bluuebunny/crossref_metadata_2025 huggingface dataset:
Conservative Management of Pseudomeningocele Secondary to Lumbar Laminectomy: A Case Report.
Authors: Ahmadi Hanieh , Roomizadeh Peyman
Published: October 2024

Introduction:
Pseudomeningocele is a rare complication following laminectomy, which can present with various symptoms. This case report aims to highlight the successful conservative management of a patient who developed a pseudomeningocele after lumbar disc herniation surgery.
Case presentation:
A 41-year-old woman presented with persistent low back pain radiating to both lower limbs after a previous laminectomy surgery. Despite the severity of her pain, there were no signs of neurological deficits. An MRI revealed a pseudomeningocele, indicating a dural leak as a result of the previous surgery. The patient was managed conservatively with pain control, rest, exercises, and physical therapy. Over a six-week period, her symptoms gradually improved, and at the 12-month follow-up, she reported minimal residual discomfort with no signs of recurrence or neurological deficits. Follow-up MRI performed one year postoperatively showed a remarkable reduction in the size of the meningocele compared to the postoperative image.
Conclusion
This case report illustrates the successful outcome of conservative management in a patient presenting with a pseudomeningocele following lumbar disc herniation surgery. Early recognition and appropriate management of this complication are vital to prevent potential neurological sequelae. Further studies and continued awareness of conservative management approaches for pseudomeningocele are warranted to establish evidence-based guidelines for patient care.
The Platform Trial In COVID-19 Vaccine priming and BOOsting (PICOBOO) booster vaccination substudy protocol
Authors: McLeod Charlie , Dymock Michael , Flanagan Katie L , Plebanski Magdalena , Marshall Helen , Marsh Julie , Estcourt Marie J , Ramsay Jessica , Wadia Ushma , Williams Phoebe CM , Tjiam Christian , Subbarao Kanta , Nicholson Suellen , Faust Saul N , Thornton Ruth B , McKenzie Anne , Snelling Tom L , Richmond Peter
Published: October 2024

Background: Coronavirus-2019 (COVID-19) vaccination in Australia commenced in February 2021. The first vaccines recommended for use were AZD1222 and BNT162b2, both delivered as a two-dose primary schedule. In the absence of sustained immunity following immunisation, recommendations for booster vaccination have followed. It is likely that periodic boosting will be necessary for at least some Australians, but it is unknown what the optimal booster vaccines and schedules are, or for whom vaccination should be recommended.
Methods: The Platform Trial In COVID-19 priming and BOOsting (PICOBOO) is a multi-site, multi-arm, randomised, Bayesian adaptive platform trial evaluating different booster vaccine interventions in immunocompetent children and adults, stratified by their primary vaccination schedule and age. Participants are randomised to receive one of three licensed COVID-19 booster vaccines available for use in Australia. PICOBOO aims to generate evidence about the immunogenicity, reactogenicity and cross-protection of different booster vaccine strategies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its variants/subvariants. The protocol structure specifying PICOBOO is modular and hierarchical. We have previously published the PICOBOO core (master) protocol. Here we detail the substudy protocol which outlines the study processes which are specific to PICOBOO participants enrolled in the booster vaccination substudy.
Discussion: PICOBOO is an adaptive platform trial evaluating different COVID-19 booster vaccination strategies to generate evidence to inform immunisation practice and policy. The modular and flexible protocol structure is intended to enable investigators to respond with agility to new research questions as they arise, such as immunogenicity targeting emergent virus variants, and the immunogenicity and reactogenicity of new vaccines as they become available for use.
Trial registration: Australian and New Zealand Clinical Trials Register ACTRN12622000238774; registered on 10/02/2022. Protocol V8.0_23112023.
Eight-and-a-half Syndrome as Presentation of Pontine Infarct - A Case Report
Authors: Ho Yan Zheng , Halim Sanihah Abdul
Published: October 2024

Introduction Eight-and-a-half syndrome is a rare neuro-ophthalmologic syndrome in which the lesion is at the dorsal tegmentum of caudal pons. The syndrome comprises conjugate horizontal gaze palsy and ipsilateral internuclear ophthalmoplegia (one-and-a-half syndrome), coupled with ipsilateral facial nerve palsy.Case Presentation A 50 years old male teacher with underlying uncontrolled diabetes mellitus and hypertension, presented with abrupt onset of diplopia and right facial asymmetry. Clinically he was alert and conscious. Examination revealed left eye exotropia, bilateral eye conjugate right gaze palsy, impaired adduction of right eye, and left eye developed jerk nystagmus to the right upon abduction. There was binocular horizontal diplopia in all directions of gaze. Vestibulo-ocular reflex was absent in both eyes. Besides, he had right hemifacial palsy with House-Brackmann grade of 5. MRI brain shows there is a small focal infarct at right pontine tegmentum, hypointensity in T1 sequence, hyperintensity in T2 sequence, and restricted in DWI sequence. He was treated as eight-and-a-half syndrome secondary to acute ischemic stroke with the involvement of vertebrobasilar artery territory, causing lacunar infarct in the right pontine tegmentum. The risk factors were uncontrolled diabetes mellitus and hypertension. After 6 weeks of medical treatment, his facial weakness had improved significantly. The left eye extotropia and right eye adduction have completely resolved. Nonetheless there is residual right gaze palsy.Conclusion Recognition of eight-and-a-half syndrome allows precise anatomical localisation of this pontine lesion. Imaging is often used as a confirmatory tool. A wide range of differential diagnoses has to be considered.
Leveraging OGTT derived metabolic features to detect Binge-eating disorder in individuals with high weight: a “seek out” machine learning approach
Authors: Segura-Garcia Cristina , Rania Marianna , Procopio Anna , Zaffino Paolo , Carbone Elvira Anna , Fiorentino Teresa Vanessa , Andreozzi Francesco , Cosentino Carlo , Arturi Franco
Published: October 2024

Binge eating disorder (BED) carries a 6 times higher risk for obesity and accounts for roughly 30% of type 2 diabetes cases. Timely identification of early glycemic disturbances and comprehensive treatment can impact on the likelihood of associated metabolic complications and the overall outcome. Machine learning (ML) techniques were trained with static and dynamic glucose-derived measures to detect BED among 281 individuals with high weight. The pipeline (training, validation, testing) was conducted twice, on two different datasets (2 hours, and 5 hours-long glucose load). After features selection, multiple ML algorithms were trained to classify the sample. The best classifier was then applied to an independent cohort (N = 21). A sensitivity-based analysis was run to investigate the relevance of each feature in the classification. 14 features were selected as relevant, with the support vector machine showing the best performance in classifying BED in both models. The model on the 5 hours-long OGTT exhibited the best metrics (sensitivity = 0.75, specificity = 0.67, F score = 0.71) diagnosing BED in 7 out of 10 cases. Sex, HOMA-IR, HbA1c and plasma glucose in different times, and hypoglycemia events were the most sensitive features for BED diagnosis. This study is the first to use metabolic hallmarks to train ML algorithms for detecting BED in individuals at high risk for metabolic complications. ML techniques applied to objective and reliable glycemic features might prompt the identification of BED among individuals at high risk for metabolic complications, enabling timely and tailored multidisciplinary treatment.
MiRNA-122-5p is Upregulated in Diabetic Foot Ulcers and Decelerates the Transition from the Inflammatory to the Proliferative Stage
Authors: Yuan Meijie , Huang Hechen , Shi Hongshuo , Hu Xiaoming , Zhao Zhuo , Chen Yuqi , Fan Weijing , Sun Jian , Liu Guobin
Published: October 2024

Transitioning from the inflammatory to the proliferative stage is critical in treating diabetic foot ulcers (DFUs), yet current treatment options are limited. MicroRNAs (miRNAs) hold significant potential in enhancing DFU healing. Previous studies have shown that miR-122-5p targets the regulation of diabetic metalloproteinases, impacting the extracellular matrix. We hypothesize that miR-122-5p plays a crucial role in the healing of DFU. MiR-122-5p levels in skin tissue samples from both patients with diabetic ulcers and diabetic mice were evaluated using quantitative real-time PCR (qRT-PCR). The streptozotocin-induced diabetes mouse model for diabetic wound healing was utilized. Animals were randomized to receive intradermal injections of either an AAVDJ empty vector (AAVDJ-EV, control) or AAVDJ-miR-122 upregulation vector. Mice were euthanized at different intervals (3, 7, and 14 days post-injury), and wound tissues were collected for gene marker analysis, histological evaluation, immunohistochemistry, and network analysis. The study focused on proteins involved in the transition from the inflammatory to the proliferative stage during DFU healing. Additionally, the role of miR-122-5p in mediating interactions between mouse macrophages and fibroblasts was analyzed. FISH and qRT-PCR results indicated that miR-122-5p levels were significantly upregulated in diabetic skin, both in individuals with DFU and diabetic mice, compared to controls. Western blot, IHC, and ELISA results indicated that in vitro, upregulation of miR-122-5p increased MMP9 expression and levels of inflammatory mediators such as TNF-α and HIF-1α, while concurrently decreasing expression levels of VEGF and markers associated with fibrosis such as FN1 and α-SMA.Our findings confirmed that miR-122-5p increases inflammatory cytokines and reduces fibrosis in fibroblasts cultured with macrophage-conditioned media.MiR-122-5p increased inflammation and reduce fibrosis during wound healing of diabetic mice, slowing the transition from the inflammatory to the proliferative stage. These findings open the door to understanding how miRNAs functionally contribute to human skin wound healing.
Using the IFASIS (Inventory of Factors Affecting Successful Implementation and Sustainment) to Advance Context-Specific and Generalizable Knowledge of Implementation Determinants: Case Study of a Digital Contingency Management Platform
Authors: Jakubowski Andrea , Patrick Briana , DiClemente-Bosco Kira , Salino Sarah , Scott Kelli , Becker Sara
Published: October 2024

Background
Contingency management (CM) is the most effective treatment for stimulant use disorder but is underutilized by opioid treatment programs (OTPs), despite the high prevalence of stimulant use in this setting. As part of a state-wide initiative, we piloted a novel assessment, the Inventory of Factors Affecting Successful Implementation and Sustainment (IFASIS), to examine determinants of implementation of a digital CM platform across a set of OTPs. We describe how the IFASIS was used to elucidate both generalizable and context-specific implementation determinants, and to guide the provision of implementation facilitation.
Methods
Six OTPs received a multi-level implementation strategy (including facilitation) to promote programmatic uptake of a digital CM platform. Pre-implementation, OTPs completed the IFASIS, a 27-item questionnaire that assesses both the valence (positive/negative) and importance of determinants across 4 domains: outside the organization, within the organization, about the intervention, and about intervention recipients. OTP staff completed the IFASIS as a team, identifying consensus ratings during recorded discussions. Transcripts of IFASIS recordings were analyzed using rapid qualitative analysis. Quantitative IFASIS results were aggregated into medians and ranges within and across organizations. Implementation facilitation meeting notes were analyzed to examine how the IFASIS was used to guide facilitation.
Results
Quantitative ratings and qualitative feedback revealed common barriers to implementation of the digital CM platform, including a lack of sustainable funding sources, absence of external and organizational policies, insufficient higher-level leadership support, and mixed attitudes among staff members toward CM. Common implementation facilitators included enthusiasm and commitment among organization leadership and the perception that the digital CM platform would reduce the workload and burden on OTP counselors. The IFASIS was used to guide facilitation in several ways, including stimulating discussion about barriers and facilitators, brainstorming strategies to address barriers rated as “very important”, and identifying facilitators that could be harnessed as part of implementation efforts.
Conclusions
The IFASIS identified important determinants of CM implementation in OTPs and was instrumental in shaping facilitation. The IFASIS may be a valuable assessment for the implementation science community to identify and address generalizable and context-specific implementation determinants.
The electromagnetic navigation ultrasonography guidance for portal vein access during transjugular intrahepatic portosystemic shunt creation
Authors: Tan Yuping , Li Xi , Li WenBo , Xiong Fei , Bao WeiDong , Dai YongZhou , Yue LinJun , Wu Yu , Liu Yuan
Published: October 2024

Purpose
This study aims to assess the feasibility and safety of utilizing electromagnetic navigation ultrasonography (ENU) guidance during transjugular intrahepatic portosystemic shunt (TIPS) creation.
Methods
Portal vein (PV) puncture during TIPS procedures was facilitated using an ENU system device. Key procedural metrics recorded for each case included the number of needle passes, fluoroscopy time, total procedure duration, dose area product (DAP), air kerma (AK), and incidence of procedural complications.
Results
The study included six patients (five men and one woman) with a mean age of 50.6 ± 13.4 years (range, 33–72 years). With ENU guidance, the mean number of needle passes for successful PV entry was 1.7 ± 0.7 (range, 1 to 3 passes). The average fluoroscopy time for the entire TIPS procedure was 15.3 ± 2.7 minutes (range, 11–19 minutes), and the mean total procedure duration was 91.7 ± 7.8 minutes. The mean DAP associated with the procedure was 143 ± 38.5 Gy · cm2 (range, 89–196 Gy · cm2), with a median AK of 707.7 ± 212.8 mGy (range, 367–1008 mGy). Notably, no clinically significant puncture-related complications were observed.
Conclusion
Electromagnetic navigation ultrasonography (ENU) guidance demonstrates potential feasibility, safety, and effectiveness in assisting with TIPS procedures.
A Study on the Effectiveness of Combining Ranibizumab and Dexamethasone Implants for Treating Macular Edema in Retinal Vein Occlusion and Diabetic Eye Disease
Authors: Fu Xiangxiang , Ying Jianing , Chen Lishuang , Zhang Yanyan , Li Hu , Yi Quanyong
Published: October 2024

Background
Macular edema (ME), a leading cause of vision impairment, is common in patients with retinal vein occlusion (RVO) and diabetic macular edema (DME). This study evaluates the efficacy and safety of combining ranibizumab, an anti-vascular endothelial growth factor (anti-VEGF) agent, with dexamethasone implants for treating ME secondary to RVO and DME.
Methods
This retrospective study involved 61 patients diagnosed with ME secondary to RVO (n = 48) or DME (n = 13) treated at Ningbo Ophthalmology Hospital, China. All patients received intravitreal injections of ranibizumab and dexamethasone implants, with outcomes measured at baseline, 1, 3, and 6 months post-treatment. Primary outcomes included best-corrected visual acuity (BCVA), central retinal thickness (CRT), vascular endothelial growth factor (VEGF) and intercellular adhesion molecule-1 (ICAM-1) levels, and intraocular pressure (IOP).
Results
Both RVO and DME groups showed significant improvement in BCVA, with the DME group demonstrating more sustained benefits. CRT decreased significantly at 1 month post-treatment and remained lower than baseline at 3 and 6 months. Although VEGF and ICAM-1 levels showed reductions post-treatment, these changes were not statistically significant. IOP increased at 1 month but returned to baseline by 3 months and remained stable.
Conclusions
Combining ranibizumab with dexamethasone implants effectively reduces ME and improves visual outcomes in RVO and DME patients, with a manageable safety profile. Further studies are needed to validate these findings and refine long-term treatment protocols.
Low Bone Mineral Density of the Spine in Adolescents With Cerebral Palsy and Scoliosis Relates to Poor Spinal Deformity Correction
Authors: Tsaknakis Konstantinos , Scheulen Charlotte , Lüders Katja , Siggelkow Heide , Lorenz Heiko , Braunschweig Lena , Hell Anna
Published: October 2024

Non-ambulant adolescents with cerebral palsy (CP) may develop secondary scoliosis requiring surgical correction. However, low bone mineral density may counteract benefits of surgical treatment. This study aims to examine volumetric bone mineral density in adolescents with CP and scoliosis and its effect on scoliosis treatment. Spinal vBMD was evaluated on computed tomography (CT) of 51 adolescents with CP and scoliosis (15.0 ± 2.6 years). 62 CTs of patients (15.1 ± 2.3 years) with trauma or other acute and not bone related conditions provided vBMD reference values for Z-scores extrapolation. Other present factors such as epilepsy, medication or pathological fractures were examined in relation to vBMD. Pre- and postoperative spinal radiographs were compared for achieved correction of deformity. Adolescents with CP had significantly lower vBMD (123.3 ± 46.3 mg/cm3) compared to healthy controls (166.9 ± 31.4 mg/cm3). Patients with pathological fractures (n = 8) showed the lowest measurements (97.3 ± 49.8 mg/cm3). Male patients had significantly lower Z-scores (-2.2 ± 1.6, n = 22) compared to their female counterparts (-1.0 ± 1.3, n = 29). Higher vBMD values (179.2 ± 45.4 mg/cm3, n = 41) correlated significantly to scoliosis angle reduction > 50% (average 67.0 ± 12%), while lower vBMD (134.9 ± 30.9 mg/cm3, n = 7) related to reduction ≤ 50% (average 36.8 ± 14%). Non-ambulant adolescents with CP have lower vBMD values compared to healthy population, which negatively affects surgical correction of scoliosis. Level of Evidence/Clinical relevance: Therapeutic Level III
Comparison of different acceleration factors of artificial intelligence-compressed sensing for brachial plexus MR imaging: scanning time and image quality
Authors: Cheng Tianxin , Li Feifei , Jiang Xuetao , Yu Dan , Wei Jie , Yuan Ying , Xu Hui
Published: October 2024

Background: 3D brachial plexus MRI scanning is prone to examination failure due to the lengthy scan times, which can lead to patient discomfort and motion artifacts. Our purpose is to investigate the efficacy of artificial intelligence-assisted compressed sensing (ACS) in improving the acceleration efficiency and maintaining or enhancing the image quality of brachial plexus MR imaging.
Methods: A total of 30 volunteers underwent 3D sampling perfection with application-optimized contrast using different flip angle evolution short time inversion recovery using a 3.0T MR scanner. The imaging protocol included parallel imaging (PI) and ACS employing acceleration factors of 4.37, 6.22, and 9.03. Radiologists evaluated the neural detail display, fat suppression effectiveness, presence of image artifacts, and overall image quality. Signal intensity and standard deviation of specific anatomical sites within the brachial plexus and background tissues were measured, with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) subsequently calculated. Cohen's weighted kappa (κ), One-way ANOVA, Kruskal-Wallis and pairwise comparisons with Bonferroni-adjusted significance level. P<0.05 was considered statistically significant.
Results: ACS significantly reduced scanning times compared to PI. Evaluations revealed differences in subjective scores and SNR across the sequences (P<0.05), with no marked differences in CNR (P>0.05). For subjective scores, ACS 9.03 were lower than the other three sequences in neural details display, image artifacts and overall image quality. There was no significant difference in fat suppression. For objective quantitative evaluation, SNR of right C6 root in ACS 6.22 and ACS 9.03 was higher than that in PI; SNR of left C6 root in ACS 4.37, ACS 6.22 and ACS 9.03 was higher than that in PI; SNR of medial cord in ACS 6.22, ACS 9.03 was higher than that in PI.
Conclusion: Compared with PI, ACS can shorten scanning time while ensuring good image quality.
The effect of brief and focused mindfulness meditation on young adults using EEG approach with machine learning
Authors: Luo Yongxin , Zhang Yaoyao , Zhai Yuqing , Lu Zhixiang , Shou Lujia , Hu Li , Chen Yu , He Wei , Qin Yue , Anwar Nafisa , Zhang Zhongfu , Xu Shutian , Sun Pingping , Lu Jianwei
Published: October 2024

Our study seeks to investigate the neural mechanisms underlying brief mindfulness meditation through the utilization of electroencephalogram (EEG) recordings and machine learning techniques. Twenty-four participants underwent mindfulness training, with pre- and post-practice physiological assessments and EEG recordings. Deep learning was used to analyze EEG data to predict mindfulness states. Models like Multilayer Perceptron (MLP), Long Short-Term Memory (LSTM), and Convolutional Neural Network (CNN) classified meditation vs. rest, with LSTM achieving 72.8% accuracy, MLP 62.4%, and CNN 64.1%. In addition, EEG analysis revealed that reduced frontal delta activity and increased alpha, beta, and gamma activity during a brief and focused mindfulness meditation. The power spectral density (PSD) of focused mindfulness meditation state in the left (F7) and right frontal (F4, TP10) was positively correlated with difference in heart rate before and after meditation. Our results in EEG and physiological measurements suggested that brief and focused mindfulness meditation could reduce anxiety and stress by inducing a hypometabolic state of the body and a tranquil but alert state of the mind. The LSTM model is a reliable data-driven approach to predict the state of focused mindfulness meditation.
Fabrication and evaluation of dissolving bird-bill microneedle arrays
Authors: Amano Natsumi , Takaki Yuusei , Takei Harunori , Matsuo Masaaki , Hara Masaya , Tashiro Yasunori , Oniki Takahiro , Ito Takahiro , Hikima Tomohiro
Published: October 2024

Coated microneedles (MNs) have some disadvantages, such as low mechanical strength, the risk of clogging and infection due to repeated application, and denaturation at high temperatures. We aimed to fabricate a dissolving bird-bill MN (dBB MN) with a vertical groove between two thin plate-shaped needles and evaluated its ability of transdermally deliver a large-molecular-weight insulin drug into systemic circulation. Hydrogels with various concentrations of polyvinylpyrrolidone (PVP) or sodium hyaluronate (HA) were prepared, and dBB MN arrays were fabricated by micromolding under negative pressure for potential mass production. The needle height of the dBB MN was maximum when the hydrogel was 25 w/w% PVP, with a viscosity of 8–9 Pa∙s. Furthermore, the buckling force of dBB MNs made from 25 w/w% PVP was 130.6 ± 51.0 mN, which increased to 195.6 ± 65.3 mN when insulin was added at 1 w/w%. The blood glucose concentration in diabetic rats decreased slowly and significantly after a 3-h application of the insulin-loaded dBB MN array. Therefore, the dBB MN array demonstrated sufficient ability to puncture rat skin and transdermally deliver a large-molecular-weight drug into the systemic circulation. These findings suggest that the dBB MN array holds promise as a minimal invasive drug delivery platform, with potential applications in improving patient adherence and expanding access to essential therapies, particularly in resource-limited settings.
Atrial fibrillation in adult cardiac patients undergoing follow-up at Adama Hospital Medical College: using a log-binomial regression model
Authors: Yousuf Eyob , Tesfaye Demu , Chala Tesfaye , Charkos Tesfaye Getachew
Published: October 2024

Introduction:
Atrial fibrillation (AF) is a prevalent arrhythmia, that is frequently associated with increased morbidity and mortality. Studies on atrial fibrillation among patients with cardiovascular disease in Ethiopia are currently scarce. Therefore, understanding the prevalence and associated risk factors for AF is crucial for guiding appropriate management and preventive strategies.
Methods
A facility-based cross-sectional study was conducted from January 1 to December 30, 2023. A simple random sampling method was used to select the study participants. A structured checklist was used to collect the data. The study applied a log-binomial regression model to assess the associations between atrial fibrillation and independent variables, with 95% confidence intervals (CIs) and relative risks (RRs). All analyses were performed using STATA (version 17) software.
Results
A total of 312 participants were included in this study. Overall, the prevalence of atrial fibrillation was 19.6% (95% CI: 15.2–24.0). The majority had longstanding AF (80.3%), followed by persistent AF (16.4%) and paroxysmal AF (3.2%). According the adjusted model, history of valvular heart disease (RR: 3.05; 95% CI: 2.13–4.374), stroke (RR: 3.28; 95% CI: 2.65–4.09), khat chewing (RR: 4.35; 95% CI: 2.70–7.024), CKD (RR: 2.74; 95% CI: 2.20–3.40), cardiomyopathy (RR: 1.99; 95% CI: 1.02–3.89), and IHD (RR: 0.20; 95% CI: 0.07–0.56) were significantly associated with atrial fibrillation among adult cardiac patients.
Conclusion
Overall, the prevalence of atrial fibrillation (AF) was 19.6% among cardiac patients in this study. Valvular heart disease (VHD), a history of stroke, and khat chewing were independently associated with AF in this study population. These findings emphasize the multifactorial nature of AF and provide valuable insights into potential risk factors for cardiac patients.
Feasibility study of PET/CT for the detection and localization of nervous system damage caused by trimethyltin chloride
Authors: Liu Anqing , Tu Qingqiang , Huang Ming
Published: October 2024

Trimethyltin chloride (TMT), an organotin compound with potent neurotoxicity, is widely used as a heat stabilizer for plastics. however, the precise pathogenic mechanism of TMT remains incompletely elucidated, and there persists a dearth of sensitive detection methodologies for early diagnosis of TMT. In this study, Sprague-Dawley rats were treated with 10 mg/kg TMT to simulate acute exposure in humans. Micro-positron emission tomography/computed tomography (Micro-PET/CT) and molecular imaging quantitative analysis tools were employed to calculate the uptake rate of 18F-2-fluoro-D-deoxy-glucose in each functional region of brain tissue. At the same time, the neurobehavioral test and neuropathological results of the experimental rats were compared, aiming to assess the feasibility of PET/CT in the detection and localization of TMT nervous system damage from many aspects. The results showed that TMT decreased glucose uptake in a wide range of brain tissues in rats, and impaired the memory, muscle strength, coordination ability and emotion of rats. Moreover, TMT induced neuronal damage within the cerebral cortex, hippocampal CA1, CA3 and DG regions as well as the cerebellum while also promoting gliosis surrounding the hippocampus. PET/CT imaging results are highly consistent with behavioral and pathological results. In conclusion, TMT induces a widespread reduction in energy metabolism across various brain regions, and PET/CT can serve as a sensitive detection method for TMT-induced encephalopathy.
Key drivers of large scale changes in North Atlantic atmospheric and oceanic circulations and their predictability
Authors: Dong Buwen , Aksenov Yevgeny Yevgeny , Colfescu Ioana , Harvey Ben , Hirschi Joël , Josey Simon , Lu Hua , Mecking Jenny , Oltmanns Marilena , Osprey Scott , Robson Jon , Rynders Stefanie , Shaffrey Len , Sinha Bablu , Sutton Rowan , Weisheimer Antje
Published: October 2024

Significant changes have occurred during the last few decades across the North Atlantic climate system, including in the atmosphere, ocean, and cryosphere. These large-scale changes play a vital role in shaping regional climate and extreme weather events across the UK and western Europe. This review synthesizes the characteristics of observed large-scale changes in North Atlantic atmospheric and oceanic circulations during past decades, identifies the drivers and physical processes responsible for these changes, outlines projected changes due to anthropogenic warming, and discusses the predictability of these circulations. On multi-decadal time scales, internal variability, anthropogenic forcings (especially greenhouse gases), and natural forcings (such as solar variability and volcanic eruptions) are identified as key contributors to large-scale variability in North Atlantic atmospheric and oceanic circulations. However, there remain many uncertainties regarding the detailed characteristics of these various influences, and in some cases their relative importance. We therefore conclude that a better understanding of these drivers, and more precise quantification of their relative roles, are crucial for more reliable decadal predictions and projections of regional climate for the North Atlantic and Europe.
Connection between autoimmune disease and pelvic neuropathic pain by vascular entrapment - a review of 128 consecutive patients
Authors: Possover Marc , Abrao Henrique
Published: October 2024

This retrospective analysis investigates the relationship between autoimmune diseases and pelvic neuropathies caused by vascular entrapment, a condition often misdiagnosed as "Chronic Pelvic Pain Syndrome of unknown origin." The study analyzed 128 female patients who underwent laparoscopic nerve decompression at the Possover International Medical Center. The average age of the patients was 42 years, with 33% having a history of autoimmune diseases, predominantly hypermobility spectrum disorder (HSD) and Ehlers-Danlos syndrome (EDS), which were present in 21.87% of cases. Intraoperative findings revealed vascular entrapment in all patients, with aberrant or enlarged blood vessels being the most common anomalies. Bilateral vascular entrapment was observed in 80% of the cases. These results suggest a significant association between autoimmune diseases and pelvic neuropathies due to vascular entrapment. The findings underscore the importance of a comprehensive patient history, particularly concerning autoimmune and hematologic conditions, in the accurate diagnosis and treatment of pelvic neuropathies. Rheumatologists should consider the possibility of vascular entrapment in patients with autoimmune diseases, especially those with EDS, who report neuropathic pelvic or sciatic pain that improves when lying down. This awareness could lead to more accurate diagnoses and improved patient outcomes in cases of intractable pelvic neuropathy.
Intellectual disability-causing mutations in KIF11 impair microtubule dynamics and dendritic arborization
Authors: Puthanveettil Sathyanarayanan , Wingfield Jenna , Niese Lukas , Diez Stefan
Published: October 2024

Precise control of axonal and dendritic architecture is vital for proper brain function, with microtubule (MT) dynamics playing a central role in this process. Here, we uncover a previously unrecognized function of the molecular motor protein KIF11, which acts as a MT dynamics rheostat in hippocampal neurons to modulate dendritic branching. Known for its role in mitotic spindle bipolarity, KIF11 is also implicated in Microcephaly with or without chorioretinopathy, lymphedema, or intellectual disabilities (MCLID). However, the specific neuronal functions of KIF11 and the impact of its mutations in MCLID have remained largely unexplored. Our studies, using quantitative imaging of MT dynamics following KIF11 inhibition, indicate that KIF11 preferentially binds to parallel MTs in mature neurons. This binding is associated with a marked increase in minus-end-out MT dynamics in both axons and dendrites upon KIF11 loss of function, coupled with enhanced MT flux and extended growth in tertiary dendrites. These changes suggest a novel role for KIF11 in orchestrating dendritic branching. Moreover, introducing MCLID-associated KIF11 mutations, KIF11Y82F, and KIF11ΔCterm, which cause minor microcephaly but severe intellectual disabilities, leads to significantly reduced MT dynamics and impaired dendritic arborization. In a microtubule sliding assay, KIF11Y82F significantly reduced KIF11 velocity while KIF11ΔCterm increased it. Temporal inhibition of KIF11 using a photo-inhibitable KIF11, show increased MT dynamics and dendritic growth, while activation results in kinked and twisted branches. Together, these data reveal that KIF11 is MT dynamics rheostat and regulator of dendritic arborization in mature neurons and provide new insights into the molecular mechanisms driving MCLID.
A visual analysis of the research hotspot and trend of oral cancer patients nursing based on Citespace
Authors: Liu Ping , Pei Saimin , Tong Li , Chen Lijun , Gu Mengjiao , Deng Lingyan
Published: October 2024

Objective To analyze the hotspot and trend of nursing care of patients with oral cancer by visualization method.Methods The literature related to the nursing of oral cancer patients in the core database of the Web of Science was systematically searched from January 1, 1978 to May 27, 2024. CiteSpace6.1.R6 software was used to visualize the authors, institutions, co-citations and keywords of the included documents.Results A total of 1154 literatures were included, and the number of published literatures showed an increasing trend. The United States had the highest number of publications, followed by the United Kingdom and China. The Journal with the most citations was the Journal Of Clinical Oncology (395 times), while the journal with the highest centrality of citations was The Lancet (0.13). The top five keywords were cancer (224 times), chemotherapy (154 times), care (126 times), quality of life (124 times) and management (123 times). A total of 8 significant clusters were formed, which could be summarized into ① different treatment methods and schemes; ② prevention of oral cancer; ③ symptomatic treatment of cancer pain; ④ prevention and treatment of complications. The research trends and directions in recent years mainly include education, outcome, impact and dysphagia, especially dysphagia.Conclusion The contents of nursing research on patients with oral cancer are rich, mainly in treatment methods; Prevention; Treatment of cancer pain and prevention of complications. Current research trends focus on education, outcomes, impact, dysphagia, and specifically dysphagia.
Translation and validation of the Caffeine Use Disorder Questionnaire (CUDQ) in Arabic
Authors: Fekih-Romdhane Feten , Hallit Rabih , Malaeb Diana , Sakr Fouad , Dabbous Mariam , Obeid Sahar , Hallit Souheil
Published: October 2024

Background
Due to the elevated global prevalence of its consumption, and the detrimental health effects it can have, CUD should receive a great deal of attention from clinicians and the research community in Arab countries as an area of concern. To help advance the field, this study aimed to translate the Caffeine Use Disorder Questionnaire (CUDQ) into the Arabic language, and examine its psychometric properties in community adults.
Methods
A descriptive, observational and cross-sectional study was carried out during the period from May to July 2024. Arabic-speaking adults from the general population of Lebanon (N = 1858, 49.8% males, mean age of 30.05 ± 11.39 years), reporting caffeine consumption at least once during the last 12 months, were included.
Results
The study’s results provided support to the theoretical assumptions of unidimensionality of the original version of the CUDQ, with excellent composite reliability (Cronbach’s α = .90). Furthermore, the structure of the Arabic CUDQ was equivalent across sex, suggesting that the latent CUD construct has the same meaning in male and female adults. The highest CUDQ scores were reported by participants drinking 7 to 9 cups and 10 cups or more of coffee/per day relative to those consuming lower amounts of coffee. Finally, our findings revealed good concurrent validity based on positive correlations of CUDQ scores with nicotine dependence, depression and anxiety scores.
Conclusion
Overall, findings suggest that the CUDQ is appropriate and suitable for use to measure CUD among Arabic-speaking adults from the general population. Making the CUDQ available in the Arabic language can fill a gap in the assessment of problematic caffeine consumption in Arab contexts. Future studies are required to further confirm the psychometric soundness of the Arabic CUDQ in more representative samples, specific populations and other Arab countries
Determinants Underlying Teenager’s Accessibility to Contraceptive Methods and HIV Preventive Measures in Rwamagana District, Rwanda
Authors: Rumenge Nt. Alain , Batamuriza Myriam , Benimana Immaculate , Bikorimana Emmanuel , Gasurira Sylvestre , Mukiza Amani , Buser Julie M.
Published: October 2024

Background: In Rwanda, despite significant political achievements in women's empowerment and efforts to eliminate child sexual abuse, the rate of teenage pregnancy remains high. Increased access to and use of contraceptive methods could reduce the rates of teenage pregnancy and HIV infection.
Objectives: This study aims to assess the determinants, needs, and barriers to the use of contraceptive methods and HIV/AIDS preventive services by adolescents in Rwamagana District, Rwanda.
Methods: A cross-sectional design was used in this study. A multistage sampling strategy with a simple random technique was employed to select 376 female students as participants. Data were collected using a pretested questionnaire composed of closed-ended questions with Likert scale constructs based on the Theory of Planned Behavior. Descriptive statistics, bivariate analysis, and multivariable logistic regression were conducted.
Results: A multiple logistic regression analysis shows that participants aged 18–20 are more than twice as likely to use contraceptive methods or HIV preventive measures compared to those aged 13–15 (OR=2.876, P=0.041, 95% CI=1.974–4.052). Urban participants are also more than twice as likely to use contraceptives or HIV preventive methods compared to those whose schools are in rural areas (OR=2.333, P=0.037, 95% CI=1.261–4.316). Female students in Senior 6 are more than three times as likely to use contraceptive methods or HIV preventive measures compared to those in Senior 1 (OR=3.444, P=0.032, 95% CI=2.544–6.884).
Participants who intend to have sex at an older age had a 24.9% reduction in the odds of using a contraceptive method or HIV preventive measures (OR=0.751, P=0.033, 95% CI=0.352–0.977). Friends of respondents also influence contraceptive use (OR=0.611, P=0.043, 95% CI=0.252–0.917). Participants with contraceptive knowledge are three times more likely to use contraceptives or HIV preventive methods compared to those with less contraceptive knowledge (OR=3.096, P=0.011, 95% CI=1.150–6.803).
Conclusion: Area of residence, age, friendships, and knowledge of contraceptive methods and HIV preventive measures are the determinants underlying early sexual activity among teenagers. One of the biggest challenges is the level of sex education, which remains a taboo topic in Rwandan culture. It is still difficult for parents to discuss sex directly with their children. We recommend further studies to focus on teenage non-scholars while conducting similar research.
Predicting Pulmonary Fibrosis Progression in Coalworker Pneumoconiosis Using a CT Radiomics and Clinical Features Model
Authors: Wang Wei , Xie Xinyi , Li Qian , Bi Chaohu , Wen Yao , Su Jing , Huang Jiao , Xie Wutao
Published: October 2024

Objective
This study aimed to construct a machine learning model based on CT radiomics combined with clinical features to predict the progression of pulmonary interstitial fibrosis in coalworker pneumoconiosis.
Methods
The clinical and imaging data of 297 patients diagnosed with coalworker pneumoconiosis by the expert panel of The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College from December 2021 to December 2023 were analysed. Among these patients, 170 progressed to pulmonary interstitial fibrosis during a three-year follow-up period and were classified as the progression group, while the remaining 127 were classified as the stable group. Patients were assigned to a training cohort (n = 207) and a test cohort (n = 90). Radiomic features were extracted from the CT images of lung tissue fibrosis lesions in the training cohort. These features were then subjected to dimensionality reduction to construct morphological biomarkers. Machine learning methods were used to construct a clinical model, a radiomics model, and a multimodal joint model. The performance of these models was evaluated in the test cohort using receiver operating characteristic (ROC) curves and decision curve analysis (DCA).
Results
In the training cohort, the area under the curve (AUC) of the ROC curves for the clinical, radiomic, and joint models were 0.835, 0.879, and 0.945, respectively. In the test cohort, the AUC values for the clinical, radiomic, and joint models were 0.732, 0.750, and 0.845, respectively. The joint model showed the best predictive efficacy and clinical benefit in both the training and test cohorts.
Conclusion
The joint model based on CT radiomics and clinical features could accurately predict the progression of pulmonary fibrosis in coalworker pneumoconiosis.
Sustained vascular inflammatory effects of SARS-CoV-2 spike protein on human endothelial cells
Authors: Gultom Mitra , Lin Lin , Brandt Camilla Blunk , Milusev Anastasia , Despont Alain , Shaw Jane , Döring Yvonne , Luo Yonglun , Rieben Robert
Published: October 2024

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with systemic inflammation and vascular injury, which contribute to the development of acute respiratory syndrome (ARDS) and the mortality of COVID-19 infection. Moreover, multiorgan complications due to persistent endothelial dysfunction have been suspected as the cause of post-acute sequelae of SARS-CoV-2 infection. Therefore, elucidation of the vascular inflammatory effect of SARS-CoV-2 will increase our understanding of how endothelial cells (EC) contribute to the short- and long-term consequences of SARS-CoV-2 infection. Here, we investigated the interaction of SARS-CoV-2 spike protein with human ECs from aortic (HAoEC) and pulmonary microvascular (HPMC) origins, cultured under physiological flow conditions. We showed that the SARS-CoV-2 spike protein triggers prolonged expression of cell adhesion markers in both ECs, similar to the effect of TNF-α. SARS-CoV-2 spike treatment also led to the release of various chemokines observed in severe COVID-19 patients. Moreover, increased binding of leucocytes to the endothelial surface and a procoagulant state of the endothelium were observed. Transcriptomic profiles of SARS-CoV-2 spike-activated HPMC and HAoEC showed prolonged upregulation of genes and pathways associated with responses to virus, cytokine-mediated signaling, pattern recognition, as well as complement and coagulation pathways. Our findings support experimental and clinical observations of the vascular consequences of SARS-CoV-2 infection and highlight the importance of EC protection as one of the strategies to mitigate the severe effects as well as the possible post-acute complications of COVID-19 disease.
Nitric Oxide: A Novel Therapeutic Target for Salt-Induced Nocturnal Polyuria in Aging
Authors: Takezawa Kentaro , Imanaka Takahiro , Kujime Yuma , Kitakaze Hiroaki , Tsujimura Go , Kuribayashi Sohei , Sekii Yosuke , Ueda Norichika , Fukuhara Shinichiro , Kiuchi Hiroshi , Negoro Hiromitsu , Nonomura Norio
Published: October 2024

Nocturnal polyuria is a major cause of nocturia, which affects quality of life. Aging-related decreases in nitric oxide production have been reported to contribute to salt-induced nocturnal polyuria. We posited that enhanced nitric oxide production from exercise could mitigate salt-induced nocturnal polyuria. To validate, we assessed the impact of exercise on intrarenal renin-angiotensin system activity and salt-induced polyuria during inactive periods in aged mice. We found an increase in nitric oxide production by moderate-intensity exercise suppressed the intrarenal renin-angiotensin system and improved salt-induced polyuria during inactive periods in aged mice. These effects were neutralized by nitric oxide synthesis inhibition. These findings indicate that exercise-induced improvements in salt-induced polyuria during inactive periods are caused by increases in nitric oxide production. In summary, increasing nitric oxide production may serve as a treatment method for salt-induced nocturnal polyuria in older adults.
Safety and efficacy of arthroscopic-assisted uni-portal spinal surgery combined with bone anchoring annulus fibrosus suture technique for treatment of lumbar disc herniation with vertebral edge annulus fibrosus tear
Authors: Xia Gushang , Song En , Li Xianglin , Kong Qingli , Sun Fei , Shao Jiannan , Lu Shaokun , Yang Rong , Zhang Liming , Zhou Yusong
Published: October 2024

Objective: To investigate the safety and clinical effectiveness of Arthroscopic-assisted Uni-portal Spinal Surgery(AUSS)combined with bone anchoringannulus fibrosus suture technique in the treatment of lumbar disc herniation(LDH) with vertebral edge annulus fibrosus tear.
Methods: A total of 52 patients with LDH with vertebral edge annulus fibrosus tear from March 2019 to March 2023 in our hospital were included in this study.All patients were treated by AUSS combined with bone anchoring annulus fibrosus suture technique.The visual analog scale (VAS) score for lower back and lower limb pain and the oswestry disability index (ODI) were used to compare before operation and 1 month, 6 months and 12 months after operation. The clinical efficacy was evaluated by modified MacNab efficacy standard at 12 months after operation.
Results: All patients completed the operation successfully and obtained follow-up results, the average follow-up time was 13.8 months (range, 12-18 months).The average operation time was 105 minutes (range, 68-143 minutes).There were 2 cases of dural sac tear during operation,one patient had aggravation of pain and numbness in the ipsilateral lower limb and hypoesthesia in the perineal region after operation,one patient developed postoperative incision infection.The incidence of complications was 7.69%. One month after operation,the VAS scores for lower back and lower limb pain and ODI were signifcantly lower than before the operation (P<0.05).The above indicators continued to improve at 6 months and 12 months after operation, and the differences were significant (P<0.05).According to the modified MacNab efficacy standard at 12 months after operation, 41 cases were excellent, 9 cases were good, and 2 cases were acceptable, with an excellent and good rate of 96.15%. No recurrence was observed.
Conclusion:AUSS combined with bone anchoring annulus fibrosus suture technique is a safe and effective surgical method for the treatment of LDH with vertebral edge annulus fibrosus tear.It can effectively reduce the recurrence rate, achieve a high excellent and good rate and good clinical efficacy ,which is worthy of clinical promotion.