bluuebunny/crossref_metadata_2025 huggingface dataset:
Does plate position influence the outcome in midshaft clavicular fractures? A multicenter analysis
Authors: Buenter Isabelle Ruth , Kremo Valerie , Beeres Frank Johannes Paulus , van Veelen Nicole Maria , Galliker Beat , Link Bjoern-Christian , Babst Reto , Pape Hans-Christoph , van de Wall Bryan Joost Marinus
Published: January 2024

Purpose

To date, it remains unclear whether superior or anterior plating is the best option for treating midshaft clavicular fractures. The aim of this study was to compare both techniques with regard to the incidence of implant removal due to implant irritation, risk of complications, time to union, and function.

Methods

In this retrospective cohort study, all midshaft clavicular fractures treated operatively between 2017 and 2020 in two hospitals in Switzerland were analyzed. The participating hospitals differed with regard to their standard practice; one offered superior plating only, while the other predominantly employed an anterior plate. The primary outcome was the incidence of implant removal for irritation. Secondary outcomes were time to union, complications, re-interventions, and range of motion during the follow-up period of at least 6 months.

Results

In total, 168 patients were included in the study of which 81 (48%) received anterior plating and 87 (52%) superior plating. The overall mean age was 45 years (SD 16). There was no significant difference between anterior and superior plating with regard to implant removal (58.5% versus 57.1%, p = 0.887), infection (5.7% versus 1.8%, p = 0.071), and time to union (median 48 weeks versus 52 weeks, p = 0.643). Data on range of motion were available in 71 patients. There was no significant difference in anteflexion (median 180 degrees anterior versus 180 degrees superior) and abduction (median 180 degrees anterior versus 180 degrees superior) between the two groups.

Conclusion

This retrospective cohort study did not find sufficient evidence to recommend one implant position over the other for midshaft clavicular fractures with regard to removal due to irritation. Time to union was similar and Infections were equally rare in both groups. Notably, a considerable number of patients in both groups had their implants removed due to irritation. Larger prospective studies are needed to determine how much plate position contributes to the occurrence of irritation and whether other patient or implant-related factors might play a role. Until this is clarified, implant position should be based on surgeons preference and experience.
Wire-EDM performance and surface integrity of Inconel 718 with unique microstructural features fabricated by laser powder bed fusion
Authors: Gokcekaya Ozkan , Günen Ali , Ceritbinmez Ferhat , Bahador Abdollah , Nakano Takayoshi , Çetin Melik
Published: January 2024

Inconel 718 alloy is difficult to machine using conventional methods due to its physical properties. Thereby, additive manufacturing (AM) of IN718 components with near-net shapes has been extensively studied. Even though AM processes provide shape and size accuracy, there is still the need for the machining of the AM-processed components to achieve the final shape of a component. Laser powder bed fusion (LPBF) has been successfully utilized to fabricate near-net shape IN718 components; moreover, the microstructure of LPBF-IN718 was unique owing to the AM processing, resulting in differences in grain size, grain boundary characteristics, and grain orientations. Furthermore, these microstructural characteristics are expected to alter the machining performance of IN718. Therefore, this study investigated the wire electro-discharge machining (WEDM) performance of LPBF-718 samples compared to wrought IN718 while focusing on the unique microstructure characteristics of LPBF-IN718 samples (lamella, single-crystal, ploy-crystal). Three different cutting strategies (rough, semi-finish, and finish) were implemented to understand the performance of the multi-pass cutting phenomenon and its effect on the surface of IN718. For all samples, rough (single pass) cutting displayed high roughness, while finish (three passes) cutting exhibited good surface quality. Compositional analyses on the machined surface showed debris formation including Zn and Cu-containing recast material, indicating wire erosion. The surface of single-crystal LPBF-IN718 after the WEDM process was smooth owing to its large grain size and less amount of grain boundary, resulting in slow cutting speed but a good surface finish. Thus, this study, for the first time, investigated the effect of unique microstructural characteristics of LPBF-fabricated IN718 on WEDM performance and machined surface quality.
Die „Reerdigung“
Authors: Schwarz Marcus , Höfert Lisa , Kutschera Ludwig , Dreißig Neele , Becker Susen , Kohl Michael , Baumann Sven , Babian Carsten , Dreßler Jan
Published: January 2024

Hintergrund

Die Reerdigung stellt eine neue Bestattungsform dar, bei der ein menschlicher Leichnam durch natürliche und mechanische Prozesse in 40 Tagen zu Erdsubstrat umgewandelt wird. Für die forensische Evaluation untersuchte das Institut für Rechtsmedizin Leipzig Proben aus den Überresten des Prozesses.

Methodik

Knochen‑, Erd- und Haarproben wurden von zwei Verstorbenen entnommen und mit molekularbiologischen, toxikologischen, morphologisch-osteologischen und bodenkundlichen Methoden untersucht.

Ergebnisse

Die DNA in den Knochen ist nach 40 Tagen degradiert und im zermahlenen, der Erde beigemischten Zustand nicht mehr mit herkömmlichen Methoden nachweisbar. Ein toxikologischer Nachweis von prämortal eingenommenen Medikamenten war analyt- und matrixabhängig teilweise möglich. Morphologisch-osteologisch entsprechen die Knochen einer Liegezeit von 20–50 Jahren. Die entstehende Erde weist die Eigenschaften von Humus auf.

Diskussion

Die neue Bestattungsform bedarf vor Beginn des Prozesses einer zweiten Leichenschau. Aus forensisch-toxikologischer Sicht ist die vereinzelte Nachweisbarkeit von Wirkstoffen tendenziell positiv zu bewerten, da im Gegensatz zur Kremierung potenziell nötige toxikologische Nachuntersuchungen teilweise noch möglich sein könnten. Für die Erdprobe vor und nach Durchmischung von Erde und Knochenmehl konnten hier keine für eine DNA-Analyse geeigneten DNA-Mengen gewonnen werden. Es ist somit davon auszugehen, dass nach der Bestattung der Überreste bei einer weiteren Zersetzung keine humane DNA aus Mischproben zur Identifizierung gewonnen werden kann. Die Erdproben weisen neben den Knochen mikro- sowie makroskopisch keine Spuren von humanem Weichgewebe auf. Das Resultat spricht dafür, dass innerhalb von 40 Tagen die Umwandlung zu Erde stattfindet. Die geringe Zahl der in dieser Pilotstudie untersuchten Leichen stellt eine Limitation dar. Weitere Untersuchungen zur Vergrößerung der Grundgesamtheit sind geplant.
A State Space for 3D Euclidean Yang–Mills Theories
Authors: Cao Sky , Chatterjee Sourav
Published: January 2024

It is believed that Euclidean Yang–Mills theories behave like the massless Gaussian free field (GFF) at short distances. This makes it impossible to define the main observables for these theories—the Wilson loop observables—in dimensions greater than two, because line integrals of the GFF do not exist in such dimensions. Taking forward a proposal of Charalambous and Gross, this article shows that it is possible to define Euclidean Yang–Mills theories on the 3D unit torus as ‘random distributional gauge orbits’, provided that they indeed behave like the GFF in a certain sense. One of the main technical tools is the existence of the Yang–Mills heat flow on the 3D torus starting from GFF-like initial data, which is established in a companion paper. A key consequence of this construction is that under the GFF assumption, one can define a notion of ‘regularized Wilson loop observables’ for Euclidean Yang–Mills theories on the 3D unit torus.
On the Determination of Lagrange Multipliers for a Weighted LASSO Problem Using Geometric and Convex Analysis Techniques
Authors: Giacchi Gianluca , Milani Bastien , Franceschiello Benedetta
Published: January 2024

Compressed Sensing (CS) encompasses a broad array of theoretical and applied techniques for recovering signals, given partial knowledge of their coefficients, cf. Candés (C. R. Acad. Sci. Paris, Ser. I 346, 589–592 (2008)), Candés et al. (IEEE Trans. Inf. Theo (2006)), Donoho (IEEE Trans. Inf. Theo. 52(4), (2006)), Donoho et al. (IEEE Trans. Inf. Theo. 52(1), (2006)). Its applications span various fields, including mathematics, physics, engineering, and several medical sciences, cf. Adcock and Hansen (Compressive Imaging: Structure, Sampling, Learning, p. 2021), Berk et al. (2019 13th International conference on Sampling Theory and Applications (SampTA) pp. 1-5. IEEE (2019)), Brady et al. (Opt. Express 17(15), 13040–13049 (2009)), Chan (Terahertz imaging with compressive sensing. Rice University, USA (2010)), Correa et al. (2014 IEEE International Conference on Acoustics, Speech and Signal Processing (ICASSP) pp. 7789–7793 (2014, May) IEEE), Gao et al. (Nature 516(7529), 74–77 (2014)), Liu and Kang (Opt. Express 18(21), 22010–22019 (2010)), McEwen and Wiaux (Mon. Notices Royal Astron. Soc. 413(2), 1318–1332 (2011)), Marim et al. (Opt. Lett. 35(6), 871–873 (2010)), Yu and Wang (Phys. Med. Biol. 54(9), 2791 (2009)), Yu and Wang (Phys. Med. Biol. 54(9), 2791 (2009)). Motivated by our interest in the mathematics behind Magnetic Resonance Imaging (MRI) and CS, we employ convex analysis techniques to analytically determine equivalents of Lagrange multipliers for optimization problems with inequality constraints, specifically a weighted LASSO with voxel-wise weighting. We investigate this problem under assumptions on the fidelity term $$\left\Vert Ax-b\right\Vert _2^2$$

A
x
-
b

2
2

, either concerning the sign of its gradient or orthogonality-like conditions of its matrix. To be more precise, we either require the sign of each coordinate of $$2(Ax-b)^TA$$

2

(
A
x
-
b
)

T

A

to be fixed within a rectangular neighborhood of the origin, with the side lengths of the rectangle dependent on the constraints, or we assume $$A^TA$$

A
T

A

to be diagonal. The objective of this work is to explore the relationship between Lagrange multipliers and the constraints of a weighted variant of LASSO, specifically in the mentioned cases where this relationship can be computed explicitly. As they scale the regularization terms of the weighted LASSO, Lagrange multipliers serve as tuning parameters for the weighted LASSO, prompting the question of their potential effective use as tuning parameters in applications like MR image reconstruction and denoising. This work represents an initial step in this direction.
Pioneering gut health improvements in piglets with phytogenic feed additives
Authors: Yu Sung Joon , Morris Andrew , Kayal Advait , Milošević Ivan , Van Thi Thu Hao , Bajagai Yadav Sharma , Stanley Dragana
Published: January 2024

This research investigates the effects of phytogenic feed additives (PFAs) on the growth performance, gut microbial community, and microbial metabolic functions in weaned piglets via a combined 16S rRNA gene amplicon and shotgun metagenomics approach. A controlled trial was conducted using 200 pigs to highlight the significant influence of PFAs on gut microbiota dynamics. Notably, the treatment group revealed an increased gut microbiota diversity, as measured with the Shannon and Simpson indices. The increase in diversity is accompanied by an increase in beneficial bacterial taxa, such as Roseburia, Faecalibacterium, and Prevotella, and a decline in potential pathogens like Clostridium sensu stricto 1 and Campylobacter. Shotgun sequencing at the species level confirmed these findings. This modification in microbial profile was coupled with an altered profile of microbial metabolic pathways, suggesting a reconfiguration of microbial function under PFA influence. Significant shifts in overall microbial community structure by week 8 demonstrate PFA treatment’s temporal impact. Histomorphological examination unveiled improved gut structure in PFA-treated piglets. The results of this study indicate that the use of PFAs as dietary supplements can be an effective strategy, augmenting gut microbiota diversity, reshaping microbial function, enhancing gut structure, and optimising intestinal health of weaned piglets providing valuable implications for swine production.

Key points

• PFAs significantly diversify the gut microbiota in weaned piglets, aiding balance.

• Changes in gut structure due to PFAs indicate improved resistance to weaning stress.

• PFAs show potential to ease weaning stress, offering a substitute for antibiotics in piglet diets.
New insights into the influence of pre-culture on robust solvent production of C. acetobutylicum
Authors: Oehlenschläger Katharina , Volkmar Marianne , Stiefelmaier Judith , Langsdorf Alexander , Holtmann Dirk , Tippkötter Nils , Ulber Roland
Published: January 2024

Clostridia are known for their solvent production, especially the production of butanol. Concerning the projected depletion of fossil fuels, this is of great interest. The cultivation of clostridia is known to be challenging, and it is difficult to achieve reproducible results and robust processes. However, existing publications usually concentrate on the cultivation conditions of the main culture. In this paper, the influence of cryo-conservation and pre-culture on growth and solvent production in the resulting main cultivation are examined. A protocol was developed that leads to reproducible cultivations of Clostridium acetobutylicum. Detailed investigation of the cell conservation in cryo-cultures ensured reliable cell growth in the pre-culture. Moreover, a reason for the acid crash in the main culture was found, based on the cultivation conditions of the pre-culture. The critical parameter to avoid the acid crash and accomplish the shift to the solventogenesis of clostridia is the metabolic phase in which the cells of the pre-culture were at the time of inoculation of the main culture; this depends on the cultivation time of the pre-culture. Using cells from the exponential growth phase to inoculate the main culture leads to an acid crash. To achieve the solventogenic phase with butanol production, the inoculum should consist of older cells which are in the stationary growth phase. Considering these parameters, which affect the entire cultivation process, reproducible results and reliable solvent production are ensured.

Key points

• Both cryo- and pre-culture strongly impact the cultivation of C. acetobutylicum

• Cultivation conditions of the pre-culture are a reason for the acid crash

• Inoculum from cells in stationary growth phase ensures shift to solventogenesis

Graphical Abstract
Amino acid PET vs. RANO MRI for prediction of overall survival in patients with recurrent high grade glioma under bevacizumab therapy
Authors: Chaban Artem , Waschulzik Birgit , Bernhardt Denise , Delbridge Claire , Schmidt-Graf Friederike , Wagner Arthur , Wiestler Benedikt , Weber Wolfgang , Yakushev Igor
Published: January 2024

Purpose

To summarize evidence on the comparative value of amino acid (AA) PET and conventional MRI for prediction of overall survival (OS) in patients with recurrent high grade glioma (rHGG) under bevacizumab therapy.

Methods

Medical databases were screened for studies with individual data on OS, follow-up MRI, and PET findings in the same patient. MRI images were assessed according to the RANO criteria. A receiver operating characteristic curve analysis was used to predict OS at 9 months.

Results

Five studies with a total of 72 patients were included. Median OS was significantly lower in the PET-positive than in the PET-negative group. PET findings predicted OS with a pooled sensitivity and specificity of 76% and 71%, respectively. Corresponding values for MRI were 32% and 82%. Area under the curve and sensitivity were significantly higher for PET than for MRI.

Conclusion

For monitoring of patients with rHGG under bevacizumab therapy, AA-PET should be preferred over RANO MRI.
The spatial extent of tauopathy on [18F]MK-6240 tau PET shows stronger association with cognitive performances than the standard uptake value ratio in Alzheimer’s disease
Authors: Gérard Thomas , Colmant Lise , Malotaux Vincent , Salman Yasmine , Huyghe Lara , Quenon Lisa , Dricot Laurence , Ivanoiu Adrian , Lhommel Renaud , Hanseeuw Bernard
Published: January 2024

Purpose

[18F]MK-6240, a second-generation tau PET tracer, is increasingly used for the detection and the quantification of in vivo cerebral tauopathy in Alzheimer’s disease (AD). Given that neurological symptoms are better explained by the topography rather than by the nature of brain lesions, our study aimed to evaluate whether cognitive impairment would be more closely associated with the spatial extent than with the intensity of tau-PET signal, as measured by the standard uptake value ratio (SUVr).

Methods

[18F]MK6240 tau-PET data from 82 participants in the AD spectrum were quantified in three different brain regions (Braak ≤ 2, Braak ≤ 4, and Braak ≤ 6) using SUVr and the extent of tauopathy (EOT, percentage of voxels with SUVr ≥ 1.3). PET data were first compared between diagnostic categories, and ROC curves were computed to evaluate sensitivity and specificity. PET data were then correlated to cognitive performances and cerebrospinal fluid (CSF) tau values.

Results

The EOT in the Braak ≤ 2 region provided the highest diagnostic accuracies, distinguishing between amyloid-negative and positive clinically unimpaired individuals (threshold = 9%, sensitivity = 79%, specificity = 82%) as well as between prodromal AD and preclinical AD (threshold = 38%, sensitivity = 81%, specificity = 93%). The EOT better correlated with cognition than SUVr (∆R2 + 0.08–0.09) with the best correlation observed for EOT in the Braak ≤ 4 region (R2 = 0.64). Cognitive performances were more closely associated with PET metrics than with CSF values.

Conclusions

Quantifying [18F]MK-6240 tau PET in terms of EOT rather than SUVr significantly increases the correlation with cognitive performances. Quantification in the mesiotemporal lobe is the most useful to diagnose preclinical AD or prodromal AD.
Rescue of NLRC5 expression restores antigen processing machinery in head and neck cancer cells lacking functional STAT1 and p53
Authors: Kinney Brendan L. C. , Gunti Sreenivasulu , Kansal Vikash , Parrish Connor J. , Saba Nabil F. , Teng Yong , Henry Mary Katherine , Su Fang-Yi , Kwong Gabriel A. , Schmitt Nicole C.
Published: January 2024

The antigen processing machinery (APM) components needed for a tumor cell to present an antigen to a T cell are expressed at low levels in solid tumors, constituting an important mechanism of immune escape. More than most other solid tumors, head and neck squamous cell carcinoma (HNSCC) cells tend to have low APM expression, rendering them insensitive to immune checkpoint blockade and most other forms of immunotherapy. In HNSCC, this APM deficiency is largely driven by high levels of EGFR and SHP2, leading to low expression and activation of STAT1; however, recent studies suggest that p53, which is often mutated in HNSCCs, may also play a role. In the current study, we aimed to investigate the extent to which STAT1 and p53 individually regulate APM component expression in HNSCC cells. We found that in cells lacking functional p53, APM expression could still be induced by interferon-gamma or DNA-damaging chemotherapy (cisplatin) as long as STAT1 expression remained intact; when both transcription factors were knocked down, APM component expression was abolished. When we bypassed these deficient pathways by rescuing the expression of NLRC5, APM expression was also restored. These results suggest that dual loss of functional STAT1 and p53 may render HNSCC cells incapable of processing and presenting antigens, but rescue of downstream NLRC5 expression may be an attractive strategy for restoring sensitivity to T cell-based immunotherapy.
Vaccination against neoantigens induced in cross-priming cDC1 in vivo
Authors: Clark Emily S. , Benaduce Ana Paula , Khan Wasif N. , Martinez Olivier , Gilboa Eli
Published: January 2024

The conventional type 1 dendritic cells (cDC1) play a pivotal role in protective immunity against pathogens and cancer. However, their low frequency in the blood and tissues limits their use in immune therapy. We have recently described a method to vaccinate against neoantigens that are induced in tumor cells by targeted delivery of a TAP siRNA to dendritic cells using a TLR9 binding CpG oligonucleotide. Since TLR9 is also expressed in immune suppressive myeloid populations TLR9 targeting could reduce the effectiveness of this approach. Here, we describe a modular multivalent antibody platform to target the TAP siRNA to resident Clec9a expressing cDC1 and show that it leads to selective and sustained TAP downregulation in cDC1 and inhibits tumor growth in mice more effectively than CpG targeted siRNA. To induce DC maturation an agonistic CD40 antibody was administered to the siRNA treated mice. To obviate the need for a second drug formulation and reduce the risk of toxicity, we exploited the multivalent nature of this targeting platform to co-deliver the TAP siRNA and a DC maturation agent, a CpG containing oligonucleotide, to cDC1 in vivo and show that it was more effective than Clec9a targeting of TAP siRNA in combination with CD40 antibody. This study describes a way to manipulate the function of cDC1 cells in vivo using a broadly applicable antibody-based targeting platform to deliver multiple biological agents to specific cells in vivo to potentiate (immune) therapy and to probe the biology of specific cell types in their natural settings.
Development of a cellular model to study CCR8 signaling in tumor-infiltrating regulatory T cells
Authors: Liu Libao , Rangan Laurie , Vanalken Nathan , Kong Qianqian , Schlenner Susan , De Jonghe Steven , Schols Dominique , Van Loy Tom
Published: January 2024

The human CC chemokine receptor 8 (CCR8) is specifically expressed on tumor-infiltrating regulatory T cells (TITRs) and is a promising drug target for cancer immunotherapy. However, the role of CCR8 signaling in TITR biology and the effectiveness of CCR8 small molecule antagonists as TITR-targeting immunotherapy remain subjects of ongoing debate. In this work, we generated a novel cellular model of TITRs by culturing peripheral blood mononuclear cell-derived regulatory T cells in medium containing tumor cell-conditioned medium, CD3/CD28 activator, interleukin-2 and 1α,25-dihydroxyvitamin D3. This cellular model (named TITR mimics) highly and stably expressed a series of TITR signature molecules, including CCR8, FOXP3, CD30, CD39, CD134, CD137, TIGIT and Tim-3. Moreover, TITR mimics displayed robust in vitro immunosuppressive activity. To unravel the functional role of CCR8 in TITR mimics, a chemotaxis assay was performed showing strong and CCR8-specific migration toward CCL1, the natural chemokine agonist of CCR8. However, either stimulation (with CCL1) or blocking (with the small molecule antagonist NS-15) of CCR8 signaling did not affect the immunosuppressive activity, proliferation and survival of TITR mimics. Collectively, our work provides a method for the generation of TITR mimics in vitro, which can be used to study TITR biology and to evaluate drug candidates targeting TITRs. Furthermore, our findings suggest that CCR8 signaling primarily regulates migration of these cells.
Predictive value of peripheral blood biomarkers in patients with non-small-cell lung cancer responding to anti-PD-1-based treatment
Authors: Su Shu , Chen Fungjun , Lv Xin , Qi Liang , Ding Zhou , Ren Wei , Wei Ming , Liu Ye , Yu Lixia , Liu Baorui , Wang Lifeng
Published: January 2024

Background

The introduction of the anti-PD-1 antibody has greatly improved the clinical outcomes of patients with non-small cell lung cancer (NSCLC). In this study, we retrospectively analyzed the efficacy of PD-1 antibody-based therapy in patients with locally advanced inoperable or metastatic NSCLC and reported an association between peripheral blood biomarkers and clinical response in these patients.

Methods

This single-center study included medical record data of patients with NSCLC treated with the PD-1 antibody as a first-line or subsequent line of treatment, either as monotherapy or in combination with chemotherapy. The patients were enrolled from 2020 to 2022. We dynamically evaluated multiple Th1 and Th2 cytokines in the blood serum and analyzed the phenotype of T cells from the peripheral blood to explore the correlation between cytokine levels, T cell phenotypes, and clinical response.

Results

A total of 88 patients with stage IIIA-IV NSCLC were enrolled, out of which 60 (68.18%) achieved a partial response (PR), 13 (14.77%) had stable disease (SD), and 15 (17.05%) experienced disease progression (PD). The disease control rate was 82.95%. Our results suggested a significant reduction (P = 0.002, P < 0.005) in lymphocyte absolute counts after treatment in patients with PD. Higher levels of IFN-γ (P = 0.023, P < 0.05), TNF-α (P = 0.00098, P < 0.005), IL-4 (P = 0.0031, P < 0.005), IL-5 (P = 0.0015, P < 0.005), and IL-10 (P = 0.036, P < 0.05) were detected in the peripheral blood before treatment in the PR group compared to the PD group. Moreover, patients with high levels of IL-5, IL-13, IL-4, IL-6, IFN-γ, and TNF-α (> 10 ng/mL) had superior progression-free survival compared to those with low levels (< 10 ng/mL). Furthermore, PD-1 expression on CD8+ T cells was higher in patients who showed a PR than in those who did not show a response (SD + PD; P = 0.042, P < 0.05).

Conclusions

The findings of this study imply that the decrease in absolute blood lymphocyte counts after treatment is correlated with disease progression. Serum cytokine levels may predict the effectiveness and survival rates of anti-PD-1 blockade therapy in patients with NSCLC. In addition, PD-1 expression on CD8+ T cells was positively associated with better clinical response. Our findings highlight the potential of peripheral blood biomarkers to predict the effectiveness of PD-1-targeted treatments in patients with NSCLC. Larger prospective studies are warranted to further clarify the value of these biomarkers.
Hidden blood loss and bleeding characteristics in children with congenital scoliosis undergoing spinal osteotomies
Authors: Raitio Arimatias , Heiskanen Susanna , Soini Venla , Helenius Linda , Syvänen Johanna , Helenius Ilkka
Published: January 2024

Purpose

Spinal osteotomies are often essential in the treatment of congenital scoliosis. Risk factors for bleeding in these patients needing extracavitatory approaches, especially hidden blood loss, are sparsely investigated. We aimed to investigate the bleeding characteristics and hidden blood loss in paediatric patients undergoing spinal osteotomies for congenital scoliosis.

Methods

A retrospective analysis identified all patients with congenital scoliosis were retrospectively identified from the prospectively collected spine register from 2010 to 2022. Operative technique, perioperative laboratory results and imaging studies were extracted. The primary outcome was total blood loss including intraoperative, drain output and hidden blood loss.

Results

Fifty-seven children (32 boys) with a mean age of 8.3 years underwent spinal osteotomy for congenital scoliosis. Posterolateral hemivertebrectomy was sufficient in 34 (59%) patients, while vertebral column resection (VCR) was required in 23 patients. Total bleeding averaged 792 (523) ml accounting for 42% of the estimated blood volume. Hidden blood loss accounted for 40% of total bleeding and 21% of estimated blood volume with a mean of 317 (256) ml. VCR was associated with greater intraoperative and total bleeding than hemivertebrectomies (p = 0.001 and 0.007, respectively). After adjusting for patient weight and fusion levels, hidden blood loss was larger in hemivertebrectomies (4.18 vs. 1.77 ml/kg/fused level, p = 0.049). In multivariable analysis, intraoperative blood loss was inversely correlated with preoperative erythrocyte levels. Younger age was associated with significantly greater drain, hidden and total blood loss.

Conclusion

Hidden blood loss constitutes a significant portion (40%) of total bleeding in congenital scoliosis surgery. Younger age is a risk factor for bleeding and the hidden blood loss should be taken into consideration in their perioperative management.
Efficacy of High-Dose Dexamethasone in Reducing the Symptoms of Postembolization Syndrome Following Prostatic Artery Embolization: Results of a Double-Blind Randomized Controlled Trial
Authors: Svarc Petra , Stroomberg Hein Vincent , Taudorf Mikkel , Brasso Klaus , Lonn Lars , Røder Andreas
Published: January 2024

Purpose

To evaluate the efficacy of a single perioperative dose of dexamethasone in reducing postembolization syndrome following prostatic artery embolization.

Materials and Methods

We conducted a single-center double-blind randomized controlled trial from March 2021 to May 2022 (NCT04588857). Participants were randomized to receive either i.v. 24 mg dexamethasone or saline. The primary outcome measures were temperature, pain, and quality of life in the first 5 days following prostatic artery embolization. Sample size of 60 patients was needed for the assessment of primary outcomes. Participants were followed for 6 months and assessed for a variety of secondary outcome measures including inflammatory markers and lower urinary tract symptoms severity.

Results

Due to lack of clinical effect and mild symptoms in the control group, the trial was terminated early. 31 participants (16 dexamethasone vs. 15 control) were enrolled and analyzed. A difference in mean temperature was observed on day 1 (37.23 ± 0.64 °C control vs 36.74 ± 0.41 °C dexamethasone, p = 0.02, 95% CI 0.09–0.89). Difference in pain (score out of 10) was seen only on day 5 (1.48 ± 1.2 control vs. 2.9 ± 2.24 dexamethasone, p = 0.04, 95% CI − 2.78–− 0.04). A difference in C-reactive protein values was observed on day 2 (108 [54–161] mg/l control vs 10 [5–33] mg/l dexamethasone, p < 0.01). No significant differences in other outcomes were observed. No side effects were recorded.

Conclusions

Twenty-four milligrams of dexamethasone bolus is safe but does not reduce postembolization syndrome following prostatic artery embolization.

Graphical Abstract
MI-DenseCFNet: deep learning–based multimodal diagnosis models for Aureus and Aspergillus pneumonia
Authors: Liu Tong , Zhang Zheng-hua , Zhou Qi-hao , Cheng Qing-zhao , Yang Yue , Li Jia-shu , Zhang Xue-mei , Zhang Jian-qing
Published: January 2024

Objective

To build and merge a diagnostic model called multi-input DenseNet fused with clinical features (MI-DenseCFNet) for discriminating between Staphylococcus aureus pneumonia (SAP) and Aspergillus pneumonia (ASP) and to evaluate the significant correlation of each clinical feature in determining these two types of pneumonia using a random forest dichotomous diagnosis model. This will enhance diagnostic accuracy and efficiency in distinguishing between SAP and ASP.

Methods

In this study, 60 patients with clinically confirmed SAP and ASP, who were admitted to four large tertiary hospitals in Kunming, China, were included. Thoracic high-resolution CT lung windows of all patients were extracted from the picture archiving and communication system, and the corresponding clinical data of each patient were collected.

Results

The MI-DenseCFNet diagnosis model demonstrates an internal validation set with an area under the curve (AUC) of 0.92. Its external validation set demonstrates an AUC of 0.83. The model requires only 10.24s to generate a categorical diagnosis and produce results from 20 cases of data. Compared with high-, mid-, and low-ranking radiologists, the model achieves accuracies of 78% vs. 75% vs. 60% vs. 40%. Eleven significant clinical features were screened by the random forest dichotomous diagnosis model.

Conclusion

The MI-DenseCFNet multimodal diagnosis model can effectively diagnose SAP and ASP, and its diagnostic performance significantly exceeds that of junior radiologists. The 11 important clinical features were screened in the constructed random forest dichotomous diagnostic model, providing a reference for clinicians.

Clinical relevance statement

MI-DenseCFNet could provide diagnostic assistance for primary hospitals that do not have advanced radiologists, enabling patients with suspected infections like Staphylococcus aureus pneumonia or Aspergillus pneumonia to receive a quicker diagnosis and cut down on the abuse of antibiotics.

Key points

• MI-DenseCFNet combines deep learning neural networks with crucial clinical features to discern between Staphylococcus aureus pneumonia and Aspergillus pneumonia.

• The comprehensive group had an area under the curve of 0.92, surpassing the proficiency of junior radiologists.

• This model can enhance a primary radiologist’s diagnostic capacity.
Borate speciation and structural studies of vanadium ion doping in borate bioglass
Authors: Elbasuoni E. G. , Abdelghany A. M. , Moustafa Y. M. , El-Damrawi G.
Published: January 2024

Different glasses in the system, xV2O5-(45–x)B2O3–24.5Na2O–24.5CaO–6P2O5, (x = 0, 3, 6, 9, 12, 15, 18, 20 and 25 Wt%) were prepared through melt quenching method. X-ray diffraction (XRD) patterns have revealed that the amorphous structure is the dominant type. There is no tendency for crystallization even with higher vanadium content. Crystallization occurred utilizing treating the glasses thermally. FTIR spectral absorption data showed the presence of both BO3 and BO4 structural groups in combination with the presence of VO4 and VO5 structural building units. The deconvolution analysis technique (DAT) was adopted to retrace the conversion progressions of the coordinated boron. At low V2O5 content (up to 10 wt%), it entered as a glass modifier as well as both Na2O and CaO. The high content of the glass modifier (Na2O + CaO + V2O5) could destroy some of the well-formed BO4 units which are transformed into asymmetric BO3. The back conversion of BO4 to asymmetric or loose BO3 can simply reduce the fraction of tetrahedral units (N4). When V2O5 entered as a glass former (> 10 wt%), the N4 fraction increased. The change in the measured densities and estimated molar volumes may assigned to the formation of BO4 units resulting from increasing vanadium oxide content.
Improved catalytic performance of Ag-doped K-OMS-2 for soot oxidation
Authors: Nithya R. , Vikram A. L. , Dasari Harshini , Nethaji S. , Murari M. S.
Published: January 2024

The catalytic behaviours of pure K-OMS-2 and Ag-doped K-OMS-2 catalysts (5% Ag doping) synthesized using the hydrothermal method are the focus of investigation in this study. To characterize the catalytic performance of these synthesized catalysts, a combination of analytical techniques, including X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), Raman spectroscopy, and Soot Temperature Programmed Reduction (Soot TPR), were employed. The analysis of the prepared samples via XRD revealed a nanocrystalline tetragonal structure, with crystal sizes measuring approximately 22.4 nm. Further examination of the samples using Field Emission Scanning Electron Microscopy (FESEM) unveiled nanorods with dimensions of 213 nm in length and 32 nm in width for K-OMS-2. In comparison, Ag-doped K-OMS-2 displayed nanorods with dimensions of 290 nm in length and 26 nm in width. Notably, the incorporation of Ag+ ions into the K-OMS-2 framework led to an increase in the intensities of the 771 and 527 cm−1 bands when compared to the pure K-OMS-2. This increase can be attributed to the replacement of K+ ions with Ag+ ions in the structure. Furthermore, the introduction of Ag+ ions into the K-OMS-2 framework significantly influenced its catalytic activity for soot oxidation, as evidenced by the augmentation of surface-adsorbed and lattice oxygen radicals, as observed in the results of Soot TPR. The doped sample exhibited substantially enhanced catalytic activity for soot oxidation, as indicated by its low T50 of 370 °C. In addition, the incorporation of the dopant was found to enhance the thermal stability of the catalyst.

Graphical abstract
Evaluation of the ankle function after Achilles tendon resection: a retrospective clinical study
Authors: Bota Olimpiu , Heinzinger Leona M. , Herzog Bianka , Disch Alexander C. , Amlang Michael , Flößel Philipp , Dragu Adrian , Taqatqeh Feras
Published: January 2024

Introduction

The Achilles tendon is the strongest tendon in the human body and has the function of plantar ankle flexion. When the tendon is exposed, the peritendineum has been breached and the thick avascular tendon colonized with bacteria, a complete resection of the tendon may be indicated to achieve infection control and facilitate wound closure. The Achilles tendon reconstruction is not mandatory, as the plantar flexion of the ankle joint is assumed by the remaining flexor hallucis longus, flexor digitorum longus and tibialis posterior muscles. Our study aimed to evaluate the impact of Achilles tendon resection without reconstruction on leg function and quality of life.

Material and methods

We retrospectively evaluated all patients who were treated with an Achilles tendon resection between January 2017 and June 2022 in our quaternary institution. After evaluating the data, the patients who survived and were not amputated were contacted for re-evaluation, which included isokinetic strength measurement of both ankle joints, evaluation of the ankle range of motion and collection of several functional scores.

Results

Thirty patients were included in the retrospective study, with a mean age of 70.3 years, including 11 women and 19 men. The most frequent cause of the infection was leg ulcer (43.3%), followed by open tendon suture (23.3%). No tendon reconstruction was performed. Fifteen patients could be gained for reevaluation. The average difference in ankle flexion torque on the injured side compared to the healthy side at 30 degrees/second was 57.49% (p = 0.003) and at 120 degrees/second was 53.13% (p = 0.050) while the difference in power was 45.77% (p = 0.025) at 30 degrees/second and 38.08% (p = 0.423) at 120 degrees/second. The follow-up time was between 4 and 49 months and a positive correlation could be determined between the time elapsed from surgery and the ankle joint strength. There was a significant loss of range of motion on the operated side compared to the healthy side: 37.30% for plantar flexion, 24.56% for dorsal extension, 27.79% for pronation and 24.99% for supination. The average Lepillhati Score was 68.33, while the average American Orthopedic Foot and Ankle Score was 74.53.

Conclusion

The complete Achilles tendon resection leaves the patient with satisfactory leg function and an almost normal gait. Especially in elderly, multimorbid patients, straightforward tendon resection and wound closure provide fast infection control with acceptable long-term results. Further prospective studies should compare the ankle function and gait in patients with and without Achilles tendon reconstruction after complete resection.
‘Concept creep’ in perceptions of mental illness — an experimental examination of prevalence-induced concept change
Authors: Speerforck Sven , Jürgensen Vanessa , Göbel Mirjam , Meyer Nicholas , Schomerus Georg
Published: January 2024

The perception of what constitutes mental illness is influenced by various social and medical developments. Prevalence-induced concept change is a phenomenon where decreasing the prevalence of a category leads people to expand their judgment of that concept. In this study, we tested whether changing the prevalence of statements describing mental illness results in a change in the concept of mental illness. Based on a population survey (n = 1031), we created a validated set of 273 brief statements depicting either clear symptoms of mental illness, clear examples of healthy behaviour, or ambiguous situations. We presented a subset of statements to 138 students, asking them to judge whether each statement represented mental illness, or not. After 96 statements, we reduced the prevalence of clearly mentally ill statements in one group, while the proportion of statements denoting clear mental illness remained the same in the other group. In the group where the proportion of clearly mentally ill statements was reduced during the experiment, a concept change of mental illness evolved: participants were more likely to identify a statement as denoting a mental illness. The results indicate that the perceived prevalence of symptoms of mental illness is important for conceptualizing mental illness and that decreasing prevalence broadens the concept of mental illness. These findings add a novel perspective to current debates around diagnostic thresholds, the treatment-prevalence paradox, the medicalization of emotions, and the focus of anti-stigma campaigns.
The association between childhood trauma and tobacco smoking in patients with psychosis, unaffected siblings, and healthy controls
Authors: de With Justine , van der Heijden Heleen S. , van Amelsvoort Therese , Daemen Maud , Simons Claudia , Alizadeh Behrooz , van Aalst Daphne , de Haan Lieuwe , Vermeulen Jentien , Schirmbeck Frederike
Published: January 2024

In patients with psychosis, rates of tobacco smoking and childhood trauma are significantly higher compared to the general population. Childhood trauma has been proposed as a risk factor for tobacco smoking. However, little is known about the relationship between childhood trauma and smoking in psychosis. In a subsample of the Genetic Risk and Outcome of Psychosis study (760 patients with psychosis, 991 unaffected siblings, and 491 healthy controls), tobacco smoking was assessed using the Composite International Diagnostic Interview and childhood trauma was measured with the Childhood Trauma Questionnaire. Logistic regression models were used to assess associations between trauma and smoking, while correcting for confounders. Positive associations were found between total trauma, abuse, and neglect, and an increased risk for smoking in patients, while correcting for age and gender (ORtrauma 1.77, 95% CI 1.30–2.42, p < 0.001; ORabuse 1.69, 95% CI 1.23–2.31, p = 0.001; ORneglect 1.48, 95% CI 1.08–2.02, p = 0.014). In controls, total trauma and abuse were positively associated with smoking, while correcting for age and gender (ORtrauma 2.40, 95% CI 1.49–3.88, p < 0.001; ORabuse 2.02, 96% CI 1.23–3.32, p = 0.006). All associations lost their significance after controlling for additional covariates and multiple testing. Findings suggest that the association between childhood trauma and tobacco smoking can be mainly explained by confounders (gender, cannabis use, and education) in patients with psychosis. These identified aspects should be acknowledged in tobacco cessation programs.
Serum calcitonin gene-related peptide in patients with persistent post-concussion symptoms, including headache: a cohort study
Authors: Eggertsen Peter Preben , Palmfeldt Johan , Schytz Henrik Winther , Hay Debbie , Olsen Rikke Katrine Jentoft , Nielsen Jørgen Feldbæk
Published: January 2024

Background

Calcitonin gene-related peptide (CGRP) plays an important role in migraine pathophysiology, and post-traumatic headache (PTH) frequently presents with migraine-like features. Despite several clinical similarities, few studies have explored CGRP in PTH and concussion. This study investigates serum CGRP levels in patients with persistent post-concussion symptoms (PPCS), including PTH.

Methods

This cohort study was based on serum samples from individuals aged 18–30 years with PPCS who participated in a previously published randomized controlled trial of a non-pharmacological intervention. The primary outcome was serum CGRP concentrations, determined at baseline before randomization and at follow-up 7 months later, using an enzyme-linked immunosorbent assay (ELISA). CGRP levels at baseline were compared with healthy anonymous blood donors in the same age group.

Results

Baseline serum samples were collected from 86 participants with PPCS. The participants were most often female (78%) and migraine-like headache was the most frequent headache phenotype (74%). Serum CGRP levels were higher in participants with PPCS than in 120 healthy individuals (median: 158.5 pg/mL vs. 76.3 pg/mL, p = 0.050). A stratified analysis revealed that females with PPCS had a fivefold higher median than healthy females (166.3 pg/mL vs. 32.1 pg/mL, p = 0.0006), while no differences were observed in males (p = 0.83). At follow-up, CGRP levels decreased with a median change of  – 1.3 pg/mL (95% confidence interval:  – 17.6–0, p = 0.024).

Discussion

Elevated serum levels of CGRP in patients with PPCS and a decrease over time suggest an involvement of CGRP in PTH/PPCS. If confirmed in other studies, it could pave the way for CGRP-targeted therapies, which could have clinical significance.
Guillain–Barré syndrome and COVID-19 vaccination: a systematic review and meta-analysis
Authors: Censi Stefano , Bisaccia Giandomenico , Gallina Sabina , Tomassini Valentina , Uncini Antonino
Published: January 2024

Background

Case-reports/series and cohorts of Guillain–Barré syndrome (GBS) associated with COVID-19 vaccination have been reported.

Methods

A systematic review and meta-analysis of cohort studies of GBS after COVID-19 vaccination was carried out. Incidence and incidence rate ratio for a number of vaccine doses and risk of GBS, also considering the specific vaccine technology, were calculated in a random-effects model.

Results

Of 554 citations retrieved, 518 were discarded as irrelevant. We finally included 15 studies. The random effect model yielded, regardless of the vaccine technology, 1.25 (95%CI 0.21; 2.83) GBS cases per million of COVID-19 vaccine doses, 3.93 (2.54; 5.54) cases per million doses for adenovirus-vectored vaccines and 0.69 (0.38; 1.06) cases per million doses for mRNA vaccines. The GBS risk was 2.6 times increased with the first dose. Regardless of the vaccine technology, the GBS risk was not increased but disaggregating the data it was 2.37 (1.67; 3.36) times increased for adenovirus-vectored vaccines and 0.32 (0.23; 0.47) for mRNA vaccines. Mortality for GBS after vaccination was 0.10 per million doses and 4.6 per GBS cases.

Conclusions

Adenovirus-vectored vaccines showed a 2.4 times increased risk of GBS that was about seven times higher compared with mRNA-based vaccines. The decreased GBS risk associated with mRNA vaccines was possibly due to an elicited reduction of infections, including SARS-CoV-2, associated with GBS during the vaccination period. How adenovirus-vectored COVID-19 vaccines may trigger GBS is unclear and further studies should investigate the relationship between vaccine technologies and GBS risk.