bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analytical solutions for Bloch waves in resonant phononic crystals: deep-subwavelength energy splitting and mode steering between topologically protected interfacial and edge states
Authors: Wiltshaw R , De Ponti J M , Craster R V 
Published: April 2023

Summary
We derive analytical solutions based on singular Green’s functions, which enable efficient computations of scattering simulations or Floquet–Bloch dispersion relations for waves propagating through an elastic plate, whose surface is patterned by periodic arrays of elastic beams. Our methodology is versatile and allows us to solve a range of problems regarding arrangements of multiple beams per primitive cell, over Bragg to deep-subwavelength scales; we cross-verify against finite element numerical simulations to gain further confidence in our approach, which relies upon the hypothesis of Euler–Bernoulli beam theory considerably simplifying continuity conditions such that each beam can be replaced by point forces and moments applied to the neutral plane of the plate. The representations of Green’s functions by Fourier series or Fourier transforms readily follows, yielding rapid and accurate analytical schemes. The accuracy and flexibility of our solutions are demonstrated by engineering topologically non-trivial states, from primitive cells with broken spatial symmetries, following the phononic analogue of the Quantum Valley Hall Effect. Topologically protected states are produced and coexist along: interfaces between adjoining chiral-mirrored bulk media, and edges between one such chiral bulk and the surrounding bare elastic plate, allowing topological circuits to be designed with robust waveguiding. Our topologically protected interfacial states correspond to zero-line modes, and our topological edgestates are produced in accordance with the bulk-edge correspondence. These topologically non-trivial states exist within near flexural resonances of the constituent beams of the phononic crystal and hence can be tuned into a deep-subwavelength regime.
Supplementation of ambient lighting with a task lamp improves daytime alertness and cognitive performance in sleep-restricted individuals
Authors: Grant Leilah K , Crosthwaite Phoebe C , Mayer Matthew D , Wang Wei , Stickgold Robert , St. Hilaire Melissa A , Lockley Steven W , Rahman Shadab A 
Published: April 2023

Abstract

Study Objectives
We examined the impact of adding a single-high-melanopic-illuminance task lamp in an otherwise low-melanopic-illuminance environment on alertness, neurobehavioral performance, learning, and mood during an 8-h simulated workday.

Methods
Sixteen healthy young adults [mean(±SD) age = 24.2 ± 2.9, 8F] participated in a 3-day inpatient study with two 8-h simulated workdays and were randomized to either ambient fluorescent room light (~30 melanopic EDI lux, 50 lux), or room light supplemented with a light emitting diode task lamp (~250 melanopic EDI lux, 210 lux) in a cross-over design. Alertness, mood, and cognitive performance were assessed throughout the light exposure and compared between conditions using linear mixed models.

Results
The primary outcome measure of percentage correct responses on the addition task was significantly improved relative to baseline in the supplemented condition (3.15% ± 1.18%), compared to the ambient conditions (0.93% ± 1.1%; FDR-adj q = 0.005). Additionally, reaction time and attentional failures on the psychomotor vigilance tasks were significantly improved with exposure to supplemented compared to ambient lighting (all, FDR-adj q ≤ 0.030). Furthermore, subjective measures of sleepiness, alertness, happiness, health, mood, and motivation were also significantly better in the supplemented, compared to ambient conditions (all, FDR-adj q ≤ 0.036). There was no difference in mood disturbance, affect, declarative memory, or motor learning between the conditions (all, FDR-adj q ≥ 0.308).

Conclusions
Our results show that supplementing ambient lighting with a high-melanopic-illuminance task lamp can improve daytime alertness and cognition. Therefore, high-melanopic-illuminance task lighting may be effective when incorporated into existing suboptimal lighting environments.

Clinical trials
NCT04745312. Effect of Lighting Supplementation on Daytime Cognition. https://clinicaltrials.gov/ct2/show/NCT04745312
Epidemiological and clinical features of the 2016–2018 Zika virus outbreak in northern Argentina
Authors: Byrne Alana B , Bonnin Florencia A , Bruno Agostina , Bono María Manuela , Contrini María Marta , López Eduardo L , Quipildor Marcelo O , Talarico Laura B 
Published: April 2023

ABSTRACT

Background
During the American epidemic, Zika virus (ZIKV) expanded rapidly through dengue virus (DENV)-endemic regions. We analyzed the presentation of ZIKV infection in patients from the City of Orán, Argentina, and compared some of its features with dengue presentation in the same region.

Methods
A retrospective study was conducted at San Vicente de Paul Hospital during 2016–2018. Clinical and demographic characteristics, pre-existing immunity to DENV, viral load and type I interferon (IFN) responses were studied in 63 patients with ZIKV infection.

Results
Clinical manifestations of ZIKV infection were generally mild compared with dengue, although rash (p&lt;0.001) and itching (p&lt;0.001) were significantly more prevalent in ZIKV patients. ZIKV patients aged &lt;15 y manifested relatively mild disease compared with older ZIKV patients, showing a decreased prevalence of headache (p=0.008), retro-orbital pain (p=0.001) and arthralgia (p=0.001). Increased Zika incidence was observed in female patients (60.3%). Serum viral load was low to undetectable in ZIKV patients and was not associated with serum anti-DENV IgG titers. Interferon-α and IFN-β serum levels did not correlate with serum viral load in ZIKV patients.

Conclusions
Clinical presentation of ZIKV and DENV infections is largely overlapping, presenting a challenge for diagnosis and risk assessment for uniquely at-risk populations.
MutaGAN: A sequence-to-sequence GAN framework to predict mutations of evolving protein populations
Authors: Berman Daniel S , Howser Craig , Mehoke Thomas , Ernlund Amanda W , Evans Jared D 
Published: April 2023

AbstractThe ability to predict the evolution of a pathogen would significantly improve the ability to control, prevent, and treat disease. Machine learning, however, is yet to be used to predict the evolutionary progeny of a virus. To address this gap, we developed a novel machine learning framework, named MutaGAN, using generative adversarial networks with sequence-to-sequence, recurrent neural networks generator to accurately predict genetic mutations and evolution of future biological populations. MutaGAN was trained using a generalized time-reversible phylogenetic model of protein evolution with maximum likelihood tree estimation. MutaGAN was applied to influenza virus sequences because influenza evolves quickly and there is a large amount of publicly available data from the National Center for Biotechnology Information’s Influenza Virus Resource. MutaGAN generated ‘child’ sequences from a given ‘parent’ protein sequence with a median Levenshtein distance of 4.00 amino acids. Additionally, the generator was able to generate sequences that contained at least one known mutation identified within the global influenza virus population for 72.8 per cent of parent sequences. These results demonstrate the power of the MutaGAN framework to aid in pathogen forecasting with implications for broad utility in evolutionary prediction for any protein population.
Understanding Academic Self-Concept and Performance in Medical Education
Authors: Harrell Kelly M. , Rawls Meagan , Stringer J.K. , Edwards Cherie D. , Santen Sally A. , Biskobing Diane 
Published: April 2023

Problem
Medical students’ academic self-concept (ASC) is an important factor in better understanding noncognitive mediators of performance in medical school. However, research is limited on ASC in medical students across multiple phases of undergraduate medical education curriculum. This pilot study explored the relationship between ASC and academic performance across different phases of a U.S. medical school curriculum, specifically at the end of the second (preclinical) and third (clinical) years.

Approach
Medical students across 2 cohorts at Virginia Commonwealth University School of Medicine, Richmond, Virginia, were surveyed using an ASC confidence subscale in 2019. Multiple linear regression analysis was conducted using medical student ASC scores in preclinical (n = 190) and clinical (n = 149) phases and performance data. Clinical performance was calculated through a weighted mean of clerkship grades based on the number of weeks for each clerkship.

Outcomes
Preclinical performance was related to ASC, gender, and performance after year 1. ASC scores varied significantly by gender in the preclinical cohort (P < .01), with men reporting higher ASC than women (mean [SD], 2.94 [0.41] vs 2.78 [0.38]). Significant gender differences in performance were found at the end of year 3 (P < .01), with women performing more favorably compared with men (mean [SD], 94.1 [59.04] vs 124.24 [64.54]). The relationship between ASC and performance at the end of year 2 suggested students with higher ASC perform better during their preclinical phase.

Next Steps
This pilot study supports future scholarship in 2 areas: (1) identification and assessment of additional factors that influence the relationship between ASC and academic performance across the entire undergraduate medical education curriculum and (2) development and implementation of evidence-based interventions to support student ASC and performance and enhance the learning environment. Analyzing longitudinal trends across multiple cohorts will drive evidence-based interventions at learner and programmatic levels.
The Utility of a Novel, Combined Biofeedback-Virtual Reality Device as Add-on Treatment for Chronic Migraine
Authors: Cuneo Ami , Yang Robin , Zhou Haoran , Wang Ke , Goh Sarah , Wang Yuntao , Raiti John , Krashin Daniel , Murinova Natalia 
Published: April 2023

Objectives:
To determine if the frequent use of a combined biofeedback-virtual reality device improves headache-related outcomes in chronic migraine.

Materials and Methods:
In this randomized, controlled pilot study, 50 adults with chronic migraine were randomized to the experimental group (frequent use of a heart rate variability biofeedback-virtual reality device plus standard medical care; n=25) or wait-list control group (standard medical care alone; n=25). The primary outcome was a reduction in mean monthly headache days between groups at 12 weeks. Secondary outcomes included mean change in acute analgesic use frequency, depression, migraine-related disability, stress, insomnia, and catastrophizing between groups at 12 weeks. Tertiary outcomes included change in heart rate variability and device-related user experience measures.

Results:
A statistically significant reduction in mean monthly headache days between groups was not demonstrated at 12 weeks. However, statistically significant decreases in the mean frequency of total acute analgesic use per month (65% decrease in the experimental group versus 35% decrease in the control group, P<0.01) and depression score (35% decrease in the experimental group versus 0.5% increase in the control group; P<0.05) were shown at 12 weeks. At study completion, more than 50% of participants reported device satisfaction on a 5-level Likert scale.

Discussion:
Frequent use of a portable biofeedback-virtual reality device was associated with decreases in the frequency of acute analgesic use and in depression in individuals with chronic migraine. This platform holds promise as an add-on treatment for chronic migraine, especially for individuals aiming to decrease acute analgesic use or interested in nonmedication approaches.
Measures of Information Content during Anesthesia and Emergence in the Caenorhabditis elegans Nervous System
Authors: Chang Andrew S. , Wirak Gregory S. , Li Duan , Gabel Christopher V. , Connor Christopher W. 
Published: April 2023

Background
Suppression of behavioral and physical responses defines the anesthetized state. This is accompanied, in humans, by characteristic changes in electroencephalogram patterns. However, these measures reveal little about the neuron or circuit-level physiologic action of anesthetics nor how information is trafficked between neurons. This study assessed whether entropy-based metrics can differentiate between the awake and anesthetized state in Caenorhabditis elegans and characterize emergence from anesthesia at the level of interneuronal communication.

Methods
Volumetric fluorescence imaging measured neuronal activity across a large portion of the C. elegans nervous system at cellular resolution during distinct states of isoflurane anesthesia, as well as during emergence from the anesthetized state. Using a generalized model of interneuronal communication, new entropy metrics were empirically derived that can distinguish the awake and anesthetized states.

Results
This study derived three new entropy-based metrics that distinguish between stable awake and anesthetized states (isoflurane, n = 10) while possessing plausible physiologic interpretations. State decoupling is elevated in the anesthetized state (0%: 48.8 ± 3.50%; 4%: 66.9 ± 6.08%; 8%: 65.1 ± 5.16%; 0% vs. 4%, P < 0.001; 0% vs. 8%, P < 0.001), while internal predictability (0%: 46.0 ± 2.94%; 4%: 27.7 ± 5.13%; 8%: 30.5 ± 4.56%; 0% vs. 4%, P < 0.001; 0% vs. 8%, P < 0.001), and system consistency (0%: 2.64 ± 1.27%; 4%: 0.97 ± 1.38%; 8%: 1.14 ± 0.47%; 0% vs. 4%, P = 0.006; 0% vs. 8%, P = 0.015) are suppressed. These new metrics also resolve to baseline during gradual emergence of C. elegans from moderate levels of anesthesia to the awake state (n = 8). The results of this study show that early emergence from isoflurane anesthesia in C. elegans is characterized by the rapid resolution of an elevation in high frequency activity (n = 8, P = 0.032). The entropy-based metrics mutual information and transfer entropy, however, did not differentiate well between the awake and anesthetized states.

Conclusions
Novel empirically derived entropy metrics better distinguish the awake and anesthetized states compared to extant metrics and reveal meaningful differences in information transfer characteristics between states.

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The Fate of the Bent Rod in Children With Osteogenesis Imperfecta
Authors: Fralinger David J. , Kraft Denver B. , Rogers Kenneth J. , Thacker Mihir M. , Kruse Richard W. , Franzone Jeanne M. 
Published: April 2023

Background:
Osteogenesis imperfecta (OI) is a genetic disorder characterized by brittle bones and long bone deformity. Realignment and intramedullary rodding with telescopic rods are indicated for progressive deformity and can help prevent fractures. Rod bending is a reported complication of telescopic rods and a common indication for revision; however, the fate of bent lower extremity telescopic rods in the setting of OI has not been reported.

Methods:
Patients with OI at a single institution who underwent lower extremity telescopic rod placement with at least 1-year follow-up were identified. Bent rods were identified, and for these bone segments, we collected the location and angle of bend, subsequent telescoping, refracture, increasing angulation of bend, and date of revision.

Results:
One hundred sixty-eight telescopic rods in 43 patients were identified. Forty-six rods (27.4%) bent during follow-up, with an average angulation of 7.3 (range: 1 to 24) degrees. In patients with severe OI, 15.7% of rods bent compared with 35.7% in nonsevere OI (P=0.003). The proportion of bent rods was different between independent and nonindependent ambulators (34.1% and 20.5%; P=0.035). Twenty-seven bent rods (58.7%) were revised, with 12 rods (26.0%) revised early (within 90 d). The angulation of rods that were revised early was significantly higher than rods not (14.6 and 4.3 degrees, P<0.001). Of the 34 bent rods not revised early, the average time to revision or final follow-up was 29.1 months. Twenty-five rods (73.5%) continued to telescope, 14 (41.2%) increased in angulation (average 3.2 degrees), and 10 bones (29.4%) refractured. None of the refractures required immediate rod revision. Two bones had multiple refractures.

Conclusions:
Bending is a common complication of telescopic rods in the lower extremities of patients with OI. It is more common in independent ambulators and patients with nonsevere OI, possibly because of the increased demand placed on the rods. Rods with a small bend and maintained fixation can telescope and need not be an indication for immediate revision.

Level of Evidence:
Level III—Retrospective review.
Occupancy Rate of Pedicle Screw Below 80% is a Risk Factor for Upper Instrumented Vertebral Fracture After Adult Spinal Deformity Surgery
Authors: Oe Shin , Yamato Yu , Hasegawa Tomohiko , Yoshida Go , Banno Tomohiro , Arima Hideyuki , Ide Koichirou , Yamada Tomohiro , Nakai Keiichi , Kurosu Kenta , Matsuyama Yukihiro 
Published: April 2023

Study Design.
Retrospective study.

Objective.
To determine whether an occupancy rate of a pedicle screw (ORPS) <80% in an upper instrumented vertebra (UIV) is a risk factor for UIV fracture (UIVF).

Summary of Background Data.
The ratio of the length of the pedicle screw to the anteroposterior diameter of the vertebral body at the UIV is defined as ORPS. Previous studies showed that the stress on the UIV is reduced to the greatest degree when ORPS is >80%. However, it remains unclear whether these results are clinically valid.

Patients and Methods.
A total of 297 patients who had undergone adult spinal deformity surgery were included in the study. The group with an ORPS ≥80% and <80% was defined as the H (n = 198) and L (n = 99) group, respectively. Propensity score matching and logistic regression analysis were used to evaluate the association between ORPS and the development of UIVF adjusting for confounders.

Results.
The mean age of both groups was 69 years. The average ORPS in the L and H groups was 70% and 85%, respectively. The incidence of UIVF was 30% in group L and 15% in group H (P < 0.01). In addition, the 99 patients in group H were subdivided into 2 groups according to whether the screws penetrated the anterior wall of the vertebral body: 68 patients had no penetration (group U), whereas 31 patients showed evidence of penetration (group B). A total of 10% and 26% of the patients in the U and B groups, respectively, experienced UIVF (P < 0.05). Logistic regression analysis indicated that ORPS <80% was significantly associated with UIVF (P = 0.007, odds ratio: 3.9, 95% CI 1.4–10.5).

Conclusion.
To reduce UIVF, screw length should be set with a target ORPS of 80% or higher. If the screw penetrates the anterior wall of the vertebral body, the risk of UIVF is greater.
Utility and Clinical Outcomes of Perioperative Inferior Vena Cava Filter Prophylaxis in Spine Surgery Patients
Authors: Makary Mina S. , Koso Mensur , Yoder Matthew 
Published: April 2023

Study Design.
Single-center retrospective chart review study.

Objective.
This study aimed to assess the clinical outcomes of prophylactic inferior vena cava (IVC) filter use for pulmonary embolism (PE) prevention in spine surgery patients.

Summary of Background Data.
IVC filters can serve an important prophylactic role in preventing PE, though research involving spine surgery patients is sparse.

Materials and Methods.
This Institutional Review Board–approved single-center retrospective study assessed the characteristics and outcomes of patients who underwent spine surgery and received perioperative IVC filters for PE prophylaxis from January 2007 until December 2021. Clinical outcomes centered primarily on the occurrence of venous thromboembolism (VTE) as well as complications related to filter placement and retrieval. Thrombi that may have been entrapped by the filters were recorded incidentally on computed tomography or during the filter retrieval procedure.

Results.
This cohort included 380 spine surgery patients (female 51%/male 49%; median age, 61) who had received perioperative prophylactic IVC filters. The mean dwell time was 6.7 months (1–39 mo), with an overall 62% retrieval rate. Retrievals were further categorized by retrieval complexity, with 92% classified as routine and 8% as involving advanced removal techniques, while complications involved 1% (four retrievals) and were all minor. Regarding VTE event occurrence, deep vein thrombi (DVT) were experienced by 11% of patients in the postplacement period, with 1% (n=4) experiencing a PE. There were 11 incidences of thrombi that were found within or near the filters (2.9%). A multivariate analysis further assessed patient characteristics that correlated with the occurrence of PE, DVT, entrapped filter thrombi, advanced technique filter removal, and removal complications.

Conclusions.
IVC filters in this high-risk spine surgery cohort achieved a relatively low rate of DVT and PE as well as a low complication rate, whereas several patient characteristics were identified that correlated with VTE events and filter retrieval outcomes.
Chemoprevention of colorectal cancer in general population and high-risk population: a systematic review and network meta-analysis
Authors: Ma Ye , You Wen , Cao Yang , He Xuxia , Wang Jing , Zhang Yuelun , Li Ji , Li Jingnan 
Published: April 2023

Abstract

Background:
Many nutritional supplements and pharmacological agents have been reported to show preventive effects on colorectal adenoma and colorectal cancer (CRC). We performed a network meta-analysis to summarize such evidence and assess the efficacy and safety of these agents.

Methods:
We searched PubMed, Embase, and the Cochrane Library for studies published in English until October 31, 2021 that fit our inclusion criteria. We performed a systematic review and network meta-analysis to assess the comparative efficacy and safety of candidate agents (low-dose aspirin [Asp], high-dose Asp, cyclooxygenase-2 inhibitors [coxibs], calcium, vitamin D, folic acid, ursodeoxycholic acid [UDCA], estrogen, and progesterone, alone or in combination) for preventing colorectal adenoma and CRC. Cochrane risk-of-bias assessment tool was employed to evaluate the quality of each included study.

Results:
Thirty-two randomized controlled trials (278,694 participants) comparing 13 different interventions were included. Coxibs significantly reduced the risk of colorectal adenoma (risk ratio [RR]: 0.59, 95% confidence interval [CI]: 0.44–0.79, six trials involving 5486 participants), advanced adenoma (RR: 0.63, 95% CI: 0.43–0.92, four trials involving 4723 participants), and metachronous adenoma (RR: 0.58, 95% CI: 0.43–0.79, five trials involving 5258 participants) compared with placebo. Coxibs also significantly increased the risk of severe adverse events (RR: 1.29, 95% CI: 1.14–1.47, six trials involving 7109 participants). Other interventions, including Asp, folic acid, UDCA, vitamin D, and calcium, did not reduce the risk of colorectal adenoma in the general and high-risk populations compared with placebo.

Conclusions:
Considering the balance between benefits and harms, regular use of coxibs for prevention of colorectal adenoma was not supported by the current evidence. Benefit of low-dose Asp for chemoprevention of colorectal adenoma still requires further evidence.

Registration:
PROSPERO, No. CRD42022296376