bluuebunny/crossref_metadata_2025 huggingface dataset:
Randomised crossover study on pulse oximeter readings from different sensors in very preterm infants
Authors: Maiwald Christian Achim , Schwarz Christoph E , Böckmann Katrin , Springer Laila , Poets Christian F , Franz Axel
Published: December 2023

Objective

In extremely preterm infants, different target ranges for pulse oximeter saturation (SpO2) may affect mortality and morbidity. Thus, the impact of technical changes potentially affecting measurements should be assessed. We studied SpO2readings from different sensors for systematic deviations.

Design

Single-centre, randomised, triple crossover study.

Setting

Tertiary neonatal intensive care unit.

Patients

24 infants, born at <32 weeks’ gestation, with current weight <1500 g and without right-to-left shunt via a patent ductus arteriosus.

Interventions

Simultaneous readings from three SpO2sensors (Red Diamond (RD), Photoplethysmography (PPG), Low Noise Cabled Sensors (LNCS)) were logged at 0.5 Hz over 6 hour/infant and compared with LNCS as control using analysis of variance. Sensor position was randomly allocated and rotated every 2 hours. Seven different batches each were used.

Outcomes

Primary outcome was the difference in SpO2readings. Secondary outcomes were differences between sensors in the proportion of time within the SpO2-target range (90–95 (100)%).

Results

Mean gestational age at birth (±SD) was 274/7(±23/7) weeks, postnatal age 20 (±20) days. 134 hours of recording were analysed. Mean SpO2(±SD) was 94.0% (±3.8; LNCS) versus 92.2% (±4.0; RD; p<0.0001) and 94.5% (±3.9; PPG; p<0.0001), respectively. Mean SpO2difference (95% CI) was −1.8% (−1.9 to −1.8; RD) and 0.5% (0.4 to 0.5; PPG). Proportion of time in target was significantly lower with RD sensors (84.8% vs 91.7%; p=0.0001) and similar with PPG sensors (91.1% vs 91.7%; p=0.63).

Conclusion

There were systematic differences in SpO2readings between RD sensors versus LNCS. These findings may impact mortality and morbidity of preterm infants, particularly when aiming for higher SpO2-target ranges (eg, 90–95%).

Trial registration number

DRKS00027285.
Particulate synovitis granuloma complication following a first metatarsophalangeal joint silastic implant
Authors: Protheroe Derek , Green Richard , Hayes Mark
Published: December 2023

This case presents a known complication of particulate synovitis granuloma associated with a first metatarsophalangeal joint silastic implant. However, the degree of soft tissue granuloma enlargement is quite unique in size and its proliferative effect—invading the medulla cavity and infiltrating the outer cortex of bone. This case study aims to demonstrate its clinical presentation, imaging investigations, surgical excision and histopathology findings. The learning points emphasised within this manuscript draw attention to the procedure selection for a silastic implant, as well as its proposed mode of action and various potential associated complications. Surgery was based on careful analysis of overall function, prior surgery conducted and patient expectations to achieve a shared decision-making process.
Common Healthcare Related Instruments Subjected To Magnetic Attraction Study (CHRISTMAS): prospective in situ experimental study
Authors: Ong Shao J , Chia Koon Liang , See Teik Choon , Graves Martin , Hoon Desmond , Hang Joanne , Teo Lycia , Su Peijing , Hallinan James T P D , Ong Michael , Ang Bertrand , Quek Swee Tian
Published: December 2023

Objective

To investigate the behaviour of common healthcare related objects in a 3 tesla (T) MRI (magnetic resonance imaging) scanner, examining their ability to self-propel towards the scanner bore and their potential for tissue penetration.

Design

Prospective in situ experimental study.

Setting

Clinical 3 T MRI scanner. Customised rig designed and built to guide objects towards the scanner bore.

Participants

12 categories of objects commonly found in hospitals, or on patients or healthcare professionals, or near an MRI scanning room. Human tissue penetration simulated with ballistic gel (Federal Bureau of Investigation and North Atlantic Treaty Organisation graded).

Main outcome measures

SANTA (site where applied newtonian mechanics triggers acceleration) measurements and depth of tissue penetration of the objects.

Results

SANTA measurements ranged from 0 cm for the 20 pence, 50 pence, and £2 coins to 152-161 cm for a knife and the biscuit tins. One penny, two pence, five pence, and 10 pence coins showed self-propulsion and acceleration towards the scanner bore at a distance >100 cm from the gantry entry point. Linear regression analysis showed no apparent correlation between the weight of the objects and their SANTA measurements (R
2
<0.1). Only five objects penetrated the ballistic gel (simulated human tissue). The deepest penetration was by the knife (5.5 cm), closely followed by the teaspoon (5.0 cm), fork (4.0 cm), spoon (3.5 cm), and a 10 pence coin (0.5 cm). Although the biscuit tins did not penetrate the simulated human tissue, they exerted substantial impact force which could potentially cause bone fractures. A smartphone, digital thermometer, metallic credit card, and pen torch remained fully functional after several passes into the MRI scanner. No discernible loss of image quality for the MRI scanner after the experiments was found.

Conclusions

The study highlights the potential for harm (major tissue damage and bone fractures) when commonly found objects in a healthcare setting are unintentionally brought into the MRI scanner room. Patients and healthcare professionals need to be aware of the dangers associated with bringing ferromagnetic objects into the MRI environment.
Adolescent idiopathic scoliosis: interdisciplinary creative art practice and nature connections
Authors: Baker Catherine , Morris Nina , Tsirikos Athanasios , Fotakopoulou Olga , Parrott Flora
Published: December 2023

Scoliosis is an abnormal lateral curvature of the spine with the large majority of cases classed as idiopathic, meaning there is no known cause. Typically, most cases occur in children and young people affecting approximately three per cent of the adult populace with five out of six cases being female. TheBackBone: Interdisciplinary Creative Practices and Body Positive Resiliencepilot research study used arts and humanities methods to measure the impact of adolescent idiopathic scoliosis (AIS) on well-being and body perception. The research aimed to contribute to a better understanding of alternative treatments towards improving quality of life in young women diagnosed with AIS. In particular, concentrating on two highlighted priorities from the Scoliosis Priority Setting Partnership: (1) How is quality of life affected by scoliosis and its treatment? How can we measure this in ways that are meaningful to patients? (2) How are the psychological impacts (including on body image) of diagnosis and treatment best managed.

Using established medical techniques, art-based workshops, and focus groups with postoperative participants with AIS and their families we gathered both quantitative and qualitative data. The workshops explored the aesthetics of imperfection through material investigations that focus on the body as both an object and how it is experienced using the metaphor of tree images. Drawing parallels between the growth patterns of trees that, for complex and often unknown reasons, have grown unexpectedly we explored questions around ideological notions of perfect growth through art-making in a non-clinical setting. Uniquely, the pilot project sought to draw on insights from four key disciplines (art, medicine, psychology and human geography), thinking across boundaries to evoke different ways of knowing and understanding the complexities of body perception through image-making.
Influence of antithrombotic medication on size and neurological outcome of spinal epidural hematoma after neuraxial anesthesia: a systematic review
Authors: Schieber Mirjam Ruth , Schubert Ann-Kristin , Hubner Wakiko , Volk Thomas
Published: December 2023

Introduction

Anticoagulation guidelines were developed to reduce the potential risk of epidural bleeding following neuraxial anesthesia. However, the influence of antithrombotic medication on size of spinal epidural hematoma and neurological outcome is unclear. Therefore, our aim was to analyze whether there is a correlation.

Methods

The study was registered at Prospero (CRD42021285833). A systematic search in MEDLINE, EMBASE, CENTRAL, Web of Science and Google Scholar was conducted in August 2023 for studies reporting spinal epidural hematoma following neuraxial anesthesia. Primary endpoints were segmental extension and neurological outcome. Secondary endpoints were age, sex, body mass index, predisposition, American Society of Anesthesiologists physical status, complicated puncture, multiple punctures, bloody puncture, successful puncture, catheter usage, needle size and worst neurological deficit before treatment. Prespecified multivariate regression and propensity score matching was performed. Publications reporting on more than one patient were critically appraised.

Results

A total of 345 cases reported in 304 publications were included. Size of hematoma was not significantly different (antithrombotic medication: OR 0.11, 95% CI (−0.67 to 0.89), p=0.78, ‘non-guideline adherent’ for puncture/removal: OR 0.13, 95% CI (−0.92 to 1.18), p=0.81). Patients receiving antithrombotic medication were more likely to have persistent neurological deficit (OR 2.00, 95% CI 1.24 to 3.23), p<0.01). Significance persisted after propensity score matching (p=0.04). Patients with non-guideline adherence had a 3.42 higher chance of persistent neurological deficit (95% CI 1.71 to 6.86, p<0.001).

Discussion

Antithrombotic medication is not significantly associated with hematoma size; however, the use of antithrombotic medication doubled the risk for persistent neurological deficit after spinal epidural hematoma.
Low-load blood flow restriction strength training in patients with COPD: a randomised single-blind pilot study
Authors: Kohlbrenner Dario , Kuhn Manuel , Manettas Anastasios , Aregger Céline , Peterer Matthias , Greco Nicola , Sievi Noriane A , Clarenbach Christian
Published: December 2023

Objective

The objective of this study is to compare the effectiveness of lower limb low-load blood flow restriction training (LL-BFRT) with high-load strength training (HL-ST) as part of an outpatient pulmonary rehabilitation programme on leg strength in patients with chronic obstructive pulmonary disease (COPD).

Methods

Participants were randomised to LL-BFRT or HL-ST (24 sessions). LL-BFRT was done at 30% 1-repetition maximum (1-RM) with 70% arterial occlusion pressure. HL-ST was done at 70% 1-RM. Primary outcome was isometric strength of knee extensors and flexors. Secondary outcomes were 1-RM, functional exercise capacity, physical activity, symptom burden and health-related quality of life. Perceptions of dyspnoea and leg fatigue were recorded after every exercise. We compared groups with t-tests.

Results

We included 30 participants (13 women, 17 men, 64 (9) years, forced expiratory volume in 1 s 47 (18)% pred.), 24 completed the study. Isometric knee extensor strength improved to a clinically relevant degree in both legs in both groups (LL-BFRT: right leg 9 (20) Nm, left leg 10 (18) Nm; HL-ST: right leg 15 (26) Nm, left leg 16 (30) Nm, data are mean (SD)), without statistically significant or clinically relevant between-group differences (right leg mean difference= −6.4, 95% CI= −13.20 to 25.92 Nm, left leg mean difference= −5.6, 95% CI= −15.44 to 26.55 Nm). 1 min sit-to-stand test performance improved to a clinically relevant degree only in the LL-BFRT group (4 (4) vs 1 (5) repetitions). Interestingly, physical activity improved to a clinically relevant degree only in the LL-BFRT group (1506 (2441) vs −182 (1971) steps/day). LL-BFRT lowered perceived in-exercise dyspnoea and increased leg fatigue compared with HL-ST in the initial 12 trainings.

Conclusion

In patients with stable COPD undergoing outpatient pulmonary rehabilitation, LL-BFRT was not superior to HL-ST in improving leg strength. LL-BFRT led to similar strength gains as HL-ST while reducing perceptions of dyspnoea in the initial training phase.

Trial registration number

NCT04151771.
Synthesis of two air- and moisture-stable copper (II)-N-heterocyclic carbene complexes
Authors: Hoare Jacob G. , George Tanner , Masuda Jason D. , Singer Robert D.
Published: December 2023

N-heterocyclic carbenes (NHCs) are a versatile class of ligands that have been widely applied in transition metal catalysis. However, NHCs are soft bases, and as such, complexes of NHCs with hard acids—such as many first-row transition metals—are typically sensitive to air and moisture, hence requiring multistep preparations. In this work, two examples of rare copper (II)-NHC complexes were prepared directly from 1,3-bis(pyridylmethyl)imidazolium chloride and 1,3-bis(2-pyridylmethyl)benzimidazolium chloride in protic conditions with no effort to exclude air or moisture. X-ray crystallographic analysis showed that both species display distorted square pyramidal geometry. A probe reaction demonstrated both complexes displayed poor catalytic activity for Chan–Evans–Lam coupling reactions.
The occurrence of cytokinins and their biosynthesis pathways in epithelioma papulosum cyprini cells
Authors: Schincaglia Angela , Seegobin Mark , Brunetti Craig R , Emery Neil R.J.
Published: December 2023

Cytokinins (CKs) are small signaling molecules present in all kingdoms of life; however, their biological relevance outside of plants is poorly characterized. CK detection across kingdoms has been shown to be inconsistent and is often organism or cell line dependent. To ensure optimal detection in epithelioma papulosum cyprini (EPC), a cold-blooded vertebrate cell line, a range of biomasses were evaluated. CKs were extracted by solid-phase extraction and then detected using high-performance liquid chromatography and tandem mass spectrometry. The objectives were to establish endogenous CK profiles and characterize their biosynthesis in EPC cells. Among the 14 CKs that were scanned for, only 4 forms were detected overall within the samples analyzed, including, N6-(Δ2-isopentenyl) adenine-9-riboside (iPR), N6-(Δ2-isopentenyl) adenine-9-riboside-5′ (mono/di/tri)phosphate (iPNT), and cis-zeatin-9-riboside-5′ (mono/di/tri)phosphate ( cZNT) and 2‐methylthio‐zeatin (2MeSZ). The total CK concentrations ranged from 0.03 pmol/g to 681.025 pmol/gfwt. The results from this study provided evidence that EPC cells can produce and process CKs.
Drought-induced growth phenotypes are associated with genetic variation across a white pine hybrid zone
Authors: Peach L.R. , Waring K.M. , Fulé P.Z. , Eckert A.J. , Menon M. , Swenson J.K.
Published: December 2023

Understanding relationships among warming climate, increased drought severity, and the genetic architecture of hybrid drought resilience is necessary for forest conservation and management. We calculated three drought-related tree-ring-growth indices (dendrophenotypes) using tree-ring data from hybrid Pinus strobiformis–Pinus flexilis study trees at nine sites across Colorado, New Mexico, Arizona, and Texas. Along with hybrid index (percentage of P. strobiformis ancestry inherited by a single tree) and climate variables, we used dendrophenotypes to (Q1) examine relationships among climate and hybrid index, (Q2) examine relationships between dendrophenotypes and hybrid index, and (Q3) conduct a genotype–phenotype analysis. We observed a significant correlation between hybrid index and dendrophenotypes resulting from high-temperature drought in addition to a significant correlation between those dendrophenotypes and our dataset of single-nucleotide polymorphisms. We conclude that P. strobiformis–P. flexilis trees exhibiting higher hybrid indices are more resilient to high-temperature drought events and encourage future research that identifies a genetic linkage between relevant loci and their conferred physiological benefits.
Coordination of Cyclic crossover and Bat Algorithm for the Travelling Salesman Problems in Different Environments: A Simulation Approach
Authors: Pal Sova , Dutta Prasanta , Khan Indadul , Pramanik Prasenjit , Maiti Ajoy Kumar , Maiti Manas Kumar
Published: December 2023

In this study, the features of cyclic crossover process and K-opt are incorporated in the bat algorithm (BA) to solve the Travelling Salesman Problems (TSP) in different environments. Swap operation and swap sequence are applied for the modification of the different operations of the BA to solve the TSPs. The cyclic crossover operation is applied in a regular interval of iterations on the best found solution and each solution of the final population of BA for the enhancement of the exploration as well as exploitation of the search process. K-Opt operation is applied on the population in each iteration of the BA with some probability for the exploitation. The algorithm is tested with a set of benchmark test instances of the TSPLIB. The algorithm produces exact results for a set of significantly large size problems. For the TSPs in fuzzy environment, a fuzzy simulation approach is proposed to deal with the fuzzy data having linear as well as non-linear membership functions. Also, a rough simulation process is proposed to deal with the TSPs in the rough environment where rough estimation can be done following any type of rough measure. The performance of the algorithm is compared with the state-of-the-art algorithms for the TSPs with crisp cost matrices using different statistical tools.
Nonverbal Communication through Expressive Objects
Authors: Valencia Stephanie , Steidl Mark , Rivera Michael L. , Bennett Cynthia L. , Bigham Jeffrey P. , Admoni Henny
Published: December 2023

Augmentative and alternative communication (AAC) devices enable speech-based communication, but generating speech is not the only resource needed to have a successful conversation. Being able to signal one wishes to take a turn by raising a hand or providing some other cue is critical in securing a turn to speak. Experienced conversation partners know how to recognize the nonverbal communication an augmented communicator (AC) displays, but these same nonverbal gestures can be hard to interpret by people who meet an AC for the first time. Prior work has identified motion through robots and expressive objects as a modality that can support communication. In this work, we work closely with an AAC user to understand how motion through a physical expressive object can support their communication. We present our process and resulting lessons on the designed object and the co-design process.
Toward a Solid Acceptance of the Decentralized Web of Personal Data: Societal and Technological Convergence
Authors: Stefanija Ana Pop , Buelens Bart , Goesaert Elfi , Lenaerts Tom , Pierson Jo , Van den Bussche Jan
Published: December 2023

Giving individuals more control of their personal data.
On Specifying for Trustworthiness
Authors: Abeywickrama Dhaminda B. , Bennaceur Amel , Chance Greg , Demiris Yiannis , Kordoni Anastasia , Levine Mark , Moffat Luke , Moreau Luc , Mousavi Mohammad Reza , Nuseibeh Bashar , Ramamoorthy Subramanian , Ringert Jan Oliver , Wilson James , Windsor Shane , Eder Kerstin
Published: December 2023

As autonomous systems increasingly become part of our lives, it is crucial to foster trust between humans and these systems, to ensure positive outcomes and mitigate harmful ones.
Wayfinding Without GPS
Authors: Greengard Samuel
Published: December 2023

Quantum entanglement provides a new direction in navigation.
Achievement in Microarchitecture
Authors: Hoffmann Leah
Published: December 2023

David Papworth, a 30-year veteran of Intel, on what led to the P6 microprocessor and how that changed the microarchitectural paradigm.
Seesaw Gold
Authors: Shasha Dennis
Published: December 2023

Tilting for treasure.
NVIDIA at the Center of the Generative AI Ecosystem---For Now
Authors: Cusumano Michael
Published: December 2023

Assessing the ascent of NVIDIA.
Epigenomics Now
Authors: Monroe Don
Published: December 2023

Computer power helps biologists track the regulation of genetic information.
Fundamental Writing Tips and Techniques
Authors: Yaffe Philip
Published: December 2023

Each "Communication Corner" essay is self-contained; however, they build on each other. For best results, before reading this essay and doing the exercise, go to the first essay "How an Ugly Duckling Became a Swan," then read each succeeding essay.

The principles of good writing are universal; they apply in all languages. However, different languages have different ways of expressing things. For example, English has a predilection toward using the gerund form, erg, "Running is good for health" rather than the infinitive "To run is good for health." By contrast, other languages, such as French, prefer the infinitive and would view the gerund as unnatural, and therefore distracting. However, in whatever language you write, such differences will always be secondary to the fundamental principles and techniques.
Scaling Blockchains with Error Correction Codes: A Survey on Coded Blockchains
Authors: Yang Changlin , Chin Kwan-Wu , Wang Jiguang , Wang Xiaodong , Liu Ying , Zheng Zibin
Published: December 2023

A fundamental issue in blockchain systems is their scalability in terms of data storage, computation, communication, and security. To resolve this issue, a promising research direction is coding theory, which is widely used for distributed storage, recovery from erasures or channel errors and/or to reduce communication cost. To this end, this article provides the
first
comprehensive survey of approaches that employ coding theory to scale blockchain systems. It shows how the use of coded symbols or shards allow participants to only store a fraction of the total blockchain, protect against malicious nodes or erasures, ensure data availability in order to promote transparency, and scale the security of sharded blockchains. Further, coded symbols help reduce communication cost when disseminating blocks, which help bootstrap new nodes and speed up consensus of blocks. For each category of solutions, we highlight problems and issues that motivated their designs and use of coding. Moreover, we provide a qualitative analysis of their storage, communication, and computation costs.
Prompt Sapper: A LLM-Empowered Production Tool for Building AI Chains
Authors: Cheng Yu , Chen Jieshan , Huang Qing , Xing Zhenchang , Xu Xiwei , Lu Qinghua
Published: December 2023

The emergence of foundation models, such as large language models (LLMs) GPT-4 and text-to-image models DALL-E, has opened up numerous possibilities across various domains. People can now use natural language (i.e., prompts) to communicate with AI to perform tasks. While people can use foundation models through chatbots (e.g., ChatGPT), chat, regardless of the capabilities of the underlying models, is not a production tool for building reusable AI services. APIs like LangChain allow for LLM-based application development but require substantial programming knowledge, thus posing a barrier. To mitigate this, we systematically review, summarise, refine and extend the concept of AI chain by incorporating the best principles and practices that have been accumulated in software engineering for decades into AI chain engineering, to systematize AI chain engineering methodology. We also develop a no-code integrated development environment,

Prompt Sapper

, which embodies these AI chain engineering principles and patterns naturally in the process of building AI chains, thereby improving the performance and quality of AI chains. With Prompt Sapper, AI chain engineers can compose prompt-based AI services on top of foundation models through chat-based requirement analysis and visual programming. Our user study evaluated and demonstrated the efficiency and correctness of Prompt Sapper.
Delayed and Partial Mixing Method of Operating Multi-Tank Redox Flow Battery Systems
Authors: Andisetiawan Anugrah , Alhammadi Ayoob , Fetyan Abdulmonem , Bamgbopa Musbaudeen O.
Published: December 2023

To reap the benefits of conventional single and multi-tank redox flow battery (RFB) fluid systems, we investigate a delayed and partial mixing methodology for operating RFB tank systems to maximise electrolyte utilisation and storage capacity. The method modulates an optimised mixing timeframe and mixed amounts of momentarily (un)circulated electrolytes in two vertically separated tank sections. The gravity-assisted mixing between the tank sections achieved by siphon or automatic valve ensures continuous uninterrupted flow occurs in a single direction within the cell while lowering additional auxiliary components/energy and system complexity/cost. We applied a detailed Multiphysics simulation of a test vanadium RFB cell to demonstrate the methodology and its capabilities - especially for larger tank volumes. Significant concentration overpotential reduction with the delayed and partial mixing leads to an increment in discharge capacity and energy efficiency up to 6.5% and 2%, respectively, compared to the conventional single tank system. The practical applicability of the investigated system was also discussed as promising for commercial RFB deployments.
Hand and distal joint tremor are most coherent with the activity of elbow flexors and wrist extensors in persons with essential tremor
Authors: Free Daniel B. , Syndergaard Ian , Pigg Adam C. , Muceli Silvia , Hallett Mark , Farina Dario , Charles Steven K.
Published: December 2023

We characterized the relationships between activity in upper limb muscles and tremor in persons with essential tremor using coherence, which provides an upper bound on the proportion of the tremor due to each muscle. Averaged across subjects and various tasks, tremor in the hand and distal joints was most coherent with elbow flexors and wrist extensors. We conclude that, without further information, these muscle groups should be among the first considered for peripheral suppression techniques.
An Intrusion Detection Model Based on Feature Selection and Improved One-Dimensional Convolutional Neural Network
Authors: Li Qingfeng , Li Bo , Wen Linzhi
Published: December 2023

The problem of intrusion detection has new solutions, thanks to the widespread use of machine learning in the field of network security, but it still has a few issues at this time. Traditional machine learning techniques to intrusion detection rely on expert experience to choose features, and deep learning approaches have a low detection efficiency. In this paper, an intrusion detection model based on feature selection and improved one-dimensional convolutional neural network was proposed. This model first used the extreme gradient boosting decision tree (XGboost) algorithm to sort the preprocessed data, and then it used comparison to weed out 55 features with a higher contribution. Then, the extracted features were fed into the improved one-dimensional convolutional neural network (I1DCNN), and this network training was used to complete the final classification task. The feature selection and improved one-dimensional convolutional neural network (FS-I1DCNN) intrusion detection model not only solved the traditional machine learning method of relying on expert experience to extract features but also improved the detection efficiency of the model, reduced the training time while reducing the dimension, and increased the overall accuracy. In comparison to the I1DCNN model without feature extraction and the conventional one-dimensional convolutional neural network (1DCNN) model, the experimental results demonstrate that the FS-I1DCNN model’s overall accuracy increases by 0.67% and 2.94%, respectively. Its accuracy, precision, recall, and F1-score were significantly better than those of the other intrusion detection models, including SVM and DBN.
Clinical Characteristics, Metabolic Parameters, and Risk Factors for Suicide Attempts Vary with Untreated Major Depressive Disorder Duration
Authors: Tong P. , Shi Y. H. , Yang Y. , Dong L. P. , Wu L. L. , Sun T. T. , Lu W. , Zhang X. Y.
Published: December 2023

Suicidal attempts (SAs) are common in major depressive disorder (MDD). However, only few studies have so far assessed how risk factors for SAs in patients with MDD might be related to the duration of untreated illness (DUI). We interviewed 1,718 drug-naive outpatients with MDD with first-episode SAs and divided them into groups that had and had not attempted suicide. DUI was used as an additional grouping criterion. The patients (20.14%; 346/1718) who had a history of SAs were older and had a longer DUI; lower educational level (middle school-educated only); more psychotic symptoms; higher scores on depression and anxiety scales; and higher BP, plasma BG, TC, and LDL-C levels, but lower HDL-C concentrations. Anxiety symptoms, high education level, and being unmarried were risk factors for SA in patients with MDD with DUIs of <3 months; anxiety symptoms, low BMI, high plasma TC, and low plasma HDL-C were risk factors for SA in the group with DUIs between 3 and 8 months; age, anxiety symptoms, and higher systolic blood pressure were risk factors for those with DUIs>8 months. This study was a single-center cross-sectional survey, and its limitations include a lack of outside validation. Patients with MDD with and without a SA history have different clinical characteristics and metabolic parameters, and risk factors for suicide vary across DUI stages. Anxiety was a general risk factor, suggesting that clinicians should strengthen their assessment of SA risk in patients with MDD during diagnosis and treatment.
Hypopituitarism due to a Large Osteoclastoma Arising from the Sphenoid Bone Invading the Pituitary Fossa in a Patient with Parathyroid Carcinoma
Authors: Bandeira Leonardo , Oliveira Lucian Batista de , Lima Maria Vitória Silva de , Rêgo Daniella , Griz Luiz , Bandeira Francisco
Published: December 2023

Background. Parathyroid carcinoma accounts for <1% of cases of primary hyperparathyroidism (PHPT). This rare condition may present with severe hypercalcemia and bone complications such as osteoclastomas and pathologic fractures. Here, we present a rare condition of panhypopituitarism resulting from an osteoclastoma in the sphenoid bone that invaded the pituitary fossa due to parathyroid carcinoma. Case Report. A 47-year-old woman previously diagnosed with PHPT underwent a parathyroidectomy 6 years earlier, with histological examination indicating a parathyroid adenoma. After surgery, she continued to exhibit high serum parathyroid hormone (PTH) and calcium levels, with the development of bone pain and spontaneous fractures. Imaging exams showed a large osteoclastoma of the sphenoid bone, invading the pituitary fossa, causing hypopituitarism. A new parathyroidectomy was performed, with histological confirmation of parathyroid carcinoma and regression of the osteoclastoma. Conclusion. This case illustrates an unusual presentation of parathyroid carcinoma, in which an osteoclastoma of the sphenoid bone caused hypopituitarism.
Metastatic Squamous Cell Carcinoma of the Urinary Bladder: Urgent Call for New Therapies
Authors: Banek Séverine , Hoeh Benedikt , Cano Garcia Cristina , Koll Florestan , Köllermann Jens , Chun Felix K.H. , Mandel Philipp , Kluth Luis A. , Wenzel Mike
Published: December 2023

Background: Squamous cell carcinoma (SCC) of the urinary bladder is the most common non-urothelial variant histology. Currently, upfront radical cystectomy is the gold standard for non-metastatic SCC of the bladder. However, several studies have shown that SCC of the bladder is associated with higher aggressiveness and worse survival outcomes, such as progression-free and cancer-specific survival, relative to the urothelial histological subtype. Moreover, metastatic SCC seems to poorly respond to systemic treatments and/or radiotherapy. Summary: This review summarizes the current knowledge and medical evidence regarding local and systematic treatment of mSCC of the bladder, including a case series of four initially locally advanced and later metastatic SCC patients of our tertiary care hospital. Key Messages: Despite being the second most common variant histology of bladder cancer, current therapies for SCC do not provide satisfactory therapeutic responses.
Molecular Characterization and Genetic Subclassification Comparison of Diffuse Large B-Cell Lymphoma: Real-Life Experience with 74 Cases
Authors: Ivanova Vanesa-Sindi , Vela Visar , Dirnhofer Stefan , Dobbie Michael , Stenner Frank , Knoblich Jan , Tzankov Alexandar , Menter Thomas
Published: December 2023

Introduction: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous entity. Lately, several algorithms achieving therapeutically and prognostically relevant DLBCL subclassification have been published. Methods: A cohort of 74 routine DLBCL cases was broadly characterized by immunohistochemistry (IHC), fluorescence in situ hybridization (FISH) of the BCL2, BCL6, and MYC loci, and comprehensive high-throughput sequencing (HTS). Based on the genetic alterations found, cases were reclassified using two probabilistic tools – LymphGen and Two-step classifier, allowing for comparison of the two models. Results: Hans and Tally’s overall IHC-based subclassification success rate was 96% and 82%, respectively. HTS and FISH data allowed the LymphGen algorithm to successfully classify 11/55 cases (1 – BN2, 7 – EZB, 1 – MCD, and 2 – genetically composite EZB/N1). The total subclassification rate was 20%. On the other hand, the Two-step classifier categorized 36/55 cases, with 65.5% success (9 – BN2, 12 – EZB, 9 – MCD, 2 – N1, and 4 – ST2). Clinical correlations highlighted MCD as an aggressive subtype associated with higher relapse and mortality. Conclusions: The Two-step algorithm has a better success rate at subclassifying DLBCL cases based on genetic differences. Further improvement of the classifiers is required to increase the number of classifiable cases and thus prove their applicability in routine diagnostics.
N-Acetyl Cysteine Prevents Arterial Thrombosis in a Dose-Dependent Manner In Vitro and in Mice
Authors: Bresette Christopher A. , Ashworth Katrina J. , Di Paola Jorge , Ku David N.
Published: December 2023

BACKGROUND:

Platelet-rich thrombi occlude arteries causing fatal infarcts like heart attacks and strokes. Prevention of thrombi by current antiplatelet agents can cause major bleeding. Instead, we propose using N-acetyl cysteine (NAC) to act against the protein VWF (von Willebrand factor), and not platelets, to prevent arterial thrombi from forming.

METHODS:

NAC was assessed for its ability to prevent arterial thrombosis by measuring platelet accumulation rate and occlusion time using a microfluidic model of arterial thrombosis with human blood. Acute clot formation, clot stability, and tail bleeding were measured in vivo with the murine modified Folts model. The effect of NAC in the murine model after 6 hours was also measured to determine any persistent effects of NAC after it has been cleared from the blood.

RESULTS:

We demonstrate reduction of thrombi formation following treatment with NAC in vitro and in vivo. Human whole blood treated with 3 or 5 mmol/L NAC showed delayed thrombus formation 2.0× and 3.7× longer than control, respectively (
P
<0.001). Blood treated with 10 mmol/L NAC did not form an occlusive clot, and no macroscopic platelet aggregation was visible (
P
<0.001). In vivo, a 400-mg/kg dose of NAC prevented occlusive clots from forming in mice without significantly affecting tail bleeding times. A lower dose of NAC significantly reduced clot stability. Mice given multiple injections showed that NAC has a lasting and cumulative effect on clot stability, even after being cleared from the blood (
P
<0.001).

CONCLUSIONS:

Both preclinical models demonstrate that NAC prevents thrombus formation in a dose-dependent manner without significantly affecting bleeding time. This work highlights a new pathway for preventing arterial thrombosis, different from antiplatelet agents, using an amino acid derivative as an antithrombotic therapeutic.
Requirement of Site-Specific Tyrosine Phosphorylation of Cortactin in Retinal Neovascularization and Vascular Leakage
Authors: Kumar Raj , Rottner Klemens , Rao Gadiparthi N.
Published: December 2023

BACKGROUND:

Retinal neovascularization is a major cause of vision impairment. Therefore, the purpose of this study is to investigate the mechanisms by which hypoxia triggers the development of abnormal and leaky blood vessels.

METHODS:

A variety of cellular and molecular approaches as well as tissue-specific knockout mice were used to investigate the role of Cttn (cortactin) in retinal neovascularization and vascular leakage.

RESULTS:

We found that VEGFA (vascular endothelial growth factor A) stimulates Cttn phosphorylation at Y421, Y453, and Y470 residues in human retinal microvascular endothelial cells. In addition, we observed that while blockade of Cttn phosphorylation at Y470 inhibited VEGFA-induced human retinal microvascular endothelial cell angiogenic events, suppression of Y421 phosphorylation protected endothelial barrier integrity from disruption by VEGFA. In line with these observations, while blockade of Cttn phosphorylation at Y470 negated oxygen-induced retinopathy–induced retinal neovascularization, interference with Y421 phosphorylation prevented VEGFA/oxygen-induced retinopathy–induced vascular leakage. Mechanistically, while phosphorylation at Y470 was required for its interaction with Arp2/3 and CDC6 facilitating actin polymerization and DNA synthesis, respectively, Cttn phosphorylation at Y421 leads to its dissociation from VE-cadherin, resulting in adherens junction disruption. Furthermore, whereas Cttn phosphorylation at Y470 residue was dependent on Lyn, its phosphorylation at Y421 residue required Syk activation. Accordingly, lentivirus-mediated expression of shRNA targeting Lyn or Syk levels inhibited oxygen-induced retinopathy–induced retinal neovascularization and vascular leakage, respectively.

CONCLUSIONS:

The above observations show for the first time that phosphorylation of Cttn is involved in a site-specific manner in the regulation of retinal neovascularization and vascular leakage. In view of these findings, Cttn could be a novel target for the development of therapeutics against vascular diseases such as retinal neovascularization and vascular leakage.
Colchicine to Prevent Atrial Fibrillation Recurrence After Catheter Ablation: A Randomized, Placebo-Controlled Trial
Authors: Benz Alexander P. , Amit Guy , Connolly Stuart J. , Singh Jasrita , Acosta-Vélez Juan G. , Conen David , Deif Bishoy , Divakaramenon Syamkumar , McIntyre William F. , Mtwesi Viwe , Roberts Jason D. , Wong Jorge A. , Zhao Robin , Healey Jeff S. ,   for the IMPROVE-PVI Investigators
Published: December 2023

BACKGROUND:

Inflammation may promote atrial fibrillation (AF) recurrence after catheter ablation. This study aimed to evaluate a short-term anti-inflammatory treatment with colchicine following ablation of AF.

METHODS:

Patients scheduled for ablation were randomized to receive colchicine 0.6 mg twice daily or placebo for 10 days. The first dose of the study drug was administered within 4 hours before ablation. Atrial arrhythmia recurrence was defined as AF, atrial flutter, or atrial tachycardia >30 s on two 14-day Holters performed immediately and at 3 months following ablation.

RESULTS:

The modified intention-to-treat population included 199 patients (median age, 61 years; 22% female; 70% first procedure) who underwent radiofrequency (79%) or cryoballoon ablation (21%) of AF. Antiarrhythmic drugs were prescribed at discharge in 149 (75%) patients. Colchicine did not prevent atrial arrhythmia recurrence at 2 weeks (31% versus 32%; hazard ratio [HR], 0.98 [95% CI, 0.59–1.61];
P
=0.92) or at 3 months following ablation (14% versus 15%; HR, 0.95 [95% CI, 0.45–2.02];
P
=0.89). Postablation chest pain consistent with pericarditis was reduced with colchicine (4% versus 15%; HR, 0.26 [95% CI, 0.09–0.77];
P
=0.02) and colchicine increased diarrhea (26% versus 7%; HR, 4.74 [95% CI, 1.95–11.53];
P
<0.001). During a median follow-up of 1.3 years, colchicine did not reduce a composite of emergency department visit, cardiovascular hospitalization, cardioversion, or repeat ablation (29 versus 25 per 100 patient-years; HR, 1.18 [95% CI, 0.69–1.99];
P
=0.55).

CONCLUSIONS:

Colchicine administered for 10 days following catheter ablation did not reduce atrial arrhythmia recurrence or AF-associated clinical events, but did reduce postablation chest pain and increase diarrhea.
The Limitations and Ethical Considerations of ChatGPT
Authors: Hua Shangying , Jin Shuangci , Jiang Shengyi
Published: December 2023

With the advancements of artificial intelligence technology, ChatGPT, a new practice of artificial intelligence, holds immense potential across multiple fields. Its user-friendly human-machine interface, rapid response capabilities, and delivery of high-quality answers have attracted considerable attention and widespread usage. Regarded by many as a groundbreaking advancement in AI, ChatGPT represents a new milestone in the field. However, as with any technological evolution, the emergence of ChatGPT brings not only benefits, but also inevitable security risks and ethical issues. This paper provides specific information about ChatGPT, including its technology, limitations, ethical issues, governance paths and future directions. Specifically, we firstly offered a thorough exploration of the technical implementation details of GPT series models. Next, we provided an intricate analysis elucidating the reasons for limitations and scrutinized the consequential impacts, such as malicious misuse, privacy violation, and so on. Finally, we explore diverse governance paths to mitigate the impacts of ChatGPT and present future directions. This review aims to equip users with crucial knowledge, facilitating well-informed decision-making, effectively handling of potential challenges in employing ChatGPT, and staying abreast with the rapidly evolving landscape of this technology.
QAmeleon: Multilingual QA with Only 5 Examples
Authors: Agrawal Priyanka , Alberti Chris , Huot Fantine , Maynez Joshua , Ma Ji , Ruder Sebastian , Ganchev Kuzman , Das Dipanjan , Lapata Mirella
Published: December 2023

The availability of large, high-quality datasets has been a major driver of recent progress in question answering (QA). Such annotated datasets, however, are difficult and costly to collect, and rarely exist in languages other than English, rendering QA technology inaccessible to underrepresented languages. An alternative to building large monolingual training datasets is to leverage pre-trained language models (PLMs) under a few-shot learning setting. Our approach, QAmeleon, uses a PLM to automatically generate multilingual data upon which QA models are fine-tuned, thus avoiding costly annotation. Prompt tuning the PLM with only five examples per language delivers accuracy superior to translation-based baselines; it bridges nearly 60% of the gap between an English-only baseline and a fully-supervised upper bound fine-tuned on almost 50,000 hand-labeled examples; and consistently leads to improvements compared to directly fine-tuning a QA model on labeled examples in low resource settings. Experiments on the TyDiqa-GoldP and MLQA benchmarks show that few-shot prompt tuning for data synthesis scales across languages and is a viable alternative to large-scale annotation.1
Intersections of Marginalization and Possibility: A Phenomenological Analysis of Disabled Students’ Experiences with Online Learning
Authors: Krazinski Meaghan , Foley Alan
Published: December 2023

During the covid-19 pandemic, online learning allowed for accommodations that were previously unavailable. However, this reconfiguration of supports did not always occur. Research centering student experience alongside the complexity of social contexts in online learning is lacking. Using Intersectional Critical Disability Studies and Queer Phenomenology, we investigate disabled students’ experiences with online learning. Interviews with secondary and postsecondary students reveal that online schooling reinforced barriers and hindered full inclusion and support. The pandemic emphasized the feelings of insignificance of their education, restricting their societal roles. Disabled students in this study relied on individual relationships and support to navigate their schooling. Using the concepts of inheritance/disinheritance to explore how the shift to online learning further affected secondary students with disabilities, this paper argues that the changes functioned primarily to protect the non-disabled and perpetuate ablebodiedness, thereby placing access further out of reach and thus entrenching limitations to dreaming past barriers.
Fewer Burdens but Greater Inequality? Reevaluating the Safety Net through the Lens of Administrative Burden
Authors: Herd Pamela , Moynihan Donald
Published: December 2023

We examine changes in administrative burden in U.S. social safety net programs, or the negative encounters with the state that people experience when trying to access and use the benefits for which they are eligible. Existing theories equate targeted safety net policies, which sharply limit eligibility, as compared to universal policies, which have more expansive eligibility, with increased administrative burden. The past 30 years, however, tell a more complicated story. While overall burdens have declined in most targeted programs, there is evidence of increasing inequality regarding who faces these burdens. We trace the cause to three factors: (1) expansions in targeted programs, like Medicaid, gave states more administrative control, which increased both geographic and racial disparities in administrative burden; (2) delivering benefits through the tax system created more burdens for low-income populations compared to high-income populations; and (3) a growing reliance on private providers to deliver benefits and services created higher burdens for low-income populations to navigate.
Policymaker and Practitioner Perspectives: Insights from Ohio: An Interview with Dr. Wendy Grove and Jennifer Vargo
Authors: Moffitt Susan L.
Published: December 2023

What supports do children need? What lessons have been learned over the past decade to provide complementary services? For policymaker and practitioner perspectives on these questions, we turned to experts in the Ohio Department of Education: Dr. Wendy Grove, the director of the Office of Early Learning and School Readiness; and Jennifer Vargo, the former director of the Office of Whole Child Supports. To identify children’s needs, Ohio has developed processes to elevate and learn from families’ voices and lived experiences. Those insights have contributed to Ohio’s cross-agency collaborations to support whole-child approaches both through policymaking and integrated data systems. Collaborations also point toward areas of ongoing need, including more investment in early childhood supports and preschool. The conversation, led by Susan Moffitt, occurred on December 2, 2022, and has been edited for length.
Who Uses the Social Safety Net? Trends in Public Benefit Use among American Households with Children, 1980–2020
Authors: Jackson Margot I. , Fanelli Ester
Published: December 2023

Research suggests that child development is positively affected when families can access overlapping, simultaneous forms of public assistance. Universal participation in social safety net programs is rare among eligible populations, though, and assessing the dynamics of multiple benefits use is particularly complex: which households with children receive multiple benefits, which combinations of benefits are most common, and which households are most likely to access benefits as the safety net expands in some ways and contracts in others? We use almost 40 years of data from the Survey of Income and Program Participation (SIPP) to examine trends in both the number of public benefits accessed by American households with children and the types and combinations of benefits that households access. We find that the percentage of households with children using at least two benefits has increased, but the beneficiaries of increasing benefit use have been disproportionately higher-educated, White, and married households with incomes above the poverty line.