bluuebunny/crossref_metadata_2025 huggingface dataset:
What Blocked Visual Stimuli in Art brings to Emotional Expression
Authors: Ma Yuan , Xu Ting , Wang Yu
Published: October 2024

Blindness is often defined as a sensory state with negative implications. However, this may be an uncertain conclusion. There has been a longstanding and fundamental debate about how emotions are conveyed through art. Some artists and theorists argue that visual features like color, line, form, and composition consistently express various emotions, while others believe that non-visual senses resonate more with the audience, conveying a stronger emotional connection. This article is inspired by blindness and explores how vision-able participants discover the potentiality of participatory creative process while blindfolded and without visual stimuli. In this case study, revolving around an experiment with blindfolded creative participants at the sensory arts festival, and used to analyze the non-visual characteristics of potential emotional expression by using interpretive phenomenological analysis (IPA). Authors found that evidence of consistency in emotional ratings by participants in the art practice process perceived under the visual blocked. Overall, the authors’ results reveal enhanced use and sensitivity of non-visual senses when visual stimuli are blocked, indicating a strong bottom-up and subjective expression of emotions. Scenario enactment offers a different perspective on artistic creation and its emotional value, tapping into fundamental non-visual mechanisms.
Mechanism and Origins of Selectivity for [Ga4L6]12- -Catalyzed SN2 Reaction with Benzylic Ether and Methanol: A Computational Mechanistic Study
Authors: Zhang Zhengxu , Sun Zehua
Published: October 2024

Supramolecular catalysis often considered as the mimic of enzymatic catalysis, exhibits the properties of high reactivity and selectivity with various transformations. Bergman demonstrated that the reaction of chiral benzylic ester and methanol with Brønsted acid catalyst in bulk solution proceeded through an SN2 mechanism and generate chirality-inversed product, while when the reaction occurred with the supramolecular [Ga4L6]12- catalyst it formed the chirality-retained product. The detailed reaction mechanism as well as the origins of selectivity remains unclear. Therefore, in this work we have performed a comprehensive theoretical study on the nucleophilic substitution reaction catalyzed by both Brønsted acid and [Ga4L6]12- catalyst. Our calculations are in agreement with experiment. Detailed analyses indicate that compared to that of a classical SN2 reaction in bulk solution, after the encapsulation of the reactants in [Ga4L6]12-, the same-side nucleophilic attack of the methanol with the leaving group is more favorable than the back-side attack, which is due to more favorable hydrogen bonding interactions and π-π stacking interaction between the reactants and the supramolecular cage. Understanding the mechanism and origins of the stereochemical outcome in the nucleophilic substitution reaction with the supramolecular host-guest catalysis would lead to the development of more efficient and selective transformations.
Development and iterative optimization of an independently usable assistance system to assess, maintain and improve the nutritional and mobility status of older adults: an iterative usability study
Authors: Förster Mareike , Happe Lisa , Quinten Vincent , Diekmann Rebecca
Published: October 2024

Background
Promoting a balanced diet and regular physical activity is crucial for maintaining independence in old age. Technical assistance systems can help identify nutritional and mobility deficits and initiate appropriate interventions. We are developing a technical assistance system consisting of a measurement and training station and a tablet-based app (AS-Tra). AS-Tra is specifically designed for independent use by participants aged ≥ 70 years to assess and improve their nutritional and mobility status.
Objective
This study aimed to identify optimization potentials of the AS-Tra system together with members of the target group through iterative test cycles until good usability is achieved.
Methods
The system is developed as a complex intervention in accordance with the MRC framework and assessed in three iterative cycles for its usability. In each cycle, participants carried out structured predefined tasks. To capture their cognitive process, they were asked to ‘think aloud’. These thoughts were recorded with the necessary support for completing each task. Usability was measured using the System Usability Scale (SUS). Improvements based on the results were made. In the third cycle, independent use was simulated by leaving the participants alone in the lab, receiving tasks via audio instructions and observing them via webcams and eye-tracking glasses.
Results
A total of 34 participants (78.60 ± 5.59 years, 70.93% female) were included in the three iterative cycles (C1–C3). The SUS score improved from 70.63 to 84.55 between C1 and C2 and decreased slightly to 78.18 at C3. Overall 63.11% of the tasks (n = 385) were completed without support. In 14.92% (n = 91) of all tasks, the task could be completed by repeating or rephrasing instructions, 20.33% (n = 124) with direct reference to the solution, and 1.15% (n = 7) of all tasks could not be completed independently.
Conclusions
The results of the cycles enabled us to develop an independently usable system for assessing the nutritional and mobility situations of older people with good usability. Additionally, the relevance of support functions and the importance of research under real conditions became clear.
Trial registration number:
German Clinical Trials Register (DRKS), DRKS00031719, registered May 2023, https://drks.de/search/de/trial/DRKS00031719
A nomogram for predicting T315I-free survival in chronic phase chronic myeloid leukemia patients: a multicenter retrospective study
Authors: Hu Shi-wei , Yang Xiu-di , Wu Di-jiong , Wang Yi , Zhu Xiaoqiong , Feng Weiying , Qian Honglan , Lu Ying , Chen Lili , Cao Lihong , Le Jing , Zhang Li , Shao Yanping , Liu Lirong , Tian Guoyan , Zhou Hui , Chen Yu , Yin Xiufeng , Feng Xiaoning , Huang Li , Zhang Kaifeng , Xia Yongming , Xu Linjuan , Zhang Huiqi , Zhang Gang , Jia Yongqing , Zhou Xiujie , Wu Gongqiang , Tu Jinming , Zhu Feng , Zhang Yuefeng , Yao Guoli , Zhu Jingjing , Tong Hongyan , Jin Jie , Huang Jian
Published: October 2024

The T315I mutation poses a significant threat to patients with chronic phase chronic myeloid leukemia (CP-CML). This study aimed to establish a nomogram to predict the risk of T315I mutation in CP-CML patients. The training cohort included 1,466 patients from 24 hematology centers, and the validation cohort included 820 patients from an additional 20 centers. Peripheral blood blast (PBB), additional chromosomal abnormality (ACA), dasatinib use, non-EMR at 3 months, and BCR::ABLIS > 1% at 6 months were identified as independent risk factors through multivariate Cox regression analysis. The performance of the nomogram was assessed via receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The area under the ROC curve (AUC) values at 5, 10, and 15 years were 0.874, 0.925, and 0.930 for the training cohort, and 0.864, 0.814, and 0.803 for the validation cohort, respectively. The calibration curves for both cohorts were close to the ideal diagonal, and the decision curves indicated clinical net benefit. In conclusion, we developed a nomogram to predict the 5-year, 10-year, and 15-year T315I-free survival probabilities of CP-CML patients. This tool can aid clinicians in the early prediction and timely management of high-risk CP-CML patients with the T315I mutation.
External ventricular drainage following purulent meningitis with hydrocephalus in pediatric patients
Authors: Sun Yaning , Xiao Jing , Luo Pengyuan , Yue Yanke , Fang Jiangshun , Wang Shengjuan , Luan Jimei , Cheng Zhenghai , Yang Zhiguo , Chen Zhiguo , Qu Yi
Published: October 2024

Background
External ventricular drain (EVD) placement is standard of care in the management of purulent meningitis with hydrocephalus (PMH). However, there are no guidelines for EVD placement and management after PMH. Optimal EVD insertion location, techniques to reduce the risk of EVD-associated infection and methods of EVD removal are critical, yet incompletely answered management variables.
Methods
The indwelling time of conventional external ventricular drainage is relatively short, 7–10 days. Long-term external drainage devices may lead to retrograde infection. This study has modified the C-EVD procedure. Clinical outcomes, cerebrospinal fluid (CSF) test results, complications, and outcomes were compared between the modified external ventricular drainage (M-EVD) (n = 21) group and C-EVD (n = 25) group.
Results
The two groups were similar regarding age, sex, weight and other general conditions (P > 0.05). There were significant differences in the values of white blood cells (WBC), glucose(GLU) and protein(PR) in cerebrospinal fluid (CSF) between the two groups when the drainage tube was removed, which was statistically significant. The median days of removing the drainage tube in the C-EVD group and the M-EVD group were 9 days and 19 days, respectively. The median days of CSF returning to normal were 19 days and 13 days (P < 0.05). A total of 13 children in the M-EVD group underwent V-P shunt surgery, while 17 children in the C-EVD group were treated with V-P shunt surgery (P = 0.665).
Conclusion
M-EVD has more obvious advantages compared to C-EVD. The modified significantly prolonged the catheterization time, which can more effectively treat PMH in pediatric patients.
Epidemiology of amebiasis around the COVID-19 pandemic period in Japan
Authors: Iida Keisuke , Mori Hirotake , Hadano Yoshiro , Mahittikorn Aongart , Naito Toshio
Published: October 2024

Amebiasis cases in Japan are reported to the government according to the Infectious Diseases Control Law. Previous studies have shown significant reductions in total case numbers after 2018 and during the COVID-19 pandemic. This study aimed to clarify the recent trends of amebiasis in Japan, including during the pandemic period, with details on places of infection and disease types, using government surveillance data from January 1, 2001, to December 31, 2022. Multiple comparisons by Dunnett’s test were performed to compare case numbers of three time periods (2015-2017, 2018-2019, and 2020-2022). Significant decreases in reported amebiasis cases were observed in 2018 (24.5%) and in 2020 (45.3%). This downward trend was observed regardless of place of infection (domestic or imported) and disease type (intestinal or extraintestinal). Male cases predominated, with most male cases in their 40s and 50s.Most cases of amebiasis have been reported in metropolitan areas. These results suggest that the decreased case numbers during the COVID-19 pandemic were due to not only the travel ban, but less socioeconomic activity. Furthermore, the epidemiology of amebiasis is similar to that of HIV infection in Japan, but the case numbers of amebiasis have not yet recovered, showing a different trend from HIV infection and syphilis.
Integrated Analysis of Cell Cycle and p53 Signaling Pathways Related Genes in Breast, Colorectal, Lung, and Pancreatic Cancers: Implications for Prognosis and Drug Sensitivity for Therapeutic Potential
Authors: Khan Jiyauddin , Ghosh Priyanjana , Bajpai Urmi , Saluja Daman
Published: October 2024

Cancer, a leading cause of death worldwide, is projected to increase by 76.6% in new cases and 89.7% in mortality by 2050 (WHO 2022). Among various types, lung cancer (LUC) is the most prevalent and lethal, while breast (BRC), colorectal (CRC), and pancreatic (PAC) cancers also show high mortality rates. Cancer progression often involves disruption in cell cycle regulation and signaling pathways, with mutations in genes like TP53, EGFR, and K-RAS playing significant roles. In this study, we analyzed gene expression datasets to identify common molecular signatures across BRC, CRC, LUC, and PAC. Our focus was on genes related to cell cycle regulation and p53 signaling pathway, intending to discover potential biomarkers for improved diagnosis and treatment strategies. The study analyzed GEO datasets; GSE45827, GSE9348, GSE30219, and GSE62165 for BRC, CRC, LUC, and PAC respectively. Differentially expressed genes (DEGs) were identified using GEO2R, and functional annotation and pathway analysis were performed using WebGestalt. Common cell cycle and p53 signaling genes were acquired from MSigDB using GSEA. A protein-protein interaction network was constructed using STRING and Cytoscape, identifying top hub genes. Validation of Hub genes at mRNA and protein levels was done via GEPIA2 and HPA. Survival analysis was conducted using TCGA data, and drug sensitivity was analyzed with the GSCA tool, highlighting potential therapeutic targets. The study identified 411 common DEGs among these four cancers. Pathway and Functional enrichment revealed key biological processes and pathways like p53 signaling, and cell cycle. The intersection of these DEGs with genes involved in cell cycle and p53 signaling, identified 23 common genes that were used for constructing a PPI network. The top 10 hub genes were validated both for mRNA and protein expression, revealing they are significantly overexpressed in all studied cancers. Prognostic relevance showed CCNA2, CDC20, and CHEK1 are associated with poor survival outcome. Additionally, drug sensitivity analysis highlighted key gene-drug interactions, suggesting potential targets for therapeutic intervention.
Clinical outcomes of early remdesivir administration in hospitalized patients at high risk for severe COVID-19 during the Omicron wave
Authors: La Yeon Ju , Oh Won Sup , Kim Changhyup , Lim Myoung-nam , Jeon Yong Duk
Published: October 2024

Background
Early remdesivir administration in high-risk patients with coronavirus disease 2019 (COVID-19) is known to be effective in preventing the progression to severe disease. However, the effect of early remdesivir administration on Omicron variants, which are known to have decreased severity, remains unclear.
Methods
This study aimed to analyze the effects of early remdesivir administration during the Omicron wave in hospitalized patients. Electronic medical records of hospitalized patients with confirmed COVID-19 between February 2022 and February 2023 were reviewed. We included patients aged ≥18 years who had symptom onset within 7 days and had at least one risk factor for disease progression at the time of diagnosis. We compared the clinical outcomes between the early remdesivir administration group and the group not administered early remdesivir. The primary outcome was all-cause mortality within 28 days and the secondary outcome was the need for oxygen supplementation within 28 days. A total of 286 patients were enrolled, with 88 and 198 in the early and control groups, respectively. Results
Clinical outcomes, including all-cause mortality (3.4% vs. 6.1%, P = 0.556) and need for oxygen supplementation (15.9% vs. 14.6%, P= 0.783) within 28 days, were not significantly different between the two groups. Early remdesivir administration was not significantly associated with all-cause mortality (HR, 0.393; 95% CI: 0.109, 1.417; P = 0.154) or the need for oxygen supplementation (OR, 0.823; 95% CI: 0.389, 1.740; P = 0.610).
Conclusions
Considering the decline in the severity of the Omicron variant and the increased vaccination rate reported in previous studies, further studies are needed to establish new indications for the use of early remdesivir in the Omicron variant.
Identifying Optimal Algorithms for Breast Cancer Prediction in Ethiopia
Authors: Takele Kasahun , Abate Jemal , Adamu Gadisa , Jifara Wabi , Dheressa Merga , Shawel Michael
Published: October 2024

The most prevalent and lethal kind of cancer in Ethiopia is breast cancer. The number of deaths from breast cancer is rising dramatically every year. It is the most common kind of cancer overall and the leading cause of death for women in Ethiopia. Considering this, this study aims to identify optimal machine learning algorithms that can predict the stages of breast cancer. Unlike traditional methods, machine learning approaches have proven to be powerful methods in early detection and prediction of breast cancer. In this study, we have used the breast cancer dataset that was collected from Hiwot Fana Specialized University Hospital and Tikur Anbesa Specialized Hospital from September 2019 to April 2024. We have applied machine learning algorithms on the preprocessed breast cancer dataset; which are random forest, logistic regression, decision tree, and hybrid machine learning algorithms (RF, DT, GBC and SVM). Based on the results obtained from each algorithm, we compared and evaluated the performance of each classifier using evaluation metrics like precision, recall, F1 score, and accuracy to identify the optimal machine-learning algorithm. In order to find the optimal algorithms and improve the accuracy of the model, 13 features were selected as inputs. The model performance evaluation was done using the train split test and the 10-fold cross-validation. The experimental results were based on dataset division (80:20) to predict stages of breast cancer. Python programing language and required libraries were used to analyze dataset. According to the comparative analysis obtained from the dataset, the random forest model performed well in both trains split test and the 10-fold cross validation performance evaluation and surpassed other experimented algorithms. It has better effects, and its recall, precision, accuracy, and F1-scores are equal, which is 99% using train split test and 97% using 10-fold cross validation. Thus, random forest is the optimal machine-learning algorithm that used to determine stages of breast cancer patients in Ethiopia.
Determination of Fibrinolytic Bacteria Ratio by Polymerase Chain Reaction Analysis in Alveolitic Cases Developed After Tooth Extraction
Authors: Akbulut Funda Gökçe , Yılmaz Ayça Dilara , Yurttutan Mehmet Emre , Üçok Cahit
Published: October 2024

Purpose: The research conducted aimed to investigate the presence and abundance of fibrinolytic bacteria in cases of alveolitis post tooth extraction, a common complication known as dry socket.
Material and Methods: The study, involving 56 patients diagnosed with alveolitis, utilized polymerase chain reaction (PCR) analysis to detect specific ratios of fibrinolytic bacteria associated with this condition.
Results: The study involved 56 patients with 59 extraction sockets diagnosed with alveolitis. Bacterial DNA was found in all 50 samples: T. denticola in 76% and P. gingivalis in 32%. T. denticola was present in all P. gingivalis samples. Most patients were female (62%) with an average age of 40.16, and alveolitis occurred mainly after lower third molar extractions (40.16) Postoperatively, 46% used antibiotics and 51% used chlorhexidine (CHX) mouthwash. Statistically, T. denticola was more common in females, while P. gingivalis was linked to lower rates of antibiotic and CHX use
Conclusions: This study suggests a high prevalence of T. denticola and P. gingivalis in alveolitis cases, potentially influenced by gender and postoperative care practices, warranting further investigation into their role in disease development and targeted prevention strategies.
Incidence and factors associated with hemodynamic change At Post Anesthesia Care Unit among adult surgical patients At Wachemo University Nigest Elleni Mohammed Memorial Comprehensive Specialized Hospital, 2023: Ethiopia, A prospective Observational study
Authors: Wolde¹ Yisehak , Samuel¹ Sintayehu , Abebe¹ Teketel
Published: October 2024

Background: Hemodynamic change, which is an independent risk factor of long-term patient morbidity and duration of stay in the hospital, is a risk for patients in the post-anaesthesia care unit. Multiple predictors contribute to the development of postoperative hemodynamic instability. Prevention and treatment of these factors may minimize patients’ hemodynamic instability, and its associated morbidity and mortality.
Objective: This study aimed to determine the incidence and factors associated with hemodynamic change among adult surgical patients in the postanesthesia care unit.
Method: An institution-based observational study was conducted from December 1, 2023, to June 30, 2024. And 409 adult surgery patients had participated. We employed consecutive sampling technique and both analytical and descriptive statistics to explain our findings. Using both bi-variable and multi-variable logistic regression, we evaluated the strength of the association and determined the crude odds ratio and adjusted odds ratio with a 95% confidence interval. A p-value of less than 0.05 is considered statistically significant in multi variable regression. Result: The total incidence of hemodynamic instability was 53.8.47% (CI: 0.45, 0.64). The incidence of hypotension, hypertension, tachycardia and bradycardia was 24.2%, 17.45%, 31.3%, and 12.6% respectively. ASA class III, procedures longer than 4 intraoperative hemodynamic instability and regional anaesthesia were significantly associated with hemodynamic instability in the postanaesthetic care unit.
Conclusion: In general, the incidence of hemodynamic instability was a significant finding. The intraoperative HDI, ASA class III, postoperative respiratory adverse events, neurologic and gynaecological procedures, use of regional anaesthesia, and prolonged duration of procedures were predictors of hemodynamic instability in the post-anesthesia care unit. Certainly, it is desirable to adopt prediction tools in surgical patients, when the risk of postoperative complications is high, so staffing and medical resources of a particular clinical setup should be considered. Developing risk prediction tools is not enough, but it can be used as a baseline source to develop evidence-based clinical pathways. Implementing and evaluating the adopted clinical pathway to improve the quality of postoperative care.
Spermidine and Chloroquine Enhance Peptide-Based pDNA Transfection Efficiency within the GRP78-Overexpressing DU145 Prostate Cancer Cells
Authors: Daniel Grace , Collak Filiz , Hilan George , Robillard Elissa , Willmore William G. , McKay Bruce C. , Sabatino David
Published: October 2024

This study describes a peptide-based formulation for plasmid gene (pDNA) delivery within the GRP78-overexpressing prostate cancer (DU145) cells. The GRP78-targeting sequence (WIFPWIQL) extended with the nona-arginine (R9) cell-penetrating peptide (WIFPWIQL-R9) effectively enabled capture and release of pDNA, while conferring serum stability, according to agarose gel electrophoresis. Characterization studies based on transmission electron microscopy revealed the formation of stably condensed peptide:pDNA nanoparticles (<200 nm) at excess peptide nitrogen (N) to pDNA phosphate (P) stoichiometric ratios (10:1 N/P) and with CaCl2 functioning as an ionic stabilizer, that rendered the nanoparticles applicable to cell biology. Confocal imaging of the FITC-labeled peptide:pDNA formulation indicated cell uptake and intracellular entrapment within endosomes that restricted pDNA gene expression in the DU145 cells. Optimization studies with a reporter plasmid Green Fluorescent Protein (pGFP) revealed spermidine and chloroquine as the most effective additives for enhancing peptide-based transfection efficiency. Furthermore, blocking with anti-GRP78 confirmed the GRP78-dependent mechanism for cell uptake. Thus, peptide-targeting of GRP78 allows for selective binding and entry within the GRP78-overexpressing cancer cells for gene (pDNA) delivery. Transfection of the tumor suppressor p53-expression vector using the optimized peptide-based transfection conditions revealed elevated levels of p53 within the DU145 prostate cancer cells. These findings indicate the potential anti-cancer utility of the GRP78-targeting peptide gene (pDNA) delivery system.
Lipoprotein(a) as a Predictor of Nonalcoholic Fatty Liver after Pancreatectomy
Authors: Abe Kyohei , Fujioka Shuichi , Takano Yuki , Shirai Yoshihiro , Tsunematsu Masashi , Matsumoto Michinori , Furukawa Kenei , Haruki Koichiro , Onda Shinji , Ikegami Toru
Published: October 2024

Purpose
Lipoprotein(a) (Lp(a)) is a complex protein that plays a role in transporting insoluble lipids in plasma. Between 70% to more than 90% of Lp(a) expression is genetically determined by the number of Kringle IV type 2 domains. We investigated the association between preoperative serum Lp(a) level and development of post-pancreatectomy nonalcoholic fatty liver disease (NAFLD) in patients underwent pancreatectomy.
Methods
Serum Lp(a) level was measured preoperatively and retrospectively evaluated with other known risk factors for NAFLD, which was defined by a computed tomography-based Hounsfield unit (HU) value for liver parenchyma below 40 HU at the anteroposterior midpoint.
Results
NAFLD developed after pancreatectomy in 40 patients (17.5%) in high Lp(a)-group, which was significantly low as compared with those of low Lp(a)-group (30 patients, 53%) (p = 0.01). There was no other significant background factors which related to preoperative Lp (a) level. Multivariate analysis indicated low Lp(a) level is independent risk factors for postoperative NAFLD as well as pancreatic head resection, small volume of residual pancreatic volume, poor intake of pancrelipase, and postoperative diarrhea
Conclusion
NAFLD after pancreatectomy could be predicted preoperatively to a certain extent by examining serum Lp(a) level.
Forecasting Volume of Patients’ Visits in the Emergency Medicine Department at Muhimbili National Hospital, Tanzania
Authors: Mwalupani Nsajigwa , Pallangyo Edgar
Published: October 2024

Background
Emergency department overcrowding has developed as a severe and mounting problem common worldwide with substantial worldwide public health problems since it impedes the realization of Sustainable Development Goals of good health and well-being, including smooth planning and provision of quality services.
Objective
The main goal of this study is to forecast monthly patients’ visits in the Emergency Medicine Department at Muhimbili National Hospital, Tanzania to provide timely information to aid the decision-making process.
Methodology
Retrospective data of monthly patient visits registered in the Emergency Department at Muhimbili National Hospital from January 2016 to December 2020, with 60 observations, were collected. Time series methods of ARIMA and Multi-layer Perceptron (MLP) neural network models were used to analyze the data. The best model was chosen, and identified based on predicted accuracy between ARIMA and MLP models with the mean absolute percentage error (MAPE), root mean square error (RMSE), and mean absolute error (MAE). The software packages R Studio and Excel 2016 were used for statistical analyses.
Results
It was found that the MLP model with structure 2-(5)-1 performed better in the testing set (RMSE = 372.37, MAPE = 5.7282 and MAE = 304.70) compared to ARIMA (1,1,4) (RMSE = 426.69, MAPE = 6.9489 and MAE = 337.58 respectively). Also, the validation set of the MLP model with structure 2-(5)-1 performed better (RMSE = 763.89, MAPE = 17.3553 and MAE = 751.935) than ARIMA (1,1,4) (RMSE = 974.573, MAPE = 19.4181 and MAE = 893.9388 respectively).
Conclusions
Therefore, the MLP model with structure 2-(5)-1 was chosen for forecasting purposes whereby we predicted forecasts for 20 months. Finally, we recommend That the results of this study be adopted to help decision-makers and planners to be prepared and avoid dire situations.
Flow diverter with or without adjunctive coils in the treatment of large and giant intracranial aneurysms: a meta-analysis
Authors: Sein Matias E. , Ceciliano Alejandro , Navarro Fernando , Molina Silvina , Villasante Francisco , Tejado Eduardo E. , Requena Manuel , Hernandez David , Lascuevas Marta de Dios , Tomasello Alejandro , Diana Francesco
Published: October 2024

Introduction
To evaluate the available evidence on the efficacy and safety of flow diverters (FD) with or without adjunctive coils (C) for the treatment of large and giant aneurysms.
Methods
A systematic review and meta-analysis of relevant studies in PubMed and selected articles up to December 2022 were conducted. The primary objective was to evaluate the rate of favorable occlusion O'Kelly Marotta (OKM) C-D at the last follow-up, while the secondary objective was to assess complication rates. A fixed-effects model was used, and relative risks (RR) and 95% confidence intervals (CI) were calculated.
Results
A total of 146 articles were identified, but only 10 were included in the meta-analysis. This included 541 controlled aneurysms out of a total of 680 large and giant aneurysms from 1,667 patients. We found no statistical differences in favorable OKM C-D outcomes with or without the adjunctive use of coils (RR 1.06 [0.96, 1.17]; p = 0.280). However, FD + C presented fewer complications (RR 0.56 [0.33, 0.95]; I²=0%; p = 0.03). No statistical differences were found for mortality (RR 0.86 [0.34, 2.18]; I²=0%; p = 0.75).
Conclusions
The use of adjunctive coils during treatment of large and giant aneurysms with FD seems to reduce the risk of procedural and delayed complications, while it does not increase the aneurysm occlusion rate.
Statin prescription reduces the risk of death in cancer patients: Analysis of the Korean nationwide health insurance database
Authors: Kim JeongSook , Kim Yong-June , Kim Joungyoun , Lee Jae-woo , Kang Hee-Taik
Published: October 2024

Cancer is a leading cause of death in Korea, with the number and prevalence of cancer patients gradually increasing. This study was aimed to examine whether statin prescription in cancer patients is inversely associated with all-cause mortality. This retrospective study used the Korean nationwide health insurance claim data. The patients were divided into four groups based on the duration of statin prescription: non-users, T1, T2, and T3. Kaplan-Meier estimates and log-rank tests were performed to compare the survival rate among the four groups. Cox proportional hazards regression models were constructed to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality. A total of 154,916 patients were included (67,207 men and 87,709 women). The median study duration was 14.6 years. The estimated cumulative survival rate was the lowest in statin non-users and the highest in T3 in both sexes. After full adjustment, HRs (95% CIs) for all-cause mortality of T1, T2, and T3 were 0.637 (0.619 − 0.658), 0.482 (0.462 − 0.503), and 0.258 (0.244 − 0.272), respectively, in men and 0.608 (0.580 − 0.637), 0.406 (0.385 − 0.430), and 0.190 (0.178 − 0.203), respectively, in women. Even after stratifying overall cancers into the most common cancer types, statin prescription was inversely associated with all-cause mortality in most male and female cancer types in a dose-response manner. Statin prescription among cancer patients was inversely associated with all-cause mortality in both sexes and in most cancer types after stratification.
GRASLND is a prognostic biomarker and associated with immune infiltration in bladder cancer
Authors: Li Yuezheng , Fu Taozhu , Wu Ziang , Chen Hongrun , Li Weiren
Published: October 2024

GRASLND has been shown to be a potent biomarker in a variety of cancers. However, studies on GRASLND and bladder cancer have been limited. Therefore, this study aimed to analyze the expression of GRASLND and their relationship with clinicopathological features, prognosis and immune cell infiltration in patients of bladder cancer. The RNA sequencing data and clinical information of 412 patients with bladder cancer and 19 normal subjects were obtained from The Cancer Genome Atlas database. Our results demonstrated that GRASLND was highly expressed in bladder cancer (P < 0.001) and could effectively distinguish bladder cancer tissue from normal bladder tissue (area under the curve = 0.805). Moreover, the expression of GRASLND was significantly correlated with pathologic stage, pathologic T stage, pathologic N stage, histologic grade and subtype. Kaplan–Meier curves analysis revealed that patients with high gene expression had shorter overall survival and worse prognosis (hazard ratio = 1.46, P = 0.012). Cox regression analysis indicated that GRASLND expression, Age, Pathologic T stage, Pathologic N stage, Pathologic M stage, Pathologic stage and Subtype were risk factors for overall survival. Immunoinfiltration analysis found that the expression of GRASLND was positively correlated with the enrichment abundance of immune cells such as macrophages, Tgd and Tem. Collectively, our results suggested that GRASLND may be an important biomarker for the diagnosis and predicting prognosis of bladder cancer, and may even be a new therapeutic target.
Depression and Associated Factors Among Adult Diabetic Patients Attending at Diabetic Follow up Clinic of Mikilililand Health Center, Addis Ababa, Ethiopia, 2023: A Facility Based Cross-Sectional Study
Authors: Demelash Assamin , Awol Kemal , Metekie Assefa , Tilinty Haileleul
Published: October 2024

Background
Globally prevalence of diabetes mellitus is increasing at an alarming rate and causes a tremendous burden for the patient, the family, the society as well as the healthcare system. Early diagnosis and treatment with glycemic control and preventing diabetes related complications has been considered as an important treatment success for patients with diabetes mellitus. Depression has a potential on-going and devastating outcome in patients with diabetes mellitus. As a result, addressing the psychosocial support and prevention of depression is a key treatment success in patients with diabetes mellitus.
Objective
The aim of this study was to assess depression and its associated factors among type-2 diabetic patients attending at diabetic follow up clinic of Mikililand health center, Addis Ababa, Ethiopia, 2023.
Methods
A facility based cross-sectional study design was conducted among 162 type-2 diabetic patients attending at diabetic follow up clinic in Mikililand health center, Addis Ababa, Ethiopia, 2023. Multivariate logistic regression analysis was used to identify factors associated with depression. All predictor variables that had a significant association in bi variable analysis with p-value ≤ 0.25 were entered into multi variable logistic regression model to assess the association between dependent and independent variables. P-value ≤ 0.05 in multi variable logistic regressions were considered as statistically significant.
Result
159 (98.15% response rate) type 2 diabetic patients were participated and among the study participants, the overall prevalence of depression was 41.5%. Patients living in rent house [AOR = 5.927 (95% CI = 1.743,20.148)], longer duration of diabetes > 5 yrs since diagnosis [AOR = 16.038 (95% CI = 1.611,159.3648)],having family history of diabetes [AOR = 4.419 (95% CI = 1.044,18.701)], presence of diabetes related complications [AOR = 9.166 (95% CI = 2.866, 29.314)] and Alcohol use status [AOR = 30.148 (95% CI = 4.670,194.630)] were significantly associated with depression among T2DM patients.
Conclusions
This study indicated the overall prevalence of depression found to be high, which was 41.5%. The study found that depression status was highly influenced by being female patients, the longer duration of diabetes mellitus diagnosed, treatment and the presence of diabetes related complications, poor glycemic control, presence of comorbid medical illnesses, and patient’s alcohol use status and housing condition status.
Therefore, more efforts are required to screen all adult diabetic patients for depression with an integration psychological assessment and counseling service provisions in chronic follow up OPD.
A descriptive analysis of drug related problems identified when prescribing the COVID-19 antiviral drug Paxlovid®
Authors: Stoiber Alina , Gray Gwen , Sailer Gudrun , Huf Wolfgang , Tonna Antonella
Published: October 2024

Background
Paxlovid® is the only licensed oral COVID − 19 antiviral containing nirmatrelvir and ritonavir. Ritonavir is a potent inhibitor of cytochrome P450 enzymes resulting in clinically significant drug-drug interactions (DDIs).
Aim
To describe the frequency, type, and severity of detected drug related problems (DRPs) with Paxlovid®
Method
This study involved a retrospective, quantitative data analysis. All patients prescribed Paxlovid® in a public hospital in Vienna, were included. Data was collected from the patients’ records and recorded on a customised and piloted data collection form. Any DRPs were also noted. The severity of DDIs was classified using an established checker tool.
Results
122 of 140 (87.1%) patients required interventions to prevent DRPs; 63.6% of cases required intervention by the pharmacist at dispensing. The most common DRPs were DDIs (57.1%). In 24.3% of cases both renal impairment and DDIs were noted. 313 DDIs were recorded in 114 patients; in 24 patients, the interactions recorded were severe. In 3 patients (2.1%), Paxlovid® was prescribed despite being contraindicated due to severe renal impairment requiring pharmacist intervention.
Conclusion
This study demonstrated that numerous DRPs involving Paxlovid® were identified by the pharmacist following prescribing. Pharmacists’ involvement in prescribing highly interacting drugs such as Paxlovid® is beneficial to enhance patient safety.
Augmented reality (AR) in microsurgical multimodal image guided focal pediatric epilepsy surgery. A technical note
Authors: Shawarba Julia , Tomschik Matthias , Wais Jonathan , Winter Fabian , Dorfer Christian , Mayer Florian , Feucht Martha , Roessler Karl
Published: October 2024

Background: Augmented reality (AR) is increasingly being used to improve surgical planning and assist in real time surgical procedures. A retrospective investigation was conducted to study its role in pediatric epilepsy surgery at a single institution.
Methods: Functional neuronavigation using multimodal imaging data (fMRI, DTI-tractography, PET, SPECT, sEEG) were used to augment the surgical navigation by transferring 3D imaging reconstructions as AR maps into the surgical microscope overlaying the surgical field.
Results: Altogether, 43 patients (17 female, 0-18 yrs, mean 9 yrs) were operated between 10/2020 and 10/2023 and fulfilled the inclusion criteria. 26 patients (60.5%) had an extra-temporal and 17 (39.5%) a temporal seizure origin. The 3 top histological diagnoses were : FCD (32.6%), ganglioglioma (23.3%) and DNT (11.6%). Preoperative MRI studies showed no epileptogenic lesion in 11 patients (25.6%, MRI negativ group), which necessitated implantation of depth electrodes before resection. Altogether, of 25 patients with a follow up of more than one year, 83% displayed a favorable ILAE grade 1 seizure outcome (75% ILAE 1a). Altogether, 14% experienced a transient hemiparesis, 7% a quadrantanopia and one needed a subdural- peritoneal shunt.
Conclusion: AR supported microscope resection facilitated targeting and removal of lesional as well as non-lesional (sEEG defined) epileptogenic lesions in pediatric epilepsy surgery with low morbidity and a remarkably favourable seizure outcome.
Measurement Bias in Machine Learning-Enhanced Opioid Risk Scoring Systems
Authors: Wang Yun , Waston Drake , Wang Hao , Miotto Karen A. , Jose Kabir Snell , Varisco Tyler J. , Sambamoorthi Usha
Published: October 2024

Over the past two decades, Prescription Drug Monitoring Programs (PDMPs), augmented by machine learning-empowered clinical decision support (CDS) tools, have become essential in monitoring opioid prescriptions. The CDS tool employs proprietary algorithms to evaluate the risk associated with opioid prescribing. However, concerns have emerged regarding potential algorithmic biases that may disproportionately impact marginalized groups. Our analysis of California's PDMP data and ZIP code-based socio-demographic characteristics examined correlations between the common predictive features used in the CDS tools and sensitive attributes. Our findings indicated that predictive features might not favor females, White, Black, Native American, and Pacific Islander populations, older patients, neighborhoods with high percentages of disability and unemployment, and Medicare patients. Given the substantial influence of these CDS tools on prescribing practices, it is imperative to address these biases to ensure equitable access to pain management and to mitigate potential adverse effects on vulnerable patient populations.
Topical dexamethasone versus topical 10%lidocaine spray to reduce post-intubation sore throat in shoulder arthroscopic surgeries: A comparative study
Authors: abdalla Mona , attallah Hatem , salem Ahmed
Published: October 2024

Background
Postoperative sore throat is one of the most common postoperative complaints and can decrease patient satisfaction. The current study aimed to evaluate the effects of topical dexamethasone compared to 10% lidocaine spray in reducing post-intubation sore throats in patients undergoing shoulder arthroscopic surgeries.
Methods
In this study, 100 patients scheduled for shoulder arthroscopy under general anesthesia were intubated and randomly allocated into two groups. For the first group, an endotracheal tube was soaked in 8 mg of dexamethasone before intubation, while for the second group, the tube was sprayed with 10% lidocaine. The severity of sore throat in both groups was evaluated at 1 hour and 6 hours after extubation.
Result
The study compared the post-operative sore throat levels between the dexamethasone and lidocaine groups, each with 50 participants. There were no significant differences in demographics or operation duration between the groups. One hour post-operation, the dexamethasone group reported significantly less sore throat, with lower mean (0.72 ± 0.83) and median (0.5, IQR 0.0–1.0) sore throat scores compared to the lidocaine group (mean: 1.48 ± 0.84; median: 2.0, IQR 1.0–2.0). Similarly, six hours post-operation, the dexamethasone group continued to report significantly lower sore throat levels (mean: 0.42 ± 0.61; median: 0.0, IQR 0.0–1.0) than the lidocaine group (mean: 0.72 ± 0.76; median: 1.0, IQR 0.0–1.0).
Conclusion
Topical dexamethasone was more effective than lidocaine in reducing postoperative sore throat.
Trial registration
Clinical trials number NO. NCT06266481 Date 04/01/2024 ({1}) ({1})(https//clinicaltrials.gov/study/NCT06266481)
An experimental rat model for simultaneous induction of peripheral neuropathy and myelotoxicity by docetaxel administration: evaluating the protective role of dimethyl fumarate
Authors: Cubides-Cely Sebastian , Negrette-Guzmán Mario
Published: October 2024

Purpose
Docetaxel is a taxane antineoplastic widely used against different types of cancer. However, its efficacy is limited mainly by its myelotoxicity and peripheral neuropathy with neutropenia and nociceptive alterations as the main clinical signs, respectively. These adverse effects undermine the quality of life of patients leading them to treatment withdrawal. In this study, we set up a unique preclinical scheme for induction of both effects associated with docetaxel administration, in such a way that we can evaluate them in the same animal and carry out future protection trials.
Methods
Four docetaxel administration schemes were tested varying dose and dosage. Four days after the last dose, behavioral/sensory paw pressure, tail pressure and hot plate tests were conducted. Next, euthanasia was performed, and blood was obtained for total cell count and other toxicological markers. Once the scheme that better showed significant alterations in both nociception and neutropenia was chosen, joint administration with 100 mg/kg/day oral dimethyl fumarate was carried out to evaluate its protective effect.
Results
A scheme with six doses (5 mg/kg) of docetaxel administered weekly was chosen for protection trials. Dimethyl fumarate showed protection in nociceptive tests compared to the damage group. However, it did not show protection against neutropenia.
Conclusion
The confirmed experimental model is clinically representative as it was designed for rats through equivalent data obtained from clinical assays. It was useful to evaluate the protective potential of dimethyl fumarate, showing how it could attenuate docetaxel-induced peripheral neuropathy, but not neutropenia.
KLF2 controls the apoptosis of neutrophils and is associated with disease activity of systemic lupus erythematosus
Authors: Zhao Hongshuai , Lin Zaichuan , Zhang Peiwen , Rao Jiayue , Xu Shumin , Luo Qing , Li Junming
Published: October 2024

Background
Neutropenia is more common in patients with systemic lupus erythematosus (SLE) and is a major cause of life-threatening infections. The increased apoptosis of neutrophils is likely to be an essential cause of neutropenia in SLE. However, the detailed mechanisms of increased neutrophil apoptosis in SLE remain unknown. Recent evidence suggests that Krüppel-like factor 2 (KLF2), a transcription factor associated with susceptibility to SLE, is likely to be a potential therapeutic target for SLE.
Methods
This study focused on the role of KLF2 in the regulation of neutrophil apoptosis and its association with SLE disease activity. First, the expression of KLF2 in neutrophils of SLE was detected by real-time PCR and western blotting. The apoptosis levels and caspase3 mRNA levels in neutrophils from SLE patients and healthy controls were detected and analyzed. The correlation between KLF2 mRNA levels and apoptosis was analyzed. neutrophils from Health controls (HCs) were cultured in RPMI 1640 medium containing the KLF2 inhibitor Geranylgeranyl pyrophosphate (GGPP) or the KLF2 inducer geranylgeranyl transferase inhibitor (GGTI-298), and then the KLF2 levels and the apoptosis levels were detected in neutrophils. Lastly, neutrophils from HCs were cultured in RPMI 1640 medium containing sera from SLE patients, followed by the detection of KLF2 mRNA levels and apoptosis levels of neutrophils. Then, the correlation between KLF2 mRNA levels and SLE disease activity index (SLEDIA) was analyzed.
Results
It was shown that the expression of KLF2 in neutrophils of SLE patients is significantly suppressed, and the decreased KLF2 is associated with the upregulation of neutrophil apoptosis. Moreover, newly diagnosed SLE patients, SLE patients with higher serum IgG and positive anti-Smith antibodies had lower KLF2 expression. Furthermore, we demonstrated that modulating the expression of KLF2 can regulate the apoptosis of neutrophils. The levels of KLF2 in neutrophils were associated with the SLEDIA. In addition, we found that serum from SLE patients could induce apoptosis in neutrophils by down-regulating the expression of KLF2.
Conclusion
In summary, we revealed for the first time that KLF2 can regulate the apoptosis of neutrophils in this study. Moreover, our research showed that the KLF2 levels in neutrophils are closely related to the disease activity of SLE, which suggests that KLF2 in neutrophils may be involved in the occurrence and development of SLE.