bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 Scientific Literacy in Medical and Nursing Students
Authors: Cabreja-Castillo Maria , Hernandez Leislany , Mustafa Alicia , Hungria Gregory , Bertoli Maria T.
Published: March 2023

The pandemic brought a whole newfound collection of words into our everyday language, some of which had been terms that were infrequently used outside academic and medical settings. However, as familiar as this new pandemic vocabulary has become, there are still several terms that often get mixed in everyday conversations, media communications, and even in the medical field.
Genomic Insights into Niche Partitioning across Sediment Depth among Anaerobic Methane-Oxidizing Archaea in Global Methane Seeps
Authors: Chen Jiawei , Li Yingdong , Zhong Cheng , Xu Zhimeng , Lu Guangyuan , Jing Hongmei , Liu Hongbin
Published: March 2023

Anaerobic methanotrophic (ANME) archaea are important methanotrophs in marine sediment, controlling the flux of biologically generated methane, which plays an essential role in the marine carbon cycle and climate change. So far, no strain of this lineage has been isolated in pure culture, which makes metagenomics one of the fundamental approaches to reveal their metabolic potential.
Development, Validation, and Utilization of a Luminex-Based SARS-CoV-2 Multiplex Serology Assay
Authors: Roy Daisy R. , Kemp Troy J. , Haynesworth Katarzyna , Loftus Sarah A. , Pinto Ligia A.
Published: March 2023

The SARS-CoV-2 pandemic resulted in the development and validation of multiple serology tests with variable performance. While there are multiple SARS-CoV-2 serology tests to detect SARS-CoV-2 antibodies, the focus is usually either on only one antigen at a time or multiple proteins from only one SARS-CoV-2 variant.
Astronomical and tectonic influences on climate and deposition revealed through radioisotopic geochronology and Bayesian age-depth modeling of the early Eocene Green River Formation, Wyoming, USA
Authors: Bruck Benjamin T. , Singer Brad S. , Schmitz Mark D. , Carroll Alan R. , Meyers Stephen , Walters Andrew P. , Jicha Brian R.
Published: March 2023

The Wilkins Peak Member (WPM) of the Green River Formation in Wyoming, USA, comprises alternating lacustrine and alluvial strata that preserve a record of terrestrial climate during the early Eocene climatic optimum. We use a Bayesian framework to develop age-depth models for three sites, based on new 40Ar/39Ar sanidine and 206Pb/238U zircon ages from seven tuffs. The new models provide two- to ten-fold increases in temporal resolution compared to previous radioisotopic age models, confirming eccentricity-scale pacing of WPM facies, and permitting their direct comparison to astronomical solutions. Starting at ca. 51 Ma, the median ages for basin-wide flooding surfaces atop six successive alluvial marker beds coincide with short eccentricity maxima in the astronomical solutions. These eccentricity maxima have been associated with hyperthermal events recorded in marine strata during the early Eocene. WPM strata older than ca. 51 Ma do not exhibit a clear relationship to the eccentricity solutions, but accumulated 31%−35% more rapidly, suggesting that the influence of astronomical forcing on sedimentation was modulated by basin tectonics. Additional high-precision radioisotopic ages are needed to reduce the uncertainty of the Bayesian model, but this approach shows promise for unambiguous evaluation of the phase relationship between alluvial marker beds and theoretical eccentricity solutions.
Supplemental Material: Oceanic subduction to continental collision in the NE Proto- Tethys revealed by early Paleozoic eclogites with high temperature granulite-facies overprinting in the East Kunlun orogenic belt, northern Tibet
Authors: Zhou Wenxiao , al. et
Published: March 2023

Text: Analytical methods. Table S1: Representative electron microprobe analyses of garnet in eclogite samples. Table S2: Representative analyses of clinopyroxene (omphacite) in eclogite samples. Table S3: Representative microprobe analyses of low-sodic clinopyroxene in eclogite samples. Table S4: Representative microprobe analyses of amphibole in eclogite samples. Table S5: Representative microprobe analyses of plagioclase in eclogite samples. Table S6: Representative microprobe analyses of other minerals (orthopyroxene and epidote) in eclogite samples. Table S7: Whole-rock major (wt%) and trace element (ppm) analyses of eclogites in Nuomuhong area, East Kunlun orogenic belt. Table S8: SHRIMP Zircon U–Pb isotopic data from the eclogite in Nuomuhong area, East Kunlun orogenic belt. Table S9: Rare earth elements (ppm) analyses of the tested zircons from the retrograde eclogites.
Frail2Fit study protocol: a feasibility and acceptability study of a virtual multimodal intervention delivered by volunteers to improve functional outcomes in older adults with frailty after discharge from hospital
Authors: Meredith Samantha Jane , Roberts Helen , Grocott Michael P W , Jack Sandy , Murphy Jane , Varkonyi-Sepp Judit , Bates Andrew , Lim Stephen Eu Ruen
Published: March 2023

Introduction

Physical activity (PA) and replete nutritional status are key to maintaining independence and improving frailty status among frail older adults. In response to the COVID-19 pandemic, healthcare has increasingly turned to virtual modes of delivery and there is interest in the use of trained volunteers to deliver PA and nutrition interventions. We aim to evaluate the feasibility and acceptability of training hospital volunteers to deliver an online intervention, comprising exercise, behaviour change and nutrition support, to older people with frailty after discharge from hospital.

Methods

We will use a quasi-experimental mixed methods approach. Hospital volunteers (n=6) will be trained to deliver an online, 3-month, multimodal intervention to frail (Clinical Frailty Scale ≥5) adults ≥65 years (n=30) after discharge from hospital. Feasibility will be assessed by determining the number of volunteers recruited, trained and retained at the end of the study; the proportion of intervention sessions delivered; participant recruitment, retention and adherence to the intervention. To determine the acceptability of the intervention, interviews will be conducted among a purposive sample of older adults, and volunteers. Secondary outcomes will include physical function, appetite, well-being, quality of life, anxiety and depression, self-efficacy for managing chronic disease and PA. Outcomes will be measured at baseline, 3 months and 6 months.

Analysis

Descriptive statistics will be used to describe feasibility and adherence to the intervention. Secondary outcomes at baseline will be compared at 3 and 6 months. Interviews will be transcribed verbatim and analysed using thematic analysis.

Ethics and dissemination

Health Research Authority ethical approval was obtained on 30 May 2022 (reference: 22/WA/0155). Results will be disseminated through peer-reviewed journal articles, volunteer organisations, National Health Service communication systems and social media platforms. A toolkit will be developed to facilitate roll out of volunteer training.

Trial registration number

NCT05384730.
Reducing incidence of postoperative acute kidney injury in trauma and orthopaedics patients: a quality improvement project
Authors: Kulkarni Sanat , Richardson Thomas , Green Alice , Acharya Radhika , Latif Arusa , Johnson Dakota , Naqvi Huma , Gella Sreenadh
Published: March 2023

Background

Acute kidney injury (AKI) is a common postoperative complication which increases morbidity and mortality. This quality improvement project aimed to implement measures targeting known risk factors to decrease the incidence of postoperative AKI in trauma and orthopaedics (T&O) patients.

Methods

Data were collected across three six-month to 7-month cycles between 2017 and 2020, analysing all elective and emergency T&O operated patients within a single NHS Trust (n=714, 1008 and 928, respectively). Patients who developed a postoperative AKI were identified using biochemical criteria and data were collected on known AKI risk factors, including use of nephrotoxic medications, and patient outcomes. In the final cycle, the same variables were collected for patients without AKI. Between cycles, measures implemented included: preoperative and postoperative medication reconciliation aiming to stop nephrotoxic medications, orthogeriatrician review of high-risk patients and junior doctor teaching on fluid therapy. Statistical analysis was undertaken to determine the incidence of postoperative AKI across cycles, prevalence of risk factors and impact on length of hospital stay and postoperative mortality.

Results

There was a statistically significant decrease in postoperative AKI incidence from 4.27% (43 of 1008 patients) in cycle 2 to 2.05% (19 of 928) in cycle 3 (p=0.006), with a notable decrease in use of nephrotoxic medications. Significant predictors for the development of postoperative AKI included use of diuretics and receiving multiple nephrotoxic drug classes. Development of postoperative AKI significantly increased length of hospital stay by 7.11 days on average (95% CI: 4.84 to 9.38 days, p<0.001) and risk of 1-year postoperative mortality (OR 3.22, 95% CI: 1.03 to 10.55, p=0.046).

Conclusion

This project demonstrates that a multifaceted approach targeting modifiable risk factors can reduce incidence of postoperative AKI in T&O patients, which may lead to reduced length of hospital stay and postoperative mortality.
Assessing and investigating children with suspected bone and abdominal tumours: an e-Delphi consensus process
Authors: Shanmugavadivel Dhurgshaarna , Liu Jo-Fen , Gamble Ashley , Polanco Angela , Vedhara Kavita , Walker David , Ojha Shalini
Published: March 2023

Background

The incidence of childhood cancer has risen by 15% since the 1990s. Early diagnosis is key to optimising outcomes, however diagnostic delays are widely reported. Presenting symptoms are often non-specific causing a diagnostic dilemma for clinicians. This Delphi consensus process was conducted to develop a new clinical guideline for children and young people presenting with signs/symptoms suggestive of a bone or abdominal tumour.

Methods

Invitation emails were sent to primary and secondary healthcare professionals to join the Delphi panel. 65 statements were derived from evidence review by a multidisciplinary team. Participants were asked to rank their level of agreement with each statement on a 9-point Likert scale (1=strongly disagree, 9=strongly agree), with responses ≥7 taken to indicate agreement. Statements not reaching consensus were rewritten and reissued in a subsequent round.

Results

All statements achieved consensus after two rounds. 96/133 (72%) participants responded to round 1 (R1) and 69/96 (72%) completed round 2 (R2). 62/65 (94%) statements achieved consensus in R1 with 29/65 (47%) gaining more than 90% consensus. Three statements did not reach consensus scoring between 61% and 69%. All reached numerical consensus at the end of R2. Strong consensus was reached on best practice of conducting the consultation, acknowledging parental instinct and obtaining telephone advice from a paediatrician to decide the timing and place of review, rather than adult cancer urgent referral pathways. Dissensus in statements was due to unachievable targets within primary care and valid concerns over a potential overinvestigation of abdominal pain.

Conclusions

This consensus process has consolidated statements that will be included in a new clinical guideline for suspected bone and abdominal tumours for use in both primary and secondary care. This evidence base will be translated into awareness tools for the public as part of the Child Cancer Smart national awareness campaign.
Exploring the appropriateness of prescribing practice of inhaled pharmacotherapy among Aboriginal Australians in the Top End Northern Territory of Australia: a retrospective cohort study
Authors: Heraganahally Subash , Howarth Timothy P , Issac Siji , Lloyd Angus , Ravichandran Shiidheshwar J , Abeyaratne Asanga , Patel Bhavini
Published: March 2023

Background

Aboriginal Australians are reported to have a high burden of chronic airway diseases. However, prescribing patterns and related outcomes of airway directed inhaled pharmacotherapy, (short-acting beta agonists (SABA), short-acting muscarinic antagonists (SAMA), long-acting β-agonists (LABA), long-acting muscarinic antagonists (LAMA) and inhaled corticosteroids (ICS)) among Aboriginal Australian patients with chronic airway disease have been sparsely reported in the past.

Methods

A retrospective cohort study was conducted, using clinical, spirometry data, chest radiology, primary healthcare (PHC) presentations and hospital admission rates among Aboriginal patients identified to have been prescribed inhaled pharmacotherapy in remote and rural communities referred to the respiratory specialist service in the Top End, Northern Territory of Australia.

Results

Of the 372 identified active patients, 346 (93%) had inhaled pharmacotherapy prescribed (64% female, median age 57.7 years). ICS was the most common prescription (72% of the total cohort) and was recorded to be prescribed in 76% of patients with bronchiectasis, and 80% of patients with asthma or chronic obstructive pulmonary disease (COPD). Fifty-eight percent of patients had a respiratory hospital admission and 57% had a recorded PHC presentation for a respiratory issue during the study period, with a higher rate of hospital admissions among patients prescribed ICS compared with those on SAMA/SABA or LAMA/LABA without ICS (median rate (per person per year) 0.42 vs 0.21 and 0.21 (p=0.004). Regression models demonstrated that presence of COPD or bronchiectasis alongside ICS was associated with significantly increased hospitalisation rates (1.01 admissions/person/year (95% CI 0.15 to 1.87) and 0.71 admissions/person/year (95% CI 0.23 to 1.18) against patients without COPD/bronchiectasis, respectively).

Conclusions

This study demonstrates that among Aboriginal patients with chronic airway diseases, ICS is the most common inhaled pharmacotherapy prescribed. Although LAMA/LABA and concurrent ICS use may be appropriate among patients with asthma and COPD, the use of ICS may have detrimental effects among those with underlying bronchiectasis either in isolation or concurrent COPD and bronchiectasis, potentially leading to higher hospital admission rates.
Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults: a randomised controlled trial
Authors: Janhunen Maarit , Katajapuu Niina , Paloneva Juha , Pamilo Konsta , Oksanen Airi , Keemu Hannes , Karvonen Mikko , Luimula Mika , Korpelainen Raija , Jämsä Timo , Kautiainen Hannu , Mäkelä Keijo , Heinonen Ari , Aartolahti Eeva
Published: March 2023

Objectives

To investigate the effects of 4 months of customised, home-based exergaming on physical function and pain after total knee replacement (TKR) compared with standard exercise protocol.

Methods

In this non-blinded randomised controlled trial, 52 individuals aged 60–75 years undergoing TKR were randomised into an exergaming (intervention group, IG) or a standard exercising group (control group, CG). Primary outcomes were physical function and pain measured before and after (2 months and 4 months) surgery using the Oxford Knee Score (OKS) and Timed Up and Go (TUG) test. Secondary outcomes included measures of the Visual Analogue Scale, 10m walking, short physical performance battery, isometric knee extension and flexion force, knee range of movement and satisfaction with the operated knee.

Results

Improvement in mobility measured by TUG was greater in the IG (n=21) at 2 (p=0.019) and 4 months (p=0.040) than in the CG (n=25). The TUG improved in the IG by −1.9 s (95% CI, −2.9 to −1.0), while it changed by −0.6 s (95% CI −1.4 to 0.3) in the CG. There were no differences between the groups in the OKS or secondary outcomes over 4 months. 100% of patients in the IG and 74% in the CG were satisfied with the operated knee.

Conclusion

In patients who have undergone TKR, training at home with customised exergames was more effective in mobility and early satisfaction and as effective as standard exercise in pain and other physical functions. In both groups, knee-related function and pain improvement can be considered clinically meaningful.

Trial registration number

NCT03717727.
One-year quality-of-life outcomes of cardiac arrest survivors by initial defibrillation provider
Authors: Haskins Brian , Nehme Ziad , Andrew Emily , Bernard Stephen , Cameron Peter , Smith Karen
Published: March 2023

Objective

To assess the long-term functional and health-related quality-of-life (HRQoL) outcomes for out-of-hospital cardiac arrest (OHCA) survivors stratified by initial defibrillation provider.

Methods

This retrospective study included adult non-traumatic OHCA with initial shockable rhythms between 2010 and 2019. Survivors at 12 months after arrest were invited to participate in structured telephone interviews. Outcomes were identified using the Glasgow Outcome Scale-Extended (GOS-E), EuroQol-5 Dimension (EQ-5D), 12-Item Short Form Health Survey and living and work status-related questions.

Results

6050 patients had initial shockable rhythms, 3211 (53.1%) had a pulse on hospital arrival, while 1879 (31.1%) were discharged alive. Bystander defibrillation using the closest automated external defibrillator had the highest survival rate (52.8%), followed by dispatched first responders (36.7%) and paramedics (27.9%). 1802 (29.8%) patients survived to 12-month postarrest; of these 1520 (84.4%) were interviewed. 1088 (71.6%) were initially shocked by paramedics, 271 (17.8%) by first responders and 161 (10.6%) by bystanders. Bystander-shocked survivors reported higher rates of living at home without care (87.5%, 75.2%, 77.0%, p<0.001), upper good recovery (GOS-E=8) (41.7%, 30.4%, 30.6%, p=0.002) and EQ-5D visual analogue scale (VAS) ≥80 (64.9%, 55.9%, 52.9%, p=0.003) compared with first responder and paramedics, respectively. After adjustment, initial bystander defibrillation was associated with higher odds of EQ-5D VAS ≥80 (adjusted OR (AOR) 1.56, 95% CI 1.15–2.10; p=0.004), good functional recovery (GOS-E ≥7) (AOR 1.53, 95% CI 1.12–2.11; p=0.009), living at home without care (AOR 1.77, 95% CI 1.16–2.71; p=0.009) and returning to work (AOR 1.72, 95% CI 1.05–2.81; p=0.031) compared with paramedic defibrillation.

Conclusion

Survivors receiving initial bystander defibrillation reported better functional and HRQoL outcomes at 12 months after arrest compared with those initially defibrillated by paramedics.
Elective ascending aortic aneurysm repair outcomes in a nationwide US cohort
Authors: Beyer Sebastian E , Secemsky Eric A , Khabbaz Kamal , Carroll Brett J
Published: March 2023

Objective

To quantify contemporary outcomes following elective ascending aortic aneurysm repair, to determine risk factors for adverse events and to evaluate difference by institutional surgical volume.

Methods

We included all elective hospitalisations of adult patients with an ascending aortic aneurysm who underwent aneurysm repair in the Nationwide Readmissions Database between 2016 and 2019. The primary outcome was a composite of in-hospital mortality, stroke (ischaemic and non-ischaemic) and myocardial infarction (MI). We identified independent predictor of adverse events and investigated outcomes by institutional volume.

Results

Among 12 043 patients (mean 62.8 years of age, 28.0% female), MI, stroke or in-hospital death occurred in 598 (4.9%) patients during the index admission (acute stroke: 2.7%, MI: 0.7%, in-hospital death: 2.0%). The strongest predictors of in-hospital death, stroke or MI were chronic weight loss, pulmonary circulation disorder and concomitant descending aortic surgery. Higher procedural volume was associated with a lower incidence of in-hospital death, stroke or MI (OR comparing the highest with the lowest tertile 0.71, 95% CI 0.57 to 0.87; p=0.001) and in-hospital death (OR 0.51, 95% CI 0.37 to 0.72; p<0.001), but no difference in 30-day readmissions.

Conclusions

The overall rate of in-hospital death, stroke and MI is nearly 5% in patients undergoing elective ascending aortic aneurysm repair. Among several predictors, chronic weight loss is associated with the largest increase in the risk of poor outcomes. Higher hospital volume is associated with a lower in-hospital mortality, highlighting the importance to refer patients to high-volume centres while discussing the risks and benefits of proceeding with repair.
Effect of opioids for breathlessness in heart failure: a systematic review and meta-analysis
Authors: Gaertner Jan , Fusi-Schmidhauser Tanja , Stock Stephanie , Siemens Waldemar , Vennedey Vera
Published: March 2023

Background

For the treatment of breathlessness in heart failure (HF), most textbooks advocate the use of opioids. Yet, meta-analyses are lacking.

Methods

A systematic review was performed for randomised controlled trials (RCTs) assessing effects of opioids on breathlessness (primary outcome) in patients with HF. Key secondary outcomes were quality of life (QoL), mortality and adverse effects. Cochrane Central Register of Controlled Trials, MEDLINE and Embase were searched in July 2021. Risk of bias (RoB) and certainty of evidence were assessed by the Cochrane RoB 2 Tool and Grading of Recommendations Assessment, Development and Evaluation criteria, respectively. The random-effects model was used as primary analysis in all meta-analyses.

Results

After removal of duplicates, 1180 records were screened. We identified eight RCTs with 271 randomised patients. Seven RCTs could be included in the meta-analysis for the primary endpoint breathlessness with a standardised mean difference of 0.03 (95% CI −0.21 to 0.28). No study found statistically significant differences between the intervention and placebo. Several key secondary outcomes favoured placebo: risk ratio of 3.13 (95% CI 0.70 to 14.07) for nausea, 4.29 (95% CI 1.15 to 16.01) for vomiting, 4.77 (95% CI 1.98 to 11.53) for constipation and 4.42 (95% CI 0.79 to 24.87) for study withdrawal. All meta-analyses revealed low heterogeneity (I2in all these meta-analyses was <8%).

Conclusion

Opioids for treating breathlessness in HF are questionable and may only be the very last option if other options have failed or in case of an emergency.

PROSPERO registration number

CRD42021252201.
Evaluating the effectiveness of implementing a more severe law on prevention of road traffic injury mortality in mainland China: an interrupted time series study based on national mortality surveillance
Authors: Liu Jiangmei , Feng Xiaoqi , Steel David , Zhou Maigeng , Astell-Burt Thomas
Published: March 2023

Background

In China, road traffic injury (RTI) is the seventh-leading cause of death More than 1.5 million adults in China live with permanent disabilities due to road traffic accidents. In 2011, the Chinese government implemented a more severe law that increased the penalty points and fines for persons charged with drink-driving as a criminal offence.

Objectives

This study evaluated the short-term and long-term effects of the drink-driving law. It also aimed to establish whether punishments of increased severity resulted in greater reductions in RTI mortality.

Methods

RTI mortality data was obtained from the Disease Surveillance Points System. A two-level interrupted time series model was used to analyse daily and monthly road traffic mortality rates, accounting for the varying trends among counties.

Results

The overall RTI mortality rate showed a decreasing trend from 2007 to 2015 in mainland China, especially after 2011, and similarly decreasing trends were noted among males and females and in urban and rural areas. After the Criminal Law and Road Traffic Law amendment was implemented in 2011, charging drink-driving as a criminal offence, the immediate daily RTI mortality rate reduced by 1.57% (RR=0.9843, 95% CI: 0.9444 to 1.0259), while the slope change significantly decreased by 0.04% (RR=0.9996, 95% CI: 0.9994 to 0.9997) compared with the period before the Law was revised. Stratified analysis showed that the effect size of the law was higher for males in urban and high socioeconomic circumstances (SEC) than females in rural and low and moderate SEC. Meanwhile, the increase in penalty points for dangerous driving behaviours showed no significant effects.

Conclusion

Evidence was found that charging criminal responsibility for drink-driving is associated with reducing RTI deaths in China.
An anti-mesothelin targeting antibody drug conjugate induces pyroptosis and ignites antitumor immunity in mouse models of cancer
Authors: Wittwer Nicole L , Staudacher Alexander H , Liapis Vasilios , Cardarelli Pina , Warren Harriet , Brown Michael P
Published: March 2023

Background

Emerging evidence suggests that the mechanism of chemotherapy-induced cell death may influence the antitumor immune response in patients with cancer. Unlike immunologically silent apoptosis, pyroptosis is a lytic and inflammatory form of programmed cell death characterized by pore formation in the cell membrane and release of proinflammatory factors. Gasdermin E (GSDME) has recently gained attention after cleavage of GSDME by certain chemotherapeutics has been shown to elicit pyroptosis. This study investigated the immunomodulatory effects of a mesothelin-targeting antibody drug conjugate (ADC) in mouse models of breast and colon cancer.

Methods

The antitumor effects of the ADC were studied in EMT6 breast cancer and CT26 colon cancer syngeneic mouse models. The immunomodulatory effects of the ADC were assessed by analysis of tumor-infiltrating immune cells using flow cytometry. ADC mechanism of action was evaluated by morphology, biological assays, ADC-mediated cleavage of key effector proteins, and CRISPR/Cas9-mediated knockout (KO). Finally, the antitumor effect of ADC and Fms-like tyrosine kinase-3 ligand (Flt3L) combination therapy was evaluated in tumors expressing GSDME as well as in GSDME-silenced tumors.

Results

The data demonstrated that the ADC controlled tumor growth and stimulated anticancer immune responses. Investigation of the mechanism of action revealed that tubulysin, the cytotoxic payload of the ADC, induced cleavage of GSDME and elicited pyroptotic cell death in GSDME-expressing cells. Using GSDME KO, we showed that GSDME expression is critical for the effectiveness of the ADC as a monotherapy. Combining the ADC with Flt3L, a cytokine that expands dendritic cells in both lymphoid and non-lymphoid tissues, restored control of GSDME KO tumors.

Conclusions

Together, these results show for the first time that tubulysin and a tubulysin containing ADC can elicit pyroptosis, and that this fiery cell death is critical for antitumor immunity and therapeutic response.
Response to commentaries: ‘autonomy-based criticisms of the patient preference predictor’
Authors: Wasserman David , Wendler David
Published: March 2023

The authors respond to four JME commentaries on their Feature Article, ‘Autonomy-based criticisms of the patient preference predictor’.
Health inequities and socioeconomic factors predicting the access to treatment for unruptured intracranial aneurysms in the USA in the last 20 years: interaction effect of race, gender, and insurance
Authors: Kandregula Sandeep , Savardekar Amey , Beyl Robbie , Caskey Joshua , Terrell Danielle , Adeeb Nimer , Whipple Stephen Garrett , Newman William Christopher , Toms Jamie , Kosty Jennifer , Sharma Pankaj , Mayeaux Edward J , Cuellar Hugo , Guthikonda Bharat
Published: March 2023

Background

The literature suggests that minority racial and ethnic groups have lower treatment rates for unruptured intracranial aneurysms (UIA). It is uncertain how these disparities have changed over time.

Methods

A cross-sectional study using the National Inpatient Sample database covering 97% of the USA population was carried out.

Results

A total of 213 350 treated patients with UIA were included in the final analysis and compared with 173 375 treated patients with aneurysmal subarachnoid hemorrhage (aSAH) over the years 2000–2019. The mean (SD) age of the UIA and aSAH groups was 56.8 (12.6) years and 54.3 (14.1) years, respectively. In the UIA group, 60.7% were white patients, 10.2% were black patients, 8.6% were Hispanic, 2% were Asian or Pacific Islander, 0.5% were Native Americans, and 2.8% were others. The aSAH group comprised 48.5% white patients, 13.6% black patients, 11.2% Hispanics, 3.6% Asian or Pacific Islanders, 0.4% Native Americans, and 3.7% others. After adjusting for covariates, black patients (OR 0.637, 95% CI 0.625 to 0.648) and Hispanic patients (OR 0.654, 95% CI 0.641 to 0.667) had lower odds of treatment compared with white patients. Medicare patients had higher odds of treatment than private patients, while Medicaid and uninsured patients had lower odds. Interaction analysis showed that non-white/Hispanic patients with any insurance/no insurance had lower treatment odds than white patients. Multivariable regression analysis showed that the treatment odds of black patients has improved slightly over time, while the odds for Hispanic patients and other minorities have remained the same over time.

Conclusion

This study from 2000 to 2019 shows that disparities in the treatment of UIA have persisted but have slightly improved over time for black patients while remaining constant for Hispanic patients and other minority groups.
CT hyperdense cerebral artery sign reflects distinct proteomic composition in acute ischemic stroke thrombus
Authors: Schartz Derrek , Akkipeddi Sajal Medha K , Chittaranjan Siddharth , Rahmani Redi , Gunturi Aditya , Ellens Nathaniel , Kohli Gurkirat Singh , Kessler Alex , Mattingly Thomas , Morrell Craig , Bhalla Tarun , Bender Matthew T
Published: March 2023

Background

Hyperdense cerebral artery sign (HCAS) is an imaging biomarker in acute ischemic stroke (AIS) that has been shown to be associated with various clinical outcomes and stroke etiology. While prior studies have correlated HCAS with histopathological composition of cerebral thrombus, it is unknown whether and to what extent HCAS is also associated with distinct clot protein composition.

Methods

Thromboembolic material from 24 patients with AIS were retrieved via mechanical thrombectomy and evaluated with mass spectrometry in order to characterize their proteomic composition. Presence (+) or absence (−) of HCAS on preintervention non-contrast head CT was then determined and correlated with thrombus protein signature with abundance of individual proteins calculated as a function HCAS status.

Results

24 clots with 1797 distinct proteins in total were identified. 14 patients were HCAS(+) and 10 were HCAS(−). HCAS(+) were most significantly differentially abundant in actin cytoskeletal protein (P=0.002, Z=2.82), bleomycin hydrolase (P=0.007, Z=2.44), arachidonate 12-lipoxygenase (P=0.004, Z=2.60), and lysophospholipase D (P=0.007, Z=2.44), among other proteins; HCAS(−) clots were differentially enriched in soluble N-ethylmaleimide-sensitive factor (NSF) attachment protein (P=0.0009, Z=3.11), tyrosine-protein kinase Fyn (P=0.002, Z=2.84), and several complement proteins (P<0.05, Z>1.71 for all), among numerous other proteins. Additionally, HCAS(−) thrombi were enriched in biological processes involved with plasma lipoprotein and protein-lipid remodeling/assembling, and lipoprotein metabolic processes (P<0.001), as well as cellular components including mitochondria (P<0.001).

Conclusions

HCAS is reflective of distinct proteomic composition in AIS thrombus. These findings suggest that imaging can be used to identify mechanisms of clot formation or maintenance at the protein level, and might inform future research on thrombus biology and imaging characterization.
Penumbra salvage in extensive stroke: exploring limits for reperfusion therapy
Authors: Broocks Gabriel , Meyer Lukas , Bechstein Matthias , Elsayed Sarah , Schön Gerhard , Kniep Helge , Kemmling Andre , Hanning Uta , Fiehler Jens , McDonough Rosalie V
Published: March 2023

Background

The effect of thrombectomy in patients presenting with extensive ischemic stroke at baseline is currently being investigated; it remains uncertain to what extent brain tissue may be saved by reperfusion in such patients. Penumbra salvage volume (PSV) has been described as a tool to measure the volume of rescued penumbra.

Objective

To assess whether the effect of recanalization on PSV is dependent on the extent of early ischemic changes.

Methods

Observational study of patients with anterior circulation ischemic stroke triaged by multimodal-CT undergoing thrombectomy. PSV was defined as the difference between baseline penumbra volume and net infarct growth to follow-up. The effect of vessel recanalization on PSV depending on the extent of early ischemic changes (defined using Alberta Stroke Program Early CT Score (ASPECTS) and core volumes based on relative cerebral blood flow) was determined using multivariable linear regression analysis, and the association with functional outcome at day 90 was tested using multivariable logistic regression.

Results

384 patients were included, of whom 292 (76%) achieved successful recanalization (modified Thrombolysis in Cerebral Infarction ≥2b). Successful recanalization was independently associated with 59 mL PSV (95% CI 29.8 to 88.8 mL) and was linked to increased penumbra salvage up to an ASPECTS of 3 and core volume up to 110 mL. Recanalization was associated with a higher probability of a modified Rankin Scale score of ≤2 up to a core volume of 100 mL.

Conclusions

Recanalization was associated with significant penumbra salvage up to a lower ASPECTS margin of 3 and upper core volume margin of 110 mL. The clinical benefit of recanalization for patients with very large ischemic regions of >100 mL or ASPECTS <3 remains uncertain and requires prospective investigation.
SARS-CoV-2 E protein-induced THP-1 pyroptosis is reversed by Ruscogenin
Authors: Huang Houda , Li Xiuzhen , Zha Duoduo , Lin Hongru , Yang Lingyi , Wang Yihan , Xu Luyan , Wang Linsiqi , Lei Tianhua , Zhou Zhou , Xiao Yun-Fei , Xin Hong-Bo , Fu Mingui , Qian Yisong
Published: March 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), an emerging pathogenic coronavirus, has been reported to cause excessive inflammation and dysfunction in multiple cells and organs, but the underlying mechanisms remain largely unknown. Here we showed exogenous addition of SARS-CoV-2 envelop protein (E protein) potently induced cell death in cultured cell lines, including THP-1 monocytic leukemia cells, endothelial cells, and bronchial epithelial cells, in a time- and concentration-dependent manner. SARS-CoV-2 E protein caused pyroptosis-like cell death in THP-1 and led to GSDMD cleavage. In addition, SARS-CoV-2 E protein upregulated the expression of multiple pro-inflammatory cytokines that may be attributed to activation of NF-κB, JNK and p38 signal pathways. Notably, we identified a natural compound, Ruscogenin, effectively reversed E protein-induced THP-1 death via inhibition of NLRP3 activation and GSDMD cleavage. In conclusion, these findings suggested that Ruscogenin may have beneficial effects on preventing SARS-CoV-2 E protein-induced cell death and might be a promising treatment for the complications of COVID-19.
de Haas van Alphen oscillations in hybridization-gap insulators as a sudden change in the diamagnetic moment of Landau levels
Authors: Julian S.R.
Published: March 2023

This note revisits the semiclassical theory of quantum oscillations in hybridization-gap insulators, and shows that the physical origin of the oscillations, at T = 0 K, is a sudden change in the diamagnetic moment of each Landau level as it crosses the hybridized region of the valence band.
Ultrastructure of an opecoelid daughter sporocyst, Podocotyle sp. (Digenea: Opecoelidae): comparative analysis of the somatic tissues and new insights into the organization of the nervous system
Authors: Denisova Sofia A. , Shunatova Natalia N. , Lebedenkov Vladimir V. , Shchenkov Sergei V.
Published: March 2023

Digenea is a group of widespread parasitic flatworms with a complex life cycle including a successive change of parthenogenetic and hermaphroditic generations. Daughter sporocysts are among the least studied parthenitae in terms of the ultrastructure of their body wall and nervous system. Here we present an ultrastructural and immunocytochemical study of Podocotyle sp. daughter sporocyst (Opecoelidae), parasitizing in Littorina obtusata Linnaeus, 1758 from the White Sea. Our results focus on the structure of the body wall, birth pore, excretory and nervous systems, and include new data on the taxonomic affiliation based on the partial cox1 mitochondrial DNA sequence. The daughter sporocyst of Podocotyle sp. has ultrastructural similarities with different plagiorchiid and diplostomid digeneans and also possesses some specific features. In the studied species, the birth canal is epithelialized, the body wall is composed of nine types of somatic cells and includes a well-developed central nervous system. Neurons of the latter form specific hemidesmosome-like attachment sites, which we found in digeneans for the first time. The obtained results are necessary to complement the comparative morphological analysis of daughter parthenogenetic generations in different digenean lineages.
Safety Net Ontario: Ontario’s outsized role in the “Global Safety Net” for climate and biodiversity
Authors: Finkelstein Sarah A , Doherty Cathal , Loder Amanda L.
Published: March 2023

Dinerstein et al. present a spatially explicit global framework for protected areas needed to reverse catastrophic biodiversity losses and stabilize climate. The Province of Ontario (Canada) stands out in this “Global Safety Net (GSN)” as a critical jurisdiction for meeting those goals, because of both the large extent of roadless lands and high carbon storage in terrestrial ecosystems. Simultaneously, pressure is increasing to develop unmanaged lands in Ontario, particularly in the Far North, for resource extraction. Here, we extract data from the GSN to identify and calculate the areal extent of target regions present in Ontario and critically review the results in terms of accuracy and implications for conservation. We show that when region-specific data are incorporated, Ontario is even more significant than what is shown in the GSN, especially in terms of carbon stocks in forested and open peatlands. Additionally, the biodiversity metrics used in the GSN only partially capture opportunities for conservation in Ontario, and the officially recognized extent of Indigenous lands vastly underestimates the role of First Nations in conservation. Despite these limitations, our analyses indicate that Ontario plays an outsized role in terms of its potential to impact the trajectories both of biodiversity and climate globally.
Lower shear velocity of HCP-Fe under anisotropic stress from first-principles calculations
Authors: Jiang Cheng-Lu , Liu Fu-Sheng , Liu Zheng-Tang , Liu Qi-Jun
Published: March 2023

Earth’s core consists of a solid inner core and a liquid outer core, composed primarily of iron. The pressure in the solid inner core is about 330 gigapascals (GPa) at the temperature close to the melting point. Considering the extensive experimental and theoretical data, the shear wave ([Formula: see text]-wave) velocity of the inner core is much lower than that of pure iron. Since the lower [Formula: see text]-wave velocity has been observed in the seismic models, reasons have been widely discussed such as the premelting of iron in the Earth’s inner core. In this paper, a new explanation is expected to be proposed under the anisotropic stress. The calculated longitudinal wave and [Formula: see text]-wave velocity of pure hexagonal close-packed iron (HCP-Fe) model based on the density functional theory (DFT) at the different density are matching with the seismic wave, the atomic distribution of HCP-Fe is obtained under the anisotropic stress. Unfortunately, it is unlikely conformed there was an inner-core condition due to the unreal anisotropic stress, although the lower [Formula: see text]-wave velocity is. Somehow, this lower [Formula: see text]-wave velocity may provide a new horizon to build mineralogical models for discussing. In addition, the [Formula: see text]-wave and viscosity of iron are strongly dependent on shear stress, we then give a mathematical equation between the [Formula: see text]-wave velocity and viscosity empirically by the shear behavior. It is revealed that the shear stress of iron has a positive influence on the [Formula: see text]-wave and viscosity.
Hierarchical MPC-based Motion Planning for Automated Vehicles in Parallel Autonomy
Authors: Cheng Zijun , Zeng Xianlin , Fang Hao , Wang Gang , Dou Lihua
Published: March 2023

Automated vehicles with parallel autonomy show advantages over fully automated vehicles and manual driving. This paper proposes a hierarchical motion planning method that mixes inputs of human drivers and the automated driving systems for automated vehicles in scenarios such as multi-lane roads and multi-intersections with dynamic obstacles. The proposed method comprises a reference path generator in the upper level and a nonlinear model predictive controller with mixed human-vehicle control in the lower level. The path planner considers dynamic obstacles, static obstacles, and human comfort to generate a reference path composed of splines with continuous curvatures in the upper level. In the lower level, the MPC generates a trajectory by tracking the reference path and optimizing the cost function containing inputs of drivers while avoiding both dynamic and static obstacles. The simulation verifies the efficacy and the computational tractability of the proposed method.
Perspectives and Psychological Impact of Infertile Couples on Postponement of Fertility Treatment Due to COVID-19 Pandemic: A Cross-Sectional Study
Authors: Chua Ai Chen , Hamdan Mukhri , Tan Albert Chao Chiet
Published: March 2023

Introduction: Coronavirus disease 2019 (COVID-19) brought forth an unprecedented suspension of fertility treatment worldwide as part of a reallocation of hospital staff and resources to avoid a collapse in the healthcare system. As a nonessential service, postponement of fertility treatment due to the pandemic has impacted the mental health of infertile patients, which comprise [Formula: see text] of the Malaysian population.

Objective: To establish the patient’s perspective on how the COVID-19 pandemic has affected their fertility treatment and to ascertain their psychological status.

Methods: This was a cross-sectional study performed in a single academic center in Malaysia. This study was approved by the Universiti Malaya Medical Centre (UMMC) medical research ethics committee (MEC ID NO: 2021714-10376). Patients and partners who were planned for fertility treatment were approached and asked to answer an anonymous electronic survey between July 16, 2021 and December 17, 2021. All patients requiring fertility treatment were included.

Results: One hundred and sixty-five patients were included, and [Formula: see text] of patients did not agree with the Ministry of Health Malaysia’s recommendation to postpone fertility treatment; [Formula: see text] would want to continue with treatment; [Formula: see text] of patients are concerned about advancing age and [Formula: see text] are concerned about reducing ovarian reserve if their treatment was postponed or suspended. From univariate analysis, mild, moderate, severe, and extremely severe levels of psychological disorders were found in our patients. According to multivariate logistic regression, mild stress was significant among 20–30 years old with [Formula: see text] (OR [Formula: see text], [Formula: see text] CI [Formula: see text]). Patients from this age group also suffer from a significant moderate level of stress with [Formula: see text] (OR [Formula: see text], [Formula: see text] CI [Formula: see text]). Other variables, when analyzed using multivariate analysis, had no significant findings.

Conclusion: Stress related to COVID-19 and concerns about its effect on the fertility rate were found to be significant psychological distress among patients undergoing fertility treatment. Therefore, fertility centers should routinely monitor the mental health of patients and offer them psychological counseling.
Automatic Extraction of Specimens from Multi-specimen Herbaria
Authors: Milleville Kenzo , Thirukokaranam Chandrasekar Krishna Kumar , Verstockt Steven
Published: March 2023

Since herbarium specimens are increasingly becoming digitized and accessible in online repositories, an important need has emerged to develop automated tools to process and enrich these collections to facilitate better access to the preserved archives. Particularly, automatic enrichment of multi-specimen herbaria sheets poses unique challenges and problems that have not been adequately addressed. The complexity of localization of species in a page increases exponentially when multiple specimens are present in the same page. This already challenges the performance of models that work accurately with single specimens. Therefore, in this work, we have performed experiments to identify the models that perform well for the plant specimen localization problem. The major bottleneck for performing such experiments was the lack of labeled data. We also address this problem by proposing tools and algorithms to semi-automatically generate annotations for herbarium images. Based on our experiments, segmentation models perform much better than detection models for the task of plant localization. Our binary segmentation model can accurately extract specimens from the background and achieves an F1 score of 0.977. The ablation experiments for multi-specimen instance segmentation show that our proposed augmentation method provides a 38% increase in performance (0.51 mAP@0.9 versus 0.37) on a dataset of 1,500 plant instances.
Fair Enough: Searching for Sufficient Measures of Fairness
Authors: Majumder Suvodeep , Chakraborty Joymallya , Bai Gina R. , Stolee Kathryn T. , Menzies Tim
Published: March 2023

Testing machine learning software for ethical bias has become a pressing current concern. In response, recent research has proposed a plethora of new fairness metrics, for example, the dozens of fairness metrics in the IBM AIF360 toolkit. This raises the question: How can any fairness tool satisfy such a diverse range of goals? While we cannot completely simplify the task of fairness testing, we can certainly reduce the problem. This article shows that many of those fairness metrics effectively measure the same thing. Based on experiments using seven real-world datasets, we find that (a) 26 classification metrics can be clustered into seven groups and (b) four dataset metrics can be clustered into three groups. Further, each reduced set may actually predict different things. Hence, it is no longer necessary (or even possible) to satisfy all fairness metrics. In summary, to simplify the fairness testing problem, we recommend the following steps: (1) determine what type of fairness is desirable (and we offer a handful of such types), then (2) lookup those types in our clusters, and then (3) just test for one item per cluster.

For the purpose of reproducibility, our scripts and data are available at https://github.com/Repoanon ymous/Fairness_Metrics.