bluuebunny/crossref_metadata_2025 huggingface dataset:
Repeated tube exposure due to masked herpes zoster ophthalmicus after Ahmed valve implantation in an eye with neovascular glaucoma: A case report
Authors: Tanabe Hirotaka , Nakakura Shunsuke , Shimizu Yoshie , Maruoka Sachiko , Shojo Tomohiro
Published: December 2024

Rationale:

Herpes zoster ophthalmicus (HZO) occurs after the reactivation of latent varicella-zoster virus (VZV) present within the sensory spinal or cerebral ganglia and sometimes causes ocular inflammatory diseases, including neovascular glaucoma (NVG), which is one of the most devastating sequelae of virus-associated uveitis. In NVG, the synechial angle ultimately closes due to the contraction of proliferating myofibroblasts, which often requires glaucoma filtration surgery, including Ahmed glaucoma drainage device implantation, to maintain optimum intraocular pressure (IOP). Although tube exposure from the conjunctiva is a complication of glaucoma implant surgery, a case in which a glaucoma tube implant was repeatedly exposed due to masked HZO in a postoperative eye with NVG has not been reported.

Patient concerns:

A 72-year-old male with NVG in his left eye ultimately underwent Ahmed glaucoma valve implantation with sulcus fixation for uncontrolled IOP. Before surgery, acyclovir ophthalmic ointment had been applied to treat a suspected VZV infection, but the regimen was discontinued because an aqueous humor sample tested negative for VZV according to polymerase chain reaction. Postoperatively, the patient’s IOP dramatically decreased without any need for glaucoma eye drops. However, the tube was exposed when the overlying conjunctiva and allogeneic scleral grafts disintegrated.

Diagnoses:

Although the tube was covered with different types of tissues, including an allogeneic corneal graft and an autogenous conjunctival graft from the same eye, the grafts completely disintegrated again. Covering the tube with another allogeneic corneal graft and an autogenous free conjunctival graft from the contralateral eye also failed, with gradual disintegration of these tissues. During the observation period, severe HZO with Hutchinson sign and clearly demarcated pseudodendritic corneal ulceration were noted.

Interventions:

After thorough consideration, we cut and removed the tube to avoid possible scleral perforation due to prolonged inflammation.

Outcomes:

Fortunately, the patient’s IOP was controlled by resuming the continuous daily application of antiviral ointment and repeatedly injecting anti-vascular endothelial growth factor for rubeosis regularly afterward.

Lessons:

The possibility of VZV reactivation should always be considered in cases of tube exposure due to an unknown cause after Ahmed valve implantation in an eye with NVG.
Clinical efficacy analysis of cosmetic suture technique combined with tension reducer in the treatment of facial skin trauma
Authors: Gao Ya , Wang Yalin , Li Wenbo , Wu Fenglian
Published: December 2024

Background:

This study aims to observe the clinical efficacy of cosmetic suture technique combined with tension reducer in the treatment of facial skin trauma and provide more sequential treatments for facial skin trauma.

Methods:

Sixty patients with facial skin trauma who visited our department from January 2023 to January 2024 were selected as the research subjects. Patients who received cosmetic sutures combined with tension reducers were selected as the observed group (n = 30), while patients who received simple cosmetic sutures were selected as the control group (n = 30). Follow-up at 1, 3, and 6 months after surgery to compare the condition of scar formation (using the Vancouver scar rating scale), scar width, and patient satisfaction between the 2 groups.

Results:

After 1, 3, and 6 months of follow-up, the total score of Vancouver scar rating scale in the observed group was lower than that in the control group (P < .05); The average postoperative scar width in the observed group was (0.72 ± 0.07 mm), which was narrower than that in the control group (1.03 ± 0.12 mm) (P < .05). The satisfaction rate of patients in the observed group was 93.33%, which was higher than 73.33% in the control group (P < .05).

Conclusion:

The combination of cosmetic sutures and tension reducer in the treatment of facial skin trauma can effectively improve the scar condition, narrow the scar width, and greatly improve patient satisfaction. It is worth popularizing in the treatment of facial skin trauma.
Network meta-analysis on 4 types of traditional Chinese medicine injections in the treatment of senile severe pneumonia
Authors: Tu Yangli , Wu Changbing , Chen Liang , Cen Yinzhi , Liu Jie
Published: December 2024

Background:

As the global population ages, senile severe pneumonia has become a prominent health challenge. Conventional drug treatments have limitations. Meanwhile, 4 types of traditional Chinese medicine injections have shown potential. Thus, it’s necessary to use network meta-analysis to comprehensively evaluate their combined effect with conventional drugs on this disease.

Methods:

China National Knowledge Infrastructure, VIP shop Database, WanFang database, PubMed, and Cochrane Library were included in randomized controlled studies on traditional Chinese medicine injections for the treatment of senile severe pneumonia from the establishment of the library to January 2023. The literature was assessed for risk of bias using the Review Manager 5.3 software. Study outcome indicators were statistically analyzed using Stata 14.0 and Review Manager 5.3 software.

Results:

Thirty-three studies were included with a total of 2598 patients. The main outcome indicator was the clinical effective rate. Secondary outcome indicators were white blood cell count, procalcitonin, and C-reactive protein. The results of network meta-analysis showed that clinical efficacy of Reduning injection combined with conventional drug had the better effect. Xiyanping injection combined with conventional drug could better reduce white blood cell and C-reactive protein indicators. Xuebijing injection combined with conventional drug had better ability to reduce procalcitonin.

Conclusion:

Reduning injection, Xiyanping injection, Tanreqing injection, and Xuebijing injection combined with conventional drugs in the treatment of senile severe pneumonia can improve the clinical effect.
Exploring a novel model for newborn genetic screening in Ningxia, northern China: A retrospective observational study
Authors: Mao Xinmei , Jing Miao , Wang Yue , An Wenzhen , Ji Taoyun
Published: December 2024

The accuracy and precision of quantitative aspects of conventional newborn screening (NBS) are limited due to the complexity of clinical manifestations and the constraints of conventional screening methods. Gene sequencing is commonly employed as an adjunct diagnostic technique to assist in diagnosis. The combined utilization of traditional NBS and newborn genetic screening can effectively reduce false-negative and false-positive rates, thereby enhancing the accuracy and precision of screening, while minimizing the health impact caused by genetic diseases in infants. This study aim to explore the feasibility and effectiveness of newborn genetic screening in Ningxia. For the first time in Ningxia, a genetic sequencing panel based on multiplex PCR technology and next-generation sequencing (NGS) combined with traditional mass spectrometry (MS/MS) was used for initial NBS. This involved the analysis of 134 disease-causing genes covering 74 common inborn disorders. A total of 1837 newborns were screened from January 2020 to December 2021 in the Ningxia region, and 7 positive cases were detected by gene panel among the 1837 newborns including 1 PAH disorder, 1 DUOX2 disorder, 1 G6PD disorder and 4 MT-RNR1 disorders. However, no 1 has yet been detected using traditional NBS. The top ten high-frequency mutant genes detected in the panel test were arranged from high to low as follows: PAH, DUOX2, SLC26A4, GJB2, ATP7B, MMACHC, SLC22A5, ACADS, DUOXA2 and SLC25A13. Population-specific newborn genetic screening can facilitate the progress of genetic defect prevention and treatment.
A narrative review of phase III and IV clinical trials for the pharmacological treatment of Huntington’s disease in adults
Authors: Alharthi Mohammed S.
Published: December 2024

Huntington disease (HD) is a hereditary neurodegenerative condition characterized by progression of motor, cognitive, and psychiatric abnormalities. Despite the lack of definitive medications, current research efforts are actively assessing novel pharmaceutical interventions through phase III and IV clinical trials to mitigate the limited effectiveness of existing therapeutic approaches. The primary objective of these trials is to enhance symptom management and improve the overall quality of life for individuals diagnosed with HD. These trials show potential for development of further efficacious therapeutic interventions in future. To identify and provide details about medications tested in completed phase III and IV clinical trials for managing HD in adults. Publicly available and relevant phase III and IV trials registered at ClinicalTrials.gov analyzed. Usage of the trialed medications for HD reviewed. As of November 10, 2023, there were 242 phase III and IV clinical trials related to HD. Eight clinical trials from these met the inclusion criteria for the current study. The medications used in phase III and IV trials are minocycline, valbenazine, deutetrabenazine, tominersen, pridopidine (phase III), and memantine (phase IV). Evaluating phase III and IV clinical studies on HD highlights the importance of tailored approaches for each patient’s unique disease presentation. Current medications aim to manage HD symptoms, potentially improving outcomes and reducing disease progression risks. The growing emphasis on specific approaches reflects a better understanding of HD’s diverse symptoms, presenting opportunities for more effective and personalized treatment strategies.
Sézary syndrome mimicking Steven–Johnson syndrome: A case report
Authors: Fan Sheng-Wei , Lai Kuan-Ming
Published: December 2024

Rationale:

Sézary syndrome is a rare and subtype of non-Hodgkin T cell lymphomas. It typically presents as papules, macules, nodules, or ulcers, frequently accompanied by lymphadenopathy and systemic symptoms. This study describes uncommon clinical and diagnostic features to distinguish Sézary syndrome from serious skin and mucous membrane disorders through a detailed case report and comprehensive literature review.

Patient concerns/Diagnosis/Intervention/Outcomes:

A 70-year-old female patient was diagnosed with progressive Sézary syndrome associated with extensive cutaneous scaly and ulcerative lesions after 5 cycles of anthracycline-based chemotherapy which is initially misleading to Steven–Johnson syndrome (SJS). SJS was clinically excluded due to no mucosal involvement. She received a single agent of steroid as a lymphoma salvage treatment due to poor performance and nutrition status. Facial and left arm skin biopsy revealed T lymphoma cells infiltrating the upper dermis. Unfortunately, she died due to progressive lymphoma disease and upper gastrointestinal bleeding.

Lessons:

Unlike mycosis fungoides, Sézary syndrome involves more than bathing suit areas of skin and it may present with scaly, ulceration, or even hemorrhagic bullae and Sézary cells in peripheral blood. Sometimes, it’s hard to differentiate from SJS or toxic epidermal necrolysis (TEN). Mucosa involvement is a crucial feature shown in patients with SJS/TEN.
Association of prognostic nutritional index with long-term survival in lung cancer receiving immune checkpoint inhibitors: A meta-analysis
Authors: Wang Lei , Long Xingxia , Zhu Ying , Luo Ailin , Yang Mei
Published: December 2024

Background:

This meta-analysis aimed to identify the association of prognostic nutritional index (PNI) with long-term survival in lung cancer patients who received the immune checkpoint inhibitors.

Methods:

The Medline, CNKI, EMBASE, and Web of Science databases were searched up to August 20, 2023. Progression-free survival (PFS) and overall survival (OS) were main outcomes and hazard ratios (HRs) and 95% confidence intervals were combined. Subgroup analysis stratified by the pathological type [non-small cell lung cancer (NSCLC) vs small cell lung cancer (SCLC)], previous treatment history and combination of other treatment was performed.

Results:

Twenty-two available studies with 2550 patients were included. Pooled results demonstrated that lower PNI was related to worse PFS (HR = 0.51, P<.001) and OS (HR = 0.43, P<.001). Furthermore, subgroup analysis based on the pathological type (non-small cell lung cancer: HR = 0.52, P<.001 for PFS, HR = 0.41, P<.001 for OS; small cell lung cancer: HR = 0.41, P = .007 for PFS, HR = 0.44, P = .007 for OS), previous treatment history (first-line treatment: HR = 0.67, P<.001 for PFS, HR = 0.52, P<.001 for OS) and combination of other treatment (No: HR = 0.54, P<.001 for PFS, HR = 0.43, P<.001 for OS; Yes: HR = 0.63, P<.001 for PFS, HR = 0.51, P<.001) showed similar findings.

Conclusion:

PNI is significantly associated with long-term survival in immune checkpoint inhibitors treated lung cancer and patients with lower PNI are more likely to experience poorer prognosis.
The expression and significance of long noncoding RNA XIST/microRNA-340-5p axis and metabolic reprogramming biomarkers in acute cerebrovascular stroke patients: A cross-sectional study
Authors: Elhorany Mahmoud , El-Horany Hemat E. , Abd-Ellatif Rania Nagi , Dawood Lamees M. , Watany Mona M. , Basiouny Mohamed Abdelaziz , Hegab Islam Ibrahim , Alsheikh Mona Y. , Kabel Ahmed M. , Atef Marwa M.
Published: December 2024

Stroke represents a worldwide major cause of death and long-term adult disability. Various human diseases pathogenesis, including stroke, are associated with dysregulation of long noncoding RNA (LncRNA) and microRNA (miR). However, their potential role is yet to be elucidated. This work aimed to assess the role of LncRNA X-inactive specific transcript (XIST), miR-340-5p, and 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase (PFKFB)3 as peripheral blood biomarkers for acute cerebrovascular stroke diagnosis and severity prediction. This cross-sectional study included 120 participants divided into 3 groups; healthy controls, acute ischemic stroke patients, and acute hemorrhagic stroke patients. XIST, miR-340-5p, and PFKFB3 expression were assessed by RT-qPCR, whereas PFKFB3, hypoxia inducible factor 1-alpha (HIF-1α) and vascular endothelial growth factor (VEGF) serum proteins were measured by ELISA. Compared to healthy control, XIST and PFKFB3 mRNA expression were significantly upregulated in stroke patients, with the highest levels in hemorrhagic type, while miR-340-5p expression was significantly downregulated and its lowest level was in hemorrhagic stroke. Serum PFKFB3, HIF-1α, and VEGF levels were significantly elevated in stroke patients with the highest levels in hemorrhagic stroke. These biomarkers correlated with National Institute of Health Stroke Scale (NIHSS). Regression analysis using NIHSS as dependent variable confirmed that PFKFB3 mRNA relative expression was the independent predictor (β = 0.7, P = .003). Receiver operating characteristic analyses revealed that XIST, miR-340-5p, and PFKFB3 mRNA relative expression levels were useful biomarkers discriminating ischemic from hemorrhagic stroke (AUC were 0.99, 0.979, and 0.980, respectively). XIST, miR-340-5p, and PFKFB3 might be involved in acute cerebrovascular stroke pathogenesis and progression providing opportunities for early detection and assessing the severity.
Synchronous pancreatic adenocarcinoma and duodenal mucosa‑associated lymphoid tissue lymphoma: A case report
Authors: Lee Yong-Pyo , Lee Jun Su , Kim Hong-Sik , Han Hye Sook , Lee Jisun , Woo Chang Gok , Lee Ok-Jun , Son Seung-Myoung
Published: December 2024

Rationale:

Duodenal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare condition. Simultaneous presence of pancreatic ductal adenocarcinoma along with duodenal MALT lymphoma has not been documented in the scientific literature. We report an exceptionally rare case of synchronous duodenal MALT lymphoma and pancreatic ductal adenocarcinoma.

Patient concerns:

A 75-year-old man was referred to our hospital with dyspepsia and weight loss.

Diagnoses:

Esophagogastroduodenoscopy was performed, revealing synchronous tumor comprising pancreatic ductal adenocarcinoma and MALT lymphoma of the duodenum.

Interventions:

Given that the pancreatic carcinoma would be the primary determinant of prognosis, we prioritized treatment of the pancreatic carcinoma. Consequently, we performed a Whipple operation first. Post-operative pathologic examination revealed metastasis of pancreatic cancer to peri-pancreatic lymph nodes, whereas the MALT lymphoma was localized to the duodenum; therefore, only adjuvant chemotherapy for pancreatic cancer was performed.

Outcomes:

To date, the patient has had no recurrence of either the pancreatic cancer or the MALT lymphoma.

Lessons:

To the best of our knowledge, this is the first case to be reported. Awareness of this co-occurrence may help diagnosis and management of similar cases.
Nurses' Perceptions of Practice Supports Related to Medical Assistance in Dying
Authors: Henderson Jill , Stephens Jennifer M.L. , Thirsk Lorraine
Published: December 2024

Since the inception of medical assistance in dying (MAiD) in Canada in 2016, the health care system continues to refine MAiD delivery models. The frameworks informing nursing practice related to MAiD are subject to variability across the country, leading to nursing role ambiguity and barriers in relational practice. Using critical incident technique, this qualitative research study explores the experiences of 7 Canadian nurses engaging with patients seeking MAiD. Semistructured interviews were conducted to understand the nurses' perceptions of the helping, hindering, and desired elements of current nursing practice supports within the context of MAiD. Eighteen significant incidents were included in the data analysis. Findings demonstrate that gaps in practice support exist related to nursing role clarity, educational support to enrich therapeutic communication skills, and staff-focused resources, such as debriefing and improved communication networks. Understanding nursing experiences within this context highlights the need for more consistent nursing practice frameworks and clinical practice supports to facilitate improved therapeutic relationships and patient care.
Three Decades of Outpatient Plastic Surgery Safety: A Review of 42,720 Consecutive Cases
Authors: Rohrich Rachel , Brown Tal , Brown Stav , Burns John , Jejurikar Sameer , Meade Ricardo , Rohrich Rod J.
Published: December 2024

Background:

Outpatient plastic surgery offers cost-effective solutions and enhanced privacy but demands careful patient assessment for suitability and vigilant anticipation of adverse events. This study provides recommendations to enhance patient safety in outpatient settings by analyzing over 40,000 consecutive cases spanning across three decades.

Methods:

We retrospectively reviewed all consecutive cases completed by board-certified plastic surgeons at an accredited outpatient surgical center between 1995-2023. Patient demographics, operative details, and postoperative complications were recorded to determine risk factors for complications and inpatient admissions. A subgroup-analysis for procedures of the face, breast and body was also performed.

Results:

42,720 consecutive cases were performed with an overall complication rate of 0.74 percent (n=318). Patients who experienced a VTE or an inpatient transfer, had a higher BMI (p<0.05), longer operative duration (p<0.05) and were more likely to have undergone combined procedures (p<0.05) compared to those who did not. Undergoing a combined procedure was the strongest predictive factor for VTE and inpatient admissions (OR=12.65, OR=3.73; p<0.05), followed by longer operative time (OR=1.45, OR=1.32; p<0.05).

Conclusion:

To our knowledge, this is the largest long-term private practice plastic surgery study in accredited outpatient settings spanning almost 30 years, further confirming that outpatient plastic surgery can be done in a consistent and safe manner with proper preoperative evaluation and patient optimization. Postoperative monitoring should be considered for high-risk patients, particularly those with a BMI exceeding 26 kg/m², operative times surpassing 3 hours, lipoaspirate volumes greater than 3 liters, and patients undergoing combined procedures - particularly in cases involving abdominoplasty.
The versatility of the Supinator to Posterior Interosseus Nerve (SPIN) transfer: Indications and outcomes, a Case Series
Authors: George Samuel , Kulenkampff Chane , Chaudhry Tahseen , Duraku Liron S. , Power Dominic M.
Published: December 2024

Background:

Transfer of the supinator motor branches to the posterior interosseous nerve (SPIN) was first described as a reliable method of restoration of digit extension in cases of paralysis when there is retained function in the 5th and 6th cervical nerve roots with loss of function in the 8th cervical nerve root.

Methods:

We performed a retrospective review of all the SPIN transfers that were performed in our unit which included 16 limbs in 14 patients over a 6-year period. The median age was 49 years (range 22-74). The average follow-up period was 15 months (range 6-24 m). Aetiology included spinal cord injury (SCI) in 5, plexus root avulsion in 3, degenerate spondyloradiculopathy in 3 and the final three patients had paralysis from oncological resection, inflammatory and compressive neuropathy respectively.

Results:

Functional digit extension (MRC grade 3 and above) was achieved in 12/16 limbs. Patients with degenerative spine lesions had the worst outcome with a median of MRC grade 2 with a median time to surgery of 20 months (average age of 67), compared to 13 months in the SCI group (average age 32.8) and four months in the BPI group (average age 34.6).

Conclusions:

The SPIN transfer may be safely performed in a wide spectrum of pathologies including brachial plexus injuries, spinal cord injuries and neuritis. However, in degenerative spondyloradiculopathy we report inferior outcomes, which may be due to late referral, chronic denervation, possible involvement of the donor nerve and an older age group and potentially diminished rehabilitation and neural plasticity potential.
Magnitude of Potential Biases in COVID-19 Vaccine Effectiveness Studies due to Differential Healthcare seeking following Home Testing: Implications for Test Negative Design Studies
Authors: Qasmieh Saba A. , Ferdinands Jill M. , Chung Jessie R. , Wiegand Ryan E. , Flannery Brendan , Rane Madhura S. , Nash Denis
Published: December 2024

The test-negative design (TND) is widely used to estimate COVID-19 vaccine effectiveness (VE). Biased estimates of VE may result from effects of at-home SARS-CoV-2 rapid diagnostic test (RDT) results on decisions to seek healthcare. To investigate magnitude of potential bias, we constructed decision trees with input probabilities obtained from longitudinal surveys of U.S. adults between March 2022 – October 2023. Prevalence of at-home RDT use and healthcare seeking following a positive or negative RDT result was estimated by participant vaccination status and socio-demographic characteristics. At trueVEvalues ranging from 5% to 95%, we defined bias as the difference between the observed and trueVE. Among 1,918 symptomatic adults, prevalence of at-home RDT use was higher among vaccinated (37%) versus unvaccinated (22%) participants. At-home RDT use was associated with seeking care, and participants reporting positive RDT were more likely than those reporting negative RDT to have sought care when ill. In primary analyses, we observed downward bias in VE estimates that increased in magnitude when trueVEwas low. Variations in proportions of vaccination, at-home RDT use and healthcare seeking by socio-demographic characteristics may impact VE estimates. Further evaluation of potential impact of at-home RDT use on VE estimates is warranted.
Inference with Viral Quasispecies: Methods for Individual Samples Comparative Analysis
Authors: Gregori Josep
Published: December 2024

The study of viral quasispecies structure and diversity presents unique challenges in comparing samples, particularly when dealing with single observations of single biosamples, taken from different time points or conditions. Traditional statistical methods are often inapplicable in these scenarios, where a biosample observation is represented by a vector of haplotypes and associated frequencies, necessitating the use of resampling techniques to empirically generate haplotype distributions from which estimate estimate expected values and corresponding variability. The authors propose a random delete-d jackknife to estimate standard errors followed by a z-test for comparing single quasispecies observations. The research highlights several key challenges in quasispecies analysis, including the need for high sequencing depth, limited clinical samples, technical inconsistencies leading to coverage disparities, and the sensitivity of diversity indices to sample size differences. To address these issues, the authors suggest using a combination of metrics with varying susceptibilities to large sample sizes, ranging from observed differences and ratios to multitest adjusted p-values. The paper emphasizes the importance of not relying solely on p-values, as the high statistical power resulting from large sample sizes can lead to very low p-values for small, potentially biologically insignificant differences.
Context-Dependent PSIICOS: A Novel Framework for Functional Connectivity Estimation Accounting for Task-Related Power Leakage
Authors: Kleeva Daria , Ossadtchi Alexei
Published: December 2024

Functional connectivity (FC) analysis using non-invasive neuroimaging methods, such as MEG and EEG, is often confounded by artifacts from spatial leakage and task-related power modulations. To address these limitations, we present Context-Dependent PSIICOS (CD-PSIICOS), a novel framework that improves the estimation of FC by incorporating task-specific cortical power distributions into the projection operator applied to the vectorized sensor-space cross-spectrum. Unlike the original PSIICOS approach, which is prone to suppress spatial leakage from all the sources, CD-PSIICOS dynamically adjusts the projection based on the active source distribution, enabling more accurate suppression of spatial leakage while preserving true zero-phase interactions. We validated CD-PSIICOS using realistic simulations and a multi-subject MEG dataset. The results demonstrate that CD-PSIICOS outperforms the original PSIICOS in suppressing artifacts at lower projection ranks, maintaining robust detection of functional networks across theta, alpha, beta, and gamma frequency bands. By requiring lower projection ranks for optimal performance, CD-PSIICOS facilitates the reconstruction of physiologically relevant networks with improved specificity and stability.
Multi-Cellular Network Model Predicts Alterations in Glomerular Endothelial Structure in Diabetic Kidney Disease
Authors: Patidar Krutika , Ford Versypt Ashlee N.
Published: December 2024

Diabetic kidney disease (DKD) progression is often marked by early glomerular endothelial cell (GEC) dysfunction, including alterations in the fenestration size and number linked to impaired glomerular filtration. However, the cellular mechanisms regulating GEC fenestrations remain poorly understood due to limitations in existingin vitromodels, challenges in imaging small fenestrationsin vivo, and inconsistencies betweenin vitroandin vivofindings. This study used a logic-based protein-protein interaction network model with normalized Hill functions for dynamics to explore how glucose-mediated signaling dysregulation impacts fenestration dynamics in GECs. We identified key drivers of fenestration loss and size changes by incorporating signaling pathways related to actin remodeling, myosin light chain kinase, Rho-associated kinase, calcium, and VEGF and its receptor. The model predicted how hyperglycemia in diabetic mice leads to significant fenestration loss and increased size of fenestrations. We found that glycemic control in the pre-DKD stage mitigated signaling dysregulation but was less effective as DKD developed and progressed. The model suggested alternative disease intervention strategies to maintain fenestration structure integrity, such as targeting Rho-associated kinase, VEGF-A, NFκB, and actin stress fibers.
Predicting adverse outcomes after cardiac surgery using multi-task deep neural networks, clinical features, and electrocardiograms
Authors: Ong Chin Siang , Padrós-Valls Raimon , Reinertsen Erik , Song Steven , Young Katherine , Sundt Thoralf , Stultz Collin M. , Aguirre Aaron D.
Published: December 2024

Background

Risk stratification models estimate the probabilities of adverse outcomes after cardiac surgical procedures, which helps clinicians and patients make informed decisions.

Objectives

We used the 12-lead electrocardiogram (ECG) and/or Society for Thoracic Surgeons (STS) variables to predict postoperative outcomes using deep learning methods that can incorporate diverse data types.

Methods

We developed a deep convolutional neural network (“ECGNet”) that predicts operative mortality and other adverse outcomes using preoperative 12-lead ECGs (n=30,877) from 12,933 patients who underwent 13,299 cardiac surgical procedures. We also developed a deep neural network applied to preoperative STS variables (“STSNet”). STSNet and ECGNet are multi-task neural networks that utilize secondary outcomes to augment prediction of mortality using the same neural network.

Results

ECGNet achieved a mean area under the receiver operating characteristic curve (AUC) of 0.85 for predicting operative mortality for all procedures and 0.93 for valve procedures. STSNet achieved a mean AUC of 0.85 for all procedures, with statistically similar performance as ECGNet for all procedures. Combining ECGNet and STSNet achieved a mean AUC of 0.90 for predicting operative mortality after all procedures, which is significantly higher than either ECGNet or STSNet alone.

Conclusions

A deep neural network trained on STS features has higher predictive performance than previously reported for existing conventional models and is not limited to certain types of cardiac surgical procedures. A model trained on ECG alone can predict operative mortality with similar performance as STS features and adding ECG to STS features in a neural network can improve performance. These findings demonstrate the potential in leveraging deep learning on multidimensional data sources to predict outcomes after cardiac surgery.

Condensed abstract

In this study, deep learning (DL) is applied to electrocardiograms and clinical features used in the standard STS risk prediction tools to generate new high-performing risk calculators for cardiac surgical procedures. Preoperative voltage waveforms contain information about cardiovascular risk and cardiac function and are passed as inputs to the deep learning model. These risk models apply to all cardiac procedures including those procedures that do not have standard STS risk calculators and provide improved performance. DL models enable the incorporation of additional modalities of data to improve risk prediction in cardiac surgery.
Upper limit on dark matter mass in the inert doublet model
Authors: Treesukrat Wararat , Pumsa-ard Kem , Supanam Nopmanee , Uttayarat Patipan
Published: December 2024

We study the upper limit on dark matter mass in the context of the inert doublet model. We derive an analytic expression for the upper bound as a function of the mass squared differences between dark matter and other new particles. We find that the upper limit varies between 20 and 80 TeV depending on the mass squared splitting.

Published by the American Physical Society
2024
Primer on the analog black hole bomb with capillary-gravity waves
Authors: Patrick Sam , Torres Théo
Published: December 2024

Draining vortices with a free surface are frequently employed as rotating black hole simulators, both in theory and experiments. However, most theoretical work is restricted to the idealized regime, where wave dispersion and dissipation are neglected. We investigate the role of these effects on the analog black hole bomb, an instability resulting from rotational superradiant amplification in confined systems. We reveal that the dispersion of deep water capillary-gravity waves significantly modifies the unstable mode eigenfrequencies, whereas viscosity only affects those with high frequencies. Furthermore, if the circulation is less than an order 1 multiple of the drain rate, superradiance does not occur and the vortex is stable. The instability is maximized in small systems with high flow velocities, provided there is sufficient space between the vortex and the outer boundary for the first excited state to lie inside the superradiant bandwidth. Implications for experiments on analog black holes and free surface vortices are discussed.

Published by the American Physical Society
2024
Quantum information science and technology professional learning for secondary science, technology, engineering, and mathematics teachers
Authors: Kelly Angela M. , Darienzo Michele , Wei Tzu-Chieh , Schneble Dominik
Published: December 2024

[This paper is part of the Focused Collection in Investigating and Improving Quantum Education through Research.] There is a growing need in the United States for a workforce trained in quantum information science and technology (QIST), a disciplinary topic that is rarely addressed in precollege science, mathematics, and computer science curricula. University quantum physics and physics education researchers designed and initiated a 4-week, 12-h QIST professional development workshop for N=51 preservice and in-service secondary school science, mathematics, and computer science educators. A STEM integration framework guided the workshop structure, which incorporated a situated cognition model for learning quantum concepts and computing, identifying recent advances in quantum technologies, planning curricula, and differentiating among QIST subfields including quantum communication, quantum computation, quantum simulation, and quantum metrology and sensing. The pre-/post-research design employed a newly developed teacher attitude survey, Exploratory factor analysis identified three latent constructs in teachers’ self-efficacy, including (i) knowledge about QIST academic pathways and careers; (ii) QIST pedagogical fluency and STEM integration; and (iii) facilitating QIST learning. Parametric comparisons of means indicated that teacher participants showed significant gains overall and in all latent constructs with medium to large effect sizes (p<0.001). This professional learning model shows promise in strengthening teachers’ self-confidence in pedagogical content knowledge of quantum ideas so they may facilitate student engagement in quantum information science, a field that involves conceptual change and is often considered abstract, counterintuitive, inaccessible, and suitable only for the academically elite. Implications for policy and practice are discussed.

Published by the American Physical Society
2024
Effects of Japanese ryokan photographs on attributes perception, values and purchase intention
Authors: Karakawa Ryuichi , Kwun David , Kang Juhee , Hara Tadayuki
Published: December 2024

Purpose

This paper aims to explore what attributes of Japanese Ryokans are important to potential customers and to what extent these attributes could enhance perceived values toward Japanese Ryokans.

Design/methodology/approach

This study used photos and descriptions of luxury Japanese Ryokans to explore potential customers’ perceptions of luxury Japanese Ryokans, which may be a new concept of luxury accommodations and hot spring facilities.

Findings

The results identified four major dimensions of Japanese Ryokan’s attributes and two significant dimensions of perceived value. Overall, Japanese Ryokan’s attributes affected both value dimensions, but in different ways. In addition, the two dimensions of perceived value significantly mediated the relationship between Ryokan attribute dimensions and purchase intention.

Research limitations/implications

This research sample was collected from participants currently living in the Northeastern region of the US and may not represent potential customers elsewhere. Furthermore, this study evaluated pre-purchased stage customers’ perceptions. Post-purchase evaluation may provoke more emotive responses from consumers. Finally, even though this study verified the positive effects of the Japanese Ryokan attribute dimensions on perceived value, other possible variables may also exist.

Practical implications

The findings provide vital insights for Japanese lodging companies to formulate effective value-based marketing strategies using visual materials to attract potential consumers. Superior service and stimulating customers’ sense of functional/hedonic and symbolic/financial value are emphasized. Furthermore, the results showed that fundamental hotel attributes, Japanese servicescape and culture could enhance potential US customers’ value perceptions.

Social implications

This study contributes to the lodging literature by identifying attributes that reflect Japanese Ryokans’ unique characteristics within the luxury hot spring hotel/resort context. The results indicate four dimensions of Japanese Ryokan attributes: hotel attributes, Japanese servicescape, hot springs and spas and Japanese culture. Furthermore, this study extended the research on luxury hospitality value study.

Originality/value

The results of this study revealed potential consumers’ value perceptions toward luxury Japanese Ryokans and their effects on purchase intention. This study provides valuable guidelines for Japanese Ryokans to create a value-based marketing strategy.
Epictetus’ stoic philosophy glance at resistance to change
Authors: Georgiadis Vasileios , Sarigiannidis Lazaros
Published: December 2024

Purpose

The purpose of this paper is a selective introduction of specific underlying principles of Epictetan Stoicism in change management, aiming to mitigate resistance to change and achieve positive outcomes through redefining the perception of change by both its agents and recipients.

Design/methodology/approach

The applied methodology included locating, distilling and extracting selected philosophical fragments, coherent in terms of contextualisation with the field of management and paralleling their content with organisational, strategic and wider social and political objectives, to provide an interdisciplinary enriched perspective on managing resistance to change in any area.

Findings

The selective combination of Epictetus’ Stoic philosophy with change management literature, focusing on resistance to change, contributes as a beneficial strategic choice, multiplying the available alternatives, not only in managing resistance to change but also in a more general sense.

Practical implications

Selectively introducing Epictetan Stoic philosophical ideas into the behavioural response of resistance to change could clarify and improve communication to avoid crises and conflicts, as well as extend Epictetan Stoic wisdom to the wider community, beyond organisations and institutions. Although the hyper-competitive, globalised market seems to contradict the tempered Stoic philosophy, from which they radically differ, this research highlights strong points of relational relevance that could facilitate overcoming resistance to change with a much wider impact.

Originality/value

Epictetus’ Stoic philosophy is already widely deployed in management, but in this project, to the best of the authors’ knowledge, it is selectively cross-discussed for the first time with the theory and practice of resistance to change as a pilot intellectual platform, identifying personal perception and distinction as the primary cognitive compass in the organisational and managerial realm, so that the upcoming change projects would mitigate resistance to change.
The role of animosity, ethnocentrism, perceived quality, and purchase intention in evaluating the country-of-origin effect for wines
Authors: Pagan Karina Munari , Pagan Natália Munari , dos Santos Vanessa Martins
Published: December 2024

Purpose

Propose a model that reports ethnocentrism, animosity, perceived quality and purchase intention in the evaluation of the country-of-origin effect for wine.

Design/methodology/approach

The sample for this study consisted of 154 students from the University of São Paulo Campus Ribeirão Preto and Piracicaba. Using scales already validated in the literature, a survey was carried out with 27 questions in the seven-point Likert format. The structural model was estimated using the partial least squares method.

Findings

It was verified that the country of origin positively influenced the purchase intention of wines, ethnocentrism positively influenced perceived quality, ethnocentrism positively influenced animosity, animosity negatively influenced the purchase intention and the country of origin positively influenced the perceived quality of the wine. It was verified that ethnocentrism did not influence purchase intention and the country of origin did not influence animosity.

Practical implications

As a managerial contribution, it helps managers to devise more effective strategies for the wine market.

Originality/value

An innovative model was proposed to investigate the role of animosity, ethnocentrism, perceived quality and purchase intention in evaluating the country-of-origin effect for wine.
Non‐Cell‐Based Extracorporeal Artificial Liver Systems: Historic Perspectives, Approaches and Mechanisms, Current Applications, and Challenges
Authors: Novokhodko Alexander , Hao Shaohang , Ahmad Suhail , Gao Dayong
Published: December 2024

Background

Liver disease is a growing burden. Transplant organs are scarce. Extracorporeal liver support systems (ELSS) are a bridge to transplantation for eligible patients. For transplant‐ineligible patients the objective becomes liver recovery.

Methods

We review seven decades of non‐cell‐based ELSS research in humans. Where possible, we emphasize randomized controlled trials (RCTs). When RCTs are not available, we describe the available human clinical data.

Results

There are three broad cell‐free approaches to remove protein‐bound toxins (PBTs) and treat liver failure. The first is a dialysate binder suspension. A material that binds the PBT (the binder) is added to the dialysate. Binders include albumin, charcoal, and polystyrene sulfonate sodium. The unbound fraction of the PBT crosses the dialyzer membrane along a chemical gradient and binds to the binder. The second approach is using grains of sorbent fixed in a plastic housing to remove PBTs. Toxin‐laden blood or plasma flows directly through the column. Toxins are removed by binding to the sorbent. The third approach is exchanging toxin‐laden blood, or fractions of blood, for a healthy donor blood product. Most systems lack widespread acceptance, but plasma exchange (PE) is recommended in many guidelines. The large donor plasma requirement of PE creates demand for systems to complement or replace it.

Conclusions

Now that PE has become recommended in some, but not all, jurisdictions, we discuss the importance of reporting precise PE protocols and dose. Our work provides an overview of promising new systems and lessons from old technologies to enable ELSS improvement.
Study on the glazed tiles of the Wenjiangduo site, Tibet, China (7th–9th centuries CE)
Authors: Ma Ding , Xi Lin , Luo Wugan , Zhang Bo , Zhang Na , Wangdue Shargan
Published: December 2024

The Central Plains of China have a long history of using glazed tiles on high‐level architectural structures. This architectural practice also had a profound impact on ancient Tibet. This study selected glazed tiles belonging to the Tubo period (7th–9th centuries CE), unearthed from the Wenjiangduo site, Lhasa city, Tibet Autonomous Region, China. A series of scientific analyses are presented, including X‐ray fluorescence, optical microscopy, scanning electron microscopy–energy‐dispersive spectrometry, X‐ray diffraction, dilatometry, and multicollector inductively coupled plasma mass spectrometry. The results reveal SiO2–Na2O, SiO2–PbO, SiO2–Na2O–PbO, and SiO2–CaO–Na2O systems in the glazes. The bodies can be divided into two categories: calcareous and noncalcareous. The original firing temperatures were likely between 900°C and 1000°C. The lead isotopes indicate that the provenance of lead material for glaze was in Tibet. The comparisons of glazing techniques reveal influences from the Central Plains of China and South and Southeast Asia, and provide new insights into the cultural interaction between Tibet and its surrounding regions in the Tubo period.
Comparison of Clinical Outcomes Between Delta‐Shaped and Circular Anastomoses After Laparoscopic Distal Gastrectomy
Authors: Yamada Takanobu , Nagasawa Shinsuke , Kanematsu Kyohei , Morita Junya , Onuma Shizune , Tanabe Mie , Nakayama Yuta , Shiozawa Manabu , Yamamoto Naoto , Ogata Takashi , Oshima Takashi
Published: December 2024

Introduction

Laparoscopic distal gastrectomy (LDG) is the standard treatment for gastric cancer, during which the laparoscopic Billroth I anastomosis technique, also known as the delta‐shaped anastomosis (DA), is widely performed. This study aimed to evaluate the differences in short‐ and long‐term symptoms between DA and traditional circular anastomosis (CA) techniques.

Methods

We retrospectively compared DA and CA procedures in patients undergoing LDG and subsequent reconstruction using the Billroth I method at the Kanagawa Cancer Center from 2017 to 2022.

Results

Other than blood loss, no significant differences were observed in the short‐term outcomes between the two groups. However, 1‐year post‐surgery, the DA group had a higher incidence of diarrhea, lower incidence of remnant gastritis, and higher weight loss than the CA group.

Conclusion

Both DA and CA techniques were similar in terms of safety. However, the DA group had a higher incidence of diarrhea and a lower incidence of remnant gastritis than the CA group 1‐year after surgery.
Laparoscopic Repair of Internal Hernia at the Pelvic Floor After Low Anterior Resection: A Case Report
Authors: Yagyu Takuki , Yamamoto Manabu , Yasui Chiharu , Ishiguro Ryo , Kono Yusuke , Kihara Kyoichi , Matsunaga Tomoyuki , Tokuyasu Naruo , Sakamoto Teruhisa , Fujiwara Yoshiyuki
Published: December 2024

Internal hernia following colorectal surgery is an uncommon but serious complication. Most reported cases have involved hernias resulting from mesenteric defects after left‐sided colon resection. We herein report a case of laparoscopic repair of an internal hernia at the pelvic floor following low anterior resection. A 78‐year‐old woman with a history of robotic low anterior resection for rectal cancer presented to our hospital with severe abdominal pain and vomiting. Computed tomography revealed a strangulated bowel passing dorsally behind the reconstructed colon in the pelvis, prompting emergency surgery. The hernia orifice was formed by the levator ani and the reconstructed colon. We successfully reduced the hernia, laparoscopically sutured the orifice, and resected the strangulated bowel segment. The patient was discharged without complications and has experienced no hernia recurrence to date. Although internal hernia at the pelvic floor is very rare, this case demonstrates that safe laparoscopic reduction and repair are possible.