bluuebunny/crossref_metadata_2025 huggingface dataset:
Elevated CO2 concentration increases maize growth under water deficit or soil salinity but with a higher risk of hydraulic failure
Authors: Liu Junzhou , Hochberg Uri , Ding Risheng , Xiong Dongliang , Dai Zhanwu , Zhao Qing , Chen Jinliang , Ji Shasha , Kang Shaozhong
Published: September 2023

Climate change presents a challenge for plants to acclimate their water relations under changing environmental conditions, and may increase the risks of hydraulic failure under stress. In this study, maize plants were acclimated to two different CO2 concentrations ([CO2]; 400 ppm and 700 ppm) while under either water stress (WS) or soil salinity (SS) treatments, and their growth and hydraulic traits were examined in detail. Both WS and SS inhibited growth and had significant impacts on hydraulic traits. In particular, the water potential at 50% loss of stem hydraulic conductance (P50) decreased by 1 MPa in both treatments at 400 ppm. When subjected to elevated [CO2], the plants under both WS and SS showed improved growth by 7–23%. Elevated [CO2] also significantly increased xylem vulnerability (measured as loss of conductivity with decreasing xylem pressure), resulting in smaller hydraulic safety margins. According to the plant desiccation model, the critical desiccation degree (time×vapor pressure deficit) that the plants could tolerate under drought was reduced by 43–64% under elevated [CO2]. In addition, sensitivity analysis showed that P50 was the most important trait in determining the critical desiccation degree. Thus, our results demonstrated that whilst elevated [CO2] benefited plant growth under WS or SS, it also interfered with hydraulic acclimation, thereby potentially placing the plants at a higher risk of hydraulic failure and increased mortality.
Extending lunar impact flash observations into the daytime with short-wave infrared
Authors: Sheward D , Delbo M , Avdellidou C , Cook A , Lognonné P , Munaibari E , Zanatta L , Mercatali A , Delbo S , Tanga P
Published: September 2023

Lunar impact flash (LIF) observations typically occur in R, I, or unfiltered light, and are only possible during night, targeting the night side of a 10–60 per cent illumination Moon, while >10° above the observers horizon. This severely limits the potential to observe, and therefore the number of lower occurrence, high energy impacts observed is reduced. By shifting from the typically used wavelengths to the J-band short-wave infrared, the greater spectral radiance for the most common temperature (2750 K) of LIFs and darker skies at these wavelengths enables LIF monitoring to occur during the daytime, and at greater lunar illumination phases than currently possible. Using a 40.0 cm f/4.5 Newtonian reflector with a Ninox 640SU camera and a J-band filter, we observed several stars and lunar nightside at various times to assess the theoretical limits of the system. We then performed LIF observations during both day and night to maximize the chances of observing a confirmed LIF to verify the methods. We detected 61 > 5σ events, from which 33 candidate LIF events could not be discounted as false positives. One event was confirmed by multiframe detection, and by independent observers observing in visible light. While this LIF was observed during the night, the observed signal can be used to calculate the equivalent signal-to-noise ratio for a similar daytime event. The threshold for daylight LIF detection was found to be between Jmag = +3.4 ± 0.18 and Jmag = +5.6 ± 0.18 (equivalent to Vmag = +4.5 and Vmag = +6.7, respectively, at 2750 K). This represents an increase in opportunity to observe LIFs by almost 500 per cent.
Dynamical energy dissipation of relativistic magnetic bullets
Authors: Kusafuka Yo , Asano Katsuaki , Ohmura Takumi , Kawashima Tomohisa
Published: September 2023

To demonstrate the magnetic energy dissipation via relativistic shocks, we carry out spherically symmetrical one-dimensional special relativistic magnetohydrodynamic simulations of highly magnetized outflows with an adaptive mesh refinement method. We first investigate the details of the dynamical energy dissipation via interaction between a single ejecta and an external medium. The energy dissipation time-scales, which affect the early behaviour of the afterglow emission in gamma-ray bursts, are estimated for a wide range of magnetization. In addition, we demonstrate the internal shock dissipation in multiple interactions between magnetically dominated relativistic ejecta and kinetically dominated non-relativistic winds. Our numerical results show that ∼10 per cent of the magnetic energy in the ejecta can be converted into the thermal energy of the relativistic and low-magnetized outflows via shocks in the rarefaction waves or the winds. Such hot and less magnetized outflows are relevant for observed non-thermal emissions in blazars or gamma-ray bursts.
Precise self-calibration of interloper bias in spectroscopic surveys
Authors: Peng Hui , Yu Yu
Published: September 2023

Interloper contamination due to line misidentification is an important issue in the future low-resolution spectroscopic surveys. We realize that the algorithm previously used for photometric redshift self-calibration, with minor modifications, can be particularly applicable to calibrate the interloper bias. In order to explore the robustness of the modified self-calibration algorithm, we construct the mock catalogues based on China Space Station Telescope (CSST), taking two main target emission lines, Hα and [O iii]. The self-calibration algorithm is tested in cases with different interloper fractions at 1 per cent, 5 per cent, and 10 per cent. We find that the interloper fraction and mean redshift in each redshift bin can be successfully reconstructed at the level of ∼ 0.002 and ∼ 0.001(1 + z), respectively. We also find the impact of the cosmic magnification can be significant, which is usually ignored in previous works, and therefore propose a convenient and efficient method to eliminate it. Using the elimination method, we show that the calibration accuracy can be effectively recovered with slightly larger uncertainty.
Understanding molecular abundances in star-forming regions using interpretable machine learning
Authors: Heyl Johannes , Butterworth Joshua , Viti Serena
Published: September 2023

Astrochemical modelling of the interstellar medium typically makes use of complex computational codes with parameters whose values can be varied. It is not always clear what the exact nature of the relationship is between these input parameters and the output molecular abundances. In this work, a feature importance analysis is conducted using SHapley Additive exPlanations (SHAP), an interpretable machine learning technique, to identify the most important physical parameters as well as their relationship with each output. The outputs are the abundances of species and ratios of abundances. In order to reduce the time taken for this process, a neural network emulator is trained to model each species’ output abundance and this emulator is used to perform the interpretable machine learning. SHAP is then used to further explore the relationship between the physical features and the abundances for the various species and ratios we considered. H2O and CO’s gas phase abundances are found to strongly depend on the metallicity. NH3 has a strong temperature dependence, with there being two temperature regimes (<100 K and >100 K). By analysing the chemical network, we relate this to the chemical reactions in our network and find the increased temperature results in increased efficiency of destruction pathways. We investigate the HCN/HNC ratio and show that it can be used as a cosmic thermometer, agreeing with the literature. This ratio is also found to be correlated with the metallicity. The HCN/CS ratio serves as a density tracer, but also has three separate temperature-dependence regimes, which are linked to the chemistry of the two molecules.
Glioma genetic profiles associated with electrophysiologic hyperexcitability
Authors: Tobochnik Steven , Dorotan Maria Kristina C , Ghosh Hia S , Lapinskas Emily , Vogelzang Jayne , Reardon David A , Ligon Keith L , Bi Wenya Linda , Smirnakis Stelios M , Lee Jong Woo
Published: September 2023

Background

Distinct genetic alterations determine glioma aggressiveness, however, the diversity of somatic mutations contributing to peritumoral hyperexcitability and seizures over the course of the disease is uncertain. This study aimed to identify tumor somatic mutation profiles associated with clinically significant hyperexcitability.

Methods

A single center cohort of adults with WHO grades 1–4 glioma and targeted exome sequencing (n = 1716) was analyzed and cross-referenced with a validated EEG database to identify the subset of individuals who underwent continuous EEG monitoring (n = 206). Hyperexcitability was defined by the presence of lateralized periodic discharges and/or electrographic seizures. Cross-validated discriminant analysis models trained exclusively on recurrent somatic mutations were used to identify variants associated with hyperexcitability.

Results

The distribution of WHO grades and tumor mutational burdens were similar between patients with and without hyperexcitability. Discriminant analysis models classified the presence or absence of EEG hyperexcitability with an overall accuracy of 70.9%, regardless of IDH1 R132H inclusion. Predictive variants included nonsense mutations in ATRX and TP53, indel mutations in RBBP8 and CREBBP, and nonsynonymous missense mutations with predicted damaging consequences in EGFR, KRAS, PIK3CA, TP53, and USP28. This profile improved estimates of hyperexcitability in a multivariate analysis controlling for age, sex, tumor location, integrated pathologic diagnosis, recurrence status, and preoperative epilepsy. Predicted somatic mutation variants were over-represented in patients with hyperexcitability compared to individuals without hyperexcitability and those who did not undergo continuous EEG.

Conclusion

These findings implicate diverse glioma somatic mutations in cancer genes associated with peritumoral hyperexcitability. Tumor genetic profiling may facilitate glioma-related epilepsy prognostication and management.
Superconductivity with Tc of 116 K discovered in antimony polyhydrides
Authors: Lu Ke , He Xin , Zhang Changling , Li Zhiwen , Zhang Sijia , Min Baosen , Zhang Jun , Zhao Jianfa , Shi Luchuan , Peng Yi , Feng Shaomin , Liu Qingqing , Song Jing , Yu Richeng , Wang Xiancheng , Wang Yu , Bykov Maxim , Jin Changqing
Published: September 2023

Superconductivity (SC) was experimentally observed for the first time in antimony polyhydride. The diamond anvil cell combined with a laser heating system was used to synthesize the antimony polyhydride sample at high pressure and high temperature. In-situ high pressure transport measurements as a function of temperature with an applied magnetic field were performed to study the SC properties. It was found that the antimony polyhydride samples show superconducting transition with critical temperature Tc 116 K at 184 GPa. The investigation of SC at magnetic field revealed the superconducting coherent length of ∼40 Å based on the Ginzburg Landau (GL) equation. Antimony polyhydride superconductor has the second highest Tc in addition to sulfur hydride among the polyhydrides of elements from main groups IIIA to VIIA in the periodic table.
A Cross-Sectional Survey on Oral Nicotine Pouches: Characterizing Use-Motives, Topography, Dependence Levels, and Adverse Events
Authors: Dowd Ashley N , Thrul Johannes , Czaplicki Lauren , Kennedy Ryan D , Moran Meghan B , Spindle Tory R
Published: September 2023

Introduction

Oral nicotine pouches (ONPs) contain a crystalized nicotine powder instead of tobacco leaves. ONPs come in a variety of flavors and are often marketed as “tobacco-free,” but research on ONP use-motivations and related experiences is limited.

Aims and Methods

This cross-sectional web-based survey collected self-report data on ONP use-characteristics (eg, frequency), brands and flavors used, use-motivations, dependence (Fagerström Test for Nicotine Dependence-Smokeless Tobacco [FTND-ST]), and ONP-related adverse events (AEs) experienced.

Results

The sample included 118 adults who reported current (past 30-day) ONP use. On average (SD), participants reported ONP use on 13 (6) days during the past month. Most participants (% of the sample) also reported the use of tobacco cigarettes (74%) and/or electronic cigarettes (53%) during the past month. Zyn (27%) and Lucy (19%) were the most currently used ONP brands with mint (23%) and tobacco (16%) as the most currently used flavors. The availability of preferred flavors was the most frequently reported (31%) ONP use-motivation. The sample demonstrated significant dependence levels (FTND-ST = 7, SD = 2). Reported AEs included mouth lesions (48%), upset stomach (39%), sore mouth (37%), sore throat (21%), and nausea (9%). Results should be interpreted in the context of study limitations, including using a relatively small and homogeneous online convenience sample. Acknowledging the limitations, this sample was deemed appropriate to include considering the novelty of the findings, the dearth of related research, and the necessity of examining foundational ONP use-characteristics (eg, topography, AEs); however, future research should consider recruiting larger and more generalizable samples.

Conclusions

The availability of preferred flavors was a key ONP use-motivation in this sample. Mint and tobacco were the most currently used flavors, with Zyn and Lucy being the most currently used ONP brands. Participants reported dependence and a substantial number of ONP-related AEs. Nationally representative surveys should investigate ONP use along with outcomes included in the current study (eg, AEs) to inform ONP surveillance and policy development efforts.

Implications

This study is among the first to assess reasons for initiating/maintaining ONP use as well as other relevant use-experiences (eg, AEs, dependence). These results highlight the role of flavors and nicotine dependence in ONP use, which are important considerations for informing ONP regulations.
Application of Deep Learning in Clinical Settings for Detecting and Classifying Malaria Parasites in Thin Blood Smears
Authors: Wang Geng , Luo Guoju , Lian Heqing , Chen Lei , Wu Wei , Liu Hui
Published: September 2023

Background

Scarcity of annotated image data sets of thin blood smears makes expert-level differentiation among Plasmodium species challenging. Here, we aimed to establish a deep learning algorithm for identifying and classifying malaria parasites in thin blood smears and evaluate its performance and clinical prospect.

Methods

You Only Look Once v7 was used as the backbone network for training the artificial intelligence algorithm model. The training, validation, and test sets for each malaria parasite category were randomly selected. A comprehensive analysis was performed on 12 708 thin blood smear images of various infective stages of 12 546 malaria parasites, including P falciparum, P vivax, P malariae, P ovale, P knowlesi, and P cynomolgi. Peripheral blood samples were obtained from 380 patients diagnosed with malaria. Additionally, blood samples from monkeys diagnosed with malaria were used to analyze P cynomolgi. The accuracy for detecting Plasmodium-infected blood cells was assessed through various evaluation metrics.

Results

The total time to identify 1116 malaria parasites was 13 seconds, with an average analysis time of 0.01 seconds for each parasite in the test set. The average precision was 0.902, with a recall and precision of infected erythrocytes of 96.0% and 94.9%, respectively. Sensitivity and specificity exceeded 96.8% and 99.3%, with an area under the receiver operating characteristic curve >0.999. The highest sensitivity (97.8%) and specificity (99.8%) were observed for trophozoites and merozoites.

Conclusions

The algorithm can help facilitate the clinical and morphologic examination of malaria parasites.
Photometric and spectroscopic properties of the eclipsing system V864 Monocerotis
Authors: Park Jang-Ho , Lee Jae Woo , Hong Kyeongsoo
Published: September 2023

We present the orbital period variability and evolutionary status of the W UMa-type binary system V864 Mon from accurately measured fundamental parameters. New BV photometric observations of this system were performed in 2019 January and 2022 January, and the first high-resolution spectroscopic observations were carried out on three nights between 2019 January and March. A total of 29 times of minimum light were collected to examine the behavior of the orbital period. Our analysis of these timings indicates a continuous period increase at a rate of +2.62 × 10−7 d yr−1 over the past 20 years, which can be interpreted as a mass transfer from the less massive primary to the secondary component with a rate of 1.22 × 10−7 M⊙ yr−1. We measured the radial velocities (RVs) for both components, and determined the effective temperature and projected rotational velocity of the more massive secondary star to be Teff,2 = 5450 ± 94 K and v2sin i = 192 ± 40 km s−1, respectively, from the comparison of the observed spectrum at the primary minimum and the theoretical models. The individual masses and radii of both components were determined from a simultaneous analysis of the light and RV curves, which are M1 = 0.34 ± 0.02 M⊙, R1 = 0.69 ± 0.01 R⊙, and M2 = 1.06 ± 0.04 M⊙, R2 = 1.16 ± 0.02 R⊙, respectively. Our results indicate that V864 Mon is a W-subtype of W UMa stars with time-varying spot activity. The positions in the mass-luminosity and mass-radius diagrams indicate that the secondary star belongs to the main-sequence region, while the hotter primary is located beyond the terminal-age main sequence.
Research Agenda for Physical Therapy From the American Physical Therapy Association
Authors: Stevens-Lapsley Jennifer , Hicks Gregory E , Zimney Kory , Slaven Emily J , Manal Tara Jo , Jeffries Lynn M
Published: September 2023

Research agendas play an important role in directing scholarly inquiry in a field. The Research Agenda for Physical Therapy From the American Physical Therapy Association (APTA) outlines research priorities that are vital to advancing physical therapist practice and the profession. The development of the research agenda included multiple iterative steps and feedback from stakeholders. A research agenda subgroup (n = 6) of the APTA Scientific and Practice Affairs Committee (SPAC), with APTA staff support, gathered information on existing research agendas, developed draft priority descriptions, and gathered feedback via surveys. The subgroup first conducted an environmental scan of the research agendas in the physical therapy and rehabilitation fields. To gather information about research priorities, APTA’s Technology and Organizational Performance department distributed a survey to 3 samples. APTA staff organized the feedback, and SPAC edited and synthesized a draft agenda. This draft was sent out in survey form to the original samples and to members of the APTA Academy of Research. Concurrently, a repeat environmental scan was conducted. A final draft of the research agenda was sent for final review to a smaller cohort (n = 95) that included content experts in each of the main categories of the agenda as identified by the APTA Academy of Research. The SPAC research agenda subgroup reviewed and incorporated the information into the final draft. The final research agenda includes priorities in topical areas (population health, mechanistic research, clinical research, education/professional development research, health services research, and workforce development) identified as key in the evolution of our profession.

Impact

The Research Agenda for Physical Therapy From APTA identifies research priorities within the profession vital to advancing the practice and profession of physical therapy. The research agenda has 6 key areas of focus: population health research, mechanistic research, clinical research, education and professional development research, health services research, and workforce research. Researchers, funding agencies, and public policy makers can use the research agenda to concentrate research efforts around these areas.
Tetrahedral framework nucleic acids enhance the chondrogenic potential of human umbilical cord mesenchymal stem cells via the PI3K/AKT axis
Authors: Fu Liwei , Li Pinxue , Wu Jiang , Zheng Yazhe , Ning Chao , Liao Zhiyao , Yuan Xun , Ding Zhengang , Zhang Zhichao , Sui Xiang , Shi Sirong , Liu Shuyun , Guo Quanyi
Published: September 2023

The field of regenerative medicine faces a notable challenge in terms of the regeneration of articular cartilage. Without proper treatment, it can lead to osteoarthritis. Based on the research findings, human umbilical cord mesenchymal stem cells (hUMSCs) are considered an excellent choice for regenerating cartilage. However, there is still a lack of suitable biomaterials to control their ability to self-renew and differentiate. To address this issue, in this study using tetrahedral framework nucleic acids (tFNAs) as a new method in an in vitro culture setting to manage the behaviour of hUMSCs was proposed. Then, the influence of tFNAs on hUMSC proliferation, migration and chondrogenic differentiation was explored by combining bioinformatics methods. In addition, a variety of molecular biology techniques have been used to investigate deep molecular mechanisms. Relevant results demonstrated that tFNAs can affect the transcriptome and multiple signalling pathways of hUMSCs, among which the PI3K/Akt pathway is significantly activated. Furthermore, tFNAs can regulate the expression levels of multiple proteins (GSK3β, RhoA and mTOR) downstream of the PI3K-Akt axis to further enhance cell proliferation, migration and hUMSC chondrogenic differentiation. tFNAs provide new insight into enhancing the chondrogenic potential of hUMSCs, which exhibits promising potential for future utilization within the domains of AC regeneration and clinical treatment.
Characterization of a New, Country Bean (Lablab purpureus) Lineage of Bean Common Mosaic Necrosis Virus
Authors: Rahman Mohammad M. , Jarugula Sridhar , Bagewadi Basavaraj , Fayad Amer , Karasev Alexander V. , Naidu Rayapati A.
Published: September 2023

Country bean (Lablab purpureus, family Fabaceae) is grown in subsistence agriculture in Bangladesh as a multipurpose crop for food, animal feed, and green manure. This study was undertaken to investigate the genetic diversity of bean common mosaic necrosis virus (BCMNV, genus Potyvirus, family Potyviridae) in country beans. Leaf samples from country beans showing yellowing, vein banding, and mosaic symptoms were collected during field surveys between 2015 and 2019 cropping seasons from farmers’ fields in different geographic regions. These samples were tested by serological and molecular diagnostic assays for the presence of BCMNV. Virus-positive samples were subjected to high-throughput Illumina sequencing to generate near-complete genomes of BCMNV isolates. In pairwise comparisons, the polyprotein sequences of BCMNV isolates from Bangladesh showed greater than 98% identities among themselves and shared less than 84% sequence identity at the nucleotide level with virus isolates reported from other countries. In the phylogenetic analysis, BCMNV isolates from Bangladeshi country beans formed a separate clade from virus isolates reported from common beans in other countries in the Americas, Africa, Europe, and from East Timor. Grow-out studies showed seed-to-seedling transmission of BCMNV, implying a possible seedborne nature of the virus in country beans.
Aggressiveness of Xanthomonas translucens pv. undulosa Isolates and Differential Reaction Among Spring Wheat Varieties Under a Controlled Environment
Authors: Hangamaisho A. , Bleakley B. H. , Ali S. , Yabwalo D. , Byamukama E.
Published: September 2023

Xanthomonas translucens pv. undulosa causes bacterial leaf streak (BLS) in wheat that can lead to up to 40% losses globally. Understanding the aggressiveness of isolates from different locations in a state may help in screening for BLS resistance in wheat-breeding programs for that area. A greenhouse study to determine the aggressiveness of 17 isolates collected from South Dakota on spring wheat cultivar SY-Rockford and differential reactions of 21 spring wheat varieties grown in South Dakota to BLS under greenhouse conditions was conducted in 2021 and 2022. To assess BLS severity, one randomly selected plant per pot was rated based on the percentage of leaf area with BLS symptoms. Significant differences among the bacterial isolates were observed, with Xtpvu21OC (23.33%) being the most aggressive in causing BLS in SY-Rockford. Spring wheat varieties MN Washburn (25.0%) and ND Frohberg (22.5%) were found to be the most susceptible to BLS. It is suggested that the most aggressive Xanthomonas translucens pv. undulosa isolate available to researchers in their region be used in screening varieties and lines for BLS resistance.
Effects of allergen immunotherapy on follicular regulatory T cells
Authors: Sun Shi-Ran , Yao Yin , Liu Zheng
Published: September 2023

Purpose of review

Emerging evidence indicating that the dysfunction of T follicular regulatory (TFR) cells contributes to excessive immunoglobulin E (IgE) production and the development of allergic diseases. Conversely, allergen immunotherapy (AIT) modulates TFR cells abundance and function to promote immune tolerance. This review focus on the role of TFR cells in allergic diseases and AIT, with the objective of providing novel insights into the mechanisms underlying immune tolerance of AIT and proposing the potential targeting of TFR cells in the context of allergic diseases.

Recent findings

Numerous studies have consistently demonstrated that TFR cells play a pivotal role in the inhibition of class switch recombination to IgE in both humans and specific murine models. This suppression is attributed to the actions of neuritin and IL-10 secreted by TFR cells, which exert direct and indirect effects on B cells. In patients with allergic rhinitis, reduced frequencies of circulating or tonsillar TFR cells have been reported, along with impaired functionality in suppressing IgE production. AIT, whether administered subcutaneously or sublingually, reinstates the frequency and functionality of TFR cells in allergic rhinitis patients, accompanied by changes of the chromatin accessibility of TFR cells. The increase in TFR cell frequency following AIT is associated with the amelioration of clinical symptoms.

TFR cells exert an inhibitory effect on IgE production and demonstrate a correlation with the clinical efficacy of AIT in patients with allergic rhinitis, suggesting TFR cells hold promise as a therapeutic target for allergic diseases and potential biomarker for AIT.
Force Profile as Surgeon-Specific Signature
Authors: Baghdadi Amir , Guo Eddie , Lama Sanju , Singh Rahul , Chow Michael , Sutherland Garnette R.
Published: September 2023

Objective:

To investigate the notion that a surgeon’s force profile can be the signature of their identity and performance.

Summary background data:

Surgeon performance in the operating room is an understudied topic. The advent of deep learning methods paired with a sensorized surgical device presents an opportunity to incorporate quantitative insight into surgical performance and processes. Using a device called the SmartForceps System and through automated analytics, we have previously reported surgeon force profile, surgical skill, and task classification. However, an investigation of whether an individual surgeon can be identified by surgical technique has yet to be studied.

Methods:

In this study, we investigate multiple neural network architectures to identify the surgeon associated with their time-series tool-tissue forces using bipolar forceps data. The surgeon associated with each 10-second window of force data was labeled, and the data were randomly split into 80% for model training and validation (10% validation) and 20% for testing. Data imbalance was mitigated through subsampling from more populated classes with a random size adjustment based on 0.1% of sample counts in the respective class. An exploratory analysis of force segments was performed to investigate underlying patterns differentiating individual surgical techniques.

Results:

In a dataset of 2819 ten-second time segments from 89 neurosurgical cases, the best-performing model achieved a micro-average area under the curve of 0.97, a testing F1-score of 0.82, a sensitivity of 82%, and a precision of 82%. This model was a time-series ResNet model to extract features from the time-series data followed by a linearized output into the XGBoost algorithm. Furthermore, we found that convolutional neural networks outperformed long short-term memory networks in performance and speed. Using a weighted average approach, an ensemble model was able to identify an expert surgeon with 83.8% accuracy using a validation dataset.

Conclusions:

Our results demonstrate that each surgeon has a unique force profile amenable to identification using deep learning methods. We anticipate our models will enable a quantitative framework to provide bespoke feedback to surgeons and to track their skill progression longitudinally. Furthermore, the ability to recognize individual surgeons introduces the mechanism of correlating outcome to surgeon performance.
Determinants of Outcome with Reoperative Surgery for Pseudomyxoma Peritonei in 186 Patients
Authors: Sugarbaker Paul H. , Chang David
Published: September 2023

Objective:

To describe the long-term survival and clinical- and treatment-related variables that determine the outcome of repeat cytoreductive surgery (CRS) for mucinous appendiceal neoplasms with peritoneal dissemination.

Summary Background:

After patients with peritoneal dissemination of an appendiceal mucinous neoplasm have a CRS, disease progression may require secondary cytoreductive surgery (SCRS) and other treatments performed in a timely manner to prolong survival and help preserve an optimal quality of life.

Methods:

The clinical- and treatment-related variables associated with the index CRS and the SCRS were statistically assessed for their impact on survival.

Results:

One hundred eighty-six of 687 complete CRS patients (27.1%) had SCRS. The median follow-up was 10 years and the median survival was 12 years. There were 95 males (51%) and the median age was 45.0 years. Survival benefit was associated with the index CRS by use of early postoperative intraperitoneal chemotherapy (EPIC) with 5-fluorouracil [Hazard ratio (HR), 0.4; P = 0.0004]. Also, survival of low-grade mucinous appendiceal neoplasms versus mucinous appendiceal adenocarcinoma (HR, 2.8; P < 0.0001) was improved. The interval between index CRS and SCRS was significant at ≤12 months versus 12–36 months versus >36 months (P < 0.0001). Change in peritoneal cancer index and disease distribution as focal or diffuse was significant by univariant and multivariant analyses.

Conclusions:

If the CRS was complete, the use of EPIC 5-fluorouracil, the interval between the index CRS and the SCRS, the histologic grade of the mucinous neoplasm, and the extent of recurrent disease were prognostic variables that should be used to help select patients for SCRS.
History and Evolution of Hip Design to Decrease Failure
Authors: Russell Thomas A. , Klima Matthew L.
Published: September 2023

The evolution of fracture fixation designs over the past 100 years is coupled with incredible advances in materials and manufacturing technology. Failures are unavoidable and should be evaluated from the perspective of refining our technology and technique to improve patient outcomes. Failure after intramedullary fixation of hip fractures is multifactorial with contributions from an unsuccessful surgery, some preventable, some unavoidable, and rarely, design and manufacturing errors. However, whenever implants are disseminated to large population groups with variable individual anatomy, physiology, and associated comorbidities, unexpected and unpredicted weaknesses in the design and surgical technique will be discovered. Surgeons have multiple choices for nail selection with specific and critical technical requirements. The surgeon should evaluate each patient individually and determine the treatment based on patient anatomy and morphology of the fracture. The surgical approach should be modified over time after deciding how best to improve surgical treatment based on the current scientific studies.
Pertrochanteric Nonunion: When and Why to Consider a Medullary Implant
Authors: Githens Michael
Published: September 2023

Pertrochanteric nonunion management is a technically challenging problem. When repair is undertaken rather than conversion arthroplasty, successful treatment revolves around accurate deformity correction, preservation of vascularity, and stable durable fixation. The decision to use an extramedullary or intramedullary implant should be influenced by nonunion-specific characteristics and patient-related conditions. Failure to understand these nuances when selecting an implant strategy often results in treatment failure. The primary purpose of this article was to discuss these variables and delineate when an intramedullary implant should be considered for treatment of a pertrochanteric nonunion. The secondary purpose was to describe the author's preferred surgical technique for implant-driven deformity correction and compression when choosing an intramedullary nail.
Residency Training Pathways of Program Directors and Chiefs/Chairs in Plastic Surgery
Authors: Lentskevich Marina A. , Reddy Narainsai K. , Yau Alice , Gosain Arun K.
Published: September 2023

Background:

Medical students interested in plastic surgery may become discouraged by barriers to career development during residency training. This study surveyed plastic surgery program directors (PDs) and chiefs/chairs to highlight the pathway followed by academic leaders in these positions.

Methods:

A self-administered anonymous survey was sent to a list of 189 PDs and chiefs/chairs identified via plastic surgery residency programs’ websites. Chi-squared tests assessed answer distributions.

Results:

Of the 189 recipients (25.9%), 49 completed the survey. Respondents’ medical school graduation range was 1973–2009. Seventeen respondents entered a plastic surgery residency directly after medical school, and 32 began in another specialty. Comparison between these two groups showed no significant differences in preference rank of their program (P = 0.671). A total of 18 respondents conducted an academic enrichment year, but timing of this year differed significantly based on the initial specialty match (P = 0.012). There was no significant perceived difficulty in gaining recognition by gender (P = 0.107) or race (P = 0.125). Six respondents did not match into the specialty of first choice; five did not complete their initial residency programs; three did not match into plastic surgery at first attempt.

Conclusions:

Information on residency training pathways and barriers to career development of current academic leaders will improve transparency as to potential stumbling blocks that current PDs and chief/chairs of plastic surgery residency programs have faced during their initial training. This will help current trainees anticipate these stumbling blocks and place these in perspective based on the experience of senior plastic surgeons.
Surgical Management of Sirenomelia: A Case Study
Authors: Bhagat Neel D. , Patel Aadarsh , Gross Jeffrey N. , Borschel Gregory H.
Published: September 2023

Background:

Sirenomelia is a rare congenital condition characterized by fusion of the lower limbs. Patients with sirenomelia generally do not survive long after birth because the condition is associated with multisystem organ dysfunction due to developmental anomalies. Considering the low incidence and few cases surviving the neonatal period, there is minimal understanding regarding the surgical management of sirenomelia. We present a unique case of an infant born with type 1 sirenomelia, absence of external genitalia, presence of a cloaca, absence of the bladder, and presence of an imperforate and vestigial anus, who not only survived the birth process, but, at the age of 11 months, was determined to be a candidate for surgical separation of the lower extremities.

Methods:

This case was approached much like a dorsal rectangular flap syndactyly release. Large Z-plasty flaps were designed and raised, and the soft tissue within the skin bridge was meticulously dissected to preserve anatomy and to provide adequate skin flaps without perineal skin grafting. A quadrangular flap was designed to reconstruct the perineum and produce a neo-vulva using de-epithelialization.

Results:

Successful lower extremity separation was achieved. There were no major postoperative complications. The patient progressed with lower extremity function, and eventually achieved independent ambulation.

Conclusions:

Management of sirenomelia is incredibly challenging, and data to guide surgical management are limited. This report details our approach to a successful lower extremity separation, repair, and neo-vulvar reconstruction in a case of type I sirenomelia.
Genotypes of Stim1 and the proximal region on chromosome 1 exert opposite effects on stroke susceptibility in stroke-prone spontaneously hypertensive rat
Authors: Ohara Hiroki , Takeuchi Fumihiko , Kato Norihiro , Nabika Toru
Published: September 2023

Background:

The stroke-prone spontaneously hypertensive rat (SHRSP) is a genetic model for cerebral stroke. Although a recent study on a congenic SHRSP suggested that a nonsense mutation in stromal interaction molecule 1 (Stim1) encoding a major component of store-operated Ca2+ entry was a causal variant for stroke in SHRSP, this was not conclusive because the congenic region including Stim1 in that rat was too wide. On the other hand, we demonstrated that the Wistar–Kyoto (WKY)-derived congenic fragment adjacent to Stim1 exacerbated stroke susceptibility in a congenic SHRSP called SPwch1.71. In the present study, we directly examined the effects of the Stim1 genotype on stroke susceptibility using SHRSP in which wild-type Stim1 was knocked in (called Stim1-KI SHRSP). The combined effects of Stim1 and the congenic fragment of SPwch1.71 were also investigated.

Methods:

Stroke susceptibility was assessed by the stroke symptom-free and survival periods based on observations of behavioral symptoms and reductions in body weight.

Results:

Stim1-KI SHRSP was more resistant to, while SPwch1.71 was more susceptible to stroke than the original SHRSP. Introgression of the wild-type Stim1 of Stim1-KI SHRSP into SPwch1.71 by the generation of F1 rats ameliorated stroke susceptibility in SPwch1.71. Gene expression, whole-genome sequencing, and biochemical analyses identified Art2b, Folr1, and Pde2a as possible candidate genes accelerating stroke in SPwch1.71.

Conclusion:

The substitution of SHRSP-type Stim1 to wild-type Stim1 ameliorated stroke susceptibility in both SHRSP and SPwch1.71, indicating that the nonsense mutation in Stim1 is causally related to stroke susceptibility in SHRSP.
Research Letter: TBI Severity Moderates the Association Between Subjective and Objective Attention in Older Veterans
Authors: Rantins Peter , Ly Monica , Clark Alexandra L. , Weigand Alexandra J. , Alshaheri Durazo Alin , Merritt Victoria C. , Bangen Katherine J. , Thomas Kelsey R.
Published: September 2023

Objective:

This study examined the moderating effect of traumatic brain injury (TBI) history on subjective and objective cognition across multiple cognitive domains.

Setting, Participants, and Design:

Participants included 242 Vietnam-era veterans with a history of no TBI (n = 86), mild TBI (n = 74), or moderate-to-severe TBI (n = 82) from the observational Department of Defense-Alzheimer's Disease Neuroimaging Initiative (DoD-ADNI) study.

Main Measures:

Objective cognition was the outcome and was measured using neuropsychological measures in the domains of memory, attention/executive functioning, and language. Subjective cognition was measured using the memory, divided attention, and language subscales from the Everyday Cognition (ECog) measure. TBI severity status was the moderating variable.

Results:

Veterans with a history of moderate-to-severe TBI had a stronger negative association between subjective and objective attention relative to participants without a TBI (P = .002). Although this association did not differ between mild TBI and no TBI history groups (P = .100), the association between subjective and objective attention for the mild TBI group was intermediate to the no TBI and moderate-to-severe TBI history groups. TBI status did not moderate associations between subjective and objective memory or language.

Conclusion:

Results highlight the importance of assessing subjective and objective cognition in older veterans and the relevance of attention in the context of TBI history. More work is needed to better understand the intersection of TBI and aging and how these factors may be used to guide individualized assessment and treatment approaches for older veterans.
Comparison Between Ocular Biometric Parameters and Intraocular Pressure With and Without Contact Lenses
Authors: Noya-Padin Veronica , Nores-Palmas Noelia , Giraldez Maria Jesus , Yebra-Pimentel Eva , Pena-Verdeal Hugo
Published: September 2023

Objectives:

To compare the values of central corneal thickness, anterior chamber depth (ACD), lens thickness (LT), vitreous length (VL), axial length (AL), and corneal-compensated intraocular pressure performed with and without contact lenses (CL).

Methods:

Forty volunteer participants (16 men and 24 women, 24.2±2.9 years) were recruited. In a single visit, participants underwent autorefraction, keratometry, biometry, topography, pachymetry, and tonometry with the naked eye (without CL). Then, biometry, pachymetry, and tonometry were repeated twice wearing two CL (somofilcon A and nesofilcon A) fitted in a random order.

Results:

Many of the ocular biometric values were affected by the use of CL during measurements (paired t test; all P≤0.003), except for LT and VL (Wilcoxon test; both P≥0.272). Corneal-compensated intraocular pressure was also affected by contact lens wear during measurements, obtaining lower values when wearing them (Wilcoxon test; all P≤0.001).

Conclusions:

Central corneal thickness, ACD, AL, and corneal-compensated intraocular pressure measurements cannot be performed while wearing CL. However, LT and VL measurements were not affected by any contact lens use. In addition, it was observed that ACD results from both devices are not interchangeable either when measured with the naked eye or using any contact lens.
Metrics of Anterior Sclera in Normal Chinese Adults: Anterior Segment Imaging Using the Swept-Source Optical Coherence Tomography
Authors: Lin Na , Sun Yunqi , Yang Maoyuan , Chen Bichi , Mao Jieli , Liu Yongshun , Deng Ruzhi
Published: September 2023

Purpose:

To measure the corneoscleral limbus and anterior sclera parameters of normal Chinese adults by swept-source optical coherence tomography (OCT).

Materials and Methods:

In this cross-sectional study, a total of 56 Chinese subjects with ametropia were evaluated in the Eye Hospital of Wenzhou Medical University from September 2020 to December 2020, including 26 (46.4%) men, with an average age of 24.7±1.8 years old. The OCT SS-1000 (CASIA, Tomey, Tokyo, Japan) was used to measure the sagittal height, corneoscleral junction (CSJ) angle, and scleral angle.

Results:

The chord was across the corneal center and the line connecting the center of the cornea and the center of the chord was perpendicular to the chord. The mean sagittal height at chord lengths of 10.0, 12.3, and 15.0 mm were 1,756±72, 2,658±110, and 3,676±155 μm, respectively. The absolute values of the differences between horizontal and vertical meridians at three chord lengths were 54±40, 70±67, and 117±95 μm, respectively. One-way analysis of variance showed that the differences of CSJ angles at 12.3-mm chord and scleral angles at 15.0-mm chord in the four segments were statistically significant (F values were 32.01 and 13.37, respectively, both P<0.001). The CSJ angles from low to high were 176.53±2.14° (nasal), 178.66±1.84° (inferior), 179.13±1.20° (temporal), and 179.31±1.68° (superior), and 87.5% of the nasal angles were less than 179°. The scleral angles from high to low were 38.35±2.47° (temporal), 38.26±3.37° (superior), 35.37±3.10° (nasal), and 35.30±4.71° (inferior).

Conclusions:

The morphology of corneoscleral limbus and anterior sclera is asymmetrical in normal Chinese adults. The nasal side of the corneoscleral limbus has the largest angle, and the superior and temporal sides of the scleral angle are larger.
A Pilot Study: Do Children Who Run Marathons Have More Osteoarthritis in the Lower Extremities as Adults
Authors: Roberts William O. , Kucera Neal S. , Miner Michael H.
Published: September 2023

Objective:

To compare self-reported osteoarthritis of the knee and hip in adults who ran at least 1 marathon as a child with adults who ran high-school cross country (HSCC).

Design:

Subject self-recall retrospective survey.

Setting:

Electronic survey.

Participants:

319 adults who either ran a marathon under age 18 or ran HSCC recruited from running clubs, marathon participants, and on-line interest groups.

Interventions:

Survey.

Main Outcome Measures:

Self-reported history of osteoarthritis (OA), joint pain, anterior cruciate ligament injury, still running or running marathons, and number of marathons as an adult.

Results:

One hundred twenty-three respondents ran a marathon under age 18 (26% female) and were 40 years old (sd 16) and 196 ran HSCC (53% female) and were 36 years old (sd 13). The mean age of first marathon was 15 (sd 2.3, range 5-17); 50% ran 1% and 50% ran >1 marathon. Child marathoners reported a family history of OA in knees or hips (26%) or a joint replacement (30%) compared with 24% and 28% of HSCC runners. 10% of child marathoners and 7% of HSCC reported OA and 24% and 21% reported daily or weekly joint pain. 91% of all respondents are still running; 78% of child marathoners (mean 17, range 1-91) and 80% HSCC ran ≥1 marathons as adults (mean 10, range 1-80).

Conclusions:

Adults who ran marathons as children compared with adults who ran HSCC self-report similar rates of the knee and hip OA, chose to participate of their own accord, continue to run as adults, played other sports, and did not “specialize” in marathons.