bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulating the shock dynamics of a neutron star accretion column
Authors: Abolmasov Pavel , Lipunova Galina
Published: June 2023

Accretion on to a highly magnetized neutron star runs through a magnetospheric flow, where the plasma follows the magnetic field lines in the force-free regime. The flow entering the magnetosphere is accelerated by the gravity of the star and then abruptly decelerated in a shock located above the surface of the star. For large enough mass accretion rates, most of the radiation comes from the radiation–pressure-dominated region below the shock, known as accretion column. Though the one-dimensional, stationary structure of this flow has been studied for many years, its global dynamics was hardly ever considered before. Considering the time-dependent structure of an accretion column allows us to test the stability of the existing stationary analytic solution, as well as its possible variability modes, and check the validity of its boundary conditions. Using a conservative scheme, we perform one-dimensional time-dependent simulations of an ideal radiative MHD flow inside an aligned dipolar magnetosphere. Whenever thermal pressure locally exceeds magnetic pressure, the flow is assumed to lose mass. Position of the shock agrees well with the theoretical predictions below a limit likely associated with advection effects: if more than $2/3$ of the released power is advected with the flow, the analytic solution becomes self-inconsistent, and the column starts leaking at a finite height. Depending on the geometry, this breakdown may broaden the column, mass load the field lines, and produce radiation-driven, mildly relativistic ejecta. Evolving towards the equilibrium position, the shock front experiences damped oscillations at a frequency close to the inverse sound propagation time.
Unresolved Rossby and gravity modes in 214 A and F stars showing rotational modulation
Authors: Henriksen Andreea I , Antoci Victoria , Saio Hideyuki , Grundahl Frank , Kjeldsen Hans , Van Reeth Timothy , Bowman Dominic M , Pápics Péter I , De Cat Peter , Krüger Joachim , Andersen M Fredslund , Pallé P L
Published: June 2023

Here, we report an ensemble study of 214 A- and F-type stars observed by Kepler, exhibiting the so-called hump and spike periodic signal, explained by Rossby modes (r modes) – the hump – and magnetic stellar spots or overstable convective (OsC) modes – the spike, respectively. We determine the power confined in the non-resolved hump features and find additional gravity-mode (g-mode) humps always occurring at higher frequencies than the spike. Furthermore, we derive projected rotational velocities from FIES, SONG, and HERMES spectra for 28 stars and the stellar inclination angle for 89 stars. We find a strong correlation between the spike amplitude and the power in the r and g modes, which suggests that both types of oscillations are mechanically excited by either stellar spots or OsC modes. Our analysis suggests that stars with a higher power in m = 1 r-mode humps are more likely to also exhibit humps at higher azimuthal orders (m = 2, 3, or 4). Interestingly, all stars that show g-mode humps are hotter and more luminous than the observed red edge of the δ Scuti instability strip, suggesting that either magnetic fields or convection in the outer layers could play an important role.
Efficacy and safety of telitacicept in primary Sjögren’s syndrome: a randomized, double-blind, placebo-controlled, phase 2 trial
Authors: Xu Dong , Fang Jianmin , Zhang Shangzhu , Huang Cibo , Huang Chenghui , Qin Li , Li Xiaomei , Chen Meiqing , Liu Xiumei , Liu Yi , Li Zhijun , Hu Jiankang , Bao Chunde , Wei Wei , Tian Jing , Duan Xinwang , Zeng Xiaofeng
Published: June 2023

Objective

To evaluate the efficacy and safety of telitacicept in adult patients with primary SS (pSS) in a phase II randomized double-blind placebo-controlled trial.

Methods

Patients with pSS with positive anti-SSA antibody and ESSDAI ≥ 5 were randomly assigned, in a 1:1:1 ratio, to receive weekly subcutaneous telitacicept 240 mg, 160 mg, or placebo for 24 weeks. The primary end point was the change from baseline in the ESSDAI at week 24. Safety was monitored.

Results

A total of 42 patients were enrolled and randomized (n = 14 per group). Administration of telitacicept 160 mg resulted in a significant reduction in ESSDAI score from baseline to week 24 compared with placebo (P < 0.05). The placebo-adjusted least-squares mean change from baseline was –4.3 (95% CI –7.0, –1.6; P = 0.002). While, mean change of ESSDAI in telitacicept 240 mg was –2.7(–5.6–0.1) with no statistical difference when compared that in placebo group (P = 0.056). In addition, MFI-20 and serum immunoglobulins decreased significantly (P < 0.05) at week 24 in both telitacicept groups compared with placebo. No serious adverse events were observed in the telitacicept treating group.

Conclusion

Telitacicept showed clinical benefits and good tolerance and safety in the treatment of pSS.

Trial registration

ClinicalTrials.gov, https://clinicaltrials.gov, NCT04078386
Can You Sing Your Way to Good Citizenship?: Recreational Association Structures and Member Political Participation
Authors: Baggetta Matthew , Bello-Gomez Ricardo
Published: June 2023

What is the relationship of recreational associations to the political engagement of their members? We answer this question using multilevel data on 25 community choirs and the 1,032 members within them. Using structural equation modelling, we model the relationships between recreational association structures and member political participation through member experiences along with countervailing selection effects. We find that selection dynamics are the primary driver of the relationship between recreational associations and member political activity. We also find some evidence that associations foster new political activity in members through an interpretive mechanism—but not through developmental mechanisms. Recreational associations with more-participatory structures and broader organizational identities lead some members to interpret their recreational activity as publicly-oriented. Adopting publicly-oriented interpretations is related to certain kinds of new political activity. The results suggest that, overall, recreational associations are having little impact on political participation; when they do, they do so not by teaching participants how to do civic work but by altering how members think about civic life.
The virome of the invasive Asian bush mosquito Aedes japonicus in Europe
Authors: Abbo Sandra R , de Almeida João P P , Olmo Roenick P , Balvers Carlijn , Griep Jet S , Linthout Charlotte , Koenraadt Constantianus J M , Silva Bruno M , Fros Jelke J , Aguiar Eric R G R , Marois Eric , Pijlman Gorben P , Marques João T
Published: June 2023

The Asian bush mosquito Aedes japonicus is rapidly invading North America and Europe. Due to its potential to transmit multiple pathogenic arthropod–borne (arbo)viruses including Zika virus, West Nile virus, and chikungunya virus, it is important to understand the biology of this vector mosquito in more detail. In addition to arboviruses, mosquitoes can also carry insect-specific viruses that are receiving increasing attention due to their potential effects on host physiology and arbovirus transmission. In this study, we characterized the collection of viruses, referred to as the virome, circulating in Ae. japonicus populations in the Netherlands and France. Applying a small RNA-based metagenomic approach to Ae. japonicus, we uncovered a distinct group of viruses present in samples from both the Netherlands and France. These included one known virus, Ae. japonicus narnavirus 1 (AejapNV1), and three new virus species that we named Ae. japonicus totivirus 1 (AejapTV1), Ae. japonicus anphevirus 1 (AejapAV1) and Ae. japonicus bunyavirus 1 (AejapBV1). We also discovered sequences that were presumably derived from two additional novel viruses: Ae. japonicus bunyavirus 2 (AejapBV2) and Ae. japonicus rhabdovirus 1 (AejapRV1). All six viruses induced strong RNA interference responses, including the production of twenty-one nucleotide-sized small interfering RNAs, a signature of active replication in the host. Notably, AejapBV1 and AejapBV2 belong to different viral families; however, no RNA-dependent RNA polymerase sequence has been found for AejapBV2. Intriguingly, our small RNA-based approach identified an ∼1-kb long ambigrammatic RNA that is associated with AejapNV1 as a secondary segment but showed no similarity to any sequence in public databases. We confirmed the presence of AejapNV1 primary and secondary segments, AejapTV1, AejapAV1, and AejapBV1 by reverse transcriptase polymerase chain reaction (PCR) in wild-caught Ae. japonicus mosquitoes. AejapNV1 and AejapTV1 were found at high prevalence (87–100 per cent) in adult females, adult males, and larvae. Using a small RNA-based, sequence-independent metagenomic strategy, we uncovered a conserved and prevalent virome among Ae. japonicus mosquito populations. The high prevalence of AejapNV1 and AejapTV1 across all tested mosquito life stages suggests that these viruses are intimately associated with Ae. japonicus.
A Moroccan Pyrenophora teres f. teres Population Defeats Rpt5, the Broadly Effective Resistance on Barley Chromosome 6H
Authors: Richards Jonathan K. , Li Jinling , Koladia Vaidehi , Wyatt Nathan A. , Rehman Sajid , Brueggeman Robert S. , Friesen Timothy L.
Published: June 2023

Net form net blotch (NFNB), caused by Pyrenophora teres f. teres, is an important barley disease. The centromeric region of barley chromosome 6H has often been associated with resistance or susceptibility to NFNB, including the broadly effective dominant resistance gene Rpt5 derived from barley line CIho 5791. We characterized a population of Moroccan P. teres f. teres isolates that had overcome Rpt5 resistance and identified quantitative trait loci (QTL) that were effective against these isolates. Eight Moroccan P. teres f. teres isolates were phenotyped on barley lines CIho 5791 and Tifang. Six isolates were virulent on CIho 5791, and two were avirulent. A CIho 5791 × Tifang recombinant inbred line (RIL) population was phenotyped with all eight isolates and confirmed the defeat of the 6H resistance locus formerly mapped as Rpt5 in barley line CI9819. A major QTL on chromosome 3H with the resistance allele derived from Tifang, as well as minor QTL, was identified and provided resistance against these isolates. F2 segregation ratios supported dominant inheritance for both the 3H and 6H resistance. Furthermore, inoculation of progeny isolates derived from a cross of P. teres f. teres isolates 0-1 (virulent on Tifang/avirulent on CIho 5791) and MorSM 40-3 (avirulent on Tifang/virulent on CIho 5791) onto the RIL and F2 populations determined that recombination between isolates can generate novel genotypes that overcome both resistance genes. Markers linked to the QTL identified in this study can be used to incorporate both resistance loci into elite barley cultivars for durable resistance.
Allograft Anterior Cruciate Ligament Reconstruction in Adolescent Patients May Result in Acceptable Graft Failure Rate in Nonpivoting Sports Athletes
Authors: Vasudevan Rajiv S. , Paras Tyler , Zogby Andrew M. , Wilps Tyler , Bastrom Tracey P. , Bomar James D. , Manhard Claire E. , Pennock Andrew T.
Published: June 2023

Background:

Studies have demonstrated that pediatric patients have an increased risk of failure with allograft anterior cruciate ligament reconstruction (ACLR); however, there is no study investigating whether allograft ACLR may be safe in older adolescent patients who are not returning to competitive pivoting sports (ie, low risk). The purpose of this study was to assess outcomes for low-risk older adolescents selected for allograft ACLR.

Methods:

We performed a retrospective chart review of patients younger than 18 years who received a bone-patellar-tendon-bone allograft or autograft ACLR by a single orthopaedic surgeon from 2012 to 2020. Patients were offered allograft ACLR if they did not intend to return to pivoting sports for 1 year. The autograft cohort was matched 1:1 based on age, sex, and follow-up. Patients were excluded for skeletal immaturity, multiligamentous injury, prior ipsilateral ACLR, or concomitant realignment procedure. Patients were contacted to obtain patient-reported outcomes at ≥2 years follow-up, including single assessment numerical evaluation, surgery satisfaction, pain scores, Tegner Activity Scale, and the Lysholm Knee Scoring Scale. Parametric and nonparametric tests were used as appropriate.

Results:

Of the 68 allografts, 40 (59%) met inclusion and 28 (70%) were contacted. Among the 456 autografts, 40 (8.7%) were matched and 26 (65%) were contacted. Two allograft patients (2/40; 5%) failed at a median (interquartile range) follow-up of 36 (12, 60) months. There were 0/40 failures in the autograft cohort and 13/456 (2.9%) among the overall autografts; neither were significantly different from the allograft failure rate (both P > 0.05). Two (5.0%) patients in the autograft cohort required manipulation under anesthesia and arthroscopic lysis of adhesions. There were no significant differences between cohorts for single assessment numerical evaluation, Lysholm, Tegner, pain, and satisfaction scores (all P > 0.05).

Conclusions:

Although ACL allograft failure rates remain nearly two times higher than autograft failure rates in older adolescents, our study suggests that careful patient selection can potentially bring this failure rate down to an acceptable level.

Level of Evidence:

Level III; retrospective matched cohort study.
The presentation and management of cesarean scar defects: an updated review on an evolving diagnosis
Authors: McGrattan Meghan , Kobylianskii Anna , Thiel Peter , Solnik M Jonathon , Murji Ally
Published: June 2023

Purpose of review

The purpose of this review is to provide a clinically relevant synthesis of the current literature on cesarean scar defects, focusing on their epidemiology and clinical presentation, diagnosis, treatment, and prevention.

Recent findings

Cesarean scar defects (CSDs) are an emerging area of gynecologic research, with an influx of higher quality cohorts, randomized controlled trials, and systematic reviews published within the last decade. Recent developments of importance include the European Niche Taskforce consensus on the measurement and diagnosis of CSDs, the proposal of clinical criteria for Cesarean scar disorder (CSDi), as well as the publication of several systematic reviews, which provide enhanced support for clinical decision-making in treatment strategies. Areas for continued research include risks factors for CSDs and preventive strategies, as well as their role in obstetrical complications.

CSDs are a common sonographic finding. While those incidentally identified in an asymptomatic population require no treatment, CSDs can cause significant burden in the form of abnormal uterine bleeding, pelvic pain, and infertility. Their role in obstetrical complications has yet to be fully elucidated. Given the high incidence of cesarean sections, many – if not all – providers of uterine care will encounter their sequalae. As such, continued awareness amongst all providers regarding their evaluation and management is key.

Video Abstract

http://links.lww.com/COOG/A91
Patellofemoral Pain Syndrome Is Associated With Chronic Disease and Allergies in 60 997 Distance Runner Race Entrants: SAFER XXX Study
Authors: Marandure Tsungai Tirivashe , Schwellnus Martin P. , Grant Catharina , Jansen van Rensburg Audrey , Jordaan Esmè , Boer Pieter
Published: June 2023

Objective:

Patellofemoral pain syndrome (PFPS) is a common running-related injury. Independent risk factors associated with PFPS have not been described in a large cohort of distance runners.

Design:

Descriptive, cross-sectional study.

Setting:

21.1 and 56 km Two Oceans Marathon races (2012-2015).

Participants:

60 997 race entrants.

Assessment of risk factors:

Participants completed a compulsory prerace medical screening questionnaire (history of PFPS in the past 12 months, n = 362; no injury history, n = 60 635). Selected risk factors associated with a history of PFPS were explored using univariate & multivariate analyses: demographics, training/running variables, history of chronic diseases (composite chronic disease score), and any allergy.

Main Outcome Measures:

Prevalence ratios (PRs, 95% confidence intervals).

Results:

Risk factors associated with PFPS (univariate analysis) were increased years of recreational running (PR = 1.09; P = 0.0107), older age (>50 years), and chronic diseases (PR > 2): gastrointestinal disease (PR = 5.06; P < 0.0001), cardiovascular disease (CVD) (PR = 3.28; P < 0.0001), nervous system/psychiatric disease (PR = 3.04; P < 0.0001), cancer (PR = 2.83; P = 0.0005), risk factors for CVD (PR = 2.42; P < 0.0001), symptoms of CVD (PR = 2.38; P = 0.0397), and respiratory disease (PR = 2.00; P < 0.0001). Independent risk factors (multivariate analysis) associated with PFPS (adjusted for age, sex, and race distance) were a higher chronic disease composite score (PR = 2.68 increased risk for every 2 additional chronic diseases; P < 0.0001) and a history of allergies (PR = 2.33; P < 0.0001).

Conclusions:

Novel independent risk factors associated with PFPS in distance runners are a history of multiple chronic diseases and a history of allergies. Identification of chronic diseases and allergies should be considered as part of the clinical assessment of a runner presenting with a history of PFPS.
Return to Play in Collision Sport After Hemorrhages of a Cerebral Cavernoma
Authors: Brauge David , Julien Adeline , Izard Philippe
Published: June 2023

Discovering a cerebral vascular malformation in an athlete should lead to evaluating hemorrhagic risk, notably in contact sports. Cavernous angioma is one of the most frequent pathologies in this context. It can be identified by a hemorrhage, the onset of an epileptic seizure, or, increasingly so, incidentally, while performing a medical examination for another reason. Whether sports practice is a risk factor for hemorrhage is unclear in available literature. When treatment is needed, surgery remains the gold standard. Currently, little data are available on the possibility of resuming contact sports after craniotomy. We report the case of a rugby player who underwent surgery for intracerebral cavernoma. We provide details on how the player was finally cleared to resume rugby practice and on the therapeutic management of this lesion.
Gastrointestinal function in critically ill patients
Authors: Reintam Blaser Annika , Bachmann Kaspar F. , Deane Adam M.
Published: June 2023

Purpose of review

To summarize recent evidence regarding the diagnosis of acute gastrointestinal dysfunction and enteral feeding intolerance, and relationship of these to development of multiple organ dysfunction syndrome, during critical illness.

Recent findings

Novel gastric feeding tubes that attenuate gastroesophageal regurgitation or facilitate continuous monitoring of gastric motility have been developed. The definition of enteral feeding intolerance remains controversial, which may be resolved using a consensus process. A novel scoring system for gastrointestinal dysfunction (GIDS – GastroIntestinal Dysfunction Score) was recently developed but it is not yet validated or tested to evaluate the effect of any interventions. Studies of biomarkers to identify gastrointestinal dysfunction have yet to yield a suitable biomarker for daily clinical use.

The assessment of gastrointestinal function in critically ill patients continues to rely on complex daily clinical assessment. Scoring systems, consensus definitions and novel technology appear the most promising tools and interventions to improve patient care.
Statins on nonalcoholic fatty liver disease: A systematic review and meta-analysis of 14 RCTs
Authors: Zhou Haiyan , Toshiyoshi, Maeda , Zhao Wenli , Zhao Ye , Zhao, Yan
Published: June 2023

Background:

The prevalence of nonalcoholic fatty liver disease (NAFLD) is rising rapidly in the world. Our aim is to investigate the efficacy and safety of statins in the treatment of NAFLD.

Methods:

This study was conducted by searching The National Library of Medicine, Cochrane Library, China National Knowledge Infrastructure, Web of Science, and Wanfang Data Knowledge Service Platform databases. Literature data are expressed as mean difference (MD) and 95% confidence intervals (CIs) or relative risk and 95% CI. For I
2 > 50% trials, random effect model is used for statistical analysis, otherwise fixed effect model is used.

Results:

Fourteen studies are selected for this meta-analysis, which includes totally 534 patients in the treatment group and 527 patients in the control group. As a result, 5 studies show that the total effective rate of the treatment group is 17% higher than that of the control group (Z = 2.11, relative risk = 1.17, 95% CI: [1.01–1.35]). Twelve studies show that alanine aminotransferase levels of the experimental group are lower than that of the control group (Z = 2.63, P = .009, MD = −5.53, 95% CI: [−9.64 to −1.41]). Eleven studies show that aspartate transaminase levels of the experimental group are lower than that of the control group (Z = 2.01, P = .04, MD = −3.43, 95% CI: [−6.77 to −0.08]). Six studies show that alkaline phosphatase levels of the experimental group are lower than that of the control group (Z = 0.79, P = .43, MD = −3.46, 95% CI: [−12.08 to 5.16]). Eight studies show that gamma-glutamyl transpeptidase levels of the experimental group are lower than that of the control group (Z = 2.04, P = .04, MD = −4.05, 95% CI: [−7.96 to −0.15]). Thirteen studies show that triglyceride levels of the experimental group are lower than that of the control group (Z = 4.15, P < .0001, MD = −0.94, 95% CI: [−1.39 to −0.50]). Eleven studies show that the total cholesterol levels of the experimental group are lower than that of the control group (Z = 5.42, P < .00001, MD = −1.51, 95% CI: [−2.05 to −0.96]). Seven studies show that low-density lipoprotein-cholesterol levels of the experimental group are lower than that of the control group (Z = 5.00, P < .00001, MD = −0.85, 95% CI: [−1.18 to −0.52]).

Conclusion:

Statins can significantly reduce liver biochemical indicators in patients with NAFLD.
Decreased expression of hyaluronan synthase and loss of hyaluronan-rich cells in the anterior tibial fascia of the rat model of chemotherapy-induced peripheral neuropathy
Authors: Wang Ruilin , Matsuoka Yoshikazu , Sue Nobutaka , Nakatsuka Kosuke , Tsuboi Chika , Morimatsu Hiroshi
Published: June 2023

Introduction:

Previous studies on chemotherapy-induced peripheral neuropathy (CIPN) have focused on neuronal damage. Although some studies have revealed that the fascia is an important sensory organ, currently, we do not know about chemotherapy drug-induced fascial dysfunction.

Objectives:

This study aimed to explore the fascia as a nonneural cause of mechanical hypersensitivity in CIPN by investigating the expression of hyaluronic acid synthase (HAS) and histology of the fascia in an animal model of CIPN.

Methods:

Rats were intraperitoneally administered with vincristine (VCR). Mechanical hypersensitivities of the hind paw and the anterior tibial muscle were assessed. The expression of HAS mRNA in the fascia of the anterior tibial muscles was quantitated using reverse transcription polymerase chain reaction. Immunohistochemistry was also performed for HAS2, hyaluronic acid–binding protein, and S100A4 in the fascia.

Results:

Vincristine administration significantly decreased mechanical withdrawal thresholds in the hind paw and the anterior tibial muscle after day 3. Quantitative polymerase chain reaction showed significant downregulation of HAS mRNAs in the fascia of VCR-treated rats. Immunohistochemical analysis showed that the number of cells with strong HAS2 immunoreactivity, classified as fasciacytes by morphology and colocalized marker S100A4, decreased significantly in the VCR group.

Conclusion:

Hyaluronic acid plays a critical role in somatic pain sensation. Damaged fascia could be a possible cause of musculoskeletal pain in patients with CIPN. This study suggests that fascia is a nonneural cause and novel therapeutic target for chemotherapy-induced “peripheral neuropathy.”
Deep Learning–Based Image Noise Quantification Framework for Computed Tomography
Authors: Huber Nathan R. , Kim Jiwoo , Leng Shuai , McCollough Cynthia H. , Yu Lifeng
Published: June 2023

Objective

Noise quantification is fundamental to computed tomography (CT) image quality assessment and protocol optimization. This study proposes a deep learning–based framework, Single-scan Image Local Variance EstimatoR (SILVER), for estimating the local noise level within each region of a CT image. The local noise level will be referred to as a pixel-wise noise map.

Methods

The SILVER architecture resembled a U-Net convolutional neural network with mean-square-error loss. To generate training data, 100 replicate scans were acquired of 3 anthropomorphic phantoms (chest, head, and pelvis) using a sequential scan mode; 120,000 phantom images were allocated into training, validation, and testing data sets. Pixel-wise noise maps were calculated for the phantom data by taking the per-pixel SD from the 100 replicate scans. For training, the convolutional neural network inputs consisted of phantom CT image patches, and the training targets consisted of the corresponding calculated pixel-wise noise maps. Following training, SILVER noise maps were evaluated using phantom and patient images. For evaluation on patient images, SILVER noise maps were compared with manual noise measurements at the heart, aorta, liver, spleen, and fat.

Results

When tested on phantom images, the SILVER noise map prediction closely matched the calculated noise map target (root mean square error <8 Hounsfield units). Within 10 patient examinations, SILVER noise map had an average percent error of 5% relative to manual region-of-interest measurements.

Conclusion

The SILVER framework enabled accurate pixel-wise noise level estimation directly from patient images. This method is widely accessible because it operates in the image domain and requires only phantom data for training.
Breast DWI Analyzed Before and After Gadolinium Contrast Administration—An Intrapatient Analysis on 1.5 T and 3.0 T
Authors: van der Hoogt Kay J.J. , Schipper Robert-Jan , Wessels Ronni , ter Beek Leon C. , Beets-Tan Regina G.H. , Mann Ritse M.
Published: June 2023

Objectives

Diffusion-weighted magnetic resonance imaging (MRI) is gaining popularity as an addition to standard dynamic contrast-enhanced breast MRI. Although adding diffusion-weighted imaging (DWI) to the standard protocol design would require increased scanning-time, implementation during the contrast-enhanced phase could offer a multiparametric MRI protocol without any additional scanning time. However, gadolinium within a region of interest (ROI) might affect assessments of DWI. This study aims to determine if acquiring DWI postcontrast, incorporated in an abbreviated MRI protocol, would statistically significantly affect lesion classification. In addition, the effect of postcontrast DWI on breast parenchyma was studied.

Materials and Methods

Screening or preoperative MRIs (1.5 T/3 T) were included for this study. Diffusion-weighted imaging was acquired with single-shot spin echo–echo planar imaging before and at approximately 2 minutes after gadoterate meglumine injection. Apparent diffusion coefficients (ADCs) based on 2-dimensional ROIs of fibroglandular tissue, as well as benign and malignant lesions at 1.5 T/3.0 T, were compared with a Wilcoxon signed rank test. Diffusivity levels were compared between precontrast and postcontrast DWI with weighted κ. An overall P ≤ 0.05 was considered statistically significant.

Results

No significant changes were observed in ADCmean after contrast administration in 21 patients with 37 ROI of healthy fibroglandular tissue and in the 93 patients with 93 (malignant and benign) lesions. This effect remained after stratification on B0. In 18% of all lesions, a diffusion level shift was observed, with an overall weighted κ of 0.75.

Conclusions

This study supports incorporating DWI at 2 minutes postcontrast when ADC is calculated based on b150-b800 with 15 mL 0.5 M gadoterate meglumine in an abbreviated multiparametric MRI protocol without requiring extra scan time.
Relationship Between Distressing Symptoms and Changes in Disability After Major Surgery Among Community-living Older Persons
Authors: Gill Thomas M. , Han Ling , Feder Shelli L. , Gahbauer Evelyne A. , Leo-Summers Linda , Becher Robert D.
Published: June 2023

Objectives:

To evaluate the relationship between distressing symptoms and changes in disability after major surgery and determine whether this relationship differs according to the timing of surgery (nonelective vs. elective), sex, multimorbidity, and socioeconomic disadvantage.

Summary Background Data:

Major surgery is a common and serious health event that has pronounced deleterious effects on both distressing symptoms and functional outcomes in older persons.

Methods:

From a cohort of 754 community-living persons, aged 70 or older, 392 admissions for major surgery were identified from 283 participants who were discharged from the hospital. The occurrence of 15 distressing symptoms and disability in 13 activities were assessed monthly for up to 6 months after major surgery.

Results:

Over the 6-month follow-up period, each unit increase in the number of distressing symptoms was associated with a 6.4% increase in the number of disabilities (adjusted rate ratio [RR]: 1.064; 95% CI: 1.053, 1.074). The corresponding increases were 4.0% (adjusted RR: 1.040; 95% CI: 1.030, 1.050) and 8.3% (adjusted RR: 1.083; 95% CI: 1.066, 1.101) for nonelective and elective surgeries. Based on exposure to multiple (i.e., 2 or more) distressing symptoms, the adjusted rate ratios (95% CI) were 1.43 (1.35, 1.50), 1.24 (1.17, 1.31), and 1.61 (1.48, 1.75) for all, nonelective, and elective surgeries. Statistically significant associations were observed for each of the other subgroups with the exception of individual-level socioeconomic disadvantage for number of distressing symptoms.

Conclusions:

Distressing symptoms are independently associated with worsening disability, providing a potential target for improving functional outcomes after major surgery.
Longitudinal characterisation of cachexia in patients undergoing surgical resection for cancer
Authors: Brown Leo R. , Laird Barry J.A. , Wigmore Stephen J. , Skipworth Richard J.E.
Published: June 2023

Purpose of review

The complexity of the cancer cachexia phenotype has undoubtedly hindered researchers’ understanding of this devastating syndrome. The presence and magnitude of host–tumour interactions are rarely considered during clinical decision-making within the current staging paradigm. Furthermore, treatment options for those patients who are identified as suffering from cancer cachexia remain extremely limited.

Recent findings

Previous attempts to characterise cachexia have largely focussed on individual surrogate disease markers, often studied across a limited timeframe. While the adverse prognostic value of clinical and biochemical features is evident, the relationships between these are less clear. Investigation of patients with earlier-stage disease could allow researchers to identify markers of cachexia that precede the refractory stage of the wasting process. Appreciation of the cachectic phenotype within ‘curative’ populations may aid our understanding of the syndrome’s genesis and provide potential routes for prevention, rather than treatment.

Holistic, longitudinal characterisation of cancer cachexia, across all at-risk and affected populations, is of vital importance for future research in the field. This paper presents the protocol for an observational study aiming to create a robust and holistic characterisation of surgical patients with, or at risk of, cancer cachexia.
Bronchial Stenosis After Lung Transplantation From cDCD Donors Using Simultaneous Abdominal Normothermic Regional Perfusion: A Single-center Experience
Authors: Mora-Cuesta Víctor M. , Tello-Mena Sandra , Izquierdo-Cuervo Sheila , Iturbe-Fernández David , Sánchez-Moreno Laura , Ballesteros Maria Angeles , Alonso-Lecue Pilar , Ortíz-Portal Felix , Ferrer-Pargada Diego , Miñambres-García Eduardo , Cifrián-Martínez José M. , Naranjo-Gozalo Sara
Published: June 2023

Background.

Controlled donation after circulatory death (cDCD) has increased the number of lung donors significantly. The use of abdominal normothermic regional perfusion (A-NRP) during organ procurement is a common practice in some centers due to its benefits on abdominal grafts. This study aimed to assess whether the use of A-NRP in cDCD increases the frequency of bronchial stenosis in lung transplant (LT) recipients.

Methods.

A single-center, retrospective study including all LTs was performed between January 1, 2015, and August 30, 2022. Airway stenosis was defined as a stricture that leads to clinical/functional worsening requiring the use of invasive monitoring and therapeutic procedures.

Results.

A total of 308 LT recipients were included in the study. Seventy-six LT recipients (24.7%) received lungs from cDCD donors using A-NRP during organ procurement. Forty-seven LT recipients (15.3%) developed airway stenosis, with no differences between lung recipients with grafts from cDCD (17.2%) and donation after brain death donors (13.3%; P = 0.278). A total of 48.9% of recipients showed signs of acute airway ischemia on control bronchoscopy at 2 to 3 wk posttransplant. Acute ischemia was an independent risk factor for airway stenosis development (odds ratio = 2.523 [1.311-4.855], P = 0.006). The median number of bronchoscopies per patient was 5 (2–9), and 25% of patients needed >8 dilatations. Twenty-three patients underwent endobronchial stenting (50.0%) and each patient needed a median of 1 (1–2) stent.

Conclusions.

Incidence of airway stenosis is not increased in LT recipients with grafts obtained from cDCD donors using A-NRP.
Validation of the International IgA risk prediction tool in American Indians and Hispanics
Authors: Shaffi Saeed Kamran , Fischer Edger , Argyropoulos Christos , Wagner Brent
Published: June 2023

Background

The International Immunoglobulin A nephropathy (IgAN) risk prediction assesses the risk of kidney failure in patients with IgAN. The performance of this risk prediction tool has not been studied in American Indians and Hispanics. We conducted a single-center study to assess the equation performance in this population.

Methods

We calculated the 5-year risk of developing kidney failure with the IgAN risk prediction equation without race and assessed the equation performance using the metrics of calibration, discrimination, and overall prediction error.

Results

Thirty-four patients were included, most of whom identified as of Hispanic race/ethnicity (44.1%), or as American Indians (26.5%). At biopsy, the median (IQR) age, serum creatinine, and spot urine protein to creatinine ratio were 38 years (27-45), 2.15 mg/dl (1.51-3.04), and 2.7 g/g (1.5-5.8), respectively. The equation identified patients at high risk of developing kidney failure early with a concordance statistic of 0.79 (95% CI 0.68 – 0.89). The agreement between observed and predicted outcomes at 5 years was marginal, with over-estimation of risk for patients with low observed risk and vice versa. Overall prediction error was suboptimal in this cohort [index of prediction accuracy 0.34 (0.03 – 0.51)].

Conclusions

The International IgAN risk prediction equation without race accurately identified patients at elevated risk of developing kidney failure. At 5 years, the agreement between the observed and predicted outcomes was sub-optimal, possibly due to advanced kidney disease in this cohort. A diverse development population may improve the risk prediction.
The Colloido-Osmotic Pressure as a useful biomarker of fatal outcome in pregnant COVID-19 patients
Authors: Zavala-Barrios B. , Cérbulo-Vázquez A. , García-Espinosa M. , Caldiño-Soto F. , Madera Sandoval Ruth L. , Ramírez-García L.A. , Eláceo-Fernández I.C. , Moreno-Álvarez O. , Guerrero-Avendaño G.M.L. , Briones-Garduño J.C.
Published: June 2023

Background

Pregnancy was considering a health condition that could support high severity in COVID-19, among others the cardiologic and respiratory systems express some physiologic change in the pregnant women and could specially affected in COVID-19. Pregnant women characteristically have an increase volume of blood, with a higher cardiac output and lower peripheral vascular resistance, these could be negative affected by hypoalbuminemia frequently observed in COVID-19. Then, an early recognition of hypoalbuminemia in pregnant women with COVID-19 would help us to predict fatal outcome.

Objective

We conduct a study to analyzed the demographic, clinical, blood gas test results, laboratory and ultrasonographic doppler data in pregnant women with COVID-19 that demand medical attention for labor. Study design: Ninety-two pregnant women with COVID-19 were included in our study from may 30th2020 to august 12th2022, and data was analyzed in survival and fatal outcome patients. Normality test were applied to data and parametric or non-parametric test were used to determine statistical difference between or among data.

Results

Demographic and clinical data were quite similar between survival and fatal outcome pregnant patients with COVID-19. Also, blood gas test shown similar results among groups (asymptomatic, mild, or severe patients who survive COVID-19 or fatal outcome patients). We observed that serum albumin was consistently low in pregnant patients with fatal outcome by COVID-19, then based on Total Protein concentration in serum we calculated the colloido-osmotic pressure and we evaluate its utility as predictor of fatal outcome. ROC analysis and Kaplan-Meier of survival curves suggest that the colloido-osmotic pressure could be a potential predictor. Also, we observed an association of low colloido-osmotic pressure and low amniotic fluid index.

Conclusion

Our study suggests that early evaluation of pregnant with COVID-19 must include the calculation of colloido-osmotic pressure and the doppler analysis to early recognition of fatal outcome in pregnant women with COVID-19.
Methylome evolution through lineage-dependent selection in the gastric pathogenHelicobacter pylori
Authors: Ailloud Florent , Gottschall Wilhelm , Suerbaum Sebastian
Published: June 2023

The bacterial pathogenHelicobacter pylori, the leading cause of gastric cancer, is genetically highly diverse and harbours a large and variable portfolio of restriction-modification systems. Our understanding of the evolution and function of DNA methylation in bacteria is limited. Here, we performed a comprehensive analysis of the methylome diversity inH. pylori, using a dataset of 541 genomes that included all known phylogeographic populations. The frequency of 96 methyltransferases and the abundance of their cognate recognition sequences were strongly influenced by phylogeographic structure and were inter-correlated, positively or negatively, for 20% of type II methyltransferases. Low density motifs were more likely to be affected by natural selection, as reflected by higher genomic instability and compositional bias. Importantly, direct correlation showed that methylation patterns can be actively enriched by positive selection and suggests that specific sites have important functions in methylation-dependent phenotypes. Finally, we identified lineage-specific selective pressures modulating the contraction and expansion of the motif ACGT, revealing that the genetic load of methylation could be dependent on local ecological factors. Taken together, natural selection shapes both the abundance and distribution of methyltransferases and their specific recognition sequences, likely permitting a fine-tuning of genome-encoded functions not achievable by genetic variation alone.
p53-Bad* in a Hepatocellular Carcinoma Mouse Model
Authors: Bowman Katherine Redd , Lu Phong , Lim Carol
Published: June 2023

Recent advances in liver cancer treatments have not changed the fact that the majority of patients will not survive the disease. In order to advance future liver cancer treatments, this work presents an exploration of various iterations of the liver cancer specific AFP promoter as well as the gene construct p53-Bad*. p53-Bad* is a mitochondrially targeted re-engineered p53 therapy that has shown previous success in a zebrafish HCC model. Both the most promising AFP promoter and p53-Bad* were packaged in an adenoviral delivery system and tested in vitro in liver cancer cell lines. Finally, mixed results for adenoviral p53-Bad* in vivo are presented, and this work suggests future modifications to study parameters in order to further explore the potential of p53-Bad* as a potential liver cancer therapeutic.
Hypoxia coordinates the spatial landscape of myeloid cells within glioblastoma to affect outcome
Authors: Haley Michael J. , Bere Leoma , Minshull James , Georgaka Sokratia , Garcia-Martin Natalia , Howell Gareth , Coope David J. , Roncaroli Federico , King Andrew , Wedge David , Allan Stuart , Pathmanaban Omar N. , Brough David , Couper Kevin
Published: June 2023

Myeloid cells are highly prevalent in glioblastoma (GBM), existing in a spectrum of phenotypic and activation states. We currently have limited knowledge of the tumour microenvironment (TME) determinants that influence the localisation and the functions of the diverse myeloid cell populations in GBM. Here we have utilised orthogonal imaging mass cytometry with single cell and spatial transcriptomics approaches to identify and map the various myeloid populations in the human GBM tumour microenvironment (TME). Our results show that different myeloid populations have distinct and reproducible compartmentalisation patterns in the GBM TME that is driven by tissue hypoxia, regional chemokine signalling, and varied homotypic and heterotypic cellular interactions. We subsequently identified specific tumour sub-regions in GBM, based upon composition of identified myeloid cell populations, that were linked to patient survival. Our results provide new insight into the spatial organisation of myeloid cell sub populations in GBM, and how this is predictive of clinical outcome.

Teaser

Multi-modal mapping reveals that the spatial organisation of myeloid cells in glioblastoma impacts disease outcome.
Selection framework of disruption analysis methods for megaprojects: an integrated fuzzy multi-criteria decision-making approach
Authors: Okudan Ozan , Cevikbas Murat , Işık Zeynep
Published: June 2023

Purpose

The purpose of this paper is to propose a decision support framework that can be used by decision-makers to identify the most convenient disruption analysis (DA) methods for megaprojects and their stakeholders.

Design/methodology/approach

The framework was initially developed by conducting a comprehensive literature review to obtain extensive knowledge about disruption management and megaprojects. Focus group discussion (FGD) sessions with the participation of the construction practitioners were then organized to validate and strengthen the findings of the literature review. Consequently, 17 selection factors were identified and categorized as requirement, ability and outcome. Lastly, the most convenient DA methods for megaprojects were identified by performing integrated fuzzy analytical hierarchy process (AHP) and fuzzy technique for order of preference by similarity to ideal solution (TOPSIS) analysis. Additionally, consistency analysis was also conducted to verify the reliability of the results.

Findings

The results revealed that the measured mile method is the most appropriate DA method for megaprojects. In case the measured mile method cannot be adopted due to various technical and contractual reasons, the decision-makers are proposed to consider program analysis, work or trade sampling, earned value analysis and control chart method, respectively. Second, the selection factors such as “Comprehensible analysis procedure,” “Existing knowledge and experience about a particular DA method,” “Ability to resolve greater number of disruption events,” “Ability to resolve complex disruption events,” “Ability to exclude factors that are not under the owner's responsibility” and “General acceptance by practitioners, courts, and arbitration, etc.” were given the top priority by the experts, highlighting the critical aspects of the DA methods.

Originality/value

Disruption claims in megaprojects are very critical for the contractors to compensate for the losses stemming from disruption events. Although the effective use of DA methods maximizes the accuracy and reliability of disruption claims, decision-makers can barely implement these methods adequately since past studies neglect to present extensive knowledge about the most convenient DA methods for megaprojects. Thus, developing a decision support framework for the selection of DA methods, this study is the earliest attempt that examines the mechanisms and inherent differences of DA methods. Additionally, owing to the robustness and versatility of this research approach, the research approach could be replicated also for future studies focusing on other project-based industries since disruption is also a challenging issue for many other industries.
Lesson study and constructivist pedagogy: teacher learning power matters in the mediation model
Authors: Pan Hui-Ling Wendy , Hung Jui-Hsuan , Bai Huilin
Published: June 2023

Purpose

Learning power is crucial in today's rapidly changing world, yet its application to teachers is under-explored. This study delved into the investigation of teacher learning power and examined how it matters in the relationship between teachers' experiences in lesson study and the adoption of constructivist pedagogy.

Design/methodology/approach

A cross-sectional survey of 226 elementary, junior high, and senior high school teachers in Taiwan was conducted, and the results were analyzed using structural equation modeling.

Findings

The findings suggest that both participation in lesson study and teacher learning power were positively associated with the practice of constructivist pedagogy. Moreover, teacher learning power partially mediated the relationship between lesson study and constructivist pedagogy.

Originality/value

By incorporating the concept of teacher learning power and performing a mediation analysis to understand how it matters, this study has added to the expanding collection of works on lesson study explored from different perspectives and in various contexts.
A new predictive approach for the MAC layer misbehavior in IEEE 802.11 networks
Authors: El Houssaini Mohammed-Alamine , Nabou Abdellah , Hadir Abdelali , El Houssaini Souad , El Kafi Jamal
Published: June 2023

Purpose

Ad hoc mobile networks are commonplace in every aspect of our everyday life. They become essential in many industries and have uses in logistics, science and the military. However, because they operate mostly in open spaces, they are exposed to a variety of dangers. The purpose of this study is to introduce a novel method for detecting the MAC layer misbehavior.

Design/methodology/approach

The proposed novel approach is based on exponential smoothing for throughput prediction to address this MAC layer misbehavior. The real and expected throughput are processed using an exponential smoothing algorithm to identify this attack, and if these metrics exhibit a trending pattern, an alarm is then sent.

Findings

The effect of the IEEE 802.11 MAC layer misbehavior on throughput was examined using the NS-2 network simulator, as well as the approval of our novel strategy. The authors have found that a smoothing factor value that is near to 0 provides a very accurate throughput forecast that takes into consideration the recent history of the updated values of the real value. As for the smoothing factor values that are near to 1, they are used to identify MAC layer misbehavior.

Originality/value

According to the authors’ modest knowledge, this new scheme has not been proposed in the state of the art for the detection of greedy behavior in mobile ad hoc networks.