Quantitative Metabolomics and Lipoprotein Analysis of PDAC Patients Suggests Serum Marker Categories for Pancreatic Function, Pancreatectomy, Cancer Metabolism, and Systemic Disturbances.

Pancreatic ductal adenocarcinoma (PDAC) is difficult to diagnose in the early stages and lacks reliable biomarkers. The scope of this project was to establish quantitative nuclear magnetic resonance (NMR) spectroscopy to comprehensively study blood serum alterations in PDAC patients. Serum samples from 34 PDAC patients obtained before and after pancreatectomy as well as 83 age- and sex-matched control samples from healthy donors were analyzed with in vitro diagnostics research (IVDr) proton NMR spectroscopy at 600 MHz. Uni- and multivariate statistics were applied to identify significant biofluid alterations. We identified 29 significantly changed metabolites and 98 lipoproteins when comparing serum from healthy controls with those of PDAC patients. The most prominent features were assigned to (i) markers of pancreatic function (e.g., glucose and blood triglycerides), (ii) markers related to surgery (e.g., ketone bodies and blood cholesterols), (iii) PDAC-associated markers (e.g., amino acids and creatine), and (iv) markers for systemic disturbances in PDAC (e.g., gut metabolites DMG, TMAO, DMSO2, and liver lipoproteins). Quantitative serum NMR spectroscopy is suited as a diagnostic tool to investigate PDAC. Remarkably, 2-hydroxybutyrate (2-HB) as a previously suggested marker for insulin resistance was found in extraordinarily high levels only after pancreatectomy, suggesting this metabolite is the strongest marker for pancreatic loss of function.

Sentence-final completion norms for 2925 Mexican Spanish sentence contexts.

Sentence-final completion tasks serve as valuable tools in studying language processing and the associated predictive mechanisms. There are several established sentence-completion norms for languages like English, Portuguese, French, and Spanish, each tailored to the language it was designed for and evaluated in. Yet, cultural variations among native speakers of the same language complicate the claim of a universal application of these norms. In this study, we developed a corpus of 2925 sentence-completion norms specifically for Mexican Spanish. This corpus is distinctive for several reasons: Firstly, it is the most comprehensive set of sentence-completion norms for Mexican Spanish to date. Secondly, it offers a substantial range of experimental stimuli with considerable variability in terms of the predictability of word sentence completion (cloze probability/surprisal) and the level of uncertainty inherent in the sentence context (entropy). Thirdly, the syntactic complexity of the sentences in the corpus is varied, as are the characteristics of the final word nouns (including aspects of concreteness/abstractness, length, and frequency). This paper details the generation of the sentence contexts, explains the methodology employed for data collection from a total of 1470 participants, and outlines the approach to data analysis for the establishment of sentence-completion norms. These norms provide a significant contribution to fields such as linguistics, cognitive science, and machine learning, among others, by enhancing our understanding of language, predictive mechanisms, knowledge representation, and context representation. The collected data is accessible through the Open Science Framework (OSF) at the following link: https://osf.io/js359/?view_only=bb1b328d37d643df903ed69bb2405ac0 .

[Transcatheter aortic-valve implantation. A ten years clinical experience]. / Resultados del implante percutáneo de válvula aórtica (TAVI). Experiencia después de la primera década desde la introducción de la técnica.

BACKGROUND: Transcatheter aortic-valve implantation (TAVI) was introduced in 2002 and the first implants in our country were performed in 2010. AIM: To review the TAVI experience in our hospital, considering the technology improvements and gained experience throughout this period. MATERIAL AND METHODS: All patients undergoing TAVI in our center were included. Results and complications were adjudicated according to the Valve Academic Research Consortium-2 (VARC-2) criteria. Patients were divided in 3 groups, according to procedural year: Period 1: 2010-2015 (n = 35); Period 2: 2016-2018 (n = 35); Period 3: 2019-2021 (n = 41). Mortality up to one year after the procedure was recorded. RESULTS: Between 2010 and 2021, 111 TAVI procedures were performed. The mean age of patients was 82 years and 47% were women. Risk scores for in-hospital mortality were STS 6.7%, EUROSCORE II 8.0% and ACC/STS TAVR Score 4.9%. The trans-femoral route was used in 88% and a balloon-expandable valve was chosen in 82% of patients. A successful implant was achieved in 96%, with an in-hospital mortality of 1.8%. Mortality at 30 days and 1-year were 2.7 and 9.0%, respectively. During period 3, 100% of implants were successful, with no in-hospital mortality, less vascular complications (p < 0.01), less stroke (p = 0.04), less severe paravalvular leak (p = 0.01) and significantly lower rate of acute complications (p < 0.01). CONCLUSIONS: TAVI achieves excellent results. With greater experience and better available technologies, these results are even more favorable.

Clinical significance of ocular manifestations in granulomatosis with polyangiitis: association with sinonasal involvement and damage.

Ocular involvement is present in 50-60% of granulomatosis with polyangiitis (GPA) patients and can affect any part of the ocular globe. The present study describes ophthalmologic manifestations, association with systemic symptoms, disease activity and damage in GPA. A cross-sectional study was conducted including patients with GPA who underwent rheumatologic and ophthalmologic evaluation. Demographics, comorbidities, ophthalmologic symptoms, serologic markers, radiographic studies, disease activity and damage were assessed. Descriptive statistics, correlation, univariable logistic regression analyses, Student's t, Mann-Whitney U, Chi-square and Fisher's exact tests were performed. Fifty patients were included, 60% female, the median age was 56 years, disease duration 72.5 months. Nineteen (38%) patients had ocular manifestations at GPA diagnosis, scleritis being the most frequent; 27 (54%) patients presented ocular involvement during follow-up, repeated scleritis and dacryocystitis being the most common manifestations. Concomitant ophthalmic and sinonasal involvement was present in 12 (24%). Ocular and ENT damage occurred in 58% and 70%, respectively. Epiphora and blurred vision were the most frequent symptoms; scleromalacia and conjunctival hyperemia (27%) the most frequent clinical abnormalities. Ocular involvement at diagnosis was associated with concomitant ocular and sinonasal involvement at follow-up (OR 4.72, 95% CI 1.17-19.01, p = 0.01). Ocular involvement at follow-up was associated with age at GPA diagnosis (OR 0.94, 95% CI 0.90-0.99, p = 0.03), VDI (OR 1.29, 95% CI 1.03-1.61, p = 0.02), and ENT damage (OR 5.27, 95% CI 1.37-20.13, p = 0.01). In GPA, ocular involvement is frequent, therefore, non-ophthalmologist clinicians should be aware of this manifestation to reduce the risk of visual morbidity and organ damage.

Clinicopathological characterization and genomic sequence differences observed in a highly virulent fowl Aviadenovirus serotype 4.

Highly virulent fowl aviadenoviruses (genus: Aviadenovirus) represent a significant risk in poultry farming that may contribute to increased mortality rates and may adversely affect the growth performance of poultry flocks. In this study, we performed the clinicopathological characterization of a FAdV strain SHP95 isolated from a commercial farm and its whole genome sequencing. The study revealed that the isolated strain is a highly virulent serotype 4 FAdV that can cause 100% mortality in day-old specific pathogen free (SPF) chickens with a dose of 2.5 × 10(5) TCID50. At a lower viral dose (1.5 × 10(4) TCID50), the infection in day-old SPF chickens caused 40% mortality and lesions characteristic for Hepatitis-hydropericardium syndrome (HHS). The viral strain was detectable by real time PCR in chicken organs, including the lymphoid organs until day 28 after infection. The whole genome assembly of strain SHP95 revealed a size of 45,641 bp, which encodes for 42 viral open reading frame (ORF). The comparative analysis in the genome shows 98.1% similarity between strain SHP95 and other FAdV-4 genomes reported. The major differences in the genome sequence between pathogenic and non-pathogenic fowl Adenovirus were identified in the right arm of the genome.

[Long term results of mitral balloon valvuloplasty]. / Resultados a largo plazo de la valvuloplastía mitral con balón.

BACKGROUND: Mitral balloon valvuloplasty (MBV) is the therapy of choice for the treatment of symptomatic mitral stenosis with suitable anatomy. Although its short and mid-term results are favorable, there is a paucity of information about long-term follow-up. AIM: To assess the late results of MBV. MATERIAL AND METHODS: A cohort of 225 patients aged 8 to 20 years who were subjected to a MBV from 1989 to 2001, was studied. All variables at the time of the procedure, short and long-term results and major events during follow-up (new mitral intervention and mortality) were recorded. Uni and multivariate analysis were used to assess prognosis. RESULTS: The mean follow-up lapse was 13.5 years (range 8 to 20 years). During this period, 88 patients (39.1%) remained event-free and in acceptable functional capacity. Eight percent died, 8% required a second MBV and 43.5% required a surgical mitral valve replacement. A post-procedural area equal or greater to 1.9 cm² was associated with a greater likelihood of free-event survival (log rank test: p = 0.02/Cox proportional regression model: coefficient 0.54, p = 0.04). CONCLUSIONS: MBV is effective, although there is a high chance of new interventions in the long-term follow-up. A larger post-procedure mitral area is associated with a better prognosis.

Hidden Threat: Incidental Finding of Pancreatic Body Solid Pseudopapillary Tumor During Bariatric Evaluation With an Open Central Pancreatectomy Resolution.

Incidentalomas, or tumors found incidentally, are very common. However, pancreatic tumors are usually not found as incidentalomas. To date, these tumors represent a diagnostic and therapeutic challenge, since the risks and benefits associated with surgeries that can be performed to remove these tumors must be evaluated due to perioperative complications. It is vitally important to always carry out a correct approach that includes a histopathological study to allow timely identification of tumors that require surgical management or other preoperative treatment, such as chemotherapy or radiotherapy. The majority of these tumors are benign cystic tumors; however, there are cases, like the one presented here, where the tumor turns out to be a solid pseudopapillary tumor (SPT) that requires a different diagnostic and surgical approach. Also, in this case, the importance of evaluating the patient's general health status is highlighted to determine whether or not the required surgery can be performed at that moment or if any prior intervention is required. This case report talks about a patient in whom an incidental pancreatic tumor was found and how its management was carried out from diagnosis to the postoperative period.

Spatially modulated ablation driven by chaotic attractors in human lung epithelial cancer cells.

A significant modification in photoinduced energy transfer in cancer cells is reported by the assistance of a dynamic modulation of the beam size of laser irradiation. Human lung epithelial cancer cells in monolayer form were studied. In contrast to the quantum and thermal ablation effect promoted by a standard focused Gaussian beam, a spatially modulated beam can caused around 15% of decrease in the ablation threshold and formation of a ring-shaped distribution of the photothermal transfer effect. Optical irradiation was conducted in A549 cells by a 532 nm single-beam emerging from a Nd:YVO4 system. Ablation effects derived from spatially modulated convergent waves were controlled by an electrically focus-tunable lens. The proposed chaotic behavior of the spatial modulation followed an Arneodo chaotic oscillator. Fractional dynamic thermal transport was analyzed in order to describe photoenergy in propagation through the samples. Immediate applications of chaos theory for developing phototechnology devices driving biological functions or phototherapy treatments can be considered.

Novel PVA-Hyaluronan-Siloxane Hybrid Nanofiber Mats for Bone Tissue Engineering.

Hyaluronan (HA) is a natural biodegradable biopolymer; its biological functions include cell adhesion, cell proliferation, and differentiation as well as decreasing inflammation, angiogenesis, and regeneration of damaged tissue. This makes it a suitable candidate for fabricating nanomaterials with potential use in tissue engineering. However, HA nanofiber production is restricted due to the high viscosity, low evaporation rate, and high surface tension of HA solutions. Here, hybrids in the form of continuous and randomly aligned polyvinyl alcohol (PVA)-(HA)-siloxane nanofibers were obtained using an electrospinning process. PVA-HA fibers were crosslinked by a 3D siloxane organic-inorganic matrix via sol-gel that restricts natural hydrophilicity and stiffens the structure. The hybrid nanofiber mats were characterized by FT-IR, micro-Raman spectroscopy, SEM, and biological properties. The PVA/HA ratio influenced the morphology of the hybrid nanofibers. Nanofibers with high PVA content (10PVA-8 and 10PVA-10) form mats with few beaded nanofibers, while those with high HA content (5PVA-8 and 5PVA-10) exhibit mats with mound patterns formed by "ribbon-like" nanofibers. The hybrid nanofibers were used as mats to support osteoblast growth, and they showed outstanding biological properties supporting cell adhesion, cell proliferation, and cell differentiation. Importantly, the 5PVA-8 mats show 3D spherical osteoblast morphology; this suggests the formation of tissue growth. These novel HA-based nanomaterials represent a relevant advance in designing nanofibers with unique properties for potential tissue regeneration.

Assessment and optimization of an ultrasound-assisted washing process using organic solvents for polychlorinated biphenyl-contaminated soil.

The goal of this work was to evaluate a washing process that uses organic solutions for polychlorinated biphenyl (PCB)-contaminated soil, and includes an ultrasound pre-treatment step to reduce operational times and organic solvent losses. In a preliminary trial, the suitability of 10 washing solutions of different polarities were tested, from which three n-hexane-based solutions were selected for further evaluation. A second set of experiments was designed using a three-level Taguchi L27 orthogonal array to model the desorption processes of seven different PCB congeners in terms of the variability of their PCB concentration levels, polarity of the washing solution, sonication time, the ratio washing solution/soil, number of extraction steps and total washing time. Linear models were developed for the desorption processes of all congeners. These models provide a good fit with the results obtained. Moreover, statistically significant outcomes were achieved from the analysis of variance tests carried out. It was determined that sonication time and ratio of washing solution/soil were the most influential process parameters. For this reason they were studied in a third set of experiments, constructed as a full factorial design. The process was eventually optimized, achieving desorption rates of more than 90% for all congeners, thus obtaining concentrations lower than 5 ppb in all cases. The use of an ultrasound-assisted soil washing process for PCB-contaminated soils that uses organic solvents seems therefore to be a viable option, especially with the incorporation of an extra step in the sonication process relating to temperature control, which is intended to prevent the loss of the lighter congeners.

The Relationship between Anxiety, Subjective and Objective Sleep, Chronotype and Circadian Rhythms with Depressive Symptoms in Insomnia Disorder.

Insomnia is a highly prevalent sleep disorder with strong bidirectional associations with depressive symptoms. The circadian preference for eveningness has been shown to be associated with depressive symptoms in insomnia and other mental health conditions. However, there is a lack of studies in insomnia investigating whether objective measures, such as dim light melatonin onset (DLMO) or polysomnographic (PSG) sleep, are associated with depressive symptoms. Therefore, we investigated the associations between subjective measures (questionnaires assessing anxiety, sleep quality and circadian preference, and sleep diary) and depressive symptoms and whether the addition of objective measures (DLMO, PSG parameters) would strengthen the associations with depressive symptoms. In 115 insomnia disorder patients we found that anxiety was strongly associated with depressive symptoms in a model including circadian preference, dysfunctional beliefs of sleep, and self-reported previous depressive symptoms (R2 = 0.496, p < 0.001). The addition of sleep diary measures did not strengthen the model. We also found that the addition of objective measures (DLMO, PSG parameters) did not improve the subjective associations with depressive symptoms. Our data suggest that objective circadian markers are less important in the prediction of depressive symptoms in insomnia compared to subjective measures.

Alternative splicing of the SUMO1/2/3 transcripts affects cellular SUMOylation and produces functionally distinct SUMO protein isoforms.

Substantial increases in the conjugation of the main human SUMO paralogs, SUMO1, SUMO2, and SUMO3, are observed upon exposure to different cellular stressors, and such increases are considered important to facilitate cell survival to stress. Despite their critical cellular role, little is known about how the levels of the SUMO modifiers are regulated in the cell, particularly as it relates to the changes observed upon stress. Here we characterize the contribution of alternative splicing towards regulating the expression of the main human SUMO paralogs under normalcy and three different stress conditions, heat-shock, cold-shock, and Influenza A Virus infection. Our data reveal that the normally spliced transcript variants are the predominant mature mRNAs produced from the SUMO genes and that the transcript coding for SUMO2 is by far the most abundant of all. We also provide evidence that alternatively spliced transcripts coding for protein isoforms of the prototypical SUMO proteins, which we refer to as the SUMO alphas, are also produced, and that their abundance and nuclear export are affected by stress in a stress- and cell-specific manner. Additionally, we provide evidence that the SUMO alphas are actively synthesized in the cell as their coding mRNAs are found associated with translating ribosomes. Finally, we provide evidence that the SUMO alphas are functionally different from their prototypical counterparts, with SUMO1α and SUMO2α being non-conjugatable to protein targets, SUMO3α being conjugatable but targeting a seemingly different subset of protein from those targeted by SUMO3, and all three SUMO alphas displaying different cellular distributions from those of the prototypical SUMOs. Thus, alternative splicing appears to be an important contributor to the regulation of the expression of the SUMO proteins and the cellular functions of the SUMOylation system.

High-intensity interval training reduces the induction of neutrophil extracellular traps in older men using live-neutrophil imaging as biosensor.

Neutrophil extracellular trap formation (NETosis) is a mechanism used by neutrophils to capture pathogens with their own DNA. However, the exacerbation of this immune response is related to serious inflammatory diseases. Aging is known to lead to an excessive increase in NETosis associated with various diseases. Under this scenario, the search for strategies that regulate the release of NETosis in older people becomes relevant. High-intensity interval training (HIIT) involves repeated bouts of relatively intense exercise with alternating short recovery periods. This training has shown beneficial effects on health parameters during aging and disease. However, little is known about the potential role of HIIT in the regulation of NETosis in healthy older people. The aim of this study was to evaluate the induction of NETosis by serum from healthy young and older men, before and after 12 weeks of HIIT using healthy neutrophils as a biosensor. HIIT was performed 3 times per week for 12 weeks in young (YOUNG; 21 ± 1 years, BMI 26.01 ± 2.64 kg⋅m-2, n = 10) and older men (OLDER; 66 ± 5 years, BMI 27.43 ± 3.11 kg⋅m-2, n = 10). Serum samples were taken before and after the HIIT program and NETosis was measured with live cell imaging in donated neutrophils cultured with serum from the participants for 30 h. Our results showed that serum from older men at baseline induced greater baseline NETosis than younger men (p < 0.05; effect size, ≥0.8), and 12 weeks of HIIT significantly reduced (Interaction Effect, p < 0.05; effect size, 0.134) the induction of NETosis in older men. In conclusion, HIIT is a feasible non-invasive training strategy modulating NETosis induction. Additionally, the use of neutrophils as a biosensor is an effective method for the quantification of NETosis induction in real time.

Whole Animal Feeding FLat (WAFFL): a complete and comprehensive validation of a novel, high-throughput fly experimentation system.

Non-mammalian model organisms have been essential for our understanding of the mechanisms that control development, disease, and physiology, but they are underutilized in pharmacological and toxicological phenotypic screening assays due to their low throughput in comparison with cell-based screens. To increase the utility of using Drosophila melanogaster in screening, we designed the Whole Animal Feeding FLat (WAFFL), a novel, flexible, and complete system for feeding, monitoring, and assaying flies in a high-throughput format. Our 3D printed system is compatible with inexpensive and readily available, commercial 96-well plate consumables and equipment. Experimenters can change the diet at will during the experiment and video record for behavior analysis, enabling precise dosing, measurement of feeding, and analysis of behavior in a 96-well plate format.

Patterns of asexual reproduction of the soybean aphid, Aphis glycines (Matsumura), with and without the secondary symbionts Wolbachia and Arsenophonus, on susceptible and resistant soybean genotypes.

Plant breeding is used to develop crops with host resistance to aphids, however, virulent biotypes often develop that overcome host resistance genes. We tested whether the symbionts, Arsenophonus (A) and Wolbachia (W), affect virulence and fecundity in soybean aphid biotypes Bt1 and Bt3 cultured on whole plants and detached leaves of three resistant, Rag1, Rag2 and Rag1 + 2, and one susceptible, W82, soybean genotypes. Whole plants and individual aphid experiments of A. glycines with and without Arsenophonus and Wolbachia did not show differences in overall fecundity. Differences were observed in peak fecundity, first day of deposition, and day of maximum nymph deposition of individual aphids on detached leaves. Bt3 had higher fecundity than Bt1 on detached leaves of all plant genotypes regardless of bacterial profile. Symbionts did not affect peak fecundity of Bt1 but increased it in Bt3 (A+W+) and all Bt3 strains began to deposit nymphs earlier than the Bt1 (A+W-). Arsenophonus in Bt1 delayed the first day of nymph deposition in comparison to aposymbiotic Bt1 except when reared on Rag1 + 2. For the Bt1 and Bt3 strains, symbionts did not result in a significant difference in the day they deposited the maximum number of nymphs nor was there a difference in survival or variability in number of nymphs deposited. Variability of number of aphids deposited was higher in aphids feeding on resistant plant genotypes. The impact of Arsenophonus on soybean aphid patterns of fecundity was dependent on the aphid biotype and plant genotype. Wolbachia alone had no detectable impact but may have contributed to the increased fecundity of Bt3 (A+W+). An individual based model, using data from the detached leaves experiment and with intraspecific competition removed, found patterns similar to those observed in the greenhouse and growth chamber experiments including a significant interaction between soybean genotype and aphid strain. Combining individual data with the individual based model of population growth isolated the impact of fecundity and host resistance from intraspecific competition and host health. Changes to patterns of fecundity, influenced by the composition and concentration of symbionts, may contribute to competitive interactions among aphid genotypes and influence selection on virulent aphid populations.

Multifunctional human monoclonal antibody combination mediates protection against Rift Valley fever virus at low doses.

The zoonotic Rift Valley fever virus (RVFV) can cause severe disease in humans and has pandemic potential, yet no approved vaccine or therapy exists. Here we describe a dual-mechanism human monoclonal antibody (mAb) combination against RVFV that is effective at minimal doses in a lethal mouse model of infection. We structurally analyze and characterize the binding mode of a prototypical potent Gn domain-A-binding antibody that blocks attachment and of an antibody that inhibits infection by abrogating the fusion process as previously determined. Surprisingly, the Gn domain-A antibody does not directly block RVFV Gn interaction with the host receptor low density lipoprotein receptor-related protein 1 (LRP1) as determined by a competitive assay. This study identifies a rationally designed combination of human mAbs deserving of future investigation for use in humans against RVFV infection. Using a two-pronged mechanistic approach, we demonstrate the potent efficacy of a rationally designed combination mAb therapeutic.

The Effect of Visit-to-Visit Blood Pressure Variability on Renal Function in Geriatric Chronic Kidney Disease.

OBJECTIVE: The visit-to-visit variability (VVV) of blood pressure (BP) has been recognized as a risk factor for cardiovascular events and chronic kidney disease (CKD). The objective of this study is to valuate the association between the VVV of BP and changes in estimated glomerular filtration rate (eGFR) in elderly CKD patients at different stages of renal function. MATERIALS AND METHODS: For 60 months, we analyzed the medical records of 105 patients with and without diabetes and hypertension. Systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) were examined. A multivariable linear regression model was used to analyze the correlation between eGFR and the VVV of BP. RESULTS: No differences were demonstrated between the groups in the clinical characteristics. Mean SBP and DBP were not significant between the groups, and we observed no decrease in renal function. A significant negative correlation between PP and eGFR was observed in the total CKD population with a P of .010 (95% CI: -0.20, -0.03) and a correlation coefficient of -0.11. CONCLUSION: Our study shows no statistical significances in terms of the VVVs of BP in any of the geriatric groups, with no significant decreases in renal function. However, we observed a significant negative correlation between PP and eGFR. We demonstrated that if a VVV of BP does not occur, there is no decrease in eGFR.

Advantages of Intraoperative Neuromonitoring Over Direct Visualization of the Recurrent Laryngeal Nerve During Thyroidectomy.

BACKGROUND: The well-recognized risk of injury to the recurrent laryngeal nerve (RLN) during thyroidectomy has instigated various preventive measures. One such measure involves directly visualizing the RLN, but this is not always feasible in practice. A more recent approach involves using intraoperative neuromonitoring to identify and preserve the RLN. This study aims to evaluate the effectiveness of intraoperative neuromonitoring compared to single visualization of the RLN in averting nerve injury. METHODS: We conducted a retrospective, observational, and descriptive study on a cohort of 218 patients. A Chi-square test was employed to determine the influence of intraoperative neuromonitoring on the incidence of nerve injury, with P < 0.05 considered statistically significant. We used Jamovi software version 2.3.18 to analyze the data. RESULTS: Of the 218 patients, intraoperative neuromonitoring was used in 150 (68.8%) cases; none of which resulted in nerve injury. Conversely, 68 (31.2%) patients underwent surgery without the use of neuromonitoring, with two (2.9%) patients in this group experiencing nerve injury (p=0.037). In comparison, the risk of nerve injury was 0% in the group monitored intraoperatively and 2.94% in the group that did not undergo intraoperatively neuromonitoring. Further, the relative risk of complications was 0.66% in patients operated with neuromonitoring, while it was 5.88% in the group operated without neuromonitoring, thus demonstrating a clinically significant protective against vasculonervous complications. CONCLUSION: The results advocate for the use of intraoperative neuromonitoring, whenever available, as it is a safe method for significantly decreasing the incidence of RLN injury during thyroidectomy compared with only visualization.

Cognitive modeling for understanding interactions between people and decision support tools in complex and uncertain environments: A study protocol.

BACKGROUND: Recent advances in Computational Intelligence Tools and the escalating need for decision-making in the face of complex and uncertain phenomena like pandemics, climate change, and geopolitics necessitate understanding the interaction between these tools and human behavior. It is crucial to efficiently utilize the decision-makers cognitive resources in addressing specific problems. METHODS: The main goal of this present protocol is to describe the effect that CITs (Computational Intelligence Tools) have on decisions made during complex and uncertain situations. It is an exploratory study with a mixed methodology. Solomon's group experiment design includes a narrative analysis of cognitive features such as integrative complexity (IC), cognitive flexibility (CF), and fluid intelligence (FI). Additionally, measures of neural activity (NA), physiological measures (PM), and eye-tracking data (ET) will be collected during the experimental session to examine the marginal impact of these processes on decision outcomes (DO) and their relation to CIT capabilities. To achieve this objective, 120 undergraduate and graduate students involved in decision-making will participate as subjects. The approximate duration of the study will be 2 years. Strict adherence to the relevant ethical considerations will be maintained during the performance of the experimental tasks. DISCUSSION: The study will provide valuable information on CITs' effect on decision-making under complex and uncertain contexts. This will help to better understand the link between technology and human behavior, which has important implications. CIT designers can use future results and at the same time, it will be possible to understand cognitive, behavioral, physiological processes, and even the subjective assessment of individuals when they use technological tools to solve a problem.