bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing Surgical Technique in Diverse Open Surgical Videos With Multitask Machine Learning
Authors: Goodman Emmett D. , Patel Krishna K. , Zhang Yilun , Locke William , Kennedy Chris J. , Mehrotra Rohan , Ren Stephen , Guan Melody , Zohar Orr , Downing Maren , Chen Hao Wei , Clark Jevin Z. , Berrigan Margaret T. , Brat Gabriel A. , Yeung-Levy Serena
Published: December 2023

Objective

To overcome limitations of open surgery artificial intelligence (AI) models by curating the largest collection of annotated videos and to leverage this AI-ready data set to develop a generalizable multitask AI model capable of real-time understanding of clinically significant surgical behaviors in prospectively collected real-world surgical videos.

Design, Setting, and Participants

The study team programmatically queried open surgery procedures on YouTube and manually annotated selected videos to create the AI-ready data set used to train a multitask AI model for 2 proof-of-concept studies, one generating surgical signatures that define the patterns of a given procedure and the other identifying kinematics of hand motion that correlate with surgeon skill level and experience. The Annotated Videos of Open Surgery (AVOS) data set includes 1997 videos from 23 open-surgical procedure types uploaded to YouTube from 50 countries over the last 15 years. Prospectively recorded surgical videos were collected from a single tertiary care academic medical center. Deidentified videos were recorded of surgeons performing open surgical procedures and analyzed for correlation with surgical training.

Exposures

The multitask AI model was trained on the AI-ready video data set and then retrospectively applied to the prospectively collected video data set.

Main Outcomes and Measures

Analysis of open surgical videos in near real-time, performance on AI-ready and prospectively collected videos, and quantification of surgeon skill.

Results

Using the AI-ready data set, the study team developed a multitask AI model capable of real-time understanding of surgical behaviors—the building blocks of procedural flow and surgeon skill—across space and time. Through principal component analysis, a single compound skill feature was identified, composed of a linear combination of kinematic hand attributes. This feature was a significant discriminator between experienced surgeons and surgical trainees across 101 prospectively collected surgical videos of 14 operators. For each unit increase in the compound feature value, the odds of the operator being an experienced surgeon were 3.6 times higher (95% CI, 1.67-7.62; P = .001).

Conclusions and Relevance

In this observational study, the AVOS-trained model was applied to analyze prospectively collected open surgical videos and identify kinematic descriptors of surgical skill related to efficiency of hand motion. The ability to provide AI-deduced insights into surgical structure and skill is valuable in optimizing surgical skill acquisition and ultimately improving surgical care.
Super‐Resolution Microscopy Unveils Synergistic Structural Changes of Organelles Upon Point Mutation
Authors: Anjum Farhan , Kaushik Kush , Salam Abdul , Yadav Aditya , Nandi Chayan Kanti
Published: December 2023

Ethyl methanesulphonate (EMS), is a widely used chemical mutagen that causes high‐frequency germline null mutation by inserting an alkyl group into the nucleotide guanine in eukaryotic cells. The effect of EMS on the dynamics of the aneuploid genome, increased cellular instability, and carcinogenicity in relation to benign and malignant tumors are reported, but the molecular level understanding of morphological changes of higher‐order chromatin structure has poorly been understood. This is due to a lack of sufficient resolution in conventional microscopic techniques to see small structures below the diffraction limit. Here, using super‐resolution radial fluctuation, a largely fragmented, decompaction, and less dense heterochromatin structure upon EMS treatment to HEK 293A cells without any change in nuclear DNA domains is observed. This result suggests an early stage of carcinogenicity happened due to the point mutation. In addition, the distinct structural changes with an elongated morphology of lysosomes are also observed. On the other hand, fragmented and increased heterogeneous populations with an increased cytoplasmic occupancy of mitochondria are observed.
Chiral Nanographene‐Based Near‐Infrared Fluorophore with Self‐Blinking Properties
Authors: Xu Xiushang , Yang Qiqi , Zhao Hao , Vasylevskyi Serhii , Bonn Mischa , Liu Xiaomin , Narita Akimitsu
Published: December 2023

Near‐infrared (NIR) fluorophores are highly desirable for super‐resolution fluorescence microscopy; however, their optical properties are typically relatively poor, with low photo‐intensity (mean photon number below 1000), and unfavorably high on‐off blinking duty cycle. In this work, the synthesis and characterization of tetrabenzodinaphthopyranthren (TBDNP) derivative as a novel nanographene that exhibits NIR emission in the range of 800–1000 nm with a photoluminescence quantum yield of 14% are reported. TBDNP demonstrated excellent self‐blinking properties, in particular, mean photon number of >3000 and a low on–off‐duty cycle (≈10−4), which are superior to reported NIR dyes, and can be successfully employed for the NIR super‐resolution imaging. Moreover, TBDNP serves also as a chiral fluorophore, showing notable chiroptical activities from 300 to 850 nm with a high dissymmetry factor (gabs) of 0.032 at 574 nm.
Passivating SnZn Defect and Optimizing Energy Level Alignment via Organic Silicon Salt Incorporation toward Efficient Solution‐Processed CZTSSe Solar Cells
Authors: Qi Yafang , Wei Na , Li Yang , Kou Dongxing , Zhou Wenhui , Zhou Zhengji , Meng Yuena , Yuan Shengjie , Han Litao , Wu Sixin
Published: December 2023

The SnZn defect passivation and heterojunction interface energetics‐modification are crucial for further improvement of open‐circuit voltage (Voc) and efficiency of Cu2ZnSn(S,Se)4 (CZTSSe) solar cells. Herein, a simple but effective cation substitution strategy is reported to promote the performance of CZTSSe devices by simultaneously modifying the absorber and heterojunction interface. This is achieved by introducing the organic silicon salt C8H20O4Si into CZTSSe precursor solution as a source of silicon to partially substitute Sn with Si. Systematic studies reveal that there are two mechanisms synergistically contributing to the increase of efficiency: 1) This strategy can passivate the undesired SnZn defect in CZTSSe absorber more efficiently, leading to at least one order of magnitude lower SnZn defect density and beneficial carrier transport properties; 2) After Si incorporation, the conduction band minimum of the CZTSSe is upshifted, thus enlarging the bandgap, which ultimately optimizes the energy level structure at the CdS/CZTSSe interface and reduces interfacial energy loss by decreasing the carrier transport barrier. Consequently, the CZTSSe device with 7% Si substitution delivers a satisfactory efficiency of 13.02% owing to an increase in Voc. It is hoped the Si substitution strategy reported here can provide inspiration for developing advanced CZTSSe devices with broad application prospects.
Theoretical Basis of Biomimetic Flexible Piezoelectric Acoustic Sensors for Future Customized Auditory Systems
Authors: Jung Young Hoon , An Jaehun , Hyeon Dong Yeol , Wang Hee Seung , Kim Ingon , Jeong Chang Kyu , Park Kwi‐Il , Lee Pooi See , Lee Keon Jae
Published: December 2023

Flexible piezoelectric sensors have been spotlighted as an essential human–machine interface (HMI) by obtaining high‐quality data from omnipresent biomechanical inputs. Because human voice is the most intuitive bio‐signal among them, flexible piezoelectric acoustic sensors (f‐PAS) have a potential to shift the paradigm of HMI technologies. Despite the reported outstanding performance such as high sensitivity and speaker recognition accuracy, the theoretical investigation of f‐PAS has been insufficient to realize future customized development, because sensing principles are fundamentally different from commercialized microphones. Here, a theoretical framework of self‐powered f‐PAS by using mechanical and electrical physics is introduced. First of all, the basic theory of f‐PAS is compared with the auditory system of human cochlear. Based on the biomimetic trapezoidal shape, the resonant frequencies are analyzed with various structural and material conditions. In addition, the piezoelectricity of f‐PAS is derived to predict the sensitivity and SNR prior to experiments. To investigate sensor properties under the medium condition that is similar to human ear, the acoustic responses depending on the states of matter are theoretically compared. Finally, the distance limit of f‐PAS is studied with the correlations between piezoelectricity and sound pressure, which would provide novel strategies of functional material design for future applications of f‐PAS.
Highly Soluble TEMPO‐Viologen Bipolar Molecule for Ultra‐Stable Aqueous Redox Flow Batteries
Authors: Wang Liwen , Huang Mingbao , Wan Kai , Fu Zhiyong , Xiang Zhipeng , Liang Zhenxing
Published: December 2023

Bipolar redox‐active organic molecule (BROM) is a feasible strategy to address the cross‐contamination issue of the electrolyte and, thus, improve the stability of the flow battery. Herein, a highly‐soluble BROM is developed by combining the 2,2,6,6‐tetramethylpiperidine‐1‐oxyl (TEMPO) and viologen moieties, and extensive characterizations are performed to evaluate its applicability in flow battery. Salient findings are as follows. First, the compound, viz. 1‐(1‐oxyl‐2,2,6,6‐tetramethylpiperidin‐4‐yl)‐1′‐(3‐(trimethylammonio)propyl)‐4,4′‐bipyridinium trichloride ((TPABPy)Cl3), features highly hydrophilic groups and yields a high aqueous solubility of 1.76 m. Second, the electrochemical result reveals that the (TPABPy)Cl3 displays two pairs of highly reversible peaks at −0.56 and 0.76 V, which respectively correspond to the viologen and TEMPO moieties. The electronic structure during the redox reactions is identified by both the density functional theory calculation and the electron paramagnetic resonance. Third, the flow battery fed with the 1.0 m (TPABPy)Cl3 solution delivers a high capacity of 25 Ah L−1 and a superior stability over the non‐bipolar counterparts. More to the point, the capacity decay can be effectively recovered by applying the polarity‐inversion rebalance strategy on the BROM. In summary, this work provides a molecular engineering way to rationally design a BROM to improve the capacity and stability of aqueous organic redox flow batteries.
Monolithic High Contrast Grating Integrated with Metal: Infrared Electrode with Exceptionally High Conductivity and Transmission
Authors: Ekielski Marek , Głowadzka Weronika , Bogdanowicz Karolina , Rygała Michał , Mikulicz Monika , Śpiewak Patrycja , Kowalski Marcin , Gębski Marcin , Motyka Marcin , Szerling Anna , Czyszanowski Tomasz
Published: December 2023

The design of transparent conductive electrodes (TCEs) for optoelectronic devices requires a trade‐off between high conductivity and transmittivity, limiting their efficiency. This paper demonstrates the best ever achieved TCEs with the novel approach to fabricating TCEs that effectively alleviates this trade‐off: a monolithic high contrast grating integrated with metal (metalMHCG). The metalMHCG enables higher electrical conductivity than other TCEs, while providing transmissive and antireflective properties. It focuses on infrared spectrum TCEs, which are essential for sensing, thermal imaging, and automotive applications. However, due to elevated free carrier absorption, they are much more demanding than TCEs for the visible spectrum. It demonstrates a record 75% absolute transmittiance of unpolarized light, resulting in a record 108% transmittance relative to plain GaAs substrate. It achieves even larger absolute transmittance of polarized light, reaching 92% or 133% relative transmittance. Despite the record high transmittance, the sheet resistance of the metalMHCG is the best ever reported, several times lower than any other TCE, ranging from 0.5 to 1 Ω Sq−1.
Early‐Responsive Immunoregulation Therapy Improved Microenvironment for Bone Regeneration Via Engineered Extracellular Vesicles
Authors: Lu Tingwei , Liu Yuanqi , Huang Xiangru , Sun Siyuan , Xu Hongyuan , Jin Anting , Wang Xinyu , Gao Xin , Liu Jingyi , Zhu Yanfei , Dai Qinggang , Wang Chao , Lin Kaili , Jiang Lingyong
Published: December 2023

Overactivated inflammatory reactions hinder the bone regeneration process. Timely transformation of microenvironment from pro‐inflammatory to anti‐inflammatory after acute immune response is favorable for osteogenesis. Macrophages play an important role in the immune response to inflammation. Therefore, this study adopts TIM3 high expression extracellular vesicles (EVs) with immunosuppressive function to reshape the early immune microenvironment of bone injury, mainly by targeting macrophages. These EVs can be phagocytosed by macrophages, thereby increasing the infiltration of TIM3‐positive macrophages (TIM3+ macrophages) and M2 subtypes. The TIM3+ macrophage group has some characteristics of M2 macrophages and secretes cytokines, such as IL‐10 and TGF‐β1 to regulate inflammation. TIM3, which is highly expressed in the engineered EVs, mediates the release of anti‐inflammatory cytokines by inhibiting the p38/MAPK pathway and promotes osseointegration by activating the Bmp2 promoter to enhance macrophage BMP2 secretion. After evenly loading the engineered EVs into the hydrogel, the continuous and slow release of EVsTIM3OE recruits more anti‐inflammatory macrophages during the early stages of bone defect repair, regulating the immune microenvironment and eliminating the adverse effects of excessive inflammation. In summary, this study provides a new strategy for the treatment of refractory wounds through early inflammation control.
Ultrasensitive Soft Sensor from Anisotropic Conductive Biphasic Liquid Metal‐Polymer Gels
Authors: Peng Yan , Peng Hao , Chen Zixun , Zhang Jiuyang
Published: December 2023

Subtle vibrations, such as sound and ambient noises, are common mechanical waves that can transmit energy and signals for modern technologies such as robotics and health management devices. However, soft electronics cannot accurately distinguish ultrasmall vibrations owing to their extremely small pressure, complex vibration waveforms, and high noise susceptibility. This study successfully recognizes signals from subtle vibrations using a highly flexible anisotropic conductive gel (ACG) based on biphasic liquid metals. The relationships between the anisotropic structure, subtle vibrations, and electrical performance are investigated using rheological–electrical experiments. The refined anisotropic design successfully realized low‐cost flexible electronics with ultrahigh sensitivity (Gauge Factor: 12787), extremely low detection limit (strain: 0.01%), and excellent frequency recognition accuracy (>99%), significantly surpassing those of current flexible sensors. The ultrasensitive flexible electronics in this study are beneficial for diverse advanced technologies such as acoustic engineering, wearable electronics, and intelligent robotics.
Synthesis of Newly Discovered Carbon Nanoframes: A Self‐Assembly Strategy Based on DTAB @ NaCl
Authors: Du Bingxuan , Li Haichao , Zhang Conglin , Ji Qingsong
Published: December 2023

Carbon nanomaterials have attracted much attention in the field of science and technology for their excellent properties; however, developing a simple, environmentally friendly, and versatile synthesis strategy for the preparation of carbon nanomaterials with novel structures remains a great challenge. Herein, a surfactant @ salt (dodecyltrimethylammonium bromide DTAB @ NaCl) self‐assembly strategy for the synthesis of carbon nanomaterials with novel structures, i.e., carbon nanoframes is reported. The synthesis differs from the traditional template method in that it is characterized by the introduction of surfactants for separation and protection, and the salt can be recycled. In addition, the carbon frame size in this system can be adjusted on demand by simply adjusting the concentration of surfactant, thus realizing that the carbon nanoframe size is adjustable in the range of 232.58–322.51 nm. Impressively, the carbon nanoframe has purple, blue, and green PL emission behavior. It is anticipated that this research will provide new insights into the development of novel carbon nanomaterials.
The functional study of a novel MKRN3 missense mutation associated with familial central precocious puberty
Authors: Chen Ziwei , You Qing , Wang Junqi , Dong Zhiya , Wang Wei , Yang Yuanyan , Ma Xiaoyu , Li Chuanyin , Lu Wenli
Published: December 2023

Central precocious puberty (CPP) refers to a syndrome of early puberty initiation with a characteristic increase in the release of gonadotropin‐releasing hormone (GnRH); therefore, it is also called GnRH‐related precocious puberty. About a quarter of idiopathic central precocious puberty (ICPP) may be familial. Studies suggest that mutations of makorin ring finger protein 3 (MKRN3) can cause familial central precocious puberty (FCPP). In this report, we describe a Chinese female patient carrying a novel MKRN3 variant (c.980G>A/p.Arg327His) and presenting the CPP phenotype. This novel variant attenuated its own ubiquitination, degradation, and inhibition on the transcriptional and translational activity of GNRH1, which was verified through functional tests. We can consider this variant as a loss‐of‐function mutation, which subsides the inhibition of GnRH1‐related signaling and gives rise to GnRH‐related precocious puberty.
An outcome‐wide analysis of the effects of diagnostic labeling of Alzheimer's disease and related dementias on social relationships
Authors: Amano Takashi , Halvorsen Cal J. , Kim Seoyoun , Reynolds Addam , Scher Clara , Jia Yuane
Published: December 2023

INTRODUCTION

This study examines how receiving a dementia diagnosis influences social relationships by race and ethnicity.

METHODS

Using data from the Health and Retirement Study (10 waves; 7,159 observations) of adults 70 years and older predicted to have dementia using Gianattasio‐Power scores (91% accuracy), this study assessed changes in social support, engagement, and networks after a dementia diagnosis. We utilized quasi‐experimental methods to estimate treatment effects and subgroup analyses by race/ethnicity.

RESULTS

A diagnostic label significantly increased the likelihood of gaining social support but reduced social engagement and one measure of social networks. With some exceptions, the results were similar by race and ethnicity.

DISCUSSION

Results suggest that among older adults with assumed dementia, being diagnosed by a doctor may influence social relationships in both support‐seeking and socially withdrawn ways. This suggests that discussing services and supports at the time of diagnosis is important for healthcare professionals.
Multi‐omics analyses reveal the interaction between colonic microbiota and host in Min and Yorkshire pigs
Authors: Huang Xiaoyu , Li Huihui , Cheng Feng , Wang Ligang , Cao Guoqing , Wang Lixian , Shi Lijun
Published: December 2023

Adoption of microbial preparations is becoming more and more prevalent in the pig breeding industry. Digestive tract microbes are recognized as crucial elements affecting physical characteristics of pigs. Until now, it is still challenging to establish connections between colonic microbiome and the host. In this study, weight gain models were created for Min and Yorkshire pigs. The colonic contents and colonic tissues were collected from two pig purebred strains (n = 8/group) with similar weights for multi‐omics analysis. By difference analysis of colonic microbiota, Min pigs observed a significantly higher relative abundance of Bacteroides, Phocaeicola, Roseburia, and Parabacteroides, and Yorkshire pigs had a strongly higher relative abundance of Streptococcus, Vescimonas, Ligilactobacillus, and Lactococcus. Functional annotation showed that the colonic microbiota of Min pigs had extensive dietary polysaccharide and immunomodulatory capacity. Through the correlation analysis of colonic microbiota with metabolomics of colonic content or transcriptomics of colonic tissues, we provided direct and indirect relationships of microorganisms and hosts. By verification, the contents of Occludin, ZO‐1, and pIgR in colonic tissue and sIgA, sIgG, and sIgM in colonic contents of Min pigs were significantly higher than that in Yorkshire pigs. This study revealed characteristics and functions of the colonic microbiota in Min and Yorkshire pigs and analyzed their interactions with the host. Also, we identified immune‐related microorganisms. These results provided a theoretical basis for understanding the influence of colonic microbiota on phenotype shaping in pigs.
Weight Loss Induced by Antiobesity Medications and All‐Cause Mortality Among Patients With Knee or Hip Osteoarthritis
Authors: Wei Jie , Hunter David , Lane Nancy E. , Wu Jing , Zeng Chao , Lei Guanghua , Zhang Yuqing
Published: December 2023

Objective

The current guidelines recommend weight loss for patients with overweight or obesity and knee or hip osteoarthritis (OA); however, there is a paucity of data on the relation of weight loss to death among patients with OA. We aimed to examine the relation of the rate of weight loss induced by antiobesity medications over one year to all‐cause mortality among patients with overweight or obesity and knee or hip OA.

Methods

Using the IQVIA Medical Research Database, we identified people with overweight or obesity and knee or hip OA. We emulated analyses of a hypothetical target trial to assess the effect of slow‐to‐moderate (2%–10%) or fast (≥10%) weight loss induced by the initiation of antiobesity medications within one year on all‐cause mortality and secondary outcomes over five years’ follow‐up.

Results

Among 6,524 participants, the five‐year all‐cause mortality rates were 5.3%, 4.0%, and 5.4% for weight gain or stable, slow‐to‐moderate weight loss, and fast weight loss arms, respectively. Compared with the weight gain or stable arm, hazard ratios of all‐cause mortality were 0.72 (95% confidence interval [CI] 0.56–0.92) for the slow‐to‐moderate weight loss arm and 0.99 (95% CI 0.67–1.44) for the fast weight loss arm. We found dose–response protective effects of weight loss on incident hypertension, type 2 diabetes, and venous thromboembolism but a slightly higher risk of cardiovascular disease, albeit not statistically significant, in the fast rate of weight loss arm than in the weight gain or stable arm and no significant relations of weight loss to the risk of cancer.

Conclusion

In this population‐based study, a slow‐to‐moderate, but not fast, rate of weight loss induced by antiobesity medications is associated with a lower risk of all‐cause mortality in people with overweight or obesity and knee or hip OA.

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A comparison of pre‐ and post‐clinical education learning preferences among medical students who elected to dissect compared to those who did not during the COVID‐19 pandemic
Authors: Liang Collin G. , Matsunaga Masako , Takakusagi Melia , DeMeo J , Thompson Jesse D. , Rettenmeier Christoph , Aytaç Güneş , Lee U‐Young , Lozanoff Scott
Published: December 2023

Anatomy instructional methods varied widely during the COVID‐19 pandemic and programs are assessing innovations for retention. Learning preferences were assessed among medical students dichotomized as elective dissectors (ED) or non‐dissectors (ND) during the COVID‐19 partial re‐opening in 2020 (preclinical) and again in 2022 after clinical exposure (post‐clinical) to assess the viability of elective dissection post‐pandemic. A mixed‐method approach was used for the assessment of test scores, learning preference surveys, learning activities rankings, and thematic analyses. No significant differences occurred in anatomy examination scores. Dissection was considered useful by both preclinical groups but significantly more so by ED, while the presence of an instructor was significantly preferred by ED although a majority of ND agreed. Elective dissection was significantly preferred by ND but also by a large minority of ED students. Pre‐ and post‐clinical ND believed that elective dissection offered more academic flexibility, did not hinder clinical learning, and did not negatively impact medical education. The corresponding ED stated that confidence improved, clinical experiences were enhanced, and dissection was irreplaceable. Preclinical ND preferred self‐learning, while ED students preferred online learning, but these differences largely disappeared post‐clinically. Learning activity rankings were not significantly different among all groups (ND, ED, preclinical, and post‐clinical). A hybrid laboratory with a virtual learning environment ranked highest across groups and preferences increased over time suggesting that students benefited from this instructional method during clinical exposure. The absence of laboratory experience ranked lowest, and preference decreased over time suggesting that anatomy dissection is valued.
High‐sensitivity immunoassay on interdigitated electrode to detect osteoporosis biological marker
Authors: Liu Jianwen , Chen Xiaohai , Lv Hanlin , He Shuming , Fan Yong
Published: December 2023

Osteoporosis is with porous bones, which refers to a decrease in the bone mineral density and weakens the bones to become brittle. Osteoporosis often progresses without any pain or symptoms until the bone fractures. Monitoring the condition of bone regularly helps to identify the bone that weakens at its earlier stages. In general, radiological techniques have been used to measure bone mineral density, are expensive, and the procedures are complicated. Therefore, researchers are focusing on the alternative method of biomarker quantification to identify bone mineral density. This research work was focused on quantifying the osteoporosis biomarker of C‐terminal telopeptide of type I collagen (CTX‐I) on an interdigitated electrode (IDE) sensor. Gold nanomaterial‐modified anti‐CTX‐I antibody was attached to silica nanomaterial‐decorated IDE and then identified by CTX‐I interaction. Higher immobilization of antibodies was recorded on diamond‐modified IDE through gold nanoparticles, and detected CTX‐I as low as 0.5 pg/mL [y = 1.5507x − 0.9043 R2 = 0.9715], determined on a linear curve at the range 0.5–3.5 ng/mL. Further, specific identification of CTX‐I was confirmed by control performances with osteopontin, IL‐6, and anti‐IgG antibody.
Evaluation of the relationship of cytokines concentrations tumor necrosis factor‐alpha, interleukin‐6, and C‐reactive protein in obese diabetics and obese non‐diabetics: A comparative study
Authors: Mohammad Imad Jassim , Kashanian Soheila , Rafipour Ronak , Aljwaid Husam , Hashemi Sadegh
Published: December 2023

Obesity has been linked to a low‐grade inflammatory process in the white adipose tissue. Our study aims to detect the relationship between cytokine levels of tumor necrosis factor‐alpha (TNF‐α), interleukin‐6 (IL‐6), and C‐reactive protein (CRP) in obese diabetics, compared to obese non‐diabetics, Iraqi individuals. Ninety Iraqi adults, 45 type 2 diabetic and 45 non‐diabetic obese, were selected as controls. Serum levels of TNF‐α, IL‐6, CRP, homeostatic model assessment for homeostasis model assessment of insulin resistance (HOMA‐IR), body fat, and body mass index (BMI) were measured. The concentration of TNF‐α, IL‐6, and CRP were significantly greater in the obese diabetics, compared to the obese non‐diabetics. BMI was significantly positively correlated with the concentration of TNF‐α, IL‐6, and CRP in the two groups. At the same time, HOMA‐IR was non‐significantly positively associated with them in obese diabetics. In contrast, the correlation was significantly positive between HOMA‐IR with TNF‐a, IL‐6, and CRP in the obese non‐diabetics group. Obese diabetics have more inflammation than obese non‐diabetics as evidenced by the former's higher levels of TNF‐α and IL‐6. Obesity‐related imbalances disrupt metabolic processes and increase CRP, TNF‐, and IL‐6 levels. Therefore, IR is promoted by the increase of cytokines.
An experimental analysis of task refusal: A comparison of negative reinforcement contingencies and transitions between academic tasks
Authors: Pálsdóttir Erna Dögg , Magnússon Atli Freyr , Sveinbjörnsdóttir Berglind
Published: December 2023

The purpose of the study was to do an experimental analysis of academic task refusal for one girl with a developmental disability. Task refusal was analyzed in two experimental analyses. First, an analysis testing if the behavior was maintained by negative reinforcement, and the second, an analysis testing if the behavior was the result of transitioning between academic tasks differing in preference. Task refusal did not occur in the demand condition of the functional analysis, indicating that the behavior was not maintained by escape from demands. Conversely, task refusal occurred solely in the second experimental analysis when transitioning from a high‐preferred to a low‐preferred academic task. In this case, the context of terminating a preferred academic task and transitioning to a less preferred academic task was aversive but not the demand itself. In addition, when an embedded break condition was compared to a no break condition in a multielement design, task refusal was reduced to zero levels.
MRI radiomics model for predicting TERT promoter mutation status in glioblastoma
Authors: Chen Ling , Chen Runrong , Li Tao , Huang Lizhao , Tang Chuyun , Li Yao , Zeng Zisan
Published: December 2023

Background and purpose

The presence of TERT promoter mutations has been associated with worse prognosis and resistance to therapy for patients with glioblastoma (GBM). This study aimed to determine whether the combination model of different feature selections and classification algorithms based on multiparameter MRI can be used to predict TERT subtype in GBM patients.

Methods

A total of 143 patients were included in our retrospective study, and 2553 features were obtained. The datasets were randomly divided into training and test sets in a ratio of 7:3. The synthetic minority oversampling technique was used to achieve data balance. The Pearson correlation coefficients were used for dimension reduction. Three feature selections and five classification algorithms were used to model the selected features. Finally, 10‐fold cross validation was applied to the training dataset.

Results

A model with eight features generated by recursive feature elimination (RFE) and linear discriminant analysis (LDA) showed the greatest diagnostic performance (area under the curve values for the training, validation, and testing sets: 0.983, 0.964, and 0.926, respectively), followed by relief and random forest (RF), analysis of variance and RF. Furthermore, the relief was the optimal feature selection for separately evaluating those five classification algorithms, and RF was the most preferable algorithm for separately assessing the three feature selectors. ADC entropy was the parameter that made the greatest contribution to the discrimination of TERT mutations.

Conclusions

Radiomics model generated by RFE and LDA mainly based on ADC entropy showed good performance in predicting TERT promoter mutations in GBM.
The adoption of I4.0 technologies for a sustainable and circular supply chain: an industry‐based SEM analysis from the textile sector
Authors: Hmamed Hala , Cherrafi Anass , Benghabrit Asmaa , Tiwari Sunil , Sharma Pankaj
Published: December 2023

Currently, researchers have been particularly interested in Industry 4.0 (I4.0) as a combination of novel revolutionary digital technologies. This evolution is transforming how organizations operate to promote sustainable and circular practices. Consequently, this research empirically investigates the capabilities of I4.0 adoption to establish a sustainable and circular supply chain. The study investigates the impact of organizational factors on the deployment of I4.0 technologies to achieve sustainability objectives. Furthermore, this approach combines empirical and qualitative analyses within a methodological framework to investigate the relationship between organizational factors, I4.0 adoption, sustainable, and circular practices. In this context, survey responses have been collected from 323 supply chain professionals in the textile sector in Morocco. Consequently, employing structural equation modeling, our results reveal a strong link between I4.0 adoption and the promotion of circular and sustainable approaches. The study finds a positive association between I4.0 adoption, technological readiness, and environmental responsiveness while highlighting the challenges posed by organizational practices on I4.0 implementation in developing countries. This research contributes to the theoretical foundations of the potential influence of I4.0 technologies, and it provides practical contributions for stakeholders to effectively embrace I4.0 technologies and thereby drive more sustainable and efficient practices.
Phytochemical Profile of Alkaloid Extract from Dendrobium huoshanense and Inhibitory Effects against Oxidative Stress in H2O2‐Induced PC12 Cells
Authors: Hui Ailing , Chen Jingchao , Deng Shaohuan , Chen Yan , He Xianglin , Yang Li , Zhang Wencheng , Wu Zeyu
Published: December 2023

This study aimed to explore the alkaloid profile of Dendrobium huoshanense and determine the potential protective effect against oxidative damage. The crude D. huoshanense alkaloid extract (DHAE) was obtained by 70 % ethanol extraction and liquid‐liquid partition. DHAE contained specific alkaloid components with abundant 6‐hydroxynobiline (58.15 %) and trace dendrobine (3.23 %) in the preliminary HPLC fingerprint and GC‐MS analysis, which was distinguished from D. officinale or D. nobile. Subsequently, six alkaloids including 6‐hydroxynobiline, 2‐hydroxy dendrobine, nobilonine, dendrobine, Findlayines D and trans‐dendrochrysanine were identified in the purified DHAE (namely DHSAE‐3, DHSAE‐3′) via further solid phase extraction coupled with UPLC‐MS/MS analysis. Meanwhile, pretreatment with DHAE or DHSAE (0.5, 5 μg/mL) increased cell viability by 14.0–57.4 % compared to that of H2O2‐induced PC12 Model cells. Among them, 5 μg/mL DHSAE‐3‐treated cells displayed a pronounced reversion than the positive vitamin E (p<0.01). Furthermore, a clear cellular morphological restoration and 38.4 % reduction in intracellular reactive oxidative species level were achieved. Our findings suggest that D. huoshanense has a characteristic alkaloid profile represented by abundant 6‐hydroxynobiline, and DHAEs exhibit obvious protection against oxidative neuronal damage. Overall, this study indicates that DHAEs might be used to inhibit oxidative stress and provide a source to develop novel neuroprotective drugs.
Congenital tunnel‐shaped ventricular septal defect
Authors: Eftekhari Mohammad Reza , Parkhideh Roya , Khoshavi Meysam , Nakhaee Akram
Published: December 2023

Key Clinical Message

We report a 47‐year‐old man who presented with right‐sided heart failure. Transthoracic echocardiography revealed a tunnel‐shaped communication (ventricular septal defect) between the left ventricle and the right ventricle with a significant left‐to‐right shunt. The VSD is connected to the lateral wall of the right ventricle by a large tunnel.
Bezoars: Culprits of gastrointestinal obstruction that may lead to surgical intervention and potentially surgical complications
Authors: Powell Shannon D. , Pereira Nicholas
Published: December 2023

Key Clinical Message

Bezoars can cause gastrointestinal obstruction and may require surgery. Surgery carries the risk of complications. Medical professionals should perform detailed history in diet and behaviors for patients presenting with abdominal pain to identify risk factors for bezoars, then educate these patients and their families about risks and complications of bezoars.

Bezoars are solid masses of undigested material that can cause obstruction of the gastrointestinal tract. There are different types of bezoars; phytobezoar, trichobezoar, pharmacobezoar, lactobezoar, and bezoars containing tissue paper or polystyrene foam. This case report is of a 13‐year‐old Hispanic male who suffered a postsurgical complication after removal of bezoar. He had a past surgical history of appendectomy and presented to the hospital with a 1‐day history of right lower quadrant abdominal pain associated with fever and diarrhea. X‐radiation images and computed tomography scans aided in the diagnosis of pelvic abscess as a complication of postsurgical enterotomy and closure of the enterotomy to remove bezoar from the small bowel. The initial bezoar removal and the postsurgical complication of pelvic abscess resulted in the patient staying for 19 days in the hospital. At discharge, the patient and his guardian were advised to follow up with the patient's primary care physician and surgical team. The patient made an uneventful recovery. He did not experience any long‐term complications and fully recovered. This report demonstrates that although bezoars are rare, they can cause significant obstruction of the gastrointestinal tract leading to the need for management, such as surgery, which carries its own risks. It is important to note that the postsurgical complication of pelvic abscess can occur due to surgery itself and not because of bezoar specifically. Abdominal surgery in general poses the risk of pelvic abscess. The consideration is to expectantly decrease the occurrence of bezoars so that consequently there will not be a need for surgery in removal of bezoars due to obstruction. The effects of bezoars can be prevented through educating the community and addressing underlying psychiatric disorders.
Folliculitis decalvans managed with adalimumab: A case report
Authors: Alsantali Adel , Baghdadi Razan , Alghamdi Yara , Abbas Elham Bin , Ghazi Rafah
Published: December 2023

Key Clinical Message

Folliculitis decalvans (FD) is a rare neutrophilic cicatricial alopecia of the scalp that manifest with inflammation, pruritus, pustules, and tufted hair. Most dermatologist treat FD with topical or oral antibiotics. We recommend considering treatment with biologics to preserve and stabilize the ongoing inflammatory process in moderate to severe FD.
Transformation of a long‐standing phosphaturic tumor‐inducing osteomalacia into malignancy
Authors: Malagon‐Rangel Jose , Solis Jose Gabriel , Zavala‐Jonguitud Luis Fernando , Basile‐Alvarez Martín Roberto , Malagon‐Liceaga Andrea
Published: December 2023

Key Clinical Message

Tumor‐induced osteomalacia is a paraneoplastic syndrome characterized by renal phosphate wasting and deranged bone turnover. Clinicians should consider tumor‐induced osteomalacia in unexplained hypophosphatemia and investigate for underlying tumors.

Tumor‐induced osteomalacia (TIO) is a rare paraneoplastic syndrome characterized by renal phosphate wasting, which leads to deranged bone turnover. TIO is usually associated with benign mesenchymal tumors, although it has also been reported in malignant tumors. We present the case of a 56‐year‐old individual who experienced a protracted 6‐year clinical course characterized by hypophosphatemia, weakness, and kyphosis, alongside the presence of a foot tumor. Subsequently, this lesion displayed malignant behavior and was ultimately diagnosed as a high‐grade sarcoma. To date, this case is among the 10 reported cases in the literature of a mesenchymal tumor associated with TIO undergoing malignant transformation. This report underscores the importance of a comprehensive evaluation of patients with unexplained hypophosphatemia and highlights the need for diligent follow‐up to detect possible malignant transformation of the underlying tumor. Clinicians should consider TIO in the differential diagnosis of hypophosphatemia and promptly investigate for the presence of an underlying tumor, as early detection may improve the patient's prognosis.
Unusual presentation of pilomatricoma: A case report and comprehensive review of the literature
Authors: Bazargan Afsaneh Sadeghzadeh , Jafarzadeh Alireza , Nobari Niloufar Najar , Dilmaghani Sara , Shayanfar Nasrin
Published: December 2023

Key Clinical Message

Pilomatricoma is a benign proliferative lesion of skin appendages that often affects the head, upper limbs, and lower limbs. The clinical appearance of the lesions is that of asymptomatic nodules measuring less than 3 cm. pathologically, these skin lesions show the presence of basaloid cell islands, eosinophilic cytoplasmic cells without nuclei, as well as hemorrhage and calcification. In this study, we present the case of an 8‐year‐old girl with a 5 × 5 cm skin lesion on the forearm, which lacked the typical firmness associated with pilomatricoma lesions during examination. After biopsy, the lesion was confirmed to be pilomatricoma. Furthermore, we have reviewed studies documenting pilomatricoma lesions with atypical clinical features. Based on reports of different clinical manifestations of pilomatricoma in these studies, we suggest that the clinical diagnosis of pilomatricoma should not be limited to the typical presentation of these lesions. In cases where the lesions exceed 3 cm in size, display cystic characteristics, are painful, or resemble keloids, consideration should also be given to the possibility of pilomatricoma.
Axillary lymph node pigmentation in tattooed patients
Authors: Yamaguchi Toshiyuki
Published: December 2023

Key Clinical Message

Tattooed pigments often migrate to the regional lymph nodes, leading to staining and swelling of these nodes. This migration can create confusion for surgeons when evaluating regional lymph nodes for staging of malignant disease like breast cancer.

A 50‐year‐old woman with left breast carcinoma underwent left mastectomy and sentinel lymph node (SLN) biopsy. A cherry blossom tattoo was observed on the left pectoral region, which she had acquired 6 years prior. Two lymph nodes were excised as SLNs and one of the two SLNs exhibited partial pink staining. Serial sections were performed on the block, revealing pinkish particles within the colored area on pathological examination. However, no metastasis was detected.
Resection of chronic expanding hematoma within the liver cyst difficult to differentiate from liver cystadenocarcinoma: A case report
Authors: Abe Kodai , Tomita Shunsuke , Suzuki Shohei , Kigasawa Yu , Kashiwagi Hironobu , Nishioka Michihito , Kabeshima Yasuo
Published: December 2023

Key Clinical Message

Liver cysts are common benign lesions with rare malignancy potential. Distinguishing between benign and malignant tumors within liver cysts is challenging. We present the case of a patient with a chronically expanding hematoma within a liver cyst that was resected under suspicion of liver cystadenocarcinoma. A 73‐year‐old female patient presented with elevated hepatobiliary enzyme levels, no viral hepatitis, elevated tumor marker levels, and preserved liver capacity (Child–Pugh grade A). Abdominal ultrasonography revealed a large cyst (>10 cm) occupying the right lobe and a 25‐mm mass lesion with mixed echogenicity inside the cyst. Contrast‐enhanced computed tomography showed atrophy of the parenchyma of the right lobe and dilation of the right intrahepatic bile duct due to the large cyst. Moreover, in the arterial phase, a point‐like high‐density area was observed inside the nodule, which increased from 25 to 35 mm over 3 months. Diffusion‐weighted magnetic resonance imaging revealed a high‐intensity signal within the nodule; however, positron emission tomography did not show an increased accumulation of fluorodeoxyglucose in the same area. Considering the risk of peritoneal dissemination if the cyst was punctured and found to be malignant, we performed a right hepatectomy. Pathological findings revealed a brownish fluid‐filled cyst containing a dark reddish nodule diffusely filled with hematoma, confirming the absence of a malignancy. To date, the patient has not experienced recurrence. We encountered a case of a chronic, expanding hematoma originating from a liver cyst that was difficult to distinguish preoperatively from a liver cystadenocarcinoma.
Pelvic and peritoneal hydatidosis: An uncommon presentation of the common entity
Authors: Kc Milan , Regmi Ishwor , Jha Alok Kumar , Pokhrel Biraj , Pathak Roshan , Kashyap Ashutosh , Gyawali Siddinath , Rijal Deepika , Awale Laligen , Bhattarai Abhishek , Kansakar Prasan Bir Singh
Published: December 2023

Key Clinical Message

The pelvic and peritoneal hydatidosis occurs mostly after the traumatic rupture or surgical spillage of Echinococcus from liver or spleen. The treatment is surgical aiming to eradicate local disease, preventing complications, and reducing recurrences.

We report a unique case of a 26‐year‐old male who presented with acute urinary retention and abdominal distention. Later, CT‐urography revealed peritoneal and pelvic hydatidosis behind this presentation, which was managed surgically.
Occurrence of adult‐onset Still's disease after coronavirus disease 2019 BNT162B2 vaccination in a patient with ulcerative colitis: A case report and review of literature
Authors: Kobayashi Takahiro , Hashimoto Kenichi , Kusanagi Yasuyoshi , Tanaka Yuji
Published: December 2023

Key Clinical Message

We report an extremely rare occurrence of adult‐onset Still's disease (AOSD) in a patient with ulcerative colitis. The possibility of autoinflammatory conditions such as AOSD should be considered when evaluating or treating symptoms suspected as side effects of the severe acute respiratory syndrome coronavirus 2 vaccination, regardless of the associated comorbidities.

A woman in her 50s with a history of stable ulcerative colitis (UC) for 20 years, managed using salazosulfapyridine, presented with migratory rashes, spiking fever, edema, and joint pain that started 1 week after receiving the BNT162B2 mRNA vaccine against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Laboratory tests revealed extremely high serum ferritin levels. The patient was diagnosed with adult‐onset Still's disease (AOSD) based on the relevant classification criteria after ruling out other diseases. Detection of high levels of interleukin‐18, an inflammatory cytokine related to AOSD, supported the diagnosis. Nonsteroidal anti‐inflammatory drug monotherapy alone resulted in significant improvements in both the abovementioned symptoms and the elevated inflammatory marker levels. AOSD in a patient with UC is extremely rare. Only one case of AOSD with UC was reported before the coronavirus disease 2019 era. This case indicates that SARS‐CoV‐2 vaccination can trigger a hyperinflammatory response, classified as AOSD, in a patient with UC, which is extremely rare.
Crafting Versatile Modes of Pt(II) Complexes with Flexidentate Pyridyl‐β‐diketones: Synthesis, Structural Characterization, and Catalytic Behavior in Olefin Hydrosilylation
Authors: Kurpik Gracjan , Walczak Anna , Łukasik Igor , Matela Zuzanna , Stefankiewicz Artur R.
Published: December 2023

Cycloplatinated complexes, with their high reactivity, combined with the capability to tailor ligands for specific catalytic processes, play a pivotal role in materials science and coordination chemistry, serving as versatile catalysts for applications in the organic synthesis of industrially relevant processes. In this report, we describe the synthesis and characterization of a new family of Pt(II) complexes based on three isomeric pyridyl‐β‐diketones diversified in terms of N‐atom location in the heterocyclic ring. By appropriate control of the reaction conditions, we were able to generate distinct coordination species, featuring ligands arranged as N,C(sp3)‐ and N,O‐chelates, as well as simple pyridyl‐N donors. Various analytical techniques, including X‐Ray diffraction, NMR spectroscopy and ESI‐MS spectrometry enabled the characterization of different coordination modes of the central atoms and unambiguously established the complex structures. Furthermore, all the Pt(II) coordination units have been found to be highly active and selective catalyst precursors in the hydrosilylation reactions within a broad scope of olefins with hydrosilanes.