bluuebunny/crossref_metadata_2025_split huggingface dataset:
The proprotein convertase FURIN is a novel aneurysm predisposition gene impairing TGF-β signalling
Authors: He Zongsheng , IJpma Arne S , Vreeken Dianne , Heijsman Daphne , Rosier Karen , Verhagen Hence J M , de Bruin Jorg L , Brüggenwirth Hennie T , Roos-Hesselink Jolien W , Bekkers Jos A , Huylebroeck Danny F E , van Beusekom Heleen M M , Creemers John W M , Majoor-Krakauer Danielle 
Published: April 2024

Abstract

Aims
Aortic aneurysms (AA) frequently involve dysregulation of transforming growth factor β (TGF-β)-signalling in the aorta. Here, FURIN was tested as aneurysm predisposition gene given its role as proprotein convertase in pro-TGF-β maturation.

Methods and results
Rare FURIN variants were detected by whole-exome sequencing of 781 unrelated aortic aneurysm patients and affected relatives. Thirteen rare heterozygous FURIN variants occurred in 3.7% (29) unrelated index AA patients, of which 72% had multiple aneurysms or a dissection. FURIN maturation and activity of these variants were decreased in vitro. Patient-derived fibroblasts showed decreased pro-TGF-β processing, phosphorylation of downstream effector SMAD2 and kinases ERK1/2, and steady-state mRNA levels of the TGF-β-responsive ACTA2 gene. In aortic tissue, collagen and fibrillin fibres were affected. One variant (R745Q), observed in 10 unrelated cases, affected TGF-β signalling variably, indicating effect modification by individual genetic backgrounds.

Conclusion
FURIN is a novel, frequent genetic predisposition for abdominal-, thoracic-, and multiple aortic or middle sized artery aneurysms in older patients, by affecting intracellular TGF-β signalling, depending on individual genetic backgrounds.
Patient-specific ascending aortic intervention criteria
Authors: Kalogerakos Paris D , Zafar Mohammad A , Li Yupeng , Ellauzi Hesham , Mukherjee Sandip K , Ziganshin Bulat A , Rizzo John A , Elefteriades John A 
Published: April 2024

Abstract

OBJECTIVES
Ascending aortic aneurysms pose a different risk to each patient. We aim to provide personalized risk stratification for such patients based on sex, age, body surface area and aneurysm location (root versus ascending).

METHODS
Root and ascending diameters, and adverse aortic events (dissection, rupture, death) of ascending thoracic aortic aneurysm patients were analysed. Aortic diameter was placed in context vis-a-vis the normal distribution in the general population with similar sex, age and body surface area, by conversion to z scores. These were correlated of major adverse aortic events, producing risk curves with ‘hinge points’ of steep risk, constructed separately for the aortic root and mid-ascending aorta.

RESULTS
A total of 1162 patients were included. Risk curves unveiled generalized thresholds of z = 4 for the aortic root and z = 5 for the mid-ascending aorta. These correspond to individualized thresholds of less than the standard criterion of 5.5 cm in the vast majority of patients. Indicative results include a 75-year-old typical male with 2.1 m2 body surface area, who was found to be at increased risk of adverse events if root diameter exceeds 5.15 cm, or mid ascending exceeds 5.27 cm. An automated calculator is presented, which identifies patients at high risk of adverse events based on sex, age, height, weight, and root and ascending size.

CONCLUSIONS
This analysis exploits a large sample of aneurysmal patients, demographic features of the general population, pre-dissection diameter, discrimination of root and supracoronary segments, and statistical tools to extract thresholds of increased risk tailor-made for each patient.
Yeast sexes: mating types do not determine the sexes in Metschnikowia species
Authors: Lachance Marc-André , Burke Christopher , Nygard Karen , Courchesne Marc , Timoshenko Alexander V 
Published: April 2024

Abstract
Although filamentous Ascomycetes may produce structures that are interpreted as male and female gametangia, ascomycetous yeasts are generally not considered to possess male and female sexes. In haplontic yeasts of the genus Metschnikowia, the sexual cycle begins with the fusion of two morphologically identical cells of complementary mating types. Soon after conjugation, a protuberance emerges from one of the conjugants, eventually maturing into an ascus. The originating cell can be regarded as an ascus mother cell, hence as female. We tested the hypothesis that the sexes, female or male, are determined by the mating types. There were good reasons to hypothesize further that mating type α cells are male. In a conceptually simple experiment, we observed the early stages of the mating reaction of mating types differentially labeled with fluorescent concanavalin A conjugates. Three large-spored Metschnikowia species, M. amazonensis, M. continentalis, and M. matae, were examined. In all three, the sexes were found to be independent of mating type, cautioning that the two terms should not be used interchangeably.
Evolutionary graph theory beyond single mutation dynamics: on how network-structured populations cross fitness landscapes
Authors: Kuo Yang Ping , Carja Oana 
Published: April 2024

Abstract
Spatially resolved datasets are revolutionizing knowledge in molecular biology, yet are under-utilized for questions in evolutionary biology. To gain insight from these large-scale datasets of spatial organization, we need mathematical representations and modeling techniques that can both capture their complexity, but also allow for mathematical tractability. Evolutionary graph theory utilizes the mathematical representation of networks as a proxy for heterogeneous population structure and has started to reshape our understanding of how spatial structure can direct evolutionary dynamics. However, previous results are derived for the case of a single new mutation appearing in the population and the role of network structure in shaping fitness landscape crossing is still poorly understood. Here we study how network-structured populations cross fitness landscapes and show that even a simple extension to a two-mutational landscape can exhibit complex evolutionary dynamics that cannot be predicted using previous single-mutation results. We show how our results can be intuitively understood through the lens of how the two main evolutionary properties of a network, the amplification and acceleration factors, change the expected fate of the intermediate mutant in the population and further discuss how to link these models to spatially resolved datasets of cellular organization.
Silyl enol ethers and related silyl ethers
Authors: Thomas Susan E. 
Published: April 2024

Abstract
This chapter focuses on related silyl ethers and silyl enol ethers. It defines silyl enol ethers as stable molecules which may be isolated, purified, and characterized using standard organic procedures. The chapter contends that they are sources of regiochemically-pure enolate ions and their equivalents, and as such, they play an important role in modern synthetic organic chemistry. The chapter then moves to explicate the formation of silyl enol ethers. It illustrates the deprotonation of an unsymmetrically substituted ketone such as 2-methylcyclohexanone, then explores the process of conjugate additions/silylation and hydrosilylation. The chapter discusses the reactions of silyl enol ethers, then elaborates on the silyl ketene acetals which are derived from ester enolates and are closely related to silyl enol ethers.
A Positive Right to Rehabilitation? An Examination of the ‘Principle of Rehabilitation’ in the Caselaw of the European Court of Human Rights
Authors: Lawrence Rebecca 
Published: April 2024

Abstract
This article analyses the development and the role of the ‘principle of rehabilitation’ in the European Court of Human Rights’ caselaw on prisoner rights. It will be demonstrated that, outside of the context of whole-life sentences, the impact of the principle on the Court’s reasoning process has been relatively limited, despite increasing reference by the Court to the growing importance of the principle. Further, that the Court allowing the pursuit of rehabilitation to be used as justification for interferences with other Convention rights within its caselaw undermines the link made by the Court between rehabilitation and human dignity. Finally, it is argued that a conception of rehabilitation that is underpinned by human dignity requires recognition of a positive duty on states to provide access to appropriate rehabilitative treatment for all prisoners.
The impact and user experience of a student-led clinic providing preventative services
Authors: Chin Sophie , Richardson Charlotte Lucy , Gardner Adam , Nazar Hamde 
Published: April 2024

Abstract

Objectives
Preventative services are required to address the risk factors for chronic conditions such as cardiovascular disease. The National Health Service Health Checks in England were introduced to provide such services. One School of Pharmacy established a student-led clinic to provide this service to the local community. The clinic was provided by undergraduate pharmacy students and delivered free of charge within a central city locality. The aim was to explore the impact of the clinic on user thoughts and motivations around healthy living and investigate user experience.

Methods
A sequential explanatory mixed methods approach was used consisting of a survey that measured users’ thoughts about their health and well-being and experience of the clinic. Qualitative interviews explored the user experience and barriers and facilitators to making healthier lifestyle choices.

Results
One hundred and fifty-four members of the public accessed the clinic over the evaluative period. Ninety-six (60%) completed the pre–post survey and 12 participated in follow-up interviews. Users reported statistically significant improvements in how informed, competent and motivated they felt towards making healthier lifestyle choices after the clinic consultation. Interview findings highlighted the positive user experience, reported appreciation for clinic accessibility, availability of healthy lifestyle education, and a desire for more preventative services being as readily available.

Conclusions
The student-led clinic has demonstrated positive impacts on user experience, knowledge, competence, and motivation to make healthier lifestyle choices. The clinic provides proof-of-concept for pharmacy students to deliver preventative community services that aim to improve population health at a time when primary care is experiencing unprecedented challenges.
UNIFIL’s “Blue Line” Demarcation: Spatial Ordering, Political Subjectivity, and Settler Colonialism in South Lebanese Borderlands
Authors: Kassem Susann 
Published: April 2024

Abstract
This article offers an ethnographic account of ongoing border conflicts in south Lebanon between members of the United Nations Interim Force in Lebanon (UNIFIL) and residents in a south Lebanese border village. It emphasizes the specific experiences of this border population with foreign intervention and land expropriations. It places UNIFIL’s current intervention in a long history of Western imperialism in the region. It underlines how UNIFIL weakens the Lebanese state by taking over the sovereign functions a state typically performs. It examines current border contestations in a context of Israeli settler colonialism and its long-term role in shaping the livelihoods in south Lebanese border villages. It argues for the importance of understanding border conflicts and the work of international interventions in their specific local and historical contexts.
39 Deep Learning and Mechanical Ventilation Period Based Inhalational Injury Score
Authors: Pang Alan , Li Yifan , Chong Jowoon 
Published: April 2024

Abstract

Introduction
Smoke inhalation is a serious complication associated with burn injuries. It notably increases mortality rates and prolongs hospital stays due to the thermal, chemical, and metabolic injuries inflicted on the airways by smoke. The current mainstream grading system, the Abbreviated Injury Score (AIS), a macroscopic evaluation of a microscopic disease process, has shown inconsistencies in accurately diagnosing and grading inhalation injury severity, largely due to its subjective nature. Our study aims to bridge these gaps by utilizing deep learning and artificial intelligence, proposing a novel method utilizing a Convolutional Neural Network (CNN) for more objective grading. Given the difficulty in collecting bronchoscopy images, we employed Contrastive Unpaired Translation (CUT) for data augmentation and conducted statistical analysis on lab work to pinpoint features impacting inhalation injury severity.

Methods
We categorize the inhalation injuries into 6 degrees based on ventilator days: 1) under 24 hours as degree 1, 2) 1-2 days as degree 2, 3) 3-7 days as degree 3, 4) 8-14 days as degree 4, 5) 15-30 days as degree 5, and 6) after 30 days as degree 6. To augment the dataset volume, graphic transformations, and Contrastive Unpaired Translation (CUT) were utilized. The augmented dataset was then evaluated using GoogLeNet, and a Random Forest algorithm was implemented to assess feature importance meticulously.

Results
Graphic transformations increased the image dataset from 153 to 1377 images, while Contrastive Unpaired Translation (CUT) further doubled the dataset to 2754 images. For evaluation, 30% of the original images were designated as the testing set and subjected to classification analysis via GoogLeNet. The enhancements through transformations and CUT propelled the classification accuracy from 36% (on original images) to a significant 91%. Statistical analysis highlighted that Total Body Surface Area (TBSA), Initial PH, Initial PaCO2, Pressors, Carboxyhemoglobin Level, and Resuscitation Fluid Amount Needed during the first 24 hours are pivotal determinants in assessing the severity of inhalation injuries.

Conclusions
This study underscores the potential of leveraging advanced computational techniques to ameliorate the accuracy of inhalation injury grading in burn victims. Through graphic transformations and Contrastive Unpaired Translation (CUT), a significant augmentation in the image dataset was achieved, facilitating a more robust analysis. The proposed methodology not only elevates the precision in grading inhalation injuries but also initiates a path towards more objective evaluations in clinical settings, thus aiding in better-informed medical interventions for burn victims.

Applicability of Research to Practice
If we can develop an objective measurement of inhalational injury with prognostic ability, then we can develop novel therapeutics and objectively measure their efficacy in treatment.
55 Assessing Pediatric Burn Wound Infection Using a Point-of-Care Autofluorescence Imaging Device
Authors: Turner Evan , Zuccaro Jennifer , Chakera Hawwa , Kelly Charis , Fish Joel 
Published: April 2024

Abstract

Introduction
Wound infection is the most common complication among pediatric burn patients and when not treated promptly, delayed healing, failure of skin grafts, or death can result. Standard burn wound assessment includes inspection for visual signs and symptoms of infection and microbial sampling. To aid in the assessment of burn wound infection, a point-of-care autofluorescence imaging device was introduced at the study institution in 2020. This imaging device uses violet light to illuminate the wound bed causing clinically relevant quantities of bacteria to fluoresce in real-time. The objectives of this study were to evaluate the role of the autofluorescence imaging device in the management of pediatric burn wounds and determine if the imaging findings corresponded to visual signs and symptoms of infection and/or microbial sampling.

Methods
A retrospective review of patients aged 0-18 years who had their burn wounds assessed with the autofluorescence imaging device between 2020-11-01 and 2023-06-08 was conducted. All imaged wounds were inspected for visual signs and symptoms of infection and had swabs collected for the purpose of microbial sampling. Sensitivity and specificity analyses were carried out on a subset of wounds that were imaged after initial wound cleaning was performed.

Results
Data were extracted from the medical records of 178 eligible burn patients with 218 wounds imaged. The mean age of patients was 3.2 years (SD 3.7), and most burns were partial thickness (78%) and due to scalds (81%). Fluorescence was detected by imaging in 16% of wounds, while 11% of wounds had visual signs and symptoms of infection and 16% had positive wound swab findings. Autofluorescence imaging corresponded with visual signs and symptoms of infection in 81% of wounds and microbial findings in 82% of wounds. Sixty-three patients with 77 wounds were included in sensitivity and specificity analyses. Relative to visual signs and symptoms of infection alone, combining autofluorescence imaging with visual signs and symptoms of infection resulted in a 39% increase in sensitivity and 19% decrease in specificity.

Conclusions
Autofluorescence imaging correlates well with visual signs and symptoms of infection and microbial sampling in pediatric burn wounds and complements inspection for visual signs and symptoms of infection by improving detection.

Applicability of Research to Practice
Incorporation of this autofluorescence imaging device in standard burn wound assessments can augment identification of wound infections, which can enhance diagnostic confidence at the point-of-care and ultimately improve wound healing outcomes.
59 Prevalence, Risk Factors, and Outcomes Associated with Food Insecurity in a Burn Clinic
Authors: Ross Erin E , Fobar Megan C , Gomez Laura Herrera , Gillenwater Justin , Yenikomshian Haig A 
Published: April 2024

Abstract

Introduction
Adequate nutrition in burn care is paramount to wound healing. As a result, food insecurity may pose a significant risk to burn patients. Due to increased caloric need, burn patients may be at increased risk for food insecurity. Here, we assess food insecurity prevalence, risk factors, and possible associated complications of wound healing.

Methods
Adult patients at a outpatient burn clinic answered the US Department of Agriculture Household Food Security Survey Module and questions about employment status and supplemental food resource use. Clinical data was abstracted from the medical record. Wound complication was defined as graft loss requiring regrafting or wound infection. Bivariate analysis by food security level was conducted by Chi-square, Fisher’s Exact test, or Mann-Whitney test. Association of age, race/ethnicity, total body surface area burned (TBSA), surgery count, hand or face burn, and unemployment to food insecurity were assessed by logistic regression, with significant predictors included in a multiple logistic regression model.

Results
104 patients completed surveys, with 44.3% of patients experiencing food insecurity in the past 12 months. Only 48.9% of food insecure patients were using any supplemental resources for food access. Among 88 patients with complete healing data, wound complications in food secure and insecure patients were 21.3% and 38.7% respectively, (p= .57, power = 43%). Of the 22 patients with wound complications, 45% had diabetes (p=.022, Chi-square). In our final regression model, food insecurity was associated with TBSA (p=.045) and unemployment (p =.0075).

Conclusions
Many patients are experiencing food insecurity during a time of increased metabolic need, and resources for food access are underutilized. Further research is needed to determine if food insecurity is associated with increased wound healing complications.

Applicability of Research to Practice
Screening for food insecurity should be a routine component of outpatient burn care, and processes to connect patients to benefits for which they may be eligible are also needed.
67 Methamphetamine-Positive Burn Patients: Not Just an Urban Problem
Authors: Proffitt Allison , Sojka John H , Heard Jason , Sen Soman , Palmieri Tina L , Greenhalgh David G , Romanowski Kathleen S 
Published: April 2024

Abstract

Introduction
Our previous research on burn patients who test positive for methamphetamines (MA) demonstrated that these patients come from areas with higher rates of poverty and lower median incomes. Our current study sought to replicate our previous results as well as further examine the communities from which our patients come with respect to their Social Vulnerability Index and Rural vs. Urban background. We hypothesized that MA-positive patients at our regional burn center would come from more highly disadvantaged urban areas.

Methods
Following IRB approval, a retrospective chart review was conducted using electronic medical records for burn patients admitted from January 2015 to December 2019. MA-positive patients were matched with MA-negative patients based on age and total body surface area (TBSA) burn. Data on Poverty levels, Median Income, Social Vulnerability Index (SVI), and Rural-Urban Commuting Areas were determined using patients’ home zip codes. Analysis was conducted with SAS statistical software, version 9.4 (SAS Institute, Cary, NC, USA) using Student t-test, Chi-square, Fisher Exact, and Wilcoxon 2-sample tests. Results are presented as median (interquartile range).

Results
We matched 107 MA-positive patients with 107 MA-negative controls based on TBSA burn and age. The median age of all patients was 49 (20) years old, and the median burn size was 22.3% (32.5). MA-positive patients experienced higher rates of Poverty (21.4% (13.1) vs 12.8% (12.4); p&lt; 0.0001), increased SVI (0.74 (0.42) vs 0.55 (0.47); p=0.0002) and lower Median Incomes ($49,520 (23,447) vs $59,693 (32,075); p&lt; 0.0001) than their MA-negative counterparts. There was no significant difference between Urban and Rural backgrounds for MA-positive and MA-negative patients (p=0.6). Most MA-positive patients came from Urban locations (16.82% Rural vs. 83.18% Urban), as did most MA-negative patients (19.63% Rural vs. 80.37% Urban). Meth-positive patients were more likely to sustain burns in an incident of suspected assault or abuse (7 vs. 2 patients) and less likely to be burned in a work-related incident (1 vs. 13 patients). Despite these differences in socioeconomic status, MA-positive patients had no significant increase in Length of Stay, Hospital Charges, or Mortality.

Conclusions
MA-positive patients come from both rural and urban areas, areas with increased poverty, lower median incomes, and increased social vulnerability when compared to MA-negative patients. Despite this MA use, by itself, does not appear to change outcomes following burn injury.

Applicability of Research to Practice
Patients with MA use come from both rural and urban areas and are often more socially disadvantaged than patients who do not use MA. These factors should be considered in inpatient care, disposition, and follow-up plans.