bluuebunny/crossref_metadata_2025 huggingface dataset:
A radiomics-based study for differentiating parasellar cavernous hemangiomas from meningiomas
Authors: Wang Chunjie , You Lidong , Zhang Xiyou , Zhu Yifeng , Zheng Li , Huang Wangle , Guo Dongmei , Dong Yang
Published: September 2022

To investigate the value of the radiomic models for differentiating parasellar cavernous hemangiomas from meningiomas and to compare the classification performance with different MR sequences and classifiers. A total of 96 patients with parasellar tumors (40 cavernous hemangiomas and 56 meningiomas) were enrolled in this retrospective multiple-center study. Univariate and multivariate analyses were performed to identify the clinical factors and semantic features of MRI scans. Radiomics features were extracted from five MRI sequences using radiomics software. Three feature selection methods and six classifiers were evaluated in the training cohort to construct favorable radiomic machine-learning classifiers. The performance of different classifiers was evaluated using the AUC and compared to neuroradiologists. The detection rates of T1WI, T2WI, and CE-T1WI for parasellar cavernous hemangiomas and meningiomas were approximately 100%. In contrast, the ADC maps had the detection rate of 18/22 and 19/25, respectively, (AUC, 0.881) with 2.25 cm as the critical value diameter. Radiomics models with the SVM and KNN classifiers based on T2WI and ADC maps had favorable predictive performances (AUC > 0.90 and F-score value > 0.80). These models outperformed MRI model (AUC 0.805) and neuroradiologists (AUC, 0.756 and 0.545, respectively). Radiomic models based on T2WI and ADC and combined with SVM and KNN classifiers have the potential to be a viable method for differentiating parasellar hemangiomas from meningiomas. T2WI is more universally applicable than ADC values due to its higher detection rate for parasellar tumors.
Lactobacillus plantarum S9 alleviates lipid profile, insulin resistance, and inflammation in high-fat diet-induced metabolic syndrome rats
Authors: Zhao Lei , Shen Yunjiao , Wang Yunlong , Wang Lei , Zhang Lin , Zhao Zijian , Li Shengyu
Published: September 2022

Probiotics are considered to play an crucial role in the treatment of high-fat diet (HFD)-induced lipid metabolic diseases, including metabolic syndrome (MS). This study aimed to investigate the effects of Lactobacillus plantarum S9 on MS in HFD-fed rats, and to explore the underlying role of probiotics in the treatment of MS. Sprague-Dawley rats were fed with HFD for 8 weeks, followed by the treatment of L. plantarum S9 for 6 weeks, and The body weight and blood glucose level of rats were detected on time. The results showed that L. plantarum S9 significantly decreased the body weight gain, Lee’s index, and liver index. Additionally, L. plantarum S9 reduced the levels of serum lipids and insulin resistance. L. plantarum S9 also decreased the levels of alanine aminotransferase (ALT) and aspartate transaminase (AST) in liver. Moreover, the serum levels of MS-related inflammatory signaling molecules, including lipopolysaccharide (LPS) and tumor necrosis factor-α (TNF-α), were significantly elevated. Western blot analysis showed that L. plantarum S9 inhibited the activation of nuclear factor-κB (NF-κB) pathway, decreased the expression level of Toll-like receptor 4 (TLR4), suppressed the activation of inflammatory signaling pathways, and reduced the expression levels of inflammatory factors in HFD-fed rats. Moreover, it further decreased the ratios of p-IκBα/IκBα, p-p65/NF-κB p65, and p-p38/p38. In summary, L. plantarum S9, as a potential functional strain, prevents or can prevent onset of MS.
A Late Devonian tree lycopsid with large strobili and isotomous roots
Authors: Liu Le , Wang De-Ming , Zhou Yi , Qin Min , Ferguson David K. , Meng Mei-Cen
Published: September 2022

Tree lycopsids prospered in the Late Devonian and constituted a major part of the Late Paleozoic forest ecosystem that deeply impacted the Earth’s climate. However, the fertile organs of these early tree lycopsids display low morphological disparity, which has hampered further knowledge about their ecological habit. Here, we report Omprelostrobus gigas gen. et sp. nov. from the Upper Devonian (Famennian) Wutong Formation at Changxing, Zhejiang, China. The collection includes aerial axes, strobili and associated roots. The strobili are the largest among coeval lycopsids to our knowledge, and are divided into proximal and distal portions by dimorphic sporophylls with differentiated laminae and probable strong photosynthetic capacity. The associated but not attached roots displaying multiple isotomous branches lack rootlets and typical rootlet scars. The varied strobili sizes of early tree lycopsids were relatively independent of their body plan, but the large strobili could suggest increased reproductive investment to overcome the disadvantages of the disturbed flooded habitat.
Iron-dependent mutualism between Chlorella sorokiniana and Ralstonia pickettii forms the basis for a sustainable bioremediation system
Authors: Rawat Deepak , Sharma Udita , Poria Pankaj , Finlan Arran , Parker Brenda , Sharma Radhey Shyam , Mishra Vandana
Published: September 2022

Phototrophic communities of autotrophic microalgae and heterotrophic bacteria perform complex tasks of nutrient acquisition and tackling environmental stress but remain underexplored as a basis for the bioremediation of emerging pollutants. In industrial monoculture designs, poor iron uptake by microalgae limits their productivity and biotechnological efficacy. Iron supplementation is expensive and ineffective because iron remains insoluble in an aqueous medium and is biologically unavailable. However, microalgae develop complex interkingdom associations with siderophore-producing bacteria that help solubilize iron and increase its bioavailability. Using dye degradation as a model, we combined environmental isolations and synthetic ecology as a workflow to design a simplified microbial community based on iron and carbon exchange. We established a mutualism between the previously non-associated alga Chlorella sorokiniana and siderophore-producing bacterium Ralstonia pickettii. Siderophore-mediated increase in iron bioavailability alleviated Fe stress for algae and increased the reductive iron uptake mechanism and bioremediation potential. In exchange, C. sorokiniana produced galactose, glucose, and mannose as major extracellular monosaccharides, supporting bacterial growth. We propose that extracellular iron reduction by ferrireductase is crucial for azoreductase-mediated dye degradation in microalgae. These results demonstrate that iron bioavailability, often overlooked in cultivation, governs microalgal growth, enzymatic processes, and bioremediation potential. Our results suggest that phototrophic communities with an active association for iron and carbon exchange have the potential to overcome challenges associated with micronutrient availability, while scaling up bioremediation designs.
Effect of polyurethane structure on arsenic adsorption capacity in nanofibrous polymer/ferrous sulphate-based systems
Authors: Domincova Bergerova Eva , Kimmer Dusan , Kovarova Miroslava , Lovecka Lenka , Vincent Ivo , Drohsler Petra , Adamec Vladimir , Kobolova Klaudia , Sedlarik Vladimir
Published: September 2022

Polyurethane-based nanofibrous structures can be used as adsorbents for arsenic in water. Their adsorption capacity can be significantly increased by doping the structure with ferrous sulphate.
Introduction to the special collection in memoriam of Susan A. Odom (16 November 1980–18 April 2021)
Authors: Augustyn Veronica , Hatzell Kelsey B. , Jeffries-EL Malika , Lutkenhaus Jodie L. , Stingelin Natalie
Published: September 2022

The materials chemistry and electrochemistry communities celebrate Susan’s scientific impact and collaborative spirit with this themed issue.
The role of molecular fluorophores in the photoluminescence of carbon dots derived from citric acid: current state-of-the-art and future perspectives
Authors: Kasprzyk Wiktor , Świergosz Tomasz , Romańczyk Piotr P. , Feldmann Jochen , Stolarczyk Jacek K.
Published: September 2022

The recent progress in the use of molecular state theory for explanation of the structure–property relationship in carbon dots is summarized.
Union carbide polymerization catalysts: from uncovering active site structures to designing molecularly-defined analogs
Authors: Trummer David , Nobile Anna Giorgia , Payard Pierre-Adrien , Ashuiev Anton , Kakiuchi Yuya , Klose Daniel , Jeschke Gunnar , Copéret Christophe
Published: September 2022

A combined SOMC and DFT studies on the Union Carbide catalyst enable to propose that Cr(iii)-H, formed at high-loading, are active in ethylene polymerization. We therefore design a well-defined supported CpCr(iii)-R ethylene polymerization catalyst.
Bolus Texture Testing as a Clinical Method for Evaluating Food Oral Processing and Choking Risk: A Pilot Study
Authors: Bandini Andrea , Gandhi Pooja , Sutton Danielle , Steele Catriona M.
Published: September 2022

Purpose:

Choking on food is a leading cause of accidental death in several populations, including children, people with intellectual/developmental disability, and older adults in residential care facilities. One contributor to choking risk is incomplete oral processing and failure to convert food to a cohesive, nonsticky bolus with a maximum particle size that will not block the airway. Clinical tests of mastication do not evaluate properties of chewed food boluses. We characterized expectorated boluses, after oral processing, using methods developed by the International Dysphagia Diet Standardisation Initiative (IDDSI).

Method:

Seventeen adults without dysphagia (seven women and 10 men), aged 23–55 years, chewed samples of a cracker, a raw baby carrot, and a circular, dome-shaped gummy candy. Chewing metrics were obtained up to the point when the person indicated that they were ready to swallow. The bolus was then either expectorated or swallowed; IDDSI tests were used to characterize the expectorated boluses.

Results:

Measures of chewing did not differ between spit and swallow conditions. Expectorated cracker and carrot boluses had maximum particle size consistent with IDDSI Level SB6 Soft & Bite-Sized foods or lower. The gummy candy samples remained at IDDSI Level RG7 Regular food consistency.

Conclusions:

This study suggests that expectorated ready-to-swallow boluses are representative of boluses that are swallowed and that oral processing in adults without dysphagia typically results in boluses at IDDSI's Level SB6 or lower. IDDSI's testing methods provide a practical method for evaluating oral processing by characterizing expectorated ready-to-swallow boluses and may guide food texture recommendations for persons who have increased risk of choking.
Liens dans une équipe pluridisciplinaire de pédopsychiatrie
Authors: Tavares Manuel , Billon Juliette , Evellin Isabelle , Die Saez Kristell , Levivier Ana-Paula , Huber Fabienne
Published: September 2022

Les auteurs rappellent la nécessité, pour un secteur de pédopsychiatrie, d’être constitué d’une équipe pluridisciplinaire, permettant une diversité des approches cliniques, pour mieux tenir compte de la complexité du fonctionnement mental de l’enfant.

Les auteurs insistent sur le besoin de passer d’une clinique de la classification à une clinique de l’accompagnement et de l’engagement de la part du thérapeute, de dépasser le seul modèle médical pour s’élargir à d’autres modèles, contribuant à la mise en place d’une « clinique de situation ».

Dans le Service de pédopsychiatrie du CHU de Reims, l’équipe du Centre-Médico-Psychologique s’est appuyée sur un fonctionnement basé sur un concept dénommé « Direction de Cure ». Il s’agit ici de créer un lien de travail rassemblant l’enfant et sa famille, voire d’autres partenaires, tout au long de la cure pédopsychiatrique, quelle qu’en soit la durée.

Une institution ne pouvant être thérapeutique que si elle développe une certaine cohérence à partir de ses différences, en prenant soin du fonctionnement institutionnel multi-référentiel. Est mis en évidence l’importance d’un réel travail thérapeutique se basant sur le tissage des liens et sur un partage et une intégration des expériences, permettant ainsi l’expression d’une véritable intelligence collective.
Ist die ASV-Therapie eine Überdruck- oder eine Beatmungstherapie?
Ein Vergleich des SBH am Tag und unter ASV
Authors: Barleben André , Allrich Marika , Grüning Wolfram
Published: September 2022

Ziel dieser Arbeit war es, festzustellen, ob die Therapie mit einer adaptiven
ServoVentilation (ASV) zu einer Hypokapnie und Alkalose führt. Dazu wurde der
Säure-Basen-Status (SBH) mit Kohlendioxid- und Sauerstoffpartialdruck im arterialisiertem Blut
(pCO2 und pO2), Standartbicarbonat (SBC) und pH am Tag spontan atmend und nachts unter ASV
gemessen. Auslöser dieser Arbeit war u.a. das Ergebnis der SERVE-HF Studie, welche bei
Patienten mit einer Herzinsuffizienz und linksventrikulärer Ejektionsfraktion <45% unter
der ASV ein erhöhtes Mortalitätsrisiko fand. Es gab u.a. die Vermutung eines
Gerätealgorithmus-basierten Effektes. Als möglicher Faktor wurde diskutiert, ob die minimale
Druckunterstützung (PSmin) von 3 cmH2O über eine respiratorische Alkalose einen
pro-arrhytmogenen Effekt hat. Eine Studie von Patienten mit therapie-assoziierter zentraler
Schlafapnoe (treatment emergent central sleep apnea,TECSA) und normaler Herzfunktion verglich
4 ASV-Geräte (J. Knitter et al. Comparison of Performance of Four Adaptive Servo Ventilation
Devices in Patients with Complex Sleep Apnea, Sleep 2018 Vol. 41 Pages A203-A204). Es fand
sich ein signifikant höheres Atemminutenvolumen nur mit dem in der SERVE-HF- Studie
verwendeten Gerät. Somit könnte diese Hyperventilation ein Geräte-und kein Klasseneffekt
sein.

Patienten 226 Patienten, die zur Verlaufskontrolle oder
Neueinstellung der ASV von 10/2018 bis 03/2020 kamen: Alter 65,2±11,3 Jahre, BMI
35,7±7,5kg/m2, Gesamtnutzungsdauer 5530±5400 h, 5,6±2,5 h/d, PSmin 4,9±1,8
cmH2O. Alle Patienten hatten eine regelrechte linksventrikuläre Funktion, der
Großteil hatte die ASV wegen TECSA, selten eine kardiale oder ganz selten eine andere
Genese.

Ergebnisse Bei 29 Patienten(12,8%) fand sich eine Hypokapnie mit
pCO2 morgens < 36 mmHg.

Schlussfolgerung Unter ASV konnten wir bei unseren nichtherzinsuffizienten Patienten eine
geringe, aber nicht signifikante Zunahme des pCO2 feststellen. Immerhin hatten 12,8% eine
Hypokapnie, die in der Hälfte der Fälle so relevant war, dass wir eine Modifikation der
Therapie vornahmen. Dies kann verschiedene Ursachen haben, eindeutige Kriterien konnten nicht
gefunden werden. Aber es besteht die Gefahr einer Hyperventilation, sodass unter ASV ein SBH
erfolgen sollte.
Increased Rate of Spontaneous Pneumothorax in Infants of COVID-19 Positive Mothers
Authors: Gürel Selçuk , Yıldırım Şule
Published: September 2022

Objective The epidemiological and clinical characteristics of neonates born to women infected with coronavirus disease 2019 (COVID-19) during pregnancy were assessed, and the correlation between this infection and spontaneous pneumothorax in neonates born to mothers with COVID-19 was evaluated in the present study.

Methods Records of 14 neonates in the neonatal intensive care unit with pneumothorax were collected and analyzed. Pregnant women were routinely screened for COVID-19 before birth. This study only included the neonates of mothers positive for severe acute respiratory syndrome coronavirus 2 immunoglobulin Mand immunoglobulin G and developing spontaneous pneumothorax. Antenatal, natal and postnatal risk factors, data related to demographic, epidemiological and clinical characteristics, treatment strategies, and breastfeeding history were obtained from medical records.

Results The gestational age of the 14 neonates was 30 to 38 weeks. One male infant was born by normal spontaneous vaginal delivery, while all other infants were born by C-section. Though the mothers did not have a diagnosis of COVID-19 in their charts, they all reported one or more symptoms when interviewed. No mother had received a COVID-19 vaccination before or during pregnancy. No mother had undergone a hospital visit or doctor examination due to suspicion of COVID and COVID polymerase chain reaction test. COVID antibody titers were present during admission to hospital before birth.

Conclusion The infants of pregnant cases with symptomatic or asymptomatic COVID-19 may develop respiratory distress and pneumothorax. Observational data obtained from case series similar to what is presented here may be accepted as a potential first step to producing hypotheses to test with preclinical or clinical models if it can be expanded in larger cohorts.
Real space study of local bonding for zinc structure based on temperature-dependent x-ray pair distribution function analysis
Authors: Masadeh Ahmad S. , Shatnawi Moneeb T. M. , Abu Waar Ziad Y. , Alzoubi Gassem M. , Ren Yang
Published: September 2022

Zinc metal has a hexagonal close packing hcp structure with an unusual axial ratio c/a. This work presents the local atomic structure analysis of elemental zinc using the x-ray atomic pair distribution function (PDF) method and total synchrotron x-ray scattering in the temperature range of 100–300 K. In this PDF study, we determined the evolution of local bonding in zinc structure in the temperature range of 100–300 K by fitting the first two peaks in the radial distribution function (RDF), R(r), with two Gaussian peaks. Our local structure results reveal a piece of evidence for unusual bond length behavior at low temperatures. The PDF analysis revealed that the a-axis varies linearly from 300 to 160 K and remains constant below 160 K. This local structural result indicates that at temperatures below 160 K, the Zn–Zn bonds are no longer thermally contractible in the ab plane, in agreement with standard crystallographic analysis [J. Nuss et al., Z. Anorg. Allg. Chem. 636, 309 (2010)]. Another significant observation is that the local thermal expansion for the a-axis was found to be three times larger than the one obtained using conventional crystallographic methods [U. Wedig et al., Z. Anorg. Allg. Chem. 639, 2036 (2013)]. This PDF result shows the advantage of total scattering PDF methods in studying the local structural features in elemental zinc, which cannot be captured by the crystallographic model. In addition, this PDF study demonstrates that multiple RDF-peak fitting is a useful approach for interpreting the local structural features of such a non-ideal hcp structure.
Интерпретация авторского символа в литературном тексте и возможность его перевода
Authors: Pejanović Ana
Published: September 2022

The paper aims at the possible interpretation of the author’s symbol and the potential problem of its accurate
translation into Russian. On the notable example of Njegoš’ lyrical poem A Night More Precious than a Century we presented the
specific algorithm of the decoding procedure in deciphering the complex semantics of the author’s symbol, as well as the method of
finding its translation equivalent in the Russian language. The analysis starts from the point of view of modern translatology,
linguistics, and literary studies and adequately takes into account the relevant data of Njegoshology, as an interdisciplinary
science. To elucidate the complex nature of the symbol, as a linguistic sign and its function in the literary text, as well as the
possibility of its translation into Russian, various methods were applied: contrastive, etymological, interpretive analysis in the
synchronic and diachronic plane. The conducted analysis illustrates the fundamental importance of attentively examining symbols
from various aspects, starting from the most elementary linguistic level within the source language, through the literary in the
style of the epoch and the idiostyle of the prominent writer and concluding with the interlingual translatological approach. This
multifaceted interpretation contributes to resolving the semantics of the symbol and finding its translation equivalent.
Pressure-induced novel structure with graphene-like boron-layer in titanium monoboride
Authors: Jin Yuan-Yuan , Zhang Jin-Quan , Ling Shan , Wang Yan-Qi , Li Song , Kuang Fang-Guang , Wu Zhi-Yan , Zhang Chuan-Zhao
Published: September 2022

The recent discovery of the novel boron-framework in boron-rich metal borides with complex structures and intriguing features under high pressure has stimulated the search into the unique boron-network in the metal monoborides or boron-deficient metal borides at high pressure. Herein, based on the particle swarm optimization algorithm combined with first-principles calculations, we thoroughly explored the structural evolution and properties of TiB up to 200 GPa. This material undergoes a pressure-induced phase transition of Pnma → Cmcm → Pmmm. Besides of two known phases Pnma and Cmcm, an unexpected orthorhombic Pmmm structure was predicted to be energetically favored in the pressure range of 110.88–200 GPa. Intriguingly, the B covalent network eventually evolved from a one-dimensional zigzag chain in Pnma-TiB and Cmcm-TiB to a graphene-like B-sheet in Pmmm-TiB. On the basis of the microscopic hardness model, the calculated hardness (H
v) values of Pnma at 1 atm, Cmcm at 100 GPa, and Pmmm at 140 GPa are 36.81 GPa, 25.17 GPa, and 15.36 GPa, respectively. Remarkably, analyses of the density of states, electron localization function and the crystal orbital Hamilton population (COHP) exhibit that the bonding nature in the three TiB structures can be considered as a combination of the B–B and Ti–B covalent interactions. Moreover, the high hardness and excellent mechanical properties of the three TiB polymorphs can be ascribed to the strong B–B and Ti–B covalent bonds.
An optimized smearing scheming for first Brillouin zone sampling and its application on thermal conductivity prediction of graphite
Authors: Li Chengye , Zhao Changying , Gu Xiaokun
Published: September 2022

We propose an optimized scheme to determine the smearing parameter in the Gaussian function that is used to replace the Dirac δ function in the first Brillouin zone sampling. The broadening width is derived by analyzing the difference of the results from the phase-space method and Gaussian broadening method. As a demonstration, using the present approach, we investigate the phonon transport in a typical layered material, graphite. Our scheme is benchmarked by comparing with other zone sampling methods. Both the three-phonon phonon scattering rates and thermal conductivity are consistent with the prediction from the widely used tetrahedron method and adaptive broadening method. The computational efficiency of our scheme is more than one order of magnitude higher than the two other methods. Furthermore, the effect of four-phonon scattering in phonon transport in graphite is also investigated. It is found that four-phonon scattering reduces the through-plane thermal conductivity by 10%. Our methods could be a reference for the prediction of thermal conductivity of anisotropic material in the future.
Translation and Cross-Cultural Adaptation of the “Early Support Monitoring Protocol”
Authors: de Albuquerque Suzana Cinthia Silva Oliveira , Marques Leonardo Brandão , Santana Pinto Ig Ibert Bittencourt , Van der Ley Quintela Júlia Carvalho
Published: September 2022

Parents are required to make various decisions after a child’s hearing loss diagnosis. With that in mind, one of the researchers of this study, the father of a child with deaf, did not find any available instrument in the Brazilian literature to support was found to the decision-making process for parents. Considering the importance of assisting parents, caretakers, and professionals who work with Deaf and Hard of Hearing children to monitor and assess the child’s development, this work aims to translate and adapt a monitoring protocol for professionals and parents. For this, we translated and cross-culturally adapted 452 items of the Early Support instrument. The items corresponded to the domains of communication, attention, listening, and vocalization. We selected 25% of the items to be assessed by specialists, which were divided into the categories: (1) cultural adequacy; (2) concept presented; and (3) target audience adequacy. A reverse translation was conducted in this stage of the research. After compiling the data and correcting the probable translation errors, it was possible to analyze the items that were not included in the specialists’ assessment and propose an assessment with new items. Afterward, the translated items were compared with the reviewed version of the instrument (Success From the Start), which comprises 347 items of the two development domains.
Multi-Layered Civil Society Documentation of Human Rights Violations in Myanmar: The Potential for Accountability and Truth-Telling
Authors: Matelski Maaike , Dijkstra Rachel , McGonigle Leyh Brianne
Published: September 2022

Serious human rights violations, particularly against ethnic minorities, have been a stark reality in Myanmar for many decades. The Rohingya crisis that deteriorated in 2017 and the ongoing abuses in areas of armed conflict such as Kachin, Rakhine, and Shan States, and more recently in response to anti-coup protests, demonstrate the recurrence of violence and trauma. During these decades of violence and ongoing violations, civil society initiatives inside and outside the country have attempted to monitor and document human rights abuses in order to contribute towards accountability and truth-telling. Despite the vast array of civil society documentation efforts, this work has sparked limited scholarly debate, especially concerning the complexities of existing multi-layered systems of documentation. This article analyses the current scope of documentation work related to serious human rights violations in Myanmar and the methods, standards, and audiences of various initiatives. We distinguish three layers of civil society documentation: (i) initiatives carried out on the local level in Myanmar and the various border areas; (ii) initiatives carried out by the refugee and diaspora communities; and (iii) third-party initiatives. We then analyse two elements that complicate documentation efforts, namely the risk of ‘over-documentation’, and issues of hierarchy and contestation. These challenges make clear the value of strengthening partnerships and cooperation for all groups involved in documentation work that aims to promote and protect human rights. We end by cautiously considering the potential impact, value, and limitations of Myanmar’s multi-layered documentation efforts for accountability and truth-telling in the aftermath of the 2021 military coup.
Transcranial magnetic stimulation (TMS) seeded tractography provides superior prediction of eloquence compared to anatomic seeded tractography
Authors: Muir Matthew , Prinsloo Sarah , Michener Hayley , Shetty Arya , de Almeida Bastos Dhiego Chaves , Traylor Jeffrey , Ene Chibawanye , Tummala Sudhakar , Kumar Vinodh A , Prabhu Sujit S
Published: September 2022

Background

For patients with brain tumors, maximizing the extent of resection while minimizing postoperative neurological morbidity requires accurate preoperative identification of eloquent structures. Recent studies have provided evidence that anatomy may not always predict eloquence. In this study, we directly compare transcranial magnetic stimulation (TMS) data combined with tractography to traditional anatomic grading criteria for predicting permanent deficits in patients with motor eloquent gliomas.

Methods

We selected a cohort of 42 glioma patients with perirolandic tumors who underwent preoperative TMS mapping with subsequent resection and intraoperative mapping. We collected clinical outcome data from their chart with the primary outcome being new or worsened motor deficit present at 3 month follow up, termed “permanent deficit”. We overlayed the postoperative resection cavity onto the preoperative MRI containing preoperative imaging features.

Results

Almost half of the patients showed TMS positive points significantly displaced from the precentral gyrus, indicating tumor induced neuroplasticity. In multivariate regression, resection of TMS points was significantly predictive of permanent deficits while the resection of the precentral gyrus was not. TMS tractography showed significantly greater predictive value for permanent deficits compared to anatomic tractography, regardless of the fractional anisotropic (FA) threshold. For the best performing FA threshold of each modality, TMS tractography provided both higher positive and negative predictive value for identifying true nonresectable, eloquent cortical and subcortical structures.

Conclusion

TMS has emerged as a preoperative mapping modality capable of capturing tumor induced plastic reorganization, challenging traditional presurgical imaging modalities.
Preoperative Blood Loss of Isolated Acetabular Fractures
Authors: McGee Andrew , Obinwa Chibuike , White Parker , Cichos Kyle , McGwin Gerald , Bergin Patrick , Spitler Clay
Published: September 2022

Objective:

To quantify preoperative blood loss in isolated acetabular fractures and identify any fracture or patient characteristics associated with increased blood loss or blood transfusion.

Design:

Retrospective cohort study.

Setting:

Two level 1 trauma centers.

Patients/Participants:

All patients with operative, isolated acetabular fractures from January 2010 to December 2018.

Intervention:

Operative management of an acetabular fracture.

Main Outcome Measurements:

Volume of preoperative blood loss and transfusion rates associated with isolated acetabular fracture patterns.

Results:

A total of 598 patients were included. The mean preoperative blood loss of all fractures was 1172.6 mL. The 3 fracture patterns with the greatest average preoperative blood loss were associated both column (1454.9 mL), T-type (1374.8 mL), and anterior column posterior hemitransverse fractures (1317.7 mL). The acetabular fracture pattern had a significant association with preoperative blood loss and preoperative transfusion. The timing from injury to surgery and body mass index were significantly associated with preoperative blood loss.

Conclusions:

In conclusion, operatively treated isolated acetabular fractures surprisingly lose an average of greater than 1 liter of blood in the preoperative setting. Surgeons must carefully assess patient's physiology, ensuring they are adequately resuscitated before surgery and remain aware that increasing body mass index is associated with increased preoperative blood loss. However, as patients await surgery, unreduced acetabular fractures continue to contribute to ongoing blood loss beyond the first 24 hours from injury. We believe the best hemostasis after initial resuscitation is provided by surgical reduction and fixation, and we recommend a continued early surgical intervention to prevent continued bleeding from fracture surfaces.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Consensus and inconsistency between different consensus documents on renal denervation worldwide: the way forward
Authors: Wang Tzung-Dau
Published: September 2022

Given the unsatisfactory hypertension control rates and high rates of non-adherence to antihypertensive medications worldwide, device therapy which can safely provide durable blood pressure-lowering effects can fulfill the unmet need. A series of second-generation randomized sham-controlled renal denervation (RDN) trials have demonstrated the efficacy and safety of RDN in a wide range of hypertensive patients. The four representative consensus documents on RDN (from the Taiwan Hypertension Society and Taiwan Society of Cardiology [THS/TSOC 2019], Asia Renal Denervation Consortium 2019, European Society of Hypertension [ESH 2021], and Society for Cardiovascular Angiography & Intervention and National Kidney Foundation [SCAI/NKF 2021]) consistently recommend RDN as an alternative or complementary treatment strategy for patients with uncontrolled hypertension. In addition, both documents from Asia further recommend that RDN can be considered as an initial treatment strategy for drug-naïve hypertensive patients. There is still inconsistency regarding whether ambulatory blood pressure monitoring should be used routinely both before and after RDN, and whether patients with a secondary cause of hypertension could be treated with RDN if their blood pressure remains uncontrolled after definitive treatment (treatment-resistant secondary hypertension). The THS/TSOC consensus provides acronyms to summarize key aspects of patient selection (RDNi2) and pre-RDN assessments (RAS). The ESH and SCAI/NKF documents recommend establishing structured pathways for clinical practice and issues regarding reimbursement. All documents identify knowledge gaps in RDN, from identifying predictors of super-responders to demonstrating effects on cardiovascular events. These gaps should be urgently filled to facilitate the wider application of this device therapy for patients with hypertension.
Efficacy of different doses of intranasal dexmedetomidine in preventing emergence agitation in children with inhalational anaesthesia
Authors: Lei Dong-Xu , Wu Chun-Ju , Wu Ze-Yan , Wang Ling-Yu , Zhao Qing , She Ying-Jun
Published: September 2022

BACKGROUND

Emergence agitation is a common paediatric complication after inhalational anaesthesia. Intranasal dexmedetomidine can prevent emergence agitation effectively, but the optimal dose is uncertain.

OBJECTIVE

The aim of our study was to investigate the 95% effective dose (ED95) of intranasal dexmedetomidine for the prevention of emergence agitation after inhalational anaesthesia for paediatric ambulatory surgery.

DESIGN

A prospective, randomised, placebo-controlled, double-blind, clinical trial.

SETTING

The study was conducted in Guangzhou Women and Children's Medical Center in China from August 2017 to December 2018.

PATIENTS

Three hundred and eighteen children scheduled for ambulatory surgery were enrolled into two age groups of less than 3 years and at least 3 years.

INTERVENTIONS

The children in each age group were randomised into five equal subgroups to receive either intranasal dexmedetomidine 0.5, 1.0, 1.5 or 2.0 μg kg−1 (Groups D0.5, D1.0, D1.5 and D2.0), or intranasal isotonic saline (group C) after induction.

MAIN OUTCOME MEASURES

The primary outcome was the ED95 dose of intranasal dexmedetomidine for preventing emergence agitation after inhalational anaesthesia for paediatric ambulatory surgery.

RESULTS

The incidences of emergence agitation for Groups C, D0.5, D1.0, D1.5 and D2.0 were 63, 40, 23, 13 and 3% in children less than 3 years, and 43, 27, 17, 7 and 3% in children at least 3 years. The ED95 of intranasal dexmedetomidine for preventing emergence agitation was 1.99 μg kg−1 [95% confidence interval (CI), 1.83 to 3.80 μg kg−1] in children less than 3 years, and 1.78  μg kg−1 (95% CI, 0.93 to 4.29 μg kg−1) in children at least 3 years. LMA removal time for groups D1.5 and D2.0 was 9.6 ± 2.2 and 9.7 ± 2.5 min, respectively, for children less than 3 years, and 9.4 ± 2.0 and 9.9 ± 2.7 min in children at least 3 years, respectively. Length of stay in the postanaesthesia care unit for Groups D1.5 and D2.0 was 34.3 ± 9.6 and 37.1 ± 11.2 min, respectively, in children less than 3 years, and 34.7 ± 10.2 and 37.3 ± 8.3 min in children at least 3 years, respectively. These times were longer in the D1.5 and D2.0 subgroups than in the control subgroup in the two age groups of less than 3 years and at least 3 years, respectively: 7.2 ± 1.9 min in children less than 3 years and 7.3 ± 2.5 min in children at least 3 years for LMA removal time, 22.2 ± 7.9 min in children less than 3 years and 22.0 ± 7.7 min in children at least 3 years for PACU stay time in control subgroup, respectively; P < 0.05).

CONCLUSION

Intranasal dexmedetomidine prevented emergence agitation after paediatric surgery in a dose-dependent manner. The optimal dose of intranasal dexmedetomidine for preventing emergence agitation was higher in younger children.

TRIAL REGISTRY

chictr.org.cn: ChiCTR-IOR-17012415.
Comparative visual outcomes of EDOF intraocular lens with FLACS vs conventional phacoemulsification
Authors: Xu Jia , Li Wenbo , Xu Zhe , Zhao Binsong , Zhong Yueyang , Wang Kai , Liu Xin , Song Xiaohui , Yu Yinhui , Zhu Yanan , Tang Qiaomei , Yao Ke
Published: September 2022

Purpose:

To investigate the visual quality after femtosecond laser–assisted cataract surgery (FLACS) and conventional phacoemulsification surgery (CPS) with the implantation of an extended depth-of-focus (EDOF) intraocular lens (IOL) TECNIS Symfony.

Setting:

Eye Center, the Second Affiliated Hospital of Zhejiang University, Zhejiang, China.

Design:

Prospective cohort study.

Methods:

Patients were given the option to choose FLACS or CPS and were implanted with a TECNIS Symfony. Main outcome measures were postoperative examinations that included defocus curves, contrast sensitivity (CS), optic path difference aberrometry scan, anterior segment photography, and questionnaires.

Results:

261 patients (261 eyes) were enrolled. The circularity index of FLACS was more precise than that of CPS (P = .001). FLACS demonstrated a significantly lower IOL decentration (P = .011) and IOL tilt (P = .009). FLACS presented a significantly lower total aberration (P < .001), higher-order aberrations (HOAs) (P = .001), coma (P = .001), and spherical aberration (P < .001). With IOL decentration of more than 0.40 mm, total internal aberration (P = .023) and HOAs (P = .045) were significantly deteriorated. As for defocus curve, FLACS was better at −1.00 diopter (P < .01). The FLACS group achieved higher CS at 6 to 18 cycles per degree under glare condition (P < .05). With regard to photic phenomena, the FLACS group received better outcomes (P < .05).

Conclusions:

With the implantation of an EDOF IOL, FLACS could precisely control the shape and size of the capsulotomy and induce a significantly better-centered IOL, leading to higher visual performance compared with CPS.
Stigma Toward Mental Illness Among Saudi Medical Students
Authors: Almadani Ahmad H. , AbuDujain Nasser M. , Aljebreen Shahad M. , AlJaffer Mohammed A.
Published: September 2022

This cross-sectional study aims to compare pre- versus post-psychiatry course stigma levels toward mental illnesses among King Saud University medical students and identify which factors could affect stigma degree. The sample included 384 randomly chosen students. The overall scores of the used scale, the 15-item Opening Minds Scale for Healthcare Providers (OMS-HC-15), indicated no statistically significant difference between the before- and the after-psychiatry-course groups. The univariate analysis for differences in OMS-HC-15 score according to the sociodemographic characteristics of the pre psychiatry course group indicated that the factors associated with the total OMS-HC-15 score were sex (p < 0.001), being diagnosed with mental illness (p < 0.001), and having a relative diagnosed with mental illness (p = 0.005). Among the post psychiatry course group, the univariate analysis indicated that the same factors, namely, sex (p = 0.001), being diagnosed with mental illness (p = 0.006), and having a relative diagnosed with mental illness (p = 0.007), were associated with the total OMS-HC-15 score. Further studies at a larger scale to confirm generalizability of the results are warranted.
Single-cell profiling identifies a CD8brightCD244brightNatural Killer cell subset that reflects disease activity in HLA-A29-positivebirdshot chorioretinopathy
Authors: Nath Pulak R. , Maclean Mary , Nagarajan Vijay , Lee Jung Wha , Yakin Mehmet , Kumar Aman , Nadali Hadi , Schmidt Brian , Kaya Koray D. , Kodati Shilpa , Young Alice , Caspi Rachel R. , Kuiper Jonas J. W. , Sen H. Nida
Published: September 2022

Birdshot chorioretinopathy uveitis (BCR-UV) is strongly associated with HLA-A29 which implicates MHC-I pathway mediated perturbation of natural killer (NK) cells as a potential disease mechanism. We profiled blood NK cells at single-cell resolution in a cohort of patients and healthy controls and investigated the links between NK cell subpopulations and disease activity. Flow cytometry analysis of major immune cell lineages revealed substantial expansion of the CD56dimCD16+ NK cells in BCR-UV compared to healthy controls and to other types of non-infectious uveitis.Ex vivorestimulation showed that NK cells from BCR-UV patients exhibit increased secretion of TNF-alpha, a cytokine considered central to the pathogenesis of BCR-UV. Unbiased transcriptomic characterization at single-cell resolution established that the expanded CD16+ (i.e.,FCGR3A+) NK cells also co-express high levels ofCD8AandCD244, indicating expansion of a subset of CD56dimCD16+ CD8+ NK cells in patients. Confirmation of these results by high-dimensional flow cytometry further showed that the BCR-UV-associated CD8brightCD244brightNK cells displayed activation receptors including CD314 (NKG2D), and cytotoxicity receptor CD337 (NKp30). Finally, longitudinal monitoring of patients showed that clinical remission after systemic immunomodulatory treatment correlated with a significant decrease in CD8brightCD244brightNK cells. In conclusion, there is an expansion of CD8brightCD244brightNK cells during active disease in BCR-UV patients which decrease upon successful systemic immunomodulatory treatment, suggesting that CD8bright/CD244brightNK cells may be a pro-inflammatory NK subset involved in the underlying disease mechanism.
Debiasing and Educational Interventions in Medical Diagnosis: A Systematic Review
Authors: Tung Arthur , Melchiorre Michael
Published: September 2022

Background

The prevalence of cognitive bias and its contribution to diagnostic errors has been documented in recent research. Debiasing interventions or educational initiatives are key in reducing the effects and prevalence of cognitive biases, contributing to the prevention of diagnostic errors. The objectives of this review were to 1) characterize common debiasing strategies implemented to reduce diagnosis-related cognitive biases, 2) report the cognitive biases targeted, and 3) determine the effectiveness of these interventions on diagnostic accuracy.

Methods

Searches were conducted on April 25, 2022, in MEDLINE, Embase, Healthstar, and PsycInfo. Studies were included if they presented a debiasing intervention which aimed to improve diagnostic accuracy. The Rayyan review software was used for screening. Quality assessments were conducted using the JBI Critical Appraisal Tools. Extraction, quality assessment, and analysis were recorded in Excel.

Results

Searches resulted in 2232 studies. 17 studies were included in the final analysis. Three major debiasing interventions were identified: tool use, education of biases, and education of debiasing strategies. All intervention types reported mixed results. Common biases targeted include confirmation, availability, and search satisfying bias.

Conclusion

While all three major debiasing interventions identified demonstrate some effectiveness in improving diagnostic accuracy, included studies reported mixed results when implemented. Furthermore, no studies examined decision-making in a clinical setting, and no studies reported long-term follow-up. Future research should look to identify why some interventions demonstrate low effectiveness, the conditions which enable high effectiveness, and effectiveness in environments beyond vignettes and among attending physicians.

PROSPERO registration number

CRD42022331128
Targeting caveolae to pump bispecific antibody to TGF-β into diseased lungs enables ultra-low dose therapeutic efficacy
Authors: Kadam Anil H. , Kandasamy Kathirvel , Buss Tim , Cederstrom Brittany , Yang Chun , Narayanapillai Sreekanth , Rodriguez Juan , Levin Michael D. , Koziol Jim , Olenyuk Bogdan , Borok Zea , Chrastina Adrian , Schnitzer Jan E.
Published: September 2022

The long-sought-after “magic bullet” in systemic therapy remains unrealized for disease targets existing inside most tissues, theoretically because vascular endothelium impedes passive tissue entry and full target engagement. We engineered the first “dual precision” bispecific antibody with one arm pair to precisely bind to lung endothelium and drive active delivery and the other to precisely block TGF-β effector function inside lung tissue. Targeting caveolae for transendothelial pumping proved essential for delivering most of the injected intravenous dose precisely into lungs within one hour and for enhancing therapeutic potency by >1000-fold in a rat pneumonitis model. Ultra-low doses (μg/kg) inhibited inflammatory cell infiltration, edema, lung tissue damage, disease biomarker expression and TGF-β signaling. The prodigious benefit of active vs passive transvascular delivery of a precision therapeutic unveils a new promising drug design, delivery and therapy paradigm ripe for expansion and clinical testing.
Impact of adverse event reporting system on burnout and job satisfaction of nurses in China: a nationwide cross-sectional study using a multilevel modeling approach
Authors: Chen Yanhua , He Yanrong , Wang Peicheng , Jiang Feng , Du Yanrong , Cheung Ming Yen , Liu Huanzhong , Liu Yuanli , Liu Tingfang , Tang Yi-lang , Zhu Jiming
Published: September 2022

IMPORTANCE

Many organizational and personal factors may contribute to burnout and poor job satisfaction experienced by nurses. Adverse Event Reporting System (AERS) is a key component of organizational-level quality improvement system which impacts workplace wellness for nurses. However, little is known about the underlying influence and mechanism that AERS have on nurse’ well-being.

OBJECTIVE

To explore the relationship between the implementation of AERS, burnout, and job satisfaction among psychiatric nurses in China. To uncover the mechanism through which AERS influences burnout and job satisfaction, while examining the mediating effect of workplace violence from patients.

DESIGN, SETTING, AND PARTICIPANTS

This cross-sectional study used the multilevel linear regression analyses with a national sample of 9,744 psychiatric nurses from 41 psychiatric hospitals across 29 provinces in China. Data collection was performed in March 2019, and the analyses were conducted from May to July 2022.

MAIN OUTCOMES AND MEASURES

The main outcomes were self-reported burnout and job satisfaction. Burnout was measured by the Maslach Burnout Inventory and job satisfaction was measured using Minnesota Satisfaction Questionnaire.

RESULTS

Among 9,744 nurses (mean [SD] age, 34.7 [8.8] years) interviewed, 8064 (82.8%) were female. AERS was positively associated with job satisfaction (β=3.70; p<0.05), but negatively with burnout (β=-3.42; p<0.01) and workplace violence (β=-0.55; p<0.1). Workplace violence was positively associated with burnout (β=2.27; p< 0.01), while negatively associated with job satisfaction (β=-0.81; p<0.01). Mediation analysis indicated that the association between AERS, burnout, and job satisfaction was mediated by workplace violence.

CONCLUSIONS AND RELEVANCE

This study highlights that the implementation of AERS is associated with less workplace violence in hospitals, and it may also contribute to lower levels of burnout and higher levels of job satisfaction among psychiatric nurses.

Key points

Question

How does hospital’s Adverse Event Reporting System (AERS) impact nurses’ well-being? What are the underlying mechanisms?

Findings

In this cross-sectional study of 9744 psychiatric nurses, nurses in hospitals with AERS reported significantly lower burnout and job dissatisfaction than those in hospitals without AERS. AERS seems to impact well-being by reducing workplace violence.

Meaning

Although Chinese authorities recently stipulated AERS, not all healthcare organizations have fully implemented it. Reporting and consequent quality improvement actions seem to alleviate workplace violence, especially in patient-provider relationship. This will inform hospital management to further leverage AERS for workplace well-being and satisfaction.