bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on the influence of stamping materials on resist flow and the residual layer in thermal nanoimprint lithography
Authors: Sun Hong‐Wen , Tang Tian‐Hua , Wang Jing‐Sheng , Gu Li‐Jun , Huang Yan‐Chun , Li Ya‐Ru
Published: September 2023

Various stamp materials can significantly affect the filling quality of nanoimprint lithography (NIL). The effects of different stamp materials on the imprinting process were investigated from the angles of residual layer (RL) thickness, contact pressure, and filling proportion. The selection of various stamp materials affects the thickness and uniformity of the RL. Soft stamps (PDMS, PU) leave a thin but uneven RL distribution, while the RL imprinted by hard stamps (Si, Ni) is thicker but more uniform. The contact pressure using soft stamps is relatively more evenly distributed than hard stamps. The uneven distribution of contact pressure leads to poor cavity‐filling proportion, especially for hard stamps. This study offers guidance for choosing proper nanoimprint stamp materials for different NIL applications.
Improved efficiency assessment in network DEA through interval data analysis: An empirical study in agriculture
Authors: Zhang Nan , Kalhor Amir , Azizi Roza , Kazemi-Matin Reza
Published: September 2023

Conventional Network Data Envelopment Analysis (NDEA) models often make an assumption of data precision, which frequently does not align with the realities of many real-world scenarios. When dealing with ambiguous data, whether it involves input, output, or intermediate products represented as bounded or ordinal data, the accurate assessment of efficiency scores poses a significant challenge. This study addresses the crucial issue of handling interval data within NDEA structures by introducing an innovative methodology that integrates both optimistic and pessimistic strategies. Our proposed methodology goes beyond the mere determination of upper and lower bounds for efficiency scores; it also incorporates target-setting and improvement approaches. Through the calculation of interval efficiency for each decision-making unit (DMU), our approach offers a comprehensive framework for efficiency classification. To underscore the effectiveness of this methodology, the study presents empirical evidence through a case study in the agriculture industry. The results not only showcase the advantages of our proposed methodology but also emphasize its potential for practical application in diverse and complex real-world contexts.
Using blockchain technology to combat counterfeiting
Authors: Chistruga Alexandru
Published: September 2023

Although the globalization of trade entails multiple benefits for both traders and consumers, such as the expansion of markets and the possibility of accessing a wide range of products, it also entails the risk of the spread of counterfeit goods. One of the tools that could be used to combat this trend is blockchain technology. The aforementioned technology presupposes the existence of a single ledger that is shared and synchronized across many sites, organizations, or computers, with participants having the ability to register any type of information. Thus, in the near future, a single ledger could be created in which relevant information about the specific traded good, such as its origin or sanitary certificate, would be recorded. By doing so, the quantity of counterfeit goods on the market will decrease, while consumer confidence will increase. The World Intellectual Property Organization is currently analyzing the possibility of incorporating blockchain technology into several areas specific to intellectual property law, with one of the goals being to combat counterfeiting. Therefore, through this article, we propose to conduct an analysis of the legal provisions of the European Union that aim at fighting against counterfeit goods. Simultaneously, we will investigate the methods used by the private sector in this field, particularly blockchain technology. In this regard, some practical examples that have been used for several years by large retailers such as Walmart and Carrefour will be presented.
The collecting of consent to the processing of children’s personal data, between volatility and disobedience
Authors: Goicovici Juanita
Published: September 2023

The paper addresses the problematics of collecting consent to the processing of children’s personal data, observing the connection between granularity and the specificity of consent and insisting on the triple level of granularity which may be seen as applicable: (i) the granularity of the first degree, relative to the delimitation by reference to the consent granted at the formation of the main contract; (ii) secondary degree of granularity, relating to the sequencing of processing purposes; (iii) tertiary granularity, regarding the taxonomic specificity of the processing operations; in the case of children’s consent, this specific protection is expected to apply particularly to the use of children’s personal data for marketing or profiling purposes and to the collection of personal data when using services directly offered to children, whose capacity to exercise rights in this matter can be established in national law as beginning at the age of 16, without being able to go below the 13-year threshold, as provided by Article 8, para. (1), second thesis of General Regulation 2016/679. Related to the purposes of the processing, the data operator must inform the child, in an unambiguous and structured way, of the purposes of the processing of personal data, so that the latter were able to express the consent for each of the purposes, in a differentiated manner without being forced to accept them in their entirety, a requirement that functions as a safeguard against the gradual expansion or blurring of the clarity of the processing purposes. In relation to the holder of responsibility or parental authority, Regulation (EU) 2016/679 imposes on the data controller an obligation of diligence, in order to verify whether the holder of responsibility or parental authority has granted or authorized the granting of consent, taking into account the available technologies (as selected by the parent), which is a requirement that implies, for data controllers, the fact that they are expected to check not only the existence of consent (when processing the child’s personal data), but also the provenience of this consent.
Delayed Reconstruction of the Perforator Pedicle Propeller Flap after the Induced Membrane Technique for Gustilo IIIB Open Distal Tibial Fracture
Authors: Ye Shuming , Jin Neng , Sun Jian , Zhang Liqian , Zhang Jisen , Jing Juehua
Published: September 2023

This study aimed to evaluate the safety and efficacy of delayed reconstruction of the perforator pedicle propeller flap after the induced membrane technique in the treatment of Gustilo
IIIB open distal tibial fracture, and to evaluate the clinical outcome and complications of two different perforator pedicle propeller flaps.

Thirty-four patients with Gustilo IIIB open distal tibial fractures treated by the induced membrane technique and delayed reconstruction of two different perforator pedicle propeller flaps
from May 2017 to March 2022 were retrospectively analyzed. Patients were divided into two groups according to the different kinds of perforator pedicle propeller flaps covered. The operation
required two stages. The Radiographic Union Score for Tibial fractures (RUST) was used to evaluate the healing of the tibial bone defect. The American Orthopaedic Foot and Ankle Society
(AOFAS) score was used to evaluate ankle function. The complications associated with the technique were recorded.

The number of serial debridements, excluding those performed during emergency and final operations, was a mean of 2.28 ± 0.83 in the PAPF group. The PAPF group had a mean bone defect
length of 6.76 ± 0.69 cm, the median healing time of 13.11 ± 0.96 months, RUST score 12.68 ± 1.63, and AOFAS score of 84.12 ± 6.38. On the other hand the PTAPF group’s mean bone defect length
was 6.73 ± 0.95 cm, the median healing time 12.63 ± 1.46 months, RUST score 13.73 ± 1.53 and AOFAS score 82.79 ± 5.49. There were no observed significant differences the two groups in the
number of serial debridements, bone defect length, bone union time, RUST score, or AOFAS score (p > 0.05). Flap size ranged from 9 × 6 cm2 to 14 × 7 cm2 in the PAPF
group and from 9 × 6 cm2 to 13 × 7 cm2 in the PTAPF group. There were no severe complications such as flap-related complications or amputation. The differences in
complications in the two groups were not statistically significant.

In cases of severe open tibial fracture, the reconstructive method is important. When delayed reconstruction is inevitable, surgeons should first perform radical debridement, followed by
vacuum sealing drainage as a bridging therapy; both PAPF and PTAPF can be considered for definitive soft tissue coverage.
Clostridioides difficile Infection in Patients with Cirrhosis Treated for Hepatic Encephalopathy
Authors: Sehgal Kanika , Spiceland Clayton M. , Lennon Ryan J. , Pardi Darrell S. , Khanna Sahil
Published: September 2023

Introduction Hospitalizations, proton-pump inhibitors (PPI), and systemic antibiotics increase the risk of Clostridioides difficile infection (CDI) in cirrhosis. We compare the risk of CDI with hepatic encephalopathy (HE) medications, hypothesizing that rifaximin may decrease CDI risk.

Materials and Methods A retrospective study of hospitalized HE patients treated with lactulose and/or rifaximin at Mayo Clinic Minnesota, Florida, and Arizona from 2008 to 2013 was conducted. Data on demographics, hospitalizations, antibiotics, and PPI use and CDI were gathered. Univariate and multivariable cox models were constructed.

Results We found 1,112 hospitalizations in 1,055 unique patients (55 had 1 subsequent readmission, 1 patient had 2); 428 (40.6%) patients were women (median age: 58 years [interquartile range: 52–65]). CDI developed after 66/1,112 (5.9%) hospitalizations within 12 months post-discharge. Lactulose was administered in 21 (31.8%), rifaximin in 5 (7.6%), both in 40 (60.6%) hospitalizations. Systemic antibiotics were used in 28 (42.4%) patients and PPIs in 60 (90.9%) patients.

Univariate analysis using medication (with lactulose alone as the reference group) showed rifaximin was not significantly associated with CDI compared with lactulose (hazard ratio [HR]: 1.57, 95% confidence interval [CI]: 0.57–4.33, p = 0.39). Use of both medications was not significant compared with lactulose (HR: 1.41, 95% CI: 0.84–2.38, p = 0.19). Results were similar after controlling for confounders. Multivariable analysis based on length of stay, age, and gender showed no differences between rifaximin versus lactulose and both versus lactulose.

Conclusion There is no significant difference between lactulose and rifaximin on CDI development in HE patients. However, CDI should still be considered when managing diarrhea in HE patients.
Systematic Review and Meta-Analysis: Seroprevalence, Vaccination Rates, and Response for Hepatitis A in Inflammatory Bowel Disease
Authors: Jena Anuraag , Singh Anupam Kumar , Neelam Pardhu B. , Mohindra Ritin , Kumar-M Praveen , Mishra Shubhra , Patil Amol , Suri Vikas , Sharma Vishal
Published: September 2023

Introduction Guidelines recommend hepatitis A virus (HAV) vaccination in individuals with inflammatory bowel disease (IBD). We performed a systematic review to inform the clinical practice regarding this guidance.

Methods After a PubMed and Embase search, duplicates were removed and the remaining titles screened for studies reporting relevant outcomes. Pooled seroprevalence rates for HAV, pooled vaccination rates, and pooled seroconversion rates were calculated. We also calculated pooled relative risk of seroprevalence for HAV among IBD and control population. Heterogeneity was investigated using subgroup analysis.

Results The pooled seroprevalence of HAV antibodies in patients with IBD (14 studies, 2,370 patients) was 0.36 (95% confidence interval [CI]: 0.22–0.53, I
2 = 95%). On comparing the seroprevalence of HAV in IBD with controls (4 studies), the pooled relative risk was not different between the two (0.94, 95% CI: 0.66–1.34, I
2 = 76%). The pooled seroconversion rate after two doses of HAV vaccination (5 studies, 221 patients) was 0.93 (95% CI: 0.88–0.96, I
2 = 0%). Three studies (104 patients) reported on the seroconversion after a single dose of HAV vaccination and the pooled seroconversion rate was 0.47 (95% CI: 0.35–0.59, I
2 = 20%). The pooled vaccination rate for hepatitis A among patients with IBD (18 studies, 9,521 patients) was 0.21 (95% CI: 0.14–0.30, I
2 = 99%).

Conclusion Hepatitis A vaccine has good immunogenicity in patients with IBD. The decision to routinely vaccinate IBD patients may be made in light of underlying seroprevalence of HAV.
The Relevance of Understanding Referencing Styles in the Era of Reference Managers
Authors: Goyal Mohit , Goyal Neha
Published: September 2023

Writing the references of a manuscript accurately requires a significant amount of time and effort. While it can be a daunting task for beginners, even experienced authors can find it time consuming. The advent of reference managers brought a ray of hope of an end to this tedious toil. While these managers have eased the authors' task to a great extent, they may not always be completely accurate in the reference output they generate. Errors, inaccuracies, omissions, and compatibility issues do occur at times with the best of reference managers. It is thus of paramount importance to be able to recognize these issues and address them before submitting the manuscript to the journal. Sound knowledge of referencing styles helps in quick recognition and redressal of such errors thus increasing accuracy, ensuring consistency of references, and saving the author's time.
Sociodemographic Profile, Genotype, and Response to Therapy in Hepatitis C Virus Infection: A Brief Report from Himachal Pradesh
Authors: Sharma Brij , Sharma Vineeta , Kumar Rajesh , Sharma Rajesh , Bodh Vishal , Chauhan Ashish , Sachdeva Amit , Majeed Tahir , Bilal Mir , Sharma Dikshant
Published: September 2023

Introduction Hepatitis C virus (HCV) infection is a major cause of liver disease worldwide. There is no data on sociodemographic profile, risk factors, genotype, and response to therapy of HCV infection from Himachal Pradesh.

Methods In this single-center study, we retrospectively analyzed data from HCV-infected patients treated with new oral direct-acting antiviral drugs from September 2019 to March 2022. Data on the sociodemographic profile of HCV-infected patients, along with risk factors for its transmission, HCV genotype, and response to therapy, was analyzed.

Results A total of 189 patients were included, with a mean age of 30.9 ± 13.8 years. Most were males and were students. Predominant risk factor for HCV transmission was intravenous drug use (61.4%), tattooing (11.7%), and hemodialysis (11.1%). A majority of the patients were students (72%). The predominant genotype was GT 3. Most (95.2%) patients were without cirrhosis, so sofosbuvir plus daclatasvir for 12 weeks was the most common regimen used. Sustained virological response was achieved in 94.7% of patients.

Conclusion This study, alarmingly, shows that intravenous drug users and tattooing are important risk factors for HCV infection in Himachal Pradesh. Further, students were the most frequently infected group.
Systematic Review and Meta-Analysis: Safety and Efficacy of Saccharomyces boulardii for Prevention of Clostridioides difficile Infection
Authors: Tariq Raseen , Tahir Muhammad Waqas , Hayat Maham , Pardi Darrell S. , Khanna Sahil
Published: September 2023

Background Clostridioides difficile infection (CDI) is associated with frequent recurrences. The role of probiotics in preventing CDI remains unclear despite patients frequently using them.

Methods We performed a systematic-review and meta-analysis to evaluate the role of Saccharomyces boulardii, a yeast probiotic, in preventing primary or recurrent CDI in patients on systemic antimicrobial therapy. We searched MEDLINE, Embase, and Web of Science up to December 2021 to identify studies (case-control, cohort, or clinical trial studies) reporting the use of systemic antimicrobials with or without S. boulardii and providing information on primary or recurrent CDI. Pooled odds ratios with 95% confidence intervals were calculated using a random effects model.

Results Eight studies (six randomized control trials and two cohort studies) were included. Six studies with 9,712 patients evaluated primary prevention. The rate of CDI in patients who received S. boulardii was 0.73% (44/5977) compared to 1.09% (41/3735) in the control group. Meta-analysis showed no difference in the risk of CDI among the two groups (odds ratio [OR], 0.71; 95%CI, 0.46–1.10; p = 0.124) with no significant heterogeneity (I2 = 0%). In two studies with 292 patients evaluating secondary prevention, the rate of recurrent CDI was 36.73% (54/147) on S. boulardii compared to 46.20% (67/145) in controls, with no significant difference (p = 0.19). Subgroup analysis of studies using S. boulardii (250 mg twice daily) showed no difference in the CDI risk with or without S. boulardii. No serious adverse events from S. boulardii were noted.

Conclusion The use of S. boulardii appears to have no benefit for preventing either primary or recurrent CDI in patients taking systemic antimicrobials.
Infections in Patients with Severe Alcoholic Hepatitis: A Retrospective Study
Authors: Jain Mayank
Published: September 2023

Introduction Severe alcoholic hepatitis (SAH) is the severest type of alcohol-related liver disease and is fraught with risk of infectious complications. The present study was done to determine the frequency and types of infections noted in patients with SAH at baseline evaluation.

Methods This is a retrospective analysis of patients with alcoholic hepatitis treated at our center between 2019 and 2022. Details of age, gender, baseline laboratory parameters, and clinical presentation were noted. All patients were screened for infections to ascertain the suitability for steroid use as per protocol. Diagnosis of infections was done as per the North American Consortium for the Study of End Stage Liver Disease (NACSELD) criteria. In culture-positive infections, the details of the microorganisms that were isolated and antibiotic susceptibility patterns were recorded.

Results A total of 66 patients with SAH formed the study cohort (median age: 42 years; 100% males). The majority of them had underlying cirrhosis (33 [50%]) and 26 had acute-on-chronic liver failure. Twenty-eight (42.4%) cases had bacterial infections. Spontaneous bacterial peritonitis (10 [35.7%]) was the commonest infection, followed by urinary tract infection (8 [28.5%]), lower respiratory infections (7 [25%]), and skin infections (3 [10.7%]). Culture positivity was noted in 12 cases (42.9%). The commonest organism cultured was Escherichia coli (6 cases), followed by Klebsiella pneumoniae (cases). Multidrug-resistant (MDR) infections were noted in nine (13.6%) cases. Two patients had tuberculosis.

Conclusion In all, 42.4% of patients with SAH had bacterial infections at baseline evaluation. Spontaneous bacterial peritonitis was the commonest infection. MDR bacterial infections were noted in nine cases (13.6%).
Navigating Social Media during Residency: A Primer
Authors: Yadav Yamini , Bollipo Steven
Published: September 2023

As social media becomes a growing part of all our lives, its use in healthcare settings continues to grow and evolve. In gastroenterology, social media is being adapted for education, networking, mentorship, and collaboration among clinicians. It also provides an interface for patients and specialists, allowing for patient education and advocacy. Its extensive reach allows for unique opportunities, which, when harnessed, are an asset to both gastroenterologists and their patients. This primer highlights how gastroenterology residents can benefit from social media while being aware of the potential risks involved.
Systematic Review and Meta-Analysis: Risk of Post-ERCP Cholangitis with Air or CO2 versus Contrast Cholangiography in Perihilar Malignant Biliary Obstruction
Authors: Giri Suprabhat , Harindranath Sidharth , Anirvan Prajna , Kumar Lohith , Sundaram Sridhar
Published: September 2023

Background Endoscopic retrograde cholangiopancreatography (ERCP) may be associated with a risk of postprocedural cholangitis in case of failed drainage of the injected contrast. The present meta-analysis was conducted to assess whether air cholangiography reduces the risk of post-ERCP cholangitis compared with contrast injection.

Methods A comprehensive search of MEDLINE, EMBASE, and Science Direct from inception to September 2022 was done for studies comparing air or CO2 and contrast agent for cholangiography during ERCP, with the last search on September 31, 2022. Dichotomous outcomes were analyzed using risk ratios (RRs) with 95% confidence intervals (CIs).

Results A total of seven studies were included in the final analysis. Among these, there were three randomized trials and four retrospective studies. The included studies had moderate to high risk of bias. There was no difference in the clinical success rate (RR: 1.02, 95% CI: 0.94–1.09; I
2 = 0%), but a lower risk of all-cause adverse events (AEs) (RR: 0.21, 95% CI: 0.12–0.36; I
2 = 0%) with air cholangiography, compared with contrast cholangiography. Concerning individual AEs, this difference was seen only for cholangitis (RR: 0.51, 95% CI: 0.37–0.69; I
2 = 0%) but not for post-ERCP pancreatitis, perforation, and bleeding. Reintervention and 30-day mortality remained comparable between groups. The certainty of evidence remained low to very low.

Conclusion Air or CO2 cholangiography reduces the risk of overall AE, especially post-ERCP cholangitis, compared with contrast cholangiography. Further trials are required to validate the findings of the study.
Melioidosis Presenting as Splenic Abscess: A Case Report
Authors: Kumar Pranav S. , Birda Chhagan Lal , Chand Yadav Suresh , Yadav Taruna , Agarwal Ashish
Published: September 2023

Melioidosis is an infectious disease caused by Gram-negative bacilli Burkholderia pseudomallei. Infection is acquired by direct exposure through broken skin, inhalation, or ingestion of the bacterium. Melioidosis has a wide variety of clinical presentations, ranging from an asymptomatic infection or localized cutaneous manifestations at the site of the entry, deep-seated abscess, to multiple organ involvement with sepsis leading to death. Although not uncommon, there is a lack of awareness of its variable presentation leading to a delay in the diagnosis and thus treatment. The diagnosis of melioidosis rests on the culture of the organism from biological samples. Presentation as a splenic abscess is rather rare and a high index of suspicion is needed for the diagnosis. In this article, we report an interesting case of recurrent splenic abscess which was eventually diagnosed to be due to melioidosis.
Enhancing Logistic Support During Chemotherapy to Nonlocal Children with Cancer and Their Families through Home Away from Home Program
Authors: K. Vasudeva Bhat , Venkatagiri Archana Melavarige , Venkatesh Vinay Munikoty , S. Ashwini , Nair Girish , Dave Ankeet , Rao Krithika Shantanu , Salins Naveen , Rao Sharath Kumar
Published: September 2023

Childhood cancers have excellent outcomes in terms of cure rates and survival if they are diagnosed early and treated appropriately. However, there is a huge disparity in outcomes between high- and low-middle income country(ies) due to out-of-pocket expenditure, therapy abandonment, and severe infections. To bridge these gaps in outcomes, a partnership between a private medical institute and a nongovernmental organization was fostered to develop a long-stay facility for children with cancer and their families while receiving disease-directed therapies. This report aims to expound the story of development of the “Home Away from Home” program and its transformative potential and societal impact.
Subthalamic Deep Brain Stimulation in Parkinson's Disease: A Boon or Bane – A Single Centre Retrospective Observational Study from India
Authors: Hazra Darpanarayan , Chandy Gina Maryann , Ghosh Amit
Published: September 2023

Background Subthalamic deep brain stimulation (STN-DBS) for refractory Parkinson's disease (PD) is more of a modality of treatment that is empirical, for which a physiological explanation is being sought. This study was done to determine the outcome and complications of patients undergoing STN-DBS for PD.

Methods This retrospective observational cohort study was conducted in an advanced neuromedicine facility in eastern India for 9 years (August 2013–August 2022), which included all patients undergoing STN-DBS.

Results A total of 53 patients were operated on during the study period. The mean age group of the study population was 60.5 (standard deviation [SD]: 8.2) years with a male (33 [62.3%]) predominance. The most common presenting complaints included rigidity and hypokinesia (27), severe dyskinesia (21), and tremors (17). During the postoperative period, rigidity and hypokinesia (21), severe dyskinesia (16), and tremors (12) improved significantly in a subset of the patients. The majority (45 [84.9%]) of these cases received bilateral monopolar simulation, whereas three patients (5.7%) had bilateral bipolar stimulation. Unilateral bipolar stimulation was used in five (9.4%) patients. In the immediate postoperative period, they were initiated on limb, speech, and swallowing therapy as indicated. Surgery-related complications were seen in five (9.4%) cases. At 6 months of follow-up, a significant improvement in the Unified PD rating scale component (mainly motor examination and complication of PD therapy) was noted in the majority (36 [67.9%]) of patients. One patient developed neuroleptic malignant syndrome and succumbed to his illness on the fourth postoperative day.

Conclusion Given these findings, STN-DBS appears to be a good, safe, and effective treatment for a subset of medically refractory PD with an overall improvement in two-thirds of the study cohort and less than 10% risk of complications.
Intracranial Interdural and Extradural Cerebellar Convexity Dermoid Cyst: A Case Report of Rare Tumor at the Rarest Location
Authors: Mishra Manish Kumar , Yadav Vikrant , Pradhan Ravi Shekhar , Prasad Ravi Shankar
Published: September 2023

Intracranial dermoid cysts are rare dysembryonic tumors of benign nature. These are uncommon in adults. If present, they are usually located in the midline or along the lines of embryonic fusion. The posterior fossa region is an infrequent site. Extradural or interdural locations are even more rare. In this case report, the authors report a laterally located large posterior fossa right cerebellar convexity interdural and extradural dermoid cyst over the sigmoid sinus. It was managed by totally extradural maximum possible safe decompression with microneurosurgical technique. The authors share their experience of addressing this rare pathology at the rarest location with unusual imaging findings.
Simplifying the Technique of Awake Brain Surgery in a Condition of Less Equipped Neurosurgical Institution in Uzbekistan
Authors: Mamadaliev Dilshod Mukhammadvalievich , Kariev Gayrat Maratovich , Asadullaev Ulugbek Maksudovich , Yakubov Jakhongir Bakhodirovich , Zokirov Kamoliddin Sodikjonovich , Khasanov Khabibullo Abdukholikovich , Akhmediev Tokhir Makhmudovich , Korotkov Dmitriy Sergeyevich
Published: September 2023

Currently, awake craniotomy (AC) is one of the most often employed procedures to map and resect tumors in eloquent brain areas, avoiding the use of general anesthesia (GA) and thereby reducing anesthesia-related complications and cost of surgery. Resource limitations are one of the basic reasons for avoiding AC in low- and middle-income countries (LMICs). The aim of this study is to describe the simplified protocol of awake brain surgery that can be implemented in a limited financial setting in LMICs and to share our first experience. Twenty-five patients diagnosed with tumor of the left frontotemporal lobes, all involving Broca's and Wernicke's areas, were operated on using AC. Brain mapping was executed using mono- and bipolar direct electrical stimulation including cortical and subcortical (axonal) mapping profiles, investigating basically cortical language centers. Neither neuronavigation nor intraoperative magnetic resonance imaging (MRI) was utilized due to financial constraints. AC was performed successfully in 23 of 25 patients, achieving a near-total resection in 16 (69.5%) patients, subtotal resection in 4 patients (17.39%) patients, and partial resection in 3 (13.04%) patients. In two patients, due to psychological instability—agitation and fear during the awake phase—speech test was not technically possible, so they were reintubated by giving them GA. There was no mortality in the early or postoperative period. In spite of the absence of advanced pre- and intraoperative technologies such as intraoperative MRI and navigation systems, AC can be safely performed in LMICs. These tools along with intraoperative cortical mapping and language testing can guarantee better surgical outcomes and quality of life. However, our study confirms that omitting these tools does not make a huge difference in getting good results with AC and that AC is not absolutely impossible. AC can be performed successfully, preserving eloquent brain areas, with minimum and basic set of the armamentarium like system for cortical and subcortical intraoperative neurostimulation which provides cortical/subcortical brain mapping.
Questionnaire for Dental Practitioners to Screen for Trigeminal Neuralgia
Authors: Komatsu Fuminari , Sasaki Kento , Tanaka Riki , Miyatani Kyosuke , Yamada Yasuhiro , Kato Yoko , Hirose Yuichi
Published: September 2023

Objective Trigeminal neuralgia (TN) is a neurological disorder that often presents as severe toothache. The majority of TN patients visit dental clinics first, so TN represents a potential pitfall for dental practitioners. This report describes the development of a trigeminal neuralgia questionnaire (TNQ), assessing 10 characteristics of TN, to assist dentists in screening for TN in dental clinics, and evaluates the effectiveness of TNQ.

Materials and Methods Fifty-three patients who visited the TN outpatient department in our institute and completed the TNQ were included in this study. All patients were examined by two neurosurgeons and neuroimaging was performed.

Statistical Analysis Patients were classified into a TN group and a non-TN group. TNQ score was retrospectively compared between groups. Furthermore, history and characteristics of TN were investigated in the TN group to clarify the status of the reference situation.

Results Thirty-seven cases were assigned to the TN group, and 16 cases to the non-TN group. Mean TNQ score was 8.3 in the TN group and 6.6 in the non-TN group. Setting a TNQ cutoff score of 7 offered 91% sensitivity and 56% specificity for TN. Investigation of the history of the present illness indicated that 39.2% of TN cases were improperly triaged and referred from initial dental clinics, and interdisciplinary practice was insufficient.

Conclusion TNQ offers a reliable, convenient method to triage TN patients, and may assist dentists in screening for TN. Multidisciplinary practice is necessary for total management of TN and the TNQ is expected to connect dentists and TN specialists.
A 10-Year Survival-Trend Analysis of Low-Grade Glioma and Treatment Patterns from an LMIC
Authors: Bajwa Mohammad Hamza , Anis Saad Bin , Yousaf Irfan , Shah Mashal
Published: September 2023

Objectives The 2021 WHO Classification of Central Nervous System Tumors taxonomy laid further stress on molecular classification and prognostication of glial tumors in comparison to histopathological grading. Research shows that low-grade gliomas (LGGs) can go through malignant differentiation and lead to severe disability and death. Data from various populations will be necessary to ascertain the exact interplay between genotypic predictors of LGG and outcomes.

Materials and Methods To assess the molecular pathology for glial tumors in the Pakistani population, the Shaukat Khanum Memorial Cancer Hospital carried out a retrospective chart review of electronic health records from 2008 to 2018, with immunohistochemistry analysis findings from 2010 to 2018. Patients with a pathological diagnosis of a glioma were included.

Statistical Analysis Analysis was performed using IBM SPSS Statistics Version 23 and STATA Version 16. A p-value of less than 0.05 was considered statistically significant with 95% confidence intervals reported.

Results In all, 281 operable tumors were recorded. The most common procedure was a subtotal resection, and astrocytomas (64.77%) were the most common tumors. Radiation therapy and PCV (procarbazine, CCNU, and vincristine) was received by 85 patients, while radiation therapy and temozolomide were administered to 15 patients.

Conclusions Isocitrate dehydrogenase (IDH) wild-type LGG had a lower survival time, while improved survival times were seen for alpha-thalassemia X-linked intellectual disability syndrome (ATRX) retained and 1p19q co-deleted LGGs. Further studies are required to gain a better understanding of lower-grade glial tumor treatment and survival in Pakistan.
Factors Affecting the Outcome after Surgical Clipping of Ruptured Distal Anterior Cerebral Artery (DACA) Aneurysms
Authors: Sharma Gopal Raman , Karki Prasanna , Joshi Sumit , Paudel Prakash , Shah Damber Bikram , Baburam Pokharel , Bidhan Gyawali
Published: September 2023

Objective The purpose of this study is to assess demographic, clinical, and unique morphological characteristics of distal anterior cerebral artery (DACA) aneurysm. The relation of outcome included Glasgow Outcome Scale (GOS) using various independent variables, Hunt and Hess clinical grade (H&H), Miller Fischer grade, intraoperative rupture, and comparison of outcomes at discharge and last follow-up.

Methods Demographic data, aneurysm characteristics, and treatment outcomes were evaluated in 28 ruptured DACA aneurysms operated over a period of 13 years. Association between independent variables and dependent variables (GOS) at discharge and at last follow-up (13 years) was analyzed, and the interrelationship between these factors and outcome was evaluated. GOS was used to assess functional outcomes.

Results Over a period of 13 years, 500 patients harboring ruptured intracranial aneurysms were surgically clipped, and out of them 28 patients (5.6%) had ruptured DACA aneurysms. In this series, 20 (71.4%) patients had low grade and 8 (28.6%) had high grade H&H. Out of the 28 patients, 19 (67.8%) had good recovery, 6 (21.5%) were severely disabled, and 3 (10.7%) died at the time of discharge. On the last follow-up (13 years), smoking (p-value 0.03) and use of temporary clip (p-value 0.00) were significant predictors for unfavorable outcome.

Conclusion The results of our case series show that even with ruptured aneurysm excellent overall outcome after microsurgical clipping can be achieved, even though among cerebral aneurysms, DACA aneurysm is considered to have less favorable outcome. Alcohol consumption and use of temporary clip were the predictors for unfavorable outcome at the time of discharge. On the last follow-up, smoking and use of temporary clip were found to be the risk factors for unfavorable outcome. Although the small sample size of this study is a limitation, smoking and use of temporary clip play an important role on the overall outcome. The aim of this study was to analyze data to determine factors which may influence outcome after surgical clipping of ruptured DACA aneurysms.
Clinical Syndrome of Seizures, Headache, and Visual Blurring in Metastatic Carcinoma Colon
Authors: Raj Lakshmi , Anoop T.M. , CA Rakesh
Published: September 2023

A 51-year-old lady diagnosed as a case of metastatic carcinoma colon stage IV involving lung and left adrenal metastasis was initiated with palliative chemotherapy with FOLFOX-6 chemotherapy infusion regimen that consisted of 5-flurouracil, calcium leucovorin, and oxaliplatin and injection bevacizumab was added to cycle seven of FOLFOX-6 chemotherapy. After 2 months of initiating bevacizumab, she was presented with one episode of generalized tonic clonic seizure, headache, and visual blurring of 2 days duration and magnetic resonance imaging brain T2 fluid-attenuated inversion recovery image revealed subcortical white matter edema in bilateral frontoparietal, occipital, left temporal lobes (Fig. 1A and B), and hyperintense edema with effacement of folia in both cerebellum with nodular areas of contrast enhancement suggestive of posterior reversible encephalopathy syndrome.
Yoga as Adjunct Therapy for Chronic Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Dutta Abhijit , Mooventhan Aruchunan , Nivethitha L.
Published: September 2023

Background Chronic heart failure (CHF) is a prevalent cardiovascular condition that can significantly impact the quality of life and increase mortality risk. Yoga is a mind–body therapy that has been studied as a potential complementary treatment for CHF. However, the effectiveness of yoga in improving outcomes in patients with CHF remains uncertain.

Methods We conducted a systematic review of randomized controlled trials (RCTs) evaluating the effects of yoga on outcomes in patients with CHF. We searched the PubMed, Embase, Scopus, Cochrane Library, and IndMED databases from inception to March 2023. The outcomes of interest were left ventricular ejection fraction (LVEF), cardiac biomarkers, exercise capacity, quality of life, and cardiac function.

Results We identified 11 RCTs that met our inclusion criteria, involving a total of 552 participants. The meta-analysis showed that yoga was associated with significant improvements in peak VO2 (mean difference [MD]= 3.29; 95% Confidence Interval [CI]: 1.64 to 4.94; I2 = 0%), exercise capacity (MD=101.54; 95% CI: 6.24 to 196.83; I2 = 96%), quality of life (MD = –19.99; 95% CI: –25.76 to –14.22; I
2 = 43%), NT-proBNP (MD = –288.78; 95% CI: –492.20 to –85.37; I
2 = 94%), and 6-minute walk test (MD = 101.54; 95% CI: 6.24–196.83; I
2 = 96%), but not in the left ventricular ejection fraction (MD = 4.28; 95% CI: –1.14 to 9.70; I
2 = 93%). Subgroup analysis suggested that the effect of yoga on the quality of life is more pronounced in patients with the “New York Heart Association” (NYHA) class I and II CHF patients and in those who practiced yoga for longer durations. No serious adverse events related to yoga were reported. Most of the included studies were of “low” quality.

Conclusion Current evidence suggests that yoga may be an effective complementary and integrative therapy for improving peak VO2 exercise capacity, NT-proBNP, and quality of life in patients with CHF. However, the low-quality evidence does not render us to conclude anything beyond doubt or draw any firm clinical recommendation. Future high-quality studies are needed to explore the optimal duration and frequency of yoga practice and its effects on long-term outcomes in this population.
Elementary intracellular Ca signals approximated as a transition of release channel system from a metastable state
Authors: Veron Guillermo , Maltsev Victor A. , Stern Michael D. , Maltsev Anna V.
Published: September 2023

Cardiac muscle contraction is initiated by an elementary Ca signal (called Ca spark) which is achieved by collective action of Ca release channels in a cluster. The mechanism of this synchronization remains uncertain. We approached Ca spark activation as an emergent phenomenon of an interactive system of release channels. We constructed a weakly lumped Markov chain that applies an Ising model formalism to such release channel clusters and probable open channel configurations and demonstrated that spark activation is described as a system transition from a metastable to an absorbing state, analogous to the pressure required to overcome surface tension in bubble formation. This yielded quantitative estimates of the spark generation probability as a function of various system parameters. We performed numerical simulations to find spark probabilities as a function of sarcoplasmic reticulum Ca concentration, obtaining similar values for spark activation threshold as our analytic model, as well as those reported in experimental studies. Our parametric sensitivity analyses also showed that the spark activation threshold decreased as Ca sensitivity of RyR activation and RyR cluster size increased.
Dynamical behavior of a stochastic HIV model with logistic growth and Ornstein-Uhlenbeck process
Authors: Liu Qun
Published: September 2023

In this paper, we investigate a stochastic human immunodeficiency virus (HIV) model with logistic growth and Ornstein-Uhlenbeck process, which is used to describe the pathogenesis and transmission dynamics of HIV in the population. We first validate that the stochastic system has a unique global solution with any initial value. Then we use a novel Lyapunov function method to establish sufficient conditions for the existence of a stationary distribution of the system, which shows the coexistence of all CD4+ T cells and free viruses. Especially, under some mild conditions which are used to ensure the local asymptotic stability of the quasi-chronic infection equilibrium of the stochastic system, we obtain the specific expression of covariance matrix in the probability density around the quasi-chronic infection equilibrium of the stochastic system. In addition, for completeness, we also obtain sufficient criteria for elimination of all infected CD4+ T cells and free virus particles. Finally, several examples together with comprehensive numerical simulations are conducted to support our analytic results.
Superoscillations and Fock spaces
Authors: Alpay Daniel , Colombo Fabrizio , Diki Kamal , Sabadini Irene , Struppa Daniele C.
Published: September 2023

In this paper we use techniques in Fock spaces theory and compute how the Segal-Bargmann transform acts on special wave functions obtained by multiplying superoscillating sequences with normalized Hermite functions. It turns out that these special wave functions can be constructed also by computing the approximating sequence of the normalized Hermite functions. First, we start by treating the case when a superoscillating sequence is multiplied by the Gaussian function. Then, we extend these calculations to the case of normalized Hermite functions leading to interesting relations with Weyl operators. In particular, we show that the Segal-Bargmann transform maps superoscillating sequences onto a superposition of coherent states. Following this approach, the computations lead to a specific linear combination of the normalized reproducing kernels (coherent states) of the Fock space. As a consequence, we obtain two new integral Bargmann-type representations of superoscillating sequences. We also investigate some results relating superoscillation functions with Weyl operators and Fourier transform.
Multicomponent KP type hierarchies and their reductions, associated to conjugacy classes of Weyl groups of classical Lie algebras
Authors: Kac Victor , van de Leur Johan
Published: September 2023

This, to a large extent, expository paper describes the theory of multicomponent hierarchies of evolution equations of XKP type, where X = A, B, C, or D, and AKP = KP and their reductions, associated with the conjugacy classes of the Weyl groups of classical Lie algebras of type X. As usual, the main tool is the multicomponent boson–fermion correspondence, which leads to the corresponding tau-functions, wave functions, dressing operators, and Lax operators.
New notions of uniformity and homogeneity of Cosserat media
Authors: Jiménez Víctor Manuel , de León Manuel
Published: September 2023

In this paper, we study internal properties of Cosserat media. In fact, by using groupoids and smooth distributions, we obtain three canonical equations. The non-holonomic material equation for Cosserat media characterizes the uniformity of the material. The holonomic material equation for Cosserat media permits us to study when a Cosserat material is a second-grade material. It is remarkable that these two equations also provide us a unique and maximal division of the Cosserat medium into uniform and second-grade parts, respectively. Finally, we present a proper definition of homogeneity of the Cosserat medium, which does not need to assume uniformity. Thus, the homogeneity equation for Cosserat media characterizes this notion of homogeneity.
Controllable growth of γ-GeSe microflakes by vapor phase deposition via rapid cooling strategy
Authors: Wang Kaiyi , Chai Ye , Gao Hui , Zhu Guohua , Hao Shijie , Zhou Hongyi , Hao Yulong , Gao Weiqi , Zhao Zhongkun , Sun Hongtao , Hao Guolin
Published: September 2023

γ-GeSe has recently emerged as a promising material for electronics and optoelectronics due to its unique band structure and excellent electrical properties. However, controllable growth of γ-GeSe remains a significant challenge. In this work, the controllable growth of γ-GeSe microflakes (MFs) on a mica substrate was reported by vapor phase deposition via a rapid cooling strategy. The screw dislocation-driven growth behavior is confirmed based on systematic characterizations. Our experimental results demonstrate that the stress induced during the rapid cooling process is critical for the controllable synthesis of γ-GeSe MFs and corresponding growth mechanism was proposed. Our work provides a new experimental strategy for the controlled growth of γ-GeSe MFs, which is beneficial for constructing GeSe-based nanoelectronic and optoelectronic devices.
Ab initiostudy of electronic states and radiative properties of the AcF molecule
Authors: Skripnikov Leonid V. , Oleynichenko Alexander V. , Zaitsevskii Andréi , Mosyagin Nikolai S. , Athanasakis-Kaklamanakis Michail , Au Mia , Neyens Gerda
Published: September 2023

Relativistic coupled-cluster calculations of the ionization potential, dissociation energy, and excited electronic states under 35 000 cm−1 are presented for the actinium monofluoride (AcF) molecule. The ionization potential is calculated to be IPe = 48 866 cm−1, and the ground state is confirmed to be a closed-shell singlet and thus strongly sensitive to the T,P-violating nuclear Schiff moment of the Ac nucleus. Radiative properties and transition dipole moments from the ground state are identified for several excited states, achieving a mean uncertainty estimate of ∼450 cm−1 for the excitation energies. For higher-lying states that are not directly accessible from the ground state, possible two-step excitation pathways are proposed. The calculated branching ratios and Franck–Condon factors are used to investigate the suitability of AcF for direct laser cooling. The lifetime of the metastable (1)3Δ1 state, which can be used in experimental searches of the electric dipole moment of the electron, is estimated to be of order 1 ms.
Temperature controlled magnon–photon coupling in a YIG/GGG-superconducting cavity coupled system
Authors: Zhao Yue , Sun Yitong , Wu Zhenfa , Chen Yanxue , Tian Yufeng , Yan Shishen , Bai Lihui
Published: September 2023

To explore potential applications in classical and quantum information transfer, the hybrid systems between yttrium iron garnet (YIG) and cavities have been extensively studied, and four coupling regimes have been defined based on the relative strength between the coupling strength and dissipation rate of each subsystem. Achieving the control of magnon–photon coupling between nano-thick YIG films and cavities remains to be explored. We experimentally measure the microwave transmission spectra of a nano-thick yttrium iron garnet/gadolinium gallium garnet (YIG/GGG) film coupled to a superconducting cavity at different temperatures. The dissipation rate of the superconducting cavity increases significantly with decreasing temperature, which is influenced by the temperature-dependent magnetic susceptibility of the GGG substrate. Accompanied by the temperature-dependent magnon dissipation rate, a continuous transformation of the coupled system in strong coupling, Purcell and weak coupling regimes is achieved.