bluuebunny/crossref_metadata_2025 huggingface dataset:
P345 Application of bowel sound computational analysis in inflammatory bowel disease
Authors: Yao C C , Tai W C
Published: January 2024

Background

Inflammatory bowel disease(IBD) is a chronic disease. Although colonscopy is the gold standard for assessing activity, itcarries a considerable discomfort. We evaluate the value of bowel sound computational analysis (BSCA) as a tool in assist diagnosis and severity in Crohn’s disease(CD) and ulcerative colitis (UC).

Methods

We used homemade BSCA as a tool in assist bowel sound(BS). Five minutes recordings were taken for patients. The BS activity, sound duration, peak frequency (Hz) and bowel sound index (SI) was recorded.

Results

We enrolled 16 CD, 22 UC and 20 healthy controls. In CD patients, BS peak frequency was significantly higher than UC and controls (p=0.01). In UC patients, BS SI was significantly higher than CD and controls (mean 2024 V/min vs 1687 and 1181, p=0.04 and 0.01, respectively). We further evaluated the relation between these two parameters and the degree of severity. In CD patients, BS peak frequency were higher in patients with CDAI over 150 than CDAI under 150 (mean 370.7 Hz vs 358.2 Hz, p=0.045). In UC patients, BS SI was significantly higher in patients with mayo score(MS) larger than 6,compare to MS 3-5, MS 0-2, and controls (mean 2269 V/min vs 1863,1638, and1181, P all=0.01).

Conclusion

CD patients had higher BS peak frequency and UC patients had higher bowel sound index. These characteristic of BS changes seemed correlated to the severity of IBD.
P431 Assessing intestinal barrier healing by fusing ultra-high magnification endoscope and automated spatial multispectral imaging analysis in PSC-colitis patients
Authors: Iacucci M , Majumder S , Santacroce G , Zammarchi I , Maeda Y , Shivaji U N , Abdawn Z , Hejmadi R , Hayes B , Crotty R , Burke L , Ghosh S
Published: January 2024

Background

PSC colitis is associated with an increased risk of colorectal carcinoma. Endoscopic monitoring is crucial since endoscopic and histological activity can persist in PSC even during clinical remission. Recent evidence suggests that the presence of barrier dysfunction may predict relapse in quiescent patients. This study aims to assess mucosal and barrier healing in quiescent PSC colitis and evaluate the potential to predict outcomes by combining an ultra-high magnification endocytoscope (ECS) with intestinal barrier protein markers.

Methods

23 PSC-colitis patients in clinical remission requiring surveillance colonoscopy were prospectively enrolled. Ileal and colonic mucosa were assessed with high definition, virtual chromoendoscopy and ultra-high magnification ECS. Endoscopic remission was defined as MES ≤1, UCEIS≤1, PICaSSO≤3, while histological remission was defined as RHI≤3 without lamina propria or epithelial neutrophils, NHI ≤1 and PHRI=0. A novel ECS score was developed to assess ileal and colonic intestinal barrier (Table 1). The expression of tight junction proteins (Claudin-2, Occludin, and JAM-A) was evaluated through immunohistochemistry and multiplex immunofluorescence, and it was quantified as cell density and mean expression using the automated inForm® Akoya Biosciences digital multiplex platform. The occurrence of significant adverse outcomes (steroid use, flare-ups, hospitalization, colectomy) was evaluated over a 12-month follow-up period.

Results

Of 18 patients in endoscopic remission, 12 and 13 were in histological remission according to RHI and NHI, respectively. The ECS score correlated moderately with endoscopic score (r=0.57 for MES, r=0.44 for UCEIS and r=0.54 for PICaSSO) and strongly with histological scores (r=0.56 for RHI, r=0.61 for NHI and r=0.62 for PHRI), especially in the right colon. Only 5 patients experienced adverse outcomes. Notably, barrier healing, as indicated by an ECS score<3 in the ileum and <5 in the colon, was significantly associated with better outcomes. The three barrier proteins showed a distinct mucosal localisation in both ileum and colon, with higher cell density of Occludin and Claudin-2 in the epithelium, while higher JAM-A cell density in the lamina propria. The combined assessment of the intestinal barrier by ECS and Claudin-2 cell density significantly predicted outcomes in both colon and ileum (p=0.02 and p=0.04, respectively).

Conclusion

ECS combined with automated multispectral imaging analysis of intestinal barrier integrity is an innovative tool to assess barrier healing precisely and predicts significant adverse outcomes in PSC colitis patients in clinical, endoscopic, and histological remission.
P575 Kono-S anastomosis reduces post-op intervention after ileocolic resection for Crohn’s disease
Authors: Uchino T , Alipouriani A , Dominguez O H , Hull T L , Steele S R , Cohen B , Lipman J , Holubar S D
Published: January 2024

Background

Ileocolic resection and anastomosis is the most common intestinal operation for Crohn's disease (CD). However, the choice of anastomosis remains a topic of debate. The SUPRME CD randomized trial demonstrated decreased rates of surgical recurrence after Kono-S anastomosis (KSA). We aimed to compare the long-term recurrence-free survival between KSA and stapled side-to-side (SSTS) anastomosis in a retrospective cohort. We hypothesized that KSA was associated with a lower risk of postoperative recurrence requiring intervention than SSTS.

Methods

We included consecutive patients from a prospectively maintained database who underwent ileocolic anastomosis for terminal ileal CD between 2020 and 2022. Patients with other types of anastomoses were excluded. The short-term postoperative outcomes and interventions for perianastomotic recurrence were compared between the two groups.

Results

Overall, 174 patients underwent ileocolic anastomosis: KSA, 83 (47.7%) and SSTS, 91 (52.3%). In the KSA group, compared to SSTS, median BMI was lower (24.3 vs. 26.4 kg/m2, p=0.04), median operative time was longer (186 vs. 146 minutes, p<0.001), and patients were more likely to have mesenteric excision (53% vs. 15.4%, p<0.001). There were no significant differences in the short-term postoperative outcomes. After 12 months, 12 (30%) patients in the KSA group and 14 (35%) in the SSTS group developed endoscopic recurrence with a Rutgeerts score ≥i2 (p = 0.81). Compared with the SSTS group, the KS group received more postoperative biologics (65.1% vs. 39.6%, p=0.001) and more frequent medical therapy for perianastomotic recurrence [18/20, 90%] vs. [15/22, 68%]; p=0.14). On multivariable analysis, the KSA (OR 0.09, 95% CI 0.01-0.95, p=0.05) was associated with a lower risk of perianastomotic recurrence requiring surgical and endoscopic intervention.

Conclusion

We did not observe any statistically significant differences in overall recurrence-free survival between KSA and SSTS. However, the Kono-S anastomosis was independently associated with a decreased rate of endoscopic or surgical intervention for perianastomotic recurrence.
P938 Effectiveness and safety of switching from original infliximab to GP1111 biosimilar in inflammatory bowel diseases – prospective, cohort study
Authors: Resál T , Bacsur P , Pápista M , Kata D , Farkas B , Bálint A , Fábián A , Bor R , Szepes Z , Farkas K , Molnár T
Published: January 2024

Background

Biosimilars are highly similar to the already approved reference biological medication, and are potentially more accessible widespread due to the better cost-effectiveness. However, both the effectiveness and immunogenicity may differ due to structure characteristics. In 2020, non-medical switch was obligated from originator infliximab (IFX) to biosimilar GP1111 amongst inflammatory bowel disease (IBD, Crohns’s disease [CD], ulcerative colitis [UC]) patients in Hungary. As data regarding GP1111 are lacking in IBD, thus we aimed to assess the pharmacokinetics, effectiveness and safety of biosimilar GP1111 following the financial switch.

Methods

This was a real-world, prospective, single-center cohort study enrolling IBD patients who were switched from original IFX to GP1111 biosimilar. Baseline was defined as the day of the switch, and 52 weeks of follow-up was set. Demographic and clinical data were recorded at w0, w8, w16, w24, and w52, while infliximab serum levels were measured at baseline and at w52. Primary outcome was change in serum trough level of IFX, while sustained steroid-free remission, loss of response rates and adverse events were secondary outcomes.

Results

Overall, data of 142 patients were analyzed (median age: 43.1 years [IQR: 32.3 - 49.6]; male/female ratio: 77/65; CD: 97, UC: 42). Mean follow-up period was 46.2 ± 10.3 weeks. Change in serum IFX level was not observed (baseline 3.2 ± 2.3, µg/mL; w24: 3.7 ± 2.7 µg/mL; p = 0.106). Sustained steroid-free remission rates did not alter at w52 (99/142) from baseline (86/142) (p = 0.11). Overall, treatment was ceased in 24 patients. Following dose escalation and intensification, 9/18 patients discontinued treatment due to loss of response. Further treatments were ceased in 15 patients due to allergy (8), paradoxical reactions (3), malaise (1), pregnancy (1), and non-compliance (2). At w52 83.1% of the patients were on drug, and treatment persistence was not associated with the length of prior IFX treatment period.

Conclusion

Our study revealed convincing effectiveness with reassuring safety profile of switching to GP1111 in long-term, with sustained IFX levels. The usage of this particular biosimilar in daily practice may be suggested.
P1064 Upadacitinib is safe and effective in Ulcerative Colitis patients with prior exposure to Tofacitinib
Authors: Gilmore R , Fernandes R , Hartley I , Arzivian A , Leong R , Andrew B , Vasudevan A , Greeve T , Moore G , Kim S , Lightowler D , Singh A , Mahy G , Mithanthaya A , Venugpal K , Han S , Bryant R , West J , Segal J , Christensen B , Ding N J , An Y K , Begun J
Published: January 2024

Background

Upadacitinib is a novel selective Janus Kinase (JAK) inhibitor which has recently been approved for use in ulcerative colitis. Clinical trials have rigorous criteria and excluded patients with prior exposure to JAK inhibitors. Given limited real-world effectiveness data we examined outcomes of patients treated with upadacitinib for ulcerative colitis in a real-world population, with a focus on prior tofacitinib exposure.

Methods

This retrospective, multi-centre study recruited patients commencing upadacitinib for moderate-to-severe ulcerative colitis from September 2022 until March 2023 from 13 Inflammatory Bowel Disease centres across Australia. Clinical, biochemical, endoscopic and intestinal ultrasound outcomes were recorded at baseline, week 8 and week 16.

The primary outcome was a comparison between clinical remission using PRO2 definitions (STRIDE II guidelines) in those with prior Tofacitinib exposure compared with Tofacitinib-naïve. Secondary endpoints included clinical response, corticosteroid free clinical remission (CFCR), biochemical response and transmural remission assessed by intestinal ultrasound (IUS). Adverse events in both cohorts were also recorded.

Results

152 patients were identified and included (Table 1) – 42 tofacitinib-exposed and 110 tofacitinib-naïve. Complete clinical data was available for all patients at baseline, week 8, and week 16.

For the overall cohort, the rate of clinical remission was 20% (30/152) at baseline, 78% (119/152) at week 8 and 85% (129/152) at week 16. In patients with prior tofacitinib exposure, the rate of clinical remission was 23% (10/42) at baseline, 72% (30/42) at week 8 and 86% (36/42) at week 16. In tofacitinib-naïve patients, the rate of clinical remission was 19% (21/110) at baseline, 78% (86/110) at week 8 and 84% (92/110) at week 16 (Figure 1). There was no statistically significant difference in rate of clinical remission at baseline (p=0.23), week 8 (p=0.13) or week 16 (p=0.67).

There was no statistically significant difference in clinical response, CFCR, biochemical response or transmural remission by IUS between the cohorts.

Adverse events were seen in 40 (26%) patients over the course of 16 weeks follow-up. Most common were acne (12%), rash (4%) and nasopharyngitis (4%). No venous thromboembolism, systemic infection or cardiovascular events were observed. These events were spread evenly among both groups (p=0.37).

Conclusion

This is the largest real-world study to show that upadacitinib is effective and safe for patients with moderate to severe ulcerative colitis and prior tofacitinib exposure.
P1144 Forecasting the Future Prevalence of Inflammatory Bowel Disease in Korea through 2048: An Epidemiologic Study Employing Autoregressive Integrated Moving Average Models
Authors: Kim J , Oh S J , Lee C K
Published: January 2024

Background

The global escalation of Inflammatory Bowel Disease (IBD) has precipitated an increased burden of disease and economic impact, particularly accentuated within the Asian context. The primary objective of this study is to predict the future prevalence trajectory of IBD in Korea and elucidate the pattern of its evolution.

Methods

Data from the Korean National Health Insurance Service (2004–2018) were analyzed using a validated diagnostic algorithm to identify IBD patients. An autoregressive integrated moving average (ARIMA) model, employing 2004–2017 data, predicted future trends based on past values and error correction. The model's accuracy was validated against the actual 2018 patient count. We projected IBD patient numbers and prevalence from 2018 to 2048, using a generalized linear model (GLM) to determine influencing factors.

Results

A consistent annual increase in the number of IBD cases across all age groups was observed from 2004 to 2018, with prevalence peaking in the 20–39 age group. The validation of our prediction model demonstrated an acceptable range of error for IBD prevalence, with a 2.45% error rate and a mean absolute difference of 2.61. The 2018–2048 projections confirm a steady rise in Crohn’s disease (CD), ulcerative colitis (UC), and IBD prevalence across both genders (Figure 1). IBD prevalence is projected to increase from 104.19 per 100,000 in 2018 to 149.59 per 100,000 by 2028, and further to 239.73 per 100,000 by 2048 (95% confidence interval [CI]: 223.73–255.73), marking a 130% increase. By 2048, the prevalence rates for UC and CD were estimated to be 159.40 per 100,000 (95% CI: 137.38–181.42) and 91.11 per 100,000 (95% CI: 0.81–181.41), respectively. The Average Annual Percent Change (AAPC) of IBD is predicted at 4.51%, varying from a 2.77% decrease in those over 60 to a 14.20% increase in the 20–39 age group. Gender-stratified forecasts show a higher AAPC in males (6.17%) compared to females (2.75%) over the next 30 years. The highest AAPC, valued at 19.48, was noted in the male group aged 20–39 years. GLM analysis indicates significant age, gender, and temporal effects on IBD prevalence, with marked gender disparities in specific age groups for both CD and UC. In UC, males aged 20–39 experienced a significantly higher increase in prevalence than females. For CD, males also showed a higher prevalence increase than females in the 20–39 and 40–59 age groups (all interaction p-values < 0.05; Table 1).

Conclusion

This study forecasts a significant increase in Korean IBD prevalence by 2048, especially among males and the 20–39 age group, highlighting the need to focus on these high-risk demographics in future disease management.
N13 Sexual satisfaction and its associated factors among patients with inflammatory bowel disease in Japan
Authors: Wakai S , Tanaka M , Takai M , Sakagami K , Hiroaki I
Published: January 2024

Background

Patients with inflammatory bowel disease (IBD) frequently experience fatigue and depression, which can lead to difficulties in their sexual lives, such as decreased motivation for sexual activity. Despite indications of sexual dysfunction and dissatisfaction, few studies have explored these issues. This study aims to clarify sexual satisfaction among patients with IBD and its related factors and to determine the percentage of respondents who were unwilling to answer the question about sexual satisfaction and their characteristics.

Methods

We consecutively recruited 500 patients from the specialized IBD clinic, of which 492 (206 with Ulcerative colitis and 286 with Crohn’s disease) valid responses were used in the study. To assess sexual satisfaction, we employed a 5-point scale using the "I am satisfied with my sex life" item from the Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F). We collected information on patient characteristics (sex, age, occupation, marital status, disease duration, and sleep deprivation status). Additionally, we obtained data from the FACIT-F regarding non-response to sexual satisfaction, emotional well-being (EWB), and the Fatigue subscale (FS). Furthermore, we collected information on disease severity from the medical records, including the partial Mayo Score (pMayo) and Crohn's Disease Activity Index (CDAI).

Results

Out of 492 patients who participated in the study, 319 (64.8%) provided responses, while 173 (35.2%) did not respond to the sexual satisfaction question. The distribution of responses was as follows: “not at all” (11.0%), “a little bit” (9.7%), “somewhat” (24.7%), “quite a bit” (12.2%), “very much” (7.1%). In the bivariate analyses of sexual satisfaction and related factors, four variables showed a significant relationship: age (rs=-0.19, p=0.001), sleep deprivation status (p=0.003), EWB (rs =0.30, <0.001), and FS (rs =0.34, p<0.001). Multiple logistic regression analysis of the factors influencing non-response preferences revealed that female gender (OR=2.41, 95%CI= 1.55-3.75) and older age (OR=1.04, 95%CI=1.02-1.06) were statistically significant.

Conclusion

Chronic conditions, such as depression, fatigue, and sleep deprivation, can affect the sexual satisfaction of patients with IBD, even during periods of remission. A substantial percentage of respondents were unwilling to answer questions regarding sexual satisfaction among Japanese patients with IBD. Hence, healthcare providers should consider offering support for sexual issues, recognizing the discomfort some individuals may feel in discussing such intimate matters.
Radiofrequency venous ablation for symptomatic relief in postural orthostatic tachycardia syndrome: a case series
Authors: McGeoch Catherine L B , Steinberg Rebecca S , Bortfeld Kristina S , Almuwaqqat Zakaria , Rheudasil J Mark , Bhatia Neal K , Cutchins Alexis C
Published: January 2024

Background

Hypovolemic postural orthostatic tachycardia syndrome (POTS) is thought to be caused by dysregulated circulating blood volume. Management is mainly limited to symptom-targeted lifestyle changes. Radiofrequency venous ablation (RFA) represents a minimally invasive method of increasing circulating blood volume. The following case series describes a novel application of RFA to successfully target POTS symptoms in patients demonstrating venous insufficiency. The use of RFA in alleviating POTS symptoms has not previously been reported.

Case summary

We describe four patients with either a well-established historical POTS diagnosis or dysautonomia symptoms refractory to both medical management and lifestyle modifications. They all demonstrated venous reflux on lower extremity venous ultrasound testing. Upon vascular surgery referral, all underwent great and small saphenous vein RFA. They each subsequently reported subjective improvement in their dysautonomia symptoms and quality-of-life. Two with symptom recurrence years later were found to have new-onset pelvic venous congestion and are being evaluated for pelvic venous insufficiency interventions.

Discussion

Lower extremity venous pooling can exacerbate dysautonomia symptoms in POTS patients. Patients refractory to conventional treatment strategies should undergo venous insufficiency workup, and if positive, should be referred for venous pooling intervention evaluation. The success of RFA at treating refractory POTS symptoms in these four patients with lower extremity venous reflux, including no surgical intervention and no adverse effects, are compelling grounds to further explore this therapy and to quantify and standardize symptom improvement assessment in a larger patient population. Future directions include a demonstration of quality-of-life improvement in randomized clinical trials.
Pacemaker implantation in a patient with isolated persistent left superior vena cava using a delivery catheter: a case report
Authors: Kawakami Toshinaru , Yahagi Kazuyuki , Horiuchi Yu , Tanabe Kengo
Published: January 2024

Background

Persistent left superior vena cava (PLSVC) with absent right superior vena cava, also termed ‘isolated PLSVC’, is extremely rare. Permanent pacemaker implantation in patients with isolated PLSVC is often difficult by the usual subclavian approach due to the unique anatomy. With the advent of delivery catheters in recent years, implantation using the same system has been reported.

Case summary

A 47-year-old woman with symptomatic sick sinus syndrome was admitted to our institution for permanent pacemaker implantation. Preprocedural cardiac multidetector computed tomography (MDCT) showed isolated PLSVC. We performed pacemaker implantation successfully via the left subclavian approach, using the C315 delivery catheter system. The leads were stable on chest radiography, and the sensing and capture thresholds were unchanged. After the procedure, we integrated the delivery catheter images with cardiac MDCT using Ziostation, and they were well matched with the fluoroscopic images. At the 1-month follow-up, the patient was free of heart failure symptoms and had decreased levels of N-terminal prohormone of brain natriuretic peptide.

Discussion

The C315 delivery catheter system was considered an option for permanent pacemaker implantation in patients with isolated PLSVC. When performing permanent pacemaker implantation in patients with unusual venous anatomy, integrating the delivery catheter images with cardiac MDCT allows for appropriate preoperative catheter selection.
Bottom-up and top-down controls on Alteromonas macleodii lead to different dissolved organic matter compositions
Authors: Chen Qi , Lønborg Christian , Chen Feng , Zhang Rui , Cai Ruanhong , Li Yunyun , He Chen , Shi Quan , Jiao Nianzhi , Zheng Qiang
Published: January 2024

The effects of both bottom-up (e.g. substrate) and top-down (e.g. viral lysis) controls on the molecular composition of dissolved organic matter have not been investigated. In this study, we investigated the dissolved organic matter composition of the model bacterium Alteromonas macleodii ATCC 27126 growing on different substrates (glucose, laminarin, extracts from a Synechococcus culture, oligotrophic seawater, and eutrophic seawater), and infected with a lytic phage. The ultra-high resolution mass spectrometry analysis showed that when growing on different substrates Alteromonas macleodii preferred to use reduced, saturated nitrogen-containing molecules (i.e. O4 formula species) and released or preserved oxidized, unsaturated sulfur-containing molecules (i.e. O7 formula species). However, when infected with the lytic phage, Alteromonas macleodii produced organic molecules with higher hydrogen saturation, and more nitrogen- or sulfur-containing molecules. Our results demonstrate that bottom-up (i.e. varying substrates) and top-down (i.e. viral lysis) controls leave different molecular fingerprints in the produced dissolved organic matter.
Role of Syndiniales parasites in depth-specific networks and carbon flux in the oligotrophic ocean
Authors: Anderson Sean R , Blanco-Bercial Leocadio , Carlson Craig A , Harvey Elizabeth L
Published: January 2024

Microbial associations that result in phytoplankton mortality are important for carbon transport in the ocean. This includes parasitism, which in microbial food webs is dominated by the marine alveolate group, Syndiniales. Parasites are expected to contribute to carbon recycling via host lysis; however, knowledge on host dynamics and correlation to carbon export remain unclear and limit the inclusion of parasitism in biogeochemical models. We analyzed a 4-year 18S rRNA gene metabarcoding dataset (2016–19), performing network analysis for 12 discrete depths (1–1000 m) to determine Syndiniales–host associations in the seasonally oligotrophic Sargasso Sea. Analogous water column and sediment trap data were included to define environmental drivers of Syndiniales and their correlation with particulate carbon flux (150 m). Syndiniales accounted for 48–74% of network edges, most often associated with Dinophyceae and Arthropoda (mainly copepods) at the surface and Rhizaria (Polycystinea, Acantharea, and RAD-B) in the aphotic zone. Syndiniales were the only eukaryote group to be significantly (and negatively) correlated with particulate carbon flux, indicating their contribution to flux attenuation via remineralization. Examination of Syndiniales amplicons revealed a range of depth patterns, including specific ecological niches and vertical connection among a subset (19%) of the community, the latter implying sinking of parasites (infected hosts or spores) on particles. Our findings elevate the critical role of Syndiniales in marine microbial systems and reveal their potential use as biomarkers for carbon export.
The active free-living bathypelagic microbiome is largely dominated by rare surface taxa
Authors: Sebastián Marta , Giner Caterina R , Balagué Vanessa , Gómez-Letona Markel , Massana Ramon , Logares Ramiro , Duarte Carlos M , Gasol Josep M
Published: January 2024

A persistent microbial seed bank is postulated to sustain the marine biosphere, and recent findings show that prokaryotic taxa present in the ocean’s surface dominate prokaryotic communities throughout the water column. Yet, environmental conditions exert a tight control on the activity of prokaryotes, and drastic changes in these conditions are known to occur from the surface to deep waters. The simultaneous characterization of the total (DNA) and active (i.e. with potential for protein synthesis, RNA) free-living communities in 13 stations distributed across the tropical and subtropical global ocean allowed us to assess their change in structure and diversity along the water column. We observed that active communities were surprisingly more similar along the vertical gradient than total communities. Looking at the vertical connectivity of the active vs. the total communities, we found that taxa detected in the surface sometimes accounted for more than 75% of the active microbiome of bathypelagic waters (50% on average). These active taxa were generally rare in the surface, representing a small fraction of all the surface taxa. Our findings show that the drastic vertical change in environmental conditions leads to the inactivation and disappearance of a large proportion of surface taxa, but some surface-rare taxa remain active (or with potential for protein synthesis) and dominate the bathypelagic active microbiome.
Zooming in on the intracellular microbiome composition of bacterivorous Acanthamoeba isolates
Authors: Rayamajhee Binod , Willcox Mark , Sharma Savitri , Mooney Ronnie , Petsoglou Constantinos , Badenoch Paul R , Sherchan Samendra , Henriquez Fiona L , Carnt Nicole
Published: January 2024

Acanthamoeba, a free-living amoeba in water and soil, is an emerging pathogen causing severe eye infection known as Acanthamoeba keratitis. In its natural environment, Acanthamoeba performs a dual function as an environmental heterotrophic predator and host for a range of microorganisms that resist digestion. Our objective was to characterize the intracellular microorganisms of phylogenetically distinct Acanthamoeba spp. isolated in Australia and India through directly sequencing 16S rRNA amplicons from the amoebae. The presence of intracellular bacteria was further confirmed by in situ hybridization and electron microscopy. Among the 51 isolates assessed, 41% harboured intracellular bacteria which were clustered into four major phyla: Pseudomonadota (previously known as Proteobacteria), Bacteroidota (previously known as Bacteroidetes), Actinomycetota (previously known as Actinobacteria), and Bacillota (previously known as Firmicutes). The linear discriminate analysis effect size analysis identified distinct microbial abundance patterns among the sample types; Pseudomonas species was abundant in Australian corneal isolates (P < 0.007), Enterobacteriales showed higher abundance in Indian corneal isolates (P < 0.017), and Bacteroidota was abundant in Australian water isolates (P < 0.019). The bacterial beta diversity of Acanthamoeba isolates from keratitis patients in India and Australia significantly differed (P < 0.05), while alpha diversity did not vary based on the country of origin or source of isolation (P > 0.05). More diverse intracellular bacteria were identified in water isolates as compared with clinical isolates. Confocal and electron microscopy confirmed the bacterial cells undergoing binary fission within the amoebal host, indicating the presence of viable bacteria. This study sheds light on the possibility of a sympatric lifestyle within Acanthamoeba, thereby emphasizing its crucial role as a bunker and carrier of potential human pathogens.
The Postoperative Breast: Imaging Findings and Diagnostic Pitfalls After Breast-Conserving Surgery and Oncoplastic Breast Surgery
Authors: Pittman Sarah M , Rosen Eric L , DeMartini Wendy B , Nguyen Dung H , Poplack Steven P , Ikeda Debra M
Published: January 2024

Breast surgery is the cornerstone of treatment for early breast cancer. Historically, mastectomy and conventional breast-conserving surgery (BCS) were the main surgical techniques for treatment. Now, oncoplastic breast surgery (OBS), introduced in the 1990s, allows for a combination of BCS and reconstructive surgery to excise the cancer while preserving or enhancing the contour of the breast, leading to improved aesthetic results. Although imaging after conventional lumpectomy demonstrates typical postsurgical changes with known evolution patterns over time, OBS procedures show postsurgical changes/fat necrosis in locations other than the lumpectomy site. The purpose of this article is to familiarize radiologists with various types of surgical techniques for removal of breast cancer and to distinguish benign postoperative imaging findings from suspicious findings that warrant further work-up.
Epistemic consequences of unfair tools
Authors: Lassen Ida Marie S , Kristensen-McLachlan Ross Deans , Almasi Mina , Enevoldsen Kenneth , Nielbo Kristoffer L
Published: January 2024

This article examines the epistemic consequences of unfair technologies used in digital humanities (DH). We connect bias analysis informed by the field of algorithmic fairness with perspectives on knowledge production in DH. We examine the fairness of Danish Named Entity Recognition tools through an innovative experimental method involving data augmentation and evaluate the performance disparities based on two metrics of algorithmic fairness: calibration within groups; and balance for the positive class. Our results show that only two of the ten tested models comply with the fairness criteria. From an intersectional perspective, we shed light on how unequal performance across groups can lead to the exclusion and marginalization of certain social groups, leading to voices and experiences being disregarded and silenced. We propose incorporating algorithmic fairness in the selection of tools in DH to help alleviate the risk of perpetuating silence and move towards fairer and more inclusive research.
Thermoelectrocatalysis: an emerging strategy for converting waste heat into chemical energy
Authors: Zhang Yuqiao , Li Shun , Zhang Jianming , Zhao Li-Dong , Lin Yuanhua , Liu Weishu , Rosei Federico
Published: January 2024

This perspective defines and explores an innovative waste heat harvesting strategy, thermoelectrocatalysis (TECatal), emphasizing materials design and potential applications in clean energy, environmental, and biomedical technologies.
Controlling bad-actor-artificial intelligence activity at scale across online battlefields
Authors: Johnson Neil F , Sear Richard , Illari Lucia
Published: January 2024

We consider the looming threat of bad actors using artificial intelligence (AI)/Generative Pretrained Transformer to generate harms across social media globally. Guided by our detailed mapping of the online multiplatform battlefield, we offer answers to the key questions of what bad-actor-AI activity will likely dominate, where, when—and what might be done to control it at scale. Applying a dynamical Red Queen analysis from prior studies of cyber and automated algorithm attacks, predicts an escalation to daily bad-actor-AI activity by mid-2024—just ahead of United States and other global elections. We then use an exactly solvable mathematical model of the observed bad-actor community clustering dynamics, to build a Policy Matrix which quantifies the outcomes and trade-offs between two potentially desirable outcomes: containment of future bad-actor-AI activity vs. its complete removal. We also give explicit plug-and-play formulae for associated risk measures.
A promising method for breaking the logjam of time-frequency analysis in astronomy
Authors: Yan Shu-Ping , Ji Li , Zhang Ping , Liu Si-Ming , Lu Lei , Long Min
Published: January 2024

Time-frequency analysis could provide detailed dynamic information of celestial bodies and is critical for comprehension of astronomical phenomena. However, it is far from being well-developed in astronomy. Hilbert–Huang transform (HHT) is an advanced time-frequency method but has two problems in analysing astronomical signals. One is that many astronomical signals may be composed of multiple components with various amplitudes and frequencies, while HHT uses assisted noises with the same amplitude to extract all components. The other is that HHT is an empirical method requiring tunable parameters to be optimized using experimental results or known facts, which are challenging to obtain in astronomy and it is therefore hard to determine whether the signal decomposition is right or not. In this study, we adjust the noise amplitude to optimize the decomposition based on the orthogonality of the obtained components and discard the decompositions with non-physical results. Three experiments show that this new extension of HHT is an effective method suitable for high-resolution time-frequency analysis in astronomy. It can be used to dig out valuable pieces of information which are inaccessible with other methods, and thus has the potential to open up new avenues for astronomy research.
Missing Data in Asset Pricing Panels
Authors: Freyberger Joachim , Hoeppner Bjoern , Neuhierl Andreas , Weber Michael
Published: January 2024

We propose a simple and computationally attractive method to deal with missing data in in cross-sectional asset pricing using conditional mean imputations and weighted least squares, cast in a generalized method of moments (GMM) framework. This method allows us to use all observations with observed returns; it results in valid inference; and it can be applied in nonlinear and high-dimensional settings. In simulations, we find it performs almost as well as the efficient but computationally costly GMM estimator. We apply our procedure to a large panel of return predictors and find that it leads to improved out-of-sample predictability.
RN-to-BS Nursing Education Research: A Scoping Review
Authors: Ringhofer Brown Cindy , Elliott Brenda , Gipson Christine S. , Holmstrom Jill , Stallings Devita
Published: January 2024

AIM

The purpose of this scoping review was to examine the extent, range, and nature of RN-to-BS nursing education research.

BACKGROUND

The state of nursing education science specific to RN-to-BS education is not available.

METHOD

Scoping review methodology was used to identify categories and types of published research related to RN-to-BS nursing education.

RESULTS

Eight categories were identified across the 41 articles that met the inclusion criteria: teaching strategies (n= 11), curriculum (n= 9), enrollment/retention (n= 8), benefits of a bachelor’s degree (n= 4), student characteristics (n= 3), professional values (n= 2), role transition (n= 2), and faculty/student expectations (n= 2).

CONCLUSION

Opportunities exist for researchers to study RN-BS students and faculty to better support evidence-based teaching practices and faculty development needs relevant for the increasingly hybrid and online student populations.
Treatment Fidelity in 94 Randomized Controlled Trials of Physical Rehabilitation in the ICU: A Scoping Review*
Authors: Farley Christopher , Newman Anastasia N.L. , Hoogenes Jen , Brooks Dina , Duffett Mark , Kho Michelle E.
Published: January 2024

OBJECTIVES:

Recent reviews demonstrated discordant effects of ICU-based physical rehabilitation on physical function. These inconsistencies may be related to differences in treatment fidelity—the extent to which a protocol is delivered as planned. Before evaluating the association of fidelity with outcomes, we must first understand the extent of treatment fidelity reporting in ICU-based physical rehabilitation randomized controlled trials (RCTs).

DATA SOURCES:

Six electronic databases from inception to December 2022.

STUDY SELECTION:

We included RCTs enrolling adults or children admitted to the ICU, if greater than or equal to 50% were invasively mechanically ventilated greater than 24 hours, and underwent an ICU-based physical rehabilitation intervention, with no limitation to comparators or outcomes.

DATA EXTRACTION:

We screened and extracted data independently and in duplicate, with a third reviewer as needed. Extracted data included study characteristics, treatment descriptions, and the presence of National Institutes of Health Behaviour Change Consortium (NIH-BCC) treatment fidelity tool components. Treatment fidelity scores were calculated as the proportion of reported (numerator) out of total NIH-BCC components (denominator). We calculated scores across studies and by treatment group (intervention vs. comparator). We used linear regression to assess for a time trend in study treatment fidelity scores.

DATA SYNTHESIS:

Of 20,433 citations, 94 studies met inclusion criteria. Authors reported a median (first–third quartiles) of 19% (14–26%) of treatment fidelity components across studies. Intervention group scores were higher than comparator groups (24% [19–33%] vs. 14% [5–24%], p < 0.01). We found a mean increase in study treatment fidelity scores by 0.7% (0.3 points) per year.

CONCLUSIONS:

Only 19% of treatment fidelity components were reported across studies, with comparator groups more poorly reported. Future research could investigate ways to optimize treatment fidelity reporting and determine characteristics associated with treatment fidelity conduct in ICU-based physical rehabilitation RCTs.
Bilateral Forehead Rotation Flap with Skin Substitute Application for Convexity Replacement
Authors: Lauck Kyle C. , Rickstrew Jace J. , Tolkachjov Stanislav N.
Published: January 2024

Large forehead defects pose reconstructive challenges, considering the tissue inelasticity and the need to preserve symmetry of the eyebrow and hairline. Local skin flaps and primary closures are mainstays of forehead reconstruction with many techniques reported, but they may not cover the entire defect. Further closure options with acceptable cosmesis are limited. While providing a functional alternative, skin grafting may take on an atrophic concavity and shiny texture. Free flaps similarly may not accurately replicate the contour of the forehead and may be discordant with the texture of adjacent skin. We describe a reproducible technique for closing a large central forehead defect in a single-stage local flap while retaining symmetry of eyebrows and neurovascular integrity. We also propose serially applying a skin substitute to the remaining portion of the defect to recreate forehead convexity and potentially expedite healing. This technique may represent a viable and reproducible method for recreating the natural contour of the forehead when complete closure may not be an option.
Persistent Monkeypox-Associated Keratouveitis in a Post-LASIK Cornea: A Case Report With Flap Removal
Authors: Rosell Domínguez María , Hernández-Cerdá Jorge , Alegre-Ituarte Víctor , González-Ocampo Dorta Samuel , Martínez-Costa Pérez Lucía
Published: January 2024

Purpose:

This study aimed to report a case of persistent keratouveitis associated with mpox virus infection in an immunocompetent patient with a history of laser-assisted in situ keratomileusis (LASIK), leading to the need for flap removal.

Methods:

A comprehensive literature review was conducted, and a detailed case report was presented.

Results:

A 44-year-old immunocompetent male patient with a history of LASIK and HIV infection presented with conjunctival and corneal lesions indicative of mpox infection. Despite initial topical treatment, the condition worsened, leading to severe epithelial and stromal keratitis with anterior chamber inflammation. Polymerase chain reaction testing confirmed the presence of mpox virus in conjunctival, corneal, and aqueous humor samples. The patient underwent various treatments, including tecovirimat, oral and topical corticosteroids, and topical trifluridine, and eventually flap removal with amniotic membrane application. Subsequent polymerase chain reaction testing of the aqueous humor yielded negative results, and the cornea gradually reepithelialized without inflammation. After 8 months, the patient's eye remained stable, with a central stromal scar.

Conclusions:

This case highlights the rare occurrence of mpox-associated keratouveitis and emphasizes the challenges faced in its management. The successful outcome achieved through a combination of antiviral therapy, antiinflammatories, and surgical intervention underscores the importance of a multidisciplinary approach in managing such cases.
Advancements and mechanisms of stem cell-based therapies for spinal cord injury in animals
Authors: Mili Bhabesh , Choudhary Om Prakash
Published: January 2024

Spinal cord injury (SCI) is a neurodegenerative disorder of the central nervous system that can lead to permanent loss of sensation and voluntary movement beyond the affected area. Extensive preclinical and clinical trials have been conducted to evaluate the safety and effectiveness of stem cells for the treatment of various central nervous system diseases or disorders, including SCI. However, several challenges hinder nerve cell regeneration in the injured spinal cord, such as extensive cell loss, limited neural cell regeneration capacity, axonal disruption, and the presence of growth-inhibiting molecules, particularly astroglial scarring or glial scars at the injury site in chronic cases. These obstacles pose significant challenges for physicians in restoring normal motor and sensory nerve function in both humans and animals following SCI. This review focuses on SCI pathogenesis, the mechanisms underlying the therapeutic potential of mesenchymal stem cells in SCI, and the potential of stem cell-based therapies as promising avenues for treatment. This review article also included relevant preclinical and clinical data from animal studies.
Machine learning prediction model of major adverse outcomes after pediatric congenital heart surgery: a retrospective cohort study
Authors: Tong Chaoyang , Du Xinwei , Chen Yancheng , Zhang Kan , Shan Mengqin , Shen Ziyun , Zhang Haibo , Zheng Jijian
Published: January 2024

Background:

Major adverse postoperative outcomes (APOs) can greatly affect mortality, hospital stay, care management and planning, and quality of life. This study aimed to evaluate the performance of five machine learning (ML) algorithms for predicting four major APOs after pediatric congenital heart surgery and their clinically meaningful model interpretations.

Methods:

Between August 2014 and December 2021, 23 000 consecutive pediatric patients receiving congenital heart surgery were enrolled. Based on the split date of 1 January 2019, the authors selected 13 927 participants for the training cohort, and 9073 participants for the testing cohort. Four predefined major APOs including low cardiac output syndrome (LCOS), pneumonia, renal failure, and deep venous thrombosis (DVT) were investigated. Thirty-nine clinical and laboratory features were inputted in five ML models: light gradient boosting machine (LightGBM), logistic regression (LR), support vector machine, random forest, and CatBoost. The performance and interpretations of ML models were evaluated using the area under the receiver operating characteristic curve (AUC) and Shapley Additive Explanations (SHAP).

Results:

In the training cohort, CatBoost algorithms outperformed others with the mean AUCs of 0.908 for LCOS and 0.957 for renal failure, while LightGBM and LR achieved the best mean AUCs of 0.886 for pneumonia and 0.942 for DVT, respectively. In the testing cohort, the best-performing ML model for each major APOs with the following mean AUCs: LCOS (LightGBM), 0.893 (95% CI: 0.884–0.895); pneumonia (LR), 0.929 (95% CI: 0.926–0.931); renal failure (LightGBM), 0.963 (95% CI: 0.947–0.979), and DVT (LightGBM), 0.970 (95% CI: 0.953–0.982). The performance of ML models using only clinical variables was slightly lower than those using combined data, with the mean AUCs of 0.873 for LCOS, 0.894 for pneumonia, 0.953 for renal failure, and 0.933 for DVT. The SHAP showed that mechanical ventilation time was the most important contributor of four major APOs.

Conclusions:

In pediatric congenital heart surgery, the established ML model can accurately predict the risk of four major APOs, providing reliable interpretations for high-risk contributor identification and informed clinical decisions-making.
Secondary analysis: heat and self-report pain sensitivity associate with biological sex and racialized sociocultural group but may not be mediated by anxiety or pain catastrophizing
Authors: Meeker Timothy J. , Kim Hee Jun , Tulloch Ingrid K. , Keaser Michael L. , Seminowicz David A. , Dorsey Susan G.
Published: January 2024

Introduction:

Previous studies have demonstrated associations between sex and racialized group on pain sensitivity and tolerance. We analyzed the association of sex and racialized group on heat pain sensitivity, sensibility to painful suprathreshold mechanical pain (STMP), and pain sensitivity questionnaire (PSQ). We hypothesized that anxiety and pain catastrophizing reported by racialized minority groups and women would mediate enhanced pain sensitivity. Our secondary aim was to evaluate validity of the PSQ in a diverse population.

Methods:

Using quantitative sensory testing for painful heat, STMP (forces: 64, 128, 256, and 512 mN), and PSQ, we evaluated pain sensitivity in 134 healthy participants [34 (18 women) Asian, 25 (13 women) Black, and 75 (41 women) White]. We used general linear and linear mixed models to analyze outcomes. We assessed mediation of state and trait anxiety and pain catastrophizing on pain sensitivity.

Results:

Racialized minority status was associated with greater heat pain sensitivity (F = 7.63; P = 0.00074) and PSQ scores (F = 15.45; P = 9.84 × 10−7) but not associated with STMP (F = 1.50; P = 0.23). Female sex was associated with greater heat pain sensitivity (F = 4.9; P = 0.029) and lower PSQ (F = 9.50; P = 0.0025) but not associated with STMP (F = 0.0018; P = 0.97). Neither anxiety nor pain catastrophizing mediated associations between sex or racialized group with heat pain threshold or PSQ. Differential experience of individual items (F = 19.87; P = 3.28 × 10−8) limited PSQ face validity in racialized minorities.

Conclusion:

Consistent with previous research, sensitivity to painful heat was associated with racialized minority status and female sex. By contrast, there was no significant effect of racialized minority status or female sex on STMP. Some PSQ items are inapplicable to participants from racialized minority groups.