bluuebunny/crossref_metadata_2025 huggingface dataset:
Recognition of Glaucomatous Fundus Images Using Machine Learning Methods Based on Optic Nerve Head Topographic Features
Authors: Wu Chao-Wei , Huang Tzu-Yu , Liou Yeong-Cheng , Chen Shih-Hsin , Wu Kwou-Yeung , Tseng Han-Yi
Published: March 2024

Précis:

Machine learning classifiers are an effective approach to detecting glaucomatous fundus images based on optic disc topographic features making it a straightforward and effective approach.

Study Design:

Retrospective case-control study.

Objective:

The aim was to compare the effectiveness of clinical discriminant rules and machine learning classifiers in identifying glaucomatous fundus images based on optic disc topographic features.

Methods:

The study used a total of 800 fundus images, half of which were glaucomatous cases and the other half non-glaucomatous cases obtained from an open database and clinical work. The images were randomly divided into training and testing sets with equal numbers of glaucomatous and non-glaucomatous images. An ophthalmologist framed the edge of the optic cup and disc, and the program calculated five features, including the vertical cup-to-disc ratio and the width of the optic rim in four quadrants in pixels, used to create machine learning classifiers. The discriminative ability of these classifiers was compared with clinical discriminant rules.

Results:

The machine learning classifiers outperformed clinical discriminant rules, with the extreme gradient boosting method showing the best performance in identifying glaucomatous fundus images. Decision tree analysis revealed that the cup-to-disc ratio was the most important feature for identifying glaucoma fundus images. At the same time, the temporal width of the optic rim was the least important feature.

Conclusions:

Machine learning classifiers are an effective approach to detecting glaucomatous fundus images based on optic disc topographic features and integration with an automated program for framing and calculating the required parameters would make it a straightforward and effective approach.
Using the Electronic Medical Record to Address Code Status Documentation: A Quality Improvement Project
Authors: Sorge John , Szpunar Susan , Daniel Theodore , Saravolatz Louis
Published: March 2024

Code status (CS) is often overlooked while admitting patients to the hospital. This is important for patients with end-stage disease. This quality improvement project investigated whether a CS pop-up alert in the electronic medical record, combined with provider education, improved addressing CS. The project consisted of a baseline chart review, implementation of the alert and physician education, and a postintervention chart review. We reviewed 1828 charts at baseline and 1,775 at postintervention. From univariable analysis, there were improvements in addressing CS, being full code, cardiopulmonary resuscitation, intubation, use of vasopressors, and cardioversion technique categories (all p < .001). Documentation of do not resuscitate did not change. From logistic regression, after controlling for age, race, end-stage liver disease, stroke, cancer, hospital unit, and sepsis, patients in the postintervention period were two times more likely to have CS addressed (odds ratio [OR] = 2.04, p < .001). There was a significant improvement in CS documentation from our interventions.
Patient-Specific Factors for Deformity after Upper Blepharoplasty in an Asian Population
Authors: Liu Jiaxi , Wu Junzheng , Zeng Xianhui , Liang Zhen , Fan Xiao , Song Baoqiang
Published: March 2024

Background:

The success of upper blepharoplasty depends on both surgeon experience and skill and on patient factors. Therefore, the authors aimed to identify patient-specific characteristics that may contribute to poor prognoses by analyzing data derived from patients with various deformities after undergoing upper blepharoplasty.

Methods:

This study included 202 patients who underwent revision surgery for upper blepharoplasty. The authors explored relationships between types of deformities before revisions and relevant patient factors before initial surgery using statistical analyses.

Results:

Age older than 30 years, thick upper lid skin, medial epicanthus, and other patient factors were significantly associated with the deformities. Asymmetric crease, crease disappearance, shallow crease, and low crease were the most prevalent deformities. For these 4 most prevalent deformities, the concordance indices and 95% confidence intervals (95% CI) of the risk prediction models were 0.654 (95% CI, 0.575 to 0.734), 0.724 (95% CI, 0.637 to 0.810), 0.783 (95% CI, 0.702 to 0.863), and 0.750 (95% CI, 0.655 to 0.844), respectively.

Conclusions:

Among the 4 most prevalent prognostic deformities, significant patient factors included medial epicanthus, thick upper eyelid skin, weak levator palpebrae superioris, age older than 30 years, and a short gap between eyes and brows. The authors also attempted to clarify the clinical importance of these patient factors. The authors’ findings provide a guide and reference for future investigations into upper blepharoplasty.

CLINICAL QUESTION/LEVEL OF EVIDENCE:

Risk, III.
Increasing Catecholamine Secretion Through NPY in Pheochromocytomas With False-Negative 123I-MIBG Scintigraphy
Authors: Ruike Yutaro , Suzuki Sawako , Yokote Koutaro
Published: March 2024

Introduction

123I-MIBG has been well established as a functional imaging tool, and 131I-MIBG therapy is being considered for catecholamine-secreting tumors. Tumors with the characteristics of a noradrenergic biochemical phenotype, small, malignant, metastatic, extra-adrenal, bilateral, and hereditary, especially SDHx-related tumors, are reported to correlate with reduced MIBG uptake. However, the potential molecular mechanisms influencing MIBG uptake have been poorly studied.

Patients and Methods

To identify critical genes that may enhance MIBG accumulation in pheochromocytomas (PCCs), we performed RNA-seq analyses for 16 operated patients with PCCs (6 MIBG-negative and 10 MIBG-positive) combined with RT-qPCR for 27 PCCs (5 MIBG-negative and 22 MIBG-positive) and examined primary cultures of the surgical tissues.

Results

In the present study, 6 adrenal nodules of 66 nodules surgically removed from 63 patients with PCCs (9%) were MIBG negative. MIBG, a guanethidine analog of norepinephrine, can enter chromaffin cells through active uptake via the cellular membrane, be deposited in chromaffin granules, and be released via Ca2+-triggered exocytosis from adrenal chromaffin cells. When we compared expression of several catecholamine biosynthesis and secretion-associated genes between MIBG-negative and MIBG-positive tumors using transcriptome analyses, we found that neuropeptide Y, which is contained in chromaffin granules, was significantly increased in MIBG-negative tumors. NPY stimulated norepinephrine secretion dose-dependently in primary cell culture derived from MIBG-positive PCC. In our study, MIBG-negative PCCs were all norepinephrine-hypersecreting tumors.

Conclusions

These data indicate that NPY upregulation in PCCs may stimulate chromaffin granule catecholamine secretion, which is associated with false-negative 123I-MIBG scintigraphy.
The Effect of Virtual Reality Practice and Music on Patients’ Pain, Comfort, and Vital Signs After Laparoscopic Abdominal Surgery
Authors: Okutan Şerafettin , Saritaş Serdar
Published: March 2024

Aim:

This research was conducted to identify the effect of virtual reality and music on patients’ pain, comfort, and vital signs after laparoscopic abdominal surgery.

Methods:

This study was designed as a prospective randomized controlled single-blind clinical trial. The research population consisted of adult patients who underwent laparoscopic abdominal surgery in surgery clinics. The research sample comprised 225 patients who had laparoscopic abdominal surgery. Experimental groups watched virtual reality videos and listened to music, whereas no intervention was administered to the control group. The research data were evaluated with descriptive statistics, the χ2 test, the Friedman test, the one-way analysis of variance, the Kruskal-Wallis test, and Tukey’s and Dunn’s post hoc tests.

Findings:

In the post-test phase after the 2 interventions, the virtual reality and music groups had lower pain and comfort levels than the control group, and this intergroup difference was statistically significant (P<0.05). Results for vital signs in successively repeated post-test measurements after interventions were in general different, and these differences were statistically significant. Patients in the virtual reality group generally had higher pulse rate, diastolic blood pressure, respiratory rate, and body temperature values in successively repeated post-test measurements than patients in other groups (P<0.05). Patients in the control group generally had higher systolic blood pressure and saturation values in successively repeated post-test measurements than patients in other groups (P<0.05).

Conclusion:

It was discerned that music and the virtual reality practice reduced patients’ pain and comfort levels and had positive effects on their vital signs after laparoscopic abdominal surgery.
Advancing CAR T-Cell Therapy: Simultaneously Attack Tumor and Immunosuppressive Cells in the Tumor Microenvironment
Authors: Luo Yan , Garavito Emiliano Sanchez , Brooks Mieu M. , Gadd Martha E. , Qie Yaqing , Navas Maria J. Ulloa , Hundal Tanya , Li Shuhua , Lopez Andrea Otamendi , Jones Vanessa K. , Lou Yanyan , Patel Tushar , Dronca Roxana , Kharfan-Dabaja Mohamed A. , Dong Haidong , Quinones-Hinojosa Alfredo , Qin Hong
Published: March 2024

Chimeric antigen receptor (CAR) T-cell therapy has encountered limited success in solid tumors. The lack of dependable antigens and the immunosuppressive tumor microenvironment (TME) are major challenges. Within the TME, tumor cells along with immunosuppressive cells employ an immune-evasion mechanism that upregulates programmed death ligand 1 (PD-L1) to deactivate effector T cells; this makes PD-L1 a reliable, universal target for solid tumors. We developed a novel PD-L1 CAR (MC9999) using our humanized anti-PD-L1 monoclonal antibody, designed to simultaneously target tumor and immunosuppressive cells. The antigen-specific antitumor effects of MC9999 CAR T-cells were observed consistently across four solid tumor models: breast cancer, lung cancer, melanoma, and glioblastoma multiforme (GBM). Notably, intravenous administration of MC9999 CAR T-cells eradicated intracranially established LN229 GBM tumors, suggesting penetration of the blood-brain barrier. The proof-of-concept data demonstrate the cytolytic effect of MC9999 CAR T-cells against immunosuppressive cells, including microglia HMC3 cells and M2 macrophages. Furthermore, MC9999 CAR T-cells elicited cytotoxicity against primary tumor-associated macrophages within GBM tumors. The concept of targeting both tumor and immunosuppressive cells with MC9999 was further validated using CAR T-cells derived from cancer patients. These findings establish MC9999 as a foundation for the development of effective CAR T-cell therapies against solid tumors.
Exaptation and de novo mutations transcend cryptic variations as drivers of adaptation in yeast
Authors: Routh Shreya , Lindsay Richard J. , Gudelj Ivana , Dhar Riddhiman
Published: March 2024

Many organisms live in predictable environments with periodic variation in growth condition which can allow populations to accumulate cryptic genetic variations. Cryptic variations can facilitate adaptation to new environments, as observed in evolution experiments with a ribozyme and a protein. Whether the same holds for cell populations remains unclear. Alternatively, living in a near-constant condition can lead to loss of nonessential cellular functions, which could be maladaptive in new environments. Through laboratory evolution experiments in yeast, we show that populations grown in a predictable nutrient-rich environment for 1000 generations start to lose their ability to respond and adapt to new stressful environments. Growth of yeast populations in the nutrient-rich environment was associated with modest fitness increase in this environment, metabolic remodeling, and increased lipid accumulation. In novel stressful environments, however, these populations generally had reduced fitness, except in salt-stress where lipid accumulation seemed to provide osmotic protection. We further found that adaptation to stressors was primarily driven by de novo mutations, with very little contribution from the mutations accumulated prior to the exposure to stressors. Thus, our work suggests that in the absence of occurrence of new environments, natural populations might not accumulate cryptic variations that could be beneficial for adaptation to these environments. In addition, presence of selection in predictable condition in natural populations may purge away some of the cryptic variations. Taken together, these findings raise questions about persistence of cryptic variations in natural populations and their importance in evolutionary adaptation.
A Novel AI-based Score for Assessing the Prognostic Value of Intra-Epithelial Lymphocytes in Oral Epithelial Dysplasia
Authors: Shephard Adam J , Mahmood Hanya , Raza Shan E Ahmed , Khurram Syed Ali , Rajpoot Nasir M
Published: March 2024

Oral epithelial dysplasia (OED) poses a significant clinical challenge due to its potential for malignant transformation and the lack of reliable prognostic markers. Current grading systems for OED may not be reliable for prediction of malignant transformation and suffer from considerable inter- and intra-rater variability, potentially leading to suboptimal treatment decisions. Recent studies have highlighted the potential prognostic significance of peri-epithelial lymphocytes (PELs) in malignant transformation, with suggestions that intra-epithelial lymphocytes (IELs) may also play a role. In this study, we propose a novel artificial intelligence (AI) based IEL score from Haematoxylin and Eosin (H&E) stained Whole Slide Images (WSIs) of OED tissue slides. We further determine the prognostic value of our IEL score on a large digital dataset of 219 OED WSIs (acquired using three different scanners), compared to pathologist-led clinical grading. Notably, despite IELs not being incorporated into the current WHO grading system for OED, our findings suggest that IEL scores carry significant prognostic value that were shown to further improve both the Binary/WHO grading systems in multivariate analyses. This underscores the potential importance of IELs, and by extension our IEL score, as prognostic indicators in OED. Further validation through prospective multi-centric studies is warranted to confirm the clinical utility of the proposed IEL score and its integration into existing grading systems for OED.

Conflict of Interest Statements

NMR is the co-founder, CEO and CSO of Histofy Ltd., UK. He is also the GSK Chair of Computational Pathology and is in receipt of research funding from GSK and AstraZeneca.

SAK is a shareholder of Histofy Ltd.

All other authors have no competing interests to declare.
First Results from a Broadband Search for Dark Photon Dark Matter in the 44 to
52  μeV
Range with a Coaxial Dish Antenna
Authors: Knirck Stefan , Hoshino Gabe , Awida Mohamed H. , Cancelo Gustavo I. , Di Federico Martin , Knepper Benjamin , Lapuente Alex , Littmann Mira , Miller David W. , Mitchell Donald V. , Rodriguez Derrick , Ruschman Mark K. , Sawtell Matthew A. , Stefanazzi Leandro , Sonnenschein Andrew , Teafoe Gary W. , Bowring Daniel , Carosi G. , Chou Aaron , Chang Clarence L. , Dona Kristin , Khatiwada Rakshya , Kurinsky Noah A. , Liu Jesse , Pena Cristián , Salemi Chiara P. , Wang Christina W. , Yu Jialin ,   BREAD Collaboration
Published: March 2024

We present first results from a dark photon dark matter search in the mass range from 44 to 52  μeV (10.7–12.5 GHz) using a room-temperature dish antenna setup called GigaBREAD. Dark photon dark matter converts to ordinary photons on a cylindrical metallic emission surface with area 0.5  m2 and is focused by a novel parabolic reflector onto a horn antenna. Signals are read out with a low-noise receiver system. A first data taking run with 24 days of data does not show evidence for dark photon dark matter in this mass range, excluding dark photon photon mixing parameters χ≳10−12 in this range at 90% confidence level. This surpasses existing constraints by about 2 orders of magnitude and is the most stringent bound on dark photons in this range below 49  μeV.

Published by the American Physical Society
2024
Inverse Volume Scaling of Finite-Size Error in Periodic Coupled Cluster Theory
Authors: Xing Xin , Lin Lin
Published: March 2024

Coupled cluster theory is one of the most popular post-Hartree-Fock methods for molecular quantum chemistry. The finite-size error of the correlation energy in periodic coupled cluster calculations for three-dimensional insulating systems has been observed to satisfy the inverse volume scaling, even in the absence of any correction schemes. This is surprising, as simpler theories that utilize only a subset of the coupled cluster diagrams exhibit much slower decay of the finite-size error, which scales inversely with the length of the system. In this study, we review the current understanding of finite-size error in quantum chemistry methods for periodic systems. We introduce new tools that elucidate the mechanisms behind this phenomenon in the context of coupled cluster doubles calculations. This reconciles some seemingly paradoxical statements related to finite-size scaling. Our findings also show that singularity subtraction can be a powerful method to effectively reduce finite-size errors in practical quantum chemistry calculations for periodic systems.

Published by the American Physical Society
2024
Viewing electromagnetic scattering characteristics on air-brake of a stealth plane
Authors: Zhou Zeyang , Huang Jun
Published: March 2024

Purpose

This study aims to learn the dynamic radar cross-section (RCS) of a deflection air brake.

Design/methodology/approach

The aircraft model with delta wing, V-shaped tail and blended wing body is designed, and high-precision unstructured grid technology is used to deal with the surface of air brake and fuselage. The calculation method based on multiple tracking and dynamic scattering is presented to calculate RCS.

Findings

The fuselage has a low scattering level, and the opening air brake will bring obvious dynamic RCS effects to itself and the whole machine. The average indicator of air brake RCS can be lower than –0.6 dBm2 under the tail azimuth, while that of forward and lateral direction is lower. The mean RCS of fuselage is obviously higher than that of air brake, while the deflected air brake and its cabin can still provide strong scattering sources at some azimuths. When the air brake is opening, the change amplitude of the aircraft forward RCS can exceed 19.81 dBm2.

Practical implications

This research has practical significance for the dynamic electromagnetic scattering analysis and stealth design of the air brake.

Originality/value

The calculation method for aircraft RCS considering air brake dynamic deflection has been established.
Understanding careers as translations: the importance of Bruno Latour for the study of careers
Authors: Van den Abeele Hannelore Ottilie
Published: March 2024

Purpose

This paper argues that Bruno Latour’s work on translation provides an alternative to dominant anthropocentric, individualistic and managerial approaches in career studies by considering careers as precarious effects of networks instead of the implicit assumption of individual strategic career actors in extant career research paradigms.

Design/methodology/approach

The article first compares the three main current approaches to studying careers – structural functionalist, interpretivist and critical – illustrated by three exemplary empirical studies. Subsequently, three concepts from the sociology of translation that are relevant for the study of careers are introduced: career making as translating interests, careers as effects of networks and career action as dislocated and overtaken. Taken together, these three concepts allow us to conceive of careers as practices performed by human and nonhuman actors. Finally, an example from an ethnographic case study in the field of contemporary art illustrates how a Latourian approach can be used.

Findings

Latour’s work on translation provides conceptual and methodological tools to investigate career processes and practices in an era of unpredictability.

Originality/value

The paper introduces Bruno Latour’s work on translation to the study of careers.
Deep learning assisted fabrication of metallic components using the robotic wire arc additive manufacturing
Authors: Zheng Pingyang , Han Shaohua , Xue Dingqi , Fu Ling , Jiang Bifeng
Published: March 2024

Purpose

Because of the advantages of high deposition efficiency and low manufacturing cost compared with other additive technologies, robotic wire arc additive manufacturing (WAAM) technology has been widely applied for fabricating medium- to large-scale metallic components. The additive manufacturing (AM) method is a relatively complex process, which involves the workpiece modeling, conversion of the model file, slicing, path planning and so on. Then the structure is formed by the accumulated weld bead. However, the poor forming accuracy of WAAM usually leads to severe dimensional deviation between the as-built and the predesigned structures. This paper aims to propose a visual sensing technology and deep learning–assisted WAAM method for fabricating metallic structure, to simplify the complex WAAM process and improve the forming accuracy.

Design/methodology/approach

Instead of slicing of the workpiece modeling and generating all the welding torch paths in advance of the fabricating process, this method is carried out by adding the feature point regression branch into the Yolov5 algorithm, to detect the feature point from the images of the as-built structure. The coordinates of the feature points of each deposition layer can be calculated automatically. Then the welding torch trajectory for the next deposition layer is generated based on the position of feature point.

Findings

The mean average precision score of modified YOLOv5 detector is 99.5%. Two types of overhanging structures have been fabricated by the proposed method. The center contour error between the actual and theoretical is 0.56 and 0.27 mm in width direction, and 0.43 and 0.23 mm in height direction, respectively.

Originality/value

The fabrication of circular overhanging structures without using the complicate slicing strategy, turning table or other extra support verified the possibility of the robotic WAAM system with deep learning technology.
Funding of Public Service Media in Germany
Authors: Sehl Annika
Published: March 2024

This article provides an overview of the current state of public service media (PSM) funding in Germany, which is primarily supported by a household levy, supplemented by advertising, sponsorship and so‐called ‘other income’. Germany is an interesting case owing to the complexities and challenges associated with funding PSM in a country with a federal structure. As such, insights into PSM funding in Germany and the debates surrounding it can benefit not only academics, but also policy makers, media professionals and others with an interest in PSM funding.
The Governance of the BBC
Authors: Coyle Diane
Published: March 2024

The governance of the BBC has been a subject of political debate for the past two decades, which have brought two major upheavals in the corporation's governance structure. Yet, governance reform was not the best way to address the editorial and cultural crises that led to demands for change; and the current model is not adequate to protect licence fee payers’ interests and the BBC's independence, particularly in the context of continuing ideological assaults on public service broadcasting.
Extensive and deep granulomatous ulcers as an atypical manifestation of cartilage‐hair hypoplasia syndrome: A diagnostic and therapeutic challenge
Authors: Rozas‐Muñoz Eduardo , Blamey‐Diaz Rodrigo , Gallardo‐Olivos Ana Maria , Jerez Javiera , Madariaga Juan‐Andres
Published: March 2024

Cartilage hypoplasia syndrome is a primary immunodeficiency disease characterized by short stature, hypoplastic hair and a variable degree of immunodeficiency. Noninfectious cutaneous granulomas represent an uncommon yet well‐recognized manifestation within the spectrum of primary immunodeficiency diseases. However, cutaneous granulomas as a manifestation of cartilage‐hair hypoplasia syndrome, are extremely rare. We present a case of a middle‐aged man with cartilage hypoplasia syndrome featuring cutaneous granulomas, manifesting as chronic, extensive and deep cutaneous ulcers. The patient was treated with anti‐TNF‐alpha adalimumab with partial improvement. Our case underscores the broad spectrum of clinical manifestations associated with cartilage hypoplasia syndrome and adds new evidence to the potential therapeutic efficacy of anti‐TNF‐alpha drugs in its treatment.
Complex patch geometries maximize species richness at the expense of forest specialists
Authors: Clements Stephanie L. , Alpízar Dunia Villalobos , Searcy Christopher A.
Published: March 2024

Habitat loss and fragmentation are the greatest threats to reptiles and amphibians (herpetofauna) around the globe, but especially in the Neotropics where high diversity and ongoing land‐use change coincide. Persistence of biodiversity in fragmented systems relies both on characteristics of habitat patches, and on the permeability of the landscape that separates the patches (the “matrix”). We sought to understand: (a) how the herpetofauna community differs between forest reserves, patches, corridors, and matrices, and (b) the landscape characteristics that increase suitability of a habitat patch. We conducted herpetofauna surveys in patches, corridors, matrices, and preserves (54 total sites) in a fragmented landscape in Costa Rica for three seasons. We recorded 1663 individuals of 52 species. We found that the herpetofauna community differed, and had lower richness and abundance, in the matrix compared to the other three habitat types. Patches and corridors supported a similar community to the forest preserves, demonstrating the conservation value of small forest remnants. Water body presence was an important predictor of richness and abundance in both patches and matrices. While total richness increased in patches with more edge, this was driven by the response of generalist species, whereas the prime indicator species of forest preserves decreased in patches with complex shapes. The differing response to landscape characteristics between specialist and generalist species demonstrates the importance of considering specific taxa when setting conservation goals, rather than using richness measures alone. Our findings can help guide preservation of forest fragments to optimize biodiversity conservation in mixed forest‐pastoral landscapes.

Abstract in Spanish is available with online material.
“You gotta tell the camera”: Advancing children's engineering learning opportunities through tinkering and digital storytelling
Authors: Pagano Lauren C. , George Riley E. , Uttal David H. , Haden Catherine A.
Published: March 2024

This study addressed whether combining tinkering with digital storytelling (i.e., narrating and reflecting about experiences to an imagined audience) can engender engineering learning opportunities. Eighty‐four families with 5‐ to 10‐year‐old (M = 7.69) children (48% female children; 57% White, 11% Asian, 6% Black) watched a video introducing a tinkering activity and were randomly assigned either to a digital storytelling condition or a no digital storytelling condition during tinkering. After tinkering, families reflected on their tinkering experience and were randomly assigned to either engage in digital storytelling or not. Children in the digital storytelling condition during tinkering spoke most to an imagined audience during tinkering, talked most about engineering at reflection, and remembered the most information about the experience weeks later.
BRCC3 mediates inflammation and pyroptosis in cerebral ischemia/reperfusion injury by activating the NLRP6 inflammasome
Authors: Huang Xiaohuan , Tan Junyi , Ji Yanyan , Luo Jing , Zhao Yong , Zhao Jing
Published: March 2024

Aims

Neuroinflammation and pyroptosis are key mediators of cerebral ischemia/reperfusion (I/R) injury‐induced pathogenic cascades. BRCC3, the human homolog of BRCC36, is implicated in neurological disorders and plays a crucial role in neuroinflammation and pyroptosis. However, its effects and potential mechanisms in cerebral I/R injury in mice are unclear.

Methods

Cellular localization of BRCC3 and the interaction between BRCC3 and NLRP6 were assessed. Middle cerebral artery occlusion/reperfusion (MCAO) and oxygen–glucose deprivation/reoxygenation (OGD/R) models were established in mice and HT22 cells, respectively, to simulate cerebral I/R injury in vivo and in vitro.

Results

BRCC3 protein expression peaked 24 h after MCAO and OGD/R. BRCC3 knockdown reduced the inflammation and pyroptosis caused by cerebral I/R injury and ameliorated neurological deficits in mice after MCAO. The effects of BRCC3 on inflammation and pyroptosis may be mediated by NLRP6 inflammasome activation. Moreover, both BRCC3 and its N‐ and C‐terminals interacted with NLRP6, and both BRCC3 and its terminals reduced NLRP6 ubiquitination. Additionally, BRCC3 affected the interaction between NLRP6 and ASC, which may be related to inflammasome activation.

Conclusion

BRCC3 shows promise as a novel target to enhance neurological recovery and attenuate the inflammatory responses and pyroptosis caused by NLRP6 activation in cerebral I/R injury.
Drivers of flight altitude during nocturnal bird migration over the North Sea and implications for offshore wind energy
Authors: Bradarić Maja , Kranstauber Bart , Bouten Willem , van Gasteren Hans , Baranes Judy Shamoun
Published: March 2024

Each year, millions of birds migrate nocturnally over the North Sea basin, an area designated for significant offshore wind energy development. Wind turbines can harm aerial wildlife through collisions and barrier effects, especially when birds fly at low altitudes below the wind turbine rotor tip. We aim to quantify seasonal and nightly differences in flight altitudes of nocturnal bird migration over the North Sea and identify how weather influences low‐altitude flight to inform wind turbine curtailment procedures for reducing bird fatalities. We used bird tracking radars at Borssele and Luchterduinen offshore wind parks, 22 and 23 km from the western Dutch coast, to monitor altitude distributions during migration. We show that median flight altitude was higher in spring compared to autumn at Borssele (spring: 285.5 m, autumn: 169.2 m; p < .001, effect size [ES] = 0.0001) and Luchterduinen (spring: 133.8 m, autumn: 126.0 m; p < .001, ES = 0.002) and below wind turbine rotor tip in both seasons. On most nights in both seasons, the majority of migrants flew predominantly at low altitudes, except for intense migration nights in spring in Borssele where, on 87% of these nights, migration mainly occurred at high altitudes. The most important predictors of low‐altitude migration in both seasons were day of year and wind assistance. Birds chose altitudes with the most favorable wind conditions for migration in both seasons. The relationship between day of year and low‐altitude migration fraction suggests that different species migrate at different altitudes. In spring, birds were flying lower at the beginning and the end of the night, reflecting departures and arrivals of birds, while radar location in autumn was a good predictor of low‐altitude flights, indicating that different local migratory axes have distinct altitude distributions. Our findings suggest that mitigation measures offshore may be more effective during autumn than spring, especially on nights with more supportive wind conditions at altitudes below 300 m.
Financial impact of donation after circulatory death heart transplantation: A single‐center analysis
Authors: Urban Marian , Ryan Timothy R. , Um John Y. , Siddique Aleem , Castleberry Anthony W. , Lowes Brian D.
Published: March 2024

Introduction

Clinical success of donation after circulatory death (DCD) heart transplantation is leading to growing adoption of this technique. In comparison to procurement from a brain‐dead donor, DCD requires additional resources. The economic impact of DCD heart transplantation from the hospital perspective is not well known.

Methods

We compared the financial data of patients who received DCD allografts to those who received a DBD organ at our institution from January 1, 2021 to December 31, 2022. We also compared the cost of ex‐situ machine perfusion to in‐situ organ perfusion employed during DCD recovery.

Results

We performed 58 DBD and 22 DCD heart‐alone transplantations during the study period. Out of 22 DCD grafts, 16 were recovered with thoracoabdominal normothermic regional perfusion (TA‐NRP) and six with direct procurement followed by normothermic machine perfusion (DP‐NMP). The contribution margin per case for DBD versus DCD was $234,362 and $235,440 (P = .72). The direct costs did not significantly differ between the two groups ($171,949 and 186,250; P = .49). In comparing the two methods of procuring hearts from DCD donors, the direct cost of TA‐NRP was $155,955 in comparison to $223,399 for DP‐NMP (P = .21). This difference translated into a clinically meaningful but not statistically significant greater contribution margin for TA‐NRP ($242, 657 vs. $175,768; P = .34).

Conclusions

Our data showed that the adoption of DCD procurement did not have a negative financial impact on the contribution margin in our institution. Programs considering starting DCD heart transplantation, and those who are currently performing DCD procurement should evaluate their own financial situation.
Diversity of bumble bees and butterflies in Minnesota roadsides depends on floral diversity and abundance but not floral native status
Authors: Darst Ashley L. , Mitchell Timothy S. , Verhoeven Michael R. , Evans Elaine , Tonsfeldt Luke , Kjaer Savannah , Snell‐Rood Emilie C.
Published: March 2024

Habitat loss is an important driver in the rapid decline of many insects. The restoration of roadside habitat has been touted as an opportunity to support communities of bumble bees and butterflies, two insect groups of conservation concern. However, it is unclear how current roadside restoration methods translate to pollinator abundance and diversity.

Here, we ask how the plant communities of roadsides seeded with native and non‐native seed mixes affect bumble bee and butterfly communities 2–20 years after planting.

We found that bumble bee and butterfly abundance and diversity were positively correlated with floral abundance and diversity. However, the pollinator community in plots planted with diverse native seed mixes did not differ from that found in plots seeded with species‐poor non‐native mixes, likely because many forbs in the native seed mixes had poor establishment, and all plots were readily colonised by species that were never planted.

While plots with more native flowers did not necessarily support higher pollinator diversity, we did find several native plants that established well in roadsides and supported pollinators, including goldenrods (Solidago spp.), milkweeds (Asclepias spp.) and wild bergamot (Monarda fistulosa).

Our data suggest that managing a more diverse and abundant floral community will benefit bumble bees and butterflies. Refining the composition of native seed mixes, adding more floral abundance to non‐native mixes and investing in management for native plant communities may increase the habitat value of roadsides for pollinator communities.
HINT2 protects against pressure overload‐induced cardiac remodelling through mitochondrial pathways
Authors: Zhang Nan , Zhou Zi‐Ying , Meng Yan‐Yan , Liao Hai‐Han , Mou Shan‐Qi , Lin Zheng , Yan Han , Chen Si , Tang Qi‐Zhu
Published: March 2024

Histidine triad nucleotide‐binding protein 2 (HINT2) is an enzyme found in mitochondria that functions as a nucleotide hydrolase and transferase. Prior studies have demonstrated that HINT2 plays a crucial role in ischemic heart disease, but its importance in cardiac remodelling remains unknown. Therefore, the current study intends to determine the role of HINT2 in cardiac remodelling. HINT2 expression levels were found to be lower in failing hearts and hypertrophy cardiomyocytes. The mice that overexpressed HINT2 exhibited reduced myocyte hypertrophy and cardiac dysfunction in response to stress. In contrast, the deficiency of HINT2 in the heart of mice resulted in a worsening hypertrophic phenotype. Further analysis indicated that upregulated genes were predominantly associated with the oxidative phosphorylation and mitochondrial complex I pathways in HINT2‐overexpressed mice after aortic banding (AB) treatment. This suggests that HINT2 increases the expression of NADH dehydrogenase (ubiquinone) flavoprotein (NDUF) genes. In cellular studies, rotenone was used to disrupt mitochondrial complex I, and the protective effect of HINT2 overexpression was nullified. Lastly, we predicted that thyroid hormone receptor beta might regulate HINT2 transcriptional activity. To conclusion, the current study showcased that HINT2 alleviates pressure overload‐induced cardiac remodelling by influencing the activity and assembly of mitochondrial complex I. Thus, targeting HINT2 could be a novel therapeutic strategy for reducing cardiac remodelling.
Transitioning from injectable resin composite restorations to resin composite CAD/CAM veneers: A clinical report
Authors: Rafeie Niyousha , Sampaio Camila S. , Hirata Ronaldo
Published: March 2024

Objective

To describe a shift from injectable resin composite technique to composite resin computer‐aided design and computer‐aided manufacturing (CAD/CAM) veneers in addressing esthetic concerns associated with diastemas between anterior lower teeth in a clinical case.

Clinical Considerations

Among several techniques proposed for direct resin composite restoration, the “Injectable resin composite technique” has gained popularity for its time‐efficiency, reduced technique sensitivity, and diminished reliance on clinician skills. However, challenges such as staining and the need for frequent polishing follow‐ups may prompt the consideration of more stable alternatives such as indirect veneer restorations. While ceramic veneers offer superior mechanical and optical properties, resin ceramic veneers, especially those milled from CAD/CAM resin ceramic blocks, offer advantages such as rapid, cost‐effective production, simplified intra‐oral repairs, less susceptibility to fracture, superior stress absorption, and requires minimal tooth preparation, making them an appealing option for many patients. Moreover, a fully‐digital approach not only streamlines the process but also saves time and labor while ensuring the delivery of high‐quality restorations to patients.

Conclusion

In addressing a patient's dissatisfaction with constant polishing of direct resin composite restorations, a shift to resin composite CAD/CAM veneers was implemented. Utilizing a fully‐digital approach with CAD/CAM resin ceramic restorations successfully restored both esthetics and function.

Clinical Significance

While the injectable resin composite technique achieves immediate esthetic results, its low color stability necessitates frequent polishing sessions. The replacement of direct resin composite restorations with CAD/CAM resin composite veneers becomes a viable option for patients seeking more stable restorations that require fewer follow‐ups. This transition addresses both esthetic concerns and the need for enduring solutions in restorative dentistry.
Post‐acute care transitions during COVID‐19: Racial, ethnic, and socioeconomic differences in older adults with Alzheimer's disease and related dementia
Authors: Yang Ming‐Ting , Temkin‐Greener Helena , Veazie Peter , Cai Shubing
Published: March 2024

Background

Differences in the post‐acute care (PAC) destinations among racial, ethnic, and socioeconomic groups have been documented before the COVID‐19 pandemic. Yet, the pandemic's impact on these differences remains unknown. We examined the impact of the COVID‐19 pandemic on PAC destinations and its variation by individual race, ethnicity, and socioeconomic status among community‐dwelling older adults with Alzheimer's disease and related dementia (ADRD).

Methods

We linked 2019–2021 national data (Medicare claims, Minimum Data Set, Master Beneficiary Summary File) and several publicly available datasets, including Provider of Services File, Area Deprivation Index, Area Health Resource File, and COVID‐19 infection data. PAC discharge destinations included skilled nursing facilities (SNFs), home health agencies (HHA), and homes without services. Key variables of interest included individual race, ethnicity, and Medicare‐Medicaid dual status. The analytic cohort included 830,656 community‐dwelling Medicare fee‐for‐service beneficiaries with ADRD who were hospitalized between 2019 and 2021. Regression models with hospital random effects and state‐fixed effects were estimated, stratified by the time periods, and adjusted for the individual, hospital, and county‐level covariates.

Results

SNF discharges decreased while home and HHA discharges increased during the pandemic. The trend was more prominent among racial and ethnic minoritized groups and even more so among dual‐eligible beneficiaries. For instance, the reduction in the probabilities of SNF admissions between the pre‐pandemic period and the 2nd year of COVID was 4.6 (White non‐duals), 18.5 (White duals), 8.7 (Black non‐duals), and 20.1 (Black duals) percentage‐point, respectively. We also found that non‐duals were more likely to replace SNF with HHA services, while duals were more likely to be discharged home without HHA.

Conclusions

The COVID‐19 pandemic significantly impacted PAC destinations for individuals with ADRD, especially among socioeconomically disadvantaged and racial and ethnic minoritized populations. Future research is needed to understand if and how these transitions may have affected health outcomes.
Preferences and feasibility of long‐acting technologies for treatment of hepatitis C virus in low‐ and middle‐income countries: A survey of providers and policymakers
Authors: Gupta Neil , Swindells Susan , Scarsi Kimberly K. , Furl Renae , Thomas David L. , Weld Ethel D. , Ofimboudem Joelle Dountio , Desalegn Hailemichael , Hamid Saeed , Rosas Alethse de la Torre , Miranda Angelica E. , Owen Andrew , Rannard Steve , Hiebert Lindsey , Sun Katherine , Ward John W.
Published: March 2024

Long‐acting technologies (LATs) for hepatitis C virus (HCV) are under development as a strategy to improve linkage to care, treatment adherence and outcomes. We conducted a survey of HCV treatment prescribers and HCV policymakers in low‐ and middle‐income countries (LMICs) regarding acceptability and feasibility of HCV LATs. We included one‐time intramuscular injection, subdermal implant and transdermal patch as potential LAT options. We surveyed participants regarding optimal health system and patient characteristics, concerns, potential barriers, overall feasibility and preferences for HCV LAT as compared to daily oral medication. Overall, 122 providers and 50 policymakers from 42 LMICs completed the survey. Among providers, 93% (113/122) expressed willingness to prescribe LAT and 72% (88/120) of providers preferred LAT if provided at comparable efficacy, safety and cost as current oral treatments. Of providers preferring HCV LAT to daily oral medication, 67% (59/88) preferred injection, 24% (21/88) preferred patch and 9% (8/88) preferred implant. Only 20% (24/122) would prescribe LAT if it were more costly than oral treatment. In regression analysis, no provider characteristics were associated with preference for LAT over oral treatment. Policymakers reported high likelihood that LAT would be included in treatment guidelines (42/50; 84%) and national drug formularies (39/50; 78%) if efficacy, safety and cost were similar to oral treatment. HCV LATs could advance progress to HCV elimination in LMICs by diversifying treatment options to improve treatment coverage and outcomes. Provider preferences from LMICs are a critical consideration in the development of HCV LATs to ensure its early and equitable availability in LMICs.
Risk factors associated with fluconazole resistance in Candida parapsilosis candidemia: A case–case study
Authors: Atalay Sabri , Çağlayan Derya , Arkalı Eren , Sönmez Ufuk , Şamlıoğlu Pınar
Published: March 2024

Background

Candida species are among the most important invasive pathogens in intensive care units (ICUs). Non‐albicans species including Candida parapsilosis (C. parapsilosis) has increased in recent years. Fluconazole is the leading antifungal agent but resistance is a concern among C. parapsilosis species.

Objectives

The aim of this study was to determine the factors associated with fluconazole resistance in patients with candidemia due to C. parapsilosis in ICUs.

Methods

This case–case study was conducted in a 750‐bed, tertiary hospital between 2015 and 2021. Patients with fluconazole‐resistant C. parapsilosis candidemia constituted the ‘cases of interest’ group and patients with fluconazole‐susceptible C. parapsilosis candidemia constituted the ‘comparison cases’ group. Demographic and clinical data of the patients were recorded. Logistic regression analysis was performed using the backward elimination method to determine the independent predictors of fluconazole‐resistant C. parapsilosis bloodstream infections.

Results

The study included 177 patients. In the cultures of these patients, 76 (43%) fluconazole‐resistant, 13 (7.3%) fluconazole‐reduced susceptible, and 88 (49.7%) fluconazole‐susceptible isolates were found. In the regression analysis the risk factors for fluconazole‐resistant C. parapsilosis bloodstream infection, malignancy, immunosuppressive treatment, history of intra‐abdominal surgery, hypoalbunemia, previous fluconazole use, and SOFA score were found to be associated in univariate analysis. In multivariate regression analysis, history of intra‐abdominal surgery (OR: 2.16; 95% CI: 1.05–4.44), hypoalbuminemia (OR: 2.56; 95% CI: 1.06–6.17) and previous fluconazole use (OR: 3.35; 95% CI: 1.02–11) were found to be independent predictors.

Conclusions

In this study, a significant correlation was found between candidemia due to fluconazole‐resistant C. parapsilosis in ICUs and intra‐abdominal surgery, hypoalbuminemia, and previous fluconazole use. C. parapsilosis isolates and fluconazole resistance should be continuously monitored, strict infection control measures should be taken and antifungal stewardship programs should be implemented.