bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deceased donor kidney function is determined by branch chained amino acid metabolism during ex vivo normothermic perfusion
Authors: Ahmadi Armin , Yu Jacquelyn , Loza Jennifer E. , Howard Brian C. , Palma Ivonne , Than Peter A. , Goussous Naeem Makarm G , Sageshima Junichiro , Roshanravan Baback , Perez Richard V. 
Published: November 2023

AbstractCurrent kidney perfusion protocols are not optimized for addressing the ex vivo physiological and metabolic needs of the kidney. Ex vivo normothermic perfusion (EVNP) may be utilized to distinguish high-risk kidneys to determine suitability for transplantation. We assessed the association of tissue metabolic changes with changes in kidney injury biomarkers and functional parameters in eight deceased donor kidneys deemed unsuitable for transplantation during a 12- hour ex vivo normothermic perfusion (EVNP). The kidneys were grouped into good and poor performers based on blood flow and urine output. The mean age of the deceased kidney donors was 43±16 years with an average cold ischemia time of 37±12 hours. Urine output and creatinine clearance progressively increased and peaked at 6 hours post-perfusion among good performers. Poor performers had 71 ng/ml greater (95% CI 1.5, 140) urinary neutrophil gelatinase-associated lipocalin (NGAL) at 6 hours compared to good performers corresponding to peak functional differences. Organ performance was distinguished by tissue metabolic differences in branch- chained amino acid (BCAA) metabolism. Tissue BCAA levels negatively correlated with urine output among all kidneys at 6 hours. Tissue lipid profiling showed poor performers were highlighted by the accumulation of membrane structure components including glycerolipids and sphingolipids at early perfusion time points. Overall, we showed that 6 hours is needed for kidney functional recovery during ENVP and that BCAA metabolism may be a major determinant of organ function and resilience.
‘Look up from the waiting list and see the bigger picture’: A qualitative analysis of clinical specialist physiotherapist perspectives on low back pain care in Ireland
Authors: Murphy Cathriona , French Helen , McCarthy Geraldine , Cunningham Caitriona 
Published: November 2023

AbstractIntroductionHealthcare systems are struggling to deliver high-quality low back pain (LBP) care. In 2012 specialist physiotherapist-led musculoskeletal (MSK) triage services were introduced in Irish hospitals to expedite patient care and alleviate pressure on elective orthopaedic/ rheumatology consultant clinics. Specialist physiotherapists have expertise to inform health service improvement and reform, but their perspectives of LBP healthcare delivery have received scant attention.ObjectivesTo explore specialist physiotherapists’ perspectives on LBP care in Ireland, the barriers and facilitators to quality LBP care and the development of MSK interface services in primary care settings.DesignCross-sectional observational study using an anonymous electronic survey with thematic framework analysis of response data from open-ended questions.ParticipantsThirty-four clinical specialist physiotherapists in Irish MSK triage services.ResultsThematic analysis resulted in six overarching themes, grouped into two categories. One category pertained to LBP healthcare in Ireland with the following three themes: 1) Inadequate health services for patients with LBP; 2) Need for defined LBP clinical pathways; 3) Need for a multisectoral approach to spine health. Themes in the second category, pertaining to the development of community-based MSK interface services, were: 4) Concern regarding isolation from secondary care services; 5) Unrealistic expectations of MSK triage; 6) Improved communication and collaboration with primary care services.ConclusionSpecialist physiotherapists have concerns regarding LBP health services and persistence of a biomedical, secondary care-led approach. They advocate for investment in primary care multi-disciplinary teams, enhanced integration across primary and secondary care, development of a national clinical pathway and a multisectoral approach.
The impact of pre-existing eye donation awareness of the next of kin on donation rate after grief counseling - A cross-sectional study
Authors: Puri Oshin , Gupta Neeti , Mittal Sanjeev 
Published: November 2023

AbstractThis cross-sectional study was conducted to assess the impact of pre-existing eye donation awareness of the next of kin on the donation rate after grief counseling with due ethical approval. The N=164 most stable next-of-kin, mostly the Brother (20.7%) or Father (20.1%) of the deceased, were approached by the Eye Donation Counselor (EDC). After assessing their awareness about eye donation through the “Awareness and Perception on Eye Donation” questionnaire (Ronanki, V.R, et. al), the EDC grief counseled the next of kin. 84.8% of all participants were aware of eye donation. The mean awareness, knowledge, and perception scores of the study population were 2.46 +/- 1.34 out of 4, 2.73 +/- 2.37 out of 6, and 1.79 +/- 1.72 out of 4 respectively. Eye care professionals (N=105 (64%)) and mass media (N=61 (37.2%)) were identified as the most common sources of information. While 52.4% expressed willingness to donate, only 7.3% donated and there was 1 voluntary donation. Counseling and the belief of eye donation being a noble deed were identified as the major motivators, and objections by other family members, and religious beliefs were the major barriers. There is no significant association between eye donation and the pre-existing awareness of the next of kin regarding eye donation. Although awareness is associated with the increased willingness to donate eyes.
CD206 upregulation in monocytes within whole blood cultures correlates with lung function in Cystic Fibrosis: a pilot study
Authors: Singh Sonali , Longmate Jessica , Onion David , Williams Paul , Camara Miguel , Smyth Alan , Barr Helen , Martinez-Pomares Luisa 
Published: November 2023

AbstractChronic inflammation dominates disease pathogenesis in Cystic Fibrosis (CF) and there is a need to characterise CF immunity. Whole blood cultures offer a cost-effective and non-invasive approach to investigate immune responses within the host environment. Here we used whole blood cultures to investigate the differentiation potential of monocytes (CD45+CD14+ cells) in CF (N=10) and controls (N=8) in the presence and absence of exogenous macrophage-colony stimulatory factor (M-CSF) or granulocyte-macrophage (GM)-CSF with and without interleukin (IL)-4. In CF and control cultures, CD45+CD14+ cells upregulated HLA-DR expression in all instances, and increased CD206 in the presence of GM-CSF with and without IL-4, and CD209 in the presence of GM-CSF and IL-4. In CF, we consistently observed reduced upregulation of CD206 in response to GM-CSF and a positive correlation between CD206 expression and lung function (FEV1). This was unique to cultured monocytes, and not seen with any other marker. These results highlight the potential of whole blood cultures to reveal cellular characteristics in differentiating monocytes related to clinical parameters that could guide the identification of novel biomarkers in CF.
Assessing GPT-4 Multimodal Performance in Radiological Image Analysis
Authors: Brin Dana , Sorin Vera , Barash Yiftach , Konen Eli , Nadkarni Girish , Glicksberg Benjamin S , Klang Eyal 
Published: November 2023

AbstractObjectivesThis study aims to assess the performance of OpenAI’s multimodal GPT-4, which can analyze both images and textual data (GPT-4V), in interpreting radiological images. It focuses on a range of modalities, anatomical regions, and pathologies to explore the potential of zero-shot generative-AI in enhancing diagnostic processes in radiology.MethodsWe analyzed 230 anonymized emergency room diagnostic images, consecutively collected over one week, using GPT-4V. Modalities included ultrasound (US), computerized tomography (CT) and X-ray images. The interpretations provided by GPT-4V were then compared with those of senior radiologists. This comparison aimed to evaluate the accuracy of GPT-4V in recognizing the imaging modality, anatomical region, and pathology present in the images.ResultsGPT-4V identified the imaging modality correctly in 100% of cases (221/221), the anatomical region in 87.1% (189/217), and the pathology in 35.2% (76/216).However, the model’s performance varied significantly across different modalities, with anatomical region identification accuracy ranging from 60.9% (39/64) in US images to 97% (98/101) and 100% (52/52) in CT and X-ray images (p<0.001).Similarly, Pathology identification ranged from 9.1% (6/66) in US images to 36.4% (36/99) in CT and 66.7% (34/51) for X-ray images (p <0.001).These variations indicate inconsistencies in GPT-4V’s ability to interpret radiological images accurately.ConclusionWhile the integration of AI in radiology, exemplified by multimodal GPT-4, offers promising avenues for diagnostic enhancement, the current capabilities of GPT-4V are not yet reliable for interpreting radiological images. This study underscores the necessity for ongoing development to achieve dependable performance in radiology diagnostics.
Virtual and remote opioid poisoning education and naloxone distribution programs: a scoping review
Authors: dos Santos Bruna , Nipun Rifat Farzan , Subic Anna Maria , Kubica Alexandra , Rondinelli Nick , Marentette Don , Muise Joanna , Paes Kevin , Riley Meghan , Bhuiya Samiya , Crosby Jeannene , McBride Keely , Salter Joe , Orkin Aaron M. 
Published: November 2023

AbstractThe opioid poisoning crisis is a complex and multi-faceted global epidemic with far-reaching public health effects. Opioid Poisoning Education and Naloxone Distribution (OPEND) programs destigmatize and legitimize harm reduction measures while increasing participants’ ability to administer naloxone and other life-saving interventions in opioid poisoning emergencies. While virtual OPEND programs existed prior to the COVID-19 pandemic and were shown to be effective in improving knowledge of opioid poisoning response, they were not widely implemented and evaluated. The COVID-19 pandemic brought both urgent and sustained interest in virtual health services, including harm reduction interventions and OPEND programs.We aimed to assess the scope of literature related to fully virtual OPEND programming, with or without naloxone distribution, worldwide. A search of the literature was conducted and yielded 7,722 articles, of which 31 studies fit the inclusion criteria. Type and content of the educational component, duration of training, scales used, and key findings were extracted and synthesized. Our search shows that virtual and remote OPEND programs appear effective in increasing knowledge, confidence, and preparedness to respond to opioid poisoning events while improving stigma regarding people who use substances. This effect is shown to be true in a wide variety of populations but is significantly relevant when focused on laypersons. Interventions ranged from the use of videos, websites, telephone calls, and virtual reality simulations. A lack of consensus was found regarding the duration of the activity and the scales used to measure its effectiveness. Despite increasing efforts, access remains an issue, with most interventions addressing White people in urban areas. These findings provide insights for planning, implementation, and evaluation of future virtual and remote OPEND programs.Author SummaryFacing a global health challenge, the opioid poisoning crisis affects individuals across all communities, ages, and socioeconomic groups, leading to high fatality rates. Educational programs addressing opioid poisoning have emerged as life-saving and cost-effective interventions. This review focuses on these programs conducted in a virtual setting, eliminating the need for in-person contact between staff and participants. We have identified and summarized evidence about the outcomes of these programs, which may include naloxone distribution. Our findings offer valuable insights for planning, implementing, and evaluating such programs. Furthermore, we highlight gaps in current knowledge, paving the way for future research.
The development and validation of a survey to measure fecal-oral child exposure to zoonotic enteropathogens: The FECEZ Enteropathogens Index
Authors: Ballard April M. , Haardörfer Regine , Angulo Betty Corozo , Freeman Matthew C. , Eisenberg Joseph N.S. , Lee Gwenyth O. , Levy Karen , Caruso Bethany A. 
Published: November 2023

AbstractChild exposure to animal feces and associated enteropathogens contribute to a significant burden of disease in low- and middle-income countries. However, there are no standardized, validated survey-based approaches to enable accurate assessment of child exposure to zoonotic enteropathogens. We developed and validated a survey-based measure of fecal-oral child exposure to zoonotic enteropathogens, the FECEZ Enteropathogens Index. First, we identified critical attributes of child exposure through in-depth interviews (IDIs) in Ecuador among individuals who care for animals (n=29) and mothers of children under two years old (n=58), and through a systematic review of existing exposure measures. Second, based on these findings, we developed a 105-question survey and administered it to 297 mothers with children under age five. Third, we refined the survey, using principal component analysis to determine the optimal number of components. The final index consisted of 34 items across two sub-domains: the childEnvironmentand childBehavior. Lastly, we compared index scores to two commonly used, unvalidated measures of child exposure – maternal reported household animal ownership and presence of animal feces. Using the FECEZ Enteropathogens Index revealed varying degrees of exposure in our study population, with only two children having no exposure. In contrast, if we had used animal ownership or the presence of animal feces as a measure of exposure, 44% and 33% of children would have been classified as having no exposure, respectively. These common binary exposure measures may be inadequate because they do not provide sufficient information to identify the relative risk of zoonotic pathogen exposure. The FECEZ Enteropathogens Index overcomes this limitation, advancing our ability to assess exposure by quantifying the multiple components of child exposure to zoonotic enteropathogens with higher resolution. Additional testing and evaluation of the index is needed to ensure its reliability, validity, and cross-cultural equivalence in other contexts.
Prognostic value of the mitral E/e’ ratio during exercise in asymptomatic patients with low-gradient severe aortic stenosis and preserved ejection fraction
Authors: Miyahara Daisuke , Izumo Masaki , Sato Yukio , Shoji Tatsuro , Murata Risako , Oda Ryutaro , Okuno Taishi , Kuwata Shingo , Akashi Yoshihiro J 
Published: November 2023

AbstractBackgroundCurrent evidence on the prognostic value of exercise stress echocardiography (ESE) in asymptomatic patients with low-gradient severe AS is limited. Therefore, this study aimed to elucidate its prognostic implications for patients with low-gradient severe AS and determine the added value of ESE in risk stratification for this population.MethodsThis retrospective observational study included 122 consecutive asymptomatic patients with either moderate (mean pressure gradient [MPG] <40 mmHg and aortic valve area [AVA] 1.0–1.5 cm2) or low-gradient severe (MPG <40 mmHg and AVA <1.0 cm2) AS and preserved left ventricular ejection fraction (≥50%) who underwent ESE. All patients were followed up for AS-related events.ResultsOf 143 patients, 21 who met any exclusion criteria, including early interventions, were excluded, and 122 conservatively managed patients (76.5 [71.0–80.3] years; 48.3% male) were included in this study. During a median follow-up period of 989 (578–1571) days, 64 patients experienced AS-related events. Patients with low-gradient severe AS had significantly lower event-free survival rates than those with moderate AS (log-rank test, p<0.001). Multivariable Cox regression analysis showed that the mitral E/e’ ratio during exercise was independently associated with AS-related events (hazard ratio=1.075, p<0.001) in patients with low-gradient severe AS.ConclusionsThis study suggests that asymptomatic patients with low-gradient severe AS have worse prognoses than those with moderate AS. Additionally, the mitral E/e’ ratio during exercise is a useful parameter for risk stratification in patients with low-gradient severe AS.Clinical PerspectiveAortic stenosis (AS) is increasingly prevalent in aging society, and risk stratification of patients with low-gradient severe AS and preserved ejection fraction remains controversial. Exercise testing has been useful for identifying symptoms or abnormal hemodynamic responses during exercise in patients with asymptomatic AS. Limited evidence supports exercise stress echocardiography (ESE) as a valuable tool for evaluating asymptomatic AS. This study investigated the prognoses of patients with low-gradient severe AS and the utilization of ESE for risk stratification of these patients. Patients with low-gradient severe AS had worse prognoses than those with moderate AS. The mitral E/e’ ratio during exercise can be utilized as a parameter for risk stratification of patients with low-gradient severe AS.
Feature analysis of joint motion while reaching the occiput in patients with mild hemiplegia: a cross-sectional study
Authors: Sakamoto Daigo , Hamaguchi Toyohiro , Kanemura Naohiko , Yasojima Takashi , Kubota Keisuke , Suwabe Ryota , Nakayama Yasuhide , Abo Masahiro 
Published: November 2023

AbstractThis cross-sectional study aimed to clarify the kinematic characteristics of reaching the occiput in patients with mild hemiplegia. Ten patients with post-stroke hemiplegia who attended the Department of Rehabilitation Medicine of the Jikei University Hospital and met the eligibility criteria were included. Reaching motion to the back of the head by the participants’ paralyzed and non-paralyzed upper limbs was measured using three-dimensional motion analysis, and the motor time, joint angles, and angular velocity were calculated. Multivariate analysis of covariance was performed on these data. After confirming the fit to the binomial logistic regression model, the cutoff values were calculated using the receiver operating characteristic curve. The cutoff values for the movement until the hand reached the back of the head were 1.6 s for the motor time, 55° for the maximum shoulder joint flexion angle, and 145° for the maximum elbow joint flexion angle. The cutoff values for the movement from the back of the head to the hand being returned to its original position were 1.6 s for the motor time, 145° for the maximum elbow joint flexion angle, 53°/s for the maximum angular velocity of shoulder joint abduction, and 62°/s for the maximum angular velocity of elbow joint flexion. The numbers of clusters were three, four, and four for the outward non-paralyzed side, outward and return paralyzed side, and return non-paralyzed side, respectively. The findings obtained by this study can be used for practice planning in patients with mild hemiplegia who aim to improve the reaching motion to the occiput.
The unusual structural properties and potential biological relevance of switchback DNA
Authors: Madhanagopal Bharath Raj , Talbot Hannah , Rodriguez Arlin , Louis Jiss Maria , Zeghal Hana , Vangaveti Sweta , Reddy Kaalak , Chandrasekaran Arun Richard 
Published: November 2023

AbstractSynthetic DNA motifs form the basis of nucleic acid nanotechnology, and their biochemical and biophysical properties determine their applications. Here, we present a detailed characterization of switchback DNA, a globally left-handed structure composed of two parallel DNA strands. Compared to a conventional duplex, switchback DNA shows lower thermodynamic stability and requires higher magnesium concentration for assembly but exhibits enhanced biostability against some nucleases. Strand competition and strand displacement experiments show that component sequences have an absolute preference for duplex complements instead of their switchback partners. Further, we hypothesize a potential role for switchback DNA as an alternate structure in sequences containing short tandem repeats. Together with small molecule binding experiments and cell studies, our results open new avenues for switchback DNA in biology and nanotechnology.
Visual interpretability of image-based classification models by generative latent space disentanglement applied to in vitro fertilization
Authors: Rotem Oded , Schwartz Tamar , Maor Ron , Tauber Yishay , Tsarfati Shapiro Maya , Meseguer Marcos , Gilboa Daniella , Seidman Daniel S. , Zaritsky Assaf 
Published: November 2023

AbstractThe success of deep learning in identifying complex patterns exceeding human intuition comes at the cost of interpretability. Non-linear entanglement of image features makes deep learning a “black box” lacking human meaningful explanations for the models’ decision. We present DISCOVER, a generative model designed to discover the underlying visual properties driving image-based classification models. DISCOVER learns disentangled latent representations, where each latent feature encodes a unique classification-driving visual property. This design enables “human-in-the-loop” interpretation by generating disentangled exaggerated counterfactual explanations. We apply DISCOVER to interpret classification of in-vitro fertilization embryo morphology quality. We quantitatively and systematically confirm the interpretation of known embryo properties, discover properties without previous explicit measurements, and quantitatively determine and empirically verify the classification decision of specific embryo instances. We show that DISCOVER provides human-interpretable understanding of “black-box” classification models, proposes hypotheses to decipher underlying biomedical mechanisms, and provides transparency for the classification of individual predictions.
Evidence that recent climatic changes have expanded the potential geographical range of the Mediterranean fruit fly
Authors: Szyniszewska Anna M. , Bieszczak Hanna , Kozyra Karol , Papadopoulos Nikos T. , Meyer Marc De , Nowosad Jakub , Ota Noboru , Kriticos Darren J. 
Published: November 2023

AbstractThe species distributions migration poleward and into higher altitudes in a warming climate is especially concerning for economically important insect pest species, as their introduction can potentially occur in places previously considered unsuitable for year-round survival. We explore the expansion of the climatically suitable areas for a horticultural pest, the Mediterranean fruit fly (medfly)Ceratitis capitata(Diptera, Tephritidae), with an emphasis on Europe and California. We reviewed and refined a published CLIMEX model forC. capitata, taking into consideration new records in marginal locations, with a particular focus on Europe. To assess the model fit and to aid in interpreting the meaning of the new European distribution records, we used a time series climate dataset to explore the temporal patterns of climate suitability forC. capitatafrom 1970 to 2019. At selected bellwether sites in Europe, we found statistically significant trends in increasing climate suitability, as well as a substantial northward expansion in the modelled potential range. In California, we also found a significant trend of northward and altitudinal expansion of areas suitable forC. capitataestablishment. These results provide further evidence of climate change impacts on species distributions and the need for innovative responses to increased invasion threats.