bluuebunny/crossref_metadata_2025 huggingface dataset:
Asteroseismology of the mild Am δ Sct star HD 118660: TESS photometry and modelling
Authors: Sarkar Mrinmoy , Joshi Santosh , Dupret Marc-Antoine , Trust Otto , De Cat Peter , Semenko Eugene , Lampens Patricia , Goswami Aruna , Mkrtichian David , Karinkuzhi Drisya , Yakunin Ilya , Gupta Archana
Published: October 2024

We present the results of an asteroseismic study of HD 118660 (TIC 171729860), being a chemically peculiar (mild Am) star exhibiting $\delta$ Scuti ($\delta$ Sct) pulsations. It is based on the analysis of two sectors of time-series photometry from the space mission TESS (Transiting Exoplanet Survey Satellite) and seismic modelling. It yielded the detection of 15 and 16 frequencies for TESS sectors 23 and 50, respectively. The identified pulsation modes include four radial ($\ell =0$) and five dipolar ($\ell =1$) ones. The radial modes are overtones with order n ranging from 3 and 6. Such high values of n are theoretically not expected for stars with the effective temperature of HD 118660 ($T_{\rm eff}\approx 7550\,\rm K$) located near the red edge of the $\delta$ Sct instability strip. To estimate the asteroseismic parameters, we have generated a grid of stellar models assuming a solar metallicity ($Z=0.014$) and different values for the convective overshooting parameter ($0.1\le \alpha _{\rm ov}\le 0.3$). We conclude that the analysis of the radial modes is insufficient to constrain $\alpha _{\rm ov}$ and Z for $\delta$ Sct stars. The value for the equatorial velocity of HD 118660 derived from the seismic radius and the rotational frequency is consistent with values found in the literature.
STK19 is a transcription-coupled repair factor that participates in UVSSA ubiquitination and TFIIH loading
Authors: Tan Yuanqing , Gao Meng , Huang Yanchao , Zhan Delin , Wu Sizhong , An Jiao , Zhang Xiping , Hu Jinchuan
Published: October 2024

Transcription-coupled repair (TCR) is the major pathway to remove transcription-blocking lesions. Although discovered for nearly 40 years, the mechanism and critical players of mammalian TCR remain unclear. STK19 is a factor affecting cell survival and recovery of RNA synthesis in response to DNA damage, however, whether it is a necessary component for TCR is unknown. Here, we demonstrated that STK19 is essential for human TCR. Mechanistically, STK19 is recruited to damage sites through direct interaction with CSA. It can also interact with RNA polymerase II in vitro. Once recruited, STK19 plays an important role in UVSSA ubiquitination which is needed for TCR. STK19 also promotes TCR independent of UVSSA ubiquitination by stimulating TFIIH recruitment through its direct interaction with TFIIH. In summary, our results suggest that STK19 is a key factor of human TCR that links CSA, UVSSA ubiquitination and TFIIH loading, shedding light on the molecular mechanisms of TCR.
Spatially restricted ecto‐5′‐nucleotidase expression promotes the growth of uterine leiomyomas by modulating Akt activity
Authors: Guo Xiaofang , Okuka Maja , Short Brittney , Ozmen Asli , Gunay Nihan Semerci , Rymer Jake , Un Burak , Guzeloglu‐Kayisli Ozlem , Rutherford Thomas J. , Kayisli Umit , Anderson Matthew L.
Published: October 2024

Found in as many as 80% of women, uterine leiomyomas are a frequent cause of abnormal uterine bleeding, pelvic pain, and infertility. Despite their significant clinical impact, the mechanisms responsible for driving leiomyoma growth remain poorly understood. After obtaining IRB permission, expression of ecto‐5′‐nucleotidase (NT5E, CD73) was assessed in matched specimens of myometrium and leiomyoma by real‐time qPCR, Western blot, and immunohistochemistry (IHC). Adenosine concentrations were measured by enzyme‐linked assay. Primary cultures were used to assess the impact of adenosine and/or adenosine receptor agonists on proliferation, apoptosis, and patterns of intracellular signaling in vitro. When compared to matched specimens of healthy myometrium, uterine leiomyomas were characterized by reduced CD73 expression. Largely limited to thin‐walled vascular structures and the pseudocapsule of leiomyomas despite diffuse myometrial distribution. Restricted intra‐tumoral CD73 expression was accompanied by decreased levels of intra‐tumoral adenosine. In vitro, incubation of primary leiomyoma cultures with adenosine or its hydrolysis‐resistant analog 2‐chloro‐adenosine (2‐CL‐AD) inhibited proliferation, induced apoptosis, and reduced proportion of myocytes in S‐ and G2‐M phases of the cell cycle. Decreased proliferation was accompanied by reduced expression of phospho‐Akt, phospho‐Cdk2‐Tyr15, and phospho‐Histone H3. Enforced expression of the A2B adenosine receptor (ADORA2B) and ADORA2B‐selective agonists similarly suppressed proliferation and inhibited Akt phosphorylation. Collectively, these observations broadly implicate CD73 and reduced extracellular concentrations of adenosine as key regulators of leiomyoma growth and potentially identify novel strategies for clinically managing these common tumors.
Removal of Retro-Corporeal Compressive Pathology Using Guttering Osteotomy During Anterior Cervical Discectomy and Fusion
Authors: Lee Dong-Ho , Hwang Chang Ju , Cho Jae Hwan , Park Sehan
Published: October 2024

Study Design:

A retrospective cohort study.

Objective:

Guttering is a technique that creates a tunnel through the vertebral body adjacent to the endplate to remove compressive pathologies behind the vertebral body during anterior cervical discectomy and fusion (ACDF). In this study, we investigated cases of patients who underwent gutter-shaped osteotomy (guttering) to decompress retro-corporeal compressive lesions.

Summary of Background Data:

Retro-corporeal pathologies causing cord compression cannot be removed using conventional ACDF.

Materials and Methods:

A total of 217 patients who underwent ACDF to treat cervical myelopathy and were followed up for ≥1 year were retrospectively reviewed. The fusion rate, subsidence, neck pain visual analog scale (VAS), arm pain VAS, and neck disability index (NDI) were assessed. Results were compared between the guttering (patients for whom guttering was performed) and nonguttering (patients for whom guttering was not performed) groups.

Results:

Thirty-five patients (16.1%) were included in the guttering group, while 182 patients (83.8%) were included in the nonguttering group. Fusion rates assessed by interspinous motion (P=0.559) and bone bridging on computed tomography (CT) (P=0.541 and 0.715, respectively) were not significantly different between the 2 groups at 1 year after surgery. Furthermore, neck pain VAS (P=0.492), arm pain VAS (P=0.099), and NDI (P=1.000) 1 year after surgery did not demonstrate significant intergroup differences. All patients in the guttering group exhibited healed guttering on 1-year postsurgery CT.

Conclusions:

Guttering as an adjunct to ACDF could provide a more expansive workspace for complete decompression when compressive pathology extends retrocorporeal. This additional bone resection is not associated with increased pseudarthrosis or subsidence or related to aggravation of patient symptoms.

Level of Evidence:

Level III.
The Impact of a Digital Cancer Survivorship Patient Engagement Toolkit on Older Cancer Survivors' Health Outcomes
Authors: Nahm Eun-Shim , McQuaige Mary , Steacy Katarina , Zhu Shijun , Seong Hohyun
Published: October 2024

Cancer predominantly affects older adults. An estimated 62% of the 15.5 million American cancer survivors are 65 years or older. Provision of supportive care is critical to this group; however, limited resources are available to them. As older survivors increasingly adopt technology, digital health programs have significant potential to provide them with longitudinal supportive care. Previously, we developed/tested a digital Cancer Survivorship Patient Engagement Toolkit for older adults, Cancer Survivorship Patient Engagement Toolkit Silver. The study examined the preliminary impact of the Cancer Survivorship Patient Engagement Toolkit Silver on older survivors' health outcomes. This was a 2-arm randomized controlled trial with two observations (baseline, 8 weeks) on a sample of 60 older cancer survivors (mean age, 70.1 ± 3.8 years). Outcomes included health-related quality of life, self-efficacy for coping with cancer, symptom burden, health behaviors, and patient-provider communication. Data were analyzed using descriptive statistics, linear mixed models, and content analysis. At 8 weeks, the Cancer Survivorship Patient Engagement Toolkit Silver group showed more improved physical health-related quality of life (P < .001, effect size = 0.64) and symptom burden (P = .053, effect size = −0.41) than the control group. Self-efficacy (effect size = 0.56), mental health-related quality of life (effect size = 0.26), and communication (effect size = 0.40) showed clinically meaningful effect sizes of improvement. Most participants reported benefits on health management (mean, 19.41 ± 2.6 [3-21]). Further research is needed with larger and more diverse older cancer populations.
Trigeminal neuralgia and its comorbidities: a nationwide disease trajectory study
Authors: Worm Jacob , Jørgensen Isabella Friis , Davídsson Ólafur Birgir , Hjalgrim Henrik , Röder Timo , Ostrowski Sisse Rye , Pedersen Ole Birger , Erikstrup Christian , Bruun Mie Topholm , Jensen Bitten Aagaard , Sørensen Erik , Ullum Henrik , Björnsdóttir Gyða , Thorgeirsson Thorgeir , Stefánsson Hreinn , Sveinsson Ólafur Árni , Stefánsson Kári ,   DBDS Genomic Consortium, Schytz Henrik Winther , Bendtsen Lars , Brunak Søren , Hansen Thomas Folkmann , Maarbjerg Stine
Published: October 2024

There is a limited understanding of risk factors and comorbidities in trigeminal neuralgia, a disease characterized by paroxysms of severe unilateral facial pain and a higher incidence in women. We aim to identify temporally associated comorbidities involving trigeminal neuralgia by analyzing nationwide disease trajectories. Using data from 7.2 million unique individuals in the Danish National Patient Register between 1994 and 2018, each individual diagnosed with trigeminal neuralgia was compared with 10,000 matched controls to identify co-occurring diseases. The sequential disease associations were identified in sex-stratified disease trajectories. A Cox-regression analysis investigated whether treatment with carbamazepine or oxcarbazepine, as compared with gabapentin, pregabalin, or lamotrigine, was associated with stroke risk. Finally, we investigated the stroke polygenic risk score and its association with stroke incidence in a subset of genotyped individuals with trigeminal neuralgia. We included 7141 individuals with trigeminal neuralgia (64.2% female, mean age at diagnosis 58.7 years) and identified 18 diseases associated with subsequent trigeminal neuralgia. After diagnosis, trigeminal neuralgia was associated with 9 diseases, including ischemic stroke (relative risk 1.55). Carbamazepine or oxcarbazepine treatment increased the ischemic stroke risk (hazard ratio 1.78; 95% confidence interval 1.47-2.17); however, the polygenic risk of stroke showed no association. In the Danish population, a trigeminal neuralgia diagnosis is temporally associated with 27 diseases revealed in systematic disease trajectories. Trigeminal neuralgia itself and its first-line treatment, but not a stroke polygenic risk score, was associated with an increased risk of ischemic stroke indicating that vascular risk factors should be routinely assessed in individuals with trigeminal neuralgia.
Integrating Evidence-Based Screening, Brief Intervention, and Referral to Treatment Into a Family Nurse Practitioner Program
Authors: Fetterhoff Kelly , Kuhns Kelly , Minter Cayleigh
Published: October 2024

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is used to screen for substance use, provide a brief intervention, and refer patients with consequential substance use for treatment. Over the past decade, consequential substance use and substance use-related deaths have dramatically increased. SBIRT has been implemented in a variety of settings across the world as a strategy to decrease substance use and prevent further deaths.

Problem Statement

Substance use disorder (SUD)—and more specifically opioid use disorder—is a national epidemic. With the increasing amounts of people suffering from SUD, all healthcare professionals should be educated to identify substance abuse, provide a brief intervention, and refer patients for treatment when indicated.

Purpose

The purpose of this project is to integrate the SBIRT into the curriculum of a graduate-level family nurse practitioner (FNP) program in southeastern Pennsylvania and to determine if educating FNP students on the SBIRT process increases their knowledge of SUDs and their treatment and increases their motivation to work with patients with SUD.

Measurements

The measurements used were as follows: shortened Alcohol and Alcohol Problems Perception Questionnaire (S-AAPPQ), shortened Drug and Drug Problems Perception Questionnaire (S-DDPPQ), a 10-question knowledge test, and demographic data.

Results

All subscales of the S-DDPPQ, the S-AAPPQ, and the knowledge test showed a statistically significant change from the pretest score means and to posttest means. This evidence-based practice project supports the integration of SBIRT education into FNP programs to increase their ability to identify and treat individuals with SUDs.
Importance of a thorough history and physical examination: Case report of atypical necrotizing fasciitis
Authors: Costa-Pattison Denise , Rush Nicole , Gillespie Sherrie , Danford Cynthia A. , Siedlecki Sandra L.
Published: October 2024

This case report presents a 34-year-old Middle Eastern woman with atypical symptoms of Type II Necrotizing Soft Tissue Infection (NSTI). Due to the difficulty in diagnosing Type II NSTI, the patient experienced protracted illness. Once diagnosed, the patient underwent multiple surgical debridement procedures requiring antibiotic and pain management therapy before being successfully discharged home. Initial diagnosis of Type II NSTI is challenging to the provider due to vague symptoms and late occurrence of cutaneous changes. When cutaneous lesions are identified, rapid surgical evaluation is imperative to minimize morbidity and mortality. This paper emphasizes the complexity of diagnosing Type II NSTI and the need for a comprehensive history and frequent physical examinations.
Prediction of preoperative lymph-vascular space invasion and survival outcomes of cervical squamous cell carcinoma by utilizing 18F-FDG PET/CT imaging at early stage
Authors: Li Jiatong , Cui Nan , Wang Yanmei , Li Wei , Jiang Zhiyun , Liu Wei , Guo Chenxu , Wang Kezheng
Published: October 2024

Objective

To establish nomograms for predicting preoperative lymph-vascular space invasion (LVSI) and survival outcomes of cervical squamous cell carcinoma (CSCC) based on PET/CT radiomics.

Methods

One hundred and twenty-three patients with CSCC and LVSI status were enrolled retrospectively. Independent predictors of LVSI were identified through clinicopathological factors and PET/CT metabolic parameters. We extracted 1316 features from PET and CT volume of interest, respectively. Additionally, four models (PET-RS: radiomic signature of PET only; CT-RS: radiomic signature of CT only; PET/CT-RS + clinical data; PET/CT-RS: radiomic signature of PET and CT) were established to predict LVSI status. Calculation of radiomics scores of PET/CT was executed for assessment of the survival outcomes, followed by development of nomograms with radiomics (NR) or without radiomics (NWR).

Results

One hundred and twenty-three patients with pathologically confirmed CSCC had been categorized into two sets (training and testing sets). It was found that only maximum standardized uptake value (SUVmax) and squamous cell carcinoma antigen were independent predictors of LVSI. Meanwhile, the PET/CT-RS + clinical data outperformed the other three models in the training set [area under the curve (AUC): 0.91 vs. 0.861 vs. 0.81 vs. 0.814] and the testing set (AUC: 0.885 vs. 0.857 vs. 0.783 vs. 0.798). Additionally, SUVmax and LVSI had been demonstrated to be independent prognostic indicators for progression-free survival and overall survival. Decision curve analysis and calibration curve indicated that NRs were superior to NWRs. The survival outcomes were assessed.

Conclusion

PET/CT-based radiomic signature nomogram enables a new method for preoperative prediction of LVSI and survival prognosis for patients with CSCC.
Rare presentation of huge ectopic ureterocele in an adult female: a case report
Authors: Jawaid Muhammad D. , Anwaar Adeel , Athar Hamna , Wahaj Zainab , Ali Masab , Saeed Humza , Ahmad Muhammad Husnain
Published: October 2024

Introduction and importance:

Ectopic ureteroceles are primarily found in children, often detected incidentally during antenatal ultrasonography or due to urinary tract infection (UTI) symptoms. However, they are rare in adults, with limited published cases.

Case presentation:

This report details a case of a 24-year-old woman who experienced recurrent UTIs and sudden urinary retention, ultimately needing manual compression to urinate due to poor urine flow. Intravenous urography revealed a large right ectopic ureterocele that protruded through the urethra during urination. Cystoscopy confirmed extensive right-sided ureteroceles affecting the bladder and causing her urinary difficulties.

Clinical discussion:

Although ectopic ureteroceles in adults can present with a range of symptoms, including obstruction and recurrent infections, the management approach is often individualized based on the clinical presentation and imaging findings. In this case, endoscopic incision was chosen for its minimally invasive nature, leading to full recovery without complications. Despite the risks of recurrence and potential scarring, the patient showed no recurrence at follow-up and remains symptom-free.

Conclusion:

This case underscores the rarity of symptomatic giant ectopic ureteroceles in adult females and highlights the importance of considering this condition in women with recurrent UTIs.
Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline From the American Physical Therapy Association Academy of Pediatric Physical Therapy
Authors: Sargent Barbara , Coulter Colleen , Cannoy Jill , Kaplan Sandra L.
Published: October 2024

Background:

Congenital muscular torticollis (CMT) is a postural condition evident shortly after birth. The 2013 CMT Clinical Practice Guideline (2013 CMT CPG) set standards for the identification, referral, and physical therapy management of infants with CMT, and its implementation resulted in improved clinical outcomes. It was updated in 2018 to reflect current evidence and 7 resources were developed to support implementation. Purpose: This 2024 CMT CPG is intended as a reference document to guide physical therapists, families, health care professionals, educators, and researchers to improve clinical outcomes and health services for children with CMT, as well as to inform the need for continued research. Results/Conclusions: The 2024 CMT CPG addresses: education for prevention, screening, examination and evaluation including recommended outcome measures, consultation with and referral to other health care providers, classification and prognosis, first-choice and evidence-informed supplemental interventions, discontinuation from direct intervention, reassessment and discharge, implementation and compliance recommendations, and research recommendations.
Development and Implementation of an Evidenced-Based Practice (EBP) Educational Program for a Multidisciplinary Rehabilitation Department
Authors: Hedgecock James B. , Muir Nancy B. , Mahnken Heather , Silveira Lori J. , Ziegler Katelyn , Judd Dana L.
Published: October 2024

Objective:

Describe the development and implementation of an evidence-based practice (EBP) training program for occupational and physical therapists in a large pediatric hospital.

Context:

EBP is valued, but a known knowledge-to-practice gap between academic training and clinical practice limits routine use. This gap was addressed through an academic-clinical partnership to develop an EBP training program.

Results:

Sixty-one therapists completed the program. Therapists demonstrated improved EBP skills, knowledge, and confidence following training and a positive trend in change score for clinical outcomes and decision-making scores was noted.

Conclusion:

Academic-clinical partnerships have a unique and valuable role to support professional EBP knowledge and skill development. Stakeholder support and engagement supported program development, execution, and meaningful outcomes.

Impact Statement:

The knowledge-to-practice gap for EBP is a challenge to regular EBP use. The described program addressed this challenge and improved therapists’ knowledge, skills, and confidence. It provides a model for professional development.
Eating Behaviors Associated With Suicidal Behaviors and Overall Risk
Authors: Sutphin Terran M.S. , Hicks Adam D. , McCord David
Published: October 2024

Objective:

Maladaptive eating behaviors remain prevalent in the US population, and a significant percentage of US college students acknowledge engaging in maladaptive eating. Formally defined eating disorders (EDs) have one of the highest mortality rates among all mental illnesses. Suicide risk is substantially elevated among individuals diagnosed with EDs, and even subclinical levels of maladaptive eating behaviors are associated with suicidality. The current study examined associations between specific problematic eating behaviors measured dimensionally (eg, purging, binging, laxative use) and specific suicide-related constructs and behaviors as well as overall suicide risk.

Methods:

College students (N=188; 62% women) completed the Eating Disorder Examination-Questionnaire, a well-established measure of dysfunctional eating, as well as several self-report measures of theoretical components of suicidality, and, finally, a semistructured clinical interview to specify suicide risk category.

Results:

Results showed a general pattern of moderate and strong associations between the subscales and the overall score of the Eating Disorder Examination-Questionnaire and core suicide constructs of the interpersonal-psychological theory of suicide. Many substantive correlations were found between specific eating behaviors and specific suicide-related behaviors; for example, purging was the highest correlate of overall suicide risk (ρ=0.36).

Discussion:

These results are discussed in terms of consistency with the interpersonal-psychological theory of suicide as well as practical implications for intervention.
The Financial Impact of a Co-Surgeon in Breast Microsurgery
Authors: DeVito Robert G. , Ke Benjamin G. , Park Rachel H. , Hollenbeck Scott T. , Campbell Chris A. , Stranix John T.
Published: October 2024

Introduction:

Co-surgeon approaches for autologous breast reconstruction have demonstrated improvements in operative efficiency. The health system financial impact, however, warrants further investigation.

Methods:

Retrospective review of consecutive autologous reconstructions between 2017-2022. Primary outcome measures: length of stay (LOS), operative time, and financial metrics. Cases were stratified by co-surgeon presence, timing, and laterality.

Results:

264 cases met inclusion criteria; there were 117 co-surgeon and 147 single surgeon cases. Co-surgeon cases demonstrated decreased LOS (2.4 vs. 3.1 days; p < 0.01), decreased operative time in unilateral (269 vs. 370 minutes; p < 0.01) and bilateral cases (399 vs. 582 minutes; p < 0.01). Co-surgeon cases were also associated with decreased total cost ($25,160 vs. $31,758; p < 0.01), direct cost ($15,558 vs. $19,283; p < 0.01), indirect cost ($9,602 vs. $12,475; p < 0.01), decreased total charges ($98,728 vs. $120,981; p < 0.01), and increased margin ($1,099 vs. -$6,255; p < 0.01). Post hoc analysis revealed significant differences, albeit at varying magnitudes, in these particular metrics across all levels of reconstruction timing with the inclusion of a co-surgeon.

Conclusion:

Co-surgeon breast microsurgery not only improves operative efficiency, but also translates to improved financial metrics. As we transition to value-based care models, this is particularly relevant to health systems offering microsurgical breast reconstruction. Analyses of downstream benefits including optimized patient throughput and surgeon opportunity cost warrant investigation.
“Metabolic Bridge Therapy Prior to Microvascular Breast Reconstruction in the Morbidly Obese: A Proof-of-Concept Risk Analysis”
Authors: Hammond Jacob B. , Tillotson McKinna , Yoon YooJin , Meza Monge Kenneth , Esch Elena M. , Madura James A. , Pratap Akshay , Winocour Julian , Mathes David W. , Kaoutzanis Christodoulos
Published: October 2024

Background:

Obese patients experience more complications after autologous breast reconstruction. This study evaluates how bariatric surgery modulates risk of complications in the setting of microvascular breast reconstruction.

Methods:

Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) databases were queried for patients with body mass index (BMI) ≥35 kg/m2 undergoing bariatric surgery from 2017-2022. Outcomes included BMI and obesity-related comorbidities before and 1 year after bariatric surgery. Paired Breast Reconstruction Risk Assessment (BRA) scores were analyzed to evaluate risk modulation before and after bariatric surgery in the setting of microvascular breast reconstruction.

Results:

A total of 1,026 patients were included with an average age of 47 and BMI of 44.7 kg/m2. Comorbidities included hypertension (601, 59%), type 2 diabetes (291, 28%), and cardiovascular disease (10, 1%). One-year outcomes after bariatric surgery included an average BMI of 32.7 kg/m2, with remission of type 2 diabetes in 29% of patients. Paired BRA risk analysis for microvascular breast reconstruction before and after bariatric surgery showed reduction in 30-day surgical complications (40.4% vs. 24.8%, P<0.0001), with an absolute risk reduction (ARR) of 15%, relative risk reduction (RRR) of 36%, and a number needed to treat (NNT) of 7. Each 1 kg/m2 reduction in preoperative BMI was associated with a 3.4% reduction in surgical complications (P<0.0001).

Conclusions:

There is potential efficacy for metabolic bridge therapy in reducing complications for obese patients undergoing microvascular breast reconstruction.
The Statistical Fragility of Outcomes on Breast Reconstruction with Acellular Dermal Matrix: A Systematic Review of Randomized Controlled Trials
Authors: Wang Anya , Kim Esther , Kwon Daniel , Coleman-Belin Janet , Oleru Olachi , Seyidova Nargiz , Taub Peter J
Published: October 2024

Introduction:

Acellular dermal matrix (ADM) is pivotal in breast surgery, yet the statistical robustness of surgical outcomes remains underexplored. This study employs the fragility index (FI), reverse fragility index (rFI), and fragility quotient (FQ) to investigate the statistical fragility of ADM breast reconstruction outcomes.

Methods:

Randomized controlled trials (RCTs) (2013-present) with dichotomous outcomes were sourced from PubMed, Embase, SCOPUS, Medline, and Cochrane databases. FI and rFI–event reversals needed to alter outcome significance–and FQ–standardized fragility across trials–were computed and reported as median (IQR). Subgroup analysis focused on intervention types.

Results:

Out of 33 studies screened, 19 RCTs comprising 204 outcomes were included, with a median FI of 4 (3 - 5) and FQ of 0.039 (0.029 - 0.070). Twenty-six outcomes achieved statistical significance, with a median FI of 3.5 (1 - 5) and FQ of 0.033 (0.010 - 0.073). The remaining 178 outcomes were nonsignificant, exhibiting a median FI of 4 (3 - 5) and FQ of 0.040 (0.030 - 0.070). Of the 204 outcomes, 18% had a number of patients lost to follow up equal to or surpassing the FI. By intervention type, the median FIs were similar in value but remained low.

Conclusion:

ADM-related breast reconstruction outcomes are statistically fragile, so reversal of a few outcomes or maintaining follow-up with patients may alter the significance of findings. Future researchers are thus recommended to report FI and FQ metrics with P-values to accurately portray reconstructive surgery outcomes.
Superior Identification of Metastatic Lesions by 68Ga-FAPI-46 PET/CT Than 18F-FDG PET/CT in Hepatic Solitary Fibrous Tumor
Authors: Fu Kaili , Zhao Liang , Cai Jiayu , Yu Lingyu , Chen Haojun
Published: October 2024

Solitary fibrous tumors (SFTs) are fibroblast tumors that occur mainly in the pleura. Hepatic SFT with skeleton metastases was rarely documented. In this case, we report the contrast-enhanced CT, 18F-FDG, and 68Ga-FAPI-46 PET/CT findings of a rare hepatic SFT with bone metastases. 68Ga-FAPI-46 PET/CT showed much higher tumor-to-background contrast of hepatic tumors and revealed more metastatic bone lesions than 18F-FDG PET/CT. This case demonstrated the superiority of 68Ga-FAPI-46 PET/CT over 18F-FDG for identifying metastatic lesions in malignant SFTs. This observation may add information on the benefit of FAPI PET/CT in SFT staging.
Integrated 68Ga-Pentixafor and 68Ga-FAPI-04 PET/MR for Diagnosing Adrenal Aldosterone-Producing Adenoma and Accessory Splenic Nodules
Authors: Ding Jie , Wang Weilun , Chen Xing , You Zhiwen , Zhao Jun
Published: October 2024

A 57-year-old man with primary aldosteronism exhibited multiple nodules in the left adrenal, pancreatic tail, and splenic region. The left adrenal nodule showed positive 68Ga-pentixafor and negative 68Ga-FAPI-04 uptake, suggesting an aldosterone-producing adrenal adenoma. The nodule in the pancreatic tail exhibited high 68Ga-pentixafor and low 68Ga-FAPI-04 uptake, similarity with the nodule in splenic region, indicating accessory splenic nodule. Postoperative pathology confirmed an adrenal cortical adenoma and an accessory splenic nodule in the pancreas. This case underscores the complementary role of 68Ga-pentixafor and 68Ga-FAPI-04 PET/MR in diagnosing complex adrenal and pancreatic pathologies.
Guidance for Circumflex Scapular Artery Flap Utilization in Pediatric Reconstruction
Authors: Lasky Sasha , Moshal Tayla , Roohani Idean , Manasyan Artur , Jolibois Marah , Wolfe Erin M. , Munabi Naikhoba C.O. , Fahradyan Artur , Daar David A. , Lee Jessica A. , Hammoudeh Jeffrey A.
Published: October 2024

Background

The circumflex scapular artery (CSA) flap system, consisting of scapular, parascapular, and chimeric flaps, is useful for pediatric reconstruction in many anatomical locations. The objectives of this case series are to offer insights into our decision-making process for selecting the CSA flap in particular pediatric reconstructive cases and to establish a framework for choosing a scapular or parascapular skin paddle. We also aim to emphasize important technical considerations of CSA flap utilization in pediatric patients.

Methods

Pediatric reconstruction with CSA flaps performed at our institution between 2006–2022 was retrospectively reviewed. Patient demographics, indications, flap characteristics, complications, and operative data were abstracted. Functional donor site morbidity was assessed through postoperative physical examinations. Unpaired t test analyzed scapular versus parascapular flap size.

Results

Eleven CSA flaps were successfully performed in 10 patients (6 scapular and 5 parascapular flaps). Patient ages ranged from 2 to 17 years. Scapular fasciocutaneous free flaps (n = 4) were performed in patients' ages 2–5 years for hand and forearm scar contractures. Two pedicled scapular flaps were performed for a single patient for bilateral axillary hidradenitis suppurativa. The 5 parascapular flaps were performed in patients' ages 2–14 years for calcaneus and forearm avulsion wounds and reconstruction after resection of hidradenitis suppurativa, nevus sebaceous, and Ewing sarcoma. In the sarcoma resection case, a chimeric flap with latissimus dorsi was employed. Average flap size was 101.6 ± 87.3 cm2 (range: 18–300 cm2). Parascapular flaps were significantly larger than scapular flaps (156.60 ± 105.84 cm2 vs 55.83 ± 26.97 cm2, P = 0.0495). Overall, 3 complications occurred (27.3% of cases) including venous congestion (n = 2) and wound dehiscence (n = 1). There were no reported cases of compromised shoulder function at 1.9 ± 2.5-year follow-up. The successful reconstruction rate for scapular, parascapular, and chimeric flaps was 100%.

Conclusions

The CSA flap treated a wide variety of indications demonstrating the flap's attributes: large vessel caliber, wide arc of rotation, reliable vascular anatomy, minimal donor site morbidity, and ability to incorporate bone and muscle. Our cases also highlight important pediatric considerations such as vascular mismatch and limited scapular bone stock. We recommend selection of the parascapular over the scapular flap with reconstruction of larger, complex defects given its ability to be harvested with a large skin paddle.
Frequency and Natural History of Emergency General Surgery Conditions in Cancer Patients
Authors: Jolissaint Joshua S. , Lobaugh Stephanie M. , Goldman Debra A. , McIntyre Sarah M. , Vos Elvira L. , Panageas Katherine S. , Wei Alice C.
Published: October 2024

Objective:

To determine if cancer patients experience variability in incidence or management of emergency general surgery (EGS) conditions compared to non-cancer patients.

Background:

The true frequency, and natural history of EGS conditions among cancer patients has not been characterized.

Methods:

We utilized SEER-Medicare data from January 2006–December 2015 to compare patients with breast, prostate, and lung cancer to a non-cancer cohort. Patients were followed from date of cancer diagnosis, or an index date for non-cancer patients, to the development of an EGS condition, death or last follow up. We assessed the cumulative incidence of EGS conditions over time, and fit multivariable Cox proportional hazards models to evaluate the impact of time-dependent surgical intervention on mortality.

Results:

We identified 322,756 patients with breast (N=82,147), lung (N=128,618), and prostate cancer (N=111,991) and 210,429 non-cancer patients.. Cancer patients had a higher incidence of an EGS condition within the first year after diagnosis (4.8% vs. 3.2%), with lung (6.8%) and breast cancer (4.0%) showing consistent rends. Cancer patients were less likely to undergo surgery for (13% vs. 14%, P=0.005), though this varied by cancer type and EGS conditions. Patients with breast (HR 1.27, 95%CI 1.17-1.39) and lung cancer (HR 3.27, 95%CI 3.07-3.48) were more likely to die within 30-days of an EGS diagnosis.

Conclusions:

Cancer patients experience a higher incidence of EGS conditions within the first year following diagnosis, but are less likely to undergo surgery. Future research is needed to explore the interplay between EGS conditions, their management, and receipt of intended oncologic therapy, and resulting outcomes.
Using artificial intelligence (AI) to assess the prevalence of false or misleading health-related claims
Authors: Rose Les , Bewley Susan , Payne Mandy , Colquhoun David , Perry Simon
Published: October 2024

Complementary healthcare in the United Kingdom is subject to voluntary, publicly funded regulation. Many such practices include pseudoscience. There are concerns that regulated practitioners make misleading health claims. This study used an artificial intelligence (AI) tool to measure the prevalence of such claims. Websites operated by practitioners of pseudoscientific complementary and alternative medicine, registered with the Complementary and Natural Healthcare Council, were downloaded and assessed by the AI, which determined whether a website was relevant to the investigation and, if so, identified health-related claims that it judged as false or misleading, supplying a rationale. Of 6096 registrants, 1326 met the selection criteria, of which 872 clinics had 725 relevant and operational websites. The AI assessed text from 11 771 web pages, identifying false or misleading claims in 704 (97%) of the websites. The AI’s performance was quality-assured by four human assessors, who manually reviewed 23 relevant web pages. Humans identified on average 39.5 claims likely to be judged false or misleading by advertising regulators, the AI identified 36. Humans misidentified an average of 4.8 claims, AI misidentified two. Most practitioners of pseudoscientific therapies registered with the Complementary and Natural Healthcare Council make misleading health claims online. AI could support regulator efficiency.
Disseminated tuberculosis with rare coccygeal involvement: a case report
Authors: Baziaa Sarra , Zegmout Adil , beaouiss Mohamed , el fathi soufiane , Rafik Aniss , souhi hicham , Rhorfi Ismail , El Ouazzani Hanane
Published: October 2024

Introduction : Tuberculosis (TB) is a preventable and usually curable disease but remains a major health problem worldwide, particularly in developing countries. TB of the lumbosacral junction is rare and occurs in only 1% to 2% of all cases of spinal TB. Moreover, isolated sacrococcygeal TB is extremely rare.
Case report : We present a case of a 64-year-old patient with a history of diabetes who presented with chronic back pain and cough. Physical examinations revealed a peri-anal fistula and left elbow joint arthritis. the patient is diagnosed with disseminated tuberculosis with coccygeal involvement. Diagnosis was achieved non-invasively using Xpert MTB/RIF confirming Mycobacterium tuberculosis infection. The patient experienced complete resolution of symptoms following the commencement of anti-tuberculosis therapy.
Conclusion : We highlight the importance of this case due to the rare coccygeal localization of tuberculosis in an immunocompetent patient, diagnosed through non-invasive means.
Emergent glutamate & dopamine dysfunction in VPS35(D620N)knock-in mice and rapid reversal by LRRK2 inhibition
Authors: Kamesh A. , Kadgien C.A. , Kuhlmann N. , Coady S. , Hurley E.P. , Barron J.C. , Parsons M.P. , Milnerwood A.J.
Published: October 2024

The D620N variant in Vacuolar Protein Sorting 35 (VPS35) causes autosomal-dominant, late- onset Parkinson’s disease. VPS35 is a core subunit of the retromer complex that canonically recycles transmembrane cargo from sorting endosomes. Although retromer cargoes include many synaptic proteins, VPS35’s neuronal functions are poorly understood. To investigate the consequences of the Parkinson’s mutation, striatal neurotransmission was assessed in 1-, 3- & 6-month-old VPS35 D620N knock-in (VKI) mice. Spontaneous and optogenetically- evoked corticostriatal glutamate transmission was increased in VKI striatal spiny projection neurons by 6 months, when total striatal glutamate release, quantified by iGluSnFR imaging, showed similarities to wild-type. dLight imaging revealed robust increases in VKI striatal dopamine release by 6 months, which were reversed with acuteex vivoleucine-rich repeat kinase 2 (LRRK2) inhibition. We conclude that increased glutamate and dopamine transmission in VKI mice progressively emerges in young-adulthood, and that dopamine dysfunction is likely the result of sustained, rapidly-reversible, LRRK2 hyperactivity.
Evaluating Cross-Platform Normalization Methods for Integrated Microarray and RNA-seq Data Analysis
Authors: Sun Xuejun , Zhang Yu , Liu Chuwen , Zheng Xiaojing , Zou Fei
Published: October 2024

Integrated analysis of human gene expression data from multiple studies has become essential in genomics research for complex traits. However, integrating data generated from different cohorts with different platforms, such as microarray and RNA-seq, often requires data preprocessing, including normalization. In this study, we empirically evaluate 9 commonly used cross-platform normalization methods. We classify these methods into two main types: joint and separate normalization. Joint methods normalize multiple datasets together, while separate methods normalize each dataset independently. We further divide these methods into unsupervised and supervised approaches depending on whether they use outcomes during their nor-malization process. Examples of joint unsupervised methods include Quantile Nor-malization (QN), while Rank-in serves as an example of a joint supervised method. Training Distribution Matching (TDM) is an example of a separate unsupervised method. We assess each method’s ability to cluster samples, predict outcomes, and detect differentially expressed (DE) genes using three real datasets and simulated data. First, our real data analysis suggests that while joint supervised methods can cluster sample groups better than the other two method groups, they double use the outcome data with artificially inflated clustering performance. Their biases are further demonstrated by their inflated type I error in DE analysis and clustering results from simulated data with no DE genes. Second, for outcome prediction, supervised normalization is no longer applicable. Among the unsupervised methods, QN significantly outperforms the other approaches, regardless of whether RNA-seq data is used to predict microarray outcomes or vice versa. Finally, we compare normalization methods on downstream DE analysis using simulation. In addition to direct DE analysis on the combined normalized data using the non-parametric Wilcoxon rank-sum test, we also perform a meta-analysis that combines p-values of the DE analysis from each individual data. For DE analysis, the meta-analysis consistently achieves the best balance between controlling type I error and maximizing power for DE gene detection. Our research suggests that while normalization is critical for the integrated analysis of transcriptomics data, simple QN is the most efficient and unbiased normalization approach for outcome prediction, and meta-analysis is the most appropriate for DE analysis.
Differential benefit of adjuvant everolimus according to endocrine therapy backbone in the randomized UNIRAD trial
Authors: Saint-Ghislain Mathilde , Chabaud Sylvie , Dalenc Florence , Allouache Djelila , Cameron David , Martinez Mathilde , Grenier Julien , Barthelemy Philippe , Brunt Murray , Kaluzinski Laure , Mailliez Audrey , Legouffe Eric , Hardy-Bessard Anne-Claire , Giacchetti Sylvie , Mouret-Reynier Marie-Ange , Canon Jean-Luc , Bliss Judith , Lemonnier Jérôme , Andre Fabrice , Bachelot Thomas , Cottu Paul
Published: October 2024

ABSTRACT

Background

The randomized, double-blind UNIRAD trial evaluating the addition of 2 years of everolimus to endocrine therapy in patients with high-risk, early luminal breast cancer failed to demonstrate a benefit. We report the subgroup analyses.

Patients and Methods

We randomized 1278 patients in a 1:1 ratio to receive 2 years of placebo or everolimus, added to endocrine therapy for up to 4 years after initiation. Randomization was stratified by endocrine therapy agent, prior adjuvant versus neoadjuvant therapy, progesterone receptor expression, and lymph node involvement. Subgroup analyses by each stratification factor were prespecified. Post hoc analyses were performed according to menopausal status and age. We also analyzed treatment adherence.

Results

We observed a limited trend toward more favorable prognostic features in tamoxifen-treated patients, with more frequent ER+/PR+ tumors (88.5% vs. 84.1%, p=0.026) and less frequent pN2+ status (39.8% vs. 46%, p=0.032). In premenopausal women, we observed a numerical benefit of everolimus: 3y-DFS was 86% in the placebo group and 90% in the everolimus group [HR=0.76 (95%CI: 0.43-1.34)]. In premenopausal patients treated with tamoxifen (n=153; 12.3%), we observed an even stronger trend in favor of everolimus as 3-year DFS was 84% in the placebo group and 91% in the everolimus group [HR=0.54 (95%CI: 0.28-1.02)]. Early discontinuation of either everolimus or placebo was less frequent in the tamoxifen group than in the AI group: 48.0% vs. 56.9% (p=0.028).

Conclusions

The present post-hoc analyses generate hypotheses regarding the interaction between menopausal status, tamoxifen and everolimus in patients with high-risk, ER-positive, HER2-negative early breast cancer. They suggest that tamoxifen alone is no longer the standard of care in high-risk premenopausal patients.
Evaluation of a Next Generation Sequencing Assay for Hepatitis B Antiviral Drug Resistance on the Oxford Nanopore System
Authors: Payne Michael , Ritchie Gordon , Lawson Tanya , Young Matthew , Jang Willson , Stefanovic Aleksandra , Romney Marc G. , Matic Nancy , Lowe Christopher F.
Published: October 2024

Background

Next-generation sequencing (NGS) for Hepatitis B virus (HBV) antiviral resistance (AVR) testing is a highly sensitive diagnostic method, able to detect low-level mutant subpopulations. Our clinical virology laboratory previously transitioned from DNA hybridization (INNO-LiPA) to NGS, initially with the GS Junior System and subsequently the MiSeq. The Oxford Nanopore Technology (ONT) sequencing system was evaluated for HBV resistance testing, with regards to sequencing accuracy and turn-around time.

Methods

We performed amplicon sequencing of the HBV polymerase gene from patient plasma and external quality assessment (EQA) samples on the MiSeq Reagent Nano Kit v2 and GridION ONT with R10.4.1 flowcells. Mutational analysis and genotyping were performed by DeepChekAssay-HBV (version 2.0).

Results

A total of 49 patient samples and 15 EQA samples were tested on both the MiSeq and ONT. There was high agreement for both patient and EQA samples between the MiSeq and ONT systems, with regards to total drug resistance mutations detected and total patient sample agreement, 68/70 (97%) and 47/49 (96%), respectively.

Conclusion

The ONT NGS platform provided accurate HBV AVR results, with improved turn- around times. Sequencing error rates at AVR codons were below 1%.
Identifying trivial and Majorana zero-energy modes using the Majorana polarization
Authors: Awoga Oladunjoye A. , Cayao Jorge
Published: October 2024

In this work we consider superconductor-semiconductor hybrids containing both trivial and Majorana zero modes and explore their signatures in the Majorana polarization. In particular, we consider trivial zero-energy states due to confinement and disorder, which seem to be very likely experimental scenarios. We show that the Majorana polarization is able to characterize the topological phase transition as well as the emergence of Majorana zero modes even when trivial zero-energy states proliferate. Notably, the Majorana polarization inherits direct information about spatial correlations which are then the key for distinguishing Majorana and trivial zero modes. We demonstrate the utility of the Majorana polarization in normal-superconductor junctions and superconductor-normal-superconductor Josephson junctions. Our results support the interpretation of the Majorana polarization as a real-space topological indicator.

Published by the American Physical Society
2024
Measurement of the
e+e−→KSKL
cross section near the
ϕ(1020)
resonance with the SND detector
Authors: Achasov M. N. , Barnyakov A. Yu. , Bedarev E. V. , Beloborodov K. I. , Berdyugin A. V. , Bogdanchikov A. G. , Botov A. A. , Chistyakov D. E. , Dimova T. V. , Druzhinin V. P. , Kardapoltsev L. V. , Kasaev A. S. , Kattsin A. A. , Kharlamov A. G. , Koop I. A. , Korol A. A. , Kovrizhin D. P. , Kupich A. S. , Kryukov A. P. , Melnikova N. A. , Muchnoi N. Yu. , Obrazovsky A. E. , Pakhtusova E. V. , Pugachev K. V. , Rastigeev S. A. , Rogovsky Yu. A. , Senchenko A. I. , Serednyakov S. I. , Shatunov Yu. M. , Sherstyuk S. P. , Shtol D. A. , Silagadze Z. K. , Surin I. K. , Usov Yu. V. , Zhabin V. N. , Zharinov Yu. M. ,   SND Collaboration
Published: October 2024

The cross section for the e+e−→KSKL process is measured in the center-of-mass energy range from 1000 to 1100 MeV in the experiment with the SND detector at the VEPP-2000  e+e− collider. The measurement is carried out in the KS→2π0 decay mode. Data with an integrated luminosity of 20  pb−1 recorded in 2018 at 18 energy points are used in the analysis. The systematic uncertainty in the measured cross section at the maximum of the ϕ resonance is 0.9%. The mass, width of the ϕ meson, and the product of the branching fractions B(ϕ→KSKL)B(ϕ→e+e−) are determined from the fit to the cross section energy dependence.

Published by the American Physical Society
2024