bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical confocal laser endomicroscopy for imaging of autofluorescence signals of human brain tumors and non-tumor brain
Authors: Reichenbach Marlen , Richter Sven , Galli Roberta , Meinhardt Matthias , Kirsche Katrin , Temme Achim , Emmanouilidis Dimitrios , Polanski Witold , Prilop Insa , Krex Dietmar , Sobottka Stephan B. , Juratli Tareq A. , Eyüpoglu Ilker Y. , Uckermann Ortrud
Published: December 2024

Purpose
Analysis of autofluorescence holds promise for brain tumor delineation and diagnosis. Therefore, we investigated the potential of a commercial confocal laser scanning endomicroscopy (CLE) system for clinical imaging of brain tumors.
Methods
A clinical CLE system with fiber probe and 488 nm laser excitation was used to aquire images of tissue autofluorescence. Fresh samples were obtained from routine surgeries (glioblastoma n = 6, meningioma n = 6, brain metastases n = 10, pituitary adenoma n = 2, non-tumor from surgery for the treatment of pharmacoresistant epilepsy n = 2). Additionally, in situ intraoperative label-free CLE was performed in three cases. The autofluorescence images were visually inspected for feature identification and quantification. For reference, tissue cryosections were prepared and further analyzed by label-free multiphoton microscopy and HE histology.
Results
Label-free CLE enabled the acquisition of autofluorescence images for all cases. Autofluorescent structures were assigned to the cytoplasmic compartment of cells, elastin fibers, psammoma bodies and blood vessels by comparison to references. Sparse punctuated autofluorescence was identified in most images across all cases, while dense punctuated autofluorescence was most frequent in glioblastomas. Autofluorescent cells were observed in higher abundancies in images of non-tumor samples. Diffuse autofluorescence, fibers and round fluorescent structures were predominantly found in tumor tissues.
Conclusion
Label-free CLE imaging through an approved clinical device was able to visualize the characteristic autofluorescence patterns of human brain tumors and non-tumor brain tissue ex vivo and in situ. Therefore, this approach offers the possibility to obtain intraoperative diagnostic information before resection, importantly independent of any kind of marker or label.
The Relationship Between Sleep and Problem Behaviours in Children with Attention Deficit/Hyperactivity Disorder
Authors: Ghanim Fanar , Harkness Kelsey , Wiley Bevin , Guadagni Veronica , Murias Kara
Published: December 2024

Purpose Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that is commonly associated with sleep disturbances. Sleep disruption can contribute to difficulties in a child’s life and; therefore, can be an important determinant of their quality of life. This study uses data from the large multisite Adolescent Brain Cognitive Development (ABCD) database to examine the relationship between sleep and behaviour in children with ADHD. We hypothesized that shorter and more interrupted sleep would relate to increased problem behaviours such as inattention and social difficulties.Methods Sleep data was obtained using commercially available actigraphy (Fitbit) measures, and The Parent Sleep Disturbance Scale (SDS) for 212 children ages, 10 to 13 years, with ADHD and an age and sex matched control group (n = 212). Behavioural and emotional subscores were obtained from the Child Behavior Checklist (CBCL).Results SDS sleep data was significantly different between ADHD and control groups, while Fitbit actigraphy data was not. ADHD diagnosis, family income, sleep latency (measured by Fitbit) and 3 out of 6 of the SDS subscores were significantly related to problem behaviour scores.Conclusion The results of this study indicate that family report of sleep difficulties but not Fitbit actigraphy measures of sleep were associated with behaviour and emotional responses in children with ADHD. Family report of sleep difficulties, direct measures of sleep parameters, as well as behaviour and quality of life, should be considered when evaluating or investigating sleep in children to better understand the influence on health and functioning.
Ultra-sensitive, tumor-informed ctDNA profiling in pembrolizumab-treated esophagogastric cancer patients predicts clinical responses
Authors: Nixon Andrew B. , Navarro Fábio C. P. , Zhou Katherine I. , Abbott Charles , McDaniel Lee , Howard Lauren , Brady J Christopher , Liu Yingmiao , Jia Jingquan , Niedzwiecki Donna , Strickler John , Boyle Sean M. , Chen Richard O. , Uronis Hope
Published: December 2024

To explore whether ultra-sensitive circulating tumor DNA (ctDNA) profiling enables early prediction of treatment response and early detection of disease progression, we applied NeXT Personal, an ultra-sensitive bespoke tumor-informed liquid biopsy platform, to profile tumor samples from the KeyLargo study, a phase II trial in which metastatic esophagogastric cancer (mEGC) patients received capecitabine, oxaliplatin, and pembrolizumab. All 25 patients evaluated were ctDNA-positive at baseline. Minimal residual disease (MRD) events varied from 406,067 down to 1.5 parts per million (PPM) of ctDNA with a median limit of detection of 2.03 PPM. ctDNA dynamics were highly correlated with changes in tumor size (ρ = 0.59, p = 7.3×10-9). Lack of early molecular response (lack of ctDNA decrease) was associated with worse overall survival (OS) (HR 6.6, 95% CI 1.8-24.1, p = 0.005) and progression-free survival (PFS) (HR 15.4, 95% CI 2.7-87.0, p = 0.002). Lack of molecular clearance of ctDNA was associated with worse OS (HR 6.9, 95% CI 1.5-30.8, p = 0.012) and PFS (HR 19.2, 95% CI 2.4-152.8, p = 0.005). Molecular progression (ctDNA increase) preceded imaging-derived progression by a median lead time of 65 days. These results suggest that ultra-sensitive liquid biopsy approaches could improve treatment decision-making for mEGC patients receiving chemotherapy and immunotherapy.
An Evaluative Case Study of the Status and Quality of STEM Education in Senior High Schools in Ghana
Authors: Osei Emmanuel
Published: December 2024

The study aims to investigate the status and quality of Senior High School’s Science, Technology, Engineering and Mathematics (STEM) education in Ghana since its inception in 2018. Following the utilization of positivist and interpretivism paradigms, the triangulation design convergence model was adopted to collect qualitative and quantitative data from 212 students and 17 teachers across two STEM schools using document analysis, questionnaires, interviews, and observations with equal weighing informing the interpretation. The analysis showed that the STEM curricula in the schools aligned with Ghana's STEM Education policy, with sufficient resources to support its implementation. However, student performance was average attributed to teachers' lack of experience in teaching STEM subjects. The study recommends a full integration of STEM curricula from early education through university to foster critical thinking and creativity. In-service teachers in STEM schools should be taken through rigorous professional development training on how to teach what they know to maximize their students’ interest. Furthermore, education training providers should design the rudiments of teaching STEM subjects and train pre-service teachers specifically for STEM Education. Finally, the Ministry of Education should establish efficient resource procurement systems to ensure the continuous supply of resources to STEM schools.
Activating PIK3CA Mutations of Adipose-derived Stem Cells Drive Mutant-like Phenotypes of Wild-type Cells in Macrodactyly
Authors: Wang Bin , Zhang Xiao , Yin Yating , Wang Zhibo , Jiang Yongkang , Yu Aiping , Dai Xinyi , Wang Xiaoli , Guo Xuesong , Mao Hailei
Published: December 2024

Background
Pathological adipose proliferation is one of characteristic manifestations of macrodactyly. Although PIK3CA gain-of-function mutations are known to impact adipose-derived stem cells (ADSCs) in macrodactyly, their effects on adjacent wild-type cells are poorly understood.
Methods
We utilized conditioned medium and transwell systems to investigate the influence of macrodactylous adipose-derived stem cells (Mac-ADSCs) on normal ADSCs, fibroblasts (FBs), and vascular endothelial cells (VECs). Cellular behavior changes were assessed by proliferation, migration, invasion, adipogenesis, and angiogenesis assays. RNA sequencing, cytokine array analysis, and western blotting were used to explore the differential secretion of cytokines, and the pathways activated.
Results
Our research demonstrated that Mac-ADSCs enhance the proliferation, migration, invasion, adipogenesis, and angiogenesis of wild-type ADSCs, FBs and VECs, attributable to the activating mutation in PIK3CA. This enhancement is predominantly mediated through the direct action of various paracrine secreted cytokines. Meanwhile, the differentially secreted cytokines could over-activate PI3K-AKT signaling pathway in wild-type cells. BYL-719, a potent PIK3CA inhibitor, emerges as a potential therapeutic option for reversing the paracrine effects induced by Mac-ADSCs.
Conclusions
The activating PIK3CA mutation modify the paracrine characteristics of Mac-ADSCs, inducing secretion of cytokines that drive adjacent wild-type cells to exhibit mutant-like phenotypes. Targeting PIK3CA could be a viable therapeutic option for macrodactyly, particularly in cases where paracrine signaling contributes to disease progression.
Clinical Outcomes of FLACS with Crater phaco-chop Technique for Grade 5 Leathery Brown Nuclear Cataracts
Authors: Huang Zhiqing , Song Xiaoqing , Hu Yingfeng , Wang Yan , Zhang Rong , Ye Xiangyu
Published: December 2024

Objective: This study evaluated the efficacy and safety of Femtosecond Laser-Assisted Cataract Surgery (FLACS) with crater phaco-chop technique for treating grade 5 leathery brown nuclear cataracts, compared to standard FLACS phaco-chop technique.
Methods: A retrospective analysis was conducted on patients with grade 5 cataracts who underwent either FLACS+phaco-chop (Group 1) or FLACS+crater+phaco-chop (Group 2). Outcome measures included intraoperative complications, cumulative dissipated energy (CDE), uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), and central corneal thickness (CCT) at baseline and postoperatively at various time points.
Results: Preoperative characteristics were similar between groups. During surgery, Group 1 encountered one case of posterior capsular rupture (PCR) and two anterior capsular tears. Intraoperative CDE was significantly lower in Group 2 compared to Group 1 (P=0.026). Postoperative CCT was significantly thinner in Group 2 on the first day after surgery (P=0.042). The rate of ECD loss was consistently lower in Group 2 across all follow-up time points (P < 0.05). Conclusion: Utilizing the crater phaco-chop technique in FLACS for treating grade 5 leathery brown nuclear cataracts reduces corneal endothelial damage and minimizes intraoperative complications compared to traditional FLACS, ensuring a more secure and efficient cataract extraction.
Factors predicting conversion from Colon Capsule Endoscopy to Conventional Optical Endoscopy - findings from the CESCAIL Study
Authors: Lei Ian Io , Parisi Ioanna , Bhandare Anirudh , Perez Francisco Porras , Lee Thomas , Shehkar Chander , McStay Mary , Anderson Simon , Watson Angus , Conlin Abby , Badreldin Rawya , Malik Kamran , Jacob John , Dixon Andrew , Butterworth Jeffrey , Parsons Nicholas , Koulaouzidis Anastasios , Arasaradnam Ramesh P. , Huhulea Cristiana , Wenzek Hagen , White Elizabeth , Noble Charlie
Published: December 2024

Background
Colon capsule endoscopy (CCE) has become an alternative to traditional colonoscopy for low-risk patients. However, CCE's low completion rate and inability to take biopsies or remove polyps often result in a CCE-to-conventional colonoscopy conversion (CCC).
Objective(s):
The aim is to identify the factors that predict issues with bowel cleansing, capsule excretion rates, pathology detection, and the need for CCC.
Methods
This prospective study analysed data from patients who underwent CCE as part of the CESCAIL study from Nov 2021 till June 2024. Predictive factors were examined for their association with CCC, including patient demographics, comorbidities, medications, and laboratory results from symptomatic and surveillance groups. Statistical methods such as LASSO, linear, and logistic regression were applied.
Results
603 participants were analysed. Elevated f-Hb levels (OR = 1.48, 95% CI:1.18–1.86, p = 0.0002) and smoking (OR = 1.44, 95% CI: 1.01–2.11, p = 0.047) were significantly associated with CCC. The area under the curve (AUC) of elevated f-Hb for predicting CCC was 0.62 after adjusting for confounders. Diabetes was linked to poor bowel preparation (OR = 0.40, 95%CI:0.18–0.87, p = 0.022). Alcohol (p = 0.004), smoking (p = 0.003), psychological conditions (p = 0.001), and haemoglobin levels (p = 0.046) were significantly associated with the number of polyps, whilst antidepressants (p = 0.003) and beta-blockers (p = 0.001) were linked to the size of polyps.
Conclusion
Non-smokers with lower f-Hb levels are less likely to need conventional colonoscopy (CCC). Patient selection criteria are key to minimising the colonoscopy conversion rate. Our findings would benefit from validation in different populations to develop a robust CCE Conversion Scoring System (CECS) and ultimately improve the cost-effectiveness.
The role of omega-3 fatty acid supplementation on glycemic control and lipid profiles in reproductive-aged women with pre-diabetes.
Authors: Yelisetti Anuhya Sateesh , Chandrasekaran Nirmala Devi , Sivan Gisha , Lenin Raji Rajesh , M Poovitha , Kumar Jananrdana S
Published: December 2024

Background: Prediabetes is a precursor to type 2 diabetes and healthy interventions results in delay or postponing. To evaluate the benefits of omega-3 fatty acid supplements in reducing glycemic and lipid profiles in reproductive-aged women with Prediabetes.
Material and Methods- This is a Randomized placebo Controlled Trial conducted on 90 patients at a tertiary Hospital and Research Centre, in India. After randomization one group (n=45) received placebo and the other received (n=45) Omega3 fatty acid supplement (1000mg) twice daily. Blood samples were collected from all participants in the morning after 12 h of fasting for lipid profile. The insulin resistance was determined using the homeostatic model assessment of insulin resistance (HOMA-IR) index, and the beta-cell function using the HOMA-B index.
Results- After a follow-up perid of three months subsequent to the drug intervention, the average FBS showed a significant reduction to 99.5 ± 8.6 (p <0.0001) in post group. Conversely, there was no notable alteration observed in the average PPBS, HbA1c, and fasting insulin levels, the mean HDL, LDL, VLDL, between the Pre and post groups. The average HOMA-IR and average TGL were decreased in the Post group (p <0.0001).
Conclusion- In the present study omega 3 fatty acid supplementations improved fasting blood sugar, triglycerides and HOMA-IR in reproductive-aged women with pre-diabetes. Considering the impact of Prediabetes in reproductive health and its outcome, omega-3 supplementation, therefore, can be recommended as a therapeutic option for glycemic control in these individuals.
Inhibition of SOD1 trimerization is a novel drug target for ALS disease
Authors: Woo Tae-gyun , Han Jin , Kim Yuju , Hwang Young Jun , Lee Mua , Kang So-mi , Park Soyoung , Ji Yeongseon , Chung Yeon-Ho , Baek Songyoung , Shin Eunbyeol , Kim Minju , Jang Hyewon , Shin Yun-Jeong , Kwon Yonghoon , Kim Bae-Hoon , Park Bum-Joon
Published: December 2024

Background Amyotrophic lateral sclerosis (ALS) is progressive neurodegenerative disease that begins with cell death of motor neurons in the spinal cord and leads to death from respiratory distress (breathing failure). Most of patients are sporadic type but several genetic causes have been reported. One well-identified genetic variation is a mutation in the SOD1 gene. Indeed, SOD1 aggregation has been reported in ALS patients, but the mechanism of SOD1 aggregation remains unclear. In previous report, we have shown that inhibiting SOD1 aggregation with a hit compound (PRG-A-01) could reduce SOD1-induced cytotoxicity and extended the lifespan of ALS mouse model (SOD1G93A-Tg). However, the compound was poorly bioavailable and rapidly degraded in vivo, necessitating the development a more effective candidate. To overcome these limitations, we generated different derivatives and finally obtained the most plausible drug candidate, PRG-A-04.
Methods To perform in vitro SOD1 aggregation inhibition efficacy of PRG-A-04, neuronal cell lines were transfected with mutant SOD1 expression vectors and incubated with PRG-A-04. SOD1 aggregation was checked by SOD1 oligomerization assay, immunofluorescence and dot blot assay with the misfolded specific SOD1 antibody. The interaction between GST-conjugated SOD1 recombinant proteins and PRG-A-04 was identified using LC-MS/MS and GST-pull down assay. To check in vivo therapeutic effect of PRG-A-04, mouse performance assessment, histological analysis and microarray were profiled on PRG-A-04 injected ALS mouse model (SOD1G93A-Tg)
Results The optimized drug candidate, PRG-A-04, demonstrated favorable pharmacokinetics including high bioavailability and significant blood-brain barrier penetration. Indeed, the oral administration of PRG-A-04 to ALS mouse model could inhibit the aggregation of SOD1 in its spinal cord, protect the neuron loss, and extend lifespan of ALS model mouse up to 3 weeks. Notably, in in vitro experiment, it was confirmed that PRG-A-04 could selectively bind to a mutant form of SOD1, not wild type, and it efficiently inhibit the aggregation caused by SOD1-G147P (SOD1 trimer stabilizer). This specific binding may inhibit the aggregation process of SOD1, which can be caused by mutant SOD1 or other cellular stress conditions.
Conclusions Our findings underscore the potential of treatments targeting trimeric SOD1 in ALS, positioning PRG-A-04 as a strong drug candidate for both familial and sporadic ALS.
The Association Between Temporomandibular Disorders and Kinematics of The Sacroiliac Joint: A 3D motion Analysis Study
Authors: Parchekouhi Ahmad Bahramian , Karimi Noureddin , barzegar Ali , Rahnama Leila
Published: December 2024

Background: Temporomandibular disorders (TMDs) have been the focus of many studies, but the relationship between TMDs and other body segments, such as the pelvis, is still controversial. This study aimed to investigate the relationship between TMD and kinematics of the sacroiliac joint.
Method: Twenty participants with chronic TMD and 20 healthy individuals were included in this study. The temporomandibular joint range of motion, pain intensity, and TMD severity were documented. The three-dimensional kinematics of the sacroiliac joint were recorded during a trunk flexion task using a motion analysis system and MATLAB software.
Results: The severity of TMD had a significant association with pain intensity in the patient group. At the starting position (before forward flexion of the trunk), we found significant differences in the linear and angular positions of the sacrum relative to the ilium in the sagittal plane and around the frontal axis on both sides between groups.
Conclusion: Our results indicated significant differences in some parameters between the healthy and TMD groups, emphasizing altered sacroiliac joint kinematics associated with TMD. This study contributes to the ongoing discussion about the relationship between TMD and other areas of the body and highlights the importance of further research in this area.
Trial registration: Clinical Trial number is not applicable.
Effect and mechanism of lateralization of cerebellar-cerebellar network abnormalities on language in patients with unilateral temporal lobe epilepsy
Authors: Pang Linlin , Chen Zirong , Fan Binglin , Chen Zexiang , Pang Xiaomin , Zhang Zhao , Zhong Cai , Zheng Jinou
Published: December 2024

Objective
Since epilepsy is associated with different levels of cerebral dysfunction, there may be a recombination of language circuits in the course of epilepsy. The cerebellum is part of the whole brain language network. We explored the differences in speech impairment patterns in patients with TLE and different hemiencephalic attacks from the perspective of the cerebellum.
Methods
Fifty-eight patients with TLE and 30 healthy controls were recruited. including 28 patients with left temporal lobe epilepsy (LTLE) and 30 patients with right temporal lobe epilepsy (RTLE). The resting state functional connection method was used to investigate the effects of lateralization and cerebellar laterality on language function in patients with TLE. The differences in functional connectivity (FC) in the whole cerebellar cortex were compared between the three groups.
Results
The FC analysis of the LTLE, RTLE, and HC groups showed significant differences between the three groups. Compared with the HC group, FC was decreased from the Cerebelum_Crus2_R to the right frontal cortex, from the Cerebelum_7_L to the right frontal cortex in both LTLE and RTLE groups. Compared with the LTLE group, FC was decreased from the Cerebelum_3_R to the left frontal pole, left inferior frontal gyrus, and left frontoorbital cortex in the RTLE group. Compared with the HC group, FC in the RTLE group was decreased between the Cerebelum 9L and right medial superior frontal gyrus and right dorsolateral superior frontal gyrus; between Cerebelum 9R and right medial superior frontal gyrus and left dorsolateral superior frontal gyrus; between Vermis9 and left posterior parietal lobe, between Vermis10 and right angular gyrus; between left middle temporal gyrus and language network; between right middle temporal gyrus and language network.
Conclusion
In the brain regions related to language, patients with RTLE had stronger left hemispheric activation than patients with LTLE. At the node level, the RTLE group had greater language central connection disorder than the HC group. Cerebellar-cerebral FC has different connectivity patterns between LTLE and RTLE groups. Cerebellar injury of TLE may lead to functional reorganization and transfer of language dominance to homologous regions in the other hemisphere.
Effect of thumbtack needle therapy at ST36 on postoperative ileus: A pragmatic randomized controlled trial
Authors: Yin Lanlan , Lu Antian , Yang Wangshuo , Liu Anyi , Zhu Tong , Zhu Li , Lai Senyan , Huang Dongmei , Feng Yongdong
Published: December 2024

Objective
This study aims to evaluate the efficacy of thumbtack needle (TN) therapy at the ST36 acupoint in reducing postoperative ileus (POI) duration following elective abdominal surgery.
Background
Postoperative ileus (POI) is a frequent complication after abdominal surgeries, leading to delayed gastrointestinal recovery. TN therapy, a non-invasive form of acupuncture, has shown promise in promoting gastrointestinal function recovery. However, its specific impact on POI, particularly at the ST36 acupoint, requires further exploration.
Methods
This single-center, single-blind randomized controlled trial enrolled 100 patients undergoing elective abdominal surgery. Patients were randomly assigned to receive either TN therapy at bilateral ST36 acupoints (TN group) or a sham treatment (CON group). The primary outcomes were First Exhaust Time, First Stool Time, and First Eating Time, Gastrointestinal Symptom Rating Scale (GSRS), and inflammatory markers (IL-6 and TNF-α), while secondary outcomes included the Visual Analog Scale (VAS).
Results
Patients in the TN group had significantly shorter First Exhaust Time (23.3 hours vs. 25.9 hours, P = 0.019) and First Stool Time (31.4 hours vs. 34.8 hours, P = 0.011) compared to the CON group. There was no significant difference in First Eating Time (P = 0.652). Additionally, the TN group exhibited lower GSRS scores and reduced levels of IL-6 and TNF-α, indicating a faster recovery and reduced postoperative inflammation.
Conclusion
TN therapy at ST36 acupoint significantly accelerated gastrointestinal recovery and reduced postoperative inflammation in patients with POI, providing a promising non-pharmacological treatment option for enhancing recovery post-surgery.
Trial Registration
Tongji Hospital, Huazhong University of Science and Technology (TJ-IRB202403012), Registration date: March 25, 2024. Chinese Clinical Trial Registry (ChiCTR2400090739), Registration Date: October 12, 2024 (additional registration).
Combined Nomogram for Differentiating Adrenal Pheochromocytoma from Large-Diameter Lipid-poor Adenoma Using Multiphase CT Radiomics and clinico-radiological features
Authors: Shan Zujuan , Zhang Xinzhang , Zhang Yiwen , Wang Shuailong , Yang Junfeng , Wang Junfeng , Li Lin , Shi Xin , Li Zhenhui , Xu Ning , Gong Lelan , Da Youguo , Song Wei , Liu Hao , Zhang Xuyuan , Yang Liuyang , Li Wenliang , Yang Liansheng
Published: December 2024

Background and Objective:
Adrenal incidentalomas (AIs) are predominantly adrenal adenomas (80%), with a smaller proportion (7%) being pheochromocytomas(PHEO). Adenomas are typically non-functional tumors managed through observation or medication, with some cases requiring surgical removal, which is generally safe. In contrast, PHEO secrete catecholamines, causing severe blood pressure fluctuations, making surgical resection the only treatment option. Without adequate preoperative preparation, perioperative mortality risk is significantly high.A specialized adrenal CT scanning protocol is recommended to differentiate between these tumor types. However, distinguishing patients with similar washout characteristics remains challenging, and concerns about efficiency, cost, and risk limit its feasibility. Recently, radiomics has demonstrated efficacy in identifying molecular-level differences in tumor cells, including adrenal tumors. This study develops a combined nomogram model, integrating key clinical-radiological and radiomic features from multiphase CT, to enhance accuracy in distinguishing pheochromocytoma from large-diameter lipid-poor adrenal adenoma (LP-AA).
Methods
A retrospective analysis was conducted on 202 patients with pathologically confirmed adrenal PHEO and large-diameter LP-AA from three tertiary care centers. Key clinico-radiological and radiomics features were selected to construct models: a clinico-radiological model, a radiomics model, and a combined nomogram model for predicting these two tumor types. Model performance and robustness were evaluated using external validation, calibration curve analysis, machine learning techniques, and Delong's test. Additionally, the Hosmer-Lemeshow test, decision curve analysis, and five-fold cross-validation were employed to assess the clinical translational potential of the combined nomogram model.
Results
All models demonstrated high diagnostic performance, with AUC values exceeding 0.8 across all cohorts, confirming their reliability. The combined nomogram model exhibited the highest diagnostic accuracy, with AUC values of 0.994, 0.979, and 0.945 for the training, validation, and external test cohorts, respectively. Notably, the unenhanced combined nomogram model was not significantly inferior to the three-phase combined nomogram model (p > 0.05 in the validation and test cohorts; p = 0.049 in the training cohort).
Conclusions
The combined nomogram model reliably distinguishes between PHEO and LP-AA, shows strong clinical translational potential, and may reduce the need for contrast-enhanced CT scans.
Myocardial contractile reserve impairment in patients with Kawasaki disease during convalescent phase: a study based on two-dimensional speckle-tracking stress echocardiography
Authors: Wang Haiyong , Long Xiaoli , Han Zhiming , Dong Xin , Yan Ruiling
Published: December 2024

Background
Persistent myocardial impairment proved by histopathologic studies universally existed in patients with Kawasaki disease (KD), however, the long-term effects on myocardial contractile reserve in KD patients, especially on patients without coronary artery lesions (CALs), is still unknown. The aim of this study was to investigate myocardial contractile reserve in KD patients during late convalescent stage by speckle-tracking adenosine triphosphate (AT) echocardiography.
Methods
A total of 63 antecedent KD patients at least 4 years after the disease onset and 40 age- and gender-matched normal controls were prospectively enrolled. Based on coronary artery status, patients were further divided into CALs group and non-CALs (NCALs) group. Left ventricular ejection fraction (LVEF), speckle-tracking derived-global longitudinal strain (GLS) and global circumferential strain (GCS) were evaluated at rest and during AT peak stress. Myocardial contractile reserve parameters including ΔLVEF, ΔGLS and ΔGCS were defined as the absolute increases in LVEF, GLS and GCS from rest to peak stress.
Results
KD patients regardless of CALs had lower GLS and GCS than normal controls at resting condition. Significant decreases in ΔGLS and ΔGCS were observed in patients with CALs compared to normal controls under peak stress. While ΔGLS and ΔGCS increased in patients without CALs following stress, improvements were significantly weaker than those in normal controls. However, no significant differences in LVEF at rest and ΔLVEF under peak stress between KD patients irrespective of CALs and normal controls were found. In additional, when comparing with patients with NCALs, patients with CALs had lower GLS and GCS at rest, lower ΔGLS and ΔGCS in response to stress.
Conclusions
Subclinical abnormality of myocardial contractile reserve existed in KD patients during late convalescent phase. Even patients without CALs need an additional surveillance on myocardial contractile reserve in the long-term follow-up. These novel findings by speckle-tracking stress echocardiographic analysis may provide more valuable clinical implications for better understanding and long-term management of such patients.
Anterior versus Posterior Transfer of Latissimus Dorsi and Teres Major Tendon in Irreparable Rotator Cuff Tears: A Retrospective Comparative Study
Authors: Baek Chang Hee , Lim Chaemoon , Kim Jung Gon , Kim Bo Taek , Kim Seung Jin
Published: December 2024

Background: There are various options of tendon transfer according to the different types of irreparable rotator cuff tears (IRCTs). However, there were no clear treatment options for the IRCTs involving the anterior, superior and posterior rotator cuff tears (global IRCTs). Latissimus dorsi and teres major (LDTM) could be transferred anteriorly or posteriorly in global IRCTs. The purpose of this study is to evaluate the efficacy of anterior LDTM (aLDTM) transfer and posterior LDTM (pLDTM) transfer in IRCTs.
Methods: The patients who underwent aLDTM transfer (aLDTM group, n=35) for anterosuperior IRCTs or pLDTM transfer (aLDTM group, n=33) for posterosuperior IRCTs between January 2017 and December 2020 were reviewed retrospectively. Clinical and functional outcomes were evaluated based on pain, patient-reported outcome scores, active range of motion (aROM) and strength of aROM. Radiological outcomes were evaluated using arthritic changesin the glenohumeral joint and transferred tendon integrity. Arthritic changes in the glenohumeral joint were evaluated using the acromiohumeral distance (AHD) and Hamada classification on the true anteroposterior radiograph.
Results: No significant intergroup difference was confirmed in patient demographics except for preoperative fat infiltration grade of subscapularis and infraspinatus. The postoperative Constant score, and University of California and Los Angeles (UCLA) score of aLDTM group were significantly higher than that of pLDTM group (p<0.001 and <0.001, respectively). Moreover, the achievement of minimal clinically important difference (MCID) for American Shoulder and Elbow Surgeons score and UCLA score showed a significant difference between two groups (p=0.021 and 0.042, respectively). The postoperative forward elevation (FE) was significantly higher in aLDTM group (p = 0.046). The postoperative FE strength and abduction strength were significantly higher in aLDTM group (p=0.001 and 0.025, respectively). Moreover, the mean improvement of internal rotation strength in aLDTM group was significantly higher than mean improvement of external rotation strength in pLDTM group (p=0.011). The progression of arthritic change was significantly higher in pLDTM group (p=0.002).
Conclusion: Although the aLDTM transfer and pLDTM transfer are effective and safe tendon transfer for IRCTs, aLDTM transfer is more effective than pLDTM transfer due to its biomechanical advantage and tendon transfer principles.
Level of study: level III
Cross-Cultural Perceptions of Police Interview Techniques: A Comparative Study of Indonesian and Dutch Respondents
Authors: Tekin Serra , Irwanda Diandra Yasmine , Bull Ray
Published: December 2024

Conducting an interview can be especially challenging with suspects from cultures different from the interviewer’s own. Previous studies show that a suspect’s culture and communication style (e.g., collectivism/individualism & high/low-context) may affect their response to the interview techniques used by the interviewer. The current study aimed to explore and compare the perception of common interview techniques between two cultures, Indonesian (high-context culture; n = 155) and Dutch (low-context culture; n = 125). After reading a vignette of a fictional crime, participants estimated the likelihood of the suspect giving information in response to various interview techniques. An exploratory factor analysis revealed a five-factor model of interviewing: Humanity, Dominance/Control, Empathy/Perspective-taking, Rapport and Guilt-focused. Indonesian participants perceived the Dominance/Control category as more likely to elicit information from the suspect than did their Dutch counterparts. Moreover, Empathy/Perspective-taking was perceived to be more effective in eliciting information by the Dutch participants than by the Indonesian participants. An examination of the mean scores revealed that both groups perceived Dominance/Control and Guilt-focused techniques as being somewhat effective. The findings indicate that an interviewee’s culture could well play a role in how they respond to the interviewer’s approach. Therefore, the cultural background of the suspect should be taken into consideration while preparing for the interview and also during the interview. Raising more awareness of the consequences of harsher interviewing techniques may also be beneficial.
Recent Incarceration and Minoritized Racial Status as Barriers to the Effectiveness of Recovery Management Checkups
Authors: Kahn Jeffrey , Hart M. Kate , Watson Dennis P. , Allen Caroline B. , Singh Ryan R. , Grella Christine E. , Dennis Michael L.
Published: December 2024

Background: Recovery management checkups done in primary care settings (RMC-PCs) can be an effective intervention to link individuals with substance use disorders (SUD) to treatment and help them stay engaged with treatment. There is reason to question, however, whether RMC-PCs are as effective for those who have been recently incarcerated or for those holding a minoritized, racial identity.
Methods: We examined data from a randomized controlled trial of RMC-PCs compared to a control condition (N = 266).
Results: Multilevel analyses of 4-wave data (3, 6, 9, and 12 months after baseline) indicated that RMC-PCs were more effective than the control condition, especially early in the 12-month study period. The relative effectiveness of RMC-PCs was stronger, however, for participants with fewer days in jail just prior to baseline as well as for White (versus non-White) participants.
Conclusions: These findings suggest the utility of examining potential mediators of these moderated effects in future research as well as tailoring SUD interventions to better meet the needs of these populations.
Trial Registration: ClinicalTrials.gov (NCT03746756).
Utility of Serial LVOT VTI as a Surrogate for Myocardial Performance During Weaning from Temporary Mechanical Circulatory Support in Cardiogenic Shock: A Retrospective Analysis
Authors: Turk Ahmad Z. , AlHammouri Hashim M. , Odeh Nada , Alzoubi Mohammad , Al-Hadeed Faisal , Gobeil Kyle , Kadado A. John , Grewal Vikram , Hernandez-Montfort Jaime
Published: December 2024

Background
Despite ongoing research, robust evidence-based recommendations for daily echocardiographic evaluation to guide the weaning process in patients supported by temporary mechanical circulatory support devices (tMCS) such the Impella or intra-aortic balloon pumps (IABP), are lacking. We propose that protocolized bedside echocardiographic evaluation using left ventricular outflow tract velocity time integral (LVOT VTI) provides a reliable surrogate for myocardial performance before explant.
Methods
This single-center retrospective observational analysis examined patients admitted for cardiogenic shock (CS) requiring tMCS (Impella CP/5.0 and/or IABP) in the cardiac ICU at Baystate Medical Center between 2014 and 2017. A total of 23 patients contributed to 80 LVOT VTI measures and corresponding cardiac index (CI) values spanning the implant-explant period. We plotted three correlation graphs: the first between raw LVOT VTI and CI; the second between indexed LVOT VTI (iVTI, adjusted for body surface area) and CI; and the third between relative LVOT VTI (rVTI) and relative CI (rCI) compared to their initial post-implant values, providing a more accurate evaluation.
Results
The tests demonstrated a strong positive correlation among the variables, with correlation coefficients of r = 0.61, 0.59, and 0.74 for the graphs representing LVOT VTI/CI, iVTI/CI, and rVTI/rCI, respectively.
Conclusion
Our data supports the routine evaluation of LVOT VTI as a surrogate for myocardial performance in CS cases requiring prolonged mechanical unloading. This approach should be further developed and standardized for daily assessment during weaning in shock centers. Further research is needed to establish specific cut-offs associated with long-term myocardial recovery or remission.
Cardiotoxicity Monitoring and Cancer Therapy-Related Cardiac Dysfunction in a Heterogeneous Cancer Population: A Retrospective Study
Authors: Stevenson Madeline , Park Sihyeong , Hartshorne Taylor , Mendoza Zachary , Nguyen Vinh , Wong Lucas , Chiles Christopher , Widmer R. Jay
Published: December 2024

Background
Cardiotoxicity from chemotherapy can lead to significant heart damage, often without overt symptoms, mainly manifesting as cancer therapy-related cardiac dysfunction (CTRCD) when left ventricular ejection fraction (LVEF) declines by over 10% to below 53%. Current guidelines recommend thorough cardiovascular risk assessments for cancer patients, incorporating personal medical histories and potential biomarkers, yet a standardized risk stratification approach is lacking. This study aims to evaluate chemotherapeutics' effects on LVEF and the influence of patient characteristics on the risk of developing CTRCD.
Methods
This study is a retrospective chart review at a single center from 2013 to 2023, to assess the CTRCD prevalence in patients referred for transthoracic echocardiography due to cardiotoxicity risk. Data on demographics, comorbidities, medications, and echocardiographic parameters were extracted while maintaining confidentiality. Statistical analysis involved descriptive statistics for 532 patients, paired t-tests and risk-odds ratios for pre- and post-chemotherapy LVEF changes, and left ventricular global longitudinal strain (LVGLS) examination.
Results
The cohort included 532 patients with a median age of 69 (IQR = 61-78) years, who were predominantly female (57.9%), and had common comorbidities such as hypertension and diabetes. Among those assessed, the median LVEF decreased from 59.5% to 58%, with 9.2% meeting CTRCD criteria, particularly in breast and lung cancer patients. Lung disease and previous transient ischemic attacks (TIA) were associated with greater LVEF declines of 2.5% and 3.5%, respectively, whereas no subclinical cardiotoxicity was found in the limited LVGLS measurements.
Conclusion
In conclusion, this single-center cohort study highlights a clinical gap in comprehensive echocardiographic surveillance for patients undergoing chemotherapy, with less than half receiving necessary pre- and post-treatment assessments. Despite the moderate incidence of CTRCD (9.2%) in this cohort, reliance solely on LVEF as a marker for cardiotoxicity may overlook significant cardiovascular damage, underscoring the importance of early detection methods. The study revealed that pre-existing lung conditions and a history of TIA impacted LVEF changes, suggesting that these comorbidities should be considered in risk assessments. Overall, the findings advocate for improved cardiac monitoring and intervention strategies to protect the cardiovascular health of cancer patients throughout treatment.
Automated analysis of the difficulty of secondary school geometry theorems
Authors: Bartha Soma , Kerekes András , Kovács Zoltán , Recio Tomás
Published: December 2024

We elaborate, as a benchmark, a list of geometry theorems that are regularly used in Hungarian high schools, in specialized tracks for mathematics. Then, these statements are implemented as GeoGebra files, and algebraically proven (with certification) in GeoGebra Discovery. Next, these files are imported in Java Geometry Expert (JGEX), and geometrically proven with the associated Geometry Deductive Database method. In both programs, through quite different approaches in each case, we define and implement an algorithmic measure of the difficulty of a geometric theorem. Then, we compute the corresponding measures on the selected list of statements, and we analyze the obtained collection of pairs of difficulty grades, finding a moderate positive correlation (0.43) between GeoGebra Discovery's algebraic, and JGEX's deductive difficulty formulations. A correlation that seems to support the adequacy of the chosen approximation in our on-going work to algorithmically establish some ad-hoc measure of the difficulty of geometric statements that could be reasonably coincidental with the appreciation of human expert users (e.g. teachers).
Physical, Mechanical, Biological Properties and Characterization of Blended Films of Chitosan-Cellulose Diacetate Derived Waste Cigarette Filters
Authors: Htwe Aung Than , Kyaw May Thazin , Htun Hninn Wutt Yee , Tawng Margaret Hkawn , Thet Yamin
Published: December 2024

Cigarette butts (CB) accumulate due to the poor biodegradability of cellulose acetate filters, and the toxic substances trapped therein pose a threat to human life, marine ecosystems and the environment if not disposed of properly increase. Due to growing concerns stemming from inadequate landfill sites and growing environmental concerns about toxic combustion gases, there is a great need for environmentally friendly alternative CB waste treatment processes. This research describes the preparation of blended films with chitosan (CS) and cellulose diacetate (CDA) derived waste cigarette filters as reinforcement. The aim was to evaluate their physical, mechanical and biodegradable properties, and to determine their potential for biomedical use. Blended films were prepared via solvent casting CDA suspensions in CS solution, at CDA amount of 0.5, 1.0, 1.5, 2.0 and 2.5 (w/w) with pure chitosan as a reference. The prepared blended films were investigated by using the physical parameters, the physico-mechanical properties, the degree of swelling, and water uptake. Comparative characterization of the prepared blended films included XRD, FT IR, SEM, and TG-DTA analysis. The various types of CS-CDA blended films were also tested for antimicrobial activity using an agar well diffusion method. Subsequently, the biodegradable nature of the prepared CS-CDA blended films was studied through the soil burial test. Based on the results, The CS/CDA blended films which could be reduce cigarette waste filters and increase the values. In the future, these CS-CDA blended films can be developed in the membrane to use for biomedical applications as face sheet and mash sheet of COVID-19 pendemic.
Self-contained relaxation-based dynamical Ising machines
Authors: Erementchouk Mikhail , Shukla Aditya , Mazumder Pinaki
Published: December 2024

Dynamical Ising machines are based on continuous dynamical systems evolving from a generic initial state to a state strongly related to the ground state of the classical Ising model on a graph. Reaching the ground state is equivalent to finding the maximum (weighted) cut of the graph, which presents the Ising machines as an alternative way to solving and investigating NP-complete problems. Among the dynamical models, relaxation-based models are distinguished by their relations with guarantees of performance achieved in time scaling polynomially with the problem size. However, the terminal states of such machines are essentially non-binary, necessitating special post-processing relying on disparate computing. We show that an Ising machine implementing a special continuous dynamical system (called the V2 model) solves the rounding problem dynamically. We prove that the V2 model, starting from an arbitrary non-binary state, terminates in a state that trivially rounds to a binary state with the cut at least as big as obtained by optimal rounding of the initial state. Besides showing that relaxation-based dynamical Ising machines can be made self-contained, this result presents a non-Boolean realization of solving a non-trivial information processing task on Ising machines. Moreover, we prove that if the initial state of the V2-machine is a random limited amplitude perturbation of a binary state, the machine progresses to a state with at least as high cut as that of the initial binary state. Since the probability of improving the cut is finite, this shows that the V2-machine with random agitations converges to a maximum cut state almost surely.
A New Auxetic Structure-based Hybrid Gripperfor Harvesting Tomato-like Soft Fruits
Authors: Ansari Shahid , Gohil Mahendra Kumar , Maeda Yusuke , Bhattacharya Bishakh
Published: December 2024

Modern agriculture is reaping the benefits of automation by harvesting fruits and vegetables using robots that have adaptive grasping force depending on the compliance or softness of the fruit or vegetable. The successful operation of fruit picking using a robotic system with a gripper as an end effector hinges on its manipulation capability and ability to interact safely with the crop without affecting its physical properties. In this paper, we have proposed a novel hybrid gripper with six soft, passive auxetic structures attached to the rigid linkage, which has high shape conformability during the grasping of tomatoes through caging. The gripper is actuated through a scotch-yoke mechanism using a servo motor. A deep learning-based fruit localization algorithm has been developed to perform the picking operation of tomatoes through the gripper. A ROS-based framework has been used to control the robotic arm to achieve an optimized trajectory for fruit picking and to control the desired grasping forces along with the actuation of the pedicel cutter.