bluuebunny/crossref_metadata_2025 huggingface dataset:
Preclinical Pharmacokinetics studies of SPH5030, a Novel, Selective, Potent, and Irreversible HER2 Inhibitor
Authors: Gong Xuelian , Xia Guangxin
Published: October 2024

SPH5030 is developed to improve the selectivity of irreversible HER2 inhibitors, which shows excellent activity and better HER2 selectivity against four common HER2 mutants than neratinib and pyrotinib, and consumed to attenuate the off-target adverse events in patients. To comprehensively evaluate SPH5030, the preclinical pharmacokinetic studies of SPH5030 were systematically completed, including in vivo pharmacokinetic, tissue distribution and excretion in Sprague Dawley rats and Cynomolgus monkeys, as well as in vitro drug-drug interaction assessment and metabolite identification in different species. The results showed low clearance, reasonable bioavailability and widely tissues distributed properties, and mainly excreted in the feces in rats. In vitro studies SPH5030 showed stable metabolism and metabolized mainly by CYP3A4/5 and CYP2C8, with no or weak inhibitory potential on CYP450 enzymes and efflux transporters. In Phase I clinical trials, SPH5030 also showed well tolerated at doses ranging from 50 to 600mg and is expected to have an ideal clinical application prospect in the future.
Inhibition of Aβ Aggregation by Cholesterol-End-Modified PEGs Vesicle and Micelle
Authors: Watanabe Shota , Ueda Motoki , Asayama Shoichiro
Published: October 2024

We evaluated the inhibitory effects of our developed Chol-PEG2000 micelles and Chol-PEG500 vesicles on amyloid-β (Aβ) aggregation, a key factor in Alzheimer's disease. ThT assay proved that Chol-PEG2000 delayed Aβ fibril elongation by 17 hours and Chol-PEG500 by 40 hours at 10-times molar ratio against Aβ40 peptide. At 50-times molar ratio, both Chol-PEG2000 and Chol-PEG500 significantly inhibited Aβ aggregation, as shown by minimal fluorescence intensity increase over 48 hours.
Derechos humanos y justicia transicional
Authors: Vázquez Martínez Alejandro Ernesto
Published: October 2024

México, de manera semejante que otras latitudes geopolíticas de varios continentes, se encuentra en los procesos propios de la denominada Justicia Transicional. Hace poco más de una década que nuestro país se halla bajo una lógica de racionalidad militar. Sin embargo, la multiplicidad de sus conflictos no se reduce a esta, pero se integran otras dimensiones.
Geometric Modelling of a Family of 3-point Quaternary Subdivision Schemes Rζ
Authors: Rabia Younis  , Muhammad Javed Iqbal  , Soomro Inayatullah , Usama Gulzar
Published: October 2024

Computer-aided geometric design combines mathematical concepts and computing skills that smooth curves through subdivision schemes. Subdivision schemes perform smoothing by turning the control polygon into a limit curve under a refinement rule, a prime example of which is improving the signal-to-noise ratio in modern devices. Because of the importance and location of subdivision schemes, mathematicians use them in CAD, computer graphics and advanced simulation methods. In this research, a family of 3-point Quaternary approximating subdivision scheme $R_{\zeta}$ is presented with its properties and analysis, including necessary conditions for convergence, Laurent polynomial, degree of the generation and polynomial reproduction, continuity analysis, Hölder regularity, and limit stencils. The visual performance of the proposed scheme is also presented to highlight the importance of this research and to validate the scheme.
Comparative Analysis of Time Series Forecasting using ARIMA, and GRNNs Models: A Case Study of Death Rate of Diabetic Mellitus in Canada
Authors: Khan Muhammad Shahbaz , Hyder Talpur Mir Ghulam , Aslam Muhammad
Published: October 2024

This research aims to compare ARIMA and GRNN models alone. For this comparison the death rate for diabetes mellitus time series data of Canada is used. Autoregressive Integrated Moving Average (ARIMA), and Generalized Regression Neural Networks (GRNN) models were applied for time series prediction of the death rate for diabetes mellitus—trained data for two models from 2000 to 2015. Test data was used to compare the precision through data from 2016 to 2021. The ARIMA model was applied using the auto-command through R package which provided the least BIC and AIC values. The mean absolute deviation (MAD), root mean squared error (RMSE), and mean absolute percentage error (MAPE) were employed to measure the forecasting efficiency of the models. The ARIMA model had the highest prediction accuracy as compared to the GRNN model. ARIMA predicts the death rate for diabetes mellitus more accurately and robustly compared to the GRNNs model.
ISOTOPE COMPOSITION OF Pb AND Nd OF THE LATE NEOPROTEROZOIC–EARLY PALEOZOIC GRANITOIDS IN EASTERN TUVA (Case study of the Kaa-Khem Batholith)
Authors: Rudnev S.N. , Savatenkov V.M. , Vasilieva I.M.
Published: October 2024

We present the results of Nd and Pb isotope studies of late Neoproterozoic–early Paleozoic granitoids of the Kaa-Khem batholith, which formed in different geodynamic settings within the early Caledonian structures of Eastern Tuva (Altai–Sayan sialic area). Based on the obtained isotope data, we assess the role of different source materials in the formation of melts for these granitoids and compare these rocks with coeval granitoids from the Lake Zone of Mongolia. The plagiogranitoid associations of the island arc stage of the Kaa-Khem batholith formation (572–562 Ma) are characterized by mantle Nd isotope values. In contrast, the Pb isotope characteristics of these intrusive associations correspond to an upper-crust source formed predominantly by terrigenous sediments. The granitoid associations of the accretion–collision stage of the Kaa-Khem batholith formation (512–450 Ma) have a less radiogenic primary Pb isotope composition as compared with the island arc granitoids. Evidently, during the magma formation at this stage, the relative role of terrigenous material decreased, while the role of depleted mantle material increased. At the same time, the decrease in ɛNd values in the granitoids as compared with the depleted mantle indicates that, along with the upper-mantle component, the role of the lower-crust component increased. These Nd and Pb isotope characteristics of the accretionary granitoids of the Kaa-Khem batholith indicate a significant contribution of the lower-crust source to their formation. This source is the crystalline basement of the Tuva–Mongolian microcontinent. The Pb isotope characteristics of the accretion–collision granitoids of the Kaa-Khem batholith are shifted to the upper-crust compositions relative to those of the Lake Zone granitoids. The reason is that the latter formed predominantly through the transformation of early Caledonian island arc complexes, which were generated with a higher portion of mantle component.
It is all about location: the performance of urgent care centers by proximity to a general hospital
Authors: Saman Fadi Abu , Lerner-Geva Liat , Mor Zohar
Published: October 2024

Background: The gradual increase of referrals to the busy emergency departments (ED) raises concerns regarding the potential negative effect on the quality of medical treatment and level of patients' satisfaction. Urgent care centers (UCC) provide an alternative to the ED for non-life saving medical conditions.
This study aimed to compare the rate of admissions, reasons for referrals and patient’s satisfaction between UCC by distance from the nearest ED.
Methods: This cross-sectional study included all medical records of four UCCs between 2017 and 2020. Rates of admission, reasons for referrals, and patients' satisfaction were compared between UCCs that were close to ED and UCCs far from ED.
Results: The study included 216,903 patients in an average age 32.4 ±24.4 years. Most of the referrals were independent, with 37.7% of the referrals being on weekends. The average time for triage and time spent in UCC were approximately 5.3 minutes and 62.8 minutes, respectively.
The proportion of residents arriving at UCC in cities with ED was 14.4% with a level of satisfaction of 91.5%, compared with UCC in cities without ED which were 23.7% and 84.4%, respectively. UCC in northern Israel treated more patients with trauma/injury (33.0%) than UCC in southern Israel (28.2%).
Conclusions:UCCs in cities without ED receive higher volume of patients, while their level of satisfaction was lower. UCC provide an alternative to ED in non-lifesaving medical conditions.
Peskas: Automated analytics for small-scale, data-deficient fisheries
Authors: Longobardi Lorenzo , Altarturi Hamza , Cagua E. Fernando , Sozinho Villiam , Tilley Alexander
Published: October 2024

Small-scale fisheries account for almost 90 percent of global fisheries employment and are responsible for landing more than 40% of the world’s fish catch. Yet their importance to livelihoods and food and nutrition security in Least Developed Countries are only recently emerging due to the logistical, financial, and capacity challenges of gathering and interpreting data in this diverse, dispersed and informal sector. Peskas was designed as a low-cost solution to tackle this problem, providing a template workflow for ingestion and analysis to a decision dashboard, which can be adapted to different contexts and needs.
Statistical analysis plan for the ARtificially Intelligent image fusion system versus standard treatment to guide endovascular Aortic aneurysm repair (ARIA): a multi-centre randomised controlled trial
Authors: Wafa Hatem A , Budge James , Carrell Tom , Yaqub Medeah , Waltham Matt , Pilecka Izabela , Kelly Joanna , Murphy Caroline , Palmer Stephen , Clough Rachel E , Wang Yanzhong
Published: October 2024

Background: Aortic aneurysms, a significant cause of mortality, particularly in individuals aged 55 years and older, have witnessed a transformative shift in treatment strategies with the advent of endovascular surgery. Cydar-EV is an innovative image fusion technology that can augment preoperative planning and surgical guidance of endovascular aneurysm repair (EVAR). The ARIA trial aims to evaluate the efficacy of using Cydar-EV with EVAR procedures to reduce operating time while enhancing procedural precision, patient outcomes, and cost-effectiveness. This paper describes the statistical analysis plan for the study.
Methods/Design: The ARIA trial, a phase III, multi-centre, open-label, two-armed, parallel groups randomized controlled surgical trial, seeks to recruit 340 patients diagnosed with abdominal or thoraco-abdominal aortic aneurysms. Participants are randomly assigned to receive either standard endovascular repair or an endovascular repair assisted by Cydar-EV for planning and surgical guidance. Primary and secondary outcomes are assessed at baseline, 4-12 weeks, and 52 weeks. The primary outcome measure is procedure duration at baseline, while additional secondary outcomes are recorded at various time points and include indicators for technical effectiveness, patient outcomes, procedure efficiency and cost-effectiveness. We plan to analyse the patient outcome data according to the treatment they received regardless of initial allocation. The statistical analysis plan outlines methods for handling missing data, covariates for adjusted analyses, and planned sensitivity analyses to ensure robust evaluation of treatment effects.
Trial registration: The trial was registered with the ISRCTN register on 03/12/2021, number ISRCTN13832085.
Developing novel Lin28 inhibitors by computer aided drug design
Authors: Dong Xuesen , Barrios Victor , Radaeva Mariia , Rosellinny Graciella , Jia Qiongqiong , Xie Ning , Smith Jason , Gleave Martin , Lallous Nada , Cherkasov Artem , Ibrahim Hanadi , Villanueva Monica , Straus Suzana
Published: October 2024

Lin28 is a key regulator of the cancer stem cell gene network that promotes therapy-resistant tumor progression in various tumors. However, no Lin28 inhibitor has been approved to treat cancer patients, urging the exploration of novel compounds as candidates to be tested for clinical trials. In this contribution, we applied computer-aided drug design (CADD) in combination with quantitative biochemical and biological assays. These efforts led to the discovery of Ln268 as a drug candidate that can block Lin28 from binding to its RNA substrates and inhibit Lin28 activities. Ln268 suppressed Lin28-mediated cancer cell proliferation and spheroid growth. Results from nuclear magnetic resonance spectroscopy confirmed that Ln268 perturbs the conformation of the zinc knuckle domain of Lin28, validating the rational drug design by CADD. The inhibitory effects of Ln268 are dependent on Lin28 protein expression in cancer cells, highlighting limited off-target effects of Ln268. Moreover, Ln268 synergizes with several chemotherapy drugs to suppress tumor cell growth. In summary, Ln268 is a promising drug candidate to target Lin28, warranting further investigations for cancer therapy.
Single-stage versus two-stage resection for large anterior midline skull base meningiomas with bihemispheric peritumoral edema
Authors: Qasem Lina-Elisabeth , Al-Hilou Ali , Oros Jan , Weber Katharina J. , Jussen Daniel , Prinz Vincent , Baumgarten Peter , Seifert Volker , Marquardt Gerhard , Czabanka Marcus
Published: October 2024

Resection of large anterior midline skull base meningiomas with extensive peritumoral edema poses high risks due to postoperative edema decompensation leading to increased intracranial pressure. Initial craniectomy prevents intracranial pressure decompensation but requires secondary cranioplasty. This study compares single-stage osteoplastic craniotomy with tumor resection to a two-stage approach using bifrontal craniectomy, tumor resection and subsequent cranioplasty after edema recovery in a second surgical step. Patients with large anterior midline skull base meningiomas (> 50 mm) and peritumoral edema greater than the tumor diameter were included. Group 1 underwent single-stage resection (historical control), while Group 2 had a two-stage approach (prospective series). The primary outcome was the Karnofsky Performance Scale (KPS) at three months post-surgery. Secondary outcomes included preoperative KPS, KPS at discharge and last follow-up, ICU stay, hospital stay length, and complication rates. At three months post-surgery, KPS significantly improved in Group 2 (75% vs. 50%; p = 0.0288), with a non-significant reduction in ICU stay (10 vs. 8 days; p = 0.9001). Complication rates were similar between groups (Group 1: 67% vs. Group 2: 56%; p = 0.6274). Two-stage surgery for large anterior midline skull base meningiomas with extensive peritumoral edema yields better clinical outcomes compared to single-stage surgery in a highly selected patient population.
Use of a Soft Guiding Template and Laser Device Improves the Success Rate of Computed Tomography-Guided Bone Biopsies and Reduces Radiation Exposure
Authors: Wang Xiaoliang , Sun Zhenye , Ji Zhilin , Zhang Jingyu , Xiong Guangyi , Liu Jinwei , Wang Wei , Dong Shuhui , Meng Xianghong
Published: October 2024

Background
Considering the need for precision and operator expertise in performing bone tumour biopsies, this study aimed to investigate the impact of combining a soft guiding template with a laser device on the success rate of computed tomography (CT)-guided bone biopsies and the associated radiation dose.
Methods
A cohort of 114 patients with bone tumours who required CT-guided biopsies were assigned to the auxiliary device group, utilizing a soft guiding template and a laser device. Another 197 patients, constituting the control group, underwent CT-guided biopsies with conventional guiding templates. The χ2 test was employed to compare the biopsy success rates and concordance rates between biopsy findings and surgical outcomes in both groups. Additionally, biopsy success rates for limb bones, limb girdles, and axial bones were compared. Independent sample t-tests were used to analyse differences in age, volume CT dose index (CTDIvol), dose-length product (DLP), and effective dose (ED) between groups, as well as the CTDIvol, DLP, and ED for limb bones, limb girdles, and axial bones individually.
Results
The biopsy success rate in the auxiliary device group (85.09%) was significantly higher compared to that in the control group (74.62%; P < 0.05). Notably, no statistically significant difference was observed in the biopsy success rates for limb girdles and axial bones between both groups (P > 0.05). In contrast, the biopsy success rate for limb bones was significantly higher in the auxiliary device group (85.51%) than in the control group (70.87%; P < 0.05). However, the concordance rate between biopsy findings and surgical outcomes did not differ significantly between the groups (P = 1.00). There was no significant difference in the CTDIvol between the two groups for limb girdles, limb bones, and axial bones (P > 0.05). While DLP and ED showed no significant differences for limb girdles (P > 0.05), they were significantly lower for limb bones and axial bones in the auxiliary device group compared to those in the control group (P < 0.05).
Conclusion
Overall, the combination of a soft guiding template and laser device significantly increased the success rate of CT-guided bone biopsies and reduced the associated radiation dose.
Effect of autologous serum eye drops on symptom improvement, adverse reactions and prognosis of dry eye patients with poor efficacy of artificial tears
Authors: Jiang Lei , Deng Zhen , Wu Yifeng , Shu Xupeng , Yu Guoxiao , Opara Chimaroke
Published: October 2024

A reduction in tear production and abnormal tear film function can cause discomfort, such as visual fatigue, dry eyes, redness, foreign body sensation, and poor night vision. Hence, the purpose of this study was to examine effect of autologous serum eye drops on symptom improvement, adverse reactions and prognosis of dry eye patients with poor efficacy of artificial tears. This study employed an experimental design whereby forty-eight patients with xerophthalmia from January 2022 to January 2023 were randomly divided into observation group (n = 48) and control group (n = 48). Basic tear secretion test, tear film rupture time, corneal fluorescein staining score and ocular surface disease index were compared. Statistical analyses were performed using SPSS 20.0. Findings revealed that combination of artificial tears and AS eye drops can significantly enhance the clinical symptoms of dry eyes patients with poor efficacy of artificial tears and increase the comfort of patients during treatment. Hence, improving the condition of the patients. The results obtained affirm important theoretical basis for AS as the main component of self-made metaphase corneal preservation solution. Hence, the study highly recommends the popularization and implementation of treatment schemes like artificial tears and AS eye drops in today’s clinics.
Neutrophil-related genes predict prognosis and contribute to immunosuppression in acute myeloid leukemia
Authors: Zhang Di , Li Yongjian , Liu Tingting , Liu Xiaomin , Zhang Jingru
Published: October 2024

Neutrophils, the predominant myeloid cells in human blood, have been implicated as pivotal contributors to cancer development. However, the relationship between neutrophils and acute myeloid leukemia (AML) prognosis remains unclear due to their great plasticity and diversity. In this study, we conducted a comprehensive analysis of gene expression data and clinical records from AML patients sourced from TCGA, GEO, and OHSU databases. We established a neutrophil-based prognostic model incorporating five neutrophil-related genes (CSF3R、BRAF、FFAR2、CD300A and CD37) and the predictive value of the model was validated in both internal and external validation cohorts. Univariate and Multivariate Cox regression analyses further demonstrated that the model remained an independent prognostic factor for overall survival, and a nomogram was constructed to facilitate its clinical application. Notably, CD37 was identified as a crucial neutrophil-related gene associated with adverse AML prognosis. Elevated CD37 expression was indicative of dysregulated cell proliferation, immunosuppressive tumor microenvironment and T cell dysfunction. Overexpression of CD37 was also correlated with increased expression of PD1, CTLA4, CD86, and LAG3. Furthermore, CD37 could serve as a valuable predictor for immunotherapy and represents a druggable target in AML. In summary, our study advances a novel prognostic model based on neutrophil-related gene expression, with CD37 emerging as a promising biomarker for anti-leukemic response prediction. This insight holds promise for personalized prognosis estimation and informed clinical decision-making in AML management.
The First cross-sectional comparative observational study of sexual dysfunction in Emirati and non-Emirati Parkinson’s disease Patients (EmPark-SD) in the UAE?
Authors: Metta Vinod , Ibrahim Huzaifa , Dhamija Rajinder K. , Popławska-Domaszewicz Karolina , Benamer Hani T. S. , Loney Tom , Mrudula Rukmini , Falup‑Pecurariu Cristian , Rodriguez‑Blazquez Carmen , Dafsari Haidar S. , Goyal Vinay , Borgohain Rupam , Chaudhuri Kallol Ray
Published: October 2024

Sexual dysfunction (SD) is common non-motor symptom in people with Parkinson’s disease (PD) yet underreported and undertreated specifically in many ethnic PD groups because of religious, social and personal perceptions. We conducted the first single-centre cross-sectional study in the United Arab Emirates of SD in 513 consecutive patients who agreed to complete the survey questionnaires. Data was collected on SD using the nonmotor symptoms Scale (NMSS), Index of Erectile Function, and Female Sexual Function Index. Our results show the non-Emirati group as having higher NMSS-SD scores than the Emirati group (p=0.038). SD was reported independent of ethnicity, race and disease stage (p<0.001). SD correlated with worsening quality of life (p<0.001), anxiety domain especially in young PD patients (p<0.001). Our data concludes no significant difference in SD between different ethnicity groups contrary to common perception. SD appears to be underreported in this population and needs addressed using culturally sensitive bespoke counselling.
AL365181.3 as a novel prognostic biomarker for lung adenocarcinoma
Authors: Liu Xiaoying , Liu Jinlong , Zeng Yingou , Qiao Di , Wang Qiang
Published: October 2024

As a lncRNA, AL365181.3 is aberrantly expressed in multiple cancer types, including lung adenocarcinoma (LUAD). However, the biological process underlying the ability of AL365181.3 to promote the progression of LUAD is unclear. Here, the pancancer expression level of AL365181.3 was analyzed using the TCGA and GTEx databases, as well as its clinical characteristics and prognostic value. Finally, the in vitro and in vivo biological functions of AL365181.3 in LUAD were revealed by using various functional assays. We found that AL365181.3 was significantly more highly expressed in many types of cancer tissues, including LUAD tissues, than in adjacent normal tissues. LUAD patients with high AL365181.3 expression had poor prognoses. Functional enrichment analyses indicated that AL365181.3 is involved in the regulation of metabolism, MAPK signaling and other tumor regulatory signaling pathways. Finally, we found that knockdown of AL365181.3 reduced the proliferation and migratory capacity of LUAD cells, and knockdown of AL365181.3 resulted in a reduced in vivo tumorigenic capacity of LUAD cells. These findings provide a comprehensive understanding of the role of AL365181.3 in LUAD.
Investigating the Impact of Background Noise on Group Decision-Making Using an Individual-Weighted Voting Model
Authors: Örnólfsson Ingvi , Ahrens Axel , May Tobias , Dau Torsten
Published: October 2024

Conceptualizing and measuring communication success is crucial for evaluating hearing interventions, as many hearing-impaired individuals struggle in interactive communication settings. However, no established methods exist to directly assess communication success in the context of hearing impairment and intervention. This study introduces a new perspective on communication success, defining it as the effective exchange of information between interlocutors. Experiments were conducted with ten triads (N = 30) to examine the impact of loud background noise on decision-making using a general-knowledge decision-making task in triadic groups. Participants answered questions twice, both before and after group discussions, under noise conditions of 78 dB and 48 dB SPL. A group decision model was applied to quantify the relative influence of group members on each other’s post-discussion decisions, formalized as a set of model weights. Four statistics were used to summarize the results across groups: overall weight change, self-weighting, weight equality, and weight similarity. Results showed that background noise significantly altered the overall weight participants gave to each other’s prior decisions, but self-weighting, weight equality, and weight similarity were not affected by the noise condition. This methodology offers a new tool for assessing the communicative consequences of hearing loss, providing insights beyond traditional hearing tests.
Clinical Characteristics, and Outcomes of Severe Neonatal Thrombocytopenia: a Retrospective Cohort Study in China
Authors: Shan Yuanyuan , Peng Ting , Zhang Peng , Cheng Guoqiang
Published: October 2024

Background: Severe neonatal thrombocytopenia, as a rare but life-threatening disease with multiple etiologies, has limited relevant reports in China. The single-center study was performed in a severe thrombocytopenic cohort to improve the prognosis of this disease.
Methods: We included all the patients diagnosed with severe thrombocytopenia (platelet counts £ 50×103/μL) in our institution between October 2016 and February 2021, and retrospectively reviewed their electronic records. Comparisons were made according to etiology and outcome.
Results: Among the 5819 inpatients, 194 with severe thrombocytopenia were included in this study, with 64.4% of the cases occurring within 72 hours of life. The highest incidence was recorded among extremely low birth weight neonates (6.5%). The main etiologies included sepsis (22.2%), genetic syndromes (14.4%), perinatal asphyxia (9.8%), necrotizing enterocolitis (NEC; 8.8%), and cytomegalovirus infection (6.7%). The mean (SD) platelet nadir was 26.0 (14.0) × 103/μL, and 112 patients developed very severe thrombocytopenia (platelet counts £ 30×103/μL), of which 21.4% were caused by late-onset sepsis. In 45 culture-positive cases, the gram-negative group had a lower level of platelets (mean [SD]: 28 [11]×103/μL) as compared to the gram-positive group (mean [SD]: 39 [12]×103/μL). A total of 120 cases (61.9%) exhibited evidence of hemorrhage, with patients diagnosed with NEC demonstrating the highest incidence of hemorrhage at 58.8%. The platelet counts took a median of 10 days to recover: 11 and 7 days for early and late-onset cases; 15 days without and 21 days with platelet transfusions, respectively. The overall mortality rate was 26.8%. The causes of severe thrombocytopenia in 32.7%, 19.2%, and 17.3% of patients who died were identified as sepsis, birth asphyxia, and NEC, respectively. The levels of PT (P = 0.025), APTT (P = 0.046), and lactate (P = 0.028) were lower among surviving patients.
Conclusions:
Sepsis, genetic syndromes, and perinatal asphyxia are the predominant etiologies of severe neonatal thrombocytopenia in China. The overall prognosis of severe neonatal thrombocytopenia is poor, but its severity and short-term prognosis can be determined by relevant laboratory tests and the etiology.
In-vitro accuracy of full arch scans with a systematic review of nine different scanning patterns
Authors: Schlögl Kerstin , Güth Jan-Frederik , Graf Tobias , Keul Christine
Published: October 2024

Objective
Evaluation of the accuracy of direct digitization of maxillary scans depending on the scanning strategy.
Materials and Method
A maxillary model with a metal bar fixed between the second molars as a reference structure was digitized using the CEREC Primescan AC scanner (N = 225 scans). Nine scanning strategies were selected (n = 25 scans per strategy), differing in scan area segmentation (F = full jaw, H = half jaw, S = sextant) and scan movement pattern (L = linear, Z = zig-zag, C = combined). Accuracy was assessed by evaluating linear differences in the X, Y, and Z axes and angular deviations (α axial, α coronal, α total) compared to a reference dataset. Differences in accuracy were analyzed using Kruskal-Wallis and Mann-Whitney U tests. Precision was analyzed by the standard deviation of linear and angular aberrations (ISO 5725-1) (p < 0.05).
Results
Strategy FL showed significantly higher trueness and precision than FZ for VE (p = 0.009), VE(y) (p = 0.010), αoverall (p = 0.004), and αaxial (p = 0.002). Strategy FC demonstrated significantly better trueness than FZ for VE (p = 0.007), αoverall (p = 0.010), and αcoronal (p = 0.013). For scan segmentation, FL showed better accuracy for VE(y) (p = 0.001) and αaxial (p < 0.001) than HL. Strategy HL showed better trueness for VE(z) than FL and SL (p = 0.001, p = 0.002). The scanning patterns FL, FC, and HL exhibited the best performance for trueness and precision.
Conclusions
Scanning motion and segmentation significantly impact the accuracy and precision of full-arch scans.
Clinical relevance:
The scanning strategy is decisive for improving clinical workflow and accuracy of full-arch scans.
Erectile Dysfunction And Associated Factors Among Adult Hypertensive Patients Attending Outpatient Care At Public Hospitals in Harari Regional State,Eastern Ethiopia
Authors: Abdi Dawit , Misgana Tadesse , Asefa Abdulselam , Bete Tilahun , Temesgen Abdi , Zewudie Abinet , Asefa Hirko , Tilahun Shimelis , Dereje Jermen
Published: October 2024

Introduction. Sexual dysfunction is lack of sexual ideas or thoughts, diminished sexual interest or desire, and unresponsive sexual desire. Sexual dysfunctions is a prevalent issue that can impact both the patients' and their spouses' quality of life. Even though Erectile dysfunction is very common and linked to many medical and health related conditions. There was no study at public hospitals in Eastern Ethiopia.
Objective. This study was aimed to assess the prevalence of erectile dysfunction and associated factors among hypertensive patients attending Public Hospitals in Harari Region, Eastern Ethiopia.
Materias and Methods. An institutional-based cross-sectional study was conducted from January 31 to February 29,2024 among 413 participants selected by systematic random sampling technique. Erectile dysfunction was assessed with the International Index of Erectile Function. Data were entered into EPI Data version 3.1 and analyzed using STATA version 14. Bivariable and multivariable logistic regressions were done to identify factors associated with Erectile dysfunction. The adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed when the p-value was less than 0.05, which was considered statistically significant.
Results. A total of 413 male adult hypertensive patients were recruited in this study with a 98.3% response rate. The prevalence of erectile dysfunction among hypertensive patients was 54%(95% CI 49.2-58.4). Age between 61 and 80 years (AOR=3.3,95% CI: 1.06-10.32),having a depression (AOR=3.1,95%CI: 1.63- 6.16),having an anxiety (AOR=2.3,95% CI:1.21- 4.41),being in a stage 2 hypertension (AOR=3.2,95% CI:1.09- 9.77),duration of hypertension more than 10 years (AOR=5.6,95%CI:1.98-16.06),having comorbid medical illnesses (AOR=4.0,95%, CI:2.13- 7.53),being on antihypertensive polytherapy (AOR=3.6,95%CI:1.99-6.51), and being physically inactive (AOR=4.4,95% CI:2.42- 8.07) were significantly associated with erectile dysfunction.
Conclusion. More than half of the study participants had erectile dysfunction. and it appears to be significantly associated with age, presence of depression and anxiety, stage of hypertension, duration of the illness, preexisting chronic illnesses, medication polytherapy, and physical activity. All hypertensive patients presenting to a physician should have routine evaluation for erectile dysfunction so as to recognize it early and reduce its effects.
The placenta area in sector 2 and cervical area correlate with massive hemorrhage in patients with placenta accreta spectrum disorders
Authors: Feng Guannan , Yan Jun , Yuan Min , Yue Yongfei
Published: October 2024

Background
Placenta accreta spectrum (PAS) is an obstetric complication related to severe maternal morbidity and mortality, magnetic resonance imaging (MRI) can predict the bleeding risk and the adverse outcomes of the maternal caesarean section in PAS patients. This study aimed to identify whether the placenta area in sector 2 (S2) and cervical area measured by MRI correlate with massive hemorrhage (MH) in complete placenta previa patients with PAS.
Methods
One hundred and thirty-eight patients were diagnosed as PAS from January 2016 to December 2023. The patients were divided into two groups according to the estimated blood loss volume: MH group (estimated blood loss > 2000mL) and non-MH group (estimated blood loss ≤ 2000mL). The correlation between placenta area in S2, cervical area and MH were evaluated with multivariate analysis. The evaluation capabilities of indicators were assessed using receiver operating characteristic (ROC) analysis.
Results
The placenta area in S2 of the MH group was significantly higher than that of the group without MH (P < 0.001), on the contrary, cervical area was significantly lower in PAS patients with MH than that of the group without MH (P < 0.001). A positive linear was found between placental area and amount of blood loss (r = 0.752), and negative linear were found between cervical area and amount of blood loss (r=-0.671), between cervical area and placenta area (r=-0.559). Combined with placental area in S2 and cervical area, the sensitivity, specificity, and the area under the curve (AUC) for the predictive MH were 89.237%, 91.548%, and 0.910, respectively.
Conclusion
The placenta area in S2 and cervical area may be used to recognize MH in patients with PAS.
Safety and Efficacy of High-Power Short-Duration Radiofrequency Ablation (50W) in Patients with Paroxysmal Atrial Fibrillation
Authors: Li Xinzhong , Xiao Zhiwen , Zhang Jiachen , Huang Xiaobo , Lin Hairuo , Huang Senlin , Liao Yulin , Wu Juefei , Xiu Jiancheng , Li Jianyong , Bin Jianping , Wang Yuegang
Published: October 2024

Background
Pulmonary vein isolation (PVI) using conventional power radiofrequency ablation (RFA) has been an effective treatment strategy for paroxysmal atrial fibrillation (PAF), but its longer duration may cause collateral damage to peripheral tissue. High-power RFA, characterized by better transmural performance and reduced collateral damage due to its shorter duration, has sparked a safety and efficacy controversy that still needs further evaluation.
Methods
In this retrospective cohort study, we included 259 patients with PAF who were had performed for lesion size index (LSI)-guided radiofrequency ablation. A total of 119 PAF patients underwent 50 W ablation. Complications and twelve-month arrhythmia-free outcomes of the procedure were compared with 140 patients who underwent 30–35 W ablation.
Results
PVI was successfully achieved in all patients. The procedural duration (140.3 ± 34.4 vs. 151.3 ± 40.6 min, P = 0.022) and overall radiation (112.0 ± 67.2 vs. 188.2 ± 119.2 mGy, P < 0.001) were significantly lower in the 50 W group. No major complications occurred in the high-power short-duration (HPSD) group. The recurrence of arrhythmia at the twelve-month follow-up was not significantly different between the two groups [11 (9.2%) vs. 19 (13.6%), P = 0.278)].
Conclusion
LSI-guided HPSD-RFA demonstrated comparable safety and efficacy for conventional ablation and resulted in reduced procedure time and radiation exposure.
Totally Endoscopic Mitral Valve Repair with Novel Technique of Left Atrial Exposure: Five Years Experience from a Single Center
Authors: Pham Thanh Dat , Nguyen Cong Huu
Published: October 2024

Background
Endoscopic mitral valve repair has become the standard procedure for the management of isolated mitral regurgitation. Our innovative technique for mitral valve exposure has been previously described. This study evaluates the outcomes of totally endoscopic mitral valve repair using this novel technique over a five-year period at a single center.
Methods
A retrospective review was conducted on 122 patients who underwent totally endoscopic mitral valve repair between May 2018 and December 2023. Clinical and echocardiographic data were meticulously collected and analyzed. The surgical procedure was performed completely endoscopic via a 3–4 cm right mini-thoracotomy, with peripheral cardiopulmonary bypass. A novel technique utilizing retraction sutures for mitral valve exposure was employed. Primary outcomes included the results of the endoscopic techniques, mitral valve repair outcomes, perioperative complications, and short-term mortality. Long-term outcomes, including survival, freedom from reoperation, and recurrent mitral regurgitation, were assessed using Kaplan–Meier analysis.
Results
Mitral valve exposure was successfully achieved in all cases. The mean age of the patients was 54.5 ± 14.2 years, and their mean log EuroSCORE II was 1.53 ± 1.30. The repair rate was 96%, with anterior leaflet repair in 13%, posterior leaflet repair in 69%, and bileaflet repair in 14%. Mean aortic cross-clamp time and cardiopulmonary bypass time were 117 ± 39 minutes and 181 ± 48 minutes, respectively. The early mortality rate was 1,6%. Three patients (2.5%) experienced intraoperative conversion to sternotomy and 6 patients (4.9%) underwent a reoperation. There were 2 cases of stroke (1,6%) and 2 cases of unilateral pulmonary edema (1.6%). The minimum follow-up duration for a patient was 6 months, extending up to 72 months, with a mean follow-up duration of 28.6 ± 15.1 months. Kaplan–Meier analysis demonstrated a 96.7 ± 1.6% survival rate at 5 years, with 98.4 ± 1.2% freedom from reoperation, and 86.1 ± 3.1% freedom from recurrent mitral regurgitation.
Conclusions
Totally endoscopic mitral valve repair utilizing the novel technique of left atrial exposure is feasible and can be safely performed with low mortality and morbidity. This approach achieves a high rate of mitral repair and demonstrates favorable long-term outcomes.
Right Ventricular Dysfunction: An Early Sign of Anthracycline Induced Cardiotoxicity - Case Series
Authors: Blair Cheavar , Bryana Levitan , Tori Brown , Nakeya Dewaswala , Amit Arbune
Published: October 2024

Background: Anthracycline-induced cardiotoxicity is clinically distinguished by a reduction in left ventricular ejection fraction (LVEF) exceeding 10% and an LVEF below 50%. Due to these guidelines, alterations in right ventricular (RV) structure and function are often neglected as indicators of cardiotoxicity. In this report, we present two cases of anthracycline-induced cardiotoxicity that initially manifested as RV dilation and dysfunction.
Case presentations: Patient One, A 41-year-old woman with a history of sub-massive pulmonary embolism and obesity, was diagnosed with right pulmonary artery sarcoma and treated with surgical resection, radiation therapy, and adjuvant doxorubicin. Months after starting chemotherapy, she experienced progressive dyspnea on exertion and lower extremity swelling; a follow-up TTE demonstrated normal LV size and function, RV dilation, and RV pressure and volume overload. Since LVEF did not fall under the definition of cardiotoxicity, she continued doxorubicin treatment. Her clinical condition worsened, leading to severe RV dilation, reduced function, and new ECG abnormalities. Eventually, a cardiac MRI revealed reduced biventricular function and RV volume overload, with a final diagnosis of biventricular failure due to chemotherapy.
Patient Two, a 21-year-old male diagnosed with osteosarcoma at age 12, underwent surgical resection, endoprosthesis reconstruction, and adjuvant chemotherapy with cisplatin and doxorubicin. A 7-year post-chemotherapy follow-up echocardiogram noted increased RV pressure suggestive of pulmonary hypertension. Follow-up TTE showed normal LVEF with borderline normal GLS, visually normal RV size and systolic function, and borderline elevated RVSP of 35 mmHg. Subsequent cardiac MRI revealed reduced right and left ventricular function and non-ischemic cardiomyopathy.
Conclusions: These cases illuminate a critical gap in the current diagnostic criteria and definition of cardiotoxicity, emphasizing the necessity for more comprehensive echocardiographic approaches to assess cardiotoxicity. Specifically, they underscore the importance of including changes in right ventricular (RV) structure and function, which are often overlooked but can serve as early indicators of cardiotoxicity.
Molecular Mosaics: Unveiling Heterogeneity in Synchronous Colorectal Cancers
Authors: Lee Hyun Gu , Kim Yesseul , Kim Mi-Ju , Kim Yeon Wook , Jun Sun-Young , Kim Deokhoon , Park In Ja , Hong Seung-Mo
Published: October 2024

Molecular characteristics of synchronous colorectal cancers (SCRCs) remain incompletely elucidated, despite their importance in targeted therapy selection. This retrospective study (2012–2014) compared the molecular characteristics and somatic mutations between SCRCs in 100 patients with surgically resected SCRCs. Molecular characteristics, including microsatellite instability (MSI) and tumor-infiltrating lymphocytes (TILs), were analyzed for all cancer lesions. The intertumoral heterogeneity of SCRCs was evaluated using whole-exome sequencing (WES) for 18 cancers from 9 patients with at least one MSI-high (MSI-H) tumor. Twelve patients had at least one MSI-H tumor; five showed discordant MSI status. Mucinous adenocarcinoma frequency and TIL density were higher in patients with at least one MSI-H tumor than in those with only microsatellite-stable tumors. WES revealed that, except one patient (6.5%), most synchronous cancers shared few variants in each patient (0.09–0.36%). The concordance rates for BRAF, KRAS, NRAS, and PIK3CA in synchronous cancers from each patient were 66.7%, 66.7%, 66.7%, and 55.6%, respectively. Although synchronous cancers shared a mutated gene, the mutation subtypes differed. SCRCs exhibited 5% MSI status discordance rate and a high discordance rate in somatic mutational variants. As intertumoral heterogeneity may affect the targeted therapy response, molecular analysis of all tumors is recommended for patients with SCRCs.
Nutritional Knowledge and Practices of Low-Income Women During Pregnancy: A Qualitative Study in Two Oaxacan Cities
Authors: Marian Marian , Pérez Ramona L. , McClain Amanda C. , Hurst Samantha , Reed Elizabeth , Barker Kathryn M. , Lundgren Rebecka
Published: October 2024

Background
Adequate dietary intake is critical for healthy pregnancies. Recent changes in social services in Mexico, coupled with high levels of food insecurity, call into question whether expecting women of the lowest socioeconomic status are able to meet their dietary and nutritional needs in this changing context. The aim of this study was to explore the nutritional practices, education and received and employed among women during their pregnancy.
Methods
Guided by Ecological Systems Theory and an Intersectionality Framework, this qualitative study was carried out in Oaxaca City and Puerto Escondido, in Oaxaca, a Mexican state with high levels of food insecurity. Women who had at least one child in the past five years and had lived in Oaxaca for the past five years were eligible to participate. Twenty-five women participated in semi-structured in-depth interviews conducted between June and December of 2023. A grounded theory approach was used for coding. NVivo was used for coding and analyses.
Results
Five key themes emerged linked to individual-level characteristics and the multiple social identities related to the social support for nutritional knowledge and practices among low-income Oaxacan women during pregnancy: 1) Life experiences, sociodemographic, and health characteristics that influence nutritional practices and knowledge during pregnancy; 2) Female family members as a primary source of nutritional knowledge and food support; 3) Support from other members of women’s social networks; 4) Medical guidance for nutrition during pregnancy; and 5) Quality and gaps in the broader health care system and social services. These themes highlight how women’s own experiences and social identities and the different interpersonal and community-level environments, particularly those of mothers and grandmothers and health care providers, interact and shape women’s nutritional knowledge and practices, such as foods and nutritional supplements consumed, during pregnancy.
Conclusion
Nutritional knowledge and practices during pregnancy are impacted by multiple social identities women have and different factors at the individual, group, and structural level. Future research and programming that use multi-level approaches (considering the individual and the family and other social influences) are needed to address the gaps in nutrition that women in Oaxaca go through during the prenatal period.
Effect of severed right gastric artery on postoperative anastomosis after Mckeown surgery for esophageal carcinoma: A Randomized controlled trial
Authors: Zhang Guibin , Gao Shuhui , Yin Qifan , Qie peng , Song Yongbin , Wang Huien
Published: October 2024

Objective To evaluate the effect of right gastric artery on anastomotic fistula and anastomotic stenosis after Mckeown surgery for esophageal carcinoma.Methods Prospective analysis of 120 esophageal cancer resection from July 2018 to July 2020 In all cases, esophagogastric and neck anastomosis was performed and randomly divided into 60 cases in the right gastric artery sparing group (Group A) and 60 cases in the right gastric artery disconnection group (Group B), and the occurrence of anastomotic fistula and stenosis in different surgical groups were analyzed.Results Postoperative anastomosis in 120 patients: there was no significant difference in the incidence of postoperative anastomotic fistula (10% / 16.7%) (P > 0.05). There were differences between the two groups in groups A and B 2 months after surgery(P < 0.05); no significant difference between the two groups 4 months after surgery (P > 0.05).Conclusion Separation of right gastric artery has no effect on anastomotic fistula after esophageal cancer and may cause postoperative anastomotic stenosis in patients.