bluuebunny/crossref_metadata_2025 huggingface dataset:
Gene Expression Assays to Tailor Adjuvant Endocrine Therapy for HR+/HER2− Breast Cancer
Authors: Bottosso Michele , Miglietta Federica , Vernaci Grazia Maria , Giarratano Tommaso , Dieci Maria Vittoria , Guarneri Valentina , Griguolo Gaia
Published: April 2024

Adjuvant endocrine therapy (ET) represents the standard of care for almost all hormone receptor (HR)+/HER2− breast cancers, and different agents and durations are currently available. In this context, the tailoring and optimization of adjuvant endocrine treatment by reducing unnecessary toxic treatment while taking into account the biological heterogeneity of HR+/HER2− breast cancer represents a clinical priority. There is therefore a significant need for the integration of biological biomarkers in the choice of adjuvant ET beyond currently used clinicopathological characteristics. Several gene expression assays have been developed to identify patients with HR+/HER2− breast cancer who will not derive benefit from the addition of adjuvant chemotherapy. By enhancing risk stratification and predicting therapeutic response, genomic assays have also shown to be a promising tool for optimizing endocrine treatment decisions. In this study, we review evidence supporting the use of most common commercially available gene expression assays [Oncotype DX, MammaPrint, Breast Cancer Index (BCI), Prosigna, and EndoPredict] in tailoring adjuvant ET. Available data on the use of genomic tests to inform extended adjuvant treatment choice based on the risk of late relapse and on the estimated benefit of a prolonged ET are discussed. Moreover, preliminary evidence regarding the use of genomic assays to inform de-escalation of endocrine treatment, such as shorter durations or omission, for low-risk patients is reviewed. Overall, gene expression assays are emerging as potential tools to further personalize adjuvant treatment for patients with HR+/HER2− breast cancers.
First-in-Human Stage III/IV Melanoma Clinical Trial of Immune Priming Agent IFx-Hu2.0
Authors: Markowitz Joseph , Shamblott Michael , Brohl Andrew S. , Sarnaik Amod A. , Eroglu Zeynep , Khushalani Nikhil I. , Dukes Christopher W. , Chamizo Alejandra , Bastawrous Marina , Garcia Edward T. , Dehlawi Ashraf , Chen Pei-Ling , De Aquino Deanryan B. , Sondak Vernon K. , Tarhini Ahmad A. , Kim Youngchul , Lawman Patricia , Pilon-Thomas Shari
Published: April 2024

IFx-Hu2.0 was designed to encode part of the Emm55 protein contained within a plasmid in a formulation intended for transfection into mammalian cells. IFx-Hu2.0 promotes both adaptive and innate immune responses in animal studies. Furthermore, previous studies have demonstrated safety/efficacy in equine, canine, and murine species. We present the first-in-human study of IFx-Hu2.0, administered by intralesional injection into melanoma tumors of seven patients with stage III/IV unresectable melanoma. No dose-limiting toxicities attributable to IFx-Hu2.0 were observed. Grade 1/2 injection site reactions were observed in five of seven patients. IgG and IgM responses to Emm55 peptides and known melanoma antigens were seen in the peripheral blood, suggesting that IFx-Hu2.0 acts as an individualized “in situ vaccine.” Three of four patients previously refractory to anti-PD1 experienced clinical benefit upon subsequent anti-PD1–based treatment. Therefore, this approach is feasible, and clinical/correlative outcomes warrant further investigation for treating patients with metastatic melanoma with an immune priming agent.
Figure S6 from Epithelial Expressed B7-H4 Drives Differential Immunotherapy Response in Murine and Human Breast Cancer
Authors: Wescott Elizabeth C. , Sun Xiaopeng , Gonzalez-Ericsson Paula , Hanna Ann , Taylor Brandie C. , Sanchez Violeta , Bronzini Juliana , Opalenik Susan R. , Sanders Melinda E. , Wulfkuhle Julia , Gallagher Rosa I. , Gomez Henry , Isaacs Claudine , Bharti Vijaya , Wilson John T. , Ballinger Tarah J. , Santa-Maria Cesar A. , Shah Payal D. , Dees Elizabeth C. , Lehmann Brian D. , Abramson Vandana G. , Hirst Gillian L. , Brown Swigart Lamorna , van ˈt Veer Laura J. , Esserman Laura J. , Petricoin Emanuel F. , Pietenpol Jennifer A. , Balko Justin M.
Published: April 2024

Supplemental Figure 6. EMT6 tumors do not respond to single-agent chemotherapy. (A) EMT6 parental or B7-H4+ tumors treated with vehicle (isotype control), anti-PD-L1, paclitaxel chemotherapy, or anti-PD-L1 + paclitaxel (n=15/group parental and n = 10/group B7-H4+). We observed no tumor response to paclitaxel single-agent therapy and thus the response observed in the combination treatment group is driven by anti-PD-L1 effects. (One-way ANOVA with Tukey’s post-hoc test for multiple comparisons. P values as shown. (B) Survival of EMT6 parental or B7-H4+ tumors. We observed significant survival of the anti-PD-L1 and combination treatment groups in both tumor types compared to vehicle or paclitaxel treatment groups. (Data were analyzed by Log-rank Mantel Cox test. Statistics performed in GraphPad Prism v10).
Epithelial Expressed B7-H4 Drives Differential Immunotherapy Response in Murine and Human Breast Cancer
Authors: Wescott Elizabeth C. , Sun Xiaopeng , Gonzalez-Ericsson Paula , Hanna Ann , Taylor Brandie C. , Sanchez Violeta , Bronzini Juliana , Opalenik Susan R. , Sanders Melinda E. , Wulfkuhle Julia , Gallagher Rosa I. , Gomez Henry , Isaacs Claudine , Bharti Vijaya , Wilson John T. , Ballinger Tarah J. , Santa-Maria Cesar A. , Shah Payal D. , Dees Elizabeth C. , Lehmann Brian D. , Abramson Vandana G. , Hirst Gillian L. , Brown Swigart Lamorna , van ˈt Veer Laura J. , Esserman Laura J. , Petricoin Emanuel F. , Pietenpol Jennifer A. , Balko Justin M.
Published: April 2024

Combinations of immune checkpoint inhibitors (ICI, including anti-PD-1/PD-L1) and chemotherapy have been FDA approved for metastatic and early-stage triple-negative breast cancer (TNBC), but most patients do not benefit. B7-H4 is a B7 family ligand with proposed immunosuppressive functions being explored as a cancer immunotherapy target and may be associated with anti-PD-L1 resistance. However, little is known about its regulation and effect on immune cell function in breast cancers. We assessed murine and human breast cancer cells to identify regulation mechanisms of B7-H4 in vitro. We used an immunocompetent anti-PD-L1–sensitive orthotopic mammary cancer model and induced ectopic expression of B7-H4. We assessed therapy response and transcriptional changes at baseline and under treatment with anti-PD-L1. We observed B7-H4 was highly associated with epithelial cell status and transcription factors and found to be regulated by PI3K activity. EMT6 tumors with cell-surface B7-H4 expression were more resistant to immunotherapy. In addition, tumor-infiltrating immune cells had reduced immune activation signaling based on transcriptomic analysis. Paradoxically, in human breast cancer, B7-H4 expression was associated with survival benefit for patients with metastatic TNBC treated with carboplatin plus anti-PD-L1 and was associated with no change in response or survival for patients with early breast cancer receiving chemotherapy plus anti-PD-1. While B7-H4 induces tumor resistance to anti-PD-L1 in murine models, there are alternative mechanisms of signaling and function in human cancers. In addition, the strong correlation of B7-H4 to epithelial cell markers suggests a potential regulatory mechanism of B7-H4 independent of PD-L1.

Significance:

This translational study confirms the association of B7-H4 expression with a cold immune microenvironment in breast cancer and offers preclinical studies demonstrating a potential role for B7-H4 in suppressing response to checkpoint therapy. However, analysis of two clinical trials with checkpoint inhibitors in the early and metastatic settings argue against B7-H4 as being a mechanism of clinical resistance to checkpoints, with clear implications for its candidacy as a therapeutic target.
Blood Profiles of Community-Dwelling People with Sarcopenia: Analysis Based on the China Health and Retirement Longitudinal Study
Authors: He Lingxiao , Shi Kewei , Chen Xiaodong , Gao Mingyue , Han Yaofeng , Fang Ya
Published: April 2024

Introduction: Routine blood factors can be economical and easily accessible candidates for sarcopenia screening and monitoring. The associations between sarcopenia and routine blood factors remain unclear. This study aimed to examine sarcopenia and blood factor associations based on a nation-wide cohort in China. Methods: A total of 1,307 participants and 17 routine blood indices were selected from two waves (year 2011 and year 2015) of the China Health and Retirement Longitudinal Study (CHARLS). The diagnosis of sarcopenia was based on the criteria proposed by the Asian Working Group for Sarcopenia (AWGS 2019). Generalized mixed-effects models were performed for association analyses. A logistic regression (LR) model was conducted to examine the predictive power of identifying significant blood factors for sarcopenia. Results: A higher sarcopenia risk was cross-sectionally associated with elevated blood concentrations of high-sensitivity C-reactive protein (hsCRP) (OR = 1.030, 95% CI [1.007, 1.053]), glycated hemoglobin (HbA1c) (OR = 1.407, 95% CI [1.126, 1.758]) and blood urea nitrogen (BUN) (OR = 1.044, 95% CI [1.002, 1.089]), and a decreased level of glucose (OR = 0.988, 95% CI [0.979, 0.997]). A higher baseline hsCRP value (OR = 1.034, 95% CI [1.029, 1.039]) and a greater over time change in hsCRP within 4 years (OR = 1.034, 95% CI [1.029, 1.039]) were associated with a higher sarcopenia risk. A higher BUN baseline value was related to a decreased sarcopenia risk over time (OR = 0.981, 95% CI [0.976, 0.986]), while a greater over time changes in BUN (OR = 1.034, 95% CI [1.029, 1.040]) and a smaller over time change in glucose (OR = 0.992, 95% CI [0.984, 0.999]) within 4 years were also related to a higher sarcopenia risk. LR based on significant blood factors (i.e., hsCRP, HbA1c, BUN, and glucose), and sarcopenia status in year 2015 yielded an area under the curve of 0.859 (95% CI: 0.836–0.882). Conclusion: Routine blood factors involved in inflammation, protein metabolism, and glucose metabolism are significantly associated with sarcopenia. In clinical practice, plasma hsCRP, BUN, blood sugar levels, sex, age, marital status, height, and weight might be helpful for sarcopenia evaluation and monitoring.
Joint Effect of Physical Activity and Sedentary Behavior with the Female Urinary Incontinence: An Analysis of NHANES 2011–2016
Authors: Sun Chen , Duan Zhengrong
Published: April 2024

Introduction: Our study aimed to assess the independent and joint effects of leisure-time physical activity and sedentary behavior with urinary incontinence (UI). Methods: Data were obtained from the National Health and Nutrition Examination Survey 2011–2016. The primary endpoint was the risk of different subtypes of UI, including stress UI, urgency UI, and mixed UI. The primary exposures were leisure-time physical activity and sedentary behavior. Sedentary behavior was assessed by screen time. Weighted univariate and multivariate logistic regression models were used to observe the independent and joint relationship of leisure-time physical activity and sedentary behavior with UI risk (including stress UI, urgency UI, and mixed UI). Results: In total, 6,927 female participants were included in this analysis. 3,377 females did not have UI, 1,534 had stress UI, 836 had urgency UI, and 1,180 had mixed UI. Screen time with ≥5 h/day was associated with increased odds of urgency UI (odds ratio [OR] = 1.31, 95% confidence intervals (CI): 1.06–1.61), which indicated the relationship of sedentary behavior and urgency UI. Engaging in leisure-time physical activity with of ≥750 metabolic equivalent (MET)·min/week was found to be significantly associated with reduced likelihood of mixed UI (OR = 0.68, 95% CI: 0.55–0.85). Additionally, the interaction term of leisure-time physical activity<750 MET·min/week and screen time ≥5 h/day was observed to be linked with increased odds of urgency and mixed UI. Conclusion: Participants experiencing a lower level of leisure-time physical activity and a higher level of sedentary behavior together might enhance the urgency and mixed UI risk.
Casiopeina III-ia: A Copper Compound with Potential Use for Treatment of Infections Caused by Leishmania mexicana
Authors: Delgado-Domínguez José , Mejía-Camacho Lizet , Torres-Martínez Lisset , Zamora-Chimal Jaime , Cervantes-Sarabia Rocely , Espinoza-Guillen Adrián , Ruiz-Azuara Lena , Becker Ingeborg
Published: April 2024

Introduction: Casiopeina III-ia (CasIII-ia) is a mixed chelate copper (II) compound capable of interacting with free radicals generated in the respiratory chain through redox reactions, producing toxic reactive oxygen species (ROS) that compromise the viability of cancer cells, bacteria and protozoa. Due to its remarkable effect on protozoa, this study evaluated the effect of CasIII-ia on Leishmania mexicana amastigotes and its potential use as a treatment for cutaneous leishmaniasis in the murine model. Methods: We analyzed the leishmanicidal effect of CasIII-ia on L. mexicana amastigotes and on their survival in bone marrow-derived macrophages. Furthermore, we evaluated the production of ROS in treated parasites and the efficacy of CasIII-ia in the treatment of mice infected with L. mexicana. Results: Our results show that CasIII-ia reduces parasite viability in a dose-dependent manner that correlates with increased ROS production. A decrease in the size of footpad lesions and in parasite loads was observed in infected mice treated with the intraperitoneal administration of CasIII-ia. Conclusions: We propose CasIII-ia as a potential drug for the treatment of cutaneous leishmaniasis.
Efficacy of Intensive Lifestyle Education and Forest-Based Exercise for the Primary Prevention of the Risk of Coronary Artery Disease
Authors: Lee Jong-Young , Joo Kee-Chan , Brubaker Peter H. , Yoon Dae-Sik , Choi Kyung-Su
Published: April 2024

Introduction: Despite its efficacy, conventional center-based cardiac rehabilitation has several limitations which have led to the emergence of home-based programs and intensive cardiac rehabilitation as alternative methods for overcoming these limitations. Alternative methods for primary prevention have been recommended for similar reasons. Lifestyle modification is considered key to success in both primary and secondary prevention. Therefore, this primary prevention study aimed to investigate the efficiency of intensive lifestyle education and home-based programs involving unstructured exercise in urban forests to prevent coronary artery disease (CAD). The availability of urban forests as preventive exercise environments was also examined. Methods: Patients with risk factors for CAD participated in primary prevention using either FBEG (forest-based exercise group (FBEG, n = 11) or CBEG (center-based exercise group (CBEG, n = 17) for 12 weeks. The FBEG was provided with intensive residential lifestyle education and followed a home program that included performing exercise in an urban forest. The CBEG followed a conventional supervised exercise program at a fitness facility. Changes in body composition, cardiometabolic variables, and functional capacity were tested using a 2-way repeated ANOVA measurement. An independent t-test was used to examine the differences in weekly energy expenditure between the two groups. Results: Significant within-group differences were identified in body composition, cardiometabolic variables, and the 10-yr probability of CAD in both groups. However, the functional capacity, weekly energy expenditure, and attendance rate showed between-group differences, with superiority in the FBEG. Conclusion: Intensive lifestyle education and subsequent home-based programs with unstructured exercise in the forest were as effective as a conventional center-based program, with superiority in terms of the change of some variables. Intensive education on experiencing and habituating a healthy lifestyle seemed to play an important role in improving motivation.
Lithium Therapy’s Potential to Lower Dementia Risk and the Prevalence of Alzheimer’s Disease: A Meta-Analysis
Authors: Lu Qiuying , Lv Huijing , Liu Xiaotong , Zang Lili , Zhang Yue , Meng Qinghui
Published: April 2024

Introduction: Dementia is a neurodegenerative disease with insidious onset and progressive progression, of which the most common type is Alzheimer's disease (AD). Lithium, a trace element in the body, has neuroprotective properties. However, whether lithium can treat dementia or AD remains a highly controversial topic. Therefore, we conducted a meta-analysis. Methods: A systematic literature review was conducted on PubMed, Embase, and Web of Science. Comparison of the effects of lithium on AD or dementia in terms of use, duration, and dosage, and meta-analysis to test whether lithium therapy is beneficial in ameliorating the onset of dementia or AD. Sensitivity analyses were performed using a stepwise exclusion method. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. We determined the relative risk (RR) between patient groups using a random-effects model. Results: A total of seven studies were included. The forest plot results showed that taking lithium therapy reduced the risk of AD (RR 0.59, 95% confidence interval [CI]: 0.44–0.78) and is also protective in reducing the risk of dementia (RR 0.66, 95% CI: 0.56–0.77). The duration of lithium therapy was able to affect dementia incidence (RR 0.70, 95% CI: 0.55–0.88); however, it is unclear how this effect might manifest in AD. It is also uncertain how many prescriptions for lithium treatment lower the chance of dementia development. Conclusion: The duration of treatment and the usage of lithium therapy seem to lower the risk of AD and postpone the onset of dementia.
Transient Receptor Potential Channels in Sensory Mechanisms of the Lower Urinary Tract
Authors: Gou Ruiqiang , Liu Yuanyuan , Gou Li , Mi Shengyan , Li Xiaonan , Yang Yichen , Cheng Xiaorong , Zhang Yibao
Published: April 2024

Background: Urine storage and excretion require a network of interactions in the urinary tract and the central nervous system, which is mediated by a reservoir of water in the bladder and the outlet to the bladder neck, urethra, and external urethral sphincter. Through communicating and coordinating each other, micturition system eventually showed a switch-like activity pattern. Summary: At cervicothoracic and lumbosacral spine, the spinal reflex pathway of the lower urinary tract (LUT) received mechanosensory input from the urothelium to regulate the bladder contraction activity, thereby controlled urination voluntarily. Impairment of above-mentioned any level could result in lower urinary tract dysfunction, placed a huge burden on patients and society. Specific expression of purinergic receptors and transient receptor potential (TRP) channels are thought to play an important role in urinary excretion in the LUT. Key Messages: This article reviewed the knowledge about the voiding reflex and described the role and function of TRP channels during voiding.
Cytomegalovirus Reactivation during Elotuzumab Therapy in Patients with Multiple Myeloma
Authors: Kikuchi Taku , Tsukada Nobuhiro , Kunisada Kodai , Nomura-Yogo Moe , Oda Yuki , Sato Kota , Takei Tomomi , Ogura Mizuki , Abe Yu , Suzuki Kenshi , Ishida Tadao
Published: April 2024

Introduction: Some treatments are associated with cytomegalovirus (CMV) reactivation (CMVRA) in patients with multiple myeloma (MM). However, no reports exist on the association between elotuzumab and CMVRA. Therefore, we assessed the incidence of CMVRA in patients with MM who received elotuzumab therapy. Methods: The medical records of 85 patients who underwent elotuzumab therapy were included in the retrospective analysis for CMV positivity. Results: Thirty patients were tested for CMV antigenemia during elotuzumab therapy, and 16 were positive for CMV antigenemia; the cumulative incidence rate of CMVRA 6 months after elotuzumab initiation was 18.4%. The history of allogeneic stem cell transplantation (allo-HSCT) was significantly more common in the CMVRA group (31.2%) than that of the group without CMVRA (8.7%). However, even among patients who did not undergo allo-HSCT, the cumulative incidence rate of CMVRA at 6 months was 15.1%. During CMVRA, the symptoms included fever in 8 cases, while retinitis was observed in 1 case. Five patients required antiviral therapy and CMV antigenemia resolved in all but 1 case. Conclusion: Although the patient population was heterogeneous, CMVRA cannot be underestimated during elotuzumab therapy, and evaluation of CMVRA, especially in symptomatic cases, is clinically important.
A new species of Lamprempis Wheeler e Melander from Brazil, with a key to the described species of the genus (Diptera, Empididae)
Authors: Smith Kenneth G. V.
Published: April 2024

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Two further new species of Amphisbaena from the semi-arid northeast of Brasil (Reptilia, Amphisbaenia)
Authors: Vanzolini P. E.
Published: April 2024

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Megalobulimus Parafragilior, SP. N., uma nova espécie de Pulmonata terrestre da Serra do Mar (Gastropoda, Megalobulimidae)
Authors: Leme J. L. M. , Indrusiak L. F.
Published: April 2024

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Avaliação do estado nutricional em idosos com diabetes mellitustus
Authors: Toscano Mariana , Damião Renata , Camilo Professor Bruno de Freitas
Published: April 2024

Objective: To analyze the nutritional status of elderly individuals with diabetes mellitus. Methods: Cross-sectional population-based study. Part of the Longitudinal Study of Health of the Elderly of Alcobaça – ELSIA, including 465 elderly people. Data analysis was performed using a structured questionnaire containing sociodemographic, health and behavioral information. Nutritional status was assessed using the Mini Nutritional Assessment – MNA. Results: There was a prevalence of risk of malnutrition/malnutrition of 47,1% (15,7% in men and 30,1% in women) in the group with diabetes. The MNA analysis revealed that the individuals in the group with diabetes, when compared to the group without diabetes, presented greater weight loss in the last three months (p=0,017), took more than three different medications per day (p=≤0,0001), believed they were malnourished (p=0,003) and considered their own health as not very good (p=0,027). When comparing genders, the male diabetes group showed differences in relation to the use of multiple medications (p=≤0,0001), mobility (p=≤0,0001), and neuropsychological problems (p=0,029). While females showed a statistically significant difference in relation to use of multiple medications (p=≤0,0001). Conclusion: The findings showed a significant prevalence of risk of malnutrition/malnutrition in elderly with diabetes mellitus, especially in females. However, the presence of the disease in males has been shown to have a significant impact on nutritional status when analyzing MNA parameters.
Íleo biliar: uma abordagem detalhada no contexto da medicina humana - relato de caso e considerações clínicas
Authors: Macedo Pamella , Silva Nunes Fabricia , De Azeredo Freitas Dalla Bernardina Brunella , Destefani Natali Lucas , Ferrari Khouri Juliana , Menegardo Siqueira de Oliveira Luis Gustavo , Rabelo Abreu dos Santos Fernando Henrique , Carvalhal Moitinho Guilherme
Published: April 2024

O íleo biliar, uma complicação rara da colelitíase, predominantemente afeta mulheres idosas com outras condições médicas relevantes. Essa condição surge devido à impactação de cálculos biliares no íleo após a passagem por uma fístula bilioentérica. O quadro clínico frequentemente se manifesta com sintomas inespecíficos e obstrução insidiosa, resultando, por vezes, em atraso no diagnóstico. A tomografia computadorizada (TC) é crucial para a investigação, sendo considerada a ferramenta padrão-ouro. A morbidade e mortalidade associadas ao íleo biliar estão diretamente relacionadas à idade avançada dos pacientes e à presença de comorbidades concomitantes, influenciando negativamente no prognóstico. Este estudo descreve o caso de uma mulher de 65 anos, diabética e hipertensa, apresentando quadro de abdome agudo obstrutivo. A obstrução em íleo terminal foi evidenciada por TC, não permitindo a determinação do fator obstrutivo. O diagnóstico de íleo biliar foi confirmado durante a laparotomia exploradora, que identificou um grande cálculo impactado no íleo distal, com dilatação de alças à montante. A abordagem cirúrgica incluiu enterotomia para extração do cálculo, seguida de enterorrafia em dois planos e lavagem da cavidade abdominal. Devido às condições clínicas da paciente, a colecistectomia e a correção da fístula colecistoduodenal não foram realizadas na mesma cirurgia.
Síndrome de May-Thurner: relato de caso e revisão de literatura
Authors: Ziliani Maria Júlia Da Gama Fortunato , Calciolari Bianca , Ozaki Mariana Valadares Aguado , Nagao Rafael Shoiti , Camargo Beatriz Milene de Oliveira , Marcatto Camila Tamassia , Campos Tercio de
Published: April 2024

May-Thurner Syndrome (MTS) is a rare clinical condition that is more prevalent in women and consists of compression of the left common iliac vein by the right iliac artery.1 The objective of this study is to report a case of MTS showing the relation with thrombotic events and perform a literature review. The etiology is categorized as multifactorial and is associated with clinical manifestations related to venous hypertension: pain, edema, varicose veins in the left lower limb, superficial venous reflux, post-thrombotic syndrome and primary lymphedema.3,4 The classification occurs according to the appearance and severity of symptoms, the last stage being the appearance of deep venous thrombosis in the left lower limb, which is most frequently affected.3,6 The diagnostic approach is initially performed through anamnesis and physical examination, with the request of complementary tests such as computed tomography, magnetic resonance imaging and venography being important.1,3,4 The treatment does not have a specific guideline, but considering the clinical condition it can be done through anticoagulant compressive stockings, balloon angioplasty or stent placement.7
Cross‐Sectional Imaging Modalities in Correlation to the Thrombolysis in Cerebral Infarction Score: The Next Frontier in Adjunctive Endovascular Stroke Therapy
Authors: Kaesmacher Johannes , Treurniet Kilian M. , Kappelhof Manon , Dobrocky Tomas , Ospel Johanna , Mujanovic Adnan , Fiehler Jens , Yan Bernard , Goyal Mayank , Yoo Albert J. , Campbell Bruce , Zaidat Osama O. , Saver Jeffrey L. , Sanossian Nerses , Raychev Radoslav , Roos Yvo B. W. E. M. , Fischer Urs , Majoie Charles B. L. M. , Gralla Jan , Liebeskind David S.
Published: April 2024

The expanded Thrombolysis in Cerebral Infarction (eTICI) scale is the default method to measure reperfusion success of endovascular treatment for acute ischemic stroke. It is an estimate of the percentage of the vascular territory affected by the initial occlusion, or target downstream territory (TDT), that is reperfused after the intervention. Traditionally, the size of the TDT is determined on the preinterventional catheter angiography images by delineating the antegrade capillary deficit caused by the catheter angiography target occlusion. As such, the current definition of eTICI grading is only suitable to estimate the efficacy of reperfusion strategies occurring after the baseline catheter angiogram. However, reperfusion therapy for acute ischemic stroke due to large vessel occlusion often encompasses intravenous thrombolysis therapy started prior to endovascular treatment but after cross‐sectional vascular imaging (computed tomography or magnetic resonance imaging) used to determine eligibility for endovascular treatment. The inherent shortcomings of the current eTICI scale to quantify preinterventional perfusion changes are discussed. We then argue that depending on the timing of the studied intervention – either between cross‐sectional imaging and endovascular treatment or after first intracranial catheter angiography – the TDT used to determine the eTICI grade should be based on the occlusion as seen on admission cross‐sectional vascular imaging or prethrombectomy catheter angiography, respectively. We propose a new conceptual framework to grade reperfusion based on the TDT derived from the occlusion seen on cross‐sectional vascular imaging: the cross‐sectional eTICI. Last, we discuss how this definition of the TDT more reliably measures preinterventional reperfusion and establishes homogenous definitions of embolization and infarctions in new territories.
Outcome of Pediatric Large Vessel Occlusion Stroke in Denmark
Authors: Bindslev Julie Brix , Hansen Klaus , Matoor Nicol Dara , Stavngaard Trine , Hoei‐Hansen Christina Engel , Truelsen Thomas
Published: April 2024

Background

We performed a nationwide study to examine clinical outcome in children with large‐vessel occlusion (LVO) stroke treated with mechanical thrombectomy (MT) or conservatively.

Methods

Study participants were enrolled by 2 methods: (1) registration of children assessed through a pediatric stroke triage‐setup from January 2021 to June 2023 and (2) identification of children registered with a stroke or stroke‐related diagnosis in the Danish National Registry of Patients between January 2011 and December 2020. Medical records were reviewed to validate possible stroke events. Children aged 29 days to 17 years with arterial ischemic stroke were included. The children were followed up for cause of stroke, site of vessel occlusion, treatment characteristics, and clinical outcome according to the modified Rankin scale.

Results

A total of 181 children with arterial ischemic stroke were identified. Angiography descriptions were available in 133 children and demonstrated LVOs in 28 (21.1%) of these. Fourteen children with LVOs underwent MT and 14 were treated conservatively. Thirteen of 14 (92.9%) children treated with MT achieved successful reperfusion. Periprocedural complications were observed in 2 children, including 1 child who developed symptomatic intracerebral hemorrhage <24 hours from MT. Long‐term outcome was poor (modified Rankin scale score 3–6) in 7 out of 14 (50.0%) children with LVOs treated conservatively and 5 out of 14 (35.7%) children treated with MT. When limiting analysis to MT procedures performed within 24 hours from stroke onset, a poor outcome was observed in 3 out of 11 (27.3%) children treated with MT. Outcome did not differ significantly between treatment groups.

Conclusion

This nationwide study demonstrates that MT is feasible and apparently safe to use in children. Among children with LVOs, outcome tended to be better for those treated with MT than those treated conservatively, but outcome did not differ significantly between groups, likely due to small sample sizes.
Unmasking the Imitators: Challenges in Identifying Intracranial Atherosclerosis‐Related Large Vessel Occlusion Mimics During Mechanical Thrombectomy
Authors: Rodriguez‐Calienes Aaron , Siddiqui Fazeel M. , Vivanco‐Suarez Juan , Shogren Sophie , Galecio‐Castillo Milagros , Dibas Mahmoud , Pandey Aditya S. , Ribo Marc , Ortega‐Gutierrez Santiago
Published: April 2024

This manuscript provides a comprehensive review of intracranial atherosclerosis (ICAS)‐related large‐vessel occlusion (ICAS‐LVO) and its mimics, focusing on the challenges in diagnosis and the need for precise diagnostic methodologies, particularly in the context of endovascular therapy. ICAS‐LVO is a significant contributor to acute ischemic stroke, with varying prevalence rates across regions. ICAS‐LVO is characterized by the presence of residual focal fixed stenosis or reocclusion following endovascular treatment or evidence of distal hypoperfusion or watershed infarction on follow‐up imaging. Despite digital subtraction angiography being the gold standard, diagnosing ICAS‐LVO is complicated by similarities with other occlusive conditions, leading to misdiagnosis and inappropriate interventions. The review explores angiographic mimics of ICAS‐LVO, such as intracranial vasospasm, intracranial dissection, partially occlusive thrombus, and rare vasculopathies like Moyamoya disease, reversible cerebral vasoconstriction syndrome, and vasculitis. Each mimic is meticulously examined, providing insights into their distinctive features, diagnostic considerations, and potential interventions. The manuscript emphasizes the importance of early identification of these mimics to guide appropriate interventions and prevent complications. Future perspectives include the incorporation of advanced imaging tools such as integration of artificial intelligence for automated image analysis, and deployment of advanced imaging techniques such as intravascular ultrasound and optical coherence tomography for a more comprehensive radiographical characterization of ICAS‐LVO. Improved diagnostic criteria and ongoing research will play a pivotal role in addressing the challenges of distinguishing ICAS‐LVO from its mimics.
0. Introduction
Authors: Richter Michael , Rubinstein Ariel
Published: April 2024

The stage on which this book's plots are set is a model called an economy. The model captures situations in which each agent in a society chooses an alternative and there exists a fundamental tension between the agents' personal desires and society-wide feasibility constraints. The chapter includes many examples of economies.

A candidate for an equilibrium includes two components:

(i) A profile of choices - one choice for each agent.

(ii) A specification of certain parameters that systematically influence either agents' choice problems or their preference relations.

In equilibrium, agents make individually optimal choices, and the parameters restrict their choice sets to be compatible, in the sense that the resulting profile of choices is feasible.

We provide an overview of the equilibrium concepts we study in the book. They are classified into two groups. In the choice group, each agent's choice set depends on a price-like equilibrium parameter, but not on the equilibrium profile of choices. In the deviation group, an equilibrium is a profile of choices which is immune to any single agent's deviation from his prescribed alternative to any other alternative in a set determined by the equilibrium parameters.
1. Equilibrium in the Jungle
Authors: Richter Michael , Rubinstein Ariel
Published: April 2024

The standard economic approach treats economic activity as voluntary: all involved parties do whatever they do of their own free will. However, life is not just a series of voluntary actions. An agent might use power to seize assets from others or to force others to do things against their will. Economic Theory typically ignores the use of power as a driver of social activity.

This chapter follows Piccione and Rubinstein (2007) which introduces a model of a society referred to as the jungle, in which economic transactions are governed only by coercion. The model consists of a set of agents with exogenous preferences over a set of assets and a power ordering of the agents. Power means that a stronger agent is able to take things away from a weaker agent without the weaker agent's consent.

A jungle equilibrium is a feasible allocation of the assets such that no agent wishes to take assets from an agent (or agents) weaker than himself. We will apply versions of the concept to the housing economy (Shapley and Scarf (1974)) and to the division economy. Throughout, we will deal with standard issues, such as: existence, uniqueness and the fundamental theorems of welfare.
2. The Permissible and the Forbidden
Authors: Richter Michael , Rubinstein Ariel
Published: April 2024

Following Richter and Rubinstein (2020), we analyze an equilibrium concept based upon social norms: the Y-equilibrium. A Y-equilibrium is a set of permissible alternatives and a profile of choices, one for each agent, such that:

(i) each agent's choice is optimal from among the permissible alternatives;

(ii) the profile of choices is feasible; and

(iii) the set of permissible alternatives is maximal in the sense that there is no superset of permissible alternatives from which a profile satisfying (i) and (ii) can be found.

By this definition, two forces make a permissible set unstable: The first modifies the permissible set in the case that the profile of (intended) choices is not feasible, while the second loosens restrictions on the permissible set as long as a new profile of optimal choices is feasible. We also consider a variant of this concept where we require that the permissible set is convex.

We study the Y-equilibria of a variety of examples and prove existence theorems, “welfare” theorems and a structure theorem when the set of alternatives is Euclidean.
5. A Comparison to Game Theory
Authors: Richter Michael , Rubinstein Ariel
Published: April 2024

In the final chapter, we compare this book's modeling approaches with each other and to those of standard Game Theory on two ``battlegrounds''.

The first is the matching economy. An even-sized population of agents must match into exclusive pairs (pairings). Each agent possesses a preference relation over potential mates.

The standard cooperative game theory solution concept for matching economies is ``pairwise stability''. Following Richter and Rubinstein (2024), we compare this concept with the jungle equilibrium, the Y-equilibrium and the status and initial status equilibrium concepts.

The second battleground is a ``political economy'' situation. A group of agents hold views on a political issue. Each agent chooses a position and has preferences only regarding the position he himself chooses (and not the choices of others). However, there is a need that a majority of agents choose the same position.

Traditionally, such a situation is modeled as a non-cooperative game and its Nash equilibria are calculated. Extending Richter and Rubinstein (2021), we compare this approach with the convex Y-equilibrium and the biased preferences equilibria.

On both battlegrounds, the new approaches lead to very different outcomes than the traditional ones.
Final Irrigant Temoporfin, Femtosecond Laser, and Chitosan Nanoparticles on Extrusion Bond Strength of Glass Fiber Post, Microhardness, and Modulus of Elasticity of Canal Dentin
Authors: Aldosari Lujain Ibrahim N.
Published: April 2024

Final root canal disinfectants Temoporfin, Femtosecond (FS) laser, and Chitosan nanoparticles (NPs) on marten hardness (MH), modulus of elasticity (EIT), and push-out bond strength (PBS) of glass fiber reinforced post (GFRP) to the root dentin. Sixty caries-free single-rooted human
premolars were decoronated and a root canal was performed followed by post space. The specimens were then arbitrarily allocated into groups according to the final disinfectant used. Group 1: 17% EDTA, Group 2: Temoporfin, Group 3: FS laser and Group 4: Chitosan NPs. Evaluation of mechanical
properties (MH and EIT) was performed on five samples from each group. Ten samples from each group were bonded with GFRP and sectioned. A universal testing machine and stereomicroscope were used to analyze the PBS and failure mode. Means and standard deviations (SD) of MH, EiT, and PBS were
assessed using ANOVA and post hoc Tukey. The highest values of MH and EiT were revealed by 5.25% NaOCl+Chitosan NP samples. The lowest scores of MH and EiT were presented by samples irrigated with 5.25% NaOCl+17% EDTA. The coronal section of samples treated with 5.25% NaOCl+Chitosan NPs showed
the highest EBS. Chitosan NPs and FS laser have proved to be valuable alternatives to EDTA as both improved PBS without deteriorating the MH and EiT.
Effect of Micro-Texture on Cutting Performance of PCBN Cutter
Authors: Li Qinghua , Shi Hu , Ma Chunlu , Xie Lintao , Yin Chunmei , Shi Yaochen
Published: April 2024

The research aimed to delve into the intricate relationship between surface microtexture and the cutting performance of a PCBN cutter. In pursuit of this goal, the study implemented three distinct microtextures on the forefront of the turning tool, each of diverse forms. To comprehensively
understand the impact, a 3D model was meticulously constructed for simulation purposes. Subsequently, these microtextures were translated into physical form on the tool’s exterior using laser machining, enabling the researchers to conduct real turning experiments. The experimental phase
was designed with precision, maintaining consistent environmental conditions across all tests. The primary focus of these experiments was to investigate the forces generated during the turning process. Additionally, the study explored the stress distribution on the tool’s surface and
evaluated the texture of the workpiece after machining. The findings revealed valuable insights into the role of microtextures in altering stress dynamics. Specifically, a tool featuring microtexture on its front exhibited a reduction in stress values, strategically shifting the stress focus
from the tool’s tip to the microtexture location on the forefront. Moreover, concerning the texture of the workpiece’s surface post-machining, the tool with parallel groove microtexture demonstrated a noteworthy 21% decrease in surface roughness. The study highlighted the pivotal
role of surface microtextures in shaping the performance of a lathe tool. These microtextures were identified as agents capable of modifying the immediate friction between the tool and its chip, thereby diminishing surface friction, cutting force, and post-machining surface roughness. The
operational stability of lathe machining was also enhanced through these microtextures. Notably, the microtexture characterized by parallel grooves demonstrated a significant improvement in chip-guiding capacity by aligning with the chip flow direction during cutting. The presented research
provided a nuanced understanding of how microtextures on a lathe tool’s surface can be strategically employed to optimize cutting performance, offering potential advancements in the field of machining technology.
Chemically Synthesized Sb-Doped SnO2 Nanoparticles for Supercapacitor Application
Authors: Babar Umesh D. , Borage Dipali B. , Wagh Gauri S. , Jadhav Vaishnavi S. , Chavan Priyanka P. , Chougale Ashok D. , Rathod Kisan C. , Patil Rahul B. , Pawar Uday T. , Kamble Pradip D. , Abd El-Salam Nasser M. , Fouad Hassan
Published: April 2024

This study explores the potential of antimony tin oxide (ATO) as an electrode material for supercapacitor applications. ATO, known for its exceptional electrical conductivity and stability, was synthesized using the coprecipitation method followed by calcination. The resulting ATO powder
underwent thorough characterization through X-ray diffraction (XRD), scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR). XRD analysis confirmed the tetragonal morphology and phase purity of ATO nanoparticles, while SEM revealed a sphere-like structure with
an irregular surface. FTIR spectroscopy identified various functional groups, including O–H stretching, C–H symmetric and asymmetric vibrations, and the characteristic–SnO2; vibration mode, providing insights into the surface properties crucial for electrochemical
performance. Electrochemical evaluations, conducted through cyclic voltammetry, galvanostatic charge-discharge, and electrochemical impedance spectroscopy, demonstrated a specific capacitance of 140 F/g for the ATO electrode. This notable specific capacitance highlights the potential of ATO
as an advanced electrode material for supercapacitors, showcasing its suitability for applications requiring rapid charge-discharge cycles and high specific power. This research contributes to the understanding of ATO’s structural and functional aspects, emphasizing its promising role
in advancing supercapacitor technology. The synthesized ATO nanoparticles, characterized by their unique morphology and enhanced electrochemical performance, pave the way for cleaner and more efficient energy storage solutions.
Combining Temperature and Precipitation to Constrain the Aerosol Contribution to Observed Climate Change
Authors: Roesch Carla M. , Ballinger Andrew P. , Schurer Andrew P. , Hegerl Gabriele C.
Published: April 2024

Using the past to improve future predictions requires an understanding and quantification of the individual climate contributions to the observed climate change by aerosols and greenhouse gases (GHGs), which is hindered by large uncertainties in aerosol forcings and responses across climate models. To estimate historical aerosol responses, we apply detection and attribution methods to attribute a joint change in temperature and precipitation to forcings by combining signals of observed changes in tropical wet and dry regions, the interhemispheric temperature asymmetry, global mean temperature (GMT), and global mean land precipitation (GMLP). Fingerprints representing the climate response to aerosols (AERs) and the remaining external forcings (noAER; mostly GHG) are derived from large ensembles of historical single- and ALL-forcing simulations from three models in phase 6 of the Coupled Model Intercomparison Project and selected using a perfect model study. Results from an imperfect model study and a hydrological sensitivity analysis support combining our choice of temperature and precipitation fingerprints into a joint study. We find that diagnostics including temperature and precipitation slightly better constrain the noAER signal than diagnostics based purely on temperature or GMT-only and allow for the attribution of AER cooling (even when GMT is not included in the fingerprint). These results are robust across fingerprints from different climate models. Estimated contributions for AER and noAER agree with other published estimates including those from the most recent IPCC report. Finally, we attribute the best estimate of 0.46 K ([−0.86, −0.05] K) of aerosol-induced cooling and 1.63 K ([1.26, 2.00] K) of noAER warming in 2010–19 relative to 1850–1900 using the combined signals of GMT and GMLP.

Significance Statement

Aerosols are small liquid or solid airborne particles. They are predominantly the secondary result of emissions of aerosol precursor gases emitted via industrial or natural processes. While greenhouse gases warm the climate, aerosols can have a cooling effect on the climate system, thus offsetting some of the greenhouse gas–related warming. We expect greenhouse gas concentrations in the atmosphere to continue to increase, while aerosol concentrations are likely going to decline due to their impacts on human health. Our study uses observed temperature and precipitation changes to quantify how much aerosols have offset warming from past greenhouse gas emissions. This can help constrain future predictions of global warming.