bluuebunny/crossref_metadata_2025 huggingface dataset:
Subtyping of Group 3/4 medulloblastoma as a potential prognostic biomarker among patients treated with reduced dose of craniospinal irradiation: a Japanese Pediatric Molecular Neuro-Oncology Group study
Authors: Fukuoka Kohei , Kurihara Jun , Shofuda Tomoko , Kagawa Naoki , Yamasaki Kai , Ando Ryo , Ishida Joji , Kanamori Masayuki , Kawamura Atsufumi , Park Young-Soo , Kiyotani Chikako , Akai Takuya , Keino Dai , Miyairi Yosuke , Sasaki Atsushi , Hirato Junko , Inoue Takeshi , Nakazawa Atsuko , Koh Katsuyoshi , Nishikawa Ryo , Date Isao , Nagane Motoo , Ichimura Koichi , Kanemura Yonehiro
Published: September 2023

Background

One of the most significant challenges in patients with medulloblastoma is reducing the dose of craniospinal irradiation (CSI) to minimize neurological sequelae in survivors. Molecular characterization of patients receiving lower than standard dose of CSI therapy is important to facilitate further reduction of treatment burden.

Methods

We conducted DNA methylation analysis using an Illumina Methylation EPIC array to investigate molecular prognostic markers in 38 patients with medulloblastoma who were registered in the Japan Pediatric Molecular Neuro-Oncology Group and treated with reduced-dose CSI.

Results

Among the patients, 23 were classified as having a standard-risk and 15 as high-risk according to the classic classification based on tumor resection rate and presence of metastasis, respectively. The median follow-up period was 71.5 months (12.0–231.0). The median CSI dose was 18 Gy (15.0–24.0) in both groups, and 5 patients in the high-risk group received a CSI dose of 18.0 Gy. Molecular subgrouping revealed that the standard-risk cohort included 5 WNT, 2 SHH, and 16 Group 3/4 cases; all 15 patients in the high-risk cohort had Group 3/4 medulloblastoma. Among the patients with Group 3/4 medulloblastoma, 9 of the 31 Group 3/4 cases were subclassified as subclass II, III, and V, which were known to an association with poor prognosis according to the novel subtyping among the subgroups. Patients with poor prognostic subtype showed worse prognosis than that of others (5-year progression survival rate 90.4% vs. 22.2%; p < 0.0001). The result was replicated in the multivariate analysis (hazard ratio12.77, 95% confidence interval for hazard ratio 2.38–99.21, p value 0.0026 for progression-free survival, hazard ratio 5.02, 95% confidence interval for hazard ratio 1.03–29.11, p value 0.044 for overall survival).

Conclusion

Although these findings require validation in a larger cohort, the present findings suggest that novel subtyping of Group 3/4 medulloblastoma may be a promising prognostic biomarker even among patients treated with lower-dose CSI than standard treatment.
History of dental biomaterials: biocompatibility, durability and still open challenges
Authors: Marin Elia
Published: September 2023

Objective

This review paper aims to provide a comprehensive understanding of the historical evolution of dental biomaterials, as well as to understand the reasons behind their biocompatibility and to identify the key factors that have influenced their development and use over the past 5000 years.

Data sources

The sources for this review were primarily obtained through Scopus and other online databases, such as Google Scholar, which were searched for relevant publications spanning clinical, archeological, and materials science literature. In cases where no other sources were available, information was gathered through consultation with museums and owners of private collections.

Study selection

Our search was conducted using specific materials and ages as keywords and, for the last two centuries, retrieving scientific articles written at that time of the first development and commercialization. When possible, secondary sources such as literature reviews were prioritized, while not peer-reviewed documents were utilized only when no other sources were available. References with varying perspective and findings were included, also when presented contradictory or controversial information.

Conclusions

In this review, clinical, archeological and chemical data could be merged into a comprehensive analysis of the historical evolution of the concept of biocompatibility in dental materials. The results of this review emphasize the significant advances that have been made in the field of dental biomaterials in terms of biocompatibility, from the use of gold and other metals in ancient civilizations to the development of modern materials such as resin composites and ceramics.

Clinical significance

By analyzing the development and use of dental biomaterials over the centuries from clinical, archeological and chemical perspectives, the review sheds light on the key factors that have shaped our understanding of biocompatibility in dental materials and the importance of this concept in the success of dental restorations.
Molecular evolution and expression assessment of DFRs in apple
Authors: Li Wen-Fang , Gao Ju , Ma Zong-Huan , Hou Ying-Jun , Li Xin , Mao Juan , Chen Bai-Hong
Published: September 2023

Background

Anthocyanins are the secondary metabolites of flavonoids in plants. As a key enzyme in the biosynthetic pathway of anthocyanin, dihydroflavonol 4-reductase (DFR) act as an important regulatory point, but DFR family genes has not been systematically characterized in apple (Malus domestica Borkh.).

Methods

The members of DFR genes in apple were identified and their gene structure, chromosome distribution, evolutionary relationships, collinearity, cis-component and protein interaction relationships were predicted using bioinformatics methods. The expression patterns of MdDFRs in various organs, such as leaves, fruit flushes, fruits, ripe fruit peels, flowers and stems were analyzed using GeneChip expression array analysis. qRT-PCR was employed to analyze the expression levels of MdDFRs in different apple varieties with varying levels of fruit skin at maturity.

Results

The apple database revealed 96 DFR genes, which are distributed on 17 chromosomes and can be divided into 3 subfamilies. These 96 DFR genes were mostly composed of α-helix and random coil according to secondary structure prediction, and were mainly expressed in chloroplasts and cytoplasm. MYB binding site involved in flavonoid biosynthetic genes regulation element (MBSI) was identified in the promoter of MdDFR15/76/81/89/90/91/93/94. Lignin/flavonoid synthesis-related elements of MYB recognition site and MYB-binding site were identified in the promoters of MdDFR05/09/13/19/22/24/26/30/31/33/34/46/50/52/54/64/65/69/75/76/79/86. The internal collinearity analysis of the apple MdDFR genome revealed a total of 34 pairs of duplicated gene pairs. Interspecific collinearity analysis showed that there were 66 and 57 homologous gene pairs in apple/tomato and apple/grape, respectively. GeneChip expression array analysis showed that MdDFR72 and MdDFR96 were higher expressed in ripe fruit fleshes and peel, MdDFR01/06/67/49/54/91 were higher expressed in flowers, MdDFR64 was higher expressed in ripe fruit peels and flowers than those of other tissues. Besides, 75 MdDFR proteins interacted directly or indirectly with anthocyanidin synthesis related proteins MdANS, MdF3H, MdMYB1, MdMYBPA1 to form a protein interaction network. Interestingly, MdDFR69 and MdDFR87 had direct interactions with these four proteins, MdDFR64 had direct interactions with MdANS and MdF3H. qRT-PCR analysis showed that the expression levels of MdDFR01/05/31/53/64/69/73/84/87/94/96 were up-regulated with the accumulation of anthocyanins.

Conclusions

This study lays a foundation for further research on the function of DFR genes in apple.

Graphical Abstract
Guided block matching and 4-D transform domain filter projection denoising method for dynamic PET image reconstruction
Authors: Xin Lin , Zhuo Weihai , Liu Haikuan , Xie Tianwu
Published: September 2023

Purpose

Dynamic PET is an essential tool in oncology due to its ability to visualize and quantify radiotracer uptake, which has the potential to improve imaging quality. However, image noise caused by a low photon count in dynamic PET is more significant than in static PET. This study aims to develop a novel denoising method, namely the Guided Block Matching and 4-D Transform Domain Filter (GBM4D) projection, to enhance dynamic PET image reconstruction.

Methods

The sinogram was first transformed using the Anscombe method, then denoised using a combination of hard thresholding and Wiener filtering. Each denoising step involved guided block matching and grouping, collaborative filtering, and weighted averaging. The guided block matching was performed on accumulated PET sinograms to prevent mismatching due to low photon counts. The performance of the proposed denoising method (GBM4D) was compared to other methods such as wavelet, total variation, non-local means, and BM3D using computer simulations on the Shepp–Logan and digital brain phantoms. The denoising methods were also applied to real patient data for evaluation.

Results

In all phantom studies, GBM4D outperformed other denoising methods in all time frames based on the structural similarity and peak signal-to-noise ratio. Moreover, GBM4D yielded the lowest root mean square error in the time-activity curve of all tissues and produced the highest image quality when applied to real patient data.

Conclusion

GBM4D demonstrates excellent denoising and edge-preserving capabilities, as validated through qualitative and quantitative assessments of both temporal and spatial denoising performance.
Diurnal variation of optical coherence tomography–based macular fluid in exudative age-related macular degeneration
Authors: Fortes Blake H. , Fairbanks Aaron M. , Nirmalan Aravindh A. , Hodge David O. , Ferenchak Kevin , Barkmeier Andrew J.
Published: September 2023

Background

Significant diurnal fluctuation of optical coherence tomography (OCT)-based macular fluid occurs in patients with several macular conditions including diabetic macular edema (DME) and cystoid macular edema due to retinal venous occlusion (RVO). OCT imaging and analysis of macular fluid status plays a central role in clinical management of exudative age-related macular degeneration (eAMD), however diurnal variation of eAMD OCT findings has not yet been formally studied. Herein, we investigate whether clinically meaningful fluctuation of OCT-based macular fluid occurs in patients with eAMD.

Methods

Prospective observational study. Patients with eAMD and intra- and/or sub-retinal fluid on early AM OCT were enrolled to receive two consecutive OCT scans at least four hours later. Retinal layers were manually segmented on all OCT rasters and AM-to-PM and PM-to-PM image pairs were analyzed for total retinal and neurosensory retinal volume changes within the central 1 and 3 mm ETDRS subfields. Finally, two masked retinal specialists analyzed all OCT image pairs for qualitative differences that may impact clinical management.

Results

21 patients with eAMD and fluid on OCT were recruited between January 2020 and November 2021. There was no mean difference between AM and PM central 3 mm total retinal volume (p = 0.56), central 3 mm neurosensory retinal volume (p = 0.25), central 1 mm total retinal mean thickness (p = 0.96), or central 1 mm neurosensory retinal mean thickness (p = 0.63), nor were any differences identified in PM-to-PM control comparisons. Qualitative analysis by two masked experts identified no clinically significant differences between any AM-to-PM OCT image pairs.

Conclusions

No significant diurnal variation in OCT-based macular fluid or thickness was identified in patients with eAMD, either quantitatively or qualitatively.
Cardiovascular adverse events of antineoplastic monoclonal antibodies among cancer patients: real-world evidence from a tertiary healthcare system
Authors: Al-Jazairi Abdulrazaq S. , Bahammam Nahlah , Aljuaid Dhai , Almutairi Lama , Alshahrani Shroog , Albuhairan Norah , Cahusac Peter M. B. , Korayem Ghazwa B.
Published: September 2023

Background

Antineoplastic monoclonal antibodies (mAbs), such as trastuzumab, bevacizumab, and pertuzumab have been the mainstay of therapy in cancer patients. Despite proven efficacy of the monoclonal antibodies, cardiovascular-induced adverse events such as heart failure, hypertension, ischemic heart disease, arrhythmias, thromboembolic events, and hemorrhage remain a major complication. The European society of cardiology address that concern with antineoplastic monoclonal antibodies issuing a guideline to manage and monitor chemotherapy-induced cardiotoxicity. There is limited evidence of the real-world prevalence of cardiovascular (CV) events induced by monoclonal antibodies among patients with cancer in Saudi Arabia.

Objective

To evaluate the prevalence of cardiovascular adverse events among patients with cancer treated with monoclonal antibodies in Saudi Arabia.

Methods

This is a retrospective study conducted in a tertiary care hospital, Riyadh, Saudi Arabia. Data were obtained from an electronic medical record of patients with cancer treated with one of the selected monoclonal antibodies, who met the inclusion criteria between January 2005 until June 2015 and have been followed up for at least one year. Patients were stratified into groups according to monoclonal antibodies treatment: trastuzumab, bevacizumab, pertuzumab, and combined mAbs.

Results

A total of 1067 patient were included in the study, within the pre-determined study period. The prevalence of cardiovascular disease among patients with cancer treated with monoclonal antibodies was 16.3%. The prevalence of heart failure was relatively higher in the trastuzumab group (46/626 patients, 7.3%). Among 418 patients treated with bevacizumab, hypertension was the most frequent adverse event, reported in 38 patients (9.1%), followed by thromboembolism reported in 27 patients (6.5%). Treatment discontinuation owing to cardiovascular adverse events was reported in 42/1,067 patients (3.9%).

Conclusion and relevance

Prevalence of antineoplastic monoclonal antibody induced cardiovascular adverse events among patients with cancer is substantially high in Saudi Arabia. There is an urgent need to streamline the practice for identifying high risk patients and flexible referral system for cardio-oncology care.
The additive diagnostic role of diffusion-weighted magnetic resonance and chemical shift imaging (CSI) in differentiation between malignant and benign cervical lymph nodes
Authors: Eissa Lamya , Manosur Maged , Darweesh Reda
Published: September 2023

Background

Imaging with conventional MRI plays a pivotal role in differentiation between benign and malignant nodes, which is crucial for choice of therapeutic plan. The purpose of this study was to evaluate the role of diffusion-weighted imaging DWI MRI and chemical shift imaging (CSI) (in and out of phase) in differentiation between malignant and benign cervical lymph nodes.

Patients and methods

We prospectively reviewed MR images of 31 patients presented to ENT department by cervical adenopathy. Imaging parameters documented included: morphology, ADC values and in-phase to out-of-phase (Ip/Op) ratios and signal drop in out-of-phase images.

Results

ADC values of the benign and malignant nodes were 1.06 ± 0.25 and 0.85 ± 0.24, respectively. A statistically significant difference was found between the two groups (p = 0.041). An ADC value of 0.9 × 10−3 mm2/s was concluded to be the best cutoff value for differentiating benign from malignant LNs. The mean values of in/out-of-phase ratios of benign and malignant lymph nodes were 0.75 ± 0.16 and 0.96 ± 0.06, respectively. A statistically significant difference was found between the two groups (p = 0.001). The mean in/out-of-phase ratio of the benign nodes was significantly lower than that of the malignant nodes.

Conclusions

CSI can differentiate between malignant and benign lymph nodes with a cutoff value of in/out-phase ratio of 0.9. Also, adding the diffusion-ADC map can prefer the same value with a cutoff value of 0.9 × 10−3 cm2/s. Adding CSI sequence to conventional MRI in examining the nodal status in patients with head and neck primary can enhance diagnostic accuracy of the examination.
The role of fiscal policy on poverty reduction in South Africa
Authors: Mokoena Mlungisi , Mazenda Adrino
Published: September 2023

This paper presents the results of ridge regression analysis of the relationship between government spending in emancipation programmes and multidimensional poverty, focusing on South Africa. Through the Principal Component analysis, we retained three variables of this relationship, affected by a range of factors, to determine the size and direction of the relationship. Besides health, we find no clear evidence that government spending on housing and social security significantly reduces multidimensional poverty. Co-production in housing, healthcare delivery, and social security should be encouraged.
Constrained nonlinear amplitude-variation-with-offset inversion for reservoir dynamic changes estimation from time-lapse seismic data
Authors: Ahmed Nisar , Waldemar Weibull Wiktor , Grana Dario , Bhakta Tuhin
Published: September 2023

We develop a novel elastic amplitude-variation-with-offset (AVO) inversion process to estimate the fluid saturation and effective pressure or variations in these properties from time-lapse seismic data sets. These changes occur in oil and gas reservoirs caused by fluid injection or hydrocarbon production that leads to changes in the elastic wave properties, reflectivity, and seismic response. Our method is based on a seismic forward model that consists of a linearized AVO equation and a rock-physics model. The AVO equation links the elastic wave properties to seismic reflection amplitudes, whereas the rock-physics model maps the saturation and pressure into seismic velocities and density. The inversion approach relies on the gradient descent technique to estimate the unknown variables by searching for the minimum of the least-squares misfit between the observed and modeled data. The first-order gradient equations of the least-squares data misfit function with respect to effective pressure and water saturation are derived by using the adjoint-state method and the chain rule. The optimization method used to minimize the misfit function and obtain the best optimal solution is a limited-memory quasi-Newton algorithm. This inversion process allows us to incorporate prior constraints by using the logistic function to map the model variables to a bounded range. To achieve a stable solution to ill-posed inversion problems, optimal regularization weights are applied. The application of the developed workflow on 1D synthetic and real well-log data from the Edvard Grieg oil field simulating various saturation-pressure conditions during production demonstrates the validity of the approach with different noise levels. The inversion is then applied to a 2D synthetic data set modeled from the reservoir model of the Smeaheia field, a potential site for a large-scale offshore CO2 storage field located in the North Sea. Our results illustrate that our inversion method efficiently and accurately estimates reservoir saturation and pressure variations.
Quantitative Blood Flow Reduction in Selective Embolization of Intranidal Fistula of Cerebral Arteriovenous Malformations: Case Series
Authors: Souter John , Stone McGuire Laura , Choi Jason , Brunozzi Denise , Hossa Jessica , Charbel Fady T. , Alaraj Ali
Published: September 2023

BACKGROUND AND OBJECTIVES:

Arteriovenous malformations (AVMs) are often associated with high-flow intranidal fistulas (INFs). Although INF embolization has been suggested to provide higher reduction of total AVM flow compared with regular pedicle embolization, this effect has not previously been quantified. The aim of this study was to characterize the effect of AVM INF embolization on total AVM flow.

METHODS:

This study is an Institutional Review Board–approved, retrospective case series of patients from 2010 to 2022 with AVMs, both with and without INFs, who underwent quantitative magnetic resonance angiography and endovascular embolization.

RESULTS:

Twenty patients accounted for 35 separate embolization sessions: 13 patients with INFs underwent a total 21 embolizations and 12 patients without INFs had 14 embolizations. No significant differences were found between groups on age, sex, laterality, drainage pattern, and Spetzler-Martin grade. However, AVMs with INFs were larger than the control group (12.7 vs 8.37 cm3, P = .049). Baseline pre-embolization AVM flow significantly differed between AVM with INF vs control groups (522 vs 320 cc/min, P = .005). Similarly, postembolization AVM flow also differed between AVM with INF and control groups (392 vs 224 cc/min, P = .008), with a larger decrease in flow per vessel per embolization session within the AVM INF group compared with controls (101.5 vs 33.2 cc/min, P < .001). Repeated measure analysis of variance showed significant differences pre-embolization and postembolization AVM flow between those with INFs vs controls (P < .001).

CONCLUSION:

This study represents the first to examine the effect of INF embolization on total AVM flow. AVMs with INFs showed higher baseline flow, and targeted embolization toward INFs significantly lowered AVM flow in comparison with controls without INFs. The results of this study emphasize the importance of recognizing the presence of INFs within AVMs and their embolization to reduce AVM flow as part of a multistep management paradigm.
Optimization of Radiofrequency Needle Placement in Percutaneous Cordotomy Using Electromyography in the Deeply Sedated Patient
Authors: Gabay Segev , Sapir Yechiam , Korn Akiva , Hochberg Uri , Tellem Rotem , Zegerman Alex , Brogan Shane E , Rahimpour Shervin , Shoty Ben , Strauss Ido
Published: September 2023

BACKGROUND AND OBJECTIVES:

Cordotomy, the selective disconnection of the nociceptive fibers in the spinothalamic tract, is used to provide pain palliation to oncological patients suffering from intractable cancer-related pain. Cordotomies are commonly performed using a cervical (C1-2) percutaneous approach under imaging guidance and require patients' cooperation to functionally localize the spinothalamic tract. This can be challenging in patients suffering from extreme pain. It has recently been demonstrated that intraoperative neurophysiology monitoring by electromyography may aid in safe lesion positioning. The aim of this study was to evaluate the role of compound muscle action potential (CMAP) in deeply sedated patients undergoing percutaneous cervical cordotomy (PCC).

METHODS:

A retrospective analysis was conducted of all patients who underwent percutaneous cordotomy while deeply sedated between January 2019 and November 2022 in 2 academic centers. The operative report, neuromonitoring logs, and clinical medical records were evaluated.

RESULTS:

Eleven patients underwent PCC under deep sedation. In all patients, the final motor assessment prior to ablation was done using the electrophysiological criterion alone. The median threshold for evoking CMAP activity at the lesion site was 0.9 V ranging between 0.5 and 1.5 V (average 1 V ± 0.34 V SD). An immediate, substantial decrease in pain was observed in 9 patients. The median pain scores (Numeric Rating Scale) decreased from 10 preoperatively (range 8-10) to a median 0 (range 0-10) immediately after surgery. None of our patients developed motor deficits.

CONCLUSION:

CMAP-guided PCC may be feasible in deeply sedated patients without added risk to postoperative motor function. This technique should be considered in a group of patients who are not able to undergo awake PCC.
Virtual Reality Simulation for the Middle Cranial Fossa Approach: A Validation Study
Authors: Lai Carolyn , Lui Justin T. , de Lotbiniere-Bassett Madeleine , Chen Joseph M. , Lin Vincent Y. , Agrawal Sumit K. , Blevins Nikolas H. , Ladak Hanif M. , Pirouzmand Farhad
Published: September 2023

BACKGROUND AND OBJECTIVES:

Virtual reality (VR) surgical rehearsal is an educational tool that exists in a safe environment. Validation is necessary to establish the educational value of this platform. The middle cranial fossa (MCF) is ideal for simulation because trainees have limited exposure to this approach and it has considerable complication risk. Our objectives were to assess the face, content, and construct validities of an MCF VR simulation, as well as the change in performance across serial simulations.

METHODS:

Using high-resolution volumetric data sets of human cadavers, the authors generated a high-fidelity visual and haptic rendering of the MCF approach using CardinalSim software. Trainees from Neurosurgery and Otolaryngology–Head and Neck Surgery at two Canadian academic centers performed MCF dissections on this VR platform. Randomization was used to assess the effect of enhanced VR interaction. Likert scales were used to assess the face and content validities. Performance metrics and pre- and postsimulation test scores were evaluated. Construct validity was evaluated by examining the effect of the training level on simulation performance.

RESULTS:

Twenty trainees were enrolled. Face and content validities were achieved in all domains. Construct validity, however, was not demonstrated. Postsimulation test scores were significantly higher than presimulation test scores (P < .001). Trainees demonstrated statistically significant improvement in the time to complete dissections (P < .001), internal auditory canal skeletonization (P < .001), completeness of the anterior petrosectomy (P < .001), and reduced number of injuries to critical structures (P = .001).

CONCLUSION:

This MCF VR simulation created using CardinalSim demonstrated face and content validities. Construct validity was not established because no trainee included in the study had previous MCF approach experience, which further emphasizes the importance of simulation. When used as a formative educational adjunct in both Neurosurgery and Otolaryngology–Head and Neck Surgery, this simulation has the potential to enhance understanding of the complex anatomic relationships of critical neurovascular structures.
Clival-Meckel's Cave Angle: A Predictor of Glycerol Displacement in Percutaneous Glycerol Rhizotomy for Trigeminal Neuralgia
Authors: Piper Keaton , George Zeegan , Gordon Jonah , Peto Ivo , Vakharia Kunal , Van Loveren Harry
Published: September 2023

BACKGROUND AND OBJECTIVES:

Percutaneous glycerol rhizotomy successfully treats trigeminal neuralgia although failure rates and durability of the procedure are variable. Some of this variability in clinical outcome might be due to egress of glycerol from Meckel's cave (MC) because of surgical positioning and individual patient anatomy. In this article, we quantitatively analyzed the anatomic variances that affect glycerol fluid dynamics to better predict patients more amenable for percutaneous glycerol injections.

METHODS:

Computed tomography imaging of 11 cadaveric heads was used to calculate bilateral Clival-Meckel's cave (CMC) and sella-temporal (ST) angles. Twenty-two cadaveric percutaneous injections of dyed glycerol into the Meckel's cave were performed using Härtel's approach, and the fluid movement was documented at prespecified intervals over 1 hour. The relationship between the angles and glycerol migration was studied.

RESULTS:

Specimens with basal cistern involvement by 60 minutes had significantly greater CMC angles (median [IQR]: basal cistern involvement = 74.5° [59.5°-89.5°] vs no basal cistern involvement = 58.0° [49.0°-67.0°]), U = 6.0, P < .001. This model may predict which patients will experience glycerol migration away from the Gasserian ganglion (area under the curve: 0.950, SE: 0.046, CI: 0.859-1.041, P < .001). Increased ST angle was associated with lateral flow of glycerol (rs = 0.639, P = .001), and CMC angle was associated with total area of dispersion (rs = −0.474, P = .026).

CONCLUSION:

Anatomic variation in skull base angles affects glycerol migration. Specifically, a more obtuse CMC angle was associated with a higher risk of posterior migration away from the Gasserian ganglion. This may be a reason for differing rates of surgical success. These results suggest that anterior head flexion for 60 minutes may prevent percutaneous glycerol rhizotomy failures and some patients with large CMC angles are more likely to benefit from postinjection head positioning. However, this clinical effect needs validation in vivo.
Percutaneous Juxtapedicular Cement Salvage of Failed Spinal Instrumentation? Institutional Experience and Cadaveric Biomechanical Study
Authors: Kurland David B. , Lendhey Matin , Delavari Nader , Winfield Jalen , Mahoney Jonathan M. , Becske Tibor , Shapiro Maksim , Raz Eytan , Pacione Donato , Bucklen Brandon S. , Frempong-Boadu Anthony K.
Published: September 2023

BACKGROUND AND OBJECTIVES:

Instrumented spinal fusion constructs sometimes fail because of fatigue loading, frequently necessitating open revision surgery. Favorable outcomes after percutaneous juxtapedicular cement salvage (perc-cement salvage) of failing instrumentation have been described; however, this approach is not widely known among spine surgeons, and its biomechanical properties have not been evaluated. We report our institutional experience with perc-cement salvage and investigate the relative biomechanical strength of this technique as compared with 3 other common open revision techniques.

METHODS:

A retrospective chart review of patients who underwent perc-cement salvage was conducted. Biomechanical characterization of revision techniques was performed in a cadaveric model of critical pedicle screw failure. Three revision cohorts involved removal and replacement of hardware: (1) screw upsizing, (2) vertebroplasty, and (3) fenestrated screw with cement augmentation. These were compared with a cohort with perc-cement salvage performed using a juxtapedicular trajectory with the failed primary screw remaining engaged in the vertebral body.

RESULTS:

Ten patients underwent perc-cement salvage from 2018 to 2022 to address screw haloing and/or endplate fracture threatening construct integrity. Pain palliation was reported by 8/10 patients. Open revision surgery was required in 4/10 patients, an average of 8.9 months after the salvage procedure (range 6.2-14.7 months). Only one revision was due to progressive hardware dislodgement. The remainder avoided open revision surgery through an average of 1.9 years of follow-up. In the cadaveric study, there were no significant differences in pedicle screw pullout strength among any of the revision cohorts.

CONCLUSION:

Perc-cement salvage of failing instrumentation is reasonably efficacious. The technique is biomechanically noninferior to other revision strategies that require open surgery for removal and replacement of hardware. Open revision surgery may be avoided by perc-cement salvage in select cases.
Targeting NHE6 gene expression identifies lysosome and neurodevelopmental mechanisms in a haploid in vitro cell model
Authors: Wu Qing , Ma Li , Joesch-Cohen Lena , Schmidt Michael , Uzun Ece D. Gamsiz , Morrow Eric M.
Published: September 2023

Christianson syndrome (CS) is an X-linked disorder resulting from loss-of-function (LoF) mutations in SLC9A6 encoding the endosomal Na+/H+ exchanger 6 (NHE6). CS presents with developmental delay, seizures, intellectual disability, nonverbal status, postnatal microcephaly, and ataxia. To define transcriptome signatures of NHE6 LoF, we conducted in-depth RNA-sequencing (RNA-seq) analysis on a haploid NHE6 null cell model. CRIPSR/Cas9 genome editing introduced multiple LoF mutations into SLC9A6 in the near haploid human cell line Hap1. Isogenic, paired parental controls were also studied. NHE6 mutant cell lines were confirmed to have intra-endosomal over-acidification as was seen in other NHE6 null cells. RNA-seq analysis was performed by two widely used pipelines: HISAT2-StringTie-DEseq2 and STAR-HTseq-DEseq2. We identified 1056 differentially expressed genes in mutant NHE6 lines, including genes associated with neurodevelopment, synapse function, voltage-dependent calcium channels, and neuronal signaling. Weighted gene co-expression network analysis was then applied and identified a critical module enriched for genes governing lysosome function. By identifying significantly changed gene expression that is associated with lysosomal mechanisms in NHE6-null cells, our analyses suggest that loss of NHE6 function may converge on mechanisms implicated in lysosome-related neurologic disease. Further, this haploid cell model will serve as an important tool for translational science in CS.
Left triangular ligament lesions are likely hepatic in origin: a systematic review
Authors: Agarwal Siddharth , Munyal Rahul , Aravinthan Aloysious , Clarke Christopher
Published: September 2023

Objectives:

The left lobe of the liver is connected to the left hemi-diaphragm by the left triangular ligament (LTL) which crosses the left upper quadrant (LUQ) of the abdomen. LTL lesions are rare and can cause diagnostic confusion. We encountered a hepatocellular carcinoma in the LTL of one patient and given that the LTL has been shown to contain liver tissue in cadaveric studies, we hypothesise that LTL lesions are likely hepatic in origin. The aim of this case series and systematic review was to develop a list of pathological processes encountered at the LTL, which could impact differential diagnoses of lesions within the LUQ.

Methods:

A case series of two patients are presented. MEDLINE, EMBASE, PubMed, and Google Scholar were searched for studies published until September 2022. All case reports of LTL lesions were eligible for inclusion. PROSPERO registration: CRD42022368250.

Results:

Twelve out of 166 screened studies were included, with 14 cases in total. Seven described mass lesions of hepatic origin, of which three were initially misdiagnosed as gastric tumours leading to considerable diagnostic delay and additional procedures. Seven other cases described postoperative bile leaks from aberrant biliary ducts in the LTL.

Conclusions:

All mass lesions observed in the LTL were hepatic in origin, and all iatrogenic injuries described resulted in bile leaks.

Advances in knowledge:

To reduce the burden of diagnostic delay and unnecessary procedures, we would suggest that these observations support the addition of hepatic lesions to the differential diagnosis of LUQ lesions.
"ME CAUSA INCÔMODO": PERCEPÇÃO DE SITUAÇÕES INVASIVAS NO AMBIENTE DE TRABALHO EM UMA ORGANIZAÇÃO PÚBLICA FEDERAL
Authors: Montezano Lana , Meira Paulo Ricardo dos Santos , Colomby Renato Koch
Published: September 2023

O objetivo da pesquisa foi identificar situações invasivas nas relações profissionais que geram incômodos no ambiente de trabalho de uma organização pública federal. Realizou-se pesquisa teórico-empírica qualitativa por meio de questionário eletrônico, com a participação de 143 respondentes. Procedeu-se à análise da nuvem de palavras e da classificação hierárquica descendente, com a ferramenta IRAMUTEQ, e a análise de conteúdo para detalhamento das situações que geram incômodo. Foram identificadas seis categorias de situações invasivas que geram constrangimento no ambiente de trabalho: contato físico; falta de etiqueta corporativa; forma e conteúdo da comunicação; invasão da vida pessoal; percepção dependente do contexto/situação; proximidade física. A pesquisa contribui com a identificação de aspectos de relações de trabalho que podem ser prejudiciais ao ambiente laboral, e pode subsidiar aos gestores o estabelecimento de políticas de gestão de pessoas que minimizem tais ocorrências para gerar um ambiente de trabalho mais agradável.
GESTÃO PÚBLICA E INSERÇÃO DAS PESSOAS COM DEFICIÊNCIA EM TEIXEIRA DE FREITAS – BAHIA
Authors: Gomes Aline Fonseca , Melo Mariana De Souza Duarte , Emerentino Nájila Da Silva , Silva Vinícius Aguilar da , Jesus Samuel Souza de , Oliveira Vagner Costa
Published: September 2023

Esta pesquisa tratou da Gestão Pública sob a perspectiva da inserção das pessoas com deficiência na comunidade de Teixeira de Freitas, Bahia, no ano de 2022, por meio dos pressupostos da Constituição Federal de 1988, cujo objetivo geral buscou identificar como a gestão pública do município de Teixeira de Freitas – Bahia promove a inserção das pessoas com deficiência na comunidade mediante os pressupostos da Constituição Federal e da Lei Orgânica da cidade pesquisada. Como metodologia, foram pesquisados, por amostra, 11 sujeitos, o que correspondeu à quantidade de entrevistados com deficiência pertencentes ao GRUDE TDF, grupo das pessoas com deficiência em Teixeira de Freitas, sendo a amostra por acessibilidade. Nesse sentido, obteve-se como principal resultado que os entrevistados disseram passar por dificuldades de locomoção nas ruas de Teixeira de Freitas e apontaram deficiência na acessibilidade a lugares de lazer em relação à adequação dos transportes públicos. Além disso, foi possível identificar a ausência de incentivos para a inserção das pessoas com deficiência na cidade onde se tem na Lei Orgânica do município de Teixeira de Freitas apenas dois incisos que correspondem, de forma muito abrangente, os direitos da pessoa com deficiência. Assim, por conclusões, tem-se que este estudo identificou as dificuldades enfrentadas pelas pessoas com deficiência da cidade em questão; entretanto, foi vista uma discrepância entre a teoria e a prática das leis.
Editorial: Gestão – o olhar perante o bem-estar das pessoas
Authors: Shibao Fábio Fábio , Coelho Arnaldo Fernandes Matos , Weersma Laodicéia Amorim
Published: September 2023

Tendo em vista os avanços tecnológicos e as constantes transformações nas quais as organizações estão inseridas, torna-se necessário que as corporações invistam na área de Gestão de Pessoas para se manterem competitivas e sobreviverem ao mercado.Assim, o interesse pela temática “bem-estar no trabalho” tem crescido atualmente, porque as pessoas passam a maior parte do tempo de suas vidas no ambiente de trabalho (HIRSCHLE; GONDIM, 2020). O assunto traz reflexos em vários aspectos pessoais do colaborador bem como no desempenho, na produtividade e nos resultados da organização, o que é relevante como estudos nessa área (SIQUEIRA; ORENGO; PEIRÓ, 2014).“Bem-estar no trabalho” é uma condição de saúde mental que vai além de não estar doente, envolve se sentir inteiro, fortalecido, autorrealizado, feliz e satisfeito com a vida (HOWELL et al., 2016). Assim, torna-se necessário que as organizações desenvolvam ações a fim de promover, motivar e engajar o colaborador, garantindo a saúde e a segurança, mantendo o interesse pelo trabalho de forma a contribuir para o aumento da produtividade e o crescimento da organização (NOGUEIRA; OLIVEIRA, 2022).A busca pelos modelos de Gestão de Pessoas deixa evidente para as organizações a importância de acompanhar o processo evolutivo na obtenção do sucesso, tal como o aumento na produtividade, a eficiência e a eficácia no trabalho (KANUNGO et al., 2023).Gestão de Pessoas tem o intuito de promover um modelo nos meios organizacionais em que as pessoas não são apenas um meio para gerar lucros, como no passado (FISCHER, 2002), isto é, as pessoas devem ser consideradas como a principal fonte de valor e não como um recurso a ser explorado no processo produtivo que pode, facilmente, ser substituído (LACOMBE; TONELLI, 2021).Portanto, independentemente de suas raízes, as pessoas possuem necessidades cuja satisfação, ou não, é determinante para a sua realização, o que interfere diretamente em seu desempenho profissional; por conseguinte, a Gestão de Pessoas deixou de se concentrar, exclusivamente, na tarefa para atuar no comportamento e nas competências e agir também no “bem-estar no trabalho” de seus colaboradores (KANUNGO et al., 2023).Convido-os para uma agradável leitura e pesquisa a partir desta edição!
A PREVIDÊNCIA SOCIAL BRASILEIRA E A SUSTENTABILIDADE FINANCEIRA DOS SEUS REGIMES: SISTEMATIZAÇÃO DA TEORIA
Authors: Reis Anna Karolina Monteiro dos , Casagranda Yasmin Gomes
Published: September 2023

A previdência social tem como finalidade garantir subsistência a seus beneficiários, possuindo, portanto, grande importância social e econômica. Diante da relevância do tema, esta pesquisa procurou apresentar como está estruturada atualmente a previdência brasileira e compreender como tem sido retratada a sustentabilidade financeira dos regimes públicos previdenciários. Para tanto, foram realizadas uma revisão sistemática e uma análise bibliométrica por meio de artigos científicos disponíveis nas bases de dados Periódicos CAPES e SciELO. A previdência, parte integrante da seguridade social, está estruturada por meio do Regime Geral, dos Regimes Próprios e dos Regimes de Previdência Complementar. Verificou-se que muitos RPPS se encontram com a sustentabilidade comprometida em face de cenários de déficit e insolvência. Quanto ao RGPS, a sua situação pode ser não deficitária, ao se considerar todas as fontes de financiamento que a Constituição determinou para a seguridade social, as quais têm sido, em parte, utilizadas para fins além dos benefícios previdenciários.
AUDITORIA INDEPENDENTE E DIVULGAÇÃO ENVIRONMENTAL, SOCIAL AND GOVERNANCE (ESG)
Authors: Guedes Francisca Yasmin De Aguiar , Brasil Carolina Machado , Garcia Editinete André Da Rocha
Published: September 2023

A divulgação de informações de environmental, social and governance (ESG), por um lado, reduz as incertezas, contribuindo para minimizar os custos de agência. Por outro, pode disfarçar comportamentos oportunistas dos gerentes, que podem investir, excessivamente, nessas práticas em prol de benefícios pessoais. Assim, podem-se observar impactos positivos ou negativos das informações de ESG, a depender dos interesses dos agentes envolvidos na sua evidenciação. Uma das formas de minimizar esses conflitos é por meio do trabalho de auditoria. Dessa forma, o ensaio tem como objetivo discutir o papel da auditoria independente nas informações ESG, evidenciadas pelas entidades à luz da Teoria da Agência.
MODELOS DE MATURIDADE EM GESTÃO DE PROCESSOS: UMA REVISÃO SISTEMÁTICA DA LITERATURA
Authors: Piana Janaina , Zola Fernanda Cavicchioli , Costa Aline Tomeleri da
Published: September 2023

A quantidade de modelos de maturidade propostos na área de Business Process Management (BPM) aumentou consideravelmente. Porém, o uso de modelos de maturidade de gestão de processos ainda não apresenta ampla aceitação na prática. Diante disso, realizou-se uma revisão sistemática da literatura para obter uma compreensão geral da existência, características e uso de modelos de maturidade em gestão de processos. Examinaram-se estudos realizados entre 2012 e 2020 nas principais bases de dados. Os estudos foram selecionados conforme o método Proknow-C. Depois se realizou uma análise bibliométrica e de conteúdo dos artigos. Descobriu-se que os principais fatores de medição dos modelos são ciclo de vida dos processos, cultura, TI e desempenho; a tendência das pesquisas está no desenvolvimento de novos modelos; e a correta escolha dos modelos está diretamente relacionada com o sucesso de sua aplicação, o que pode contribuir para maior aceitação de uso de modelos de maturidade na prática.
PESQUISA CIENTÍFICA: O OLHAR POR MEIO DE REVISÃO SISTEMÁTICA, ANÁLISE BIBLIOMÉTRICA E META-ANÁLISE
Authors: Coelho Arnaldo Fernandes Matos , Weersma Laodicéia Amorim
Published: September 2023

Assistimos ao aumento substancial no uso de revisões sistemáticas da literatura, análises bibliométricas e meta-análises em, praticamente, todas as áreas da ciência. Essas metodologias tornaram-se populares devido à sua abordagem rigorosa e estruturada para sintetizar o conhecimento existente e gerar novas perspectivas e pistas para futuras investigações. A praticidade em aceder a bases como a Scopus, Web of Science ou Google Acadêmico e a utilização de instrumentos como o Vosviewer ou o RStudio tornaram esses trabalhos muito apetecíveis e instrumentalmente acessíveis.
MATURITY 4.0 IN THE LAW SERVICE: A SYSTEMATIC REVIEW OF THE LITERATURE
Authors: Maia Shynaide Mafra Holanda , Melo Fagner José Coutinho de
Published: September 2023

This paper aims to identify maturity models in Industry 4.0 for application in law firms' services through a systematic literature review. It used the Web of Science and Scopus databases from 2017 to 2022 and divided them into three stages: planning, preparation, and reporting, using an exploratory sequential mix to later explain the difference in their results. The search results showed a compendium of 11 relevant papers. This work contributes significant information for managers of law firms, encouraging a sequence of research on the subject in search of strengthening and expanding such initiatives. The study is unprecedented and original because, although there are several maturity models of 4.0, there is nothing specific for law firms. The findings will contribute to future studies, such as the development of a maturity model for law firms, as well as for the decision-making of Managers/Lawyers when implementing 4.0 in the corporate environment.
Οι έννομες συνέπειες των αποφάσεων που εκδίδονται επί συλλογικών αγωγών
Authors: Βωβού Μαρία
Published: September 2023

Η μελέτη αφορά τη νομική φύση των ενδίκων βοηθημάτων συλλογικής δικαστικής προστασίας καθώς και τις έννομες συνέπειες των αποφάσεων που εκδίδονται επ' αυτών. Αναλύεται ειδικότερα το είδος της δεσμευτικής ενέργειας (ιδιότυπη δεσμευτικότητα, δεδικασμένο) καθώς και η εκτελεστότητα των εν λόγω αποφάσεων, από πλευράς αντικειμενικών και υποκειμενικών ορίων, με κριτική θεώρηση όλων των απόψεων που έχουν διατυπωθεί στα οικεία ζητήματα.
Efficacy of vitamin D supplementation on the severity of atopic dermatitis in children: A systematic review and meta-analysis
Authors: Hidayati Afif Nurul , Sawitri Sawitri , Sari Desiana Widityaning , Prakoeswa Cita Rosita Sigit , Indramaya Diah Mira , Damayanti Damayanti , Zulkarnain Iskandar , Citrashanty Irmadita , Widia Yuri , Anggraeni Sylvia
Published: September 2023

Background: Atopic Dermatitis (AD) is a common dermatosis in children, that includes skin architecture defects, immune dysregulation, and changes of skin flora. Several new drugs have been found to reduce the severity of AD. Vitamin D is one of the new therapies that is still controversial. The purpose of this research is to conclude the efficacy of vitamin D on atopic dermatitis severity in children aged 0-18 years old.

Methods: A systematic search was conducted on the PubMed, Cochrane, ProQuest, Google Scholar, Clinical Trial website, and university repositories including studies published from January 2010 through October 2020. We compared populations, intervention, study design, and outcomes. Statistical analysis was done with Review Manager 5.4.1.

Results: Eight articles met eligibility and inclusion criteria, four articles provided complete data and were analysed. Not all studies demonstrated the efficacy of vitamin D but a meta-analysis of four studies of vitamin D supplementation vs placebo found a mean difference of -0.93 (95%CI -1.76, to -0.11, p<0.001) of patient outcome, but statistically, there was no difference in cure rate (risk ratio 1.46 (95%CI 0.72, to 2.97, p=0.008) in vitamin D supplementation groups compared to placebo groups.

Conclusions: Vitamin D supplementation in paediatric atopic dermatitis patients could offer improvement of disease severity but the recommended dose and duration of administration cannot be concluded yet.