bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic models for prediction of perioperative allogeneic red blood cell transfusion in adult cardiac surgery: A systematic review and meta‐analysis
Authors: Van den Eynde Raf , Vrancken Annemarie , Foubert Ruben , Tuand Krizia , Vandendriessche Thomas , Schrijvers An , Verbrugghe Peter , Devos Timothy , Van Calster Ben , Rex Steffen
Published: December 2024

Objectives

Identifying cardiac surgical patients at risk of requiring red blood cell (RBC) transfusion is crucial for optimizing their outcome. We critically appraised prognostic models preoperatively predicting perioperative exposure to RBC transfusion in adult cardiac surgery and summarized model performance.

Methods

Design: Systematic review and meta‐analysis. Study eligibility criteria: Studies developing and/or externally validating models preoperatively predicting perioperative RBC transfusion in adult cardiac surgery. Information sources MEDLINE, CENTRAL & CDSR, Embase, Transfusion Evidence Library, Web of Science, Scopus, ClinicalTrials.gov, and WHO ICTRP. Risk of bias and applicability: Quality of reporting was assessed with the Transparent Reporting of studies on prediction models for Individual Prognosis or Diagnosis adherence form, and risk of bias and applicability with the Prediction model Risk of Bias ASsessment Tool. Synthesis methods: Random‐effects meta‐analyses of concordance‐statistics and total observed:expected ratios for models externally validated ≥5 times.

Results

Nine model development, and 27 external validation studies were included. The average TRIPOD adherence score was 66.4% (range 44.1%–85.2%). All studies but 1 were rated high risk of bias. For TRUST and TRACK, the only models externally validated ≥5 times, summary c‐statistics were 0.74 (95% CI: 0.65–0.84; 6 contributing studies) and 0.72 (95% CI: 0.68–0.75; 5 contributing studies) respectively, and summary total observed:expected ratios were 0.86 (95% CI: 0.71–1.05; 5 contributing studies) and 0.94 (95% CI: 0.74–1.19; 5 contributing studies), respectively. Considerable heterogeneity was observed in all meta‐analyses.

Discussion

Future high quality external validation and model updating studies which strictly adhere to reporting guidelines, are warranted.
Fast Goodstein walks
Authors: Fernández‐Duque David , Weiermann Andreas
Published: December 2024

We introduce a family of fast‐growing functions based on and use these to define a variant of the Goodstein process. We show that this variant terminates and that this fact is not provable in Kripke–Platek set theory (or other theories of Bachmann–Howard strength). We, moreover, show that this Goodstein process is of maximal length, so that any alternative Goodstein process based on the same fast‐growing functions will also terminate.
Differential Associations Between Device-Assessed and Parent-Reported Physical Activity With Indicators of Mental Health in Children and Youth With Disabilities
Authors: O’Rourke Roxy H. , Arbour-Nicitopoulos Kelly P. , Voss Christine , Martin Ginis Kathleen A. , Brown Denver M.Y.
Published: December 2024

Purpose: We examined associations between device-assessed and parent-reported physical activity with mental health indicators among children and youth with disabilities. Method: Physical activity and mental health data were collected from a larger national surveillance study of physical activity in children and youth with disabilities in Canada. A total of 122 children and youth with disabilities (mean age = 10 y; 80% boys, 57% with developmental disability) wore a Fitbit for 28 days to measure their daily steps. Parents reported the frequency and duration of their child’s leisure-time physical activity during the previous 7 days. Parents also completed the Strengths and Difficulties Questionnaire (ie, total difficulties score, internalizing problems, externalizing problems, and prosocial behavior) as a measure of mental health symptoms. Results: Significant relationships were observed between parent-reported physical activity and total difficulties as well as internalizing problems but not externalizing problems. Nonsignificant relationships were observed between median daily step counts and mental health indicators. Conclusion: Differential relationships between physical activity and mental health indicators may exist among children and youth with disabilities depending on how physical activity is operationalized (ie, steps vs active minutes) and measured (ie, proxy report vs device assessed). Interventionists seeking to improve mental health outcomes among children and youth with disabilities through physical activity promotion should consider these findings when deciding upon methods to assess physical activity behaviors.
MtlD as a therapeutic target for intestinal and systemic bacterial infections
Authors: Schwieters Andrew , Cole Allysa L. , Rego Emily , Gao Chengyu , Kebriaei Razieh , Wysocki Vicki H. , Gunn John S. , Ahmer Brian M. M.
Published: December 2024

The ability to treat infections is threatened by the rapid emergence of antibiotic resistance among pathogenic microbes. Therefore, new antimicrobials are needed. Here we evaluate mannitol-1-phosphate 5-dehydrogenase (MtlD) as a potential new drug target. In many bacteria, mannitol is transported into the cell and phosphorylated by MtlA, the EIICBA component of a phosphoenolpyruvate-dependent sugar phosphotransferase system. MtlD catalyzes the conversion of mannitol-1-phosphate (Mtl-1P) to fructose-6-phosphate, which enters the glycolytic pathway. Mutants lacking
mtlD
are sensitive to mannitol due to accumulation of Mtl-1P. Here, we constructed
mtlD
mutants in four different bacterial species (
Cronobacter sakazakii
,
Pseudomonas aeruginosa,
five serovars of
Salmonella enterica
, and three strains of
Escherichia coli
), confirming and quantifying their mannitol sensitivity. The quantification of mannitol sensitivity
in vitro
was complicated by an inoculum effect and a resumption of growth following mannitol intoxication. The rate of resumption at different mannitol concentrations and cell population densities is fairly constant and reveals what is likely an intoxication processing rate. Provision of mannitol in drinking water, or by intraperitoneal injection, dramatically attenuates infection of a
Salmonella enterica
serovar Typhimurium
mtlD
mutant in mouse models of both gastroenteritis and systemic infection. Using CC003/Unc mice, we find that a
mtlD
mutant of
Salmonella enterica
serovar Typhi is also attenuated by provision of mannitol in drinking water. Therefore, we postulate that MtlD could be a valuable new therapeutic target.

IMPORTANCE

The ability to treat infections is threatened by the rapid emergence of antibiotic resistance. Mannitol is a polyol used in human medicine and the food industry. During catabolism of mannitol, many bacteria transport mannitol across the inner membrane forming the toxic intermediate mannitol-1-phosphate (Mtl-1P). Mtl-1P must be processed by mannitol dehydrogenase (MtlD) or it accumulates intracellularly, causing growth attenuation. We test and confirm here that
mtlD
mutants of
Escherichia coli
(including UPEC, and EHEC),
Salmonella
(including serovars Typhi, and Paratyphi A, B, and C),
Cronobacter
, and
Pseudomonas
experience mannitol sensitivity
in vitro
. Furthermore, providing mannitol in drinking water can alleviate both gastrointestinal and systemic
Salmonella
infections in mice. This suggests that inhibition of MtlD could be a viable antimicrobial strategy.
Short-term evolution and dispersal patterns of fluconazole-resistance in
Candida auris
clade III
Authors: Cancino-Muñoz Irving , Mulet-Bayona Juan Vicente , Salvador-García Carme , Tormo-Palop Nuria , Guna Remedios , Gimeno-Cardona Concepción , González-Candelas Fernando
Published: December 2024

The rapid increase in infections caused by the emerging fungal pathogen
Candida auris
is of global concern, and understanding its expansion is a priority. The phylogenetic diversity of the yeast is clustered in five major clades, among which clade III is particularly relevant, as most of its strains exhibit resistance to fluconazole, reducing the therapeutic alternatives and provoking outbreaks that are difficult to control. In this study, we have investigated the phylogenetic structure of clade III by analyzing a global collection of 566 genomes. We have identified three subgroups within clade III, among which two are genetically most closely related. Moreover, we have estimated the evolutionary rate of clade III to be 2.25e-7 s/s/y (2.87 changes per year). We found that one of these subgroups shows intrinsic resistance to fluconazole and is responsible for the majority of cases within this clade globally. We inferred that this subgroup may have originated around December 2010 (95% High Probability Density (HPD): April 2010–June 2011), and since then it has spread across continents, generating multiple large outbreaks, each with a unique pattern of transmission and dissemination. These results highlight the remarkable ability of the pathogen to adapt to its environment and its rapid global spread, underscoring the urgent need to address this epidemiological challenge effectively.

IMPORTANCE

The number of cases affected by
Candida auris
has increased worryingly worldwide. Among the currently recognized clades, clade III has the highest proportion of fluconazole-resistant cases and is spreading very rapidly, causing large nosocomial outbreaks across the globe. By analyzing complete fungal genomes from around the world, we have confirmed the origin of this clade and unraveled its dispersal patterns in the early 2010s. This finding provides knowledge that may be helpful to the public health authorities for the control of the disease.
Pseudomonas aeruginosa
alkyl quinolone response is dampened by
Enterococcus faecalis
Authors: Fink Maggie M. , Weaver Abigail A. , Parmar Dharmeshkumar , Paczkowski Jon E. , Li Lingyun , Klaers Maggie K. , Junker Ella A. , Jarocki Elizabeth A. , Sweedler Jonathan V. , Shrout Joshua D.
Published: December 2024

The bacterium
Pseudomonas aeruginosa
is an opportunistic pathogen that can cause lung, skin, wound, joint, urinary tract, and eye infections. While
P. aeruginosa
is known to exhibit a robust competitive response toward other bacterial species, this bacterium is frequently identified in polymicrobial infections where multiple species survive. For example, in prosthetic joint infections,
P. aeruginosa
can be identified along with other pathogenic bacteria including
Staphylococcus aureus
,
Enterococcus faecalis
, and
Corynebacterium striatum
. Here, we have explored the survival and behavior of such microbes and find that
E. faecalis
readily survives culturing with
P. aeruginosa
while other tested species do not. In each of the tested conditions,
E. faecalis
growth remained unchanged by the presence of
P. aeruginosa
, indicating a unique mutualistic interaction between the two species. We find that
E. faecalis
proximity leads
P. aeruginosa
to attenuate competitive behaviors as exemplified by reduced production of
Pseudomonas
quinolone signal and pyocyanin. Reduced alkyl quinolones are important to
E. faecalis
as these will grow in supernatant from a quinolone mutant but not
P. aeruginosa
wild-type in planktonic culture. The reduced pyocyanin production of
P. aeruginosa
is attributable to production of ornithine by
E. faecalis
, which we recapitulate by adding exogenous ornithine to
P. aeruginosa
monocultures. Similarly, co-culture with an ornithine-deficient strain of
E. faecalis
leads
P. aeruginosa
to yield near monoculture amounts of pyocyanin. Here, we directly demonstrate how notorious pathogens such as
P. aeruginosa
might persist in polymicrobial infections under the influence of metabolites produced by other bacterial species.

IMPORTANCE

While we now appreciate that many infections are polymicrobial, we understand little of the specific actions between a given set of microbes to enable combinatorial survival and pathogenesis. The bacteria
Pseudomonas aeruginosa
and
Enterococcus faecalis
are both prevalent pathogens in wound, urinary tract, and bacteremic infections. While
P. aeruginosa
often kills other species in standard laboratory culture conditions, we present here that
E. faecalis
can be reliably co-cultured with
P. aeruginosa
. We specifically detail that ornithine produced by
E. faecalis
reduces the
Pseudomonas
quinolone signal response of
P. aeruginosa
. This reduction of the
Pseudomonas
quinolone signal response aids
E. faecalis
growth.
Inorganic polyphosphate and the stringent response coordinately control cell division and cell morphology in
Escherichia coli
Authors: Hamm Christopher W. , Gray Michael J.
Published: December 2024

Bacteria encounter numerous stressors in their constantly changing environments and have evolved many methods to deal with stressors quickly and effectively. One well-known and broadly conserved stress response in bacteria is the stringent response, mediated by the alarmone (p)ppGpp. (p)ppGpp is produced in response to amino acid starvation and other nutrient limitations and stresses and regulates both the activity of proteins and expression of genes.
Escherichia coli
also makes inorganic polyphosphate (polyP), an ancient molecule evolutionary conserved across most bacteria and other cells, in response to a variety of stress conditions, including amino acid starvation. PolyP can act as an energy and phosphate storage pool, metal chelator, regulatory signal, and chaperone, among other functions. Here we report that
E. coli
lacking both (p)ppGpp and polyP have a complex phenotype indicating previously unknown overlapping roles for (p)ppGpp and polyP in regulating cell division, cell morphology, and metabolism. Disruption of either (p)ppGpp or polyP synthesis led to the formation of filamentous cells, but simultaneous disruption of both pathways resulted in cells with heterogenous cell morphologies, including highly branched cells, severely mislocalized Z-rings, and cells containing substantial void spaces. These mutants also failed to grow when nutrients were limited, even when amino acids were added. These results provide new insights into the relationship between polyP synthesis and the stringent response in bacteria and point toward their having a joint role in controlling metabolism, cell division, and cell growth.

IMPORTANCE

Cell division is a fundamental biological process, and the mechanisms that control it in
Escherichia coli
have been the subject of intense research scrutiny for many decades. Similarly, both the (p)ppGpp-dependent stringent response and inorganic polyphosphate (polyP) synthesis are well-studied, evolutionarily ancient, and widely conserved pathways in diverse bacteria. Our results indicate that these systems, normally studied as stress-response mechanisms, play a coordinated and novel role in regulating cell division, morphology, and metabolism even under non-stress conditions.
A bacterial membrane-disrupting protein stimulates animal metamorphosis
Authors: Malter Kyle E. , Dunbar Tiffany L. , Westin Carl , Darin Emily , Alfaro Josefa Rivera , Shikuma Nicholas J.
Published: December 2024

Diverse marine animals undergo a metamorphic larval-to-juvenile transition in response to surface-bound bacteria. Although this host-microbe interaction is critical to establishing and maintaining marine animal populations, the functional activity of bacterial products and how they activate the host’s metamorphosis program has not yet been defined for any animal. The marine bacterium
Pseudoalteromonas luteoviolacea
stimulates the metamorphosis of a tubeworm called
Hydroides elegans
by producing a molecular syringe called metamorphosis-associated contractile structures (MACs). MACs stimulate metamorphosis by injecting a protein effector termed metamorphosis-inducing factor 1 (Mif1) into tubeworm larvae. Here, we show that MACs bind to tubeworm cilia and form visible pores on the cilia membrane surface, which are smaller and less numerous in the absence of Mif1.
In vitro
, Mif1 associates with eukaryotic lipid membranes and possesses phospholipase activity. MACs can also deliver Mif1 to human cell lines and cause parallel phenotypes, including cell surface binding, membrane disruption, calcium flux, and mitogen-activated protein kinase activation. Finally, MACs can also stimulate metamorphosis by delivering two unrelated membrane-disrupting proteins, MLKL and RegIIIɑ. Our findings demonstrate that membrane disruption by MACs and Mif1 is necessary for
Hydroides
metamorphosis, connecting the activity of a bacterial protein effector to the developmental transition of a marine animal.

IMPORTANCE

This research describes a mechanism wherein a bacterium prompts the metamorphic development of an animal from larva to juvenile form by injecting a protein that disrupts membranes in the larval cilia. Specifically, results show that a bacterial contractile injection system and the protein effector it injects form pores in larval cilia, influencing critical signaling pathways like mitogen-activated protein kinase and calcium flux, ultimately driving animal metamorphosis. This discovery sheds light on how a bacterial protein effector exerts its activity through membrane disruption, a phenomenon observed in various bacterial toxins affecting cellular functions, and elicits a developmental response. This work reveals a potential strategy used by marine organisms to respond to microbial cues, which could inform efforts in coral reef restoration and biofouling prevention. The study’s insights into metamorphosis-associated contractile structures’ delivery of protein effectors to specific anatomical locations highlight prospects for future biomedical and environmental applications.
High-quality draft genomes of ecologically and geographically diverse
Psilocybe
species
Authors: Bollinger Ian M. , Singer Harte , Jacobs Jordan , Tyler Marshall , Scott Kelsey , Pauli Christopher S. , Miller Dusty Rose , Barlow Caine , Rockefeller Alan , Slot Jason C. , Angel-Mosti Victor
Published: December 2024

Psilocybe
is a genus of mushroom-forming fungi with ecological, ethnomycological, and clinical importance due to psilocybin production by most species. We present five genomes that enable deeper discovery and analysis of the psilocybin gene cluster and increase taxonomic resolution within
Psilocybe
:
Psilocybe semilanceata
,
Psilocybe gandalfiana
nom. prov.,
Psilocybe caeruleorhiza
,
Psilocybe azurescens
, and
Psilocybe allenii
.
Genome assembly and annotation of microalga
Nannochloropsis oceanica
C018
Authors: Estrada-Graf Adrian , Koneru Hari , Arnold Jason , Calhoun Sara , Grigoriev Igor V. , Johnson Zackary I.
Published: December 2024

The microalga
Nannochloropsis
is an important organism for algae-based biocommodity production of food, feed, and fuel, among other products. Using PacBio Revio, we sequenced, assembled, and annotated a 26.41 Mbp
Nannochloropsis oceanica
C018 genome.
Amplicon sequences of sourdough starter cultures treated with varying levels of water chlorination
Authors: Lau Pearson , Jain Swapan , Peraza Rei , Perron Gabriel G.
Published: December 2024

Here, we present amplicon sequences from sourdough starter cultures that have been treated with a chlorine concentration gradient mirroring public water distribution systems. Data derived present insights into the effect of important environmental factors that may influence the formation of microbial communities in food biomes.
Complete genome sequence of
Dorea formicigenerans
JCM 31256
Authors: Tourlousse Dieter M. , Murotomi Kazutoshi , Hamajima Mayu , Sekiguchi Yuji
Published: December 2024

We describe a complete genome sequence of
Dorea formicigenerans
JCM 31256. The genome consists of a single circular chromosome with a length of 3,090,452 base pairs and a GC content of 40.8%, and was predicted to contain 3,061 total genes, encoding for 2,907 proteins.
Phenotypic and genotypic characterization of clinical carbapenem-resistant
Acinetobacter
species harboring the metallo-beta-lactamases IMP-8 or NDM-1 in China
Authors: Xu Qingye , Mu Xinli , He Jintao , Liu Haiyang , Liu Xiaochen , Wang Yanfei , Hua Xiaoting , Yu Yunsong
Published: December 2024

Carbapenem-resistant
Acinetobacter
spp. pose a significant challenge in clinical settings due to limited treatment options for nosocomial infections. Carbapenem-hydrolyzing class D beta-lactamases are the primary cause for carbapenem resistance, while metallo-beta-lactamases (MBLs) New Delhi metallo beta-lactamase (NDM) and imipenemase (IMP) also contribute. This study investigated five MBL-producing
Acinetobacter
spp. strains isolated from a clinic in China in 2010. The
bla
IMP-8
-carrying A1014 was the first identified CRAB among all known ST
Pas
150 isolates worldwide. Through whole-genome sequencing and the southern blot analysis, we determined that
bla
IMP-8
was located on a pR4WN-type plasmid and
bla
NDM-1
was located on four distinct pSU1904NDM-type plasmids. The
bla
IMP-8
gene was identified within a class 1 integron organized as a 5’-conserved segment (
intI
), variable region (
bla
IMP-8
-
aac(6')-Ib
), and 3’-conserved segment (
qacE
Δ1/
sul1
). All available sequences of
bla
IMP
variants in
A. baumannii
from the NCBI were investigated and classified into five types of class 1 integrons. All
bla
NDM-1
plasmids were transferable, and the
bla
NDM-1
genes were in a conservative region. Additionally, multiple resistance genes, including those conferring resistance to aminoglycosides, tetracyclines, and macrolides, were detected on plasmids from these strains. All strains were resistant to meropenem and imipenem, while they were all susceptible to tigecycline and intermediate to polymyxin. A207 and A1014 were susceptible to cefiderocol, and only
bla
IMP-8
-carrying A1014 had low MIC value (4/2 µg/mL) toward cefoperazone/sulbactam. In conclusion, we characterized the phenotypic and genotypic features of one IMP-8-producing and four NDM-1-producing plasmids recovered from
Acinetobacter
spp. strains isolated in 2010, contributing to the understanding of the dissemination and evolution of these enzymes.

IMPORTANCE

Given the low prevalence of IMP among
A. baumannii
and the limited sequencing technology in earlier years, research on
bla
IMP
in
A. baumannii
is scarce, and genetic information on
bla
NDM-1
-producing
Acinetobacter
spp. strains isolated in earlier years is limited. This study revisited five MBL-carrying
Acinetobacter
spp. strains isolated in 2010, characterizing their phenotypic and genotypic features. This retrospective analysis serves as a form of “bacterial archaeology,” providing evidence of the evolutionary changes in genetic elements conferring antibiotic resistance.
Sequential phreatomagmatic eruptions during the lateral propagation of giant dyke swarms
Authors: Pryce Evan , Cartwright Joe , Kirkham Chris , Phillips Daniel
Published: December 2024

Giant dyke swarms are widely developed on Earth, Venus, and Mars and form by lateral propagation of constituent dykes over hundreds to thousands of kilometers. The failure of these dykes to erupt magma at surface partly accounts for their long-range propagation. However, the lack of preservation of the upper regions of most terrestrial dykes is a barrier to fully explaining the reasons for this upward arrest below ground level. Here we use 3-D seismic and well data to document the near surface expression of dykes comprising the Mull Dyke Swarm from the southern North Sea (UK). The upper tips of these dykes are overlain by linear arrays of craters with deeply eroded bases. Craters are flanked by a tephra apron comprising reworked chalky sediments. The well data allow us to exclude crater forming mechanisms based on collapse into a void but are consistent with those linked to phreatomagmatic eruption. We propose that the rapid cooling of dyke magma during the phreatomagmatic eruptive process was an important contributory factor in the upward arrest of dyke propagation, preventing surface extrusion and hence promoting lateral propagation.
Second trimester medical abortion in acute promyelocytic leukaemia
Authors: Siwatch Sujata , Khastgir Gaurav , Sikka Pooja , Sachdeva Man Updesh Singh
Published: December 2024

Acute promyelocytic leukaemia (APL) is a highly lethal haematological malignancy. It is rare in pregnancy and may be fatal if not managed promptly and appropriately. A woman in her 20s presented with high-grade fever at 16 weeks of her third pregnancy. She was referred to our institution due to persistent fever with pancytopenia. A peripheral blood smear revealed atypical promyelocytes with reduced red cell density and giant platelets. Bone marrow biopsy demonstrated Auer rods and faggot cells consistent with APL. Though emotionally challenged by the circumstances, the couple decided to terminate the pregnancy and receive chemotherapy. She was given arsenic trioxide and all-trans retinoic acid. Following one dose of oral mifepristone and two doses of vaginal misoprostol, she spontaneously expelled a female abortus. Her chemotherapy was completed, and 3 years on, she is currently doing well. This case describes the dilemmas in management for the couple and providers.
Anterograde amnesia recurrence in temporal lobe epilepsy with amygdala-enlargement
Authors: Nakagawa Yuta , Satake Yuto , Hata Masahiro , Ikeda Manabu
Published: December 2024

Temporal lobe epilepsy (TLE) can cause different types of memory impairments. Here, we report a case of immediate improvement of memory impairment following antiepileptic drug (AED) treatment in a patient with TLE with amygdala enlargement (TLE-AE), who rapidly developed recurrence. The patient was a man in his 60s whose family members complained of his amnesia. Neuropsychological investigations detected obvious recent and remote memory loss and executive function impairments. Our examinations revealed evidence of TLE and bilateral amygdala enlargement without any results suggesting organic diseases, resulting in a diagnosis of TLE-AE. Although treatment with levetiracetam immediately improved recent memory and executive function, the improvement of the former was temporary. His recent memory loss impairments recurred within 3 months, but were recovered again after switching drug treatment to lacosamide and suppressing epileptic seizures. Careful follow-up after starting AED and sufficient AED adjustment is important in the treatment of memory problems in TLE-AE.
Predicting complications in elderly patients undergoing oral cancer resection with free flap reconstruction in China: a retrospective cohort study using the modified Frailty Index and Prognostic Nutritional Index
Authors: Luo Tao , Huang Can , Zhou Ren , Sun Yu
Published: December 2024

Objectives

This study aimed to evaluate the predictive abilities of the 5-item modified Frailty Index (5-mFI), Prognostic Nutrition Index (PNI), and their combination in older adult patients undergoing oral cancer resection and free flap reconstruction.

Design

Retrospective cohort study.

Setting

Secondary care involving multiple centres treating older adult patients for oral cancer.

Participants

This study included a total of 1197 patients aged ≥60 years who underwent oral cancer resection with free flap reconstruction between January 2014 and December 2022. The study included patients aged ≥60 years with malignant tumours who underwent selective radical surgery, such as mandibulectomy, maxillectomy, glossectomy or laryngectomy, followed by free flap reconstruction under general anaesthesia. Exclusion criteria included the presence of any inflammatory disease affecting blood test results, incomplete clinical records or missing data for any of the five items in the 5-mFI. Patients were categorised into four groups based on PNI and 5-mFI values: (1) ‘Control’ (neither frail nor malnourished), (2) ‘Frailty’ (frail only), (3) ‘Malnutrition’ (malnourished only) and (4) ‘Frailty+Malnutrition’ (both frail and malnourished).

Primary and secondary outcome measures

The primary outcome was the rate of complications within 30 days after surgery. Secondary outcomes included unplanned reoperation rates, length of postoperative hospital stay and the predictive performance of PNI, 5-mFI and their combination.

Results

The overall complication rate within 30 days post-surgery was 34.6%. The Frailty+Malnutrition group exhibited the highest risk of complications, longer postoperative hospital stays and increased rates of unplanned reoperation compared with the Control, Frailty and Malnutrition groups. The combined PNI and 5-mFI model significantly improved the predictive value for postoperative complications compared with either PNI or 5-mFI alone.

Conclusions

Older adult patients undergoing oral cancer resection with free flap reconstruction face considerable risk from frailty and malnutrition. Although both 5-mFI and PNI independently demonstrated good predictive abilities for postoperative complications, the combined model provided the best prediction. These findings could help optimise preoperative management in this high-risk population.
Exploring the status of online social support for older adults with cancer: a scoping review protocol
Authors: Liu Fei , Pilleron Sophie , Pinker India
Published: December 2024

Introduction

The estimated number of new cases among older adults with cancer has been increasing. Considering the decrease in social networks as adults age, their need for social support is often unmet. Notably, an increasing number of older adults with cancer have access to social support through online technologies, especially since the COVID-19 pandemic, which heightened the need for online social support. Little is known, however, about the extent to which online social support for older people with cancer has developed. This scoping review aims to explore the developments in online social support for older adults with cancer.

Methods and analysis

We will search PubMed, Elsevier Embase (including Medline) and EBSCO CINAHL Complete to identify eligible studies based on predefined criteria. Screening of articles and data extraction will be carried out independently by two reviewers, with conflicts resolved by a third reviewer. This scoping review will be based on the Arksey and O’Malley methodological framework with the extension proposed by Levac and colleagues. The review findings will be presented in a narrative analysis using tables. This protocol is registered on Open Science Framework athttps://doi.org/10.17605/OSF.IO/Z9XJ7.

Ethics and dissemination

No ethical approval is needed. The findings will be published in a peer-reviewed journal and presented at conferences.
Association of diet quality and nutrient intake with odds of dyslipidaemia in patients with cardiovascular diseases: a hospital based cross-sectional study in Bangladesh
Authors: Tasnim Tasmia , Karim Kazi Muhammad Rezaul , Bhatta Chaity
Published: December 2024

Objective

The aim of this study is to evaluate diet quality and other associated factors with dyslipidaemia in cardiovascular disease (CVD) patients in Bangladesh.

Design

The study employed a cross-sectional design.

Setting

Data from medical records, dietary intake and socioeconomic factors were collected from January to October 2022 at the National Institute of Cardiovascular Disease, Dhaka, and Noakhali Sadar Hospital.

Participants

A total of 570 CVD patients, aged 25–80 years, with a confirmed diagnosis within the past 3 months, were included in the study.

Main outcome measures

The primary outcomes were the Global Diet Quality Score (GDQS) and dyslipidaemia. Multivariate logistic regression models were used to explore the associations between dyslipidaemia and various sociodemographic, nutritional, and dietary factors in CVD patients.

Results

Dyslipidaemia was identified in more than two-thirds (70.4%) of participants. The mean GDQS was 24.38, with 69.8% of the population maintaining a healthy diet. GDQS was significantly higher in the non-dyslipidaemic group (25.21±2.53) compared with the dyslipidaemic group (24.03±2.33). Nutrient intake was generally higher in non-dyslipidaemic patients. The odds of hypercholesterolaemia, hypertriglyceridaemia and elevated low-density lipoprotein (LDL) were notably higher for participants in the lowest GDQS tertile compared with the highest. Multivariable logistic regression identified sex, employment status, body mass index (BMI) and GDQS as significant predictors of dyslipidaemia. Males (adjusted odds ratio (AOR)=4.18, 95% CI 2.32 to 7.54), homemakers (AOR=2.86) and obese individuals (AOR=1.0) were at increased odds of dyslipidaemia. Compared with the highest GDQS tertile, the odds of dyslipidaemia were nearly double in the middle tertile (AOR: 1.87, 95% CI 1.13 to 3.11) and almost four times higher in the lowest tertile (AOR: 3.67, 95% CI 2.02 to 6.64).

Conclusions

A high-quality diet was associated with significantly lower odds of dyslipidaemia, hypercholesterolaemia, hypertriglyceridaemia and elevated LDL cholesterol. The study findings highlight the potential of targeted nutritional interventions with a multifaceted approach to managing dyslipidaemia, emphasising the need for personalised dietary guidelines that consider the individual’s gender, occupation and BMI.
Neoadjuvant atezolizumab + chemotherapy for resectable NSCLC: 3-year clinical update of phase II clinical trial results and translational findings
Authors: Henick Brian S , Koch Peter D , Gainor Justin F , Awad Mark M , Chiuzan Codruta , Izard Stephanie , Georgis Yohanna , Mallick Samyukta , Garofano Robert F , Wong Cheryl V , Saqi Anjali , Grindheim Jessica , Schulze Katja , Sonett Joshua R , Rizvi Naiyer A , Izar Benjamin , Taylor Alison M , Shu Catherine A
Published: December 2024

Introduction

Neoadjuvant chemoimmunotherapy has achieved overall survival (OS) benefit for patients with resectable non-small cell lung cancer (NSCLC). Here, we present outcomes after 3 years of follow-up from the first reported study of neoadjuvant atezolizumab+chemotherapy.

Methods

This open-label, multicenter single-arm investigator-initiated phase II study conducted at three US hospitals tested up to four cycles of atezolizumab, carboplatin, and nab-paclitaxel prior to surgery. Major pathological response (MPR, primary endpoint) was previously reported; here, we report 3-year disease-free survival (DFS), OS, and clinical characteristics of patients developing brain metastases (BM) with integrated data from tumor genomics, gene expression, and quantitative immunofluorescent measurement of immune markers.

Results

Of 30 enrolled patients, 29 were taken to the operating room. 26 underwent R0 resection, with 17 experiencing MPR (10 pCR). With a median follow-up of 39.5 months, the median OS was 55.8 months, and the median DFS was 34.5 months. Landmark OS at 36 months was 77%. Among 14 patients with recurrent disease, 6 patients had BM. Patients whose tumors had mutations in
STK11
and
KEAP1
did not have a significantly higher incidence of BM. Reduced copy number of
STK11
and
KEAP1
, both residing on chromosome 19p, was observed in ~1/3 of tumors. Reduced CN of
STK11
was significantly associated with worse pathological response and incidence of BM.

Conclusions

Consistent with recent phase III studies, 3-year OS data with neoadjuvant atezolizumab+chemotherapy was associated with prolonged PFS and OS. Establishing associations between
STK11
and
KEAP1
genomic alterations and key clinical outcomes in early-stage NSCLC requires further study.
Anatomy-centred deep learning improves generalisability and progression prediction in radiographic sacroiliitis detection
Authors: Dorfner Felix J. , Vahldiek Janis L. , Donle Leonhard , Zhukov Andrei , Xu Lina , Häntze Hartmut , Makowski Marcus R. , Aerts Hugo J. W. L. , Proft Fabian , Rios Rodriguez Valeria , Rademacher Judith , Protopopov Mikhail , Haibel Hildrun , Hermann Kay-Geert , Diekhoff Torsten , Adams Lisa C. , Torgutalp Murat , Poddubnyy Denis , Bressem Keno K.
Published: December 2024

Purpose

To examine whether incorporating anatomy-centred deep learning can improve generalisability and enable prediction of disease progression.

Methods

This retrospective multicentre study included conventional pelvic radiographs of four different patient cohorts focusing on axial spondyloarthritis collected at university and community hospitals. The first cohort, which consisted of 1483 radiographs, was split into training (n=1261) and validation (n=222) sets. The other cohorts comprising 436, 340 and 163 patients, respectively, were used as independent test datasets. For the second cohort, follow-up data of 311 patients was used to examine progression prediction capabilities. Two neural networks were trained, one on images cropped to the bounding box of the sacroiliac joints (anatomy-centred) and the other one on full radiographs. The performance of the models was compared using the area under the receiver operating characteristic curve (AUC), accuracy, sensitivity and specificity.

Results

On the three test datasets, the standard model achieved AUC scores of 0.853, 0.817, 0.947, with an accuracy of 0.770, 0.724, 0.850. Whereas the anatomy-centred model achieved AUC scores of 0.899, 0.846, 0.957, with an accuracy of 0.821, 0.744, 0.906, respectively. The patients who were identified as high risk by the anatomy-centred model had an OR of 2.16 (95% CI 1.19, 3.86) for having progression of radiographic sacroiliitis within 2 years.

Conclusion

Anatomy-centred deep learning can improve the generalisability of models in detecting radiographic sacroiliitis. The model is published as fully open source alongside this study.
Rationale for phosphodiesterase-4 inhibition as a treatment strategy for interstitial lung diseases associated with rheumatic diseases
Authors: Aringer Martin , Distler Oliver , Hoffmann-Vold Anna-Maria , Kuwana Masataka , Prosch Helmut , Volkmann Elizabeth R
Published: December 2024

Interstitial lung disease (ILD) associated with rheumatoid arthritis or with connective tissue diseases such as systemic sclerosis can be collectively named systemic autoimmune rheumatic disease-associated ILDs (SARD-ILDs) or rheumatic musculoskeletal disorder-associated ILDs. SARD-ILDs result in substantial morbidity and mortality, and there is a high medical need for effective therapies that target both fibrotic and inflammatory pathways in SARD-ILD. Phosphodiesterase 4 (PDE4) hydrolyses cyclic AMP, which regulates multiple pathways involved in inflammatory processes. PDE4 is overexpressed in peripheral blood monocytes from patients with inflammatory diseases. However, clinical data on pan-PDE4 inhibition in fibrotic conditions are lacking. The PDE4B subtype is highly expressed in the brain, lungs, heart, skeletal muscle and immune cells. As such, inhibition of PDE4B may be a novel approach for fibrosing ILDs such as idiopathic pulmonary fibrosis (IPF) and SARD-ILD. Preclinical data for PDE4B inhibition have provided initial evidence of both anti-inflammatory and antifibrotic activity, with reduced potential for gastrointestinal toxicity compared with pan-PDE4 inhibitors. In a proof-of-concept phase II trial in patients with IPF, nerandomilast (BI 1015550), the only PDE4B inhibitor currently in clinical development, prevented a decline in lung function over 12 weeks compared with placebo. The potential clinical benefit of PDE4B inhibition is now being investigated in the phase III setting, with two trials evaluating nerandomilast in patients with IPF (FIBRONEER-IPF) or with progressive pulmonary fibrosis other than IPF (FIBRONEER-ILD). Here, we review the preclinical and clinical data that provide rationale for PDE4B inhibition as a treatment strategy in patients with SARD-ILD.
Outcome of anatomical versus non-anatomical lung resection for necrotizing pneumonia in children
Authors: Da Silva Paulo Sérgio Lucas , De Oliveira Renato , Tamura Nikkei , Camargo Leonardo , Kubo Emerson Yukio
Published: December 2024

Objective

We aimed to evaluate the characteristics, complications and outcomes of necrotizing pneumonia (NP) requiring surgical intervention.

Methods

We conducted a retrospective study of all children who underwent surgical therapy for NP from January 2010 to December 2023. Patients were analyzed based on two surgical approaches: anatomic resection (AR) or non-AR (NAR).

Results

A total of 66 patients (median age: 36 months) required a surgical intervention for NP. A total of 37 patients received AR, 29 received NAR. The AR procedures were segmentectomy (n=29), lobectomy (n=8), bilobectomy (n=1) whereas NAR included wedge resection (n=13) and necrosectomy (n=16). The most common reasons for surgery were failure to respond to treatment (43.9%) and sepsis/septic shock (42.4%). A significantly greater proportion of patients in the AR group underwent surgery due to sepsis (p=0.023). There was no difference in the proportion of patients experiencing complications between the AR group (40.5%) and the NAR group (27.5%) (p=0.266). The majority of complications in both groups (68.0%) were categorized as minor, with 59.0% of cases occurring in patients who underwent AR. Prolonged air leak was the most frequent complication in both groups. There was no difference in the postoperative hospital stay, or duration of mechanical ventilation between the groups. There were no deaths.

Conclusions

Surgical intervention for NP may result in complications in one-third of patients, mostly minor and unlikely to significantly impact outcomes. Surgery should be tailored to the extent of parenchymal involvement.
Neutron stars in extended scalar-Gauss–Bonnet gravity: the richness of the solution spectrum
Authors: Staykov Kalin V. , Yordanov Peter Y. , Doneva Daniela D. , Yazadjiev Stoytcho S.
Published: December 2024

Neutron stars are natural laboratories for testing gravity in the strong field regime. That is why the full spectrum of neutron star solutions in different modified theories should be thoroughly studied. Among the most natural modifications of general relativity are the theories in which additional scalar degrees of freedom are present. That is why scalar-tensor theories like Brans–Dicke and Damour–Esposito–Farese theories, as well as their extensions such as scalar-Gauss–Bonnet gravity, attracted attention throughout the years. In the present work, we combine those theory families and explore extensively the neutron star solution space in their realm. We identify qualitative new behavior of the solutions, including the existence of new types of phase transitions and new branches of solutions present only for high neutron star masses. Due to the peculiarities of the solutions, they can not be easily mimicked by a simple change of the equation of state.
Semiclassical defect measures and the observability estimate for Schrödinger operators with homogeneous potentials of order zero
Authors: Mikami Keita
Published: December 2024

In this paper, we study the asymptotic behavior of solutions as [Formula: see text] of Schrödinger operators with homogeneous potentials. For this purpose, we use methods from semiclassical analysis and investigate semiclassical defect measures. We prove the localization in directions for the semiclassical defect measures. We apply the localization results to obtain a necessary observability condition.
Architecture Knowledge Distillation for Evolutionary Generative Adversarial Network
Authors: Xue Yu , Lin Yan , Neri Ferrante
Published: December 2024

Generative Adversarial Networks (GANs) are effective for image generation, but their unstable training limits broader applications. Additionally, neural architecture search (NAS) for GANs with one-shot models often leads to insufficient subnet training, where subnets inherit weights from a supernet without proper optimization, further degrading performance. To address both issues, we propose Architecture Knowledge Distillation for Evolutionary GAN (AKD-EGAN). AKD-EGAN operates in two stages. First, architecture knowledge distillation (AKD) is used during supernet training to efficiently optimize subnetworks and accelerate learning. Second, a multi-objective evolutionary algorithm (MOEA) searches for optimal subnet architectures, ensuring efficiency by considering multiple performance metrics. This approach, combined with a strategy for architecture inheritance, enhances GAN stability and image quality. Experiments show that AKD-EGAN surpasses state-of-the-art methods, achieving a Fréchet Inception Distance (FID) of 7.91 and an Inception Score (IS) of 8.97 on CIFAR-10, along with competitive results on STL-10 (FID: 20.32, IS: 10.06). Code and models will be available at https://github.com/njit-ly/AKD-EGAN .
Online and Cross-User Finger Movement Pattern Recognition by Decoding Neural Drive Information from Surface Electromyogram
Authors: Zhao Haowen , Liu Yunfei , Li Xinhui , Chen Xiang , Zhang Xu
Published: December 2024

Cross-user variability is a well-known challenge that leads to severe performance degradation and impacts the robustness of practical myoelectric control systems. To address this issue, a novel method for myoelectric recognition of finger movement patterns is proposed by incorporating a neural decoding approach with unsupervised domain adaption (UDA) learning. In our method, the neural decoding approach is implemented by extracting microscopic features characterizing individual motor unit (MU) activities obtained from a two-stage online surface electromyogram (SEMG) decomposition. A specific deep learning model is designed and initially trained using labeled data from a set of existing users. The model can update adaptively when recognizing the movement patterns of a new user. The final movement pattern was determined by a fuzzy weighted decision strategy. SEMG signals were collected from the finger extensor muscles of 15 subjects to detect seven dexterous finger-movement patterns. The proposed method achieved a movement pattern recognition accuracy of ([Formula: see text])% over seven movements under cross-user testing scenarios, much higher than that of the conventional methods using global SEMG features. Our study presents a novel robust myoelectric pattern recognition approach at a fine-grained MU level, with wide applications in neural interface and prosthesis control.
The polarization tensor approach for Casimir effect
Authors: Khusnutdinov Nail , Emelianova Natalia
Published: December 2024

This paper gives a brief overview of the polarization tensor approach to the Casimir effect. The fundamental principles of this approach are discussed, along with its various applications to both three-dimensional and two-dimensional systems, with a focus on its implications for graphene.
Recent solution to the Casimir puzzle awaits its experimental confirmation
Authors: Mostepanenko V. M. , Klimchitskaya G. L.
Published: December 2024

The plausible resolution of the Casimir puzzle implying that the dissipative Drude model is not applicable in the area of transverse electric evanescent waves is discussed. Calculations show that for the propagating waves, as well for the evanescent waves with transverse magnetic polarization, the Drude model can be used in calculations of the Casimir force by the Lifshitz theory with no contradictions with the measurement data. The lateral component of magnetic field of the magnetic dipole oscillating near a metallic surface is computed for the parameters of experiment in preparation which is aimed to directly check the validity of the Drude model in the area of transverse electric evanescent waves. By comparing with the case of graphene, whose dielectric response is spatially nonlocal and possesses the double pole at zero frequency, it is hypothesized that the success of the dissipationless plasma model in this area is also caused by the presence of a double pole.