bluuebunny/crossref_metadata_2025 huggingface dataset:
Anal and Perianal Masses: The Common, the Uncommon, and the Rare
Authors: Augustine Antony , Issac Rijo , Lakhani Aisha , Kanamathareddy Harsha Veena , John Reetu , Simon Betty , Masih Dipti , Eapen Anu , Chandramohan Anuradha
Published: March 2024

A variety of tumors involve the anal canal because the anal canal forms the transition between the digestive system and the skin, and this anatomical region is made of a variety of different cells and tissues. Magnetic resonance imaging (MRI) is the modality of choice for diagnosis and local staging of the anal canal and perianal neoplasms. In this pictorial review, we demonstrate the MRI anatomy of the anal canal and perianal region and display the imaging spectrum of tumors in the region along with an overview of its management. Imaging appearances of many tumorlike lesions that can cause diagnostic dilemmas are also demonstrated with pointers to differentiate between them.
Endothelial LAT1 (SLC7A5) Mediates S-Nitrosothiol Import and Modulates Respiratory Sequelae of Red Blood Cell Transfusion In Vivo
Authors: Zhu Hongmei , Auten Richard L. , Whorton Augustus Richard , Mason Stanley Nicholas , Bock Cheryl B. , Kucera Gary T. , Kelleher Zachary T. , Vose Aaron T. , McMahon Tim J.
Published: March 2024

Background Increased adhesivity of red blood cells (RBCs) to endothelial cells (ECs) may contribute to organ dysfunction in malaria, sickle cell disease, and diabetes. RBCs normally export nitric oxide (NO)-derived vascular signals, facilitating blood flow. S-nitrosothiols (SNOs) are thiol adducts formed in RBCs from precursor NO upon the oxygenation-linked allosteric transition in hemoglobin. RBCs export these vasoregulatory SNOs on demand, thereby regulating regional blood flow and preventing RBC–EC adhesion, and the large (system L) neutral amino acid transporter 1 (LAT1; SLC7A5) appears to mediate SNO export by RBCs.

Methods To determine the role of LAT1-mediated SNO import by ECs generally and of LAT1-mediated SNO import by ECs in RBC SNO-dependent modulation of RBC sequestration and blood oxygenation in vivo, we engineered LAT1fl/fl; Cdh5-Cre+ mice, in which the putative SNO transporter LAT1 can be inducibly depleted (knocked down, KD) specifically in ECs (“LAT1ECKD”).

Results We show that LAT1 in mouse lung ECs mediates cellular SNO uptake. ECs from LAT1ECKD mice (tamoxifen-induced LAT1fl/fl; Cdh5-Cre+) import SNOs poorly ex vivo compared with ECs from wild-type (tamoxifen-treated LAT1fl/fl; Cdh5-Cre−) mice. In vivo, endothelial depletion of LAT1 increased RBC sequestration in the lung and decreased blood oxygenation after RBC transfusion.

Conclusion This is the first study showing a role for SNO transport by LAT1 in ECs in a genetic mouse model. We provide the first direct evidence for the coordination of RBC SNO export with EC SNO import via LAT1. SNO flux via LAT1 modulates RBC–EC sequestration in lungs after transfusion, and its disruption impairs blood oxygenation by the lung.
A Case Report of the First CEA Transplant in an HIV-Positive Burn Patient in South Africa Using a Novel Composite Culture Technique
Authors: Kleintjes Wayne George , Prinsloo Tarryn Kay
Published: March 2024

Resource-limited burn centers are usually devoid of cultured epithelial autografts (CEA) owing largely to prohibitive costs. A modified CEA technique at our burn center incorporated cost-effective, routinely-used dressings with favorable outcomes. One unknown concern was the immunosuppressive effect that extensive burns and potentially human immunodeficiency virus (HIV) infection may have on graft take. This case study reports on the graft take outcomes of the first CEA transplanted in an HIV-positive patient with extensive burns in South Africa, using this technique. Graft take was determined after 21 days at 80% and a long-term follow-up of 8 years indicated good pigmentation return and skin pliability. Delayed diagnosis of pyoderma gangrenosum caused partial graft loss; however, successful regrafting occurred after pyoderma gangrenosum treatment and eradication. The case was considered clinically successful. HIV may not directly affect graft take, but may result in immunosuppressive conditions that delay graft take success.
Percutaneous Biliary Interventions in Pediatric Patients
Authors: Vogt Katharina , Hammer Simone , Grözinger Gerd , Knott Emily A. , Uller Wibke
Published: March 2024

Percutaneous biliary interventions have become standard for a variety of indications in pediatric patients. They offer a minimally invasive approach to managing biliary pathologies often associated with liver transplantation and hepatobiliary surgery. Interventions include the insertion of drainage catheters for bilomas, percutaneous transhepatic cholangiography for diagnostic purposes, and percutaneous transhepatic biliary drainage for the treatment of biliary leaks and cholestasis. Sonography, computed tomography, and fluoroscopy are used to guide the procedures. This review aims to demonstrate the indications and technical aspects of percutaneous biliary interventions in pediatric patients with a special focus on radiation protection.
Deep Neck Lifting
Authors: Wever Capi C.
Published: March 2024

Creating tight and durable profile neck results has perhaps become the principal objective of many surgeons. On social media such results are quickly recognized by colleagues and potential clients alike, much more so than “en-face” results. Yet individual patient characteristics play an essential role in determining if such results are technically possible and also dictate which techniques are required to achieve it. In many patients, these techniques involve manipulation of the deeper neck structures and are oriented more laterally than the direct submental region. Each surgeon needs to decide which technique feels proportionate in terms of an individualized risk–benefit analysis.
The contact origin(s) of ‘hand’ and ‘foot’ > ‘limb’ in
Antioquian Spanish
Authors: Raynor Eliot
Published: March 2024

This study examines the semantic extension of
mano ‘hand’ and pie ‘foot’ to
their contemporary senses of ‘upper limb’ and ‘lower limb’ in
Spanish varieties of Antioquia, Colombia. This dialectally
idiosyncratic pattern, hitherto unexplained in the literature, is
accounted for here as the combined outcome of adult acquisition
among various groups. First, Chocoan languages predominating in the
region throughout the early colonial period show a congruent pattern
in the lexemes for ‘upper limb’ (e.g., Embera Chamí
húa) and ‘lower limb’ (e.g., Embera Catío
hẽ́ɾṹ), and their speakers plausibly initiated
the change via L1 transfer. Chroniclers’ accounts also reveal that
Antioquia’s earliest Europeans relied heavily upon enslaved
African(-descendants), and records of ships carrying enslaved
peoples to the nearby port cities demonstrate that much of the
African-born population in 16th-century Antioquia spoke languages
with congruent patterns also (e.g., Kikongo kóoko
‘upper limb’ and kúulu ‘lower limb’). It is
proposed that adult Spanish learners with these L1s reinforced the
innovative variant.
Towards an acquisitionally informed historical
sociolinguistics
Authors: Sanz-Sánchez Israel
Published: March 2024

This conclusion chapter offers an overview of
some of the main themes developed throughout the volume and
highlights several important theoretical and methodological
implications for the development of new acquisitionally informed
research agendas in historical sociolinguistics. The use of
acquisition theory and corpora as sources of information to
interpret the sociohistorical and sociolinguistic archive is
complicated by several methodological and analytical hurdles –
nevertheless, it is argued here that acquisitional analogues between
past and present and a knowledge of how various groups of learners
process different forms of variation can do much to propel the study
of language variation and change in historical situations. In
addition, new technological developments and sources of data can
furnish researchers additional information about how individual
acquisitional trajectories may have contributed to the linguistic
patterns attested in the archival record. Lastly, an acquisitionally
informed perspective can also be a step to address structural
inequalities in linguistic description and in the construction of
knowledge in our field.
The unfinished double glosses in Durham Cathedral Library, MS A.iv.19
Authors: Langmuir Christopher
Published: March 2024

Incomplete multiple glosses are a prominent feature of Aldred’s glossing practice in the Lindisfarne Gospels
(Cotton MS Nero D IV). In his later gloss, that to Durham Cathedral Library, MS A.iv.19, incomplete double glosses are
predominant. Their raison d´être is unclear. This paper addresses the range of functions represented
by vel (‘or’) in Durham Cathedral Library, MS A.iv.19. It is argued that the appended
vel of incomplete glosses may carry a vel potius (‘or rather’) value thereby
alerting readers to the provisional character of the gloss. Inspection of the manuscript reveals that in many
instances insufficient space has been allowed for any second gloss. Incomplete glosses must also be considered in the
context of how the same lemmata are glossed elsewhere in the manuscript.
Investigating the dynamics of the lexicon
Authors: Landmann Julia
Published: March 2024

This chapter focuses on the lexical influence of Yiddish on English throughout its history. The findings
rely on an analysis of the linguistic evidence in electronic dictionaries and corpora. Specific value will be accorded
to the use of Yiddish borrowings in informal language. Yiddish has provided English with a number of terms relating to
various semantic domains, ranging from gastronomy, faith and religion, to people and everyday life. An important
objective is to provide an overview of the domains influenced by Yiddish over time. Particular attention will be given
to socio-cultural and historical reasons that might explain the introduction and spread of Yiddish borrowings into
different domains over the centuries, contributing to variation in the English lexicon.
A manipulative technique in a congressional debate
Authors: Rudanko Juhani , Rickman Paul
Published: March 2024

This article examines a debate in the United States House of Representatives in 1789 and presents a case study of ad socordiam, which is shown to be an informal fallacy in the language of politics. This fallacy is based on inferences about covert intentions of speakers, depending in part on the level of the hearer’s epistemic vigilance. The study shows how an inference about a speaker’s intention can be substantiated on the basis of evidence even in the case of a historical debate. The present study advocates a view of pragmatics and discourse analysis that regards inferences about covert intentions as a legitimate object of investigation to provide a fuller picture of political debates involving deep disagreements and manipulation.
“No criticism or remarks & pray burn it as fast as you read it”
Authors: Oudesluijs Tino
Published: March 2024

Building on what has been written about copy letters and copying practices in Late Modern English correspondence, this paper explores the copying behaviour of a highly cultured and well-connected woman in eighteenth-century British polite society, Mary Hamilton (1756–1816), by closely scrutinising a selection of her writings containing material copied from various other letters. Close attention is paid to what linguistic features were changed in the copying process, which is contextualised and subsequently discussed in the appropriate socio-historical context. The case studies reveal that various linguistic elements were changed in the copying process, part of which can be attributed to changes in addressee, Hamilton’s expectations of who else might read her writings, and how her letters would have been delivered.
Revisiting Modality
Authors: Míguez Vítor
Published: March 2024

This book presents the first in-depth investigation of modality in Galician linguistics, offering a theoretical discussion of modal categories and a fine-grained description of epistemic adverbs. The first half of the monograph deconstructs the most relevant approaches to modal categories and shows how the traditional concept of modality is a problematic notion, how it relates to other concepts such as evidentiality and mitigation, and how it ought to be conceived of in order to become a more useful instrument for linguistic analysis. A new way of understanding modality is explored and illustrated through Galician examples. The second half of the book zooms in on six epistemic adverbs, which are exhaustively studied from both a formal and a functional perspective. Combining a quantitative and a qualitative perspective, the book shows that adverbs make up a rich semantic scale and establishes several factors that condition their occurrence in discourse, challenging previous conceptions of this grammatical domain.
Raising awareness of stroke, stroke survivor-perspectives, and stroke–carer research
Authors: Kambanaros Maria
Published: March 2024

The aim of this chapter is to propose a research agenda that will promote awareness of stroke warning signs and risk for stroke in culturally and linguistically diverse (CALD) communities. The targeted community in this case, is the Greek immigrant community in Australia. The research agenda also advocates a better understanding of CALD stroke survivors and carers needs to enable capacity-building to encourage wellbeing by supporting unmet needs. This will have a positive impact on health, care and psychosocial outcomes for people living with stroke deficits from CALD backgrounds and their carers and families who support them in everyday life.
Subjecthood transparency
Authors: O’Conaill Donnchadh
Published: March 2024

In recent work Philip Goff has defended the thesis of subjecthood transparency: someone possessing the concept ‘subjecthood’ is thereby in a position to know, a priori, what it is for an entity to be a subject of experiences. Kevin Morris has criticized a specific argument that Goff provides for subjecthood transparency. I will argue that Morris’s criticism of Goff’s argument does not succeed. I will then present an alternative criticism of Goff’s argument, one that also applies to the thesis of subjecthood transparency itself.
To reason or not to reason: arbitral awards—the conflict between conciseness and the duty to provide reasons under national laws and international rules
Authors: Zamir Noam , Kaplan Neil
Published: March 2024

The duty to give reasons in arbitral awards has a mixed history. While it can be traced back to the second part of the 20th century in England, it has been part of accepted practice in civil law countries for a long period. It has become the norm in international arbitration, both in commercial disputes and in investment disputes. While the duty to give reasons is, in general, positive, this article suggests that many international awards tend to be too long. This prolongs the arbitration proceedings and increases costs—both in terms of the arbitrators’ fees and the costs that the parties to dispute must bear while waiting for the award to be issued. To tackle this problem, the article examines the required scope of reasoning in international awards; it then discusses why many international awards tend to be too long. Finally, it suggests ways in which awards can and should be shorter.
Plasma biomarkers for Alzheimer’s and related dementias: A review and outlook for clinical neuropsychology
Authors: Dark Heather E , Duggan Michael R , Walker Keenan A
Published: March 2024

Recent technological advances have improved the sensitivity and specificity of blood-based biomarkers for Alzheimer’s disease and related dementias. Accurate quantification of amyloid-ß peptide, phosphorylated tau (pTau) isoforms, as well as markers of neurodegeneration (neurofilament light chain [NfL]) and neuro-immune activation (glial fibrillary acidic protein [GFAP] and chitinase-3-like protein 1 [YKL-40]) in blood has allowed researchers to characterize neurobiological processes at scale in a cost-effective and minimally invasive manner. Although currently used primarily for research purposes, these blood-based biomarkers have the potential to be highly impactful in the clinical setting – aiding in diagnosis, predicting disease risk, and monitoring disease progression. Whereas plasma NfL has shown promise as a non-specific marker of neuronal injury, plasma pTau181, pTau217, pTau231, and GFAP have demonstrated desirable levels of sensitivity and specificity for identification of individuals with Alzheimer’s disease pathology and Alzheimer’s dementia. In this forward looking review, we (i) provide an overview of the most commonly used blood-based biomarkers for Alzheimer’s disease and related dementias, (ii) discuss how comorbid medical conditions, demographic, and genetic factors can inform the interpretation of these biomarkers, (iii) describe ongoing efforts to move blood-based biomarkers into the clinic, and (iv) highlight the central role that clinical neuropsychologists may play in contextualizing and communicating blood-based biomarker results for patients.
A Novel Validated GC–MS/MS Method for the Estimation of N-Nitroso Dimethyl Amine and N-Nitroso Diethyl Amine in Zidovudine
Authors: Papadasu Narayanareddy , Kotanka Ramakrishnareddy , Pannala Raghuram
Published: March 2024

A novel method has been developed for the estimation of N-Nitroso dimethyl amine impurities (NDMA) and N-Nitroso diethyl amine (NDEA) in Zidovudine by using Gas chromatograph Triple Quadrupole Mass with Liquid autosampler (GC–MS/MS) and the method is validated as per International Conference on Harmonization recommendations. Sample analysis was executed for Zidovudine by developed method. Both NDMA and NDEA were detected in below quantitation limit for the Zidovudine batches. Efficient chromatographic separation was achieved on a DB-WAX 30 m length × 0.25 mm internal diameter, 0.5-μm film thickness, Triple quad-8040 GC–MS/MS. Quantification was carried out at Triple quad electron ionization source was at a column flow of 1.5 mL/min at a column oven temperature 50°C. The precision was in the range of 0.9–2.5% for NDMA and 0.8–2.3% for NDEA, and regression analysis shows as r value (correlation coefficient) of is >0.99. This method is capable to detect the NDMA and NDEA impurities in Zidovudine at a level of 0.006 ppm for limit of detection and 0.018 ppm for limit of quantitation with respect to test concentration of 66.66 mg/mL.
A 20-year follow-up study of identical twin sisters with immunoglobulin A nephropathy
Authors: Okabe Masahiro , Tsuboi Nobuo , Ueda Hiroyuki , Hishida Erika , Miyazaki Yoichi , Yokoo Takashi
Published: March 2024

Immunoglobulin A nephropathy (IgAN) is characterized by diverse clinicopathological phenotypes. Herein we present a follow-up study of previously reported identical twin sisters with IgAN. The older sister exhibited more severe kidney histopathology and proteinuria and a lower birthweight than did her younger sister, and only the older sister experienced two childbirths. These raised concerns regarding her kidney outcomes. However, with timely multidisciplinary treatments, the older sister's kidney function remained preserved after 20 years of IgAN history. Our findings indicate the significant contribution of environmental/epigenetic factors to IgAN progression and the need for tailored medical care corresponding to life events.
Longer Colonoscopy Withdrawal Time Is Associated With the Detection of Visible Dysplasia in Patients With Inflammatory Bowel Disease
Authors: McMillan Chandler , Li Darrick K , Mohamed Gamal , Alsadoun Danah A , Almohsen Leena A , Gaidos Jill K J , Proctor Deborah D , Al-Bawardy Badr
Published: March 2024

Background

Colonoscopy withdrawal time (CWT) of at least 6–9 minutes is the minimum time needed for adequate adenoma detection in the general population. The ideal CWT in patients with inflammatory bowel disease (IBD) has not been determined. We aimed to identify the optimal CWT associated with the detection of visible dysplasia in patients with IBD.

Methods

This is a retrospective study from 1/1/2017 to 9/1/2022 of adult patients with IBD in endoscopic healing undergoing surveillance via high-definition white light colonoscopy. The primary outcome was the association of CWT with visible dysplasia detection.

Results

A total of 259 patients (mean age 56 ± 14.8 years; 51.3% female, 68% with ulcerative colitis; 8.9% with primary sclerosing cholangitis) underwent 330 colonoscopies. Patients with visible dysplasia were more likely to be older (P < .001) and have a personal history of visible dysplasia (P < .001) and invisible dysplasia (P = .023). The mean CWT was significantly longer in the visible dysplasia group at 26 minutes (interquartile range [IQR] 20–38.5) vs. 21 minutes (IQR 15–28) in procedures without visible dysplasia (P < .001). On multivariable analysis, increased age (P < .001), increased CWT (P = .001), and personal history of visible dysplasia (P = .013) were independently associated with the detection of visible dysplasia. A CWT of ≥15 minutes (odds ratio [OR] 2.71; 95% confidence interval [CI], 1.11–6.6; P = .02] and not ≥9 minutes (OR 2.57; 95% CI, 0.33–20.2; P = .35) is significantly associated with detection of visible dysplasia.

Conclusions

For patients with IBD undergoing surveillance via high-definition white light colonoscopy, the mean CWT was independently associated with the detection of visible dysplasia.
Spending and Pricing to Deter Arbitrage
Authors: Salant Stephen W
Published: March 2024

This article presents examples of arbitrage deterrence from the pharmaceutical, chemical and auto industries. Based on these cases, it develops two models where a monopolist prices and spends to deter arbitrage. The models differ in whether the lower price is set by the firm or negotiated with a representative of consumers. In both models, imports into the high-price market are completely deterred, but the two markets are nonetheless linked by the threat of arbitrage. If this linkage is ignored and the absence of arbitrage is misattributed to exogenous factors, econometric estimates of firm bargaining power will be biased upwards.
Perceived Benefits of Curling in Older Canadian Women
Authors: Mazhar Alia , Patelia Shruti , Baker Joseph
Published: March 2024

Objectives

An increasing proportion of older Canadians are pursuing sports. The objective of this study was to examine the experiences of older Canadian women in curling.

Methods

Semistructured interviews were conducted with 17 participants. Interviews were transcribed and coded using thematic analysis.

Results

Participants simultaneously resisted, accepted, and ultimately redefined conceptualizations of personal aging in the context of curling. Although gender was deemed inconsequential, concepts such as the physical and cognitive demands of curling, inclusivity, social connection and support, and competition were perceived to be integral to participants’ experiences.

Discussion

This study extends our understanding of the value of curling specifically, and sport in general, for older women.
Computational Approaches and Observer Variation in the 3D Musculoskeletal Modeling of the Heads of Anolis
Authors: Lagorio A D , McGechie F R , Fields M G , Fortner J , Mackereth E , Perez C , Wilken A T , Leal M , Ward C V , Middleton K M , Holliday C M
Published: March 2024

Synopsis

High-resolution imaging, 3D modeling, and quantitative analyses are equipping evolutionary biologists with new approaches to understanding the variation and evolution of the musculoskeletal system. However, challenges with interpreting DiceCT data and higher order use of modeled muscles have not yet been fully explored, and the error in and accuracy of some digital methods remain unclear. West Indian Anolis lizards are a model clade for exploring patterns in functional adaptation, ecomorphology, and sexual size dimorphism in vertebrates. These lizards possess numerous jaw muscles with potentially different anatomies that sculpt the adductor chamber of the skull. Here we test approaches to quantifying the musculoskeletal shape of the heads of two species of Anolis: A. pulchellus and A. sagrei. We employ comparative approaches such as DiceCT segmentation of jaw muscles, 3D surface attachment mapping, and 3D landmarking with the aim of exploring muscle volumes, 3D muscle fiber architecture, and sexual dimorphism of the skull. We then compare sources of measurement error in these 3D analyses while also presenting new 3D musculoskeletal data from the Anolis feeding apparatus. These findings demonstrate the accessibility and repeatability of these emerging techniques as well as provide details regarding the musculoskeletal anatomy of the heads of A. pulchellus and A. sagrei which show potential for further research of comparative biomechanics and evolution in the clade.
Ensemble pretrained language models to extract biomedical knowledge from literature
Authors: Li Zhao , Wei Qiang , Huang Liang-Chin , Li Jianfu , Hu Yan , Chuang Yao-Shun , He Jianping , Das Avisha , Keloth Vipina Kuttichi , Yang Yuntao , Diala Chiamaka S , Roberts Kirk E , Tao Cui , Jiang Xiaoqian , Zheng W Jim , Xu Hua
Published: March 2024

Objectives

The rapid expansion of biomedical literature necessitates automated techniques to discern relationships between biomedical concepts from extensive free text. Such techniques facilitate the development of detailed knowledge bases and highlight research deficiencies. The LitCoin Natural Language Processing (NLP) challenge, organized by the National Center for Advancing Translational Science, aims to evaluate such potential and provides a manually annotated corpus for methodology development and benchmarking.

Materials and Methods

For the named entity recognition (NER) task, we utilized ensemble learning to merge predictions from three domain-specific models, namely BioBERT, PubMedBERT, and BioM-ELECTRA, devised a rule-driven detection method for cell line and taxonomy names and annotated 70 more abstracts as additional corpus. We further finetuned the T0pp model, with 11 billion parameters, to boost the performance on relation extraction and leveraged entites’ location information (eg, title, background) to enhance novelty prediction performance in relation extraction (RE).

Results

Our pioneering NLP system designed for this challenge secured first place in Phase I—NER and second place in Phase II—relation extraction and novelty prediction, outpacing over 200 teams. We tested OpenAI ChatGPT 3.5 and ChatGPT 4 in a Zero-Shot setting using the same test set, revealing that our finetuned model considerably surpasses these broad-spectrum large language models.

Discussion and Conclusion

Our outcomes depict a robust NLP system excelling in NER and RE across various biomedical entities, emphasizing that task-specific models remain superior to generic large ones. Such insights are valuable for endeavors like knowledge graph development and hypothesis formulation in biomedical research.
Surgical Management of Diabetic Foot Burns Is Associated With Poor Outcomes: A Systematic Review and Meta-Analysis
Authors: Cannata Brigette , Malkoff Nicolas , Choe Deborah , Manasyan Artur , Yenikomshian Haig A , Gillenwater T Justin
Published: March 2024

There is no consensus on the optimal management of diabetic foot burn injuries. Here, we systematically identify studies reporting on diabetic foot burns and evaluate outcomes among patients managed operatively vs nonoperatively. PubMed, Embase, and Web of Science were searched. Screening was performed by independent reviewers. Primary research studies with English full texts published between 1980 and 2023 that discussed outcomes of foot burns in adults with diabetes were included and critically appraised using validated tools. Results are presented using descriptive statistics of aggregated data. The search yielded 2402 nonduplicate papers, of which 35 met the inclusion criteria. Nine papers were included for meta-analysis, including 7 retrospective comparative analyses, 1 cross-sectional study, and 1 retrospective chart review. There were 1798 diabetic foot burn patients. The mean age was 58.2 years (SD 4.12), and 73.1% (n = 1314) were male. A total of 15.7% (n = 283) of patients were surgically managed, including debridement (3.7%, n = 66), grafting (8.2%, n = 147), flap (0.2%, n = 3), and primary amputation (7.1%, n = 127). The secondary amputation rate, defined as amputation following initial surgery, was 4.9% (n = 14). The overall amputation rate was 7.8% (n = 141). Other complications included infection (4.0%, n = 72), osteomyelitis (1.9%, n = 34), and graft failure (8.2%, n = 12). One study reported functional status at the last visit. Diabetic foot burns are highly morbid. The surgical management of these complex injuries is high risk, as amputation results in poorer quality of life and functional outcomes.
Hierarchical RNNs with graph policy and attention for drone swarm
Authors: Wei XiaoLong , Cui WenPeng , Huang XiangLin , Yang LiFang , Geng XiaoQi , Tao ZhuLin , Zhai Yan
Published: March 2024

In recent years, the drone swarm has experienced remarkable growth, finding applications across diverse domains such as agricultural surveying, disaster rescue and logistics delivery. However, the rapid expansion of drone swarm usage underscores the necessity for innovative approaches in the field. Traditional algorithms face challenges in adapting to complex tasks, environmental modeling and computational complexity, highlighting the need for more advanced solutions like multi-agent deep reinforcement learning to enhance efficiency and robustness in drone swarm. Our proposed approach tackles this challenge by embracing temporal and spatial. In terms of the temporal, the proposed approach builds upon historical data, it enhances the predictive capabilities regarding future behaviors. In the spatial, the proposed approach leverage graph theory to model the swarm's features, while attention mechanisms strengthen the relationships between individual drones. The proposed approach addresses the unique characteristics of drone swarms by incorporating temporal dependencies, spatial structures and attention mechanisms. Extensive experiments validate the effectiveness of the proposed approach.
MIWI N-terminal arginines orchestrate generation of functional pachytene piRNAs and spermiogenesis
Authors: Vrettos Nicholas , Oppelt Jan , Zoch Ansgar , Sgourdou Paraskevi , Yoshida Haruka , Song Brian , Fink Ryan , O’Carroll Dónal , Mourelatos Zissimos
Published: March 2024

N-terminal arginine (NTR) methylation is a conserved feature of PIWI proteins, which are central components of the PIWI-interacting RNA (piRNA) pathway. The significance and precise function of PIWI NTR methylation in mammals remains unknown. In mice, PIWI NTRs bind Tudor domain containing proteins (TDRDs) that have essential roles in piRNA biogenesis and the formation of the chromatoid body. Using mouse MIWI (PIWIL1) as paradigm, we demonstrate that the NTRs are essential for spermatogenesis through the regulation of transposons and gene expression. The loss of TDRD5 and TDRKH interaction with MIWI results in attenuation of piRNA amplification. We find that piRNA amplification is necessary for transposon control and for sustaining piRNA levels including select, nonconserved, pachytene piRNAs that target specific mRNAs required for spermatogenesis. Our findings support the notion that the vast majority of pachytene piRNAs are dispensable, acting as self-serving genetic elements that rely for propagation on MIWI piRNA amplification. MIWI-NTRs also mediate interactions with TDRD6 that are necessary for chromatoid body compaction. Furthermore, MIWI-NTRs promote stabilization of spermiogenic transcripts that drive nuclear compaction, which is essential for sperm formation. In summary, the NTRs underpin the diversification of MIWI protein function.
A comparison of sodium-glucose co-transporter 2 inhibitor kidney outcome trial participants with a real-world chronic kidney disease primary care population
Authors: Forbes Anna K , Hinton William , Feher Michael D , Elson William , Ordóñez-Mena José M , Joy Mark , Fan Xuejuan , Banerjee Debasish , Cole Nicholas I , Munro Neil , Whyte Martin , Suckling Rebecca J , Swift Pauline A , de Lusignan Simon
Published: March 2024

Background

Observational studies suggest sodium-glucose co-transporter 2 (SGLT2) inhibitor kidney outcome trials are not representative of the broader population of people with chronic kidney disease (CKD). However, there are limited data on the generalizability to those without co-existing type 2 diabetes (T2D), and the representativeness of the Study of Heart and Kidney Protection with Empagliflozin (EMPA-KIDNEY) trial has not been adequately explored. We hypothesized that SGLT2 inhibitor kidney outcome trials are more representative of people with co-existing T2D than those without, and that EMPA-KIDNEY is more representative than previous trials.

Methods

A cross-sectional analysis of adults with CKD in English primary care was conducted using the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub. The proportions that met the eligibility criteria of SGLT2 inhibitor kidney outcome trials were determined, and their characteristics described. Logistic regression analyses were performed to identify factors associated with trial eligibility.

Results

Of 6 670 829 adults, 516 491 (7.7%) with CKD were identified. In the real-world CKD population, 0.9%, 2.2% and 8.0% met the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE), Dapagliflozin and Renal Outcomes and Cardiovascular Mortality in Patients with Chronic Kidney Disease (DAPA-CKD) and EMPA-KIDNEY eligibility criteria, respectively. All trials were more representative of people with co-existing T2D than those without T2D. Trial participants were 9–14 years younger than the real-world CKD population, and had more advanced CKD, including higher levels of albuminuria. A higher proportion of the CREDENCE (100%), DAPA-CKD (67.6%) and EMPA-KIDNEY (44.5%) trial participants had T2D compared with the real-world CKD population (32.8%). Renin–angiotensin system inhibitors were prescribed in almost all trial participants, compared with less than half of the real-world CKD population. Females were under-represented and less likely to be eligible for the trials.

Conclusion

SGLT2 inhibitor kidney outcome trials represent a subgroup of people with CKD at high risk of adverse kidney events. Our study highlights the importance of complementing trials with real-world studies, exploring the effectiveness of SGLT2 inhibitors in the broader population of people with CKD.
Improving patient-centred care in the emergency department: Implementation of a Sensory Toolkit for children with autism
Authors: Roy Meagan A , Kinlin Ceilidh , Estes Myka , MacEachern Sarah J
Published: March 2024

Emergency department (ED) visits for children with autism can present challenges due to the unique sensory needs of this population. This Quality Improvement (QI) project executed two Plan-Do-Study-Act (PDSA) cycles to create and implement a Sensory Toolkit in the ED for children with autism. Most caregivers (94%; n = 31/33) and healthcare providers (HCPs; 86%; n = 37/44) identified the need for sensory items in the ED. In PDSA Cycle 1, 100% of caregivers (n = 21) and HCPs (n = 3) agreed/strongly agreed that the ED Sensory Toolkit was helpful. In PDSA Cycle 2, 92% of caregivers (n = 12/13) and 100% of HCPs (n = 3) agreed/strongly agreed that they were helpful. The Sensory Toolkit was positively evaluated by caregivers of children with autism and HCPs during the child’s visit to the ED. There is an opportunity to adapt the Sensory Toolkit for other EDs and areas of the hospital.
Early Mobilization Dose Reporting in Randomized Clinical Trials With Patients Who Were Mechanically Ventilated: A Scoping Review
Authors: González-Seguel Felipe , Letelier-Bernal Renato
Published: March 2024

Objective

The aim of this scoping review was to investigate the mobilization dose reporting in the randomized clinical trials (RCTs) of patients receiving mechanical ventilation in the intensive care unit.

Methods

In this scoping review, RCTs published from inception to December 2022 were searched in relevant electronic databases. Trials that involved adults receiving mechanical ventilation (>48 hours) and any early mobilization modality were analyzed. Two independent authors screened, selected, and extracted data. The mobilization doses of the intervention groups (IGs) and the comparator groups (CGs) were assessed as the proportion of reported items/total applicable from the main items of the Consensus on Exercise Reporting Template (CERT).

Results

Twenty-three RCTs comprising 2707 patients (1358 from IG and 1349 from CG) were included, involving studies on neuromuscular electrical stimulation (n = 7), progressive mobility (n = 6), leg cycling (n = 3), tilt table (n = 1), and multicomponent (n = 6) mobilization. The pooled reporting of CERT items was 68% (86% for IG and 50% for CG). The most reported CERT items were type of exercise (100%) and weekly frequency (100%) for IG, whereas the least reported were intensity (4%) and individualization (22%) for CG. Regardless of the group, individualization, progression, and intensity of mobilization were the least reported items. Eight IGs (35%) reported all CERT items, whereas no CGs reported all of them.

Conclusions

Deficits in mobilization dose reporting of intensive care unit RCTs were identified, especially for exercise intensity in adults receiving mechanical ventilation. One-third of IG reported all exercise dosing items, whereas no CG reported all of them. Future studies should investigate the details of optimal dosage reporting, particularly for CG.

Impact

The lack of dose reporting may partially explain the inconsistency in the meta-analysis results of early mobilization trials, thus limiting the interpretation for clinical practice in the intensive care unit.
Reliability and validity of intervention characteristic measures for assessing barriers to evidence-based practice use
Authors: Jones Salene M W , Weiner Bryan J
Published: March 2024

Assessing barriers before implementing an evidence-based practice can increase the chances of successful implementation. This project evaluated measures of intervention characteristics that could affect implementation: evidence strength and quality; relative advantage; adaptability; trialability; complexity; design quality and packaging; perceived cost; compatibility; observability; risk; and burden. Measures (109 items total) for each intervention characteristic were developed in a previous study, using prior measures, and expert feedback. Measures were scored such that higher scores meant a more positive view. Healthcare personnel implementing a new practice (n = 175) completed two surveys, 1 month apart. Participants completed the intervention characteristic item banks and questions on the use of the evidence-based practice. Reliability and validity were assessed for each item bank. All measures had Cronbach’s alphas over 0.7 (range: 0.700–0.932) indicating good reliability. Frequent users of the practice reported better levels of each determinant at the first (Cohen’s d range: −0.239 to −0.687) and second surveys (Cohen’s d range: −0.043 to −1.081) except for costs (0.096) with use on the second survey. This preliminary test of measures to assess determinants of implementing evidence-based practice supports the validity and reliability of these tools. Additional studies are needed to further test the psychometric properties of the measures and develop short forms of each intervention characteristic measure.
Biosafety and toxicity assessment of transgenic cotton-harboring insecticide and herbicide tolerant genes on albino mice
Authors: Bhutta Muhammad Saad , Awais Muhammad , Raouf Abdul , Anjum Aqsa , Azam Saira , Shahid Naila , Malik Kausar , Shahid Ahmed Ali , Rao Abdul Qayyum
Published: March 2024

Introduction

Genetic engineering has revolutionized agriculture by transforming biotic and abiotic stress-resistance genes in plants. The biosafety of GM crops is a major concern for consumers and regulatory authorities.

Methodology

A 14-week biosafety and toxicity analysis of transgenic cotton, containing 5 transgenes ((Cry1Ac, Cry2A, CP4 EPSPS, VIP3Aa, and ASAL)), was conducted on albino mice. Thirty mice were divided into three groups (Conventional, Non-transgenic, without Bt, and transgenic, containing targeted crop) according to the feed given, with 10 mice in each group, with 5 male and 5 female mice in each group.

Results

During the study, no biologically significant changes were observed in the non-transgenic and transgenic groups compared to the control group in any of the study’s parameters i.e. increase in weight of mice, physiological, pathological, and molecular analysis, irrespective of the gender of the mice. However, a statistically significant change was observed in the hematological parameters of the male mice, while no such change was observed in the female study group mice. The expression analysis, however, of the TNF gene increases many folds in the transgenic group as compared to the non-transgenic and conventional groups.

Conclusion

Overall, no physiological, pathological, or molecular toxicity was observed in the mice fed with transgenic feed. Therefore, it can be speculated that the targeted transgenic crop is biologically safe. However, more study is required to confirm the biosafety of the product on the animal by expression profiling.
Systematic Dental Screening Before Transcatheter Aortic Valve Replacement: A Call to Action!
Authors: Amoroso Giovanni , Mellema Erni C.
Published: March 2024

Transcatheter aortic valve implantation (TAVR) offers an alternative to surgical aortic valve replacement for high-risk patients. Despite its benefits, concerns arise from its association with prosthetic valve endocarditis (PVE), a severe complication. Recent studies indicate a potential higher incidence of PVE in TAVR recipients, especially within the first year postimplantation. A significant proportion of these cases trace back to oral-pharyngeal bacteria. However, no consensus exists on dental screening for TAVR, unlike the standard procedure for surgical aortic valve replacement. Dental screenings could reduce PVE risks and aid in patient recovery. This article underscores the importance of dental screenings, calling for more research to establish its efficacy and systematic application for TAVRI candidates. Collaborative efforts between oral and maxillofacial surgeons and cardiologists are crucial for optimal patient outcomes.
Harnessing the Power of AI: A Comprehensive Review of Left Ventricular Ejection Fraction Assessment With Echocardiography
Authors: Barris Ben , Karp Avrohom , Jacobs Menachem , Frishman William H.
Published: March 2024

The quantification of left ventricular ejection fraction (LVEF) has important clinical utility in the assessment of cardiac function and is vital for the diagnosis of cardiovascular diseases. A transthoracic echocardiogram serves as the most commonly used tool for LVEF assessment for several reasons, including, its noninvasive nature, great safety profile, real-time image processing ability, portability, and cost-effectiveness. However, transthoracic echocardiogram is highly dependent on the clinical skill of the sonographer and interpreting physician. Moreover, even amongst well-trained clinicians, significant interobserver variability exists in the quantification of LVEF. In search of possible solutions, the usage of artificial intelligence (AI) has been increasingly tested in the clinical setting. While AI-derived ejection fraction is in the preliminary stages of development, it has shown promise in its ability to rapidly quantify LVEF, decrease variability, increase accuracy, and utilize higher-order processing capabilities. This review will delineate the latest advancements of AI in evaluating LVEF through echocardiography and explore the challenges and future trajectory of this emerging domain.
Otic Capsule Demineralization and Hearing Outcome of Stapes Surgery for Osteogenesis Imperfecta in Comparison With Otosclerosis
Authors: Kimura Akira , Morita Yuka , Kitazawa Meiko , Yagi Chihiro , Takahashi Kuniyuki , Ohshima Shinsuke , Yamagishi Tatsuya , Izumi Shuji , Horii Arata
Published: March 2024

Objective

To assess the location/number of otic capsule demineralization and hearing outcomes of stapes surgery (SS) for osteogenesis imperfecta (OI) compared with otosclerosis (OS).

Patients

This study included 11 and 181 consecutive ears from 6 and 152 patients with OI and OS, respectively.

Interventions

Demineralization loci observed as hypodense area of the otic capsule were examined using high-resolution computed tomography. All patients underwent SS.

Main Outcome Measures

Locations of the hypodense areas were classified into the anterior oval window, anterior internal auditory canal, and pericochlear area. The location/number of hypodense areas and preoperative/postoperative hearing parameters were correlated. Postoperative hearing outcome was evaluated 12 months after surgery.

Results

Hypodense area was more frequently observed in OI (9 of 11 ears [81.8%]) than in OS (96 of 181 ears [53.0%]), with significant differences. Multiple sites were involved in 81.8% OI and 18.8% OS patients, showing significant differences. Preoperative air conduction (AC), bone conduction, and air-bone gap (ABG) were 48.9 ± 17.8, 28.0 ± 11.3, and 20.7 ± 8.4 dB, respectively, in OI and 56.2 ± 13.5, 30.5 ± 9.9, and 26.4 ± 9.7 dB, respectively, in OS, demonstrating greater AC and ABG in OS than in OI. Postoperative AC (31.3 ± 20.5 dB), ABG (10.6 ± 10.0 dB), and closure of ABG (12.1 ± 4.7 dB), that is, preoperative ABG minus postoperative ABG of OI, were comparable to those of OS (AC, 30.9 ± 13.3 dB; ABG, 7.0 ± 7.4 dB; closure of ABG, 20.1 ± 11.6 dB).

Conclusion

OI ears showed more severe demineralization of otic capsule than OS ears. However, favorable hearing outcomes could be obtained through SS for OI and OS ears.
MRI Safety of Stapes Prostheses: A Systematic Review
Authors: Daher Ghazal S. , Kocharyan Armine , Carlson Matthew L. , Dillon William P. , Fischbein Nancy J. , Jackler Robert , Rassner Ulrich , Gurgel Richard K.
Published: March 2024

Objective

To assess magnetic resonance imaging (MRI) safety of stapes prostheses.

Data Sources

Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus databases were searched from inception to November 2021 following PRISMA guidelines.

Review Methods

Studies reporting evidence of stapes prosthesis displacement or interaction in adult or pediatric implant recipients undergoing MRI. Cadaveric, animal, and basic studies with nonhuman data were also included.

Results

From an initial search of 123 articles, 42 full-text studies were evaluated for eligibility and 19 studies that met the inclusion criteria were included. Motion artifact was reported in a few stainless steel prosthesis types in vitro; however, such displacement was not observed in human cadaver temporal bone studies and had no adverse reported outcomes. A small subgroup of patients in the 1980s received a ferromagnetic stainless steel stapes implant that was recalled and has not been used since 1987. Patients with implants performed in the 1980s should be directed to 1.5T scanners from an abundance of caution.

Conclusion

Modern (post-1987) stapes prostheses do not pose a risk in vivo when exposed to the magnetic fields of MRI scanners.