bluuebunny/crossref_metadata_2025 huggingface dataset:
Fast and scalable querying of eukaryotic linear motifs with gget elm
Authors: Luebbert Laura , Hoang Chi , Kumar Manjeet , Pachter Lior
Published: February 2024

Motivation

Eukaryotic linear motifs (ELMs), or Short Linear Motifs, are protein interaction modules that play an essential role in cellular processes and signaling networks and are often involved in diseases like cancer. The ELM database is a collection of manually curated motif knowledge from scientific papers. It has become a crucial resource for investigating motif biology and recognizing candidate ELMs in novel amino acid sequences. Users can search amino acid sequences or UniProt Accessions on the ELM resource web interface. However, as with many web services, there are limitations in the swift processing of large-scale queries through the ELM web interface or API calls, and, therefore, integration into protein function analysis pipelines is limited.

Results

To allow swift, large-scale motif analyses on protein sequences using ELMs curated in the ELM database, we have extended the gget suite of Python and command line tools with a new module, gget elm, which does not rely on the ELM server for efficiently finding candidate ELMs in user-submitted amino acid sequences and UniProt Accessions. gget elm increases accessibility to the information stored in the ELM database and allows scalable searches for motif-mediated interaction sites in the amino acid sequences.

Availability and implementation

The manual and source code are available at https://github.com/pachterlab/gget.
Rapid IDH1-R132 genotyping panel utilizing locked nucleic acid loop-mediated isothermal amplification
Authors: Choate Kristian A , Raack Edward J , Mann Paul B , Jones Evan A , Winn Robert J , Jennings Matthew J
Published: February 2024

While the detection of single-nucleotide variants (SNVs) is important for evaluating human health and disease, most genotyping methods require a nucleic acid extraction step and lengthy analytical times. Here, we present a protocol which utilizes the integration of locked nucleic acids (LNAs) into self-annealing loop primers for the allelic discrimination of five isocitrate dehydrogenase 1 R132 (IDH1-R132) variants using loop-mediated isothermal amplification (LAMP). This genotyping panel was initially evaluated using purified synthetic DNA to show proof of specific SNV discrimination. Additional evaluation using glioma tumor lysates with known IDH1-R132 mutational status demonstrated specificity in approximately 35 min without the need for a nucleic acid extraction purification step. This LNA-LAMP-based genotyping assay can detect single base differences in purified nucleic acids or tissue homogenates, including instances where the variant of interest is present in an excess of background wild-type DNA. The pH-based colorimetric indicator of LNA-LAMP facilitates convenient visual interpretation of reactions, and we demonstrate successful translation to an end-point format using absorbance ratio, allowing for an alternative and objective approach for differentiating between positive and negative reactions. Importantly, the LNA-LAMP genotyping panel is highly reproducible, with no false-positive or false-negative results observed.
Efficacy of depatuxizumab mafodotin (ABT-414) in preclinical models of head and neck cancer
Authors: Mani Lucas , Naveed Abdullah , McAdoo Ashtyn , Rosenthal Eben , Hom Marisa
Published: February 2024

Epidermal growth factor receptor (EGFR) is highly expressed in 80–90% of head and neck squamous cell carcinomas (HNSCCs), making it an ideal target for antibody–drug conjugates. Depatuxizumab mafodotin (ABT-414), is an EGFR-targeting ADC comprised of the monoclonal antibody ABT-806 conjugated to monomethyl auristatin F, a tubulin polymerization inhibitor. This study assessed the in vivo efficacy of ABT-414 in HNSCC. The effects of ABT-414 on HNSCCs were determined using in vitro cytotoxicity assays and in vivo flank xenograft mouse models. The distribution of ABT-414 was assessed ex vivo via optical imaging methods using a conjugate of ABT-414 to the near-infrared agent IRDye800. In vitro treatment of high EGFR-expressing human HNSCC cell lines (UMSCC47 and FaDu) with ABT-414 (0–3.38 nM) resulted in dose-dependent cell death (IC50 values of 0.213 nM and 0.167 nM, respectively). ABT-414 treatment of the FaDu mouse xenografts displayed antitumor activity (P = 0.023) without a change in body mass (P = 0.1335), whereas treatment of UMSCC47 did not generate a significant response (P = 0.1761). Fluorescence imaging revealed ABT-414-IRDye800 accumulation in the tumors of both FaDu and UMSCC47 cell lines, with a signal-to-background ratio of >10. ABT-414 treatment yielded antitumor activity in FaDu tumors, but not in UMSCC47, highlighting the potential for ABT-414 efficacy in high EGFR-expressing tumors. Although ABT-414-IRDye800 localized tumors in both cell lines, the differing antitumor responses highlight the need for further investigation into the role of the tumor microenvironment in drug delivery.
Synthesis, structure, and magnetic properties of cubane-type tetranuclear Ni(II) and Cu(II) complexes with amide-containing polydentate ligand
Authors: Tanaka Akihiro , Kusumoto Sotaro , Umeno Harue , Kim Yang , Nakamura Masaaki , Hayami Shinya
Published: February 2024

Synthesis, structure, and magnetic properties of a tetranuclear metal complex with a symmetrical polydentate ligand, trans-(±)-1,2-(2-hydroxy-3-methoxybenzamido)cyclohexane (H2L), were characterized. The complexes have tetranuclear cubane cores with the formulae [Ni4(L)2(μ3-OMe)4(CH3OH)4] (1) and [Cu4(L)2(μ3-OMe)4(CH3OH)2] (2), whose cluster units are each composed of chiral ligands [(R, R)- or (S, S)-L]. The magnetic properties of the two compounds were characterized by 1 being ferromagnetic and 2 being antiferromagnetic.
Exploring the Infectious Contribution to Intussusception Causality Using the Effects of COVID-19 Lockdowns in Australia: An Ecological Study
Authors: Townley Benjamin , Akin Deniz , Dimaguila Gerardo Luis , Sawires Rana , Sepulveda Kattan Gonzalo , King Sebastian , Bines Julie , Wood Nicholas , Lambert Stephen , Buttery Jim
Published: February 2024

Background

Intussusception is the primary cause of acute bowel obstruction in infants. The majority of cases <2 years of age are classed as idiopathic, with viral infection implicated as one of the causes. Coronavirus disease 2019 (COVID-19) public health measures led to significant decreases in communicable disease prevalence. During these times, reductions in intussusception frequency were greater than would be expected with our previous understanding of its infectious etiology.

Methods

We conducted a retrospective, multistate, ecological study over a 12-year period. Monthly case numbers of “intussusception”-coded admissions (code K56.1; International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification) were acquired from state-wide admissions data sets from New South Wales, Victoria, and Queensland, representing 77.62% of the eligible Australian population. These counts within differing jurisdictional lockdowns were compared with non-lockdown periods in order to investigate a correlation between intussusception frequency and lockdown periods.

Results

We found a negative association between intussusception frequency and lockdown periods in both eligible states. The largest reductions were seen in the <2-year age groups, with Victoria experiencing a 62.7% reduction (rate ratio, 0.37; P < .001) and New South Wales a 40.1% reduction (0.599; P = .006) during lockdown times. Controls for variations in lockdown restrictions between both regional and metropolitan areas also showed expected decreases.

Conclusions

Our ecological study demonstrates significant decreases in the frequency of pediatric intussusception admissions during the COVID-19 lockdown periods. The unexpected magnitude of the reductions suggests that the true proportion of infectious disease-caused idiopathic intussusception is greatly underestimated.
Is accounting a matter for bookkeepers only? The effects of IFRS adoption on the financialisation of economy
Authors: Haldane Andrew G , Migliavacca Alessandro , Palea Vera
Published: February 2024

The process of financialisation has been extensively studied and several stylised facts identified. Short-termism is one of these. This article analyses the role that changes in accounting rules have played in increasing short-termism in company management. Our study considers the adoption of the International Financial Reporting Standards in the European Union (EU), showing that the new accounting standards have altered companies’ sensitivity to investment opportunities, leading to underinvestment in the real economy. In doing so, our article highlights the public-policy profile of accounting standards setting and possible tensions with EU societal objectives. To the best of our knowledge, this is the first study empirically analysing the role of accounting rules in the financialisation of economy.
The effect of the conduit size on middle-term outcomes in patients with extracardiac total cavopulmonary connection
Authors: Hirose Keiichi , Ikai Akio , Ito Hiroki , Ishidou Motonari , Toritsuka Daisuke , Nakamura Yuji , Watanabe Seito , Nakatani Eiji , Sakamoto Kisaburo
Published: February 2024

OBJECTIVES

The 18- and 16-mm conduits in extracardiac total cavopulmonary connection (eTCPC) were reported to be optimal based on energy loss and flow stagnation at the relatively early phase. However, because the artificial conduit lacks growth potential, we have recently encountered some cases in which the conduit needs to be changed several years after eTCPC. These cases prompted us to reconsider the surgical strategy for eTCPC.

METHODS

We reviewed our 20-year single-centre experience with eTCPC patients (n = 256) to compare the 18-mm conduit (n = 195) and 16-mm conduit (n = 61) in terms of mortality and morbidity.

RESULTS

The 16-mm conduit was used significantly more frequently in patients whose main chamber was right ventricle (P < 0.001). There was also a significant difference in preoperative inferior vena cava pressure (P = 0.008). There was a significant difference in the actuarial rate of freedom from late-occurring complications, including mortality, between the 2 groups (P = 0.003). There was a significant difference in the actuarial rate of reoperation-free survival (P = 0.042); however, there was no significant difference in resurgical intervention for the conduit (P = 0.333). In multivariate analysis, preoperative inferior vena cava pressure was an independent predictor for late-occurring complications (hazard ratio 1.19; P = 0.026). Conduit size (18 or 16 mm) itself was not an independent predictive factor for late-occurring complications (P = 0.690).

CONCLUSIONS

The mid-term clinical outcomes in patients who underwent eTCPC were excellent with low mortality. Preoperative inferior vena cava pressure was the only predictive risk factor for postoperative morbidity, and the 16 mm conduit was not predictive thereof.
An evaluation of Goudriaan’s summary model for light interception in strip canopies, using functional-structural plant models
Authors: Li Shuangwei , van der Werf Wopke , Gou Fang , Zhu Junqi , Berghuijs Herman N C , Zhou Hu , Guo Yan , Li Baoguo , Ma Yuntao , Evers Jochem B
Published: February 2024

Dealing with heterogeneity in leaf canopies when calculating light interception per species in a mixed canopy is a challenge. Goudriaan developed a computationally simple, though conceptually sophisticated, model for light interception in strip canopies, which can be reasonably represented as ‘blocks’, such as vineyards and crop rows. This model is widely used, but there is no independent verification of the model. Hence, we developed a comparison of light interception calculations with Goudriaan’s model and with detailed spatially explicit three-dimensional functional–structural plant models (FSPM) of maize in which plant architecture can be represented explicitly. Two models were developed, one with small randomly oriented leaves in blocks, similar to Goudriaan’s assumption, which we refer to as the intermediate model (IM), and another with a realistic representation of individual plants with stems and leaves having shape, orientation and so on, referred as FSPM. In IM and FSPM, light interception was calculated using ray tracing. In Goudriaan’s model, the light extinction coefficient (k), including both its daily and seasonal average values, was generated using the FSPM. Correspondence between the three models was excellent in terms of light capture for different levels of crop height, leaf area and uniformity, with the difference less than 3.3 %. The results are strong support for the use of Goudriaan’s summary model for calculating light interception in strip canopies.
Cost-effectiveness of surveillance intervals after curative resection of colorectal cancer
Authors: Takayama Yuji , Tsukamoto Shunsuke , Kudose Yozo , Takamizawa Yasuyuki , Moritani Konosuke , Esaki Minoru , Kanemitsu Yukihide , Igarashi Ataru
Published: February 2024

Background

Major guidelines consistently recommend 5 years of postoperative surveillance for patients with colorectal cancer. However, they differ in their recommendations for examination intervals and whether they should vary according to disease stage. Furthermore, there are no reports on the cost-effectiveness of the different surveillance schedules. The objective of this study is to identify the most cost-effective surveillance intervals after curative resection of colorectal cancer.

Methods

A total of 3701 patients who underwent curative surgery for colorectal cancer at the National Cancer Center Hospital were included. A cost-effectiveness analysis was conducted for the five surveillance strategies with reference to the guidelines. Expected medical costs and quality-adjusted life years after colorectal cancer resection were calculated using a state-transition model by Monte Carlo simulation. The incremental cost-effectiveness ratio per quality-adjusted life years gained was calculated for each strategy, with a maximum acceptable value of 43 500–52 200 USD (5–6 million JPY).

Results

Stages I, II and III included 1316, 1082 and 1303 patients, respectively, with 45, 140 and 338 relapsed cases. For patients with stage I disease, strategy 4 (incremental cost-effectiveness ratio $26 555/quality-adjusted life year) was considered to be the most cost-effective, while strategies 3 ($83 071/quality-adjusted life year) and 2 ($289 642/quality-adjusted life year) exceeded the threshold value. In stages II and III, the incremental cost-effectiveness ratio for strategy 3 was the most cost-effective option, with an incremental cost-effectiveness ratio of $18 358–22 230/quality-adjusted life year.

Conclusions

In stage I, the cost-effectiveness of intensive surveillance is very poor and strategy 4 is the most cost-effective. Strategy 3 is the most cost-effective in stages II and III.
Seed traits and recruitment interact with habitats to generate patterns of local adaptation in a perennial grass
Authors: Razzaque Samsad , Juenger Thomas E
Published: February 2024

A fundamental challenge in the field of ecology involves understanding the adaptive traits and life history stages regulating the population dynamics of species across diverse habitats. Seed traits and early seedling vigor are thought to be key functional traits in plants, with important consequences for recruitment, establishment, and population persistence. However, little is known about how diverse seed traits interact with seed and microsite availability to impact plant populations. Here, we performed a factorial experiment involving seed addition and surface soil disturbance to explore the combined effects of seed and site availability using genotypes characterized by varying seed mass and dormancy traits. Additionally, we included hybrids that exhibited recombined seed trait relationships compared with natural genotypes, allowing us to assess the impact of specific seed traits on establishment across different sites. We detected a significant three-way interaction between seed addition, site conditions, and soil surface disturbance, influencing both seedling establishment and adult recruitment in Panicum hallii, a perennial grass found in coastal mesic (lowland) and inland xeric (upland) habitats. This establishment/recruitment pattern suggests that mesic and xeric establishment at foreign sites is constrained by the interplay of seed and site limitations. Notably, soil surface disturbance facilitated establishment and recruitment of the xeric genotype while limiting the mesic genotype across all sites. Our results highlight the importance of seed size and dormancy as key factors impacting seedling establishment and adult recruitment, suggesting a potential interactive relationship between these traits.
Twenty years of irrigation acclimation is driven by denser canopies and not by plasticity in twig- and needle-level hydraulics in a Pinus sylvestris forest
Authors: Gauthey Alice , Bachofen Christoph , Chin Alana , Cochard Hervé , Gisler Jonas , Mas Eugénie , Meusburger Katrin , Peters Richard L , Schaub Marcus , Tunas Alex , Zweifel Roman , Grossiord Charlotte
Published: February 2024

Climate change is predicted to increase atmospheric vapor pressure deficit, exacerbating soil drought, and thus enhancing tree evaporative demand and mortality. Yet, few studies have addressed the longer-term drought acclimation strategy of trees, particularly the importance of morphological versus hydraulic plasticity. Using a long-term (20 years) irrigation experiment in a natural forest, we investigated the acclimation of Scots pine (Pinus sylvestris) morpho-anatomical traits (stomatal anatomy and crown density) and hydraulic traits (leaf water potential, vulnerability to cavitation (Ψ50), specific hydraulic conductivity (Ks), and tree water deficit) to prolonged changes in soil moisture. We found that low water availability reduced twig water potential and increased tree water deficit during the growing season. Still, the trees showed limited adjustments in most branch-level hydraulic traits (Ψ50 and Ks) and needle anatomy. In contrast, trees acclimated to prolonged irrigation by increasing their crown density and hence the canopy water demand. This study demonstrates that despite substantial canopy adjustments, P. sylvestris may be vulnerable to extreme droughts because of limited adjustment potential in its hydraulic system. While sparser canopies reduce water demand, such shifts take decades to occur under chronic water deficits and might not mitigate short-term extreme drought events.
Live Iterative Ptychography
Authors: Weber Dieter , Ehrig Simeon , Schropp Andreas , Clausen Alexander , Achilles Silvio , Hoffmann Nico , Bussmann Michael , Dunin-Borkowski Rafal E , Schroer Christian G
Published: February 2024

We demonstrate live-updating ptychographic reconstruction with the extended ptychographical iterative engine, an iterative ptychography method, during ongoing data acquisition. The reconstruction starts with a small subset of the total data, and as the acquisition proceeds the data used for reconstruction are extended. This creates a live-updating view of object and illumination that allows monitoring the ongoing experiment and adjusting parameters with quick turn around. This is particularly advantageous for long-running acquisitions. We show that such a gradual reconstruction yields interpretable results already with a small subset of the data. We show simulated live processing with various scan patterns, parallelized reconstruction, and real-world live processing at the hard X-ray ptychographic nanoanalytical microscope PtyNAMi at the PETRA III beamline.
Investigating the Evolution of Drosophila STING-Dependent Antiviral Innate Immunity by Multispecies Comparison of 2′3′-cGAMP Responses
Authors: Hédelin Léna , Thiébaut Antonin , Huang Jingxian , Li Xiaoyan , Lemoine Aurélie , Haas Gabrielle , Meignin Carine , Cai Hua , Waterhouse Robert M , Martins Nelson , Imler Jean-Luc
Published: February 2024

Viruses represent a major threat to all animals, which defend themselves through induction of a large set of virus-stimulated genes that collectively control the infection. In vertebrates, these genes include interferons that play a critical role in the amplification of the response to infection. Virus- and interferon-stimulated genes include restriction factors targeting the different steps of the viral replication cycle, in addition to molecules associated with inflammation and adaptive immunity. Predictably, antiviral genes evolve dynamically in response to viral pressure. As a result, each animal has a unique arsenal of antiviral genes. Here, we exploit the capacity to experimentally activate the evolutionarily conserved stimulator of IFN genes (STING) signaling pathway by injection of the cyclic dinucleotide 2′3′-cyclic guanosine monophosphate-adenosine monophosphate into flies to define the repertoire of STING-regulated genes in 10 Drosophila species, spanning 40 million years of evolution. Our data reveal a set of conserved STING-regulated factors, including STING itself, a cGAS-like-receptor, the restriction factor pastel, and the antiviral protein Vago, but also 2 key components of the antiviral RNA interference pathway, Dicer-2, and Argonaute2. In addition, we identify unknown species- or lineage-specific genes that have not been previously associated with resistance to viruses. Our data provide insight into the core antiviral response in Drosophila flies and pave the way for the characterization of previously unknown antiviral effectors.
Adaptive Selection of Cis-regulatory Elements in the Han Chinese
Authors: Liu Shuai , Luo Huaxia , Zhang Peng , Li Yanyan , Hao Di , Zhang Sijia , Song Tingrui , Xu Tao , He Shunmin
Published: February 2024

Cis-regulatory elements have an important role in human adaptation to the living environment. However, the lag in population genomic cohort studies and epigenomic studies, hinders the research in the adaptive analysis of cis-regulatory elements in human populations. In this study, we collected 4,013 unrelated individuals and performed a comprehensive analysis of adaptive selection of genome-wide cis-regulatory elements in the Han Chinese. In total, 12.34% of genomic regions are under the influence of adaptive selection, where 1.00% of enhancers and 2.06% of promoters are under positive selection, and 0.06% of enhancers and 0.02% of promoters are under balancing selection. Gene ontology enrichment analysis of these cis-regulatory elements under adaptive selection reveals that many positive selections in the Han Chinese occur in pathways involved in cell–cell adhesion processes, and many balancing selections are related to immune processes. Two classes of adaptive cis-regulatory elements related to cell adhesion were in-depth analyzed, one is the adaptive enhancers derived from neanderthal introgression, leads to lower hyaluronidase level in skin, and brings better performance on UV-radiation resistance to the Han Chinese. Another one is the cis-regulatory elements regulating wound healing, and the results suggest the positive selection inhibits coagulation and promotes angiogenesis and wound healing in the Han Chinese. Finally, we found that many pathogenic alleles, such as risky alleles of type 2 diabetes or schizophrenia, remain in the population due to the hitchhiking effect of positive selections. Our findings will help deepen our understanding of the adaptive evolution of genome regulation in the Han Chinese.
A system of reporters for comparative investigation of EJC-independent and EJC-enhanced nonsense-mediated mRNA decay
Authors: Kolakada Divya , Campbell Amy E , Galvis Laura Baquero , Li Zhongyou , Lore Mlana , Jagannathan Sujatha
Published: February 2024

Nonsense-mediated mRNA decay (NMD) is a network of pathways that degrades transcripts that undergo premature translation termination. In mammals, NMD can be divided into the exon junction complex (EJC)-enhanced and EJC-independent branches. Fluorescence- and luminescence-based reporters have long been effective tools to investigate NMD, yet existing reporters largely focus on the EJC-enhanced pathway. Here, we present a system of reporters for comparative studies of EJC-independent and EJC-enhanced NMD. This system also enables the study of NMD-associated outcomes such as premature termination codon (PTC) readthrough and truncated protein degradation. These reporters are compatible with fluorescence or luminescence-based readouts via transient transfection or stable integration. Using this reporter system, we show that EJC-enhanced NMD RNA levels are reduced by 2- or 9-fold and protein levels are reduced by 7- or 12-fold compared to EJC-independent NMD, depending on the reporter gene used. Additionally, the extent of readthrough induced by G418 and an NMD inhibitor (SMG1i), alone and in combination, varies across NMD substrates. When combined, G418 and SMG1i increase readthrough product levels in an additive manner for EJC-independent reporters, while EJC-enhanced reporters show a synergistic effect. We present these reporters as a valuable toolkit to deepen our understanding of NMD and its associated mechanisms.
Characterising polymyalgia rheumatica on whole-body 18F-FDG PET/CT: an atlas
Authors: Owen Claire E , Poon Aurora M T , Liu Bonnia , Liew David F L , Yap Lee Pheng , Yang Victor , Leung Jessica L , McMaster Christopher R , Scott Andrew M , Buchanan Russell R C
Published: February 2024

The impact of modern imaging in uncovering the underlying pathology of PMR cannot be understated. Long dismissed as an inflammatory syndrome with links to the large vessel vasculitis giant cell arteritis (GCA), a pathognomonic pattern of musculotendinous inflammation is now attributed to PMR and may be used to confirm its diagnosis. Among the available modalities, 18F-fluorodeoxyglucose (18F-FDG) PET/CT is increasingly recognized for its high sensitivity and specificity, as well as added ability to detect concomitant large vessel GCA and exclude other relevant differentials like infection and malignancy. This atlas provides a contemporary depiction of PMR’s pathology and outlines how this knowledge translates into a pattern of findings on whole body 18F-FDG PET/CT that can reliably confirm its diagnosis.
Exploring rabbit as a nonrodent species for general toxicology studies
Authors: Sokolowski Katie , Turner Patricia V , Lewis Elise , Wange Ronald L , Fortin Marie C
Published: February 2024

To avoid adverse events in humans, toxicity studies in nonclinical species have been the foundation of safety evaluation in the pharmaceutical industry. However, it is recognized that working with animals in research is a privilege, and conscientious use should always respect the 3Rs: replacement, reduction, and refinement. In the wake of the shortages in routine nonrodent species and considering that nonanimal methods are not yet sufficiently mature, the value of the rabbit as a nonrodent species is worth exploring. Historically used in vaccine, cosmetic, and medical device testing, the rabbit is seldom used today as a second species in pharmaceutical development, except for embryo-fetal development studies, ophthalmic therapeutics, some medical devices and implants, and vaccines. Although several factors affect the decision of species selection, including pharmacological relevance, pharmacokinetics, and ADME considerations, there are no perfect animal models. In this forum article, we bring together experts from veterinary medicine, industry, contract research organizations, and government to explore the pros and cons, residual concerns, and data gaps regarding the use of the rabbit for general toxicity testing.
Should I stay or should I go: an assessment of criteria for safe day of surgery discharge of displaced supracondylar humerus fractures
Authors: Yang Daniel , Baldwin Keith D. , Balar Pooja , Spiegel David A. , Zheng Jenny L. , Anari Jason B.
Published: February 2024

Immobilization type and in-hospital observation following surgical management of displaced supracondylar fractures are subject to surgeon preference and training. Our goal was to determine criteria for immediate discharge and optimal type of immobilization. Medical records of 661 patients with type III, IV or flexion-type displaced supracondylar humerus fractures treated at a level 1 pediatric trauma center from January 2013 to September 2019 were reviewed. Patients were separated into ‘admission appropriate’ (AA = 113) and ‘discharge appropriate’ (DA = 548) sub-cohorts. Neurovascular deficit at presentation (P < 0.001), post-operative physical exam deterioration (P < 0.001), age (P < 0.001) and post-operative immobilization modality (P = 0.02) were significantly different between AA and DA groups. When comparing patients who presented with neurologic deficit to those neurovascularly intact, there was a significant difference in whether circumferential immobilization was used post-operatively (P < 0.001), IV medication need (P < 0.001), discharge or admission (P < 0.001), neurologic decline (P < 0.001), return to ED (P = 0.008) and vascular compromise (P = 0.05). Twenty-four of the 56 (43%) patients who were AA and had no neurovascular finding on presentation had their immobilization adjusted (bivalved or loosened) to accommodate for swelling overnight. Only 1 was initially maintained in a splint or bivalved cast; the other 23 were initially maintained post-operatively in circumferential immobilization (P = 0.01). Our findings suggest that patients with intact neurovascular exams at presentation are candidates for early discharge, and splinting or bivalved casting may be preferable, especially in patients who are discharged.
Does menopause hormone therapy improve symptoms of depression? Findings from a specialized menopause clinic
Authors: Gnanasegar Rahavi , Wolfman Wendy , Galan Leticia Hernandez , Cullimore Amie , Shea Alison K.
Published: February 2024

Objective

Depressive symptoms are commonly reported during the perimenopause and in the early postmenopausal years. Although menopausal hormone therapy (MHT) is considered the most effective treatment option for vasomotor symptoms, its effect on mood-related symptoms is less established. This study aims to assess interval change in depressive symptoms after initiation of MHT treatment in women seeking care at a Canadian specialized menopause clinic.

Methods

Women and female-presenting people attending the St. Joseph's Healthcare Menopause Clinic in Hamilton, Ontario, were invited to participate in this study. Participants (n = 170) completed a self-report questionnaire, which included their medical history as well as validated tools for bothersome symptoms at their initial visit. A shortened version was administered at the follow-up visit 3 to 12 months later with the same validated tools. We sought to examine interval changes on the Center for Epidemiological Studies Depression Scale based on type of treatment used and MHT dose, while controlling for relevant demographic variables (smoking, education level, age).

Results

There was a high rate of depressive symptoms in those seeking specialized menopause care (62%). MHT use was associated with significantly improved depressive symptoms, both alone and in addition to an antidepressant medication (P < 0.001). Younger age, lower education attainment, and smoking were all associated with higher depression scores.

Conclusion

This study supports the use of MHT to improve depressive symptoms experienced by those seeking specialized menopause care. Further investigation into timing of treatment initiation may facilitate a personalized treatment approach to improve quality of life of women in the peri- and postmenopausal years.
A unique dermatologic adverse event from enfortumab vedotin
Authors: Bielawa Megan , Trivedi Apoorva
Published: February 2024

Enfortumab vedotin (EV) is a novel chemotherapeutic agent used in the treatment of metastatic urothelial cancer. Although rashes are reported as a common adverse event from this therapy, a paucity of literature is available on dermatologic toxicities to EV, especially with respect to bullous dermatoses. This case report will review a unique bullous dermatosis in the setting of EV therapy, including the diagnostic workup and management. Because cutaneous adverse events to chemotherapy and immunotherapy are common and can often result in dose reduction and treatment withdrawal for cancer patients, awareness of these manifestations and understanding how to manage them is crucial to providing quality care to this patient population.
Overview of head and neck cancer and the role of survivorship care
Authors: Fazer-Posorske Casey , Guenzel Rachael , McGrath Laura , Ziebarth Michelle , Kunkel Elizabeth , Chintakuntlawar Ashish V. , Price Katharine
Published: February 2024

Head and neck cancer (HNC) accounted for 4% of all malignancies in 2022 and is often associated with tobacco and alcohol use, but the incidence of human papillomavirus (HPV)–associated HNC has steadily increased in recent decades. Unlike HPV-negative HNC, HPV-positive HNC has a favorable prognosis and survival is significantly better resulting in a large population of HNC survivors. Survivorship for HNC is of the utmost importance as there is a high burden of side effects that impact function and quality of life, and the patients with HPV HNC are living longer with the sequelae of their treatment.
Efficacy of surgical intervention over conservative management in intertrochanteric fractures among nonagenarians and centenarians: a prospective cohort study
Authors: Guo Junfei , Xu Xin , Geng Qian , Wang Tao , Xu Ke , He Jinwen , Long Yubin , Zhang Qi , Jing Wensen , Li Zheng , Pan Ying , Xu Peng , Hou Zhiyong
Published: February 2024

Background:

Optimal treatment strategy for nonagenarians and centenarians with hip fractures (NCHF) remained unknown. We aimed to compare the outcomes of surgical and conservative management in NCHF.

Methods:

A prospective cohort study was conducted based on CPMHF database with NCHF patients hospitalized during 2014–2020. Comorbidities were evaluated by mECM score and restricted cubic spline was utilized to visually assess the dose-effect relationship between the mECM and outcomes. Propensity score matching was performed to balance baseline characteristics between non-surgical and surgical groups. Multivariate logistic regression, Cox proportional hazard analysis, and survival analysis were employed for unfavorable outcomes (UFO) evaluation. Competing risk of death were analyzed based on Fine and Gray’s hazard model and then constructed nomogram models for predicting survival rates. Subgroup analyses were used to determine potential population heterogeneity and sensitivity analyses were performed to test robustness of the results.

Results:

We found increasing trends for UFO with the increase in the mECM score, and that high mECM score (HMS, ≥3) was independently associated with a 2.42-fold (95%CI, 2.07-3.54; P=0.024) increased risk of UFO, which remained significant after considering the competing role of death and were more pronounced in non-surgical treatment, women, no insurance, and patients with spouse (all P for interaction<0.05). Surgical intervention was identified to be significant protective factors for UFO (RR, 0.59; 95%CI, 0.46-0.75; P<0.001) and severe complications (RR, 0.63; 95%CI, 0.41-0.96; P=0.033) after PSM, as well as survival (HR, 0.40, 95%CI, 0.28-0.58; P<0.001), which remained significant after considering the competing role of death and in all sensitivity analyses and were more pronounced in HMS participants (P for interaction=0.006). Subgroup analyses revealed surgical patients with HMS had a significantly higher UFO rate (excluding death, P<0.001) while non-surgical patients with HMS had higher mortality rate as compared to the others (P=0.005).

Conclusion:

Surgical treatment for NCHF yields better outcomes compared to conservative treatment.
Novel 3D morphological characteristics for congenital biliary dilatation diagnosis: A case-control study
Authors: Dou Jiaqi , Jiang Nan , Zeng Jianping , Wang Siyuan , Tian Song , Shan Siqiao , Li Yuze , Xu Ziming , Lin Xiaoqi , Jin Shuo , Dong Jiahong , Chen Huijun
Published: February 2024

Background:

Congenital biliary dilatation (CBD) necessitates the timely removal of dilated bile ducts. Accurate differentiation between CBD and secondary biliary dilatation (SBD) is crucial for treatment decisions, and identification of CBD with intrahepatic involvement is vital for surgical planning and supportive care. This study aimed to develop quantitative models based on bile duct morphology to distinguish CBD from SBD and further identify CBD with intrahepatic involvement.

Materials and Methods:

The retrospective study included 131 CBD and 209 SBD patients between December 2014 and December 2021 for model development, internal validation and testing. A separate cohort of 15 CBD and 34 SBD patients between January 2022 and December 2022 was recruited for temporally-independent validation. Quantitative shape-based (Shape) and diameter-based (Diam) morphological characteristics of bile ducts were extracted to build a CBD diagnosis model to distinguish CBD from SBD and an intrahepatic involvement identification model to classify CBD with/without intrahepatic involvement. The diagnostic performance of the models was compared with that of experienced hepatobiliary surgeons.

Results:

The CBD diagnosis model using clinical, Shape, and Diam characteristics showed good performance with an AUROC of 0.942 [95% CI: 0.890-0.994], AUPRC of 0.917 [0.855-0.979], accuracy of 0.891, sensitivity of 0.950 and F1-score of 0.864. The model outperformed two experienced surgeons in accuracy, sensitivity, and F1-score. The intrahepatic involvement identification model using clinical, Shape, and Diam characteristics yielded outstanding performance with an AUROC of 0.944 [0.879-1.000], AUPRC of 0.982 [0.947-1.000], accuracy of 0.932, sensitivity of 0.971 and F1-score of 0.957. The models demonstrated generalizable performance on the temporally-independent validation cohort.

Conclusions:

This study developed two robust quantitative models for distinguishing CBD from SBD and identifying CBD with intrahepatic involvement, respectively, based on morphological characteristics of the bile ducts, showing great potential in risk stratification and surgical planning of CBD.
Prone Split-Leg vs Galdakao-Modified Supine Valdivia Position During Endoscopic Combined Intrarenal Surgery: A Noninferiority Design Randomized Controlled Trial
Authors: Sugino Teruaki , Hamamoto Shuzo , Taguchi Kazumi , Inoue Takaaki , Okada Shinsuke , Yanase Takahiro , Sue Yasuhito , Kawase Kengo , Unno Rei , Ando Ryosuke , Okada Atsushi , Yasui Takahiro
Published: February 2024

Purpose:

Endoscopic combined intrarenal surgery (ECIRS) combines percutaneous nephrolithotomy and ureteroscopy. This procedure has become common with the development of the prone split-leg (PRO) and Galdakao-modified supine Valdivia (GMSV) positions. In this study, we evaluated the surgical outcomes of these positions during ECIRS.

Materials and Methods:

A noninferior randomized controlled trial was performed in accordance with the Consolidated Standards of Reporting Trials. The eligibility criteria were age 20 to 80 years and presence of > 15-mm renal and/or ureteral stones. They were assigned to the PRO or GMSV groups and underwent ECIRS in the PRO or GMSV position, respectively. The primary outcome was stone-free rate (SFR) 3 months after surgery. The secondary outcomes were surgical outcomes—surgery time, percutaneous access time, and complication rate. A noninferiority margin of 30% was used.

Results:

Eighty-six patients (46 in the PRO group and 43 in the GMSV group) were analyzed. The SFR was 91.3% and 90.7% in the PRO and GMSV groups, respectively. No between-group differences were observed regarding the overall complication rates. Percutaneous access time was longer in the PRO group than in the GMSV group for upper calyx punctures, whereas surgery and percutaneous access times were shorter in the PRO group for those with a middle calyx puncture.

Conclusions:

Surgical position did not affect the success rates. There was no difference in complications between the groups, except for perinephric hematoma formation.
Sonographic Findings of Abdominal Wall Endometriosis in Persistent Abdominal Wall Pain: A Case Report
Authors: Machač Stanislav , Hanušová Šárka , Hroncová Michaela , Drahonovský Jan
Published: February 2024

Introduction/Background:

Endometriosis is considered a chronic neuroinflammatory disease of debilitating pain, most often in the pelvic area. In rare cases, endometriosis can develop through iatrogenic implantation of endometrial cells/fragments into a scar area during the cesarean delivery.

Case Description:

A case of a 32-year-old female patient who underwent physical therapy for abdominal muscle pain with occasional irradiation of pain to the sacral region is presented. The pain developed soon after a cesarean delivery, which was performed 3 years ago.

Outcomes:

Palpation performed at the initial examination and after removal of the lesions showed a significant reduction in tone at the site of the lesions and a reduction in palpation pain. The objective primary tools and specific outcome measures used in this case were musculoskeletal sonography and a patient questionnaire (36-Item Short Form Health Survey [SF-36]). Abdominal wall lesions were found to be 34 × 13 × 40 mm and 30 × 15 × 22 mm in size and were surgically removed by a specialized surgeon with histological confirmation of endometriosis. The SF-36 scores considerably improved in all domains following removal of the lesions compared with the condition at the initial examination.

Discussion:

The presented case is an example of the musculoskeletal sonography evaluation following palpation of the abdominal wall in women after a cesarean delivery. The described sonographic examination performed by a physical therapist can be part of a comprehensive assessment of scar healing, diastasis, and the ability to activate the abdominal muscles during postpartum rehabilitation.

Informed Consent:

The patient signed informed consent, in which she agreed to the anonymous publication of her case.

A supplemental video abstract available at: https://www.youtube.com/watch?v=Vd87WB8ZQd0&t=16s
Celebrating Magnet® Nursing Excellence—Meet the Recipients of the 2023 National Magnet Nurse of the Year® Awards and ANCC Magnet Prize®
Authors: Curto Christine
Published: February 2024

This month's Magnet® Perspectives column spotlights the recipients of the 2023 American Nurses Credentialing Center (ANCC) Magnet Program® National Magnet Nurse of the Year® (MNOY) awards and the ANCC Magnet Prize®, sponsored by Press Ganey, recognized during the colocated ANCC National Magnet Conference® and the ANCC Pathway to Excellence Conference® in Chicago, Illinois, October 12 to 14, 2023. The MNOY awards recognize 5 clinical nurses in Magnet designated organizations who demonstrate outstanding contributions in innovation, consultation, leadership, and professional risk taking. The ANCC Magnet Prize, sponsored by Press Ganey, recognizes a Magnet organization whose nursing team spearheaded exemplary achievements including initiative(s) in healthcare delivery and research leading to innovations in patient care services. Press Ganey sponsors the Magnet Prize by providing a $125 000 purse to further develop and advance its innovative program/project.
Neurological Diagnosis
Authors: Finelli Pasquale F.
Published: February 2024

Objective:

Artificial intelligence has recently become available for widespread use in medicine, including the interpretation of digitized information, big data for tracking disease trends and patterns, and clinical diagnosis. Comparative studies and expert opinion support the validity of imaging and data analysis, yet similar validation is lacking in clinical diagnosis. Artificial intelligence programs are here compared with a diagnostic generator program in clinical neurology.

Methods:

Using 4 nonrandomly selected case records from New England Journal of Medicine clinicopathologic conferences from 2017 to 2022, 2 artificial intelligence programs (ChatGPT-4 and GLASS AI) were compared with a neurological diagnostic generator program (NeurologicDx.com) for diagnostic capability and accuracy and source authentication.

Results:

Compared with NeurologicDx.com, the 2 AI programs showed results varying with order of key term entry and with repeat querying. The diagnostic generator yielded more differential diagnostic entities, with correct diagnoses in 4 of 4 test cases versus 0 of 4 for ChatGPT-4 and 1 of 4 for GLASS AI, respectively, and with authentication of diagnostic entities compared with the AI programs.

Conclusions:

The diagnostic generator NeurologicDx yielded a more robust and reproducible differential diagnostic list with higher diagnostic accuracy and associated authentication compared with artificial intelligence programs.
Extracranial Meningioma-Pelvic Bone on FDG PET/CT: A Rare of the Rarest Site
Authors: Jain Tarun Kumar , Bohra Mansha , Punia Anushree , Vijay Maneesh Kumar , Malhotra Hemant
Published: February 2024

Meningiomas are benign extra-axial tumors of the central nervous system. Extracranial meningiomas are extremely rare (2%) and can develop as a direct extension from a primary intracranial meningioma or as a true primary extracranial meningioma originating from ectopic arachnoid cells. We report an extremely unusual case of a 61-year-old woman who was diagnosed with pelvic meningioma with the help of PET/CT and PET/CT-guided biopsy. The clinicopathological features of the patient and immunoprofile of the tumor are presented.
Do Children With Osteosarcoma Benefit From Pulmonary Metastasectomy?
Authors: Boam Tristan , Rogoyski Bethan G. , Jawaid Wajid , Losty Paul D.
Published: February 2024

Objective:

To critically examine the evidence-base for survival benefit of pulmonary metastasectomy (PM) for osteosarcoma (OS) in the pediatric population.

Background:

PM for OS is recommended as the standard of care in both pediatric and adult treatment protocols. Recent results from the “Pulmonary Metastasectomy in Colorectal Cancer” trial demonstrate no survival benefit from PM in colorectal cancer in adults.

Methods:

A systematic review was undertaken according to “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” guidelines. Medline, Embase, and 2 clinical trial registers were searched for all studies detailing pediatric patients with OS (<18 years) undergoing PM with a comparison cohort group that did not receive PM.

Results:

Eleven studies met inclusion criteria dating from 1984 to 2017. All studies were retrospective and none directly compared PM versus no PM in pediatric patients as its main objective(s). Three-year survival rates ranged from 0% to 54% for PM and 0% to 16% for no PM. No patients receiving PM were usually those with unresectable disease and/or considered to have a poor prognosis. All studies were at high risk of bias and there was marked heterogeneity in the patient selection.

Conclusions:

There is a weak evidence base (level IV) for a survival benefit of PM for OS in pediatric patients likely due to selection bias of “favorable cases.” The included studies many of which detailed outdated treatment protocols were not designed in their reporting to specifically address the questions directly. A randomized controlled trial—while ethically challenging in a pediatric population—incorporating modern OS chemotherapy protocols is needed to crucially address any “survival benefit.”