bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-stakeholder aged care research networks: A scoping review
Authors: Gillard Anna K , McNeair Tracy , Andrew Nadine E , Haines Terry , Hill Keith D , Moran Chris , Rawson Helen , Russell Grant , Long Katrina M
Published: October 2024

Background and Objectives

An ageing population worldwide has highlighted the need for improved care in long term aged care homes. In Australia, such homes are called Residential Aged Care homes, and reform is underway to improve the quality and safety of aged care. A key enabler of quality improvement is increasing evidence-based practice through creating a system to support research translation. Collaborative multi-stakeholder research networks offer a potential solution by bringing together stakeholders to identify evidence-to-practice gaps, co-design research and translate knowledge into practice. The aim of this scoping review was to understand the current evidence on the creation and maintenance of multi-stakeholder aged care research networks internationally, reported facilitators and barriers, and outcomes.

Research Design and Methods

An academic literature search in five databases to identify existing multi-stakeholder aged care research networks. A grey literature search was conducted using Google, Google Scholar, grey literature databases and a manual search of targeted websites.

Results

10 papers and 19 web-based resources were identified, reporting on six multi-stakeholder research networks internationally. Enabling factors of successful networks included flexibility in structure, good governance, leveraging pre-existing research relationships, consistent and open communication, staff with dual roles in research and practice, and a focus on building long term partnerships independent of research projects.

Discussion and Implications

Collaborative multi-stakeholder research networks offer promise for improving research translation in aged care. Advancing the development of impactful multi-stakeholder aged care research networks requires internationally agreed terminology for network models, clear reporting and evaluation guidelines and dedicated infrastructure resources.
Deep learning phase pickers: how well can existing models detect hydraulic-fracturing induced microseismicity from a borehole array?
Authors: Lim Cindy S Y , Lapins Sacha , Segou Margarita , Werner Maximilian J
Published: October 2024

Deep learning (DL) phase picking models have proven effective in processing large volumes of seismic data, including successfully detecting earthquakes missed by other standard detection methods. Despite their success, the applicability of existing extensively trained DL models to high-frequency borehole data sets is currently unclear. In this study, we compare four established models [Generalized Seismic Phase Detection (GPD), U-GPD, PhaseNet and EQTransformer] trained on regional earthquakes recorded at surface stations (100 Hz) in terms of their picking performance on high-frequency borehole data (2000 Hz) from the Preston New Road (PNR) unconventional shale gas site, in the United Kingdom (UK). The PNR-1z data set, which we use as a benchmark, consists of continuously recorded waveforms containing over 38 000 seismic events previously catalogued, ranging in magnitudes from −2.8 to 1.1. Remarkably, all four DL models can detect induced seismicity in high-frequency borehole data and two might satisfy the monitoring requirements of some users without any modifications. In particular, PhaseNet and U-GPD demonstrate exceptional recall rates of 95 and 76.6 per cent, respectively, and detect a substantial number of new events (over 15 800 and 8300 events, respectively). PhaseNet’s success might be attributed to its exposure to more extensive and diverse instrument data set during training, as well as its relatively small model size, which might mitigate overfitting to its training set. U-GPD outperforms PhaseNet during periods of high seismic rates due to its smaller window size (400 samples compared to PhaseNet’s 3000-sample window). These models start missing events below $M_w$ −0.5, suggesting that the models could benefit from additional training with microseismic data-sets. Nonetheless, PhaseNet may satisfy some users’ monitoring requirements without further modification, detecting over 52 000 events at PNR. This suggests that DL models can provide efficient solutions to the big data challenge of downhole monitoring of hydraulic-fracturing induced seismicity as well as improved risk mitigation strategies at unconventional exploration sites.
Probabilistic geophysical inversion of complex resistivity measurements using the Hamiltonian Monte Carlo method
Authors: Hase Joost , Wagner Florian M , Weigand Maximilian , Kemna Andreas
Published: October 2024

In this work, we introduce the probabilistic inversion of tomographic complex resistivity (CR) measurements using the Hamiltonian Monte Carlo (HMC) method. The posterior model distribution on which our approach operates accounts for the underlying complex-valued nature of the CR imaging problem accurately by including the individual errors of the measured impedance magnitude and phase, allowing for the application of independent regularization on the inferred subsurface conductivity magnitude and phase, and incorporating the effects of cross-sensitivities. As the tomographic CR inverse problem is nonlinear, of high dimension and features strong correlations between model parameters, efficiently sampling from the posterior model distribution is challenging. To meet this challenge we use HMC, a Markov-chain Monte Carlo method that incorporates gradient information to achieve efficient model updates. To maximize the benefit of a given number of forward calculations, we use the No-U-Turn sampler (NUTS) as a variant of HMC. We demonstrate the probabilistic inversion approach on a synthetic CR tomography measurement. The NUTS succeeds in creating a sample of the posterior model distribution that provides us with the ability to analyse correlations between model parameters and to calculate statistical estimators of interest, such as the mean model and the covariance matrix. Our results provide a strong basis for the characterization of the posterior model distribution and uncertainty quantification in the context of the tomographic CR inverse problem.
Consumer Moral Decision Making: The Impact of Alignable Versus Nonalignable Differences
Authors: Park Sang Kyu , Cho Young Joo , Kim Jungkeun , Lee Jin Yong , Park Jongwon
Published: October 2024

Consumer choice decisions often involve a tradeoff between an alignable difference (a difference along a shared attribute) and a nonalignable difference (a difference between unique attributes of each alternative). For example, Café A provides friendly service, while Café B offers unwelcoming service (an alignable difference). However, Café A occasionally makes billing errors, and Café B has comfortable seating (a nonalignable difference). Prior research shows that alignable differences tend to have a greater impact on choice than nonalignable differences (known as the “alignability effect”). Yet, little research has examined tradeoffs involving moral attributes. Contrary to the prevailing evidence, eight studies (N = 2,861) demonstrate that in moral attribute tradeoffs, nonalignable (vs. alignable) differences have a greater impact on choice (termed the “nonalignability effect”). Consequently, consumers prefer an alternative that is superior on a nonalignable moral difference but inferior on an alignable moral difference. Moreover, in moral–quality tradeoffs, where one alternative is more ethical but is of lower quality, consumers show a stronger preference for the ethical alternative when its moral superiority is represented by a nonalignable (vs. alignable) difference. The nonalignability effect is driven by consumers’ unique decision process in making moral attribute tradeoffs, characterized by categorical valence coding and attribute-by-attribute win–loss counting.
Enhancing anti-corruption via investment arbitration: from red flags to due diligence
Authors: Kryvoi Yarik , Godhe Aleksander
Published: October 2024

As the number of corruption allegations in investor–State disputes (ISDS) grows, tribunals must balance their duty to resolve disputes and to render enforceable awards. Given the difficulty of proving corruption, arbitrators increasingly consider red flags to detect it, but still struggle with drawing consequences for corrupt conduct that would serve as an effective deterrent. Our empirical analysis of 92 ISDS cases that involved allegations of corruption reveals that over a quarter of arbitral decisions already utilize a red flags approach, which helps tribunals assess corruption risks and provide circumstantial evidence. This article proposes a novel list of red flags based on the empirical analysis, domestic and international law sources as well as soft law instruments. It then frames a corresponding anti-corruption due diligence mechanism, which can minimize the risks of corruption occurring, bring more predictability to ISDS and disincentivize frivolous allegations of corruption.
Are there compensatory behaviors in response to a sit-stand desk intervention?
Authors: Silva Hélio , Teno Sabrina C , Júdice Pedro B
Published: October 2024

Objectives: Office workers represent one of the most sedentary groups. Alarmingly, more than one-third of their sitting time during workdays occurs in prolonged bouts. Sit-stand desk (SSD) interventions have been found to be effective in reducing sitting time, but heterogeneity exists amongst studies, which may be due to compensations outside the workplace. This study aimed to assess the impact of a 6-month SSD intervention on office workers’ sitting and standing times during the work shift and outside work (leisure time).

Methods: A 2-arm (1:1) clustered randomized controlled trial was conducted with 38 participants randomly assigned to either the intervention or control group. The intervention included a psychoeducational session, motivational prompts, and environmental modification (SSD implemented in the workplace). The waiting-list control group maintained the usual work conditions and only received the initial session. We employed repeated measures analysis of covariance to compare changes between groups while adjusting for relevant covariates, with significance set at 5%.

Results: In the intervention group, there was a significant reduction in sitting time at work by 32.97 minutes, along with a notable increase in standing time by 27.88 minutes (P < .05). Although nonsignificant (P > .05), there was an increase in sitting time in the leisure context of about 23.07 minutes.

Conclusions: This study underscores the effectiveness of SSD as a key strategy to mitigate sitting time among office workers. However, future interventions should consider integrating comprehensive behavioral strategies beyond the workplace to sustain potential increases in sitting time during leisure time and avoid compensatory behaviors.
Primary intraosseous meningioma: a case of early symptomatic calvarial origin meningioma
Authors: Poursina Olia , Qiu Jingxin
Published: October 2024

Primary intraosseous meningiomas are rare extradural tumors. They are typically slow-growing, painless, and asymptomatic until they cause a mass effect. We report a case of a calvarial primary intraosseous meningioma, which became symptomatic despite a very small size. A 67-year-old female with a history of precancerous breast tissue presented with right-sided stroke-like symptoms. Computed tomography showed right parietal convexity irregularity without hemorrhage or infarct. MRI indicated a right parietal calvarial signal abnormality and dural thickening, suggesting metastases or primary osseous neoplasm. A PET scan revealed heterogeneous uptake in the right parietal skull with no other abnormalities. Histology confirmed the diagnosis of primary intraosseous meningioma. Histopathological examination is crucial to avoid misdiagnosis and treatment planning, which may involve wide-margin skull resection, radiation, or both.
Routine laboratory screening for cyp51a-related azole resistance in Aspergillus fumigatus using Etest: Concordance with gene sequencing
Authors: Rabault Charlotte , Rakotoarivony Yann , Houzé Sandrine , Bonnal Christine , Joste Valentin
Published: October 2024

We evaluated the combined performance of itraconazole and voriconazole Etest® gradient concentration strips for the detection of Aspergillus fumigatus azole resistance associated with cyp51a mutations confirmed by gene sequencing. Among 118 A. fumigatus clinical isolates collected in a French center, 6 (5%) had azole resistance mutations, 5 of which were probably of environmental origin. Using recent method-dependent epidemiological cutoff values as thresholds, the combination's sensitivity and specificity were 100% [95% confidence interval 61–100] and 99% [95–100]. Our results support itraconazole and voriconazole Etest® combined use as a promising self-sufficient method for simple, efficient and reliable cyp51a-related azole-resistant A. fumigatus detection.
Dynamics and structure of network magnetic fields: supergranular vortex expansion–contraction
Authors: Chian Abraham C -L , Rempel Erico L , Rubio Luis Bellot , Gošić Milan
Published: October 2024

We report on the formation of a large magnetic coherent structure in a vortex expansion–contraction interval, resulting from the merger of two plasmoids driven by a supergranular vortex observed by Hinode in the quiet-Sun. Strong vortical flows at the interior of vortex boundary are detected by the localized regions of high values of the instantaneous vorticity deviation, and intense current sheets in the merging plasmoids are detected by the localized regions of high values of the local current deviation. The spatiotemporal evolution of the line-of-sight magnetic field, the horizontal electric current density, and the horizontal electromagnetic energy flux is investigated by elucidating the relation between velocity and magnetic fields in the photospheric plasma turbulence. A local and continuous amplification of magnetic field from 286 G to 591 G is detected at the centre of one merging plasmoid during the vortex expansion–contraction interval of 60 min. During the period of vortex contraction of 22.5 min, the line-of-sight magnetic field at the centre of plasmoid-1 (2) exhibits a steady decrease (increase), respectively, indicating a steady transfer of magnetic flux from plasmoid-1 to plasmoid-2. At the end of the vortex expansion–contraction interval, the two merging plasmoids reach an equipartition of electromagnetic energy flux, leading to the formation of an elongated magnetic coherent structure encircled by a shell of intense current sheets. Evidence of the disruption of a thin current sheet at the turbulent interface boundary layers of two merging plasmoids is presented.
High γ-ray escape time in 2003fg-like supernovae: A challenge to proposed models
Authors: Sharon Amir , Kushnir Doron , Schinasi-Lemberg Eden
Published: October 2024

A rare subclass of Type Ia supernovae (SNe Ia), named after the prototype SN 2003fg, includes some of the brightest SNe Ia, often called ”super Chandrasekhar-mass” SNe Ia. We calculate the γ-ray deposition histories and the 56Ni mass synthesized in the explosion, MNi56, for eight 2003fg-like SNe. Our findings reveal that the γ-ray escape time, t0, for these objects is t0 ≈ 45–60  days, significantly higher than that of normal SNe Ia. 2003fg-like SNe are distinct from normal SNe Ia in the t0–MNi56 plane, with a noticeable gap between the two populations. The observed position of 2003fg-like SNe in this plane poses a significant challenge for theoretical explosion models. We demonstrate that the merger of two white dwarfs (WDs) and a single star exceeding the Chandrasekhar limit fail to reproduce the observed t0–MNi56 distribution. However, preliminary calculations of head-on collisions of massive WDs show agreement with the observed t0–MNi56 distribution.
Discovering changing-look AGN in the 6dF Galaxy Survey using ATLAS light curves
Authors: Amrutha Neelesh , Wolf Christian , Onken Christopher A , Hon Wei Jeat , Lai Samuel , Tonry John L , Webster Rachel
Published: October 2024

Changing-look active galactic nuclei (CLAGNs) are characterized by extreme variations in line emission over short time-scales, mostly affecting broad H $\beta$ lines. While a few hundred CLAGNs are known, a complete sample of turn-on CLAGNs is still elusive. Here, we present a search for turn-on CLAGNs in a complete sample of galaxies, using archival spectra and recent light curves. We obtained light curves from the Asteroid Terrestrial Impact Last Alert System for 16 232 emission-line galaxies, including both star-forming and active galaxies, at $z< 0.1$ with spectra from the Six-degree Field Galaxy Survey (6dFGS). We first establish typical variability behaviour for different active galactic nucleus (AGN) types, as recorded between 2001 and 2009, and then select outliers from the bulk behaviour as CLAGN candidates. We obtain new spectra for the candidates and identify 12 new turn-on CLAGNs (appearing broad H $\beta$ line) and 19 new turn-off CLAGNs (disappearing broad H $\beta$ line). We may have missed AGNs that changed and reverted their state over the 15–20 yr since 6dFGS spectra were taken, and thus our CLAGN rates of 1.7 per cent for turn-on and 9.6 per cent for turn-off are lower limits. The turn-on rate is naturally much lower as the type 1.9/2 sample is dominated by obscured AGNs due to orientation, which is not expected to change. However, the number of turn-on (27) and turn-off (24) CLAGNs we find are similar, suggesting that our parent AGN sample is reasonably complete in our search volume at $z < 0.1$.
The Effect of Algae Supplementation on Anthropometric Indices in Adults: A GRADE-Assessed Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Kazeminejad Shervin , Arzhang Pishva , Baniasadi Mohammadreza Moradi , Hatami Alireza , Azadbakht Leila
Published: October 2024

Context

Inconsistent results have been reported regarding the effects of different types of algae, such as Spirulina and Chlorella, on anthropometric indices.

Objective

To conduct a meta-analysis to assess the efficacy of algae supplementation on anthropometric indices.

Data Sources

A comprehensive systematic search was conducted to find relevant articles published from January 1990 to January 2024.

Data Extraction

Randomized controlled trials (RCTs) comparing algae supplementation with a placebo or control group were included. The risk of bias and certainty of the evidence were evaluated using the Cochrane risk-of-bias tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, respectively. The random-effects model was used to find the Weighted mean differences (WMDs) for each outcome.

Data Analysis

Of 9079 distinct articles in the initial screening, 61 clinical trials were included in this meta-analysis. Algae supplementation resulted in lower body mass index (WMD, –0.27 kg/m2 (95% CI, –0.42 to –0.13); GRADE rating, low), body weight (WMD: −0.78 kg [–1.18 to –0.38]; GRADE rating, low), waist circumference (WMD, –0.68 cm [–1.27 to –0.10]; GRADE rating, very low), kilograms of body fat (WMD, –0.65 kg [–1.13 to –0.17]; GRADE rating, low), and body fat percentage (WMD, –0.9% [–1.62 to –0.17]; GRADE rating, very low) compared with placebo or controls. Nevertheless, the statistically significant effects of algae supplementation on hip circumference (WMD, –0.20 cm [–0.73 to 0.32]; GRADE rating, moderate), waist to hip ratio (WMD, –0.01 [–0.01 to 0.00]; GRADE rating, moderate), and lean body mass (WMD, –0.30 kg [–0.62 to 0.02]; GRADE rating, moderate) were not observed.

Conclusions

Overall, the findings of this meta-analysis indicate supplementation with algae may exert beneficial effects on anthropometric indices. However, due to between-studies heterogeneity and very low to low levels of GRADE for significant outcomes, the results should be interpreted with caution.

Systematic Review Registration

PROSPERO registration no. CRD42024522923.
Cor triatriatum sinister in an elderly woman patient with successful conservative treatment
Authors: Inami Kana , Sugihara Ryuta , Kumada Masahiro , Hayashi Takaharu , Fukuoka Hidetada , Fukushima Naoki , Nakagawa Tsutomu , Sakata Yasushi
Published: October 2024

Cor triatriatum sinister (CTS) is a relatively rare congenital condition characterized by an abnormal septum dividing the left atrium, morphologically presenting as three atria. Although most individuals with heart failure related to CTS undergo surgical treatment in childhood, those with larger fenestrations may remain asymptomatic until they reach an age where surgery is less viable, presenting treatment challenges. In our case study, we report on an elderly woman who declined all invasive treatments and developed heart failure due to severe functional mitral valve regurgitation triggered by atrial fibrillation. She opted for conservative treatment after a comprehensive evaluation of her condition using transesophageal echocardiography, cardiac magnetic resonance imaging, and right-heart catheterization. This multimodal evaluation highlights the importance of accurate diagnostic approaches and tailored treatments for elderly patients with CTS.
Religious Tension and Ethnic Consciousness in the Later Russian Empire
Authors: Marsden Thomas
Published: October 2024

The Russian Empire collapsed because it failed to assimilate non-Russian minorities, and did not provide a coherent national narrative to unite the Russian population. Its religious policies were key contributors to these failures, and this article examines their impact in order to shine a new light on the religious background to the empire’s demise. The Orthodox Church was supposed to provide the means to assimilate non-Russians and offer up the core cultural component for a Russian national consciousness. Its inability to do so became clear in the 1860s–1880s when, in the liminal regions of the empire, Orthodoxy fragmented along ethnic lines. Russians deserted churches for the dissenting Old Believer movement, and non-Russians returned to their ancestral faiths of animism and Islam. This was partly down to an inconsistency in government, which meant that religious repression overlapped with the principle of toleration; however, an exploration of the dynamics of apostasy at a parish level shows that where Russians and non-Russians were compelled to worship together, religious tensions emerged and churches lost their sacred character. As well as providing new insights into how the empire alienated its subjects at a local level, this exploration reveals pathways to ethnic consciousness from below. Ethnicization was the process that separated ethnicity from religion, and places of worship possessed characteristics, most importantly the performance of communal historical memory, that made them into key sites of ethnic boundary formation.
Learning from and about scientists: Consensus messaging shapes perceptions of climate change and climate scientists
Authors: Orchinik Reed , Dubey Rachit , Gershman Samuel J , Powell Derek M , Bhui Rahul
Published: October 2024

Despite overwhelming scientific consensus on the existence of human-caused climate change, public opinion among Americans remains split. Directly informing people of scientific consensus is among the most prominent strategies for climate communication, yet the reasons for its effectiveness and its limitations are not fully understood. Here, we propose that consensus messaging provides information not only about the existence of climate change but also traits of climate scientists themselves. In a large (n=2,545) nationally representative survey experiment, we examine how consensus information affects belief in human-caused climate change by shaping perceptions of climate scientist credibility. In the control group (n=847), we first show that people learn both from and about climate scientists when presented with consensus and that perceived scientist credibility (especially skill) mediates up to about 40% of the total effect of consensus information on climate belief. We demonstrate that perceptions of climate scientists are malleable with two novel interventions that increase belief in climate change above and beyond consensus information.
Competitive performativity of academic social networks: the subjectivation of competition on ResearchGate
Authors: Pühringer Stephan , Wolfmayr Georg
Published: October 2024

This paper develops a better understanding of the explicit and implicit implications of the academic field’s competitization, with a specific focus on the role that academic social networks and platforms (ASNPs) play in this process. While ASNPs are embedded within a broad and complex ecology of academic competition we show that particularly ResearchGate offers a broad variety of tools for competitive subjectivation and thus can be seen as an important organizer and promoter of competition in academia. By applying a mixed-methods approach combining a structural analysis and a questionnaire study, we examine how and to what extent the platform ResearchGate contributes to the competitive subjectivation of its users. Therefore, we differentiate between suggested and enacted subjectivation. Concerning differences in age, gender and disciplinary background, our results show that ResearchGate is used more by younger and male researchers and especially younger researchers also perceive their work significantly more in a competitive context and thus also tend to act more competitively. While metric research evaluation is assessed as most important in the natural sciences and economics and rather unimportant in the humanities, subjectivation via the use of ResearchGate is perceived higher in the humanities, which are still less confronted with the competition ecology in academia.
Surgery With or Without Radiotherapy Versus Radiotherapy Alone for Malignant Spinal Cord Compression
Authors: Haro-Perez Patricio , Pinzon-Leal Daniela , Del Pozo-Acosta Prisca , Cruz-Bravo Michael , Ortiz-Ordonez Andrea
Published: October 2024

Study Design:

A systematic review and meta-analysis

Objective:

To conduct a meta-analysis of studies that compared surgery with or without radiotherapy to radiotherapy alone for patients with malignant spinal cord compression, and a subgroup analysis of patients stratified by hematologic and solid malignancies.

Summary of Background Data:

Two previous meta-analyses showed that surgery with or without radiotherapy was better than radiotherapy alone in patients with malignant spinal cord compression. Nevertheless, there was no stratification by tumor type, leading to uncertainty regarding best approach for patients with hematologic malignancies.

Methods:

We searched PubMed, Scopus, and Web of Science, for studies comparing surgery with or without radiotherapy to radiotherapy alone in patients with malignant spinal cord compression. The primary outcomes were improvement in ambulatory status and survival at 12 months. For neurological outcomes, we included studies involving both locally advanced primary malignancies of the spine and metastatic tumors. We restricted our analysis to studies on metastases for survival outcomes.

Results:

We included 2536 patients from 18 studies. Surgery was performed in 890 (35%) patients. The pooled analysis of all studies revealed that improvement in ambulatory status (OR 2.65; 95% CI 1.60-4.39) and survival at 12 months (OR 1.66; 95% CI 1.10-2.52) were significantly higher in patients who underwent surgery with or without radiotherapy. Improvement in ambulatory status (OR 1.92; 95% CI 1.19-3.09) and survival at 12 months (OR 4.24; 95% CI 2.35-7.66) were significantly higher in patients with hematologic malignancies in the surgical arm. The primary outcomes were not significantly different between patients with solid malignancies.

Conclusion:

Surgical intervention demonstrates superior neurological outcomes and increased survival compared with radiotherapy alone. Subgroup analysis revealed that patients with hematologic malignancies on surgery group experienced superior primary outcomes; however, high risk of bias of the included studies preclude definitive changes in standard care based on this data. These findings underscore the need for further research regarding the efficacy of surgical versus radiotherapeutic approaches for specific tumor types.

Level of Evidence:

2
Evaluation of BUBR1, MCM2, and GMNN as oral cancer biomarkers
Authors: Abrahim Naíza M.M. , Cavalcante Roberta B. , Pardini Maria Inês de M.C. , Rabenhorst Silvia H.B. , Ferrasi Adriana Camargo
Published: October 2024

Oral cancer is a public health problem worldwide. Late diagnosis results in a low survival rate. However, this tumor can arise from oral precancerous lesions and identification of biomarkers in precursor lesions has the potential for early diagnosis, improving patient survival. In this context, proteins involved in the cell cycle control are potentially promising. This study aimed to evaluate the importance of immunohistochemical expression of BUBR1, MCM2, and GMNN as biomarkers of oral carcinogenesis considering different oral sites. Sixty-six samples of oral epithelial dysplasia (from 33 males and 33 females) and 63 samples of oral squamous cell carcinoma (from 44 males and 19 females) were subjected to immunohistochemistry to detect some human proteins. Ki67 expression was included as a marker of cell proliferation. Marker expression was quantified by manually counting at least 1000 cells, and the labeling index was used in all statistical analyses. GMNN, MCM2, BUBR1 (nuclear and cytoplasmic labeling), and Ki67 expression levels were higher in carcinomas than in dysplasia (P < 0.05). Cytoplasmic BUBR1 was a good marker of malignancy (AUC = 0.8525, P < 0.05), but Ki67 was not (AUC = 0.5943, P = 0.0713). GMNN, MCM2, BUBR1, and Ki67 had higher expression in carcinoma than in dysplasia, regardless of the site of the lesion. Cytoplasmic BUBR1 has the potential to be used as a marker of tumor progression.
Use of Albumin In Situ Hybridization to Diagnose Cutaneous Metastatic Hepatocellular Carcinoma With Poorly Differentiated Features: A Case Report and Review of the Literature
Authors: Gauger Andrew J. , Li Aofei , Fritz Mike , Katona Terrence M. , Alomari Ahmed K.
Published: October 2024

Hepatocellular carcinoma (HCC) rarely metastasizes to the skin. When it occurs, it is often poorly differentiated making the diagnosis challenging. There exists a male predominance, and clinical presentation usually includes papules or nodules resembling pyogenic granulomas or dermal deposits. Histopathology shows malignant dermal cells. Hepatoid features including nests or cords of cells arranged in a trabecular or pseudoglandular pattern, sinusoidal formation, or the presence of bile exist in less than 50% of cases. Limitations exist with immunohistochemical staining, particularly in poorly differentiated neoplasms. Albumin in situ hybridization is more sensitive for detecting poorly differentiated HCC. Immunostaining in conjugation with albumin in situ hybridization enhances the detection of metastatic hepatocellular carcinoma. We report the case of a 74-year-old man with a history of HCC and a stable lung metastasis who presented with painful, growing bumps on his nose for 2 months. Examination revealed multiple, pink to white, shiny dermal-based papules with telangiectasias involving the right nasal tip and naris. Alpha-fetoprotein level was markedly elevated. Computed tomography showed expanding right lower lobe lung nodules. Histopathology of the cutaneous biopsy revealed features of a poorly differentiated basaloid carcinoma. Immunohistochemical staining was diffusely positive for glypican-3, focally positive for arginase-1, and negative for hepatocyte paraffin 1. Albumin in situ hybridization was diffusely positive, clinching the diagnosis of HCC. Metastatic HCC is a rare encounter for dermatopathologists. We aim to increase awareness of its occurrence in patients with advanced HCC and highlight the importance of clinical correlation when faced with poorly differentiated or unusual-looking basaloid neoplasms.
Different degrees of summed difference perfusion score in women: influence on the prognostic variables associated with cardiac events
Authors: Romero-Farina Guillermo , Aguadé-Bruix Santiago , Ferreira-González Ignacio
Published: October 2024

Objective

Evaluating the predictive models (PM) for a major adverse cardiac event (MACE) only in women with abnormal summed difference score (SDS ≥ 1), borderline myocardial ischemia (borderline-MIsch: SDS = 1), MIsch (SDS ≥ 2), mild-MIsch (SDS = 2–4), and moderate–severe MIsch (ms-MIsch: SDS ≥ 5).

Methods

Between January 2000 and January 2018, of 25 943 consecutive patients who underwent gated single-photon emission computed tomography myocardial perfusion imaging (gSPECT-MPI) for coronary risk stratification; 717 women (age 68.37 ± 3.4 years) with an abnormal SDS ≥ 1 were included. During the follow-up (mean 4 ± 2.9 years) post-gSPECT-MPI, MACE (unstable angina, nonfatal myocardial infarction, coronary revascularization, cardiac death) was assessed.

Results

In the global women cohort with abnormal SDS (n = 717), the PM was angina [hazard ratio (HR): 1.65, P = 0.016], diabetes (HR: 1.72, P = 0.004), beta-blockers (HR: 1.61, P = 0.009), pharmacological stress (HR: 1.74, P = 0.007), ↓ segment (ST) mm ≥ 1 (HR: 1.54, P = 0.039), and moderate-to-severe abnormal summed stress score (ms-SSS) (HR: 2.92, P = 0.001). In borderline-MIsch group (n = 208), the PM was previous myocardial infarction (HR: 3.8, P = 0.001), nitrates (HR: 2.13, P = 0.047), pharmacological stress (HR: 4.81, P < 0.001), and ↓ST mm ≥ 1 (HR: 3.07, P = 0.014). In MIsch group (n = 509), the PM model was ms-SSS (HR: 2.25, P = 0.001), diabetes (HR: 1.73, P = 0.011), angina (HR: 1.68, P = 0.029), beta-blockers (HR: 1.59, P = 0.026), and ms-MIsch (HR: 1.62, P = 0.044). In mild-MIsch group (n = 399), the PM was ms-SSS (HR: 2.55, P = 0.003), diabetes (HR: 2.17, P = 0.004), angina (HR: 1.89, P = 0.037), and beta-blockers (HR: 2.01, P = 0.011). In ms-MIsch group (n = 110), the predictive variable for MACE was ms-SSS (HR: 2.27, P = 0.016). The ms-SSS significantly increases the prognostic value of the ms-MIsch (P = 0.001).

Conclusion

Women with different degrees of abnormal SDS have different PMs of MACE. The ms-SSS stands out as the most significant predictive variable.
Another Tool for the Sexual Health Toolkit: US Health Care Provider Knowledge and Attitudes About Doxycycline Postexposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections Among Men Who Have Sex With Men
Authors: Perkins Rodney , Beima-Sofie Kristin , Christopoulos Katerina , Cohen Stephanie E. , Dright Aurnell , Dombrowski Julia C. , Gougougui Ashley , Kohler Pamela , Luetkemeyer Anne F. , Pintye Jillian , Celum Connie
Published: October 2024

Background

Doxycycline post-exposure prophylaxis (doxy-PEP) reduces chlamydia, gonorrhea, and syphilis infections among men who have sex with men (MSM) and transwomen (TW). Perspectives of health care providers (HCPs) regarding doxy-PEP can inform implementation efforts.

Methods

From August 2022 to January 2023, HCPs were recruited from 13 cities with high sexually transmitted infection (STI) rates for semi-structured, in-depth interviews about their awareness of and attitudes toward doxy-PEP for STI prevention. Health care providers were purposively sampled to include people with experience prescribing PrEP and provision of care to MSM. Interviews were conducted virtually via Zoom. Transcripts and debrief reports were analyzed using a directed content analysis approach to explore knowledge, attitudes, and beliefs about doxy-PEP.

Results

Among 30 HCPs, almost half (47%) were between 31–40 years of age, 53% identified as male, and 47% reported their sexual orientation as gay or queer. Half (53%) of participants practiced in the South, 43% had >100 MSM in their clinic panel, and 17% had previously prescribed doxy-PEP. We identified four overarching themes: 1) HCPs expressed positive attitudes toward doxy-PEP; 2) antimicrobial resistance concerns limit enthusiasm for some HCPs; 3) additional data about the long-term safety of doxy-PEP would improve their confidence; and 4) development of guidelines would facilitate the prescription of doxy-PEP, including eligibility, dosing instructions, and treatment management.

Conclusion

HCPs were motivated to prescribe doxy-PEP with almost 20% already having prescribed it. Guidelines and data about long-term safety, especially antimicrobial resistance, would facilitate introduction of doxy-PEP into clinical practice.
SOX17 Expression in Mesotheliomas and Benign Mesothelial Proliferations: Implications for Differential Diagnosis With Gynecologic Carcinomas
Authors: Laokulrath Natthawadee , Hung Yin P. , Watkins Jaclyn C. , Oliva Esther , Devins Kyle M.
Published: October 2024

SOX17 has recently emerged as a novel immunohistochemical marker for cancers of endometrial and ovarian origin with improved specificity compared with the widely used Mullerian marker PAX8. However, evaluation of SOX17 in benign and malignant peritoneal mesothelial proliferations remains limited, and these may mimic gynecologic carcinomas, particularly on small biopsies. We evaluated SOX17 and PAX8 expression in 20 benign mesothelial lesions (5 adenomatoid tumors, 5 well-differentiated papillary mesothelial tumors, and 10 peritoneal inclusion cysts) and 16 epithelioid peritoneal mesotheliomas. The 17 female and 3 male patients with benign mesothelial lesions ranged from 20 to 80 yr (median: 56.5 yr), while the 9 females and 7 males with mesothelioma ranged from 47 to 85 yr (median: 57.5 yr). SOX17 was positive in 5 (25%) benign lesions (2 adenomatoid tumors, 3 peritoneal inclusion cysts) and 2 (13%) mesotheliomas, while PAX8 stained 8 (40%) benign lesions (1 adenomatoid tumor, 1 well-differentiated papillary mesothelial tumor, 6 peritoneal inclusion cysts), and 2 (13%) mesotheliomas. Results for the 2 stains showed incomplete concordance, with agreement in 15 (75%) benign proliferations and 14 (88%) mesotheliomas. Our findings suggest that SOX17 positivity alone is insufficient to confirm a diagnosis of gynecologic carcinoma over a mesothelial proliferation and pathologists should exercise caution when these entities are diagnostic considerations.
Retroperitoneal Malakoplakia Mimicking Metastatic Disease
Authors: Dominguez Dylan , Eichhorn Joshua , Palot Manzil Fathima Fijula
Published: October 2024

Malakoplakia is a rare inflammatory granulomatous disease that can produce a tumor-like appearance in nearly any organ system. Imaging findings of malakoplakia overlap with malignancy and tissue sampling are typically required for definitive diagnosis. We present a case of a 66-year-old woman with a previous history of liver adenocarcinoma status post resection that subsequently developed an intensely FDG-avid retroperitoneal mass on surveillance imaging. CT-guided biopsy of the mass demonstrated Michaelis-Gutmann bodies, supporting the diagnosis of malakoplakia. The patient underwent antibiotic treatment with complete resolution of the mass.
Rare Gastric Metastasis of Lobular Type Breast Cancer Detected With 68Ga-FAPI-46 PET/CT
Authors: Akgun Elife , Şahin Omer Faruk , Baloglu Mehmetcan , Alcin Goksel , Yarikkaya Enver , Arslan Esra
Published: October 2024

Invasive lobular breast cancer (ILBC) is characterized with low tracer uptake on 18F-FDG PET images. ILBC metastasis to gastrointestinal tract is a rare clinic scenario. We present a case of ILBC who presented with gastric metastasis and diagnosed with 68Ga-FAPI-46 PET/CT and 18F-FDG PET/CT images.
Incidence and Risk Factors for Secondary Surgery and Amputation After Lower Extremity Limb Salvage
Authors: Brown Ciara , Ash Makenna , Menon Ambika , Knaus William , Hernandez-Irizarry Roberto , Ghareeb Paul
Published: October 2024

Background

Traumatic defects of the lower extremity (LE) require robust soft tissue to cover critical structures and facilitate healing. Free tissue transfer (FTT) is often necessary when local tissue is inadequate. While much of the literature emphasizes free flap viability in successful limb salvage, there is limited understanding regarding the need for additional surgeries or eventual amputation. We investigated a single institution's limb salvage efforts to better understand the need for additional procedures.

Methods

All patients who underwent LE limb salvage were retrospectively reviewed from 2014 to 2022 at a single level 1 trauma center. Our primary clinical outcome was the incidence and indication of secondary surgeries following FTT.

Results

Ninety-two LE free flaps were performed during the study period. The mean age was 45 and majority were male. Seventy-two percent of flaps were fasciocutaneous while 28% were muscle flaps. Seventy-two percent of patients required a secondary surgery following FTT, with a mean of 7 total surgeries per salvage attempt. Ten percent of patients proceeded to amputation. Body mass index >30, higher frailty scores, flap type, and masquelet technique were significantly associated with subsequent amputation (P = 0.017, P = 0.024, P = 0.005, P = 0.04, respectively). Older age, the need for bony reconstruction, and longer period from injury to flap coverage were significantly associated with the need for secondary surgeries (P = 0.05, P < 0.001, and P = 0.22 respectively)

Conclusions

FTT is an important component of limb salvage. Patients undergoing limb salvage should be counseled on the need for secondary surgeries, as the process is often not complete following FTT. Furthermore, risk factors identified in this study may increase the likelihood of subsequent amputation. Thorough preoperative counseling is necessary to optimize the postoperative course and expectations in this population.
Physiological and Functional Restoration of the Modiolus Using a Double Tendon Sling in Patients With Full-Thickness Oral Defects
Authors: Maeda Taku , Hayashi Toshihiko , Ishikawa Kosuke , Miura Takahiro , Funayama Emi , Yamamoto Yuhei
Published: October 2024

Background

Reconstruction of the oral modiolus should be considered for facial defects involving the lip and cheek. We have performed free flap reconstruction using a novel technique that includes a vertical and a horizontal sling for full-thickness defects involving the oral commissure.

Patients and Methods

We used a free radial forearm flap and the palmaris longus tendon to correct lip and cheek defects in 6 patients (3 men, 3 women; age, 55–84 years). The tendon was divided into 2 portions for use as the double sling. One sling was used to connect the upper and lower stumps of the orbicularis oris in the vertical direction and the other to connect the vertical sling and masseter muscle. The outcomes assessed were esthetic appearance and functional results.

Results

The facial defects ranged in size from 3.0 cm × 4.0 cm to 7.0 cm × 6.0 cm and the mucosal defects from 1.5 cm × 4.0 cm to 6.5 cm × 5.0 cm. The length of the harvested tendon ranged from 11.5 to 13.5 cm. All flaps survived without complications. Good esthetic outcomes were achieved (excellent facial appearance, n = 1; no lip deviation or drooping, n = 5). Functionally, all patients had acceptable mouth opening and were able to eat a regular diet.

Conclusions

Good physiological and functional results can be achieved using a double tendon sling for reconstruction of the modiolus in patients with full-thickness defects involving the oral commissure.
DNAm aging biomarkers are responsive: Insights from 51 longevity interventional studies in humans
Authors: Sehgal Raghav , Borrus Daniel , Kasamato Jessica , Armstrong Jenel F. , Gonzalez John , Markov Yaroslav , Priyanka Ahana , Smith Ryan , Carreras Natàlia , Dwaraka Varun B. ,   DNAm aging biomarkers community,   community Longevity interventional studies, Higgins-Chen Albert
Published: October 2024

Aging biomarkers can potentially allow researchers to rapidly monitor the impact of an aging intervention, without the need for decade-spanning trials, by acting as surrogate endpoints. Prior to testing whether aging biomarkers may be useful as surrogate endpoints, it is first necessary to determine whether they are responsive to interventions that target aging. Epigenetic clocks are aging biomarkers based on DNA methylation with prognostic value for many aging outcomes. Many individual studies are beginning to explore whether epigenetic clocks are responsive to interventions. However, the diversity of both interventions and epigenetic clocks in different studies make them difficult to compare systematically. Here, we curate TranslAGE-Response, a harmonized database of 51 public and private longitudinal interventional studies and calculate a consistent set of 16 prominent epigenetic clocks for each study, along with 95 other DNAm biomarkers that help explain changes in each clock. With this database, we discover patterns of responsiveness across a variety of interventions and DNAm biomarkers. For example, clocks trained to predict mortality or pace of aging have the strongest response across all interventions and show consistent agreement with each other, pharmacological and lifestyle interventions drive the strongest response from DNAm biomarkers, and study population and study duration are key factors in driving responsiveness of DNAm biomarkers in an intervention. Some classes of interventions such as TNF-alpha inhibitors have strong, consistent effects across multiple studies, while others such as senolytic drugs have inconsistent effects. Clocks with multiple sub-scores (i.e. “explainable clocks”) provide specificity and greater mechanistic insight into responsiveness of interventions than single-score clocks. Our work can help the geroscience field design future clinical trials, by guiding the choice of interventions, specific subsets of epigenetic clocks to minimize multiple testing, study duration, study population, and sample size, with the eventual aim of determining whether epigenetic clocks can be used as surrogate endpoints.
Exploring mechanisms of change in a Southern Ocean fishery with a co-produced network model
Authors: Ward Delphi , Hill Nicole , Melbourne-Thomas Jessica , Welsford Dirk , Arangio Rhys , McNeill Malcolm , Wotherspoon Simon , Ziegler Philippe , Corney Stuart
Published: October 2024

A key challenge in planning long-term fisheries sustainability is overcoming uncertainties in predicted changes in target populations and catch rates in response to climate change and fishery trends. We combine transdisciplinary knowledge co-production and qualitative network modelling to advance system understanding and elucidate likely responses of a Patagonian toothfish fishery to future change. We co-developed a model of the Kerguelen Plateau biophysical-socioeconomic system with knowledge holders from industry and science; the first whole-of-system qualitative network model of intermediate complexity for this region. We present new approaches for dealing with uncertainty in network structure, and for investigating how perturbations propagate through a network. Using these tools, we found multiple potential pathways of decline for toothfish population and catch, but also some possible mechanisms of increase dependent on magnitude of certain effects. Our results highlight critical information gaps, including the potential role of scavenging benthos in fishery-ecosystem interactions and likely changes in the prey-field in response to warmer water, that require filling to improve predictions for toothfish populations and catch and forward planning for the fishery.