bluuebunny/crossref_metadata_2025 huggingface dataset:
Design, synthesis and characterization of tetra substituted 2,3-dihydrothiazole derivatives as DNA and BSA targeting agents: advantages of the visible-light-induced multicomponent approach
Authors: Aggarwal Ranjana , Jain Naman , Dubey Gyan Prakash
Published: July 2024

This report describes the visible-light-induced one-pot multicomponent regioselective synthesis of a series of 5-aroyl-3-((arylidene)amino)-2-((arylidene)hydrazono)-4-methyl-2,3-dihydrothiazoles as DNA and BSA targeting agents.
Overview of the chemistry and biological activities of natural atisine-type diterpenoid alkaloids
Authors: Zheng Jiaqi , Jiang Hongjun , Yan Yuanfeng , Yin Tianpeng
Published: July 2024

Atisine-type C20-diterpenoid alkaloids are a very important class of diterpenoid alkaloids, which possess high chemical and biological diversity.
From molecular salt to layered network: cation-driven tuning of band gap, structure, and charge transport in A3Bi2I9 (A = Cs, Rb) perovskites
Authors: Bouzidi Mohamed , Ben Bechir Mohamed , Almalawi Dhaifallah R. , Smaili Idris H. , Aljuaid Fahad
Published: July 2024

The increasing demand for eco-friendly and stable optoelectronic materials has led to interest in all-inorganic lead-free halide perovskites.
Elucidating the role of potassium addition on the surface chemistry and catalytic properties of cobalt catalysts for ammonia synthesis
Authors: Ronduda Hubert , Zybert Magdalena , Patkowski Wojciech , Ostrowski Andrzej , Sobczak Kamil , Moszyński Dariusz , Raróg-Pilecka Wioletta
Published: July 2024

K-doped cobalt catalysts for ammonia synthesis: the location, state and effect of potassium dopant on the surface chemistry and catalytic properties.
Techno-economic analysis of a solar-driven biomass pyrolysis plant for bio-oil and biochar production
Authors: Amjed Muhammad Ahsan , Sobic Filip , Romano Matteo C. , Faravelli Tiziano , Binotti Marco
Published: July 2024

Transforming conventional biomass pyrolysis through solar-driven pyrolysis with a falling particle receiver and intermediate hybrid solution reduces costs by 21% and 32% and emissions by 27.5 and 22.3 kgCO2 GJoil−1, respectively.
Fabrication of biological cushioning materials with natural wood structure by an ionic liquid-based sustainable chemistry approach
Authors: Sakagami Hiroki , Tsuda Tetsuya
Published: July 2024

While retaining wood characteristics, elastic softened wood was fabricated by the partial removal of lignin and hemicellulose from C. japonica wood without morphological change during a simple ionic liquid-based sustainable chemistry approach.
Facile synthesis of propargylamines by metal-free doubly decarboxylative coupling
Authors: Hu Junduo , Shi Xiaofan , Huang Liliang , Zhang Rongkang , Feng Huangdi
Published: July 2024

A sustainable and catalyst-free strategy has been developed for the synthesis of propargylamines by a three-component doubly decarboxylative coupling reaction.
Improving long-term capacity retention of NMC811 via lithium aluminate coatings using mixed-metal alkoxides
Authors: Riesgo-González Víctor , O'Keefe Christopher A. , Grey Clare P. , Wright Dominic S.
Published: July 2024

The solution deposition of LiAlO2 onto the cathode material NMC811 using the lithium aluminate Li[Al(OtBu)4] is shown to result in a large improvement in capacity retention and significant regeneration of the capacity of water-exposed cathode.
Stormwater alters the resistome of urban surface water, an impact that can be mitigated by green stormwater infrastructure
Authors: O'Malley Kassidy , McDonald Walter , McNamara Patrick
Published: July 2024

Bioretention cell treatment lessened stormwater's impact on surface water, reducing the diversity of antibiotic resistance genes after a rainfall event.
Trends in the energy and environmental applications of metal–organic framework-based materials
Authors: Yusuf Mohammed , Kurzina Irina , Voronova Gulnara , Islam Md. Monjurul , Mohammed Salisu Danlami , Oladoja Nurudeen Abiola
Published: July 2024

Over the past 20 years, metal–organic framework (MOF) nanosheets have garnered a great deal of interest in the fields of energy and environmental management because of their inherent extraordinary qualities.
Differences in endothelial function between patients with Type 1 and Type 2 diabetes: effects of red blood cells and arginase
Authors: Tengbom John , Kontidou Eftychia , Collado Aida , Yang Jiangning , Alvarsson Michael , Brinck Jonas , Rössner Sophia , Zhou Zhichao , Pernow John , Mahdi Ali
Published: July 2024

The mechanisms underlying endothelial dysfunction in Type 1 and Type 2 diabetes (T1DM and T2DM) are unresolved. The red blood cells (RBCs) with increased arginase activity induce endothelial dysfunction in T2DM, but the implications of RBCs and the role of arginase inhibition in T1DM are unexplored. We aimed to investigate the differences in endothelial function in patients with T1DM and T2DM, with focus on RBCs and arginase. Thirteen patients with T1DM and twenty-six patients with T2DM, matched for HbA1c and sex were included. In vivo endothelium-dependent and -independent vasodilation (EDV and EIDV) were assessed by venous occlusion plethysmography before and after administration of an arginase inhibitor. RBCs were co-incubated with rat aortic segments for 18h followed by evaluation of endothelium-dependent (EDR) and -independent relaxation (EIDR) in isolated organ chambers. In vivo EDV, but not EIDV, was significantly impaired in patients with T2DM compared with patients with T1DM. Arginase inhibition resulted in improved EDV only in T2DM. RBCs from patients with T2DM induced impaired EDR but not EIDR in isolated aortic segments, whereas RBCs from patients with T1DM did not affect EDR nor EIDR. The present study demonstrates markedly impaired EDV in patients with T2DM in comparison with T1DM. In addition, it highlights the divergent roles of RBCs and arginase in mediating endothelial dysfunction in T1DM and T2DM. While endothelial dysfunction is mediated via RBCs and arginase in T2DM, these phenomena are not prominent in T1DM thereby indicating distinct differences in underlying mechanisms.
Convex equilibrium‐free stability and performance analysis of discrete‐time nonlinear systems
Authors: Koelewijn Patrick J. W. , Weiland Siep , Tóth Roland
Published: July 2024

This paper considers the equilibrium‐free stability and performance analysis of discrete‐time nonlinear systems. Two types of equilibrium‐free notions are considered. Namely, the universal shifted concept, which considers stability and performance w.r.t. all equilibrium points of the system, and the incremental concept, which considers stability and performance between trajectories of the system. This paper shows how universal shifted stability and performance of discrete‐time systems can be analysed by making use of the time‐difference dynamics. Moreover, the existing results are extended for incremental dissipativity for discrete‐time systems based on dissipativity analysis of the differential dynamics to more general state‐dependent storage functions for less conservative results. Finally, it is shown how both these equilibrium‐free notions can be cast as a convex analysis problem by making use of the linear parameter‐varying framework, which is also demonstrated by means of an example.
Memory‐based event‐triggered control for networked control system under cyber‐attacks
Authors: Nafir Noureddine , Khemissat Abdel Mouneim , Farrag Mohamed Emad , Rouamel Mohamed
Published: July 2024

This article focuses on the problem of stability for a class of linear networked control systems (NCSs) subjected to network communication delays and random deception attacks. A new memory event‐triggered mechanism (METM) is proposed to reduce the unnecessary transmitted data through the communication channel and then enhance the network resources. In this context, a new memory stochastic state feedback controller is proposed to stabilize the closed‐loop networked control system. A new randomly occurring deception attacks model is employed to deal with the security problem of NCSs. Sufficient stability conditions are derived based on a suitable Lyapunov‐Krasovskii functional (LKF). The designed methodology is proposed in terms of linear matrix inequality to synthesize both event‐triggered parameters and controller gains, and to reduce the conservatism of the system some integral lemma are exploited to bind the time derivative of the LKF. Finally, two numerical examples are presented to illustrate the effectiveness of the proposed method which provides a maximal upper bound value of the network‐induced delay and less transmitted packet regarding the maximal value delay obtained in other works, so less conservatism results are obtained, compared to previous ones in the literature.
Real‐time fire and smoke detection with transfer learning based on cloud‐edge collaborative architecture
Authors: Yang Ming , Qian Songrong , Wu Xiaoqin
Published: July 2024

Recent years have seen increased interest in object detection‐based applications for fire detection in digital images and videos from edge devices. The environment's complexity and variability often lead to interference from factors such as fire and smoke characteristics, background noise, and camera settings like angle, sharpness, and exposure, which hampers the effectiveness of fire detection applications. Limited picture data for fire and smoke scenes further challenges model accuracy and robustness, resulting in high false detection and leakage rates. To address the need for efficient detection and adaptability to various environments, this paper focuses on (1) proposing a cloud‐edge collaborative architecture for real‐time fire and smoke detection, incorporating an iterative transfer learning strategy based on user feedback to enhance adaptability; (2) improving the detection capabilities of the base model YOLOv8 by enhancing the data augmentation method and introducing the coordinate attention mechanism to improve global feature extraction. The improved algorithm shows a 2‐point accuracy increase. After three iterations of transfer learning in the production environment, accuracy improves from 93.3% to 96.4%, and mAP0.5:0.95 increases by nearly 5 points. This program effectively addresses false detection issues in fire and smoke detection systems, demonstrating practical applicability.
The significance of genetic mutations in the pathogenesis of the development of nephropathy in chronic kidney diseases of different etiologies
Authors: Akhmedova Nilufar , Makhmudov Ravshan
Published: July 2024

In modern medicine, a number of scientific studies are being conducted on the importance of genetic predisposition in the development of chronic kidney disease (CKD). This article presents the results of a study conducted to determine the level of APOL1 gene polymorphism in the pathogenesis of nephropathies of various etiologies in the Uzbek population. The analysis showed that the APOL1 gene polymorphism G1 and G2 mutations were found among the patients included in the study.
Evaluation of cupcakes bioavailability and nutritional value
Authors: Ponomareva Elena , Fedorchenko Nina , Lukina Svetlana , Alekhina Nadezhda , Bakaeva Irina , Grebenshikov Andrey
Published: July 2024

Numerous studies aimed at expanding the production of domestic healthy food products meet the objectives of national programs and projects implemented at the state level. Flour confectionery products are known to be an integral part of the food basket of our country's inhabitants. Therefore, the use of non-traditional vegetable raw materials with a high content of fiber, vitamins, and minerals in their manufacture is an important research field. In addition, these technologies are resource-saving and allow expanding the range of products for specialized and therapeutic purposes, including those for people with gluten intolerance. However, it should be mentioned that the introduction of additional raw materials is an interference with the traditional cooking technology and may affect the finished product quality, which requires additional research. Therefore, the effect of biologically active components on the bioavailability and nutritional value of a cupcake enriched with non-traditional types of raw materials was studied in the work. The ciliates P. caudatum were used as a test object for assessing the studied samples bioavailability. In addition, indicators of nutritional and energy value were determined in finished products. The studies carried out proved that the use of whole wheat flour, grape seed flour, sesame oil and sesame seeds in the production of cupcakes helps to increase its biotic potential, biological and nutritional value.
The effectiveness of flow-through substrateless hydroponics in the adaptation of strawberry microplants
Authors: Kornatskiy Sergey , Kuzmina Milana , Serebryakova Zhanna , Kudrina Anastasia
Published: July 2024

A new approach to the adaptation of test-tube strawberry microplants under flow-through hydroponics conditions was tested. The study was carried out on strawberry cultivars “Asia”, “Florence”, “Kimberly”. Murashige-Skoog medium was used for in vitro cultivation. During propagation, 1.0 mg•L-16-BAP was added to the medium, during elongation - 0.05 mg•L-16-BAP, and during rooting - 1.0 mg•L-1IBA. Plants were grown in vitro in a light room at a temperature of 23±1°C, a 16-hour photoperiod and a light intensity of 5-6 klx. Flow hydroponics was used to adapt microplants. Plastic containers with dimensions of 0.6 x 0.4 x 0.04 m (volume 9 l), specially prepared for working in a hydroponic system, were taken. They were covered on top with non-woven polymer material, perforated with planting holes with a diameter of 3-4 mm according to a 4 x 4 cm pattern (150 pcs/box), into which plants were planted. This reduced labor costs for adaptation and ensured the efficiency of the operation to 86- 100% within 1 month.
Improvement of laboratory courses in biochemistry for medical students using an electronic textbook
Authors: Nurutdinova Feruza , Madjidov Abdunabi , Rasulova Yulduz , Amonova Nargiza , Amonova Hikoyat , Tokhtayev Sardor
Published: July 2024

Today, at the main stage of reforming education, it is very important to create a new generation of educational literature that meets the requirements of modernity. In our time, new modern information technologies open up a lot of opportunities. For example, computer, printer, scanner, multiplication, animation presentation and so on. This, in turn, simplifies the creation of an active learning system and e-books. As a result, it is possible to organize modern informative lectures, practical and experimental laboratories.
Effect of the level of somatotropin hormone in blood serum on the meat productivity of Aberdeen angus bulls
Authors: Zavyalov O.A. , Frolov A.N. , Medetov E.S. , Aldyyarov T.B. , Sycheva I.N.
Published: July 2024

The studies were performed on Aberdeen Angus bulls at the age of 18 months. Animals, depending on the level of somatotropin in blood serum, were divided into three groups by the percentile method: group I – up to the 25th percentile; group II – within the limits of 25-75 percentiles; group III – above the 75th percentile. The somatotropin content was determined in blood serum by enzyme-linked immunoassay using an automatic microplate analyzer Infinite F200 PRO. To study the meat qualities of steers, a control slaughter was carried out at the age of 18 months. It was found that animals with the maximum level of somatotropin in the blood serum had a higher pre-slaughter mass, hot carcass weight, chilled carcass, pulp mass and bone mass, with a minimum content of internal fat in the carcasses. The chemical composition of the average sample of meat and the longest back muscle in these animals was characterized by an increased protein content and a minimum fat concentration. The protein-qualitative indicator estimated by the ratio of tryptophan to oxyproline in the longest back muscle increased with an increase in serum somatotropin.
Increasing the effectiveness of complex influence on the condition of parodontal tissue in patients with diseases of the digestive system and having fixed dentures
Authors: Khojaeva Shakhnoza , Rajabov Otabek , Muhsinova Lola , Hamroyeva Dilafruz , Samadova Shahzoda , Kazakova Nozima
Published: July 2024

The study is dedicated to analyzing the effectiveness of comprehensive treatment of periodontal tissues in patients with digestive system diseases who use non-removable prostheses. The work considers the connection between periodontal diseases and digestive system disorders, emphasizing the importance of an integrated approach to treatment. A significant number of patients were included in the study, various clinical and biochemical parameters were evaluated, and a comprehensive methodological approach was used, including statistical analysis. The results of the study showed that a combined approach to treatment significantly improved the oral cavity and periodontal condition in these patients, suggesting greater effectiveness of such integrated strategies for treating periodontal diseases in individuals with digestive system disorders and non-removable dental prostheses. The findings of the study are significant for developing more effective methods of treating periodontal diseases, especially for patients with concurrent digestive system diseases. Objective: to develop and evaluate new methods of comprehensive treatment of the periodontium in patients with digestive system diseases who use non-removable prostheses. Materials and Methods: The study was conducted at the Department of Dentistry of Bukhara State Medical Institute in the years 2020–2023. Participants: 138 patients, aged 18–60, including 101 men and 37 women. Age group distribution: 78 people aged 18–39, 39 people aged 40–49, 21 people aged 50–65. All patients suffered from chronic generalized periodontitis of varying severity, had digestive system diseases, and used non-removable prostheses. The main group included 108 patients with gastrointestinal tract exacerbations: 52 with metal bridge prostheses, 28 with metal-ceramic prostheses, and 28 with dental prostheses on dental implants. The control group consisted of 30 patients: 12 with metal bridge prostheses, 10 with dental prostheses on dental implants, and 8 with metal-ceramic prostheses. Results: The treatment improved clinical-hygienic indicators in patients, reducing OHI-S and PMA indices. The microbial population in the oral cavity significantly decreased, particularly the levels of Lactobacillus and Streptococcus mutans. The effectiveness of the treatment was higher in the first group, with improved microflora and a reduction in pathogens. The use of Traumeel-S, HelboBlue, and ALT-Vostok model 03 contributed to the improvement of periodontal health. Patients experienced a restoration of metabolic processes in periodontal tissues, an increase in the levels of L-arginine and citrulline, and a decrease in nitrates and urea. The integrated approach proved effective in correcting the condition of the periodontium in patients with gastrointestinal diseases and non-removable prostheses.
Determination of the relationship between the polymorphic genes of metaloproteinases MMP9 (A-8202G) RS11697325 and the level of cystatin c in children with chronic nephritic syndrome
Authors: Bazarova Nigina , Akhedov Bekhzod , Oltiboyeva Mavsuma , Narzullayeva Mexrangiz , Jurayeva Barno
Published: July 2024

An analysis of the scientific literature in recent years reliably indicates the importance of molecular diagnostics in the field of nephrology. Research contains information on the role of genetic factors in the chronicization of the process of nephritic syndrome, ongoing research in this area. The pathology of development is explained by the fact that the chronicity of the process occurs primarily due to genetic inferiority of parts of the nephron, which leads to changes in the structure of the protein. The results of the study show the relationship between changes in the genotype of MMP9 (Matrix metalloproteinase-9) (A-8202G) rs11697325 with the development of the chronicization process. Our results provide evidence that cystatin C is an accurate diagnostic and prognostic marker of chronic nephritic syndrome in the pediatric population. At the same time, chromosomal polymorphic MMP9 genes affect the glomerular filtration rate by increasing the amount of Cystatin C, which is a gold marker in the diagnosis of chronic nephritic syndrome in children, determining the prognosis of the disease, which makes it possible for timely treatment and further tactics of the doctor.
Comparative analysis of trunk indicators in children with scoliosis
Authors: Kharibova Elena , Kamalova Shakhnoza
Published: July 2024

Anthropometric measurements and subsequent methods for classifying body shapes make it possible to assess, study and predict the characteristics of the course of human diseases. Scoliosis, a lateral curvature of the spine, is a dangerous disease with serious complications, especially for growing children. Disorders that occur in the musculoskeletal system during the period of growth and development of children are dangerous because if not detected in time, they often become irreversible. The purpose of this study was to determine the anthropometric characteristics of the parameters of the upper extremities depending on gender and age characteristics in children aged the first and second periods of childhood.
Clinical characteristics of children with hymenolepidosis in Bukhara
Authors: Khamidova Nargiza , Kelditorova Zilola
Published: July 2024

In 12% of children diagnosed with hymenolepiasis, a mild degree of the disease was observed, in 53% - moderate, and in 35% - severe. Of the clinical signs of the disease, weight loss was detected in 57.1% of children with a mild course, in 40.9% with a moderate course and in 92.5% with a severe course. Growth retardation was observed in 57.1%, 34.4% and 71.1% of children, and pruritus - in 50%, 37.7% and 74.3% of children, respectively. The introduction of the immunocorrective drug immunal into the treatment complex for children diagnosed with hymenolepiasis showed a significant increase in the effectiveness of treatment, which is shown as an important recommendation for use in practical healthcare.
Prevalence and prognostic role of thoracic lymphadenopathy in Covid-19
Authors:   Autorinnen/Autoren,   RACOON Study Group
Published: July 2024

Purpose The prevalent coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world and is considered a serious threat to global health. The prognostic role of thoracic lymphadenopathy in COVID-19 is unclear. The aim of the present meta-analysis was to analyze the prognostic role of thoracic lymphadenopathy for the prediction of 30-day mortality in patients with COVID-19.

Materials and Methods The MEDLINE library, Cochrane, and SCOPUS databases were screened for associations between CT-defined features and mortality in COVID-19 patients up to June 2021. In total, 21 studies were included in the present analysis. The quality of the included studies was assessed by the Newcastle-Ottawa Scale. The meta-analysis was performed using RevMan 5.3. Heterogeneity was calculated by means of the inconsistency index I2. DerSimonian and Laird random-effect models with inverse variance weights were performed without any further correction.

Results The included studies comprised 4621 patients. The prevalence of thoracic lymphadenopathy varied between 1 % and 73.4 %. The pooled prevalence was 16.7 %, 95 % CI = (15.6 %; 17.8 %). The hospital mortality was higher in patients with thoracic lymphadenopathy (34.7 %) than in patients without (20.0 %). The pooled odds ratio for the influence of thoracic lymphadenopathy on mortality was 2.13 (95 % CI = [1.80–2.52], p < 0.001).

Conclusion The prevalence of thoracic lymphadenopathy in COVID-19 is 16.7 %. The presence of thoracic lymphadenopathy is associated with an approximately twofold increase in the risk for hospital mortality in COVID-19.

Key Points 

Citation Format
The Role of Botulinum Toxin A Neuromodulator in the Management of Synkinesis in Facial Palsy
Authors: Yener Asalet , Acharya Vikas , Andrews Peter , Meller Catherine , Shamil Eamon
Published: July 2024

Facial palsy describes the denervation of the facial nerve leading to difficulty in facial animation and expression. Facial synkinesis is the result of complex pathological nerve regeneration following damage to the facial nerve axons. Synkinesis in facial palsy can be managed using facial neuromuscular rehabilitation, botulinum toxin neuromodulators, and surgical treatment options. Botulinum toxin A can be used as an adjunct to other treatment options to manage synkinesis. This article will explore the role of botulinum toxin A in the management of synkinesis in facial palsy including the clinical assessment, injection location (muscles targeted), dosages, treatment interval, and long-term results. It will also include surgical management options.
In Vitro Fertilization and Hearing Impairment in Twins
Authors: Guo Mingming , Liu Hanyao , Liao Seni , Huang Jinxia , Tan Ziruo , Mo Peixi , Ouyang Shunlin , Zhang Huasong , Chen Yanhong
Published: July 2024

Objective: This study investigates the potential correlation between in vitro fertilization (IVF) and hearing impairment in twins compared to naturally conceived twins.
Method: Analyzing data from 2416 twin infants born between 2019 and 2021. Analyze the pregnancy conditions and complications of mothers, the birth conditions of newborns, perinatal diseases, initial hearing screening results, and subsequent follow-up conditions.
Results: Our findings reveal that the incidence of hearing impairment in IVF-conceived twins is comparable to that in naturally conceived twins. Significant differences in low birth weight, preterm birth, respiratory distress syndrome, and hyperbilirubinemia were observed between infants who passed and referred the hearing screening (P ＜ 0.05). The IVF group exhibited a lower incidence of low birth weight (P < 0.05) and older maternal age (P < 0.05), while showing higher rates of placental abnormalities and placental abruption (P < 0.05). Notably, these distinctions did not translate into a significant impact on hearing impairment. Regardless of the method of conception, the following key factors contributing to hearing impairment in twins were identified: low birth weight, preterm birth, respiratory distress syndrome, and hyperbilirubinemia.
Conclusion: IVF technology does not exert specific effects on hearing impairment in twins, with perinatal complications being the primary influencing factors.
Access to 1,3- and 1,5-Disubstituted 1,2,4-Triazoles by Condensation of Acyl Hydrazides with Formamidinium Acetate
Authors: Bremerich Maximilian
Published: July 2024

A simple redox-neutral method for the regioselective preparation of 1,3- and 1,5-disubstituted 1,2,4-triazoles from the corresponding unactivated acyl hydrazides and the inexpensive, non-toxic, and shelf-stable formamidinium acetate was developed. The addition of zinc salts proved to be pivotal to ensure full regioselectivity for the 1,3-disubstitution pattern, while 1,5-disubstituted 1,2,4-triazoles could be accessed without. A variety of sensitive functional groups were tolerated, and [1,2,4]triazolo[4,3-a]pyridines were obtained from the corresponding 2-hydrazopyridines without Dimroth rearrangement.
The reality of epilepsy in primary care in Rio de Janeiro: the importance of educational projects for better patient care
Authors: Lessa Vanessa Cristina Colares , Martins Marília Bezerra Magalhães , Vidal Alexandra Seide Cardoso , Araujo Leonardo Alves , D'Andrea Meira Isabella
Published: July 2024

Background The Basic Health Unit (Unidade Básica de Saúde – UBS, in Portuguese) is the first point of contact in the public healthcare system for people with epilepsy. Primary care professionals need to appropriately diagnose, treat, and refer, if necessary, to tertiary services.

Objective To evaluate the knowledge of UBS professionals on the management of patients with epilepsy in Rio de Janeiro.

Methods Online questionnaires were performed on the topic of epilepsy before and after exposure to classes taught by epileptologists.

Results A total of 66 doctors participated, 54.5% of whom were residents or trained in family medicine. The majority had from 1 to 3 years of practice. Insecurity prevailed in the management of pregnant women and the elderly. Around 59.1% of the participants referred patients with seizures without examinations. A total of 78% of the participants did not correctly classify seizure types, and 2/3 did not define drug-resistant epilepsy. Induction and broad-spectrum drugs were common. The therapeutic decision depended on availability in the basic health unit (UBS) (81.8%), dosage (60.6%), side effects (34.8%), and age (36.4%). Comorbidities and sex influenced 1/4 of the sample. For 23% of the participants, the type of crisis did not affect the choice. Regarding typical non-pharmacological options, 75% of the participants were aware of cannabidiol, 40.9% of surgery, 22.7% of ketogenic diet, and 22.8% of deep brain stimulation/vagus nerve stimulation (DBS/VNS). A total of 90.2% indicated the need for training.

Conclusion There are deficits in the knowledge of UBS professionals in the management of epilepsy. Specialized training is imperative to optimize the care offered within SUS.
Lasting Effects of Surgically Used Topical Vasodilators on DIEP Artery Vascular Function
Authors: Kofoed Jason S. , Tuncer Fatma B. , Kwok Alvin C. , Agarwal Jayant P. , Ruple Bradley A. , Borrelli Marta , Symons J. David , Richardson Russell S. , Broxterman Ryan M.
Published: July 2024

Background Surgeons routinely apply papaverine, lidocaine, or verapamil to produce acute vasodilation and prevent vasospasms during microvascular surgeries. There is evidence that topical vasodilators may induce postoperative endothelial and smooth muscle dysfunction, which would present after the acute vasodilatory effects of the topical drugs wear off. Therefore, the purpose of the current study was to evaluate the lasting effects of papaverine, lidocaine, and verapamil on human deep inferior epigastric perforator artery vasodilatory function after the acute effects of the topical drugs had worn off.

Methods Deep inferior epigastric arterial samples were obtained from 12 patients during surgery. Each artery was dissected into four rings which where incubated for 1 minute in either physiological saline solution (control), papaverine (30 mg/mL), lidocaine (20 mg/mL), or verapamil (2.5 mg/mL), followed by a 2-hour washout. Endothelial-dependent and -independent vasorelaxation were then assessed by the isometric tension responses to acetylcholine or sodium nitroprusside, respectively.

Results Peak acetylcholine-evoked vasorelaxation (mean ± standard deviation) was not different between control (62 ± 23%) and lidocaine (57 ± 18%, p = 0.881), but was reduced (all p < 0.002) in papaverine (22 ± 27%) and verapamil (22 ± 20%). Peak sodium nitroprusside-evoked vasorelaxation was not different (all p > 0.692) among control (132 ± 35%), lidocaine (121 ± 22%), and verapamil (127 ± 22%), but was less in papaverine (104 ± 41%; p = 0.045) than control.

Conclusion Surgically used doses of papaverine and verapamil, but not lidocaine, have lasting negative effects on arterial vasodilatory function despite the acute effects of the drugs having worn off. These findings, in conjunction with the spasmolytic properties of each drug, may help guide the selection of an optimal topical vasodilator for use during microvascular surgeries.
Microvascular Free-Flap Head and Neck Reconstruction: The Utility of the Modified Frailty Five-Item Index
Authors: Othman Sammy , Robinson Emma , Kamdar Dev , Pereira Lucio , Miles Brett , Kasabian Armen , Ricci Joseph A. , Knobel Denis
Published: July 2024

Background Microvascular free tissue transfer is a common tool for the reconstruction of oncologic head and neck defects. Adequate preoperative assessment can aid in appropriate risk stratification and peri-operative optimization. The modified five-item frailty index (mFI-5) is a validated risk-assessment scale; however, its utility in head and neck free-flap reconstruction is unknown when compared with other common risk factors.

Methods A retrospective, single-institution chart review (2017–2020) was performed. Patient demographics, defect and repair characteristics, pre- and peri-operative factors, and flap outcomes were recorded. A high mFI-5 score was defined as greater than 2. The total score, as well as other patient factors, was correlated to postoperative flap complications.

Results A total of 214 patients were deemed appropriate for conclusion. The mean age was 63.9 ± 12.8 years. There were an even number of males (52.8%) and females (47.2%). A fifth of subjects (20.8%) underwent preoperative radiotherapy. There were 21 cases (9.8%) of complete flap loss. A total of 34 patients (29.4%) experienced any postoperative complication related to flap outcomes. An elevated mFI-5 was significantly associated with a higher overall rate of postoperative complications (39.7 vs. 29.4%, p < 0.019) and total flap loss (16.7% vs. 6.6%, p < 0.033). Preoperative radiation was found to be associated with an increased complication rate (p < 0.003).

Conclusion The mFI-5 score may be a potentially significant tool in the risk stratification of patients undergoing head and neck free-flap reconstruction as opposed to commonly utilized risk factors. Preoperative radiotherapy is significantly associated with postoperative complications. Appropriate preoperative assessment may help tailor patient care preoperatively.
HoloDIEP—Faster and More Accurate Intraoperative DIEA Perforator Mapping Using a Novel Mixed Reality Tool
Authors: Necker Fabian N. , Cholok David J. , Fischer Marc J. , Shaheen Mohammed S. , Gifford Kyle , Januszyk Michael , Leuze Christoph W. , Scholz Michael , Daniel Bruce L. , Momeni Arash
Published: July 2024

Background Microsurgical breast reconstruction using abdominal tissue is a complex procedure, in part, due to variable vascular/perforator anatomy. Preoperative computed tomography angiography (CTA) has mitigated this challenge to some degree; yet it continues to pose certain challenges. The ability to map perforators with Mixed Reality has been demonstrated in case studies, but its accuracy has not been studied intraoperatively. Here, we compare the accuracy of “HoloDIEP” in identifying perforator location (vs. Doppler ultrasound) by using holographic 3D models derived from preoperative CTA.

Methods Using a custom application on HoloLens, the deep inferior epigastric artery vascular tree was traced in 15 patients who underwent microsurgical breast reconstruction. Perforator markings were compared against the 3D model in a coordinate system centered on the umbilicus. Holographic- and Doppler-identified markings were compared using a perspective-corrected photo technique against the 3D model along with measurement of duration of perforator mapping for each technique.

Results Vascular points in HoloDIEP skin markings were −0.97 ± 6.2 mm (perforators: −0.62 ± 6.13 mm) away from 3D-model ground-truth in radial length from the umbilicus at a true distance of 10.81 ± 6.14 mm (perforators: 11.40 ± 6.15 mm). Absolute difference in radial distance was twice as high for Doppler markings compared with Holo-markings (9.71 ± 6.16 and 4.02 ± 3.20 mm, respectively). Only in half of all cases (7/14), more than 50% of the Doppler-identified points were reasonably close (<30 mm) to 3D-model ground-truth. HoloDIEP was twice as fast as Doppler ultrasound (76.9s vs. 150.4 s per abdomen).

Conclusion HoloDIEP allows for faster and more accurate intraoperative perforator mapping than Doppler ultrasound.
Dynamic Eye Closure Restoration in Facial Palsy with Neurotized Platysma Muscle Graft in Rats
Authors: Voravitvet Tsz Yin , Huang Yenlin , Voravitvet Sawarin , Larsson Juan , Lien Po-Hao , Chuang David Chwei-Chin , Lu Johnny Chuieng-Yi , Chang Tommy Nai-Jen
Published: July 2024

Background One of the most devastating deficits of facial paralysis is eyelid dysfunction, which is controlled by the orbicularis oculi muscle (OOM), as it leads to loss of the protective mechanism of the eye. This study used a rat model to assess the functional outcomes of neurotized platysma muscle grafts (PMGs) for OOM replacement.

Methods Forty male Sprague-Dawley rats with iatrogenic right eyelid dysfunction were divided into five groups: one control group and four groups utilizing PMG with different sources of nerve innervation. Eyelid function recovery was assessed at 2, 4, 6, and 8 weeks. The PMGs were harvested for pathological examination at the end of the study.

Results All rats except those in the control group and one from the group using ipsilateral frontal and upper zygomatic frontal nerve branches directly neurotized to the PMG (nerve-to-muscle) recovered eyelid closure function within 8 weeks of the study period. The mean recovery time was 3.87 ± 1.28 weeks. A total of 87.5% of rats that had the contralateral zygomatic branch as the donor nerve regained the consensual corneal reflex (p-value < 0.001).

Conclusion Replacement of neurotized PMG for OOM function is successful in a rat model. Using the upper zygomatic branch as the donor nerve, it was possible to restore the consensual corneal reflex. This method shows promise for further human studies.
Evaluation and Management of Unresectable Hepatocellular Carcinoma: Multidisciplinary Indian Consensus Statements from a Delphi Panel
Authors: Ramaswamy Anant , Shukla Akash , Engineer Reena , Sundaram Sridhar , Srinivas Sujay , Kulkarni Suyash , Patkar Shraddha , Baijal Sanjay , Kale Aditya , Kapoor Akhil , Mukund Amar , Choudhari Amit , Rauthan Amit , Mathew Ashwathy Susan , Panchal Rushi , Bhattacharya Kausik , Patil Prachi , Shetty Nitin , Gala Kunal , Kumar Lijesh , Thiruchunapalli Deepashree , Kalra Naveen , Sahoo Tarini Prasad , Krishna M Vamshi , Lavingia Viraj , Mohanka Ravi , Talwar Vineet , Ostwal Vikas , Bhargava Prabhat , Poddar Jyoti , Singal Amit , Goel Mahesh
Published: July 2024

Background India, like many parts of Asia, likely faces a high burden of hepatocellular carcinoma (HCC), though large-scale data on etiology, presentation, and outcomes are lacking. There appears to be a predominance of unresectable, advanced-stage HCC at presentation in India with variable level of expertise in India to manage these scenarios. This publication summarizes the latest evidence with cognizance of the unique challenges faced in India by treating clinicians.

Methods A multidisciplinary panel of medical oncologists, gastroenterologists, hepatologists, interventional radiologists, and hepatobiliary surgical oncologists held a meeting in June 2022 and reviewed the evidence available for management of HCC. The meeting concentrated on the recognition and management of HCC not amenable to surgical approaches in the Indian context. A literature review of these aspects of management was conducted and consensus statements with level of evidence and grades of recommendation were prepared by individual specialists in each field. Statements were evaluated by the modified Delphi method.

Key Content and Findings The panel comprising 22 experts formulated 40 consensus statements with regard to defining unresectable HCC, optimization of underlying conditions prior to management, rationale use of various liver-directed therapies (LDTs) in unresectable HCC, and systemic therapeutic options in this group of patients.

Conclusion Our consensus statements offer practical, yet evidence-based management guidelines for treating unresectable HCC in the Indian context. There is an emphasis on the crucial need for combining available approaches for LDT, even if less well studied though possibly effective, with standard systemic therapy.
Into the Neuroscape: Perceptions of Pakistani Medical Students and Recent Graduates toward Neurosurgery
Authors: Shakir Muhammad , Irshad Hammad Atif , Shahzad Akmal , Ali Eisha Abid , Khowaja Aly Hamza , Ahmer Areesha , Enam Syed Ather
Published: July 2024

Introduction Neurosurgery receives several applicants every year, but the decreasing size of the neurosurgery workforce in Pakistan despite evidence of initial student interest is perplexing. Therefore, it is vital to evaluate the perspective of medical students and recent graduates to get a holistic view of perceptions toward neurosurgery.

Materials and Methods A nationwide cross-sectional study was conducted on a sample of medical students and recent graduates from different medical colleges. Their perceptions were gauged by multiple choice questions and barriers identified using Likert scale questions. Statistical analyses were carried out using the IBM Statistical Package for Social Sciences (SPSS) version 26.

Results A total of 2,481 responses were recorded from study participants. Neurosciences and neurosurgery were a part of a medical school curriculum for the majority (64.9%) of the participants. However, a significant number (65.4%) of the participants do not have the opportunity to rotate in the field of neurosurgery. The respondents' perception of neurosurgery is shaped by various factors, such as university lectures (21.9%), digital media (16.7%), and social media (15.2%). Known patients (5.7%) and known neurosurgeons (4.8%) were considered the least influential sources. The top three characteristics associated with neurosurgery were consistent for both male and female students: difficult, interesting, and brain. Male respondents (25.22%) predominantly described neurosurgery as difficult, while female respondents (21.98%) found it interesting. Many females perceived neurosurgery as a male-dominated specialty, with 64% female participants agreeing with gender bias compared to 36% of males.

Conclusion This study uncovers that medical students' views on neurosurgery are shaped by lectures, digital media, and social media, leading to preconceived ideas. These notions, including extended working hours, limited work–life balance, competition, gender bias, and stereotypes, impede their interest and comprehension of neurosurgery as a profession. To address this, students should have more opportunities to familiarize themselves with the field, allowing them to challenge these misconceptions and discover the captivating world of neurosurgery.
Evaluation of the Characteristics of Respiratory Viruses and Coinfections in Hospitalized Children during the COVID-19 Pandemic
Authors: Geçkalan Damla , Gülcan Aynur
Published: July 2024

Objective Studies have shown that more than one viral agent is not uncommonly detected simultaneously in respiratory tract infections of children. The aim of this study was to analyze our single-center experience with the seasonal distribution, clinical and laboratory outcomes of respiratory viruses, and coinfections in hospitalized children during the coronavirus disease 2019 (COVID-19) pandemic.

Methods During the pandemic period of June 1, 2021 to February 1, 2022, 156 pediatric patients hospitalized with non-COVID-19 respiratory tract infections were retrospectively analyzed. Among these children, 92 were found to be positive for respiratory pathogens. These children's ages, genders, polymerase chain reaction results, and blood parameters were analyzed.

Results The median age of the patients was 8 months (10 days–17.1 years) and 63% were male. A total of 16.3% of the patients were neonates (0–28 days), 55.4% were infants (1–24 months), 16.3% were preschool (2–5 years), and 12% were school-aged (5–18 years); 73.9% of the patients were hospitalized in the pediatric ward, 16.3% in the neonatal intensive care unit, and 9.8% in the pediatric intensive care unit. In 76.5% of hospitalized patients, only one pathogen was identified. Respiratory syncytial virus was detected as a causative agent of either mono- or coinfections in 78.4% of all patients. There was no statistical difference between inflammatory parameters in the patients infected with single or multiple viral agents.

Conclusion As a result of the precautions taken during the pandemic, we found that the viral distribution of respiratory tract infections changed. In addition, we believe that hematological parameters are not useful for distinguishing between mono- and coinfections.
Aging in (con)text: a systematic review on how scientific discourses embed the intersectional reality of elderly
Authors: Teixeira da Silva Polliana , Hochdorn Alexander , Chariglione Isabelle Patriciá Freitas Soares
Published: July 2024

The aim of the current study was to access the intersectional link between aging and different contextual determinants, such as social class, gender identity, sexual orientation and race/ethnicity, among others, elder adults are exposed to in contemporary societies. Accordingly, a systematic review of existing literature in accordance with the PRISMA guidelines, processed through statistical text-mining-analysis, has been carried out to understand how the production of scientific knowledge shapes sociocultural representations concerning the aforementioned reality. The findings showed a prevalence of studies investigating the development of elderly, with intersectional elements appearing only peripherally. However, although Psychology itself has not engaged much in this discussion so far, human sciences already began to understand aging as a heterogeneous, multifaceted and complex process of human development. It is worth noting, indeed, that scientific production focused on topics such as gender, race, nationality and sexual orientation are becoming increasingly prominent, suggesting to address special attention to these variables in future studies on aging. Contextual factors, circumscribing healthcare issues focused on aging, should be taken into account in order to overcome prejudices historically directed against elder adults. An increased longevity is, in fact, an achievement, and not a burden to be lived in precarious conditions of development.
Exact solutions to SIR epidemic models via integrable discretization
Authors: Nobe Atsushi
Published: July 2024

An integrable discretization of the SIR model with vaccination is proposed. Through the discretization, the conserved quantities of the continuous model are inherited to the discrete model, since the discretization is based on the intersection structure of the non-algebraic invariant curve defined by the conserved quantities. Uniqueness of the forward/backward evolution of the discrete model is demonstrated in terms of the single-valuedness of the Lambert W function on the positive real axis. Furthermore, the exact solution to the continuous SIR model with vaccination is constructed via the integrable discretization. When applied to the original SIR model, the discretization procedure leads to two kinds of integrable discretization, and the exact solution to the continuous SIR model is also deduced. It is furthermore shown that the discrete SIR model geometrically linearizes the time evolution by using the non-autonomous parallel translation of the line intersecting the invariant curve.