bluuebunny/crossref_metadata_2025 huggingface dataset:
Charge Relay Without Proton Transfer: Coupling of Two Short Hydrogen Bonds via Imidazole in Models of Catalytic Triad of Serine Protease Active Site
Authors: Tupikina Elena Yu. , Sigalov Mark V. , Alkhuder Omar , Tolstoy Peter M.
Published: April 2024

A homologous series of 20 substituted alcohol‐imidazole‐acetate model complexes imitating the charge relay system in Ser‐His‐Asp catalytic triad of serine proteases is considered quantum‐chemically. We show qualitatively that the geometries of alcohol‐imidazole and imidazole‐acetate short hydrogen bonds are strongly coupled via the central imidazole and such complexes are capable of effectively relaying the charge from acetate to alcohol moiety upon relatively small concerted proton displacements. We hypothesize an alternative catalytic mechanism of serine proteases that does not require two complete proton transfers or hydrogen bond breakage between Ser and His residues.
Tracing Digital Therapeutics Research Across Medical Specialties: Evidence from ClinicalTrials.gov
Authors: Masanneck Lars , Stern Ariel D.
Published: April 2024

Digital therapeutics (DTx), evidence‐based software interventions for preventing, managing, or treating medical disorders, have rapidly evolved with healthcare's shift toward online, patient‐centric solutions. This study scrutinizes DTx clinical trials from 2005 to 2022, analyzing their growth, funding, underlying medical specialties, and other R&D characteristics, using ClinicalTrials.gov data. Our analysis includes trials categorized via the ICD‐11 system, covering active, recruiting, or completed studies and considering trials listing multiple conditions. In analyzing 5,889 registered DTx trials, we document a more than five‐fold increase in such trials since 2011, and a compound annual growth rate of 22.82% since 2005. While most trials were single‐center, the median number of study subjects increased in recent years, driven by larger interventional trials. The key disciplines driving this growth were psychiatry, neurology, oncology, and endocrinology. Mental health dominated DTx trials in recent years, led by neurocognitive disorders, substance abuse disorders, and mood disorders. Industry funding varied across disciplines and was particularly high in visual system diseases and dermatology. DTx trials have surged since 2005, accelerated by recent growth in mental health trials. These trends mirror developments toward remote healthcare delivery, amplified by digital health investments during the COVID‐19 pandemic. Growing numbers of participants in DTx trials point to increased demand for more robust trials. However, because most trials are single‐center and country‐specific, more international cooperation and harmonized evaluation standards will be essential for DTx trials to become more efficient and provide validation across countries, health systems, and groups of individuals.
On the realization of an amplifier‐tuned low/high frequency family of oscillators
Authors: Elwakil A. S. , Maundy B. J. , Psychalinos C.
Published: April 2024

We propose a family of equal‐R equal‐C dual amplifier oscillators with gain‐tunable start‐up condition and oscillation frequency. In particular, while one of the amplifiers can be used to satisfy the oscillator start‐up condition, the second amplifier can be used to tune the oscillation frequency. In this regard, it is observed that the oscillation frequency can be made very low or very high independent of the RC time constant of the circuit by properly choosing the amplifier gain and the circuit topology. In one possible topology, the oscillation frequency is directly proportional to the tuning amplifier gain, while in a second topology, it is inversely proportional to this gain. Both topologies generate two outputs which also have a gain‐tunable leading or lagging phase shift. Circuit simulations and experimental results are presented to verify the theory in addition to a non‐conventional application in chaos generation.
Effects of resource availability and interspecific interactions on Arctic and red foxes' winter use of ungulate carrion in the Fennoscandian low‐Arctic tundra
Authors: Lacombe Simon , Ims Rolf , Yoccoz Nigel , Kleiven Eivind Flittie , Nicolau Pedro G. , Ehrich Dorothee
Published: April 2024

In the Arctic tundra, predators face recurrent periods of food scarcity and often turn to ungulate carcasses as an alternative food source. As important and localized resource patches, carrion promotes co‐occurrence of different individuals, and its use by predators is likely to be affected by interspecific competition. We studied how interspecific competition and resource availability impact winter use of carrion by Arctic and red foxes in low Arctic Fennoscandia. We predicted that the presence of red foxes limits Arctic foxes' use of carrion, and that competition depends on the availability of other resources. We monitored Arctic and red fox presence at supp lied carrion using camera traps. From 2006 to 2021, between 16 and 20 cameras were active for 2 months in late winter (288 camera‐winters). Using a multi‐species dynamic occupancy model at a week‐to‐week scale, we evaluated the use of carrion by foxes while accounting for the presence of competitors, rodent availability, and supplemental feeding provided to Arctic foxes. Competition affected carrion use by increasing both species' probability to leave occupied carcasses between consecutive weeks. This increase was similar for the two species, suggesting symmetrical avoidance. Increased rodent abundance was associated with a higher probability of colonizing carrion sites for both species. For Arctic foxes, however, this increase was only observed at carcasses unoccupied by red foxes, showing greater avoidance when alternative preys are available. Supplementary feeding increased Arctic foxes' carrion use, regardless of red fox presence. Contrary to expectations, we did not find strong signs of asymmetric competition for carrion in winter, which suggests that interactions for resources at a short time scale are not necessarily aligned with interactions at the scale of the population. In addition, we found that competition for carcasses depends on the availability of other resources, suggesting that interactions between predators depend on the ecological context.
The effects of dune plant roots on loggerhead turtle (Caretta caretta) nest success
Authors: Redding Olivia T. , Castorani Max C. N. , Lasala Jake
Published: April 2024

Sand dunes are supported by the extensive root systems of dune plants that anchor the dune and protect it from erosion. While all plants that grow on the dunes support their structure, invasive plants can outcompete the native and non‐native dune plants for resources such as nutrients, sunlight, and space to grow. During the summer, sea turtles lay nests on beaches and near dunes; however, their eggs and hatchlings are at risk of destruction and entrapment by dune plant root penetration. Dune plant roots can penetrate sea turtle nest cavities, thus decreasing hatch success of the eggs and emergence success of the hatchlings. We aimed to determine how plant roots impact threatened loggerhead sea turtle (Caretta caretta) nests on Casey Key, Sarasota County, Florida, USA and to assess the factors affecting plant root invasion. Specifically, we determined the effect of plant roots on loggerhead sea turtle nest success, the extent of the impact of invasive plants over non‐invasive plants on nests, and if the distance from the dune (barrier) affects whether roots will penetrate the nest. From July to August 2022, we excavated 93 nests to determine the extent of root penetration and identify associated plant species. This field campaign was supported by a long‐term dataset (1987–2022) on loggerhead sea turtle nesting across the region. We found that root presence decreased hatch success by 21% and emergence success by 18%, compared to nests that lacked roots within the nest chamber. Nests closer to the dune were more likely to have a higher proportion of root damage and lower hatch and emergence success. This study helps advance understanding of how native and non‐native plants affect sea turtle reproductive success and helps inform coastal management aimed at conserving threatened loggerhead populations.
A new threshold selection method for species distribution models with presence‐only data: Extracting the mutation point of the P/E curve by threshold regression
Authors: Yu Boyang , Dai Wenyu , Li Siqing , Wu Zhaoning , Wang Jiechen
Published: April 2024

Selecting thresholds to convert continuous predictions of species distribution models proves critical for many real‐world applications and model assessments. Prevalent threshold selection methods for presence‐only data require unproven pseudo‐absence data or subjective researchers' decisions. This study proposes a new method, Boyce‐Threshold Quantile Regression (BTQR), to determine thresholds objectively without pseudo‐absence data. We summarize that the mutation point is a typical shape feature of the predicted‐to‐expected (P/E) curve after reviewing relevant articles. Analysis based on source‐sink theory suggests that this mutation point may represent a transition in habitat types and serve as an appropriate threshold. Threshold regression is introduced to accurately locate the mutation point. To validate the effectiveness of BTQR, we used four virtual species of varying prevalence and a real species with reliable distribution data. Six different species distribution models were employed to generate continuous suitability predictions. BTQR and nine other traditional methods transformed these continuous outputs into binary results. Comparative experiments show that BTQR has advantages in terms of accuracy, applicability, and consistency over the existing methods.
Changes and driving factors of microbial community composition and functional groups during the decomposition of Pinus massoniana deadwood
Authors: Shi Bingyang , Wang Xiurong , Yang Shuoyuan , Chen Hongmei , Zhao Yang , Shen Junjie , Xie Meixuan , Huang Bufang
Published: April 2024

Clarifying changes in the microbial community in deadwood at different stages of decomposition is crucial for comprehending the role of deadwood in the biogeochemical processes and the sustainability of forest development. However, there have been no reports on the dynamics of microbial community during the decomposition of Pinus massoniana. We used the “space‐for‐time” substitution to analyze the characteristics of microbial community changes and the key influencing factors in the P. massoniana deadwood during different decomposition stages by 16S and ITS rRNA gene sequencing. The results suggest that the microbial community structure of the early decomposition (decay class I) was significantly different from the other decay classes, while the diversity and richness of the microbial community were the highest in the late decomposition (decay class V). The Linear Discriminant Analysis Effect Size analysis revealed that most bacterial and fungal taxa were significantly enriched in decay classes I and V deadwood. During the initial stages of decomposition, the relative abundance of the bacterial functional group responsible for carbohydrate metabolism was greater than the later stages. As decomposition progressed, the relative abundance of saprophytic fungi gradually decreased, and there was a shift in the comparative abundance of mixed saprophytic‐symbiotic fungi from low to high before eventually decreasing. Total organic carbon, total nitrogen, carbon‐to‐nitrogen ratio, total potassium, total phenol, condensed tannin, lignin, and cellulose were significantly correlated with microbial community structure, with the carbon‐to‐nitrogen ratio having the greatest effect. Our results indicate that the physicochemical properties of deadwood, microbial community structural composition and functional group changes were related to the decay class, among which the carbon‐to‐nitrogen ratio may be an important factor affecting the composition and diversity of microbial communities.
Visuomotor coordination with gaze, head and arm movements during table tennis forehand rallies
Authors: Shinkai Ryosuke , Ando Shintaro , Nonaka Yuki , Kizuka Tomohiro , Ono Seiji
Published: April 2024

The purpose of this study was to clarify the temporal coordination between gaze, head, and arm movements during forehand rallies in table tennis. Collegiate male table tennis players (n = 7) conducted forehand rallies at a constant tempo (100, 120, and 150 bpm) using a metronome. In each tempo condition, participants performed 30 strokes (a total of 90 strokes). Gaze, head, and dominant arm (shoulder, elbow, and wrist) movements were recorded with an eye‐tracking device equipped with a Gyro sensor and a 3‐D motion capture system. The results showed that the effect of head movements relative to gaze movements was significantly higher than that of eye movements in the three tempo conditions. Our results indicate that head movements are closely associated with gaze movements during rallies. Furthermore, cross‐correlation coefficients (CCs) between head and arm movements were more than 0.96 (maximum coefficient: 0.99). In addition, head and arm movements were synchronized during rallies. Finally, CCs between gaze and arm movements were more than 0.74 (maximum coefficient: 0.99), indicating that gaze movements are temporally coordinated with arm movements. Taken together, head movements could play important roles not only in gaze tracking but also in the temporal coordination with arm movements during table tennis forehand rallies.
Landscape evolution and sediment delivery in a High Arctic proglacial lake, Ellesmere Island, Canadian Arctic Archipelago
Authors: Chassiot Léo , Lajeunesse Patrick , Francus Pierre , Normandeau Alexandre , Lapointe François , Massa Charly , De Coninck Arnaud
Published: April 2024

Geophysical and morphosedimentary investigations were conducted at Strathcona Lake, a High Arctic proglacial lake and its catchment connected to the Taggart Lake Glacier, northwest corner of the Prince of Wales Icefield in Ellesmere Island (eastern Canadian Arctic Archipelago). The mapping of glaciomarine landforms and units provides, together with updated radiocarbon information, a framework for catchment evolution and sediment delivery to the lake during deglaciation and glacio‐isostatically induced relative sea level fall. A staircase of deltas with descending altitudes provide evidence for a spatially diachronous timing of ice retreat from the catchments around Strathcona Lake. Swath bathymetric mapping coupled with acoustic sediment stratigraphy show draped infills with a transition from marine to rhythmically bedded lacustrine sediments produced by hyperpycnal flows. Multiproxy investigations on a set of sediment cores highlight proglacial varves interrupted by rhythmites resulting from the erosion of fluvially incised glaciomarine sediments stored in the catchment. Pluricentimetric proglacial varves formed during the last century in response to periods of intense glacial melt, notably since the 21st century. The sedimentary record suggests the varved sediments from Strathcona Lake can be used to reconstruct the melting history of the Prince of Wales Icefield. This work provides a geomorphological, sedimentological, and geochemical framework that should guide future varve‐based reconstructions of glacial and climatic variability in Ellesmere Island.
Spatial variability of soil physicochemical properties under different land uses impacted by erosion on karst hillslopes in Southwest China
Authors: Chen Lei , Zhang Keli , Li Yetong
Published: April 2024

Karst hillslopes are generally characterized by different land uses. Land use and slope position impact soil erosion seriously, which in turn impacts the process of soil development and the patterns of soil properties. However, the impact of land use on soil physicochemical properties and the spatial variations and correlations between them are not fully understood on karst hillslopes. Therefore, nine sites had similar soil types, slope gradients, elevations, slope aspects and previous tillage practices were selected to conduct further research. This study was conducted to quantify the spatial distribution, variability and correlation of soil physical and chemical properties and stoichiometries as impacted by different land uses on a karst hillslope in Southwest China. Soil physical properties were significantly affected by slope position and soil depth. The soil bulk density and clay content increased with soil depth, while the opposite was true for the sand content. For the three land uses, the soil bulk density varied the most at the lower slope position, while clay and sand particles varied the most at the middle slope position. The mean spatial coefficient of variation (CV) of soil physical properties was ranked as sand (11.08%) > clay (7.77%) > bulk density (6.85%) > silt (3.81%). The mean spatial CV of soil chemical properties was ranked as available K (44.49%) > total P (16.77%) > total C (16.31%) > total N (13.09%) > available P (8.45%) > total K (7.51%). Overall, soil physicochemical properties exhibited significant spatial differences with slope location and land use on karst hillslopes. Soil chemical properties had greater spatial variation than physical properties, moreover, there were significant correlations between them. The results not only contribute to a deeper understanding of the impact of land use on the erosion process and mechanism on karst hillslopes but also provide a scientific understanding of the sustainable restoration of karst ecosystems.
Association of socioeconomic status and poststroke cognitive function: A systematic review and meta‐analysis
Authors: Tian Jingyuan , Wang Qiuyi , Guo Shuang , Zhao Xiaoqing
Published: April 2024

Background

Stroke survivors are at high risk of coping with cognitive problems after stroke. In recent decades, the relationship between socioeconomic status (SES) and health‐related outcomes has been a topic of considerable interest. Learning more about the potential impact of SES on poststroke cognitive dysfunction is of great importance.

Objective

The purpose of this systematic review and meta‐analysis was to summarize the association between SES and poststroke cognitive function by quantifying the effect sizes of the existing studies.

Method

We searched studies from PubMed, Ovid, Embase, Cochrane, Scopus, and PsychINFO up to January 30th 2024 and the references of relevant reviews. Studies reporting the risk of poststroke cognitive dysfunction as assessed by categorized SES indicators were included. The Newcastle‐Ottawa scale and the Agency for Healthcare Research and Quality were used to evaluate the study quality. Meta‐analyses using fixed‐effect models or random‐effect models based on study heterogeneity were performed to estimate the influence of SES on cognitive function after stroke, followed by subgroup analyses stratified by study characteristics.

Results

Thirty‐four studies were eligible for this systematic review and meta‐analysis. Of which, 19 studies reported poststroke cognitive impairment (PSCI) as the outcome, 13 reported poststroke dementia (PSD), one reported both PSCI and PSD, and one reported vascular cognitive impairment no dementia. The findings showed that individuals with lower SES levels had a higher risk of combined poststroke cognitive dysfunction (odds ratio (OR) = 1.91, 95% confidence interval (CI) = 1.59–2.29), PSCI (OR = 2.09, 95% CI = 1.57–2.78), and PSD (OR = 1.95, 95% CI = 1.48–2.57). Subgroup analyses stratified by SES indicators demonstrated the protective effects of education and occupation against the diagnoses of combined poststroke cognitive dysfunction, PSCI, and PSD.

Conclusions

Stroke survivors belonging to a low SES are at high risk of poststroke cognitive dysfunction. Our findings add evidence for public health strategies to reduce the risk of poststroke cognitive dysfunction by reducing SES inequalities.
Comparison between natural rubber knee support and sponge knee support on the protection of knee joint: A crossover randomized controlled study among patients with bleeding disorders
Authors: Maneekhiew Supicha , Kovitwanawong Nalinee , Raweekul Sakrawee , Kijkunasathian Chusak , Panuwannakorn Monratta , Uampornvanich Parsiri , Chuansumrit Ampaiwan , Wongwerawattanakoon Pakawan , Sirachainan Nongnuch
Published: April 2024

Background and Aims

Knee support, frequently made from sponge, is used to reduce injury. Sponge has less elasticity and durability compared with natural rubber. To our knowledge, there was no study that demonstrated the effectiveness of natural rubber and sponge in prevention of injury in children with bleeding disorders. The study aimed to demonstrate the effectiveness and satisfaction of natural rubber knee support compared with sponge knee support among children with bleeding disorders.

Methods

The study consisted of three phases: (I) measuring reduced compression force, (II) producing size‐appropriate knee support prototypes, and (III) conducting a randomized crossover trial, including 8 weeks wearing natural rubber knee support and sponge knee support with a 4‐week wash‐out period. The number of knee bleeds and user satisfaction were recorded.

Results

A better compression force reduction in natural rubber (60%) than sponge (12%) was demonstrated. Knee support comprised a body part, made from natural‐stretchable cotton and a protection part, made from either natural rubber or sponge. They were produced in four sizes: S, M, L, and XL and appropriately applied to 42 patients (21 hemophilia, 21 platelet disorders) with a mean (SD) age of 7.0 (2.9) years. The results from randomization showed no significant difference in the number of knee bleeds between the two knee support groups (10 vs. 7, p = 0.37). In terms of satisfaction score, the natural rubber knee supports were more durable (45.2% vs. 23.8%, p = 0.04) and easier to use (28.5% vs. 14.3%, p = 0.03). In addition, a higher percentage of parents chose natural rubber knee support when compared with sponge knee supports (71.0% vs. 29.0%, p = 0.006).

Conclusion

Natural rubber knee support showed comparable effectiveness in the prevention of knee bleeding but was superior to sponge knee support in compression force reduction and satisfaction.
The mental health self‐direction scale: An abridged version and its sensitivity to change
Authors: de Haas Sam M. H. , Janse Pauline D. , Tiemens Bea G. , Hutschemaekers Giel J. M.
Published: April 2024

Objective

The Mental Health Self‐Direction Scale (MHSD) measures the extent to which clients are able to resolve mental problems by themselves. Because this scale had not yet been evaluated, the aims of this paper were (a) to evaluate and improve the MHSD and (b) to explore the sensitivity to change of the improved scale.

Method

The MHSD was evaluated and improved by means of confirmatory factor analyses of data from one longitudinal and two cross‐sectional outpatient sample. Inconsistent items were removed in a stepwise fashion. Subsequently, the scale's sensitivity to change was explored in the longitudinal sample by using latent growth curve models.

Results

The original 31‐item scale was reduced to a more stable version with 19 items that yielded four factors named: actorship, demoralization, commitment, and understanding. Throughout clients’ treatment, actorship and understanding tended to increase; demoralization tended to decrease; and commitment remained consistently high.

Conclusions

The abridged MHSD scale is stable and sensitive to change. It measures the extent to which clients experience and develop self‐direction throughout their treatment. With the use of the new MHSD scale, new views on mental health that emphasize clients’ ability to actively engage and cope with health‐challenges can be incorporated into clinical treatment.
Prenatal diagnosis of pulmonary arteriovenous malformations with a postnatal diagnosis of Osler–Weber–Rendu syndrome
Authors: Daglar Halil Korkut , Kaymak Didem , Ceylaner Serdar , Uysal Nihal Şahin , Sanhal Cem Yaşar
Published: April 2024

Hereditary Hemorrhagic Telangiectasia (HHT), commonly known as Osler–Weber–Rendu disease, is an autosomal dominant multisystemic vascular disease associated with approximately 70% of cases of pulmonary arteriovenous malformations (PAVMs). Prenatal cases of PAVMs typically present with pulmonary vein dilatation on ultrasonography. This study presents a prenatal diagnosis of PAVMs with enlarged right pulmonary vein, cardiomegaly, cystic‐appearing areas in the right lung and subsequent confirmation of Osler–Weber–Rendu syndrome using autopsy and whole exom sequencing.
Robotic‐assisted total knee arthroplasty is not associated with improved accuracy in implant position and alignment compared to conventional instrumentation in the execution of a preoperative digital plan
Authors: Nogalo Christian , Farinelli Luca , Meena Amit , di Maria Fabrizio , Abermann Elisabeth , Fink Christian
Published: April 2024

Purpose

The primary objective of the present study was to evaluate if robotic‐assisted total knee arthroplasty (RO‐TKA) results in improved accuracy compared to conventional TKA (CO‐TKA) with respect to alignment and component positioning executing a preoperative digital plan. The secondary objective was to compare patient‐reported outcome measures (PROMs) between the two groups at 6 months of follow‐up (FU).

Methods

Patients who underwent primary TKA using the concept of constitutional alignment were identified from the database. Each patient underwent preoperative digital planning as well as postoperative evaluation of the preoperative plan (alignment and component position) using mediCAD® software (Hectec GmbH). Two groups were formed: (i) The RO‐TKA group (n = 30) consisted of patients who underwent TKA with a robotic surgical system (ROSA®, Zimmer Biomet) and (ii) the CO‐TKA group (n = 67) consisted of patients who underwent TKA with conventional instrumentation. To assess accuracy, all qualitative variables were analysed using the χ2 test. Tegner activity scale, Oxford Knee Score and visual analogue scale were assessed preop and at 6‐month FU. To assess differences between the two groups, a 2 × 2 repeated measures analysis of variance was performed.

Results

There was no significant (p > 0.05) difference in the accuracy of alignment as well as tibial and femoral component position between the two groups. At the 6‐month FU, there was no significant (p > 0.05) difference in PROMs between the two groups.

Conclusion

While robotic TKA may have some potential advantages, no significant difference was found between robotic and conventional TKA with respect to limb alignment, clinical outcomes and component positioning.

Level of Evidence

Level III.
The book is just being written: The enduring journey of parents of children with emerging‐ ultrarare disorders
Authors: Stafford‐Smith Bethany , Sullivan Jennifer A. , McAllister Marion , Walley Nicole , Shashi Vandana , McConkie‐Rosell Allyn
Published: April 2024

Ultra rare disorders are being diagnosed at an unprecedented rate, due to genomic sequencing. These diagnoses are often a new gene association, for which little is known, and few share the diagnosis. For these diagnoses, we use the term emerging‐ultrarare disorder (E‐URD), defined as <100 diagnosed individuals. We contacted 20 parents of children diagnosed with an E‐URD through the Duke University Research Sequencing Clinic. Seventeen completed semi‐structured interviews exploring parental perspectives (7/17 had children in publications describing the phenotype; 4/17 had children in the first publication establishing a new disorder). Data were analyzed using a directed content approach informed by an empowerment framework. Parents reported a range of responses, including benefits of a diagnosis and challenges of facing the unknown, some described feeling lost and confused, while others expressed empowerment. Empowerment characteristics were hope for the future, positive emotions, engagement, and confidence/self‐efficacy to connect with similar others, partner with healthcare providers, and seek new knowledge. We identified a subset of parents who proactively engaged researchers, supported research and publications, and created patient advocacy and support organizations to connect with and bolster similarly diagnosed families. Other parents reported challenges of low social support, low tolerance for uncertainty, limited knowledge about their child's disorder, as well as difficulty partnering with HCPs and connecting to an E‐URD community. An overarching classification was developed to describe parental actions taken after an E‐URD diagnosis: adjusting, managing, and pioneering. These classifications may help genetic counselors identify and facilitate positive steps with parents of a child with an E‐URD.
Arsenic's shadowy influence: A systematic review of its carcinogenic role in gallbladder cancer
Authors: Elgenidy Anas , Odat Ramez M. , Al‐Ghorbany Horiah Amer , Shahin Hatim Nasruldin , Abdel‐bary Ibrahim S. , AbdulHamid Roaa AbdulTawab , Dhahab Amal , Salem Moustafa , Negm Youmna A. , El Attar Nada Mostafa , Abdelfattah Ahmed Assem , Khaliel Mai M. , Moawad Shehab M. , Afifi Ahmed M.
Published: April 2024

Introduction

Gallbladder carcinoma (GBC) and cholangiocarcinoma are aggressive forms of cancer developed in the gallbladder and biliary tracts which are related to the liver. This systematic review aimed to highlight the significant association between gallbladder, biliary cancers, and arsenic exposure.

Methods

An extensive search was conducted in Embase, Cochrane, Scopus, PubMed, and Web of Science. We included studies that assessed arsenic levels in gallbladder cancer patients, without restrictions on age, sex, or language. Biological samples, such blood, bile, gallbladder tissue, gallstones, and hair were obtained, and arsenic levels were measured. Also, arsenic water and soil concentrations were collected.

Results

A total of 13 studies were included in our review. These studies included 2234 non‐gallbladder carcinoma patients and 22 585 gallbladder carcinoma cases. The participant demographics showed a gender distribution of 862 males and 1845 females, with an age range of 20–75 years. The average body mass index (BMI) was 19.8 kg/m2 for nongallbladder carcinoma patients and 20.1 kg/m2 for gallbladder carcinoma cases. The selected studies examined arsenic concentrations across various biological samples, including blood, hair, gallstones, and bile. Blood arsenic levels ranged from 0.0002 to 0.3893 μg/g and were significantly associated with increased gallbladder carcinoma risk in several studies. Hair also demonstrated a significant correlation, with arsenic concentrations ranging from 0.0002 to 6.9801 μg/g.

Conclusion

There is a strong link between arsenic exposure and gallbladder cancer or cholangiocarcinoma. Even chronic exposure to low‐moderate amounts could lead to gallbladder carcinoma. These findings stress the need for more comprehensive and dedicated studies, to control arsenic water/soil levels and seek other preventive measures for this high mortality disease.
頭部外傷を契機に発症した，小児脳静脈洞血栓症2症例(Traumatic cerebral venous sinus thrombosis in pediatric patients: Report of two cases)
Authors: 有未 船登 , 憲太郎 小林 , 亮 佐々木 , 雅人 井上 , 昭夫 木村
Published: April 2024

小児の脳静脈洞血栓症（CVST）の発生率は年間0.67人/10万人と稀である。外傷は原因の一つだが広く認識されておらず，しばしば診断が遅れる。頭部外傷後にCVSTを発症した小児症例を2例経験したので報告する。症例1：6歳の女児。遊具から転落後，嘔吐があり受診。CTで後頭骨骨折を認め，経過観察入院した。翌日のCTで急性硬膜外血腫および右横行静脈洞に一致した高吸収域を認め，MRIで右横静脈洞の信号欠損を認めCVSTの診断となった。出血および水頭症の増悪に対して開頭血腫除去術を施行した。その後はMRIで血栓は吸収過程と考えられ，後遺症なく受傷17日目に退院となった。症例2：7歳の女児。遊具から転落後，嘔気が遷延し受傷翌日に受診。CTでは異常所見を認めず帰宅となった。受傷3日目も活気不良が継続し，再検したCTで右横静脈洞に一致して高吸収域がみられ，MRIで右横静脈洞に欠損を認めCVSTの診断となった。ヘパリン投与を開始し血栓の縮小を認め，症状も消失しワーファリンに切り替えて受傷21日目に退院となった。今回の2症例は受傷初期のCTで所見を認めなかったが，症状が遷延したことで再検したCTで静脈洞に一致する高吸収域が出現しCVSTが発覚した。被ばくの懸念から小児では繰り返しのCT撮像は躊躇されるが，症状が遷延する場合CTの再検およびMRIなどでの精査を検討するべきである。
Association of periodontitis with gastrointestinal tract disorders: A bidirectional Mendelian randomization study
Authors: Wang Yuqiang , Zhu Jiakang , Tang Ying , Huang Cui
Published: April 2024

Background

The bidirectional link of periodontitis (PD) and gastrointestinal tract (GIT) disorders has been investigated in previous epidemiological studies; however, the conclusions still remain controversial. The aim of this study was to comprehensively explore the bidirectional causal effect between PD and various GIT diseases.

Methods

Based on summary‐level data of genome‐wide association studies (GWASs), a two‐sample bidirectional Mendelian randomization (MR) study was undertaken. Single‐nucleotide polymorphisms (SNPs) associated with PD or GIT disorders (chronic gastritis [CG], gastric ulcer [GU], duodenal ulcer [DU], gastroesophageal reflux disease [GERD], irritable bowel syndrome [IBS], and diverticular disease of the intestine [DI]) in GWASs were applied as exposure. The primary method employed was the inverse‐variance weighted (IVW) method, and several sensitivity analyses were performed to investigate potential pleiotropy.

Results

With regard to the investigation of the causality between PD and GIT disorders, the IVW method revealed that there is a causal impact of PD on GU (odds ratio [OR] 1.088; 95% confidence interval [CI], 1.036–1.141; adjusted p = 0.004) and DI (OR 0.938; 95% CI, 0.911–0.965; adjusted p = 0.000). However, no significant genetic liability was observed for the causal effect of PD on CG, DU, GERD, and IBS. Furthermore, the primary analysis did not demonstrate a causal effect of GIT disorders on PD.

Conclusion

This MR study suggests that PD may be associated with an increased risk of GU and a reduced risk of DI, with possibly limited clinical relevance. Further studies are needed to support the conclusions of this MR study.
Rheological‐based digital approach for gel curve analysis of alcohol ethoxylates
Authors: King Timothy , Caputo Franklin , Hughes Auriana , Barnes Julian
Published: April 2024

Many surfactants, such as higher mole alcohol ethoxylates like C12‐15–7EO and C9‐11–8EO, when diluted in water, will form a gel at specific concentrations and temperatures. Gels can be highly viscous and semi‐solid and should be avoided since they take time and energy to disperse once formed. Historically, the creation of gel diagrams or maps for our technical product brochures primarily has depended on visual observation, leading to variable interpretations and inconsistent results over time. Also, completing a gel map for one surfactant grade requires a minimum of one day, due to testing many samples across various concentrations and temperatures. To improve objectivity, consistency, and speed in gel mapping, oscillatory rheology was utilized to identify gels using viscoelastic properties by testing samples prepared at various concentrations. The digitization of the gel mapping technique provides two significant benefits. It offers a rheological‐based approach giving a non‐subjective, digital gel map and it is faster than our visual‐based method. Furthermore, this digital method is consistent with our visual‐based method giving good discrimination between surfactant grades and reproducibility within batches of the same grade. This work also demonstrates the promising potential of utilizing machine learning algorithms to model the rheological behavior of gel maps effectively. R and Python, programming languages widely used for data analysis, graphing, and machine learning, were employed. Overall, the new digital approach presented yields several benefits for surfactant gel behavior study, including a reduction in subjectivity, faster data generation, and increased efficiency in the gel map analysis process.
The potent effect of selenium nanoparticles: insight into the antifungal activity and preservation of postharvest strawberries from gray mold diseases
Authors: Hamouda Ragaa A , Abdel‐Hamid Marwa S , Hagagy Nashwa , Nofal Ashraf M
Published: April 2024

BACKGROUND

Most microorganisms that cause food decay and the lower the shelf life of foods are fungi. Nanotechnologies can combat various diseases and deal with the application of nanomaterial to target cells or tissues. In this study selenium nanoparticles (Se‐NPs) were synthesized using ascorbic acid and characterized by ultraviolet–visible spectroscopy, transmission electron microscopy (TEM), X‐ray diffraction and zeta potential. The different concentrations of As/Se‐NPs were tested against various fungi, including Alternaria linicola, Alternaria padwickii, Botrytis cinerea, Bipolaris sp., Cephalosporium acremonium, Fusarium moniliform and Fusarium semitectum. This study tested the influence of coated As/Se‐NPs on healthy strawberry fruits and those infected with Botrytis cinerea during 16 days of storage, with regard to shelf life, decay percentage, weight loss, total titratable acidity percentage, total soluble solids content (TSS) and anthocyanin content.

RESULTS

Energy‐dispersive X‐ray analysis showed only two elements: selenium and oxygen. TEM images showed that the nanoparticles ranged in size between 26 to 39 nm and were rhombohedral in shape. Se‐NPs showed antifungal activity against all tested fungi, the most effective being against Botrytis cinerea, Cephalosporium acremonium and Fusarium semitectum. During storage periods of strawberries fruits coated with As/Se‐NPs, the shelf life was increased, and the number of decaying fruits was less than in control (uncoated) and coated infected fruits. The decline in weight loss was lower in coated fruits than in control fruits.

CONCLUSION

These findings demonstrated that As/Se‐NPs could effectively maintain the postharvest quality of strawberries, even when the fruit was infected with B. cinerea. © 2024 Society of Chemical Industry.
Natural history of undifferentiated pleomorphic sarcoma: Experience from the US Sarcoma Collaborative
Authors: Makris Eleftherios A. , Tran Thuy B. , Delitto Daniel J. , Lee Byrne , Ethun Cecilia G. , Grignol Valerie , Harrison Howard J. , Bedi Meena , Clark Gamblin T. , Tseng Jennifer , Roggin Kevin K. , Chouliaras Konstantinos , Votanopoulos Konstantinos , Cullinan Darren , Fields Ryan C. , Cardona Kenneth , Poultsides George , Kirane Amanda
Published: April 2024

Background

Undifferentiated pleomorphic sarcoma (UPS) is a relatively rare but aggressive neoplasm. We sought to utilize a multi‐institutional US cohort of sarcoma patients to examine predictors of survival and recurrence patterns after resection of UPS.

Methods

From 2000 to 2016, patients with primary UPS undergoing curative‐intent surgical resection at seven academic institutions were retrospectively reviewed. Epidemiologic and clinicopathologic factors were reviewed by site of origin. Overall survival (OS), recurrence‐free survival (RFS), time‐to‐locoregional (TTLR), time‐to‐distant recurrence (TTDR), and patterns of recurrence were analyzed.

Results

Of the 534 UPS patients identified, 53% were female, with a median age of 60 and median tumor size of 8.5 cm. The median OS, RFS, TTLR, and TTDR for the entire cohort were 109, 49, 86, and 46 months, respectively. There were no differences in these survival outcomes between extremity and truncal UPS. Compared with truncal, extremity UPS were more commonly amenable to R0 resection (87% vs. 75%, p = 0.017) and less commonly associated with lymph node metastasis (1% vs. 6%, p = 0.031). R0 resection and radiation treatment, but not site of origin (extremity vs. trunk) were independent predictors of OS and RFS. TTLR recurrence was shorter for UPS resected with a positive margin and for tumors not treated with radiation.

Conclusion

For patients with resected extremity and truncal UPS, tumor size >5 cm and positive resection margin are associated with worse survival OS and RFS, irrespectively the site of origin. R0 surgical resection and radiation treatment may help improve these survival outcomes.
Off‐label use of rituximab for dermatologic conditions: A single center review
Authors: Porter Emma , Finnegan Paula , Long Amy , Bourke John F. , Murphy Michelle , O'Connor Cathal
Published: April 2024

Background

Rituximab (RTX) has been utilised off‐label for a variety of dermatological indications beyond pemphigus vulgaris. Efficacy has been reported in other immunobullous disorders, inflammatory dermatoses and connective tissue diseases.

Objectives

To assess the off‐label use of RTX in our centre with respect to indications, frequency and duration of treatment, efficacy, and adverse events.

Methods

Charts were retrospectively reviewed for all patients who received dermatologist‐prescribed RTX infusions off‐label at our centre between 2009 and 2022. Efficacy was categorised based on reported percentage reduction of disease activity: very good (75%–100%), good (50%–74%), partial (25%–49%) and none (0%–24%).

Results

Twenty‐nine patients received RTX off‐label during this time period. Infusions were discontinued in 28% (n = 8), due to insufficient clinical response. Median treatment duration for those on 6‐12‐monthly regular infusions was 2.4 years (range 0.5–11 years). Indications included cutaneous lupus (n = 9), mucous membrane pemphigoid (n = 5), pyoderma gangrenosum (n = 6), lichen planus (n = 2), dermatomyositis (n = 1), livedoid vasculitis (n = 1), sarcoidosis (n = 1), bullous pemphigoid (n = 1), pemphigus vulgaris, foliaceus and vegetans (n = 1 each). Clinical improvement was documented in 79% (n = 23); very good in 48% (n = 14), good in 17% (n = 5), and moderate in 14% (n = 4). Clinical efficacy in immunobullous disorders was 100% (9/9), 67% in cutaneous lupus (6/9), 33% in pyoderma gangrenosum (2/6), and 50% in lichen planus (1/2). No side effects were documented for 79% (n = 23). Adverse peri‐infusion events were seen in three patients (10%). Four patients died during follow up; one due to neutropenic sepsis with a background of advanced malignancy, and three due to Covid‐19. 

Conclusions

RTX was prescribed for multiple off‐label dermatological indications, often for recalcitrant disease. Responses were good overall, with a reassuring safety profile. Three patients died of Covid‐19; knowledge of the impact of RTX on the immune response and efficacy of vaccines is expanding and will continue to inform guidelines for RTX use in the post‐Covid era.
The Comparative Diagnostic Capability of Large Language Models in Otolaryngology
Authors: Warrier Akshay , Singh Rohan , Haleem Afash , Zaki Haider , Eloy Jean Anderson
Published: April 2024

Objectives

Evaluate and compare the ability of large language models (LLMs) to diagnose various ailments in otolaryngology.

Methods

We collected all 100 clinical vignettes from the second edition of Otolaryngology Cases—The University of Cincinnati Clinical Portfolio by Pensak et al. With the addition of the prompt “Provide a diagnosis given the following history,” we prompted ChatGPT‐3.5, Google Bard, and Bing‐GPT4 to provide a diagnosis for each vignette. These diagnoses were compared to the portfolio for accuracy and recorded. All queries were run in June 2023.

Results

ChatGPT‐3.5 was the most accurate model (89% success rate), followed by Google Bard (82%) and Bing GPT (74%). A chi‐squared test revealed a significant difference between the three LLMs in providing correct diagnoses (p = 0.023). Of the 100 vignettes, seven require additional testing results (i.e., biopsy, non‐contrast CT) for accurate clinical diagnosis. When omitting these vignettes, the revised success rates were 95.7% for ChatGPT‐3.5, 88.17% for Google Bard, and 78.72% for Bing‐GPT4 (p = 0.002).

Conclusions

ChatGPT‐3.5 offers the most accurate diagnoses when given established clinical vignettes as compared to Google Bard and Bing‐GPT4. LLMs may accurately offer assessments for common otolaryngology conditions but currently require detailed prompt information and critical supervision from clinicians. There is vast potential in the clinical applicability of LLMs; however, practitioners should be wary of possible “hallucinations” and misinformation in responses.

Level of Evidence

3 Laryngoscope, 134:3997–4002, 2024
Complementing seedling planting with nucleation techniques increases forest restoration potential in areas around bauxite mining
Authors: Fonseca Wesley da Silva , Martins Sebastião Venâncio , Fioresi Enzo Mauro , Villa Pedro Manuel
Published: April 2024

The soil seed bank is one of the most important ecological indicators to evaluate and monitor the ecological restoration process of plant communities. We aimed to analyze the influence of two different ecological restoration techniques on the diversity and floristic composition of the soil seed bank and of standing vegetation, in two 4‐year‐old areas under forest restoration around bauxite mining, Southeast Brazil. A total of 30 soil samples were collected in each area (SPN—forest restoration by seedling planting in rows and nucleation techniques between planting rows and SP—forest restoration by seedling planting in rows). The samples were transported to a shade house and evaluated for 6 months, where germinated individuals were counted and identified weekly. A floristic census of shrub/tree species was conducted to assess the diversity of standing vegetation. The results indicated that the soil seed banks of the two areas are floristically similar (predominance of pioneer, herbaceous, and native origin species). The two restoration techniques did not differ in their effects on the species composition of the soil seed bank, mainly due to the restoration age. However, when analyzing the standing vegetation, 38 species were recorded in SPN, while only 20 species were in SP. This result demonstrates that nucleation techniques contributed to the increase in species diversity in SPN. We conclude that combining seedling planting in rows with nucleation techniques (topsoil transposition, direct seeding, and artificial perches) can enhance species diversity in standing vegetation, improve forest functionality, and consequently enhance the potential for forest restoration.
Earlier ice melt increases hypolimnetic oxygen despite regional warming in small Arctic lakes
Authors: Hazuková Václava , Burpee Benjamin T. , Northington Robert M. , Anderson N. John , Saros Jasmine E.
Published: April 2024

Although trends toward earlier ice‐out have been documented globally, the links between ice‐out timing and lake thermal and biogeochemical structure vary spatially. In high‐latitude lakes where ice‐out occurs close to peak intensity of solar radiation, these links remain unclear. Using a long‐term dataset from 13 lakes in West Greenland, we investigated how changing ice‐out and weather conditions affect lake thermal structure and oxygen concentrations. In early ice‐out years, lakes reach higher temperatures across the water column and have deeper epilimnia. Summer hypolimnia are the warmest (~ 11°C) in years when cooler air temperatures follow early ice‐out, allowing full lake turnover. Due to the higher potential for substantive spring mixing in early ice‐out years, a warmer hypolimnion is associated with higher dissolved oxygen concentrations. By affecting variability in spring mixing, the consequences of shifts in ice phenology for lakes at high latitudes differ from expectations based on temperate regions.
Surface Acoustic Microwave Photonic Filters on Etchless Lithium Niobate Integrated Platform
Authors: Yu Yue , Sun Xiankai
Published: April 2024

Lithium niobate on insulator emerges as a promising platform for integrated microwave photonics because of its capability of ultralow‐loss guidance and high‐efficiency modulation of light. Chip‐level integration of microwave filters is important for signal processing in the 5G/6G wireless communication. Here, by employing bound states in the continuum for low‐loss waveguiding, high‐performance microwave photonic filters are realized on an etchless lithium niobate integrated platform. These microwave photonic filters consist of a high‐quality photonic microcavity modulated by piezoelectrically excited surface acoustic waves. Acoustic time delays from 21 to 106 ns and passbands with bandwidth as narrow as 0.89 MHz are achieved in the fabricated filters operating at gigahertz frequencies. This demonstration may open up new applications on the lithium niobate integrated platform, such as optical communication, signal processing, and beam steering.