bluuebunny/crossref_metadata_2025 huggingface dataset:
Analytic and Clinical Validity of Myositis-Specific Antibodies by Line-Blot Immunoassay Is Essential
Authors: Tseng Chih-Wei , Satoh Minoru , Hasegawa Tomoko , Tanaka Shin , Chen Yi-Ming
Published: November 2023

Objectives

This study assessed the concordance between line blot (LB) and immunoprecipitation (IP) assays for detecting myositis-specific antibodies (MSAs) in idiopathic inflammatory myopathies (IIMs) and their association with IIM subtypes.

Methods

One hundred patients with IIM were enrolled, and MSA was detected using LB and IP. The IIM subtypes, including immune-mediated necrotizing myopathy–like, anti–tRNA synthetase syndrome–like, and clinically amyopathic dermatomyositis–like, were clinically diagnosed. The validity and reliability of the LB compared with the IP were evaluated. Optimal cutoff levels for LB were determined using various statistical methods including Cohen κ, Gwet's AC, diagnostic odds ratios, and receiver operating characteristic analysis.

Results

Line blot exhibited lower specificity and accuracy than IP in predicting IIM subtypes. Some MSAs performed better at higher LB cutoff values. Anti–signal recognition particle antibodies showed poor performance in predicting the immune-mediated necrotizing myopathy–like subtype using LB. Raising the cutoffs improved the reliability of anti–threonyl-tRNA synthetase and anti–signal recognition particle antibodies. Anti–histidyl-tRNA synthetase antibodies performed well at lower positivity, whereas diagnostic odds ratios increased for anti–transcription intermediary factor 1γ and anti–nuclear matrix protein 2 with higher cutoffs.

Conclusions

Inconsistencies between LB and IP have been observed in patients with IIM. Individual optimal cutoffs for MSA by LB correlating with IP were determined. Rheumatologists should consider the differences between LB and IP results when classifying IIM subtypes.
Sex-Related Differences of Left Atrial Strain in Patients With Hypertension Using Cardiac Magnetic Resonance Feature Tracking
Authors: Yang Zhaoxia , Wen Jinyang , Tang Dazong , Luo Yi , Xiang Chunlin , Xia Liming , Huang Lu
Published: November 2023

Purpose:

Previous studies demonstrated the impact of sex on left ventricular (LV) strain in patients with essential hypertension. However, little is known about the effect of sex on left atrial (LA) strain in patients with hypertension. This study aimed to explore the sex-related differences of LA strain by using cardiac magnetic resonance feature tracking in patients with hypertension and preserved LV ejection fraction.

Materials and Methods:

One hundred and fifty hypertensive patients (100 men and 50 women) and 105 age-matched and sex-matched normotensive controls (70 men and 35 women) were retrospectively enrolled and underwent cardiac magnetic resonance examination. LA strain parameters included LA reservoir strain (εs), conduit strain (εe), pump strain (εa), and their corresponding strain rate (SRs, SRe, and SRa).

Results:

Men had significantly higher LV mass index, lower εs and εe than women in both patients and controls (all P<0.05). LA strain and strain rate were significantly reduced in hypertensive patients compared with controls, both in men and women (all P<0.05). In men, hypertension and its interaction were associated with increased LV mass index and decreased εs and εe. In multivariable analysis, men, LV ejection fraction, and LA minimum volume index remained independent determinants of εs and εe in all hypertensive patients (all P<0.05).

Conclusion:

LA strain was significantly impaired in hypertensive patients, and men had more impaired LA strain than women. These findings further emphasize the sex-related differences in the response of LA strain to hypertension in the early stage.
Feature-Tracking Strain Parameters Differ Between Highly Accelerated and Conventional Acquisitions
Authors: Halfmann Moritz C. , Klimzak Tim , Schoepf U. Joseph , Kloeckner Roman , Chitiboi Teodora , Schmidt Michaela , Wenzel Philip , Müller Lukas , Geyer Martin , Varga-Szemes Akos , Kreitner Karl-Friedrich , Dueber Christoph , Emrich Tilman
Published: November 2023

Background:

Cardiac magnetic resonance imaging protocols have been adapted to fit the needs for faster, more efficient acquisitions, resulting in the development of highly accelerated, compressed sensing-based (CS) sequences. The aim of this study was to evaluate intersoftware and interacquisition differences for postprocessing software applied to both CS and conventional cine sequences.

Materials and Methods:

A total of 106 individuals (66 healthy volunteers, 40 patients with dilated cardiomyopathy, 51% female, 38±17 y) underwent cardiac magnetic resonance at 3T with retrospectively gated conventional cine and CS sequences. Postprocessing was performed using 2 commercially available software solutions and 1 research prototype from 3 different developers. The agreement of clinical and feature-tracking strain parameters between software solutions and acquisition types was assessed by Bland-Altmann analyses and intraclass correlation coefficients. Differences between softwares and acquisitions were assessed using Kruskal-Wallis analysis of variances. In addition, receiver operating characteristic curve-derived cutoffs were used to evaluate whether sequence-specific cutoffs influence disease classification.

Results:

There were significant intersoftware (P<0.002 for all except LV end-diastolic volume per body surface area) and interacquisition differences (P<0.02 for all except end-diastolic volume per body surface area from Neosoft, left ventricular mass per body surface area from cvi42 and TrufiStrain and global circumferential strain from Neosoft). However, the intraclass correlation coefficients between acquisitions were strong-to-excellent for all parameters (all ≥0.81). In comparing individual softwares to a pooled mean, Bland-Altmann analyses revealed smaller magnitudes of bias for cine acquisition than for CS acquisition. In addition, the application of conventional cutoffs to CS measurements did not result in the false reclassification of patients.

Conclusion:

Significantly lower magnitudes of strain and volumetric parameters were observed in retrospectively gated CS acquisitions, despite strong-to-excellent agreement amongst software solutions and acquisition types. It remains important to be aware of the acquisition type in the context of follow-up examinations, where different cutoffs might lead to misclassifications.
Application of Staged Negative Pressure Wound Therapy and Flap Surgery for Infection Control After Patellar Internal Fixation Surgery
Authors: Cheng Lin , Du Wei-Li , Zhang Ying , Chen Zhong , Shen Yu-ming
Published: November 2023

The anatomic position of the patella is superficial, making it vulnerable to injuries. Treatment of patella infection after internal fixation surgery remains a big challenge due to minimal soft tissue coverage and vital tissue exposure. Forty-two patients aged 10 to 59 years were admitted to the institution’s burn unit between January 2010 and December 2019. Each presented with infection after patellar fracture surgery. Twenty-seven infections were superficial, whereas 15 were deep with pyogenous arthritis of the knee. Negative pressure wound therapy (NPWT) was applied after radical debridement to remove necrotic subcutaneous tissues and internal fixation devices. In addition, cases with septic arthritis were irrigated continuously with normal saline. After 5 to 10 days of NPWT treatment and irrigation, wound infection was well controlled. Afterward, 42 wounds were resurfaced with pedicled flaps, the 42 patients received 17 reverse-flow anterolateral thigh (ALT) perforator flap, 12 medial sural artery perforator flaps, 7 gastrocnemius musculocutaneous flaps, as well as 6 saphenous artery flaps. Thirty-seven flaps survived uneventfully. However, 3 flaps developed venous congestion in the distal end. Two flaps developed tip necrosis. All patients were followed up between 3 and 48 months. Infection beneath the flap occurred in 3 patients and healed after an additional debridement surgery. The staged NPWT and flap surgery strategy focus on thorough debridement and immediate internal fixation devices removal, effective fracture fixation, efficient NPWT application, targeted administration of antibiotics, and adequate soft tissue coverage. This study established that the procedure was effective in infection control after patellar internal fixation surgery.
Rhinoplasty and Le Fort I Maxillary Osteotomy in Cleft Patients
Authors: Harjunpää Roni , Grann Annemari , Saarikko Anne , Heliövaara Arja
Published: November 2023

Introduction:

Cleft patients often need orthognathic surgery to correct maxillary hypoplasia and rhinoplasty to correct nasal deformity. Rhinoplasty can be performed as a staged procedure after orthognathic surgery or simultaneously with maxillary osteotomy.

Aim:

The authors evaluated need for and complications of staged and simultaneous rhinoplasties in patients with different cleft types undergoing maxillary osteotomy.

Patients and Methods:

This retrospective study examined 99 (54 females) consecutive nonsyndromic patients with cleft lip/palate [23 bilateral cleft lip and palate (BCLP), 51 unilateral cleft lip and palate (UCLP), and 25 cleft palate (CP)] with a mean age of 17.8 (range: 11.5–45.3) years who had undergone Le Fort I maxillary advancement or bimaxillary osteotomy at the Cleft Palate and Craniofacial Center, Helsinki University Hospital, Finland, between 2002 and 2016. Medical charts were accessed through the hospital’s archives and database.

Results:

Of patients who underwent maxillary osteotomy, 45% (45/99) needed rhinoplasty (14 BCLP, 27 UCLP, and 4 CP). A significant difference (P<0.01) existed in the need for rhinoplasty between different cleft types, those with BCLP and UCLP needing the most operations (60% and 53%). In 20 patients (20%), rhinoplasty was performed simultaneously with maxillary osteotomy, and in 25 patients (25%) in a second operation after osteotomy. The overall complication rate was 14%. No difference existed in complication rate in patients with or without simultaneous rhinoplasty.

Conclusions:

Of cleft patients who underwent maxillary osteotomy, 45% needed rhinoplasty. Patients with BCLP and UCLP needed rhinoplasty most often. Staged and simultaneous procedures were almost equally common with similar complication rates.
A Novel Neurovascular Protection Method In Nasolabial Muscle Biomechanical Bionic Surgery For Secondary Unilateral Cleft Lip Repair: A Three-Dimensional Evaluation Of Short And Long-Term Results
Authors: Liu Siyu , Jiang Chanyuan , Ma Hengyuan , Wang Yongqian , Song Tao , Li Haidong , Wu Di , Yin Ningbei
Published: November 2023

Background:

Neurovascular protection within the upper lip muscles is essential in muscle tension reconstruction and functional recovery during surgery. This study aimed to investigate a novel neurovascular protection method based on the intramuscular neurovascular partitions of the upper lip applied to nasolabial muscle biomechanical bionic surgery for secondary unilateral cleft lip repair and to evaluate postoperative outcomes.

Methods:

From November 30, 2019 to October 31, 2020, 50 consecutive patients with secondary unilateral cleft lips who underwent the modified biomechanical bionic surgery were reviewed retrospectively. Three-dimensional (3D) photographs of patients were collected preoperatively, 7-day postoperatively, and during long-term follow-up (at least 6 months). The Global Aesthetic Improvement Scale was used to evaluate surgical subjective outcomes, and statistical analysis of nasolabial measurements on 3D photographs was used to evaluate objective outcomes before and after surgery.

Results:

The Global Aesthetic Improvement Scale showed that 94% of patients had improved upper lip morphology and 92% had improved nasal morphology 7-day postoperatively. In all, 84% maintained favorable nasolabial morphology during long-term follow-up. Statistical results showed that the postoperative alar width, philtral depth, columellar angle, and nasal base inclination angle were significantly improved compared with preoperatively (P<0.01). The differences between the above 4 indexes were not statistically significant (P >0.05) between 7-day postoperatively and long-term follow-up, indicating that the postoperative lasting outcomes were satisfactory.

Conclusions:

The novel method of neurovascular protection in nasolabial muscle biomechanical bionic surgery can achieve a long-term improvement of labial-nasal morphology and function in patients with secondary unilateral cleft lip.
Diversity and Surgical Management of Intracranial Fungal Infections
Authors: Wang Linkai , Fan Haonan , Feng Weijian , Wang Bo , Mo Jun , Chen Yili
Published: November 2023

Intracranial fungal infection is a rare entity. This disease is mainly concentrated in dry and hot climates, such as India, Africa, California, and usually occurs in patients with immune deficiency. Now, we retrospectively analyzed the clinical manifestations, pathologic manifestations, imaging features, surgical methods, and prognosis of 4 patients with fungal infection who were confirmed by postoperative pathology. Intermittent pricking on the right face was presented in 2 patients, headache in 2 patients, orbital apex syndrome in 2 patients, and 1 patient presented with fever. Imaging showed the lesions of all patients were located in the right temporal, including 2 patients involving the right orbital, 1 patient involving the right trigeminal semilunar ganglion, 1 patient involving the right brainstem and tentorium cerebellum, 1 patient involving the right internal carotid artery. Craniotomy was performed in 2 patients, endoscopic biopsy in 1 patient, and stereotactic surgery in 1 patien. Aspergilloma was the most common pathogenic bacteria. One patient relapsed repeatedly and died. Secondary aneurysm complicated with subarachnoid hemorrhage occurred in 1 patient. Therefore, the author confirmed that intracranial fungal infection has diverse clinical, imaging, and pathologic manifestations. Neurosurgeons should be aware of the possibility of intracranial fungal infection when they find abnormal intracranial lesions, neurologic deficits, and inflammation of paranasal sinuses. Combining multiple clinical data may help doctors to improve the accuracy of diagnosis. Individualized and diversified surgical protocols should be selected for diverse lesions. Notably, secondary intracranial fungal vasculitis is common, with high mortality and disability rates.
Repair of Oroantral Fistulas Using Free Bone and Mucoperiosteal Flaps After Endoscopic Removal of the Medial Wall of the Maxillary Sinus
Authors: Wang Ai , Zhao Changqing , Li Qingfeng , An Yunfang , Xue Jinmei , Wang Min
Published: November 2023

Introduction:

Oroantral fistula (OAF) refers to a pathological connection between the oral cavity and maxillary sinus. It may lead to symptoms that include purulent mucus, nasal congestion, facial swelling, bad breath, and nasal regurgitation of food, all of which negatively impact patients’ quality of life.

Objective:

This study presents a novel approach for OAF repair using a 2-layered structure composed of free bone and a mucoperiosteal flap obtained from the medial wall of maxillary sinus.

Materials and methods:

Ten OAF patients who underwent repair using this method were retrospectively reviewed between August 2015 and June 2022.

Results:

The extraction of maxillary molars was the most common cause of OAF. The size of the fistulas ranged from 1×2 mm to 5×8 mm. Nine of the 10 patients achieved successful OAF closure following the initial operation using the 2-layer structure composed of free bone and mucoperiosteal flag. One patient was lost to follow-up. The 9 patients were observed for 6 months to 1 year, and they exhibited no obvious complications or recurrence.

Conclusion:

The use of free bone and mucoperiosteal flag from the medial wall of maxillary sinus through an endoscope was effective for OAF repair.
Goals of care are rarely discussed prior to potentially futile trauma transfer: Is it okay to say “No”?
Authors: Trenga-Schein Nellie , Zonies David , Cook Mackenzie
Published: November 2023

BACKGROUND

It is unknown how often the physician-to-physician trauma transfer conversation includes a discussion of patient goals of care (GOC). We hypothesized that physicians would rarely discuss GOC on transfer calls when faced with patients with catastrophic injuries.

METHODS

We completed a retrospective case series of trauma patients transferred to an ACS-verified Level I trauma center between 2018 and 2022 who died or were discharged to hospice without surgical intervention within 48 hours. Transfer call recordings were analyzed for GOC conversations.

RESULTS

A total of 5,562 patients were accepted as transfers and 82 (1.5%) met inclusion criteria. Eighty of the 82 patients had recorded transfer calls and were analyzed. The most common transfer reason was traumatic brain injury (TBI) and need for neurosurgical capabilities (53%) followed by complex multisystem trauma (23%). There was explicit discussion of code status prior to transfer in 20% and a more in depth GOC conversation for 10% of patients. Appropriateness of transfer was discussed in 21% and at least one physician expressed explicit concerns of futility for 14%, though all were subsequently transferred. Code status was changed immediately upon arrival for 15% for patients and 19% of patients transferred for neurosurgical expertise were deemed to have non-survivable injuries based on imaging and examination that were unchanged from the referring hospital.

CONCLUSION

Among a group of profoundly injured trauma patients at high risk of death, an explicit discussion of GOC occurred in just 10%. This suggests that even when the catastrophic nature of patient injury is understood, transfers still occur, and patients and their families are subjected to an expensive, disruptive, and displacing experience with little to no anticipated benefit. A discussion of GOC and therapeutic objectives should be considered in all severely injured trauma patients prior to transfer.

LEVEL OF EVIDENCE

Therapeutic/Care Management; Level IV.
Transplantation of Wnt3a-modified neural stem cells promotes neural regeneration and functional recovery after spinal cord injury via Wnt-Gli2 pathway
Authors: Lin Jiezhao , Lin Yucong , Zhu Shuangfang , Luo Jinzhou , Zhou Chusong
Published: November 2023

Neural stem cell (NSCs) transplantation has great potential in the treatment of spinal cord injury (SCI). Previous studies have indicated that the Wnt pathway could regulate the expression of basic helix-loop-helix (bHLH) family factor Hes5 and Mash1 in NSCs, but not through the notch intracellular domain. This suggests that there are other signals involved in this process. The aim of this study was to investigate the role of Wnt-Gli2 pathway in the treatment of SCI by transplanting neural stem cells. NSCs were isolated from the striata of embryonic day 14 mice. Activation of the Wnt pathway was achieved using Wnt3a protein, while Gli2 was inhibited using Gli2-siRNA. Expression levels of Gli2 and bHLH factors were assessed using western blotting. NSCs proliferation was evaluated using CCK-8 assay, and neural differentiation was determined by immunofluorescence staining. Finally, the modified NSCs were transplanted into mice with SCI, and their effects were assessed using behavioral and histological tests. Our results demonstrated that Wnt3a promoted the expression of Mash1 through Gli2. Moreover, the expression of Ngn1 and Hes1 was up-regulated, while Hes5 was down-regulated. Wnt3a also promoted NSCs proliferation and neural differentiation through this signaling pathway. In vivo experiments showed that NSCs transplantation mediated by Wnt3a-Gli2 signaling increased the number of neurons and resulted in improved Basso Mouse Scale scores. In conclusion, our findings suggest that Gli2 plays a role in mediating the regulation of Wnt3a signaling on promoting NSCs proliferation and neural differentiation. This pathway is therefore important in NSCs-mediated SCI recovery.
Delirium risk screening and assessment among older patients in general wards and the emergency department: a best practice implementation project
Authors: Lafarga-Molina Laura , Albornos-Muñoz Laura , González-María Esther , Vrbová Tereza , Moreno-Casbas María Teresa , Klugar Miloslav , Klugarová Jitka
Published: November 2023

Objectives:

The aim of this project was to improve compliance with evidence-based criteria regarding risk of delirium and the assessment of delirium among older patients in the general hospitalization wards and the emergency department.

Introduction:

More than 50% of older hospitalized patients experience delirium. Some studies have highlighted the need to implement an orientation protocol in the emergency department and to continue this in the general wards, with the aim of decreasing the delirium rate among older patients admitted to hospital.

Methods:

The project followed the JBI evidence implementation framework. We conducted a baseline audit, a half-way audit, and final audit of 50 patients at risk of delirium admitted to the emergency department and the general wards, respectively. The audits measured compliance with eight criteria informed by the available evidence.

Results:

In the final audit, three of the eight criteria achieved more than 50% compliance in the general wards: pressure injury screening (96%); monitoring changes (74%); and performing interventions (76%). In the emergency department, worse results were reported because of the service conditions. The exception was the criterion on the training of nurses on the topic, with 98%. The integration of a tool to screen for delirium in older patients in the hospital's electronic clinical history records increased the percentage of compliance with audit criteria regarding the use of the scale and delirium detection (rising from 0% to 32% in the final audit in the general wards).

Conclusion:

Through the implementation of this project, validated and evidence-based evaluation will ensure that nurses are supported through appropriate measures to reduce patient confusion and aggression resulting from delirium.
A Multicenter Retrospective Chart Review on the Effectiveness and Tolerability of Electroconvulsive Therapy in Adolescents and Young Adults With Major Depressive Disorder or Bipolar Depression
Authors: Schukking Nout , Scheepstra Karel W.F. , Bergfeld Isidoor O. , van Waarde Jeroen A. , Tendolkar Indira , Spaans Harm-Pieter , Hegeman Annette J. M. , Scheepens Dominique S. , Lok Anja
Published: November 2023

Background

Major depressive disorder and bipolar depression in adolescents and young adults are prevalent and major contributors to the global burden of disease, whereas effective interventions are limited. Available evidence is insufficient to assess effectiveness and tolerability of electroconvulsive therapy in depressed adolescents and young adults.

Methods

A retrospective chart review was conducted in patients with major depressive disorder or bipolar depression who underwent electroconvulsive therapy from 2001 to 2021 in 12 centers in the Netherlands. Patients were classified as young (15–25 years) and older adults (26–80 years). Primary outcome was effectiveness, expressed as response (≥50% reduction in rating scale score compared with baseline) and remission. Rating scale scores were cross-sectionally assessed at baseline and at the end of the index course. Outcomes of remitters were included in responders. Secondary outcome was occurrence of subjective cognitive impairment and adverse events. Long-term outcomes were not available.

Results

In the young (n = 57) and older adult (n = 41) group, 40.4% and 56.1% (P = 0.153) of patients achieved response and 28.1% and 39.0% (P = 0.281) remission, respectively. Subjective cognitive impairment (80.5% vs 56.3%; P = 0.001) and transient cardiac arrhythmia (14.6% vs 2.8%; P = 0.020) were reported significantly more frequently in the older adult group.

Conclusions

Despite significantly more comorbidity of personality disorders, autism spectrum disorders, and anxiety disorders, effectiveness in the young was similar to the older adults. Tolerability was even superior in the young, despite significantly more bilateral treatment. Electroconvulsive therapy could be considered a viable treatment option in depressed adolescents and young adults.
Diabetes mellitus in patients with chronic bipolar disorder: prevalence, clinical correlates and relationship with homocysteine
Authors: Mu Li , Chen Dachun , Xiu Meihong , Zhou Huixia , Wang Dongmei , Zhang Xiang-Yang
Published: November 2023

Comorbid diabetes mellitus in patients with bipolar disorder may contribute to increased morbidity and mortality. To determine the prevalence of diabetes mellitus in bipolar disorder patients and its clinico-demographic and homocysteine correlates, we conducted a cross-sectional survey of 195 bipolar disorder inpatients. They received questionnaires, clinical measurements and laboratory tests to assess demographic characteristics, anthropometric variables, clinical variables and plasma homocysteine levels. The prevalence of diabetes mellitus (including type 1, type 2 and special types) in Chinese bipolar disorder patients was 14.9%. Analysis of variance or chi-square test showed that compared with non-diabetic bipolar disorder patients, diabetic bipolar disorder patients were older, more often married, had a longer duration of disease, took less olanzapine and had a higher frequency of hypertension. However, there were no significant differences in body mass index (BMI) and homocysteine levels between diabetic and non-diabetic bipolar disorder patients. Logistic regression analysis showed that marital status and duration of disease were independently associated with diabetes mellitus in patients with bipolar disorder after controlling for age, use of olanzapine, presence of hypertension, BMI and homocysteine levels. These findings shed light on the clinico-demographic correlates of the increased prevalence of diabetes mellitus in bipolar disorder patients, rather than the correlation with some metabolic risk factors.
Relevance of pharmacogenetic analyses and therapeutic drug monitoring of antidepressants for an individualized treatment of peripartum psychopathology
Authors: Colombo Anna , Cafaro Rita , Di Bernardo Ilaria , Mereghetti Marta , Cerolini Lucia , Giacovelli Luca , Giorgetti Federica , Vanzetto Simone , Girone Nicolaja , Savasi Valeria , Cetin Irene , Clementi Emilio , Bosi Monica Francesca , Viganò Caterina Adele , Dell’Osso Bernardo
Published: November 2023

Objective

Psychiatric disorders burden the peripartum period, often requiring psychopharmacological treatment, including antidepressants. Efficacy and tolerability of antidepressants are influenced by the physiological changes of the peripartum and individual metabolic profiles, which in turn can be modified by pregnancy. The objective of this study is to assess the relationship between antidepressants’ pharmacokinetic profiles during pregnancy and individual metabolic profiles, along with the efficacy of the treatment.

Methods

In total 87 outpatients with diagnoses of bipolar disorder, major depression, anxiety, obsessive-compulsive disorder and post-traumatic stress disorder who required antidepressant treatment during pregnancy were recruited. Genotyping analysis of hepatic cytochrome P450 (CYPs) individual isoforms was performed. Antidepressants’ blood concentrations and psychometric assessments were collected at five time points. Antidepressants’ cord blood concentrations were assessed at birth.

Results

Sertraline showed greater stability in plasma concentrations and a lower placental penetrance index. Most of the antidepressants’ concentrations below the therapeutic range were found in women with an extensive/ultrarapid metabolic profile. Antidepressants mainly metabolized by CYP2C19 were less frequently below the therapeutic range compared with antidepressants metabolized by CYP2D6.

Conclusions

Pregnancy modulates cytochrome activity and drugs’ pharmacokinetics. Genotyping analysis of CYPs isoforms and therapeutic drug monitoring might be used to guide clinicians in a well-tolerated treatment of psychiatric symptoms in pregnant women.
A novel learning function for adaptive surrogate-model-based reliability evaluation
Authors: Yang Shiyuan , Meng Debiao , Wang Hongtao , Yang Chang
Published: November 2023

The classical reliability analysis methods, due to the ever-increasing complexity of engineering structure, may lead to higher and higher calculation errors and costs. The adaptive surrogate-model-based reliability evaluation method strikes a desirable balance between computational efficiency and accuracy, making it a prevalent technique in the domain of reliability evaluation. Learning function is the core of this reliability evaluation method. In this study, a novel learning function is proposed to adaptively choose the best update sample. This learning function does not depend on the prediction variance provided by the Kriging model. Therefore, this learning function is not limited to the Kriging model. In theory, it can be combined with different surrogate models. Four comparative cases are used to illustrate the computational efficiency and accuracy of the proposed method, including series system case with four branches, highly nonlinear two-dimensional numerical example, and two practical engineering case.

This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 2)'.
Data-driven based fracture prediction of notched components
Authors: Talebi Hossein , Bahrami Bahador , Daneshfar Mohammad , Bagherifard Sara , Ayatollahi Majid R.
Published: November 2023

A data-driven approach is developed to predict the fracture load of a notched component. To do so, more than 1500 fracture tests (507 unique experimental data points) on mixed-mode I/II loading of notched brittle samples were collected from the literature. After pre-processing the raw data, six features of maximum tangential stress

(

σ

θ
θ

max

)

, maximum tangential stress angle

(

θ

σ

θ
θ

max

)

, ultimate tensile strength

(

σ
u

)

, fracture toughness

(

K

I
c

)

, notch opening angle

(
2
α
)

and notch tip radius

(
ρ
)

were selected by using the neighbourhood component analysis (NCA) technique. To predict the fracture load of various types of notched samples, several machine learning (ML) models were trained using the methods of Gaussian process regression (GPR), decision tree ensemble and artificial neural network (ANN). Then, the Bayesian optimization algorithm was applied to find the optimum hyperparameters for each model. Lastly, the performance of the models in predicting fracture load was evaluated against 124 unseen data points. The results revealed the high potential of data-driven methods for assessing the fracture load of notched brittle components with acceptable precisions of 92%, 89% and 88% accuracy, respectively, for GPR, decision tree ensemble and ANN models. The superior performance of the GPR method can be attributed to its ability to capture complex nonlinear relationships in the data while providing reliable uncertainty estimates. Furthermore, thanks to its interpolation capabilities, GPR is able to seamlessly fill the gaps between data points, resulting in more comprehensive and precise predictions across the entire range of input data. Additionally, the presented models were capable of predicting the fracture load of VO-shaped notched samples with acceptable accuracy, though this type of notch was not used in the model training process.

This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 2)'.
Physics-informed deep learning for structural vibration identification and its application on a benchmark structure
Authors: Zhang Minte , Guo Tong , Zhang Guodong , Liu Zhongxiang , Xu Weijie
Published: November 2023

Structural vibration identification is an important task in civil engineering that is based on processing measured data from structural monitoring. However, predicting the response at unsensed locations based on limited sensor data can be challenging. Deep learning (DL) methods have shown promise in vibration data feature extraction and generation, but they struggle to capture the underlying physics laws and dynamic equations that govern vibration identification. This paper presents a novel framework called physics-informed deep learning (PIDL) that combines deep generative networks with structural dynamics knowledge to address these challenges. The PIDL framework consists of a data-driven convolutional neural network for structural excitation identification and a physics-informed variational autoencoder for explicit time-domain (ETD) vibration analysis with the generated unit impulse response (UIR) signal of the measured structure. The proposed framework is evaluated on a benchmark structure for structural health monitoring, demonstrating its effectiveness in extracting physics-related dynamics features and accurately identifying excitation signals and latent physics parameters across different damage patterns. Additionally, the incorporation of an ETD method-aided convolution function in the loss function aligns the generated UIR signals with the dynamic properties of the measured structure. Compared with conventional DL-based vibration analysis methods, the PIDL framework offers improved accuracy and reliability by integrating structural dynamics knowledge. This study contributes to the advancement of structural vibration identification and showcases the potential of the PIDL framework in civil structure monitoring applications.

This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 2)'.
Interpretable fusion methodology of health indices with an application to industrial turbine cavitation condition monitoring
Authors: Fu Yichu , Chen Yikai , Wang Dong , Peng Zhike
Published: November 2023

Using health indices (HIs) to characterize machine conditions is greatly helpful to prevent machine failures and their subsequent catastrophe. Fusion and interpretation of the main contributions of HIs to machine condition monitoring are still challenging. In this paper, an interpretable fusion methodology of HIs is proposed for machine condition monitoring. The proposed methodology begins with elements of statistical learning for classification, following by an essence of how HIs are fused with their associated linear weights to realize machine condition monitoring. One main contribution of this paper gives a theoretical justification for positive and negative weights of the proposed fusion methodology for understanding their importance for machine condition monitoring and making the proposed methodology physically interpretable. In order to be suitable for two practical situations, in which whether faulty data are available or not, two solutions including an offline solution with healthy and faulty datasets and an online solution with only available healthy datasets are suggested to estimate interpretable weights of the proposed methodology. Finally, industrial turbine cavitation status data collected from our group are used to verify the proposed methodology and show its superiority to two existing popular machine fault diagnosis methods.

This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 2)'.
Physics-based and machine-learning models for accurate scour depth prediction
Authors: Jatoliya Ajay , Bhattacharya Debayan , Manna Bappaditya , Bento Ana Margarida , Fazeres Ferradosa Tiago
Published: November 2023

Scour phenomena remain a significant cause of instability in offshore structures. The present study estimates scour depths using physics-based numerical modelling and machine-learning (ML) algorithms. For the ML prediction, datasets were collected from previous studies, and the trained models checked against the statistical measures and reported outcomes. The numerical assessment of the scour depth has been also carried out for the current and coupled wave–current environment within a computational fluid dynamics framework with the aid of the open-source platform REEF3D. The outcomes are validated against the previously reported experimental studies. The results obtained from ML schemes demonstrated that the artificial neural network and adaptive neuro-fuzzy interface system models have an elevated level of effectiveness compared with the other models. Whereas the numerical analysis results show a good agreement against the reported values. For the current only conditions, the normalized scour depth (S/D) at the front and rear end of the pier is 0.65 and 0.81. For the wave–current conditions, the normalized scour depth (S/D) is 0.26. The study highlights the importance of machine learning and physics-based numerical modelling to assess scour depth within a reasonable time frame without compromising accuracy.

This article is part of the theme issue 'Physics-informed machine learning and its structural integrity applications (Part 2)'.
Muricauda myxillae sp. nov., isolated from a marine sponge (Myxilla rosacea), and reclassification of Flagellimonas hymeniacidonis as Muricauda symbiotica nom. nov.
Authors: Moon Yea-Lin , Kim Kyung-Hyun , Park Jin-Sook
Published: November 2023

A Gram-stain-negative, aerobic and non-motile rods strain, designated as strain 2012CJ39-3T, was isolated from a marine sponge, Myxilla rosacea, collected on Chuja Island, Republic of Korea. Optimal growth of strain 2012CJ39-3T was observed at 25 °C, pH 7.0 and in the presence of 2.0–3.0 % (w/v) NaCl. Strain 2012CJ39-3T contained menaquinone-6 as the respiratory quinone, iso-C15 : 1 G, iso-C15 : 0, and iso-C17 : 0 3-OH as the predominant fatty acids, and phosphatidylethanolamine, an unidentified phospholipid, an unidentified glycolipid, three unidentified aminolipids and nine unidentified lipids as major polar lipids. The genomic DNA G+C content was 38.4 mol%. Results of phylogenetic analyses based on the 16S rRNA gene and whole-genome sequences revealed that strain 2012CJ39-3T formed a distinct phyletic lineage in the genus

Muricauda

. Strain 2012CJ39-3T was most closely related to

Flagellimonas hymeniacidonis

176CP5-101T, Muricauda spongiicola 2012CJ35-5T,

Muricauda algicola

AsT0115T,

Muricauda flava

DSM 22638T and

Muricauda parva

SW169T with 96.5, 96.4, 96.3, 95.8 and 95.6 % 16S rRNA gene sequence similarity, respectively. The average nucleotide identity and digital DNA–DNA hybridization values between strain 2012CJ39-3T and M. spongiicola 2012CJ35-5T,

F. hymeniacidonis

176CP5-101T,

M. algicola

AsT0115T,

M. flava

DSM 22638T and

M. parva

SW169T were 75.6, 74.2, 78.6, 75.3 and 74.8 % and 27.4, 19.9, 36.3, 24.2 and 18.9 %, respectively. Based on these results, strain 2012CJ39-3T represents a novel species of the genus

Muricauda

, for which the name Muricauda myxillae sp. nov. is proposed. The type strain is 2012CJ39-3T (=KACC 22644T= LMG 32582T). In addition,

Flagellimonas hymeniacidonis

is reclassified as Muricauda symbiotica nom. nov.
PTFSpot: Deep co-learning on transcription factors and their binding regions attains impeccable universality in plants
Authors: Gupta Sagar , Kesarwani Veerbhan , Bhati Umesh , Jyoti  , Shankar Ravi
Published: November 2023

Unlike animals, variability in transcription factors (TF) and their binding regions (TFBR) across the plants species is a major problem which most of the existing TFBR finding software fail to tackle, rendering them hardly of any use. This limitation has resulted into underdevelopment of plant regulatory research and rampant use ofArabidopsislike model species, generating misleading results. Here we report a revolutionary transformers based deep-learning approach, PTFSpot, which learns from TF structures and their binding regions co-variability to bring a universal TF-DNA interaction model to detect TFBR with complete freedom from TF and species specific models’ limitations. During a series of extensive benchmarking studies over multiple experimentally validated data, it not only outperformed the existing software by >30% lead, but also delivered consistently >90% accuracy even for those species and TF families which were never encountered during model building process. PTFSpot makes it possible now to accurately annotate TFBRs across any plant genome even in the total lack of any TF information, completely free from the bottlenecks of species and TF specific models.
Public Health Response to Pan-ResistantPseudomonas aeruginosaSequence Type 309 with Tandem Guiana Extended Spectrum β-Lactamases – Genetic Characterization andIn VivoEfficacy Assessment using Translational Murine Model
Authors: Lloyd Tyler , Gill Christian M. , Herrera Jade Aquino , Heaton Dustin , Shemsu Munira , Trivedi Kavita K. , Gorzalski Andrew , Bender Monica , Pandori Mark , Varghese Vici , Nicolau David P.
Published: November 2023

Through phenotypic and genetic profiling, we identified the first pan resistantPseudomonas aeruginosahigh-risk sequence type 309 (ST-309) with Guiana Extended Spectrum β-Lactamase (GES) in California, prior to a national outbreak of VIM-GESPseudomonas aeruginosa(1). Our findings highlight detection and use of the translational murine model provide treatment implications for this emergingPseudomonas aeruginosa.
Association with TFIIIC limits MYCN localization in hubs of active promoters and chromatin accumulation of non-phosphorylated RNA Polymerase II
Authors: Vidal Raphael , Leen Eoin , Herold Steffi , Müller Mareike , Fleischhauer Daniel , Schülein-Völk Christina , Papadopoulos Dimitrios , Röschert Isabelle , Uhl Leonie , Ade Carsten P. , Gallant Peter , Bayliss Richard , Eilers Martin , Büchel Gabriele
Published: November 2023

MYC family oncoproteins regulate the expression of a large number of genes and broadly stimulate elongation by RNA polymerase II. While the factors that control the chromatin association of MYC proteins are well understood, much less is known about how interacting proteins mediate MYC’s effects on transcription. Here we show that TFIIIC, an architectural protein complex that controls the three-dimensional chromatin organization at its target sites, binds directly to the amino-terminal transcriptional regulatory domain of MYCN. Surprisingly, TFIIIC has no discernible role in MYCN-dependent gene expression and transcription elongation. Instead, MYCN and TFIIIC preferentially bind to promoters with paused RNAPII and globally limit the accumulation of non-phosphorylated RNAPII at promoters. Consistent with its ubiquitous role in transcription, MYCN broadly participates in hubs of active promoters. Depletion of TFIIIC further increases MYCN localization to these hubs. This increase correlates with a failure of the nuclear exosome and BRCA1, both of which are involved in nascent RNA degradation, to localize to active promoters. Our data suggest that MYCN and TFIIIC exert an censoring function in early transcription that limits promoter accumulation of inactive RNAPII and facilitates promoter-proximal degradation of nascent RNA.
Improving Diagnostic Sensitivity for Imbalanced Musculoskeletal Disorder Data: A Sensitivity-Based Multi-Sampling Technique for Osteoarthritis Prediction
Authors: Kim Jun-hee
Published: November 2023

Background

Medical datasets containing musculoskeletal disorders may have data imbalances due to the incidence of the disease, which may limit the predictive ability, such as the sensitivity, of musculoskeletal diagnostic prediction models built from these data. This study aimed to increase the sensitivity performance of osteoarthritis (OA) prediction when building a model by adjusting an OA imbalanced dataset using a sensitivity-based multi-sampling (SMS) technique.

Methods

OA Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANES). SMS technique combining oversampling and undersampling was applied to the imbalanced OA data, and the RandomForest algorithm was used for machine learning modeling. Model performance was evaluated based on accuracy, sensitivity, and specificity and compared with other hybrid sampling techniques.

Result

In the SMS technique, ADASYN, Borderline-SMOTE, SMOTE oversampling and ENN undersampling techniques were combined and applied. The OA prediction model using the SMS technique showed the highest sensitivity (82.20) but the lowest specificity (82.26) and accuracy (82.26) compared to other hybrid models.

Conclusion

SMS technique offers a potential solution for improving sensitivity performance for prediction models built on medical data imbalances due to low-incidence diseases. Nonetheless, caution is warranted due to the concern that while improving sensitivity, it may decrease specificity with a trade-off.
Development of an EngineeredMycobacterium tuberculosisStrain for a Safe and Effective Tuberculosis Human Challenge Model
Authors: Wang Xin , Su Hongwei , Wallach Joshua B. , Wagner Jeffrey C. , Braunecker Benjamin , Gardner Michelle , Guinn Kristine M. , Klevorn Thais , Lin Kan , Liu Yue J. , Liu Yao , Mugahid Douaa , Rodgers Mark , Sixsmith Jaimie , Wakabayashi Shoko , Zhu Junhao , Zimmerman Matthew , Dartois Véronique , Flynn JoAnne L. , Lin Philana Ling , Ehrt Sabine , Fortune Sarah M. , Rubin Eric J. , Schnappinger Dirk
Published: November 2023

Human challenge experiments could greatly accelerate the development of a tuberculosis (TB) vaccine. Human challenge for tuberculosis requires a strain that can both replicate in the host and be reliably cleared. To accomplish this, we designedMycobacterium tuberculosis(Mtb) strains featuring up to three orthogonal kill switches, tightly regulated by exogenous tetracyclines and trimethoprim. The resultant strains displayed immunogenicity and antibiotic susceptibility similar to wild-type Mtb under permissive conditions. In the absence of supplementary exogenous compounds, the strains were rapidly killed in axenic culture, mice and nonhuman primates. Notably, the strain that contained three kill switches had an escape rate of less than 10-10per genome per generation and displayed no relapse in a SCID mouse model. Collectively, these findings suggest that this engineered Mtb strain could be a safe and effective candidate for a human challenge model.