bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a dual VEGF/PDL1 inhibitor based on high-affinity scFv heterodimers as an anti-cancer therapeutic strategy
Authors: Tzuri Noam , Yegodayev Ksenia M. , Novoplansky Ofra , Elkabets Moshe , Aharoni Amir , Papo Niv
Published: July 2023

Cancer progression is enhanced by the interaction of programmed death-ligand 1 (PDL1), which is associated with inhibition of the immune response against tumors, and vascular endothelial growth factor (VEGF), which inhibits immune cell activity while inducing angiogenesis and proliferation of cancer cells. Dual inhibition of PDL1 and VEGF may therefore confer a synergistic anti-cancer therapeutic effect. We present a novel strategy for developing a therapeutic that simultaneously binds and inhibits both PDL1 and VEGF. We generated a bi-specific protein, designated DuRan-Bis, comprising a single chain variable fragment (scFv)-based inhibitor of PDL1 fused to an scFv-based inhibitor of VEGF, with the latter being attached to an Fc fragment. We found that DuRan-Bis binds to both PDL1 and VEGF with high affinity. Compared to treatments with mono-specific proteins, alone or in combination, the DuRan-Bis chimera showed superior inhibition of the proliferation of glioblastoma cells. In comparison to treatment with immune cells alone, a combination of immune cells with DuRan-Bis decreased the viability of head and neck cancer cells. To the best of our knowledge, this study is the first to use a single polypeptide chain scFv-scFv-Fc scaffold for engineering a high-affinity bi-specific inhibitor of PDL1 and VEGF.
Assessment of gut microbial β-glucuronidase and β-glucosidase activity in women with polycystic ovary syndrome
Authors: Patel Jalpa , Chaudhary Hiral , Rajput Kiransinh , Parekh Bhavin , Joshi Rushikesh
Published: July 2023

PCOS is a prevalent endocrine disorder among women of reproductive age, characterized by hormonal imbalances and metabolic disturbances. This study explores the correlation between gut microbial β-glucuronidase and β-glucosidase and PCOS, focusing on their association with hormone levels and other clinical parameters. In this case-control study, fecal samples were collected from women of reproductive age, both with and without PCOS. The analysis of gut β-glucuronidase and β-glucosidase enzymes was conducted with the other clinical parameters, including body mass index, hormone levels, and hirsutism. These factors were then subjected to correlation analysis. PCOS women showed significantly higher levels of β-glucuronidase activity with a statistically significant P-value (0.05 ± 0.1 vs. 0.04 ± 0.1; P = 0.006) as well as β-glucosidase activity (0.13 ± 0.08 vs. 0.09 ± 0.05; P = 0.06) compared to the controls. This study also revealed intriguing connections between the selected enzymes and hormone levels, particularly testosterone and estradiol. Gut microbial enzymes β-glucuronidase and β-glucosidase may be used as biomarkers for early detection and monitoring of PCOS in women with metabolic challenges. It could lead to improved diagnostic tools and treatment options.
Duality in response of intracranial vessels to nitroglycerin revealed in rats by imaging photoplethysmography
Authors: Sokolov Alexey Y. , Volynsky Maxim A. , Potapenko Anastasiia V. , Iurkova Polina M. , Zaytsev Valeriy V. , Nippolainen Ervin , Kamshilin Alexei A.
Published: July 2023

Among numerous approaches to the study of migraine, the nitroglycerin (NTG) model occupies a prominent place, but there is relatively insufficient information about how NTG affects intracranial vessels. In this study we aim to assess the effects of NTG on blood-flow parameters in meningeal vessels measured by imaging photoplethysmography (iPPG) in animal experiments. An amplitude of the pulsatile component (APC) of iPPG waveform was assessed before and within 2.5 h after the NTG administration in saline (n = 13) or sumatriptan (n = 12) pretreatment anesthetized rats in conditions of a closed cranial window. In animals of both groups, NTG caused a steady decrease in blood pressure. In 7 rats of the saline group, NTG resulted in progressive increase in APC, whereas decrease in APC was observed in other 6 rats. In all animals in the sumatriptan group, NTG administration was accompanied exclusively by an increase in APC. Diametrically opposite changes in APC due to NTG indicate a dual effect of this drug on meningeal vasomotor activity. Sumatriptan acts as a synergist of the NTG vasodilating action. The results we obtained contribute to understanding the interaction of vasoactive drugs in the study of the headache pathophysiology and methods of its therapy.
A performance evaluation of drug response prediction models for individual drugs
Authors: Park Aron , Lee Yeeun , Nam Seungyoon
Published: July 2023

Drug response prediction is important to establish personalized medicine for cancer therapy. Model construction for predicting drug response (i.e., cell viability half-maximal inhibitory concentration [IC50]) of an individual drug by inputting pharmacogenomics in disease models remains critical. Machine learning (ML) has been predominantly applied for prediction, despite the advent of deep learning (DL). Moreover, whether DL or traditional ML models are superior for predicting cell viability IC50shas to be established. Herein, we constructed ML and DL drug response prediction models for 24 individual drugs and compared the performance of the models by employing gene expression and mutation profiles of cancer cell lines as input. We observed no significant difference in drug response prediction performance between DL and ML models for 24 drugs [root mean squared error (RMSE) ranging from 0.284 to 3.563 for DL and from 0.274 to 2.697 for ML; R2ranging from −7.405 to 0.331 for DL and from −8.113 to 0.470 for ML]. Among the 24 individual drugs, the ridge model of panobinostat exhibited the best performance (R20.470 and RMSE 0.623). Thus, we selected the ridge model of panobinostat for further application of explainable artificial intelligence (XAI). Using XAI, we further identified important genomic features for panobinostat response prediction in the ridge model, suggesting the genomic features of 22 genes. Based on our findings, results for an individual drug employing both DL and ML models were comparable. Our study confirms the applicability of drug response prediction models for individual drugs.
Myocardial strain-curve deformation patterns after Fontan operation
Authors: Schäfer Michal , Mitchell Max B. , Frank Benjamin S. , Barker Alex J. , Stone Matthew L. , Jaggers James , von Alvensleben Johannes C. , Hunter Kendall S. , Friesen Richard M. , Ivy D. Dunbar , Jacobsen Roni , Di Maria Michael V.
Published: July 2023

Myocardial deformation analysis by cardiac MRI (CMR) yielding global circumferential and longitudinal strain (GCS and GLS) is an increasingly utilized method to accurately quantify systolic function and predict clinical events in patients with Fontan circulation. The purpose of this study was to use principal component analysis (PCA) to investigate myocardial temporal deformation patterns derived from strain–time curves to learn about latent strain features beyond peak values. We conducted the study with specific attention to dominant single left or right ventricle (SLV and SRV) morphologies. Methods and Results: Patients remote from Fontan operation who underwent follow-up CMR were analyzed for standard volumetric and function hemodynamics including myocardial deformation parameters including GCS and GLS. We applied PCA to investigate in an unbiased fashion the strain–time curve morphology and to calculate patient specific shape scores. All variables were subjected to single variable Cox regression analysis to detect composite clinical outcome including death, heart transplant, protein losing enteropathy and plastic bronchitis. A total of 122 patients, (SLV = 67, SRV = 55) with a mean age of 12.7 years underwent comprehensive CMR analysis. The PCA revealed 3 primary modes of strain-curve variation regardless of single ventricle morphology and type of strain investigated. Principle components (PCs) described changes in (1) strain–time curve amplitude, (2) time-to-peak strain, and (3) post-systolic slope of the strain–time curve. Considering only SLV patients, GCS was only CMR variable predictive of clinical events (HR 1.46, p = 0.020). In the SRV group, significant CMR predictors of clinical events were derived indexed end-diastolic (HR 1.02, p = 0.023) and end-systolic (HR 1.03, p = 0.022) volumes, GCS (HR 1.91, p = 0.003) and its related first component score (HR 1.20, p = 0.005), GLS (HR 1.32, p = 0.029) and its third component score (HR 1.58, p = 0.017). CMR derived global strain measures are sensitive markers of clinical outcomes in patients with Fontan circulation, particularly in patients with the SRV morphology. Myocardial strain–time curve morphology specific to SLV and SRV patients inspired by unbiased PCA technique can further aid with predicting clinical outcomes.
Bioarchaeological and paleogenomic profiling of the unusual Neolithic burial from Grotta di Pietra Sant’Angelo (Calabria, Italy)
Authors: Fontani Francesco , Boano Rosa , Cinti Alessandra , Demarchi Beatrice , Sandron Sarah , Rampelli Simone , Candela Marco , Traversari Mirko , Latorre Adriana , Iacovera Rocco , Abondio Paolo , Sarno Stefania , Mackie Meaghan , Collins Matthew , Radini Anita , Milani Chantal , Petrella Enrico , Giampalma Emanuela , Minelli Antonella , Larocca Felice , Cilli Elisabetta , Luiselli Donata
Published: July 2023

The Neolithic burial of Grotta di Pietra Sant’Angelo (CS) represents a unique archaeological finding for the prehistory of Southern Italy. The unusual placement of the inhumation at a rather high altitude and far from inhabited areas, the lack of funerary equipment and the prone deposition of the body find limited similarities in coeval Italian sites. These elements have prompted wider questions on mortuary customs during the prehistory of Southern Italy. This atypical case requires an interdisciplinary approach aimed to build an integrated bioarchaeological profile of the individual. The paleopathological investigation of the skeletal remains revealed the presence of numerous markers that could be associated with craft activities, suggesting possible interpretations of the individual’s lifestyle. CT analyses, carried out on the maxillary bones, showed the presence of a peculiar type of dental wear, but also a good density of the bone matrix. Biomolecular and micromorphological analyses of dental calculus highlight the presence of a rich Neolithic-like oral microbiome, the composition of which is consistent with the presence pathologies. Finally, paleogenomic data obtained from the individual were compared with ancient and modern Mediterranean populations, including unpublished high-resolution genome-wide data for 20 modern inhabitants of the nearby village of San Lorenzo Bellizzi, which provided interesting insights into the biodemographic landscape of the Neolithic in Southern Italy.
Multi-omic analysis reveals dynamic changes of three-dimensional chromatin architecture during T cell differentiation
Authors: Zhang Ge , Li Ying , Wei Gang
Published: July 2023

Cell differentiation results in widespread changes in transcriptional programs as well as multi-level remodeling of three-dimensional genome architecture. Nonetheless, few synthetically investigate the chromatin higher-order landscapes in different T helper (Th) cells. Using RNA-Seq, ATAC-Seq and Hi-C assays, we characterize dynamic changes in chromatin organization at different levels during Naive CD4+ T cells differentiation into T helper 17 (Th17) and T helper 1 (Th1) cells. Upon differentiation, we observe decreased short-range and increased extra-long-range chromatin interactions. Although there is no apparent global switch in the A/B compartments, Th cells display the weaker compartmentalization. A portion of topologically associated domains are rearranged. Furthermore, we identify cell-type specific enhancer-promoter loops, many of which are associated with functional genes in Th cells, such as Rorc facilitating Th17 differentiation and Hif1a responding to intracellular oxygen levels in Th1. Taken together, these results uncover the general patterns of chromatin reorganization and epigenetic landscapes of gene regulation during T helper cell differentiation.
Zfp296 knockout enhances chromatin accessibility and induces a unique state of pluripotency in embryonic stem cells
Authors: Miyazaki Satsuki , Yamano Hiroyuki , Motooka Daisuke , Tashiro Fumi , Matsuura Takumi , Miyazaki Tatsushi , Miyazaki Jun-ichi
Published: July 2023

The Zfp296 gene encodes a zinc finger-type protein. Its expression is high in mouse embryonic stem cells (ESCs) but rapidly decreases following differentiation. Zfp296-knockout (KO) ESCs grew as flat colonies, which were reverted to rounded colonies by exogenous expression of Zfp296. KO ESCs could not form teratomas when transplanted into mice but could efficiently contribute to germline-competent chimeric mice following blastocyst injection. Transcriptome analysis revealed that Zfp296 deficiency up- and down-regulates a distinct group of genes, among which Dppa3, Otx2, and Pou3f1 were markedly downregulated. Chromatin immunoprecipitation sequencing demonstrated that ZFP296 binding is predominantly seen in the vicinity of the transcription start sites (TSSs) of a number of genes, and ZFP296 was suggested to negatively regulate transcription. Consistently, chromatin accessibility assay clearly showed that ZFP296 binding reduces the accessibility of the TSS regions of target genes. Zfp296-KO ESCs showed increased histone H3K9 di- and trimethylation. Co-immunoprecipitation analyses revealed interaction of ZFP296 with G9a and GLP. These results show that ZFP296 plays essential roles in maintaining the global epigenetic state of ESCs through multiple mechanisms including activation of Dppa3, attenuation of chromatin accessibility, and repression of H3K9 methylation, but that Zfp296-KO ESCs retain a unique state of pluripotency while lacking the teratoma-forming ability.
Single-cell analyses implicate ascites in remodeling the ecosystems of primary and metastatic tumors in ovarian cancer
Authors: Zheng Xiaocui , Wang Xinjing , Cheng Xi , Liu Zhaoyuan , Yin Yujia , Li Xiaoduan , Huang Zhihao , Wang Ziliang , Guo Wei , Ginhoux Florent , Li Ziyi , Zhang Zemin , Wang Xipeng
Published: July 2023

Ovarian cancer (OC) is an aggressive gynecological tumor usually diagnosed with widespread metastases and ascites. Here, we depicted a single-cell landscape of the OC ecosystem with five tumor-relevant sites, including omentum metastasis and malignant ascites. Our data reveal the potential roles of ascites-enriched memory T cells as a pool for tumor-infiltrating exhausted CD8+T cells and T helper 1-like cells. Moreover, tumor-enriched macrophages exhibited a preference for monocyte-derived ontogeny, whereas macrophages in ascites were more of embryonic origin. Furthermore, we characterized MAIT and dendritic cells in malignant ascites, as well as two endothelial subsets in primary tumors as predictive biomarkers for platinum-based chemotherapy response. Taken together, our study provides a global view of the female malignant ascites ecosystem and offers valuable insights for its connection with tumor tissues and paves the way for potential markers of efficacy evaluation and therapy resistance in OC.
Ultrasound-responsive glycopolymer micelles for targeted dual drug delivery in cancer therapy
Authors: Lin Shanmeng , Zhu Liwei , Li Zhiying , Yue Siyuan , Wang Zhaohan , Xu Youwei , Zhang Yichuan , Gao Quan , Chen Jie , Yin Ting , Niu Lili , Geng Jin
Published: July 2023

Controlled drug release of nanoparticles was achieved by irreversibly disrupting polymer micelles through high-intensity focused ultrasound (HIFU) induction.
Biotemplate synthesis of a Co3O4 microtube sensor for fast triethylamine detection
Authors: Xu Tingting , Wang Heru , Zhao Jing , Zhao Fangbo , Cong Wenbo , Wang Guiling , Li Junqing
Published: July 2023

Co3O4-0.10 sensors exhibit excellent sensitivity to TEA at 160 °C with the detection limit of 50 ppb. Meanwhile, the Co3O4-0.10 sensor also shows a short response/recovery time, fine repeatability, long-term stability and humidity resistance.
Effects of enzymatic modification on the stability of cashew-based milk
Authors: Pan Wenjie , Zheng Zhaojun , Li Panpan , Ai Zixuan , Liu Yuanfa
Published: July 2023

Moderate hydrolysis improved the physical and oxidative stability of cashew-based milk, which was highly associated with protein solubility and secondary structures.
Development of an asymmetric formal synthesis of (−)-quinagolideviaenzymatic resolution and stereoselective iminium ion reduction
Authors: Comparini Lucrezia Margherita , Menichetti Andrea , Favero Lucilla , Di Pietro Sebastiano , Badalassi Fabrizio , Ryberg Per , Pineschi Mauro
Published: July 2023

The study of the reduction of a benzo[g]octahydroquinolinium ion was examined in detail under different perspectives until we found a viable solution to get an advanced chiral intermediate of (3S,4aS,10aR)-(−)-quinagolide as a single stereoisomer.
A theoretical study of selective radical relay and coupling reactions for alkene difunctionalization
Authors: Yang Kai , Liu Jiabin , Fu Dongmin , Niu Linbin , Li Shi-Jun , Lan Yu
Published: July 2023

The present work developed a radical relay model for cross-coupling reactions involving multi-radical systems.
Curcumin nanoparticles: physicochemical fabrication, characterization, antioxidant, enzyme inhibition, molecular docking and simulation studies
Authors: Kanwal Qudsia , Ahmed Mahmood , Hamza Muhammad , Ahmad Muhammad , Atiq-ur-Rehman  , Yousaf Numan , Javaid Arshad , Anwar Aneela , Khan Iqra Haider , Muddassar Muhammad
Published: July 2023

Curcumin is an extensively studied natural compound due to its extensive biological applications.
Study on qualitative identification of aflatoxin solution based on terahertz metamaterial enhancement
Authors: Hu Jun , Zhan Chaohui , Chen Rui , Liu Yande , Yang Shimin , He Yong , Ouyang Aiguo
Published: July 2023

Aflatoxin is the main carcinogen that contaminates agricultural products and foods such as peanuts and corn.
Characteristics and health risk assessment of heavy metals in dust of a waste printed circuit board recycling workshop, China
Authors: Wang Ye , Xu Jingru , Liu Guijian
Published: July 2023

The heavy metals in workshop and outside workshop dust of different processing zones resulting from WPCBs recycling showed different. The crushing zone represented significantly higher enrichment and exposure risk of heavy metals.
Microwave absorbing characteristics of porphyrin derivates: a loop of conjugated structure
Authors: Dogari Haniyeh , Peymanfar Reza , Ghafuri Hossein
Published: July 2023

Microwave absorbing architectures have gained a great deal of attention due to their widespread application in diverse fields, especially in refining electromagnetic pollution.
The construction of an efficient magnesium–lithium separation thin film composite membrane with dual aqueous-phase monomers (PIP and MPD)
Authors: Cheng Xin , Pan Qiaoming , Tan Huifen , Chen keke , Liu Wenchao , Shi Yingying , Du Shengyu , Zhu Baoku
Published: July 2023

By systematically comparing the performance of the membranes prepared with different PIP/MPD ratios, aimed to identify the optimal ratio for achieving high efficient magnesium–lithium separation. The structure-performance relationship was discussed.
Achieving favourable oxygen electrocatalytic activity with compositionally complex metal molybdates
Authors: Beere Hemanth Kumar , Kulkarni Pranav , Maiti Uday Narayan , Balakrishna R. Geetha , Mukherjee Priyam , Jung Hyun Young , Samanta Ketaki , Ghosh Debasis
Published: July 2023

First row transition metal-based compositionally complex molybdate is explored with promising bifunctional oxygen electrocatalytic performance in alkaline conditions.
Strain correlation functions in isotropic elastic bodies: large wavelength limit for two-dimensional systems
Authors: Wittmer J. P. , Semenov A. N. , Baschnagel J.
Published: July 2023

Strain correlation functions in two-dimensional isotropic elastic bodies are shown theoretically (using the general structure of isotropic tensor fields) and numerically (using a glass-forming model system) to generally depend on the directions of field vector and coordinate system.
Emerging high-entropy coordination compounds and their derivatives for energy application
Authors: Gonçalves Josué M. , Ruiz-Montoya José G.
Published: July 2023

This highlight focuses on the advancements in high-entropy coordination compounds and their derivatives. It explores their synthesis strategies, effectiveness in catalyzing water electrolysis, and electrochemical performance in secondary batteries.
Naive Listener Ratings of Speech Intelligibility Over the Course of Motor-Based Intervention in Children With Childhood Apraxia of Speech
Authors: Wang Emily W. , Grigos Maria I.
Published: July 2023

Purpose:

The aim of this study was to describe changes in speech intelligibility and interrater and intrarater reliability of naive listeners' ratings of words produced by young children diagnosed with childhood apraxia of speech (CAS) over a period of motor-based intervention (dynamic temporal and tactile cueing [DTTC]).

Method:

A total of 120 naive listeners (i.e., listeners without experience listening to children with speech and/or language impairments; age range: 18–45 years) orthographically transcribed single-word productions by five children (age range: 2;6–3;11 [years;months]) across three time points over an intervention period (baseline, post-treatment, maintenance). Changes in intelligibility and interrater and intrarater reliability were examined within and across time points.

Results:

Speech intelligibility significantly increased in children with CAS over the course of treatment, and these gains were also maintained at 6 weeks posttreatment. There was poor-to-fair consistency
between
listeners (interrater reliability) and excellent consistency
within
listeners (intrarater reliability) in ratings of speech intelligibility within and across time points.

Conclusions:

Motor-based intervention increases speech intelligibility following a period of DTTC treatment. Variability among naive listeners of speech intelligibility was also present, with intrarater reliability (within listeners) yielding greater consistency than interrater reliability (between listeners). The implications for including naive listeners as raters of speech intelligibility for research and clinical purposes are discussed.
Heartbeat information prediction based on transformer model using millimetre‐wave radar
Authors: Hu Bojun , Jin Biao , Xue Hao , Zhang Zhenkai , Xu Zhaoyang , Zhu Xiaohua
Published: July 2023

Millimetre‐wave radar offers high ranging accuracy and can capture subtle vibration information of the human heart. This study proposes a heartbeat prediction method based on the transformer model using millimetre‐wave radar. Firstly, the millimetre‐wave radar was used to collect the heartbeat data and conduct normalisation processing. Secondly, a position coding was introduced to assign sine or cosine variables to input data and extract their relative position relationship. Subsequently, the transformer encoder was adopted to allocate attention to input data through the multi‐head attention mechanism, using a mask layer before the decoding layer to prevent the leakage of future information. Finally, we employ the fully connected layer was employed in the linear decoder for regression and output the predicted results. Our experimental results demonstrate that the proposed transformer model achieves nearly 30% higher prediction accuracy than traditional long short‐term memory models while improving both the prediction accuracy and convergence rate. The proposed method has great potential in predicting the heartbeat state of elderly and sick patients.
Intermittent properties of the quasi-periodic oscillations of MAXI J1820+070 revealed by Insight-HXMT
Authors: Zhang P. , Soria R. , Zhang S. , Ji L. , Kong L. D. , Chen Y. P. , Zhang S. N. , Chang Z. , Ge M. Y. , Li J. , Liu G. C. , Liu Q. Z. , Ma X. , Peng J. Q. , Qu J. L. , Shui Q. C. , Tao L. , Tian H. J. , Wang P. J. , Yan J. Z. , Zeng X. Y.
Published: July 2023

We investigate the dynamical properties of low-frequency quasi-periodic oscillations (QPOs) observed from the black hole X-ray binary MAXI J1820+070 during the early part of its 2018 outburst, when the system was in a bright hard state. To do this, we used a series of observations from the Hard X-ray Modulation Telescope Insight-HXMT and applied a wavelet decomposition (weighted waveletZ-transforms) to the X-ray light curve. We find that the QPO phenomenon is intermittent within each individual observation, with some subintervals in which the oscillation is strongly detected (high root-mean-square amplitude) and others in which it is weak or absent. The average lifetime of individual QPO segments is about 5 oscillation cycles, with a 3σtail of up to about 20 cycles. There is no substantial difference between the energy spectra during intervals with strong and weak or absent QPOs. Alternatively, we suggest that the changes in oscillation amplitude can be caused by changes in the jet speed. We discuss a possible reason for the intermittent QPO strength within the precessing-jet model previously proposed for MAXI J1820+070: we suggest that the changes in oscillation amplitude are caused by changes in the jet speed. We argue that a misaligned precessing-jet scenario is also consistent with other recent observational findings that suggest that the oscillation of the Compton reflection component is in phase with the QPOs.
Qualitative analysis of solutions to mixed-order positive linear coupled systems with bounded or unbounded delays
Authors: Tuan Hoang The , Van Thinh La
Published: July 2023

This paper addresses the qualitative theory of mixed-order positive linear coupled systems with bounded or unbounded delays. First, we introduce a general result on the existence and uniqueness of solutions to mixed-order linear systems with time-varying delays. Next, we obtain necessary and sufficient criteria which characterize the positivity of mixed-order delay linear coupled systems. Our main contributions are in Section 5. More precisely, by using a smoothness property of solutions to fractional differential equations and developing a new appropriated comparison principle for solutions to mixed-order delay positive systems, we prove the attractivity of mixed-order non-homogeneous linear positive coupled systems under the impact of bounded or unbounded delays. We also establish a necessary and sufficient condition to| ensure the stability of homogeneous systems. As a consequence of these results, we show the smallest asymptotic bound of solutions to mixed-order delay positive non-homogeneous linear coupled systems where disturbances are continuous and bounded. Finally, we provide numerical simulations to illustrate the proposed theoretical results.
Minimally Invasive Aortic Valve Replacement on Minimally Invasive Extracorporeal Circulation: Going beyond Aesthetics
Authors: Gunaydin Serdar , Ozisik Kanat , Gunertem Orhan Eren , Budak Ali Baran , Babaroglu Seyhan , Tekeli Atike , McCusker Kevin
Published: July 2023

We present our multidisciplinary and multistep strategy in patients undergoing minimally invasive aortic valve replacement (mAVR) on minimally invasive extracorporeal circulation (MiECC) compared with control groups of a single strategy and conventional techniques. This cohort study included high-risk patients (Society of Thoracic Surgeons [STS] risk score >8%) undergoing aortic valve surgery under different strategies during the period from January 2017 until March 2019. Patients were matched for age, gender, body mass index, and STS score: group 1 (MiAVR) based on a minimally invasive technique with J-mini-sternotomy, rapid deployment valve (RDV), and type IV customized MiECC; group 2 (control-mAVR) consisted of minimally invasive technique with only J mini-sternotomy and RDV on a conventional extracorporeal system; group 3 (control-MiECC): full sternotomy and type IV customized MiECC; and group 4 (control): full sternotomy on a conventional extracorporeal system. The MiAVR group had significantly less duration of x-clamp time (35.4 ± 11 minutes), postoperative respiratory support (4.1 ± 1 hour), postoperative hemorrhage (250 ± 50 mL), and intensive care unit stay (1 ± .5 days) than the control-conventional (group 4) group. Seventy-six percent of patients did not receive any blood products in MiAVR (p = .025 vs. group 4). Incidence of atrial fibrillation (8%) and low cardiac output (14%) in MiAVR were significantly better than control. Critics of minimally invasive techniques sustain that potential advantages are offset by a longer cross-clamp and cardiopulmonary bypass duration, which may translate into inferior clinical outcomes. We advocate that our multidisciplinary approach supported by multiple technologies may be associated with faster recovery and superior outcomes than conventional minimally/conventional techniques.
Bloodless Arterial Switch Operation in a 2.7-kg Jehovah’s Witness Patient
Authors: Burnside Jeffrey L. , Ratliff Todd M. , Kelly Madeleine N. , Naguib Aymen N. , Galantowicz Mark , Hodge Ashley
Published: July 2023

Bloodless pediatric cardiac surgery requiring the use of cardiopulmonary bypass (CPB) remains a challenge for the entire operating room (OR) team. The amount of circulating blood volume to pump prime volume mismatch of small patients results in hemodilution that frequently results in transfusion of allogeneic blood products. Patients of families of the Jehovah’s Witness (JW) faith reject the use of these products because of religious beliefs. Our institution is a referral center for children of JW families because we have developed techniques to minimize blood loss with the hope of performing bloodless pediatric cardiac surgery whenever possible. These techniques include preoperative treatment with erythropoietin, intraoperative acute normovolemic hemodilution, CPB circuit miniaturization, ultrafiltration during and after CPB, limiting blood gas analyses or other unnecessary blood draws, and using hemostatic agents during and after CPB. We present the case of a 4-day-old patient of the JW faith weighing 2.7 kg with transposition of the great arteries and an intact ventricular septum who underwent an arterial switch operation. The patient received no allogeneic blood product administration throughout the entire hospitalization. The patient’s first hematocrit in the OR was 43%, lowest hematocrit on bypass was 15%, and first hematocrit in the cardiothoracic intensive care unit post-procedure was 21%. The patient was discharged on post-op day nine with a hematocrit of 36%.
Fragen an das Dr.-Sommer-Team
Authors: Döring Nicola
Published: July 2023

Einleitung Jugendzeitschriften wie „Bravo“ und „Bravo Girl!“ sind auch im Digitalzeitalter noch bedeutsame sexuelle Sozialisationsinstanzen. Insbesondere die Beratung durch das Dr.-Sommer-Team erfreut sich großer Bekanntheit und Beliebtheit unter Jugendlichen in Deutschland.

Forschungsziele Ziel der vorliegenden Studie war es herauszuarbeiten, welche Merkmale die Ratsuchenden haben, die in der Dr.-Sommer-Rubrik von „Bravo“ und „Bravo Girl!“ sichtbar werden (Forschungsfrage 1), welche Themen ihre Fragen ansprechen (F2), inwiefern es in den Fragen und Antworten um zentrale Risiken oder Chancen der Sexualität (F3) sowie um sexualbezogenen Mediengebrauch geht (F4).

Methoden Im Rahmen einer quantitativen Medieninhaltsanalyse wurden alle Fragen an das Dr.-Sommer-Team samt zugehörigen Antworten ausgewertet, die in den Jahren 2018 und 2019 in der 14-täglich erscheinenden „Bravo“ (n = 306) und in der monatlich erscheinende „Bravo Girl!“ (n = 121) veröffentlicht wurden (N = 427). Die Datenerhebung erfolgte mittels eines reliabilitätsgeprüften Codebuchs durch einen geschulten Codierer. Die Datenanalyse beinhaltete deskriptiv- und inferenzstatistische Auswertungen sowie qualitative Interpretationen.

Ergebnisse Es zeigte sich, dass als Ratsuchende vor allem 14-jährige Mädchen mit weißer Hautfarbe und normattraktivem Körper sichtbar waren (F1). Bei den angesprochenen Themen waren Körper, Emotionen, Beziehungen und sexuelle Techniken vorrangig vertreten (F2). Risiken (z. B. ungeplante Schwangerschaft) und Chancen (z. B. sexuelles Vergnügen) wurden in den Fragen und Antworten ausgewogen thematisiert, wobei in der Jugendzeitschrift „Bravo“ die Lust beim Partnersex als Thema signifikant sichtbarer war als in der Mädchenzeitschrift „Bravo Girl!“ (F3). Medienthemen waren in 9 % der Fragen präsent (F4).

Schlussfolgerung Die Ergebnisse stehen im Einklang mit früheren Inhaltsanalysen der Sexualaufklärung in Jugendzeitschriften im Allgemeinen und in der „Bravo“ im Besonderen. Mediennutzungs- und Wirkungsstudien zur Sexualberatung in Jugendzeitschriften fehlen indessen weitgehend.
Integrierte Behandlung von Patient*innen mit somatischer
Belastungsstörung in Hausarztpraxen – Eine qualitative,
patient*innenbeteiligende Evaluation einer randomisierten
Machbarkeitsstudie
Authors: Tönnies Justus , Graue Leike , Ayoub-Schreifeldt Marayah , Wensing Michel , Szecsenyi Joachim , Friederich Hans-Christoph , Haun Markus W.
Published: July 2023

Ziel der Studie Die VISION-Intervention ist eine manualisierte
Kurzzeitbehandlung für Menschen mit somatischer
Belastungsstörung, die von Psychotherapeut*innen über
Videokonsultationen durchgeführt wird und direkt in die Hausarztpraxis
integriert ist. Als innovativer technologiebasierter Ansatz wurde die
Intervention zuletzt in einer randomisierten Machbarkeitsstudie erprobt. Im Zuge
der hier vorgestellten qualitativen Begleitstudie sollte durch Einbezug der in
die Machbarkeitsstudie eingeschlossenen Patient*innen die Intervention
evaluiert und aus der Perspektive der Nutzer*innen weiterentwickelt
werden.

Methodik Es wurden insgesamt N=10 in die Interventionsgruppe
eingeschlossene Patient*innen in drei leitfadengestützten
Fokusgruppendiskussionen dazu befragt, wie sie (1) die Intervention hinsichtlich
Akzeptanz und Wirksamkeit einschätzen und (2) welche Anpassungen aus der
Nutzer*innenperspektive zur weiteren Optimierung der Intervention
erforderlich sind. Die Auswertung erfolgte softwaregestützt mittels
qualitativer Inhaltsanalyse in MAXQDA Plus 2022.

Ergebnisse Die Befragten berichteten von ihren anfänglichen
Vorbehalten bezüglich der Versorgung per Videokonsultation. Nach einer
gewissen Zeit der Gewöhnung wurde die Intervention in einem hohen
Maße akzeptiert. Zu den wichtigsten Verbesserungsvorschlägen
gehörten ein stärkerer Fokus auf die Unterstützung der
Patient*innen bei der Suche nach einer Anschlusspsychotherapie (falls
indiziert), flexiblere Rahmenbedingungen (z. B. Ort der
Videokonsultation) sowie eine noch stärkere Integration der Behandlung
in die hausärztliche Versorgung.

Diskussion und Schlussfolgerung Die Studie liefert systematisch
ausgearbeitete Erkenntnisse zu Behandlungserfahrungen von Menschen mit
somatischer Belastungsstörung. Das Modell scheint geeignet zu sein zur
Behandlung von Menschen mit somatischer Belastungsstörung. Wichtige
Verbesserungsvorschläge sollten vor der Umsetzung in der Zukunft
gründlich abgewogen werden. Dabei sollten Betroffene weiterhin
einbezogen werden.
Ähnliche Weisheitsstrategien für unterschiedliche
Lebensprobleme
Authors: Meier-Credner Anne , Eberl-Kollmeier Mareike , Muschalla Beate
Published: July 2023

Ziel Weisheit kann verstanden werden als Fähigkeit,
unlösbare Probleme zu lösen. Weisen Menschen gelingt es besser,
verschiedene schwierige Lebenssituationen zu bewältigen. Dabei helfen
ihnen Weisheitsstrategien. Fraglich ist, ob in verschiedenen schwierigen
Lebenssituationen die gleichen oder verschiedene Weisheitsstrategien
benötigt werden. Diese Studie geht deshalb der Frage nach, ob Menschen
die gleichen oder unterschiedliche Weisheitsstrategien für sinnvoll
halten, wenn sie mit zwei verschiedenen Lebensproblemen konfrontiert werden.

Methodik Insgesamt 416 Personen (40,4 Jahre alt) lasen jeweils zwei
Vignetten, eine zu einer beruflichen Problemsituation und eine zu einer privaten
Problemsituation. Für jede Situation schätzten sie ein, wie
stark sie den angebotenen Weisheitsstrategien, bezogen auf die jeweilige
Situation, zustimmten. Die Weisheitsstrategien wurden mittels
Selbstbeurteilungsfragebogen erfasst.

Ergebnisse Die Befragten stimmten den Weisheitsstrategien für
beide Situationen ähnlich stark zu. Für beide Situationen
stimmten sie am stärksten der Bedeutung von Fakten- und
Problemlösewissen, Emotionswahrnehmung und -akzeptanz, Wertrelativismus
sowie Problem- und Anspruchsrelativierung zu. Die Reihenfolge der
übrigen acht Weisheitsstrategien ist für beide Situationen
dieselbe.

Diskussion und Schlussfolgerung Menschen tendieren dazu, allgemeinen
Weisheitsstrategien zuzustimmen, ungeachtet der situationsspezifischen
Hinweisreize. Weisheitsstrategien werden über verschiedene
Lebenssituationen hinweg für sinnvoll erachtet. Das ist bedeutsam
für die Gestaltung von Präventions- und
Interventionsmaßnahmen zur Förderung psychischer Resilienz.
Latency of epileptic and psychogenic nonepileptic seizures
Authors: Ozkan Hulya , Turksever Meliha , Guldiken Baburhan , Sut Necdet
Published: July 2023

Background Due to their semiological similarities, psychogenic nonepileptic seizures (PNESs) can occasionally hardly be differentiated from epileptic seizures (ESs), and long-term video-electroencephalographic monitoring (VEM) is needed for the differential diagnosis.

Objective To investigate the time of the first clinical event and its distribution on the days of VEM in ES and PNES patients.

Methods In total, a consecutive series of 48 PNES and 51 ES patients matched for gender and age were retrospectively and consecutively evaluated. The time distribution of the seizures during the day was noted. Seizure latency was determined as the time in hours from the start of the video-electroencephalographic recording to the first clinical event.

Results The seizure latency was significantly shorter in PNES patients compared to ES patients (p < 0.001). Seventy-two percent of PNES patients and 49.1% of ES patients had their first seizure in the 24 hours of video-EEG recording (p = 0.023). Recording longer than 48 hours was required for 12.5% of PNES patients and 37.3% of ES patients (p = 0.006). While ESs were almost evenly distributed throughout the day, most PNESs occurred during the evening hours (p = 0.011).

Conclusion We observed that the PNESs appeared earlier than the ESs in the VEM and were concentrated during daylight hours. Although not strictly reliable, seizure latency can contribute to the differential diagnosis of ES and PNES.
The Impact of Tinnitus Severity on Work Functioning among U.S. Military Veterans with Tinnitus
Authors: Coco Laura , Hooker Elizabeth R. , Gilbert Tess A. , Harker Graham R. , Clark Khaya D. , Reavis Kelly M. , Henry James A. , Zaugg Tara L. , Carlson Kathleen F.
Published: July 2023

Tinnitus is highly prevalent among military Veterans. Severe tinnitus can be associated with negative impacts on daily life. Veterans with severe tinnitus may also have greater difficulties in functional roles, including work. However, few studies have explicitly explored this relationship. Traumatic brain injury (TBI), also prevalent among Veterans, is associated with tinnitus and can additionally impair work functioning. This quantitative investigation used a population-based survey to assess the relationship between tinnitus severity, measured using the Tinnitus Functional Index (TFI), and the impact of tinnitus on work, measured using a composite score from the Tinnitus History Questionnaire, among a stratified random sample of VA healthcare-using Veterans diagnosed with tinnitus, with and without comorbid TBI. Analyses were weighted to account for sampling design and Veteran non-response; multiple imputation was used to account for missing data. Results indicated that for every 1-point increase in TFI score, there was an average 8% increase in the odds of reporting a high level of impact on work functioning (OR: 1.08; 95% CI: 1.06, 1.11). Veterans with a comorbid TBI diagnosis, compared with those without, were more likely to have high tinnitus-related impact on work functioning (OR: 2.69, 95% CI: 1.85, 3.91), but the relationship between tinnitus severity and the impact of tinnitus on work functioning did not differ by TBI status. These data can help researchers and clinicians understand complex symptoms experienced by Veterans with tinnitus, with and without TBI, supporting the improved provision of clinical services to these patients.
Complications and Long-Term Outcomes after Combined Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Transposition for Treatment of Concurrent Cranial Cruciate Ligament Rupture and Grade III or IV Medial Patellar Luxation
Authors: Redolfi Giovanna , Grand Jean-Guillaume
Published: July 2023

Objectives This study aims to report complications and long-term outcomes of combined tibial plateau leveling osteotomy and tibial tuberosity transposition (TPLO-TTT) for treatment of concurrent cranial cruciate ligament rupture and medial patellar luxation (MPL).

Study Design This is a retrospective study. Dogs that underwent TPLO-TTT for treatment of combined cranial cruciate ligament rupture and grade III or IV MPL were included. Signalment, fixation method, and complications were recorded. Long-term outcome assessment (minimum 1 year postoperatively) was performed through clinical and radiographic reexamination at the authors' institution.

Results Twenty-four stifles (22 dogs) were included. Twenty-one stifles had a grade III MPL, and 3 stifles had grade IV MPL. Four major complications consisting of surgical site infection (n = 3) and recurrent grade II MPL (n = 1) were observed. Dogs with surgical site infections were successfully treated with implant removal and oral antibiotics. No additional surgery was performed for the patient with recurrent MPL as no signs of lameness were observed. Minor complications occurred in five cases. At long-term evaluation (median: 27 months; range: 12–67 months), 21/22 dogs were clinically sound and 23/24 stifles had a complete resolution of MPL.

Conclusion TPLO-TTT can be considered as an effective surgical option to treat patients with concurrent cranial cruciate ligament rupture and MPL with a relatively low major complication rate. Owners should be warned of the potential need for implant removal.
Infarctive Apoplexy of Previously Healthy Pituitary Glands: A Small Case Series and Literature Review
Authors: Funari Abigail , Jeong Seth S. , Pecorari Isabella L. , Flaquer Isabella , Anderson Cassidy L. , Agarwal Vijay
Published: July 2023

Introduction We present two cases of suspected pituitary apoplexy found instead to be infarcted pituitary glands without histopathologic evidence of neoplastic cells, likely resulting from spontaneous infarction of previously healthy pituitary glands.

Case Presentations The first case is a 55-year-old man who presented with a pulsating headache, nausea, and several months of decreased libido, polyuria, and polydipsia. Magnetic resonance imaging (MRI) revealed a rim-enhancing sellar/suprasellar mass with evidence of recent hemorrhage on the right. Testosterone, follicle-stimulating hormone, and luteinizing hormone levels were suppressed. Analysis of the resected specimen showed fibrocollagenous tissue with evidence of old hemorrhage and microscopic focus of necrotic tissue. The second case is a 56-year-old man who presented with a throbbing headache, associated nausea, and 6 weeks of polyuria and polydipsia. Testosterone levels were found to be low, and 8-hour water deprivation test showed evidence for partial diabetes insipidus. MRI revealed a mass on the right side of the pituitary gland, with evidence of likely hemorrhage on the left. Analysis of the resected specimen showed necrotic tissue without neoplastic cells.

Conclusion When evaluating small pituitary lesions in patients presenting with indolent onset of pituitary insufficiency, there should be a high degree of suspicion for an infarcted pituitary gland.
Inverse Association of Lipoprotein(a) on Long-Term Bleeding Risk in Patients with Coronary Heart Disease: Insight from a Multicenter Cohort in Asia
Authors: Wang Peizhi , Yuan Deshan , Zhao Xueyan , Zhu Pei , Guo Xiaogang , Jiang Lin , Xu Na , Wang Zhifang , Liu Ru , Wang Qingsheng , Chen Yan , Zhang Yongzhen , Xu Jingjing , Liu Zhenyu , Song Ying , Zhang Zheng , Yao Yi , Feng Yingqing , Tang Xiaofang , Wang Xiaozeng , Gao Runlin , Han Yaling , Yuan Jinqing
Published: July 2023

Background Lipoprotein(a), or Lp(a), has been recognized as a strong risk factor for atherosclerotic cardiovascular disease. However, the relationship between Lp(a) and bleeding remains indistinct, especially in the secondary prevention population of coronary artery disease (CAD). This investigation aimed to evaluate the association of Lp(a) with long-term bleeding among patients with CAD.

Methods Based on a prospective multicenter cohort of patients with CAD consecutively enrolled from January 2015 to May 2019 in China, the current analysis included 16,150 participants. Thus, according to Lp(a) quintiles, all subjects were divided into five groups. The primary endpoint was bleeding at 2-year follow-up, and the secondary endpoint was major bleeding at 2-year follow-up.

Results A total of 2,747 (17.0%) bleeding and 525 (3.3%) major bleeding were recorded during a median follow-up of 2.0 years. Kaplan–Meier survival analysis showed the highest bleeding incidence in Lp(a) quintile 1, compared with patients in Lp(a) quintiles 2 to 5 (p < 0.001), while the incidence of major bleeding seemed similar between the two groups. Moreover, restricted cubic spline analysis suggested that there was an L-shaped association between Lp(a) and 2-year bleeding after adjustment for potential confounding factors, whereas there was no significant association between Lp(a) and 2-year major bleeding.

Conclusion There was an inverse and L-shaped association of Lp(a) with bleeding at 2-year follow-up in patients with CAD. More attention and effort should be made to increase the clinician awareness of Lp(a)'s role, as a novel marker for bleeding risk to better guide shared-decision making in clinical practice.
Machine Learning Classification of Psychiatric Data Associated with Compensation Claims for Patient Injuries
Authors: Juhola Martti , Nikkanen Tommi , Niemi Juho , Welling Maiju , Kampman Olli
Published: July 2023

Background Adverse events are common in health care. In psychiatric treatment, compensation claims for patient injuries appear to be less common than in other medical specialties. The most common types of patient injury claims in psychiatry include diagnostic flaws, unprevented suicide, or coercive treatment deemed as unnecessary or harmful.

Objectives The objective was to study whether it is possible to form different categories of patient injury types associated with the psychiatric evaluations of compensation claims and to base machine learning classification on these categories. Further, the binary classification of positive and negative decisions for compensation claims was the other objective.

Methods Finnish psychiatric specialist evaluations for the compensation claims of patient injuries were classified into six different categories called classes applying the machine learning methods of artificial intelligence. In addition, another classification of the same data into two classes was performed to test whether it was possible to classify data cases according to their known decisions, either accepted or declined compensation claim.

Results The former classification task produced relatively good classification results subject to separating between different classes. Instead, the latter was more complex. However, classification accuracies of both tasks could be improved by using the generation of artificial data cases in the preprocessing phase before classifications. This preprocessing improved the classification accuracy of six classes up to 88% when the method of random forests was used for classification and that of the binary classification to 89%.

Conclusion The results show that the objectives defined were possible to solve reasonably.