bluuebunny/crossref_metadata_2025 huggingface dataset:
Reusable and thermostable multiwalled carbon nanotubes membrane for efficient removal of benz[α]anthracene from cigarette smoke
Authors: Vishwakarma Pramod Kumar , Pandey Sumit Kumar , Singh Anshu Kumar , Rathore Sanny , Ram Kirpa , Giri Rajiv , Srivastava Anchal
Published: July 2023

Poly-aromatic hydrocarbons (PAHs), such as benz[α]anthracene (BaA), are often released from cigarette smoke and pose a severe threat to public health. In this quest, several filtration techniques have been proposed for the elimination of these toxins, but the challenges remain the same in terms of low efficiency, high cost and complex manufacturing processes. Herein, we report a simple, cost-effective and reusable multiwalled carbon nanotubes (MWCNTs) membrane-based filter for enhanced removal (∼90%) of BaA from cigarette smoke. In terms of the excellent thermal stability of the MWCNTs membrane, the adsorbed PAHs could be removed simply by a thermolysis process. We believe that the present study may serve as inspiration for the design and development of high-performance fibrous materials for filtering and separation applications.
Retailing After the Industrial Revolution
Authors: Fujioka Rika , Reynolds Jonathan
Published: July 2023

Retailing is a sector seemingly permanently characterized by change. While it was among the earliest economic activities, since the industrial revolution retailers have developed an increasingly critical role as intermediaries and become powerful economic actors in their own right. This chapter shows how, from the nineteenth century onward, the sector experienced significant periods of change through the development of new formats and business models, ranging from department stores to supermarkets and chain stores to convenience stores, and how these traditional forms of store-based retailing are presently being challenged by digitalization and the emergence of new forms of intermediation, such as e-commerce aggregators, commercial platforms and others. The chapter also discusses the—somewhat belated—efforts by a number of retailers to grow through cross-border or global development of their businesses, although not always with success.
EMDR Therapy and Traumatic Grief (Clinical Guidelines)
Authors: Solomon Roger , Meysner Larissa
Published: July 2023

Eye movement desensitization reprocessing (EMDR) can be an effective therapy for treating grief and bereavement-related distress and adapting to the loss. The adaptive information processing (AIP) model informs clinicians how to address and treat the traumatic impact and emotional intensity of the loss, as well as the yearning and separation distress felt after the loss of a close relationship. This chapter examines the evidence for using EMDR with a bereaved population and provides practical guidance for supporting clients mourning the death of a loved one. Utilizing the AIP model, suggestions the selection and sequencing for reprocessing grief-related memories is addressed to promote adaptation to the loss.
On the Union of Emptiness and Bliss
Authors: Donnelly Paul B.
Published: July 2023

Tibetan Buddhism was established and developed in a period when tantric Buddhism had become the new orthodoxy in the great Mahāyāna centers of northern India. The philosophical “schools” of Madhyamaka and Yogācāra were being synthesized with the tantric practice lineages of the siddha traditions associated with the “Highest Yoga Tantras.” Tibetan yogi/scholars were the recipients of this rich collection of Mahāyāna sūtras and śāstras as well as tantras and the teachings of the siddhas. By the fourteenth century, Tibetans began to create doctrinal systems that sought to unify and reconcile Madhyamaka, Yogācāra, and tantric texts as well as the seemingly divergent lines of interpretation according to a scholastic analytical approach and an experiential one. By deploying long-established hermeneutical structures Tibetan scholars created grand syntheses that negotiated and sometimes unified the relationship between Mahāyāna thought and tantric praxis, culminating in the unifying categories of emptiness of other and Great Madhyamaka.
A 3 mm molecular line survey toward the C-star envelope CIT 6
Authors: Yang Kuilu , Zhang Yong , Qiu Jianjie , Ao Yina , Li Xiaohu
Published: July 2023

We present an unbiased molecular line survey toward the carbon-rich circumstellar envelope CIT 6 carried out between 90 and 116 GHz with the Arizona Radio Observatory 12 m telescope. A total of 42 lines assigned to 10 molecular species and four isotopologues are detected. Despite the absence of any newly identified circumstellar molecules, several transitions are freshly reported for this object. This work is a complement to our previous line survey toward CIT 6 in the frequency ranges of 36–49 GHz and 131–268 GHz. Based on the measurements and in combination with previously published data, we perform a rotation-diagram analysis to determine the column densities, excitation temperatures, and fractional abundances of the molecules. The excitation temperature varies along the radius. The abundance pattern of CIT 6 is broadly consistent with that of the prototype C-star IRC +10216 at the specified detection sensitivity, indicating that the molecular richness in IRC +10216 cannot be attributed to an interpretation of unusual chemistry. Nevertheless, subtle distinctions between the two C-stars are found. The higher abundance of carbon-chain molecules and lower 12C$/$13C ratio in CIT 6 compared to IRC +10216 imply that the former is more massive or in a more evolved phase than the latter.
Implementation of carbon pricing in an aging world calls for targeted protection schemes
Authors: Tian Peipei , Feng Kuishuang , Zheng Heran , Hubacek Klaus , Li Jiashuo , Zhong Honglin , Chen Xiangjie , Sun Laixiang
Published: July 2023

Understanding the impact of climate fiscal policies on vulnerable groups is a prerequisite for equitable climate mitigation. However, there has been a lack of attention to the impacts of such policies on the elderly, especially the low-income elderly, in existing climate policy literature. Here, we quantify and compare the distributional impacts of carbon pricing on different age–income groups in the United States, the United Kingdom, and Japan and then on different age groups in other 28 developed countries. We find that the elderly are more vulnerable to carbon pricing than younger groups in the same income group. In particular, the low-income elderly and elderly in less wealthy countries face greater challenges because carbon pricing lead to both higher rate of increase in living cost among low-income elderly and greater income inequality within the same age group. In addition, the low-income elderly would benefit less than the younger groups within the same income group in the commonly proposed carbon revenues recycling schemes. The high vulnerability of the low-income elderly to carbon pricing calls for targeted social protection along with climate mitigation polices toward an aging world.
Ethylene-mediated metabolic priming increases photosynthesis and metabolism to enhance plant growth and stress tolerance
Authors: Brenya Eric , Dutta Esha , Herron Brittani , Walden Lauren H , Roberts Daniel M , Binder Brad M
Published: July 2023

Enhancing crop yields is a major challenge because of an increasing human population, climate change, and reduction in arable land. Here, we demonstrate that long-lasting growth enhancement and increased stress tolerance occur by pretreatment of dark grown Arabidopsis seedlings with ethylene before transitioning into light. Plants treated this way had longer primary roots, more and longer lateral roots, and larger aerial tissue and were more tolerant to high temperature, salt, and recovery from hypoxia stress. We attributed the increase in plant growth and stress tolerance to ethylene-induced photosynthetic-derived sugars because ethylene pretreatment caused a 23% increase in carbon assimilation and increased the levels of glucose (266%), sucrose/trehalose (446%), and starch (87%). Metabolomic and transcriptomic analyses several days posttreatment showed a significant increase in metabolic processes and gene transcripts implicated in cell division, photosynthesis, and carbohydrate metabolism. Because of this large effect on metabolism, we term this “ethylene-mediated metabolic priming.” Reducing photosynthesis with inhibitors or mutants prevented the growth enhancement, but this was partially rescued by exogenous sucrose, implicating sugars in this growth phenomenon. Additionally, ethylene pretreatment increased the levels of CINV1 and CINV2 encoding invertases that hydrolyze sucrose, and cinv1;cinv2 mutants did not respond to ethylene pretreatment with increased growth indicating increased sucrose breakdown is critical for this trait. A model is proposed where ethylene-mediated metabolic priming causes long-term increases in photosynthesis and carbohydrate utilization to increase growth. These responses may be part of the natural development of seedlings as they navigate through the soil to emerge into light.
Patient and Clinician Experience of Using Telehealth During the 'COVID-19 Pandemic in a Public Mental Health Service in Australia
Authors: Robinson Lewis , Parsons Charles , Northwood Korinne , Siskind Dan , McArdle Peter
Published: July 2023

Background

During the coronavirus disease 2019 (Covid-19) pandemic, mental health services adopted telehealth to facilitate ongoing assessment and treatment of patients with severe mental illness. We aimed to assess the telehealth experience of mental health patients and clinicians during the COVID-19 pandemic to inform ongoing clinical telehealth service usage.

Methods

Two participant cohorts were recruited: Patients with severe mental illness at a community public mental health service; and clinicians working within this service. Participants from both cohorts were surveyed regarding their experience of using telehealth.

Results

The survey was completed by 44 patients and 51 clinicians. Most participants reported having access to appropriate telehealth technology. Among patients, 80% reported having participated in any telephone consultations, while 39% reported having taken part in video-telehealth consultations with their psychiatrist. Similarly, 77% of clinicians reported having used video telehealth. Patients reported feeling more confident with video telehealth if they were younger, lived with friends, family or partner, or had access to the internet or a smartphone. Patients reported that telehealth consultations were more convenient and may reduce nonattendance. They reported having good rapport when using video telehealth. The majority of clinicians reported feeling positively about assessing risk and delivering therapy using video telehealth but not with telephone consultations.

Conclusions

Our study suggests that video telehealth is a feasible way of delivering mental health care and appears to be acceptable to both patients and clinicians. However, clinicians raised concerns about their ability to assess risk and provide therapy using telephone consultations. Patients also reported that the convenience of telehealth may improve engagement.
The effects of chromium propionate supplementation to yearling steers in a commercial feedyard on growth performance, carcass characteristics, and health
Authors: Trojan Sara J , Hergenreder Jerilyn E , Canterbury Landon G , Leonhard John T , Clark William D , Beckett Jonathan L , Long John M
Published: July 2023

British crossbred steers (n = 3,072; initial body weight [BW] = 358 ± 37 kg) were used to evaluate the effects of chromium propionate supplementation to yearling steers in a commercial feedyard on growth performance, carcass characteristics, and health. Steers were blocked by initial BW; pens were assigned randomly to one of two dietary treatments within block. Treatments, replicated in 15 pens per treatment with 75 to 135 heads per pen, included 1) control, 0 mg supplemental Cr/kg dietary dry matter (DM) (CTL); 2) 0.50 mg supplemental Cr/kg diet DM (chromium propionate; KemTRACE Chromium 0.4%, Kemin Industries, Des Moines, IA) (chromium propionate, CR). Final BW (638 vs. 641 kg), average daily gain (1.81 vs. 1.82 kg), DM intake (11.02 vs. 11.02 kg), and gain efficiency (0.164 vs. 0.165) did not differ between CTL and CR, respectively (P ≥ 0.75). No differences among treatments for hot carcass weight (407 vs. 408 kg, CTL and CR, respectively), dressing percentage, longissimus muscle area, or yield grade were observed (P ≥ 0.15). Twelfth-rib fat thickness tended (P = 0.10) to be greater for CR vs. CTL (1.55 vs. 1.29 cm, respectively). A trend (P = 0.10) for marbling score to be higher for CR vs. CTL was detected (452 vs. 440, respectively). Distribution of quality grade was similar between CR and CTL; 1.52% of carcasses graded prime (P = 0.68), and 87.2% of carcasses graded choice (P = 0.68). Respiratory morbidity was low (1.93%) and not different among treatments (P = 0.20); likewise, there was no difference in respiratory treatment rates between treatments (P ≥ 0.18). Supplementing Cr to high-performing yearling steers did not alter growth performance, carcass characteristics, or health outcomes.
Role of FBXL5 in redox homeostasis and spindle assembly during oocyte maturation in mice
Authors: Wang Shiwei , Wu Xuan , Wang Han , Song Shuang , Hu Yuling , Guo Yajun , Chang Siyu , Cheng Yuanweilu , Zeng Shenming
Published: July 2023

As an E3 ubiquitin ligase, F‐box and leucine‐rich repeat protein 5 (FBXL5) participates in diverse biologic processes. However, the role of Fbxl5 in mouse oocyte meiotic maturation has not yet been fully elucidated. The present study revealed that mouse oocytes depleted of Fbxl5 were unable to complete meiosis, as Fbxl5 silencing led to oocyte meiotic failure with reduced rates of GVBD and polar body extrusion. In addition, Fbxl5 depletion induced aberrant mitochondrial dynamics as we noted the overproduction of reactive oxygen species (ROS) and the accumulation of phosphorylated γH2AX with Fbxl5 knockdown. We also found that Fbxl5‐KD led to the abnormal accumulation of CITED2 proteins in mouse oocytes. Our in vitro ubiquitination assay showed that FBXL5 interacted with CITED2 and that it mediated the degradation of CITED2 protein through the ubiquitination‐proteasome pathway. Collectively, our data revealed critical functions of FBXL5 in redox hemostasis and spindle assembly during mouse oocyte maturation.
Vulvar Lichen Sclerosus Clinical Severity Scales and Histopathologic Correlation: A Case Series
Authors: Pyle Hunter J. , Evans Jessica C. , Vandergriff Travis W. , Mauskar Melissa M.
Published: July 2023

Several vulvar lichen sclerosus (VLS) clinical severity scales have recently been proposed. In this prospective case series, we characterized histopathology in the context of clinical severity in 6 treatment-naïve postmenopausal patients with VLS. The Vulvar Quality of Life Index (VQLI) and an adaptation of the 2018 International Society for the Study of Vulvovaginal Disease Delphi consensus VLS severity score were administered. Vulvar skin punch biopsies were obtained to measure inflammatory density, constituent inflammatory cells, thickness of the stratum corneum and other epidermal layers, dermal edema, and dermal sclerosis. Clinicopathologic correlations were assessed. Two cases demonstrated sparse inflammatory densities, 1 case demonstrated patchy and nodular inflammatory density, 1 case demonstrated dense lichenoid inflammatory density, and 2 cases demonstrated dense lichenoid and epitheliotropic inflammatory densities. Those patients who reported severe pruritus demonstrated the greatest lymphocytic inflammatory densities on histopathological examination. Both cases of ulceration or erosion were associated with severe VQLI scores. Severe VQLI scores were also associated with trends for higher average thickness of the epidermal layers and of dermal sclerosis. Altogether, histopathologic grading of biopsy sites may reflect clinical severity in patients with VLS.
A female-specific role for trigeminal dynorphin in orofacial pain comorbidity
Authors: Shu Hui , Liu Sufang , Crawford Joshua , Tao Feng
Published: July 2023

Migraine is commonly reported in patients with temporomandibular disorders (TMDs), but little is known about the mechanisms underlying the comorbid condition. Here, we prepared a mouse model to investigate this comorbidity, in which masseter muscle tendon ligation (MMTL) was performed to induce a myogenic TMD, and the pre-existing TMD enabled a subthreshold dose of nitroglycerin (NTG) to produce migraine-like pain in mice. RNA sequencing followed by real-time quantitative polymerase chain reaction confirmation showed that MMTL plus NTG treatment increased prodynorphin (Pdyn) mRNA expression in the spinal trigeminal nucleus caudalis (Sp5C) of female mice but not in male mice. Chemogenetic inhibition of Pdyn-expressing neurons or microinjection of antidynorphin antiserum in the Sp5C alleviated MMTL-induced masseter hypersensitivity and diminished the MMTL-enabled migraine-like pain in female mice but not in male mice. Moreover, chemogenetic activation of Pdyn-expressing neurons or microinjection of dynorphin A(1-17) peptide in the Sp5C enabled a subthreshold dose of NTG to induce migraine-like pain in female mice but not in male mice. Taken together, our results suggest that trigeminal dynorphin has a female-specific role in the modulation of comorbid TMDs and migraine.
Scalp trichilemmal cyst: A case report
Authors: Zhu Zipeng , Yang Xiaoqian , Fu Jinyue , Zhang Shubao , Chong Zonglei
Published: July 2023

Rationale:

Trichilemmal cyst (TC), also known as trichodermal cyst, trichodermal isthmus-degenerative cyst. It is a benign skin lesion originating from the outer hair root sheath, with low incidence and few reports.

Patient concerns:

A 41-year-old patient had found a scalp lump for more than 10 years. A 2.0 cm × 1.0 cm × 1.0 cm lump on the right occipital region was touched more than 10 years ago without special treatment. In the past 2 years, the lump has gradually increased. Physical examination: 4 protruding lumps can be reached in the scalp. One lump in the right occipital region is about 3.0 cm × 2.0 cm × 2.0 cm, with 1 lump immediately below and 2 lumps in the left temporal region. All lumps can be pushed.

Diagnoses:

The lesion is located in dermis, The lesion is solid, and the contents of the cyst were cheese-like white material, and the inner and outer walls of the cyst were smooth and shiny. Pathological results showed that the lesion was TC. The cyst wall is epidermal tissue, the spinous layer and basal layer are intact, there is no granular layer, and the protein in the cyst is dense.

Interventions:

All lumps were completely surgically removed.

Outcomes:

The wound healed well after TC resection. There was no recurrence of TC after 1 year follow-up.

Lessons:

The clinical manifestations of scalp TC are not specific, and the diagnosis needs pathological examination, and the prognosis of total excision is good.
Multi-omics analysis revealing a senescence-relevant lncRNAs signature for the assessment of response to immunotherapy for breast cancer
Authors: Yu Ziyi , Zhu Yanhui , Ji Jie
Published: July 2023

Breast cancer (BRCA) is the most fatal malignancy of women. Immunotherapy has greatly improved the prognosis of advanced BRCA. Cellular senescence contributes to tumorigenesis and suppresses anti-cancer immunity. Identification of senescence-relevant long noncoding RNAs (SRlncRNAs) signature may benefit the predictions of prognosis and response to immunotherapy of BRCA. RNA-seq, mutation, and clinical data of BRCA were acquired from public databases. SRlncRNAs were screened using univariate Cox regression analysis. Consensus clustering classified BRCA patients into 2 clusters, and the differences of overall survival (OS) and immune status between the 2 clusters were analyzed by survival analysis, CIBERSORT, and ESITIMATE. The SRlncRNAs signature was constructed by least absolute shrinkage and selection operator (LASSO) regression analysis, and BRCA patients were divided into 2 risk groups. Enrichment analyses were performed to explore the cancer- and immunotherapy-relevant pathways. Transcriptome analysis was performed to investigate the differences of OS, immune infiltration, and ESITIMATE score of the 2 groups. Genome analysis was applied to investigate the differences of somatic mutation, tumor mutation burden (TMB) and microsatellite instability (MSI) between the 2 risk groups. A nomogram combined with calibration curves and decision curve analysis (DCA) was established for better clinical decision. Tumor Immune Dysfunction and Exclusion (TIDE) score and IMvigor-210 were applied for the predicting of response to immunotherapy. Profiling Relative Inhibition Simultaneously in Mixtures (PRISM) and the Cancer Therapeutics Response Portal resource (CTRP) databases were used for drug susceptibility analysis. Ten prognostic SRlncRNAs were identified and BRCA patients were divided into 2 clusters. Cluster 1 had better OS with anti-tumor immune microenvironment. The high-risk BRCA had poorer OS in the Cancer Genome Atlas (TCGA) training cohort, which was also verified by TCGA validation cohort and GSE20685 validation cohort. Low-risk patients also had anti-tumor immune microenvironment. Genome analysis demonstrated that the high-risk group had significant higher TMB. High-risk BRCA were more susceptive to immunotherapy according to the TIDE score and IMvigor-210. Finally, drug susceptibility analysis showed that 6 compounds were sensitive to high-risk BRCA patients. We developed and verified an original SRlncRNAs signature by multi-omics analysis, which could serve as a prognosis and immunotherapy predictor for BRCA.
Prognostic models for predicting overall and cancer-specific survival of patients with initially diagnosed metastatic cervical squamous cell carcinoma: A study based on SEER database
Authors: Ding Ruilin , Su Zhou , Chen Mi , Chen Longxia
Published: July 2023

Cervical squamous cell carcinoma (CSCC) is the most common histological type of cervical cancer (CC). And mCSCC is the end stage of CSCC. The aim of this study was to develop prognostic nomograms that provide better predictions for overall survival (OS) and cancer-specific survival (CSS) in mCSCC patients. Data from patients with initially diagnosed mCSCC were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The nomograms for OS and CSS were constructed based on Cox regression analysis. The validation of the newly established nomograms was evaluated by concordance index (C-index), calibration curves, and decision curve analyses (DCAs). A total of 2198 patients with mCSCC were included and randomly split into training (n = 1539) and validation (n = 659) cohorts in a 7:3 ratio. Multivariate analyses revealed that the prognostic variables significantly related to the OS and CSS were marital status, T stage, brain metastasis, lung metastasis, tumor size, number of positive lymph nodes, chemotherapy, and radiotherapy. The nomograms were constructed based on these factors. The C-index value of the nomograms for predicting OS and CSS was 0.714 and 0.683, respectively. The calibration curves of the nomograms showed good consistency between nomogram prediction and actual survival for both OS and CSS, and the DCAs showed great clinical usefulness of the nomograms. The mCSCC patients were classified into low- and high-risk groups based on the scores from the nomograms. In the validation cohort, mCSCC patients with low-risk had much higher OS and CSS than those with high-risk. We constructed nomograms for predicting the OS and CSS of patients with initially diagnosed mCSCC. Our models had satisfactory predictive performance and could be useful in survival prediction for mCSCC.
A prospective observational study of optimal acupoint selection on patients with functional gastrointestinal disorders
Authors: Moon Heeyoung , Yoon Da-Eun , Seo Yoonjeong , Lee In-Seon , Chae Younbyoung
Published: July 2023

Introduction:

Functional gastrointestinal disorders (FGIDs), which include irritable bowel syndrome (IBS) and functional dyspepsia (FD), are common gastrointestinal (GI) diseases that have a large financial impact on patients’ quality of life (QoL). Traditional Korean medicine has a particular diagnostic pattern for treating FGIDs. However, FGIDs have not been thoroughly explored because of their complexity. In this proposed study, we will investigate the acupoint selection pattern for FGID patients with various disease patterns, and further determine the best acupoints for treating FGID patients using a machine-learning algorithm.

Methods:

We will collect clinical data from 15 multi-center Korean medical clinics that treat FGID as part of an observational study registry. Patients who meet the criteria will be added to the registry after screening. They will receive a maximum 4-week treatment, and they will respond 3 times to a series of questions. We will investigate how doctors of FGID patients with diverse disease patterns choose the acupoints, and we will use a machine learning technique to identify the best acupoints for treating FGID patients.

Discussion:

This will be the first multi-center observational registry study to assess how traditional Korean medical practitioners diagnose and treat patients in the real world. The findings will shed light on how traditional Korean medicine treats FGIDs and demonstrate the rationale for the diagnostic and acupuncture treatment flow.
Circulating tumor DNA analysis detects micrometastatic disease and predicts recurrence in a patient with colon cancer: A case report
Authors: Luo Jiamin , Zhou Bo , Zhao Liang , Yuan Jing , Zhou Jinming , Shen Lu , Li Fang , Qian Chengyuan
Published: July 2023

Rationale:

Colorectal cancer (CRC) is one of the most prevalent and deadly cancers worldwide, and approximately 50% of patients with early-stage disease develop metastases. A critical limitation for successful management of CRC is early disease detection and identification of progression. Next-generation sequencing-based circulating tumor DNA (ctDNA) profiling has emerged as a promising biomarker for the assessment of minimal or molecular residual disease in CRC.

Patient concerns:

The patient was initially diagnosed with resectable CRC with uncertain small lung nodules.

Diagnoses:

The patient was diagnosed with sigmoid colon adenocarcinoma placed at 15 to 20 cm above the anal verge (ypT4N1R0). Lung nodules were found in the apical part of the upper lobe of the right lung and the dorsal segment of the lower lobe of the left lung.

Interventions:

The patient received systemic therapy and local treatment and plasma ctDNA-MRD detection was performed for monitoring the molecular disease status after surgery.

Outcomes:

The patient achieved a complete response after treatment. However, he presented with disease recurrence in liver lesions. The postoperative ctDNA detection suggested the possibility of micrometastatic pulmonary disease, and that was confirmed by follow-up examination. Serial ctDNA detection revealed disease relapse ahead of radiologic imaging by a lead time of 9 months. This case demonstrated the potential of ctDNA analysis to be a sensitive and specific tool for the detection of micrometastatic disease and prediction of recurrence.
Volar wrist ganglion associated with radial artery atherosclerosis: A case report
Authors: Lee Young-Keun , Kim Jong Hong
Published: July 2023

Rationale:

There have been no reports of volar wrist ganglions being associated with atherosclerosis of the radial artery. Good results were obtained with radial artery reconstruction through ganglion excision and autogenous vein grafting. Hence, we report a previously unreported case, along with a review of the literature.

Patient concerns:

A 58-year-old female presented with the chief complaint of a mass on the volo-radial side of her right wrist. The patient complained of a tingling sensation in the thumb, index, and extensor zones that worsened when pressing the mass.

Diagnoses:

Sonography revealed a well-defined, anechoic cystic lesion adjacent to the radial artery.

Interventions:

Exploration was performed using a zig-zag incision on the mass. The superficial radial nerve (SRN), which innervates the thumb, was distorted by the mass and the nerve dissected from the mass. However, the artery and ganglion cysts were not separated completely in a part where hardening of the artery wall progressed as a result of degenerative changes, showing multiple small, hard, and yellowish masses. We resected the radial artery (approximately 1.5 cm) along with the ganglion and sent it for histological examination. The radial artery was then reconstructed using an autogenous venous graft.

Outcomes:

At the 34-month follow-up, the patient was asymptomatic. Radial artery patency was normal without recurrence of the ganglion cyst.

Lessons:

In patients with risk factors for radial artery atherosclerosis, a more careful diagnosis is required for the surgical treatment of the volar wrist ganglion. In addition, if the ganglion and radial artery are not completely dissected, excision of the radial artery and subsequent reconstruction of the radial artery using an autogenous vein may be a good surgical strategy.
Nonaccidental Pediatric Trauma; Which Traditional Clues Predict Abuse?
Authors: Baab Shad Masters , Lawsing James Fuller , Macalino Cassandra Sarmiento , Springer Jacob Hartry , Cline David Martin
Published: July 2023

Objectives

The objective of this study is to determine which of the child abuse clues quoted in the literature predict nonaccidental trauma (NAT): history incongruent with injuries found on examination or imaging, old injuries present, history of trauma denied by caregivers, multiple fractures present, changing history, fractures of varied duration, metaphyseal fracture, ear bruise, neck bruise, different history (second historian), and metaphyseal fracture.

Methods

This is a 4-year retrospective study of all suspected NAT cases referred to our medical center. In addition to the index visit, medical records were searched for visits before the index visit with patient historical or physical findings that might have suggested NAT but were not investigated. The association of diagnostic clues and the outcome were assessed by chi-square and logistic regression analysis.

Results

For 48 months, there were 109 cases of suspected NAT referred for evaluation (age range, 1 week to 15 years). After formal investigation by an abuse specialist, 79.3% of the cases were considered “likely abuse”. Those historical or physical findings with a univariate association with a final conclusion of likely abuse included history incongruent with injuries, old injuries present, trauma history denied, changed history, and retinal hemorrhage. In multivariate logistic regression, only a history incongruent with injures remained an independent predictor of likely abuse (odds ratio, 8.65; 95% confidence interval, 1.74–43.07; P = 0.0151). After review of prior records, in only 2 of 109 cases (1.8%) was there a prior visit where NAT could have been suspected; however, history was thought to be congruent with the injury at the original visits.

Conclusion

In this 4-year study of NAT, the clinical clue that best predicted likely abuse after expert investigation was a history that was incongruent with the injuries found on emergency department evaluation. The incidence of possible early recognition from a prior emergency department visit in this group was very low, <2% of cases.
Parental Attitudes About Lumbar Puncture in Children With Suspected Central Nervous System Infection
Authors: Sahin Aslıhan , Kara-Aksay Ahu , Demir Gulsah , Ekemen-Keles Yıldız , Ustundag Gulnihan , Berksoy Emel , Karadag-Oncel Eda , Yilmaz Dilek
Published: July 2023

Objectives

This study aimed to evaluate parents' attitudes toward lumbar puncture (LP) for their children with suspected central nervous system infection to determine the reasons for rejection and related factors.

Methods

The survey was provided to parents of children (1 month to 18 years old) for whom LP was recommended because of a concern for central nervous system infection. Sociodemographic characteristics and other related factors of parents who did and did not approve of LP were compared statistically. The reasons for the disapproval of parents who refused LP were revealed.

Results

A total of 100 parents were included in the study. Eighty-two percent of the participating parents were mothers, and the median age of the mothers was 31 years (min: 17 years; max: 70 years). The median age of the fathers was 37 years (min: 22 years; max: 60 years). Among the parents, 34% did not give consent for LP. The most common reason for the participants to refuse LP was fear of paralysis of their children due to the procedure (82.3%). There was a statistical difference between the approval of the LP procedure and the person who informed the parents about the LP procedure and read the informed consent form (P = 0.004 and P = 0.038, respectively).

As a result of the binary logistic regression analysis, it was seen that the rate of acceptance of the LP procedure by the parents informed by the specialist doctors was 7.1-fold (P = 0.02; 95% confidence interval, 1.3–37.6) higher than the parents informed by the resident physicians.

Conclusion

The informed consent process mainly influenced parents' attitudes toward LP. To increase the acceptance rates of LP, we should standardize the informed consent process so that it is not affected by factors such as seniority of the physician.
Optimizing Education During Pediatric Resident Mock Code Sessions
Authors: Zimmerman Elise , Wai Shannon S. , Hollenbach Kathryn A. , Cameron Melissa A.
Published: July 2023

Introduction

Most pediatric residents have limited opportunities to manage cardiac arrest. We used simulation to fill that educational void. Given work hours and other obligations, resident education sessions must be high-yield. We examined the effectiveness of adding varying amounts of formal education to a mock code session on resident knowledge and confidence in managing pediatric cardiac arrest compared with participation alone.

Methods

Convenient groups of 3 to 8 pediatric residents completed a simulation session with the identical scenario: a 3-month-old infant with pulseless ventricular tachycardia and then pulseless electrical activity. All residents completed pretests and posttests, which consisted of open-ended knowledge questions from the American Heart Association Pediatric Advanced Life Support guidelines and confidence Likert scale assessments. Resident groups were assigned to 1 of 3 educational models: experiential-only: participation in the mock, traditional: mock code participation with standardized education after the mock code, or reinforced: standardized education before and after mock code participation.

Results

Ninety-five residents participated. Collectively, residents demonstrated a median 2-point (interquartile range, 1–4) increase in knowledge (test maximum score, 10) after they attended a mock code simulation session (P < 0.0001); however, there were no statistically significant differences noted between educational modalities. All residents also demonstrated a 4-point median increase in confidence (test maximum score, 25) after completing their simulation session (interquartile range, 3–6) (P < 0.001), but no differences were seen by type or amount of accompanying education.

Conclusions

Residents had gains in confidence and knowledge of pediatric cardiac arrest management after participation in the mock code. Formal educational sessions and reinforced formal education sessions accompanying the mock code did not significantly increase knowledge or confidence.
Enhancing Breast Ultrasound Segmentation through Fine-tuning and Optimization Techniques: Sharp Attention UNet
Authors: Khaledyan Donya , Marini Thomas J. , O’Connell Avice , Parker Kevin
Published: July 2023

Segmentation of breast ultrasound images is a crucial and challenging task in computer-aided diagnosis systems. Accurately segmenting masses in benign and malignant cases and identifying regions with no mass is a primary objective in breast ultrasound image segmentation. Deep learning (DL) has emerged as a powerful tool in medical image segmentation, revolutionizing how medical professionals analyze and interpret complex imaging data. The UNet architecture is a highly regarded and widely used DL model in medical image segmentation. Its distinctive architectural design and exceptional performance have made it a popular choice among researchers in the medical image segmentation field. With the increase in data and model complexity, optimization and fine-tuning models play a vital and more challenging role than before. This paper presents a comparative study evaluating the effect of image preprocessing and different optimization techniques and the importance of fine-tuning different UNet segmentation models for breast ultrasound images. Optimization and fine-tuning techniques have been applied to enhance the performance of UNet, Sharp UNet, and Attention UNet. Building upon this progress, we designed a novel approach by combining Sharp UNet and Attention UNet, known as Sharp Attention UNet. Our analysis yielded the following quantitative evaluation metrics for the Sharp Attention UNet: the dice coefficient, specificity, sensitivity, and F1 score obtained values of 0.9283, 0.9936, 0.9426, and 0.9412, respectively. In addition, McNemar’s statistical test was applied to assess significant differences between the approaches. Across a number of measures, our proposed model outperforms the earlier designed models and points towards improved breast lesion segmentation algorithms.
Electrical spiking activity of proteinoids-ZnO colloids
Authors: Mougkogiannis Panagiotis , Kheirabadi Noushin Raeisi , Chiolerio Alessandro , Adamatzky Andrew
Published: July 2023

We are studying the remarkable electrical properties of Proteinoids-ZnO micro-spheres with the aim of exploring their potential for a new form of computing. Our research has revealed that these microspheres exhibit behavior similar to neurons, generating electrical spikes that resemble action potentials. Through our investigations, we have studied the underlying mechanism behind this electrical activity and proposed that the spikes arise from oscillations between the degradation and reorganization of proteinoid molecules on the surface of ZnO. These findings offer valuable insights into the potential use of Proteinoids-ZnO colloids in unconventional computing and the development of novel neuromorphic liquid circuits.
Autoantibodies to nuclear valosin-containing protein-like protein: identification and characterization of systemic sclerosis-related anti-nucleolar antibodies utilizingin vitrohuman proteome
Authors: Matsuda Kazuki M , Kotani Hirohito , Yamaguchi Kei , Ono Chihiro , Okumura Taishi , Ogawa Koji , Miya Ayako , Sato Ayaka , Uchino Rikako , Yumi Murakami , Matsunaka Hiroshi , Kono Masanori , Norimatsu Yuta , Hisamoto Teruyoshi , Kawanabe Ruriko , Kuzumi Ai , Fukasawa Takemichi , Yoshizaki-Ogawa Asako , Okamura Tomohisa , Shoda Hirofumi , Fujio Keishi , Matsushita Takashi , Goshima Naoki , Sato Shinichi , Yoshizaki Ayumi
Published: July 2023

Objectives

To identify and characterize undescribed systemic sclerosis (SSc)-related autoantibodies targeting nucleolar antigens and to assess their clinical significance.

Methods

We conducted proteome-wide autoantibody screening (PWAS) against serum samples from SSc patients with nucleolar patterned anti-nuclear antibodies (NUC-ANAs) of specific antibodies (Abs) unknown, utilizing wet protein arrays fabricated fromin vitrohuman proteome. Controls included SSc patients with already-known SSc-related autoantibodies, patients with other connective tissue diseases, and healthy subjects. The selection of nucleolar antigens was performed by database search in the Human Protein Atlas. The Presence of autoantibodies was certified by immunoblots, indirect immunofluorescence assays, and immunoprecipitations. Clinical assessment was conducted by retrospective review of electric medical records.

Results

PWAS identified autoantibodies targeting nuclear valosin-containing protein-like (NVL), DIM1 rRNA methyltransferase ribosome maturation factor (DIMT1), and telomeric repeat binding factor 1 (TERF1) as candidates. Additional measurements in disease controls revealed that only anti-NVL Abs are exclusively detected in SSc. Detection of anti-NVL Abs was reproduced by conventional assays. Anti-NVL Ab-positive cases were characterized by significantly low prevalence of diffuse skin sclerosis and interstitial lung disease, compared to SSc cases with NUC-ANAs other than anti-NVL Abs, such as anti-U3-RNP and anti-Th/To Abs.

Conclusions

Anti-NVL Ab is an SSc-related autoantibody associated with a unique combination of clinical features, including limited skin sclerosis and lack of lung involvement.
Common- and rare-variant genetic architecture of heart failure across the allele frequency spectrum
Authors: Lee David S.M. , Cardone Kathleen M. , Zhang David Y. , Tsao Noah L. , Abramowitz Sarah , Sharma Pranav , DePaolo John S. , Conery Mitchell , Aragam Krishna G. , Biddinger Kiran , Dilitikas Ozan , Hoffman-Andrews Lily , Judy Renae L. , Khan Atlas , Kulo Iftikhar , Puckelwartz Megan J. , Reza Nosheen , Satterfield Benjamin A. , Singhal Pankhuri , Center Regeneron Genetics , Arany Zoltan P. , Cappola Thomas P. , Carruth Eric , Day Sharlene M. , Do Ron , Haggarty Christopher M. , Joseph Jacob , McNally Elizabeth M. , Nadkarni Girish , Owens Anjali T. , Rader Daniel J. , Ritchie Marylyn D. , Sun Yan V. , Voight Benjamin F. , Levin Michael G. , Damrauer Scott M.
Published: July 2023

Heart failure (HF) is a complex trait, influenced by environmental and genetic factors, which affects over 30 million individuals worldwide. Historically, the genetics of HF have been studied in Mendelian forms of disease, where rare genetic variants have been linked to familial cardiomyopathies. More recently, genome-wide association studies (GWAS) have successfully identified common genetic variants associated with risk of HF. However, the relative importance of genetic variants across the allele-frequency spectrum remains incompletely characterized. Here, we report the results of common- and rare-variant association studies of all-cause heart failure, applying recently developed methods to quantify the heritability of HF attributable to different classes of genetic variation. We combine GWAS data across multiple populations including 207,346 individuals with HF and 2,151,210 without, identifying 176 risk loci at genome-wide significance (P-value < 5×10−8). Signals at newly identified common-variant loci include coding variants in Mendelian cardiomyopathy genes (MYBPC3,BAG3) and in regulators of lipoprotein (LPL) and glucose metabolism (GIPR,GLP1R). These signals are enriched in myocyte and adipocyte cell types and can be clustered into 5 broad modules based on pleiotropic associations with anthropomorphic traits/obesity, blood pressure/renal function, atherosclerosis/lipids, immune activity, and arrhythmias. Gene burden studies across three biobanks (PMBB, UKB, AOU), including 27,208 individuals with HF and 349,126 without, uncover exome-wide significant (P-value < 1.57×10−6) associations for HF and rare predicted loss-of-function (pLoF) variants inTTN,MYBPC3,FLNC, and BAG3.Total burden heritability of rare coding variants (2.2%, 95% CI 0.99-3.5%) is highly concentrated in a small set of Mendelian cardiomyopathy genes, while common variant heritability (4.3%, 95% CI 3.9-4.7%) is more diffusely spread throughout the genome. Finally, we show that common-variant background, in the form of a polygenic risk score (PRS), significantly modifies the risk of HF among carriers of pathogenic truncating variants in the Mendelian cardiomyopathy gene TTN. Together, these findings provide a genetic link between dysregulated metabolism and HF, and suggest a significant polygenic component to HF exists that is not captured by current clinical genetic testing.
Induced-hyperandrogenism in female rats: assessing possible modulation of neurobehavioural and neurotransmitter changes following clomiphene/letrozole intervention
Authors: Onaolapo Olakunle J. , Aworinde Olufemi O. , Olofinnade Anthony T , Onaolapo Adejoke Y.
Published: July 2023

Hyperandrogenism is the excessive production of androgenic hormones resulting in infertility in a number of women. While letrozole and clomiphene citrate have been used to increase chances of achieving pregnancy, their effects on the brain has been scarcely studied. This study examined the effects of clomiphene and letrozole alone or in combination on neurobehavioural and neurochemical changes in female rats exposed to testosterone. Weaned rats were assigned into eight groups of ten each. Animals were grouped as normal control administered vehicle (normal saline) orally at 10 ml/kg or subcutaneously at 2 ml/kg, three groups administered clomiphene (CLOM) at 100 µg/kg, letrozole (LETR) at 5 mg/kg and or a combination of clomiphene and letrozole (CLOM/LETR) orally and saline subcutaneously. There were also four groups Testosterone (Test), Test/CLOM, Test/LETR or Test/CLOM+LETR administered testosterone enantate subcutaneously at 1 mg/100 g. Testosterone or saline was administered from day 1-35, while beginning on day 36, clomiphene, letrozole or saline was administered daily for 10 days. At the end of the dosing period, animals were exposed to different behavioural paradigms. After the behavioural tests, animals were sacrificed, the cerebral cortex was homogenised for the assessment of biochemical assays. The result showed an increase in body weight, food intake, locomotor activity, rearing and self grooming with CLOM, LETR and CLOM/LETR in all treated groups. Decreased spatial working memory and anxiolysis was observed with letrozole and/or clomiphene. Increased oxidative stress, decreased total antioxidant capacity, altered inflammatory cytokines and brain neurotransmitter were observed with letrozole and /or clomiphene. In conclusion, the administration of clomiphene and/or letrozole was associated with significant alterations in brain function, oxidative stress, inflammatory markers and brain neurotransmitter levels.
Host species and geography impact bee-associated RNA virus communities with evidence for isolation-by-distance in viral populations
Authors: Robinson Chris R. P. , Dolezal Adam G. , Newton Irene L. G.
Published: July 2023

1

Virus symbionts are important mediators of ecosystem function, yet we know little of their diversity and ecology in natural populations. The alarming decline of pollinating insects, especially the European honey bee,Apis mellifera, has been driven in part by worldwide transmission of virus pathogens. Previous work has examined the transmission of known honey bee virus pathogens to wild bee populations, but only a handful of studies have investigated the native viromes associated with these bees, limiting epidemiological predictors associated with viral pathogenesis. Further, social variation among different bee species might have important consequences in the acquisition and maintenance of bee-associated virome diversity.

We utilized comparative metatranscriptomics to develop a baseline description of the RNA viromes associated with wild bee pollinators and to document the interaction between hymenopteran insect social behavior and virus community composition. Our sampling includes five wild-caught, native bee species that vary in social behavior as well as managed honey bees. We describe 26 putatively new RNA virus species and contrary to our expectations, find few differences in virus diversity or abundance among socially variable bee species. Each bee species was associated with a specific virus community composition, even among sympatric populations of distinct host species. From 17 samples of a single host species, we recovered a single virus species despite over 600 km of distance between host populations and found strong evidence for isolation-by distance in associated viral populations. Our work adds to the small number of studies examining viral prevalence and community composition in wild bees.