bluuebunny/crossref_metadata_2025 huggingface dataset:
HM_ADET: a hybrid model for automatic detection of eyelid tumors based on photographic images
Authors: Jiang Jiewei , Liu Haiyang , He Lang , Pei Mengjie , Lin Tongtong , Yang Hailong , Yang Junhua , Gong Jiamin , Wei Xumeng , Zhu Mingmin , Wu Guohai , Li Zhongwen
Published: February 2024

Background

The accurate detection of eyelid tumors is essential for effective treatment, but it can be challenging due to small and unevenly distributed lesions surrounded by irrelevant noise. Moreover, early symptoms of eyelid tumors are atypical, and some categories of eyelid tumors exhibit similar color and texture features, making it difficult to distinguish between benign and malignant eyelid tumors, particularly for ophthalmologists with limited clinical experience.

Methods

We propose a hybrid model, HM_ADET, for automatic detection of eyelid tumors, including YOLOv7_CNFG to locate eyelid tumors and vision transformer (ViT) to classify benign and malignant eyelid tumors. First, the ConvNeXt module with an inverted bottleneck layer in the backbone of YOLOv7_CNFG is employed to prevent information loss of small eyelid tumors. Then, the flexible rectified linear unit (FReLU) is applied to capture multi-scale features such as texture, edge, and shape, thereby improving the localization accuracy of eyelid tumors. In addition, considering the geometric center and area difference between the predicted box (PB) and the ground truth box (GT), the GIoU_loss was utilized to handle cases of eyelid tumors with varying shapes and irregular boundaries. Finally, the multi-head attention (MHA) module is applied in ViT to extract discriminative features of eyelid tumors for benign and malignant classification.

Results

Experimental results demonstrate that the HM_ADET model achieves excellent performance in the detection of eyelid tumors. In specific, YOLOv7_CNFG outperforms YOLOv7, with AP increasing from 0.763 to 0.893 on the internal test set and from 0.647 to 0.765 on the external test set. ViT achieves AUCs of 0.945 (95% CI 0.894-0.981) and 0.915 (95% CI 0.860-0.955) for the classification of benign and malignant tumors on the internal and external test sets, respectively.

Conclusions

Our study provides a promising strategy for the automatic diagnosis of eyelid tumors, which could potentially improve patient outcomes and reduce healthcare costs.
A French classification to describe medical deserts: a multi-professional approach based on the first contact with the healthcare system
Authors: Bonal Marie , Padilla Cindy , Chevillard Guillaume , Lucas-Gabrielli Véronique
Published: February 2024

Background

Increasing inequalities in accessibility to primary care has generated medical deserts. Identifying them is key to target the geographic areas where action is needed. An extensive definition of primary care has been promoted by the World Health Organization: a first level of contact with the health system, which involves the co-presence of different categories of health professionals alongside the general practitioner for the diagnosis and treatment of patients. Previous analyses have focused mainly on a single type of provider while this study proposes an integrated approach including various ones to define medical deserts in primary care.

Method

Our empirical approach focuses on the first point of contact with the health system: general practitioners, proximity primary care providers (nurses, physiotherapists, pharmacies, laboratories, and radiologists), and emergency services. A multiple analysis approach was performed, to classify French municipalities using the information on the evolution and needs of health care accessibility, combining a principal component analysis and a hierarchical ascending classification.

Results

Two clusters of medical deserts were identified with low accessibility to all healthcare professionals, socio-economic disadvantages, and a decrease in care supply. In other clusters, accessibility difficulties only concern a part of the health supply considered, which raises concern for the efficiency of primary care for optimal healthcare pathways. Even for clusters with better accessibility, issues were identified, such as a decrease and high needs of health care supply, revealing potential future difficulties.

Conclusion

This work proposes a multi-professional and multi-dimensional approach to medical deserts based mainly on an extensive definition of primary care that shows the relevance of the co-presence of various healthcare professionals. The classification also makes it possible to identify areas with future problems of accessibility and its potential consequences. This framework could be easily applied to other countries according to their available data and their health systems’ specificities.
In-hospital and mid-term follow-up of low-density lipoprotein cholesterol and target-goal attainment among patients with acute cerebral infarction: a retrospective study
Authors: Chen Zhong , Jin Shijia , Zhang Yifan
Published: February 2024

Objective

To investigate the baseline and six-month follow-up data of the main lipid indices as well as low-density lipoprotein cholesterol (LDL-C) target goal attainment in accordance with the current guidelines among patients with acute cerebral infarction (ACI).

Methods

One thousand ninety-nine patients were consecutively enrolled from January 2021 to December 2022 and divided into ACI, old cerebral infarction (OCI), and control groups. General data [sex, age, body mass index (BMI), medications, smoking status, disease history, etc.], baseline data, and six-month follow-up main laboratory data were collected and analyzed. ACI patients were grouped into dyslipidemia and normal groups according to the lipid management guidelines of the European, American, and Chinese populations. Statistical methods were used to screen for possible predictors of dyslipidemia.

Results

Patients with ACI or OCI had higher total cholesterol (TC) and LDL-C levels than did the control group (all P < 0.05). According to European (94.7%, 89.0% and 13.4%, P < 0.01), American (94.7% vs. 67.7% vs. 45.9%, P < 0.001) and Chinese (85.1% vs. 59.1% vs. 18.6%, P < 0.001) standards, the proportion of dyslipidemia in the ACI group was greater than that in the OCI and control groups. According to European and American standards, increases in BMI and the estimated glomerular filtration rate (eGFR) are predictors of dyslipidemia in ACI patients. According to Chinese standards, increases in BMI, glycated hemoglobin (HbA1c) levels, and eGFRs are independent predictors of dyslipidemia in ACI patients. The 6-month follow-up of the main lipid levels revealed that among the ACI group, TC, LDL-C and triglyceride(TG) levels (4.86 vs. 3.79, P < 0.001; 2.98 vs. 2.01, P < 0.001; 1.46 vs. 1.20, P < 0.001) and the proportion of dyslipidemia decreased significantly in accordance with European/American and Chinese standards (86.8% vs. 64.6%, P = 0.015; 97.2% vs. 84.7%, P = 0.012).

Conclusion

These results revealed that lipid management is still not optimal for patients with ACI. More attention should be given to ACI patients with elevated BMI, eGFR, and HbA1c values, which could lead to more individualized lipid management. Although the main lipid levels decreased significantly 6 months after discharge with lipid-lowering therapy, there is still a long way to go to enable more ACI patients to meet the guideline-recommended LDL-C target goal.
Lymph node ratio is a more robust predictor of overall survival than N stage in stage III colorectal adenocarcinoma
Authors: Beirat Amir F. , Amarin Justin Z. , Suradi Haya H. , Qwaider Yasmeen Z. , Muhanna Adel , Maraqa Bayan , Al-Ani Abdallah , Al-Hussaini Maysa
Published: February 2024

Background

Lymph node ratio (LNR) may offer superior prognostic stratification in colorectal adenocarcinoma compared with N stage. However, candidate cutoff ratios require validation. We aimed to study the prognostic significance of LNR and its optimal cutoff ratio.

Methods

We reviewed the pathology records of all patients with stage III colorectal adenocarcinoma who were managed at the King Hussein Cancer Center between January 2014 and December 2019. We then studied the clinical characteristics of the patients, correlates of lymph node count, prognostic significance of positive lymph nodes, and value of sampling additional lymph nodes.

Results

Among 226 included patients, 94.2% had ≥ 12 lymph nodes sampled, while 5.8% had < 12 sampled lymph nodes. The median number of lymph nodes sampled varied according to tumor site, neoadjuvant therapy, and the grossing pathologist’s level of training. According to the TNM system, 142 cases were N1 (62.8%) and 84 were N2 (37.2%). Survival distributions differed according to LNR at 10% (p = 0.022), and 16% (p < 0.001), but not the N stage (p = 0.065). Adjusted Cox-regression analyses demonstrated that both N stage and LNR at 10% and 16% predicted overall survival (p = 0.044, p = 0.010, and p = 0.001, respectively).

Conclusions

LNR is a robust predictor of overall survival in patients with stage III colorectal adenocarcinoma. At a cutoff ratio of 0.10 and 0.16, LNR offers better prognostic stratification in comparison with N stage and is less susceptible to variation introduced by the number of lymph nodes sampled, which is influenced both by clinical variables and grossing technique.
Long-term beneficial effect of faecal microbiota transplantation on colonisation of multidrug-resistant bacteria and resistome abundance in patients with recurrent Clostridioides difficile infection
Authors: Nooij Sam , Vendrik Karuna E. W. , Zwittink Romy D. , Ducarmon Quinten R. , Keller Josbert J. , Kuijper Ed J. , Terveer Elisabeth M. ,   on behalf of the Netherlands Donor Feces Bank study group
Published: February 2024

Background

Multidrug-resistant (MDR) bacteria are a growing global threat, especially in healthcare facilities. Faecal microbiota transplantation (FMT) is an effective prevention strategy for recurrences of Clostridioides difficile infections and can also be useful for other microbiota-related diseases.

Methods

We study the effect of FMT in patients with multiple recurrent C. difficile infections on colonisation with MDR bacteria and antibiotic resistance genes (ARG) on the short (3 weeks) and long term (1–3 years), combining culture methods and faecal metagenomics.

Results

Based on MDR culture (n = 87 patients), we notice a decrease of 11.5% in the colonisation rate of MDR bacteria after FMT (20/87 before FMT = 23%, 10/87 3 weeks after FMT). Metagenomic sequencing of patient stool samples (n = 63) shows a reduction in relative abundances of ARGs in faeces, while the number of different resistance genes in patients remained higher compared to stools of their corresponding healthy donors (n = 11). Furthermore, plasmid predictions in metagenomic data indicate that patients harboured increased levels of resistance plasmids, which appear unaffected by FMT. In the long term (n = 22 patients), the recipients’ resistomes are still donor-like, suggesting the effect of FMT may last for years.

Conclusions

Taken together, we hypothesise that FMT restores the gut microbiota to a composition that is closer to the composition of healthy donors, and potential pathogens are either lost or decreased to very low abundances. This process, however, does not end in the days following FMT. It may take months for the gut microbiome to re-establish a balanced state. Even though a reservoir of resistance genes remains, a notable part of which on plasmids, FMT decreases the total load of resistance genes.
Fetal brain growth and infant autistic traits
Authors: Aydin Ezra , Tsompanidis Alex , Chaplin Daren , Hawkes Rebecca , Allison Carrie , Hackett Gerald , Austin Topun , Padaigaitė Eglė , Gabis Lidia V. , Sucking John , Holt Rosemary , Baron-Cohen Simon
Published: February 2024

Background

Structural differences exist in the brains of autistic individuals. To date only a few studies have explored the relationship between fetal brain growth and later infant autistic traits, and some have used fetal head circumference (HC) as a proxy for brain development. These findings have been inconsistent. Here we investigate whether fetal subregional brain measurements correlate with autistic traits in toddlers.

Methods

A total of 219 singleton pregnancies (104 males and 115 females) were recruited at the Rosie Hospital, Cambridge, UK. 2D ultrasound was performed at 12-, 20- and between 26 and 30 weeks of pregnancy, measuring head circumference (HC), ventricular atrium (VA) and transcerebellar diameter (TCD). A total of 179 infants were followed up at 18–20 months of age and completed the quantitative checklist for autism in toddlers (Q-CHAT) to measure autistic traits.

Results

Q-CHAT scores at 18–20 months of age were positively associated with TCD size at 20 weeks and with HC at 28 weeks, in univariate analyses, and in multiple regression models which controlled for sex, maternal age and birth weight.

Limitations

Due to the nature and location of the study, ascertainment bias could also have contributed to the recruitment of volunteer mothers with a higher than typical range of autistic traits and/or with a significant interest in the neurodevelopment of their children.

Conclusion

Prenatal brain growth is associated with toddler autistic traits and this can be ascertained via ultrasound starting at 20 weeks gestation.
Integrating substance use peer support and screening brief intervention and referral to treatment services in the emergency department: a descriptive study of the ED leads program
Authors: Avalone Lynsey , Lalane Monique , King Carla , Pfeiffer Kayna , Linn-Walton Rebecca , Barron Charles
Published: February 2024

Background

The ED Leads program was introduced to 11 emergency departments (EDs) within New York City public hospitals from 2018 to 2019 to address a need for addiction support services in the ED. The purpose of this study is to (i) describe the ED Leads blended licensed-clinician and peer counselor team model in the ED at three hospitals, (ii) provide a descriptive analysis of patient engagement and referrals to substance use disorder (SUD) care post-intervention, and (iii) highlight potential barriers and facilitators to implementing the model.

Methods

The program intended to combine Screening Brief Intervention and Referral to Treatment and peer support services. The authors analyzed electronic medical records data for patients encountered by ED Leads in the first 120 days of program launch. Data included the outcome of an encounter when a patient was engaged with one or both staff types, and 7-day attendance at an SUD treatment appointment when a patient accepted a referral within the 11-hospital system.

Results

There were 1785 patients approached by ED Leads staff during the study period. Engagement differed by staff type and patient demographics, and encounter outcomes varied significantly by hospital. Eighty-four percent (N = 1503) of patients who were approached engaged with at least one staff type, and 6% (N = 86) engaged with both. Patients were predominantly male (N = 1438, 81%) with an average age of 45 (SD = 13), and enrolled in Medicaid (N = 1062, 59%). A majority (N = 801, 45%) had alcohol use disorder. Of the patients who accepted a referral within the system (N = 433), 63% received treatment services within 7 days of the ED Leads encounter, a majority at detoxification treatment (N = 252, 58%).

Conclusions

This study describes the potential value and challenges of implementing a blended peer counselor and licensed clinician model in the ED to provide SUD services. While teams provided a high volume of referrals and the analysis of post-intervention treatment follow up is promising, the blended team model was not fully realized, making it difficult to assess the benefits of this combined service. Further research might examine patient outcomes among ED patients who are offered services by both a peer counselor and licensed clinician.
Curcuma longa L. extract increased immune responses in RAW 264.7 cells and cyclophosphamide-induced BALB/c mice
Authors: Kim Se Jeong , Kim San , Jang Sehyeon , Gu Da Hye , Park Jeong Min , Ryu Jung A. , Yoon Sung Ran , Jung Sung Keun
Published: February 2024

Curcuma longa L. extract (CLE) exerts various biological functions including antioxidant, anti-inflammation, anticancer, and antiallergenic effects. However, its immune-enhancing capacity remains unclear. Therefore, the immune-enhancing effect of CLE was investigated in RAW 264.7 cells and cyclophosphamide (CPP)-induced immunosuppression model. CLE upregulated nitric oxide (NO) and reactive oxygen species production and increased inducible nitric oxide synthase and cyclooxygenase-2 expression without affecting the RAW 264.7 cells viability. The results of quantitative real-time reverse transcription polymerase chain reaction and sandwich enzyme-linked immunosorbent assay showed that CLE increased the gene expression and protein levels of tumor necrosis factor-α, interleukin-6, and interleukin-1β in RAW 264.7 cells. Moreover, CLE upregulated p65, I kappa B kinase α/β, and I kappa B α (IκBα) phosphorylation and downregulated IκBα expression in RAW 264.7 cells. CLE also increased p65 translocation from the cytoplasmic to the nucleus in RAW 264.7 cells. The oral administration of CLE increased organ indexes (including the spleen and thymus) and NO production in peritoneal macrophages and improved natural killer cell activity in CPP-induced immunosuppression BALB/c mice. Overall, CLE could be a useful health functional food material that can improve innate immunity via macrophage activation.
Metabolomics characterization of two saffron from Iran and China using GC–MS and LC–MS methods
Authors: Li Donglin , Zuo Wenhui , Ma Shuo , Li Renjie , Ye Zhenfeng
Published: February 2024

Saffron is a medicinally important species of the Iridaceae family. Saffron’s quality depends on the concentration of secondary metabolites. In this study, GC–MS and LC–MS were utilized to dissect the different metabolites profile of two saffron produced in Iran and China. As a result, a total of 325 differential metabolites (237 from LC–MS, 88 from GC–MS) were identified. These differential metabolites were grouped into the following categories such as lipids, alkaloids, amino acids, terpenoids, organic acids, and flavonoids in saffron from the LC–MS analysis. The differential metabolites mainly concentrated on metabolic pathways, nucleotide metabolism, purine metabolism, and flavonoid biosynthesis. In Iran vs. China, the category of flavonoids includes Styrene, Apigenin-7-O-(6''-p-Coumaryl)glucoside, Houpulin F, Apigenin-5-O-glucoside, Tiglic acid; 2-Methyl-2-Butenoic Acid, p-Cymene, and 2,4-Nonadienal, (E,E)-. The terpenoids including downregulated Cafestol, rhodomollein XI, inumakiol G, D-Limonene, Bicyclo[3.1.0]hexane, 4-methylene-1-(1-methylethyl)- and upregulated rhodomollein XI were significantly different identified in Iran vs. China. In conclusion, the saffron from different cultivation areas possess many metabolites that are beneficial for health, including lipids, alkaloids, amino acids, terpenoids, organic acids, and flavonoids. Thus, compared with Iran, saffron from China have a higher medicinal value. This study provides a direction for the subsequent development and utilization of saffron.
Recent advances in earthquake seismology using machine learning
Authors: Kubo Hisahiko , Naoi Makoto , Kano Masayuki
Published: February 2024

Given the recent developments in machine-learning technology, its application has rapidly progressed in various fields of earthquake seismology, achieving great success. Here, we review the recent advances, focusing on catalog development, seismicity analysis, ground-motion prediction, and crustal deformation analysis. First, we explore studies on the development of earthquake catalogs, including their elemental processes such as event detection/classification, arrival time picking, similar waveform searching, focal mechanism analysis, and paleoseismic record analysis. We then introduce studies related to earthquake risk evaluation and seismicity analysis. Additionally, we review studies on ground-motion prediction, which are categorized into four groups depending on whether the output is ground-motion intensity or ground-motion time series and the input is features (individual measurable properties) or time series. We discuss the effect of imbalanced ground-motion data on machine-learning models and the approaches taken to address the problem. Finally, we summarize the analysis of geodetic data related to crustal deformation, focusing on clustering analysis and detection of geodetic signals caused by seismic/aseismic phenomena.

Graphical Abstract
Relation between earthquake swarm activity and tides in the Noto region, Japan
Authors: Hirose Fuyuki , Tamaribuchi Koji , Kobayashi Akio , Maeda Kenji
Published: February 2024

The Noto region in Japan has been experiencing earthquake swarm activity since mid-2018, with repeated rises and falls in activity. Crustal deformation (expansion and uplift) observed there since the end of 2020 has been connected to crustal fluids. Studies in other regions have suggested that tides are related to earthquake swarm activities associated with crustal fluids. Therefore, we investigated whether tides are also involved in the Noto earthquake swarm activity. Our results suggest a tidal correlation only at greater depths in the southern part of the analyzed area (‘region Sd’). There, we inferred that an increase in pore fluid pressure caused by the inflow of deep fluids may have led to a decrease in fault fracture strength, making the local seismicity relatively susceptible to the effects of tidal forces. The significantly high value in region Sd of the scaling parameter $$b$$
b
of the Gutenberg–Richter law (describing the earthquake magnitude–frequency distribution) and observed crustal deformation are consistent with this interpretation.

Graphical Abstract
A case of late-onset bleeding from an intercostal artery pseudoaneurysm after hemostasis using soft coagulation
Authors: Shimizu Rie , Suda Kenichi , Takemoto Toshiki , Fukuda Shota , Chiba Masato , Shimoji Masaki , Soh Junichi , Mitsudomi Tetsuya , Tsutani Yasuhiro
Published: February 2024

Background

The use of soft coagulation is becoming common in thoracic surgery. Soft coagulation provides rapid hemostasis from small vessels during surgery by dehydrating tissue and denaturing proteins, without burning the tissue.

Case presentation

A 68-year-old man, with a history of right lower lobectomy 3 years prior, underwent a partial resection of the right upper lobe for a pulmonary nodule suspicious for secondary lung cancer. During the surgery, dissection of the adhesion caused a bleeding from the 6th intercostal artery, and hemostasis was achieved using soft coagulation (some degree of tissue carbonization was noticed at later mortality and morbidity conference). He experienced hemoptysis at postoperative day 18 and was transferred to our hospital. Contrast-enhanced CT scan revealed bleeding from the pseudoaneurysm of the 6th intercostal artery. Embolization was performed by angiography to stop the bleeding.

Conclusions

We experienced a case of late-onset bleeding from a pseudoaneurysm related to soft coagulation hemostasis. Lessons learned from this patient are that additional hemostasis, such as ligation, would be considered for small arteries after hemostasis has been achieved by soft coagulation, especially when some degree of tissue carbonization is suspected.
In vitro effects of anti-MRSA agent adsorption onto the AN69ST hemofilter
Authors: Inano Yoshinori , Tsuchiya Kayoko , Kumano Ryota , Miura Go , Nakasa Hiromitsu
Published: February 2024

Background

Blood purification therapy with a sulfonated polyacrylonitrile surface treated (AN69ST) hemofilter is used to treat sepsis. However, the AN69ST hemofilter has been reported to adsorb and remove therapeutic drugs; warranting further investigation. In this study, we evaluated the adsorption effects of AN69ST membranes and hemofilters connected to a dialysis circuit model on anti-methicillin-resistant Staphylococcus aureus (anti-MRSA) agents, such as arbekacin sulfate (ABK), linezolid (LZD), vancomycin hydrochloride (VCM), teicoplanin (TEIC), and daptomycin (DAP), in in vitro experiments.

Methods

Drug solutions were exposed to AN69ST membranes. The absorbance of the drug solution was measured over time, and the drug content was calculated. Additionally, we calculated the drug content over time by circulating the drug solution through a dialysis circuit model. The clearance of each drug was determined at 5 and 60 min.

Results

The content of ABK, TEIC, DAP, and VCM decreased substantially after the addition of AN69ST membranes compared to those of the standard reagent. However, the LZD content did not decrease. In the dialysis circuit model, the content of ABK, TEIC, DAP, and VCM were 3.7%, 25.7%, 43.8%, and 44.5%, respectively, at 20 min, which were clearly lower than those of the standard reagent (62–64%). However, the LZD content remained unchanged. The clearance of ABK, TEIC, DAP, and VCM increased after 5 min.

Conclusions

The in vitro adsorption of anti-MRSA agents onto the AN69ST hemofilter was confirmed for ABK, TEIC, DAP, and VCM. Positively charged ABK was particularly susceptible to adsorption and should be avoided during blood purification using the AN69ST hemofilter. In addition, we concluded that TEIC, DAP, and VCM should be used for therapeutic drug monitoring because the adsorption rate of each drug is believed to vary depending on its protein binding rate.
Takotsubo syndrome: left atrial and ventricular myocardial strain impairment in the subacute and convalescent phases assessed by CMR
Authors: Pambianchi Giacomo , Marchitelli Livia , Cundari Giulia , Ruoli Letizia , Conia Luca , Catalano Carlo , Galea Nicola
Published: February 2024

Background

We investigated the differences in impairment of left ventricle (LV) and left atrium (LA) contractile dysfunction between subacute and convalescent takotsubo syndrome (TTS), using myocardial strain analysis by cardiac magnetic resonance (CMR) feature-tracking technique.

Methods

We retrospectively selected 50 patients with TTS clinical-radiological diagnosis who underwent CMR within 30 days since symptoms onset: 19 studied during the early subacute phase (sTTS, ≤ 7 days) and 31 during the convalescence (cTTS, 8–30 days). We measured the following: LV global longitudinal, circumferential, and radial strain (lvGLS, lvGCS, lvGRS) and strain rate (SR) and LA reservoir (laS_r), conduit (laS_cd), and booster pump strain (laS_bp) and strain rate (laSR_r, laSR_cd, laSR_bp). Patients were compared with 30 age- and sex-matched controls.

Results

All patients were women (mean age 63 years). TTS patients showed altered LV- and LA-strain features, compared to controls. sTTS was associated with increased laS_bp (12.7% versus 9.8%) and reduced lvEF (47.4% versus 54.8%), lvGLS (-12.2% versus 14.6%), and laS_cd (7.0% versus 9.5%) compared to cTTS (p ≤ 0.029). The interval between symptoms onset and CMR was correlated with laS_bp (r = -0.49) and lvGLS (r = 0.47) (p = 0.001 for both). At receiver operating characteristics analysis, laS_bp was the best discriminator between sTTS and cTTS (area under the curve [AUC] 0.815), followed by lvGLS (AUC 0.670).

Conclusions

LA dysfunction persists during the subacute and convalescence of TTS. laS_bp increases in subacute phase with progressive decrease during convalescence, representing a compensatory mechanism of LV dysfunction and thus a useful index of functional recovery.

Relevance statement

Atrial strain has the potential to enhance the delineation of cardiac injury and functional impairment in TTS patients, assisting in the identification of individuals at higher risk and facilitating the implementation of more targeted and personalized medical therapies.

Key points

• In TTS, after ventricular recovery, atrial dysfunction persists assessable with CMR feature tracking.

• Quantitative assessment of atrial strain discriminates atrial functions: reservoir, conduit, and booster pump.

• Atrial booster pump changes after acute TTS, regardless of ventricular function.

• Atrial strain may serve as a temporal marker in TTS.

Graphical Abstract
Whole exome sequencing in a sample of Egyptian patients with covert cerebral small vessel disease
Authors: Aref Hany , Maged Mohamed , Roushdy Tamer , Shokri Hossam , Hamid Eman , Cho Bernard P. H. , Markus Hugh S. , Fathy Mai , El Nahas Nevine
Published: February 2024

Background

Covert cerebral small vessel disease (cCSVD) is associated with many age-related morbidities with little available data regarding the pathophysiology and role of genetics in it. This study aims to investigate the genetic load in a sample of Egyptian patients with cCSVD.

Results

Thirty patients with cCSVD were recruited and underwent cognitive, gait, sphincter assessment, magnetic resonance imaging (MRI) brain, and blood sampling for whole exome sequencing. The mean age for the patients was 65.93 ± 8.8 with male patients representing 63.33% of the studied sample. The major risk factor was hypertension followed by diabetes mellitus, dyslipidaemia, and smoking. The main presenting symptom was cognitive impairment, found in 60% of the patients and the mean duration of symptoms was 2.1 ± 1.12 years. Two out of thirty patients were positive for a known pathogenic gene (NOTCH3 and COL4A1) despite the absence of family history in one representing 6.7% of the entire studied sample. Meanwhile, three patients had variant genes not previously linked to cCSVD.

Conclusions

Whole exome sequencing and genetic studying of patients with cCSVD is of utmost importance as the genetic load is underestimated in the Egyptian population.
Wildfire probability estimated from recent climate and fine fuels across the big sagebrush region
Authors: Holdrege Martin C. , Schlaepfer Daniel R. , Palmquist Kyle A. , Crist Michele , Doherty Kevin E. , Lauenroth William K. , Remington Thomas E. , Riley Karin , Short Karen C. , Tull John C. , Wiechman Lief A. , Bradford John B.
Published: February 2024

Background

Wildfire is a major proximate cause of historical and ongoing losses of intact big sagebrush (Artemisia tridentata Nutt.) plant communities and declines in sagebrush obligate wildlife species. In recent decades, fire return intervals have shortened and area burned has increased in some areas, and habitat degradation is occurring where post-fire re-establishment of sagebrush is hindered by invasive annual grasses. In coming decades, the changing climate may accelerate these wildfire and invasive feedbacks, although projecting future wildfire dynamics requires a better understanding of long-term wildfire drivers across the big sagebrush region. Here, we integrated wildfire observations with climate and vegetation data to derive a statistical model for the entire big sagebrush region that represents how annual wildfire probability is influenced by climate and fine fuel characteristics.

Results

Wildfire frequency varied significantly across the sagebrush region, and our statistical model represented much of that variation. Biomass of annual and perennial grasses and forbs, which we used as proxies for fine fuels, influenced wildfire probability. Wildfire probability was highest in areas with high annual forb and grass biomass, which is consistent with the well-documented phenomenon of increased wildfire following annual grass invasion. The effects of annuals on wildfire probability were strongest in places with dry summers. Wildfire probability varied with the biomass of perennial grasses and forbs and was highest at intermediate biomass levels. Climate, which varies substantially across the sagebrush region, was also predictive of wildfire probability, and predictions were highest in areas with a low proportion of precipitation received in summer, intermediate precipitation, and high temperature.

Conclusions

We developed a carefully validated model that contains relatively simple and biologically plausible relationships, with the goal of adequate performance under novel conditions so that useful projections of average annual wildfire probability can be made given general changes in conditions. Previous studies on the impacts of vegetation and climate on wildfire probability in sagebrush ecosystems have generally used more complex machine learning approaches and have usually been applicable to only portions of the sagebrush region. Therefore, our model complements existing work and forms an additional tool for understanding future wildfire and ecological dynamics across the sagebrush region.
Unique heterocyclic phenolic compounds from shrimp (Pandalus borealis) and beyond
Authors: Onodenalore Akhile Collins , Hossain Abul , Banoub Joseph , Shahidi Fereidoon
Published: February 2024

Shrimps are the most consumed species among crustaceans and are well appreciated for their flavor and high nutritional value. This work investigated the antioxidative compounds of Northern shrimp (Pandalus borealis) and its processing discards (shells and heads) using various solvents and chromatographic techniques as well as mass spectrometry. Ethanol served as the best extraction medium, and the extracts obtained demonstrated strong antioxidant activity in a β-carotene-linoleate emulsion system. The antioxidative compounds of the extract were isolated using a silica gel column chromatography, followed by thin layer chromatography. This led to the identification of two highly polar and two low polarity compounds. These compounds, for the first time, were isolated and purified by using reversed-phase HPLC. Their structures were tentatively elucidated using electrospray mass spectrometry. These unique compounds were heterocyclic phenolic compounds and identified as 7-(3-butenyl)-2-hydroxy-6-(1,2,5,6-tetrahydropyridin-2-yl) quinoline and 7-(3-butenyl)-2-hydroxy-6-(1,2,5,6-tertahydropyridin-2-yl)-7,8-dihydroquinoline and their isomers. The proposed novel compounds in shrimp provide a reason for their oxidative stability and potential benefits, as well as possibly serving as substrates for the discoloration of shrimp.

Graphical Abstract
Cordycepin alleviates osteoarthritis by inhibiting chondrocyte ferroptosis via Keap1/Nrf2 axis
Authors: Li Jianlei , Lv Zuo
Published: February 2024

Background

Intervertebral disc degeneration (IVDD) is a prevalent condition known to contribute to lower back pain and various spinal disorders. The progression of IVDD is closely associated with cell ferroptosis. This study aimed to explore the therapeutic potential of a reactive oxygen species (ROS)-responsive hydrogel loaded with garlic extract for the inhibition of cell ferroptosis and the treatment of IVDD.

Results

The study encapsulated garlic extract within the hydrogel using physical entrapment and controlled the release of the extract through the ROS-responsive degradation of the hydrogel. Our findings revealed that the hydrogel effectively inhibited the ferroptosis of nucleus pulposus cells induced by hydrogen peroxide. Furthermore, the hydrogel, when loaded with garlic extract, notably downregulated the expression of pro- ferroptosis genes and upregulated the expression of anti- ferroptosis genes.

Conclusions

This study demonstrated that the hydrogel loaded with garlic extract significantly mitigated IVDD. These results highlight the promising potential of ROS-responsive hydrogel loaded with garlic extract as a viable treatment option for addressing IVDD.
Clinically Relevant Germline Variants in Children With Nonmedullary Thyroid Cancer
Authors: van der Tuin Karin , Ruano Dina , Knijnenburg Jeroen , van der Luijt Rob B , Morreau Hans , Links Thera P , Hes Frederik J ,   Dutch Pediatric Thyroid Cancer Consortium, Klein Hesselink Mariëlle S , Nies Marloes , Bocca Gianni , Brouwers Adrienne H , Burgerhof Johannes G M , van Dam Eveline W C M , Havekes Bas , van den Heuvel-Eibrink Marry M , Corssmit Eleonora P M , Kremer Leontien C M , Netea-Maier Romana T , van der Pal Helena J H , Peeters Robin P , Plukker John T M , Ronckers Cécile M , van Santen Hanneke M , Smit Jan W A , Links Thera P , Tissing Wim J E , van der Tuin Karin , Hes Frederik J , van Velsen Evert F , van Leeuwaarde Rachel S
Published: February 2024

Context

The underlying genetic cause of nonmedullary thyroid cancer (NMTC) in children is often unknown, hampering both predictive testing of family members and preventive clinical management.

Objective

Our objectives were to investigated the potential heritability in the largest childhood NMTC cohort that has been genotyped to date.

Methods

Nationwide retrospective cohort study in tertiary referral centers. In total, 97 patients diagnosed with pediatric NMTC between 1970 and 2020 were included in this study. Patients underwent germline whole genome sequencing. The main outcome measures were mutation detection yield in (1) clinically relevant tumor predisposition genes and (2) genes previously associated with NMTC.

Results

In total, 13 of 97 patients (13%) carried a germline (likely) pathogenic variant in a well-known tumor predisposition gene: APC (n = 1), BRCA2 (n = 2), CHEK2 (n = 4), DICER1 (n = 4), HOXB13 (n = 1), and MITF (n = 1). In addition, 1 patient was diagnosed with Pendred syndrome (SLC26A4) and 9 variants of high interest were found in other NMTC candidate susceptibility genes.

Conclusion

The reported prevalence (13%) of germline variants in well-known tumor predisposing genes and the added value of a revised personal/family history and histology led us to recommend genetic counseling for all patients with childhood NMTC. The detected tumor predisposition syndromes are associated with a risk for second cancers which necessitates additional surveillance of the index patients and presymptomatic genetic testing of at risk family members.
Perioperative Plasma in Addition to Red Blood Cell Transfusions Is Associated With Increased Venous Thromboembolism Risk Postoperatively
Authors: Choi Una E. , Nicholson Ryan C. , Frank Steven M. , Cha Stephanie , Aziz Hamza , Lester Laeben C. , Ariyo Promise , Cho Brian C. , Hensley Nadia B.
Published: February 2024

BACKGROUND:

Perioperative red blood cell (RBC) transfusions increase venous thromboembolic (VTE) events. Although a previous study found that plasma resuscitation after trauma was associated with increased VTE, the risk associated with additional perioperative plasma is unknown.

METHODS:

A US claims and EHR database (TriNetX Diamond Network) was queried. We compared surgical patients who received perioperative plasma and RBC to patients who received perioperative RBC but not plasma. Subanalyses included (1) all surgeries (n = 48,580) and (2) cardiovascular surgeries (n = 38,918). Propensity score matching was performed for age at surgery, ethnicity, race, sex, overweight and obesity, type 2 diabetes, disorders of lipoprotein metabolism, essential hypertension, neoplasms, nicotine dependence, coagulopathies, sepsis, chronic kidney disease, liver disease, nonsteroidal anti-inflammatory analgesics, platelet aggregation inhibitors, anticoagulants, hemoglobin level, outpatient service utilization, and inpatient services; surgery type was included for “all surgeries” analyses. Outcomes included 30-day mortality, postoperative VTE, pulmonary embolism (PE), and disseminated intravascular coagulation (DIC).

RESULTS:

After matching the surgical cohorts, compared to only RBC, plasma + RBC was associated with higher risk of postoperative mortality (4.52% vs 3.32%, risk ratio [RR]: 1.36 [95% confidence interval, 1.24–1.49]), VTE (3.92% vs 2.70%, RR: 1.36 [1.24–1.49]), PE (1.94% vs 1.33%, RR: 1.46 [1.26–1.68]), and DIC (0.96% vs 0.35%, RR: 2.75 [2.15–3.53]). Among perioperative cardiovascular patients, adding plasma to RBC transfusion was associated with similar increased risk.

CONCLUSIONS:

When compared with perioperative RBC transfusion, adding plasma was associated with increased 30-day postoperative mortality, VTE, PE, and DIC risk among surgical and cardiovascular surgical patients. Reducing unnecessary plasma transfusion should be a focus of patient blood management to improve overall value in health care.
Examination of Potentially Morally Injurious Events and Moral Injury in Medical Professionals
Authors:   , Keegan Fallon
Published: February 2024

The current study examined the nature and extent of endorsement of PMIEs, the nature and severity of MI symptoms related to endorsement of a PMIE, and the relations between extent of endorsement of PMIEs and MI symptoms. We hypothesized that (1) PMIEs perpetrated by others would be endorsed to a greater extent than PMIEs perpetrated by oneself; (2) medical professionals who endorsed a PMIE would report significantly greater severity on all MI symptoms compared to medical professionals who did not endorse a PMIE; (3) experiencing PMIEs (perpetrated by oneself and/or others) to a greater extent would predict higher levels of MI symptom severity, and MI symptom severity would specifically be most strongly predicted by PMIEs perpetrated by oneself. Hypotheses were examined using t-tests, Pearson's r correlations, and multiple multivariate regression analyses. First, the current study found that PMIEs perpetrated by others were endorsed to a greater extent than those perpetrated by themselves; second, greater exposure to PMIEs was associated with significantly greater severity of 10 of the 14 outcomes. Third, PMIEs perpetrated by oneself predicted more MI symptomatology than PMIEs perpetrated by others, indicating that while PMIEs perpetrated by others are more common, PMIEs perpetrated by oneself are more strongly associated with MI outcomes. This study highlights the widespread and harmful impact of PMIEs among medical professionals.
The Impact of Socioeconomic Status on Attachment Security and Psychological Well-Being
Authors:   , Zuniga Sabrina Graciela
Published: February 2024

Socioeconomic status (SES) has been shown to reliably predict parenting practices, family well-being, and psychological outcomes throughout the lifespan. The current study employed a cross-sectional, quantitative design in which adult participants (N = 336) completed an online survey measuring demographic variables, financial stress, attachment security, and psychological well-being. The study results suggest that (a) both current and family history of financial stress negatively predicted attachment security, (b) SES positively predicted general psychological well-being, although individual SES factors (e.g., income, subjective SES, financial stress) demonstrated nuanced relationships with well-being, life satisfaction, and resilience, (c) family history of financial stress and attachment security mediated the relationship between calculated social status and psychological well-being, and (d) the mediated relationship between calculated social status and psychological well-being via the pathway of attachment security was significant for racial/ethnic minorities, but not for White participants. The present findings contribute to the current literature by (1) including multidimensional measurements of SES, (2) addressing nuances in the relationship between SES and attachment, (3) emphasizing the role of financial stress on attachment security, and (4) providing initial cross-cultural considerations in the relationships among SES, attachment, and psychological well-being. Future researchers are encouraged to conduct longitudinal analyses, amplify sample recruitment efforts, and expand SES, attachment, and racial/ethnic identity measurement. Lastly, the current study has significant clinical implications regarding multiculturalism and social justice, relational schemas developed in context of financial stress, and cognitive appraisal regarding subjective SES.
Examining the Educational Depth of Medical Case Reports and Radiology with Text Mining
Authors:   , Collinsworth Amy L.
Published: February 2024

The purpose of this dissertation was to use the technology of text mining and topic modeling to explore unobserved themes of medical case reports that involve medical imaging. Case reports have a valuable place in medical research because they provide educational benefits, offer evidence, and encourage discussions. Their form has evolved throughout the years, but they have remained a key staple in providing important information to the medical communities around the world with educational context and illuminating visuals. Examining medical case reports that have been published throughout the years on multiple medical subjects can be challenging, therefore text mining and topic modeling methods were used to analyze a large set of abstracts from medical case reports involving radiology. The total number of abstracts used for the data analysis was 68,845 that were published between the years 1975 to 2022. The findings indicate that text mining and topic modeling can offer a unique and reproducible approach to examine a large quantity of abstracts for theme analysis.
Exploring Psychological Intimate Partner Violence Using Brief Expressive Writing Essays
Authors:   , Laajala Allison
Published: February 2024

Non-physical intimate partner violence (NPIPV) is the most pervasive type of abuse, yet literature has predominantly focused on physical IPV victimization. This study employed a mixed-methods design utilizing archival expressive writing data previously collected to identify the presence of NPIPV victimization. Participants wrote about their experience after a relationship dissolution using the expressive writing paradigm. They were asked to share their deepest thoughts and feelings across two sessions. A constructivist grounded theory approach established the theoretical framework for coding the presence of NPIPV acts between romantic partners. Four themes of NPIPV were established (degradation, isolation, control, and jealousy). Disclosure of NPIPV and other themes were also evident in these data. Quantitative analyses assessed changes in participants' psychological distress after completing a brief writing intervention. The intervention increased the likelihood of NPIPV victimization being mentioned from Time 1 to Time 2 writing sessions. This study increases clinical awareness regarding NPIPV by providing insights into this longest-sustained IPV subtype. All participants reported a reduction in avoidance symptoms after completing the writing intervention. Finally, gender continues to complicate this field as researchers must acknowledge both the existence of men's victimization experiences and the greater severity of women's victimization. Clinical implications demonstrate a strength in narrative therapy when processing relationship dissolution particularly when NPIPV victimization is present.
Cross-Conjugation Effects on Fused β, β'–π–Extended Porphyrins
Authors:   , Washburn Spenser L.
Published: February 2024

Cross-conjugation in molecules has been seen in nature for many years but was not pursued due to the difficulty of their synthesis and their lack of stability. Recently, it has become more interesting due to the rise of molecular electronics. Linear conjugation serves well as the wires to conduct electrons, but molecular electronics are made up of more than just wires. Molecules are needed that possess an on/off switch that can allow or deter conduction. Cross-conjugated systems show promise in their ability to be turned on or off from external stimuli. Pentacene quinone is a well-known cross-conjugated molecule that already shows promise in the field of molecular semiconductors. By synthetically fusing the pentacene quinone to the β, β' positions of a porphyrin, it has been shown that both the solubility and stability have been greatly improved. This has allowed us to pursue functionalization of the quinone moiety. Several new cross-conjugated pentacene quinone fused porphyrin systems were synthesized and studied. It was found that cross-conjugated platinum porphyrins show enhanced fluorescence, and phosphorescence that shifts toward the Near IR. Additionally, strong electron withdrawing groups show potential in charge transfer, and a lower HOMO to LUMO gap, while mildly withdrawing groups have a higher HOMO to LUMO gap. Furthermore, a new method to introduce halogenated methine bridges at the pentacene quinone core was developed, thus opening the doors to new polycyclic aromatic hydrocarbons to be synthesized and studied.