bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical phenotypes of heart failure patients with supranormal ejection fraction
Authors: Huang Liyan , Feng Jiayu , Zhai Mei , Huang Yan , Zhou Qiong , Zhang Yuhui , Zhang Jian
Published: August 2024

Aims

Heart failure (HF) with supranormal ejection fraction (HFsnEF) represents a distinct clinical entity characterized by limited treatment options and an unfavourable prognosis. Revealing its phenotypic diversity is crucial for understanding disease mechanism and optimizing patient management. We aim to identify phenotypic subgroups in HFsnEF using unsupervised clustering analysis.

Methods

Consecutive hospitalized patients with a diagnosis of HF and a left ventricular ejection fraction ≥65% at baseline echocardiographic evaluations were included for analysis. We conducted unsupervised hierarchical clustering analysis on principal components (HCPC) to identify HFsnEF phenogroups using mixed data variables including demographics, HF duration, vital signs, anthropometrics, smoking/drinking status, HF aetiology, comorbid diseases, laboratory tests and echocardiographic parameters. We then employed decision tree modelling to identify parameters capable of distinguishing distinct clusters. Clinical outcomes, including all‐cause death, cardiovascular (CV) death and CV readmission for different clusters, were examined.

Results

Three mutually exclusive clusters were identified from the cohort of 221 HFsnEF patients. Cluster 1 (52.5%) predominantly consisted of patients with valvular heart disease, who had larger cardiac chambers and a higher prevalence of atrial fibrillation/atrial flutter. Cluster 2 (26.2%) primarily comprised older ischaemic patients with a higher prevalence of metabolic comorbidities. Cluster 3 (21.3%) were mainly hypertrophic cardiomyopathy patients. Two clinical variables were identified that could be used to group all HFsnEF patients into one of the clusters; they were HF aetiology and comorbid diabetes. During the median follow‐up of 53.4 months, 46 (20.8%) all‐cause deaths occurred, among them 39 of CV causes. Seventy (31.7%) patients experienced CV readmissions. Three clusters showed distinct differences in mortality outcomes, with Cluster 1 exhibiting the highest risk of all‐cause mortality [Cluster 1 vs. Cluster 2: adjusted hazard ratio (aHR) = 3.32, P = 0.022; Cluster 1 vs. Cluster 3: aHR = 3.81, P = 0.036; Cluster 2 vs. Cluster 3: aHR = 1.15, P = 0.865] and CV mortality (Cluster 1 vs. Cluster 2: aHR = 3.73, P = 0.022; Cluster 1 vs. Cluster 3: aHR = 4.27, P = 0.020; Cluster 2 vs. Cluster 3: aHR = 1.15, P = 0.870). CV readmission risk was comparable among the three clusters (Cluster 1 vs. Cluster 2: aHR = 0.82, P = 0.590; Cluster 1 vs. Cluster 3: aHR = 1.04, P = 0.900; Cluster 2 vs. Cluster 3: aHR = 1.28, P = 0.580).

Conclusions

In a heterogeneous HFsnEF cohort, three clusters were identified by unsupervised HCPC with distinct clinical characteristics and outcomes.
How to find the best sampling design: A new measure of spatial balance
Authors: Prentius Wilmer , Grafström Anton
Published: August 2024

We present a novel measure to assess the spatial balance of a sample by utilizing the balancing equation, which captures the balance between the sample units and their neighbours. Spatially balanced samples are desirable as they may reduce the variance of an estimator of a population parameter. If the auxiliary variables we employ to spread the sample possess high explanatory power for the variable(s) of interest, the resulting reduction in variance can be substantial. An advantageous aspect of using auxiliary variables is that their availability is not contingent upon the sampling effort. Therefore, we can assess and compare sampling designs before committing resources to full‐scale surveys. By comparing the proposed measure with commonly used measures of spatial balance, we ascertain that our measure consistently yields meaningful insights regarding the spatial balance of samples. Consequently, our measure can effectively differentiate between various designs when planning a survey, evaluate the potential gains from replacing an existing sample, and determine which non‐responding units would contribute the most to enhancing the set of responding units.
Memory compromise at extended delays in people with new‐onset epilepsy
Authors: Pugh Remy , Vaughan David N. , Jackson Graeme D. , Ponsford Jennie , Tailby Chris
Published: August 2024

Objective

Memory is one of the most sensitive markers of cognitive compromise in people with new‐onset epilepsy. Nonetheless, around half of these cases score within the normal range on standard memory testing. Here we explore whether memory retention at a 1‐week delay reveals otherwise undetected memory compromise in such individuals, and how it relates to subjective memory complaints and mood.

Methods

Using a prospective design, 38 adults with new‐onset epilepsy underwent baseline memory screening via telephone using an abbreviated Rey Auditory Verbal Learning Test (RAVLT). Psychological screening occurred via online questionnaires. One week later, without forewarning, participants completed three follow‐up memory tasks. Of particular focus, we explored longer‐term memory performances and forgetting trajectories in those individuals (n = 23) who demonstrated normal memory performances (scores >10th percentile) at baseline (30‐min delay). Outcomes were compared to 32 healthy controls, matched for age, sex, and education.

Results

As a group, people with epilepsy performed worse than controls on all memory measures, with 44 percent impaired at baseline testing. Of those unimpaired at baseline, the rate and volume of information loss over 1 week was significantly greater than for controls. Contextual memory performance at 1 week was also significantly poorer for people with epilepsy. At the individual level, the prevalence of impaired forgetting was not significantly different between patients and controls. Subjective memory complaints were not related to any objective tests but were strongly related to self‐reported mood and anxiety symptoms.

Significance

People with new‐onset epilepsy show reduced memory at short and extended intervals. For those showing normal memory at baseline, information does appear to be forgotten more quickly than in healthy controls, though the effect is not large. The findings indicate that while extended delay memory testing is not essential in all new epilepsy cases, it could provide useful information for particular individuals.

Plain Language Statement

Memory problems are common in people with epilepsy shortly after seizure onset, however, many individuals still show normal memory performances on standard neuropsychological testing. Through testing memory at an extended timepoint (1 week), our study found that on average, these individuals showed a slightly quicker rate of forgetting over a 1‐week period than people without a brain condition. Self‐reported memory complaints in people with new epilepsy were unrelated to their actual memory skills on testing at short and long timepoints but were rather linked to lower mood and quality of life.
Importance of vegetation in riverbank resilience: An experimental approach
Authors: Barman Jyotirmoy , Kumar Bimlesh
Published: August 2024

Floodplain (FP) vegetation determines the flow structures in river channels based on its shape, type, spacing and root‐soil binding capacity. The present study focuses on experimental approach to understand the role of FP vegetation in determining the flow patterns and morphological changes in the channels. Flow properties like streamwise and transverse velocity, along with secondary flow and turbulent kinetic energy, were compared between rectangular and compound channels considering partial vegetation cover. The presence and absence of dip phenomenon in the main channel (MC) of compound and rectangular channel respectively suggest that the dip phenomenon is influenced by both vegetation emergence in FPs and differential cross‐sectional depths of compound channels. The secondary flow direction in the slopes and MC of compound channel is towards the FP region which is opposite to that observed in rectangular channel where secondary flow is towards MC showing the effect of non‐uniform cross‐section of compound channels. The morphological changes were analysed by performing experiments in unsymmetrical erodible riverbank channels with bankfull condition considering artificial rigid FP vegetation (Phragmites karka) and naturally growing flexible vegetation (Oryza sativa). After more than 24 h of continuous experimental runs, the O. sativa remains intact in the soil because of development of strong root‐soil bond whereas; all the P. karka gets uprooted. The channel cross‐section in the downstream channel becomes almost uniform for P. karka, whereas differential cross‐sectional height is observed for O. sativa. This study shows that along with the shapes and size of vegetation, root‐soil binding capacity also determines the morphological changes in river channels. Furthermore, it also shows the importance of growing vegetation in the laboratory to properly simulate vegetation observed in river channels.
Sublethal Imidacloprid Administration to Honey Bee Workers is More Lethal to the Queen Larvae
Authors: Chen Yun-Ru , Tzeng David T. W. , Lin Shih-Shun , Yang En-Cheng
Published: August 2024

Imidacloprid and other neonicotinoid insecticides severely impact the performance and survival of honey bees and other pollinators. In the present study, we focused on the gene expression profile of newly emerged Apis mellifera queen bees after sublethal imidacloprid treatment during the larval stage. Royal jelly containing 1 ppb imidacloprid was provided to larvae for 3 consecutive days (2–4 days postemergence). Queen larvae treated with imidacloprid showed lower capping and emergence rates (35.5% and 24.22%, respectively) than did control larvae (61.68% and 52.95%, respectively), indicating a high failure rate of queen rearing associated with imidacloprid exposure during the larval stage. The molecular response to imidacloprid treatment was examined next. By comparing the gene expression profiles of imidacloprid-treated queen larvae and those of control queen larvae using DESeq2, we identified 215 differentially expressed genes, with 105 and 111 up- and downregulated genes, respectively. Gene Ontology results indicated that chitin binding– and calcium ion binding–related genes were upregulated, while phototransduction- and visual perception–related genes were downregulated. The high mortality rate and altered gene expression profiles suggest that treatment with even 1 ppb imidacloprid can severely impact queen bee survival. Environ Toxicol Chem 2024;43:2232–2242. © 2024 SETAC
Case study of a cluster of simple and complex monogenetic volcanoes in the north‐east part of the Michoacan–Guanajuato Volcanic Field, Central Mexico: Nomenclature implications
Authors: Kshirsagar Pooja , Aviles Raúl Miranda , de Puy y Alquiza María Jésus , Chako Tchamabe Boris , Dominguez Andrés Josué Campos
Published: August 2024

With the advent of new terminologies to categorize and characterize the simple and complex monogenetic volcanoes, also came the semantic issues, which caused a predicament for the usage of terms like simple, complex, polycyclic, polymagmatic, complex monogenetic volcanoes with polygenetic inheritance. To analyse and validate this nomenclature, we studied an overlapping volcanic structure located south of the present‐day town of Irapuato, Central Mexico, that appears to be a monogenetic complex at first sight. Field observations, tephra stratigraphy, petrography and geochemistry of the tephra deposits confirms that the structure is in fact a cluster of three simple (San Joaquin tuff ring and two scoria mounds) and one complex, polycyclic, polymagmatic (La Sanabria‐San Roque tuff ring) monogenetic volcanoes formed by independent events, governed by distinct conduits and magma bodies of different origin (subduction‐related, OIB and E‐MORB origin) and separated by different tephra sequences of dissimilar components and depositional characteristics. We estimate the magma volumes (using the juvenile content and their vesicularity percentage) to be at 0.40–1.31 × 108, 0.25 × 108 and 0.42–0.90 × 108 m3 for San Joaquin, La Sanabria and San Roque, reckoning an eruption duration of 77 and 48 and 81 days, respectively (considering an average eruption rate of 6 m3/s from the well‐documented shallow crater (<30 m), Ukinrek maars in Alaska) occurring within the age range of 40–70 k years (crater diameter and depth ratio). This study not only aided to validate the above‐mentioned terms for monogenetic volcanoes, but also reconsider a few of them and avoid confusion with the polygenetic counterparts.
Comparing physical therapist clinical specialists to experienced nonspecialists on physical activity education for patients with heart failure: A modified retrospective cohort study
Authors: Prince Tamira , Cahalin Lawrence P. , Cohen Meryl , Hartley Gregory W. , Kirk‐Sanchez Neva , Roach Kathryn E.
Published: August 2024

Background and Aims

The purpose of this study was to compare the knowledge and practices of specialist and experienced nonspecialist physical therapists in performing patient education about physical activity with patients with heart failure (HF).

Methods

Responses on a nationwide anonymous online survey were used to compare specialist and experienced nonspecialist physical therapists on knowledge and frequency of providing physical activity related education to patients hospitalized with acutely decompensated HF. Responses to survey items were scored on 5‐point scales ranging from “Strongly agree” to “Strongly disagree” or “Always” to “Never.” Mann−Whitney U statistics were used to compare specialist and experienced nonspecialist responses and Wilcoxon signed‐ranks tests were used to examine the gap between knowledge and practice.

Results

Twenty‐seven specialists and 43 experienced nonspecialists completed the survey. Both groups were similar in age, and experience treating patients hospitalized with acutely decompensated HF. Both groups “strongly agree” that they had the required knowledge and skills to educate patients with HF on the physical activity topics. However, specialists more often than experienced nonspecialists provided education on topics such as how to monitor vital signs during physical activity (“most of the time” vs. “about half of the time”) that promoted patient confidence and safety during exercise. Specialists demonstrated a smaller gap between knowledge and frequency of providing patient education than experienced nonspecialists on three of the four patient education topics.

Conclusion

Specialist physical therapists treating patients with HF in the inpatient hospital setting provided patient education on physical activity at a level more closely matching their skills and the clinical practice guideline than did experienced nonspecialists. Physical therapy clinical specialists practicing in the inpatient hospital setting may improve patient outcomes and lower costs to the health care system by improving physical activity adherence and thereby may reduce avoidable hospital readmissions.
Extracellular adenosine oppositely regulates the purinome machinery in glioblastoma and mesenchymal stem cells
Authors: Pietrobono Deborah , Russo Lara , Bertilacchi Maria Sofia , Marchetti Laura , Martini Claudia , Giacomelli Chiara , Trincavelli Maria Letizia
Published: August 2024

Glioblastoma (GB) is a lethal brain tumor that rapidly adapts to the dynamic changes of the tumor microenvironment (TME). Mesenchymal stem/stromal cells (MSCs) are one of the stromal components of the TME playing multiple roles in tumor progression. GB progression is prompted by the immunosuppressive microenvironment characterized by high concentrations of the nucleoside adenosine (ADO). ADO acts as a signaling molecule through adenosine receptors (ARs) but also as a genetic and metabolic regulator. Herein, the effects of high extracellular ADO concentrations were investigated in a human glioblastoma cellular model (U343MG) and MSCs. The modulation of the purinome machinery, i.e., the ADO production (CD39, CD73, and adenosine kinase [ADK]), transport (equilibrative nucleoside transporters 1 (ENT1) and 2 (ENT2)), and degradation (adenosine deaminase [ADA]) were investigated in both cell lines to evaluate if ADO could affect its cell management in a positive or negative feed‐back loop. Results evidenced a different behavior of GB and MSC cells upon exposure to high extracellular ADO levels: U343MG were less sensitive to the ADO concentration and only a slight increase in ADK and ENT1 was evidenced. Conversely, in MSCs, the high extracellular ADO levels reduced the ADK, ENT1, and ENT2 expression, which further sustained the increase of extracellular ADO. Of note, MSCs primed with the GB‐conditioned medium or co‐cultured with U343MG cells were not affected by the increase of extracellular ADO. These results evidenced how long exposure to ADO could produce different effects on cancer cells with respect to MSCs, revealing a negative feedback loop that can support the GB immunosuppressive microenvironment. These results improve the knowledge of the ADO role in the maintenance of TME, which should be considered in the development of therapeutic strategies targeting adenosine pathways as well as cell‐based strategies using MSCs.
Development of the cranial lateral line system of Brook Trout, Salvelinus fontinalis (Teleostei: Salmonidae): Evolutionary and ecological implications
Authors: Jones Aubree E. , Rizzato Pedro P. , Webb Jacqueline F.
Published: August 2024

The mechanosensory lateral line (LL) system of salmonid fishes has been the focus of comparative morphological studies and behavioral and physiological analyses of flow sensing capabilities, but its morphology and development have not been studied in detail in any one species. Here, we describe the post‐embryonic development of the cranial LL system in Brook Trout, Salvelinus fontinalis, using vital fluorescent staining (4‐Di‐2‐ASP), scanning electron microscopy, µCT, and clearing and staining to visualize neuromasts and the process of cranial LL canal morphogenesis. We examined the relationship between the timing of LL development, the prolonged life history of salmonids, and potential ecological implications. The LL system is composed of seven canals containing canal neuromasts (CNs) and four lines of superficial neuromasts (SNs) on the skin. CNs and SNs increase in number and size during the alevin (larval) stage. CN number stabilizes as canal morphogenesis commences, but SN number increases well into the parr (juvenile) stage. CNs become larger and more elongated than SNs, but the relative area occupied by sensory hair cells decreases during ontogeny in both types of neuromasts. Neuromast‐centered canal morphogenesis starts in alevins (yolk sac larvae), as they swim up into the water column from their gravel nests (~4 months post‐fertilization), after which yolk sac absorption is completed and exogenous feeding begins. Canal morphogenesis proceeds asynchronously within and among canal series and is not complete until ~8 months post‐fertilization (the parr stage). Three characters in the LL system and associated dermal bones were used to identify their homologs in other actinopterygians and to consider the evolution of LL canal reduction, thus demonstrating the value of salmonids for the study of LL evolution. The prolonged life history of Brook Trout and the onset of canal morphogenesis at swim‐up are predicted to have implications for neuromast function at these critical behavioral and ecological transitions.
Exploring the interplay between Kaposi's sarcoma and SARS‐CoV‐2 infection: A case series and systematic review
Authors: Pietroluongo Erica , Luciano Angelo , Peddio Annarita , Buonaiuto Roberto , Caltavituro Aldo , Servetto Alberto , De Angelis Carmine , Arpino Grazia , Palmieri Giovannella , Veneziani Bianca Maria , De Placido Sabino , Bianco Roberto , De Placido Pietro , Giuliano Mario
Published: August 2024

Kaposi's sarcoma (KS) is an angio‐proliferative disease with a viral etiology and a multifactorial pathogenesis that results from immune dysfunction. In patients affected by latent viral infections such as herpesviruses, SARS‐CoV‐2 infection may result in lytic cycle reactivation in host cells. A robust immune system response is crucial for eliminating pathogens and resolving both latent and non‐latent viral infections. We report a case series of KS characterized by tumor progression after SARS‐CoV‐2 infection. We performed a systematic literature review of the PubMed/MEDLINE and EMBASE databases. The keyword terms included “SARS‐CoV‐2,” “HHV‐8,” “Kaposi's sarcoma,” “IL‐6,” and “COVID‐19.” English language restriction was applied. Items not covered by our study were excluded. KS is a complex disease linked to an impaired immune system. Conditions that result in temporary or permanent immunodeficiency can trigger viral reactivation or exacerbate an existing disease. It is feasible that the increase in cytokine levels in COVID‐19 patients, coupled with lymphocyte downregulation and treatment that induces herpesvirus lytic reactivation, may contribute to the progression of KS after SARS‐CoV‐2 infection. These observations suggest that patients with KS should be clinically monitored both during and after SARS‐CoV‐2 infection. Nevertheless, prospective data should be collected to validate this hypothesis and enhance our understanding of the mechanisms implicated in the onset or progression of KS.
Macroporous polymeric resin for the purification of flavonoids from medicinal plants: A review
Authors: Aljawarneh Raghad Yousef Ali , Che Zain Mohamad Shazeli , Zakaria Fauziahanim
Published: August 2024

The purification of flavonoids using the macroporous polymer resin method has gained attention in recent years due to its simplicity, precision, cost‐effectiveness, and the ability to separate flavonoids from other constituents. Several studies have been conducted to investigate the efficiency and effectiveness of macroporous polymer resin in purifying flavonoids from various plant sources. This review aims to evaluate the existing literature on macroporous polymer resin purification of flavonoids and provide a comprehensive analysis of the current research trends and advancements in this field. It also highlights the importance of optimizing the adsorption parameters and conditions such as resin type, resin concentration, pH, and temperature for efficient purification of flavonoids using macroporous polymer resin. The key findings of this review reveal that macroporous resins with weak polarity, large surface areas, and pore diameters have a stronger adsorption capacity for flavonoids compared to polar resins. Furthermore, ultrasonic‐solvent assisted extraction often combines with macroporous resin for effective the extraction and purification of flavonoids.
Histo‐Anatomy and Sonographic Examination for the Retrocalcaneal Bursal Complex: EURO‐MUSCULUS/USPRM Approach
Authors: Ricci Vincenzo , Cocco Giulio , Mezian Kamal , Chang Ke‐Vin , Tamborrini Giorgio , Naňka Ondřej , Özçakar Levent
Published: August 2024

Insertional Achilles tendinopathy is an umbrella medical term referring to pain and swelling on the posterior aspect of the calcaneus. High‐resolution ultrasound imaging is commonly used in daily practice to assess the pathological changes of the Achilles tendon, cortical bone of the calcaneus, and soft tissues located inside the retrocalcaneal space to optimize the management of relevant patients. To the best of our knowledge, a standardized ultrasound protocol to evaluate the retrocalcaneal bursal complex is lacking in the pertinent literature. In this sense, our step‐by‐step sonographic approach is intended to be an easy and ready‐to‐use guide for sonographers/physicians in daily practice to assess this anatomical complex in patients with Achilles tendinopathy. Needless to say, the peculiar histological features of this V‐shaped synovial/fibrocartilaginous bursa surrounding the posteroinferior wedge of the Kager's fat pad and the retrocalcaneal space make the examination challenging.
Ultrasound‐Guided Polypectomy
Authors: Sarkar Papri , Vest Adriana , Baker Marisa , Hochberg Lauri Silver
Published: August 2024

Objective

To present a novel technique for office resection of pedunculated endometrial polyps under ultrasound guidance.

Methods

A prospective trial was conducted at an academic center where women with abnormal uterine bleeding (AUB) who were diagnosed an endometrial polyp following saline infusion sonogram (SIS), were offered polyp removal under ultrasound guidance using a universal grasping forceps (2.5 mm × 25 cm). The primary outcome was to evaluate the feasibility of this technique for complete removal of the polyp. The secondary outcomes were to evaluate the patients' pain score, satisfaction score using visual analogue score (VAS), and efficacy of the technique in alleviating symptoms in patients with AUB due to polyps.

Results

Thirty patients participated, with a mean age of 54.8 ± 11 years. Average polyp volume was 1.87 cm3 and mean duration for polypectomy was 11 minutes 31 seconds. The median pain score immediately post‐procedure was 5 (0–9). We were unable to complete the procedure in two patients due to patient discomfort and poor visualization. Complete removal of polyp was ensured by checking for a thin endometrial echo at the end of the procedure and by performing SIS at 3‐months post‐procedure. Of the 22 patients who returned for follow‐up, 19 (86.36%) showed no evidence of polyp on SIS and all reported resolution of AUB symptoms. The median satisfaction score at the follow‐up was 10/10. Adequate pathology samples were obtained from all cases, diagnosing malignancy in one and endometrial hyperplasia in one patient.

Conclusion

This technique offers safe and effective removal of pedunculated endometrial polyps in an office setting, avoiding the need for general anesthesia. It can be offered as a therapeutic option at the initial point of contact, providing symptom relief and tissue diagnosis while reducing costs and patient visits.
Prenatal Diagnosis of Persistent Left Superior Vena Cava Using High‐Definition Flow Render Mode and Spatiotemporal Image Correlation
Authors: Li Tian‐gang , Wu Wen‐rui , Ma Bin , Yan Zhi‐heng , Niu Ke‐xiong
Published: August 2024

Objective

This study aimed to assess the use of two‐dimensional (2D) ultrasound combined with high‐definition flow (HD‐flow) render mode and spatiotemporal image correlation (STIC) in diagnosing and classifying fetal persistent left superior vena cava (PLSVC).

Methods

Overall, 114 cases of fetal PLSVC were diagnosed using 2D ultrasound combined with STIC, and 114 normal fetuses of the same gestational week were selected. These cases were retrospectively analyzed to evaluate the effectiveness of the diagnostic approach.

Results

All 114 PLSVC cases were diagnosed using 2D ultrasound combined with STIC. Although the diagnostic coincidence rate of PLSVC in the HD‐flow combined with STIC was similar to that in the 2D ultrasound combined with HD‐flow (96.8 vs 96.2%), 2D ultrasound with STIC enabled dynamic visualization of the PLSVC, furthering prenatal diagnosis. These cases were classified as type I PLSVC: 80 cases of type Ia, 29 cases of type Ib, and 5 cases of type Ic. Seventy isolated PLSVC cases (61.4%) were noted, whereas 44 cases (35.6%) were associated with concomitant structural abnormalities. Intracardiac structural malformations accounted for the highest proportion (n = 53, 58.89%), followed by single umbilical artery and facial/bodily abnormalities (n = 10, 11.11%).

Conclusion

Combining HD‐flow and STIC complements 2D ultrasound in diagnosing and classifying fetal PLSVC, demonstrating significant clinical relevance.
Transoral Robotic Surgery Versus Hypoglossal Nerve Stimulation for OSA: A Cost Analysis Study
Authors: Mandloi Shreya , Garg Neha , Naimi Bita , Shah Riya , Kaki Praneet , Alnemri Angela , Duffy Alexander , Zhan Tingting , Kaffenberger Thomas M. , Boon Maurits S. , Huntley Colin T.
Published: August 2024

Background

Transoral robotic surgery (TORS) lingual tonsillectomy and hypoglossal nerve stimulation (HGNS) are effective surgical interventions for well‐selected patients with obstructive sleep apnea (OSA) intolerant to continuous positive airway pressure (CPAP) therapy. Previous publications have demonstrated that HGNS patients have a lower postoperative apnea‐hypopnea index (AHI) and length of hospital stay than TORS patients. No prior study has investigated the differences in costs between HGNS and TORS.

Objectives

This study aims to compare surgery‐related costs in patients undergoing HGNS versus TORS lingual tonsillectomy for OSA intolerant to CPAP.

Methods

A retrospective study on OSA patients intolerant to CPAP that underwent HGNS or TORS from 2015 to 2022 at a tertiary care center. Cost was defined as the dollar amount associated with providing a specific service prior to the application of insurance.

Results

This study included 395 patients (375 UAS and 20 TORS). Average total cost was significantly higher in the UAS group than the TORS group (UAS: $25,582.60; TORS: $5832.60; p < 0.001). Operating room costs were also significantly higher in the UAS group (UAS: $1978.20; TORS: $1490.90; p = 0.001). The TORS cohort averaged higher costs for pharmacy (UAS: $201.30; TORS: $416.60; p < 0.001) and anesthesia (UAS: $139.00; TORS: $307.60; p < 0.001).

Discussion

The total cost was significantly higher in the UAS group compared to the TORS group. When making management decisions, it is important to consider the cost of care provided as well as patient‐centered outcomes to optimize the value of care.

Level of Evidence

N/A Laryngoscope, 2024
Optimization of Genotyping‐by‐Sequencing (GBS) for Germplasm Fingerprinting and Trait Mapping in Faba Bean
Authors: Zhang Hailin , Fechete Lavinia I. , Himmelbach Axel , Poehlein Anja , Lohwasser Ulrike , Börner Andreas , Maalouf Fouad , Kumar Shiv , Khazaei Hamid , Stein Nils , Jayakodi Murukarthick
Published: August 2024

Faba bean (Vicia faba L.) is an important pulse crop with a wide range of agroecological adaptations. The development of genomic tools and a comprehensive catalog of extant genetic diversity are crucial for developing improved faba bean cultivars. The lack of a cost‐effective genotyping platform limits the characterization of large germplasm collections, understanding of genetic diversity across populations, and implementing breeder's tools like genomic selection. Genotyping‐by‐sequencing (GBS) offers high‐resolution genotyping for both model and crop plant species, even without a reference genome sequence. The genome fragments targeted by GBS depend substantially on the restriction enzyme (RE) used for the complexity reduction step. Species with complex genomic architecture require optimization of GBS with proper RE to realize the full potential of GBS. Here, we evaluated various REs in the GBS method and identified that the combination of ApeKI/MseI proved to be the most appropriate for faba bean based on the best library quality, a high number of genomic loci spread across chromosomes, and high enrichment loci associated with the gene space. With the new optimized protocol, we constructed a genetic map using a recombinant inbred line (RIL) population and identified a QTL for seed hilum color on Chromosome 1. In addition, we also genotyped a diversity panel and performed a genome‐wide association studies (GWAS) for important agronomic traits, including plant height (PH), flowering time (FT), and number of pods per plant (PPP). We identified six SNP markers significantly associated with these traits and listed potential candidate genes. The optimized faba bean‐specific GBS procedure will facilitate access to the untapped genetic diversity for genetic research and breeding and may facilitate functional genomics.
Efficient oxidation attenuates porewater‐derived methane fluxes in mangrove waters
Authors: Yau Yvonne Y. Y. , Cabral Alex , Reithmaier Gloria , Cotovicz Luiz C. , Barreira João , Abril Gwenaël , Morana Cedric , Borges Alberto V. , Machado Wilson , Godoy José M. , Bonaglia Stefano , Santos Isaac R.
Published: August 2024

Mangroves store significant amounts of carbon in both sediment and water. Methane (CH4) is often produced in anoxic, organic‐rich sediments during carbon degradation and released to overlying waters via porewater exchange. Yet, a portion of CH4 can be oxidized to CO2 before emission. Here, we investigate whether CH4 oxidation impacts its emissions using high‐temporal resolution CH4 concentration and stable isotope (δ13C‐CH4) observations collected over 14 tidal cycles in 2 Brazilian mangrove creeks with no river inputs. We found higher CH4 concentrations (~ 150 nM) more depleted in 13C (−75‰) during low tide than high tide at both creeks. Similar δ13C‐CH4 values between low tide surface waters and porewaters further suggest tidally driven porewater exchange as the main source of CH4. More 13C‐enriched CH4 in surface waters and surface sediments than deep sediments indicate partial CH4 oxidation prior to exchange with the atmosphere. A stable isotope mass balance revealed that 17–58% of CH4 was oxidized at rates of 3–25 μmol m−2 d−1 in the water column of tidal creeks. A larger portion of deep porewater CH4 (45–61%) was oxidized in sediments prior to porewater exchange with surface creek waters. The two mangrove creeks had average water–air CH4 fluxes of 51–109 μmol m−2 d−1 over spring‐neap tidal cycles. These aquatic CH4 emissions offset only < 3% of the mangroves' soil carbon sequestration. Overall, CH4 oxidation in both surface water and sediment attenuated CH4 emissions to the atmosphere.
Heating Rate Sensitive Polyethylene Terephthalate
Authors: Jerusalem Robert David Ludwig , Maricanov Michail , Raidt Thomas , Katzenberg Frank , Tiller Joerg Christian
Published: August 2024

Smart materials react to external triggers by changing size, color, mechanical properties, or permeability. The next generation of smart materials will be able to not only recognize and react to external triggers but also to their dynamics. The only existing example of such a material is heating rate‐sensitive polymorphous cross‐linked syndiotactic polypropylene. This study presents a new principle of a heating rate‐sensitive material on the example of cross‐linked and fully amorphous quenchable semi‐crystalline polyethylene terephthalate (x‐PET). The x‐PET is stretched to high elongation above its melting temperature and constrained quenched to a fully amorphous state. Then the polymer is heated to 120–170 °C with different heating rates. Due to its heating‐rate sensitivity, x‐PET shrinks to different stabilized lengths dependent on the heating rate. The new length can be used to read out the heating rate and to specifically answer to this by mechanically switching a process. Detailed analytics of this process reveal that amorphous stretched x‐PET is starting the retraction above Tg and simultaneously stopping it by crystallization. The different rates of these processes result in the heating rate sensitivity of x‐PET.
Controllable Self‐Assembly of Carbon Nanotubes on Ammonium Polyphosphate as a Game‐Changer for Flame Retardancy and Thermal Conductivity in Epoxy Resin
Authors: Xia Yan , Hong Yutong , Zhang Li , Chai Juan , Wang Bingtao , Guo Zhenghong , Li Juan , Huo Siqi , Fang Zhengping
Published: August 2024

The optimization of flame retardancy and thermal conductivity in epoxy resin (EP), utilized in critical applications such as mechanical components and electronics packaging, is a significant challenge. This study introduces a novel, ultrasound‐assisted self‐assembly technique to create a dual‐functional filler consisting of carbon nanotubes and ammonium polyphosphate (CNTs@APP). This method, leveraging dynamic ligand interactions and strategic solvent selection, allows for precise control over the assembly and distribution of CNTs on APP surfaces, distinguishing it from conventional blending approaches. The integration of 7.5 wt.% CNTs@APP10 into EP nanocomposites results in substantial improvements in flame retardancy, as evidenced by a limiting oxygen index (LOI) value of 31.8% and achievement of the UL‐94 V‐0 rating. Additionally, critical fire hazard indicators, including total heat release (THR), total smoke release (TSR), and the peak intensity of CO yield (PCOY), are significantly reduced by 45.9% to 77.5%. This method also leads to a remarkable 3.6‐fold increase in char yield, demonstrating its game‐changing potential over traditional blending techniques. Moreover, despite minimal CNTs addition, thermal conductivity is notably enhanced, showing a 53% increase. This study introduces a novel approach in the development of multifunctional EP nanocomposites, offering potential for wide range of applications.
Pyroptosis‐related gene GSDMC indicates poor prognosis and promotes tumor progression by activating the AKT/mTOR pathway in lung squamous cell carcinoma
Authors: Zhang Yi , Wang Yuzhi , Weng Jiamiao , Chen Jianlin , Zheng Yue , Xia Yu , Huang Zhixin , Zhao Lilan , Chen Xiongfeng , Tang Haijun , Huang Yi
Published: August 2024

Lung squamous cell carcinoma (LUSC) is one of the most common malignant tumors of the respiratory. Pyroptosis plays an essential role in cancer, but there is limited research investigating pyroptosis in LUSC. In this study, pyroptosis‐related genes were observed to have extensive multiomics alterations in LUSC through analysis of the TCGA database. Utilizing machine learning for selection and verifying expression levels, GSDMC was chosen as the critical gene for further experiments. Our research found that GSDMC is overexpressed in LUSC tissues and cells, and is associated with poor prognosis. Knockdown of GSDMC in LUSC inhibits cell proliferation, invasion, metastasis, chemotherapeutic sensitivity, and reduced tumor formation in nude mice, accompanied by downregulation of proliferative and EMT‐related protein expression. However, these effects were counteracted in cells where GSDMC is overexpressed. Mechanistically, the oncogenic role of GSDMC is primarily achieved through the activation of the AKT/mTOR pathway, and this effect can be significantly reversed by rapamycin. Finally, SMAD4's interaction with the promoter region of GSDMC results in the suppression of GSDMC expression. In summary, our study through bioinformatics and experimental approaches not only proves that SMAD4 regulates the protumorigenic role of GSDMC through transcriptional targeting, but also indicates the possibility of developing the SMAD4/GSDMC/AKT/mTOR signaling axis as a potential biomarker and treatment target for LUSC.
SIRT1 promotes doxorubicin‐induced breast cancer drug resistance and tumor angiogenesis via regulating GSH‐mediated redox homeostasis
Authors: Sahoo Shashikanta , Kumari Sunita , Pulipaka Sriravali , Chandra Yogesh , Kotamraju Srigiridhar
Published: August 2024

Sirtuin 1 (SIRT1), a member of histone deacetylase III family, plays a pivotal role in mediating chemoresistance in several cancers, including breast cancer. However, the molecular mechanism by which the deregulated SIRT1 promotes doxorubicin (Dox) resistance is still elusive. Here, we showed that the cell proliferation rates and invasive properties of MDA‐MB‐231 breast cancer cells were increased from low‐ to high‐Dox‐resistant cells. In agreement, severe combined immunodeficiency disease (SCID) mice bearing labeled MDA‐MB‐231high Dox‐Res cells showed significantly higher tumor growth, angiogenesis, and metastatic ability than parental MDA‐MB‐231 cells. Interestingly, the levels of SIRT1 and glutathione (GSH) were positively correlated with the degree of Dox‐resistance. Dox‐induced SIRT1 promoted NRF2 nuclear translocation with an accompanying increase in the antioxidant response element promotor activity and GSH levels. In contrast, inhibition of SIRT1 by EX527 greatly reversed these events. More so, Dox‐resistance‐induced pro‐proliferative, proangiogenic, and invasive effects were obviated with depletion of either SIRT1 or GSH. Together, Dox‐induced SIRT1 promotes dysregulation of redox homeostasis leading to breast cancer chemoresistance, tumor aggressiveness, angiogenesis, and metastasis.
Voltage‐controlled attenuator based on PIN diode and compensated gold wire inductors
Authors: Chen Jiming , Peng Hao , Chen Lifeng , Sun Tianyang , Liu Yu , Tatu Serioja Ovidiu , Yang Tao
Published: August 2024

This paper proposes an innovative design approach for a voltage‐controlled (variable) attenuator that allows continuous control of attenuation through analog voltage. Different from fixed attenuators, this work employs PIN diodes and compensated gold wire inductors to configure the attenuation network. It is based in imperfect matching theory, ensuring to obtain the acceptable S‐parameters over the operating band. Measurement results demonstrate effective performance of the attenuator within the voltage range of 0.7–1.03 V. Return losses of the attenuator are all better than 15 dB in the operating range of 10.5–19 GHz. The insertion losses exhibit continuous variation from 2 to 15 dB, requiring only a single controlled voltage to adjust the attenuation value.
On‐board synthetic 4D MRI generation from 4D CBCT for radiotherapy of abdominal tumors: A feasibility study
Authors: Quintero Paulo , Wu Can , Otazo Ricardo , Cervino Laura , Harris Wendy
Published: August 2024

Background

Magnetic resonance‐guided radiotherapy with an MR‐guided LINAC represents potential clinical benefits in abdominal treatments due to the superior soft‐tissue contrast compared to kV‐based images in conventional treatment units. However, due to the high cost associated with this technology, only a few centers have access to it. As an alternative, synthetic 4D MRI generation based on artificial intelligence methods could be implemented. Nevertheless, appropriate MRI texture generation from CT images might be challenging and prone to hallucinations, compromising motion accuracy.

Purpose

To evaluate the feasibility of on‐board synthetic motion‐resolved 4D MRI generation from prior 4D MRI, on‐board 4D cone beam CT (CBCT) images, motion modeling information, and deep learning models using the digital anthropomorphic phantom XCAT.

Methods

The synthetic 4D MRI corresponds to phases from on‐board 4D CBCT. Each synthetic MRI volume in the 4D MRI was generated by warping a reference 3D MRI (MRIref, end of expiration phase from a prior 4D MRI) with a deformation field map (DFM) determined by (I) the eigenvectors from the principal component analysis (PCA) motion‐modeling of the prior 4D MRI, and (II) the corresponding eigenvalues predicted by a convolutional neural network (CNN) model using the on‐board 4D CBCT images as input. The CNN was trained with 1000 deformations of one reference CT (CTref, same conditions as MRIref) generated by applying 1000 DFMs computed by randomly sampling the original eigenvalues from the prior 4D MRI PCA model. The evaluation metrics for the CNN model were root‐mean‐square error (RMSE) and mean absolute error (MAE). Finally, different on‐board 4D‐MRI generation scenarios were assessed by changing the respiratory period, the amplitude of the diaphragm, and the chest wall motion of the 4D CBCT using normalized root‐mean‐square error (nRMSE) and structural similarity index measure (SSIM) for image‐based evaluation, and volume dice coefficient (VDC), volume percent difference (VPD), and center‐of‐mass shift (COMS) for contour‐based evaluation of liver and target volumes.

Results

The RMSE and MAE values of the CNN model reported 0.012 ± 0.001 and 0.010 ± 0.001, respectively for the first eigenvalue predictions. SSIM and nRMSE were 0.96 ± 0.06 and 0.22 ± 0.08, respectively. VDC, VPD, and COMS were 0.92 ± 0.06, 3.08 ± 3.73 %, and 2.3 ± 2.1 mm, respectively, for the target volume. The more challenging synthetic 4D‐MRI generation scenario was for one 4D‐CBCT with increased chest wall motion amplitude, reporting SSIM and nRMSE of 0.82 and 0.51, respectively.

Conclusions

On‐board synthetic 4D‐MRI generation based on predicting actual treatment deformation from on‐board 4D‐CBCT represents a method that can potentially improve the treatment‐setup localization in abdominal radiotherapy treatments with a conventional kV‐based LINAC.
Factors Precipitating Overnight Admission After Sialolithectomy
Authors: Rind Fahad , Schofield Minka , Carrau Ricardo L.
Published: August 2024

Objective

To determine factors predicting overnight admission after sialolithectomy.

Study Design

Quality outcome database research.

Setting

The National Surgical Quality Improvement Program American College of Surgeons Participant User Files.

Methods

Current Procedural Terminology (CPT) codes 42330, 42335, and 42340 between 2007, and 2020 resulted 916 cases. Correlations between perioperative factors and overnight admission (ie, length of stay >0 days) were tested. Cases were stratified into endoscopic (ES) and nonendoscopic (NES) procedures using concurrent CPT codes 42660, 42669, and 42650.

Results

After sialolithectomy, 13.7% (126 cases) were admitted at least overnight. Upon multivariate analysis, wound Class 4 (odds ratio [OR]: 2.15, 95% confidence interval: 1.05, 4.40), American Society of Anesthesiologists (ASA) 3 classification (OR: 2.17, 1.06‐4.46, P = .035), and the operative time (OR: 1.01 [1.01‐1.01], P < .001) correlated with overnight stay; while Class 2 wounds had a lower risk of overnight admission (OR: 0.31 [0.12‐1.63], P < .001). The ES cohort had longer operative times (56.1 vs 73.6 minutes). In the NES cohort's multivariate analysis, ASA III (OR: 2.459 [1.13, 5.34], P < .001) and operative time (OR: 1.01 [1.01, 1.02], P < .001) correlated with overnight stay while Class 2 wound classifications protected against overnight stay (OR: 0.28 [0.15, 0.52], P < .001).

Conclusion

This study highlights the correlation between intraoperative complexity, as operative time, wound classification and ASA Class 3, and the need for admission after a typically ambulatory sialolithectomy. The significantly longer operative time with evidence of a shorter length of stay in ES cases suggests a valuable trade off, within the limits of indication.
Potential barriers to the use of anti‐obesity medications in persons with spinal cord injuries and disorders
Authors: LaVela Sherri L. , Berryman Kelsey , Kale Ibuola , Farkas Gary J. , Henderson Geoffrey V. , Rosales Vanessa , Eisenberg Dan , Reyes Lorena
Published: August 2024

Background

Anti‐obesity medications (AOMs) may provide a viable option for obesity management. However, little is known about the use of AOMs in persons with SCI/D.

Objective

Describe health care providers' (HCPs) views about barriers to AOM use in persons living with SCI/D.

Methods

Descriptive qualitative design using in‐depth interviews Descriptive statistics were used to calculate demographic and employment characteristics. Interviews were audio‐recorded and transcribed verbatim. Transcripts were coded and analyzed using Braun and Clarke's (2006) six thematic analysis phases.

Results

HCPs (n = 12) were from 11 different nationwide facilities. Most HCPs were male (75%), a large majority were white (67%), and most were 26–49 years of age. Participants were dietitians (75%), physicians (17%), and psychologists (8%). HCPs ranged from 1.5 to 15 years of providing SCI/D care. HCPs described four main thematic barriers to AOM use in persons with SCI/D: (1) AOM side effects that are especially concerning in persons with SCI/D; (2) AOMs contribute to poor eating habits; (3) availability, accessibility, and administration; and (4) lack of evidence, clinical agreement, and knowledge about AOM use in the SCI/D population.

Conclusions

There are several potential barriers to AOM use in the SCI/D population. Barriers include AOM side effects which may cause or exacerbate conditions that are already concerns in persons with SCI/D, such as bowel and skin problems, and muscle loss. SCI/D HCPs reported a lack of evidence about AOM use in persons with SCI/D, but interest in obtaining more knowledge.