bluuebunny/crossref_metadata_2025 huggingface dataset:
Culex pipiens and Culex restuans larval interactions shape the bacterial communities in container aquatic habitats
Authors: Njoroge Teresia M , Berenbaum May R , Stone Christopher M , Kim Chang-Hyun , Dunlap Christopher , Muturi Ephantus J
Published: February 2024

Container aquatic habitats host a community of aquatic insects, primarily mosquito larvae that browse on container surface microbial biofilm and filter-feed on microorganisms in the water column. We examined how the bacterial communities in these habitats respond to feeding by larvae of two container-dwelling mosquito species, Culex pipiens and Cx. restuans. We also investigated how the microbiota of these larvae is impacted by intra- and interspecific interactions. Microbial diversity and richness were significantly higher in water samples when mosquito larvae were present, and in Cx. restuans compared to Cx. pipiens larvae. Microbial communities of water samples clustered based on the presence or absence of mosquito larvae and were distinct from those of mosquito larvae. Culex pipiens and Cx. restuans larvae harbored distinct microbial communities when reared under intraspecific conditions and similar microbial communities when reared under interspecific conditions. These findings demonstrate that mosquito larvae play a major role in structuring the microbial communities in container habitats and that intra- and interspecific interactions in mosquito larvae may shape their microbiota. This has important ecological and public health implications since larvae of the two mosquito species are major occupants of container habitats while the adults are vectors of West Nile virus.
Humanitarian forensic action in East Asia: where are we now? A concise review
Authors: Zeng Zixuan , Lv Yehui
Published: February 2024

Humanitarian forensic action (HFA) is practiced in many parts of the world. In recent years, with the development of forensic humanitarian methods and applications and the increasing inclusion or even prioritization of HFA by organizations and institutions, research in this field has evidenced greater depth and diversity, although perspectives from the humanities and some disciplines remain limited. In-depth inquiries into this topic and an analysis of regional humanitarian data reveal the existence of ideological and cultural foundations for HFA in East Asia. At the same time, given past occurrences of natural disasters and large-scale wars in this region, the need and motivation for advancing this field and developing HFA is considerable. Currently, because of a lack of practical experience of HFA in East Asia, research on this relevant topic in the region focuses on the development of humanitarian forensic applications. Consequently, studies reporting on social surveys, psychological care and other methods are limited. It is to be hoped that East Asian countries will improve their practical HFA applications, while simultaneously carrying out social surveys and social scientific research on all aspects of HFA.

Key Points
RNase P: Beyond Precursor tRNA Processing
Authors: Wang Peipei , Lin Juntao , Zheng Xiangyang , Xu Xingzhi
Published: February 2024

Ribonuclease P (RNase P) was first described in the 1970’s as an endoribonuclease acting in the maturation of precursor transfer RNAs (tRNAs). More recent studies, however, have uncovered non-canonical roles for RNase P and its components. Here, we review the recent progress of its involvement in chromatin assembly, DNA damage response, and maintenance of genome stability with implications in tumorigenesis. The possibility of RNase P as a therapeutic target in cancer is also discussed.
Benchmarking the United States bison meat industry: stakeholder perceptions, production parameters, and live animal factors affecting meat quality
Authors: Velazco David M , Hess Ann , Edwards-Callaway Lily N , Nair Mahesh N
Published: February 2024

The objectives of this study were 1) to understand stakeholder perceptions regarding the bison industry, 2) to benchmark live animal characteristics and production parameters of the bison industry, and 3) to identify live animal factors related to animal welfare and their effect on specific quality characteristics of bison meat. A survey was conducted both online and in-person at the National Bison Association Winter Conference (2022). Descriptive statistics were performed on a total of 110 surveys. Most stakeholders (94%, n = 104) agreed that the industry should continue to grow, and the majority (99%, 108) agreed that animal welfare impacts meat quality. Facility design (80%, n = 88), animal handling (78%, 86), employee training (56%, 62), and transportation duration (56%, 62) were selected as the factors that affect animal welfare. More than half of the stakeholders selected flavor (67%, n = 74) as the most important quality attribute of bison meat. For the in-plant antemortem and postmortem parameters data was collected from three plants in the United States over the course of a year. A total of 2,284 bison (bulls: n = 1,101; cows: n = 199; heifers: n = 984) were included in the study. Antemortem measurements such as distance traveled, vocalization, prod use, mobility, and head bumps were measured, followed by postmortem measurements that included bruise score, live weight, dressing percentage, ribeye area, and instrumental color. Approximately 97% of bison (n = 2,213) had at least one bruise. The average distance traveled from producer to slaughter plant was (mean ± SD; 823 ± 583 km) and the average dressing percentage was (mean ± SD; 60.5 ± 3.3%). Average (mean ± SD) fat thickness and ribeye area were 1.4 ± 1.1 cm and 62.6 ± 9.8 cm2, respectively. Approximately 30% (n = 676) of the bison in this study head bumped between 1 and 5 times in the restraining chute or the single-file gate before being stunned. Linear regression indicated that differences in lean a* were associated with plant, number of head bumps in the chute, ribeye area, fat thickness, live weight, and sex class (P < 0.05). Logistic regression indicated that season, sex class, live weight, plant, and season were associated with differences (P < 0.05) in bruising. These results can be used as a baseline for current production parameters and serve as the foundation for future research to monitor improvement.
Relationships between protein degradation, cellular senescence, and organismal aging
Authors: Hamazaki Jun , Murata Shigeo
Published: February 2024

Aging is a major risk factor for many diseases. Recent studies have shown that age-related disruption of proteostasis leads to the accumulation of abnormal proteins and that dysfunction of the two major intracellular proteolytic pathways, the ubiquitin-proteasome pathway, and the autophagy-lysosome pathway, is largely responsible for this process. Conversely, it has been shown that activation of these proteolytic pathways may contribute to lifespan extension and suppression of pathological conditions, making it a promising intervention for anti-aging. This review provides an overview of the important role of intracellular protein degradation in aging and summarizes how the disruption of proteostasis is involved in age-related diseases.
Systematic approaches to assessing high-temperature limits to fertility in animals
Authors: Bretman Amanda , Fricke Claudia , Baur Julian , Berger David , Breedveld Merel C , Dierick Diego , Canal Domenech Berta , Drobniak Szymon M , Ellers Jacintha , English Sinead , Gasparini Clelia , Iossa Graziella , Lagisz Malgorzata , Nakagawa Shinichi , Noble Daniel W A , Pottier Patrice , Ramm Steven A , Rowe Melissah , Schultner Eva , Schou Mads , Simões Pedro , Stockley Paula , Vasudeva Ramakrishnan , Weaving Hester , Price Tom A R , Snook Rhonda R
Published: February 2024

Critical thermal limits (CTLs) gauge the physiological impact of temperature on survival or critical biological function, aiding predictions of species range shifts and climatic resilience. Two recent Drosophila species studies, using similar approaches to determine temperatures that induce sterility (thermal fertility limits [TFLs]), reveal that TFLs are often lower than CTLs and that TFLs better predict both current species distributions and extinction probability. Moreover, many studies show fertility is more sensitive at less extreme temperatures than survival (thermal sensitivity of fertility [TSF]). These results present a more pessimistic outlook on the consequences of climate change. However, unlike CTLs, TFL data are limited to Drosophila, and variability in TSF methods poses challenges in predicting species responses to increasing temperature. To address these data and methodological gaps, we propose 3 standardized approaches for assessing thermal impacts on fertility. We focus on adult obligate sexual terrestrial invertebrates but also provide modifications for other animal groups and life-history stages. We first outline a “gold-standard” protocol for determining TFLs, focussing on the effects of short-term heat shocks and simulating more frequent extreme heat events predicted by climate models. As this approach may be difficult to apply to some organisms, we then provide a standardized TSF protocol. Finally, we provide a framework to quantify fertility loss in response to extreme heat events in nature, given the limitations in laboratory approaches. Applying these standardized approaches across many taxa, similar to CTLs, will allow robust tests of the impact of fertility loss on species responses to increasing temperatures.
Qoheleth’s Use of Proverbial Sayings: The Example of Ecclesiastes 7:1–12
Authors: Goswell Gregory
Published: February 2024

There is no evidence that Ecclesiastes, either the body of the book or the epilogue, is interested in the question of its relation to the book of Proverbs. The epilogue does not quote or allude to Proverbs. Qoheleth’s use of proverbs is not derived from the book of Proverbs but must be studied in its own right in the expectation that it will throw light on this author’s method and message. The Epilogist in 12:9 specifically comments on Qoheleth’s use of proverbs, and 7:1–12 provide an extended example of how he handles proverbs. His use of proverbs shows that his teaching is in the mainstream of the wisdom movement, for he works in much the same way as the author of Proverbs. Qoheleth places proverbs in a certain order, adjusts their wording, and adds his own comments to them. The contents of 7:1–12 serve the positive purpose of teaching readers how to handle proverbs, and by means of proverbs, Qoheleth teaches people to look more deeply at the issues of life.
Synthesized modeling and active disturbance rejection control for the Leighton Chajnantor Telescope
Authors: Chen Weirui , Yao Yiwei , Wang Zheng
Published: February 2024

The Caltech Submillimeter Observatory telescope was completely disassembled in 2023 October and will be shipped from Hawaii, USA to the new site at Chajnantor Plateau, Chile in 2024, where it is expected to be refurbished and renamed the Leighton Chajnantor Telescope (LCT). Since the much stronger wind load at the new site will provide a great challenge for LCT’s realization of a higher pointing and tracking accuracy, an active disturbance rejection controller (ADRC) is designed for LCT’s pointing control system. Due to the unavailability of LCT during its relocation process, it is necessary to develop a testbed to verify the performance of ADRC by constructing a synthesized simulation model of LCT’s pointing control system, including a mechanical dynamics model of the antenna, an analog circuit model of the motor drive system, a mathematical model of the direct current motors and the reducers, and a wind disturbance model. On the testbed, ADRC undergoes simulations to verify its capability to eliminate the negative impact of strong wind disturbance on LCT’s pointing control performance. The simulation results show that ADRC can bring benefits in improving LCT’s pointing and tracking accuracy when facing strong wind disturbance.
SuÁrez on the Possibility of Causal Overdetermination
Authors: Adriaenssen Han Thomas
Published: February 2024

This paper studies Francisco Suárez's defence of the possibility of causal overdetermination. I show that, according to Suárez, the main arguments against the possibility of causal overdetermination rely on (i) a flawed conception of causal dependence and (ii) a flawed ontology of action. I argue that his objections to (i) and (ii) amount to a significant challenge to his opponents’ case against the possibility of causal overdetermination.
Stem heating results in hydraulic dysfunction in Symplocos tinctoria: implications for post-fire tree death
Authors: Hoffmann William A , Sherry Catherine D K , Donnelly Tallis M
Published: February 2024

Fire-induced heating of stems can impair plant water transport by deforming xylem and increasing vulnerability to cavitation, but it is not clear whether these effects can result in tree death, or how quickly this may occur. In field experiments, we heated stems of Symplocos tinctoria (L.) L’Hér saplings to 90 °C using a thin-film resistive heater, and we monitored stomatal conductance, leaf water potential, sap flow and hydraulic conductivity until stem death. Sap flow and stomatal conductance declined quickly after heating, while whole-plant hydraulic conductance and leaf water potential remained high for the first week. In fact, leaf water potential increased during the first days after heating, indicating that stomatal closure was not initially caused by leaf water deficit induced by impaired water transport. After 1 week, leaf water potential and whole-plant conductance declined below unheated controls, while stomatal conductance and sap flow continued declining, approaching zero after 2 weeks. To better understand the cause of these declines, we directly measured hydraulic conductivity of heated stems. Stems underwent a progressive decline in conductivity after heating, and by the time that samples were severely wilted or desiccated, the heated portion of stems had little or no conductivity. Importantly, conductivity of heated stems was not recovered by flushing stems to remove embolisms, suggesting the existence of physical occlusions. Scanning electron micrographs did not reveal deformed cell walls, nor did it identify alternative causes of blockages. These results reveal that stem heating can result in xylem dysfunction and mortality, but neither response is immediate. Dysfunction was likely caused by wound responses rather than embolism, but improved understanding of the mechanisms of heat-induced hydraulic failure is needed.
Identification and Characterization of Polyamine Metabolism in Citrus in Response to ‘Candidatus Liberibacter asiaticus’ Infection
Authors: Sun Qifang , Hao Yingbin , Liu Yongquan , Cui Meng , Zhang Gaowei , Yu Wenjie , Luo Liping
Published: February 2024

Citrus Huanglongbing, one of the most devastating citrus diseases, is caused by ‘ Candidatus Liberibacter asiaticus’ ( CLas). Polyamines are aliphatic nitrogen-containing compounds that play important roles in disease resistance and are synthesized primarily by two pathways: an arginine decarboxylation pathway and an ornithine decarboxylation pathway. However, it is unclear whether polyamines play a role in the tolerance of citrus to infection by CLas and, if so, whether one or both of the core polyamine metabolic pathways are important. We used high-performance liquid chromatography and ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry to detect the contents of nine polyamine metabolism-related compounds in six citrus cultivars with varying levels of tolerance to CLas. We also systematically detected the changes in polyamine metabolism-related compounds and H2O2 contents and compared the gene expression levels and the activities of enzymes involved in the polyamine metabolic pathway among healthy, asymptomatic, and symptomatic leaves of Newhall navel oranges infected with CLas. The tolerant and moderately tolerant varieties showed higher polyamine metabolism-related compound levels than those of susceptible varieties. Compared with the healthy group, the symptomatic group showed significantly increased contents of arginine, ornithine, γ-aminobutyric acid, and putrescine by approximately 180, 19, 1.5, and 0.2 times, respectively, and upregulated expression of biosynthetic genes. Arginase and ornithine decarboxylase enzyme activities were the highest in the symptomatic group, whereas arginine decarboxylase and agmatine deiminase enzyme activities were the highest in the asymptomatic group. The two polyamine biosynthetic pathways showed different trends with the increase of the CLas titer, indicating that polyamines were mainly synthesized through the arginine decarboxylase pathway in the asymptomatic leaves and were synthesized via the ornithine decarboxylase pathway in symptomatic leaves. These findings provide new insight into the changes in polyamine metabolism in citrus infected with CLas.
Rapid Detection of a Downy Mildew Pathogen, Peronospora destructor, in Infected Onion Tissues and Soils by Loop-Mediated Isothermal Amplification
Authors: Lee In Seong , Kim Wonyong , Jo Gyeongpyo , Yang Kwang-Yeol
Published: February 2024

Downy mildew of onion caused by a soil-inhabiting water mold, Peronospora destructor, is one of the most devastating diseases that can destroy entire onion fields in a matter of days. In this study, we developed a loop-mediated isothermal amplification (LAMP) assay that allows for rapid detection of P. destructor by visual inspection. The internal transcribed spacer 2 region of P. destructor was used to design primer sets for LAMP reactions. The optimal temperature and incubation time were determined for the most efficient primer set. In the optimized condition, the LAMP assay exhibited at least 100 times more sensitivity than conventional PCR, detecting femtogram levels of P. destructor genomic DNA (gDNA). Detection of the pathogen from a small number of spores without gDNA extraction further confirmed the high sensitivity of the assay. For specificity, the LAMP assay was negative for gDNA of other fungal pathogens that cause various diseases on onion and oomycetes, whereas the assay was positive for gDNA extracted from onion tissues showing the typical downy mildew symptoms. Finally, we examined the efficacy of the LAMP assay in detection of P. destructor in soils. Soils collected from onion fields that had been contaminated with P. destructor were solarized for 60 days. Whereas the LAMP assay was negative for the solarized soils, we were able to detect P. destructor that oversummers in fields. The LAMP assay developed in this study enables rapid detection and diagnosis of downy mildew of onion in infected tissues and in soil.
Prescription Opioid Decision-Making and Use Behaviors in Adolescents with Acute Pain
Authors: Kapos Flavia P. , Gordon Grace O. , Groenewald Cornelius B. , Slack Katherine , Wang Vienna , Palermo Tonya M. , Wilson Anna C. , Rabbitts Jennifer A.
Published: February 2024

Objectives:

Understanding adolescent perspectives on prescribed opioids in the context of medical care for acute pain is needed to prevent opioid-related adverse outcomes. We explored factors that may influence opioid decision-making and use behaviors among adolescents prescribed opioids for acute pain.

Methods:

We conducted semi-structured interviews with nineteen adolescents (63% females, ages 12-17) prescribed opioids upon discharge from surgery or intensive care unit admission. Interview transcripts were coded using inductive thematic analysis.

Results:

Five themes were identified: “Opioid use to reduce extreme pain and facilitate acute recovery”; “Familiarity with risks and negative effects of opioids”; “Assessment of opioid risk based on individual characteristics and use behaviors”; “Careful balance of risks, benefits, and symptoms when taking opioids”; “Importance of trusted adults for adolescent opioid management”. Adolescents commonly believed opioids are only appropriate for severe pain that cannot be managed with other strategies. Most (but not all) adolescents were aware of addiction and other potential opioid harms, and generally disapproved of misuse. However, a few adolescents would consider taking unprescribed opioids for severe pain. Adolescents wanted to be well informed for opioid decision-making, considering guidance from trusted adults.

Discussion:

Adolescents often demonstrated active and sound participation in shared opioid decision-making, influenced by complex integration of inputs and self-reflection. Conversely, potential factors that could contribute to risky behaviors included low personal risk perceptions, uncertainty about what constitutes opioid misuse, and avoidance of prescribed opioids despite extreme pain. Future studies may explore associations of adolescents’ opioid decision-making with longer-term pain and opioid-related outcomes.
Understanding New Machine Learning Architectures: Practical Generative Artificial Intelligence for Anesthesiologists
Authors: Connor Christopher W.
Published: February 2024

Recent advances in neural networks have given rise to generative artificial intelligence, systems able to produce fluent responses to natural questions or attractive and even photorealistic images from text prompts. These systems were developed through new network architectures that permit massive computational resources to be applied efficiently to enormous data sets. First, this review examines autoencoder architecture and its derivatives the variational autoencoder and the U-Net in annotating and manipulating images and extracting salience. This architecture will be important for applications like automated x-ray interpretation or real-time highlighting of anatomy in ultrasound images. Second, this article examines the transformer architecture in the interpretation and generation of natural language, as it will be useful in producing automated summarization of medical records or performing initial patient screening. The author also applies the GPT-3.5 algorithm to example questions from the American Board of Anesthesiologists Basic Examination and find that, under surprisingly reasonable conditions, it correctly answers more than half the questions.
The Inhibitory Effect of NSAIDs and Opioids on Spinal Fusion
Authors: Lambrechts Mark J. , D’Antonio Nicholas D. , Heard Jeremy C. , Yalla Goutham , Karamian Brian A. , Markova Dessislava Z. , Kepler Christopher K.
Published: February 2024

Study Design.

Translational research.

Objective.

To evaluate the relative effects of NSAIDs, opioids, and a combination of the two on spinal fusion inhibition in a rodent model.

Summary of Background Data.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids are common postoperative analgesic agents. Since NSAIDs inhibit the cyclooxygenase (COX) pathway, they are seldom prescribed following spinal fusion. Opioids may be given instead, but recent evidence suggests opioids also adversely affect spinal fusion quality and success.

Methods.

Eighty male Sprague-Dawley rats underwent L4-5 posterior lumbar fusion and were given one of the following analgesia regimens: saline, morphine (6 mg/kg), ketorolac (4 mg/kg), or morphine (3 mg/kg) and ketorolac (2 mg/kg). Serum samples were drawn to evaluate systemic pro-osteoblastic cytokines and vascular endothelial growth factor-A (VEGF-A) levels, which were measured through enzyme-linked immunosorbent assays (ELISA). After six weeks, the rats were sacrificed, and the operated spinal segments underwent manual palpation, microCT, and histologic analysis.

Results.

Manual palpation scores were significantly diminished in the opioid, NSAID, and multimodal groups when compared with control (P<0.001). MicroCT fusion scores (P<0.001) and fusion rates (control: 75% vs. NSAID: 35% vs. opioid: 0% vs. combination: 15%, P<0.001) were significantly diminished in the treatment groups. The bone volume (BV) to tissue volume (TV) ratio (BV/TV) (P<0.001) and bone mineral density (BMD) (P<0.001) were all lower in the treatment groups, with the opioid and combined groups having the lowest BMD. Although statistically insignificant (P<0.09), the concentration of VEGF-A was greater in the control group compared with opioids, NSAIDs, and the combined group.

Conclusion.

Opioids and NSAIDs, both independently and combined, inhibited spinal fusion and caused inferior bony callus. Administration of opioids resulted in the lowest rate of spinal fusion. We propose this may be due to the inhibition of VEGF-A, which limits angiogenesis to the burgeoning fusion mass.
Complexities of Coexisting Cardiac Amyloidosis and Coronary Artery Disease: A Contemporary Review of Diagnostic and Treatment Approaches
Authors: Lu Yahui , Bai Geng , Wang Weiding , Li Guangping
Published: February 2024

Cardiac amyloidosis (CA) represents an emerging challenge in cardiovascular medicine, with notable clinical overlaps and diagnostic complexities when coexisting with coronary artery disease (CAD). This integrative review navigates the intricate terrain of CA and CAD, elucidating epidemiology, clinical presentations, and diagnostic considerations. Examining both immunoglobulin light chain amyloidosis (AL) and transthyretin amyloidosis, we underscore their shared demographic associations, diagnostic intricacies, and potential diagnostic confounders with CAD. Notably, we emphasize the impact of CA on epicardial coronary arteries and the consequential implications for coronary microcirculation. Further exploration reveals the connection between CA and acute myocardial infarction, emphasizing early recognition as pivotal. In terms of differential diagnosis, we underscore the significance of clinical symptoms, electrocardiography, echocardiography, cardiac magnetic resonance, and bone scintigraphy. Additionally, we scrutinize the intricate realm of treatment, encompassing medication selection, antithrombotic strategies, and revascularization modalities. Our review addresses the distinctive challenges posed by CA patients’ limited tolerance for conventional therapies. This comprehensive synthesis serves as an invaluable resource for clinicians confronting the intricate intersection of CA and CAD. By offering insights into diagnostic refinement and innovative therapeutic avenues, we aim to enhance patient outcomes and quality of life within this complex clinical landscape.
The Association and Utility of Left Ventricular End-Diastolic Pressure in Predicting the Development of and in Managing Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography
Authors: Del Rio-Pertuz Gaspar , Leelaviwat Natnicha , Mekraksakit Poemlarp , Benjanuwattra Juthipong , Nugent Kenneth
Published: February 2024

Contrast-induced nephropathy (CIN) is a significant complication in patients undergoing coronary angiography, and its development is associated with increased morbidity and mortality. Left ventricular end-diastolic pressure (LVEDP) provides one index of left heart filling status. An elevated LVEDP can reflect volume overload or abnormal diastolic function and indicates a cardiac disorder. Data on the association between an elevated LVEDP and CIN are limited and have had conflicting results. We systematically searched the databases PubMed, Embase, and Scopus for full-text articles from database inception to May 2022. Studies were included if they evaluated the association between a high LVEDP and the incidence of CIN in patients undergoing coronary angiography. The study was registered in the PROSPERO CRD42022334070. A second search in PubMed identified randomized controlled trials using LVEDP to guide fluid administration during coronary procedures. Four studies were identified that used LVEDP to classify patients into groups to determine the association between the level and the development of CIN. In these studies, 240 patients of 2441 patients (9.8%) developed CIN. One study found no association between LVEDP levels and the development of CIN. Two studies found an increased frequency of CIN in patients with elevated levels using 2 cutoff points for LVEDP, ≥20 mm Hg and >30 mm Hg. One study found that lower LVEDP levels (5–14 mm Hg) were associated with the development of CIN. Three randomized control trials used LVDEP levels to manage fluid administration in patients undergoing coronary procedures; only one study found that the use of these levels to guide fluid administration resulted in better outcomes. In patients undergoing coronary angiography, an elevated LVEDP was not consistently associated with increased risk of CIN, and using LVEDP levels to guide fluid administration during these procedures did not always improve outcomes in comparison to other protocols. The use of LVEDP levels can help classify patients with cardiac disorders but does not necessarily provide an adequate description of the hemodynamic patterns in these patients to predict or prevent CIN in patients undergoing angiography.
Challenging the Chatbot: An Assessment of ChatGPT's Diagnoses and Recommendations for DBP Case Studies
Authors: Kim Rachel , Margolis Alex , Barile Joe , Han Kyle , Kalash Saia , Papaioannou Helen , Krevskaya Anna , Milanaik Ruth
Published: February 2024

Objective:

Chat Generative Pretrained Transformer-3.5 (ChatGPT) is a publicly available and free artificial intelligence chatbot that logs billions of visits per day; parents may rely on such tools for developmental and behavioral medical consultations. The objective of this study was to determine how ChatGPT evaluates developmental and behavioral pediatrics (DBP) case studies and makes recommendations and diagnoses.

Methods:

ChatGPT was asked to list treatment recommendations and a diagnosis for each of 97 DBP case studies. A panel of 3 DBP physicians evaluated ChatGPT's diagnostic accuracy and scored treatment recommendations on accuracy (5-point Likert scale) and completeness (3-point Likert scale). Physicians also assessed whether ChatGPT's treatment plan correctly addressed cultural and ethical issues for relevant cases. Scores were analyzed using Python, and descriptive statistics were computed.

Results:

The DBP panel agreed with ChatGPT's diagnosis for 66.2% of the case reports. The mean accuracy score of ChatGPT's treatment plan was deemed by physicians to be 4.6 (between entirely correct and more correct than incorrect), and the mean completeness was 2.6 (between complete and adequate). Physicians agreed that ChatGPT addressed relevant cultural issues in 10 out of the 11 appropriate cases and the ethical issues in the single ethical case.

Conclusion:

While ChatGPT can generate a comprehensive and adequate list of recommendations, the diagnosis accuracy rate is still low. Physicians must advise caution to patients when using such online sources.
Autologous Stem Cell-derived Therapies for Androgenetic Alopecia: A Systematic Review of Randomized Control Trials on Efficacy, Safety, and Outcomes
Authors: Gasteratos Konstantinos , Kouzounis Konstantinos , Goverman Jeremy
Published: February 2024

Background:

Androgenic alopecia (AGA), a prevalent and extensively studied condition characterized by hair loss, presents a significant global issue for both men and women. Stem cell therapy has emerged as a promising therapeutic approach for AGA due to its regenerative and immunomodulatory properties. The primary objective of this systematic review was to assess the current literature on the efficacy and safety of cellular and acellular stem cell–derived therapies in the management of AGA.

Methods:

A computerized literature search was conducted in ClinicalTrials.gov, PubMed, and Cochrane Library in October 2023. The online screening process was performed by three independent reviewers with the Covidence tool. The protocol was reported using the Preferred Reporting Items for Systematic Review and Meta-Analyses, and it was registered at the International Prospective Register of Systematic Reviews of the National Institute for Health Research.

Results:

The search yielded 53 articles from 2013 to 2023. Twelve randomized controlled trials were included. Stem cells and their derivatives were isolated from human adipose tissue, hair follicles, bone marrow, umbilical cord blood, and exfoliated deciduous teeth. These trials showed that stem cell–derived treatments can promote hair regeneration and density.

Conclusions:

Both cellular and acellular stem cell–based therapies are safe and effective in improving hair regeneration and density in AGA patients. Although the outcomes may be temporary in some cases, regenerative treatments may become useful adjuncts in combination with traditional methods of hair transplantation. Future research should focus on protocol optimization to enhance long-term patient outcomes.
Relaxing descemetotomy: microscope-integrated OCT-guided technique for acute corneal hydrops
Authors: Kanu Levi N. , Qureshi Sana , Cherny Christina , Ng Veronica , Ciolino Joseph B.
Published: February 2024

Introduction:

3 cases are used to illustrate the technique of Descemet membrane (DM) relaxing incisions followed by air descemetopexy for the management of patients with acute corneal hydrops.

Patients and Clinical Findings:

In each case, anterior-segment optical coherence tomography (OCT) demonstrated taut DM detachments and hydrops was refractory to conservative medical management and intracameral air injection.

Diagnosis, Intervention, and Outcomes:

To facilitate the reapproximation of DM and potentiate corneal deturgescence, intraoperative OCT-guided descemetotomy was performed with bent surgical scissors and a bent 30-gauge needle. Subsequent air descemetopexy was successful, and DM reattachment was maintained postoperatively. Corneal edema improved in all patients relatively rapidly postoperatively.

Conclusions:

Relaxing descemetotomy with air descemetopexy may be useful in cases of acute corneal hydrops with taut DM detachments that are unresponsive to air tamponade alone.
Eyelid margin disease (blepharitis and meibomian gland dysfunction): clinical review of evidence-based and emerging treatments
Authors: Rocha Karolinne Maia , Farid Marjan , Raju Leela , Beckman Kenneth , Ayres Brandon D. , Yeu Elizabeth , Rao Naveen , Chamberlain Winston , Zavodni Zachary , Lee Barry , Schallhorn Julie , Garg Sumit , Mah Francis S. ,   From the ASCRS Cornea Clinical Committee
Published: February 2024

Blepharitis is a common ophthalmic condition with multiple etiologies and no definitive, universal treatment. The treatment modalities for managing lid margin diseases vary depending on the disease's cause, location, and severity. For anterior blepharitis, management options include eyelid hygiene with warm compresses, eyelid scrubs, baby shampoo, and over-the-counter eyelid cleansers. Topical antibiotics and antibiotic-steroid combination drops/ointments for the eye and eyelid may accompany these. For posterior blepharitis/meibomian gland dysfunction (MGD), at-home warm compress or in-office administration of heat therapy/thermal pulsation treatment that aims to clear obstruction in the meibomian glands and restore meibum secretions to maintain a healthy tear film is recommended. In addition to the above treatment strategies, various other compounds to manage lid margin diseases are in the late stages of development. This review summarizes the available treatment modalities or those in the pipeline for treating blepharitis and MGD.
Visual and refractive outcomes after bilateral implantation of an enhanced monofocal intraocular lens: prospective study
Authors: García-Bella Javier , Burgos-Blasco Bárbara , Vidal-Villegas Beatriz , Garzón Nuria , Villanueva Celia , García-Feijoo Julián
Published: February 2024

Purpose:

To evaluate visual and refractive outcomes, as well as patient satisfaction after bilateral implantation of an enhanced monofocal intraocular lens (IOL) with emmetropia as a target refraction.

Setting:

San Carlos Hospital, Madrid, Spain.

Design:

Prospective, monocentric, noncomparative study.

Methods:

Adults 21 years or older suitable for cataract surgery and with corneal astigmatism <1.50 diopters (D) were bilaterally implanted with the RayOne EMV IOL and followed up for 3 months. Outcomes measures included refraction, monocular and binocular uncorrected distance visual acuity, corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity, distance-corrected intermediate visual acuity (DCIVA), and defocus curve, aberrometry, and satisfaction. Visual symptoms were assessed using the CatQuest-9SF questionnaire.

Results:

50 eyes of 25 patients were included. At month 3, the mean manifest spherical equivalent was −0.39 ± 0.28 D, with all eyes within 1.00 D. Binocularly, uncorrected, at distance, 68% of patients could read ≤0.0 logMAR and 95% ≤0.2 logMAR; at intermediate 59% of patients could read ≤0.1 and 100% ≤0.2 logMAR. Mean monocular CDVA was −0.03 ± 0.06 logMAR and mean monocular DCIVA was 0.28 ± 0.07 logMAR. Binocular defocus curve demonstrated a visual acuity ≤0.2 logMAR over a 2 D range from +1.00 D to −1.25 D. Satisfaction was good in 96% of patients.

Conclusions:

Bilateral implantation of an enhanced monofocal IOL with emmetropia as a target provided excellent binocular CDVA and good DCIVA, with a high level of satisfaction.
Comparative study of FLACS vs conventional phacoemulsification for cataract patients with high myopia
Authors: Zhao Lijuan , Tan Mengjia , Zhang Junfang , Hao Mengyao , Liang Shu , Ji Min , Guan Huaijin
Published: February 2024

Purpose:

To compare the short-term changes in cornea, retina, and choroid of femtosecond laser–assisted cataract surgery (FLACS) with conventional phacoemulsification (CPS) in high myopia patients with cataract.

Setting:

Affiliated Hospital of Nantong University, Jiangsu Province, China.

Design:

Prospective single-center study.

Methods:

Demographics, ocular clinical features, ultrasound power, absolute phacoemulsification time, and effective phacoemulsification time were recorded for each patient. Endothelial cell density (ECD), central corneal thickness (CCT), corrected distance visual acuity (CDVA), intraocular pressure (IOP), center foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and choroidal vascularity index (CVI) were evaluated preoperatively and at 1 week, 1 month, and 3 months postoperatively. Intraoperative parameters and intraoperative/postoperative complications were recorded.

Results:

97 eyes (46 eyes and 51 eyes in the FLACS and CPS groups, respectively) were included and analyzed. Effective phacoemulsification time was lower in the FLACS group compared with the CPS group (P < .05). The increase in CCT was significantly lower in the FLACS group compared with the CPS group at 1 week and 1 month (P < .05). CDVA and IOP were similar in both groups at the final visit (P > .05). The ECD decreased was lower among CPS patients compared with FLACS patients. CFT, SFCT, and CVI increase in both groups but were increased more in the CPS group with high myopia patients. No serious complications occurred in either group.

Conclusions:

FLACS is a more safety and effective in cataract patients with high myopia. It has advantages in effectively reducing EPT and promoting faster recovery of the cornea, macular, and choroidal thickness.
The Impact of Mobility Technicians on Mobility Rates for Hospitalized Adults in a Large Academic Medical Center
Authors: Wells Chris L. , Frampton Katherine , Horn Linda B. , Gimie Afnan , Falvey Jason R.
Published: February 2024

Introduction:

Promotion of early mobility is part of an ongoing effort to mitigate the iatrogenic effects of hospitalization. To assist with mobilization efforts, nursing departments hire mobility technicians (MTs). However, little is known about whether hospital units that hire MTs have increased rates of patient mobilization.

Purpose:

The aim of this retrospective study was to determine whether units in an academic medical setting that hired an MT had greater improvements in mobility compared with similar units that did not hire an MT.

Methods:

Two levels of care-matched pairs of hospital units were used for this analysis. Within each pairing, one unit hired an MT. We captured activity days, defined as any documented out-of-bed activity in a 24-hour period, from standardized documentation. A monthly activity rate was calculated for each unit as the average daily percentage of patients who had out-of-bed orders. A difference-in-difference generalized linear model with a time-by-MT interaction, weighted for patient volume, was used to compare the relative improvement in mobility 6 months prior (baseline) to the hiring of an MT to periods 3 and 6 months post-hire.

Results:

There was a 2.3% absolute increase in activity rate from preperiod to the 3-month postperiod for units that hired an MT, as compared with a 5.1% decline in similar units that did not have an MT. This 8.4% difference in activity rates was statistically significant (P = .03). Over 6 months, the effects of the program waned. Control units continued to decline with a 7.1% drop from baseline) compared with a marginal 0.1% increase in activity rates for units with an MT from baseline. This relative 7.6% increase in mobility was not significant (P = .13).

Conclusion:

There was a significant improvement in activity rates associated with MT hire that declined over time. These results may be contributed to a nonstructured MT utilization, variability with nursing education on the role of the MT, and staffing challenges that diverted the use of the MT to nonmobility activities.
Using Outcome Measures to Transition Ambulation From Physical Therapy to Nursing for Patients With Mechanical Circulatory Support
Authors: Mondkar Rajashree S. , Attorri Andrea , Bridges Carolyn , Stawarz-Gugala Agata , Stolboushkin Catherine , Schwing Terrence , Ragsdale Judy , Belarmino Bobby
Published: February 2024

Purpose:

The primary aim of this pilot study was to propose cutoff scores for the functional outcome measures at which patients with mechanical circulatory support (MCS) device can transition ambulation from a skilled physical therapy service to a nursing-led ambulation program.

Methods:

This was an exploratory pilot study (N = 46) of patients in an intensive care unit (ICU) with MCS devices. Three functional outcome measures were used: Activity Measure for Post-Acute Care (AM-PAC), Perme ICU Mobility Score (Perme Score), and 5-m gait speed test (gait speed). Cutoff scores were identified using area under the curve (AUC) of receiver operating characteristic.

Results:

Twenty-two patients (intra-aortic balloon pump n = 16; Impella n = 6) were transitioned to a nursing-led ambulation program. The proposed cutoff scores to transition to a nursing-led ambulation program were 19.5 raw score (whole number >19) (>45.44 t score) for AM-PAC, 29.5 (whole number >29) for Perme Score, and 0.57 m/s or more for gait speed.

Conclusion:

The proposed cutoff scores for the 3 commonly used outcome measures for patients in the ICU are possibly useful when transitioning the ambulation program safely from skilled physical therapy to nursing service.
Emotional Exhaustion in Healthcare Workers
Authors: Siddique Sundus , Gore Rebecca , Zhang Yuan , Punnett Laura
Published: February 2024

Objective

Emotional exhaustion (EE)—the first stage of burnout—is related to preventable work environment exposures. We examined the understudied impact of organizational support for safety (OSS) and safety hazards (SH) on EE in a mixed licensed and unlicensed population of healthcare workers (HCWs).

Methods

A work environment exposures survey was conducted in five US public healthcare facilities in 2018–2019. A total of 1059 questionnaires were collected from a predominantly female population of mixed HCWs.

Results

Mean EE scores were higher among women, direct care workers, and younger subjects. In linear regression models, EE was positively associated with SH, emotional labor, psychological demands, physical demands, job strain, assault, and negative acts, while OSS was negatively associated. Safety hazard s both mediated and moderated the relationship between OSS and EE.

Conclusions

When perception of SH is high, OSS has less impact on reducing EE, suggesting a need to effectively put safety policies to practice for improving EE in HCWS.
Impact of varied immunosuppressive agents and posttransplant diabetes mellitus on prognosis among diverse transplant recipients (Experimental studies)
Authors: Liu Yuan , Zheng Jinxin , He Qining , Zhang Haijiao , Wen Peizhen , Wen Peihao , Ge Jifu , Yang Yang , Zhang Tao , Wang Rangrang
Published: February 2024

The success of solid organ transplantation (SOT) and the use of immunosuppressive agents offer hope to patients with end-stage diseases. However, the impact of posttransplant diabetes mellitus (PTDM) on SOT patients has become increasingly evident. In our study, we utilized the Scientific Registry of Transplant Recipients (SRTR) database to investigate the association between PTDM and patient survival in various types of organ transplantations, including liver, kidney, intestinal, heart, lung, and combined heart-lung transplantations (all P<0.001). Our findings revealed a negative effect of PTDM on the survival of these patients. Furthermore, we examined the effects of both generic and innovator immunosuppressive agents on the development of PTDM and the overall survival of different SOT populations. Interestingly, the results were inconsistent, indicating that the impact of these agents may vary depending on the specific type of transplantation and patient population. Overall, our study provides a comprehensive and systematic assessment of the effects of different immunosuppressive agents on prognosis, as well as the impact of PTDM on the survival of patients undergoing various types of SOT. These findings emphasize the need for further research and highlight the importance of optimizing immunosuppressive regimens and managing PTDM in SOT patients to improve their long-term outcomes.
Preoperative duration of type 2 diabetes mellitus and remission after Roux-en-Y gastric bypass: a single center long-term cohort study
Authors: Hage Karl , Abi Mosleh Kamal , Sample Jack W. , Vierkant Robert A. , Mundi Manpreet S. , Spaniolas Konstantinos , Abu Dayyeh Barham K. , Ghanem Omar M.
Published: February 2024

Background:

Roux-en-Y gastric bypass (RYGB) has demonstrated excellent glycemic control and type 2 diabetes mellitus (T2DM) remission for patients with obesity and T2DM. Duration of T2DM is a consistent negative predictor of remission after RYGB. However, the exact timing to offer surgical intervention during the course of the disease is not well elucidated.

Material and methods:

The authors performed a retrospective cohort study between 2008 and 2020 to establish the exact association between duration of T2DM and remission after RYGB. The authors divided our cohort into quartiles of preoperative disease duration to quantify the change in remission rates for each year of delay between T2DM diagnosis and RYGB. The authors also compared the average time to remission and changes in glycemic control parameters.

Results:

A total of 519 patients (67.2% female; age 53.4±10.7 year; BMI 46.6±8.4 kg/m2) with a follow-up period of 6.6±3.8 years were included. Remission was demonstrated in 51% of patients. Longer duration of T2DM was a significant negative predictor of remission with an estimated decrease in remission rates of 7% for each year of delay [(OR=0.931 (95% CI: 0.892–0.971); P<0.001)]. Compared to patients with <3 years of T2DM, remission decreased by 37% for patients with 3–6 years, 64% for those with 7–12 years, and 81% for patients with more than 12 years (P<0.001). Half of the patients reached T2DM remission after 0.5 and 1.1 years, respectively, for the first and second quartiles, while patients in the other quartiles never reached 50% remission. Lastly, The authors noted an overall improvement in all glycemic control parameters for all quartiles at last follow-up.

Conclusion:

Patients with a recent history of T2DM who undergo early RYGB experience significantly higher and earlier T2DM remission compared to patients with a prolonged history of preoperative T2DM, suggesting potential benefit of early surgical intervention to manage patients with obesity and T2DM.