bluuebunny/crossref_metadata_2025 huggingface dataset:
A near real-time interactive dashboard for monitoring and anticipating demands in emergency care in the Île-de-France region (France)
Authors: Hanf Matthieu , Salle Léopoldine , Mas Charline , Ghribi Saif Eddine , Huitorel Mathias , Mebarki Nabia , Larid Sonia , Mazué Jane-Lore , Wargon Mathias
Published: June 2024

Objective

To allow health professionals to monitor and anticipate demands for emergency care in the Île-de-France region of France.

Materials and Methods

Data from emergency departments and emergency medical services are automatically processed on a daily basis and visualized through an interactive online dashboard. Forecasting methods are used to provide 7 days predictions.

Results

The dashboard displays data at regional and departmental levels or for 5 different age categories. It features summary statistics, historical values, predictions, comparisons to previous years, and monitoring of common reasons for care and outcomes.

Discussion

A large number of health professionals have already requested access to the dashboard (n = 606). Although the quality of data transmitted may vary slightly, the dashboard has already helped improve health situational awareness and anticipation.

Conclusions

The high access demand to the dashboard demonstrates the operational usefulness of real-time visualization of multisource data coupled with advanced analytics.
Potential negative effects of genomic selection
Authors: Misztal Ignacy , Lourenco Daniela
Published: June 2024

Initial findings on genomic selection (GS) indicated substantial improvement for major traits, such as performance, and even successful selection for antagonistic traits. However, recent unofficial reports indicate an increased frequency of deterioration of secondary traits. This phenomenon may arise due to the mismatch between the accelerated selection process and resource allocation. Traits explicitly or implicitly accounted for by a selection index move toward the desired direction, whereas neglected traits change according to the genetic correlations with selected traits. Historically, the first stage of commercial genetic selection focused on production traits. After long-term selection, production traits improved, whereas fitness traits deteriorated, although this deterioration was partially compensated for by constantly improving management. Adding these fitness traits to the breeding objective and the used selection index also helped offset their decline while promoting long-term gains. Subsequently, the trend in observed fitness traits was a combination of a negative response due to genetic antagonism, positive response from inclusion in the selection index, and a positive effect of improving management. Under GS, the genetic trends accelerate, especially for well-recorded higher heritability traits, magnifying the negatively correlated responses for fitness traits. Then, the observed trend for fitness traits can become negative, especially because management modifications do not accelerate under GS. Additional deterioration can occur due to the rapid turnover of GS, as heritabilities for production traits can decline and the genetic antagonism between production and fitness traits can intensify. If the genetic parameters are not updated, the selection index will be inaccurate, and the intended gains will not occur. While the deterioration can accelerate for unrecorded or sparsely recorded fitness traits, GS can lead to an improvement for widely recorded fitness traits. In the context of GS, it is crucial to look for unexpected changes in relevant traits and take rapid steps to prevent further declines, especially in secondary traits. Changes can be anticipated by investigating the temporal dynamics of genetic parameters, especially genetic correlations. However, new methods are needed to estimate genetic parameters for the last generation with large amounts of genomic data.
Genetic structure and diversity of the island-endemic freshwater prawn Macrobrachium shokitai Fujino & Baba, 1973 (Decapoda: Caridea: Palaemonidae) on Iriomote Island, Ryukyu Archipelago, southern Japan
Authors: Doi Wataru , Nohara Kenji , Inoue Hiroyuki , Kohno Hiroyoshi
Published: June 2024

Iriomote Island is a small continental island hosting approximately 40 rivers characterized by short, steep-gradient streams and small waterfalls. We examined the population genetic structure and diversity of the freshwater prawn Macrobrachium shokitaiFujino & Baba, 1973 (Palaemonidae) using the mitochondrial cytochrome c oxidase subunit I (COI) gene sequence. Specimens were collected from 19 sites along ten rivers on the island, covering the known geographic distribution of the species. Haplotype and nucleotide diversities were very low within each river on the island. Nearly all haplotypes were exclusive to a given river, confirming distinct population structures among rivers at a small geographical scale. Slight genetic differentiation was discerned between the upper and lower sites of waterfalls in only the Yuchin River. Phylogenetic tree reconstruction, haplotype network, and principle coordinate analysis classified five clades roughly correspond to geographical groups in the western, southern, central, and northern regions of the island. Extreme caution should therefore be taken when translocating individuals to other rivers to avoid introducing genetic disturbance, even during conservation and mitigation efforts.
Take your sunscreen: plant photoreceptor systems in Serritaenia testaceovaginata
Authors: Hess Wolfgang R , Hiltbrunner Andreas
Published: June 2024

This article comments on:

Busch A, Gerbracht JV, Davies K, Hoecker U, Hess S. 2024. Comparative transcriptomics elucidates the cellular responses of an aeroterrestrial zygnematophyte to UV radiation. Journal of Experimental Botany 75, 3624–3642.
Introducing the BRAHMA simulation suite: signatures of low-mass black hole seeding models in cosmological simulations
Authors: Bhowmick Aklant K , Blecha Laura , Torrey Paul , Kelley Luke Zoltan , Weinberger Rainer , Vogelsberger Mark , Hernquist Lars , Somerville Rachel S , Evans Analis Eolyn
Published: June 2024

While the first “seeds” of supermassive black holes (BH) can range from $\sim 10^2-10^6 \rm ~{\rm M}_{\odot }$, the lowest mass seeds ($\lesssim 10^3~\rm {\rm M}_{\odot }$) are inaccessible to most cosmological simulations due to resolution limitations. We present our new BRAHMA simulations that use a novel flexible seeding approach to predict the $z\ge 7$ BH populations for low-mass seeds. We ran two types of boxes that model $\sim 10^3~\rm {\rm M}_{\odot }$ seeds using two distinct but mutually consistent seeding prescriptions at different simulation resolutions. First, we have the highest resolution $[9~\mathrm{Mpc}]^3$ (BRAHMA-9-D3) boxes that directly resolve $\sim 10^3~\rm {\rm M}_{\odot }$ seeds and place them within haloes with dense, metal-poor gas. Second, we have lower resolution, larger volume $[18~\mathrm{Mpc}]^3$ (BRAHMA-18-E4), and $\sim [36~\mathrm{Mpc}]^3$ (BRAHMA-36-E5) boxes that seed their smallest resolvable $\sim 10^4~\&~10^5~\mathrm{{\rm M}_{\odot }}$ BH descendants using new stochastic seeding prescriptions calibrated using BRAHMA-9-D3. The three boxes together probe key BH observables between $\sim 10^3\,\mathrm{ and}\,10^7~\rm {\rm M}_{\odot }$. The active galactic nuclei (AGN) luminosity function variations are small (factors of $\sim 2-3$) at the anticipated detection limits of potential future X-ray facilities ($\sim 10^{43}~ \mathrm{ergs~s^{-1}}$ at $z\sim 7$). Our simulations predict BHs $\sim 10-100$ times heavier than the local $M_*$ versus $M_{\mathrm{ bh}}$ relations, consistent with several JWST-detected AGN. For different seed models, our simulations merge binaries at $\sim 1-15~\mathrm{kpc}$, with rates of $\sim 200-2000$ yr−1 for $\gtrsim 10^3~\rm {\rm M}_{\odot }$ BHs, $\sim 6-60$ yr−1 for $\gtrsim 10^4~\rm {\rm M}_{\odot }$ BHs, and up to $\sim 10$ yr−1 amongst $\gtrsim 10^5~\rm {\rm M}_{\odot }$ BHs. These results suggest that Laser Interferometer Space Antenna mission has promising prospects for constraining seed models.
Systematic analysis of jellyfish galaxy candidates in Fornax, Antlia, and Hydra from the S-PLUS survey: a self-supervised visual identification aid
Authors: Gondhalekar Yash , Chies-Santos Ana L , de Souza Rafael S , Queiroz Carolina , Lopes Amanda R , Ferrari Fabricio , Azevedo Gabriel M , Monteiro-Pereira Hellen , Overzier Roderik , Smith Castelli Analía V , Jaffé Yara L , Haack Rodrigo F , Rahna P T , Shen Shiyin , Mu Zihao , Lima-Dias Ciria , Barbosa Carlos E , Oliveira Schwarz Gustavo B , Riffel Rogério , Jimenez-Teja Yolanda , Grossi Marco , Mendes de Oliveira Claudia L , Schoenell William , Ribeiro Thiago , Kanaan Antonio
Published: June 2024

We study 51 jellyfish galaxy candidates in the Fornax, Antlia, and Hydra clusters. These candidates are identified using the JClass scheme based on the visual classification of wide-field, twelve-band optical images obtained from the Southern Photometric Local Universe Survey. A comprehensive astrophysical analysis of the jellyfish (JClass > 0), non-jellyfish (JClass = 0), and independently organized control samples is undertaken. We develop a semi-automated pipeline using self-supervised learning and similarity search to detect jellyfish galaxies. The proposed framework is designed to assist visual classifiers by providing more reliable JClasses for galaxies. We find that jellyfish candidates exhibit a lower Gini coefficient, higher entropy, and a lower 2D Sérsic index as the jellyfish features in these galaxies become more pronounced. Jellyfish candidates show elevated star formation rates (including contributions from the main body and tails) by $\sim$1.75 dex, suggesting a significant increase in the SFR caused by the ram-pressure stripping phenomenon. Galaxies in the Antlia and Fornax clusters preferentially fall towards the cluster’s centre, whereas only a mild preference is observed for Hydra galaxies. Our self-supervised pipeline, applied in visually challenging cases, offers two main advantages: it reduces human visual biases and scales effectively for large data sets. This versatile framework promises substantial enhancements in morphology studies for future galaxy image surveys.
The Alfvén transition zone observed by the Parker Solar Probe in young solar wind – global properties and model comparisons
Authors: Chhiber Rohit , Pecora Francesco , Usmanov Arcadi V , Matthaeus William H , Goldstein Melvyn L , Roy Sohom , Wang Jiaming , Thepthong Panisara , Ruffolo David
Published: June 2024

The transition from subAlfvénic to superAlfvénic flow in the solar atmosphere is examined by means of Parker Solar Probe (PSP) measurements during solar encounters 8 to 14. Around 220 subAlfvénic periods with a duration ≥10 min are identified. The distribution of their durations, heliocentric distances, and Alfvén Mach number are analysed and compared with a global magnetohydrodynamic model of the solar corona and wind which includes turbulence effects. The results are consistent with a patchy and fragmented morphology, and suggestive of a turbulent Alfvén zone within which the transition from subAlfvénic to superAlfvénic flow occurs over an extended range of helioradii. These results inform and establish context for detailed analyses of subAlfvénic coronal plasma that are expected to emerge from PSP’s final mission phase, as well as for NASA’s planned PUNCH mission.
Understanding variants of unknown significance: the computational frontier
Authors: Fu Xi , Rabadan Raul
Published: June 2024

The rapid advancement of sequencing technologies has led to the identification of numerous mutations in cancer genomes, many of which are variants of unknown significance (VUS). Computational models are increasingly being used to predict the functional impact of these mutations, in both coding and noncoding regions. Integration of these models with emerging genomic datasets will refine our understanding of mutation effects and guide clinical decision making. Future advancements in modeling protein interactions and transcriptional regulation will further enhance our ability to interpret VUS. Periodic incorporation of these developments into VUS reclassification practice has the potential to significantly improve personalized cancer care.
Variants of uncertain significance in precision oncology: nuance or nuisance?
Authors: Mellgard George S , Atabek Zoey , LaRose Meredith , Kastrinos Fay , Bates Susan E
Published: June 2024

Variants of unknown significance cause uncertainty for patients and are a challenge for oncologists. This commentary describes 4 clinical examples illustrating these challenges.
Structure, function, and assembly of PSI in thylakoid membranes of vascular plants
Authors: Rolo David , Schöttler Mark A , Sandoval-Ibáñez Omar , Bock Ralph
Published: June 2024

The photosynthetic apparatus is formed by thylakoid membrane-embedded multiprotein complexes that carry out linear electron transport in oxygenic photosynthesis. The machinery is largely conserved from cyanobacteria to land plants, and structure and function of the protein complexes involved are relatively well studied. By contrast, how the machinery is assembled in thylakoid membranes remains poorly understood. The complexes participating in photosynthetic electron transfer are composed of many proteins, pigments, and redox-active cofactors, whose temporally and spatially highly coordinated incorporation is essential to build functional mature complexes. Several proteins, jointly referred to as assembly factors, engage in the biogenesis of these complexes to bring the components together in a step-wise manner, in the right order and time. In this review, we focus on the biogenesis of the terminal protein supercomplex of the photosynthetic electron transport chain, PSI, in vascular plants. We summarize our current knowledge of the assembly process and the factors involved and describe the challenges associated with resolving the assembly pathway in molecular detail.
An intronless tau class glutathione transferase detoxifies several herbicides in flufenacet-resistant ryegrass
Authors: Dücker Rebecka , Lümmen Peter , Wolf Thomas , Brabetz Veronika , Beffa Roland
Published: June 2024

Resistance to preemergence herbicides, e.g. inhibitors of the biosynthesis of very-long-chain fatty acids (VLCFAs), is evolving in response to increased use of these compounds. Grass weeds such as ryegrasses (Lolium spp.) have accumulated resistance to various herbicide modes of action. Here, an RNA-seq analysis was conducted using 3 ryegrass populations resistant to the VLCFA biosynthesis inhibitor flufenacet to investigate this phenomenon. Besides various transcripts, including putative long noncoding RNAs (lncRNAs), a single putatively functional tau class glutathione transferase (GST) was constitutively differentially expressed. It was further induced by herbicide application. This GST was expressed as a recombinant protein in Escherichia coli along with other GSTs and detoxified flufenacet rapidly in vitro. Detoxification rates of other herbicides tested in vitro were in accordance with cross-resistance patterns previously determined in vivo. A genome-wide GST analysis revealed that the candidate GST was located in a cluster of 3 intronless GSTs. Their intronless nature possibly results from the retroposition of cellular mRNAs followed by tandem duplication and may affect gene expression. The large number of GSTs (≥195) in the genome of rigid ryegrass (Lolium rigidum) compared with other plant organisms is likely a key factor in the ability of this weed to evolve resistance to different herbicide chemistries. However, in the case of flufenacet resistance, a single upregulated GST with high affinity for the substrate flufenacet possibly contributes overproportionally to rapid herbicide detoxification in planta. The regulation of this gene and the role of differentially expressed transcripts, including various putative lncRNAs, require further investigation.
Financial Effects of Remote Product Delivery: Evidence from Hospitals
Authors: Cornaggia Kimberly , Li Xuelin , Ye Zihan
Published: June 2024

We study financial effects of remote product delivery in the healthcare industry. Exploiting staggered law adoption for identification, we find that telehealth provision redistributes hospital operations and access to capital away from rural communities. As urban telehealth providers acquire rural patients, rural hospitals experience decreased revenue and profit, credit rating downgrades, increased cost of capital, and ultimately risk of closure. Although telehealth reduces travel costs, some communities lose access to acute care. Overall, we conclude that remote healthcare services have financial consequences as well as real effects, and their benefits are unequally distributed.
Preoperative Cervical Epidural Steroid Injections
Authors: Alasadi Husni , Baidya Joydeep , Alasadi Yazan , Chakrani Zakaria , Herrera Michael M. , Zubizarreta Nicole , Stern Brocha Z. , Poeran Jashvant , Chaudhary Saad B.
Published: June 2024

Study Design:

Retrospective cohort study.

Objective:

Identify factors associated with cervical epidural steroid injection (CESI) receipt before anterior cervical discectomy and fusion (ACDF), posterior cervical decompression and fusion (PCDF), or decompression; evaluate the association between CESI receipt and 90-day postoperative complications; and determine characteristics of CESI associated with complications.

Summary of Background Data:

Previous literature has suggested that a preoperative CESI may increase the risk of postoperative complications. However, these studies were limited in the procedures and complications they evaluated.

Methods:

The IBM MarketScan database was queried for patients aged 18 years or older who underwent ACDF, PCDF, or cervical decompression for disc herniation, stenosis, radiculopathy, myelopathy, and/or spondylosis without myelopathy between January 1, 2014 and September 30, 2020. CESI receipt within 12 months preoperatively, injection characteristics, and postoperative complications were extracted. Multivariable logistic regression models were used to investigate associations between patient characteristics and receipt of CESI, receipt of a CESI and each 90-day postoperative complication, and CESI characteristics and each 90-day complication.

Results:

Among the unique patients who underwent each procedure, 20,371 ACDF patients (30.93%), 1259 (22.24%) PCDF patients, and 3349 (36.30%) decompression patients received a preoperative CESI. In all 3 cohorts, increasing age, increasing comorbidity burden, smoker status, and diagnosis of myelopathy were associated with decreased odds of preoperative CESI receipt, while female sex and diagnosis of radiculopathy and spondylosis without myelopathy were associated with increased odds. There were no meaningful between-group comparisons or significant associations between preoperative CESI receipt and any 90-day postoperative complications in multivariable models (all P>0.05).

Conclusions:

This study elucidated the main determinants of CESI receipt and found no differences in the odds of developing 90-day postoperative complications, but did identify differential outcomes with regard to some injection characteristics.

Level of Evidence:

Level III.
Comparing withdrawal- and anxiety-like behaviors following oral and subcutaneous oxycodone administration in C57BL/6 mice
Authors: De Almeida Suzannah S. , Drinkuth Caryssa R. , Sartor Gregory C.
Published: June 2024

Excessive prescribing and misuse of prescription opioids, such as oxycodone, significantly contributed to the current opioid crisis. Although oxycodone is typically consumed orally by humans, parenteral routes of administration have primarily been used in preclinical models of oxycodone dependence. To address this issue, more recent studies have used oral self-administration procedures to study oxycodone seeking and withdrawal in rodents. Behavioral differences, however, following oral oxycodone intake versus parenteral oxycodone administration remain unclear. Thus, the goal of the current studies was to compare anxiety- and withdrawal-like behaviors using established opioid dependence models of either home cage oral intake of oxycodone (0.5 mg/ml) or repeated subcutaneous (s.c.) injections of oxycodone (10 mg/kg) in male and female mice. Here, mice received 10 days of oral or s.c. oxycodone administration, and following 72 h of forced abstinence, anxiety- and withdrawal-like behaviors were measured using elevated zero maze, open field, and naloxone-induced precipitated withdrawal procedures. Global withdrawal scores were increased to a similar degree following oral and s.c. oxycodone use, while both routes of oxycodone administration had minimal effects on anxiety-like behaviors. When examining individual withdrawal-like behaviors, mice receiving s.c. oxycodone exhibited more paw tremors and jumps during naloxone-induced precipitated withdrawal compared with oral oxycodone mice. These results indicate that both models of oxycodone administration are sufficient to elevate global withdrawal scores, but, when compared with oral consumption, s.c. oxycodone injections yielded more pronounced effects on some withdrawal-like behaviors.
Gender Differences in Quality of Bowel Preparation for Colonoscopy
Authors: Maida Marcello , Vitello Alessandro , Zullo Angelo , Ramai Daryl , Facciorusso Antonio , Vassallo Roberto
Published: June 2024

Objective:

Bowel cleansing is a key element for a quality colonoscopy. Despite recent advances, not all predictors of successful cleansing are fully known. This post hoc analysis of an RCT aims to explore gender differences in bowel cleansing quality.

Methods:

The “OVER” trial was a multicenter phase-4 RCT including 478 patients randomized 1:1 to receive split-dose 1L polyethylene glycol plus ascorbate (PEG+ASC) or 4L-PEG. In this post hoc analysis, multivariable logistic regression models were designed to assess predictors of cleansing success (CS) and adenoma detection rate (ADR) by gender.

Results:

Of the 478 randomized patients, 50.2% were males and 49.8% females.

Overall, CS was comparable between females and males (87.1% vs 88.4, P = 0.6), whereas CS in the right (95.7% vs 90.9, P = 0.049) and transverse colon (98.6% vs 93.9, P=0.011) was significantly higher in females.

At multivariable regression analysis for CS outpatient setting (OR = 5.558) and higher withdrawal time (OR = 1.294) were independently associated with CS in females, whereas screening/surveillance indication (OR = 6.776) was independently associated with CS in males.

At multivariable regression analysis for ADR, running time <5 hours (OR = 3.014) and higher withdrawal time (OR = 1.250) were independently associated with ADR in females, whereas older age (OR = 1.040) and higher withdrawal time (OR = 1.093) were independently associated with ADR in males.

Conclusions:

This study showed different results in bowel preparation quality and different predictors of CS and ADR by gender. These findings suggest the need for further research to explore gender-specific approaches for bowel preparation.
Control rate of hyperthyroidism and its associated factors after prolonged use of anti-thyroid drugs in a hospital setting, Northwest Ethiopia
Authors: Mengesha Seyoum , Tadesse Abilo , Worku Biruk Mulat , Alamrew Kifle , Yesuf Tesfaye , Gedamu Yonas
Published: June 2024

Hyperthyroidism is increased synthesis and secretion of thyroid hormones by the thyroid gland resulting in thyrotoxicosis. The modality of therapy for hyperthyroidism includes anti-thyroid drugs, radioiodine and surgery. Anti-thyroid drugs are the only available therapy for hyperthyroid patients in developing world as radioiodine is inaccessible and surgical set up does not exist as required. The aim of this study was to determine the magnitude and predictors of uncontrolled hyperthyroidism among hyperthyroid patients after prolonged anti-thyroid drug use. An institutional-based cross sectional study was conducted at the University of Gondar hospital, Northwest Ethiopia, between April 1, 2022 and October 31, 2022. A consecutive sampling method was used to recruit 317 study subjects. Data were collected through a pre-designed questionnaire. Patients were interviewed to obtain socio-demographic data and relevant medical information. Laboratory analyses were done based on the follow up protocol. Data were entered into EPI Info version 4.6.0.0 (EPI Info, Atlanta) and analyzed in STATA version 14 (Stata Corp LP, Texas, USA). Binary logistic regression model was used to identify variables associated with uncontrolled hyperthyroidism among hyperthyroid patients. P value < .05 was used to declare significant association. A total of 317 patients with hyperthyroidism were included in the study. The median age of the study subjects was 45 years (IQR 36–55 years). Most (95%) of the study participants were females. Toxic multi-nodular goiter was the most common cause of hyperthyroidism (92%), followed by toxic adenoma (5%) and Graves’ disease (2%). On multivariate binary logistic regression, large goiter size (AOR: 3.163, 95% CI [1.333–7.506]), severe disease (AOR: 2.275, 95% CI [1.060–4.880]), infrequent iodinated salt intake (AOR: 3.668, 95% CI [1.245–10.802]), and poor adherence to anti-thyroid drug (AOR:15.724, 95% CI [5.542–44.610]) were statistically significant with uncontrolled hyperthyroidism at 12 months of anti-thyroid drug intake. A quarter of patients with hyperthyroidism didn’t achieve euthyroid state after 12 months of anti-thyroid drug use. The identified predictors for non-euthyroid state were large goiter size, severe disease, infrequent iodinated salt intake, and poor adherence to anti-thyroid drug.
Metabolic syndrome and its association with physical activity in Sudanese early adolescents – Khartoum state, Sudan: An observational study
Authors: Elfaki Fatima A. , Mukhayer Aziza I. G. , Moukhyer Mohamed E. , Chandika Rama M. , Khalafalla Husameldin E. , Kremers Stef P. J.
Published: June 2024

The growing prevalence of overweight/obesity in adolescents highlights the significance of studying metabolic syndrome (MetS) in increasingly sedentary adolescents. To date, no study in Sudan has examined the association between MetS and physical activity (PA) among adolescents. This study aimed to assess the association between MetS and its components and PA among Sudanese early adolescents. A cross-sectional assessment was conducted from to 2018 to 2019 on a sample of 921 primary school students from Khartoum State, Republic of Sudan. MetS was defined according to the International Diabetes Federation criteria and a standardized questionnaire was used to assess PA. Metabolic equivalents of task were calculated, and levels of different intensities of PA (tertiles) were identified accordingly. The association between PA and MetS and its components was assessed using a logistic regression model. The participants comprised 388 boys and 533 girls with a mean age of 12.59 ± 1.21 years. The prevalence of MetS was significantly higher in subjects in the 1st PA tertile (least active) than in the 2nd and 3rd (most active) tertiles of PA, and this difference was observed in both boys and girls. After adjusting for other study factors, the odds of MetS among adolescents in the 1st PA tertile were 7 times higher than those in the highest PA tertile (adjusted odds ratio = 7.01, 95% confidence interval: 1.48, 32.99). A physically inactive lifestyle was associated with higher odds of MetS and its components, especially waist circumference and triglyceride levels, in Sudanese early adolescents. This study highlights the importance of promoting PA in this age group.
Prediction of gait recovery using machine learning algorithms in patients with spinal cord injury
Authors: Yoo Hyun-Joon , Koo Bummo , Yong Chan-woo , Lee Kwang-Sig
Published: June 2024

With advances in artificial intelligence, machine learning (ML) has been widely applied to predict functional outcomes in clinical medicine. However, there has been no attempt to predict walking ability after spinal cord injury (SCI) based on ML. In this situation, the main purpose of this study was to predict gait recovery after SCI at discharge from an acute rehabilitation facility using various ML algorithms. In addition, we explored important variables that were related to the prognosis. Finally, we attempted to suggest an ML-based decision support system (DSS) for predicting gait recovery after SCI. Data were collected retrospectively from patients with SCI admitted to an acute rehabilitation facility between June 2008 to December 2021. Linear regression analysis and ML algorithms (random forest [RF], decision tree [DT], and support vector machine) were used to predict the functional ambulation category at the time of discharge (FAC_DC) in patients with traumatic or non-traumatic SCI (n = 353). The independent variables were age, sex, duration of acute care and rehabilitation, comorbidities, neurological information entered into the International Standards for Neurological Classification of SCI worksheet, and somatosensory-evoked potentials at the time of admission to the acute rehabilitation facility. In addition, the importance of variables and DT-based DSS for FAC_DC was analyzed. As a result, RF and DT accurately predicted the FAC_DC measured by the root mean squared error. The root mean squared error of RF and the DT were 1.09 and 1.24 for all participants, 1.20 and 1.06 for those with trauma, and 1.12 and 1.03 for those with non-trauma, respectively. In the analysis of important variables, the initial FAC was found to be the most influential factor in all groups. In addition, we could provide a simple DSS based on strong predictors such as the initial FAC, American Spinal Injury Association Impairment Scale grades, and neurological level of injury. In conclusion, we provide that ML can accurately predict gait recovery after SCI for the first time. By focusing on important variables and DSS, we can guide early prognosis and establish personalized rehabilitation strategies in acute rehabilitation hospitals.
Role of scalp nerve block in improving the quality of rehabilitation in patients after meningioma resection: A randomized controlled clinical trial
Authors: Zhang Yongguo , He Kai , Chen Lvlv , Ji Kuiquan , Zhang Zhongwei , Wang Weijun
Published: June 2024

Background:

In this study, we analyzed whether scalp nerve block with ropivacaine can improve the quality of rehabilitation in patients after meningioma resection.

Methods:

We included 150 patients who were undergoing craniotomy in our hospital and categorized them into 2 groups – observation group (patients received an additional regional scalp nerve block anesthesia) and control group (patients underwent intravenous general anesthesia for surgery), using the random number table method approach (75 patients in each group). The main indicator of the study was the Karnofsky Performance Scale scores of patients at 3 days postoperatively, and the secondary indicator was the anesthesia satisfaction scores of patients after awakening from anesthesia. The application value of different anesthesia modes was studied and compared in the 2 groups.

Results:

Patients in the observation group showed better anesthesia effects than those in the control group, with significantly higher Karnofsky Performance Scale scores at 3 days postoperatively (75.02 vs 66.43, P < .05) and anesthesia satisfaction scores. Compared with patients in the control group, patients in the observation group had lower pain degrees at different times after the surgery, markedly lower dose of propofol and remifentanil for anesthesia, and lower incidence of adverse reactions and postoperative complications. In addition, the satisfaction score of the patients and their families for the treatment was higher and the results of all the indicators were better in the observation group than in the control group, with statistically significant differences (P < .05).

Conclusion:

Scalp nerve block with ropivacaine significantly improves the quality of short-term postoperative rehabilitation in patients undergoing elective craniotomy for meningioma resection. This is presumably related to the improvements in intraoperative hemodynamics, relief from postoperative pain, and reduction in postoperative nausea and vomiting.
Effect of herbal medicine on postoperative nausea and vomiting after laparoscopic surgery: A systematic review and meta-analysis
Authors: Ha Na-Yeon , Park Mu-Jin , Ko Seok-Jae , Park Jae-Woo , Kim Jinsung
Published: June 2024

Background:

Traditionally, herbal medicines have been used to alleviate nausea and vomiting; however, a comprehensive clinical evaluation for postoperative nausea and vomiting (PONV), especially after laparoscopic surgery, remains limited. This review aimed to evaluate the efficacy and safety of herbal medicine as an alternative therapy to prevent and manage nausea and vomiting after laparoscopic surgery compared with untreated, placebo, and Western medicine groups.

Methods:

We searched 11 databases, including EMBASE, PubMed, and the Cochrane Library, to collect randomized controlled trials (RCTs) of herbal medicines on PONV after laparoscopic surgery on July 7, 2022. Two independent reviewers screened and selected eligible studies, extracted clinical data, and evaluated the quality of evidence using the Cochrane risk-of-bias tool. The primary outcome was the incidence of PONV, whereas the secondary outcomes included the frequency and intensity of PONV, symptom improvement time, antiemetic requirement frequency, and incidence of adverse events. Review Manager Version 5.3. was used for the meta-analysis.

Results:

We identified 19 RCTs with 2726 participants comparing herbal medicine with no treatment, placebo, and Western medicine. The findings showed that compared with no treatment, herbal medicine demonstrated significant effects on vomiting incidence (risk ratio [RR] = 0.43, 95% confidence interval [CI] 0.32–0.57, P < .00001). Compared with placebo, herbal medicine revealed a significant effect on the severity of nausea 12 hours after laparoscopic surgery (standardized mean difference = −2.04, 95% CI −3.67 to −0.41, P = .01). Herbal medicines showed similar effects with Western medicine on the incidence of postoperative nausea (RR = 0.94, 95% CI 0.63–1.42, P = .77) and vomiting (RR = 0.68, 95% CI 0.25–1.84, P = .45). Furthermore, comparing the experimental group containing herbal medicine and control group excluding herbal medicine, adverse events were considerably lower in the group with herbal medicine (RR = 0.45, 95% CI 0.27–0.72, P = .001).

Conclusion:

Herbal medicine is an effective and safe treatment for nausea and vomiting secondary to laparoscopic surgery. However, the number of studies was small and their quality was not high; thus, more well-designed RCTs are warranted in the future.
Staged treatment with arterial reconstruction and flap transplantation for ischemic mangled extremity: An observational study
Authors: Lee Young-Keun , Jeon Mooheon , Ho Ji-Woong
Published: June 2024

Patients with traumatic ischemic mangled extremities first undergo arterial reconstruction using autogenous vein grafts, followed by flap transplantation as a staged treatment for soft tissue reconstruction. This study aimed to report the outcomes of such a staged treatment. Thirteen patients underwent arterial reconstruction between February 2015 and April 2017 due to damage to the major blood vessels by the traumatic mangled extremities. Of them, 6 patients (5 males and 1 female with a mean age of 51 years, age range: 36–60 years) who underwent soft tissue reconstruction due to necrosis were retrospectively analyzed. The average Mangled Extremity Severity Score was 7.2 (range, 6–8). Injuries were found in the lower leg (4 cases), foot (1 case), and wrist and hand (1 case). Arterial reconstruction was performed using autologous venous grafts. The reconstructed arteries included the posterior tibial artery (3 cases), anterior tibial artery (1 case), dorsalis pedis artery (1 case), and radial artery (1 case). The blood circulation status of the reconstructed blood vessels was assessed using computed tomography angiography at an average of 5 weeks (range, 4–6 weeks) after arterial reconstruction. For some necrotic soft tissues, debridement and flap transplantation were performed an average of 7 weeks (range, 6–8 weeks) after arterial reconstruction. Soft tissue reconstruction was performed with an anterolateral thigh free flap in 4 cases, a local flap in 1 case, and a muscle flap in 1 case. In 5 out of 6 cases, blood circulation was maintained in the reconstructed blood vessels, resulting in the salvaging of the extremities. All the patients who underwent flap surgery survived. Notably, there were no special complications during a follow-up visit conducted at an average of 19 months post-reconstruction. To treat an ischemic mangled extremity, the limbs should first be salvaged with arterial reconstruction, followed by subsequent appropriate flap surgery when soft tissue necrosis occurs at the mangled site as a staged treatment.
Inflammatory bowel disease and breast cancer: A two-sample bidirectional Mendelian randomization study
Authors: Guo Zihao , Xu Changyu , Fang Zhihao , Yu Xiaoxiao , Yang Kai , Liu Changxu , Ning Xinwei , Dong Zhichao , Liu Chang
Published: June 2024

There is a correlation between IBD and breast cancer according to previous observational studies. However, so far there is no evidence to support if there is a causal relationship between these 2 diseases. We acquired comprehensive Genome-Wide Association Study (GWAS) summary data on IBD (including ulcerative colitis [UC] and Crohn disease [CD]) as well as breast cancer of completely European descent from the IEU GWAS database. The estimation of bidirectional causality between IBD (including UC and CD) and breast cancer was achieved through the utilization of 2-sample Mendelian randomization (MR). The MR results were also assessed for any potential bias caused by heterogeneity and pleiotropy through sensitivity analyses. Our study found a bidirectional causal effect between IBD and breast cancer. Genetic susceptibility to IBD was associated with an increased risk of breast cancer (OR = 1.053, 95% CI: 1.016–1.090, P = .004). Similarly, the presence of breast cancer may increase the risk of IBD (OR = 1.111, 95% CI: 1.035–1.194, P = .004). Moreover, the bidirectional causal effect between IBD and breast cancer can be confirmed by another GWAS of IBD. Subtype analysis showed that CD was associated with breast cancer (OR = 1.050, 95% CI: 1.020–1.080, P < .001), but not UC and breast cancer. There was a suggestive association between breast cancer and UC (OR = 1.106, 95% CI: 1.011–1.209, P = .028), but not with CD. This study supports a bidirectional causal effect between IBD and breast cancer. There appear to be considerable differences in the specific associations of UC and CD with AD. Understanding that IBD including its specific subtypes and breast cancer constitute common risk factors can contribute to the clinical management of both diseases.
The expression and clinical significance of UHRF1 in soft tissue sarcomas and its prognostic value
Authors: Shu Qiang , Liu XiaoLing , Xiang Xing , Bo Xu
Published: June 2024

To explore the expression and prognostic value of UHRF1 gene in soft tissue sarcoma (STS) and its related molecular mechanism. The expression data and clinicopathological parameters of STS were downloaded from the Cancer Genome Atlas (TCGA). The expression level of UHRF1 in STS and adjacent tissues and its relationship with clinicopathological characteristics were analyzed. The expression level of UHRF1 in STS tissues was significantly higher than that in paracancerous tissues (P < .001), and the overall survival (OS) time of patients with high UHRF1 expression was significantly shorter than that of patients with low UHRF1 expression (P = .002). The expression of UHRF1 was correlated with tumor necrosis, histological type and metastasis, and the differences were statistically significant (P = .013; P = .001; P = .002). The area ratio under receiver operating characteristic (ROC) curve between STS tissue and adjacent tissue of UHRF1 expression was 0.994. Number of tumors (HR = 0.416, 95%CI = 0.260–0.666, P < .001), depth of tumor (HR = 2.888, 95%CI = 0.910–9.168, P = .033), metastasis (HR = 2.888, 95% CI = 1.762–4.732, P < .001), residual tumor (HR = 2.637, 95% CI = 1.721–4.038, P < .001) and UHRF1 expression (HR = 1.342, 95% CI = 1.105–1.630, P = .003) were significantly associated with OS, and high expression of UHRF1 (HR = 1.387, 95%CI = 1.008–1.907, P = .044) was an independent risk factor for the prognosis of STS patients. The results of the nomogram exhibited that UHRF1 expression level had a significant effect on the total score value. GSEA enrichment analysis suggested that UHRF1 was involved in 14 signaling pathways regulating mRNA spliceosome, cell cycle, P53 signaling pathway were identified. Single sample gene set enrichment analysis (ssGSEA) exhibited that the expression of UHRF1 in STS was positively correlated with the level of Th2 cell infiltration, and negatively correlated with plasmacytoid dendritic cells (pDC), natural killer cells (NK), Eosinophils, Mast cells, etc. UHRF1 expression is involved in the immune microenvironment of HCC and affects the occurrence and development of HCC. UHRF1 is highly expressed in STS tissues. It is involved in the regulation of multiple tumor-related signaling pathways and immune cell microenvironment, suggesting that UHRF1 may be a potential molecular marker for prognosis prediction and targeted therapy of STS patients.
Intervention for work–family conflict and work deviance behavior among female workers in Tourism, Museum, Art Gallery Exhibition Centers: Implications for sustainable Tourism development intervention study
Authors: Ejikeme Joy Nneka Uchenye , Ede Moses Onyemaechi , Mawila Daphney , Oneli Joy Obiageli
Published: June 2024

Background:

This study was motivated due to psychological exhaustion, demands, and conflict degenerating from the work environment and family responsibilities facing career female workers. These roles and expectations have posed serious dilemmas to female populations in workplaces. Leaving them untreated is risky and could lead to severe psychological disturbances. Based on these, this study investigated the effect of the occupation health model of Rational Emotive Behaviour Therapy on work–family conflict and work-deviant behavior among female workers in Tourism, Museum, Art Gallery and Exhibition Centers in Enugu State.

Methods:

A randomized control design was used. A total of 119 female workers were randomized into intervention and control groups, measured at 3 points (pretest, posttest, and follow-up test), and the data collected were analyzed using repeated measure statistics.

Results:

The finding showed that the intervention is significantly effective in reducing the work–family conflict and work deviance behavior among female workers in Tourism, Museum, and Art Gallery Exhibition Centers. Nonetheless, the findings show that the gender and time interaction effects did not significantly affect the work–family conflict and work deviance behavior scores of the workers. The follow-up stage improved the intervention’s favorable impact on the reduction of work–family conflict and work-deviant behaviors.

Conclusion:

This suggest that occupation health model of Rational Emotive Behaviour Therapy has significant impact in reducing and changing female workers’ perceptions of work–family conflict and work deviant behaviors.
Efficacy and safety of electroacupuncture for urinary retention: A systematic review and meta-analysis
Authors: Xu Hanyu , Wu Linna , Ba Te , Niu Liqing , Zhang Yuan , Zhao Xiaofeng
Published: June 2024

Background:

Electroacupuncture (EA) is considered as an effective treatment for urinary retention (UR).

Methods:

Up to April 7, 2023, randomized controlled trials (RCTs) of EA for UR were extensively searched in 8 databases, including Pubmed, Cochrane, Embase, Web of Science, Chinese Biomedical Literature Database, Chinese Journal Full-text Database, Wanfang Data, and VIP Full-text e-Journals Database. The Cochrane Risk of Bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) were utilized to evaluate the quality of all included RCTs. Meta-analysis was conducted using Stata 15.0 software.

Results:

A total of 23 trials were included, and the meta-analysis results suggested that compared with the control group, EA can effectively treat various types of UR (risk ratio [RR] = 1.22, 95CI%: 1.14, 1.31) and promote bladder function recovery, with a significant reduce in residual urine volume (weighted mean differences [WMD] = −49.60, 95CI%: −64.10, −35.11), an increase in maximum bladder capacity (WMD = 47.00, 95CI%: 12.76, 81.24), a shorten in the first urination time (standardized mean difference [SMD] = −1.42, 95CI%: −2.08, −0.76), and less adverse reactions (RR = 0.21, 95CI%: 0.07, 0.65).

Conclusion:

EA has significant advantages in treating UR, but the efficacy and safety are still needed to be further verified through large-sample and high-quality RCTs.
Does subclinical hypothyroidism affect the prognosis of patients with chronic systolic heart failure: A systematic review and meta-analysis
Authors: Han Xiao , Wang Xiuge
Published: June 2024

Background:

Chronic systolic heart failure (CSHF) is a significant health burden with high morbidity and mortality. The role of subclinical hypothyroidism (SCH) in the prognosis of CSHF patients remains a critical area of inquiry. This systematic review and meta-analysis aim to elucidate the impact of SCH on the prognosis of patients with CSHF.

Methods:

Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this meta-analysis employed a comprehensive search strategy across major databases including PubMed, Embase, Web of Science, and the Cochrane Library. The Patient, Intervention, Comparison, Outcome framework guided the inclusion of studies focusing on patients with CSHF, comparing those with and without SCH. Quality assessment was performed using the Newcastle–Ottawa scale. Statistical analyses assessed heterogeneity and publication bias, employing fixed-effect or random-effects models based on heterogeneity levels.

Results:

From an initial pool of 1439 articles, 8 studies met the stringent inclusion criteria. These studies, conducted across diverse geographical regions, highlighted the relationship between SCH and all-cause mortality, cardiac events, and subgroup differences in CSHF patients. The meta-analysis revealed SCH as a significant risk factor for all-cause mortality (HR = 1.42) and cardiac events (HR = 1.46). Subgroup analysis indicated variability in risk based on region, sample size, age, and follow-up duration. Sensitivity analysis confirmed the stability of these findings, and publication bias assessment indicated symmetric funnel plot and nonsignificant Egger test results.

Conclusions:

SCH emerges as a predictive factor for all-cause mortality, cardiovascular events, and rehospitalization in CSHF patients. This finding underscores the importance of screening for SCH in CSHF patients, highlighting its potential role in improving patient prognosis.