bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Ex Situ Heart Perfusion in Pediatric Transplantation: An Analysis of the OPTN Database
Authors: Conway Jennifer , Hong Yongzhe , Pidborochynski Tara , Freed Darren H.
Published: July 2023

Ex situ heart perfusion (ESHP) has increased the pool of donors in adults. However, this is not true in pediatrics due to lack of devices. Therefore, we sought to understand organ refusal in pediatrics and estimate donor heart usage with ESHP. Donor hearts offered to pediatrics were identified from the Organ Procurement and Transplantation Network Database (2000–2019). A linear regression model was built to predict average travel speed, and the extended maximum permitted distance with ESHP was calculated. This extended distance was compared with the policy for maximum travel distance. There were 33,708 donor offers (n = 10,807 hearts) to pediatric programs [24.1% (n = 2,604) transplanted]. Six percent of the offers (n = 1,832) (n = 771 hearts) were turned down due to distance, with 676 of the hearts never transplanted. Based on the modeling and using an ESHP time of 5.5 hours, 84% (n = 570/676) of hearts turned down due to distance could be utilized by pediatric programs. This proportion increased to 100% with 10 hours of support time. By addressing prolonged ischemic time due to distance, ESHP has the potential to increase the number of donors utilized in pediatric candidates. Although no device exists for pediatrics, this analysis lends support to the importance of developing this technology.
The procoagulant potential before and after surgery for endometriosis and its association with disease severity
Authors: Rottenstreich Amihai , Kalish Yosef , Gilan Adi , Spectre Galia , Kleinstern Geffen , Dior Uri
Published: July 2023

Objectives

Previous studies have suggested that endometriosis is associated with increased hypercoagulable state. We aimed to determine the procoagulant potential among women with endometriosis before and after surgery.

Methods

A prospective longitudinal study performed during 2020−2021 at a university hospital. Women undergoing laparoscopic surgery for endometriosis served as the study group. Blood samples were taken preoperatively and 3 months after surgery. The degree of hypercoagulability was assessed by thrombin generation, a global marker of the activation of the coagulation system, expressed as the endogenous thrombin potential (ETP). Healthy volunteers, without any medical condition or medications use, matched for age and weight of the study group, served as a control group.

Results

Thirty women with histologically-proven endometriosis and thirty healthy control subjects were enrolled in this study. Median preoperative ETP was significantly higher in women with moderate-to-severe endometriosis (3313 [interquartile range, IQR 3067–3632] nM) as compared to those with minimal-to-mild disease (2368 [IQR 1850–2621] nM) and the control group (2451 [2096–2617] nM) (P < 0.001 for both comparisons). Following surgery, the ETP significantly decreased in those with moderate-to-severe endometriosis (postoperative: 2368 vs. preoperative: 3313 nM, P < 0.001) and was comparable to the ETP in the control group (P = 0.35). In multivariate analysis, moderate-to-severe endometriosis was the only independent predictor of the preoperative ETP level (P < 0.001), with a direct positive correlation between disease revised American Society for Reproductive Medicine severity score and the preoperative ETP level (r
s = 0.67; P < 0.0001).

Conclusion

Moderate-to-severe endometriosis is associated with enhanced hypercoagulable state, which decreases significantly after surgery. Disease severity was independently associated with the degree of hypercoagulability.
Interstitial lung disease in patients with anti-neutrophil cytoplasm antibody-associated vasculitis: an update on pathogenesis and treatment
Authors: Turgeon David , Balter Meyer S. , Pagnoux Christian
Published: July 2023

Purpose of review

Interstitial lung disease (ILD) is now recognized as a common complication of anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitides (AAV), especially myeloperoxidase (MPO)-ANCA-positive AAV and microscopic polyangiitis (MPA). This review focuses on current concepts pertaining to the pathogenesis, clinical assessment, and management of AAV-ILD.

Recent findings

ILD is typically identified before or at the onset of systemic AAV, and usual interstitial pneumonia (UIP) is the most common CT pattern. MPO-ANCA production, neutrophil extracellular traps formation, reactive oxidative species production, complement activation, environmental exposures, and genetic background might play a role in the pathogenesis of AAV-ILD. Recent research has identified promising biomarkers as potential diagnostic and prognostic tools in AAV-ILD. The optimal treatment for AAV-ILD is not well defined but might rely on a combination of immunosuppression and antifibrotics, especially in patients with progressive lung fibrosis. Despite the effectiveness of current therapies for AAV, the outcome of patients with AAV-ILD remains poor.

ANCA screening should be considered in patients with newly diagnosed ILD. Management of AAV-ILD should be overviewed by a collaborative team comprising vasculitis experts and respirologists.

Video abstract

http://links.lww.com/COPM/A33
Antithrombin III activity is associated with prognosis, infection, and inflammation in patients with hepatitis B virus-related acute-on-chronic liver failure
Authors: Zhou Xueshi , Chen Xinyue , Du Hejuan , Ye Yangqun , Miu Youhan , Su Tingting , Guo Xiaoye , Wang Sen , Qiu Yuanwang , Wang Jun , Zhao Weifeng
Published: July 2023

Objective

Patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) are characterized by severe liver function impairment, coagulation disorder, and multiple organ function impairment. The aim of this study was to explore the predictive value of antithrombin Ⅲ activity to the prognosis of HBV-ACLF patients.

Methods

A total of 186 HBV-ACLF patients were included in the analysis, and the baseline clinical data of patients were recorded to analyze the risk factors affecting the 30-day survival outcome of patients. Bacterial infection, sepsis, and hepatic encephalopathy were observed in ACLF patients. Antithrombin Ⅲ activity and serum cytokine levels were determined.

Results

The antithrombin Ⅲ activity of ACLF patients in the death group was significantly lower than that in the survival group, and antithrombin Ⅲ activity was independent factors affecting the 30-day outcome. The areas under the receiver operation characteristic (ROC) curve of antithrombin Ⅲ activity to predict the 30-day mortality of ACLF was 0.799. Survival analysis showed that the mortality of patients with antithrombin Ⅲ activity less than 13% was significantly increased. Patients with bacterial infection and sepsis had lower antithrombin Ⅲ activity than those without infection. Antithrombin Ⅲ activity was positively correlated with platelet count, fibrinogen, interferon (IFN)-γ, interleukin (IL)-13, IL-1β, IL-4, IL-6, tumor necrosis factor-α, IL-23, IL-27, and IFN-α, but negatively correlated with C-reactive protein, D dimer, total bilirubin, and creatinine levels.

Conclusion

As a natural anticoagulant, antithrombin Ⅲ can be regarded as a marker of inflammation and infection in patients with HBV-ACLF, and as a predictor of survival outcome in patients with ACLF.
Prognostic impact of gamma-glutamyl transpeptidase to platelets ratio on hepatocellular carcinoma patients who have undergone surgery: a meta-analysis and systematic review
Authors: Zhang Yang , Jin Fangfang , Wu Yuan , Wang Bingyu , Xie Jingri , Li Yu , Pan Yujia , Liu Zhaolan , Shen Wenjuan
Published: July 2023

Gamma-glutamyl transpeptidase to platelet ratio (GPR) is an inflammatory index and has been used as a prognostic index for a variety of tumors. However, the association between GPR and hepatocellular carcinoma (HCC) still remained controversial. Therefore, we performed a meta-analysis to determine the prognostic impact of GPR on HCC patients. PubMed, Embase, Cochrane Library, Web of Science, the Chinese National Knowledge Infrastructure, Wanfang Database, Chinese VIP Database, the US Clinical Trials Registry, and the Chinese Clinical Trials Registry were searched from inception to December 2022. A hazard ratio (HR) with a 95% confidence interval (CI) was used to evaluate the association between preoperative GPR and the prognosis of HCC patients. Ten cohort studies including 4706 HCC patients were identified. This meta-analysis showed that higher GPRs were closely related to worse overall survival (HR: 1.79; 95% CI: 1.35–2.39; P < 0.001; I
2 = 82.7%), recurrence-free survival (HR: 1.30; 95% CI: 1.16–1.46; P < 0.001; I
2 = 0%), and disease-free survival (HR: 1.84; 95% CI: 1.58–2.15; P < 0.001; I
2 = 25.4%) in patients with HCC. This meta-analysis suggests that preoperative GPR appears to be significantly associated with the prognosis of HCC patients who have undergone surgery and may be an effective prognostic marker. Trial registration: PROSPERO: CRD42021296219.
Outcomes of patients with hepatorenal syndrome undergoing liver transplantation in the era of terlipressin
Authors: Terbah Ryma , Cao Janet , Wong Darren , Lim Peter Chee Hau , Gow Paul , Testro Adam , Sinclair Marie
Published: July 2023

Background

The efficacy of terlipressin in improving pre-liver transplant renal function in hepatorenal syndrome (HRS) has been well documented, however, its impact on post-transplant renal function remains poorly described. This study aims to describe the impact of HRS and terlipressin on post-liver transplant renal function and survival.

Methods

A single-centre, retrospective, observational study was conducted to identify post-transplant outcomes of patients diagnosed with HRS undergoing liver transplant (HRS cohort) and those undergoing transplant for non-HRS, non-hepatocellular carcinoma cirrhotic indications (comparator cohort) between January 1997 and March 2020. The primary outcome was serum creatinine at 180 days post-liver transplant. Other renal outcomes and overall survival were secondary outcomes.

Results

109 patients with HRS and 502 comparator patients underwent liver transplant. The comparator cohort was younger than the HRS cohort (53 vs. 57 years, P < 0.001). The median creatinine at day 180 post-transplant was higher in the HRS transplant group (119 µmol/L vs. 103 µmol/L, P < 0.001), however, this association lost significance following multivariate analysis. Seven patients (7%) in the HRS cohort received a combined liver-kidney transplant. There was no significant difference in the 12-month post-transplant survival between the two groups (94% vs. 94%, P = 0.5).

Conclusion

Patients with HRS treated with terlipressin who subsequently undergo liver transplantation have post-transplant renal and survival outcomes comparable to patients transplanted for cirrhosis without HRS. This study supports the practice of liver-only transplant in this cohort and the reservation of renal allografts for those who have primary renal disease.
Bulbar and post-bulbar duodenal ulcers: characteristics based on location
Authors: Okamoto Takeshi , Okamoto Satomi , Yamamoto Kazuki , Takasu Ayaka , Murashima Yuko , Fukui Sho , Fukuda Katsuyuki
Published: July 2023

Objectives

Most research on duodenal ulcers has focused on bulbar ulcers; details on post-bulbar ulcers remain largely unknown. This study was conducted to determine the characteristics of patients with post-bulbar duodenal ulcers depending on their location.

Methods and materials

We conducted a retrospective study of hospitalized patients newly diagnosed with duodenal ulcers on endoscopy at a tertiary referral center in Japan between April 2004 and March 2019. Five hundred fifty-one patients diagnosed with duodenal ulcers were extracted for analysis.

Results

Ulcers were observed only in the bulbus in 383 cases, only in the post-bulbar duodenum in 82 cases, and were co-existing in both areas in 86 cases. The Bulbar group had less comorbidities and was more likely to have atrophic gastritis, while the Post-bulbar and Co-existing groups were more likely to be admitted for non-gastrointestinal conditions. Regular acid suppressant use was more common in the post-bulbar group than in the Bulbar group. Bulbar ulcers were associated with a shorter length of stay relative to post-bulbar and co-existing ulcers, but ulcer location was not an independent predictor of length of stay. Patients with co-existing bulbar and post-bulbar ulcers have characteristics similar to those with post-bulbar ulcers alone.

Conclusion

Patients with post-bulbar ulcers and those with co-existing bulbar and post-bulbar ulcers have different characteristics and outcomes relative to patients with bulbar ulcers.
Vaccines – beliefs and concerns: the voice of patients with inflammatory immunomediated diseases
Authors: Abreu Cândida , Martins António , Branco Elsa , Rocha Rafael , Sarmento António , Magro Fernando
Published: July 2023

Background

Vaccination is a key issue in patients with immunomodulated inflammatory diseases on immune-mediated therapy. Still, vaccination rates in these patients are low. This study aimed to assess the knowledge and fears of patients with immune-mediated inflammatory diseases (IMIDs) regarding vaccines, with the ultimate goal of increasing vaccination rates through the definition and implementation of more effective communication strategies with the patient.

Methods

This study was conducted in a Portuguese hospital, between January 2019-December 2020, and included adult patients with an IMID. A questionnaire was developed and applied to evaluate knowledge and fears regarding vaccines.

Results

From the 275 included patients, more than 90% answered correctly to all questions on general knowledge, with an exception for the question related to protection from severe disease, without differences between age groups or education levels, except for the question about vaccine contraindications (P = 0.017). Regarding vaccines in immunocompromised hosts, the proportion of correct answers was lower and significantly different between education levels (P = 0.00–0.042),. More than 50% of the participants showed moderate to very high concern about several aspects of vaccines, with differences between age groups (P = 0.018).

Conclusion

Our patients have general knowledge of vaccines but regarding vaccines in immunocompromised patients knowledge is lower and dependent on the education level. In addition, age influences the pattern of concerns related to vaccines. The information gathered in this study shall be considered to identify potential local interventions targeted to improve vaccination.
Platelet-albumin-bilirubin score – a risk stratification scoring system to predict outcome of acute variceal bleeding in patients with cirrhosis
Authors: Swarna Anupama , Ramamoorthy Murali , kini Ratnakar , Annasamy Chezhian , Kalyanasundaram Muthukumaran , Immaneni Shubha
Published: July 2023

Background

Acute variceal bleed is a common complication of cirrhosis of liver. Up to 25% of patients with newly diagnosed varices will experience bleeding within 2 years. Of patients who have stopped bleeding, approximately one-third will rebleed within the next 6 weeks. Though scores like Child-Turcotte-Pugh (CTP) and Model of End-stage Liver Disease (MELD) predict the survival of upper gastrointestinal bleed, they have certain limitations in this regard. So, there is a need for reliable scoring system to assess the outcome of patients who had acute variceal bleed.

Aim

To evaluate the platelet-albumin-bilirubin (PALBI) score in predicting outcome of acute variceal bleeding in patients with cirrhosis.

Methods

A total of 130 patients who presented to our institute with acute variceal bleed over a period of 1 year were analyzed. CTP, MELD Na and PALBI scores were calculated for these patients on admission and the outcome was compared in the form of 90-day rebleeding rates. The areas under the receiver operating characteristic curves (AUROC) were calculated for this purpose.

Results

Mean age was 56 years; 80 were male (61.5%), 50 were female (38.5%), 62 CTP-A (47.7%), 53 CTP-B (40.8%), 15 CTP-C (11.5%); 63 PALBI 1 (48.5%), 23 PALBI 2 (17.8%), and 44 PALBI 3 (33.8%). 1 patient died in the due course of the study. The AUROC for predicting rebleeding was 0.732, 0.71 and 0.803 for CTP, MELD Na and PALBI scores, respectively.

Conclusion

PALBI score on admission is a good predictor of outcomes in cirrhotics with acute variceal bleed.
Machine learning in the positron emission tomography imaging of Alzheimer’s disease
Authors: Ayubcha Cyrus , Singh Shashi B. , Patel Krishna H. , Rahmim Arman , Hasan Jareed , Liu Litian , Werner Thomas , Alavi Abass
Published: July 2023

The utilization of machine learning techniques in medicine has exponentially increased over the last decades due to innovations in computer processing, algorithm development, and access to big data. Applications of machine learning techniques to neuroimaging specifically have unveiled various hidden interactions, structures, and mechanisms related to various neurological disorders. One application of interest is the imaging of Alzheimer’s disease, the most common cause of progressive dementia. The diagnoses of Alzheimer’s disease, mild cognitive impairment, and preclinical Alzheimer’s disease have been difficult. Molecular imaging, particularly via PET scans, holds tremendous value in the imaging of Alzheimer’s disease. To date, many novel algorithms have been developed with great success that leverage machine learning in the context of Alzheimer’s disease. This review article provides an overview of the diverse applications of machine learning to PET imaging of Alzheimer’s disease.
Incremental value of 99mTc-MIBI single-photon emission computed tomography/computed tomography fusion imaging for the diagnosis of secondary hyperparathyroidism
Authors: Peng Ye , Pan Guixia , Zhao Bo , Zuo Changjing , Wang Yingqiu , Chen Rui
Published: July 2023

Purpose

To assess the added value of 99mTc-MIBI single-photon emission computed tomography/computed tomography (SPECT/CT) fusion imaging over dual-phase scintigraphy in the diagnosis of secondary hyperparathyroidism (SHPT).

Methods

This retrospective study included 23 patients with SHPT. The diagnostic efficacy of 99mTc-MIBI dual-phase scintigraphy and SPECT/CT fusion imaging was analyzed and compared based on the result of postoperative pathology and follow-up. To evaluate the diagnostic ability of 99mTc-MIBI dual-phase scintigraphy, the volume and radioactive count of parathyroid lesions were assessed using the region of interest method.

Results

A total of 79 hyperplastic parathyroid glands and two thyroid tissues were surgically removed from 23 SHPT patients and 13 normal parathyroid glands were preserved. 99mTc-MIBI SPECT/CT fusion imaging showed higher sensitivity and accuracy than 99mTc-MIBI dual-phase scintigraphy [sensitivity, 77.2% (61/79) vs 46.8% (37/79); accuracy, 80.4% (74/92) vs 54.3% (50/92), respectively], but comparable specificity [100% (13/13)). Among 61 positive lesions detected by 99mTc-MIBI SPECT/CT fusion imaging, 37 were dual-phase scintigraphy positive and 24 were dual-phase scintigraphy false negative. The radioactivity counts and radioactivity per unit volume in dual-phase scintigraphy positive were higher than that in dual-phase scintigraphy false negative (P < 0.05), but the volume of parathyroid lesions between the two groups had no significant difference (P > 0.05).

Conclusion

Compared with 99mTc-MIBI dual-phase scintigraphy, 99mTc-MIBI SPECT/CT fusion imaging has incremental value in the diagnosis of SHPT. The low uptake of MIBI in the whole gland and low MIBI uptake per unit volume are easy to cause dual-phase scintigraphy false negative.
Value of subspecialist second opinion reads of 18F-FDG PET-CT examinations for patients with breast cancer
Authors: Fardanesh Reza , Beavers Kimberly , Jochelson Maxine S. , Ulaner Gary A.
Published: July 2023

Objectives

Determine if subspecialist second opinion review alters reporting of malignancy on 18F-FDG PET/CT for patients with breast cancer.

Methods

This IRB-approved retrospective study compared 248 s opinion reads of 18F-FDG PET/CT exams performed for patients with breast cancer against the original outside institution reports. Subspecialist reviews documented if malignant findings on the outside report were believed to be malignant and noted additional malignant findings not described on the outside report. Reference standard for malignancy or benignity was determined by pathology or follow-up imaging.

Results

Of 248 cases, 27 (11%) had discrepancies in the presence or absence of extra-axillary nodal or distant metastases. Of these 27, 14 (52%) had biopsy or imaging follow-up as a reference standard for malignancy/benignity. In cases with reference standard proof, the subspecialist second opinion review was correct in 13/14 (93%) of cases. This included eleven cases that the original report called malignant, but the subspecialist review called benign and subsequently proven to be benign; as well as two metastases called on subspecialist review, but not on the original report, and subsequently biopsy proven to be metastases. In one case, the second opinion read called a suspicious lesion that was biopsy proven to be benign.

Conclusion

Subspecialist review improves the accuracy of diagnosis for the presence or absence of malignancy on FDG PET/CT examinations in patients with breast cancer. This demonstrates the value of performing second opinion reads of 18F-FDG PET/CT studies in patients with breast cancer, particularly by subspecialist second opinion review reducing false positive reads.
A Pilot Randomized Clinical Trial of Base-in Relieving Prism Spectacle Treatment for Intermittent Exotropia
Authors:   Pediatric Eye Disease Investigator Group (PEDIG)
Published: July 2023

Significance

This pilot randomized trial, the first to evaluate a specific base-in relieving prism treatment strategy for childhood intermittent exotropia, did not support proceeding to a full-scale clinical trial. Defining and measuring prism adaptation in children with intermittent exotropia is challenging and needs further study.

Purpose

Determine whether to proceed to a full-scale trial of relieving base-in prism spectacles versus refractive correction alone for children with intermittent exotropia.

Methods

Children 3- to <13-years-old with distance intermittent exotropia control score of ≥2 points on the Intermittent Exotropia Office Control Scale1(0 = phoria to 5 = constant), ≥1 episode of spontaneous exotropia,16–35∆ by prism-and-alternate-cover test, who did not fully prism adapt on a 30-minute in-office prism-adaptation test were randomized to base-in relieving prism (40% of the larger of distance and near exodeviations) or non-prism spectacles for 8 weeks.A prioricriteria to conduct a full-scale trial were defined for the adjusted treatment group difference in mean distance control: “proceed” (≥ 0.75 points favoring prism), “uncertain” (> 0 to <0.75 points favoring prism), or “do not proceed" (≥ 0 points favoring non-prism).

Results

57 children (mean age 6.6 ± 2.2 years; mean baseline distance control 3.5 points) received prism (N = 28) or non-prism (N = 29) spectacles. At 8-weeks, mean control was 3.6 and 3.3 points in prism (N = 25) and non-prism (N = 25) groups, respectively; adjusted difference 0.3 points (95% confidence interval -0.5 to 1.1) favoring non-prism (meeting oura priori“do not proceed” criterion).

Conclusions

Base-in prism spectacles, equal to 40% of the larger of the exodeviations at distance or near, worn for 8 weeks by 3- to 12-year-old children with intermittent exotropia did not yield better distance control than refractive correction alone, with the confidence interval indicating a favorable effect of 0.75 points or larger is unlikely. There was insufficient evidence to warrant a full-scale randomized trial.
Use of Tranexamic Acid in Gender-Affirming Mastectomy Reduces Rates of Postoperative Hematoma and Seroma
Authors: Rifkin William J. , Parker Augustus , Bluebond-Langner Rachel
Published: July 2023

BACKGROUND:

The established safety and efficacy of tranexamic acid (TXA) in minimizing perioperative blood loss has led to increased interest within plastic surgery. Prior studies demonstrate decreased edema, ecchymosis, and reduced rates of postoperative collections with administration of TXA, however its use has not been reported in gender-affirming mastectomy. This represents the first study to evaluate the impact of TXA on postoperative outcomes in patients undergoing gender-affirming mastectomy.

METHODS:

A single-center cohort study was performed analyzing all consecutive patients undergoing top surgery with the senior author between February 2017 and October 2022. Beginning in June 2021, all patients received 1000 mg intravenous TXA prior to incision and 1000 mg at the conclusion of the procedure. Patients were stratified according to intraoperative administration of TXA, with demographics, surgical characteristics, and postoperative outcomes compared between groups.

RESULTS:

A total of 851 patients underwent gender-affirming mastectomy. Of these, 646 cases were performed without TXA, while 205 patients received intravenous TXA intraoperatively as above. Patients who received TXA had significantly lower rates of seroma (20.5% vs. 33.0%; p<0.001), and hematoma (0.5% vs. 5.7%; p=0.002). There was no difference in rates of surgical site infection (p=0.74), and use of TXA was not associated with increased rates of venous thromboembolism (p=0.42).

CONCLUSIONS:

Intraoperative administration of TXA in patients undergoing top surgery may safely reduce the risk of postoperative seroma and hematoma without increased risk of thromboembolic events. Additional data collection and prospective studies are warranted to corroborate these findings.
No association between use of tenofovir disoproxil fumarate, etravirine, or integrase-strand transfer inhibitors and acquisition or severe outcomes of SARS-CoV-2 infection in people with HIV in the Netherlands
Authors: Verburgh Myrthe L. , van der Valk Marc , Rijnders Bart J.A. , Reiss Peter , Wit Ferdinand W.N.M.
Published: July 2023

In two Dutch observational cohorts of people with HIV, the use of TDF, ETR, or INSTIs was not independently associated with either the risk of incident SARS-CoV-2 infection or severe COVID-19 outcomes, as was suggested by previous observational and molecular docking studies. Our findings do not support a strategy of modifying antiretroviral therapy to include these agents to protect against SARS-CoV-2 infection and severe COVID-19 outcomes.
Maxillary Sinus Volume in Patients With Unilateral Cleft Lip and Palate by CBCT
Authors: Yassaei Soghra , Ezodini Fatemeh , Shiri Armin , Nasr Nazanin
Published: July 2023

Cleft lip and palate (CLP) is one of the most common congenital craniofacial anomalies, which can change the morphology of the skull, face, and maxillary sinus due to the disruption in the fusion of palatal shelves. This study aimed to investigate the volume and dimensions of the maxillary sinus in unilateral CLP patients along with comparing the healthy and affected sides. This cross-sectional study was conducted on 27 cone-beam computed tomography stereotypes (14 male and 13 female) of patients with unilateral CLP. Maxillary sinuses were traced separately on each side and analyzed by OnDemand3D software in a separate room with low light. The height and base area of the maxillary sinuses were measured on each side. After dividing each sinus into smaller pyramids, the volume of the sinus was obtained using the partial frustum model method and analyzed by paired t test. There was no significant difference between cleft and noncleft sides in terms of mean volume and height of the sinus (P > 0.05). The average area of the sinus base on the cleft side was 32.77 mm2 more than the noncleft side, and this difference was statistically significant (P = 0.027). The mean upper maxillary sinus volume on the cleft side was 541.62 mm3 larger than the noncleft side, but this difference was not statistically significant (P = 0.075). Considering the age groups, the average upper sinus volume on the cleft side in patients under 20 years old was 4.66 mm3 less than the noncleft side. In the age group of more than 20 years, the average volume of the upper sinus on the cleft side was 978.66 mm3 more than the noncleft side. The mean volume of the lower sinus on the cleft side was 505.92 mm3 lower than the noncleft side, and this difference was statistically significant (P = 0.010). The average area of the sinus base of the cleft side was significantly higher than the noncleft side. Also, the lower sinus volume of the cleft side was significantly lower than the noncleft side. However, no significant difference was observed in upper sinus volume between the cleft and noncleft sides.
Using the “Frontalis-Free Orbital Septum-Complex Flap” in the Correction of Unilateral Congenital Ptosis
Authors: Yan Yucheng , Gan Cheng
Published: July 2023

Congenital ptosis has deleterious effects on the appearance and vision-related function. Patients need timely and effective treatments. A new surgical practice was performed using the discarded fibrous and thickened orbital septum to prolong the advanced frontalis muscular flap and reduce iatrogenic injuries in the frontalis. A 5-year-old boy with severe unilateral congenital ptosis was enrolled and got satisfactory surgical effects without complication. The “frontalis-free orbital septum-complex flap” is a new and relatively ideal method. The purpose of this paper is to demonstrate this surgical practice and provide a new idea for correcting congenital ptosis with the thickened and fibrotic orbital septum.
Caring for people in prison with palliative and end-of-life care needs
Authors: McParland Chris , Johnston Bridget , Ouwehand Isa E.I.
Published: July 2023

Purpose of review

The prison population is growing and ageing, and many people will die from natural causes while incarcerated. This article provides a contemporary review of key issues related to palliative and end-of-life care in prisons.

Recent findings

Few countries have integrated prison hospices. Palliative care needs may go unrecognised in prison. Older offenders may not trust the prison to care for them and may benefit from segregation. Cancer remains a major cause of death. Training staff remains a priority, and technology can help facilitate this. The coronavirus disease 2019 (COVID-19) had a significant impact on prisons, less is known about its impact on palliative care. Compassionate release is underutilised, and the issue of medically assisted dying adds complexity to decisions around end-of-life care. Peer carers can provide reliable symptom assessment. Family members are often absent when someone dies in prison.

Palliative and end-of-life care in prisons requires a joined-up approach, and staff must understand the challenges of both this and custodial care in general. The relational network both inside and outside of the prison should be involved, and when possible and appropriate, we should consider alternatives to dying whilst incarcerated, such as compassionate release.
Ferrostatin-1 attenuates brain injury in animal model of subarachnoid hemorrhage via phospholipase A2 activity of PRDX6
Authors: Wang Huiqing , Zhou Yao , Zhao Mingpei , Yu Lianghong , Lin Yuanxiang , Kang Dezhi
Published: July 2023

Subarachnoid hemorrhage (SAH) is an acute catastrophic neurological disorder with high morbidity and mortality. Ferroptosis is one of the pathophysiological processes during secondary brain injury of SAH, which could be inhibited by ferrostatin-1 (Fer-1) effectively. Peroxiredoxin6 (PRDX6) is an antioxidant protein and is currently proven to be associated with lipid peroxidation in ferroptosis except in GSH/GPX4 and FSP1/CoQ10 antioxidant systems. However, the alteration and function of PRDX6 in SAH are still unknown. In addition, whether PRDX6 is involved in the neuroprotection of Fer-1 in SAH is yet to be investigated. Endovascular perforation was employed to induce the SAH model. Fer-1 and in vivo siRNA aiming to knockdown PRDX6 were administrated intracerebroventricularly to investigate relevant regulation and mechanism. We confirmed the inhibition of ferroptosis and neuroprotection from brain injury by Fer-1 in SAH. The induction of SAH reduced the expression of PRDX6, which could be alleviated by Fer-1. Accordingly, dysregulated lipid peroxidation indicated by GSH and MDA was improved by Fer-1, which was counteracted by si-PRDX6. Similarly, the neuroprotection of Fer-1 in SAH was diminished by the knockdown of PRDX6 and the administration of a calcium-independent phospholipase A2 (iPLA2) inhibitor. PRDX6 is involved in ferroptosis induced by SAH and is associated with Fer-1 neuroprotection from brain injury via its iPLA2 activity.
Transcranial direct current stimulation to dorsolateral prefrontal cortex improves performance of obstacle avoidance gait task
Authors: Matsuura Akihiro , Shinoda Ryohei , Karita Tetsuya , Ishikawa Mamoru , Yoshino Kai , Mori Futoshi
Published: July 2023

We aimed to investigate the effect of dual-task interference between cognitive and obstacle avoidance walking tasks, and the effect of transcranial direct current stimulation (tDCS) on the performance of this cognitive-motor dual task. The healthy young subjects participated in a single task consisting of a three-digit subtraction task (e.g. 783 − 7) or a 15-m track with six 7.5-cm high obstacles. Then, the subjects performed two single tasks simultaneously as dual tasks, before and after sham and anodal tDCS (2 mA, 20 min) to left dorsolateral prefrontal cortex (DLPFC, the F3 region of the 10/20 electroencephalogram electrode placement system). The effect of tDCS on each outcome (number of correct answers, the clearance height above the obstacle, and foot placement position) was analyzed using repeated-measures analysis of variance. Model effects included tDCS (real, sham), time (pre-, post-tDCS), and task (single task, dual task) conditions. A significant difference in the tDCS, time, and task conditions was observed; the correct number of subtraction tasks increased, and the clearance height and the distance between the obstacle and foot decreased in front of the obstacle. Our findings suggest that dual task performance is causally related to left DLPFC activation under complicated walking tasks and tDCS over this cortical area increases overloaded its information processing capacity.
Cortical Origin of Theta Error Signals
Authors: Herrera Beatriz , Sajad Amirsaman , Errington Steven P. , Schall Jeffrey D. , Riera Jorge J.
Published: July 2023

A multi-scale approach elucidated the origin of the error-related-negativity (ERN), with its associated theta-rhythm, and the post-error-positivity (Pe) in macaque supplementary eye field (SEF). Using biophysical modeling, synaptic inputs to layer-3 (L3) and layer-5 (L5) pyramidal cells (PCs) were optimized to account for error-related modulation and inter-spike intervals. The intrinsic dynamics of dendrites in L5 but not L3 PCs generate theta rhythmicity with random phase. Saccades synchronized the phase of this theta-rhythm, which was magnified on errors. Contributions from L5 PCs to the laminar current source density (CSD) observed in SEF were negligible. The CSD derived from L3 PCs could not explain the observed association between their error-related spiking modulation and scalp-EEG. Laminar CSD comprises multipolar components, with dipoles explaining ERN features, and quadrupoles reproducing those for Pe. The presence of monopoles indicates diffuse activation. These results provide the most advanced explanation of the cellular mechanisms generating the ERN.
PSite: inference of read-specific P-site offsets for ribosomal footprints
Authors: Chang Yue , Lei Tianyu , Zhang Hong
Published: July 2023

Ribosome profiling is a powerful method for global survey of ribosomal footprints. Inferring the offsets of footprint 5’ ends to the ribosomal P-site is essential to pinpoint codons translated by ribosomes. By convention, global or read length-specific P-site offsets are estimated by inspecting the distribution of ribosome footprints around the annotated start or stop codons. However, actual offsets might be different even for footprints of the same length due to the influence of sequence context and the cutting bias of endoribonucleases. To address this issue, we present PSite, a python package for inferring read-specific P-site offsets using a gradient boosting trees model. PSite assigned more reads to the correct reading frame than conventional methods and improved the prediction of translated ORFs by existing software. Besides, PSite is robust to ribosome profiling datasets of varying quality or using endonucleases with cutting bias for digestion.

Availability and implementation

https://github.com/gxelab/psite.

Contact

hong_zhang@lzu.edu.cn.
Inflammatory and neurodegenerative serum protein biomarkers increase sensitivity to detect disease activity in multiple sclerosis
Authors: Chitnis Tanuja , Qureshi Ferhan , Gehman Victor M. , Becich Michael , Bove Riley , Cree Bruce A. C. , Gomez Refujia , Hauser Stephen L. , Henry Roland G. , Katrib Amal , Lokhande Hrishikesh , Paul Anu , Caillier Stacy J. , Santaniello Adam , Sattarnezhad Neda , Saxena Shrishti , Weiner Howard , Yano Hajime , Baranzini Sergio E.
Published: July 2023

Background/Objectives

Serum proteomic analysis of deeply-phenotyped samples, biological pathway modeling and network analysis were performed to elucidate the inflammatory and neurodegenerative processes of multiple sclerosis (MS) and identify sensitive biomarkers of MS disease activity (DA).

Methods

Over 1100 serum proteins were evaluated in >600 samples from three MS cohorts to identify biomarkers of clinical and radiographic (gadolinium-enhancing lesions) new MS DA. Protein levels were analyzed and associated with presence of gadolinium-enhancing lesions, clinical relapse status (CRS), and annualized relapse rate (ARR) to create a custom assay panel.

Results

Twenty proteins were associated with increased clinical and radiographic MS DA. Serum neurofilament light chain (NfL) showed the strongest univariate correlation with radiographic and clinical DA measures. Multivariate modeling significantly outperformed univariate NfL to predict gadolinium lesion activity, CRS and ARR.

Discussion

These findings provide insight regarding correlations between inflammatory and neurodegenerative biomarkers and clinical and radiographic MS DA.

Funding

Octave Bioscience, Inc (Menlo Park, CA).
Macrophages sense ECM mechanics and growth factor availability through cytoskeletal remodeling to regulate their tissue repair program
Authors: Meizlish Matthew L. , Kimura Yoshitaka , Pope Scott D. , Matta Rita , Kim Catherine , Philip Naomi , Meyaard Linde , Gonzalez Anjelica , Medzhitov Ruslan
Published: July 2023

Tissue resident macrophages play important roles in tissue homeostasis and repair. However, how macrophages monitor and maintain tissue integrity is not well understood. The extracellular matrix (ECM) is a key structural and organizational component of all tissues. Here, we find that macrophages sense the mechanical properties of the ECM in order to regulate a specific tissue repair program. We show that macrophage mechanosensing is mediated by cytoskeletal remodeling and can be performed in three-dimensional environments through a non-canonical, integrin-independent mechanism analogous to amoeboid migration. We find that these cytoskeletal dynamics also integrate biochemical signaling by CSF1 and ultimately regulate chromatin accessibility to control the mechanosensitive gene expression program. This study suggests a distinct mode of ECM mechanosensing and growth factor signaling through which macrophages may regulate tissue repair and fibrosis.
Resource distribution unifies optimal offspring size and bacterial aging
Authors: Sakal Taom , Proulx Stephen
Published: July 2023

How should a parent optimally distribute limited resources among its offspring? This question is as relevant to a mother bird deciding how to allocate food among her chicks as it is to a bacterium dividing high-quality organelles between its daughters. Optimal offspring size theory has long explored the tradeoff between the number and size of off-spring in higher organisms. Meanwhile, the emerging field of bacterial aging examines when cells evolve unequal sharing of old cellular components. Our study unifies these two disciplines through a model of resource allocation. This model highlights that the convexity of how resources affect offspring survivorship determines whether even or uneven resource distribution evolves. Based on this, we derive the optimal resource distribution strategies, show that they evolve, and characterize when these strategies are robust to fluctuating environments. These results not only agree with and strengthen existing models, but also provide an organizing framework that enables new predictions. These include the conditions which select for strategies that contain a”runt of the litter.”
Cardiology researchers’ practices and perceived barriers to open science: an international survey
Authors: Cobey Kelly D , Alayche Mohsen , Saba Sara , Barnes Nana Yaa , Ebrahimzadeh Sanam , Alarcon Emilio , Hibbert Benjamin , Moher David
Published: July 2023

Background

Open science is a movement and set of practices to conduct research more transparently. Implementing open science will significantly improve public access and supports equity. It also has the potential to foster innovation and reduce duplication through data and materials sharing. Here, we survey an international group of researchers publishing in cardiovascular journals regarding their perceptions and practices related to open science.

Methods

We identified the top 100 “Cardiology and Cardiovascular Medicine” subject category journals from the SCImago journal ranking platform. This is a publicly available portal that draws from Scopus. We then extracted the corresponding author’s name and e-mail from all articles published in these journals between March 1, 2021 - March 1, 2022. Participants were sent a purpose-built survey about open science. The survey contained primarily multiple choice and scale-based questions for which we report count data and percentages. For the few text-based responses we conducted thematic content analysis.

Results

198 participants responded to our survey. Participants had a mean response of 6.8 (N=197, SD=1.8) on a 9-point scale with endpoints, not at all familiar (1) and extremely familiar (9), when indicating how familiar they were with open science. When asked about where they obtained open science training, most participants indicated this was done on the job self-initiated while conducting research (n=103, 52%), or that they had no formal training with respect to open science (n=72, 36%). More than half of the participants indicated they would benefit from practical support from their institution on how to perform open science practices (N=106, 54%). A diversity of barriers to each of the open science practices presented to participants were acknowledged. Participants indicated that funding was the most essential incentive to adopt open science.

Discussion

It is clear that policy alone will not lead to the effective implementation of open science. This survey serves as a baseline for the cardiovascular research community’s open science performance and perception and can be used to inform future interventions and monitoring.
Hierarchical Classification of Insects with Multitask Learning and Anomaly Detection
Authors: Bjerge Kim , Geissmann Quentin , Alison Jamie , Mann Hjalte M. R. , Høye Toke T. , Dyrmann Mads , Karstoft Henrik
Published: July 2023

Cameras and computer vision are revolutionising the study of insects, creating new research opportunities within agriculture, epidemiology, evolution, ecology and monitoring of biodiversity. However, a major challenge is the diversity of insects and close resemblances of many species combined with computer vision are often not sufficient to classify large numbers of insect species, which sometimes cannot be identified at the species level. Here, we present an algorithm to hierarchically classify insects from images, leveraging a simple taxonomy to (1) classify specimens across multiple taxonomic ranks simultaneously, and (2) highlight the lowest rank at which a reliable classification can be reached. Specifically, we propose multitask learning, a loss function incorporating class dependency at each taxonomic rank, and anomaly detection based on outlier analysis for quantification of uncertainty. First, we compile a dataset of 41,731 images of insects, combining images from time-lapse monitoring of floral scenes with images from the Global Biodiversity Information Facility (GBIF). Second, we adapt state-of-the-art convolutional neural networks, ResNet and EfficientNet, for the hierarchical classification of insects belonging to three orders, five families and nine species. Third, we assess model generalization for 11 species unseen by the trained models. Here, anomaly detection is used to predict the higher rank of the species not present in the training set. We found that incorporating a simple taxonomy into our model increased accuracy at higher taxonomic ranks. As expected, our algorithm correctly classified new insect species at higher taxonomic ranks, while classification was uncertain at lower taxonomic ranks. Anomaly detection can effectively flag novel taxa that are visually distinct from species in the training data. However, five novel taxa were consistently mistaken for visually similar species in the training data. Above all, we have demonstrated a practical approach to hierarchical classification based on species taxonomy and uncertainty during automatedin situmonitoring of live insects. Our method is simple and versatile and could be implemented to classify a wide range of insects as well as other organisms.
Brooding brittle-star is a global hybrid polyploid swarm
Authors: Hugall Andrew F. , Byrne Maria , O’Hara Timothy D.
Published: July 2023

The widespread and abundant brooding brittle-star (Amphipholis squamata) is a simultaneous hermaphrodite with a complex mitochondrial phylogeography of multiple divergent overlapping mtDNA lineages and can exhibit high levels of inbreeding or clonality and unusual sperm morphology. We use exon-capture and transcriptome data to show that the nuclear genome comprises multiple (>3) divergent (π > 6%) expressed components spread across the mitochondrial lineages, and encompassing several other genera, including diploid dioecious dimorphic species. We also report a massive sperm genome size inA. squamata, an order of magnitude larger than in the sperm of other brittle-star species, consistent with our genetic measures of elevated and variable ploidy (>6). We propose thatA. squamata(and related taxa) is a hybrid polyploid complex with many independent hybrid origins, variable ploidy, and complex patterns of parental subgenomes. We hypothesize thatA. squamatahas facultative sperm-dependent asexual reproduction, where sperm is required for embryogenesis but the egg and sperm only occasionally undergo fertilisation, a process that has been associated with the formation of polyploid hybrid swarms in other taxa [1]. Unique amongst known marine allopolyploids, theA. squamatacomplex inhabits an extensive bathymetric as well as geographic range. A. squamata is a much-studied animal amenable to laboratory culture: appreciating it as a hybrid polyploid complex makes it even more interesting to the study of evolutionary biology.