bluuebunny/crossref_metadata_2025 huggingface dataset:
Strategies for the Use of Antithrombotic Drugs in Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention. A review Article
Authors: Khalifa Ahmed Mohammed Ali , Alamoodi Abdullah. A. , Muthanna Fares M.S
Published: December 2024

Atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) pose a significant therapeutic challenge due to the need for effective anticoagulation and antiplatelet therapy. This review examines the strategies used to manage anticoagulation in AF patients undergoing PCI, focusing on dual antiplatelet therapy (DAPT), anticoagulants, and the complexities of combining these therapies. We explore the use of various anticoagulants, including unfractionated heparin (UFH), low molecular weight heparin (LMWH), bivalirudin, warfarin, and direct oral anticoagulants (DOACs), with particular attention to their mechanisms of action, dosing regimens, and potential risks. The review also discusses the use of DAPT in combination with anticoagulation therapy, highlighting the increased bleeding risks associated with these therapies. The duration of DAPT and the option of triple therapy, combining anticoagulation with DAPT, are examined, with a focus on optimizing the duration of treatment to reduce complications. Key challenges, including bleeding risks, kidney function, and the choice of anticoagulant, are addressed, emphasizing the need for individualized treatment plans. Based on the evidence reviewed, we propose recommendations for managing anticoagulation in AF patients undergoing PCI, stressing the importance of balancing thromboembolic risk with bleeding complications. This review aims to provide a comprehensive framework for clinicians in selecting the most appropriate anticoagulation strategy for AF patients undergoing PCI.
Excessive Internet Use Among Adolescents in Yemen: Prevalence, and Health Implications
Authors: Basodan Maha , Moqbel Amr Esam , Fadhle Ahmad Mohammed , Abdulwadood Ayman , Qahtan Qahtan Afnan Abdulwadod , Ahmad Ezzaldeen Naser Ali , Alyafey Rayan Yousef Mohammed , Al-Qattibi Sultan Ahmed Fadl , Saeed Al-Hasan Ali Saleh , Tarmoom Yousef Mohammed , Muhammad Zaher Abdel-Qawi , Ali Hareth Mohammed , Sylan Hassan Ali Saleh , Salim Hamza Mohammed , Saeed Hudhaifa Mohammed , Jaem Oasama , Ba-Makhramah Abdullah Awadh Abdullah , Mossed  Al-Khatab Abdullah , Almoflehy Khaled Abdulrahman , Alqhes Ahmad Ali Saleh , Al_Azraqi Osama Nasr Saif Qayed , Alsakkaf Arwa Adnan , Shaher Fahmi
Published: December 2024

The research examines the effects of internet and social media utilisation on the physical and mental health of students aged 15-19 at Al-Bayhani School in Aden, Yemen. The study included 64 students from a total population of 205, who were evaluated on their perceptions of the impact of internet and social media usage on their health. The findings indicated that 75% of children allocate 2 to 6 hours each day to internet usage, exhibiting uniform habits across all school levels. This study also indicated that 23.4% of students encountered heightened isolation, while 60.9% reported experiencing anxiety in the absence of internet connection. Physical health problems including ocular or cervical discomfort, adverse impacts on physical activity and sleep quality, and a considerable detrimental influence on academic performance. The research highlights the necessity for judicious and ethical internet utilisation to alleviate these hazards and optimise its advantages for students.
The Concept of Experimental Psychology as Part of the Reconstruction of Islamic Psychology: An Educational Perspective
Authors: Rahman Imas Kania , Andriana Nesia , Elita Desi
Published: December 2024

This study explores the integration of experimental psychology within an Islamic framework to contribute to the reconstruction of Islamic psychology from an educational perspective. Using qualitative descriptive analysis, this research examines how experimental methods, when adapted to Islamic ethical standards, can enhance the validation and applicability of Islamic psychological concepts in educational settings. Findings indicate that while experimental psychology offers valuable tools for empirical inquiry, its application within Islamic psychology requires modifications that respect spiritual dimensions central to Islam. This integration supports a holistic approach to student development, addressing cognitive, emotional, and moral growth. The study highlights the potential for a culturally relevant educational model that aligns with both scientific rigor and Islamic values, offering a foundation for further research and practical applications in Islamic educational psychology
Marketing Mix Implementation Strategy in Improving Teacher Performance: A Study at State Senior High Schools In Bandung City
Authors: Sinaga Herty Ramayanti
Published: December 2024

This study examines the impact of marketing mix elements (Product, Price, Promotion, Place) on teacher performance in Bandung City’s State Senior High Schools. Using quantitative methods and multiple regression analysis, the findings reveal that Product and Place have the strongest positive influence, while Price moderately contributes, and Promotion shows limited direct impact. Validity, reliability, and normality tests confirm robust data quality. The results emphasize the importance of curriculum innovation, equitable incentives, and quality infrastructure in enhancing teacher performance. Recommendations for holistic improvements in education management are discussed.
Fossil fish assemblage of the Laguna Formation, Philippines: Unveiling the uniqueness of Pleistocene freshwater ecosystems in Southeast Asia
Authors: Přikryl Tomáš , Castro Abigael , Fernando Allan Gil , Nogot Jaan Ruy Conrad , Magtoto Clarence , Garas Kevin , Mediodia Dominique , Lin Chien-Hsiang
Published: December 2024

This study offers a comprehensive analysis and detailed description of the fossil fish assemblage from the Pleistocene Laguna Formation in Luzon Island, Philippines. The fish fossils were collected from the deeper lacustrine facies of the formation, and a total of three fish families were identified. The identification is based on the recognizable synapomorphies in 10 moderately preserved semi-articulated individuals of ray-finned fish specimens, some of which include counterparts. The assemblage is predominantly composed of small clupeiforms of the family Dorosomatidae, accompanied by a gobioid fish (Gobiidae or Oxudercidae) and a synbranchid specimen (Synbranchidae), each represented by a single specimen. This taphocoenosis preserves free-swimming dorosomatids and demersal gobioid and synbranchid, suggesting an autochthonous assemblage with minimal postmortem sorting. Despite all recognized taxa being tolerant to changes in salinity, the environment is inferred to have been freshwater, analogous to modern Taal Lake, where a freshwater sardine thrives. This study represents the first systematic description of freshwater fish fossils in the Philippines and marks the first discovery of these taxa in the tropical West Pacific region.
The obesity paradox in osteoporosis risk among older adults is mostly driven by women: a population-based prospective study
Authors: Luo Qingfeng , Zhang Shiyong , Liang Zixin , Wang Danni , Zhong Yanlin , Xia Bin , Xie Peng , Wang Can , Yuan Jinqiu , Zhang Ziji , Li Xingsheng
Published: December 2024

Objectives
The obesity paradox is widespread among older adults at risk for various diseases, including the unclear association between obesity and osteoporosis (OP) risk. This study aimed to investigate the association between obesity and OP risk in an older population.
Methods
A cross-sectional and prospective study was conducted based on the UK Biobank cohort. The association of body mass index (BMI), waist circumference (WC), and fat percentage with BMD was examined using Spearman correlation analysis with baseline BMD data. Cox proportional hazards regression analysis was used to investigate the association between obesity and OP risk. Restricted cubic spline (RCS) were used to assess the nonlinear associations of BMI, WC, and fat percentage with OP.
Results
Baseline cross-sectional analyses revealed a positive association between BMI, WC, and fat percentage with BMD in women, while no significant correlation was found in men. Cox analyses showed that obesity as defined by BMI, WC, and fat percentage was associated with a 33%, 23%, and 31% reduction in the risk of OP in women but not in men, respectively. Conjoint analysis showed that lower BMI was associated with increased risk of OP in older adults, whereas the lowest risk was observed in women with higher BMI and higher body fat. RCS revealed an inverse J-shaped nonlinear association between obesity metrics and OP risk in women.
Conclusion
Lower BMI is an independent risk factor for OP in older adults, and the obesity paradox for OP risk exists only in women.
Spatio-temporal segregation between sensory relay and swallowing pre-motor population activities by optical imaging in the rat nucleus of the solitary tract.
Authors: Fuse Shinya , Sugiyama Yoichiro , Dhingra Rishi R. , Hirano Shigeru , Dutschmann Mathias , Okada Yasumasa , Oku Yoshitaka
Published: December 2024

The nucleus tractus solitarius (NTS) contains neurons that relay sensory swallowing commands information from the oropharyngeal cavity and swallowing premotor neurons of the dorsal swallowing group (DSG). However, the spatio-temporal dynamics of the interplay between the sensory relay and the DSG is not well understood. Here we employed fluorescence imaging after microinjection of the calcium indicator into the NTS in an arterially perfused brainstem preparation of rat (n = 8) to investigate neuronal population activity in the NTS in response to superior laryngeal nerve (SLN) stimulation. Respiratory and swallowing motor activities were determined by simultaneous recordings of phrenic and vagal nerve activity (PNA, VNA). Analysis of SLN stimulation near the threshold triggering a swallowing allowed us to analyze Ca2+ signals related to the sensory relay and the DSG. We show that activation of sensory relay neurons triggers spatially confined Ca2+ signals exclusively unilateral to the stimulated SLN at short latencies (114.3 ± 94.4 ms). However, SLN-evoked swallowing triggered Ca2+ signals bilaterally at longer latencies (200 ± 145.2 ms) and engaged anatomically distributed DSG activity across the dorsal medulla oblongata. The Ca2+ signals originating from the DSG preceded evoked VNA swallow motor bursts, thus the swallowing premotor neurons that drive laryngeal motor pools are located outside the DSG. In conclusion, the study illuminates the spatial-temporal features of sensory-motor integration of swallowing in the NTS and further supports the hypothesis that the NTS harbors swallowing pre-motor neurons that may generate the swallowing motor activity while first order pre-motor pools are located outside the DSG.
Unraveling the microstructure evolution and element diffusion behavior of gradient nanostructured heat-resistant stainless steel during high-temperature oxidation
Authors: Wei L. L. , Xia C.H. , Wang Y.G. , Kundin J. , Jin X.J.
Published: December 2024

Thermal stability of nanocrystalline grains is a crucial factor that determines the unique microstructure and properties of the gradient nanostructured (GNS) materials at elevated temperatures. Nevertheless, oxidation is unavoidable for GNS metal materials utilized at high temperatures, potentially impacting the microstructure stability. In this study, we reveal the correlation between the high temperature selective oxidation and the thermal stability of GNS layer through experimental research and phase-field simulations. The improved anti-oxidation property of GNS samples was ascribed to the excellent thermal stability of (Cr, Mn)3O4 oxides and a large proportion of low-energy twin boundaries. After prolonged oxidation, the GNS layer exhibited a bimodal microstructure. To analyze the elemental diffusion mechanism and microstructure evolution in the GNS layer, the phase-field simulation technique was employed. Selective oxidation led to the concentration of chromium reduced in the region near grain boundary, thereby diminishing the thermal stability of the grains and causing abnormal grain growth in the surface layer. Particularly, grain growth had conduction effect, the topmost grains coarsening will cause grain growth in the underlying layers, and subsequently, the grains in the interior region will also be gradually affected.
Efficacy of radiotherapy to local recurrence and distant metastasis nasopharyngeal carcinoma: long-term retrospective multicenter study
Authors: li lu , Deng Mingyou , Ren Jianlan , Liao Wenjun , Zheng Liangjian , Ma Hui , Lang Jinyi , Feng Mei , Luo Yangkun
Published: December 2024

Purpose
The patients with locoregional recurrence and distant failure after initial treatment was a unique group of nasopharyngeal carcinoma(NPC). This patients population presented unique challenges in management: when and in what sequence to add radiotherapy(RT) to address locoregional and distant disease.
Methods
This retrospective multicenter investigation enrolled local recurrence and distant metastasis (rmNPC) from five hospitals. Kaplan-Meier and log-rank tests were utilized for survival assessment of patients with distinct profiles of recurrence and metastasis, as well as diverse treatment modalities. Additionally, we employed the Cox regression model to investigate the stand-alone risk factors influencing the survival of patients with local recurrence and distant metastasis (rmNPC).
Results
52 patients were enrolled in the study, the median follow up time was 68.3 months (range: 7-240 months). The median overall survival (OS) time was 23.4 months (range: 11.1–35.6 months), with 1, 2, 3, 4 and 5 years OS rates of 61.3%, 46.5%, 31.0%, 27.9%, 10.5% respectively. OS had no statistical difference in treatment modalities(p = 0.071), the median OS was 10.8 months (95% CI, 7.7 to 13.9) for chemotherapy alone, 24.2 months (95% CI, 8.9 to 39.4) for chemotherapy combined with PD-1 inhibitors, and 47.1 months (95% CI, 10.2 to 84.0) for chemotherapy combined with radiotherapy. Among patients with oligometastasis, those who received radiotherapy exhibited a prolonged OS (50.1 vs. 24.1 months, p = 0.021), whereas patients with polymetastasis who received radiotherapy failed to experience a substantial extension in OS (8.6 vs. 14.8 months, p = 0.168). Similarly, among patients with one-organ metastasis, radiotherapy was intricately linked to extended OS(50.1 vs. 24.1 months, p = 0.026), while patients with multiple organ metastases did not demonstrate a substantial OS benefit from radiotherapy (8.6 vs. 11.0 months, p = 0.831).
Conclusions
The combines radiotherapy shows the promising efficacy for rmNPC patients with one-organ metastasis or oligometastasis.
Developmental exposure to perfluorooctanoic sulfonate（PFOS） impairs the endometrial receptivity
Authors: Ren Rui , Zhou Xinyue , Jia Tianyu , Wang Bin , Liu Ahui , Song Ji , Wang Liyan , Jing Yuanxue , Yu Liulin , Shen Haofei , Zhang Xuehong , Gao Min
Published: December 2024

Perfluorooctanoic sulfonate (PFOS) is difficult to degrade and tends to accumulate in the body, which causes widespread concern. The expression of genes related to endometrial receptivity and the differentiation of human endometrial stromal cells (hESCs) were assessed in this study concerning PFOS. In this study, we investigated the effect of PFOS exposure on endometrial tolerance by cell and animal experiments. The activity against endometrial mesenchymal cells was significantly reduced by PFOS intervention, and the apoptosis flow assay results showed that PFOS significantly promoted cell death in a concentration-dependent manner. Transmission electron microscopy results revealed mitochondrial damage in the PFOS-intervened group, and WB results showed that the expression levels of endometrial tolerance-related proteins Homeobox A10 (HOXA10) and integrin beta3 (ITGB3) were decreased, and the expression level of Forkhead box O1 (FOXO1) protein was increased. Animal studies have shown that PFOS can affect the locomotor cycle in mice, and significant damage to pinopodes morphology was observed after PFOS exposure administration. In the present study, we found that PFOS may synergistically affect the viability of endometrial mesenchymal stromal cells through accumulation in vivo, and that PFOS may contribute to the failure of embryo implantation by affecting mitochondrial function and consequently endometrial permissive sites.
High Abundance of Gut Bacteroides in Early Childhood correlates with Microbiome Stability and Resilience after Antibiotic Treatment and with Increased Risk for Childhood Infections
Authors: Hauptmann Matthias , Gottschick Cornelia , Muthukumarasamy Uthayakumar , Klee Bianca , Strowig Till , Mikolajczyk Rafael , Schaible Ulrich Emil
Published: December 2024

Background
Early childhood events, up to the age of two, are critical for the development of the microbiome and balanced immunity later in life. We investigated whether susceptibility to infections and microbiome resilience after antibiotic treatment are associated with key taxa in the early childhood microbiota. Therefore, we performed longitudinal microbiota analysis from stool samples of children within the German LöwenKIDS intensified subcohort. According to the exposure to antibiotic treatment, sample groups were defined as never-treated controls, 45–225 days pre-treatment (pre45-225), 0–30 days pre-treatment (pre0-30), 0–30 days post-treatment (post0-30), or > 90 days post-treatment and age > 540 days (post > 90).
Results
1176 stool samples of 162 children were included in our analysis, of which 49 children received antibiotics. Using generalized linear mixed models adjusted for age, we show that high abundance of Bacteroides was associated with receiving antibiotic treatment later, while low Bacteroides abundance before treatment was associated with low alpha diversity and increased beta diversity post treatment.
Conclusions
Our data suggest a key role of the genus Bacteroides for the susceptibility to infections requiring antibiotic treatment and for microbiome stability and resilience in early childhood.
Treatment of limb skin defect with self-made skin distractor
Authors: Lei Gao , Kai Li , Yanlong Zhang , Hongrun Wang , Shibo Liu , Yong Wang , Aqin Peng
Published: December 2024

Objective To investigate the effect of self-made skin distractor in the treatment of limb skin defects.
Methods From September 2018 to January 2020, 15 cases of limb skin defects (16 wounds) were treated with self-designed skin distractor, including 13 males and 2 females, with an average age of 42 years (range, 9-73 years). The smallest area of skin defect was 6cm×3cm, the largest was 32cm ×7cm, with an average of 72.4cm2. The wound healing was observed, complications and the time of use of the distractor were recorded.
Results All patients were followed up for 6-12 months with an average of 9.2 months. Of the 16 wounds in 15 patients, 2 wounds were closed in one stage during operation, 13 wounds were delayed in primary closure. Skin incision occurred in 1 case, but the wound closure was not affected；One wounds were not closed completely, because the skin was cut by Kirschner wire, and could not be stretched continously. The remaining wounds were closed by skin grafting. Another case also had skin cutting was occurred in another case, but the wound closure was not affected. No skin stretch was terminated due to pain. All wounds were healed. The elasticity and color of the skin on the wound surface were not different from the surrounding skin. The movement of the adjacent joints was basically normal.
Conclusion The self-made skin stretcher is simple in structure and easy to use. It provides a reliable and effective method for the treatment of skin defects of limbs.
The Establishing of Stellate Ganglion Regulation Model in Mice by Using Infrared Polarized Light Irradiation
Authors: Zhao Kaixuan , Zhang Haoyue , Liu Yanbo , Zhou Ying , Zhi Juan , Wang Qianyu , Yang Dong
Published: December 2024

Objective
To explore the feasibility of establishing a mouse stellate ganglion (SG) regulation model through infrared polarized light (IPL) irradiation of the SG, and preliminarily evaluate its effects on SG function and related physiological indicators.
Methods
BALB/c mice were randomly divided into control, Sham surgery, and IPL groups, with 8 mice in each group. A ZZIR-ID therapeutic device was used to directly irradiate bilateral SG regions of IPL group mice, with wavelength 980 nm, power density 1000 mW/cm2, 15 minutes each time, every other day for 6 times. The control group received no treatment, while the Sham surgery group received IPL irradiation on the top of the head. Horner's syndrome manifestations were observed and eye temperature was measured before and immediately after treatment. Heart rate changes were continuously recorded.
Results
Compared with the control and Sham surgery groups, the incidence of Horner's syndrome in the IPL group increased significantly (P < 0.05), manifesting as bilateral ptosis and enophthalmos, lasting about 2 hours. Immediately after treatment, eye temperature in the IPL group increased significantly compared to pre-treatment (P < 0.05). Heart rate in the IPL group decreased significantly 30 minutes post-treatment compared to pre-treatment (P < 0.01), lasting 1–2 hours. There was no statistically significant difference in weight changes between groups (P > 0.05).
Conclusion
IPL irradiation of SG can effectively induce Horner's syndrome in mice, elevate eye temperature, reduce heart rate, and exert certain anti-inflammatory immunomodulatory effects. This provides experimental evidence for IPL as a novel method to establish SG regulation models.
Heat Transfer Visualization of Transitional Growth of Turbulent Spot on a Wedge in Mach 5.2 Hypersonic Flow Using Fast-Response TSP
Authors: Yoshikawa Kosuke , Ozawa Hiroshi
Published: December 2024

In the present study, the propagation velocity and lateral spreading angle of turbulent spots on a wedge in transient hypersonic boundary layer flows were investigated and characterized by measuring the heat flux distribution using a fast-response Temperature-Sensitive Paint (TSP) in a shock tunnel facility. The shock tunnel was operated under the over-tailored condition and provided with the low- to high unit Reynolds number during a test duration, which was realized by the contact surface arrival in the shock tube that changed the temperature and density of the reservoir gas. Power Spectral Density (PSD) estimated from the pressure recordings may indicate that the boundary layer flow was transitional. In TSP measurements, the global heat flux distribution on the wedge was accurately obtained qualitatively. Surprisingly, turbulent spots were visualized using TSP for each unit Reynolds number condition. The propagation velocities at the head, peak heat flux point, and tail of turbulent spots for low- and high unit Reynolds number conditions were approximated from the TSP images to be 87 ~ 96%, 69 ~ 73%, and 52 ~ 57% of the boundary layer edge velocities at each condition, respectively. These results were in good agreement with the available data in previous investigations. The lateral spreading angle of turbulent spots was also measured to be 5˚~10˚ from the TSP images. This study showed that the fast-response TSP had the ability to visualize the temporally resolved turbulent spots by measuring the heat flux on the wedge.
Ca2+-dependent H2O2 response in roots and leaves of barley - A transcriptomic investigation
Authors: Bhattacharyya Sabarna , Bleker Carissa , Meier Bastian , Giridhar Maya , Rodriguez Elena Ulland , Braun Adrian Maximilian , Peiter Edgar , Vothknecht Ute C. , Chigri Fatima
Published: December 2024

Background
Ca2+ and H2O2 are second messengers that regulate a wide range of cellular events in response to different environmental and developmental cues. In plants, stress-induced H2O2 has been shown to initiate characteristic Ca2+ signatures; however, a clear picture of the molecular connection between H2O2-induced Ca2+ signals and H2O2-induced cellular responses is missing, particularly in cereal crops such as barley. Here, we employed RNA-seq analyses to identify transcriptome changes in roots and leaves of barley after H2O2 treatment under conditions that inhibited the formation of cytosolic Ca2+ transients. To that end, plasma membrane Ca2+ channels were blocked by LaCl3 application prior to stimulation of barley tissues with H2O2.
Results
We examined the expression patterns of 4246 genes that had previously been shown to be differentially expressed upon H2O2 application. Here, we further compared their expression between H2O2 and LaCl3+H2O2 treatment. Genes showing expression patterns different to the previous study were considered to be Ca2+-dependent H2O2-responsive genes. These genes, numbering 331 in leaves and 1320 in roots, could be classified in five and four clusters, respectively. Expression patterns of several genes from each cluster were confirmed by RT-qPCR. We furthermore performed a network analysis to identify potential regulatory paths from known Ca2+-related genes to the newly identified Ca2+-dependent H2O2 responsive genes, using the recently described Stress Knowledge Map. This analysis indicated several transcription factors as key points of the responses mediated by the cross-talk between H2O2 and Ca2+.
Conclusion
Our study indicates that about 70% of the H2O2-responsive genes in barley roots require a transient increase in cytosolic Ca2+ concentrations for alteration in their transcript abundance, whereas in leaves, the Ca2+ dependency was much lower at about 33%. Targeted gene analysis and pathway modeling identified not only known components of the Ca2+ signaling cascade in plants but also genes that are not yet connected to stimuli-associated signaling. Potential key transcription factors identified in this study can be further analyzed in barley and other crops to ultimately disentangle the underlying mechanisms of H2O2-associated signal transduction mechanisms. This could aid breeding for improved stress resistance to optimize performance and productivity under increasing climate challenges.
Long-Term Outcomes of Corpus Callosotomy in Adult Patients with Drug-Resistant Epilepsy; Results from a Single Neurosurgical Center in Mexico
Authors: Pichardo-Rojas Diego , Pech-Cervantes Claudio Hiram , Macias-Lopez Jonathan Ulises , Camarena-Rubio Karen Janely , Río-Quiñones Manuel Alejandro Del , Ballesteros-Herrera Daniel , Paredes-Aragon Elma , Hernandez-Vanegas Laura E , Pichardo-Rojas Pavel S , Mejía-Pérez Sonia Iliana
Published: December 2024

Objective Corpus callosotomy (CC) is a commonly indicated palliative surgery for Drug-Resistant Epilepsy (DRE). While younger age at the time of surgery is a well-established positive prognostic factor, there is limited evidence on long-term outcomes in adult patients with DRE. A study that evaluates seizure control at various follow-up points is necessary to better understand the outcomes of CC.Methods In this retrospective longitudinal cohort we included adult CC patients operated by our institution’s epilepsy surgery service between 1993 and 2023. We compiled epilepsy etiology, preoperative seizure frequency, and postoperative seizure outcomes at < 1-year follow-up, 1–3 years follow-up, and > 3 years of follow-up. Our outcomes were seizure freedom and response rate (50% frequency decrease from preoperative).Results We analyzed data from 63 patients. The most common indication for CC was DRE due to Lennox-Gastaut Syndrome. Median seizure frequency had a significant decrease from preoperative (70 seizures per month [spm], IQR = 16–210) to the 1-year follow-up (4 spm, IQR = 0–20, p = < 0.0001), 1–3 years follow-up (8 spm, IQR = 1–30, p = < 0.0001), and > 3 years of follow-up (7 spm, IQR = 2.25-30, p = < 0.0001). Seizure freedom at one year postoperative decreased from 25.4–9.7% at 1–3 years (p = 0.032), while the overall response rate of our sample remained consistent, being 81% at 1-year follow-up and 70% at the long-term follow-up (p = 0.20).Conclusion We identified that CC effectively decreases seizure frequency in adult patients with DRE. The reduction of seizure frequency after CC remained consistent after the first postoperative year. Prospective clinical trials are needed to better understand the long-term outcomes of CC in adults.
Spatial accuracy of dose delivery significantly impacts the planning target volume margin in linear accelerator-based intracranial stereotactic radiosurgery
Authors: Takahashi Yuta , Oshika Riki , Tachibana Rie , Shirai Katsuyuki , Asakura Hiroshi , Miyazaki Masayoshi , Sagawa Tomohiro , Takahashi Shinichi , Kuwae Tsunekazu , Kojima Hironori , Nishiyama Shiro , Nemoto Hikaru , Ishihara Yoshitomo , Umeda Mariko , Kijima Kotaro , Kobayashi Daisuke , Suzuki Keiji , Nozawa Yuki , Hoshida Kento , Kitagawa Tomoki , Endo Hiromitsu , Matsunaga Yuki , Itagaki Hiroya , Ishida Mayumi , Kanahara Shigeru , Horita Ryo , Hori Daisuke , Tachibana Hidenobu
Published: December 2024

The impact of three-dimensional (3D) dose delivery accuracy of C-arm linacs on the planning target volume (PTV) margin was evaluated for non-coplanar intracranial stereotactic radiosurgery (SRS). A multi-institutional 3D starshot test using beams from seven directions was conducted at 22 clinics using Varian and Elekta linacs with X-ray CT-based polymer gel dosimeters. Variability in dose delivery accuracy was observed, with the distance between the imaging isocenter and each beam exceeding 1 mm at one institution for Varian and nine institutions for Elekta. The calculated PTV margins for Varian and Elekta linacs that could cover the gross tumor volume with 95% probability at 95% of the institutions were 2.3 and 3.5 mm, respectively, in the superior–inferior direction. However, with multifactorial system management (i.e., high-accuracy 3D dose delivery with rigorous linac quality assurance, strict patient immobilization, and high intra-fractional positioning accuracy), these margins could be reduced to 1.0 mm and 1.5 mm, respectively. The findings indicate significant millimeter-level variability in 3D dose delivery accuracy among linacs installed in clinical settings, but effective system management can achieve PTV margins below 2 mm, suitable for SRS applications.
Temperature Monitoring Under Regional Anesthesia: Tympanic Temperature vs Temple Touch Pro™ Core
Authors: Racca Fabrizio , Ruvolo Domenico , Pogliano Marco , Caputo Giorgia , Savarese Benedetta , Racca Giulia , Conti Elena , Cascio Nunzio Dario , Barberis Luigi , Mahajan Aman , Planinsic Raymond , Longhitano Yaroslava , Via Luigi La , Deana Cristian , Zanza Christian , Leo Mirco
Published: December 2024

BACKGROUND
Perioperative hypothermia is a common finding with potential associated complications. Tympanic temperature measurement (Temptympanic) is the most commonly used method for assessing core temperature in patients undergoing neuraxial anesthesia. The Temple Touch Pro™ (TTP™) is a new, totally non-invasive core temperature monitoring device, allowing temperature measurement in conscious patients undergoing regional anesthesia. We tested the hypothesis that this tool estimates core temperature to an accuracy within 0.5ºC.
METHODS
Core temperature was continuously monitored in adult surgical patients by positioning the TTP™ sensor over the skin above the temporal artery (TempTTP). Reference temperature was Temptympanic. Accuracy of the two methods was assessed by Bland-Altman comparisons of differences with multiple measurements and by Pearson correlation coefficient analysis.
RESULTS
A total of 199 pairs of TempTTP and Temptympanic were measured for 23 patients. The 92.5% difference in temperature measured between TTP™ and the reference Temptympanic is within the interval of 0.5°C. Bland-Altmann analysis showed a TempTTP mean bias of 0.20°C with 95% limits of agreement within − 0.44°C to + 0.85°C compared to Temptympanic, indicating good agreement between the two methods. Good agreement was also supported by a Pearson correlation coefficient of 0.74. Furthermore, the TTP™ system demonstrated superior performance compared to the reference method, as it maintained a more stable core temperature.
CONCLUSIONS
We consider the non-invasive TTP™ system as a reasonable tool for perioperative temperature monitoring for conscious patients undergoing regional anesthesia.
MRI quantiﬁed perivascular space metrics as imaging biomarkers for assessing the severity of cognitive impairment and sleep disturbance in young adults with long-time mobile phone use through machine learning approaches
Authors: Li Li , Wu Jiaojiao , Li Bin , Hua Rui , Shi Feng , Chen Lizhou , Wu Yeke
Published: December 2024

Emerging evidence has linked long-time mobile phone use (LTMPU) with cognitive impairment and sleep issues, with MRI-detected enlarged perivascular spaces (EPVSs) serving as markers for these conditions. Our study seeks to develop predictive model using MRI-based PVS measurements and machine learning to assess cognitive impairment, subjective sleep quality, and excessive daytime sleepiness in young adults with LTMPU. Eighty-two participants were included, deep learning algorithms were used to segment EPVS lesions and extract quantitative metrics. Training and testing datasets were randomly assigned to perform radiomics analysis, where EPVS metrics combined with sex and age were used to select the most valuable features for model construction. Finally, a Gaussian process model was constructed based on six features for assessing cognitive impairment, yielding an AUC of 0.818 (95% confidence interval [CI] 0.610-1) in the testing dataset. For sleep quality and sleepiness, two decision tree (DT) models using six features achieved an AUC value of 0.826 (95% CI 0.616-1) and 0.875 (95% CI 0.718-1) in the testing dataset respectively. Our study leveraged MRI-based PVS metrics and machine learning to assess the severity of cognitive impairment and sleep problems in young adults with LTMPU, and sheds light on a potential link between PVS and sleepiness.
Optimal Initial PEEP in Management of Preterm Infant with Respiratory Distress Syndrome: A Prospective Study at Newborn Unit of Moi Teaching and Referral Hospital
Authors: Vulalo Deborah Makasi , Mwangi Ann , Chepkemoi Audrey K. , A. Philippe Poli , Ayaya Samuel O.
Published: December 2024

Background:Respiratory distress syndrome remains an important cause of neonatal mortality and morbidity worldwide. Early initiation of continuous positive airway pressure is a standard of care for preterm infants with respiratory distress syndrome. Positive end-expiratory pressure reduces the need for invasive ventilation and prevents chronic lung disease. However, the optimum positive end expiratory pressure level to effectively treat respiratory distress syndrome in preterm infants remains unknown.
Objective: To determine the optimal initial positive end expiratory pressure level in management of preterm infants with respiratory distress syndrome.
Methods:This prospective descriptive study was conducted from July 2023 to January 2024 in the newborn unit of Moi Teaching and Referral Hospital. A total of 204 preterm infants (28-34 weeks gestational age) with respiratory distress syndrome who required Continuous Positive Airway Pressure treatment were recruited. Data on the maternal and neonatal characteristics, low and high positive end expiratory pressure levels, and outcomes at 72 hours were collected and analysed. Descriptive statistics were used for continuous variables, and frequencies were used for categorical data. A p value less than 0.05 was considered statistically significant at the 95% confidence interval. Receiver operating characteristic curves were used to determine the optimal positive end expiratory pressure level.
Results:A total of 45 and 159 preterm infants were started on low and high positive end expiratory pressure levels, respectively. Among 159 (77.9%) of the preterm infants started on high positive end expiratory pressure levels, majority (135, 66.2%) were initiated at a positive end expiratory pressure level of 6 cmH2O. The Area under the curve for low positive end expiratory pressure levels was 0.5757 and the one for high positive end expiratory pressure levels was 0.5405. DeLong's test for two ROC curves D = 0.82979, df = 120.8, p value = 0.4083. The area under the curve of both low and high positive end expiratory pressure levels were close and not significantly different (p=0.4083).
Conclusion: In this study, low positive end expiratory pressure was associated with low failure rate and complications. However low and high positive end expiratory pressure levels were not significantly different to determine the optimal initial PEEP.
The optimal positive end expiratory pressure level for continuous positive airway pressure initiation in preterm infants with respiratory distress syndrome could not be determined because of the small sample size
Spatial variation of soil characteristics within an urban arboretum. A case study of the Salisbury University Arboretum, Maryland, U.S.A.
Authors: Harris Daniel W. , Folkoff Michael E. , Gelata Samuel B. , Briand Christopher H.
Published: December 2024

The impact of long-term institutional management on soil chemistry within urban greenspaces is important to recognize given the proliferation of these urban planning methods in our ever-increasing urban environments. Most research on urban soils primarily focuses upon heavy metal pollutant accumulation and its relationship to industrial history and current environmental quality. Far less research, especially in the United States, examines the impact of soil and landscape management practices aimed at providing greenspaces for the residents of the ever-expanding urban environments. Moreover, systematic studies detailing resultant soil chemistry changes in managed greenspaces rarely exist given the lack of a non-urban analogs by which to compare. Also, land use histories of urban sites are often ambiguous and through time soil management practices vary as managers seek to create varied “aesthetically pleasing” landscapes in these institutional environments. This study details soil chemistry differences within the varied landscapes of an urban greenspace, a University arboretum, following almost 100 years of institutional soil management as the University expanded into former agriculture soils. Soil series mapped on the University campus prior to arboretum establishment remain agriculturally active in the surrounding community enabling our analysis. Results indicate the widespread addition of lime throughout arboretum environments has elevated soil pH thereby increasing the availability of macro- and micronutrients in vegetative communities including lawns, gardens and woodlands. Of concern, organic matter amounts are also elevated in the arboretum, fundamentally changing its natural inverse relationship with pH. The over enrichment of nutrients in this greenspace likely represents the outcome of anthropogenic management practices across many types of urban greenspaces. These soil chemistry modifications likely result in significant changes in runoff water chemistry thereby impacting local surface and groundwater resources. “Urban soils often become defined by human activities and land use histories at a particular location rather than by the continuum of geologic processes.” – Solano 2013 “Urban plant communities are as much a product of the cultural environment as they are a part of the physical landscape.” – Whitney and Adams 1980
Generative Artificial Intelligence in Medicine: A Mixed Methods Survey of UK General Practitioners
Authors: Blease Charlotte , Kharko Anna , Locher Cosima , Torous John , Roche Anna Sophie , Hägglund Maria , Gaab Jens , McMillan Brian , Sundemo David , Mandl Kenneth D.
Published: December 2024

Background: With the debut of OpenAI’s ChatGPT, there has been growing interest in the use of generative artificial intelligence (AI), including in healthcare. However, there is only limited research into doctors’ adoption of these tools and their opinions about their application in clinical practice.
Objective: This study aimed to explore the opinions of general practitioners (GPs) in the United Kingdom (UK) about the use of generative AI tools (ChatGPT/Bard/Bing AI) in primary care.
Methods: Between February 2nd-24th 2024, using a convenience sample, we administered a web-based mixed methods survey of 1000 GPs in the UK. Participants were recruited from registered GPs currently working in the UK through Doctors.net.uk. Quantitative data were analyzed using descriptive statistics and nonparametric tests. We used thematic content analysis to investigate free-text responses to 2 open-ended questions embedded in the questionnaire.
Results: A total of 1006 GPs responded, with 53% being male and 54% aged 46 years and older. Most GPs (80%) expressed a need for more support and training in understanding these tools. GPs at least somewhat agreed AI would improve documentation (59%), patient information gathering (56%), treatment plans (41%), diagnostic accuracy (40%), and prognostic accuracy (38%). Additionally, 62% believed patients might rely more on AI, 55% felt it could increase inequities, and 54% saw potential for patient harm, but 47% believed it would enhance healthcare efficiency. GPs who used these tools were significantly more optimistic about the scope for generative AI in improving clinical tasks compared with those who did not. 31% of the GPs (307/1006) left comments that were classified into 4 major themes: (1) lack of familiarity and understanding, (2) a role in clinical practice, (3) concerns, and (4) thoughts on future of healthcare.
Conclusions: This study highlights UK GPs' perspectives on generative AI in clinical practice, emphasizing the need for more training. Many GPs reported a lack of knowledge and experience with this technology and a significant proportion used non-medical grade technology for clinical tasks, with the risks that this entails. Medical organizations must urgently invest in educating and guiding physicians on AI use and limitations.
Alzheimer's Disease and Related Dementia among Black Adults Stratified by Nativity
Authors: Sorkpor Setor K , Yang Yijiong , Lane Brittany , Amu Hubert , Tefera Gashaye Melaku , Miao Hongyu , Wang Jing
Published: December 2024

Purpose: To explore ADRD prevalence by nativity, comparing US-born and non-US-born Black individuals to uncover risk factor differences and inform targeted interventions.
Methods: We conducted a retrospective cohort study with 77,069 Black individuals from the All of Us Research Program. We analyzed two cohorts, US-born and non-US-born individuals with ADRD, using 1:1 propensity score matching to balance key factors. Analyses were performed in R and Python with significance set at α = 0. 05.
Results: Of 72,311 US-born and 4,758 non-US-born Black individuals, 1:1 propensity score matching resulted in 4,758 matched participants per group. ADRD prevalence was 3.76% in US-born and 4.12% in non-US-born Blacks, with rates increasing with age and being higher among retirees and the unemployed.
Conclusion: Non-US-born Black individuals have a higher ADRD risk than US-born Blacks due to socioeconomic and demographic factors, supporting the need for targeted interventions and further research to address health inequities.
The Power to Resolve Cultural Transmission and Sibling Interaction Using Polygenic Scores
Authors: Bernardo Josefina Benita , Pahnke Charlotte Katharina Louise , Bergen Elsje van , Dolan Conor Vivian
Published: December 2024

In the classical twin design, the assumption that the additive genetic (A) and shared environment (C) variance components are uncorrelated may not hold. If there is positive AC covariance, the C component is overestimated. Two processes have been studied that lead to AC covariance: Cultural transmission (e.g., genetic nurture), when the parents’ genotype contributes to the effective environment of the child, and sibling interaction, when the genotype of one sibling contributes to the effective environment of another. Several designs use polygenic scores of parents or siblings to detect AC covariance, but these models cannot unambiguously identify the source. A combined model has been proposed, but its power to identify both processes has not been well-studied yet. This study uses simulated data from genotyped twins and their parents to investigate the power to disentangle these processes. Results demonstrated that we can detect AC covariance using either genotyped-sibling or genotyped-parent data, but we cannot resolve its source and risk making wrong inferences. However, these sources of AC covariance can be resolved using genotyped data of both siblings and parents. This emphasizes the need for whole-family genotyping and modeling.
Mechanics of plant epidermal cell wall: Effect of anisotropic alignment of cellulose microfibrils in the junction region
Authors: Lee Jongcheol , Kim Jessica Sohyun , Yu Jingyi , Ryu Jihyeong , Choi Juseok , Cosgrove Daniel J. , Yi Hojae , Kim Seong H.
Published: December 2024

In plants, cellulose microfibrils (CMFs) play a major role in cell wall mechanics. Plant epidermal peels have been widely used as a model system to study the relationship between the CMF arrangement and the mechanical properties of the cell wall. Recently, vibrational sum frequency generation (SFG) spectroscopy imaging has discovered that CMFs in the cell-cell junction regions (i.e., edges of each cell) in the periclinal wall are preferentially aligned (anisotropic) perpendicular to the anticlinal plane, while those in the face regions have the crossed-polylamellate (isotropic) structure possessing all possible orientations. Here, we studied the effect of these regiospecific CMF orientations on the tensile properties of peeled plant epidermal cell walls using finite element analysis (FEA). The FEA simulation showed that the anisotropic fibers in the junction region of the elongated hexagonal cells amplified the anisotropy in the mechanical behavior of the wall under tensile stretching and exhibited a strain-dependent Poisson’s ratio with nonlinear mechanical behavior. The SFG analysis suggested that, in the junction region, there are alterations in cellulose chain conformation within CMFs and/or in CMF-CMF bundling upon tensile stretch.
How can we optimize the surgical management of the axilla in breast cancer since the MonarchE trial ?
Authors: Jankowski Clémentine , Houvenaeghel Gilles , Renaudeau Celine , Leveque Jean , Marchal Frederic , Benbara Amélie , Barranger Emmanuel , Rouzier Roman , Cohen Monique , Classe Jean-Marc , Ladoire Sylvain , Coutant Charles
Published: December 2024

Purpose
Results of MonarchE trial have changed adjuvant therapy for estrogen-receptor-positive(ER+), HER-2-negative breast cancer. Given the importance of the extent of nodal disease in this study, surgical management of the axilla has resurfaced as a question asked at multidisciplinary boards.
Methods
Using data from a cohort of Werkoff (JCO, 2009) in which patients underwent both sentinel lymph nodebiopsy(SLNB) and axillary node dissection(ALND), we assessed the proportion of patients in whom the absence of ALND would have led to a lack of awareness of "high-risk" status. We evaluated the contribution of the Katz nomogram (that predict pN2/N3 stage) to guide possible indications for complementary ALND.
Results
Among the 536 patients, 88 were excluded (ER- and/or isolated cells in SLN). Of patients with 1 or 2 SLN+(n = 352), only 7.9% were pN2/N3. When the ratio (number of SLN+/total number of SLN sampled) was less than 1, only 3.9% were pN2/N3. Patients with 1 or 2 SLN + met the ACOSOG Z0011 criteria so none would benefit from an ALND, but 7.9% of patients at high risk will not receive Abemaciclib. If we use the Katz nomogram (threshold ≤ 5%), this rate decrease at 3.3% but 116 patients will have an ALND with no benefit. With a threshold ≤ 20%, 5% patients at high risk will not receive Abemaciclib but 21 patients will have an ALND with no benefit.
Conclusion
The indications for adjuvant Abemaciclib should not lead to surgical escalation in the management of the axilla.