bluuebunny/crossref_metadata_2025 huggingface dataset:
New approach for combined aortic valve and coronary procedures through the left anterior minithoracotomy
Authors: Babliak Oleksandr , Demianenko Volodymyr , Babliak Dmytro , Marchenko Anton , Melnyk Yevhenii , Stohov Oleksii
Published: January 2024

OBJECTIVES

We have developed a novel technique for accessing the aortic valve (AoV) through the left anterior minithoracotomy (LAmT). This approach has been used in patients requiring both AoV surgery and coronary artery bypass grafting (CABG).

METHODS

From April 2023 to July 2023, we performed 6 concomitant AoV procedures and CABG through the LAmT. The mean age was 71.5 [standard deviation (SD): 5.8; 64; 82] years, and the mean left ventricular ejection fraction was 53% (SD: 12.1; 30; 60). Surgical technique includes LAmT in the fourth intercostal space, peripheral cardiopulmonary bypass, aortic cross-clamping using transthoracic clamp, cold blood cardioplegia, conventional oblique aortotomy and special surgical exposure manoeuvres, aimed to position the ascending aorta and AoV close to the surgical incision.

RESULTS

AoV was effectively visualized and the procedure was performed as planned in all 6 patients. No conversion to sternotomy was required. AoV replacement with biological prosthesis was performed in 6 (100%) patients. Conventional surgical instruments were used in all cases. The long-shafted instruments were not required. Knot-pusher was used in 4 (67%)cases. Concomitant complete revascularization was achieved in all cases. The mean number of distal anastomosis was 2.0 (SD: 0.6; 1; 3). Total operation time was 371 (SD: 43; 300; 420) min, cardiopulmonary bypass time was 253 (SD: 36; 193; 284) min and cross-clamp time was - 162 (SD: 29; 128; 214) min. intensive care unit stay was—1.5 (SD: 0.55; 1; 2) days, total hospital stay was—7.3 (SD: 1; 6; 9) days. There were no revisions for bleeding, no strokes or other major complications, and no hospital or 30-days mortality.

CONCLUSIONS

The simultaneous performance of AoV replacement and multivessel CABG through a single left anterior thoracotomy is technically feasible and can be carried out by experienced surgeons. However, a larger number of cases are required to fully comprehend the potential limitations of this procedure.
B-Side Spirituality: An Empathetic Theory of Religion and Ethnographic Data About Spiritual (but Not Religious) Belonging
Authors: Johnston Lucas
Published: January 2024

According to some cognitive and neuroscientific theories, religion is not an evolved adaptation but rather an artifact, one that may lead to adaptive behaviors. Here I relate (a) an empathetic theory of religion with (b) a functional theory of musicality to clarify religion’s adaptive features. This theory contributes to previous research by explaining the link between spirituality and music and makes the nontrivial prediction that increasing numbers of people who are disaffected by traditional religious institutions will find modes of meaning-making and fellow-feeling in contemporary festival and live music scenes.
A fast and reliable LC–MS-MS method for the quantification of saxitoxin in blood plasma samples
Authors: Odehnalová Klára , Přibilová Petra , Maršálek Blahoslav , Babica Pavel
Published: January 2024

Saxitoxins (STXs) are potent neurotoxins produced by marine dinoflagellates or freshwater cyanobacteria known to cause acute and eventually fatal human intoxications, which are classified as paralytic shellfish poisonings (PSPs). Rapid analysis of STXs in blood plasma can be used for a timely diagnosis and confirmation of PSPs. We developed a fast and simple method of STX extraction based on plasma sample acidification and precipitation by acetonitrile, followed by quantification using liquid chromatography-tandem mass spectrometry (LC–MS-MS). Our approach provides the results ≤30 min, with a limit of detection of 2.8 ng/mL and a lower limit of quantification of 5.0 ng/mL. Within-run and between-run precision experiments showed good reproducibility with ≤15% values. Standard curves for calibration were linear with correlation coefficients ≥0.98 across the assay calibration range (5–200 ng/mL). In an interlaboratory analytical exercise, the method was found to be 100% accurate in determining the presence or absence of STX in human plasma specimens, with recovery values of 86–99%. This simple method for STX determination in animal or human plasma can quickly and reliably diagnose STX exposures and confirm suspected PSP cases to facilitate patient treatment or expedite necessary public health or security actions.
Prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults: a nationwide cross-sectional study
Authors: Asavamongkolkul Apichat , Adulkasem Nath , Chotiyarnwong Pojchong , Vanitcharoenkul Ekasame , Chandhanayingyong Chandhanarat , Laohaprasitiporn Panai , Soparat Krabkaew , Unnanuntana Aasis
Published: January 2024

Thailand has transitioned from an aging society to an aged society, which implies that the prevalence of age-related disorders will increase; however, epidemiological data specific to the prevalence of age-related degenerative musculoskeletal disorders among Thai older adults remain limited. Accordingly, the aim of this study was to investigate the prevalence of age-related musculoskeletal diseases, including osteoporosis, sarcopenia, and high falls risk among healthy community-dwelling Thai older adults. This cross-sectional nationwide study enrolled Thai adults aged ≥60 yr from 2 randomly selected provinces from each of the 6 regions of Thailand via stratified multistage sampling during March 2021 to August 2022. All enrolled participants were evaluated for BMD, skeletal muscle mass, grip strength, and gait speed. Osteoporosis was diagnosed according to the World Health Organization definition, and sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Falls risk was determined using the self-rated Fall Risk Questionnaire. A total of 2991 eligible participants were recruited. The mean age of participants was 69.2 ± 6.5 yr (range: 60–107), and 63.1% were female. The prevalence of osteoporosis, sarcopenia, and high falls risk was 29.7%, 18.1%, and 38.5%, respectively. Approximately one-fifth of subjects (19.1%) had at least 2 of 3 risk factors (ie, osteoporosis, sarcopenia, and high falls risk) for sustaining a fragility fracture, and 3.4% had all 3 risk factors. In conclusion, the results of this study revealed a high and increasing prevalence of osteoporosis, sarcopenia, and high falls risk in healthy community-dwelling Thai older adults. Since these conditions are all major risk factors for fragility fracture, modification of Thailand’s national health care policy is urgently needed to address the increasing prevalence of these conditions among healthy community-dwelling older adults living in Thailand.
Rotational femoral osteotomies and cam resection improve hip function and internal rotation for patients with anterior hip impingement and decreased femoral version
Authors: Lerch Till D , Meier Malin K , Hanke Markus. S , Boschung Adam , Schmaranzer Florian , Siebenrock Klaus A , Tannast Moritz , Steppacher Simon D
Published: January 2024

Femoroacetabular impingement (FAI) patients with reduced femoral version (FV) are poorly understood. The aim of this study is to assess (i) hip pain and range of motion, (ii) subjective satisfaction and (iii) subsequent surgeries of symptomatic patients who underwent rotational femoral osteotomies. A retrospective case series involving 18 patients (23 hips, 2014–2018) with anterior hip pain that underwent rotational femoral osteotomies for treatment of decreased FV was performed. The mean preoperative age was 25 ± 6 years (57% male), and all patients had decreased FV < 10° and minimum 1-year follow-up (mean follow-up 2 ± 1 years). Surgical indication was the positive anterior impingement test, limited internal rotation (IR) in 90° of flexion (mean 10 ± 8°) and IR in extension (mean 24 ± 11°), anterosuperior chondrolabral damage in Magnet resonance (MR) arthrography, CT-based measurement of decreased FV (mean 5 ± 3°, Murphy method) and no osteoarthritis (Tönnis Grade 0). Most patients had intra- and extra-articular subspine FAI (patient-specific 3D impingement simulation). Subtrochanteric rotational femoral osteotomies to increase FV (correction 20 ± 4°) were combined with cam resection (78%) and surgical hip dislocation (91%). (i) The positive anterior impingement test decreased significantly (P < 0.001) from pre- to postoperatively (100% to 9%). IR in 90° of flexion increased significantly (P < 0.001, 10 ± 8° to 31 ± 10°). (ii) Subjective satisfaction increased significantly (P < 0.001) from pre- to postoperatively (33% 77%). The mean Merle d’Aubigné and Postel score increased significantly (P < 0.001) from 14 ± 2 (8–15) points to 17 ± 1 (13–18, P < 0.001) points. Most patients (85%) reported at follow-up that they would undergo surgery again. (iii) At follow-up, all 23 hips were preserved (no conversion to total hip arthroplasty). One hip (4%) underwent revision osteosynthesis. Proximal rotational femoral osteotomies combined with cam resection improve hip pain and IR in most FAI patients with decreased FV at short-term follow-up. Rotational femoral osteotomies to increase FV are safe and effective.
A novel grading system combining histological grade and CDKN2A homozygous and hemizygous deletion to predict prognosis in IDH-mutant astrocytoma
Authors: Xi Shaoyan , Huang Qitao , Zeng Jing
Published: January 2024

Isocitrate dehydrogenase (IDH)-mutant astrocytoma with microvascular proliferation, necrosis, CDKN2A/B homozygous deletion, or any combination of these features corresponds to World Health Organization grade 4 according to current criteria. However, the prognostic significance of CDKN2A hemizygous deletion in IDH-mutant astrocytoma is not well established. We undertook a comprehensive study that included assessments of histological and genetic approaches to prognosis for these tumors. Samples from a cohort of 114 patients with extended observation were subjected to histological review and molecular analysis. CDKN2A (9p21) deletion was detected by fluorescence in situ hybridization. Overall survival (OS) was calculated via Kaplan-Meier estimation using the log-rank test. Histological grade, Ki-67 index, and the extent of surgical resection correlated with the OS of IDH-mutant astrocytoma patients. Both CDKN2A homozygous deletion and hemizygous deletion were detectable. Patients with CDKN2A homozygous-deletion tumors had the poorest OS; those with CDKN2A hemizygous-deletion tumors had an intermediate OS (p < .001). We then established a novel grading system that combined CDKN2A homozygous and hemizygous deletions with histological grade; the combined grading system was an independent prognostic factor for IDH-mutant astrocytomas. We conclude that CDKN2A homozygous and hemizygous deletion should be combined in a grading system for IDH-mutant astrocytomas.
Nutrient resorption exacerbates nitrogen–phosphorus imbalances in plants under increasing nitrogen addition in a saline–alkaline grassland
Authors: Su Yuan , Wu Shuaikai , Hao Jie , Diao Huajie , Dong Kuanhu , Wang Changhui
Published: January 2024

Reabsorbing nutrients from senescent tissues before leaf falling has been recognized as a strategy to adapt to nutrient deficiency. However, how nutrient resorption modulates the nitrogen (N)–phosphorus (P) balance inside plants remains unclear, especially under increased soil N availability. We examined the impacts of N addition at varying rates (0–32 g N m−2 yr−1) on nutrient resorption and the performance of nutrient resorption on controlling the internal N–P balance in the leaf and stem of a dominant grass species, Leymus secalinus, in a saline–alkaline grassland in northern China. After 6 years of N addition, N concentration and N:P ratio in green and senesced tissues (leaf and stem) rose with increasing N addition. The P concentration in green tissues decreased, but did not significantly change in senesced tissues with increasing N addition. The N resorption efficiency (NRE), P resorption efficiency (PRE), and NRE:PRE ratio significantly decreased along the N addition gradient. Moreover, we found more sensitive responses of N:P ratio in senesced tissues than in green tissues; such exacerbation of plant internal N–P imbalances mainly resulted from a disproportionate reduction in nutrient resorption, especially NRE. Overall, our study suggested that differences in NRE and PRE further exacerbated the internal N–P imbalances in plant litters.
Platform trial design for neurofibromatosis type 1, NF2-related schwannomatosis and non-NF2-related schwannomatosis: A potential model for rare diseases
Authors: Dhaenens Britt A E , Heimann Günter , Bakker Annette , Nievo Marco , Ferner Rosalie E , Evans D Gareth , Wolkenstein Pierre , Leubner Jonas , Potratz Cornelia , Carton Charlotte , Iloeje Uchenna , Kirk George , Blakeley Jaishri O , Plotkin Scott , Fisher Michael J , Kim AeRang , Driever Pablo Hernáiz , Azizi Amedeo A , Widemann Brigitte C , Gross Andrea , Parke Tom , Legius Eric , Oostenbrink Rianne
Published: January 2024

Background

Neurofibromatosis type 1, NF2-related schwannomatosis and non-NF2-related schwannomatosis (grouped under the abbreviation “NF”) are rare hereditary tumor predisposition syndromes. Due to the low prevalence, variability in the range, and severity of manifestations, as well as limited treatment options, these conditions require innovative trial designs to accelerate the development of new treatments.

Methods

Within European Patient-Centric Clinical Trial Platforms (EU-PEARL), we designed 2 platform-basket trials in NF. The trials were designed by a team of multidisciplinary NF experts and trial methodology experts.

Results

The trial will consist of an observational and a treatment period. The observational period will serve as a longitudinal natural history study. The platform trial design and randomization to a sequence of available interventions allow for the addition of interventions during the trial. If a drug does not meet the predetermined efficacy endpoint or reveals unacceptable toxicities, participants may stop treatment on that arm and re-enter the observational period, where they can be re-randomized to a different treatment arm if eligible. Intervention-specific eligibility criteria and endpoints are listed in intervention-specific-appendices, allowing the flexibility and adaptability needed for highly variable and rare conditions like NF.

Conclusions

These innovative platform-basket trials for NF may serve as a model for other rare diseases, as they will enhance the chance of identifying beneficial treatments through optimal learning from a small number of patients. The goal of these trials is to identify beneficial treatments for NF more rapidly and at a lower cost than traditional, single-agent clinical trials.
Paying for Parenthood: Understanding Parental Leave Policies in Infectious Disease Fellowship
Authors: Gardiner Catherine P , Desrochers Laura , Finn Kathleen , McDonald Furman , Melia Michael , Melfe Michael , Stead Wendy
Published: January 2024

Background

Many physician trainees plan pregnancy during residency and fellowship. A study of internal medicine program directors (PDs) demonstrated frequent misinterpretation of American Board of Internal Medicine (ABIM) leave policies applied to parental leave. The primary aim was to investigate how infectious disease (ID) PDs interpret current ABIM leave policies.

Methods

We surveyed 155 ID PDs in an online anonymous questionnaire about knowledge of ABIM leave policies and application toward trainee leaves.

Results

Of 155 PDs, 56 (36%) responded to the survey. Nearly 70% incorrectly identified leave limits permitted. A majority mistakenly chose to extend training when a competent fellow was within the allowed duration of leave. PDs reported that the majority of ID trainee maternity/birth parent leaves (60%) were ≤7 weeks and only 7% were ≥12 weeks; 50% of paternity/nonbirth parent leaves were ≤3 weeks.

Conclusions

Surveyed ID fellowship PDs often misinterpret ABIM leave policies and apply policies incorrectly when given sample scenarios..
Introduction
Authors: Bloomfield Paul , Copp David
Published: January 2024

What is moral realism? And why does it matter whether moral realism is true? These are the questions addressed in this chapter. The chapter also explains the organization of the volume. It begins, intuitively, with what we think is the basic idea that underlies moral realism, and with several considerations that motivate it. The fundamental thought, we think, can be expressed as a parity thesis – moral facts, properties, judgments, and truths have the same basic metaphysical status as other kinds, including physical, psychological, mathematical, and temporal ones, whatever other differences there are among them. We elaborate and articulate this basic idea. We conclude with a brief overview of the volume.
Histone Trimethylations and HDAC5 Regulate Spheroid Subpopulation and Differentiation Signaling of Human Adipose-Derived Stem Cells
Authors: Chang Ming-Min , Hong Yi-Kai , Hsu Chao-Kai , Harn Hans I-Chen , Huang Bu-Miin , Liu Ya-Hsin , Lu Fu-I , Hsueh Yuan-Yu , Lin Shau-Ping , Wu Chia-Ching
Published: January 2024

Human adipose-derived stem cells (ASCs) have shown immense potential for regenerative medicine. Our previous work demonstrated that chitosan nano-deposited surfaces induce spheroid formation and differentiation of ASCs for treating sciatic nerve injuries. However, the underlying cell fate and differentiation mechanisms of ASC-derived spheroids remain unknown. Here, we investigate the epigenetic regulation and signaling coordination of these therapeutic spheroids. During spheroid formation, we observed significant increases in histone 3 trimethylation at lysine 4 (H3K4me3), lysine 9 (H3K9me3), and lysine 27 (H3K27me3), accompanied by increased histone deacetylase (HDAC) activities and decreased histone acetyltransferase activities. Additionally, HDAC5 translocated from the cytoplasm to the nucleus, along with increased nuclear HDAC5 activities. Utilizing single-cell RNA sequencing (scRNA-seq), we analyzed the chitosan-induced ASC spheroids and discovered distinct cluster subpopulations, cell fate trajectories, differentiation traits, and signaling networks using the 10x Genomics platform, R studio/language, and the Ingenuity Pathway Analysis (IPA) tool. Specific subpopulations were identified within the spheroids that corresponded to a transient reprogramming state (Cluster 6) and the endpoint cell state (Cluster 3). H3K4me3 and H3K9me3 were discovered as key epigenetic regulators by IPA to initiate stem cell differentiation in Cluster 6 cells, and confirmed by qPCR and their respective histone methyltransferase inhibitors: SNDX-5613 (a KMT2A inhibitor for H3K4me3) and SUVi (an SUV39H1 inhibitor for H3K9me3). Moreover, H3K9me3 and HDAC5 were involved in regulating downstream signaling and neuronal markers during differentiation in Cluster 3 cells. These findings emphasize the critical role of epigenetic regulation, particularly H3K4me3, H3K9me3, and HDAC5, in shaping stem cell fate and directing lineage-specific differentiation.
Are trajectories of self-rated health and physical working capacity during the retirement transition predicted by work-related factors and social class?
Authors: Eyjólfsdóttir Harpa S , Peristera Paraskevi , Agahi Neda , Fritzell Johan , Westerlund Hugo , Lennartsson Carin
Published: January 2024

We aimed to identify short and long-term trajectories of self-rated health (SRH) and physical working capacity during the retirement transition, and investigate whether work-related factors and social class predict belonging to these trajectories. We used the representative, biennial Swedish Longitudinal Occupational Survey of Health (SLOSH) 2006–2018. We applied group-based trajectory modeling with B-spline smoothers to model trajectories of SRH (n = 2,183) and physical working capacity (n = 2,152) during the retirement transition. Multinomial logistic regression analyses were conducted to investigate trajectory belonging by work-related factors and social class. There was a small “honeymoon effect” in SRH for the total sample. We found four trajectories of SRH and five of physical working capacity. The large majority sustained excellent or good SRH and physical working capacity throughout the study period. Almost 6% had Fairly poor SRH and physical working capacity starting from years before retirement, which remained throughout the study period. High job demands, low job control, adverse physical working conditions, and being in manual occupation increased the likelihood of belonging to the trajectory groups Deteriorating or Fairly poor when compared with the Excellent trajectory group for both SRH and physical working capacity. Our findings suggest that for most people health status is already established some years’ preretirement and maintained for years after retirement, except a short improvement in SRH in accordance with a honeymoon effect. In order to improve health and employability, interventions focusing on working environment should be aimed at younger and midlife employees as well as older workers.
Overexpression of GmPAL Genes Enhances Soybean Resistance Against Heterodera glycines
Authors: Yang Xiaowen , Liu Ting , Yang Ruowei , Fan Haiyan , Liu Xiaoyu , Xuan Yuanhu , Wang Yuanyuan , Chen Lijie , Duan Yuxi , Zhu Xiaofeng
Published: January 2024

Soybean cyst nematode ( Heterodera glycines, soybean cyst nematode [SCN]) disease adversely affects the yield of soybean and leads to billions of dollars in losses every year. To control the disease, it is necessary to study the resistance genes of the plant and their mechanisms. Isoflavonoids are secondary metabolites of the phenylalanine pathway, and they are synthesized in soybean. They are essential in plant response to biotic and abiotic stresses. In this study, we reported that phenylalanine ammonia-lyase (PAL) genes GmPALs involved in isoflavonoid biosynthesis, can positively regulate soybean resistance to SCN. Our previous study demonstrated that the expression of GmPAL genes in the resistant cultivar Huipizhi (HPZ) heidou are strongly induced by SCN. PAL is the rate-limiting enzyme that catalyzes the first step of phenylpropanoid metabolism, and it responds to biotic or abiotic stresses. Here, we demonstrate that the resistance of soybeans against SCN is suppressed by PAL inhibitor l-α-(aminooxy)-β-phenylpropionic acid (L-AOPP) treatment. Overexpression of eight GmPAL genes caused diapause of nematodes in transgenic roots. In a petiole-feeding bioassay, we identified that two isoflavones, daidzein and genistein, could enhance resistance against SCN and suppress nematode development. This study thus reveals GmPAL-mediated resistance against SCN, information that has good application potential. The role of isoflavones in soybean resistance provides new information for the control of SCN.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Evaluation and Identification of Powdery Mildew Resistance Genes in Aegilops tauschii and Emmer Wheat Accessions
Authors: Jin Yuli , Yu Ziyang , Su Fuyu , Fang Tianying , Liu Shuang , Xu Hongxing , Wang Jiaojiao , Xiao Bei , Han Guohao , Li Hongjie , Ma Pengtao
Published: January 2024

Powdery mildew, caused by Blumeria graminis f. sp. tritici (Bgt), is a serious threat to wheat (Triticum aestivum L.) production. Narrow genetic basis of common wheat boosted the demand for diversified donors against powdery mildew. Aegilops tauschii Coss (2n = 2x = DD) and emmer wheat (2n = 4x = AABB), as the ancestor species of common wheat, are important gene donors for genetic improvement of common wheat. In this study, a total of 71 Ae. tauschii and 161 emmer wheat accessions were first evaluated for their powdery mildew resistance using the Bgt isolate E09. Thirty-three Ae. tauschii (46.5%) and 108 emmer wheat accessions (67.1%) were resistant. Then, all these accessions were tested by the diagnostic markers for 21 known Pm genes. The results showed that Pm2 alleles were detected in all the 71 Ae. tauschii and only Pm4 alleles were detected in 20 of 161 emmer wheat accessions. After haplotype analysis, we identified four Pm4 alleles (Pm4a, Pm4b, Pm4d, and Pm4f) in the emmer wheat accessions and three Pm2 alleles (Pm2d, Pm2e, and Pm2g) in the Ae. tauschii. Further resistance spectrum analysis indicated that these resistance accessions displayed different resistance reactions to different Bgt isolates, implying they may have other Pm genes apart from Pm2 and/or Pm4 alleles. Notably, a new Pm2 allele, Pm2S, was identified in Ae. tauschii, which contained a 64-bp deletion in the first exon and formed a new termination site at the 513th triplet of the shifted reading frame compared with reported Pm2 alleles. The phylogenetic tree of Pm2S showed that the kinship of Pm2S was close to Pm2h. To efficiently and accurately detect Pm2S and distinguish with other Pm2 alleles in Ae. tauschii background, a diagnostic marker, YTU-QS-3, was developed, and its effectiveness was verified. This study provided valuable Pm alleles and enriched the genetic diversity of the powdery mildew resistance in wheat improvement.
Complete Genome Resource of Xanthomonas oryzae pv. leersiae Strain YXol-1 Isolated from Plateau japonica Rice in Yunnan Province, China
Authors: A Xinxiang , Mei Le , Yang Yayun , Tang Cuifeng , Zhang Feifei , Dong Chao , Wang Bin , Liu Pengcheng , Chen Xifeng , Ma Bojun , Dai Luyuan
Published: January 2024

Xanthomonas oryzae are destructive phytopathogens in rice production and also an important model system for studying the interaction between plants and bacterial pathogens. Here, we report the isolation and complete genome sequence of the X. oryzae strain YXol-1. Through the identification of transcription activator-like effectors and whole-genome-based phylogenetic analysis, we confirmed that YXol-1 belongs to a rarely reported type of X. oryzae pathovar named X. oryzae pv. leersiae ( Xol). The present work enriches the genetic resources of Xol for studying the evolution of X. oryzae strains and can contribute to a better understanding of Xol–host interaction.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Validity of Birth Certificate Data Compared With Hospital Discharge Data in Reporting Maternal Morbidity and Disparities
Authors: Gemmill Alison , Passarella Molly , Phibbs Ciaran S. , Main Elliott K. , Lorch Scott A. , Kozhimannil Katy B. , Carmichael Suzan L. , Leonard Stephanie A.
Published: January 2024

A growing number of studies are using birth certificate data, despite data-quality concerns, to study maternal morbidity and associated disparities. We examined whether conclusions about the incidence of maternal morbidity, including Black–White disparities, differ between birth certificate data and hospitalization data. Using linked birth certificate and hospitalization data from California and Michigan for 2018 (N=543,469), we found that maternal morbidity measures using birth certificate data alone are substantially underreported and have poor validity. Furthermore, the degree of underreporting in birth certificate data differs between Black and White individuals and results in erroneous inferences about disparities. Overall, Black–White disparities were more modest in the birth certificate data compared with the hospitalization data. Birth certificate data alone are inadequate for studies of maternal morbidity and associated racial disparities.
Financial Performance of Accountable Care Organizations: A 5-Year National Empirical Analysis
Authors: Coyne Joseph , Gutman Roee , Ferraro Christopher , Muhlestein David
Published: January 2024

Goals:

Of 513 accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) in 2020, 67% generated a positive shared savings of approximately $2.3 billion. This research aimed to examine their financial performance trends and drivers over time.

Methods:

The unit of analysis was the ACO in each year of the study period from 2016 to 2020. The dependent variable was the ACOs' total shared savings earned annually per beneficiary. The independent variables included ACO age, risk model, clinician staffing type, and provider type (hybrid, hospital-led, or physician-led). Covariates were the average risk score among beneficiaries, payer type, and calendar year. The Centers for Medicare & Medicaid Services (CMS) public use files (PUFs) and a commercial healthcare data aggregator were the data sources.

Results:

ACOs' earned shared savings grew annually by 35%, while the proportions of ACOs with positive shared savings grew by 21%. For 1-year increase in ACO age, an additional $0.57 of shared savings per beneficiary was observed. ACOs with two-sided risk contracting were associated with an average marginal increase of $109 in shared savings per beneficiary compared to ACOs with one-sided risk contracting. Primary care physicians were associated with the greatest increase in earned shared savings per beneficiary. In contrast, nurse practitioners/physician assistants/clinical nurse specialists were associated with a reduction in earned shared savings. Under a one-sided risk model, hospital-led ACOs were associated with $18 higher average shared savings earning per beneficiary compared to hybrid ACOs, while physician-led ACOs were associated with lower average saved shared earnings per beneficiary at –$2 compared to hybrid ACOs. Provider-type results were not statistically significant at the 5% nominal level. No statistically significant differences were observed between provider types under a two-sided risk model.

Practical Applications:

For all ACO provider types, building broader primary care provider networks was correlated with positive financial results. Future research should examine whether ACOs are conducting specific preventive screenings for cancer or monitoring conditions such as diabetes, hypertension, heart disease, obesity, mental disorders, and joint disorders. Such studies may answer health policy and strategy questions about the effects of incentives for improved ACO performance in serving a healthier population.
Factors affecting the efficiency of walking independence in patients with subacute stroke following robot-assisted gait training with conventional rehabilitation
Authors: Maki Yoshiaki , Ii Takuma , Yamada Masanari , Tanabe Shigeo
Published: January 2024

Factors affecting the efficiency of walking independence in patients with subacute stroke following robot-assisted gait training (RAGT) and conventional treatment (RAGT-CT) were examined. This retrospective cohort study included 37 patients with stroke [n = 11 ischemic; n = 26 hemorrhagic; median poststroke interval, 28 days (interquartile range, IQR, 24–42)] who underwent RAGT using Welwalk for a median of 3 weeks (IQR, 2–4) followed by conventional training (median, 129 days; IQR, 114–146). The primary outcome was the change in functional independence measure (FIM)-walk item score from before to after RAGT (FIM-walk efficiency). The secondary outcome was the FIM-walk score at discharge. The independent variables included sensorimotor function [lower extremity (LE) motor and sensory scores and trunk function from the Stroke Impairment Assessment Set (SIAS) and Berg Balance Scale (BBS)] and cognitive function (FIM-cognitive, MMSE and Cognitive-related Behavioral Assessment) before RAGT-CT and RAGT dose duration per session, total steps and average treadmill speed at week 1, and number of sessions). We first determined the bivariate associations of each independent variable with the FIM-walk efficiency at the end of the RAGT period as decided by the therapists and with the FIM-walk score at discharge. Hierarchical multiple regression revealed that only the FIM-cognitive score was a significant predictor of the FIM-walk efficiency at the end of the RAGT period (β = 0.47; P < 0.01, adjusted R
2 = 0.21) after accounting for age, days post-stroke, SIAS-total lower extremity (SIAS-LE) motor score, and number of RAGT sessions (all nonsignificant). Furthermore, only the SIAS-trunk score was a significant predictor of the FIM-walk score at discharge (β = 0.52; P < 0.01; adjusted R
2 = 0.65) after accounting for age, days post-stroke, FIM-cognitive score, SIAS-LE motor score, and average treadmill speed at week 1 (all nonsignificant). Although patients with better cognition at the start of locomotor training achieved the pragmatic targets for terminating RAGT and proceeding with conventional therapy at a faster rate, the outcome at discharge is mainly dependent on early trunk function.
Digital gangrene: can be the first manifestation of essential thrombocythemia? a case report
Authors: Mirhosseini Amirhossein , Bozorgmehr Ramin , Bastan Fatemeh , Rashidian Maryam
Published: January 2024

Introduction and importance:

Essential thrombocythemia (ET) is a rare chronic myeloproliferative hematologic disorder, leading to an elevated platelet count. Two-thirds of patients are asymptomatic during their lifetime, while others may experience symptoms like redness, congestion, and erythromelalgia after long symptom-free intervals.

Case presentation:

The authors present a rare instance of a 55-year-old female who, despite receiving aspirin and losartan treatment, eventually developed digital gangrene. In further work-ups, she had an elevated platelet count and a positive JAK 2 mutation. Her platelet count was reduced throughout treatment with aspirin, hydroxyurea, and heparin, which was followed by the necrotic tip of her index finger being surgically debrided.

Clinical discussion:

Significant symptoms, such as severe acrocyanosis and even peripheral gangrene, can be treated with a single dose of aspirin. Daily aspirin consumption withstanding, this case developed the severe form of ET. In addition, while thrombocytosis predisposes patients to thrombotic complications in theory, there is little evidence to support a correlation between absolute platelet count and thrombosis.

Conclusion:

The initial symptom of ET could be such severe and uncommon that may develop arterial acral thrombosis despite previous daily low-dose aspirin consumption.
Disseminated appendicular lymphoma presenting as acute appendicitis: a case report
Authors: Regmi Dipesh , Devkota Shishir , Bhatta Om Prakash , Bhetwal Prashant , Yadav Sushil Kumar , Baral Pratik , Kandel Bishnu Prasad , Joshi Lakhey Paleswan
Published: January 2024

Introduction and importance:

Acute appendicitis is a common surgical emergency marked by appendix inflammation, presenting as acute abdominal pain and typically treated with appendectomy. The authors report a rare case of disseminated appendicular lymphoma presenting as acute appendicitis. Acute appendicitis is a common surgical emergency.

Case presentation:

This case involved a 75-year-old male patient who underwent appendectomy, revealing an enlarged appendix with lymphomatous nodules.

Clinical discussion:

Lymphoma involvement in the appendix is extremely rare, and lymphomas presenting as acute appendicitis are even more exceptional. Imaging investigations, including ultrasound and CECT scan of the abdomen, are recommended to aid in diagnosis. On computed tomography, appendiceal lymphoma is characterized by markedly diffuse mural soft-tissue thickening with preserved vermiform morphology and occasional aneurysmal dilatation of the lumen.

Conclusion:

This case underscores the importance of considering unusual etiologies in atypical appendicitis presentations.
A rare case of cecal foreign body leading to cecal perforation in 12-year-old child: a clinical case report and review of literature
Authors: Ibrahim Amelmasin Faris , Hussen Mohammed Seid , Tekle Yared , Mohammed Hussen
Published: January 2024

Introduction and importance:

Cecal foreign bodies are uncommon causes of acute abdomen, and their presentation can often mimic acute appendicitis (AA), making it challenging to diagnose. The authors present the case of a 12-year-old male from Ethiopia who initially presented with symptoms suggestive of AA. However, during surgery, the authors found a multiple magnetic fields result in perforation. This case highlights the importance of considering unusual etiologies.

Case presentation:

A 12-year-old boy with AA associated with anorexia, nausea, and low-grade fever was referred from a private clinic. Otherwise, no history of recent respiratory infection and diarrhea, and was previously in good health. The patient did not report any history of a foreign body (FB), even to his own family, and, except for himself, no one was aware of the ingested FB. The work has been reported in line with the Surgical CAse REport (SCARE) 2023 criteria.

Discussion:

In this case, the authors experienced multiple magnetic FB in the cecum, which were not observed on ultrasound (U/S). However, this case closely resembled appendicitis. U/S can aid in differentiation. However, it may not always identify the underlying etiology, specifically in a resource-limited setting.

Conclusion:

Based on the patient’s presentation, AA was diagnosed and emergency surgery was presumed to be inflamed. However, three magnetic FB were the underlying cause of the presentation, which created pressure on the cecal wall, and the authors successfully performed surgical management. This case reminds us of uncommon etiologies, such as magnets in patients with symptoms of appendicitis. This underscores the importance of an open-minded approach to unexpected findings during surgery.
Solving two-dimensional adjoint QCD with a basis-function approach
Authors: Trittmann Uwe
Published: January 2024

We apply a method (“eLCQ”) to find the asymptotic spectrum of a Hamiltonian from its symmetries to two-dimensional adjoint QCD. Streamlining the approach, we construct a complete set of asymptotic eigenfunctions in all parton sectors and use it in a basis-function approach to find the spectrum of the full theory. We are able to reproduce previous results including the degeneracy of fermionic and bosonic masses at the supersymmetric point, and to understand the properties of the lowest states in the massless theory. The approach taken here is continuous at fixed parton number, and therefore complementary to standard formulations, e.g. discretized light-cone quantization (DLCQ). Despite its limitation to rather small parton numbers, it can be used to test and validate conclusions of other frameworks in an independent way.

Published by the American Physical Society
2024
Fault-Tolerant Postselection for Low-Overhead Magic State Preparation
Authors: Bombín Héctor , Pant Mihir , Roberts Sam , Seetharam Karthik I.
Published: January 2024

We introduce a framework for fault-tolerant postselection (FTPS) of fault-tolerant codes and channels—such as those based on surface codes—using soft-information metrics based on visible syndrome and erasure information. We introduce several metrics for ranking configurations of syndromes and erasures. In particular, we introduce the (and variants thereof) as a powerful soft-information metric for predicting logical error rates of fault-tolerant channels based on topological error-correcting codes. The logical gap is roughly the unsigned weight difference between inequivalent logical corrections and is adaptable to any tailored noise model or decoder. We deploy this framework to prepare high-quality surface-code magic states with low overhead under a model of independent and identically distributed (IID) Pauli and erasure errors. Postselection strategies based on the logical gap can suppress the encoding error rate (EER) of a magic state preparation channel to the level of the physical error rate with low overhead. For example, when operating at 60% of the bulk threshold of the corresponding surface code, an overall reduction of the EER by a factor of 15 is achievable with a relative overhead factor of <2 (approximately 23 times less than that of simple syndrome-counting rules). We analyze a schematic buffer architecture for implementing postselection rules on magic state factories in the context of magic state distillation. The FTPS framework can be utilized for mitigating errors in more general fault-tolerant logical channels.

Published by the American Physical Society
2024
Investigating the early signs of ASD in preschool children in the UAE as a model for GCC countries
Authors: AlQahtani Omniah , Efstratopoulou Maria
Published: January 2024

Purpose

Identifying autism spectrum disorder (ASD) in children’s early years significantly impacts their academic performance and future life. It allows them to receive special support services and the required early intervention. Preschool teachers spend considerable time with their students, which allows them to observe their behaviors in different settings like classrooms and playgrounds. However, teachers need to be knowledgeable of ASD early assessment to detect them. Whereas, all well-known ASD assessment tools are designed for populations from different cultures than the Gulf Cooperation Councils' (GCC) culture. This study emphasizes the importance of preschool age, from 3 to 5, in indicating children's early signs of ASD. This paper aims to indicate the early signs of ASD in preschool children in the UAE as a model for other GCC countries.

Design/methodology/approach

A qualitative method consisting of interviews with preschool teachers and the ASD children’s parents was conducted to investigate the ASD early symptoms in children.

Findings

The findings of the study show that there is a direct connection between the opinions expressed by preschool teachers and the parents of children with ASD (Autism Spectrum Disorder). These results also highlight the presence of early indications of ASD among preschool-aged children in the United Arab Emirates, such as difficulties in communication, repetitive actions, delayed speech, excessive focus on tablets, trouble paying attention, hyperactivity, sleep problems, and aggressive behavior.

Originality/value

The outcomes suggest a strong connection between the feedback from preschool teachers and the parents of children with ASD. The study uncovers initial indications of ASD in preschool-aged children from the United Arab Emirates, such as difficulties in communication, repetitive actions, delayed speech, excessive fascination with tablets, problems with attention, hyperactivity, sleep disturbances, and aggressive behavior.
A novel granular decomposition based predictive modeling framework for cryptocurrencies' prices forecasting
Authors: Ghosh Indranil , Jana Rabin K. , Sharma Dinesh K.
Published: January 2024

Purpose

Owing to highly volatile and chaotic external events, predicting future movements of cryptocurrencies is a challenging task. This paper advances a granular hybrid predictive modeling framework for predicting the future figures of Bitcoin (BTC), Litecoin (LTC), Ethereum (ETH), Stellar (XLM) and Tether (USDT) during normal and pandemic regimes.

Design/methodology/approach

Initially, the major temporal characteristics of the price series are examined. In the second stage, ensemble empirical mode decomposition (EEMD) and maximal overlap discrete wavelet transformation (MODWT) are used to decompose the original time series into two distinct sets of granular subseries. In the third stage, long- and short-term memory network (LSTM) and extreme gradient boosting (XGB) are applied to the decomposed subseries to estimate the initial forecasts. Lastly, sequential quadratic programming (SQP) is used to fetch the forecast by combining the initial forecasts.

Findings

Rigorous performance assessment and the outcome of the Diebold-Mariano’s pairwise statistical test demonstrate the efficacy of the suggested predictive framework. The framework yields commendable predictive performance during the COVID-19 pandemic timeline explicitly as well. Future trends of BTC and ETH are found to be relatively easier to predict, while USDT is relatively difficult to predict.

Originality/value

The robustness of the proposed framework can be leveraged for practical trading and managing investment in crypto market. Empirical properties of the temporal dynamics of chosen cryptocurrencies provide deeper insights.
Enrichment of Schema.org with cultural heritage context standards for the description and processing of electronic thesis and dissertations
Authors: Mohammadi Ostani Morteza , Ebadollah Amoughin Jafar , Jalili Manaf Mohadeseh
Published: January 2024

Purpose

This study aims to adjust Thesis-type properties on Schema.org using metadata models and standards (MS) (Bibframe, electronic thesis and dissertations [ETD]-MS, Common European Research Information Format [CERIF] and Dublin Core [DC]) to enrich the Thesis-type properties for better description and processing on the Web.

Design/methodology/approach

This study is applied, descriptive analysis in nature and is based on content analysis in terms of method. The research population consisted of elements and attributes of the metadata model and standards (Bibframe, ETD-MS, CERIF and DC) and Thesis-type properties in the Schema.org. The data collection tool was a researcher-made checklist, and the data collection method was structured observation.

Findings

The results show that the 65 Thesis-type properties and the two levels of Thing and CreativeWork as its parents on Schema.org that corresponds to the elements and attributes of related models and standards. In addition, 12 properties are special to the Thesis type for better comprehensive description and processing, and 27 properties are added to the CreativeWork type.

Practical implications

Enrichment and expansion of Thesis-type properties on Schema.org is one of the practical applications of the present study, which have enabled more comprehensive description and processing and increased access points and visibility for ETDs in the environment Web and digital libraries.

Originality/value

This study has offered some new Thesis type properties and CreativeWork levels on Schema.org. To the best of the authors’ knowledge, this is the first time this issue is investigated.