bluuebunny/crossref_metadata_2025 huggingface dataset:
Atomic view of photosynthetic metabolite permeability pathways and confinement in synthetic carboxysome shells
Authors: Sarkar Daipayan , Maffeo Christopher , Sutter Markus , Aksimentiev Aleksei , Kerfeld Cheryl A. , Vermaas Josh V.
Published: November 2024

Carboxysomes are protein microcompartments found in cyanobacteria, whose shell encapsulates rubisco at the heart of carbon fixation in the Calvin cycle. Carboxysomes are thought to locally concentrate CO
2
in the shell interior to improve rubisco efficiency through selective metabolite permeability, creating a concentrated catalytic center. However, permeability coefficients have not previously been determined for these gases, or for Calvin-cycle intermediates such as bicarbonate (

HCO

3
−

), 3-phosphoglycerate, or ribulose-1,5-bisphosphate. Starting from a high-resolution cryogenic electron microscopy structure of a synthetic

β

-carboxysome shell, we perform unbiased all-atom molecular dynamics to track metabolite permeability across the shell. The synthetic carboxysome shell structure, lacking the bacterial microcompartment trimer proteins and encapsulation peptides, is found to have similar permeability coefficients for multiple metabolites, and is not selectively permeable to

HCO

3
−

relative to CO
2
. To resolve how these comparable permeabilities can be reconciled with the clear role of the carboxysome in the CO
2
-concentrating mechanism in cyanobacteria, complementary atomic-resolution Brownian Dynamics simulations estimate the mean first passage time for CO
2
assimilation in a crowded model carboxysome. Despite a relatively high CO
2
permeability of approximately 10
−2
cm/s across the carboxysome shell, the shell proteins reflect enough CO
2
back toward rubisco that 2,650 CO
2
molecules can be fixed by rubisco for every 1 CO
2
molecule that escapes under typical conditions. The permeabilities determined from all-atom molecular simulation are key inputs into flux modeling, and the insight gained into carbon fixation can facilitate the engineering of carboxysomes and other bacterial microcompartments for multiple applications.
Multi-hop quantum teleportation based on HSES via GHZ-like states
Authors: Jiang 蒋 She-Xiang 社想 , Wei 韦 Xiao-Long 晓龙 , Li 李 Jin-Huan 金欢 , Li 李 Shuai-Shuai 帅帅
Published: November 2024

Implementing quantum wireless multi-hop network communication is essential to improve the global quantum network system. In this paper, we employ eight-level GHZ states as quantum channels to realize multi-hop quantum communication, and utilize the logical relationship between the measurements of each node to derive the unitary operation performed by the end node. The hierarchical simultaneous entanglement switching (HSES) method is adopted, resulting in a significant reduction in the consumption of classical information compared to multi-hop quantum teleportation (QT) based on general simultaneous entanglement switching (SES). In addition, the proposed protocol is simulated on the IBM Quantum Experiment platform (IBM QE). Then, the data obtained from the experiment are analyzed using quantum state tomography, which verifies the protocol’s good fidelity and accuracy. Finally, by calculating fidelity, we analyze the impact of four different types of noise (phase-damping, amplitude-damping, phase-flip and bit-flip) in this protocol.
Correcting on-chip distortion of control pulses with silicon spin qubits
Authors: Ni 倪 Ming 铭 , Ma 马 Rong-Long 荣龙 , Kong 孔 Zhen-Zhen 真真 , Chu 楚 Ning 凝 , Liao 廖 Wei-Zhu 伟筑 , Zhu 祝 Sheng-Kai 圣凯 , Wang 王 Chu 儲 , Luo 罗 Gang 刚 , Liu 刘 Di 頔 , Cao 曹 Gang 刚 , Wang 王 Gui-Lei 桂磊 , Li 李 Hai-Ou 海欧 , Guo 郭 Guo-Ping 国平
Published: November 2024

In semiconductor quantum dot systems, pulse distortion is a significant source of coherent errors, which impedes qubit characterization and control. Here, we demonstrate two calibration methods using a two-qubit system as the detector to correct distortion and calibrate the transfer function of the control line. Both methods are straightforward to implement, robust against noise, and applicable to a wide range of qubit types. The two methods differ in correction accuracy and complexity. The first, coarse predistortion (CPD) method, partially mitigates distortion. The second, all predistortion (APD) method, measures the transfer function and significantly enhances exchange oscillation uniformity. Both methods use exchange oscillation homogeneity as the metric and are suitable for any qubit driven by a diabatic pulse. We believe these methods will enhance qubit characterization accuracy and operation quality in future applications.
Effect of orbital symmetry on atomic ionization in near-infrared laser fields
Authors: Xu 徐 Manqi 嫚琦 , Hu 胡 Shilin 师林 , Guo 郭 Li 丽 , Chen 陈 Jing 京
Published: November 2024

We have performed a comparative study of the photoelectron spectra adopting different initial states (2s or 2p0) of hydrogen atoms in a near-infrared laser pulse by using the full three-dimensional time-dependent Schrödinger equation. It is demonstrated that the atomic photoelectron spectra oscillate out of step as a function of electron kinetic energies for different initial states (2s or 2p0), which is well reproduced by the simulations based on strong field approximation, and the above distinct feature is ascribed to the different interferences from the partial electron wave packets detached by positive and negative electric fields for different initial states of 2s and 2p0.
Novel Retrofitting Technique for Beam by External Wrapped with Glass Fiber and Internally Embedded Damper System for Sustainable Construction
Authors: Kallur Gourish , Roopa A.K , Hunashyal A. M. , Hiremath Murughendra
Published: November 2024

Reinforced concrete structures are often exposed to extreme loads, such as those from sudden and accidental impacts. This has led to an increasing interest in strengthening these structures, improving their fatigue performance, and extending their service life, particularly for components like beams. A more sustainable approach to maintaining their functionality involves strengthening and repairing damaged components. Therefore, glass fiber polymers are ideal reinforcements for retrofitting due to their high tensile strength and low cost compared to other polymer substitutes This paper presents the performance of plain concrete beams reinforced externally with glass fiber sheets (GFS) and dampers embedded internally. A unique methodology has been adopted to improve the adhesion between the fiber glass sheets (GFS) and the concrete surface. Two adhesive components utilized are epoxy resin (ER) and epoxy hardener (EH), mixed in a ratio of 9:1. Internally embedded dampers are devices used to resist lateral forces on structures, particularly during impact or sudden loading. The adopted damper technique involves incorporating chopped Glass Fiber during the casting process of the dampers. These dampers are subsequently embedded into beams at point of failure. After the curing of 28 days, all the cast beam compositions undergo flexural test, and dampers are tested for compressive strength. After the dampers have undergone compression testing, a microstructural analysis is conducted using SEM (Scanning Electron Microscope). For further details on stress formation in beams, finite element analysis of Ansys is used to model beams for all beam compositions. Also, sustainability goals are addressed by reducing cement usage in construction by introducing retrofitting in older buildings and using this system to improve the design of newer buildings by reducing overall section sizes
A Study on γ-Ray Attenuation in MnO
Authors: Madhusudhan Rao A S , Kalyani Parcha , Shankar J
Published: November 2024

An experimental study has been conducted to determine the attenuation of γ-photons in Manganese oxide (MnO). Determining the thermophysical properties of the chemical at various temperatures within the 300K–1075K temperature range is the primary goal of the study. Additionally, the investigation on attenuation has been expanded to assess photon interaction characteristics at varying γ-energies.
Hot Ductility Behaviour of AA7075-T651 Aluminium Alloy
Authors: Karthikeyan KMB. , Cyril Moses L , Eshwar NK , Sam Richard N , Sai Ram B
Published: November 2024

This study focused on examining the hot ductility characteristics of aluminium alloy 7075-T651. Hot ductility is the capacity of a substance to undergo deformation at high temperatures without fracturing. Aluminium alloys typically demonstrate favorable hot ductility, rendering them appropriate for a wide range of high-temperature applications. The investigation entails performing hot tensile tests for AA7075-T651 aluminium alloy at different deformation temperatures (350°C-525°C), followed by fractography to ascertain the fracture mode. The ductility of the AA7075-T651 alloy was greatly enhanced during this procedure. The findings indicate that the hot working range of the aluminium alloy 7075-T651 can be expanded to 525°C instead of a liquidus start temperature of 477°C with a maximum of 30% ductility. The fractography results demonstrate that the fracture mode remains ductile. The AA7075-T651 aluminium alloy exhibits excellent thermal stability, allowing it to be hot worked at temperatures as high as 525°C without experiencing any sudden alterations in its characteristics or fracture behaviour.
Periodic trajectories and topology of the integrable Boltzmann system
Authors: Gasiorek Sean , Radnović Milena
Published: November 2024

We consider the Boltzmann system corresponding to the motion of a billiard with a linear boundary under the influence of a gravitational field. We derive analytic conditions of Cayley’s type for periodicity of its trajectories and provide geometric descriptions of caustics. The topology of the phase space is discussed using Fomenko graphs.
Higher-order nonlinear special functions: Painlevé hierarchies, a survey
Authors: Gordoa P. , Pickering A.
Published: November 2024

The six Painlevé transcendents are widely accepted as nonlinear special functions. Over the last quarter of a century or so, there has been a surge of interest in higher-order analogues of the Painlevé equations, most often defined as members of hierarchies of equations of increasing order, i.e., of so-called Painlevé hierarchies. We give here a survey of such Painlevé hierarchies, including of their derivation and the derivation of their properties. Amongst other aspects, we discuss the relationships between the properties of completely integrable hierarchies, e.g., Hamiltonian structures and Miura maps, nonisospectral scattering problems, and those of Painlevé hierarchies, e.g., Lax pairs, Bäcklund and auto-Bäcklund transformations, and sequences of special solutions. Given the large number of papers published on Painlevé hierarchies, we hope this review will serve as a useful future reference.
From the operator KP equation to scalar and matrix-valued solutions
Authors: Porten Egmont , Schiebold Cornelia
Published: November 2024

In this paper, which has a partially introductory character, the point of departure is very general solution formulas to the operator-valued Kadomtsev–Petviashvili equations (KPI and KPII). Their generality relies on the presence of parameters, which are allowed to be linear mappings between Banach spaces. While this freedom gives access to very complicated solutions, like countable nonlinear superpositions of solitons, the applications in the present article are restricted to matrix parameters. The necessary techniques to ‘project’ to scalar and matrix-valued solutions are explained in detail.

The applications part is focused on the KPII. For scalar solutions, the testing ground is the celebrated classification of web structures of interacting line-solitons by Biondini, Chakravarty, Kodama, et al. We establish an explicit link between the different approaches and add some details about interactions of few line-solitons and solutions with singularities. Starting from more complicated algebraic data, we construct solutions beyond web structures, for which we prove asymptotic movement along logarithmic curves in time slices. The article is concluded by a section on solutions to the

d

×

d

{\mathsf {d}}\times {\mathsf {d}}

matrix KPII. We realize

N
N

-solitons in the sense of Gilson, Nimmo, and Sooman (and originally Goncharenko) and discuss the question about nonscalar Miles structures.
Chest wall perforator flaps are safe and can decrease mastectomy rates in breast cancer surgery: multicentre cohort study
Authors: Karakatsanis Andreas , Meybodi Farid , Pantiora Eirini , Elder Elisabeth , Cabel Faustine , Hsu Jeremy , French James , Aristokleous Iliana , Sjökvist Olivia , Önefäldt Daniel , Navia Jaime , O’Connell Rachel L , Rusby Jennifer E , Barry Peter A
Published: November 2024

Background

Chest wall perforator flaps are emerging in oncoplastic breast conservation, mostly as an alternative to mastectomy. However, standardization and consensus on patient selection, techniques, and outcomes have not yet been reached. The aim of this international multicentre collaborative study was to explore practice patterns and outcomes in high-volume centres from different countries.

Methods

Patients with both pre-invasive and invasive breast cancer treated at the Uppsala University Hospital in Uppsala, Sweden, the Royal Marsden Hospital in London, UK, and the Westmead Breast Cancer Institute in Sydney, Australia, were included in this study. The rationale for offering chest wall perforator flaps and surgical outcomes were prospectively documented.

Results

In total, 603 patients were analysed median age of 54 (interquartile range (i.q.r.) 48–63) years, median BMI of 25.0 (i.q.r. 22.5–28.1) kg/m2, median tumour extent of 30 (IQR 19–45) mm, median breast volume of 280 (i.q.r. 216–430) ml, and median calculated resection ratio of 16% (i.q.r. 9%–28%). In 67.7%, the treating surgeon had offered chest wall perforator flaps to avoid mastectomy. The procedure was performed as day surgery in 69.5% of patients, with an overall complication rate of 8.6% and the majority of complications being classified as Clavien–Dindo grade I (5.3% of patients). The re-excision rate was 15.9%, with only 1.5% of patients converting to a mastectomy. There were no flap losses. At a median follow-up of 22 (range 12 to 98) months, rates of local recurrence, distant recurrence, and breast cancer-related mortality were 1.9%, 4.9%, and 1.7% respectively.

Conclusion

Chest wall perforator flaps are a useful option to allow more women to avoid mastectomy. In experienced hands, the procedure is safe and should be offered to suitable patients.
Sternal elevation in pectus excavatum repair: comparison of a unilateral versus bilateral frame crane system
Authors: Janssen Nicky , Coorens Nadine A , Daemen Jean H T , Franssen Aimée J P M , van Polen Elise J , van der Hoven Pelle A , Hulsewé Karel W E , Vissers Yvonne L J , de Loos Erik R
Published: November 2024

OBJECTIVES

Instability in the conventional, unilateral frame crane system occurs when greater sternal elevation forces are required, which potentially limits optimal sternal elevation during Nuss repair of the pectus excavatum. A bilateral frame setup was subsequently developed. We hypothesized that increasing the retractor’s stability with the bilateral frame crane system would yield superior sternal elevation, as reflected by a greater lift of the anterior chest wall.

METHODS

Pectus excavatum patients who underwent the Nuss procedure utilizing sternal elevation between November 2022 and October 2023 were included in this crossover study. Three-dimensional surface imaging was used to evaluate differences in established maximum and average combined chest wall elevation, comparing unilateral to bilateral frame crane systems. The results were also compared to the effect of bar implantation on the deepest point of the deformity.

RESULTS

The 30 patients included in the final analysis were predominantly male (83%) with a median age of 16.0 years (interquartile range 14.3–17.0) and median Haller index of 3.3 (interquartile range 2.9–3.8). The bilateral frame crane system achieved maximum combined chest wall elevation comparable to the effect of definitive bar placement (33 mm vs 38 mm, P = 0.06) and provided significantly greater elevation than the unilateral frame crane system (33 mm vs 24 mm, P < 0.001). Both systems, however, showed similar results for average combined chest wall elevation (4 mm vs 5 mm, P = 0.16).

CONCLUSIONS

The bilateral frame crane system demonstrates superiority in achieving sternal elevation at the deepest point of the deformity, which may theoretically facilitate safer and more optimal bar placement.
Enzymes Repertoires and Genomic Insights into Lycium Barbarum Pectin Polysaccharides Biosynthesis
Authors: Yue Haiyan , Tang Yiheng , Li Aixuan , Zhang Lili , Niu Yiwei , Zhang Yiming , Wang Hao , Luo Jianjun , Zhao Yi , He Shunmin , Chen Chang , Chen Runsheng
Published: November 2024

Lycium barbarum, a member of the Solanaceae family, represents an important eudicot lineage with homology of food and medicine. Lycium barbarum pectin polysaccharides (LBPPs) are key bioactive ingredients of Lycium barbarum, and are among the few polysaccharides with both biocompatibility and biomedical activity. While previous studies have primarily focused on the functional properties of LBPPs, the mechanisms of biosynthesis and transport by key enzymes remain poorly understood. Here, we reported the completion of a 2.18-gigabase reference genome of Lycium barbarum, reconstructed the first entire biosynthesis of pectin polysaccharides and sugar transport, and characterized the important genes responsible for backbone extending, sidechain synthesis, and modification of pectin polysaccharides. Additionally, we characterized long non-coding RNAs (lncRNAs) associated with polysaccharide metabolism and identified a specific rhamnogalacturonan I (RG-I) rhamnosyltransferase, RRT3020, which enhances RG-I biosynthesis in LBPPs. These newly identified enzymes and pivotal genes endow L. barbarum with specific pectin biosynthesis capabilities, distinguishing it from other Solanaceae species. Our findings provide a foundation for evolutionary studies and molecular breeding to enhance the diverse applications of L. barbarum.
Incidence of Pneumonia Following Bronchoscopy and Bronchoalveolar Lavage in Burn Patients
Authors: Murphy Tyler J , Krebs Elizabeth D , Riffert Derek A , Mubang Ronnie , Nordness Mina F , Guidry Christopher , Gondek Stephen , Beyene Robel T
Published: November 2024

The standard modality for diagnosis of smoke inhalational injury in burn patients is bronchoscopy with or without bronchoalveolar lavage (BAL). However, the risks associated with these procedures are poorly described in established literature. We sought to investigate the association between diagnostic BAL at admission and the development of pneumonia in burn patients. This retrospective analysis of intubated burn patients studied those who underwent bronchoscopy on admission, comparing patients who received BAL to those who did not. Demographics and baseline characteristics were analyzed using chi-squared or Student’s t-test. Unadjusted and multivariable logistic regression studies assessed the effect of admission BAL on the development of pneumonia. Out of the 196 patients who underwent bronchoscopy, 98 met our criteria for analysis. The BAL group was more likely to be male and have a higher grade of abbreviated injury score. Patients who received BAL were more likely to develop pneumonia during the admission in both unadjusted and multivariable logistic regression models. These patients also had a longer hospital length of stay, greater number of ventilator days, and were more likely to undergo second bronchoscopy. These findings associate admission BAL with increased risk of pneumonia during the index hospitalization, suggesting a judicious use of BAL during admission bronchoscopy in burn patients.
Analysis of platelet transfusion efficacy during extracorporeal membrane oxygenation (ECMO) treatment in pediatric patients post-cardiac surgery-a retrospective cohort study
Authors: Chen Xusheng , Yang Yongtao
Published: November 2024

Background

Postoperative extracorporeal membrane oxygenation (ECMO) may be necessary for pediatric patients following cardiac surgery, with associated risks of thrombocytopenia and bleeding. Prophylactic platelet transfusions are utilized to mitigate these risks, but the effectiveness of platelet transfusion cannot be reliably predicted. The aim of this study was to investigate the effect of platelet transfusion during postoperative treatment with ECMO in children undergoing cardiac surgery and to explore the optimal transfusion thresholds to reduce the number of platelet transfusions in patients and reduce the risk of death.

Methods

We included in our study patients from the Pediatric Cardiac Surgery Department at the First Affiliated Hospital of Tsinghua University who underwent cardiac surgery and received ECMO treatment from January 1, 2019, to December 31, 2023, and received platelets transfusion at least once during the ECMO therapy. The platelet counts were determined both before and 24 hours posttransfusion of the platelet product. The corrected count increment (CCI) was calculated for the effectiveness estimation of platelet transfusion. The research subjects were divided into 3 groups based on the platelet count before transfusion (pretransfusion platelet count ≤30×109/L was the low-threshold group, pretransfusion count 31-50×109/L was the medium-threshold group, and ≥51×109/L was the high-threshold group) and the effective rates of each group were calculated.

Results

A total of 11 patients received 47 platelet transfusions, an average of 4.27 ± 1.67 per patient. According to the 24-hour postinfusion platelet (Plt) corrected critical control increase index (24-hour CCI) ≥4500, the infusion was considered to be effective, and ineffective when the CCI was <4500. Out of these, 22 transfusions (46.8%) proved effective, whereas 25 (53.2%) were deemed ineffective. The effective transfusion rates across the 3 groups were 69.2%, 50%, and 27.7%, respectively.

Conclusion

The efficacy of platelet transfusion may be higher if a low threshold of platelet transfusion is chosen during ECMO treatment, on the premise of ensuring life safety.
The Angry Patient
Authors: Doleys Daniel M.
Published: November 2024

Anger is not uncommon in the chronic pain setting, and the manner in which patients manage their anger may or may not be adaptive. This chapter will focus on the biopsychosocial processes instrumental to the development and experience of anger and how anger, in turn, can impact pain outcomes. It is helpful to recognize our own reactions to anger directed our way, for example when we are on the receiving end of “You” accusations or blanket “always/never” statements. Strategies for communicating and interacting with the angry patient to successfully diffuse emotionally charged situations and move toward productive resolution are provided. Lastly, effective communication strategies with various “angry patient” scenarios will be demonstrated with case examples.
Chloroplast redox state mediates the short-term regulation of leaf isoprene emission
Authors: Wang Wen-Lin , Yu Yuan , Kang Huixing , Yang Yanrong , Li Shao-Meng , Yuan Xiangyang , Wang Yin , Tang Yanhong
Published: November 2024

Isoprene emission from plants not only confers thermoprotection, but also has profound impacts on atmospheric chemistry and the climate. Leaf isoprene emission is dynamically regulated in response to various environmental cues, but the exact mechanism remains unclear. It has been proposed that chloroplast redox/energy state or cytosolic phosphoenolpyruvate carboxylation regulates isoprene biosynthesis and consequently emission, and the latter has been disproven by recent literature. However, the possible covariation of chloroplast redox/energy state and cytosolic PEP carboxylation in previous experiments impedes the independent examination of the former hypothesis. We developed an index of chloroplast redox state and showed its validity by examining the relationships between the index and the rates of certain processes that have been demonstrated to be affected or unaffected by chloroplast redox/energy state. According to the former hypothesis alone, we modeled how isoprene emission rate (IER) responded to different short-term environmental variations and compared theoretical predictions with experimental data. We predicted that no matter which environmental factor was varied, IER would respond to the index of chloroplast redox state with similar velocities. We found that IER showed comparable increasing rates in response to the increase in the index of chloroplast redox state caused by different environmental variations (0.0479, 0.0439 or 0.0319 when ambient CO2 concentration, photosynthetic photon flux density or leaf temperature was varied, respectively). These results support that chloroplast redox/energy state regulates isoprene biosynthesis, leading to dynamic isoprene emission in nature.
HIV-1 reservoir landscape of post-treatment control
Authors: Charre Caroline , Merad Yanis , Avettand-Fenoel Véronique
Published: November 2024

Purpose of review

This review explores the viral reservoir landscape in individuals who control viral replication after treatment interruption (TI), designated as post-treatment controllers (PTCs). Identifying their virologic features is crucial to inform drug-free HIV remission strategies.

Recent findings

Traditionally characterized as small, likely due to early treatment, the viral reservoir of PTCs, after TI, exhibits limited transcriptional activity, residual viral replication and subsequent proviral diversity. Intact proviruses are found to be restricted. In nonhuman primate PTCs, this depletion of intact proviruses is already observed in lymph nodes before TI, suggesting that control mechanisms begin during antiretroviral therapy. Furthermore, recent studies suggest immune-driven proviral deep latency associated with repressive epigenetic features and integration sites in PTCs. While molecular mapping of virological features of PTCs is increasingly precise and coupled with in-depth immunologic assays, robust predictive biomarkers of PTCs are still lacking.

Despite limited sample sizes and heterogeneous definitions, common virologic features of PTCs include restricted reservoir size and transcriptional activity, fewer intact proviruses and deep proviral latency. Ongoing research using innovative technologies will further elucidate the mechanisms underlying post-treatment control, paving the way for successful HIV cure interventions.
Modified Early-Warning Score combined with early-warning symptoms and electrocardiographic findings in predicting in-hospital cardiac arrest in critically ill patients: a retrospective cohort study
Authors: Zhang Wenbo , Gu Wei
Published: November 2024

Background

We aimed to investigate the clinical value of the Modified Early-Warning Score (MEWS) combined with early-warning symptoms and electrocardiogram (ECG) findings in predicting in-hospital cardiac arrest (IHCA) in critically ill patients, to assess and reduce the occurrence of IHCA.

Methods

This retrospective cohort study examined critically ill patients who were enrolled in a hospital from January 2019 to March 2023 and divided into an IHCA group and NO-IHCA group. The critically ill patients were randomly divided into 2 sets at the ratio of 7:3, for the training set and test set. The training set used to develop the model and the test set used to test the model. Univariate and multivariate logistic regressions were used to determine the independent predictors. The generated prediction models were evaluated using 10-fold cross verification, and the areas under the curve (AUCs), accuracy, sensitivity, and specificity were reported. Hosmer-Lemeshow goodness of fit test was used to compare the calibration degree of the model and Delong test was used to compare the AUC.

Results

Multivariate logistic analysis showed that MEWS, early-warning symptoms, and ECG findings were independent risk factors for IHCA in critically ill patients (P < 0.05). The AUC values for MEWS, early-warning symptoms, and ECG findings were 0.671, 0.527, and 0.723, respectively. The AUC value for the combination of MEWS, early-warning symptoms, and ECG findings was 0.792 (P < 0.001), which was higher than MEWS.

Conclusion

MEWS combined with early-warning symptoms and ECG findings can predict IHCA in critically ill patients, which may help reduce IHCA in this population.
Predicting long-term survival among patients with HCC
Authors: Goldberg David , Reese Peter P. , Kaplan David A. , Zarnegarnia Yalda , Gaddipati Neelima , Gaddipati Sirisha , John Binu , Blandon Catherine
Published: November 2024

Background:

Prognosticating survival among patients with HCC and cirrhosis must account for both the tumor burden/stage, as well as the severity of the underlying liver disease. Although there are many staging systems used to guide therapy, they have not been widely adopted to predict patient-level survival after the diagnosis of HCC. We sought to develop a score to predict long-term survival among patients with early- to intermediate-stage HCC using purely objective criteria.

Methods:

Retrospective cohort study among patients with HCC confined to the liver, without major medical comorbidities within the Veterans Health Administration from 2014 to 2023. Tumor data were manually abstracted and combined with clinical and laboratory data to predict 5-year survival from HCC diagnosis using accelerated failure time models. The data were randomly split using a 75:25 ratio for training and validation. Model discrimination and calibration were assessed and compared to other HCC staging systems.

Results:

The cohort included 1325 patients with confirmed HCC. A risk score using baseline clinical, laboratory, and HCC-related survival had excellent discrimination (integrated AUC: 0.71 in the validation set) and calibration (based on calibration plots and Brier scores). Models had superior performance to the BCLC and ALBI scores and similar performance to the combined BCLC-ALBI score.

Conclusions:

We developed a risk score using purely objective data to accurately predict long-term survival for patients with HCC. This score, if validated, can be used to prognosticate survival for patients with HCC, and, in the setting of liver transplantation, can be incorporated to consider the net survival benefit of liver transplantation versus other curative options.
MFRP GENE MUTATION: NOVEL MANIFESTATION AND INSIGHTS ON PATHOPHYSIOLOGY - A CASE REPORT.
Authors: Bezerra Fernandes João Arthur , Alves Pereira Arthur Maerllyson , Cardoso Pinto Nayara Queiroz , de Queiroz Tavares Ferreira Felipe , Nascimento Maurício Abujamra
Published: November 2024

Purpose:

The aim of this study is to delineate a novel manifestation linked to the mutation of the MFRP gene: a macular neovascular membrane (MNV). The authors provide detailed insights into this rare condition, shedding light on a previously unreported observation and proposing potential pathophysiological mechanisms.

Methods:

A single case report from a tertiary center in Brazil was conducted for evaluation.

Results:

A female patient presenting with microphthalmos, retinal pigmentary alterations, and optic disc drusen, which had previously been misdiagnosed as Intracranial Idiopathic Hypertension (IIH), was diagnosed with MNV and inherited retinal dystrophy. Genetic testing confirmed the presence of an MFRP mutation, revealing novel manifestation of heterozygous gene mutations (c.498del p. Asn167Thrfs*25 and c.650G>A p. Gly217Glu).

Conclusion:

MNV in the context of retinal dystrophies is a rare occurrence and has not been previously associated with an MFRP mutation. The documentation of this novel observation is crucial for enhancing our understanding of the potential disease presentations, aiding in diagnosis, elucidating the underlying pathophysiology, and guiding appropriate management strategies in such cases.
PARACENTRAL ACUTE MIDDLE MACULOPATHY AND HENLE FIBER LAYER HEMORRHAGE IN DENGUE FEVER: MULTIMODAL IMAGING AND REVIEW OF THE LITERATURE
Authors: Ferreira Bruno F. A. , Sakuno Gustavo , Kato Juliana M. , Sato Rodrigo H. , Ferreira Álvaro F. , Missaka Ruy F. B. G. , Nakashima Yoshitaka
Published: November 2024

Purpose:

To use multimodal imaging to report a case of dengue fever presenting with Henle fiber layer hemorrhage (HH) and acute paracentral acute middle maculopathy (PAMM).

Methods:

Fundus photography and autofluorescence, fluorescein angiography, and optical coherence tomography (OCT) were acquired over a month, and a literature review of dengue fever-associated maculopathy was performed.

Results:

A 19-year-old man presented with a sudden loss of vision in both eyes 12 days after experiencing initial systemic symptoms suggestive of dengue fever. His best-corrected visual acuity (BCVA) was counting fingers in the right eye (OD) and 20/200 in the left eye (OS). Pupillary light reflex was reduced in both eyes (OU). Dilated fundoscopic examination revealed optic disc swelling and a small deep hemorrhage near the fovea in OU. OCT revealed a petaloid shape hyperreflectivity involving both outer nuclear and plexiform layers in OU and a subtle hyperreflectivity thinning the inner nuclear layer (INL) in OS, findings compatible with HH and PAMM, respectively. Immunoglobin M was positive for dengue fever. Thus, a diagnosis of dengue fever-associated maculopathy was performed and oral steroids were started. After a month, the final BCVA reached 20/25 (OD) and 20/20 (OS), the HH reabsorbed utterly, and a INL thinning in the area of the PAAM was observed.

Conclusion:

Dengue fever-associated maculopathy can present with PAAM and HH. Multimodal imaging is helpful to characterize the extension of the changes in the retina and to monitor its recovery. In such cases, structural and functional damage may occur despite treatment with oral steroids.
Central Retinal Artery Occlusion Following Sphenopalatine Artery Embolization: A Case Report and Review of the Literature
Authors: Zhou Henry W , Foulsham William , Rossin Elizabeth J
Published: November 2024

Purpose:

Report of a case of central retinal artery occlusion following sphenopalatine artery (SPA) embolization. A review of the literature describing complications following SPA embolization and ligation.

Methods:

Retrospective case report and literature review.

Results:

A 68-year-old woman with a history notable for hypertension, hyperlipidemia, and eight years of intermittent right-sided epistaxis previously requiring blood transfusions underwent right-sided embolization of the SPA with the neurosurgery service. SPA embolization was achieved with Embosphere microspheres and Concerto coils. No thromboembolic complications were noted at the conclusion of the case. On waking from general anesthesia, the patient reported painless right sided vision loss and was found to have best-corrected visual acuity of light perception, a relative afferent pupillary defect, and a cherry-red spot with vascular attenuation consistent with central retinal artery occlusion (CRAO).

Conclusions:

CRAO can be a complication of ipsilateral SPA embolization.
Intraepithelial Sebaceous Gland Carcinoma: A Multicenter Retrospective Case Series
Authors: Liu Ebony , Juniat Valerie , Tong Jessica Y. , Wu Albert , Tsirbas Angelo , Hersh Dov , O’Donnell Brett A. , James Craig , Huilgol Shyamala C. , Selva Dinesh
Published: November 2024

Purpose:

Intraepithelial sebaceous gland carcinoma is a rare form of sebaceous gland carcinoma, with 10 published case reports to date. The authors report the clinical, histological, and prognostic features of this rare carcinoma.

Methods:

This is a multicenter retrospective case series of patients from 3 Australian sites. Information collected included patient demographics, clinical risk factors, initial and subsequent presentations, histology results, management, and outcomes.

Results:

Twelve cases were identified. The average age of presentation was 72 years (range 52–92 years), with more females (n = 8) affected than males. The most common symptoms and signs were ocular irritation (n = 9) and eyelid mass (n = 8), with a predilection toward upper lid involvement. Five cases of sebaceous gland carcinoma were confirmed on initial histology. Initial management included wide local excision with margin control (n = 11), and primary topical mitomycin C (n = 1). Adjunctive conjunctival mapping biopsy was performed in 5 cases. Recurrence occurred in 7 cases, at an average of 31 months (range 7–83 months) after initial treatment. There were no cases of distant metastasis, however, 2 cases developed local invasion. Management of recurrences included exenteration (n = 2), further excisions alone (n = 3), and excision with adjuvant mitomycin C (n = 2).

Conclusions:

Clinicians and pathologists should have a high index of suspicion for primary intraepithelial sebaceous gland carcinoma on the upper eyelid. Close follow-up is recommended, given the high risk of local recurrence.
Comparing optical quality and simulated defocus curves: head-to-head analysis of hydrophilic and hydrophobic trifocal intraocular lenses
Authors: Łabuz Grzegorz , Yan Weijia , Khoramnia Ramin , Auffarth Gerd U.
Published: November 2024

Purpose:

To examine the optical function of the new AT ELANA trifocal intraocular lens (IOL) made of hydrophobic material against an equivalent version made of hydrophilic material.

Setting:

David J Apple Center for Vision Research, Heidelberg, Germany.

Design:

Laboratory investigation.

Methods:

This optical investigation was conducted on +20 diopter (D) samples of the AT ELANA and AT LISA tri. The area under the modulation transfer function (MTFa) served as a quality criterion. Simulated visual acuity (VA) and defocus curves across +1 to −3.5 D range were derived from an empirical formula according to ANSI Z80.35. Susceptibility to photic phenomena was evaluated by assessing the light distribution around a point light source.

Results:

The 2 models demonstrated comparable optical quality. While at distance, a 4% improvement was noted with the AT LISA tri, the AT ELANA's near MTFa was 5% higher. Only a marginal difference (1%) was noted at intermediate. Both IOLs reached simulated VA of 0.0 logMAR far vision, 0.10 logMAR at 80 cm, and 0.05 logMAR at 40 cm. Still, the near range was slightly expanded with the hydrophobic model. The light-spread profile was comparable between the 2 trifocals.

Conclusions:

The AT ELANA and AT LISA tri demonstrated comparable optical quality and similarities in the potential for inducing photic phenomena. This study suggests that the hydrophobic trifocal IOL may provide visual range comparable with its hydrophilic counterpart. However, the asphericity change may facilitate the selection of a model that more effectively addresses specific corneal aberrations.
Application of dexmedetomidine combined with propofol–etomidate mixture in radical gastrectomy under general anesthesia
Authors: Liu Ji , Yang Jinqiu , Yang Xiyang , Yin Guangfen , Li Tao , Li Ruoyu , Wang Ai
Published: November 2024

Background:

Gastric cancer is the third most common malignant tumor with the second highest mortality rate in the world, and radical gastrectomy is the main treatment method, but the operation needs a long period of time to carry out and has strong surgical trauma stimulation, which is likely to cause sympathetic nerve excitement and stress reaction in the body. Therefore, the selection of appropriate anesthetic medication regimen and anesthesia method has an important impact on the intraoperative management and postoperative recovery of patients. This study aims to compare the clinical effects of dexmedetomidine alone in combination with propofol, etomidate and propofol-etomidate mixture in the treatment of radical gastrectomy for gastric cancer.

Methods:

A total of 90 patients undergoing elective radical gastrectomy were randomly divided into the propofol group (group P), the etomidate group (group E), and the etomidate–propofol mixture group (group PE). Anesthesia induction was performed under the monitoring of bispectral index anesthesia depth. The same pumping drugs were used in 3 groups: 0.1 to 0.3 μg/kg·min remifentanil, 0.5 μg/kg·h dexmedetomidine, and 5 to 10 μg/kg·min rocuronium. The primary outcome indicator was the hemodynamic conditions. The secondary outcome indicators included awakening time and time to accurately answer questions after operation, the prevalence of postoperative respiratory depression and adverse events, the incidence of postoperative cognitive dysfunction, and preoperative and postoperative Montreal Cognitive Assessment and Mini-Mental State Examination scores.

Results:

Among the 3 groups of patients, the use rate of vasoactive drugs in group P was higher (P < .05); the systolic blood pressure, diastolic blood pressure, and heart rate of group P at T1 to T4 were significantly lower than those of groups E and PE (P < .05); the systolic blood pressure, diastolic blood pressure, and heart rate of group E in T
2, T
4, and T
6 were significantly higher than those of groups P and PE (P < .05). The wake-up time after operation and the time to accurately answer the questions were longer in group E than in groups P and PE (P < .05). The incidence of postoperative respiratory depression in group P was higher than that in groups E and PE (P < .05). The Montreal Cognitive Assessment score of group P was lower than that of groups E and PE 7 days after operation (P < .05).

Conclusion:

Dexmedetomidine combined with propofol–etomidate mixture is a better anesthesia drug combination.
The application effect of autologous platelet-rich plasma combined with negative pressure sealing drainage technology in pressure ulcer wound repair
Authors: Tian Baoxiang , Yang Xiong , Liu Yang , Wei Chunlin , Liu Dujuan , Ren Xue , Lin Hailong
Published: November 2024

This study aimed to evaluate the efficacy of combining autologous platelet-rich plasma (PRP) with negative pressure wound therapy (NPWT) for the repair of pressure ulcers. We included 90 patients with pressure ulcers from General Technology Gemstone Flower Healthcare Jilin City Hospital of Chemical Industry between January 2021 and December 2023. Patients were randomly assigned to either a control group or an observation group, with 45 patients in each. The control group received NPWT alone, while the observation group received a combination of PRP and NPWT. Outcomes were compared between the groups, including clinical efficacy, wound recovery time (infection control time, wound healing time, hospital stay), levels of inflammatory markers (C-reactive protein, erythrocyte sedimentation rate, white blood cell count), pain scores (numerical rating scale), Pressure Ulcer Scale for Healing scores, and incidence of complications. The observation group demonstrated a total effective rate of 95.56% (43/45), significantly higher than the control group’s 80.00% (35/45) (P < .05). Additionally, the observation group had significantly shorter infection control times, wound healing times, and hospital stays (P < .05). Two weeks post-surgery, the observation group had significantly lower levels of C-reactive protein, erythrocyte sedimentation rate, and white blood cell count, as well as reduced numerical rating scale and Pressure Ulcer Scale for Healing scores (P < .05). The incidence of complications was 6.67% (3/45) in the observation group compared to 33.33% (15/45) in the control group, with a significant difference (P < .05). Combining autologous PRP with NPWT significantly improves clinical outcomes, reduces inflammatory responses, decreases pain, accelerates wound healing, and lowers complication rates in patients with pressure ulcers.
Development of machine learning prediction model for AKI after craniotomy and evacuation of hematoma in craniocerebral trauma
Authors: Zhang Wenjuan , Niu Huanjiang , Yuan Fang , Shang Shucheng , Zhu Zehang , Huang Chen , Pang Xiaonan , Zhu Fuhua
Published: November 2024

The aim of this study was to develop a machine-learning prediction model for AKI after craniotomy and evacuation of hematoma in craniocerebral trauma. We included patients who underwent craniotomy and evacuation of hematoma due to traumatic brain injury in our hospital from January 2015 to December 2020. Ten machine learning methods were selected to model prediction, including XGBoost, Logistic Regression, Light GBM, Random Forest, AdaBoost, GaussianNB, ComplementNB, Support Vector Machines, and KNeighbors. We totally included 710 patients. 497 patients were used for the training of the machine learning models and the remaining patients were used to test the performance of the models. In the validation cohort, the AdaBoost model got the highest area under the receiver operating characteristic curve (AUC) (0.909; 95% CI, 0.849–0.970) compared with other models. The AdaBoost model showed an AUC of 0.909 (95% CI, 0.849–0.970) in the validation cohort. Although there was an underestimated acute kidney injury risk for the model in the calibration curve, there was a net benefit for the AdaBoost model in the decision curve. Our machine learning model was evaluated to have a good performance in the validation cohorts and could be a useful tool in the clinical practice.
Causal relationships between epilepsy and the microstructure of the white matter: A Mendelian randomization study
Authors: Xie Zhijun , Chen Zhe , Jiang Yuhong , Yao Jiaqi , Zhang Pengcheng , Lei Hang , Tang Wenfu
Published: November 2024

To examine the causal bidirectional relationships between epilepsy and microstructural changes in the white matter (WM). A genome-wide association study meta-analysis of the International League Against Epilepsy Consortium on Epilepsy and 360 WM imaging-derived phenotypes (IDPs) from the UK Biobank was used for the analysis. Genetic correlation analyses were conducted based on summary statistics of various “IDP-epilepsy” pairs for 2-sample Mendelian randomization (MR) analysis to explore the causal relationships. We used the inverse variance weighted (IVW) method as the primary MR analysis approach, and conducted sensitivity analyses for pleiotropy and heterogeneity. Forward MR analysis revealed that alterations in the 16 WM IDPs increased the risk of epilepsy (q value < 0.05). Changes in the 38 WM IDPs were associated with a decreased risk of epilepsy (q value < 0.05). In the reverse analysis, seizures from all epilepsy types changed 5 WM IDPs, whereas seizures from juvenile myoclonic epilepsy altered 11 WM IDPs (q value < 0.05). This study revealed causal associations between changes in the WM microstructure and epilepsy subtypes. These findings offer new directions for early prevention and treatment of epilepsy.
Vitamin D levels in children and adolescents are associated with coronavirus disease-2019 outcomes: A systematic review and meta-analysis
Authors: Wang Ji-Gan , Dou Hui-Hong , Liang Qiong-You
Published: November 2024

Background:

To explore the relationship between vitamin D levels and risk of SARS-CoV-2 infection and its severity in children and adolescents, and provide a theoretical basis for clinical practice.

Methods:

The PubMed, Web of Science, Embase, MEDLINE, and Cochrane Library databases were searched for comprehensive cohort and case–control studies on the association between childhood vitamin D deficiency and the risk and prognosis of coronavirus disease-2019 (COVID-19). The search period was set from December 1, 2019, to December 31, 2023.

Results:

The vitamin D insufficiency rate in children with COVID-19 was 80.78% (95% CI, 62.6% to 93.89%), with a deficiency rate of 32% (95% CI: 19.01% to 46.61%). Vitamin D insufficiency was more common in children with COVID-19 than in healthy children (OR, 4.86; 95% CI: 2.56–9.26). The incidence of severe illness was higher (OR, 4.73; 95% CI: 1.39–16.11) whereas that of asymptomatic illness was lower (OR, 0.38; 95% CI: 0.38–0.81) in children with COVID-19 who had vitamin D insufficiency than in those who did not.

Conclusions:

Vitamin D insufficiency in children may increase the risk of COVID-19 infection and is associated with poor prognostic outcomes. Further research is required to confirm the optimal Vitamin D dose to prevent insufficiency in various sections of the population.