bluuebunny/crossref_metadata_2025 huggingface dataset:
Legal Issues
Authors: Sell Jarrett K.
Published: September 2023

This chapter will assist the learner to demonstrate knowledge about legal issues surrounding HIV health care and to communicate effectively, professionally, and sensitively with patients and their families. Legal topics include recommendations for routine HIV testing in various health care settings, recommended frequency of testing for at-risk populations, consent, and allowable circumstances for HIV testing without consent. The learner will also be able to describe disease reporting systems and requirements. Issues related to partner notification and confidentiality, disclosure, HIV criminalization, and stigma are also discussed. Advance planning topics are delineated, as well as end-of-life issues, such as durable power of attorney, advanced directives, wills, and physician orders for life-sustaining treatment.
The effect of cottonseed oil on lipids/lipoproteins: a systematic review and plasma cholesterol predictive equations estimations
Authors: Hart Tricia L , Petersen Kristina S , Kris-Etherton Penny M
Published: September 2023

Context

Cottonseed oil (CSO) is higher in polyunsaturated fatty acids (PUFA) and saturated fatty acids (SFAs) than many liquid plant oils.

Objectives

To conduct a systematic review of randomized controlled trials (RCTs) examining effects of CSO on markers of lipid metabolism and evaluate lipid and lipoprotein effects of incorporating CSO into a healthy dietary pattern using regression equations.

Data Sources

A systematic search was conducted for RCTs comparing CSO with a non-CSO comparator in any population.

Data Analyses

The Katan regression equation was used to predict lipid/lipoprotein changes when incorporating CSO into a US-style healthy eating pattern at 25 to 100% of the total oil allowance (ie, 27 g/2000 kcal) compared with average American intake (NHANES 2017 to 2020 pre-COVID pandemic).

Results

In total, 3 eligible publications (n = 2 trials), with 58 participants that provided 44% and 30% of total energy as CSO, were included. Fasting low-density lipoprotein cholesterol (LDL-C; ≈ –7.7 mg/dL) and triglycerides (≈ –7.5 mg/dL) were lower after 5 days of a CSO-enriched diet vs olive oil (OO). In a 56-day trial, CSO lowered total cholesterol (TC; ≈ –14.8 mg/dL), LDL-C (≈ –14.0 mg/dL), and non–high-density lipoprotein cholesterol (≈ –14.2 mg/dL) vs OO. Postprandially, angiopoietin-like protein-3, -4, and -8 concentrations decreased with CSO and increased with OO intake. Compared with average American intake, a healthy eating pattern with 27 g of CSO was estimated to lower TC (–8.1 mg/dL) and LDL-C (–7.3 mg/dL) levels, with minimal reduction in high-density lipoprotein cholesterol (–1.1 mg/dL). Compared with the healthy eating pattern, incorporating 27 g of CSO was predicted to increase TC and LDL-C levels by 2.4 mg/dL.

Conclusion

Limited high-quality research suggests CSO may improve lipid/lipoprotein levels compared with OO. Cholesterol predictive equations suggest CSO can be incorporated into a healthy dietary pattern without significantly affecting lipids/lipoproteins.
The power of berries against cardiovascular diseases
Authors: Kocabas Sule , Sanlier Nevin
Published: September 2023

Cardiovascular diseases (CVDs) pose a serious threat to human health and incidence is increasing gradually. Nutrition has an important impact on the prophylaxis and progression of CVD. In this article, general attention is drawn to the possible positive effects of berries on CVD. Polyphenols have beneficial effects on the vascular system by inhibiting low-density lipoprotein oxidation and platelet aggregation, lowering blood pressure, improving endothelial dysfunction, and attenuating antioxidant defense and inflammatory responses. This review provides an overview of the effects of berries for the prevention and treatment of CVDs. Berries contain several cardioprotective antioxidants, vitamins, and numerous phytochemicals, such as phenolic compounds, that have antioxidant properties and antiplatelet activity. Phytochemical compounds in their structures can modulate dissimilar signaling pathways related to cell survival, differentiation, and growth. Important health benefits of berries include their antioxidant roles and anti-inflammatory impacts on vascular function. The effectiveness and potential of polyphenols primarily depend on the amount of bioavailability and intake. Although circulating berry metabolites can improve vascular function, their biological activities, mechanisms of action, and in vivo interactions are still unknown. Analyzing human studies or experimental studies to evaluate the bioactivity of metabolites individually and together is essential to understanding the mechanisms by which these metabolites affect vascular function.
Prudential Problems for the Counterfactual Comparative Account of Harm and Benefit
Authors: Carlson Erik , Johansson Jens , Risberg Olle
Published: September 2023

In this paper, we put forward two novel arguments against the counterfactual comparative account (CCA) of harm and benefit. In both arguments, the central theme is that CCA conflicts with plausible judgements about benefit and prudence.
Gender Neutrality Made Easy and Constitutional: Why We Call Members of the House “Congressman” and “Congresswoman,” and Why We Should Not
Authors: Wirls Daniel
Published: September 2023

How did we come to use and accept “congressman” and, later, “congresswoman” instead of “representative” as the nearly default designation for members of the House, while at the same time referring to senators exclusively by that title? And despite it being inherently inaccurate and unnecessarily binary, this convention for members of the House has gone unchallenged, even as gender-neutral language advances and even as the House of Representatives has considered such things as adding more gender-neutral bathrooms. This article traces, for the first time, the history of “congressman” (and “congresswoman”) conceptualized as a linguistic meme subject to a process of replication and imitation. It explores the first uses of “congressman” prior to the Constitution, how the reporting of elections in the early decades of the republic embedded the use of “congressman” for House members in the national vocabulary, and how the arrival of congresswomen ironically reinforced this convention. This study also uses comparisons to the titles for legislators in American states and other nations to show how exceptional these terms are in being both gendered and institutionally inaccurate. Finally, it draws on that history to argue that the House, press, and public should drop these gendered, civically confusing, and politically inappropriate honorifics in favor of the one specified in the Constitution.
Dinaciclib exerts a tumor-suppressing effect via β-catenin/YAP axis in pancreatic ductal adenocarcinoma
Authors: Li Yichen , Zheng Zhenjiang , Xiao Li , Chen Yonghua , Liu Xubao , Long Dan , Chai Li , Li Yi , Tan Chunlu
Published: September 2023

Dinaciclib, a cyclin-dependent kinase-5 (CDK5) inhibitor, has significant anti-tumor properties. However, the precise mechanism of dinaciclib requires further investigation. Herein, we investigated the anti-tumor functions and molecular basis of dinaciclib in pancreatic ductal adenocarcinoma (PDAC). PDAC and matched para-carcinoma specimens were collected from the patients who underwent radical resection. Immunohistochemistry was performed to assess CDK5 expression. Cell proliferation ability, migration, and invasion were measured using Cell Counting Kit-8, wound healing, and transwell assay, respectively. The cell cycle and apoptosis were assessed using flow cytometry. Gene expression was examined using RNA-seq and quantitative real-time PCR. Protein expression of proteins was measured by western blot analysis and immunofluorescence microscopy. Tumor-bearing mice were intraperitoneally injected with dinaciclib. CDK5 is highly expressed in PDAC. The expression level of CDK5 was significantly related to tumor size, T stage, and the American Joint Committee on Cancer stage. High CDK5 expression can predict poor survival in PDAC patients. In addition, the expression level of CDK5 might be an independent prognostic factor for PDAC patients. Dinaciclib inhibits the growth and motility of PDAC cells and induces apoptosis and cell cycle arrest in the G2/M phase. Mechanistically, dinaciclib down-regulated yes-associated protein (YAP) mRNA and protein expression by reducing β-catenin expression. Moreover, dinaciclib significantly inhibited PDAC cell growth in vivo. Our findings reveal a novel anti-tumor mechanism of dinaciclib in which it decreases YAP expression by down-regulating β-catenin at the transcriptional level rather than by activating Hippo pathway-mediated phosphorylation-dependent degradation.
Innovative Strategies to Address Systemic Inequities in Youth Sexual Health Programs
Authors: Sattler Victoria P. , Courtney Kristin E. , McCray Celena J. , Burlingham Bonnie S. , Casanova Nicole L. , Klos Bradley J. , Ghaffar Rabeeha
Published: September 2023

Disparities in sexual health outcomes between racial and ethnic groups throughout the state of Washington suggest the presence of systemic inequities impeding young people's experience with and access to sexual health care and education. Emerging innovations in sexual health look to center young people, particularly those who have been historically excluded, in the design and implementation of programs that aim to serve them. The Washington Youth Sexual Health Innovation and Impact Network (WYSHIIN) and 11 grant-funded partners engaged communities of youth across the state of Washington, including Two Spirit, lesbian, gay, bisexual, transgender, queer, questioning, intersex, and/or asexual (2SLGBTQIA+) and Black, Indigenous, and People of Color (BIPOC) youth, with the goal of equitably engaging participants and stakeholders to broaden services in schools and community settings. Evaluation staff from the Washington State Department of Health conducted virtual interviews with community partners for preliminary program evaluation purposes and identified 6 strategies for engaging youth. WYSHIIN partners highlighted strategies for centering youth voice and needs at all levels of program development and implementation, embracing holistic and culturally relevant approaches, and 2SLGBTQIA+ inclusion. These themes, reflective of wisdom across multiple Washington communities, offer strategies to address systemic issues that negatively impact youth access to and experience with sexual health care.
Artificial intelligence-based clinical decision support for liver transplant evaluation and considerations about fairness: A qualitative study
Authors: Strauss Alexandra T. , Sidoti Carolyn N. , Sung Hannah C. , Jain Vedant S. , Lehmann Harold , Purnell Tanjala S. , Jackson John W. , Malinsky Daniel , Hamilton James P. , Garonzik-Wang Jacqueline , Gray Stephen H. , Levan Macey L. , Hinson Jeremiah S. , Gurses Ayse P. , Gurakar Ahmet , Segev Dorry L. , Levin Scott
Published: September 2023

Background:

The use of large-scale data and artificial intelligence (AI) to support complex transplantation decisions is in its infancy. Transplant candidate decision-making, which relies heavily on subjective assessment (ie, high variability), provides a ripe opportunity for AI-based clinical decision support (CDS). However, AI-CDS for transplant applications must consider important concerns regarding fairness (ie, health equity). The objective of this study was to use human-centered design methods to elicit providers’ perceptions of AI-CDS for liver transplant listing decisions.

Methods:

In this multicenter qualitative study conducted from December 2020 to July 2021, we performed semistructured interviews with 53 multidisciplinary liver transplant providers from 2 transplant centers. We used inductive coding and constant comparison analysis of interview data.

Results:

Analysis yielded 6 themes important for the design of fair AI-CDS for liver transplant listing decisions: (1) transparency in the creators behind the AI-CDS and their motivations; (2) understanding how the AI-CDS uses data to support recommendations (ie, interpretability); (3) acknowledgment that AI-CDS could mitigate emotions and biases; (4) AI-CDS as a member of the transplant team, not a replacement; (5) identifying patient resource needs; and (6) including the patient’s role in the AI-CDS.

Conclusions:

Overall, providers interviewed were cautiously optimistic about the potential for AI-CDS to improve clinical and equitable outcomes for patients. These findings can guide multidisciplinary developers in the design and implementation of AI-CDS that deliberately considers health equity.
The rapidly evolving landscape of HCC: Selecting the optimal systemic therapy
Authors: Zanuso Valentina , Rimassa Lorenza , Braconi Chiara
Published: September 2023

Over the past years, there has been a remarkable advance in the systemic treatment options for advanced HCC. The overall survival has gradually increased over time, with larger benefits for patients with sensitive tumors and preserved liver function, the latter being an essential condition for the delivery of sequential lines of treatment and optimization of clinical outcomes. With the approval of new first-line agents and the introduction of immune checkpoint inhibitor-based therapies, the treatment landscape of advanced HCC is becoming wider than ever. Atezolizumab plus bevacizumab and, more recently, durvalumab plus tremelimumab have entered the clinical practice and are the current standard of care for treatment-naïve patients, surpassing sorafenib and lenvatinib monopoly. As no head-to-head comparisons are available among all the first-line treatment options, the recommendation for the most appropriate choice and sequence is patient-driven and integrates efficacy data with clinical comorbidities, background liver disease, and the safety profile of available drugs. In addition, predictive biomarkers for successful patients’ stratification are yet to be available and constitute the focus of ongoing research. The treatment algorithm is likely to become even more complex since systemic therapeutic approaches are now being translated into earlier stages of the disease, with an impact on the evolution of the sequential treatment of patients with HCC.
Factors Associated With Alcohol Consumption Among Thai People by Gender
Authors: Sitthisongkram Somporn , Prakobchai Sattha , Rajchawang Nutthachayada
Published: September 2023

Objective

The aim of this study was to examine the factors associated with alcohol consumption among Thai people by gender using the social determinants of health theoretical framework.

Method

Participants were Thai people aged 15 years or older. A total of 25,758 Thai people were selected through a stratified random sampling method. The study was a secondary analysis of a national cross-sectional study using the data from the Thailand Smoking and Drinking Behavior Survey 2014.

Results

Thai people were regular drinkers (13.69%). Regarding gender, 26.54% of men and 2.72% of women were regular drinkers. The risk factors for regular drinking among Thai men included family members and close friends consuming alcohol, being aged 25–44 years, living in Northern Thailand, being a skilled or unskilled worker, smoking, and income of 10,001–30,000 Thai baht/month (31 Thai Baht (THB)/U.S. dollars). Protective factors against alcohol consumption were living in Southern Thailand and being unemployed/a student. For women, the risk factors for regular drinking were family members and close friends drinking as well as smoking. Being married, living in a nonmunicipal area, holding a diploma or bachelor's degree, and being unemployed/a student were protective factors against alcohol drinking among women.

Factors associated with alcohol consumption among Thai people vary by gender. Therefore, solving the drinking problems should consider both the risk and protective factors for men and women separately.
Acceptability Among Frontline Staff Toward Distributing an Anonymous Alcohol Survey in Emergency Departments
Authors: Sivertsen Ditte M. , Andersen Karen V. , Becker Ulrik , Lisby Marianne , Andersen Ove , Brünes Nina , Kirk Jeanette W.
Published: September 2023

Emergency departments (EDs) serve as the front line when patients encounter the hospital system. Limited data are available of patients' alcohol habits collected during Danish ED visits, and no studies have, to our knowledge, examined frontline staffs' (registered nurses and medical secretaries) acceptability to deliver anonymous alcohol surveys to patients. We aimed at examining the proportion of survey respondents and the prevalence of patients' alcohol habits and also exploring frontline staff acceptability of the distribution of an anonymous survey regarding patients' alcohol habits in EDs. Intendedly, all eligible patients ≥18 years old entering two EDs in March 2019 should receive a survey based on the Alcohol Use Disorder Identification Test. The study was an explanatory, sequential, mixed methods design, and results were analyzed with descriptive statistics and a deductive content analysis based on the theoretical framework of acceptability. In total, 15% (n = 1,305) of the total 8,679 patients in the EDs returned the survey. Qualitative analysis of interviews (n = 31) with staff showed that they had been reluctant to distribute the survey primarily because of ethical concerns of anonymity, freedom of choice, and being nonjudgmental toward patients. Hence, patients with no obvious alcohol problems were more likely to receive the survey. Still, we found that 23% of the respondents had an Alcohol Use Disorder Identification Test score ≥ 8. Results indicate that frontline staffs' recognition of patients' alcohol use is inadequate, and findings show a low degree of acceptability among staff to deliver an anonymous survey, which is in line with earlier described barriers toward screening activities in EDs.
Risk factors associated with saphenous vein graft aneurysm after coronary artery bypass graft
Authors: Ghosh Bikona , SIbi Krishna Thiyagarajan , Boini Aishwarya , Castillo Miranda Jose C. D. , Sinha Mehul , Bansal Radha , Visconti-Lopez Fabriccio J. , Mesfin Girma Samuel , Aliye Asfaw Yonathan
Published: September 2023

Introduction:

Saphenous vein graft aneurysm (SVGA) is a rare but life-threatening complication following coronary artery bypass grafting (CABG). The authors aim to identify the potential risk factors that lead to SVGA in post-CABG patients.

Methods:

A systematic review of original studies, observational studies, systematic reviews, meta-analyses, case studies, and case series was conducted using PubMed, Web of Science, Scopus, EMBASE, and Google Scholar involving adult patients (>18) with SVGA after CABG using MESH terminology in a broad search strategy. All searches were performed and analyzed according to PRISMA and duplicates were removed via Rayyan. Two independent investigators extracted and assessed the data involving demographics, and baseline data related to CABG and its manifestations.

Results:

Out of 487 finalized articles, 14 of them matched the inclusion requirements and reported 12 cases of SVGAs following CABG. Atherosclerosis with intimal calcification was the most common risk factor followed by infection. Others included hyperlipidemia, pneumonia, and cardiac pathologies mostly related to the ventricles and valves.

Conclusion:

Atherosclerosis associated with intimal calcification is the most common risk factor. Patient outcomes seem to improve upon early identification and regular follow-up imaging. The exclusion criteria indicated the study’s limits, and future studies that address these constraints may be able to better understand the risk variables involved in the genesis of SVGA.
Methodology for Analyzing Qualitative Data in Multiple Languages
Authors: Dolan Hanne R. , Alvarez Alexis A. , Freylersythe Sarah G. , Crane Tracy E.
Published: September 2023

Background

Translation strategies are commonly used for qualitative interview data to bridge language barriers. Inconsistent translation of interviews can lead to conceptual inequivalence, where meanings of participants' experiences are distorted, threatening scientific rigor.

Objectives

Our objective is to describe a systematic method developed to analyze multilingual, qualitative interview data while maintaining the original language of the transcripts.

Methods

A literature review of translation strategies, cross-language, and multilingual qualitative research was conducted. Combined with criteria for qualitative content analysis and trustworthiness, the methodology was developed and used for a qualitative descriptive study.

Results

The study had interview data in both English and Spanish. The research team consisted of both native Spanish and English speakers, who were grouped based on language. Verbatim transcription of data occurred in the original languages. All codes were kept in English, allowing the research team to view the data set as a whole. Two researchers within each group coded each transcript independently before reaching a consensus. The entire research team discussed all transcripts, and finally, major themes were determined. Participants' quotes remained in the original language for publication, with an English translation included when needed.

Discussion

Analyzing transcripts in the original language brought forth cultural themes that otherwise may have been overlooked. This methodology promotes conceptual equivalence and trustworthiness that is paramount in cultural, linguistic, and social determinants of health research to advance health equity.
Critical Appraisal of Histologic Grading for Mucoepidermoid Carcinoma of Salivary Gland
Authors: Xu Bin , Alzumaili Bayan , Furlan Karina C. , Martinez German H. , Cohen Marc , Ganly Ian , Ghossein Ronald A. , Katabi Nora
Published: September 2023

Multiple 3-tiered grading systems exist for mucoepidermoid carcinoma (MEC), leading to controversial results on the frequency and prognostic values of each grade. We aimed to identify prognostic histologic factors and to evaluate grading schemes in this retrospective study of 262 resected primary head and neck MECs. The rate of nodal metastasis was 8.4%. Large tumor size, tumor fibrosis, infiltrative border, lymphovascular invasion, perineural invasion, atypical mitosis, mitotic index (MI) ≥4/2 mm2 (4/10 HPFs), necrosis, and pT4 stage were associated with increased risk of nodal metastasis. The 5-year recurrence-free survival (RFS) was 95%. Significant prognostic factors for RFS included infiltrative border, tumor-associated lymphoid stroma, architectural patterns (macrocystic, microcystic, and noncystic), anaplasia, atypical mitosis, MI, necrosis, lymphovascular invasion, margin, pT stage, and tumor size. Nuclear anaplasia, high mitotic rate, and ≥25% microcystic component were significant independent prognostic factors on multivariate survival analysis. There was no significant difference between low-grade (LG) and intermediate-grade (IG) MECs in terms of risk of nodal metastasis and outcomes using all 4 known grading systems. Rather, high-grade MEC was consistently associated with an increased risk of nodal metastasis at presentation and decreased RFS and distant metastasis–free survival (DMFS) compared with the LG/IG MECs. We therefore recommend simplifying MEC grading to a 2-tiered grading scheme using MI and/or tumor necrosis. Using a 2-tiered grading, high-grade histology independently predict RFS, and is associated with a 25% risk of nodal metastasis, a 5-year RFS of 76%, and a 5-year DMFS of 76%, whereas LG MEC has a nodal metastasis rate of 7.0%, 5-year RFS of 97% and 5-year DMFS of 99%.
Addressing the Gray Zone in Affirmative Mastectomy
Authors: Krakauer Kelsi N. , Balumuka Darius , Meza-Rochin Ana , Rapp Katrina , White Elizabeth , Hansen Juliana
Published: September 2023

Background

Surgical decision making in gender-affirming mastectomy (GAM) is based on a patient's classification using the Fischer scale. Fischer 1 patients are excellent candidates for periareolar (PA) approach and Fischer 3 patients almost exclusively undergo double incision with free nipple grafting (DIFNG). Fischer 2 patients are in a gray zone in which decision making is more challenging. In this patient population, periareolar approaches can lead to increased complication and revision rates but free grafting procedures seem excessive. We have created a treatment algorithm to address Fischer 2 patients and additionally developed a novel technique, the batwing, to provide patients with more options.

Methods

A retrospective chart review was undertaken to analyze the Fischer classification of all patients undergoing top surgery by a single surgeon at an academic institution from 2014 to 2021. The choice of surgical technique used as well as the outcomes of GAM among Fischer 2 patients was analyzed.

Results

Four hundred four patients underwent GAM, and 51 (11%) had Fischer 2 classification. The surgical techniques used were PA (27%), batwing (39%), nipple-sparing double incision (NSDI, 24%), and DIFNG (10%). Of those, 10% had major complications and 20% requested revision for contour irregularities. Major complication rates for PA, batwing, NSDI, and DIFNG were as follows: 2 of 14 patients (14%), 1 of 20 patients (5%), 1 of 12 patients (8%), and 1 of 5 patients (20%), respectively. The revision rate by technique was PA (36%), batwing (15%), NSDI (17%), and DIFNG (0%).

Conclusions

For Fischer 2 patients, batwing and NSDI techniques avoid the need for free nipple graft while providing better exposure, improved control of nipple-areolar complex position, and decreased rate of revision as compared with the PA technique. The complication rate was not significantly different. We present an algorithm accounting for Fischer grade, unique patient characteristics, and patient desires.
A 10-Year Update of Outcome Measures Used to Assess Results After Surgery for Cubital Tunnel Syndrome
Authors: Delancy Matthew M. , Kozusko Steven D. , Franco Michael J.
Published: September 2023

Hypothesis

Outcomes reporting for the surgical release of ulnar nerve cubital tunnel entrapment have variability in subjective, objective, and validated measures. The aim of this study is to review the literature to reassess the measures used to report surgical outcomes for ulnar neurolysis at the elbow.

Methods

This study was conducted in accordance with the PRISMA guidelines on systematic reviews. Six electronic databases were queried from the past 10 years using specific search terms and Boolean operators. Two independent reviewers assessed 4290 unique titles and abstracts that were screened for inclusion criteria. Sixty-eight full text articles were included for analysis.

Results

Statistical significance was noted in the number of outcome measures reported between studies from journals of impact factor within the first and third quartiles (P = 0.0086) and first and fourth quartiles (P = 0.0247), although no significance exists in the number of cubital tunnel–specific measures based on impact factor (P = 0.0783). Seventy-nine percent (n = 54) of the included studies report subjective measures; 54% (n = 37) included objective measures. Seventy percent (n = 48) of the studies report disease-specific outcome measures.

Conclusion

There exists a discordance within the literature regarding the most appropriate, descriptive, and translational measures for reporting surgical outcomes of cubital tunnel syndrome. We recommend journal editors implement a requirement that authors reporting outcomes of ulnar nerve decompression must use a standard, validated measure to make comparisons across the literature universal. Furthermore, a minimum of at least 1 subjective and 1 objective measure should be standard.
Using a New Deep Learning Method for 3D Cephalometry in Patients With Hemifacial Microsomia
Authors: Xu Meng , Liu Bingyang , Luo Zhaoyang , Sun Min , Wang Yongqian , Yin Ningbei , Tang Xiaojun , Song Tao
Published: September 2023

Deep learning algorithms based on automatic 3D cephalometric marking points about people without craniomaxillofacial deformities have achieved good results. However, there has been no previous report about hemifacial microsomia (HFM). The purpose of this study is to apply a new deep learning method based on a 3D point cloud graph convolutional neural network to predict and locate landmarks in patients with HFM based on the relationships between points. The authors used a PointNet++ model to investigate the automatic 3D cephalometry. And the mean distance error (MDE) of the center coordinate position and the success detection rate (SDR) were used to evaluate the accuracy of systematic labeling. A total of 135 patients were enrolled. The MDE for all 32 landmarks was 1.46 ± 1.308 mm, and 10 landmarks showed SDRs at 2 mm over 90%, and only 4 landmarks showed SDRs at 2 mm under 60%. Compared with the manual reproducibility, the standard distance deviation and coefficient of variation values for the MDE of the artificial intelligence system was 0.67 and 0.43, respectively. In summary, our training sets were derived from HFM computed tomography to achieve accurate results. The 3D cephalometry system based on the graph convolutional network algorithm may be suitable for the 3D cephalometry system in HFM cases. More accurate results may be obtained if the HFM training set is expanded in the future.
Distinguishing Authentic Voices in the Age of ChatGPT: Comparing AI-Generated and Applicant-Written Personal Statements for Plastic Surgery Residency Application
Authors: Patel Viren , Deleonibus Anthony , Wells Michael W. , Bernard Steven L. , Schwarz Graham S.
Published: September 2023

Background

ChatGPT, a generative artificial intelligence model, may be used by future applicants in the plastic surgery residency match.

Methods

Ten personal statements (5 generated by ChatGPT, 5 written by applicants) were rated by 10 reviewers, blinded to the source of the essay.

Results

A total of a 100 evaluations were collected. There was no significant difference in ratings for readability, originality, authenticity, and overall quality (all P > 0.05) when comparing computer-generated and applicant essays.

Conclusion

Personal statements prepared by ChatGPT are indistinguishable from essays written by actual applicants. This finding suggests that the current plastic surgery application format be reevaluated to better aid in holistic evaluation of students.
Comparison of Dorsoulnar Artery Perforator, Superficial Palmar Branch of the Radial Artery, and Superficial Circumflex Iliac Artery Perforator Flaps in Volar Finger Defects
Authors: Tatar Burak Ergün , Erçin Burak Sercan
Published: September 2023

Background

Volar finger defects can sometimes be challenging for plastic surgeons. There are many reconstruction options from local flaps to free flaps. Therefore, the aim of this study was to present a functional and cosmetic comparison of the results of using dorsoulnar artery perforator (DUAP), superficial palmar branch of the radial artery (SPBRA), and superficial circumflex iliac artery perforator (SCIP) flaps for repairing volar finger defects.

Methods

Thirty-two patients were included in the study. The age and sex of the patients, cause of injury, defect location, defect size, and presence or absence of nerve damage were noted. The patients' defects were reconstructed with DUAP, SCIP, or SPBRA flaps. The flap size, flap elevation time, vessels, and early postoperative complications were noted. During the postoperative follow-up period, the Michigan Hand Outcomes Questionnaire scale was used to evaluate hand function, and the modified Vancouver Scar Scale was used to assess aesthetic appearance. Two-point discrimination tests and cold intolerance tests were performed to measure sensory outcomes. Donor site improvements were also noted.

Results

There was no significant difference between the groups in terms of age, defect size, flap size, follow-up time, and 2-point discrimination. It was observed that the elevation time was significantly shorter in the SCIP flap group, and the Michigan Hand Outcomes Questionnaire score was significantly lower in the DUAP flap group compared with the other 2 groups (P < 0.01). In addition, the modified Vancouver Scar Scale score was significantly higher in the DUAP flap group (P < 0.01).

Conclusion

The findings of this study show that the use of SPBRA flaps has more advantages than the use of DUAP and SCIP flaps in many respects.
Enhanced Efficacy of Resveratrol Loaded Silver Nanoparticle in Attenuating Sepsis-Induced Acute Liver Injury: Modulation of Inflammation, Oxidative Stress, and SIRT1 Activation
Authors: ÜSTÜNDAĞ Hilal , DANIŞMAN KALINDEMİRTAŞ Ferdane , DOĞANAY Songül , DEMİR Özlem , KURT Nezahat , TAHİR HUYUT Mehmet , ÖZGERİŞ Betül , KARİPER İshak Afşin
Published: September 2023

Sepsis-induced acute liver injury is a life-threatening condition involving inflammation, oxidative stress, and endothelial dysfunction. In the present study, the preventive effects of resveratrol (RV) alone and resveratrol-loaded silver nanoparticles (AgNPs+RV) against sepsis-induced damage were investigated and compared in a rat model of polymicrobial sepsis induced by cecal ligation and puncture (CLP). Rats were divided into four groups: Sham, CLP, RV, and AgNPs+RV. Pro-inflammatory cytokines (tumor necrosis factor-alpha [TNF-α], interleukin-1 beta [IL-1β], interleukin-6 [IL-6]), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) activation, presepsin, procalcitonin, 8-hydroxy-2'-deoxyguanosine (8-OHDG), vascular endothelial growth factor (VEGF), and Sirtuin-1 (SIRT-1) levels were assessed to determine the treatments' effects. AgNPs+RV treatment significantly reduced pro-inflammatory cytokines, NF-κB activation, presepsin, procalcitonin, 8-OHDG, and VEGF levels compared to the CLP group, indicating attenuation of sepsis-induced liver injury. Both RV and AgNPs+RV treatments increased SIRT1 levels, suggesting a potential role of SIRT1 activation in mediating the protective effects. In conclusion, AgNPs+RV treatment demonstrated extremely enhanced efficacy in alleviating sepsis-induced liver injury by modulating inflammation, oxidative stress, and endothelial dysfunction, potentially mediated through SIRT1 activation. In this study, the effect of AgNPs+RV on sepsis was evaluated for the first time and these findings highlight AgNPs+RV as a promising therapeutic strategy for managing sepsis-induced liver injury, warranting further investigation.
A Randomized Double-blind Study to Assess the Skin Irritation and Sensitization Potential of a Once-weekly Donepezil Transdermal Delivery System in Healthy Volunteers
Authors: Sabbagh Marwan N. , Mathew Philip , Blau Alan
Published: September 2023

Background:

A once-weekly donepezil transdermal delivery system (TDS; Adlarity; Corium, LLC) is indicated for the treatment of mild, moderate, and severe dementia of the Alzheimer type.

Methods:

In this placebo-controlled, randomized, double-blind phase 1 trial, healthy volunteers aged 40 years or older were randomized to receive a placebo and donepezil TDS and were evaluated for the primary endpoints of skin irritation and sensitization potential. Skin irritation was scored.

Results:

Two hundred fifty-six participants were randomized and received ≥1 dose of any treatment. After the first weekly TDS application, no skin irritation or minimal irritation was evident between donepezil and placebo TDSs. At the third weekly TDS application, for donepezil TDS, the average of the mean combined skin irritation score was 0.55 of a possible maximum of 7, indicating none to minimal skin irritation, and for placebo, the score was 0.19, indicating no skin irritation. Of 198 participants, 4 (2.0%) were considered potentially sensitized to donepezil TDS, and 0 were potentially sensitized to placebo TDS.

Conclusion:

Once-weekly 5-mg/d donepezil TDS demonstrated minimal skin irritation under conditions of use of 3 consecutive weekly patch applications to the same skin site and minimal sensitization potential.
Impact of inoculum density of Fusarium oxysporum f. sp. zingiberi on symptomatic appearances and yield of ginger (Zingiber officinale Roscoe)
Authors: Matthews Andrea , Muthukumar Sharan P. T. , Hamill Sharon , Aitken Elizabeth A. B. , Chen Andrew
Published: September 2023

Ginger (Zingiber officinale Roscoe) is an important horticultural crop valued for its medicinal and culinary properties. Fusarium yellows, caused by the ascomycete fungus Fusarium oxysporum f. sp. zingiberi (Foz), is a devastating soil-borne disease of ginger. It has curtailed ginger production in Australia and around the world, leading to significant economic losses. An integrated approach is required to manage soil-borne diseases such as those caused by Foz. However, little is known about the influence of Foz inoculum on disease severity. This study aimed to establish a minimum threshold level of spores per gram of soil required for plant infection and to develop and evaluate a pot inoculation method for screening large numbers of plants in a controlled environment. To achieve this, the dominant Australian ginger cultivar Canton was inoculated with 101, 103, 105, 106 and 107 microconidia g−1 soil. The inoculum density was positively associated with leaf and stem yellows, and rhizome discolouration, and negatively associated with root length and rhizome weight. The lowest threshold required for plant infection was 101 microconidia g−1 soil, which may provide an important basis for outbreaks of Foz in the field. This finding adds significantly to our knowledge of the impact of soil health on ginger production, thereby contributing to the integrated management of Foz. When used at a high dose, this method can facilitate reliable and accurate screening of Foz-susceptible ginger genotypes in a controlled environment.
Emendation of Rules 8, 15, 22, 25a, 30(3)(b), 30(4), 34a, and Appendix 7 of the International Code of Nomenclature of Prokaryotes
Authors: Oren Aharon
Published: September 2023

Following an electronic discussion on proposals to emend Rules 8, 15, 22, 25a, 30(3)(b), 30(4), 34a, and Appendix 7 of the International Code of Nomenclature of Prokaryotes, I here report the outcome of the ballot on these proposals by the members of the International Committee on Systematics of Prokaryotes.
Pan-cancer characterization and clinical outcome of ecDNA-enhancer mediated transcriptional dysregulation
Authors: Zhong Tengwei , zhao Huan , Liu Yupeng , Yan Danyang , Li Yuguo , Guo Zhiyun
Published: September 2023

Extrachromosomal circular DNAs (ecDNAs) are extrachromosomal circular DNA elements harboring enhancers that can function as mobile transcriptional enhancers to promote oncogene amplification in diverse human cancers. However, little is known about the mechanism how ecDNA and relevant enhancers influence the transcription control in different cancers. Here, we performed a comprehensive pan-cancer analysis to explore the potential transcriptional regulatory network between ecDNA and enhancer, and the association with clinical outcomes in different human cancers. Firstly, we identified 18,385 enhancers on ecDNA in 1,921 samples of 20 TCGA tumors. By integrating corresponding RNA-seq data, we found that the expression levels of enhancer RNAs (eRNAs) were significantly different between ecDNA regions and corresponding linear chromosomes. This suggested that enhancers on ecDNA may employ eRNA to perform transcriptional regulation. Furthermore, we identified enhancer co-amplification with oncogenes and found that enhancers on ecDNA significantly affect the expression of co-amplified cancer genes and consequently influence the survival of cancer patients. In addition, we found that, compared to corresponding linear chromosomes, enhancers on ecDNA generally have lower levels of methylation, which may be mainly caused by the enhancer co-amplification with oncogenes. Genome-wide analysis of open chromatin regions revealed significantly higher levels of chromatin accessibility and certain chromosomal preferences in ecDNA regions comparing corresponding linear chromosomes. Moreover, we found that the downregulation of antigen presentation genes and the suppression of antigen presentation pathways may cause the tumor immune evasion mediated by ecDNA. Finally, we identified tumor-infiltrating activated mast cells in ecDNA-positive patients, which are associated with poorer prognosis. In summary, through pan-cancer analysis, we illustrate the characteristics and regulatory mechanisms of ecDNA and its enhancers in cancers, providing insights for future cancer treatment.
Epigenetic regulation of p63 blocks squamous-to-neuroendocrine transdifferentiation in esophageal development and malignancy
Authors: Zhang Yongchun , Karagiannis Dimitris , Liu Helu , Lin Mi , Fang Yinshan , Jiang Ming , Chen Xiao , Suresh Supriya , Huang Haidi , She Junjun , Shi Feiyu , Yang Patrick , El-Rifai Wael , Zaika Alexander , Oro Anthony E. , Rustgi Anil K. , Wang Timothy C. , Lu Chao , Que Jianwen
Published: September 2023

While cell fate determination and maintenance are important in establishing and preserving tissue identity and function during development, aberrant cell fate transition leads to cancer cell heterogeneity and resistance to treatment. Here, we report an unexpected role for the transcription factor p63 (Trp63/TP63) in the fate choice of squamous versus neuroendocrine lineage in esophageal development and malignancy. Deletion ofp63results in extensive neuroendocrine differentiation in the developing mouse esophagus and esophageal progenitors derived from human embryonic stem cells. In human esophageal neuroendocrine carcinoma (eNEC) cells, p63 is transcriptionally silenced by EZH2-mediated H3K27 trimethylation (H3K27me3). Upregulation of the major p63 isoform ΔNp63α, through either ectopic expression or EZH2 inhibition, promotes squamous transdifferentiation of eNEC cells. Together these findings uncover p63 as a rheostat in coordinating the transition between squamous and neuroendocrine cell fates during esophageal development and tumor progression.
The role of big data analytics and organizational agility in improving organizational performance of business processing organizations
Authors: Turi Jamshid Ali , Khwaja Muddasar Ghani , Tariq Fareena , Hameed Athar
Published: September 2023

Purpose

Business processing organizations are continuously focusing on customer knowledge management (CKM) due to the competitive business environment. CKM is being recognized as an essential source for improving organizational performance (OP). This study focuses on understanding CKM and its impact on OP. It also explores the moderating role of big data analytics capability (BDAC) on OP. Moreover, the mediating role of operational and strategic agility on OP was empirically tested.

Design/methodology/approach

Positivist research doctrine has been deployed and data was collected using structured survey using cross-sectional approach. The data were collected from 392 employees working in business processing software houses in the emerging market of Pakistan. Structural equation modeling (SEM) was deployed for the estimation of theoretical model.

Findings

The study's findings indicate that CKM has no significant impact on OP; although the presence of BDAC moderates the relationship significantly. Moreover, the study recommends that CKM and BDAC to be tested in the project environment, considering organization's operational and technical capabilities.

Research limitations/implications

The study proclaims that BDAC can be helpful for organizations to improve their capabilities and output. Likewise, enhancing BDAC reduces failure rates of the projects.

Originality/value

This study provides a critical theoretical and practical contribution to project management in business processing organizations. Big data analytics can be of value for diagnostic, predictive and prescriptive analysis in the project management context.
The competitiveness of Portugal: views from the market
Authors: Silva Gustavo , Pereira Leandro F. , Crespo Carvalho José , Vinhas da Silva Rui , Simoes Ana
Published: September 2023

Purpose

This study aims to conduct a pertinent assessment of the concept of business competitiveness and how Portugal can progress in that field, for the sake of becoming a more sustainable and wealth-creator economy.

Design/methodology/approach

The research was elaborated with 65 in-depth interviews with expert persons from the Portuguese business ecosystem, who were asked to reflect on the state of the economy and competitiveness of the country.

Findings

There is much room for improvement in almost all areas of activity, in particular by promoting an innovative, value-adding and exporting private sector and a lighter and more efficient public sector. The conclusions point to modernisation of the Portuguese economy as a way of making it more competitive in a highly competitive and demanding global scenario.

Originality/value

To the best of the authors’ knowledge, it is the first time that a reflection with experts of the local Portuguese economy has been carried out, especially after a difficult period of COVID.
Open access (OA) publishing behavior of university faculty members from the perspective of decomposed theory of planned behavior (DTPB)
Authors: Khokhar Maryam Tahir , Rafiq Muhammad , Malik Amara
Published: September 2023

Purpose

Open access (OA) has emerged as a modern academic publishing paradigm that strives to provide all members of society with free access to scholarly knowledge. This study aims to assess the behavior of faculty members to publish in OA journals from the perspective of the decomposed theory of planned behavior (DTPB).

Design/methodology/approach

A quantitative survey research design based on a cross-sectional survey approach was applied to investigate the phenomenon. The data were collected through a structured questionnaire from 338 faculty members of two large universities in Pakistan.

Findings

The findings of the study indicate that behavioral intentions (β= 0.664,p< 0.01), subjective norms (β= 0.159,p< 0.01) and perceived behavioral control (β= 0.238,p< 0.01) positively while attitude toward behavior negatively affected the actual behavior of the university faculty members to publish in OA journals.

Research limitations/implications

The study offers theoretical implications for researchers and practical implications for educational authorities, policymakers and funding agencies.

Originality/value

The study fills the literature gap and offers insight into the OA publishing behavior of academicians from the perspective of DTPB.
Framework for critical information infrastructure protection in smart government: a case study in Indonesia
Authors: Putro Prasetyo Adi Wibowo , Sensuse Dana Indra , Wibowo Wahyu Setiawan Setiawan
Published: September 2023

Purpose

This paper aims to develop a framework for critical information infrastructure (CII) protection in smart government, an alternative measure for common cybersecurity frameworks such as NIST Cybersecurity Framework and ISO 27001. Smart government is defined as the government administration sector of CII due to its similarity as a core of smart technology.

Design/methodology/approach

To ensure the validity of the data, the research methodology used in this paper follows the predicting malfunctions in socio-technical systems (PreMiSTS) approach, a variation of the socio-technical system (STS) approach specifically designed to predict potential issues in the STS. In this study, PreMiSTS was enriched with observation and systematic literature review as its main data collection method, thematic analysis and validation by experts using fuzzy Delphi method (FDM).

Findings

The proposed CII protection framework comprises several dimensions: objectives, interdependency, functions, risk management, resources and governance. For all those dimensions, there are 20 elements and 41 variables.

Practical implications

This framework can be an alternative guideline for CII protection in smart government, particularly in government administration services.

Originality/value

The author uses PreMiSTS, a socio-technical approach combined with thematic analysis and FDM, to design a security framework for CII protection. This combination was designed as a mixed-method approach to improve the likelihood of success in an IT project.