bluuebunny/crossref_metadata_2025 huggingface dataset:
Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy
Authors: Ya See Xin , Xanthavanij Nutchapon , Lee Yu-Che , Ong Tze Ern , Wang Tsu Hsien , Ahmed Omer , Chang Yu-Cheng , Peng Chun-Yu , Chi Kuan-Yu , Chang Yu , Chang Ko-Yun , Chiang Cho-Han
Published: October 2024

Introduction

Patients with chronic obstructive pulmonary disease (COPD) on triple therapy often face exacerbations and comorbidities. Emerging evidence suggests that glucagon-like peptide-1 (GLP-1) analogs may reduce the risk of exacerbation in patients with COPD and type 2 diabetes mellitus (T2DM). This study investigates the impact of GLP-1 analogs on pulmonary outcomes in patients with COPD on single-inhaler triple therapy (SITT) and T2DM.

Methods

We conducted a retrospective cohort study using the TriNetX database and analysed adult patients with COPD and T2DM who received SITT between April 2005 and July 2023. Patients were categorized into GLP-1 analog and dipeptidyl peptidase-4 inhibitors (DPP4i) cohorts. The primary efficacy outcome was COPD exacerbation and the secondary efficacy outcomes were pneumonia, acute respiratory distress syndrome, intubation, oxygen dependence, and all-cause mortality. The secondary outcomes were serious gastrointestinal adverse events.

Results

We included 6898 patients, with 4184 receiving GLP-1 analogs and 2714 receiving DPP4i. After matching, 1751 GLP-1 analog users were matched with 1751 DPP4i users. GLP-1 analog users had an 18% lower risk of COPD exacerbation (hazard ratio [HR], 0.82 [95% CI: 0.71–0.94]), a 28% reduced risk of pneumonia (HR, 0.72 [95% CI: 0.61–0.85]), a 34% reduced risk of oxygen dependence (HR, 0.66 [95% CI: 0.47–0.91]), and a 40% decreased risk of all-cause mortality (HR, 0.60 [95% CI: 0.47–0.77]). No significant serious gastrointestinal adverse events were observed.

Conclusion

GLP-1 analogs may be associated with reduced COPD exacerbations, pulmonary comorbidities, and mortality in patients with COPD receiving SITT and T2DM, with no significant serious gastrointestinal safety concerns.
ELAVL1 regulates glycolysis in nasopharyngeal carcinoma cells through the HMGB3/β-catenin axis
Authors: Cui Yi , Wen Haojie , Tang Jinyong , Chen Jiawen , Zhou Juan , Hou Minghua , Rong Xiaohan , Lan Yuanzhao , Wu Qiong
Published: October 2024

Background

The role of ELAVL1 in the progression of various tumors has been demonstrated. Our research aims to investigate how ELAVL1 controls the glycolytic process in nasopharyngeal carcinoma cells through the HMGB3/β-catenin pathway.

Methods

The expression of ELAVL1 was detected in clinical tumor samples and nasopharyngeal carcinoma cell lines. A subcutaneous tumor model was established in nude mice to investigate the role of ELAVL1 in tumor progression. The relationship between HMGB3 and ELAVL1 was validated by RNA pull down and RIP assays. TOPFlash/FOPFlash reporter assay was used to detect β-catenin activity. Assay kits were utilized to measure glucose consumption, lactate production, and G6PD activity in nasopharyngeal carcinoma cells. Western blot was conducted to detect the expression of glycolysis-related proteins. The glycolytic capacity was analyzed through extracellular acidification rate (ECAR).

Results

In both clinical samples and nasopharyngeal carcinoma cell lines, the expression levels of ELAVL1 mRNA and protein were found to be upregulated. Knockdown of ELAVL1 significantly inhibited the in vivo proliferation of nasopharyngeal carcinoma and suppressed the glycolytic capacity of nasopharyngeal carcinoma cells. ELAVL1 interacts with HMGB3, leading to an increase in the stability of HMGB3 mRNA. Overexpression of HMGB3 elevated the reduced β-catenin activity caused by sh-ELAVL1 and reversed the inhibitory effect of sh-ELAVL1 on cellular glycolytic capacity. Treatment with β-catenin inhibitor (FH535) effectively suppressed the promotion of glycolytic capacity induced by HMGB3 overexpression.

Conclusions

ELAVL1 promotes glycolysis in nasopharyngeal carcinoma cells by interacting with HMGB3 to stabilize HMGB3 mRNA, thereby activating β-catenin pathway. Therefore, targeting the ELAVL1-HMGB3-β-catenin axis has the potential to be a novel approach for treating nasopharyngeal carcinoma.
Contour Detection Algorithm for α Phase Structure of TB6 Titanium Alloy fused with Multi-Scale Fretting Features
Authors: He Fei , Dou Yan , Zhang Xiaoying , Zhang Lele
Published: October 2024

Aiming at the problems of inaccuracy in detecting the α phase contour of TB6 titanium alloy. By combining computer vision technology with human vision mechanisms, the spatial characteristics of the α phase can be simulated to obtain the contour accurately. Therefore, an algorithm for α phase contour detection of TB6 titanium alloy fused with multi-scale fretting features is proposed. Firstly, through the response of the classical receptive field model based on fretting and the suppression of new non-classical receptive field model based on fretting, the information maps of the α phase contour of the TB6 titanium alloy at different scales are obtained; then the information map of the smallest scale contour is used as a benchmark, the neighborhood is constructed to judge the deviation of other scale contour information, and the corresponding weight value is calculated; finally, Gaussian function is used to weight and fuse the deviation information, and the contour detection result of TB6 titanium alloy α phase is obtained. In the Visual Studio 2013 environment, 484 metallographic images with different temperatures, strain rates, and magnifications were tested. The results show that the performance evaluation F value of the proposed algorithm is 0.915, which can effectively improve the accuracy of α phase contour detection of TB6 titanium alloy.
Cell death of long-lived ray parenchyma cells during heartwood formation in trees
Authors: Nakaba Satoshi , Funada Ryo
Published: October 2024

Cell death plays an important role in the determination of secondary xylem cell functions. Tracheary elements (TEs), such as vessel elements and tracheids, lose their organelles due to rapid autolysis after the completion of secondary wall thickening and lignification, and play an important role in water movement along the stem. In contrast, xylem axial and ray parenchyma cells (xylem parenchyma cells) remain alive for several years or longer and retain their organelles even after maturation. As a result, xylem parenchyma cells play important roles in nutrient storage, axial and radial transportation of materials, and defense responses in the stem. In addition, they are involved in the formation of heartwood, which contributes to increases in the resistance of the tree trunk to decay, as they synthesize heartwood components such as polyphenols prior to their death. The present review focuses on changes in long-lived ray parenchyma cells during heartwood formation, such as morphology and contents of organelles, gene expression, and survival rate in sapwood. This review also summarizes the differences in cell death characteristics between TEs and ray parenchyma cells. The elucidation of the cell death mechanism of ray parenchyma cells is expected to provide useful information for controlling the properties of heartwood.
The comparative morphology of the oral cavity glands in captive South African painted dogs (Lycaon pictus pictus) and captive fennec foxes (Vulpes zerda) (Carnivora: Canidae)
Authors: Klećkowska-Nawrot Joanna , Stegmann Krzysztof , Dziech Arkadiusz , Jędrszczyk Gabriela , Jucenco Igor , Barszcz Karolina , Goździewska-Harłajczuk Karolina
Published: October 2024

Background

The African painted dog is classified as a relic canid lineage, inhabiting areas south of the Sahara. The fennec fox is the smallest member of the Canidae family, found in the Arabian Peninsula and northern Sahara.

Methods

The gross anatomy and light microscopic examination of the oral cavity glands were studied in five adult captive South African painted dogs and five adult captive fennec foxes from the Wroclaw Zoological Garden, Poland. In this research, the zygomatic gland, monostomatic sublingual gland, polystomatic sublingual gland, mandibular gland, and parotid gland were examined for their topography, morphometry, histology, and histochemistry using hematoxylin and eosin, azan trichrome, mucicarmine, PAS, AB pH 1.0, AB pH 2.5, AB pH 2.5 PAS, and HID.

Results

We found that the parotid glands were consistently the largest, followed by the mandibular and sublingual glands (both monostomatic and polystomatic). The zygomatic gland was the smallest in both South African painted dogs and fennec foxes. Interestingly, there were noticeable differences in the size, shape, and even composition of the secretory products between the two species. The zygomatic and polystomatic sublingual glands in the South African painted dog and the fennec fox were complex branched tubular. In the South African painted dog, the monostomatic gland was a branched tubular compound gland, while in the fennec fox, it was a branched tubuloalveolar compound gland. The mandibular gland in hunting dogs was a branched tubular compound gland, while in the fennec fox a branched tubuloalveolar compound gland. The parotid gland in the fennec fox was a branched acinar compound gland, whereas in the painted dog was a branched tubuloacinar.

Conclusions

The basic structure of their glands is similar to that of other terrestrial carnivores, indicating a shared evolutionary origin and function. However, differences in the composition of their secretory products can reflect adaptations to their specific diets. This research provides valuable insights for veterinary medicine and underscores the importance of further studies. By analyzing wild canid populations and including a broader range of species with diverse diets, we could gain a deeper understanding of how diet influences salivary gland morphology within the Canidae.
Mechanisms of neural infiltration-mediated tumor metabolic reprogramming impacting immunotherapy efficacy in non-small cell lung cancer
Authors: Zheng Yuanyuan , Li Lifeng , Shen Zhibo , Wang Longhao , Niu Xiaoyu , Wei Yujie , Sun Shilong , Zhao Jie
Published: October 2024

Background

Current evidence underlines the active role of neural infiltration and axonogenesis within the tumor microenvironment (TME), with implications for tumor progression. Infiltrating nerves stimulate tumor growth and dissemination by secreting neurotransmitters, whereas tumor cells influence nerve growth and differentiation through complex interactions, promoting tumor progression. However, the role of neural infiltration in the progression of non-small cell lung cancer (NSCLC) remains unclear.

Methods

This study employs the techniques of immunohistochemistry, immunofluorescence, RNA sequencing, molecular biology experiments, and a murine orthotopic lung cancer model to deeply analyze the specific mechanisms behind the differential efficacy of NSCLC immunotherapy from the perspectives of neuro-tumor signal transduction, tumor metabolism, and tumor immunity.

Results

This study demonstrates that nerve growth factor (NGF) drives neural infiltration in NSCLC, and 5-hydroxytryptamine (5-HT), which is secreted by nerves, is significantly elevated in tumors with extensive neural infiltration. Transcriptome sequencing revealed that 5-HT enhanced glycolysis in NSCLC cells. Pathway analysis indicated that 5-HT activated the PI3K/Akt/mTOR pathway, promoting tumor metabolic reprogramming. This reprogramming exacerbated immunosuppression in the TME. Neutralizing 5-HT-mediated metabolic reprogramming in tumor immunity enhanced the efficacy of PD-1 monoclonal antibody treatment in mice.

Conclusions

The findings of this study provide a novel perspective on the crosstalk between nerves and lung cancer cells and provide insights into further investigations into the role of nerve infiltration in NSCLC progression.
Validation of the Mirai model for predicting breast cancer risk in Mexican women
Authors: Avendano Daly , Marino Maria Adele , Bosques-Palomo Beatriz A. , Dávila-Zablah Yesika , Zapata Pedro , Avalos-Montes Pablo J. , Armengol-García Cecilio , Sofia Carmelo , Garza-Montemayor Margarita , Pinker Katja , Cardona-Huerta Servando , Tamez-Peña José
Published: October 2024

Objectives

To validate the performance of Mirai, a mammography-based deep learning model, in predicting breast cancer risk over a 1–5-year period in Mexican women.

Methods

This retrospective single-center study included mammograms in Mexican women who underwent screening mammography between January 2014 and December 2016. For women with consecutive mammograms during the study period, only the initial mammogram was included. Pathology and imaging follow-up served as the reference standard. Model performance in the entire dataset was evaluated, including the concordance index (C-Index) and area under the receiver operating characteristic curve (AUC). Mirai’s performance in terms of AUC was also evaluated between mammography systems (Hologic versus IMS). Clinical utility was evaluated by determining a cutoff point for Mirai’s continuous risk index based on identifying the top 10% of patients in the high-risk category.

Results

Of 3110 patients (median age 52.6 years ± 8.9), throughout the 5-year follow-up period, 3034 patients remained cancer-free, while 76 patients developed breast cancer. Mirai achieved a C-index of 0.63 (95% CI: 0.6–0.7) for the entire dataset. Mirai achieved a higher mean C-index in the Hologic subgroup (0.63 [95% CI: 0.5–0.7]) versus the IMS subgroup (0.55 [95% CI: 0.4–0.7]). With a Mirai index score > 0.029 (10% threshold) to identify high-risk individuals, the study revealed that individuals in the high-risk group had nearly three times the risk of developing breast cancer compared to those in the low-risk group.

Conclusions

Mirai has a moderate performance in predicting future breast cancer among Mexican women.

Critical relevance statement

Prospective efforts should refine and apply the Mirai model, especially to minority populations and women aged between 30 and 40 years who are currently not targeted for routine screening.

Key Points

The applicability of AI models to non-White, minority populations remains understudied.

The Mirai model is linked to future cancer events in Mexican women.

Further research is needed to enhance model performance and establish usage guidelines.

Graphical Abstract
Exploring Carolingian and Romanesque cycles: a study of the detached wall paintings from the Church of St. Johann in Müstair
Authors: Lombardo Tiziana , Caroselli Marta , Martinucci Camilla , Hildbrand Erwin , Moretti Patrizia , Cassitti Patrick
Published: October 2024

Twenty-six fragment of wall paintings detached from the upper register of the Carolingian and Romanesque cycles of the church of St. John in Müstair (Switzerland) have been part of the Swiss National Museum collection since the beginning of the twentieth century. As some of these objects were in a critical state of conservation, a research project was launched to assess and document their conditions, and to gain knowledge about painting materials and execution techniques, in view of planning a conservation project. In a first phase, non-destructive analyses were carried out, using handheld XRF and portable FTIR spectroscopy; followed by the targeted collection of samples for detailed analysis in the laboratory. In parallel, similar investigations were carried out on the imprints left on the walls of the church’s attic. The results allowed the identification of the pigment palette and the execution technique. Besides earth pigments such as ochres, a lime-based white, probably bianco di San Giovanni, and limited amounts of lapis lazuli were used in both painting cycles. For the Carolingian cycle, Egyptian blue and mixtures of several lead-based pigments were also identified. In several instances, the deterioration of lead-based pigments resulted in shades of grey to black severely modifying the original appearance of the wall paintings. Additionally, both cycles have suffered from pigment alteration due to fire. The obtained results, together with iconographic considerations, allowed for an extended interpretation of possible original colour palette.

Graphical Abstract
Methods of grout quality measurement in borehole exchangers for heat pumps and their rehabilitation
Authors: Nakládal Petr , Procházka Martin , Goliáš Viktor , Hrdá Jaromíra
Published: October 2024

Methods and instrumentation for measuring grout quality in heat pump boreholes, including the measurement of groundwater flow through boreholes outside partly grouted borehole exchanger pipes, have been developed in the Czech Republic. A Semtex charge has also been developed to repair rock massifs, which reliably disconnects borehole exchanger pipes without severely harming the surrounding rock environment or buildings. The resulting hole can then be used for regrouting, thus preventing undesirable vertical water flow through the borehole.
Oropharyngeal swab sampling for PRRSV detection in large-scale pig farms: a convenient and reliable method for mass sampling
Authors: Fan Mingyu , Li Yang , Hu Zhiqiang , Bian Lujie , Wu Weisheng , Liu Wei , Li Meng , wang Xinglong , Ren Jing , Wu Lili , Li Xiaowen
Published: October 2024

Background

Porcine reproductive and respiratory syndrome virus (PRRSV) has significant productivity and economic impacts in swine herds. Accurately determining the PRRSV status at the herd level is crucial for producers and veterinarians to implement strategies to control and eliminate the virus from infected herds. This study collected oropharyngeal swabs (OSs), nasal swabs (NSs), oral fluid swabs (OFs), rectal swabs (RSs), and serum samples continuously from PRRSV challenged pigs under experimental conditions and growing pigs under field conditions. Additionally, OSs and serum samples were collected from individual sows from 50 large-scale breeding farms, and the collection of OSs does not require the sows to be restrained. Ct values of PRRSV were detected in all samples using real-time reverse transcriptase-polymerase chain reaction (RT-qPCR).

Results

In PRRSV challenged pigs, OSs showed a higher PRRSV-positive rate until the end of the observation period. The Ct values of OSs were significantly lower than those of NSs, OFs, and RSs at 2, 8, 12, 14 and 20 days post-challenge (DPC) (P < 0.05). For growing pigs, the positivity rate of PRRSV in OSs was higher than that in other sample types at 30, 70, and 110 days of age. In sows, 24,718 OSs and 6259 serum samples were collected, with PRRSV-positive rate in OSs (9.4%) being significantly higher than in serum (4.1%) (P < 0.05). However, the Ct values of PRRSV RNA in serum were significantly lower than those in OSs (P < 0.001).

Conclusions

The OSs sample type yielded higher PRRSV-positive rates for longer periods compared to NSs, RSs, OFs and serum samples for PRRSV detection in infected pigs. Therefore, OSs has a good potential to be a convenient, practical, and reliable sample type for implementing mass sampling and testing of PRRSV in large-scale pig farms.
‘Resettlement is worthwhile for our children’s future’: reflections from the Stateless Rohingya refugees in Malaysia
Authors: Martuscelli Patrícia Nabuco , Ahmed Bayes , Sammonds Peter
Published: October 2024

Resettlement to a third country offers a durable solution for refugees who cannot integrate into their asylum or transit countries. While most studies focus on the experiences of refugees after their arrival in resettlement countries or on the political aspects of resettlement, fewer studies explore refugees’ perspectives prior to resettlement. This paper examines how Rohingyas in Malaysia view their resettlement opportunities. We collected qualitative micronarratives from 56 adult Rohingyas living in Malaysia between March and September 2019, to explore the complexities of their decision-making processes. The findings indicate that most Rohingyas aspire to resettle in another country to gain legal status or citizenship, providing a better future for their children, including access to education and healthcare. However, preferences among Rohingyas vary: while some are eager to resettle, others express a strong desire to return to their home country in Myanmar. Still, others wish to reunite with family in Myanmar or Bangladesh, and a significant minority are reluctant to resettle in non-Islamic countries, reflecting broader concerns about cultural and religious compatibility. This study highlights the varied resettlement preferences among Rohingyas, underscoring the need for resettlement policies to consider these diverse priorities to enhance the effectiveness of resettlement programs.
Harnessing machine learning for sustainable futures: advancements in renewable energy and climate change mitigation
Authors: Ukoba Kingsley , Onisuru Oluwatayo Racheal , Jen Tien-Chien
Published: October 2024

Background

Renewable energy and climate change are vital aspects of humanity. Energy is needed to sustain life on Earth. The exploration and utilisation of traditional fossil-based energy has led to global warming. The exploration and use of fossil-based energy have significantly contributed to global warming, making the shift to renewable energy crucial for mitigating climate change. Renewable energies offer a sustainable alternative that does not harm the environment. This review aims to examine the role of machine learning (ML) in optimising renewable energy systems and enhancing climate change mitigation strategies, addressing both opportunities and challenges in this evolving field. The vital significance of renewable energy and measures to circumvent climate change in modern civilisation is first contextualised in the review. It draws attention to the difficulties encountered in these fields and describes the exciting potential of ML to solve them. Important discoveries highlight how ML can improve renewable energy technology scalability, dependability and efficiency while enabling more precise climate change projections and practical mitigation strategies. Simultaneously, issues including ethical considerations, interpretability of models and data quality demand attention.

Method

This review conducted a systematic literature analysis on the application of ML in renewable energy and climate change mitigation. It involved a comprehensive search, selection, and analysis of recent studies, focusing on ML’s role in energy forecasting, predictive maintenance, and climate modelling. The review synthesised key developments, challenges, and future directions, emphasising the need for ongoing transdisciplinary research to fully realise ML’s potential in advancing sustainable energy solutions.

Result

The review found that machine learning significantly enhances renewable energy system efficiency, scalability, and climate change mitigation through improved forecasting, predictive maintenance, and climate modelling. However, challenges like ethical concerns, model interpretability, and data quality persist. Ongoing research is essential to fully leverage ML’s potential in these areas.

Short conclusion

The paper highlights how machine learning can be used to revolutionise the energy and climate change mitigation industries for sustainable futures. It promotes ongoing transdisciplinary research and innovation to fully realise ML’s synergistic potential and tackle urgent global issues. In the end, the review advances our knowledge of how to use ML to hasten the transition to a future that is more robust and sustainable.
Profiling hippocampal expression of long non-coding RNA GM12371 in a rat model of vascular dementia
Authors: Hooshmandi Etrat , Akbari Somayeh , Gharbi Negin , Ghobadi Mojtaba , Shahrokhabadi Ava , Salehi Mohammad Saied , Afshari Afsoon , Haghani Masoud , Bayat Mahnaz
Published: October 2024

Background

Dementia, characterized by synaptic dysfunction and memory loss, presents a significant challenge in medical research. Long non-coding RNAs (lncRNAs), known for their crucial roles in regulating gene expression, represent a gap in knowledge regarding their specific involvement in synaptic structure, transmission, and plasticity. This study aims to investigate the dynamic changes in hippocampal lncRNA GM12371 expression in response to acute and chronic hypoperfusion in the rat brain using the 2VO model.

Methods

The 2VO model was induced by permanently occluding the common carotid arteries. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to evaluate hippocampal lncRNA GM12371 expression at both acute (day 4) and chronic (day 28) stages post-2VO surgery. Comparative analysis was conducted with a sham-operated group.

Results

A notable reduction in GM12371 expression was observed in the rat hippocampus on day 4 following 2VO surgery compared to the sham group (P < 0.05). However, there was no significant difference in GM12371 expression between the sham and 2VO-28 groups.

Conclusion

These findings suggest that the downregulation of GM12371 is a response to acute hippocampal blood flow reduction but tends to normalize during the chronic phase of cerebral hypoperfusion. This dynamic regulation of GM12371 expression may be significant in the adaptive response to vascular dementia. Further clinical studies are warranted to investigate potential peripheral alterations in GM12371 expression in individuals with dementia.
Assessment of IV albumin and ringer lactate on the acute oral toxicity of acetylsalicylic acid in albino rats
Authors: Harb Inas , Medhat Engy , Samir Mai , Abdel Fattah Shereen , Badawy Hend Ahmed Abdallah , Gamal Sarah Mohamoud , Ateyya Hayam
Published: October 2024

Background

Despite the frequent inclusion of fluid therapy in the treatment of many conditions, there are limited studies available to provide an evidence-based specific recommendation for fluid therapy in acute drug toxicity. Salicylate toxicity is considered one of the common clinical problems. It is commonly associated with fatal complications and even can lead to death. The study was designed to investigate the effects of various IV fluid types as isotonic saline (NaCl 0.9%), Ringer lactate (RL), and albumin and their impact on acetyl salicylic acid (ASA) toxicity outcome in a rat model of acute salicylate toxicity.

Sixty male Albino rats were divided into 10 groups of 6 rats each. The first four groups were the control, saline, RL, and albumin groups. The fifth group received two doses of ASA solution orally, and the next five groups were treated with IV fluids as follows: saline-ASA, RL-ASA, albumin-ASA, RL + albumin-ASA, and saline + albumin-ASA. Upon completion of the study, spirometry, arterial blood gas analysis (ABG), and serum liver and kidney function tests were done on all groups. Furthermore, quantitative real-time polymerase chain reaction (PCR) was used to assess interleukin-6 (IL6), nuclear factor kappa beta (NF-kβ), and beta-actin mRNA gene expression of histopathology and immunohistochemistry assessments were also performed on liver and kidney tissues.

Results

The results revealed the ASA group showed marked deterioration across all the investigated parameters. The groups that received saline and RL showed improvements in the following: respiratory rates, ABG, liver and kidney function, and histopathological findings.

The RL + albumin group did not show any improvements. The albumin group and the saline + albumin group showed variable responses, ranging from mild improvement to no improvement.

Conclusions

The saline and RL groups showed positive results; however, the RL + albumin group showed the worst outcomes. The inclusion of albumin did not appear to provide any extra benefits and produced varying results.
Unnoticed freshwater leech as a hidden cause for recurring epistaxis: a case series and review of literature conducted at Tertiary Care Hospital Sikkim, North East India
Authors: Rai C. S. , Lepcha Pema Seden , Bhutia Tenzing Jigmee , Rai Sachika
Published: October 2024

Background

While leeches as intranasal foreign bodies are not frequently encountered, they can be one of the causes of epistaxis. The aim of the study is to raise awareness among healthcare professionals about the possibility of patients from leech endemic regions presenting with epistaxis.

Case presentation

We present a series of epistaxis cases due to intranasal leech infestation. In our series of 10 cases, there were 7 male and 3 female patients, aged between 2 and 53 years old. The duration of the complaint ranged from 1 to 5 weeks. All patients experienced with blood-stain nasal discharge or frank nasal bleeding at some point and most of them have a history of leech infestation from spring water as a local source. This article presents our approach to managing nasal leech infestation as epistaxis and outlines the precautionary measures taken for the retrieval of this living foreign body.

Conclusion

Details of the history must be taken before concluding the diagnosis. Maintain a high index of suspicion of leech infestation as a hidden cause of epistaxis especially in patients coming from endemic areas.
The quality of the electrodiagnostic referral system and the electrodiagnostic patterns in a sample of Egyptian patients
Authors: Nassif Mohamed Elsayed , Saba Emmanuel Kamal Aziz , El-Tawab Sarah Sayed , Elemary Wafaa Samir , Abdelnaby Hoda Mohamed , Khalil Naylan Fayez Wahba , Ibrahiem Aya Hanafy , Elsakka Ahmed Mosaad Mohamed Arafa , Elshatby Nehad Mohamed
Published: October 2024

Background

Electrodiagnosis is a localizing, diagnostic, and prognostic tool for individuals with suspected neuromuscular diseases. In addition to detailed history taking and thorough clinical examination, correct execution and interpretation of these tests can provide vital insights into the underlying neuromuscular disorders and frequently guide the need for proper management decision. The request for an electrodiagnosis examination should include brief clinical information and a provisional clinical diagnosis; this enhances the efficient easy performance of the test. The current study aims to detect the pattern of neuromuscular diseases in the Alexandria Main University Hospital, Egypt, and to evaluate the quality of the referral system to the electrodiagnosis unit.

Results

The study included 371 patients, out of which, 65% were referred from the Governmental Specialized Medical Councils and the Neurosurgery department. Although sensory complaints were the main reason for referral, yet 28.8% of patients did not show any electrodiagnosis abnormality. A compatible referral note led to shorter test times and fewer electromyography needle insertions.

Conclusion

Disorders of the peripheral nerves are the most frequent neuromuscular diseases referred to the electrodiagnosis unit with carpal tunnel syndrome being the most common disorder. A compatible referral letter is necessary when requesting an electrodiagnosis test, to save the physician time and focus on targeted procedures.
12417 Atypical Patterns Of Hypoglycemia Post-bariatric Surgery Due To Pancreatic Insulinoma
Authors: Chopra Karishma A
Published: October 2024

Disclosure: K.A. Chopra: None.

Accurately diagnosing an insulinoma in patients who have had bariatric surgery can be challenging because the autonomic symptoms of palpitations, tremors, anxiety and neuroglycopenic hypoglycemia symptoms of confusion and loss of consciousness may overlap with dumping syndrome or be attributed to non-insulinoma pancreatogenous hypoglycemia. When evaluating hypoglycemia, it is crucial to obtain a detailed history of the pattern and timing of hypoglycemia episodes and collect a critical sample of insulin, proinsulin, c-peptide levels during an episode of low glucose to prevent misdiagnosis. 58-year-old woman with hypertension, obesity, and history of laparoscopic sleeve gastrectomy presented for evaluation of hypoglycemia. The patient lost 100 pounds after her sleeve gastrectomy. Within the past year, the patient had two hospitalizations for severe symptomatic hypoglycemia with associated loss of consciousness. Imaging showed atrophic pancreas and she was discharged with a prescription for daily prednisone without critical sample testing for insulin or c-peptide levels. She sought a second opinion for her hypoglycemia at UCM. Since she was taking prednisone for 10 months prior to initial evaluation at UCM, evaluation for adrenal insufficiency could not be completed initially. She started continuous glucose monitoring which showed multiple daily episodes of hypoglycemia, fasting and at other various timepoints. Fasting labs showed low glucose of 20 mg/dL (RR 60-99 mg/dL), elevated proinsulin 120 pmol/L (RR 3.6- 22 pmol/L), inappropriately normal insulin 16.4 uIU/mL (RR <28.5 uIU/mL), and inappropriately normal c-peptide 0.82 pmol/mL (RR 0.30-2.35 pmol/mL), consistent with insulinoma. CT abdomen showed 1.4 cm arterially enhancing round lesion in the pancreatic body. Endoscopic ultrasound showed 13 mm mass in the pancreatic body with fine needle aspiration with pathology showing a well-differentiated neuroendocrine tumor. She received stress dose hydrocortisone preceding surgery and underwent successful enucleation of 1.6 cm pancreatic neuroendocrine tumor. A few weeks after her surgery, her HPA axis was re-evaluated, and steroids were discontinued. She has had no episodes of hypoglycemia since. Although hypoglycemia can be associated post-bariatric surgery, most patients develop postprandial hypoglycemia due to surgical alterations in alimentary flow leading to increased incretin and insulin secretion (Mulla et al 2016). Therefore, it is important to consider insulinoma in the differential diagnosis of post-bariatric surgery patients presenting without typical postprandial patterns of hypoglycemia. Reference: Mulla CM, Storino A, Yee EU, Lautz D, Sawnhey MS, Moser AJ, Patti ME, Insulinoma After Bariatric Surgery: Diagnostic Dilemma and Therapeutic Approaches. Obes Surg. 2016 Apr;26(4):874-81.

Presentation: 6/1/2024
Linkage between Fuz and Gpr161 genes regulates sonic hedgehog signaling during mouse neural tube development
Authors: Kim Sung-Eun , Kim Hyun-Yi , Wlodarczyk Bogdan J. , Finnell Richard H.
Published: October 2024

Sonic hedgehog (Shh) signaling regulates embryonic morphogenesis utilizing the primary cilium, the cell's antenna, which acts as a signaling hub. Fuz, an effector of planar cell polarity signaling, regulates Shh signaling by facilitating cilia formation, and the G protein-coupled receptor 161 (Gpr161) is a negative regulator of Shh signaling. The range of phenotypic malformations observed in mice bearing mutations in either of the genes encoding these proteins is similar; however, their functional relationship has not been previously explored. This study identified the genetic and biochemical linkage between Fuz and Gpr161 in mouse neural tube development. Fuz was found to be genetically epistatic to Gpr161 with respect to regulation of Shh signaling in mouse neural tube development. The Fuz protein biochemically interacts with Gpr161, and Fuz regulates Gpr161-mediated ciliary localization, a process that might utilize β-arrestin 2. Our study characterizes a previously unappreciated Gpr161-Fuz axis that regulates Shh signaling during mouse neural tube development.
The importance of muscle activation on the interpretation of muscle mechanical performance
Authors: Kissane Roger W. P. , Askew Graham N.
Published: October 2024

The work loop technique was developed to assess muscle performance during cyclical length changes with phasic activation, simulating the in vivo conditions of many muscles, particularly during locomotion. To estimate muscle function in vivo, the standard approach involves subjecting a muscle to length trajectories and activation timings derived from in vivo measurements, whilst simultaneously measuring force. However, the stimulation paradigm typically used, supramaximal, ‘square-wave’ stimulation, does not accurately reflect the graded intensity of activation observed in vivo. While the importance of the timing and duration of stimulation within the cycle on estimates of muscle performance has long been established, the importance of graded muscle activation has not been investigated. In this study, we investigated how the activation pattern affects muscle performance by comparing square-wave, supramaximal activation with a graded in vivo activation pattern. First, we used in vivo electromyography-derived activation patterns and fibre strains from the rabbit digastric muscle during mastication and replayed them in situ. Second, we used Hill-type musculoskeletal model-derived activation patterns and fibre strains in a trotting mouse, replayed ex vivo in the soleus (SOL) and extensor digitorum longus (EDL) muscles. In the rabbit digastric muscle, square-wave activation led to an 8-fold higher estimate of net power, compared with the in vivo graded activation pattern. Similarly, in the mouse SOL and EDL, supramaximal, square-wave activation resulted in significantly greater positive and negative muscle work. These findings highlight that realistic interpretations of in vivo muscle function rely upon more accurate representations of muscle activation intensity.
Formalization of topology and electrical circuit verification for computer-aided design systems
Authors: Skvortsova Tatyana , Zolnikov Konstantin , Plotnikov Aleksey , Scorkin I
Published: October 2024

The article examines the study of methods for verifying the correspondence of topology and electrical circuit in electronic devices. The authors present a new approach to the analysis and verification of the topological structure, taking into ac-count electrical characteristics, which leads to an increase in the formalization of tasks and provides better optimization of human interaction and a computer CAD system. The research includes an analysis of modern methods and tools used in the development of electronic devices, and also offers innovative approaches to ensuring consistency between to-pology and electrical functionality. LVS verification of the project is performed using Calibre, xRC extraction of the project, physical verification of the project using CADENCE Physical Verification System (PVS), LVS verification of the project using PVS. Presents a detailed analysis of the inte-grated circuit verification process performed using modern CAD tools. The paper discusses the key stages of verifica-tion, including LVS verification of the project using the Cal-ibre tool, xRC extraction of the project, as well as physical verification of the project using Cadence Physical Verifica-tion System (PVS). Special attention is paid to LVS checks, which represent an important design stage that guarantees the compliance of the topology and the electrical circuit. The features of using Calibre to perform LVS checks, as well as the xRC extraction process to extract the parameters of re-sistors and capacitors, are considered. For the physical veri-fication of the project, the capabilities of Cadence PVS were used, which provides an analysis of the compliance of the physical implementation of the scheme with the specified rules. The results obtained and the experience presented in the article can be useful for engineers and researchers in-volved in the design of integrated circuits, as well as for those interested in the use of modern CAD tools in the field of verification and validation of electronic devices
Development of models of network targets for complex organizational systems for special purposes
Authors: Sumin Viktor , Kravchenko Andrey , Rodin Sergey
Published: October 2024

This article discusses an approach to the development of a network model based on the target installation of complex organizational systems for special purposes using methods for determining the coefficients of relative importance of the goals of this system based on the method of paired comparisons, which are based on the Thurstone model, to denote the arcs of the graph for the network model. The development of a graph for a network model is based on an expert survey by an expert group on the importance of goals for complex organizational systems of special purpose. The problem of formal assessment of the level of training of experts in a discrete subject area has been studied in various scientific papers, however, among many scientific papers it is difficult to single out one that could give an integral assessment of the level of knowledge that would objectively assess the main qualities of an expert. In this paper, it is proposed to carry out such an assessment based on statistics, the participation of experts in similar examinations. As an advantage of the software in question
Holy Hell: Religious/Spiritual Abuse and Attachment to God
Authors:   , Ellis Heidi M.
Published: October 2024

Although religion and spirituality (R/S) can be a protective factor for many, R/S can also be maladaptive in the form of R/S abuse and trauma. R/S abuse and trauma can have a significant impact on one's psychological functioning and has been positively associated with anxiety, depression, trauma-related symptoms, and R/S struggles. However, relatively few studies have explored the relationship between R/S abuse and attachment to God. This study helps address this gap in research by exploring the potential associations between R/S abuse and attachment to God in a sample of 308 adults who endorsed a current and/or past R/S identity. The current study found that (a) individuals with marginalized identities reported higher rates of R/S abuse than those with fewer or no marginalized identities, (b) individuals who reported more frequent R/S abuse reported higher levels of R/S struggles, depression, anxiety, and trauma-related symptoms, even when controlling for other experiences of trauma and abuse, (c) length of time since one's conversion moderated the association between R/S abuse and God attachment anxiety and avoidance but not R/S deidentification, and (d) God attachment anxiety and avoidance did not moderate the relationship between R/S abuse and trauma-related symptoms or R/S deidentification. I conclude by discussing my findings considering attachment theory and the extant literature on R/S abuse. By better understanding R/S abuse, clinicians will be better equipped to interact with clients of diverse R/S identities, potentially utilizing R/S as a strength in addition to addressing the maladaptive aspects of R/S.
How Your Thinking Style Relates to Your Personality: The Relationships between Naïve Dialecticism, Self-Complexity, and Personality Functioning
Authors:   , Xu Chenle
Published: October 2024

Despite their relevance to self-concept, naïve dialecticism (ND) and self-complexity (SC) have not been applied to the study of personality disorders. In personality pathology research, disturbances in personality functioning are operationalized in terms of problems in self-conception and interpersonal affiliation (as assessed in Criterion A of the DSM-5 alternative model of personality disorder). Thus, exploring the influence of ND and SC on personality functioning would contribute to the understanding of self-concept in personality pathology, especially in the context of Eastern versus Western cultures. The current study recruited participants from both of these cultural groups and the results showed preliminary support for the predictive effects of ND and SC on personality functioning impairment, respectively, and for the partial mediating effect of SC on the association between dialecticism and personality functioning in each cultural group. Implications for the future conceptualization of personality pathology across cultures and the study limitations are also discussed.
Program Evaluation of Evidenced-Based Autism Spectrum Disorder (ASD) Treatment: Replication and Extension
Authors:   , Gordon Amanda
Published: October 2024

Applied behavioral analysis (ABA) is an evidenced-based treatment used in the treatment of autism spectrum disorder (ASD) symptomology. This treatment modality addresses difficulties individuals with ASD experience, including deficits in social communication, and repetitive and/or restricted behaviors. A variable pattern of developmental milestone acquisition, particularly language, is an early indicator of ASD. Perhaps due to the variability in presentation, the mean age at diagnosis is 4-5 years old despite feasibility of diagnosis as early as 2 years of age. Tracking a child's development is essential for early identification of ASD, with age at diagnosis significantly impacting intervention outcomes in this population. Ideally, individuals with suspected ASD are comprehensively assessed and engaged in intensive early intervention with personalized goals targeting multiple domains of functioning, including cognitive abilities, adaptive functioning, and/or language functioning. Unfortunately, significant barriers (e.g., too few qualified professionals, inaccessible treatment centers, long waitlists) have been identified that preclude access to care for many individuals in need of evaluation and/or treatment. Given the typical delays in identification and the frequent barriers to access, assuring families that the care of their child is of paramount importance and will be met with high quality, evidence-based practices is appropriate. The purpose of the multi-site study was to assess treatment-as-usual across autism intervention centers, drawing archival data from Autism Comprehensive Educational Services (ACES). Results indicated no significant differences in standardized scores of adaptive functioning but significant differences in criterion referenced skills across three time points. Future directions are discussed.
An Exploration of Biracial Identity Development among Native American-White Individuals
Authors:   , Doty Dominique Catherine
Published: October 2024

The representation of biracial individuals in the United States is steadily growing, with individuals identifying as Native American and White being the largest biracial group. Despite their large representation, there are few theories that capture identity development among biracial individuals, and specifically those who are not biracial Black-White. This study draws from both the continuum of biracial identity (COBI) model and acculturation theories to investigate the biracial identity development of Native American-White individuals. Semi-structured interviews were conducted with 12 biracial Native American-White individuals (Mage = 24.6 years). Interview data were analyzed using a modified grounded theory approach and revealed that the process of biracial Native American-White identity development is both a stagewise (e.g., rejecting and then feeling affirmed in their identity) and multidimensional (e.g., physical appearance, sense of pride and belonging, and culture) process. The implication of study findings for researchers, mental health practitioners, and others invested in fostering positive identity development among biracial Native American-White biracial individuals is discussed.