bluuebunny/crossref_metadata_2025 huggingface dataset:
Kripke, Quine, the ‘Adoption Problem’ and the Empirical Conception of Logic
Authors: Boghossian Paul , Wright Crispin
Published: November 2023

Recently, there has been a significant upsurge of interest in what has come to be known as the 'Adoption Problem', first developed by Saul Kripke in 1974. The problem purports to raise a difficulty for Quine’s anti-exceptionalist conception of logic. In what follows, we first offer a statement of the problem and argue that, so understood, it depends upon natural but resistible assumptions. We then use that discussion as a springboard for developing a different adoption problem, arguing that, for a significant class of basic logical principles, there is indeed a difficulty in seeing how they might be ‘freely adopted,’ thereby vindicating something close to the spirit of Kripke’s original claim. This first part of our argument will enforce a significant qualification of Quine’s claim that basic logical principles can be empirically confirmed. In the concluding sections of the paper, we turn to the question, specifically, of the empirical revisability of logic, arguing that when proper attention is paid to the role of reasoning in theory revision, it does indeed emerge that anti-exceptionalism, in full generality, is untenable.
Coherent deflection pattern and associated temperature enhancements in the near-Sun solar wind
Authors: Laker Ronan , Horbury T S , Woodham L D , Bale S D , Matteini L
Published: November 2023

Measurements of transverse magnetic field and velocity components from Parker Solar Probe have revealed a coherent quasi-periodic pattern in the near-Sun solar wind. As well as being Alfvénic and arc-polarized, these deflections were characterized by a consistent orientation and an increased proton core temperature, which was greater parallel to the magnetic field. We show that switchbacks represent the largest deflections within this underlying structure, which is itself consistent with the expected outflow from interchange reconnection simulations. Additionally, the spatial scale of the deflections was estimated to be around 1 Mm on the Sun, comparable to the jetting activity observed at coronal bright points within the base of coronal plumes. Therefore, our results could represent the in situ signature of interchange reconnection from coronal bright points within plumes, complementing recent numerical and observational studies. We also found a consistent relationship between the proton core temperature and magnetic field angle across the Parker Solar Probe encounters and discussed how such a persistent signature could be more indicative of an in situ mechanism creating a local increase in temperature. In future, observations of minor ions, radio bursts, and remote sensing images could help further establish the connection between reconnection events on the Sun and signatures in the solar wind.
The tidal excitation of r modes in a solar-type star orbited by a giant planet companion and the effect on orbital evolution – II. The effect of tides in the misaligned case
Authors: Papaloizou J C B , Savonije G J
Published: November 2023

We extend the study of Papaloizou and Savonije of the tidal interactions of close orbiting giant planets with a central solar-type star to the situation where the spin axis of the central star and the orbital angular momentum are misaligned. We determine the tidal response taking into account the possibility of the excitation of r modes and the effect of tidal forcing due to potential perturbations that have zero frequency in a non-rotating frame. Although there is near resonance with r modes with degree l′ = 1 and orders m = ±1, half widths turn out to be sufficiently narrow so that in practice dissipation rates are found to be similar to those produced by non-resonant potential perturbations. We use our results to determine the evolution of the misalignment for the full range of initial inclination angles taking account of the spin-down of the central star due to magnetic braking. Overall we find the rate of tidal evolution to be unimportant for a one Jupiter mass planet with orbital period ∼3.7 d over a main-sequence lifetime. However, it becomes significant for higher mass planets and shorter orbital periods, approximately scaling as the square of the planet mass and the inverse fourth power of the orbital period.
Building Phylogenetic Trees From Genome Sequences With kSNP4
Authors: Hall Barry G , Nisbet Jeremiah
Published: November 2023

Performing phylogenetic analysis with genome sequences maximizes the information used to estimate phylogenies and the resolution of closely related taxa. The use of single-nucleotide polymorphisms (SNPs) permits estimating trees without genome alignments and permits the use of data sets of hundreds of microbial genomes. kSNP4 is a program that identifies SNPs without using a reference genome, estimates parsimony, maximum likelihood, and neighbor-joining trees, and is able to annotate the discovered SNPs. kSNP4 is a command-line program that does not require any additional programs or dependencies to install or use. kSNP4 does not require any programming experience or bioinformatics experience to install and use. It is suitable for use by students through senior investigators. It includes a detailed user guide that explains all of the many features of kSNP4. In this study, we provide a detailed step-by-step protocol for downloading, installing, and using kSNP4 to build phylogenetic trees from genome sequences.
Re-emphasising the importance of catheter-based angiography to differentiate polyarteritis nodosa from cutaneous arteritis: Two case reports
Authors: Suzuki Koji , Akiyama Mitsuhiro , Kondo Yasushi , Saito Shuntaro , Kikuchi Jun , Hanaoka Hironari , Kaneko Yuko
Published: November 2023

Polyarteritis nodosa (PAN) is a systemic necrotising vasculitis with a poor prognosis, characterised by inflammation and necrosis of medium-sized arteries. PAN patients can present with a wide range of systemic manifestations, whereas cutaneous arteritis (CA) is a restricted manifestation to skin of the disease with a more favourable prognosis. Thus, differentiation between PAN and CA is crucial. Here, we present two cases that were initially diagnosed as CA due to the limited presence of systemic symptoms, but were finally diagnosed as PAN through catheter-based angiography. Although contrast-enhanced computed tomography and computed tomographic angiography are increasingly used to diagnose PAN, neither case had any abnormal findings on these examinations. Our cases therefore underscore that catheter-based angiography is critical for differentiation between PAN and CA, even in cases with limited systemic symptoms.
Pediatric low-grade glioma: State-of-the-art and ongoing challenges
Authors: Fangusaro Jason , Jones David T , Packer Roger J , Gutmann David H , Milde Till , Witt Olaf , Mueller Sabine , Fisher Michael J , Hansford Jordan R , Tabori Uri , Hargrave Darren , Bandopadhayay Pratiti
Published: November 2023

The most common childhood central nervous system (CNS) tumor is pediatric low-grade glioma (pLGG), representing 30%–40% of all CNS tumors in children. Although there is high associated morbidity, tumor-related mortality is relatively rare. pLGG is now conceptualized as a chronic disease, underscoring the importance of functional outcomes and quality-of-life measures. A wealth of data has emerged about these tumors, including a better understanding of their natural history and their molecular drivers, paving the way for the use of targeted inhibitors. While these treatments have heralded tremendous promise, challenges remain about how to best optimize their use, and the long-term toxicities associated with these inhibitors remain unknown. The International Pediatric Low-Grade Glioma Coalition (iPLGGc) is a global group of physicians and scientists with expertise in pLGG focused on addressing key pLGG issues. Here, the iPLGGc provides an overview of the current state-of-the-art in pLGG, including epidemiology, histology, molecular landscape, treatment paradigms, survival outcomes, functional outcomes, imaging response, and ongoing challenges. This paper also serves as an introduction to 3 other pLGG manuscripts on (1) pLGG preclinical models, (2) consensus framework for conducting early-phase clinical trials in pLGG, and (3) pLGG resistance, rebound, and recurrence.
Women’s Education and Improved Infant and Child Survival
Authors: Jejeebhoy Shireen J
Published: November 2023

The inverse relationship of women’s education to infant and child mortality is well established in all regions of the developing world. Even a small amount of education leads to improvements in child survival and well-being. Moreover, in most studies, a woman’s education has a stronger net effect on child survival than does either the household’s economic status or her husband’s characteristics. The differentials between women with some secondary education and those with no education tend to be wider and threshold levels lower in higher income, higher literacy, and more egalitarian (in terms of literacy) settings. The literature speculates that the main reasons underlying the inverse relationship have to do with educated women’s greater propensity to care for their children, to use modem health facilities, and to adopt modem health practices. This is not necessarily the result of their greater knowledge of disease causation; rather, it appears to result from their enhanced awareness of good health practices, their greater confidence about dealing with their environments, and their greater ability to make and implement independent decisions on children’s well-being.
Summary and Conclusions
Authors: Jejeebhoy Shireen J
Published: November 2023

This review of literature has borne out the indisputable impact of education on women’s lives. More specifically, this review has offered unambiguous, although qualified, support for the widely held belief that fertility reduction is one consequence of improvements in female education and consequent changes in women’s autonomy. Support is unambiguous because in almost every known social setting, regardless of region, culture, or level of development, the best educated women bear fewer children than uneducated women do. Also, in almost every setting where it has been studied, the impact of female education on fertility is genuine; it cannot be explained by the fact that educated women marry better educated men or come from wealthier households.
Comparative efficacy and safety of bimekizumab in axial spondyloarthritis: a systematic literature review and network meta-analysis
Authors: Deodhar Atul , Machado Pedro M , Mørup Michael , Taieb Vanessa , Willems Damon , Orme Michelle , Pritchett David , Gensler Lianne S
Published: November 2023

Objectives

To compare the efficacy and safety of bimekizumab 160 mg every 4 weeks, a selective inhibitor of IL-17F and IL-17A, with those of biologic/targeted synthetic DMARDs (b/tsDMARDs) in non-radiographic axial SpA (nr-axSpA) and AS.

Methods

A systematic literature review identified randomized controlled trials until January 2023 for inclusion in Bayesian network meta-analyses (NMAs), including three b/tsDMARDs exposure networks: predominantly-naïve, naïve, and experienced. Outcomes were Assessment of SpondyloArthritis international Society (ASAS)20, ASAS40 and ASAS partial remission (PR) response rates at 12–16 weeks. A safety NMA investigated discontinuations due to any reason and serious adverse events at 12–16 weeks.

Results

The NMA included 36 trials. The predominantly-naïve network provided the most comprehensive results. In the predominantly-naïve nr-axSpA analysis, bimekizumab had significantly higher ASAS20 response rates vs secukinumab 150 mg [with loading dose (LD)/without LD], and comparable response rates vs other active comparators. In the predominantly-naïve AS analysis, bimekizumab had significantly higher ASAS40 response rates vs secukinumab 150 mg (without LD), significantly higher ASAS-PR response rates vs secukinumab 150 mg (with LD) and comparable response rates vs other active comparators. Bimekizumab demonstrated similar safety to that of other b/tsDMARDs.

Conclusion

Across ASAS outcomes, bimekizumab was comparable with most b/tsDMARDs, including ixekizumab, TNF inhibitors and upadacitinib, and achieved higher response rates vs secukinumab for some ASAS outcomes in predominantly b/tsDMARD-naïve nr-axSpA and AS patients at 12–16 weeks. In a pooled axSpA network, bimekizumab demonstrated comparable safety vs other b/tsDMARDs.
Effect of SARS-CoV2 infection on disease flares in patients with systemic lupus erythematosus: a case–control study
Authors: Mok Chi Chiu , Cheung Chris Ching Lam , Chan Kar Li , Tse Sau Mei , To Chi Hung
Published: November 2023

Objectives

To study the effect of SARS-CoV2 infection on flares of systemic lupus erythematosus (SLE).

Methods

Patients who fulfilled the ACR/SLICC criteria for SLE and had documented COVID-19 between February and November 2022 were identified retrospectively from our hospital COVID-19 registry. SLE controls who did not have SARS-CoV2 infection were randomly matched for age, sex and the time of infection in a 2:1 ratio with those infected. The primary outcome of interest was clinical flare of SLE within 90 days of COVID-19. The rate of SLE flares (mild/moderate or severe) was compared between SARS-CoV2-infected SLE patients and controls.

Results

Ninety-one SLE patients with COVID-19 (age 48.6 (14.0) years; 95.6% women) and 182 SLE controls (age 48.7 (13.8) years; 95.6% women) were studied. Eleven of 91 (12.1%) SARS-CoV2-infected patients had serious manifestations. One (1.1%) patient died and 7 (7.7%) developed severe complications. Within 90 days of SARS-CoV2 infection, 14 (15.4%) patients developed mild/moderate clinical SLE flares and two (2.2%) patients had severe SLE flares. The incidence of SLE flares in SARS-CoV2-infected patients was significantly higher than in those without the infection (17.6% vs 5.5%; odds ratio 3.67 [95% CI: 1.59, 8.46]; P = 0.001). The changes in anti-dsDNA and complement levels, however, were not significantly different between the two groups. Among SARS-CoV2-infected SLE patients, those with clinical SLE flares had significantly lower C3 values (P = 0.004) before the infection than those without.

Conclusion

Clinical flares within 90 days were significantly more common in SLE patients infected with SARS-CoV2 than matched non-infected SLE controls.
Barriers and Facilitators of Center-Based Cardiac Rehabilitation Utilization in South Asian Ethnic Minorities
Authors: Inayat Shahzad , Hayden K. Alix , Campbell Tavis , Shier Kathryn King
Published: November 2023

Aim:

The aim of this review was to synthesize literature on the perceptions of South Asian ethnic minorities of the barriers and facilitators to center-based, phase II cardiac rehabilitation (CR).

Methods:

A meta-synthesis approach was used, and findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was conducted from database inception dates to July 2022 using the following databases: MEDLINE, EMBASE, APA PsycINFO, Cochrane Database of Systematic Review, CINAHL, Scopus, and Web of Science. The inclusion criteria were studies that examined the barriers and/or facilitators of structured center-based CR among South Asian adult ethnic minorities. Critical appraisal of the included studies was conducted using the Mixed Methods Appraisal Tool. Findings were synthesized using a thematic synthesis approach.

Results:

Among the 7110 records initially retrieved only nine studies conducted in the United Kingdom or Canada met the inclusion criteria. More barriers than facilitators were studied and reported. Key barriers were the English language difficulty, fatalistic beliefs, previous bad interactions with and negative perception of health care professionals, transportation problems, work schedule conflict, safety issues, and long-distance CR centers. The facilitators included patient-preferred environment, presence of family members during exercise, family and friends support, and encouragement to change lifestyle and enroll in a CR program.

Conclusion:

The review findings revealed that South Asian ethnic minorities encounter various barriers and facilitators to enroll and complete CR. The findings can inform researchers and clinicians in the development of interventions that are tailored to their cultural needs.

Practice Implications:

The findings can be valuable to health care professionals and policy makers in designing customized CR programs for South Asian minorities.
Physiological Responses and Performance of Simulated High-Rise Firefighting
Authors: Stevenson Richard Daniel Mark , Warwick Joseph , Bilzon James Lee John
Published: November 2023

Objective

The aim of the study is to determine the physiological effects of breathing apparatus and ascent strategies during a simulated 120-m vertical high-rise firefighting ascent.

Methods

Twenty-eight firefighters completed four high-rise firefighting trials wearing standard- or extended-duration breathing apparatus with continuous ascent (SDBA-C/EDBA-C) or with breaks (SDBA-B/EDBA-B). Task time, heart rate, ratings of perceived exertion, core body temperature, and thermal comfort were recorded at predetermined elevations.

Results

Task time took significantly longer during the EDBA-C compared with SDBA-C trial. Heart rate (at 40, 80, and 100 m) was significantly lower in trials following breaks compared with the continuous trials. Core body temperature rose by 0.11°C every 10 m of ascent. During the SDBA trials, 89% to 96% of firefighters activated their low air alarm compared with only 7% in EDBA.

Conclusions

Firefighters should wear EDBA beyond 80 m of ascent and are encouraged to take regular breaks.
Assessing the efficacy and safety of Craniosacral therapy for migraine: A single center randomized controlled trial
Authors: Jiang Guangya , Ma Saichao , Zhao Jinfeng , Zhang Ming , Li Yan , Chen Wenli , Cui Lin , Jia Liuyun
Published: November 2023

Objective:

Design a feasible study to assess the efficacy and safety of Craniosacral therapy (CST) in the treatment of migraine, using a rigorous and innovative randomized controlled study design involving complementary light-touch sham treatments (CLST) as an attention control intervention.

Methods:

This was a single-center, randomized, cross-over placebo-controlled experimental design. A total of 87 participants who suffered migraine attacks from 4 to 9 per month were randomly assigned into either 2 weekly units of CST or CLST for 4 weeks. And then the 2 groups were crossed and continued treatment for 4 weeks plus a follow-up observation for 4 weeks. As the primary outcome measures, Headache Impact Test-6 (HIT-6) and headache frequency were assessed every 4 weeks (at baseline, week 4, week 8 and week 12). The secondary outcome was the scores of Headache Disability inventory (HDI) and the Hamilton Anxiety Scale (HAMA) as well as the adverse events.

Results:

All 87 individuals had been screened for eligibility, of which 60 were licensed for the study. The difference of HIT-6 and headache frequency between the 2 groups was not significant at the baseline. But the headache frequency and HIT-6 of 2 groups were all declined respectively after the CST at week 4 (group A) and week 8 (group B) than before (P
☆= 0.01 < 0.05, 95% CI, −3.06 to −1.87; P
※= 0.01 < 0.05, 95% CI, −3.52 to −2.53; P
1A = 0.01 < 0.05, 95% CI, 4.55–11.7; P
2B = 0.01 < 0.05, 95% CI, −11.78 to −6.01) while the changes were not obvious after CLST with previous treatment. The scores and frequency of fourth evaluation showed that there was no significant increase or decrease in both the 2 groups. Besides, we found that the mean scores of HIT-6 for all participants, compared with the baseline, were decreased significantly after the 3 round treatments (P
3A = 0.01 < 0.05, 95% CI, −13.12 to −6.4; P
3B = 0.01 < 0.05, CI, −12.73 to −6.69). We also showed the similar result in the scores of HDI and HAMA.

Conclusion:

The results indicated that standardized CST was both effective and safe in alleviating the migraine intensity and frequency as well as the headache-related disability. Further larger research is needed.
Higher systemic immune-inflammation index is associated with increased risk of erectile dysfunction: Result from NHANES 2001–2004
Authors: Zhong Lian , Zhan Xiangpeng , Luo Xin
Published: November 2023

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) to investigate the association between the systemic immune-inflammation index (SII) and erectile dysfunction (ED) in adult males. The SII is a novel index derived from the counts of neutrophils, lymphocytes, and platelets in the peripheral blood and serves as a comprehensive indicator of the immune response and inflammation levels. The study included 3601 participants from the NHANES 2001-2004 cycle. Covariates such as age, race, marital status, education, smoking, alcohol consumption, BMI, hypertension, and diabetes were taken into account. Weighted analysis and logistic regression models were applied to assess the relationship between SII and ED, adjusting for potential confounding factors. The prevalence of ED was found to be 6.28%. Overall, there is a linear correlation between SII (nonlinear P > .05) and ED. After adjusting for various confounding factors, a significant association was observed between high levels of the SII and ED. The odds ratio (OR) for ED in individuals with high SII levels was 1.45 (95% CI: 1.01–2.17, P = .045). Subgroup analysis further identified specific participant subgroups with a significant association between SII and ED. Our findings suggest that higher levels of the SII are independently associated with an increased risk of ED in adult males. The SII may serve as a valuable biomarker for identifying individuals at higher risk of ED and may aid in the development of tailored treatment approaches. Further research is needed to explore the underlying mechanisms and potential therapeutic implications.
Combined effect of left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease
Authors: Won Mi Hwa , Shim JaeLan
Published: November 2023

Sedentary behavior has been associated with poor adherence to treatment in patients with coronary artery disease. Low left ventricular ejection fraction and obesity have been separately linked to increased sedentary behavior in patients with coronary artery disease. However, the combined effect of low left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease has not been thoroughly investigated. Therefore, this study aimed to examine the combined influence of left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease. This descriptive cross-sectional study enrolled 200 inpatients aged ≥ 20 years who were diagnosed with coronary artery disease at a tertiary hospital in Korea between March and August 2022. Data were collected using structured questionnaires, and multivariate logistic regression analysis was performed to determine the combined effect of left ventricular ejection fraction and obesity on sedentary behavior in patients with coronary artery disease. Among the 111 patients with sedentary behavior, 38 (34.2%) had both low left ventricular ejection fraction and obesity, whereas only 11 (12.4%) of the 89 patients without sedentary behavior had both low left ventricular ejection fraction and obesity. In multivariate logistic regression analysis, patients with coronary artery disease who had both low left ventricular ejection fraction and obesity had the highest risk of sedentary behavior compared to those without either low left ventricular ejection fraction or obesity (odds ratio = 13.98, 95% confidence interval = 5.19–37.69, P < .001). The co-existence of low left ventricular ejection fraction and obesity in patients with coronary artery disease may be associated with sedentary behavior. Therefore, evaluating both left ventricular ejection fraction and obesity when assessing sedentary behavior in patients with coronary artery disease may be valuable in implementing patient-centered approaches for the secondary prevention and management of sedentary behavior in patients with coronary artery disease. However, further prospective cohort studies with larger sample sizes are required to establish causal relationships and explore interventions to mitigate sedentary behavior in this population.
Assessing the scientific quality and reliability of YouTube videos about chemotherapy
Authors: Sahin Elif , Seyyar Mustafa
Published: November 2023

No studies have evaluated the interaction, quality, and reliability of chemotherapy-related videos published on YouTube. The aim was to evaluate the content of YouTube videos about chemotherapy using 5 different scoring tools. In this cross-sectional register-based study, popular videos on YouTube about the following keywords were examined; “chemotherapy,” “what is chemotherapy,” “types of chemotherapy,” “chemotherapy side effects” and “chemotherapy treatments.” Quality and reliability of video content were measured using the modified DISCERN (mDISCERN), the Journal of the American Medical Association (JAMA), the Global Quality Score (GQS), the Video Information Quality Index (VIQI), and Health on the Net code (HONcode) scores. A total of 108 videos were analyzed in the study. The median duration was 200 (30-2020) seconds and the median total number of views was 17500 (61-8615000). Among the video publishers, private hospitals were the most (n = 36, 33%). The most (n = 71, 66%) populer category of videos were patient education videos. Half (n = 55, 51%) of the narrators in the videos were only oncology professionals. Mean DISCERN, JAMA, GQS, VIQI, and HONcode scores were 2.73 ± 1.18, 1.97 ± 1.05, 2.94 ± 1.08, 14.03 ± 3.73, and 4.68 ± 2.46, respectively. A positive correlation was found between the 5 scoring points (P < .001 for all pairwise comparisons). There was a significant difference between video quality scores according to video categories and video publishers (P < .001 for both). Although most YouTube videos about chemotherapy were helpful to patients, content quality and reliability were moderate-low. Cancer patients looking for information on chemotherapy may find YouTube videos beneficial, but clinicians must be cautious to clear up any misunderstandings.
Psychiatric Treatment of Medical Colleagues and Their Families: Potential Risks
Authors: Constantino Eduardo , Spina Thomas
Published: November 2023

Clinicians treating “very important persons” face potential problems that can negatively impact the quality of care they provide. Mental health professionals face similar pressures, particularly when asked to treat a particular kind of patient who is a very important person: medical colleagues or their family members. The authors present 3 cases that exemplify possible risks associated with the psychiatric treatment of these individuals, including negative effects on the physician-patient relationship, lapses in patient confidentiality, and violations of medical ethics. Preventive and mitigative steps to avoid these pitfalls are discussed. Awareness of these issues when treating fellow physicians or their family members is an important consideration for any mental health clinician.
The Neuropsychiatric Side of Cerebral Venous Thrombosis: A Case of Delirium and Catatonia
Authors: Calva-González Metzli , Tello-Gerez Triana Juliana , Serrano-Arias Fabiola , Cano-Nigenda Vanessa , Ramírez-Bermúdez Jesus
Published: November 2023

We report a patient with cerebral venous thrombosis who initially presented with psychosis and who then progressed to delirium and catatonia within a few days. Upon treatment and resolution of the thrombosis, she presented complete remission of the psychiatric disturbances. This case highlights a specific neuropsychiatric presentation of cerebral venous thrombosis involving psychosis, catatonia, and delirium, which, to our best knowledge, has not been reported in the neurological or psychiatric literature. However, it reminds us of mental status and behavioral abnormalities which are not infrequent features of cerebral venous thrombosis. This leads to a discussion regarding the psychopathology, etiology, and pathophysiology of the case.
Machine Learning–Based Magnetic Resonance Radiomics Analysis for Predicting Low- and High-Grade Clear Cell Renal Cell Carcinoma
Authors: Sim Ki Choon , Han Na Yeon , Cho Yongwon , Sung Deuk Jae , Park Beom Jin , Kim Min Ju , Han Yeo Eun
Published: November 2023

Purpose

To explore whether high- and low-grade clear cell renal cell carcinomas (ccRCC) can be distinguished using radiomics features extracted from magnetic resonance imaging.

Methods

In this retrospective study, 154 patients with pathologically proven clear ccRCC underwent contrast-enhanced 3 T magnetic resonance imaging and were assigned to the development (n = 122) and test (n = 32) cohorts in a temporal-split setup. A total of 834 radiomics features were extracted from whole-tumor volumes using 3 sequences: T2-weighted imaging (T2WI), diffusion-weighted imaging, and contrast-enhanced T1-weighted imaging. A random forest regressor was used to extract important radiomics features that were subsequently used for model development using the random forest algorithm. Tumor size, apparent diffusion coefficient value, and percentage of tumor-to-renal parenchymal signal intensity drop in the tumors were recorded by 2 radiologists for quantitative analysis. The area under the receiver operating characteristic curve (AUC) was generated to predict ccRCC grade.

Results

In the development cohort, the T2WI-based radiomics model demonstrated the highest performance (AUC, 0.82). The T2WI-based radiomics and radiologic feature hybrid model showed AUCs of 0.79 and 0.83, respectively. In the test cohort, the T2WI-based radiomics model achieved an AUC of 0.82. The range of AUCs of the hybrid model of T2WI-based radiomics and radiologic features was 0.73 to 0.80.

Conclusion

Magnetic resonance imaging–based classifier models using radiomics features and machine learning showed satisfactory diagnostic performance in distinguishing between high- and low-grade ccRCC, thereby serving as a helpful noninvasive tool for predicting ccRCC grade.
Diagnostic Approaches to Neuroendocrine Neoplasms of Unknown Primary Site
Authors: Daoud Taher , Morani Ajaykumar C. , Waters Rebecca , Bhosale Priya , Virarkar Mayur K.
Published: November 2023

Neuroendocrine tumors (NETs) are relatively uncommon heterogeneous neoplasms arising from endocrine and neuronal origin cells showing highly variable clinical behavior. By the time these tumors are discovered, up to 14% of patients with histologically proven NETs have metastasis, with the liver as the most frequently affected organ. Sometimes, no known primary site can be identified via routine imaging. Neuroendocrine tumors of unknown origin carry a poorer prognosis (compared with metastatic NETs with a known primary site) because of a lack of tailored surgical intervention and appropriate medical therapy (eg, chemotherapy or targeted therapy). A multimethod approach is frequently used in the trial to accurately determine the primary site for NETs of unknown primary sites and may include clinical, laboratory, radiological, histopathological, and surgical data. New molecular techniques using the genomic approach to identify the molecular signature have shown promising results. Various imaging modalities include ultrasound, computed tomography (CT), dual-energy CT, magnetic resonance imaging, and functional and hybrid imaging (positron emission tomography/CT, positron emission tomography/magnetic resonance imaging); somatostatin receptor imaging with new tracers is frequently used in an attempt for localization of the primary site.
Mylohyoid Muscle: Current Understanding for Clinical Management Part II: Clinical Anatomy, Radiology, and Surgical/Clinical Relevance
Authors: Obata Kyoichi , Kitagawa Norio , Ono Kisho , Kanemoto Hideka , Fukino Keiko , Takeshita Yohei , Ibaragi Soichiro , Tubbs R. Shane , Iwanaga Joe
Published: November 2023

The mylohyoid is one of the suprahyoid muscles along with the geniohyoid, digastric, and stylohyoid muscles that lies between the anterior belly of the digastric muscle inferiorly and the geniohyoid superiorly. In Part II, the radiology and clinical/surgical importance of the mylohyoid muscle will be discussed.
Evaluation of Sella Turcica Morphology and Morphometry Based on Gender and Age in Our Population Using Computed Tomography
Authors: Sönmez Elif İpek , Polat Sema , Öksüzler Mahmut , Göker Pinar
Published: November 2023

In this study, it was aimed to determine the reference values for the healthy Turkish population by evaluating the age-related changes in the morphology and morphometry of Sella Turcica (ST) and the relationship with the body mass index. In addition, it has been investigated whether the morphology and morphometry of this structure vary in diabetes mellitus (DM) patients. The study group was consisted of a total of 524 individuals (266 females and 258 males) (426 healthy and 48 with DM) between the ages of 1 and 80, who applied to the Department of Radiology between January 2018 and February 2021. Axial brain computed tomography scans which have no pathology in ST were retrospectively examined. The ST length (STL), height (STH), diameter (STD), processus clinoideus anterior right-left (PCAR_L), processus clinoideus posterior right-left (PCPR_L) did not differ significantly in healthy individuals and individuals with DM (P>0.05). When the ST morphology according to the ST shape classification performed by Meyer Marcotti and colleagues and Axellson and colleagues was evaluated, it was observed that there was no statistically significant difference between the 2 groups (P>0.05). There was a significant difference in STL, STD values (P<0.05), however, there was no difference in STH, PCAR_L, PCPR_L values between genders (P>0.05). While the distance between STL, STD, PCAR_L showed a significant difference between the decades in all groups, there was no significant difference in the STH, PCPR_L in both classifications (P>0.05). When the relationship between the parameters and body mass index was evaluated, STL, STD, PCAR_L showed a significant difference between the groups (P<0.05). Detailed knowledge of the ST anatomy will be helpful in terms of early diagnosis of diseases that may be related and guiding surgical interventions in this region.
Mylohyoid Muscle: Current Understanding for Clinical Management—Part I: Anatomy and Embryology
Authors: Obata Kyoichi , Kitagawa Norio , Ono Kisho , Kanemoto Hideka , Fukino Keiko , Takeshita Yohei , Ibaragi Soichiro , Tubbs Richard S. , Iwanaga Joe
Published: November 2023

The mylohyoid is one of the suprahyoid muscles, along with the geniohyoid, digastric, and stylohyoid muscles. It lies between the anterior belly of the digastric muscle inferiorly and the geniohyoid superiorly. In Part I, the anatomy and embryology of the mylohyoid muscle will be reviewed in preparation for the clinical discussion in Part II.
Resurfacing of Sleeve-Like Circumferential Giant Congenital Melanocytic Nevi on the Upper Extremity With Pre-Expanded Pedicled Flap
Authors: Li Jie , Yang Xiaoning , Ma Jiguang
Published: November 2023

As the relative shortage of healthy tissue obviates the option of local soft tissue coverage, reconstruction of circumferential giant congenital melanocytic nevi (GCMN) on the upper extremity remains particularly challenging. Here the authors report a 3-stage procedure involving pre-expanded pedicled flap from the torso for the reconstruction of upper extremity after circumferential GCMN excision in pediatric patients. The giant nevus was completely removed and the size of the excised nevus was 31 × 14.5 cm. The donor site was primarily closed. No major complication was encountered. Reconstruction with expanded pedicled flap achieved satisfactory results, both functionally and cosmetically.
Question Mark Ear: An Unusual Anomaly and a Novel Surgical Technique for Reconstruction
Authors: Yalcin Can Ege , Ozpur Ismail , Cetinkale Oguz
Published: November 2023

The question mark ear is a rare abnormality characterized by a cleft between the helix and the earlobe, resulting in a protrusion of the upper part of the ear. The severity of this ear malformation can range from a minor notch in the helix to a complete separation of the helix and the earlobe. In this study, we present a case of a patient with a moderately severe right-sided unilateral question mark deformity. To address this issue, we utilized a novel technique that involves a combination of a Y-V flap with double opposing Z-plasty. Our clinical study demonstrates that using this technique for reconstructing the deformity yields excellent results in terms of the helical rim and fold contour, utilizing solely the local tissues.
Tolerability and Acceptability of Autonomous Immersive Virtual Reality Incorporating Digital Twin Technology for Mass Training in Healthcare
Authors: Zackoff Matthew W. , Davis David , Rios Michele , Sahay Rashmi D. , Zhang Bin , Anderson Ian , NeCamp Matthew , Rogue Ingrid , Boyd Stephanie , Gardner Aimee , Geis Gary L. , Moore Ryan A.
Published: November 2023

Introduction

As part of onboarding and systems testing for a clinical expansion, immersive virtual reality (VR) incorporating digital twin technology was used. While digital twin technology has been leveraged by industry, its use in health care has been limited with no prior application for onboarding or training. The tolerability and acceptability of immersive VR for use by a large population of healthcare staff were unknown.

Methods

A prospective, observational study of an autonomous immersive VR onboarding experience to a new clinical space was conducted from May to September 2021. Participants were healthcare staff from several critical care and acute care units. Primary outcomes were tolerance and acceptability measured by reported adverse effects and degree of immersion. Secondary outcomes were attitudes toward the efficacy of VR compared with standard onboarding experiences.

Results

A total of 1522 healthcare staff participated. Rates of adverse effects were low and those with prior VR experience were more likely to report no adverse effects. Odds of reporting immersion were high across all demographic groups, though decreased with increasing age. The preference for VR over low-fidelity methods was high across all demographics; however, preferences were mixed when compared with traditional simulation and real-time clinical care.

Conclusions

Large-scale VR onboarding is feasible, tolerable, and acceptable to a diverse population of healthcare staff when using digital twin technology. This study also represents the largest VR onboarding experience to date and may address preconceived notions that VR-based training in health care is not ready for widespread adoption.
Staphylococcus Great Britain and Ireland 2023 (StaphGBI 2023) Conference Report
Authors: O'Gara James P. , Zeden Merve Suzan
Published: November 2023

Since 1997, StaphGBI conferences have brought together the Staphylococcus research community in the UK and Ireland. The twelfth StaphGBI conference, hosted by University of Galway on June 22nd and 23rd 2023 was co-chaired by Dr Merve S. Zeden and Prof James P. O’Gara supported by a local organising committee of Chloe Hobbs-Tobin, Dr Rakesh Roy, Órla Burke and Aaron Nolan. Anchored by keynote speaker Prof Vinai Thomas, all other StaphGBI 2023 oral and post presentations were delivered by early career researchers. The conference attracted approximately 100 delegates including 72 MRes/PhD students and postdoctoral fellows, 22 principal investigators and 4 exhibitors. The mix of scientists, clinicians and early career researchers stimulated excellent discussions on key issues and challenges in the Staphylococcus field. S. aureus interactions with the host immune system, AMR and new therapeutic approaches using antimicrobial peptides or metabolites, chronic wound and device-associated infections, and improving our understanding of Staphylococcal genomics were common themes at StaphGBI 2023.
An optimized protocol for the creation of constructs expressing sodium channel subunits to be used in functional studies of genetic epilepsies
Authors: Lindo-Samanamud Saúl , Canto Amanda M. do , Torres Fabio R. , Gonsales Marina C. , Godoi Alexandre B. , da Rosa Douglas C. , Vieira André S. , Lopes-Cendes Iscia
Published: November 2023

Background

We aim to develop a method for cloning highly unstable plasmids encoding sodium channel subunits expressed in the brain.

Method

NEB Stable competent cells (NSCC) were transformed with the native plasmid. After purification, plasmids with the expected profile of enzymatic digestion were sequenced. Finally, mutant linear plasmids (MLP) created by site-directed mutagenesis were used to transform NSCC.

Results

We found that choosing a suitable host for transformation and subcloning, the controlled temperature during cell growth, and a small volume of Luria Bertani (LB) medium allowed the generation of plasmids without undesirable mutations or structural alterations.

Comparison with existing method

At present, there is little information on a detailed method for cloning plasmids carrying the SCN1A gene. Using the method proposed here, we observed increased cell growth and precision in the sequence of the obtained plasmids.

Conclusion

We have developed an optimized strategy for replicating unstable plasmids using NSCC with an appropriate volume of culture medium and an adequate temperature in the cloning and subcloning phases. We have also demonstrated how to create the desired plasmid constructs by using site-directed mutagenesis. We expect that our protocol will assist investigators interested in functional studies of sodium channels expressed in the brain.
Keeping FIT: Iron-mediated post-transcriptional regulation inToxoplasma gondii
Authors: Sloan Megan A. , Scott Adam , Harding Clare R.
Published: November 2023

Iron is required to support almost all life; however, levels must be carefully regulated to maintain homeostasis. Although the obligate parasiteToxoplasma gondiirequires iron, how it responds when iron becomes limiting has not been investigated. Here, we show that iron depletion triggers significant transcriptional changes in the parasite, including in pathways that require iron. Interestingly, we find that a subset ofT. gondiitranscripts contain stem-loop structures which have been associated with post-transcriptional iron-mediated regulation in other cellular systems. We validate one of these (found in the 3’ UTR of TGME49_261720) using a reporter cell line. We show that the presence of the stem-loop containing UTR is sufficient to confer accumulation at the transcript and protein levels under low iron. We show that this response is dose and time-dependent and is specific for iron. Using immunoprecipitation, we show that the metabolic enzyme aconitase is capable of binding to mRNA, includingfit, and that the presence of thefitUTR leads to stabilisation of the transcript under low iron conditions. These results demonstrate the existence of iron-mediated post-transcriptional regulation inToxoplasmafor the first time, and show that the metabolic enzyme aconitase may have an additional role as an RNA-binding protein.
Impact of host species on assembly, composition, and functional profiles of phycosphere microbiomes
Authors: Roager Line , Kempen Paul J. , Bentzon-Tilia Mikkel , Sonnenschein Eva C. , Gram Lone
Published: November 2023

Microalgal microbiomes play vital roles in the growth and health of their host, however, their composition and functions remain only partially characterized, especially across microalgal phyla. In this study, a natural seawater microbiome was introduced to three distinct, axenic species of microalgae, the haptophyteIsochrysis galbana,the chlorophyteTetraselmis suecica,and the diatomConticribra weissflogii(previouslyThalassiosira), and its divergence and assembly was monitored over 49 days using 16S rRNA amplicon and metagenomic analyses. The microbiomes had a high degree of host specificity in terms of taxonomic composition and potential functions, including CAZymes profiles. Rhodobacteraceae and Flavobacteriaceae families were abundant across all microalgal hosts, butI .galbanamicrobiomes diverged further fromT. suecicaandC. weissflogiimicrobiomes.I .galbanamicrobiomes had a much higher relative abundance of Flavobacteriaceae, whereas the two other algal microbiomes had higher relative abundances of Rhodobacteraceae. This could be due to the mixotrophic nature ofI. galbanaaffecting the carbohydrate composition available to the microbiomes, which was supported by the CAZymes profile ofI. galbanamicrobiomes diverging further from those ofT. suecicaandC. weissflogiimicrobiomes. Finally, the presence of denitrification and other anaerobic pathways was found exclusively in microbiomes ofC. weissflogiipotentially resulting from anoxic microenvironments in aggregates formed by this diatom during the experiment. These results underline the deterministic role of the microalgal host species on microbiome composition and functional profiles along with other factors, such as trophic mode of the microalgal host.

Importance

As the main primary producers of the oceans, microalgae serve as cornerstones of the ecosystems they are part of. Additionally, they are increasingly used for biotechnological purposes such as the production of nutraceuticals, pigments, and antioxidants. Since the bacterial microbiomes of microalgae can affect their hosts in beneficial and detrimental ways, understanding these microbiomes is crucial to both ecological and applied roles of microalgae. The present study advances the understanding of microalgal microbiome assembly, composition, and functionality across microalgal phyla, which may inform modeling and engineering of microalgal microbiomes for biotechnological purposes.
Transglobal spread of an ecologically significant sea urchin parasite
Authors: Ritchie Isabella T. , Vilanova-Cuevas Brayan , Altera Ashley , Cornfield Kaileigh , Evans Ceri , Evans James S. , Hopson-Fernandes Maria , Kellogg Christina A. , Looker Elayne , Taylor Oliver , Hewson Ian , Breitbart Mya
Published: November 2023

Mass mortality of the dominant coral reef herbivoreDiadema antillarumin the Caribbean in the early 1980s led to a persistent phase shift from coral-to algal-dominated reefs. In 2022, a scuticociliate most closely related toPhilaster apodigitiformiscaused further mass mortality ofD. antillarumacross the Caribbean, leading to >95% mortality at affected sites. Mortality was also reported in the related speciesDiadema setosumin the Mediterranean in 2022, where urchins experienced gross signs compatible with scuticociliatosis. However, the causative agent of the Mediterranean outbreak has not yet been determined. In April 2023, mass mortality ofD. setosumoccurred along the Sultanate of Oman’s coastline. Urchins displayed signs compatible with scuticociliatosis including abnormal behavior, drooping and loss of spines, followed by tissue necrosis and death. Here we report the detection of an 18S rRNA gene sequence in abnormal urchins from Muscat, Oman that is identical to thePhilasterstrain responsible forD. antillarummass mortality in the Caribbean. We also show that scuticociliatosis signs can be elicited inD. setosumby experimental challenge with the cultivatedPhilasterstrain associated with Caribbean scuticociliatosis. These results demonstrate thePhilastersp. associated withD. antillarummass mortality has rapidly spread to geographically distant coral reefs, compelling global-scale awareness and monitoring for this devastating condition through field surveys, microscopy, and molecular microbiological approaches, and prompting investigation of long-range transmission mechanisms.