bluuebunny/crossref_metadata_2025 huggingface dataset:
Examination of fully automated mammographic density measures using LIBRA and breast cancer risk in a cohort of 21,000 non-Hispanic white women
Authors: Habel Laurel A. , Alexeeff Stacey E. , Achacoso Ninah , Arasu Vignesh A. , Gastounioti Aimilia , Gerstley Lawrence , Klein Robert J. , Liang Rhea Y. , Lipson Jafi A. , Mankowski Walter , Margolies Laurie R. , Rothstein Joseph H. , Rubin Daniel L. , Shen Li , Sistig Adriana , Song Xiaoyu , Villaseñor Marvella A. , Westley Mark , Whittemore Alice S. , Yaffe Martin J. , Wang Pei , Kontos Despina , Sieh Weiva
Published: August 2023

Background

Breast density is strongly associated with breast cancer risk. Fully automated quantitative density assessment methods have recently been developed that could facilitate large-scale studies, although data on associations with long-term breast cancer risk are limited. We examined LIBRA assessments and breast cancer risk and compared results to prior assessments using Cumulus, an established computer-assisted method requiring manual thresholding.

Methods

We conducted a cohort study among 21,150 non-Hispanic white female participants of the Research Program in Genes, Environment and Health of Kaiser Permanente Northern California who were 40–74 years at enrollment, followed for up to 10 years, and had archived processed screening mammograms acquired on Hologic or General Electric full-field digital mammography (FFDM) machines and prior Cumulus density assessments available for analysis. Dense area (DA), non-dense area (NDA), and percent density (PD) were assessed using LIBRA software. Cox regression was used to estimate hazard ratios (HRs) for breast cancer associated with DA, NDA and PD modeled continuously in standard deviation (SD) increments, adjusting for age, mammogram year, body mass index, parity, first-degree family history of breast cancer, and menopausal hormone use. We also examined differences by machine type and breast view.

Results

The adjusted HRs for breast cancer associated with each SD increment of DA, NDA and PD were 1.36 (95% confidence interval, 1.18–1.57), 0.85 (0.77–0.93) and 1.44 (1.26–1.66) for LIBRA and 1.44 (1.33–1.55), 0.81 (0.74–0.89) and 1.54 (1.34–1.77) for Cumulus, respectively. LIBRA results were generally similar by machine type and breast view, although associations were strongest for Hologic machines and mediolateral oblique views. Results were also similar during the first 2 years, 2–5 years and 5–10 years after the baseline mammogram.

Conclusion

Associations with breast cancer risk were generally similar for LIBRA and Cumulus density measures and were sustained for up to 10 years. These findings support the suitability of fully automated LIBRA assessments on processed FFDM images for large-scale research on breast density and cancer risk.
Acromegaly with initial negative oral glucose tolerance test: a case report
Authors: Tsai Wen-Hsuan , Chien Ming-Nan , Dai Shuen-Han , Chan Yun-Kai
Published: August 2023

Background

Acromegaly can be diagnosed by a growth hormone value ≥ 1 µg/L following an oral glucose tolerance test. However, normal growth hormone suppression following oral glucose tolerance test may not exclude acromegaly.

Case presentation

We present a case of a 55-year-old Chinese man with pituitary macroadenoma incidentally noted after a traffic accident. He reported feet enlargement in the past few years. At the beginning, elevated insulin-like growth factor-1 was noted with growth hormone value < 1 µg/L after oral glucose tolerance test. Fracture-related high insulin-like growth factor-1 was suspected. Insulin-like growth factor-1 decreased gradually but was still above the upper limit of normal . However, he suffered from dizziness 1 year later and insulin-like growth factor-1 increased again. Besides, secondary hypocortisolism developed. The size of the pituitary macroadenoma was stationary. Follow-up oral glucose tolerance test showed a growth hormone value > 1 µg/L. Endoscopic endonasal approach to the remove pituitary macroadenoma was performed subsequently. After the resection of the pituitary macroadenoma, pathology showed positive staining of growth hormone and prolactin. Insulin-like growth factor-1 normalized as well.

Conclusions

Suppressed growth hormone after oral glucose tolerance test cannot exclude acromegaly, and some patients may have only mild or no clinical presentation of acromegaly. Patients with pituitary microadenoma or macroadenoma and elevated insulin-like growth factor-1 should be closely monitored for signs/symptoms of acromegaly and hypopituitarism.
Structural Behavior of Ultra-High Strength Concrete Columns Reinforced with Basalt Bars Under Axial Loading
Authors: El-Sayed Taha A. , Abdallah Kareem S. , Ahmed Hossam E. , El-Afandy Tamer H.
Published: August 2023

The axial compressive behavior of Ultra-High Strength Concrete (UHPC) columns reinforced with basalt bars was investigated in this work. Only a few research projects have used basalt Reinforced Concrete Columns. Under axial stress, 12 columns of 150 × 150 mm in cross section and 1200 mm in height manufactured of M120 grade UHPC, incorporating glass powder lime powder, were tested. The primary characteristics investigated in this study were axial load capacity, axial deformation, failure pattern, ductility, and stiffness. The findings of the experimental tests revealed that the ultimate loads and behavior of UHPCC reinforced with BFRP were superior to concrete columns strengthened with steel reinforcement. When compared to steel RC columns, basalt RC columns carry about 90% of the axial load. Moreover, the BFRP bar tensile strength was 2.5 greater than reinforcing steel yield strength and 1.79 times larger than that of bar. The Ansys software-based analytical analysis assisted in predicting the eventual carrying capacity of UHPC columns. The agreement among the experimental and NLFE ultimate load is around 92.2%, with a standard deviation of 0.005 and a coefficient of variation of 0.00002. The nonlinear BFRP–UHPC columns’ structural performance was adequately predicted by the finite element analysis. In addition, equations are employed to forecast the strength of confined concrete. Equation 4 merely produced improved forecasts, it aids in comparing the outcomes of analytical and experimental tests. Results of this study indicated that the UHPC-columns reinforced with BFRP bars offer potential economic and environmental advantages as compared to traditional RC columns.
Generation of double knockout cattle via CRISPR-Cas9 ribonucleoprotein (RNP) electroporation
Authors: Gim Gyeong-Min , Eom Kyeong-Hyeon , Kwon Dong-Hyeok , Jung Dae-Jin , Kim Dae-Hyun , Yi Jun-Koo , Ha Jae-Jung , Lee Ji-Hyun , Lee Seong-Beom , Son Woo-Jae , Yum Soo-Young , Lee Won-Wu , Jang Goo
Published: August 2023

Background

Genome editing has been considered as powerful tool in agricultural fields. However, genome editing progress in cattle has not been fast as in other mammal species, for some disadvantages including long gestational periods, single pregnancy, and high raising cost. Furthermore, technically demanding methods such as microinjection and somatic cell nuclear transfer (SCNT) are needed for gene editing in cattle. In this point of view, electroporation in embryos has been risen as an alternative.

Results

First, editing efficiency of our electroporation methods were tested for embryos. Presence of mutation on embryo was confirmed by T7E1 assay. With first combination, mutation rates for MSTN and PRNP were 57.6% ± 13.7% and 54.6% ± 13.5%, respectively. In case of MSTN/BLG, mutation rates were 83.9% ± 23.6% for MSTN, 84.5% ± 18.0% for BLG. Afterwards, the double-KO embryos were transferred to surrogates and mutation rate was identified in resultant calves by targeted deep sequencing. Thirteen recipients were transferred for MSTN/PRNP, 4 calves were delivered, and one calf underwent an induction for double KO. Ten surrogates were given double-KO embryos for MSTN/BLG, and four of the six calves that were born had mutations in both genes.

Conclusions

These data demonstrated that production of genome edited cattle via electroporation of RNP could be effectively applied. Finally, MSTN and PRNP from beef cattle and MSTN and BLG from dairy cattle have been born and they will be valuable resources for future precision breeding.
Preservation evaluation method of Chinese traditional shadow puppet relics based on pixel lattice and membership function
Authors: Lei Xinyi , Li Long , Liu Xinyu , Du Zhiyan
Published: August 2023

The conservation and preservation of shadow puppet artifacts is an important task that requires accurate assessment of their preservation status. Currently, there are many shadow puppet artifacts in collections with varying degrees of deterioration, and an easy-to-use and accurate deterioration assessment method is urgently needed. To address this, this paper proposes a method to convert the color rendering characteristics of shadow puppet artifacts in two-dimensional images into digital information, which is used to create a pixel lattice in processing software Adobe Photoshop. The quantitative signal of the shadow puppet image is extracted and used to calculate the offset of the overall or local chromaticity of the shadow puppet relative to the average chromaticity, allowing for the assessment of the degree of cortical variation and risk of deterioration. A membership function is established based on the observed values of shadow puppet color in the pixel lattice, and the discrete fuzzy set and its scoring index are specified to assign corresponding weight values to the regions with different chromaticity attributes in the pixel lattice.The method of computing scores using the membership function involves ordinary mathematical operations, the overall scoring values are used to comprehensively evaluate the preservation status of the shadow puppet artifacts. This paper establishes a preliminary technical standard for the preventive conservation evaluation of shadow puppet artifacts using pixel lattice and membership function, providing an important guideline for the quantitative and standardized virtual restoration of shadow puppets. The proposed method provides a new approach to quantitatively assess the preservation status of shadow puppets, which is essential for their efficient scientific conservation.
Intravenous immunoglobulin treatment of congenital parvovirus B19 induced anemia - a case report
Authors: Aronson Stephanie T. , Celiker Mahmut Y. , Guarini Ludovico , Agha Rabia
Published: August 2023

Background

Parvovirus is a common childhood infection that could be very dangerous to the fetus, if pregnant women become infected. The spectrum of effects range from pure red blood cell aplasia with hydrops fetalis to meningoencephalitis, with many symptoms in between. Severe anemia in the setting of pure red blood cell aplasia is one of the more common effects that neonatal experience (if infected intrapartum), with the current gold standard treatment being intrauterine or postnatal packed red blood cell (PRBC) transfusions, yet intravenous immunoglobulin (IVIG) may be a superior treatment option.

Case presentation

A preterm infant was born at 26th week of gestational age via emergency Cesarean section due to hydrops fetalis, with parvovirus B19 exposure one month prior. The infant tested positive for IgM antibodies against parvovirus B19. Among many other serious complications of both hydrops fetalis and premature delivery, the infant had severe unremitting anemia, and received many PRBC transfusion over the course of his 71-day-long neonatal intensive care unit stay. During a follow up appointments as outpatient, his blood tests showed persistent high copies of parvovirus B19. He was then supported with PRBC transfusions and treated with IVIG. After three doses of IVIG, the infant’s parvovirus B19 viral copy numbers have dramatically reduced and the infant did not require any more PRBC transfusions.

Conclusions

IVIG infusion effectively treated the parvovirus B19 infection and restored erythropoiesis making the child transfusion independent. Furthermore, since IVIG is safe and readily crosses the placenta, further studies are needed to determine if IVIG should be considered as an alternative prenatal treatment for congenital parvovirus B19 infection.
Promoting knowledge elaboration, socially shared regulation, and group performance in collaborative learning: an automated assessment and feedback approach based on knowledge graphs
Authors: Zheng Lanqin , Long Miaolang , Chen Bodong , Fan Yunchao
Published: August 2023

Online collaborative learning is implemented extensively in higher education. Nevertheless, it remains challenging to help learners achieve high-level group performance, knowledge elaboration, and socially shared regulation in online collaborative learning. To cope with these challenges, this study proposes and evaluates a novel automated assessment and feedback approach that is based on knowledge graph and artificial intelligence technologies. Following a quasi-experimental design, we assigned a total of 108 college students into two conditions: an experimental group that participated in online collaborative learning and received automated assessment and feedback from the tool, and a control group that participated in the same collaborative learning activities without automated assessment and feedback. Analyses of quantitative and qualitative data indicated that the introduced automated assessment and feedback significantly promoted group performance, knowledge elaboration, and socially shared regulation of collaborative learning. The proposed knowledge graph-based automated assessment and feedback approach shows promise in providing a valuable tool for researchers and practitioners to support online collaborative learning.
AI-based quantification of whole-body tumour burden on somatostatin receptor PET/CT
Authors: Gålne Anni , Enqvist Olof , Sundlöv Anna , Valind Kristian , Minarik David , Trägårdh Elin
Published: August 2023

Background

Segmenting the whole-body somatostatin receptor-expressing tumour volume (SRETVwb) on positron emission tomography/computed tomography (PET/CT) images is highly time-consuming but has shown value as an independent prognostic factor for survival. An automatic method to measure SRETVwb could improve disease status assessment and provide a tool for prognostication. This study aimed to develop an artificial intelligence (AI)-based method to detect and quantify SRETVwb and total lesion somatostatin receptor expression (TLSREwb) from [68Ga]Ga-DOTA-TOC/TATE PET/CT images.

Methods

A UNet3D convolutional neural network (CNN) was used to train an AI model with [68Ga]Ga-DOTA-TOC/TATE PET/CT images, where all tumours were manually segmented with a semi-automatic method. The training set consisted of 148 patients, of which 108 had PET-positive tumours. The test group consisted of 30 patients, of which 25 had PET-positive tumours. Two physicians segmented tumours in the test group for comparison with the AI model.

Results

There were good correlations between the segmented SRETVwb and TLSREwb by the AI model and the physicians, with Spearman rank correlation coefficients of r = 0.78 and r = 0.73, respectively, for SRETVwb and r = 0.83 and r = 0.81, respectively, for TLSREwb. The sensitivity on a lesion detection level was 80% and 79%, and the positive predictive value was 83% and 84% when comparing the AI model with the two physicians.

Conclusion

It was possible to develop an AI model to segment SRETVwb and TLSREwb with high performance. A fully automated method makes quantification of tumour burden achievable and has the potential to be more widely used when assessing PET/CT images.
Procedural applications of total quality management in university education in light of the COVID-19 pandemic
Authors: Idan Mahmoud Fadhel
Published: August 2023

The current study aimed to establish the basic infrastructure to facilitate the implementation of the procedural applications of total quality management, through the introduction of a fully functional total quality management unit in colleges and scientific departments, in line with internationally recognized standards, by meeting ISO 21001: standards for the requirements of the management system of educational institutions 2018 in light of the coronavirus crisis. A questionnaire was printed including all applications and 40 actions distributed to three categories of volunteers: undergraduate students, graduate students, and faculty members at the university. The current study involved the calculation of several key metrics, including the average number of volunteers, the average level of satisfaction across all choices, and the proportion of overall satisfaction attributable to the mean values observed across all groups. The results indicate a relatively low rating of 15 and a satisfaction level of 25.125 among the sample of undergraduates who participated in the study. In the context of postgraduate education, the scale reached a numerical value of 12.1, resulting in a satisfaction rate of 48.4. The responses or alternatives provided by respected faculty members at the university indicated a high level of confidence and clarity. The results indicate that a large percentage of the respondents 62.322 expressed their satisfaction unequivocally in the categorical response of “exactly yes” with a similar frequency of 8.725. The rationale behind their selection can be attributed to various factors, such as their proximity to the deanship, their great experience in university work, their active participation in decision-making processes, and the limited impact of the Corona pandemic. The satisfaction rate of university professors reached 80.57% overall. The graduate student group ranked second, peaking at 70.56%. In contrast, the statistical figures related to undergraduate students were relatively lower, as they ranked third with a rate of 55.21%.
Fuel treatments in shrublands experiencing pinyon and juniper expansion result in trade-offs between desired vegetation and increased fire behavior
Authors: Williams Claire L. , Ellsworth Lisa M. , Strand Eva K. , Reeves Matt C. , Shaff Scott E. , Short Karen C. , Chambers Jeanne C. , Newingham Beth A. , Tortorelli Claire
Published: August 2023

Background

Native pinyon (Pinus spp.) and juniper (Juniperus spp.) trees are expanding into shrubland communities across the Western United States. These trees often outcompete with native sagebrush (Artemisia spp.) associated species, resulting in increased canopy fuels and reduced surface fuels. Woodland expansion often results in longer fire return intervals with potential for high severity crown fire. Fuel treatments are commonly used to prevent continued tree infilling and growth and reduce fire risk, increase ecological resilience, improve forage quality and quantity, and/or improve wildlife habitat. Treatments may present a trade-off; they restore shrub and herbaceous cover and decrease risk of canopy fire but may increase surface fuel load and surface fire potential. We measured the accumulation of surface and canopy fuels over 10 years from ten sites across the Intermountain West in the Sagebrush Steppe Treatment Evaluation Project woodland network (www.SageSTEP.org), which received prescribed fire or mechanical (cut and drop) tree reduction treatments. We used the field data and the Fuel Characteristic Classification System (FCCS) in the Fuel and Fire Tools (FFT) application to estimate surface and canopy fire behavior in treated and control plots in tree expansion phases I, II, and III.

Results

Increased herbaceous surface fuel following prescribed fire treatments increased the modeled rate of surface fire spread (ROS) 21-fold and nearly tripled flame length (FL) by year ten post-treatment across all expansion phases. In mechanical treatments, modeled ROS increased 15-fold, FL increased 3.8-fold, and reaction intensity roughly doubled in year ten post-treatment compared to pretreatment and untreated controls. Treatment effects were most pronounced at 97th percentile windspeeds, with modeled ROS up to 82 m min−1 in mechanical and 106 m min−1 in prescribed fire treatments by 10 years post-treatment compared to 5 m min−1 in untreated controls. Crown fire transmissivity risk was eliminated by both fuel treatments.

Conclusions

While prescribed fire and mechanical treatments in shrublands experiencing tree expansion restored understory vegetation and prevented continued juniper and pinyon infilling and growth, these fuel treatments also increased modeled surface fire behavior. Thus, management tradeoffs occur between desired future vegetation and wildfire risk after fuel treatments.
Prevalence of psychiatric morbidity among school-going adolescents in the age group of 13–19 years
Authors: Shafi Majid , Younis Neelofar , Rasool Ubaid , Younis Sabah , Rather Yasir Hassan , Lone Burhan Bashir , Bhat Fazle Roub , Khan Athiya Fahiem
Published: August 2023

Background

Adolescent mental health problems are vast and varied and early identification and intervention can be of utmost help. There is sparse data on mental health issues in the adolescent population from India in general and J&K in particular; thus, it was decided to embark on this study.

Results

The prevalence of various psychiatric disorders among school-going adolescents was as major depressive disorder 13.7%, obsessive compulsive disorder 4.0%, panic disorder 1.4%, self-harming behavior 2.5%, generalized anxiety disorder 2.5%, social anxiety disorder 2.2%, dysthymia 1.7%, and adjustment disorder 0.8%. There was no statistically significant difference in the overall psychiatric morbidity group among males and females (P = 0.90). However, panic disorder and borderline personality disorder as a group were more commonly found among females compared to males (P = 0.016 and 0.001 respectively). Also, 34% from urban and 28% from rural areas met the criteria for any psychiatric disorder (P = 1.38).

Conclusion

Children and adolescents represent a tender part of the human life cycle and they may be at a higher risk of psychiatric disorders. There is a very high prevalence of psychiatric morbidity of any kind among adolescents in Kashmir, many of which are unidentified and thus untreated. Depression is the most common psychiatric illness among adolescents with a higher prevalence in males while anxiety disorders are more common among females. There is a need for further research in this age group and teachers and parents need psycho-education for the identification of such children.
Burn trauma in infants
Authors: Demir Yiğit Yasemin , Yiğit Ebral , Taş Ilhan
Published: August 2023

Background

A wealth of data exists concerning pediatric burn epidemiology in general, but more is explicitly needed in infants under 1 year of age, a particular group in which mobility begins to develop.

Methods

In this study,206 patients followed up for burns in Diyarbakır Gazi Yaşargil Training and Research Hospital Burn Center between January 2016 and September 2021 were included in the study.

Results

Of the patients, 120 (58.3%) were male, and 86 (41.7%) were female. The mean age was 10.0 ± 2.0 months. The total number of cases ranged from 3 to 12 months, with the incidence of burns peaking at 12 months.

When we look at the etiology of burns, scalding burns were the most common, with 184 (89.3%) cases. Most of the burns occurred in the kitchen because their mothers and children spent a lot of time there.

It was positive in 23.8% of the wound culture results obtained with a punch biopsy. Staphylococcus aureus was the most abundant microorganism in wound culture results, with 5.8%. The mean hospital stay of the patients was 4.99 ± 3.67 days. Our mortality rate was 1.94% (n:4).

Conclusion

In conclusion, As preventive measures, it is necessary to increase protective measures at home and to raise awareness of families about burn etiologies.
A case report of extensive condyloma acuminata in a pediatric patient clearing with compounded 3% cidofovir gel
Authors: Wroblewski Ben , Lopes Fabiana Castro Porto Silva , Boothe William David , Diaz Lucia Z.
Published: August 2023

Background

Management and treatment of condyloma acuminata in children are often challenging. The mode of transmission is not always traceable and a sexual abuse investigation should be considered. Treatment ranges from no intervention to reconstructive surgery depending on the extent and symptoms.

Case presentation

We are reporting a case of an 18-month-old female with extensive symptomatic condyloma acuminata who was able to avoid surgical treatment after treatment with topical cidofovir 3% gel.

Conclusion

This patient is being presented to highlight a medical treatment that can be considered in extensive or large condyloma acuminata cases.
Arbitrarily structured quantum emission with a multifunctional metalens
Authors: Li Chi , Jang Jaehyuck , Badloe Trevon , Yang Tieshan , Kim Joohoon , Kim Jaekyung , Nguyen Minh , Maier Stefan A. , Rho Junsuk , Ren Haoran , Aharonovich Igor
Published: August 2023

Structuring light emission from single-photon emitters (SPEs) in multiple degrees of freedom is of great importance for quantum information processing towards higher dimensions. However, traditional control of emission from quantum light sources relies on the use of multiple bulky optical elements or nanostructured resonators with limited functionalities, constraining the potential of multi-dimensional tailoring. Here we introduce the use of an ultrathin polarisation-beam-splitting metalens for the arbitrary structuring of quantum emission at room temperature. Owing to the complete and independent polarisation and phase control at the single meta-atom level, the designed metalens enables simultaneous mapping of quantum emission from ultra-bright defects in hexagonal boron nitride and imprinting of an arbitrary wavefront onto orthogonal polarisation states of the sources. The hybrid quantum metalens enables simultaneous manipulation of multiple degrees of freedom of a quantum light source, including directionality, polarisation, and orbital angular momentum. This could unleash the full potential of solid-state SPEs for their use as high-dimensional quantum sources for advanced quantum photonic applications.
Anomalous bronchus and pulmonary artery in a patient who underwent subsegmentectomy of right S6a + b
Authors: Tsukamoto Yo , Yabe Mitsuo , Ishikawa Ai , Kato Daiki , Shibazaki Takamasa , Nakada Takeo , Ohtsuka Takashi
Published: August 2023

This report describes the case of a woman with small-sized peripheral lung cancer who underwent thoracoscopic right superior subsegmentectomy of S6a + b. Preoperative multiplanar reconstruction computed tomography revealed an anomalous posterior basal bronchus (B10c) and pulmonary artery (A10c), branching from the right lower superior segment bronchus (B6) and artery (A6), respectively. A three-dimensional (3D) model of the bronchi and pulmonary vessels and virtual bronchoscopy images were created to confirm the anomalous bronchus and pulmonary artery. Right superior subsegmentectomy of the right S6a + b was performed with the preservation of the anomalous posterior basal bronchus and pulmonary artery, as planned preoperatively, with no intraoperative or postoperative complications. The preoperative 3D reconstruction image was useful for understanding the patient’s anatomy. Furthermore, an understanding of anatomy is necessary when performing segmentectomy in patients with anomalous bifurcations of the pulmonary artery and bronchus.
A framework for multi-faceted content analysis of social media chatter regarding non-medical use of prescription medications
Authors: Raza Shaina , Schwartz Brian , Lakamana Sahithi , Ge Yao , Sarker Abeed
Published: August 2023

Background

Substance use, including the non-medical use of prescription medications, is a global health problem resulting in hundreds of thousands of overdose deaths and other health problems. Social media has emerged as a potent source of information for studying substance use-related behaviours and their consequences. Mining large-scale social media data on the topic requires the development of natural language processing (NLP) and machine learning frameworks customized for this problem. Our objective in this research is to develop a framework for conducting a content analysis of Twitter chatter about the non-medical use of a set of prescription medications.

Methods

We collected Twitter data for four medications—fentanyl and morphine (opioids), alprazolam (benzodiazepine), and Adderall® (stimulant), and identified posts that indicated non-medical use using an automatic machine learning classifier. In our NLP framework, we applied supervised named entity recognition (NER) to identify other substances mentioned, symptoms, and adverse events. We applied unsupervised topic modelling to identify latent topics associated with the chatter for each medication.

Results

The quantitative analysis demonstrated the performance of the proposed NER approach in identifying substance-related entities from data with a high degree of accuracy compared to the baseline methods. The performance evaluation of the topic modelling was also notable. The qualitative analysis revealed knowledge about the use, non-medical use, and side effects of these medications in individuals and communities.

Conclusions

NLP-based analyses of Twitter chatter associated with prescription medications belonging to different categories provide multi-faceted insights about their use and consequences. Our developed framework can be applied to chatter about other substances. Further research can validate the predictive value of this information on the prevention, assessment, and management of these disorders.
Safety Analysis of a New Portable Electrical Drill With a Smart Autostop Mechanism for Bedside Cranial Procedures
Authors: Assumpcao de Monaco Bernardo , Benjamin Carolina Gesteira , Doomi Ahmed , Taylor Ruby , Stringfellow Cheyenne Elaina , Benveniste Ronald J. , Jagid Jonathan R. , Graciolli Cordeiro Joacir
Published: August 2023

BACKGROUND AND OBJECTIVES:

Bedside procedures are often helpful for neurosurgical patients, especially in neurocritical care. Portable drills with technological advancements may bring more safety and efficiency to the bedside. In this study, we compared the safety and efficiency of a new cordless electric drill with smart autostop (“HD”—Hubly Cranial Drill, Hubly Surgical) with those of a well-established standard traditional electrical neurosurgical perforator (“ST”).

METHODS:

A cadaveric study was conducted using both drills to perform several burr holes in the fronto-temporo-parietal region of the skull. An evaluation was performed on the number of dura plunges, and complete burr hole success rates were compared.

RESULTS:

A total of 174 craniotomies using the HD and 36 burr holes using the ST perforator were performed. Despite significantly exceeding intended drill bit tolerance by multiple uses of a single-use disposable HD, autostop engaged in 100% of the 174 craniotomies and before violating dura in 99.4% of the 174 craniotomies, with the single dura penetration occurring on craniotomy no. 128 after the single-use drill bit had significantly dulled beyond its single-use tolerance. Autostop engaged before dura penetration for 100% of the 36 burr holes drilled with the ST perforator (P = .610). All the perforations were complete using the HD after resuming drilling. An autostop mechanism in a cranial drill is not commonly available for portable bedside perforators. In the operating room, most use a mechanical method to stop the rotation after losing bone resistance. This new drill uses an electrical mechanism (smart autostop) to stop drilling, making it a single-use cranial drill with advanced features for safety and efficiency at the bedside.

CONCLUSION:

There was no difference in the safety and efficacy of the new cordless electric drill with smart autostop when performing craniotomies compared with a traditional well-established electric cranial perforator with mechanical autostop on a cadaveric model.
Incorporation of Brain Connectomics for Stereotactic Radiosurgery Treatment Planning
Authors: Dayawansa Sam , Schlesinger David , Mantziaris Georgios , Dumot Chloe , Donahue Joseph H. , Sheehan Jason P.
Published: August 2023

BACKGROUND AND IMPORTANCE:

Neurosurgeons have integrated neuroanatomy-based tractography to avoid critical structures during dose planning. However, they have yet to integrate more comprehensive connectome networks for radiosurgical planning.

CLINICAL PRESENTATION:

A young man presented with a Spetzler-Martin Grade 3 right temporal arteriovenous malformation.

DISCUSSION:

As proof of concept, we incorporated connectomic networks including default mode network, optic radiation and central executive network into the Gamma Knife radiosurgical treatment planning workflow. Connectome networks were created from T1 anatomic and diffusion-weighted images magnetic resonance images using Quicktome software. The resulting networks were voxel-encoded in the magnetic resonance images, imported into GammaPlan, and segmented by image thresholding. The GammaPlan Lightning optimizer was used to create radiosurgical plans with a dose of 20 Gy to the 50% isodose line delivered to the arteriovenous malformation nidus both with and without treating these networks as risk structures. When taking into account the connectome networks, a maximum dose restriction of 14 Gy was placed on each network during lightning dose planning. With default mode network, optic radiation, and central executive network as risk structures, the maximum dose and V12Gy were reduced by 23.4% and 88.3%, 20% and 34.3%, and 29.8% and 63.2%, respectively.

CONCLUSION:

We were able to incorporate connectomes into radiosurgical dose planning approaches. This allowed for dose reductions to the networks while still achieving delivery of a therapeutic dose to the target volume.
A Practical and Convenient Synthesis of the Essential Antibiotic Drug Cefazolin under Sequential One-Flow Conditions
Authors: Sugita Shoichi , Ishitani Haruro , Kobayashi Shū
Published: August 2023

A sequential continuous-flow synthesis of cefazolin, which is a vital first-choice drug used for the prevention of primary infection in most surgeries, was investigated. Rapid flow and efficient mixing of substrates in suitable flow reactors enabled the target compound to be obtained in a short period without any intermediate isolation. A flexible system design that can be applied from a small-scale to medium-scale synthesis was demonstrated, and optimal parameters were established to realize the synthesis. A 0.3 mol/h scale synthesis was achieved in 54% isolated yield with 13.75 g/h dL space–time–yield of cefazolin. The obtained material had an acceptable impurity profile and could be purified by simple acid–base extraction and precipitation.
Money practices and couplehood among individuals in the third age in Sweden
Authors: Stenström Kristina , Kridahl Linda , Duvander Ann-Zofie
Published: August 2023

Couple relationships and money practices are intimately connected. Money can often cause disagreement and conflict within couples and represents symbolic values and expectations between partners. This study adopts a practices approach to exploring money practices among Swedish couples in the third age (60–80 years old) through 17 semi-structured interviews. We focus particularly on how money practices constitute and are constituted by dimensions of ‘being and doing couple’. We find that money practices both reflect and constitute couplehood. Our analysis has revealed that money practices are interlinked with couplehood through the primary themes of togetherness, fairness and trust, independence and finally, a reluctance to imagine oneself outside of couplehood, for other reasons than widowhood.
Mixed-sex civil partnerships: developing a morality of love
Authors: Carter Julia , Hayfield Nikki
Published: August 2023

Civil partnerships were extended to mixed-sex couples in England and Wales at the end of 2019, shortly followed by Northern Ireland (2020) and Scotland (2021). Since then, thousands of mixed-sex couples have entered a civil partnership. While civil partnerships were favoured by politicians as an alternative to legal rights for cohabitants, we know little about why mixed-sex couples would choose a civil partnership. In 2020–21 we interviewed individuals and couples who had entered or were planning a mixed-sex civil partnership (MSCP) to explore this further. We find that MSCPs are constructed in opposition to the ‘traditional’ image of marriage/weddings and yet symbolic elements including dress, form and structure are necessarily relied on in constructing something new, via a process of bricolage. Moreover, through civil partnership motivation talk, mixed-sex couples are constructing an individual morality that is centred on resisting cultural norms, advocating equality and justice, and pragmatic love.
Challenging assumptions: investigating measurement sensitivity in substantive representation and its effects on policy satisfaction
Authors: Talukder David
Published: August 2023

In recent decades, a growing body of scholarship has shed light on the persistent inequalities in political representation, revealing that citizens are far from equal in their access to, and experience of, representation. While ample research has focused on the issue of under-representation, scarce attention has been given to the implications of descriptive and substantive under-representation on the perception of being substantively represented, as reflected in citizens’ satisfaction with implemented policies. This study aims to make a significant contribution to the existing literature by investigating the substantive representation of descriptively under-represented citizens in the context of Belgium. Specifically, this research examines the intricate dynamics of substantive (under-)representation with political institutions (government, parliament and political parties) and citizens’ perceptions of being represented in terms of satisfaction with government policies. The findings reveal intriguing variations in different measures of substantive representation, highlighting the need for critical review and further investigation in future studies.
Performing meat reduction across scripted social sites: exploring the experiences and challenges of meat reducers in Norway
Authors: Sundet Øyvind , Hansen Arve , Wethal Ulrikke
Published: August 2023

Current meat consumption trends are associated with extensive resource use, environmental degradation, and detrimental effects on animal and human health, making meat reduction a core sustainability target. The experiences of meat reducers, often conceptualised as flexitarians, have gradually attracted more academic attention. This literature has shown that in many cases meat reducers do not radically reduce their meat intake and have untangled a complex web of factors contributing to meat consumption, reduction and avoidance. This article contributes to a nuanced understanding of the experiences, approaches and challenges faced by meat reducers. The data was collected through in-depth interviews with 26 self-declared meat reducers in Norway. By framing consumption as embedded in social practices, this article highlights how broader cultural, social and material conditions structure eating and hence meat consumption. A central finding is that through processes of socialisation and habituation, performances of eating often conform to the prevailing conventions inscribed in the socio-material environment in which they are embedded. We thus question the popular depictions of individuals as efficient drivers of dietary changes and highlight the many factors involved in reproducing the ‘normalness’ of meat-intense diets, demonstrating how individual intentions, choices and habits are themselves rooted in, and circumscribed by, prevailing conventions, that is, practices.
The Morphological Evaluation of the Cervical Muscle in Patients With Basilar Invagination: A Magnetic Resonance Imaging-Based Study
Authors: Lin Junyu , Xu Panjie , Zheng Jianying , Zefan Zhang , Tan Jingwen , Xiao Hang , Yu Siyan , Zhu Qingan , Ji Wei
Published: August 2023

Objective: To investigate the characteristics of functional muscle and muscle size in patients with basilar invagination (BI) and explore the effects of atlantoaxial dislocation.Methods: Eighty BI patients (BI group) and 80 age- and sex-matched asymptomatic people (control group) were included. Axial T2 magnetic resonance imaging image was used to measure the cross-sectional area (CSA) and functional CSA (FCSA). The sternocleidomastoid (SCM), longus capitis and longus colli (LCap & LC), trapezius (Trap), splenius capitis (SpCap), splenius cervicis (SpC), semispinalis capitis (SSCap), semispinalis cervicis (SSC), multifidus (MS), levator scapulae (LS) and posterior deep layer muscles (PDLM) were evaluated. Correlations between age, atlantodental interval (ADI), Chamberlain distance and muscles were observed.Results: BI group (39.4 ± 18.4 years; 33 males/47 females) exhibited significantly lower FCSA/CSA ratios than the control group in all extensor and flexor muscles, and presented smaller CSAs on the right and left Trap, SSC, LS, SCM, and left LCap & LC. FCSA/CSA ratios were significantly lower in BI patients with dislocation on the right Trap, SpCap, SpC, SSCap, MS, LS, LCap & LC, and PDLM, and the left SSCap, MS, and LCap & LC than in patients without deformity. Additionally, functional muscles of all parameters decreased with age in BI patients. Excluding children, the Trap, SpC, MS, and LS muscle sizes of BI patients tended to increase with age. ADI and Chamberlain distance tended to correlate negatively with FCSA/CSA ratio.Conclusion: The BI patients, especially those with atlantoaxial dislocation, had less functional muscles compared with the control group. Moreover, their functional muscles decreased with age more obviously.
Electroacupuncture-Modulated MiR-106b-5p Expression Enhances Autophagy by Targeting Beclin-1 to Promote Motor Function Recovery After Spinal Cord Injury in Rats
Authors: Guo Shuhui , Chen Jianmin , Yang Ye , Li Xiaolu , Tang Yun , Gui Yuchang , Chen Jianquan , Xu jianwen
Published: August 2023

Objective: Electroacupuncture (EA) has a definite effect on the treatment of spinal cord injuries (SCIs), but its underlying molecular mechanism remains unclear. Meanwhile, MiR106b-5p is an autophagy- and apoptosis-related microribonucleic acid, but whether it regulates the progression of autophagy and apoptosis in SCIs is yet undetermined. As such, this study aimed to elucidate the involvement of miR-106b-5p in the EA treatment of an SCI.Methods: The miR-106b-5p level was detected by quantitative real-time polymerase chain reaction. In vitro, SH-SY5Y cells were transfected with miR-106b-5p mimics or inhibitors to regulate the miR-106b-5p expression, while in vivo, SCI rats were treated with EA for 7 days at the bilateral Zusanli (ST36) and Jiaji (EX-B2) acupoints. The motor function was evaluated using the Basso-Beattie-Bresnahan (BBB) criteria. Further, autophagic vacuoles, pathological damage, and neuronal cell morphology were observed by transmission electron microscopy, as well as by hematoxylin and eosin and Nissl staining, respectively.Results: The miR-106b-5p level, which can interact directly with Beclin-1 by influencing its expression, as well as the expressions of P62, Caspase-3, and Bax, was upregulated after an SCI, but it decreased after EA. Moreover, the ratio of LC3-II to LC3-I was upregulated after EA. EA can enhance autophagy, reduce neuronal apoptosis, and minimize motor dysfunction and histopathological deficits after an SCI. More importantly, however, all the above effects induced by EA can be reversed after an injection of miR-106-5p agomir to produce an overexpression of miR-106b-5p.Conclusion: EA treatment could downregulate miR-106b-5p to alleviate SCI-mediated injuries by promoting autophagy and inhibiting apoptosis.
A Comparative Study of Healthy Dietary Patterns for Incident and Fatal Digestive System Cancer
Authors: Kim Jihye , Zhang Yin , Kim Hanseul , Zhang Yiwen , Zhang Xuehong , Giovannucci Edward
Published: August 2023

INTRODUCTION:

We examined multiple dietary patterns in relation to total digestive system cancer (DSC) incidence and death.

METHODS:

A total of 213,038 health professionals from the Health Professionals Follow-up Study (1986–2016), the Nurses' Health Study (1986–2018), and the Nurses' Health Study II (1991–2017) with no cancer diagnosis at baseline were analyzed. DSC incidence and death were estimated using time-varying Cox proportional hazards regression models.

RESULTS:

During up to 32 years of follow-up, 5,724 DSC cases accrued. Adherence to 8 healthy diet patterns was associated with a 7%–13% lower risk of DSC, particularly for digestive tract cancers. An inverse association with gastrointestinal tract cancer was also shown for all pattern scores except Alternate Mediterranean Diet and the healthful Plant-based Diet Index, with hazard ratios between 0.84 and 0.89. Inverse associations were shown for the reversed empirical dietary index for hyperinsulinemia (hazard ratio for 90th vs 10th percentile 0.64, 95% confidence interval [CI] 0.47–0.87) and the empirical dietary index associated with lower inflammation (rEDIP) (0.53, 95% CI 0.39–0.72) for stomach cancer, and for the rEDIP (0.58, 95% CI 0.37–0.92) for small intestine cancer. Among accessory cancers, the Alternate Healthy Eating Index-2010, alternate Mediterranean diet, and diabetes risk reduction diet were associated with a 43%–51% lower risk of liver cancer. The reversed empirical dietary index for hyperinsulinemia, rEDIP, and the Alternate Healthy Eating Index-2010 were inversely associated with the risk of fatal DSC.

DISCUSSION:

Adherence to healthy diets was associated with a lower risk of incident and fatal DSC, although the magnitude of the association varied slightly among the patterns.
Thirty-Day Readmissions Are Largely Not Preventable in Patients With Cirrhosis
Authors: Orman Eric S. , Desai Archita P. , Ghabril Marwan S. , Nephew Lauren D. , Patidar Kavish R. , Holden John , Samala Niharika R. , Gawrieh Samer , Vuppalanchi Raj , Sozio Margaret , Lacerda Marco , Vilar-Gomez Eduardo , Lammert Craig , Liangpunsakul Suthat , Crabb David , Masuoka Howard , Dakhoul Lara , Pan Minmin , Gao Sujuan , Chalasani Naga
Published: August 2023

INTRODUCTION:

Hospital readmissions are common in patients with cirrhosis, but there are few studies describing readmission preventability. We aimed to describe the incidence, causes, and risk factors for preventable readmission in this population.

METHODS:

We performed a prospective cohort study of patients with cirrhosis hospitalized at a single center between June 2014 and March 2020 and followed up for 30 days postdischarge. Demographic, clinical, and socioeconomic data, functional status, and quality of life were collected. Readmission preventability was independently and systematically adjudicated by 3 reviewers. Multinomial logistic regression was used to compare those with (i) preventable readmission, (ii) nonpreventable readmission/death, and (iii) no readmission.

RESULTS:

Of 654 patients, 246 (38%) were readmitted, and 29 (12%) were preventable readmissions. Reviewers agreed on preventability for 70% of readmissions. Twenty-two (including 2 with preventable readmission) died. The most common reasons for readmission were hepatic encephalopathy (22%), gastrointestinal bleeding (13%), acute kidney injury (13%), and ascites (6%), and these reasons were similar between preventable and nonpreventable readmissions. Preventable readmission was often related to paracentesis timeliness, diuretic adjustment monitoring, and hepatic encephalopathy treatment. Compared with nonreadmitted patients, preventable readmission was independently associated with racial and ethnic minoritized individuals (odds ratio [OR] 5.80; 95% CI, 1.96–17.13), nonmarried marital status (OR 2.88; 95% CI, 1.18–7.05), and admission in the prior 30 days (OR 3.45; 95% CI, 1.48–8.04).

DISCUSSION:

For patients with cirrhosis, readmission is common, but most are not preventable. Preventable readmissions are often related to ascites and hepatic encephalopathy and are associated with racial and ethnic minorities, nonmarried status, and prior admissions.