bluuebunny/crossref_metadata_2025 huggingface dataset:
Reigniting the Flame: An Exploration of Flow in Surgery
Authors: McQueen Sydney A. , Hammond Melanie , McParland Aidan L. , Sonnadara Ranil R. , Moulton Carol-anne
Published: November 2024

Purpose

Although distress and burnout in medical practice are widely acknowledged, less attention has been paid to the positive experiences that help keep physicians engaged. Cognitive flow (being “in the zone”) is an intrinsically rewarding state in which individuals feel challenged and focused. To date, academic investigations of flow have largely been limited to the cognitive aspects of the phenomenon, limiting understanding of other elements, such as practice culture and environment. This study examines flow in surgical practice through a multifaceted lens.

Method

Guided by a constructivist grounded theory approach, semistructured interviews were conducted from June 2018 to May 2021 with staff surgeons at the University of Toronto. Purposive sampling was used to include a range of surgical disciplines and experience levels to produce a conceptual framework that captures the multifaceted experience of flow.

Results

Twenty staff surgeons from diverse specialties participated. A conceptual framework was developed for illustrating the different facets of flow, including the traditional view (cognitive) and an expanded view (physiologic, physical, affective, social, cultural, and environmental facets). Through the cognitive lens, participants appreciated how they could achieve the necessary mindset to experience flow and enjoy their work. The ability to feel in control, use creative approaches to solve problems, and possess the agency to continue to learn and improve invoked positive feelings about their work and practice. In the expanded view, it became evident that experiences of flow were much more multifaceted and complex. Beyond the individual, aspects such as the sociocultural environment shaped and comprised key aspects of the flow experience that surgeons found truly meaningful in their practice.

Conclusions

Appreciating flow as a multifaceted phenomenon may assist in the identification and optimization of experiences that are central to encouraging lifelong career advancement and innovation while also helping protect against burnout and distress.
Accounting for Twins and Other Multiple Births in Perinatal Studies of Live Births Conducted Using Healthcare Administration Data
Authors: Brown Jeremy P. , Yland Jennifer J. , Williams Paige L. , Huybrechts Krista F. , Hernández-Díaz Sonia
Published: November 2024

The analysis of perinatal studies is complicated by twins and other multiple births even when multiples are not the exposure, outcome, or a confounder of interest. In analyses of infant outcomes restricted to live births, common approaches to handling multiples include restriction to singletons, counting outcomes at the pregnancy level (i.e., by counting if at least one twin experienced a binary outcome), or infant-level analysis including all infants and accounting for clustering of outcomes, such as by using generalized estimating equations or mixed effects models. Several healthcare administration databases only support restriction to singletons or pregnancy-level approaches. For example, in MarketScan insurance claims data, diagnoses in twins are often assigned to a single infant identifier, thereby preventing ascertainment of infant-level outcomes among multiples. Different approaches correspond to different questions, produce different estimands, and often rely on different assumptions. We demonstrate the differences that can arise from these different approaches using Monte Carlo simulations, algebraic formulas, and an applied example.
Body Shapes of Multiple Anthropometric Traits and All-cause and Cause-specific Mortality in the UK Biobank
Authors: Bohmann Patricia , Stein Michael J. , Weber Andrea , Konzok Julian , Fontvieille Emma , Peruchet-Noray Laia , Gan Quan , Fervers Béatrice , Viallon Vivian , Baurecht Hansjörg , Leitzmann Michael F. , Freisling Heinz , Sedlmeier Anja M.
Published: November 2024

Background:

Individual traditional anthropometric measures such as body mass index and waist circumference may not fully capture the relation of adiposity to mortality. Investigating multitrait body shapes could overcome this limitation, deepening insights into adiposity and mortality.

Methods:

Using UK Biobank data from 462,301 adults (40–69 years at baseline: 2006–2010), we derived four body shapes from principal component analysis on body mass index, height, weight, waist and hip circumference, and waist-to-hip ratio. We then used multivariable-adjusted Cox proportional hazard models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between body shapes and mortality for principal component scores of +1 and −1.

Results:

During 6,114,399 person-years of follow-up, 28,807 deaths occurred. A generally obese body shape exhibited a U-shaped mortality association. A tall and centrally obese body shape showed increased mortality risk in a dose–response manner (comparing a score of +1 and 0: HR = 1.16, 95% CI = 1.14, 1.18). Conversely, tall and lean or athletic body shapes displayed no increased mortality risks when comparing a score of +1 and 0, with positive relations for the comparison between a score of −1 and 0 in these shapes (short and stout shape: HR = 1.12, 95% CI = 1.10, 1.14; nonathletic shape: HR = 1.15, 95% CI = 1.13, 1.17).

Conclusion:

Four distinct body shapes, reflecting heterogeneous expressions of obesity, were differentially associated with all-cause and cause-specific mortality. Multitrait body shapes may refine our insights into the associations between different adiposity subtypes and mortality.
REDUCTION OF SCLERAL THICKNESS WITH TOPICAL FLUOROMETHOLONE IN MANAGEMENT OF CHRONIC CENTRAL SEROUS CHORIORETINOPATHY COMPLICATED BY POSTERIOR CYSTOID DEGENERATION
Authors: Maltsev Dmitrii S. , Kulikov Alexei N. , Vasiliev Alexander S. , Kalinicheva Yana A. , Chhablani Jay
Published: November 2024

Purpose.

To describe the role of topical fluorometholone in the management of eyes with central serous chorioretinopathy (CSCR) complicated by posterior cystoid degeneration (PCD).

Methods.

Patients with PCD associated with CSCR were prospectively recruited, examined with multimodal imaging and prescribed for topical fluorometholone four times daily. Eyes with macular neovascularization were excluded based on optical coherence tomography angiography. Spectral-domain optical coherence tomography was used to monitor central retinal thickness, subfoveal choroidal thickness, and the thickness of the anterior sclera.

Results.

Five eyes of four patients were included. Intraretinal and subretinal fluid in all eyes had been unresponsive to all standard treatments, but improved remarkably or completely resolved with limited improvement of visual acuity after a mean of 6.0 ± 2.0 weeks of topical fluorometholone administration. In all cases, significant reduction of scleral thickness was observed with no or mild intraocular pressure rise.

Conclusion.

Severe cases of CSCR complicated by PCD associated with vision loss may be managed with topical fluorometholone. The positive effects of steroids in CSCR may be mediated by their effects on reduction of the scleral thickness.
Efficiency of phacoemulsification handpieces with high and low intraocular pressure settings
Authors: Spaulding Justin , Hall Brad
Published: November 2024

Purpose:

To compare the efficiencies of the Active Sentry handpiece at low intraocular pressure (IOP) (20 mm Hg) with the Ozil handpiece at high IOP (50 mm Hg).

Setting:

Private practice (Medford, Oregon).

Design:

Single-site, prospective, double-arm, randomized, contralateral eye study.

Methods:

The first operated eye was randomized to receive phacoemulsification with either the Active Sentry handpiece at 20 mm Hg (Active Sentry group) or the Ozil handpiece at 50 mm Hg (Ozil group). The second operated eye was assigned to the other group. Outcome measures included phacoemulsification time, total aspiration time, aspiration time during phacoemulsification, fluid use, cumulative dissipated energy, total torsional time, total longitudinal time, and central corneal thickness.

Results:

36 participants (72 eyes) completed the study. Mean total aspiration time was 90.1 ± 16.4 seconds in the Active Sentry group and 85.1 ± 17.0 seconds in the Ozil group (P > .05). Mean aspiration time during phacoemulsification was 40.9 ± 8.5 seconds in the Active Sentry group and 40.4 ± 8.8 seconds in the Ozil group (P > .05). Mean total phacoemulsification time was 29.5 ± 7.3 seconds in the Active Sentry group and 31.0 ± 7.4 seconds in the Ozil group (P > .05). Mean total fluid volume was 32.8 ± 4.6 mL in the Active Sentry group and 33.8 ± 6.0 mL in the Ozil group (P > .05).

Conclusions:

The results of this study suggest that the efficiencies of the Active Sentry handpiece at low IOP settings and the Ozil handpiece at high IOP are similar.
Assessment of measurement variability across automated biometry devices
Authors: Micheletti J. Morgan , Hall Brad
Published: November 2024

Purpose:

To evaluate measurement variability between different readily available automated biometric devices for the purposes of improving surgeon decision-making for phakic intraocular lens (IOL) sizing.

Setting:

Private practice (Houston, Texas).

Design:

Prospective, single-center, bilateral, nonrandomized, open-label, observational study.

Methods:

This study included healthy eyes, with no prior eye surgery, and with a spherical equivalent of at least −1.00 diopter. Orbscan II was compared with Argos, Atlas 9000, caliper, IOLMaster 500, IOLMaster 700, iTrace, Lenstar LS900, Pentacam HR, and Pentacam AXL Wave. Preoperative measurements included white-to-white (WTW), anterior chamber depth (ACD), and central corneal thickness (CCT). Linear mixed-effect models were created to determine adjustment factor between the Orbscan II and other devices for WTW, ACD, and CCT measurements.

Results:

204 participants (408 eyes) completed the study. All mean WTW measurements were significantly different compared with the Orbscan II (P < .01), except for Pentacam AXL Wave. All mean ACD and CCT measurements were significantly different compared with the Orbscan II (P < .01). Adjustment factors for WTW ranged from −0.65 to 0.24 mm. Adjustment factors for ACD ranged from −0.21 to −0.16 mm. Adjustment factors for CCT ranged from 19.9 to −36.0 μm.

Conclusions:

The biometers tested were not interchangeable with the Orbscan II. Adjustment factors for WTW and ACD may compensate for differences between devices and adapt ICL sizing recommendations.
Citrate in autosomal dominant polycystic kidney disease: biomarker or therapeutic agent?
Authors: Rocha Daniel Ribeiro , Matos Ana Cristina Carvalho , Heilberg Ita Pfeferman
Published: November 2024

Purpose of review

This review highlights the latest findings regarding hypocitraturia in autosomal dominant polycystic kidney disease (ADPKD), from both experimental and clinical studies, exploring the underlying pathophysiology and potential therapeutic approach.

Recent findings

Experimental studies have shown that the lodging of microcrystals in the tubules can trigger cyst formation and growth in polycystic kidney disease (PKD). ADPKD patients are prone to developing hypocitraturia in early stages, which could predispose to calcium microcrystal formation. Low urinary citrate excretion has been associated with a more rapid decline in eGFR and poorer renal survival in ADPKD patients. Animal studies employing citrate supplementation have shown promising effects on preserving the decline in estimated glomerular filtration rate (eGFR) and cyst growth.

Current knowledge suggests that urinary citrate could be incorporated into existing prognostic markers for disease progression and potential adjuvant therapy in ADPKD, but further clinical studies to support such hypothesis must be undertaken.
Feasibility, reliability, and validity of the two-minute step test for assessing aerobic exercise capacity and functional endurance in participants with anterior cruciate ligament reconstruction
Authors: Kararti Caner , Özyurt Fatih , Gürses Ömer Alperen , Basat Hakki Çağdaş , Özsoy İsmail , Erol Sümeyye , Caylan Gurses Kubra
Published: November 2024

The aim of this study was to investigate the feasibility, test–retest reliability, and construct validity of the 2-min step test (2MST) in measuring aerobic exercise capacity and functional endurance in participants with anterior cruciate ligament reconstruction (ACLR). Fifty participants with quadriceps tendon autograft, bone-patellar tendon-bone graft, or hamstring autograft were included. Feasibility was assessed by the time and support required to complete the measures and the feedback from participants, including their satisfaction ratings. Test–retest reliability was assessed using the intraclass correlation coefficients (ICC2,1), a Bland–Altman plot with 95% limits of agreement (LoA), SEM, SEM%, and minimum detectable change (MDC95). The participants were assessed with the visual analogue scale (VAS), Lysholm Knee Scoring Scale, Knee Injury and Osteoarthritis Outcome Score (KOOS), stair climbing test (SCT), and 6-min walk test to assess construct validity. The test took less than 5 min to describe and perform, and participants required minimal verbal support. The satisfaction rate was notably high. The ICC2,1 was 0.98 (0.96–0.99). SEM and MDC95 were 2.96 and 8.20 (2.41–14.00), respectively. The SEM% of 2.99 was considered to be at a very good level. The Bland–Altman plot illustrates that the 2MST scores had a 95% LoA ranging from −21.52 to 2.68 steps. The SCT score and VAS rest score were found to be associated with the 2MST performance, explaining 42.5% of the variance. The 2MST is a feasible, reliable, and valid test to measure aerobic exercise capacity and functional endurance in participants with ACLR.
Combined coronary artery bypass grafting and orthopedic fixation in a patient with multiple comorbidities: a case report
Authors: Natsha Noor , Najjar Roua , Warasna Haya Jebreen Mohammad , Awad Mohammad Yaser Hasan , Alhadad Baha , Marzouqa Bisher , Qabaja Murad
Published: November 2024

Background:

Coronary artery disease is a prevalent cardiovascular condition and the leading cause of morbidity and mortality worldwide. The management of orthopedic injuries requiring surgical fixation is particularly complex in patients with comorbidities such as diabetes mellitus and hypertension (HTN). Coordinating the sequence, timing, and execution of coronary artery bypass grafting (CABG) and orthopedic fixation requires careful consideration of the patient’s overall health, surgical risks, and recovery potential.

Case presentation:

A 55-year-old male presented with a right distal tibial fracture following a fall. His medical history included HTN, type 2 diabetes mellitus, and Kyrle’s skin disease. During his hospital stay, he was diagnosed with non-ST-segment elevation myocardial infarction. Severe multivessel Coronary artery disease was confirmed by catheterization. After interdisciplinary consultation, simultaneous CABG and open reduction and internal fixation of the tibial fracture were performed. He was discharged in good condition and showed positive recovery during a 1-month follow-up.

Discussion:

This case highlights the complexities of managing patients with multiple comorbidities who require both cardiac and orthopedic surgeries. This simultaneous approach allows for efficient treatment, leading to a shorter hospital stay and recovery period. This report supports the feasibility and benefits of simultaneous surgery in complex clinical scenarios, although further studies are required to establish broader guidelines.

Conclusion:

Our case emphasizes the importance of a multidisciplinary approach for managing patients with multiple comorbidities who require concurrent surgical intervention. Preoperative planning and speciality coordination ensured optimal outcomes. Further research is needed to develop standardized guidelines for intraoperative care of patients undergoing simultaneous procedures.
Protein-losing enteropathy as the first presentation of systemic lupus erythematosus the first case reported in Palestine with systemic review
Authors: Abu Jheasha Amal , Alsharif Tasneem , Alwahsh Raghad , Abumunshar Ahmad , Al-Ardah Rawand , Abuturki Abdelwadod
Published: November 2024

Introduction:

Systemic lupus erythematosus is a chronic inflammatory disease affecting women, causing gastrointestinal issues like acute pancreatitis, esophagitis, and protein-losing enteropathy. Protein loss is uncommon, but a case study shows protein-losing enteropathy as a first sign.

Importance:

Protein-losing enteropathy (PLE) is a rare gastrointestinal manifestation of SLE, often seen years before diagnosis. Suspecting hypoalbuminemia without protein loss is crucial, but diagnosis is challenging due to imaging and histological findings.

Case presentation:

A 22-year-old woman with epigastric pain experienced sudden abdominal pain, vomiting, and arthralgia. An abdominal CT scan revealed moderate bilateral hydronephrosis, pelvic free fluid, a kidney stone, and a cyst. Laboratory tests showed normal hemoglobin levels, platelets, white blood cells, C-reactive protein, and ESR. Diagnosis of SLE was confirmed, and pulse steroid therapy and hydroxychloroquine were initiated. Severe ascites required pigtail insertion, and ceftazidime was added. The patient’s condition improved, and she was discharged with regular follow-ups.

Clinical discussion:

A 22-year-old female was diagnosed with protein-losing enteropathy, a rare gastrointestinal manifestation of systemic lupus erythematosus (SLE). The disease is divided into mesenteric vasculitis, pseudo-obstruction, and protein loss enteropathy. The patient also had severe enteritis, abdominal pain, nausea, and diarrhea. The study found that the main complaint was abdominal pain with dysphagia, mainly due to active SLE inflammation. The patient responded well to treatment, with a 62.5% rapid improvement in pulse steroids and a cure for underlying causes through DMARDS or immunosuppressant drugs.

Conclusions:

The case presents a rare SLE diagnosis with gastrointestinal involvement, pleural effusion, and progressive swelling. Despite correct diagnosis and aggressive treatment, clinical improvement occurred, requiring high clinical suspicion.
The Association Between Change in Symptom Severity and Personal Recovery in Patients With Severe Mental Illness
Authors: Van Eck Robin Michael , Jelsma Auke , Blondeel Jelle , Burger Thijs Jan , Vellinga Astrid , de Koning Mariken Beatrijs , Schirmbeck Frederike , Kikkert Martijn , Boyette Lindy-Lou , de Haan Lieuwe
Published: November 2024

This study examined the relationship between change in symptom severity and personal recovery in patients with severe mental illness (SMI). Forty-nine outpatients at Mentrum/Arkin, Amsterdam, the Netherlands, were assessed at baseline and 3 years later, using the Brief Psychiatric Rating Scale and the Mental Health Recovery Measure. Correlation coefficients and linear regression analyses were used. Further, the impact of severity of symptoms at baseline on change in personal recovery was evaluated. Results show that change in symptom severity explained 31.8% of the variance of change in personal recovery. Change in depression/anxiety explained 27.3% of the variance of change in personal recovery. Higher affective symptom severity at baseline significantly predicted positive change in personal recovery. In conclusion, besides change in symptom severity, other potential determinants of personal recovery should be addressed in treatment of patients with SMI, for example, self-esteem and social functioning. Treatment of depression/anxiety symptoms may increase personal recovery.
Visibility, Physical Work Environment, and Stress in ICU Nurses
Authors: Keys Yolanda , Fineout-Overholt Ellen
Published: November 2024

OBJECTIVE

Relationships among coworker and patient visibility, reactions to physical work environment, and work stress in ICU nurses are explored.

BACKGROUND

Millions of dollars are invested annually in the building or remodeling of ICUs, yet there is a gap in understanding relationships between the physical layout of nursing units and work stress.

METHODS

Using a cross-sectional, correlational, exploratory, predictive design, relationships among variables were studied in a diverse sample of ICU nurses.

RESULTS

Visibility had a direct effect on work stress (P < 0.01). The ViPES (Visibility, Physical Environment and Stress) model can help explain relationships among study variables. The findings from this study support the notion that high visibility is a job resource and low visibility is a job demand.

CONCLUSIONS

Design features supporting a sense of connection may be especially important to less experienced ICU nurses. Elements of the built environment that allow nurses to see not only patients, but also their coworkers, may help mitigate work stress.
L-Serovar Rectal Chlamydia trachomatis in Patients Who Were Male-Assigned at Birth Attending Two Sexual Health Clinics, Baltimore, Maryland 2009–2016
Authors: Hamill Matthew M. , Deng Zhongyue , Hardick Justin , Tobias Susan , Page Kathleen R. , Quinn Thomas C. , Gaydos Charlotte A. , Hsieh Yu-Hsiang
Published: November 2024

Introduction

Lymphogranuloma venereum (LGV) caused by L-serovars of Chlamydia trachomatis (CT) is a sexually transmitted infection (STI) causing asymptomatic infection, and anogenital disease. Epidemiologically, LGV has been strongly associated with human immunodeficiency virus (HIV) infection.

Methods

Using a retrospective longitudinal study design, we first described unadjusted and adjusted associations between demographic and sociobehavioral characteristics and rectal (r) CT (rCT) and rLGV in sexual health clinic attendees in Baltimore, MD, between 2009 and 2016 at baseline visits. Rectal samples that tested positive for CT with the Aptima AC2 assay underwent DNA extraction and in-house L-serovar PCR analysis. Then, patients were followed over 24 months and incident STIs were described using multivariable Cox-proportional hazard regression models.

Results

In 292/391 (73.4%) patients who were male-assigned at birth (MAB), LGV prevalence was 20/292 (6.8% (95% confidence interval, 4.2%–10.4%)). In the final multivariable regression model, LGV was significantly associated with age greater than 25 years, transgender identity, and a history of syphilis. Baseline LGV was not associated with incident HIV or gonorrhea, but after adjusting for age, race, HIV status, and history of syphilis, LGV was marginally associated with a new syphilis diagnosis (hazard ratio 2.35 (95% confidence interval, 0.96–5.73), P = 0.06) over 24 months follow-up.

Conclusion

Lymphogranuloma venereum accounted for almost 7% of rCT in patients MAB attending sexual health clinics in Baltimore between 2009 and 2016. Lymphogranuloma venereum was not associated with prevalent or incident HIV as in other studies. FDA-cleared tests and better surveillance measures are required to understand changes in the epidemiology of LGV in the United States.
Computer-assisted Cognitive Behavior Therapy and Mobile Apps for Depression and Anxiety: Evidence-based Digital Tools for Clinical Practice
Authors: Rajeshkumar Lavanya , Mishkind Matthew , Coleman Jeremy J. , Pahwa Mehak , LaPreze Dani , Solenske Shaelyn , Wright Jesse H.
Published: November 2024

Purpose of Review:

Provider shortages and other barriers to traditional mental health care have led to the development of technology-based services designed to enhance access and improve the efficiency and convenience of treatment. We reviewed research on computer-assisted cognitive behavior therapy (CCBT) and mobile mental health applications to assess the effectiveness of these methods of delivering or augmenting treatment, evaluating patient and provider uptake, and making recommendations on the clinical use of these tools in the treatment of depression and anxiety.

Results:

Research on CCBT has found solid evidence for efficacy when the use of a therapeutic computer program is supported by a clinician or other helping professional. Lower levels of efficacy have been found when CCBT is used as a stand-alone treatment. Current CCBT programs have many desirable features; however, few of the current programs incorporate services such as artificial intelligence that have the potential to help improve communication with patients. An increasing number of mobile apps have been created that claim to be useful for depression and/or anxiety, yet caution is warranted before using most due to limited research on effectiveness, low retention rates, and other issues like safety concerns.

Growth in the development of CCBT and mental health applications for depression/anxiety has provided several tools that could enhance treatment delivery. A large number of randomized, controlled trials have documented the effectiveness of CCBT, while research on mobile apps has been much less robust. The advantages and disadvantages of these digital technologies are identified, and recommendations are made for clinical use.
Exploring sex differences in the needs and priorities of people with lower limb amputations: An adaptation of the Prosthesis Evaluation Questionnaire
Authors: Carswell Tess M. R. , Monkman Helen , Giles Joshua W.
Published: November 2024

Background:

Females with lower limb amputations have different risk factors and lower success with their prostheses overall. Studying priorities of this population, specifically in how they differ between sexes, through survey methods may improve understanding of female-specific needs and inform sex-specific prosthetic design.

Objectives:

To adapt the Prosthesis Evaluation Questionnaire and use this to assess sex differences in needs and priorities of people with lower limb amputations (pLLAs).

Study design:

Cross-sectional questionnaire study.

Methods:

A committee was formed to modify the Prosthesis Evaluation Questionnaire. The modified questionnaire was completed online by 26 pLLAs (13 females, 13 males). Sex differences in subscale and individual closed-question responses were analyzed using Mann-Whitney U tests. Sex differences in open-ended question responses were analyzed using affinity diagramming.

Results:

Significant sex differences were found in subscale scores and separate closed questions, with resulting qualitative themes further suggesting sex-specific priorities and perspectives. Females reported lower satisfaction with prosthetic appearance, poorer overall ambulation abilities, and greater perception of social burden than males. Sex differences were also found in themes related to prosthesis satisfaction and other psychosocial factors including social adjustment.

Conclusions:

Findings demonstrated all-encompassing sex differences in the priorities and needs of pLLAs. This work can be used to better understand and target female's unique priorities through sex-specific considerations in research and prosthetic design.
Sonographic and Disease Activity Findings Related With Medication Change in JIA
Authors: Esteban Ysabella , Avar-Aydin Pinar Ozge , Ting Tracy V. , Cassedy Amy , Vega-Fernandez Patricia
Published: November 2024

Background

Musculoskeletal ultrasound (MSUS) is increasingly used to evaluate pediatric inflammatory arthritis. This study aimed to explore the relationship between MSUS findings with medication modifications in patients with juvenile idiopathic arthritis (JIA) and clinical disease activity measurements (clinical Juvenile Arthritis Disease Activity Score [cJADAS-10], active joint count [AJC], patient/parent global assessment [PPGA], and physician global assessment [PGA]).

Methods

Data from patients with JIA who underwent a 12-joint (bilateral second and third metacarpophalangeal, wrist, elbow, knee, and ankle) MSUS examination during a 57-month period were collected. Patients were categorized into 2 groups: a medication change group and a control group (patients without medication change). A pediatric-specific MSUS scoring system was used to assess MSUS findings. The association between clinical and MSUS findings was examined for the study groups.

Results

A total of 38 patients, 23 in the medication change group and 15 in the control group were included. The medication change group had higher AJC, PGA, and cJADAS-10. These patients also had a statistically significant presence of abnormal knee MSUS findings. For other joints, the frequency of abnormal MSUS findings was slightly higher in patients with a medication change, but the difference was not statistically significant. No strong correlation was observed between MSUS findings and clinical disease activity measurements.

Conclusions

Abnormal MSUS findings were not observed to be higher in patients with a change in medication except for the involvement of the knee joint. Further longitudinal studies are needed to understand the role of MSUS in the medical decision-making process in JIA.
Voxel-Based Dosimetry Predicts Local Tumor Progression Post 90Y Radiation Segmentectomy of Colorectal Liver Metastases
Authors: Dimopoulos Platon M. , Sotirchos Vlasios S. , Dunne-Jaffe Cynthia , Petre Elena N. , Gonen Mithat , Zhao Ken , Kirov Assen S. , Crane Christopher , D’Angelica Michael , Connell Louise C. , Sofocleous Constantinos T.
Published: November 2024

Background

Radiation segmentectomy (RS) is an alternative potential local curative treatment for selected colorectal liver metastases (CLMs) not amenable to ablation or limited resection.

Purpose

The aim of this study was to evaluate the dosimetric response of low volume CLMs to RS in heavily pretreated patients who are not candidates for resection or percutaneous ablation.

Patients and Methods

This single-center retrospective study evaluated CLMs patients treated with RS (prescribed tumor dose >190 Gy) from 2015 to 2023. RS doses to tumor(s) and margins were calculated from SPECT/CT and PET/CT images. Response and local tumor progression (LTP) were assessed using anatomic (RECIST 1.1) and metabolic (PERCIST) criteria. LTP-free survival (LTPFS) and overall survival were estimated with Kaplan-Meier methodology. Variables were assessed as predictors of LTPFS using the Cox proportional hazards model.

Results

Thirty-six patients underwent 38 RS procedures to treat 57 tumors. Median time from initial diagnosis to detection of liver metastases and RS were 16.4 (interquartile range: 6.5–32.2) and 26.8 (interquartile range: 12.5–40.0) months, respectively. Median overall survival after RS was 14.3 (95% confidence interval [CI]: 10.8–30.7) months. Predictors of LTPFS included tumor number(s), mean tumor dose (MTD), and margin mean absorbed dose (MMAD). Complete radiographic (hazards ratio [HR]: 1.29e-16, 95% CI: 4.06e–17-4.07e-16, P < 0.001) and metabolic response (HR: 0.38, 95% CI: 0.15–0.95, P = 0.038) correlated with prolonged LTPFS. One-year LTPFS rate was 83.3% for tumors receiving MTD ≥400 Gy and a 5-mm surrounding MMAD ≥350 Gy (P = 0.006). No instances of LTP were observed when tumors received stereotactic irradiation over 300 Gy (at least 95% of the tumor volume received ≥300 Gy). One-year LTPFS rate for tumors receiving MTD ≥400 Gy was 68.6% versus 14.3% for those that did not reach this threshold (P = 0.013). In multivariate analysis, MTD ≥400 Gy and 5-mm MMAD ≥350 Gy were independent predictors of LTPFS (HR: 0.11; 95% CI: 0.01–0.81; P = 0.03).

Conclusions

MTD ≥400 Gy, MMAD ≥350 Gy, and stereotactic tumor irradiation ≥300 Gy are associated with prolonged LTPFS after RS for CLMs.
Has the Time Come to Switch From Extensive Lymph Node Dissection to Sentinel Lymph Node Biopsy in Prostate Cancer Patients Treated With Radical Laparoscopic Prostatectomy?
Authors: Delgado Bolton Roberto C. , Calapaquí Terán Adriana K. , Giammarile Francesco
Published: November 2024

The efficacy of the available procedures currently recommended for staging and prognostic evaluation of prostate cancer patients treated with radical laparoscopic prostatectomy is discussed, taking into account the available evidence and potential implications in patient management.
Effect of Social Isolation Due to the COVID-19 Pandemic on Cognitive Dysfunction of Patients With Alzheimer Disease
Authors: Nakamura Yu , Omori Takumi , Nishiyama Kenichi , Ishikawa Ichiro , Aoki Hiroshi , Nagakura Naoki
Published: November 2024

Background:

Previous studies were examined effects of social restriction by COVID-19 pandemic on elderly peoples or compared difference of before/after restrictions on patients with Alzheimer disease-related dementia (ADRD). Here, we assessed the effects of restrictions on the cognitive function of the patients by comparing control group.

Methods:

We examined the impact on cognitive function using the Alzheimer Disease Assessment Scale (Japanese version) cognitive subscale (ADAS-JCOG), in patients with mild to moderate ADRD by a post hoc subgroup analysis of double-blinded, noninferiority study of donepezil 27.5 mg patches and donepezil hydrochloride 5 mg tablets (JapicCTI-194582). After demonstrating the noninferiority of both treatments, we used combined data for this analysis.

Results:

The analyzed subpopulation of the per-protocol set groups was balanced (n=126 and 135, respectively). Patient demographics were similar between subgroups. The difference of ADAS-JCOG scores [least-squares mean (95%CI)] between the groups was 0.388 (-0.377 to 1.152, not statistically significant).

Conclusion:

Social isolation affects cognitive function on ADRD and this knowledge should be considered in future.
Breed function and behaviour correlate with endocranial volume in domestic dogs
Authors: Balcarcel Ana M. , Sánchez-Villagra Marcelo R. , Evin Allowen , Nussbaumer Marc , Hemelsdaël Adeline , Geiger Madeleine
Published: November 2024

Domestic dogs display a remarkable diversity of functions, morphologies and cognitive abilities. Using data from 1682 dogs representing 172 breeds, we tested for variation in relative endocranial volume (REV), a proxy for brain size and a basic measure of cognitive ability, in relation to breed function, phylogenetic classification, cranial shape, cooperative behaviour and temperament. Function, body size, phylogenetic clade and cranial shape correlate with REV. Toy dogs, functioning mainly as companions, have the largest endocranial volumes relative to their body size. Working dogs, bred to perform complex human-assistance skills and reportedly possessing higher cognitive abilities, have the smallest. Our results thus show that complex skills and cooperative behaviour—a hallmark of social cognition—do not predict larger REV in dogs. However, REV increases with fear and aggression, attention-seeking and separation anxiety and decreases with trainability. Significant correlations between REV and behavioural traits underscore the evolutionary plasticity of mammalian brain size under domestication and artificial selection and provide support for hypotheses linking the modulation of fear and aggression to brain size change under domestication.
Constant companions: wild zebra finch pairs display extreme spatial cohesion
Authors: Tyson Chris , Loning Hugo , Griffith Simon C. , Naguib Marc
Published: November 2024

Many animals maintain long-term monogamous partnerships, but the extent to which partners associate varies substantially and has implications for the scope of cooperation between pair members. Zebra finches (
Taeniopygia castanosis
) are monogamously paired for life and maintain continuous partnerships, raising questions as to if and how they maintain pair cohesion despite being non-territorial and having only short-range acoustic signals. While zebra finches are the best-studied songbird in captivity, their social and spatial behaviour in the wild is poorly understood. Determining pair cohesion in songbirds to date has almost exclusively been studied at specific locations where pairs would be expected to meet, such as nesting or feeding sites, without quantifying broader movements. Here, we used solar-powered automated tracking to simultaneously monitor the movements of radio-tagged zebra finch pairs during periods of breeding activity. We reveal extremely high spatial cohesion with pairs using nearly identical home ranges and maintaining close spatial proximity across large areas. This characterization of extremely high spatio-temporal coordination of zebra finch pairs provides important insights into the operation and benefits of monogamous relationships in highly mobile taxa, such as birds.
Cocoon microstructures through the lens of topological persistence
Authors: Raichenko Vira , Rosenthal Nikolai , Eder Michaela , Evans Myfanwy E.
Published: November 2024

Biological materials display a wide array of functionality, often dictated by complicated microstructures. New geometric and topological strategies allow one to describe the microstructures in a precise and systematic way. This article describes the application of topological persistence and other geometric methods to the microstructural analysis of three-dimensional X-ray micro-computed tomography scans of the
Bombyx mori
silkworm cocoons. These methods allow conclusions to be drawn about pore space gradients, silk fibre thickness gradients and fibre alignment within the cocoon. The study demonstrates the applicability of these topological and geometric methods to quantify and characterize fibrous materials.
The suppression of ocean waves by biogenic slicks
Authors: Laxague Nathan J. M. , Zappa Christopher J. , Soumya Shantanu , Wurl Oliver
Published: November 2024

Ocean waves are significantly damped by biogenic surfactants, which accumulate at the sea surface in every ocean basin. The growth, development, and breaking of short wind-driven surface waves are key mediators of the air–sea exchange of momentum, heat and trace gases. The mechanisms through which surfactants suppress waves have been studied in great detail through careful laboratory experimentation in quasi-one-dimensional wave tanks. However, the spatial scales over which this damping occurs in structurally complex surfactant slicks on the real ocean have not been resolved. Here, we present the results of field observations of the spatial response of decimetre- to millimetre-scale waves to biogenic surfactant slicks. We found that wave damping in organic material-rich coastal waters resulted in a net (spatio-temporally averaged) reduction of approximately 50% in wave slope variance relative to the open ocean for low to moderate wind speeds. This reduction of wave slope variance is understood to result in a corresponding reduction in momentum input to the wave field. This significant effect had thus far evaded quantification due in large part to the enormous range of scales required for its description—spanning the sea surface microlayer to the ocean submesoscale.
Global and local identifiability analysis of a nonlinear biphasic constitutive model in confined compression
Authors: Peloquin John M. , Elliott Dawn M.
Published: November 2024

Application of biomechanical models relies on model parameters estimated from experimental data. Parameter non-identifiability, when the same model output can be produced by many sets of parameter values, introduces severe errors yet has received relatively little attention in biomechanics and is subtle enough to remain unnoticed in the absence of deliberate verification. The present work develops a global identifiability analysis method in which cluster analysis and singular value decomposition are applied to vectors of parameter–output variable correlation coefficients. This method provides a visual representation of which specific experimental design elements are beneficial or harmful in terms of parameter identifiability, supporting the correction of deficiencies in the test protocol prior to testing physical specimens. The method was applied to a representative nonlinear biphasic model for cartilaginous tissue, demonstrating that confined compression data does not provide identifiability for the biphasic model parameters. This result was confirmed by two independent analyses: local analysis of the Hessian of a sum-of-squares error cost function and observation of the behaviour of two optimization algorithms. Therefore, confined compression data are insufficient for the calibration of general-purpose biphasic models. Identifiability analysis by these or other methods is strongly recommended when planning future experiments.
Personalized
in silico
model for radiation-induced pulmonary fibrosis
Authors: Ioannou Eleftherios , Hadjicharalambous Myrianthi , Malai Anastasia , Papageorgiou Elisavet , Peraticou Antri , Katodritis Nicos , Vomvas Dimitrios , Vavourakis Vasileios
Published: November 2024

Radiation-induced pulmonary fibrosis (RIPF) is a severe late-stage complication of radiotherapy (RT) to the chest area, typically used in lung cancer treatment. This condition is characterized by the gradual and irreversible replacement of healthy lung tissue with fibrous scar tissue, leading to decreased lung function, reduced oxygen exchange and critical respiratory deficiencies. Currently, predicting and managing lung fibrosis post-RT remains challenging, with limited preventive and treatment options. Accurate prediction of fibrosis onset and progression is therefore clinically crucial. We present a personalized
in silico
model for pulmonary fibrosis that encompasses tumour regression, fibrosis development and lung tissue remodelling post-radiation. Our continuum-based model was developed using data from 12 RT-treated lung cancer patients and integrates computed tomography (CT) and dosimetry data to simulate the spatio-temporal evolution of fibrosis. We demonstrate the ability of the
in silico
model to capture the extent of fibrosis in the entire cohort with a less than 1% deviation from clinical observations, in addition to providing quantitative metrics of spatial similarity. These findings underscore the potential of the model to improve treatment planning and risk assessment, paving the way for more personalized and effective management of RIPF.
The pivotal role of osteopontin in UV-induced skin inflammation in a mouse model
Authors: Kim Haesoo , Shin Chang-Yup , Park Chi-Hyun , Lee Dong Hun , Lee Si-Hyung , Chung Jin Ho
Published: November 2024

Osteopontin (OPN) is a pro-inflammatory protein that influences bone remodelling, wound healing, angiogenesis, allergic inflammation, and skin diseases such as psoriasis, contact dermatitis and skin cancer. However, the role of OPN in the skin remains unclear. Therefore, this study aimed to investigate the role of OPN in the skin, particularly in the context of ultraviolet (UV) irradiation-induced inflammation. OPN expression and its effects on inflammatory modulators were assessed in human skin, in a mouse model and
in vitro
, using a UV source emitting both UVB and UVA radiation, which collectively contribute to UV-induced skin inflammation. OPN expression increased in human and mouse skin after UV irradiation. Compared with wild-type mice, UV irradiation-induced skin phenotypes, such as erythema and skin thickening, were alleviated in OPN
−/−
mice. In addition, the number of immune cells recruited to the skin after UV irradiation and the expression of inflammatory cytokines and matrix metalloproteinases (MMPs) were observed to be decreased in the skin of OPN
−/−
mice compared with that of wild-type mice. By contrast, the degree of skin inflammation was higher in the hOPN KI mice than in wild-type mice. Treatment with recombinant OPN increased the expression of MMP-1 and inflammatory cytokines in human dermal fibroblasts and epidermal keratinocytes
in vitro
. Our results suggest that OPN may play a regulatory role in UV-induced skin inflammation.
Stochastic analysis of Ebola infection in small zoonotic niches
Authors: Mursel Sena , Bocchini Paolo , Buceta Javier
Published: November 2024

The size of fruit bat colonies ranges from dozens to hundreds of thousands of individuals, depending on the species. While a deterministic modelling approach is appropriate for large colonies, the role of population fluctuations can be all-important for small colonies. From this perspective, we analyse the infection dynamics in small zoonotic niches due to filoviruses, e.g. Ebola. To this end, we perform stochastic numerical simulations and analytical calculations. The inherent stochasticity in ecological processes may play a significant role in driving small populations towards extinction. Here, we reveal that fluctuations can either lead to virus eradication or to sustain infection compared with the deterministic dynamics, depending on the size of the zoonotic niche. Altogether, our findings reveal non-trivial stochastic effects, which can shed light on the infection dynamics in small- and medium-sized bat colonies and help design preventive measures for zoonotic diseases.
Rhythmic qualities of jazz improvisation predict performer identity and style in source-separated audio recordings
Authors: Cheston Huw , Schlichting Joshua L. , Cross Ian , Harrison Peter M. C.
Published: November 2024

Great musicians have a unique style and, with training, humans can learn to distinguish between these styles. What differences between performers enable us to make such judgements? We investigate this question by building a machine learning model that predicts performer identity from data extracted automatically from an audio recording. Such a model could be trained on all kinds of musical features, but here we focus specifically on rhythm, which (unlike harmony, melody and timbre) is relevant for any musical instrument. We demonstrate that a supervised learning model trained solely on rhythmic features extracted from 300 recordings of 10 jazz pianists correctly identified the performer in 59% of cases, six times better than chance. The most important features related to a performer’s ‘feel’ (ensemble synchronization) and ‘complexity’ (information density). Further analysis revealed two clusters of performers, with those in the same cluster sharing similar rhythmic traits, and that the rhythmic style of each musician changed relatively little over the duration of their career. Our findings highlight the possibility that artificial intelligence can perform performer identification tasks normally reserved for experts. Links to each recording and the corresponding predictions are available
on an interactive map
to support future work in stylometry.
Animal emotions and consciousness: a preliminary assessment of researchers’ perceptions and biases and prospects for future progress
Authors: Zipple Matthew N. , Hazelwood Caleb , Webster Mackenzie F. , Benítez Marcela E.
Published: November 2024

Scientists and philosophers have long struggled with the question of whether non-human animals experience emotions or consciousness. Yet, it is unclear where the scientific consensus on these topics lies today. To address this gap, we administered a survey of professional animal behaviour researchers to assess perceptions regarding (i) the taxonomic distribution of emotions and consciousness in non-human animals, (ii) respondents’ confidence in this assessment, and (iii) attitudes towards pitfalls and potential for progress when addressing these questions. Respondents (
n
= 100) ascribe emotionality and consciousness to a broad swath of the animal taxonomy, including non-human primates, other mammals, birds and cephalopods. Respondents’ attribution of these phenomena was strongly associated with their confidence in their assessments (
R
2
> 0.9), with respondents assuming an absence of emotions and consciousness when they were unsure. We also identify an emergent consensus of the components involved in a functional definition of emotions. Researchers are optimistic that tools either currently exist or will exist in the future to rigorously address these questions (>85%) and that animal behaviour, as a field, should do more to encourage research works on emotions (>70%). We discuss implications for publication bias and future work in this area as well as ethical considerations regarding animal care and use.