The sexually transmitted infections (STIs) gonorrhea and chlamydia are known to disproportionately affect impoverished communities and communities of color, especially in urban areas. Moreover, socioeconomic and demog...The sexually transmitted infections (STIs) gonorrhea and chlamydia are known to disproportionately affect impoverished communities and communities of color, especially in urban areas. Moreover, socioeconomic and demographic factors such as poverty and race/ethnicity may contribute to a difference in treatment setting choice as well as a delay in care seeking. In an urban metropolitan area such as Boston, the overall gonorrhea and chlamydia rates are higher than national rates, and such differences are even more marked in certain neighborhoods with greater proportions of individuals who are impoverished, young, and of color. Using a retrospective analysis of city wide data, we highlight the effects of socioeconomic and demographic variables on urban STI prevalence. High poverty rates, race/ethnicity and younger adult populations are linked to disproportionately high STI rates. Interestingly, STI rates do not appear to be influenced by the universal health care coverage offered to the whole Massachusetts’ resident populations. We examine the effects of these variables in Boston neighborhoods in conjunction to STI rates and hypothesize that the observed rates are underestimates of the true prevalence of infection. Future studies will investigate how these same socioeconomic and demographic factors influence which treatment settings are chosen and subsequently lead to a delay in treatment.展开更多
AIM To characterize the understanding of hepatitis B virus(HBV)and determine if outreach improves HBV understanding among Greater Boston Area immigrants.METHODS Six outreach sessions were held in various community ven...AIM To characterize the understanding of hepatitis B virus(HBV)and determine if outreach improves HBV understanding among Greater Boston Area immigrants.METHODS Six outreach sessions were held in various community venues in the Greater Boston Area.Verbal consent was obtained from participants prior to starting each session.Each session included a pre-session questionnaire,followed by a teaching session,and then a post-session questionnaire.In person interpreters were present for translation during the teaching session and assistance for questionnaire completion when needed.The questions were developed based on the HBV clinical experience of physicians who serve largely immigrant populations.Questionnaires included Likerttype scale,open-ended,and true-false questions.All results were anonymous.RESULTS One hundred and one people participated in this study.Participants were 30%male with ages ranging from 19 to 87 years.The study population included immigrants from 21 countries,as well as seven United States-born participants.The greatest numbers of participants were from Somalia(44%),Morocco(10%),and Cameroon(8%).Pre session questionnaires revealed that 42%of participants were unaware that HBV can cause cancer,and 50%were unaware that therapies for HBV exist.Our brief teaching intervention led to improved scores on post session questionnaires.For example,at baseline,58%of participants responded correctly to the question"HBV infection can cause scarring of the liver and liver cancer",whereas 79%of participants responded correctly after the teaching session(P=0.01).Furthermore,the mean of total correct answers in the true or false portion of the questionnaire increased from 5.5 to 7.6(P<0.001).CONCLUSION A teaching session targeting Boston Immigrants atrisk for HBV helped improve scores on HBV knowledge questionnaires.Outreach may empower at-risk patients to pro-actively seek HBV care.展开更多
This special issue of Current Zoology concerning the behavior, ecology, and evolution of fishes is comprised of the peer-reviewed Proceedings of the 2008 Ecological and Evolutionary Ecology of Fishes Biennial Conferen...This special issue of Current Zoology concerning the behavior, ecology, and evolution of fishes is comprised of the peer-reviewed Proceedings of the 2008 Ecological and Evolutionary Ecology of Fishes Biennial Conference that was held June 29 - July 3 at Boston University, Boston, Massachusetts, USA. The conference and its four symposia were organized by a local organization committee and scientific program committee which included Maria Abate, host at Boston University; Sigal Balshine, McMaster University; Michael Clancy, Boston University; Ronald Coleman, California State University, Sacramento; John Godwin, North Carolina State University; Les Kaufinan, Boston University;展开更多
Within the last few decades, increases in computational resources have contributed enormously to the progress of science and engineering (S & E). To continue making rapid advancements, the S & E community must...Within the last few decades, increases in computational resources have contributed enormously to the progress of science and engineering (S & E). To continue making rapid advancements, the S & E community must be able to access computing resources. One way to provide such resources is through High-Performance Computing (HPC) centers. Many academic research institutions offer their own HPC Centers but struggle to make the computing resources easily accessible and user-friendly. Here we present SHABU, a RESTful Web API framework that enables S & E communities to access resources from Boston University’s Shared Computing Center (SCC). The SHABU requirements are derived from the use cases described in this work.展开更多
BACKGROUND While varices and variceal bleeds are well-known and feared complications of advanced cirrhosis and portal hypertension,omental variceal bleed are a rare sequala even in patients with known esophageal or ga...BACKGROUND While varices and variceal bleeds are well-known and feared complications of advanced cirrhosis and portal hypertension,omental variceal bleed are a rare sequala even in patients with known esophageal or gastric varices.While rare,omental varices pose a risk for hemoperitoneum if ruptured,which is a lifethreatening complication with high mortality rates despite surgical intervention.CASE SUMMARY This report reviews the case of a patient 36-year-old female with alcohol related cirrhosis decompensated by ascites,but no history of varices admitted for hemorrhagic shock from spontaneous rupture of omental varices requiring emergency surgery.She underwent the first documented successful orthotopic liver transplantation the same admission.CONCLUSION This case report and literature review stresses the importance of early consideration and identification of intraabdominal variceal sources in cirrhotic patients with refractory shock.展开更多
Artificial intelligence(AI)is reshaping financial systems and services,as intelligent AI agents increasingly form the foundation of autonomous,goal-driven systems capable of reasoning,learning,and action.This review s...Artificial intelligence(AI)is reshaping financial systems and services,as intelligent AI agents increasingly form the foundation of autonomous,goal-driven systems capable of reasoning,learning,and action.This review synthesizes recent research and developments in the application of AI agents across core financial domains.Specifically,it covers the deployment of agent-based AI in algorithmic trading,fraud detection,credit risk assessment,roboadvisory,and regulatory compliance(RegTech).The review focuses on advanced agent-based methodologies,including reinforcement learning,multi-agent systems,and autonomous decision-making frameworks,particularly those leveraging large language models(LLMs),contrasting these with traditional AI or purely statistical models.Our primary goals are to consolidate current knowledge,identify significant trends and architectural approaches,review the practical efficiency and impact of current applications,and delineate key challenges and promising future research directions.The increasing sophistication of AI agents offers unprecedented opportunities for innovation in finance,yet presents complex technical,ethical,and regulatory challenges that demand careful consideration and proactive strategies.This review aims to provide a comprehensive understanding of this rapidly evolving landscape,highlighting the role of agent-based AI in the ongoing transformation of the financial industry,and is intended to serve financial institutions,regulators,investors,analysts,researchers,and other key stakeholders in the financial ecosystem.展开更多
Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathop...Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.展开更多
The shared links between Alzheimer’s disease and type 2 diabetes mellitus:Alzheimer’s disease(AD)and type 2 diabetes mellitus(T2DM)are two prevalent conditions that come with substantial daily struggles.Emerging evi...The shared links between Alzheimer’s disease and type 2 diabetes mellitus:Alzheimer’s disease(AD)and type 2 diabetes mellitus(T2DM)are two prevalent conditions that come with substantial daily struggles.Emerging evidence highlights that these diseases share similar pathophysiological features,including insulin resistance and chronic inflammation,which contribute to their rapid progression(Chen et al.,2022).Insulin resistance,a hallmark of T2DM,has been suggested to exacerbate neurodegeneration in AD.Similarly,chronic low-grade inflammation in T2DM parallels with neuroinflammation,which is observed in AD,suggesting overlapping pathophysiological mechanisms in T2DM and AD.展开更多
BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investig...BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.展开更多
Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genoty...Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genotype data and 681 participants with gene expression data from the Molecular Epidemiology of ARDS(MEARDS),the Molecular Epidemiology of Sepsis in the ICU(MESSI),and the Molecular Diagnosis and Risk Stratification of Sepsis(MARS)cohorts in a three-step study focusing on sepsis-associated ARDS and sepsis-only controls.First,we identified and validated interferon-related genes associated with sepsis-associated ARDS risk using genetically regulated gene expression(GReX).Second,we examined the association of the confirmed gene(interferon regulatory factor 1,IRF1)with ARDS risk and survival and conducted a mediation analysis.Through discovery and validation,we found that the GReX of IRF1 was associated with ARDS risk(odds ratio[OR_(MEARDS)]=0.84,P=0.008;OR_(MESSI)=0.83,P=0.034).Furthermore,individual-level measured IRF1 expression was associated with reduced ARDS risk(OR=0.58,P=8.67×10^(-4)),and improved overall survival in ARDS patients(hazard ratio[HR_(28-day)]=0.49,P=0.009)and sepsis patients(HR_(28-day)=0.76,P=0.008).Mediation analysis revealed that IRF1 may enhance immune function by regulating the major histocompatibility complex,including HLA-F,which mediated more than 70%of protective effects of IRF1 on ARDS.The findings were validated by in vitro biological experiments including time-series infection dynamics,overexpression,knockout,and chromatin immunoprecipitation sequencing.Early prophylactic interventions to activate IRF1 in sepsis patients,thereby regulating HLA-F,may reduce the risk of ARDS and mortality,especially in severely ill patients.展开更多
BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar k...BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.展开更多
Type 2 diabetes mellitus has central complications:Diabetes,a metabolic disorder primarily characterized by hyperglycemia due to insufficient insulin secretion,or impaired insulin signaling,has significant central com...Type 2 diabetes mellitus has central complications:Diabetes,a metabolic disorder primarily characterized by hyperglycemia due to insufficient insulin secretion,or impaired insulin signaling,has significant central complications.Type 2 diabetes mellitus(T2DM),the most prevalent type of diabetes,affects more than 38 million individuals in the United States(approximately 1 in 10)and is defined by chronic hyperglycemia and insulin resistance,which refers to a reduced cellular response to insulin.展开更多
Background:Stomach cancer(SC)is one of the most lethal malignancies worldwide due to late-stage diagnosis and limited treatment.The transcriptomic,epigenomic,and proteomic,etc.,omics datasets generated by high-through...Background:Stomach cancer(SC)is one of the most lethal malignancies worldwide due to late-stage diagnosis and limited treatment.The transcriptomic,epigenomic,and proteomic,etc.,omics datasets generated by high-throughput sequencing technology have become prominent in biomedical research,and they reveal molecular aspects of cancer diagnosis and therapy.Despite the development of advanced sequencing technology,the presence of high-dimensionality in multi-omics data makes it challenging to interpret the data.Methods:In this study,we introduce RankXLAN,an explainable ensemble-based multi-omics framework that integrates feature selection(FS),ensemble learning,bioinformatics,and in-silico validation for robust biomarker detection,potential therapeutic drug-repurposing candidates’identification,and classification of SC.To enhance the interpretability of the model,we incorporated explainable artificial intelligence(SHapley Additive exPlanations analysis),as well as accuracy,precision,F1-score,recall,cross-validation,specificity,likelihood ratio(LR)+,LR−,and Youden index results.Results:The experimental results showed that the top four FS algorithms achieved improved results when applied to the ensemble learning classification model.The proposed ensemble model produced an area under the curve(AUC)score of 0.994 for gene expression,0.97 for methylation,and 0.96 for miRNA expression data.Through the integration of bioinformatics and ML approach of the transcriptomic and epigenomic multi-omics dataset,we identified potential marker genes,namely,UBE2D2,HPCAL4,IGHA1,DPT,and FN3K.In-silico molecular docking revealed a strong binding affinity between ANKRD13C and the FDA-approved drug Everolimus(binding affinity−10.1 kcal/mol),identifying ANKRD13C as a potential therapeutic drug-repurposing target for SC.Conclusion:The proposed framework RankXLAN outperforms other existing frameworks for serum biomarker identification,therapeutic target identification,and SC classification with multi-omics datasets.展开更多
Aim:Although vascularized lymph node transplantation(VLNT)has gained recognition as an effective treatment option for lymphedema,no consensus on the timing of transplant with other lymphatic procedures has been establ...Aim:Although vascularized lymph node transplantation(VLNT)has gained recognition as an effective treatment option for lymphedema,no consensus on the timing of transplant with other lymphatic procedures has been established.The aim of this study is to describe our institutional experience with VLNT,including our staged approach and report postoperative outcomes.Methods:A retrospective review of patients who underwent VLNT for upper extremity lymphedema from May 2017 to April 2022 was conducted.Patients were divided into fat-or fluid-dominant phenotypes based on preoperative workup.Patients with a minimum of 12-month follow-up were included.Records were reviewed for demographic,intraoperative,and surveillance data.Results:Twenty-three patients underwent VLNT of the upper extremity during the study period,of which eighteen met the study criteria.Nine patients had fluid-dominant disease and nine patients had fat-dominant disease and had undergone prior debulking at our institution.Fluid-dominant patients demonstrated slight reductions in limb volume and hours in compression,and improvement in quality-of-life scores at twelve months.Fat-dominant patients who underwent prior debulking had a slight increase in limb volume without a change in hours of compression,and demonstrated improvements in quality-of-life scores in nearly all subdomains.Overall,17% of patients discontinued compression therapy entirely.Improvement in extremity edema was present in 83% of postoperative MRIs.Conclusion:VLNT had varying effects on limb measurements while reliably improving quality-of-life and allowing for the potential of discontinuing compression.Utilizing a staged approach wherein debulking is performed upfront may be particularly beneficial for patients with fat-dominant disease.展开更多
文摘The sexually transmitted infections (STIs) gonorrhea and chlamydia are known to disproportionately affect impoverished communities and communities of color, especially in urban areas. Moreover, socioeconomic and demographic factors such as poverty and race/ethnicity may contribute to a difference in treatment setting choice as well as a delay in care seeking. In an urban metropolitan area such as Boston, the overall gonorrhea and chlamydia rates are higher than national rates, and such differences are even more marked in certain neighborhoods with greater proportions of individuals who are impoverished, young, and of color. Using a retrospective analysis of city wide data, we highlight the effects of socioeconomic and demographic variables on urban STI prevalence. High poverty rates, race/ethnicity and younger adult populations are linked to disproportionately high STI rates. Interestingly, STI rates do not appear to be influenced by the universal health care coverage offered to the whole Massachusetts’ resident populations. We examine the effects of these variables in Boston neighborhoods in conjunction to STI rates and hypothesize that the observed rates are underestimates of the true prevalence of infection. Future studies will investigate how these same socioeconomic and demographic factors influence which treatment settings are chosen and subsequently lead to a delay in treatment.
文摘AIM To characterize the understanding of hepatitis B virus(HBV)and determine if outreach improves HBV understanding among Greater Boston Area immigrants.METHODS Six outreach sessions were held in various community venues in the Greater Boston Area.Verbal consent was obtained from participants prior to starting each session.Each session included a pre-session questionnaire,followed by a teaching session,and then a post-session questionnaire.In person interpreters were present for translation during the teaching session and assistance for questionnaire completion when needed.The questions were developed based on the HBV clinical experience of physicians who serve largely immigrant populations.Questionnaires included Likerttype scale,open-ended,and true-false questions.All results were anonymous.RESULTS One hundred and one people participated in this study.Participants were 30%male with ages ranging from 19 to 87 years.The study population included immigrants from 21 countries,as well as seven United States-born participants.The greatest numbers of participants were from Somalia(44%),Morocco(10%),and Cameroon(8%).Pre session questionnaires revealed that 42%of participants were unaware that HBV can cause cancer,and 50%were unaware that therapies for HBV exist.Our brief teaching intervention led to improved scores on post session questionnaires.For example,at baseline,58%of participants responded correctly to the question"HBV infection can cause scarring of the liver and liver cancer",whereas 79%of participants responded correctly after the teaching session(P=0.01).Furthermore,the mean of total correct answers in the true or false portion of the questionnaire increased from 5.5 to 7.6(P<0.001).CONCLUSION A teaching session targeting Boston Immigrants atrisk for HBV helped improve scores on HBV knowledge questionnaires.Outreach may empower at-risk patients to pro-actively seek HBV care.
文摘This special issue of Current Zoology concerning the behavior, ecology, and evolution of fishes is comprised of the peer-reviewed Proceedings of the 2008 Ecological and Evolutionary Ecology of Fishes Biennial Conference that was held June 29 - July 3 at Boston University, Boston, Massachusetts, USA. The conference and its four symposia were organized by a local organization committee and scientific program committee which included Maria Abate, host at Boston University; Sigal Balshine, McMaster University; Michael Clancy, Boston University; Ronald Coleman, California State University, Sacramento; John Godwin, North Carolina State University; Les Kaufinan, Boston University;
文摘Within the last few decades, increases in computational resources have contributed enormously to the progress of science and engineering (S & E). To continue making rapid advancements, the S & E community must be able to access computing resources. One way to provide such resources is through High-Performance Computing (HPC) centers. Many academic research institutions offer their own HPC Centers but struggle to make the computing resources easily accessible and user-friendly. Here we present SHABU, a RESTful Web API framework that enables S & E communities to access resources from Boston University’s Shared Computing Center (SCC). The SHABU requirements are derived from the use cases described in this work.
文摘BACKGROUND While varices and variceal bleeds are well-known and feared complications of advanced cirrhosis and portal hypertension,omental variceal bleed are a rare sequala even in patients with known esophageal or gastric varices.While rare,omental varices pose a risk for hemoperitoneum if ruptured,which is a lifethreatening complication with high mortality rates despite surgical intervention.CASE SUMMARY This report reviews the case of a patient 36-year-old female with alcohol related cirrhosis decompensated by ascites,but no history of varices admitted for hemorrhagic shock from spontaneous rupture of omental varices requiring emergency surgery.She underwent the first documented successful orthotopic liver transplantation the same admission.CONCLUSION This case report and literature review stresses the importance of early consideration and identification of intraabdominal variceal sources in cirrhotic patients with refractory shock.
基金supported by the Ministry of Education and Science of the Republic of North Macedonia through the project“Utilizing AI and National Large Language Models to Advance Macedonian Language Capabilties”。
文摘Artificial intelligence(AI)is reshaping financial systems and services,as intelligent AI agents increasingly form the foundation of autonomous,goal-driven systems capable of reasoning,learning,and action.This review synthesizes recent research and developments in the application of AI agents across core financial domains.Specifically,it covers the deployment of agent-based AI in algorithmic trading,fraud detection,credit risk assessment,roboadvisory,and regulatory compliance(RegTech).The review focuses on advanced agent-based methodologies,including reinforcement learning,multi-agent systems,and autonomous decision-making frameworks,particularly those leveraging large language models(LLMs),contrasting these with traditional AI or purely statistical models.Our primary goals are to consolidate current knowledge,identify significant trends and architectural approaches,review the practical efficiency and impact of current applications,and delineate key challenges and promising future research directions.The increasing sophistication of AI agents offers unprecedented opportunities for innovation in finance,yet presents complex technical,ethical,and regulatory challenges that demand careful consideration and proactive strategies.This review aims to provide a comprehensive understanding of this rapidly evolving landscape,highlighting the role of agent-based AI in the ongoing transformation of the financial industry,and is intended to serve financial institutions,regulators,investors,analysts,researchers,and other key stakeholders in the financial ecosystem.
文摘Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.
基金supported by grants from NIH T32(DK007260,to WC)the Steno North American Fellowship awarded by the Novo Nordisk Foundation(NNF23OC0087108,to WC).
文摘The shared links between Alzheimer’s disease and type 2 diabetes mellitus:Alzheimer’s disease(AD)and type 2 diabetes mellitus(T2DM)are two prevalent conditions that come with substantial daily struggles.Emerging evidence highlights that these diseases share similar pathophysiological features,including insulin resistance and chronic inflammation,which contribute to their rapid progression(Chen et al.,2022).Insulin resistance,a hallmark of T2DM,has been suggested to exacerbate neurodegeneration in AD.Similarly,chronic low-grade inflammation in T2DM parallels with neuroinflammation,which is observed in AD,suggesting overlapping pathophysiological mechanisms in T2DM and AD.
文摘BACKGROUND There has been an increasing focus in recent years on health-care disparities.Studies investigating return to work(RTW)or sports are often performed in large,urban areas.Relatively few studies have investigated rates of return to farming or other heavy labor that is of interest to patients in rural areas.AIM To evaluate the literature regarding RTW in farming or heavy labor after orthopedic hip,knee,or shoulder surgery.METHODS A search was performed in the PubMed and EMBASE databases using Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines.Studies were included if they reported patients employed in farming or heavy labor,RTW rates after orthopedic surgery of the hip,knee,or shoulder,and had a minimum 6-month follow-up.A meta-analysis of proportions using a random-effects model was performed on three single-arm observational studies to estimate the pooled RTW rate following arthroscopic shoulder surgery.RESULTS Ten studies were included,and 101 farmers were identified among 440 total patients.One study involved hip surgery,two studies involved knee surgery,and seven studies involved shoulder surgery.RTW rates across studies varied by type of surgery and follow-up interval,ranging from 24%to 100%.The RTW rate was only 53.6%at 1 year following total hip arthroplasty.No studies investigated RTW in farmers following total knee arthroplasty.Among non-comparative studies,meta-analysis revealed a pooled RTW rate of 89%following arthroscopic shoulder surgery,with low heterogeneity(I^(2)=30.1%).Among comparative studies,one study reported significantly higher RTW odds for patients undergoing anatomic total shoulder arthroplasty compared to reverse shoulder arthroplasty(odds ratio=5.45).Overall,surgical intervention for shoulder pathology was associated with a high likelihood of RTW across multiple techniques,with particularly favorable outcomes for anatomic total shoulder arthroplasty.CONCLUSION This systematic review highlights the high rates of RTW in farmers and heavy laborers after shoulder surgery.However,our findings also underscore the need for more rural-specific research to guide patient counseling,rehabilitation expectations,and shared decision-making in this underserved population,particularly for orthopedic surgery of the hip and knee.
基金supported by the National Natural Science Foundation of China(Grant No.82220108002 to F.C.and Grant No.82273737 to R.Z.)the U.S.National Institutes of Health(Grant Nos.CA209414,HL060710,and ES000002 to D.C.C.,Grant Nos.CA209414 and CA249096 to Y.L.)+1 种基金the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)supported by the Qing Lan Project of the Higher Education Institutions of Jiangsu Province and the Outstanding Young Level Academic Leadership Training Program of Nanjing Medical University.
文摘Interferon-related genes are involved in antiviral responses,inflammation,and immunity,which are closely related to sepsis-associated acute respiratory distress syndrome(ARDS).We analyzed 1972 participants with genotype data and 681 participants with gene expression data from the Molecular Epidemiology of ARDS(MEARDS),the Molecular Epidemiology of Sepsis in the ICU(MESSI),and the Molecular Diagnosis and Risk Stratification of Sepsis(MARS)cohorts in a three-step study focusing on sepsis-associated ARDS and sepsis-only controls.First,we identified and validated interferon-related genes associated with sepsis-associated ARDS risk using genetically regulated gene expression(GReX).Second,we examined the association of the confirmed gene(interferon regulatory factor 1,IRF1)with ARDS risk and survival and conducted a mediation analysis.Through discovery and validation,we found that the GReX of IRF1 was associated with ARDS risk(odds ratio[OR_(MEARDS)]=0.84,P=0.008;OR_(MESSI)=0.83,P=0.034).Furthermore,individual-level measured IRF1 expression was associated with reduced ARDS risk(OR=0.58,P=8.67×10^(-4)),and improved overall survival in ARDS patients(hazard ratio[HR_(28-day)]=0.49,P=0.009)and sepsis patients(HR_(28-day)=0.76,P=0.008).Mediation analysis revealed that IRF1 may enhance immune function by regulating the major histocompatibility complex,including HLA-F,which mediated more than 70%of protective effects of IRF1 on ARDS.The findings were validated by in vitro biological experiments including time-series infection dynamics,overexpression,knockout,and chromatin immunoprecipitation sequencing.Early prophylactic interventions to activate IRF1 in sepsis patients,thereby regulating HLA-F,may reduce the risk of ARDS and mortality,especially in severely ill patients.
文摘BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.
基金supported by grants from NIH T32(DK007260,to WC)the Steno North American Fellowship awarded by the Novo Nordisk Foundation(NNF23OC0087108,to WC)+6 种基金STI2030-Major Projects(2021ZD0202700,to HY)the National Natural Science Foundation of China(32241004,to HY)the Natural Science Foundation of Zhejiang Province of China(LR24C090001,to HY)Key R&D Program of Zhejiang Province(2024SSYS0017,to HY)CAMS Innovation Fund for Medical Sciences(2019-12M-5-057,to HY)Fundamental Research Funds for the Central Universities(226-2022-00193,to HY)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2023-PT310-01,to HY)。
文摘Type 2 diabetes mellitus has central complications:Diabetes,a metabolic disorder primarily characterized by hyperglycemia due to insufficient insulin secretion,or impaired insulin signaling,has significant central complications.Type 2 diabetes mellitus(T2DM),the most prevalent type of diabetes,affects more than 38 million individuals in the United States(approximately 1 in 10)and is defined by chronic hyperglycemia and insulin resistance,which refers to a reduced cellular response to insulin.
基金the Deanship of Research and Graduate Studies at King Khalid University,KSA,for funding this work through the Large Research Project under grant number RGP2/164/46.
文摘Background:Stomach cancer(SC)is one of the most lethal malignancies worldwide due to late-stage diagnosis and limited treatment.The transcriptomic,epigenomic,and proteomic,etc.,omics datasets generated by high-throughput sequencing technology have become prominent in biomedical research,and they reveal molecular aspects of cancer diagnosis and therapy.Despite the development of advanced sequencing technology,the presence of high-dimensionality in multi-omics data makes it challenging to interpret the data.Methods:In this study,we introduce RankXLAN,an explainable ensemble-based multi-omics framework that integrates feature selection(FS),ensemble learning,bioinformatics,and in-silico validation for robust biomarker detection,potential therapeutic drug-repurposing candidates’identification,and classification of SC.To enhance the interpretability of the model,we incorporated explainable artificial intelligence(SHapley Additive exPlanations analysis),as well as accuracy,precision,F1-score,recall,cross-validation,specificity,likelihood ratio(LR)+,LR−,and Youden index results.Results:The experimental results showed that the top four FS algorithms achieved improved results when applied to the ensemble learning classification model.The proposed ensemble model produced an area under the curve(AUC)score of 0.994 for gene expression,0.97 for methylation,and 0.96 for miRNA expression data.Through the integration of bioinformatics and ML approach of the transcriptomic and epigenomic multi-omics dataset,we identified potential marker genes,namely,UBE2D2,HPCAL4,IGHA1,DPT,and FN3K.In-silico molecular docking revealed a strong binding affinity between ANKRD13C and the FDA-approved drug Everolimus(binding affinity−10.1 kcal/mol),identifying ANKRD13C as a potential therapeutic drug-repurposing target for SC.Conclusion:The proposed framework RankXLAN outperforms other existing frameworks for serum biomarker identification,therapeutic target identification,and SC classification with multi-omics datasets.
基金partially supported by the National Heart,Lung,and Blood Institute of the National Institutes of Health(https://www.nhlbi.nih.gov/)under Award Number R01HL157991sponsored by the 2022 JOBST Lymphatic Research Grant awarded by the Boston Lymphatic Symposium,Inc.
文摘Aim:Although vascularized lymph node transplantation(VLNT)has gained recognition as an effective treatment option for lymphedema,no consensus on the timing of transplant with other lymphatic procedures has been established.The aim of this study is to describe our institutional experience with VLNT,including our staged approach and report postoperative outcomes.Methods:A retrospective review of patients who underwent VLNT for upper extremity lymphedema from May 2017 to April 2022 was conducted.Patients were divided into fat-or fluid-dominant phenotypes based on preoperative workup.Patients with a minimum of 12-month follow-up were included.Records were reviewed for demographic,intraoperative,and surveillance data.Results:Twenty-three patients underwent VLNT of the upper extremity during the study period,of which eighteen met the study criteria.Nine patients had fluid-dominant disease and nine patients had fat-dominant disease and had undergone prior debulking at our institution.Fluid-dominant patients demonstrated slight reductions in limb volume and hours in compression,and improvement in quality-of-life scores at twelve months.Fat-dominant patients who underwent prior debulking had a slight increase in limb volume without a change in hours of compression,and demonstrated improvements in quality-of-life scores in nearly all subdomains.Overall,17% of patients discontinued compression therapy entirely.Improvement in extremity edema was present in 83% of postoperative MRIs.Conclusion:VLNT had varying effects on limb measurements while reliably improving quality-of-life and allowing for the potential of discontinuing compression.Utilizing a staged approach wherein debulking is performed upfront may be particularly beneficial for patients with fat-dominant disease.
