bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between the telecommuting environment and somatic symptoms among teleworkers in Japan
Authors: Kanamori Satoru , Tabuchi Takahiro , Kai Yuko
Published: December 2023

Objectives: This study aimed to clarify the association between telecommuting environments and somatic symptoms among teleworkers in Japan.

Methods: This cross-sectional study, conducted from September 27 to October 29, 2021, used data from the Japan COVID-19 and Society Internet Survey (JACSIS study) in Japan. Of the 31 000 male and female respondents, who were Japanese residents aged 15-79 years and were randomly selected from the panel members of an internet survey company, 4569 home-based teleworkers were finally included in the analysis; 26 431 respondents who met the exclusion criteria were excluded. The analysis included 4 cut-offs (≥4, 8, 12, and 16 points) for somatic symptoms on the Somatic Symptom Scale-8 as objective variables, and the telecommuting environment, such as having adequate desk light and a quiet environment, as explanatory variables. Adjusted Poisson regression analysis was conducted using demographic variables as covariates.

Results: The prevalence ratio (PR) for somatic symptoms increased significantly as the number of poor telecommuting conditions increased, regardless of the cut-off value for somatic symptoms or the frequency of teleworking. In the telecommuting environment, the PR for somatic symptoms was significantly higher for the following 6 items: poor teleworking space to concentrate, inadequate foot space, poor communication environment, poor space for relaxation, noise, and inappropriate temperature and humidity.

Conclusions: These results suggest that for home-based teleworkers, the more inadequate the telecommuting environment, especially in the aforementioned 6 areas, the higher the likelihood of somatic symptoms. Improving these environments may be useful in preventing various somatic symptoms.
Whole-exome sequencing uncovers a novel EFEMP2 gene variant (c.C247T) associated with dominant nonsyndromic thoracic aortic aneurysm
Authors: Sadeghipour Parham , Valuian Marzieh , Ghasemi Serwa , Rafiee Farnaz , Pourirahim Maryam , Mahmoodian Mehran , Maleki Majid , Kalayinia Samira
Published: December 2023

Background

Thoracic aortic aneurysm (TAA) is a multifactorial disorder. Familial TAA, which is more clinically aggressive, is associated with a high risk of lethal dissection or rupture. Genetic evaluation can provide TAA patients with personalized treatment and help in predicting risk to family members.

Objective

The purpose of this investigation was to report a likely pathogenic variant in the EFEMP2 gene that may contribute to TAA in a family with a documented history of the condition.

Methods

In the index patient, the causative genetic predisposition was identified using whole-exome sequencing. The potential likely pathogenic effect of the candidate variant was further analyzed through bioinformatics analysis, homology modeling, and molecular docking.

Results

The results revealed a likely pathogenic heterozygous variant, c.247C>T p.Arg83Cys, in exon 4 of the EFEMP2 gene (NM_016938), which was predicted to have disease-causing effects by MutationTaster, PROVEAN, SIFT, and CADD (phred score = 27.6).

Conclusion

In this study, a likely pathogenic variant in the EFEMP2 gene was identified in an Iranian family with a dominant pattern of autosomal inheritance of TAA. This finding underscores the importance of conducting molecular genetic evaluations in families with nonsyndromic TAA and the significance of early detection of at-risk family members.
Galactic cosmic ray transport in the absence of resonant scattering
Authors: Pezzi O , Blasi P
Published: December 2023

Galactic cosmic ray transport relies on the existence of turbulence on scales comparable with the gyration radius of the particles and with wavenumber vector oriented along the local magnetic field. In the standard picture, in which turbulence is injected at large scales and cascades down to smaller scales, it is all but guaranteed that the turbulent fluctuations at the scales relevant for resonant scattering may be present, either because of anisotropic cascading or because of the onset of damping processes. This raises questions on the nature of cosmic ray scattering, especially at energies ≳1 TeV, where self-generation is hardly relevant. Here, by means of numerical simulations of charged test particles in a prescribed magnetic field, we perform a gedankenexperiment aimed at investigating particle diffusion in a situation in which turbulence is mainly present at large scales, and discuss possible implications of this set-up for cosmic ray transport phenomenology.
Ruling out strongly interacting dark matter–dark radiation models from joint observations of cosmic microwave background and quasar absorption spectra
Authors: Chatterjee Atrideb , Mitra Sourav , Banerjee Amrita
Published: December 2023

The cold dark matter paradigm provides a remarkably good description of the Universe’s large-scale structure. However, some discrepancies exist between its predictions and observations at very small sub-galactic scales. To address these issues, the consideration of a strong interaction between dark matter particles and dark radiation emerges as an intriguing alternative. In this study, we explore the constraints on those models using joint observations of cosmic microwave background and quasars absorption spectra with our previously built parameter estimation package cosmoreionmc. At 2σ confidence limits, this analysis rules out the strongly interacting dark matter–dark radiation models within the recently proposed effective theory of structure formation framework, representing the most stringent constraint on those models to the best of our knowledge. Future research using a 21-cm experiment holds the potential to reveal stronger constraints or uncover hidden interactions within the dark sector.
Strongly magnetized accretion in two ultracompact binary systems
Authors: Maccarone Thomas J , Kupfer Thomas , Casarrubias Edgar Najera , Sandoval Liliana E Rivera , Shaw Aarran W , Britt Christoper T , van Roestel Jan , Zurek David R
Published: December 2023

We present the discoveries of two of AM CVn systems, Gaia14aae and SDSS J080449.49+161624.8, which show X-ray pulsations at their orbital periods, indicative of magnetically collimated accretion. Both also show indications of higher rates of mass transfer relative to the expectations from binary evolution driven purely by gravitational radiation, based on existing optical data for Gaia14aae, which show a hotter white dwarf temperature than expected from standard evolutionary models, and X-ray data for SDSS J080449.49+161624.8 which show a luminosity 10−100 times higher than those for other AM CVn at similar orbital periods. The higher mass transfer rates could be driven by magnetic braking from the disc wind interacting with the magnetosphere of the tidally locked accretor. We discuss implications of this additional angular momentum transport mechanism for evolution and gravitational wave detectability of AM CVn objects.
Simulations of Sequence Evolution: How (Un)realistic They Are and Why
Authors: Trost Johanna , Haag Julia , Höhler Dimitri , Jacob Laurent , Stamatakis Alexandros , Boussau Bastien
Published: December 2023

Motivation

Simulating multiple sequence alignments (MSAs) using probabilistic models of sequence evolution plays an important role in the evaluation of phylogenetic inference tools and is crucial to the development of novel learning-based approaches for phylogenetic reconstruction, for instance, neural networks. These models and the resulting simulated data need to be as realistic as possible to be indicative of the performance of the developed tools on empirical data and to ensure that neural networks trained on simulations perform well on empirical data. Over the years, numerous models of evolution have been published with the goal to represent as faithfully as possible the sequence evolution process and thus simulate empirical-like data. In this study, we simulated DNA and protein MSAs under increasingly complex models of evolution with and without insertion/deletion (indel) events using a state-of-the-art sequence simulator. We assessed their realism by quantifying how accurately supervised learning methods are able to predict whether a given MSA is simulated or empirical.

Results

Our results show that we can distinguish between empirical and simulated MSAs with high accuracy using two distinct and independently developed classification approaches across all tested models of sequence evolution. Our findings suggest that the current state-of-the-art models fail to accurately replicate several aspects of empirical MSAs, including site-wise rates as well as amino acid and nucleotide composition.
Beyond MitoCarta—expanding the list of candidate proteins involved in mitochondrial functions using a biological network approach
Authors: Leyfer Dmitriy , Fetterman Jessica L
Published: December 2023

Mitochondrial diseases are the result of pathogenic variants in genes involved in the diverse functions of the mitochondrion. A comprehensive list of mitochondrial genes is needed to improve gene prioritization in the diagnosis of mitochondrial diseases and development of therapeutics that modulate mitochondrial function. MitoCarta is an experimentally derived catalog of proteins localized to mitochondria. We sought to expand this list of mitochondrial proteins to identify proteins that may not be localized to the mitochondria yet perform important mitochondrial functions. We used a computational approach to assign statistical significance to the overlap between STRING database gene network neighborhoods and MitoCarta proteins. Using a data-driven stringent significance threshold, 2059 proteins that were not located in MitoCarta were identified, which we termed mitochondrial proximal (MitoProximal) proteins. We identified all of the oxidative phosphorylation complex subunits and 90% of 149 genes that contain confirmed oxidative phosphorylation disease causal variants, lending validation to our methodology. Among the MitoProximal proteins, 134 are annotated to be localized to mitochondria but are not in the MitoCarta 3.0 database. We extend MitoCarta nearly 3-fold, generating a more comprehensive list of mitochondrial genes, a resource to facilitate the identification of pathogenic variants in mitochondrial and metabolic diseases.
Risk Factors for Invasive Fungal Infection in Lung Transplant Recipients on Universal Antifungal Prophylaxis
Authors: Huggins Jonathan P , Arthur David , Chow Shein-Chung , Pease Robert , Stanly Kelly , Workman Adrienne , Reynolds John , Alexander Barbara D
Published: December 2023

Background

Many centers use universal antifungal prophylaxis after lung transplant, but risk factors for invasive fungal infection (IFI) in this setting are poorly described.­

Methods

This retrospective, single-center cohort study including 603 lung transplant recipients assessed risk factors for early (within 90 days of transplant) invasive candidiasis (IC) and invasive mold infection (IMI) and late (90–365 days after transplant) IMI using Cox proportional hazard regression.

Results

In this cohort, 159 (26.4%) patients had 182 IFIs. Growth of yeast on donor culture (hazard ratio [HR], 3.30; 95% CI, 1.89–5.75) and prolonged length of stay (HR, 1.02; 95% CI, 1.01–1.03) were associated with early IC risk, whereas transplantation in 2016 or 2017 (HR, 0.21; 95% CI, 0.06–0.70; HR, 0.25; 95% CI, 0.08–0.80, respectively) and female recipient sex (HR, 0.53; 95% CI, 0.30–0.93) were associated with reduced risk. Antimold therapy (HR, 0.21; 95% CI, 0.06–0.78) was associated with lower early IMI risk, and female donor sex (HR, 0.40; 95% CI, 0.22–0.72) was associated with lower late IMI risk. Recent rejection was a risk factor for late IMI (HR, 1.73; 95% CI, 1.02–2.95), and renal replacement therapy predisposed to early IC, early IMI, and late IMI (HR, 5.67; 95% CI, 3.01–10.67; HR, 7.54; 95% CI, 1.93–29.45; HR, 5.33; 95% CI, 1.46–19.49, respectively).

Conclusions

In lung transplant recipients receiving universal antifungal prophylaxis, risk factors for early IC, early IMI, and late IMI differ.
Absence of Type I Interferon Autoantibodies or Significant Interferon Signature Alterations in Adults With Post–COVID-19 Syndrome
Authors: Achleitner Martin , Mair Nina K , Dänhardt Juliane , Kardashi Romina , Puhan Milo A , Abela Irene A , Toepfner Nicole , de With Katja , Kanczkowski Waldemar , Jarzebska Natalia , Rodionov Roman N , Wolf Christine , Lee-Kirsch Min Ae , Steenblock Charlotte , Hale Benjamin G , Bornstein Stefan R
Published: December 2023

Genetic defects in the interferon (IFN) system or neutralizing autoantibodies against type I IFNs contribute to severe COVID-19. Such autoantibodies were proposed to affect post–COVID-19 syndrome (PCS), possibly causing persistent fatigue for >12 weeks after confirmed SARS-CoV-2 infection. In the current study, we investigated 128 patients with PCS, 21 survivors of severe COVID-19, and 38 individuals who were asymptomatic. We checked for autoantibodies against IFN-α, IFN-β, and IFN-ω. Few patients with PCS had autoantibodies against IFNs but with no neutralizing activity, indicating a limited role of type I IFNs in PCS pathogenesis. In a subset consisting of 28 patients with PCS, we evaluated IFN-stimulated gene activity and showed that it did not correlate with fatigue. In conclusion, impairment of the type I IFN system is unlikely responsible for adult PCS.
Rapid population decline in McKay’s Bunting, an Alaskan endemic, highlights the species’ current status relative to international standards for vulnerable species
Authors: Richardson Rachel M , Amundson Courtney L , Johnson James A , Romano Marc D , Taylor Audrey R , Fleming Michael D , Matsuoka Steven M
Published: December 2023

The McKay’s Bunting (Plectrophenax hyperboreus) is endemic to Alaska, breeds solely on the remote and uninhabited St. Matthew and Hall islands (332 km2) in the central Bering Sea, and is designated as a species of high conservation concern due to its small population size and restricted range. A previous hypothesized population estimate (~2,800 to 6,000 individuals) was greatly increased (~31,200 individuals) after systematic surveys of the species’ entire breeding range in 2003, establishing McKay’s Bunting as one of the rarest passerines in North America. In 2018, we replicated the 2003 surveys and used density surface models to estimate breeding season densities, distributions, and population change over the intervening time period. Our results indicate that the McKay’s Bunting population declined by 38% (95% CI: 27 to 48%) from ~31,560 to 19,481 individuals since 2003. Spatial model predictions showed no areas with an increase of birds on either St. Matthew or Hall islands but revealed declines across 13% (42 km2) of St. Matthew Island. Declines disproportionately occurred both in marginal habitats with reduced rocky nesting substrate and in high-density hotspots along the coast of St. Matthew Island. The total area occupied by breeding adults decreased by 8%, and high-density hotspots shifted inland from the coast of St. Matthew Island to higher elevations on both islands, the latter potentially responses to exceptionally warm weather and reduced spring snow cover in 2018. Additionally, we observed low numbers of predators and interspecific competitors in 2018, suggesting that these did not cause the decline. Our findings indicate that McKay’s Bunting meets international standards for elevating its conservation status from Least Concern to Endangered based on the International Union for Conservation of Nature Red List of Threatened Species ranking criteria. Additional population monitoring and studies to identify the causal mechanisms of the recent population decline of this rare species could assist future population assessments.
Corpus Modeling and the Geometries of Text
Authors: Stoltz Dustin S. , Combs Marissa A. , Taylor Marshall A.
Published: December 2023

This chapter explores the theoretical implications of spatial metaphors in the field of computational text analysis and inspects how the properties of topologies aid and inhibit our theories of textual meaning. Rather than mining for “ground truth,” machine learning algorithms for text, especially word embedding models, provide a selectively simplistic map of the semantic space. The representation of that textual map depends not only on the choice of algorithm but also on the composition of the corpora used to train them. Along with reviewing the technical aspects of embedding text into space, this chapter surveys the consequences of training algorithms with internal and external objectives. The implications of different types of training corpora are enumerated, with particular attention to ethical considerations. More scholarship, institutional support, and technical infrastructure directed toward the careful building, documenting, and sharing of corpora as well as machine learning models trained on those corpora are recommended.
Gender, Sex, and the Constraints of Machine Learning Methods
Authors: Lockhart Jeffrey W.
Published: December 2023

This chapter discusses the wide array of ways that gender and sex interact with machine learning (ML) and the artificial intelligence technologies that rely on it. Some of these interactions are intentional; others are unintentional or even against practitioners’ concerted efforts. Some are born out of the allure of a seemingly simple variable that is aligned with the technical needs of ML. Often, gender lurks without invitation, because these methods mine data for associations, and gendered associations are ubiquitous. In a growing body of work, scholars are using ML to actively interrogate measurements and theories of gender and sex. ML brings with it new paradigms of quantitative reasoning that hold the potential to either reinscribe or revolutionize gender in both technical systems and scientific knowledge.
Meaning and Machines
Authors: Stuhler Oscar , Stoltz Dustin S. , Martin John Levi
Published: December 2023

Given the non-sentient nature of current machines, it can be puzzling to attempt to use ideas regarding “meaning” to explicate their results, even when these involve language outputs, often considered the acme of meaning creation. This chapter proposes a formal approach to meaning that treats it as a dyad of a relation of reference, allowing a clear translation to the case of data analysis, and considers the ways that machine learning may be used to help human analysts explore the meanings in some set of data. Building on the two ways (formal and informal) that humans learn language, the chapter proposes that there are two promising approaches to using machines, a more formal, grammar-based, one, and a more informal, embedding-based, one. Each of these has certain advantages and disadvantages, and the chapter suggests ways that analysts can best make use of developing technologies as opposed to letting their theoretical imagination be hijacked by the path of the development of computer science.
Europe and International Law
Authors: Anghie Antony
Published: December 2023

Historians of international law have emphasized its European character. This chapter explores implications of this assertion by discussing how European ideas became the basis of international law through the processes of imperialism. It studies specific jurists, Vitoria and Grotius, to suggest some of the main features of European international law. It then surveys the different ways in which non-European peoples understood, adopted, adapted, and contested European international law over the past two centuries. The chapter concludes by suggesting some of the enduring legacies of European international law, such as the nation-state and capitalism, and what these might mean for the future of international order.
Arabidopsis HSFA9 Acts as a Regulator of Heat Response Gene Expression and the Acquisition of Thermotolerance and Seed Longevity
Authors: Wang Xiaohua , Zhu Yan , Tang Ling , Wang Yuanyuan , Sun Runze , Deng Xin
Published: December 2023

Heat-shock transcription factors (HSFs) are crucial for regulating plant responses to heat and various stresses, as well as for maintaining normal cellular functions and plant development. HSFA9 and HSFA2 are two of the Arabidopsis class A HSFs and their expressions are dramatically induced in response to heat shock (HS) stress among all 21 Arabidopsis HSFs. However, the detailed biological roles of their cooperation have not been fully characterized. In this study, we employed an integrated approach that combined bioinformatics, molecular genetics and computational analysis to identify and validate the molecular mechanism that controls seed longevity and thermotolerance in Arabidopsis. The acquisition of tolerance to deterioration was accompanied by a significant transcriptional switch that involved the induction of primary metabolism, reactive oxygen species and unfolded protein response, as well as the regulation of genes involved in response to dehydration, heat and hypoxia. In addition, the cis-regulatory motif analysis in normal stored and controlled deterioration treatment (CDT) seeds confirmed the CDT-repressed genes with heat-shock element (HSE) in their promoters. Using a yeast two-hybrid and molecular dynamic interaction assay, it is shown that HSFA9 acted as a potential regulator that can interact with HSFA2. Moreover, the knock-out mutants of both HSFA9 and HSFA2 displayed a significant reduction in seed longevity. These novel findings link HSF transcription factors with seed deterioration tolerance and longevity.
Can artificial intelligence reach human thought?
Authors: Fokas Athanassios S
Published: December 2023

The transformative achievements of deep learning have led several scholars to raise the question of whether artificial intelligence (AI) can reach and then surpass the level of human thought. Here, after addressing methodological problems regarding the possible answer to this question, it is argued that the definition of intelligence proposed by proponents of the AI as “the ability to accomplish complex goals,” is appropriate for machines but does not capture the essence of human thought. After discussing the differences regarding understanding between machines and the brain, as well as the importance of subjective experiences, it is emphasized that most proponents of the eventual superiority of AI ignore the importance of the body proper on the brain, the laterization of the brain, and the vital role of the glia cells. By appealing to the incompleteness theorem of Gödel’s and to the analogous result of Turing regarding computations, it is noted that consciousness is much richer than both mathematics and computations. Finally, and perhaps most importantly, it is stressed that artificial algorithms attempt to mimic only the conscious function of parts of the cerebral cortex, ignoring the fact that, not only every conscious experience is preceded by an unconscious process but also that the passage from the unconscious to consciousness is accompanied by loss of information.
The Right to Silence Under Scrutiny: Unveiling the Significance of Section 313 of the Code of Criminal Procedure of India
Authors: Chadha Vaibhav , Poddar Deepali
Published: December 2023

The often-overlooked provision of criminal law, which holds significant importance is section 313 of the Code of Criminal Procedure 1973. Section 313 grants the accused an opportunity to provide their statement, ensuring their right to be heard and preventing self-incrimination. This article explores the background, evolution, and objectives of section 313 CrPC, as well as its alignment with the principles of natural justice. The main aim of the article is to demonstrate how India still falls short in upholding the right to silence as per section 313, through a detailed analysis of various judgments passed by the Supreme Court of India, and laws enacted in other jurisdictions around the world. The article addresses the issue of Indian courts using adverse inferences from an accused person’s silence, which conflicts with Article 20(3) of the Indian Constitution. It argues that drawing such inferences should be reconsidered by the courts, as it contradicts important legal principles and undermines the right to a fair trial.
Empowering the Care of Older Adults Through the Use of Technology
Authors: Xu Heng , Xie Bo , Chang Chu-Hsiang
Published: December 2023

In recent years, the COVID-19 pandemic and other global crises have significantly affected the lives of older adults, impacting their healthcare, social connections, and daily routines. While the increasing digitization and automation of services offer benefits such as remote healthcare access and reduced isolation, these technologies also pose challenges in terms of unfamiliarity, learning curves, and privacy and security concerns. Addressing these issues requires a collaborative approach across various fields, including health informatics, gerontology, social psychology, human–computer interaction, and cybersecurity and privacy. Understanding the cognitive, emotional, and sociocultural factors influencing older adults’ use of technologies is crucial for creating inclusive and accessible digital tools. This multidisciplinary effort, as highlighted in the special issue of Work, Aging and Retirement, aims to enhance our understanding of aging and technology in today’s world, empowering older adults to remain connected and maintain their well-being.
Primary prevention of HPV-related diseases from the patients’ perspective in Poland
Authors: Trojnarska Dominika , Jach Robert
Published: December 2023

Objectives

This study aimed to assess the knowledge of human papillomavirus (HPV) and attitudes toward HPV vaccination (HPVv) among female patients in Poland, investigating the impact of sociodemographic factors on these aspects. The study also explored awareness of state-funded bivalent vaccination and gauged willingness to vaccinate children, especially in the aspect of the newly introduced nonavalent vaccine.

Material and methods

An 11-question questionnaire was administered to newly referred patients at a dysplasia consultation center in Kraków University Hospital between February and December 2022. Statistical analysis using IBM SPSS Statistics 25 evaluated sociodemographic characteristics, HPV knowledge, attitudes toward HPVv and correlations among responses.

Results

By December 2022, 187 completed forms were received, primarily from women aged 30-40 years, residing in large cities, and with higher education qualifications. While most were aware of HPV’s association with cancer and abnormal cytology, over 40% were unaware of its asymptomatic nature. Higher education is correlated with better HPV awareness. Participants generally showed positive attitudes toward HPVv for themselves and their children, yet only a small fraction had received the vaccine. Education significantly influenced HPV knowledge, with higher education levels linked to better awareness and willingness to vaccinate children. Awareness of HPV is positively correlated with knowledge test performance and vaccination attitudes.

Conclusion

The study revealed a lack of awareness regarding government co-financing for the bivalent vaccine. Campaigns endorsing reimbursed vaccination were found to be inadequate, highlighting the need for corrective measures to enhance awareness and improve vaccination rates, particularly for individuals outside the age range between 12 and 13 years relying on self-financing or sporadic government initiatives.
The Combined Application of Bleomycin and Triamcinolone for Treating Refractory Keloids
Authors: Mozafari Nikoo , Mollaabasi Faeghe , Mansouri Parvin , Robati Reza M.
Published: December 2023

BACKGROUND

Triamcinolone acetate injections are considered the first treatment option for keloids, but quite high proportions of keloids either do not respond to triamcinolone or develop recurrence. Beneficial effects of intralesional bleomycin have been recently shown in the treatment of keloids and hypertrophic scars. However, the efficacy of combination therapy using intralesional triamcinolone and bleomycin remains undetermined.

OBJECTIVE

The purpose of this study was to evaluate the efficacy of using bleomycin and triamcinolone mixture to treat refractory keloids.

MATERIALS AND METHODS

In total, 33 patients with resistant keloids (including 8 men and 25 women) and a mean age of 36.52 years (age range of 18–65 years) were enrolled in this study. A mixture of bleomycin (1 u/cc) with triamcinolone acetonide (13.3 mg/cc) was injected intralesionally into the keloids every 4 to 6 weeks for a maximum of 6 cycles. The clinical improvement was evaluated using the Japan Scar Scale (JSS) and the physician's global assessment of the flattening of the lesions. Side effects were also noted and recorded.

RESULTS

In all patients, the total JSS scores decreased significantly after treatment (2.33 ± 1.05), compared with baseline (11.61 ± 2.59), (p < .001); 26 keloids (78.8%) showed an excellent response (75%–100% flattening), 7 keloids (21.2%) showed a fair response (25%–75% flattening), and 0 keloids (0%) showed a poor response (<25% flattening). Observed side effects were ulceration (33.3%), hyperpigmentation (33.3%), hypopigmentation (15.15%), secondary infection (33.3%), and telangiectasis (15.15%).

CONCLUSION

The combined use of bleomycin and triamcinolone offers a promising treatment option for individuals who have not responded well to traditional therapies.
Bone mass, fracture risk, and associated factors in postmenopausal women living with HIV
Authors: Leite-Silva Paula R. , Pinheiro Rebeca S. , Barbosa-Ferreira João M.B. , Balieiro Antonio , Sabidó Meritxell , Lacerda Marcus V.G. , Chaves Yury O. , Nogueira Paulo A. , Benzaken Adele S.
Published: December 2023

Objective

The aim of this study was to assess the prevalence of low bone mass (osteopenia/osteoporosis), the factors associated with low bone mass, and the risk of fractures in Brazilian postmenopausal women living with HIV (WLH) in the Amazon region

Methods

This is a cohort study with a cross-sectional assessment at baseline conducted between March 2021 to August 2022 with 100 postmenopausal WLH undergoing antiretroviral therapy (ART) between 45 and 60 years of age and 100 age-matched HIV-negative women. Data on bone mineral density in the lumbar spine (LS) and femoral neck (FN) were collected using dual x-ray absorptiometry and the 10-year risk of hip and major osteoporotic fractures was assessed using the Fracture Risk Assessment tool (FRAX).

Results

The age of menopause onset occurred earlier in WLH (P < 0.001). No differences in prevalence of osteoporosis and osteopenia in LS and FN were observed except for a lower T score in FN in WLH (P = 0.039). The FRAX for major osteoporotic fracture and hip fracture were low in both groups, despite the mean of both FRAX scores was higher in WLH (P < 0.001). Multivariate analysis showed that years since menopause onset, higher body mass index and higher FRAX major osteoporotic fracture were associated with the WLH group, while a higher frequency of physical activity was registered in the HIV-negative group. Multivariate analysis also showed that in WLH, a lower T score in FN was associated with years since menopause onset and body mass index and that the number of years since menopause onset was associated with a lower T score in the LS and a higher score in the FRAX hip fracture.

Conclusions

Our findings show a high prevalence of low bone mass (osteopenia/osteoporosis) in Brazilian postmenopausal women from the Amazon region. Women living with HIV have higher FRAX scores than HIV-negative women and a lower T score in the FN.
Surgical Procedures, Complications, and Durations in Patients with Noma Disease: A Cross-sectional Study
Authors: Gebretsadik Heron G.
Published: December 2023

Background:

Noma is a devastating disease that causes severe destruction of facial tissue, necessitating comprehensive surgical intervention for functional restoration and improved quality of life. This cross-sectional study aimed to identify common surgical procedures used for noma defect reconstruction in Ethiopia, analyze their durations, and assess associated complications.

Methods:

The study retrospectively analyzed noma patient records from Facing Africa’s database, covering electronic medical data from 2007 to 2019, and utilized SPSS version 2020 for analysis.

Results:

Facing Africa treated 235 noma cases (2007–2019) with 438 procedures. The most commonly used surgical technique was reconstructive surgery, which encompassed two or more other surgical methods and was used in 177 cases. This was followed by the submental flap in 47 cases and ankylosis release in 35 cases. The study also found complications in 11 cases, including flap necrosis, abscesses, and ankylosis-related mouth restriction. Additionally, the analysis of 102 noma cases revealed significant variations in the duration of surgical procedures, ranging from 10 to 48 hours for specific cases, with the majority (63.7%) requiring 2 to 5 hours. The mean duration of noma surgery was calculated to be 4.08 hours.

Conclusions:

Comprehending common surgical techniques, complications, and durations benefits surgical planning, resource allocation, and patient care. Thus, the results of this study are a useful contribution to the development of effective noma treatment. However, further research and continuous efforts are needed to refine surgical practices, address potential complications, and enhance patient care in the battle against this devastating disease.
Artificial intelligence scoring of liver biopsies in a phase II trial of semaglutide in nonalcoholic steatohepatitis
Authors: Ratziu Vlad , Francque Sven , Behling Cynthia A. , Cejvanovic Vanja , Cortez-Pinto Helena , Iyer Janani S. , Krarup Niels , Le Quang , Sejling Anne-Sophie , Tiniakos Dina , Harrison Stephen A.
Published: December 2023

Background and Aims:

Artificial intelligence–powered digital pathology offers the potential to quantify histological findings in a reproducible way. This analysis compares the evaluation of histological features of NASH between pathologists and a machine-learning (ML) pathology model.

Approach and Results:

This post hoc analysis included data from a subset of patients (n=251) with biopsy-confirmed NASH and fibrosis stage F1–F3 from a 72-week randomized placebo-controlled trial of once-daily subcutaneous semaglutide 0.1, 0.2, or 0.4 mg (NCT02970942). Biopsies at baseline and week 72 were read by 2 pathologists. Digitized biopsy slides were evaluated by PathAI’s NASH ML models to quantify changes in fibrosis, steatosis, inflammation, and hepatocyte ballooning using categorical assessments and continuous scores. Pathologist and ML-derived categorical assessments detected a significantly greater percentage of patients achieving the primary endpoint of NASH resolution without worsening of fibrosis with semaglutide 0.4 mg versus placebo (pathologist 58.5% vs. 22.0%, p < 0.0001; ML 36.9% vs. 11.9%; p=0.0015). Both methods detected a higher but nonsignificant percentage of patients on semaglutide 0.4 mg versus placebo achieving the secondary endpoint of liver fibrosis improvement without NASH worsening. ML continuous scores detected significant treatment-induced responses in histological features, including a quantitative reduction in fibrosis with semaglutide 0.4 mg versus placebo (p=0.0099) that could not be detected using pathologist or ML categorical assessment.

Conclusions:

ML categorical assessments reproduced pathologists’ results of histological improvement with semaglutide for steatosis and disease activity. ML-based continuous scores demonstrated an antifibrotic effect not measured by conventional histopathology.
A systematic review of the prevalence of postamputation and chronic neuropathic pain associated with combat injury in military personnel
Authors: Kumar Alexander , Soliman Nadia , Gan Zoe , Cullinan Paul , Vollert Jan , Rice Andrew S.C. , Kemp Harriet
Published: December 2023

Combat trauma can lead to widespread tissue damage and limb loss. This may result in chronic neuropathic and post amputation pain, including phantom limb pain (PLP) and residual limb pain (RLP). The military population is distinct with respect to demographic, injury, and social characteristics compared with other amputation and trauma cohorts. We undertook a systematic review of studies of military personnel, with a history of combat injury, that reported a prevalence of any type of postamputation pain or chronic neuropathic pain, identified from Embase and MEDLINE databases.Using the inverse variance method with a random-effects model, we undertook a meta-analysis to determine an overall prevalence and performed exploratory analyses to identify the effect of the type of pain, conflict, and time since injury on prevalence. Pain definitions and types of pain measurement tools used in studies were recorded. Thirty-one studies (14,738 participants) were included. The pooled prevalence of PLP, RLP, and chronic neuropathic pain were 57% (95% CI: 46-68), 61% (95% CI: 50-71), and 26% (95% CI: 10-54), respectively. Between-study heterogeneity was high (I2: 94%-98%). Characterisation of duration, frequency, and impact of pain was limited. Factors reported by included studies as being associated with PLP included the presence of RLP and psychological comorbidity. The prevalence of postamputation pain and chronic neuropathic pain after combat trauma is high. We highlight inconsistency of case definitions and terminology for pain and the need for consensus in future research of traumatic injury.
Psychometric Properties of the Advance Care Planning Engagement Survey-9 in Cardiovascular and Metabolic Diseases
Authors: Heo Seongkum , Kim Sun Hwa , Heo Ran , Cho KyungAh , Yang Jisun , Kim Hee Ryang , An Minjeong , Kang JungHee , Kim JinShil
Published: December 2023

The purpose of this study was to test the reliability and validity of the Advance Care Planning Engagement Survey-9 Korean version in patients with cardiovascular diseases or metabolic syndrome. In this cross-sectional study, data on advance care planning engagement, registration of advance directives and the intention, and sociodemographic characteristics were collected from 105 patients (mean age, 66.3 years) at 4 medical institutions. Cronbachαwas used to test the reliability. Confirmatory factor analysis and independentttests were used to test the validity. Cronbachαs for the total scale and the self-efficacy and readiness dimensions were .93, .82, and .97, respectively. In confirmatory factor analysis with 2 factors, all indices of model fit were acceptable: comparative fit index, 0.995; Tucker-Lewis index, 0.989; standardized root-mean-square residual, 0.024; root-mean-square error of approximation, 0.059; and factor loadings > 0.65. Patients who registered advance directives (P< .001) or had the intention (P< .001) had higher scores of the Advance Care Planning Engagement Survey-9 Korean version than their counterparts. The findings demonstrate that the Advance Care Planning Engagement Survey-9 Korean version was a reliable and valid instrument. Health care providers, including nurses, can use this instrument to assess and manage advance care planning engagement in Korean patients with cardiovascular diseases or metabolic syndrome.
Vaccination and Nutritional Outcomes of Hemodialysis Patients Infected With SARS-CoV-2
Authors: Villaverde-Núñez Alberto , Ramírez López María Teresa , Rodríguez Cristina Antón , Hammel Inés Constanze , Pérez Ramos Cristina , Álvarez Villarreal Miriam , Ruíz Fernández Sandra , Arriero López Beatriz , Hernández Cordobés Gema , Manzano Guerrero Nemesio , Baena Ruíz Laura , Guerra Llamas María Isabel
Published: December 2023

Background

Patients on hemodialysis are particularly vulnerable to COVID-19 and may have a reduced response to vaccination due to a decreased immune response. The nutritional status prior or during the infection could also impact on the clinical effectiveness of vaccination.

Objectives

We aim to describe the evolution of clinical and nutritional biomarkers of hemodialysis patients infected with SARS-CoV-2 and to assess their association with vaccination status.

Methods

An observational, analytic, longitudinal, retrospective multicenter study was carried out in 82 patients on hemodialysis with SARS-CoV-2 infection. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI), anthropometry and biochemical parameters. The association of the vaccine doses with clinical and nutritional related variables were also evaluated.

Results

The percentage of vaccinated patients was similar to non-vaccinated patients. Prior to infection, the majority of the patients were malnourished. They presented lower albumin, creatinine and urea levels than the well-nourished patients. Significant deterioration of nutritional status after infection was evidenced considering GNRI score, dry weight and Body Mass Index. Albumin and creatinine also decreased significantly post-infection whereas C-reactive protein increased in the acute phase. Significant inverse correlation was found between the variation of post-pre GNRI scores and basal albumin and C-reactive protein at 7 days. Additionally, we observed the opposite trend between albumin at 30 days and basal cholesterol. A negative value in the GNRI variation was associated with bilateral pneumonia, need for hospitalization and nutritional support. Vaccinated patients presented substantially less bilateral pneumonia and hospitalization. No significant effects were observed between vaccine doses and the variation in nutritional status, although a positive correlation was detected with the albumin at 7 days and C-reactive protein prior to infection and the number of vaccine doses received.

Discussion

COVID-19 is associated with affectations in the nutritional status and biomarkers in hemodialysis patients. In this study vaccines have demonstrated a protective effect against the clinical consequences of COVID. However, they have shown limitations in preventing the deterioration of nutritional status after infection. The results highlight the importance of promoting the vaccination in these patients as well as incorporating nutritional assessment before, during and after the infection.
(How) ChatGPT - Artificial Intelligence Thinks It Can Help/Harm Physiatry
Authors: Jačisko Jakub , Veselý Viktor , Chang Ke-Vin , Özçakar Levent
Published: December 2023

ChatGPT is a chatbot that is based on the generative pre-trained transformer (GPT) architecture as an artificial inteligence based large language model. Its widespread use in health care practice, research and education seems to be (increasingly) inevitable. Also considering the relevant limitations regarding privacy, ethics, bias, legal and validity, in this article, its use as a supplement (for sure not as a substitute for physicians) is discussed in light of the recent literature. Particularly, the “opinion“ of ChatGPT about how it can help/harm physiatry is exemplified.
Posttraumatic Amputations Epidemiology and Outcomes Within the National Trauma Data Bank
Authors: Hergert Brooke C. , Rana Amtul-noor , Velasquez Jose E. , Johnson Anthony E. , Ali Sadia , Wong Kristin A. , Teixeira Pedro G.
Published: December 2023

Objective

Acute trauma care has significantly reduced mortality over the last two decades. The last study to examine the epidemiology of traumatic amputees predates these gains. The majority of those who sustain traumatic amputation are male; therefore, limited data exist on female amputees. This study aimed to (1) provide a current epidemiological analysis of traumatic amputees and (2) compare male and female amputees.

Design

All patients sustaining a major limb amputation in the National Trauma Data Bank from 2013 to 2017 were identified. First, descriptive analyses of patient demographics and injury characteristics were performed and compared with a previous 2000–2004 National Trauma Data Bank study. Second, female and male traumatic amputees were compared in this study.

Results

From 2013 to 2017, we identified 7016 patients who underwent major limb amputation. Compared with previous years, the current amputees were older and more severely injured. Mortality was 6.3% in the current years compared with 13.4% in the previous years (odds ratio, 0.44, 95% CI = 0.37–0.51, P < 0.001). After multivariable analysis, mortality remained significantly decreased, with no difference in hospital length of stay.

Conclusions

Contemporary National Trauma Data Bank analysis demonstrated that patients with traumatic amputations, regardless of sex, often survive until hospital discharge, despite more severe injuries.
A Tale of Bilateral Rapidly Progressive Osteoarthritis of the Hip—It Is Not Always the Steroid Injection
Authors: Cheng Jennifer , Barcavage Christine , Leupold Olivia , Tsai Jefferson , Wyss James
Published: December 2023

Rapidly progressive osteoarthritis of the hip is an unusual subset of hip osteoarthritis in which a >2 mm/yr rate of joint space narrowing occurs. Rapidly progressive osteoarthritis of the hip has been associated with intra-articular steroid injection, with the incidence of rapidly progressive osteoarthritis of the hip after intra-articular steroid injection ranging from 2.8% to 21%. The occurrence of rapidly progressive osteoarthritis of the hip unrelated to intra-articular steroid injection is rare, and not frequently reported. This report presents a unique case of rapidly progressive osteoarthritis of the hip in the bilateral hips of one patient. The first hip developed rapidly progressive osteoarthritis of the hip within 6 mos after an intra-articular steroid injection. Three years later, the second hip developed rapidly progressive osteoarthritis of the hip within 4 mos without any injection or use of systemic steroid medication. The etiology of rapidly progressive osteoarthritis of the hip in the absence of intra-articular steroid injection is unclear, and this case presents the opportunity to observe the development of rapidly progressive osteoarthritis of the hip due to different causes within the same individual.