bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical decompression in spinal Paget’s disease: illustrative case
Authors: Price Anthony , File Christopher , Call-Orellana Francisco , Andrade de Almeida Romulo Augusto , North Robert Y 
Published: July 2024

BACKGROUND
Paget’s disease of bone (PDB) is a common bone metabolic pathology in older adults, characterized by mixed osteolytic, osteoblastic, and quiescent periods. Surgical guidelines for PDB involving the spine are not well-defined and are reserved for cases refractory to medical treatments, typically bisphosphonates like zoledronic acid. This case study describes a 52-year-old male with PDB who presented with rapidly progressing myelopathy symptoms refractory to standard medical treatment, warranting surgical decompression.

OBSERVATIONS
Surgical decompression and fusion, involving laminectomy with partial facetectomies, placement of pedicle screw instrumentation, and posterolateral arthrodesis spanning beyond the pathological segment, was performed. Follow-up visits indicated progressive improvement in symptoms and mobility, and imaging showed stable postsurgical changes with increased sclerosis in the affected vertebrae on a 2-year postsurgical course.

LESSONS
This case underscores that PDB of the spine can transition from asymptomatic to significant impairment and demonstrates that surgical intervention can provide effective symptomatic relief in myelopathy secondary to PDB. The case contributes to the growing evidence of the effectiveness of surgical decompression in PDB involving the spine.
https://thejns.org/doi/10.3171/CASE24203
A Computational Approach of Anti-diabetic Potential Evaluation of Flower and Seed of Nyctanthes arbor tristis Linn
Authors: Shrestha Ram Lal Swagat , Parajuli Nirmal , Neupane Prabhat , Dhital Sujan , Maharjan Binita , Shrestha Timila , Bharati Samjhana , Marasini Bishnu Prasad , Adhikari Subin Jhashanath 
Published: July 2024

Exploring the medicinal significance of bioactive compounds through computational methods is an increasingly practiced approach in contemporary medicinal research. This study aims to assess the antidiabetic potential of compounds extracted from the plant Nyctanthes arbor tristis by evaluating their ability to inhibit the carbohydrate metabolic enzyme α-glucosidase. The research work was conducted through molecular docking calculation, molecular dynamics simulation (MDS), and ADMET prediction techniques. Among the compounds, arbortistoside-C (NAS03), and arbortristoside-D (NAS04) found in the seed of the plant were identified as hit inhibitors of the target protein with docking scores, -9.9 and -9.4 kcal/mol, respectively. The compounds showed a comparable docking score with the drug of diabetes acarbose (-8.6 kcal/mol). Geometrical parameters like radius of gyration, solvent accessibility surface, root mean square deviation, and root mean square fluctuation from MDS supported the stability of the protein-ligand complex. MMPBSA calculations demonstrated the stability and feasibility of the complex with binding free energy changes of -29.06±6.06 and -23.58±8.80 kcal/mol for compounds NAS03 and NAS04, respectively. The ADMET prediction suggested the drug-likeness of the compounds compared with that of the standard drugs. The results could be used in proposing the antidiabetic potential of the two compounds from the plant as a potential inhibitors of α-glucosidase enzyme. Further, in vitro and in vivo experiments on such compounds could be a more reliable path to validate the output of this computational research.
The predictive value of peripheral blood cell mitochondrial gene expression in identifying the prognosis in pediatric sepsis at preschool age
Authors: Jing Siyuan , Zhang Yue , Zhao Wanling , Li Yifei , Wen Yan 
Published: July 2024

BackgroundSepsis represents a severe manifestation of infection often accompanied by metabolic disorders and mitochondrial dysfunction. Notably, mitochondrial DNA copy number (mtDNA-CN) and the expression of specific mitochondrial genes have emerged as sensitive indicators of mitochondrial function. To investigate the utility of mitochondrial gene expression in peripheral blood cells for distinguishing severe infections and predicting associated outcomes, we conducted a prospective cohort study.MethodsWe established a prospective cohort comprising 74 patients with non-sepsis pneumonia and 67 cases of sepsis induced by respiratory infections, aging from 2 to 6 years old. We documented corresponding clinical data and laboratory information and collected blood samples upon initial hospital admission. Peripheral blood cells were promptly isolated, and both total DNA and RNA were extracted. We utilized absolute quantification PCR to assess mtDNA-CN, as well as the expression levels of mt-CO1, mt-ND1, and mt-ATP6. Subsequently, we extended these comparisons to include survivors and non-survivors among patients with sepsis using univariate and multivariate analyses. Receiver operating characteristic (ROC) curves were constructed to assess the diagnostic potential.ResultsThe mtDNA-CN in peripheral blood cells was significantly lower in the sepsis group. Univariate analysis revealed a significant reduction in the expression of mt-CO1, mt-ND1, and mt-ATP6 in patients with sepsis. However, multivariate analysis did not support the use of mitochondrial function in peripheral blood cells for sepsis diagnosis. In the comparison between pediatric sepsis survivors and non-survivors, univariate analysis indicated a substantial reduction in the expression of mt-CO1, mt-ND1, and mt-ATP6 among non-survivors. Notably, total bilirubin (TB), mt-CO1, mt-ND1, and mt-ATP6 levels were identified as independent risk factors for sepsis-induced mortality. ROC curves were then established for these independent risk factors, revealing areas under the curve (AUCs) of 0.753 for TB (95% CI 0.596–0.910), 0.870 for mt-CO1 (95% CI 0.775–0.965), 0.987 for mt-ND1 (95% CI 0.964–1.000), and 0.877 for mt-ATP6 (95% CI 0.793–0.962).ConclusionMtDNA-CN and mitochondrial gene expression are closely linked to the severity and clinical outcomes of infectious diseases. Severe infections lead to impaired mitochondrial function in peripheral blood cells. Notably, when compared to other laboratory parameters, the expression levels of mt-CO1, mt-ND1, and mt-ATP6 demonstrate promising potential for assessing the prognosis of pediatric sepsis.
Flexible encoding of multiple task dimensions in human cerebral cortex
Authors: Tamber-Rosenau Benjamin J. , Newton Allen T. , Marois René 
Published: July 2024

IntroductionCognitive models have proposed that behavioral tasks can be categorized along at least three dimensions: the sensory-motor modality of the information, its representational format (e.g., location vs. identity), and the cognitive processes that transform it (e.g., response selection). Moreover, we can quickly and flexibly encode, represent, or manipulate information along any of these dimensions. How is this flexibility in encoding such information implemented in the cerebral cortex?MethodsTo address this question, we devised a series of functional magnetic resonance imaging (fMRI) experiments in each of which participants performed two distinct tasks that differed along one of the three dimensions.ResultsUsing multivariate pattern analysis of the fMRI data, we were able to decode between tasks along at least one task dimension within each of the cortical regions activated by these tasks. Moreover, the multiple demand network, a system of brain regions previously associated with flexible task encoding, was largely composed of closely juxtaposed sets of voxels that were specialized along each of the three tested task dimensions.DiscussionThese results suggest that flexible task encoding is primarily achieved by the juxtaposition of specialized representations processing each task dimension in the multiple demand network.
Friends, followers, peers, and posts: adolescents' in-person and online friendship networks and social media use influences on friendship closeness via the importance of technology for social connection
Authors: Al-Jbouri Elizabeth , Volk Anthony A. , Spadafora Natalie , Andrews Naomi C. Z. 
Published: July 2024

IntroductionWith the proliferation of smartphones, social media access and use is ubiquitous. As such, many adolescent friendships now comprise both in-person and online contexts. Our paper explores the relationship between these contexts in two parts: the first is an exploratory comparison of in-person and online friendship networks with peers at school using descriptive social network analysis; the second, an investigation of how the use of different social media platforms relates to the importance placed on social media for connectedness and friendship closeness.MethodsParticipants were 547 adolescents (M = 15.25 years, 52% male, 55% white) from six schools in Southern Ontario, Canada. Participants completed a peer nomination survey on their relationships with peers at school and a self-report survey on social media use.ResultsWhile in-person and online networks are largely overlapping, there are important differences between the two. Results from the path analyses suggest that length of cell phone usage, Instagram, Snapchat, and YouTube were positively associated with the importance placed on technology for social connection and that this importance was also positively associated with feelings of friendship closeness. Daily cell phone usage, Instagram, and Snapchat use were positively indirectly associated with friendship closeness through the importance of technology for social connection.DiscussionOur findings also suggest slight gender differences, with daily time spent on a smartphone only significantly positively associated with the importance of technology for social connection for girls. Implications for future study are discussed.
Causal associations between sleep traits and temporomandibular disorders: a bidirectional mendelian randomization analysis
Authors: Xu Lihan , Zhou Haojing 
Published: July 2024

ObjectivesThis study aims to investigate the relationship between five sleep traits (insomnia, sleep duration, getting up in morning, snoring, and daytime nap) and temporomandibular disorders (TMD) using bi-directional Mendelian randomization.MethodsThe bi-directional Mendelian randomization study was conducted in two stages. Initially, sleep traits were examined as exposures while TMD was evaluated as an outcome, whereas the second step was reversed. The inverse variance weighted (IVW) method and other Mendelian randomization methods were used for analysis. Furthermore, we performed the MR-Egger intercept, MR-PRESSO, Cochran’s Q test, and “Leave-one-out” to assess the levels of pleiotropy and heterogeneity.ResultsThe IVW method indicates that getting up in the morning reduces the risk of developing TMD (OR = 0.50, 95% CI 0.30–0.81, p = 0.005), while insomnia may increase the risk of TMD (OR = 2.05, 95% CI 1.10–3.85, p = 0.025). However, other sleep traits are not associated with the risk of TMD, and having TMD does not alter an individual’s sleep traits. After removing outliers, the results remained robust, with no pleiotropy detected.ConclusionGenetically determined difficulty in getting up in the morning and insomnia can increase the risk of TMD. By optimizing sleep, the risk of developing TMD can be reduced. This underscores the importance of sleep in preventing TMD.
Proposal of a novel cardiovascular risk prediction score in lupus nephritis
Authors: Molnár Adél , Juha Márk , Bulajcsík Klaudia , Tabák Ádám Gy. , Tislér András , Ledó Nóra 
Published: July 2024

IntroductionPatients with systemic lupus erythematosus are prone to develop cardiovascular disease (CVD), and have increased morbidity and mortality.MethodsWe conducted a retrospective analysis on lupus nephritis patients to assess the occurrence and predictors of major adverse cardiovascular events (MACE). Data were collected from patients who underwent kidney biopsy between 2005 and 2020. Statistical analysis was performed to unveil correlations.Results91 patients were analyzed in this period, with a mean age of 37.3 ± 12.3 years and 86% being female. The mean follow-up time was 62 ± 48 months. 15.38% of the patients underwent at least one MACE. Two patients deceased of CVD. Increased age (35.81 ± 11.14 vs 45.5 ± 15.11 years, p=0.012) entailed a higher occurrence of MACEs. Neutrophil count (5.15 ± 2.83 vs 7.3 ± 2.99 Giga/L, p=0.001) was higher, whereas diastolic blood pressure (DBP) was lower (89.51 ± 10.96 vs 78.43 ± 6.9 mmHg, p&lt;0.001) at the time of the biopsy in patients with MACE. Age, neutrophil count, and DBP proved to be independent predictors of MACEs. We propose a new model (CANDE – Cardiovascular risk based on Age, Neutrophil count, and Diastolic blood pressure Estimation score) calculated from these variables, which predicts the probability of MACE occurrence.ConclusionThis study underscores the importance of actively screening for cardiovascular risks in this vulnerable patient population. Age, neutrophil count, and diastolic blood pressure have been established as independent risk factors for MACE in lupus nephritis. The CANDE score derived from these parameters may serve as a prompt, cost-effective, and easily accessible estimation tool for assessing the likelihood of major adverse cardiovascular risk. These findings emphasize the necessity for comprehensive management strategies addressing both immune dysregulation and cardiovascular risk factors in systemic lupus erythematosus to mitigate adverse outcomes.
Human stem cell–derived neurons and astrocytes to detect novel auto-reactive IgG response in immune-mediated neurological diseases
Authors: Mathias Amandine , Perriot Sylvain , Jones Samuel , Canales Mathieu , Bernard-Valnet Raphaël , Gimenez Marie , Torcida Nathan , Oberholster Larise , Hottinger Andreas F. , Zekeridou Anastasia , Theaudin Marie , Pot Caroline , Du Pasquier Renaud 
Published: July 2024

Background and objectivesUp to 46% of patients with presumed autoimmune limbic encephalitis are seronegative for all currently known central nervous system (CNS) antigens. We developed a cell-based assay (CBA) to screen for novel neural antibodies in serum and cerebrospinal fluid (CSF) using neurons and astrocytes derived from human-induced pluripotent stem cells (hiPSCs).MethodsHuman iPSC-derived astrocytes or neurons were incubated with serum/CSF from 99 patients [42 with inflammatory neurological diseases (IND) and 57 with non-IND (NIND)]. The IND group included 11 patients with previously established neural antibodies, six with seronegative neuromyelitis optica spectrum disorder (NMOSD), 12 with suspected autoimmune encephalitis/paraneoplastic syndrome (AIE/PNS), and 13 with other IND (OIND). IgG binding to fixed CNS cells was detected using fluorescently-labeled antibodies and analyzed through automated fluorescence measures. IgG neuronal/astrocyte reactivity was further analyzed by flow cytometry. Peripheral blood mononuclear cells (PBMCs) were used as CNS-irrelevant control target cells. Reactivity profile was defined as positive using a Robust regression and Outlier removal test with a false discovery rate at 10% following each individual readout.ResultsUsing our CBA, we detected antibodies recognizing hiPSC-derived neural cells in 19/99 subjects. Antibodies bound specifically to astrocytes in nine cases, to neurons in eight cases, and to both cell types in two cases, as confirmed by microscopy single-cell analyses. Highlighting the significance of our comprehensive 96-well CBA assay, neural-specific antibody binding was more frequent in IND (15 of 42) than in NIND patients (4 of 57) (Fisher’s exact test, p = 0.0005). Two of four AQP4+ NMO and four of seven definite AIE/PNS with intracellular-reactive antibodies [1 GFAP astrocytopathy, 2 Hu+, 1 Ri+ AIE/PNS)], as identified in diagnostic laboratories, were also positive with our CBA. Most interestingly, we showed antibody-reactivity in two of six seronegative NMOSD, six of 12 probable AIE/PNS, and one of 13 OIND. Flow cytometry using hiPSC-derived CNS cells or PBMC-detected antibody binding in 13 versus zero patients, respectively, establishing the specificity of the detected antibodies for neural tissue.ConclusionOur unique hiPSC-based CBA allows for the testing of novel neuron-/astrocyte-reactive antibodies in patients with suspected immune-mediated neurological syndromes, and negative testing in established routine laboratories, opening new perspectives in establishing a diagnosis of such complex diseases.
Behavioral response of megafauna to boat collision measured via animal-borne camera and IMU
Authors: Chapple Taylor K. , Cade David E. , Goldbogen Jeremy , Massett Nick , Payne Nicholas , McInturf Alexandra G. 
Published: July 2024

Overlap between marine megafauna and maritime activities is a topic of global concern. Basking sharks (Cetorhinus maximus; CM) are listed as Globally Endangered under the IUCN, though reported sightings appear to be increasing in Ireland. While such trends in the region are welcome, increasing spatiotemporal overlap between CM and numerous water users poses an increased risk of boat strikes to the animals. To demonstrate the risk and impact of boat strikes on marine megafauna, we present camera-enabled animal-borne inertial measurement unit (IMU) data from a non-lethal boat strike on a CM within a proposed National Marine Park in Ireland. We tagged a ~7-m female CM in County Kerry, Ireland, which was struck by a boat ~6 h after tag deployment. Comparison of pre-strike data with 4 h of video and ~7.5 h of IMU data following the boat strike provides critical insight into the animal’s response. While the CM reacted momentarily with an increase in activity and swam to the seafloor, it quickly reduced its overall activity (i.e., overall dynamic body acceleration, tailbeat cycles, tailbeat amplitude, and vertical velocity) for the remainder of the deployment. Notably, the animal also ceased feeding for the duration of the video and headed towards deep offshore waters, which is in stark contrast to the pre-strike period where the animal was consistently observed feeding along the surface in shallow coastal water. This work provides insight into a CM’s response to acute injury and highlights the need for appropriate protections to mitigate risks for marine megafauna.
Comparison of sevoflurane and propofol in combination with remifentanil on the quality of postoperative recovery in patients undergoing laparoscopic bariatric surgery
Authors: Shu Zhuolin , Lin Tiancheng , Xu Dingchen , Zheng Shuyuan 
Published: July 2024

ObjectiveThis study aimed to evaluate and compare the effects of sevoflurane + remifentanil (Sev + Rem) and propofol + remifentanil (Pro + Rem) on the postoperative recovery quality of patients undergoing laparoscopic bariatric surgery to determine which anesthesia regimen provides a better overall recovery experience.MethodsSixty patients were divided into two groups based on the treatments they underwent: Sev + Rem (n = 30) and Pro + Rem (n = 30). The Sev + Rem group received sevoflurane inhalation (0.5%, increasing to 0.5–4%) and remifentanil via target-controlled infusion. The Pro + Rem group received propofol [4–8 mg/(kg·h)] and remifentanil via target-controlled infusion. Anesthesia depth was maintained at a bispectral index of 40–60 in both groups. Perioperative data, hemodynamic parameters, and postoperative recovery quality were assessed.ResultsCompared to the Pro + Rem group, the dose of remifentanil in the Sev + Rem group was significantly lower (1693.67 ± 331.75 vs. 2,959 ± 359.77, p &lt; 0.001), the proportion of patients used norepinephrine was markedly higher [16 (53.33) vs. 8 (26.67), p = 0.035], and the time of extubation was earlier (356.33 ± 63.17 vs. 400.3 ± 50.11, p = 0.004). The Hemodynamic results showed the HR in the Sev + Rem group was faster than that in the Pro + Rem group at the beginning of surgery and 1 h post-surgery (67.37 ± 4.40 vs. 64.33 ± 4.44, p = 0.010, 69.07 ± 4.23 vs. 66.40 ± 5.03, p = 0.030). In regard to the assessment of postoperative recovery quality, the emotional state scores in the Sev + Rem group were significantly lower than the Pro + Rem group (36.83 ± 2.79 vs. 39.50 ± 4.64, p = 0.009).ConclusionThe two anesthesia modalities (Sev + Rem and Pro + Rem) have their advantages and disadvantages for patients undergoing laparoscopic bariatric surgery and have comparable effects on postoperative recovery quality.
A robust ensemble deep learning framework for accurate diagnoses of tuberculosis from chest radiographs
Authors: Sun Xin , Xing Zhiheng , Wan Zhen , Ding Wenlong , Wang Li , Zhong Lingshan , Zhou Xinran , Gong Xiu-Jun , Li Yonghui , Zhang Xiao-Dong 
Published: July 2024

IntroductionTuberculosis (TB) stands as a paramount global health concern, contributing significantly to worldwide mortality rates. Effective containment of TB requires deployment of cost-efficient screening method with limited resources. To enhance the precision of resource allocation in the global fight against TB, this research proposed chest X-ray radiography (CXR) based machine learning screening algorithms with optimization, benchmarking and tuning for the best TB subclassification tasks for clinical application.MethodsThis investigation delves into the development and evaluation of a robust ensemble deep learning framework, comprising 43 distinct models, tailored for the identification of active TB cases and the categorization of their clinical subtypes. The proposed framework is essentially an ensemble model with multiple feature extractors and one of three fusion strategies-voting, attention-based, or concatenation methods-in the fusion stage before a final classification. The comprised de-identified dataset contains records of 915 active TB patients alongside 1,276 healthy controls with subtype-specific information. Thus, the realizations of our framework are capable for diagnosis with subclass identification. The subclass tags include: secondary tuberculosis/tuberculous pleurisy; non-cavity/cavity; secondary tuberculosis only/secondary tuberculosis and tuberculous pleurisy; tuberculous pleurisy only/secondary tuberculosis and tuberculous pleurisy.ResultsBased on the dataset and model selection and tuning, ensemble models show their capability with self-correction capability of subclass identification with rendering robust clinical predictions. The best double-CNN-extractor model with concatenation/attention fusion strategies may potentially be the successful model for subclass tasks in real application. With visualization techniques, in-depth analysis of the ensemble model's performance across different fusion strategies are verified.DiscussionThe findings underscore the potential of such ensemble approaches in augmenting TB diagnostics with subclassification. Even with limited dataset, the self-correction within the ensemble models still guarantees the accuracies to some level for potential clinical decision-making processes in TB management. Ultimately, this study shows a direction for better TB screening in the future TB response strategy.