bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic transorbital and transcranial multiportal resection of a sphenoorbital meningiomas with custom bone 3D printing reconstruction: Case report
Authors: d'Avella Elena , Somma Teresa , Fabozzi Gianluca Lorenzo , Committeri Umberto , Romano Antonio , Cappabianca Paolo , Cavallo Luigi Maria
Published: November 2023

Background

Sphenoorbital meningiomas (SOM) harbor intrinsic features that render their surgical management and the reconstruction of the resulting bony defect overtly challenging.

Methods

A 70‐year‐old woman, harboring a long‐standing left frontotemporal bony swelling conservatively managed, presented with progressive left proptosis. Radiological features were consistent with an en plaque SOM. A one‐step multiportal transcranial and endoscopic transorbital approach (TOA) with custom bone three‐dimensional (3D) printing reconstruction using polymethylmethacrylate (PMMA) was scheduled.

Results

Postoperative functional and aesthetic results were excellent, with proptosis and calvarian deformity resolution. Tumor subtotal resection was achieved. Histopathological diagnosis confirmed a transitional meningioma (WHO grade I).

Conclusions

The endoscopic TOA, isolated or as part of a multiportal strategy, has entered the surgical armamentarium for the treatment of SOMs. A customized PMMA cranioplasty can be considered a possible option for the reconstruction of large bony defects in a one‐step fashion.
Unhealthy and health promoting sponsorship of male and female professional sporting teams in Australia
Authors: Pitt Hannah , McCarthy Simone , Randle Melanie , Thomas Samantha , Arnot Grace , Daube Mike
Published: November 2023

Issue Addressed

There are concerns that unhealthy industries may use sponsorships to align their brands with the increased popularity of professional women's sporting events. This study aimed to identify and compare the sponsors of Australian male and female professional sporting teams in relation to unhealthy industries (alcohol, gambling, discretionary food and drink, and venues) and health‐promoting companies and organisations (charities, government departments, and educational institutions).

Methods

A web‐based scan was conducted from July to October 2021 to identify team and uniform sponsors, with descriptive statistics used to identify and compare results.

Results

About one tenth of sponsors (team n = 269; 10.9%; uniform n = 62; 10.6%) were for unhealthy industries. Men's teams had a greater number of these sponsors as compared to women's teams. Just under 10% of sponsors were for health‐promoting organisations (team n = 210; 8.5%; uniform n = 44; 7.5%), with women's teams more likely to have these sponsors as compared to men's teams.

Conclusions

Professional sport provides an important opportunity to facilitate health‐promoting rather than ‐harming sponsors. Health‐promoting sponsors are more prominent in women's sport, but as women's professional sport continues to grow in popularity, there is a need for policy, funding, and support to prevent engagement with unhealthy industry sponsorship and create a level playing field with men's sport.

So What?

Mechanisms should be developed to help sporting codes, particularly women's sport, to adopt business models that are not reliant on industries that cause harm. Establishing strong relationships with health‐promoting organisations may provide alternative sponsorship opportunities for sporting teams.
Direct oral anticoagulants (DOAC) versus vitamin K antagonist in left ventricular thrombus: An updated meta‐analysis
Authors: Shrestha Dhan B. , Dawadi Sagun , Dhakal Bishal , Shtembari Jurgen , Patel Toralben , Shaikh Rafae , Bodziock George M. , Shantha Ghanshyam , Trankle Cory R. , Patel Nimesh K.
Published: November 2023

Background and Aims

Current clinical guidelines for treating left ventricular thrombus (LVT) are limited by inadequate evidence to inform the comparative efficacy of oral anticoagulants. In this meta‐analysis, we aimed to compare the efficacy and safety of direct oral anticoagulants (DOAC) to vitamin K antagonists (VKA) in patients with LVT.

Methods

Four standard databases were searched for relevant literature comparing the efficacy and safety between DOAC and VKA for LVT treatment, published before August 19, 2023. Both the randomized controlled trials and observational studies were included in the analysis. The outcomes of interest were the resolution of LVT, all‐cause mortality, stroke, systemic embolism, and bleeding. Data from the selected studies were extracted and analyzed using RevMan 5.4 using odds ratio.

Results

Among 3959 studies from the database search and bibliography review, 33 were included in the analysis. LVT resolution was observed in 72.59% in the DOAC group versus 67.49% in the VKA group (odds ratio [OR]: 1.28, confidence interval [CI]: 1.07–1.53). Mortality was lower in the DOAC group (11.71% vs. 18.56%) (OR: 0.60, CI: 0.36–1.00; borderline statistical significance). Likewise, bleeding events (9.60% vs. 13.19%) (OR: 0.65, CI: 0.52–0.81) and stroke (7.54% vs. 11.04%) (OR: 0.71, CI: 0.53–0.96) were also significantly lower in the DOAC group.

Conclusion

DOAC use for LVT showed better thrombus resolution and reduced risk of bleeding and stroke compared to VKA. Likewise, DOAC use was associated with lower mortality with borderline statistical significance.
Noble gas dative bonding with coinage metal carbene complexes: A theoretical study
Authors: Yashmin Farnaz , Sharma Rohan , Mazumder Lakhya J. , Sharma Pankaz K.
Published: November 2023

The structure and stability of noble gas (Ng) bound [NHCM]+ complexes (M = Cu, Ag, and Au) were investigated using Quantum chemical calculations. Dissociation energies, enthalpy, and free energy changes were computed to comprehend the stability of these Ng‐bonded complexes. The nature of interactions associated to the bonding between metal and noble gas atoms was studied through the computation of electron density‐based descriptors. Detailed electronic structure study revealed electron donation from the noble gas atoms towards the metal center, resulting in the formation of dative bonds.
Use of shear wave imaging with intestinal ultrasonography in patients with chronic diarrhea
Authors: Kapoor Atul , Singh Anil , Kapur Aprajita , Mahajan Goldaa , Sharma Shalinder
Published: November 2023

Objective

A retrospective study was designed to determine the role of shear wave elastography (SWE) and intestinal ultrasonography to differentiate between inflammatory and fibrotic bowel strictures by determining Young's modulus (E) and shear wave dispersion (SWD) and to compare its role with contrast‐enhanced computed tomography (CECT) in patients with chronic diarrhea and pain abdomen.

Methods

Seventy‐six patients who had increased small bowel thickness (SBWT) >3 mm, and large bowel wall thickness (LBWT) >4 mm on intestinal ultrasonography (IUS) were evaluated in a two‐step manner. The first step involved classifying patients with increased SBWT >3 mm and LBWT >4 mm by use of SWE and dispersion into three groups that is group I (fibrotic), group II (inflammatory) thickening, and group III (mixed‐fibrosis and inflammatory) wall thickening. In the second step, etiological classification was done using six gray scale features of IUS that is length and degree of bowel thickening, presence of bowel stratification, Limberg grade of vascularity, status of mesenteric fat, juxta bowel status‐nodes, fluid, and fistula formation to reach to a definitive diagnosis. These findings were compared with findings on CECT. Twenty‐three patients had diagnosis confirmed by biopsy while 18 underwent surgery with histologic confirmation of operative findings. The sensitivity, specificity and AUROC for both modalities were compared.

Results

Group I that is fibrotic group had 33 patients with fibrotic strictures of which fibrotic Crohn's disease (CD)and tuberculosis of the bowel were the dominant types followed by neoplastic and infective causes. In Group II that is inflammatory there were 32 patients with predominantly infective ileo‐colitis, and ulcerative colitis patients while 11 patients were present in group III that is (mixed fibrotic and inflammatory) type of bowel wall thickening and were patients of inflammatory CD, infective ileo‐colitis. The presence of length of bowel involvement, Limberg grade, mesenteric fat proliferation, and SBWT>9 mm were the statistically significant parameters on IUS which helped to reach to final diagnosis. The sensitivity and specificity of combined SWE with SWD and IUS were 100% and 99% while that of CECT was 78% and 96% respectively with AUROC of 100% and 64%.

Conclusion

SWI combined with IUS in a two‐step manner is an accurate way to evaluate patients with chronic diarrhea who have increased SBWT and is not only able to differentiate inflammatory from fibrotic bowel wall thickening but also helps to form an etiological diagnosis.
Homologous recombination deficiency reflects the heterogeneity and monitoring treatment response for patients with breast cancer
Authors: Long Quanyi , Wang Yunfei , Li Hongjiang
Published: November 2023

Background

In breast cancer (BC), homologous recombination defect (HRD) is a common carcinogenic mechanism. It is meaningful to classify BC according to HRD biomarkers and to develop a platform for identifying BC molecular features, pathological features and therapeutic responses.

Methods

In total, 109 HRD genes were collected and screened by univariate Cox regression analysis to determine the prognostic genes, which were used to construct a consensus matrix to identify BC subtype. Differentially expressed genes (DEGs) were filtered by the Limma package and screened by random forest analysis to build a model to analyze the immunotherapy response and sensitivity and prognosis of patients suffering from BC to different drugs.

Results

Thirteen out of 109 HRD genes were prognostic genes of BC, and BC was classified into two subgroups based on their expression. Cluster 1 had a significantly backward survival outcome and a significantly higher adaptive immunity score relative to cluster 2. Six genes were identified by random forest analysis as factors for developing the model. The model provided a prediction called risk score, which showed a significant stratification effect on BC prognosis, immunotherapy response and IC50 values of 62 drugs.

Conclusions

In the present study, two HRD subtypes of BC were successfully identified, for which mutation and immunological features were determined. A model based on differential genes of HRD subtypes was established, which was a potential predictor of prognosis, immunotherapy response and drug sensitivity of BC.
The potential of 3rd‐generation nanopore sequencing for B‐cell clonotyping in lymphoproliferative disorders
Authors: Hansen Marcus H. , Cédile Oriane , Abildgaard Niels , Nyvold Charlotte G.
Published: November 2023

Lymphoid malignancies are characterized by clonal cell expansion, often identifiable by unique immunoglobulin rearrangements. Heavy (IGH) and light‐chain gene usage offers diagnostic insights and enables sensitive residual disease detection via next‐generation sequencing. With its adaptable throughput and variable read lengths, Oxford Nanopore thirdgeneration sequencing now holds promise for clonotyping. This study analyzed CD138+ plasma‐cell DNA from eight multiple myeloma patients, comparing clonotyping performance between Nanopore sequencing, Illumina MiSeq, and Ion Torrent S5. We demonstrated clonotype consistency across platforms through Smith‐Waterman local alignment of nanopore reads. The mean clonal percentage of IGH V and J gene usage in the CD138+ cells was 69% for Nanopore, 67% for S5, and 76% for MiSeq. When aligned with known clonotypes, clonal cells averaged a 91% similarity, exceeding 85%. In summary, Nanopore sequencing, with its capacity for generating millions of high‐quality reads, proves effective for detecting clonal IGH rearrangements. This versatile platform offers the potential for measuring residual disease down to a sensitivity level of 10‐6 at a lower cost, marking a significant advancement in clonotyping techniques.
Four‐Dimensional Flow MRI‐Derived Hemodynamics in Abdominal Aortic Aneurysms: Reproducibility and Associations With Diameter, Intraluminal Thrombus Volume, and Vorticity
Authors: Aalbregt Eva , Indrakusuma Reza , Jalalzadeh Hamid , Planken R. Nils , van Schuppen Joost , Meijboom Lilian , Balm Ron , Nederveen Aart J. , Yeung Kak Khee , van Ooij Pim
Published: November 2023

Background

Maximum diameter measurements are used to assess the rupture risk of abdominal aortic aneurysms (AAAs); however, these are not precise enough to predict all ruptures. Four‐dimensional (4D) flow MRI‐derived parameters provide additional information by visualizing hemodynamics in AAAs but merit further investigation before they are clinically applicable.

Purpose

To assess the reproducibility of 4D flow MRI‐derived hemodynamics, to investigate possible correlations with lumen and maximum diameter, and to explore potential relationships with vorticity and aneurysm growth.

Study Type

Prospective single‐arm study.

Population

A total of 22 (71.5 ± 6.1 years, 20 male) asymptomatic AAA patients with a maximum diameter of at least 30 mm.

Field Strength/Sequence

A 3.0 T/Free‐breathing 4D flow MRI phase‐contrast acquisition with retrospective ECG‐gating.

Assessment

Patients underwent two consecutive 4D flow MRI scans 1‐week apart. Aortic volumes were segmented from time‐averaged phase contrast magnetic resonance angiographies. Reproducibility was assessed by voxelwise analysis after registration. Mean flow velocity, mean wall shear stress (WSS), mean lumen diameter, and qualitative vorticity scores were assessed. In addition, Dixon MRI and retrospective surveillance data were used to study maximum diameter (including thrombus), intraluminal thrombus volume (ILT), and growth rate.

Statistical Tests

For reproducibility assessment, Bland–Altman analyses, Pearson correlation, Spearman's correlation, and orthogonal regression were conducted. Potential correlations between hemodynamics and vorticity scores were assessed using linear regression. P < 0.05 was considered statistically significant.

Results

Test–retest median Pearson correlation coefficients for flow velocity and WSS were 0.85 (IQR = 0.08) m/sec and 0.82 (IQR = 0.10) Pa, respectively. Mean WSS significantly correlated with mean flow velocity (R = 0.75) and inversely correlated with mean lumen diameter (R = −0.73). No significant associations were found between 4D flow MRI‐derived hemodynamic parameters and maximum diameter (flow velocity: P = 0.98, WSS: P = 0.22).

Data Conclusion

A 4D flow MRI is robust for assessing the hemodynamics within AAAs. No correlations were found between hemodynamic parameters and maximum diameter, ILT volume and growth rate.

Level of Evidence

2

Technical Efficacy

Stage 2
Clinical Breast MRI‐based Radiomics for Distinguishing Benign and Malignant Lesions: An Analysis of Sequences and Enhanced Phases
Authors: Wang Guangsong , Guo Qiu , Shi Dafa , Zhai Huige , Luo Wenbin , Zhang Haoran , Ren Zhendong , Yan Gen , Ren Ke
Published: November 2023

Background

Previous studies have used different imaging sequences and different enhanced phases for breast lesion calsification in radiomics. The optimal sequence and contrast enhanced phase is unclear.

Purpose

To identify the optimal magnetic resonance imaging (MRI) radiomics model for lesion clarification, and to simulate its incremental value for multiparametric MRI (mpMRI)‐guided biopsy.

Study Type

Retrospective.

Population

329 female patients (138 malignant, 191 benign), divided into a training set (first site, n = 192) and an independent test set (second site, n = 137).

Field Strength/Sequence

3.0‐T, fast spoiled gradient‐echo and fast spin‐echo T1‐weighted imaging (T1WI), fast spin‐echo T2‐weighted imaging (T2WI), echo‐planar diffusion‐weighted imaging (DWI), and fast spoiled gradient‐echo contrast‐enhanced MRI (CE‐MRI).

Assessment

Two breast radiologists with 3 and 10 years' experience developed radiomics model on CE‐MRI, CE‐MRI + DWI, CE‐MRI + DWI + T2WI, CE‐MRI + DWI + T2WI + T1WI at each individual phase (P) and for multiple combinations of phases. The optimal radiomics model (Rad‐score) was identified as having the highest area under the receiver operating characteristic curve (AUC) in the test set. Specificity was compared between a traditional mpMRI model and an integrated model (mpMRI + Rad‐score) at sensitivity >98%.

Statistical Tests

Wilcoxon paired‐samples signed rank test, Delong test, McNemar test. Significance level was 0.05 and Bonferroni method was used for multiple comparisons (P = 0.007, 0.05/7).

Results

For radiomics models, CE‐MRI/P3 + DWI + T2WI achieved the highest performance in the test set (AUC = 0.888, 95% confidence interval: 0.833–0.944). The integrated model had significantly higher specificity (55.3%) than the mpMRI model (31.6%) in the test set with a sensitivity of 98.4%.

Data Conclusion

The CE‐MRI/P3 + DWI + T2WI model is the optimized choice for breast lesion classification in radiomics, and has potential to reduce benign biopsies (100%–specificity) from 68.4% to 44.7% while retaining sensitivity >98%.

Level of Evidence

3

Technical Efficacy

Stage 2
MR Diffusion Kurtosis Imaging (DKI) of the Normal Human Uterus in Vivo During the Menstrual Cycle
Authors: Li Yajie , Chen Ye , Fu Caixia , Li Qing , Liu Hanqiu , Zhang Qi
Published: November 2023

Background

The uterus undergoes dynamic changes throughout the menstrual cycle. Diffusion kurtosis imaging (DKI) is based on the non‐Gaussian distribution of water molecules and can perhaps represent the changes of uterine microstructure.

Purpose

To investigate the temporal changes in DKI‐parameters of the normal uterine corpus and cervix during the menstrual cycle.

Study Type

Prospective.

Population

21 healthy female volunteers (26.64 ± 4.72 years) with regular menstrual cycles (28 ± 7 days).

Field Strength/Sequence

Readout segmentation of long variable echo‐trains (RESOLVE)‐based DKI and fast spin‐echo T2‐weighted sequences at 3.0T.

Assessment

Each volunteer was scanned during the menstrual phase, ovulatory phase, and luteal phase. Regions of interest (ROI) were manually delineated in the endometrium, junctional zone, and myometrium of the uterine body, and in the mucosal layer, fibrous stroma layer, and loose stroma layer of the cervix. The mean Kapp (diffusion kurtosis coefficient), Dapp (diffusion coefficient), and ADC (apparent diffusion coefficient) values were measured in the ROI.

Statistical Tests

ANOVA with Bonferroni or Tamhane correction. Intraclass correlation coefficient (ICC) for assessing agreement. P < 0.05 was considered statistically significant.

Results

During the menstrual cycle, the highest Kapp (0.848 ± 0.184) and lowest Dapp (1.263 ± 0.283 *10−3 mm2/sec) values were found in the endometrium during the menstrual phase. The Dapp values for the myometrium were significantly higher than those of the endometrium and the junctional zone in every phase. Meanwhile, the Dapp values for the three zonal structures of the cervix during ovulation were significantly higher than those during the luteal phase. However, there was no significant difference in the ADC values of the loose stroma between ovulation and the luteal phase (P = 0.568). The reproducibility of DKI parameters was good (ICC, 0.857–0.944).

Data Conclusion

DKI can show dynamic changes of the normal uterus during the menstrual cycle.

Level of Evidence

2

Technical Efficacy

Stage 2
Systemic lupus erythematosus is associated with lower risk of hepatitis B virus infection: A multivariable Mendelian randomization study in East Asian population
Authors: Li Wei , Zhang Hua , Ren Ao , Fan Wei , Qin Qiong , Zhao Ling , Ma Ruidong , Peng Qiufeng , Luo Shiqiao
Published: November 2023

The relationship between systemic lupus erythematosus (SLE) and hepatitis B virus (HBV) infection is still unclear. We conducted a two‐sample Mendelian randomization (MR) analysis using summary statistics from genome‐wide association studies for SLE and HBV infection in individuals of East Asian ancestry. The inverse‐variance weighted (IVW) method, weighted median (WM) method, and MR‐Egger method were used to estimate the causal effect of SLE on HBV infection. Additionally, we performed a multivariable MR analysis adjusting for the effects of body mass index and rheumatoid arthritis. This MR study included a total of 225 106 individuals of East Asian ancestry, comprising 5616 cases and 219 490 controls. The IVW method (OR: 0.79, p = 3.34E−08) and the WM method (OR: 0.79, p = 9.09E−06) revealed a causal relationship between genetically predicted SLE and a low risk of HBV infection. The multivariable MR analysis still suggested a low risk of HBV infection associated with SLE (OR: 0.83, p = 2.89E−06). Our MR analysis supports a causal relationship between SLE and a low risk of HBV infection in individuals of East Asian ancestry.
Optimum design of slot and magnet structure of permanent magnet synchronous generator with teaching‐learning‐studying‐based optimization
Authors: Duman Serhat , Dalcalı Adem
Published: November 2023

From the point of production to consumption, electrical energy should be utilized effectively and qualitatively. Efficiency at the electricity consumption stage is not sufficient, and the desired criteria must be met at the production stage. The efficient and high‐quality generation of electrical energy is directly related to the performance of the generator used. In order to achieve the desired criteria for a generator design, many issues should be considered together. In order for this study to do, a 14‐pole and 5 kW permanent magnet synchronous generator (PMSG) was designed using the innovative optimizer named the weighted mean of vectors (INFO), the jumping spider optimization algorithm (JSOA), the teaching–learning‐based optimization (TLBO), the pelican optimization algorithm (POA) and the teaching‐learning‐studying‐based optimization (TLSBO) algorithms. The generator performance was optimized within the determined inequality constraints by the offset and embrace value and six parameters of the stator slot structure. The generator designed with the parameters determined by the TLSBO was more successful than the generators designed according to all the other proposed algorithms. The total harmonic distortion (THD) value decreased by 51.983% compared to the initial design at approximately the same efficiency.
Selective vulnerability of hippocampal CA1 and CA3 pyramidal cells: What are possible pathomechanisms and should more attention be paid to the CA3 region in future studies?
Authors: Einenkel Anne‐Marie , Salameh Aida
Published: November 2023

Transient ischemia and reperfusion selectively damage neurons in brain, with hippocampal pyramidal cells being particularly vulnerable. Even within hippocampus, heterogeneous susceptibility is evident, with higher vulnerability of CA1 versus CA3 neurons described for several decades. Therefore, numerous studies have focused exclusively on CA1. Pediatric cardiac surgery is increasingly focusing on studies of hippocampal structures, and a negative impact of cardiopulmonary bypass on the hippocampus cannot be denied. Recent studies show a shift in selective vulnerability from neurons of CA1 to CA3. This review shows that cell damage is increased in CA3, sometimes stronger than in CA1, depending on several factors (method, species, age, observation period). Despite a highly variable pattern, several markers illustrate greater damage to CA3 neurons than previously assumed. Nevertheless, the underlying cellular mechanisms have not been fully deciphered to date. The complexity is reflected in possible pathomechanisms discussed here, with numerous factors (NMDA, kainate and AMPA receptors, intrinsic oxidative stress potential and various radicals, AKT isoforms, differences in vascular architecture, ratio of pro‐ and anti‐apoptotic Bcl‐2 factors, vulnerability of interneurons, mitochondrial dysregulation) contributing to either enhanced CA1 or CA3 vulnerability. Furthermore, differences in expressed genome, proteome, metabolome, and transcriptome in CA1 and CA3 appear to influence differential behavior after damaging stimuli, thus metabolomics‐, transcriptomics‐, and proteomics‐based analyses represent a viable option to identify pathways of selective vulnerability in hippocampal neurons. These results emphasize that future studies should focus on the CA3 field in addition to CA1, especially with regard to improving therapeutic strategies after ischemic/hypoxic brain injury.
The evolutionary characteristics of temperature change in China during 1961–2020
Authors: Zhou Mengzi , Zhou Guangsheng , Song Yanling , Zhou Li , Ji Yuhe , Lv Xiaomin
Published: November 2023

The changes of annual average, minimum and maximum temperature (Tavg, Tmin and Tmax) in China over 1961–2020 were examined based on the Chinese gridded observation dataset (CN05.1), and the relative contributions of Tmin and Tmax to the tendency of Tavg were addressed. The results show that the nationwide mean warming rate reached 0.29°C·decade−1 for Tavg, 0.39°C·decade−1 for Tmin and 0.24°C·decade−1 for Tmax, respectively, from 1961 to 2020, which depended on temporal windows. The relative contributions of Tmin and Tmax to the trends of Tavg over China during 1961–2020 are 56% and 44%, respectively. On the spatial scale, the majority of China exhibits a greater relative contribution of Tmin than Tmax, except for some areas along the Hu Huanyong Line. As in the case of the warming rate, the temporal patterns of the magnitude of the relative contribution of Tmin and Tmax are also identified. For the first 30 years (1961–1990), Tmin is the primary contributor to changes in the trend of Tavg over a broad area excluding the Qinling Mountain‐Huai River to the Nanling Mountain. The national average magnitudes of the relative contribution of Tmax is slightly larger than Tmin in the latter 30 years (1991–2020). The areas with larger contributions of Tmax are mainly scattered along Hu Huanyong Line, the southern part of the Qinghai‐Tibet Plateau and the patchy parts of Northwest China. Changes in downward longwave radiation, solar radiation, cloud cover, land use, soil moisture, atmospheric circulation and urbanization likely accounted for much of the trend difference of Tmin and Tmax, thereby leading to various relative contributions across different regions during different periods. The warming mechanisms in China have been subjected to novel changes. The study could provide information for decision making on scientific response to warming.
Scrutinizing the use of contrasted chest CTs in extremity sarcoma staging and surveillance
Authors: Priester Jacob I. , Simister Samuel K. , Sario Matthew , Choi Justin , Pina Dagoberto , Theriault Raminta , Bateni Cyrus , Ghasemiesfe Ahmadreza , Carr‐Ascher Janai , Monjazeb Arta M. , Canter Robert J. , Randall R. L. , Thorpe Steven W.
Published: November 2023

Background

Since 2015, the American College of Radiology (ACR) has recommended staging for lung metastasis via chest computed tomography (CT) without contrast for extremity sarcoma staging and surveillance. The purpose of this study was to determine our institutional compliance with this recommendation.

Methods

This was a retrospective chart review of patients diagnosed with sarcoma in the extremities who received CT imaging of the chest for pulmonary staging and surveillance at our institution from 2005 to 2023. A total of 1916 CT studies were included for analysis. We scrutinized ordering patterns before and after 2015 based on the ACR‐published metastasis staging and screening guidelines. An institutional and patient cost analysis was performed between CT modalities.

Results

The prevalence of CT scans ordered and performed with contrast was greater than those without contrast both prior and post‐ACR 2015 guidelines. Furthermore, 79.2% of patient's final surveillance CTs after 2015 were performed with contrast. A cost analysis was performed and demonstrated an additional $297 704 in patient and institutional costs.

Conclusions

At our institution, upon review of CT chest imaging for pulmonary staging and surveillance in patients with extremity sarcoma the use of contrast has been routinely utilized despite a lack of evidence for its necessity and contrary to ACR guidelines.
Ultra‐high‐performance liquid chromatography‐quadrupole‐time of flight‐mass spectrometry combined with network pharmacology for analysis of potential quality markers of three processed products of Qingpi
Authors: Zhang Qian , Xu Ruijie , Xue Rong , Mei Xi , Qin Yuwen , Shen Ke , Xu Jinguo , Su Lianlin , Mao Chunqin , Xie Hui , Lu Tulin
Published: November 2023

Qingpi, a well‐known traditional Chinese medicine for qi‐regulating and commonly processed into three types of pieces, has been widely used in the clinical application of liver disease for thousands of years. In this study, an ultra‐high‐performance liquid chromatography‐quadrupole‐time of flight‐mass spectrometry approach along with multivariate statistical analysis was developed to assess and characterize the differentiations of three processed products and confirm the potential quality markers of Qingpi. In addition, a systematic analysis combined with network pharmacology and molecular docking was performed to clarify the potential mechanism of Qingpi for the treatment of liver disease. As a result, 18 components were identified and an integrated network of Qingpi‐Components‐Target‐Pathway‐Liver Disease was constructed. Eight compounds were finally screened out as the potential quality markers acting on ten main targets and pathways of liver disease. Molecular docking analysis results indicated that the quality markers had a good binding activity with the targets. Overall, this work preliminarily identified the potential quality markers of three processed products of Qingpi, and predicted its targets in the prevention and treatment of liver disease, which can provide supporting information for further study of the pharmacodynamic substances and mechanisms of Qingpi.
Urban green and blue spaces for influencing physical activity in the United Kingdom: A narrative review of the policy and evidence
Authors: Leese Callum , Al‐Zubaidi Hussain
Published: November 2023

Introduction

With the rapid growth of urbanization globally and in the UK, increasing attention is now being directed towards urban green spaces (UGS). The appeal of UGS to policymakers lies in their capacity to address multiple policy objectives, including improving physical and mental wellbeing, mitigating noncommunicable diseases (NCDs), combating climate change through carbon sequestration, providing climate adaptation measures, and enhancing biodiversity.

Method

This narrative review gives an overview of the current literature and UK policy relating to urban green and blue spaces, with a particular focus on the use of UGS to increase physical activity levels.

Results

UGS have a profound impact on public health, with evidence indicating their positive effect on both physical and psychological health. Thirty‐eight percent of adults in the UK do not live within 15 minutes of UGS, so policy makers at national and international level are aiming to address this gap. One reason for the health benefits of UGS is associated increased physical activity, a vital component needed to address the burden of non‐communicable disease. To effectively harness UGS to promote physical activity various factors must be considered; proximity and diversity of urban green spaces, and the presence of suitable infrastructure features. Tailoring UGS to meet the needs and preferences of different population demographics is essential, as is ensuring safety, and addressing barriers to access particularly for lower socio‐economic groups. The careful planning of UGS must avoid potential gentrification effects and displacement of vulnerable communities, whilst utilising the equigenic nature of UGS.

Conclusions

To create a brighter future and capitalize on the potential of UGS, a collaborative approach is needed, involving communities, local governments, and national authorities. Primary‐care professionals, represented by organizations like the Royal College of General Practitioners (RCGP), can play a crucial role in advocating for UGS and physical activity, promoting their use, and providing guidance and support.
The prototype of a frailty learning health system: The HARMONY Model
Authors: Parker Kirsten J. , Hickman Louise D. , McDonagh Julee , Lindley Richard I. , Ferguson Caleb
Published: November 2023

Introduction

Rapid translation of research findings into clinical practice through innovation is critical to improve health systems and patient outcomes. Access to efficient systems of learning underpinned with real‐time data are the future of healthcare. This type of health system will decrease unwarranted clinical variation, accelerate rapid evidence translation, and improve overall healthcare quality.

Methods

This paper aims to describe The HARMONY model (acHieving dAta‐dRiven quality iMprovement to enhance frailty Outcomes using a learNing health sYstem), a new frailty learning health system model of implementation science and practice improvement. The HARMONY model provides a prototype for clinical quality registry infrastructure and partnership within health care.

Results

The HARMONY model was applied to the Western Sydney Clinical Frailty Registry as the prototype exemplar. The model networks longitudinal frailty data into an accessible and useable format for learning. Creating local capability that networks current data infrastructures to translate and improve quality of care in real‐time.

Conclusion

This prototype provides a model of registry data feedback and quality improvement processes in an inpatient aged care and rehabilitation hospital setting to help reduce clinical variation, enhance research translation capacity, and improve care quality.
Three EHDA Processes from a Detachable Spinneret for Fabricating Drug Fast Dissolution Composites
Authors: Chen Shu , Zhou Jianfeng , Fang Boya , Ying Yue , Yu Deng‐Guang , He Hua
Published: November 2023

In this study, three kinds of electrohydrodynamic atomization (EHDA) processes (electrospraying, electrospinning, and coaxial electrospinning) are implemented to create hydroxypropyl methylcellulose (HPMC) based ultra‐thin products for providing the fast dissolution of a poorly water‐soluble drug ketoprofen (KET). An EHDA apparatus, characterized by a novel spinneret, is homemade for conducting the three processes. The three types of products are electrospun nanofibers E1, electrosprayed microparticles E2, and core‐shell nanofibers E3. SEM and TEM results indicate that they have the anticipated morphologies and inner structures. X‐ray diffraction and Fourier Transform Infrared results verify that KET is mainly amorphous in all the composites due to its fine compatibility with HPMC. In vitro dissolution tests demonstrate that the drug rapid release performances has an order of E3>E1>E2≫KET powders. The fast dissolution mechanisms are suggested and the advantages of the three products are compared. The super performance of E3 in furnishing the rapid release is attributed to a synergistic action of small size (of the shell thickness), high porosity, amorphous state of drug, and the solubility of HPMC. EHDA nanostructures can support the development of nano drug delivery systems (DDSs) through tailoring the spatial distribution of drug molecules within the nano products.
Genome‐wide meta‐analysis and fine‐mapping prioritize potential causal variants and genes related to leprosy
Authors: Wang Zhenzhen , Liu Tingting , Li Wenchao , Yu Gongqi , Mi Zihao , Wang Chuan , Liao Xiaojie , Huai Pengcheng , Chu Tongsheng , Liu Dianchang , Sun Lele , Fu Xi'an , Sun Yonghu , Wang Honglei , Wang Na , Liu Jianjun , Liu Hong , Zhang Furen
Published: November 2023

To date, genome‐wide association studies (GWASs) have discovered 35 susceptible loci of leprosy; however, the cumulative effects of these loci can only partially explain the overall risk of leprosy, and the causal variants and genes within these loci remain unknown. Here, we conducted out new GWASs in two independent cohorts of 5007 cases and 4579 controls and then a meta‐analysis in these newly generated and multiple previously published (2277 cases and 3159 controls) datasets were performed. Three novel and 15 previously reported risk loci were identified from these datasets, increasing the known leprosy risk loci of explained genetic heritability from 23.0 to 38.5%. A comprehensive fine‐mapping analysis was conducted, and 19 causal variants and 14 causal genes were identified. Specifically, manual checking of epigenomic information from the Epimap database revealed that the causal variants were mainly located within the immune‐relevant or immune‐specific regulatory elements. Furthermore, by using gene‐set, tissue, and cell‐type enrichment analyses, we highlighted the key roles of immune‐related tissues and cells and implicated the PD‐1 signaling pathways in the pathogenetic mechanism of leprosy. Collectively, our study identified candidate causal variants and elucidated the potential regulatory and coding mechanisms for genes associated with leprosy.
A Case Series of Isolated Smiling Tremor: What Is the Phenomenology?
Authors: Radmard Sara , Amlang Christian Johannes , Weimer Louis , Pullman Seth L.
Published: November 2023

Background

Five cases of tremor only upon smiling have been reported where no facial tremor is present at rest, when talking, or with full smile.

Cases

This report highlights four cases of tremor upon partial smiling, discusses the phenomenology of smiling tremor, and reviews the current literature. Four subjects with lower facial tremor present only upon smiling underwent movement disorders evaluation with video. Tremor frequencies were determined by parsing the video clips into 1‐second intervals and averaging the number of oscillations per interval and were determined to be high‐frequency 8 to 10 Hz irregular facial tremors with harmonic variations upon moderate effort in all cases. Slight or full‐effort smiling did not elicit facial muscle oscillations. Subjects had no other signs of tremor, dystonia, or parkinsonism on examination or in family history.

Conclusions

Tremor upon smiling only, or isolated smiling tremor, is a unique task‐ and position‐specific tremor of the facial musculature.
Charting Disease Trajectories from Isolated REM Sleep Behavior Disorder to Parkinson's Disease
Authors: Di Folco Cécile , Couronné Raphaël , Arnulf Isabelle , Mangone Graziella , Leu‐Semenescu Smaranda , Dodet Pauline , Vidailhet Marie , Corvol Jean‐Christophe , Lehéricy Stéphane , Durrleman Stanley
Published: November 2023

Background

Clinical presentation and progression dynamics are variable in patients with Parkinson's disease (PD). Disease course mapping is an innovative disease modelling technique that summarizes the range of possible disease trajectories and estimates dimensions related to onset, sequence, and speed of progression of disease markers.

Objective

To propose a disease course map for PD and investigate progression profiles in patients with or without rapid eye movement sleep behavioral disorders (RBD).

Methods

Data of 919 PD patients and 88 isolated RBD patients from three independent longitudinal cohorts were analyzed (follow‐up duration = 5.1; 95% confidence interval, 1.1–8.1] years). Disease course map was estimated by using eight clinical markers (motor and non‐motor symptoms) and four imaging markers (dopaminergic denervation).

Results

PD course map showed that the first changes occurred in the contralateral putamen 13 years before diagnosis, followed by changes in motor symptoms, dysautonomia, sleep—all before diagnosis—and finally cognitive decline at the time of diagnosis. The model showed earlier disease onset, earlier non‐motor and later motor symptoms, more rapid progression of cognitive decline in PD patients with RBD than PD patients without RBD. This pattern was even more pronounced in patients with isolated RBD with early changes in sleep, followed by cognition and non‐motor symptoms and later changes in motor symptoms.

Conclusions

Our findings are consistent with the presence of distinct patterns of progression between patients with and without RBD. Understanding heterogeneity of PD progression is key to decipher the underlying pathophysiology and select homogeneous subgroups of patients for precision medicine. © 2023 International Parkinson and Movement Disorder Society.
Epigenetic aging of mammalian gametes
Authors: Klutstein Michael , Gonen Nitzan
Published: November 2023

The process of aging refers to physiological changes that occur to an organism as time progresses and involves changes to DNA, proteins, metabolism, cells, and organs. Like the rest of the cells in the body, gametes age, and it is well established that there is a decline in reproductive capabilities in females and males with aging. One of the major pathways known to be involved in aging is epigenetic changes. The epigenome is the multitude of chemical modifications performed on DNA and chromatin that affect the ability of chromatin to be transcribed. In this review, we explore the effects of aging on female and male gametes with a focus on the epigenetic changes that occur in gametes throughout aging. Quality decline in oocytes occurs at a relatively early age. Epigenetic changes constitute an important part of oocyte aging. DNA methylation is reduced with age, along with reduced expression of DNA methyltransferases (DNMTs). Histone deacetylases (HDAC) expression is also reduced, and a loss of heterochromatin marks occurs with age. As a consequence of heterochromatin loss, retrotransposon expression is elevated, and aged oocytes suffer from DNA damage. In sperm, aging affects sperm number, motility and fecundity, and epigenetic changes may constitute a part of this process. 5 methyl‐cytosine (5mC) methylation is elevated in sperm from aged men, but methylation on Long interspersed nuclear elements (LINE) elements is reduced. Di and trimethylation of histone 3 lysine 9 (H3K9me2/3) is reduced in sperm from aged men and trimethylation of histone 3 lysine 27 (H3K27me3) is elevated. The protamine makeup of sperm from aged men is also changed, with reduced protamine expression and a misbalanced ratio between protamine proteins protamine P1 and protamine P2. The study of epigenetic reproductive aging is recently gaining interest. The current status of the field suggests that many aspects of gamete epigenetic aging are still open for investigation. The clinical applications of these investigations have far‐reaching consequences for fertility and sociological human behavior.
Authoritarian populism and response to COVID‐19: A comparative study of the United States, India, and Brazil
Authors: Imran Sumeera , Javed Humayun
Published: November 2023

As the phenomenon of populism is in the preliminary stages of exploratory research, the present study involves an empirical investigation involving a case study of the United States, India, and Brazil to examine whether a correlation exists between populism and management of COVID‐19. The study adopts the ideational approach of populism as a set of ideas or discourse to review how core conceptual features of populism have impacted on management of COVID‐19. The study has two main objectives: (1) to examine whether populism in the United States, India, and Brazil has determined “a populist response” to the pandemic in dealing with the health crises and (2) to explore the management of COVID‐19 in the states led by right‐wing populism and the commonality of populist approaches adopted in handling the health crisis. Comparing the three states' statistical data of management models, the study has argued that common populist mechanisms such as distrust for experts, contempt for institutions, and suspicion of “others” have guided the US, India, and Brazilian leadership response to COVID‐19. It further argues that leadership in the United States, India, and Brazil has prevented effective management by politicizing the crisis, aggravating social polarization, and contradicting expert advice. Moreover, populist and nationalist orientation of the leadership has evaded responsibility in these states with the leadership blaming ethnicities for spreading the virus and by weakening societal solidarity.
Coastal residents' affective engagement with the natural and constructed environment
Authors: Buitendijk Tomas , Morris‐Webb Elisabeth S. , Hadj‐Hammou Jeneen , Jenkins Stuart R. , Crowe Tasman P.
Published: November 2023

Coastal communities and their landscapes are subject to constant change, and today face new challenges as a result of climate change and the sustainable energy transition. To ensure the resilience of coastal communities to ongoing changes in the natural and constructed environment, it is imperative that planners and other decision‐makers understand the importance of local places to residents.

We used an interdisciplinary, mixed‐methods approach to study relationships between coastal residents and places in south Co. Wicklow, Ireland, introducing the concept of ‘affective engagement’. Grounded in new materialist theory (notably actor–network theory), this term connects the meaning derived by residents from their relationships with coastal places (‘affect’) to the extent of their material interactions (‘engagement’). ‘Affect’ was determined from thematic analysis of interviews and open questionnaire responses, as well as place attachment scales included in the questionnaire. Measures describing the strength of the relationship between residents and coastal places were used as a proxy for ‘engagement’.

To understand how experienced meaning and material interaction interlink, principal component analysis (PCA) was used to join and visually explore the different measures of ‘affect’ and ‘engagement’. Potentially mediating sociodemographic variables were investigated using a permutational multivariate analysis of variance (PERMANOVA).

The majority of self‐selected study participants displayed strong place attachment to their most frequently visited places. We found that affective engagement does not vary with age, gender or type of place. Participants favoured natural and constructed places in equal measure. This implies that constructed places can be of high value due to their different functions for different individuals, and that landscape transformations may impact on coastal residents if they cause a change in functionality.

We found two domains comprising affective engagement that are not measurable by quantitative or qualitative data alone. The first of these domains is driven by attachments to places, and the other by meanings relating to either personal or social fulfilment afforded by a place.

Our findings may help planners better understand the meanings behind local support for (or resistance against) landscape transformations, and how residents' affective engagement might be impacted by proposed interventions.

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