bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal adaptation in pre-obesity patients with hypertension
Authors: Bosch Agnes , Rauh Manfred , Striepe Kristina , Schiffer Mario , Schmieder Roland E. , Kannenkeril Dennis
Published: September 2024

Background and hypothesis:

Obesity aggravates the risk to develop chronic kidney disease in hypertensive patients. Whether pre-obesity already impairs renal function, renal perfusion and intraglomerular hemodynamics in hypertensive patients is unknown.

Methods:

Renal hemodynamic profiles were measured using steady state input clearance (infusion of para-amino-hippuric acid and inulin) in 36 patients with primary arterial hypertension stage 1–2 without antihypertensive medication. Intraglomerular pressure (IGP) and resistances of the afferent (RA) and efferent (RE) arterioles were calculated. The study population was divided into two groups based on median of waist circumference (WC) (96 cm) (pre-obesity and non-obesity group1) and median of body mass index (BMI) (26.5 kg/m2) (pre-obesity and non-obesity group2), respectively.

Results:

All patients were males, non-smoking, aged 36 ± 10 years, with an office blood pressure of 145 ± 8.6/89 ± 11.8 mmHg. None of the patients had cardiovascular disease. Patients from the pre-obese group 1 showed lower glomerular filtration rate (GFR), lower renal plasma flow (RPF) and lower IGP compared to the non-obese group1. Renal vascular resistance (RVR) and RA were higher in the pre-obese group1 compared to the non-obese group1. Similar differences in the hemodynamic profile were found for patients in the pre-obesity group2 compared to the non-obesity group2.

Conclusion:

The renal hemodynamic profile in hypertensive patients with pre-obesity, irrespective whether defined by WC or BMI, was characterized by a reduced GFR and RPF and by an increased RVR preferentially at the preglomerular site. Our results suggest that hypofiltration is the first phase of renal adaptation in pre-obesity hypertension.

Clinical trial registration:

www.clinicaltrials.gov: NCT02783456.
Barriers and facilitators to home blood pressure monitoring in women with pregnancies complicated by hypertensive disorders: a qualitative study
Authors: Kovell Lara C. , Denu Mawulorm , Revoori Ritika , Sadaniantz Katherine , Staples Brooke , Chiriboga Germán , Forrester Sarah N. , Lemon Stephenie C. , Moore Simas Tiffany A. , Person Sharina , McManus David D. , Mazor Kathleen M.
Published: September 2024

Background/objective:

Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality in the US. Improved diagnosis and treatment of HDP may be achieved through home blood pressure monitoring (HBPM). However, there are challenges to effective HBPM during pregnancy. This qualitative study was conducted to explore patients’ perspectives and experiences with HBPM.

Methods:

Pregnant or recently postpartum women with HDP (≥18 years) were recruited from an academic medical center to virtual focus groups from March to September 2023. The discussions centered on experiences with HDP and barriers and facilitators to HBPM. Qualitative thematic analysis was performed.

Results:

Among 20 participants, the mean age was 33.8 (SD 5.9) years, with 35% Hispanic and 35% Black/African–American. Facilitators to HBPM included understanding the parameters/purpose of HBPM, prior experience with healthcare/duration of hypertension, free access to HBPM equipment and decision support, creating a routine, external support/counseling (e.g., partner/healthcare/family), and technology support. Barriers to HBPM included uncertainty/lack of training about the HBPM process, accessing/using HBPM equipment, the belief that clinic monitoring was sufficient/achieving good control, and activation barriers to making HBPM a priority (e.g., fear of affirming the diagnosis, higher priorities/life stressors).

Conclusion:

Many of the barriers to HBPM in pregnancy can be overcome through patient education/counseling, technology support, clinician/family reinforcement, and better access to validated blood pressure monitors. Given the importance of HBPM in improving outcomes for HDP, it is important for healthcare providers and policy makers to work to reduce barriers and amplify facilitators to HBPM for better adoption.
Recreational beach tennis training reduces ambulatory blood pressure in adults with hypertension: a randomized clinical trial
Authors: Ferrari Rodrigo , de Oliveira Carpes Leandro , Betti Domingues Lucas , Mallmann Schneider Vinícius , Leal Rodrigo , Tanaka Hirofumi , Jung Nathalia ,   The BAH Study Groupb
Published: September 2024

Objective:

To determine the effect of 12 weeks of beach tennis training on 24-h ambulatory blood pressure in adults with essential hypertension.

Methods:

This was a randomized, single-blinded, two-arm, parallel superiority trial. Forty-two participants aged 35–65 years with a previous diagnosis of hypertension were randomized into 12 weeks of beach tennis training group (two sessions per week lasting 45–60 min) or a nonexercising control group. Ambulatory 24 h (primary outcome) and office blood pressure, heart rate at rest, cardiorespiratory fitness, and muscle strength were assessed at baseline and after the intervention period. Generalized estimating equation analyses were employed to examine the main effects of the interventions.

Results:

In the beach tennis group, night-time systolic (−9 mmHg, P = 0.023), diastolic (−4 mmHg, P = 0.026), and mean arterial pressure (−7 mmHg, P = 0.023) decreased after 12 weeks of training. The office SBP/DBP (−6 mmHg, P = 0.016/−6 mmHg, P = 0.001) also decreased in the beach tennis group. Heart rate at rest decreased in the beach tennis group (−4 bpm, P = 0.012) but increased in the control group (6 bpm, P = 0.005). The lower and upper limb muscle strength increased in the beach tennis group after training. However, no such changes were observed in the control group.

Conclusion:

A 12-week recreational beach tennis training significantly reduced office and ambulatory BP among untrained adults with essential hypertension. Additionally, participation in this sport has led to improvements in physical fitness and overall cardiovascular risk profiles.

This clinical trial was registered at Clinicaltrials.gov (NCT03909321).
Combination blood pressure lowering therapy in patients with type 2 diabetes: messages from the ADVANCE trial
Authors: Wang Nelson , Chalmers John , Harris Katie , Poulter Neil , Mancia Giuseppe , Harrap Stephen , Hamet Pavel , Grobbee Diederick E. , Marre Michel , Woodward Mark
Published: September 2024

The Action in Diabetes and Vascular disease: preterAx and diamicroN Controlled Evaluation (ADVANCE) trial investigated the effects of intensive blood pressure (BP) lowering using a fixed combination of perindopril-indapamide versus placebo in type 2 diabetes (T2D). The study showed that combination perindopril-indapamide had significant benefits in reducing cardiovascular, renal, and mortality events, with consistent relative risk reductions across different patient subgroups. Secondary analyses of ADVANCE have identified novel risk markers in T2D including cessation of BP lowering therapy, absent peripheral pulses and cardiac biomarkers to name a few. ADVANCE also shed light on practical aspects of hypertension management, including the limitations of office BP, tolerability of combination BP lowering therapy across the range of BP levels and the interpretation of changes in serum creatinine after treatment initiation. This review article summarizes the findings of ADVANCE and its subsequent substudies, which have been foundational in our understanding of BP management and the use of combination BP lowering therapy in T2D.
Daytime actisensitivity predicts nocturnal dipping patterns and morning surge in blood pressure: the Home-Activity ICT-based Japan Ambulatory Blood Pressure Monitoring Prospective study
Authors: Tomitani Naoko , Hoshide Satoshi , Kanegae Hiroshi , Kario Kazuomi ,   the HI–JAMP Study Group
Published: September 2024

Background:

Ambulatory blood pressure (BP) is influenced by physical activity and the BP response to physical activity (actisensitivity) differs between individuals. This study investigated associations between daytime actisensitivity and nighttime BP dipping status and morning BP surge.

Methods:

Twenty-four-hour ambulatory BP monitoring (ABPM) with simultaneously monitored physical activity using a multisensor all-in-one device (TM-2441; A&D Company) was performed at baseline in HI-JAMP study participants. Those with complete BP measurements and complete physical activity monitoring data were included in this analysis. Actisensitivity was calculated as the slope of the regression line between daytime SBP and log-transformed physical activity over a 5 min period before each BP reading. Hyper and negative reactivity were defined as actisensitivity greater than 90th and less than 10th percentile, respectively.

Results:

Data from 2692 individuals (mean age 69.9 ± 11.9 years; mean BMI 24.8 ± 4.1 kg/m2, 53.6% men) were analyzed. Those with hyper reactivity had a high prevalence of the extreme dipper pattern of nighttime BP and exaggerated morning BP surge; those with negative reactivity had higher nighttime BP and a riser pattern of nighttime BP. Results remained significant after adjusting for 24-h physical activity. Differences in diurnal BP variability based on actisensitivity were augmented in individuals aged at least 75 years.

Conclusion:

This study is the first to investigate associations between actisensitivity and 24-h ambulatory BP profiles using an all-in-one multisensor device in a large real-world population. The associations seen between either hyper or negative actisensitivity and abnormal diurnal BP variability, especially in the elderly, could contribute to increased cardiovascular event risk.

Clinical Trial Registration:

University Hospital Medical Information Network Clinical Trials Registry, UMIN000029151 (HI-JAMP study).
Ocular bee sting injury: case report
Authors: Bertazzi Luiza C. , Iguma Juliana I. , Chen Hanny Rui Qi , Langella Eugênia Diniz Adán , Teixeira Ivan Corso
Published: September 2024

Introduction:

Eye accidents caused by bee stings are uncommon and little reported worldwide. There is still no protocol to be followed in these situations that need to be individualized. A case is reported of a bee sting remaining inside the lens of a middle-aged man that was surgically removed without phacoemulsification, which kept the patient's accommodation and good sight.

Patient and Clinical Findings:

A 41-year-old man presented with red left eye, low visual acuity, and pain after being stung by bees all over his body, including his left eye. There was a lot of inflammation and corneal edema that did not allow complete visualization.

Diagnosis, Intervention, and Outcomes:

After starting clinical treatment, it was possible to visualize the sting inside the patient's lens. Conservative surgery was proposed with the removal of the stinger keeping the patient's lens clear. After 6 months, he presented visual acuity with no correction of 0.1 logMAR in both eyes and J1 without high intraocular pressure, but corneal endothelial specular microscopy demonstrated significant endothelial loss such as a consequence poison of the sting.

Conclusions:

There is still a lack of cases in the literature that could assist in a protocol in cases of intraocular bee sting. What is known is that each patient must be individualized, and in this situation, it was possible to conduct the event while maintaining the lens and the patient's accommodation capacity.
Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Field Setting: A Case Report From China
Authors: Li Xixi , Xie Nan , Zhou Tong , Yang Bo
Published: September 2024

BACKGROUND:

The widespread use of agricultural machinery in China has increased the incidence of agricultural machinery-related injuries, posing challenges to on-site medical rescue. This study explores resuscitative endovascular balloon occlusion of the aorta (REBOA) as a life-saving intervention for a patient with severe trauma from agricultural machinery.

CASEPRESENTATION:

This study reviews the emergency medical response for a 70-year-old male who suffered machinery entanglement injuries in an agricultural field in western China. The intervention involved a tiered multidisciplinary medical response, including the implementation of REBOA.

CONCLUSION:

This case demonstrates the successful use of REBOA in the prehospital setting in China. While prehospital REBOA use is rare, it is increasingly reported in both military and civilian contexts in austere environments in different countries. Further research is required to validate the feasibility and efficacy of REBOA as a prehospital resuscitation strategy.
Conducting Comparative Effectiveness, Multisite Palliative Care and Advance Care Planning Trials
Authors: El-Jawahri Areej , Waterman Brittany , Enguidanos Susan , Gibbs Lisa , Navarro Victor , Olsen Maren , Temel Jennifer , Totten Annette , Grudzen Corita R.
Published: September 2024

The Patient-Centered Outcomes Research Institute (PCORI) funded multiple large-scale comparative effectiveness clinical trials evaluating palliative care (PC) and advance care planning (ACP) healthcare delivery models. This article provides an overview of the most common barriers our investigative teams encountered while implementing these trials and the strategies we utilized to overcome these challenges, with particular attention to identifying research partners for multisite trials; addressing contracting and regulatory issues; creating a team governance structure; training and engaging study staff across sites; recruiting, consenting, and enrolling study participants; collecting PC and ACP data and study outcomes; and managing multisite collaborations. The goal of this article is to provide guidance on how to best plan for and conduct rigorous trials evaluating PC and ACP healthcare delivery interventions moving forward.
Corticosteroid-induced bradycardia following high-dose methylprednisolone administration: a case report
Authors: Zkib Jwil , Sattout Raneem , Faour Sabah , Haddad Sultaneh , Bassut Ranim , Swed Wajd , Hritani Shahd , Mansouer Milad , Ghabally Mike
Published: September 2024

Introduction:

Besides their wide use in the clinical field due to their anti-inflammatory and immune-modulating effect, corticosteroids still have a lot of adverse effects. The most common adverse effects are hyperglycemia, hypertension, osteoporosis, psychosis, immunosuppression, weight gain, and hyperlipidemia. Another important side effect is cardiac arrhythmias.

Case presentation:

We report a case of a 43-year-old woman with multiple sclerosis who developed symptomatic bradycardia after 3 days of treatment with a high dose of methylprednisolone. The patient received a dose of atropine and her bradycardia resolved after 36 h of stopping methylprednisolone.

Discussion:

While tachyarrhythmias are more common, bradyarrhythmias such as bradycardia and premature atrial or ventricular contraction are rare but crucial to be considered.

Conclusion:

Corticosteroid-induced bradycardia is usually in sinus rhythm and has an unknown etiology, possibly occurring at high and low doses. The majority of cases in the literature were asymptomatic and resolved spontaneously.
Feasibility, clinical outcomes, and learning curves of robotic-assisted colorectal cancer surgery in a high-volume district general hospital: a cohort study
Authors: Massias Samuel , Vadhwana Bhamini , Arjomandi Rad Arian , Hollingshead James , Patel Vanash
Published: September 2024

Introduction:

Robotic-assisted surgery (RAS) is one of the most influential surgical advances with widespread clinical and health-economic benefits. West Hertfordshire Teaching Hospital NHS Trust was the first in the UK to simultaneously integrate two CMR Surgical Versius robots. This study aims to investigate clinical outcomes of RAS, explore surgeon learning curves and assess the feasibility of implementation within a district general hospital (DGH).

Methods:

A prospective cohort study of 100 consecutive patient data were collected between July 2022 and August 2023, including demographics, operative and clinical variables, and compared with laparoscopic surgery (LS) data from the National Bowel Cancer Audit. Surgeon learning curves were analysed using sequential surgical and console times.

Results:

In the RAS cohort, the median age was 70 (IQR 57–78 years) and 60% were male. Retrieval of a minimum of 12 lymph nodes significantly increased in RAS compared to LS (95% vs. 88%, P=0.05). The negative mesorectal margin rate was similar between RAS and LS (97% vs. 91%, P=0.10), as well as length of stay greater than 5 days (42% vs. 39%, P=0.27). For anterior resections performed by the highest volume surgeon (n=16), surgical time was reduced over 1 year by 35% (304.9–196.9 min), whilst console time increased by 111% (63.0–132.8 min).

Conclusions:

Key quality performance indicators were either unchanged or improved with RAS. There is potential for improved theatre utilisation and cost-savings with increased RAS. This study demonstrates the feasibility and easy integration of robotic platforms into DGHs, offering wider training opportunities for the next generation of surgeons.
Cerebellopontine angle metastasis from pancreatic cancer: a case report
Authors: Wang Tianhong , Pu Kuairong , Lin Xiwen , Li Zhe , Wu Jun , Shao Dongchuan , Zhao Nan
Published: September 2024

Introduction:

Pancreatic cancer metastasis to the cerebellopontine angle (CPA) is extremely rare and often misdiagnosed preoperatively. The clinical characteristics and prognosis of this uncommon condition remain largely unknown.

Case presentation:

We report the case of a 68-year-old male who presented with recurrent headaches, dizziness, and gait disturbances. The patient had undergone pancreaticoduodenectomy for pancreatic head adenocarcinoma two years prior. Preoperative imaging suggested a right CPA meningioma. The patient underwent resection of the CPA tumor under general anesthesia. Postoperative pathology revealed a metastatic pancreatic adenocarcinoma. Despite treatment with adjuvant chemotherapy, the patient developed widespread metastatic disease and succumbed 2 months after the CPA tumor resection.

Discussion:

The rarity of pancreatic cancer metastasizing to the CPA presents diagnostic challenges, as evidenced by the initial misdiagnosis of meningioma in this case. The clinical presentation can mimic benign conditions, leading to delays in appropriate management. This case underscores the importance of considering metastatic disease in patients with a history of cancer, even when presenting with symptoms typical of more common CPA lesions.

Conclusion:

Vigilant monitoring is crucial in pancreatic cancer patients, as neurological symptoms may herald metastatic spread to uncommon sites like the CPA. Despite surgical intervention, widespread metastasis can lead to poor outcomes. Early diagnosis and a high index of suspicion are essential for optimal management of these rare cases.
Fractionated irradiation promotes radioresistance and decreases oxidative stress by increasing Nrf2 of ALDH-positive nasopharyngeal cancer stem cells
Authors: Zhang Gong , Duan Guosheng , Yang Zhengyan , Deng Xubin , Han Luwei , Zhu Meiling , Jia Xiaorong , Li Lei
Published: September 2024

Radiotherapy is widely regarded as the primary therapeutic modality for nasopharyngeal cancer (NPC). Studies have shown that cancer cells with high resistance to radiation, known as radioresistant cancer cells, may cause residual illness, which in turn might contribute to the occurrence of cancer recurrence and metastasis. It has been shown that cancer stem-like cells (CSCs) exhibit resistance to radiation therapy. In the present study, fractionated doses of radiation-induced epithelial-mesenchymal transition (EMT) and ALDH+ CSCs phenotype of NPC tumor spheroids. Furthermore, it has been shown that cells with elevated ALDH activity have increased resistance to the effects of fractionated irradiation. Nuclear factor erythroid-2-related factor 2 (Nrf2) plays a pivotal role in regulating cellular antioxidant systems. A large body of evidence suggests that Nrf2 plays a significant role in the development of radioresistance in cancer. The authors’ research revealed that the application of fractionated irradiation resulted in a decline in Nrf2-dependent reactive oxygen species (ROS) levels, thereby mitigating DNA damage in ALDH+ stem-like NPC cells. In addition, immunofluorescence analysis revealed that subsequent to the process of fractionated irradiation of ALDH+ cells, activated Nrf2 was predominantly localized inside the nucleus. Immunofluorescent analysis also revealed that the presence of the nuclear Nrf2+/NQO1+/ALDH1+ axis might potentially serve as an indicator of poor prognosis and resistance to radiotherapy in patients with NPC. Thus, the authors’ findings strongly suggest that the radioresistance of ALDH-positive NPC CSCs to fractionated irradiation is regulated by nuclear Nrf2 accumulation. Nrf2 exerts its effects through the downstream effector NQO1/ALDH1, which depends on ROS attenuation.
Twelve-month results for a randomized sham-controlled effectiveness trial of an in-home skills-based virtual reality program for chronic low back pain
Authors: Maddox Todd , Oldstone Liesl , Sackman Josh , Maddox Roselani , Adair Takisha , Ffrench Kelsey , Sparks Charisse , Darnall Beth D.
Published: September 2024

Introduction:

Low-risk, accessible, and long-term effective nonpharmacologic behavioral interventions for chronic low back pain (cLBP) are needed. Pain education and cognitive behavioral therapy (CBT) are recommended first-line treatments, but access is poor, treatment effectiveness is variable, and long-term effectiveness is inconsistent. In-home virtual reality (VR)-delivered therapies might address these shortcomings because therapeutic content can be delivered in a consistent and quality-controlled manner.

Objective:

To determine whether a 56-session, self-administered in-home, Skills-Based VR program for cLBP (RelieVRx) yields long-term reductions in pain intensity and pain interference 12 months posttreatment in a large demographically diverse and clinically severe real-world sample.

Methods:

Participants were 1,093 demographically diverse individuals with self-reported nonmalignant cLBP >3 months duration and average pain intensity and interference scores >4/10. Participants were randomized to Skills-Based VR or active Sham, and data were collected from January 31, 2022 to October 31, 2023. Pretreatment to 12-month posttreatment analyses were conducted.

Results:

From baseline to 12 months posttreatment, Skills-Based VR reductions for average pain intensity (1.7 ± 2.1) and pain interference (1.9 ± 2.3) were robust and significantly greater than those found for Sham. More than half of Skills-Based VR participants reported at least a 2-point reduction in pain intensity, pain interference, or both at 12 months posttreatment.

Conclusions:

A standardized, in-home Skills-Based VR therapy is effective for reducing pain intensity and pain interference, and these effects are maintained to 12 months posttreatment.
Advanced Practice Providers in Pediatric Surgery: A 10-Year Analysis of Clinical Productivity
Authors: Layon Sarah A. , Marsack Kristina , Parham Matthew J. , Burns Heather R. , Hollier Larry H.
Published: September 2024

Introduction:

Advanced practice providers (APPs) are integral to nonsurgical and surgical fields. In surgical settings, APPs work autonomously alongside surgeons to enhance continuity of care. While small-scale studies across various surgical specialties have explored APP utilization, literature specific to the pediatric population is limited. This study assesses the impact of increased APP utilization on productivity within one of the largest pediatric surgery departments in the United States.

Methods:

Data was sourced from the Surgery Department Executive Committee (SDEC) annual reports. Descriptive analyses were performed to delineate trends in clinical volumes, OR cases, gross charges, work relative value units (wRVUs), and provider full-time equivalents (FTEs) between October 2011 and September 2023. Secondary analyses were performed from 2016 to 2023, after APP roles were refined in each division.

Results:

Since 2012, an upward trend is observed in total clinic visits, total OR cases, and OR cases per MD. In 2016, APPs saw 1 clinic patient for every 2.2 seen by MDs, decreasing to a 1:1 ratio by 2023. The MD surgical conversion rate has increased by 20.5% since 2016, while the conversion rate per total clinic volume has decreased by 7.3% over the same period. Total wRVUs and gross charges increased across the department and per provider, despite fewer overall providers since 2021.

Conclusion:

Increased utilization of APPs within the department of surgery may enhance procedural productivity for surgeons while ensuring continued patient access to care. This study highlights the importance of developing care models that optimize the full skillset of APPs.
Effectiveness of Core Excision Technique for Keloids: A Systematic Review
Authors: Ran Xiaoye , Guo Xiaoshuang , Liu Yuanbo , Zhu Shan , Li Shanshan , Chen Zixiang , Han Tinglu , Jin Shengyang , Zhou Mengqi , Zang Mengqing
Published: September 2024

Background:

The keloid core excision technique mitigates the risk of wound tension and promotes favorable morphological outcomes. However, whether residual keloid tissue or other factors increase the risk of recurrence remains unclear. This systematic review aimed to evaluate the therapeutic outcomes of core excision techniques for keloids.

Methods:

A systematic literature review was conducted by searching PubMed, Embase, Web of Science Core Collection, and Cochrane Library databases on July 30, 2023. The search terms employed were “keloid,” “core excision,” “intralesional excision,” “intramarginal excision,” “rind flap,” and “fillet flap.” The inclusion criteria for the studies were established in advance and evaluated by multiple investigators.

Results:

Overall, 20 studies involving 926 keloid cases managed through core excision were included. Adjuvant therapies were used in 19 studies, with radiotherapies and steroid injections emerging as the predominant methods. The recurrence rates ranged from 0% to 28.6%. Residual scar tissue after core excision and complications, such as flap necrosis and hematoma, are the major factors contributing to recurrence.

Conclusion:

The core excision technique is a surgical treatment of keloids with a low recurrence rate when combined with adjuvant therapies. However, randomized controlled trials and conclusive quantitative studies are necessary to further investigate the effects of the core excision technique on keloids.
Innovative Endovascular Management of Giant Superficial Temporal Artery Pseudoaneurysm Presented With Periorbital Ulcerative Mass
Authors: Shao Miriam M. , Huda Shayan , Narayan Vinayak , Serulle Yafell , Ben-Shalom Netanel
Published: September 2024

Objective:

Superficial temporal artery (STA) pseudoaneurysms, characterized by arterial wall defects leading to blood leakage into perivascular tissues, present as pulsatile edematous masses, often originating from trauma or iatrogenic causes. Although rare (<1% of vascular lesions), anticoagulation agent use may contribute to their increasing incidence.

Methods:

Traditional surgical ligation and resection have been standard, but the advent of endovascular techniques offers minimally invasive alternatives that mitigate surgical risks, especially in patients with multiple medical comorbidities. This case report details the successful endovascular management of an STA pseudoaneurysm using n-butyl cyanoacrylate (n-BCA) glue embolization.

Results:

A 93-year-old female with renal failure, cardiac history, and anticoagulant therapy presented with large periorbital ecchymosis and edema after a fall. Computed tomography revealed a periorbital mass corresponding to her symptoms, and a repeat computed tomography conducted 2 months later indicated mass growth. Doppler ultrasonography suggested a partially thrombosed pseudoaneurysm from the right STA. Considering the patient’s age and medical conditions, endovascular embolization using n-BCA glue was chosen over surgical ligation. The patient was discharged uneventfully, and follow-up confirmed spontaneous resolution.

Conclusion:

This case demonstrates the evolving role of endovascular techniques, particularly in cases unsuitable for surgery. Liquid embolic agents like n-BCA offer precise occlusion capabilities, solidifying their potential as a standalone treatment option for STA pseudoaneurysms.
Analysis of Indeterminate QuantiFERON Assay Results in Solid Organ Transplant Candidates and Proposed Management Algorithm
Authors: Chiu Chia-Yu , Mahmood Maryam , Brumble Lisa M. , Vikram Holenarasipur R. , Theel Elitza S. , Beam Elena
Published: September 2024

Background.

Identification and treatment of latent tuberculosis infection (LTBI) mitigate the risk of tuberculosis (TB) reactivation after transplantation. TB reactivation is higher in those with indeterminate QuantiFERON (QFT) than those with negative results. Management of indeterminate QFT results in the pretransplant period remains unclear.

Methods.

We conducted a retrospective study of solid organ transplant (SOT) recipients, 18 y and older, who were screened with QFT assay pretransplantation at Mayo Clinic between January 2010 and June 2023. We examined the frequency of indeterminate QFT results, results of repeat LTBI screening, treatment decisions, and rate of posttransplant TB infection.

Results.

Of 13 008 patients screened for LTBI before SOT, 736 (6%) patients had indeterminate QFT results. Among these, 247 (34%) underwent a second LTBI screening test, and 39 (5%) received LTBI treatment. Among 247 patients with a repeat LTBI screening test, 185 (75%), 48 (19%), and 14 (6%) were tested by QFT, T-SPOT.TB, or TST, respectively. The repeat QFT remained indeterminate in 160 (86%) patients, whereas all T-SPOT.TB results were negative. Posttransplant TB infection occurred in 2 (0.3%) patients; neither had a second TB screening test pretransplant nor received LTBI treatment.

Conclusions.

In SOT recipients with indeterminate QFT results at pretransplant evaluation, opting for T-SPOT.TB as a second test may be preferable over repeat QFT. TB infection after transplantation in patients with a pretransplant indeterminate QFT result was rare. Patient management and LTBI treatment in those with indeterminate QFT pretransplant should account for epidemiological risk factors, and shared decision-making is recommended.
Drifting plasmons in two-dimensional electron channels: circuit analogy
Authors: Sydoruk O.
Published: September 2024

Plasmons in two-dimensional electron channels have potential applications in the terahertz frequency range. Equivalent circuit models provide a convenient framework for analysing the plasmons. This article introduces a circuit model for plasmons in the presence of a dc current that flows in a gated channel. It is shown that drifting plasmons can be described by an
LC
-transmission line with distributed dependent sources. A circuit analogue of the Dyakonov–Shur instability is demonstrated. Then, a lumped-element transmission line with dependent sources is analysed, and non-reciprocity is demonstrated for examples of a right- and a left-handed transmission line. Effects of ohmic loss are discussed. The results could be used for the design of non-reciprocal transmission line devices.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
The past, present and future of multi-scale modelling applied to wave–structure interaction in ocean engineering
Authors: Sriram V. , Saincher Shaswat , Yan S. , Ma Q. W.
Published: September 2024

Concepts and evolution of multi-scale modelling from the perspective of wave–structure interaction have been discussed. In this regard, both domain and functional decomposition approaches have come into being. In domain decomposition, the computational domain is spatially segregated to handle the far-field using potential flow models and the near field using Navier–Stokes equations. In functional decomposition, the velocity field is separated into irrotational and rotational parts to facilitate identification of the free surface. These two approaches have been implemented alongside partitioned or monolithic schemes for modelling the structure. The applicability of multi-scale modelling approaches has been established using both mesh-based and meshless schemes. Owing to said diversity in numerical techniques, massively collaborative research has emerged, wherein comparative numerical studies are being carried out to identify shortcomings of developed codes and establish best-practices in numerical modelling. Machine learning is also being applied to handle large-scale ocean engineering problems. This paper reports on the past, present and future research consolidating the contributions made over the past 20 years. Some of these past as well as future research contributions have and shall be actualized through funding from the Newton International Fellowship as the next generation of researchers inherits the present-day expertise in multi-scale modelling.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Potential of coupled array harvester in enhanced energy harvesting
Authors: De Srimanta Lal , Ali Shaikh Faruque
Published: September 2024

Harvesting energy from nonlinear systems has been at the centre of research in the energy harvesting community. Many such proposed systems are single nonlinear harvester. While these systems show an increase in bandwidth of harvesting frequency, overall, they are not effective enough in power generation. This article studies power harvesting and frequency bandwidth characteristics of an array of harvesters. Multiple harvesters are considered with linear and nonlinear coupling between the harvesters. The phenomena of internal resonance (IR) and stochastic resonance (SR) are reported. The IR in multiple coupled nonlinear harvesters is explored using multiple-scale analysis. A parametric study is conducted to demonstrate the effect of coupling strength, frequency mistuning, innate nonlinearity and other parameters. The parametric study helped establish effective ways to increase bandwidth. Moreover, a stochastically loaded linearly coupled bistable harvester array is numerically analysed to find the effect of coupling strength and array size on the phenomenon of SR and on the system’s harvesting performance. Through these studies, the potential of multiple coupled nonlinear harvesters in enhanced energy harvesting is demonstrated under both harmonic and stochastic excitation.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
SU-8-meta-phenylenediamine-conjugated thin film for temperature sensing
Authors: Barhum Hani , Attrash Mohammad , Brice Inga , Salgals Toms , Matar Madhat , Amer Mariam , Abdeen Ziad , Alnis Jānis , Bobrovs Vjačeslavs , Abdeen Abdul Muhsen , Ginzburg Pavel
Published: September 2024

Polymers have distinctive optical properties and facile fabrication methods that have been well-established. Therefore, they have immense potential for nanophotonic devices. Here, we demonstrate the temperature-sensing potential of SU8-meta-phenylenediamine (SU8-mPD), produced by epoxy amination of the SU-8 polymer. Its properties were examined through a series of molecular structural techniques and optical methods. Thin layers have demonstrated optical emission and absorption in the visible range around 420 and 520 nm, respectively, alongside a strong thermal responsivity, characterized by the 18 ppm °C
−1
expansion coefficient. A photonic chip, comprising a thin 5–10 μm SU8-mPD layer, encased between parallel silver and/or gold thin film mirrors, has been fabricated. When pumped by an external light source, this assembly generates a pronounced fluorescent signal that is superimposed with the Fabry–Pérot (FP) resonant response. The chip undergoes mechanical deformation in response to temperature changes, thereby shifting the FP resonance and encoding temperature information into the fluorescence output spectrum. The time response of the device was estimated to be below 1 s for heating and a few seconds for cooling, opening a new avenue for optical sensing using SU8-based polymers. Thermoresponsive resonant structures, encompassing strong tunable fluorescent properties, can further enrich the functionalities of nanophotonic polymer-based platforms.

This article is part of the theme issue ‘Celebrating the 15th anniversary of the Royal Society Newton International Fellowship’.
Validation of an improved reference freeze-dried direct agglutination test for detecting leishmaniasis in the canine reservoir
Authors: el Harith Abdallah , Abass Elfadil , Martinkovic Franjo , Mansour Durria , Osman Hussam Ali
Published: September 2024

Introduction

Proper identification and management of reservoir post-kala-azar dermal leishmaniasis (PKDL) and canine visceral leishmaniasis (CVL) cases are prerequisites to the effective control of visceral leishmaniasis (VL) worldwide. Unlike PKDL, CVL still awaits effective improvement because of its cryptic nature, absence of Leishmania parasite in lesions or lymph nodes, and insensitivity of tools in current use. Because of the need for certain skills and equipment, both the liquid direct agglutination test (LQ-DAT) and freeze-dried direct agglutination test (FD-DAT) versions, present in comparison with the indirect immunofluorescence (IFAT) or enzyme-linked immunosorbent assay (ELISA), practical and feasible diagnostic alternatives.

Aim

Validate the performance of an improved FD-DAT to suit routine and large-scale applications in CVL endemic areas.

Methodology

Introducing of citrate-saline formaldehyde (CSF) as an anti-clumping agent to replace normal saline for antigen reconstitution and drastically however eligibly lowering the concentration of promastigotes (1.4X107) in comparison with the original reference FD-DAT (> 5X107/ml), To ensure optimal safety, β-mercaptoethanol (β-ME) was replaced by urea or sodium dodecyl sulphate (SDS) as a serum reducing agent.

Results

Through improving the procedure for reconstitution of FD-DAT antigen with CSF a 150% reduction in the test application cost was achieved. Expired test batches (+ 4 years earlier), were successfully revitalized to full validity. As compared to 48-hour shelf-life time for the original, an FD-DAT batch re-constituted here with CSF maintained validity for + 12 months.

Conclusions

The highly concordant results with IFAT and ELISA (One Way ANOVA Test P = 0.142, Homogeneity of Variances P = 0.009) as routine CVL diagnostics further motivate the application of the improved FD-DAT for detection of the disease in endemic areas.
Proposal of Paenimyroides marinum (Song et al. 2013) comb. nov. to replace the illegitimate name Paenimyroides aquimaris (García-López et al. 2020) Zhang et al. 2023
Authors: Li Meng-Syun
Published: September 2024

In this article, the author addresses the issue of nomenclatural illegitimacy of Paenimyroides aquimaris (García-López et al. 2020) Zhang et al. 2023. This name was formed without re-establishment of the earlier legitimate epithet marinum and should be considered to be illegitimate according to Rule 41a. As required by Rule 54, the author proposes Paenimyroides marinum (Song et al. 2013) as a new combination to replace the illegitimate name Paenimyroides aquimaris.
Antidiabetic Agents and Bone Quality: A Focus on Glycation End Products and Incretin Pathway Modulations
Authors: Zaki Muthanna K. , Abed Mohammed N. , Alassaf Fawaz A.
Published: September 2024

Diabetes mellitus is associated with inadequate bone health and quality and heightened susceptibility to fractures, even in patients with normal or elevated bone mineral density. Elevated advanced glycation end-products (AGEs) and a suppressed incretin pathway are among the mechanisms through which diabetes affects the bone. Accordingly, the present review aimed to investigate the effects of antidiabetic medications on bone quality, primarily through AGEs and the incretin pathway. Google Scholar, Cochrane Library, and PubMed were used to examine related studies until February 2024. Antidiabetic medications influence AGEs and the incretin pathway directly or indirectly. Certain antidiabetic drugs including metformin, glucagon-like peptide-1 receptor agonists (GLP-1RA), dipeptidyl-peptidase-4 (DDP-4) inhibitors, α-glucosidase inhibitors (AGIs), sodium-glucose co-transporter-2 inhibitors, and thiazolidinediones (TZDs), directly affect AGEs through multiple mechanisms. These mechanisms include decreasing the formation of AGEs and the expression of AGEs receptor (RAGE) in tissue and increasing serum soluble RAGE levels, resulting in the reduced action of AGEs. Similarly, metformin, GLP-1RA, DDP-4 inhibitors, AGIs, and TZDs may enhance incretin hormones directly by increasing their production or suppressing their metabolism. Additionally, these medications could influence AGEs and the incretin pathway indirectly by enhancing glycemic control. In contrast, sulfonylureas have not demonstrated any obvious effects on AGEs or the incretin pathway. Considering their favorable effects on AGEs and the incretin pathway, a suitable selection of antidiabetic drugs may facilitate more protective effects on the bone in diabetic patients.
Body Composition, Sarcopenia, and Serum Myokines in Acromegaly: A Narrative Review
Authors: Inojosa Arthur Costa , Ribeiro Ana Vitória Hirt , Araújo Thaís Florêncio , Xavier Maria Eduarda , Rêgo Daniella , Bandeira Francisco
Published: September 2024

Patients with active acromegaly have a higher percentage of lean body mass, a lower percentage of fat body mass, and an increase in their extracellular water compartment compared to healthy individuals. However, muscle function appears to be compromised in patients with acromegaly, with some experiencing worsened physical performance and sarcopenia. Myokine alterations, insulin resistance, dysregulation of protein metabolism, muscle oxidative stress, neuromuscular junction impairment, and increased ectopic intramuscular fat deposits may play roles in muscle dysfunction in patients with acromegaly.
Bone Mineral Density and Clinical Outcome after Ankle Fracture
Authors: Kang Hyunseong , Kim Ho-Hyup , Lim Chaemoon
Published: September 2024

Background: No gold standard exists for bone mineral density (BMD) measurement of the ankle. This study aimed to determine the correlation between bone density using Hounsfield units (HU) based on computed tomography (CT) and BMD using dual energy X-ray absorptiometry (DXA) as well as to evaluate the correlation between HU and clinical outcome of ankle fracture.Methods: Fifty-one patients aged ≥65 years who underwent surgical treatment for trimalleolus or bimalleolus ankle fractures were included. The HU were measured at the distal tibia metaphyseal region approximately 1 cm proximal to the plafond on the axial images of preoperative CT. BMD was measured using DXA within one year before the injury. The clinical outcome was evaluated according to the Foot and Ankle Outcome Score (FAOS).Results: Although the HU of an osteoporosis group was lower than that of a non-osteoporosis group, we observed no significant difference between the two groups. The mean HU significantly correlated with the lumbar and total lumbar spine BMD using DXA. Increased HU significantly correlated with improved clinical outcomes in three of five FAOS subscales: symptoms, pain, activity of daily living (ADL), and quality of life (QOL). In a linear regression analysis adjusted for age and body mass index, increased HU significantly correlated with improved clinical outcomes in three of five FAOS subscales: symptoms, pain, ADL, and QOL.Conclusions: The correlations between bone density using HU and BMD and those between HU and the clinical outcome were confirmed in ankle fractures. The HU of preoperative CT might provide valuable information for predicting postoperative clinical outcomes.
Time spent in conversation over meals predicts default network function: Evidence from a passive mobile-sensing and fMRI study
Authors: Bhatt Dhaval , Huckins Jeremy F. , Nepal Subigya , Campbell Andrew T. , Meyer Meghan L.
Published: September 2024

Sharing meals with others, often referred to as ‘commensality,’ fosters social connection and may have been essential to human brain evolution. Here, we investigate whether shared meals impact social brain processes through the conversations they afford. If so, then time spent in conversation over meals should affect the default network– a set of interconnected cortical regions reliably associated with the social exchange of ideas. To test this possibility, we combined passive-mobile sensing with neuroimaging. Undergraduate participants had an application on their smartphone for two months that unobtrusively captured their time spent in conversation, as well as their location on and around campus. In between these two months, participants completed a resting state scan. Time spent in conversations around meals (e.g., at cafeterias and restaurants) during the prior month predicted greater functional connectivity in the dorsomedial default network subsystem, specifically between the left inferior frontal gyrus (LIFG) portion and the rest of the subsystem regions. This relationship was preferential to: (1) time spent in conversation over the past (vs. future) month, (2) connectivity with the LIFG (vs. other dorsomedial subsystem nodes), (3) the dorsomedial subsystem (vs. other default network subsystems), (4) eateries (vs. other locations), and (5) time spentaround conversationat eateries, rather than time at eateries more generally. Follow-up analyses further revealed results were driven by a ventral portion of the LIFG, with peaks in voxel-connectivity associated with language, social, memory, and affective processes, as determined by the meta-analytic platform, NeuroSynth. Time spent in conversation over meals may exercise social cognitive processes supported by the dorsomedial subsystem, a network key to social communication, understanding, and connection.