bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the Importance of Daily Imaging in the Treatment of Non-Melanoma Skin Cancer with Image Guided Superficial Radiation Therapy
Authors: Stricker Jeffrey , Hopkins Janine , Farberg Aaron , Harris Peyton
Published: April 2024

: Image guided superficial radiation therapy (IGSRT) combines superficial radiation therapy (SRT) with full dermal visualization (FDV) via high resolution dermal ultrasound (HRDUS) for the treatment of non-melanoma skin cancer (NMSC). The gold standard for IGSRT delivery includes a comprehensive cancer care model with support for the dermatologists by a multidisciplinary team. When delivered in this model, IGSRT can achieve cure rates of 99% for treatment of NMSC. This paper focuses on the benefits of IGSRT during therapy. Medical records from 7 dermatology clinics of 883 patients with 1,507 cases of NMSC treated with IGSRT be-tween 2017 and 2018 were retrospectively reviewed. 92% of the NMSC lesions showed daily depth fluctuations, 60.32% of lesions did not require changes during therapy, and nearly 40% of lesions required at least one compensatory change during therapy. 83% of NMSC lesions were labeled high-risk based on the 2024 NCCN guidelines. Increasing and decreasing tumor depth measurements during IGSRT inform dermatologists when adaptive changes in energy (kV), TDF and dose will result in more efficacy and less toxicity, respectively.
Bethe’s Wave-Function Revisited
Authors: Szeftel Jacob , Lévy Jean-Claude
Published: April 2024

The scattering eigenstates of any Hamiltonian of electrons, coupled through a two-body force and moving on a one-dimensional lattice, are shown to be Bethe's wave-functions. The energy of the groundstate is compared with values, obtained previously for the Hubbard Hamiltonian by means of Bethe's wave-function and within the framework of the correlated Fermi gas. The same analysis is applied to electrons, interacting on neighbouring sites. The significance of those various groundstates is assessed with help of thermodynamics.
Molecular Links between Inflammatory Bowel Disease and Mild Cognitive Impairment- a Narrative Review
Authors: Sarb Oliviu Florentiu , Porca Adriana Daniela , Iacobescu Maria , Vlad Irina-Maria , Milaciu Mircea Vasile , Ciumarnean Lorena , Vacaras Vitalie , Tantau Alina-Ioana
Published: April 2024

IBD, encompassing CD and UC, are characterized by chronic gastrointestinal inflammation due to abnormal immune responses to gut microflora. The bidirectional communication between the gut and the brain, known as the GBA, is disrupted in IBD, leading to neurobiological imbalances and affective symptoms. Systemic inflammation in IBD affects the brain's inflammatory response system, hormonal axis, and BBB integrity, influencing gut microbiota and clinical responses to probiotics.
This review aims to explore the links between dysregulations in the GBA, serum biomarkers, and the development of MCI and NDDs. The objective is to identify potential correlations and propose future research directions to understand the impact of altered microbiomes and intestinal barrier functions on NDDs. Studies suggest a potential link between IBD and extraintestinal complications such as MCI and NDDs. Mechanisms include systemic inflammation, BBB dysfunction, autoimmune responses, GBA dysfunction, medication effects, and comorbidities. Serum biomarkers, including vitamin D3, C-reactive protein, high-sensitivity C-reactive protein, vitamin B12, homocysteine, serum amyloid, neuron-specific enolase, neurofilament light chain, S100 proteins, brain-derived neurotrophic factor, IL-6, LP-2 associated phospholipase, prostaglandin E2, IL-1β, and TNF-α, have been investigated for their potential to predict MCI but current results are lacking clarity.
Navigating Uncertainty in High-Frequency Trading: A DIKWP Model Approach to Compliance and Strategy under the Financial Regulation
Authors: Wu Kunguang , Duan Yucong
Published: April 2024

The paper examines the various uncertainties encountered in high-frequency trading (HFT) environments and delves into the multiple challenges faced by HFT firms in navigating the Dodd-Frank Wall Street Reform and Consumer Protection Act (referred to as the "Dodd-Frank Act"), particularly during the initial stages of its enactment. These challenges include the ambiguity surrounding the definition of HFT, the lack of clarity regarding regulatory requirements and boundaries, inconsistencies in enforcement resulting from deviations in understanding the content, and the absence of detailed descriptions of the Act’s provisions. These hurdles significantly impact not only the daily operations of HFT firms but also pose higher demands on their long-term strategic planning and risk management. Drawing upon the Data, Information, Knowledge, Wisdom, and Purpose (DIKWP) model, this study employs an innovative analytical framework. Through the comprehensive application of conceptual space, cognitive space, and semantic space, it provides a systematic methodology for identifying and analyzing the aforementioned issues. This approach not only aids firms in better comprehending and adhering to complex regulatory requirements but also enables them to explore new business opportunities and competitive advantages while ensuring compliance.
Towards Improving YARN performance for Frugal Heterogeneous SBC-based Edge Clusters
Authors: Qureshi Basit
Published: April 2024

In the dynamic landscape of sustainable computing, use of edge devices is paramount for reducing the need for large-scale centralized data centers. By processing data locally, edge devices minimize the energy-intensive computing in data centers, improving the overall performance, cost-effectiveness whereas reducing the environmental impact. Edge devices may constitute edge clusters composed of resource frugal Single Board Computers (SBC) such as Raspberry Pi etc. The small form-factor and energy efficiency of these computers makes them ideal for processing large data on the edge. Despite their potential, traditional Hadoop configurations struggle to optimize performance in heterogeneous SBC clusters due to disparities in computing resources. Consequently, we propose modifications to the Yet Another Resource Negotiator (YARN) scheduling mechanism to address these challenges. Our proposed changes include the introduction of a Frugality Index and an adaptiveConfig policy. The Frugality Index categorizes SBC nodes based on their capabilities, enabling intelligent resource allocation. The adaptiveConfig policy dynamically adjusts resource allocation in response to workload and cluster conditions, enhancing system efficiency. Additionally, we introduce a fetch_threshold for reduce tasks to improve task prioritization based on locality and data processing efficiency. We evaluate our approach using a 13-node SBC cluster and conduct experiments with CPU-intensive and IO-intensive Hadoop benchmarks. The results demonstrate significant performance improvements compared to native YARN settings, with execution times 4.7 times faster than the worst_native and 1.9 times faster than the best_native scenarios. Furthermore, the proposed adaptiveConfig policy implementing the frugality index and a fetch_threshold outperforms the native YARN by 5.86 times and 1.79 times in Terasort and wordcount executions respectively. Our findings underscore the effectiveness of our approach in managing the heterogeneous nature of SBC clusters and optimizing performance across various hardware configurations. The adaptive policies prove well-suited to the frugal SBC-cluster context, yielding enhanced outcomes and paving the way for sustainable big data processing initiatives.
Urinary L-FABP as an Early Biomarker for Pediatric Acute Kidney Injury Following Cardiac Surgery with Cardiopulmonary Bypass: A Systematic Review and Meta-analysis
Authors: Wilnes Bruno , Castello-Branco Beatriz , Castello Branco Bárbara , Sanglard André , Vaz de Castro Pedro Alves Soares , Simões e Silva Ana Cristina
Published: April 2024

Acute kidney injury (AKI) following surgery with cardiopulmonary bypass (CPB-AKI) is common in pediatrics. Urinary liver-type fatty acid binding protein (uL-FABP) increases in some kidney diseases and may indicate CPB-AKI earlier than current methods. The aim of this systematic review with meta-analysis was to evaluate the potential role of uL-FABP in early predicting CPB-AKI. Databases Pubmed/MEDLINE, Scopus, and Web of Science were searched on November 12th, 2023, using the MeSH terms “Children”, “CPB”, “L-FABP”, and “Acute Kidney Injury”. Included papers were revised. AUC values from similar studies were pooled by meta-analysis, performed using random- and fixed-effect models, with p
How a Thermodynamic Version of the Friedmann Equation Appears to Solve the Early Galaxy Formation Problem
Authors: Haug Espen , Tatum Eugene
Published: April 2024

Based on our recent thermodynamic formulation of the Friedmann equation, we demon- strate how the age of the universe must be approximately 14.6 billion years. This is about 800 million years older than predicted by the Λ-CDM model and therefore greatly alleviates the early galaxy formation problem.
Understanding Superlinear Speedup in Current HPC Architectures
Authors: Galeazzo Flavio Cesar Cunha , Weiß R. Gregor , Lesnik Sergey , Rusche Henrik , Ruopp Andreas
Published: April 2024

The performance of OpenFOAM in strong scaling tests on HPC systems with AMD EPYC processors exhibits a pronounced superlinear speedup. Simple test cases show superlinear speedups of over 300%, which significantly impacts the efficient use of computing resources. With the last generation of HPC architectures, a superlinear speedup of about 10% to 20% was well expected and accepted by CFD users. The measured superlinear speedup is much more pronounced and withstands the communication overhead to even larger scales. A detailed performance analysis of OpenFOAM follows, employing various High-Performance Computing (HPC) architectures, including AMD, ARM and Intel systems. The performance metric FVOPS (Finite VOlumes solved Per Second) is introduced to compare the performance of Computational Fluid Dynamics (CFD) applications when varying the grid size, as occurs in a strong scaling test. The achievable FVOPS depends on various factors, including the simulation type, boundary conditions, and especially the grid size of a use case. Analysing FVOPS on a single node level with varying grid size shows a significant difference in performance and cache utilization, which explains the large superlinear speedups seen in the strong scaling tests. Furthermore, FVOPS can be used as a simple benchmark to determine the optimal number of grid elements per rank to simulate a given use case at peak efficiency on a given platform, resulting in time, energy, and cost savings. The FVOPS metric also facilitates the direct comparison between different HPC architectures. The tests using AMD, ARM, and Intel processors show a peak in performance when employing around 10,000 grid elements per core. The presence of a large L3 cache on AMD processors is particularly advantageous, as indicated by L3 cache miss rates observed on AMD EPYC processors. Our results suggest that future HPC architectures with larger caches and higher memory bandwidth would benefit the CFD community.
From Sequence to Structure to Function: De Novo Protein Design, the Role of AI and Structure Prediction Neural Networks
Authors: Kauffman Marcelo
Published: April 2024

Recent advancements in artificial intelligence (AI) and deep learning have revolutionized the field of protein engineering, particularly in the area of de novo protein design. This review article explores the impact of AI-driven approaches on protein design, with a specific focus on the role of structure prediction neural networks, such as AlphaFold and RoseTTAFold. The article discusses the paradigm shift brought about by these networks, which have enabled the design of proteins with unique structures and functions that are not found in nature. The review covers various aspects of AI-driven protein design, including the use of protein language models to harness evolutionary information, the development of de novo protein design workflows utilizing deep learning, and the application of generative models like RFdiffusion and RoseTTAFold All-Atom. The article also highlights the successes and applications of AI-driven protein design across diverse domains, such as enzyme engineering, antibody design, and vaccine development. Additionally, the review identifies current challenges and future directions in the field, emphasizing the need to address limitations in modeling conformational dynamics and designing proteins for in vivo functionality. The article concludes by underscoring the potential of AI-driven protein design to transform various aspects of science and technology, while also acknowledging the importance of interdisciplinary collaboration and the development of robust pipelines for the validation and optimization of designed proteins. Overall, this comprehensive review serves as a valuable resource for researchers and practitioners interested in understanding the current state and future prospects of AI-driven protein design.
Evaluation of serum levels of leptin and ghrelin in patients with celiac disease before and after treatment with a gluten-free diet
Authors:   Zabol University of Medical Sciences, Zabol, Iran, Rakhshaninasab Sh. , Goodarzi M.T. ,   Islamic Azad University, Shahrood Branch, Shahrood, Iran, Poudine N. ,   Zabol University of Medical Sciences, Zabol, Iran, Shahramian I. ,   Shiraz University of Medical Sciences, Shiraz, Iran, Afshari M. ,   Zabol University of Medical Sciences, Zabol, Iran, Tahani M. ,   Zabol University of Medical Sciences, Zabol, Iran
Published: April 2024

Background and Objective. Celiac disease (CeD) is an autoimmune condition characterized by specific serological and tissue characteristics resulting from gluten consumption in genetically predisposed individuals. The only currently treatment available for CeD is strict lifelong adherence to a gluten-free diet (GFD), which leads to remission. This study aimed to evaluate leptin and ghrelin serum levels in celiac patients before and after treatment with a gluten-free diet. Patients and Methods. Thirty patients aged 3 to 50 years with CeD and 30 age- and gender-matched healthy controls were included in the study. Serum levels of leptin and ghrelin in patients before GFD and after four months of GFD treatment were measured using ELISA kits. Results. The mean serum ghrelin concentration in celiac cases decreased from 653.6 pg/ml to 483.2 pg/ml after GFD treatment (p < 0.001). Although the mean serum ghrelin concentration before treatment was not significantly different between the case and control groups, it was significantly lower in celiac patients than in the control group after treatment (p < 0.001). The average concentration of serum leptin in the control group was significantly higher than before and after the treatment of celiac patients, but the average concentration of serum leptin in celiac patients did not change significantly after GFD treatment (p = 0.298). Conclusion. In conclusion, this study suggests that a GFD can positively affect the levels of leptin and ghrelin hormones in celiac patients. Key words: celiac disease, leptin, ghrelin, gluten-free diet
Clinical and morphological evaluation of teduglutide efficacy in children with short bowel syndrome: a pilot study in Russia
Authors:   N.F.Filatov Children’s City Clinical Hospital, Moscow, Russian Federation, Chubarova A.I. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Kostomarova E.A. ,   N.F.Filatov Children’s City Clinical Hospital, Moscow, Russian Federation, Tumanova E.L. ,   N.F.Filatov Children’s City Clinical Hospital, Moscow, Russian Federation,   Pirogov Russian National Research Medical University, Moscow, Russian Federation, Bezzubova T.V. ,   N.F.Filatov Children’s City Clinical Hospital, Moscow, Russian Federation, Matveenko E.N. ,   N.F.Filatov Children’s City Clinical Hospital, Moscow, Russian Federation
Published: April 2024

The main aim of rehabilitation in patients with short bowel syndrome (SBS) is the reduction of parenteral nutrition (PN) dependency. Glucagonlike peptide 2 analog teduglutide is a trophic factor with a potential ability to reduce intestinal insufficiency. Objective. To evaluate the clinical efficacy of teduglutide and morphological markers of intestinal adaptation in children with SBS. Patients and methods. The study included 26 patients with aged 2.5 to 14 years (5 ± 2.5 years), dependent from PN during 52 ± 20 months (min 29, max 116 months) before study and receiving teduglutide at a dose of 0.05 mg/kg/day. In 11 patients SBS occurred because of volvulus or thrombosis, in 7 – Hirschsprung disease and in 9 – intestinal atresia; the residual intestinal length was 30 ± 28 cm. The study design included three control points: initiation of therapy with teduglutide, 6 months and 1 year after therapy. Physical development, need for parenteral nutrition, and intestinal mucosa morphometry (n = 18) were assessed. The efficacy of treatment was stated if 1 of 3 following criterion was seen: the reduction of PN ≥20%, more days without PN or PN withdrawal. An increase in villus length by ≥100 μm was considered as a morphological criterion of adaptation. Results. Reduction in PN dependence was noted in 69% of children. Morphological adaptation of the small intestinal was noted in 66% of children, positive correlation was found between villous height and the duration of therapy (r = 0.39, p < 0.05). The length of the preserved ileum was positively correlated with the possibility of morphological adaptation (r = 0.58, p < 0.05). Better morphological adaptation was demonstrated by patients with acute intestinal blood flow disorders. The use of teduglutide allowed to maintain normal Z-score values during a significant reduction in the proportion of PN. Conclusion. Teduglutide demonstrated its safety and efficacy in children with SBS in the terms of PN dependency reduction and morphological adaptation. However, these results require further investigation in larger cohorts in multicenter trials. Key words: children, short bowel syndrome, teduglutide, parenteral nutrition, intestinal adaptation
Refractory non-erosive reflux disease: characteristics of pathogenesis, diagnosis and treatment
Authors:   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Makushina A.A. , Trukhmanov A.S. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Storonova O.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Paraskevova A.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Ivashkin V.T. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: April 2024

The prevalence of gastroesophageal reflux disease is steadily rising. The number of patients with non-erosive reflux disease is increasing worldwide, including the form of the disease refractory to standard therapy. This article presents current data on the pathogenesis, diagnosis, and therapeutic approaches for patients with refractory non-erosive reflux disease. Key words: proton pump inhibitors, non-erosive reflux disease, refractory symptoms
A Curricular Model for Simulation Within Orthopaedic Residency Training
Authors: Schreiner Bryan , Unger Robert , Herzka Andrea S. , Friess Darin M. , Nazir Omar F. , Brady Jacqueline M.
Published: April 2024

Introduction:

American Board of Orthopaedic Surgery/American Council on GraduateMedical Education Residency Review Committee training requirements have necessitated the need for the adoption of simulation education into existing programmatic requirements. Current guidelines focus only on interns at a potentially significant cost to programs; both in total dollar amount and time.

Methods:

The authors aim to provide a model that can maximize utility for all resident levels, manage cost by maximizing the use of cadaveric material, and allow integration of varied industry support.

Results:

The Oregon Health & Science University Orthopaedic education program has developed a high-fidelity training curriculum that (1) is applicable to both junior and senior residents (2) has minimized the cost per resident with the reuse of cadaveric specimens and (3) has nurtured partnerships with industry stakeholders to reduce bias in training by collaborating with most major industry representatives.

Conclusion:

The simulation curriculum outlined in this manuscript may serve as a reference for other programs and institutions to develop their own residency educational curriculum models.
American Orthopaedic Association's (AOA) Council of Orthopaedic Residency Directors (CORD) 2022 Summer Conference: Top Abstracts
Authors: Mulcahey Mary K. , Balach Tessa ,   On behalf of the CORD/Academics Committee
Published: April 2024

In a continuing collaboration between the American Orthopaedic Association's (AOA) Council of Orthopaedic Residency Directors (CORD) and JBJS, the following 10 abstracts highlight the scientific research presented at AOA's annual national meeting held in June 2022. These abstracts embody CORD's purpose and mission:

“The American Orthopaedic Association's Council of Orthopaedic Residency Directors (CORD) program strives to recognize best practices in orthopaedic residency education and fellowship education based on ACGME [Accreditation Council for Graduate Medical Education]-defined essential knowledge and skills in each of the residency education competency areas. CORD provides a forum for academic orthopaedic leaders to exchange ideas, discuss solutions to challenges, and find ways to teach residents in orthopaedic programs effectively.”

We hope this education-related research will inspire further inquiry to advance the development of future orthopaedic surgeons.
Increasing lateral transport of soil and carbon on the Tibetan Plateau
Authors: xin zhongbao , Huang Yanzhang , Gao Guangyao , Lu Xixi , Ran Lishan , Wang Yafeng , Zhang Zhiqiang
Published: April 2024

Soil erosion by water and loss of soil organic carbon (SOC) are two major contributors to global land degradation. However, the impact of soil erosion and its effect on SOC in the fragile, sensitive alpine ecosystem of the Tibetan Plateau, where climate change is amplified, is not well understood. We used the Universal Soil Loss Equation (USLE) ensemble model to analyse soil erosion, SOC loss, and their dynamics over the past 40 years (1981-2018) on the Tibetan Plateau. The mean soil erosion and SOC erosion rates were 5.91±2.29 t ha-1 yr-1 and 0.374±0.113 t C ha-1 yr-1, respectively, with significant increasing trends because of increased rainfall. The SOC erosion rates increased from 0.34±0.03 t C ha-1 yr-1 in the 1980s by 19.0% to 0.40±0.02 t C ha-1 yr-1 in the 2010s. The increasing erosion rates after 1999 were weakened because of the slow increase in rainfall and rapid vegetation greening. We also determined the spatial distribution of areas prone to soil and SOC erosion across the entire plateau. Our findings highlight the extreme vulnerability of soil erosion and SOC loss on the Tibetan Plateau to climate change, which were helpful for sustainable land resource management in an ecologically fragile environment.
Automotive motor rotor design synthesis using cWGAN-gp with distortion penalty
Authors: Kato Nobuhito , Suzuki Keisuke , Kondo Yoshihisa , Suzuki Katsuyuki , Yonekura Kazuo
Published: April 2024

This study proposes a motor-rotor-shape generation method based on a conditional Wasserstein generative adversarial networks (GAN) with gradient penalty (cWGAN-gp) to perform the initial design of the automotive motor efficiently. We introduced a distortion degree as a regularization in the training process to generate smooth, intuitively understandable, and easy to manufacture shapes. Rotor shapes generated by cWGAN-gp exhibited characteristics similar to a combination of multiple training data with performances close to that of the input label data. Furthermore, smooth shapes were generated by appropriately setting the influence of the distortion degree. The motor shapes could be generated accurately when a sufficient amount of training data existed. These results suggest that training the model with accumulated motor data allows for the rapid generation of new shapes based on input performance criteria in a short period of time.
Efficacy and Safety of Ciprofol for General Anesthesia in Transcatheter Aortic Valve Replacement: A Study Protocol for a Randomized Controlled Trial
Authors: ni tingting , ni tingting , wu shuguang , lv tao , Yao Yuan-yuan , Luo Ge , Gao Qi , Wang Ting-ting , Yan Min
Published: April 2024

Background: Patients who have gone through transcatheter aortic valve replacement (TAVR) and have experienced a decrease in physical and physiological capabilities are more likely to experience unfavorable cardiovascular reactions, including hypotension during induction of anesthesia. Due to the impaired cardiac function of these patients, maintaining hemodynamic stability during anesthesia induction can be challenging. Ciprofol, a novel anesthetic and a version of propofol, brings about a speedy onset, a brief recovery time, reduced injection pain, and consistent cardiorespiratory functioning. This study aims to investigate the effectiveness and safety of ciprofol in induction and maintaining general anesthesia in patients undergoing TAVR to establish its potential use in clinical practice.
Methods:
124 elderly patients aged 65–80 undergoing elective TAVR with general anesthesia will be randomly assigned to two parallel groups in this single-center trial. Patients will be randomly allocated to receive either ciprofol or propofol for induction. The primary outcome is the area under the baseline of the mean arterial pressure (MAP) over the first 15 minutes after induction. Hypotension will be identified as a decrease in MAP below 65 mmHg or more than 20% from the initial value during induction. Secondary outcomes include the incidence of adverse events, such as hypotension, bradycardia, nausea and vomiting, stroke, covert central nervous system injury, myocardial infarction, and acute kidney injury, as well as the cumulative doses of vasoactive drugs, the occurrence and intensity of injection pain, and ScO2 values less than 55% of the area under the curve (AUC).
Discussion: This study will provide valuable information on the effectiveness and safety of ciprofol as a general anesthetic for patients undergoing TAVR.
Trial registration: ClinicalTrials.gov (NCT05881291).
Brain injury and ketamine study (BIKe): a prospective, randomized controlled double blind clinical trial to study the effects of ketamine on Therapy Intensity Level and intracranial pressure in severe traumatic injury patients.
Authors: De Sloovere Veerle Tineke , Mebis Liese , Wouters Pieter , Grandas Fabian Guïza , Boonen Eva , Bourgeois Marc , Dubois Jasperina , Ledoux Didier , Lormans Piet , Maréchal Hugues , Hauwaert Emmanuel Van der , Depreitere Bart , Meyfroidt Geert
Published: April 2024

Background: In severe traumatic brain injury (TBI), sedatives are often used to control intracranial pressure (ICP), to reduce brain metabolism, to allow for other treatments such as mechanical ventilation or targeted temperature management, or to control paroxysmal sympathetic hyperactivity. Prolonged sedation is often necessary. The most commonly used sedatives in TBI are propofol and midazolam, often in combination, but both have significant side effects when used at high doses for several days. Ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, provides sedation and analgesia with minimal respiratory depression or haemodynamic instability. However, ketamine carries a US Food and Drug Administration (FDA) precaution regarding its use in patients with pre-anesthetic elevated cerebrospinal fluid pressure, which discourages its use in TBI patients. Several observational studies and two large meta-analyses do not suggest that the use of ketamine as an induction agent or sedative in sedated and mechanically ventilated TBI patients would increase the ICP. Off-label use of ketamine for this indication is increasing worldwide. To date, no prospective randomized clinical trial (RCT) has demonstrated the safety of ketamine in TBI patients.
Methods: The Brain Injury and Ketamine (BIKe) study is a prospective multicentre double-blind placebo-controlled RCT, to evaluate the safety, and effect on therapeutic intensity to reduce ICP, of ketamine as an adjunct to a standard sedation regimen in patients with severe TBI. Adult TBI patients, admitted to the intensive care unit (ICU), requiring sedation and ICP monitoring within 72 hours of admission, will be randomized to ketamine or placebo. The study drug will be started within 6 hours of randomization. The dose of the investigational medicinal product (IMP) is 1 mg/kg/hour, by continuous infusion. The IMP will be stopped when the last ICP control sedative is discontinued. Data collection will stop when the patient is discharged from the ICU. All patients will be followed for 6 months post-trauma. The study is powered for the safety endpoint of detecting a clinically relevant increase of two episodes in the median number of episodes of high intracranial pressure episodes per ICU stay. A total of 100 patients are required to meet these objectives. We hypothesize a clinically relevant reduction in the therapeutic intensity level (TIL) score of at least 3 points.
Discussion: This study is the first prospective RCT to investigate the safety of ketamine as an adjunct to a standard sedation regimen in TBI patients.
Trial registration: ClinicalTrials.gov NCT05097261.
Wilson's Disease Masquerading as Acute Encephalitis: A Case Report
Authors: Kalwar Asifa , Rid Quratulain , Ahsan Sadia , Ochani Sidhant
Published: April 2024

Introduction:
Wilson's disease (WD) is a rare autosomal recessive disorder characterized by copper accumulation in the liver, brain, and cornea, resulting from mutations in the ATP7B gene.
Case Presentation:
This case report presents a unique manifestation of WD, as a 14-year-old female from rural Pakistan presented with acute encephalitis and the ‘Face of the Giant Panda Sign’. Encephalitis is an uncommon initial presentation of WD, and this case highlights the diagnostic challenges, especially in resource-limited settings. The patient exhibited sudden-onset fever, generalized tonic-clonic seizures, and altered mental status. Initially misattributed to possession by the parents, the patient underwent empirical treatment for encephalitis in the hospital without improvement. Further evaluation revealed abnormal liver function, positive HepBsAg, and characteristic brain MRI findings indicative of WD. Confirmation was made through low ceruloplasmin, Kayser-Fleischer rings, and modified Leipzig criteria. Treatment with penicillamine and vitamin B6 resulted in clinical improvement.
Conclusion
This case emphasizes the importance of considering WD in cases of encephalitis, even in the absence of typical hepatic symptoms. The delay in diagnosis and initial misinterpretation underscore the need for increased awareness and education, particularly in regions with limited healthcare resources. Early recognition and intervention can prevent the progression of WD, improving patient outcomes. The report also underscores the significance of familial screening and long-term follow-up to manage the chronic nature of the disease. Further studies and reporting of atypical presentations contribute to the understanding and management of this rare and clinically heterogeneous disorder.
Expression of c-erb-B2 oncoprotein as a neoantigen strategy to repurpose anti-neu antibody therapy in a model of melanoma
Authors: Gabriel Emmanuel M. , Necela Brian , Bahr Deborah , Vivekanandhan Sneha , Shreeder Barath , Bagaria Sanjay , Knutson Keith L.
Published: April 2024

In this study, we tested a novel approach of “repurposing” a biomarker typically associated with breast cancer for use in melanoma. HER2/neu is a well characterized biomarker in breast cancer for which effective anti-HER2/neu therapies are readily available. We constructed a lentivirus encoding c-erb-B2 (the animal homolog to HER2/neu). This was used to transfect B16 melanoma in vitro for use in an orthotopic preclinical mouse model, which resulted in expression of c-erb-B2 as a neoantigen target for anti-c-erb-B2 monoclonal antibody (7.16.4). The c-erb-B2-expressing melanoma was designated B16/neu. 7.16.4 produced statistically significant in vivo anti-tumor responses against B16/neu. This effect was mediated by NK-cell antibody-dependent cell-mediated cytotoxicity. To further model human melanoma (which expresses <5% HER2/neu), our c-erb-B2 encoding lentivirus was used to inoculate naïve (wild-type) B16 tumors in vivo, resulting in successful c-erb-B2 expression. When combined with 7.16.4, anti-tumor responses were again demonstrated where approximately 40% of mice treated with c-erb-B2 lentivirus and 7.16.4 achieved complete clinical response and long-term survival. For the first time, we demonstrated a novel strategy to repurpose c-erb-B2 as a neoantigen target for melanoma. Our findings are particularly significant in the contemporary setting where newer anti-HER2/neu antibody-drug candidates have shown increased efficacy.
Effect of activator dosage and mass ratio of GGBFS to FA on 3D printing performance of kenaf geopolymer
Authors: Kong Xiao , Dai Li , Chen Shicai , Guo Yuan , Zhang Zehuan , Wang Shaojie
Published: April 2024

Kenaf geopolymer for 3D printing is a promising representative for comprehensive and intelligent utilization of industrial and agricultural wastes. Aiming at exploring the effect of raw materials’ proportion on printing performances, alkali activator dosage (10 wt.%, 15 wt.%, 20 wt.%) and mass ratio of ground granulated blast furnace slag (GGBFS) to fly ash (FA) (15:85, 20:80, 25:75) were adopted as main variables in this paper. Results have shown that increasing the activator dosage and decreasing the mass ratio of GGBFS to FA can improve the flowability, and adjusting these two parameters can tailor the fluidity to a suitable range. Moreover, dry density of kenaf geopolymer was more significantly affected by alkali activator dosage compared with mineral powder ratio, and lightweight characteristic due to kenaf participation effectively improved shape retention ability of printed specimens. Besides, microstructure analysis further confirmed that with appropriate alkali activator dosage and mineral powder ratio, high level of geopolymerization reaction can be achieved to produce enough gel product for a satisfactory internal structure, which externally manifested as excellent printability and mechanical strength. Finally, formula with alkali activator dosage of 15 wt.% and GGBFS to FA mass ratio of 25:75 was recommended for satisfactory printing performance and mechanical properties.
Epidemiology, Outcomes and Prognosis of Infective Endocarditis in Northern Morocco
Authors: Boussaadani Badre El , Soussan Ilias , Bendoudouch Houssam , Hara Loubna , Ech-chenbouli Amine , Raissouni Zainab
Published: April 2024

Introduction:Infective endocarditis is a rare but potentially severe disease, associated with significant morbidity and mortality. Our study aims to describe the epidemiology and management aspects of endocarditis in northern Morocco and compare it with international management guidelines.
Materials and Methods:This is a retrospective study involving all patients hospitalized in the cardiology department of the University Hospital of Tangier for infective endocarditis over a period of 4 years and 7 months, from May 2019 to February 2024.
Results: 80 patients were hospitalized for IE during the study period. The average age of the patients was 46 years, with an even sex ratio. IE concerned native valves in 77% of cases, mechanical prostheses in 19% of cases, and on bio prostheses in 4%. The average diagnostic delay was 25 days. Blood cultures were negative in 59% of cases. The predominant infective microorganism was the bacteria Staphylococcus (65.6%).
Imaging results showed vegetations in 76.3% of cases, predominantly on the mitral valve (39.3%), followed by the aortic valve (21.3%). The main complications included heart failure (51.2%), peripheral arterial embolisms (22.5%) and splenic infarction (17.5%)
Management wise, the most commonly used antibiotic therapy was a combination of ceftriaxone and gentamicin. Clinical and biological improvement was observed in 70% of cases, with a mortality rate of 12.5%. Twelve patients underwent urgent surgery (41.7%).
Conclusion: Our study highlights the challenges in managing infective endocarditis in northern Morocco. The prognosis of infective endocarditis can be improved through multidisciplinary management within the implementation of an Endocarditis Team.
Transmission of quantum-secured images
Authors: Johnson Steven , Rarity John , Padgett Miles
Published: April 2024

The secure transmission of an image can be accomplished by encoding the image information, securely communicating this information, and subsequently reconstructing the image. Alternatively, here we show how the image itself can be directly transmitted while ensuring that the presence of any eavesdropper is revealed in a way akin to quantum key distribution (QKD). We achieve this transmission using a photon-pair source with the deliberate addition of a thermal light source as background noise. One photon of the pair illuminates the object, which is masked from an eavesdropper by adding indistinguishable thermal photons, the other photon of the pair acts as a time reference with which the intended recipient can preferentially filter the image carrying photons from the background. These reference photons are themselves made sensitive to the presence of an eavesdropper by traditional polarisation-based QKD encoding. Interestingly the security verification is performed in the two-dimensional polarisation-basis, but the image information is encoded in a much higher-dimensional, hence information-rich, pixel basis. In our example implementation, our image comprises of 152 independent pixels. Beyond the secure transmission of images, our approach to the distribution of secure high-dimensional information may offer new high-bandwidth approaches to QKD.
OrthoFusion: A Super-Resolution Algorithm to Fuse Orthogonal CT Volumes
Authors: Abbott Rebecca E. , Nishimwe Alain , Wiputra Hadi , Breighner Ryan E. , Ellingson Arin M.
Published: April 2024

OrthoFusion, an intuitive super-resolution algorithm, is presented in this study to enhance the spatial resolution of clinical CT volumes. The efficacy of OrthoFusion is evaluated, relative to high-resolution CT volumes (ground truth), by assessing image volume and derived bone morphological similarity, as well as its performance in specific applications in 2D-3D registration tasks. Results demonstrate that OrthoFusion significantly reduced segmentation time, while improving structural similarity of bone images and relative accuracy of derived bone model geometries. Moreover, it proved beneficial in the context of biplane videoradiography, enhancing the similarity of digitally reconstructed radiographs to radiographic images and improving the accuracy of relative bony kinematics. OrthoFusion's simplicity, ease of implementation, and generalizability make it a valuable tool for researchers and clinicians seeking high spatial resolution from existing clinical CT data. This study opens new avenues for retrospectively utilizing clinical images for research and advanced clinical purposes, while reducing the need for additional scans, mitigating associated costs and radiation exposure.
Leaf and Seed Yield Response of Vegetable Amaranths to Nitrogen Fertilizers Applications and Harvesting Frequency at Jimma, South West, Ethiopia
Authors: Birhanu Tinsae , Olika Ambecha , Etissa Edossa
Published: April 2024

Amaranthus (Amaranthus cruentus) is an alternative food crops and requires low agronomic practice relative to other food crops, but the yield varies due to season, soil fertility, and variety and management practices variations. There is scant information on agronomic practices such as harvesting frequency and N fertilizer application rates.The objective of this study was to determine effect of nitrogen levels and harvesting frequencies on growth, leaf and seed yield and yield component of Amaranth Madiira-2 cultivar at Jimma under irrigation. Randomized complete Block design with factorial arrangement combination of five N levels (0, 34.5, 69, 103.5 and 138) with three harvesting frequency (weekly, Two weeks and every three weeks) replicated three times. Data on pheonological, growth yield and yield component were collected. Collected data were analysed using SAS software version (9.3). Results revealed that the combination effect of nitrogen and harvesting frequency significantly influenced (p<0.05) days to 50% flowering, days to 50% physiological maturity. whereas leaf area, leaf length, leaf width, plant height, above ground fresh weight, above ground dry weight per plant at harvest, leaf yield, and seed yield highly significantly influenced (p<0.01). However thousand seed weight highly influenced by harvesting. The highest leaf yield (30.33 ton ha-1) was obtained when 103.5 kg N ha-1 applied with Two weeks harvesting after transplanting. The highest seed yield (3.23 ton ha-1) was obtained for 103.5 kg N ha-1 and every three week harvesting. The positive correlation was observed between leaf yield, leaf area and branch there is also correlation between seed yield, plant height, branches and leaf area. Therefore, the present finding showed that farmers can benefit by applying 103.5 kg N ha-1 with Two weeks harvesting and 103.5 kg N ha-1 with every three week harvesting resulted in better leaf and seed yield respectively. However, since the data is collected from only one season and location, it would be worth repeating the experiment under field condition, across different season and locations to draw sound conclusions and recommendations.
Predictive Factors For The Outcome of Anterior Cervical Discectomy and Fusion Surgery for Myelopathy Cervical Disc Herniation: A Single-Center Study in Vietnam
Authors: Pham Tuan Anh , Bui Hoang Thanh , Nguyen Duy Nhat , Le Viet-Thang
Published: April 2024

Background: Cervical disc herniation is a prevalent condition contributing to cervical myelopathy. This technique has gained popularity in various centers around the globe. However, there is a lack of data on the actual surgical outcomes for this specific patient group in Vietnam. This study aims to investigate predictive factors for the surgical outcomes and postoperative complications associated with anterior cervical discectomy and fusion surgery in patients presenting with myelopathy due to cervical disc herniation.
Methods: A retrospective analysis was conducted on 74 patients who underwent ACDF surgery for myelopathy resulting from cervical disc herniation at Nguyen Tri Phuong Hospital, from January 2019 to September 2021. Data encompassing demographics, clinical and radiological characteristics, surgical outcomes, and complications were meticulously collected.
Results: Among the 74 patients, 53 were men and 21 were women, ranging from 29 to 79 years. Herniation occurred at one level in 45.9% of cases, at two levels in 47.3%, and at three levels in 6.8%. Neurological improvement was assessed during a 12-month follow-up. Patients were assessed with VAS and NDI preprocedural and postprocedural for 1-month, 6-month, and 12-month follow-ups. There was a significant improvement in postprocedural VAS and NDI scores (p<0.001). The mean preoperative mJOA score was 11.1, increasing to 14.8 postoperatively. A recovery rate exceeding 75% was noted in 21.6% of patients. Dysphagia was the most common complication (8.1%).
Conclusions: Anterior cervical discectomy and fusion surgery emerge as an effective and secure treatment modality for myelopathy stemming from cervical disc herniation.
Haemosporidians mediate nestlings' life-history along an urban-to-rural gradient
Authors: Neumann Astrid E , Suarez-Rubio Marcela , Renner Swen C
Published: April 2024

Urban areas, i.e. dense housing and reduced green spaces, can significantly impact avian health, through altering land use and increasing biotic and abiotic stress. This study assessed the influence of urbanization on Haemosporidian infections, vectors, immune response, and body condition in Parus major nestlings, across four classes of urbanization along an urban-to-rural gradient in Vienna, Austria. Contrary to our expectations, vector abundance remained largely consistent across the gradient, while urban environmental factors, particularly impervious surfaces, significantly influenced Haemosporidian intensity. We found that nestlings in more urbanized areas exhibited higher parasite intensities and altered immune responses, as evidenced by variations in the heterophil to lymphocyte ratio and leucocyte counts. Moreover, nestlings from smaller clutches faced higher infection risks, suggesting increased probabilities to precept infections. Urbanization negatively impacted nestling body condition, with a decrease in fat deposits from forested to highly urbanized areas. Our findings highlight the complex interplay between urbanization, vector-borne parasite transmission, and host immune response, emphasizing the need for comprehensive urban planning. Understanding how urbanization affects bird immunity and parasite infections is critical for adapting urban landscapes for wildlife health and ecosystem integrity.
Two hydatid cysts in the psoas muscle of a 40-year-old female: A rare case report from Syria
Authors: Arab Hazem , Alsaffaf Yousef , Kattan Osama , Khallouf Saleem
Published: April 2024

Background:
Hydatid disease, a zoonotic infection common in pastoral areas, can affect any human organ. Muscular involvement, especially in the psoas muscle, is rare, comprising only 1-3% of cases, even in endemic regions. The presence of multiple cysts is even rarer. Clinical presentation varies, making them challenging to diagnostic. Surgical intervention is the primary treatment for psoas hydatid cysts.
Case presentation:
A 40-year-old female from a rural area presented with fatigue and abdominal pain, without constipation or changes in appetite. Physical examination revealed tenderness in the right hypochondrium. Her medical history included tonsillectomy twenty years ago, cesarean delivery two years ago, and pulmonary hydatid cystectomy seven years ago. Ultrasound detected a retroperitoneal hydatid cyst, while a multi-slice CT scan showed a hydatid cyst within the left psoas major muscle and an additional cyst in the anterior and lateral portions of the left psoas major muscle. Surgeries successfully removed two cysts from the left psoas major muscle, and the patient was discharged in good condition two days post-surgery.
Conclusions:
This case highlights the rarity of psoas major muscle hydatid cysts in a middle-aged woman from a rural area. Early recognition, accurate radiological assessment, and proper surgical treatment are crucial for positive outcomes and averting complications like infection, compression of nearby structures, or anaphylactic reactions.