bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound-Based Noncontrast Microvascular Imaging for Evaluation of Breast Lesions: Imaging Techniques and Review of Diagnostic Criteria
Authors: Mohindra Namita , Soni Neetu
Published: March 2024

Vascularity plays a pivotal role in the progression of breast lesions and may be associated with their aggressiveness and likelihood of being malignant. Contrast-enhanced imaging techniques are necessary to evaluate vascularity due to the limited sensitivity of conventional color Doppler techniques, in which motion artifacts are eliminated using wall filters. However, in this process, low-flow signals from small vessels also get removed unintentionally. Advancements in technology have revolutionized the way ultrasound images are generated, resulting in tremendous improvements in Doppler imaging techniques. The new, ultrasound-based noncontrast microvascular imaging techniques overcome the limitations of conventional Doppler, and are highly sensitive for detecting microvessels and low flow. The resultant high Doppler sensitivity leads to detection of vascularity in more breast lesions. It is important for radiologists to understand the imaging principles and the clinical implications of the new techniques, to optimally utilize them and aid correct diagnosis. Angio-PLUS is one such recent advancement, which uses unfocused or plane waves and three-dimensional wall filtering to analyze tissue motion in time, space, and amplitude domains that effectively distinguish between blood flow and tissue. The information is beneficial for assessing the lesion vascularity without using contrast. This article aims to explain the Doppler imaging techniques, their clinical applications, scanning methods, and review the common Doppler-based diagnostic criteria used in the evaluation of breast lesions.
Deep unrolling networks with recurrent momentum acceleration for nonlinear inverse problems
Authors: Zhou Qingping , Qian Jiayu , Tang Junqi , Li Jinglai
Published: March 2024

Combining the strengths of model-based iterative algorithms and data-driven deep learning solutions, deep unrolling networks (DuNets) have become a popular tool to solve inverse imaging problems. Although DuNets have been successfully applied to many linear inverse problems, their performance tends to be impaired by nonlinear problems. Inspired by momentum acceleration techniques that are often used in optimization algorithms, we propose a recurrent momentum acceleration (RMA) framework that uses a long short-term memory recurrent neural network (LSTM-RNN) to simulate the momentum acceleration process. The RMA module leverages the ability of the LSTM-RNN to learn and retain knowledge from the previous gradients. We apply RMA to two popular DuNets—the learned proximal gradient descent (LPGD) and the learned primal-dual (LPD) methods, resulting in LPGD-RMA and LPD-RMA, respectively. We provide experimental results on two nonlinear inverse problems: a nonlinear deconvolution problem, and an electrical impedance tomography problem with limited boundary measurements. In the first experiment we have observed that the improvement due to RMA largely increases with respect to the nonlinearity of the problem. The results of the second example further demonstrate that the RMA schemes can significantly improve the performance of DuNets in strongly ill-posed problems.
Occupational skin dose from radionuclide contamination: one country’s approach at standardising skin dose estimates using Varskin+
Authors: Sharpe Katherine , McCallum Stephen , O’Neill Janice , Paterson Carolyn , McCormick Jennifer , Sexton Kate
Published: March 2024

The manipulation of unsealed radiopharmaceuticals by healthcare workers can cause accidental personal contamination leading to occupational radiation skin dose. The UK Ionising Radiations Regulations 2017 require that potential skin doses arising from reasonably foreseeable accident scenarios are included in risk assessments. Workers must be designated as classified if these dose estimates exceed 150 mSv equivalent dose averaged over 1 cm2. Updates from the UK Health and Safety Executive recently prompted many in the UK to review the classification of workers in Nuclear Medicine. Skin dose from contamination cannot be measured, it must be estimated. Varskin+ is a code that is widely recommended for estimating skin dose. The subjective choices made by users when defining modelled scenarios in Varskin+ lead to significant variation in the calculated skin doses. At the time of writing there is no definitive calculation method and all calculations rely on theoretical models. NHS Health Boards in Scotland have adopted a standardised framework for performing skin dose estimates for risk assessments. The parametric sensitivity of Varskin+ inputs were examined and the available evidence was reviewed. Generic, reasonably forseeable, worst-case accident scenarios were decided upon for: direct skin contamination, glove contamination and needlestick injury. Standardised inputs and assumptions for each scenario were compiled in a protocol that has been adopted by the Scottish Health Boards. The protocol allows for differences in practice between departments, but standardises most inputs. While significant uncertainty remains in the estimated skin doses, this approach reduces variation and enables the comparison of estimated skin doses between departments. The framework facilitates continuous improvement as more evidence is gathered to refine the standardised assumptions. Task by task skin dose estimates were made for workers in Nuclear Medicine in Scotland and many workers were designated classified as a result.
When should PIC simulations be applied to atmospheric pressure plasmas? Impact of correlation heating
Authors: Acciarri M D , Moore C , Beving L P , Baalrud S D
Published: March 2024

Molecular dynamics simulations are used to test when the particle-in-cell (PIC) method applies to atmospheric pressure plasmas. It is found that PIC applies only when the plasma density and macroparticle weight are sufficiently small because of two effects associated with correlation heating. The first is the physical effect of disorder-induced heating (DIH). This occurs if the plasma density is large enough that a species (typically ions) is strongly correlated in the sense that the Coulomb coupling parameter exceeds one. In this situation, DIH causes ions to rapidly heat following ionization. PIC is not well suited to capture DIH because doing so requires using a macroparticle weight of one and a grid that well resolves the physical interparticle spacing. These criteria render PIC intractable for macroscale domains. The second effect is a numerical error due to artificial correlation heating (ACH). ACH is like DIH in that it is caused by the Coulomb repulsion between particles, but differs in that it is a numerical effect caused by a macroparticle weight larger than one. Like DIH, it is associated with strong correlations. However, here the macroparticle coupling strength is found to scale as

Γ

w

2

/

3

, where Γ is the physical coupling strength and w is the macroparticle weight. So even if the physical coupling strength of a species is small, as is expected for electrons in atmospheric pressure plasmas, a sufficiently large macroparticle weight can cause the macroparticles to be strongly coupled and therefore heat due to ACH. Furthermore, it is shown that simulations in reduced dimensions exacerbate these issues.
Bogoliubov corner excitations in a conventional s-wave superfluid
Authors: Tu Wei , Wu Ya-Jie , Li Ning , Guo Miaodi , Hou Junpeng
Published: March 2024

Higher-order topological superconductors and superfluids have triggered a great deal of interest in recent years. While Majorana zero-energy corner or hinge states have been studied intensively, whether superconductors and superfluids host higher-order topological Bogoliubov excitations with finite energies remain elusive. In this work, we propose that Bogoliubov corner excitations with finite energies can be induced through only mirror-symmetric local potentials from a trivial conventional s-wave superfluid. The topological Bogoliubov excited modes originate from the nontrivial Bogoliubov excitation bands. These modes are protected by the mirror symmetry and are robust against mirror-symmetric perturbations as long as the Bogoliubov energy gap remains open. Our work provides a new insight into higher-order topological excitation states in superfluids and superconductors.
Suppression of the m/n = 2/1 tearing mode by electron cyclotron resonance heating on J-TEXT
Authors: FANG 方 Jiangang 建港 , CHEN 陈 Zhongyong 忠勇 , YAN 严 Wei 伟 , WANG 王 Nengchao 能超 , MAO 毛 Feiyue 飞越 , LUO 罗 Qiang 蔷 , XUAN 玄 Zijian 子健 , CHEN 陈 Xixuan 曦璇 , REN 任 Zhengkang 正康 , ZHANG 张 Feng 峰 , HUANG 黄 Mei 梅 , XIA 夏 Donghui 冬辉 , YANG 杨 Zhoujun 州军 , CHEN 陈 Zhipeng 志鹏 , DING 丁 Yonghua 永华 , Team the J-TEXT
Published: March 2024

Stabilization of tearing modes and neoclassical tearing modes is of great importance for tokamak operation. Electron cyclotron waves (ECWs) have been extensively used to stabilize the tearing modes with the virtue of highly localized power deposition. Complete suppression of the m/n = 2/1 tearing mode (TM) by electron cyclotron resonance heating (ECRH) has been achieved successfully on the J-TEXT tokamak. The effects of ECW deposition location and power amplitude on the 2/1 TM suppression have been investigated. It is found that the suppression is more effective when the ECW power is deposited closer to the rational surface. As the ECW power increases to approximately 230 kW, the 2/1 TM can be completely suppressed. The island rotation frequency is increased when the island width is reduced. The experimental results show that the local heating inside the magnetic island and the resulting temperature perturbation increase at the O-point of the island play dominant roles in TM suppression. As the ECW power increases, the 2/1 island is suppressed to smaller island width, and the flow shear also plays a stabilizing effect on small magnetic islands. With the stabilizing contribution of heating and flow shear, the 2/1 TM can be completely suppressed.
Oh, Rats!
Authors: Sarkar Natasha
Published: March 2024

Part of what came to be known as the ‘pioneer phase’ in modern plague research, that of eventual acceptance of the rat flea as the plague vector, is discussed in this chapter. All attention was directed to the termination of rats as a means of combating plague. The chapter surveys the varied experiments aimed at killing rats that were devised and tested in Bombay, Punjab, Calcutta, Central Provinces, and Madras. Measures especially for destroying rat fleas came to be instituted much later, only in 1911, while experiments for devising successful methods to exterminate rats were well underway. The chapter also looks at the various changes introduced in plague policy at the turn of the century, when Lord Curzon took over as the Viceroy and Governor-General of India. The final section of the chapter engages with the complexities of seasonal variations and their influence of the intensity and diffusion of plague.
Imaginative Exhibition in Morality
Authors: Matherne Samantha
Published: March 2024

This chapter aims to show that in Kant’s framework one of the main ways in which we morally use our imagination is as the faculty of exhibition. After addressing some initial reasons to worry that Kant can accord imagination, as the faculty of exhibition, a substantive role in our moral lives, it makes the case for why he nevertheless regards imaginative exhibition as something that is morally valuable. To this end, the chapter canvasses various ways in which Kant thinks our imagination morally serves us by making moral ideas sensible through indirect and direct modes of exhibition. In the indirect vein, it considers the moral value of the exhibition of moral ideas in our aesthetic engagement with beauty, art, and sublimity. And in the direct vein, it discusses the moral value of the exhibition of moral ideas through moral ideals, moral examples, and moral perception.
Clinical decision support to improve CBC and differential ordering
Authors: Mahowald Grace K , Lewandrowski Kent B , Dighe Anand S
Published: March 2024

Objectives

Complete blood count and differential (CBC diff) is a common laboratory test that may be overused or misordered, particularly in an inpatient setting. We assessed the ability of a clinical decision support (CDS) alert to decrease unnecessary orders for CBC diff and analyzed its impact in the laboratory.

Methods

We designed 3 CDS alerts to provide guidance to providers ordering CBC diff on inpatients at frequencies of daily, greater than once daily, or as needed.

Results

The 3 alerts were highly effective in reducing orders for CBC diff at the frequencies targeted by the alert. Overall, test volume for CBC diff decreased by 32% (mean of 5257 tests per month) after implementation of the alerts, with a corresponding decrease of 22% in manual differentials performed (mean of 898 per month). Turnaround time for manual differentials decreased by a mean of 41.5 minutes, with a mean decrease of up to 90 minutes during peak morning hours.

Conclusions

The 3 CDS alerts successfully decreased inpatient orders for CBC diff and improved the quality of patient care by decreasing turnaround time for manual differentials.
The rise of taxon-specific epitope predictors
Authors: Campelo Felipe , Lobo Francisco P
Published: March 2024

Computational predictors of immunogenic peptides, or epitopes, are traditionally built based on data from a broad range of pathogens without consideration for taxonomic information. While this approach may be reasonable if one aims to develop one-size-fits-all models, it may be counterproductive if the proteins for which the model is expected to generalize are known to come from a specific subset of phylogenetically related pathogens. There is mounting evidence that, for these cases, taxon-specific models can outperform generalist ones, even when trained with substantially smaller amounts of data. In this comment, we provide some perspective on the current state of taxon-specific modelling for the prediction of linear B-cell epitopes, and the challenges faced when building and deploying these predictors.
DeTox: a pipeline for the detection of toxins in venomous organisms
Authors: Ringeval Allan , Farhat Sarah , Fedosov Alexander , Gerdol Marco , Greco Samuele , Mary Lou , Modica Maria Vittoria , Puillandre Nicolas
Published: March 2024

Venomous organisms have independently evolved the ability to produce toxins 101 times during their evolutionary history, resulting in over 200 000 venomous species. Collectively, these species produce millions of toxins, making them a valuable resource for bioprospecting and understanding the evolutionary mechanisms underlying genetic diversification. RNA-seq is the preferred method for characterizing toxin repertoires, but the analysis of the resulting data remains challenging. While early approaches relied on similarity-based mapping to known toxin databases, recent studies have highlighted the importance of structural features for toxin detection. The few existing pipelines lack an integration between these complementary approaches, and tend to be difficult to run for non-experienced users. To address these issues, we developed DeTox, a comprehensive and user-friendly tool for toxin research. It combines fast execution, parallelization and customization of parameters. DeTox was tested on published transcriptomes from gastropod mollusks, cnidarians and snakes, retrieving most putative toxins from the original articles and identifying additional peptides as potential toxins to be confirmed through manual annotation and eventually proteomic analysis. By integrating a structure-based search with similarity-based approaches, DeTox allows the comprehensive characterization of toxin repertoire in poorly-known taxa. The effect of the taxonomic bias in existing databases is minimized in DeTox, as mirrored in the detection of unique and divergent toxins that would have been overlooked by similarity-based methods. DeTox streamlines toxin annotation, providing a valuable tool for efficient identification of venom components that will enhance venom research in neglected taxa.
scMLC: an accurate and robust multiplex community detection method for single-cell multi-omics data
Authors: Chen Yuxuan , Zheng Ruiqing , Liu Jin , Li Min
Published: March 2024

Clustering cells based on single-cell multi-modal sequencing technologies provides an unprecedented opportunity to create high-resolution cell atlas, reveal cellular critical states and study health and diseases. However, effectively integrating different sequencing data for cell clustering remains a challenging task. Motivated by the successful application of Louvain in scRNA-seq data, we propose a single-cell multi-modal Louvain clustering framework, called scMLC, to tackle this problem. scMLC builds multiplex single- and cross-modal cell-to-cell networks to capture modal-specific and consistent information between modalities and then adopts a robust multiplex community detection method to obtain the reliable cell clusters. In comparison with 15 state-of-the-art clustering methods on seven real datasets simultaneously measuring gene expression and chromatin accessibility, scMLC achieves better accuracy and stability in most datasets. Synthetic results also indicate that the cell-network-based integration strategy of multi-omics data is superior to other strategies in terms of generalization. Moreover, scMLC is flexible and can be extended to single-cell sequencing data with more than two modalities.
Effective multi-modal clustering method via skip aggregation network for parallel scRNA-seq and scATAC-seq data
Authors: Hu Dayu , Liang Ke , Dong Zhibin , Wang Jun , Zhao Yawei , He Kunlun
Published: March 2024

In recent years, there has been a growing trend in the realm of parallel clustering analysis for single-cell RNA-seq (scRNA) and single-cell Assay of Transposase Accessible Chromatin (scATAC) data. However, prevailing methods often treat these two data modalities as equals, neglecting the fact that the scRNA mode holds significantly richer information compared to the scATAC. This disregard hinders the model benefits from the insights derived from multiple modalities, compromising the overall clustering performance. To this end, we propose an effective multi-modal clustering model scEMC for parallel scRNA and Assay of Transposase Accessible Chromatin data. Concretely, we have devised a skip aggregation network to simultaneously learn global structural information among cells and integrate data from diverse modalities. To safeguard the quality of integrated cell representation against the influence stemming from sparse scATAC data, we connect the scRNA data with the aggregated representation via skip connection. Moreover, to effectively fit the real distribution of cells, we introduced a Zero Inflated Negative Binomial-based denoising autoencoder that accommodates corrupted data containing synthetic noise, concurrently integrating a joint optimization module that employs multiple losses. Extensive experiments serve to underscore the effectiveness of our model. This work contributes significantly to the ongoing exploration of cell subpopulations and tumor microenvironments, and the code of our work will be public at https://github.com/DayuHuu/scEMC.
Coarse-grained molecular dynamics simulation of the effect of cross-linking on the wear mechanism of polymer brush
Authors: Liu Zhongmin , Ootani Yusuke , Uehara Shuichi , Zhang Jing , Chen Qian , Wang Yang , Ozawa Nobuki , Kubo Momoji
Published: March 2024

The effects of a cross-linking layer on the wear resistance of polymer brush were investigated by using molecular dynamics-based sliding simulations. We found that a cross-linking layer improved wear resistance. The cross-linking layer suppressed the interpenetration of polymer chains on the counter surface and thus lowered the frictional force and wear. The degrees of interpenetration decreased as the cross-linking layer closed to the tip of the chain. A cross-linking layer in the tip of the polymer chains was thus found to improve wear resistance most effectively.
Computed tomography pericoronary adipose tissue density predicts coronary allograft vasculopathy and adverse clinical outcomes after cardiac transplantation
Authors: Wall Christopher , Weir-McCall Jonathan , Tweed Katharine , Hoole Stephen P , Gopalan Deepa , Huang Yuan , Corovic Andrej , Peverelli Marta , Dey Damini , Bennett Martin R , Rudd James H F , Kydd Anna , Bhagra Sai , Tarkin Jason M
Published: March 2024

Aims

To assess pericoronary adipose tissue (PCAT) density on coronary computed tomography angiography (CCTA) as a marker of inflammatory disease activity in coronary allograft vasculopathy (CAV).

Methods and results

PCAT density, lesion volumes, and total vessel volume-to-myocardial mass ratio (V/M) were retrospectively measured in 126 CCTAs from 94 heart transplant patients [mean age 49 (SD 14.5) years, 40% female] who underwent imaging between 2010 and 2021; age- and sex-matched controls; and patients with atherosclerosis. PCAT density was higher in transplant patients with CAV [n = 40; −73.0 HU (SD 9.3)] than without CAV [n = 86; −77.9 HU (SD 8.2)], and controls [n = 12; −86.2 HU (SD 5.4)], P < 0.01 for both. Unlike patients with atherosclerotic coronary artery disease (n = 32), CAV lesions were predominantly non-calcified and comprised of mostly fibrous or fibrofatty tissue. V/M was lower in patients with CAV than without [32.4 mm3/g (SD 9.7) vs. 41.4 mm3/g (SD 12.3), P < 0.0001]. PCAT density and V/M improved the ability to predict CAV from area under the receiver operating characteristic curve (AUC) 0.75–0.85 when added to donor age and donor hypertension status (P < 0.0001). PCAT density above −66 HU was associated with a greater incidence of all-cause mortality {odds ratio [OR] 18.0 [95% confidence interval (CI) 3.25–99.6], P < 0.01} and the composite endpoint of death, CAV progression, acute rejection, and coronary revascularization [OR 7.47 (95% CI 1.8–31.6), P = 0.01] over 5.3 (SD 2.1) years.

Conclusion

Heart transplant patients with CAV have higher PCAT density and lower V/M than those without. Increased PCAT density is associated with adverse clinical outcomes. These CCTA metrics could be useful for the diagnosis and monitoring of CAV severity.
Post-harvest regeneration is driven by ecological factors rather than wood procurement intensity in eastern Canadian forests
Authors: Canuel Claudie-Maude , Thiffault Évelyne , Thiffault Nelson
Published: March 2024

Biomass from surplus forest growth that is not harvested for wood supply of conventional industries can be an important source of feedstock for bioenergy. Its procurement can be integrated with little effort into current harvest operations. However, the increasing harvesting intensity to meet greater demand for biomass procurement can impact forest ecosystem functions because of its direct and indirect effects on woody debris and the regeneration of next-rotation stands. In this context, we aimed to determine the relationships between wood procurement intensity, woody debris inputs, and regeneration success over 2 years after harvesting. We tested four treatments of increasing wood procurement intensity using a randomized block design within six experimental sites along a gradient of varying forest characteristics of boreal and temperate forests. We assessed stand characteristics in terms of standing trees, woody debris, and regeneration pre- and post-harvest. We used mixed effects models to evaluate (i) the effects of wood procurement intensity and pre-harvest stand characteristics on the volume and cover of woody debris and (ii) the specific influence of woody debris on the presence of suitable planting microsites post-harvest. Furthermore, we used principal component regressions to explore the relationships between harvesting intensity and the presence of natural regeneration and competing vegetation as a function of pre- and post-harvest stand characteristics (iii). Our results showed that increasing wood procurement intensity reduced the volume of post-harvest woody debris while having a limited effect on regeneration. Increasing harvesting intensity had a negligible effect on suitable planting microsites in hardwood-dominated stands but it increased their presence in conifer-dominated stands. Natural regeneration and competing vegetation were mainly related to stand characteristics, and only broadleaf regeneration was sensitive to harvest intensity. We conclude that the relationships between wood procurement intensity and regeneration are complex and rely mainly on stand characteristics rather than wood procurement needs.
Comprehensive phenotypic characterization of an allelic series of zebrafish models of NEB-related nemaline myopathy
Authors: Fabian Lacramioara , Karimi Esmat , Farman Gerrie P , Gohlke Jochen , Ottenheijm Coen A C , Granzier Hendrikus L , Dowling James J
Published: March 2024

Nemaline myopathy (NM) is a rare congenital neuromuscular disorder characterized by muscle weakness and hypotonia, slow gross motor development, and decreased respiratory function. Mutations in at least twelve genes, all of each encode proteins that are either components of the muscle thin filament or regulate its length and stability, have been associated with NM. Mutations in Nebulin (NEB), a giant filamentous protein localized in the sarcomere, account for more than 50% of NM cases. At present, there remains a lack of understanding of whether NEB genotype influences nebulin function and NM-patient phenotypes. In addition, there is a lack of therapeutically tractable models that can enable drug discovery and address the current unmet treatment needs of patients. To begin to address these gaps, here we have characterized five new zebrafish models of NEB-related NM. These mutants recapitulate most aspects of NEB-based NM, showing drastically reduced survival, defective muscle structure, reduced contraction force, shorter thin filaments, presence of electron-dense structures in myofibers, and thickening of the Z-disks. This study represents the first extensive investigation of an allelic series of nebulin mutants, and thus provides an initial examination in pre-clinical models of potential genotype-phenotype correlations in human NEB patients. It also represents the first utilization of a set of comprehensive outcome measures in zebrafish, including correlation between molecular analyses, structural and biophysical investigations, and phenotypic outcomes. Therefore, it provides a rich source of data for future studies exploring the NM pathomechanisms, and an ideal springboard for therapy identification and development for NEB-related NM.
A delicate balance: the challenges of hypoparathyroidism
Authors: Papaioannou Garyfallia , Mannstadt Michael
Published: March 2024

Vignette

A 38-yr-old woman with chronic non-surgical hypoparathyroidism, managed elsewhere, presented to our practice with symptomatic hypocalcemia. At the age of 17, she began to suffer from muscle cramps, paresthesia, and ongoing diffuse pain. It took years before she was correctly diagnosed with hypoparathyroidism. Her symptoms were severe enough that she required emergency room visits several times a year. After she was properly diagnosed and started on calcium and calcitriol therapy, she continued to experience frequent episodes of severe hypocalcemia. She saw multiple healthcare providers who each introduced a new regimen. In addition, poor communication led to her discontinuing her medications altogether. As a result, her calcium levels remained consistently low, and she lost confidence in her prospect for better health. At the time of her visit to our clinic, she had discontinued calcitriol, was taking a large amount of oral calcium daily all at once, and had hypocalcemia. We addressed her concerns, and the challenges she faces with adherence to her medication regimen. We provided her with detailed information about the disease and the reasoning behind her treatment plan. Treatment was initiated with calcium carbonate 600 mg 3 times daily and calcitriol 0.5 mcg once daily. One week after treatment initiation, her test results showed improvement in her albumin-adjusted calcium, phosphorus, and 24-h urine calcium which were all within target range.
Study on the prediction method of grasshopper occurrence risk in Inner Mongolia based on the maximum entropy model during the growing period
Authors: Wen Fu , Liu Ronghao , Garcia y Garcia Axel , Ye Huichun , Lu Longhui , Qimuge Eerdeng , Sun Zhongxiang , Nie Chaojia , Han Xuemei , Zhang Yue
Published: March 2024

Grasshoppers represent a significant biological challenge in Inner Mongolia’s grasslands, severely affecting the region’s animal husbandry. Thus, dynamic monitoring of grasshopper infestation risk is crucial for sustainable livestock farming. This study employed the Maxent model, along with remote sensing data, to forecast Oedaleus decorus asiaticus occurrence during the growing season, using grasshopper suitability habitats as a base. The Maxent model’s predictive accuracy was high, with an AUC of 0.966. The most influential environmental variables for grasshopper distribution were suitable habitat data (34.27%), the temperature-vegetation dryness index during the spawning period (18.81%), and various other meteorological and vegetation factors. The risk index model was applied to calculate the grasshopper distribution across different risk levels for the years 2019–2022. The data indicated that the level 1 risk area primarily spans central, eastern, and southwestern Inner Mongolia. By examining the variable weights, the primary drivers of risk level fluctuation from 2019 to 2022 were identified as accumulated precipitation and land surface temperature anomalies during the overwintering period. This study offers valuable insights for future O. decorus asiaticus monitoring in Inner Mongolia.
Hematological Complications of Human Immunodeficiency Virus (HIV) Infection: An Update From an HIV-Endemic Setting
Authors: Opie Jessica , Verburgh Estelle , Bailly Jenique , Mayne Elizabeth , Louw Vernon
Published: March 2024

Medical professionals, particularly in regions with a high burden of human immunodeficiency virus (HIV), should be alert to the hematological complications of HIV, which may include cytopenias, malignancy, and coagulation disturbances. Patients may present with these conditions as the first manifestation of HIV infection. Hematological abnormalities are often multifactorial with opportunistic infections, drugs, malignancy, and HIV infection itself contributing to the clinical presentation, and the diagnosis should consider all these factors. Life-threatening hematological complications requiring urgent diagnosis and management include thrombotic thrombocytopenic purpura, superior mediastinal syndrome, spinal cord compression, and tumor lysis syndrome due to aggressive lymphoma. Antiretroviral therapy is the therapeutic backbone, including for patients with advanced HIV, in addition to specific therapy for the complication. This article reviews the impact of HIV on the hematological system and provides a clinical and diagnostic approach, including the role of a bone marrow biopsy, focusing on perspectives from sub-Saharan Africa.
Amelanotic melanoma in a kidney transplant patient: a rare case report
Authors: Melhem Yara , Khattab Seham , Al-janabi Moatasem Hussein , Saeid Hussein , Ahmad Issa , Hasan Fouz
Published: March 2024

Immunosuppressed individuals face a significantly elevated risk of developing aggressive cutaneous malignancies, often surpassing the aggressiveness observed in immunocompetent counterparts. Our patient exhibited several risk factors associated with melanoma development in renal recipients, including skin type, sun exposure, and the duration of immunosuppression. The determination of staging holds paramount importance as it directly influences both prognosis and subsequent management. It is crucial to handle suspected lesions with caution in these patients to facilitate early melanoma detection and enhance overall prognosis.
Association between amiodarone use and risk of cataract: a population-based active-comparator study
Authors: To Sheng-Yin , Lin Hsin-Ting , Liao Chun-Cheng , Pan Ke-Ting , Wen Yuan-Liang , Kao Senyeong , Kao Li-Ting
Published: March 2024

Background

Despite previous concerns about ocular side effects related to amiodarone, the relationship between amiodarone and cataract remains uncertain. Therefore, this study aimed to assess the potential association between amiodarone use and the subsequent risk of cataract, taking into account potential confounders.

Methods

This population-based, active comparator-controlled cohort study utilized the data from the Taiwan National Health Insurance program and involved adults over 40 years old between 2001 and 2013. We analyzed 12 055 new amiodarone users and contrasted them with a propafenone user cohort. The primary outcome was the incidence of cataract. Inverse-probability treatment-weighting (IPTW) was further used to eliminate the potential confounding effects, and Cox proportional-hazard regression analyses were performed to calculate the risk of cataract. Serial subgroup analyses were also performed.

Results

In the main analysis, amiodarone users did not exhibit a significant causal relationship in both full cohort [adjusted hazard ratio (aHR): 0.994, 95% confidence interval (CI): 0.913–1.082] and IPTW cohort (IPTW-aHR 0.977, 95% CI: 0.900–1.060). Furthermore, it is important to highlight a significantly reduced risk of cataract among patients with heart failure (IPTW-aHR 0.708, 95% CI: 0.554–0.905) and during the 2-year follow-up period (IPTW-aHR 0.889, 95% CI: 0.794–0.996), implying potential advantages linked to the use of amiodarone.

Conclusions

The study found no increased risk of cataract with amiodarone, one of the most frequently used antiarrhythmic medications, compared to the use of propafenone. Future research is recommended to explore potential mechanisms and their implications for clinical practice.
Assessment of cellular senescence potential of PM2.5 using 3D human lung fibroblast spheroids in vitro model
Authors: Xu Shengmin , Ma Lin , Wu Tao , Tian Yushan , Wu Lijun
Published: March 2024

Background

Epidemiological studies demonstrate that particulate matter 2.5 (PM2.5) exposure closely related to chronic respiratory diseases. Cellular senescence plays an important role in many diseases. However, it is not fully clear whether PM2.5 exposure could induce cellular senescence in the human lung. In this study, we generated a three-dimensional (3D) spheroid model using isolated primary human lung fibroblasts (HLFs) to investigate the effects of PM2.5 on cellular senescence at the 3D level.

Methods

3D spheroids were exposed to 25-100 μg/ml of PM2.5 in order to evaluate the impact on cellular senescence. SA-β-galactosidase activity, cell proliferation, and the expression of key genes and proteins were detected.

Results

Exposure of the HLF spheroids to PM2.5 yielded a more sensitive cytotoxicity than 2D HLF cell culture. Importantly, PM2.5 exposure induced the rapid progression of cellular senescence in 3D HLF spheroids, with a dramatically increased SA-β-Gal activity. In exploiting the mechanism underlying the effect of PM2.5 on senescence, we found a significant increase of DNA damage, upregulation of p21 protein levels, and suppression of cell proliferation in PM2.5-treated HLF spheroids. Moreover, PM2.5 exposure created a significant inflammatory response, which may be at least partially associated with the activation of TGF-β1/Smad3 axis and HMGB1 pathway.

Conclusions

Our results indicate that PM2.5 could induce DNA damage, inflammation, and cellular senescence in 3D HLF spheroids, which may provide a new evidence for PM2.5 toxicity based on a 3D model which has been shown to be more in vivo-like in their phenotype and physiology than 2D cultures.
Predictors for prolonged qt intervals in acute antipsychotic poisoned patients
Authors: Khalifa Heba K , Mostafa Mansour Nouran , Elmansy Alshaimma
Published: March 2024

Background

Acute antipsychotic poisoning is correlated to a high prevalence of qt interval prolongation.

Aim

This study aimed to evaluate early qt interval prolongation predictors in acute antipsychotic-poisoned patients.

Methodology

This prospective cohort study enrolled 70 symptomatic patients with acute antipsychotic poisoning. Sociodemographic data, toxicological, clinical, investigation, and outcomes were collected and analyzed. The estimation of the corrected qt interval (QTc) was performed using Bazett’s method. Primary outcome was normal or abnormal length of QTc interval. Secondary outcomes included duration of hospital stay, complete recovery and mortality. The corrected qt interval was analyzed by univariate and multivariate logistic regression analysis.

Results

Patients were divided into groups A (normal QTc interval up to 440 msec; 58.6% of cases) and B (prolonged QTc interval ≥ 440 msec; 41.4% of cases). Patients in group B had significantly high incidences of quetiapine intake, bradycardia, hypotension, hypokalemia, and long duration of hospital stay. By multivariate analysis, quetiapine [Odd’s ratio (OR): 39.674; Confidence Interval (C.I:3.426–459.476)], bradycardia [OR: 22.664; C.I (2.534–202.690)], and hypotension [OR: 16.263; (C.I: 2.168–122.009)] were significantly correlated with prolonged QTc interval.

Conclusion

In acute antipsychotic poisoning, quetiapine, bradycardia, and hypotension are early clinical predictors for prolonged QTc interval.
Closing the (Vascular) Loop: What Matters in Neurovascular Conflicts
Authors: Abou Karam Gaby , Payabvash Seyedmehdi
Published: March 2024

There is an abundance of literature regarding neurovascular conflicts. Yet, when we look at a case in the reading room, radiologists may find asking: “what should we look for and what should we mention in the report?” In this article, we discuss the important aspects of imaging technique, anatomy, and pathology of the cranial nerves with emphasis on the relevant aspects to the radiologist, closing any loops the radiologists may have in knowledge of the neurovascular conflicts on imaging, and increasing radiologists' comfort level interpreting these cases.
Real-time Reconstruction of Comminuted Mandibular Fractures Using 3D Printing
Authors: Shilo Dekel , Capucha Tal , Krasovsky Andrei , Blanc Ori , Emodi Omri , Haze Amir , Rachmiel Adi
Published: March 2024

Background:

Comminuted fractures of the jaws are complex injuries requiring special attention. In the past, treatment included closed reduction using maxillomandibular fixation. With advancements in technology and fixation systems, open reduction became a prevalent option. These fractures are difficult to reconstruct during the primary treatment phase, thus resulting in higher complication rates. The introduction of three-dimensional (3D) planning and printing brought about superior outcomes, yet these focus on secondary reconstruction due to the need for outsourcing planning and titanium printing.

Methods:

In this report, we describe real-time in-house 3D planning and printing using computer-assisted design software and a 3D-fused deposition printer for virtual reduction of the comminuted fractures and printing of the reconstructed mandible.

Results:

Following virtual 3D reduction, the newly created mandibles were 3D printed. The model was then used to preband a reconstruction plate, which in turn was used as a template during surgery for reducing the segments. The process of virtual reduction and printing should take a couple of hours at most. The results of five cases showed good alignment and proper function.

Conclusion:

Three-dimensional technology can be applied in the everyday primary care treatment protocol of comminuted fractures as an in-house tool which greatly improves both functional and aesthetic outcomes.
Three-Year Outcomes of the Paul Glaucoma Implant for Treatment of Glaucoma
Authors: Tan Marcus Chun Jin , Ong Chee Wui , Aquino Maria Cecilia , LUN Katherine Wanxian , Sng Chelvin Cheryl Agnes , Lim Dawn Ka Ann , Loon Seng Chee , KOH Victor Teck Chang , CHEW Paul Tec Kuan
Published: March 2024

Précis:

In our case series, the 3-year failure for Paul Glaucoma Implant (PGI) implantation was 14.6%. At 3 years postoperatively, there was a significant reduction in mean intraocular pressure (IOP) and the number of glaucoma medications used.

Objective:

To determine the 3-year efficacy and safety of the PGI, a novel glaucoma tube shunt in patients with glaucoma.

Methods:

Retrospective review of all patients who had undergone PGI implantation in a single tertiary institution in Singapore between May 1, 2017 and January 1, 2022. Data were extracted from electronic health records (Computerized Patient Support System 2 and Epic). The primary outcome measure was failure, defined as IOP >18 mm Hg or <6 mm Hg on 2 consecutive visits after 3 months, reoperation for IOP-related indication, explantation of implant, or loss of light perception vision. Complete success was defined as the absence of failure without medications at 36 months, and qualified success similarly, but with medications. Postoperative mean IOP, mean number of IOP-lowering medications used, and visual acuity were also assessed.

Results:

Forty-eight eyes in 48 patients were identified. Thirty-one patients (64.6%) had primary open angle and angle closure glaucoma, and 18 (37.5%) had previous existing tube implants or trabeculectomy. At 3 years postoperatively, 7 cases (14.6%) fulfilled the criteria for failure and 36 (75%) met the criteria for complete success. The mean IOP at 36 months was 14.9 ± 4.11 mm Hg, from the mean preoperative IOP of 20.6 ± 6.13 mm Hg (P < 0.001). The mean number of IOP-lowering medications used was reduced from 3.13 ± 0.959 preoperatively to 0.167 ± 0.476 at 36 months (P < 0.001). The most common postoperative complication was hypotony (n = 17, 35.4%), of which the majority were self-limiting, followed by hyphema (n = 5, 10.4%) and tube exposure (n = 4, 8.3%).

Conclusion:

The PGI demonstrated sustained IOP reduction and a reduction of medication burden at 3 years postoperatively.
Prediction of Sepsis Mortality in ICU Patients Using Machine Learning Methods
Authors: Gao Jiayi , Lu Yuying , Ashrafi Negin , Domingo Ian Raymond , Alaei Kamiar , Pishgar Maryam
Published: March 2024

Problem: Sepsis, a life-threatening condition, accounts for the deaths of millions of people worldwide. Accurate prediction of sepsis outcomes is crucial for effective treatment and management. Previous studies have utilized machine learning for prognosis but have limitations in feature sets and model interpretability. Aim: This study aims to develop a machine learning model that enhances prediction accuracy for sepsis outcomes using a reduced set of features, thereby addressing the limitations of previous studies and enhancing model interpretability. Methods: This study analyzes intensive care patient outcomes using the MIMIC-IV database, focusing on adult sepsis cases. Employing the latest data extraction tools, such as Google BigQuery, and following stringent selection criteria, we selected 38 features in this study. This selection is also informed by a comprehensive literature review and clinical expertise. Data preprocessing included handling missing values, regrouping categorical variables, and using the Synthetic Minority Over-sampling Technique (SMOTE) to balance the data. We evaluated several machine learning models: Decision Trees, Gradient Boosting, XGBoost, LightGBM, Multilayer Perceptrons (MLP), Support Vector Machines (SVM), and Random Forest. The Sequential Halving and Classification (SHAC) algorithm was used for hyperparameter tuning, and both train-test split and cross-validation methodologies were employed for performance and computational efficiency. Results: The Random Forest model was the most effective, achieving an area under the receiver operating characteristic curve (AUROC) of 0.94 with a confidence interval of 0.93 to 0.95. This significantly outperformed other models and set a new benchmark in the literature. The model also provided detailed insights into the importance of various clinical features, with the Sequential Organ Failure Assessment (SOFA) score and average urine output being highly predictive. SHAP (Shapley Additive Explanations) analysis further enhanced the model's interpretability, offering a clearer understanding of feature impacts. Conclusion: This study demonstrates significant improvements in predicting sepsis outcomes using a Random Forest model, supported by advanced machine learning techniques and thorough data preprocessing. Our approach provided detailed insights into the key clinical features impacting sepsis mortality, making the model both highly accurate and interpretable. By enhancing the model's practical utility in clinical settings, we offer a valuable tool for healthcare professionals to make data-driven decisions, ultimately aiming to minimize sepsis-induced fatalities.
Health related quality of life and associated factors among postpartum women after normal vaginal delivery and caesarean section: A comparative cross-sectional study
Authors: Workneh Wubet Mihretu , Handebo Simegnew , Geleta Temesgen , Wotango Biniam Yohannes , Bekele Bisrat Tamene
Published: March 2024

Background

Postpartum influences women’s physical health conditions and may affect their quality of life and future health. Some women suffer from health problems which are largely related to delivery mode. Assessing the postnatal quality of life is essential to address the concern of women and provide comprehensive postnatal care and minimizes the morbidity of the mother during and beyond the postnatal period.

Objectives

To assess health related quality of life and associated factors among postpartum women after normal vaginal delivery and caesarean section in public hospitals, Addis Ababa, Ethiopia.

Methods

A hospital-based comparative cross-sectional study was conducted in public hospitals of Addis Ababa using Short Form-36. Systematic random sampling method was used and telephone interviews were conducted for 171 Caesarian Section and 165 Normal Vaginal Delivery postpartum women. The collected data entered into Epi-info version 7.2 and then analysied by SPSS version 25. The Multiple linear regression model was used after checking the assumptions were met to identify associated factors and p-value of 0.05 and a confidence interval of 95% was employed.

Result

Overall 336 postpartum women participated with a response rate of 88%. The mean health-related quality of life was 91.42 and 81.89 for normal vaginal delivery and cesarean section group respectively.In multivariable linear regression for both groups, age =(β=-0.166;95%CI:-0.504,-0.121), family income (β=-0.188 95%CI-0.001,0.000), gestational age (β =0.131,95%CI:0.44,0.185), normal vaginal delivery (β=0.526; 95% CI: 6.790,9.621), and live birth (β=2.471,95% CI:1.094,9.643) were significantly associated factors and explained 47% of the variance in Health Related Quality of Life among postpartum women.

Conclusion and Recommendation

The study finds a higher level of health-related quality of life in the normal vaginal delivery group compared to the cesarean section. Health workers should give appropriate counseling on modes of delivery, inorder to help patients to make an informed decision about their childbirth experience.