bluuebunny/crossref_metadata_2025 huggingface dataset:
Management strategy and experience of vasa previa in perinatal centers: A nationwide survey in Japan
Authors: Ogoyama Manabu , Hasegawa Junichi , Saji Shota , Hirono Satsuki , Horie Kenji , Suzuki Hirotada , Takahashi Hironori
Published: December 2024

Aim

To clarify the current situation and outcomes of vasa previa (VP) in Japan.

Methods

A questionnaire survey on VP was conducted at all 408 perinatal centers in Japan. The content of the survey included (1) the management strategy for pregnant women who were diagnosed with VP and (2) the number and outcomes of VP cases managed between January 2020 and December 2022.

Results

Questionnaires were collected from 220 (53.9%: 220/408) perinatal centers. (1) A total of 78.8% (164/208) of facilities implemented routine hospitalization. Routine hospitalization was initiated at 32 (22–36) [median (range)] weeks of gestation. The timing of planned cesarean section (CS) was at 36 (33.5–39) weeks of gestation in 198 facilities. (2) Of the 220 facilities that responded, 109 (49.5%: 109/220) accommodated patients with VP during the observation period. The total number of VP cases was 351, with a frequency of one case (0–33) per single perinatal center for 3 years. Emergency CS was required in 89 cases (25.4%: 89/351). There were no fetal or neonatal deaths in this study. The number of undiagnosed patients with VP prenatally was seven (2.0%: 7/351). Umbilical vessel rupture occurred in two cases (0.6%: 2/351).

Conclusions

Current management strategies in Japanese perinatal centers that responded to this survey appear to yield good perinatal outcomes in VP. Additional studies and comparisons are needed to elucidate the necessity of routine hospitalization, the optimal duration of hospitalization, and the timing of planned CS.
The three‐dimensionality of the “gummy smile”
Authors: Bockow Rebecca
Published: December 2024

The “gummy smile” is a complex developmental issue that requires a three‐dimensional approach to diagnosis and treatment. This article explores the multifaceted nature of the gummy smile, tracing its origins to early childhood growth patterns and breathing dysfunctions. It emphasizes the importance of understanding the interplay between skeletal development, soft tissue function, and breathing modalities in the formation of craniofacial structures. The article discusses how early mouth breathing and tongue dysfunction can lead to maladaptive skeletal growth, resulting in vertical maxillary excess and other facial imbalances. It highlights the critical role of nasal breathing and proper tongue posture in promoting healthy craniofacial development. Treatment options are presented for both growing children and adults, ranging from preventive measures to surgical interventions. For children, the focus is on early intervention to redirect growth patterns, while for adults, comprehensive treatment may include orthognathic surgery to correct established skeletal discrepancies. By providing an in‐depth analysis of the three‐dimensional aspects of the gummy smile, this article aims to equip interdisciplinary teams with the knowledge needed for accurate diagnosis and effective treatment planning. It underscores the importance of addressing underlying causes rather than merely treating symptoms, promoting a holistic approach to patient care in aesthetic dentistry.
Longitudinal cytokine profile in severe COVID‐19 and multisystem inflammatory syndrome in children: A single centre study from Egypt
Authors: Sobh Ali , Elnagdy Marwa H , Mosa Doaa Mosad , Korkor Mai S , Alawfi Abdulsalam D , Alshengeti Amer M , Al‐Mazroea Abdulhadi H , Bafail Rawan , Samman Waad A , El‐Agamy Dina S , Abo‐Haded Hany M
Published: December 2024

Aim

The severity of COVID‐19 is influenced by uncontrolled hyper‐inflammatory response with excessive release of many cytokines and chemokines. The understanding of the temporal change in the cytokine levels that underlies the diverse clinical presentations of COVID‐19 can help in the prediction of the disease outcome and in the design of proper treatment strategies.

Method

Data were collected from children (<18 years old) hospitalised with severe COVID‐19 or severe MIS‐C who were compared to a group of healthy control children. Patient demographics, clinical, laboratory data and cytokines profiles were evaluated. Blood samples were collected within 24 h of admission for all enrolled children and on Day 14.

Results

Twenty‐five children with severe COVID‐19 and 23 cases with severe MIS‐C were included in the study. The biochemical and inflammatory markers tend to be elevated in MIS‐C group. There was a significant difference between studied cases and the control group in the following cytokines: G‐CSF, IL‐10, HMGB1, TNF‐α, IL‐6, IL‐8 and INF‐gamma (P < 0.05). While there was a significant difference between severe COVID‐19 and MIS‐C groups in the following cytokines at Day 1 of admission; IL‐10, IL‐6, IL‐8 and INF‐gamma; while at Day 14, there was a significant difference only for G‐CSF, IL‐10 and IL‐6, all other cytokines were comparable.

Conclusion

Our study underpinned patterns of cytokine response in severe COVID‐19 and MIS‐C. There is a significant upregulation in pro‐inflammatory cytokines (mainly G‐CSF, IL‐10, HMGB1, TNF‐α, IL‐6, IL‐8 and INF‐gamma). These biomarkers that could imply on the severity rating and treatment strategies, should be preferentially assessed in SARS‐CoV‐2 associated immunological events.
Multimodes of floral disparity versus species diversity in adaptive radiation of Petrocodon (Gesneriaceae) upon Qinghai–Tibet Plateau uplift
Authors: Li Peng‐Wei , Liu Jing , Liu Ming‐Tao , Pan Bo , Dong Yang , Wang Yin‐Zheng
Published: December 2024

Adaptive radiation is usually triggered by great in situ or ex situ environmental changes. How an adaptive radiation occurs on lands and how species richness relates to morphodisparity have been a major focus of evolutionary biology. Petrocodon, diversified in the southeastern Qinghai–Tibet Plateau (QTP), represents an ideal model to address these questions. To elucidate the dynamics of adaptive radiation of Petrocodon, we took an integrative approach, including phylogenetic, dating, disparity versus diversity, pollination, and gene expression analyses. Petrocodon with six clades has experienced radiation following the QTP uplift. Multiple modes of floral morphodisparity versus species diversity occur in the radiation process that are directly linked to their colonizing new environments and diversification with geographic expansion. Pollination and gene expression analyses suggest that accelerated emergence of de novo mutations might be relevant to the multiplex floral disparity and pollinator shifts in Petrocodon. For the first time in plants, we report that decreased genetic constraints on floral architecture triggered by QTP uplift might have generated abundant floral morphological variants, which were further targeted by selection for ecological divergence. The multiple modes of floral disparity versus species diversity may be attributed to accelerated mutations in colonizing new environments and repeated modifications of the already evolved traits in subsequent diversification and geographic expansion in Petrocodon. Our findings shed novel light on the interplay of ecological, developmental and evolutionary dynamics of disparity versus diversity in relation to trajectory changes of floral architecture in responses to environmental disturbance in a terrestrial plant group.
On Rortian conceptual engineering
Authors: Huang Yuanfan
Published: December 2024

This paper explores how contemporary discussions of conceptual engineering can benefit from Richard Rorty's approach by outlining Rortian conceptual engineering. Three perspectives on Rortian conceptual engineering are discussed. First, Rortian conceptual engineering represents a form of radical conceptual engineering that dismisses the role of folk intuitions and views philosophical progress as the replacement of old problems with new ones. More specifically, Rortian conceptual engineering sees conceptual revolution as a process in which new metaphors replace old literal meanings. Second, Rorty's metaphilosophical distinction between epistemological and conversational philosophy is more profound than the distinctions between conceptual analysis and conceptual engineering, or between functional and nonfunctional approaches, thus enhancing our understanding of two types of contemporary conceptual engineering: epistemological and conversational. Third, Rorty argues that choosing concepts should take into account not only the competing concepts but also the conceptual schemes in which these concepts are situated.
The counternarrative in early Pynchon: Race and power in “The Secret Integration”
Authors: Larsson Kristian
Published: December 2024

The issue of race and power in “The Secret Integration” requires re‐examination. Politically oriented readers have characterized the plot as forms of alignment with racism and segregation, whereas readers focusing on the esthetics and development of the authorship have to some degree recognized the role of the counternarrative in this early short story. What is at stake in the debate is the function of Pynchon's textual strategies of ambiguity and unreliable narration, and the significance of the text in relation to the wider authorship. This essay maintains that the story signals counternarratives to systemic racism and power on the plot, discourse, and thematic level. Pynchon's text not only makes resistance to racist and segregationist worldviews a prominent feature of the discourse and the reading process but also locates tension between openness and narrow‐mindedness among the main characters, at the thematic and plot levels. This essay demonstrates how “The Secret Integration” moves from modes of non‐conformism so prevalent in Pynchon's early short stories to a mode of counterhistory of fundamental importance to the later work.
The Effect of Reminiscence Therapy on the Assessment of Depression, Anxiety and Self‐Esteem in Community‐Dwelling Older Adults: An Intervention Study
Authors: Zeleníková Renáta , Hosáková Jiřina , Kozáková Radka , Bobčíková Katka , Bužgová Radka
Published: December 2024

Background

Reminiscence therapy (RT) is a widely used approach to promote well‐being among older adults and is an effective intervention method for older adults with diverse health conditions, including community‐dwelling older adults.

Objectives

The aim of the study was to determine the impact of group RT on assessments of depression, anxiety and self‐esteem in older adults living in the community.

Methods

We implemented sessions of group simple RT. The sample consisted of 24 older adults living in the community who attended a 12‐week RT course. The duration of each reminiscence session was 60 min. The average age of the sample was 74.7 years. We used the Geriatric Depression Scale, the Geriatric Anxiety Inventory, the Rosenberg self‐esteem scale, the Older adults' Quality of Life—Brief version and the Sense of Coherence scale to assess mental health outcomes before and after intervention.

Results

After intervention, we observed statistically significant improvements in assessments of depression (p < 0.001), anxiety (p = 0.011), self‐esteem (p = 0.007) and the comprehensibility dimension of the sense of coherence scale (p = 0.039). Depression showed the largest effect size (Cohen's d = 0.870; 95% CI: 0.392 to 1.335), indicating a large effect, followed by self‐esteem (Cohen's d = 0.612; 95% CI: −1.044 to −0.170) and anxiety (Cohen's d = 0.543; 95% CI: 0.108 to 0.967), both of which demonstrated a moderate effect.

Conclusions

We found group RT to be effective for several outcomes among older adults. Reminiscence is a good non‐invasive treatment for the promotion of mental health in community‐dwelling older adults.

Implications for Practice

As research has now established RT to be an essential component of activities for older adults in senior care facilities, we should also offer it to those living in the community as an effective activity for the promotion of healthy aging among older adults.
Short Exposure to Full Moonlight Has a Long‐Term Impact on Brassica juncea Cell Activity and Growth
Authors: Priyanka Govindegowda , Singiri Jeevan R. , Novoplansky Nurit , Grafi Gideon
Published: December 2024

Lunar farming, often regarded as a myth, is regularly practiced in many places around the world (e.g., India) where framers organized their agricultural activities according to moon phases. Early and recent work showed that exposure to moonlight affects the life cycle of plants, from seed germination and vegetative growth to fruit maturation and dispersal. Here we addressed the long‐term effect of short exposure to full moonlight (FML) on cellular activities in Brassica juncea by analyzing protein and metabolite profiles immediately after 3‐night‐exposure (3NE) or 7 and 15 days after exposure (DAE) to FML. This study shows an increase in nuclear size following 3NE to FML, which was accompanied by changes in protein and metabolite profiles. We identified significant alterations in protein and metabolite profiles between FML and dark‐treated plants in conjunction with developmental stages, which persisted long after exposure to FML. Most notable are the changes in composition of metabolite interconversion enzymes (MIEs) at various developmental stages which were intensified in FML‐treated plants. Changes in MIEs were accompanied by significant alterations in metabolite composition and level, particularly at 15DAE, including branched‐chain amino acids (e.g., valine, leucine), multiple sugars (raffinose, glucose, sucrose) as well as the tricarboxylic acid (TCA) cycle intermediates malic acid and citric acid. Thus, our results show that short‐term exposure to FML triggers a developmental switch resulting in a long‐term impact on plant performance that brings about an increase in cell activities and consequently enhanced growth. Our results call for meticulous research on this lunar phenomenon and its potential to enhance crop plant growth and development.
From bias to balance: Testing the effect of feedback on ideological bias expression. A registered report
Authors: Ziemer Carolin‐Theresa , Finn Christine , Rothmund Tobias
Published: December 2024

Motivated reasoning posits that ideological beliefs and goals bias individuals' information processing particularly regarding socio‐political information. However, most individuals are unaware that ideological bias shapes their perception and judgment making them easy targets for political polarization. This leads to the strong need to address and mitigate this bias. Utilizing an ideological bias task that assesses the degree of expressing one's ideological bias in the estimation of socio‐political facts, we test the effects of feedback on the reduction of ideological bias. With a three between‐factor design (feedback‐only vs. feedback + social norm nudge vs. no feedback control), we test a representative German sample at two time points (Nt1 = 1229, Nt2 = 1001). Participants who received feedback on the extent of their ideological bias displayed a significant bias reduction between t1 and t2 compared to the control group. An additional social norm nudge emphasizing the societal value of unbiased decision‐making did not result in a stronger reduction of ideological bias. Moreover, general bias awareness did not moderate the effect of feedback on bias reduction. Our findings contribute to a growing understanding about the suggestibility of ideological bias and illuminate the (limited) potential of bias awareness in mitigating biased information processing.
Assessing the Impact of Exposure Misclassification in Case–Control Studies of Self‐Reported Medication Use
Authors: Adrien Nedghie , MacLehose Richard F. , Werler Martha M. , Yazdy Mahsa M. , Fox Matthew P. , Parker Samantha E. ,   The National Birth Defects Prevention Study
Published: December 2024

Background

Empirically evaluating the potential impact of recall bias on observed associations of prenatal medication exposure is crucial.

Objective

We sought to assess the effects of exposure misclassification on previous studies of the use of nonsteroidal anti‐inflammatory drugs (NSAIDs) in early pregnancy and increased risk of amniotic band syndrome (ABS).

Methods

Using data from the National Birth Defects Prevention Study (NBDPS) on births from 1997 to 2011, we included 189 mothers of infants with ABS and 11,829 mothers of infants without congenital anomalies. We identified external studies of medication use during pregnancy to obtain validity parameters for a probabilistic bias analysis to adjust for exposure misclassification. Due to uncertainty about the transportability of these parameters, we conducted multidimensional bias analyses to explore combinations of values on the results.

Results

When we assumed higher specificity in cases or higher sensitivity in controls, misclassification‐adjusted estimates suggested confounding‐adjusted estimates were attenuated. However, in a few instances, when we assumed greater sensitivity in the cases than the controls (and Sp ≥ 0.9), the misclassification‐adjusted estimates suggested upward bias in the confounding‐adjusted estimates.

Conclusions

Results from our bias analysis highlighted that the magnitude of bias depended on the mechanism and the extent of misclassification. However, the parameters available from the validation studies were not directly applicable to our study. In the absence of reliable validation studies, considering mechanisms of bias and simulation studies to outline combinations of plausible scenarios to better inform conclusions on the effects of these medications on pregnancy outcomes remains important.
Enhancing risk and crisis communication with computational methods: A systematic literature review
Authors: Munro Madison H. , Gore Ross J. , Lynch Christopher J. , Hastings Yvette D. , Reinhold Ann Marie
Published: December 2024

Recent developments in risk and crisis communication (RCC) research combine social science theory and data science tools to construct effective risk messages efficiently. However, current systematic literature reviews (SLRs) on RCC primarily focus on computationally assessing message efficacy as opposed to message efficiency. We conduct an SLR to highlight any current computational methods that improve message construction efficacy and efficiency. We found that most RCC research focuses on using theoretical frameworks and computational methods to analyze or classify message elements that improve efficacy. For improving message efficiency, computational and manual methods are only used in message classification. Specifying the computational methods used in message construction is sparse. We recommend that future RCC research apply computational methods toward improving efficacy and efficiency in message construction. By improving message construction efficacy and efficiency, RCC messaging would quickly warn and better inform affected communities impacted by current hazards. Such messaging has the potential to save as many lives as possible.
Can a Universal Mindfulness Intervention in Schools Reduce ADHD Symptoms among Adolescents? A Cluster Randomized Controlled Trial
Authors: Holopainen Marianne , Hintsanen Mirka , Lahti Jari , Vahlberg Tero , Volanen Salla‐Maarit
Published: December 2024

Existing studies suggest that mindfulness‐based interventions (MBIs) can reduce ADHD symptoms when delivered as targeted clinical programs to young people diagnosed with ADHD. However, there is currently a lack of research on whether MBIs are effective in reducing elevated ADHD symptoms when delivered as universal programs to whole classes in schools. This study investigated the effects of a universal nine‐week MBI (.b program) on students' elevated ADHD symptoms using an cluster randomized controlled trial (RCT) design. The modifying effects of pupils' baseline characteristics (gender, age, and socioeconomic status) and home‐practice intensity were examined. A total of 3519 adolescents aged 12 to 15 years from Finnish schools were randomized into an MBI group, a relaxation‐based active‐control group, and a passive‐control group. ADHD symptoms were measured at baseline (T0), at nine weeks (T9), and at 26‐weeks (T26, follow‐up) using parent‐reported assessments. The study found no positive intervention effects on parent‐reported ADHD symptoms in the MBI group compared to the control groups. Neither boys nor girls benefited from the MBI. The same was true of different age groups and socioeconomic levels. Moreover, regular home practice during the follow‐up period did not strengthen the intervention effects. The results do not support the use of brief, universal MBIs in whole school classes as part of the routine curriculum to reduce elevated ADHD symptoms in adolescents. Further research is essential to identify optimal content and delivery methods for MBIs in schools. Particularly among adolescents with elevated ADHD symptoms, targeted MBIs, adapted to the unique needs of this subgroup, should be examined.

Trial Registration: Healthy Learning Mind—a school‐based mindfulness and relaxation program: a study protocol for a cluster randomized controlled trial (RCT) ISRCTN18642659 retrospectively registered on 13 October 2015. The full trial protocol can be accessed at http://rdcu.be/t57S
Deep learning can detect elbow disease in dogs screened for elbow dysplasia
Authors: Hauback Mari Nyborg , Huynh Bao Ngoc , Steiro Sunniva Elisabeth Daae , Groendahl Aurora Rosvoll , Bredal William , Tomic Oliver , Futsaether Cecilia Marie , Skogmo Hege Kippenes
Published: December 2024

Medical image analysis based on deep learning is a rapidly advancing field in veterinary diagnostics. The aim of this retrospective diagnostic accuracy study was to develop and assess a convolutional neural network (CNN, EfficientNet) to evaluate elbow radiographs from dogs screened for elbow dysplasia. An auto‐cropping tool based on the deep learning model RetinaNet was developed for radiograph preprocessing to crop the radiographs to the region of interest around the elbow joint. A total of 7229 radiographs with corresponding International Elbow Working Group scoring were included for training (n = 4000), validation (n = 1000), and testing (n = 2229) of CNN models for elbow diagnostics. The radiographs were classified in a binary manner as normal (negative class) or abnormal (positive class), where abnormal radiographs had various severities of osteoarthrosis and/or visible primary elbow dysplasia lesions. Explainable artificial intelligence analysis were performed on both correctly and incorrectly classified radiographs using VarGrad heatmaps to visualize regions of importance for the CNN model's predictions. The highest‐performing CNN model showed excellent test accuracy, sensitivity, and specificity, all achieving a value of 0.98. Explainability analysis showed frequent highlighting along the margins of the anconeal process of both correctly and incorrectly classified radiographs. Uncertainty estimation using entropy to characterize the uncertainty of the model predictions showed that radiographs with ambiguous predictions could be flagged for human evaluation. Our study demonstrates robust performance of CNNs for detecting abnormal elbow joints in dogs screened for elbow dysplasia.
CAT(0) and cubulated Shephard groups
Authors: Goldman Katherine M.
Published: December 2024

Shephard groups are common generalizations of Coxeter groups, Artin groups, and graph products of cyclic groups. Their definition is similar to that of a Coxeter group, but generators may have arbitrary order rather than strictly order 2. We extend a well‐known result that Coxeter groups are to a class of Shephard groups that have ‘enough’ finite parabolic subgroups. We also show that in this setting, if the associated Coxeter group is type (FC), then the Shephard group acts properly and cocompactly on a cube complex. As part of our proof of the former result, we introduce a new criteria for a complex made of simplices to be .
Rational points on 3‐folds with nef anti‐canonical class over finite fields
Authors: Bernasconi Fabio , Filipazzi Stefano
Published: December 2024

We prove that a geometrically integral smooth projective 3‐fold with nef anti‐canonical class and negative Kodaira dimension over a finite field of characteristic and cardinality has a rational point. Additionally, under the same assumptions on and , we show that a smooth projective 3‐fold with trivial canonical class and non‐zero first Betti number has a rational point. Our techniques rely on the Minimal Model Program to establish several structure results for generalized log Calabi–Yau 3‐fold pairs over perfect fields.
Gemology and Chemical Aspects of Aquamarines from Quixeramobim, Brazil
Authors: De Oliveira Isaac Gomes , Rodrigues Linara Ivina de Castro , Menezes Diniz Madruga Marcelo , De Araújo Paschoal Carlos William , Dos Santos Lucilene , Falcão de Oliveira Neri Tereza
Published: December 2024

Since the end of the 20th century, it has become extremely common for countries with a significant exploration of gemstones to catalog and disclose the properties of their gems for various purposes. This paper aimed to analyze the gemological characterization and geochemical aspects of aquamarines from the County region of the city of Quixeramobim (State of Ceara). Usual gemology equipment was used; in addition, we used a scanning electron microscope with energy dispersive system (SEM-EDS). The studied minerals have the standard characteristics of aquamarines from different parts of the world, except for above-average birefringence and the presence of fluorescence. In the case of Quixeramobim aquamarine studied, a linear correlation was noted involving the geochemistry and some gemological aspects. However, the studied gems diverge in four characteristics and chemical elements, if compared to the aquamarines of a nearby region, named Berilândia (CE). This demonstrates the importance of gemological characterization, not only at a state/regional level. The Quixeramobim aquamarines are unique within the Brazilian scenario.
Nuevas tendencias indemnizatorias para la protección del consumidor: Modificaciones al régimen de productos defectuosos en la Unión Europea
Authors: Tabares Cortes Felipe
Published: December 2024

Este artículo examina la modificación del régimen de responsabilidad por productos defectuosos como fue definido por el Parlamento Europeo en la Resolución de 12/03/2024 abrogatoria de la Directiva 85/374/CEE, así como el Reglamento 2023/988 relativo a la Seguridad General de Productos. Se analizan los elementos principales del nuevo régimen, incluyendo los objetivos regulatorios, los productos regulados, las personas sometidas a la nueva normativa y los beneficiarios de la misma. También se exploran las reglas propias a la responsabilidad civil de los productos defectuosos. Además, el artículo analiza el impacto del nuevo régimen en el mercado de seguros y en el régimen jurídico colombiano. Se abordan cuestiones como la delimitación de la garantía de rotura de maquinaria que surge de la responsabilidad contractual, según interpretación por la Corte Suprema de Justicia de Colombia en Sentencia SC4066-2020 de 26 de octubre de 2020. Se estudia también el tema de las pruebas a cargo de la víctima por productos defectuosos en el régimen de consumo. A través de este análisis, se busca proporcionar una comprensión integral de los cambios y desafíos que trae consigo la implementación del nuevo régimen de productos defectuosos.
Analysis of nickel sulfoselenide materials by XPS
Authors: Meyerson Melissa L. , Rosenberg Samantha G. , Wygant Bryan R.
Published: December 2024

Metal chalcogenides are of interest as electrocatalysts, battery materials, and more. XPS is a valuable tool for studying changes to these materials before and after catalysis, making reference spectra for the pristine materials valuable. Here, we present XPS spectra for a family of nickel sulfoselenide (NiSSe) materials based on the Ni3X2 crystal structure, Ni3S2−xSex. XPS surveys and high-resolution spectra of Ni 2p, S 2p, S 2s, Se 3d, Se 3p, and Se 3s were recorded using Al Kα radiation.
Luminescent silicon nanocrystals capped with naturally occurring ligands
Authors: Stacy Benjamin J. , Ngo Loc , Nagasaki Kara , Korgel Brian A.
Published: December 2024

Several naturally occurring terpenes, including limonene, valencene, eugenol, eugenol acetate, and linalool, have alkene functional groups that can add to a silicon (Si) surface by hydrosilylation. Here, we demonstrate their use as capping ligands for luminescent Si nanocrystals that can be dispersed in either polar or nonpolar solvents depending on the hydrophobicity of the ligand shell. The dispersions are stable for months. 1H NMR spectra show that either of the two available alkene groups in limonene, linalool, and valencene will undergo hydrosilylation with the Si surface.
Generalized frequency-sum beamforming for low frequencies
Authors: Lee Jeunghoon , Park Yongsung , Gerstoft Peter
Published: December 2024

For direction-of-arrival (DOA) estimation in the low-frequency range, we improve spatial resolution using generalized frequency-sum (gFS) beamforming with the Qth order frequency-sum autoproduct. The order Q does not exceed the maximum value, determined by the criteria that the sum of frequencies used to create the autoproduct must be less than the array's spatial Nyquist frequency. Unlike other high-resolution beamformers, gFS maintains stable performance even with a single snapshot and is unaffected by the coherence of steering vectors. Rigorous analysis using the multinomial expansion has shown the inapplicability of gFS to multi-DOA scenarios. Simulation and experimental results support that the method is a practical alternative for low-frequency single-DOA estimation with limited data.
Local Field and Dynamic Heterogeneities in the ±J Ising Spin Glasses
Authors: Abalmasov V. A.
Published: December 2024

The average domain size is calculated for zero and nonzero absolute values of the local field in the
$$ \pm J$$
Ising spin glasses in 2D and 3D at different temperatures using Monte Carlo simulations. The absolute values of the local field determine the spin flip probability, and thus the obtained domain sizes shed light on dynamical heterogeneities in glasses, which are currently being actively studied. It turns out that the average domain size for nonzero absolute values of the local field, corresponding to slow spin dynamics at low temperature, increases and saturates with decreasing temperature, mainly due to an increase in the probability of finding nonzero local fields. However, a slight effect of spatial correlations of the local field is also revealed. These results can be useful for understanding the nature and specific features of glass transition and dynamical heterogeneities in glasses.
Regional ischaemic immune myopathy: unraveling a rare subtype of dermatomyopathy
Authors: Ingrid Elvina , McLean Catriona , Mundae Maninder , Lim Keith
Published: December 2024

Regional ischaemic immune myopathy (RIIM) is a subtype of dermatomyopathy which has distinct histopathology features of regional muscle fibre necrosis and regeneration. This case report aims to provide an in-depth exploration of RIIM, emphasising its clinical features and the crucial role of muscle biopsy as a diagnostic investigation, as well as the potential role of immunomodulatory therapies.
Bouveret syndrome managed conservatively with the insertion of a double pigtail stent between the stomach and the gallbladder
Authors: Garg Joshua , Wiggins Tom , Sahloul Mohamed
Published: December 2024

A woman in her early 90s presented to the acute surgical take with a 3-day history of worsening reflux, vomiting, epigastric pain and constipation. Subsequent imaging demonstrated two large, impacted gallstones in the pylorus and proximal jejunum secondary to a cholecystoduodenal fistula. A diagnosis of Bouveret syndrome was made, and endoscopic attempts to break down and remove the stones were unsuccessful. The stones were left in the stomach, with a pigtail stent placed through the fistula between the stomach and gallbladder to prevent the stones impacting again and to allow adequate drainage of the gallbladder to prevent further flare-ups. Due to the patient’s comorbidities, it was decided to leave the stent in situ long term as opposed to surgical management. This has shown to be successful in follow-up. Our case highlights that Bouveret syndrome can potentially be managed conservatively long term in patients deemed unfit for major surgical intervention.
Bilateral Urrets-Zavalia syndrome after uneventful Descemet membrane endothelial keratoplasty
Authors: Qi Ziqiao , Mukhija Ritika , Nanavaty Mayank A
Published: December 2024

Urrets-Zavalia syndrome (UZS) stands out as a rare yet clinically consequential complication associated with ophthalmic surgery, marked by the emergence of a fixed and dilated pupil. While it was originally described post-penetrating keratoplasty (PKP) in patients with keratoconus and its prevalence is notably higher following PKP, instances of UZS have been documented in the context of other procedures, including intraocular lens implantation, Descemet-stripping endothelial keratoplasty and Descemet membrane endothelial keratoplasty (DMEK). We report a unique case of bilateral UZS after uneventful DMEK surgeries, highlighting a rare but potential complication after DMEK.
Challenges in the management of a secondary retrosternal goitre with superior vena cava syndrome
Authors: Rich Jevis , Mehra Bhupendra , Ghoshal Soumya , Dubhashi Siddharth P
Published: December 2024

Retrosternal or substernal goitre is a clinical entity defined when a significant proportion of the thyroid gland extends inferiorly through the thoracic inlet into the mediastinum. It has an incidence of 5.1–15.7%, with a female predominance. The clinical course can be indolent without any symptoms or may present as an emergency with compression features of breathlessness, hoarseness of voice, facial oedema, dysphagia and stridor. Definitive management is surgery. We report a case of an elderly woman who presented in the emergency at our tertiary care hospital with superior vena cava syndrome due to a large retrosternal goitre, along with concomitant comorbidities such as obesity, hypertension, atrial fibrillation and severe pulmonary hypertension with pericardial effusion, which posed a significant risk and added complexity to her management.
Regenerative endodontic treatment for the management of immature permanent teeth with focal fibrous hyperplasia
Authors: Kumari Monika , Bharti Ramesh , Pandey Pragya , Verma Promila
Published: December 2024

Frequent irritation in the oral cavity can result in a benign condition called focal fibrous hyperplasia. This condition is rarely associated with an open apex in the teeth. This case report details the treatment of a patient with an open apex in teeth 11 and 12, worsened by localised fibrous hyperplasia. Regenerative endodontic therapy (RET) was employed for this patient. Remarkably, after initiating RET, the fibrous hyperplasia gradually resolved without the need for surgical excision. Following this observation, two hypotheses were proposed: (1) focal fibrous hyperplasia may have an endodontic origin and (2) hyperplastic development coupled with endodontic involvement might diminish with endodontic therapy alone. Excision of the growth is not always necessary. This case report highlights the potential connection between regenerative endodontic therapy and the resolution of focal fibrous hyperplasia, providing new insights into managing such rare conditions.
White epidermoid cyst of brainstem
Authors: Shah Aneree Nilesh , Shah Kewal Sanjay , Sankhe Shilpa , Kolhe Ashvini
Published: December 2024

White epidermoid cysts are rare intra-cranial lesions with an intrinsic brainstem location, though still rare. The location of the tumour poses radiological confusion and a therapeutic dilemma. Neuroimaging techniques like MRI with diffusion tensor imaging (DTI) in this case proved a useful tool in ruling out other pathologies at this location with certain morphologic similarities. MRI findings indicated a bilobed intra-axial lesion with heterogenous signal intensities on T1 and T2 weighted images. DTI showed splaying of cortico-spinal tracts. The intraoperative cystic nature of the lesion was established, followed by a biopsy report confirming the lesion to be a white epidermoid cyst.
Extensor pollicis brevis reconstruction using the extensor digitorum proprius tendon through the first dorsal compartment for a clasped thumb in an adolescent
Authors: Takeya Hiroaki , Takagi Takehiko
Published: December 2024

Clasped thumb is characterised by thumb adduction and flexion deformity at the metacarpophalangeal joint caused by abnormalities in the extensor tendons. While conservative treatments are effective in infants, surgical intervention is necessary for older who experience deformities or functional impairments. We report an adolescent patient with an untreated clasped thumb who underwent extensor pollicis brevis (EPB) reconstruction using the extensor indicis proprius (EIP) tendon through the first dorsal compartment. The patient suffered from a right thumb deformity and pain. EPB reconstruction was performed by passing the EIP tendon through the first dorsal compartment. After 1 year and 6 months of follow-up, the patient’s right thumb function significantly improved, with an increased range of motion and strength of the thumb, and the preoperative pain was relieved. EPB reconstruction using EIP passing through the first dorsal compartment for clasped thumbs in adolescents can reconstruct the EPB function appropriately and is a possible treatment option.
Unilateral posterior scleral defect was not associated with altered ocular biomechanics
Authors: Oskam Joshua , Gale Jesse
Published: December 2024

Technologies that describe the biomechanics of the eye are of emerging importance in glaucoma and keratoconus. A defect in the wall of the eye would be expected to affect biomechanics, resulting in the dispersion of mechanical energy and more viscous rather than elastic behaviour. Here, a mildly myopic man in his 50s was noted to have a deep conduit beside the right optic disc which appeared to pass posteriorly to the optic nerve sheath or orbit. We assessed the intraocular pressure and ocular biomechanics with several methods, and compared them with the normal fellow eye. Corneal hysteresis, ocular pulse amplitude, deformation amplitude, changes in pressure with standing and lying and response to water-drinking test were all very similar between the two eyes. In this case with a unilateral posterior scleral defect, current clinical techniques to assess ocular biomechanics did not detect an asymmetry.
Integrating political prioritisation into national surgical planning: a scoping review of surgical, obstetric and anaesthesia care in Cameroon
Authors: Agoubi Lauren , Carvalho Melissa , Fewer Sara , Oke Rasheedat , Fabo Brice , Daya Leonid , Obiezu Fiona , Adeola Janet , Nteungue Boris A K , Ekane Yannick , Etoundi Alain Mballa , Juillard Catherine
Published: December 2024

Background

Surgical diseases contribute substantially to death and disability in Cameroon. Strategic planning for surgical, obstetric and anaesthesia (SOA) care in low-income and middle-income countries (LMICs) requires consideration of the policy environment in addition to the issue severity. We aimed at the current landscape of SOA care in Cameroon, incorporating a framework for political prioritisation.

Methods

A scoping review of published and grey literature was performed. Literature specific to Cameroon, published between 2010 and 2020 and written in either English or French, was included. Abstracts and full texts were screened for discussion of SOA policy context, care and delivery conditions, and issue characteristics. Data extraction and analysis were performed using the Shiffman and Smith framework for political prioritisation accounting for actors, ideas, political context and issue characteristics.

Results

121 articles were included. By specialty, 83 articles were specific to surgery, 45 to obstetrics and 6 to anaesthesia. Policy environment was discussed by 20% (n=25) articles; 30% (n=37) discussed actor power; 22% (n=27) discussed ideas in SOA care and 93% discussed issue characteristics. Core challenges to political prioritisation of SOA care in Cameroon are limited actor support, a lack of consensus definitions, gaps in capacity and a need for systematic data collection on surgical diseases. Policy opportunities include leveraging existing multilateral partnerships to unify SOA actors, conducting national assessments of SOA care capacity, formalisation of task shifting to build capacity, defining essential SOA procedures, including surgical care in future health coverage, and defining and including SOA benchmarks in strategic planning.

Conclusions

Integrating a framework for political prioritisation into a situational analysis of SOA care is critical to understanding an LMIC’s policy context and actors, in addition to issue severity. Such an approach can serve as a baseline for analysis in evidence-informed policy-making for SOA care, even in the absence of centralised, country-wide data.
Factors associated with preterm birth and mother-to-child transmission in HIV-positive pregnant women in Henan, China, 2016–2022: a retrospective cohort study
Authors: Zhang Meng , Zhang Hongyan , He Junjian , Cao Yuan , Xu Feng , Shi Cannan , Xia Junfen , Qu Huimin , Hu Mengcai
Published: December 2024

Introduction

HIV can greatly impact the quality of life of pregnant women and may cause adverse pregnancy outcomes, such as preterm birth (PB) and mother-to-child transmission (MTCT). The purpose of this study was to analyse the influencing factors of PB and MTCT in HIV-positive pregnant women.

Methods

HIV-positive pregnant women in Henan Province between January 2016 and December 2022 were selected for the study. Data were collected through the Management Information System for the Prevention of MTCT of HIV, syphilis and hepatitis B. Information on their demographic and clinical characteristics, treatment status and pregnancy outcomes was collected. A logistic regression model and χ2automatic interaction detector (CHAID) decision tree model were used to analyse the correlation factors of PB and MTCT.

Results

The average age of the 1073 study participants was 28.44 years, with an incidence of 11.93% for PB and 6.71% for MTCT. Hepatitis B virus or hepatitis C virus coinfection (OR=3.686, 95% CI 1.630 to 8.333) and Han nationality (OR=0.426, 95% CI 0.194 to 0.936) were risk factors for PB. Unknown HIV infection prior to pregnancy (OR=2.006, 95% CI 1.233 to 3.264) and primipara (OR=5.125, 95% CI 1.202 to 21.849) were risk factors for MTCT. The CHAID decision tree model was used to screen for the six and two influencing factors of PB and MTCT in HIV-positive women, respectively.

Conclusion

Early HIV testing, scientific counselling, precise maternal HIV infection assessment and targeted prevention measures can help prevent PB and MTCT in HIV-positive pregnant women.
Characterisation of type 2 diabetes subgroups at diagnosis: the COPERNICAN prospective observational cohort study protocol
Authors: Fernandez-Camins Berta , Vlacho Bogdan , Canudas Albert , Ortega Marta , Granado-Casas Minerva , Perera-LLuna Alexandre , Boluda-Sanson Alejandro , El-Khattabi-Ofkir Yesmina , Franch-Nadal Josep , Mauricio Didac
Published: December 2024

Introduction

Type 2 diabetes mellitus (T2DM) is a highly heterogeneous and complex metabolic disease harbouring different metabolic characteristics. Adequate characterisation of subjects is essential to allow the implementation of precision medicine for the prevention, diagnosis, prognosis and treatment of this condition.

Methods and analysis

This prospective observational cohort study aims to identify and characterise relevant clinical clusters that are reproducibly associated with various clinical outcomes in T2DM in our Mediterranean region. The COPERNICAN study will include 1200 subjects with newly diagnosed T2DM from 28 primary care centres from the city of Barcelona and the healthcare district of Lleida in Catalonia (Spain). Participants will undergo a comprehensive phenotypic evaluation including, among others, six relevant variables: age, antibodies against glutamic acid decarboxylase, body mass index, glycated haemoglobin (HbA1c), indexes of insulin sensibility (HOMA2-IR) and secretion (HOMA2-beta). We will collect additional comprehensive data on glucose-lowering and other drug treatments, clinical evaluation (including complications), laboratory parameters, advanced lipoprotein profile, dietary habits and physical activity. The linkage with the population database will be done to perform a pragmatic follow-up of participants as part of their usual clinical care. A state-of-the-art cluster analysis (k-means and hierarchical clustering) will be performed.

Ethics and dissemination

The present study complies with all the ethical aspects and protection of participant subjects complying with all current local and European Union legislation. All Ethics Committees from the institutions involved in the study (IR Sant Pau Ethics Committee, Ethics Committee for Drug Research at IDIAP Jordi Gol and University Hospital of Bellvitge Ethics Committee for Research) approved this protocol. Confidentiality and anonymity of the data are ensured according to the current Spanish Organic Law 3/2018 of 05 December.

Trial registration number

ClinicalTrials.gov. registration numberNCT05333718, 27 January 2023.
Predictors of treatment adherence in patients with type 2 diabetes: a cross-sectional study in Southern Iran based on Pender’s Health Promotion Model using structural equation modelling
Authors: Shahabi Nahid , Hosseini Zahra , Ghanbarnejad Amin , Aghamolaei Teamur
Published: December 2024

Objectives

Treatment adherence in type 2 diabetes (T2D) is an important factor in optimal diabetes control and prevention of mortality. The present study aimed to determine the predictability of Pender’s Health Promotion Model (HPM) constructs in T2D treatment adherence behaviour.

Design

The present cross-sectional and analytical study was conducted from November 2022 to January 2023.

Setting

The present study was conducted in Bandar Abbas, a city in Hormozgan Province, in the south of Iran.

Participants

The participants included 396 patients with T2D with medical records in the Hormoz Diabetes Clinic. Based on their record number, the participants were selected for inclusion in the study through a random systematic sampling.

Primary and secondary outcome measures

The data collection instruments included a demographic questionnaire and a researcher-made questionnaire based on HPM constructs. The questionnaire was valid and reliable, achieving Cronbach’s alpha coefficients ranging from 0.609 to 0.798 across various constructs. The questionnaires were completed face to face. Pearson’s correlation test, path analysis and structural equation modelling were conducted using SPSS V.23, and STATA V.15.

Study stage

This study was conducted before intervention (pre-results).

Results

As the path analysis showed, perceived self-efficacy (β=0.23, p<0.001), treatment adherence experiences (β=0.26, p<0.001), immediate competing demands and preferences (β=−0.15, p<0.001) and commitment to plan of action (β=0.24, p<0.001) could significantly predict the treatment adherence behaviour. The results of indirect path analysis showed that the total effect of perceived benefits (β=0.24, p<0.001), perceived barriers (β=−0.14, p=0.002), perceived self-efficacy (β=0.32, p<0.001) on commitment to plan of action was statistically significant. Through the mediation of commitment to plan of action, they could predict the treatment adherence behaviour.

Conclusions

In light of the present findings, it can be concluded that the proposed model of T2D treatment adherence behaviour has an acceptable fit. Commitment to plan of action, treatment adherence experiences, perceived self-efficacy and immediate competing demands and preferences are the main predictors of T2D treatment adherence behaviour. It is recommended that educational interventions focus on these constructs.

Trial registration number

This study is registered on the Iranian Registry of Clinical Trials (IRCT20211228053558N1).