bluuebunny/crossref_metadata_2025 huggingface dataset:
The innovation of AI-based software in oral diseases: clinical-histopathological correlation diagnostic accuracy primary study
Authors: Zayed Shaimaa O. , Abd-Rabou Rawan Y.M. , Abdelhameed Gomana M. , Abdelhamid Youssef , Khairy Khalid , Abulnoor Bassam A. , Ibrahim Shereen Hafez , Khaled Heba
Published: May 2024

Background

Machine learning (ML) through artificial intelligence (AI) could provide clinicians and oral pathologists to advance diagnostic problems in the field of potentially malignant lesions, oral cancer, periodontal diseases, salivary gland disease, oral infections, immune-mediated disease, and others. AI can detect micro-features beyond human eyes and provide solution in critical diagnostic cases.

Objective

The objective of this study was developing a software with all needed feeding data to act as AI-based program to diagnose oral diseases. So our research question was: Can we develop a Computer-Aided Software for accurate diagnosis of oral diseases based on clinical and histopathological data inputs?

Method

The study sample included clinical images, patient symptoms, radiographic images, histopathological images and texts for the oral diseases of interest in the current study (premalignant lesions, oral cancer, salivary gland neoplasms, immune mediated oral mucosal lesions, oral reactive lesions) total oral diseases enrolled in this study was 28 diseases retrieved from the archives of oral maxillofacial pathology department. Total 11,200 texts and 3000 images (2800 images were used for training data to the program and 100 images were used as test data to the program and 100 cases for calculating accuracy, sensitivity& specificity).

Results

The correct diagnosis rates for group 1 (software users), group 2 (microscopic users) and group 3 (hybrid) were 87%, 90.6, 95% respectively. The reliability for inter-observer value was done by calculating Cronbach’s alpha and interclass correlation coefficient. The test revealed for group 1, 2 and 3 the following values respectively 0.934, 0.712 & 0.703. All groups showed acceptable reliability especially for Diagnosis Oral Diseases Software (DODS) that revealed higher reliability value than other groups. However, The accuracy, sensitivity & specificity of this software was lower than those of oral pathologists (master’s degree).

Conclusion

The correct diagnosis rate of DODS was comparable to oral pathologists using standard microscopic examination. The DODS program could be utilized as diagnostic guidance tool with high reliability & accuracy.
The ameliorative effects of curcumin nanomicelle on testicular damage in the mouse model of multiple sclerosis
Authors: Koohpeyma Farhad , Khodaparast Zahra , Salehi Sara , Danesh Sina , Gheshlagh Farhad Mohammadi , Naseri Arzhang , Montazeri-Najafabady Nima
Published: May 2024

Background

This study investigated the effect of curcumin nanomicelle (CUR-n) on the structure of testis tissue, the process of spermatogenesis, LH, FSH, testosterone, and oxidative stress in a model of multiple sclerosis.

Methods

Twenty-four male mice C57BL/6 were randomly allocated into 4 groups of 6 (1: group receiving 2% CPZ diet, 2: group receiving the diet of 2% CPZ + CUR-n with a dose of 50 mg/kg, 3: group receiving the diet of 2% CPZ + CUR-n with a dose of 100 mg/kg). The concentration of hormones (testosterone, LH and FSH), was measured by the special hormone assay ELISA kits. Measuring total antioxidant capacity (TAC) and Malondialdehyde (MDA) levels was done by spectrophotometry and calorimetric methods, respectively. Stereological analysis was done in order to explore the number of spermatogenesis cells, testis and sperm properties.

Results

The results indicated that CUR-n (100 mg/kg) significantly enhanced the concentration of LH, FSH, testosterone, and TAC but reduced MDA levels. It also notably increased the quantity of spermatogonia, spermatocyte, round spermatids, long spermatids and LCs, augmented testis weight and volume, and germinal epithelium volume, improved sperm count, morphology, viability, and motility. In addition, a considerable decrease in the amount of wrinkling and disruption of the germinal epithelium was observed after intervention with CUR-n (100 mg/kg). Furthermore, a significant increase in the number of germ cells compared to the group receiving CPZ was detected.

Conclusion

This study proposes that CUR-n could be a therapeutic agent for decreasing the adverse effects of MS on testis.
Burden, social support, and coping strategies in family caregivers of individuals receiving home mechanical ventilation: a cross-sectional study
Authors: Płaszewska-Żywko Lucyna , Fajfer-Gryz Izabela , Cichoń Jakub , Kózka Maria
Published: May 2024

Background

Home mechanical ventilation (HMV) is a treatment method for patients with chronic respiratory failure. HMV is a challenge for both patients and their caregivers. Some studies have shown a higher risk of depression, job loss, or lifestyle disturbance in family members caring for HMV patients. The purpose of the study was to measure caregiver burden, perceived social support, and coping strategies.

Methods

In the cross-sectional study, 58 caregivers (65.52% female) of HMV patients treated at five healthcare institutions were surveyed. The questionnaires including patient/caregiver demographic data, the type and duration of MV, the Caregiver Burden Scale (CBS), the Social Support Scale (SSS), and the Brief-COPE questionnaire were applied. For statistical analysis, the Mann‒Whitney U test, the Kruskal‒Wallis H test, Dunn’s test, and Spearman correlations were used.

Results

In the CBS, a high level of burden was observed mainly in the isolation and disappointment subscales. The female caregivers achieved a higher score for general strain than did the male caregivers (p = 0.023). Differences in the distribution of the isolation (p = 0.028) and disappointment (p = 0.03) variables between the financial situation groups were observed. The older the patient, the lower the burden in the domains of isolation (p = 0.015) and disappointment (p = 0.005) was elicited. Invasive MV was associated with greater burdens of general strain (p = 0.005), isolation (p = 0.001), and disappointment (p = 0.001). A medium total SSS score was shown (74.5 ± 7.56). Caregivers used various coping strategies. The most common were planning, acceptance, and active coping. Self-blame and denial were positively related to several CBS subscales, whereas acceptance of difficult situations and positive reframing were related to lower scores.

Conclusions

Caregivers most frequently experienced a medium level of burden. Female caregivers were characterized by higher level of burden. Invasive ventilation increased the burden. Respondents who assessed their financial situations as good, had lower burden in the selected subscales. Using some positive coping strategies may reduce the level of burden. Interventions to ensure that caregivers overcome these burdens should be undertaken.
Inequity in clinical research access for service users presenting comorbidity within alcohol treatment settings: findings from a focused ethnographic study
Authors: Hemrage Sofia , Parkin Stephen , Kalk Nicola J. , Shah Naina , Deluca Paolo , Drummond Colin
Published: May 2024

Background

While healthcare policy has fostered implementation strategies to improve inclusion and access of under-served groups to clinical care, systemic and structural elements still disproportionately prevent service users from accessing research opportunities embedded within clinical settings. This contributes to the widening of health inequalities, as the absence of representativeness prevents the applicability and effectiveness of evidence-based interventions in under-served clinical populations. The present study aims to identify the individual (micro), organisational (meso) and structural (macro) barriers to clinical research access in patients with comorbid alcohol use disorder and alcohol-related liver disease.

Methods

A focused ethnography approach was employed to explore the challenges experienced by patients in the access to and implementation of research processes within clinical settings. Data were collected through an iterative-inductive approach, using field notes and patient interview transcripts. The framework method was utilised for data analysis, and themes were identified at the micro, meso and macro levels.

Results

At the micro-level, alcohol-related barriers included encephalopathy and acute withdrawal symptoms. Alcohol-unrelated barriers also shaped the engagement of service users in research. At the meso-level, staff and resource pressures, as well as familiarity with clinical and research facilities were noted as influencing intervention delivery and study retention. At the wider, macro-level, circumstances including the ‘cost of living crisis’ and national industrial action within healthcare settings had an impact on research processes. The findings emphasise a ‘domino effect’ across all levels, demonstrating an interplay between individual, organisational and structural elements influencing access to clinical research.

Conclusions

A combination of individual, organisational and structural barriers, exacerbated by the COVID-19 pandemic, and the socioeconomic landscape in which the study was conducted further contributed to the unequal access of under-served groups to clinical research participation. For patients with comorbid alcohol use disorder and alcohol-related liver disease, limited access to research further contributes towards a gap in effective evidence-based treatment, exacerbating health inequalities in this clinical population.
Mild hyperthermia enhanced synergistic uric acid degradation and multiple ROS elimination for an effective acute gout therapy
Authors: Zhao Pei , Hu Hua-Zhong , Chen Xiao-Tong , Jiang Qi-Yun , Yu Xue-Zhao , Cen Xiao-Lin , Lin Shi-Qing , Mai Sui-qing , Pang Wei-lin , Chen Jin-Xiang , Zhang Qun
Published: May 2024

Background

Acute gouty is caused by the excessive accumulation of Monosodium Urate (MSU) crystals within various parts of the body, which leads to a deterioration of the local microenvironment. This degradation is marked by elevated levels of uric acid (UA), increased reactive oxygen species (ROS) production, hypoxic conditions, an upsurge in pro-inflammatory mediators, and mitochondrial dysfunction.

Results

In this study, we developed a multifunctional nanoparticle of polydopamine-platinum (PDA@Pt) to combat acute gout by leveraging mild hyperthermia to synergistically enhance UA degradation and anti-inflammatory effect. Herein, PDA acts as a foundational template that facilitates the growth of a Pt shell on the surface of its nanospheres, leading to the formation of the PDA@Pt nanomedicine. Within this therapeutic agent, the Pt nanoparticle catalyzes the decomposition of UA and actively breaks down endogenous hydrogen peroxide (H2O2) to produce O2, which helps to alleviate hypoxic conditions. Concurrently, the PDA component possesses exceptional capacity for ROS scavenging. Most significantly, Both PDA and Pt shell exhibit absorption in the Near-Infrared-II (NIR-II) region, which not only endow PDA@Pt with superior photothermal conversion efficiency for effective photothermal therapy (PTT) but also substantially enhances the nanomedicine’s capacity for UA degradation, O2 production and ROS scavenging enzymatic activities. This photothermally-enhanced approach effectively facilitates the repair of mitochondrial damage and downregulates the NF-κB signaling pathway to inhibit the expression of pro-inflammatory cytokines.

Conclusions

The multifunctional nanomedicine PDA@Pt exhibits exceptional efficacy in UA reduction and anti-inflammatory effects, presenting a promising potential therapeutic strategy for the management of acute gout.

Graphical Abstract
Testing the generalizability and effectiveness of deep learning models among clinics: sperm detection as a pilot study
Authors: Wang Jiaqi , Jin Yufei , Jiang Aojun , Chen Wenyuan , Shan Guanqiao , Gu Yifan , Ming Yue , Li Jichang , Yue Chunfeng , Huang Zongjie , Librach Clifford , Lin Ge , Wang Xibu , Zhao Huan , Sun Yu , Zhang Zhuoran
Published: May 2024

Background

Deep learning has been increasingly investigated for assisting clinical in vitro fertilization (IVF). The first technical step in many tasks is to visually detect and locate sperm, oocytes, and embryos in images. For clinical deployment of such deep learning models, different clinics use different image acquisition hardware and different sample preprocessing protocols, raising the concern over whether the reported accuracy of a deep learning model by one clinic could be reproduced in another clinic. Here we aim to investigate the effect of each imaging factor on the generalizability of object detection models, using sperm analysis as a pilot example.

Methods

Ablation studies were performed using state-of-the-art models for detecting human sperm to quantitatively assess how model precision (false-positive detection) and recall (missed detection) were affected by imaging magnification, imaging mode, and sample preprocessing protocols. The results led to the hypothesis that the richness of image acquisition conditions in a training dataset deterministically affects model generalizability. The hypothesis was tested by first enriching the training dataset with a wide range of imaging conditions, then validated through internal blind tests on new samples and external multi-center clinical validations.

Results

Ablation experiments revealed that removing subsets of data from the training dataset significantly reduced model precision. Removing raw sample images from the training dataset caused the largest drop in model precision, whereas removing 20x images caused the largest drop in model recall. by incorporating different imaging and sample preprocessing conditions into a rich training dataset, the model achieved an intraclass correlation coefficient (ICC) of 0.97 (95% CI: 0.94-0.99) for precision, and an ICC of 0.97 (95% CI: 0.93-0.99) for recall. Multi-center clinical validation showed no significant differences in model precision or recall across different clinics and applications.

Conclusions

The results validated the hypothesis that the richness of data in the training dataset is a key factor impacting model generalizability. These findings highlight the importance of diversity in a training dataset for model evaluation and suggest that future deep learning models in andrology and reproductive medicine should incorporate comprehensive feature sets for enhanced generalizability across clinics.
HIV-1 with gag processing defects activates cGAS sensing
Authors: Sumner Rebecca P. , Blest Henry , Lin Meiyin , Maluquer de Motes Carlos , Towers Greg J.
Published: May 2024

Background

Detection of viruses by host pattern recognition receptors induces the expression of type I interferon (IFN) and IFN-stimulated genes (ISGs), which suppress viral replication. Numerous studies have described HIV-1 as a poor activator of innate immunity in vitro. The exact role that the viral capsid plays in this immune evasion is not fully understood.

Results

To better understand the role of the HIV-1 capsid in sensing we tested the effect of making HIV-1 by co-expressing a truncated Gag that encodes the first 107 amino acids of capsid fused with luciferase or GFP, alongside wild type Gag-pol. We found that unlike wild type HIV-1, viral particles produced with a mixture of wild type and truncated Gag fused to luciferase or GFP induced a potent IFN response in THP-1 cells and macrophages. Innate immune activation by Gag-fusion HIV-1 was dependent on reverse transcription and DNA sensor cGAS, suggesting activation of an IFN response by viral DNA. Further investigation revealed incorporation of the Gag-luciferase/GFP fusion proteins into viral particles that correlated with subtle defects in wild type Gag cleavage and a diminished capacity to saturate restriction factor TRIM5α, likely due to aberrant particle formation. We propose that expression of the Gag fusion protein disturbs the correct cleavage and maturation of wild type Gag, yielding viral particles that are unable to effectively shield viral DNA from detection by innate sensors including cGAS.

Conclusions

These data highlight the crucial role of capsid in innate evasion and support growing literature that disruption of Gag cleavage and capsid formation induces a viral DNA- and cGAS-dependent innate immune response. Together these data demonstrate a protective role for capsid and suggest that antiviral activity of capsid-targeting antivirals may benefit from enhanced innate and adaptive immunity in vivo.
Combining analytical techniques to assess the translocation of diesel particles across an alveolar tissue barrier in vitro
Authors: Gunasingam Gowsinth , He Ruiwen , Taladriz-Blanco Patricia , Balog Sandor , Petri-Fink Alke , Rothen-Rutishauser Barbara
Published: May 2024

Background

During inhalation, airborne particles such as particulate matter ≤ 2.5 μm (PM2.5), can deposit and accumulate on the alveolar epithelial tissue. In vivo studies have shown that fractions of PM2.5 can cross the alveolar epithelium to blood circulation, reaching secondary organs beyond the lungs. However, approaches to quantify the translocation of particles across the alveolar epithelium in vivo and in vitro are still not well established. In this study, methods to assess the translocation of standard diesel exhaust particles (DEPs) across permeable polyethylene terephthalate (PET) inserts at 0.4, 1, and 3 μm pore sizes were first optimized with transmission electron microscopy (TEM), ultraviolet-visible spectroscopy (UV-VIS), and lock-in thermography (LIT), which were then applied to study the translocation of DEPs across human alveolar epithelial type II (A549) cells. A549 cells that grew on the membrane (pore size: 3 μm) in inserts were exposed to DEPs at different concentrations from 0 to 80 µg.mL− 1 ( 0 to 44 µg.cm− 2) for 24 h. After exposure, the basal fraction was collected and then analyzed by combining qualitative (TEM) and quantitative (UV-VIS and LIT) techniques to assess the translocated fraction of the DEPs across the alveolar epithelium in vitro.

Results

We could detect the translocated fraction of DEPs across the PET membranes with 3 μm pore sizes and without cells by TEM analysis, and determine the percentage of translocation at approximatively 37% by UV-VIS (LOD: 1.92 µg.mL− 1) and 75% by LIT (LOD: 0.20 µg.cm− 2). In the presence of cells, the percentage of DEPs translocation across the alveolar tissue was determined around 1% at 20 and 40 µg.mL− 1 (11 and 22 µg.cm− 2), and no particles were detected at higher and lower concentrations. Interestingly, simultaneous exposure of A549 cells to DEPs and EDTA can increase the translocation of DEPs in the basal fraction.

Conclusion

We propose a combination of analytical techniques to assess the translocation of DEPs across lung tissues. Our results reveal a low percentage of translocation of DEPs across alveolar epithelial tissue in vitro and they correspond to in vivo findings. The combination approach can be applied to any traffic-generated particles, thus enabling us to understand their involvement in public health.
Renin in critically ill patients
Authors: Kotani Yuki , Chappell Mark , Landoni Giovanni , Zarbock Alexander , Bellomo Rinaldo , Khanna Ashish K.
Published: May 2024

The renin-angiotensin system (RAS) constitutes one of the principal mechanisms to maintain hemodynamic and fluid homeostasis. However, most research until now on RAS primarily focuses on its relationship with hypertension and its role in critically ill hypotensive populations is not well understood. With the approval of angiotensin II (Ang II) in the United States and Europe, following a phase 3 randomized controlled trial showing efficacy in catecholamine-resistant vasodilatory shock, there is growing interest in RAS in critically ill patients. Among the fundamental components of RAS, renin acts as the initial stimulus for the entire system. In the context of hypotension, its release increases in response to low blood pressure sensed by renal baroreceptors and attenuated negative Ang II feedback loop. Thus, elevated renin could reflect disease severity and predict poor outcomes. Studies investigating this hypothesis have validated the prognostic accuracy of renin in various critically ill populations, with several reports indicating its superiority to lactate for mortality prediction. Accordingly, renin reduction has been used to assess the effectiveness of Ang II administration. Furthermore, renin holds potential to identify patients who might benefit from Ang II treatment, potentially paving the way for personalized vasopressor management. Despite these promising data, most available evidence is derived from retrospective analysis and necessitates prospective confirmation. The absence of a rapid, point-of-care and reliable renin assay presents another hurdle to its integration into routine clinical practice. This narrative review aims to describe the current understanding and future directions of renin as a biomarker during resuscitation of critically ill patients.
Statistical convergence of integral form of modified Szász–Mirakyan operators: an algorithm and an approach for possible applications
Authors: Bhardwaj Neha , Singh Rashmi , Chaudhary Aryan , Shankar Achyut , Kumar Rahul
Published: May 2024

In this study, we take into account the of modified Szász–Mirakyan–Kantorovich operators to obtain their rate of convergence using the modulus of continuity and for the functions in Lipschitz space. Then, we obtain the statistical convergence of this form. In addition, we determine the weighted statistical convergence and compare it with the statistical one for the same operator. Medical applications and traditional mathematics; one way to get a close approximation of the Riemann integrable functions is through the use of the Kantorovich modification of positive linear operators. The use of Kantorovich operators is tremendously helpful from a medical point of view. Their application is shown as an approximation of the rate of convergence in respect of modulus of continuity.
A pair of centro-symmetric heteroclinic orbits coined
Authors: Wang Haijun , Pan Jun , Ke Guiyao , Hu Feiyu
Published: May 2024

Although the axis-symmetric heteroclinic orbits of Lorenz-like systems have been intensively studied in the past decades, scholars seem to pay scant attention to the centro-symmetric ones. To achieve this target, the present paper introduces a new subquadratic centro-symmetric three-dimensional Lorenz-like system: $\dot{x}=a(y - x)$

x
˙

=
a
(
y
−
x
)
, $\dot{y}=cx - \sqrt[3]{x^{2}}z$

y
˙

=
c
x
−

x
2

3

z
, $\dot{z}= -bz + \sqrt[3]{x^{2}}y$

z
˙

=
−
b
z
+

x
2

3

y
, and proves the existence of a pair of centro-symmetric to $E_{0}$

E
0

and $E_{\pm}$

E
±

combining the definitions of α-limit and ω-limit set, Lyapunov functions. The effectiveness and correctness of the theoretical conclusions are verified via a few numerical examples. Not only does the study provide new ideas for finding heteroclinic orbits, but also it poses an interesting question that the existence of heteroclinic orbits may depend on the degrees of the considered models.
Opportunistic screening for long-term muscle wasting in critically ill patients: insights from an acute pancreatitis cohort
Authors: Kolck Johannes , Hosse Clarissa , Leimbach Alexandra , Beetz Nick L. , Auer Timo A. , Collettini Federico , Fehrenbach Uli , Pille Christian , Geisel Dominik
Published: May 2024

Objectives

To assess the feasibility of long-term muscle monitoring, we implemented an AI-guided segmentation approach on clinically indicated Computed Tomography (CT) examinations conducted throughout the hospitalization period of patients admitted to the intensive care unit (ICU) with acute pancreatitis (AP). In addition, we aimed to investigate the potential of muscle monitoring for early detection of patients at nutritional risk and those experiencing adverse outcomes. This cohort served as a model for potential integration into clinical practice.

Materials

Retrospective cohort study including 100 patients suffering from AP that underwent a minimum of three CT scans during hospitalization, totaling 749 assessments. Sequential segmentation of psoas muscle area (PMA) was performed and was relative muscle loss per day for the entire monitoring period, as well as for the interval between each consecutive scan was calculated. Subgroup and outcome analyses were performed including ANOVA. Discriminatory power of muscle decay rates was evaluated using ROC analysis.

Results

Monitoring PMA decay revealed significant long-term losses of 48.20% throughout the hospitalization period, with an average daily decline of 0.98%. Loss rates diverged significantly between survival groups, with 1.34% PMA decay per day among non-survivors vs. 0.74% in survivors. Overweight patients exhibited significantly higher total PMA losses (52.53 vs. 42.91%; p = 0.02) and average PMA loss per day (of 1.13 vs. 0.80%; p = 0.039). The first and the maximum decay rate, in average available after 6.16 and 17.03 days after ICU admission, showed convincing discriminatory power for survival in ROC analysis (AUC 0.607 and 0.718). Both thresholds for maximum loss (at 3.23% decay per day) and for the initial loss rate (at 1.98% per day) proved to be significant predictors of mortality.

Conclusions

The innovative AI-based PMA segmentation method proved robust and effortless, enabling the first comprehensive assessment of muscle wasting in a large cohort of intensive care pancreatitis patients. Findings revealed significant muscle wasting (48.20% on average), particularly notable in overweight individuals. Higher rates of initial and maximum muscle loss, detectable early, correlated strongly with survival. Integrating this tool into routine clinical practice will enable continuous muscle status tracking and early identification of those at risk for unfavorable outcomes.
Feedback loop between hypoxia and energy metabolic reprogramming aggravates the radioresistance of cancer cells
Authors: Shi Zheng , Hu Cuilan , Zheng Xiaogang , Sun Chao , Li Qiang
Published: May 2024

Radiotherapy is one of the mainstream approaches for cancer treatment, although the clinical outcomes are limited due to the radioresistance of tumor cells. Hypoxia and metabolic reprogramming are the hallmarks of tumor initiation and progression and are closely linked to radioresistance. Inside a tumor, the rate of angiogenesis lags behind cell proliferation, and the underdevelopment and abnormal functions of blood vessels in some loci result in oxygen deficiency in cancer cells, i.e., hypoxia. This prevents radiation from effectively eliminating the hypoxic cancer cells. Cancer cells switch to glycolysis as the main source of energy, a phenomenon known as the Warburg effect, to sustain their rapid proliferation rates. Therefore, pathways involved in metabolic reprogramming and hypoxia-induced radioresistance are promising intervention targets for cancer treatment. In this review, we discussed the mechanisms and pathways underlying radioresistance due to hypoxia and metabolic reprogramming in detail, including DNA repair, role of cancer stem cells, oxidative stress relief, autophagy regulation, angiogenesis and immune escape. In addition, we proposed the existence of a feedback loop between energy metabolic reprogramming and hypoxia, which is associated with the development and exacerbation of radioresistance in tumors. Simultaneous blockade of this feedback loop and other tumor-specific targets can be an effective approach to overcome radioresistance of cancer cells. This comprehensive overview provides new insights into the mechanisms underlying tumor radiosensitivity and progression.
Anti-pruritic effect of L-carnitine against chloroquine-induced pruritus mediated via nitric oxide pathway
Authors: Seemab Kiran , Khan Arif-ullah , Khan Muhammad Imran , Qazi Neelum Gul , Minhas Amber Mahmood , Ali Fawad
Published: May 2024

Background

Pruritus, or itching, is a distressing symptom associated with various dermatological and systemic diseases. L-carnitine (βeta hydroxy-γ-tri methyl amino-butyric acid), is a naturally occurring substance, it controls numerous physiological processes. The present research aims to identify L-carnitine for its anti-pruritic effect via nitric oxide-dependent mechanism.

Methods

Chloroquine-induced pruritus serves as an experimental model to investigate possible therapeutic interventions. In this study, we evaluated the efficacy of L-carnitine in combating oxidative stress, nitric oxide, and inflammatory cytokines in a chloroquine-induced pruritus model.

Results

L-carnitine treatment significantly reduced scratching behavior compared to the disease group (***P < 0.001 vs. chloroquine group), indicating its antipruritic potential. The markers of oxidative stress, GST, GSH, Catalase, and LPO were dysregulated in the disease model, but administration of L-carnitine restored GST, GSH, and Catalase levels and decreased LPO levels (***P < 0.001 vs. chloroquine group), thereby alleviating oxidative stress. L-carnitine also reduced nitric oxide synthase (NOS) activity, suggesting that it modulates nitric oxide signaling pathways involved in pruritus. In addition, L-carnitine lowered levels of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), inflammatory marker nuclear factor kappa B (p-NFκB) and also reduces an inflammatory enzyme, cyclooxygenase-2 (COX-2), determined by ELISA (Enzyme-Linked Immunosorbent Assay) (***P < 0.001 vs. chloroquine group). It downregulates nNOS mRNA expression confirmed by real-time polymerase chain reaction (RT-PCR).

Conclusion

These findings highlight the therapeutic effects of L-carnitine in alleviating chloroquine-induced pruritus.
Subtotal esophagectomy and concurrent reconstruction with free jejunal flap for primary esophageal cancer after pancreatoduodenectomy
Authors: Moriwake Kazuya , Noma Kazuhiro , Kawasaki Kento , Matsumoto Tasuku , Hashimoto Masashi , Kato Takuya , Maeda Naoaki , Tanabe Shunsuke , Shirakawa Yasuhiro , Fujiwara Toshiyoshi
Published: May 2024

Background

Pancreatoduodenectomy and subtotal esophagectomy are widely considered the most invasive and difficult surgical procedures in gastrointestinal surgery. Subtotal esophagectomy after pancreatoduodenectomy is expected to be extremely difficult due to complicated anatomical changes, and selecting an appropriate intestinal reconstruction method will also be a difficult task. Therefore, perhaps because the method is considered impossible, there have been few reports of subtotal esophagectomy after pancreatoduodenectomy.

Case presentation

A 73-year-old man with a history of pancreatoduodenectomy was diagnosed with superficial thoracic esophageal squamous cell carcinoma. Definitive chemoradiation therapy was recommended at another hospital; however, he visited our department to undergo surgery. We performed the robot-assisted thoracoscopic subtotal esophagectomy. There were some difficulties with the reconstruction: the gastric tube could not be used, the reconstruction was long, and the organs reconstructed in the previous surgery had to be preserved. However, the concurrent reconstruction was achieved with the help of a free jejunal flap and vascular reconstruction. All reconstructions from the previous surgery, including the remnant stomach, were preserved via regional abdominal lymph node dissection. After reconstruction, intravenous indocyanine green showed that circulation in the reconstructed intestines was preserved. On postoperative day 1, no recurrent nerve paralysis was observed during laryngoscopy. The patient could start oral intake smoothly 2 weeks after surgery and did not exhibit any postoperative complications related to the reconstruction. The patient was transferred to another hospital on postoperative day 21.

Conclusions

Owing to the free jejunal flap interposition method, we safely performed one stage subtotal esophagectomy and concurrent reconstruction, preservation of the remnant stomach, and pancreaticobiliary reconstruction in patients with a history of pancreatoduodenectomy. We believe that this method is acceptable and useful for patients undergoing complicated reconstruction.
Grid connection method of gravity energy storage generator motor based on voltage index sensitivity analysis
Authors: Wang Qingshan , Li Yan , Zhang Qun , He Darui
Published: May 2024

The basic requirements for the grid connection of the generator motor of the gravity energy storage system are: the phase sequence, frequency, amplitude, and phase of the voltage at the generator end and the grid end must be consistent. However, in actual working conditions, there will always be errors in the voltage indicators of the generator and grid terminals, resulting in transient impulse currents. In addition, due to the difference between gravity energy storage systems and conventional power generation units, frequent switching between charging and discharging operating conditions is required according to the needs of the power grid. Each switching requires the completion of the generator motor startup and grid connection. If there is always a significant error in the voltage indicators between the generator and grid terminals during frequent grid connection, stable transient surge currents will be generated. Without human intervention, long-term operation will bring hidden dangers to the safety of the grid connected system, leading to a series of consequences such as equipment aging and even damage. In response to the above issues, this article establishes a gravity energy storage power generation/motor grid connection model. Through simulation analysis, the variation law of the weight of the impact of different terminal voltage indicators on the grid connected transient impulse current is summarized. A grid connection method for gravity energy storage systems based on sensitivity analysis of voltage grid connection indicators is proposed. Through simulation verification, this method can significantly reduce the grid connected transient impulse current while improving the success rate of grid connection, The correctness and practicality of the proposed method have been fully verified.
Endosulfan induces reproductive & genotoxic effect in male and female Swiss albino mice
Authors: Priya  , Kumar Arun , Ali Mohammad , Srivastava Abhinav , Kumar Ranjit , Ghosh Ashok Kumar
Published: May 2024

Background

Toxicity by pesticide has become a global health issue and leaves a harmful impact on human health via various ways. The people exposed to pesticides in the rural population get affected by the harmful effects of it as they enter the human body system through skin, inhalation, oral administration, food chain and many more ways. The present work is designed to study the toxic effect of endosulfan in male (n=30) and female (n=30) Swiss albino mice. Endosulfan was administered by oral gavage (oral administration) method, at the dose of 3.5 mg/Kg body weight daily for period of 3 weeks, 5 weeks and 7 weeks. After the completion of the treatment, the mice were sacrificed and their ovary and testis tissues were dissected out to check the degeneration. The blood was collected for karyotyping, biochemical and hormonal analysis of pesticide induced genotoxicity. After 7 weeks of administration with Endosulfan, various abnormalities were observed in male and female mice.

Results

Treatment with endosulfan at the dose of 3.5 mg/Kg body weight caused a higher degree of degeneration in the reproductive organ of Swiss albino mice . Treatment by this pesticide generated degeneration in long duration of dosage for 3,5 and 7 weeks. Ovaries of endosulfan administered groups showed degenerated germinal epithelium, Graffian follicles and corpus luteum. In testis of endosulfan treated mice, microscopic examination showed that there is significant damage and reduction in the tissue of seminiferous tubules and primordial germ cells. High degree of degeneration caused the disarrangement and deformation of spermatogonia with the decrease in the number of Sertoli cells. Biochemical and hormonal properties was also affected by endosulfan treatment. There was significant 5 folds decrease in the testosterone value of endosulfan in 7 weeks treated mice in comparison to control (p < 0.0001) and similarly there was significant elevation in the estrogen levels found in 7th week endosulfan treated mice. It also influenced the level of free radicals as there was significant decrease (p < 0.0001) in the value in catalase levels in 7 weeks endosulfan treated male and female mice, while significant (p < 0.0001) increase in the values of lipid peroxidation levels as 8 folds and 10 folds in 7 weeks endosulfan treated male and female Swiss albino mice respectively. This study hence speculates that the endosulfan exposed population are at the risk of reproductive health hazards.

Conclusions

The present study thus concludes that, endosulfan after 7 weeks of exposure caused significant reproductive damage to both male and female Swiss albino mice groups. Moreover, the karyotyping study also correlated the genotoxic damage in the mice.
Image quality and patient satisfaction in cone-beam and multidetector computed tomography of the wrist: a randomized trial
Authors: Reidelbach Carolin S. , Neubauer Claudia , Geissler Ann-Kristin H. , Lampert Florian , Zajonc Horst , Simunovic Filip , Bamberg Fabian , Kotter Elmar , Goerke Sebastian M. , Neubauer Jakob
Published: May 2024

Background

Musculoskeletal cone-beam computed tomography (CBCT) is an imaging technique for wrist assessment. In this study, we compared image quality and patient satisfaction between CBCT and multidetector computed tomography (MDCT) in traumatic wrist patients in a dose-matched setting.

Methods

We prospectively enrolled traumatic patients who were scheduled for CT of the wrist. Patients were randomly assigned to CBCT or MDCT. Radiation dose was kept identical between both modalities. Subsequently, patients were asked to complete a questionnaire regarding the examination. Measurements of contrast-to-noise ratio (CNR) were performed. Three blinded readers independently rated image quality on Likert scales.

Results

A total of 125 patients (mean age 35 years [standard deviation 16]; 91 men) were included. A total of 108 patients returned the questionnaire. With equivalent dose, CNRs were higher in CBCT compared to MDCT (p < 0.001) and the median ratings of image quality were better for CBCT compared to MDCT (p ≤ 0.04). Patients only rated positioning in CBCT as more comfortable than in MDCT (p < 0.001), while there were no further differences regarding satisfaction with both modalities.

Conclusions

At equivalent dose settings to MDCT, CBCT showed a high image quality for the depiction of bony structures, soft tissue and artifacts in wrist examinations of trauma patients. Overall, patients were equally satisfied with both methods. Altogether, CBCT might be a promising alternative for wrist imaging. However, further studies with more different devices are needed.
Probiotic potential of lactic acid bacteria isolated from yaks
Authors: He Yuanyuan , Li Feiran , Xu Mengen , Jin Chao , Zhang Yu , Nawaz Shah , Kulyar Muhammad Fakhar-e-Alam , Iqbal Mudassar , Qin Zhen , Li Jiakui
Published: May 2024

The prevalence of bacterial digestive diseases in plateau animals has caused considerable losses to the Tibetan livestock industry. Therefore, this study aimed to isolate safe lactic acid bacteria (LAB) with beneficial probiotic properties to protect yaks from intestinal diseases. After 16S rDNA matching, four strains of Lactobacillus fermentum (A4), Pediococcus pentosaceus (A3.4 and A1.2), and Pediococcus acidilactici (B1.9) were isolated from the intestinal tissues and content of healthy yaks. The results indicated that A4 was more tolerant to bile salt (0.3%), while A3.4 had better stability in an acidic (pH = 3.0) environment. The results of the antibacterial activity test suggested that the isolates inhibited most pathogenic bacteria by up to 20%, except for A3.4, which inhibited Pasteurella and Staphylococcus aureus by more than 20%. Moreover, the results of the antioxidant test demonstrated that A4 and A3.4 had potent antioxidant activity. In addition, the drug sensitivity test revealed that the isolates were susceptible to commonly used antibiotics. In terms of safety, the isolates promoted growth, enhanced intestinal development, and protected the intestinal barrier without causing any adverse effects. In conclusion, LAB isolated from yak intestinal contents are potential probiotics with excellent antibacterial properties.
3D airborne electromagnetic data inversion based on the block coordinate descent method
Authors: Zhang Bo , Qu Kelin , Yin Changchun , Liu Yunhe , Ren Xiuyan , Su Yang , Baranwal Vikas Chand
Published: May 2024

Airborne electromagnetic (AEM) surveys usually cover a large area and create a large amount of data. This has limited the application of 3D AEM inversions. To make 3D AEM data inversion at a large scale possible, the local mesh method has been developed to avoid solving large matrix equations in 3D AEM modeling. However, the local mesh only saves the computational cost and memory during forward modeling and Jacobian calculations. When the survey area is very large, the cost for storing and solving the inversion equations can be very high. This brings significant challenges to practical 3D AEM inversions. To solve this problem, we develop a 3D scheme based on the block coordinate descent (BCD) method for inversions of large-scale AEM data. The BCD method divides the inversion for large models into series of small-local inversions, so that we can avoid solving the large matrix equations. Numerical experiments determine that the BCD method can obtain very similar results to those from the existing inversion methods but saves huge amounts of memory.
The Effect of Thiazide Diuretics on Urinary Prostaglandin E2 Excretion and Serum Sodium in the General Population
Authors: Geurts Frank , Rudolphi Crissy F , Pelouto Anissa , van der Burgh Anna C , Salih Mahdi , Imenez Silva Pedro Henrique , Fenton Robert A , Chaker Layal , Hoorn Ewout J
Published: May 2024

Context

Thiazide-induced hyponatremia is one of the most common forms of hyponatremia, but its pathogenesis is incompletely understood. Recent clinical data suggest links with prostaglandin E2 (PGE2) and a single nucleotide polymorphism (SNP) in the prostaglandin transporter gene (SLCO2A1), but it is unknown if these findings also apply to the general population.

Objective

To study the associations between serum sodium, thiazide diuretics, urinary excretions of PGE2, and its metabolite (PGEM), and the rs34550074 SNP in SLCO2A1 in the general population.

Design

Prospective population-based cohort study (Rotterdam Study).

Setting

General population.

Participants

2178 participants (65% female, age 64 ± 8 years)

Intervention(s)

None.

Main Outcome Measure(s)

Serum sodium levels.

Results

Higher urinary PGE2 excretion was associated with lower serum sodium: difference in serum sodium for each 2-fold higher PGE2 −0.19 mmol/L [95% confidence interval (CI) −0.31 to −0.06], PGEM −0.29 mmol/L (95% CI −0.41 to −0.17). This association was stronger in thiazide users (per 2-fold higher PGE2 −0.73 vs −0.12 mmol/L and PGEM −0.6 vs −0.25 mmol/L, P for interaction <.05 for both). A propensity score matching analysis of thiazide vs non-thiazide users yielded similar results. The SNP rs34550074 was not associated with lower serum sodium or higher urinary PGE2 or PGEM excretion in thiazide or non-thiazide users.

Conclusion

Serum sodium is lower in people with higher urinary PGE2 and PGEM excretion, and this association is stronger in thiazide users. This suggests that PGE2-mediated water reabsorption regulates serum sodium, which is relevant for the pathogenesis of hyponatremia in general and thiazide-induced hyponatremia specifically.
Publicly Funded Molecular Testing of Indeterminate Thyroid Nodules: Canada's Experience
Authors: Lévesque Florence , Payne Richard J , Beaudoin Danielle , Boucher Andrée , Fortier Pierre-Hugues , Massicotte Marie-Hélène , Pusztaszeri Marc , Rondeau Geneviève , Corriveau Edith , El Malt Farida , Brassard Maryse
Published: May 2024

Context

Indeterminate thyroid nodules (ITNs) lead to diagnostic surgeries in many countries. The use of molecular testing (MT) is endorsed by several guidelines, but costs are limitative, especially in public health care systems like in Canada.

Objectives

The primary objective of this work was to evaluate the clinical value of ThyroSeq v3 (TSv3) using benign call rate (BCR) in a real-world practice. The secondary objective was to assess the cost-effectiveness of MT.

Methods

This multicentric prospective study was conducted in 5 academic centers in Quebec, Canada. A total of 500 consecutive patients with Bethesda III (on 2 consecutive cytopathologies) or IV and TIRADS 3 or 4 nodules measuring 1 to 4 cm were included. MT was performed between November 2021 and November 2022. Patients with a positive TSv3 were referred for surgery. Patients with a negative TSv3 were planned for follow-up by ultrasonography for a minimum of 2 years. The BCR, corresponding to the proportion of ITNs with negative TSv3 results, was assessed.

Results

A total of 500 patients underwent TSv3 testing, with a BCR of 72.6% (95% CI, 68.5%-76.5%; P < .001). Ultimately, 99.7% of patients with a negative result avoided surgery. The positive predictive value of TSv3 was 68.2% (95% CI, 58.5%-76.9%). The cost-benefit analysis identified that the implementation of MT would yield a cost savings of $6.1 million over the next 10 years.

Conclusion

The use of MT (TSv3) in a well-selected population with ITNs led to a BCR of 72.6%. It is cost-effective and prevents unnecessary surgeries in a public health care setting.
Migration, Gender, and Families: The Effects of Spousal Migration on Women's Empowerment
Authors: West Heidi , Khan Angubeen , Razzaque Abdur , Kuhn Randall
Published: May 2024

Labor migration has a profound effect on families, but evidence documenting the impact of migration on women left behind is still lacking. Utilizing the Matlab Health and Socioeconomic Surveys, we examined the roles of migration and families in four domains of empowerment for women in Bangladesh. We found that women with international migrant spouses saw significant improvements in economic empowerment, mobility, and decision-making relative to women with coresident spouses (p < .0001). However, women who lived in multigenerational households with their parents or in-laws experienced significant reductions in empowerment across these three domains. Both having a migrant spouse and living in a multigenerational household had negative effects on beliefs about gender equivalence and reduced joint decision-making for women. Results, which were robust to migration selection controls (including propensity approaches), indicate that the benefits of migration for women left behind might be diluted by family structures that perpetuate unequal gender dynamics.