bluuebunny/crossref_metadata_2025 huggingface dataset:
Elevated middle cerebral artery peak systolic velocity and risk of death in donor twin affected by twin–twin transfusion syndrome but not twin anemia–polycythemia sequence
Authors: Espinoza J. , Agarwal N. , Johnson A. , Hernandez‐Andrade E. , Backley S. , Papanna R. , Bergh E. P.
Published: March 2024

Objectives

To determine the association between elevated (> 1.5 multiples of the median (MoM)) middle cerebral artery (MCA) peak systolic velocity (PSV) and fetal demise of the donor twin in pregnancies complicated by twin–twin transfusion syndrome (TTTS) in the absence of twin anemia–polycythemia sequence (TAPS). Secondary objectives were to evaluate if donor or recipient MCA‐PSV is associated with a risk for their corresponding fetal death, and to compare the proportion of donor fetuses with low MCA pulsatility index (PI) among donor twins with high MCA‐PSV and those with normal MCA‐PSV to evaluate the contribution of blood‐flow redistribution to the fetal brain in donor twins with high MCA‐PSV.

Methods

This prospective cohort study included TTTS cases that underwent laser surgery between 2011 and 2022 at a single center. TAPS cases were excluded from the study. Multivariable and Poisson regression analysis were performed to explore the association between isolated elevated donor MCA‐PSV and fetal demise, adjusted for TTTS stage, selective fetal growth restriction (sFGR) and other confounders.

Results

Of 660 TTTS cases, donor MCA‐PSV was not recorded in 48 (7.3%) cases. Of the remaining 612 patients, nine (1.5%) were lost to follow‐up and 96 TAPS cases were excluded; thus, 507 cases were included in the study. High donor MCA‐PSV was seen in 6.5% (33/507) of cases and was an independent risk factor for donor fetal demise (adjusted relative risk (aRR), 4.52 (95% CI, 2.72–7.50)), after adjusting for confounders. Regression analysis restricted to each Quintero TTTS stage demonstrated that high donor MCA‐PSV was an independent risk factor for fetal demise of the donor in Quintero Stage II (aRR, 14.21 (95% CI, 1.09–186.2)) and Quintero Stage III (aRR, 3.41 (95% CI, 1.82–6.41)). Donor MCA‐PSV in MoM was associated with fetal demise of the donor (area under the receiver‐operating‐characteristics curve (AUC), 0.69; P < 0.001), but recipient MCA‐PSV in MoM was not associated with fetal demise of the recipient (AUC, 0.54; P = 0.44). A higher proportion of donor twins in the group with high MCA‐PSV had a low MCA‐PI compared to the group with normal MCA‐PSV (33.3% vs 15.5%; P = 0.016).

Conclusions

Elevated donor MCA‐PSV without TAPS prior to laser surgery for TTTS is associated with a 4‐fold increased risk for donor fetal demise, adjusted for sFGR, TTTS stage and other confounders. Doppler evaluation of donor MCA‐PSV prior to laser surgery may help stratify TTTS staging to evaluate the risk of donor fetal demise. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.
Mechanical and cytotoxic analysis of cutlery developed from phenol‐formaldehyde modified soy‐jute composite
Authors: Behera Ajaya Kumar , Pattnaik Shruti Swaroop , Mohanty Chirasmayee , Srivastav Rohit , Pradhan Jyotsnarani
Published: March 2024

The need of the hour is for the creation of natural fiber‐based, biodegradable cutlery in order to protect our planet from pollution caused by plastic. Soy resin creates a hard eco‐friendly/biodegradable composite when combined with phenol‐formaldehyde/resole and a natural fiber like jute. In this experiment, soy and other ingredients are combined with various weight percentages of resoles. Jute‐modified soy composites are characterized through Fourier transform infra‐red spectroscopy, mechanical testing and found maximum tensile strength of 46.62 MPa. After 8 weeks of microbial degradation testing on the generated composites, it is discovered that the mechanically optimized composite lost only 17.7% of its initial weight. Cutlery pieces are molded using the jute‐soy/jute‐resole modified soy composition, and cytotoxicity testing has shown that they are non‐toxic. Because they are non‐toxic and biodegradable, these composites can be used as a substitute to non‐biodegradable plastic in a range of industries.
Functionalization of a liquid natural rubber by iron‐mediated radical chloro‐nitration and its thermal decomposition
Authors: Doan Khai Minh , Tran Trung Bao , Kim Hop Dinh , Dam Hieu Quang , Nguyen Tuan Duy , Ly Vuong Quoc
Published: March 2024

This study presents the functionalization of liquid natural rubber (LNR) by iron‐mediated radical chloro‐nitration over the LNR backbone, resulting in a chloro‐nitro compound of liquid natural rubber (Cl‐N‐LNR). The chloro‐nitration was prepared by a reaction of LNR with iron(III) nitrate nonahydrate and iron(III) chloride in an organic solvent. The structure of the obtained product was confirmed by using Fourier‐transform infrared spectroscopy (FTIR), proton nuclear magnetic resonance (1H NMR), and carbon‐13 nuclear magnetic resonance (13C NMR), which showed the existence of chloro‐nitro groups in the Cl‐N‐LNR chain. The degree of functionalization with a nitro group is 13.4% mol units of Cl‐N‐LNR. The thermal degradation was determined by the thermogravimetric analysis (TGA) method. As a result, the kinetic parameters for the degradation of Cl‐N‐LNR were calculated in the range from 40 to 330 °C. The half‐life of Cl‐N‐LNR was found to be about 33.0 years.
Synthesis of materials from agricultural wastes combined with Fe3O4for methylene blue adsorption and application to treat organic pollutants in water samples
Authors: Thi Hoang Anh , Phuc Le Thien , Van Trong Nguyen , Thuy Tran Thi Thanh
Published: March 2024

This study presents the adsorption process of methylene blue and other organic pigments in water samples using synthetic materials derived from agricultural waste combined with Fe3O4. The properties of the materials were determined through Fourier transform infrared spectroscopy, scanning electron microscopy, X‐ray diffraction, and nitrogen adsorption‐desorption isotherm. The result shows the successful association of Fe3O4on materials prepared from agriculture with a surface area = 3.594 m2g−1and a pore size of 49.713 nm. The optimal factors of methylene blue removal process, such as pH, mass, initial concentration, time, and shaking speed, were also investigated, respectively. The maximum adsorption capacity of the material is 268.64 mg g−1, with an adsorption efficiency of 98.84%. The research method was applied to analyze and evaluate the materials' adsorption capacity in the southern provinces of Vietnam water samples.
Synthesis, characterization and anticancer activity of Ni(II), Cu(II), Pd(II) and Au(III) complexes derived from novel Mannich base
Authors: Manhee Tamara Q. , Alabdali Ammar J.
Published: March 2024

New four complexes of Ni(II), Cu(II), Pd(II), and Au(III) were derived from the tridentate ligand 3‐((3‐(4‐hydroxyphenyl)‐5‐mercapto‐4H‐1,2,4‐triazol‐4‐yl)(3‐oxobutyl)amino)naphtho[2,3‐b]furan‐2(3H)‐one (L), which synthesized using condensation reaction of formaldehyde, acetone, and secondary amine (Mannich reaction). The secondary amine is a heterocyclic compound possesses two rings, naphthafuran and triazole, both rings prepared through intermolecular cyclization reactions. Considering that naphthafuran‐2‐one derived from α‐amino nitrile. The α‐amino nitrile compound contains the other triazole ring which illustrated to the structure through successive steps. The compounds were characterized using elemental analysis (C.H.N.S), FT‐IR, ultraviolet–visble spectroscopy, thermal gravimetric analysis (TGA), flame atomic absorption, molar conductivity, and magnetic susceptibility measurements. Accordingly, the probable geometries of the complexes were suggested as square planner, and they have electrolytic nature. Thus, chemical formula; [NiLCl]Cl·6H2O, [CuLCl]Cl·2H2O, [PdLCl]Cl·2H2O, and [AuLCl]Cl2·3H2O. Cytotoxic effect was studied on brain cancer cell line (AMJM cell line) at different concentrations for L and complexes. The results showed that gold(III) complex has the highest cytotoxicity among all compounds.
Design, in silico studies, synthesis, and in vitro anticancer assessment of new naphthylidene isoxazolidinedione derivatives
Authors: Upadhyay Neha , Tilekar Kalpana , Oak Aditi , Pokrovsky Vadim S. , Subramanian Chelakara Ramaa
Published: March 2024

Cancer is the most destructive and fatal disease, representing an urgent medical challenge to the world. The discovery of a new anticancer candidate may help reduce or eliminate this alarming disease to a greater extent. On similar lines, in silico research was carried out on novel naphthylidene isoxazolidinedione derivatives that were logically conceived, synthesized, purified, and structurally characterized. In vitro biological evaluation revealed the most active compound 4d with an inhibitory concentration of 42.87 µm against K562 and 47.42 µm on A549 cells. The anticancer activity of this naphthylidene isoxazolidinedione derivative was evident by cell cycle and apoptosis assays, which showed arrest of the G2/M phase (65.6%) of the K562 cells and induction of apoptosis with 21.47% apoptotic cells as compared to 0.2% of untreated cells, respectively.
Potential oxidoreductases inhibitors from medicinal plants‐based phytochemicals: A review
Authors: Gomes Tarsila , Alejandro Gracebio , Thao Tran Thi Phuong , Vieira Amandio Vincent
Published: March 2024

Oxidoreductases (ORases) are enzymes that catalyze oxidation and reduction reactions in cells or extracellular compartments of the body. Genetic mutations and other factors that affect ORase activity have been implicated in a range of diseases, especially inherited metabolic disorders. Aldose reductase, sorbitol dehydrogenase, xanthine oxidoreductase are the ORases with relevance to diabetes pathology. Herein, the strategies for screening modulators of ORase activities, and medicinal plants whose phytochemicals have the potential to influence ORase activity, are described. The overall goal is to test and identify natural products and other compounds that may have a therapeutic benefit in relation to hyperglycemia and diabetes.
Cell-specific IL-1R1 regulates the regional heterogeneity of microglial displacement of GABAergic synapses and motor learning ability
Authors: You Yi , An Da-dao , Wan Yu-shan , Zheng Bai-xiu , Dai Hai-bin , Zhang She-hong , Zhang Xiang-nan , Wang Rong-rong , Shi Peng , Jin Mingjuan , Wang Yi , Jiang Lei , Chen Zhong , Hu Wei-Wei
Published: March 2024

Microglia regulate synaptic function in various ways, including the microglial displacement of the surrounding GABAergic synapses, which provides important neuroprotection from certain diseases. However, the physiological role and underlying mechanisms of microglial synaptic displacement remain unclear. In this study, we observed that microglia exhibited heterogeneity during the displacement of GABAergic synapses surrounding neuronal soma in different cortical regions under physiological conditions. Through three-dimensional reconstruction, in vitro co-culture, two-photon calcium imaging, and local field potentials recording, we found that IL-1β negatively modulated microglial synaptic displacement to coordinate regional heterogeneity in the motor cortex, which impacted the homeostasis of the neural network and improved motor learning ability. We used the Cre-Loxp system and found that IL-1R1 on glutamatergic neurons, rather than that on microglia or GABAergic neurons, mediated the negative effect of IL-1β on synaptic displacement. This study demonstrates that IL-1β is critical for the regional heterogeneity of synaptic displacement by coordinating different actions of neurons and microglia via IL-1R1, which impacts both neural network homeostasis and motor learning ability. It provides a theoretical basis for elucidating the physiological role and mechanism of microglial displacement of GABAergic synapses.
Caspase-11/GSDMD contributes to the progression of hyperuricemic nephropathy by promoting NETs formation
Authors: Wu Fan , Chen Caiming , Lin Guo , Wu Chengkun , Xie Jingzhi , Lin Kongwen , Dai Xingchen , Chen Zhengyue , Ye Keng , Yuan Ying , Chen Zhimin , Ma Huabin , Lin Zishan , Xu Yanfang
Published: March 2024

Hyperuricemia is an independent risk factor for chronic kidney disease (CKD) and promotes renal fibrosis, but the underlying mechanism remains largely unknown. Unresolved inflammation is strongly associated with renal fibrosis and is a well-known significant contributor to the progression of CKD, including hyperuricemia nephropathy. In the current study, we elucidated the impact of Caspase-11/Gasdermin D (GSDMD)-dependent neutrophil extracellular traps (NETs) on progressive hyperuricemic nephropathy. We found that the Caspase-11/GSDMD signaling were markedly activated in the kidneys of hyperuricemic nephropathy. Deletion of Gsdmd or Caspase-11 protects against the progression of hyperuricemic nephropathy by reducing kidney inflammation, proinflammatory and profibrogenic factors expression, NETs generation, α-smooth muscle actin expression, and fibrosis. Furthermore, specific deletion of Gsdmd or Caspase-11 in hematopoietic cells showed a protective effect on renal fibrosis in hyperuricemic nephropathy. Additionally, in vitro studies unveiled the capability of uric acid in inducing Caspase-11/GSDMD-dependent NETs formation, consequently enhancing α-smooth muscle actin production in macrophages. In summary, this study demonstrated the contributory role of Caspase-11/GSDMD in the progression of hyperuricemic nephropathy by promoting NETs formation, which may shed new light on the therapeutic approach to treating and reversing hyperuricemic nephropathy.
Knotted toroidal sets, attractors and incompressible surfaces
Authors: Barge Héctor , Sánchez-Gabites J. J.
Published: March 2024

In this paper we give a complete characterization of those knotted toroidal sets that can be realized as attractors for discrete or continuous dynamical systems globally defined in $${\mathbb {R}}^3$$

R

3

. We also see that the techniques used to solve this problem can be used to give sufficient conditions to ensure that a wide class of subcompacta of $${\mathbb {R}}^3$$

R

3

that are attractors for homeomorphisms must also be attractors for flows. In addition we study certain attractor-repeller decompositions of $${\mathbb {S}}^3$$

S

3

which arise naturally when considering toroidal sets.
Decreased circulating CTRP3 levels in acute and chronic cardiovascular patients
Authors: Schmid Andreas , Pankuweit Sabine , Vlacil Ann-Kathrin , Koch Sören , Berge Benedikt , Gajawada Praveen , Richter Manfred , Troidl Kerstin , Schieffer Bernhard , Schäffler Andreas , Grote Karsten
Published: March 2024

C1q/TNF-related protein 3 (CTRP3) represents an adipokine with various metabolic and immune-regulatory functions. While circulating CTRP3 has been proposed as a potential biomarker for cardiovascular disease (CVD), current data on CTRP3 regarding coronary artery disease (CAD) remains partially contradictory. This study aimed to investigate CTRP3 levels in chronic and acute settings such as chronic coronary syndrome (CCS) and acute coronary syndrome (ACS). A total of 206 patients were classified into three groups: CCS (n = 64), ACS having a first acute event (ACS-1, n = 75), and ACS having a recurrent acute event (ACS-2, n = 67). The control group consisted of 49 healthy individuals. ELISA measurement in peripheral blood revealed decreased CTRP3 levels in all patient groups (p < 0.001) without significant differences between the groups. This effect was exclusively observed in male patients. Females generally exhibited significantly higher CTRP3 plasma levels than males. ROC curve analysis in male patients revealed a valuable predictive potency of plasma CTRP3 in order to identify CAD patients, with a proposed cut-off value of 51.25 ng/mL. The sensitivity and specificity of prediction by CTRP3 were congruent for the subgroups of CCS, ACS-1, and ACS-2 patients. Regulation of circulating CTRP3 levels in murine models of cardiovascular pathophysiology was found to be partly opposite to the clinical findings, with male mice exhibiting higher circulating CTRP3 levels than females. We conclude that circulating CTRP3 levels are decreased in both male CCS and ACS patients. Therefore, CTRP3 might be useful as a biomarker for CAD but not for distinguishing an acute from a chronic setting.

Key messages

CTRP3 levels were found to be decreased in both male CCS and ACS patients compared to healthy controls. Plasma CTRP3 has a valuable predictive potency in order to identify CAD patients among men and is therefore proposed as a biomarker for CAD but not for distinguishing between acute and chronic settings.

Regulation of circulating CTRP3 levels in murine models of cardiovascular pathophysiology was found to be partly opposite to the clinical findings in men.
The Irreducibility of the Monodromy Representation Associated with the Dotsenko–Fateev Equation
Authors: Mimachi Katsuhisa
Published: March 2024

We study the monodromy representation on the solution space of the Fuchsian differential equation of order 3 derived by Dotsenko and Fateev. In particular, we give a condition for the representation being irreducible, construct the subsystems in reducible cases, and obtain the monodromy-invariant Hermitian form on the solution space.
Mutational analysis in Corynebacterium stationis MFS transporters for improving nucleotide bioproduction
Authors: Kinose Keita , Shinoda Keiko , Konishi Tomoyuki , Kawasaki Hisashi
Published: March 2024

Product secretion from an engineered cell can be advantageous for microbial cell factories. Extensive work on nucleotide manufacturing, one of the most successful microbial fermentation processes, has enabled Corynebacterium stationis to transport nucleotides outside the cell by random mutagenesis; however, the underlying mechanism has not been elucidated, hindering its applications in transporter engineering. Herein, we report the nucleotide-exporting major facilitator superfamily (MFS) transporter from the C. stationis genome and its hyperactive mutation at the G64 residue. Structural estimation and molecular dynamics simulations suggested that the activity of this transporter improved via two mechanisms: (1) enhancing interactions between transmembrane helices through the conserved “RxxQG” motif along with substrate binding and (2) trapping substrate-interacting residue for easier release from the cavity. Our results provide novel insights into how MFS transporters change their conformation from inward- to outward-facing states upon substrate binding to facilitate efflux and can contribute to the development of rational design approaches for efflux improvements in microbial cell factories.

Keypoints

• An MFS transporter from C. stationis genome and its mutation at residue G64 were assessed

• It enhanced the transporter activity by strengthening transmembrane helix interactions and trapped substrate-interacting residues

• Our results contribute to rational design approach development for efflux improvement

Graphical Abstract
A Different Approach for Protruding Earlobe Correction—Modified Fish-tail Technique
Authors: Sert Batuhan , Oral Meltem Ayhan , Turan Ozgur , Uyar Ilker
Published: March 2024

Background

Protruding ears are the most common auricular abnormalities seen in children (1). Protruding ears are a condition that has social and psychological consequences due to its physical appearance and one of the main causes of peer bullying at young ages (2). While various surgical methods exist to address prominent ears, the options for correcting the lobule are relatively scarce. In this study, we are aimed to present the modified fish-tail technique that we have developed and to compare it with other techniques in the literature.

Methods

The patients were selected from the cases that underwent otoplasty for prominent ear correction in our clinic between 2020 and 2022. A total of 21 cases that required protruded lobule correction during otoplasty were included in our study. Keloid and hypertrophic scar formation, wound dehiscence, hematoma, infection and recurrence in the lobule were evaluated. The patients were followed up for at least 1 year for early and late complications.

Results

Each patient in the study underwent bilateral prominent ear correction, including bilateral modified fish-tail technique. All cases were followed for at least 12 months. There was no wound dehiscence, infection, recurrence in lobule prominence or hematoma during the follow-up period. No hypertrophic scar or keloid was observed in any case.

Conclusions

Our method stands out for its ability to achieve both adjustable vertical height and effective lobule correction with a reduced need for skin excision. We recommend the modified fish-tail technique as an alternative technique for prominent lobule surgery.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of contents or the online Instructions to Authors www.springer.com/00266.
Robot-assisted laparoscopic nephrectomy: early outcome measures with the implementation of multimodal analgesia and intrathecal morphine via the acute pain service
Authors: Meineke Minhthy N. , Losli Matthew V. , Sztain Jacklynn F. , Swisher Matthew W. , Abramson Wendy B. , Martin Erin I. , Furnish Timothy J. , Salmasi Amirali , Derweesh Ithaar H. , Gabriel Rodney A. , Said Engy T.
Published: March 2024

Purpose

The objective of this study was to perform a retrospective cohort analysis, in which we measured the association of an acute pain service (APS)-driven multimodal analgesia protocol that included preoperative intrathecal morphine (ITM) compared to historic controls (i.e., surgeon-driven analgesia protocol without ITM) with postoperative opioid use.

Methods

This was a retrospective cohort study in which the primary objective was to determine whether there was a decrease in median 24-h opioid consumption (intravenous morphine equivalents [MEQ]) among robotic nephrectomy patients whose pain was managed by the surgical team prior to the APS, versus pain managed by APS. Secondary outcomes included opioid consumption during the 24–48 h and 48–72 h period and hospital length of stay. To create matched cohorts, we performed 1:1 (APS:non-APS) propensity score matching. Due to the cohorts occurring at the different time periods, we performed a segmented regression analysis of an interrupted time series.

Results

There were 76 patients in the propensity-matched cohorts, in which 38 (50.0%) were in the APS cohort. The median difference in 24-h opioid consumption in the pre-APS versus APS cohort was 23.0 mg [95% CI 15.0, 31.0] (p < 0.0001), in favor of APS. There were no differences in the secondary outcomes. On segmented regression, there was a statistically significant drop in 24-h opioid consumption in the APS cohort versus pre-APS cohort (p = 0.005).

Conclusions

The implementation of an APS-driven multimodal analgesia protocol with ITM demonstrated a beneficial association with postoperative 24-h opioid consumption following robot-assisted nephrectomy.
Total knee arthroplasty survivorship and outcomes in young patients: a review of the literature and 40-year update to a longitudinal study
Authors: Bergstein Victoria E. , Weinblatt Aaron I. , Taylor Walter L. , Long William J.
Published: March 2024

Introduction

Growing numbers of younger patients are electing to undergo total knee arthroplasty (TKA) for end-stage osteoarthritis. The purpose of this study was to compare established literature regarding TKA outcomes in patients under age 55, to data from an ongoing longitudinal young patient cohort curated by our study group. Further, we aimed to provide a novel update on survivorship at 40 years post-TKA from our longitudinal cohort.

Methods

A literature search was conducted using the electronic databases PubMed, Embase, and Cochrane Library, using terms related to TKA, patients under age 55, and osteoarthritis. Demographic and outcome data were extracted from all studies that met the inclusion criteria. Data were divided into the “longitudinal study (LS) group,” and the “literature review (LR) group” based on the patient population of the study from which it came.

Results

After screening, 10 studies met the inclusion criteria; 6 studies comprised the LR group, and 4 studies comprised the LS group. 2613 TKAs were performed among the LR group, and 114 TKAs were longitudinally followed in the LS group. The mean patient ages of the LR and LS groups were 46.1 and 51, respectively. Mean follow-up was 10.1 years for the LR group. Mean postoperative range of motion was 113.6° and 114.5° for the LR and LS groups, respectively. All-cause survivorship reported at 10 years or less ranged from 90.6% to 99.0%. The LS cohort studies reported survivorship ranges of 70.1–70.6% and 52.1–65.3% at 30 and 40 years, respectively.

Conclusions

Young TKA patients demonstrated improved functionality at each follow-up time point assessed. Survivorship decreased with increasing lengths of follow-up, ultimately ranging from 52.1–65.3% at 40 years post-TKA. The paucity of literature on long-term TKA outcomes in this patient population reinforces the necessity of further research on this topic.
A nasal airflow oscillation device targeting nasal congestion: a preliminary report
Authors: Bartley Jim , Hankin Robin
Published: March 2024

Purpose

Upper respiratory tract complaints are common in the general population. A safe, non-pharmacologic treatment would be an attractive option for many patients either as an alternative to existing therapies, or as a complementary therapy. This study assessed the acceptability, safety and possible efficacy of a nasal airflow oscillation device in a group of people suffering chronic nasal congestion.

Methods

Subjects with a known history of nasal congestion, but without fixed anatomical obstruction, participated in a prospective clinical study. Efficacy was assessed using peak nasal inspiratory flow (NPIF) and a 10-point visual analogue scale (VAS) administered before and after the oscillation device had been worn for twenty minutes.

Results

Twenty-one subjects (mean age 37 years; 43% female) were enrolled in the study. After treatment with the small nasal airflow oscillation device for twenty minutes, average NPIF increased significantly from 84.8 L/minute to 99.0 L/minute (p < 0.05). There was a corresponding significant reduction in the VAS score for nasal congestion (p < 0.05). Similar significant improvements were also seen for the immediate sensation of nasal drainage, sinonasal pressure and overall sinonasal symptoms (p < 0.05). There was no change in the sense of smell (p = 0.37). Subjects rated ease of use highly; average = 9.1 (Range 7–10).

Conclusion

Treatment of nasal congestion with the nasal airflow oscillation device was found to result in significant improvement in NPIF after twenty minutes of use. Initial patient-reported outcomes improved significantly, and the treatment was safe and highly acceptable.

Trial registration

Public clinical trial registration: Universal Trial Number (U1111-1259-0704). Australian New Zealand clinical trials registration: ACTRN12623001307695.
Effectiveness and tolerability of brivaracetam in patients with epilepsy stratified by comorbidities and etiology in the real world: 12-month subgroup data from the international EXPERIENCE pooled analysis
Authors: Szaflarski Jerzy P. , Besson Hervé , D’Souza Wendyl , Faught Edward , Klein Pavel , Reuber Markus , Rosenow Felix , Salas-Puig Javier , Soto Insuga Victor , Steinhoff Bernhard J. , Strzelczyk Adam , Bourikas Dimitrios , Daniels Tony , Floricel Florin , Friesen David , Laloyaux Cédric , Villanueva Vicente
Published: March 2024

Objective

To assess the effectiveness and tolerability of brivaracetam (BRV) in adults with epilepsy by specific comorbidities and epilepsy etiologies.

Methods

EXPERIENCE/EPD332 was a pooled analysis of individual patient records from several non-interventional studies of patients with epilepsy initiating BRV in clinical practice. Outcomes included ≥ 50% reduction from baseline in seizure frequency, seizure freedom (no seizures within prior 3 months), continuous seizure freedom (no seizures since baseline), BRV discontinuation, and treatment-emergent adverse events (TEAEs) at 3, 6, and 12 months. Analyses were performed for all adult patients (≥ 16 years of age) and stratified by comorbidity and by etiology at baseline (patients with cognitive/learning disability [CLD], psychiatric comorbidity, post-stroke epilepsy, brain tumor−related epilepsy [BTRE], and traumatic brain injury−related epilepsy [TBIE]).

Results

At 12 months, ≥ 50% seizure reduction was achieved in 35.6% (n = 264), 38.7% (n = 310), 41.7% (n = 24), 34.1% (n = 41), and 50.0% (n = 28) of patients with CLD, psychiatric comorbidity, post-stroke epilepsy, BTRE, and TBIE, respectively; and continuous seizure freedom was achieved in 5.7% (n = 318), 13.7% (n = 424), 29.4% (n = 34), 11.4% (n = 44), and 13.8% (n = 29), respectively. During the study follow-up, in patients with CLD, psychiatric comorbidity, post-stroke epilepsy, BTRE, and TBIE, 37.1% (n = 403), 30.7% (n = 605), 33.3% (n = 51), 39.7% (n = 68), and 27.1% (n = 49) of patients discontinued BRV, respectively; and TEAEs since prior visit at 12 months were reported in 11.3% (n = 283), 10.0% (n = 410), 16.7% (n = 36), 12.5% (n = 48), and 3.0% (n = 33), respectively.

Conclusions

BRV as prescribed in the real world is effective and well tolerated among patients with CLD, psychiatric comorbidity, post-stroke epilepsy, BTRE, and TBIE.
Deriving and validating a protocol to determine the need for prophylactic peritoneal dialysis in neonates after cardiopulmonary bypass surgery
Authors: Webb Tennille N. , Borasino Santiago , Hock Kristal M. , Aban Inmaculada , Ingram Daryl , Short Kara , Dabal Robert , Askenazi David
Published: March 2024

Background

Prophylactic peritoneal dialysis (PD) in neonates undergoing cardiopulmonary bypass (CPB) is safe and improves outcomes. We sought to (1) derive the pre-operative characteristics of neonates who are most likely to benefit from PD after CPB and (2) validate a new prophylactic PD protocol based on our retrospective analysis.

Methods

First, we retrospectively evaluated neonates requiring cardiac surgery with CPB from October 2012 to June 2016. We categorized neonates as those who “needed PD” and those who “did not need PD” based on prior experience with neonates requiring kidney support therapy. Pre-operative serum creatinine ≥ 0.8 mg/dL, pre-operative weight ≤ 2.5 kg, or having an open chest post-operatively were independently associated with “needed PD.” Next, beginning in March 2019, we implemented a new prophylactic PD protocol in which only those who met at least one of the three criteria derived in the retrospective analysis had a PD catheter placed in the OR.

Results

In Era 2, after the implementation of a new prophylactic PD protocol, 100% of neonates in the “needed PD” group had a PD catheter placed in the OR, which was more than in the prior era (Era 1 = 86.6%) (p = 0.05). Only 26.1% in the “did not need PD” group had a PD catheter placed in the OR which was less than in the prior era (Era 1 = 50.6%) (p < 0.01).

Conclusions

We successfully developed and implemented an evidence-based prophylactic PD protocol that has improved our ability to provide prophylactic PD in neonates after CPB.

Graphical Abstract
An extended intuitionistic fuzzy ABAC method for evaluating innovative project ideas
Authors: Cubukcu Ahmet , Ervural Bilal , Ayaz Halil Ibrahim
Published: March 2024

The innovation process typically follows a predefined sequence of phases: idea generation, screening, evaluation/selection, development, and launch/diffusion. This process exhibits a dynamic and cyclic structure. At each stage, potential ideas may undergo elimination or redefinition based on considerations such as their problem–solution fit or product–market fit. Consequently, the idea evaluation phase can be conducted continuously, involving varying numbers of potential ideas. To address the challenges associated with this process, a systematic approach for selecting the best new project ideas is essential. This study introduces the IF-ABAC method, which extends the alternative-by-alternative comparison-based (ABAC) method to the intuitionistic fuzzy (IF) environment. The proposed approach represents the first combination of fuzzy sets and ABAC within a group decision-making environment. The IF-ABAC method is employed during the evaluation phase, with the best–worst method determining the criteria weights. The study describes how the IF-ABAC approach adeptly manages changes in the set of alternatives after the decision process, addressing the dynamics inherent in decision-making environments. The study further includes an analysis of innovative business ideas in a real case study from Turkey, demonstrating the feasibility and efficiency of the proposed approach. A comprehensive sensitivity analysis is conducted to illustrate the stability and utility of the method. Finally, the results are compared with three other IF-based multi-criteria decision-making methods from the literature. The study concludes by asserting that the proposed IF-ABAC method provides a comprehensive and practical approach to select innovation project ideas in an environment of uncertainty and complexity.
High remnant cholesterol as a risk factor for developing chronic kidney disease in patients with prediabetes and type 2 diabetes: a cross-sectional study of a US population
Authors: Zhu Wenting , Liu Qiushi , Liu Fang , Jiao Chenfeng , Zhang Lihua , Xie Honglang
Published: March 2024

Aims

To examine any potential links between remnant cholesterol (RC) and comorbid chronic kidney disease (CKD) in individuals with prediabetes and type 2 diabetes mellitus (T2DM).

Methods

We used data from 2709 American people aged > 20 years from the National Health and Nutrition Examination Survey (NHANES) during 2011–2018. Subjects were categorized according to whether they had comorbid CKD. Logistic regression models and smoothed curve fitting methods were employed to assess the association of RC with comorbid CKD in patients with prediabetes and T2DM.

Results

The 2709 participants included 1473 patients with T2DM and 1236 with prediabetes [impaired glucose tolerance (IGT) and impaired fasting glucose (IFG)], of whom 744 (27.46%) had comorbid CKD. In multivariate-adjusted analysis, both RC and triglycerides (TG) were significantly associated with an increased risk of comorbid CKD, and a 1 mmol/L elevation of RC increased the risk by 38.1% [OR (95% CI) 1.636 (1.242, 2.156)], which was higher than the risk associated with a 1 mmol/L increase in TG [1.255 (1.106, 1.424)]. Additionally, those in the highest quartile of RC had a 43.6% higher risk of concomitant renal damage than those in the lowest quartile. RC was linearly and positively associated with the incidence of comorbid CKD in this population.

Conclusions

RC is an independent risk factor for comorbid CKD in patients with prediabetes and T2DM. This finding provides a novel insight into the management and early detection of renal disease in patients with impaired glucose metabolism.
Evaluation of the effect of extraction in comparison to distalization on the maxillary third molars in class II malocclusion: a retrospective study
Authors: Aboalnaga Amira A. , Fouda Ahmed S.
Published: March 2024

Objective

To compare the effects of first premolar extraction versus distalization on the vertical position and mesiodistal angulation of maxillary third molars (MxM3) in adolescent class II patients.

Methods

The panoramic x-rays (OPGs) of 200 adolescent class II patients with developing MxM3s were screened. The chosen sample consisted of 2 groups: Group 1 (Distalization) comprising 48 MxM3s, and Group 2 (Extraction) comprising 50 MxM3s. The pre- and post-treatment OPGs were traced to detect the mesiodistal angulation changes of the second molars (MxM2) and MxM3s.

Results

The angulation and vertical position of the MxM3s at T0 & T1 were also evaluated using Archer’s classification. The distalization group presented a non-significant decrease in the mean angulation of MxM2 and MxM3 (-2.4o & -4.5o uprighting respectively). In the extraction group, both MxM2 and MxM3 presented a highly significant decrease in the mean angulation (-10.5o & -11o uprighting respectively). The angulation and vertical position change of MxM3 significantly improved in the extraction group when compared to the distalization group (P < .001).

Conclusion

Significant uprighting and occlusal positioning of the maxillary third molars occurred in the premolar extraction treatment group when compared to the distalization treatment group. The results of the current study highlight the importance of recognizing maxillary third molars during orthodontic treatment planning of Class II malocclusion cases.
Non-photorealistic rendering as a feedback strategy in virtual reality for rehabilitation
Authors: Quintana David , Rodríguez Antonio , Sbert Mateu , Silva Yolanda , Rufino Elisvan , Boada Imma
Published: March 2024

Virtual reality (VR) rehabilitation has been proven to be a very promising method to increase the focus and attention of patients by immersing them in a virtual world, and through that, improve the effectiveness of the rehabilitation. One of the biggest challenges in designing VR Rehabilitation exercises is in choosing feedback strategies that guide the patient and give the appropriate success/failure indicators, without breaking their sense of immersion. A new strategy for feedback is proposed, using non-photorealistic rendering (NPR) to highlight important parts of the exercise the patient needs to focus on and fade out parts of the scene that are not relevant. This strategy is implemented into an authoring tool that allows rehabilitators specifying feedback strategies while creating exercise profiles. The NPR feedback can be configured in many ways, using different NPR schemes for different layers of the exercise environment such as the background environment, the non-interactive exercise objects, and the interactive exercise objects. The main features of the system including the support for universal render pipeline, camera stacking, and stereoscopic rendering are evaluated in a testing scenario. Performance tests regarding memory usage and supported frames per second are also considered. In addition, a group of rehabilitators evaluated the system usability. The proposed system meets all the requirements to apply NPR effect in VR scenarios and solves all the limitations with regard to technical function and image quality. In addition, the system performance has been shown to meet the targets for low-cost hardware. Regarding authoring tool usability rehabilitators agree that is easy to use and a valuable tool for rehabilitation scenarios. NPR schemes can be integrated into VR rehabilitation scenarios achieving the same image quality as non-VR visualizations with only a small impact on the frame rate. NPR schemes are a good visual feedback alternative.
A Multi-user Cross-platform hands-on virtual lab within the Metaverse – the case of machining training
Authors: Chuang Tung-Jui , Smith Shana
Published: March 2024

Distance learning has become a popular learning channel today. However, while various distance learning tools are available, most of them only support a single platform, offer only the trainer’s perspective, and do not facilitate student-instructor interaction. As a result, distance learning systems tend to be inflexible and less effective. To address the limitations of existing distance learning systems, this study developed a cross-platform hands-on virtual lab within the Metaverse that enables multi-user participation and interaction for distance education. Four platforms, HTC VIVE Pro, Microsoft HoloLens 2, PC, and Android smartphone, are supported. The virtual lab allows trainers to demonstrate operation steps and engage with multiple trainees simultaneously. Meanwhile, trainees have the opportunity to practice their operational skills on their virtual machines within the Metaverse, utilizing their preferred platforms. Additionally, participants can explore the virtual environment and interact with each other by moving around within the virtual space, similar to a physical lab setting. The user test compares the levels of presence and usability in the hands-on virtual lab across different platforms, providing insights into the challenges associated with each platform within the Metaverse for training purposes. Furthermore, the results of the user test highlight the promising potential of the architecture due to its flexibility and adaptability.
Cardiac autonomic involvement in Huntington’s disease
Authors: İşcan Dilek , Çetinkaya Yakup
Published: March 2024

Introduction

Huntington’s disease (HD) is known as a neurodegenerative disease with movement disorder and cognitive impairment; autonomic involvement is also becoming common in some recent studies. The aim of this study is to demonstrate the presence of cardiac autonomic involvement in HD patients.

Method

Time and frequency domain parameters obtained from the 24-h Holter ECG(hECG) were compared between 20 HD patients and 20 healthy control subjects.

Results

Fourteen HD patients had tachycardia, bradycardia, and extra beats. Interval between two heartbeats, normal-to-normal (NN), standard deviation of all normal-to-normal (SDNN), square root of the mean of the sum of the squares of the differences between consecutive N-N intervals in ms (rMSSD), and the ratio of the number of consecutive pairs of N-N intervals that differ by more than 50 ms to the total number of N-N intervals (pNN50) were all significantly higher in the patient group than in the control group during 24-h hECG monitoring. However, hECG monitoring showed that the patient group had significantly higher values of the frequency-domain metrics high frequency (HF) than the control group did (P = 0.003). Very low frequency (VLF) was lower in the patient group (P = 0.009). There was no difference in low frequency (LF) in both groups. In comparison to the control group, LF/HF was much reduced in the patient group (P = 0.001).

Conclusion

Cardiac disfunction increases, and autonomic functions change in HD, but more comprehensive studies are needed to distinguish sympathetic and parasympathetic involvement.
Hybrid capture shotgun sequencing detected unexpected viruses in the cerebrospinal fluid of children with acute meningitis and encephalitis
Authors: Launes Cristian , Camacho Juan , Pons-Espinal Marina , López-Labrador F. Xavier , Esteva Cristina , Cabrerizo María , Fernández-García María Dolores , Fogeda Marta , Masa-Calles Josefa , López-Perea Noemí , Echevarría Juan Emilio , Muñoz-Almagro Carmen , Tarragó David
Published: March 2024

Purpose

Investigation of undiagnosed cases of infectious neurological diseases, especially in the paediatric population, remains a challenge. This study aimed to enhance understanding of viruses in CSF from children with clinically diagnosed meningitis and/or encephalitis (M/ME) of unknown aetiology using shotgun sequencing enhanced by hybrid capture (HCSS).

Methods

A single-centre prospective study was conducted at Sant Joan de Déu University Hospital, Barcelona, involving 40 M/ME episodes of unknown aetiology, recruited from May 2021 to July 2022. All participants had previously tested negative with the FilmArray Meningitis/Encephalitis Panel.

HCSS was used to detect viral nucleic acid in the patients’ CSF. Sequencing was performed on Illumina NovaSeq platform. Raw sequence data were analysed using CZ ID metagenomics and PikaVirus bioinformatics pipelines.

Results

Forty episodes of M/ME of unknown aetiology in 39 children were analysed by HCSS. A significant viral detection in 30 CSF samples was obtained, including six parechovirus A, three enterovirus ACD, four polyomavirus 5, three HHV-7, two BKV, one HSV-1, one VZV, two CMV, one EBV, one influenza A virus, one rhinovirus, and 13 HERV-K113 detections. Of these, one sample with BKV, three with HHV-7, one with EBV, and all HERV-K113 were confirmed by specific PCR. The requirement for Intensive Care Unit admission was associated with HCSS detections.

Conclusion

This study highlights HCSS as a powerful tool for the investigation of undiagnosed cases of M/ME. Data generated must be carefully analysed and reasonable precautions must be taken before establishing association of clinical features with unexpected or novel virus findings.
The effect of smooth parametrizations on nonconvex optimization landscapes
Authors: Levin Eitan , Kileel Joe , Boumal Nicolas
Published: March 2024

We develop new tools to study landscapes in nonconvex optimization. Given one optimization problem, we pair it with another by smoothly parametrizing the domain. This is either for practical purposes (e.g., to use smooth optimization algorithms with good guarantees) or for theoretical purposes (e.g., to reveal that the landscape satisfies a strict saddle property). In both cases, the central question is: how do the landscapes of the two problems relate? More precisely: how do desirable points such as local minima and critical points in one problem relate to those in the other problem? A key finding in this paper is that these relations are often determined by the parametrization itself, and are almost entirely independent of the cost function. Accordingly, we introduce a general framework to study parametrizations by their effect on landscapes. The framework enables us to obtain new guarantees for an array of problems, some of which were previously treated on a case-by-case basis in the literature. Applications include: optimizing low-rank matrices and tensors through factorizations; solving semidefinite programs via the Burer–Monteiro approach; training neural networks by optimizing their weights and biases; and quotienting out symmetries.
Assessing sand dams for contributions to local water security and drought resilience in the semi-arid eastern Shashe catchment, Zimbabwe
Authors: Lazurko Anita , Lautze Jonathan , Hussey Stephen , Muzarabani Celine , Ngwenya Nobubelo , Ebrahim Girma
Published: March 2024

Climate change is increasing the frequency and severity of droughts in semi-arid regions. Small-scale water storage can help build drought resilience, particularly in rural areas with no access to formal water infrastructure. Sand dams, which store water by capturing water in sand-filled ephemeral rivers during the wet season, are one promising storage option. While emerging studies indicate tentative evidence of their benefits, the focus on resilience is under-addressed. This study evaluates the impact of sand dams on resilience to climate variability and changes through a participatory case study approach in the Shashe catchment, a semi-arid catchment shared by Botswana and Zimbabwe. Participatory research was conducted via site inspections, focus group discussions, and interviews at 20 sand dams utilized by 19 villages across the Zimbabwean portion of the Shashe catchment. The results show that sand dams significantly improved local water availability, most notably with a significant increase in the number of months per year that water could be collected from the dam site (mean = 6.5 months before, to mean = 10.9 months after construction, p < 0.05). This increase is also reflected in drought years (mean = 5.8 months before, to mean = 9.6 months after construction, p < 0.05). Sand dams also contribute to the adaptive capacity of communities via key benefits such as diversification of livelihood activities, improved health and hygiene, and reduced erosion in the surrounding area due to increased vegetation. In sum, the study demonstrates clear benefits to communities facing drought, supporting calls to elevate sand dams on the development agenda.