bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of researchers’ perceived pressure on their publication strategies
Authors: Johann David , Neufeld Jörg , Thomas Kathrin , Rathmann Justus , Rauhut Heiko
Published: March 2024

This article investigates researchers’ publication strategies and how their perceived pressure to publish and to obtain external funding are related to these strategies. The analyses rely on data from the Zurich Survey of Academics (ZSoA), an online survey representative of academics working at higher education institutions in Germany, Austria, and Switzerland. The results suggest that academics pursue both instrumental and normative publication strategies. The main finding is that academics who perceive high pressure to publish tend to employ instrumental publication strategies rather than normative ones: they are more likely to focus on the journal's reputation and the speed of publication when selecting an outlet for peer review. Publishing results in open-access outlets or in native languages other than English is less important for those under pressure. However, the extent to which researchers’ perceived pressure affects publication strategies also depends on other factors, such as the discrepancy between the time available for research and the time actually desired for research.
Estimation of internal-exposure contribution in radiation dose exposure for boron neutron capture therapy
Authors: Narita Ryosuke , Sakurai Yoshinori
Published: March 2024

Although boron neutron capture therapy (BNCT) causes minor damage to normal cells owing to the nuclear reactions induced by neutrons with major elements of tissues such as hydrogen and nitrogen, it is useful to estimate the accurate exposure dose for radiation protection. This study aims to estimate the contribution of internal exposure in radiation exposure dose for BNCT. The study was performed by referring to clinical studies at a reactor-based BNCT facility on the basis of computational dosimetry. Five irradiation regions of head and neck were selected for the estimation. The results suggest that external exposure occurred primarily in and around the irradiation field. Furthermore, during the exposure dose estimation in BNCT, internal exposure was found to be not negligible, implying that the irradiation regions in treatment planning must be considered for avoiding damage to certain critical organs that are susceptible to internal exposure.
Early Intervention in Psychosis and Management of First Episode Psychosis in Low- and Lower-Middle-Income Countries: A Systematic Review
Authors: Farooq Saeed , Fonseka Nishani , Ali Malik Wajid , Milner Abbie , Hamid Shumaila , Sheikh Saima , Khan Muhammad Firaz , Azeemi Mian Mukhtar-ul-Haq , Ariyadasa Gayan , Khan Abdul Jalil , Ayub Muhammad
Published: March 2024

Background and Hypothesis

People with first-episode psychosis (FEP) in low- and lower-middle-income countries (LMIC) experience delays in receiving treatment, resulting in poorer outcomes and higher mortality. There is robust evidence for effective and cost-effective early intervention in psychosis (EIP) services for FEP, but the evidence for EIP in LMIC has not been reviewed. We aim to review the evidence on early intervention for the management of FEP in LMIC.

Study Design

We searched 4 electronic databases (Medline, Embase, PsycINFO, and CINAHL) to identify studies describing EIP services and interventions to treat FEP in LMIC published from 1980 onward. The bibliography of relevant articles was hand-searched. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed.

Study Results

The search strategy produced 5074 records; we included 18 studies with 2294 participants from 6 LMIC countries. Thirteen studies (1553 participants) described different approaches for EIP. Pharmacological intervention studies (n = 4; 433 participants) found a high prevalence of metabolic syndrome among FEP receiving antipsychotics (P ≤ .005). One study found a better quality of life in patients using injectables compared to oral antipsychotics (P = .023). Among the non-pharmacological interventions (n = 3; 308 participants), SMS reminders improved treatment engagement (OR = 1.80, CI = 1.02–3.19). The methodological quality of studies evidence was relatively low.

Conclusions

The limited evidence showed that EIP can be provided in LMIC with adaptations for cultural factors and limited resources. Adaptations included collaboration with traditional healers, involving nonspecialist healthcare professionals, using mobile technology, considering the optimum use of long-acting antipsychotics, and monitoring antipsychotic side effects.
Mechanisms of Near-Peer Learning in a Longitudinal Clerkship: A Grounded Theory Study
Authors: Smith Lauren E. , McBride Mary E. , Henschen Bruce , Bierman Jennifer , Uchida Toshiko , Eppich Walter
Published: March 2024

Purpose

Many medical schools incorporate longitudinal clerkships, which promote continuity and may offer early clinical exposure during the preclinical curriculum. However, the mechanisms of near-peer learning and how it contributes to the development of clinical skills in longitudinal clinical experiences are less clear. The authors explored how peer-to-peer interactions among medical students influenced their developmental trajectories from nascent clinicians to more seasoned practitioners capable of juggling dual roles of clinical care and clinical supervision within longitudinal clerkships.

Method

The Education-Centered Medical Home (ECMH) at Northwestern University Feinberg School of Medicine is a longitudinal clerkship that represents an ideal setting to explore peer learning. At ECMH, continuity is established across all 4 years of medical school among small groups of students from each year, a preceptor, and a panel of outpatients. The authors conducted 6 focus groups and 9 individual interviews between March 2021 and February 2023 with medical students from all years. Using constructivist grounded theory, the authors collected and analyzed data iteratively using constant comparison to identify themes and explore their relationships.

Results

Within ECMH, peer relationships fostered an informal learning culture that enabled meaningful peer interactions while reinforcing the established culture. The authors identified 3 essential learning practices between senior and junior medical students: preparing for patient encounters, shifting roles dynamically during the joint encounter, and debriefing encounters afterward. These practices strengthened learning relationships and supported students’ developmental trajectories.

Conclusions

Longitudinal peer learning relationships enabled meaningful peer interaction that influenced medical students’ clinical development and capability for clinical supervision. Mutual trust, familiarity, and continuity facilitate targeted feedback practices and growth at the edge of junior students’ capabilities. Optimizing this peer learning environment and seeking new opportunities to use longitudinal peer learning in clinical environments could promote psychological safety and professional identity formation for medical students.
Let’s Chalk About It: Introducing the TinyTalks Curriculum, a Paradigm for Short, Virtual Chalk Talks
Authors: Handorf Anna , Healy Michael G. , Klouda Anna , Lu Alice , Moawad Iman , Tan Weizhen , Park Yoon Soo , Frey-Vogel Ariel
Published: March 2024

In busy clinical environments, educational opportunities must be designed to accommodate learner-specific needs. Many adult learners prefer short, relevant, technology-enhanced learning. As such, electronic learning (e-learning) experiences have become a prominent part of medical education. Yet, there remain challenges to e-learning experiences in the current educational landscape. To address these challenges, the authors developed the TinyTalks paradigm, which serves as the educational foundation for the TinyTalks curriculum.

The TinyTalks paradigm was developed using the existing e-learning literature and foundational principles of adult learning and related theories. The TinyTalks paradigm includes 3 ground rules: (1) all TinyTalks videos must identify a category (approach to, explanation of, or application of) to clarify the focus of the topic, (2) all TinyTalks videos must be less than 7 minutes with all material presented on one virtual chalkboard screen, and (3) all TinyTalks videos must use the hook, frame, and delivery model, which guides the creation of the video. The resulting TinyTalks curriculum is an online repository of short, chalk talk–style educational videos, developed by interdisciplinary health professionals and targeted to the level of trainees, that is available to be used flexibly by learners for just-in-time learning, flipped classroom sessions, and/or self-study.

The authors used Kern’s 6-step approach to curriculum development as the conceptual framework for the development and implementation of the TinyTalks curriculum at Mass General for Children (June 2021–January 2023). While developing and implementing the curriculum, the authors focused on topic selection, stakeholder recruitment, establishing a process flow, and creating a virtual home.

The authors believe the TinyTalks paradigm outlines an effective educational strategy that accommodates the unique needs of both learners and teachers in the medical education setting. The next steps are to scale the TinyTalks curriculum up by expanding the content library and to evaluate its efficacy.
Communication Under Sharply Degraded Auditory Input and the “2-Sentence” Problem
Authors: Svirsky Mario A. , Neukam Jonathan D. , Capach Nicole Hope , Amichetti Nicole M. , Lavender Annette , Wingfield Arthur
Published: March 2024

Objectives:

Despite performing well in standard clinical assessments of speech perception, many cochlear implant (CI) users report experiencing significant difficulties when listening in real-world environments. We hypothesize that this disconnect may be related, in part, to the limited ecological validity of tests that are currently used clinically and in research laboratories. The challenges that arise from degraded auditory information provided by a CI, combined with the listener’s finite cognitive resources, may lead to difficulties when processing speech material that is more demanding than the single words or single sentences that are used in clinical tests.

Design:

Here, we investigate whether speech identification performance and processing effort (indexed by pupil dilation measures) are affected when CI users or normal-hearing control subjects are asked to repeat two sentences presented sequentially instead of just one sentence.

Results:

Response accuracy was minimally affected in normal-hearing listeners, but CI users showed a wide range of outcomes, from no change to decrements of up to 45 percentage points. The amount of decrement was not predictable from the CI users’ performance in standard clinical tests. Pupillometry measures tracked closely with task difficulty in both the CI group and the normal-hearing group, even though the latter had speech perception scores near ceiling levels for all conditions.

Conclusions:

Speech identification performance is significantly degraded in many (but not all) CI users in response to input that is only slightly more challenging than standard clinical tests; specifically, when two sentences are presented sequentially before requesting a response, instead of presenting just a single sentence at a time. This potential “2-sentence problem” represents one of the simplest possible scenarios that go beyond presentation of the single words or sentences used in most clinical tests of speech perception, and it raises the possibility that even good performers in single-sentence tests may be seriously impaired by other ecologically relevant manipulations. The present findings also raise the possibility that a clinical version of a 2-sentence test may provide actionable information for counseling and rehabilitating CI users, and for people who interact with them closely.
Early dose reduction of osimertinib in advanced EGFR-mutated non-small cell lung cancer
Authors: Ferreira Marion , Ebia Matthew I. , Reckamp Karen L.
Published: March 2024

Osimertinib has become the standard of care for epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC). In order to prevent or treat toxicity, the osimertinib dose may be reduced. However, data regarding the impact of dose reduction during treatment are limited. We aimed to compare the efficacy of osimertinib early dose reduction during the first 3 months of treatment with late dose reduction in EGFR-mutated advanced NSCLC. This retrospective study included patients with EGFR-mutated advanced NSCLC who received osimertinib. We constituted two groups: ‘early dose reduction’ (early) with patients receiving a reduced dose of osimertinib from 80 to 40 mg within the 3 months of osimertinib initiation and ‘late dose reduction’ (late) with patients receiving a reduced dose after 3 months of full-dose treatment. Thirty-five patients were included, with 17 and 18 patients in the early and late groups, respectively, and a higher median age in the early group (76 vs. 67 years). The real-world progression-free survival (rwPFS) at 1 year was 70.5% in the early group and 88.9% in the late group (P = 0.31). Median rwPFS was 32.7 and 24.6 months (P = 0.98), and the median overall survival was 46.9 versus not reached in early and late groups, respectively (P = 0.17). Central nervous system rwPFS was not different between the early and late groups: 29.8 and 35.8 months, respectively (P = 0.39). We showed that a reduced dose of osimertinib within the first 3 months of treatment, compared to a later reduced dose, could influence treatment response or patient survival.
Central and peripheral mechanisms underlying postexercise hypotension: a scoping review
Authors: Brasil Iedda A. , Silva José Cristiano P.L. , Pescatello Linda S. , Farinatti Paulo
Published: March 2024

Blood pressure (BP) reduction occurs after a single bout of exercise, referred to as postexercise hypotension (PEH). The clinical importance of PEH has been advocated owing to its potential contribution to chronic BP lowering, and as a predictor of responders to exercise training as an antihypertensive therapy. However, the mechanisms underlying PEH have not been well defined. This study undertook a scoping review of research on PEH mechanisms, as disclosed in literature reviews. We searched the PubMed, Web of Science, Scopus, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Sport Discus databases until January 2023 to locate 21 reviews – 13 narrative, four systematic with 102 primary trials, and four meta-analyses with 75 primary trials involving 1566 participants. We classified PEH mechanisms according to major physiological systems, as central (autonomic nervous system, baroreflex, cardiac) or peripheral (vascular, hemodynamic, humoral, and renal). In general, PEH has been related to changes in autonomic control leading to reduced cardiac output and/or sustained vasodilation. However, the role of autonomic control in eliciting PEH has been challenged in favor of local vasodilator factors. The contribution of secondary physiological outcomes to changes in cardiac output and/or vascular resistance during PEH remains unclear, especially by exercise modality and population (normal vs. elevated BP, young vs. older adults). Further research adopting integrated approaches to investigate the potential mechanisms of PEH is warranted, particularly when the magnitude and duration of BP reductions are clinically relevant. (PROSPERO CRD42021256569).
Associations of traditional cardiovascular risk factors with 15-year blood pressure change and trajectories in Chinese adults: a prospective cohort study
Authors: Zhang Yiqian , Sun Qiufen , Yu Canqing , Sun Dianjianyi , Pang Yuanjie , Pei Pei , Du Huaidong , Yang Ling , Chen Yiping , Yang Xiaoming , Chen Xiaofang , Chen Junshi , Chen Zhengming , Li Liming , Lv Jun ,   the China Kadoorie Biobank Collaborative Group∗
Published: March 2024

Objective:

How traditional cardiovascular disease (CVD) risk factors are related to long-term blood pressure change (BPC) or trajectories remain unclear. We aimed to examine the independent associations of these factors with 15-year BPC and trajectories in Chinese adults.

Methods:

We included 15 985 participants who had attended three surveys, including 2004–2008 baseline survey, and 2013–2014 and 2020–2021 resurveys, over 15 years in the China Kadoorie Biobank (CKB). We measured systolic and diastolic blood pressure (SBP and DBP), height, weight, and waist circumference (WC). We asked about the sociodemographic characteristics and lifestyle factors, including smoking, alcohol drinking, intake of fresh vegetables, fruits, and red meat, and physical activity, using a structured questionnaire. We calculated standard deviation (SD), cumulative blood pressure (cumBP), coefficient of variation (CV), and average real variability (ARV) as long-term BPC proxies. We identified blood pressure trajectories using the latent class growth model.

Results:

Most baseline sociodemographic and lifestyle characteristics were associated with cumBP. After adjusting for other characteristics, the cumSBP (mmHg × year) increased by 116.9 [95% confidence interval (CI): 111.0, 122.7] for every 10 years of age. The differences of cumSBP in heavy drinkers of ≥60 g pure alcohol per day and former drinkers were 86.7 (60.7, 112.6) and 48.9 (23.1, 74.8) compared with less than weekly drinkers. The cumSBP in participants who ate red meat less than weekly was 29.4 (12.0, 46.8) higher than those who ate red meat daily. The corresponding differences of cumSBP were 127.8 (120.7, 134.9) and 70.2 (65.0, 75.3) for BMI per 5 kg/m2 and WC per 10 cm. Most of the findings of other BPC measures by baseline characteristics were similar to the cumBP, but the differences between groups were somewhat weaker. Alcohol drinking was associated with several high-risk trajectories of SBP and DBP. Both BMI and WC were independently associated with all high-risk blood pressure trajectories.

Conclusions:

Several traditional CVD risk factors were associated with unfavorable long-term BPC or blood pressure trajectories in Chinese adults.
Perioperative and post-hospital whole-course nutrition management in patients with pancreatoduodenectomy – a single-center prospective randomized controlled trial
Authors: Xu Jingyong , Wang Lijuan , Li Pengxue , Hu Yifu , Wang Chunping , Cheng Bo , Ding Lili , Shi Xiaolei , Shi Haowei , Xing Cheng , Li Lei , Li Zhe , Chen Chen , Cui Hongyuan , Han Sheng , Wang Hongguang , Song Jinghai , Wei Junmin
Published: March 2024

Objective:

Whole-course nutrition management (WNM) has been proven to improve outcomes and reduce complications. We conducted this randomized controlled trial to validate its effectiveness in patients undergoing pancreatoduodenectomy (PD).

Methods:

From 1 December 2020, to 30 November 2023, this single-center randomized clinical trial was conducted at the Department of Hepatobiliopancreatic Surgery in a major hospital in Beijing, China. Participants who were undergoing PD were enrolled and randomly allocated to either the WNM group or the control group. The primary outcome was the incidence of postoperative complications. Subgroup analysis in patients who were at nutritional risk was performed. Finally, a 6-month follow-up was conducted and the economic benefit was evaluated using an incremental cost-effectiveness ratio (ICER).

Results:

A total of 84 patients were randomly assigned (1:1) into the WNM group and the control group. The incidences of total complications (47.6% vs. 69.0%, P=0.046), total infections (14.3% vs. 33.3%, P=0.040), and abdominal infection (11.9% vs. 31.0%, P=0.033) were significantly lower in the WNM group. In the subgroup analysis of patients at nutritional risk, 66 cases were included (35 cases in the WNM group and 31 cases in the control group). The rate of abdominal infection (11.4% vs. 32.3%, P=0.039) and postoperative length of stay (23.1±10.3 vs. 30.4±17.2, P=0.046) were statistically different between the two subgroups. In the 6-month follow-up, more patients reached the energy target in the WNM group (97.0% vs. 79.4%, P=0.049) and got a higher daily energy intake (1761.3±339.5 vs. 1599.6±321.5, P=0.045). The ICER suggested that WNM saved 31 511 Chinese Yuan (CNY) while reducing the rate of total infections by 1% in the intention-to-treat (ITT) population and saved 117 490 CNY in patients at nutritional risk, while WNM saved 31 511 CNY while reducing the rate of abdominal infections by 1% in the ITT population and saved 101 359 CNY in patients at nutritional risk.

Conclusion:

In this trial, whole-course nutrition management was associated with fewer total postoperative complications, total and abdominal infections, and was cost-effective, especially in patients at nutritional risk. It seems to be a favorable strategy for patients undergoing PD.
Updates on Urinary Bladder Tumors With Neuroendocrine Features
Authors: Akbulut Dilara , Al-Ahmadie Hikmat
Published: March 2024

The most common neuroendocrine tumor in the urinary bladder is small cell carcinoma, which can be pure or mixed with components of urothelial or other histologic subtypes. Large cell neuroendocrine carcinoma of the bladder is rare and remains ill-defined but is increasingly recognized. Well-differentiated neuroendocrine tumor and paraganglioma can arise in the bladder but are very rare in this location. Recent advances in molecular characterization allowed for better classification and may offer improved stratification of these tumors.
Evolution of Testicular Germ Cell Tumors in the Molecular Era With Histogenetic Implications
Authors: Kilic Irem , Acosta Andres M. , Idrees Muhammad T.
Published: March 2024

The current WHO classification of testicular germ cell tumors is based on the pathogenesis of the tumors driven by different genomic events. The germ cell neoplasia in situ is the precursor lesion for all malignant germ cell tumors. The current understanding of pathogenesis is that the developmental and environmental factors with the erasure of parental genomic imprinting lead to the development of abnormal gonocytes that settle in the “spermatogonial Niche” in seminiferous tubules. The abnormal primordial germ cells in the seminiferous tubules give rise to pre-GCNIS cells under the influence of TPSY and OCT4 genes. The whole genome duplication events give rise to germ cell neoplasia in situ, which further acquires alterations in 12p along with NRAS and KRAS mutations to produce seminoma. A subset of seminomas acquires KIT mutation and does not differentiate further. The remaining KIT-stable seminomas differentiate to nonseminomatous GCTs after obtaining recurrent chromosomal losses, epigenetic modification, and posttranscriptional regulation by multiple genes. Nonseminomatous germ cell tumors also develop directly from differentiated germ cell neoplasia in situ. TP53 pathway with downstream drivers may give rise to somatic-type malignancies of GCT. The GCTs are remarkably sensitive to cisplatin-based combination chemotherapy; however, resistance to cisplatin develops in up to 8% of tumors and appears to be driven by TP53/MDM2 gene mutations. Serum and Plasma miRNAs show promise in diagnosing, managing, and following up on these tumors. The mechanisms underlying the development of most tumors have been elucidated; however, additional studies are required to pinpoint the events directing specific characteristics. Advances in identifying specific molecular markers have been seen recently and may be adopted as gold standards in the future.
Investigational Approaches for Treatment of Melanoma Patients Progressing After Standard of Care
Authors: Fletcher Kylie A. , Johnson Douglas B.
Published: March 2024

The advent of effective immunotherapy, specifically cytotoxic T-lymphocyte associated protein 4 and programmed cell death 1 inhibitors, as well as targeted therapy including BRAF/MEK inhibitors, has dramatically changed the prognosis for metastatic melanoma patients. Up to 50% of patients may experience long-term survival currently. Despite these advances in melanoma treatment, many patients still progress and die of their disease. As such, there are many studies aimed at providing new treatment options for this population. Therapies currently under investigation include, but are not limited to, novel immunotherapies, targeted therapies, tumor-infiltrating lymphocytes and other cellular therapies, oncolytic viral therapy and other injectables, and fecal microbiota transplant. In this review, we discuss the emerging treatment options for metastatic melanoma patients who have progressed on standard of care treatments.
Psychosocial Impairment in Older Patients With Bipolar I Disorder
Authors: Vahapoğlu Berkay , Aksoy Poyraz Cana , Özdemir Armağan
Published: March 2024

Background.

The goal of this study was to assess psychosocial functioning in older patients with bipolar I disorder compared with healthy subjects and to identify the psychopathological factors associated with poor functioning in patients.

Methods:

We recruited 68 euthymic patients with bipolar I disorder from the outpatient unit and 89 healthy controls who were older than 50 years of age. In addition to clinical variables, we used other standardized measures, including the Young Mania Rating Scale, the Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Functional Assessment Short Test, and the Montreal Cognitive Assessment.

Results.

Older patients with bipolar I disorder had poorer psychosocial functioning in general and in the domains of occupation, autonomy, and cognition than the healthy controls on the basis of previously defined Functional Assessment Short Test cutoff scores. We found that 35.3% (95% CI: 23%-47%) of the patients did not have clinically significant functional impairment, 38.2% (95% CI: 26%-50%) had mild impairment, and 26.5% (95% CI: 16%-37%) had moderate impairment. Depressive symptoms and impaired cognition were associated with poor overall functioning.

Conclusions.

The level of psychosocial functioning was heterogeneous among the patients. Subsyndromal depressive symptoms, even at low levels, and impaired cognition predicted poor functioning in euthymic middle-aged and older patients with bipolar I disorder.
Current Trends in Breast Cancer Treatment in Chinese and Chinese American Women
Authors: Putnam Geneviève , Williams Tokoya , Park Seong , Grundman Kendra , Goel Chirag , Huffman Kristin , Galiano Robert D.
Published: March 2024

Background

Breast cancer screening and surgical interventions are often underutilized in the Chinese community. For both Chinese American (CA) and native Chinese (NC) patients, screening rates are well below medical recommendations, which places these patients at risk for late diagnoses and larger tumors. There is also a notable reluctance to breast reconstruction after mastectomy. We investigated the role of sociodemographic and cultural barriers in breast treatment trends among Chinese breast cancer survivors.

Methods

A literature search for full-text articles published between 2011 and 2021 was performed using PubMed, The Web of Science, and Embase. The articles that were selected contained information regarding Chinese individuals in the United States or China who had undergone breast cancer screening or diagnosis of breast cancer and received treatment with or without reconstructive surgery.

Results

Both patient populations exhibited screening rates that were significantly lower than national recommendations. Of the CA patients, 25% reported never receiving a mammogram, whereas 450 million NCs have been left unscreened despite efforts made by the Chinese government. Misinformation, cultural beliefs, and fear significantly contributed to diminished breast health care among CA and NC women. Fear of recurrence, breast value, community influence, and limited health care resources were found to be the primary drivers of low breast reconstruction uptake.

Conclusions

In both NC and CA women, there is a critical need for improved breast health information dissemination and overall quality of care. The findings summarized in this review can guide such efforts.
Reported Variability in General Surgery Training Across Integrated Plastic Surgery Residency Programs
Authors: Chopra Christina S. , Abdirahman Hana J. , Mullikin Alexandria M. , Abramov Daniella , Aref Youssef , Lee Clara J. , Al-Hamad Daubs Mariam , Reid Chris M.
Published: March 2024

Background

Since their development, integrated plastic and reconstructive surgery (PRS) residency training programs have established diverse methods of incorporating general surgery training into graduate medical education. Programs have questioned the necessary duration and timing of such training. The aim of this study is to assess the landscape of general surgery exposure in integrated PRS residency programs.

Methods

Thirty-six integrated PRS residency programs were included based on the availability of postgraduate year (PGY)-level rotation data. Rotations were measured in units of weeks with descriptive titles maintained as advertised by the program. Individual general surgery rotations were also categorized as being either PRS-aligned, American Board of Plastic Surgery (ABPS) Required Clinical (RC) or ABPS Strongly Suggested (SS). Statistical analyses were carried out on the relative proportions of each subcategory in the 2 parent groups.

Results

All 36 programs evaluated required general surgery rotations in years PGY- 1 to -2. By PGY-3, 69% of programs required general surgery, and by PGY-6, 25%, and these were limited to 4- to 6-week rotations in burn, breast, or trauma. Looking across all 6 years, with 312 weeks of training total, the minimum number of weeks spent in general surgery rotations was 32, and the maximum number was 119, with an average of 61 weeks (±21).

Programs were subcategorized into 2 groups based on whether they spent more (n = 16) or less (n = 20) than the net average number of weeks in ABPS RC + SS rotations. No significant difference was found in the relative proportion of PRS-aligned general surgery across groups. Programs with <60 weeks of general surgery had a relatively greater proportion of ABPS RC and SS rotations.

Conclusions

These data demonstrate that there exists significant variability in overall duration of general surgery training across integrated PRS training programs. When controlling overall general surgery exposure for variables of interest like PRS-aligned exposure or compatibility with ABPS requirements, we found no discernable educational model or patterns to explain the observed range in exposure. These results warrant reexamination of an ideal general surgery track within the integrated plastic surgery training model that optimizes training for the PRS resident
Virtual Surgical Planning and Customized CAD/CAM Cranial Implants: Preoperative and Intraoperative Strategies for Temporal Intraosseous Meningioma Resection
Authors: Westarp Emilia , Thieringer Florian M. , Roethlisberger Michel
Published: March 2024

Primary intraosseous meningioma (PIM) is a rare subtype of extradural meningiomas, with the indication for surgical resection in most cases. With an increasing demand for efficient workflows with optimal functional and cosmetical results, techniques for bone reconstruction after resection are developing rapidly. The authors present 2 cases with one-stage cranioplasty after resection of PIM, using 3D technology for preplanned patient-specific implants. In the first case, a premanufactured patient-specific PEEK implant was used for reconstruction; in the second case, a 3-dimensional (3D)-based premanufactured silicon mold was used to produce a customized PMMA implant intraoperatively. Both techniques enabled the surgeons to achieve optimal intraoperative fit of the implant after craniectomy, leading to satisfying functional and cosmetic results. The use of 3D technology, such as Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) for the production of patient-specific implants can optimize 1-stage cranioplasty after PIM resection.
Myelin Oligodendrocyte Glycoprotein Antibody Disease Optic Neuritis: A Structure–Function Paradox?
Authors: Ross Ruby , Kenney Rachel , Balcer Laura J. , Galetta Steven L. , Krupp Lauren , O'Neill Kimberly A. , Grossman Scott N.
Published: March 2024

Background:

Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a demyelinating disorder that most commonly presents with optic neuritis (ON) and affects children more often than adults. We report 8 pediatric patients with MOG-associated ON and characterize focal optical coherence tomography (OCT) abnormalities over time that help distinguish this condition from the trajectories of other demyelinating disorders. These OCT findings are examined in the context of longitudinal visual function testing.

Methods:

This is a retrospective case series of 8 pediatric patients with MOG-associated ON who were referred for neuro-ophthalmic evaluation. Longitudinal data for demographics, clinical history, physical examination, and OCT obtained in the course of clinical evaluations were collected through retrospective medical record review.

Results:

Patients demonstrated acute peripapillary retinal nerve fiber layer (RNFL) thickening in one or both eyes, consistent with optic disc swelling. This was followed by steady patterns of average RNFL thinning, with 9 of 16 eyes reaching significantly low RNFL thickness using OCT platform reference databases (P < 0.01), accompanied by paradoxical recovery of high-contrast visual acuity (HCVA) in every patient. There was no correlation between HCVA and any OCT measures, although contrast sensitivity (CS) was associated with global thickness, PMB thickness, and nasal/temporal (N/T) ratio, and color vision was associated with PMB thickness. There was a lower global and papillomacular bundle (PMB) thickness (P < 0.01) in clinically affected eyes compared with unaffected eyes. There was also a significantly higher N:T ratio in clinically affected eyes compared with unaffected eyes in the acute MOG-ON setting (P = 0.03), but not in the long-term setting.

Conclusions:

MOG shows a pattern of prominent retinal atrophy, as demonstrated by global RNFL thinning, with remarkable preservation of HCVA but remaining deficits in CS and color vision. These tests may be better clinical markers of vision changes secondary to MOG-ON. Of the OCT parameters measured, PMB thickness demonstrated the most consistent correlation between structural and functional measures. Thus, it may be a more sensitive marker of clinically significant retinal atrophy in MOG-ON. The N:T ratio in acute clinically affected MOG-ON eyes in our study was higher than the N:T ratio of neuromyelitis optica (NMO)-ON eyes and similar to the N:T ratio in multiple sclerosis (MS)-ON eyes as presented in the prior literature. Therefore, MOG may share a more similar pathophysiology to MS compared with NMO.
Application of sensory nerve quantitative tests to analyze the subtypes of motor disorders in Parkinson’s disease
Authors: Tian Hongxue , Yuan Yongsheng , Zhang Kezhong
Published: March 2024

This study investigated the sensory nerve function in people with different subtypes of Parkinson’s disease (PD), which included the tremor-dominant (TD) group (n = 30), postural instability and gait disorder (PIGD) group (n = 33), and healthy-controls (HC) group (n = 33). Sural nerve's current perception threshold (CPT) and pain tolerance threshold (PTT) in both feet were measured at different frequencies. Results were evaluated using the mini-mental state examination (MMSE), Hoehn Yahr scale (H-Y) , and 3-meter timed-up-and-go-test (TUGT). The MMSE scores of the TD and HC groups were higher than those of the PIGD group (TD < HC). The 3-meter TUGT scores of the PIGD group were higher than theTD and HC groups (TD > HC). The PIGD patients experienced a significantly shorter disease duration and higher H-Y score than the TD patients (P < 0.05). The values of 2 KHz CPT of left-side (CPTL), 2KHz CPT of right-side (CPTR), and 5 Hz CPTR in the PIGD group were significantly higher compared to the TD and HC groups (P < 0.05, Bonferroni correction). Additionally, the values of 250 Hz CPTL, 5 Hz CPTL, 250 Hz CPTR, 2 kHz PTT of left-side (PTTL), 250 Hz PTTL, and 5 Hz PTTL in the PIGD group were significantly elevated relative to the TD group (P < 0.05, Bonferroni correction). Distinctive current threshold perception and PTT of the sural nerve can be observed in patients with varying PD subtypes, and sensory nerve conduction threshold electrical diagnostic testing can detect these discrepancies in sensory nerve function.
Frequency effects can modulate the neural correlates of prosodic processing in Mandarin
Authors: Zhang Zhongpei
Published: March 2024

In tonal languages, tone perception involves the processing of both acoustic and phonological information conveyed by tonal signals. In Mandarin, in addition to four canonical full tones, there exists a group of weak syllables known as neutral tones. This study aims to investigate the impact of lexical frequency effects and prosodic information associated with neutral tones on the auditory representation of Mandarin compounds. We initially selected disyllabic compounds as targets, manipulating their lexical frequencies and prosodic structures. Subsequently, these target compounds were embedded into selected sentences and auditorily presented to native speakers. During the experiments, participants engaged in lexical decision tasks while their event-related potentials were recorded. The results showed that the auditory lexical representation of disyllabic compounds was modulated by lexical frequency effects. Rare compounds and compounds with rare first constituents elicited larger N400 effects compared to frequent compounds. Furthermore, neutral tones were found to play a role in the processing, resulting in larger N400 effects. Our findings showed significantly increased amplitudes of the N400 component, suggesting that the processing of rare compounds and compounds with neutral tones may require more cognitive resources. Additionally, we observed an interaction effect between lexical frequency and neutral tones, indicating that they could serve as determining cues in the auditory processing of disyllabic compounds.
Hematologic and Serum Biochemical Values Associated With Different Stages of Hospital-Acquired Pressure Injuries in Patients
Authors: Chang Wen-Pei , Jen Hsiu-Ju , Chang Yu-Pei
Published: March 2024

PURPOSE:

The primary purpose of this study was to determine whether hematologic and serum biochemical values used as indicators of nutritional status, anemia, and/or infection were associated with the risk of hospital-acquired pressure injuries (PIs) and stage of PIs in patients.

DESIGN:

A retrospective review of medical records.

SUBJECTS AND SETTING:

Data were collected from medical records including official PI records and PI incident reports of inpatients at a teaching hospital in Taiwan between January 2019 and October 2020.

METHODS:

We collected demographic variables of the inpatients and their hematologic and serum biochemical values within 1 day of PI occurrence (including the day of PI occurrence), 6 to 7 days before PI occurrence, and 13 to 14 days before PI occurrence.

RESULTS:

Among the 309 inpatients with official PI records, 105 (34.0%) had Stage 1 PIs, 131 (42.4%) had Stage 2 or 3 PIs, and 73 (23.6%) had unstageable or suspected deep tissue injuries. After controlling for the type of department where PIs occurred and length of hospital stay up to the day of PI occurrence, we found significant differences in levels of hemoglobin (odds ratio [OR] = 0.47, P = .009) within 1 day of PI occurrence and in albumin (OR = 0.30, P = .001) 13 to 14 days before PI occurrence.

CONCLUSIONS:

Study findings suggest that lower hemoglobin levels on the day of PI occurrence and lower albumin levels 2 weeks before PI occurrence resulted in a significantly higher risk of developing unstageable or suspected deep tissue injuries than of developing Stage 1 PIs.
High-energy particle observations from the Moon
Authors: Dandouras Iannis , Roussos Elias
Published: March 2024

The Moon is a unique natural laboratory for the study of the deep space plasma and energetic particles environment. During more than 3/4 of its orbit around the Earth it is exposed to the solar wind. Being an unmagnetized body and lacking a substantial atmosphere, solar wind and solar energetic particles bombard the Moon's surface, interacting with the lunar regolith and the tenuous lunar exosphere. Energetic particles arriving at the Moon's surface can be absorbed, or scattered, or can remove another particle from the lunar regolith by sputtering or desorption. A similar phenomenon occurs also with the galactic cosmic rays, which have fluxes and energy spectra representative of interplanetary space. During the remaining part of its orbit the Moon crosses the tail of the terrestrial magnetosphere. It then provides the opportunity to study
in-situ
the terrestrial magnetotail plasma environment as well as atmospheric escape from the Earth's ionosphere, in the form of heavy ions accelerated and streaming downtail. The lunar environment is thus a unique natural laboratory for analysing the interaction of the solar wind, the cosmic rays and the Earth's magnetosphere with the surface, the immediate subsurface, and the surface-bounded exosphere of an unmagnetized planetary body.

This article is part of a discussion meeting issue ‘Astronomy from the Moon: the next decades (part 2)’.
Transformer Model Generated Bacteriophage Genomes are Compositionally Distinct from Natural Sequences
Authors: Ratcliff Jeremy
Published: March 2024

Novel applications of language models in genomics promise to have a large impact on the field. The megaDNA model is the first publicly available generative model for creating synthetic viral genomes. To evaluate megaDNA’s ability to recapitulate the nonrandom genome composition of viruses and assess whether synthetic genomes can be algorithmically detected, compositional metrics for 4,969 natural bacteriophage genomes and 1,002de novosynthetic bacteriophage genomes were compared. Transformer-generated sequences had varied but realistic genome lengths and 58% were classified as viral by geNomad. However, the sequences demonstrated consistent differences in various compositional metrics when compared to natural bacteriophage genomes by rank-sum tests and principal component analysis. A simple neural network trained to detect transformer-generated sequences on global compositional metrics alone displayed a median sensitivity of 93.0% and specificity of 97.9% (n = 12 independent models). Overall, these results demonstrate that megaDNA does not yet generate bacteriophage genomes with realistic compositional biases and that genome composition is a reliable method for detecting sequences generated by this model. While the results are specific to the megaDNA model, the evaluate framework described here could be applied to any generative model for genomic sequences.
Engineering Tumor Stroma Morphogenesis Using Dynamic Cell-Matrix Spheroid Assembly
Authors: Buckenmeyer Michael J. , Brooks Elizabeth A. , Taylor Madison S. , Yang Liping , Holewinski Ronald J. , Meyer Thomas J. , Galloux Mélissa , Garmendia-Cedillos Marcial , Pohida Thomas J. , Andresson Thorkell , St. Croix Brad , Wolf Matthew T.
Published: March 2024

The tumor microenvironment consists of resident tumor cells organized within a compositionally diverse, three-dimensional (3D) extracellular matrix (ECM) network that cannot be replicated in vitro using bottom-up synthesis. We report a new self-assembly system to engineer ECM-rich 3D MatriSpheres wherein tumor cells actively organize and concentrate microgram quantities of decellularized ECM dispersions which modulate cell phenotype. 3D colorectal cancer (CRC) MatriSpheres were created using decellularized small intestine submucosa (SIS) as an orthotopic ECM source that had greater proteomic homology to CRC tumor ECM than traditional ECM formulations such as Matrigel. SIS ECM was rapidly concentrated from its environment and assembled into ECM-rich 3D stroma-like regions by mouse and human CRC cell lines within 4-5 days via a mechanism that was rheologically distinct from bulk hydrogel formation. Both ECM organization and transcriptional regulation by 3D ECM cues affected programs of malignancy, lipid metabolism, and immunoregulation that corresponded with an in vivo MC38 tumor cell subpopulation identified via single cell RNA sequencing. This 3D modeling approach stimulates tumor specific tissue morphogenesis that incorporates the complexities of both cancer cell and ECM compartments in a scalable, spontaneous assembly process that may further facilitate precision medicine.
Effects of nano urea on growth and gene expression ofArabidopsis thalianain hydroponics
Authors: Jangir Neelam , Marik Debankona , Verma Devanshu , Dey Arpan , Shekhawat Rajveer Singh , Patel Deep , Yadav Pankaj , Sankhala Kirti , Sadhukhan Ayan
Published: March 2024

Introduction

Hydroponics enables precise control over nutrient delivery, optimized water requirements and growing conditions. The combination of nanotechnology and hydroponics paves the way towards sustainable agriculture with less environmental footprints. We investigated the effects of nano urea on the model plantArabidopsis thalianain hydroponics.

Methods

A growth experiment in a nitrogen-free hydroponic medium compared the effects of a liquid nano urea formulation (NUF) marketed by Indian Farmers Fertilizer Cooperative (IFFCO) to an equimolar bulk urea. Transcriptome analysis identified the molecular mechanisms of growth enhancement. Dynamic light scattering and transmission electron microscopy confirmed NUF’s negative surface charge and sub-100 nm size, correlating its uptake and distribution in the plant.

Results and discussion

A two-week growth in the hydroponic medium with 70 μM NUF led to a 20% higher biomass and 16% higher chlorophyll content than a medium with 70 μM urea. Higher doses of NUF inhibited growth, whereas higher equivalent urea doses did not. NUF led to the differential expression of more genes than urea at 12 h to seven days of treatment. Nitrogen assimilation, growth, photosynthesis, and stress tolerance genes showed higher transcript levels in NUF than in urea. On the other hand, NUF led to greater suppression of many negative growth-regulating genes. After seven days of treatment, chlorophyll biosynthesis genes got up-regulated, while chlorophyll catabolism genes got down-regulated at higher levels by NUF than by urea, correlating with the higher chlorophyll content of NUF-treated seedlings. In conclusion, NUF outperformed equimolar urea for the growth promotion ofA. thalianaat a low concentration in hydroponics, leading to a greater regulation of genes for nitrogen metabolism and chlorophyll biosynthesis. Our results suggest a potential use of NUF as a nitrogen fertilizer for hydroponic agriculture.