bluuebunny/crossref_metadata_2025 huggingface dataset:
Mer for cognition: an emotion analysis algorithm in identifying moods of song and valence through musical features
Authors: Leysa C M , De Castro J , Gerardo B , Byun Yung-Cheol , Dionio Rosel L
Published: August 2023

This study aimed to classify the moods of the song based on musical features that include Acousticness, danceability, energy, Instrumentalness, loudness, liveliness, valence, tempo, and Speechiness. The researcher used the circumplex plane of James Russell, which has four quadrants. Quadrant 1 (Q1) says that when arousal is higher than 5 and valence is lower than 5, the mood is happy. Quadrant 3 (Q3) says that when arousal is lower than 5 and valence is higher than 5, the mood is sad, and Quadrant 4 (Q4) says that when arousal is lower than 5 and valence is higher than 5, the mood is calm. The desktop application music player was integrated to automatically categorize the moods of the songs after testing and training. The leverage of the TensorFlow algorithm will be the basis for classification.
Design and development of a Synergistic Educational Tool with Hiligaynon-English Recurrent Neural Network Model
Authors: Siosan Rosie Jane P. , De Castro Joel T. , Byun Y C
Published: August 2023

This project aimed to develop a mobile app tool to teach the Hiligaynon language to elementary pupils, designed with Machine Learning features using the Hiligaynon-Filipino-English Translation RNN Model. The app included games as a pedagogical tool, background music, and incentives to engage learners. The RNN model was developed using Data Science Methodology, while Rapid Agile Development Methodology was used to develop the mobile app for Android operating systems. To assess the app’s effectiveness, elementary teachers and IT professionals evaluated its compliance with standards for acceptability. The app was found to be very acceptable, recommended for use in a gamified classroom setting and by parents. Overall, this project promotes technology in language learning to make it more accessible and enjoyable for elementary pupils.
Boosting quantum amplitude exponentially in variational quantum algorithms
Authors: Kyaw Thi Ha , Soley Micheline B , Allen Brandon , Bergold Paul , Sun Chong , Batista Victor S , Aspuru-Guzik Alán
Published: August 2023

We introduce a family of variational quantum algorithms, which we coin as quantum iterative power algorithms (QIPAs), and demonstrate their capabilities as applied to global-optimization numerical experiments. Specifically, we demonstrate the QIPA based on a double exponential oracle as applied to ground state optimization of the H
2 molecule, search for the transmon qubit ground-state, and biprime factorization. Our results indicate that QIPA outperforms quantum imaginary time evolution (QITE) and requires a polynomial number of queries to reach convergence even with exponentially small overlap between an initial quantum state and the final desired quantum state, under some circumstances. We analytically show that there exists an exponential amplitude amplification at every step of the variational quantum algorithm, provided the initial wavefunction has non-vanishing probability with the desired state and that the unique maximum of the oracle is given by

λ
1

>
0

, while all other values are given by the same value

0
<

λ
2

<

λ
1

(here λ can be taken as eigenvalues of the problem Hamiltonian). The generality of the global-optimization method presented here invites further application to other problems that currently have not been explored with QITE-based near-term quantum computing algorithms. Such approaches could facilitate identification of reaction pathways and transition states in chemical physics, as well as optimization in a broad range of machine learning applications. The method also provides a general framework for adaptation of a class of classical optimization algorithms to quantum computers to further broaden the range of algorithms amenable to implementation on current noisy intermediate-scale quantum computers.
Human and climatic influences on wildfires ignited by recreational activities in national forests in Washington, Oregon, and California
*
Authors: Jenkins Jeffrey S , Abatzoglou John T , Rupp David E , Fleishman Erica
Published: August 2023

In Washington, Oregon, and California, ignitions from recreational activities accounted for 12% of human-caused wildfires, and 8% of the area burned, from 1992–2020. Wildfires ignited by recreational activities not only increase fire suppression expenditures but have the potential to limit recreational activities traditionally associated with use of fire, such as camping. From 1992–2020, 50% of recreation-caused ignitions in these three states occurred on lands managed by the U.S. Forest Service. The mean annual number of recreation-caused ignitions on national forests in the three states during this period was relatively stable, about 500, whereas recreation-caused ignitions within other jurisdictions decreased by 40%. Improved understanding of the impact of human and climatic factors on recreation-caused ignitions could provide valuable insights for shaping policy and management decisions. We found that mean annual densities of recreation-caused ignitions on national forests were 7 times greater within 1 km of designated campgrounds than >1 km from campgrounds, although 80% of recreation-caused ignitions occured >1 km from designated campgrounds. Ignition density in campgrounds increased non-linearly with overnight visitor density; a doubling of visitor density was associated with a ∼40% increase in ignitions. Large (≥4 ha) recreation-caused wildfires, especially those ignited in designated campgrounds, tended to occur concurrent with drought and 1–2 years after anomalously wet conditions. These results suggest that accounting for drought in implementation of fire restrictions, and targeting wildfire-prevention awareness to recreational users outside designated campgrounds, might reduce the likelihood of recreation-caused ignitions.
A forecast-model-based extreme weather event attribution system developed for Aotearoa New Zealand
Authors: Tradowsky Jordis S , Bodeker Greg E , Noble Christopher J , Stone Dáithí A , Rye Graham D , Bird Leroy J , Herewini William I , Rana Sapna , Rausch Johannes , Soltanzadeh Iman
Published: August 2023

A largely automated extreme weather event (EWE) attribution system has been developed that uses the Weather Research and Forecast numerical weather prediction model to simulate EWEs under current and pre-industrial climate conditions. The system has been applied to two extreme precipitation events in Aotearoa New Zealand with the goal of quantifying the effect of anthropogenic climate change on the severity of these events. The forecast simulation of the target event under current climate conditions constitutes the first scenario (ALL). We then apply a climate change signal in the form of delta fields in sea-surface temperature, atmospheric temperature and specific humidity, creating a second ‘naturalised’ scenario (NAT) which is designed to represent the weather system in the absence of human interference with the climate system. A third scenario, designed to test for coherence, is generated by applying deltas of opposite sign compared to the naturalised scenario (ALL+). Each scenario comprises a 22-member ensemble which includes one simulation that was not subject to stochastic perturbation. Comparison of the three ensembles shows that: (1) the NAT ensemble develops an extreme event which resembles the observed event, (2) the severity, i.e. maximum intensity and/or the size of area affected by heavy precipitation, changes when naturalising the boundary conditions, (3) the change in severity is consistently represented within the three scenarios and the signal is robust across the different ensemble members, i.e. it is typically shown in most of the 22 ensemble members. Thus, the attribution system presented here can be used to provide information about the influence of anthropogenic climate change on the severity of specific extreme events.
The Mediating Role of Depression in the Association Between Hearing Impairment and Functional Disability Among Middle-Aged and Older Adults in China
Authors: Han Dan , Li Sangsang , Wu Yunyi , Zhao Jie , Zhang Mei , Liao Hui , Ma Ying , Yan Chaoyang , Wang Jing
Published: August 2023

Background and Objectives

This study aims to explore the association between hearing impairment (HI) and functional disability and to examine whether depression mediates this association.

Research Design and Methods

In the study, 11 335 individuals aged 45 years and older were analyzed from the China Health and Retirement Longitudinal Study. The study used logistic regression and Karlson/Holm/Breen’s method to examine the correlation between HI, depression, and functional disability. Functional disability was assessed using activities of daily living and instrumental activities of daily living.

Results

HI was significantly associated with activities of daily living disability (odds ratio [OR] = 1.34, 95% confidence interval [CI] = 1.21–1.49) and instrumental activities of daily living disability (OR = 1.57, 95% CI = 1.46–1.68). The mediated effect of depression accounted for 22.80% and 15.17% of the total effect of HI on activities of daily living and instrumental activities of daily living disability, respectively. Additionally, depression partially mediated the effects of HI on specific activities of daily living and instrumental activities of daily living tasks, including bathing (33.23%), toileting (27.50%), doing chores (37.36%), preparing meals (28.04%), shopping (25.81%), taking care of finances (11.82%), and taking medicine (12.71%).

Discussion and Implications

HI increased the likelihood of functional disability partially through depression in middle-aged and older adults, suggesting that emphasizing the mental wellness of these people with HI is necessary to prevent impairments in physical function.
781 Eye of the Beholder: Does Visual Assessment in Severe Frostbite Accurately Predict Need for Thrombolytics?
Authors: Coward Alexandra , Dahl Rachel , Endorf Frederick W , Freese Rebecca , Lumbard Derek , Nygaard Rachel M , Schmitz Kyle
Published: August 2023

Introduction

The most promising therapy to salvage limb length following severe frostbite injury is thrombolytics (tPA). Along with screening for contraindications, most protocols use Tc99 bone scan or angiography to identify post-rewarming perfusion deficit. However, the efficacy of tPA is time dependent and many centers lack the ability to rapidly assess perfusion in the impacted limb. Based on this, our aim was to assess perfusion using a visual assessment scale developed for the austere environment. Our aims were to assess 1) the use of this scale to identify tPA eligibility, 2) the accuracy of measured perfusion deficit using this visual scale, and 3) the predictive value of three imaging modalities to amputation level. We hypothesize that the visual scale will provide less accuracy compared to traditional perfusion assessments but could be an appropriate adjunct to assessing eligibility for tPA.

Methods

Data from our prospectively maintained institutional database was used to identify a retrospective cohort of severe frostbite patients with pictures of the injury between 2016-20 (N=93). Aim 1 identified tPA eligibility based on the presence or absence of a perfusion deficit in pre-tPA visual assessment compared to pre-tPA Tc99 (N=60). Aim 2 compared the level of perfusion deficit on visual assessment to Tc99 scan (N=92). Visual assessment measure of perfusion was considered accurate if within 5% of calculated Tc99 scan. Imaging was temporally matched (i.e. pre-tPA visual to pre-tPA Tc99 and post-tPA visual to post-tPA Tc99). In aim 3 we calculated predictive values of 3 imaging modalities compared to amputation. Definitions for the predictive calculations are in figure 1.

Results

Based on visual assessment alone, 17% of patients would have received tPA who did not have a post-rewarming perfusion deficit (Aim 1). When comparing the accuracy of the measure in Aim 2, only 9% of visual assessments were accurate based on Tc99 scan and a majority (67%) were over-estimations of the level of perfusion deficit. Aim 3 assessed the predictive values of imaging to amputation and are presented in Table 1.

Conclusions

Early visual assessment of frostbite injury lacks accuracy, even in centers with high volumes of frostbite and experienced surgeons. We found high specificity and moderate to low sensitivity with all early assessment techniques. Future studies should include methods to assess perfusion feasible for use in the low resource arena. Additional studies are needed to further elucidate the use of imaging for surgical planning following severe frostbite injury in the urban setting.

Applicability of Research to Practice

Early visual assessment of severe frostbite injury lack specificity to predict amputation but may be used as an adjunct in low resource areas.
285 Determinants of Mortality Amongst Adult Burn Patients Admitted to a Regional Burn Center: Twenty-year Review
Authors: Shah Pankti , Bhavsar Dhaval , Nazir Niaman , Reynolds Jessica , Vazquez Machado Maria C , Work Emily D
Published: August 2023

Introduction

Established determinants of morbidity and mortality in burn patients include age and total burn surface area (TBSA), followed by inhalation injuries. We investigated determinants of mortality in burn patients admitted to our unit over the last two decades. The goal of this study was to determine the trends associated with burn mortality.

Methods

The burn registry was reviewed for the data of 5,401 burn patients admitted to our burn unit from 2002 to 2021. Patient demographics, payer source, burn characteristics, TBSA, injury circumstances, length of stay, ventilator and ICU days, comorbidities, complications, and surgery/procedures data were obtained for all patients. Chart reviews were completed for patients who died to investigate trends in mortality. The chi-square test, Wilcoxon two sample Test, Cochran-Armitage trend test, and Jonckheere-Terptra test will be used to evaluate the difference in risk factors of patients who survived and those who died. Two-sided p values less than 0.05 were considered statistically significant.

Results

A total of 4093 adult burn patients were hospitalized from 2002 to 2021, of which 155 died. Data showed a significant mortality risk for patients of older age with increased TBSA, higher number of ventilator days, higher ICU Days, and a higher number of complications and smoke inhalation. Male patients had a significantly higher mortality rate. Burn injury by flash-flame represented a higher mortality risk. Accidental burn injury unrelated to employment was significantly more common in all patient populations. The relationship between the number of comorbidities and mortality risk was not clear. There wasn’t a significant difference in the mortality risk based on ethnicity (p=0.1218). Mortality rates did not change significantly over the 20 years (p=0.2027).

Conclusions

Age, %TBSA, and presence of inhalation injury continue to be major determinants of mortality. Higher incidence of longer stay and ICU/ventilator days, complications, and surgical procedures are associated with burn patients who don’t survive but these may be related to previous parameters. Overall mortality trends have not changed.

Applicability of Research to Practice

The results of this study can be used to increase accuracy in the triage of burn patients at higher risk of complications and death, to offer patients precise prognostics and better outcomes in terms of morbidity and mortality.
286 A Comparison of Teleburn to In-person Consultations of Pediatric Patients in a Children’s Emergency Department
Authors: Ayers Claci , Byrd Hannah , Gondek Stephen , Kidd Rebecca , Mubang Ronnie , Solomon Barbara J , Wagner Anne L
Published: August 2023

Introduction

Regional Burn Centers provide burn care but there are disparities in access to regional burn centers for pediatric patients. Teleburn is a tool that enables providers without a certified burn center to provide photos of a burn to experts and receive recommendations on burn care. Our facility implemented a Teleburn system in December 2019. The purpose of this study is to evaluate the effectiveness of a Teleburn system to the gold standard in-person consultation in regards to burn infection rate, clinic follow up rate, post-burn admission rate, and 72-hour bounce back rate.

Methods

Data was collected from December 2019-March 2022 through the electronic medical record. A total of 416 patient encounters that met criteria were analyzed. The criteria for a Teleburn encounter are displayed in Fig. 1 and this was the criteria applied to the in-person burn consults. A non-inferiority study was designed comparing proportional outcomes of telemedicine burn initial visits to emergency department visits in regard to burn infection rate, clinic follow up rate, post-burn admission rate, and 72-hour bounce back rate. The data were compared with a difference of greater than 10% being considered inferior.

Results

Amongst the patient encounters 45.6% were female and ages ranged from 7 weeks to 19 years. Most common burn type was scald at 47.5%, with thermal being second at 43.7%. No differences were identified in rates of readmission - 1.67% difference (95% CI -27%< x< 23.8%) and return within 72 hours – 0.7% difference (-18.4%< x< 19.7%). Teleburn patients were 12.6% less likely to follow up (2.7%< x< 22.40%). Only one infection was identified, which is insufficient to conclude non-inferiority in terms of infection events.

Conclusions

While convenient, Teleburn consult could not be demonstrated to be non-inferior to in-person consultation. No differences in infection rates were identified, and difference in readmission and return were clinically insignificant. Efforts to improve follow-up may prove successful in raising the standard to that of in person visits given the large geographic areas covered by most regional burn centers.

Applicability of Research to Practice

This research advocates for more enhancement of Teleburn consult systems for pediatric acute minor burns and presents easily surmountable limitations. This study demonstrates that telemedicine may be effective and feasible to regional burn centers if follow up can be improved.
291 Hypernatremia Is Associated with Acute Renal Dysfunction in Severe Burn Patients
Authors: Obias Isabel B , Amador Dalton , Arceneaux Amy M , El Ayadi Amina , Golovko Georgiy , Karam Kathleen , Song Juquan , Soudah Chris K , Wolf Steven E
Published: August 2023

Introduction

Hypernatremia often occurs concurrently with acute kidney disease and is associated with increased mortality. It is a common electrolyte disorder presenting in severe burn patients, who are additionally at high risk for acute kidney disease. The purpose of this study is to determine if burn patients presenting with hypernatremia are at greater risk of developing acute kidney disease and related complications.

Methods

Patients diagnosed with severe burns (20% or more of total body surface area) were identified using the TriNetX Research Network and the relevant ICD-10 Codes. TriNetX is a national research database that provides real-time access to de-identified medical records.

Burn patients were stratified into hypernatremic (serum sodium ≥ 145 mmol/L) and eunatremic (serum sodium between 135 and 145 mmol/L) groups. Both groups excluded patients with a prior diagnosis of diabetes or hypothyroidism, as both may render patients more susceptible to electrolyte dysregulation. Patients with a personal history of diseases involving the circulatory, urinary, and respiratory systems were also excluded to control for pre-existing conditions that may affect the outcomes of this study.

We analyzed acute kidney disease, mortality, pulmonary edema, and respiratory failure one month after the onset of hypernatremia; these latter two complications are often associated with kidney injury. Statistical analysis was performed within TriNetX to generate the risk ratios and risk differences for each outcome.

Results

A total of 10,352 patients across 53 healthcare organizations were identified. Excluded from the study were 1,039 (10.04%) patients who were diagnosed with comorbidities. The remaining 9,313 patients were sorted respectively into the hypernatremic (n = 1,116) and eunatremic (n = 6,656) groups. The two cohorts were balanced using (1:1) propensity score matching for age, race, sex, ethnicity, and burn surface area.

The hypernatremic group showed a greater risk of developing acute kidney disease (risk ratio [RR], 4.343, p < 0.001) and associated complications. Severe burn patients with hypernatremia had a 1.987 times greater risk of developing pulmonary edema (p < 0.001), a 2.896 times greater risk of developing respiratory failure (p < 0.001), and a 2.873 times greater 30-day mortality rate (p < 0.001).

Conclusions

Hypernatremia in severe burn patients is associated with an increased risk of developing acute kidney injury, mortality, and related pulmonary complications.

Applicability of Research to Practice

This study indicates that hypernatremia is a potential marker for the development of renal and pulmonary complications.
294 Outcomes in Stevens-johnson Syndrome/toxic Epidermal Necroylsis Patients Treated Without Admission to a Verified Burn Center
Authors: Lewcun Joseph , Feldman Michael J , Kontzias Christina , Newsom Megan , Vagonis Alex
Published: August 2023

Introduction

The care of patients with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necroylsis (TEN) has traditionally been delivered within a burn center. Our burn center utilizes a multi-disciplinary approach which involves admission to the medicine service, with support from the burn team. The aim of this study is to determine whether SJS/TEN patients cared for with our system, including burn involvement but not burn admission, demonstrate equivalent outcomes.

Methods

A retrospective review of all SJS/TEN patients admitted to the medicine service at a single academic medical center from 2009 to 2021 was conducted. Demographic characteristics and outcome measures such as mortality, length of intensive care unit (ICU) stay and total length of hospitalization were collected. The Severity-of-Illness Score for Toxic Epidermal Necrolysis (SCORTEN) was used to calculate expected mortality rates within the cohort [2]. The observed mortality rates were then compared to the expected mortality rates.

Results

126 patients who were admitted for SJS/TEN were included (70 SJS, 40 SJS/TEN overlap, 16 TEN). The mortality rate for the entire cohort was 10.32% as compared to a 22.33% expected mortality rate (p=0.010). The observed and expected mortality rates for SJS, SJS/TEN overlap, and TEN sub-groups were 1.43% observed versus 10.22% expected (p=0.029), 20.00% observed versus 35.83% expected (p=0.133), and 25.00% observed version 44.06% expected (p=0.264) respectively. The mean ICU length of stay was 3.58 days, and the mean length of total hospitalization was 11.69 days.

Conclusions

Mortality rates in SJS/TEN patients admitted to medicine units are equivalent or decreased as compared to SCORTEN predicted mortality rates.

Applicability of Research to Practice

Admission of SJS/TEN patients to a medicine unit is appropriate as long as there is burn team involvement in their care, which may be more suitable for patients who require management of complex medical comorbidities.
304 A Novel Burn Education Program in a New Comprehensive Burn Center
Authors: ONeill Keisha M , Hollowed Kathleen , Kahn Steven A , Lesher Aaron , Smith Tiffany
Published: August 2023

Introduction

In 2020 a large academic hospital with an existing pediatric burn program expanded its services to take adults. Prior to opening the comprehensive center, training and education for the nursing staff was designed and implemented, in amalgamation with the existing pediatric education program. This study describes and evaluates the implementation and efficacy of a novel burn nursing education program, established using the American Burn Association’s (ABA) nursing competencies and Kolb’s Experiential Learning Model.

Methods

For the purpose of this study Cohort 1 (C1) is defined as 83 nurses hired prior to 2021 and Cohort 2 (C2) is defined as 304 nurses hired after 2022.

Didactic and simulated education sessions were created and presented in tandem for both initial and ongoing competency. Didactic sessions were evaluated in two cohorts because the program content was redesigned after 2021. C1 was evaluated using a pre-posttest, whereas, C2 was evaluated using only a post-test. Simulated content was evaluated using the verification in practice method with a check off sheet created using institutional wound care guidelines. Course efficacy was evaluated by attendees using a 1-5 Likert scale.

Test scores from 2020-2022 were compared using a T-test with a p-value of < 0.05 considered significant.

Results

To date 387 nurses have completed a written exam, been validated in practice, and if in C1, completed an annual ongoing burn competency activity. In 2020, C1 showed a statistically significant increase in pre and posttest scores from 66.87%±9.36 to 88.26%±7.90, p=0.000015. When C1 was retested in 2021 using the same posttest, the scores were 80%±1.73 in 2020 to 84.33%±3.84 in 2022, p=0.36. The mean score for posttests for C2 in 2022 was 88%.

Course evaluations returned by 155 nurses (77%) in 2020 indicated the course was too long, and some of the information was exorbitant for nursing practice. Therefore, in 2021 the course was redesigned. An additional 251 (65%) nurses have taken the course since, and have reported a mean of 4.5/5 for course efficacy and 4.9/5 for an increase in nursing confidence to care for the burn patient population.

Conclusions

The education program resulted in significantly higher posttest scores in C1 during the 2020-2021 period showcasing an increase in initial burn knowledge. Although the scores for C1 in 2022 were not statistically significant, the increase in mean scores shows the nurses not only retained the initial information, but built on it throughout the year with the addition of clinical practice. Nurses in C1 continue to practice at high levels and train nurses in C2 who reported the course was critical to their understanding of burn care. Nurses in both C1 and C2 will be required to complete an annual burn competency module to ensure ongoing competency in burn care.

Applicability of Research to Practice

Nursing Education
306 Review of CRRT in Burn Patients with Non-survivable Injuries
Authors: Brock Amanda D , Coffey Rebecca , Mandell Samuel P
Published: August 2023

Introduction

There is a subset of burn patients that have a non-survivable injury. Careful and thoughtful use of health care resources in this population is needed to provide end of life care. The purpose of this quality improvement project was to review patients with non-survivable injuries (NSI), started on continuous renal replacement (CRRT), to identify areas of improvement in end-of-life care.

Methods

A retrospective review of all patients admitted to one verified burn center from 1/1/2020 – 5/9/2022 who received CRRT as a life prolonging measure in patients with NSI. NSI was defined as modified BAUX predicted mortality of >90 0 and/or significant comorbidities, peri burn events ( i.e. Delayed presentation, cardiac arrest in the field) and physician judgement as documented in the chart. Data points collected include, age, TBSA and BAUX scores, indication for CRRT, any documented goals of care discussions, duration of CRRT, days from admit to initiation of CRRT and additional blood products and CRRT filters.

Results

A total of 21 patients who received CRRT were reviewed. Of those, 1 survived, 2 had incorrect MRNs in the hospital database, leaving 17 patients who died for analysis. The median age was 68 (IQR 18). The median TBSA was 43% (IQR 42). There were 2 patients with 0 % TBSA, 1 sustained a lightning strike and 1 with inhalation only. The median BAUX was 112 (IQR 37). The median hospital Length of stay (LOS) was 12 days (IQR 24). The median time in days to start of CRRT from time of injury was 2.5 days (IQR 11.5). Median time of CRRT initiation to time of death was 48 hours (IQR 239.5 range of 2.5 hours to 720 hours.). Blood product and filter use related to the initiation of CRRT for the 17 patients is in Table 1.

Of the patients included in the review, there were several issues related to the initiation of CRRT. One had a DNR, but family did not provide documentation and/or follow patient’s wishes. Several families were offered CRRT as an option despite futility and then insisted on that progression of care. Others were started on CRRT to allow time for family to be located or to arrive before transitioning to comfort care.

Conclusions

In patients with NSI, CRRT was often initiated within 24 hours of death. In several cases, when comfort measure only was the known plan of care. This in turn led to increased use of blood products and filters. For patients with non-survivable injuries, establishing early goals of care and discussing end of life care is imperative.

Applicability of Research to Practice

Early goals of care conversations and thoughtful use of resources in patients with non-survivable injuries should be examined to determine the appropriateness of care offered and interventions provided.
Epidemiology and survival of adult-type diffuse glioma in Belgium during the molecular era
Authors: Pinson Harry , Silversmit Geert , Vanhauwaert Dimitri , Vanschoenbeek Katrijn , Okito Jean-Pierre Kalala , De Vleeschouwer Steven , Boterberg Tom , De Gendt Cindy
Published: August 2023

Background

Survival data of diffuse adult-type glioma is mostly based on prospective clinical trials or small retrospective cohort studies. Real-world data with large patient cohorts is currently lacking.

Methods

Using the nationwide, population-based Belgian Cancer Registry, all known histological reports of patients diagnosed with an adult-type diffuse glioma in Belgium between 2017 and 2019 were reviewed. The ICD-O-3 morphology codes were matched with the histological diagnosis. The gathered data were transformed into the 2021 World Health Organization classification of CNS tumors using the IDH- and 1p/19q-mutation status.

Results

Between 2017 and 2019, 2233 diffuse adult-type gliomas were diagnosed in Belgium. Full molecular status was available in 67.1% of identified cases. The age-standardized incidence rate of diffuse adult-type glioma in Belgium was estimated at 8.55 per 100 000 person-years and 6.72 per 100 000 person-years for grade 4 lesions. Median overall survival time in IDH-wild-type glioblastoma was 9.3 months, significantly shorter compared to grade 4 IDH-mutant astrocytoma (median survival time: 25.9 months). The 3-year survival probability was 86.0% and 75.7% for grades 2 and 3 IDH-mutated astrocytoma. IDH-wild-type astrocytoma has a worse prognosis with a 3-year survival probability of 31.6% for grade 2 and 5.7% for grade 3 lesions.

Conclusions

This registry-based study presents a large cohort of adult-type diffuse glioma with known molecular status and uses real-world survival data. It adds to the current literature which is mainly based on historical landmark trials and smaller retrospective cohort studies.
YTHDF2-mediated regulations bifurcate BHPF-induced programmed cell deaths
Authors: Lin Jiebo , Zhan Guankai , Liu Jinfeng , Maimaitiyiming Yasen , Deng Zhiping , Li Baohua , Su Kunhui , Chen Jiafeng , Sun Siqi , Zheng Wanlin , Yu Xianghui , He Feng , Cheng Xiaodong , Wang Lingfang , Shen Bin , Yao Ziqin , Yang Xinquan , Zhang Jian , He Wentao , Wu Hengyu , Naranmandura Hua , Chang Kao-Jung , Min Junxia , Ma Jun , Björklund Mikael , Xu Peng-Fei , Wang Fudi , Hsu Chih-Hung
Published: August 2023

N6-methyladenosine (m6A) is a critical regulator in the fate of RNA, but whether and how m6A executes its functions in different tissues remains largely obscure. Here we report downregulation of a crucial m6A reader, YTHDF2, leading to tissue-specific programmed cell deaths (PCDs) upon fluorene-9-bisphenol (BHPF) exposure. Currently, Bisphenol A (BPA) substitutes are widely used in plastic manufacturing. Interrogating eight common BPA substitutes, we detected BHPF in 14% serum samples of pregnant participants. In a zebrafish model, BHPF caused tissue-specific PCDs triggering cardiac and vascular defects. Mechanistically, BHPF-mediated downregulation of YTHDF2 reduced YTHDF2-facilitated translation of m6A-gch1 for cardiomyocyte ferroptosis, and decreased YTHDF2-mediated m6A-sting1 decay for caudal vein plexus (CVP) apoptosis. The two distinct YTHDF2-mediated m6A regulations and context-dependent co-expression patterns of gch1/ythdf2 and tnfrsf1a/ythdf2 contributed to YTHDF2-mediated tissue-specific PCDs, uncovering a new layer of PCD regulation. Since BHPF/YTHDF2-medaited PCD defects were also observed in mammals, BHPF exposure represents a potential health threat.
Conferring liver selectivity to a thyromimetic using a novel nanoparticle increases therapeutic efficacy in a diet-induced obesity animal model
Authors: Wu Ruiling , Prachyathipsakul Theeraphop , Zhuang Jiaming , Liu Hongxu , Han Yanhui , Liu Bin , Gong Shuai , Qiu Jingyi , Wong Siu , Ribbe Alexander , Medeiros Jewel , Bhagabati Jayashree , Gao Jingjing , Wu Peidong , Dutta Ranit , Herrera Roman , Faraci Steve , Xiao Hang , Thayumanavan S
Published: August 2023

Optimization of metabolic regulation is a promising solution for many pathologies, including obesity, dyslipidemia, type 2 diabetes, and inflammatory liver disease. Synthetic thyroid hormone mimics–based regulation of metabolic balance in the liver showed promise but was hampered by the low biocompatibility and harmful effects on the extrahepatic axis. In this work, we show that specifically directing the thyromimetic to the liver utilizing a nanogel-based carrier substantially increased therapeutic efficacy in a diet-induced obesity mouse model, evidenced by the near-complete reversal of body weight gain, liver weight and inflammation, and cholesterol levels with no alteration in the thyroxine (T4) / thyroid stimulating hormone (TSH) axis. Mechanistically, the drug acts by binding to thyroid hormone receptor β (TRβ), a ligand-inducible transcription factor that interacts with thyroid hormone response elements and modulates target gene expression. The reverse cholesterol transport (RCT) pathway is specifically implicated in the observed therapeutic effect. Overall, the study demonstrates a unique approach to restoring metabolic regulation impacting obesity and related metabolic dysfunctions.
Disproportionate impact of COVID-19 severity and mortality on hospitalized American Indian/Alaska Native patients
Authors: Hurwitz Ivy , Yingling Alexandra V , Amirkabirian Teah , Castillo Amber , Khan Jehanzaeb J , Do Alexandra , Lundquist Dominic K , Barnes October , Lambert Christophe G , Fieck Annabeth , Mertz Gregory , Onyango Clinton , Anyona Samuel B , Teixeira J Pedro , Harkins Michelle , Unruh Mark , Cheng Qiuying , Leng Shuguang , Seidenberg Philip , Worsham Anthony , Langsjoen Jens O , Schneider Kristan A , Perkins Douglas J
Published: August 2023

Epidemiological data across the United States of America illustrate health disparities in COVID-19 infection, hospitalization, and mortality by race/ethnicity. However, limited information is available from prospective observational studies in hospitalized patients, particularly for American Indian or Alaska Native (AI/AN) populations. Here, we present risk factors associated with severe COVID-19 and mortality in patients (4/2020–12/2021, n = 475) at the University of New Mexico Hospital. Data were collected on patient demographics, infection duration, laboratory measures, comorbidities, treatment(s), major clinical events, and in-hospital mortality. Severe disease was defined by COVID-related intensive care unit requirements and/or death. The cohort was stratified by self-reported race/ethnicity: AI/AN (30.7%), Hispanic (47.0%), non-Hispanic White (NHW, 18.5%), and Other (4.0%, not included in statistical comparisons). Despite similar timing of infection and comparable comorbidities, admission characteristics for AI/AN patients included younger age (P = 0.02), higher invasive mechanical ventilation requirements (P = 0.0001), and laboratory values indicative of more severe disease. Throughout hospitalization, the AI/AN group also experienced elevated invasive mechanical ventilation (P < 0.0001), shock (P = 0.01), encephalopathy (P = 0.02), and severe COVID-19 (P = 0.0002), consistent with longer hospitalization (P < 0.0001). Self-reported AI/AN race/ethnicity emerged as the highest risk factor for severe COVID-19 (OR = 3.19; 95% CI = 1.70–6.01; P = 0.0003) and was a predictor of in-hospital mortality (OR = 2.35; 95% CI = 1.12–4.92; P = 0.02). Results from this study highlight the disproportionate impact of COVID-19 on hospitalized AI/AN patients, who experienced more severe illness and associated mortality, compared to Hispanic and NHW patients, even when accounting for symptom onset and comorbid conditions. These findings underscore the need for interventions and resources to address health disparities in the COVID-19 pandemic.
Towards elucidating species diversity of European inlandStrigamia(Chilopoda: Geophilomorpha): a first reassessment integrating multiple lines of evidence
Authors: Bonato Lucio , Bortolin Francesca , De Zen Giada , Decker Peter , Lindner E Norman , Orlando Marco , Spelda Jörg , Voigtländer Karin , Wesener Thomas
Published: August 2023

Strigamia centipedes are widespread in European forest soils. However, a complex and inconsistent taxonomy has developed over time. Based on a modern species concept, we evaluated multiple lines of evidence for speciation among inland populations of Strigamia from the Italian region to the Baltic region, across central Europe. Hypotheses of species delimitation were drawn independently from: (1) morphological differentiation, by means of model-based cluster analyses of 52 specimens, after controlling for allometry and sexual dimorphism; (2) syntopy of morphologically distinct individuals, assumed to be representatives of coexistent species, from > 700 sites; and (3) molecular differentiation, by various methods applied to cytochrome c subunit I sequences of the same 52 specimens. Diagnoses and geographical distributions were revised by re-examining > 2000 specimens and the entire literature. We found preliminary evidence for: a Strigamia acuminata species complex, widespread, including a candidate species from the Eastern Alps differing in the forcipules; a Strigamia carniolensis species complex, hitherto often called Strigamia crassipes, widespread south of the Alps but absent from Sicily; a Strigamia crassipes species complex, hitherto often called Strigamia transsilvanica, more widespread than previously known, including three candidate species co-occurring in the Western Alps and differing in body size and the number of legs despite little genetic divergence; and Strigamia engadina, exclusive to a narrow part of the Central Alps.
Genetic differentiation and host usage of coral and fire coral-associated barnacles (Cirripedia: Pyrgomatinae and Wanellininae) across the Indian and Pacific Oceans
Authors: Yu Meng-Chen , Ganmanee Monthon , Tsao Yao-Feng , Chan Benny K K
Published: August 2023

Using two molecular markers (COI and 12S) collected from seven genera and 20 species of coral associated and fire coral-associated barnacles, we examined whether genetic differentiation occurs between the Indian (total 261 sequences) and Pacific populations (195 sequences). Molecular phylogenetic analysis revealed pyrgomatinid barnacles formed two major sister-clades: the Cantellius clade and the major clade. Most of the species in the Cantellius clade did not show Indo-Pacific genetic divergence, except Cantellius sextus, which formed sister Indian and Pacific Ocean clades. Within the major clade, Darwiniella angularis, Galkinius maculosus, Nobia grandis, and Hiroa stubbingsi were composed of well-supported clades corresponding to the Indian and Pacific Oceans. The fire coral-associated barnacles Wanella milleporae have molecular clades corresponding to the populations in the Red Sea, Phuket waters, and Pacific Ocean. Species delimitation analyses and haplotype network supported the divergence of sequences in some coral barnacle species and fire coral barnacle between Indian and Pacific populations. Indo-Pacific genetic differentiation in some species appears to have resulted from Pleistocene glaciations. Life-history traits, length of larval development period, and host specificity appear can further affect the differentiation of coral barnacles across the Indian and Pacific Oceans.
Underestimated diversity and range size of diving beetles in tank bromeliads—Coleoptera of ‘hygrofloric’ lifestyle (Dytiscidae)
Authors: Hájek Jiří , Alarie Yves , Benetti Cesar J , Hamada Neusa , Springer Monika , Hendrich Lars , Villastrigo Adrián , Ospina Torres Rodulfo , Basantes Michael S , Balke Michael
Published: August 2023

Tank bromeliads provide a vast amount of stagnant water high up in the Neotropical forest canopy. However, the aquatic macroinvertebrate diversity in this specialized habitat remains poorly explored. Here, we study obligatorily bromeliadicolous species of the diving beetle genus Copelatus Erichson, 1832. We review the known species Copelatus bromeliarum Scott, 1912 (Trinidad and Venezuela) and Copelatus bimaculatus Resende & Vanin, 1991 (Brazil). We describe three new species: Copelatus espinhasso sp. nov. (Brazil), Copelatus florae sp. nov. (Brazil, Colombia, Costa Rica, Ecuador and Panama) including its larva, and Copelatus panguana sp. nov. (Peru). Based on their male genital morphology, these species form a distinct clade within the genus. Other shared characters such as compact drop-shaped habitus, shortened appendages, and reduction of natatory setae on legs are interpreted as adaptations for what we call the ‘hygrofloric’ lifestyle. We document the thin water layer between leaf axils as the preferred habitat of both Copelatus adults and larvae, and not necessarily the central tank.
How temperature affects the body size of terrestrial tardigrades
Authors: Kaczmarek Łukasz , Fontaneto Diego , Nelson Diane R , Budka Anna , Łacka Agnieszka , Bartylak Tomasz , Rzymski Piotr
Published: August 2023

Many vertebrates, both homeo- and poikilothermic, show a significant relationship between body size and environmental temperature. Whether such an association may exist in microscopic invertebrates has been less explored. Therefore, we decided to analyse terrestrial Tardigrada from various habitats worldwide to examine whether these animals reveal any relationship pattern between body size and environmental temperature. Data on minimum, maximum, and mean body sizes were extracted from original descriptions or sometimes from later re-descriptions of the species. Minimum, maximum, and mean temperature data from the type localities of the species were retrieved from WorldClim 2. In general, accounting for geographic and phylogenetic confounding factors, the body size of terrestrial tardigrades decreased as the environmental temperature increased. The same tendency was observed for most of the genera when additional analyses were carried out separately for each genus. This is the first biogeographical analysis demonstrating that terrestrial tardigrades generally conform to the temperature–size rule.
Osteoporosis management in primary care
Authors: Jarrell Lynda
Published: August 2023

Osteoporosis is the most prevalent bone disease in the US. Once diagnosed, osteoporosis requires ongoing management; therefore, primary care providers are vital in managing both primary and secondary fracture prevention. Safe, efficacious, and economical medications are available, but osteoporosis remains underdiagnosed and undertreated. Bisphosphonates, selective estrogen receptor modulators (raloxifene), conjugated estrogens/bazedoxifene, estrogen therapy/hormone therapy, parathyroid hormone analogues, RANK ligand inhibitors (denosumab), sclerostin inhibitors (romosozumab), and calcitonin are all drugs or drug classes commonly used to treat osteoporosis that are discussed in this article.
Remote Cochlear Implant Assessments: Validity and Stability in Self-Administered Smartphone-Based Testing
Authors: Wasmann Jan-Willem A. , Huinck Wendy J. , Lanting Cris P.
Published: August 2023

Objectives:

The stability of remote testing in cochlear implant care was studied by testing the influence of time-of-day, listener fatigue, and motivation on the outcomes of the aided threshold test (ATT) and digit triplets test (DTT) in cochlear implant (CI) recipients using self-tests at-home on a smartphone or tablet.

Design:

A single-center repeated measures cohort study design (n = 50 adult CI recipients). The ATT and DTT were tested at-home ten times, with nine of these sessions planned within a period of eight days. Outcomes were modeled as a function of time-of-day, momentary motivation, listeners’ task-related fatigue, and chronotype (i.e., someone’s preference for morning or evening due to the sleep-wake cycle) using linear mixed models. Additional factors included aided monosyllabic word recognition in quiet, daily-life fatigue, age, and CI experience.

Results:

Out of 500 planned measurements, 407 ATTs and 476 DTTs were completed. The ATT determined thresholds and impedances were stable across sessions. The factors in the DTT model explained 75% of the total variance. Forty-nine percent of the total variance was explained by individual differences in the participants’ DTT performance. For each 10% increase in word recognition in quiet, the DTT speech reception threshold improved by an average of 1.6 dB. DTT speech reception threshold improved, on average by 0.1 dB per repeated session and correlated with the number of successful DTTs per participant. There was no significant time-of-day effect on auditory performance in at-home administered tests.

Conclusions:

This study is one of the first to report on the validity and stability of remote assessments in CI recipients and reveals relevant factors. CI recipients can be self-tested at any waking hour to monitor performance via smartphone or tablet. Motivation, task-related fatigue, and chronotype did not affect the outcomes of ATT or DTT in the studied cohort. Word recognition in quiet is a good predictor for deciding whether the DTT should be included in an individual’s remote test battery. At-home testing is reliable for cochlear implant recipients and offers an opportunity to provide care in a virtual hearing clinic setting.
A Cross-Sectional Analysis of Sharps Injuries Among Dermatologic Surgeons: A Survey of American College of Mohs Surgery Members
Authors: Talebi-Liasi Faezeh , Lewin Jesse M.
Published: August 2023

BACKGROUND

There is a paucity of data on sharps injuries and bloodborne pathogen exposure among Dermatologic Surgeons.

OBJECTIVE

Quantify occupational risks from sharps injuries among Mohs surgeons. Determine rate of injury, reporting, and confidence in staff's sharps handling.

METHODS

A cross-sectional analysis performed using survey responses from Mohs surgeons with membership in the American College of Mohs Surgery (ACMS).

RESULTS

A total of 60 ACMS members completed the survey. Overall, 56.7% reported at least 1 sharps injury within the past year, of which 14.7% resulted in a bloodborne exposure (odds of exposure: 7.5% per year). The most common type of injury was self-inflicted suture needlestick (76.5%). Forty-four-point-one percent did not report their injuries. Ninety-five percent reported access to postexposure prophylaxis at their workplace. In addition, respondents in academic and single-specialty practices were more likely to report high or moderate confidence in staff sharps handling knowledge and in injury reporting compared with respondents from multispecialty and solo practices (88% vs 54% p = .02, 76%–81% vs 27% p = .0004, respectively).

CONCLUSION

Sharps injuries and under-reporting of these injuries are common among Mohs surgeons. Despite reporting of higher confidence in staff knowledge and training in academic and single-specialty practices, there was no correlation with surgeon's rate of injury.