bluuebunny/crossref_metadata_2025 huggingface dataset:
An analysis of FRE @ BC8 SympTEMIST track: named entity recognition
Authors: Martinez Ander , García-Santa Nuria
Published: September 2024

This paper is a more in-depth analysis of the approaches used in our submission (Martínez A, García-Santa N. (2023) FRE @ BC8 SympTEMIST track: Named Entity Recognition Zenodo.) to the ‘SympTEMIST’ Named Entity Recognition (NER) shared subtask at ‘BioCreative 2023’. We participated on the challenge submitting two systems based on a RoBERTa architecture LLM trained on Spanish-language clinical data available at ‘HuggingFace’ model repository. Before choosing the systems that would be submitted, we tried different combinations of the techniques described here: Conditional Random Fields and Byte-Pair Encoding dropout. In the second system we also included Sub-Subword feature based embeddings (SSW). The test set used in the challenge has now been released (López SL, Sánchez LG, Farré E et al. (2024) SympTEMIST Corpus: Gold Standard annotations for clinical symptoms, signs and findings information extraction. Zenodo), allowing us to analyze more in depth our methods, as well as measuring the impact of introducing data from CARMEN-I (Lima-López S, Farré-Maduell E, Krallinger M. (2023) CARMEN-I: Clinical Entities Annotation Guidelines in Spanish. Zenodo) corpus. Our experiments show the moderate effect of using the Sub-Subword feature based embeddings and the impact of including the symptom NER data from the CARMEN-I dataset.

Database URL: https://physionet.org/content/carmen-i/1.0/
Does speculation increase volatility in grain futures markets? Evidence from the Interwar Chicago Board of Trade
Authors: Iorgulescu Elissa A M , Pütz Alexander
Published: September 2024

A key justification for futures regulation in the interwar period was the idea that speculators were making grain prices volatile, and therefore speculative activity needed to be restricted. This paper uses new data on grain futures contracts traded at the Chicago Board of Trade to empirically assess whether speculators Granger caused volatility in futures markets during the interwar period. We find that speculators did not Granger cause volatility, but volatile markets Granger caused speculative activity. These results suggest that speculators entered volatile markets but did not increase volatility.
Body image concerns in patients with an implantable cardioverter defibrillator: association with other patient-reported outcome measures
Authors: Frydensberg Vivi Skibdal , Möller Sören , Johansen Jens Brock , Strömberg Anna , Pedersen Susanne S
Published: September 2024

Aims

To investigate associations between body image concerns (BICs) measured by the implantable cardioverter defibrillator body image concerns questionnaire (ICD-BICQ) and other patient-reported outcomes (PROs), in a cohort of patients with an implantable cardioverter defibrillator (ICD).

Methods and results

In a cross-sectional survey, we included patients > 18 years implanted with a first-time ICD (VVI, DDD, and cardiac re-synchronization therapy defibrillator) who had lived with their ICD from 3–24 months. They completed the 39-item ICD-BICQ together with the Generalized Anxiety Disorder scale, Patient Health Questionnaire, Type D Scale, Health Status Questionnaire, and the Florida Patient Acceptance Survey. Data were analysed using linear regression to compare personality constructs between patients with and without BICs. Logistic repression and receiver operating characteristic curves were used to predict patients with BICs based on other PROs. A total of 330 patients completed the survey. Five patients were excluded due to re-operations leaving 325 patients in the analyses. A total of 20% reported BICs at the recommended cut-off at 36 points. Patients with BICs reported higher anxiety and depression levels, lower device acceptance and health status, and had a Type D personality as compared to patients without BICs. Florida Patient Acceptance Survey was moderately able to predict BICs, while other PROs only had limited ability to predict BICs.

Conclusion

Patients with BICs reported poorer PROs. The PRO instruments were not able to predict patients with BICs, indicating that the ICD-BICQ provides independent relevant clinical information. In clinical practice, healthcare professionals can use the ICD-BICQ to identify and obtain information on possible BICs. The ICD-BICQ can also be used to evaluate new operation techniques.
Components of the Atrial fibrillation Better Care pathway for holistic care of patients with atrial fibrillation: a win ratio analysis from the COOL-AF registry
Authors: Krittayaphong Rungroj , Treewaree Sukrit , Lip Gregory Y H
Published: September 2024

Aims

Compliance with integrated care based on the Atrial fibrillation Better Care (ABC) pathway has been associated with improved clinical outcomes. The primary objective of this study was to compare clinical outcomes of AF patients according to the compliant status of each component of the ABC pathway in a hierarchical win ratio approach.

Methods and results

We studied AF patients in the COOL-AF registry. Each patient was followed every 6 months until 3 years. A win ratio analysis was performed, as not all clinical outcomes are equivalent. The hierarchical outcomes were (1) all-cause death, (2) intracranial haemorrhage (ICH), (3) ischaemic stroke/systemic embolism, (4) non-ICH major bleedings, and (5) acute myocardial infarction or heart failure. We also assessed win ratio and win proportion variance over the follow-up time, and the variations over time. A total of 3405 patients (mean age 67.8 ± 11.3; 41.8% female) were studied. Win ratio of ABC-compliant (all three components) vs. ABC-not-compliant was 1.57 (1.35–1.83), P < 0.001. When adding time in therapeutic range (TTR) data for compliant criteria for those who were on warfarin, the win ratio increased to 2.28 (1.89–2.75), P < 0.001. The A-compliant group (plus TTR data), B-compliant, and C-compliant had the win ratio of 1.81 (1.51–2.12), 1.82 (1.53–2.16), and 1.39 (1.18–1.62), all P < 0.001, compared to not compliant group.

Conclusion

Management of AF patients according to each component of the ABC pathway is associated with better clinical outcomes compared to those non-compliant to ABC pathway. This finding underscores the importance of a holistic management approach strategy for AF patients.
Socioeconomic Inequalities in Frailty Distribution: A Cross-National Comparison of the United States and England
Authors: Wilkie Rachel Z , Ailshire Jennifer A
Published: September 2024

Objectives

The objective of this study is to examine differences in socioeconomic gradients (i.e., education, income, and wealth) in frailty by gender in the United States and England.

Methods

We used harmonized data from the Health and Retirement Study and the English Longitudinal Study of Ageing in 2016. Frailty status was determined from measured and self-reported signs and symptoms in 5 domains: unintentional weight loss, exhaustion, low physical activity, slow walking speed, and weakness. Respondents were classified as robust (no signs or symptoms of frailty), prefrail (signs or symptoms in 1–2 domains), or frail (signs or symptoms in 3 or more domains). Gender-stratified multinomial logistic regression models were used to assess the relationship between educational attainment, household income, and household wealth with the risk of frailty and prefrailty, with and without covariates. We also calculated the slope index of inequalities on the predicted probabilities of frailty by income and wealth quintiles.

Results

We found socioeconomic gradients in prefrailty and frailty by education, income, and wealth. Furthermore, the educational gradient in frailty was significantly steeper for U.S. women compared to English women, and the income gradient was steeper for U.S. men and women compared to English men and women. The between-country differences were not accounted for by adjusting for race/ethnicity and behavioral factors.

Discussion

Socioeconomic gradients in prefrailty and frailty differ by country setting and gender, suggesting contextual factors such as cultural norms, healthcare access and quality, and economic policy may contribute to the effect of different measures of socioeconomic status on prefrailty and frailty risk.
Organizational resilience and primary care nurses’ work conditions and well-being: a multilevel empirical study in China
Authors: Wang Wenhua , Li Mengyao , Zhang Jinnan , Zhao Ruixue , Yang Huiyun , Mitchell Rebecca
Published: September 2024

Resilience is crucial for a health system to better prevent and respond to public health threats and provide high-quality services. Despite the growing interest in the concept of resilience in health care, however, there is little empirical evidence of the impact of organizational resilience, especially in primary care settings. As the largest professional group in primary care, primary care nurses are taking more and more responsibilities during their daily practice, which influences both their work conditions and well-being. This study aims to examine the association between organizational resilience and primary care nurses’ working conditions and well-being. Using a convenience sampling approach, we recruited 175 primary care nurses from 38 community health centres (CHCs) in four cities in China. Organizational resilience was operationalized as comprising two domains: adaptive capacity and planning capacity, and measured using a 16-item scale. The primary care nurses’ working condition indicators comprised variables of psychological safety, organizational commitment, professional commitment, and self-directed learning; well-being indicators included depression and burn-out. Hierarchical linear regression models were built for analysis. We found that the sampled CHCs have a relatively high level of organizational resilience. The organizational resilience was positively associated with the four indicators of working conditions: psychological safety (β = 0.04, P < 0.01), organizational commitment (β = 0.38, P < 0.01), professional commitment (β = 0.39, P < 0.01), and self-directed learning (β = 0.28, P < 0.01). However, organizational resilience was not significantly associated with the two well-being indicators. Furthermore, we found that the adaptive capacity has stronger association compared with planning capacity. Therefore, primary care manager should build resilient organizations, especially the adaptive capacity, in order to enhance primary care nurses’ psychological safety, commitment and learning behaviours. Further studies should also be conducted to understand the link between organizational resilience and primary care nurses’ well-being.
Distinct Effects of Major Affective Disorder Diagnoses and Suicidal Symptom Severity on Inhibitory Control Function and Proinflammatory Cytokines: Single-Site Analysis of 800 Adolescents and Adults
Authors: Bai Ya-Mei , Chen Mu-Hong , Hsu Ju-Wei , Huang Hsiang-Hsuan , Jeng Jia-Shyun , Tsai Shih-Jen
Published: September 2024

Background

Inhibitory control function and proinflammatory cytokines play a role in the pathomechanisms underlying major affective disorders and suicidal behavior. However, the distinct or interactive effects of major affective disorders and suicidal symptom severity on inhibitory control function and proinflammatory cytokines remain unclear.

Methods

This study included 287 patients with bipolar disorder, 344 with major depressive disorder, and 169 healthy controls. We categorized the participants into 3 groups based on Montgomery–Åsberg Depression Rating Scale (MADRS) item 10 (suicidal symptoms) score: 0, 2 or 3, and ≥4. The participants completed the go/no-go task and the measurements for C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) levels.

Results

Errors in the go/no-go task were associated with suicidality (P = .040), regardless of the severity of suicidal symptoms and diagnosis. An elevated CRP level was especially associated with a Montgomery–Åsberg Depression Rating Scale item 10 score ≥4 (P = .001). An increased TNF-α level could distinguish bipolar disorder from major depressive disorder (P < .001).

Discussion

Our study indicated the distinct effects of major affective disorder diagnosis and suicide symptom severity on inhibitory control function and CRP and TNF-α levels. Importantly, individuals with the poorest inhibitory control function and highest CRP levels had more severe suicidal symptoms.
How is tree growth rate linked to root functional traits in phylogenetically related poplar hybrids?
Authors: Rabearison Toky Jeriniaina , Poirier Vincent , Laganière Jérôme , DesRochers Annie
Published: September 2024

Fine roots play a crucial role in soil nutrient and water acquisition, significantly contributing to tree growth. Fine roots with a high specific root length (SRL) and small diameter are often considered to help trees grow fast. However, inconsistencies in the literature do not provide a clear basis on the effect of root functional traits, such as SRL or root mass density (RMD), on tree growth rate in phylogenetically related trees. Our aim was to examine relationships between tree growth rate and root functional traits, using clones displaying different growth rates in a hybrid poplar plantation located in New Liskeard, ON, Canada. Fine roots (diameter < 2 mm) samples were collected using soil cores at depths of 0–20, 20–40 and 40–60 cm, and analyzed for morphological, chemical and architectural traits. High SRL and thin fine roots were associated with the least productive clones, which is not consistent with the root economics spectrum (RES) theory. However, the most productive clone had larger fine root diameter and higher root lignin concentrations, probably reducing root construction and maintenance costs and carbon losses. Therefore, at the 0–20 and 20–40 cm depths, tree growth rates showed positive correlations with root diameter and root lignin concentrations, but negative correlations with SRL and root soluble compounds concentration. Increasing RMD at the 0–20 cm depth promoted tree growth rates, showing the importance of soil exploration in the topsoil for tree growth. We conclude that fine root variation does not always follow the RES hypothesis and argue that the rapid growth rate of trees may also be driven by fine root growth in diameter and mass in phylogenetically related trees.
Methane concentration in the heartwood of living trees in a cold temperate mountain forest: variation, transport and emission
Authors: Epron Daniel , Mochidome Takumi
Published: September 2024

Forest soils are the largest terrestrial sink of methane (CH4), but CH4 produced in tree trunks by methanogenic archaea and emitted into the atmosphere can significantly offset CH4 oxidation in the soil. However, our mechanistic understanding of CH4 accumulation in tree trunks, in relation to CH4 emission from the trunk surface, is still limited. We characterized temporal variations in the molar fraction of CH4 in the heartwood of trees ([CH4]HW) of four different species in a mountain forest and addressed the relationship between [CH4]HW and emission from the surface of the trunk (${F}_{CH_4}$), in connection with the characteristics of the wood. [CH4]HW measurements were made monthly for 15 months using gas-porous tubes permanently inserted into the trunk. [CH4]HW were above ambient CH4 molar fraction for all trees, lower than 100 p.p.m. for seven trees, higher for the nine other trees and greater than 200,000 p.p.m. (>20%) for two of these nine trees. [CH4]HW varied monthly but were not primarily determined by trunk temperature. Heartwood diffusive resistance for CH4 was variable between trees, not only due to heartwood characteristics but probably also related to source location. ${F}_{CH_4}$were weakly correlated with [CH4]HW measured a few days after. The resulting apparent diffusion coefficient was also variable between trees suggesting variations in the size and location of the CH4 production sites as well as resistance to gas transport within the trunk. Our results highlight the challenges that must be overcome before CH4 emissions can be simulated at the tree level.
Complexity and Challenges of Cross-Cover Care in Graduate Medical Education: A Qualitative Study
Authors: Heidemann Lauren A. , Vinson Alexandra H. , Hughes David T. , McDermott Catherine , Hartley Sarah
Published: September 2024

Purpose

Cross-cover care (care for hospitalized patients when the primary team is absent) is a common graduate medical education responsibility; however, it may lead to increased preventable adverse events. Despite understanding the difficulties of cross-cover care, medical educators lack comprehensive knowledge of specific challenges that residents face and how they handle these challenges. This study explores the challenges residents experience when providing cross-cover care.

Method

The authors conducted 60 semistructured, qualitative interviews with 20 internal medicine and surgery residents at a single academic institution between October 2021 and April 2022. Each resident participated in 3 interviews, 2 immediately after a shift. Working inductively, the authors generated codes for important themes. Study design and data collection were guided by interpretive description, a qualitative approach for health care research focused on experiences and perceptions to develop meaningful findings. To illustrate residents’ workflow and aid in quality improvement efforts, the authors created a process map.

Results

Seventeen cross-cover challenges were organized into 7 interrelated and overlapping themes: lack of baseline knowledge, inadequate or inaccurate information transfer from the primary team, unfamiliarity with cross-cover patients, high task volume leading to increased interruptions, ill-defined roles leading to unmet expectations from others, perceived decreased access to resources, and fatigue. The process map illustrates 4 cross-cover workflow components: information transfer from the primary team to the cross-cover team, direct handling of cross-cover tasks that are assigned by the primary team or that arise during the time of cross-cover, information transfer back to primary team and other care team members, and responsibilities that residents have overnight that are not directly related to cross-cover.

Conclusions

Residents face substantial challenges when providing cross-cover care, which have important implications for patient safety and resident well-being. The medical community should strive to develop educational and structural interventions to improve this process.
Medial Patellofemoral Ligament Reconstruction Improves Patella Alta
Authors: Yang Daniel Z. , Orellana Kevin , Houlihan Nathan V. , Lee Julianna , Carter Michael V. , Ganley Theodore J. , Lawrence J. Todd R. , Williams Brendan A. , Maguire Kathleen J.
Published: September 2024

Background:

Patellofemoral instability (PFI) is a common problem with various anatomic risk factors identified, including patella alta as one of the most powerful predictors. Given that the medial patellofemoral ligament (MPFL) is the primary soft tissue stabilizer of the patella, a common procedure to treat recurrent patellar instability is MPFL reconstruction. The aim of this study is to examine the relationship between MPFL reconstruction and patellar height. We hypothesize that after reconstruction, patellar instability patients would have demonstrable reduction in patella height and patella alta correction.

Methods:

Patient records were queried for patients who underwent MPFL reconstruction for recurrent patellar instability. Patient and operative demographics were collected. We measured Insall-Salvati ratio (ISR), Caton Deschamps index (CDI), and Blackburne-Peel ratio (BPR) in all patients at various time points. The height indices were compared across the preoperative, immediately postoperative, and 6-month time points in a pairwise fashion using paired-sample t-tests. Further subgroup analysis of patients (n=27) with elevated preoperative Caton Deschamps Index (defined as >1.3) was completed.

Results:

The final cohort was 103 patients. There was a significant difference between pre- and postoperative ISR (P<0.001) and at 6-month follow up (P<0.001), between preoperative CDI and the 6-month follow-up (P<0.0010), and between the postoperative and preoperative CDI (P<0.001). There was also a difference between preoperative and postoperative BPR (P<0.001), as well as between the preoperative and 6-month follow-up BPR (P=0.002). Twenty-seven patients had an initial CDI greater than 1.3. Differences were observed between pre- and postoperative mean CDI (P=0.001) and at 6-month follow-up (P=0.006), between both postoperative and 6-month ISR (both P<0.001), and preoperative mean BPR and the postoperative (P=0.004) and 6-month mean BPR (P=0.027).

Conclusions:

Patients with pre-existing patella alta and recurrent patella dislocations who undergo isolated MPFL reconstruction have decreased patella alta at their 6-month follow-up as measured by ISR, CDI, and BPR. Patients without patella alta do not demonstrate statistically significant differences after their MPFL reconstruction.

Level of Evidence:

III (retrospective comparative study)
Lessons Learned From Moving to Living Guidelines—The Canadian Clinical Practice Guideline for the Rehabilitation of Adults With Moderate-to-Severe TBI
Authors: Patsakos Eleni M. , Kua Ailene , Gargaro Judith , Yaroslavtseva Olga , Teasell Robert , Janzen Shannon , Harnett Amber , Bennett Phoebe , Bayley Mark
Published: September 2024

Objective:

It is often challenging for providers to remain up to date with best practices gleaned from clinical research. Consequently, patients may receive inappropriate, suboptimal, and costly care. Living clinical practice guidelines (CPGs) maintain the methodological rigor of traditional CPGs but are continuously updated in response to new research findings, changes in clinical practice, and emerging evidence. The objective of this initiative was to discuss the lessons learned from the transformation of the Canadian Clinical Practice Guideline for the Rehabilitation of Adults with Traumatic Brain Injury (CAN-TBI) from a traditional guideline update model to a living guideline model.

Design:

The CAN-TBI Guideline provides evidence-based rehabilitative care recommendations for individuals who have sustained a TBI. The Guideline is divided into 2 sections: Section I, which provides guidance on the components of the optimal TBI rehabilitation system, and Section II, which focuses on the assessment and rehabilitation of brain injury sequelae. A comprehensive outline of the living guideline process is presented.

Results:

The CAN-TBI living guideline process has yielded 351 recommendations organized within 21 domains. Currently, 30 recommendations are supported by level A evidence, 81 recommendations are supported by level B evidence, and 240 consensus-based recommendations (level C evidence) comprise 68% of the CAN-TBI Guideline.

Conclusion:

Given the increasing volume of research published on moderate-to-severe TBI rehabilitation, the CAN-TBI living guideline process allows for real-time integration of emerging evidence in response to the fastest-growing topics, ensuring that practitioners have access to the most current and relevant recommendations.
FACTORS DEFINING DENSITY OF RETINAL MACROPHAGE-LIKE CELLS DISPLAYED WITH OPTICAL COHERENCE TOMOGRAPHY
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Gorlova Arina S. , Vasiliev Alexander S.
Published: September 2024

Purpose:

To study the factors that define the density of macrophage-like cells (MLC) of the inner retinal surface in healthy eyes.

Methods:

Healthy individuals, including candidates for laser in situ keratomileusis surgery, and post–laser in situ keratomileusis patients were included. Density of MLC was calculated using structural en face projections of optical coherence tomography angiography scans. The status of the vitreoretinal interface was assessed as the distance from the inner limiting membrane to the posterior hyaloid membrane on cross-sectional scans and as the area of tight posterior vitreous adhesion on en face projections. The correlation between MLC density and various demographic and anatomical parameters, including the status of the vitreoretinal interface, was calculated.

Results:

Fifty-four healthy individuals, 30 post–laser in situ keratomileusis patients all without posterior vitreous detachment, and 20 patients with partial posterior vitreous detachment were included. Density of MLC showed a statistically significant correlation with axial length, refractive error, age, subfoveal choroidal thickness, and the status of the vitreoretinal interface (P < 0.05) in eyes without posterior vitreous detachment. In multiple regression analysis, the axial length was the main parameter independently correlated with MLC density (P = 0.025). The status of the vitreoretinal interface had a statistically significant correlation with the axial length (P < 0.001). Partial posterior vitreous detachment was associated with almost complete loss of MLC (P < 0.001).

Conclusion:

The status of the vitreoretinal interface is a characteristic directly defining the density of retinal MLC in healthy eyes. However, axial length seems to be a key anatomical parameter that correlates with MLC density because of its effects on the adhesion of the posterior hyaloid membrane to the retinal surface.
The evaluation of postoperative exocrine pancreatic insufficiency in patients with benign and low-malignant pancreatic tumor: A multicenter, prospective, observational study
Authors: Zhang Jingcheng , Wang Jingqiao , Wang Yutong , Wang Huaizhi , Jiang Kuirong , Qiu Yudong , Yuan Chunhui , Lou Wenhui , Tao Jing , Wu Wenming
Published: September 2024

Objectives:

We assess the incidence of exocrine pancreatic insufficiency (EPI) at different time points after pancreatic surgery and explore pancreatic enzyme replacement therapy's (PERT) efficacy.

Background:

EPI is characterized by inadequate pancreatic enzymes, resulting in maldigestion and abdominal symptoms. EPI is a common postoperative complication of pancreatic surgery, yet often overlooked by surgeons. There is no clear answer to when EPI occurs after pancreatic surgery nor the duration of PERT after partial pancreatectomy.

Methods:

Benign or borderline pancreatic tumor patients undergoing surgeries were recruited between December 2020 and November 2021 from 10 medical centers in China. The EPI Questionnaire (EPI-Q) was performed at discharge, and 3-, 6-, 9-, and 12-month follow-ups to evaluate the occurrence of EPI. Statistical analyses were performed to identify the occurrence of EPI and explore PERT's efficacy.

Results:

Of the 146 patients, 105 (71.9%) were female, and the median age was 49 (range 16-78 yrs). Symptoms of EPI patients were most pronounced within 3 months post-surgery (15.7%), while most patients recovered after 1 year (96.9%). There was a negative correlation between symptom score and time since surgery. Lack of PERT in the 3-month post-surgery was associated with higher symptom scores in pancreatoduodenectomy (PD) patients, while not in distal pancreatectomy (DP) patients.

Conclusions:

Generally, the high-occurrence period for postoperative EPI is within 3 months after resection in patients with benign or borderline pancreatic tumors, and most will gradually recuperate with time. PERT can improve symptoms in PD patients, while reduced PERT duration may be considered for DP patients.
Diagnostic value of biochemical markers in prediction of perforation in acute appendicitis: a cross-sectional study
Authors: Basukala Sunil , Gurung Suman , Tamang Ayush , Shrestha Oshan , Devkota Manu , Thapa Niranjan , Pathak Bishnu Deep , Mehta Kshitij , Bhattarai Arabinda Mohan
Published: September 2024

Background:

Acute appendicitis, despite being the most common surgery, can result in increased morbidity and mortality in the case of perforated appendicitis. Identifying a perforation early can reduce the impact on the patient. Bilirubin, C-reactive protein (CRP), and white blood cell (WBC) count have been shown to indicate perforation in appendicitis.

Methods:

A cross-sectional analytical study was conducted to observe the association between preoperative bilirubin, CRP, and white cell count with the histological findings of either the presence or absence of perforation of the appendix. The eligibility criteria included all patients above 18 years with appendicitis who were managed surgically in the study hospital, Shree Birendra Hosptial, between 1 December 2021 to 30 May 2022. The study was conducted after the approval from the ethics committee.

Results:

Out of 150 patients, 112 had open surgery and 38 underwent laparoscopic appendectomy. One hundred thirty-four had non-perforated appendix and 16 cases had perforated appendix. The older age group was associated with appendiceal perforation more than the younger age group. Patients with a duration of symptoms less than 24 h and more than 72 h developed perforated appendicitis less frequently. The odds of encountering perforated appendicitis increased by 2.644 times per 0.972 rise in total bilirubin (P= 0.004) and the odds of encountering perforated appendicitis increased by 6.474 times per 1.868 rise in conjugated bilirubin (P= 0.003). There was no significant difference in total leucocyte count and neutrophil percentage among perforated and non-perforated groups.

Conclusion:

The diagnostic value of the CRP, total bilirubin, and conjugated bilirubin levels was strong and significant when used in combination rather than their individual performance in the diagnosis of perforated acute appendicitis.
Prediction of the outcome of intracerebral hemorrhage by blood neutrophil to lymphocyte ratio: a prospective observational study
Authors: Shrestha Gyaneswhor , Gurung Ashim , Sedhain Gopal , Bajpai Swmaya , Hamal Aliza , Verma Rupesh , Bashyal Bibhav , Shrestha Aakriti , Dhakal Bishal , Shrestha Aayushi , Acharya Roshan , Neupane Ashish , Bhandari Shiva
Published: September 2024

Introduction:

Intracerebral haemorrhage (ICH) is defined as bleeding within the brain parenchyma. Neutrophil lymphocyte ratio (NLR) is a dynamic parameter that can be affected by an underlying condition like microangiopathy (e.g. hemorrhagic stroke). The NLR value at the time of stress (e.g. ICH) could be a predictor among various other factors on the outcome of the disease. The aim of this study is to see if NLR could be a predictor of the outcome of the ICH.

Methods:

This is a prospective observational study conducted in the Department of Neurosurgery and Department of Neurology, from March 2020 to February 2021. The ICH cases presented to the emergency department within 24 h of symptoms were included. The baseline haematological and biochemical investigations were sent and the noncontrast computed tomography (NCCT) head was done for the diagnosis of ICH. The NLR was measured. The ICH volume was calculated by ABC/2. Follow-up of the patient to measure outcome was done with a modified Rankin scale (mRS) on 30 days. Student’s t-test was used to correlate NLR-mRS. Fischer’s exact test was used for a categorical association of NLR to mRS.

Results:

A total of 89 patients with ICH were enrolled in this study. In this study, 62.92% of patients had good outcomes (NLR of 4.88±3.06), whereas 37.08% of patients had bad outcomes (NLR of 9.09± 4.92). Statistically, higher NLR was significantly predictive of poorer outcomes.

Conclusions:

ICH causes stress in the body, which alters the value of NLR. Components of NLR are altered after haemorrhage due to a change in homeostasis of brain parenchyma. The NLR value obtained at the time of emergency department visits may help to predict the 30 days outcome of ICH.
Changes of the Buccal Fat Pad Volume According to the Different Age Groups, Gender, and Body Mass Index: An Evaluation With Computed Tomography
Authors: Akşamoğlu Melih , Bayar Muluk Nuray , Şahan Mehmet Hamdi
Published: September 2024

Objectives

We investigated volumetric changes in buccal fat pad (BFP) in age groups and sexes by cranial or neck computed tomography (CT) or cranial CT angiography.

Methods

One hundred twenty patients underwent cranial or neck CT examinations or cranial CT angiography were retrospectively screened: 18–29 years old (group 1), 30–49 years old (group 2), and 50 years and older (group 3). Left buccal fat tissue measurements were performed in age groups, sexes, and body mass index (BMI) groups.

Results

Left buccal fat volume in the 30–49 age group and the ≥50 age group was significantly higher than that in the 18–29 age group (P < 0.05). Across all groups and specifically within the 18–29 age group, females exhibited significantly lower buccal fat volume than males (P < 0.05). The left buccal fat volume of individuals classified as overweight and obese was significantly higher than that of the underweight and normal weight groups. There was a negative relationship between buccal fat volume and fat density. Moreover, as age increased, within age groups 1 to 3, there was a notable increase in body weight, body length, BMI, and BMI groups (underweight and normal weight to obesity), accompanied by a significant rise in buccal fat volume. Conversely, fat density exhibited a significant decrease with advancing age.

Conclusions

Buccal fat volume, localized in the middle third of the face, increased with aging and increasing BMI values. Young females had lower buccal fat volume. Buccal fat tissue volume is important in facial rejuvenation procedures such as facial filler applications.
Evaluation of Pericoronary Fat Attenuation Index to Better Identify Culprit Lesions in Acute Coronary Syndrome According to Stenosis Severity
Authors: Li Lili , Tang Jia , Fang Pinyan , Sun YuLin , Gao Yanan , Qi Hanxiong , Liu Bing , Zhang Jiwang , Fan Lijuan
Published: September 2024

Objective

To investigate the incremental value of pericoronary fat attenuation index (FAI) in routine coronary artery computed tomography angiography (CCTA) to identify culprit lesions in acute coronary syndrome (ACS).

Methods

We reviewed the CCTA data from 80 ACS patients and 40 individuals with stable coronary atherosclerosis. ACS patient plaques were categorized into culprit and nonculprit groups. The plaque-specific pericoronary FAI was assessed using the Perivascular Fat Analysis Tool. We applied a default prespecified window of −190 to −30 Hounsfield units (HU) and a broader prespecified window of −190 to 20 HU. FAI values within these prespecified windows and the types and severity of plaque stenosis were compared across the 3 groups. Additionally, we investigated high-risk characteristics of plaques in the ACS group and their correlation with FAI. The effectiveness and worthiness of FAI in identifying culprit lesions were analyzed based on the receiver operating characteristic curve.

Results

The FAI values under the 2 prespecified windows were higher in the culprit group than in the nonculprit and control groups (all P < 0.001). The culprit group showed the most mixed plaques and the most severe stenosis (all P < 0.001). In the ACS group, the FAI value was significantly lower around calcified lesions (−85.00 ± 9.97 HU) than around noncalcified (−78.00 ± 11.52 HU) and mixed plaques (−78.00 ± 9.24 HU) (both P < 0.001). The culprit group had more high-risk plaques, and high-risk plaques had higher FAI values than those without high-risk characteristics (−70.00 ± 7.67 HU vs −82.00 ± 10.16 HU, P < 0.001). The efficacy of FAI under the default prespecified window in identifying culprit lesions was higher compared than that under the broader prespecified window (area under the curve = 0.799 vs 0.761, P = 0.042), and the diagnostic cutoff values were −77 versus −58 HU. The FAI under the default prespecified window exhibited an incremental value for identifying culprit lesions, as compared with stenosis severity (area under the curve = 0.970 vs 0.939, P < 0.001).

Conclusion

The culprit lesions have higher FAI than the nonculprit lesions and the controls. FAI is a worthy parameter for identifying culprit lesions in routine CCTA according to stenosis severity, and the default prespecified window is a better option.
Robotic-Assisted Microsurgery in Lymphatic Reconstruction
Authors: Stögner Viola A. , Pucciarelli Dean M. , Pomahac Bohdan , Ayyala Haripriya S.
Published: September 2024

Lymphatic reconstruction entails microsurgery of the smallest human vessels with little microsurgical error tolerance. Surgical outcomes are therefore tightly tied to microsurgical performances and can be restricted by physiologic tremor or muscle tiring throughout extensive procedures. Recently introduced highly specialized microsurgical robots are promising to help overcome these human limitations, particularly relevant for lymphatic microsurgery. Ideal indications and setups for these robotic systems, however, are not yet well established. Reviewing the first 5 years of clinical experience with these microsurgical robots revealed a total of 204 robotically performed lymphatic anastomoses. Most reported use cases (84.4%) involved microsurgical reconstructions of lymphatic flow at the upper and lower extremities, of which 42% of patients were treated for breast cancer-related lymphedema. Considering rising cancer incidences and survival rates, these numbers highlight the potential of robotic-assisted microsurgery for this patient group, whereas the concept of robotic-assisted microsurgery per se can aid surgeons to achieve a new level of microsurgical excellence.
A Scopus-Based Bibliometric Analysis of the Journal of Craniofacial Surgery From 1990 to 2023
Authors: Durna Yusuf Muhammed , Tekin Mustafa Said , Duymaz Yaşar Kemal , Bahşi İlhan
Published: September 2024

Objectives:

This study aims to conduct a Scopus-based bibliometric analysis of the studies published in the Journal of Craniofacial Surgery, which has a very important place in its field.

Methods:

In this bibliometric study, all articles in the Journal of Craniofacial Surgery in the Scopus database on 7 July 2024 were listed. The information of the listed articles was exported in CSV file format. When exporting these articles, the citation information, bibliographic information, abstract and keywords, funding details, and other information options were all selected. These exported CSV data were analyzed with VOSviewer software (version 1.6.18).

Results:

The bibliometric analysis of the Journal of Craniofacial Surgery from 1990 to 2023 included 15,271 articles listed in the Scopus database. The majority (84.7%) of these articles were original studies. The top 5 countries with the highest number of publications were the United States (4004 articles), Turkey (2124 articles), China (2111 articles), South Korea (1597 articles), and Italy (1109 articles).

Conclusion:

This comprehensive bibliometric analysis demonstrates the Journal of Craniofacial Surgery’s increasing prominence and impact in the field over the years. The diverse international contributions highlight the journal’s role in fostering global collaboration and knowledge dissemination in craniofacial and maxillofacial research. While the use of a single database (Scopus) is a limitation, the study provides a detailed overview of the journal’s scholarly contributions, influential authors, and publication trends. These findings underscore the journal’s pivotal position in advancing craniofacial surgery research and education.
A Step-by-Step Surgical Technique to the Posterior Auricular “Revolving Door” Flap for Conchal Tumor Excision: A Guide for the Surgical and Dermatological Trainee
Authors: Louca Milton , Grech Stanley Wilfred , Dayaratna Nirmal , Dusseldorp Joseph R.
Published: September 2024

Skin cancer is the most common malignancy worldwide and the auricle is particularly vulnerable to the effects of cumulative sun exposure. Reconstruction of auricular defects after skin cancer excision remains a vexing surgical challenge owing to the complex three-dimensional- anatomy of the external ear, particularly in the conchal bowl. The postauricular island “revolving door” flap is a reliable single-stage method for reconstructing anterior auricular and conchal defects. While the revolving door flap is well known in the literature, a clear description of how to use the flap to reconstruct an anterior auricular conchal bowl defect is lacking. Herein, we present a step-by-step description of the surgical technique, using surgical photos of a patient who presented with basal cell carcinoma on their anterior auricular concha.
Human microRNA-153-3p targets specific neuronal genes and is associated with the risk of Alzheimer's disease.
Authors: Wang Ruizhi , Maloney Bryan , Nho Kwangsik , Beck John , Counts Scott E , Lahiri Debomoy K.
Published: September 2024

Alzheimers disease (AD) is a progressive degenerative disease characterized by a significant loss of neurons and synapses in cognitive brain regions and is the leading cause of dementia worldwide. AD pathology comprises extracellular amyloid plaques and intracellular neurofibrillary tangles. However, the triggers of this pathology are still poorly understood. Repressor element 1-silencing transcription/neuron-restrictive silencer factor (REST/NRSF), a transcription repressor of neuronal genes, is dysregulated during AD pathogenesis. How REST is dysregulated is still poorly understood, especially at the post-transcriptional level. MicroRNAs (miRNAs), a group of short non-coding RNAs, typically regulate protein expression by interacting with target mRNA transcript 3-untranslated region (UTR) and play essential roles in AD pathogenesis. Herein, we demonstrate that miR-153-3p reduces REST 3-UTR activities, mRNA, and protein levels in human cell lines, along with downregulating amyloid β precursor protein (APP) and α-synuclein (SNCA). We determine by mutational analyses that miR-153-3p interacts with specific targets via the seed sequence present within the respective mRNA 3-UTR. We show that miR-153-3p treatment alters the expression of these specific proteins in human neuronally differentiated cells and human induced pluripotent stem cells and that miR-153-3p is itself dysregulated in AD. We further find that single nucleotide polymorphisms (SNPs) within 5kb of the MIR153-1 and MIR153-2 genes are associated with AD-related endophenotypes. Elevation of miR-153-3p is associated with reduced AD probability, while elevated REST may associate with a greater AD probability. Our work suggests that a supplement of miR-153-3p would reduce levels of toxic protein aggregates by reducing APP, SNCA, and REST expression, all pointing towards a therapeutic and biomarker potential of miR-153-3p in AD and related dementias.
Localizing the Sources of Diffusion Mediating Structure-Function Mapping Using Graph Diffusion Wavelets
Authors: Jain Chirag , Upadrasta Naga Sita Sravanthi , Sharma Avinash , Surampudi Bapi Raju
Published: September 2024

The intricate link between brain functional connectivity (FC) and structural connectivity (SC) is explored through models performing diffusion on SC to derive FC, using varied methodologies from single to multiple graph diffusion kernels. However, existing studies have not correlated diffusion scales with specific brain regions of interest (RoIs), limiting the applicability of graph diffusion. We propose a novel approach using graph heat diffusion wavelets to learn the appropriate diffusion scale for each RoI to accurately estimate the SC-FC mapping. Using the open HCP dataset, we achieve an average Pearson’s correlation value of 0.833, surpassing the state-of-the-art methods for prediction of FC. It is important to note that the proposed architecture is entirely linear, computationally efficient, and notably demonstrates the power-law distribution of diffusion scales. Our results show that the bilateral frontal pole, by virtue of it having large diffusion scale, forms a large community structure. The finding is in line with the current literature on the role of the frontal pole in resting-state networks. Overall, the results underscore the potential of graph diffusion wavelet framework for understanding how the brain structure leads to functional connectivity.

AUTHOR SUMMARY

In the network diffusion paradigm for brain structure-to-function mapping, we noticed limitations such as manually decided diffusion scales and the absence of RoI-level analysis. We addressed this problem by independently developing the graph diffusion wavelets having multiscale and multiresolution property. Each brain region is associated with a diffusion scale that defines the extent of spatial communication. Using graph diffusion wavelets, we are able to predict the functional connectome with state-of-the-art (SoTA) results. We observe that the diffusion scales follow a power-law degree distribution, which is indicative of a scale-free process in the brain. The frontal pole is a dominant member of the various resting-state networks, and our model is able to associate higher diffusion scales to this region. The graph diffusion wavelet model is a novel method which not only excels in downstream task but also provides insights into the structure-function relation.
RAD50 is a potential biomarker for breast cancer diagnosis and prognosis
Authors: Chhatwal Kunwer S. , Liu Hengrui
Published: September 2024

BACKGROUND: RAD50 is one of the most critical genes in DNA double-strand break processing, which can lead to a single strand of DNA overhang and is potentially involved in forcing incomplete DNA repair. This research study aims to investigate the role of RAD50 in breast cancer diagnosis and prognosis. METHODS: Breast cancer mRNA expression data was collected from TCGA and the difference between cancer and non-cancer in gene expression of RAD50 was analyzed. The survival association of RAD50 was also analyzed. RESULTS: RAD50 expression is significantly lower in cancer than in normal tissue. High expression of RAD50 is associated with worse survival. Conclusion: RAD50 is a potential biomarker for breast cancer diagnosis and prognosis
Towards genuine three-dimensional diffusion imaging with physiological motion compensation
Authors: Wang Yishi , Weng Dehe , Zhang Jieying , Qian Tianyi , Liu Wenzhang , Zhou Kun , Wu Yanglei , Zhang Baogui , Li Qing , Jing Jing , Zhang Zhe
Published: September 2024

Purpose

We aim to implement a 3D DWI sequence and show its usage on patients with new ischemic lesions.

Materials and Methods

The proposed 3D DWI sequence was implemented by integrating second-order gradient moment nulling (M2) and cardiac motion synchronization (Sync). All data were acquired on a 3T MAGNETOM Prisma scanner (Siemens Healthcare, Erlangen, Germany) using a 64 channel head and neck coil. 21 healthy volunteers underwent 3D DWI scans at 0.9 mm isotropic resolution using four motion compensation methods for comparison: no compensation (M0), M2 only, Sync only and the proposed M2+Sync method. 2D phase variation maps with different motion compensation methods were also acquired for one subject to illustrate the mechanism of the proposed method. A ghost-to-signal ratio (GSR) and blurring index was defined and compared among the four methods with repeated measures ANOVA and Tukey’s test. 3D DWI was compared with 2D DWI for ADC quantification. Image quality and ischemic lesion conspicuity were evaluated with 12 patients after endovascular treatment.

>Results

Whole brain 3D DWI was achieved at 0.9 mm isotropic resolution within 5 minutes using the proposed sequence. M2+Sync achieved the lowest level of GSR and blurring along the slice direction. ADC quantification showed no statistically significant difference between M2+Sync compared to 2D DWI. 3D DWI showed similar image quality, higher lesion conspicuity and counts compared to 2D DWI.

Conclusion

Direct 3D DWI can be achieved by the combination of second order gradient moment nulling and cardiac synchronization.