bluuebunny/crossref_metadata_2025 huggingface dataset:
Palisade cell geometry in relation to leaf optical and photosynthetic properties in Viburnum
Authors: Borsuk Aleca M , Randall Josh M , Richburg Jennifer , Montes Kyra G , Edwards Erika J , Brodersen Craig R
Published: December 2024

The optical properties of lobed palisade mesophyll cells remain poorly understood despite their presence in diverse taxa and the critical role of the palisade layer in leaf-light interactions and carbon assimilation. Using micro-computed tomography, 3D ray tracing simulations, and physiological experiments, we tested the interactions between palisade cell geometry, chloroplast localization, light directional quality, and leaf optical and photosynthetic performance in the model taxon Viburnum. Simulations showed that lobed cells shifted between absorptance- or transmittance-dominated states depending on chloroplast localization, irrespective of light directional quality. In contrast, columnar palisade optics were driven by light directional quality, with absorptance-dominated properties under diffuse light and transmittance-dominated properties under direct light, irrespective of chloroplast localization. Lobed palisade cells in planta were less densely packed yet more productive on a per cell basis than columnar palisade cells, resulting in interspecific conservation of maximum carbon assimilation rate per unit leaf tissue. For the Viburnum species studied, our results indicate a ‘many-to-one’ mapping of multiple palisade cell forms to a common rate of photosynthetic productivity per unit tissue. This work highlights the dynamic relationship between palisade mesophyll form and function and informs the anatomical basis of plant carbon assimilation.
Functional connectivity analyses of individual hippocampal subregions in major depressive disorder with electroconvulsive therapy
Authors: Sun Hui , Xu Dundi , Sun Qinyao , Bai Tongjian , Wang Kai , Wang Jiaojian , Zhang Jiang , Tian Yanghua
Published: December 2024

Background

The hippocampus has been widely reported to be involved in the neuropathology of major depressive disorder (MDD). All the previous researches adopted group-level hippocampus subregions atlas to investigate abnormal functional connectivities in MDD in absence of capturing individual variability. In addition, the molecular basis of functional impairments of hippocampal subregions in MDD remains elusive.

Objective

We aimed to reveal functional disruptions and recovery of individual hippocampal subregions in MDD patients before and after ECT and linked these functional connectivity differences to transcriptomic profiles to reveal molecular mechanism.

Methods

we used group guided individual functional parcellation approach to define individual subregions of hippocampus for each participant. Resting-state functional connectivity (FC) analysis of individual hippocampal subregions was conducted to investigate functional disruptions and recovery in MDD patients before and after ECT. Spatial association between functional connectivity differences and transcriptomic profiles was employed to reveal molecular mechanism.

Results

MDD patients showed increased FCs of the left tail part of hippocampus with dorsolateral prefrontal cortex and middle temporal gyrus while decreased FC with primary visual cortex. These abnormal FCs in MDD patients were normalized after ECT. In addition, we found that functional disruptions of the left tail part of hippocampus in MDD were mainly related to synaptic signaling and transmission, ion transport, cell-cell signaling and neurogenesis.

Conclusion

Our findings provide initial evidence for functional connectome disruption of individual hippocampal subregions and their molecular basis in MDD.
Believed Gender Differences in Social Preferences
Authors: Exley Christine L , Hauser Oliver P , Moore Molly , Pezzuto John-Henry
Published: December 2024

While there is a vast (and mixed) literature on gender differences in social preferences, little is known about believed gender differences in social preferences. Using data from 15 studies and 8,979 individuals, we find that women are believed to be more generous and more equality-oriented than men. This believed gender gap is robust across a wide range of contexts that vary in terms of strategic considerations, selfish motives, fairness concepts, and payoffs. Yet this believed gender gap is largely inaccurate. Consistent with models of associative memory, specifically the role of similarity and interference, the believed gender gap is correlated with recalled prior life experiences from similar contexts and significantly affected by an experience that may interfere with the recall process of prior memories, even though this interfering experience should not affect the beliefs of perfect-memory Bayesians. Application studies further reveal that believed gender differences extend to the household (i.e., beliefs about contributions to the home, family, and upbringing of children), the workplace (i.e., beliefs about equal pay), and policy views (i.e., beliefs about redistribution, equal access to education, healthcare, and affordable housing).
Semi-quantitative scoring criteria based on multiple staining methods combined with machine learning to evaluate residual nuclei in decellularized matrix
Authors: Zhong Meng , He Hongwei , Ni Panxianzhi , Huang Can , Zhang Tianxiao , Chen Weiming , Liu Liming , Wang Changfeng , Jiang Xin , Pu Linyun , Yuan Tun , Liang Jie , Fan Yujiang , Zhang Xingdong
Published: December 2024

The detection of residual nuclei in decellularized extracellular matrix (dECM) biomaterials is critical for ensuring their quality and biocompatibility. However, current evaluation methods have limitations in addressing impurity interference and providing intelligent analysis. In this study, we utilized four staining techniques—hematoxylin-eosin staining, acetocarmine staining, the Feulgen reaction and 4’,6-diamidino-2-phenylindole staining—to detect residual nuclei in dECM biomaterials. Each staining method was quantitatively evaluated across multiple parameters, including area, perimeter and grayscale values, to establish a semi-quantitative scoring system for residual nuclei. These quantitative data were further employed as learning indicators in machine learning models designed to automatically identify residual nuclei. The experimental results demonstrated that no single staining method alone could accurately differentiate between nuclei and impurities. In this study, a semi-quantitative scoring table was developed. With this table, the accuracy of determining whether a single suspicious point is a cell nucleus has reached over 98%. By combining four staining methods, false positives caused by impurity contamination were eliminated. The automatic recognition model trained based on nuclear parameter features reached the optimal index of the model after several iterations of training in 172 epochs. The trained artificial intelligence model achieved a recognition accuracy of over 90% for detecting residual nuclei. The use of multidimensional parameters, integrated with machine learning, significantly improved the accuracy of identifying nuclear residues in dECM slices. This approach provides a more reliable and objective method for evaluating dECM biomaterials, while also increasing detection efficiency.
A high polygenic risk score is associated with SSA/SSB antibody positivity and early onset in primary Sjögren’s disease
Authors: Fugmann Cecilia , Reid Sarah , Pucholt Pascal , Kvarnström Marika , Björk Albin , Mofors Johannes , Sjöwall Christopher , Eriksson Per , Olsson Peter , Mandl Thomas , Forsblad-d’Elia Helena , Magnusson Bucher Sara , Johnsen Svein Joar , Norheim Katrine Brække , Appel Silke , Hammenfors Daniel , Jensen Janicke Liaaen , Palm Øyvind , Omdal Roald , Jonsson Roland , Baecklund Eva , Wahren-Herlenius Marie , Leonard Dag , Imgenberg-Kreuz Juliana , Nordmark Gunnel
Published: December 2024

Objectives

To calculate a polygenic risk score (PRS) based on single nucleotide variants (SNVs) previously associated with primary Sjögren’s disease (SjD) with genome-wide significance and determine the genetic risk for SjD stratified by antibodies, sex and age at diagnosis.

Methods

Patients with SjD (n = 1065) were genotyped using Illumina OmniExpressExome chip. Control genotype data were available (n = 7742). Two PRSs were constructed, one including HLA gene variants (n = 21 SNVs), and one without HLA (n = 18 SNVs). High PRS quartile (Q4) individuals were compared with low PRS (Q1–3).

Results

A high PRS was associated with SSA antibody-positive SjD (OR 9.16, 95% CI 7.75–10.85, P = 3.7 × 10−146), and strengthened in SjD positive for both SSA/SSB antibodies (OR 13.67, 95% CI 10.88–17.32, P = 4.6 × 10−108). High PRS classified SSA/SSB antibody-positive SjD with very good accuracy (AUC 0.86). PRS without HLA showed a weaker association with SSA/SSB positive SjD (OR 2.09, 95% CI 1.71–2.55, P = 6.4 × 10−13). Antibody negative SjD displayed a PRS similar to controls. Patients in the high PRS quartile were significantly younger at diagnosis, 48.9 ± 14.9 vs 53.4 ± 13.4 years in the low PRS quartiles (Q1–3), P = 2.2 × 10−6, and presented higher frequencies of ANA, SSA and SSA/SSB antibodies, P < 1 × 10−5.

Conclusion

A high PRS is associated with SSA/SSB antibody positivity and early disease onset, both largely attributed to the weight of the HLA alleles. Integration of PRS with other biomarkers applied to clinical phenotypes could be a useful tool for disease risk stratification and treatment decisions.
Beyond continuous positive airway pressure for cardiovascular risk reduction in patients with obstructive sleep apnea
Authors: Healy William J , Kundel Vaishnavi , Taub Pam R , Cho Yeilim , Healy Sara J , Kwon Younghoon
Published: December 2024

An accumulating body of evidence suggests a bidirectional relationship between sleep and cardiovascular (CV) health. A high level of evidence has linked obstructive sleep apnea (OSA) with cardiovascular disease (CVD). Accordingly, clinical sleep medicine emphasizes the diagnosis and treatment of OSA in the context of promoting CV health. While continuous positive airway pressure (CPAP), the mainstay treatment for OSA, is effective in improving several sleep-related quality-of-life outcomes and leads to modest reductions in blood pressure, there is currently insufficient evidence to justify using CPAP alone for improving CVD outcomes in OSA. Sleep physicians are uniquely positioned to expand their focus beyond the evaluation of OSA and administering CPAP, in efforts to enhance the CV health of sleep patients. Herein, we suggest the role of sleep physicians as CV preventionists. Key focus areas for managing CV risk beyond CPAP therapy in OSA include identifying comorbid disorders that are vital for optimizing CV health. This involves risk-stratifying patients and providing appropriate counseling, referrals, and treatment as appropriate for comorbid sleep conditions such as insomnia and insufficient sleep, comorbid CV risk factors including hypertension, dyslipidemia, metabolic dysfunction-associated steatohepatitis, as well as counseling for weight management programs, smoking, and alcohol cessation. We urge sleep clinicians to play an active and integral role in optimizing the CV health of patients with sleep disorders.
Individual and clinical factors associated with patient acceptance of referrals to social services and community resources at a multi-purpose resource hub
Authors: Green Gabrielle , Flores Roxana , Barragan Noel C , Gonzalez Karla , Kuo Tony
Published: December 2024

Emerging evidence suggests that bi-directional communication and referral pathways, when employed strategically, can lead to favorable health outcomes by connecting patients with complex, multi-faceted health and social needs to appropriate services and resources. However, despite these benefits, patient acceptance of referrals via these pathways remains suboptimal. In this study, we describe individual and clinical factors associated with patient acceptance of these referrals. We extracted individual-level demographic and clinical data for patients referred primarily from a large safety-net health system to a multi-purpose resource hub co-located on the campus of its largest hospital, for the period October 2019 to June 2023. Descriptive statistics, Chi-square analyses, and multinomial regression modeling were performed to examine these data. Of 1865 patients in the study sample, 54.2% accepted a referral, 27.4% were lost to follow-up, and 18.4% declined. Most patients who accepted referrals were female (67.1%), Latino (81.5%), and had hypertension and/or prediabetes or diabetes (84.1%). In modeling analyses, those who accepted referrals tended to be female, and were referred from primary care clinics; many were referred for multiple service/resource categories. We found associations between patient acceptance of referrals and gender and source of referral. Drawing upon these results as well as experience implementing these systems, we propose several practical strategies for increasing successful referrals, including identifying and addressing barriers for patients who declined or were lost to follow-up; using standardized screening tools to routinely assess for multi-faceted health and social needs; increasing provider awareness about the benefits and functioning of these pathways; and monitoring progress so mid-course adjustments can be made when necessary.
Implementation of the RQI System: Baseline Skills and Self-Report Competence and Confidence Data From 12 NLN Inaugural Change Agent Nursing Programs
Authors: Kardong-Edgren Suzan , Nikitas Donna , Gavin Elizabeth , DiGregorio Heiddy , O'Keefe Dama , Opsahl Angela G. , Sharpnack Patricia A.
Published: December 2024

AIM

This article describes the implementation, baseline cardiopulmonary resuscitation (CPR) skills, and competence and confidence in skills of participants in 12 nursing programs piloting the Resuscitation Quality Improvement (RQI) program. Of 1,847 participants, 175 had not previously completed a CPR course.

METHOD

Schools could choose the sequence for completing baselines skills and required e-learning modules. For baseline skills, participants did 60 compressions and 12 continuous ventilations with RQI feedback turned off. Self-report competence and confidence in CPR skills data were collected.

RESULTS

Forty-five percent of participants achieved passing scores on adult ventilations and compressions; 31 percent achieved passing scores on infant compressions, and 34 percent on ventilations. Forty-five percent were confident in their adult CPR skills; 32 percent were confident in their infant CPR skills.

CONCLUSION

Nursing students and faculty, regardless of previous health care experience or CPR courses, need more frequent opportunities for CPR skill practice and assessment.
Effectiveness of Simulation Best Practices in Nurse Practitioner Education
Authors: Hobbs Jill Roberts , Wilson Kimberly Ellison
Published: December 2024

Nurse educators are challenged to implement simulation best practices (SBP) in advanced practice curricula. Prebriefing and debriefing were implemented in a nurse practitioner course using software-generated asynchronous virtual simulation. A pretest-posttest design was used to evaluate simulation scores and debriefing experience in a convenience sample of 36 students. Scores were statistically higher in the prebriefing group. Debriefing experience scale scores increased on the posttest with four items showing statistical significance. Results of the study provide support for implementation of SBP with prebriefing in online graduate-level nursing education.
Intelligent imaging technology applications in multidisciplinary hospitals
Authors: Fan Ke , Yang Lei , Ren Fei , Zhang Xueyuan , Liu Bo , Zhao Ze , Gu Jianwen
Published: December 2024

With the rapid development of artificial intelligence technology, its applications in medical imaging have become increasingly extensive. This review aimed to analyze the current development status and future direction of intelligent imaging technology by investigating its application in various medical departments. To achieve this, we conducted a comprehensive search of various data sources up to 2024, including PubMed, Web of Science, and Google Scholar, based on the principle of comprehensive search. A total of 332 articles were screened, and after applying the inclusion and exclusion criteria, 56 articles were selected for this study. According to the findings, intelligent imaging technology exhibits robust image recognition capabilities, making it applicable across diverse medical imaging modalities within hospital departments. This technology offers an efficient solution for the analysis of various medical images by extracting and accurately identifying complex features. Consequently, it significantly aids in the detection and diagnosis of clinical diseases. Its high accuracy, sensitivity, and specificity render it an indispensable tool in clinical diagnostics and related tasks, thereby enhancing the overall quality of healthcare services. The application of intelligent imaging technology in healthcare significantly enhances the efficiency of clinical diagnostics, resulting in more accurate and timely patient assessments. This advanced technology offers a faster and more precise diagnostic approach, ultimately improving patient care and outcomes. This review analyzed the socioeconomic changes brought about by intelligent imaging technology to provide a more comprehensive evaluation. Also, we systematically analyzed the current shortcomings of intelligent imaging technology and its future development directions, to enable future research.
EUS-guided fine-needle biopsy versus fine-needle aspiration for histopathological evidence for type 1 autoimmune pancreatitis: A single-center retrospective study in China
Authors: Zhou Yuyan , Sun Liqi , Wang Xinyue , Wan Dongling , Xu Jiaheng , Jiang Mengruo , Liu Yue , Liu Chao , Tu Yatao , Huang Haojie , Jin Zhendong
Published: December 2024

Background and Objectives

EUS is recommended for guiding pancreatic tissue acquisition in suspected autoimmune pancreatitis (AIP) cases. However, there is a lack of comparative research on the effectiveness between EUS-guided fine-needle aspiration (EUS-FNA) and EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing AIP in China. This study aimed to evaluate the diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) specifically for type 1 AIP.

Methods

Between 2010 and 2023, individuals with AIP who received EUS-TA at Changhai Hospital were included in the study.

Results

A total of 173 patients diagnosed with AIP who underwent EUS-TA were included in the final analysis. Of these, 104 patients (60.1%) received EUS-FNA, and 69 patients (39.9%) underwent EUS-FNB. Sufficient pancreatic tissue samples (>5 cells/high-power field) were obtained in 164 of 173 patients (94.8%), with success rates of 94.2% for EUS-FNA and 95.7% for EUS-FNB (P > 0.05). EUS-FNB exhibited higher rates of reliable level 1 histopathological findings (40.9% vs. 16.3%, P < 0.001) and reliable level 2 histopathological findings (33.3% vs. 12.2%, P < 0.001) compared with EUS-FNA. Furthermore, a higher occurrence of IgG4-positive plasma cell infiltration (>10 cells/high-power field) was observed with EUS-FNB compared with EUS-FNA (74.2% vs. 27.9%, P < 0.001). The multivariate logistic analysis also revealed that EUS-FNA was less effective in obtaining reliable evidence compared with EUS-FNB, as evident in both level 2 (P = 0.002; odds ratio, 0.21; 95% confidence interval, 0.08–0.56) and level 1 (P = 0.001; odds ratio, 0.19; 95% confidence interval, 0.08–0.49) histopathological evidence.

Conclusions

EUS-FNB demonstrates higher rates of level 1 and level 2 histopathological findings, as well as more abundant IgG4-positive plasma cell infiltration, compared with EUS-FNA.
Adequacy of EUS–guided fine-needle aspiration and fine-needle biopsy for next-generation sequencing in pancreatic malignancies: A systematic review and meta-analysis
Authors: Pan Yundi , Ran Taojing , Zhang Xianda , Qin Xianzheng , Zhang Yao , Zhou Chunhua , Zou Duowu
Published: December 2024

Background and Objectives

A majority of pancreatic malignancies are unresectable at the time of presentation and require EUS–guided fine-needle aspiration or fine-needle biopsy (EUS-FNA/FNB) for diagnosis. With the advent of precision therapy, there is an increasing need to use EUS-FNA/FNB sample for genetic analysis. Next-generation sequencing (NGS) is a preferred technology to detect genetic mutations with high sensitivity in small specimens. We performed a meta-analysis to evaluate the adequacy of EUS-FNA/FNB for NGS in pancreatic malignancies.

Methods

PubMed, Embase, Cochrane Library, and Web of Science were searched from database inception to November 11, 2023. The primary outcome was the proportion of sufficient sample acquired by EUS-FNA/FNB in pancreatic malignancies for NGS. Secondary outcomes were the proportion of sufficient sample for NGS in pancreatic ductal adenocarcinoma (PDAC) and the detection rates of mutations in KRAS, TP53, CDKN2A, and SMAD4 and actionable mutations in PDAC. The pooled proportions were calculated using a random-effects model. Potential sources of heterogeneity were investigated with subgroup analyses and meta-regression.

Results

Twenty studies with 881 samples were included. The pooled adequacy of EUS-FNA/FNB sample for NGS was 89.9% (95% CI, 80.8%–96.7%) in pancreatic malignancies and 92.0% (95% CI, 81.3%–98.8%) in PDAC. Screening sample suitability before NGS testing was associated with lower adequacy in subgroup analysis (79.7% vs. 98.4%, P = 0.001). The pooled prevalences of mutations in KRAS, TP53, CDKN2A, and SMAD4 in PDAC were 87.4% (95% CI, 83.2%–91.2%), 62.6% (95% CI, 53.2%–71.7%), 20.6% (95% CI, 11.9%–30.8%), and 19.4% (95% CI, 11.2%–29.1%), respectively. The pooled prevalence of potentially actionable mutations in PDAC was 14.5% (95% CI, 8.2%–22.0%).

Conclusions

In the majority of cases, EUS-FNA/FNB can acquire adequate sample for NGS and identify tumor-specific mutations in patients with pancreatic malignancies. Strict pre-analysis screening criteria may negatively impact the sample adequacy and the success rate for NGS.
Updated analysis of the pharmacogenomics of pediatric bronchodilator response
Authors: Brailsford Jennifer , Labilloy Guillaume , Menze Nolan , Henson Morgan , Fishe Jennifer
Published: December 2024

This short communication serves as an update to previously published pilot study results on bronchodilator response (BDR) in children with asthma. We expanded our cohort from 54 to 165 pediatric patients seeking emergency department care for an asthma exacerbation. We obtained measured BDR before and after albuterol administration using the Pediatric Asthma Severity Score and collected genomic DNA. Based on a literature review, we analyzed whether 21 candidate single-nucleotide polymorphisms (SNPs) were associated with BDR. Among the three SNPs initially reported in our pilot study as significantly associated with BDR (rs912142, rs7081864, and rs7903366), we confirmed that rs7081864 was still significantly associated with suboptimal BDR (odds ratio, 0.47; confidence interval, 0.24–0.92). If externally validated in broader studies, simple outpatient testing for that SNP variant could help guide pharmacologic therapy for acute asthma symptoms.
THERAPEUTIC REFRACTIVE VITRECTOMY (TRV) FOR THE MANAGEMENT OF VITREOUS FLOATERS AND OPACITIES (VFO) ASSESSED BY THE STANDARDIZED AND KINETIC ANATOMICAL AND FUNCTIONAL TESTING OF VITREOUS FLOATERS AND OPACITIES (SK VFO TEST)
Authors: Stanga Paulo Eduardo , Reinstein Dan Z , Valentin Bravo Francisco Javier , Saladino Andrea , Eduardo Stanga Sebastian Francis , Reinstein Ursula Inge , O’Neill Yvonne , Archer Timothy J , Harmer Stuart W , Sebag J. , Marshall John
Published: December 2024

Purpose:

Propose new terminology and evaluate the effectiveness of Therapeutic Refractive Vitrectomy (TRV) for selective removal of vitreous floaters and opacities (VFO) utilizing Standardized Kinetic Anatomical Functional Testing of VFO (SK VFO Test) and new ultra widefield (UWF) OCT imaging techniques.

Methods:

Retrospective analysis. Twenty eyes underwent TRV for symptomatic VFO. Pre-/post-TRV assessments: SK-VFO Test, including straylight measurements (HD Analyzer, Light Disturbance Analyzer, C-Quant) alongside non-contact imaging including a new UWF OCT to evaluate changes in vitreous anatomical and optical properties.

Results:

Post-TRV evaluations indicated objective changes in vitreous optical properties and subjective measures. Reduced straylight measurements: HDA 22%, LDA 54.4% (p=0.013), and C-Quant 7.8% (p=0.034). Patient reported outcomes statistically significantly improved (p=0.022). Corrected distance visual acuity (CDVA) changes were marginal. New UWF 26 mm with a 12 mm imaging window OCT facilitated detailed vitreous imaging, confirming status of posterior vitreous detachment (PVD) (100%). Post-TRV UWF and OCT imaging demonstrated restoration of vitreous clarity, confirmed presence of residual cortical vitreous and absence of new PVDs.

Conclusion:

TRV is a significant contribution for therapeutic refractive surgery as a safe and effective approach to enhancing visual quality, correcting refractive and opaque vitreous anomalies. Improvement in CDVA was minimal representing limited effectiveness as a measure of comprehensive visual function. Improvements in objective straylight measures and imaging are in alignment with subjective symptom improvements post-TRV. This underscores the utility and value of new holistic evaluation methods beyond traditional metrics to assess the impact of TRV on visual function and quality of life.
Quality and reliability of short Chinese videos related to acute pancreatitis on TikTok and Bilibili
Authors: Wang Yibo , Liu Hengyu , Li Chengqing , Wu Jiahao , Guo Wenyi , Li Feng , Wang Lei
Published: December 2024

Background

Acute pancreatitis (AP) is becoming a growing public health problem worldwide, with an increasing incidence year by year. Social media platforms such as TikTok and Bilibili are becoming increasingly popular, and they can be a source of information on AP. However, the quality of information in these videos remains unknown.

Objective

The objective of this study is to assess the information quality of Chinese AP short videos shared on TikTok and Bilibili short video platforms.

Methods

In April 2024, we conducted an assessment of the information quality and reliability of Chinese AP short videos (200 videos in total) from TikTok and Bilibili. This assessment was conducted using the JAMA, GQS, and DISCERN tools. Additionally, we explored the factors affecting video quality.

Results

Compared to Bilibili short videos, TikTok short videos are shorter in length but have more thumbs up, comments, favorites and shares, indicating that they are more popular. The quality of TikTok's and Bilibili's AP shorts is not as good as it could be, with Tiktok shorts being even worse, with median GQS scores of 1 and 2, median DISCERN scores of 34 and 42, and median JAMA scores of 2 and 1, respectively. Video duration is positively correlated with video quality, while thumbs up, comments, favorites and shares are negatively correlated with video quality.

Conclusions

The study demonstrated that short videos containing AP-related health information on Bilibili and TikTok were of poor quality, and that videos uploaded by healthcare professionals did not exhibit a significant advantage in terms of quality and reliability. Consequently, short videos providing healthcare information on TikTok and Bilibili must be meticulously evaluated for their scientific soundness before making healthcare management decisions. Overall, videos uploaded by healthcare professionals were of higher quality than those uploaded by others, but there was no significant difference in DISCERN scores.
Association of Cognitive Symptoms and Abnormal Oculomotor Signs With Recovery in Adolescents After Sport-Related Concussion
Authors: Stavisky Christopher J. , Miecznikowski Jeffrey C. , Haider Mohammad N. , Chizuk Haley M. , Nazir Muhammad S. Z. , Grady Matthew F. , McPherson Jacob I. , Nowak Andrew S. , Willer Barry S. , Master Christina L. , Leddy John J.
Published: December 2024

Objective:

Sport-related concussion (SRC) affects cognitive and oculomotor function. We evaluated recovery from SRC in athletes with cognitive symptoms and/or oculomotor impairments who were prescribed early aerobic exercise treatment.

Design:

Secondary exploratory analysis of a randomized controlled trial.

Setting:

Outpatient sports medicine clinics.

Participants:

Male and female adolescents (13–18 years) within 10 days of SRC who were prescribed aerobic exercise and who reported either a low (<12 points) or high (≥12 points) burden of cognitive symptom scores on the Post-Concussion Symptom Inventory at initial assessment.

Interventions:

Early aerobic exercise treatment.

Main Outcome Measures:

Recovery time and incidence of persisting postconcussive symptoms beyond 1 month.

Results:

Adolescents with a high burden of cognitive symptoms (n = 24, 16.0 ± 1.3 years old, 50% male, 5.3 ± 2.4 days since injury) took longer to recover (34.4 ± 37.1 vs 15.3 ± 7.6 days) than adolescents with a low burden (n = 32, 14.9 ± 1.4 years old, 69% male, 6.1 ± 2.3 days since injury) and had 6-fold higher odds of developing persisting postconcussive symptoms (odds ratio = 6.17 [1.15–33.15]). Abnormal repetitive saccades and vestibular ocular reflex were independently associated with longer recovery after controlling for multiple comparisons (P < 0.0125), but only abnormal smooth pursuits were a significant effect modifier for the association between cognitive symptoms and recovery (interaction term hazard ratio = 0.133 [0.035–0.504], P = 0.003).

Conclusions:

Individuals with impaired ability to smoothly track a moving target and whose cognitive symptoms are a significant burden are at substantial risk for delayed recovery from SRC. Early initiation of oculomotor rehabilitation may facilitate recovery in these patients.

Trials Registration:

Clinicaltrials.gov ID NCT02959216.
Novel Dynamic Organ Storage System Enhances Liver Graft Function in a Porcine Donation After Circulatory Death Model
Authors: Shishido Yutaka , Tracy Kaitlyn M. , Petrovic Mark , Adesanya TiOluwanimi , Fortier Avery K. , Raietparvar Kimya , Glomp Gabriella A. , Simonds Elizabeth , Harris Timothy R. , Simon Victoria , Tucker William D. , Petree Brandon , Cortelli Michael , Cardwell Nancy L. , Crannell Christian , Liang Jiancong , Murphy Alexandria C. , Fields Blanche L. , McReynolds Melanie , Demarest Caitlin T. , Ukita Rei , Rizzari Michael , Montenovo Martin , Magliocca Joseph F. , Karp Seth J. , Rauf M. Ameen , Shah Ashish S. , Bacchetta Matthew
Published: December 2024

Donation after circulatory death (DCD) livers face increased risks of critical complications when preserved with static cold storage (SCS). Although machine perfusion (MP) may mitigate these risks, its cost and logistical complexity limit widespread application. We developed the Dynamic Organ Storage System (DOSS), which delivers oxygenated perfusate at 10°C with minimal electrical power requirement and allows real-time effluent sampling in a portable cooler. In a porcine DCD model, livers were preserved using DOSS or SCS for 10 hours and evaluated with 4 hours of normothermic MP, with n = 5 per group. After 4 hours of normothermic MP, the DOSS group demonstrated significantly lower perfusate lactate (p = 0.023), increased perfusate fibrinogen (p = 0.005), higher oxygen consumption (p = 0.018), greater bile production (p = 0.013), higher bile bicarbonate levels (p = 0.035) and bile/perfusate sodium ratio (p = 0.002), and lower hepatic arterial resistance after phenylephrine administration (p = 0.018). Histological analysis showed lower apoptotic markers in DOSS-preserved livers, with fewer cleaved caspase-3 (p = 0.039) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL; p = 0.009) positive cells. These findings suggest that DOSS can enhance DCD allograft function during transport, offering potential clinical benefits and contributing to the expansion of the donor pool.
Pathological Q waves at presentation of anterior ST segment elevation myocardial infarction predict heart failure: a Southeast Asian perspective
Authors: Houdmont Marie , Lim Eng How , Djohan Hartanto Andie , Lau Vianne , Chan Siew Pang , Win Saw Kalyar , Tung Benjamin , Ng Zhe Yan , Chan Mark , Lee Ronald , Low Adrian F. , Tan Huay Cheem , Yeo Tiong-Cheng , Loh Poay Huan , Chan Koo Hui
Published: December 2024

Background

Pathological Q waves at presentation in ST segment elevation myocardial infarction (STEMI) have been associated with poorer clinical outcomes including heart failure. This observational study highlights the prognostic value of pathological Q waves at presentation in the Southeast Asian population.

Methods

Multiethnic Asian patients presenting with STEMI and treated with primary coronary intervention were recruited from 2015 to 2019. The presenting ECG was reviewed for pathological Q waves and patients were divided into groups with and without Q waves. The confirmatory multivariate analyses concerning the presence of Q wave, occurrence of heart failure, time to heart failure at 1 year, and the mortality status were performed with generalized structural equation model.

Results

A total of 1385 patients were included. Patients with pathological Q waves were more likely to suffer from anterior myocardial infarction (55.6 vs. 43.6%) and classified as Killip class >2 (13.5 vs. 8.0%). Among them, fewer reported ST segment resolution >50% (66.5 vs. 79.7%). They reported significantly lower LVEF (45.5 vs. 51.1%), longer symptom onset to ECG (168 vs. 111 min), and longer symptom-onset-to-balloon time (228 vs. 176 min). In addition, patients with Q waves were likely to stay longer in hospital (6.4 vs. 6.1 days) and faced a higher risk of heart failure (5.2 vs. 2.5%) in a year.

Conclusion

We highlight the important morbidity associated with Q waves at presentation and found not only that heart failure occurrence was higher in the Q wave group, but there was also an acceleration of and shorter onset to heart failure.
The impact of perceived stress on the prognosis in patients undergoing percutaneous coronary intervention
Authors: Shi Qiuyin , Wang Xuefei , Zhao Dongxia , Tang Weihong , Mo Yongzhen
Published: December 2024

Objective

To assess the impact of perceived stress levels in patients undergoing percutaneous coronary intervention (PCI) on the occurrence of major adverse cardiovascular events (MACEs) within a 6-month follow-up period postprocedure.

Methods

A cohort of 339 hospitalized patients with coronary heart disease undergoing initial PCI was prospectively enrolled in the Department of Cardiology at two branches of Zhongda Hospital Affiliated to Southeast University between January 2022 and July 2022. Baseline data including demographic and clinical characteristics, along with the Chinese Perceived Stress Scale (CPSS), were collected. The occurrence of MACE was evaluated at 3 and 6 months post-PCI. Kaplan–Meier survival analysis and Cox regression models were engaged to analyze the relationship between perceived stress and MACE within 6 months after PCI.

Results

MACE occurred in 16.22% (55/339) of patients during the 6 following months. High CPSS at baseline was significantly associated with an increasing risk of short-term MACE occurrence (HR: 6.48, 95% confidence interval: 2.98–14.11, P < 0.05).

Conclusion

High perceived stress during the baseline period after PCI was significantly correlated with increased incidence of MACE within 6 months postprocedure. The perceived stress level could help to identify patients undergoing PCI at heightened risk of short-term MACE.
Early Continuous Electroencephalography, Clinical Parameters, and Short-Term Functional Outcomes in Pediatric Traumatic Brain Injury: Single-Center, Retrospective Cohort, 2010–2020
Authors: Pascall Akilah , Zhang Anqing , Dughly Omar , Bell Michael J. , Harrar Dana , Dean Terry
Published: December 2024

Objectives:

Traumatic brain injury (TBI) is a leading cause of pediatric morbidity and mortality. This study first investigates clinical characteristics and continuous electroencephalography (cEEG) parameters associated with short-term functional outcomes in pediatric patients following TBI. Second, we use these data for a hypothesis-generating model about outcomes.

Design:

Retrospective cohort study.

Setting:

PICU within a quaternary care hospital.

Patients:

Pediatric patients (< 18 yr) admitted from January 2010 to December 2020 with TBI who underwent cEEG within 72 hours of admission.

Interventions:

None.

Measurements and Main Results:

Patient demographics, clinical parameters, hospital course, and cEEG features were reviewed for associations with mortality and new disability (as defined by change in Functional Status Score between admission and discharge of ≥ 3 points). A statistical prediction model for patient outcome was created combining cEEG parameters with admission Glasgow Coma Scale (GCS) score and radiographic findings. We included 142 patients: 100 (70%) of whom had no new disability at hospital discharge; 42 (30%) had a new disability, including eight deaths. Univariate analysis showed favorable outcomes were associated with normal electroencephalogram background, reactivity, and sleep features (p < 0.001 for each). A model inclusive of these electroencephalogram parameters and GCS had high predictive ability for outcome with 0.94 with 95% CI (0.90–0.98).

Conclusions:

Specific cEEG findings observed acutely after injury, in combination with other clinical characteristics, may serve as biomarkers for short-term functional outcomes after pediatric TBI. Further validation of the model in another population is now required.
Granulocyte Colony-Stimulating Factor–Associated Aortitis Unveiled by 18F-FDG PET/CT
Authors: Artigou Hélène , Foka Tichoue Hervé , Marques Cindy , Charlotte Frédéric , Vion PA , Kas Aurélie , Rozenblum Laura
Published: December 2024

In oncology, G-CSF (granulocyte colony-stimulating factor) is often administered to counteract chemotherapy-induced neutropenia. Recent studies have highlighted a significant side effect, G-CSF–associated aortitis, with an incidence of ~0.4%. Identification of this condition’s imaging characteristics is crucial for nuclear medicine specialists, given its substantial impact on clinical decision-making. It is notably prevalent in the follow-up of gynecologic malignancies and lymphoma. We detail a case of G-CSF–related aortitis in a metastatic ovarian cancer patient, diagnosed by increased 18F-FDG uptake in the aortic arch on PET/CT, confirmed by contrast-enhanced CT and biopsy, which regressed spontaneously in under 5 weeks without corticosteroid treatment.
Declining Blowout Fracture Cases and Rising Costs in South Korea (2010–2023)
Authors: Kang Daihun
Published: December 2024

Objective:

Blowout fractures are a significant component of maxillofacial trauma care, but their incidence appears to be declining in South Korea. This study aims to investigate the trends in blowout fracture cases from 2010 to 2023 and assess the implications for plastic and reconstructive surgery, as well as the financial burden on patients.

Methods:

A retrospective observational study was conducted using data from the Health Insurance Review and Assessment Service in South Korea. Patients diagnosed with orbital fractures (International Classification of Diseases, 10th Revision code S02.3) between 2010 and 2023 were included. Variables such as patient demographics, National Health Insurance (NHI) payments, and patient out-of-pocket expenses in United States dollars were analyzed. Time-series forecasting was performed using the Auto-Regressive Integrated Moving Average (1,1,1) model to predict future trends.

Results:

A total of 163,146 patients were diagnosed with blowout fractures from 2010 to 2023. The number of cases decreased by 48.0%, from 18,340 in 2010 to 9534 in 2023 (P < 0.001). Despite the decline in cases, the average NHI payment per patient increased by 135.5%, and patient out-of-pocket expenses rose by 127.5% (P < 0.01). Strong negative correlations were found between patient numbers and per-patient costs for both NHI payments (r = −0.933) and patient expenses (r = −0.929). The Auto-Regressive Integrated Moving Average model forecasts suggest that case numbers may stabilize, but health care costs will continue to rise through 2028.

Conclusion:

The declining trend in blowout fracture cases poses challenges to the sustainability of this subspecialty in plastic and reconstructive surgery. Concurrently, the increasing financial burden on patients highlights limitations in the current health care coverage. Plastic and reconstructive surgeons must adapt by diversifying skills and fostering interdisciplinary collaboration. Policy reforms are necessary to reduce the financial burden on patients and ensure equitable access to care.
Seizure Detection and Lateralization Using Thalamic Deep Brain Stimulator Recordings
Authors: Ortiz-Guerrero Gloria , Park Sihyeong , Starnes Keith , Lundstrom Brian N. , Brinkmann Benjamin H. , Van Gompel Jamie J. , Worrell Gregory A. , Gregg Nicholas M.
Published: December 2024

The lack of reliable seizure detection remains a significant challenge for epilepsy care. A clinical deep brain stimulation (DBS) system provides constrained ambulatory brain recordings; however, limited data exist on the use of DBS recordings for seizure detection and lateralization. We present the case of an 18-year-old patient with drug-resistant focal epilepsy, who had seizure detection and lateralization by DBS recordings. Prior stereotactic-EEG, including a thalamus lead, identified independent left orbitofrontal and mesial temporal onset seizures. Notably, low-frequency thalamic ictal power was significantly elevated relative to baseline awake and sleep states. The patient was subsequently implanted with an anterior nucleus of the thalamus DBS system. Postimplantation, low-frequency power-in-band (5.3–10.3 Hz) recordings were initiated. Nursing staff identified four typical clinical seizures during the inpatient DBS recording period. Thalamic DBS trends contained relative peaks that were coincident with each nurse-reported seizure. Peri-ictal power was uniformly maximal ipsilateral to the seizure network. This case demonstrates the feasibility of seizure detection and lateralization by a thalamic DBS system for some individuals, and suggests DBS sensing parameter selection may be guided by thalamic stereotactic EEG. Further research is necessary to assess the generalizability of DBS seizure detection across individuals and diverse seizure networks.
Weak-form inference for hybrid dynamical systems in ecology
Authors: Messenger Daniel , Dwyer Greg , Dukic Vanja
Published: December 2024

Species subject to predation and environmental threats commonly exhibit variable periods of population boom and bust over long timescales. Understanding and predicting such behaviour, especially given the inherent heterogeneity and stochasticity of exogenous driving factors over short timescales, is an ongoing challenge. A modelling paradigm gaining popularity in the ecological sciences for such multi-scale effects is to couple short-term continuous dynamics to long-term discrete updates. We develop a data-driven method utilizing weak-form equation learning to extract such hybrid governing equations for population dynamics and to estimate the requisite parameters using sparse intermittent measurements of the discrete and continuous variables. The method produces a set of short-term continuous dynamical system equations parametrized by long-term variables, and long-term discrete equations parametrized by short-term variables, allowing direct assessment of interdependencies between the two timescales. We demonstrate the utility of the method on a variety of ecological scenarios and provide extensive tests using models previously derived for epizootics experienced by the North American spongy moth (
Lymantria dispar dispar
).
Factors shaping socio-emotional trajectories in sanctuary-living bonobos: a longitudinal approach
Authors: Kordon Stephanie , Webb Christine E. , Brooker Jake S. , de Waal Frans B.M. , Clay Zanna
Published: December 2024

Early maternal loss can have lasting detrimental effects on primate social development. While many rehabilitation settings provide enriching environments to buffer against such effects in orphans, previous research indicates that young bonobo (
Pan paniscus
) orphans exhibit striking deficiencies in socio-emotional competence compared to their mother-reared peers. However, such studies are generally cross-sectional, without accounting for changes across the lifespan. We conducted longitudinal observations in bonobos living in an accredited African ape sanctuary to examine how rearing background, sex and age predict social tendencies including affiliation, consolation and aggression risk. Affiliative tendencies increased in females and decreased in males with age but were overall lower in orphans compared to mother-reared bonobos. Consolation tendencies decreased with age in mother-reared bonobos, while orphans showed consistently lower consolation (akin to levels of older mother-reared individuals). Young and male bonobos were more likely to receive aggression, while mother-reared and older females were more likely aggressors. Our study highlights the potential that ape sanctuaries like this can have by demonstrating that orphans exhibit decreased affiliative tendencies yet show social functioning ranging within patterns of their mother-reared peers. We discuss these results in the context of bonobos’ natural social ecology and ongoing rehabilitation efforts in this species.
Flexible males, proactive females: increased boldness/exploration damping with time in male but not female colonists
Authors: Tchabovsky Andrey V. , Surkova Elena N. , Savinetskaya Ludmila E. , Khropov Ivan S.
Published: December 2024

Individuals colonizing new areas during range expansion encounter challenging and unfamiliar environments, suggesting that colonists should differ in behavioural traits from residents of source populations. The colonizer syndrome is supposed to be associated with boldness, exploration, activity and low sociability. We assessed spatial and temporal variation of the colonizer syndrome in an expanding population of midday gerbils (
Meriones meridianus
). Male-first colonists did not differ significantly from residents of the source population, whereas female-first colonists were bolder, faster and more explorative than females from the source population. These findings support a boldness/exploration syndrome as a typical colonizer trait, which appears to be restricted to females in midday gerbils. Males and females also differed in behavioural dynamics after colony establishment. In males, boldness/exploration/sociability peaked in newly founded colonies, then sharply decreased in subsequent generations consistently with decreasing environmental uncertainty in ageing colonies. In females, greater boldness/exploration did not diminish with time post-colonization, i.e. female colonists retained the bold/explorative phenotype in subsequent generations despite facing a less challenging environment. Thus, female colonists, unlike males, carry a specialized behavioural colonizer phenotype corresponding to a proactive behavioural coping strategy. We link sex differences in behavioural traits of colonists to sex-specific life-history strategies.