bluuebunny/crossref_metadata_2025 huggingface dataset:
Endokarditisprophylaxe
Authors: Veulemans Verena
Published: October 2024

Die infektiöse Endokarditis (IE) ist eine seltene, aber potenziell lebensbedrohliche Erkrankung, die durch eine Infektion verursacht wird. Obwohl sie selten ist, kann sie schwerwiegende Komplikationen wie Herzklappeninsuffizienz oder septische Embolien nach sich ziehen. Im Jahr 2019 betrug die geschätzte Inzidenz der IE 13,8 Fälle pro 100000 Probanden pro Jahr und verursachte weltweit über 66000 Todesfälle. Die Endokarditisprophylaxe als Vorbeugung gegen diese Erkrankung ist von entscheidender Bedeutung, insbesondere für Personen mit bestimmten Risikofaktoren. Seit der Veröffentlichung der ESC-Leitlinien für die Behandlung der IE 2015 wurden wichtige neue Daten veröffentlicht, die eine Aktualisierung der Empfehlungen erforderten. In diesem Artikel werden die aktuellen Empfehlungen zur Endokarditisprophylaxe gemäß den ESC-Leitlinien 2023 erläutert.
Device-assoziierte Endokarditis – was ist zu beachten?
Authors: Hillmann Henrike A. K. , Albert Karolin , Duncker David
Published: October 2024

Die Device-assoziierte Endokarditis stellt eine ernstzunehmende Komplikation nach Implantation von kardialen elektronischen Devices dar. Die Symptomatik ist variabel – Patienten können mit Veränderungen im Bereich der Wunde, aber auch mit unspezifischen Symptomen wie Fieber auffällig werden. Eine frühzeitige Diagnosestellung ist essenziell, um das Risiko lebensbedrohlicher Komplikationen zu minimieren. Hierfür stehen unter anderem mikrobiologische sowie multimodale bildgebende Verfahren zur Verfügung. Therapeutische Möglichkeiten sind prognoserelevant und beinhalten die frühzeitige antiinfektive Therapie sowie die Systemexplantation.
Sicherheitsprofil von Acalabrutinib auch unter Real-World-Bedingungen ähnlich
Authors: Willen Christine
Published: October 2024

Anlässlich des EHA 2024 präsentierte Stephen Opat, Monash Health University, Melbourne, Australien, Interimsanalysen aus der Phase-3b-Studie ASSURE zum Sicherheitsprofil von Acalabrutinib bei chronisch lymphatischer Leukämie (CLL) unter Real-World-Bedingungen.
Pembrolizumab verbessert Effektivität der Chemotherapie
Authors: Arnheim Katharina
Published: October 2024

Die Phase-II-Studie HERCULES spricht für die Effektivität der Immuncheckpoint-Blockade zusätzlich zur platinbasierten Chemotherapie (PBC) bei den prognostisch ungünstigen fortgeschrittenen Plattenepithelkarzinomen des Penis: Vielfach gelingt eine Tumorschrumpfung; auch wird ein Gesamtüberleben (OS) von fast 10 Monaten erreicht.
Cabazitaxel verstärkt Effekt der Androgenblockade
Authors: Arnheim Katharina
Published: October 2024

In der Phase-II-Studie CHAARTED2 bei vorbehandelten Patienten mit metastasiertem kastrationsresistentem Prostatakarzinom (mCRPC) wurde durch die Addition von Cabazitaxel zu Abirateron/Prednison eine signifikante Verlängerung des progressionsfreien Überlebens (PFS) erreicht. Auch das PSA-Ansprechen und die Zeit bis zum PSA-Progress (TTPP) wurden so verlängert.
Laparoscopic Transabdominal Needle-free Emergency Cerclage in the Early Second Trimester of Pregnancy after Failed Transvaginal Cerclage: Two Case Reports and a Review of the Literature
Authors: Dayan Davut , Schmid Marinus , Ebner Florian K. , Janni Wolfgang , Reister Frank , Hüner Beate , Lato Krisztian , Friebe-Hoffmann Ulrike , Lukac Stefan
Published: October 2024

The aim of the study was to describe the preventive option and safety of laparoscopic transabdominal emergency cerclage in pregnant women with advanced cervical shortening after failed vaginal cerclage or in whom vaginal cerclage is no longer possible.

Laparoscopic isthmo-cervical emergency cerclage was carried out in two patients at 13+0 and 15+5 weeks of gestation (GW) respectively. Both patients had cervical shortening and it was no longer possible to expose the cervix after conization or re-conization. The attempts to carry out transvaginal cerclage were unsuccessful. The technical aspects, feasibility, safety, and pregnancy outcomes after laparoscopic transabdominal cerclage are presented here, based on two case reports.

The cerclages were placed after blunt dissection of the uterine vessels and careful introduction of a KELLY forceps through the avascular space between the ascending and descending branches of the uterine vessels without using a needle. The operating times were 93 and 134 minutes (min), respectively. The estimated blood loss during the procedure was less than 50 ml and neither perioperative nor postoperative complications occurred. The subsequent course of both pregnancies was uneventful and fetal development in both cases was normal. In the first case, the baby was delivered by secondary cesarean section following premature rupture of membranes in week 35+4 of gestation. The baby had a birthweight of 2786 g, APGAR scores of 8/9/10 and an umbilical cord arterial pH of 7.36. In the second case, delivery was by primary cesarean section in week 39+5 of gestation. The infant had a birth weight of 4160 g, APGAR scores of 5/9/10 and an umbilical cord arterial pH of 7.20.

Laparoscopic transabdominal cerclage is a safe and effective treatment option, even early in the second trimester of pregnancy, for patients in whom transvaginal cerclage is no longer possible due to anatomical factors. The method is technically very feasible and is associated with positive obstetric outcomes. The overall risk of perioperative complications is within acceptable limits.
Structural Requirements for the Outpatient Treatment of Benign Diseases of the Uterus
Authors: Brucker Cosima , Dimpfl Thomas , Scharl Anton
Published: October 2024

In many cases, outpatient surgical treatment of benign diseases of the uterus has advantages over inpatient care. This has been demonstrated by the healthcare situation in other countries. However, the prerequisite for the provision of outpatient services is that this does not lead to any impairment in the quality of care or of patient safety. The ultimate goal should not be to reduce costs but rather to maintain and, ideally, improve the quality of care. This requires that services are not just defined by the surgical procedure but also by the entire treatment chain, including, for example, psychosocial support, and are remunerated accordingly. It is particularly worrying that the final decision as to whether an outpatient operation is possible is not the responsibility of the operating unit, but of the “Medizinischer Dienst,” with the corresponding options and threats of sanctions. This situation is unique internationally and requires a paradigm shift. Furthermore,
structural prerequisites must be maintained which currently only exist inadequately in Germany. Since a substantial proportion of planned outpatient operations require immediate or secondary inpatient treatment, there must be a barrier-free transition between the outpatient and inpatient sectors. This will require the creation of networks between outpatient service providers and one or more hospitals that are equipped and competent to manage even complex complications. It is important to create structures that, with intensive involvement of the operating unit, include adequate preoperative evaluation and patient education as well as needs-oriented postoperative care at home. The current separation of sectors is a significant hinderance. Moreover, when expanding and promoting outpatient surgery, the aspect of training and further education of specialist staff must be taken into account, as well as cross-sectoral quality assurance.

Based on a review of the international literature, this article presents 13 recommendations for adequate structures when providing outpatient services which should serve as a prerequisite for the greatest possible guarantee of patient safety.
Neoadjuvante Kohorten-Studie beim muskelinvasiven Blasenkarzinom (MIBC) vor Zystektomie
Authors: Rexer Heidrun , Bögemann Martin , Retz Margitta
Published: October 2024

Eine offene, multizentrische, randomisierte Phase-2 Studie zu TAR-200 in Kombination mit Cetrelimab und Cetrelimab Monotherapie für Patienten mit muskelinvasivem Urothelkarzinom der Blase, die für eine radikale Zystektomie vorgesehen sind und für eine neoadjuvante Cisplatin-Therapie nicht geeignet sind oder diese ablehnen – SUNRISE-4 – AB 86/23 der AUO.
Erstlinien-Erhaltungstherapie bei erwachsenen Patienten mit lokal fortgeschrittenem oder metastasiertem Urothelkarzinom, die nach einer platinbasierten Chemotherapie progressionsfrei sind
Authors: Rexer Heidrun , Gschwend Jürgen , Merseburger Axel S.
Published: October 2024

Internationale, nicht-interventionelle Studie zur Dokumentation der Avelumab (Bavencio) Erstlinien-Erhaltungstherapie von Patienten mit einem fortgeschrittenen/metastasierten Urothelkarzinom, die nach einer platinbasierten Erstlinien-Chemotherapie progressionsfrei sind, unter den Bedingungen der täglichen klinischen Routinebehandlung (AVENUE NIS) – AB 82/21 der AUO.
Chemotherapie plus Dostarlimab ist beim Endometriumkarzinom kosteneffizient
Authors: Lorenz Judith
Published: October 2024

Patientinnen mit einem primär fortgeschrittenen oder rezidivierten Endometriumkarzinom profitieren im Hinblick auf das progressionsfreie und das Gesamtüberleben von einer Kombinationstherapie aus Carboplatin, Paclitaxel und dem Immuncheckpoint-Inhibitor Dostarlimab. Ein US-Forscherteam prüfte nun die Kosteneffizienz dieser Kombinationsbehandlung im Vergleich zur alleinigen Chemotherapie.
Brustkrebs-Chirurgie: Vermeidung der axillären Lymphknoten-Dissektion ist sicher
Authors: Krome Susanne
Published: October 2024

Frauen ohne klinische Lymphknoten-Metastasen, aber mit positiven Sentinel-Lymphknoten erhalten immer seltener eine vollständige axilläre Lymphknoten-Dissektion. Bisherige Studien hinterließen Unsicherheiten, weil u. a. Subgruppen unterrepräsentiert waren, die nodalen Zielvolumina der Bestrahlung unklar blieben oder Mikrometastasen der Sentinel-Lymphknoten vorlagen. Die SENOMAC-Studie mit 2540 Erkrankten bestätigt, dass die Vermeidung der axillären Ausräumung das krankheitsspezifische und Gesamtüberleben nicht beeinträchtigte.
Endometriumkarzinom: Verschlechtert die hysteroskopische Diagnose die Prognose?
Authors: Lorenz Judith
Published: October 2024

Die Hysteroskopie erlaubt eine präzise Biopsie von Endometriumkarzinomen. Theoretisch können im Zuge des Eingriffs allerdings maligne Zellen in die Bauchhöhle gespült werden. Ist die hysteroskopische Diagnostik angesichts dieser potenziellen Gefahr onkologisch vertretbar? Oder muss im Vergleich zu anderen Biopsieverfahren mit schlechteren Überlebenschancen gerechnet werden? Dieser Frage ging ein Forscherteam aus Israel nach.
Kardiovaskuläres Risiko nach Mammakarzinomdiagnose und -therapie
Authors: Lorenz Judith
Published: October 2024

Die modernen Screening- und Therapiemöglichkeiten haben die Überlebenschancen nach einer Mammakarzinomdiagnose deutlich verbessert. Allerdings wird befürchtet, dass der Tumor und/oder die onkologische Therapie kardiovaskuläre Ereignisse begünstigen. Wie häufig erleiden asiatischstämmige Mammakarzinompatientinnen eine Koronarerkrankung oder einen Schlaganfall? Dieser Frage ging eine retrospektive Kohortenstudie aus Taiwan nach.
New Onset Seizure in the Elderly: Classification, Etiology, and Impact on Quality of Life and Caregiver Burden
Authors: Maitan Naresh , Choudhary Neetu , Kharbanda Parampreet S. , Vyas Sameer , Aggarwal Ashish , Panda Prashant , Baishya Jitupam
Published: October 2024

Objective The incidence of seizures is highest in the elderly, and their management is challenging in view of atypical presentation and comorbidities. The aims of this analysis were to study the classification, etiology, and risk factors in new onset seizures in the elderly (>60 years) and their impact on the quality of life (QOL) and caregiver burden.

Materials and Methods All the elderly presenting to neurology, neurosurgery and emergency medicine OPD with new onset seizures after the age of 60 years were included. QOL and caregiver burden were assessed at least 6 months after the first seizure. The QOL was assessed with the World Health Organization Quality of Life OLD (WHOQOL-OLD) and was compared with age-matched controls. Caregiver burden was assessed with the Zarit Burden Interview.

Result Eighty patients fulfilling the inclusion criteria and 80 age-matched controls were recruited. There was no difference in age (68.30 ± 6.22 vs. 69.09 ± 6.07 years; p = 0.39) and gender (M:F = 50:30 vs. 48:32; p = 0.74) among the cases and controls. Forty-four (55%) patients had focal seizure. Hypertension was the commonest risk factor (61.3%), followed by ethanol intake (40%) and diabetes (38.8%). Cerebrovascular disease was the commonest etiology (37.5%), followed by infection (15%). Thirteen (16.2%) patients died during hospital stay and 20 (25%) died after discharge from the hospital. Cases scored significantly low on all domains of WHOQOL-OLD at 6 months of follow-up. In all, 54.1% caregivers reported mild to moderate burden.

Conclusion Focal seizure is the commonest seizure type of new onset seizure in the elderly. Hypertension is the commonest risk factor and cerebrovascular disease is the commonest etiology. New onset seizures in the elderly have a significant impact on both QOL and caregiver burden.
Delayed Maxillary Reconstruction with Free Osteocutaneous Fibula Flap Using CAD-CAM Technology
Authors: Krishnappa Madhusudhan , Gaba Sunil , Sharma Shagun , Sharma Shubham , Ahuja Chirag K. , Kalra Parveen
Published: October 2024

Background Maxillary reconstruction poses unique challenges for the reconstructive surgeon because of the complex three-dimensional (3D) anatomy of the maxilla. Undertaking this endeavor on secondary reconstruction makes it more difficult due to problems in recreating the true defect. This study is an attempt to demonstrate the role of virtual surgical planning (VSP), 3D printing, and mock surgery in reconstructing such defects using free fibula flaps.

Materials and Methods This was a prospective study involving 10 patients of maxillary defects who underwent delayed reconstruction with a free fibula flap. The planning was done preoperatively using computer-aided design and computer-aided manufacturing (CAD-CAM) technology. A mock surgery with 3D printed models was done before the surgery. After the surgery, the accuracy results were obtained by overlapping and measuring fixed point distances between preoperative virtual planning and postoperative computed tomography (CT) scan data.

Results and Discussion Nine patients underwent successful reconstruction and were satisfied with the outcome. One patient had flap loss. The mean shift along the horizontal, vertical, and 3D axes was less than 5 mm between the preoperative virtual planning and postoperative CT scan data, indicating accurate reconstruction. We also suggest strategies for soft-tissue and bony inset including inferolateral pedicle origin, anteriorly facing lateral fibular surface, and two bony struts for the alveolus.

Conclusion VSP and CAD-CAM technology in maxillary reconstructions help achieve an anatomically accurate neo-maxilla. The addition of mock surgery to the routine and the use of cutting guide avoid unpredictability and reduce the need for adaptation activities on the operating table. CAD-CAM technology despite its limitations is invaluable in maxillary reconstruction and is an important tool for a reconstructive plastic surgeon.
Sana und Landkreise: Neue Träger für Regiomed
Authors: Kohrs Jens
Published: October 2024

So komplex wie der Regiomed-Verbund an sich sind auch die Lösungen in seinem Insolvenzverfahren. Während beim bayerischen Teil der Sana-Konzern den Zuschlag erhalten soll, läuft für die Häuser in Thüringen alles auf eine kommunale Trägerschaft hinaus.
Primärversorgungszentren: Eine Chance zur besseren Gesundheitsversorgung
Authors: Schluttig Marie , Kurscheid Clarissa
Published: October 2024

Primärversorgungszentren könnten die Gesundheitsversorgung in Deutschland verbessern, indem sie medizinische und soziale Dienste unter einem Dach vereinen, besonders in ländlichen Regionen. Eine geplante Gesetzesinitiative wurde nun aber gestrichen. Beispiele aus Schweden und Österreich zeigen jedoch, dass diese Art der Versorgung erfolgreich umgesetzt werden kann und sich bewährt.
Form to Assess Result Reproducibility of Manuscripts
Authors:   American Society of Civil Engineers, Larbi Jelian
Published: October 2024

Use this worksheet to assess the: (a) availability of manuscript data, models, code, directions, and other digital artifacts; and (b) reproducibility of figures, tables, and other results presented in the manuscript. Should you answer “no” or “not sure” to any question, skip to Section IV and then answer the final questions to provide the authors constructive feedback to improve their repository and materials. The Journal asks that AERs and reproducibility reviewers take no more than four hours to assess the reproducibility of a manuscript’s results. Should an assessment take longer, skip to Section IV and provide the authors feedback on the steps that took a long time and how the authors can better organize their repository and materials to reduce the time to assess result reproducibility.
Functional inorganic nanoparticles in cancer: Biomarker detection, imaging, and therapy
Authors: Li Mengmeng , Tang Qinglai , Wan Hua , Zhu Gangcai , Yin Danhui , Lei Lanjie , Li Shisheng
Published: October 2024

Cancer poses a major global public health challenge. Developing more effective early diagnosis methods and efficient treatment techniques is crucial to enhance early detection sensitivity and treatment outcomes. Nanomaterials offer sensitive, accurate, rapid, and straightforward approaches for cancer detection, diagnosis, and treatment. Inorganic nanoparticles are widely used in medicine because of their high stability, large specific surface area, unique surface properties, and unique quantum size effects. Functional inorganic nanoparticles involve modifying inorganic nanoparticles to enhance their physical properties, enrichment capabilities, and drug-loading efficiency and to minimize toxicity. This Review provides an overview of various types of inorganic nanoparticles and their functionalization characteristics. We then discuss the progress of functional inorganic nanoparticles in cancer biomarker detection and imaging. Furthermore, we discuss the application of functional inorganic nanoparticles in radiotherapy, chemotherapy, gene therapy, immunotherapy, photothermal therapy, photodynamic therapy, sonodynamic therapy, and combination therapy, highlighting their characteristics and advantages. Finally, the toxicity and potential challenges of functional inorganic nanoparticles are analyzed. The purpose of this Review is to explore the application of functional inorganic nanoparticles in diagnosing and treating cancers, while also presenting a new avenue for cancer diagnosis and treatment.
Thermomechanical-chemical devulcanization of ground tire rubber
Authors: Görbe Á , Kohári A , Halász-Kutasi I Z , Bárány T
Published: October 2024

We developed a thermomechanical devulcanization process of ground tire rubber (GTR) by incorporating chemicals to achieve better devulcanization. The samples were devulcanized in a twin-screw extruder with the help of three types of chemicals that aid devulcanization: N-(cyclohexylthio) phthalimide (PVI), dibenzamid diphenyl disulfide (DBD) and dialkyl-pentasulfide (DPS, commercialized as Aktiplast 79). We characterized the resulting devulcanizates by Soxhlet-extraction, and produced vulcanized sheets, which we characterized mechanically and examined the vulcanization process. We found that all chemicals facilitated better devulcanization and the devulcanizate had a more rubber-like behavior during mixing. Vulcanization was also slightly improved and reversion was reduced. When revulcanized, the rubber had improved strain at break and tear strength.
Improving the bonding technology of aluminium sheet used in the construction industry by gas flame surface treatment
Authors: Tajti F , Capár A
Published: October 2024

According to current building trends, aluminium sheets can be used as building cladding elements. The advantage is that aluminium has a low density but high strength and resistance to atmospheric corrosion. For a nice appearance, these sheets are coloured with a polyester-based powder coating and are fixed by adhesive bonding on the reverse side. For adhesion, a flexible adhesive is required, and it should be noted that the surface is painted. From a safety point of view, it is important that the strength of the bonded joint does not deteriorate over many years. In our research, we investigate the applicability of gas flame surface treatment technologies to improve the bonding technology of aluminium sheets coated with polyester-based paints. The effectiveness of the surface treatment is tested by surface wettability measurements and, based on the results obtained, test joints are made to test their tensile and shear strength.
Cold plasma irradiation inhibits skin cancer via ferroptosis
Authors: Sun Tao , Liu Changqing , Kong Ling , Zha Jingjing , Ni Guohua
Published: October 2024

Cold atmospheric plasma (CAP) has been extensively utilized in medical treatment, particularly in cancer therapy. However, the underlying mechanism of CAP in skin cancer treatment remains elusive. In this study, we established a skin cancer model using CAP treatment in vitro. Also, we established the Xenograft experiment model in vivo. The results demonstrated that treatment with CAP induced ferroptosis, resulting in a significant reduction in the viability, migration, and invasive capacities of A431 squamous cell carcinoma, a type of skin cancer. Mechanistically, the significant production of reactive oxygen species (ROS) by CAP induces DNA damage, which then activates Ataxia-telangiectasia mutated (ATM) and p53 through acetylation, while simultaneously suppressing the expression of Solute Carrier Family 7 Member 11 (SLC7A11). Consequently, this cascade led to the down-regulation of intracellular Glutathione peroxidase 4 (GPX4), ultimately resulting in ferroptosis. CAP exhibits a favorable impact on skin cancer treatment, suggesting its potential medical application in skin cancer therapy.
Prediction of prostate cancer recurrence after radiotherapy using a fused machine learning approach: utilizing radiomics from pretreatment T2W MRI images with clinical and pathological information
Authors: Nanekaran Negin Piran , Felefly Tony H , Schieda Nicola , Morgan Scott C , Mittal Richa , Ukwatta Eranga
Published: October 2024

Background. ThePlease provide an email address for the corresponding author. risk of biochemical recurrence (BCR) after radiotherapy for localized prostate cancer (PCa) varies widely within standard risk groups. There's a need for low-cost tools to more robustly predict recurrence and personalize therapy. Radiomic features from pretreatment MRI show potential as noninvasive biomarkers for BCR prediction. Previous research has not fully combined radiomics with clinical and pathological data in predicting BCR of PCa patients after radiotherapy. Purpose. This study aims to predict 5-year BCR using radiomics from pretreatment T2W MRI and clinical-pathological data in PCa patients treated with radiation therapy, and to develop a unified model compatible with 1.5T and 3T MRI scanners. Methods. 150 T2W scans and clinical parameters were preprocessed. 120 cases were used for training and validation, and 30 for testing. Four distinct machine learning models were developed: Model 1 used radiomics, Model 2 used clinical and pathological data, Model 3 combined these via late fusion. Model 4 integrated radiomic and clinical-pathological data via early fusion . Results. Model 1 achieved an AUC of 0.73, while Model 2 had an AUC of 0.64 for predicting outcomes in 30 new test cases. Model 3, using late fusion, had an AUC of 0.69. Early fusion models showed promise: Model 4 reached an AUC of 0.84 highlighting the effectiveness of early fusion model. Conclusions. This study is the first to use fusion technique for predicting BCR in PCa patients following radiotherapy, using pre-treatment T2W MRI images and clinical-pathological data. Our methodology improves predictive accuracy by fusing radiomics with clinical-pathological information, even with a small dataset, and introduces the first unified model for both 1.5T and 3T MRI images.
Noise-induced instabilities in a stochastic Brusselator
Authors: Engel Maximilian , Olicón-Méndez Guillermo
Published: October 2024

We consider a stochastic version of the so-called Brusselator - a mathematical model for a two-dimensional chemical reaction network - in which one of its parameters is assumed to vary randomly. It has been suggested via numerical explorations that the system exhibits noise-induced synchronization when time goes to infinity. Complementing this perspective, in this work we explore some of its finite-time features from a random dynamical systems perspective. In particular, we focus on the deviations that orbits of neighboring initial conditions exhibit under the influence of the same noise realization. For this, we explore its local instabilities via finite-time Lyapunov exponents. Furthermore, we present the stochastic Brusselator as a fast-slow system in the case that one of the parameters is much larger than the other one. In this framework, an apparent mechanism for generating the stochastic instabilities is revealed, being associated to the transition between the slow and fast regimes.
The Possibility of Perceptual Knowledge
Authors: Stroud Barry
Published: October 2024

Stroud identifies two obstacles that stand in the way of a satisfactory understanding of perceptual knowledge: an overly restrictive conception of what we can perceive and an overly intellectualized conception of knowledge. He traces these obstacles to a broadly Cartesian approach to perceptual knowledge that focusses on individual “perceptual experiences”. Stroud develops an alternative approach by putting centre stage not “experiences” and their phenomenal properties, but the perceiver or knower as a competent intentional agent, and by describing the capacities that someone must possess and exercise in order to know something by perceptual means.
Perception, Knowledge, and Reflection
Authors: Roessler Johannes
Published: October 2024

Some philosophers take it that understanding human self-knowledge must be a matter of giving an account of how we discover the relevant facts about ourselves. Others maintain that rational thinkers have no need for any way of finding out (e.g.) what they believe or what they are intentionally doing: self-knowledge in these cases is thought to flow from the successful exercise of the relevant first-order capacities (capacities to believe, or act, for reasons). This chapter aims to develop the second tradition in a way that broadens its traditional remit, which has been restricted to attitudes or actions for which reasons can intelligibly be asked. It is argued that if a rational perceiver can see that p she will typically be aware that she can see that p, in virtue of exercising relevant capacities for perceptual recognition. Such capacities, it is suggested, are potentially reflective in the following sense: we paradigmatically exercise them in making perceptual judgements, underwritten by an implicit awareness of how we know what we judge to be the case.
X—Synthetic Philosophy: A Restatement
Authors: Schliesser Eric
Published: October 2024

The guiding thread of the paper is the diagnosis that the advanced division of cognitive labour (that is, intellectual specialization) engenders a set of perennial, political and epistemic challenges (Millgram 2015) that, simultaneously, also generate opportunities for philosophy. In this paper, I re-characterize the nature of synthetic philosophy as a means to advance and institutionalize philosophy. In §i, I treat Plato’s Republic as offering two models to represent philosophy’s relationship to the other sciences within the advanced division of labour. I highlight that for Plato intellectual specialization is central not just to economic but also to political life; and yet, that the very dispersion of scientific expertise, and its esoteric nature, also generates non-trivial challenges to the recognition and political utilization of knowledge. From Plato we can infer that in imperfect circumstances, philosophy’s self-constitution is, in part, a response to these challenges in political epistemology. However, how philosophy is institutionalized differs through time. In §ii, I re-introduce my conceptualization of synthetic philosophy and restate it. I use recent work by Dorst (2023) to illustrate synthetic philosophy and to identify some of the processes that give rise to the need for it. In §§ii–iii, I contrast my account with the evolving ways that Philip Kitcher has conceptualized synthetic philosophy, in order to make more precise the version promoted here. I do so not just because Kitcher and I use the same term, ‘synthetic philosophy’, but because the temptations inherent in Kitcher’s approach should be resisted.
The oculomotor microcosm
Authors: Antoniades Chrystalina A
Published: October 2024

This scientific commentary refers to ‘Noradrenergic modulation of saccades in Parkinson’s disease’, by  Orlando et al. (https://doi.org/10.1093/braincomms/fcae297).
Modified creatinine index as a marker of skeletal muscle mass in peritoneal dialysis patients
Authors: Ng Jack Kit-Chung , Fung Winston Wing-Shing , Chan Gordon Chun-Kau , Cheng Phyllis Mei-Shan , Pang Wing-Fai , Chow Kai-Ming , Szeto Cheuk-Chun
Published: October 2024

Background

Sarcopenia is common in peritoneal dialysis (PD) patients. Modified creatinine index (MCrI) by the Canaud's formula and single-pool Kt/V value is an accurate surrogate marker for muscle mass in hemodialysis patients. However, the method of calculation and validity of MCrI has not been tested in PD.

Methods

In the exploratory cohort, we studied 138 consecutive patients converted from PD to hemodialysis. Their MCrI during PD, calculated by the Canaud's formula with total weekly Kt/V, and the conventional MCrI after conversion to HD, were compared by the Bland–Altman method. Their correlation with muscle mass as determined by bioimpedance spectroscopy and creatinine kinetic methods was explored. The result was then validated in a second cohort of 605 incident PD patients.

Results

In the exploratory cohort, the average bias of computing MCrI during PD and hemodialysis was 0.758 mg/kg/day (95%CI −4.356 to 5.873 mg/kg/day). The MCrI during PD significantly correlated with the muscle mass by creatinine kinetics (r = .684, P < .0001) and by bioimpedance spectroscopy (r = .641, P < .0001), but not with protein nitrogen appearance, overhydration, or adipose tissue mass, and the result was similar in the validation cohort. For incident PD patients, MCrI quartile was significantly associated with the risk of death from all cause in 12 months (Gray's test, P = .013) but not conversion to chronic hemodialysis (P = .14).

Conclusion

In PD patients, MCrI computed by the Canaud's formula and total weekly Kt/V is a simple and reliable marker of skeletal muscle mass and may serve as a short-term prognostic indicator.
Bilateral lung volume reduction surgery outperforms the unilateral approach in functional improvement
Authors: Okumus Özlem , Seebacher Gernot , Valdivia Daniel , Slama Alexis , Darwiche Kaid , Karpf-Wissel Rüdiger , Wienker Johannes , Collaud Stephane , Kampe Sandra , Hegedüs Balazs , Aigner Clemens
Published: October 2024

OBJECTIVES

Lung volume reduction surgery (LVRS) is an established treatment approach for patients with severe pulmonary emphysema, enhancing lung function and quality of life in selected patients. Functional benefits and outcomes after uni- versus bilateral lung volume reduction remain a topic of debate.

METHODS

A retrospective analysis of patients undergoing LVRS from January 2018 to October 2022 was conducted. After encouraging initial results, the standard unilateral LVRS approach was switched to bilateral. The goal of this study was to assess the impact on functional outcomes at 3 and 6 months post-surgery compared to preoperative levels for the uni- versus the bilateral approach.

RESULTS

A total of 83 patients were included (43 bilateral, 40 unilateral). Baseline demographic and functional parameters were comparable between groups. The most common complication was prolonged air leak in 19 patients (11 in the unilateral group, 8 in the bilateral group). Two patients died perioperatively (2.4%). Overall, LVRS improved forced expiratory volume in 1 s by 8.3% after 3 and 12.5% after 6 months postoperatively compared to baseline. Bilateral surgery presented significantly superior forced expiratory volume in 1 s improvement than unilateral approach at both 3 (29.2% versus 2.9%; P = 0.0010) and 6 months (21.5% versus 3%; P = 0.0310) postoperatively. Additionally, it reduced hyperinflation (residual volume) by 23.1% after 3 months and by 17.5% after 6 months, compared to reductions of 16% and 9.1% in the unilateral group.

CONCLUSIONS

Bilateral approach resulted in better functional outcomes 3 and 6 months postoperatively compared to unilateral surgery.
Delayed jamming-induced oscillatory migration patterns of epithelial collectives under long-range confinement
Authors: Lohmann S , Pramotton F M , Taloni A , Ferrari A , Poulikakos D , Giampietro C
Published: October 2024

Collective dynamics of cells in confined geometry regulate several biological processes including cell migration, proliferation, differentiation, and communication. In this work, combining simulation with experimental data, we studied the oscillatory motion of epithelial sheets in smaller areas of confinement, and we linked the monolayer maturation induced-jamming with the wave formation. We showed that epithelial cell populations with delayed jamming properties use the additional time available from this delay to coordinate their movement, generating wave motion in larger areas of confinement compared to control populations. Furthermore, the effects of combining geometric confinement with contact guiding micro-gratings on this wave formation were investigated. We demonstrated that collective migratory oscillations under large geometrical confinement depend on the jamming state of the cell monolayers. The early dynamical state of the experimental results obtained was simulated by self-propelled Voronoi computations, comparing cells with solid-like and fluid-like behavior. Together our model describes the wave formation under confinement and the nodal oscillatory dynamics of the early dynamic stage of the system.

Insight Box: Collective behavior of cells in confined spaces impacts biological processes. Through experimental data combined with simulations, the oscillatory motion of epithelial sheets in small areas of confinement was described. A correlation between the level of cell jamming and the formation of waves was detected. Cell populations with delayed jamming presented wave motion in larger confinement areas. The effects of combining geometric confinement with substrate micro-gratings demonstrated that the collective migratory oscillations in large confinement areas rely on the jamming state of cells. The early dynamical state was simulated using self-propelled Voronoi computations that help to understand wave formation under confinement and the nodal oscillatory dynamics of early-stage systems.
Sputum culture conversion and its predictors among drug-resistant pulmonary tuberculosis patients in eastern Ethiopia
Authors: Gamachu Mulugeta , Deressa Alemayehu , Regassa Lemma Demissei , Bayu Miesso , Mussa Ibsa , Kumsa Fekede Asefa , Dingeta Tariku
Published: October 2024

Background

Evidence of time to culture conversion is used to predict the time of cure from the disease and the overall drug-resistant tuberculosis (TB) treatment duration. Even though evidence about sputum culture conversion is enormous in TB treatment, no study has yet been done in our areas, where cases are common. The study aimed to assess the time to sputum conversion and its predictors among drug-resistant TB patients from October 2013 to September 2021 in eastern Ethiopia.

Methodology

A retrospective cohort study was conducted in eastern Ethiopia among 273 drug-resistant TB patients who were treated from October 2013 to September 2021 at Dire Dawa City and Harari regional treatment centres. The Kaplan–Meier method was used to estimate the median time of sputum culture conversion. Cox proportional hazards regression was employed to detect the predictors of sputum culture conversion. An adjusted hazard ratio (aHR) with 95% confidence interval (CI) was used to determine the strength and significance of the association.

Results

Of the 273 drug-resistant TB patients, the sputum culture of 216 (79.12%) patients became negative in a median time of 3 months (interquartile range 2–7). The time to sputum culture conversion was negatively associated with underweight (aHR 0.65 [95% CI 0.49 to 0.90]) and poor adherence (aHR 0.41 [95% CI 0.24 to 0.69]). The time to sputum culture conversion was also positively associated with patients resistant to two or more drugs (aHR 1.58 [95% CI 1.07 to 2.32]) and patients receiving a short treatment regimen (aHR 2.24 [95% CI 1.10 to 2.55]).

Conclusions

A shorter culture conversion rate was observed compared with the median time recommended by the World Health Organization. Being underweight, poor adherence to treatment, resistance to two or more drugs and receiving a short treatment regimen were found to be predictors of time to sputum culture conversion. Implementing nutrition assessment, counselling and support of drug adherence may improve sputum culture conversion.
Nontechnical Factors and Postprocedural Considerations for Image-guided Breast Biopsy
Authors: Dodelzon Katerina , Bhole Sonya , Coffey Kristen , Dashevsky Brittany Z , Mullen Lisa , Parikh Jay , Reig Beatriu , Grimm Lars
Published: October 2024

Beyond the technical aspects, success and long-term patient outcomes of image-guided breast biopsies depend on the overall patient experience. Patient experience in turn is influenced by intangible factors, such as environmental features during the procedure; patient-centered communication prior to, during, and subsequent to the procedure; and management of expectations and biopsy complications. Here, we review evidence-based literature and results of a national Society of Breast Imaging survey on approaches to both mitigate and manage common image-guided core biopsy complications as well as nontechnical strategies to improve the patient biopsy experience.
Vocal functional flexibility in a nonprimate vocal learning species
Authors: Magdaleno Francisco R , Quintanilla Salinas Isaac , Rothstein Stephen I
Published: October 2024

Can nonhuman animals use the same acoustic signal to transmit different illocutions on different occasions? This communicative capacity is known as vocal functional flexibility and occurs, for example, in speech, when a sentence serves different illocutionary forces or functions on different occasions based on changes to visual and intonational cues. Although common in human speech, there is a lack of clear evidence for this ability in other species. Here, we examined a likely candidate, the Brown-headed Cowbird (Molothrus ater), which is a vocal-learning songbird species that develops a repertoire of structurally distinct song types. Most of this species’ songs are directed towards conspecific males and females less than a meter away, making it unusually easy to determine the apparent target of songs, unlike the broadcast songs done by most songbirds. Songs directed to other males have clear aggressive/threatening intent, while those to females involve courtship/sexual intent. Extensive prior work shows that male cowbirds perform the visual display that accompanies singing differently in these two social settings and also modulate the intonation of song types differently. Because of these display and tonal modulations, constancy of song type usage across male- vs female-directed singing would provide evidence of vocal functional flexibility. Herein, we examined 4,828 songs in three captive flocks containing twenty-four males and thirty females during the breeding season. Males did not use their song types randomly and had strongly favored songs and less commonly used ones. Importantly, favored song types and less commonly used ones were the same whether directing courtship song to a female, aggressive song to another male or singing nonsocially with no receiver nearby. Results were consistent within and across the three flocks, providing strong evidence of vocal functional flexibility. These findings indicate that some species may evolve the ability to modulate and exaggerate visual display components and prosody more than vocal presentation per se because a learned phonological system in this and possibly other species is constrained by its vital role as an indicator trait.
DMRdb: a disease-centric Mendelian randomization database for systematically assessing causal relationships of diseases with genes, proteins, CpG sites, metabolites and other diseases
Authors: Zheng Xiao , Tian Zhihao , Che Xiaohui , Zhang Xu , Xiang Yu , Ge Zhijian , Zhai Zhaoyu , Ma Qinfeng , Pan Jianbo
Published: October 2024

Exploring the causal relationships of diseases with genes, proteins, CpG sites, metabolites and other diseases is fundamental to the life sciences. However, large-scale research using Mendelian randomization (MR) analysis is currently lacking. To address this, we introduce DMRdb (http://www.inbirg.com/DMRdb/), a disease-centric Mendelian randomization database, designed to systematically assess causal relationships of diseases with genes, proteins, CpG sites, metabolites and other diseases. The database consists of three main components: (i) 6640 high-quality disease genome-wide association studies (GWASs) from public sources that were subjected to rigorous quality filtering and standardization; (ii) over 497 billion results from MR analyses involving 6640 disease GWAS datasets, 16 238 expression quantitative trait loci (eQTLs) data, 2564 protein quantitative trait loci (pQTLs) data, 12 000 methylation quantitative trait locus (meQTLs) data and 825 metabolites data and (iii) over 380 000 causal relationship pairs from 1223 literature sources relevant to MR analyses. A user-friendly online database was developed to allow users to query, search, and download all the results. In summary, we anticipate that DMRdb will be a valuable resource for advancing our understanding of disease mechanisms and identifying new biomarkers and therapeutic targets.
Subclinical Myocardial Fibrosis in South African Youth With HIV: Results From the CTAAC-Heart Study
Authors: Jao Jennifer , Zar Heather J , Kahts Morné , Jermy Stephen , Egan Daniel , Nyathi Mothabisi N , Asafu-Agyei Nana Akua , Legbedze Justine , Carkeek Emma , Jele Nomawethu , Mautsa Tafadzwa , Bonner Lauren Balmert , McComsey Grace A , Feinstein Matthew , Kurland Irwin J , Myer Landon , Ntusi Ntobeko A B
Published: October 2024

Background

Few data exist on myocardial fibrosis and inflammation in youth with HIV.

Methods

We performed cardiovascular magnetic resonance (CMR) on a cross section of South African youth: youth with perinatally acquired HIV (YPHIV) undergoing antiretroviral therapy (ART), youth with nonperinatally acquired HIV (YNPHIV) receiving ART, and youth without HIV. Quantile regression models were fit to assess the association between HIV status and CMR outcomes: subclinical fibrosis (late gadolinium enhancement [LGE] mass and fraction, native T1, extracellular volume) and inflammation (native T1, T2 mapping).

Results

Of 464 youth, 287 were YPHIV, 87 were YNPHIV, and 90 were HIV seronegative. The median age was 16 years (range, 11–24). LGE mass was higher in YPHIV and YNPHIV than in youth who were HIV seronegative (1.85 vs 2.00 vs 1.41 g, respectively), as was fraction (5.8% vs 6.4% vs 4.5%); native T1 was highest in YNPHIV. In adjusted analyses, when compared with youth with HIV seronegativity, YPHIV and YNPHIV exhibited higher LGE mass (β = 0.468, P = .001; β = 0.544, P = .002) and LGE fraction (β = 1.587, P < .001; β = 1.781, P < .001). CMR outcomes were similar between YPHIV and YNPHIV.

Conclusions

Despite ART use, YPHIV and YNPHIV appear to have higher subclinical myocardial fibrosis than youth who are HIV seronegative and healthy adults in South Africa and may benefit from early screening/monitoring for cardiovascular disease.
Epidemiology and Outcomes of Recurrent C Difficile Infection Among Hematopoietic Cell Transplant Recipients: A Single-center, Retrospective 10-year Study
Authors: Sanchez Eduardo , Krantz Elizabeth M , Escobar Zahra Kassamali , Tverdek Frank , Rosen Emily A , Oshima Masumi Ueda , Carpenter Paul A , Pergam Steven A , Liu Catherine
Published: October 2024

Background

There are limited data on the contemporary epidemiology of recurrent Clostridioides difficile infection (CDI) among hematopoietic cell transplant (HCT) recipients. We aimed to determine the incidence, risk factors, and outcomes for recurrent CDI among HCT recipients.

Methods

We conducted a retrospective study of adult HCT recipients between 2012 and 2021 diagnosed with index CDI between HCT day −7 and +100. Recurrent CDI was defined as new symptoms and a positive test within 12 weeks after treatment for index CDI. Cox proportional hazards models were used to investigate associations between prespecified variables (age, neutropenia, exposure to antibiotics with antianaerobic coverage, cytomegalovirus viremia/disease, and metronidazole monotherapy) and recurrent infection, presented as hazard ratios with 95% confidence intervals (CI).

Results

Of 3479 HCT recipients, 416 (12%) had index CDI and were treated with oral vancomycin (31%), metronidazole (41%), oral vancomycin and metronidazole (29%). Of 381 patients eligible for recurrent CDI analysis, 35 had recurrent infection; cumulative incidence was 10% (95% CI, 7–13) at 12 weeks. In the 14 days after recurrence, 2/25 (8%) patients required hospital admission; none died within 30 days. Metronidazole monotherapy for treatment of index CDI was associated with an increased rate of recurrence (adjusted hazard ratio, 2.0; 95% CI, 1.0–4.0; P = .048).

Conclusions

Recurrent CDI occurred in 10% of HCT recipients in the early posttransplant period and was associated with use of metronidazole. Further study is needed to characterize risk factors for recurrent CDI among HCT recipients to guide use of agents aimed at preventing recurrence.
Promoting civil discourse on social media using nudges: A tournament of seven interventions
Authors: Celadin Tatiana , Panizza Folco , Capraro Valerio
Published: October 2024

In this article, we test and compare several message-based nudges designed to promote civil discourse and reduce the circulation of harmful content such as hate speech. We conducted a large pre-registered experiment (N = 4,081) to measure the effectiveness of seven nudges: making descriptive norms, injunctive norms, or personal norms salient, cooling down negative emotions, stimulating deliberation or empathy, and highlighting reputation. We used an online platform that reproduces a social media newsfeed and presented the nudge as a message when entering the platform. Our findings indicate that none of the nudges significantly impacts participants’ engagement with harmful content. At the same time, nudges making descriptive norms salient selectively increase participants’ overall engagement with relatively harmless content. Additionally, making injunctive norms salient increased the likelihood of liking harmless posts. Exploratory text analysis also reveals that highlighting reputation leads to more substantial and coherent comments on harmful posts. These results suggest that nudges that activate norm considerations represent a promising approach to promoting civil discourse and making social media a safer and more inclusive space for all.