bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of cardiovascular risk on the diagnostic accuracy of the ultrasound Halo Score for giant cell arteritis
Authors: Molina-Collada Juan , López Gloria Katerine , Castrejón Isabel , Nieto-González Juan Carlos , Martínez-Barrio Julia , Anzola Alfaro Ana M. , Rivera Javier , Álvaro-Gracia José María
Published: October 2022

Objective

To evaluate the impact of cardiovascular risk (CVR) on the diagnostic accuracy of the ultrasonographic (US) Halo Score in patients with suspected giant cell arteritis (GCA).

Methods

Retrospective observational study of patients referred to our US fast track clinic with suspected GCA for a 2-year period. The intima-media thickness (IMT) of cranial and extra-cranial arteries and the Halo Score was determined to assess the extent of vascular inflammation. The European Society of Cardiology Guidelines on CV Disease Prevention were used to define different categories of CVR and patients were classified according to the Systemic Coronary Risk Evaluation (SCORE). The gold standard for GCA diagnosis was clinical confirmation after a 6-month follow-up.

Results

Of the 157 patients included, 47 (29.9%) had GCA after a 6-month follow-up. Extra-cranial artery IMT was significantly higher in patients with high/very high CVR than in those with low/moderate CVR, but only among patients without GCA. Non-GCA patients with high/very high CVR had also a significantly higher Halo Score in contrast with low/moderate CVR [9.38 (5.93) vs 6.16 (5.22); p = 0.007]. The area under the ROC curve of the Halo Score to identify GCA was 0.835 (95% CI 0.756–0.914), slightly greater in patients with low/moderate CVR (0.965 [95% CI 0.911–1]) versus patients with high/very high CVR (0.798 [95% CI 0.702–0.895]). A statistically weak positive correlation was found between the Halo Score and the SCORE (r 0.245; c = 0.002).

Conclusions

Elevated CVR may influence the diagnostic accuracy of the US Halo Score for GCA. Thus, CVR should be taken into consideration in the US screening for GCA.
A scoping review of the unassisted physical exam conducted over synchronous audio-video telemedicine
Authors: Yao Peter , Adam Mahad , Clark Sunday , Hsu Hanson , Stern Michael , Sharma Rahul , Mages Keith , Greenwald Peter , Naik Neel
Published: October 2022

Background

This scoping review aims to provide a broad overview of the research on the unassisted virtual physical exam performed over synchronous audio-video telemedicine to identify gaps in knowledge and guide future research.

Methods

Searches for studies on the unassisted virtual physical exam were conducted in 3 databases. We included primary research studies in English on the virtual physical exam conducted via patient-to-provider synchronous, audio-video telemedicine in the absence of assistive technology or personnel. Screening and data extraction were performed by 2 independent reviewers.

Results

Seventy-four studies met inclusion criteria. The most common components of the physical exam performed over telemedicine were neurologic (38/74, 51%), musculoskeletal (10/74, 14%), multi-system (6/74, 8%), neuropsychologic (5/74, 7%), and skin (5/74, 7%). The majority of the literature focuses on the telemedicine physical exam in the adult population, with only 5% of studies conducted specifically in a pediatric population. During the telemedicine exam, the patients were most commonly located in outpatient offices (28/74, 38%) and homes and other non-clinical settings (25/74, 34%). Both patients and providers in the included studies most frequently used computers for the telemedicine encounter.

Conclusions

Research evaluating the unassisted virtual physical exam is at an early stage of maturity and is skewed toward the neurologic, musculoskeletal, neuropsychologic, and skin exam components. Future research should focus on expanding the range of telemedicine exam maneuvers studied and evaluating the exam in the most relevant settings, which for telemedicine is trending toward exams conducted through mobile devices and in patients’ homes.
A unified global genotyping framework of dengue virus serotype-1 for a stratified coordinated surveillance strategy of dengue epidemics
Authors: Li Liqiang , Guo Xiang , Zhang Xiaoqing , Zhao Lingzhai , Li Li , Wang Yuji , Xie Tian , Yin Qingqing , Jing Qinlong , Hu Tian , Li Ziyao , Wu Rangke , Zhao Wei , Xin Sherman Xuegang , Shi Benyun , Liu Jiming , Xia Shang , Peng Zhiqiang , Yang Zhicong , Zhang Fuchun , Chen Xiao-Guang , Zhou Xiaohong
Published: October 2022

Background

Dengue is the fastest spreading arboviral disease, posing great challenges on global public health. A reproduceable and comparable global genotyping framework for contextualizing spatiotemporal epidemiological data of dengue virus (DENV) is essential for research studies and collaborative surveillance.

Methods

Targeting DENV-1 spreading prominently in recent decades, by reconciling all qualified complete E gene sequences of 5003 DENV-1 strains with epidemiological information from 78 epidemic countries/areas ranging from 1944 to 2018, we established and characterized a unified global high-resolution genotyping framework using phylogenetics, population genetics, phylogeography, and phylodynamics.

Results

The defined framework was discriminated with three hierarchical layers of genotype, subgenotype and clade with respective mean pairwise distances 2–6%, 0.8–2%, and ≤ 0.8%. The global epidemic patterns of DENV-1 showed strong geographic constraints representing stratified spatial-genetic epidemic pairs of Continent-Genotype, Region-Subgenotype and Nation-Clade, thereby identifying 12 epidemic regions which prospectively facilitates the region-based coordination. The increasing cross-transmission trends were also demonstrated. The traditional endemic countries such as Thailand, Vietnam and Indonesia displayed as persisting dominant source centers, while the emerging epidemic countries such as China, Australia, and the USA, where dengue outbreaks were frequently triggered by importation, showed a growing trend of DENV-1 diffusion. The probably hidden epidemics were found especially in Africa and India. Then, our framework can be utilized in an accurate stratified coordinated surveillance based on the defined viral population compositions. Thereby it is prospectively valuable for further hampering the ongoing transition process of epidemic to endemic, addressing the issue of inadequate monitoring, and warning us to be concerned about the cross-national, cross-regional, and cross-continental diffusions of dengue, which can potentially trigger large epidemics.

Conclusions

The framework and its utilization in quantitatively assessing DENV-1 epidemics has laid a foundation and re-unveiled the urgency for establishing a stratified coordinated surveillance platform for blocking global spreading of dengue. This framework is also expected to bridge classical DENV-1 genotyping with genomic epidemiology and risk modeling. We will promote it to the public and update it periodically.

Graphical Abstract
Lived experience perspectives on a definition of eating disorder recovery in a sample of predominantly white women: a mixed method study
Authors: Kenny Therese E. , Trottier Kathryn , Lewis Stephen P.
Published: October 2022

Background

There has recently been a push for recovery-focused research in the eating disorder (ED) field, starting with a consensus definition of recovery. One definition, in particular, proposed by Bardone-Cone et al. [21] has received considerable attention given its transdiagnostic nature and validation studies. However, no studies to date have elicited lived experience views of this definition. The goal of the current study was to examine perspectives on this definition of recovery from individuals with a past or present ED and to determine whether participant agreement with the model differed based on diagnostic history or current symptom severity.

Methods

Sixty-two individuals (95.2% women; 91.9% White/European) participated in a 1–2 h interview aimed at capturing their perspectives on ED recovery. Transcripts were analyzed using qualitative content analysis and codebook thematic analysis to examine agreement with and thoughts on Bardone-Cone’s definition of recovery, respectively. Chi-squared tests of independence and binary logistic regression were computed to determine whether agreement with the definition differed across diagnostic history and self-reported symptoms.

Results

Although some participants indicated acceptance of the definition, the majority expressed concerns related to its categorical nature, proposed criteria, feasibility, language, and applications. There were no differences in acceptance based on diagnostic history or current symptom severity.

Conclusion

A single definition of recovery does not seem to fit individuals’ lived ED experience. Future research may benefit from distinguishing between recovery as an individually-defined phenomenon and related constructs such as remission (i.e., loss of diagnosis or absence of clinical symptoms). A more comprehensive multi-faceted, and person-centered model of recovery may have merit in clinical settings.
A practical Alzheimer’s disease classifier via brain imaging-based deep learning on 85,721 samples
Authors: Lu Bin , Li Hui-Xian , Chang Zhi-Kai , Li Le , Chen Ning-Xuan , Zhu Zhi-Chen , Zhou Hui-Xia , Li Xue-Ying , Wang Yu-Wei , Cui Shi-Xian , Deng Zhao-Yu , Fan Zhen , Yang Hong , Chen Xiao , Thompson Paul M. , Castellanos Francisco Xavier , Yan Chao-Gan
Published: October 2022

Beyond detecting brain lesions or tumors, comparatively little success has been attained in identifying brain disorders such as Alzheimer’s disease (AD), based on magnetic resonance imaging (MRI). Many machine learning algorithms to detect AD have been trained using limited training data, meaning they often generalize poorly when applied to scans from previously unseen scanners/populations. Therefore, we built a practical brain MRI-based AD diagnostic classifier using deep learning/transfer learning on a dataset of unprecedented size and diversity. A retrospective MRI dataset pooled from more than 217 sites/scanners constituted one of the largest brain MRI samples to date (85,721 scans from 50,876 participants) between January 2017 and August 2021. Next, a state-of-the-art deep convolutional neural network, Inception-ResNet-V2, was built as a sex classifier with high generalization capability. The sex classifier achieved 94.9% accuracy and served as a base model in transfer learning for the objective diagnosis of AD. After transfer learning, the model fine-tuned for AD classification achieved 90.9% accuracy in leave-sites-out cross-validation on the Alzheimer’s Disease Neuroimaging Initiative (ADNI, 6,857 samples) dataset and 94.5%/93.6%/91.1% accuracy for direct tests on three unseen independent datasets (AIBL, 669 samples / MIRIAD, 644 samples / OASIS, 1,123 samples). When this AD classifier was tested on brain images from unseen mild cognitive impairment (MCI) patients, MCI patients who converted to AD were 3 times more likely to be predicted as AD than MCI patients who did not convert (65.2% vs. 20.6%). Predicted scores from the AD classifier showed significant correlations with illness severity. In sum, the proposed AD classifier offers a medical-grade marker that has potential to be integrated into AD diagnostic practice.
The cardioprotective and anti-inflammatory effect of inhaled nitric oxide during Fontan surgery in patients with single ventricle congenital heart defects: a prospective randomized study
Authors: Kolcz Jacek , Karnas Elzbieta , Madeja Zbigniew , Zuba-Surma Ewa K.
Published: October 2022

Background

Fontan surgery with cardiopulmonary bypass (CPB) causes tremendous systemic stress and inflammatory responses, affecting postoperative organ function, morbidity, and mortality. Although this reaction triggers partially protective anti-inflammatory responses, it is harmful in patients with single ventricle congenital heart defects. Despite decades of research, an effective anti-inflammatory and stress defense strategy is lacking. This study investigated the influence of inhaled nitric oxide (NO) during CPB on early clinical results, including the duration of postoperative respiratory support as a primary outcome and a panel of laboratory analytes.

Methods

In this study, 115 patients were randomized to the Fontan-NO group (n = 48) and the Fontan group (n = 49). Eighteen patients were excluded from the study. The Fontan-NO group received NO inhaled directly into the oxygenator during CPB. Clinical data were collected, and blood samples were drawn for analysis at repeated intervals. Multiplex assays were used to analyze a proteome profile of molecules involved in stress response, inflammation, metabolic reactions, as well as heart and lung protection.

Results

Fontan-NO patients had significantly shorter respiratory support time with a median of 9.3 h (7.0; 13,2) vs 13.9 h (3.7; 18.5) by the absolute difference of 4.6 h [95% confidence interval, − 30.9 to 12.3; (p = 0.03)]. In addition, they have a shorter time in intensive care (p = 0.04) and lower pulmonary artery pressure after CPB discontinuation (p = 0.04), 4 h (p = 0.03) and 8 h (p = 0.03) after surgery. Fontan-NO patients also had a lower concentration of lactates (p = 0.04) and glucose after separation from CPB (p = 0.02) and lower catecholamine index (p = 0.042). Plasma factors analysis has shown a significantly higher concentration of interleukin-10, and a lower concentration of interleukin-6, interleukin-8, interleukin-1β, pentraxin, matrix metalloproteinase-8, troponin-I, creatine kinase myocardial band (CK-MB), and insulin in Fontan-NO group.

Conclusions

NO inhaled into the oxygenator during CPB can improve short-term clinical outcomes. It shortens intubation time and intensive care time. It reduces inflammatory response, improves myocardial and lung protection, and diminishes metabolic stress in patients with a single ventricle undergoing Fontan surgery.

Trial registration number:The trial was preregistered, supervised, and supported by The Polish National Science Center (NCN/01/B/NZ5/04246).
Personalized pancreatic cancer therapy: from the perspective of mRNA vaccine
Authors: Huang Xing , Zhang Gang , Tang Tian-Yu , Gao Xiang , Liang Ting-Bo
Published: October 2022

Pancreatic cancer is characterized by inter-tumoral and intra-tumoral heterogeneity, especially in genetic alteration and microenvironment. Conventional therapeutic strategies for pancreatic cancer usually suffer resistance, highlighting the necessity for personalized precise treatment. Cancer vaccines have become promising alternatives for pancreatic cancer treatment because of their multifaceted advantages including multiple targeting, minimal nonspecific effects, broad therapeutic window, low toxicity, and induction of persistent immunological memory. Multiple conventional vaccines based on the cells, microorganisms, exosomes, proteins, peptides, or DNA against pancreatic cancer have been developed; however, their overall efficacy remains unsatisfactory. Compared with these vaccine modalities, messager RNA (mRNA)-based vaccines offer technical and conceptional advances in personalized precise treatment, and thus represent a potentially cutting-edge option in novel therapeutic approaches for pancreatic cancer. This review summarizes the current progress on pancreatic cancer vaccines, highlights the superiority of mRNA vaccines over other conventional vaccines, and proposes the viable tactic for designing and applying personalized mRNA vaccines for the precise treatment of pancreatic cancer.
What do we want to know about MOOCs? Results from a machine learning approach to a systematic literature mapping review
Authors: Despujol Ignacio , Castañeda Linda , Marín Victoria I. , Turró Carlos
Published: October 2022

By the end of 2020, over 16,300 Massive Open Online Courses (MOOCs) from 950 universities worldwide had enrolled over 180 million students. Interest in MOOCs has been matched by significant research on the topic, including a considerable number of reviews. This study uses Machine Learning techniques and human expert supervision to generate a comprehensive systematic literature mapping review that overcomes some limitations of the traditional ones and provides a broader overview of the content and main topics studied in the specialized literature devoted to MOOCs. The sample consisted of 6320 publications automatically classified within six research topics, denominated by human experts: institutional approach, pedagogical approach, evaluation, analytics, participation, and educational resources. The content analysis of the topics identified was conducted using visual network analysis, which supported the identification of different thematic sub-clusters and endorsed the classification. Results from the review show that the lowest production of MOOC papers is within the topics of the pedagogical approach and educational resources. In contrast, participation and evaluation are the most frequent ones. In addition, the most cited papers are on the topics of analytics and resources, being the pedagogical approach and the institutional approach the less cited. This highlights the need for more MOOC research from a pedagogical perspective and calls upon the presence of educators.
FOLFIRINOX Pharmacodynamic Interactions in 2D and 3D Pancreatic Cancer Cell Cultures
Authors: Allen-Coyle Taylor J. , Niu Jin , Welsch Eva , Conlon Neil T. , Garner Weylon , Clynes Martin , O’Sullivan Finbarr , Straubinger Robert M. , Mager Donald E. , Roche Sandra
Published: October 2022

The multi-drug combination regime, FOLFIRINOX, is a standard of care chemotherapeutic therapy for pancreatic cancer patients. However, systematic evaluation of potential pharmacodynamic interactions among multi-drug therapy has not been reported previously. Here, pharmacodynamic interactions of the FOLFIRINOX agents (5-fluorouracil (5-FU), oxaliplatin (Oxa) and SN-38, the active metabolite of irinotecan) were assessed across a panel of primary and established pancreatic cancer cells. Inhibition of cell proliferation was quantified for each drug, alone and in combination, to obtain quantitative, drug-specific interaction parameters and assess the nature of drug interactions. The experimental data were analysed assuming Bliss independent interactions, and nonlinear regression model fitting was conducted in SAS. Estimates of the drug interaction term, psi (ψ), revealed that the Oxa/SN-38 combination appeared synergistic in PANC-1 (ψ = 0.6, 95% CI = 0.4, 0.9) and modestly synergistic, close to additive, in MIAPaCa-2 (ψ = 0.8, 95% CI = 0.6, 1.0) in 2D assays. The triple combination was strongly synergistic in MIAPaCa-2 (ψ = 0.2, 95% CI = 0.1, 0.3) and modestly synergistic/borderline additive in PANC-1 2D (ψ = 0.8, 95% CI = 0.6, 1.0). The triple combination showed antagonistic interactions in the primary PIN-127 and 3D PANC-1 model (ψ > 1). Quantitative pharmacodynamic interactions have not been described for the FOLFIRINOX regimen; this analysis suggests a complex interplay among the three chemotherapeutic agents. Extension of this pharmacodynamic analysis approach to clinical/translational studies of the FOLFIRINOX combination could reveal additional pharmacodynamic interactions and guide further refinement of this regimen to achieve optimal clinical responses.

Graphical abstract
Sensitivity of accelerator-based neutrino experiments to neutrino-dark matter interaction: Elko as a viable dark matter candidate
Authors: Moura C. A. , Kamiya F. , Duarte L. , Dias M. , Hoff da Silva J. M.
Published: October 2022

We analyze the potential of accelerator-based neutrino experiments, such as the Deep Underground Neutrino Experiment, to constrain a five-dimensional operator mediating a beyond standard model interaction between a mass-dimension-one fermion field, labeled elko, and neutrino. We identify the parameter space where elko is a viable dark matter candidate.
The Hitchhiker Position in Endoscopic Pituitary Surgery
Authors: Kilgallon John L. , Thorne Alison , Laws Edward R.
Published: October 2022

BACKGROUND:

Technically and ergonomically correct positioning is essential in endoscopic transsphenoidal pituitary surgery.

OBJECTIVE:

To propose a safe, ergonomic approach to conduct endoscopic endonasal pituitary and skull base surgery in large patients without sacrificing important aspects of current standard practice.

METHODS:

The patient's right arm is outstretched and secured in a supine position, with the primary surgeon standing in the axillary area. Considerations include maintaining comfort, immobility, anesthesia access, endotracheal tube fixation, intravenous lines, thorax elevated 25° to 30° for optimization of respiration, free and exposed abdomen for fat graft, legs positioned with no sciatic stretch or venous strain, and the patient's head in parallel with the surrounding area to sustain a strict midline.

RESULTS:

Ten patients who underwent transsphenoidal pituitary tumor resections conducted using the hitchhiker position from October 2019 to June 2021 comprised our study cohort. The patients' mean height was 168.70 ± 9.29 cm, their mean weight was 114.35 ± 19.32 kg, and their mean body mass index was 40.19 ± 6.39 kg/m2. Twenty percent (n = 2) patients had a body mass index classified as “obesity class 1,” 50% (n = 5) as “obesity class 2,” and 30% (n = 3) as “extreme obesity class 3.” The primary surgeon consistently reported decreased bodily strain and improved ergonomic access to the surgical site using the hitchhiker position.

CONCLUSION:

The hitchhiker position offers the opportunity to improve both patient and physician well-being in the context of endoscopic pituitary surgery.
Nerve Transfers for Elbow Reconstruction in Upper and Extended Upper-Type Brachial Plexus Injuries: A Case Series
Authors: Estrella Emmanuel P. , Montales Tristram D.
Published: October 2022

BACKGROUND:

Nerve transfers for elbow flexion in brachial plexus injuries have been used with increasing frequency because of the higher rate of success and acceptable morbidity. This is especially true in upper and extended upper-type brachial plexus injuries.

OBJECTIVE:

To present the clinical outcomes of nerve transfers for elbow flexion in patients with upper and extended upper-type brachial plexus injuries.

METHODS:

A retrospective cohort review was done on all patients with upper and extended upper-type brachial plexus injuries from 2006 to 2017, who underwent nerve transfers for the restoration of elbow flexion. Outcome variables include Filipino version of the disability of the arm, shoulder, and hand (FIL-DASH) score, elbow flexion strength and range of motion, and pain. All statistical significance was set at P < .05.

RESULTS:

Fifty-six patients with nerve transfers to restore elbow flexion were included. There was a significant improvement in FIL-DASH scores in 28 patients after the nerve transfer procedure. Patients with C56 nerve root injuries and those with more than 2 years' follow-up have a higher percentage of regaining ≥M4 elbow flexion strength. Those with double nerve transfers had a higher percentage of ≥M4 elbow flexion strength, greater range of elbow flexion, and better FIL-DASH scores compared with single nerve transfers, but this did not reach statistical significance.

CONCLUSION:

Nerve transfer procedures improve FIL-DASH scores in upper and upper-type brachial plexus injuries. After nerve transfer, stronger elbow flexion can be expected in patients with C56 injuries, and those with longer follow-up.
Contactless Ultrasonic Cavitation for the Prevention of Shunt Obstruction in Hydrocephalus: A Proof-of-Concept Study
Authors: Gomez-Gonzalez Emilio , Munoz-Gonzalez Francisco Javier , Barriga-Rivera Alejandro , Perales-Esteve Manuel A. , Guerrero-Claro Manuel , Fernandez-Lizaranzu Isabel , Requena-Lancharro Desirée , Rosales-Martinez Marina , Marquez-Rivas Javier
Published: October 2022

BACKGROUND:

Obstructive failure of implanted shunts is the most common complication in the treatment of hydrocephalus. Biological material and debris accumulate in the inner walls of the valve and catheters block the normal flow of the drained cerebrospinal fluid causing severe symptoms with high morbidity and mortality. Unfortunately, at present, there is no effective preventive protocol or cleaning procedure available.

OBJECTIVE:

To assess whether externally applied, focused ultrasound beams can be used to resuspend deposits accumulated in brain shunts safely.

METHODS:

A computational model of an implanted brain shunt was implemented to test the initial design parameters of a system comprising several ultrasound transducers. Under laboratory conditions, configurations with 3 and 4 transducers were arranged in a triangle and square pattern with their radiation axis directed towards a target model of the device, 2 catheters and a brain shunt filled with water and deposited graphite powder. The ultrasound beams were then concentrated on the device across a head model.

RESULTS:

The computational model revealed that by using only 3 transducers, the acoustic field intensity on the valve was approximately twice that on the brain surface suggesting that acoustic cavitation could be selectively achieved. Resuspension of graphite deposits inside the catheters and the valve were then physically demonstrated and video-recorded with no temperature increase.

CONCLUSION:

The technology presented here has the potential to be used routinely as a noninvasive, preventive cleaning procedure to reduce the likelihood of obstruction-related events in patients with hydrocephalus treated with an implanted shunt.
Use of Cannulated Reamers to Facilitate Thoracic Diskectomy Using a Minimally Invasive Retropleural Thoracotomy Approach—Surgical Technique
Authors: Nemani Venu M. , Shen Jesse , Sethi Rajiv K. , Leveque Jean-Christophe
Published: October 2022

BACKGROUND:

The surgical treatment of symptomatic thoracic disk herniations is technically challenging. In the past decade, a minimally invasive retropleural thoracotomy approach has become more popular to treat this pathology. However, efficient bone removal to safely perform the diskectomy and spinal cord decompression is difficult with this technique because of the small incision size and long working distance in the thoracic cavity and the proximity of the compressed thoracic cord.

OBJECTIVE:

To describe a novel surgical technique for performing a thoracic diskectomy using a minimally invasive lateral approach using cannulated reamers to facilitate bone removal.

METHODS:

This technique was used in 7 consecutive patients who presented with thoracic myelopathy from a thoracic disk herniation. First, a standard lateral minimally invasive retropleural approach to the thoracic spine was performed. Partially threaded guide wires were placed in the posterior aspect of the vertebral bodies adjacent to the affected disk space, and sequential cannulated reamers were passed over the guidewires to perform partial corpectomies. The posterior annulus, posterior longitudinal ligament, and herniated disk material were then resected using Penfield dissectors and Kerrison rongeurs to complete the decompression.

RESULTS:

All 7 patients who underwent thoracic diskectomy using this approach had stable or improved neurologic function postoperatively. There were no complications related to the use of the cannulated reamer technique.

CONCLUSION:

The use of cannulated reamers provides a simple and efficient method for safe bone removal to facilitate minimally invasive thoracic diskectomy using a lateral approach. This is an easily reproducible technique using commonly available equipment.
A Patient-Specific Reference Tracker for Noninvasive Electromagnetic Navigation of Endoscopic Skull Base Surgery
Authors: Micko Alexander , Minchev Georgi , Wurzer Ayguel , Kronreif Gernot , Wolfsberger Stefan
Published: October 2022

BACKGROUND:

Owing to the possibility of nonrigid head fixation, electromagnetic navigation (EM) is a mainstay for endoscopic skull base surgery. The currently available dynamic reference trackers (RTs) are invasive or inaccurate.

OBJECTIVE:

To investigate the feasibility and stability of this innovative oral tracker (OT), which is adhesive to the hard palate in comparison with a commercially available skin adhesive tracker (ST).

METHODS:

A prospective series of 31 patients with intrasellar lesions who underwent surgery between 2019 and 2021 using a pure endoscopic transsphenoidal approach were evaluated. A patient-specific palatal mold was designed from preoperative computed tomography data. The OT was cast using a biocompatible algin with an integrated EM tracker assembly. In comparison with a skull-mounted RT, which served as a gold standard, the deviations of OT vs those of the ST with the RT were continuously assessed.

RESULTS:

The OT showed significantly lower deviations from the RT than the ST during the surgical steps: start of endoscopic surgery (OT vs ST: 0.62 mm, IQR 0.36-0.89 vs 1.65 mm, IQR 1.35-2.32, P < .001), drilling phase (OT vs ST: 0.81 mm, IQR 0.51-1.32 vs 1.89 mm, IQR 1.6-2.74, P < .001), and end of endoscopic surgery (OT vs ST: 1.1 mm, IQR 0.68-1.64 vs 1.9 mm, IQR 1.6-2.72, P < .001).

CONCLUSION:

The OT showed significantly higher intraoperative stability than the ST. Therefore, this noninvasive and patient-specific tool could be used to achieve accurate EM guidance during endoscopic skull base surgeries.
High-Fidelity Virtual Reality Simulation for the Middle Cranial Fossa Approach—Modules for Surgical Rehearsal and Education
Authors: Lai Carolyn , Lui Justin T. , Chen Joseph M. , Lin Vincent Y. , Agrawal Sumit K. , Blevins Nikolas H. , Ladak Hanif M. , Pirouzmand Farhad
Published: October 2022

BACKGROUND:

Virtual reality simulation has gained prominence as a valuable surgical rehearsal and education tool in neurosurgery. Approaches to the internal auditory canal, cerebellopontine angle, and ventral brainstem region using the middle cranial fossa are not well explored by simulation.

OBJECTIVE:

We hope to contribute to this paucity in simulation tools devoted to the lateral skull base, specifically the middle cranial fossa approach.

METHODS:

Eight high-resolution microcomputed tomography scans of human cadavers were used as volumetric data sets to construct a high-fidelity visual and haptic rendering of the middle cranial fossa using CardinalSim software. Critical neurovascular structures related to this region of the skull base were segmented and incorporated into the modules.

RESULTS:

The virtual models illustrate the 3-dimensional anatomic relationships of neurovascular structures in the middle cranial fossa and allow a realistic interactive drilling environment. This is facilitated by the ability to render bone opaque or transparent to reveal the proximity to critical anatomy allowing for practice of the virtual dissection in a graduated fashion.

CONCLUSION:

We have developed a virtual library of middle cranial fossa approach models, which integrate relevant neurovascular structures with aims to improve surgical training and education. A ready extension is the potential for patient-specific application and pathology.
Continuous Tissue Plasminogen Activator Infusion Using a Minimally Invasive Irrigating Catheter for the Treatment of Intraparenchymal Hemorrhage Within the Basal Ganglia: Case Reports
Authors: Varela Samantha , Carrera Diego , Elazim Ahmed Abd , Robinson Myranda B. , Torbey Michel , Carlson Andrew P.
Published: October 2022

BACKGROUND AND IMPORTANCE:

Intraparenchymal hemorrhage (IPH) is a debilitating and highly morbid type of stroke with limited effective treatment modalities. Minimally invasive evacuation with tissue plasminogen activator (rt-PA) has demonstrated promise for mortality/functional improvements with adequate clot volume reduction. In this study, we report 2 cases of continuous rt-PA infusion using a closed circuit, dual lumen catheter, and irrigation system (IRRAflow) for IPH treatment.

CLINICAL PRESENTATION:

A 55-year-old man was admitted for acute onset left hemiparesis; he was found to have right basal ganglia IPH. He was treated with continuous rt-PA irrigation using the IRRAflow device, at a rate of 30 mL/h for 119 hours, with a total volume reduction of 87.8 mL and post-treatment volume of 1.2 mL. At 3-month follow-up, he exhibited a modified Rankin score of 4 and improved hemiparesis. A 39-year-old woman was admitted for acute onset left facial droop, left hemianopsia, and left hemiparesis; she was diagnosed with a right basal ganglia IPH. She was treated with drainage and continuous rt-PA irrigation at 30 mL/h for 24 hours, with a total hematoma volume reduction of 41 mL and with a final post-treatment volume of 9.1 mL. At 3-month follow-up, she exhibited a modified Rankin score of 3 with some improvement in left hemiparesis.

CONCLUSION:

Continuous rt-PA infusion using a minimally invasive catheter with saline irrigation was feasible and resulted in successful volume reduction in 2 patients with IPH. This technique is similar to the Minimally Invasive Surgery Plus rt-PA for Intracerebral Hemorrhage Evacuation (MISTIE) approach but offers the potential advantages of less breaks in the sterile circuit, continuous intracranial pressure monitoring, and may provide more efficient clot lysis compared with intermittent bolusing.
Epidural Pretemporal Transcavernous Approach Double-Barrel Superficial Temporal Artery-Posterior Cerebral Artery/Superior Cerebellar Artery Bypass for a Ruptured Anterior Spinal Artery Aneurysm
Authors: Hu Peng
Published: October 2022

BACKGROUND:

Rostral posterior circulation bypass is technically challenging. Pretemporal approach has been reported to facilitate the bypass procedure within the oculomotor-tentorial triangle. However, bridging veins converging into cavernous sinus at the temporal pole usually need to be sacrificed.

OBJECTIVE:

To report operative nuances of rostral posterior circulation bypass with an emphasis on preserving the Sylvian veins and enlarging surgical space, we use a double-barrel superficial temporal artery-posterior cerebral artery/superior cerebellar artery anastomosis using an epidural pretemporal transcavernous approach.

METHODS:

A 54-year-old man had a subarachnoid hemorrhage attack 1 month before the admission. A flow-related anterior spinal artery aneurysm with bilateral vertebral artery occlusive diseases was indicated. The aneurysm was difficult to be directly treated, either by the endovascular approach or by the microsurgical clipping. A double-barrel superficial temporal artery-superior cerebellar artery/posterior cerebral artery bypass was performed using an epidural pretemporal transcavernous approach.

RESULTS:

The anastomoses were successfully accomplished in a large surgical space. The patient recovered well with no events, except a transient right cranial nerve III paralysis. The aneurysm was demonstrated to be completely regressed at the 5-month follow-up.

CONCLUSION:

An epidural pretemporal transcavernous approach could be an alternative for rostral posterior circulation bypass.
Exposure of the Lumbosacral Plexus by Using the Pararectus Approach: A Technical Note
Authors: Häckel Sonja , Christen Samuel , Vögelin Esther , Keel Marius J. B.
Published: October 2022

BACKGROUND:

Surgical exploration of the lumbosacral plexus is challenging. Previously described approaches reach from invasive open techniques with osteotomy of the ilium to laparoscopic techniques.

OBJECTIVE:

To describe a novel surgical technique to explore lumbosacral plexopathies such as benign nerve tumors or iatrogenic lesions of the lumbosacral plexus in 4 case examples.

METHODS:

We retrospectively evaluated 4 patients suffering from pathologies or injuries of the lumbosacral plexus between 2017 and 2019. The mean follow-up period after surgery was 23.5 (range 11-52) months. All patients underwent neurolysis of the lumbosacral plexus using the single incision, intrapelvic, extraperitoneal pararectus approach.

RESULTS:

In all patients, the pathology of the lumbosacral plexus was successfully visualized, proving feasibility of the extraperitoneal pararectus approach for this indication. There were no major complications, and all patients recovered well.

CONCLUSION:

The pararectus approach allows excellent visualization of the lumbar plexus and intrapelvic lesions of the femoral and sciatic nerves.
A New Noninvasive Frameless Registration System for Stereotactic Cranial Biopsy: A Technical Note
Authors: Almairac Fabien , Leplus Aurélie , Mondot Lydiane , Fontaine Denys
Published: October 2022

BACKGROUND:

Although frame-based stereotactic biopsy is still considered the gold standard for brain biopsies, frameless robot-assisted stereotactic systems are now able to provide an equal level of safety and accuracy. However, both systems suffer from a lack of efficiency of the operative workflow.

OBJECTIVE:

To describe the technique of a new frameless and noninvasive registration tool Neurolocate (Renishaw). This tool, combined with an intraoperative cone-beam computed tomography imaging system like O-ARM (Medtronic), might facilitate the achievement and workflow of robot-assisted stereotactic intracranial biopsies.

METHODS:

Neurolocate is a 3-dimensional fiducial tool fixed directly on the Neuromate (Renishaw) robot arm. It consists of 5 radio-opaque spherical fiducials, whose geometry is constant. This tool made it possible to carry out the coregistration then the biopsy in the same operating time, following a five-step procedure described here. We retrospectively extracted selected preliminary results from our initial experience.

RESULTS:

Over 1 year, 23 consecutive adult patients were biopsied with Neurolocate in our center. The mean overall operative time, from patient's installation to skin closure, was 97 minutes ± 27 (SD). The entire procedure took place in a single location unit (operating room), which facilitated workflow and surgical planning. No invasive gesture was performed outside of the operating time.

CONCLUSION:

Neurolocate is a new frameless and noninvasive registration tool that could improve workflow and flexibility for operating room management and surgical planning. It may also increase the comfort of patients undergoing robot-assisted intracranial stereotactic biopsies. The accuracy and safety profile should be addressed in specific studies.
Pavlovian conditioning of gentoo penguins (Pygoscelis papua) to underwater sound
Authors: Rasmussen Maria S. , Sørensen Kenneth , Vittrup Malou F. , Wahlberg Magnus
Published: October 2022

Penguins are known to react to underwater noise, but it is unknown if they make use of sound cues while diving. We tested whether captive gentoo penguins (Pygoscelis papua) can pair underwater sounds with food through Pavlovian conditioning. Two seconds after an underwater sound (a 1-4 kHz sweep with a received level of 130 dB re 1 µPa RMS) was played back to one or two unidentifiable penguins, a dead fish was flushed into the water close to the underwater sound source. After 8 weeks of conditioning, one or more individual penguins approached the sound source after sound emission in 78.3% out of 230 trials. In 43 intermixed control trials with no sound preceding the fish, the penguins did not show any reaction in the pre-flush period. In an additional experiment, three identified penguins reacted to the sound in 66.7-100% out of 30 trials, with 0% reactions in five intermixed control trials. Our experiments demonstrate that gentoo penguins can be conditioned to underwater sound and that they associate underwater sounds with food. It is possible that gentoos, as well as other species of penguins, use sound cues while foraging. This may explain why penguins have been observed to react negatively to anthropogenic noise.
Scavenger: A pipeline for recovery of unaligned reads utilising similarity with aligned reads
Authors: Yang Andrian , Tang Joshua Y. S. , Troup Michael , Ho Joshua W. K.
Published: October 2022

Read alignment is an important step in RNA-seq analysis as the result of alignment forms the basis for downstream analyses. However, recent studies have shown that published alignment tools have variable mapping sensitivity and do not necessarily align all the reads which should have been aligned, a problem we termed as the false-negative non-alignment problem. Here we present Scavenger, a python-based bioinformatics pipeline for recovering unaligned reads using a novel mechanism in which a putative alignment location is discovered based on sequence similarity between aligned and unaligned reads. We showed that Scavenger could recover unaligned reads in a range of simulated and real RNA-seq datasets, including single-cell RNA-seq data. We found that recovered reads tend to contain more genetic variants with respect to the reference genome compared to previously aligned reads, indicating that divergence between personal and reference genomes plays a role in the false-negative non-alignment problem. Even when the number of recovered reads is relatively small compared to the total number of reads, the addition of these recovered reads can impact downstream analyses, especially in terms of estimating the expression and differential expression of lowly expressed genes, such as pseudogenes.
Fluoxetine pharmacokinetics and tissue distribution quantitatively supports a therapeutic role in COVID-19 at a minimum dose of 20 mg per day
Authors: Eugene Andy R.
Published: October 2022

Background.  Various in vitro studies have shown fluoxetine inhibits multiple variants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pathogen causing the coronavirus disease 2019 (COVID-19) worldwide pandemic and multiple observational clinical studies have shown that patients receiving fluoxetine experienced clinical benefit by lowering the risk of intubation and death. The aim of this study is to conduct population pharmacokinetic dosing simulations to quantify the percentage of patients achieving a trough level for the effective concentration resulting in 50% (EC50) and 90% (EC90) inhibition of SARS-CoV-2 as reported in Calu-3 human lung cells.

Methods.  Pharmacometric parameter estimates used in this study were obtained from the U.S. FDA website from a new drug application for fluoxetine hydrochloride. A population of 1,000 individuals were simulated at standard fluoxetine antidepressant doses (20 mg/day, 30 mg/day, 40 mg/day, 50 mg/day, and 60 mg/day) to estimate the percentage of the patients achieving a trough plasma level for the EC50 and EC90 SARS-CoV-2 inhibition. All analyses were conducted in R.

Results.  By day-10 at 20 mg/day, 93.2% and 47% of the population will achieve the trough target plasma EC50 and EC90 concentrations, respectively, which translates to a lung tissue distribution coefficient of 60-times higher EC50 (283.6 ng/ml [0.82 mM]) and EC90 (1390.1 ng/ml [4.02 mM]). Further, by day-10 at an ideal dose of 40 mg/day, 99% and 93% of patients will reach the trough EC50 and EC90 concentrations, respectfully. Lastly, only a dose of 60 mg/day will reach the SARS-CoV-2 EC90 inhibitory concentration in the brain at pharmacokinetic steady-state.

Conclusion. Overall, with a minimum treatment period of 10-days and a minimum dose of 20 mg/day, this study corroborates in vitro studies reporting fluoxetine inhibiting SARS-CoV-2 titers and also multiple observational clinical studies showing therapeutic benefit of fluoxetine in COVID-19 patients.
The genome sequence of the acorn piercer, Pammene fasciana (Linnaeus, 1761)
Authors: Boyes Douglas ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective, Lewin Thomas ,   Darwin Tree of Life Consortium
Published: October 2022

We present a genome assembly from an individual male Pammene fasciana (acorn piercer; Arthropoda; Insecta; Lepidoptera; Tortricidae). The genome sequence is 564 megabases in span. The majority of the assembly (99.94%) is scaffolded into 28 chromosomal pseudomolecules with the Z sex chromosome assembled. The complete mitochondrial genome was also assembled and is 16.4 kilobases in length.
Retrospective of Information Security Education in National Schoolsh
Authors: Zubrilin Andrej , Rybkina Viktoriya , Devyataykina Oksana
Published: October 2022

The article substantiates the need for information security training in Russian schools. A review of informatics textbooks from 1985 to the present is given with a view to changing views on teaching safe work with information resources, highlighting the dominant areas that are reflected in educational materials. The place of information security in regulatory documents, in particular, in the federal state educational standards (FSES) of basic and secondary general education, is considered. It is shown what forms of information security training are in the classroom (situational tasks, role-playing and business games, watching educational animated videos) and in the extracurricular (information security olympiads, thematic classroom hours, discussion platforms, extracurricular activities, meetings with IT workers, visiting IT enterprises) activities should prevail. Specific examples of gaming tasks for teaching information security are given, which can be used in the classroom as learning tasks or in extracurricular activities as separate competitions.
Wokół biografii metropolity Andrzeja Szeptyckiego – stan badań, źródła i metoda
Authors: Nowak Magdalena
Published: October 2022

ON THE BIOGRAPHY OF THE METROPOLITAN ANDREI SHEPTYTS’KYI – RESEARCH, SOURCES AND METHODS The text discusses the state of research, sources and methods of studying which concern the metropolitan Andrei Sheptyts’kyi, his life and activities. It indicates institutions and archives, where scholars can search for documents on his biography. The author of the text has summed up the state of research on Sheptyts’kyi’s biography, referring readers to numerous publications, including bibliographic sources. Moreover, she has underlined the high rank of studies on Andrei Sheptyts’kyi in the world historiography. The author stated that these considerations need further international research. The text also recognises the areas that require further scholarly studies and complementary analysis.
Lwowski okres twórczości Wasyla Simowycza
Authors: Szeluch Olha , Kazan Emilia
Published: October 2022

THE LVIV PERIOD OF VASYL SIMOVYCH’S CREATIVITY 

aVasyl Simovych was a full member of the National Association of Taras Shevchenko, professor and rector of the Ukrainian Higher Pedagogical Institute in Prague, head of the Ukrainian language department and dean of the philological faculty of Lviv University (1939- 1941). The article discusses the scientific and organisational, publishing, cultural and educational activities of Vasyl Simovych in Lviv and Prague. His influence is shown not only in the context of the scientific, social and public life of Lviv but also of Galicia.
Augmented Difference-in-Differences
Authors: Li Kathleen T. , Van den Bulte Christophe
Published: October 2022

We propose a new, easy-to-implement augmented difference-in-differences (ADID) method to estimate causal effects from quasi-experimental data.
Learning Product Rankings Robust to Fake Users
Authors: Golrezaei Negin , Manshadi Vahideh , Schneider Jon , Sekar Shreyas
Published: October 2022

Analytics in the Face of Fraudulent Data

This article presents a novel online learning algorithm for identifying optimal product rankings in the presence of fake users and corrupted data. In recent years, e-commerce platforms, such as Amazon, have witnessed a growing number of fake users and click farms. These fraudulent actors seek to boost the position of certain products in the display ordering (i.e., product ranking). Further, platforms’ reliance on data analytics exacerbates the effect of these fake users as machine learning algorithms leverage user feedback to determine product rankings. In the face of these challenges, the present article departs from the status quo that is based on detecting fake users and instead proposes a robust learning methodology. More specifically, the article presents a robust online learning algorithm that converges to the optimal product ranking even when it is impossible to distinguish between real and fake users in the data.