bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deliberate Practice and Process Analysis in DIEP Flap Breast Reconstruction: An Immediate and Sustained Decrease in Morbidity and Operative Time
Authors: Haddock Nicholas T. , Tycher John T. , Teotia Sumeet S. 
Published: March 2023

Background:
DIEP flaps are nuanced, multi-step complex procedures. Recent studies have hinted that operational flow can be a sensitive barometer for safety, efficiency and overall outcomes. We critically assess the utility of implementing deliberate practice and process mapping as a research tool in the context of morbidity and operative time.

Methods:
Co-surgeons at a university hospital implemented deliberate practice and performed two prospective process analysis studies evaluating critical steps in DIEP flap reconstruction. During the 9-month period (June 2018-February 2019), the flap harvest and microsurgery steps were assessed. During the 8-month period (January-August 2020), the analysis was expanded to encompass the entire operation. To evaluate the immediate and sustained impact of process analysis, 375 bilateral DIEP flap patients were divided into eight consecutive 9-month intervals completed before, during and after the two studies. Using risk-adjusted multivariate regressions morbidity and operative time was compared between groups.

Results:
Time intervals completed prior to the first study had comparable morbidity and operative time. During the first study, there is an immediate 83.8% (p<.001) decrease risk in morbidity. Operative time during the second study decreased by 2.19 hours (p<.001). Morbidity and operative time continue to decrease until the end of data collection (62.1% decrease risk in morbidity, p=.023 and 2.22 hours, p<.001).

Conclusions:
Deliberate practice and process analysis are powerful tools. Implementation of these tools can generate immediate and sustained decreases in morbidity and operative time for patients in procedures such as DIEP flap breast reconstruction.
Tricuspid Regurgitation After Heart Transplantation: The Cause or the Result of Graft Dysfunction?
Authors: Bart Nicole K. , Hungerford Sara L. , Namasivayam Mayooran , Granger Emily , Conellan Mark , Kotlyar Eugene , Muthiah Kavitha , Jabbour Andrew , Hayward Christopher , Jansz Paul C. , Keogh Anne M. , Macdonald Peter S. 
Published: March 2023

Background.
Tricuspid regurgitation (TR) is common following heart transplantation and has been shown to adversely influence patient outcomes. The aim of this study was to identify causes of progression to moderate–severe TR in the first 2 y after transplantation.

Methods.
This was a retrospective, single-center study of all patients who underwent heart transplantation over a 6-y period. Transthoracic echocardiogram (TTE) was performed at month 0, between 6 and 12 mo, and 1–2 y postoperatively to determine the presence and severity of TR.

Results.
A total of 163 patients were included, of whom 142 underwent TTE before first endomyocardial biopsy. At month 0, 127 (78%) patients had nil–mild TR before first biopsy, whereas 36 (22%) had moderate–severe TR. In patients with nil–mild TR, 9 (7%) progressed to moderate–severe TR by 6 mo and 1 underwent tricuspid valve (TV) surgery. Of patients with moderate–severe TR before first biopsy, by 2 y, 3 had undergone TV surgery. The use of postoperative extracorporeal membrane oxygenation (ECMO) in the latter group was significant (78%; P < 0.05) as was rejection profile (P = 0.02). Patients with late progressive moderate–severe TR had a significantly higher 2-y mortality than those who had moderate–severe TR immediately.

Conclusions.
Overall, our study has shown that in the 2 main groups of interest (early moderate–severe TR and progression from nil–mild to moderate–severe TR), TR is more likely to be the result of significant underling graft dysfunction rather than the cause of it.
Effects of Exercise on Testosterone and Implications of Drug Abuse: A Review
Authors: Perreault Brendan , Hammond Nikki , Thanos Panayotis K. 
Published: March 2023

Objective
Research points to exercise having a positive effect in fighting relapse and use of drugs of abuse. Through conducting this research, differences have been observed in the effects of exercise on drug abuse between sexes. Many of the studies found that exercise tends to cause a more profound effect in blocking drug relapse or reinstatement in males when compared with females.

Methods
Our hypothesis is that these differences in response to drugs of abuse after an exercise regimen could in part be attributed to variations in testosterone levels between males and females.

Results
Testosterone has been shown to have a modulatory impact on the dopaminergic activity in the brain, causing an effect on the brain's response to drugs of abuse. Exercise has demonstrated a causal effect on increasing testosterone levels in males, whereas drugs of abuse decrease testosterone levels in males.

Conclusions
Thus, exercise raising testosterone levels in males helps to decrease the dopaminergic response in the brain to drugs of abuse causing attenuation to drugs. To find sex-specific exercise treatments for drugs of abuse, it is important to continue researching exercise's efficacy against drugs of abuse.
Multiple Sleep Latency Test/Maintenance of Wakefulness Test and Central Hypersomnias: Evolving Diagnostic and Therapeutic Approaches
Authors: Sampat Ajay C. , Avidan Alon Y. 
Published: March 2023

Summary:
Central disorders of hypersomnolence include a spectrum of conditions, such as narcolepsy, idiopathic hypersomnia, and Kleine–Levin syndrome, in which excessive daytime sleepiness is the primary feature. Subjective testing with tools, such as sleep logs and sleepiness scales, are often helpful in the evaluation of these disorders but do not necessarily correlate well with objective testing, such as polysomnography and multiple sleep latency test and maintenance of wakefulness test. The most recent International Classification of Sleep Disorders-Third Edition has incorporated biomarkers, such as cerebrospinal fluid hypocretin level, into the diagnostic criteria and have restructured the classification of conditions based on our evolved understanding of their underlying pathophysiologic mechanisms. Therapeutic approaches largely consist of behavioral therapy, with a focus on optimizing sleep hygiene, optimizing opportunity for sleep, and strategic napping, along with judicious use of analeptic and anticataleptic agents when necessary. Emerging therapy has revolved around hypocretin-replacement therapy, immunotherapy, and nonhypocretin agents, with the goal of better targeting the underlying pathophysiology of these disorders rather than addressing symptoms. The most novel treatments have targeted the histaminergic system (pitolisant), dopamine reuptake transmission (solriamfetol), and gamma-aminobutyric acid modulation (flumazenil and clarithromycin) to promote wakefulness. Continued research is required for a more solid understanding of the biology of these conditions to develop a more robust armamentarium of therapeutic options.
A Concise Review of Polysomnography and Obstructive Sleep Apnea for the Neurophysiologist
Authors: Soltis Marjorie E. , Spector Andrew R. 
Published: March 2023

Summary:
Sleep as an electrical phenomenon in the brain was first recorded in 1875. Over the next 100 years, recordings of sleep evolved into modern-day polysomnography, which includes not only electroencephalography but also combinations of electro-oculography, electromyography, nasal pressure transducers, oronasal airflow monitors, thermistors, respiratory inductance plethysmography, and oximetry. The most common usage of polysomnography is to identify obstructive sleep apnea (OSA). Research has demonstrated that subjects with OSA have distinctive patterns detected by EEG. The evidence indicates that increased slow activity is seen in both sleep and wake for subjects with OSA and that these changes are reversible with treatment. This article reviews normal sleep, changes in sleep that result from OSA, and the effect that treatment of OSA via continuous positive airway pressure therapy has on normalizing the EEG. A review of alternative OSA treatment options is included, although their effects on EEG in OSA patients have not been studied.
Face2face: advancing the science of social interaction
Authors: Hamilton Antonia F de C. , Holler Judith 
Published: March 2023

Face-to-face interaction is core to human sociality and its evolution, and provides the environment in which most of human communication occurs. Research into the full complexities that define face-to-face interaction requires a multi-disciplinary, multi-level approach, illuminating from different perspectives how we and other species interact. This special issue showcases a wide range of approaches, bringing together detailed studies of naturalistic social-interactional behaviour with larger scale analyses for generalization, and investigations of socially contextualized cognitive and neural processes that underpin the behaviour we observe. We suggest that this integrative approach will allow us to propel forwards the science of face-to-face interaction by leading us to new paradigms and novel, more ecologically grounded and comprehensive insights into how we interact with one another and with artificial agents, how differences in psychological profiles might affect interaction, and how the capacity to socially interact develops and has evolved in the human and other species. This theme issue makes a first step into this direction, with the aim to break down disciplinary boundaries and emphasizing the value of illuminating the many facets of face-to-face interaction.
This article is part of a discussion meeting issue ‘Face2face: advancing the science of social interaction’.
Intertwining the social and the cognitive loops: socially enactive cognition for human-compatible interactive systems
Authors: Kahl Sebastian , Kopp Stefan 
Published: March 2023

It is increasingly important for technical systems to be able to interact flexibly, robustly and fluently with humans in real-world scenarios. However, while current AI systems excel at narrow task competencies, they lack crucial interaction abilities for the adaptive and co-constructed social interactions that humans engage in. We argue that a possible avenue to tackle the corresponding computational modelling challenges is to embrace interactive theories of social understanding in humans. We propose the notion of socially enactive cognitive systems that do not rely solely on abstract and (quasi-)complete internal models for separate social perception, reasoning and action. By contrast, socially enactive cognitive agents are supposed to enable a close interlinking of the enactive socio-cognitive processing loops within each agent, and the social-communicative loop between them. We discuss theoretical foundations of this view, identify principles and requirements for according computational approaches, and highlight three examples of our own research that showcase the interaction abilities achievable in this way.This article is part of a discussion meeting issue ‘Face2face: advancing the science of social interaction’.
Self-Configuring Capsule Networks for Brain Image Segmentation
Authors: Avesta Arman , Hossain Sajid , Aboian Mariam , Krumholz Harlan M. , Aneja Sanjay 
Published: March 2023

AbstractWhen an auto-segmentation model needs to be applied to a new segmentation task, multiple decisions should be made about the pre-processing steps and training hyperparameters. These decisions are cumbersome and require a high level of expertise. To remedy this problem, I developed self-configuring CapsNets (scCapsNets) that can scan the training data as well as the computational resources that are available, and then self-configure most of their design options. In this study, we developed a self-configuring capsule network that can configure its design options with minimal user input. We showed that our self-configuring capsule netwrok can segment brain tumor components, namely edema and enhancing core of brain tumors, with high accuracy. Out model outperforms UNet-based models in the absence of data augmentation, is faster to train, and is computationally more efficient compared to UNet-based models.
Leisure time sedentary behaviour and risks of breast, colorectal, and prostate cancer: A Mendelian randomization analysis
Authors: Papadimitriou Nikos , Kazmi Nabila , Dimou Niki , Tsilidis Konstantinos K , Martin Richard M , Lewis Sarah J , Lynch Brigid M , Hoffmeister Michael , Kweon Sun-Seog , Li Li , Milne Roger L , Sakoda Lori C , Schoen Robert E , Phipps Amanda I , Figueiredo Jane C , Peters Ulrike , Dixon-Suen Suzanne C. , Gunter Marc J , Murphy Neil 
Published: March 2023

AbstractSedentary behaviours have been associated with increased risks of some common cancers in epidemiological studies; however, it is unclear if these associations are causal. We examined potential causal associations between self-reported leisure television watching and computer use and risks of breast, colorectal, and prostate cancer using a two-sample Mendelian randomization framework. Genetic variants were identified from a recent genome-wide association study (GWAS). Cancer data were obtained from cancer GWAS consortia. Additional sensitivity analyses were applied to examine the robustness of the results. A 1-standard deviation increment in hours of television watching increased risk of breast (OR: 1.15, 95% confidence interval [CI]: 1.05,1.26) and colorectal cancer (OR: 1.32, 95%CI: 1.16,1.49) with little evidence of an association for prostate cancer risk. In multivariable models adjusted for years of education, the effect estimates for television watching were attenuated (breast cancer, OR: 1.08, 95%CI: 0.92,1.27; colorectal cancer, OR: 1.08, 95%CI: 0.90,1.31). Post-hoc analyses showed that years of education might have a possible confounding and mediating role in the association between television watching with breast and colorectal cancer. Consistent results were observed by sex (colorectal cancer), anatomical subsites, and cancer subtypes. There was little evidence of associations between computer use and cancer risk. We found evidence of positive associations between hours of television watching and risks of breast and colorectal cancer. However, these findings should be interpreted cautiously given the complex role of education. Future studies using objective measures of exposure can provide new insights into the possible role of sedentary behaviour in cancer development.Novelty and impactEvidence from observational studies that examined associations between sedentary behaviours and common cancers is mixed and causality is uncertain. In our Mendelian randomization analyses, higher levels of leisure television watching were found to increase the risks of breast and colorectal cancer, suggesting that the that the promotion of lowering sedentary behaviour time could be an effective strategy in the primary prevention of these commonly diagnosed cancers.Article categoryCancer Epidemiology
Virological evidence of the impact of non-pharmaceutical interventions against COVID-19 in a resource-limited setting
Authors: Moreira-Soto Andres , Bruno Alfredo , de Mora Doménica , Paez Michelle , Garces Jimmy , Wulf Ben , Sander Anna-Lena , Olmedo Maritza , Basantes Mantilla Maria José , Gonzalez Manuel , Nárvaez Alberto Orlando , Salgado Silvia , Zevallos Juan Carlos , Drexler Jan Felix 
Published: March 2023

AbstractEcuador was an early COVID-19 hotspot with substantial COVID-19-mortality. In developed countries, low socioeconomic status is associated with COVID-19 infection and low compliance with non-pharmaceutical interventions (NPIs). However, if NPI were successful in resource-limited settings with high human mobility and informal labour is still unclear. We performed a retrospective observational molecular and serological study of Ecuador’s reference laboratory. We tested 1,950 respiratory samples from COVID-19 surveillance for SARS-CoV-2 and 12 respiratory viruses using RT-PCR, characterized 642 SARS-CoV-2 genomes, and examined SARS-CoV-2 seroprevalence in 1,967 samples from patients with fever in Ecuador’s reference laboratory during 2020-2021. Molecular and serological data were compared to NPI stringency in Bayesian, maximum-likelihood and modelling frameworks.SARS-CoV-2 (Pearson correlation test; r=-0.74; p=0.01) and other respiratory viruses (r=-0.68; p=0.02) detection correlated negatively with NPI stringency. SARS-CoV-2 seroprevalence increased from <1% during February-March 2020 to 50% within 6 weeks and plateaued after NPI implementation. Decrease of effective reproduction number <1 and antibody reactivity over time suggested intense SARS-CoV-2 transmission during pandemic onset, subsequently limited by NPIs. Phylogeographic analyses revealed that travel restrictions were implemented late not preventing 100 near-parallel SARS-CoV-2 introductions, and implementation of NPIs modified SARS-CoV-2 geographic spread by restricting recreational activity. NPIs stringency correlated negatively with the number of circulating SARS-CoV-2 lineages (r=-0.69; p=0.02). Virological evidence supports NPIs restricting human movement as an effective public health tool to control the spread of respiratory pathogens in resource-limited settings, providing a template for emerging SARS-CoV-2 variants and future epidemics.
The Prevalence of Tuberculosis Infection Among Foreign-Born Canadians: A Modelling Study
Authors: Jordan Aria Ed , Nsengiyumva Ntwali Placide , Houben Rein M. G. J. , Dodd Peter J. , Dale Katie D. , Trauer James M. , Denholm Justin T. , Johnston James C. , Khan Faiz Ahmad , Campbell Jonathon R. , Schwartzman Kevin 
Published: March 2023

AbstractBackgroundThe prevalence of tuberculosis infection (TBI) is critical to designing tuberculosis (TB) prevention strategies, yet it is unknown in Canada. We estimated TBI prevalence among foreign-born Canadians.MethodsUsing a previously developed Gaussian process regression model, annual risk of infection trends abroad were constructed and used to estimate TBI prevalence by age and year of migration to Canada for persons from each of 168 countries. These stratified TBI prevalence estimates were combined with Canadian census data to estimate overall TBI prevalence among foreign-born residents during census years 2001, 2006, 2011, and 2016. We also estimated TBI prevalence according to age, WHO-estimated TB incidence in country of origin, and province/territory of residence. Finally, we estimated the prevalence of TBI acquired within the two preceding years.ResultsEstimated TBI prevalence among foreign-born Canadians overall was 25% (95% uncertainty interval [UI]: 20-35%), 24% (20-33%), 23% (19-30%), and 22% (19-28%) for census years 2001, 2006, 2011, and 2016, respectively. TBI prevalence increased with age at migration and TB incidence in the country of origin. In 2016, estimated TBI prevalence was lowest in Quebec (19%, 95% UI: 16-25) and highest in Alberta and British Columbia, at 24% each. Among all foreign-born Canadian residents with TBI in 2016, we estimated that only 1 in 440 were infected within the two preceding years.InterpretationApproximately 1 in 4 foreign-born Canadians has TBI; estimated prevalence has remained quite stable over the last two decades. However, a very small minority of people with TBI were infected within the last two years—the highest risk period for progression to TB disease. These data may inform future TBI screening policies.
Large Extracellular Vesicles Transfer Higher Levels of Prions and Infect Cell Culture Better than Small Extracellular Vesicles
Authors: Soukup Jakub , Moško Tibor , Kereïche Sami , Holada Karel 
Published: March 2023

AbstractPrions are responsible for a number of lethal neurodegenerative and transmissible diseases in humans and animals. Extracellular vesicles, especially small exosomes, have been extensively studied in connection with various diseases. In contrast, larger microvesicles are often overlooked. In this work, we compared the ability of large extracellular vesicles (lEVs) and small extracellular vesicles (sEVs) to spread prions in cell culture. We utilized CAD5 cell culture model of prion infection and isolated lEVs by 20,000 × g force and sEVs by 110,000 × g force. The lEV fraction was enriched in β-1 integrin with a vesicle size starting at 100 nm. The fraction of sEVs was depleted of β-1 integrin with a mean size of 79 nm. Both fractions were enriched in prion protein, but the lEVs contained a higher prion-converting activity. In addition, lEV infection led to stronger prion signals in both cell cultures, as detected by cell and western blotting. These results were verified on N2a-PK1 cell culture. Our data suggest the importance of lEVs in the trafficking and spread of prions over extensively studied small EVs.
Long noncoding RNA AL109754.1 Regulates Myeloid Dendritic Cell Differentiation and Potentiates TLR signaling
Authors: Naqvi Raza Ali , Valverde Araceli , Naqvi Afsar 
Published: March 2023

AbstractDendritic cells (DCs) are key antigen presentation cells (APC) that bridge innate and adaptive immune functions to contain the pathogenic threats. Long noncoding RNAs (lncRNAs) are implicated in functional regulation of various biological processes including inflammation and immunity. However, the knowledge on myeloid DC expressed lncRNA repertoire and their regulatory functions is limited. In this study, we have reconnoitered the time-kinetics of lncRNA expression profiles during monocyte-to-DC differentiation and their roles in shaping DC functions. Our RNA-seq data identified thousands of differentially expressed lncRNAs associated with primary human monocyte-to-DC differentiationin vitro. We selected two lncRNAsviz., AL109754.1 and AC093278.2 that were enriched during DC differentiation. Knockdown of AL109754.1 but not AC093278 affects DCs differentiation as observed by marked reduction of surface markers CD1a, CD93 and CD209. These DCs also exhibit significant reduction in the expression of TLR 2, 4, 5, 7 and 9, suggesting that AL109754.1 expression is critical in maintaining TLR expression in DCs. Furthermore, reduced phosphorylation of NF-κB, IRF3 and IRF7 in AL109754.1 knockdown DCs treated with TLR agonists further substantiate their role in potentiating TLR signaling. Mechanistically, AL109754.1 knockdown DC showed significant downregulation of multiple NF-κB-induced genes and time-dependent inhibition of pro-inflammatory cytokine (IL-1β, IL-6, IL-8 and TNFα) secretion upon challenge with TLR 4, 5, or 7 agonists. Overall, this study characterized novel functions of AL109754.1 that regulates DC differentiation, and TLR-dependent innate immune activation.