bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal trends in mental health terminology in Alzheimer’s disease clinical trials
Authors: Golrokhian-Sani Amir-Ali , Morcos Maya , Philippi Alecco , Al-Rawi Reem , Morcos Marc , Fu Rui
Published: December 2024

Background

Despite several studies having correlated Alzheimer’s disease with mental health conditions, the extent to which they have been incorporated into Alzheimer’s disease clinical trials remains unclear.

Objective

This study aimed to assess the temporal trends in mental health-related terminology in Alzheimer’s disease clinical trials as a proxy measure of research interest. Additionally, it sought to determine the effect of the COVID-19 pandemic on the frequency of these terms through pre-pandemic and post-pandemic trend assessment.

Methods

In this retrospective descriptive analysis, we included 2243 trials with a start date between 1988 and 2022 by searching for the keyword “Alzheimer Disease” in the U.S. National Library of Medicine ClinicaTrials.gov database. A Python program was created to extract and count the frequency of four mental health terms (loneliness, depression, anxiety, and distress) by year and trial status (e.g., completed, active, recruiting). Binary logistic regression analyses were conducted to examine the yearly patterns in the appearance of the four mental health terms. A multivariable logistic regression analysis was performed to identify trial characteristics associated with each mental health term.

Results

Our results depicted a statistically significant increasing trend in three (i.e., loneliness, anxiety, distress) of the four mental health conditions by year. A comparison between pre-pandemic and post-pandemic trials showed an increase in the mention of the same three words over time.

Interpretation

These results may suggest a growing awareness of mental health conditions and a greater interest in considering these conditions in Alzheimer’s disease trials, particularly after the onset of COVID-19. Future researchers should conduct more in-depth analyses to examine how mental health variables are operationalized in these trials, with consideration for their subsequent success.
Semi-supervised emotion-driven music generation model based on category-dispersed Gaussian Mixture Variational Autoencoders
Authors: Ning Zihao , Han Xiao , Pan Jie
Published: December 2024

Existing emotion-driven music generation models heavily rely on labeled data and lack interpretability and controllability of emotions. To address these limitations, a semi-supervised emotion-driven music generation model based on category-dispersed Gaussian mixture variational autoencoders is proposed. Initially, a controllable music generation model is introduced, which disentangles and manipulates rhythm and tonal features, enabling controlled music generation. Building on this, a semi-supervised model is developed, leveraging a category-dispersed Gaussian mixture variational autoencoder to infer emotions from the latent representations of rhythm and tonal features. Finally, the objective loss function is optimized to enhance the separation of distinct emotional clusters. Experimental results on real-world datasets demonstrate that the proposed method effectively separates music with different emotions in the latent space, thereby strengthening the association between music and emotions. Additionally, the model successfully disentangles and separates various musical features, facilitating more accurate emotion-driven music generation and emotion transitions through feature manipulation.
Associations between dietary patterns and intestinal inflammation among HIV-infected and uninfected adults: A cross-sectional study in Tanzania
Authors: Malindisa Evangelista Kenan , Dika Haruna , Rehman Andrea Mary , Kweka Belinda , Todd Jim , Olsen Mette Frahm , Krogh-Madsen Rikke , Frikke-Schmidt Ruth , Friis Henrik , Faurholt-Jepsen Daniel , Kelly Paul , Filteau Suzanne , PrayGod George
Published: December 2024

The increased burden of non-communicable diseases (NCDs) is fueled by lifestyle factors including diet. This cross-sectional study explored among Tanzanian adults whether unhealthy dietary patterns are associated with intestinal and systemic inflammation which could increase the risk of NCDs. The study included 574 participants, with both diet and inflammatory markers data. Dietary patterns were derived using principal component analysis and reduced rank regression, revealing three main patterns: vegetable-rich, vegetable-poor, and carbohydrate-dense diets. Fecal myeloperoxidase (MPO) and neopterin (NEO) were markers of intestinal inflammation whereas plasma lipopolysaccharide-binding protein (LBP) and C-reactive protein (CRP) were assessed as markers of systemic inflammation. Ordinal logistic regression was used to assess associations between terciles of dietary patterns and quintiles of the inflammatory markers adjusting for potential confounders. High adherence to a vegetable-poor dietary pattern was associated with elevated MPO (adjusted OR, 1.7 95% CI 1.1, 2.8). NEO tended to be higher in people with high adherence to both vegetable-poor pattern (adjusted OR, 2.6 95% CI 1.0, 6.4) and vegetable-rich pattern (adjusted OR, 2.7, 95% CI 1.1, 6.5). No associations were found between dietary patterns and systemic inflammation markers (LBP and CRP). We found links between dietary vegetable intake and intestinal inflammation but not systemic inflammation. However, the cross-sectional nature of the study limits establishing causality and the sample size for some variables may have been inadequate, emphasizing the need for further studies to understand how dietary habits influence inflammation in this population.
Advancing nuclear transfer cloning in zebrafish (Danio rerio) into a translational pathway using interdisciplinary tools
Authors: Bodenstein Sarah , Poulos William , Jimenez Fermin , Stout Michael , Liu Yue , Varga Zoltan M. , Cibelli Jose , Tiersch Terrence R.
Published: December 2024

The Zebrafish International Resource Center (ZIRC) is an NIH-funded national stock center and germplasm repository that maintains and distributes genetically modified and wild-type zebrafish (Danio rerio) lines to the biomedical research community. The ZIRC and its community would benefit from incorporating somatic cell nuclear transfer (SCNT) cloning which would allow the preservation of diploid genomes. The goal of this study was to advance a zebrafish SCNT cloning protocol into a reproducible community-level pathway by use of process mapping and simulation modeling approaches to address training requirements, process constraints, and quality management gaps. Training, for most steps in the SCNT protocol, could be completed within two months; however, steps that involved micromanipulation of eggs required more than four months of training. Dechorionation of embryos and egg micromanipulation were identified as major constraints because the processes were performed manually and required advanced operator manual skills. Chemical dechorionation and microfluidic devices to aid micromanipulation were identified as ways to eliminate these constraints. Finally, quality control steps to record the initial quality of collected germplasm were recommended to prevent production defects and harmonize the SCNT pathway across multiple facilities. By beginning to enhance the reproducibility of the SCNT cloning pathway, this technique can be implemented across zebrafish research facilities and facilities that work with other biomedical models.
Spatiotemporal variation in population size and relative abundance of Kalij pheasant (Lophura leucomelanos) in scrub forest
Authors: Saba Maria , Khalil Sangam , Hussain Majid , Khanam Surrya , Akhter Ali , Khatoon Rukhsana , Khan Muhammad Awais , Khan Kamal Ahmed , Gul Zartasha , Habiba Ume
Published: December 2024

Most species of pheasants (Galliformes: Phasianidae) occur in Asia. In Pakistan, pheasants occur from 245–3050 m in altitude, and one of these, the Kalij pheasant (Lophura leucomelanos) is a large-bodied, brightly-colored habitat quality indicator species. The present study was designed to determine spatiotemporal variation, population size, and the relative abundance of Kalij pheasants in Haripur, Pakistan. The line transects and point count methods were used to collect direct (physical observations) and indirect signs (feathers and calls) to avoid double counting. Twenty field surveys were conducted along 16 transects with an area of 0.811 km2 in 4 study sites to quantify habitat utilization of Kalij pheasant. Kalij pheasant activities were observed at the start of dawn (0600 hours to 0730 hours) and ended by 1630 hours to 1800 hours dusk period with only a few sightings during the middle of the day. Study sites were selected based on confirmation of presence signs. Twenty-seven individuals with direct (16) and indirect (feather = 5, calls = 6) signs were encountered while walking along line transects. Twelve signs were counted (sightings = 3, Calls = 9) within the radius of 11–50 m in the point count method. Results showed that the Kalij pheasant occupied scrub forest with dense vegetation between 500-1100m away. The mean encounter rate of the Kalij pheasant was 0.82/km, which was higher from July to September. The sex ratio (1.17) is biased toward males in the overall population of Kalij pheasants. The estimated mean density of the Kalij pheasant in Haripur was 6.97 animals/km2, and the total abundance was 142 individuals. New potential sites may be identified and declared as protected areas, and awareness and support of the local community are recommended for the protection and management of the Kalij pheasant.
Monitoring the impact of confinement on hyphal penetration and fungal behavior
Authors: Guo Yi-Syuan , Liber Julian A. , Morrell-Falvey Jennifer L. , Bonito Gregory , Retterer Scott T.
Published: December 2024

Through their expansive mycelium network, soil fungi alter the physical arrangement and chemical composition of their local environment. This can significantly impact bacterial distribution and nutrient transport and can play a dramatic role in shaping the rhizosphere around a developing plant. However, direct observation and quantitation of such behaviors is extremely difficult due to the opacity and complex porosity of the soil microenvironment. In this study, we demonstrate the development and use of an engineered microhabitat to visualize fungal growth in response to varied levels of confinement. Microfluidics were fabricated using photolithography and conventional soft lithography, assembled onto glass slides, and prepared to accommodate fungal cultures. Selected fungal strains across three phyla (Ascomycota: Morchella sextalata, Fusarium falciforme; Mucoromycota: Linnemannia elongata, Podila minutissima, Benniella; Basidiomycota: Laccaria bicolor, and Serendipita sp.) were cultured within microhabitats and imaged using time-lapse microscopy to visualize development at the mycelial level. Fungal hyphae of each strain were imaged as they penetrated through microchannels with well-defined pore dimensions. The hyphal penetration rates through the microchannels were quantified via image analysis. Other behaviors, including differences in the degree of branching, peer movement, and tip strength were also recorded for each strain. Our results provide a repeatable and easy-to-use approach for culturing fungi within a microfluidics platform and for visualizing the impact of confinement on hyphal growth and other fungal behaviors pertinent to their remodeling of the underground environment.
Psychometric evaluation and translation of the Persian version of the Organizational Silence Behavior Scale (OSBS-P) for clinical nurses
Authors: Mirzaei Alireza , Jamshidinia Mobina , Aghabarari Mehrzad , Abadi Pouya Dolat , Nemati-Vakilabad Reza
Published: December 2024

Background

Healthcare professionals have a crucial responsibility to provide optimal patient care. However, maintaining silence within an organization can often lead to ethical dilemmas and negatively impact the quality of care. Healthcare professionals must speak up and ensure their concerns are heard and addressed to promote a safe and ethical healthcare environment. This study aimed to translate and assess the psychometric properties of the Persian version of the Organizational Silence Behavior Scale (OSBS-P) for clinical nurses.

Methods

A methodological study was conducted on 338 clinical nurses to evaluate the psychometric properties of the Persian version of the 32-item OSBS-P. A multilevel approach was used: forward-backward translation, face and content validity, construct validity (confirmatory factor analysis), and reliability (internal consistency and stability) of the Persian version of the OSBS-P were analyzed, respectively.

Results

The psychometric evaluation demonstrated that the Persian version of OSBS-P is not only understandable but also retains the conceptual integrity of the original English version. Confirmatory factor analysis validated its alignment with the proposed four-factor model, indicating robust construct validity. The OSBS-P’s reliability was excellent, with a Cronbach’s alpha coefficient of α = 0.969, and stability was confirmed with an intraclass correlation coefficient (ICC) of 0.951 (95% CI, 0.919–0.945).

Conclusion

The OSBS-P is a valid tool for evaluating the organizational silence behavior of clinical nurses.
Use of youth-friendly health services and predictive factors: A community-based analytical cross-sectional study among young people in the Tamale metropolis
Authors: Awuah Vivian , Aninanya Gifty Apiung , Bionkum Konlan Benson
Published: December 2024

Globally, teenage pregnancies, unsafe abortions and sexually transmitted infections are on the increase among young people. However, their knowledge and uptake of youth-friendly sexual and reproductive health services are low. This study evaluated young people’s knowledge, attitude and utilization of youth-friendly health services in the Tamale Metropolis. 420 young people aged between 15 and 24 years were proportionately selected from four suburbs within the Tamale metropolis and a Likert scale was used to collect quantitative data. To determine the correlation between the relevant characteristics and attitudes toward youth-friendly health services, a logit model and chi-square statistics were applied. Respondents’ knowledge of youth-friendly health services was low (69%). A majority (71%) of them had a negative attitude towards youth-friendly health services and 63% of them had never used such services before. Level of education and religion were significantly associated with the knowledge levels of respondents while religion, employment status and individuals contributing to decision-making concerning the health of the participants were associated with attitudes towards the services. Cost and level of education were also associated with the uptake of youth-friendly health services. In conclusion, most young people had low knowledge, poor attitudes and low uptake of youth-friendly health services. Predictors of uptake of youth-friendly services were cost and educational level. The study suggests the need for Ghana Health Service to rigorously embark on sensitization programmes on the benefits of utilising youth-friendly health services and the cost of patronising these services could be subsidized to promote its utilization among the youth.
Leveraging feature extraction and risk-based clustering for advanced fault diagnosis in equipment
Authors: Ji Hyeonbin , Hwang Ingeun , Kim Junghwon , Lee Suan , Lee Wookey
Published: December 2024

In the contemporary manufacturing landscape, the advent of artificial intelligence and big data analytics has been a game-changer in enhancing product quality. Despite these advancements, their application in diagnosing failure probability and risk remains underexplored. The current practice of failure risk diagnosis is impeded by the manual intervention of managers, leading to varying evaluations for identical products or similar facilities. This study aims to bridge this gap by implementing advanced data analysis techniques on maintenance data from an aluminum extruder. We have employed text embedding, dimensionality reduction, and feature extraction methods, integrating the K-means algorithm with the Silhouette Score for risk level classification. Our findings reveal that the combination of Word2Vec for embedding and Contractive Auto Encoder for dimensionality reduction and feature extraction yields high-performance results. The optimal cluster count, identified as three, achieved the highest Silhouette Score. Statistical analysis using one-way ANOVA confirmed the significance of these findings with a p-value of 5.3213 × e−6, well within the 5% significance threshold. Furthermore, this study utilized BERTopic for topic modeling to extract principal topics from each cluster, facilitating an in-depth analysis of the clusters in relation to the extruder’s characteristics. The outcome of this research offers a novel methodology for facility managers to objectively diagnose equipment failures. By minimizing subjective judgment, this approach is poised to significantly enhance the efficacy of quality assurance systems in manufacturing, leveraging the robust capabilities of artificial intelligence.
The efficacy of virtual reality in adults during puncture biopsy: A protocol of a systematic review and meta-analysis
Authors: Qiu Xueling , Sun Lukun , Tang Lu , Jiang Xiaochen , Wang Weifeng , Sun Fan , Sun Chenxi , Song Tianyi
Published: December 2024

Background

Puncture biopsy is a primary method for obtaining tissue or cell samples from tumors for histopathological diagnosis. However, patients often experience pain, anxiety, and discomfort during the procedure. Virtual reality is a novel technology developed through advancements in computer skill, and it is utilized in healthcare as a cognitive approach to relieve pain and relaxation. However, there is controversy in published trials regarding the efficacy of virtual reality in adults during puncture biopsy. Therefore, a synthesis of objective and accurate data is needed to support the efficacy of virtual reality for pain relief during puncture biopsy in adults.

Method and analysis

To identify suitable randomized controlled trials, published literature in eight electronic databases will be searched, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, Chinese National Knowledge Infrastructure (CNKI), Wan-fang Data, and Chinese Biomedical Database (CBM). The collected data will be consolidated and subjected to meta-analysis by using RevMan 5.4. Mean difference will describe the continuous variables. 95% confidence intervals (CI) will characterize the interval estimates. Model categories will be selected based on heterogeneity. The quality of the inclusion of randomized controlled trials in terms of methodological quality will be assessed by the Cochrane Risk of Bias Assessment Tool. Additionally, strength and certainty of the evidence will be assessed by the GRADE system.

Discussion

The following protocol delineates the fundamental process and methodology to be employed in a systematic review and meta-analysis of data pertaining to the efficacy of virtual reality in the context of adult puncture biopsy. The results of the study will furnish healthcare professionals with evidence-based clinical evidence, thereby facilitating sound clinical decision-making and yielding beneficial consequences for the clinical domain.

Trial registration

PROSPERO registration number: CRD42024539303.
Plasmidome of Salmonella enterica serovar Infantis recovered from surface waters in a major agricultural region for leafy greens in California
Authors: Quiñones Beatriz , Lee Bertram G. , Avilés Noriega Ashley , Gorski Lisa
Published: December 2024

Non-typhoidal Salmonella enterica is a leading cause of gastrointestinal illnesses in the United States. Among the 2,600 different S. enterica serovars, Infantis has been significantly linked to human illnesses and is frequently recovered from broilers and chicken parts in the U.S. A key virulence determinant in serovar Infantis is the presence of the megaplasmid pESI, conferring multidrug resistance. To further characterize the virulence potential of this serovar, the present study identified the types of plasmids harbored by Infantis strains, recovered from surface waters adjacent to leafy greens farms in California. Sequencing analysis showed that each of the examined 12 Infantis strains had a large plasmid ranging in size from 78 kb to 125 kb. In addition, a second 4-kb plasmid was detected in two strains. Plasmid nucleotide queries did not identify the emerging megaplasmid pESI in the examined Infantis strains; however, the detected plasmids each had similarity to a plasmid sequence already cataloged in the nucleotide databases. Subsequent comparative analyses, based on gene presence or absence, divided the detected plasmids into five distinct clusters, and the phylogram revealed these Infantis plasmids were clustered based either on the plasmid conjugation system, IncI and IncF, or on the presence of plasmid phage genes. Assignment of the putative genes to functional categories revealed that the large plasmids contained genes implicated in cell cycle control and division, replication and recombination and defense mechanisms. Further analysis of the mobilome, including prophages and transposons, demonstrated the presence of genes implicated in the release of the bactericidal peptide microcin in the IncF plasmids and identified a Tn10 transposon conferring tetracycline resistance in one of the IncI1 plasmids. These findings indicated that the plasmids in the environmental S. enterica serovar Infantis strains from surface waters harbored a wide variety of genes associated with adaptation, survivability and antimicrobial resistance.
Frequency of superoxide dismutase 1 c.118: G˃A mutation associated with canine degenerative myelopathy in German Shepherd dogs from Uruguay and Paraguay
Authors: Artigas Rody , Menchaca Carolina , Castro Liz , Mondino Alejandra , Perdomo Yamila , Bera Facundo , Stagno Sofía , Borca Micaela , Mendez Natalia , Ramirez José , Llambí Silvia
Published: December 2024

Background and Aim: Canine degenerative myelopathy (DM) is an autosomal recessive inherited disease that affects different dog breeds. It has an invariably fatal outcome once the clinical symptoms begin. This study aimed to investigate the population behavior of the mutation superoxide dismutase 1 (SOD1) c.118: G˃A responsible for the high risk of developing DM in two populations of German Shepherd dogs from Uruguay and Paraguay.

Materials and Methods: A total of 158 German Shepherd dogs from Uruguay (n = 114) and Paraguay (n = 44) were analyzed. Genomic DNA was extracted from peripheral whole blood. The SOD1 c.118: G˃A mutation was identified by polymerase chain reaction-restriction fragment length polymorphism and subsequently validated using sequencing. Allelic and genotypic frequencies and Hardy–Weinberg equilibrium were calculated for both populations. The rate of clinical progression was evaluated in animals homozygous for the mutation.

Results: The frequencies of allele A associated with a higher risk of DM, were 0.15 and 0.23 in Paraguay and Uruguay, respectively. Paraguay’s population was found to be in Hardy–Weinberg equilibrium (p = 1.00), whereas the population of dogs from Uruguay deviated from equilibrium (p = 0.008). When comparing the populations, no significant difference was observed in the distribution of genotypes (p = 0.26). When evaluating the clinical progression rate, all animals aged >10 years showed clinical symptoms compatible with DM.

Conclusion: This study demonstrated for the first time the presence of the SOD1:c118 G>A mutation in German Shepherd dogs from Uruguay and Paraguay. The frequency detected in Uruguay was significant. Although the frequency was lower in Paraguay, the allele was present. This demonstrates the need to implement genotyping tests as part of a possible DM control program in both countries studied.

Keywords: degenerative myelopathy, genetic disease, German Shepherd dog, superoxide dismutase 1 gene.
Long-term tumor suppression in cholangiocarcinoma using cytokine-induced killer cell therapy and high-dose vitamin C: a case report
Authors: Kim Kangseok , Wang Hyunhye , Lee Jiewon , Yeom Changhwan
Published: December 2024

This case study explores the effectiveness of autologous cytokine-induced killer (CIK) cell-based immunotherapy in a 49-year-old male patient with inoperable stage IIIb cholangiocarcinoma, characterized by high levels of the sodium-dependent vitamin C transporter-2 (SVCT2) in immune cells. Despite an initial lack of tumor reduction following chemotherapy, the patient showed a significant decrease in tumor markers and stabilization of the tumor after undergoing radiation and proton therapy. Subsequently, CIK cell therapy, combined with high-dose vitamin C, was administered 52 times over 6 years. The patient’s tumor size reduced, and no cancer activity was detected for 7 years and 10 months post-diagnosis, indicating a successful long-term outcome without recurrence. This study suggests that CIK cell therapy, particularly in patients with elevated SVCT2 levels, may offer a promising adjuvant treatment for cholangiocarcinoma and potentially other cancers. Further research is needed to validate SVCT2 as a biomarker for the effectiveness of CIK cell therapy.
The unseen spread–Schnitzler’s metastasis unveiled: a case report
Authors: Ayyamperumal Jeya Anand , Chandrabose Ambedkar Maravadi Jayaraman , Lakshmanan Anand , Satyanesan Jeswanth
Published: December 2024

Metastasis to the rectum is very rare and is usually caused by primaries from the breast, gastrointestinal tract, and genitourinary system. We report here a case of acute intestinal obstruction caused by an unusual rectal stenosis, for which he underwent a diversion stoma. On extensive evaluation for the etiology of the rectal stenosis, he was diagnosed with diffuse gastric cancer with Schnitzler’s metastasis to the rectal submucosa. This is an unusual type of metastasis, very rarely seen. Only 11 such cases have been reported in the literature.
Quem responsabilizar? Casos de violência letal e racismo em espaços comerciais no Brasil
Authors: Durão Susana Soares Branco , Argentin Paola , Vituri Gabriel
Published: December 2024

Às vésperas do Dia da Consciência Negra no Brasil em 2020, o país foi abalado pelo brutal assassinato de João Alberto Freitas, um homem negro espancado até a morte por funcionários de segurança de um hipermercado situado em Porto Alegre (RS). Mas se o caso instaurou imediatamente um debate e indignação sobre o racismo estrutural e institucional no país, ele também tornou públicas as disputas sobre onde situar, como localizar e responsabilizar os envolvidos no crime. Neste texto, acompanhamos as repercussões midiáticas sobre o caso, o embate a respeito do conceito de racismo estrutural que gerou e as diferentes decisões judiciais que afetaram os envolvidos. Demonstramos que enquanto o grupo profissional dos seguranças privados, e mesmo a própria vítima, foram simbolicamente penalizados e moralmente questionados, as empresas e a corporação envolvidas emergiram publicamente como exemplos de combate ao racismo, com medidas reparadoras. No final, percebemos que tais decisões contribuem para o esquecimento social destes casos, até que outro episódio surja e se faça novamente a pergunta: Quem, e como, responsabilizar?
Predicting Neck Dysfunction After Open-Door Cervical Laminoplasty — A Prospective Cohort Patient-Reported Outcome Measurement Study
Authors: Hsu Chiu-Hao , Chen Wei-Wei , Ho Meng-Yin , Wu Chin-Chieh , Lai Dar-Ming
Published: December 2024

Objective: To analyze the predictive factors for neck pain and cervical spine function after laminoplasty for degenerative cervical myelopathy (DCM) using K-means for longitudinal data (KML).Methods: In this prospective cohort study, we collected clinical and radiographic data from patients with DCM who underwent cervical laminoplasty. A novel index of surgical outcome, “neck function,” which comprises neck pain and cervical spine function according to the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire, was proposed. We treated surgical outcomes as longitudinal rather than cross-sectional data and used KML for analysis. Patients were categorized as having good or poor outcomes based on the KML graph of neck pain and cervical spine function.Results: From 2016 to 2020, 104 patients underwent laminoplasty for DCM; however, 35 patients were excluded because of loss to follow-up or incomplete data. The authors found that central canal stenosis (odds ratio [OR], 17.93; 95% confidence interval [CI], 1.26–254.73; p=0.03) and preoperative neck pain (OR per 1 point increase=1.49; 95% CI, 1.12–1.99; p=0.006) were 2 negative predictive factors and that a positive K-line during flexion was a positive predictive factor (OR, 0.11; 95% CI, 0.01–0.87; p=0.036) for neck function after laminoplasty.Conclusion: Central canal stenosis, preoperative neck pain and a K-line during flexion were found to be predictive of postoperative neck pain and cervical spine function after laminoplasty. To achieve better surgical outcomes for neck function, the authors suggest the utilization of these determinants as a guiding framework for the selection of surgical approaches for DCM.
Comparative Outcomes of Biportal Endoscopic Decompression, Conventional Subtotal Laminectomy, and Minimally Invasive Transforaminal Lumbar Interbody Fusion for Lumbar Central Stenosis
Authors: Lee Mu Ha , Jang Hyun Jun , Moon Bong Ju , Kim Kyung Hyun , Chin Dong Kyu , Kim Keun Su , Park Jeong-Yoon
Published: December 2024

Objective: Spinal stenosis is a prevalent condition; however, the optimal surgical treatment for central lumbar stenosis remains controversial. This study compared the clinical outcomes and radiological parameters of 3 surgical methods: unilateral laminectomy bilateral decompression with unilateral biportal endoscopy (ULBD-UBE), conventional subtotal laminectomy (STL), and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF).Methods: This retrospective study included 86 patients, divided into ULBD-UBE (n=34), STL (n=24), and MIS-TLIF (n=28) groups. We evaluated demographics and perioperative factors and assessed clinical outcomes using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and neurogenic intermittent claudication (NIC). Radiological parameters assessed included lumbar lordosis, L4S1 Cobb angle (L4S1), T12S1 Cobb angle (T12S1), increased cross-sectional dural area (CSA), dynamic angulation (DA), dynamic slip (DS), and development of postoperative instability.Results: The ULBD-UBE group showed a significantly shorter hospital stay duration and operation time and reduced blood loss than the other groups (p<0.001). ULBD-UBE group showed a trend towards greater VAS and ODI improvement at 1 month and postoperative NIC symptom relief. Radiologically, MIS-TLIF group exhibited lower postoperative DA and DS (p<0.001), indicating higher postoperative stability. Postoperative instability was lower in the ULBD-UBE group (2.9%) than in the STL group (16.7%) and similar to the MIS-TLIF group (0.0%) (p=0.028). The CSA was highest in the MIS-TLIF group (295.5%) compared to that in the other groups (ULBD-UBE, 216.3%; STL, 245.2%) (p<0.001).Conclusion: Compared to other procedures, ULBD-UBE is a safe, effective, and viable surgical procedure for treating lumbar central stenosis.
Transforaminal Endoscopic Lumbar Foraminotomy for Iatrogenic Foraminal Stenosis Following Vertebroplasty
Authors: Ahn Yong , Rhee Do-Yeon
Published: December 2024

We present a case of iatrogenic lumbar foraminal stenosis caused by bone-cement leakage during vertebroplasty, successfully managed using transforaminal endoscopic lumbar foraminotomy (TELF). Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures (VCFs); however, complications such as bone-cement leakage can lead to vascular or neurological issues, including lumbar radiculopathy. TELF is a minimally invasive surgical option for addressing various forms of lumbar foraminal stenosis. An 82-year-old female patient presented to Gachon University Gil Medical Center with severe right inguinal pain radiating to the anterior thigh and knee. Six months prior, she had undergone vertebroplasty at the L3 level for an osteoporotic VCF at another hospital. Following the procedure, she developed radicular leg pain with a diminished knee jerk reflex, which progressively worsened despite extensive conservative treatment. Magnetic resonance imaging and computed tomography revealed right-sided L3–4 foraminal stenosis caused by bone-cement leakage from the prior vertebroplasty. TELF was performed under local anesthesia to decompress the affected area. Bone-cement fragments, along with hypertrophic bone and ligaments, were successfully removed, achieving sufficient decompression of the exiting nerve root. The patient experienced immediate postoperative pain relief. This case represents the first documented instance of endoscopic decompression for iatrogenic foraminal stenosis following vertebroplasty. TELF, performed safely under local anesthesia, demonstrates its effectiveness as a minimally invasive solution for this rare complication.
Practical Guidance of Full-Endoscopic Technique for Incidental Durotomy Repair: A Surgical Video Demonstration
Authors: Trathitephun Warayos , Kamolpak Jackapol , Suvithayasiri Siravich
Published: December 2024

This surgical video demonstrates the full-endoscopic repair of an incidental durotomy, offering practical guidance and insights into the technique. Incidental dural tears occur in up to 1% of lumbar endoscopic surgeries, with risk factors including interlaminar approaches, stenosis decompression, and power drill usage. Although many dural tears are managed with sealant or gel foam, no standard exists for when surgical repair is necessary. Complications such as cerebrospinal fluid leakage, radiculopathy, and neurological deficits can arise, prompting the need for effective repair techniques. A 50-year-old man presented with bilateral leg claudication due to lumbar stenosis (L4–S1). Full-endoscopic decompression was performed, during which an incidental 10-mm dural tear occurred at L5–S1. The nerve root was repositioned into the dural sac, and the tear was repaired using a 6-0 prolene suture with a knot pusher under endoscopic guidance. Gelfoam was applied to aid compression, and irrigation pressure was reduced to prevent increased intracranial pressure. The patient was mobilized after 48 hours and experienced significant symptom improvement without neurological deficits. We propose that dural tears should be repaired when possible to prevent complications. Surgeon experience, tear size, and location are critical factors. This case demonstrates a simple, effective endoscopic repair method, though further studies are needed to establish its long-term efficacy.
Full-Endoscopic Resection of a Lumbar Intradural Tumor (Schwannoma): Video Case Report and Description of the Surgical Technique
Authors: Hagel Vincent , Isseldyk Facundo Van
Published: December 2024

Endoscopic spinal surgery has gained increasing popularity over the past 10 years. Its muscle-preserving nature, reduction in postoperative pain, and lower complication rates have contributed to the growing number of surgeons adopting this technique year after year. This same progression has led to the application of the technique in oncological pathology, primarily for separation surgeries and biopsies of extradural lesions. However, reports in the literature on the use of this technique to treat intradural spinal tumors remain scarce. To present a case report of a patient with an intradural lesion, compatible with schwannoma, successfully removed using a fully endoscopic technique. A 46-year-old female patient presented with a long-standing history of low back pain and bilateral leg pain. The pain worsened over the past few months before her initial presentation. She also reported experiencing weakness in her feet and intermittent hypesthesia in her legs. Magnetic resonance imaging (MRI) showed a small intradural extramedullary tumor at the L1 level. Given the patient’s young age, the tumor location at the thoracolumbar junction, and the rather small tumor size, a full-endoscopic approach was selected and performed. A step-by-step video of the surgical technique is provided with the manuscript. The current follow-up period is 2.5 years, with the patient remaining asymptomatic. The most recent follow-up MRI, conducted 16 months after the surgery, indicated no signs of recurrence. To our knowledge, this is the first video report providing a step-by-step description of this procedure. More high-quality evidence is needed to properly evaluate the safety and outcomes of this technique.
First-in-Human Trial of Photodynamic Therapy for Spinal Cord Malignant Astrocytoma: Study Protocol
Authors: Endo Toshiki , Takahashi Yoshiharu , Nishizawa Taketo , Sasaki Tatsuya , Sato Aya , Fukami Shinjiro , Miyata Satoshi , Akimoto Jiro
Published: December 2024

Our extensive basic research on photodynamic therapy (PDT) application in models of intracranial malignant astrocytoma led to its clinical application for intracranial malignant astrocytoma in Japan. Having considered the safety and effectiveness of this pathology, we initiate a first-in-human clinical study of PDT for spinal cord malignant astrocytoma. This study has an open-label, single-arm design. The initial follow-up period is 12 months, at the end of which we will quantify survival after PDT for spinal cord malignant astrocytoma as primary objective. The secondary objective is to quantify the overall progression-free survival of treated patients and the percentage of patients surviving 6 months after PDT without recurrence. Twenty patients suffering from spinal cord malignant astrocytoma will be recruited. In particular, 10 of those should be newly diagnosed World Health Organization grade 4. After obtaining consent, each patient will receive a single intravenous injection of talaporfin sodium (40 mg/m2) 1 day before tumor resection. One day after completing tumor removal, the residual lesion and/or resection cavity will be irradiated using a 664-nm semiconductor laser with a radiation power density of 150 mW/cm2 and a radiation energy density of 27 J/cm2. The procedure will be performed 22–26 hours after talaporfin sodium administration. This study protocol has been reviewed and approved by the Certified Committee in the Japanese Ministry of Health, Labor, and Welfare University Hospital Medical Information Network Clinical Trials Registry (Japan Registry of Clinical Trials number, jRCT2021220040).
Publishing the Holocaust: An Inside View from the Editorial Trenches
Authors: Frankel Ellen
Published: December 2024

Over the course of an 18-year tenure as the Editor-in-Chief of The Jewish Publication Society, the author encountered numerous ethical dilemmas relating to publishing Holocaust manuscripts. These dilemmas concerned a book's provenance, authorship, distribution of royalties, authenticity, and appropriateness. In the article, the author presents several case studies of various Holocaust manuscripts and their disposition, describing the processes of vetting and debate pertaining to each problematic acquisition.
A survey of the

α

-

mangostin

content of commercial mangosteen beverages
Authors: Geilman Wayne , Zhou Bing-nan , West Brett
Published: December 2024

The xanthone content of commercial mangosteen juices was investigated using α-mangostin as a marker, as it is a prominent xanthone in mangosteen pericarp.Samples of commercial mangosteen juices, reported to contain the pericarp or an extract of the pericarp, were purchased at retail stores, through product distributors, or via the internet.Samples were analyzed for α-mangostin by HPLC.The samples were also subject to the Oxygen Radical Absorbance Capacity (ORAC) assay, which was then correlated to α-mangostin content. Our chemical analysis of Mango●Xan® mangosteen juice for α-mangostin, the major xanthone component with notable antioxidant activity, reveals that beneficial compounds are retained following commercial processing. This samplecontained 266 μg α-mangostin /mL. Our analysis also revealed that several other commercial mangosteen juices contained α-mangostin in the range of 18 to 238 μg /mL.Additionally, we found that α-mangostin concentrations correlate fairly well with the antioxidant capacity (R
2=0.84). For instance, the juices that contained 266 and 18 μg α-mangostin/mL had measured oxygen radical absorbance capacity (ORAC) values of 66,285 and 9,714 μmol trolox equivalents (TE)/L, respectively. However, we could not detect any α-mangostin in one particular brand.Some commercial mangosteen juices contain appreciable quantities of xanthones, indicating that normal fruit juice manufacturing processes do not cause significant degradation or removal. However, the observed variability in the α-mangostin content observed is likely due to differences in ingredient composition. Inclusion of mangosteen pericarp, or extracts derived there from, is not equal among the several brands. Not all commercial mangosteen juices are of equivalent quality and value.
Adaptive Behaviors, Esophageal Anxiety, and Hypervigilance Modify the Association Between Dysphagia Perception and Histological Disease Activity in Eosinophilic Esophagitis
Authors: Visaggi Pierfrancesco , Del Corso Giulio , Solinas Irene , Ovidi Filippo , Adamo Giulia , Dulmin Isabella , Baiano Svizzero Federica , Bellini Massimo , Savarino Edoardo V. , de Bortoli Nicola
Published: December 2024

INTRODUCTION:

Adaptive behaviors at mealtime, esophageal symptom-specific anxiety and hypervigilance may affect dysphagia reporting in patients with eosinophilic esophagitis (EoE), but this has not been investigated. Moreover, the relationship between such confounding factors and histological disease activity (HDA) is unclear.

METHODS:

This was a prospective study on adults with EoE. Dysphagia, anxiety, and hypervigilance were assessed using specific questionnaires (i.e., modified dysphagia symptom questionnaire [mDSQ], Dysphagia Symptom Score [DSS], and Esophageal Hypervigilance and Anxiety Scale). Adaptive behaviors were assessed using the Pisa EoE Adaptation Questionnaire. Appropriate statistics was used to investigate correlation between dysphagia, anxiety, hypervigilance, adaptive behaviors, and HDA.

RESULTS:

Ninety-five patients were included. Esophageal anxiety, hypervigilance, and use of adaptive behaviors were found in about 50% of patients with EoE. Esophageal anxiety and hypervigilance were significantly higher (P = 0.03 for both), and adaptive behaviors were significantly more prevalent in histologically active EoE compared with EoE in remission (76.8% vs 25.6%, P < 0.001). As a standalone measurement, mDSQ and DSS had area under the receiver operating characteristic curve of 77.7% and 75.3% for predicting HDA. Adjustments of mDSQ and DSS based on individual Esophageal Hypervigilance and Anxiety Scale scores and adaptive behaviors at mealtime significantly improved the area under the receiver operating characteristic curve of mDSQ and DSS to 86.6% and 84.3%, respectively (P < 0.05 for both).

DISCUSSION:

Use of adaptive behaviors, higher esophageal anxiety and hypervigilance are associated with active EoE and represent clinical markers of HDA. Adaptive behaviors provide complementary clinical information that is not detected by symptoms alone. The assessment of adaptive behaviors, anxiety, and hypervigilance improves the correlation between clinical and HDA in EoE.
Assessing the Accuracy of Diagnosis Codes and Their Present on Admission Indicator for the Occurrence of Pressure Ulcers
Authors: Choi Eun Young , Jaeun Jaeun , Jeong Hyeran , Pyo Jeong , Ock Minsu
Published: December 2024

Purpose: Pressure ulcers (PU) are significant diseases with substantial social and economic burdens, necessitating the monitoring of their occurrence and exacerbation. This study evaluated the accuracy of PU diagnostic codes and present on admission (POA) indicators.Methods: Using cross-section analysis, PU diagnostic codes and POA indicators were compared with PU reports to assess their accuracy among patients with myocardial infarction, ischemic stroke, or hemorrhagic stroke who are registered in the regional cardiocerebrovascular disease center registry between the second half of 2018 and second half of 2022.Results: Among 3,762 patients, 512 (13.6%) had PU according to the PU reports. During the analysis period, the accuracy of PU diagnostic codes was 56.1%, increasing from 17.5% in the second half of 2018 to 86.8% in the second half of 2022. The accuracy of POA Y and N indicators was 98.4% and 55.1%, respectively. The accuracy of the POA N indicators decreased from 80.0% in the second half of 2018 to 50.0% in the second half of 2022.Conclusion: Presently, the accuracy of the PU diagnostic codes and POA indicators is low. To improve the accuracy of PU diagnostic codes and POA indicators within the administrative data, strategies, such as improving perceptions among healthcare professionals, implementing education, and introducing evaluation measures, should be initiated.
Osteological analysis of Nyctereutes procyonoides bones excavated from the Gasan-ri archaeological site
Authors: Lee Sijoon , Choi Jonghyuk , Won Chungkil
Published: December 2024

Archaeological research has mainly focused on stone tools, pottery, and metal relics excavated from ruins. Recently, interest in natural relics such as animal bones has increased, as these relics can provide insight into the eating habits, cultural level, and perception of animals of the people at that time. This study investigated morphological structures and dimensions of Nyctereutes procyonoides bones excavated from a well at the Gasan-ri archaeological site in Jinju. These bones are presumed to be relics from the Three Kingdoms period. A total of 447 animal bones were excavated, of which 59 (13.2%) were identified as N. procyonoides bones. These identified bones weighed 47.14 g, accounting for 4.83% of the total bone weight (975.30 g). These N. procyonoides bones were found to belong to 2 individuals estimated to be 5 to 6 weeks old. These bones included 5 skull fragments, 2 mandibles, 9 vertebrae, 11 ribs, 10 forelimb bones, 3 hip bones, and 19 hindlimb bones. A fracture was observed near the bregma of one skull. The presence of a complete specimen in the well suggested that it was used in animal sacrifice rituals. This study estimated the value of animals and human dietary culture at that time by utilizing N. procyonoides bones presumed to be relics of the Three Kingdoms period.
A Reflection on the Current State of Active Learning Research
Authors: Marchand Martella Amedee , Schneider Darryl
Published: December 2024

Interest in active learning continues to grow worldwide. Although the large volume of active learning research has provided a myriad of ways to implement active learning in the classroom, the construct remains underdeveloped and difficult to operationalize because of three main issues in the research literature: (a) the variation in active learning activities in research and in practice; (b) the dichotomy between active learning and lecture; and (c) whether “active” in active learning refers to behavioral activity, cognitive activity, or both. The purpose of this reflection article is to articulate these issues so that active learning can move beyond its current status as a “curious construct.” By discussing avenues for future research that address those issues, our goal is to move the field forward by helping researchers focus on why active learning is effective, which forms of it are the most effective, how it should be implemented to maximize learning, and for whom different active learning interventions are the most effective. Just as active learning is easy to prescribe, it should also be easy to implement.