bluuebunny/crossref_metadata_2025 huggingface dataset:
The first low-mass eclipsing binary within the fully convective zone from TMTS
Authors: Liu Cheng , Wang Xiaofeng , Zhang Xiaobing , Kovalev Mikhail , Lin Jie , Xi Gaobo , Mo Jun , Li Gaici , Peng Haowei , Li Xin , Xia Qiqi , Iskandar Abdusamatjan , Zeng Xiangyun , Wang Letian , Zhu Liying , Song Xuan , Guo Jincheng , Jiang Xiaojun , Yan Shengyu , Zhang Jicheng
Published: May 2024

We present a comprehensive photometric and spectroscopic analysis of the short-period (∼5.32 h) and low-mass eclipsing binary TMTSJ0803 discovered by Tsinghua-Ma Huateng Telescope for Survey (TMTS). By fitting the light curves and radial velocity data with the Wilson–Devinney code, we find that the binary is composed of two late spotted active M dwarfs below the fully convective boundary. This is supported by the discovery of a significant Balmer emission lines in the LAMOST spectrum and prominent coronal X-ray emission. In comparison with the typical luminosity of rapidly rotating fully convective stars, the much brighter X-ray luminosity (LX/Lbol = 0.0159 ± 0.0059) suggests the stellar magnetic activity of fully convective stars could be enhanced in such a close binary system. Given the metallicity of [M/H] = − 0.35 dex as inferred from the LAMOST spectrum, we measure the masses and radii of both stars to be M1 = 0.169 ± 0.010 M⊙, M2 = 0.162 ± 0.016 M⊙, R1 = 0.170 ± 0.006 R⊙, and R2 = 0.156 ± 0.006 R⊙, respectively. Based on the luminosity ratio from the light-curve modelling, the effective temperatures of two components are also estimated. In comparison with the stellar evolution models, the radii, and effective temperatures of two components are all below the isochrones. The radius deflation might be mainly biased by a small radial velocity (RV) data or (and) a simple correction on RVs, while the discrepancy in effective temperature might be due to the enhanced magnetic activity in this binary.
Efficacy and safety of abatacept for systemic juvenile idiopathic arthritis: A systematic review
Authors: Nishimura Kenichi , Ishikawa Takashi , Okamoto Nami , Akamine Keiji , Inoue Natsumi , Irabu Hitoshi , Kato Kentaro , Keino Hiroshi , Kojima Masayo , Kubo Hiroshi , Maruyama Kazuichi , Mizuta Mao , Shabana Kosuke , Shimizu Masaki , Sugita Yuko , Takakuwa Yukiko , Takanashi Satoshi , Takase Hiroshi , Umebayashi Hiroaki , Umezawa Natsuka , Yamanishi Shingo , Yamazaki Kazuko , Yashiro Masato , Yasumi Takahiro , Mori Masaaki
Published: May 2024

Objectives

This systematic review assessed the efficacy and safety of abatacept in patients with systemic juvenile idiopathic arthritis (JIA).

Methods

Studies published between 2000 and 2021 were searched using PubMed, Embase, Cochrane, Ichushi-Web, and clinical trial registries. The risk of bias was assessed according to the manual for development clinical practice guidelines by Minds, a project to promote evidence-based medicine in Japan.

Results

Seven observational studies were included. American College of Rheumatology pediatric 30/50/70 responses at 3, 6, and 12 months were 64.8%/50.3%/27.9%, 85.7%/71.4%/42.9%, and 80.0%/50.0%/40.0%, respectively. Outcomes on systemic symptoms, joint symptoms, and activities of daily living were not obtained. No macrophage activation syndrome or infusion reaction occurred. Serious infection occurred in 2.6% of cases.

Conclusions

Abatacept improved the disease activity index. In addition, abatacept was as safe as interleukin-6 (IL-6) and IL-1 inhibitors. However, both the efficacy and safety data in this systematic review should be reviewed with caution because their quality of evidence is low or very low. Further studies are needed to confirm the efficacy and safety of abatacept for systemic JIA, especially its efficacy on joint symptoms.
Next generation sequencing technologies to address aberrant mRNA translation in cancer
Authors: Román Ángel-Carlos , Benítez Dixan A , Díaz-Pizarro Alba , Del Valle-Del Pino Nuria , Olivera-Gómez Marcos , Cumplido-Laso Guadalupe , Carvajal-González Jose M , Mulero-Navarro Sonia
Published: May 2024

In this review, we explore the transformative impact of next generation sequencing technologies in the realm of translatomics (the study of how translational machinery acts on a genome-wide scale). Despite the expectation of a direct correlation between mRNA and protein content, the complex regulatory mechanisms that affect this relationship remark the limitations of standard RNA-seq approaches. Then, the review characterizes crucial techniques such as polysome profiling, ribo-seq, trap-seq, proximity-specific ribosome profiling, rnc-seq, tcp-seq, qti-seq and scRibo-seq. All these methods are summarized within the context of cancer research, shedding light on their applications in deciphering aberrant translation in cancer cells. In addition, we encompass databases and bioinformatic tools essential for researchers that want to address translatome analysis in the context of cancer biology.
Medulloblastomas with ELP1 pathogenic variants: A weakly penetrant syndrome with a restricted spectrum in a limited age window
Authors: Guerrini-Rousseau Léa , Masliah-Planchon Julien , Filser Mathilde , Tauziède-Espariat Arnault , Entz-Werle Natacha , Maugard Christine M , Hopman Saskia M J , Torrejon Jacob , Gauthier-Villars Marion , Simaga Fatoumata , Blauwblomme Thomas , Beccaria Kevin , Rouleau Etienne , Dimaria Marina , Grill Jacques , Abbou Samuel , Claret Béatrice , Brugières Laurence , Doz François , Bouchoucha Yassine , Faure-Conter Cécile , Bonadona Valerie , Mansuy Ludovic , de Carli Emilie , Ingster Olivier , Legrand Clémentine , Pagnier Anne , Berthet Pascaline , Bodet Damien , Julia Sophie , Bertozzi Anne-Isabelle , Wilems Marjolaine , Maurage Claude-Alain , Delattre Olivier , Ayrault Olivier , Dufour Christelle , Bourdeaut Franck
Published: May 2024

Background

ELP1 pathogenic variants (PV) have been recently identified as the most frequent variants predisposing to Sonic Hedgehog (SHH) medulloblastomas (MB); however, guidelines are still lacking for genetic counseling in this new syndrome.

Methods

We retrospectively reviewed clinical and genetic data of a French series of 29 ELP1-mutated MB.

Results

All patients developed SHH-MB, with a biallelic inactivation of PTCH1 found in 24 tumors. Other recurrent alterations encompassed the TP53 pathway and activation of MYCN/MYCL signaling. The median age at diagnosis was 7.3 years (range: 3–14). ELP1-mutated MB behave as sporadic cases, with similar distribution within clinical and molecular risk groups and similar outcomes (5 y – OS = 86%); no unusual side effect of treatments was noticed. Remarkably, a germline ELP1 PV was identified in all patients with available constitutional DNA (n = 26); moreover, all tested familial trio (n = 11) revealed that the PVs were inherited. Two of the 26 index cases from the French series had a family history of MB; pedigrees from these patients and from 1 additional Dutch family suggested a weak penetrance. Apart from MB, no cancer was associated with ELP1 PVs; second tumors reported in 4 patients occurred within the irradiation fields, in the usual time-lapse for expected radiotherapy-induced neoplasms.

Conclusions

The low penetrance, the “at risk’ age window limited to childhood and the narrow tumor spectrum, question the actual benefit of genetic screening in these patients and their family. Our results suggest restricting ELP1 germline sequencing to patients with SHH-MB, depending on the parents” request.
Comparison of Tobacco Product Prices at Fort Liberty Army Installation and Surrounding Community Areas, 2021
Authors: Elliott Alison M , Kong Amanda Y , McGuirt Jared , Prentice-Dunn Hannah , Gougler-Reeves Krysta M , Little Melissa A , Ribisl Kurt M
Published: May 2024

Introduction

High rates of tobacco use persist in the U.S. military, with 18.4% of service members smoking cigarettes in 2018. The Department of Defense’s (DoD) 2017 policy required that tobacco retailers on military installations set tobacco product prices equal to the most common community price, including tax, but there is limited evidence confirming whether local retailers are adhering to this policy. We examined tobacco product pricing in tobacco retailers on- and off-post at the largest U.S. Army installation, Fort Liberty, and Cumberland County, North Carolina.

Aims and Methods

Between June and August 2021, we collected data on tobacco product availability, price, and promotions from retailers on Fort Liberty (n = 14) and a random sample of off-post retailers within 10 miles of installation gates (n = 52). We calculated the mode, mean, and median price of each product, plus the difference in these prices at on- and off-post retailers. We used Welch’s t-test to test differences in mean prices between on- versus off-post retailers.

Results

The mode, mean, and median prices of cigarette packs and cartons were lower on-post than off-post (eg, $0.51–$0.55 cheaper for Marlboro cigarette packs on-post). However, the mode, mean, and median prices of smokeless tobacco products and little cigars were higher on-post than off-post (eg, $0.82–$0.89 more costly for Swisher Sweets 2-packs on-post).

Conclusions

Results highlight the need for continued enforcement to ensure compliance with the 2017 DoD policy. Comprehensive policy action to reduce tobacco price disparities on- and off-post is critical to reducing high rates of tobacco use among service members.

Implications

Despite the implementation of the 2017 DoD pricing policy, some tobacco products remain cheaper at tobacco retailers on-post compared to off-post retailers. Our results highlight the need for greater routine surveillance to increase implementation of the policy—particularly for cigarettes—to reduce high rates of tobacco use among service members.
Attitudes and Exposure to Illicit Tobacco in England, 2022
Authors: Davies Nathan , Langley Tessa , Jayes Leah , Bains Manpreet , Brown Jamie , Arnott Deborah , Bogdanovica Ilze
Published: May 2024

Introduction

The United Kingdom has achieved reductions in illicit tobacco (IT) market size and share. However, there remains a 17.7% tobacco duty gap, contributing to health inequalities. In January 2024, the UK government announced a new strategy to control IT, along with provision of new funding.

Methods

A representative cross-sectional survey of adults in England ran in April 2022 to evaluate attitudes and exposure to IT. Tobacco smokers were asked questions about encounters with IT, while all participants answered questions on knowledge and perspectives on IT.

Results

Of 262 tobacco smokers, 18.3% (95% CI 13.8% to 23.6%) had come across IT in the past year. Men had four times the odds of encountering IT recently than women. Among 1767 adults responding to questions on IT, two-thirds agreed IT harmed children, and more than half agreed IT was linked to organized crime. Younger adults, smokers, and those in lower socioeconomic groups were less likely to agree IT was harmful.

Conclusions

Exposure to IT, especially among younger males, remains a concern. While most of the public acknowledge its harm, this is not universal, and some population groups are less likely to do so.

Implications

The study highlights persistent exposure to IT in England, especially among younger males, and varying perceptions of IT harm across socioeconomic groups. Tackling IT requires collaboration between health and enforcement agencies, independent of the tobacco industry’s influence. Strategies should include components that shift demand for IT and denormalize its presence in communities, particularly in lower socioeconomic areas with higher smoking prevalence.
Molecular dissection of the pseudokinase ZED1 expands effector recognition to the tomato immune receptor ZAR1
Authors: Diplock Nathan , Baudin Maël , Xiang Xincheng (Derek) , Liang Lung-Yu , Dai Weiwen , Murphy James M , Lucet Isabelle S , Hassan Jana A , Lewis Jennifer D
Published: May 2024

The highly conserved angiosperm immune receptor HOPZ-ACTIVATED RESISTANCE 1 (ZAR1) is a bacterial pathogen recognition hub that mediates resistance by guarding host kinases for modification by pathogen effectors. The pseudokinase HOPZ-ETI DEFICIENT 1 (ZED1) is the only known ZAR1-guarded protein that interacts directly with a pathogen effector, HopZ1a, from the bacterial pathogen Pseudomonas syringae, making it a promising system for rational design of effector recognition for plant immunity. Here, we conducted an in-depth molecular analysis of ZED1. We generated a library of 164 random ZED1 mutants and identified 50 mutants that could not recognize the effector HopZ1a when transiently expressed in Nicotiana benthamiana. Based on our random mutants, we generated a library of 27 point mutants and found evidence of minor functional divergence between Arabidopsis (Arabidopsis thaliana) and N. benthamiana ZAR1 orthologs. We leveraged our point mutant library to identify regions in ZED1 critical for ZAR1 and HopZ1a interactions and identified two likely ZED1-HopZ1a binding conformations. We explored ZED1 nucleotide and cation binding activity and showed that ZED1 is a catalytically dead pseudokinase, functioning solely as an allosteric regulator upon effector recognition. We used our library of ZED1 point mutants to identify the ZED1 activation loop regions as the most likely cause of interspecies ZAR1-ZED1 incompatibility. Finally, we identified a mutation that abolished ZAR1-ZED1 interspecies incompatibility while retaining the ability to mediate HopZ1a recognition, which enabled recognition of HopZ1a through tomato (Solanum lycopersicum) ZAR1. This provides an example of expanded effector recognition through a ZAR1 ortholog from a non-model species.
Who Can Tell Which Banks Will Fail?
Authors: Blickle Kristian , Brunnermeier Markus , Luck Stephan
Published: May 2024

We study the run on the German banking system in 1931 to understand whether depositors anticipate which banks will fail in a major financial crisis. We find that deposits decline by around 20% during the run. There is an equal outflow of retail and nonfinancial wholesale deposits from both failing and surviving banks. In contrast, we find that interbank deposits almost exclusively decline for failing banks. Our evidence suggests that banks are better informed about which fellow banks will fail. In turn, banks being informed allows the interbank market to continue providing liquidity even during times of severe financial distress.
Potential impact of European Medicines Agency measures to minimize risk of serious side effects on JAKi prescribing and utilization in the UK
Authors: Tian Zixing , Kearsley-Fleet Lianne , Galloway James , Watson Kath ,   BSRBR-RA Contributors Group, Lunt Mark , Hyrich Kimme L
Published: May 2024

Objective

Janus kinase inhibitors (JAKis) or targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) effectively treat rheumatoid arthritis (RA). However, due to safety concerns, the European Medicines Agency (EMA) published risk-minimization measures limiting JAKi prescription to certain at-risk patients unless no suitable alternative is available. This analysis included patients who had started their first-ever JAKi (before EMA measures were published) in a large national cohort study to investigate the potential impact of these measures on JAKi prescribing and utilization in the UK.

Method

RA patients starting first-ever JAKi therapy in BSRBR-RA between 13 February 2017 and 31 May 2022 were included. The percentages of patients meeting the EMA risk criteria were presented. For the at-risk patients, their previous numbers of distinct biologic (b) DMARD classes prescribed were described.

Result

A total of 1341 patients were included, and 80% (N = 1075) met ≥1 EMA risk criterion. Of those who met ≥1 risk criterion, 529 patients (49%) had received JAKi as their first or second b/tsDMARD class, whereas 299 (28%) had received ≥3 prior bDMARD classes.

Conclusion

Four-fifths of RA patients who had commenced a JAKi before the EMA advisory were considered ‘at-risk’, with prescribing only advised if there was no suitable alternative. Almost a third of those patients had already received ≥3 bDMARDs classes, and alternative therapies would be very limited for them; however, suitable alternatives might have existed for the remaining proportion, especially for those who received a JAKi as their first or second b/tsDMARD, and re-evaluation of the suitability of their treatment may be needed.
Legal Basis for the Application of the Principles of Legality and Justice in the System of Administrative Proceedings of the Republic of Kazakhstan
Authors: Abdrasulov Ermek , Akhmetov Yerik , Abdrasulova Aizhan , Tapakova Vilor , Mutalyapova Aiman
Published: May 2024

The purpose of the work is to study the principles of legality and justice in the practice of administrative proceedings of the Republic of Kazakhstan. For this, methods such as system and comparative analysis, logical analysis, deduction, induction, and formal-legal methods were used. During the implementation of the study, the significance, and role of legal principles in administrative justice in the Republic of Kazakhstan were investigated. After analysing the model of the transition of the countries of the former USSR to the system of administrative justice and the specifics of its implementation in Kazakhstan, it was concluded that the principles of legality and justice are legally fixed in the Administrative Procedure Code of the Republic of Kazakhstan. This article analyses the studies of both Kazakhstani and foreign scientists concerning the application of laws and principles in administrative proceedings. In addition, some aspects of improving the system of administrative justice in the context of legislative regulation of the application of legal principles are considered. The practical value of the results obtained is to provide recommendations that will have an impact on the activities of the administrative justice system of Kazakhstan and will allow it to be implemented more efficiently.
Effects of Trace Mineral Injections on Measures of Growth and Trace Mineral Status of Primiparous Cows and their Calves
Authors: Hernandez Gracia P , Ferreira Matheus F L , Santos Aline C R , Bohnert David , Ranches Juliana
Published: May 2024

The objective of this study was to evaluate the effects of injectable trace minerals (ITM) administrations at strategic moments in the beef cattle production cycle. At calving, 50 primiparous cows (Angus × Hereford) and their calves were randomly assigned to 1 of 2 treatments: 1) ITM: cattle assigned to the ITM treatment received an ITM injection at calving and a subsequent administration at breeding (cattle over 2 yr: 1.0 mL/90 kg body weight [BW]; calves: 1.0 mL/45 kg BW); or 2) Control: cattle assigned to the control treatment were administered with saline following the same procedure as the cattle assigned to the ITM treatment. Body weight, blood, and liver samples were collected from dams and calves at multiple time points to evaluate the growth and mineral status of cow–calf pairs. All variables were analyzed using the MIXED procedure of SAS. A treatment effect (P = 0.02) was observed for Cu liver concentration of primiparous cows at breeding. Cows assigned to ITM treatment had greater Cu status than cohorts assigned to Control treatment. No treatment effects were observed for the mineral status or growth of calves. The administration of ITM to primiparous cows enhanced Cu status when grazing Cu forages scarce of Cu.
T6SS and T4SS Redundantly Secrete Effectors to Govern the Virulence and Bacterial Competition in Pectobacterium PccS1
Authors: Che Shu , Sun Chen , Yang Liuke , Zhou Min , Xia Lingyan , Yan Jingyuan , Jiang Mengyi , Wang Jiaju , Wang Huan , Zhao Wenjun , Toth Ian , Hu Baishi , Guo Tao , Fan Jiaqin
Published: May 2024

Previous studies revealed that the type VI secretion system (T6SS) has an essential role in bacterial competition and virulence in many gram-negative bacteria. However, the role of T6SS in virulence in Pectobacterium atrosepticum remains controversial. We examined a closely related strain, PccS1, and discovered that its T6SS comprises a single-copy cluster of 17 core genes with a higher identity to homologs from P. atrosepticum. Through extensive phenotypic and functional analyses of over 220 derivatives of PccS1, we found that three of the five VgrGs could be classified into group I VgrGs. These VgrGs interacted with corresponding DUF4123 domain proteins, which were secreted outside of the membrane and were dependent on either the T6SS or type IV secretion system (T4SS). This interaction directly governed virulence and competition. Meanwhile, supernatant proteomic analyses with strains defective in the T6SS and/or T4SS confirmed that effectors, such as FhaB, were secreted redundantly to control the virulence and suppress host callose deposition in the course of infection. Notably, this redundant secretion mechanism between the T6SS and T4SS is believed to be the first of its kind in bacteria.
Safety of Magnetic Resonance Imaging in Orthopaedic Trauma Patients With External Fixation: A Two-Center Case Series
Authors: Borgida Jacob S. , Wagner Robert Kaspar , Wong Alice W. , Yee Seonghwan , Husseini Jad , Aneja Arun , Harris Mitchel B. , Ly Thuan V.
Published: May 2024

OBJECTIVES:

To report on adverse events during magnetic resonance imaging (MRI) in patients with external fixators.

METHODS:

 

Design:

Retrospective case series.

Setting:

Two Level 1 trauma centers.

Patient Selection Criteria:

Patients with external fixators on the appendicular skeleton or pelvis undergoing MRI between January 2005 and September 2023.

Outcome Measures and Comparisons:

Adverse events, defined as any undesirable event associated with the external fixator being inside or outside the MRI bore during imaging, including (subjective) heating, displacement or pullout of the external fixator, or early MRI termination for any reason.

RESULTS:

A total of 97 patients with 110 external fixators underwent at least one MRI scan with an external fixator inside or outside of the MRI bore. The median age was 51 years (interquartile range: 39–63) and 56 (58%) were male. The most common external fixator locations were the ankle (24%), knee (21%), femur (21%), and pelvis (19%). The median duration of the MRI was 40 minutes (interquartile range: 26–58), 86% was performed using 1.5-Tesla MRI, and 14% was performed using 3.0-Tesla MRI. Ninety-five percent of MRI was performed for the cervical spine/head. Two MRI scans (1.6%), one of the shoulder and one of the head and cervical spine, with the external fixator outside of the bore were terminated early because of patient discomfort. There were no documented events of displacement or pullout of the external fixator.

CONCLUSIONS:

These findings suggest that MRI scans of the (cervical) spine and head can be safely obtained in patients with external fixators on the appendicular skeleton or pelvis. Given the low numbers of MRI scans performed with the external fixator inside the bore, additional studies are necessitated to determine the safety of this procedure. The results from this study can aid orthopaedic surgeons, radiologists, and other stakeholders in developing local institutional guidelines on MRI scanning with external fixators in situ.

LEVEL OF EVIDENCE:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Immune checkpoint inhibition as a therapeutic strategy for HIV eradication: current insights and future directions
Authors: Lee Jina , Whitney James B.
Published: May 2024

Purpose of review

HIV-1 infection contributes substantially to global morbidity and mortality, with no immediate promise of an effective prophylactic vaccine. Combination antiretroviral therapy (ART) suppresses HIV replication, but latent viral reservoirs allow the virus to persist and reignite active replication if ART is discontinued. Moreover, inflammation and immune disfunction persist despite ART-mediated suppression of HIV. Immune checkpoint molecules facilitate immune dysregulation and viral persistence. However, their therapeutic modulation may offer an avenue to enhance viral immune control for patients living with HIV-1 (PLWH).

Recent findings

The success of immune checkpoint inhibitor (ICI) therapy in oncology suggests that targeting these same immune pathways might be an effective therapeutic approach for treating PLWH. Several ICIs have been evaluated for their ability to reinvigorate exhausted T cells, and possibly reverse HIV latency, in both preclinical and clinical HIV-1 studies.

Although there are very encouraging findings showing enhanced CD8+ T-cell function with ICI therapy in HIV infection, it remains uncertain whether ICIs alone could demonstrably impact the HIV reservoir. Moreover, safety concerns and significant clinical adverse events present a hurdle to the development of ICI approaches. This review provides an update on the current knowledge regarding the development of ICIs for the remission of HIV-1 in PWH. We detail recent findings from simian immunodeficiency virus (SIV)-infected rhesus macaque models, clinical trials in PLWH, and the role of soluble immune checkpoint molecules in HIV pathogenesis.
Strip Harvesting Follicular Unit Transplantation Versus Follicular Unit Excision: Comparing the Number of Hairs and the Ratio of Hairs to Follicular Unit
Authors: Takata Pontes Luciana , Ruston Antonio , de Moraes Aparecida Machado
Published: May 2024

BACKGROUND

There are 2 extraction techniques for follicular units (FUs) in hair transplantation: strip harvesting follicular unit transplantation (FUT) and follicular unit excision (FUE). Currently, no extant studies have demonstrated that one technique is superior in extraction and donor area optimization for a dense result.

OBJECTIVE

This study compares the FUT and FUE techniques by evaluating the percentage of FUs with 3 or more hairs and the hairs-to-follicular-unit ratio in patients who underwent both procedures at different times.

MATERIALS AND METHODS

The medical records of patients who underwent at least 1 FUT procedure and at least 1 FUE procedure (with this being the second surgical procedure) were reviewed. The surgeries were performed in the same clinic with the same surgeon and surgical team.

RESULTS

There was a higher percentage of FUs with 3 or more hairs and a higher hairs-to-follicular-unit ratio with the FUE technique than with the FUT technique.

CONCLUSION

In FUE, surgeons tend to choose better-looking FUs with thick, plentiful hairs. Even with these results, it is impossible to declare one procedure superior because the correct indication considers multiple factors.
Three-dimensional Simulation on Patient-reported Outcomes Following Oncoplastic and Reconstructive Surgery of the Breast: A Randomized Trial
Authors: Kuroda Flávia , Urban Cícero A. , Dória Maíra , Rabinovich Íris , Spautz Cleverton , Lima Rubens , Schunemann Eduardo , Furlan Karina Anselmi , Nissen Leonardo , Fornazari Alessandra C. , Soares Isabela , Sobreiro Bernardo , Lourenço Mateus , Loureiro Marcelo
Published: May 2024

Background:

Three-dimensional (3D) imaging using computer simulations is an evolving technology. There is a lack of strong data on the use of this technology for oncoplastic (OP) and reconstructive surgery.

Methods:

A prospective, randomized, single-center trial including breast cancer patients undergoing OP or mastectomy with immediate breast reconstruction with implant (IBR) enrolled from November 2019 to October 2021 at the Hospital Nossa Senhora das Graças, Breast Unit in Curitiba, Brazil. Both patients undergoing OP and those in the IBR group were randomized to undergo 3D imaging and simulation of postoperative results (intervention group) or 3D imaging without simulation (control group). All patients were invited to complete a patient-reported outcome (BREAST-Q) expectations module and breast reconstruction or reduction/mastopexy module before and 6 months after surgery.

Results:

A total of 96 patients were enrolled. Sixty-nine patients (45 OP and 24 IBR) completed the pre- and postoperative questionnaires and were randomized for the simulation. Women in the OP group had higher expectations for breast appearance when clothed than those in the IBR implant group (93.4 ± 16.3 versus 82.9 ± 26.5; P = 0.03). The intervention group was more satisfied with information than the control group (P = 0.021). Both patients who underwent OP and IBR believed that the 3D simulation helped them understand the surgical process (86.6% and 75%, respectively).

Conclusions:

Preoperative 3D simulation significantly improved patient’s satisfaction with information and did not decrease postoperative satisfaction with the outcomes. The incorporation of preoperative 3D simulation may be a valuable tool in breast reconstruction.
Autologous Fat Grafting Air-valve Loading Technique
Authors: Garrett Harrison C. , Lam Thomas C.
Published: May 2024

Autologous fat transfer is fast becoming a common adjunct procedure in plastic surgical operations, especially in breast reconstruction. Postharvest fat processing can be performed actively or passively with various techniques. All techniques require the final step of loading the harvested fat into a syringe for injection. We describe here an innovative and elegant technique for safer and more efficient loading of the plunger back into the barrel of a fat-filled syringe before injection. This technique improves ease of loading, reduces loss of harvested fat, and eliminates the risk of bodily fluid splash.
Chinese text recognition and knowledge graph of Shen Nong Ben Cao Jing based on BERT pre-trained language models
Authors: Tong Lin , Tong Xu , Lei Lei , Zeng Ziling , Liu Sihong , Zhang Lei , Wang Cheng , Yang Hongjun , Zhang Huamin
Published: May 2024

Background:

The research and utilization of ancient traditional Chinese medicine (TCM) books are relatively limited at present. With the rapid development of artificial intelligence (AI), knowledge graph related technology has brought light on this field.

Objective:

To construct the knowledge graph of Shen Nong Ben Cao Jing, analyze basic knowledge of materia medica, explore implicit knowledge, and conduct visualization display, as well to provide methodological references for the study of ancient TCM books.

Methods:

The types of knowledge entities and relationships between entities in Shen Nong Ben Cao Jing were analyzed. A training corpus dataset was produced by using the BIO sequence labeling method; a self-developed CNLP text labeling system was used for text labeling; the BERT model was used to recognize named entities; the relationships between entities were set based on rules and semantic associations; the data into the Neo4j-community 4.4.9 graph database was imported by using Cypher language for storage and visualization display after knowledge fusion; finally, a knowledge graph was constructed.

Results:

The knowledge graph of Shen Nong Ben Cao Jing included 5, 273 nodes and 11, 064 relationships. The schema layer contained 14 entity types and 15 relationship types. Through the query, knowledge can be visualized from the aspects of classification, property, and seven mutual relationships of herbal combination.

Conclusion:

The knowledge graph constructed in this study directly reflects the knowledge recorded in Shen Nong Ben Cao Jing and the relationship between them, which is suitable for knowledge mining and intuitive multi-dimensional display of ancient TCM books.
Costs of Forced Retirement
Authors: Voss Maren Wright , Hung Man , Li Wei , Richards Lorie Gage , Price Pollie , Terrill Alexandra , Barrett Tyson
Published: May 2024

Objective

Unemployment is a known health stressor that also increases early retirements. This study addresses mixed literature on retiree health and underreporting of forced retirement to better identify potential health impacts of lost work opportunity.

Methods

A Lost-work Opportunity Score (LOS) was created using variables from the Health and Retirement Study assessing unemployment, forced retirement, and earlier-than-planned retirement for 2576 respondents. Reliability and unidimensionality of the score with multivariate regression analyses examined health impacts controlling for demographics and prior health status.

Results

The LOS possessed unidimensionality with a Cronbach’s alpha of a = 0.76 while predicting self-reported health declines (LOS = 2; β = 0.381, OR = 1.464, P < 0.05) and depression increase (LOS = 2; β = 0.417, OR = 1.517, P < 0.05).

Conclusions

LOS predicts 46% increased odds of negative self-reported health change after retirement associated with two LOS events, with implications to support aging workers.
Endobronchial Phenylephrine in Airway Bleeding During Bronchoscopy Does not Cause Hypertension
Authors: Kim Jeremy , Phan Chinh , Adams Jason , Cortes-Puch Irene , Stocking Jacqueline C. , Liu Anna , Ren Yunyi , Taylor Sandra , Yoneda Ken Y.
Published: May 2024

Background:

Bleeding is a known complication during bronchoscopy, with increased incidence in patients undergoing a more invasive procedure. Phenylephrine is a potent vasoconstrictor that can control airway bleeding when applied topically and has been used as an alternative to epinephrine. The clinical effects of endobronchial phenylephrine on systemic vasoconstriction have not been clearly evaluated. Here, we compared the effects of endobronchial phenylephrine versus cold saline on systemic blood pressure.

Methods:

In all, 160 patients who underwent bronchoscopy and received either endobronchial phenylephrine or cold saline from July 1, 2017 to June 30, 2022 were included in this retrospective observational study. Intra-procedural blood pressure absolute and percent changes were measured and compared between the 2 groups.

Results:

There were no observed statistical differences in blood pressure changes between groups. The median absolute change between the median and the maximum intra-procedural systolic blood pressure in the cold saline group was 29 mm Hg (IQR 19 to 41) compared with 31.8 mm Hg (IQR 18 to 45.5) in the phenylephrine group. The corresponding median percent changes in SBP were 33.6 % (IQR 18.8 to 39.4) and 28% (IQR 16.8 to 43.5) for the cold saline and phenylephrine groups, respectively. Similarly, there were no statistically significant differences in diastolic and mean arterial blood pressure changes between both groups.

Conclusions:

We found no significant differences in median intra-procedural systemic blood pressure changes comparing patients who received endobronchial cold saline to those receiving phenylephrine. Overall, this argues for the vascular and systemic safety of phenylephrine for airway bleeding as a reasonable alternative to epinephrine.
Different extramedullary disease shown in chemokine receptor 4 targeted PET/CT with [68Ga]Ga-pentixafor in patients with Waldenström macroglobulinemia and smoldering disease
Authors: Pan Qingqing , Cao Xinxin , Li Jian , Li Fang , Luo Yaping
Published: May 2024

Introduction

It is important to distinguish Waldenström macroglobulinemia from smoldering Waldenström macroglobulinemia (sWM), because only patients with Waldenström macroglobulinemia require treatment, however the distinction can be clinically complex. The aim of this study is to investigate whether [68Ga]Ga-pentixafor PET/CT shows different characteristics in sWM and Waldenström macroglobulinemia patients and therefore can help to differentiate Waldenström macroglobulinemia and sWM.

Results

Thirty-seven patients with newly diagnosed Waldenström macroglobulinemia and 11 sWM patients were analyzed [35 men and 13 women; 64.3 ± 10.7 (range, 29–87) years old]. The SUVmax of bone marrow disease, lymph nodes, and other extramedullary diseases on [68Ga]Ga-pentixafor were significantly higher than those on 2-[18F]FDG PET/CT (P < 0.05). On [68Ga]Ga-pentixafor PET/CT, patients with Waldenström macroglobulinemia had more lymph node regions involved, significantly higher incidence of involvement in more than three lymph node regions, larger nodal disease, and higher incidence of other extramedullary disease when compared with sWM patients (P < 0.05). Waldenström macroglobulinemia patients showed significantly higher total lesions uptake, total lesion volume, and SUVmax of extramedullary disease than sWM patients did (P < 0.05). None of the visual or semiquantitative indexes in 2-[18F]FDG PET/CT showed significant difference between Waldenström macroglobulinemia and sWM patients.

Conclusion

[68Ga]Ga-pentixafor PET/CT had better diagnostic performance than 2-[18F]FDG PET/CT in Waldenström macroglobulinemia. Patients with Waldenström macroglobulinemia presented with more extensive extramedullary disease shown in [68Ga]Ga-pentixafor PET/CT than sWM patients did.
Unruptured tubal ectopic pregnancy concurrent with trophoblastic tissue spread to the rectum: a case report
Authors: Zabad Kareem , Tarakji Massa , Arafat Raghad , Al-Douni Yeser , Nakhleh Merry , Kurdi Bashar
Published: May 2024

Introduction and importance:

Ectopic pregnancy is a term used to describe pregnancies outside of the uterus. If ruptured, persistent trophoblastic tissue can be present at the site of an ectopic pregnancy, which is an unusual complication. In rare cases, the patients may present with primary implants.

Case presentation:

A 23-year-old woman who was pregnant for the first time complained of abdominal pain and was diagnosed with a 10-week tubal ectopic pregnancy. During laparotomy, trophoblastic implants were discovered in the rectum; however, the pregnancy did not rupture.

Clinical discussion:

The presented case report highlights a rare and late diagnosis of ectopic pregnancy in a 23-year-old primigravida woman with no known risk factors. The patient experienced sudden abdominal pain in the tenth week of gestation, leading to the surgical approach of salpingectomy. Notably, trophoblastic tissue was found in the rectum, indicating local invasion. It was then treated with methotrexate therapy. However, the low-resource setting in Syria limited the use of laparoscopy and resulted in the use of laparotomy.

Conclusion:

This case emphasizes the importance of considering trophoblastic implantation in the management plan for ectopic pregnancies, even in cases in which the pregnancy has not ruptured. It is crucial to evaluate all possible complications of this disease to ensure proper treatment and care of the patient.
Nutritional Science at the University of Illinois at Urbana-Champaign
Authors: Erdman John W. , Donovan Sharon M.
Published: May 2024

The University of Illinois at Urbana-Champaign (UIUC), the land-grant university for the State of Illinois, was founded in 1865, and education in nutrition was recorded as early as 1874. Herein, the contributions of the UIUC to research and graduate training in the field of nutrition are highlighted. Over the past 150 years, faculty members from many academic units have provided foundational nutrition research, including identifying the last essential amino acid, threonine, and establishing chemically defined amino acid diets for chicks, rats, dogs, and cats that led to establishing amino acid requirements for these species. Research on the adverse health effects of trans fatty acids supported their removal from the food system. UIUC has led in the area of functional foods for health, including plant bioactives, soy, and fiber. More recently, UIUC faculty have evaluated the interactions between dietary components and neurocognitive, microbiome, and health outcomes, including cancer. In 2020, the cross-campus Personalized Nutrition Initiative was launched to coordinate interdisciplinary research. The Division of Nutritional Sciences was established in 1968 as one of the country’s first interdisciplinary graduate training programs. The Division of Nutritional Sciences program has conferred over 580 degrees and has implemented innovations in graduate education, many supported by federal training grants and endowed awards and programs.
Characteristics of Intracranial Injuries in Pediatric Patients Following Blunt Head Trauma
Authors: Akie Thomas E. , Gupta Malkeet , Rodriguez Robert M. , Hendey Gregory W. , Wilson Jake L. , Quinones Alexandra K. , Mower William R.
Published: May 2024

Objectives

Pediatric head trauma is a frequent reason for presentation to the emergency department. Despite this, there are few reports on specific characteristics and injury patterns in head injured children. The goal of this study was to evaluate head injury patterns in children with blunt head injury and their prevalence by age group.

Methods

This is a planned secondary analysis of the NEXUS II Head CT validation study. Consecutive patients with blunt head trauma were enrolled between 2006 and 2015. Demographics and criteria from 2 clinical decision instruments (NEXUS and Canadian Head CT rules) were gathered at the time of enrollment. We abstracted and cataloged injuries for pediatric patients based on radiologist report. Frequencies of injuries and severity were analyzed by developmental age group.

Results

A total of 1018 pediatric patients were enrolled, 128 (12.6%) of whom had an injury on computed tomography scan. Median age was 11.9 (Interquartile range 4.5–15.5) for all patients and 12 (4.8–15.5) for injured patients. Of injured patients, 49 (38.3%) had a significant injury, and 27 (21.1%) received an intervention. Teenagers had the highest rate of significant injury (50%) and intervention (30%). Injuries were most frequently noted in the temporal (46.1%), frontal (45.3%), and parietal (45.3%) regions. Subarachnoid hemorrhage (29.7%) and subdural hematoma (28.9%) were the most common injuries observed.

Intraparenchymal hemorrhage and cerebral edema were more prevalent in older age groups. The most common injury mechanism overall was fall from height (24.7%). Motor vehicle accidents and nonmotorized wheeled vehicle accidents were more common in older patients.

Conclusions

Serious injuries requiring intervention were rarely encountered in pediatric patients experiencing blunt head trauma. Mechanisms of injury, type of injury, and rates of intervention varied between developmental age groups.
Implementation Barriers Encountered During a Universal Suicide Screening Program in Pediatric Emergency Departments
Authors: Seag Dana E. M. , Cervantes Paige E. , Narcisse Iriane , Wiener Ethan , Tay Ee Tein , Knapp Katrina , Horwitz Sarah McCue
Published: May 2024

Objective

Because understanding barriers to universal suicide risk screening in pediatric emergency departments (PEDs) may improve both identification and management of suicidal behaviors and ideation, this study assessed barriers to a quality improvement initiative examining the use of a novel computerized adaptive test (CAT), the Kiddie-CAT, in 2 PEDs.

Methods

Research assistants (RAs) trained in Rapid Assessment Procedures-Informed Clinical Ethnography methods documented barriers related to the environment, individuals, and workflow as encountered during screening shifts, categorizing the barriers' impacts as either general to a screening shift or related to screening an individual youth/caregiver dyad. Using thematic content analysis, investigators further categorized barriers based on type (eg, workflow, language/comprehension, clinician attitudes/behaviors) and relationship to the limited integration of this initiative into clinical protocols. Reasons for refusal and descriptive data on barriers are also reported.

Results

Individual screen barriers were most often related to workflow (22.9%) and youth/caregiver language/comprehension challenges (28%). Similarly, workflow issues accounted for 48.2% of all general shift barriers. However, many of these barriers were related to the limited integration of the initiative, as RAs rather than clinical staff conducted the screening.

Conclusions

Although this study was limited by a lack of complete integration into clinical protocols and was complicated by the COVID-19 pandemic impacts on PEDs, the findings suggest that considerable attention needs to be directed both to physician education and to workflow issues that could impede universal screening efforts.
Viral infections and inborn errors of immunity
Authors: Ewing Anne , Madan Rebecca Pellett
Published: May 2024

Purpose of review

The purpose of this focused review is to discuss unusual presentations of viral infections in the context of specific inborn errors of immunity. We will discuss hyper immunoglobulin E (IgE) syndromes, epidermodysplasia verruciformis, and X-linked agammaglobulinemia as examples of inborn errors of immunity associated with specific presentations of viral infection and disease.

Recent findings

Advances in both genetic and viral diagnostics have broadened our understanding of viral pathogenesis in the setting of immune dysfunction and the variable phenotype of inborn errors of immunity. Dedicator of cytokinesis 8 (DOCK8) deficiency is now recognized as an inborn error of immunity within the hyper IgE syndrome phenotype and is associated with unusually aggressive cutaneous disease caused by herpes simplex and other viruses. Studies of patients with epidermodysplasia verruciformis have proven that rarely detected human papillomavirus subtypes may cause malignancy in the absence of adequate host defenses. Finally, patients with X-linked agammaglobulinemia may remain at risk for severe and chronic viral infections, even as immune globulin supplementation reduces the risk of bacterial infection.

Susceptibility to viral infections in patients with inborn errors of immunity is conferred by specific, molecular defects. Recurrent, severe, or otherwise unusual presentations of viral disease should prompt investigation for an underlying genetic defect.
Pierre Robin Sequence: An Updated Evidence-Based Treatment Proposal
Authors: Gomez Oswaldo J. , Lopez Andrea , Gutierrez Esteban
Published: May 2024

Background:

The Pierre Robin sequence (PRS) is characterized by the presence of micrognathia, glossoptosis, and respiratory obstruction during the neonatal period, its prompt recognition allows to mitigate the associated morbidity and mortality. A diagnosis and treatment algorithm was previously proposed based on data from the literature to guide therapeutic efforts; therefore, it was proposed to carry out a new search for relevant evidence to update or complement it.

Methods:

A literature review of the subject was conducted in PubMed, Embase, and Cochrane databases, corresponding to the period between November 2016 and September 2021. Using the GRADE methodology, 38 articles from different clinical studies that discussed diagnostic tests or therapeutic approaches, directly or indirectly compared, were selected and evaluated.

Results:

After evaluating and analyzing the selected articles, the new information was incorporated into an updated algorithm according to the most recent evidence found for the diagnosis and comprehensive management of patients with PRS.

Conclusion:

To date, there is no consensus in the literature on the treatment of patients with PRS nor are there multicenter studies comparing different management modalities. The indications to proceed with surgical strategies do not present changes with respect to the previous article. Nutritional monitoring is the main objective, and the study of oral feeding is essential in all scenarios.