bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of supraglottic airway devices for caesarean section under general anaesthesia. A scoping literature review with a proposed algorithm for the appropriate use of supraglottic airway devices for caesarean sections
Authors: Sanganee Urvi , Jansen Karen , Lucas Nuala , Van de Velde Marc
Published: June 2024

This review aims to assess the published evidence on airway management with a supraglottic airway device (SGA) for general anaesthesia in patients requiring a caesarean section. Physiological changes during pregnancy can make airway management in parturients challenging. At the same time, pregnant patients are at risk of pulmonary aspiration due to hormonal and mechanical alterations. The standard airway management for parturients undergoing caesarean section is rapid sequence induction followed by tracheal intubation. Evidence exists that using second-generation SGA devices is well tolerated and effective in selected patients. In this review, we provide an overview of the existing evidence and provide an algorithm to make an evidence-based clinical decision on the use of SGA devices. An online literature search was performed in Medline, Embase, PubMed, Emcare, Cochrane Library and CINAHL. The search terms used were ‘supraglottic airway’, ‘supraglottic airway device’, ‘supraglottic airway management’, ‘supraglottic tube’, ‘i-gel’, laryngeal mask’, ‘laryngeal mask airway’, ‘LMA’, ‘SGA’, ‘Proseal’, ‘Supreme’, ‘obstetric surgery’, ‘obstetric operation’, ‘general anaesthesia’, ‘caesarean’ or ‘caesarean section’, ‘abdominal delivery’. Full-text articles in English, Dutch and French were included. Case reports and studies in which the surgery was not a caesarean section were excluded. The initial search yielded 815 results. Following screening, deduplication and removal of publications that were unrelated to the topic or did not fit the inclusion criteria, 13 manuscripts were included in our analysis. A total of 7722 patients were described in the articles included. In the majority of manuscripts, second-generation SGA devices were used. There were seven cases of failed insertion and a need for conversion to tracheal intubation; first-generation SGA devices were used in these cases. There were no cases of pulmonary aspiration, and only one case of gastric regurgitation was described. Growing evidence suggests that the use of second-generation SGA devices might be well tolerated as the primary method for securing the airway for caesarean sections requiring general anaesthesia, in selected patients with a low risk for aspiration and difficult intubation.
Oral health in Behçet’s disease and its association with disease severity: a case-control study
Authors: Khalayli Naram , Haidar Ghina , Ataya Jawdat , Al Darwish Lama , Rabah Nour , Rabah Karam , Ataya Jamal , Kudsi Maysoun
Published: June 2024

Background:

Behçet’s disease is a chronic autoimmune disorder that affects various organs, including oral aphthae, genital ulceration, cutaneous manifestation, ocular involvement, and positive pathergy test according to the International Study Group for Behçet’s Disease criteria. This study aimed to investigate the oral health condition of patients with Behçet’s disease and to assess how it correlates with the patient’s gender, clinical symptoms, and severity of the disease.

Methods:

A total of 92 participants, including 42 patients with Behçet’s disease and 50 healthy controls, were enrolled in this case-control study. The periodontal indices were measured and compared between the two groups. Logistic regression analysis was used to identify potential risk factors for disease severity. The P value must be (P<0.05) to be considered as significant.

Results:

This study assessed the periodontal health of patients with Behçet’s disease and found that they had significantly higher plaque, gingival, bleeding, and probing depth scores compared to healthy controls (P<0.05). Logistic regression analysis revealed that plaque accumulation was a significant risk factor for higher severity scores in Behçet’s disease. Gender-specific approaches may be necessary in the management and treatment of periodontal disease in Behçet’s disease patients.

Conclusions:

The findings of this study suggest that patients with Behçet’s disease are at increased risk for periodontal disease and its associated symptoms. Specifically, plaque accumulation is a significant risk factor for more severe periodontal health issues in these patients. Therefore, it is important for clinicians to be aware of this increased risk and to develop tailored treatment plans that address both the underlying Behçet’s disease and the associated periodontal disease.
Spatial proteomic landscape of primary and relapsed hepatocellular carcinoma reveals immune escape characteristics in early relapse
Authors: Yang Meilin , Song Xiaoyi , Zhang Fan , Li Mingan , Chang Wuguang , Wang Zheyan , Li Man , Shan Hong , Li Dan
Published: June 2024

Background and Aims:

Surgical resection serves as the principal curative strategy for HCC, yet the incidence of postoperative recurrence remains alarmingly high. However, the spatial molecular structural alterations contributing to postoperative recurrence in HCC are still poorly understood.

Approach and Results:

We employed imaging mass cytometry to profile the in situ expression of 33 proteins within 358,729 single cells of 92 clinically annotated surgical specimens from 46 patients who were treated with surgical resections for primary and relapsed tumors. We revealed the recurrence progression of HCC was governed by the dynamic spatial distribution and functional interplay of diverse cell types across adjacent normal, tumor margin, and intratumor regions. Our exhaustive analyses revealed an aggressive, immunosuppression-related spatial ecosystem in relapsed HCC. Additionally, we illustrated the prominent implications of the tumor microenvironment of tumor margins in association with relapse HCC. Moreover, we identified a novel subpopulation of dendritic cells (PDL1+CD103+ DCs) enriched in the peritumoral area that correlated with early postoperative recurrence, which was further validated in an external cohort. Through the analysis of single-cell RNA sequencing data, we found the interaction of PDL1+CD103+ DCs with regulatory T cells and exhausted T cells enhanced immunosuppression and immune escape through multiple ligand-receptor pathways.

Conclusions:

We comprehensively depicted the spatial landscape of single-cell dynamics and multicellular architecture within primary and relapsed HCC. Our findings highlight spatial organization as a prominent determinant of HCC recurrence and provide valuable insight into the immune evasion mechanisms driving recurrence.
Assessment of spinal alignment in standing position using Biplanar X-ray images and three-dimensional vertebral models
Authors: Kobayashi Koichi , Sakamoto Makoto , Sasagawa Keisuke , Nakai Masaaki , Okamoto Masashi , Hasegawa Kazuhiro , Narita Kengo
Published: June 2024

We developed two methods for three-dimensional (3D) evaluation of spinal alignment in standing position by image matching between biplanar x-ray images and 3D vertebral models. One used a Slot-Scanning 3D x-ray Imager (sterEOS) to obtain biplanar x-ray images, and the other used a conventional x-ray system and a rotating table. The 3D vertebral model was constructed from the CT scan data. The spatial position of the vertebral model was determined by minimizing the contour difference between the projected image of the model and the biplanar x-ray images. Verification experiments were conducted using a torso phantom. The relative positions of the upper vertebrae to the lowest vertebrae of the cervical, thoracic, and lumbar vertebrae were evaluated. The mean, standard deviation, and mean square error of the relative position were less than 1° and 1 mm in all cases for sterEOS. The maximum mean squared errors of the conventional x-ray system and the rotating table were 0.7° and 0.4 mm for the cervical spine, 1.0° and 1.2 mm for the thoracic spine, and 1.1° and 1.2 mm for the lumbar spine. Therefore, both methods could be useful for evaluating the spinal alignment in standing position.
Experience of Patients With Heroin Addiction Receiving Methadone Maintenance Treatment in Community Settings in Taiwan
Authors: SHIH Meng-Hsiu , HSU Wen-Yu , SIAO Chun-Ling , LEE Li-Hung , CHEN Shu-Ling , TSAY Shiow-Luan , YANG Cheng-I
Published: June 2024

Background

The World Health Organization has identified methadone maintenance therapy (MMT) as the most effective treatment for reducing patient dependence on heroin. In Taiwan, MMT has been used as a heroin harm reduction strategy since 2006. Although the effectiveness of MMT in reducing heroin addiction has been examined quantitatively in prison samples, little attention has been paid to the experiences and perspectives of patients with heroin addiction receiving MMT. This study was designed to address this gap in scientific knowledge.

Purpose

The aim of this study was to investigate the experiences of individuals struggling with heroin addiction who are receiving MMT in the community.

Methods

A qualitative descriptive research approach and semistructured interviews were used in this study. We interviewed 14 participants who had received MMT in a medical center in central Taiwan. All of the interview data were recorded, transcribed, and analyzed using qualitative content analysis.

Results

Four themes emerged: (a) a chance to change one's life, (b) the helpfulness of MMT, (c) a sense of being restricted and controlled, and (d) need for support.

Conclusions/Implications for Practice

This article fills a gap in current scholarly understanding of patient experiences and their perspectives on the helpfulness of MMT. Understanding patient experiences and perspectives is critical to informing and developing concrete strategies for clinical practice and MMT policy. Clinical professionals should assess patient needs and concerns to determine whether they are met by current treatment programs. Policymakers should design more flexible policies to facilitate easier access by patients to methadone to reduce the risk of relapse.
Current opinion: functional dyspepsia
Authors: Olson Caroline G. , Travers Paul , Lacy Brian E.
Published: June 2024

Purpose of review

Functional dyspepsia is a common gastrointestinal disease that is under-recognized and under-diagnosed. It is a complex disorder of gut–brain interaction with no FDA-approved treatment options. The purpose of this review is to highlight updates in the proposed pathophysiology and present new data regarding potential therapies for functional dyspepsia.

Recent findings

Alterations in the intestinal microbiome and integrity of the intestinal membrane may play a crucial role in the pathogenesis of functional dyspepsia. The low FODMAP diet, in addition to modulating the microbiome with antibiotics and probiotics, are targets for large future studies. Novel methods of delivery of gut–brain therapies have shown promising results, especially virtual reality.

The pathophysiology and management of functional dyspepsia is complex and there is still much unknown; however, continued research is identifying new targets for treatment. New and more targeted treatment options provide clinicians a variety of tools to offer patients with functional dyspepsia.
Use of piezoelectric instrumentation in craniofacial surgery
Authors: Bessen Sarah , Gadkaree Shekhar K. , Derakhshan Adeeb
Published: June 2024

Purpose of review

The use of piezoelectric instrumentation is increasingly recognized as an alternative to traditional bone-cutting techniques across a wide array of surgeries. Here, we provide an overview of the technique, including device principles, benefits, and drawbacks. We also review its use in craniofacial surgery.

Recent findings

Piezoelectric surgery is a minimally invasive bone-cutting system with lower risk of damage to surrounding soft tissue structures. Indications for its use are rapidly expanding across multiple fields, including craniofacial surgery. To date, piezosurgical techniques have been most widely adopted and studied in the contexts of rhinoplasty, orthognathic surgery, and cranioplasty in craniosynostosis. Piezosurgery can facilitate more precise and consistent osteotomies while decreasing morbidities associated with traditional osteotomy techniques. Primary limitations include cost and concerns regarding increased operative times secondary to operator learning curves and decreased cutting efficiency.

Piezoelectric surgery represents an alternative to traditional bone-cutting modalities to improve precision, consistency, and safety of osteotomies. Further research is needed to better understand the efficacy of the technique as well as potential for additional applications.
Walking the path to fitness
Authors: Hammond Lori , Moseley Kelly
Published: June 2024

Encouraging older adults to exercise is crucial, considering the increasing aging population in the US. Tailored exercise routines such as weight lifting, biking, yoga, or walking improve the health and well-being of patients, reducing illness and chronic conditions.
Left atrial appendage closure
Authors: O'Leary Geraldine M.
Published: June 2024

By implanting a closure device into the left atrial appendage, this procedure offers an alternative to oral anticoagulants, which is crucial for patients with contraindications to standard therapy.
Support over comfort
Authors: Hermann Maureen , Mixson Emily , Kun Emilja , Daehn Nathan
Published: June 2024

Taking the time to inspire and generate confidence in Gen Z students is necessary, especially in nursing courses that are rigorous and demanding.
Comprehensive Analysis of Bacterial Diversity in the Salt Walls of Khewra Salt Mine Using 16S rRNA Gene Sequencing
Authors: Noor Syeda Wardah , Arshad Sara , Abdullah Syed Muhammad , Kayani Bushra Khudadad , Fazal Sahar
Published: June 2024

The Khewra Salt Mine, also known as the source of Himalayan Pink Salt, is the second-largest salt mine in the world and a significant site for salt export. The mine's salt exhibits both amorphous and crystalline textures, with colors ranging from white to deep red, contributing to its distinctive pink hue. While previous research has extensively explored the mine's soil, plants, and brine samples, little attention has been given to the salt walls, which are a major tourist attraction. This study aimed to investigate the bacterial diversity within the salt walls from four distinct locations, including an under-construction area sampled for the first time.
From these four collection points, seven samples were gathered, yielding 19 isolates cultured on 2% NaCl nutrient agar. Bacterial isolates from the under-construction area (US1-1, US1-2, US2-1, and US2-2) and the museum walls (MS1-1 and MS1-2) underwent further biochemical, antibiotic sensitivity, and salt requirement testing, followed by 16S rRNA sequencing. Biochemical assays identified these isolates as gram positive, catalase and oxidase positive rods. All isolates were sensitive to chloramphenicol (30μg/ml). Salt tolerance tests classified them as slightly halophilic, thriving at 2-4% NaCl concentrations.
Molecular characterization revealed two strains from the under-construction area, US1-1 and US2-2, as uncultured Bacillus species and Bacillus thuringiensis, respectively, both with 94% sequence similarity. These sequences have been submitted to NCBI under accession numbers OQ295687 and OQ692139. The phylogenetic results show monophyletic associations between these two strains which could be due to their shared salt location and common ancestors.
The sequences of US1-2, US2-1, and MS1-1 were 100% identical to Bacillus licheniformis, while MS1-2 matched Staphylococcus saprophyticus with 100% similarity. These sequences have been submitted to NCBI as OQ978592, OQ978561, OQ978562, and OQ978593, respectively.
The results of this study point towards significant diversity of bacteria, slightly halophilic, cocci or bacillus shaped. These halophilic bacterial strains, possessing salt-tolerant genes, present the need for further identification of bacterial colonies in the mine and their evolutionary patterns, which could also help uncover the role these microbes play in the ecosystem of the salt mine. Additionally, they show promise for industrial enzyme production.
Factors affecting anal sphincter recruitment during intraoperative pudendal nerve stimulation
Authors: Lagunas Amador C , Chen Po-Ju , Ruiz Luis , Jhand Amolak S , Baishya Nystha , Lempka Scott F , Gupta Priyanka , Bruns Tim M
Published: June 2024

Introduction and Hypothesis

The relationship between pudendal neuromodulation and patient factors is not well understood. This study aimed to identify and quantify physiological, demographic, and stimulation factors that significantly affect external anal sphincter (EAS) recruitment and outcomes in participants receiving pudendal neuromodulation for treatment of lower urinary tract symptoms and pelvic pain.

Methods

Participants (N=16) provided demographic and diagnostic information upon entry to this observational study. EAS activation at different stimulation amplitudes and pulse widths was recorded during lead implantation. Magnetic resonance imaging and computed tomography were used to determine the distance of the electrodes on the implanted lead from the nerve. Linear mixed modeling was used to quantify the impact of each variable on EAS recruitment.

Results

Participant sex, age, and body-mass index did not significantly affect EAS recruitment with pudendal nerve stimulation. Participant diagnoses had significant relationships to EAS recruitment, likely due to unbalanced group sizes. A pulse width of 210 µs required less current than 60 µs (p = 0.005) and less charge than 450 µs (p = 0.02) to activate the EAS at threshold. Increased electrode-to-nerve distance decreased the magnitude of the EAS response (p = 0.0011), increased the EAS activation threshold (p < 0.001), and was related to reduced bladder symptom improvements.

Conclusions

Of the three tested pulse widths, 210 µs requires the least charge and is a good choice for stimulation. The distance between the electrode and pudendal nerve has an important role in nerve recruitment and minimizing this distance should be a priority during lead implantation.

Brief Summary

This study identifies key factors in external anal sphincter recruitment during pudendal neuromodulation that should be considered during lead implantation.
Multimodal Precision Neuroimaging of the Individual Human Brain at Ultra-high fields
Authors: Cabalo Donna Gift , Leppert Ilana Ruth , Thevakumaran Risa , Dekraker Jordan , Hwang Youngeun , Royer Jessica , Kebets Valeria , Tavakol Shahin , Wang Yezhou , Zhou Yigu , Benkarim Mohammed Oualid , Eichert Nicole , Paquola Casey , Tardif Christine Lucas , Rudko David , Smallwood Jonathan , Cruces Raul Rodriguez , Bernhardt Boris
Published: June 2024

Multimodal neuroimaging allows for non-invasive examination of human brain structure and function across multiple scales. Precision neuroimaging builds upon this foundation, enabling the mapping of brain structure, function, and connectivity patterns with high fidelity in single individuals. Ultra-high field (UHF) neuroimaging, operating at magnetic field strengths of 7 Tesla or higher, increases signal-to-noise ratio and offers even higher spatial resolution. Here, we provide a multimodal Precision Neuroimaging and Connectomics (PNI) dataset, utilizing UHF 7T magnetic resonance imaging (MRI). Ten healthy individuals underwent a comprehensive MRI protocol, including T1 relaxometry, magnetization transfer imaging, T2*-weighted imaging, diffusion MRI, and multi-state functional MRI paradigms, aggregated across three imaging sessions. Alongside anonymized raw imaging data, we release cortex-wide connectomes from different modalities across multiple parcellation scales, and supply gradients that compactly characterize spatial patterning of cortical organization. Our precision imaging dataset will advance our understanding of structure-function relationships in the individual human brain and is publicly available via the Open Science Framework (https://osf.io/mhq3f/) and the Canadian Open Neuroscience Platform data portal (https://portal.conp.ca).
Training data composition determines machine learning generalization and biological rule discovery
Authors: Ursu Eugen , Minnegalieva Aygul , Rawat Puneet , Chernigovskaya Maria , Tacutu Robi , Sandve Geir Kjetil , Robert Philippe A. , Greiff Victor
Published: June 2024

Supervised machine learning models rely on training datasets with positive (target class) and negative examples. Therefore, the composition of the training dataset has a direct influence on model performance. Specifically, negative sample selection bias, concerning samples not representing the target class, presents challenges across a range of domains such as text classification and protein-protein interaction prediction. Machine-learning-based immunotherapeutics design is an increasingly important area of research, focusing on designing antibodies or T-cell receptors (TCRs) that can bind to their target molecules with high specificity and affinity. Given the biomedical importance of immunotherapeutics, there is a need to address the unresolved question of how negative training set composition impacts model generalization and biological rule discovery to enable rational and safe drug design. We set out to study this question in the context of the antibody-antigen binding prediction problem by varying the negative class, encompassing a binding affinity gradient. We based our investigation on large synthetic datasets that provide ground truth structure-based antibody-antigen binding data, allowing access to residue-wise binding energy on the binding interface. We found that both out-of-distribution generalization and binding rule discovery depended on the type of negative dataset used. Importantly, we discovered that a model’s capacity to learn the binding rules of the positive dataset is not a trivial correlate of its classification accuracy. We confirmed our findings with real-world relevant experimental data. Our work highlights the importance of considering training dataset composition for achieving optimal out-of-distribution performance and rule learning in machine-learning-based research.

Significance Statement

The effectiveness of supervised machine learning models hinges on the composition of their training datasets, particularly the inclusion of negative examples. This bias in negative sample selection can greatly impact model performance. As the development of immunotherapeutic agents using machine learning is becoming increasingly crucial in biomedicine, understanding the impact of negative training set composition is imperative. Our study, focused on the antibody-antigen binding prediction problem, reveals that the choice of negative dataset significantly affects both out-of-distribution generalization and binding rule discovery across synthetic and experimental data. These findings underscore the necessity of carefully considering training dataset composition in machine-learning-driven biomedical research for optimal performance, robustness and meaningful rule acquisition.
Mutations in the albinism geneoca2alter vision-dependent prey capture behavior in the Mexican tetra
Authors: Choy Stefan , Thakur Sunishka , Polyakov Ellen , Abdelaziz Jennah , Lloyd Evan , Enriquez Maya , Jayan Nikita , Fily Yaouen , McGaugh Suzanne , Keene Alex C , Kowalko Johanna E
Published: June 2024

Understanding the phenotypic consequences of naturally occurring genetic changes, as well as their impact on fitness, is fundamental to understanding how organisms adapt to an environment. This is critical when genetic variants have pleiotropic effects, as determining how each phenotype impacted by a gene contributes to fitness is essential to understand how and why traits have evolved. A striking example of a pleiotropic gene contributing to trait evolution is theoca2gene, coding mutations in which underlie albinism and reductions of sleep in the blind Mexican cavefish,Astyanax mexicanus. Here, we characterize the effects of mutations in theoca2gene on larval prey capture. We find that when conspecific surface fish with engineered mutations in theoca2allele are hunting, they use cave-like, wide angle strikes to capture prey. However, unlike cavefish or surface fish in the dark, which rely on lateral line mediated hunting,oca2mutant surface fish use vision when striking at prey from wide angles. Finally, we find that whileoca2mutant surface fish do not outcompete pigmented surface siblings in the dark, pigmented fish outcompete albino fish in the light. This raises the possibility that albinism is detrimental to larval feeding in a surface-like lighted environment, but does not have negative consequences for fish in cave-like, dark environments. Together, these results demonstrate thatoca2plays a role in larval feeding behavior inA. mexicanus. Further, they expand our understanding of the pleiotropic phenotypic consequences ofoca2in cavefish evolution.
Age differences in brain functional connectivity underlying proactive interference in working memory
Authors: Andersson P , Schrooten M.G.S. , Persson J
Published: June 2024

Aging is typically accompanied by a decline in working memory (WM) capacity, even in the absence of pathology. Proficient WM requires cognitive control processes which can retain goal-relevant information for easy retrieval and resolve interference from irrelevant information. Aging has been associated with a reduced ability to resolve proactive interference (PI) in WM, leading to impaired retrieval of goal-relevant information. It remains unclear how age-related differences in the ability to resolve PI in WM are related to patterns of resting-state functional connectivity (rsFC) in the brain. Here we investigated the association between PI in WM and rsFC cross-sectionally (n = 237) and 5-year longitudinally (n = 134) across the adult life span by employing both seed-based and data-driven approaches. Results revealed that the ability to resolve PI was associated with differential patterns of rsFC in younger/middle-aged adults (25-60y) and older adults (65-80y) in two clusters centered in the vermis and caudate. Specifically, more PI was associated with stronger inferior frontal gyrus – vermis connectivity and weaker inferior frontal gyrus – caudate connectivity in older adults, while younger/middle-aged adults showed associations in the opposite directions with the identified clusters. Whole brain multivariate pattern analyses showed age-differential patterns of rsFC indicative of age-related structural decline and age-related compensation. The current results show that rsFC is associated with the ability to control PI in WM and that these associations are modulated by age.
Multi-task Bayesian Model Combining FDG-PET/CT Imaging and Clinical Data for Interpretable High-Grade Prostate Cancer Prognosis
Authors: Larose Maxence , Archambault Louis , Touma Nawar , Brodeur Raphaël , Desroches Félix , Raymond Nicolas , Bédard-Tremblay Daphnée , LeBlanc Danahé , Rasekh Fatemeh , Hovington Hélène , Neveu Bertrand , Vallières Martin , Pouliot Frédéric
Published: June 2024

We propose a fully automatic multi-task Bayesian model, named Bayesian Sequential Network (BSN), for predicting high-grade (Gleason≥8) prostate cancer (PCa) prognosis using pre-prostatectomy FDG-PET/CT images and clinical data. BSN performs one classification task and five survival tasks: predicting lymph node invasion (LNI), biochemical recurrence-free survival (BCR-FS), metastasis-free survival, definitive androgen deprivation therapy-free survival, castration-resistant PCa-free survival, and PCa-specific survival (PCSS). Experiments are conducted using a dataset of 295 patients. BSN outperforms widely used nomograms on all tasks except PCSS, leveraging multi-task learning and imaging data. BSN also provides automated prostate segmentation, uncertainty quantification, personalized feature-based explanations, and introducesdynamic predictions, a novel approach that relies on short-term outcomes to refine long-term prognosis. Overall, BSN shows great promise in its ability to exploit imaging and clinico-pathological data to predict poor outcome patients that need treatment intensification with loco-regional or systemic adjuvant therapy for high-risk PCa.
Multi-joint approach for assessing lower limb proprioception: reliability and precision in school-aged children
Authors: Jacobs Nina , van den Bogaart Maud , Hallemans Ann , Meyns Pieter
Published: June 2024

Background

The Joint Position Reproduction (JPR) approach has been commonly used to assess joint position sense (JPS), however, no prior study investigated its psychometric properties in children. This study aimed to assess the reliability and precision of a newly developed multi-joint JPR protocol for assessing lower limb JPS in school-aged typically developing (TD) children.

Methods

Ankle, knee and hip JPS was assessed in TD children (aged 5–12 years), on two different days, by a single rater using a standardized JPR protocol (re-identification of a passively placed target position of the ipsilateral joint). The mean and best error(JRE,°) between target and reproduction angle were calculated from three-dimensional(3D) kinematics for each tested joint on both sides for three trials. Furthermore, total, joint- and limb-JRE scores were provided for clinical use. For JPR-reliability, the Intraclass Correlation Coefficient(ICC,2.1) was reported. For JPR-precision, the standard error of measurement (SEM) was calculated.

Results

270 JPR trials were assessed in 15 TD children (8.6±1.2 years,8boys). The mean and best JRE, summarized for all joints for test and retest, was 3.7° and 2.5°, respectively. The ICC were poor to fair(0.01-0.44) for mean JRE, but fair to very good(0.46-0.77) for best JRE. The SEM ranged from 0.8°–1.8°, depending on the joint and side being tested.

Conclusion

Evaluating ankle, knee and hip JPS in children, using passive JPR, is more reliable and precise when using the best JRE. This study highlights the need for a multi-joint JPR approach in research and clinics, and provides joint- and limb-specific SEM values.
An artificial-intelligence interpretable tool to predict risk of deep vein thrombosis after endovenous thermal ablation
Authors: Tabari Azadeh , Ma Yu , Alfonso Jesus , Gebran Anthony , Kaafarani Haytham , Bertsimas Dimitris , Daye Dania
Published: June 2024

Abstract

Introduction

Endovenous thermal ablation (EVTA) stands as one of the primary treatments for superficial venous insufficiency. Concern exists about the potential for thromboembolic complications following this procedure. Although rare, those complications can be severe, necessitating early identification of patients prone to increased thrombotic risks. This study aims to leverage AI-based algorithms to forecast patients’ likelihood of developing deep vein thrombosis (DVT) within 30 days following EVTA.

Materials and Methods

From 2007 to 2017, all patients who underwent EVTA were identified using the American College of Surgeons National Surgical Quality Improvement Program database. We developed and validated 4 machine learning models using demographics, comorbidities, and laboratory values to predict the risk of postoperative deep vein thrombosis: Classification and Regression Trees (CART), Optimal Classification Trees (OCT), Random Forests, and Extreme Gradient Boosting (XGBoost). The models were trained using all the available variables. SHAP analysis was adopted to interpret model outcomes and offer medical insights into feature importance and interactions.

Results

A total of 21,549 patients were included (mean age of 54 ± SD years, 67% female). In this cohort, 1.59% developed DVT. The XGBoost model had good discriminative power for predicting DVT risk with AUC of 0.711 in the hold-out test set for all-variable model. Stratification of the test set by age, BMI, preoperative white blood cell and platelet count shows that the model performs equally well across these groups.

Conclusion

We developed and validated an interpretable model that enables physicians to predict which patients with superficial venous insufficiency has higher risk of developing deep vein thrombosis within 30 days following endovenous thermal ablation.
Multiple Physiological and Behavioural Parameters Identification for Dietary Monitoring Using Wearable Sensors: A Study Protocol
Authors: Shi Mayue , Zhou Jiaying , Cai Mingzhu
Published: June 2024

Introduction

Traditional dietary intake assessment is labour- and time-consuming and prone to inaccuracies and biases. Emerging wearable sensing technology may offer a promising solution. This protocol paper describes a study investigating the physiological responses to energy intake utilising a customised wearable multi-sensor band, which is specifically designed to monitor multiple physiological and behavioural responses related to eating and digestion events for dietary monitoring.

Methods and Analysis

This study will recruit 10 healthy volunteers from databases and public advertisements, with informed consent required prior to participation. Participants will attend two main study visits at a clinical research facility, consuming pre-defined high- and low-calorie meals in a randomised order. Wearable sensors will be worn throughout the eating episodes to track hand-to-mouth movements and physiological changes, including skin temperature (Tsk), heart rate (HR), and oxygen saturation (SpO2). These sensor readings will be validated against a traditional bedside monitor which additionally measures blood pressure. Blood samples will be collected via intravenous cannula to measure blood glucose, insulin, and hormone levels. Relationship between eating episodes (e.g., occurrence, duration, use of cutlery, high- vs. low-calorie) with hand movement patterns, as well as physiological and blood biochemical responses, will be analysed.

Ethics and Dissemination

Ethical approval has been granted by London – Westminster Research Ethics Committee. REC reference: 23/PR/1379. Written informed consent will be obtained from all participants. Findings will be disseminated through peer-reviewed journals, conferences, and seminar presentations. Protocol V.5. Protocol date: 16 January 2024.

Trial Registration Number

NCT06398340.

Strengths and Limitations of This Study

This study is the first trial to develop an objective and reproducible wearable dietary monitoring tool by tracking physiological and motor changes. The novelty of this tool is the ability to estimate food intake without capturing food images which raises fewer privacy concerns compared to the existing technologies in this field.

The comprehensive monitoring of various physiological and behavioural parameters provides a thorough evaluation of the relationship between eating behaviour and physiological changes, with validation through bedside monitors.

The exploratory outcomes of the study offer the opportunity to identify physiological markers that can be tracked by a wearable device to predict postprandial blood glucose and hormone levels that have implications for glycaemic control and appetite regulation.

This study recruits healthy subjects, and investigations should be expanded to include disease groups such as obese individuals who may have different cardiac outputs.

The study will be conducted under a controlled environment and requires further investigations in real-life settings.
A systematic review of the effect of renal replacement therapy on the pharmacokinetics of co-amoxiclav
Authors: Al-Mahdi Sarraa , Patel Jignna , Sweatman James , Oakley Robert , Shah Reya V. , Standing Joseph F. , Lonsdale Dagan
Published: June 2024

1.

Background & Aim

Co-amoxiclav is a commonly used antibiotic. Although, the dose administered during renal replacement therapy may be subtherapeutic. This study aims to describe the current literature on the pharmacokinetics and pharmacodynamics of co-amoxiclav in patientss undergoing renal replacement therapy.

Method

We carried out a systematic review of the available literature in MEDLINE, Embase, Pubmed, and Google Scholar from inception to Oct 2023. Studies were included if they reported pharmacokinetic data on adults given amoxicillin or clavulanic acid during renal replacement therapy.

Results

Seven studies were identified which were published between 1984 to 2021. Variability was observed in the participant characteristics within the studies, the renal replacement therapy settings, the drug exposure, drug assay methods, and the analysis of the pharmacokinetic parameters.

Conclusion

Further pharmacokinetic-pharmacodynamic studies are needed on co-amoxiclav during renal replacement therapy.
Determinants of quality Antenatal Care utilization in Kenya: insights from the 2022 Kenya Demographic and Health Survey
Authors: Asiimwe John Baptist , Namulema Angella , Sserwanja Quraish , Kawuki Joseph , Amperiize Mathius , Amwiine Earnest , Nuwabaine Lilian
Published: June 2024

Introduction

One of the most important strategies to lower mother and newborn fatalities worldwide is providing quality Antenatal care (ANC). The utilization of quality ANC by women of reproductive age and associated factors remains unclear in many developing countries. Therefore, the purpose of this study was to determine the factors associated with the utilization of quality ANC in Kenya.

Methods

We analyzed Secondary data from the Kenya Demographic Health Survey (KDHS) 2022, which included 11,863 women. Participants were selected using a two-stage stratified sampling design. Using SPSS, version 20, univariate and multivariable logistic regression was used to analyze the data.

Results

Of the 11,863 women, 61.2% (95% CI: 59.7-62.6) received quality ANC. Older mothers (aged 20–34) had a 1.82 (95%CI: 1.15-2.87) times higher likelihood of receiving quality ANC when compared with younger mothers (15–19 years old). Participating mothers who had attended 4 or more ANC visits were 1.42 (95%CI: 1.14-1.79) times more likely to receive quality ANC than those who attended 3 or fewer visits. Comparing participants with and without media access, those with media access were 1.47 (95%CI: 1.06-2.03) times more likely to receive quality ANC. Furthermore, the likelihood of receiving quality ANC was 1.93 (95%CI: 1.21-3.08) and 1.44 (95%CI: 1.01-2.06) times higher for participants in the richest and richer quintiles, respectively, than for those in the poorest quintile. On the contrary, the odds of receiving quality ANC were 0.25 (95%CI: 0.15-0.31) to 0.64 (95%CI: 0.44-0.92) times lower for participating mothers from all other Kenyan regions than for those from the coastal region. Participants whose husbands or partners made decisions for them to seek healthcare, compared with those who made decisions independently were 0.74 (95%CI: 0.58-0.95) times less likely to receive quality antenatal care.

Conclusion

The study revealed that about 60% of mothers received quality ANC. Several factors associated with quality ANC were identified: age, region, maternal education, health-seeking decision-making, access to media (TV), time to the health facility, ANC visits, and ANC providers (doctor and nurse/midwife/clinical officer). Maternal health improvement programs should prioritize promoting access to education for girls. Additionally, interventions should focus on promoting shared decision-making and autonomy in healthcare-seeking behaviors among pregnant women and their partners, increasing access to care provided by skilled health workers, and addressing regional disparities in healthcare delivery.
Impact of Atrial Fibrillation with Rapid Ventricular Response in Acute Decompensated Heart Failure
Authors: Halhal Basheer , Bar Omer , Mohammad Suliman , Aronson Doron
Published: June 2024

Background

Rapid atrial fibrillation (AF) is considered to be a trigger for heart failure (HF) decompensation. Few data are available on AF (particularly with a rapid ventricular response) as a trigger for HF decompensation and its effect on clinical outcomes.

Methods

We studied 11,446 patients with acute HF. Rapid AF at admission was defined as ventricular rate ≥110 beats per minute, present at the first ECG performed after hospital arrival. The primary endpoint was in-hospital mortality.

Results

Rapid AF (defined as ventricular rate ≥ 110 beats per minute) at admission was present in 609 patients (5.3%). In-hospital mortality occurred in 83 (13.6%) and 951 (8.8%) patients with and without rapid AF, respectively. In a multivariable Cox regression model, the HR for in-hospital mortality was 1.50 (95% 1.16 to 1.93,P<0.0001). With further adjustment for heart rate, the effect of rapid AF on in-hospital mortality was no longer significant (HR 1.11; 95% CI 0.83–1.50,P=0.48).

From the original cohort, 419 participants with rapid AF in admission were matched on their propensity score to 419 patients with sinus tachycardia. In-hospital mortality occurred in 62 (14.8%) and 61 (14.6%) patients with and without rapid AF, respectively. Compared with the sinus tachycardia group, the HR for the in-hospital mortality in patients with rapid AF was 0.98 (95% CI 0.68 to 1.42;P=0.93).

Conclusion

Rapid AF in ADHF patients is associated with increased mortality risk that is mediated predominantly by rapid ventricular rate. The magnitude of the AF effect is similar to that of sinus tachycardia, indicating that the underlying mechanism for the adverse outcome is not directly related to AF.
Greenness, Blue Spaces and Human Health: An Updated Umbrella Review of Epidemiological Meta-analyses
Authors: Wang XiaoWen , Feng Bowen , Wang Juan
Published: June 2024

We systematically summarizes and evaluates the relationship between green and blue spaces and human health through an umbrella review of epidemiological meta- analyses up to the year 2024. Green spaces have been recognized for their ecological services, including air purification and biodiversity protection, which contribute to the enhancement of life quality and well-being. The review highlights significant advancements in research methodologies and the emergence of new evidence linking green spaces with reduced risks of various health issues, such as type 2 diabetes, obesity, cardiovascular diseases, and improved mental health.

The study follows the PRISMA guidelines and includes meta-analyses from PubMed, Embase, and Cochrane databases, focusing on new evidence and methodological improvements. Inclusion criteria encompass studies on human populations, exposure to green and blue spaces, and health outcomes such as mortality, disease risk, and physiological indicators. Data extraction and quality assessment of evidence and methods are conducted using the GRADE system and AMSTAR 2 tool.

The review finds that green space exposure is associated with reduced all-cause mortality, cardiovascular disease mortality, incidence of diabetes and metabolic syndrome, low birth weight, and mental health improvements. Blue spaces also show positive associations with health outcomes, including reduced obesity rates and improved psychological well-being. However, the evidence regarding green space exposure and specific health outcomes like cancer, asthma, and allergic rhinitis remains heterogeneous and unclear.

The review underscores the need for future research to address methodological limitations, incorporate various green space indicators, and explore the complex mechanisms of human-environment interactions. It concludes by emphasizing the importance of green and blue spaces in urban planning and public health strategies to improve residents’ health and quality of life.
Machine-learning-based pressure-anomaly detection system for SuperKEKB accelerator
Authors: Suetsugu Yusuke
Published: June 2024

This study developed a pressure-anomaly detection system utilizing machine learning for the vacuum system of the SuperKEKB accelerator. The system identified abnormal pressure behaviors among approximately 600 vacuum gauges before triggering the conventional alarm system, facilitating the early implementation of countermeasures and minimizing potential vacuum issues. By comparing the recent pressure behaviors of each vacuum gauge with the previous behaviors, the program detected anomalies using the decision boundary of a feed-forward neural network previously trained on actual abnormal behaviors. Realistic regression models for pressure data curves enabled a reasonable prediction of the causes of anomalies. The program, implemented in python, has been operational since April 2024. Although based on a rudimentary machine-learning concept, the developed anomaly detection system is beneficial for ensuring the stable operation of large-scale machines, including accelerators, and is helpful in designing systems for fault detection.

Published by the American Physical Society
2024
Evidence for double resonant Raman decay from a Ag surface
Authors: Schumann F. O. , Wei Z. , Di Filippo G. , Stefani G.
Published: June 2024

We have investigated the electron pair emission from a Ag(100) surface upon photon absorption which leads to the emission of a 4p photoelectron. The subsequent Auger decay proceeds in a single-step process as shown previously. Key finding was the emergence of a diagonal intensity feature in a two-dimensional kinetic energy distribution of the electron pair whose width reveals a characteristic time of 30 as for the dynamics of the core-hole decay process. We utilize this observation as a tool to identify an unexpected pathway of electron pair emission. Once the photon energy is at the threshold of a double 4p core hole creation we notice a sizeable broadening of the energy sharing distribution. We associate this process to the excitation of two 4p electrons between the Fermi and vacuum level followed by radiation less double electron excitation. This feature is characterized by an energy sum of the pair which disperses linearly with the photon energy. Therefore, we regard it as a double resonant Raman decay.

Published by the American Physical Society
2024
How much strangeness is needed for the axial-vector form factor of the nucleon?
Authors: Hermsen Felix , Isken Tobias , Lutz Matthias F. M. , Thoma David
Published: June 2024

We consider the axial-vector together with its induced pseudoscalar form factor of the nucleon as computed from the chiral Lagrangian with nucleon and isobar degrees of freedom. The form factors are evaluated at the one-loop level, where particular emphasis is put on the use of on-shell masses in the loop expressions. Our results are presented in terms of a novel set of basis functions that generalize the Passarino-Veltman scheme to the case where power-counting violating structures are to be subtracted. The particularly important role of the isobar degrees of freedom is emphasized. We obtain a significant and simultaneous fit to the available lattice QCD results based on flavor SU(2) ensembles for the baryon masses and form factors up to pion masses of about 500 MeV. Our fit includes sizeable finite volume effects that are implied by using in-box values for the hadron masses entering our one-loop expressions. We conclude that from flavor SU(2) ensembles it appears not possible to predict the empirical form factor at the desired precision. Effects from strange quarks are expected to remedy the situation.

Published by the American Physical Society
2024