bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuroanatomical correlates of subjective tinnitus: insights from advanced cortical morphology analysis
Authors: Pandey Himanshu R , Keshri Amit , Sinha Neeraj , Kumar Uttam
Published: November 2024

Subjective tinnitus, characterized by the perception of phantom sounds in the absence of external stimuli, presents significant challenges in both audiology and neurology. Once thought to primarily involve aberrant neural activity within auditory pathways, it is now understood to engage a broader array of neuroanatomical structures. This study investigated the connections between auditory, cognitive, and sensory processing regions, which are crucial for unraveling the complex neurobiological basis of tinnitus. Using high-resolution T1-weighted magnetic resonance imaging, we compared 52 individuals with subjective tinnitus with 52 age-matched healthy controls, focusing on cerebral cortex features, including fractal dimensionality, gyrification, and sulcal depth. Covariate analyses were conducted to explore the relationships between tinnitus duration, Tinnitus Handicap Inventory scores, anxiety score, and neuroanatomical changes. We found significant alterations in key brain regions involved in sensory processing, cognition, and emotional regulation, including the insula, lateral occipital cortex, middle frontal gyrus, and superior parietal lobule. These neuroanatomical changes were strongly correlated with the severity and chronicity of tinnitus symptoms. Our findings reveal profound structural changes in the brain associated with subjective tinnitus, offering valuable insights into the condition’s underlying mechanisms and providing a potential framework for guiding future research and therapeutic interventions.
Neurophysiological characteristics of reward processing in individuals at different levels of gaming
Authors: Peng Yanjie , Wu DanTong , Tian Mingyuan , Zhou Yanyin , Peng Xiaohong , Peng Zhenlei , Gong Ke , Liu Kezhi , Chen Jing , Lei Wei
Published: November 2024

Altered reward processing has been repeatedly reported in Internet gaming disorder (IGD). However, it remains unclear whether these changes are linked to the severity of addictive symptoms or the extent of gaming experience. This study examined the neurophysiological responses regarding reward anticipation and consummation in individuals at different levels of gaming (including 22 casual gamers, 31 regular gamers, and 27 individuals with IGD) through a monetary incentive delay task. Three event-related potential components during reward anticipation—cue-related P300 (Cue-P3), contingent negative variation, and stimulus-preceding negativity (SPN)—and two during reward consummation—feedback-related negativity and feedback-related P300 (FB-P3)—were measured. We found that IGD individuals exhibited greater Cue-P3 but lower SPN amplitude compared to casual gamers, while regular gamers fell between the two without significant differences. Regressions indicated that more extensive gaming experience, rather than the severity of the symptoms, primarily contributed to the increased Cue-P3 in IGD. No group differences were found during reward consummation. Our results highlight disrupted reward anticipation processing in IGD, characterized by increased attention bias toward reward cues (Cue-P3) but diminished cognitive resources for reward anticipation (SPN) and emphasize the role of gaming experience in increased attention bias in IGD.
Neurophysiological evidence of motor contribution to vicarious affective touch
Authors: Butti Niccolò , Urgesi Cosimo , Makris Stergios , McGlone Francis P , Montirosso Rosario , Cazzato Valentina
Published: November 2024

Understanding observed interpersonal touch, particularly the so-called affective touch targeting the CT fibers, is essential for social interactions. Research has documented that observing other people being touched activates the same cortical areas involved in direct tactile experiences. However, observing interpersonal touch also activates an inner simulation of the movements in the observer’s motor system. Given the social and affective significance of CT-optimal touch, the present study tested the hypothesis that observing stroking touches targeting or not targeting the CT fibers system might distinctly influence motor resonance to vicarious touch. With this aim, we used single-pulse transcranial magnetic stimulation and motor-evoked potentials recording while participants observed video clips of interpersonal touch events at different stroking velocities. We found a modulation of motor system activity, particularly a decrease in corticospinal excitability, when observing CT-optimal touch as opposed to non-CT-optimal velocities, a mechanism that might aid in understanding the touchee’s feelings during vicarious interpersonal touch. Moreover, participants with higher reliance on bodily cues to be emotionally aware showed greater motor suppression for CT-optimal compared to non-CT-optimal velocities. These results shed light on the complex interplay between motor and somatosensory systems in social touch perception and emphasize the importance of affective touch in human social interactions.
Extending the scope of instrumental variable methods
Authors: Chesher Andrew , Rosen Adam M
Published: November 2024

Since Philip Wright’s proposal of the linear instrumental variables (IV) estimator in 1928, the scope of application of IV models has greatly expanded. There are now nonlinear IV models in use with both additive and nonadditive latent variables, employing both semiparametric and nonparametric specifications. A notable feature of Wright’s linear IV estimator is that it is applicable to incomplete models that leave the genesis of endogenous explanatory variables unspecified. However, inversion of the linear model enables the value of unobservable heterogeneity to be expressed as a function of observable variables. Only recently has the application of incomplete IV models been extended to cases in which this inversion produces a non-singleton set of values of unobservable variables. This situation arises in many models such as those featuring discrete choice, counts, or censored outcomes, or when there are multiple sources of heterogeneity as in random coefficient models, or when economic considerations result in inequality restrictions on values taken by observed and unobserved variables. This paper provides an introduction to the methods set out for analysing such generalized instrumental variable models in Chesher and Rosen (2017). An illustrative example is provided in which an outcome is determined by a random coefficients linear model with an endogenous explanatory variable and instrumental variable exclusion and independence restrictions.
Intercontinental insights into autism spectrum disorder: a synthesis of environmental influences and DNA methylation
Authors: Kuodza George E , Kawai Ray , LaSalle Janine M
Published: November 2024

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder characterized by a broad range of symptoms. The etiology of ASD is thought to involve complex gene–environment interactions, which are crucial to understanding its various causes and symptoms. DNA methylation is an epigenetic mechanism that potentially links genetic predispositions to environmental factors in the development of ASD. This review provides a global perspective on ASD, focusing on how DNA methylation studies may reveal gene–environment interactions characteristic of specific geographical regions. It delves into the role of DNA methylation in influencing the causes and prevalence of ASD in regions where environmental influences vary significantly. We also address potential explanations for the high ASD prevalence in North America, considering lifestyle factors, environmental toxins, and diagnostic considerations. Asian and European studies offer insights into endocrine-disrupting compounds, persistent organic pollutants, maternal smoking, and their associations with DNA methylation alterations in ASD. In areas with limited data on DNA methylation and ASD, such as Africa, Oceania, and South America, we discuss prevalent environmental factors based on epidemiological studies. Additionally, the review integrates global and country-specific prevalence data from various studies, providing a comprehensive picture of the variables influencing ASD diagnoses over region and year of assessment. This prevalence data, coupled with regional environmental variables and DNA methylation studies, provides a perspective on the complexities of ASD research. Integrating global prevalence data, we underscore the need for a comprehensive global understanding of ASD’s complex etiology. Expanded research into epigenetic mechanisms of ASD is needed, particularly in underrepresented populations and locations, to enhance biomarker development for diagnosis and intervention strategies for ASD that reflect the varied environmental and genetic landscapes worldwide.
Homo sapiens, Neanderthals and speciation complexity in palaeoanthropology
Authors: Meneganzin Andra , Stringer Chris
Published: November 2024

Tracking the origins of new species and delimiting taxa across space and time present well-trodden sources of controversy for palaeoanthropology. Although biological diversity comes with frustratingly elusive boundaries, the task of describing and understanding diversity remains no less crucial, and palaeotaxonomy no more dispensable. This is epitomized by recent developments in discussions on our species’ origins and the extent to which Middle Pleistocene hominin forms represent distinct lineages. While it is tempting to think that progress in such debates is only hampered by the paucity of fossil and genomic data, we argue that problems also lie with unrealistic assumptions in theory. In particular, we examine ongoing discussions on whether Homo sapiens and Neanderthals deserve distinct species status as a means to advocate for the necessity of reframing speciation in palaeoanthropology in a more biologically plausible way. We argue that available palaeontological evidence is best interpreted under a framework that sees speciation as an evolutionary process that starts in space, thereby involving a geographical dimension, and progresses in time, thereby involving a diachronic dimension, with an incremental accumulation of relevant characters at different phases of the process. We begin by discussing evidence about species-level differentiation of H. sapiens and Neanderthals and analyse major sources of taxonomic disagreement, before illustrating the potential of this perspective in making progress on the earliest stages of H. sapiens speciation within Africa.
Diverse Genome Structures among Eukaryotes May Have Arisen in Response to Genetic Conflict
Authors: Sterner Elinor G , Cote-L’Heureux Auden , Maurer-Alcalá Xyrus X , Katz Laura A
Published: November 2024

In contrast to the typified view of genome cycling only between haploidy and diploidy, there is evidence from across the tree of life of genome dynamics that alter both copy number (i.e. ploidy) and chromosome complements. Here, we highlight examples of such processes, including endoreplication, aneuploidy, inheritance of extrachromosomal DNA, and chromatin extrusion. Synthesizing data on eukaryotic genome dynamics in diverse extant lineages suggests the possibility that such processes were present before the last eukaryotic common ancestor. While present in some prokaryotes, these features appear exaggerated in eukaryotes where they are regulated by eukaryote-specific innovations including the nucleus, complex cytoskeleton, and synaptonemal complex. Based on these observations, we propose a model by which genome conflict drove the transformation of genomes during eukaryogenesis: from the origin of eukaryotes (i.e. first eukaryotic common ancestor) through the evolution of last eukaryotic common ancestor.
Why nature evolved GPI-anchored proteins: unique structure characteristics enable versatile cell surface functions
Authors: Zhang Qi , Fujita Morihisa
Published: November 2024

It remains a mystery why nature evolved the unique structural characteristics of GPI-anchored proteins (GPI-APs) and continues to sustain the complex, energy-intensive process of synthesizing these proteins. GPI-APs, despite their small size, rely on the coordinated activity of nearly 30 genes for their synthesis and remodeling, raising important evolutionary questions. The biological advantages of GPI-APs lie in their ability to rapidly redistribute across the cell membrane, localize within lipid rafts, utilize unique intracellular trafficking pathways, and function as both membrane-bound and soluble proteins. These properties allow GPI-APs to participate in diverse cellular processes such as synaptic plasticity, immune regulation, and signal transduction, highlighting their indispensable roles. Additionally, the shedding capability of GPI-APs extends their functional reach, adding further versatility to their biological roles. This review not only summarizes these key insights but also explores the broader implications of GPI-APs in cell signaling and disease. By understanding the evolutionary necessity of GPI-APs, we can better appreciate their complexity and potential as therapeutic targets.
Variation in second-grade reading in children who are deaf and hard-of-hearing
Authors: Couvee Sascha , Wauters Loes , Knoors Harry , Verhoeven Ludo , Segers Eliane
Published: November 2024

We investigated relations between kindergarten precursors and second-grade reading skills in deaf and hard-of-hearing (DHH) children, and aimed to identify subgroups based on reading skills, in order to explore early signs of later reading delays. DHH children (n = 23, Mage kindergarten = 6.25) participated from kindergarten-second grade. They were tested on phonological awareness, letter knowledge, spoken vocabulary, speechreading, fingerspelling, and sign vocabulary in kindergarten, and word decoding and reading comprehension in second grade. In second grade, word decoding scores were low-average while reading comprehension scores were below average compared to hearing norms. Word decoding correlated with phonological awareness, letter knowledge, and spoken vocabulary. Reading comprehension correlated with all measures except fingerspelling. Cluster analysis identified three second-grade-reading subgroups; group-1: below-average word decoding and reading comprehension; group-2: high-average word decoding, below-average reading comprehension; group-3: average word decoding and reading comprehension. Furthermore, group-1 differed from group-2 and group-3 on word decoding, group-1 and group-2 differed from group-3 in reading comprehension. Regarding kindergarten measures, group-1 scored below group-2 on letter knowledge, and below group-3 on spoken and sign vocabulary. We found that particularly letter knowledge and spoken and sign vocabulary seem to be crucial for the development of reading skills 2 years later.
GIST-ery solved: story of an intestinal mass in a young lady
Authors: Jayasheelan Shikha , Sreeram Saraswathy , NS Akash , Mohan Abhay
Published: November 2024

A 19-year-old woman presented with abdominal pain and a palpable mass, initially suspected to be a gastrointestinal stromal tumor (GIST) based on imaging. Surgical excision revealed a sclerotic spindle cell neoplasm with minimal cytological atypia, but immunohistochemistry (IHC) was negative for GIST-specific markers. The pan-negative IHC profile, along with calcification foci and low Ki67 index (<1%), led to a diagnosis of calcifying fibrous tumor (CFT). This case highlights the importance of precise diagnostic evaluation and consideration of rare entities like CFT. Comprehensive histopathological evaluation and IHC are essential diagnostic tools, as they can distinguish between GIST and CFT, leading to accurate treatment and patient management. This case underscores the value of thorough pathological assessment in resolving diagnostic challenges.
Relationship between sexual dysfunction and burnout among physicians in primary hospital: a cross-sectional study
Authors: Tan Xing , Tian Yu , Zhu Ting-Ting , Ge Peng-Peng , Wang Quan-Jie , Chen Rong , Xu Rong-Hui , Meng Xiao-Juan , Zhang Tong-Tong
Published: November 2024

Background

The relationship between sexual dysfunction and burnout among physicians remains unclear.

Aim

To investigate the frequency of sexual dysfunction among physicians in primary hospital and explore the association between sexual dysfunction and burnout.

Methods

This study was a cross-sectional survey conducted through a questionnaire. We used the Arizona Sexual Experience Scale and the Chinese version of the Maslach Burnout Inventory–Human Service Survey to assess sexual function and burnout among physicians in primary hospital. Considering the working environment of physicians, we also evaluated the doctor-patient relationship and sleep quality.

Outcomes

Over one-third of physicians experience sexual dysfunction. Burnout is a significant factor to sexual dysfunction among medical professionals.

Results

A total of 382 doctors participated in this survey, and the prevalence of sexual dysfunction was 33.51%. Sexual arousal and orgasm were the main sexual dysfunctions faced by male and female doctors, respectively. The prevalence of burnout among physicians was 43.72%. The prevalence of sexual dysfunction among physicians experiencing burnout (45.51%) was higher than that observed in physicians without burnout (24.19%). Physicians with burnout exhibited significantly higher total and individual scores on the Arizona Sexual Experience Scale as compared with physicians without burnout (all P values <.05). There was a significant positive correlation between depersonalization and sexual drive (r = 0.508, P < .001), sexual arousal (r = 0.521, P < .001), lubrication (r = 0.432, P < .001), orgasm/erection (r = 0.420, P < .001), and sexual satisfaction (r = 0.434, P < .001). Logistic regression analysis confirmed that—in addition to burnout—older age, dissatisfaction with income, a poor doctor-patient relationship, and poor sleep were significant contributors to sexual dysfunction among physicians in primary hospitals.

Clinical Implications

Sexual health is an integral aspect of well-being. Prioritizing the sexual health of medical professionals can significantly contribute to improving their productivity.

Strengths and Limitations

First, our sample size was small, and the impact of different specialties on sexual functioning was somewhat overlooked. Second, we lacked laboratory data (eg, testosterone and prolactin levels) that could provide substantial support to sexual identification. Finally, although we used logistic regression to establish causality, the relationship between sexual dysfunction and certain factors may be bidirectional.

Conclusions

The issue of sexual dysfunction among doctors needs more attention. We should make targeted efforts to improve the quality of physicians’ sexual lives.
Symptomatic Entamoeba dispar Infections Among Men Who Have Sex With Men, New York City, 2018
Authors: Mergen Kimberly , Alleyne Lisa , Fitzhenry Robert , Sunkara Rajmohan , Gutelius Bruce , Alderman Ashley , Dickinson Michelle C , McGibbon Emily , Thompson Corinne N , Madison-Antenucci Susan
Published: November 2024

Entamoeba histolytica is considered the primary species causing the parasitic gastrointestinal infection amebiasis. A cluster of amebiasis infections was identified in 2018 among men who have sex with men in New York City and was likely caused by Entamoeba dispar, traditionally considered to be nonpathogenic.
A Road Map to Hepatitis C Elimination: Yesterday, Today, and Tomorrow
Authors: Gonzalez Corro Luis A , Lucas Gregory M , Page Kathleen R
Published: November 2024

There are an estimated 3.5 million people with hepatitis C virus (HCV) infection in the United States, resulting in 15 000 HCV-related deaths in 2019 and approximately $7 billion annually in healthcare costs. Although the United States had experienced declining incidence, since 2010 hepatitis C infections have rebounded. The history of HCV treatment can be seen as a series of scientific triumphs that should be celebrated as the accomplishments that they represent. But new treatments will only get us so far: Social determinants of health drive the majority of health outcomes. Without addressing the factors that impact the lives of our patients, we will fall short in the outcomes we seek. Public health systems, hospital networks, and governments must work more cohesively to eradicate hepatitis C. We have the tools, both biomedical and social. The end of hepatitis C depends on our willingness to make use of them.
Insights on Arc Magmatic Systems Drawn from Natural Melt Inclusions and Crystallization Experiments at P
H2O
= 800 MPa under Oxidizing Conditions
Authors: Andrys Janine L , Cottrell Elizabeth , Kelley Katherine A , Waters Laura E , Coombs Michelle L
Published: November 2024

Whole rock compositions at Buldir Volcano, western Aleutian arc, record a strong, continuous trend of iron depletion with decreasing MgO, classically interpreted as a calc-alkaline liquid line of descent. In contrast, olivine-hosted melt inclusions have higher total iron (FeO*) than whole rocks and show little change in FeO* with decreasing MgO. To investigate this discrepancy and determine the conditions required for strong iron depletion, we conducted oxygen fugacity (ƒO2) buffered, water-saturated crystallization experiments at 800 MPa and ƒO2 = QFM + 1.6 ± 0.4 (1$\sigma$) (where QFM refers to the quartz-fayalite-magnetite buffer) on a high-Al, basaltic starting material modeled after a Buldir lava. Experimental conditions were informed by olivine-hosted melt inclusions that record minimum entrapment pressures as high as 570 MPa, >6 wt % H2O, and ƒO2 of QFM + 1.4 (±0.2), making Buldir one of the most oxidized and wettest arc volcanoes documented globally. The experiments produce melts with Si-enrichment and Fe-depletion signatures characteristic of evolved, calc-alkaline magmas at the lowest MgO, although FeO* remains roughly constant over most of the experimental temperature range. Experiments saturate CrAl-spinel and olivine at 1160°C, followed by clinopyroxene and Al-spinel at 1085°C, hornblende at 1060°C, and, finally, plagioclase and magnetite between 1040°C and 960°C. Hornblende crystallization, not magnetite, generates the largest increase in SiO2 and largest decrease in FeO* in coexisting melts. Compositions of melt inclusions are consistent with experimental melts and reflect crystallization of a basaltic parent magma at high PH2O. In contrast, the whole rock compositional trends are influenced by magma mixing and phenocryst redistribution and accumulation. The crystallization experiments and natural liquids (melt inclusions and groundmass glass) from Buldir suggest that for an oxidized, hydrous primary basalt starting composition, significant Fe depletion from the melt will not occur until intermediate to late stages of magma crystallization (< ~4.5 wt % MgO). We conclude that the Buldir whole rock trend cannot be reproduced by crystallization at arc-relevant oxygen fugacities and is not a true liquid line of descent, warranting caution when interpreting volcanic trends globally.
Virulence effectors encoded in the rice yellow dwarf phytoplasma genome participate in pathogenesis
Authors: Zhang Shuai , Gan Peng , Xie Huiting , Li Chuan , Tang Tianxin , Hu Qiong , Zhu Zhihong , Zhang Zhongkai , Zhang Jisen , Zhu Yongsheng , Hu Qun , Hu Jie , Guan Hongxin , Zhao Shanshan , Wu Jianguo
Published: November 2024

Bacteria-like phytoplasmas alternate between plant and insect hosts, secreting proteins that disrupt host development. In this study, we sequenced the complete genome of “Candidatus Phytoplasma oryzae” strain HN2022, associated with rice yellow dwarf (RYD) disease, using PacBio HiFi technology. The strain was classified within the 16Sr XI-B subgroup. Through SignalP v5.0 for prediction and subsequent expression analysis of secreted proteins in Nicotiana benthamiana and rice (Oryza sativa L.), we identified the key virulence effector proteins RY348 and RY378. RY348, a homolog of Secreted Aster Yellows Phytoplasma Effector 54 (SAP54), targets and degrades the MADS-box transcription factors MADS1 and MADS15, causing pollen sterility. Meanwhile, RY378 impacts the strigolactone and auxin signaling pathways, substantially increasing tillering. These findings offer insights into the interactions between plants and phytoplasmas.
Rationale and concerns for using JAK inhibitors in axial spondyloarthritis
Authors: Ahmed Saad , Yesudian Rohan , Ubaide Hassan , Coates Laura C
Published: November 2024

Axial spondyloarthritis (axSpA) is a chronic illness with limited treatment options. The role of Janus kinase (JAK) inhibition as a therapeutic option has increasingly become a focus of research in recent years as they have brought a new mode of action to the clinical armamentarium. This review assesses the efficacy and safety profile of these drugs in axSpA. The current phase 2 and 3 clinical trials data are summarized across tofacitinib, upadacitinib and filgotinib. Moreover, the safety profiles of these drugs, in the context of emerging safety signals such as during the ORAL surveillance study, are reviewed. In summary, JAK inhibitors offer a novel therapeutic target for axSpA and appear to address some of the unmet needs for patients who have either failed to respond to current treatment options or in whom they are contraindicated. There is a relative lack of evidence in non-radiographic axSpA and longer-term trials are needed to establish true efficacy and safety profile in radiographic axSpA.
Capturing drought stress signals: the potential of dendrometers for monitoring tree water status
Authors: Ziegler Yanick , Grote Rüdiger , Alongi Franklin , Knüver Timo , Ruehr Nadine K
Published: November 2024

The severity of droughts is expected to increase with climate change, leading to more frequent tree mortality and a decline in forest ecosystem services. Consequently, there is an urgent need for monitoring networks to provide early warnings of drought impacts on forests. Dendrometers capturing stem diameter variations may offer a simple and relatively low-cost opportunity. However, the links between stem shrinkage, a direct expression of tree water deficit (TWD), and hydraulic stress are not well understood thus far. In this study, we exposed two widespread conifers Pinus sylvestris L. and Larix decidua Mill. to lethal dehydration by withholding water and closely monitored TWD, midday water potential ($\psi $) and midday stomatal conductance (${\textit g}_{\textit s}$) under controlled greenhouse conditions. We found strong relationships between the three variables throughout the dehydration process, particularly suggesting the potential for continuous $\psi $ predictions and stomatal closure assessments. However, the relationships decoupled during recovery from severe drought. We also identified TWD thresholds that signal the onset of drought stress and tissue damage, providing insights into stress impacts and recovery potential. While these findings are promising, challenges remain in practically transferring them to field set-ups by suitable TWD normalization. Importantly, we observed that midday ${\textit g}_{\textit s}$ was drastically reduced when TWD persisted overnight, providing a directly applicable drought stress signal that does not require normalization. In conclusion, while challenges remain, our results highlight the potential of dendrometers for monitoring tree water dynamics. Implementing dendrometer networks could support the development of early warning metrics for drought impacts, enabling large-scale monitoring in diverse settings, such as urban areas and forest ecosystems.
Breech Presentation: Delivery Management and Future Perspectives
Authors: Fiorentini Marta , Nedu Bianca , Dapoto Fabrizio , Brognoli Silvia , Brunelli Elena , Youssef Aly
Published: November 2024

Breech presentation is a relatively common fetal malposition, affecting 3% to 5% of fetuses at term. Although various clinical conditions are associated with breech presentation, its prevalence decreases as gestational age progresses toward term. Despite ongoing global academic and clinical debates on the management of breech presentation, there is a growing recognition that the decision on the mode of delivery should consider the patient’s preferences. Adequate counseling on available options is crucial. For patients with a term singleton fetus in a breech position who prefer a planned vaginal delivery, the external cephalic version (ECV) serves as an alternative to planned cesarean section (CS). ECV involves gently manipulating the fetus on the mother’s abdomen to achieve a cephalic presentation, with a reported success rate of 58%. The procedure is typically performed at or after 37 weeks, and a thorough assessment of fetal well-being is mandatory. While short-term benefits of planned CS for term breech presentation have been demonstrated in neonatal and maternal outcomes, a trial of breech vaginal delivery can be considered in the absence of contraindications and based on the patient’s preference. It is crucial for an experienced healthcare provider to offer appropriate assistance to ensure maternal and child well-being and minimize complications, whether attempting a vaginal birth or opting for a CS for breech presentation. Ultrasonography plays a crucial role in diagnosing breech presentation, and transabdominal ultrasound can offer valuable information for predicting ECV success, including placental location and amniotic fluid quantity. Emerging techniques in ultrasonography, such as transperineal ultrasound to assess fetal presenting part engagement and transabdominal ultrasound to evaluate fetal head flexion and position, are increasingly employed in labor ward evaluations. The recently introduced breech progression angle, a transperineal sonographic parameter, holds promise as a reliable tool not only for predicting ECV success but also for assessing the risk of cesarean delivery in patients who will undergo a trial of breech vaginal delivery.
Acupuncture-induced gene co-expression networks in postmenopausal women with osteoarthritis and osteoporosis: in-silico analysis
Authors: García-Espinosa Michell E. , Limias-Quezada Paul , Ortega-Meléndez Alejandra I. , Ballinas-Verdugo Martha A. , López-Gómez Rosa E. , López-Espinosa Emma , Jiménez-Ortega Rogelio F.
Published: November 2024

Objective:

Bone is a tissue that is constantly remodeled to adjust the microarchitecture and maintain the mechanical needs of bone through the balance of bone resorption and formation processes. Alterations in these processes can lead to the development of different diseases, such as osteoarthritis and osteoporosis. In recent years, it has been shown that acupuncture is an effective treatment for pain, physical dysfunctions, and the immune system, so the stimulation of acupuncture points could affect genes associated with inflammatory processes and, therefore, osteoarthritis and osteoporosis. To analyze changes in gene expression post-acupuncture in data from a group of individuals with osteoarthritis that also manifests in osteoporosis.

Methods:

Through using microarray technology and bioinformatics analysis, potential genes associated with osteoarthritis after acupuncture treatment are identified and compared with genes implicated in osteoporosis. The genes identified in each disease were evaluated through a Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway analysis, where the results allowed the generation of an in-silico model that shows interaction networks between signaling pathways and genes involved in both diseases.

Results:

In this interaction, 37 differentially expressed genes were identified in patients with osteoarthritis before and after acupuncture treatment, and 665 differentially expressed genes were involved in osteoporosis. In the osteoarthritis group, 15 signaling pathways involved in this disease were obtained, and for osteoporosis, 13 signaling pathways associated with immunological processes that participate in bone metabolism were obtained osteoarthritis and osteoporosis are two age-associated diseases that are characterized by alterations in the bone remodeling mechanism induced by changes in gene expression profiles.

Conclusions:

Treatment with acupuncture can modify various cytokines involved in diseases related to the immune system so that it can have beneficial effects on osteoarthritis and osteoporosis. In addition, bioinformatics analysis allows us to know those signaling pathways through which they could have acupuncture effects.
Priming immunity via herbal components and their nanomedicines for the treatment of cancer
Authors: Li Xiang , Gong Chenkai , Naeem Abid , Liu Jing , Yang Ming , Zhang Jing , Shang Hongming
Published: November 2024

Recently, immunotherapy has redefined cancer treatment by promoting the rapid killing of tumor cells through the immune system. Herbal medicines have been increasingly used as adjunct therapies to complement cancer treatment along with chemotherapy and radiotherapy to delay tumor development, reduce pain, and prolong patient survival. However, the potential immunotherapeutic effects of these herbal derivatives are limited by their structural instability, poor membrane permeability, and low bioavailability. To address this issue, nanotechnology has been used to enhance the activity of active compounds. Therefore, this review focuses on the effectiveness of the active ingredients of herbal medicines in suppressing tumor progression by modulating both the innate and adaptive immune systems, challenges in their delivery, and the application of nanocarriers for the effective delivery of these herbal components.
A Novel Anthropometric Phantom for Rapid Radiological Triage: A Quick Sort Triage Solution
Authors: Datz Hanan , Aviv Ofer , Spitz Henry
Published: November 2024

Rapidly identifying individuals who have received internal radiation exposure above action guidelines is crucial for mitigating health risks and addressing public concerns immediately following a radiological event involving the dispersal of radioactive materials. This study describes a novel triage method using a conventional Geiger-Mueller (GM) detector to select those individuals from the large group of persons who may have received an intake of radioactive material at levels corresponding to one Clinical Decision Guide (CDG). The triage method involves placing a portable GM detector against the lower anterior torso of a sitting person as they bend over to surround the detector with their body. The response of the GM detector is evaluated using a new, specially designed anthropometric phantom that simulates combined tissues of the lower thorax and gastrointestinal (GI) tract and is fabricated with a tissue substitute material that matches the overall radiological properties of human tissue present in this body region. The phantom has four separate layers of tissue substitute material with ports to accommodate a single GM detector at the center and one or more sealed radioactive sources that can be arranged to characterize the detector response for a variety of source distributions, including a “hot spot.” In this study, the response of a Ludlum Model 133-4 GM detector was evaluated using sealed sources of 232Th and 137Cs to determine the measurement efficiency for a quantity of activity present in the abdomen within a few hours post-intake equivalent to 1 CDG. Results demonstrate that the Quick Sort triage procedure using a single GM detector placed against the abdomen of a person can reliably detect internal deposition resulting from an intake equivalent to 1 CDG for 232Th or a significantly lower activity of 137Cs within a few hours following a radiological incident. The evaluation was performed over a wide range of photon energies, so the Quick Sort triage procedure is expected to be suitable for most fission products distributed uniformly within the abdomen or as a single “hot spot.”
Corneal Higher-Order Aberrations and Visual Acuity After Anterior Lamellar Keratoplasty in Treating Limbal Dermoid
Authors: Hashi Shiori , Kasamatsu Hirotsugu , Ogiwara Yurina , Takanori Suzuki  , Matsumae Hiroshi , Yagi-Yaguchi Yukari , Daisuke Tomida  , Shimazaki Jun , Yamaguchi Takefumi
Published: November 2024

Purpose:

To evaluate the corneal higher-order aberrations (HOAs) in eyes with limbal dermoids before and after excision and anterior lamellar keratoplasty (ALK) and its impact on visual acuity.

Methods:

This retrospective consecutive study included 39 eyes of 39 patients with limbal dermoid who underwent ALK. Higher-order aberrations were measured using anterior segment optical coherence tomography. The correlation between HOAs and visual acuity was investigated.

Results:

The mean logarithm of the minimum angle of resolution significantly improved from 0.21±0.41 to 0.12±0.34 after ALK (P=0.038). The HOAs of the total cornea within a 4-mm diameter significantly decreased from 2.66±5.51 μm to 1.09±1.48 after ALK (P=0.006). Logarithm of the minimum angle of resolution was significantly correlated with corneal HOAs (r=0.610, P<0.001 before ALK, r=0.518, P=0.008 after ALK), preoperative corneal astigmatism (r = −0.336, P=0.036), and dermoid diameter (r=0.467, P=0.004) but not with postoperative corneal astigmatism (r=0.017, P=0.934).

Conclusions:

Corneal HOAs and dermoid diameter were associated with decreased visual acuity in limbal dermoid. Excision of limbal dermoids and ALK significantly reduced corneal HOA and improved visual acuity.
Severe Corneal Flattening After Endothelial Keratoplasty: Collagen Compaction Syndrome
Authors: Moloney Gregory , Al-Zanki Sara , Burgos-Blasco Barbara , Fadaifard Martinez Mariam , Bujak Matthew , Dhaliwal Deepinder K.
Published: November 2024

Purpose:

The purpose of this study was to present a case series of patients with extreme corneal flattening after uneventful endothelial keratoplasty (EK): collagen compaction syndrome.

Methods:

Four patients (2 men, 2 women, mean age 64.8 ± 11.8 years) underwent successful EK after a period of chronic corneal edema (4–7.5 months): 3 received Descemet membrane endothelial keratoplasty after unsuccessful Descemet stripping only for Fuchs dystrophy and 1 received Descemet automated endothelial keratoplasty after prolonged pseudophakic bullous keratopathy.

Results:

All patients developed significant corneal flattening, affecting their vision and inducing a large hyperopic refractive outcome, best-corrected visual acuities ranging from 20/40 to 20/200.

Conclusions:

Chronic corneal edema may result in severe corneal flattening after EK. Preoperative duration of stromal edema might affect the outcome of EK and should, therefore, be considered in the timing of surgery. In cases of dense focal edema, including post-Descemet stripping only surgery, rescue treatment at week 8 should be considered.
Management of portal vein thrombosis in liver transplant candidates
Authors: Turon Fanny , Shalaby Sarah , García-Pagán Juan Carlos , Hernández-Gea Virginia
Published: November 2024

Portal vein thrombosis (PVT) is a frequent event among patients with advanced liver disease, with a prevalence reaching up to 26% in those awaiting liver transplantation (LT). Extensive thrombosis affecting the mesenteric vein confluence correlates with increased morbidity and mortality post-LT, particularly when it impedes physiological anastomosis or contraindicates the LT. Current guidelines advocate for routine PVT screening in all potential liver transplant candidates and prompt treatment upon detection. The main objective in LT candidates is to facilitate physiological portal-to-portal anastomosis. Anticoagulation serves as the first-line therapy, achieving recanalization rates between 33 and 75%. Discontinuation of anticoagulation significantly heightens the risk of rethrombosis in a substantial proportion of patients and therefore, it is recommended to continue anticoagulation until LT for those awaiting LT or potential LT candidates. Nevertheless, 30-60% of patients fail to respond to anticoagulation, with PVT progression occurring in up to 14% despite anticoagulation. In such cases, TIPS placement emerges as a viable alternative to maintain portal vein patency. While the feasibility of TIPS placement diminished with the presence of portal cavernoma or chronic portal vein thrombosis, the introduction of novel interventional radiological techniques to recanalize the portal venous axis through transplenic, transmesenteric and/or transhepatic routes is revolutionizing this landscape. These advancements achieve TIPS placement and recanalization in 90-100% of patients, warranting consideration in cirrhotic patients with chronic PVT for whom LT would otherwise be contraindicated or when physiological anastomosis is not feasible.
Prognosis and ablation success in thyroid cancer: overcoming the challenges of incomplete clinical profiles
Authors: Ora Manish , Nazar Aftab Hasan , Mishra Prabhakar , Barai Sukanta , Arya Amitabh , Pradhan Prasanta Kumar , Gambhir Sanjay
Published: November 2024

Background

Differentiated thyroid carcinoma (DTC) is managed by surgery followed by radioiodine (RAI) therapy in most intermediate and high-risk patients. Most nonmetastatic patients have excellent treatment responses and have long-term disease-free status. A lack of comprehensive medical services in resource-limited nation leads to attrition of critical clinical prognostication information. This study aimed to identify readily available clinical, biochemical, and histopathological parameters to predict remnant ablation success and long-term outcomes.

Methods

The study included DTC patients who underwent RAI after surgery. Ablation success was determined by thyroglobulin (Tg) and whole-body radioiodine scan. Patients were followed for at least 5 years to assess biochemical incomplete response (BIR) and structural recurrence.

Results

The study included 383 patients (a mean age of 37.8 ± 12.9 years). Successful ablation was noted in 251 (65.5%). High preablative stimulated serum Tg (presTg), papillary variants, and central and lateral compartment lymph nodal metastases were associated with ablation failure. PresTg (P < 0.001) was the most significant predictor. After a 102.9 ± 34.5 months follow-up, 280 (73.1%) patients were disease-free. BIR and structural recurrence were noted in 103 and 32 patients. PresTg (8.1 ± 27.7 vs. 92.3 ± 99.9 ng/ml), ATg (112.9 ± 389.8 vs. 43.2 ± 89.8 IU/ml), papillary variant, central [109 (66.1%) vs. 56 (33.9%)], and lateral compartment [65 (63.7%) vs. 37 (36.3%) lymph nodal metastases were associated (P < 0.05) with BIR. PresTg >10.5 has a sensitivity and specificity of 86.6 and 86.0% for predicting BIR. Patients with successful remnant ablation and a presTg level <10.5 ng/ml had a low risk of long-term disease recurrence (less than 5%).

Conclusion

This ambispective study found that successful ablation and long-term disease-free survival were achievable in a significant proportion of DTC patients. BIR (26.9%) and structural recurrence (8.4%) were not uncommon. PresTg levels emerged as a crucial predictor of ablation success and subsequent outcomes. In resource-limited regions, presTg levels and ablation failure can aid in optimizing treatment strategies and improving patient care.
Exploring the potential role of financial interventions to improve the health of families impacted by incarceration
Authors: Tolliver Destiny G. , Howell Benjamin , Blanton Sarah , Wang Emily A.
Published: November 2024

Purpose of review

To summarize the impact of financial hardship on children whose parents have been incarcerated, describe both existing cash transfer and guaranteed income programs, and highlight their impact on child and family well being.

Recent findings

Emerging data on guaranteed income programs for formerly incarcerated adults indicates that the funds improve recipient health and legal system outcomes and allow participants to spend funds on stabilizing themselves and their families. Guaranteed income programs in the broader population similarly highlight the use of funds to support families’ basic needs and improved parent-child relationships, but more data are needed to understand the impact on child health and well being among families impacted by the criminal legal system.

Over 5 million children experience parental incarceration, which directly contributes to financial hardship and subsequent negative health outcomes. Cash transfers may assist these families, but policies and administrative burdens limit the ability of existing programs to fully address financial hardship. Guaranteed income programs may therefore serve a unique role in supporting the financial needs of families impacted by incarceration. More longitudinal data focusing on child health outcomes are necessary to fully understand the impact of guaranteed income of children and families impacted by parental incarceration.
Timing and risk factors of complications following total knee arthroplasty
Authors: Aljuhani Wazzan S. , Aljaian Amer R. , Alyahya Yahya K. , Alanazi Abdulmalik M. , Aljaafri Ziad A. , Alanazi Abdullah M.
Published: November 2024

Introduction:

Total knee arthroplasty (TKA) is a common surgical procedure for end-stage arthritis; however, the precise timing of postoperative complications remains uncertain. This study aimed to estimate complication rates, timing, and risk factors associated with TKA.

Methods:

Data from 846 patients with TKA treated at a single tertiary center, were scrutinized. Complications were categorized based on timing, whereas risk factors were assessed through logistic regression.

Results:

Most patients were aged >60 years (76.2%) and obese (78.4%). Urinary tract infection (UTI) was the most common complication (2.7%). Fever and hypernatremia each affected 1.8% of patients, whereas acute kidney injury (AKI) occurred in 1.4% of cases. Major complications typically arose within the first 4 days after surgery, with delirium, fever, and hyponatremia appearing earliest (median 2.0 days). Late complications included deep vein thrombosis (median 13.5 days) and surgical site infections (median 11.5 days). Risk factors included age ≥60 for UTI (odds ratio [OR]=9.09) and longer surgery duration for AKI (OR=1.01).

Conclusions:

This study offers crucial insights into the risk factors and timing of complications after TKA. By identifying the risk factors and timing of post-TKA complications, clinicians can better tailor interventions, and improve patient care. Further research is needed to refine risk prediction models and optimize therapeutic strategies.
Distal femur osteosarcoma in a seven-year-old: a case report on acute symptom presentation
Authors: Shalalfa Neveen , Wajeeh Saleh , Sheeb Zaina , Nawaja Omama , Abuarqoub Fatima , Abufara Jameel , Shalalfa Shatha
Published: November 2024

Introduction and importance:

Osteosarcoma is an exceptionally serious, uncommon disease in children with morbidity, mortality, and psychological burdens.

Case presentation:

In this report, the authors present the case of a previously healthy 7-year-old girl who exhibited continuous, painful limping. Plain imaging and a MRI scan revealed the presence of a lytic lesion in the femur on the left side. The diagnosis of osteosarcoma was confirmed. There was no significant familial history of cancer. The girl and her family underwent the operation and chemotherapy, received follow-up and support for a year, and both the patient and the medical team expressed a lot of satisfaction.

Clinical discussion:

The survival and prognosis from osteosarcoma in the literature was 59% for all patients at a median follow-up up 54 months, current treatment of osteosarcoma involves chemotherapy and limb surgery, with (60–80)% of patients in remission after 5 years.

Conclusion:

This case emphasizes the importance of promptly considering osteosarcoma in a child when the clinical presentation and medical imaging align with the diagnosis.