bluuebunny/crossref_metadata_2025 huggingface dataset:
Degrees of truthlikeness, independence, equality and order in probabilistic propositional knowledge representation
Authors: Kuipers Theo A F
Published: August 2024

Probabilistic propositional knowledge representation, as here conceived, deals with knowledge representation in the form of probabilistic (p-)valuations of the atomic propositions of a propositional language, of probability (p-)distributions over propositional state descriptions and with their relation. The aim of the paper is conceptual: introducing and illustrating a number of related, normalized concepts regarding both valuations and distributions: degrees of truthlikeness, (internal) independence, equality and order. The backbone of these concepts is the relevant sum of absolute distances. All degrees are in the unit interval and will be illustrated at the relevant place by data about the co-morbidity of psychiatric syndromes (Van Loo et al., 2016). In a new section we illustrate all concepts by an example of weather conditions, to be precise: (not) windy, (not) hot, (not) rainy days in March 2023, in De Bilt (NL). We also briefly discuss some other approaches: other distance measures, covariance as a measure of mutual dependence and various degrees of equality. In the final section we enlist several further research questions and issues, among which the question whether this paper is relevant for propositional probability logics. The paper is highly inspired by the rich paper of Gustavo Cevolani and Roberto Festa (2021).
Introductory Information for Therapists
Authors: Smits Jasper A. J. , Otto Michael W.
Published: August 2024

This chapter provides a brief background on integrating exercise-based interventions into mental-health care. It explains how the therapist guide works hand in hand with the client workbook. Due to the obvious benefits of exercise for stress, mood, anxiety, habit control, and cognition, there is a clear need for the adoption of exercise-based interventions across the range of settings where clients seek help. The chapter then provides an overview of the scope of the issue concerning mood and anxiety disorders. It emphasizes that exercise interventions may be an acceptable treatment modality for individuals who are unwilling to commit to psychotherapy or pharmacotherapy.
Exercise for Stress, Worry, and Panic
Authors: Smits Jasper A. J. , Otto Michael W.
Published: August 2024

This chapter focuses on exercise programs for clients with stress, worry, and panic. It discusses strategies to complement and fine-tune the exercise prescription to help target these core features of anxiety disorders. According to research, individuals who have a high level of anxiety sensitivity respond to benign bodily sensations with fear because they are concerned that these sensations have harmful consequences. Thus, targeting anxiety sensitivity may be critical to overcoming panic disorder. The chapter suggests educating clients about the roles of fears of anxiety sensations in panic disorder and the efficacy of exposure to bodily sensations through exercise in an effort to overcome anxiety sensitivity.
Exercise to Enhance Resilience
Authors: Smits Jasper A. J. , Otto Michael W.
Published: August 2024

This chapter focuses on how exercise programs can be used in the transdiagnostic task of enhancing psychological resilience. The term “psychological resilience” primarily refers to a person’s ability to recover from stress and adversity. Exercise prescriptions can serve as a tool to help insulate individuals from some of the emotional and physical sequelae of stressors. Exercise programs to enhance resilience can also be introduced as part of the relapse-prevention phase of treatment. The chapter introduces the notion of mind/body balance as a way to generalize interventions to broader well-being, focusing on feeling mentally fit in order to better manage stressors.
Intervention Issues
Authors: Smits Jasper A. J. , Otto Michael W.
Published: August 2024

This chapter examines the issues of long term maintenance of an exercise program. It offers recommendations for helping clients develop a cognitive style for noticing and positively interpreting their exercise experiences and working to eliminate the barriers that arise during an exercise program. Cognitive coaching refers to an adaptive style of self-talk designed to direct attention to the most pleasurable aspects of exercise and exercise-related achievements during and after exercise. The chapter covers the therapist’s role in working to overcome barriers to the regular adoption of exercise and helping clients develop a self-coaching style to deal with lapses and exercise over the long term. It emphasizes that the management of self-coaching is vital in maintaining early exercise efforts.
Exercising over the Long Term
Authors: Otto Michael W. , Smits Jasper A. J.
Published: August 2024

This chapter highlights the impact of exercising over the long term. It emphasizes that variety is important in maintaining a strong exercise habit over time. One way to keep exercise interesting over the long term is for clients to allow their goals for exercise to change. Additionally, keeping a log of moods and exercise can help the client to keep track of the nature and quality of the exercise program while simultaneously providing the client with space for coaching toward new exercise goals. The chapter warns about the possibility of lapses in exercise habits before offering advice on how to do self-coaching regardless of the level of motivation.
Diasporic Somali migration to Turkey: Exploring the intersection of mobility, place, and geopolitics
Authors: Abdi Ayan Yasin , Galal Lise Paulsen
Published: August 2024

This article explores the recent migration of diasporic Somalis to Turkey. Drawing on ethnographic studies, we examine the interplay between mobility and place within this context. Through an analysis of historical ties, geographical location, and geopolitical implications, we investigate how diasporic Somalis’ sense of Turkey as a place emerges as a preferred destination. We argue that Turkey's engagement with Somalia and its growing presence in the region have not only been valued but also highly regarded, thus motivating diasporic Somalis to choose Turkey as their new migration destination. However, the issue of diasporic Somalis' migration to Turkey extends beyond its perceived moral and strategic appeal, encompassing aspects of neo-colonialism and a place of exclusion. In conclusion, this article highlights the complex interplay of political and geopolitical factors that contribute to the uncertain future of diasporic Somalis in Turkey.
A novel interaction between the 5′ untranslated region of the Chikungunya virus genome and Musashi RNA binding protein is essential for efficient virus genome replication
Authors: Sun Kaiwen , Appadoo Francesca , Liu Yuqian , Müller Marietta , Macfarlane Catriona , Harris Mark , Tuplin Andrew
Published: August 2024

Chikungunya virus (CHIKV) is a re-emerging, pathogenic alphavirus that is transmitted to humans by Aedesspp. mosquitoes—causing fever and debilitating joint pain, with frequent long-term health implications and high morbidity. The CHIKV replication cycle is poorly understood and specific antiviral therapeutics are lacking. In the current study, we identify host cell Musashi RNA binding protein-2 (MSI-2) as a proviral factor. MSI-2 depletion and small molecule inhibition assays demonstrated that MSI-2 is required for efficient CHIKV genome replication. Depletion of both MSI-2 and MSI-1 homologues was found to synergistically inhibit CHIKV replication, suggesting redundancy in their proviral function. Electromobility shift assay (EMSA) competition studies demonstrated that MSI-2 interacts specifically with an RNA binding motif within the 5′ untranslated region (5′UTR) of CHIKV and reverse genetic analysis showed that mutation of the binding motif inhibited genome replication and blocked rescue of mutant virus. For the first time, this study identifies the proviral role of MSI RNA binding proteins in the replication of the CHIKV genome, providing important new insight into mechanisms controlling replication of this significant human pathogen and the potential of a novel therapeutic target.
Dynamics of diversified A-to-I editing in Streptococcus pyogenes is governed by changes in mRNA stability
Authors: Wulff Thomas F , Hahnke Karin , Lécrivain Anne-Laure , Schmidt Katja , Ahmed-Begrich Rina , Finstermeier Knut , Charpentier Emmanuelle
Published: August 2024

Adenosine-to-inosine (A-to-I) RNA editing plays an important role in the post-transcriptional regulation of eukaryotic cell physiology. However, our understanding of the occurrence, function and regulation of A-to-I editing in bacteria remains limited. Bacterial mRNA editing is catalysed by the deaminase TadA, which was originally described to modify a single tRNA in Escherichia coli. Intriguingly, several bacterial species appear to perform A-to-I editing on more than one tRNA. Here, we provide evidence that in the human pathogen Streptococcus pyogenes, tRNA editing has expanded to an additional tRNA substrate. Using RNA sequencing, we identified more than 27 editing sites in the transcriptome of S. pyogenes SF370 and demonstrate that the adaptation of S. pyogenes TadA to a second tRNA substrate has also diversified the sequence context and recoding scope of mRNA editing. Based on the observation that editing is dynamically regulated in response to several infection-relevant stimuli, such as oxidative stress, we further investigated the underlying determinants of editing dynamics and identified mRNA stability as a key modulator of A-to-I editing. Overall, our findings reveal the presence and diversification of A-to-I editing in S. pyogenes and provide novel insights into the plasticity of the editome and its regulation in bacteria.
CRISPR perfect adaptation for robust control of cellular immune and apoptotic responses
Authors: Zhang Yichi , Zhang Shuyi
Published: August 2024

A central challenge in the quest for precise gene regulation within mammalian cells is the development of regulatory networks that can achieve perfect adaptation—where outputs consistently return to a set baseline post-stimulus. Here, we present such a system that leverages the CRISPR activation (CRISPRa) and anti-CRISPR proteins as two antithetic elements to establish perfect adaptation in mammalian cells and dynamically regulate gene expression. We demonstrate that this system can maintain stable expression levels of target genes in the face of external perturbations, thus providing a robust platform for biological applications. The versatility of our system is further showcased through its integration with endogenous regulatory mechanisms in T cells, such as the NF-κB-mediated immune response, and its ability to program apoptosis responses for precise spatial and temporal control of cellular growth and death. This study not only advances our understanding of gene regulation in mammalian cells but also opens new avenues for therapeutic intervention, particularly in diseases characterized by dysregulated gene expression.
CytoCellDB: a comprehensive resource for exploring extrachromosomal DNA in cancer cell lines
Authors: Fessler Jacob , Ting Stephanie , Yi Hong , Haase Santiago , Chen Jingting , Gulec Saygin , Wang Yue , Smyers Nathan , Goble Kohen , Cannon Danielle , Mehta Aarav , Ford Christina , Brunk Elizabeth
Published: August 2024

Recently, the cancer community has gained a heightened awareness of the roles of extrachromosomal DNA (ecDNA) in cancer proliferation, drug resistance and epigenetic remodeling. However, a hindrance to studying ecDNA is the lack of available cancer model systems that express ecDNA. Increasing our awareness of which model systems express ecDNA will advance our understanding of fundamental ecDNA biology and unlock a wealth of potential targeting strategies for ecDNA-driven cancers. To bridge this gap, we created CytoCellDB, a resource that provides karyotype annotations for cell lines within the Cancer Dependency Map (DepMap) and the Cancer Cell Line Encyclopedia (CCLE). We identify 139 cell lines that express ecDNA, a 200% increase from what is currently known. We expanded the total number of cancer cell lines with ecDNA annotations to 577, which is a 400% increase, covering 31% of cell lines in CCLE/DepMap. We experimentally validate several cell lines that we predict express ecDNA or homogeneous staining regions (HSRs). We demonstrate that CytoCellDB can be used to characterize aneuploidy alongside other molecular phenotypes, (gene essentialities, drug sensitivities, gene expression). We anticipate that CytoCellDB will advance cytogenomics research as well as provide insights into strategies for developing therapeutics that overcome ecDNA-driven drug resistance.
Analysis of the discontinuation and nonpublication of neurooncological randomized clinical trials
Authors: Butler Molly , Mehra Mehul , Chandasir Abdullah , Kaoutzani Lydia , Vale Fernando L
Published: August 2024

Background

Premature discontinuation and nonpublication of clinical trials contribute to research waste and compromise our ability to improve patient outcomes. However, the extent to which these problems exist in neurooncological randomized clinical trials (RCTs) is not known. This study aimed to evaluate the prevalence of discontinuation and nonpublication of neurooncological RCTs, identify contributing factors, and assess trial characteristics associated with each.

Methods

We performed a retrospective, cross-sectional study of neurooncological RCTs registered in Clinicaltrials.gov before March 7, 2023. Data were collected from Clinicaltrials.gov and associated publications were located. We attempted to contact authors for all trials without associated publications or an identified reason for discontinuation.

Results

Of 139 included RCTs, 57 (41%) were discontinued. The most common reason for discontinuation identified was slow enrollment or accrual (23%), though 30 trials (53%) were discontinued for unknown reasons. Trials funded by sources other than industry or the National Institutes of Health were more likely to be discontinued (odds ratio 4.2, 95% confidence interval 1.3–13.8). In total, 67 of the 139 (48%) RCTs were unpublished, including 50 of the 57 (88%) discontinued studies and 17 of the 82 (21%) completed studies.

Conclusions

In our study, discontinuation of neurooncological clinical trials was common and often occurred for unknown reasons. Trials were also frequently unpublished, particularly those that were discontinued. Addressing these findings may provide an opportunity to reduce research waste and improve outcomes for patients with neurological cancers.
The Party-State, Fragmented Authoritarianism, and the Health Emergency Response Regime
Authors: Yang Dali L.
Published: August 2024

The Chinese party-state is recognized for its stability maintenance regime, bolstered by its propaganda and censorship apparatus. Simultaneously, the “fragmented authoritarianism” model explicates the complexities of governing a sprawling country with multiple levels of party-government authorities, thus enabling decentralized and adaptable policy execution. Nestled within this vast neo–Communist Party-state lies the public health emergency response system. This chapter examines the principal institutions, disease surveillance mechanisms, and laws and regulations pertaining to health emergency response, with particular emphasis on the relational dynamics among the National Health Commission, the China Centers for Disease Control and Prevention (CDC) at the national level, and subnational health commissions and CDCs. By shedding light on the complex interaction between political institutions and the health emergency response regime, this chapter provides essential institutional context for comprehending the challenges and missteps the Chinese government encountered during the Wuhan coronavirus outbreak.
The Stability Imperative and the Silencing of Doctors
Authors: Yang Dali L.
Published: August 2024

During the early stages of the COVID-19 outbreak, the Chinese political-administrative system showcased an organizational culture that prioritized social stability and information control. This and the next chapter uncover the factors that motivated this response, including political considerations, career incentives, and a desire for information control. Despite the Hubei/Wuhan health authorities’ awareness of the outbreak and its SARS-like symptoms, they initially failed to report it to central authorities and instead sought to manage the crisis locally. The chapter also delves into the investigations and punishments meted out to doctors such as Dr. Ai Fen and Dr. Li Wenliang, who disseminated information about the outbreak. The attempt to control the narrative and suppress “rumors” led to a lack of vital information for decision-making and failed to prepare the public for the impending crisis. The adverse consequences of this approach are highlighted as a cautionary tale for future crisis management.
Conducting Public Health Emergency Response in Stealth
Authors: Yang Dali L.
Published: August 2024

Despite the emergence of new novel coronavirus cases beyond Wuhan and even outside China during mid-January 2020, both the Hubei/Wuhan authorities and the National Health Commission (NHC) fell short of taking decisive public action. The local authorities persistently downplayed the risk of sustained human-to-human transmission, striving to maintain an appearance of normalcy. Similarly, the NHC adhered to political constraints, conducting confidential meetings and discreetly updating its prevention and control documents. This lack of public warnings about the severity of the outbreak exacerbated the virus’s spread. It also illuminated the limitations of China’s political-administrative system, characterized by fragmented authoritarianism and an emphasis on social stability and information control. Nonetheless, responding to alerts of human-to-human transmission from Guangdong and Thailand, the NHC assembled a third expert team to visit Wuhan on January 19, 2020.
“The Battle for Wuhan”
Authors: Yang Dali L.
Published: August 2024

As the cordon sanitaire was imposed, overwhelmed hospitals and a lack of quarantine facilities put the leadership and residents of Wuhan to the test amid the exploding COVID-19 crisis. This chapter examines the national efforts to support Wuhan and contain the epidemic. Under Xi Jinping’s leadership, the Chinese party-state adopted a mission-oriented structure, effectively countering pre-lockdown information suppression and leveraging its organizational power to mobilize the largest medical aid mission ever. The initial strategy of constructing Fire and Thunder God Hospitals, mirroring the SARS-era response, proved inadequate. Instead, as expertise on COVID-19 grew, the medical profession improved treatment of COVID-19, while the emergency response leadership adapted their response strategy. The rapid conversion of existing buildings, including public facilities, dramatically increased hospital and quarantine capacity. Fangcang shelter hospitals played a crucial role in reducing potential community infection sources.
ANA-associated arthritis: clinical and biomarker characterization of a population for basket trials
Authors: Arnold Jack , Carter Lucy M , Md Yusof Md Yuzaiful , Dutton Katherine , Wigston Zoe , Dass Shouvik , Wood Samuel , Relton Samuel , Vital Edward M
Published: August 2024

Objectives

ANA-associated rheumatic and musculoskeletal (MSK) diseases (RMDs) [SLE, primary SS (pSS), scleroderma, inflammatory myositis, MCTD and UCTD] make up a disease spectrum with overlapping clinical and immunological features. MSK inflammation is common and impactful across ANA-associated RMDs. The objectives of this study were to evaluate MSK inflammation (ANA-associated arthritis) prevalence in a multidisease ANA-associated RMD study, assess its clinical impact across ANA-associated RMD diagnoses, propose new basket groupings of patients, and evaluate immunological profiles in legacy and new basket contexts.

Methods

An observational study enrolled patients with ANA-associated RMDs. Demographic variables, comorbidities, therapies, disease activity instruments [BILAG, SLEDAI, the EULAR SS disease activity index (ESSDAI), physician visual analogue scale (VAS)], patient-reported outcomes [SF36, FACIT-Fatigue, EQ5D, ICECAP-A, Work Productivity and Activity impairment (WPAI), patient VAS] and the biomarker profile (six-gene expression scores, flow cytometry, autoantibody profile) were analysed. Reclustering utilized Gaussian mixture modelling (GMM). The clinical and immune features of new and legacy clusters were compared.

Results

Inflammatory MSK symptoms were prevalent across ANA-associated RMDs, in 213/294 patients. In ANA-associated arthritis patients, most variables did not differ between diagnoses, with the exception of the EQ5D-5L index and mobility domains (lower in MCTD/pSS, both P < 0.05). FM and OA prevalence were similar across diagnoses. Therapy use differed significantly, the use of biologics being greatest in SLE (P < 0.05). GMM yielded two multidisease clusters: High MSK disease activity (n = 89) and low MSK disease activity (n = 124). The high MSK disease activity cluster included all patients with active joint swelling, and they had significantly higher prednisolone usage, physician global assessment (PGA), Sm/RNP/SmRNP/chromatin positivity, Tetherin mean fluorescence intensity (MFI), and IFN Score-A activity, along with numerically lower FM and OA prevalence.

Conclusion

We defined ANA-associated arthritis, a more clinically and immunologically homogeneous population than existing RMD populations for trials, and a more prevalent population for therapies in the clinic.
Impact of growth implants and low-level tannin supplementation on enteric emissions and nitrogen excretion in grazing steers
Authors: Raynor Edward J , Kutz Mesa , Thompson Logan R , Carvalho Pedro H V , Place Sara E , Stackhouse-Lawson Kimberly R
Published: August 2024

The primary objective of this experiment was to evaluate the effects of a growth-hormone implant (Revalor-G, Merck Animal Health., Rahway, NJ, USA) and tannin supplementation (Silvafeed BX, Silva Team, San Michele Mondovi CN, Italy) on enteric methane (CH4) emissions and estimated nitrogen (N) excretion in grazing steers. Steers (n = 20; initial body weight [IBW] = 343 ± 14 kg) were acclimated to use a portable automated head-chamber system (AHCS) to measure CH4 and a SmartFeed Pro automated feeder for dietary supplementation (C-Lock Inc., Rapid City, SD, USA). After the training period, steers were randomly assigned to a 2 × 2 factorial arrangements of treatments, with 2 levels of growth-hormone implants, no-implant (NO-IMP) or implanted (IMP), and 2 levels of tannin supplementation, no tannin supplementation (NO-TAN) or tannin supplementation (TAN). This created 4 treatment groups: (1) NO-TAN and NO-IMP, (2) TAN and NO-IMP, (3) IMP and NO-TAN, and (4) TAN and IMP. Tannin was offered daily at 0.30% dry matter intake (DMI) through 0.5 kg/hd/d sweetfeed supplement (Sweetfeed Mix, AgFinity., Eaton, CO, USA) with a targeted tannin intake at 48 g/hd/d. No (P ≥ 0.05) implant × tannin interaction was detected for any dependent variable, so only the main effects of implant (NO-IMP vs. IMP) and tannin supplementation (NO-TAN vs. TAN) are discussed. Implant status did not affect (P ≥ 0.56) final body weight (FBW) or average daily gain (ADG) during the 90 d grazing period. There was no effect (P ≥ 0.15) of growth implant on CH4 production or emission intensity (EI; g CH4/kg gain). Additionally, IMP steers tended (P ≤ 0.08) to have less CH4 yield (MY; g CH4/g DMI) and higher blood urea nitrogen (BUN) than NO-IMP steers. Tannin supplementation did not impact (P ≥ 0.26) FBW or ADG. However, NO-TAN steers tended (P = 0.06) to have a greater total DMI than steers supplemented with tannin. No effect (P ≥ 0.22) of tannin supplementation was observed for CH4 production and EI. Nitrogen utilization as measured through BUN, urine N, fecal N, or fecal P was similar (P ≥ 0.12) between TAN and NO-TAN animals. The findings indicate that low-level dietary supplementation to reduce enteric emissions is difficult in grazing systems due to inconsistent animal intake and that growth implants could be used as a strategy to improve growth performance and reduce EI of steers grazing improved pasture.
Effect of Temperature on the Embryogenesis of Three Geographically Distinct Populations of Meloidogyne incognita Is Driven by Intrinsic Thermal Acclimation Reaction
Authors: Hada Alkesh , Bucki Patricia , Shimoni Natalia Sichov , Glanz Eyal , Kumar Anil , Miyara Sigal Brown
Published: August 2024

Research interest in the mechanisms enabling plant-parasitic nematodes to adjust their physiological performance and cope with changing temperatures has intensified in light of global warming. Here, we show that geographically distinct populations of the root-knot nematode Meloidogyne incognita, which is prevalent in the three main pepper-growing regions in Israel—Carmel Valley (Carmel), Jordan Valley (JV), and Arava Rift (Arava)—possess persistent differences in their thermal acclimation capacity, which affect pre- and postembryonic development. The optimal temperature for embryonic growth completion was 25°C for the Carmel population; 25 and 30°C for the JV population; and 30°C for the Arava population. Cumulative hatching percentages showed variations among populations; relative to hatching at 25°C, the Carmel population experienced hatching reduction at the higher studied temperatures 30 and 33°C, while the JV and Arava populations exhibited an increase in hatching at 30 and 33°C, respectively. Juvenile survival indicates that at the lowest temperature (20°C), the Carmel population gained the highest survival rates throughout the experimental duration, while at the same duration at 33°C, the Arava population gained the highest survival rate. Infective juveniles of the Carmel population demonstrated increased penetration of tomato roots at 25°C compared to the JV and Arava populations. Inversely, at 33°C, increased penetration was observed for the Arava compared to the Carmel and JV populations. Altogether, the Arava population’s performance at 33°C might incur distinct fitness costs, resulting in consistent attenuation compared to the Carmel population at 25°C. Precisely defining a population’s thermal acclimation response might provide essential information for models that predict the impact of future climate change on these populations.
Postoperative pain management after thoracic transplantations
Authors: Lobo Clara , Tufegdzic Boris
Published: August 2024

Purpose of review

Heart and lung transplantation evolution marked significant milestones. Pioneering efforts of Dr Christiaan Barnard with the first successful heart transplant in 1967, followed by advancements in heart–lung and single-lung transplants by Drs Bruce Reitz, Norman Shumway, and Joel Cooper laid the groundwork for contemporary organ transplantation, offering hope for patients with end-stage heart and pulmonary diseases.

Recent findings

Pretransplant opioid use in heart transplant recipients is linked to higher mortality and opioid dependence posttransplant. Effective pain control is crucial to reduce opioid-related adverse effects and enhance recovery. However, research on specific pain management protocols for heart transplant recipients is limited. In lung transplantation effective pain management is crucial. Studies emphasize the benefits of multimodal strategies, including thoracic epidural analgesia and thoracic paravertebral blocks, to enhance recovery and reduce opioid use. Perioperative pain control challenges in lung transplantation are unique and necessitate careful consideration to prevent complications and improve outcomes.

This review emphasizes the importance of tailored pain management in heart and lung transplant recipients. It advocates for extended follow-up and alternative analgesics to minimize opioid dependency and enhance quality of life. Further high-quality research is needed to optimize postoperative analgesia and improve patient outcomes.
Relationship between Lumbar Foraminal Stenosis and Multifidus Muscle Atrophy – A Retrospective Cross-Sectional Study
Authors: Guven Ali E. , Schönnagel Lukas , Chiapparelli Erika , Camino-Willhuber Gaston , Zhu Jiaqi , Caffard Thomas , Arzani Artine , Finos Kyle , Nathoo Isaac , Amoroso Krizia , Shue Jennifer , Sama Andrew A. , Cammisa Frank P. , Girardi Federico P. , Hughes Alexander P.
Published: August 2024

Study Design.

Retrospective cross-sectional study.

Objective.

To evaluate the relationship between lumbar foraminal stenosis (LFS) and multifidus muscle atrophy.

Background.

The multifidus muscle is an important stabilizer of the lumbar spine. In LFS, the compression of the segmental nerve can give rise to radicular symptoms and back pain. LFS can impede function and induce atrophy of the segmentally innervated multifidus muscle.

Methods.

Patients with degenerative lumbar spinal conditions who underwent posterior spinal fusion for degenerative lumbar disease from December 2014 to February 2024 were analyzed. Multifidus fatty infiltration (FI) and functional cross-sectional area (fCSA) were determined at the L4 upper endplate axial level on T2- weighted MRI scans using dedicated software. Severity of LFS was assessed at all lumbar levels and sides using the Lee classification (Grade: 0 – 3). For each level, Pfirrmann and Weishaupt gradings were used to assess intervertebral disc disease (IVDD) and facet joint osteoarthritis (FJOA), respectively. Multivariable linear mixed models were run for the LFS grade of each level and side separately as the independent predictor of multifidus FI and fCSA. Each analysis was adjusted for age, sex, BMI, as well as FJOA and IVDD of the level corresponding to the LFS.

Results.

A total of 216 patients (50.5% female) with a median age of 61.6 years (IQR=52.0 – 69.0) and a median BMI of 28.1 kg/m2 (IQR=24.8 – 33.0) were included. Linear mixed model analysis revealed that higher multifidus FI (Estimate [Confidence interval]=1.7% [0.1 – 3.3], P=0.043) and lower fCSA (−18.6 mm2 [−34.3 – −2.6], P=0.022) were both significantly predicted by L2-L3 level LFS severity.

Conclusion.

The observed positive correlation between upper segment LFS and multifidus muscle atrophy points towards compromised innervation. This necessitates further research to establish the causal relationship and guide prevention efforts.
The Causal Roadmap and Simulations to Improve the Rigor and Reproducibility of Real-data Applications
Authors: Nance Nerissa , Petersen Maya L. , van der Laan Mark , Balzer Laura B.
Published: August 2024

The Causal Roadmap outlines a systematic approach to asking and answering questions of cause and effect: define the quantity of interest, evaluate needed assumptions, conduct statistical estimation, and carefully interpret results. To protect research integrity, it is essential that the algorithm for statistical estimation and inference be prespecified prior to conducting any effectiveness analyses. However, it is often unclear which algorithm will perform optimally for the real-data application. Instead, there is a temptation to simply implement one’s favorite algorithm, recycling prior code or relying on the default settings of a computing package. Here, we call for the use of simulations that realistically reflect the application, including key characteristics such as strong confounding and dependent or missing outcomes, to objectively compare candidate estimators and facilitate full specification of the statistical analysis plan. Such simulations are informed by the Causal Roadmap and conducted after data collection but prior to effect estimation. We illustrate with two worked examples. First, in an observational longitudinal study, we use outcome-blind simulations to inform nuisance parameter estimation and variance estimation for longitudinal targeted minimum loss-based estimation. Second, in a cluster randomized trial with missing outcomes, we use treatment-blind simulations to examine type-I error control in two-stage targeted minimum loss-based estimation. In both examples, realistic simulations empower us to prespecify an estimation approach with strong expected finite sample performance, and also produce quality-controlled computing code for the actual analysis. Together, this process helps to improve the rigor and reproducibility of our research.
Where Do Plastic Surgery Leaders Come From? A Cross-sectional Analysis of Research Productivity
Authors: Rodriguez Megan M. , Swiekatowski Kylie R. , Tung Robert C. , Greives Matthew R. , Mathes David W. , Nguyen Phuong D.
Published: August 2024

Background:

It is increasingly apparent that plastic surgery residency applications with lengthy research publications are the new standard in applicant competitiveness. This study aims to evaluate the research history of plastic surgery program faculty leadership to understand the trends and evolution of research expectations.

Methods:

The curriculum vitaes of faculty involved in residency admissions among all US Accreditation Council for Graduate Medical Education-accredited integrated and independent plastic surgery programs were reviewed. Doximity, program websites, and Scopus were used to gather information. H-index and publication count at the time of medical school and residency graduations were collected. Student t test and Pearson product-moment correlation were used for analysis.

Results:

Of the 236 plastic surgeons considered, faculty averaged one publication by medical school graduation, two by general surgery residency graduation, and six by plastic surgery residency graduation. Integrated residents held more publications after medical school (1.67 versus 0.56; P = 0.09) and plastic surgery residency (8.48 versus 4.89; P = 0.01) compared with independent residents. Later plastic surgery residency graduation year correlated with more publications (P < 0.001). Chairs had higher h-indices compared with program directors and associate positions (chair: 23.7, program director: 14.7, associate: 12.2; P < 0.001).

Conclusions:

The majority of faculty leaders’ research was published after residency. The emerging trend of increased research volume among plastic surgeons-in-training may be a consequence of competitive research requirements to matriculate into residency. Longer-term career follow-up of newer graduates will need to be assessed to determine whether this predicts future postgraduate productivity or if it is just the price of admission to train as a plastic surgeon.
Relative Distribution of Common Breast and Chest Asymmetries in 2051 Primary Augmentation Mammoplasties in Nonptotic Subgroup of Patients
Authors: Khan Umar D.
Published: August 2024

Background:

Breast and chest asymmetries are extremely common, and primary augmentation mammoplasty can be challenging in these cases. However, there is a paucity of information on the relative distribution of these asymmetries and the implant sizes used in these patients.

Methods:

A retrospective chart review of all consecutive cases of primary augmentation mammoplasty performed by a single surgeon from May 1999 to May 2012 was conducted. Patients with chest and breast asymmetries were noted by clinical examination and observation. These patients were selected to review how many patients had similar or different-sized implants. Patients presenting with unilateral or bilateral ptosis and requiring mastopexy were excluded.

Results:

A total of 2051 patients underwent primary augmentation mammoplasty. Uneven chest wall or uneven ribs were noted in 274 patients (right more prominent 72, left more prominent 202). Of these, 169 patients had implants of the same size, and 37 patients had implants of different sizes. Similarly, 1008 patients presented with uneven breasts, and of these, 272 patients had different-sized implants. One patient needed revision surgery for implant size and breast volume readjustment.

Conclusions:

Chest and breast asymmetries are extremely common. Routine clinical examination is more than adequate to delineate such asymmetries. The majority of these patients have small differences, and not all patients with asymmetries require implants of different sizes.
Unilateral globus pallidus internus combined contralateral subthalamic nucleus deep brain stimulation in the treatment of cervical dystonia: a case report and literature review
Authors: Liang Kun , Yin Zixiao , Gao Yuan , Han Chunlei , Giovanna Brown Kayla , Zhang Jianguo , Meng Fangang
Published: August 2024

Background:

Deep brain stimulation (DBS) is an effective treatment modality for medication-refractory cervical dystonia (CD). In recent years, the asymmetric targets for lead implantation of DBS have become a more valued topic.

Objectives:

To explore the efficacy of the asymmetric targets for lead implantation of DBS.

Methods:

A patient with CD underwent unilateral globus pallidus internus (GPi) combined contralateral subthalamic nucleus (STN) deep brain stimulation.

Results:

Although neither unilateral GPi nor STN stimulation relieved the patient’s clinical symptoms during temporary testing after surgery, the positive effect of bilateral stimulation was substantial. At the 12-month postoperative evaluation, the patient’s clinical symptoms improved remarkably, with an improvement rate of 78% compared with the preoperative assessment.

Conclusions:

Combined with the previous kinds of literature we reviewed in this article, we propose that in addition to conventional lead implantation, the option of using asymmetric targets for lead implantation can be considered when physicians encounter special conditions and can also be effective in relieving clinical symptoms in patients with CD.
Outcome of arthroscopic suturing repair of nonretracted full-thickness rotator cuff tears with fast-track rehabilitation
Authors: Yang Xinhua , Wang Zengliang , Li Guishi
Published: August 2024

Background:

This study aims to evaluate the effectiveness of nonretracted full-thickness rotator cuff tears with arthroscopic rotator cuff suturing, and examine whether clinical functional outcomes are superior in the fast-track rehabilitation team.

Objectives:

To study the effects of arthroscopic rotator cuff suturing in the treatment of nonretracted full-thickness rotator cuff tears.

Methods:

From August 2013 to May 2018, 68 cases of nonretracted full-thickness rotator cuff tears underwent arthroscopic rotator cuff suturing repair. Postoperatively, 35 arms were suspended with a triangular arm sling, without immobilization at abduction or the 0-degree position. The remaining 33 arms were traditionally immobilized after operation for 6 weeks. All patients were evaluated using the University of California Los Angeles (UCLA) Shoulder Rating Scale (UCLA score), Constant-Murley score and VAS pain score before the operation and during the follow-up visits.

Results:

The follow-up time ranged from 12 to 36 months with an average of 12.1 months. All patients were satisfied with their operations. There were no significant differences in preoperative UCLA score, Constant-Murley score and VAS pain scores between the groups. Both groups showed significant improvement in these clinical function scores at follow-up. There were no significant differences in the UCLA score, Constant-Murley score, and VAS pain scores between the 2 groups at the last follow-up. However, the fast-track team had better activity motion especially in flexion and external rotation movement, suggesting that the triangular arm sling is as effective as the traditional immobilization in postoperative rehabilitation and allow patients to better perform rehabilitation exercises.

Conclusions:

Arthroscopic suturing repair is a safe, efficient and minimally invasive treatment for nonretracted full-thickness rotator cuff tears. For small nonretracted rotator cuff tears, compared with the traditional team, the fast-track rehabilitation team achieved faster recovery and higher patient’s satisfaction.
Histon activities in the extracellular environment: regulation and prothrombotic implications
Authors: Keulen Gwen M. , Huckriede Joram , Wichapong Kanin , Nicolaes Gerry A.F.
Published: August 2024

Purpose of review

Thromboembolic complications are a major contributor to global mortality. The relationship between inflammation and coagulation pathways has become an emerging research topic where the role of the innate immune response, and specifically neutrophils in “immunothrombosis” are receiving much attention. This review aims to dissect the intricate interplay between histones (from neutrophils or cellular damage) and the haemostatic pathway, and to explore mechanisms that may counteract the potentially procoagulant effects of those histones that have escaped their nuclear localization.

Recent findings

Extracellular histones exert procoagulant effects via endothelial damage, platelet activation, and direct interaction with coagulation proteins. Neutralization of histone activities can be achieved by complexation with physiological molecules, through pharmacological compounds, or via proteolytic degradation. Details of neutralization of extracellular histones are still being studied.

Leveraging the understanding of extracellular histone neutralization will pave the way for development of novel pharmacological interventions to treat and prevent complications, including thromboembolism, in patients in whom extracellular histones contribute to their overall clinical status.
Impact of 2022 flood on socio-economic and health status of people residing in flood-stricken areas of Pakistan: a cross-sectional survey
Authors: Khan Qaisar Ali , Jan Ayiz , Iram Sumaira , Haider Iqbal , Badshah Aliena , Khan Arooba , Hidayat Aabdar , Farrukh Ameer Mustafa , Ain Hoor Ul , Verma Ravina
Published: August 2024

Background:

The events of extreme weather and climate-related disasters such as drought, flood, and heat waves are increasing worldwide. This paper highlights the impact of the 2022 flood in Pakistan on the socio-economic and health status of people residing in flood-stricken areas of Pakistan.

Methodology:

A post-flood survey was conducted from three districts of Pakistan with a myriad of questions inquiring about the biopsychosocial aspects of the affected community. Data were collected through a validated questionnaire and was analyzed through SPSS software version 25.

Results:

Forty percent of people became homeless; the number of individuals with a low income decreased by 9%; and the number of individuals with a moderate income decreased by 22%. Additionally, 48.7% of subjects lost their income due to flooding, 83.4% of subjects reported having some type of illness or disability since the flooding (previously 16.4%), and 92.8% believed that the floods had affected the health and sanitation of their area. Importantly, 22.6% of subjects expressed difficulty in accessing food after flooding compared to before and 59.9% of respondents noted they were unaware of proper pre-flood evacuation protocols in their area.

Conclusion:

The authors’ study indicates that the floods had a significant impact on the socio-economic and health status of residents, particularly those with lower incomes depriving a large proportion of nutrition, health facilities, and property. Without access to necessities and healthcare, individuals are more vulnerable to illnesses, such as chronic respiratory disease, diabetes, and heart disease. The authors stress the importance of providing infrastructural, nutritional, and medical services support to ensure that a community such as Pakistan can recover and thrive post-environmental disaster.
The efficacy of virtual reality-based rehabilitation in improving motor function in patients with stroke: a systematic review and meta-analysis
Authors: Prajjwal Priyadarshi , Chandrasekar Kiran Kishor , Battula Pavani , Gaviria Elizabeth , Awe Mishael Oluwadamilola , Inban Pugazhendi , Almutairi Adel S. , Das Arpan , Tekuru Yogesh , Marsool Mohammed Dheyaa Marsool , Reddy Murali Mohan , Mitra Spandana , Bamba Hyma , Singh Gurmehar , Jain Hritvik , Gadam Srikanth , Hussin Omniat Amir
Published: August 2024

Background:

Stroke is a major cause of adult disability, prompting the exploration of innovative rehabilitation methods. Virtual rehabilitation (VR), leveraging technological advances, has gained popularity as a treatment for stroke recovery.

Methodology:

The authors conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published in English within the last decade, adhering to the PRISMA guidelines. The authors searched databases such as Medline/PubMed, and the Cochrane Library using specific search keywords and Medical Subject Headings (MeSH). The methodological quality was assessed using the PEDro scale, focusing on RCTs involving adult stroke patients undergoing VR rehabilitation, with outcomes related to motor function and quality of life.

Results:

The authors included 15 studies in our meta-analysis. VR rehabilitation offers several advantages over traditional therapy, such as enhanced feedback and increased patient motivation. Engaging VR environments helps improve focus during treatment, potentially boosting recovery from post-stroke impairments. VR therapies significantly benefit motor function, which can improve activities of daily living and overall quality of life.

Conclusion:

VR has demonstrated efficacy in improving motor function and quality of life for stroke survivors. Future research should explore patient variability and refine intervention methods. Incorporating VR into rehabilitation programs could optimize stroke recovery outcomes.
Artificial intelligence: revolutionizing robotic surgery: review
Authors: Iftikhar Muhammad , Saqib Muhammad , Zareen Muhammad , Mumtaz Hassan
Published: August 2024

Robotic surgery, known for its minimally invasive techniques and computer-controlled robotic arms, has revolutionized modern medicine by providing improved dexterity, visualization, and tremor reduction compared to traditional methods. The integration of artificial intelligence (AI) into robotic surgery has further advanced surgical precision, efficiency, and accessibility. This paper examines the current landscape of AI-driven robotic surgical systems, detailing their benefits, limitations, and future prospects. Initially, AI applications in robotic surgery focused on automating tasks like suturing and tissue dissection to enhance consistency and reduce surgeon workload. Present AI-driven systems incorporate functionalities such as image recognition, motion control, and haptic feedback, allowing real-time analysis of surgical field images and optimizing instrument movements for surgeons. The advantages of AI integration include enhanced precision, reduced surgeon fatigue, and improved safety. However, challenges such as high development costs, reliance on data quality, and ethical concerns about autonomy and liability hinder widespread adoption. Regulatory hurdles and workflow integration also present obstacles. Future directions for AI integration in robotic surgery include enhancing autonomy, personalizing surgical approaches, and refining surgical training through AI-powered simulations and virtual reality. Overall, AI integration holds promise for advancing surgical care, with potential benefits including improved patient outcomes and increased access to specialized expertise. Addressing challenges and promoting responsible adoption are essential for realizing the full potential of AI-driven robotic surgery.