bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization of Physicochemical Properties, Bioactivities, and Sensory Attributes of Sea Buckthorn–Fava Bean Composite Instant Powder: Spray-Drying Versus Freeze-Drying Coupled with Carriers
Authors: Li Shi , Fu Xizhe , Wen Jing , Jiang Lin , Shao Liheng , Du Yinglin , Shan Chunhui
Published: December 2024

Foods and beverages with health benefits have become increasingly popular with consumers, and fruits and legumes are considered good sources of nutrients. In this study, sea buckthorn and fava bean were used as the main raw materials to prepare sea buckthorn–fava bean composite instant powder (S-FCP). Different drying methods (spray-drying (SD) and freeze-drying (FD)) combined with carriers (maltodextrin (MD) and inulin (INU)) were involved to investigate their effects on physicochemical properties, functional properties, and sensory attributes of instant powder. The results showed that FD better protected the color of the S-FCP and produced particles possessing more porous structures compared to SD; FD-INU (freeze-dried-inulin) had the shortest dissolution time and the largest solubility. In addition, FD-INU had the highest total phenolic and total flavonoid contents and the strongest antioxidant capacity, and FD-INU had better overall organoleptic properties and hypoglycemic potential. Therefore, FD and the use of INU as a carrier are more suitable for the production of the S-FCP. This work provides a promising approach for developing a high-valued instant powder beverage composed of sea-buckthorn/broad bean, which also contributes to the development of the functional food industry.
An Improved pH-Driven Method for Upcycling Polyphenols from Plants or Byproducts into Foods
Authors: Gong Xiping , Wang Minghe , Lu Peng , Zhou Hualu
Published: December 2024

The incorporation of polyphenols into food systems provides various health benefits, yet their stability and bioactivity are often compromised by processing conditions. In this study, we advanced the pH-driven method for processing highly pH-sensitive polyphenols, such as quercetin, by optimizing operating conditions, including minimizing oxygen exposure and reducing operating times. As a result, an improved post-pH-driven (PPD) method was developed to encapsulate pH-sensitive quercetin into nanoemulsions with an encapsulation efficiency exceeding 95%, indicating that this method could be broadly applicable for incorporating various polyphenols. For example, it has been successfully applied to upcycle plant polyphenols from peanut skin into nanoemulsions, serving as a representative food model. The PPD method demonstrated superior performance compared to a conventional water-based method, achieving 1.8 times higher remaining percentage of total polyphenolic content. Additionally, the PPD-based nanoemulsions exhibited significantly enhanced antioxidant properties, with DPPH and ABTS radical scavenging activities increasing by 3.7 and 2.8 times, respectively, compared to the water-based method. These findings underscore the potential of the PPD method as a versatile and efficient approach for developing polyphenol-powered foods by upcycling plant byproducts and improving processing efficiency.
Bioactive Peptides in Greek Goat Colostrum: Relevance to Human Metabolism
Authors: Petre Maria Louiza , Kontouli Pertesi Anna Nefeli , Boulioglou Olympia Eirini , Sarantidi Eleana , Korovesi Artemis G. , Kozei Athina , Katsafadou Angeliki I. , Tsangaris George T. , Trichopoulou Antonia , Anagnostopoulos Athanasios K.
Published: December 2024

Colostrum is essential for the survival and development of newborn mammals. This primary source of nourishment during the first days of infant life is rich in functional components conductive to the enhancement of neonate immunity and growth. Compared with mature milk, a higher protein and peptide content is observed in colostrum, whilst it is low in fat and carbohydrates. The functional properties of colostrum are closely linked to the release of bioactive peptides during the gastrointestinal digestion of colostrum proteins. Our study aimed to comprehensively analyze the whey proteome of colostrum from indigenous Greek goats and to examine the influence of bioactive peptides released during digestion on human metabolism. Colostrum and mature milk samples from healthy ewes were subjected to nanoLC-MS/MS analysis, revealing differentially expressed proteins. These proteins were functionally characterized and subjected to in silico digestion. Using machine learning models, we classified the peptide functional groups, while molecular docking assessed the binding affinity of the proposed angiotensin-converting enzyme (ACE)- and dipeptidyl peptidase IV (DPPIV)-inhibitory peptides to their target molecules. A total of 898 proteins were identified in colostrum, 40 of which were overexpressed compared with mature milk. The enzymatic cleavage of upregulated proteins by key gastrointestinal tract proteases and the downstream analysis of peptide sequences identified 117 peptides predicted (with >80% confidence) to impact metabolism, primarily through modulation of the renin–angiotensin system, insulin secretion, and redox pathways. This work advances our understanding of dietary bioactive peptides and their relevance to human metabolism, highlighting the potential health benefits of colostrum consumption.
Metabolomics Characterization of Chemical Composition and Bioactivity of Highland Barley Monascus Tea Decoction Before and After Simulated Digestion In Vitro
Authors: Wu Haiyu , Dang Bin , Zhang Wengang , Zhang Jie , Zheng Wancai , Hao Jing , Ma Ping , Yang Xijuan
Published: December 2024

A broadly targeted metabolomics approach based on UPLC-MS/MS was employed to investigate the changes in chemical composition and in vitro activity of highland barley Monascus tea decoction before and after simulated digestion. The characteristic metabolites of the tea decoction before and after in vitro-simulated digestion were identified, and the in vitro antioxidant and enzyme inhibitory activities of the tea decoction were further analyzed. The study detected 1431 metabolites, including amino acids and their derivatives, alkaloids, organic acids, nucleotides and their derivatives, lipids, terpenoids, and phenolic acids. A total of 136 differential compounds were identified, primarily distributed in amino acids and their derivatives, alkaloids, organic acids, phenolics, and lipids. in vitro-simulated digestion significantly increased the content of amino acids, alkaloids, lipids, and phenolics in the tea. The differential metabolic compounds were primarily assigned to 20 metabolic pathways, mainly involving the metabolism of amino acids, nucleotides, carbohydrates, fatty acids, and other compounds. Additionally, after simulated digestion in vitro, the comprehensive antioxidant index (60.53%), α-glucosidase inhibitory activity (54.35%), and pancreatic lipase inhibitory activity (4.06%) was significantly improved. The highland barley Monascus tea decoction showed potential hypoglycemic and hypolipidemic efficacy. This study can provide a theoretical basis for the high-value utilization of highland barley and the development of healthy grain tea.
Generalizing the Classical Remainder Theorem: A Reflection-Based Methodological Strategy
Authors: Cruz Rambaud Salvador
Published: December 2024

The framework of this paper is the presentation of a case study in which university students are required to extend a particular problem of division of polynomials in one variable over the field of real numbers (as generalizing action) clearly influenced by prior strategies (as reflection generalization). Specifically, the objective of this paper is to present a methodology for generalizing the classical Remainder Theorem to the case in which the divisor is a product of binomials (x−a1)n1(x−a2)n2⋯(x−ak)nk, where a1,a2,⋯,ak∈R and n1,n2,⋯,nk∈N. A first approach to this issue is the Taylor expansion of the dividend P(x) at a point a, which clearly shows the quotient and the remainder of the division of P(x) by (x−a)k, where the degree of P(x), say n, must be greater than or equal to k. The methodology used in this paper is the proof by induction which allows to obtain recurrence relations different from those obtained by other scholars dealing with the generalization of the classical Remainder Theorem.
Generalized Dimensions of Self-Affine Sets with Overlaps
Authors: Ma Guanzhong , Luo Jun , Zhou Xiao
Published: December 2024

Two decades ago, Ngai and Wang introduced a well-known finite type condition (FTC) on the self-similar iterated function system (IFS) with overlaps and used it to calculate the Hausdorff dimension of self-similar sets. In this paper, inspired by Ngai and Wang’s idea, we define a new FTC on self-affine IFS and obtain an analogous formula on the generalized dimensions of self-affine sets. The generalized dimensions raised by He and Lau are used to estimate the Hausdorff dimension of self-affine sets.
Genetic Analysis of the Peach SnRK1β3 Subunit and Its Function in Transgenic Tomato Plants
Authors: Zhao Shilong , Wu Xuelian , Liang Jiahui , Wang Zhe , Fan Shihao , Du Hao , Yu Haixiang , Xiao Yuansong , Peng Futian
Published: December 2024

Background/Objectives: The sucrose non-fermentation-related kinase 1 (SnRK1) protein complex in plants plays an important role in energy metabolism, anabolism, growth, and stress resistance. SnRK1 is a heterotrimeric complex. The SnRK1 complex is mainly composed of α, β, βγ, and γ subunits. Studies on plant SnRK1 have primarily focused on the functional α subunit, with the β regulatory subunit remaining relatively unexplored. The present study aimed to elucidate the evolutionary relationship, structural prediction, and interaction with the core α subunit of peach SnRK1β3 (PpSnRK1) subunit. Methods: Bioinformatics analysis of PpSnRK1 was performed through software and website. We produced transgenic tomato plants overexpressing PpSnRK1 (OEPpSnRK1). Transcriptome analysis was performed on OEPpSnRK1 tomatoes. We mainly tested the growth index and drought resistance of transgenic tomato plants. Results: The results showed that PpSnRK1 has a 354 bp encoded protein sequence (cds), which is mainly located in the nucleus and cell membrane. Phylogenetic tree analysis showed that PpSnRK1β3 has similar domains to other woody plants. Transcriptome analysis of OEPpSnRK1β3 showed that PpSnRK1β3 is widely involved in biosynthetic and metabolic processes. Functional analyses of these transgenic plants revealed prolonged growth periods, enhanced growth potential, improved photosynthetic activity, and superior drought stress tolerance. Conclusions: The study findings provide insight into the function of the PpSnRK1 subunit and its potential role in regulating plant growth and drought responses. This comprehensive analysis of PpSnRK1 will contribute to further enhancing our understanding of the plant SnRK1 protein complex.
Application of Aerial Photographs and Coastal Field Data to Understand Sea Turtle Landing and Spawning Behavior at Kili-Kili Beach, Indonesia
Authors: Darmawan Arief , Takewaka Satoshi
Published: December 2024

We investigated sea turtle landing and spawning behavior along 1.4 km of Kili-Kili Beach in East Java, Indonesia, by combining aerial photographs and field survey data. In the study, we surveyed marks of sea turtles landing and spawning on the beach and utilized aerial photographs, beach profile survey records, grain size measurements of the beach material, and tide records to understand the behavior of the turtles. Firstly, aerial photographs are processed into ortho-mosaics, and beach surfaces are classified into land cover categories. Then, we calculate the number of spawning and non-spawning instances for each category, visualizing landing positions to identify local concentrations. Spawning distances from the waterline are estimated, and beach stability is evaluated by analyzing the temporal elevation change through standard deviation. Our findings reveal preferred spawning locations on bare sand surfaces, around 8 to 45 m from the waterline, with beach elevations ranging from 1 to 5 m. The standard deviations of beach elevation were between 0.0 and 0.7 m, with a mean slope of 0.07. This information is important for effectively conserving sandy beaches that serve as spawning sites for sea turtles.
The Mobility of Major and Trace Elements in EOC Minerals on Parent Chondrite Bodies
Authors: Sukhanova Kristina , Skublov Sergey
Published: December 2024

The combined EPMA and SIMS study of the geochemical features of olivine, low-Ca pyroxene and plagioclase in equilibrated ordinary chondrites (EOCs) has revealed the effect of thermal metamorphism on trace element concentrations in EOC silicate minerals. In ordinary chondrites of petrological type 6, trace element composition is homogenized in olivine (Zr, Al, Ti, Ca, Cr, Sr and Ba) and low-Ca pyroxene (Zr, Hf, Y, Ti, Ca, Cr, Sr, Ba and Rb). Trace element concentrations in silicate minerals of petrological types 4 and 5 remain unequilibrated. Although variations in trace element concentrations have decreased, their concentrations in EOC minerals remain unchanged with an increase in the grade of thermal metamorphism. Plagioclase in equilibrated ordinary chondrites displays a consecutive decrease in trace element concentrations with a rise in the peak temperature of thermal metamorphism measured with an olivine-Cr spinel geothermometer. Chondrites of petrological type 4 show a metamorphic temperature of 670–682 °C, and meteorites of petrological type 5 reached equilibrium at a temperature of 687–700 °C. Chondrites of petrological type 6 show the highest metamorphic temperature of 734 °C. The temperatures are generally consistent with the concentric model of parent chondrite bodies.
Relevance of Preoperative Cognitive Impairment for Predicting Postoperative Delirium in Surgical Medicine: A Prospective Cohort Study
Authors: Moellmann Henriette Louise , Alhammadi Eman , Olbrich Philipp , Frohnhofen Helmut
Published: December 2024

Background: Post-operative delirium is a dreaded complication after surgery in older patients. The identification of risk factors for delirium and comprehensive geriatric assessment is an extensive part of recent research. However, the preoperative assessment of risk factors, such as impaired cognition, is frequently not standardized. Methods: A comprehensive preoperative assessment was performed in 421 surgical patients to investigate the impact of preoperative cognitive impairment (PCI) on the risk of delirium and to evaluate appropriate screening tools (Six-item screener (SIS) and clock-drawing test (CDT)). Results: Both screening tools showed a significantly increased risk of delirium with p < 0.001 (OR 12.5, 95% [6.42; 24.4]) in SIS and p = 0.042 (OR 2.02, 95%CI [1.02; 4.03]) in CDT for existing cognitive impairment. A higher level of care (p < 0.001) and statutory care (p < 0.001, OR 5.42, 95%CI [2.34; 12.6]) also proved to be significant risk factors. The ROC curves of the two tests show AUC values of 0.741 (SIS) and 0.630 (CDT). The COP values for the SIS are 4 points with a Youden index of 0.447; for the CDT, the COP is 2 (Youden index = 0.177). Conclusions: The recording of PCI should be a central component of the preoperative geriatric assessment. The tools used are simple yet effective and can be easily implemented in routine clinical practice. By reliably identifying patients at risk, the available resources can be personalized and used in a targeted approach.
Hemodynamic Effects of SGLT2 Inhibitors in Patients with and Without Diabetes Mellitus—A Narrative Review
Authors: Brata Roxana , Pascalau Andrei Vasile , Fratila Ovidiu , Paul Ioana , Muresan Mihaela Mirela , Camarasan Andreea , Ilias Tiberia
Published: December 2024

Background: The current review aims to present the beneficial effects of SGLT2 inhibitors (dapagliflozin and empagliflozin) on several hemodynamic parameters such as blood pressure, filtration pressure at the level of the glomerular capillaries, and the improvement of the preload and afterload of heart muscle. In order to stop chronic kidney disease (CKD) from progressing, SGLT2 inhibitors have become an important disease-modifying treatment. Materials and methods: Recent clinical studies have shown the success of these drugs in treating heart failure, reducing the risk of cardiovascular events, hospitalization, and mortality. Results: The hemodynamic effects of SGLT2 inhibitors include a diuretic effect, due to reduced sodium reabsorption. Also, at this level, numerous studies have confirmed the beneficial effect of dapagliflozin in patients with chronic kidney disease, associated with a 44% reduced risk of progression in this pathology. SGLT2 inhibitors are associated with a reduction in blood pressure and weight loss, because of their diuretic effect, especially empagliflozin, which can explain the beneficial effects in patients with heart failure. In addition, mainly empagliflozin reduces stiffness and arterial resistance. Conclusions: Although the exact mechanism of action is unknown, SGLT2 inhibitors reduce the interstitial volume by blocking the tubular reabsorption of glucose. This leads to reduced blood pressure and enhanced endothelial function. Consequently, there have been improvements in hospitalization and fatality rates. Because of their beneficial effects, these medications have been guidelines for managing heart failure and chronic kidney disease.
Regarding the Pain of Others? Contradictions Between Public Discourse and the Lived Experience of Pain
Authors: Cerrillo-Vidal José A. , García-Rodríguez Mª Isabel , Serrano-del-Rosal Rafael
Published: December 2024

Background/Objectives: Pain is a complex and subjective experience influenced by psychological, cultural, and social factors. This study aims to investigate how social perceptions of pain affect the lived experiences and coping mechanisms of individuals suffering from pain. By comparing public discourse with the experiences of sufferers, we explore whether the social legitimacy of pain influences how it is managed. Methods: A multi-phase qualitative study was conducted, comprising eight focus groups with members of the Spanish general population and 19 in-depth interviews with individuals suffering from various types of pain. The focus groups explored social perceptions of pain’s legitimacy, while the interviews delved into the sufferers’ personal experiences. The data were analyzed using thematic analysis to identify patterns and disparities between public discourse and individual narratives. Results: The focus groups revealed widespread social empathy towards all types of pain. However, interviewees reported significant social pressure to normalize their behavior and downplay their pain. Many felt misunderstood, unsupported, and stigmatized, especially in environments where they held subordinate roles, such as the workplace or healthcare settings. Sufferers often resorted to silence or isolation to avoid judgment. Conclusions: While Spanish society outwardly legitimizes all forms of pain, sufferers experience significant discrepancies between public empathy and actual social support. The findings suggest that raising awareness alone is insufficient, and that structural changes are needed to address the daily burdens that individuals face when coping with pain, particularly in workplace and healthcare environments.
The Major Domains of Comprehensive Assessment Tools for Older Adults Requiring Home-Based Aged Care Services: A Systematic Review
Authors: Fang Weiwei , Phung Hai , Olley Richard , Lee Patricia
Published: December 2024

Background/Objectives: The global population is aging rapidly, increasing the need for appropriate health care. Older people often prefer to remain in their homes for as long as possible as they age. Therefore, it is crucial to assess their overall health and understand the individualized care needs for developing tailored home care services. This systematic review aims to examine the major domains of a range of assessment tools used for older people receiving home care services. Methods: A systematic search of Medline and PsycINFO via Ovid, CINAHL via EBSCO, Web of Science, and Scopus was conducted to identify studies investigating assessment of older people requiring home care services. The literature findings were systematically synthesized and classified using the International Classification of Functioning, Disability and Health (ICF) by the World Health Organization (WHO). Results: A total of 32 studies were included in the systematic review. Three primary categories were identified based on the WHO ICF classification system: (1) body functions, (2) activities and participation, and (3) environmental factors. Body functions included physical functions and mental functions. Mobility, self-care, and domestic life were three major aspects within the ICF category of activities and participation. Regarding the environmental factors, support, relationships, and services provided to older people were commonly considered in the included studies. Among them, the most assessed domains were physical, psychological, cognitive, functional, and nutritional assessment. Conclusions: The synthesis of findings in this review reveals major domains in various assessment tools, contributing to the development of a comprehensive framework to guide the assessment for older people requiring home care services.
Prevalence of Internet Gaming Disorder, Depression, and Anxiety Symptoms Before and After the Pandemic
Authors: Bailey Kira , Propp Audrey , Alonso Maria
Published: December 2024

“Internet gaming disorder” (IGD) is a condition for further study in the DSM-5, with its prevalence estimated to be anywhere from 0.7% to 27.5% depending on the methodology used to measure it. Previous research has linked the symptoms of IGD to symptoms of depression and anxiety among college students. Methods: The current study explored the relationships between self-reported symptoms of IGD, depression, and anxiety in two small, non-overlapping samples of college students, one collected before the pandemic (n = 52) and another during the global pandemic (n = 89). Data on the time spent gaming, IGD, depression, and anxiety symptoms were collected via anonymous online surveys at a small Mid-Western liberal arts university. The samples differed significantly in age, likely due to the smaller incoming first-year class size as a result of many families deciding to defer the start of college in 2020. Conclusions: These findings partially support past research suggesting a small to moderate association between self-reports of IGD and depression symptoms. While the pandemic does not appear to have greatly changed the overall number of self-reported symptoms experienced or the time spent playing video games between the two samples, it may have exacerbated the relationship between these variables within the sample. The stronger relationship between symptoms of depression or anxiety and the time spent playing video games in the later sample may be particularly concerning if the trend continues, as it may lead to additional problematic gaming behavior in the future.
Vulnerability: An Interpretive Descriptive Study of Personal Support Workers’ Experiences of Working During the COVID-19 Pandemic in Ontario, Canada
Authors: Panda Upasana , Lanoix Monique , Gewurtz Rebecca , Moll Sandra , Durocher Evelyne
Published: December 2024

Background/Objectives: Personal support workers (PSWs) are important healthcare workers providing essential services to thousands of Canadians. PSWs face many challenges that were exacerbated in the context of the COVID-19 pandemic. In this study we explore experiences of PSWs working through the pandemic in Ontario long-term care (LTC) homes by focusing on the vulnerability of such workers. Methods: An interpretive description approach was adopted. Eleven PSWs working in LTC homes in an urban center in Ontario participated in semi-structured interviews between January and May 2022. Thematic analysis of the transcripts was informed by concepts of vulnerability. Results: The results suggest that PSWs experienced inherent, situational, and pathogenic vulnerability. Inherent vulnerability was experienced in relation to risks of contracting the coronavirus working in person with residents, and of experiencing physical and psychological distress in relation to challenging interactions with staff, residents and their superiors. Situational vulnerability was experienced in relation to demanding workloads, which were intensified in the context of the pandemic. Participants expressed feeling undervalued, unappreciated, and disrespected, reflecting experiences of pathogenic vulnerability. The narratives shared by PSWs highlighted how the COVID-19 pandemic added new, and magnified pre-existing, challenges and vulnerability, affecting their health and well-being. Conclusions: Understanding risks faced by PSWs in LTC settings is crucial for developing targeted interventions and policies to support PSWs’ health and well-being, mitigate factors that contribute to their vulnerability and promote the long-term sustainability of this caregiving workforce, ultimately enhancing the quality of care provided to residents in LTC facilities.
Current Progress in the Development of mRNA Vaccines Against Bacterial Infections
Authors: Khlebnikova Alina , Kirshina Anna , Zakharova Natalia , Ivanov Roman , Reshetnikov Vasiliy
Published: December 2024

Bacterial infections have accompanied humanity for centuries. The discovery of the first antibiotics and the subsequent golden era of their discovery temporarily shifted the balance in this confrontation to the side of humans. Nevertheless, the excessive and improper use of antibacterial drugs and the evolution of bacteria has gotten the better of humans again. Therefore, today, the search for new antibacterial drugs or the development of alternative approaches to the prevention and treatment of bacterial infections is relevant and topical again. Vaccination is one of the most effective strategies for the prevention of bacterial infections. The success of new-generation vaccines, such as mRNA vaccines, in the fight against viral infections has prompted many researchers to design mRNA vaccines against bacterial infections. Nevertheless, the biology of bacteria and their interactions with the host’s immunity are much more complex compared to viruses. In this review, we discuss structural features and key mechanisms of evasion of an immune response for nine species of bacterial pathogens against which mRNA vaccines have been developed and tested in animals. We focus on the results of experiments involving the application of mRNA vaccines against various bacterial pathogens in animal models and discuss possible options for improving the vaccines’ effectiveness. This is one of the first comprehensive reviews of the use of mRNA vaccines against bacterial infections in vivo to improve our knowledge.
An Optimised CNN Hardware Accelerator Applicable to IoT End Nodes for Disruptive Healthcare
Authors: Ghani Arfan , Aina Akinyemi , Hwang See Chan
Published: December 2024

In the evolving landscape of computer vision, the integration of machine learning algorithms with cutting-edge hardware platforms is increasingly pivotal, especially in the context of disruptive healthcare systems. This study introduces an optimized implementation of a Convolutional Neural Network (CNN) on the Basys3 FPGA, designed specifically for accelerating the classification of cytotoxicity in human kidney cells. Addressing the challenges posed by constrained dataset sizes, compute-intensive AI algorithms, and hardware limitations, the approach presented in this paper leverages efficient image augmentation and pre-processing techniques to enhance both prediction accuracy and the training efficiency. The CNN, quantized to 8-bit precision and tailored for the FPGA’s resource constraints, significantly accelerates training by a factor of three while consuming only 1.33% of the power compared to a traditional software-based CNN running on an NVIDIA K80 GPU. The network architecture, composed of seven layers with excessive hyperparameters, processes downscale grayscale images, achieving notable gains in speed and energy efficiency. A cornerstone of our methodology is the emphasis on parallel processing, data type optimization, and reduced logic space usage through 8-bit integer operations. We conducted extensive image pre-processing, including histogram equalization and artefact removal, to maximize feature extraction from the augmented dataset. Achieving an accuracy of approximately 91% on unseen images, this FPGA-implemented CNN demonstrates the potential for rapid, low-power medical diagnostics within a broader IoT ecosystem where data could be assessed online. This work underscores the feasibility of deploying resource-efficient AI models in environments where traditional high-performance computing resources are unavailable, typically in healthcare settings, paving the way for and contributing to advanced computer vision techniques in embedded systems.
Cognitive Impairment in Cerebral Amyloid Angiopathy: A Single-Center Prospective Cohort Study
Authors: Theodorou Aikaterini , Athanasaki Athanasia , Melanis Konstantinos , Pachi Ioanna , Sterpi Angeliki , Koropouli Eleftheria , Bakola Eleni , Chondrogianni Maria , Stefanou Maria-Ioanna , Vasilopoulos Efthimios , Kouzoupis Anastasios , Paraskevas Georgios P. , Tsivgoulis Georgios , Tzavellas Elias
Published: December 2024

Background/Objectives: Cognitive impairment represents a core and prodromal clinical feature of cerebral amyloid angiopathy (CAA). We sought to assess specific cognitive domains which are mainly affected among patients with CAA and to investigate probable associations with neuroimaging markers and Cerebrospinal Fluid (CSF) biomarkers. Methods: Thirty-five patients fulfilling the Boston Criteria v1.5 or v2.0 for the diagnosis of probable/possible CAA were enrolled in this prospective cohort study. Brain Magnetic Resonance Imaging and CSF biomarker data were collected. Every eligible participant underwent a comprehensive neurocognitive assessment. Spearman’s rank correlation tests were used to identify possible relationships between the Addenbrooke’s Cognitive Examination—Revised (ACE-R) sub-scores and other neurocognitive test scores and the CSF biomarker and neuroimaging parameters among CAA patients. Moreover, linear regression analyses were used to investigate the effects of CSF biomarkers on the ACE-R total score and Mini-Mental State Examination (MMSE) score, based on the outcomes of univariate analyses. Results: Cognitive impairment was detected in 80% of patients, and 60% had a coexistent Alzheimer’s disease (AD) pathology based on CSF biomarker profiles. Notable correlations were identified between increased levels of total tau (t-tau) and phosphorylated tau (p-tau) and diminished performance in terms of overall cognitive function, especially memory. In contrast, neuroimaging indicators, including lobar cerebral microbleeds and superficial siderosis, had no significant associations with cognitive scores. Among the CAA patients, those without AD had superior neurocognitive test performance, with significant differences observed in their ACE-R total scores and memory sub-scores. Conclusions: The significance of tauopathy in cognitive impairment associated with CAA may be greater than previously imagined, underscoring the necessity for additional exploration of the non-hemorrhagic facets of the disease and new neuroimaging markers.
Navigating the Rare and Dangerous: Successful Clipping of a Superior Cerebellar Artery Aneurysm Against the Odds of Uncontrolled Hypertension
Authors: Toader Corneliu , Serban Matei , Covache-Busuioc Razvan-Adrian , Radoi Mugurel Petrinel , Aljboor Ghaith Saleh Radi , Glavan Luca-Andrei , Corlatescu Antonio Daniel , Ilie Milena-Monica , Gorgan Radu M.
Published: December 2024

Background/Objectives: Superior cerebellar artery (SCA) aneurysms are exceedingly rare, posing unique diagnostic and management challenges due to their complex anatomical location within the posterior circulation. The proximity of the SCA to vital structures, such as the brainstem and cerebellum, along with the significant role of poorly controlled hypertension in aneurysm formation, further complicates treatment. This case aims to highlight the surgical approach and management strategies employed in treating a rare SCA aneurysm in a patient with longstanding hypertension. Methods: A 68-year-old female presented with an acute onset of severe headache, nausea, and vomiting, later confirmed to be due to a ruptured SCA aneurysm. The patient’s history of poorly controlled hypertension was identified as a major contributing factor to the aneurysm’s development and rupture. Due to the aneurysm’s wide-neck morphology and irregular shape, microsurgical clipping was selected as the treatment method. The occipito-parietal far-lateral approach was employed to gain optimal access to the aneurysm, minimizing the risk to adjacent neurovascular structures. Results: Microsurgical clipping successfully excluded the aneurysm while preserving the parent artery. The surgical approach enabled precise aneurysm isolation and ensured no postoperative neurological deficits. The patient recovered well, with no significant complications, and hypertension management was emphasized as a vital element of the patient’s long-term care. Conclusions: The surgical technique effectively achieved complete aneurysm exclusion with preservation of the parent artery and no associated neurological deficits. The patient’s recovery was uneventful, highlighting the efficacy of the approach. Long-term management of hypertension remains a critical component to prevent recurrence and ensure sustained outcomes.
Management of Acute Ischemic Stroke Following Transcatheter Aortic Valve Implantation: A Systematic Review and Multidisciplinary Treatment Recommendations
Authors: Hammond-Haley Matthew , Almohtadi Ahmad , Gonnah Ahmed R , Raha Oishik , Khokhar Arif , Hartley Adam , Khawaja Saud , Hadjiloizou Nearchos , Ruparelia Neil , Mikhail Ghada , Malik Iqbal , Banerjee Soma , Kwan Joseph
Published: December 2024

Background/Objectives: Acute ischemic stroke is an uncommon but potentially devastating complication of Transcatheter Aortic Valve Implantation (TAVI). Despite improvements in device technology and procedural techniques, stroke rates have remained stable, with cerebral embolic protection devices demonstrating only limited efficacy to date. Therefore, the management of acute ischemic stroke complicating TAVI (AISCT) remains a key priority. We conducted a systematic review of the management of AISCT and provided multidisciplinary consensus recommendations for optimal management. Methods: PubMed, Google Scholar, and Cochrane databases were searched from inception to October 2023. All the original studies focusing on the treatment of AISCT were included. Non-English language studies, review articles, and studies in pediatric populations were excluded. Consensus recommendations were made by a working group comprising experts in stroke medicine and structural interventional cardiology. Results: A total of 18 studies met the inclusion criteria, including 14 case reports/series and 4 observational studies. No clinical trials were identified. The included case reports and series suggest that tissue-type plasminogen activator (tPA) and mechanical thrombectomy (MT) might be effective strategies for managing AISCT. However, significant bleeding complications were reported in two out of the four patients receiving tPA. Four observational studies also suggest an association between tPA and/or MT and improved functional outcomes and survival compared to conservative management. Higher bleeding rates were reported following tPA. Observational data suggest that there is currently little real-world utilization of either reperfusion strategy. Conclusions: There is an absence of high-quality randomized data to guide clinical decision making in this important area. Observational data suggest reperfusion strategies are associated with improved clinical outcomes once important confounders such as stroke severity have been accounted for. While MT can be recommended as the standard of care in appropriately selected patients, significantly increased rates of bleeding with tPA following large-bore arterial access raise important safety concerns. We present simple clinical guidance for AISCT based on the limited available data. Close multidisciplinary work and patient-specific consideration of ischemic and bleeding risk is essential.
Risk Factors of Marginal Cord Insertion in Singleton Pregnancies: A Systematic Review and Meta-Analysis
Authors: Siargkas Antonios , Tsakiridis Ioannis , Gatsis Athanasios , De Paco Matallana Catalina , Gil Maria Mar , Chaveeva Petya , Dagklis Themistoklis
Published: December 2024

Background: Marginal cord insertion (MCI) is increasingly recognized as a pathological variation that necessitates early diagnosis. Identifying the risk factors associated with MCI is essential for improving prenatal screening and optimizing management strategies. Our meta-analysis systematically and quantitatively synthesizes the current evidence on various potential risk factors for MCI. Methods: This systematic review and meta-analysis adhered to the PRISMA and MOOSE guidelines. Comprehensive searches were performed in three databases up until 6 May 2024, identifying observational cohort and case–control studies that examined risk factors for MCI in singleton pregnancies compared with central or eccentric cord insertion. Quality and risk of bias assessment were performed using the Newcastle–Ottawa Scale and the Quality In Prognosis Studies tool, respectively. Statistical analyses employed random-effects models to calculate relative risks (RR) and mean differences with their 95% confidence intervals (95% CI). Heterogeneity was assessed via Cochran’s Q and I2 statistics. Results: A total of 18 studies (14 cohort and 4 case–control), encompassing 51,463 MCI cases and 901,020 control cases, were included. The meta-analysis revealed a prevalence of MCI at 5.71% among singleton pregnancies. Significant risk factors for MCI included the use of assisted reproductive technology (RR = 1.55; 95% CI: 1.34–1.78), chronic hypertension (RR = 1.47; 95% CI: 1.11–1.95), placenta previa (RR = 1.83; 95% CI: 1.62–2.08), and nulliparity (RR = 1.18; 95% CI: 1.08–1.30). No significant associations were found for smoking, maternal age, prior Cesarean section, preexisting diabetes, or Caucasian ethnicity. Sensitivity analyses corroborated the robustness of these findings. Conclusions: This meta-analysis identified assisted reproductive technology, chronic hypertension, placenta previa, and nulliparity as significant risk factors for marginal cord insertion in singleton pregnancies. These findings can inform the development of prenatal screening protocols and enable targeted screenings for high-risk populations.
Comparative Efficacy of Glucosamine-Based Combination Therapies in Alleviating Knee Osteoarthritis Pain: A Systematic Review and Network Meta-Analysis
Authors: Sumsuzzman Dewan Md. , Khan Zeeshan Ahmad , Jung Jin Ho , Hong Yunkyung , Yang Won Jong , Park Kanghui , Choi Hong Jin , Jeong Ok Chan , Kim Sang Jin , Hong Yonggeun
Published: December 2024

Background: The lack of definitive scientific evidence sustains uncertainty about the efficacy of glucosamine and its combination therapies for knee osteoarthritis (KOA), contributing to an ongoing debate among clinical practice guidelines and healthcare practitioners. This systematic review and network meta-analysis (NMA) aimed to identify the most effective glucosamine combination therapy for KOA patients. Methods: Frequentist random-effects models were employed for this NMA, with standardized mean differences (SMDs) and 95% confidence intervals (CIs) calculated for primary outcomes. We incorporated an SMD value of 0.40 as a minimum clinically important difference (MCID) to interpret the pain outcome. Confidence in evidence was evaluated using CINeMA. Results: Thirty randomized controlled trials (RCTs) covering 5265 patients were included. Glucosamine with omega-3 (G + omega-3, SMD –2.59 [95% CI –4.42 to –0.75], moderate quality) and glucosamine with ibuprofen (G + ibuprofen, SMD –2.27 [95% CI –3.73 to –0.82], moderate quality) significantly reduced overall pain compared to placebo. Similarly, glucosamine + chondroitin sulfate + methylsulfonylmethane showed effectiveness in pain reduction (SMD –2.25 [95% CI –3.84 to –0.67], low-quality). None of the other interventions met the MCID threshold for overall pain reduction. Moreover, clustered ranking results showed that glucosamine with omega-3 interventions was more effective than others in reducing overall pain and adverse events. Conclusions: For KOA, combining glucosamine with omega-3 and ibuprofen effectively reduces pain and may lower NSAID side effects, improving treatment guidelines and decision-making for better patient care.
Assessing the Efficacy of 18F FDG PET-CT in Preoperative Staging of Early-Stage Cervical Cancer in Novi Sad, Serbia—A Pilot Study
Authors: Malenković Goran , Malenković Jelena , Tomić Sanja , Šljivo Armin , Tomić Slobodan
Published: December 2024

Background and Objectives: This study primarily aims to evaluate the preoperative staging effectiveness of PET-CT in early-stage cervical cancer, particularly, its ability to detect primary tumors and micrometastases. Materials and Methods: In this retrospective study, cervical cancer patients who had undergone preoperative 18F FDG PET-CT scans and were treated at the Department of Gynecology, Institute of Oncology, Vojvodina, in Sremska Kamenica, during the period from 2016 to 2020 were analyzed. Results: The study included 62 patients (mean age, 49.3 ± 9.6 years). Squamous cell carcinoma was the predominant histological type (95.2%), with G2 differentiation (82.3%) and FIGO stage Ib1 (80.6%) being the most common. Assessed by 18F FDG PET-CT, the mean tumor size was 26.4 ± 10.8 mm, which is slightly lower than the 26.9 mm measured during clinical examination (p = 0.784), with a significant (r = 0.678, p < 0.001) correlation between these methods. 18F FDG PET-CT demonstrated an overall accuracy of 88.7% for identifying primary tumors, with a sensitivity of 86.8%, specificity of 100.0%, PPV of 100.0%, and NPV of 56.2%. An intraoperative examination showed identical overall accuracy but higher sensitivity (98.1%) and lower specificity (33.3%). For 18F FDG PET-CT, the level of agreement with the histopathological examination was good (Kappa 0.656), while for the intraoperative examination, it was moderate (Kappa 0.409). Regarding the lymph node assessment, 18F FDG PET-CT’s accuracy was 82.2%, with a sensitivity of 53.8% and a specificity of 89.8%. The intraoperative examination showed lower accuracy (66.1%) but higher sensitivity (76.9%). The 18F FDG PET-CT Kappa value indicated moderate agreement (0.449), while the intraoperative examination showed poor agreement (0.282). Conclusions: In conclusion, significant effectiveness is shown by 18F FDG PET-CT for preoperative staging of early-stage cervical cancer, offering superior accuracy in detecting primary tumors and micrometastases, particularly in predicting lymph node metastases, thereby enhancing diagnostic accuracy and informing treatment decisions.
Effect of Pilates on Pain and Health-Related Quality of Life in Fibromyalgia Patients: A Systematic Review and Meta-Analysis
Authors: Nithuthorn Chalisa , Chaipichit Natapohn , Jeeraaumponwat Thammasorn , Maiprasert Mart , Dilokthornsakul Piyameth
Published: December 2024

Background: Pilates is one of the non-pharmacological interventions for fibromyalgia (FM). However, its impacts on pain and health-related quality of life (HRQOL) in fibromyalgia patients (FMPs) are inconclusive. This study aimed to assess the effects of Pilates on pain and HRQOL among FMPs. Methods: A systematic review and meta-analysis were conducted. Four databases—PubMed, ScienceDirect, Scopus, and Cochrane CENTRAL—along with one grey literature source, Google Scholar, were searched for randomized controlled trials comparing Pilates with other exercises or usual care in FMPs. The outcomes were pain and HRQOL. A meta-analysis was performed using a random-effects model. Results: Six studies were included (n = 265). We found that the effects of Pilates from each individual study on pain were inconsistent. Our pooled analysis of visual analog scale (VAS) scores demonstrated significant pain reduction (mean difference (MD), −0.71, 95%CI, −1.33 to −0.10, p = 0.023; (I2 = 29.3%, p = 0.226)). However, neither the algometric score (AS) nor tender point count (TPC) showed an insignificant difference (AS: MD, −0.43, 95%CI, −2.60 to 1.74, p = 0.700; (I2 = 0.0%, p = 0.654); TPC: MD, −0.16, 95%CI, −2.22 to 1.89, p = 0.520; (I2 = 0.0%, p = 0.515)). Regarding HRQOL, Pilates showed statistically significant improvements on the Fibromyalgia Impact Questionnaire (FIQ) (MD, −7.28, 95%CI, (−12.06 to −2.49), p = 0.003; (I2 = 95.7%, p < 0.001)). A sensitivity analysis of three RCTs (n = 176) based on the ACR 2010 supported this finding (MD, −7.68, 95% CI, −8.60 to −6.76, p < 0.001; (I2 = 0.0%, p = 0.832)) with non-important heterogeneity. Conclusions: Pilates may benefit FMPs. It could reduce pain and improve HRQOL. Given the small number of studies and the presence of data heterogeneity, future high-quality RCTs would provide a clearer conclusion.
Nanoparticle-Based Approaches in the Diagnosis and Treatment of Brain Tumors
Authors: Pourmasoumi Parvin , Banihashemian Seyed Abdolvahab , Zamani Farshid , Rasouli-Nia Aghdass , Mehrabani Davood , Karimi-Busheri Feridoun
Published: December 2024

Glioblastomas are highly invasive brain tumors among perilous diseases. They are characterized by their fast proliferation and delayed detection that render them a significant focal point for medical research endeavors within the realm of cancer. Among glioblastomas, Glioblastoma multiforme (GBM) is the most aggressive and prevalent malignant brain tumor. For this, nanomaterials such as metallic and lipid nanoparticles and quantum dots have been acknowledged as efficient carriers. These nano-materials traverse the blood–brain barrier (BBB) and integrate and reach the necessary regions for neuro-oncology imaging and treatment purposes. This paper provides a thorough analysis on nanoparticles used in the diagnosis and treatment of brain tumors, especially for GBM.
A 10 V-to-1 V Double Step-Down Buck Converter Using Time-Based Current Mode Control with Minimum Delay Frequency Difference Phase Adder for 1 MHz Operation
Authors: Tan Chong Boon , Siek Liter
Published: December 2024

An extreme step-down ratio buck converter is proposed using a double step-down (DSD) buck converter architecture and a single time-based current mode PWM controller able to generate two non-overlapping control signal phases. Current sampling for two inductors is implemented with a multiplexer and a pair of VCOs only, which treats the two inductors as one inductor operating at double the frequency. This is achieved without the use of any large external passive components in the controller while remaining stable. The type-II time-based controller uses a VCO, a frequency difference phase adder (FDPA), and a phase detector, generating a control signal with fully integrated components with minimum area. FDPA for proportional control also significantly limits the signal delay of the high gain controller, allowing the use of time-based control technique at <10 MHz, which improves converter efficiency. The proposed time-based current mode controller DSD buck converter is simulated in 130 nm BCD technology operating at 1 MHz for 10 V to 1 V conversion. The simulated peak efficiency is 82.2% at 0.4 A, and recovers from a 1.8 A loading and unloading current step in 5.75 μs and 9.9 μs, respectively.