bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying and Controlling Anthracnose Caused by Colletotrichum Taxa of Welsh Onion in Sanxing, Taiwan
Authors: Yu Yu-Hsiang , Cho Yi-Tun , Xu Yuan-Cheng , Wong Zhang-Jian , Tsai Yi-Chen , Ariyawansa Hiran A.
Published: December 2023

Leaves of Welsh onion ( Allium fistulosum) are subject to various fungal diseases such as anthracnose ( Colletotrichum species) and Stemphylium leaf blight ( Stemphylium vesicarium). These diseases are the main biotic limitations to Welsh onion production in northern Taiwan. From 2018 to 2020, anthracnose symptoms were observed throughout Welsh onion fields in northern Taiwan, mainly the Sanxing area. In total, 33 strains of Colletotrichum species were isolated from diseased leaves, and major causative agents were identified based on a multilocus phylogenetic analysis using four genomic regions ( act, tub2, gapdh, and internal transcribed spacer). Based on this phylogeny, Colletotrichum species causing anthracnose of Welsh onion were identified as C. spaethianum ( C. spaethianum species complex) and C. circinans ( C. dematium species complex) in the Sanxing area, northern Taiwan. To determine and compare the pathogenicity of each species, representative fungal strains of each species were inoculated on the cultivar ‘Siao-Lyu’ by spraying spore suspension onto the leaf surface. Welsh onion plants were susceptible to both species, but disease incidence and severity were higher in C. spaethianum. In total, 31 fungicides were tested to determine their efficacy in reducing mycelial growth and conidial germination of representative strains of C. spaethianum and C. circinans under laboratory conditions. Five fungicides—fluazinam, metiram, mancozeb, thiram, and dithianon—effectively reduced mycelial growth and spore germination in both C. spaethianum and C. circinans. In contrast, difenoconazole and trifloxystrobin + tebuconazole, which are commonly used in Welsh onion production in northern Taiwan, mainly the Sanxing area, were ineffective. These results serve as valuable insights for growers, enabling them to identify and address the emergence of anthracnose caused by C. spaethianum and C. circinans of Welsh onion, employing fungicides with diverse modes of action. The findings of this study support sustainable management of anthracnose in Sanxing, northern Taiwan, although further field tests of the fungicides are warranted.
Patella and Trochlea Osteochondritis Dissecans: Demographics and Treatment Paradigms
Authors: Kiani Sara N. , Yellin Joseph L. , Huffman William H. , Guzek Ryan H. , Shea Kevin G. , Nguyen Jie C. , Ganley Theodore J.
Published: December 2023

Objective:

Previous research on patellar and trochlear groove osteochondritis dissecans (OCD) is limited by small sample sizes. This study aims to describe the presentation of patients with OCD lesions of the patella and trochlea and characterize the outcomes of operative and nonoperative treatments.

Methods:

This retrospective cohort study identified all patients from a single institution from 2008 to 2021 with patellar and/or trochlear OCD lesions. Patients were excluded from the study if surgical records were unavailable or if the patient had knee surgery for a different injury at index surgery or in the 12 months postoperative. Minimum follow-up was 12 months. Outcomes included a return to sports (RTS), pain resolution, radiographic healing, and treatment “success” (defined as full RTS, complete pain resolution, and full healing on imaging).

Results:

A total of 68 patients (75 knees) were included—45 (60%) with patellar OCD and 30 (40%) with trochlear. Of the patients, 69% were males. The median age at knee OCD diagnosis was 14 years. At the final follow-up, 62% of knees (n = 44) recovered sufficiently to allow a full RTS and 54% of knees (n = 39) had full pain resolution. Of the 46 knees with radiographic imaging at least 1 year apart, 63% had full healing of the lesion. There was no significant difference in RTS, pain resolution, radiographic healing, or overall success when comparing treatments.

Conclusions:

This study provides valuable epidemiologic demographic and outcome data regarding the scarcely reported patellar and trochlear OCD. While over half of patients fully returned to sports and reported full pain resolution, a large proportion continued to experience symptoms over a year after presentation. Future research should aim to better define the treatment algorithms for these OCD subtypes.

Level of Evidence:

Level III.
Think Twice: De-Implementation of Laboratory Testing After Colorectal Surgery
Authors: Dave Yatee A. , Temple Larissa , Juviler Peter , Nabozny Michael J , Cvetanovska Marija , Wakeman Derek , Cannon Lisa M.
Published: December 2023

BACKGROUND:

Clinically unindicated laboratory testing contributes to low-value care. Most postoperative day one labs after colorectal surgery are normal. However, no published interventions have shown reducing overall postoperative laboratory testing is safe.

OBJECTIVE:

The aim of this study was to investigate the impact of reducing postoperative laboratory testing after colorectal surgery.

DESIGN:

This is a quality improvement study.

SETTINGS:

The study was conducted at an academic center with an enhanced recovery after surgery program including 5 daily labs until discharge.

PATIENTS:

All adults undergoing colorectal or small bowel surgery formed intervention and non-intervention cohorts based on surgeons who chose to opt-into the study. Pre-implementation (November 2019 – October 2021) there were 545 intervention and 577 non-intervention patients. post-implementation (November 2021 – March 2023) there were 448 intervention and 437 non-intervention patients.

INTERVENTIONS:

The intervention included 3 postoperative day one labs and subsequent clinically indicated labs.

MAIN OUTCOME MEASURES:

Outcome measures included laboratory tests and lab-free days.

RESULTS:

Post-intervention, the intervention group had a 33% reduction in labs per hospital stay, 26% reduction in labs per day, and 49% increase in lab-free days. There was no difference in length of stay (4 v 4; p = 0.79) or readmissions (14.9% v 12.9%; p = 0.39). The non-intervention group had no significant changes in lab work or lab-free days, with no differences in length of stay (4 v 4; p = 0.49) or readmissions (11.1% v 11.0%; p = 0.96).

LIMITATIONS:

Demographics and complication rate were not reported.

CONCLUSIONS:

An intervention targeting reflexive laboratory testing after colorectal surgery resulted in safe, significant, sustained reductions in postoperative lab work, with substantial cost savings. These findings prompted a change in the laboratory order set to an opt-out system, and lab work reduction approaches have been implemented within other surgical divisions. Continuation and spread of these efforts are instrumental for prioritization of high-value surgical care. See Video Abstract at http://links.lww.com/DCR/Bxxx.
Clinical Observation or Further Excision: A Retrospective Review of Margin-positive Squamous and Basal Cell Carcinomas
Authors: Alkhatib Bailey , Waler Alexandria , Welch Madelyn , McCarthy Jack , Nam Arthur , Friedman Harold I.
Published: December 2023

Background:

Patients determined to have margin-positive nonmelanoma skin cancer (NMSC) after initial shave or punch biopsy performed by a primary care physician or dermatologist are commonly referred to extirpative surgeons for definitive removal. Not infrequently, the residual tumor is not appreciable, and the exact location of the lesion is indiscernible. The consulting surgeon must decide to excise the presumed lesion or clinically monitor for recurrence.

Methods:

This single-center, retrospective review examined patients with squamous and basal cell carcinomas referred over a 5-year period to two senior authors.

Results:

In total, 233 patients had a total of 312 lesions excised. Thirty-nine (12.5%) of these lesions (in 33 patients) demonstrated no residual tumor on pathologic examination. Twelve patients were managed nonoperatively (5.15%) and observed to have had no tumor recurrence with a mean observation period of 14.66 months (range 1–54 months). Thus, approximately 19.3% of all patients referred had no residual tumor.

Conclusion:

Based on our observations and low proclivity for metastases, nonoperative monitoring of NMSC may be a reasonable option for certain lesions less than 1 cm that are undiscernible at the time of referral.
Adjuvant and neoadjuvant therapies for hepatocellular carcinoma
Authors: Vogel Arndt , Grant Robert C. , Meyer Tim , Sapisochin Gonzalo , O’Kane Grainne M. , Saborowski Anna
Published: December 2023

Immune-oncology–based regimens have shown efficacy in advanced HCC and have been implemented as standard of care as first-line therapy. Their efficacy, including high response rates, and safety justify their evaluation in earlier disease stages. Following negative results for adjuvant sorafenib in the global STORM trial in 2015, 4 global phase 3 trials, featuring different immune checkpoint inhibitor combinations, entered in parallel the race in the adjuvant setting. The IMbrave050 trial, comparing adjuvant atezolizumab in combination with bevacizumab to active surveillance following curative-intent resection or ablation, was the first to report, fast-tracking the results of the first interim analysis and demonstrating an improvement in recurrence-free survival. The trial has provoked a discussion on the horizon of expectations from adjuvant treatment and the clinical relevance of efficacy endpoints. Moreover, major pathological responses reported from early phase 2 data in the neoadjuvant setting provide a strong rationale for the evaluation of these concepts in phase 3 trials. In this review, we summarize current evidence and outline future directions for systemic therapies in early-stage HCC.
Mineralocorticoid receptor antagonist treatment in patients with renal insufficiency and the associated risk of hyperkalemia and death
Authors: Hedlund Møller Sara , Haagensen Kofod Dea , Schou Morten , Torp-Pedersen Christian , Gislason Gunnar , Carlson Nicholas , Lindhardt Morten
Published: December 2023

Objectives:

Mineralocorticoid receptor antagonist (MRA) treatment is kidney protective but not recommended to patients with advanced renal failure due to the risk of hyperkalemia and death. This study aimed to examine the impact of MRA treatment in patients with chronic kidney disease on risk of hyperkalemia and subsequent mortality.

Methods:

Rates of hyperkalemia were compared across strata of estimated glomerular filtration rate (eGFR) and MRA treatment based on cox regression using a nested case–control framework with 1 : 4 matching of patients with hyperkalemia (K+ ≥6.0 mmol/l) with controls from the Danish general population on age, sex, diabetes, and hypertension. Risk of subsequent 30-day mortality was assessed in a cohort study with comparisons across strata of eGFR and MRA treatment based on multiple Cox regression.

Results:

Thirty-two thousand four hundred twenty-six cases with hyperkalemia were matched with 127 038 controls. MRA treatment was associated with an increased rate of hyperkalemia with hazard ratios [95% confidence interval (95% CI)] of 8.28 (7.78–8.81), 5.12 (4.67–5.62), 3.58 (3.23–3.97), and 1.89 (1.60–2.23) in patients with eGFR at least 60, 45–59, 30–44, and less than 30 ml/min/1.73 m2, respectively (Reference: No MRA).

However, MRA-exposed patients had a lower 30-day mortality risk following hyperkalemia with absolute risks (95% CI) of 29.3% (27.8–31.1), 20.3% (18.7–22.4), 19.5% (17.9–21.7), and 19.7% (17.4–22.5) compared to 39.8% (38.8–40.8), 32.0% (30.7–33.1), 28.8% (27.5–31.2), and 22.5% (21.4–23.4) in patients without MRA exposure in patients with GFR at least 60, 45–59, 30–44, and less than 30 ml/min/1.7 3m2, respectively.

Conclusion:

MRA treatment was associated with an increased rate of hyperkalemia but decreased risk of subsequent 30-day mortality across all stages of renal impairment.
INDOCYANINE GREEN ANGIOGRAPHY OF OPTIC DISK GRANULOMA IN OCULAR SARCOIDOSIS
Authors: Soifer Matias , Nguyen Nam V. , Purt Boonkit , Bellur Sunil , Kodati Shilpa
Published: December 2023

Purpose:

The aim of this study was to report novel indocyanine green angiography findings of optic disk granulomas secondary to sarcoidosis.

Methods:

This was an observational case report.

Results:

A 36-year-old White man, who had previously been evaluated for birdshot chorioretinopathy and tested HLA-A29 negative, was referred for evaluation of choroidal lesions in both eyes. Fundus examination revealed ovoid choroidal lesions bilaterally in the posterior pole. Optical coherence tomography demonstrated bilateral focal choroidal elevations in the posterior pole and optic disks consistent with granulomas. Indocyanine green angiography revealed diffuse choroidal hypocyanescent spots with late-phase focal hypercyanescence of the optic disks in both eyes corresponding to the granulomas. After 3 months of prednisone and immunomodulatory treatment, the granulomas improved, and the optic disk hypercyanescence resolved.

Conclusion:

The authors describe a case of ocular sarcoidosis mimicking birdshot-like lesions, and indocyanine green angiography findings revealed late hypercyanescence, which resolved with treatment.
OPTIC NERVE HYPOPLASIA AND BILATERAL PERSISTENT FETAL VASCULATURE DUE TO TUBA1A TUBULINOPATHY
Authors: Ramirez David A. , Anninger William V. , Scoles Drew
Published: December 2023

Purpose:

To describe a case of TUBA1A-associated optic nerve hypoplasia and persistent fetal vasculature.

Methods:

Observational case report.

Results:

A female, full-term infant was found to have a Dandy–Walker malformation with cerebellar and brainstem hypoplasia, ventriculomegaly, and lissencephaly. Her ophthalmic examination was notable for persistent fetal vasculature, optic nerve hypoplasia, vitreous hemorrhage, and peripheral retinal nonperfusion. Subsequent genetic testing revealed a TUBA1A genetic variant.

Conclusion:

Persistent fetal vasculature, peripheral retinal vascular abnormalities, and optic nerve hypoplasia may be associated with TUBA1A variants. These patients should be carefully evaluated with dilated retinal examination and fluorescein angiography to detect retinal perfusion abnormalities requiring treatment.
Glaucoma surgical procedures under development
Authors: Levin Ariana M. , Sheybani Arsham
Published: December 2023

Purpose of review

Rapid innovation in glaucoma surgery is expanding surgical options in the angle, subconjunctival space, and supraciliary space.

Recent findings

Advancements in glaucoma surgery make it possible for surgeons to provide treatments with less risk. In particular, new devices and lasers are available for minimally invasive glaucoma surgeries. There are also new implants and techniques for bleb-forming glaucoma surgery.

As glaucoma surgeons have access to an increasing number of procedures, devices, and treatments, it is important for evidence to drive decision-making.
An Analysis of Biopsychosocial Factors Associated With Chronic Pain Severity Among Hospitalized People Living With HIV in Shenzhen, China: A Cross-Sectional Study
Authors: Wu Ni , Kong Hanhan , Han Lu , Chen Yongfeng , Bai Jinbing , Liu Yanqun
Published: December 2023

Chronic pain is a primary health problem in people living with HIV (PWH). However, there is limited research regarding chronic pain among PWH in Chinese health care settings. To investigate biopsychosocial factors of chronic pain severity, we conducted a cross-sectional study in Shenzhen, China. Chronic pain was defined as pain lasting for more than three months. Pain intensity was measured using the numeric rating scale (NRS). Among 123 hospitalized PWH, 78.86% of participants had mild pain and 21.14% had moderate–severe pain. Multiple logistic regression results indicated that PWH in moderate–severe pain group were more likely to have higher levels of interleukin [IL]-6 (OR = 1.034, 95% CI: 1.003–1.066, p = .029) and anxiety (OR = 1.334, 95% CI: 1.071–1.662, p = .010) than those in the mild chronic pain group. Targeted pain management interventions should be explored in clinical practices and future studies regarding PWH with high levels of IL-6 and anxiety.
Rotator Cuff Augmentation: Its Role and Best Practices
Authors: Ciccone William J. , Geers Brent , Jensen Bodrie , Bishai Shariff K.
Published: December 2023

Rotator cuff tears are a common source of pain and impairment in the shoulder. Healing of the rotator cuff tendons following repair has been associated with improved patient outcomes. While there have been many technical improvements in surgical techniques for rotator cuff repair, failure rates are still surprisingly high. Augmentation of these repairs has been shown to help with fixation biomechanics as well as healing rates. The described types of augments include autograft, allograft, xenograft, and synthetic options. This report reviews the commonly available types of augments and some of the outcomes associated with their use.
Single-row or Double-row Rotator Cuff Repair
Authors: Cobaleda-Aristizabal Andres Felipe , Ruiz-Suarez Michell , Barber F. Alan , Lara Antonio Miguel , Lopez Ramos Mauricio , Torres Rangel Eduardo , Gamba Galeazzi Rafael
Published: December 2023

Rotator cuff tears are potentially a career-ending injury for athletes. The surgeon must identify which patients will benefit from surgical repair. The factors to consider are age, type of sport, time since injury, athlete’s level, and the patient’s expectations. An essential and independent fact determining the surgical treatment is whether the damage is due to overuse or from a traumatic/collision injury. Some sports are more demanding than others resulting in different return-to-participation (RTP) rates. This RTP return rate can present a real challenge and more so by a desire to reach the pre-injury level of play. The incidence of rotator cuff tearing varies from one sport to another. In football players this can be 12% whereas for tennis players this incidence is 4% to 17%. The RTP rate must be considered when making treatment decisions and is influenced by the level of the athlete: for professional athletes, the rate is 61%, and for recreational 73%. When the surgeon and the patient decide on the surgical treatment, the surgeon must consider whether to perform a double-row or a single-row rotator cuff tendon repair. The decision-making and the surgical technique will be addressed.
KRAS-mutant colorectal cancer cell lines cause a prothrombotic state through the upregulation of thrombin: experimental study
Authors: Xu Duogang , Liao Changkang , Tan Jing
Published: December 2023

Background:

The KRAS genotype status is strongly associated with a prothrombotic state in colorectal cancer, and hypercoagulability and cancer-related thrombosis are among the significant events leading to poor prognosis. However, this correlation has not been confirmed at the cellular level. This study aimed to assess the maximum platelet aggregation rate and thrombin expression induced by colorectal cancer cells under different KRAS genotypes.

Materials and methods:

Platelet aggregation rate assay and western blotting analysis were used to detect platelet aggregation and thrombin expression induced by four colorectal cancer cells with different KRAS genotypes, including RKO, HCT116, SW480, and SW620. FVIIa/tissue factor and thrombin inhibitors were added to explore changes in platelet aggregation rates induced by colorectal cancer cells and the association between KRAS genotype status and hypercoagulable state.

Results:

KRAS-mutant cells were more likely to increase maximal platelet aggregation, with RKO, HCT116, SW480, and SW620 inducing 34.7%, 55.4%, 44.4%, and 63.8% of platelet aggregation, respectively. The maximum platelet aggregation rate was higher in the metastatic rectal cancer tumour strain SW620 than in the primary rectal cancer strain SW480. RKO cells had lower thrombin expression than the other three cells. Furthermore, the addition of thrombin inhibitors caused a more significant decrease in the platelet aggregation rate in KRAS-mutant cell lines compared to KRAS wild-type cell lines.

Conclusion:

Compared to KRAS wild-type colorectal cancer cells, KRAS-mutant colorectal cancer cell lines were more likely to be hypercoagulable through the upregulation of thrombin expression, which was mainly achieved through the TF-thrombin pathway.
Women Veterans’ Barriers to Care-Seeking for Cardiovascular Disease Prevention
Authors: Orshak Jennifer , Ondoma Cissy , Johnson Heather M. , Lauver Diane
Published: December 2023

Background

Women veterans have a high prevalence of traditional and nontraditional risks for cardiovascular disease (CVD) including obesity and posttraumatic stress disorder. Experts from the U.S. Department of Veterans Affairs have called for actions to improve the cardiovascular health of this population. One approach is to assess women veterans’ barriers to care-seeking for CVD prevention, to inform future intervention research.

Objective

The objective of this study was to describe women veterans’ barriers to care-seeking for CVD prevention, guided by the theory of care-seeking behavior and concept awareness.

Methods

Using a cross-sectional, descriptive design, a national sample of 245 women veterans participated in an online survey about barriers to care-seeking. Participants provided narrative responses to open-ended items, endorsements to closed-ended items, and rankings of their top five barriers. Researchers conducted poststratification weighting of numerical data to reflect the women veteran population.

Results

Narrative responses described unaffordable and inaccessible services, feeling harassed or not respected in healthcare settings, and lack of awareness of risks for CVD. Frequently endorsed barriers were unaffordable and inaccessible services. Frequently ranked barriers were feeling not respected in healthcare settings and clinicians not recommending CVD prevention.

Discussion

Findings support concepts in theory of care-seeking behavior and concept awareness. Understanding women veterans’ barriers to care-seeking for CVD prevention can inform clinicians and researchers as they address these barriers.
Systematic Review and Meta-Analysis of Psychological Distress and Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Consequences
Authors: Kham-ai Prasert , Heaton Karen , Xiao Chunhong , Wheeler Pariya
Published: December 2023

Background

People with chronic obstructive pulmonary disease (COPD) occasionally develop acute exacerbation of COPD—a potentially fatal condition. Psychological distress was associated with acute exacerbation of COPD. However, the evidence on the effect of psychological distress on acute exacerbation of COPD remains unclear.

Objective

The aim of this study was to explore the influence of psychological distress on acute exacerbation of COPD and its consequences.

Methods

The current review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using three databases (PubMed, CINAHL, and PsyINFO) that were searched to identify relevant articles. Pooled risk ratios and 95% confidential interval were calculated from the included studies’ data with random-effect methods to estimate the effect of psychological distress on acute exacerbation of COPD and its consequences.

Results

Nineteen articles were included in the review. Most revealed that psychological distress was significantly associated with increased risk of acute exacerbation of COPD and its consequences. The meta-analyses showed that psychological distress increased risk of acute exacerbation of COPD, COPD-related hospitalization, and death.

Conclusion

Psychological distress had negative effects on acute exacerbation of COPD and its consequences. The results of the meta-analyses show that persons with COPD and psychological distress had a greater risk of acute exacerbation of COPD, hospitalization, and death.
Rehabilitation of hemidystonia as a result of right pontine hemorrhagic stroke
Authors: Aing Melanie , DiTommaso Craig
Published: December 2023

Dystonia is a movement disorder characterized by involuntary, repetitive writhing movements. Historically, dystonia is a disorder of the basal ganglia. However, recent studies have reported cases of dystonia associated with brainstem disorders. Although many theories have been proposed, the pathologic mechanism of the disorder is uncertain. Furthermore, few effective treatment options have been proposed. This case study reports a case of hemidystonia resulting from acute pontine hemorrhagic stroke successfully treated with pharmacotherapy and intensive inpatient rehabilitation. The patient presented to our inpatient rehabilitation facility, where baclofen was administered with intensive rehabilitation. On discharge, his functionality improved to mostly independent with activities of daily living.
The relation of body mass index and total symptom burden in female oncologic patients
Authors: Correa Ady M. , Molinares Diana , Tiozzo Eduard , Huang Laura
Published: December 2023

Objectives:

Examine the relationship between obesity and symptom burden (SB) among female oncologic patients evaluated in cancer rehabilitation (CR) clinics. Secondary aims included evaluation of the relationship between obesity and SB among race, types of cancer, comorbid conditions and differences in symptom severity on the Edmonton Symptom Assessment Scale (ESAS) questionnaire across body mass index.

Background:

Obesity is a risk factor for some types of breast and gynecologic cancers. Studies have shown an increased risk for pain persistence and higher symptom severity experienced by obese female patients who undergo oncologic treatments. The severity of symptom burden (SB), however, has not been studied in obese oncologic patients in the rehabilitation medicine setting.

Methods:

Retrospective chart review study in CR clinics, single institution. All the medical records of female patients (n = 61) who completed ESAS on initial evaluation in CR clinics were evaluated, from August 2020 to January 2022.

Results:

Obese female patients reported increased SB based on the ESAS questionnaire, specifically three symptom domains: pain, drowsiness, and spiritual distress.

Conclusions:

Nutrition counseling and lifestyle modifications in CR clinics may positively impact SB.
Goal attainment with integrated upper limb spasticity management including botulinum toxin-A (BoNT-A): Subanalysis of Australian data from the ULIS-III study
Authors: Luk Edwin , Baguley Ian J. , Olver John , Nunan Rachael , Estell John , Gonzalez Senen , Marinkovich Dion , Grandoulier Anne-Sophie , Turner-Stokes Lynne
Published: December 2023

Background:

Primary results from the international upper limb international spasticity-III study provided robust evidence for the benefit of repeated cycles of botulinum toxin-A (BoNT-A) for upper limb spasticity.

Objectives:

Internationally, patients with active function goals tended to require more frequent injections, and we hypothesized that reimbursement restrictions in Australia (which typically limited the number of injections received) may have adversely impacted outcomes compared with the international cohort.

Methods:

Upper Limb International Spasticity-III was a prospective, observational study following adults living with spasticity over 2 years of goal-directed upper limb spasticity management including repeated BoNT-A treatment.

Results:

The Australian subgroup included 115 patients (mean±SD age 53.8±16.9 years, 56% male, 79% stroke etiology), of whom 74% had previously been treated with BoNT-A. Australian participants had fewer injection cycles [2.7 (2.3, 3.0) vs. 4.1 (4.0, 4.3)] with longer injection intervals [330.6 (280.3, 381.0) vs. 200.3 (189.4, 211.1) days] than the international cohort. Across each evaluation cycle, patients in the Australian subgroup showed a change from baseline in Goal Attainment Scaling (GAS) T scores of >10, confirming relevant improvement. At 2 years, cumulated GAS T scores were 47.9 (46.4, 49.4) for the Australian subgroup versus 49.7 (49.3, 50.1) in the international cohort. Active function goals were generally underachieved in the Australian subgroup (mean cumulated GAS-T-score 43.6 (41.6, 45.6) vs. 47.4 (46.5, 48.3) internationally].

Conclusions:

As anticipated, the Australian cohort had fewer injection cycles with longer intervals than seen internationally. Their overall goal attainment was lower than for the total cohort, which appeared to be driven by less active function goal attainment. Among other possible factors, these data support the idea that restricted reimbursement may have impacted BoNT-A injection frequency and consequently, patient outcomes.
Canadian Kidney Transplant Professionals’ Perspectives on Precision Medicine and Molecular Matching in Kidney Allocation
Authors: Affdal Aliya , Ballesteros Fabian , Malo Marie-Françoise , Sancho Carina , Cochran-Mavrikakis Savannah-Lou , Bryan Stirling , Keown Paul , Sapir-Pichhadze Ruth , Fortin Marie-Chantal
Published: December 2023

Background.

Antibody-mediated rejection is an important cause of kidney transplant loss. A new strategy requiring application of precision medicine tools in transplantation considers molecular compatibility between donors and recipients and holds the promise of improved immunologic risk, preventing rejection and premature graft loss. The objective of this study was to gather Canadian transplant professionals’ perspectives on molecular compatibility in kidney transplantation.

Methods.

Seventeen Canadian transplant professionals (14 nephrologists, 2 nurses, and 1 surgeon) participated in semistructured interviews in 2021. The interviews were digitally recorded, transcribed, and analyzed using the qualitative description approach.

Results.

Participants identified fair access to transplantation as the most important principle in kidney allocation. Molecular compatibility was viewed as a promising innovation. However, participants were concerned about increased waiting times, negative impact on some patients, and potential problems related to the adequacy of information explaining this new technology. To mitigate the challenges associated with molecular matching, participants suggested integrating a maximum waiting time for molecular-matched kidneys and expanding the program nationally/internationally.

Conclusions.

Molecular matching in kidney transplantation is viewed as a promising technology for decreasing the incidence of antibody-mediated rejection and improving graft survival. Further studies are needed to determine how to ethically integrate this technology into the kidney allocation algorithm.
Trabecular Bone Score Improves Early After Successful Kidney Transplantation Irrespective of Antiresorptive Therapy and Changes in Bone Mineral Density
Authors: Strømmen Ruth C. , Godang Kristin , Finnes Trine E. , Smerud Knut T. , Reisæter Anna V. , Hartmann Anders , Åsberg Anders , Bollerslev Jens , Pihlstrøm Hege K.
Published: December 2023

Background.

Trabecular bone score (TBS) is a new tool to assess trabecular bone microarchitecture based on standard dual-energy x-ray absorptiometry (DXA) of lumbar spine images. TBS may be important to assess bone quality and fracture susceptibility in kidney transplant recipients (KTRs). This study aimed to investigate the effect of different bone therapies on TBS in KTRs.

Methods.

We reanalyzed DXA scans to assess TBS in 121 de novo KTRs at baseline, 10 wk, and 1 y. This cohort, between 2007 and 2009, participated in a randomized, placebo-controlled trial evaluating the effect of ibandronate versus placebo in addition to vitamin D and calcium.

Results.

Although bone mineral density (BMD) Z scores showed a subtle decrease in the first weeks, TBS Z scores increased from baseline to 10 wk for both treatment groups, followed by a slight decline at 12 mo. When comparing treatment groups and adjusting for baseline TBS, there were no differences found in TBS at 12 mo (P = 0.419). Correlation between TBS and BMD at baseline was weak (Spearman’s ρ = 0.234, P = 0.010), and change in TBS was not correlated with changes in lumbar spine BMD in either of the groups (ρ = 0.003, P = 0.973).

Conclusions.

Treatment with ibandronate or vitamin D and calcium did not affect bone quality as measured by TBS in de novo KTRs, but TBS increased early, irrespective of intervention. Changes in TBS and BMD during the study period were not correlated, indicating that these measurements reflect different aspects of bone integrity. TBS may complement BMD assessment in identifying KTRs with a high fracture risk.
Order and change in art: towards an active inference account of aesthetic experience
Authors: Van de Cruys Sander , Frascaroli Jacopo , Friston Karl
Published: December 2023

How to account for the power that art holds over us? Why do artworks touch us deeply, consoling, transforming or invigorating us in the process? In this paper, we argue that an answer to this question might emerge from a fecund framework in cognitive science known as predictive processing (a.k.a. active inference). We unpack how this approach connects sense-making and aesthetic experiences through the idea of an ‘epistemic arc’, consisting of three parts (curiosity, epistemic action and aha experiences), which we cast as aspects of active inference. We then show how epistemic arcs are built and sustained by artworks to provide us with those satisfying experiences that we tend to call ‘aesthetic’. Next, we defuse two key objections to this approach; namely, that it places undue emphasis on the cognitive component of our aesthetic encounters—at the expense of affective aspects—and on closure and uncertainty minimization (order)—at the expense of openness and lingering uncertainty (change). We show that the approach offers crucial resources to account for the open-ended, free and playful behaviour inherent in aesthetic experiences. The upshot is a promising but deflationary approach, both philosophically informed and psychologically sound, that opens new empirical avenues for understanding our aesthetic encounters.

This article is part of the theme issue ‘Art, aesthetics and predictive processing: theoretical and empirical perspectives’.
Metaphors or mechanism? Predictive coding and a (brief) history of empirical study of the arts
Authors: Leder Helmut , Pelowski Matthew
Published: December 2023

Predictive processing (PP) offers an intriguing approach to perception, cognition, but also to appreciation of the arts. It does this by positing both a theoretical basis—one might say a ‘metaphor’—for how we engage and respond, placing emphasis on mismatches rather than fluent overlap between schema and environment. Even more, it holds the promise for translating metaphor into neurobiological bases, suggesting a means for considering mechanisms—from basic perceptions to possibly even our complex, aesthetic experiences. However, while we share the excitement of this promise, the history of empirical or psychological aesthetics is also permeated by metaphors that have progressed our understanding but which also tend to elude translation into concrete, mechanistic operationalization—a challenge that can also be made to PP. We briefly consider this difficulty of convincing implementation of PP via a brief historical outline of some developments in the psychological study of aesthetics and art in order to show how these ideas have often anticipated PP but also how they have remained at the level of rather metaphorical and difficult-to-measure concepts. Although theoretical in scope, we hope that this commentary will spur researchers to reflect on PP with the aim of translating metaphorical explanations into well-defined mechanisms in future empirical study.

This article is part of the theme issue ‘Art, aesthetics and predictive processing: theoretical and empirical perspectives’.
LLM Instruction-Example Adaptive Prompting (LEAP) Framework for Clinical Relation Extraction
Authors: Zhou Huixue , Li Mingchen , Xiao Yongkang , Yang Han , Zhang Rui
Published: December 2023

Objective

To investigate the demonstration in Large Language Models (LLMs) for clinical relation extraction. We focus on examining two types of adaptive demonstration: instruction adaptive prompting, and example adaptive prompting to understand their impacts and effectiveness.

Materials and Methods

The study unfolds in two stages. Initially, we explored a range of demonstration components vital to LLMs’ clinical data extraction, such as task descriptions and examples, and tested their combinations. Subsequently, we introduced the Instruction-Example Adaptive Prompting (LEAP) Framework, a system that integrates two types of adaptive prompts: one preceding instruction and another before examples. This framework is designed to systematically explore both adaptive task description and adaptive examples within the demonstration. We evaluated LEAP framework’s performance on the DDI and BC5CDR chemical interaction datasets, applying it across LLMs such as Llama2-7b, Llama2-13b, and MedLLaMA_13B.

Results

The study revealed thatInstruction + Options + Examplesand its expanded form substantially raised F1-scores over the standardInstruction + Optionsmode. LEAP framework excelled, especially with example adaptive prompting that outdid traditional instruction tuning across models. Notably, the MedLLAMA-13b model scored an impressive 95.13 F1 on the BC5CDR dataset with this method. Significant improvements were also seen in the DDI 2013 dataset, confirming the method’s robustness in sophisticated data extraction.

Conclusion

The LEAP framework presents a promising avenue for refining LLM training strategies, steering away from extensive finetuning towards more contextually rich and dynamic prompting methodologies.
The effect of long-term sleep disruption on the brain – looking beyond amyloid
Authors: Mentink L.J. , van Osch M.J.P. , Bakker L.J. , Olde Rikkert M.G.M. , Beckmann C.F. , Claassen J.A.H.R. , Haak K.V.
Published: December 2023

The mechanism underlying the possible causal association between long-term sleep disruption and Alzheimer’s disease remains unclear [1]. A hypothesised pathway through increased brain amyloid load was not confirmed in previous work in our cohort of maritime pilots with long-term work-related sleep disruption [2]. Here, using functional MRI, T2-FLAIR and Arterial Spin Labeling MRI scans, we explored alternative neuroimaging biomarkers related to both sleep disruption and AD: resting-state network co-activation and between-network connectivity of the default mode network (DMN), salience network (SAL) and frontoparietal network (FPN), vascular damage and cerebral blood flow (CBF).

We acquired data of 16 maritime pilots (56 ± 2.3 years old) with work-related long-term sleep disruption (23 ± 4.8 working years) and 16 healthy controls (59 ± 3.3 years old), with normal sleep patterns (Pittsburgh Sleep Quality Index ≤ 5). Maritime pilots did not show altered co-activation in either the DMN, FPN, or SAL and no differences in between-network connectivity. We did not detect increased markers of vascular damage in maritime pilots, and additionally, maritime pilots did not show altered CBF-patterns compared to healthy controls.

In summary, maritime pilots with long-term sleep disruption did not show neuroimaging markers indicative of preclinical AD compared to healthy controls. These findings do not resemble those of short-term sleep deprivation studies. This could be due to resiliency to sleep disruption or selection bias, as participants have already been exposed to and were able to deal with sleep disruption for multiple years, or to compensatory mechanisms [3]. This suggests the relationship between sleep disruption and AD is not as strong as previously implied in studies on short-term sleep deprivation, which would be beneficial for all shift workers suffering from work-related sleep disruptions.
Reduced Lateralization of Multiple Functional Brain Networks in Autistic Males
Authors: Peterson Madeline , Prigge Molly B. D. , Floris Dorothea L. , Bigler Erin D. , Zielinski Brandon , King Jace B. , Lange Nicholas , Alexander Andrew L. , Lainhart Janet E. , Nielsen Jared A.
Published: December 2023

Background

Autism spectrum disorder has been linked to a variety of organizational and developmental deviations in the brain. One such organizational difference involves hemispheric lateralization, which may be localized to language-relevant regions of the brain or distributed more broadly.

Methods

In the present study, we estimated brain hemispheric lateralization in autism based on each participant’s unique functional neuroanatomy rather than relying on group-averaged data. Additionally, we explored potential relationships between the lateralization of the language network and behavioral phenotypes including verbal ability, language delay, and autism symptom severity. We hypothesized that differences in hemispheric asymmetries in autism would be limited to the language network, with the alternative hypothesis of pervasive differences in lateralization. We tested this and other hypotheses by employing a cross-sectional dataset of 118 individuals (48 autistic, 70 neurotypical). Using resting-state fMRI, we generated individual network parcellations and estimated network asymmetries using a surface area-based approach. A series of multiple regressions were then used to compare network asymmetries for eight significantly lateralized networks between groups.

Results

We found significant group differences in lateralization for the left-lateralized Language (d = −0.89), right-lateralized Salience/Ventral Attention-A (d = 0.55), and right-lateralized Control-B (d = 0.51) networks, with the direction of these group differences indicating less asymmetry in autistic individuals. These differences were robust across different datasets from the same participants. Furthermore, we found that language delay stratified language lateralization, with the greatest group differences in language lateralization occurring between autistic individuals with language delay and neurotypical individuals.

Limitations

The generalizability of our findings is restricted due to the male-only sample and greater representation of individuals with high verbal and cognitive performance.

Conclusions

These findings evidence a complex pattern of functional lateralization differences in autism, extending beyond the Language network to the Salience/Ventral Attention-A and Control-B networks, yet not encompassing all networks, indicating a selective divergence rather than a pervasive one. Furthermore, a differential relationship was identified between Language network lateralization and specific symptom profiles (namely, language delay) of autism.
Evaluating Augmentation Approaches for Deep Learning-based Major Depressive Disorder Diagnosis with Raw Electroencephalogram Data*
Authors: Ellis Charles A. , Miller Robyn L. , Calhoun Vince D.
Published: December 2023

While deep learning methods are increasingly applied in research contexts for neuropsychiatric disorder diagnosis, small dataset size limits their potential for clinical translation. Data augmentation (DA) could address this limitation, but the utility of EEG DA methods remains relatively underexplored in neuropsychiatric disorder diagnosis. In this study, we train a model for major depressive disorder diagnosis. We then evaluate the utility of 6 EEG DA approaches. Importantly, to remove the bias that could be introduced by comparing performance for models trained on larger augmented training sets to models trained on smaller baseline sets, we also introduce a new baseline trained on duplicate training data to better. We lastly examine the effects of the DA approaches upon representations learned by the model with a pair of explainability analyses. We find that while most approaches boost model performance, they do not improve model performance beyond that of simply using a duplicate training set without DA. The exception to this is channel dropout augmentation, which does improve model performance. These findings suggest the importance of comparing EEG DA methods to a baseline with a duplicate training set of equal size to the augmented training set. We also found that some DA methods increased model robustness to frequency (Fourier transform surrogates) and channel (channel dropout) perturbation. While our findings on EEG DA efficacy are restricted to our dataset and model, we hope that future studies on deep learning for small EEG datasets and on new EEG DA methods will find our findings helpful.
Automating literature screening and curation with applications to computational neuroscience
Authors: Ji Ziqing , Guo Siyan , Qiao Yujie , McDougal Robert A.
Published: December 2023

Objective

ModelDB (https://modeldb.science) is a discovery platform for computational neuroscience, containing over 1800 published model codes with standardized metadata. These codes were mainly supplied from unsolicited model author submissions, but this approach is inherently limited. We estimate we have captured only around one-third of NEURON models and lower fractions for other simulators. To more completely characterize the state of computational neuroscience modeling work, we aim to identify works containing results derived from computational neuroscience approaches and their standardized associated metadata (e.g. cell types, research topics).

Materials and Methods

Known computational neuroscience work from ModelDB and identified neuroscience work queried from PubMed were included in our study. After pre-screening with SPECTER2, GPT-3.5 and GPT-4 were used to identify likely computational neuroscience work and their relevant metadata.

Results

SPECTER2, GPT-4, and GPT-3.5 demonstrated varied but high abilities in identification of computational neuroscience work. GPT-4 achieved 96.9% accuracy and GPT-3.5 improved from 54.2% to 85.5% through instruction-tuning and Chain of Thought. GPT-4 also showed high potential in identifying relevant metadata annotations.

Discussion

Due to computational limitations, we only used each paper’s title and abstract, partially leading to false negatives. Further efforts should be devoted to including more training data and further improving current LLMs through fine-tuning approaches.

Conclusion

NLP and LLM techniques can be added to ModelDB to facilitate further model discovery, and will contribute to a more standardized and comprehensive framework for establishing domain-specific resources.