bluuebunny/crossref_metadata_2025 huggingface dataset:
Metabolic alkalosis: a new red flag in status epilepticus
Authors: Misirocchi Francesco , Quintard Hervé , Seeck Margitta , De Stefano Pia
Published: July 2024

Background

Status epilepticus (SE) is a heterogeneous neurological emergency with significant variability in prognosis, influenced by underlying disease and pathophysiological context. Acid–base disturbances are common in critically ill patients, yet their distribution and impact in SE patients remain poorly understood.

Methods

This was an observational cohort study including non-hypoxic SE patients with available blood gas analysis within the first 24 h of SE, treated at the University Hospital of Geneva, Switzerland between 2015 and 2023. Acid–base disturbances were classified using the Henderson–Hasselbalch equation, with prevalent metabolic alkalosis confirmed through the Stewart approach. Primary outcomes were in-hospital mortality, Glasgow Outcome Scale (GOS) at discharge, and return to premorbid neurologic function.

Findings

Among 540 SE patients, 365 were included. Half of patients exhibited acid–base disturbances within the initial 24 h of SE, with metabolic and respiratory acidosis being the most prevalent, though not prognostically significant. After correction for possible confounders, metabolic alkalosis (6%) was associated with increased in-hospital mortality (P = 0.011; OR = 4.87, 95% CI = 1.29–7.84), worse GOS (P = 0.012; OR = 3.18, 95% CI = 1.29–7.84), and reduced likelihood of returning to premorbid function (P = 0.017; OR = 3.30, CI95% = 1.24–8.80). Following the Stewart approach, 9% of patients had predominant metabolic alkalosis, associated with worse GOS (P = 0.005; OR:3.37, 95%CI = 1.45–7.82), and reduced chance of returning to baseline (P = 0.012; OR = 3.29, CI95% = 1.30–8.32). Metabolic alkalosis was related to hypoalbuminemia and lower serum potassium.

Conclusion

Metabolic alkalosis strongly predicts mortality and adverse functional outcome in SE patients. Prospective studies should assess whether early detection and correction of metabolic alkalosis and related electrolyte imbalances can improve SE prognosis.
Role of liver augmentation prior to hepatic resection – a survey on standards, procedures, and indications in Germany, Switzerland, and Austria
Authors: Yilmaz Elif , Torsello Giovanni F. , Hosseini Ali Seif Amir , Zygmunt Anne-Christine , Lorf Thomas , Keck Jan , Schild-Suhren Stina , Wellge Björn , Oberhuber Rupert , Kollmar Otto , Ghadimi Michael , Bösch Florian
Published: July 2024

Purpose

For primary and secondary liver tumors oncological resection remains a chance of cure. Augmentation of functional liver tissue may be necessary to preserve sufficient future liver remnant (FLR). Clinical decision-making on liver augmentation techniques and indications may differ internationally. Thus, this study aims to identify standards of liver augmentation in hepato-pancreatico-biliary (HPB) centers in Germany, Switzerland, and Austria.

Methods

Using a web-based survey, 48 hospitals in Germany, Switzerland, and Austria were invited to report their surgical indication, standard procedures, and results of liver augmentation.

Results

Forty (83.3%) of the hospitals invited participated. Most of the hospitals were certified liver centers (55%), performing complex surgeries such as liver transplantation (57.5%) and ALPPS (80%). The standard liver augmentation technique in all countries was portal vein embolization (PVE; 56%), followed by ALPPS (32.1%) in Germany or PVE with hepatic vein embolization (33.3%) in Switzerland and Austria. Standard procedure for liver augmentation did not correlate with certification as liver center, performance of liver transplantation or ALPPS. Surgical indication for PVE varied depending on tumor entity. Most hospitals rated the importance of PVE before resection of cholangiocarcinoma or colorectal metastases as high, while PVE for hepatocellular carcinoma was rated as low.

Conclusion

The survey gives an overview of the clinical routine in HPB centers in Germany, Austria, and Switzerland. PVE seems to dominate as standard technique to increase the FLR. However, there is a variety in the main indication for liver augmentation. Further studies are necessary evaluating the differing PVE techniques for liver augmentation.
Garcinol in gastrointestinal cancer prevention: recent advances and future prospects
Authors: Patwa Nitika , Chauhan Ritu , Chauhan Abhishek , Kumar Manoj , Ramniwas Seema , Mathkor Darin Mansor , Saini Adesh Kumar , Tuli Hardeep Singh , Haque Shafiul , Slama Petr
Published: July 2024

Gastrointestinal cancers continue to pose a significant global health challenge, with millions of new cases diagnosed each year. Despite advancements in treatment, the prognosis for many patients remains poor. This article explores the potential of garcinol, a polyisoprenylated benzophenone found in various Garcinia species, as a therapeutic agent against gastrointestinal malignancies. The objective is to review recent research on garcinol’s anticancer properties, its mechanisms of action, and safety aspects. Garcinol exhibits anticancer effects in esophageal, gastric, colorectal, pancreatic, and liver cancers by inhibiting metastasis, inducing apoptosis, and targeting key molecular pathways in cancer progression. Nanotechnology is explored as a means to enhance garcinol delivery and efficacy. Safety assessments suggest a promising toxicity profile. Garcinol shows significant potential as a natural therapeutic agent for gastrointestinal cancers, and future research is needed on optimizing its delivery, exploring synergistic combinations, and conducting clinical trials to validate its efficacy and safety for clinical applications.
Exploring the impact of body mass index on tumor biology and cancer development
Authors: Ahrenfeldt Johanne , Carstensen Stine , Eriksen Ida Maria Hemdorff , Birkbak Nicolai Juul
Published: July 2024

Purpose

Cancer continues to be a major global health challenge, affecting millions of individuals and placing substantial burdens on healthcare systems worldwide. Recent research suggests a complex relationship between obesity and cancer, with obesity increasing the risk of various cancers while potentially improving outcomes for diagnosed patients, a phenomenon termed the "obesity paradox". In this study, we used a cohort of 1781 patients to investigate the impact of obesity on tumor characteristics, including gene expression, pathway dysfunction, genetic alterations and immune infiltration.

Methods

Patient samples spanned 10 different cancer types, and were obtained from the Cancer Genome Atlas, with annotations for body mass index (BMI), age, sex, tumor size and tumor gene expression data.

Results

When we compared the proportion of large (T3–T4) to small tumors (T1–T2) between obese and non-obese patients, we found that obese patients tended to present with smaller, less invasive tumors and exhibited distinct gene expression profiles, particularly in metabolic and proliferative pathways. Moreover, smaller tumors in obese patients show higher immune cell infiltration and increased T cell diversity, suggesting enhanced immune activity.

Conclusion

Taken together, these findings highlight the influence of obesity on tumor biology, with implications for personalized treatment strategies that consider patient physiology alongside tumor characteristics.
Early postoperative outcomes following bariatric surgery in the United States: Are racial disparities improving?
Authors: Mustian Margaux N. , Naik Gurudatta , Wood Lauren , Wong Kristen , Stahl Richard , Grams Jayleen , Chu Daniel I.
Published: July 2024

Background

Bariatric surgery offers effective treatment for morbid obesity and associated medical comorbidities, with excellent short- and long-term outcomes. Although it has been well documented that racial minority bariatric patients have worse outcomes than White patients, it remains unclear whether this recognition has led to improvement. Herein, we assess recent trends in bariatric surgery among Black and White patients and compare early postoperative outcomes by race.

Methods

Primary sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) patients from 2015 to 2021 reported to the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program were studied. Bariatric patients were stratified by race (Black and White) and perioperative outcomes were compared between matched Black and White patients. Primary outcome was 30-day mortality. Secondary outcomes included hospital readmissions, hospital length of stay (LOS), reoperation, and postoperative complications.

Results

Overall, there were 193,071 Black and 645,224 White primary bariatric patients, with a higher volume of SG and RGYB performed among White patients. A total of 219,566 Black and White bariatric patients were matched and included in the case–control. Black patients were found to have higher rates of 30-day mortality (0.02% vs. 0.01%; p = 0.03) and readmissions (3.68% vs. 2.65%; p < 0.001). There were no significant differences in LOS, reoperations, or overall postoperative complications. However, there was a higher postoperative pulmonary thromboembolism rate (0.16% vs 0.08%; p < 0.001).). The differences in perioperative outcomes stratified by race persisted over the study period (Fig. 1).

Conclusion

Black bariatric surgery patients continue to have worse perioperative outcomes compared with their White counterparts. Further work must be done to determine contributing factors in order to effect improvement in outcomes in bariatric surgical care for racial minority patients.
Localization and activity of lipoxygenase in the ovule of Larix kaempferi (Lamb.) Carr. during female gametophyte maturation
Authors: Seta-Koselska Aleksandra , Szczuka Ewa , Koselski Mateusz
Published: July 2024

Key message

Lipoxygenase activity and localization vary throughout the development of Larix kaempferi ovules, with the highest enzyme activity observed in ovules at the cellular stage and the most intense immunogold reaction noted at the mature archegonium stage of gametophyte development.

Lipoxygenases are a family of oxidoreductases with a significant role in biological systems, widespread in living organisms e.g. mammals, fish, corals, plants, mosses, algae, fungi, yeasts, and bacteria. Lipoxygenase activity in plants leads to the formation of phytooxylipins, i.e. signaling molecules, which play a crucial role in many significant physiological processes such as male and female gametophyte maturation, germination and seedling growth, pathogen resistance, abiotic stress response, fruit ripening, and senescence. The activity and localization of lipoxygenase change during plant growth and development. The localization of lipoxygenase in a developing ovule of Larix kaempferi was analyzed using the immunogold labeling method, and the activity was determined spectrophotometrically with linolenic acid as a substrate. Among the investigated stages, the immunogold reaction was the most intense at the mature archegonium stage in the ovule. Lipoxygenase was found in all parts of the L. kaempferi ovule. The largest number of immunogold particles was detected in the integument cells of all the analyzed stages of ovule development. Only one isoform of lipoxygenase with an optimum at pH 8 was active in the ovules during female gametophyte maturation. The highest enzyme activity was determined at the cellular stage, whereas the mature archegonium stage was characterized by its lowest level, which means that LOX activity in developing ovules of the Japanese larch is not correlated with the number of antibody-labeled molecules of the enzyme.
Inter-America meridional circulation and boreal summer climate
Authors: Jury Mark R.
Published: July 2024

Atmospheric convection across the northern inter-Americas is modulated by trade-wind subsidence and subtropical easterly waves from June to October. Northward migration of the equatorial trough is coupled to the meridional circulation (MC) and surface temperatures above 27ºC. Forming a MC index via S-N height sections of total and anomalous streamfunction, statistical relationships are examined which focus on Jun-Oct season when the South American monsoon is quiescent. Both east Pacific and tropical north Atlantic exhibit cool ocean – dry atmosphere response to an intensified MC. During periods of faster MC, composite humidity is depleted over the Caribbean 10–25 N in conjunction with westerly wind shear, thereby limiting atmospheric convection. The ocean response to intensified MC is evaporative cooling and a deep layer of increased salinity in the Caribbean, that may sustain anomalous air-sea interactions. Long-term trends reveal intensification of the MC in boreal summer: rising over the Amazon, subsiding over the Caribbean, inter-connected by lower and upper airflows. The annually pulsed MC conspires with inter-decadal trends to produce many of the features presented.
Alanine, a potential amino acid biomarker of pediatric sepsis: a pilot study in PICU
Authors: Liu Tiantian , Xu Yaya , Hu Shaohua , Feng Shuyun , Zhang Hong , Zhu Xiaodong , Wang Chunxia
Published: July 2024

Sepsis is characterized by a metabolic disorder of amino acid occurs in the early stage; however, the profile of serum amino acids and their alterations associated with the onset of sepsis remain unclear. Thus, our objective is to identify the specific kinds of amino acids as diagnostic biomarkers in pediatric patients with sepsis. Serum samples were collected from patients with sepsis admitted to the pediatric intensive care unit (PICU) between January 2019 and December 2019 on the 1st, 3rd and 7th day following admission. Demographic and laboratory variables were also retrieved from the medical records specified times. Serum amino acid concentrations were detected by UPLC-MS/MS system. PLS-DA (VIP > 1.0) and Kruskal-Wallis test (p < 0.05) were employed to identify potential biomarkers. Spearman’s rank correlation analysis was conducted to find the potential association between amino acid levels and clinical features. The diagnostic utility for pediatric sepsis was assessed using receiver operating characteristic (ROC) curve analysis. Most of amino acid contents in serum were significantly decreased in patients with sepsis, but approached normal levels by the seventh day post-diagnosis. Threonine (THR), lysine (LYS), valine (VAL) and alanine (ALA) emerged as potential biomarkers related for sepsis occurrence, though they were not associated with PELOD/PELOD-2 scores. Moreover, alterations in serum THR, LYS and ALA were linked to complications of brain injury, and serum ALA levels were also related to sepsis-associated acute kidney injury. Further analysis revealed that ALA was significantly correlated with the Glasgow score, serum lactate and glucose levels, C-reactive protein (CRP), and other indicators for liver or kidney dysfunction. Notably, the area under the ROC curve (AUC) for ALA in distinguishing sepsis from healthy controls was 0.977 (95% CI: 0.925-1.000). The serum amino acid profile of children with sepsis is significantly altered compared to that of healthy controls. Notably, ALA shows promise as a potential biomarker for the early diagnosis in septic children.
Diagnose Glioblastom und das Geschäft mit der Hoffnung
Authors: Oberndorfer Stefan , Rubeis Giovanni , Kreye Gudrun , Nikolic Katarina , Calabek-Wohinz Bernadette
Published: July 2024

Eine qualitativ hochwertige Versorgung von Patient:innen mit Glioblastomen erfolgt in Österreich durch die etablierten Neuroonkologischen Zentren (NONKZ, Versorgungsmodell ÖSG). Die interdisziplinäre und fächerübergreifende Zusammenarbeit ist das wesentliche Element für die bestmögliche diagnostische und therapeutische Sicherheit und Effizienz.

Vor allem sog. „alternativmedizinische“ u. a. Methoden, angewandt bei Patient:innen mit Glioblastomen, eröffnen ein breites ethisches Spannungsfeld. Diese Patient:innen mit hochmalignen Erkrankungen sind eine besonders vulnerable Personengruppe. Neben dem offensichtlichen Geschäft mit der Hoffnung in einer persönlichen Ausnahmesituation für Patient:innen und Angehörige sind zusätzliche tumorbedingte kognitive Einschränkungen bei dieser Patientengruppe, mit potenziell einhergehender Beeinträchtigung der Entscheidungsfähigkeit, von besonderer Problematik.

Ansätze zur Lösung beinhalten eine vermehrte und strukturierte Aufklärung von Patient:innen und Angehörigen zu komplementären/alternativen Praktiken, eine psychoonkologische Betreuung, ausreichende personelle Ressourcen in den neuroonkologischen Zentren, einen kritischen Journalismus und den öffentlicher Diskurs über Ethik in der Medizin.
Crosstalk between bone and the immune system
Authors: Okamoto Kazuo
Published: July 2024

Bone functions not only as a critical element of the musculoskeletal system but also serves as the primary lymphoid organ harboring hematopoietic stem cells (HSCs) and immune progenitor cells. The interdisciplinary field of osteoimmunology has illuminated the dynamic interactions between the skeletal and immune systems, vital for the maintenance of skeletal tissue homeostasis and the pathogenesis of immune and skeletal diseases. Aberrant immune activation stimulates bone cells such as osteoclasts and osteoblasts, disturbing the bone remodeling and leading to skeletal disorders as seen in autoimmune diseases like rheumatoid arthritis. On the other hand, intricate multicellular network within the bone marrow creates a specialized microenvironment essential for the maintenance and differentiation of HSCs and the progeny. Dysregulation of immune–bone crosstalk in the bone marrow environment can trigger tumorigenesis and exacerbated inflammation. A comprehensive deciphering of the complex “immune–bone crosstalk” leads to a deeper understanding of the pathogenesis of immune diseases as well as skeletal diseases, and might provide insight into potential therapeutic approaches.
Development of a defined medium for the heterotrophic cultivation of Metallosphaera sedula
Authors: Sedlmayr Viktor Laurin , Luger Maximilian , Pittenauer Ernst , Marchetti-Deschmann Martina , Kronlachner Laura , Limbeck Andreas , Raunjak Philipp , Quehenberger Julian , Spadiut Oliver
Published: July 2024

The heterotrophic cultivation of extremophilic archaea still heavily relies on complex media. However, complex media are associated with unknown composition, high batch-to-batch variability, potential inhibiting and interfering components, as well as regulatory challenges, hampering advancements of extremophilic archaea in genetic engineering and bioprocessing. For Metallosphaera sedula, a widely studied organism for biomining and bioremediation and a potential production host for archaeal ether lipids, efforts to find defined cultivation conditions have still been unsuccessful. This study describes the development of a novel chemically defined growth medium for M. sedula. Initial experiments with commonly used complex casein-derived media sources deciphered Casamino Acids as the most suitable foundation for further development. The imitation of the amino acid composition of Casamino Acids in basal Brock medium delivered the first chemically defined medium. We could further simplify the medium to 5 amino acids based on the respective specific substrate uptake rates. This first defined cultivation medium for M. sedula allows advanced genetic engineering and more controlled bioprocess development approaches for this highly interesting archaeon.
A novel missense variant in the ATPase domain of ATP8A2 and review of phenotypic variability of ATP8A2-related disorders caused by missense changes
Authors: Flannery Kyle P. , Safwat Sylvia , Matsell Eli , Battula Namarata , Hamed Ahlam A. A. , Mohamed Inaam N. , Elseed Maha A. , Koko Mahmoud , Abubaker Rayan , Abozar Fatima , Elsayed Liena E. O. , Bhise Vikram , Molday Robert S. , Salih Mustafa A. , Yahia Ashraf , Manzini M. Chiara
Published: July 2024

ATPase, class 1, type 8 A, member 2 (ATP8A2) is a P4-ATPase with a critical role in phospholipid translocation across the plasma membrane. Pathogenic variants in ATP8A2 are known to cause cerebellar ataxia, impaired intellectual development, and disequilibrium syndrome 4 (CAMRQ4) which is often associated with encephalopathy, global developmental delay, and severe motor deficits. Here, we present a family with two siblings born from a consanguineous, first-cousin union from Sudan presenting with global developmental delay, intellectual disability, spasticity, ataxia, nystagmus, and thin corpus callosum. Whole exome sequencing revealed a homozygous missense variant in the nucleotide binding domain of ATP8A2 (p.Leu538Pro) that results in near complete loss of protein expression. This is in line with other missense variants in the same domain leading to protein misfolding and loss of ATPase function. In addition, by performing diffusion-weighted imaging, we identified bilateral hyperintensities in the posterior limbs of the internal capsule suggesting possible microstructural changes in axon tracts that had not been appreciated before and could contribute to the sensorimotor deficits in these individuals.
Clinical characteristics of pediatric noninfectious uveitis and risk factors for severe disease: a single-center study
Authors: Koru Lutfiye , Esen Fehim , Turkyilmaz Ozlem , Kucuk Elif , Kaya Feray , Aydin Zelal , Haslak Fatih , Ozturk Kubra
Published: July 2024

Objectives

We aimed to present the demographic, clinical, laboratory, and treatment data of children with non-infectious uveitis and to evaluate the risk factors for the development of complications and the need for biological treatment.

Method

Patients diagnosed with non-infectious uveitis in childhood and followed up for at least 1 year were included in the study. Demographic data, including age, gender, age at diagnosis, uveitis in first-degree relatives, and rheumatologic diseases, were obtained retrospectively from medical records. The presence of complications or the need for biologic therapy was considered a composite outcome suggesting severe disease.

Results

The study included 123 patients (female: n = 59, 48%). The mean age at diagnosis was 14.89 ± 4.86 years. Uveitis was symptomatic in 104 patients (84.6%). Approximately one-quarter of the patients had at least one rheumatic disease (n = 35, 28.5%), the most common being juvenile idiopathic arthritis. Thirty-three patients (26.8%) had anti-nuclear antibody positivity. Biologic agents were needed in 60 patients (48.8%). Complications developed in 14 patients (11.4%). Early age at disease onset (aOR, 0.875; 95% C.I. 0.795–0.965, p = 0.007) and female gender (aOR, 2.99; 95% C.I. 1.439–6.248, p = 0.003) were significantly associated with the need for biologic treatment, while Behçet’s disease (BD) was strongly associated with uveitis-related complications (aOR, 14.133; 95% C.I. 2.765–72.231, p = 0.001).

Conclusion

We suggest that among pediatric patients with non-infectious uveitis, females, those with an early age of disease onset, and those with BD need to be closely monitored due to a significantly increased risk of severe disease.

Key Points• Limited data exist on the clinical course of non-infectious uveitis in children and the associated risk factors for severe disease.• Our study reveals that nearly a quarter of pediatric patients with non-infectious uveitis also have a rheumatic disease.• Among pediatric patients diagnosed with non-infectious uveitis, we observed an increased risk of severe disease in those with an earlier onset age, in female patients, and in those diagnosed with Behçet’s disease.
Looks like home: numerosity, but not spatial frequency guides preference in zebrafish larvae (Danio rerio)
Authors: Adam Elisabeth , Zanon Mirko , Messina Andrea , Vallortigara Giorgio
Published: July 2024

Despite their young age, zebrafish larvae have a well-developed visual system and can distinguish between different visual stimuli. First, we investigated if the first visual surroundings the larvae experience during the first days after hatching shape their habitat preference. Indeed, these animals seem to “imprint” on the first surroundings they see and select visual stimuli accordingly at 7 days post fertilization (dpf). In particular, if zebrafish larvae experience a bar background just after hatching, they later on prefer bars over white stimuli, and vice versa. We then used this acquired preference for bars to investigate innate numerical abilities. We wanted to specifically test if the zebrafish larvae show real numerical abilities or if they rely on a lower-level mechanism—i.e. spatial frequency—to discriminate between two different numerosities. When we matched the spatial frequency in stimuli with different numbers of bars, the larvae reliably selected the higher numerosity. A previous study has ruled out that 7 dpf zebrafish larvae use convex hull, cumulative surface area and density to choose between two numerosities. Therefore, our results indicate that zebrafish larvae rely on real numerical abilities rather than other cues, including spatial frequency, when spontaneously comparing two sets with different numbers of bars.
Cinnamaldehyde and baicalin reverse colistin resistance in Enterobacterales and Acinetobacter baumannii strains
Authors: Mireles Natalia A. , Malla Cristina F. , Tavío María M.
Published: July 2024

Purpose

Colistin is used as a last resort antibiotic against infections caused by multidrug-resistant gram-negative bacteria, especially carbapenem-resistant bacteria. However, colistin-resistance in clinical isolates is becoming more prevalent. Cinnamaldehyde and baicalin, which are the major active constituents of Cinnamomum and Scutellaria, have been reported to exhibit antibacterial properties. The aim of this study was to evaluate the capacity of cinnamaldehyde and baicalin to enhance the antibiotic activity of colistin in Enterobacterales and Acinetobacter baumannii strains.

Methods

The MICs of colistin were determined with and without fixed concentrations of cinnamaldehyde and baicalin by the broth microdilution method. The FIC indices were also calculated. In addition, time-kill assays were performed with colistin alone and in combination with cinnamaldehyde and baicalin to determine the bactericidal action of the combinations. Similarly, the effects of L-arginine, L-glutamic acid and sucrose on the MICs of colistin combined with cinnamaldehyde and baicalin were studied to evaluate the possible effects of these compounds on the charge of the bacterial cell- wall.

Results

At nontoxic concentrations, cinnamaldehyde and baicalin partially or fully reversed resistance to colistin in Enterobacterales and A. baumannii. The combinations of the two compounds with colistin had bactericidal or synergistic effects on the most resistant strains. The ability of these agents to reverse colistin resistance could be associated with bacterial cell wall damage and increased permeability.

Conclusion

Cinnamaldehyde and baicalin are good adjuvants for the antibiotic colistin against Enterobacterales- and A. baumannii-resistant strains.
Convergence in distribution of randomized algorithms: the case of partially separable optimization
Authors: Luke D. Russell
Published: July 2024

We present a Markov-chain analysis of blockwise-stochastic algorithms for solving partially block-separable optimization problems. Our main contributions to the extensive literature on these methods are statements about the Markov operators and distributions behind the iterates of stochastic algorithms, and in particular the regularity of Markov operators and rates of convergence of the distributions of the corresponding Markov chains. This provides a detailed characterization of the moments of the sequences beyond just the expected behavior. This also serves as a case study of how randomization restores favorable properties to algorithms that iterations of only partial information destroys. We demonstrate this on stochastic blockwise implementations of the forward–backward and Douglas–Rachford algorithms for nonconvex (and, as a special case, convex), nonsmooth optimization.
Adaptive unified defense framework for tackling adversarial audio attacks
Authors: Du Xia , Zhang Qi , Zhu Jiajie , Liu Xiaoyuan
Published: July 2024

Adversarial attacks aimed at subverting recognition systems have laid bare significant security vulnerabilities inherent in deep neural networks. In the automatic speech recognition (ASR) domain, prevailing defense mechanisms have primarily centered on pre-processing procedures to mitigate adversarial threats stemming from such attacks. However, despite their initial success, these methods have shown surprising vulnerabilities when confronted with robust and adaptive adversarial attacks. This paper proposes an adaptive unified defense framework tailored to address the challenges posed by robust audio adversarial examples. The framework comprises two pivotal components: (1) a unified pre-processing mechanism is designed to disrupt the continuity and transferability of adversarial attacks. Its objective is to thwart the consistent operation of adversarial examples across different systems or conditions, thereby enhancing the robustness of the defense. (2) an adaptive ASR transcription method is proposed to further bolster our defense strategy. Empirical experiments conducted using two benchmark audio datasets within a state-of-the-art ASR system affirm the effectiveness of our adaptive defense framework. It achieves an impressive 100% accuracy rate against representative audio attacks and consistently outperforms other state-of-the-art defense techniques, achieving an accuracy rate of 98.5% even when faced with various challenging adaptive adversarial attacks.
Four decades of changing dissolved organic matter quality and stoichiometry in a Swedish forest stream
Authors: Evans Chris D. , Jutterström Sara , Stadmark Johanna , Peacock Mike , Futter Martyn , Kothawala Dolly , Monteith Don , Moldan Filip
Published: July 2024

Dissolved organic matter (DOM) concentrations have risen by a factor of two or more across much of Europe and North America during recent decades. These increases have affected the carbon cycle, light regime, drinking water treatability, and the energy and nutrient budgets of lakes and streams. However, while trends in DOM quantity are well characterised, information on how/whether qualitative properties of DOM have changed are scarce. Here, we describe over 40 years of monitoring data from a forested headwater stream in the Gårdsjön experimental catchment, southwest Sweden, which provides a unique record of biogeochemical change, including optical and stoichiometric DOM quality metrics, spanning the entire period of recovery from acidification. For the period 1980–2020 we find a 71% reduction in decadal mean sulphate concentrations, and a similar reduction in inorganic aluminium concentrations, alongside a 64% increase in dissolved organic carbon (DOC) concentrations. Over the same period, colour (absorbance at 420 nm) increased almost twice as much as DOC, whereas dissolved organic nitrogen (DON) increased by only one third as much. These results demonstrate a shift in stream water composition, with DOM becoming dominated by highly coloured, complex, nitrogen-poor compounds. This material is likely more resistant to biological degradation, but more susceptible to photochemical degradation. Changes in DOM stoichiometry could lead to intensified nitrogen and/or phosphorus limitation in surface waters, while increased colour/DOC ratios could intensify light-limitation of primary production beyond that expected from DOC increases alone. We observed increases in organic matter associated metals (iron 117%, organically complexed aluminium 85%) that exceeded the increase in DOC, consistent with their increased mobilisation by more aromatic organic matter. All observed changes are consistent with recovery from acidification being the primary driver of change, implying that past acidification, and ongoing recovery, have profoundly affected terrestrial and aquatic biogeochemistry, ecology and the carbon cycle.
Background, establishment and initial experiences of the Danish cardiovascular homograft biobank
Authors: Stenehjem Margrete , Holm Dorte Kinggaard , Riber Lars , Nielsen Christian , Riber Sara Schødt , Akgül Cengiz , Lindholt Jes S.
Published: July 2024

Odense University Hospital is a major tertiary vascular hospital in Scandinavia, performing approx. 200 aortic repairs annually. This article presents the rationale behind this endeavor and the early outcomes of the initial implantation of locally processed homografts. All patients receiving a homograft were identified from the established homograft biobank database and their medical records were reviewed after obtaining consent. All surgeons in charge of homograft implantations were semi structured interviewed regarding the harvesting procedure, the tools for detecting available homografts, their quality and delivery. The National board of Health approved the biobank fulling the EU Directive of Tissues and Cells after 18 months of preparation. From May 6, 2021, to March 1, 2023, 26 patients had a homograft implantation, with 7 for mycotic aneurysms, 10 for aorto-iliac graft infection, 6 for infra-inguinal graft infection, and 3 for graft infection in thoracic aorta. Six (23%) were emergently performed. Two (7.7%) died within 30 days postoperatively, both following in situ replacement of an infected aortoiliac graft, corresponding to a 20% mortality in this subgroup. The incidence of reinfections was 19.2%; one each in the mycotic aneurysm group, the aortoiliac graft infection group, and the thoracic graft infection group. After 90 days, two patients were diagnosed with aorto-enteric fistula. All involved surgeons could easily identify available suitable homografts, and within 2 h have homografts of acceptable quality and requested dimensions. The establishment of the Danish Cardiovascular Homograft Biobank was straightforward and effectively serves cardiovascular procedures performed 24/7. Additionally, the initial experiences seem comparable to others experiences.
Application of RiTiCE in understanding hydro-meteorological controls on ice break-up patterns in River Tornionjoki
Authors: Shahrood Abolfazl Jalali , Ahrari Amirhossein , Karjalainen Niina , Klöve Björn , Haghighi Ali Torabi
Published: July 2024

The Arctic region experiences significant annual hydrologic events, with the spring flood and ice break-up being the most prominent. River ice break-up, in particular, poses high socioeconomic and ecological expenses, including morphological changes and damage to riverine structures. This study aims to investigate the spatiotemporal patterns of river ice in the River Tornionjoki, including the timing of ice break-up at different latitudes. We utilized observation data and remote sensing techniques to track changes in ice patterns overtime on the River Tornionjoki. The study indicates that the ice break-up in the River Tornionjoki basin typically occurs during Apr-Jun based on the reach location in different latitudes; therefore, different stations behave according to their latitudinal location. We observed significant spatial variations in ice break-up timing across the basin, with an earlier break-up in the lower latitudes compared to the upper latitudes. The average ice break-up day in lower latitude stations ranges between 200–205, while in higher latitude stations the average ice break-up day ranges between 215–228.
Analysis of Autistic Adolescents’ Essays Using Computer Techniques
Authors: Chojnicka Izabela , Wawer Aleksander
Published: July 2024

Purpose

Challenges associated with narrative discourse remain consistently observable across the entire spectrum of autism. We analyzed written narratives by autistic and non-autistic adolescents and aimed to investigate narrative writing using quantitative computational methods.

Methods

We employed Natural Language Processing techniques to compare 333 essays from students in the final eighth grade of primary school: 195 written by autistic and 138 by non-autistic participants.

Results

Autistic students used words with a positive emotional polarity statistically less frequently (p < .001), and their stories were less abstract (p < .001) than those written by peers from the non-autistic group. However, autistic adolescents wrote more complex stories in terms of readability than participants from the non-autistic group (p < .001). The writing competencies assessed by teachers did not differ significantly between the two groups.

Conclusion

Findings suggest that written narratives by autistic individuals may exhibit characteristics similar to those detected by computational methods in spoken narratives. Collecting data from national exams and its potential usefulness in distinguishing autistic individuals could pave the way for future large-scale and cost-effective epidemiological studies on autism.
Caregiver Perspectives on Telehealth Assessment and Other Supports for Infants with Early Developmental Concerns
Authors: Schmidt Daltrey , Urias Chloe , Dufek Sarah , Talbott Meagan R.
Published: July 2024

This study examined the experiences of families of children with developmental concerns in the first year of life, before formal diagnostic evaluations are typically conducted. We aimed to understand the impact of participation in a telehealth-based research evaluation in infancy, identify existing community-based supports perceived favorably by caregivers, and identify suggestions for future directions. Participants were recruited from an prior study evaluating a telehealth assessment for infants with early social communication delays. Here, we interviewed caregivers (n = 19) who participated in follow-up study in toddlerhood. Transcripts from the semi-structured interviews were transcribed and analyzed using both inductive thematic and content coding approaches. Analysis of these interviews resulted in four core themes describing caregiving during this time: (1) Caregivers felt lonely, overwhelmed, and dismissed by providers, leading to feelings of uncertainty about their child’s development and future; (2) Telehealth assessments were appreciated because external supports are minimal, complex to navigate, and do not address all areas of need; (3) Desire for additional community and connection; and (4) Information is power. Caregivers reported participating in the telehealth assessments helped them to feel reassured, validated and supported. Outside the study, they sought a wide variety of services and resources. The most frequent requests were for parent coaching sessions and family navigation. Caregivers experienced uncertainty and disempowerment during the pre-diagnostic period and sought education and guidance during this time. Findings reflect the importance of centering family priorities when developing early intervention services for infants with elevated likelihood of autism.
Incidental ablation of ganglionated plexus during atrial fibrillation ablation
Authors: Keane Stephen , Patel Darshak , Otto Brian , Englander Lily , Kumareswaran Ramanan , Lin David , Riley Michael P. , Nazarian Saman , Marchlinski Francis E. , Markman Timothy M.
Published: July 2024

Background

Cardioneuroablation targeting the autonomic nerves within ganglionated plexus (GP) has been used to treat atrial fibrillation (AF). Incidental cardioneuroablation may be an important mechanism by which pulmonary vein isolation (PVI) is effective. Automated fractionation mapping software can identify regions of fractionation correlating with GP locations.

Objective

To examine the overlap between standard PVI ablation lesions and fractionated electrograms suggestive of GP.

Methods

We retrospectively examined AF ablations performed from 2021 to 2023 that included only PVI performed using wide antral circumferential isolation without prospective evaluation of fractionation. Retrospectively, a fractionation map was created (width 10 ms, refractory time 30 ms, roving sensitivity 0.1 mv, and threshold of 2). We evaluated the anatomic overlap between PVI lesions and fractionation in regions associated with GP.

Results

Among 52 patients (mean 65 (IQR 46–74) years, 82% male, and 69% paroxysmal AF), sites of fractionation corresponding to GP locations were seen in all cases. PVI ablation incidentally overlapped with fractionation in 50 (96%) patients. On average, 26% of the fractionation corresponding with GP locations were incidentally ablated. The highest proportion of fractionated areas were ablated in the left superior (36%) and right superior (31%) GP regions. More complete incidental ablation of these regions was associated with a greater intraprocedural increase in heart rate (ρ = 0.46, p < 0.001), which was subsequently associated with freedom from AF during 15.9 ± 5.2 months of follow-up.

Conclusion

Patients undergoing AF ablation universally have fractionated electrograms corresponding to anticipated sites of GP. Partial ablation of these regions frequently occurs incidentally during PVI.

Graphical Abstract
Intraoperative somatosensory evoked potential (SEP) monitoring: an updated position statement by the American Society of Neurophysiological Monitoring
Authors: Toleikis J. Richard , Pace Christopher , Jahangiri Faisal R. , Hemmer Laura B. , Toleikis Sandra C.
Published: July 2024

Somatosensory evoked potentials (SEPs) are used to assess the functional status of somatosensory pathways during surgical procedures and can help protect patients’ neurological integrity intraoperatively. This is a position statement on intraoperative SEP monitoring from the American Society of Neurophysiological Monitoring (ASNM) and updates prior ASNM position statements on SEPs from the years 2005 and 2010. This position statement is endorsed by ASNM and serves as an educational service to the neurophysiological community on the recommended use of SEPs as a neurophysiological monitoring tool. It presents the rationale for SEP utilization and its clinical applications. It also covers the relevant anatomy, technical methodology for setup and signal acquisition, signal interpretation, anesthesia and physiological considerations, and documentation and credentialing requirements to optimize SEP monitoring to aid in protecting the nervous system during surgery.
Incidence Rates and Predictors of Recurrent Long-Term Mental Sickness Absence Due to Common Mental Disorders
Authors: Mulder Matthew , Kok Robin , Aben Bart , de Wind Astrid
Published: July 2024

Purpose

Several predictors have been identified for mental sickness absence, but those for recurrences are not well-understood. This study assesses recurrence rates for long-term mental sickness absence (LTMSA) within subgroups of common mental disorders (CMDs) and identifies predictors of recurrent LTMSA.

Methods

This historical prospective cohort study used routinely collected data from 16,310 employees obtained from a nationally operating Dutch occupational health service (ArboNed). Total follow-up duration was 23,334 person-years. Overall recurrence rates were assessed using Kaplan–Meier estimators. Recurrence rates within subgroups of CMDs were calculated using person-years. Univariable and multivariable Cox proportional hazards models were used to identify predictors.

Results

15.6% of employees experienced a recurrent LTMSA episode within three years after fully returning to work after a previous LTMSA episode. Highest recurrence rates for LTMSA were observed after a previous LTMSA episode due to mood or anxiety disorders. Mood or anxiety disorders and shorter previous episode duration were predictors of recurrent LTMSA. No associations were found for age, gender, company size, full-time equivalent and job tenure.

Conclusion

Employees should be monitored adequately after they fully returned to work after LTMSA. It is recommended to monitor high-risk employees (i.e. employees with mood or anxiety disorders and short LTMSA episode) more intensively, also beyond full return to work. Moreover, diagnosis of anxiety and depressive symptoms should be given a higher priority in occupational healthcare.
Analyzing digital communication: a comprehensive literature review
Authors: Strauss Christina , Harr Michael Dominic , Pieper Torsten M.
Published: July 2024

Digital communication has become an essential part of both personal and professional contexts. However, unique characteristics of digital communication—such as lacking non-verbal cues or time asynchrony—clearly distinguish this new form of communication from traditional face-to-face communication. These differences raise questions about the transferability of previous findings on traditional communication to the digital communication context and emphasize the need for specialized research. To support and guide research on the analysis of digital communication, we conducted a systematic literature review encompassing 84 publications on digital communication in leading journals. By doing so, we provide an overview of the current body of research. Thereby, we focus on distinct fields of communication, methods used to collect and analyze digital communication data, as well as common methodological limitations. Building on these insights, we derive a series of comprehensive guidelines from five distinct areas for the collection and analysis of digital communication that can guide future research and organizational practice.
Suicide Attempt and Its Correlates Among School-Going Argentinian Adolescents with Suicidal Thoughts: Insights from a National Survey
Authors: Dadras Omid
Published: July 2024

A combination of personal, psychological, and environmental factors contributes to the risk of suicide attempts among those with suicidal thoughts and warrants further research. The study explored the associations of demographic, psychosocial, and behavioral factors with suicide attempts among a nationally representative of school-going Argentinian adolescents who have suicidal thoughts. The study analyzed the data from the Argentina Global School-based Students Survey 2018. The sample was restricted to adolescents with suicidal thoughts. The chi-square test was used to examine the association, and logistic regression determined the odds of suicide attempts across risk factors including demographic factors, psychosocial and environmental risks, as well as substance use and risk sex behaviors. In total, 11,962 (21.46%) of school-going Argentinian adolescents had suicidal thoughts, of whom 6033 (51.67%) had suicide attempts at least once in the last 12 months. Findings indicated that female adolescents had higher odds of attempts, paralleling global trends, while grade differences suggested a transitional phase’s significance. Among those with suicidal thoughts, psychosocial factors like loneliness, bullying, and school absenteeism played pivotal roles in enhancing the odds of suicide attempts. In addition, substance use, notably marijuana, amphetamines, alcohol, and early initiation were associated with a heightened risk of suicide attempts. Risky sexual behaviors, like early activity and multiple partners, were also associated with a higher likelihood of suicide attempts in suicide ideators. Emphasizing preventive measures targeting adolescents, particularly within school settings, is crucial for reducing suicide attempts among those experiencing suicidal thoughts.