bluuebunny/crossref_metadata_2025 huggingface dataset:
Little evolution of dust emissivity in bright infrared galaxies from 2 < z < 6
Authors: Ward B A , Eales S A , Ivison R J , Arumugam V
Published: February 2024

Variations in the dust emissivity index, $\beta$, within and between galaxies, are evidence that the chemistry and physics of dust must vary on large scales, although the nature of the physical and/or chemical variations is still unknown. In this paper, we estimate values of $\beta$ and dust temperature for a sample of 109 dusty star-forming galaxies (DSFGs) over the range, $2 \ \lt\ z \ \lt\ 6$. We compare the results obtained with both an optically thin model and a general opacity model, finding that our estimates of $\beta$ are similar between the models but our estimates of dust temperature are not. We find no evidence of a change in $\beta$ with redshift, with a median value of $\beta = 1.96$ for the optically thin model with a confidence interval (16–84 per cent) of 1.67 to 2.35 for the population. Using simulations, we estimate the measurement errors from our procedure and show that the variation of $\beta$ in the population results from intrinsic variations in the properties of the dust in DSFGs. At a fixed far-infrared luminosity, we find no evidence for a change in dust temperature, $T_{\textrm {dust}}$, with redshift. After allowing for the effects of correlated measurement errors, we find an inverse correlation between $\beta$ and $T_{\textrm {dust}}$ in DSFGs, for which there is also evidence in low-redshift galaxies.
Transient quasi-periodic oscillations in the gamma-ray light curves of bright blazars
Authors: Chen Junping , Yu Jinjie , Huang Weitian , Ding Nan
Published: February 2024

Transient quasi-periodic oscillations (QPOs) are extremely interesting observational phenomena. However, the precise physical mechanisms leading to their generation are still hotly debated. We performed a systematic search for transient QPO signals using Weighted Wavelet Z-transforms on the gamma-ray light curves of 134 bright blazars with peak flux exceeding 1 × 10−6 ph cm−2 s−1 as monitored by Fermi-LAT. Artificial light curves were generated from the power spectral density and probability distribution functions of the original light curves to assess the significance level of transient QPO. We discuss several physical mechanisms that produce transient QPOs, with the helical jet model providing the best explanation. This study identified four new transient QPO events. Interestingly, repetitive transient QPOs are observed in PKS 0537-441, and nested transient QPOs are detected in PKS 1424−41. Additionally, we find that transient QPOs tend to occur in the flare state of the blazar. Finally, we estimate the incidence of transient QPO events to be only about 3 per cent.
The radio-loud fraction of quasars at z > 6
Authors: Keller Pascal M , Thyagarajan Nithyanandan , Kumar Ajay , Kanekar Nissim , Bernardi Gianni
Published: February 2024

Quasars at redshifts z > 6 are an excellent probe of the formation and evolution of supermassive black holes in the early Universe. The population of radio-luminous quasars is of particular interest, as such quasars could potentially be used to study the neutral intergalactic medium during cosmic reionization via H i 21 cm absorption studies. However, the lack of deep radio observations of z > 6 quasars leaves the population poorly constrained, and suitable candidates for an H i 21 cm absorption study have yet to be found. In this work, we present Jansky Very Large Array (VLA) 1–2 GHz radio continuum observations of 138 quasars at redshifts 6.0 ≤ z < 7.6. We detect the radio continuum emission of the z = 6.1 quasar J1034−1425, with a 1.6 GHz flux density of $170\pm 36\, \mu$Jy. This quasar is radio-quiet with radio-loudness, R ≡ f5 GHz/fν, 4400 Å = 2.4 ± 0.5. In addition, we detect seven other quasars at z > 6, which have previously been characterized in the literature at these frequencies. Using the full sample, we estimate the radio-loud fraction to be $3.8^{+6.2}_{-2.4}\ \hbox{per cent}$, where the uncertainties are 95 per cent confidence intervals. This is lower than recent estimates of the radio-loud fraction in the literature, but is still marginally consistent with no redshift evolution of the radio-loud fraction. We explore the undetected quasar population by stacking their continuum images at their optical positions and obtain a median stacked flux density of 13.8 ± 3.9 µJy and luminosity of log L5 GHz/(W Hz−1) = 24.2 ± 0.1.
Amalgame: cosmological constraints from the first combined photometric supernova sample
Authors: Popovic Brodie , Scolnic Daniel , Vincenzi Maria , Sullivan Mark , Brout Dillon , Chen Rebecca , Patel Utsav , Peterson Erik R , Kessler Richard , Kelsey Lisa , Sanchez Bruno O , Bailey Ava Claire , Wiseman Phil , Toy Marcus
Published: February 2024

Future constraints of cosmological parameters from Type Ia supernovae (SNe Ia) will depend on the use of photometric samples, those samples without spectroscopic measurements of the SNe Ia. There is a growing number of analyses that show that photometric samples can be utilized for precision cosmological studies with minimal systematic uncertainties. To investigate this claim, we perform the first analysis that combines two separate photometric samples, SDSS and Pan-STARRS, without including a low-redshift anchor. We evaluate the consistency of the cosmological parameters from these two samples and find they are consistent with each other to under 1σ. From the combined sample, named Amalgame, we measure ΩM = 0.328 ± 0.024 with SN alone in a flat ΛCDM model, and ΩM = 0.330 ± 0.018 and w = $-1.016^{+0.055}_{-0.058}$ when combining with a Planck data prior and a flat wCDM model. These results are consistent with constraints from the Pantheon+ analysis of only spectroscopically confirmed SNe Ia, and show that there are no significant impediments to analyses of purely photometric samples of SNe Ia. The data and results are made available at https://github.com/bap37/AmalgameDR.
Understanding the association between fatigue and neurocognitive functioning in patients with glioma: A cross-sectional multinational study
Authors: Röttgering Jantine G , Taylor Jennie W , Brie Melissa , Luks Tracy , Hervey-Jumper Shawn L , Phan Stephanie , Bracci Paige M , Smith Ellen , De Witt Hamer Philip C , Douw Linda , Weyer-Jamora Christina , Klein Martin
Published: February 2024

Background

Fatigue and neurocognitive impairment are highly prevalent in patients with glioma, significantly impacting health-related quality of life. Despite the presumed association between these two factors, evidence remains sparse. Therefore, we aimed to investigate this relationship using multinational data.

Methods

We analyzed data on self-reported fatigue and neurocognitive outcomes from postoperative patients with glioma from the University of California San Francisco (n = 100, UCSF) and Amsterdam University Medical Center (n = 127, Amsterdam UMC). We used multiple linear regression models to assess associations between fatigue and seven (sub)domains of neurocognitive functioning and latent profile analysis to identify distinct patterns of fatigue and neurocognitive functioning.

Results

UCSF patients were older (median age 49 vs. 43 years, P = .002), had a higher proportion of grade 4 tumors (32% vs. 18%, P = .03), and had more neurocognitive deficits (P = .01). While the number of clinically fatigued patients was similar between sites (64% vs. 58%, P = .12), fatigue and the number of impaired neurocognitive domains were not correlated (P = .16–.72). At UCSF, neurocognitive domains were not related to fatigue, and at Amsterdam UMC attention and semantic fluency explained only 4–7% of variance in fatigue. Across institutions, we identified four distinct patterns of neurocognitive functioning, which were not consistently associated with fatigue.

Conclusions

Although individual patients might experience both fatigue and neurocognitive impairment, the relationship between the two is weak. Consequently, both fatigue and neurocognitive functioning should be independently assessed and treated with targeted therapies.
Legislative Intent and Agency: A Rational Unity Account
Authors: Collins Stephanie , Tan David
Published: February 2024

Realist theories of legislative intent can be divided between aggregative theories (on which legislative intent is what some proportion of legislators intend) and common intent theories (on which legislative intent is a unanimous intent among legislators). In this article, we advance and defend an alternative realist conception of legislative intent: the rational unity account. On this account, the legislature is an agent with a distinctive ‘rational point of view’—a concept we adopt from social ontology. The legislature’s rational point of view is shaped by its procedures and structures, in ways not determined by either a common intention held by legislators or an aggregation of the intentions of legislators. We explain how our view improves on existing accounts. We then apply it to three cases to demonstrate its implications for legal interpretation. Importantly, on the proposed account, legislative intent can depart from what individual legislators think or know.
Effects of Group Exercise on Motor Function and Mobility for Parkinson Disease: A Systematic Review and Meta-Analysis
Authors: Palm Diana , Swarowsky Alessandra , Gullickson Mackenzie , Shilling Holly , Wolden Mitch
Published: February 2024

Objective

Parkinson disease (PD) is associated with a predictable decline in motor function and mobility that is commonly managed with exercise. There is a limited understanding of the effects of group exercise compared to individual exercise (IE) and usual care (UC) on motor function and mobility. Our purpose was to investigate the effects of group exercise compared to IE and UC on motor function and mobility for people with PD.

Methods

A systematic review and meta-analysis was performed with randomized control trials that investigated the effects of group compared with IE and UC on motor function and mobility for people with PD. A systematic search was performed in PubMed, EBSCO, and Science Direct databases. Methodological quality was assessed using the Cochrane Grading of Recommendations Assessment, Development, and Evaluation approach.

Results

Twenty-three studies assessed at least 1 mobility-related outcome measure, met our inclusion criteria, and were included in quantitative analysis. There was no significant difference on motor function and mobility between group exercise and IE for all standardized outcome assessment meta-analyses. Motor function and mobility were significantly improved with group exercise compared to UC in 9 of 11 standardized outcome assessment meta-analyses. Results were based upon low to moderate quality of evidence.

Conclusion

Based upon low to moderate quality of evidence, group exercise has a similar to larger effect as IE and UC on improving motor function and mobility for people with PD. When used in combination with skilled physical therapy, group exercise may be an appropriate adjunct to individualized physical therapy to maximize mobility and function.

Impact

Long-term adherence to exercise is essential to maintain mobility and motor function for people with PD. Our study suggests group exercise is as effective as IE and may be an appropriate option to encourage long-term adherence related to increased access, socialization, and accountability.
Differences in management approaches for lupus nephritis within the UK
Authors: Ibrahim Sara T , Edwards Christopher J , Ehrenstein Michael R , Griffiths Bridget , Gordon Caroline , Hewins Peter , Jayne David , Lightstone Liz , McLaren Zoe , Rhodes Benjamin , Vital Edward M , Reynolds John A
Published: February 2024

Objectives

Outcomes of therapy for LN are often suboptimal. Guidelines offer varied options for treatment of LN and treatment strategies may differ between clinicians and regions. We aimed to assess variations in the usual practice of UK physicians who treat LN.

Methods

We conducted an online survey of simulated LN cases for UK rheumatologists and nephrologists to identify treatment preferences for class IV and class V LN.

Results

Of 77 respondents, 48 (62.3%) were rheumatologists and 29 (37.7%) were nephrologists. A total of 37 (48.0%) reported having a joint clinic between nephrologists and rheumatologists, 54 (70.0%) reported having a multidisciplinary team meeting for LN and 26 (33.7%) reported having a specialized lupus nurse. Of the respondents, 58 (75%) reported arranging a renal biopsy before starting the treatment. A total of 20 (69%) of the nephrologists, but only 13 (27%) rheumatologists, reported having a formal departmental protocol for treating patients with LN (P < 0.001). The first-choice treatment of class IV LN in pre-menopausal patients was MMF [41 (53.2%)], followed by CYC [15 (19.6%)], rituximab [RTX; 12 (12.5%)] or a combination of immunosuppressive drugs [9 (11.7%)] with differences between nephrologists’ and rheumatologists’ choices (P = 0.026). For class V LN, MMF was the preferred initial treatment, irrespective of whether proteinuria was in the nephrotic range or not. RTX was the preferred second-line therapy for non-responders.

Conclusion

There was variation in the use of protocols, specialist clinic service provision, biopsies and primary and secondary treatment choices for LN reported by nephrologists and rheumatologists in the UK.
Effective mission-oriented research: A new framework for systemic research impact assessment
Authors: Pfeifer Lena , Helming Katharina
Published: February 2024

Mission-oriented research combines a wide array of natural and social science disciplines to offer solutions for complex and multi-dimensional challenges such as climate change, loss of biodiversity, and scarcity of natural resources. The utilization of the outputs of mission-oriented research aims for changes in behavior, policy and practice resulting in real world impacts. Systematically assessing such research impacts and impact-generating processes is novel and offers great potential to plan for impactful research. This article develops a framework for systemic research impact assessment (RIA) on the basis of a literature review taking natural resource management (NRM) research as an example. The review compiles and analyzes 70 relevant RIA approaches. The resulting framework combines four components for improving societal impacts (1) an integrated component enabling reflection of impacts on all sustainability dimensions, (2) a missions component orienting toward societal goals to ensure societal relevance, (3) an inclusive component enabling wide participation to ensure legitimacy of research and its impact, and (4) a strategic component to choose appropriate assessment scales and time dimensions to ensure effectiveness. We provide suitable examples for the framework and we conclude with a call for an increased use of systemic and formative RIA that incorporate participatory strategies for research priority setting as well as socially deliberated target systems (e.g. SDGs), to plan for impactful mission-oriented research.
Developmental changes in brain function linked with addiction-like social media use two years later
Authors: Flannery Jessica S , Burnell Kaitlyn , Kwon Seh-Joo , Jorgensen Nathan A , Prinstein Mitchell J , Lindquist Kristen A , Telzer Eva H
Published: February 2024

Addiction-like social media use (ASMU) is widely reported among adolescents and is associated with depression and other negative health outcomes. We aimed to identify developmental trajectories of neural social feedback processing that are linked to higher levels of ASMU in later adolescence. Within a longitudinal design, 103 adolescents completed a social incentive delay task during 1–3 fMRI scans (6–9th grade), and a 4th self-report assessment of ASMU and depressive symptoms ∼2 years later (10–11th grade). We assessed ASMU effects on brain responsivity to positive social feedback across puberty and relationships between brain responsivity development, ASMU symptoms, and depressive symptoms while considering gender effects. Findings demonstrate decreasing responsivity, across puberty, in the ventral media prefrontal cortex, medial prefrontal cortex, posterior cingulate cortex, and right inferior frontal gyrus associated with higher ASMU symptoms over 2 years later. Significant moderated mediation models suggest that these pubertal decreases in brain responsivity are associated with increased ASMU symptoms which, among adolescent girls (but not boys), is in turn associated with increased depressive symptoms. Results suggest initial hyperresponsivity to positive social feedback, before puberty onset, and decreases in this response across development, may be risk factors for ASMU in later adolescence.
Zygomaticus activation through facial neuromuscular electrical stimulation (fNMES) induces happiness perception in ambiguous facial expressions and affects neural correlates of face processing
Authors: Efthimiou Themis Nikolas , Baker Joshua , Clarke Alasdair , Elsenaar Arthur , Mehu Marc , Korb Sebastian
Published: February 2024

The role of facial feedback in facial emotion recognition remains controversial, partly due to limitations of the existing methods to manipulate the activation of facial muscles, such as voluntary posing of facial expressions or holding a pen in the mouth. These procedures are indeed limited in their control over which muscles are (de)activated when and to what degree. To overcome these limitations and investigate in a more controlled way if facial emotion recognition is modulated by one’s facial muscle activity, we used computer-controlled facial neuromuscular electrical stimulation (fNMES). In a pre-registered EEG experiment, ambiguous facial expressions were categorised as happy or sad by 47 participants. In half of the trials, weak smiling was induced through fNMES delivered to the bilateral Zygomaticus Major muscle for 500 ms. The likelihood of categorising ambiguous facial expressions as happy was significantly increased with fNMES, as shown with frequentist and Bayesian linear mixed models. Further, fNMES resulted in a reduction of P1, N170 and LPP amplitudes. These findings suggest that fNMES-induced facial feedback can bias facial emotion recognition and modulate the neural correlates of face processing. We conclude that fNMES has potential as a tool for studying the effects of facial feedback.
Efficacy and safety of short- vs. standard-course antibiotics for culture-negative neonatal sepsis: a systematic review and meta-analysis
Authors: Devi Risha , Priyadarshi Mayank , Singh Poonam , Chaurasia Suman , Basu Sriparna
Published: February 2024

Objectives

To conduct a systematic review and meta-analysis of evidence from randomized controlled trials (RCTs) comparing a short course of antibiotics (2–4 days), to a standard course (5–7 days), for the treatment of culture-negative neonatal sepsis.

Methods

Relevant databases were searched for RCTs comparing short- vs. standard-course of antibiotics for culture-negative sepsis. The primary outcomes were mortality and treatment failure, defined as the reappearance of clinical signs suggestive of sepsis within 7 days of stoppage of antibiotics. Secondary outcomes included neurological impairment, duration of hospital stay, need for oxygen, respiratory support and double-volume exchange transfusion (DVET).

Results

Seven RCTs were included in the review with 729 neonates >30 weeks gestational age at birth. No mortality occurred in either of the groups (2 studies; 276 neonates). Treatment failure rates were similar in the short- and standard-course antibiotic groups [7 studies; 729 neonates; risk ratio (RR) = 1.01; 95% confidence interval (CI), 0.55 to 1.86; very low certainty]. The short course of antibiotics resulted in a shorter hospital stay [3 studies; 293 neonates; mean difference (MD), −2.46 days; 95% CI, −3.16 to −1.75]. There was no difference in the need for oxygen supplementation (2 studies; 258 neonates; RR, 1.40; 95% CI, 0.40 to 4.91), any respiratory support (2 studies; 258 neonates; RR, 1.04; 95% CI, 0.92 to 1.17) or DVET (2 studies; 258 neonates; RR, 1.29; 95% CI, 0.56 to 2.95).

Conclusion

Very-low certainty evidence suggests that a short antibiotic course, compared to a standard course, does not affect treatment failure rates in culture-negative neonatal sepsis. There is a need for well-designed RCTs powered enough to assess critical outcomes such as mortality and neurological sequelae to generate stronger evidence and inform guidelines.

PROSPERO registration number

CRD42023437199
SETD3 regulates endoderm differentiation of mouse embryonic stem cells through canonical Wnt signaling pathway
Authors: Alganatay Ceren , Balbasi Emre , Tuncbag Nurcan , Sezginmert Dersu , Terzi Cizmecioglu Nihal
Published: February 2024

With self‐renewal and pluripotency features, embryonic stem cells (ESCs) provide an invaluable tool to investigate early cell fate decisions. Pluripotency exit and lineage commitment depend on precise regulation of gene expression that requires coordination between transcription (TF) and chromatin factors in response to various signaling pathways. SET domain‐containing 3 (SETD3) is a methyltransferase that can modify histones in the nucleus and actin in the cytoplasm. Through an shRNA screen, we previously identified SETD3 as an important factor in the meso/endodermal lineage commitment of mouse ESCs (mESC). In this study, we identified SETD3‐dependent transcriptomic changes during endoderm differentiation of mESCs using time‐course RNA‐seq analysis. We found that SETD3 is involved in the timely activation of the endoderm‐related gene network. The canonical Wnt signaling pathway was one of the markedly altered signaling pathways in the absence of SETD3. The assessment of Wnt transcriptional activity revealed a significant reduction in Setd3‐deleted (setd3∆) mESCs coincident with a decrease in the nuclear pool of the key TF β‐catenin level, though no change was observed in its mRNA or total protein level. Furthermore, a proximity ligation assay (PLA) found an interaction between SETD3 and β‐catenin. We were able to rescue the differentiation defect by stably re‐expressing SETD3 or activating the canonical Wnt signaling pathway by changing mESC culture conditions. Our results suggest that alterations in the canonical Wnt pathway activity and subcellular localization of β‐catenin might contribute to the endoderm differentiation defect of setd3∆ mESCs.
Epidermal ET‐1 signal induces activation of resting hair follicles by upregulating the PI3K/AKT pathway in the dermis
Authors: Gao Ying , Fan Zhimeng , Xiao Xing , Kong Deqiang , Han Jimin , Chu Weiwei
Published: February 2024

The prevalence of alopecia has increased recently. Hair loss is often accompanied by the resting phase of hair follicles (HFs). Dermal papilla (DP) plays a crucial role in HF development, growth, and regeneration. Activating DP can revive resting HFs. Augmenting WNT/β‐catenin signaling stimulates HF growth. However, the factors responsible for activating resting HFs effectively are unclear. In this study, we investigated epidermal cytokines that can activate resting HFs effectively. We overexpressed β‐catenin in both in vivo and in vitro models to observe its effects on resting HFs. Then, we screened potential epidermal cytokines from GEO DATASETs and assessed their functions using mice models and skin‐derived precursors (SKPs). Finally, we explored the molecular mechanism underlying the action of the identified cytokine. The results showed that activation of WNT/β‐catenin in the epidermis prompted telogen–anagen transition. Keratinocytes infected with Ctnnb1‐overexpressing lentivirus enhanced SKP expansion. Subsequently, we identified endothelin 1 (ET‐1) expressed higher in hair‐growing epidermis and induced the proliferation of DP cells and activates telogen‐phase HFs in vivo. Moreover, ET‐1 promotes the proliferation and stemness of SKPs. Western blot analysis and in vivo experiments revealed that ET‐1 induces the transition from telogen‐to‐anagen phase by upregulating the PI3K/AKT pathway. These findings highlight the potential of ET‐1 as a promising cytokine for HF activation and the treatment of hair loss.
Predicting Medical Student Performance With a Situational Judgment Test in Admissions
Authors: Ballejos Marlene P. , Cestone Christina , Copeland H. Liesel , Dunleavy Dana M. , Geiger Thomas , Patel Dimple
Published: February 2024

Purpose

To explore correlations between AAMC situational judgment test (SJT) scores, other admissions data, and learners’ medical school performance.

Method

First- and second-year medical students from 8 U.S. MD-granting medical schools completed a prototype version of the AAMC SJT in 2017. Outcomes included research-only faculty ratings of student performance, final course grades, and faculty evaluations of student performance, 2017–2018 and 2018–2019 academic years. Bivariate correlations were used to investigate the relationship between SJT scores and student performance outcomes and hierarchical regressions to investigate whether SJT scores provided incremental validity over MCAT total scores and cumulative undergraduate grade point averages (UGPAs) for predicting student performance outcomes.

Results

In general, there were small positive correlations with research-only faculty ratings from the first year of medical school, with the highest for social skills/service orientation (r
corrected = .33, P < .05). Correlations were higher, with the highest for social skills/service orientation and cultural competence (r
corrected = .33 and .36, respectively, P < .05) in the second year in medical school. SJT scores improved prediction of research-only faculty ratings over MCAT total scores and UGPAs for reliability and dependability/capacity for improvement, cultural competence, social skills/service orientation, and the overall composite score in the first year and for resilience and adaptability, social skills/service orientation, cultural competence, and the overall composite score in the second year. SJT scores demonstrated small correlations with course grades (r
sample-weighted = .10, P = ns) and faculty evaluations related to professionalism skills (r
sample-weighted = .14, P < .05); however, MCAT total scores explained most of the variance associated with course outcomes.

Conclusions

These studies provide initial evidence that SJT scores may add value to the medical school admissions process because scores were related to faculty ratings of professional behaviors and provided unique information relative to MCAT scores and UGPAs.
Examining ChatGPT Performance on USMLE Sample Items and Implications for Assessment
Authors: Yaneva Victoria , Baldwin Peter , Jurich Daniel P. , Swygert Kimberly , Clauser Brian E.
Published: February 2024

Purpose

In late 2022 and early 2023, reports that ChatGPT could pass the United States Medical Licensing Examination (USMLE) generated considerable excitement, and media response suggested ChatGPT has credible medical knowledge. This report analyzes the extent to which an artificial intelligence (AI) agent’s performance on these sample items can generalize to performance on an actual USMLE examination and an illustration is given using ChatGPT.

Method

As with earlier investigations, analyses were based on publicly available USMLE sample items. Each item was submitted to ChatGPT (version 3.5) 3 times to evaluate stability. Responses were scored following rules that match operational practice, and a preliminary analysis explored the characteristics of items that ChatGPT answered correctly. The study was conducted between February and March 2023.

Results

For the full sample of items, ChatGPT scored above 60% correct except for one replication for Step 3. Response success varied across replications for 76 items (20%). There was a modest correspondence with item difficulty wherein ChatGPT was more likely to respond correctly to items found easier by examinees. ChatGPT performed significantly worse (P < .001) on items relating to practice-based learning.

Conclusions

Achieving 60% accuracy is an approximate indicator of meeting the passing standard, requiring statistical adjustments for comparison. Hence, this assessment can only suggest consistency with the passing standards for Steps 1 and 2 Clinical Knowledge, with further limitations in extrapolating this inference to Step 3. These limitations are due to variances in item difficulty and exclusion of the simulation component of Step 3 from the evaluation—limitations that would apply to any AI system evaluated on the Step 3 sample items. It is crucial to note that responses from large language models exhibit notable variations when faced with repeated inquiries, underscoring the need for expert validation to ensure their utility as a learning tool.
A Comparison of Montreal Cognitive Assessment Scores among Individuals with Normal Hearing and Cochlear Implants
Authors: Graves Emily A. , Sajjadi Autefeh , Hughes Michelle L.
Published: February 2024

Objectives:

The Montreal Cognitive Assessment (MoCA) is a cognitive screening tool that has 4 of 10 test items heavily dependent on auditory input, potentially leaving hearing-impaired (HI) individuals at a disadvantage. Previous work found that HI individuals scored lower than normal-hearing (NH) individuals on the MoCA, potentially attributed to the degraded auditory signals negatively impacting the ability to commit auditory information to memory. However, there is no research comparing how cochlear implant (CI) recipients perform on the MoCA relative to NH and HI individuals. This study aimed to (1) examine the effect of implementing three different hearing-adjusted scoring methods for a group of age-matched CI recipients and NH individuals, (2) determine if there is a difference between the two groups in overall scores and hearing-adjusted scores, and (3) compare scores across our CI and NH data to the published HI data for all scoring methods. We hypothesized that (1) scores for CI recipients would improve with implementation of the hearing-adjusted scoring methods over the original method, (2) CI recipients would score lower than NH participants for both original and adjusted scoring methods, and (3) the difference in scores between NH and CI listeners for both adjusted and unadjusted scores would be greater than that reported in the literature between NH and HI individuals due to the greater severity of hearing loss and relatively poor spectral resolution of CIs.

Design:

A total of 94 adults with CIs and 105 adults with NH were initially enrolled. After age-matching the two groups and excluding those who self-identified as NH but failed a hearing screening, a total of 75 CI participants (mean age 61.2 y) and 74 NH participants (mean age 58.8 y) were administered the MoCA. Scores were compared between the NH and CI groups, as well as to published HI data, using the original MoCA scoring method and three alternative scoring methods that excluded various auditory-dependent test items.

Results:

MoCA scores improved for all groups when two of the three alternative scoring methods were used, with no significant interaction between scoring method and group. Scores for CI recipients were significantly poorer than those for age-matched NH participants for all scoring methods. CI recipients scored better than the published data for HI individuals; however, the HI group was not age matched to the CI and NH groups.

Conclusions:

MoCA scores are only partly affected by the potentially greater cognitive processing required to interpret degraded auditory signals. Even with the removal of the auditory-dependent items, CI recipients still did not perform as well as the age-matched NH group. Importantly, removing auditory-dependent items significantly and fundamentally alters the test, thereby reducing its sensitivity. This has important limitations for administration and interpretation of the MoCA for people with hearing loss.
Cardiovascular complications of rheumatoid arthritis
Authors: Park Elizabeth , Bathon Joan
Published: February 2024

Purpose of review

Rheumatoid arthritis (RA) patients remain at higher cardiovascular (CV) risk compared to non-RA patients, driven by accelerated atherosclerosis, leading to plaque rupture and acute CV events (CVE), including heart failure (HF). It has been hypothesized that chronic inflammation is the main driving force behind such outcomes. We summarize the current evidence supporting this hypothesis, focusing on arterial disease and myocardial disease.

Recent findings

RA patients demonstrate higher prevalence of subclinical atherosclerosis (high risk plaque and arterial inflammation) compared to non-RA patients, with RA disease activity correlating independently with CVE and death. Nonischemic HF with preserved ejection fraction (HFpEF) is more common in RA compared to non-RA, with subclinical myocardial structural and functional alterations also more prevalent in RA. HFpEF and myocardial remodeling and dysfunction bear a strong and independent association with inflammatory correlates.

All of this suggests that inflammation contributes to enhanced risk of CVE in RA. A more accurate and specific CV risk stratification tool for RA, incorporating biomarkers or imaging, is needed. Likewise, more prospective studies outlining the trajectory from preclinical to clinical HF, incorporating biomarkers and imaging, are also needed.
Epidemiology of Schmorl’s Node in the Thoracic Spine
Authors: Que Yongsheng , Zhang Miaoru , Luo Xiaozhen , Xia Xing , Huang Yuantao , Wang Ce , Chen Min , Xu Junqing
Published: February 2024

Study Design.

Retrospective observational study.

Objective.

To describe the epidemiology of Schmorl’s nodes (SN) of primarily developmental cause (SNd) and SN of primarily acquired cause (SNa) separately in the thoracic spine in subjects aged 35-90 years old.

Summary of Background Data.

The epidemiology of SN and its relationship with age and gender remain controversial. Based on a pathophysiological hypothesis and the different morphological characteristics, two subtypes of SN may exist and should be considered separately.

Patients and Methods.

Chest CT scans of subjects who came to our institution for health check aged 35-90 years old were retrospectively reviewed. Presence or absence of SN was recorded for each thoracic vertebra. The SNs were further classified into SNd and SNa. The prevalence, location and relationship with age, gender and bone mineral density (BMD) were evaluated separately for the two subtypes.

Results.

Of the 848 subjects (407 female, mean age, 53±12.2 y) included, 15.7% had SNs. Of the 303 SNs, 49.2% were SNd and 48.5% were SNa. Aging increased the prevalence of SNa while it was not related to the prevalence of SNd. Males had significantly more SNd than females (11.3% vs 4.7%, P<0.001), while the prevalence of SNa was not different between the two genders (10.2% vs 9.1%, P=0.666). A similar distribution of SNd and SNa among thoracic vertebral levels was appreciated, with T9 most frequently involved. Subjects with SNa had lower lumbar BMD than controls (P=0.006), while no significant difference in BMD was found between subjects with SNd and controls (P=0.166).

Conclusions.

The clinical characteristics of SN differ based on the developmental and acquired subtype, including the relationship with age, gender and BMD. The subtypes may be considered as distinct clinical entities as a result.
Review of Fractional Nonablative Lasers for the Treatment of Dermatologic Conditions in Darker Skin Phototypes
Authors: Aggarwal Ishita , Rossi Marcus , Puyana Carolina , Tsoukas Maria
Published: February 2024

BACKGROUND

Fractional nonablative lasers (NAFLs) have demonstrated efficacy and safety for treating dermatologic conditions in patients with darker skin phototypes. Nonablative lasers are preferred in darker skin tones due to lower risk of postinflammatory hyperpigmentation.

OBJECTIVE

This review aims to identify the ideal laser options and parameters for treating common dermatologic conditions in patients with skin types IV-VI.

MATERIALS AND METHODS

A comprehensive literature search was conducted on PubMed in May 2023. Of 1,065 articles were identified, and 40 articles met the inclusion criteria. The studies were classified based on design, dermatologic condition, and skin phototype of patients, and assigned levels of evidence according to the Modified Criteria of the Oxford Center of Evidence Based Medicine.

RESULTS

Strong level 1 evidence supports the treatment of melasma and atrophic scars using NAFL. Moderate level 2 evidence was found for using NAFL in acne vulgaris, striae, and skin rejuvenation; 45% of the studies examined skin types III-IV, 20% III-V, 7.5% II-IV, 5% II-V, 5% IV alone, and 2.5% I-IV.

CONCLUSION

Further research is needed to determine the optimal treatment modalities and parameters for skin types V and VI. Appropriate device selection and conservative treatment settings are crucial for optimizing outcomes and minimizing adverse events.
Study on core competencies of midwives in China
Authors: Sun Kejuan , Qi Jinghan , Luo Bin , Yang Lisha , Shu Chang , Tang Huijun , Qin Yanyue , Zang Yu
Published: February 2024

The aim of this study is to investigate the core competencies of midwives in China. Combination of qualitative research and quantitative research. A total of 100 midwives in 3 tertiary (Grade 3) hospitals in Shijiazhuang were investigated by using the Midwife Core Competency Scale, and simultaneously followed by semi-structured interviews with 12 midwives. The questionnaire survey showed that the average score of core competencies of midwives was 4.17 ± 0.17. The scores of midwives’ competency for labor and delivery care (4.31 ± 0.09), new-born care (4.29 ± 0.04), and postpartum care (4.25 ± 0.13) were relatively high, while the prepregnancy care had the lowest score (3.88 ± 0.07). The interview results showed that the self-perception of core midwifery competencies was not bad, the limitations of midwives’ work scope affect the core competencies, and midwifery education needs to strengthen the humanistic care and the training of obstetric knowledge and technology.
Black hairy tongue treated with traditional Chinese medicine: A case report
Authors: Kuo Po-Yuan , Chen Ping-Ho , Wu Shan-Hong
Published: February 2024

Rationale:

Black hairy tongue (BHT) is a rare condition that is conventionally managed by discontinuing associated medications or habits and practicing good oral hygiene, including tongue brushing. Previous studies have indicated that black tongue coating is often associated with gastrointestinal discomfort, which traditional Chinese medicine (TCM) could be a potentially effective option for treating this condition with minimal side effects. We present a case of BHT diagnosed and treated within 2 weeks by using TCM methods.

Patient concerns:

A 73-year-old woman presented with a chief concern of a black tongue that had persisted for 2 weeks and was accompanied by thirst and diarrhea. These symptoms were initially observed during her hospitalization for the treatment of staghorn calculi, xanthogranulomatous pyelonephritis, and urosepsis. Using the “four diagnostic methods” of TCM, we observed that her tongue had a thick black coating surrounded by a thick white coating; her tongue was of medium size with tooth marks, and its body color was light red.

Diagnoses, interventions, and outcomes:

On the basis of TCM theory, we made a clinical diagnosis of BHT and “spleen Qi deficiency with turbid dampness,” which may have been caused by the antibiotic treatment during hospitalization. Subsequently, we administered a Chinese herbal medicine (CHM) formula comprising a combination of Wu-Ling-San (五苓散) and a modification of Da-Yuan-Yin (達原飲). After 2 weeks of CHM treatment, the patient’s BHT was nearly eliminated, and the thick white coating and the corresponding symptoms were ameliorated. After 4 weeks of CHM treatment, the BHT was completely resolved.

Lesson and conclusion:

We present a case of BHT, a benign condition that may be caused by antibiotics. The literature does not contain reports on TCM-based diagnosis and treatment strategies for BHT. Using the 4 diagnostic methods of TCM, we observed that BHT was associated with gastrointestinal symptoms, which is consistent with the TCM theory. Moreover, CHM treatment rapidly relieved BHT and related symptoms without adverse events.
The first Vietnamese patient who presented late onset of pantothenate kinase-associated neurodegeneration diagnosed by whole exome sequencing: A case report
Authors: Tran Van Khanh , Vu Chi Dung , Tran Hai Anh , Lien Nguyen Thi Kim , Tung Nguyen Van , Lan Nguyen Ngoc , Tran Huy Thinh , Hoang Nguyen Huy
Published: February 2024

Rationale:

Pantothenate kinase-associated neurodegeneration (PKAN), also called Hallervorden-Spatz syndrome, is a rare autosomal recessive disease associated with brain iron accumulation and characterized by progressive dystonia, dementia, and dysarthria symptoms. PKAN, caused by a defective pantothenate kinase 2 (PANK2) gene, is the most common neurodegeneration with a brain iron accumulation (NBIA) group. The “eye of the tiger” sign in the magnetic resonance imaging demonstrated a bilateral hyperintense signal in the basal ganglia region on T2-weighted images, which is a characteristic feature of the diagnosis. PKAN is classified into 2 main types. The early-onset type (classic type) with rapid progression is characterized by symptoms of gait impairment and dystonia leading to loss of ambulation in early childhood. In the later-onset type (atypical type), slow progression usually takes place in the second decade of life with symptoms of neurodegeneration, dystonia, dysarthria, rigidity, choreoathetosis, and motor impairment. Until now, PKAN patients have only been reported in a few countries in Asia such as China, Korea, India, Iran, Taiwan, and Thailand.

Patient concerns:

Here we report the first case of PKAN in Vietnam. The patient had a late onset but the disease progresses rapidly with symptoms of dyskinesia, dysphagia, and difficulty speaking.

Diagnoses:

Pantothenate kinase-associated neurodegeneration.

Interventions:

Whole exome sequencing was performed to identify heterozygous mutations in the PANK2 gene (NM_153638.4) (c.856C>T, p.Arg286Cys and c.1351C>T, p.Arg451Ter) that has been confirmed as the cause of the disease.

Outcomes:

In this study, the first Vietnamese patient with late-onset PKAN was diagnosed by the whole exome sequencing method.

Lessons:

The patient’s case marks an important milestone for the first case in Vietnam. The results of the study will provide a scientific basis for clinicians in the diagnosis and genetic counseling of patients.
Difficult airway code activation for emergency endotracheal intubation outside the operating room in a tertiary care university hospital of Thailand: A single-center retrospective observational study
Authors: Buasuk Tarinee , Khongcheewinrungruang Nalinpas , Suphathamwit Aphichat
Published: February 2024

Emergency airway management outside the operating room (OR) is a higher risk procedure as compared to the OR setting. Inappropriate airway management leading to complications, including pulmonary aspiration, dental trauma, esophageal intubation, prolonged recovery, unplanned intensive care unit admission and death. The emergency difficult airway management team of Siriraj hospital has been established since 2018 under the name of Code-D delta. The aim of this study is to determine the rate of Code D-delta activation, the performance of the code, the complications and outcome of the patients. This is a single-centered, observational, and retrospective study included all adult patient who was emergency intubated outside the OR between July and November 2020. The criteria for code D-delta activation included failed intubation for more than 2 attempts and suspected difficult intubation. The collected data were categorized into Code D-delta activation and non-activation group. The primary outcome was a frequency of Code D-delta activation. The demographic data, ward and indication of activation, intubation process, the complications of intubation were also collected and analyzed. During the study period, 247 patients with 307 intubations were included. The incidence of code D-delta activation was 8.14%. Regarding indication of activation, failed intubation more than 2 attempts was 40%, while suspected difficult intubation was 92%. Respiratory failure was the highest main diagnosis at 36%. The highest rate of activation was from medicine ward (60%), followed by surgery ward (16%) and emergency department (16%). Regarding the code responses and intubation performance, 7 and 10 minutes were the median time from call to scene in- and out- of official hours. The success rate of intubation at scene by code D-delta team was 85%. The airway and other complications were comparable between groups. This is the first study about emergency difficult airway management team in university hospital of Thailand. This study showed the rate of Code-D delta activation, the emergency airway management code, was 8.14% with the success rate of 85% at scene. Emergency airway management outside the operating room is particularly challenging. Airway assessment, planning, decision making of the team relevant to the patients outcomes.
Visualizing research trends and identifying hotspots of herbal components for treating cardiovascular diseases: A bibliometric analysis from 2000 to 2023
Authors: Chen Ying , Li Wen-Wen , Bi Si-Ling , Zhang He-Meng , Sun Zhenhai , Zuo Yao-Yao , Xu Liang , Chen Shou-Qiang
Published: February 2024

Objective:

The objective of this study was to investigate the global research trends in herbal medicine for the treatment of cardiovascular disease (CVD) from 2000 to 2023. A bibliometric approach was employed to analyze international collaborations, knowledge structures, emerging trends, and research frontiers.

Method:

The Web of Science (WOS) core collection was utilized as the database, employing the search formula (((TS = (traditional Chinese medicine)) OR TS = (Chinese herbal medicinal ingredient)) OR TS = (Chinese herbal medicinal constituent)) AND TS = (cardiovascular disease) to conduct the search. The search period spanned from January 1, 2000, to February 14, 2023, and the literature type included articles and reviews.

Results:

A total of 1478 papers were included in the analysis after searching the WOS database and excluding conference proceedings, news articles, retractions, editorials, and letters. China demonstrated the highest number of publications, followed by the United States and Taiwan (China). The institution with the highest publications was the Chinese Academy of Medical Sciences. China, the United States, and India were the main countries involved in research in this field, and there was significant collaboration among them. The hotspots related to herbal components for treating cardiovascular diseases from 2000 to 2023 included systematic reviews, ischemic reperfusion injury, global burden, type 2 diabetes, and protection.

Conclusion:

This paper provides a reference for the future development of herbal research in cardiovascular aspects by revealing the current status, hotspots, and trends of global herbal research in cardiovascular factors over more than 20 years. Identification of potential collaborators and institutions can assist researchers in exploring new directions for future research and discovering new perspectives for potential collaborations in this field.