bluuebunny/crossref_metadata_2025 huggingface dataset:
3D-Printed Prosthesis with an Articular Interface for Anatomical Acetabular Reconstruction After Type I + II (+ III) Internal Hemipelvectomy
Authors: Huang Xin , Huang Donghua , Lin Nong , Yan Xiaobo , Qu Hao , Ye Zhaoming
Published: October 2024

Background:

Pelvic reconstruction after type I + II (or type I + II + III) internal hemipelvectomy with extensive ilium removal is a great challenge. In an attempt to anatomically reconstruct the hip rotation center (HRC) and achieve a low mechanical failure rate, a custom-made, 3D-printed prosthesis with a porous articular interface was developed. The aim of this study was to investigate the clinical outcomes of patients treated with this prosthesis.

Methods:

This retrospective cohort study included 28 patients with type I + II (+ III) internal hemipelvectomy through the articular interface of the sacroiliac joint and managed with a prosthesis at a single center between August 2016 and August 2021. Complications and oncological outcomes were analyzed. The position of the reconstructed HRC was assessed and lower-limb function was evaluated. Biomechanical analyses of different fixation modes of the prosthesis were conducted using finite element analysis.

Results:

The displacement distance of the HRC from preoperatively to postoperatively was a mean (and standard deviation) of 14.12 ± 8.75 mm. The rate of implant-related complications was 14.3% (4 of 28) for prosthetic breakage, 14.3% (4 of 28) for aseptic loosening, 7.1% (2 of 28) for dislocation, and 7.1% (2 of 28) for deep infection. The mean Musculoskeletal Tumor Society (MSTS)-93 score was 18.2. The aseptic loosening rate was significantly greater for prostheses fixed with 3 sacral screws (4 of 10, 40.0%) than for those fixed with 4 (0 of 10, 0%) or 5 screws (0 of 8, 0%) (p = 0.024). The prosthetic breakage rate was lower in patients who underwent lumbosacral fixation (0 of 13, 0%) than in those who did not (4 of 15, 26.7%), although the difference did not reach significance (p = 0.102). Biomechanical analyses suggested that the addition of lumbosacral fixation or increasing the number of sacral screws from 3 to 4 or 5 visibly reduced the peak stress of the sacral screws.

Conclusions:

The use of a 3D-printed prosthesis with an articular interface for pelvic reconstruction demonstrated stable prosthetic fixation, anatomical acetabular reconstruction, and acceptable early functional outcomes.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
GEOCHEMISTRY OF GROUNDWATERS AND SURFACE WATERS, AND GROUND ICE OF THE OKA PLATEAU (Eastern Sayan, Russia)
Authors: Alexeev S.V. , Alexeeva L.P. , Svetlakov A.A. , Pellinen V.A. , Orgil’yanov A.I. , Badminov P.S. , Gutareva O.S.
Published: October 2024

The study area is located in the Eastern Sayan hydrogeological folded area. The objects of the study were groundwaters, surface waters and ground ice in the Sentsa River basin on the Oka Plateau. Cold and thermal groundwaters are associated with Proterozoic and Paleozoic metamorphic and igneous rocks. Their discharge as springs occurs in the river valleys along fault zones. Ground ice was studied in mineral frost mounds (lithalsas) composed of clays, clayey silts and silts of lacustrine-alluvial and fluvioglacial genesis. It has been established that thermal and cold groundwaters have HCO3 Ca-Na compositions, river and lake waters, as a rule, have HCO3 Ca-Na compositions, and ground ice melts – HCO3, SO4-HCO3 and NH4-HCO3 Ca. Thermal waters are largely enriched in Li, Be, B, Si, Mn, Ga, Ge, Se, As, Br, Rb, Sr, Cs, Ba and all REE relative to river and rain waters, and have the highest values of trace elements enrichment factor (EFREE). The latter shows that atmospheric precipitation participates in the formation of the composition of groundwaters (cold and thermal) and surface waters. The specificity of the geochemistry of ground ice is determined by the composition of precipitation, the injection of ice-forming groundwater from taliks, the interaction in the water-rock system, and the presence of organic matter in unconsolidated sediments. The participation of river water and groundwater in the formation of the frost mound ice core is also evidenced by similar values of stable isotopes (δ18O, δD) in surface water, groundwater and ground ice. The 3He/4He ratio points to a possible influx of mantle helium into thermal waters, and δ13С points to the magmatic and thermometamorphic mechanisms of carbon dioxide accumulation in thermal waters. The 87Sr/86Sr ratio in travertines indicates a significant contribution of intrusive rocks to the formation of fluid composition.
La transformación del sistema público de salud en la Ciudad de México
Authors: López-Arellano Oliva , Delgado-Campos Victoria Ixshel
Published: October 2024

La política pública en materia de salud puesta en marcha por el gobierno actual sintetiza una transformación radical del sistema público de salud de México. Se diseñó como un proyecto de magnitud nacional con matices locales. Para la Ciudad de México en particular, representa un compromiso continuo y permanente con la garantía de derechos, las libertades y la democracia y, al mismo tiempo, supone retos en diversos de sus componentes como el financiero y presupuestal, la cultura organizacional, así como en los campos especializados de la salud como la atención médica y la atención colectiva, por mencionar algunos. Este artículo se propone señalar los principales aspectos que implicó la implementación del nuevo modelo de salud en la capital, tomando en consideración cuatro momentos coyunturales, pero de gran impacto: primero, la incorporación del modelo de Salud en tu Vida en la ley local y su puesta en marcha; segundo, enfrentar la pandemia por Covid-19 y con ello, la reorganización de los servicios de salud; tercero, concluir la transferencia de los servicios de atención médica hacia un organismo de nueva creación denominado Servicios de Salud IMSS-Bienestar; y cuarto, fortalecer la capacidad y las funciones de rectoría de la Secretaría de Salud de la Ciudad de México.
La importancia del Servicio Nacional de Salud Pública en la reestructuración del sistema público de salud
Authors: López-Manning Mauricio , Lopez-Ridaura Ruy
Published: October 2024

La reestructuración del sistema de salud en México avanza paralelamente en sus dos ejes, la atención individual y la atención colectiva. En materia de salud colectiva, la transformación tiene dos objetivos objetivos centrales, robustecer la capacidad rectora del Estado mexicano en materia sanitaria y brindarle a la Secretaría de Salud federal un brazo operativo para el ejercicio de sus atribuciones. Para ello la Secretaría de Salud creó el Servicio Nacional de Salud Pública (SNSP), un cuerpo personas servidoras públicas que tiene como misión salvaguardar y proteger la salud de la población a través del fortalecimiento de las Funciones Esenciales de la Salud Pública. En ese sentido, la transformación sanitarista se materializa con tres acciones claves para el SNSP; reorganizar el ejercicio de la salud colectiva en el país por funciones (gerencia, operaciones, logística e inteligencia) en lugar de programas temáticos verticales, consolidar funcional y orgánicamente a las personas servidoras públicas dedicadas a salud pública con una identidad profesional definida, y redefinir la acción rectora de la Secretaría de Salud como un acompañamiento territorial desplegado de manera constante a lo largo de todo el territorio nacional.
WITHDRAWN: A Study Protocol for “Comparative Evaluation of Effectiveness of Demineralized Freeze-Dried Bone Allografts (DFDBA) with Titanium Platelet Rich Fibrin (T-PRF) and Autologous Dentin Graft (ADG) with T-PRF in Alveolar Socket Preservation: A Randomized Controlled Clinical Trial”
Authors: Thakre Shivani , Bajaj Pavan
Published: October 2024

Background: Socket preservation is a pivotal procedure in modern dentistry, dedicated to the preservation of the alveolar ridge architecture after tooth extraction. The techniques vary from basic socket fillers such as blood clot preservation to more advanced techniques using barrier membranes and bone grafts such as autografts, allografts, xenografts, and synthetic materials. The aim of this study is to evaluate and compare the effectiveness of alveolar socket preservation with T-PRF (Titanium-Prepared Platelet-Rich Fibrin) and ADG (Autologous Dentin Graft) with T-PRF in socket preservation. This assessment will be carried out through comprehensive clinical, radiographic, and histomorphometric analysis. The objective is to determine the most efficient method for maintaining socket integrity after tooth extraction.
Method and Design: A total of 16 patients who match the specified criteria will be randomly assigned to one of two groups:(1) Socket preservation using DFDBA in combination with T-PRF and (2) Socket preservation performed using ADG with T-PRF. Following four months all the clinical variables will be assessed, a CBCT radiograph will be used to examine volumetric bone status, and biopsies will be analyzed histomorphometrically obtained during implant placement. Linear phenotypic dimensional changes will be assessed as secondary outcomes.
Discussion: The results obtained from this study will demonstrate if T-PRF along with ADG will lead to better radiographic bone fill and improved socket measurements compared to that of DFDBA with T-PRF. The results and patient-reported outcomes will be used to help choose the most effective type of therapy for socket preservation.
Trial registration: The registration number for this trial is CTRI/2024/05/068192.
The Design of Human-Computer Interaction Learning System for Children's Education
Authors: Li Mengru , Lv Yang , Pu Yongming , Wu Min
Published: October 2024

This study aims to develop and evaluate an interactive learning system for children. Through mixed-method research, combined with quantitative and qualitative data analysis, this study provides a comprehensive evaluation of the educational effectiveness of the system. The study involves children in grades 1-6, and data on learning effectiveness before and after using the system are collected through pre-experiments and formal experiments. The results of quantitative analysis show that after using the system, the average improvement rate for students in grades 1-3 is 24.6% in mathematics and 28.1% in science, while in grades 4-6, the improvement rate is 22.2% in mathematics and 26.8% in science. The average response time of the system is 1.77 seconds, with the longest response time being 3.1 seconds. User satisfaction is 94%, and the error rate is 0.2%. These results demonstrate that the developed learning system has significant effects on improving children's learning effectiveness and optimizing user experience.
Efficacy and Predictors of Noninvasive Ventilation in neonates with congenital heart disease
Authors: Zhang Han , Zuo Yansong , Li Qiangqiang , Sun Jiashu , Li Gang , Wang Qiang
Published: October 2024

Background: To evaluate the outcomes of noninvasive ventilation (NIV) therapy in neonates with congenital heart disease at our institute, and identify predictors associated with noninvasive ventilation therapy.
Methods: We examined 207 neonates who underwent cardiac surgery at a single institution from 2018 to 2023. Relevant data, such as demographic information, operative details, and postoperative records, were gathered from medical and surgical records. Our primary focus was on the NIV failure.
Results: Median age and weight at surgery were 12(6-19) days and 3.3 (2.9-3.6) kg, respectively. 86(41.5%) patients were extubated to NIV (NIV group), and 121(58.5%) were not experienced NIV (No-NIV group). In NIV group, 47 (57.4%) were assigned to the preventive group and 39 (47.3%) to the non-preventive group. The NIV failure rate was 6.8% (14/86) and mortality rate was 2.4% (n=5). According to multivariate logistic regression analysis PaCO2>37.5mmHg at pre-extubation and requirement for emergent resuscitation before surgery were the independent predictors associated with NIV therapy, the duration of postoperative mechanical ventilation (MV), PaCO2 value at 24h post-extubation and vasoactive-inotropic score (VIS) influenced the occurrence of NIV failures, and there were more NIV failure happened after 24 hours of NIV therapy (8/14, 57.1%). For the patients with longer aortic cross‑clamp time, higher PCO2 value at pre-extubation and required peritoneal dialysis after surgery were more likely to receive preventive NIV therapy.
Conclusions: NIV can be successfully used in neonates who after cardiac surgery. For patients at risk, the preventive NIV therapy could more effective in avoiding NIV failure.
White matter tract involvement in alien hand syndrome following stroke: diffusion tensor imaging study
Authors: Park Jihee , Lee Sekwang , Tae Woo-Suk , Pyun Sung-Bom
Published: October 2024

Alien Hand Syndrome (AHS) disrupts hand control, often attributed to corpus callosum (CC) damage, which connects the two brain hemispheres. AHS can also result from damage to the medial frontal cortex, parietal lobe, or thalamus, but its precise causes remain unclear. This study aimed to identify the white matter tracts associated with AHS development using the automated reconstruction of 42 tracts from diffusion tensor imaging (DTI). We included three female AHS patients with anterior cerebral arterial (ACA) infarctions. Additionally, we enrolled 20 age-matched control subjects and six patients with ACA infarctions but without AHS symptoms (N-AHS group) for comparison. DTI was conducted in AHS, N-AHS, and control groups. Fractional anisotropy (FA) and volume values were extracted from the DTI datasets of participants using TRActs Constrained by UnderLying Anatomy (TRACULA) technique. The AHS group showed lower FA values of the CC body (parietal and temporal section), right arcuate fasciculus, corticospinal tract, extreme capsule, inferior longitudinal fasciculus, and superior longitudinal fasciculus than the control group. However, these tracts exhibited no significant difference between N-AHS and control groups. Similarly, the volume value in the genu of CC in the AHS group was lower than controls, but not in other tracts. Our results suggest that the extensive CC lesion, especially in the posterior parietal and temporal section of CC body, is associated with the development of AHS. These results shed light on the neural mechanisms involved in AHS and underscore the significance of considering various white matter tracts beyond CC for understanding this syndrome.
Primary intracranial sarcoma associated with DICER1-mutant: A case report and preclinical investigation
Authors: Honma Hirokuni , Tateishi Kensuke , Iwashita Hiromichi , Miyake Yohei , Tsujimoto Shinichi , Hayashi Hiroaki , Ohgaki Fukutaro , Nakano Yoshiko , Ichimura Koichi , Yamanaka Shoji , Kato Motohiro , Fujii Satoshi , Ito Shuichi , Yokoo Hideaki , Yamamoto Tetsuya
Published: October 2024

Primary intracranial sarcoma (PIS) is a rare and aggressive pediatric brain tumor, which is partially associated with DICER1 mutant. Although the molecular genetic characteristics of this tumor have previously been investigated, novel therapeutic targets remain unclear. Further, the lack of faithful preclinical models has hampered the development of novel therapeutic strategies. Herein, we describe a pediatric case of PIS with DICER1 mutant and describe the development of the first novel patient-derived xenograft (PDX) model of this rare tumor. Somatic genomic profiling of the tumor revealed mutations in DICER1, TP53, and ATRX. Germline analysis further revealed a pathogenic variant of DICER1, significant for the diagnosis and management of hereditary tumor predisposition syndrome. Overall, we demonstrated that the PDX model faithfully retained the phenotype and genotype of the patient’s tumor, as well as the DNA methylation profile. Through high-throughput drug screening using PDX tumor cells, we found that activation of the retinoic acid receptor (RAR) signaling pathway reduced tumor cell viability. These findings indicate that the RAR signaling pathway is a potential therapeutic target for PIS in DICER1 mutant.
Non-specific abdominal pain in elderly patients discharged from the emergency department: frequency, outcomes and risk-factors for adverse events (EDEN-43 study)
Authors: Miró Oscar , Morales Xavier , Cardeñosa Sandra Cuerpo , Möckel Martin , Fernandez Cesareo , Burillo Guillermo , Alquezar-Arbé Aitor , Montero-Pérez Francisco Javier , Jacob Javier , Bellido Andrea , Aguiló Sira , Castillo Juan González del
Published: October 2024

Objective: To determine how frequent the diagnosis of non-specific abdominal pain (NSAP) is among elderly patients discharged from emergency departments (EDs), investigate short-term outcomes and look for factors related to adverse outcomes.
Methods: We included all patients 65 years or older diagnosed with NSAP and discharged home after ED care in 52 Spanish EDs during a one-week period. Outcomes consisted of 7-day and 30-day all-cause death, 30-day ED reconsultation and hospitalization, and 30-day combined adverse events (AEs) (ED reconsultation, hospitalization or death). Selected sociodemographic and index episode data were investigated for their potential relationship with 30-day combined AEs.
Results: Among 25,557 elderly patients attended in EDs during the 1-week period, 19,026 were discharged home and 397 (2.1%) had NSAP as the final diagnosis. The 7-day and 30-day mortality were 0.3% and 1.5%, respectively. The 30-day ED reconsultation was 21.9% and the 30-day hospitalization was 16.4%. Thirty-day combined AEs were recorded in 22.9% of patients and were independently associated with comorbidity and functional impairment as well as the use of opiate and non-opiate analgesia and lack of laboratory and imaging studies in the ED during the index episode.
Conclusions: A diagnosis of NSAP at ED discharge is frequent in elderly patients and carries a risk of adverse short-term outcomes. Discharge of those patients should be cautious, especially in comorbid patients with limited functional capacity, those needing analgesia, particularly opiates, and patients discharged without laboratory and imaging studies.
CatLet© score for estimation of benefits of percutaneous coronary intervention versus optimal medical therapy in patients with acute myocardial infarction
Authors: He Yang , Xu Jian-Ping , Pan Yun , Wang Peng , He Yong-Ming
Published: October 2024

Background
The recently developed the Coronary Artery Tree description and Lesion EvaluaTion (CatLet©) angiographic scoring system has adequately accounted for the variability in coronary anatomy and considered both the severity of a coronary artery stenosis and its subtended myocardial territory. This study aims to investigate its potential roles played in guiding treatment strategies.
Methods
A total of consecutive 544 acute myocardial infarction (AMI) patients with single vessel disease were enrolled and their CatLet scores were calculated. The patients were divided into two groups: high (≥10) or low (< 10) CatLet score group. The primary endpoint was all-cause death. Cox regression survival analysis was performed to determine the benefits of percutaneous coronary intervention (PCI) versus optimal medical therapy in each group.
Results
The survival rate of all-cause death in the low CatLet score group was similar regardless of whether PCI was performed (P = 0.86). However, in the high CatLet score group, the survival rate was significantly higher when PCI was performed as compared to those whose PCI was not performed (P = 0.0067). The multivariable-adjusted hazard ratios (95% CI, P) were 0.20 (0.07–0.62, P = 0.005) for PCI in higher CatLet score group and 6.96 (0.22-205.65, P = 0.277) in lower CatLet score group.
Conclusions
The CatLet angiographic scoring system, capable to semi-quantify the myocardial territory, can be a useful tool to guide the treatment strategy for patients with AMI. Those with a CatLet score≥10 or more than five myocardial segments involved (CatLet score divided by the coefficient of 2) would benefit from the PCI strategy (http://www.chictr.org.cn; Registry Number: ChiCTR2000033730).
Loss of the wild-type allele promotes carcinogenesis of bladder urothelial cells with p53 missense mutation
Authors: Kobayashi Takashi , Hamada Akihiro , Kita Yuki , Sakatani Toru , Nakamura Kenji , Takada Hideaki , Ikeuchi Ryosuke , Koike Shuhei , Masuda Norihiko , Murakami Kaoru , Sano Takeshi , Goto Takayuki , Saito Ryoichi , Teramoto Yuki , Fujimoto Masakazu , Hatano Narumi , Kamada Mayumi , Ogawa Osamu
Published: October 2024

In advanced bladder cancer cases, p53 is the most frequently altered gene. Despite missense mutation accounts for over 60% of p53 alterations while homozygous deletion (HOM) for only 5% or less, most of the previously reported mouse models are deficient of p53. Accordingly, there have been few studies addressing whether missense mutations have an advantage over HOM in bladder cancer development. Pten-deficient, Trp53-mutant (Trp53R172H/+) organoids derived from Krt5-expressing mouse urothelium (K5-mUrorganoid) were tumorigenic in athymic mice, but every formed tumors showed loss of wild-type allele of Trp53 (Trp53R172H/LOH). Both Trp53R172H/Δ and Trp53Δ/Δ K5-mUrorganoids formed tumor in athymic mice, whereas only Trp53R172H/Δ K5-mUrorganoid formed tumor even when directly inoculated in immunocompetent syngeneic mice. The absence of wild-type Trp53 was associated with upregulation of proliferative signaling, and the presence of a mutant Trp53 allele was associated with reduced intratumoral CD8+ T cells, increased CD206+ M2 macrophages, and increased Foxp3+ regulatory T cells. This study highlights the functional significance of p53 mutant LOH in bladder carcinogenesis conferring several hallmarks of cancer such as sustaining proliferative signaling and avoiding immune destruction, and provides a novel immunocompetent mouse model of urothelial carcinoma harboring p53 mutations as a novel tool for cancer immunology research.
HDC downregulation induced by chronic stress promotes ovarian cancer progression via IL-6/STAT3/S100A9 pathway
Authors: Xu Feng , Chen Zhicong , Cao Jinming , Xiao Zhijun , Yang Zhen , Yang Zhen , Duan Jingjing , Zhou Ting
Published: October 2024

Depression is prevalent in ovarian cancer patients and contribute to the progression of the disease. However, the underlying mechanism remains unclear. In vivo, we established a comorbidity mouse model of ovarian cancer and depression. We found that chronic stress induced depression-like behaviors and promoted inoculated ovarian tumor growth in mice. Histidine decarboxylase (HDC) level was downregulated both in tumor tissue and in plasma of model mice. Exogenous histamine (HIS) treatment significantly alleviated chronic stress-induced depression-like behaviors and inhibited ovarian tumor growth, as well as decreased serum levels of inflammatory factors IL-6 and IL-17A, stress hormones norepinephrine (NE) and cortisol (COR), and 5-hydroxytryptamine (5-HT). Furthermore, HIS treatment regulated the immune response, particularly by increasing the percentage of CD3+ T cells, CD8+ cytotoxic T (Tc) cells, and decreasing the secretion of IL-17A. In vitro research of A2780 and ES-2 cell lines, NE and COR treatment down-regulated HDC expression and promoted cancer cells proliferation, migration, and invasion. HIS treatment reversed these effects. Preliminary mechanism research showed that chronic stress downregulated HDC expression and promoted ovarian cancer progression via IL-6/STAT3/S100A9 pathway. HIS may be a potential molecule for treating comorbidity of ovarian cancer and depression.
Brain imaging and machine learning reveal uncoupled functional network for contextual threat memory in long sepsis
Authors: Huerta Patricio T. , Strohl Joshua J. , Carrión Joseph
Published: October 2024

Positron emission tomography (PET) is a highly sensitive tool for studying physiology and metabolism through positron-emitting radionuclides that label molecular targets in the body with unparalleled specificity, without disturbing their biological function. Here, we introduce a small-animal technique called behavioral task–associated PET (beta-PET) consisting of two scans: the first after a mouse is familiarized with a conditioning chamber, and the second upon recall of contextual threat. Associative threat conditioning occurs between the scans. Beta-PET focuses on brain regions encoding threat memory (e.g., amygdala, prefrontal cortex) and contextual aspects (e.g., hippocampus, subiculum, entorhinal cortex). Our results show that beta-PET identifies a biologically defined functional network encoding contextual threat memory and its uncoupling in a mouse model of long sepsis. Moreover, machine learning algorithms (linear logistic regression) and ordinal trends analysis demonstrate that beta-PET robustly predicts the behavioral defense response and its breakdown during long sepsis.
2-[18F]Fluoropropionic Acid PET Imaging of Doxorubicin-induced Cardiotoxicity
Authors: Azcona Juan A. , Wacker Anja S. , Lee Chul-Hee , Fung Edward K. , Jeitner Thomas M. , Manzo Onorina L. , Lorenzo Annarita Di , Babich John W. , Amor-Coarasa Alejandro , Kelly James M.
Published: October 2024

Purpose
Treatment of pediatric cancers with doxorubicin is a common and predictable cause of cardiomyopathy. Early diagnosis of treatment-induced cardiotoxicity and intervention are major determinants for the prevention of advanced disease. The onset of cardiomyopathies is often accompanied by profound changes in lipid metabolism, including an enhanced uptake of short-chain fatty acids (SCFA). Therefore, we explored the utility of 2-[18F]fluoropropionic acid ([18F]FPA), an SCFA analog, as an imaging biomarker of cardiac injury in mice exposed to doxorubicin. Procedures: Cardiotoxicity and cardiac dysfunction were induced in mice by an 8-dose regimen of doxorubicin (cumulative dose 24 mg/kg) administered over 14 days. The effects of doxorubicin exposure were assessed by measurement of heart weights, left ventricular ejection fractions, and blood cardiac troponin levels. Whole body and cardiac [18F]FPA uptakes were determined by PET and tissue gamma counting in the presence or absence of AZD3965, a pharmacological inhibitor of monocarboxylate transporter 1 (MCT1). Radiation absorbed doses were estimated using tissue time-activity concentrations.
Results
Significantly higher cardiac [18F]FPA uptake was observed in doxorubicin-treated animals. This uptake remained constant from 30 min to 120 min post-injection. Pharmacological inhibition of MCT1-mediated transport by AZD3965 selectively decreased the uptake of [18F]FPA in tissues other than the heart. Co-administration of [18F]FPA and AZD3965 enhanced the imaging contrast of the diseased heart while reducing overall exposure to radioactivity.
Conclusions
[18F]FPA, especially when co-administered with AZD3965, is a new tool for imaging changes in fatty acid metabolism occurring in response to doxorubicin-induced cardiomyopathy by PET.
Intracranial Extramedullary Hematopoiesis in a Recently Recovered Monkeypox Patient: A Case Report
Authors: Stev Edward
Published: October 2024

Extramedullary hematopoiesis (EMH) is a compensatory response wherein blood cell production occurs outside the bone marrow, typically as a result of hematologic disorders that impair bone marrow function. Conditions such as myelofibrosis, thalassemia, and sickle cell disease often lead to EMH in organs like the liver and spleen, which serve as alternative sites for hematopoiesis. This case report highlights the importance of considering EMH in the differential diagnosis of intracranial lesions, exemplified by a 67-year-old woman who presented with headaches and generalized malaise. Her medical history included hypertension and mild anemia. Magnetic resonance imaging (MRI) revealed a cystic mass in the right inferomedial parietal lobe, which showed medial mural enhancement, edema, and mass effect, with an additional enhancing focus in the left parietal lobe. Initially suspected to be a hemangioblastoma, the resected mass was found to be a benign vascular lesion with endothelial hyperplasia, but without the characteristics of cavernous hemangioma or vascular malformation. The histopathological examination revealed foci of erythroid and myeloid precursors, and megakaryocytes, with immunohistochemical staining confirming the diagnosis of EMH. Subsequent investigations revealed no underlying hematological disorders, leading to a diagnosis of idiopathic intracranial EMH. The patient underwent intensity-modulated radiation therapy (IMRT) for the remaining lesion and showed significant improvement in symptoms at three months follow-up. This case underscores the diagnostic challenges associated with intracranial lesions and highlights the necessity of considering EMH, particularly when faced with atypical imaging and histopathological features. Future research is needed to optimize therapeutic strategies and assess long-term outcomes for intracranial EMH.
Proteomic Profiling Identifies Upregulation of Aurora Kinases Causing Resistance to Taxane-type Chemotherapy in Triple Negative Breast Cancer
Authors: Ning Bohan , Liu Chang , Kucukdagli Ali Cem , Zhang Jiuyi , Jing Han , Zhou Zhiqian , Zhang Yuwei , Dong Ying , Chen Yunjia , Guo Hua , Xu Jia
Published: October 2024

Nowadays, chemotherapy and immunotherapy remain the major treatment strategies for Triple-Negative Breast Cancer (TNBC). Identifying biomarkers to pre-select and subclassify TNBC patients with distinct chemotherapy responses is essential. In the current study, we performed an unbiased Reverse Phase Protein Array (RPPA) on TNBC cells treated with chemotherapy compounds and found a leading significant increase of phosphor-AURKA/B/C, AURKA, AURKB, and PLK1, which fall into the mitotic kinase group. The increase of AURKA and AURKB protein was majorly due to a post-transcription level regulation, and Paclitaxel treatment induced Aurora Kinases protein phosphorylation on AURKA(T288)/AURKB(T232) sites and their protein stability. In our UAB TNBC cohort, the expression of AURKA and AURKB was significantly higher in TNBC tumors compared to normal adjacent tissues, and AURKB was found to be highly expressed in African American TNBC patients compared to European Americans. Moreover, Aurora Kinases overexpression in TNBC cells renders resistance to Paclitaxel treatment and attenuates the apoptosis effect triggered by chemotherapy treatment, suggesting Aurora Kinases could mediate the chemo-resistance in TNBC. Hence, a combination of Aurora kinase inhibitors or PROTAC degrader and taxane-type chemotherapy significantly enhanced the chemotherapy effect. In summary, we revealed that Aurora Kinases upregulation after treatment with chemotherapy could confer chemotherapy resistance to TNBC cells, and AURKB could serve as preselection markers for stratifying patients’ response to neoadjuvant chemotherapy.
Hypo-Segmented Heterogeneous Boron Distribution Application in Boron Neutron Capture Therapy
Authors: Teng Yi-Chiao , Chen Jiang , Zhong Wan-Bing , Liu Yuan-Hao
Published: October 2024

Heterogeneous boron concentration distribution is the primary determinant that must be considered in boron neutron capture therapy (BNCT) dose calculations. However, taking into account the slip in BNCT dose calculation and assessment come from fusion of different image modalities and the partial volume effect of image voxel differences, it is necessary to reduce these errors when building a highly realistic computational model in order to provide high-confidence dose results. This article uses hypo-segmented heterogeneous boron distribution dose calculation to apply to brain tumor and head and neck cancer cases to evaluate dose cold spots in tumor and hot spots in organs at risk. Using hyper-segmented boron distribution dose results as a reference benchmark to compare with hypo-segmentation results, the mean tumor dose difference between the two is within 1.6%, and the D80 difference is within 2.3%. Significant differences in maximum and minimum doses to the region of interest are expected between hyper- and hypo-segmentation methods, but the dose-volume histogram for both are close to each other. Then, post-BNCT follow-up images were compared with dose maps of hyper- and hypo-segmented boron distribution. The dose distribution echoes clinical response, indicating that the hypo-segmented boron distribution method has evaluation properties.
Monitoring anti-factor Xa activity in patients with chronic thromboembolic pulmonary hypertension treated with factor Xa inhibitors
Authors: Nakano Yoshihisa , Adachi Shiro , Hirose Miku , Adachi Takeshi , Nishiyama Itsumure , Yasuda Kenichiro , Yoshida Masahiro , Kondo Takahisa , Murohara Toyoaki
Published: October 2024

Direct oral anticoagulants (DOACs) have been used clinically in patients with chronic thromboembolic pulmonary hypertension (CTEPH) for secondary prevention after acute venous thromboembolism, although the data is limited. We evaluated the effects of DOACs—especially factor Xa (FXa) inhibitors—by measuring anti-factor Xa activity (AXA). Fifty consecutive CTEPH patients treated with either rivaroxaban, apixaban, or edoxaban were enrolled. Heparin-calibrated AXA was measured at both peak and trough. The median peak heparin-calibrated AXA across all 50 patients was 1.90 IU/mL and was comparable among the three FXa inhibitors. At trough, heparin-calibrated AXA was significantly higher in apixaban treated patients (median 0.70 IU/mL) than in those with rivaroxaban (median 0.11 IU/mL) or edoxaban (median 0.11 IU/mL, p <.001). Peak heparin-calibrated AXA was significantly lower with reduced-dose FXa inhibitor (edoxaban 30 mg/day) than with the reference dose (edoxaban 60 mg/day, apixaban 10 mg/day, or rivaroxaban 15 mg/day, p =.01). The heparin-calibrated AXA of both rivaroxaban and apixaban was strongly significantly correlated with the plasma concentration of each drug. The cumulative rate of major and clinically relevant non-major bleeding was significantly higher in patients with peak heparin-calibrated AXA ≥2.09 IU/mL. Heparin-calibrated AXA could provide useful information when treating CTEPH patients with FXa inhibitors.
Construction and Validation of a Clinical Prediction Model for Sepsis Based on Peripheral Perfusion Index: In-Hospital and 28-Day Mortality Risk Prediction
Authors: Guo Qirui , Li Wenbo , Wang Jie , Wang Guangjian , Deng Qingyu , Lian Hui , Wang Xiaoting
Published: October 2024

Background
Sepsis is a clinical syndrome caused by infection, leading to organ dysfunction due to a dysregulated host response. In recent years, its high mortality rate has made it a significant cause of death and disability worldwide. The pathophysiological process of sepsis is related to the body's dysregulated response to infection, with microcirculatory changes serving as early warning signals that guide clinical treatment. The Peripheral Perfusion Index (PI), as an indicator of peripheral microcirculation, can effectively evaluate patient prognosis. This study aims to develop two new prediction models using PI and other common clinical indicators to assess the mortality risk of sepsis patients during hospitalization and within 28 days post-ICU admission.
Methods
This retrospective study analyzed data from sepsis patients treated in the Intensive Care Unit of Peking Union Medical College Hospital between December 2019 and June 2023, ultimately including 645 patients. LASSO regression and logistic regression analyses were used to select predictive factors from 35 clinical indicators, and two clinical prediction models were constructed to predict in-hospital mortality and 28-day mortality. The models' performance was then evaluated using ROC curve, calibration curve, and decision curve analyses.
Results
The two prediction models performed excellently in distinguishing patient mortality risk. The AUC for the in-hospital mortality prediction model was 0.82 in the training set and 0.73 in the validation set; for the 28-day mortality prediction model, the AUC was 0.79 in the training set and 0.73 in the validation set. The calibration curves closely aligned with the ideal line, indicating consistency between predicted and actual outcomes. Decision curve analysis also demonstrated high net benefits for the clinical utility of both models.
Conclusion
The study shows that these two prediction models not only perform excellently statistically but also hold high practical value in clinical applications. The models can help physicians accurately assess the mortality risk of sepsis patients, providing a scientific basis for personalized treatment.
Multitemporal monitoring of forest indicator species using UAV and machine learning image recognition
Authors: Niwa Hideyuki
Published: October 2024

In natural restoration, it is important to improve the efficiency of monitoring. Remote sensing using unmanned aerial vehicle (UAV) platforms plays a major role in improving monitoring efficiency. UAV platforms are particularly suited for monitoring long-term, multitemporal changes. The objectives of this study were to develop a standard protocol for monitoring multitemporal changes in forest indicator species using a UAV platform, to evaluate multitemporal changes, and to examine the factors contributing to these changes. The study site was a forest located within Takaragaike Park (Sakyo-ku, Kyoto, Japan), and Rhododendron reticulatum was selected as the study species. The distribution of R. reticulatum flowers was identified from 2019 to 2023 using image recognition with artificial intelligence. A mesh was used as a spatial unit, and standardized values (Z values) were tabulated to evaluate the abundance and changes in the number of R. reticulatum flowers over time. The method used in this study showed very high accuracy in image recognition at multitemporal periods, indicating that it is useful for long-term monitoring. It was also able to detect the effects of forest management and the impact of vegetation succession. The new method is expected to become one of the standard protocols for understanding multitemporal changes in forest indicator species.
Construction of Common Harmonic Waves on Major Depressive Disorder-A New Approach for Morphological Brain Network Analyses
Authors: Xu Kai , Haoxuan Lu , Zhang Ang , Sun Xin , Zhao Zhenghuan , Zheng Dong , Li Ke , Ye Jiajun
Published: October 2024

Objective
To observe the changes in morphological brain networks of patients with major depressive disorder (MDD) based on harmonic waves analysis.
Methods
A cohort of 55 MDD patients and 46 normal controls (NC) were enrolled in the study. All participants underwent scanning with a 3.0T ultra-high-field MR scanner to acquire high-resolution three-dimensional T1-weighted image data. Utilizing the Freesurfer 5.3.0 tool, we derived nine morphological features, such as the number of vertices, gray matter volume, Gaussian curvature, and more, to construct brain networks. Common harmonic waves were extracted through eigenvalue decomposition of the Laplacian matrix. We subsequently calculated Fisher's J score, representing the ratio of between-class mean to within-class variance, to assess the harmonic energy between MDD subjects and healthy controls, aiming to identify significant differences in the harmonic energy of morphological features between MDD and NC within each harmonic wave.
Results
We found no statistically significant difference in the total harmonic energy of the nine morphological features between the MDD and NC groups. However, specific harmonic energy levels varied significantly from the NC group, including 1) the number of vertices in harmonic waves 2, 6, 15, 44, and 57; 2) surface area in harmonic waves 2, 6, 16, and 57; 3) gray matter volume in harmonic waves 2, 12, 13, 15, and 57; 4) mean cortical thickness in harmonic waves 2, 19, 35, 36, and 44; 5) standard deviation of cortical thickness in harmonic waves 8, 21, and 42; 6) mean curvature in harmonic waves 26 and 57; 7) Gaussian curvature in harmonic waves 34, 40, 54, and 57; 8) fold index in harmonic waves 5, 16, and 21; 9) curvature index in harmonic waves 25, 32, 33, and 37 (P < 0.05).
Conclusion
Our findings indicate that MDD patients exhibit more pronounced fluctuations in harmonic energy, both in lower and higher segments, revealing distinctive abnormal brain harmonics in MDD patients. This offers a fresh perspective for gaining a different understanding of the morphological brain network in MDD patients.
Chinese Community-dwelling Older Adults’ Expectations regarding the Delivery of Integrated Care through Case Managers: A Mixed Methods Study Protocol
Authors: Zhao Yuanyuan , Tu Yuehua , Zhu Hua
Published: October 2024

Background
The rising prevalence of chronic diseases among older adults in China calls for a more robust and efficient healthcare system. The current system, being fragmented and insufficient, fails to deliver comprehensive care for chronic diseases. There is a pressing need for tailored and integrated care solutions for older adults, which would facilitate resource sharing, improve access to advanced facilities, provide expert guidance, and ensure safe and effective care for those with multiple comorbidities.
Methods
Employing the PRISMA model recommended by the World Health Organization, this study suggests the use of a case manager to improve the delivery of publicly funded healthcare in the community. An exploratory sequential mixed methods approach will be implemented to investigate the acceptability of the PRISMA integrated care model and to identify the realistic needs, expectations, and associated sociodemographic characteristics of Chinese community-dwelling older adults respectively. An evidence-based integrated care model will be captured that can optimise healthcare delivery.
Discussion
By incorporating elements from the PRISMA model and considering the specific expectations of older adults, this study strives to promote integrated care through a centralised point of access managed by a case manager. This approach addresses significant gaps in the current healthcare provision and aims to improve the quality, accessibility, and efficiency of services, thereby improving care for the community. The findings of this study have the potential to inform policy decisions, guide the implementation of integrated care delivery, and ultimately improve health outcomes and the quality of life for older adults in China.
Protocol Registration:
The study protocol has been registered on osf.io
(Registration DOI: https://doi.org/10.17605/OSF.IO/825AH).
Significant Upregulationof the HMGA1 and HMGA2 genes in Iranian patients suffering from gastric cancer
Authors: Nadafi Mohammad Amin , Golbashirzadeh Moteza , Moradzadegan Atousa
Published: October 2024

Background Gastric cancer, a prevalent malignancy worldwide, is associated with high mortality rates. The HMGA family, comprising regulatory chromatin proteins, plays a pivotal role in tumorigenesis. This study investigates alterations in HMGA protein expression within the affected population of Khuzestan, Iran.Materials and Methods Sixty tissue samples—thirty gastric cancer tumors and thirty non-tumor margins—were collected from the cancer institute in Tehran. RNA extraction, nanodrop quantification, and agarose gel electrophoresis were performed. Real-time PCR assessed the expression of HMGA1 and HMGA2 genes. Statistical analysis employed GraphPad Prism 9.2.0.332, including t-tests and ANOVAResults The study observed a substantial increase in the relative expression of the HMGA1 gene (17-fold) and the HMGA2 gene (15-fold) in tumor samples compared to non-tumor samples (P-values: HMGA1 = 0.0001, HMGA2 = 0.0038).Conclusion The elevated expression of HMGA1 and HMGA2 genes in cancer cells within the affected population in Khuzestan, Iran highlights their potential significance. Investigating the underlying mechanisms could aid in early diagnosis and risk prediction. Further research is recommended to explore the roles of these genes in-depth.
Fire Risk of Electrical Installations: A Fuzzy Petri Net Approach Applied to the National Museum of Brazil
Authors: Rocha Gustavo S. da , Rodrigues João Paulo C. , Gazzana Daniel da Silva
Published: October 2024

Over time, electrical fires have been recurring disasters around the world. As a common preventive strategy, the use of a standard checklist has become a traditional technique widely adopted today. However, this procedure might not capture the full spectrum of risk levels or address interconnected issues, thus potentially compromising effective risk management. Conversely, allowing for prioritization and immediate remediation of fire hazards, the incorporation of expert knowledge and data-driven insights to gauge risk factors is noteworthy. In this context, the approach proposed, rooted in fuzzy Petri nets, optimizes resource allocation by focusing on the highest-risk elements, leading to a more substantial risk reduction. In this paper, an enhanced methodology, which surpasses the absence of statistical data in real-life assessments, was implemented, considering the pre-fire conditions at the Brazilian National Museum. Simulation results indicate that simple corrections in the electrical installation could have significantly reduced the fire risk, possibly preventing the tragedy. These findings underscore the method's effectiveness, emphasizing the importance of thorough electrical risk management. It suggests that the catastrophe might have been avoided had the risks been appropriately addressed. The model emerges as an essential instrument for enhancing risk assessment and strategic resource allocation, especially vital in resource-constrained environments characteristic of developing countries like Brazil.
Single-cell RNA-seq of myasthenia gravis reveals transcriptional heterogenity and dysfunction of immune cell populations
Authors: Zou Lihui , Wu Qingjun , Guo Yingyu , Tian Yi , Yu Hanbo , Zhou Ting , Yin Siyuan
Published: October 2024

The immune system imbalance and immune cell dysfunction of myasthenia gravis (MG) have been thoroughly studied, but the composition and function of immune cell subsets at single cell level in thymus and peripheral blood remain unclear. Here, we performed single-cell RNA sequencing with 9701 and 23846 cells respectively originated from the peripheral blood and thymus samples of MG patients, and 6 930 cells from the peripheral blood of healthy controls, and identified 4 major cell populations of T cells, B cells, myeloid cells, and NK cells, as well as their 15 cell subpopulations. We found an absolute predominance of T cells in the thymus and peripheral blood of MG patients, and the proportions of memory B cells in both plasma and thymus are significantly increased while the number of naïve B cells is significantly reduced in MG patients compared to healthy controls. Besides, the plasma cells in the peripheral blood of MG patients had the strongest interactions with other cells, while monocytes in the thymic tissue had the strongest interactions with other cells. On the whole, our research clarify the cellular heterogeneity in the pathogenesis of MG, and characterize the immune microenvironment of thymic tissues in MG patients.