interventions comprised any (non)pharmacological and/or surgical treatment. Interventions were compared with each other, placebos, and/or no interventions. Primary outcome was reduction of enterostomy output. Secondary outcomes were morbidity, mortality, quality of life, associated healthcare costs, and adverse events.

Results

The literature search identified 4278 original articles of which 366 were screened on full text, revealing that none of the articles met the inclusion criteria.

Conclusion

This first systematic review on management of high‐output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking. There is an urgent need for evidence on conservative treatment strategies including fluid restrictions, dietary advices, oral rehydration solution, chyme re‐infusion, and pharmacological and surgical treatments of high‐output enterostomy in children, aiming to reduce the risk for short‐ and long‐term complications. Till more evidence is available, a systematic and multidisciplinary step‐up approach is needed. Therefore, a therapeutic work‐up is proposed that could guide the care.
Implementation and participation of an online nutrition curriculum for pediatric gastroenterology fellows
Authors: Jump Candi , Shaikhkhalil Ala , Smith Amber , Oliveira Stephanie B. , Chugh Ankur , Carey Alexandra , Goday Praveen S.
Published: December 2023

Our team of nutrition experts developed an online nutrition curriculum consisting of 21 modules to serve as a resource for a stand‐alone nutrition curriculum or as a supplement to existing nutrition electives during the Pediatric Gastroenterology fellowship. From April 2020 through January 2023, 2090 modules were completed by 436 fellows from 75 different programs across North America. The program was accessed most during tight restrictions on in‐person learning during the COVID‐19 pandemic. Overall, participants posttest scores improved from baseline pretest scores indicating retention of information from the modules. The overall success of this program suggests that there should be continued efforts to develop and offer online learning opportunities in clinical nutrition. There is an opportunity to expand the audience for the curriculum to include pediatric gastroenterologists from across the globe.
Transnasal endoscopy ease score “TNEase score” to evaluate patient tolerance of unsedated transnasal endoscopy
Authors: Nguyen Nathalie , Pan Zhaoxing , Smith Clint , Friedlander Joel A.
Published: December 2023

Transnasal endoscopy (TNE) with virtual reality (VR) distraction allows for unsedated pediatric upper endoscopy. Understanding the pediatric population that is successful with TNE is imperative for patient selection and experience. We developed a “TNEase Score” to assess patient tolerance from the physician's assessment. The aim of this study was to identify factors that influence patient's acceptance and tolerability of sedation‐free TNE in pediatric patients undergoing the procedure. From March 2020 to April 2021, 110 TNEs were performed on subjects 5–22 years of age. The overall completion rate was 98.1%. Of these subjects, 66 subjects (60%) were graded by the gastroenterologist as TNEase Score 1 (with ease); 27 subjects (25%) were graded as TNEase Score 2 (minimal complaints); nine subjects (8%) were graded as TNEase score 3 (moderate complaints, required frequent reassurance); six subjects were graded as TNEase Score 4 (significant complaints and resistance); two subjects (2%) were graded as TNEase Score 5 (procedure terminated). Feasibility of TNE was significantly related to age, height, and whether the patient had undergone previous TNE. Thus, young age, shorter height, and first time TNE were significant predictors of higher TNEase score or difficulty tolerating TNE. Factors examined that did not predict higher TNEase score included gender, junior versus senior endoscopist, past medical history of anxiety, autism, attention‐deficit/hyperactivity disorder (ADHD), or history of using a nasal spray at home. “TNEase score” allowed grading of the subject's experience and the majority of patients tolerated TNE with minimal complaints.
Appendiceal mucinous neoplasm in adolescence: Diagnosis, management, and surveillance
Authors: Farrar Andrew , Blanco Paola , Fabbrini Abigail , Armstrong Lindsey , Metts Jonathan , Monforte Hector , Karjoo Sara , Danielson Paul , Wilsey Michael
Published: December 2023

This case report describes a 17‐year‐old patient with a low‐grade appendiceal mucinous neoplasm. The patient presented with non‐bloody diarrhea, abdominal pain, and weight loss. A colonoscopy revealed a cecal polypoid mass that required laparoscopic surgery. The residual appendix was dilated with myxoglobulosis and histopathology confirmed the diagnosis of a low‐grade appendiceal mucinous neoplasm staged pT3Nx. The potential risk of pseudomyxoma peritonei is a serious complication of these tumors. Surveillance plans include computed tomography abdomen and pelvis, and tumor markers every 6 months for the next 2 years. This case highlights the importance of considering appendiceal malignancy in patients with abdominal pain and weight loss, despite the rarity of the disease. It also emphasizes the need for careful monitoring due to the possible complications associated with these tumors. Treatment and prognosis for appendiceal neoplasms depend on the histopathologic characteristics, tumor‐nodes‐metastasis stage, tumor grade, and presence of peritoneal disease.
Intractable diarrhea in an infant—autoimmune enteropathy: A case report
Authors: Tetarbe Shivangi , Shah Kasvi , Shah Ira
Published: December 2023

Autoimmune enteropathy is a rare cause of chronic intractable diarrhea and is present in <1 in 100,000 infants. We report the case of a 9‐month‐old boy who presented with intractable diarrhea and vomiting. Genetic panel testing revealed a STAT3 heterozygous mutation in exon 6, suggesting infantile‐onset multisystem autoimmune disease‐1. The patient was initially treated with steroids and sulfasalazine. However, on tapering steroids, he had another episode of diarrhea and was subsequently put on baricitinib to which he responded.
Fabrication and characterization of complex coacervates utilizing gelatin and carboxymethyl starch
Authors: Zhang Yiling , Xie Shumin , Huang Weijuan , Zhan Lei , Huang Yingwei , Chen Pei , Xie Fengwei
Published: December 2023

Background

Modified polysaccharides have greatly expanded applications in comparison with native polysaccharides due to their improved compatibility and interactions with proteins and active compounds in food‐related areas. Nonetheless, there is a noticeable dearth of research concerning the utilization of carboxymethyl starch (CMS) as a microcapsule wall material in food processing, despite its common use in pharmaceutical delivery. The development of an economical and safe embedding carrier using CMS and gelatin (GE) holds immense importance within the food‐processing industry. In this work, the potential of innovative coacervates formed by the combination of GE and CMS as a reliable, stable, and biodegradable embedding carrier is evaluated by turbidity measurements, thermogravimetric analysis (TGA), X‐ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and rheological measurements.

Results

The results indicate that GE‐CMS coacervates primarily resulted from electrostatic interactions and hydrogen bonding. The optimal coacervation was observed at pH 4.6 and with a GE/CMS blend ratio of 3:1 (w/w). However, the addition of NaCl reduced coacervation and made it less sensitive to temperature changes (35–55 °C). In comparison with individual GE or CMS, the coacervates exhibited higher thermal stability, as shown by TGA. X‐ray diffraction analysis shows that the GE‐CMS coacervates maintained an amorphous structure. Rheological testing reveals that the GE‐CMS coacervates exhibited shear‐thinning behavior and gel‐like properties.

Conclusion

Overall, attaining electroneutrality in the mixture boosts the formation of a denser structure and enhances rheological properties, leading to promising applications in food, biomaterials, cosmetics, and pharmaceutical products. © 2023 Society of Chemical Industry.
The surface morphology of Atractylodes macrocephala polysaccharide and its inhibitory effect on PCV2 replication
Authors: Qi Changxi , Lv Changyang , Jiang Menglin , Zhao Ximan , Gao Yifan , Wang Ying , Zhang Pu , Liu Jianzhu , Zhao Xiaona
Published: December 2023

BACKGROUND

Porcine infection with Porcine circovirus type 2 (PCV2) causes immunosuppression, which is easy to cause concurrent or secondary infection, making the disease complicated and difficult to treat, and causing huge economic losses to the pig industry. Total polysaccharide from the rhizoma of Atractylodes macrocephala Koidz. (PAMK) is outstanding in enhancing non‐specific immunity and cellular immunity, and effectively improving the body's disease resistance, indicating its potential role in antiviral immunotherapy.

RESULTS

PAMK had the characteristics of compact, polyporous and agglomerated morphology, but does not have triple helix conformation. PCV2 infection led to the increase in LC3‐II, degradation of p62 and the increase of viral Cap protein expression and viral copy number. PAMK treatment significantly alleviated PCV2‐induced autophagy and inhibited PCV2 replication. Moreover, PAMK treatment significantly attenuated the increase of PINK1 protein expression and the decrease of TOMM20 protein expression caused by PCV2 infection, alleviated Parkin recruitment from cytoplasm to mitochondria and intracellular reactive oxygen species accumulation, restored mitochondrial membrane charge, alleviated viral Cap protein expression.

CONCLUSION

PAMK alleviates PCV2‐induced mitophagy to suppress PCV2 replication by inhibiting the Pink 1/Parkin pathway. These findings may provide new insights into the prevention and treatment of PCV2. © 2023 Society of Chemical Industry.
Surgical Outcomes of Modified Technique for Transcutaneous Bone Conduction Hearing Aid Implantation
Authors: Hicks Kayla B. , Brown Kevin D. , Selleck A. Morgan , Dedmon Matthew M. , Thompson Nicholas J.
Published: December 2023

Objective

To detail a modified surgical technique for implantation of the Osia 2 Bone Conduction Hearing Aid (BCHA) system and to assess intra‐ and postoperative outcomes of this technique.

Methods

A retrospective review was performed for cases undergoing implantation of an Osia 2 BCHA at a tertiary academic medical center. Modifications were made to the surgical procedure including: horizontal or curvilinear incisions, placement of the osseointegrated screw slightly superior to the plane of the external auditory canal, and double layer wound closure. Data regarding outcomes including demographics, incision type, surgical time, drilling requirements, and complications were collected using the electronic medical record.

Results

A total of twenty‐eight cases were evaluated with 57.1% and 42.9% utilizing horizontal and curved incisions, respectively. The median age for recipients was 43.1 years with six pediatric cases included in the study. Median operative time was 58 min (43–126 min). The majority of cases required minimal (60.7%) or no drilling (28.6%) with a significant increase in operative time for those requiring moderate drilling versus minimal to no drilling (F = 8.02, p = 0.002). There were no intraoperative complications. One (3.6%) postoperative seroma occurred which resolved with conservative management.

Conclusion

The proposed modified surgical technique is a safe and effective method for implantation of the transcutaneous BCHA system with a low complication rate. Keys include incision design, implant placement, and two‐layered closure to minimize wound tension. These modifications can improve ease of the procedure and reduce operative time. These techniques also appear to be applicable to the pediatric population.

Level of Evidence

3 Laryngoscope, 134:2401–2404, 2024
Characterization of a Southern Ocean deep chlorophyll maximum: Response of phytoplankton to light, iron, and manganese enrichment
Authors: Latour Pauline , Eggins Sam , van der Merwe Pier , Bach Lennart T. , Boyd Philip W. , Ellwood Michael J. , Bowie Andrew R. , Wuttig Kathrin , Strzepek Robert F.
Published: December 2023

Southern Ocean phytoplankton growth is limited by low iron (Fe) supply and irradiance, impacting the strength of the biological carbon pump. Unfavorable upper ocean conditions, such as low nutrient concentrations, can lead to the formation of deep chlorophyll or biomass maxima (DCM/DBM). While common in the Southern Ocean, these features remain understudied due to their subsurface location. To increase our understanding of their occurrence, we studied the responses of phytoplankton communities from a Southern Ocean DCM to increasing light, Fe, and manganese (Mn) levels. The DCM communities were light‐ and Fe‐limited, but light limitation did not increase phytoplankton Fe requirements. The greatest physiological responses were observed under combined Fe/light additions, which stimulated macronutrient drawdown, biomass production and the growth of large diatoms. Combined Mn/light additions induced subtle changes in Fe uptake rates and community composition, suggesting species‐specific Mn requirements. These results provide valuable information on Southern Ocean DCM phytoplankton physiology.
Low Loss 1 × 16/40 Flat Type Beam Splitters on Thin Film Lithium Niobate Using Photolithography Assisted Chemo‐Mechanical Etching
Authors: Zhu Zhuangzhuang , Wang Zhe , Fang Zhiwei , Lin Dong , Zhou Yuan , Zhong Yunxian , Xu Jian , He Jinping , Cheng Ya
Published: December 2023

Integrated photonic devices based on thin film lithium niobate (TFLN) have attracted great attention due to their excellent performance. In this work, a flat type TFLN 1×N beam splitter is designed by adjusting the widths of tapered waveguides between free propagation region and arrayed waveguides. Two chips with 16 and 40 output ports, respectively, are manufactured with the femtosecond laser photolithography assisted chemo‐mechanical etching technology (PLACE). The excess losses are measured ≈1.43 and 1.94 dB, respectively. In theory, the flat‐type beam splitter for a single‐mode structure can maintain the flat intensity distribution within a 300 nm wavelength range. Experimentally, different types of output intensity distribution such as tilted or M‐shaped distributions can be obtained with the multimode structure by varying the position of the lensed fiber when the input light is TM‐polarized. This work explores an efficient way for the development of multichannel optical beam splitters.
Advances in proteomics methods for the analysis of exhaled breath condensate
Authors: Yoo Edwin J. , Kim Julie S. , Stransky Stephanie , Spivack Simon , Sidoli Simone
Published: December 2023

The analysis of exhaled breath condensate (EBC) demonstrates a promising avenue of minimally invasive biopsies for diagnostics. EBC is obtained by cooling exhaled air and collecting the condensation to be utilized for downstream analysis using various analytical methods. The aqueous phase of breath contains a large variety of miscible small compounds including polar electrolytes, amino acids, cytokines, chemokines, peptides, small proteins, metabolites, nucleic acids, and lipids/eicosanoids—however, these analytes are typically present at minuscule levels in EBC, posing a considerable technical challenge. Along with recent improvements in devices for breath collection, the sensitivity and resolution of liquid chromatography coupled to online mass spectrometry‐based proteomics has attained subfemtomole sensitivity, vastly enhancing the quality of EBC sample analysis. As a result, proteomics analysis of EBC has been expanding the field of breath biomarker research. We present an au courant overview of the achievements in proteomics of EBC, the advancement of EBC collection devices, and the current and future applications for EBC biomarker analysis.
Single‐stage versus two‐stage bone flap reconstruction in chronic osteomyelitis: Multicenter outcomes comparison
Authors: Piccato Alice , Crosio Alessandro , Antonini Andrea , Battiston Bruno , Titolo Paolo , Tos Pierluigi , Ciclamini Davide
Published: December 2023

Background

Chronic osteomyelitis is an invalidating disease, and its severity grows according to the infection's particular features. The Cierny‐Maiden criteria classify it according to the anatomical aspects (I to IV) and also by physiological class (A host being in good immune condition and B hosts being locally (L) or systemically (S) compromised). The surgical approach to chronic osteomyelitis involves radical debridement and dead space reconstruction. Two‐stage management with delayed reconstruction is the most common surgical management, while one‐stage treatment with concomitant reconstruction is a more aggressive approach with less available literature. Which method gives the best results is unclear. The purpose of this study is to compare single and two‐stage techniques.

Methods

The authors carried out a retrospective multicentric cohort study to compare two primary outcomes (bone union and infection healing) in one versus two‐stage reconstructions with vascularized bone flaps in 23 cases of limb osteomyelitis (22 patients, 23 extremities). Thirteen subjects (56.5%) sustained a single‐stage treatment consisting of a single surgery of radical debridement, concomitant soft tissue coverage, and bone reconstruction. Ten cases (43.5%) sustained a two‐stage approach: radical debridement, simultaneous primary soft tissue closure, and antibiotic PMMA spacers implanted in 7 patients.

Results

No statistical differences were observed between one‐ and two‐stage approaches in bone union rate and infection recurrence risk. Even though bone union seems to be higher and faster in the two‐stage than in the one‐stage group, and all infection relapses occurred in the one‐stage group, data did not statistically confirm these differences. Two of the six cases (33.3%) of bone nonunion occurred in compromised hosts (representing only 17.4% of our sample). The B‐hosts bone union rate was 50.0%, while it reached 78.9% in A‐hosts, but the difference was not statistically significant (p = .5392). Infection recurrence was higher in B‐hosts than in A‐hosts (p = .0086) and in Pseudomonas aeruginosa sustained infections (p = .0208), but in the latter case, the treatment strategy did not influence the outcome (p = .4000).

Conclusions

Bone union and infection healing rates are comparable between one and two‐stage approaches. Pseudomonas aeruginosa infections have a higher risk of infection relapse, with similar effectiveness of one‐ and two‐stage strategies. B‐hosts have a higher infection recurrence rate without comparable data between the two approaches. Further studies with a larger sample size are required to confirm our results and define B‐hosts' best strategy.

Level of Evidence

Level III of evidence, retrospective cohort study investigating the results of treatments.
DDD coil design for wireless charging of unmanned aerial vehicles
Authors: Doğan Tuğba H. , Ağçal Ali
Published: December 2023

The utilization of unmanned aerial vehicles (UAV) has become prevalent nowadays. UAVs are autonomous devices, except for self‐charging. Wireless power transfer (WPT) technologies eliminate human intervention in UAV charging and enable independent charging. The factors making WPT systems popular are autonomizing charging, eliminating cable complexity, and avoiding difficulties caused by environmental conditions. WPT of the UAV in the near field is provided by inductive coupling. In this paper, two vertical rectangular coils and horizontal DDD (triple rectangle) coils were placed in the receiver and the transmitter for UAV wireless charging, respectively. The design of the coils was made in ANSYS Maxwell 3D. A wireless charger of the UAV was designed for 100 W output power at 140 kHz frequency. The misalignment tolerance of the proposed design concerning the x‐ and y‐axis was examined. In addition, the magnetic flux density and magnetic field distributions of the WPT system were investigated. The study found that the proposed design can transfer energy wirelessly with 94% efficiency up to 10.3 cm horizontal and 1.7 cm vertical misalignment.
Simulation‐driven training of vision transformers enables metal artifact reduction of highly truncated CBCT scans
Authors: Fan Fuxin , Ritschl Ludwig , Beister Marcel , Biniazan Ramyar , Wagner Fabian , Kreher Björn , Gottschalk Tristan M. , Kappler Steffen , Maier Andreas
Published: December 2023

Background

Due to the high attenuation of metals, severe artifacts occur in cone beam computed tomography (CBCT). The metal segmentation in CBCT projections usually serves as a prerequisite for metal artifact reduction (MAR) algorithms.

Purpose

The occurrence of truncation caused by the limited detector size leads to the incomplete acquisition of metal masks from the threshold‐based method in CBCT volume. Therefore, segmenting metal directly in CBCT projections is pursued in this work.

Methods

Since the generation of high quality clinical training data is a constant challenge, this study proposes to generate simulated digital radiographs (data I) based on real CT data combined with self‐designed computer aided design (CAD) implants. In addition to the simulated projections generated from 3D volumes, 2D x‐ray images combined with projections of implants serve as the complementary data set (data II) to improve the network performance. In this work, SwinConvUNet consisting of shift window (Swin) vision transformers (ViTs) with patch merging as encoder is proposed for metal segmentation.

Results

The model's performance is evaluated on accurately labeled test datasets obtained from cadaver scans as well as the unlabeled clinical projections. When trained on the data I only, the convolutional neural network (CNN) encoder‐based networks UNet and TransUNet achieve only limited performance on the cadaver test data, with an average dice score of 0.821 and 0.850. After using both data II and data I during training, the average dice scores for the two models increase to 0.906 and 0.919, respectively. By replacing the CNN encoder with Swin transformer, the proposed SwinConvUNet reaches an average dice score of 0.933 for cadaver projections when only trained on the data I. Furthermore, SwinConvUNet has the largest average dice score of 0.953 for cadaver projections when trained on the combined data set.

Conclusions

Our experiments quantitatively demonstrate the effectiveness of the combination of the projections simulated under two pathways for network training. Besides, the proposed SwinConvUNet trained on the simulated projections performs state‐of‐the‐art, robust metal segmentation as demonstrated on experiments on cadaver and clinical data sets. With the accurate segmentations from the proposed model, MAR can be conducted even for highly truncated CBCT scans.
Anisotropic continuum framework of coupled gas flow – adsorption – deformation in sedimentary rocks
Authors: Zhang Qi , Yin Zhen‐Yu , Yan Xia
Published: December 2023

Solid deformation is always a crucial factor of gas transport in sedimentary rocks. While previous studies always adopt the assumption of isotropic poroelastic deformation, anisotropic poroelastoplastic deformation is rarely considered, despite anisotropy being a ubiquitous property of natural sedimentary rocks. In this work, an anisotropic poromechanical model is established to analyze the matrix porosity and apparent permeability evolutions during the process of gas migration. Using a thermodynamic formulation that treats the fluid–solid interface as an independent phase, we derive a rate form for matrix porosity and obtain the new dissipation function that contains three parts: dissipations from solid deformation, gas adsorption, and fluid flow. For gas adsorption, we justify the rationality of the adopted model; for fluid flow, the updated porosity can be substituted into sophisticated apparent permeability models for full‐scale analysis; and for solid deformation, a recently developed constitutive model appropriate for rocks exhibiting transverse isotropy in both the elastic and plastic responses is adopted in this work. Through the novel stress‐point simulation incorporating two effective stress measures and adsorption strain, new patterns of apparent permeability are obtained, which fit the experimental data quite well and cannot be reproduced from the assumption of isotropic poroelasticity. The advantages of our poromechanical model include thermodynamic consistency and the ability to employ finite‐element‐based formulation. Finally, an initial‐boundary value problem of gas production considering anisotropic plasticity is conducted, and the effects of the bedding plane and different adsorption models are highlighted.
The association between testosterone deficiency and nocturia: Insights from The National Health and Nutrition Examination Survey data set
Authors: Kim Sung Jin , Lee Donghyun , Park Sung Gon , Pak Sahyun , Lee Young Goo , Cho Sung Tae
Published: December 2023

Aims

To examine the association between testosterone deficiency (TD) and nocturia in males, with specific attention to age and cardiovascular disease (CVD) comorbidity.

Methods

This cross‐sectional study utilized the National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2016, assessing 6137 adult male participants. TD was defined by a serum total testosterone (TT) concentration less than 300 ng/dL. Nocturia was determined based on participants' responses to a standard NHANES question regarding the frequency of urination during the night.

Results

The study observed a significant association between TD and nocturia (adjusted odds ratio [95% confidence interval] = 1.211 [1.060–1.384], p = 0.005). Moreover, a U‐shape pattern was noted in the relationship between serum TT concentration and the relative odds of nocturia. Subgroup analysis revealed a robust correlation between TD and nocturia in those over 60 years old, and those with hypertension, dyslipidemia, and CVDs.

Conclusion

Our findings suggest a positive correlation between TD and nocturia, particularly among elderly individuals with CVD. This association underscores the potential therapeutic significance of addressing TD in the management of nocturia. Furthermore, longitudinal studies are needed to establish a causal relationship between TD and nocturia.
Robust block diagonal preconditioners for poroelastic problems with strongly heterogeneous material
Authors: Luber Tomáš , Sysala Stanislav
Published: December 2023

This paper focuses on the analysis and the solution of the saddle‐point problem arising from a three‐field formulation of Biot's model of poroelasticity, discretized in time by the implicit Euler method. A block diagonal‐preconditioner, based on the Schur complement, is analyzed on a functional level and compared with two other block‐diagonal preconditioners having a similar structure. The problem is discretized in space using mixed finite elements and solved with appropriate iterative solvers, incorporating the investigated preconditioners. The solvers are tested on numerical examples inspired by geotechnical practice, with particular attention devoted to the solvers' robustness concerning strong heterogeneity in permeability.
AI tool round‐up: Text, image, and other resources to explore
Authors: Talarico Donna
Published: December 2023

The last time you opened a fresh Google Doc, were you welcomed with a sparkly bluish‐purple prompt “help me write”? Existing tools many of us know and love have already implemented AI features like this; in fact, you might say the lovable (or love‐to‐loathe) Clippy — Microsoft's office‐supply‐shaped assistant — was the first. And he was probably way ahead of his time.
Understand service animal requirements on campus
Authors: Lyerly Eric
Published: December 2023

The Office for Civil Rights has published several resolution agreements/letters of findings in 2023 involving discrimination against individuals with disabilities who use service animals. These letters can help postsecondary institutions identify common patterns of discrimination in service animal policies and help them avoid compliance issues in their own policies. This article will summarize the major 2023 OCR letters that address service animals, Section 504, and Title II.
Overhauling technology can boost your students’ experiences
Authors: D’Orio Wayne
Published: December 2023

The pandemic nearly broke the Metropolitan State University of Denver.
Pediatric heart failure classification based on left ventricular ejection fraction
Authors: Huang Shan , Xiang Xue , Zhu Xu , Tian Jie , Pan Bo , Zheng Min
Published: December 2023

Left ventricle ejection fraction (LVEF) is still not well acknowledged in classification of pediatric heart failure (PHF). We categorized PHF according to LVEF and aimed to determine the role of LVEF in PHF classification. Patients who were diagnosed with HF were divided into three groups according to their LVEF values: HF with reduced ejection fraction (HFrEF), HF with mildly reduced ejection fraction (HFmrEF), and HF with preserved ejection fraction (HFpEF). The clinical information of PHF patients was compared among those three groups. Factors associated with HF with improved EF (HFimpEF) and risk factors for in‐hospital death in PHF patients were analyzed. A total number of 1228 cases were collected. The proportion of HF patients with preserved LVEF (66.3%) was significantly higher than those with mildly reduced LVEF (21.7%) and reduced LVEF (12%). Clinical features such as age, B‐type natriuretic peptide (BNP) level, Ross classification, and E/A abnormal proportion in HF children with different LVEF value were statistically different. HF patients with younger age, lower BNP levels, minor cardiac dysfunction and less E/A abnormality could be found with higher LVEF value. The proportion of primary disease in PHF was largely different in HFpEF, HFmrEF and HFrEF groups. Medication treatment was more aggressive in patients with lower LVEF, except for vasoactive drugs. Children with congenital heart disease in HFrEF group were more prone to develop into HFimpEF. Sepsis, renal insufficiency, and an abnormal E/A ratio are risk factors for in‐hospital death of HF children. Clinical features of PHF could be well classified by LVEF, which is an essential and helpful indicator for PHF classification and management.
Variability of mpMRI diagnostic performance according to the upfront individual patient risk of having clinically significant prostate cancer
Authors: Pellegrino Francesco , Stabile Armando , Sorce Gabriele , Mazzone Elio , Cannoletta Donato , Cirulli Giuseppe Ottone , Quarta Leonardo , Leni Riccardo , Robesti Daniele , Brembilla Giorgio , Gandaglia Giorgio , De Cobelli Francesco , Montorsi Francesco , Briganti Alberto
Published: December 2023

Background

To assess the variation of multiparametric magnetic resonance imaging (mpMRI) positive predictive value (PPV) according to each patient's risk of clinically significant prostate cancer (csPCa) based exclusively on clinical factors.

Methods

We evaluated 999 patients with positive mpMRI (PI‐RADS ≥ 3) receiving targeted (TBx) plus systematic prostate biopsy. We built a multivariable logistic regression analysis (MVA) using clinical risk factors to calculate the individual patients' risk of harboring csPCa at TBx. A second MVA tested the association between individual patients' clinical risk and mpMRI PPV accounting for the PI‐RADS score. Finally, we plotted the PPV of each PI‐RADS score by the individual patient pretest probability of csPCa using a LOWESS approach.

Results

Overall, TBx found csPCa in 21%, 51%, and 80% of patients with PI‐RADS 3, 4, and 5 lesions, respectively. At MVA, age, PSA, digital rectal examination (DRE), and prostate volume were significantly associated with the risk of csPCa at biopsy. DRE yielded the highest odds ratio (OR: 2.88; p < 0.001). The individual patient's clinical risk was significantly associated with mpMRI PPV (OR: 2.49; p < 0.001) using MVA. Plotting the mpMRI PPV according to the predicted clinical risks, we observed that for patients with clinical risk close to 0 versus patients with risk higher than 90%, the mpMRI PPV of PI‐RADS 3, 4, and 5 ranged from 0% to 75%, from 0% to 96%, and from 45% to 100%, respectively.

Conclusion

mpMRI PPV varies according to the individual pretest patient's risk based on clinical factors. These findings should be considered in the decision‐making process for patients with suspect MRI findings referred for a prostate biopsy. Moreover, our data support the need for further studies to create an individualized risk prediction tool.
Clinical considerations on monkeypox antiviral medications: An overview
Authors: Pourkarim Fariba , Entezari‐Maleki Taher
Published: December 2023

Monkeypox (mpox), a virus belonging to the orthopoxvirus family, can cause a zoonotic infectious disease with morbidity and cosmetic complications. Therefore, effective antiviral drugs with appropriate safety profiles are important for the treatment of patients with mpox. To date, there is no FDA‐approved drug for the treatment of mpox. However, tecovirimat, brincidofovir, and cidofovir are the candidate therapies for the management of mpox. Given the safety concerns following the use of these medications, we aimed to review evidence on the clinical considerations of mpox antiviral medications that will be useful to guide clinicians in the treatment approach. Based on the current evidence, tecovirimat has favorable clinical efficacy, safety, and side effect profile and it can be considered as first‐line treatment for mpox.