bluuebunny/crossref_metadata_2025 huggingface dataset:
95 MODIFIED HISTOPATHOLOGICAL GRADING OPTIMIZES PREDICTION OF SURVIVAL OUTCOMES IN SMALL INTESTINAL NEUROENDOCRINE TUMOURS
Authors: Daskalakis K , Tsoli M , Wallin G , Kogut A , Srirajaskanthan R , Giovos G , Weickert M O , Kos-Kudla B , Kaltsas G
Published: May 2024

Background

We aimed to identify optimal grading Ki-67 cut-offs to delineate differences in prognosis of patients with small intestinal neuroendocrine tumours (SI-NETs) in terms of overall- and event-free survival rates.

Methods

We included 551 patients with SI-NETs diagnosed from June 15th, 1993, through March 8th, 2021, identified using the SI-NET databases from five European referral centers.

Results

Median age at baseline was 62.3(17-90) years; 252 patients were women (45.7%). All tumours were well-differentiated; 326 were G1 tumours (59.2%), 169 G2(30.7%), only 8 G3(1.5%), while 48 tumours were of unspecified grade(8.7%). The median Ki67 was 2%(1-70%). 247 patients(44.8%) had distant metastases at baseline (stage IV), 217 locoregional disease(41.1%; stage III), whereas 29(7.1%) and 25(4.5%) presented at stages II and I, respectively. Within a mean(SD) follow-up of 51.5(52.9) months, 94 patients(17.1%) died, whereas overall 188 experienced disease recurrence, progression and/or death(34.1%). The median OS was 214.7(95%CI: 152.7-276.6) months and the median EFS was 79.8(95%CI: 68.2-91.5) months, respectively. In multivariable Cox-regression OS analysis, age (HR=1.07, 95%CI: 1.04-1.09; p<0.001), Charlson Comorbidity Index(HR=1.1, 95%CI: 1.03-1.17; p=0.006) and the proposed modified histopathological Ki67 grading system(K67:5-10% group: HR=2.4, 95%CI: 1.3-4.5; p=0.007 and K67≥10% group: HR=5.1, 95%CI: 2.9-9.2; p<0.001) were independent predictors for death. Pertinent EFS analysis, confirmed age(HR=1.04, 95%CI: 1.02-1.05;p<0.001) and the proposed modified histopathological Ki67 grading system(K67≥10% group: HR=4; 95%CI:2.5-6.2;p<0.001) as independent predictors for recurrence, progression and/or death.

Conclusions

Ki-67 proliferation index is an independent predictor of EFS and OS. A modified site-specific histopathological grading system applying Ki-67 cut-offs of 5% and 10% seems more optimal to predict differences in SI-NET patient prognosis.
127 CATECHOLAMINE-INDUCED HYPERTENSIVE CRISIS DURING LAPAROSCOPIC ADRENALECTOMY FOR UNILATERAL PHEOCHROMOCYTOMA
Authors: Criqui C N , Nguyen-Thi P L , Duclos A , Polazzi S , Haythem Najah N , Gaujoux S , Fabrice M , Mirallié E , Sebag F , Zinzindoue F , Lifante J C , Brunaud L
Published: May 2024

Background

Laparoscopic adrenalectomy (LA) is the standard of care for the management of pheochromocytoma after preoperative medical preparation (PMP) using antihypertensive medications. Catecholamine-induced hypertensive crisis (CIHC) was recently defined by an international consortium as blood pressure > 180/120 mmHg. However, the impact of PMP on intraoperative CIHC and perioperative complications remains controversial. The aim of this study was to evaluate the impact of PMP on the incidence of intraoperative CIHC and perioperative complications.

Methods

Multi-institutional retrospective cohort study including data from all patients who underwent LA for pheochromocytoma in 8 high-volume surgical departments from 01/01/2000 to 12/31/2016. Patients who underwent emergency surgery, bilateral or open adrenalectomy were excluded (n=140).

Results

Data were available for 922 patients (female n=520, 56.4%). Long-term antihypertensive treatment prior surgery and specific PMP were recorded in 479 (51.9%) and 604 patients (65.5%), respectively. During LA, at least one episode of CIHC was observed in 123 patients (13.7%). Perioperative mortality rate was 0.3% (3 patients). Thirty-day postoperative complication rate was 20.4% (188 patients). In multivariable analysis, tumor size (0.99, 0.98-1.00; p=0.04) remained the only independent predictor for intraoperative CIHC incidence (ASA score, long-term antihypertensive treatment, and PMP had no significant impact). ASA score (2.17, 1.56-3.01; p<0.001), tumor size (1.01, 1.00-1.02; p<0.01), long-term antihypertensive treatment (1.59, 1.11-2.28; p=0.01), and intraoperative CIHC incidence (0.62, 0.39-0.97; p=0.03) remained independent predictors for perioperative complications, but not PMP.

Conclusions

The use of PMP had no significant impact on intraoperative CIHC incidence and perioperative complications in this multi-institutional cohort study.
146 NEOADJUVANT SYSTEMIC THERAPY FOR “INOPERABLE” THYROID CANCERS: SURGICAL RESECTION STRATEGIES
Authors: Dickerson K , Niu J , Metzger R , Tomeh C , Ahmad I , Hebert M , Nasr C , Nelson J , Westfall E , Eisen R , Milas M
Published: May 2024

Background

Limited treatment options exist for “inoperable” thyroid cancers. Neoadjuvant (NEO) use of systemic tyrosine kinase inhibitors (TKI) has been anecdotally reported. We aimed to evaluate whether NEO-TKI therapy facilitates surgical resection.

Methods

Single-institution experience of patients receiving TKI for papillary (PTC), follicular (FTC) and anaplastic thyroid carcinomas (ATC) during 2018-2023 was reviewed. Our center has a well-established multidisciplinary pathway with protocol-driven management of advanced thyroid cancers. TKI regimens included dabrafenib/trametinib, lenvatinib/pembrolizumab or lenvatinib alone.

Results

10/42 patients (median age 56 years) received NEO-TKI with intent to improve resectability of primary (n=5, 2 FTC/3 PTC) or recurrent tumors (n=5, 1 ATC/4 PTC). All had locoregionally advanced disease: CT size 9±2.6 cm with lymphadenopathy (n=9) and vital structure involvement (n=8). All were “inoperable” or resectable with unacceptable morbidities. Genomic analysis detected BRAF V600E mutation in 1/1 ATC and 6/7 PTC, and NRAS/TERT or HRAS/TERT in both FTC. NEO-TKI yielded clinical results quickly, including mass reduction and cessation of hemoptysis from tracheal invasion. Seven patients received intended surgery with R0 resection and without major surgical complications. Patients tolerated NEO-TKI well with minimal toxicity. Two years post-operatively, all patients are alive without new locoregional recurrence.

Conclusions

NEO-TKI seems extremely effective in downstaging surgically “inoperable” thyroid cancers to achieve R0 resection while avoiding unnecessary morbidities. Multidisciplinary approach with early genomic profiling to guide personalized NEO-TKI is essential. Prospective studies using NEO-TKI are urgently needed as this series suggests neoadjuvant therapy may have a significant role in future surgical resection strategies for thyroid cancers.
75 CIRCULATING EXTRACELLULAR VESICLES AS DIAGNOSTIC BIOMARKERS FOR INDETERMINATE THYROID NODULES
Authors: Ahmed N , Beatson K , Patel J , Eddama M , Abdel-Aziz T , Clapp L
Published: May 2024

Background

Preoperative differentiation of benign from malignant indeterminate thyroid nodules (ITN) remains one of the most challenging issues in endocrine oncology. Most patients with an ITN will undergo diagnostic surgery with around 80% receiving a benign diagnosis on final histology. Liquid biopsy-based analysis of circulating extracellular vesicles (EVs) presents a promising diagnostic modality. The objective of this study is to measure the plasma levels of circulating EVs and identifying differentially expressed EV miRNAs in patients with benign versus malignant ITNs.

Methods

To quantify EVs: EVs where isolated by differential centrifugation from plasma of 28 patients with ITN (14 benign and 14 cancers on histology) and 16 matched healthy controls (HCs). The total and subpopulations of cancer related EVs (CXCR7+, CD147+, SDC4+, EpCAM+) were measured using a scatter calibrated flow cytometer. For miRNA sequencing: plasma EVs were isolated, and EV-RNA extracted using exoRNeasy Midi kit (Qiagen) from 3 HCs, 6 benign and 9 cancer patients. Sequencing was performed using DNBseq-G400 sequencer (BGI).

Results

The total plasma EV levels as well as CXCR7+, CD147+, SDC4+, EpCAM+ EVs were significantly higher in patients with ITN (both cancer and benign) compared to HCs (p<0.0001 for all). Two miRNAs (hsa-miR-195-3p, hsa-miR-619-5p) were significantly upregulated (p<0.0001) and 4 were downregulated: hsa-miR-3176, hsa-miR-205-5p, a novel miRNA: hsa-miR208-3p (p<0.0001 for all 3), and hsa-let-7i-3p (p=0.03) in patients with malignant versus benign ITNs

Conclusions

Circulating EVs, especially EV miRNAs, have a high diagnostic value and may improve the diagnostic strategy for patients with ITNs.
259 DEVELOPMENT OF AN ONTOLOGY FOR LAPAROSCOPIC TRANSABDOMINAL ADRENALECTOMY FOR SURGICAL TRAINING AND VIDEO ANALYSIS WITH MACHINE LEARNING ALGORITHMS AND ITS VALIDATION VIA A COMPREHENSIVE MODIFIED DELPHI SURVEY
Authors: Di Lorenzo S , Seeliger Barbara , Francesco A P , Brunaud L , Chiapponi C , De Crea C , Donatini G , Iacobone M , Makay Ö , Mihai R , Mogl M , Mutter D , Padoy N , Palazzo F , Vidal O , Vix M , Raffaelli M
Published: May 2024

Background

Although the safety of laparoscopic transabdominal lateral adrenalectomy (TLA) depends on the learning curve and experience of surgeons, surgical training remains a challenge as adrenalectomies are relatively rare. Structured laparoscopic video analysis supports individual training and could pave the way for automatic workflow recognition and safety alerts via Artificial Intelligence systems. We aimed to develop and validate a surgical ontology for TLA video analysis suitable for multicentric use.

Methods

An ontology hierarchically structured in phases and steps of laparoscopic right (RTLA) and left (LTLA) TLA was developed and submitted to a web-based survey via a 2-rounds modified Delphi process shared among 17 experienced adrenal surgeons across Europe. Consensus was defined at ≥ 80% agreement for each statement.

Results

RTLA was subdivided in 6 phases and 27 steps, and LTLA in 6 phases and 25 steps. Phases on both sides were: I) Preparation (5 statements), II) Exposition (8 statements), III) Dissection of the main adrenal vein (RTLA 14 statements, LTLA 12 statements), IV) Dissection of adrenal gland (6 statements), V) Extraction and disassembling (6 statements), and VI) any complementary intervention (1 statement). Panelist response rate was 88 % (15/17). Consensus was reached for LTLA in all 38 statements, and for RTLA in 39/40 statements (97,5%), as identification of the renal vein was not unanimously considered mandatory.

Conclusions

An expert consensus validated the developed ontology for TLA techniques as performed across Europe, suitable for multicentric video assessments and for surgical training and video analysis with machine learning algorithms.
98 A MULTIDISCIPLINARY TEAM - CENTRED ONE-STOP THYROID NODULE CLINIC REDUCES DELAY IN THYROID CANCER DIAGNOSIS AND MANAGEMENT – A SINGLE INSTITUTIONAL EXPERIENCE
Authors: Al Omar A , Oh H B , Ahmed A , Abdelsalam A , Garcia V , Kurzawinski T , Al-Lawati A , Pomplun S , Amin S , Gutierrez-Arniaz M , Monne F , Flynn D , Abdel-Aziz T
Published: May 2024

Background

Thyroid nodules are a common presentation in the surgical clinic. Patients are often referred by the GP under the 2-week wait rule in the UK. Majority of these nodules are benign but require an US scan and in many cases an US-FNAC. We launched the Multidisciplinary Team (MDT) one-stop clinic (OSC) in January 2022 to streamline services and improve patients’ experience.

Methods

Demographics, cytology reports and management plans of all patients who attended the OSC from January 2022-March 2023 were reviewed from the electronic medical records. Time to definitive surgery was also reviewed and patients were followed up for a minimum of 6 months.

Results

308 patients attended OSC (Females:251(81%), Males:57(19%)). 144(47%) were symptomatic while 164(53%) were incidental. 113(37%) had palpable thyroid nodules with only 7% having a family history of Thyroid Cancer. 144(47%) patients had thyroid nodules targeted for FNAC and 72(50%) patients were diagnosed with definite/suspected malignancy. 65(45%) patients with benign cytology had their results explained to them via telemedicine. All patients with malignant/indeterminate results were discussed in the same-day MDT with a median time to definitive/diagnostic surgery of 27 days. Of note, only 5% had a non-diagnostic (Thy1) result.

Conclusions

A comprehensive one-stop clinic reduces patient visits and delays in thyroid cancer diagnosis and management. In addition, 75% of patents were reassured that they do not have thyroid cancer with results discussed on the same day. To our knowledge, this is the first novel one-stop thyroid clinic with same-day cytology results, MDT review and counselling for management.
264 IMPROVING INTELLECT WITH PARATHYROIDECTOMY
Authors: Jovanovic M , Grujicic S S , Tausanovic K , Slijepcevic N , Rovcanin B , Stojanovic M , Odalovic B , Jovanovic K , Buzejic M , Ivanis S , Parezanovic M , Ilic J , Zivaljevic V
Published: May 2024

Background

Along with classic clinical symptoms and its negative effects on quality of life, primary hyperparathyroidism (pHPT) can influence cognitive status, as well. The aim of this study was to evaluate the cognitive status of patients with primary hyperparathyroidism before and after parathyroidectomy.

Methods

During a two-year period, a panel study was conducted at our institution, that included patients scheduled for parathyroidectomy. Basic demographic data of interest and relevant clinical data were collected. Cognitive status was assessed in interviews before surgery, one month, and six months following surgery using a Mini-Mental State Examination (MMSE).

Results

A total of 101 patients (88 females) with pHPT were included in the study, with an average age of 60.7 years. The average preoperative calcium and PTH levels were 2.98 mmol/L and 305.9 ng/mL, respectively. There was a significant improvement in MMSE score six months after parathyroidectomy (from 27.6 to 28.9, p<0.001). Preoperatively, 9.9% of patients had a pathological MMSE score (≤25), and six months after parathyroidectomy, only one patient had the mild disorder. According to the univariable linear regression analysis, older age, lower level of education, unemployment and higher PTH level preoperatively were risk factors for lower MMSE score. Still, based on the multivariable linear regression analysis, only age over 61 was an independent predictor. The risk factor for greater change of MMSE score postoperatively was lower level of education.

Conclusions

A notable number of patients with primary hyperparathyroidism preoperatively show signs of impaired cognitive status, with substantial improvement after successful parathyroidectomy.
249 SURGICAL MANAGEMENT OF ZOLLINGER-ELLISON SYNDROME IN MULTIPLE ENDOCRINE NEOPLASIA TYPE 1, AN AFCE AND GTE COHORT STUDY. (ASSOCIATION FRANCOPHONE DE CHIRURGIE ENDOCRINIENNE AND GROUPE D'ÉTUDE DES TUMEURS ENDOCRINES)
Authors: Gaujoux S , Pattou F , Caiazzo R , Deguelte S , Donatini G , Lifante J C , Mirallié E , Santucci N , Sebag F , Goudet P
Published: May 2024

Background

Management of ZES in MEN1 remains controversial. The objective was to describe surgical indications, procedures and outcome in patients operated for Zollinger-Ellison syndrome (ZES) in Multiple Endocrine Neoplasia type 1 (MEN1) using a large nationwide cohort.

Methods

All patients with ZES diagnosed through the MEN1 AFCE/GTE network during the 1985-2015 period.

Results

Among 233 ZES patients, 66 (28%) were operated for ZES-related gastrinoma(s). Thirty-three (51%) procedures aimed at removing gastrinoma(s) and associated pancreatic neuroendocrine tumor(s) (pNET(s)) by appropriate resection(s). Thirty-two procedures (49%) aimed at removing gastrinoma(s) alone (ZES group). Survival was decreased in metastatic patients at ZES diagnosis (p<0.001). Fifteen-year survival among non-metastatic patients was not significantly better in operated patients (82% (95% CI:67-90) versus 70% (95% CI:60-78)) (p=0.2). Operative mortality was nil. Metastatic lymph nodes were found in 30/42 lymphadenectomies (71%). The choice between duodenopancreatectomy versus duodenal focused surgery in the ZES group was associated with pre-operative detection of adenopathies (p>0.001), leading to more frequent lymphadenectomies (p<0.01). Previous pancreatic surgeries (30%) may have influenced the choice of ZES procedures.

Conclusions

The high rate of invaded nodes in lymphadenectomies in MEN1 patients operated for ZES, the absence of operative mortality, and the decreased survival in metastatic patients are indirect arguments for surgery. Duodenopancreatectomy was chosen more frequently than duodenal focused surgery in case of suspected lymph nodes in the ZES group. Duodenopancreatectomy may be indicated in young and fit patients to prevent metastatic evolution in the ZES group. Removing gastrinoma(s) when associated with large pNET(s) is justified.
Major surgical conditions of childhood and their lifelong implications: comprehensive review
Authors: Cullis Paul S , Fouad Dina , Goldstein Allan M , Wong Kenneth K Y , Boonthai Ampaipan , Lobos Pablo , Pakarinen Mikko P , Losty Paul D
Published: May 2024

Background

In recent decades, the survival of children with congenital anomalies and paediatric cancer has improved dramatically such that there has been a steady shift towards understanding their lifelong health outcomes. Paediatric surgeons will actively manage such conditions in childhood and adolescence, however, adult surgeons must later care for these ‘grown-ups’ in adulthood. This article aims to highlight some of those rare disorders encountered by paediatric surgeons requiring long-term follow-up, their management in childhood and their survivorship impact, in order that the adult specialist may be better equipped with skills and knowledge to manage these patients into adulthood.

Methods

A comprehensive literature review was performed to identify relevant publications. Research studies, review articles and guidelines were sought, focusing on the paediatric management and long-term outcomes of surgical conditions of childhood. The article has been written for adult surgeon readership.

Results

This article describes the aforementioned conditions, their management in childhood and their lifelong implications, including: oesophageal atresia, tracheo-oesophageal fistula, malrotation, short bowel syndrome, duodenal atresia, gastroschisis, exomphalos, choledochal malformations, biliary atresia, Hirschsprung disease, anorectal malformations, congenital diaphragmatic hernia, congenital lung lesions and paediatric cancer.

Conclusion

The increasing survivorship of children affected by surgical conditions will translate into a growing population of adults with lifelong conditions and specialist healthcare needs. The importance of transition from childhood to adulthood is becoming realized. It is hoped that this timely review will enthuse the readership to offer care for such vulnerable patients, and to collaborate with paediatric surgeons in providing successful and seamless transitional care.
Experiment and performance analysis of serpentine-shaped cantilever beam for pipeline vibration-based piezoelectric energy harvester prototype development
Authors: Mohd Fairuz Wan Nabila , Mohd Nawi Illani , Ahmad Mohamad Radzi , Kannan Ramani
Published: May 2024

Pipelines produce vibrations during fluid or gas transportation. These vibrations are less likely to cause structural failure as they exist with a small magnitude and can be harvested into useful energy. This paper presents a study on the piezoelectric energy-harvesting method converting mechanical energy from pipeline vibration into electrical energy. The performance of the serpentine-shaped piezoelectric cantilever beam was observed to check whether the design can produce the highest output voltage within the allowable vibration region of the pipeline from 10 to 300 Hz through finite element analysis using COMSOL Multiphysics software (Supplementary Material). In addition, this study investigates the energy-harvesting potential of the proposed design under real pipeline vibration conditions through a lab vibration test. The harvested energy output is evaluated based on various vibration frequencies and amplitudes, which gives an idea of the device and its performance under different operating conditions. The experiment result shows that the energy harvester produced an open-circuit voltage of 10.28–15.45 V with 1 g of vibration acceleration. The results of this research will contribute to the development of efficient piezoelectric energy harvesters adapted for pipeline environments.
Artificial intelligence algorithms and three-dimensional volumetric rendering for basal cell carcinoma detection and tumour depth assessment in reflectance confocal microscopy–optical coherence tomography images: a pilot study
Authors: Pan Alexander , de Carvalho Nathalie , Silva Luisa , Harris Ucalene , Dusza Stephen , Sahu Aditi , Kose Kivanc , Monnier Jilliana , Chen Chih-Shan , Jain Manu
Published: May 2024

The reflectance confocal microscopy (RCM)–optical coherence tomography (OCT) device has shown utility in detecting and assessing the depth of basal cell carcinoma (BCC) in vivo but is challenging for novices to interpret. Artificial intelligence (AI) applied to RCM-OCT could aid readers. We trained AI models, using OCT rasters of biopsy-confirmed BCC, to detect BCC, create three-dimensional rendering and automatically measure tumour depth. Trained AI models were applied to a separate test set containing rasters of BCC, benign lesions, and healthy skin. Blinded reader analysis and tumour depth correlation with histopathology were conducted. BCC detection improved from viewing OCT rasters only (sensitivity 73.3%, specificity 45.5%) to viewing rasters with AI-generated BCC rendering (sensitivity 86.7%, specificity 48.5%). A Pearson correlation r2 = 0.59 (P = 0.02) was achieved for the tumour depth measurement between AI and histological measured depths. Thus, addition of AI to the RCM-OCT device may expand its utility widely.
Topographic effect on body-wave polarization and near-surface wave speed estimation
Authors: Li Yuanshen , Park Sunyoung
Published: May 2024

This study examines the topographic effect on the body-wave polarization and, subsequently, on near-surface wave speed estimation. We first derive 3-D P- and S-wave polarization angles in the presence of ground tilt, where the angles are functions of the ground tilt orientation, the near-surface wave speeds and the incident wave direction. We find that S-wave polarization angle varies considerably (e.g. more than 100 per cent) when the incident angle is close to the critical angle. The counter-intuitive phenomenon for flat surface, that is, P-wave polarization being only sensitive to S but not P wave speeds, breaks down in the presence of ground tilt, and P-wave polarization becomes sensitive to both P and S wave speeds. Examining the differences in the inferred wave speeds with and without the flat-surface assumption reveals that bias in wave speed estimates is, in general, higher for smaller incident angles, for example, about 50 per cent or higher for a 15° ground tilt and near-vertical (<5°) incidence. The effect on P wave speed estimates is also significant when the S-wave incident angle approaches the critical angle. In order to investigate the topographic effect on wave speed estimates inferred using teleseismic polarization data, we revisit the near-surface wave speed estimates at Hi-net stations from a previous study that did not account for the topography. Based on the ground tilt and strike angles measured for each Hi-net site at 300-m scale—which is found to be the most relevant scale—we constrain P and S wave speeds utilizing the P-wave polarization data. We find that P-wave polarization data alone can effectively constrain not only S but also P wave speeds, especially when the ground tilt is sufficiently large (e.g. >5°). Furthermore, our additional test suggests that including S-wave polarization data with the tilt consideration will improve the near-surface wave speed estimates significantly compared to when the tilt effect is ignored.
Surface electrocardiogram f wave analysis in patients with atrial fibrillation undergoing thoracoscopic epicardial ablation
Authors: An Kang , Li Haojie , Yu Chunyu , Zheng Zhe
Published: May 2024

OBJECTIVES

To investigate the predictive values of surface electrocardiogram-derived parameters in patients with atrial fibrillation who underwent thoracoscopic epicardial ablation.

METHODS

The present study included 102 patients with atrial fibrillation who underwent thoracoscopic epicardial ablation and whose baseline 12-lead electrocardiograms were available. Frequency domain analysis was performed to calculate the electrocardiogram-derived parameters. Cox proportional hazards regression was used to identify predictive risk factors for postoperative recurrence.

RESULTS

At 36-month interval, the overall rate of freedom from atrial tachyarrhythmia without antiarrhythmic drugs was 58.5%. The results of the univariable and multivariable analyses showed that larger left atrial diameter (hazard ratio: 1.074, 95% confidence interval: 1.021–1.130, P = 0.006) was an independent risk factor for atrial fibrillation recurrence, while higher fibrillatory wave amplitude was a protective factor (hazard ratio: 0.292, 95% confidence interval: 0.157–0.542, P < 0.001). The associations were clarified by the restricted cubic splines. The dominant frequency and organization index were not identified as statistically significant parameters.

CONCLUSIONS

The fibrillatory wave amplitude has the highest predictive value for atrial fibrillation recurrence in electrocardiogram-derived parameters. Together with left atrial diameter, it may help identify patients in whom thoracoscopic ablation is likely to be effective.
L
2-Maximal Functions on Graded Lie Groups
Authors: Cardona Duván
Published: May 2024

Bourgain in his seminal paper of 1986 about the analysis of maximal functions associated to convex bodies has estimated in a sharp way the $L^{2}$-operator norm of the maximal function associated to a kernel $K\in L^{1},$ with differentiable Fourier transform $\widehat{K}.$ We formulate the extension to Bourgain’s $L^{2}$-estimate in the setting of maximal functions on graded Lie groups. Our criterion is formulated in terms of the group Fourier transform of the kernel. We discuss the application of our main result to the $L^{p}$-boundedness of maximal functions on graded Lie groups.
Blockade of CCR5 and CXCR3 attenuates murine acute graft-versus-host disease through modulating donor-derived T-cell distribution and function
Authors: Tang Bo , Qin Chenchen , Liu Huihui , Miao Shengchao , Xue Chao , Wang Zhenhua , Zhang Yang , Dong Yujun , Liu Wei , Ren Hanyun
Published: May 2024

Lymphocyte trafficking via chemokine receptors such as C-C chemokine receptor 5 (CCR5) and CXCR3 plays a critical role in the pathogenesis of acute graft-versus-host disease (aGVHD). Our previous studies showed that the addition of CCR5 or CXCR3 antagonists could only slightly alleviate the development of aGVHD. Given the specificity of T lymphocytes bearing CXCR3 and CCR5, we investigated whether combined CCR5 and CXCR3 blockade could further attenuate murine aGVHD. A mouse model of aGVHD was established to assess the efficacy of CCR5 and/or CXCR3 blockade on the development of aGVHD. The distribution of lymphocytes was calculated by quantification of immunostaining cells. The immunomodulatory effect on T cells was assessed by evaluating T-cell proliferation, viability, and differentiation. Using the murine allogeneic hematopoietic stem cell transplantation model, we demonstrated that blockade of both CCR5 and CXCR3 could efficiently alleviate the development of aGVHD. Further investigation on the immune mechanisms for this prophylactic effect showed that more T cells were detained into secondary lymphoid organs (SLOs), which may lead to reduced infiltration of T cells into GVHD target organs. Our study also showed that T cells detained in SLOs dampened the activation, suppressed the polarization toward T helper type 1 (Th1) and T cytotoxic type 1 (Tc1) cells, and induced the production of Treg cells. These data suggest that concurrent blockade of CCR5 and CXCR3 attenuates murine aGVHD through modulating donor-derived T-cell distribution and function, and this might be applicable for aGVHD prophylaxis in clinical settings.
Call me Dr Ishmael: trends in electronic health record notes available at emergency department visits and admissions
Authors: Patterson Brian W , Hekman Daniel J , Liao Frank J , Hamedani Azita G , Shah Manish N , Afshar Majid
Published: May 2024

Objectives

Numerous studies have identified information overload as a key issue for electronic health records (EHRs). This study describes the amount of text data across all notes available to emergency physicians in the EHR, trended over the time since EHR establishment.

Materials and Methods

We conducted a retrospective analysis of EHR data from a large healthcare system, examining the number of notes and a corresponding number of total words and total tokens across all notes available to physicians during patient encounters in the emergency department (ED). We assessed the change in these metrics over a 17-year period between 2006 and 2023.

Results

The study cohort included 730 968 ED visits made by 293 559 unique patients and a total note count of 132 574 964. The median note count for all encounters in 2006 was 5 (IQR 1-16), accounting for 1735 (IQR 447-5521) words. By the last full year of the study period, 2022, the median number of notes had grown to 359 (IQR 84-943), representing 58 662 (IQR 12 615-162 775) words. Note and word counts were higher for admitted patients.

Discussion

The volume of notes available for review by providers has increased by over 30-fold in the 17 years since the implementation of the EHR at a large health system. The task of reviewing these notes has become commensurately more difficult. These data point to the critical need for new strategies and tools for filtering, synthesizing, and summarizing information to achieve the promise of the medical record.
Impact of age on the reproductive output of Hermetia illucens (Diptera: Stratiomyidae)
Authors: Dickerson Amy J , Lemke Noah B , Li Chujun , Tomberlin Jeffery K
Published: May 2024

The current study examined the impact of adult black soldier fly (Hermetia illucens (L.)), age on reproductive output. Four treatments consisting of an equal sex ratio of the following combinations were used: 2-day-old males with 2-day-old females (YMYF); 6-day-old males with 2-day-old females (OMYF); 2-day-old males with 6-day-old females (YMOF); 6-day-old males with 6-day-old females (OMOF). Adult age was a significant factor for the overall number of mating events observed, with YMYF having 2.2× more than YMOF and 2.7× more than OMOF. Time was a significant factor in the number of mating events observed, with 97.8% observed on days 2–6. Age was not a significant factor for the total number of oviposition events, but the inclusion of time as a factor was significant, with 91.5% of all events occurring on days 2–6. Treatment and trial significantly interacted with egg production. This response can be attributed to treatments containing old females, which had a 50% variation in egg output across trials. Treatments containing young females were consistent in terms of egg production. As anticipated, due to oviposition events, 94.8% of total eggs were oviposited on days 2–6. Fecundity and egg hatch were also significantly impacted by female age, with a 50% reduction in both cases across trials occurring in old females. Young females paired with old males had a 20% reduction in egg hatch, but this difference was not statistically significant.
The moderating role of diabetes distress on the effect of a randomized eHealth intervention on glycemic control in Black adolescents with type 1 diabetes
Authors: Knauft Katherine M , Jacques-Tiura Angela J , Idalski Carcone April , Evans Meredyth , Weissberg-Benchell Jill , Buggs-Saxton Colleen , Boucher-Berry Claudia , Miller Jennifer L , Drossos Tina , Dekelbab Bassem , Ellis Deborah A
Published: May 2024

Objective

Due to systemic inequities, Black adolescents with type 1 diabetes are more likely to have suboptimal glycemic control and high rates of diabetes distress, but tailored interventions for this population are lacking. In primary outcomes of a randomized clinical trial, a family-based eHealth intervention improved glycemic control in Black adolescents with type 1 diabetes and elevated depressive symptoms. The present study is a secondary analysis of these clinical trial data examining the moderating effect of diabetes distress on the efficacy of the intervention.

Methods

Using secondary data from a multicenter randomized clinical trial (Clinicaltrials.gov [NCT03168867]), caregiver–adolescent dyads were randomly assigned to either up to three sessions of an eHealth parenting intervention (n = 75) or a standard medical care control group (n = 74). Black adolescents (10 years, 0 months to 14 years, 11 months old) with type 1 diabetes and a caregiver willing to participate were eligible. Adolescents reported their diabetes distress at baseline, and hemoglobin A1c (HbA1c) data were collected at baseline, 6-, 13-, and 18-month follow-up.

Results

No between-group contrasts emerged in a linear mixed-effects regression (p’s > .09). Within-group contrasts emerged such that adolescents assigned to the intervention who reported high diabetes distress had lower HbA1c at the 18-month follow-up relative to baseline (p = .004); the 18-month decrease in HbA1c was −1.03%.

Conclusions

Black adolescents with type 1 diabetes and high levels of diabetes distress showed significant decreases in HbA1c following a family-based eHealth intervention, suggesting diabetes distress may be a key moderator of intervention efficacy within this population.
Recent advances in paclitaxel biosynthesis and regulation
Authors: Coombe-Tennant Toby , Zhu Xiaoping , Wu Shihua , Loake Gary J
Published: May 2024

Paclitaxel (PTX) is a high value plant natural product derived from Taxus (yew) species. This plant specialized metabolite (PSM) and its derivatives constitute a cornerstone for the treatment of an increasing variety of cancers. New applications for PTX also continue to emerge, further promoting demand for this WHO-designated essential medicine. Here we review recent advances in our understanding of PTX biosynthesis and its cognate regulation, which have been enabled by the development of transcriptomic approaches and the recent sequencing and annotation of three Taxus genomes. Collectively, this has resulted in the elucidation of two functional gene sets for PTX biosynthesis, unlocking new potential for the use of heterologous hosts to produce PTX. Knowledge of the PTX pathway also provides a valuable resource for understanding the regulation of this key PSM. Epigenetic regulation of PSM in plant cell culture is a major concern for PTX production, given the loss of PSM production in long-term cell cultures. Recent developments aim to design tools for manipulating epigenetic regulation, potentially providing a means to reverse the silencing of PSM caused by DNA methylation. Exciting times clearly lie ahead for our understanding of this key PSM and improving its production potential.
Association of barium deficiency with Type 2 diabetes mellitus incident risk was mediated by mitochondrial DNA copy number (mtDNA-CN): a follow-up study
Authors: Zhang Yiqin , Ye Jing , Zhou Lina , Xuan Xianfa , Xu Liping , Cao Xia , Lv Tianyu , Yan Jianhua , Zhang Siyu , Wang Yuxin , Huang Qingyu , Tian Meiping
Published: May 2024

Accumulating evidence indicates that plasma metal levels may be associated with Type 2 diabetes mellitus (T2DM) incident risk. Mitochondrial function such as mitochondrial DNA copy number (mtDNA-CN) might be linked to metal exposure and physiological metabolism. Mediation analysis was conducted to determine the mediating roles of mtDNA-CN in the association between plasma metals and diabetes risk. In the present study, we investigated associations between plasma metals levels, mtDNA-CN, and T2DM incident in the elderly population with a 6-year follow-up (two times) study. Ten plasma metals [i.e. manganese, aluminum, calcium, iron, barium (Ba), arsenic, copper, selenium, titanium, and strontium] were measured using inductively coupled plasma mass spectrometry. mtDNA-CN was measured by real-time polymerase chain reaction. Multivariable linear regression and logistic regression analyses were carried out to estimate the relationship between plasma metal concentrations, mtDNA-CN, and T2DM incident risk in the current work. Plasma Ba deficiency and mtDNA-CN decline were associated with T2DM incident risk during the aging process. Meanwhile, plasma Ba was found to be positively associated with mtDNA-CN. Mitochondrial function mtDNA-CN demonstrated mediating effects in the association between plasma Ba deficiency and T2DM incident risk, and 49.8% of the association was mediated by mtDNA-CN. These findings extend the knowledge of T2DM incident risk factors and highlight the point that mtDNA-CN may be linked to plasma metal elements and T2DM incident risk.
Extensive reforms to improve funding efficiency: an interview with President Xiankang Dou of National Natural Science Foundation of China
Authors: Zhao Weijie , Zhu He
Published: May 2024

Dr. Xiankang Dou (窦贤康) was appointed the President of the National Natural Science Foundation of China (NSFC) in April 2023. As a distinguished researcher specializing in studying the middle and upper atmosphere of earth, Dr. Dou had served as the President of Wuhan University during 2016 to 2022 and was elected an academician of the Chinese Academy of Sciences (CAS) in 2017.

At his new post in NSFC, Dr. Dou's first priorities include curtailing personal favors in the review process (often known as ‘say hello’ with an intent to lobby), reforming the scoring and renewing mechanisms for the National Science Fund for Distinguished Young Scholars (DYS), opening the channel for DYS applications to researchers from Hong Kong and Macau, extending the age limit of female scientists for applying for DYS, and initiating funding programs for outstanding doctoral and undergraduate students. Recently, National Science Review (NSR) had an interview with Dr. Dou. He believes only through reform and experimentation can NSFC make steady progress in its efforts to support research of basic science and applied basic science in China and to cultivate promising scholars.
Cyberpunk
Authors: Mili Lakhimai , Usean F Rasik
Published: May 2024

Studies in cyberpunk, a subgenre of science fiction, evolved in 1980, and it has retained its relevance due to the increasing advancement in science and technology where a world of high-tech tools with sophisticated machines, artificial intelligence, robotics, and cybernetics are involved. Cyberpunk can be taken as a genre that visualizes a chaotic, dystopian future full of disparity that needs a revolutionary repulsion. The earliest use of the term cyberpunk traces to Bruce Bethke, who used it as a title for one of his short stories. He was followed by writers like Gardner Dozois who used it to describe the futuristic worlds of science fiction that heavily relied on computerized global economic culture. In The Cambridge Companion to Science Fiction (Cambridge, UK: Cambridge University Press, 2003), John Clute uses the term “noir” to define cyberpunk. Cyberpunk studies emphasize issues that weave around a society where conflicts of interest arise between the government and the corporate society that controls the rest of the less privileged population at the cost of freedom and democracy. As a result, there is the birth of the countercultural antiheroes or the “punks,” characters drawn from the popular culture movement who are supposed to be divergent and rebels and are wizards in hacking through high-tech machines with their skill in computer applications. The importance of theoretical research in cyberpunk as a subject of study has become necessary in the contemporary world, which is influenced by technology in every aspect of human existence—from the entertainment industry to economic conditions, power structures in society, geopolitical conflicts, and human memory. Contemporarily, the literary trends in cyberpunk fiction have branched out into different fields of study. Some of the areas of study taken here are Postmodern Cyberpunk Fiction; Afrofuturism and Postcolonial Cyberpunk; Feminist Cyberpunk and Queerpunk; and Anime, Manga, and Techno-Orientalism. The article also encapsulates other emerging theoretical areas in cyberpunk under the labels of Memory and the Cyberspace, Cyberpunk and Psychology, Posthumanism, Cyberpunk and Culture, and Marxist Ideas in Cyberpunk.
Latino/a/e and Latin American Biblical Interpretation
Authors: Ruiz Gilberto A.
Published: May 2024

Latino/a/e biblical interpretation refers to the analysis of biblical texts, of interpretations of biblical texts, and of the process of interpretation itself from the perspective of Latino/a/e identities, experiences, and contexts. It is a form of minoritized biblical criticism that foregrounds Latinx identity and culture (in any of its varieties) as an interpretive lens (see the separate Oxford Bibliographies article “Minoritized Criticism of the New Testament”). Recurring themes include identity, marginalization, race, ethnicity, mestizaje, mulatez, exile, migration, and gender. Often, Latino/a/e biblical critics operate with a sense that their work be informed by the daily lived reality of Latino/a/es and be accountable to the wider Latine community, especially with respect to matters of justice and equity. Still early in its formation, questions remain over what precisely counts as Latino/a/e biblical criticism. For example, does a scholar’s Latino/a/e identity by itself render their analysis an exercise in “Latino/a/e biblical interpretation,” or must they ground it explicitly in contextual Latino/a/e realities to qualify? “Latine” and “Latinx” have emerged as terms that transcend the gender binary implied by “Latino/a” and will appear in the bibliography (including in combinations like “Latino/a/e” and “Latinoax”). So will “Hispanic,” which Latino/a/e biblical critics now use sparingly. Turning to Latin America, biblical criticism there encompasses the diverse methods and approaches employed today, notably historical criticism, literary and semiotic analysis, feminist hermeneutics, and sociological and materialist approaches (see the separate Oxford Bibliographies article “Interpretation and Hermeneutics”). Engagement with sociopolitical and economic realities, the struggles of marginalized communities, matters of social justice and liberation from oppression, the legacy of the region’s colonialization and of more recent political turmoil and rule by repressive dictatorial regimes, indigenous perspectives, and the environment all also characterize Latin American biblical interpretation, which emphasizes situating interpretation within the contextual realities of Latin America. Rather than cover the entire scope of Latin American biblical interpretation, this bibliography focuses on its development in relation to liberation theology, since Latin American liberationist hermeneutics have indelibly shaped biblical studies. Also limiting this bibliography’s scope is its concentration on English translations, because these are more widely available and themselves contain bibliographies to explore Latin American scholarship in its original languages (mainly Spanish and Portuguese). Since Latin American liberationist hermeneutics predate and influenced Latino/a/e biblical criticism, the bibliography first addresses Latin American biblical interpretation before turning to Latino/a/e biblical interpretation.
Fair Water Distribution: From Theory to Application
Authors: Syme Geoff
Published: May 2024

Worldwide there are increasing stresses on water resources from rising population, burgeoning demand for water for different purposes, and uncertainties created by climate change. Often provision of water supply for one group may lead to a disadvantage for others, whether it be alienation of their land through dam construction or loss of access of water to downstream users. Overuse of water can lead to ecological degradation. These problems are exacerbated in the case of water as both volume and quality of water are both vital. Nevertheless, there are shared cultural principles of justice and fairness that give us some hope that there can be systematic approaches to managing potential conflict at all levels. These principles can and have been applied to achieve “fair” agreements. Understandably, there has been significant research and commentary on what is “fair” in water agreements. Philosophers, social psychologists, sociologists, economists, and mathematical and systems-based modelers have all made a contribution, but sometimes at a different scale and from differing assumptions about how fairness can and should be depicted. Often the concepts of fairness and equity are conflated. Some analyses define what the distribution of water between groups should be and then compare the outcomes with their ideals. Others operate at a situational level and seek agreements that are seen as “fair enough” by the interest groups rather than from pre-set assumptions. Both approaches can be applied to allocation problems when some members of society complain or protest that the allocation isn’t fair from their perspective. Protest for this imbalance to be rectified is almost always the starting point for “fairness” investigations. When a stable agreement that is regarded as “fair enough” by all parties is in place, there is no comment and fairness does not raise its profile in day-to-day water management. This article examines how “fairness” can be defined in relation to water distribution, and how it has been modeled. Working definitions of justice and fairness are then provided to encourage consistency in terminology. This is followed by an examination of what benefits we are sharing when we allocate water (as opposed to volumes of water). Many benefits can be achieved simultaneously and are related. The important relationship between fairness and procedural justice during decision-making is then examined. The article concludes with a discussion of how the concept of fairness can be developed to assist in resilient allocation decision-making.