bluuebunny/crossref_metadata_2025 huggingface dataset:
An Unusual Case of Pheochromocytoma Associated with von Hippel-Lindau Disease and Lynch Syndrome During Pregnancy
Authors: Tang Michael , Meng Shumei
Published: June 2024

Pheochromocytomas (PCCs) and/or paragangliomas (PGLs) are a challenge to diagnose during pregnancy because of elusive signs and testing difficulties. We report a 25-year-old woman with no pertinent medical history who presented to the hospital with hypertension, vision loss, and weakness and was initially diagnosed with preeclampsia. Imaging showed hemangioblastomas in the medulla and thoracic spine, pancreatic cysts, and a renal cyst. The endocrinology service was consulted for possible PCCs associated with von Hippel-Lindau disease (VHL). Serum and urine normetanephrine levels were elevated despite the lack of overt PCCs/PGLs seen on magnetic resonance imaging and magnetic resonance angiography. The patient was medically managed with doxazosin and then labetalol. Despite successful resection of the hemangioblastoma in the medulla, the patient suffered respiratory distress requiring tracheostomy and venous-venous extracorporeal membrane oxygenation (V-V ECMO) and fetal demise. After 3 months, the patient was discharged to rehabilitation. Follow-up genetics were heterozygous for VHL and Lynch syndrome. DOTATATE positron emission tomography/computed tomography scan showed a small hepatic focus of a maximum standard uptake value of 12.1. Altogether, this case illustrates the importance of prompt diagnosis and proper management of PCCs/PGLs during pregnancy and incorporating genetic information during surveillance to lower morbidity and mortality.
Delayed Type Hypersensitivity Reaction Induced By Liraglutide With Tolerance to Semaglutide
Authors: Moreno-Borque Ricardo , Guhl-Millán Guillermo , Mera-Carreiro Sara , Pazos-Guerra Mario , Cortés-Toro Jose Antonio , López-Bran Eduardo
Published: June 2024

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the management of type 2 diabetes and obesity. It was the first GLP-1 receptor agonist to be approved by the US Food and Drug Administration and the European Medicines Agency for the treatment of obesity. To date, numerous skin adverse reactions to liraglutide have been reported, but data regarding hypersensitivity reactions are scarce, raising concerns about its safety and clinical management. We present the case of a 56-year-old female patient with class 3 obesity who was started on subcutaneous liraglutide (Saxenda) by her endocrinologist. One month after starting the aforementioned treatment, the patient presented well-defined, round, erythematous pruriginous plaques surrounding the injection site, around 24 hours after the drug administration. A liraglutide-induced, delayed-type hypersensitivity reaction was suspected, which could be subsequently confirmed by allergy testing and histopathological study. This paper explores the clinical use of liraglutide, the occurrence of hypersensitivity reactions, diagnosis, management, and implications for future research. Understanding and managing liraglutide hypersensitivity is crucial to ensuring the safety and efficacy of this medication.
An Innovative Approach to Determine Programmed Intermittent Epidural Bolus Pump Settings for Labor Analgesia: A Randomized Controlled Trial
Authors: Munro Allana , George Ronald B. , Andreou Pantelis
Published: June 2024

BACKGROUND:

Three settings are required on a programmed intermittent epidural bolus (PIEB) pump for labor analgesia: the PIEB next bolus (PIEBnb), PIEB interval (PIEBi), and PIEB volume (PIEBv). The ideal settings for these parameters are still unknown. We hypothesized a mathematical modeling tool, response surface methodology (RSM), could estimate 3 PIEB pump parameters while balancing 3 clinically important patient outcomes simultaneously. The study objective was to use RSM to estimate PIEB settings (PIEBnb, PIEBi, and PIEBv) while maximizing maternal satisfaction, minimizing the need for clinician-administered boluses, and optimizing the ratio of delivered/requested patient-controlled epidural analgesia (PCEA) boluses simultaneously.

METHODS:

With institutional ethics approval, a double-blind randomized trial was completed in a tertiary care labor and delivery center. Nulliparous, English-speaking American Society of Anesthesiologists (ASA) physical status II patients aged 18 to 45 years at full term, single gestation in vertex presentation, in spontaneous labor and ≤7 cm cervical dilation were included. Patients with comorbidities, contraindications to neuraxial analgesia, using chronic analgesics, <152 cm, or body mass index (BMI) >45 kg/m2 were excluded. After informed consent, labor analgesia was initiated using 10 mL ropivacaine 0.2% with 10 µg/mL fentanyl solution and PCEA (volume 6 mL every 10 minutes). Patients were randomized to predetermined PIEB settings. RSM identified 3 pump settings that represented a stationary point that best maximized or minimized 3 outcomes simultaneously: PCEA ratio (a ratio closest to 1), clinician bolus (optimal is 0), and maternal satisfaction (visual analog scale, 0–100, ideal response is ≥90).

RESULTS:

Of 287 potential participants, 192 did not meet inclusion criteria or declined to participate, and 26 were withdrawn, leaving 69 patients for study inclusion. Using RSM, the suggested PIEB settings for all the primary study outcomes were as follows: PIEBnb = 29.4 minutes, PIEBi = 59.8 minutes, and PIEBv = 6.2 mL. These PIEB settings corresponded to the following clinical outcomes: maternal satisfaction at 93.9%, PCEA ratio at 0.77, and need for clinician bolus at 0.29. The dermatome sensory score was between T10 and T5 in 89% of the patients. The median lowest Bromage score was 4.

CONCLUSIONS:

This novel study used a mathematical model to estimate PIEB pump settings while simultaneously maximizing 3 clinical outcomes. Equally weighted clinical outcomes prevent maximal outcome optimization and may not reflect patient priorities. Future studies or quality improvement endeavors could use RSM methodology to estimate PIEB pump settings targeting optimal values for a single clinical outcome of determined importance to parturients.
Breaking the Saffron Wave?
Authors: Schonthal Benjamin , Ginsburg Tom
Published: June 2024

In recent years, thousands of Buddhist monastics have marched in antiregime protests across South and Southeast Asia. Among the largest and most influential nonstate organizations in the region, monastic communities appear to be powerful agents for political change. Yet, like similar movements over the last half-century, recent monastic protests did not produce broader political resistance among the monkhood, nor did they lead to substantive political change. What explains this? Why has antigovernment activism among Buddhist monks been less durable or impactful than other types of monastic activism, such as the varieties of chauvinistic nationalism that have risen to prominence in recent years? This article draws on three case studies—Myanmar, Thailand, and Sri Lanka—to offer one answer: sangha capture, the strategic use of law, bureaucracy, patronage, and coercion by governing elites to induce compliance among monastics while also muffling and marginalizing would-be critics.
Pedicle Subtraction Osteotomies for Surgical Correction of Fixed Sagittal Imbalance: A Meta-Analysis and Systematic Review
Authors: Makineni Pratheek S. , El-Abtah Mohamed E. , Porto Joshua R. , Steinmetz Michael P. , Benzel Edward C.
Published: June 2024

BACKGROUND AND OBJECTIVES:

Disruption of the spine's sagittal balance is associated with significant negative impacts on quality of life. Compared with other spinal osteotomies, pedicle subtraction osteotomy (PSO), which can potentially offer greater correction, is considered technically challenging and performed at lower rates. The aim of this study was to review the use of PSO to correct fixed sagittal imbalance and assess its efficacy and associated perioperative complications.

METHODS:

In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, EBSCO host, MEDLINE, and Google Scholar databases were queried for full-text English manuscripts published from 1961 to 2022, exploring PSO for the management of fixed sagittal imbalance. Studies were included if they reported preoperative and postoperative radiographic measurements. The mean Methodological Index for Nonrandomized Studies (MINORS) for included articles was 9.6 ± 1.1. The outcomes of interest included etiology, operative time, blood loss, complications, radiographic outcomes, and patient-reported outcomes. Statistical analysis was performed using a random-effects, inverse variance-weighted meta-analysis of observational data. Pre and postoperative radiographic and clinical outcomes were compared using a Student t-test.

RESULTS:

Fourteen studies with 595 patients were included. Meta-analysis showed that the mean operative time was 7.2 ± 2.0 hours, and the average blood loss was 2033 ± 629 mL. After PSO, there was a significant improvement in sagittal vertebral axis (12.41-3.92 cm, P = .0003), LL (13.35°-42.60°, P = .000002), PSO angle (5.11° to −26.91°, P = .0001), and Oswestry Disability Index (55.36-27.35, P = .02). Common complications include pseudarthrosis (8.1%), neurological deficits (7.8%), and proximal junctional failure (6.0%).

CONCLUSION:

PSO offers significant correction of sagittal vertebral axis, lumbar lordosis, PSO angle, and Oswestry Disability Index scores despite its reduced utilization in recent years. Blood loss and high complication rates must be considered when evaluating the efficacy of this procedure; however, surgeon experience and operative techniques can be used to reduce morbidity.
Thrombectomy Outcomes in Acute Basilar Artery Occlusions Due to Intracranial Atherosclerotic Disease
Authors: Mierzwa Adam T. , Al Kasab Sami , Nelson Ashley , Gutierrez Santiago Ortega , Vivanco-Suarez Juan , Farooqui Mudassir , Jadhav Ashutosh P. , Desai Shashvat , Toth Gabor , Alrohimi Anas , Nguyen Thanh N. , Klein Piers , Abdalkader Mohamad , Salahuddin Hisham , Pandey Aditya , Koduri Sravanthi , Wilseck Zachary , Vora Nirav , Aladamat Nameer , Gharaibeh Khaled , Afreen Ehad , Zaidi Syed , Jumaa Mouhammad
Published: June 2024

BACKGROUND AND OBJECTIVES:

Intracranial atherosclerotic disease (ICAD) large vessel occlusion (LVO) is responsible for up to 30% of LVO. In this study, we aimed to determine the likelihood of favorable functional outcomes (modified Rankin Scale 0-3) in acute ICAD-LVO basilar occlusion compared with embolic basilar occlusion.

METHODS:

This is an analysis of the Posterior Circulation Ischemic Stroke Evaluation: Analyzing Radiographic and Intraprocedural Predictors for Mechanical Thrombectomy Registry in which patients with acute basilar artery occlusions from 8 comprehensive stroke centers were included from 2015 to 2021. Patients were dichotomized into with (ICAD-LVO) or without underlying ICAD (embolic). Descriptive statistics for each group and multivariate logistic analysis were performed on the primary outcome.

RESULTS:

Three hundred forty-six patients were included. There were 215 patients with embolic (62%) and 131 patients with ICAD-LVO (38%). Baseline demographics were equivalent between the 2 groups except for sex (male 47% vs 67%; P < .001), history of stroke (12% vs 25%; P = .002), and atrial fibrillation (31% vs 17%; P = .003). At 90 days, patients in the ICAD-LVO cohort were less likely to achieve favorable functional outcomes (odds ratio [OR] 0.41, 95% CI 0.22-0.72; P = .003) after adjusting for potentially confounding factors. In addition, ICAD-LVO strokes were less likely to achieve thrombolysis in cerebral infarction ≥2b (OR 0.29, 95% CI 0.14-0.57; P < .001). ICAD-LVO lesions were more likely to require stent placement (OR 14.94, 95% CI 4.91-45.49; P < .001). Subgroup analysis demonstrated favorable functional outcomes in patients who underwent stenting and angioplasty compared with failed recanalization cohort (OR 4.96, 95% CI 1.68-14.64; P < .004).

CONCLUSION:

Patients with acute basilar ICAD-LVO have higher morbidity and mortality compared with patients with embolic source. Lower rates of successful recanalization in the ICAD-LVO cohort support this finding. Our subgroup analysis demonstrates that stenting should be considered in patients with recanalization failure. Rates of symptomatic intracranial hemorrhage were similar between the ICAD-LVO and embolic cohorts.
Predictors of Durable Remission After Successful Surgery for Cushing Disease: Results From the Multicenter RAPID Registry
Authors: Findlay Matthew C. , Tenhoeve Sam , Alt Jeremiah , Rennert Robert C. , Couldwell William T. , Evans James , Collopy Sarah , Kim Won , Delery William , Pacione Donato , Kim Albert , Silverstein Julie M. , Chicoine Michael R. , Gardner Paul , Rotman Lauren , Yuen Kevin C. J. , Barkhoudarian Garni , Fernandez-Miranda Juan , Benjamin Carolina , Kshettry Varun R. , Zada Gabriel , Van Gompel Jamie , Catalino Michael P. , Little Andrew S. , Karsy Michael
Published: June 2024

BACKGROUND AND OBJECTIVE:

Cushing disease (CD) affects mortality and quality of life along with limited long-term remission, underscoring the need to better identify recurrence risk. The identification of surgical or imaging predictors for CD remission after transsphenoidal surgery has yielded some inconsistent results and has been limited by single-center, single-surgeon, or meta-analyses studies. We sought to evaluate the multicenter Registry of Adenomas of the Pituitary and Related Disorders (RAPID) database of academic US pituitary centers to assess whether robust nonhormonal recurrence predictors could be elucidated.

METHODS:

Patients with treated CD from 2011 to 2023 were included. The perioperative and long-term characteristics of CD patients with and without recurrence were assessed using univariable and multivariable analyses.

RESULTS:

Of 383 patients with CD from 26 surgeons achieving postoperative remission, 288 (75.2%) maintained remission at last follow-up while 95 (24.8%) showed recurrence (median time to recurrence 9.99 ± 1.34 years). Patients with recurrence required longer postoperative hospital stays (5 ± 3 vs 4 ± 2 days, P = .002), had larger average tumor volumes (1.76 ± 2.53 cm3 vs 0.49 ± 1.17 cm3, P = .0001), and more often previously failed prior treatment (31.1% vs 14.9%, P = .001) mostly being prior surgery. Multivariable hazard prediction models for tumor recurrence found younger age (odds ratio [OR] = 0.95, P = .002) and Knosp grade of 0 (OR = 0.09, reference Knosp grade 4, P = .03) to be protective against recurrence. Comparison of Knosp grade 0 to 2 vs 3 to 4 showed that lower grades had reduced risk of recurrence (OR = 0.27, P = .04). Other factors such as length of stay, surgeon experience, prior tumor treatment, and Knosp grades 1, 2, or 3 failed to reach levels of statistical significance in multivariable analysis.

CONCLUSION:

This multicenter study centers suggests that the strongest predictors of recurrence include tumor size/invasion and age. This insight can help with patient counseling and prognostication. Long-term follow-up is necessary for patients, and early treatment of small tumors may improve outcomes.
A Case for Pilates as Treatment for Obstructive Sleep Apnea
Authors: Mahnke Alexandra , Allen Charles
Published: June 2024

Apply It!

• Learn about the onset and risks of obstructive sleep apnea.

• Evaluate the different types of possible treatments for obstructive sleep apnea.

• Incorporate a Pilates protocol as a treatment intervention to focus on outcomes in respiratory strength and performance in chronic diseased populations.
ACSM Committee on Certification and Registry Boards Update on Recertification and Continuing Education Credit Provider Policy
Authors: Gallo Paul M. , Langton Becky , Magal Meir , Reed Rachelle , Whitworth James W. , Neric Francis
Published: June 2024

Apply It!

By reading this article you will be able to:

• Define the current competencies of the ACSM-Group Exercise Instructor®(ACSM-GEI), ACSM-Certified Personal Trainer® (ACSM-CPT), ACSM-Exercise Physiologist® (ACSM-EP), and ACSM-Clinical Exercise Physiologist®(ACSM-CEP).

• Understand the procedures associated with ACSM recertification and categories of continuing education credits (CEC) that apply to recertification.

• Discuss policy for continuing education providers that is considered acceptable and within the competencies of each certification program.
Review of the Pupilloidea of Pakistan (Gastropoda: Eupulmonata: Cochlicopidae, Chondrinidae, Orculidae, Pyramidulidae)
Authors: Auffenberg Kurt , Masroor Rafaqat , Gojšina Vukašin , Páll-Gergely Barna
Published: June 2024

The land snail fauna of Pakistan is poorly known. During surveys conducted in the summer months of 1990–1992 the Pupilloidea was the most diverse and commonly encountered group of land snails. The Chondrinidae, Cochlicopidae, Orculidae, and Pyramidulidae are reviewed herein. Sphyradium doliolum (Bruguière, 1792) is recorded from Pakistan for the first time. New Pakistan records for Granopupa lapidaria (Hutton, 1849), Cochlicopa cf. lubrica (O. F. Müller, 1774), and Pyramidula humilis (Benson, 1838) are provided. Pyramidula cf. salimalii is reported from localities other than the type locality for the first time. An unidentifiable species of Pyramidula is also reported.
Micronutrients in Adverse Pregnancy Outcomes
Authors: . Sairoz , Prabhu Krishnananda , Dastidar Ranita Ghosh , Aroor Annayya Rao , Rao Mahadev , shetty Sahana , Poojari Vidyashree G , BS Varashree
Published: June 2024

About 10 to 20% of reported pregnancies have complications like spontaneous abortion (SA), preeclampsia (PE), preterm birth (PTB), and fetal growth restriction (FGR); 60% are attributed to maternal nutritional alterations. Multiple micronutrients (MMN) are supplemented in the antenatal period, but no proper validation/guidelines are available regarding dosing/time, the need for initiation, and the duration of supplementation. Studies have reported adverse pregnancy complications related to the overuse/unwanted use of multiple micronutrient supplementations during pregnancy. Identifying the exact population requiring supplementation is necessary to prevent its abuse. This article attempts to review the impacts of micronutrient deficiency/supplementation in cases of SA, FGR, and gestational diabetes mellitus (GDM), preterm delivery and PE. The study used a literature search using PubMed, Google Scholar, Mendeley, and Scopus Databases using search words pregnancy, spontaneous abortion, gestational diabetes mellitus (GDM), fetal growth restriction (FGR), preterm delivery, preeclampsia (PE) or “adverse pregnancy” associated with minerals, micronutrients, or supplementation. The review also considered in-house literature databases, a single-window search at Kasturba Medical College (KMC) Health sciences library, MAHE (Manipal Academy of Higher Education). The figures included in the study were created by Biorender.com. Micronutrients play multiple roles during pregnancy and fetoplacental growth stimulating growth hormone secretion, Lysyl oxidase (LOX), involved in the crosslinking between collagen and elastin in the amniotic membrane, downregulation of interleukin (IL)-1 alpha, IL-1 beta, IL-4, IL-6, Il-10, IL-12, tumor necrosis factor (TNF)-alpha and several chemokines involved in hypertension, immune-inflammatory pathways, attenuate insulin resistance, structural development of neurons and glia. Over-supplementation has led to complications such as spontaneous abortion and gestational diabetes mellitus. Since there is a lack of standardization concerning micronutrient supplementation during pregnancy, there is a need for systematic study related to the role of micronutrients during each trimester of pregnancy to optimize its supplementation and to prevent hazards associated with its abuse.
Post-pubertal management of undescended testes from the malignancy risk point of view: a systematic review
Authors: Tendi William , Raharja Putu Angga Risky , Wahyudi Irfan , Rodjani Arry , Situmorang Gerhard Reinaldi
Published: June 2024

Background Undescended testes (UDT) is a condition where one or both testes is absent in the scrotum. The general age recommendation in which the treatment should be performed is before 18 months old due to the infertility risk and malignancy in later life. On the other hand, in post-pubertal UDT, the current guideline recommends orchiectomy; however, this recommendation is weak. Therefore, this study aimed to provide a systematic review of post-pubertal UDT treatment, focusing on the malignancy risk point of view. Methods A systematic search was performed using PubMed, Wiley Online Library and the Cochrane Library up to 5 March 2023. Any study with either post-pubertal orchiectomy or orchidopexy in patients with UDT and reporting the testicular malignancy was included. The exclusion criteria were studies with lack of information of UDT correction time, no history of correction and the full text wasn’t available. The data collected were the occurrence of testicular malignancy in post-pubertal UDT patients corrected with any method. Quality and bias assessment was assessed with Newcastle-Ottawa scale and Joanna Briggs Institute tools. Results Seven articles (three case reports and four observational studies) were reviewed with a total of 42 patients who underwent post-pubertal correction of either unilateral or bilateral UDT. The correction age ranged from 13 to 34 years old, with follow-up of 48.7–252 months. Among those who developed malignancies, the most common were seminoma, teratoma and carcinoma in situ of the testes. In addition, this study was able to propose an algorithm for post-pubertal UDT treatment strategy. Conclusions The scarce resource was the main limitation of this study. Nevertheless, this review showed that post-pubertal UDT management should be tailored individually. Several factors that should be considered include the condition of the contralateral descended testis, UDT location, serum testosterone level, patient’s age, comorbidities, and interest in fertility.
Role of Magnetic Resonance Imaging in evaluating T2-weighted hyperintensities in spinal cord in a tertiary care hospital in central India
Authors: Dhabalia Rishabh , Kashikar Shivali
Published: June 2024

Background Hyperintensities on T2-weighted images in the spinal cord are a complex and diagnostically challenging entity that can present with diverse clinical features. This study protocol outlines a comprehensive investigation to understand the causes, clinical and imaging characteristics, and correlation with pathological findings of hyperintensities on T2-weighted images in the spinal cord. By establishing a systematic assessment approach, this study seeks to provide valuable insights into these abnormalities’ diagnostic and prognostic implications. Methods The study will be conducted as a prospective observational design. Patients with clinically diagnosed or suspected spinal cord lesion presenting with intramedullary T2-weighted hyperintensity and referred for MRI evaluation will be included. Data collection will encompass patient demographics, clinical features, and extensive imaging parameters. Pathological data, when available, will be correlated with imaging findings. Various statistical methods will be employed to analyse the data, including frequency analysis, comparative tests, logistic regression, and survival analysis. Expected Results The study anticipates elucidating the spectrum of etiologies underlying hyperintensities on T2-weighted images in the spinal cord and their clinical and imaging profiles. The systematic approach will offer a structured diagnostic method, while correlations with pathological data will provide an enhanced understanding of these conditions. The results are expected to provide clinicians with valuable insights into diagnosing, treating, and prognosticating patients with spinal cord hyperintensities on T2-weighted images.
Association of cancer and outcomes of patients hospitalized for COVID-19 between 2020 and 2023
Authors: Jalloh Abdulai  Tejan , Merson Laura , Nair Divya , Hassan Shermarke , Kamara Ibrahim Franklyn , Nuwagira Innocent , Tengbe Sia Morenike , Tejan Yusuf Sheku , Kabba Mustapha , Lakoh Sulaiman , Grant Donald S , Samuels Robert J , Kamara Rugiatu Z , Terry Robert F
Published: June 2024

Background The coronavirus disease 2019 (COVID-19) has caused substantial morbidity and mortality on a global scale. A strong correlation has been found between COVID-19 treatment outcomes and noncommunicable diseases such as cancers. However, there is limited information on the outcomes of cancer patients who were hospitalised for COVID-19. Methods We conducted an analysis on data collected in a large prospective cohort study set-up by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC). All patients with laboratory-confirmed or clinically-diagnosed SARS-CoV-2 infection were included. Cancer was defined as having a current solid organ or haematological malignancy. The following outcomes were assessed; 30-day in-hospital mortality, intensive care unit (ICU) admission, length of hospitalization and receipt of higher-level care. Results Of the 560,547 hospitalised individuals who were analysed, 27,243 (4.9%) had cancer. Overall, cancer patients were older and had more comorbidities than non-cancer patients. Patients with cancer had higher 30-day in-hospital mortality than non-cancer patients (29.1.3% vs 18.0%) and longer hospital stays (median of 12 days vs 8 days). However, patients with cancer were admitted less often to intensive care units than non-cancer patients (12.6% vs 17.1%) and received less invasive mechanical ventilation than non-cancer patients (4.5% vs 7.6%). The hazard ratio of dying from cancer, adjusted for age, sex and country income level was 1.18 (95%CI: 1.15-1.2). Conclusions This study’s findings underscore the heightened vulnerability of hospitalized COVID-19 patients with cancer, revealing a higher mortality rate, longer hospital stays, and an unstructured pattern of care that reflects the complexity of managing severely ill patients during a public health crisis like the COVID-19 pandemic.
The gamma-band activity model of the near-death experience: a critique and a reinterpretation.
Authors: A Shaw Nigel
Published: June 2024

Near-death experience (NDE) is a transcendent mental event of uncertain etiology that arises on the cusp of biological death. Since the discovery of NDE in the mid-1970s, multiple neuroscientific theories have been developed in an attempt to account for it in strictly materialistic or reductionistic terms. Therefore, in this conception, NDE is at most an extraordinary hallucination without any otherworldly, spiritual, or supernatural denotations. During the last decade or so, a number of animal and clinical studies have emerged which reported that about the time of death, there may be a surge of high frequency electroencephalogram (EEG) at a time when cortical electrical activity is otherwise at a very low ebb. This oscillatory rhythm falls within the range of the enigmatic brain wave-labelled gamma-band activity (GBA). Therefore, it has been proposed that this brief, paradoxical, and perimortem burst of the GBA may represent the neural foundation of the NDE. This study examines three separate but related questions concerning this phenomenon. The first problem pertains to the electrogenesis of standard GBA and the extent to which authentic cerebral activity has been contaminated by myogenic artifacts. The second problem involves the question of whether agents that can mimic NDE are also underlain by GBA. The third question concerns the electrogenesis of the surge in GBA itself. It has been contended that this is neither cortical nor myogenic in origin. Rather, it arises in a subcortical (amygdaloid) location but is recorded at the cortex via volume conduction, thereby mimicking standard GBA. Although this surge of GBA contains genuine electrophysiological activity and is an intriguing and provocative finding, there is little evidence to suggest that it could act as a kind of neurobiological skeleton for a phenomenon such as NDE.
Case Report: Acute large bowel obstruction with actinomycosis of the sigmoid colon mimicking neoplasm
Authors: Hajri Mohamed , Zouari Rami , Mallek Ines , Bacha Dhouha , Bayar Rached , ben slama Sana
Published: June 2024

Introduction Actinomycosis is an uncommon inflammatory bacterial disease caused by Actinomyces species, especially Actinomyces Israeli. Abdominopelvic forms are relatively rare and may involve the colon as a solid mass, mimicking a malignant tumor. Case presentation A 68-year-old Tunisian man, with a history of diabetes, hypertension, penicillin allergy, and renal failure, presented to the emergency department with abdominal pain, vomiting, and bowel obstruction. CT scan showed an acute intestinal obstruction upstream with obstructive tissular mass at the sigmoid colon. Emergency surgery revealed a sigmoid mass and a pre-perforative cecum. Subtotal colectomy was performed, with ileostomy and distal end closure. Histological examination confirmed Actinomyces infection. The patient was then placed on long-term doxycycline and Bactrim, with no recurrence over a 9-month follow-up period. Conclusion Abdominal actinomycosis, though rare, presents diagnostic challenges. It can be mistaken for malignancy, leading to unnecessary surgery in non-complicated cases, since it is effectively treated by antibiotics. In complicated cases, a combined approach involving both surgery and antibiotic therapy is necessary until the infection is completely eradicated.
Jellyfish (Aurelia aurita) collagen scaffolds potential in alveolar bone regeneration
Authors: Rachmawati Ranny , Hidayat Mohammad , Permatasari Nur , Widyarti Sri
Published: June 2024

Background: Collagen scaffold is one of the most important parts of bone engineering especially for the alveolar bone regeneration. Jellyfish Aurelia aurita is one of the marine animals with the most potential for the development of collagen scaffold due to its high content of collagen and amino acid. This research aimed to evaluate the potential of jellyfish A. aurita collagen scaffold as a supporter for alveolar bone regeneration.

Methods: Collagen was extracted from jellyfish by sonication method while scaffold was prepared by freeze-drying method, and chemical cross-linking with N-(3-dimethyl aminopropyl)-N’-ethyl-carbodiimide hydrochloride (EDC). Scaffold was characterized using Scanning Electron Microscope (SEM), Energy Dispersive X-Ray (EDX) spectroscopy, Fourier Transformed Infra-Red (FTIR), Cytotoxicity test with human mesenchymal stem cells (hMSCs), and biodegradability test.

Results: The scaffold has a porous surface with a slightly rough texture and it has pores with size 159.9mm – 325.6mm. Carbon and oxygen are the highest elements in the scaffold. Based on FTIR results, the collagen scaffold with EDC has a lower infrared absorption rate compared to collagen scaffold without EDC. The result in cytotoxicity test showed that collagen scaffold that had been combined with EDC was not toxic to human mesenchymal stem cells (hMSCs) and even able to increase the cells growth. The scaffold with EDC has been degraded slower compared to the scaffold without EDC.

Conclusion: The collagen scaffold is appropriate with the requirements as the biomaterial in supporting the alveolar bone regeneration, by fulfilling the following criteria, such as biocompatible, biodegradable, ideal porous interconnection, non-toxic, and cell viability support.
Does Sex affect Antipsychotic Associated Weight Gain in Patients Being Treated for Psychotic Disorders: A Protocol for a Systematic Review
Authors: O'Riain Colm , Crowley Sean , McDonagh Siofra , Murray Nuala , Sukainah Alkhalaf , Clarke Gerard , Khasan Ali S , O'Connor Karen
Published: June 2024

Background Psychotic disorders are mental illnesses whose treatment often includes antipsychotic medication, a treatment option associated with metabolic side effects including weight gain. However, the influence of sex on antipsychotic-associated weight gain remains inadequately explored. We aim to synthesise the evidence on the sex-specific differences in weight gain among patients with psychotic disorders receiving antipsychotic treatment. Methods We will include cohort studies, case-control studies, cross-sectional studies and randomized controlled trials, which examine the association between a treated psychotic disorder and weight gain in male and female patients. PubMed, EMBASE, and PsycINFO and Web of Science databases will be systematically searched in accordance with a detailed search strategy. Other inclusion criteria are; only articles which mention gender or sex in the title or abstract, only data from original studies, studies where diagnosis of a psychotic disorder must be made by a medical practitioner using diagnostic guidelines, studies published in English only, and only peer-reviewed literature. Two review authors will independently review the titles and abstracts of all studies and perform data extraction and quality assessment using standardized tools. We will perform meta-analyses to estimate the overall pooled associations using the generic inverse variance method. We will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Ethics and Dissemination This systematic review and meta-analysis, relying solely on already published data, does not necessitate ethics approval. The results will be shared at scientific gatherings and disseminated via publication in a peer-reviewed journal. Registration CRD42023495785
Shutdown dose rate calculations in high-temperature gas-cooled reactors using the MCNP-ORIGEN activation automation tool
Authors: Fairhurst-Agosta Roberto , Kozlowski Tomasz
Published: June 2024

Background High-temperature gas-cooled reactors (HTGRs) have many distinct features from the current light water reactor (LWR) fleet, and potential decommissioning strategies should take them into consideration. The proper characterization of the shutdown dose rates can establish a suitable strategy. Methods This article introduces a new shutdown dose rate calculation capability that relies on the MCNP-ORIGEN activation automation tool and the MCNP repeated structures to explicitly model the TRistructural ISOtropic (TRISO) particles as decay radiation sources. Results Three exercises are conducted with this capability, and their results discussed. The first two exercises verify and demonstrate the workflow. The third exercise proposes a decommissioning strategy for a high-temperature gas-cooled microreactor and studies its feasibility from the shutdown dose rate standpoint. The calculations yield a dose rate map above at the reactor citadel after a three month cool-down, showing values above 40 mSv/h. Conclusions The findings imply that the decommissioning strategy based on placing the reactor in a safe shutdown state and allowing it to cool down for three months before removing various components and extracting the fuel assemblies, may not be sufficient to minimize unnecessary exposure of personnel.
Design and additive manufacturing of a lightweight aerospace electric actuator
Authors: Lizarribar Carrillo Borja , Prieto Borja , Martínez-Iturralde Miguel , García Goikoetxea Javier , Montes Sergio , San José Ekain
Published: June 2024

Background The ambitious electrification targets set for the aeronautical sector are leading to a thorough research into improving the performance of different electromechanical components. In this regard, Additive Manufacturing is gaining strength due to the positive physical properties of the processed parts and the freedom in manufacturable geometries. Methods Thus, this article presents the design of an electric actuator for an aerospace active sidestick in which Additive Manufacturing is used with the aim of minimising the weight and power consumption of the device. The electromagnetic design of the actuator is detailed, considering 8 different permanent magnet machine topologies, and a mechanical design applying Topology Optimisation to reduce the overall weight of the component is carried out. Results Three prototypes involving the rotor, the stator and the casing are manufactured via Laser Powder Bed Fusion in stainless steel and Permendur (Fe49Co49V2) and the corresponding actuators are experimentally tested, showing a great agreement between tests and simulations and excellent repeatability in the electromagnetic behaviour of the prototypes. Conclusions The research results highlight the great potential of Additive Manufacturing to manufacture functional electrical machine components.
The genome sequence of the Pink-barred Sallow moth, Xanthia togata Esper
Authors: Crowley Liam M. , Holland Peter W.H. ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: June 2024

We present a genome assembly from an individual male Xanthia togata (the Pink-barred Sallow moth; Arthropoda; Insecta; Lepidoptera; Noctuidae). The genome sequence is 799.5 megabases in span. Most of the assembly is scaffolded into 31 chromosomal pseudomolecules, including the Z sex chromosome. The mitochondrial genome has also been assembled and is 15.41 kilobases in length.
The genome sequence of the European pine marten, Martes martes (Linnaeus, 1758)
Authors: O'Brien David , Januszczak Inez ,   Natural History Museum Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: June 2024

We present a genome assembly from an individual male Martes martes (the European pine marten; Chordata; Mammalia; Carnivora; Mustelidae). The genome sequence is 2,484.6 megabases in span. Most of the assembly is scaffolded into 20 chromosomal pseudomolecules, including the X and Y sex chromosomes. The mitochondrial genome has also been assembled and is 16.57 kilobases in length.
Fisetin Protects the Wistar Rats from the Oxidative and Inflammatory Damage Caused by Ethelene Glycol Induced Urolithiasis
Authors:   Institute of Pharmaceutical Technology, Sri Padmavati Mahila Viswavidyalayam, Tirupati, Sri Padmavathi Mahila Viswavidyalayam, Nageswari Patnam , Konda Swathi ,   Institute of Pharmaceutical Technology, Sri Padmavati Mahila Viswavidyalayam, Tirupati, Sri Padmavathi Mahila Viswavidyalayam
Published: June 2024

Urolithiasis, commonly referred to as urinary stones, is the third most prevalent condition affecting the urinary system and affects 12% of people worldwide. In this investigation, we assessed the prospective flavonoid fisetin's anti-urolithiasis activity. Fisetin reduced the nucleation, aggregation, and crystallization of kidney stones in in vitro tests at dosages of 62.5, 125, 250, 500, and 1,000 ug/mL in a dose-dependent manner. Twenty-four male Wistar rats (n = 6) were induced with urolithiasis using ethylene glycol (0.75% v/v) with ammonium chloride (1% w/v) in drinking water for seven days. Except for the animals in the vehicle control and disease control groups, the remaining animals were supplemented with either Fisetin 15 mg/kg or 30 mg/kg body weight from days 7 to 21. On day 22, a urine evaluation showed that fisetin significantly increased the glycosaminoglycan (GAG) content, corrected urine pH, increased creatinine clearance, and increased urine volume. Additionally, fisetin decreased the levels of calcium, creatinine, uric acid, and N-acetyl glucouronidase (NAG) activity. Serum biochemical analysis revealed that fisetin reduced the excretion of creatinine, uric acid, and blood urea nitrogen (BUN). Further, fisetin reduced the content of total protein, calcium, oxalate, protein carbonyl content (PCC), malondialdehyde (MDA), tumor necrosis factor (TNF-α), interlukin-6 (IL-6), and increased the content of reduced glutathione (GSH), the activities of superoxide dismutase (SOD), and catalase (CAT). Histological findings also support our findings. Based on the above observations, fisetin can be a potential candidate for the treatment of urolithiasis.
Evaluation of Fluorescent Spot Test with Dried Blood Spots for Glucose-6-Phosphate Dehydrogenase Deficiency Screening in A Malaria-Endemic Area
Authors:   The Office of Disease Prevention and Control Region 1 Chiang Mai, Chiang Mai, Thailand, Saejeng Aungkana , Lin Yan ,   Institute for Cancer Medicine and School of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, 646000, China, Srithep Sarinee ,   The Office of Disease Prevention and Control Region 1 Chiang Mai, Chiang Mai, Thailand, Khantikul Nardlada ,   The Office of Disease Prevention and Control Region 1 Chiang Mai, Chiang Mai, Thailand, Phukphakum Pitchayadon ,   Ban Thung Laeng Subdistrict Health Promoting Hospital, Mae Sareang District, Mae Hong Son, Thailand, Lu Ying ,   Institute for Cancer Medicine and School of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, 646000, China, Pornprasert Sakorn ,   Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
Published: June 2024

The utilization of dried blood spot (DBS) samples for screening glucose-6-phosphate dehydrogenase (G6PD) deficiency remains limited in resource-constrained and malaria-endemic regions of Thailand. This study evaluated the feasibility of employing DBS for G6PD deficiency screening among 242 participants (118 males and 124 females) who provided fresh whole blood (FWB) and DBS samples for analysis. The G6PD deficiency diagnostic performances of the fluorescent spot test using DBS (FST-DBS) were compared to those using FWB (FST-FWB). The G6PD gene variant was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using DBS samples. The FST-DBS showed no significant difference in sensitivity (95.0% vs 100.0%) but superior specificity (100.0% vs 80.2%) and a positive predictive value (100.0% vs. 50.0%) compared to FST-FWB. The PCR-RFLP revealed a G6PD mutation incidence rate of 16.5% (11.1% in males and 5.4% in females). Among 40 DBS samples, 39 (97.5%) were the Mahidol (487G>A) while a sample (2.5%) which both FST-DBS and FST-FWB showed positive results had an unidentified variant. Therefore, FST-DBS is an alternative format for G6PD deficiency screening in malaria-endemic regions, particularly where resources are limited.
Gender and Sexuality Center Professionals' Narrative Accounts of Racialized Institutional Resistance to Anti-Racism Work
Authors: Duran Antonio , Jourian T.J.
Published: June 2024

Abstract: Using data from a narrative study investigating the experiences of 20 gender and sexuality center (GSC) practitioners, this study examined how professionals described the racialized nature of institutions and its influence on their engagement with anti-racist practices. Findings revealed how participants perceived the foundations of GSC work as grounded in whiteness, how resources upheld whiteness, and the impacts of racialized organizations on professionals across racial identity. We provide implications for research and practice, arguing that a major contribution is to consider how the racialized nature of organizations of higher education is intricately connected to other forms of marginalization (e.g., queer and trans oppression).
The State of the Empirical Evidence for Interdisciplinary Learning Outcomes in Higher Education: A Systematic Review
Authors: Oudenampsen Jessica , Das Enny , Blijlevens Nicole , van de Pol Marjolein H.J.
Published: June 2024

Abstract: This review systematically synthesizes empirical evidence on learning outcomes of interdisciplinary learning. A meta-synthesis approach was used to synthesize data in two rounds, based on strict (n = 38) versus more lenient (n = 60) operationalizations of interdisciplinary learning. The results revealed a variety of interdisciplinary learning outcomes that were categorized into three overarching themes: 1) academic and disciplinary engagement, 2) metacognitive skills, and 3) perspective taking skills. Process results revealed that empirical evidence in the field is still in its infancy. The findings of this review can be considered as a starting point for the further operationalization of interdisciplinary learning outcomes, so that robust evidence for various aspects of interdisciplinary learning can be collected, and compared with other forms of learning such as cross or transdisciplinary learning.
Heat dissipation and temperature control method for quantum cascade lasers in external cavity spectral beam combining systems
Authors: Huang Junzhe , Li Dongdong , Zhang Jinlong , Dun Xiong , Jiao Hongfei , Xue Dongbai , Xing Yujie , Wang Xuquan , Cheng Xinbin , Wang Zhanshan
Published: June 2024

The
thermal effects of quantum
cascade lasers (QCLs) can cause wavelength locking instability and
reduce output power in external cavity spectral beam combining
(EC-SBC) systems. We propose a micro-channel structure (MCH) for heat
dissipation and temperature control that rapidly stabilizes the QCL at
20.159°C, showing a linear relationship with the controlled
temperature. Experimental comparisons demonstrate that MCH enhances
the heat transfer rate within the structure, reducing the time
required to stabilize and control QCL temperature. The output power
and locked wavelength remain stable in the EC-SBC system under high
currents. This study provides technical support for heat dissipation
QCL arrays.
Accurate modeling of thermal-optical performance for a lightweight SiC mirror
Authors: Zhang Yan , Wang Jianli , Liu Jie , Wu Xiaoxia , Chen Baogang , Fan Wenqiang , Wang Zhichen , Cao Yuyan , Qu Rijin
Published: June 2024

The SiC mirror has excellent structural rigidity and thermal stability, making it widely applicable in high-power optical systems. This manuscript aims to establish a coupled analysis model of thermal-optical performance for a lightweight SiC reflector under high-power laser irradiation. First, based on the Fourier principle, the transient temperature rise of the mirror is analyzed using the finite element method, considering boundary conditions such as heat source and convective radiation. A transient thermal response model for the mirror is established. Then, the reflective surface deformation is solved based on the mirror temperature field. By processing the data of node deformation, the decrease in the mirror surface shape accuracy (RMS) value is obtained. Finally, the experimental platform is built to measure the transient temperature rise and wavefront aberration change of the mirror after high-power laser excitation. Based on the deviation between the calculated data of the analysis model and the measured data, thermodynamic parameters in the analysis model are adjusted according to the principle of minimum residual. The research findings of this manuscript can be utilized for accurately predicting the temperature rise and optical degradation of SiC mirrors under high-power laser irradiation and provide a theoretical basis for the subsequent design of actively compensating methods for thermal-induced distortions.