bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide or Homicide? A Case of Self-Inflicted Triple Gunshot Wound by Double-Barrel Shotgun
Authors: Tarozzi Ilaria , Bugelli Valentina 
Published: May 2023

Abstract
Differential diagnosis between suicide and homicide by firearms is still a major challenge in forensic practice, especially when multiple gunshot wounds are present. A case of self-inflicted triple wound by double-barrel shotgun is presented. A 73-year-old White male patient was found dead in a wooden area. According to investigations, he had disappeared from home the day before. The corpse was covered with clothing in a prone position on a gravel road, a short distance from a car with driver-side-door open and keys in the ignition. Next to the body, a 12-gauge double-barrel shotgun was found, with 3 fired cartridges and 1 unused in the left front pocket of the trousers. No signs of struggle were present. Two penetrating wounds in the upper torso were detected by postmortem computer tomography. Autopsy showed 2 near-contact entrance wounds in the pectoral region bilaterally, each associated with exit wounds in the omni lateral hip. Only organs of “delayed incapacitation” were injured. Death was determined to be a suicide. This uncommon case of self-inflicted triple wound by shotgun highlights the importance to integrate proper analysis of the scene with autopsy findings in order to avoid misinterpretation of a suicidal death as a homicide.
Influencing the insulin system by placebo effects in patients with diabetes type-2 and healthy controls: A randomized controlled trial
Authors: Skvortsova Aleksandrina , Veldhuijzen Dieuwke S. , van Dillen Lotte F. , Zech Hilmar , Derksen Suzanne M.J.C. , Sars Ruben H. , Meijer Onno C. , Pijl Hanno , Evers Andrea W.M. 
Published: May 2023

Abstract

Objective
The objective of this study was to investigate whether placebo effect induced by pharmacological conditioning with intranasal insulin can affect glucose, insulin, c-peptide, hunger and memory in patients with diabetes type-2 and healthy controls.

Methods
Placebo effect was induced by pharmacological conditioning. Thirty-two older patients (mean age = 68.3) with diabetes type-2 and age and sex matched thirty-two healthy older adults (mean age = 67.8) were randomly assigned to a conditioned or a control group. On day 1, conditioned group received 6 administrations of intranasal insulin with a CS (smell of rosewood oil) while the control group received a placebo with the CS. On day 2, both groups received a placebo spray with the CS. Glucose, insulin and c-peptide were repeatedly measured in blood. Hunger and memory were assessed with validated measures.

Results
Intranasal insulin stabilized dropping glucose levels in patients (B = 0.03, SE = 0.02, p = 0.027) and healthy men (B = 0.046, SE = 0.02, p = 0.021), and decreased C-peptide levels in healthy controls (B = 0.01, SE = 0.001, p = 0.008). Conditioning also prevented the drop of glucose levels but only in men (both healthy and patients) (B = 0.001, SE = 0.0003, p = 0.024). Conditioning significantly decreased hunger in healthy participants (B = 0.31, SE = 0.09, p < 0.001). No effects were found on other measures.

Conclusions
Placebo effect induced by conditioning with intranasal insulin modify blood glucose levels and decrease hunger in older adults but its effects depend on health status and sex. Insulin conditioning might be beneficial for groups suffering from intensive hunger but seems not be particularly suitable for blood glucose reduction.

Trial registration. Netherlands Trial Register, NL7783 (https://www.trialregister.nl/trial/7783).
Patient-Reported Quality of Life after Breast Conserving Surgery with Radiotherapy versus Mastectomy and Reconstruction
Authors: Diao Kevin , Lei Xiudong , He Weiguo , Jagsi Reshma , Giordano Sharon H. , Smith Grace L. , Caudle Abigail , Shen Yu , Peterson Susan , Smith Benjamin D. 
Published: May 2023

Objective:
To compare long-term QOL outcomes in breast cancer survivors who received breast conserving surgery with radiotherapy (BCS+RT) with those who received mastectomy and reconstructive surgery (Mast+Recon) without RT and identify other important factors.

Summary Background Data:
The long-term differences in patient-reported QOL outcomes following BCS+RT and Mast+Recon are not well understood.

Methods:
We identified patients from the Texas Cancer Registry with stage 0-II breast cancer diagnosed 2009-2014 after BCS+RT or Mast+Recon without RT. Sampling was stratified by age and race and ethnicity. A paper survey was sent to 4,800 patients which included validated BREAST-Q and PROMIS modules. Multivariable linear regression models were implemented for each outcome. Minimal clinically important difference for BREAST-Q and PROMIS modules, respectively, was 4 points and 2 points.

Results:
Of 1,215 respondents (25.3% response rate), 631 received BCS+RT and 584 received Mast+Recon. The median interval from diagnosis to survey completion was 9 years. In adjusted analysis Mast+Recon was associated with worse BREAST-Q psychosocial well-being (effect size −3.80, P=0.04) and sexual well-being (effect size −5.41, P=0.02), but better PROMIS physical function (effect size 0.54, P=0.03) and similar BREAST-Q satisfaction with breasts, physical well-being, and PROMIS upper extremity function (P>0.05) compared to BCS+RT. Only the difference in sexual well-being reached clinical significance. Older (≥65) patients receiving BCS+RT and younger (<50) patients receiving autologous Mast+Recon typically reported higher QOL scores. Receipt of chemotherapy was associated with detriments to multiple QOL domains.

Conclusions:
Patients who underwent Mast+Recon reported worse long-term sexual well-being compared to BCS+RT. Older patients derived a greater benefit from BCS+RT while younger patients derived a greater benefit from Mast+Recon. These data inform preference-sensitive decision making for women with early-stage breast cancer.
Utilizing Simulation to Evaluate Robotic Skill Acquisition and Learning Decay
Authors: Liu Shinban , Watkins Kayla , Hall Caroline E. , Liu Yuki , Lee Shih-Hao , Papandria Dominic , Delman Keith A. , Srinivasan Jahnavi , Patel Ankit , Davis S. Scott , Lin Edward , Stetler Jamil 
Published: May 2023

Background:
We aim to evaluate how new robotic skills are acquired and retained by having participants train and retest using exercises on the robotic platform. We hypothesized that participants with a 3-month break from the robotic platform will have less learning decay and increased retention compared with those with a 6-month break.

Methods:
This was a prospective randomized trial in which participants voluntarily enrolled and completed an initial training phase to reach proficiency in 9 robot simulator exercises. They were then instructed to refrain from practicing until they retested either 3 or 6 months later. This study was completed at an academic medical center within the general surgery department. Participants were medical students, and junior-level residents with minimal experience in robotic surgery were enrolled. A total of 27 enrolled, and 13 participants completed the study due to attrition.

Results:
Overall, intragroup analysis revealed that participants performed better in their retest phase compared with their initial training in terms of attempts to reach proficiency, time for completion, penalty score, and overall score. Specifically, during the first attempt in the retesting phase, the 3-month group did not deviate far from their final attempt in the training phase, whereas the 6-month group experienced significantly worse time to complete and overall score in interrupted suturing {[−4 (−18 to 20) seconds vs. 109 (55 to 118) seconds, P=0.02] [−1.3 (−8 to 1.9) vs. −18.9 (−19.5 to (−15.0)], P=0.04} and 3-arm relay {[3 (−4 to 23) seconds vs. 43 (30 to 50) seconds, P=0.02] [0.4 (−4.6 to 3.1) vs. −24.8 (−30.6 to (−20.3)], P=0.01] exercises. In addition, the 6-month group had a significant increase in penalty score in retesting compared with the 3-month group, which performed similarly to their training phase [3.3 (2.7 to 3.3) vs. 0 (−0.8 to 1.7), P=0.03].

Conclusions:
This study identified statistically significant differences in learning decay, skills retention, and proficiency between 3-month and 6-month retesting intervals on a robotic simulation platform.
Cognitive Outcome After Islet Transplantation
Authors: Mailliez Aurélie , Ternynck Camille , Jannin Arnaud , Lemaître Madleen , Chevalier Benjamin , Le Mapihan Kristell , Defrance Frédérique , Mackowiak Marie-Anne , Rollin Adeline , Mehdi Maanaoui , Chetboun Mikael , Pattou François , Pasquier Florence , Vantyghem Marie-Christine 
Published: May 2023

Background.
Severe or repeated hypoglycemia events may favor memory complaints in type 1 diabetes (T1D). Pancreatic islet transplantation (IT) is an alternative option to exogenous insulin therapy in case of labile T1D, implying a maintenance immunosuppression regimen based on sirolimus or mycophenolate, associated with tacrolimus, that may also have neurological toxicity. The objective of this study was to compare a cognitive rating scale Mini-Mental State Examination (MMSE) between T1D patients with or without IT and to identify parameters influencing MMSE.

Methods.
This retrospective cross-sectional study compared MMSE and cognitive function tests between islet-transplanted T1D patients and nontransplanted T1D controls who were transplant candidates. Patients were excluded if they refused.

Results.
Forty-three T1D patients were included: 9 T1D patients before IT and 34 islet-transplanted patients (14 treated with mycophenolate and 20 treated with sirolimus). Neither MMSE score (P = 0.70) nor higher cognitive function differed between islet versus non–islet-transplanted patients, whatever the type of immunosuppression. In the whole population (N = 43), MMSE score was negatively correlated to glycated hemoglobin (r = –0.30; P = 0.048) and the time spent in hypoglycemia on the continuous glucose monitoring (r = –0.32; P = 0.041). MMSE score was not correlated to fasting C-peptide level, time spent in hyperglycemia, average blood glucose, time under immunosuppression, duration of diabetes, or beta-score (success score of IT).

Conclusions.
This first study evaluating cognitive disorders in islet-transplanted T1D patients argues for the importance of glucose balance on cognitive function rather than of immunosuppressive treatment, with a favorable effect of glucose balance improvement on MMSE score after IT.
The potential crosstalk genes andmolecular mechanismsbetweenintracranial aneurysm and periodontitis
Authors: Huang Jian-huang , Chen Yao , Kang Yuan-bao , Yao Zheng-jian , Song Jian-hua 
Published: May 2023

AbstractBackgroundThe risk of intracranial aneurysm (IAs) development and rupture is significantly higher in patients with periodontitis (PD), suggesting an association between the two. However, the specific mechanisms of association between these two diseases have not been fully investigated. The aim of this study was to investigate potential crosstalk genes, pathways between IAs and PD.MethodsWe downloaded IAs and PD data from the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were identified, and functional enrichment analysis was performed on these overlapping DEGs. The protein-protein interaction (PPI) network was constructed and the cytoHubba plugin was used to identify PPI key genes. Next, weighted gene co-expression network analysis (WGCNA) was performed. Subsequently, we validated the key crosstalk genes in 2 independent external datasets. In addition, the immune cell landscape was assessed and the correlation of key crosstalk genes with each immune cell was calculated. Finally, transcription factors (TFs) regulating key crosstalk genes were explored and their expression levels were further validated in the full dataset.Results127 overlapping DEGs were identified and functional enrichment analysis highlighted the important role of immune reflection in the pathogenesis. We identified ITGAX and COL4A2 as key crosstalk genes and the expression levels of them were significantly elevated in the test dataset and external validation dataset. In addition, the expression of multiple immune cells was significantly elevated in PDs and IAs compared to controls, and both key crosstalk genes were significantly negatively associated with Macrophages M2. Finally, GATA2 was identified as a potential key transcription factor (TF), which regulates two key crosstalk genes and was upregulated in expression in the full dataset.ConclusionThe present study identifies key crosstalk genes and TF in IAs and PD, providing new insights for further study of the co-pathogenesis of IAs and PD from an immune and inflammatory perspective.
Evolutionary rescue effect disappears under more realistic assumptions
Authors: Hinsch Martin , Robertson David L. , Silverman Eric 
Published: May 2023

AbstractIn a recent paper Zhang et al. [1] elegantly incorporate the evolution of inter-host virus fitness into an epidemiological model. They show that this leads to substantial changes in the system dynamics and in particular that evolution can “rescue” the pathogen population if the mutation rate is high enough. However, their model rests on the assumption that mutations that affect inter-host fitness are neutral on average. Here we show that under more realistic assumptions concerning the fitness distribution of mutations, the effect can easily disappear and higher mutation rates in fact reduce the likelihood of a pandemic.
Derivation of a prognostic model for critically ill children in locations with limited resources
Authors: Chandna Arjun , Keang Suy , Vorlark Meas , Sambou Bran , Chhingsrean Chhay , Sina Heav , Vichet Pav , Patel Kaajal , Habsreng Eang , Riedel Arthur , Mwandigha Lazaro , Koshiaris Constantinos , Perera-Salazar Rafael , Turner Paul , Chanpheaktra Ngoun , Turner Claudia 
Published: May 2023

AbstractBackgroundCapacity and demand for paediatric critical care are growing in many resource-constrained contexts. However, tools to support resource stewardship and promote sustainability of critical care services are lacking.MethodsThis study assessed the ability of nine severity scores to risk stratify children admitted to a paediatric intensive care unit (PICU) in Siem Reap, northern Cambodia. It then developed a bespoke clinical prediction model to enable risk stratification in resource-constrained PICU contexts. The primary outcome was death during PICU admission.Results1,550 consecutive PICU admissions were included, of which 97 (6.3%) died. Most existing severity scores achieved comparable discrimination (area under the receiver operating characteristic curves [AUCs] 0.71-0.76) but only three scores demonstrated moderate diagnostic utility for triaging admissions into high- and low-risk groups (positive likelihood ratios 2.65-2.97 and negative likelihood ratios 0.40-0.46). The newly derived model outperformed all existing severity scores (AUC 0.84, 95% CI 0.80-0.88; p < 0.001). Using one particular threshold, the model classified 13.0% of admissions as high-risk, amongst which probability of mortality was almost ten-fold greater than admissions triaged as low-risk (PLR 5.75; 95% CI 4.57-7.23 and NLR 0.47; 95% CI 0.37-0.59). Decision curve analyses indicated that the model would be superior to all existing severity scores and could provide utility across the range of clinically plausible decision thresholds.ConclusionsExisting paediatric severity scores have limited potential as risk stratification tools in resource-constrained PICUs. If validated, the prediction model developed herein would provide a readily implementable mechanism to support triage of critically ill children on admission to PICU and could be tailored to suit a variety of contexts where resource prioritisation is important.
Susceptibility of Simuliidae larvae (Diptera) to a new solid formulation based onBacillus thuringiensisvar.israelensis(Bti), and bioecological aspects of the breeding sites in Cascavel - Paraná, Brazil
Authors: Costa Lis Paula , Alves Luis Francisco Angeli , Zequi João Antônio Cyrino , Cardoso Priscilla de Freitas , Vilas Boas Gislayne Trindade , Marques Francisco A. , Schorr Renan R. , Andreazza Itamar Francisco , Molina Óscar Sánchez 
Published: May 2023

AbstractDue to the hematophagous habits of females, some species of black fly (Diptera, Simuliidae) are known to be responsible for economic losses and can cause significant damage to the health of human and livestock populations. To control populations of these insects, several bioinsecticides based on the bacteriumBacillus thuringiensisvar.israelensis(Bti) are widely used. The objective of the current study was to evaluate the susceptibility of black fly larvae to a new Bti solid effervescent formulation, comparing it with a commercial standard formulation, Vectobac® liquid formulation, under laboratory conditions. The study was carried out in the municipality of Cascavel, Paraná, Brazil. Eighteen hours after application of the formulations, larval mortality was evaluated. The control group did not exceed 20% mortality, for concentrations of 50 and 60 mg/L, the mean mortality rates were 50.6% and 64.2%, respectively, and neither differed significantly from the Vectobac®. The stream sampled showed external fecal contamination during the eight weeks of monitoring and water quality parameters that could interfere with the efficiency of the control with Bti at the site. The following species of black flies were collected and identified in the two watersheds sampled:Simulium pertinax, S. subpallidum, S. nigrimanum, S. rubrithorax, S. perflavum, andS. inaequale. Bioecological aspects of the breeding site were addressed and presented here, this being the first report of black fly species for the municipality of Cascavel. The potential of the solid effervescent formulation was proven under laboratory conditions and the bioecological evaluations demonstrated the relevance of environmental diagnosis and monitoring in the optimization of control protocols for Simuliidae.
Aging drives cerebrovascular network remodeling and functional changes in the mouse brain
Authors: Bennett Hannah C. , Zhang Qingguang , Wu Yuan-ting , Chon Uree , Pi Hyun-Jae , Drew Patrick J. , Kim Yongsoo 
Published: May 2023

AbstractAging is the largest risk factor for neurodegenerative disorders, and commonly associated with compromised cerebrovasculature and pericytes. However, we do not know how normal aging differentially impacts the vascular structure and function in different brain areas. Here we utilize mesoscale microscopy methods (serial two-photon tomography and light sheet microscopy) andin vivoimaging (wide field optical spectroscopy and two-photon imaging) to determine detailed changes in aged cerebrovascular networks. Whole-brain vascular tracing showed an overall ~10% decrease in vascular length and branching density, and light sheet imaging with 3D immunolabeling revealed increased arteriole tortuosity in aged brains. Vasculature and pericyte densities showed significant reductions in the deep cortical layers, hippocampal network, and basal forebrain areas. Moreover,in vivoimaging in awake mice identified delays in neurovascular coupling and disrupted blood oxygenation. Collectively, we uncover regional vulnerabilities of cerebrovascular network and physiological changes that can mediate cognitive decline in normal aging.Highlight-Brain-wide mapping of vasculature and pericyte changes with normal aging-Simplified vascular network with tortuous vessels in aged brains-Vascular rarefication in the deep cortical layers, hippocampus, and the basal forebrain-Slowed hemodynamic response in aged animals
Longitudinal host transcriptional responses to SARS-CoV-2 infection in adults with extremely high viral load
Authors: Avadhanula Vasanthi , Creighton Chad J. , Ferlic-Stark Laura , Sucgang Richard , Zhang Yiqun , Nagaraj Divya , Nicholson Erin G. , Rajan Anubama , Menon Vipin Kumar , Doddapaneni Harshavardhan , Muzny Donna Marie , Metcalf Ginger , Cregeen Sara Joan Javornik , Hoffman Kristi Louise , Gibbs Richard A , Petrosino Joseph , Piedra Pedro A 
Published: May 2023

AbstractCurrent understanding of viral dynamics of SARS-CoV-2 and host responses driving the pathogenic mechanisms in COVID-19 is rapidly evolving. Here, we conducted a longitudinal study to investigate gene expression patterns during acute SARS-CoV-2 illness. Cases included SARS-CoV-2 infected individuals with extremely high viral loads early in their illness, individuals having low SARS-CoV-2 viral loads early in their infection, and individuals testing negative for SARS-CoV-2. We could identify widespread transcriptional host responses to SARS-CoV-2 infection that were initially most strongly manifested in patients with extremely high initial viral loads, then attenuating within the patient over time as viral loads decreased. Genes correlated with SARS-CoV-2 viral load over time were similarly differentially expressed across independent datasets of SARS-CoV-2 infected lung and upper airway cells, from both in vitro systems and patient samples. We also generated expression data on the human nose organoid model during SARS-CoV-2 infection. The human nose organoid-generated host transcriptional response captured many aspects of responses observed in the above patient samples, while suggesting the existence of distinct host responses to SARS-CoV-2 depending on the cellular context, involving both epithelial and cellular immune responses. Our findings provide a catalog of SARS-CoV-2 host response genes changing over time.
Differentiation of related events in hippocampus supports memory reinstatement in development
Authors: Varga Nicole L. , Roome Hannah E. , Molitor Robert J. , Martinez Lucia , Hipskind Elizabeth M. , Mack Michael L. , Preston Alison R. , Schlichting Margaret L. 
Published: May 2023

AbstractAdults are capable of either differentiating or integrating similar events in memory based on which representations are optimal for a given situation. Yet how children represent related memories remains unknown. Here, children (7-10 years) and adults formed memories for separate yet overlapping events. We then measured how successfully remembered events were represented and reinstated using functional magnetic resonance imaging (fMRI). We found that children formed differentiated representations in hippocampus—such that related events were stored as less similar to one another compared to unrelated events. Conversely, adults formed integrated representations, wherein related events were stored as more similar, including in medial prefrontal cortex (mPFC). Furthermore, hippocampal differentiation among children and mPFC integration among adults tracked neocortical reinstatement of the specific features associated with the individual events. Together, these findings reveal that the same memory behaviors are supported by different underlying representations across development. Specifically, whereas differentiation underlies memory organization and retrieval in childhood, integration exhibits a protracted developmental trajectory.
Intact reinforcement learning in healthy ageing
Authors: Lin Wei-Hsiang , Clarke Aaron M. , Pilz Karin S. , Herzog Michael H. , Kunchulia Marina 
Published: May 2023

AbstractWhat does age in ageing? Results in reinforcement learning (RL) are mixed. Some studies found deteriorated performance in older participants compared to younger controls whereas other studies did not. Daniel et al. (2020) suggested that task demand can explain these differences, with less demanding tasks showing no effect of age. Here, we increased the task demand of previous studies turning them into a classic navigation task. We extracted 4 behavioral parameters and 2 parameters (learning and exploration rates) of a classic Q-learning model. Except for one specific parameter, all other parameters showed no group differences, i.e., RL turned out to be intact in older individuals also with higher task demands. It is important to publish such null results to avoid the stigmatizing impression of an overall performance deficit among older people.