bluuebunny/crossref_metadata_2025 huggingface dataset:
Synchronization-induced violation of thermodynamic uncertainty relations
Authors: Razzoli Luca , Carrega Matteo , Cavaliere Fabio , Benenti Giuliano , Sassetti Maura
Published: August 2024

Fluctuations affect the functionality of nanodevices. Thermodynamic uncertainty relations (TURs), derived within the framework of stochastic thermodynamics, show that a minimal amount of dissipation is required to obtain a given relative energy current dispersion, that is, current precision has a thermodynamic cost. It is therefore of great interest to explore the possibility that TURs are violated, particularly for quantum systems, leading to accurate currents at lower cost. Here, we show that two quantum harmonic oscillators are synchronized by coupling to a common thermal environment, at strong dissipation and low temperature. In this regime, periodically modulated couplings to a second thermal reservoir, breaking time-reversal symmetry and taking advantage of non-Markovianity of this latter reservoir, lead to strong violation of TURs for local work currents, while maintaining finite output power. Our results pave the way for the use of synchronization in the thermodynamics of precision.
Structural safety of in-service motorway tunnel linings under defective conditions
Authors: Yan Wenjia , Wang Bin , Li Rongfeng , Liu Zonghan , Li Junni , Zhang Min , Li Peng
Published: August 2024

The structural safety of in-service tunnel lining structures is assessed and calculated using a numerical simulation based on the damage statistics of a motorway tunnel to study the effects of the surrounding rock classification, defect type, defect location, and severity of defects on the lining. The main conclusions are as follows. (1) Void defects mainly exist in the shoulder section and account for 73% of the total defects, whereas insufficient thickness is primarily observed at the sidewalls, accounting for 52% of the total defects. (2) As the width clearance of the tunnel increases, the safety factor of each region on the lining structure is reduced to different extents. Voids in the crown section have the highest impact on the safety factor of the lining structure. When the maximum width exceeds 2 m, the safety factor is reduced by up to 91.92%. (3) When the tunnel lining is insufficiently thick, the influence of the defect generally does not extend beyond the defective area. The maximum reduction rates of the safety factors for the crown, shoulder, and sidewalls are 91.28%, 96.12%, and 90.48%, respectively. (4) Thickness defects are more prevalent than void defects. Compared with insufficient thickness defects, void defects more considerably affect the safety factor of the lining structure. Hence, the results of this study can provide an engineering basis for the operational status of in-service tunnels.
Climate hazards and human migration: literature review
Authors: Ivanova Anna , Singh Deepti , Rai Pronoy , Richards Claire , Vasconcelos Hugo , Goldsby Michael
Published: August 2024

Human populations are migrating as a result of climate change. We conducted a systematic literature review examining the relationship between several climate hazards and migration flows. We reviewed 58 empirical studies between 2010 and 2023 that examined current and future migration related to acute and long-term climate hazards. The results indicate that the relationship between climate hazards and migration is diverse and depends on a range of socio-economic factors. Droughts and rising temperatures have a major impact on both international and domestic migration. Our review also reveals that multiple climate hazards collectively tend to intensify domestic migration toward urban areas, especially in agriculturally dependent regions. A better understanding of migration patterns and the climate hazards that drive them can inform global policy and preparedness for climate migration.
From crisis to opportunity: climate change benefits livestock production in Somalia
Authors: Hussein Jaabir , Bilotto Franco , Sircely Jason , Mbui Damaris , Omondi Philip , Ferreira Carla Sofia Santos , Fahad Shah , Liu Ke , Harrison Matthew Tom
Published: August 2024

While livelihoods of Somalian livestock smallholders rely heavily on seasonal climate conditions, little is known of long-term implications of the changing climate for this nation. Here, we quantify implications of the changing climate on the productivity and profitability of livestock smallholders across a rainfall gradient in northwestern Somalia. Using the Sustainable Grazing Systems (SGS) model, we explore 80 future climate realisations, with global climate model projections including low- and high-impact socio-economic pathways (SSP245 and SSP585), two climate horizons (2040 and 2080) and four case study farm regions. In general, future seasonal and annual rainfall and temperature relative to the baseline period (1981–2020) increased for most regions. Mean annual temperatures increased by 9%–14%, while cumulative annual precipitation increased by 37%–57% from mid to late century, respectively. Grassland production increased with later climate horizons, as higher average annual rainfall together with elevated atmospheric carbon dioxide drove up growth rates in spring and autumn. Under the low emissions scenario (SSP245), changes in farm profit were modest or positive, ranging from negative 4% in Berbera–20% plus in Sheikh. Under the higher emissions scenario (SSP585), farm profits were higher, ranging from 23% to 42% above baseline profits, largely due to greater pasture production and lower requirements for supplementary feed. We conclude that future climates will benefit the productivity and profitability of smallholder farmers in Somalia, although more agile farm management will be required to cope with increased seasonal climate variability.
Decreased glutathione synthesis in granulosa cells, but not oocytes, of growing follicles decreases fertility in mice
Authors: Cinco Rachel , Malott Kelli , Lim Jinhwan , Ortiz Laura , Pham Christine , del Rosario Angelica , Welch Jennifer , Luderer Ulrike
Published: August 2024

Prior studies showed that mice deficient in the modifier subunit of glutamate cysteine ligase (Gclm), the rate-limiting enzyme in synthesis of the thiol antioxidant glutathione, have decreased ovarian glutathione concentrations, chronic ovarian oxidative stress, poor oocyte quality resulting in early preimplantation embryonic mortality and decreased litter size, and accelerated age-related decline in ovarian follicle numbers. Global deficiency of the catalytic subunit of this enzyme, Gclc, is embryonic lethal. We tested the hypothesis that granulosa cell- or oocyte-specific deletion of Gclc recapitulates the female reproductive phenotype of global Gclm deficiency. We deleted Gclc in granulosa cells or oocytes of growing follicles using Gclc floxed transgenic mice paired with Amhr2-Cre or Zp3-Cre alleles, respectively. We discovered that granulosa cell-specific deletion of Gclc in Amhr2Cre;Gclc(f/−) mice recapitulates the decreased litter size observed in Gclm−/− mice but does not recapitulate the accelerated age-related decline in ovarian follicles observed in Gclm−/− mice. In addition to having lower glutathione concentrations in granulosa cells, Amhr2Cre;Gclc(f/−) mice also had decreased glutathione concentrations in oocytes. By contrast, oocyte-specific deletion of Gclc in Zp3Cre;Gclc(f/−) mice did not affect litter size or accelerate the age-related decline in follicle numbers, and these mice did not have decreased oocyte glutathione concentrations, consistent with transport of glutathione between cells via gap junctions. The results suggest that glutathione deficiency at earlier stages of follicle development may be required to generate the accelerated follicle depletion phenotype observed in global Gclm null mice.
Intraspinal microstimulation of the ventral horn has therapeutically relevant cross-modal effects on nociception
Authors: Bandres Maria F , Gomes Jefferson L , McPherson Jacob Graves
Published: August 2024

Electrical stimulation of spinal networks below a spinal cord injury is a promising approach to restore functions compromised by inadequate and/or inappropriate neural drive. The most translationally successful examples are paradigms intended to increase neural transmission in weakened yet spared descending motor pathways and spinal motoneurons rendered dormant after being severed from their inputs by lesion. Less well understood is whether spinal stimulation is also capable of reducing neural transmission in pathways made pathologically overactive by spinal cord injury. Debilitating spasms, spasticity and neuropathic pain are all common manifestations of hyperexcitable spinal responses to sensory feedback. Whereas spasms and spasticity can often be managed pharmacologically, spinal cord injury-related neuropathic pain is notoriously medically refractory. Interestingly, however, spinal stimulation is a clinically available option for ameliorating neuropathic pain arising from aetiologies other than spinal cord injury, and the limited evidence available to date suggests that it holds considerable promise for reducing spinal cord injury-related neuropathic pain, as well. Spinal stimulation for pain amelioration has traditionally been assumed to modulate sensorimotor networks overlapping with those engaged by spinal stimulation for rehabilitation of movement impairments. Thus, we hypothesize that spinal stimulation intended to increase the ability to move voluntarily may simultaneously reduce transmission in spinal pain pathways. To test this hypothesis, we coupled a rat model of incomplete thoracic spinal cord injury, which results in moderate to severe bilateral movement impairments and spinal cord injury-related neuropathic pain, with in vivo electrophysiological measures of neural transmission in networks of spinal neurons integral to the development and persistence of the neuropathic pain state. We find that when intraspinal microstimulation is delivered to the ventral horn with the intent of enhancing voluntary movement, transmission through nociceptive specific and wide dynamic range neurons is significantly depressed in response to pain-related sensory feedback. By comparison, spinal responsiveness to non-pain-related sensory feedback is largely preserved. These results suggest that spinal stimulation paradigms could be intentionally designed to afford multi-modal therapeutic benefits, directly addressing the diverse, intersectional rehabilitation goals of people living with spinal cord injury.
Mapping functional traces of opioid memories in the rat brain
Authors: Gomes-Ribeiro Joana , Martins João , Sereno José , Deslauriers-Gauthier Samuel , Summavielle Teresa , Coelho Joana E , Remondes Miguel , Castelo-Branco Miguel , Lopes Luísa V
Published: August 2024

Addiction to psychoactive substances is a maladaptive learned behaviour. Contexts surrounding drug use integrate this aberrant mnemonic process and hold strong relapse-triggering ability. Here, we asked where context and salience might be concurrently represented in the brain during retrieval of drug–context paired associations. For this, we developed a morphine-conditioned place preference protocol that allows contextual stimuli presentation inside a magnetic resonance imaging scanner and investigated differences in activity and connectivity at context recall. We found context-specific responses to stimulus onset in multiple brain regions, namely, limbic, sensory and striatal. Differences in functional interconnectivity were found among amygdala, lateral habenula, and lateral septum. We also investigated alterations to resting-state functional connectivity and found increased centrality of the lateral septum in a proposed limbic network, as well as increased functional connectivity of the lateral habenula and hippocampal ‘cornu ammonis’ 1 region, after a protocol of associative drug–context. Finally, we found that pre- conditioned place preference resting-state connectivity of the lateral habenula and amygdala was predictive of inter-individual conditioned place preference score differences. Overall, our findings show that drug and saline-paired contexts establish distinct memory traces in overlapping functional brain microcircuits and that intrinsic connectivity of the habenula, septum, and amygdala likely underlies the individual maladaptive contextual learning to opioid exposure. We have identified functional maps of acquisition and retrieval of drug-related memory that may support the relapse-triggering ability of opioid-associated sensory and contextual cues. These findings may clarify the inter-individual sensitivity and vulnerability seen in addiction to opioids found in humans.
BRAF and MEK inhibitor targeted therapy in papillary craniopharyngiomas: a cohort study
Authors: De Alcubierre Dario , Gkasdaris Grigorios , Mordrel Margaux , Joncour Anthony , Briet Claire , Almairac Fabien , Boetto Julien , Mouly Celine , Larrieu-Ciron Delphine , Vasiljevic Alexandre , Villa Chiara , Sergeant Camille , Ducray François , Feuvret Loic , Chanson Philippe , Baussart Bertrand , Raverot Gerald , Jouanneau Emmanuel
Published: August 2024

Objective

Targeted therapy (TT) with BRAF/MEK inhibitors has emerged as a potential treatment in papillary craniopharyngiomas (PCPs). However, standardized data on large cohorts are lacking. Our study aimed to assess real-life efficacy and safety of BRAF/MEK inhibition in patients with PCPs.

Design

Retrospective French multicenter study involving BRAF V600E–mutated PCP patients, treated with BRAF/MEK inhibitor combination dabrafenib and trametinib, from April 2019 to July 2023.

Methods

Objective response and clinical and safety outcomes were assessed after 3 months and at the last available follow-up during TT.

Results

Sixteen patients (8 females, mean age 50.5 ± 15.75 years), receiving either neoadjuvant therapy (NEO) for non-resectable tumors (n = 6), post-surgical adjuvant therapy (ADJ; n = 8), or palliative therapy (PAL) following failure of multimodal treatment (n = 2), were included.

At the last follow-up (mean 7.6 ± 5.3 months), 12 patients showed subtotal response, 3 exhibited partial response, and 1 maintained stable disease. Mean volume reduction was 88.9 ± 4.4%, 73.3 ± 23.4%, and 91.8 ± 4.3% in the NEO, ADJ, and PAL groups, respectively.

Targeted therapy resolved headaches in 5/5 patients and visual impairment in 6/9; 2/3 patients had improved neurological symptoms, 1/4 presented weight loss, and 2/14 recovered endocrine function.

Targeted therapy was well-tolerated in 62.5% of cases; adverse events led to treatment discontinuation in 5 patients and definitive discontinuation in 3 cases.

Conclusions

In this study, 94% of patients showed partial response or better to TT. Adverse events were acceptable. Further research is needed to establish standardized protocols; however, these results advocate for a NEO approach in invasive PCPs.
Combining anthropology and imaging to reconstruct antemortem trauma for identification purposes
Authors: Petaros Anja , Lindblom Maria , Cunha Eugénia
Published: August 2024

Identification of unidentified remains involves a comparison of ante- and postmortem features using biological identifiers. Anthropological identifiers, referred to by International Criminal Police Organization (INTERPOL) as secondary identifiers, have often been judged less reliable than DNA, fingerprints and dental records (referred to as primary identifiers). However, anthropological identifiers have been proven as discriminatory as the primary sources in many instances, and play a decisive role in positive identification. To guarantee better use of anthropological identifiers, it is not only essential to develop standard protocols and statistical frameworks, but also to test different identification approaches in cases from daily practice. Evidence of skeletal antemortem trauma can be a valuable aid in the identification process, especially if the exact type of traumatic event causing the injury is identified. Here, we present a case in which the combination of anthropological analysis and imaging confirmed an interesting and unique sequence of antemortem traumatic events in incomplete skeletal remains. The remains were assumed to pertain to an individual who went missing several years earlier, and whose medical records revealed a unique history of trauma to the right femur. The individual had sustained a fracture due to a fall from a high height followed, 10 years after the primary trauma, by a gunshot wound to the same bone; both treated by intramedullary nail fixation. While the anthropological analysis matched the biological profile of the missing individual and identified a healed defect to the right femur compatible with a gunshot wound, the radiological examination indicated that the bone underwent three surgical procedures on different occasions. Radiological examination also identified a pre-existing healed fracture adjacent to the gunshot defect. In addition to presenting the identification process in this specific case, this article discusses the difficulties in antemortem trauma interpretation, importance of combining macroscopic and radiological analysis to aid the reconstruction of previous traumatic events and mechanisms of injury from healed fractures that can play important roles in forensic human identification.
Being ashamed of others: shame and partial concern for persons
Authors: Chaplin Rosalind
Published: August 2024

The philosophical literature on shame treats shame as essentially a self-concerning emotion. According to this view, when we experience shame, it is always the self that is subject to negative assessment, and shame concerning others traces back to some form of self-concern. Against this, I argue for an expanded conception of shame. On the view I advance, shame always manifests investment and partiality regarding its target, but investment and partiality need not trace back to self-concern, and shame does not essentially require an appraisal of the self at all. I also argue that this can help us improve our understanding of partial concern for persons more broadly. While we often think of partial concern for a person's well-being as the paradigmatic form of partial concern, partial concern for a person's character (broadly construed) plays an equally important role in our moral-emotional lives, and especially in our close relationships.
The Emergence of the Second Amendment Sanctuary Movement: Partisan Federalism, Not White Protectionism
Authors: Filindra Alexandra , Reller Cassidy , Burnett Craig
Published: August 2024

One-third of all US counties have enacted Second Amendment Sanctuary (2AS) ordinances, preventing the enforcement of state and federal gun control laws. We test two theories to explain 2AS enactment. First, 2AS may be a manifestation of partisan federalism. This perspective predicts that the nationalization of policy issues has led partisan groups to support “sanctuary” policies in friendly jurisdictions to frustrate the opposition. Second, given the close link between gun policy preferences and racial identities, 2AS enactment may be related to racial dynamics and especially the declining political power of White Americans. Thus, we should expect that 2AS adoptions will occur in majority White counties with declining White populations. We leverage a unique dataset of county-level 2AS enactments to test these hypotheses. We find strong evidence for the partisan federalism hypothesis. In contrast, we find weak and inconsistent evidence for the racial threat hypothesis.
A Gene Cassette Vd276-280 in Verticillium dahliae Contains Two Genes that Affect Melanized Microsclerotium Formation and Virulence
Authors: Liu Tao , Yu Haonan , Qin Jun , Shang Wenjing , Chen Jieyin , Subbarao Krishna V. , Hu Xiaoping
Published: August 2024

Verticillium dahliae is a soilborne phytopathogenic fungus causing Verticillium wilt on hundreds of plant species. Several sequenced genomes of V. dahliae are available, but functional characterization of most genes has just begun. Based on our previous comparison of the transcriptome from the wild-type and Δ VdCf2 strains, a significant upregulation of the gene cassette, Vd276-280, in the Δ VdCf2 strain was observed. In this study, the functional characterization of the Vd276-280 gene cassette was performed. Agrobacterium-mediated knockout of this gene cassette in V. dahliae significantly inhibited conidiation, melanized microsclerotium formation in the mutant strains, and their virulence toward cotton. Furthermore, deletion of individual genes in the Vd276-280 gene cassette identified that the disruption of VDAG_07276 and VDAG_07280 delayed microsclerotium formation, inhibited conidiation, and reduced virulence toward cotton. Our data suggest that VDAG_07276 and VDAG_07280 in the Vd276-280 gene cassette mainly act as positive regulators of development and virulence in V. dahliae.
Inpatient Versus Outpatient Management of Prenatally Diagnosed Vasa Praevia: A Systematic Review and Meta-analysis
Authors: Laiu Shelene , McMahon Carine , Rolnik Daniel Lorber
Published: August 2024

(Abstracted from Eur J Obstet Gynecol Reprod Biol 2024:293:156–166

Vasa previa is characterized by unprotected fetal blood vessels in close proximity to the internal cervical os and occurs in an estimated 1 in 1200 pregnancies. Risk factors for vasa previa include low-lying placenta, succenturiate or bilobed placenta, velamentous cord insertion, in vitro fertilization, and multiple pregnancies.
National Rapid Genome Sequencing in Neonatal Intensive Care
Authors: Marom Daphna , Mory Adi , Reytan-Miron Sivan , Amir Yam , Kurolap Alina , Cohen Julia Grinshpun , Morhi Yocheved , Smolkin Tatiana , Cohen Lior , Zangen Shmuel , Shalata Adel , Riskin Arieh , Peleg Amir , Lavie-Nevo Karen , Mandel Dror , Chervinsky Elana , Fisch Clari Felszer , Sheffer Vered Fleisher , Falik-Zaccai Tzipora C. , Rips Jonathan , Shlomai Noa Ofek , Friedman Smadar Eventov , Shporen Calanit Hershkovich , Ben-Yehoshua Sagie Josefsberg , Simmonds Aryeh , Yaacobi Racheli Goldfarb , Bauer-Rusek Sofia , Omari Hussam , Weiss Karin , Hochwald Ori , Koifman Arie , Globus Omer , Batzir Nurit Assia , Yaron Naveh , Segel Reeval , Morag Iris , Reish Orit , Eliyahu Aviva , Leibovitch Leah , Schwartz Marina Eskin , Abramsky Ramy , Hochberg Amit , Oron Anat , Banne Ehud , Portnov Igor , Samra Nadra Nasser , Singer Amihood , Feldman Hagit Baris
Published: August 2024

(Abstracted from JAMA Network Open 2024;7(2):e240146

A large portion of mortality in neonatal intensive care units (NICUs) can be attributed to genetic disorders and/or birth defects; often, diagnosis of specific disorders can be difficult due to overlapping symptomology and insufficient sensitivity of tests for this age group. Next-generation sequencing has the potential to provide precision diagnosis that will assist in prognosis, lifesaving therapy, and palliative care decisions and has been shown to be highly accurate.
Amenorrhea in Adolescents Using the Etonogestrel Contraceptive Implant
Authors: Tsevat Danielle , Mercier Rebecca , Bernheimer Camryn , Lin Stephanie , Schwartz Beth
Published: August 2024

(Abstracted from Contraception 2024:133:110413

Contraceptive implants have been rising in popularity as evidence has shown them to be highly effective for reversible contraception as well as for treatment of abnormal uterine bleeding and dysmenorrhea. The etonogestrel implant in particular is popular among adolescents and young adults and acts through the release of progestin, suppressing ovulation and leading to endometrial glandular atrophy, thus decreasing the thickness of the endometrium and potentially resulting in amenorrhea.
The Different Influence of Cutibacterium acnes and Staphylococcus epidermidis in the Lumbar Disc
Authors: Zhang Mingtao , Deng Liangna , Jia Jingwen , Cao Zhenyu , Li Yalong , Zhang Junfu , He Xuegang , Lei Shuanhu , Hu Xuchang , Kang Xuewen
Published: August 2024

Study Design.

Animal laboratory study.

Objective.

This study investigated the effects of Cutibacterium
acnes and Staphylococcus
epidermidis on the lumbar discs of rabbits, as well as the outcomes of combined infection.

Summary of Background Data.

Many studies have indicated that bacterial infections are associated with lumbar disc degeneration (LDD). The most commonly cultured bacteria from disc tissues are C. acnes and S. epidermidis.

Methods.

New Zealand white rabbits (n=40) were randomly divided into control, C. acnes, S. epidermidis, and C. acnes plus S. epidermidis (i.e., combined) groups. All groups except the control were injected with 25 μL of saline at L4–L5 and 25 μL of bacteria (1×107 CFU/mL) at L5–L6. All injections were performed under x-ray guidance. Weight measurements, haematological evaluations, and magnetic resonance imaging were performed after 4, 8, and 12 weeks. Histological examination and gene expression detection were performed 12 weeks after surgery.

Results.

Inflammatory factors in the blood and weight did not differ among the groups after 4, 8, and 12 weeks (P>0.05). However, after 4 weeks, LDD occurred in the C. acnes group, and discitis occurred in the S. epidermidis and combined groups, all of which worsened after 8 weeks. After 12 weeks, the nucleus pulposus (NP) protruded and compressed the spinal cord in the C. acnes group, and tissue staining showed decreased NP tissue and cartilaginous endplate fracture. In the S. epidermidis and combined groups, the discitis was more confined, but tissue staining revealed a significant decrease in NP tissue, and loss of the normal disc structure.

Conclusions.

In the early stage of infection in rabbits, C. acnes caused LDD, and S. epidermidis caused discitis. Coinfection with C. acnes and S. epidermidis caused discitis but was more limited in scope than infection with S. epidermidis alone.
Impact of Prior Cervical Fusion on Patients Undergoing Thoracolumbar Deformity Correction
Authors: Singh Manjot , Balmaceno-Criss Mariah , Daher Mohammad , Lafage Renaud , Eastlack Robert K. , Gupta Munish C. , Mundis Gregory M. , Gum Jeffrey L. , Hamilton Kojo D. , Hostin Richard , Passias Peter G. , Protopsaltis Themistocles S. , Kebaish Khaled M. , Lenke Lawrence G. , Ames Christopher P. , Burton Douglas C. , Lewis Stephen M. , Klineberg Eric O. , Kim Han Jo , Schwab Frank J. , Shaffrey Christopher I. , Smith Justin S. , Line Breton G. , Bess Shay , Lafage Virginie , Diebo Bassel G. , Daniels Alan H. ,   on behalf of the ISSG
Published: August 2024

Study Design.

Retrospective analysis of prospectively collected data.

Objective.

Evaluate the impact of prior cervical constructs on upper instrumented vertebrae (UIV) selection and postoperative outcomes among patients undergoing thoracolumbar deformity correction.

Background.

Surgical planning for adult spinal deformity (ASD) patients involves consideration of spinal alignment and existing fusion constructs.

Methods.

ASD patients with (ANTERIOR or POSTERIOR) and without (NONE) prior cervical fusion who underwent thoracolumbar fusion were included. Demographics, radiographic alignment, patient-reported outcome measures (PROMs), and complications were compared. Univariate and multivariate analyses were performed on POSTERIOR patients to identify parameters predictive of UIV choice and to evaluate postoperative outcomes impacted by UIV selection.

Results.

Among 542 patients, with 446 NONE, 72 ANTERIOR, and 24 POSTERIOR patients, mean age was 64.4 years and 432 (80%) were female. Cervical fusion patients had worse preoperative cervical and lumbosacral deformity, and PROMs (P<0.05). In the POSTERIOR cohort, preoperative LIV was frequently below the cervicothoracic junction (54%) and uncommonly (13%) connected to the thoracolumbar UIV. Multivariate analyses revealed that higher preoperative cervical SVA (coeff=−0.22, 95% CI=−0.43 to −0.01, P=0.038) and C2SPi (coeff=−0.72, 95% CI=−1.36 to −0.07, P=0.031), and lower preoperative thoracic kyphosis (coeff=0.14, 95% CI=0.01-0.28, P=0.040) and thoracolumbar lordosis (coeff=0.22, 95% CI=0.10-0.33, P=0.001) were predictive of cranial UIV. Two-year postoperatively, cervical patients continued to have worse cervical deformity and PROMs (P<0.05) but had comparable postoperative complications. Choice of thoracolumbar UIV below or above T6, as well as the number of unfused levels between constructs, did not affect patient outcomes.

Conclusions.

Among patients who underwent thoracolumbar deformity correction, prior cervical fusion was associated with more severe spinopelvic deformity and PROMs preoperatively. The choice of thoracolumbar UIV was strongly predicted by their baseline cervical and thoracolumbar alignment. Despite their poor preoperative condition, these patients still experienced significant improvements in their thoracolumbar alignment and PROMs after surgery, irrespective of UIV selection.

Level of Evidence.

IV.
Hepatitis co-infection in paediatric HIV: progressing treatment and prevention
Authors: Rubino Chiara , Stinco Mariangela , Indolfi Giuseppe
Published: August 2024

Purpose of review

To analyse the main evidence and recommendations for the management of hepatitis co-infection in children living with HIV.

Recent findings

We analysed available data pertaining to the natural history of liver disease and treatment of co-infected children.

Viral hepatitis co-infection in people living with HIV (PLHIV) is a global problem owing to the shared routes of transmission, particularly in areas of high endemicity for the three viruses. Viral hepatitis co-infection can accelerate liver disease progression and increase morbidity and mortality, even in patients on suppressive antiretroviral treatment (ART). Viral hepatitis should be routinely screened in PLHIV and, once diagnosed with viral hepatitis, PLHIV should be closely monitored for liver disease progression and complications. Children living with HIV-HBV co-infection should be treated with ART containing agents which are active against both viruses. Children living with HIV-HCV co-infection should receive directly acting antivirals (DAA) to eradicate HCV infection. Prevention measures to reduce vertical and horizontal transmission of HBV and HCV (anti-HBV vaccination and immunoglobulins, anti-HBV treatment in pregnancy, anti-HCV DAAs in people of childbearing age, avoiding blood contact, sexual barrier precautions) should be adopted and encouraged, particularly in high endemicity countries.
Comparative Rheology of Hyaluronic Acid Fillers, Poly-l-lactic Acid, and Varying Dilutions of Calcium Hydroxylapatite
Authors: McCarthy Alec D. , Soares Danny J. , Chandawarkar Akash , El-Banna Radia , de Lima Faria Gladstone E. , Hagedorn Nadine
Published: August 2024

Background:

This study examines the rheological properties of various dermal fillers, including hyaluronic acid (HA) fillers, poly-L-lactic acid (PLLA), and calcium hydroxylapatite-carboxymethylcellulose (CaHA-CMC) gels, with a particular focus on the impact of aqueous dilution on CaHA-CMC’s rheology and potential clinical implications.

Methods:

Using standardized rheological analysis, we measured and compared the elastic modulus (G′), viscous modulus (G″), and the tan δ values of different dilutions of CaHA-CMC against published values of HA and PLLA fillers. The study aimed to determine the potential clinical use of application-specific CaHA-CMC hydrogel dilutions along a range of gel strength and cohesion for hydrogel fillers in current use.

Results:

The findings demonstrate that CaHA-CMC’s rheological properties can be tailored across a broad spectrum of viscoelastic parameters through titrated dilution, ranging from high elasticity to low cohesion. Varying the aqueous volume allows for the rheomodulation of CaHA-CMC, potentially matching the entire rheological spectrum of HA fillers and suggesting an expanded range of clinical applications.

Conclusions:

The versatility of CaHA-CMC through dilution may offer a customizable approach for clinical applications, providing practitioners with the ability to fine-tune the properties of fillers to meet specific patient needs and treatment goals. This study lays the groundwork for the potential future use of filler dilutional rheomodulation in clinical practice, tailored to patient- and application-specific needs.
Alexithymia Prevalence, Characterization, and Associations With Emotional Functioning and Life Satisfaction: A Traumatic Brain Injury Model System Study
Authors: Neumann Dawn , Hammond Flora M. , Sander Angelle M. , Bogner Jennifer , Bushnik Tamara , Finn Jacob A. , Chung Joyce S. , Klyce Daniel W. , Sevigny Mitch , Ketchum Jessica M.
Published: August 2024

Objectives: Alexithymia an emotional processing deficit that interferes with a person’s ability to recognize, express, and differentiate emotional states. Study objectives were to (1) determine rates of elevated alexithymia among people with moderate-to-severe traumatic brain injury (TBI) 1-year post-injury, (2) identify demographic and injury-related variables associated with high versus low-average levels of alexithymia, and (3) examine associations among alexithymia with other aspects of emotional functioning and life satisfaction. Setting: Data were collected during follow-up interviews across four TBI Model System (TBIMS) centers. Participants: The sample consisted of 196 participants with moderate-to-severe TBI enrolled in the TBIMS. They were predominately male (77%), White (69%), and had no history of pre-injury mental health treatment (66.3%). Design: Cross-sectional survey data were obtained at study enrollment and 1-year post-injury. Main Measures: Toronto Alexithymia Scale-20 (TAS-20) as well as measures of anger, aggression, hostility, emotional dysregulation, post-traumatic stress, anxiety, depression, resilience and life satisfaction. Sociodemographic information, behavioral health history and injury-related variables were also included. Results: High levels of alexithymia (TAS-20 score > 1.5 standard deviation above the normative mean) were observed for 14.3%. Compared to individuals with low/average levels of alexithymia, the high alexithymia group tended to have lower levels of education. At 1-year follow-up, high TAS-20 scores were strongly associated with emotional dysregulation and post-traumatic stress; moderately associated with anger, hostility, depression, anxiety, lower resilience and lower satisfaction with life; and weakly associated with aggression. Conclusion: These findings provide further evidence that alexithymia is associated with poor emotional functioning and life satisfaction after TBI. Longitudinal studies are needed to determine if alexithymia is a risk factor that precipitates and predicts worse emotional outcomes in the TBI population. This line of work is important for informing treatment targets that could prevent or reduce of psychological distress after TBI.
Prebiotic Treatment in People With Schizophrenia
Authors: Buchanan Robert W. , Werkheiser Anne E. , Michel Hanna , Zaranski Jennifer , Glassman Matthew , Adams Heather A. , Vyas Gopal , Blatt Frank , Pilli Nageswara R. , Pan Yezhi , Chen Shuo , Fraser Claire M. , Kelly Deanna L. , Kane Maureen A.
Published: August 2024

Background

Preliminary evidence suggests that people with schizophrenia have decreased relative abundance of butyrate-producing bacteria in the gut microbiota. Butyrate plays a critical role in maintaining the integrity of the gut-blood barrier and has a number of anti-inflammatory effects. This proof-of-concept study was designed to assess whether the addition of the oligofructose-enriched inulin (OEI) prebiotic: Prebiotin could increase the production of butyrate.

Methods

Twenty-seven people who met the criteria for either Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, schizophrenia or schizoaffective disorder were entered into a 10-day, double-blind, placebo-controlled, randomized clinical trial. The study was conducted on an inpatient unit to standardize the participant diet and environment. Participants were randomized to either OEI (4 g, 3 times a day) or a placebo (4 g of maltodextrin, 3 times a day). In order to assess the effect of OEI treatment on butyrate levels, participants underwent pretreatment and posttreatment OEI challenges. The primary outcome measure was relative change in postchallenge plasma butyrate levels after 10 days of OEI treatment.

Results

In both the intent-to-treat and completer analyses, OEI treatment was associated with a greater number of participants who met the OEI challenge responder criteria than those treated with placebo. OEI treatment was also associated with an increase in baseline butyrate levels (effect size for the group difference in the change of baseline butyrate levels was 0.58).

Conclusions

We were able to demonstrate that treatment with the prebiotic OEI selectively increased the level of plasma butyrate in people with schizophrenia.

Trial registration:
ClinicalTrials.gov identifier NCT03617783
Rotator Cuff Tears, Repairs, and Shoulder Arthroplasties Among Workers' Compensation Claimants
Authors: Hunt Dan L. , Bernacki Edward J. , Tsourmas Nicholas F. , Kalia Nimisha , Yuspeh Larry , Leung Nina , Green-McKenzie Judith , Malak Paul , Tao Xuguang (Grant)
Published: August 2024

Background

Rotator cuff repair (RCR) is increasingly being performed for both acute traumatic and degenerative tears of the rotator cuff, whereas total shoulder arthroplasty (TSA) is reserved for osteonecrosis of the humeral head, arthritis of the glenohumeral joint, and failed RCR.

Objective

This study aimed to assess the incidence and patient characteristics of rotator cuff tears (RCTs), RCRs, and TSAs among workers' compensation claimants.

Methods

A total of 8347 RCTs indemnity claims filed to Accident Fund Group from 2007 to 2022 were studied.

Results

Over the study period, the percentages of RCTs increased from 41% to 65% among shoulder injury indemnity claimants, RCRs increased from 88% to 92% of RCTs, and TSAs increased from 1% to 5%.

Conclusions

RCT, RCR, and TSA have increased dramatically among workers' compensation claimants, with age of the injured worker being the primary determinant of the increase.
Artificial Intelligence for Diagnosis in Otologic Patients: Is It Ready to Be Your Doctor?
Authors: Marshall Camryn , Forbes Jessica , Seidman Michael D. , Roldan Luis , Atkins James
Published: August 2024

Objective

Investigate the precision of language-model artificial intelligence (AI) in diagnosing conditions by contrasting its predictions with diagnoses made by board-certified otologic/neurotologic surgeons using patient-described symptoms.

Study Design

Prospective cohort study.

Setting

Tertiary care center.

Patients

One hundred adults participated in the study. These included new patients or established patients returning with new symptoms. Individuals were excluded if they could not provide a written description of their symptoms.

Interventions

Summaries of the patient's symptoms were supplied to three publicly available AI platforms: Chat GPT 4.0, Google Bard, and WebMD “Symptom Checker.”

Main Outcome Measures

This study evaluates the accuracy of three distinct AI platforms in diagnosing otologic conditions by comparing AI results with the diagnosis determined by a neurotologist with the same information provided to the AI platforms and again after a complete history and physical examination.

Results

The study includes 100 patients (52 men and 48 women; average age of 59.2 yr). Fleiss' kappa between AI and the physician is −0.103 (p < 0.01). The chi-squared test between AI and the physician is χ
2 = 12.95 (df = 2; p < 0.001). Fleiss' kappa between AI models is 0.409. Diagnostic accuracies are 22.45, 12.24, and 5.10% for ChatGPT 4.0, Google Bard, and WebMD, respectively.

Conclusions

Contemporary language-model AI platforms can generate extensive differential diagnoses with limited data input. However, doctors can refine these diagnoses through focused history-taking, physical examinations, and clinical experience—skills that current AI platforms lack.
Cochlear Implantation in Post-Meningitis Deafness: Audiological, Imaging, and Postoperative Outcomes: A Systematic Review With Qualitative Synthesis
Authors: Ahmadian David , Young Kurtis , Gallego Charles , Miller Mia
Published: August 2024

Introduction

Post-meningitis deafness (PMD) is a potentially devastating cause of hearing loss among pediatric and adult patients, for which hearing rehabilitation with cochlear implants (CIs) remains the standard of care. To date, there have been limited systematic studies on the impact of cochlear ossification (CO) and time-to-implantation (TTI) on audiological outcomes.

Methods

An online database search was performed on the PubMed, Embase, and Scopus databases for articles within the past 20 years pertaining to audiological outcomes among pediatric and adult patients with PMD. Information on study characteristics, patient demographics, clinical outcomes, and postoperative complications was collected and analyzed.

Results

From 8,325 articles generated in the original search, 11 were included in the final analysis, representing 376 patients in total. Of the articles discussing TTI, the majority (3 of 4) found that a shorter TTI of 6 months on average led to improved audiological outcomes compared with control groups with a longer TTI. Of the articles that discussed the impact of preoperative CO, the majority (4 of 6) found that the presence of CO had a detrimental effect on postoperative audiological outcomes after CI. Finally, of the articles that discussed long-term audiological outcomes for PMD compared with the non-PMD control group after CI, the majority (4 of 7) found that PMD patients had inferior long-term outcomes.

Conclusion

CI is a safe and effective treatment modality for PMD, with the majority of literature demonstrating improved long-term outcomes for patients without CO and a reduced TTI.
The Use of Immunomodulators, Biologic Therapies, and Small Molecules in Patients With Inflammatory Bowel Disease and Solid Organ Transplant
Authors: Ghusn Wissam , Mourad Fadi H. , Francis Fadi F. , Pasha Shabana , Farraye Francis A. , Hashash Jana G.
Published: August 2024

Patients with inflammatory bowel diseases (IBDs) may require solid organ transplants (SOTs) for multiple reasons, making its prevalence slightly higher than the general population. Although immunosuppression used in SOT may help control IBD-related inflammation, many patients still require additional immunosuppressive medications. We aim to assess the effectiveness and safety of the combination of SOT-related immunosuppression and IBD medications in patients with liver, kidney, or heart transplantation. We conducted a clinical review using PubMed, Scopus, MEDLINE, Embase, and Google Scholar databases for our search. We included data from systematic reviews, meta-analyses, case series, and case reports to assess the safety, effectiveness, and side effect profile of immunomodulators, biologic therapies, and small molecules in patients with SOT. Our review encompassed 25 liver, 6 kidney, and 1 heart transplant studies involving patients with IBD. Common liver transplant immunosuppressants included tacrolimus, mycophenolate mofetil, cyclosporine, and steroids. Anti-TNF agents, widely used in all SOT types, showed no significant safety issues, though infections and malignancies were noted. Patients with liver transplant on tacrolimus responded well to anti-integrins and ustekinumab without major complications. For kidney transplants, cyclosporine and tacrolimus were prevalent, and their combination with anti-TNF or ustekinumab was generally safe, with rare reports of malignancy or infection. Hence, the use of anti-TNF, anti-integrin agents, and ustekinumab appears to be safe in patients with SOT, regardless of their transplant related immunosuppression. More studies are needed in patients with kidney and heart transplants and in patients treated with small molecules for their IBD.
Outcomes of Endoscopic Antireflux Mucosectomy for the Treatment of Gastroesophageal Reflux Disease
Authors: Galvarini Martin , Angeramo Cristian A. , Kerman Javier , Balmaceda Rubén , Debes Ignacio , Herbella Fernando A.M. , Schlottmann Francisco
Published: August 2024

Objective:

Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders in western countries. Endoscopic procedures have recently emerged as an alternative therapy to surgery for patients with GERD. The aim of this study was to determine outcomes after endoscopic antireflux mucosectomy (ARMS).

Methods:

A systematic review and meta-analysis were performed to analyze outcomes after ARMS. The main outcomes included patients’ satisfaction, GERD health-related quality of life, use of proton pump inhibitors, and DeMeester score. The secondary endpoint was postprocedural adverse events. A meta-analysis of proportions was used to assess the effect of each approach on different outcomes.

Results:

A total of 22 studies comprising 654 patients were included for analysis. The mean age of patients was 51.83 (36 to 59.39) years, and the mean body mass index was 25.06 (23.5 to 27) kg/m2. The weighted pooled proportion of patient satisfaction after ARMS was 65% (95% CI: 52%-76%). The pooled proportion of patients taking proton pump inhibitors decreases from 100% to 40.84% (P < 0.001). The mean GERD health-related quality of life scores (pre 19.48 vs post 7.90, P < 0.001) and DeMeester score (pre 44.99 vs post 15.02 P = 0.005) significantly improved after ARMS. Overall morbidity rate was 27% (95% CI: 13%-47%), with a weighted pooled proportion of perforation, stricture, and bleeding of 3% (95% CI: 2%-6%), 12% (95% CI: 9%-16%), and 6% (95% CI: 2%-17%), respectively.

Conclusions:

Endoscopic ARMS for GERD is associated with symptomatic improvement, reduction of medical therapy, and enhanced quality of life. Refinements of the technique, however, are needed to decrease morbidity.
Updates on temporomandibular joint reconstruction following ablative surgery
Authors: Disse Gregory D. , Masheeb Zahrah , Abouyared Marianne
Published: August 2024

Purpose of review

Considerations regarding reconstruction of the temporomandibular junction (TMJ) following ablation have been underreported in head and neck surgery literature. Here, we discuss the complexity of reconstructing this unique joint and highlight the benefits and drawbacks of free tissue transfer. Additionally, we address the growing role of customized alloplastic implants and virtual surgical planning technologies in TMJ reconstruction.

Recent findings

Technological advances in computerized manufacturing, 3D printing, and virtual reality have led to a recent burgeoning in patient-specific customization that may become the method of choice in these complex reconstruction cases.

Since trauma and malignancy rarely compromise the entire TMJ, guidelines currently do not exist regarding how to best reconstruct the region in these unique cases. The methods that work in ankylosis and other intrinsic joint diseases are likely less appropriate in this patient population. Recent literature has reported improved patient outcomes and reduced operative times with virtual surgical planning techniques that may optimize autogenous graft approaches.