bluuebunny/crossref_metadata_2025 huggingface dataset:
Entropy formulae on Feldman–Katok metric of random dynamical systems
Authors: Xie Yunxiang , Chen Ercai , Yang Kexiang
Published: August 2024

Feldman–Katok metric is the weakest metric in some sense that makes entropy formulae valid, which can also be considered as the topological counterpart of the edit distance. In this paper, we study Feldman–Katok metric of random dynamical systems and establish topological entropy formula as well as Brin–Katok local entropy formula and Katok entropy formula on Feldman–Katok metric.
Geometric ergodicity of SGLD via reflection coupling
Authors: Li Lei , Liu Jian-Guo , Wang Yuliang
Published: August 2024

We consider the geometric ergodicity of the Stochastic Gradient Langevin Dynamics (SGLD) algorithm under nonconvexity settings. Via the technique of reflection coupling, we prove the Wasserstein contraction of SGLD when the target distribution is log-concave only outside some compact sets. The time discretization and the minibatch in SGLD introduce several difficulties when applying the reflection coupling, which are addressed by a series of careful estimates of conditional expectations. As a direct corollary, the SGLD with constant step size has an invariant distribution and we are able to obtain its geometric ergodicity in terms of [Formula: see text] distance. The generalization to non-gradient drifts is also included.
The Lp-saturation of linear combinations of Szász–Mirakjan–Kantorovich operators
Authors: Wang Shuli , Xie Linsen
Published: August 2024

In this paper, we investigate the [Formula: see text]-saturation of linear combinations of Szász–Mirakjan–Kantorovich operators. The main difficulty is how to tackle the differential operators deduced by Szász–Mirakjan–Kantorovich operators. We firstly investigate the regularity of these differential operators. By virtue of the regularity, the saturation theorem for linear combinations of Szász–Mirakjan–Kantorovich operators is ultimately obtained. Namely, the [Formula: see text]-saturation class of these combinations is characterized.
Eccentric connectivity index in complementary prisms
Authors: Aytaç Aysun , Coşkun Belgin
Published: August 2024

The topological index is just one of several very useful tools that graph theory has made available to chemists. Topological indices are invariants of real numbers under graph isomorphisms. Several topological indices have been defined. Some of them are used to model chemical, pharmaceutical and other properties of molecules. The eccentric connectivity index (eci) is also a topological index. The eci of [Formula: see text], denoted by [Formula: see text], is defined as [Formula: see text], where [Formula: see text] represents the degree of a vertex [Formula: see text] and [Formula: see text] is its eccentricity. In this paper, exact formula for the eci of complementary prisms is derived.
From “Made In” to Mukokuseki: Exploring the Visual Perception of National Identity in Robots
Authors: Seaborn Katie , Kotani Haruki , Pennefather Peter
Published: August 2024

People read human characteristics into the design of social robots, a visual process with socio-cultural implications. One factor may be nationality, a complex social characteristic that is linked to ethnicity, culture, and other factors of identity that can be embedded in the visual design of robots. Guided by social identity theory (SIT), we explored the notion of “mukokuseki,” a visual design characteristic defined by the absence of visual cues to national and ethnic identity in Japanese cultural exports. In a two-phase categorization study (

\(n=212\)

), American (

\(n=110\)

) and Japanese (

\(n=92\)

) participants rated a random selection of nine robot stimuli from America and Japan, plus multinational Pepper. We found evidence of made-in and two kinds of mukokuseki effects. We offer suggestions for the visual design of mukokuseki robots that may interact with people from diverse backgrounds. Our findings have implications for robots and social identity, the viability of robotic exports, and the use of robots internationally.
Efficient and User-Friendly Visualization of Neural Relightable Images for Cultural Heritage Applications
Authors: Righetto Leonardo , Khademizadeh Mohammad , Giachetti Andrea , Ponchio Federico , Gigilashvili Davit , Bettio Fabio , Gobbetti Enrico
Published: August 2024

We introduce an innovative multi-resolution framework for encoding and interactively visualizing large relightable images using a neural reflectance model derived from a state-of-the-art technique. The framework is seamlessly integrated into a scalable multi-platform framework that supports adaptive streaming and exploration of multi-layered relightable models in web settings. To enhance efficiency, we optimized the neural model, simplified decoding, and implemented a custom WebGL shader specific to the task, eliminating the need for deep-learning library integration in the code. Additionally, we introduce an efficient level-of-detail management system supporting fine-grained adaptive rendering through on-the-fly resampling in latent feature space. The resulting viewer facilitates interactive neural relighting of large images. Its modular design allows the incorporation of functionalities for cultural heritage analysis, such as loading and simultaneous visualization of multiple relightable layers with arbitrary rotations.
Investigation of Dynamic Water Cluster and Droplet Interactions in Polymer Electrolyte Fuel Cells using Operando X-ray Tomographic Microscopy
Authors: Dörenkamp Tim , Sabharwal Mayank , Marone Federica , Büchi Felix N. , Schmidt Thomas J. , Eller Jens
Published: August 2024

Efficient removal of the electrochemically produced water from the gas diffusion layer (GDL) in polymer electrolyte fuel cells is crucial for reducing mass transport losses and improving the efficiency at high current densities. Understanding the relationship between the water percolation through the GDL and droplet formation in the gas channel will allow the design of advanced GDL materials, which provide optimal water management. In this study, a catalyst-coated membrane with 8 individual active areas (0.06 mm2 each) is investigated using operando X-ray tomographic microscopy to study the transient development and interaction of multiple percolating water clusters in a GDL and droplet formation in the channel. The 4D imaging results at a time resolution of 1 Hz showed transient instabilities in the developed percolating water networks at various frequencies associated with break-through and spontaneous water drainage.
The Environment and Features of Digital Place‐Based Media at Minibus Taxi Ranks as Nontraditional Advertising Media
Authors: Roux A. T. , Wannenburg E. , Manetje T. V.
Published: August 2024

Despite the substantial growth in digital out‐of‐home media and the promising potential of digital place‐based media, there is a limited understanding of this medium at minibus taxi ranks. The scholarly literature mostly neglects transit advertising’s digital transformation, while practitioners are starting to recognize its potential. This paper bridges the academic‐practitioner gap by reviewing digital place‐based media’s potential within minibus taxi ranks. The integrative review process involved defining the issue, detailing contributions and research questions, and synthesizing diverse sources into a conceptual framework. This framework comprehensively portrays the environment, distinguishes traditional and nontraditional media, and explores digital place‐based media features. It offers guidelines for digital marketers, advertisers, and content managers, proposing future research areas in contextual factors, media comparisons, and DPB media features. Multiple aspects for future research are suggested across three distinct areas: contextual factors in transit media; comparative analysis of traditional and nontraditional media, focusing on their image, cost, integration with technologies, and human interaction with media; and examination of DPB media features, encompassing creativity in content creation and delivery, contextually relevant content, and digital programmatic content.
Ethanolic Extract of Mangifera indica Protects against CCl4‐Induced Hepatotoxicity via Antioxidant Capabilities in Albino Rats
Authors: Kabbashi Ahmed Saeed , Eltawaty Salwa Abdulla , Ismail Amar Mohamed , Elshikh Ahmed Abdelhhafiz , Alrasheid Ayat Ahmed , Elmahi Rawan Ahmed , Koko Waleed S. , Osman Elbadri Elamin
Published: August 2024

Objective. To investigate the antioxidant and hepatoprotective effects of ethanolic Mangifera indica (M. indica) seed extract on carbon tetrachloride (CCl4)‐induced hepatotoxicity in albino rats. Methods. Forty‐eight albino rats weighing (100–150 g) were used for hepatoprotective and toxicity experiments. Antioxidant activity was determined using the 2, 2‐diphenyl‐1‐picrylhydrazyl (DPPH) assay. The toxicity of M. indica seeds on the liver was evaluated by examining wellness parameters, body weight, and liver histological sections. The protective effects of 50 mg/kg and 100 mg/kg of seed extract on CCl4‐induced hepatotoxicity were investigated by evaluating hematological, renal, and liver function parameters, body weight, and liver histological sections. Results. The antioxidant activity of the M. indica ethanolic extract was (92 ± 0.03 RSA %) compared with (91 ± 0.01 RSA %) of propyl gallate, and the IC50 was (8.3 ± 0.01 µg/ml) and (14.1 ± 0.01 µg/ml). No changes were observed in the health indicators, body weights, and liver histological sections following oral administration of 50 mg/kg and 100 mg/kg of M. indica seed extracts. Treatment with M. indica seed extract significantly reduced alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), blood sugar, and urea levels compared with those in the CCl4‐treated group. Conclusion. The IC50 of the M. indica ethanolic extract was 8.3 µg/ml, and the M. indica extract is a potential source of natural antioxidants that protect against CCl4‐induced hepatotoxicity.
Heuristic Forest Fire Detection Using the Deep Learning Model with Optimized Cluster Head Selection Technique
Authors: N. Sengottaiyan , J. Ananthi , R. Rajesh Sharma , S. Hamsanandhini , Akey Sungheetha , R. Chinnaiyan , Gemeda Ketema Adare
Published: August 2024

Disaster prediction systems enable authorities and communities to identify and understand the risks associated with various natural and man‐made disasters. Disaster prediction systems are essential tools for enhancing public safety, reducing the impact of disasters, and enabling more informed and strategic decision‐making across various sectors. Their development and implementation represent a crucial aspect of modern disaster risk management and resilience systems. This novel technique introduces a modern approach to forest fire prediction by integrating a deep learning model with an optimized cluster head selection technique. The major goal is to augment the accuracy and efficiency of forest fire prediction, leveraging the capabilities of advanced machine learning algorithms and optimized sensor network management. The proposed system comprises two core components: a deep learning model for predictive analysis and an optimized selection process for cluster heads in sensor networks. The deep learning model utilizes various environmental data parameters such as humidity, wind speed, temperature and former fire incidents. These parameters are processed through a sophisticated neural network architecture designed to identify patterns and correlations that signify the likelihood of a forest fire. The model is trained on historical data to improve its predictive accuracy, and its performance is continuously evaluated against new data. Simultaneously, the optimized cluster head selection using the cat‐mouse optimization technique plays a crucial role in efficiently managing sensor networks deployed in forests. The integration of these two components results in a robust system capable of predicting forest fires with high precision. The system not only assists in early detection and timely alerts but also contributes to the strategic planning of firefighting and resource allocation efforts. This approach has the prospective to significantly lessen the impact of forest fires, thereby protecting ecosystems and communities.
Table 2 from Characterizing Relationships between T-cell Inflammation and Outcomes in Patients with High-Risk Neuroblastoma According to Mesenchymal and Adrenergic Signatures
Authors: Kaufman Maria E. , Vayani Omar R. , Moore Kelley , Chlenski Alexandre , Wu Tong , Lee Sang Mee , Desai Ami V. , He Chuan , Cohn Susan L. , Applebaum Mark A.
Published: August 2024

Inflammation and cell state characteristics of the Discovery and Validation cohorts
Figure 6 from Characterizing Relationships between T-cell Inflammation and Outcomes in Patients with High-Risk Neuroblastoma According to Mesenchymal and Adrenergic Signatures
Authors: Kaufman Maria E. , Vayani Omar R. , Moore Kelley , Chlenski Alexandre , Wu Tong , Lee Sang Mee , Desai Ami V. , He Chuan , Cohn Susan L. , Applebaum Mark A.
Published: August 2024

Inflammation score may be associated with OS in adrenergic tumors of patients >18 months with stage IV disease. A, OS was significantly better for TCI tumors than NI tumors in ADRN patients in this subgroup of the Discovery cohort and B, trended similarly in the Validation cohort. C, There was no difference in survival for patients with MES tumors according to TCI status in this subgroup in the Discovery cohort. D, The MES patients in this subgroup in the Validation cohort also had no difference in OS according to the TCI status.
Figure 3 from Characterizing Relationships between T-cell Inflammation and Outcomes in Patients with High-Risk Neuroblastoma According to Mesenchymal and Adrenergic Signatures
Authors: Kaufman Maria E. , Vayani Omar R. , Moore Kelley , Chlenski Alexandre , Wu Tong , Lee Sang Mee , Desai Ami V. , He Chuan , Cohn Susan L. , Applebaum Mark A.
Published: August 2024

MES scores are anticorrelated with ADRN scores and correlated with TCI. A, Association of MES and ADRN scores in the Discovery cohort. B, MESadj scores were also significantly higher in TCI tumors in the Discovery cohort. C, Similar trends for inverse correlations were seen in the Validation cohort. D, MESadj scores were also significantly higher in TCI tumors in the Validation cohort.
Contraction and intracellular Ca2+ in ventricular myocytes from rats receiving fructose-enriched diets
Authors: Howarth F.C. , Qureshi A. , Al-Mansoori D. , Ponery A.S. , Naseer O. , Adeghate E.
Published: August 2024

Contraction and intracellular Ca2+ in ventricular myocytes from rats receiving fructose-enriched diets (FED) were
investigated. Groups of male Wistar rats received normal rat chow together with either normal drinking water or water
containing 500 mM fructose ad libitum. Experiments were performed 12-14 weeks later. Rats receiving FED responded
differently to a standard glucose tolerance test. Fasting blood glucose levels in FED and control rats were 48.5±2.3 (4) and
47.0±1.9 (4) mg/dl, respectively. At 30 min after intraperitoneal administration of glucose (2g/kg body weight),
concentrations of blood glucose were significantly (P<0.05) higher in rats receiving FED (206.3±19.5 mg/dl) compared to
controls (150.3±8.5 mg/dl). At 120 min, blood glucose in FED (87.3±4.2) and control (80.3±3.4 mg/dl) rats were still
significantly (P<0.01) higher than initial values. Amplitude and time to half (THALF) relaxation of ventricular myocyte
shortening and Ca2+ transient were not altered by FED. Time to peak (TPK) shortening was unaltered, however, the TPK Ca2+
transient was significantly prolonged in FED rats (65.1±3.4 ms) compared to controls (56.4±2.0 ms). In conclusion, diets
supplemented with drinking water containing 500 mM fructose for a period of 12-14 weeks did not have significant effects on
ventricular myocyte shortening but did prolong the time course of the Ca2+ transient suggesting that defects in Ca2+ transport
may precede defects in myocyte contractility in this experimental model.
Clinical and genetic features of childhood-onset type 2 diabetes in Japan
Authors: Otabe Shuichi , Nakayama Hitomi , Fukutani Tomoka , Yuan Xiaohong , Hirota Naotoshi , Inada Chizuko , Yamada Kentaro
Published: August 2024

Aims: We aimed to define the detailed clinical features of Japanese childhood-onset Type 2 diabetes mellitus (T2DM) patients
and to determine whether their discernable characteristics were similar to those of adult- and childhood-onset T2DM in other
countries. Research design and methods: Subjects were 22 patients (10 males and 12 females) under treatment without
hepatocyte nuclear factor-1α or mitochondrial gene mutations and who were diagnosed as diabetic when less than 15 years of
age. Results: Body mass indices in boys and girls at onset were 25.8 ± 6.3 and 24.7 ± 3.6, respectively, with mean ages of
13.3 ± 1.7 and 12.8 ± 2.0 years, respectively. Most patients had a short diabetic duration that required insulin treatment. One
or both parents of 18 of the 22 T2DM subjects were diabetic and seven subjects had a history of diabetes in their family over
three generations. Conclusion: We demonstrated that a relatively high number of Japanese childhood-onset T2DM cases have
a strong genetic factor, and are not necessarily related to excessive obesity. Furthermore, most patients required insulin
therapy in the initial stages because of insufficient pancreatic ß-cell reserves. This suggests that malfunction of pancreatic ßcells
triggers hyperglycemia resulting in the requirement for insulin in some Japanese childhood-onset T2DM patients. (Int J
Diabetes Metab 14: 106-109, 2006)
Atypical diabetic presentation in Saudi Arabian adolescents
Authors: Udezue Emmanuel , Bzour Abeer , Jawabreh Sumyah
Published: August 2024

Background: The prevalence of diabetes mellitus is increasing worldwide. Adolescents in Saudi Arabia frequently present
with the disease, some with clinical features which differ from those expected in youth from other countries. This new
pattern is reported in the following study of newly diagnosed young diabetic patients from Eastern Saudi Arabia. Patients
and Method: Patients aged 14-20 diagnosed with diabetes over a five year period (1998-2003) in a private health centre were
studied. The presenting clinical features are described and compared with those of diabetic children from the same
population base. Results: Most newly diagnosed adolescent diabetic patients presented with the classical clinical features of
polyuria, polydipsia and weight loss, rather than diabetic keto-acidosis. About one third of them (30%) behaved clinically
like patients with type 2 diabetes (Type2 DM), with subsequent reasonable glycaemic control on diet and oral hypoglycaemic
agents (OHAs), while only about a quarter (23%) presented with diabetic keto-acidosis (DKA) which was relatively mild.
Conclusion: Only about a quarter of patients with adolescent onset diabetes mellitus in the Hasa area of Saudi Arabia
presented with DKA. The majority presented with the classical features of polydipsia, polyuria and weight loss with about a
third behaving clinically like patients with Type 2 DM. (Int J Diabetes Metab 15: 4-8, 2007)
Improving best practices through nutrition education among Caribbean healthcare professionals
Authors: Xuereb Godfrey , Samuda Pauline , Ragoobirsingh Dalip , Morrison Errol Y.
Published: August 2024

Diabetes and hypertension are among the leading causes of mortality and morbidity in the Caribbean with obesity being the
major underlying factor. The Caribbean Food and Nutrition Institute (CFNI) developed a “Protocol for the Nutritional
Management of Obesity, Diabetes and Hypertension in the Caribbean” whose main goal is to improve the standards of care in
the region. A short training programme was developed on how to implement the Protocol. The successful implementation of
the Protocol depended on the effectiveness of this training, thus an evaluation of the training was conducted. Two hundred
and seventy nine (279) healthcare workers were trained in Jamaica, Guyana, Belize, St. Vincent and the Grenadines, and
Suriname through a three-day workshop. Participants were given a short pre and post-knowledge test and completed an end
of workshop evaluation. The results showed that in all the countries there was a positive shift in the knowledge and that most
of the participants rated the content and quality of the training highly. Participants stated that the overall aim, structure and
scope of the workshop were met and that they appreciated greatly the overall usefulness of the training. The improved
knowledge of healthcare professionals is key to the successful implementation of the protocol and improved quality of care.
Do contraindications to metformin therapy deprive type 2 diabetic patients of its benefits?
Authors: Al Awadhi S.S. , Clifford R.M. , Sunderland V.B. , Hackett L.R.P. , Farah H. , Shareef T.M.
Published: August 2024

Background: Metformin is considered to be the drug of choice in overweight, newly diagnosed type 2 diabetes. Lactic acidosis is stated to be the most serious side effects of metformin therapy. Current available guidelines contain so many ambiguous terms in describing the contraindications to metformin use that they do little to assist in addressing this problem. Moreover, these ambiguous contraindications may deprive many diabetic patients from the benefit of metformin. Objectives: The aim of the current study was to evaluate the safety of metformin use in the presence of “standard” contraindications to its use. Research design and methods: This was a cross sectional study that involved type 2 diabetic patients who were on chronic treatment with metformin. A fasting blood sample was taken from each subject to determine levels of serum creatinine levels, bicarbonate, fasting blood sugar, lactate, insulin, C-Peptide, and metformin plasma concentration. Results: 106 patients were recruited in the study with 68 (64%) females. The mean age was 58 ± 13 years. The results illustrate that metformin has been prescribed for patients who are listed in the guidelines as having standard contraindications to its use. There were 30 (28%) patients with impaired renal function (Clcr < 60ml/min.) and five with Clcr < 30ml/min. Moreover, 30 (28%) had ischemic heart disease, six (5%) patients were diagnosed as having congestive heart failure, five (4%) with chronic obstruction pulmonary disease, and three (2%) with peripheral vascular disease. Although the numbers of those patients were not large enough to establish and confirm the safety of metformin in the presence of these standard contraindications and precautions, there were no cases of lactic acidosis observed. Conclusions: This study along with other studies has revealed that there is vagueness in the available guidelines in prescribing metformin, which led to the different observed practices. This study revealed that metformin is still prescribed to patients with listed contraindications. Clearer guidelines are needed for prescribing metformin with more specific contraindications. For example it would be more beneficial if the degree of heart failure, classified according to the New York Heart Association is specified.
Ocular Metastasis as First Presentation of Large-Cell Neuroendocrine Carcinoma
Authors: Chong Yu Jeat , Azzopardi Matthew , Ng Benjamin , Salvi Sachin M. , Sreekantam Sreekanth
Published: August 2024

Introduction: We report a rare case of an aggressive large-cell neuroendocrine lung tumour, which presented with ocular metastasis. Case Presentation: A 70-year-old lady presented with a 4-week history of left eye pain and photophobia. Ocular examination revealed left-sided episcleritis and she was treated with topical lubricants and steroids. However, she re-presented 6 months later with recurrent left eye symptoms and was found to have an iris stroma amelanotic lesion, posterior synechiae, 360-degrees rubeosis iridis, raised intraocular pressure, and trace vitreous inflammation. Ultrasound biomicroscopy revealed a left thickened iris with an associated ciliary body lesion. Sarcoid-related ocular inflammation was suspected, but a computed tomography (CT) scan of the lung revealed an incidental right upper lobe lesion. Histology from a transcorneal iris biopsy showed a high-grade neuroendocrine carcinoma, and the diagnosis of metastatic lung large-cell neuroendocrine carcinoma was confirmed via high-resolution CT scan, positron emission tomography scan, and CT-guided lung biopsy. She was given multiple courses of different chemotherapy regimens along with palliative radiotherapy. However, the tumour and its metastases continued to progress and she passed away 4 years after her initial presentation. Conclusion: Ocular metastatic large-cell neuroendocrine carcinoma is rare, and the first presentation with ocular metastasis is even rarer. This case highlights the importance of early detection of ocular metastases in order to hasten oncological treatment. A low threshold for systemic investigations and ophthalmology referral in cases of unexplained, refractory ocular symptomatology is essential, given the heterogeneous presentation, rarity, and poor prognosis of these tumours, even with maximal treatment.
Glyceraldehyde-3-Phosphate Dehydrogenase Binds with Spike Protein and Inhibits the Entry of SARS-CoV-2 into Host Cells
Authors: Dilawari Rahul , Chaubey Gaurav Kumar , Modanwal Radheshyam , Dhiman Asmita , Talukdar Sharmila , Kumar Ajay , Raje Chaaya Iyengar , Raje Manoj
Published: August 2024

Introduction: Coronavirus disease 2019 caused by coronavirus-2 (SARS-CoV-2) has emerged as an aggressive viral pandemic. Health care providers confront a challenging task for rapid development of effective strategies to combat this and its long-term after effects. Virus entry into host cells involves interaction between receptor-binding domain (RBD) of spike (S) protein S1 subunit with angiotensin converting enzyme present on host cells. Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is a moonlighting enzyme involved in cellular glycolytic energy metabolism and micronutrient homeostasis. It is deployed in various cellular compartments and the extra cellular milieu. Though it is known to moonlight as a component of mammalian innate immune defense machinery, till date its role in viral restriction remains unknown. Method: Recombinant S protein, the RBD, and human GAPDH protein were used for solid phase binding assays and biolayer interferometry. Pseudovirus particles expressing four different strain variants of S protein all harboring ZsGreen gene as marker of infection were used for flow cytometry-based infectivity assays. Results: Pseudovirus entry into target cells in culture was significantly inhibited by addition of human GAPDH into the extracellular medium. Binding assays demonstrated that human GAPDH binds to S protein and RBD of SARS-CoV-2 with nanomolar affinity. Conclusions: Our investigations suggest that this interaction of GAPDH interferes in the viral docking with hACE2 receptors, thereby affecting viral ingress into mammalian cells.
Lower Eyelid Merkel Cell Carcinoma in a Non-Immunocompromised Young Female: A Case Report
Authors: Komatsu Yoshifumi , Kitaguchi Yoshiyuki , Kurashige Masako , Morimoto Takeshi , Nishida Kohji
Published: August 2024

Introduction: Merkel cell carcinoma (MCC) is a rare neuroendocrine skin tumor associated with Merkel cell polyomavirus and ultraviolet light exposure. MCC typically affects older individuals, and it also influences young patients with immunosuppressive conditions. We report a case of lower eyelid MCC in a non-immunocompromised 37-year-old woman. Case Presentation: A 37-year-old woman presenting with suspected MCC on her right lower eyelid was referred to our hospital for further resection. The patient underwent wide excision with clear margins followed by reconstruction and radiation therapy. The patient has shown no signs of recurrence after 5 months of follow-up. Conclusion: MCC needs to be considered as a possible diagnosis when examining an eyelid tumor in a young patient.
Efficacy and Clinical Outcomes of mRNA COVID-19 Vaccine in Pregnancy: A Systematic Review and Meta-Analysis
Authors: Santimano Antonio J. , Al-Zoubi Raed M. , Al-Qudimat Ahmad R. , Al Darwish Mohamed B. , Ojha Laxmi Kumari , Rejeb Mohamed Amine , Hamad Yasser , Elrashid Malaz A. , Ruxshan Noorah M. , El Omri Abdelfatteh , Bawadi Hiba , Al-Asmakh Maha A. , Yassin Aksam , Aboumarzouk Omar M. , Zarour Ahmad , Al-Ansari Abdulla A.
Published: August 2024

Background: The world has witnessed one of the largest pandemics, dubbed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of December 2020, the USA alone reported 98,948 cases of coronavirus disease 2019 (COVID-19) infection during pregnancy, with 109 related maternal deaths. Current evidence suggests that unvaccinated pregnant women infected with SARS-CoV-2 are at a higher risk of experiencing complications related to COVID-19 compared to nonpregnant women. This review aimed to provide healthcare workers and non-healthcare workers with a comprehensive overview of the available information regarding the efficacy of vaccines in pregnant women. Summary: We performed a systematic review and meta-analysis following PRISMA guidelines. The search through the database for articles published between December 2019 and October 2021 was performed. A comprehensive search was performed in PubMed, Scopus, and EMBASE databases for research publications published between December 2019 and October 2021. We focused on original research, case reports, case series, and vaccination side effect by authoritative health institutions. Phrases used for the Medical Subject Heading [MeSH] search included (“COVID-19” [MeSH]) or (“Vaccine” [MeSH]) and (“mRNA” [MeSH]) and (“Pregnant” [MeSH]). Eleven studies were selected and included, with a total of 46,264 pregnancies that were vaccinated with mRNA-containing lipid nanoparticle vaccine from Pfizer/BioNTech and Moderna during pregnancy. There were no randomized trials, and all studies were observational (prospective, retrospective, and cross-sectional). The mean maternal age was 32.2 years, and 98.7% of pregnant women received the Pfizer COVID-19 vaccination. The local and systemic adverse effects of the vaccination in pregnant women were analyzed and reported. The local adverse effects of the vaccination (at least 1 dose) such as local pain, swelling, and redness were reported in 32%, 5%, and 1%, respectively. The systemic adverse effects such as fatigue, headaches, new onset or worsening of muscle pain, chills, fever, and joint pains were also reported in 25%, 19%, 18%, 12%, 11%, and 8%, respectively. The average birthweight was 3,452 g. Among these pregnancies, 0.03% were stillbirth and 3.68% preterm (<37 weeks) births. Key Messages: The systemic side effect profile after administering the COVID-19 mRNA vaccine to pregnant women was similar to that in nonpregnant women. Maternal and fetal morbidity and mortality were lowered with the administration of either one or both the doses of the mRNA COVID-19 vaccination.
Macrophage: Hidden Criminal in Therapy Resistance
Authors: Ding Yimin , Cao Qian , Yang Wenjuan , Xu Junjie , Xiao Peng
Published: August 2024

Background: Although substantial efforts have been made by researchers to develop drugs, a disappointing reality is that the emergence of drug resistance is an unavoidable reality for the majority of patients. In recent years, emerging evidence suggests a connection between drug resistance and immune dysregulation. Summary: As a ubiquitously distributed, versatile innate immune cell, macrophages play essential roles in maintaining tissue homeostasis in a steady state. Nevertheless, it is becoming aware that macrophages undermine the action of therapeutic drugs across various disease types. Reprogramming macrophage function has been proven to be effective in restoring patient responsiveness to treatment. Herein, we comprehensively reviewed how macrophages respond to drugs and the mechanisms by which they contribute to treatment unresponsiveness in cancer, inflammatory diseases, and metabolic diseases. In addition, future prospects in macrophage-based combination therapy were discussed. Key Messages: Targeting macrophages is a promising strategy for overcoming drug resistance in immune disorders.
Peribiliary Gland Hyperplasia That Required Differentiation from Extrahepatic Bile Duct Cancer: A Case Report
Authors: Takami Kazuhiro , Yamamoto Kuniharu , Sakurai Hiroto , Sato Yoshihiro , Kondo Noriko , Nakano Toru , Tsujinaka Shingo , Koiwai Akinobu , Hirota Morihisa , Murakami Keigo , Murakami Kazuhiro , Shibata Chikashi , Katayose Yu
Published: August 2024

Introduction: The peribiliary gland is an accessory bile duct gland. Hyperplasia of these tissues may lead to elevation of the mucosa in the bile ducts and bile duct stenosis. We herein report a case of peribiliary gland hyperplasia that required preoperative differentiation from bile duct cancer, with a discussion of the literature. Case Presentation: The patient had an adenomatous lesion in the ascending colon that was difficult to treat endoscopically; therefore, surgery was planned. Preoperative abdominal ultrasonography revealed a bile duct tumor, and endoscopic ultrasonography revealed a mass lesion around the confluence of the cystic duct. Computed tomography revealed localized wall thickening in the middle bile duct, and the upstream bile ducts were slightly dilated. In addition, continuous thickening of the bile duct wall from the gallbladder to the confluence of the cystic duct was observed. No distant metastases, such as liver metastases, or nearby enlarged lymph nodes were observed. Endoscopic retrograde cholangiopancreatography and magnetic resonance cholangiopancreatography revealed a papillary-like elevated lesion in the bile duct near the confluence of the cystic duct, and a biopsy and bile cytology from the same area showed no malignant findings. As a result, the possibility that the patient had gallbladder or bile duct cancer could not be ruled out; therefore, a policy of surgery together with the ascending colon tumor was decided after receiving sufficient informed consent. During surgery, the patient underwent extrahepatic bile duct resection, reconstruction of the biliary tract using the Roux-en-Y method, and right hemicolectomy. Both duodenal and hilar bile duct transects were subjected to a fast frozen section analysis during surgery, and the results were negative for cancer. A histopathological examination of the resected specimen revealed no malignant findings in the bile duct lesions, and a diagnosis of peribiliary gland hyperplasia with chronic inflammatory cell infiltration and fibrosis of the extrahepatic bile duct wall was made. Conclusions: We encountered a case of peribiliary gland hyperplasia that was difficult to distinguish from bile duct cancer.
Intervention Bundle for Optimization of Procedural Sedation for Newborns Undergoing Magnetic Resonance Imaging: A Single-Center Quality Improvement Project in Qatar
Authors: Daoud Ghalib , Karayil Mohammad Ali Sanoj , Chakkarapani Aravanan Anbu , Durrani Naveed Ur Rehman
Published: August 2024

Introduction: Magnetic resonance imaging (MRI) is a common procedure in tertiary care neonatal intensive care units (NICUs). MRIs aid in detailing structural anatomy and are increasingly utilized for prognostication. Keeping babies calm and motion-free in the MRI suite is challenging, and various approaches have been adopted to obtain the best image quality. We share our experience of intervention bundle for procedural sedation with the novel use of buccal midazolam in our NICU for babies undergoing MRI. Methods: This single-center quality improvement project comprised two epochs. Epoch 1 from April 2018 to December 2020 provided baseline data regarding sedation use and helped identify causes for suboptimal images and the adverse event rate. Following the implementation of an interventional bundle comprising specific midazolam dose recommendations tailored to background risk factors and streamlining the procedural sedation process, similar comparative data were collected in epoch 2 (May 2021 to December 2022) after a washout period. Results: Of 424 patients, 238 and 108 had MRI done under either procedural sedation protocol or feed and wrap technique in epoch 1 and 2, respectively. After excluding babies whose MRIs were performed under sedative infusions, 30 (13%) babies had adverse events in epoch 1, while only 8 (7%) events occurred in epoch 2. There was also a 37% improvement in the documentation of procedural sedation between the two epochs. Conclusion: Procedural sedation with buccal midazolam under neonatologist supervision is safe, efficient, and effective in babies undergoing MRI in this single-center study. More extensive studies may be warranted to assess the suitability of this sedation modality for broader use.
Successful Management of Acute Streptococcal Meningoencephalitis Complicated by Bilateral Third-Nerve Palsies, Wall-Eyed Bilateral Internuclear Ophthalmoplegia, Blindness, and Deafness: Case Report
Authors: Sidhu Amitouj S. , Walker Charles E.L. , Riisfeldt Thomas D. , Tweedie Peter J. , Gerbis Natasha , Sutherland Emily J. , Simon Neil G. , Somerville Lucy K. , Bradbury Ross , Cook Raymond , Parkinson Jonathon , Goetti Robert , Francis Ian C.
Published: August 2024

Introduction: Streptococcal meningoencephalitis (SME) is a rare, and frequently lethal, acute infection, and inflammation of the central nervous system parenchyma, with associated meningeal involvement. Bacterial meningoencephalitis is generally associated with high rates of morbidity and mortality, despite available antimicrobial and corticosteroid treatments. While Streptococcus pneumoniae is well recognised to cause bacterial meningitis, direct extension into the central nervous system parenchyma is rare. Case Presentation: A previously well 49-year-old man presented with sudden onset severe headache, fevers, neck stiffness, and reduced consciousness. The manifestations of SME in this patient were bilateral pupil-involving third-nerve palsies, wall-eyed bilateral internuclear ophthalmoplegia (WEBINO), bilateral blindness, bilateral deafness, a right lower motor neuron facial palsy, and upper motor neuron signs in his limbs. Initially, a partial response to high dose intravenous antibiotics occurred, but with administration of intravenous corticosteroids, further substantial resolution of the patient’s neurological and neuro-ophthalmological deficits occurred. Conclusion: This case highlights the benefit of multidisciplinary diagnostic and therapeutic interventions in a case of SME complicated by bilateral pupil-involving third-nerve palsies, WEBINO, bilateral blindness, bilateral deafness, a right lower motor neuron facial palsy, and upper motor neuron signs. It appears to be the first reported case of SME with this rare collection of neuro-ophthalmological abnormalities.
Bronchoscopy-Guided High-Power Microwave Ablation in an in vivo Porcine Lung Model
Authors: Sebek Jan , Goh Steven , Beard Warren L. , Biller David S. , Hodgson David S. , Highland Margaret A. , Smith Abbe , Hemphill Nicholas , Yu Kun-Chang , Myers Renelle A. , Lam Stephen , Wibowo Henky , Prakash Punit
Published: August 2024

Introduction: Percutaneous microwave ablation (MWA) is clinically accepted for the treatment of lung tumors and oligometastatic disease. Bronchoscopic MWA is under development and evaluation in the clinical setting. We previously reported on the development of a bronchoscopy-guided MWA system integrated with clinical virtual bronchoscopy and navigation and demonstrated the feasibility of transbronchial MWA, using a maximum power of 60 W at the catheter input. Here, we assessed the performance of bronchoscopy-guided MWA with an improved catheter (maximum power handling of up to 120 W) in normal porcine lung in vivo (as in the previous study). Methods: A total of 8 bronchoscopy-guided MWA were performed (n = 2 pigs; 4 ablations per pig) with power levels of 90 W and 120 W applied for 5 and 10 min, respectively. Virtual bronchoscopy planning and navigation guided transbronchial or endobronchial positioning of the MWA applicator for ablation of lung parenchyma. Following completion of ablations and post-procedure CT imaging, the lungs were harvested and sectioned for gross and histopathologic ablation analysis. Results: Bronchoscopy-guided MWA with applied energy levels of 90 W/5 min and 120 W/10 min yielded ablation zones with short-axis diameters in the range of 20–28 mm (56–116% increase) as compared to ∼13 mm from our previous study (60 W/10 min). Histology of higher-power and previous lower-power ablations was consistent, including a central necrotic zone, a thermal fixation zone with intact tissue architecture, and a hemorrhagic periphery. Catheter positioning and its confirmation via intra-procedural 3D imaging (e.g., cone-beam CT) proved to be critical for ablation consistency. Conclusion: Bronchoscopy-guided MWA with an improved catheter designed for maximum power 120 W yields large ablations in normal porcine lung in vivo.
Clinical, Genetic, and Pathological Studies in Two Brothers with Stress-Induced Childhood-Onset Neurodegeneration with Variable Ataxia and Seizures: A Case Report
Authors: Tompa Marton , Tolvaj Balazs , Vadvari Arpad , Feher Nora , Kiss Zsuzsanna , Kalman Bernadette
Published: August 2024

Introduction: Stress-induced childhood-onset neurodegeneration with variable ataxia and seizures (CONDSIAS) is an autosomal recessive disorder caused by biallelic pathogenic variants in the ADPRS gene. Since its first description in 2018, less than fifty cases have been reported worldwide, but thus far, without histopathology of the nervous system. Case Presentation: We summarize the clinical, paraclinical, and genetic characteristics of the disease in the proband, and the pathological workup in his older brother who passed away more than a decade ago. The characteristics of CONDSIAS in the two brothers overlapped with those of Friedreich ataxia. A final clarification of the diagnosis was made possible by whole exome sequencing (WES) that identified the homozygous pathogenic variants in the ADPRS gene. Conclusion: CONDSIAS is a rare disorder with highly variable presentation. Based on solely clinical and even pathological workup, establishing a definite diagnosis may be challenging. In the two brothers, we observed clinical and histopathological features of the disease suggesting, though not completely fulfilling, the diagnosis of Friedreich’s ataxia. WES allowed us to rapidly identify the underlying genetic abnormality and to make a shortcut to the right diagnosis amongst recessive ataxias. As of today, no specific treatment for CONDSIAS is available. Repurposing of certain approved modalities that also target the affected pathway in CONDSIAS recently arose, though as yet without proven success. Knowing the biological relevance of the affected gene product offers potential targets for the development of disease-modifying drugs for this highly disabling disease in the near future.
Cat Scratch Disease Presenting with Right Branch Retinal Artery Occlusion and Left Neuroretinitis
Authors: Jafari Samira , Micieli Jonathan A.
Published: August 2024

Introduction: Bartonella henselae, the causative agent of cat scratch disease (CSD), presents with diverse ocular manifestations, posing diagnostic challenges. This study aimed to elucidate the diagnostic complexities through a unique case. Case Presentation: A 42-year-old male presented with vision loss in the right eye, subsequent to flu-like symptoms following exposure to a stray kitten. Clinical examination revealed branch retinal artery occlusion (BRAO) in the right eye and neuroretinitis in the left, indicating concurrent ocular manifestations of CSD. Thorough investigations, including serological testing, ruled out alternative causes, highlighting the rarity of such coexisting ocular complications. Conclusions: The coexistence of BRAO and neuroretinitis in different eyes underscores the variable presentation of CSD. Recognition of infectious etiologies, particularly Bartonella, is paramount in diagnosing ocular vasculopathies. This case emphasizes the importance of considering Bartonella infection in patients with ocular vascular occlusions, especially in the context of recent cat exposure and systemic symptoms suggestive of CSD.
Dietary Treatment for Children and Adults with Eosinophilic Esophagitis: Which Patient and Which Doctor Is It Suitable for?
Authors: Chahuan Javier , Lucendo Alfredo J.
Published: August 2024

Background: The effectiveness of dietary therapy to induce remission of eosinophilic esophagitis (EoE) has been evaluated over the last decades and summarized in meta-analyses. Choosing the dietary modality, identifying the most suitable patients, and implementing specific prerequisites are essential to ensure long-term success. Summary: Impractical exclusive elemental diets provided the highest remission rates in EoE; however, they are not recommended due to their numerous disadvantages and detrimental effects on patient quality of life. Allergy testing-guided diets for EoE are limited; their insufficient effectiveness and low reproducibility are due to poor accuracy of skin or serum test results in identifying EoE food triggers. Initial experiences with a six-food elimination diet have provided evidence of high and predictive effectiveness rates and paved the way for less restrictive and more efficient step-up approaches, including four-food, two-food, and most recently, milk elimination diets. Dietary treatment for EoE is challenging for patients and families and requires certain skills to ensure success in the short and long term. Key Messages: The selection of appropriate patients is essential to ensure the success of and long-term adherence to dietary treatment of EoE. As normal triggers for EoE are commonly found in the staple diet, it is important to ensure adequate nutritional substitutes to avoid nutrient deficiency risks when long-lasting feeding difficulties or extensive restrictions are present. Specialized facilities in dietary therapy should adopt patient-centered and personalized approaches in order to provide timely monitoring and support for complex cases.
A Case of Hepatocellular Carcinoma after Treatment for Chronic Myeloid Leukemia in a Patient without Liver Disease
Authors: Raval Darshankumar M. , Pagán Ricardo J. , Butt Shayan , Rueda Prada Libardo
Published: August 2024

Introduction: Chronic myeloid leukemia (CML) is a myeloproliferative disease caused by the reciprocal translocation of chromosomes 9 and 22, which leads to a chimeric gene product known as BCR-ABL. Some studies have shown a higher incidence of secondary malignancies than the one seen in the general population in patients with CML. Hepatocellular carcinoma (HCC) is rarely reported in association with CML and/or CML-related treatment. Case Presentation: We describe a case of a patient with no history of liver disease and CML on imatinib for 10 years, who presented with worsening right upper quadrant abdominal pain. Imaging revealed a large hepatic mass highly suspicious of malignancy that later was confirmed to be HCC after biopsy. The patient was bracketed with advanced stage HCC (BCLC stage C) and given her advanced age and poor performance status; palliative care was offered. Conclusion: Patients with CML have a common association with secondary malignancies. This is the first case report based on our extensive review of available literature that HCC was diagnosed in a patient with CML on treatment with imatinib without any clear or usual underlying cause.