bluuebunny/crossref_metadata_2025 huggingface dataset:
Humans predict the forest, not the trees: statistical learning of spatiotemporal structure in visual scenes
Authors: Yan Chuyao , Ehinger Benedikt V , Pérez-Bellido Alexis , Peelen Marius V , de Lange Floris P
Published: April 2023

The human brain is capable of using statistical regularities to predict future inputs. In the real world, such inputs typically comprise a collection of objects (e.g. a forest constitutes numerous trees). The present study aimed to investigate whether perceptual anticipation relies on lower-level or higher-level information. Specifically, we examined whether the human brain anticipates each object in a scene individually or anticipates the scene as a whole. To explore this issue, we first trained participants to associate co-occurring objects within fixed spatial arrangements. Meanwhile, participants implicitly learned temporal regularities between these displays. We then tested how spatial and temporal violations of the structure modulated behavior and neural activity in the visual system using fMRI. We found that participants only showed a behavioral advantage of temporal regularities when the displays conformed to their previously learned spatial structure, demonstrating that humans form configuration-specific temporal expectations instead of predicting individual objects. Similarly, we found suppression of neural responses for temporally expected compared with temporally unexpected objects in lateral occipital cortex only when the objects were embedded within expected configurations. Overall, our findings indicate that humans form expectations about object configurations, demonstrating the prioritization of higher-level over lower-level information in temporal expectation.
Dynamics of corticocortical brain functional connectivity relevant to therapeutic response to biologics in inflammatory arthritis
Authors: Sakiyama Kodai , Abe Nobuya , Fujieda Yuichiro , Tha Khin K , Narita Hisashi , Karino Kohei , Kanda Masatoshi , Kono Michihito , Kato Masaru , Atsumi Tatsuya
Published: April 2023

Aberrant functional connectivity (FC) of the brain regions, evaluated by functional magnetic resonance imaging (fMRI), affects clinical courses in inflammatory arthritis (IA). The static analysis methods would be simplistic to estimate the whole picture of resting-state brain function because blood oxygen level-dependent (BOLD) signals fluctuate over time. The effects of FC dynamics on clinical course are unknown in IA. Therefore, we aimed to evaluate dynamic FC for therapeutic responsiveness to biologics in IA patients. We analyzed resting-state fMRI data of 64 IA patients in 2 cohorts. Dynamic FC was derived as a correlation coefficient of the windowed BOLD signal time series. We determined representative whole-brain dynamic FC patterns by k-means++ cluster analysis, leading to 4 distinct clusters. In the first cohort, occurrence probability of the distinct cluster was associated with favorable therapeutic response in disease activity and patients’ global assessment, which was validated by the second cohort. The whole-brain FC of the distinct cluster indicated significantly increased corticocortical connectivity, and probabilistically decreased after therapy in treatment-effective patients compared with -ineffective patients. Taken together, frequent emergence of corticocortical connections was associated with clinical outcomes in IA. The coherence of corticocortical interactions might affect pain modulation, possibly relevant to therapeutic satisfaction.
Increases in group A streptococcal infections in the pediatric population in Houston, TX, 2022
Authors: Aboulhosn Aya , Sanson Misu A , Vega Luis Alberto , Segura Maria G , Summer Lauren M , Joseph Marritta , McNeil J Chase , Flores Anthony R
Published: April 2023

Beginning in October 2022, we observed a substantial increase in the total number of cases of invasive GAS disease (iGAS) in the pediatric population in Houston, TX. Emm12 GAS strains were disproportionately represented but the overall proportion of iGAS infections observed during the current spike was similar to pre-pandemic years.
Interleukin 6 Blockade With Tocilizumab Diminishes Indices of Inflammation That Are Linked to Mortality in Treated Human Immunodeficiency Virus Infection
Authors: Funderburg Nicholas T , Shive Carey L , Chen Zhengyi , Tatsuoka Curtis , Bowman Emily R , Longenecker Chris T , McComsey Grace A , Clagett Brian M , Dorazio Dominic , Freeman Michael L , Sieg Scott F , Moisi Daniela , Anthony Donald D , Jacobson Jeffrey M , Stein Sharon L , Calabrese Leonard H , Landay Alan , Flexner Charles , Crawford Keith W , Capparelli Edmund V , Rodriguez Benigno , Lederman Michael M
Published: April 2023

Background

People with human immunodeficiency virus (PWH) are at increased risk for comorbidities, and plasma interleukin 6 (IL-6) levels are among the most robust predictors of these outcomes. Tocilizumab (TCZ) blocks the receptor for IL-6, inhibiting functions of this cytokine.

Methods

This was a 40-week, placebo-controlled, crossover trial (NCT02049437) where PWH on stable antiretroviral therapy (ART) were randomized to receive 3 monthly doses of TCZ or matching placebo intravenously. Following a 10-week treatment period and a 12-week washout, participants were switched to the opposite treatment. The primary endpoints were safety and posttreatment levels of C-reactive protein (CRP) and CD4+ T-cell cycling. Secondary endpoints included changes in inflammatory indices and lipid levels.

Results

There were 9 treatment-related toxicities of grade 2 or greater during TCZ administration (mostly neutropenia) and 2 during placebo administration. Thirty-one of 34 participants completed the study and were included in a modified intent-to-treat analysis. TCZ reduced levels of CRP (median decrease, 1819.9 ng/mL, P < .0001; effect size, 0.87) and reduced inflammatory markers in PWH, including D-dimer, soluble CD14, and tumor necrosis factor receptors. T-cell cycling tended to decrease in all maturation subsets after TCZ administration, but was only significant among naive CD4 T cells. Lipid levels, including lipid classes that have been related to cardiovascular disease risk, increased during TCZ treatment.

Conclusions

TCZ is safe and decreases inflammation in PWH; IL-6 is a key driver of the inflammatory environment that predicts morbidity and mortality in ART-treated PWH. The clinical significance of lipid elevations during TCZ treatment requires further study.

Clinical Trials Registration. NCT02049437.
Pathogenic SCN2A variants cause early-stage dysfunction in patient-derived neurons
Authors: Asadollahi R , Delvendahl I , Muff R , Tan G , Rodríguez D G , Turan S , Russo M , Oneda B , Joset P , Boonsawat P , Masood R , Mocera M , Ivanovski I , Baumer A , Bachmann-Gagescu R , Schlapbach R , Rehrauer H , Steindl K , Begemann A , Reis A , Winkler J , Winner B , Müller M , Rauch A
Published: April 2023

Pathogenic heterozygous variants in SCN2A, which encodes the neuronal sodium channel NaV1.2, cause different types of epilepsy or intellectual disability (ID)/autism without seizures. Previous studies using mouse models or heterologous systems suggest that NaV1.2 channel gain-of-function typically causes epilepsy, whereas loss-of-function leads to ID/autism. How altered channel biophysics translate into patient neurons remains unknown. Here, we investigated iPSC-derived early-stage cortical neurons from ID patients harboring diverse pathogenic SCN2A variants [p.(Leu611Valfs*35); p.(Arg937Cys); p.(Trp1716*)] and compared them with neurons from an epileptic encephalopathy (EE) patient [p.(Glu1803Gly)] and controls. ID neurons consistently expressed lower NaV1.2 protein levels. In neurons with the frameshift variant, NaV1.2 mRNA and protein levels were reduced by ~ 50%, suggesting nonsense-mediated decay and haploinsufficiency. In other ID neurons, only protein levels were reduced implying NaV1.2 instability. Electrophysiological analysis revealed decreased sodium current density and impaired action potential (AP) firing in ID neurons, consistent with reduced NaV1.2 levels. In contrast, epilepsy neurons displayed no change in NaV1.2 levels or sodium current density, but impaired sodium channel inactivation. Single-cell transcriptomics identified dysregulation of distinct molecular pathways including inhibition of oxidative phosphorylation in neurons with SCN2A haploinsufficiency and activation of calcium signaling and neurotransmission in epilepsy neurons. Together, our patient iPSC-derived neurons reveal characteristic sodium channel dysfunction consistent with biophysical changes previously observed in heterologous systems. Additionally, our model links the channel dysfunction in ID to reduced NaV1.2 levels and uncovers impaired AP firing in early-stage neurons. The altered molecular pathways may reflect a homeostatic response to NaV1.2 dysfunction and can guide further investigations.
Real-World Effectiveness of Primary Series and Booster Doses of Inactivated Coronavirus Disease 2019 Vaccine Against Omicron BA.2 Variant Infection in China: A Retrospective Cohort Study
Authors: Tang Lin , Wang Fu-Zhen , Rodewald Lance E , Wang Xuan-Yi , Liu Si-Yu , Liu Qian-Qian , Wang Xiao-Qi , Wu Dan , Li Ming-Shuang , Zhang Qian , Shao Yi-Ming , Huang Li-Fang , Song Yu-Dan , Huang Yong , Zeng Xiang , Liu Li-Jun , Yang Hong , Huang Ao-Di , Bao Li-Ming , Zheng Hui , Ma Chao , Lv Xiao-Ya , Song Lei , Ma Zhao , Wang Shu-Guang , Ma Hao , Guan Wei-Jie , Wu Zhi-Yin , Zhong Nan-Shan , Yin Zun-Dong
Published: April 2023

Background

China has been using inactivated coronavirus disease 2019 (COVID-19) vaccines as primary series and booster doses to protect the population from severe to fatal COVID-19. We evaluated primary and booster vaccine effectiveness (VE) against Omicron BA.2 infection outcomes.

Methods

This was a 13-province retrospective cohort study of quarantined close contacts of BA.2-infected individuals. Outcomes were BA.2 infection, COVID-19 pneumonia or worse, and severe/critical COVID-19. Absolute VE was estimated by comparison with an unvaccinated group.

Results

There were 289 427 close contacts ≥3 years old exposed to Omicron BA.2 cases; 31 831 turned nucleic acid amplification test–positive during quarantine, 97.2% with mild or asymptomatic infection, 2.6% with COVID-19 pneumonia, and 0.15% with severe/critical COVID-19. None died. Adjusted VE (aVE) against any infection was 17% for primary series and 22% when boosted. Primary series aVE in adults >18 years was 66% against COVID-19 pneumonia or worse and 91% against severe/critical COVID-19. Booster dose aVE was 74% against pneumonia or worse, and 93% against severe/critical COVID-19.

Conclusions

Inactivated COVID-19 vaccines provided modest protection from infection, very good protection against pneumonia, and excellent protection against severe/critical COVID-19. Booster doses are necessary to provide strongest protection.
A marker-based neural network system for extracting social determinants of health
Authors: Zhao Xingmeng , Rios Anthony
Published: April 2023

Objective

The impact of social determinants of health (SDoH) on patients’ healthcare quality and the disparity is well known. Many SDoH items are not coded in structured forms in electronic health records. These items are often captured in free-text clinical notes, but there are limited methods for automatically extracting them. We explore a multi-stage pipeline involving named entity recognition (NER), relation classification (RC), and text classification methods to automatically extract SDoH information from clinical notes.

Materials and Methods

The study uses the N2C2 Shared Task data, which were collected from 2 sources of clinical notes: MIMIC-III and University of Washington Harborview Medical Centers. It contains 4480 social history sections with full annotation for 12 SDoHs. In order to handle the issue of overlapping entities, we developed a novel marker-based NER model. We used it in a multi-stage pipeline to extract SDoH information from clinical notes.

Results

Our marker-based system outperformed the state-of-the-art span-based models at handling overlapping entities based on the overall Micro-F1 score performance. It also achieved state-of-the-art performance compared with the shared task methods. Our approach achieved an F1 of 0.9101, 0.8053, and 0.9025 for Subtasks A, B, and C, respectively.

Conclusions

The major finding of this study is that the multi-stage pipeline effectively extracts SDoH information from clinical notes. This approach can improve the understanding and tracking of SDoHs in clinical settings. However, error propagation may be an issue and further research is needed to improve the extraction of entities with complex semantic meanings and low-frequency entities. We have made the source code available at https://github.com/Zephyr1022/SDOH-N2C2-UTSA.
The evaluation of the supplementation of vitamin A, beta-carotene, and oxidized beta-carotene in prepubertal gilts
Authors: Elefson Sarah K , Greiner Laura L
Published: April 2023

Finishing pigs (N = 224; 28.66 ± 1.90 kg bodyweight) were randomly assigned across 56 pens of either four barrows or gilts, and assigned to one of four diets: control (7,656 IU vitamin A/kg), control supplemented with vitamin A (4.36 ppm, Rovimix A 1000, DSM, Parsippany, NJ, USA), control supplemented with beta-carotene (163.28 ppm, Rovimix β-Carotene 10%, DSM, Parsippany), or control supplemented with oxidized beta-carotene (40 ppm; 10% active ingredient, Avivagen, Ottawa, ON, Canada). Pigs and feeder weights were obtained at the start of the study (d 0), and end of each phase (d 21, 42, and 63). A subset of gilts had a blood sample taken via jugular venipuncture on d 0, a blood sample and vaccinations of Lawsonia intracellularis and porcine circovirus type 2 (PCV2) on d 18, a blood sample and booster vaccination of PCV2 on d 39, a blood sample on day 60, and a final blood sample on day 63. Gilts were euthanized at the end of the study to obtain a liver (entire right lobe) and a jejunum sample (15.24 cm at 10% of length). Additionally, the second and fourth right anterior mammary were collected to assess anterior mammary tissues. Data were analyzed in SAS 9.4 (Statistical Analysis System, Cary, NC) via GLIMMIX procedure. Oxidized beta-carotene supplementation increased (P = 0.02) ADG across phases over vitamin A supplementation, although there were no differences (P = 0.18) in the body weight of pigs. There was no effect (P > 0.05) of diet on plasma or hepatic retinol, IgG or IgM levels, or immune cell presence in developing mammary tissue. Supplemented vitamin A tended (P = 0.05) to increase the mRNA abundance of retinol binding protein in the jejunum, but other mRNA abundance for genes (alcohol dehydrogenase class 1, lecithin retinol acyltransferase phosphatidylcholine-retinol O-acyltransferase, and beta-carotene oxygenase 1) were not affected (P > 0.05) by dietary treatments. A diet by time interaction (P = 0.04) was noted for the circovirus S/P ratio, where vitamin A supplementation had the best ratio compared to other diets. Analyzed titer levels for the circovirus vaccine had an interaction (P < 0.01) for diet by time, where vitamin A supplementation had the highest titer at the end of the study. Thus, pigs supplemented with oxidized beta-carotene had an improved ADG over vitamin A supplemented pigs, but pigs supplemented with vitamin A seemed to have an improved immune status.
Resilience as a predictor for why some marital relationships flourished and others struggled during the initial months of COVID-19
Authors: Salehuddin Abdullah S , King Jesse , Afifi Tamara D , Afifi Walid A
Published: April 2023

Using the theory of resilience and relational load, this study examined how married individuals’ baseline communal orientation (CO) and relational load (RL) at the beginning of the pandemic predicted their stress, conflict, mental health, and flourishing during quarantine. Using a Qualtrics Panel, married individuals (N = 3,601) completed four online surveys from April to June 2020. Results revealed the initial levels of CO brought to quarantine predicted less stress and conflict, and better mental health and flourishing at baseline, and these outcomes remained relatively stable across the next 3 months. RL at baseline did the exact opposite for these outcomes, making coping more difficult. We also hypothesized CO and RL moderate the impact of stress (T1) on mental health 3 months later by reducing conflict. Rather than serving as buffers, CO and RL at baseline directly affected conflict (T2/T3) and mental health (T4) throughout quarantine.
Testing homogeneity: the trouble with sparse functional data
Authors: Zhu Changbo , Wang Jane-Ling
Published: April 2023

Testing the homogeneity between two samples of functional data is an important task. While this is feasible for intensely measured functional data, we explain why it is challenging for sparsely measured functional data and show what can be done for such data. In particular, we show that testing the marginal homogeneity based on point-wise distributions is feasible under some mild constraints and propose a new two-sample statistic that works well with both intensively and sparsely measured functional data. The proposed test statistic is formulated upon energy distance, and the convergence rate of the test statistic to its population version is derived along with the consistency of the associated permutation test. The aptness of our method is demonstrated on both synthetic and real data sets.
Multi-copper oxidases SKU5 and SKS1 coordinate cell wall formation using apoplastic redox-based reactions in roots
Authors: Chen Chaofan , Zhang Yi , Cai Jianfa , Qiu Yuting , Li Lihong , Gao Chengxu , Gao Yiqun , Ke Meiyu , Wu Shengwei , Wei Chuan , Chen Jiaomei , Xu Tongda , Friml Jiří , Wang Junqi , Li Ruixi , Chao Daiyin , Zhang Baocai , Chen Xu , Gao Zhen
Published: April 2023

The primary cell wall is a fundamental plant constituent that is flexible but sufficiently rigid to support the plant cell shape. Although many studies have demonstrated that reactive oxygen species (ROS) serve as important signaling messengers to modify the cell wall structure and affect cellular growth, the regulatory mechanism underlying the spatial-temporal regulation of ROS activity for cell wall maintenance remains largely unclear. Here, we demonstrate the role of the Arabidopsis (Arabidopsis thaliana) multicopper oxidase-like protein skewed 5 (SKU5) and its homolog SKU5-similar 1 (SKS1) in root cell wall formation through modulating ROS homeostasis. Loss of SKU5 and SKS1 function resulted in aberrant division planes, protruding cell walls, ectopic deposition of iron, and reduced nicotinamide adeninedinucleotide phosphate (NADPH) oxidase-dependent ROS overproduction in the root epidermis–cortex and cortex–endodermis junctions. A decrease in ROS level or inhibition of NADPH oxidase activity rescued the cell wall defects of sku5 sks1 double mutants. SKU5 and SKS1 proteins were activated by iron treatment, and iron over-accumulated in the walls between the root epidermis and cortex cell layers of sku5 sks1. The glycosylphosphatidylinositol-anchored motif was crucial for membrane association and functionality of SKU5 and SKS1. Overall, our results identified SKU5 and SKS1 as regulators of ROS at the cell surface for regulation of cell wall structure and root cell growth.
PbrBZR1 interacts with PbrARI2.3 to mediate brassinosteroid-regulated pollen tube growth during self-incompatibility signaling in pear
Authors: Wang Yicheng , Liu Panpan , Cai Yiling , Li Yu , Tang Chao , Zhu Nan , Wang Peng , Zhang Shaoling , Wu Juyou
Published: April 2023

S-RNase-mediated self-incompatibility (SI) prevents self-fertilization and promotes outbreeding to ensure genetic diversity in many flowering plants, including pear (Pyrus sp.). Brassinosteroids (BRs) have well-documented functions in cell elongation, but their molecular mechanisms in pollen tube growth, especially in the SI response, remain elusive. Here, exogenously applied brassinolide (BL), an active BR, countered incompatible pollen tube growth inhibition during the SI response in pear. Antisense repression of BRASSINAZOLE-RESISTANT1 (PbrBZR1), a critical component of BR signaling, blocked the positive effect of BL on pollen tube elongation. Further analyses revealed that PbrBZR1 binds to the promoter of EXPANSIN-LIKE A3 (PbrEXLA3) to activate its expression. PbrEXLA3 encodes an expansin that promotes pollen tube elongation in pear. The stability of dephosphorylated PbrBZR1 was substantially reduced in incompatible pollen tubes, where it is targeted by ARIADNE2.3 (PbrARI2.3), an E3 ubiquitin ligase that is strongly expressed in pollen. Our results show that during the SI response, PbrARI2.3 accumulates and negatively regulates pollen tube growth by accelerating the degradation of PbrBZR1 via the 26S proteasome pathway. Together, our results show that an ubiquitin-mediated modification participates in BR signaling in pollen and reveal the molecular mechanism by which BRs regulate S-RNase-based SI.
“Deservingness” and Public Support for Universal Public Goods: A Survey Experiment
Authors: Gift Thomas , Lastra-Anadón Carlos X
Published: April 2023

Voters support less spending on means-tested entitlements when they perceive beneficiaries as lacking motivation to work and pay taxes. Yet do concerns about the motivations of “undeserving” beneficiaries also extend to universal public goods (UPGs) that are free and available to all citizens? Lower spending on UPGs poses a particular trade-off: it lessens subsidization of “unmotivated” beneficiaries, but at the expense of reducing the ideal levels of UPGs that voters personally can access. Studies suggest that individuals will sacrifice their preferred amounts of public goods when beneficiaries who do not pay taxes try to access these goods, but it is unclear whether they distinguish based on motivations. To analyze this question, we field a nationally representative survey experiment in the UK that randomly activates some respondents to think about users of the country's universal National Health Service as either “motivated” or “unmotivated” noncontributors. Although effect sizes were modest and spending preferences remained high across the board, results show that respondents support less spending on the NHS when activated to think of users as “unmotivated” noncontributors. These findings suggest how the deservingness heuristic may shape public attitudes toward government spending, regardless of whether benefits are targeted or universal.
Money Market Disconnect
Authors: Ballensiefen Benedikt , Ranaldo Angelo , Winterberg Hannah
Published: April 2023

A repurchase agreement (repo) is a source of cash and collateral. We document that the money market is more segmented when the collateral motive prevails. Two crucial aspects of the central bank framework lead to this disconnect: banks’ access to the central bank’s deposit facility and assets’ eligibility for quantitative easing (QE). We show that repo rates lent by banks with access to the deposit facility and secured by QE eligible assets are more collateral-driven and disconnected from funding-based money market rates. Our results are relevant for different monetary policies and have suggestive implications for the monetary policy pass-through.

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Identification and Genetic Characterization ofPseudomonas syringaepv.actinidiaefrom Kiwifruit in Sichuan, China
Authors: Pei Yangang , Ma Li , Zheng Xiaojuan , Yao Kaikai , Fu Xiangru , Chen Huabao , Chang Xiaoli , Zhang Ming , Gong Guoshu
Published: April 2023

Pseudomonas syringae pv. actinidiae causes kiwifruit bacterial canker and poses a major threat to the kiwifruit industry. This study aimed to investigate the genetic characteristics of the P. syringae pv. actinidiae population from kiwifruit in Sichuan, China. Sixty-seven isolates obtained from diseased plants were characterized using morphological features, multiplex-PCR, and multilocus sequence analysis (MLSA). The isolates exhibited the typical colony morphology of P. syringae pv. actinidiae. Multiplex PCR amplification identified every isolate as P. syringae pv. actinidiae biovar 3. MLSA of the three housekeeping genes gapA, gyrB, and pfk, revealed that the reference strains of the five described biovars were clearly distinguished by a combined phylogenetic tree, and all of the tested isolates clustered with the reference strains of P. syringae pv. actinidiae biovar 3. Through a phylogenetic tree constructed from a single gene, it was found that pkf gene alone could distinguish biovar 3 from the other biovars. Furthermore, all P. syringae pv. actinidiae isolates analyzed by BOX-A1R-based repetitive extragenic palindromic (BOX)-PCR and enterobacterial repetitive intergenic consensus (ERIC)-PCR clustered into four groups. The clustering results of BOX- and ERIC-PCR indicated that group III had the largest number of isolates, accounting for 56.72 and 61.19% of all 67 isolates, respectively, and the two characterization methods were similar and complementary. The results of this study revealed that the genomes of P. syringae pv. actinidiae isolates from Sichuan had rich genetic diversity but no obvious correlation was found between clustering and geographical region. This research provides novel methodologies for rapidly detecting kiwifruit bacterial canker pathogen and a molecular differentiation at genetic level of P. syringae pv. actinidiae biovar diversity in China.
Identification and Pathogenicity of Cladosporium, Fusarium, and Diaporthe spp. Associated with Late-Season Bunch Rots of Grape
Authors: Cosseboom Scott D. , Hu Mengjun
Published: April 2023

Fungal pathogens continue to pose a significant threat to grape production. Previous studies of pathogens associated with late-season bunch rots in Mid-Atlantic vineyards had elucidated the primary causal agents of these diseases, but the significance and identity of the less commonly isolated genera was unclear. Therefore, to more fully understand the identity and pathogenicity of Cladosporium, Fusarium, and Diaporthe spp. associated with late-season bunch rots of wine grapes in the Mid-Atlantic, phylogenic analyses and pathogenicity assays were conducted. Isolates were characterized to the species level by sequencing the TEF1 and Actin, TEF1 and TUB2, and TEF1 genes for 10, 7, and 9 isolates of Cladosporium, Diaporthe, and Fusarium, respectively. Four Cladosporium, three Fusarium, and three Diaporthe species were identified, and C. allicinum, C. perangustum, C. pseudocladosporioides, F. graminearum, and D. guangxiensis had not yet been isolated from grape in North America. The pathogenicity of each species was evaluated on detached table and wine grapes, and D. eres, D. ampelina, D. guangxiensis, and F. fujikuroi were found to be the most aggressive on both table and wine grapes. Further investigations through more extensive isolate collection and of myotoxicity testing may be warranted due to the prevalence and pathogenicity of D. eres and F. fujikuroi.
Clinical and Electroencephalographic Predictors of Seizures and Status Epilepticus in 12,450 Critically Ill Adults: A Retrospective Cohort Study
Authors: Snider Samuel B. , Fong Michael W. K. , Nolan Neal M. , Ruiz Andres Rodriguez , Wang Wei , LaRoche Suzette , Hirsch Lawrence J. , Lee Jong W. ,   for the Critical Care EEG Monitoring Research Consortium
Published: April 2023

OBJECTIVES:

Status epilepticus (SE) is associated with significantly higher morbidity and mortality than isolated seizures. Our objective was to identify clinical diagnoses and rhythmic and periodic electroencephalogram patterns (RPPs) associated with SE and seizures.

DESIGN:

Retrospective cohort study.

SETTING:

Tertiary-care hospitals.

SUBJECTS:

Twelve thousand four hundred fifty adult hospitalized patients undergoing continuous electroencephalogram (cEEG) monitoring in selected participating sites in the Critical Care EEG Monitoring Research Consortium database (February 2013 to June 2021).

INTERVENTIONS:

Not applicable.

MEASUREMENTS AND MAIN RESULTS:

We defined an ordinal outcome in the first 72 hours of cEEG: no seizures, isolated seizures without SE, or SE (with or without isolated seizures). Composite groups included isolated seizures or SE (AnySz) and no seizure or isolated seizures. In this cohort (mean age: 60 ± 17 yr), 1,226 patients (9.8%) had AnySz and 439 patients (3.5%) had SE. In a multivariate model, factors independently associated with SE were cardiac arrest (9.2% with SE; adjusted odds ratio, 8.8 [6.3–12.1]), clinical seizures before cEEG (5.7%; 3.3 [2.5–4.3]), brain neoplasms (3.2%; 1.6 [1.0–2.6]), lateralized periodic discharges (LPDs) (15.4%; 7.3 [5.7–9.4]), brief potentially ictal rhythmic discharges (BIRDs) (22.5%; 3.8 [2.6–5.5]), and generalized periodic discharges (GPDs) (7.2%; 2.4 [1.7–3.3]). All above variables and lateralized rhythmic delta activity (LRDA) were also associated with AnySz. Factors disproportionately increasing odds of SE over isolated seizures were cardiac arrest (7.3 [4.4–12.1]), clinical seizures (1.7 [1.3–2.4]), GPDs (2.3 [1.4–3.5]), and LPDs (1.4 [1.0–1.9]). LRDA had lower odds of SE compared with isolated seizures (0.5 [0.3–0.9]). RPP modifiers did not improve SE prediction beyond RPPs presence/absence (p = 0.8).

CONCLUSIONS:

Using the largest existing cEEG database, we identified specific predictors of SE (cardiac arrest, clinical seizures prior to cEEG, brain neoplasms, LPDs, GPDs, and BIRDs) and seizures (all previous and LRDA). These findings could be used to tailor cEEG monitoring for critically ill patients.
Safety of glucagon-like peptide-1 receptor agonists for weight management in adults, adolescents, and children with obesity: a scoping review
Authors: Baden Christoffer S. , Andersen Jon T. , Christensen Mikkel B. , Gade Christina
Published: April 2023

As obesity continues to be a global health challenge presenting various negative impacts on health outcomes and healthcare costs, there is a growing need for pharmacological interventions to address the issue. Glucagon-like peptide-1 receptor agonists have shown potential in treating obesity and reducing the risk of type 2 diabetes, but there is a lack of studies comparing adverse events across different populations. This review intends to indirectly compare the adverse events of available glucagon-like peptide-1 receptor agonist pharmaceuticals for treating overweight or obesity in adults, adolescents, and children.
Integration of three-dimensional printing model into navigator-assisted surgery on fibrous dysplasia patient
Authors: Huang Chao-Hsin , Chen Meng-Ta , Lee Su-Shin
Published: April 2023

Fibrous dysplasia refers to a chronic bone deformity caused by abnormal fibrotic and osseous tissue replacing normal ones. Craniofacial fibrous dysplasia can lead to facial asymmetry, which can cause misalignment of jaw, nasal airway congestion, proptosis, and vision loss. To improve facial asymmetry and preserve optic nerve function, operation is indicated. However, pathological bone at the affected ocular area can be really close to the optic nerve. Complicated and limited surgical field increased operation difficulty. Thus, precise operation is required for minimizing risk of optic nerve injury. Navigator-assisted surgery can be applied to these patients with optic nerve compression. In addition, we proposed integrating three-dimensional computer simulation into preoperational planning in navigator-assisted surgery to improve precision. Here, we present a case diagnosed as craniofacial dysplasia undergoing navigator-assisted surgery with integration of computer simulation.
Utilization of a 3D Printed Simulation Training Model to Improve Microsurgical Training
Authors: Geoghegan Luke , Papadopoulos Dimitrios , Petrie Nicola , Teo Isabel , Papavasiliou Theodora
Published: April 2023

Background:

Simulation is integral to the development and maintenance of micro- surgical skills. Several simulation models have been described ranging from bench- top to live animal models. High fidelity models are often burdened by cost and ethical issues limiting widespread implementation. This study aims to determine the feasibility of a microsurgical training platform using the Konjac noodle model.

Methods:

A prospective cohort study was conducted at our institution. A progressive microsurgical training curriculum was developed. A bespoke three-dimensional printed training platform was produced to enable residents to record training and assessment tasks. Microsurgical skills were blindly assessed before and after completing the training program using the University of Western Ontario Microsurgical Skills Assessment instrument.

Results:

Plastic surgery residents at various stages of training were recruited (n = 10). A significant improvement in vessel preparation from a pre-training median of 3 (IQR 2 -4) versus a post-training of 4 (IQR 3 -5, P = 0.0035) and suturing with a pre-training median of 3 (IQR 2 -4) versus a post-training of 4 (IQR 3 -5, P = 0.0047) domains of the University of Western Ontario Microsurgical Skills Assessment score was demonstrated after completion of the training program. There was a significant improvement in the global rating score (3 ± 1 versus 5 ± 1, P = 0.0045). Participants felt more confident performing a microsurgical anastomosis following the training program.

Conclusion:

The use of the Konjac noodle model and video-based assessment using a three-dimensional printed model is an effective teaching tool that improves resident's microsurgical skills.
Mental Health Conditions and Health-related Quality of Life Changes after Reduction Mammaplasty in Younger Patients
Authors: White Ava G. , Nuzzi Laura C. , McNamara Catherine T. , Nussbaum Lisa S. , Cappitelli Alex T. , DiVasta Amy D. , Labow Brian I.
Published: April 2023

Background:

Reduction mammaplasty is increasingly common in younger patients with macromastia. Unfortunately, a recent surge in mental health disorders has been documented in this population. It is unknown how mental health disorders affect patients undergoing reduction mammaplasty. This study examines the impact of concurrent mental health conditions on health-related quality of life outcomes after reduction mammaplasty.

Methods:

A prospective cohort study was performed on patients aged 12–21 years undergoing reduction mammaplasty. Patients were assigned to unaffected or affected (baseline mental health condition) cohorts based on psychological history. Patients completed the Short-form-36, Rosenberg Self-esteem Scale, Eating Attitudes Test 26, and Breast-related Symptoms Questionnaire at baseline and postoperatively.

Results:

A total of 250 patients were included (81 affected and 169 unaffected). Mean age at surgery was 17.9 ± 2.0 and 18.1 ± 1.8 years for affected and unaffected patients, respectively. Anxiety (n = 59, 23.6%) and depression (n = 38, 15.2%) were the most prevalent conditions. Affected patients were outscored by controls at baseline and postoperatively in most measures. However, significant score improvements were also reported in the affected cohort. In fact, the magnitude of score improvements observed in both cohorts were similar (P > 0.05, all).

Conclusions:

Baseline mental health conditions are common in young patients presenting for reduction mammaplasty. After surgery, health-related quality of life in affected patients remains below unaffected peers; however, significant and similar gains are achieved. We advise providers to recommend mental health treatment to affected patients, but not preclude otherwise appropriate candidates from surgery.
Multiple Retinal Emboli and Medial Canthal Swelling Following Injection of Acellular Porcine Urinary Bladder Matrix for Hair Restoration
Authors: Schultz Hannah , Dharssi Shazia , Bacorn Colin , Priluck Aaron Z. , Cai Sophie , Mahoney Nicholas R.
Published: April 2023

Acellular porcine urinary bladder matrix promotes wound healing and is also used to stimulate hair growth. A 64-year-old female presented with acute-onset OD pain and decreased visual acuity after subcutaneous injection of acellular porcine urinary bladder matrix at the hairline. Fundus examination revealed multiple emboli at retinal arcade branch points, and fluorescein angiography demonstrated corresponding areas of peripheral nonperfusion. Two weeks later, external examination revealed new swelling of the right medial canthus without erythema or fluctuance, which was felt to possibly represent recruitment of vessels after occlusion in the facial vasculature. At 1-month follow up, visual acuity of the OD improved with resolution of right medial canthal swelling. Fundus examination was normal with no visible emboli. Herein, the authors present a case of retinal occlusion and medial canthal swelling following injection of acellular porcine urinary bladder matrix for hair restoration, which to the authors knowledge has not been previously reported.
Correction of Lacrimal Gland Ptosis in Blepharoplasty: A Systematic Review
Authors: Henares Chavarino Ángel Andrés , Estiragués Cerdá María , Ros Magallón Andrés , Vicente Ruiz Miriam , Arroyo Pérez Íñigo , Bazán Álvarez Antonio
Published: April 2023

Purpose:

Lacrimal gland ptosis has a prevalence of 10% to 15% in Caucasian patients, reaching up to 60% in older age. Its involuntary resection during blepharoplasty carries the potential risk of compromising corneal lubrication. The purpose of this systematic review is to check whether there is a consensus in the literature regarding the surgical procedure of choice and which outcomes and complications have been observed.

Methods:

A systematic review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search was carried out in the Medline, Scopus, and Cochrane databases in March 2022.

Results:

A total of 16 studies involving 483 patients with lacrimal gland ptosis have been included. In 90.06% of patients, resuspension or direct refixation of the gland to the lacrimal fossa with suture to the orbital periosteum was performed. Follow up has been inconsistent, with an average of 18 months. Regarding complications, 5 recurrences and only 2 patients with persistent dry eye were observed.

Conclusions:

In general, the evidence is sparse. Nevertheless, repair of lacrimal gland ptosis is a relatively simple, reproducible, and safe surgical technique, with a low likelihood of recurrence, severe, or persistent complications. A classification is proposed for both the grading of ptosis and its treatment.
Apocrine Cystadenoma of the Eyelid, a Rare Neoplasm: Expanded Immunohistologic Profile
Authors: Charles Norman C. , McGee Rebecca P. , Kim Eleanore T.
Published: April 2023

An 83-year-old woman experienced the slow enlargement of a right lower eyelid mass. Histopathologic examination of the excised tissue showed a mucin-filled cystic tumor emanating from an apocrine bilayer that displayed bleb-like apocrine decapitation secretion. The outer flattened myoepithelial layer of the bilayer reacted with immunohistochemical stains for smooth muscle actin and calponin. In foci, the tumor exhibited a cribriform architecture with small pockets of mucin. Tumor cells were reactive for cytokeratin 7, Gross Cystic Disease Fluid Protein 15 (BRST-2), estrogen and progesterone receptors, androgen receptors, mammaglobin, epithelial membrane antigen, and GATA3. Ki67 showed a very low proliferation fraction. The lesion exemplifies the fourth instance of an eyelid apocrine cystadenoma in the literature.
A Cross-Sectional Study of the Characteristics Associated With Chronic Pain Documentation on the Problem List
Authors: Rylee Tina L. , Copenhaver David , Drake Christiana , Joseph Jill
Published: April 2023

Chronic pain is often elusive because of its specific diagnosis and complex presentation, making it challenging for healthcare providers to develop safe and effective treatment plans. Experts recommend a multifaceted approach to managing chronic pain that requires interdisciplinary communication and coordination. Studies have found that patients with a complete problem list receive better follow-up care. This study aimed to determine the factors associated with chronic pain documentation in the problem list. This study included 126 clinics and 12,803 patients 18 years or older with a chronic pain diagnosis within 6 months before or during the study period. The findings revealed that 46.4% of the participants were older than 60 years, 68.3% were female, and 52.1% had chronic pain documented on their problem list. Chi-square tests revealed significant differences in demographics between those who did and did not have chronic pain documented on their problem list, with 55.2% of individuals younger than 60 years having chronic pain documented on their problem list, 55.0% of female patients, 60.3% of Black non-Hispanic people, and 64.8% of migraine sufferers. Logistic regression analysis revealed that age, sex, race/ethnicity, diagnosis type, and opioid prescriptions were significant predictors of chronic pain documentation on the problem list.
Experience and Hospital Context Influence Fall Prevention Practice by Physical Therapists: A Survey Study
Authors: Crick James P. , Juckett Lisa , Salsberry Marka , Quatman Carmen , Quatman-Yates Catherine C.
Published: April 2023

Background:

Falls in and following hospitalization are common and problematic. Little is understood about the factors that impede or promote effective implementation of fall prevention practices.

Purpose and Relevance:

Physical therapists are commonly consulted for acute care patients at risk for falling. The purpose of this study is to understand therapist perceptions of their effectiveness in fall prevention and to explore the impact of contextual factors on practice patterns to prevent falls surrounding hospitalization.

Methods:

Survey questions were tailored to the constructs of hospital culture, structural characteristics, networks and communications, and implementation climate, in addition to inquiries regarding practice patterns and attitudes/beliefs.

Results:

Overall, 179 surveys were analyzed. Most therapists (n = 135, 75.4%) affirmed their hospital prioritizes best practices for fall prevention, although fewer agreed that therapists other than themselves provide optimal fall prevention intervention (n = 105, 58.7%). Less practice experience was associated with greater odds of affirming that contextual factors influence fall prevention practice (OR 3.90, p < .001). Respondents who agreed that their hospital system prioritizes best practices for fall prevention had 14 times the odds of believing that their system prioritizes making improvements (p = .002).

Conclusions/Implications:

As experience influences fall prevention practice, quality assurance and improvement initiatives should be used to ensure minimum specifications of practice.
Frequency of Goal Setting Contact with Physical Therapists Is Associated with Orthotist’s Perceived Skill Level
Authors: Kenworthy Sally , Reno Ariel , Roy Tara , Glahn Castille Megan
Published: April 2023

Introduction

Effective communication is key to the development of a successful interdisciplinary team, and effective communication cannot be achieved without an accurate understanding of role awareness. Communication within interdisciplinary teams may be particularly important for orthotists given their highly specialized scope of practice, the limited public awareness of the profession, and relatively recent increases to minimum education requirements. Because physical therapists (PTs) and orthotists commonly work together to restore mobility, the purpose of this study was to determine if there are factors associated with the perceived value of orthotists as members of the health care team among PTs.

Materials and Methods

This study consisted of a cross-sectional survey assessing demographic characteristics and four value variables. The survey was distributed via email using snowball sampling to health care team members. Responses from PTs were analyzed through a series of statistical testing for significant correlations of the demographic characteristics and value variables.

Results

A total of 68 responses from PTs were included in the final analysis. Mutual patient goal setting contact showed a statistically significant relationship with frequency of contact and the perceived skill level of orthotists. The mean orthotist skill level was 86.57 (±10.24, min = 59, max = 100). The frequency of mutual patient goal setting contact was higher for PTs who were younger, had a higher level of education, and fewer years of experience.

Conclusions

Despite its rich history, orthotics may be considered relatively new as a profession, and orthotists are often still establishing their role within a team setting. Mutual patient goal setting may provide a key opportunity for orthotists to increase awareness of their skill set and demonstrate their value as professional members of the health care team. Interprofessional education is another opportunity to increase role awareness and may explain why younger PTs with higher levels of education and fewer years of experience were more likely to set mutual patient goals with orthotists.

Clinical Relevance

The results of this study show that engaging in mutual patient goal setting with PTs may be an avenue for orthotists to demonstrate their skills, knowledge, and, ultimately, their value.
Performance of Surface Topography Systems in Scoliosis Management: A Narrative Review
Authors: Bidari Shahrbanoo , Kamyab Mojtaba , Kakavand Reza , Komeili Amin
Published: April 2023

Introduction

The aesthetic appearance of the torso is the foremost concern of scoliotic patients, which, if not addressed, could adversely affect their life quality. The Cobb angle limitation in describing three-dimensional (3D) deformities of the spine and its associated ionizing radiation motivated clinicians to implement noninvasive surface topography (ST) methods for monitoring scoliosis. This study aimed to review the accuracy of the most commonly used ST systems and their ST parameters in predicting and monitoring scoliosis.

Materials and Methods

The scientific databases were used to search for the studies considering the validity and reliability of different ST methods published in English from 1970 to July 2020.

Results

Of 221 found publications, 41 journal publications were evaluated for this review. The accuracy of ST methods was affected by light source quality, acquisition time, and postural sway. Some ST parameters resulted in a high correlation with radiographic measurements and classified scoliosis deformities into mild, moderate, and severe. Some ST parameters may not effectively predict the Cobb angle but could monitor curve progression accurately. Representing spine deformities in the lumbar section and subjects with higher body mass index was associated with more significant errors due to thicker soft tissues around the spine.

Conclusions

According to the present review, ST systems could complement radiography measurements and provide valuable insights into different aspects of internal and external deformity; however, they have not reached a state that can replace radiography in the management of scoliosis.

Clinical Relevance

The present study helps clinicians choose the most appropriate ST methods for predicting and monitoring scoliotic curves and torso asymmetry evaluations.