bluuebunny/crossref_metadata_2025 huggingface dataset:
Lactobacillus plantarum J26 postbiotics alleviate high‐fat and high‐cholesterol diet‐induced hypercholesterolemia via regulating the LXRα‐CYP7A1‐bile acid‐excretion pathway
Authors: Zheng Miao , Ma Ming , Wang Linge , Yang Xinyan , Zhang Yu , Man Chaoxin , Zhao Qianyu , Jiang Yujun
Published: September 2023

Postbiotics have received increasing interest for their storage stability and safety compared to probiotics, as well as their potential functionality. In this study, edible Lactobacillus plantarum J26 postbiotics (J26P) were prepared by spray drying using skimmed milk as the medium, and 1113 compounds were identified. The aim of this study was to evaluate the cholesterol lowering effect of J26P on hypercholesterolemic mice induced by a high‐fat and high‐cholesterol diet (HCD). The results suggest that J26P significantly alleviated weight gain and appetite reduction in HCD mice. J26P also improved serum and liver biochemical parameters at various levels, including lower total cholesterol (TC), triglyceride (TG), low‐density lipoprotein cholesterol (LDL‐C) in the serum, and TC, TG, LDL‐C, glutamic oxaloacetic transaminase, and glutamic‐pyruvic transaminase in the liver, and increase high‐density lipoprotein cholesterol in the serum and liver. Moreover, liver histopathologic examinations revealed that J26P significantly inhibited fat accumulation and degeneration in hypercholesterolemic mice and increased the expression of liver uncoupling protein 1. Furthermore, the J26P intervention effectively promoted the reduction of cholesterol levels in hypercholesterolemic mice via the LXRα‐CYP7A1‐bile acid‐excretion pathway, which was corroborated by the increased fecal total cholesterol and fecal total bile acid levels. This work provided a theoretical basis for the industrial development of postbiotics and the alleviation of hypercholesterolemia and its complications.
Predictive value of hematological indices on incidence and severity of pulmonary embolism in COVID‐19 patients
Authors: Radkhah Hanieh , Mansouri Ensieh Sadat , Rahimipour Anaraki Shiva  , Gholizadeh Mesgarha Milad , Sheikhy Ali , Khadembashiri Mohamad Mehdi , Khadembashiri Mohamad Amin , Eslami Mohamad , Mahmoodi Tara , Inanloo Behnaz , Pour Mohammad Arash
Published: September 2023

Background

Pulmonary thromboembolism (PTE) is a common complication of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), which raises the COVID‐19 disease's fatality rate from 3% to 45%. Nevertheless, due to fairly indistinguishable clinical symptoms and a lack of validated clinical prediction models, PTE diagnosis in COVID‐19 patients is challenging. This study aims to investigate the applicability of hematological indices to predict PTE incidence and its severity in SARS‐CoV‐2 patients.

Methods

A retrospective cohort study was conducted on hospitalized patients with a confirmed diagnosis of SARS‐CoV‐2 infection who underwent CT angiography to assess probable PTE in them. The correlation between complete blood count parameters 1 day before CT angiography and CT angiography outcomes, and simplified pulmonary embolism severity index (s‐PESI) was investigated.

Results

We discovered that among individuals with a probable PTE, males and those with higher platelet‐to‐lymphocyte (PLR) and neutrophil‐to‐lymphocyte (NLR) ratios had a greater likelihood of PTE incidence (p < .001, .027, and .037, respectively). PLR was a significant and independent predictor of PTE with a p value of .045. Moreover, a higher neutrophil count was associated with a higher s‐PESI score in COVID‐19 patients developing PTE (p: .038).

Conclusions

Among hematological indices, NLR and more precisely PLR are cost‐effective and simply calculable markers that can assist physicians in determining whether or not COVID‐19 patients with clinically probable PTE require CT angiography and the higher neutrophil count can be employed as an indicator of PTE severity in COVID‐19 patients. Further large multicenter and prospective studies are warranted to corroborate these observations.
Posterior Palatal Expansion via Subnasal Endoscopy (2PENN) for Maxillary Deficiency: A Pilot Study
Authors: Jara Sebastian M. , Thuler Eric R. , Hutz Michael J. , Yu Jason L. , Cheong Crystal S. , Boucher Normand , Evans Marianna , Dedhia Raj C.
Published: September 2023

Objective

Surgically assisted rapid palatal expansion (SARPE) addresses transverse maxillary deficiency, a known contributor to nasal obstruction. The purpose of this study was to assess the feasibility, preliminary outcomes, and safety of posterior palatal expansion via subnasal endoscopy (2PENN), a modified SARPE procedure, aimed at achieving anterior and posterior maxillary expansion.

Methods

This prospective case series included consecutive adult patients with findings of transverse maxillary deficiency that underwent the 2PENN procedure from 4/2021 to 4/2022. Patients completed pre‐ and post‐operative clinical evaluations, Nasal Obstruction and Septoplasty Effectiveness (NOSE) questionnaires, and computed tomography (CT), with measures including expansion at the level of the posterior nasal spine (PNS), first maxillary inter‐molar distance (IMD), and anterior nasal spine (ANS).

Results

The cohort (N = 20) was middle‐aged (39 ± 11 years), predominantly male (80%), and overweight (BMI 28 ± 4 kg/m2). The majority (85%) of patients had sleep breathing issues, of which 10 (59%) had polysomnography‐confirmed obstructive sleep apnea (OSA). Full anterior–posterior separation of the mid‐palatal suture line was evident on all post‐operative CT scans, with mean expansion at the PNS of 3.6 ± 1.3 mm, IMD of 6.1 ± 1.6 mm and ANS of 7.0 ± 1.6 mm (p < 0.001). Following surgery, mean NOSE scores improved from 57 ± 23 to 14 ± 13 (p < 0.001). One patient required maxillary antrostomy for post‐operative sinusitis.

Conclusion

2PENN is an effective and safe technique for achieving both anterior and posterior maxillary expansion in patients with transverse maxillary deficiency. Further study is warranted to better understand the effect of 2PENN in patients with OSA, particularly as it relates to improving pharyngeal patency.

Level of Evidence

4 Laryngoscope, 134:1970–1977, 2024
Intraoperative Parathyroid Hormone Monitoring In Normohormonal Primary Hyperparathyroidism: How Low Do You Go?
Authors: Law Richard H. , Larrabee Katherine A. , Stefan Andrew J. , Quan Daniel L. , Peterson Edward L. , Singer Michael C.
Published: September 2023

Objective

The primary goal of this study was to determine in patients with normohormonal primary hyperparathyroidism (NHHPT) what percent reduction in post‐excision intraoperative parathyroid hormone (IOPTH) from baseline would yield a rate of cure comparable to that in patients with classical primary hyperparathyroidism (PHPT).

Methods

This is a retrospective cohort study of patients who underwent parathyroidectomy between July 2013 and February 2020. Demographic data, preoperative, intraoperative, and postoperative metrics were collected. Patients with NHHPT were compared to those with classical PHPT. Subgroup analyses were performed.

Results

Of the 496 patients included in the study, 66 (13.3%) were of the normohormonal variant based on preoperative intact parathyroid hormone (PTH) levels and 28 (5.6%) based on baseline IOPTH levels. The cure rates in the two normohormonal groups were not significantly different from their classical counterparts (98.4% and 100.0% vs. 97.1%, p = 1.000). The median percent decline in post‐excision IOPTH from baseline that achieved cure in the normohormonal groups were 82.6% and 80.4% compared to their respective controls at 87.3%, p = 0.011 and p = 0.001. Although the rate of multiglandular disease was higher in one of the normohormonal variant groups, this difference was due to a higher rate of double adenomas, not four‐gland hyperplasia.

Conclusion

Patients with NHHPT undergoing parathyroidectomy can expect cure rates similar to that in patients with classical PHPT. The results of this study indicate that achieving an 80% drop or more in IOPTH levels predicts a high likelihood of cure. This is true irrespective of whether the patient is deemed normohormonal based on preoperative or intraoperative testing.

Level of Evidence

3 Laryngoscope, 134:2480–2484, 2024
Pathogenesis of Reinke's Edema of the Vocal Fold
Authors: Sato Kiminobu , Kurita Takashi , Sato Fumihiko , Sato Kiminori , Chitose Shun‐ichi , Ono Takeharu , Umeno Hirohito
Published: September 2023

Objectives

The most frequent etiologic factor of Reinke's edema (RE) is considered to be smoking. However, the mechanism for the onset and development of the disease remains unclear. Hypoxia‐inducible factor‐1α (HIF‐1α) is an oxygen‐dependent transcriptional activator which plays crucial roles in angiogenesis in hypoxic microenvironments. HIF‐1α induces the expression of vascular endothelial growth factor (VEGF) which involves angiogenesis and enhances vascular permeability. This study investigated the roles of HIF‐1α in the pathogenesis of RE.

Methods

Surgical specimens of RE from patients who underwent endolaryngeal microsurgery were used. Normal vocal folds were used as a control group. Expression of HIF‐1α and VEGF was analyzed by immunohistochemistry. Three‐dimensional fine structures of the vessels in RE were investigated using correlative light and electron microscopy (CLEM) technique.

Results

HIF‐1α and VEGF were broadly expressed in the stromal, inflammatory, and endothelial cells in the lamina propria of the vocal fold of RE. The expression of HIF‐1α and VEGF of RE were significantly higher than in the lamina propria of the normal vocal fold mucosa. CLEM showed vascularization and telangiectasia and there were many dilated capillaries with thin endothelium not covered with pericytes indicating the vessels were fragile.

Conclusion

Transcription factor HIF‐1α and induced VEGF likely play roles in the pathogenesis of RE. And increased vascular permeability with fragile vessels in angiogenesis is likely to be an etiology of RE. Transcription factor HIF‐1α and induced VEGF are potential therapeutic targets for RE.

Level of Evidence

NA Laryngoscope, 134:1785–1791, 2024
Metagenomic insight into antagonistic effects of a nitrification inhibitor and phosphate‐solubilizing bacteria on soil protease activity
Authors: Liu Yaohui , Wang Weijin , Nessa Ashrafun , Yang Shengyou , Zhang Wenyuan , Zhang Manyun
Published: September 2023

Soil protease plays a fundamental role in soil nitrogen (N) transformations. Soil N and phosphorus (P) management significantly influence soil protease activity. However, the impacts of N and P combined modification on soil protease remain unclear. A better understanding of the activity and dynamic of soil protease could provide new insights into soil N cycling and available N supply. This study aimed to quantify the influences of combined effects of N and P managements on soil protease activities and decipher the potential mechanism from the perspectives of soil chemical properties, functional microbes, and functional genes. The nitrification inhibitor 3, 4‐dimethylpyrazole phosphate (DMPP) application or phosphate‐solubilizing bacteria (PSB) Klebsiella inoculation significantly increased soil protease activity (23.39% and 70.99%, respectively) and ammonium N (NH4+–N) contents, relative to the blank control. However, compared with the DMPP or PSB alone application, the combined applications of DMPP and PSB significantly decreased protease activity, implying that an antagonistic effect on soil protease activity was generated. The abundances of genus Klebsiella were stimulated by the DMPP or PSB but significantly inhibited by the combined additions of DMPP and PSB. The DMPP and PSB applications also significantly changed soil microbial communities and led to more complicated soil microbial co‐occurrence networks. Soil protease activity had a significantly positive correlation with the normalized abundances of tri and clpX genes. Our findings suggested that the combined additions of DMPP and PSB generated an antagonistic effect on soil protease activity and that the antagonistic effect was directly associated with soil NH4+–N and NO3−–N contents, P fractions, and functional gene abundances.
High Refractive Index Copolymers from Aromatic Heterocycle‐Based Vinyl Sulfides and Phthalimide/Maleimide Derivatives
Authors: Watanabe Ibuki , Morikawa Kaori , Samitsu Sadaki , Mori Hideharu
Published: September 2023

Herein, the rational design and facile synthesis of high‐refractive‐index copolymers with good optical transparency and tunable thermal stability using aromatic heterocycle‐based vinyl sulfides via conventional radical copolymerization is presented. 2‐Thiazolylvinylsulfide (2TVS), 1,3,4‐thiadiazolylvinylsulfide (1,3,4‐TVS), 3‐methylimidazolylvinylsulfide (3MIVS), and 5‐methlthio‐1,3,4‐thiadiazolylvinylsulfide (MeSTVS) are selected to enhance the refractive index, and N‐vinylphthalimide (NVPI) and N‐phenylmaleimide (NPMI) are chosen as comonomers to achieve improved transparency and thermal stability while maintaining the refractive index. The sulfur, ─C═N─, and imide contents in the copolymers are varied by adjusting the monomer structures and their compositions, and their effects on the refractive index, Abbe number, and optical and thermal properties are investigated. The MeTVS monomer in poly(MeSTVS) and poly(MeSTVS‐co‐NVPI) contained three sulfur atoms and two ─C═N─ units; consequently, these polymers exhibit excellent refractive indices in the 1.7139–1.6567 range at 589 nm, Abbe numbers between 19.1–29.1, good transparency (>90% at 400 nm), and tunable thermal properties (Tg = 49–138 °C, Td10 = 244–268 °C). Optically transparent poly(1,3,4‐TVS‐co‐NVPI) films (>95% at 400 nm) with improved thermal stability (Tg = 89–175 °C, Td10 = 251–301 °C) are obtained while maintaining a relatively high refractive index (1.6662–1.6752).
Indocyanine Green‐Glycogen Conjugates for Near‐Infrared‐Triggered Photothermal Cancer Therapy
Authors: Shirinichi Farbod , Karkera Chetna , Ibrahim Tarek , Khan Hayat , Clemons Tristan , Senejani Alireza G. , Sun Hao
Published: September 2023

Photothermal reagents sensitive to near‐infrared (NIR) light are promising imaging agents and therapeutics for anticancer applications because of the deep tissue penetration of NIR light, allowing for spatiotemporal control over the therapeutic activity, with minimal damage to normal tissues. Herein, a new class of NIR‐sensitive biopolymer‐based nanoparticles is presented by covalently conjugating indocyanine green (ICG) onto the surface of naturally occurring glycogen nanoparticles. The resulting ICG‐glycogen conjugates exhibit a markedly enhanced aqueous stability in comparison to free ICG molecules. Furthermore, an efficient light‐to‐heat conversion is enabled by ICG‐glycogen conjugates, as evidenced by the elevated temperatures of their aqueous solutions upon exposure to NIR light. Critically, ICG‐glycogen conjugates are capable of cell internalization, and under NIR irradiation the effective eradication of breast cancer cells, demonstrating their potential in photothermal therapy for cancer.
Biocompatible, 3D Printable Magnetic Soft Actuators – Ink Formulation, Rheological Characterization and Hydrogel Actuator Prototypes
Authors: Puza Fatih , Barth Lukas , Thiel Marc‐Christopher , Seemann Ralf , Lienkamp Karen
Published: September 2023

3D printable inks for the preparation of magnetic hydrogel actuators are difficult to formulate because magnetic nanoparticles tend to aggregate without stabilization through other ink components. At the same time, such inks need to be shear‐thinning and recover their high viscosity state sufficiently fast to be suitable for the printing process. Here, the use of chitosan as dispersing agent for Fe2O3 nanoparticles is reported. Combined with Pluronic F127 as a rheology modifier and acrylamide as the base monomer, thermoresponsive and shear‐thinning magnetic inks containing well‐dispersed particles are obtained. The ink viscosity is tuned over two orders of magnitude by varying the chitosan and Pluronics F127 content. 3D‐printed shapes with good shape fidelity are obtained at a print bed temperature of 50 °C, where aggregation of the Pluoronics F127 micelles occurs. This leads to a fast recovery of the high viscosity state of the material, so that the printed shape can then be locked in by UV cross‐linking. This treatment yielded magneto‐responsive prototypes which are promising for soft robotics applications. Thanks to the simplicity of the ink formulation, it is easily transferable also to nonspecialist laboratories, and the concept is potentially applicable also to other types of nanoparticles.
Orthopedic implants affect the electric field induced by switching gradients in MRI
Authors: Zilberti Luca , Arduino Alessandro , Torchio Riccardo , Zanovello Umberto , Baruffaldi Fabio , Sanchez‐Lopez Hector , Bettini Paolo , Alotto Piergiorgio , Chiampi Mario , Bottauscio Oriano
Published: September 2023

Purpose

To investigate whether the risk of peripheral nerve stimulation increases in the presence of bulky metallic prostheses implanted in a patient's body.

Methods

A computational tool was used to calculate the electric field (E‐field) induced in a realistic human model due to the action of gradient fields. The calculations were performed both on the original version of the anatomical model and on a version modified through “virtual surgery” to incorporate knee, hip, and shoulder prostheses. Five exam positions within a body gradient coil and one position using a head gradient coil were simulated, subjecting the human model to the readout gradient from an EPI sequence. The induced E‐field in models with and without prostheses was compared, focusing on the nerves and all other tissues (both including and excluding the bones from the analysis).

Results

In the nerves, the most pronounced increase in the E‐field (+24%) was observed around the knee implant during an abdominal MRI (Y axis readout). When extending the analysis to encompass all tissues (excluding bones), the greatest amplification (+360%) occurred around the knee implant during pelvic MRI (Z axis readout). Notable increases in E‐field peaks were also identified around the shoulder and hip implants in multiple scenarios.

Conclusion

Based on the presented results, further investigations aimed at quantifying the threshold of nerve stimulation in the presence of bulky implants are desirable.
Computing the completely positive factorization via alternating minimization
Authors: Behling R. , Lara H. , Oviedo H.
Published: September 2023

In this article, we propose a novel alternating minimization scheme for finding completely positive factorizations. In each iteration, our method splits the original factorization problem into two optimization subproblems, the first one being a orthogonal procrustes problem, which is taken over the orthogoal group, and the second one over the set of entrywise positive matrices. We present both a convergence analysis of the method and favorable numerical results.
Covid‐19 communication in emerging markets—Not viral enough?
Authors: Annapureddy Rama Papi Reddy , Suresh Saparya , Khandker Varsha
Published: September 2023

Public health communication acts as a social vaccine in case of pandemics. Prior research has identified that such initiatives often fail to reach vulnerable sections of society. In India, while the first wave of infections mainly hit the urban areas, rural areas witnessed a surge in the second wave. Using the World Bank data, we attempt to understand the effectiveness of public awareness campaigns in rural areas. We use the Ecological Model for public health and find how the various factors relate to public health outcomes. The ecological factors are found to be related to awareness of Covid‐19. We find inadequate awareness about the symptoms and preventive measures associated with Covid‐19 among the rural population. We also find significant differences in communication and awareness along dimensions such as education and access to media. The role played by SHGs and hospitals in dealing with pandemics is also evident in this study. We conclude that the disparity in public health communication needs to be bridged to ensure equitable access to health information in society during public health crises.
Preparation and properties of vermiculite modified by triphenylbutylphosphonium bromide and PBAT composite film
Authors: Pei Meng , Shang Xiaoyu , Xu Yuhuan , Zhang Daohai
Published: September 2023

In this study, quaternary phosphonium salt (P4) was prepared, vermiculite (VMT) was modified by P4, and P4@VMT/poly (butylene adipate‐co‐terephthalate) (PBAT) composite film was prepared by the solution method. The structure of the synthesized P4 was determined by nuclear magnetic resonance and infrared. The structure and performance of P4 modified vermiculite were explored and analyzed by particle size, XRD, infrared and micro‐morphology. The structure, thermal properties, crystallization properties, rheological properties, cross‐section morphology, tensile properties and antibacterial properties of pure PBAT film and P4@VMT/PBAT composite film were tested and compared. The results show that the crystallization temperature and melting temperature of P4@VMT/PBAT composite film are higher than those of pure PBAT film. With the increase in P4@VMT content, the thermal stability of the composite film becomes worse, and the crystallization enthalpy, melting enthalpy and crystallinity also decrease, while the storage modulus, loss modulus and complex viscosity of P4@VMT/PBAT composite film increase significantly. In addition, compared with pure PBAT film, the tensile strength of P4@VMT/PBAT‐20% composites decreased by 12.0% and the elongation at break decreased by 95.7%.

Highlights

Successful synthesis of phosphonium quaternary P4 and modification of vermiculite.

The properties of P4@VMT/PBAT composite films with different contents were studied.
Teacher surveys: The pros and cons of random probability surveys versus teacher panels
Authors: Jerrim John
Published: September 2023

Two commonly used approaches to capturing information about teachers are random probability surveys and teacher panels. This paper reviews the strengths and limitations of these two approaches in the context of capturing information about the teacher workforce. A case study is then presented drawing upon recent teacher survey data collections in England. Although both designs should continue to play an important role in generating evidence about the teaching profession, random probability surveys of teachers should be used sparingly, and only when they will be properly resourced.
SIK2‐positive tumor epithelial cells in breast cancer maybe potential anti‐cancer messengers: A systematic analysis from a single‐cell perspective
Authors: Wu Qian , Qu Chang , Xin Lin , Yang Fan , Xu Ling
Published: September 2023

Breast cancer is the most common malignancy in the world and one of the leading causes of cancer death, which is a heterogeneous disease involving genetic and environmental factors. Breast cancer stem cells (BCSCs) are the main players in the aggressiveness of different tumors, at the same time, these cells are the main challenge for cancer treatment. There are multiple treatment options for breast cancer (BC) patients and the lack of understanding of prognostic and predictive biomarkers for breast cancer is a potential research direction for us to develop better treatments in the future. In this paper, we conducted a correlation analysis between SIK2 and clinical traits by searching numerous BRCA datasets in the GEO database. The model was constructed and validated by incorporating tumor samples from the TCGA‐BRCA cohort. Surprisingly, we found differential expression of SIK2 gene in individual tumor samples from the UCSC database. Subsequently, we found significantly high expression of SIK2 in epithelial cells by comparing the differential expression of SIK2 in different cell subpopulations and performed subsequent immune infiltration and pathway correlation analysis. Differential genes in SIK2+ epithelial cells, which may be potential therapeutic targets for breast cancer. In conclusion, our results suggest that SIK2 may be a potential prognostic and predictive biomarker that could serve as an oncogenic messenger for breast cancer. This discovery of SIK2 may provide more valuable references for potential therapeutic tools for breast cancer.
(R/S)-lactate/2-hydroxybutyrate dehydrogenases in and biosynthesis of block copolyesters by Ralstonia eutropha
Authors: Ishihara Shizuru , Orita Izumi , Matsumoto Ken’ichiro , Fukui Toshiaki
Published: September 2023

Bacterial polyhydroxyalkanoates (PHAs) are promising bio-based biodegradable polyesters. It was recently reported that novel PHA block copolymers composed of (R)-3-hydroxybutyrate (3HB) and (R)-2-hydroxybutyrate (2HB) were synthesized by Escherichia coli expressing PhaCAR, a chimeric enzyme of PHA synthases derived from Aeromonas caviae and Ralstonia eutropha. In this study, the sequence-regulating PhaCAR was applied in the natural PHA-producing bacterium, R. eutropha. During the investigation, (R/S)-2HB was found to exhibit strong growth inhibitory effects on the cells of R. eutropha. This was probably due to formation of excess 2-ketobutyrate (2KB) from (R/S)-2HB and the consequent l-valine depletion caused by dominant l-isoleucine synthesis attributed to the excess 2KB. Deletion analyses for genes of lactate dehydrogenase homologs identified cytochrome-dependent d-lactate dehydrogenase (Dld) and [Fe-S] protein-dependent l-lactate dehydrogenase as the enzymes responsible for sensitivity to (R)-2HB and (S)-2HB, respectively. The engineered R. eutropha strain (phaCAR+, ldhACd-hadACd+ encoding clostridial (R)-2-hydroxyisocaproate dehydrogenase and (R)-2-hydoroxyisocaproate CoA transferase, ∆dld) synthesized PHA containing 10 mol% of 2HB when cultivated on glucose with addition of sodium (RS)-2HB, and the 2HB composition in PHA increased up to 35 mol% by overexpression phaCAR. The solvent fractionation and NMR analyses showed that the resulting PHAs were most likely to be block polymers consisting of P(3HB-co-3HV) and P(2HB) segments, suggesting that PhaCAR functions as the sequence-regulating PHA synthase independently from genetic and metabolic backgrounds of the host cell.

Key points

(R/S)-2-hydroxubutyrates (2HB) caused l-valine deletion in Ralstonia eutropha

(R)- and (S)-lactate/2HB dehydrogenases functional in R. eutropha were identified

The engineered R. eutropha synthesized block copolymers of 2HB-containing polyhydroxyalkanoates on glucose and 2HB

Graphical Abstract
Sociocultural and Demographic Factors Predict Readmissions for General Surgery Patients
Authors: Kovoor Joshua G. , Bacchi Stephen , Gupta Aashray K. , Nann Silas D. , Stretton Brandon , Chong Esther H. L. , Hewitt Joseph N. , Bhanushali Ameya , Nathin Kayla , Aujayeb Nidhi , Lu Amy , Ovenden Christopher D. , John Athul , Reid Jessica L. , Gluck Samuel , Liew Danny , Reddi Benjamin A. , Hugh Thomas J. , Dobbins Christopher , Padbury Robert T. , Hewett Peter J. , Trochsler Markus I. , Maddern Guy J.
Published: September 2023

Introduction

Readmission is a poor outcome for both patients and healthcare systems. The association of certain sociocultural and demographic characteristics with likelihood of readmission is uncertain in general surgical patients.

Method

A multi‐centre retrospective cohort study of consecutive unique individuals who survived to discharge during general surgical admissions was conducted. Sociocultural and demographic variables were evaluated alongside clinical parameters (considered both as raw values and their proportion of change in the 1–2 days prior to admission) for their association with 7 and 30 days readmission using logistic regression.

Results

There were 12,701 individuals included, with 304 (2.4%) individuals readmitted within 7 days, and 921 (7.3%) readmitted within 30 days. When incorporating absolute values of clinical parameters in the model, age was the only variable significantly associated with 7‐day readmission, and primary language and presence of religion were the only variables significantly associated with 30‐day readmission. When incorporating change in clinical parameters between the 1–2 days prior to discharge, primary language and religion were predictive of 30‐day readmission. When controlling for changes in clinical parameters, only higher comorbidity burden (represented by higher Charlson comorbidity index score) was associated with increased likelihood of 30‐day readmission.

Conclusions

Sociocultural and demographic patient factors such as primary language, presence of religion, age, and comorbidity burden predict the likelihood of 7 and 30‐day hospital readmission after general surgery. These findings support early implementation a postoperative care model that integrates all biopsychosocial domains across multiple disciplines of healthcare.
External validation, radiological evaluation, and development of deep learning automatic lung segmentation in contrast-enhanced chest CT
Authors: Dwivedi Krit , Sharkey Michael , Alabed Samer , Langlotz Curtis P. , Swift Andy J. , Bluethgen Christian
Published: September 2023

Objectives

There is a need for CT pulmonary angiography (CTPA) lung segmentation models. Clinical translation requires radiological evaluation of model outputs, understanding of limitations, and identification of failure points. This multicentre study aims to develop an accurate CTPA lung segmentation model, with evaluation of outputs in two diverse patient cohorts with pulmonary hypertension (PH) and interstitial lung disease (ILD).

Methods

This retrospective study develops an nnU-Net-based segmentation model using data from two specialist centres (UK and USA). Model was trained (n = 37), tested (n = 12), and clinically evaluated (n = 176) on a diverse ‘real-world’ cohort of 225 PH patients with volumetric CTPAs. Dice score coefficient (DSC) and normalised surface distance (NSD) were used for testing. Clinical evaluation of outputs was performed by two radiologists who assessed clinical significance of errors. External validation was performed on heterogenous contrast and non-contrast scans from 28 ILD patients.

Results

A total of 225 PH and 28 ILD patients with diverse demographic and clinical characteristics were evaluated. Mean accuracy, DSC, and NSD scores were 0.998 (95% CI 0.9976, 0.9989), 0.990 (0.9840, 0.9962), and 0.983 (0.9686, 0.9972) respectively. There were no segmentation failures. On radiological review, 82% and 71% of internal and external cases respectively had no errors. Eighteen percent and 25% respectively had clinically insignificant errors. Peripheral atelectasis and consolidation were common causes for suboptimal segmentation. One external case (0.5%) with patulous oesophagus had a clinically significant error.

Conclusion

State-of-the-art CTPA lung segmentation model provides accurate outputs with minimal clinical errors on evaluation across two diverse cohorts with PH and ILD.

Clinical relevance

Clinical translation of artificial intelligence models requires radiological review and understanding of model limitations. This study develops an externally validated state-of-the-art model with robust radiological review. Intended clinical use is in techniques such as lung volume or parenchymal disease quantification.

Key Points

• Accurate, externally validated CT pulmonary angiography (CTPA) lung segmentation model tested in two large heterogeneous clinical cohorts (pulmonary hypertension and interstitial lung disease).

• No segmentation failures and robust review of model outputs by radiologists found 1 (0.5%) clinically significant segmentation error.

• Intended clinical use of this model is a necessary step in techniques such as lung volume, parenchymal disease quantification, or pulmonary vessel analysis.

Graphical Abstract
Measurement of high-Re turbulent pipe flow using single-pixel PIV
Authors: Oldenziel G. , Sridharan S. , Westerweel J.
Published: September 2023

In this paper are presented PIV measurements of turbulent pipe flow at bulk Reynolds numbers Re$$_D$$

D

between 3.4$$\times$$
×
10$$^5$$

5

and 6.9$$\times$$
×
10$$^5$$

5

. So-called single-pixel correlation is applied that yields a superior spatial resolution that is slightly larger than the equivalent size of a pixel in the flow. The location and shape of the averaged correlation peak give the mean velocity and normal and Reynolds stresses. A novel aspect of the single-pixel correlation approach is the extension to determine the 2-point spatial correlation of the velocity fluctuations and the spectrum of the longitudinal velocity fluctuations. Detailed results are presented for Re$$_D$$

D

= 4.98$$\times$$
×
10$$^5$$

5

, corresponding to a shear Reynolds number Re$$_\tau$$

τ

= 10.3$$\times$$
×
10$$^3$$

3

, with a spatial resolution in wall units of $$\varDelta y^+$$

Δ

y
+

= 19.
Wintertime ocean–atmosphere interaction processes associated with the SST variability in the North Pacific subarctic frontal zone
Authors: Huang Qionghui , Fang Jiabei , Tao Lingfeng , Yang Xiu-Qun
Published: September 2023

Recent research indicates that the midlatitude oceanic frontal zones are the key regions of ocean–atmosphere interaction. The thermal condition of midlatitude ocean in frontal zones can affect the atmosphere efficiently through both diabatic heating and transient eddy feedback. In this study, the wintertime SST variability in the subarctic frontal zone (SAFZ) of the North Pacific and the associated ocean–atmosphere interaction mechanism are examined based on observational and theoretical analyses. It is found that the SAFZ-related SST anomaly is characterized as a large-scale interannual mode that can persist during the whole winter, and that its evolution is accompanied with local ocean–atmosphere interaction processes. The initial anticyclonic surface wind anomaly associated with the weakened Aleutian Low forces a large-scale warm SST anomaly in midlatitude North Pacific by driving northward Ekman flow and downward heat flux. With the increase of SST anomaly, the air-sea heat flux exchange reverses, indicating that the ocean starts to heat the atmosphere. In addition to increasing the diabatic heating, the warm SST anomaly strengthens the SST gradient in the north part of SAFZ. The low-level atmospheric baroclinicity is adjusted to synchronize with the SAFZ correspondingly due to oceanic thermal influence, causing change of transient eddy activities. Though all the ocean-induced diabatic heating, transient eddy heating and transient eddy vorticity forcing are enhanced over SAFZ, the last physical process plays the most important role in shifting and maintaining the equivalent barotropic atmospheric circulation anomalies. Therefore, the ocean–atmosphere interaction provides a mechanism for the development and maintenance of SAFZ-related anomalies of the North Pacific ocean–atmosphere system throughout the winter.
Endoscopic posterior ventricular cordectomy with contact diode laser: how I do it
Authors: Meneghesso Stefano , Saetti Roberto , Silvestrini Marina
Published: September 2023

Background

The treatment of bilateral vocal fold paralysis is mainly surgical and several procedures can be used to guarantee adequate breathing. Furthermore, other causes of the narrowing of the natural airways could coexist and the treatment should consider all of them.

Methods

A supraglottic extension of posterior cordectomy to the false homolateral chord is described, which provides a further widening of the airway while maintaining acceptable voice quality.

Conclusion

Endoscopic posterior ventricular cordectomy performed by contact diode laser may be a viable and safe option, especially in those patients who present bilateral vocal fold paralysis associated with various degrees of laryngospasm.
Prediction of instantaneous perceived effort during outdoor running using accelerometry and machine learning
Authors: Pirscoveanu Cristina-Ioana , Oliveira Anderson Souza
Published: September 2023

The rate of perceived effort (RPE) is a subjective scale widely used for defining training loads. However, the subjective nature of the metric might lead to an inaccurate representation of the imposed metabolic/mechanical exercise demands. Therefore, this study aimed to predict the rate of perceived exertions during running using biomechanical parameters extracted from a commercially available running smartwatch. Forty-three recreational runners performed a simulated 5-km race on a track, providing their RPE from a Borg scale (6–20) every 400 m. Running distance, heart rate, foot contact time, cadence, stride length, and vertical oscillation were extracted from a running smartwatch (Garmin 735XT). Machine learning regression models were trained to predict the RPE at every 5 s of the 5-km race using subject-independent (leave-one-out), as well as a subject-dependent regression method. The subject-dependent method was tested using 5%, 10%, or 20% of the runner’s data in the training set while using the remaining data for testing. The average root-mean-square error (RMSE) in predicting the RPE using the subject-independent method was 1.8 ± 0.8 RPE points (range 0.6–4.1; relative RMSE ~ 12 ± 6%) across the entire 5-km race. However, the error from subject-dependent models was reduced to 1.00 ± 0.31, 0.66 ± 0.20 and 0.45 ± 0.13 RPE points when using 5%, 10%, and 20% of data for training, respectively (average relative RMSE < 7%). All types of predictions underestimated the maximal RPE in ~ 1 RPE point. These results suggest that the data accessible from commercial smartwatches can be used to predict perceived exertion, opening new venues to improve training workload monitoring.
Fluviispira vulneris sp. nov., isolated from human wound secretions
Authors: Tang Peijuan , Peng Na , Ouyang Pengwen , Long Sheng , Wei Zhenhua , Chen Xingchun , Qu Pinghua , Xie Liangyi
Published: September 2023

Human infections by environmental bacteria is becoming an increasing problem and has become a matter of great concern due to the adverse effects worldwide. In this study, we reported a new environmental pathogen. Isolate GX5518T was a novel Gram-negative, aerobic, non-motile, pleomorphic and red-pigmented bacterium, was isolated from human wound secretions (GuangXi, People’s Republic of China). Growth occurred at pH 6.0–8.0 (optimum, pH 7.0) and 10–37 °C (optimum, 28–32 °C) with 0–1.5% (w/v) NaCl in R2A agar. Comparative analysis of the 16S rRNA gene sequences revealed that isolate GX5518T was closely related to Fluviispira sanaruensis JCM 31447T (99.73%) and Fluviispira multicolorata 33A1-SZDPT (98.49%). However, the estimated ANI values of the isolate GX5518T compared to the F. sanaruensis JCM 31447T and F. multicolorata 33A1-SZDPT were 88.67% and 77.35%, respectively. The estimated dDDH, ANI and AAI values between isolate GX5518T and its closely related strains were below the threshold values generally considered for recognizing a new species. The genome size was 3.6 Mbp and the DNA G + C content was 33.1%. The predominant fatty acids (> 5%) in GX5518T cells were iso-C15:0, C16:0, C17:0, C17:1ω8c and C16:1ω7c/C16:1ω6c. The major menaquinone was MK-8 (86.9%). The polar lipids were phosphatidylethanolamine (PE), phosphatidylglycerol (PG) and three unknown lipids (L1-3). The chemical composition was different from that of the F. sanaruensis JCM 31447T. Comparative genomics analysis between isolate GX5518T and its related strains revealed that there were a number of genes involved in resistance to antibiotics and toxic compounds in isolate GX5518T, which were responsible for the copper homeostasis, cobalt-zinc-cadmium resistance, resistance to fluoroquinolones, and zinc resistance. Based on the phenotypic, chemotaxonomic, and genomic analyses, isolate GX5518T (= CGMCC 1.18685T = KCTC 82149T) represents a novel species of the genus Fluviispira, for which the name Fluviispira vulneris sp. nov. is proposed.
The influence of phosphorus availability on rice root traits driving iron plaque formation and dissolution, and implications for phosphorus uptake
Authors: Martinengo Sara , Santoro Veronica , Schiavon Michela , Celi Luisella , Martin Maria , Said-Pullicino Daniel
Published: September 2023

Background and aims

Iron (Fe) plaque which normally coats rice roots has a strong affinity for phosphorus (P), with a debated effect on plant P uptake. Furthermore, plant responses to P availability shape the rhizospheric environment, possibly affecting the rates of Fe plaque formation and dissolution. The role of Fe plaque to serve as a sink or source of available P may depend on root traits, themselves influenced by P availability. However, the underlying mechanism regulating these interactions remains unclear. In this study, we investigated the effects of P availability on root traits, Fe plaque dynamics and their implications for P uptake and rice plant growth.

Methods

Plants were hydroponically grown for 60 days under P-sufficiency or P-deficiency, with or without Fe plaque. Root traits, rhizosphere acidification, and the rates of Fe plaque formation and dissolution were investigated and linked to differences in rice P content and growth.

Results

P-deficient conditions stimulated root development and promoted Fe plaque formation on the root surface compared to P-sufficient conditions. However, P limited plants exhibited a faster Fe plaque dissolution, along with increased net proton exudation. After 60 d, P-deficient plants showed higher P uptake in the presence of Fe plaque, whereas the opposite was observed in P-sufficient plants, where Fe plaque limited plant P uptake.

Conclusions

The role of Fe plaque in regulating P uptake highly depends on the dynamic nature of this Fe pool that is strictly linked to P availability and regulated by plant responses to P deficiency.
The influence of philosophical training on the evaluation of philosophical cases: a controlled longitudinal study
Authors: Maćkiewicz Bartosz , Kuś Katarzyna , Hensel Witold M.
Published: September 2023

According to the expertise defense, practitioners of the method of cases need not worry about findings that ordinary people’s philosophical intuitions depend on epistemically irrelevant factors. This is because, honed by years of training, the intuitions of professional philosophers likely surpass those of the folk. To investigate this, we conducted a controlled longitudinal study of a broad range of intuitions in undergraduate students of philosophy (n = 226), whose case judgments we sampled after each semester throughout their studies. Under the assumption, made by proponents of the expertise defense, that formal training in philosophy gives rise to the kind of expertise that accounts for changes in the students’ responses to philosophically puzzling cases, our data suggest that the acquired cognitive skills only affect single case judgments at a time. There does not seem to exist either a general expertise that informs case judgments in all areas of philosophy, or an expertise specific to particular subfields. In fact, we argue that available evidence, including the results of cross-sectional research, is best explained in terms of differences in adopted beliefs about specific cases, rather than acquired cognitive skills. We also investigated whether individuals who choose to study philosophy have atypical intuitions compared to the general population and whether students whose intuitions are at odds with textbook consensus are more likely than others to drop out of the philosophy program.
Monetary incentives and eye movements: an eye-tracking investigation in a risky choice experiment with real and hypothetical incentives
Authors: Uto Nobuyuki
Published: September 2023

Although eye-tracking is useful for investigating economic decision-making processes, it remains unclear whether monetary incentives affect eye movements. The current study used a binary risky choice experiment with two incentive conditions: real incentive and hypothetical incentive. Eye movements, choices, and decision times were recorded and compared. For eye movements, participants’ total fixation durations, and visual transitions between probabilities and outcomes were analyzed. The choice distributions were almost identical between the two conditions. The decision times and total fixation durations were longer for the real incentive conditions. Visual transitions that are consistent with expected-utility-like models were less frequent in the real incentive conditions when the calculation of expected values of lotteries was easy. These findings indicate that decision-making processes, such as information processing patterns and the amount of cognitive effort, are affected by monetary incentives. To ensure that eye-tracking is used to examine economic decision-making processes appropriately, providing monetary incentives is important.
Utilizing vancomycin as secondary prophylaxis for the prevention of recurrent Clostridioides difficile infection
Authors: Kristen Zeitler , Nguyen Andrew , Mateja Candice , Jariwala Ripal , Bertran-Rodriguez Carlos , Mayer Cynthia , Nguyen Diep , Sampson Mindy
Published: September 2023

Background: Recurrent Clostridioides difficile infection (CDI) is associated with significant morbidity, mortality, and healthcare-related costs. Although data are minimal, agents including oral vancomycin have been used as secondary prophylaxis to prevent recurrent CDI. Methods: We conducted a randomized, double-blind, placebo-controlled trial to determine the effectiveness of vancomycin at preventing CDI from October 2019 to September 2022. Eligible patients had a history of at least 1 episode of CDI and were receiving systemic antibiotics for another condition. Participants were randomized 1:1 to oral vancomycin 125 mg by mouth twice daily and were interviewed at 1, 2, and 3 months thereafter to assess recurrence. We enrolled 26 patients: 15 completed the 1-month interview, 12 completed the 2-month interview, and 11 completed the full study. Those 15 participants who did not complete the 3-month interview were considered dropouts. The final sample for this study included those 11 participants who completed all interviews. Demographics and outcomes are shown in Table 1. Results: One case of recurrent CDI was reported at the 1-month interview and a second was reported at 3 months; both cases had received the placebo. The study was terminated early due to low enrollment. Conclusions: Although our results did not reach statistical significance and this study was limited in small sample size, our findings suggest that secondary prophylaxis with oral vancomycin may be beneficial in patients who are actively receiving antibiotics, which is consistent with prior retrospective studies. Future studies with larger sample sizes are still needed to examine this important question of whether secondary prophylaxis is useful for preventing recurrent CDI.

Disclosure: None