bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep versus moderate neuromuscular blockade during total hip arthroplasty to improve postoperative quality of recovery and immune function: protocol for a randomised controlled study
Authors: Bijkerk Veerle , Visser Jetze , Jacobs Lotte M C , Keijzer Christiaan , Warlé Michiel C 
Published: August 2023

IntroductionThere is accumulating evidence that deep neuromuscular blockade (NMB) improves intraoperative surgical conditions during laparoscopic surgery. Studies investigating the effects of deep NMB in open surgery are scarce. In theory, by limiting surgical damage through deeper muscle relaxation, postoperative inflammation and concomitant immune suppression can be reduced. Therefore, this study will investigate the effects of deep NMB during total hip arthroplasty, which demands a relatively large exposure of the hip joint through and in between muscles.Methods and analysisThis study is a monocentre blinded randomised controlled trial in 100 patients undergoing total hip arthroplasty under general anaesthesia. Patients will be randomised in a 1:1 fashion to an intervention group of intraoperative deep NMB (a post-tetanic count of 1–2) or a control group receiving moderate NMB (a train-of-four count of 1–2). NMB will be achieved by continuous or bolus administration of rocuronium, respectively. The primary endpoint is the quality of recovery at postoperative day 1 measured by the Quality of Recovery-40 Questionnaire, analysed by Analysis of Variance. The secondary endpoint is postoperative innate immune function, measured byex vivoproduction capacity of tumour necrosis factor and interleukin-1β on endotoxin stimulation of whole blood.Ethics and disseminationEthical approval for this study was granted by the Medical Ethics Committee ‘METC Oost-Nederland’ (reference number 2022-15754). Informed consent will be obtained prior to study participation. Study results will be published in an international peer-reviewed journal.Trial registration numbersClinicalTrials.gov Registry (NCT05562999) and EudraCT Registry (2022-002451-19).
SocialBit: protocol for a prospective observational study to validate a wearable social sensor for stroke survivors with diverse neurological abilities
Authors: White Kelly , Tate Samuel , Zafonte Ross , Narayanan Shrikanth , Mehl Matthias R , Shin Min , Dhand Amar 
Published: August 2023

IntroductionSocial isolation has been found to be a significant risk factor for health outcomes, on par with traditional risk factors. This isolation is characterised by reduced social interactions, which can be detected acoustically. To accomplish this, we created a machine learning algorithm called SocialBit. SocialBit runs on a smartwatch and detects minutes of social interaction based on vocal features from ambient audio samples without natural language processing.Methods and analysisIn this study, we aim to validate the accuracy of SocialBit in stroke survivors with varying speech, cognitive and physical deficits. Training and testing on persons with diverse neurological abilities allows SocialBit to be a universally accessible social sensor. We are recruiting 200 patients and following them for up to 8 days during hospitalisation and rehabilitation, while they wear a SocialBit-equipped smartwatch and engage in naturalistic daily interactions. Human observers tally the interactions via a video livestream (ground truth) to analyse the performance of SocialBit against it. We also examine the association of social interaction time with stroke characteristics and outcomes. If successful, SocialBit would be the first social sensor available on commercial devices for persons with diverse abilities.Ethics and disseminationThis study has received ethical approval from the Institutional Review Board of Mass General Brigham (Protocol #2020P003739). The results of this study will be published in a peer-reviewed journal.
Texting is caring: a content analysis of clinical text messages by hospitalists
Authors: Donnelly Claire Elyse , Flores Perla L , Weiner Michael , Kara Areeba Y , Lee Joy L 
Published: August 2023

BackgroundClinical texting systems (CTS) are widely used in hospitals for team communication about patients. With more institutions adopting such systems, there is a need to understand how texting is being used in clinical practice.MethodsWe conducted content analysis of 809 randomly selected message threads sent to and from hospitalists in a 9-month window. The process, purpose and content of messages were analysed. We also examined messages for personal content (to identify whether CTS was being used for professional matters) and discussion of near miss errors. The risk levels of these near misses were also assessed.ResultsMost messages focused on clinical management of patient needs (62%; n=498) and functioned to provide a notification or update regarding clinical care (64%; n=518) or make a request of the recipient (63%; n=510). Personal content was infrequent in message threads (10%; n=80). Five per cent (n=38) of message threads included discussion of a near miss, and most near misses posed low clinical risk overall (66%; n=25).ConclusionMost CTS communication centred around direct clinical management. Fewer messages were focused on non-clinical areas such as administrative tasks or personal communication. Further examination of care delivery, error communication and the consequences of the care discussed in messages would help clinical leaders understand the impact of clinical texting on teamwork and quality of care.
Adding liposomal doxorubicin enhances the abscopal effect induced by radiation/αPD1 therapy depending on tumor cell mitochondrial DNA and cGAS/STING
Authors: Wang Liqun , Luo Ren , Onyshchenko Kateryna , Rao Xi , Wang Meidan , Menz Beatrice , Gaedicke Simone , Grosu Anca-Ligia , Firat Elke , Niedermann Gabriele 
Published: August 2023

BackgroundLocalized radiotherapy (RT) can cause a T cell-mediated abscopal effect on non-irradiated tumor lesions, especially in combination with immune checkpoint blockade. However, this effect is still clinically rare and improvements are highly desirable. We investigated whether triple combination with a low dose of clinically approved liposomal doxorubicin (Doxil) could augment abscopal responses compared with RT/αPD-1 and Doxil/αPD-1. We also investigated whether the enhanced abscopal responses depended on the mitochondrial DNA (mtDNA)/cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING)/IFN-I pathway.Materials/methodsWe used Doxil in combination with RT and αPD-1 in two tumor models (B16-CD133 melanoma and MC38 colon carcinoma) with mice bearing two tumors, only one of which was irradiated. Mechanistic studies on the role of the mtDNA/cGAS/STING/IFN-I axis were performed using inhibitors and knockout cells in vitro as well as in mice.ResultsAddition of a single low dose of Doxil to RT and αPD-1 strongly enhanced the RT/αPD-1-induced abscopal effect in both models. Complete cures of non-irradiated tumors were mainly observed in triple-treated mice. Triple therapy induced more cross-presenting dendritic cells (DCs) and more tumor-specific CD8+T cells than RT/αPD-1 and Doxil/αPD-1, particularly in non-irradiated tumors. Coincubation of Doxil-treated and/or RT-treated tumor cells with DCs enhanced DC antigen cross-presentation which is crucial for inducing CD8+T cells. CD8+T cell depletion or implantation of cGAS-deficient or STING-deficient tumor cells abolished the abscopal effect. Doxorubicin-induced/Doxil-induced IFNβ1 markedly depended on the cGAS/STING pathway. Doxorubicin-treated/Doxil-treated tumor cells depleted of mtDNA secreted less IFNβ1, of the related T cell-recruiting chemokine CXCL10, and ATP; coincubation with mtDNA-depleted tumor cells strongly reduced IFNβ1 secretion by DCs. Implantation of mtDNA-depleted tumor cells, particularly at the non-irradiated/abscopal site, substantially diminished the Doxil-enhanced abscopal effect and tumor infiltration by tumor-specific CD8+T cells.ConclusionsThese data show that single low-dose Doxil can substantially enhance the RT/αPD-1-induced abscopal effect, with a strong increase in cross-presenting DCs and CD8+tumor-specific T cells particularly in abscopal tumors compared with RT/αPD-1 and Doxil/αPD-1. Moreover, they indicate that the mtDNA/cGAS/STING/IFN-I axis is important for the immunogenic/immunomodulatory doxorubicin effects. Our ﬁndings may be helpful for the planning of clinical radiochemoimmunotherapy trials in (oligo)metastatic patients.
Intramuscular lesions in musculoskeletal MRI as a favourable prognostic sign in patients with anti-MDA5 antibody-positive dermatomyositis
Authors: Oto Yohsuke , Yoshida Ken , Fukuda Takeshi , Fukuda Taiki , Ukichi Taro , Noda Kentaro , Ito Haruyasu , Kurosaka Daitaro 
Published: August 2023

ObjectivesAnti-differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis, which has been described as clinically amyopathic dermatomyositis, complicates rapidly progressive interstitial lung disease (ILD). Owing to the absence of significant muscle symptoms, musculoskeletal MRI is often not performed. In this study, we aimed to devise a simple evaluation method using musculoskeletal MRI findings to elucidate the relationship between MRI findings and ILD prognosis and development.MethodsThe medical records and MRI scans of the proximal muscles at the time of diagnosis were retrospectively reviewed for 28 patients with anti-MDA5 antibody-positive dermatomyositis who were admitted to The Jikei University Hospital and The Jikei University Kashiwa Hospital between January 2008 and March 2022. Three observers evaluated nine proximal muscles for high signals on either short-tau inversion recovery images and/or fat-saturated gadolinium-enhanced T1-weighted images in the fascia and/or in the margins of the muscles in contact with the fascia (fascial pattern), and/or high signals in the muscles away from the fascia (intramuscular pattern), and a consensus was reached.ResultsOf the 28 patients, 15 presented with ‘radiological myositis’, where an intramuscular pattern was observed at any site. Patients with radiological myositis had significantly higher survival rates than those without radiological myositis, despite the lower rate of triple therapy with prednisolone, calcineurin inhibitors and cyclophosphamide. The spread of ILD on chest CT negatively and significantly correlated with the proportion of intramuscular lesions.ConclusionThe detection of intramuscular lesions on musculoskeletal MRI using our novel evaluation method could be clinically useful as a favourable prognostic marker.
Residual inflammatory risk predicts long-term outcomes following stenting for symptomatic intracranial atherosclerotic stenosis
Authors: Yu Ying , Lou Yake , Pan Yuesong , Yan Long , Fu Weilun , Hou Zhikai , Cui Rongrong , Miao Zhongrong , Wang Yongjun , Lou Xin , Ma Ning 
Published: August 2023

Background and purposeResidual inflammatory risk (RIR) can predict the unfavourable outcomes in patients with minor ischaemic stroke. However, the impact of preprocedural RIR on long-term outcomes in patients with symptomatic intracranial atherosclerotic stenosis (sICAS) who underwent stenting remains understudied.MethodsThis retrospective, single-centre cohort study evaluated consecutive patients with severe sICAS who underwent intracranial stenting. Patients were categorised into four groups based on preprocedural high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L) and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). The long-term clinical outcomes included recurrent ischaemic stroke and death. The long-term imaging outcomes consisted of in-stent restenosis (ISR) and symptomatic ISR (sISR) after stenting.ResultsIn this study, 952 patients were included, with 751 (78.9%) being male. Forty-six cases were categorised into the RCIR group, 211 into the RIR group, 107 into the RCR group and 588 into the NRR group. Patients with RCIR (adjusted HR 6.163; 95% CI 2.603 to 14.589; p<0.001) and RIR (adjusted HR 2.205; 95% CI 1.294 to 3.757; p=0.004) had higher risks of recurrent ischaemic stroke than those with NRR during the 54 months of median follow-up time. Patients with RCIR (adjusted HR 3.604; 95% CI 1.431 to 9.072; p=0.007) were more likely to occur ISR, and patients in the RIR group showed a significant increase in the risk of sISR (adjusted HR 2.402; 95% CI 1.078 to 5.351; p=0.032) compared with those in the NRR group with a median follow-up time of 11.9 months.ConclusionsIn patients with sICAS, preprocedural RIR may predict long-term recurrent ischaemic stroke, ISR and sISR following intracranial stenting.
Feigin–Semikhatov conjecture and related topics
Authors: Nakatsuka Shigenori 
Published: August 2023

Feigin–Semikhatov conjecture, now established, states algebraic isomorphisms between the cosets of the subregular [Formula: see text]-algebras and the principal [Formula: see text]-superalgebras of type A by their full Heisenberg subalgebras. It can be seen as a variant of Feigin–Frenkel duality between the [Formula: see text]-algebras and also as a generalization of the connection between the [Formula: see text] superconformal algebra and the affine algebra [Formula: see text]. We review the recent developments on the correspondence of the subregular [Formula: see text]-algebras and the principal [Formula: see text]-superalgebras of type A at the level of algebras, modules and intertwining operators, including fusion rules.
Gamma-ray mean lifetimes of transitions 2+→0+ state for even–even nuclei in the range 58≤Z≤100
Authors: Vasudha G. S. , Sowmya N. , Manjunatha H. C. , PrakashBabu D. 
Published: August 2023

We explored [Formula: see text]-ray mean lifetimes of transitions [Formula: see text] state suggested by earlier researchers such as Grodzins [Phys. Lett. 2 (1962)], Bohr and Mettelson [Mat. Fys. Medd. Dan. Vid. Selsk 27 (1953) 1], Wang’s formula [Chin. J. Phys. 18 (1980) 151], and best global fit formulae [Phys. Rev. C 37 (1988) 805], equations accessible in the literature for nuclei ranging from [Formula: see text]Ce to [Formula: see text]Fm. Also, as compared to other equations accessible in the literature, the standard deviation observed utilizing Grodzins formula with regard to experiments was lower. We also forecasted [Formula: see text]-ray mean lifetimes of transitions [Formula: see text] state and [Formula: see text]-values for nuclei ranging from [Formula: see text]Ce to [Formula: see text]Fm. Around 136 even–even nuclei’s mean lifetimes and [Formula: see text]-values are predicted which are helpful in the Coulomb fission process.
Effects of a Passive Back-Support Exosuit on Erector Spinae and Abdominal Muscle Activity During Short-Duration, Asymmetric Trunk Posture Maintenance Tasks
Authors: Kang Sang Hyeon , Mirka Gary A. 
Published: August 2023

Objective To examine the effects of asymmetry and lower extremity mobility restrictions on the effectiveness of a passive back-support exosuit in short-duration, static trunk flexion postures. Background The effectiveness of trunk exoskeletons/suits for sagittally symmetric trunk posture maintenance has been investigated, but there has been limited study of the effects of asymmetric trunk postures or lower extremity motion restriction. Method Sixteen participants held trunk flexion postures involving trunk flexion (20°, 40°, 60°), asymmetry (0°, 30°), and lower extremity mobility (Free, Restricted) for 3 s. Participants held these postures with and without an exosuit while erector spinae and abdominal muscle activities were collected. Results There were no significant interactions between exosuit and asymmetry or exosuit and lower extremity motion restrictions, indicating no significant effects of these factors on the effectiveness of the exosuit at reducing trunk muscle activity. The exosuit was found to be effective at reducing erector spinae muscle activity regardless of asymmetry of posture or lower extremity restrictions (average 21%, from 11.2% MVC to 8.8% MVC). The magnitude of the erector spinae activity at 60° of trunk flexion with the exosuit was similar to that seen at 20° without the exosuit. Conclusion The exosuit consistently provided biomechanical benefit through reduced activation of the erector spinae muscles and neither asymmetry of trunk posture nor lower extremity restriction influenced this effectiveness. Application Trunk exoskeletons/suits can reduce trunk muscle activation and understanding how characteristics of the trunk postures assumed impact these responses may help target tasks wherein these devices may be effective.
Hiding in Plain Sight: The Invisibilized Challenges of Black Girlhood in Elite Independent Schools
Authors: Odim Chinyere 
Published: August 2023

Background/Context: The experiences of Black girls navigating elite, predominantly white independent schools remain underresearched in the academy despite this issue being integral in disciplines such as sociology, education, and African American studies. Within such institutions, Black girls must navigate the duality of their privilege in having access to the highest quality and resourced education with the marginality of being a demographic minority within a space controlled by cultural elites. Purpose: This study investigates the experiences of Black girls in independent schools via the accounts of Black-woman-identifying alumni of such institutions. This study utilizes a Black feminist framework for understanding the often overlooked excess challenges that Black girls are forced to face. Research Design: Through qualitative semi-structured, conversational interviews with 13 Black women graduates of 10 Mid-Atlantic and New England boarding and day schools, this study explores how the graduates reflect on their experiences navigating elite schooling during formative adolescent years, decision-making processes, and management of Black girl identities within the exceedingly white and wealthy context of independent schools. Conclusions: Significant themes that emerged from the qualitative data generated by this study include feelings of rootlessness from Black and white communities, difficulty navigating a racialized and gendered social hierarchy, and heightened levels of social anxiety and self-consciousness about physical and ideological selves. Through a thematic retelling from those who have lived through the challenges and understand how they are presented in these contexts, the significance of this study’s exploration of Black girls in independent school is the (1) liberation of these historically marginalized voices and (2) potential to provide current school leaders a framework for how best to support their students.
Effects of coagulation function indicators and tumor markers on diagnosis and clinicopathological characteristics of endometrial cancer
Authors: Li Huayan , Liao Huifeng , Jing Bilin , Wang Yifeng 
Published: August 2023

Background Endometrial cancer is currently the prevalent malignant cancer worldwide. Diagnostic efficiency of tumor markers is limited, and coagulation function indicators in endometrial cancer are less concerned. Methods This study attempted to evaluate the effects of coagulation function indicators and tumor markers on the clinical diagnosis and clinicopathological characteristics of patients with endometrial cancer. The retrospective analysis compared the differences in coagulation function indicators and tumor markers among 175 patients with endometrial cancer and 170 healthy women from January 2020 to October 2022. Results Compared to the healthy control, the levels of D-dimer, fibrinogen, human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), CA153, and CA199 in patients with endometrial cancer were significantly higher ( P < 0.05). Univariate and multivariate regression analyses revealed that abnormal levels of D-dimer, fibrinogen, HE4, CA125, CA153, and CA199 were related risk factors affecting the incidence of endometrial cancer. Receiver operating characteristic curve analysis exhibited that the area under the curve (0.931) and accuracy (85.2%) of combined diagnosis of coagulation function indicators (D-dimer, fibrinogen) and tumor markers (HE4, CA125, CA153, CA199) were the highest, and its sensitivity (82.3%) and specificity (88.2%) were higher than any single or combined indicators of four tumor markers. Moreover, relative expression levels of the combined indicators were significantly different among clinicopathological characteristics that had the highest predictive value in the FIGO stage ( P < 0.001). Conclusions D-dimer and fibrinogen represent potential diagnostic factors for endometrial cancer. The combination of coagulation function indicators and tumor markers exhibited high diagnostic value in endometrial cancer, as well as predictive value for clinicopathological characteristics.
Neu Laxova Syndrome—A Terrifying Disease in Two Siblings With a Novel Variant in PHGDH Gene
Authors: Gonçalves Carolina Ferreira , Andrade Alexandra , Silva Patrícia , Barros Cremilda , Camacho Carmo , Costa Edite 
Published: August 2023

Introduction Neu-Laxova Syndrome (NLS) is a rare, autosomal, and recessively inherited disease characterized by severe congenital malformations, leading to prenatal or early postnatal mortality. The hallmark clinical features of this syndrome are severe intrauterine growth restriction, central nervous system abnormalities, restrictive dermopathy, and characteristic facial dysmorphia. There is no cure or treatment for this syndrome and the termination of the pregnancy is the suggested approach. Case description Here, we report a new case of 2 siblings with NLS, diagnosed in utero by ultrasonography and genetic examination. Two variants in heterozygosity in the phosphoglycerate dehydrogenase gene were discovered, including a previously uncharacterized variant (c.487C>T p. [Arg163Trp]). Comments Despite all the advances in prenatal diagnosis, NLS remains undiagnosed in many pregnancies. Early and sequential US examinations should be performed in high-risk pregnant women, to establish an early diagnosis.
Middle meningeal artery embolization combined with surgical evacuation for chronic subdural hematoma: A single-center experience of 75 cases
Authors: Orscelik Atakan , Senol Yigit Can , Bilgin Cem , Kobeissi Hassan , Arul Santhosh , Cloft Harry , Lanzino Giuseppe , Kallmes David F , Brinjikji Waleed 
Published: August 2023

Background Chronic subdural hematoma (cSDH) is a challenging and common neurosurgical condition. Our goal is to demonstrate that middle meningeal artery (MMA) embolization combined with surgical evacuation can be a promising adjuvant option for treatment of cSDHs and prevent recurrence in symptomatic patients who require surgical treatment. Method We retrospectively collected data from patients who underwent MMA embolization using polyvinyl alcohol particles and surgical evacuation with burr hole or craniotomy in a single center for the treatment of new and recurrent cSDHs. The primary outcome was recurrence of cSDH requiring surgical rescue during follow up, and secondary outcomes were defined as >50% decrease in the maximum width of cSDHs on the longest follow-up computed tomography (CT) scan, complications following procedure, and improvement in modified Rankin scale (mRS) score. Results A total of 51 patients successfully underwent 72 MMA embolization procedures (96% of the total 75 cases in the cohort) combined with surgical evacuation. Seventy cases (93.3%) achieved at least 50% reduction in the size of the cSDHs on the last CT imaging. A surgical evacuation was required in five cases (6.7%) due to cSDH recurrence during the follow-up period. There were three complications (6.0%) related to embolization procedure. Forty patients (78.4%) showed improvement in mRS score. There was one mortality (2%) regardless of the embolization and evacuation. Conclusions Our study demonstrates the safety and efficacy of adjunct MMA embolization in significantly reducing size and recurrence of cSDHs.