bluuebunny/crossref_metadata_2025 huggingface dataset:
Alteration of medial temporal lobe metabolism related to Alzheimer’s disease and dementia with lewy bodies
Authors: Kang Sungwoo , Jeon Seun , Lee Young-gun , Ye Byoung Seok
Published: April 2024

Background

Association of medial temporal lobe (MTL) metabolism with Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB) has not been evaluated considering their mixed disease (MD).

Methods

131 patients with AD, 133 with DLB, 122 with MD, and 28 normal controls (NCs) underwent neuropsychological tests, assessments for parkinsonism, cognitive fluctuation (CF), and visual hallucinations (VH), and 18F-fluorodeoxyglucose PET to quantify MTL metabolism in the amygdala, hippocampus, and entorhinal cortex. The effects of AD and DLB on MTL metabolism were evaluated using general linear models (GLMs). Associations between MTL metabolism, cognition, and clinical features were evaluated using GLMs or logistic regression models separately performed for the AD spectrum (NC + AD + MD), DLB spectrum (NC + DLB + MD), and disease groups (AD + DLB + MD). Covariates included age, sex, and education.

Results

AD was associated with hippocampal/entorhinal hypometabolism, whereas DLB was associated with relative amygdalar/hippocampal hypermetabolism. Relative MTL hypermetabolism was associated with lower attention/visuospatial/executive scores and severe parkinsonism in both the AD and DLB spectra and disease groups. Left hippocampal/entorhinal hypometabolism was associated with lower verbal memory scores, whereas right hippocampal hypometabolism was associated with lower visual memory scores in both the AD spectrum and disease groups. Relative MTL hypermetabolism was associated with an increased risk of CF and VH in the disease group, and relative amygdalar hypermetabolism was associated with an increased risk of VH in the DLB spectrum.

Conclusions

Entorhinal-hippocampal hypometabolism and relative amygdala-hippocampal hypermetabolism could be characteristics of AD- and DLB-related neurodegeneration, respectively.
Exploring morphological similarity and randomness in Alzheimer’s disease using adjacent grey matter voxel-based structural analysis
Authors: Chen Ting-Yu , Zhu Jun-Ding , Tsai Shih-Jen , Yang Albert C.
Published: April 2024

Background

Alzheimer’s disease is characterized by large-scale structural changes in a specific pattern. Recent studies developed morphological similarity networks constructed by brain regions similar in structural features to represent brain structural organization. However, few studies have used local morphological properties to explore inter-regional structural similarity in Alzheimer’s disease.

Methods

Here, we sourced T1-weighted MRI images of 342 cognitively normal participants and 276 individuals with Alzheimer’s disease from the Alzheimer's Disease Neuroimaging Initiative database. The relationships of grey matter intensity between adjacent voxels were defined and converted to the structural pattern indices. We conducted the information-based similarity method to evaluate the structural similarity of structural pattern organization between brain regions. Besides, we examined the structural randomness on brain regions. Finally, the relationship between the structural randomness and cognitive performance of individuals with Alzheimer’s disease was assessed by stepwise regression.

Results

Compared to cognitively normal participants, individuals with Alzheimer’s disease showed significant structural pattern changes in the bilateral posterior cingulate gyrus, hippocampus, and olfactory cortex. Additionally, individuals with Alzheimer’s disease showed that the bilateral insula had decreased inter-regional structural similarity with frontal regions, while the bilateral hippocampus had increased inter-regional structural similarity with temporal and subcortical regions. For the structural randomness, we found significant decreases in the temporal and subcortical areas and significant increases in the occipital and frontal regions. The regression analysis showed that the structural randomness of five brain regions was correlated with the Mini-Mental State Examination scores of individuals with Alzheimer’s disease.

Conclusions

Our study suggested that individuals with Alzheimer’s disease alter micro-structural patterns and morphological similarity with the insula and hippocampus. Structural randomness of individuals with Alzheimer’s disease changed in temporal, frontal, and occipital brain regions. Morphological similarity and randomness provide valuable insight into brain structural organization in Alzheimer’s disease.
DPSCs regulate epithelial-T cell interactions in oral submucous fibrosis
Authors: Wang S. Y. , Zhang S. J. , Meng H. F. , Xu H. Q. , Guo Z. X. , Yan J. F. , Gao J. L. , Niu L. N. , Wang S. L. , Jiao K.
Published: April 2024

Background

Oral submucous fibrosis (OSF) is a precancerous lesion characterized by fibrous tissue deposition, the incidence of which correlates positively with the frequency of betel nut chewing. Prolonged betel nut chewing can damage the integrity of the oral mucosal epithelium, leading to chronic inflammation and local immunological derangement. However, currently, the underlying cellular events driving fibrogenesis and dysfunction are incompletely understood, such that OSF has few treatment options with limited therapeutic effectiveness. Dental pulp stem cells (DPSCs) have been recognized for their anti-inflammatory and anti-fibrosis capabilities, making them promising candidates to treat a range of immune, inflammatory, and fibrotic diseases. However, the application of DPSCs in OSF is inconclusive. Therefore, this study aimed to explore the pathogenic mechanism of OSF and, based on this, to explore new treatment options.

Methods

A human cell atlas of oral mucosal tissues was compiled using single-cell RNA sequencing to delve into the underlying mechanisms. Epithelial cells were reclustered to observe the heterogeneity of OSF epithelial cells and their communication with immune cells. The results were validated in vitro, in clinicopathological sections, and in animal models. In vivo, the therapeutic effect and mechanism of DPSCs were characterized by histological staining, immunohistochemical staining, scanning electron microscopy, and atomic force microscopy.

Results

A unique epithelial cell population, Epi1.2, with proinflammatory and profibrotic functions, was predominantly found in OSF. Epi1.2 cells also induced the fibrotic process in fibroblasts by interacting with T cells through receptor-ligand crosstalk between macrophage migration inhibitory factor (MIF)-CD74 and C-X-C motif chemokine receptor 4 (CXCR4). Furthermore, we developed OSF animal models and simulated the clinical local injection process in the rat buccal mucosa using DPSCs to assess their therapeutic impact and mechanism. In the OSF rat model, DPSCs demonstrated superior therapeutic effects compared with the positive control (glucocorticoids), including reducing collagen deposition and promoting blood vessel regeneration. DPSCs mediated immune homeostasis primarily by regulating the numbers of KRT19 + MIF + epithelial cells and via epithelial-stromal crosstalk.

Conclusions

Given the current ambiguity surrounding the cause of OSF and the limited treatment options available, our study reveals that epithelial cells and their crosstalk with T cells play an important role in the mechanism of OSF and suggests the therapeutic promise of DPSCs.
Development and application of haploid embryonic stem cells
Authors: Wang Hai-Song , Ma Xin-Rui , Guo Yi-Hong
Published: April 2024

Haploid cells are a kind of cells with only one set of chromosomes. Compared with traditional diploid cells, haploid cells have unique advantages in gene screening and drug-targeted therapy, due to their phenotype being equal to the genotype. Embryonic stem cells are a kind of cells with strong differentiation potential that can differentiate into various types of cells under specific conditions in vitro. Therefore, haploid embryonic stem cells have the characteristics of both haploid cells and embryonic stem cells, which makes them have significant advantages in many aspects, such as reproductive developmental mechanism research, genetic screening, and drug-targeted therapy. Consequently, establishing haploid embryonic stem cell lines is of great significance. This paper reviews the progress of haploid embryonic stem cell research and briefly discusses the applications of haploid embryonic stem cells.
The Effect of Partial Replacement of Cement with Diatomaceous Earth (DE) and Polypropylene Fibers (PPF) on Fresh, Hardened, and Durability Properties of Concrete
Authors: Alex Alexander Gladwin , Jose Prakash Arul , Antony Maria Rajesh , Dhanalakshmi Krishnan
Published: April 2024

This research aims to investigate the fresh and mechanical properties of concrete with diatomaceous earth (DE) and polypropylene fiber (PPF). The cement was partially replaced by DE in the concentration ranging from 5 to 20% by weight; whereas, PPF was incorporated in concrete mix as in range of 0.05–0.20% by cement weight. Totally, 25 different mix proportions were developed and their fresh properties were examined using slump, density and compacting factor tests. Besides, mechanical properties were evaluated by. Using compressive, split tensile, and flexural strength analysis at the ages of 7th, 14th and 28th days. Furthermore, concrete durability properties were evaluated using water penetration, chloride permeability as well as sorptivity tests, which have been performed at the age of 28th day. The result exhibits that the incorporation of D.E slightly affects the slump value meanwhile PPF decreases the fresh values. Furthermore, the combination of DE and PPF in concrete significantly enhances the mechanical properties compared to the control mix. The mix proportion of 15% DE and 0.15% of PPF exhibited a noticeable influence on mechanical properties as well as durability properties compare to control concrete.
The personality traits with depression and suicidal ideation among Thai medical students: a university-based multiregional study
Authors: Pitanupong Jarurin , Sa-i Adchara , Sathaporn Katti , Jiraphan Aimorn , Ittasakul Pichai , Karawekpanyawong Nuntaporn
Published: April 2024

Background

The prevalence of depression in medical students was greater than in the general population. Knowing of predictive factors for depression among medical students is useful. The objectives of this study included the assessment of personality traits as well as the association between the personality traits and the presence of symptoms of depression, and suicidal ideation among medical students covering several regions of Thailand.

Methods

From April to July 2023, a cross-section study was conducted. The participants included first to sixth-year medical students studying at three Faculties of Medicine in Thailand; Prince of Songkla University; Ramathibodi Hospital, Mahidol University; and Chiang Mai University. Using the online process, the questionnaires were composed of three sections; demographic data; the International Personality Item Pool-NEO (IPIP-NEO), Thai version; and the Patient Health Questionnaire-9 (PHQ-9), Thai version. Demographics, personality traits, depression, and suicidal ideation were analyzed using descriptive statistics. The results were presented as frequency, mean, and standard deviation (SD) or median and interquartile range (IQR). The association between independent variables and the presence of depression was identified using binary logistic regression analysis, and the association with suicidal ideation was identified using ordinal logistic regression analysis.

Results

The 868 medical students participated in this study. Most of them were female (63.5%), Buddhist (82.0%), and first-year medical students (31.8%). The mean age (SD) was 20.8 (2.2) years, and the mean cumulative Grade Point Average (SD) was 3.5 (0.4). They reported the median (IQR) score of PHQ-9 as 6.0 (3.0–9.0), 238 participants (27.4%) presented with depression, and 138 (15.9%) participants reported suicidal ideation. According to the IPIP-NEO, participants with depression or suicidal ideation had higher Neuroticism scores and lower Extraversion, Agreeableness, and Conscientiousness scores compared to those without such issues. An increase in the Neuroticism score was linked to higher odds of depression, while an increase in the Conscientiousness score was associated with lower odds of depression. Suicidal ideation significantly increased with higher Neuroticism scores and the presence of a psychiatric illness.

Conclusions

More than a quarter of Thai medical students reported depression. A higher Neuroticism and lower Extraversion, Agreeableness, and Conscientiousness scores related to depression. Therefore, medical schools may benefit from knowing medical students’ personality traits, to identify coping mechanisms and predict those at a higher risk of developing depression in the future.
Mouse serum albumin induces neuronal apoptosis and tauopathies
Authors: Hou Sheng-jie , Huang Ya-ru , Zhu Jie , Jia Ying-bo , Niu Xiao-yun , Yang Jin-ju , Yu Xiao-lin , Du Xiao-yu , Liang Shi-yu , Cui Fang , Li Ling-jie , Tian Chen , Liu Rui-tian
Published: April 2024

The elderly frequently present impaired blood–brain barrier which is closely associated with various neurodegenerative diseases. However, how the albumin, the most abundant protein in the plasma, leaking through the disrupted BBB, contributes to the neuropathology remains poorly understood. We here demonstrated that mouse serum albumin-activated microglia induced astrocytes to A1 phenotype to remarkably increase levels of Elovl1, an astrocytic synthase for very long-chain saturated fatty acids, significantly promoting VLSFAs secretion and causing neuronal lippoapoptosis through endoplasmic reticulum stress response pathway. Moreover, MSA-activated microglia triggered remarkable tau phosphorylation at multiple sites through NLRP3 inflammasome pathway. Intracerebroventricular injection of MSA into the brains of C57BL/6J mice to a similar concentration as in patient brains induced neuronal apoptosis, neuroinflammation, increased tau phosphorylation, and decreased the spatial learning and memory abilities, while Elovl1 knockdown significantly prevented the deleterious effect of MSA. Overall, our study here revealed that MSA induced tau phosphorylation and neuron apoptosis based on MSA-activated microglia and astrocytes, respectively, showing the critical roles of MSA in initiating the occurrence of tauopathies and cognitive decline, and providing potential therapeutic targets for MSA-induced neuropathology in multiple neurodegenerative disorders.
Quantitative assessment of ecological assets in the world heritage karst sites based on remote sensing: with a special reference to South China Karst
Authors: Liu Qiangqiang , Wang Jiancheng , Xiong Kangning , Gong Lanqiang , Chen Yue , Yang Jianzai , Xiao Hua , Bai Jie
Published: April 2024

The benefits provided by ecological assets play a crucial role in enhancing human well-being. However, there is a scarcity of viable methods for assessing their status. This study is grounded in Land Use and Land Cover Change (LUCC) and integrates both the quantity and quality aspects of these assets. Utilizing the ecological asset index (EQ and EQi), this study conducts a quantitative assessment of the assets in the Shibing karst and the Libo-Huanjiang karst heritage sites, while also qualitatively analyzing their influencing factors. The findings reveal that: (1) In the Shibing heritage site, forest and impervious surface assets exhibited an upward trend, whereas cropland and grassland experienced a decline; meanwhile, shrub and water body assets remained relatively stable. The total area of assets rated as excellent or good increased by 95.371 km2, resulting in an EQ enhancement of 45.427. (2) Likewise, in the Libo-Huanjiang heritage site, forest and impervious surface assets demonstrated an upward trajectory, while shrub assets declined. Cropland, grassland, and water body assets experienced minimal variation. The total area of assets rated as excellent or good expanded by 168.227 km2, resulting in an EQ enhancement of 80.806. (3) The execution of a series of ecological protection projects and management plans for heritage site conservation primarily accounts for the enhancement of regional assets. Notably, ecological resources, socio-economic conditions, human resources, and conservation management policies serve as pivotal drivers influencing the alterations in heritage site assets.
Sample size and the limits to precision in Pb-isotopic dating by ID-TIMS
Authors: Amelin Yuri
Published: April 2024

Using isotope analysis of ancient (4555 Ma) radiogenic Pb by ID-TIMS as an example, I evaluate the sample size required to achieve the target precision of the207Pb/206Pb ratio 0.007% (2σ), corresponding to the uncertainty of the207Pb*/206Pb* age of 0.1 million years, considering various analytical uncertainties. In a hypothetical perfect analytical setup that would enable measuring isotopic ratios without noise, losses and biases, this precision can be achieved by analysis of a sample containing 2.9 picograms of Pb. Assessment of the sources of noise, loss and bias introduced by sample preparation and mass spectrometry shows that incomplete ionization of Pb during evaporation from the filament and baseline noise of a mass spectrometer make the greatest contributions to the additional uncertainty. Subtraction of analytical blank and minor spike isotopes can also substantially increase the uncertainty under some analytical conditions. The contributions from the other sources are smaller, but can become significant if a higher precision level is sought.
Plant endophytic fungi exhibit diverse biotransformation pathways of mogrosides and show great potential application in siamenoside I production
Authors: Lin Wenxi , Jiang Qiang , Dong Yamin , Xiao Yiwen , Wang Ya , Gao Boliang , Zhu Du
Published: April 2024

Fungal endophytes, as an untapped resource of glycoside hydrolase biocatalysts, need to be further developed. Mogroside V, the primary active compound in Siraitia grosvenorii fruit, can be converted into other various bioactive mogrosides by selective hydrolysis of glucose residues at C3 and C24 positions. In present study, 20 fungal strains were randomly selected from our endophytic fungal strain library to assess their capability for mogroside V transformation. The results revealed that relatively high rate (30%) endophytic fungal strains exhibited transformative potential. Further analysis indicated that endophytic fungi could produce abundant mogrosides, and the pathways for biotransforming mogroside V showed diverse. Among the given fungal endophytes, Aspergillus sp. S125 almost completely converted mogroside V into the end-products mogroside II A and aglycone within just 2 days of fermentation; Muyocopron sp. A5 produced rich intermediate products, including siamenoside I, and the end-product mogroside II E. Subsequently, we optimized the fermentation conditions for Aspergillus sp. S125 and Muyocopron sp. A5 to evaluate the feasibility of large-scale mogroside V conversion. After optimization, Aspergillus sp. S125 converted 10 g/L of mogroside V into 4.5 g/L of mogroside II A and 3.6 g/L of aglycone after 3 days of fermentation, whereas Muyocopron sp. A5 selectively produced 4.88 g/L of siamenoside I from 7.5 g/L of mogroside V after 36 h of fermentation. This study not only identifies highly effective biocatalytic candidates for mogrosides transformation, but also strongly suggests the potential of plant endophytic fungi as valuable resources for the biocatalysis of natural compounds.
Poorly differentiated mucinous carcinoma of the ascending colon complicated by bilateral ovarian mature cystic teratomas in a 17-year-old female patient: a case report
Authors: Shimogawa Takuya , Hiyoshi Yukiharu , Ouchi Mayuko , Kosumi Keisuke , Eto Kojiro , Ida Satoshi , Iwatsuki Masaaki , Baba Yoshifumi , Miyamoto Yuji , Okazaki Nasa , Miyasato Yuko , Baba Hideo
Published: April 2024

Background

Colorectal cancer (CRC) is one of the most common cancers worldwide, and screening colonoscopy has led to a decreasing incidence rate. However, the incidence of CRC is increasing among young people, especially adolescents and young adults (AYAs) who are not routinely screened. Although CRC is the fourth most common cancer among AYAs, it is extremely rare. In younger patients, CRC is often diagnosed later, and the proportion of patients with advanced CRC is higher than that in older patients. We herein present a case of poorly differentiated mucinous carcinoma of the ascending colon complicated by bilateral ovarian mature cystic teratomas (MCTs) in an AYA.

Case presentation

A 17-year-old female patient presented with a chief complaint of abdominal pain and diarrhea that had persisted for more than 3 years. Colonoscopy revealed circumferential wall thickening of the ascending colon, and colonic biopsy revealed a mucous mass and findings of adenocarcinoma, predominantly signet ring cell carcinoma. Abdominal computed tomography (CT) and pelvic magnetic resonance imaging (MRI) showed bilateral ovarian tumors. Laparoscopic right hemicolectomy and enucleation of bilateral ovarian tumors were performed. Although the ascending colon cancer formed a large mass, there were no signs of peritoneal dissemination or direct invasion to the surrounding organs. Microscopically, the ascending colon was a poorly differentiated mucinous carcinoma with signet ring cell carcinoma and lymph node metastasis (9/42). The ovarian tumors were diagnosed as MCTs without any malignant components. The pathological diagnosis was ascending colon cancer (pT4aN2bM0, pStage IIIC) and bilateral ovarian MCTs. Microsatellite instability (MSI) testing was negative, and there were no gene mutations in either RAS or BRAF. Postoperative adjuvant chemotherapy with oxaliplatin and 5-FU was started.

Conclusions

We presented a case of locally advanced ascending colon cancer in a 17-year-old female patient. CRC rarely occurs in AYAs. However, the incidence has gradually increased in recent years. It should be considered as a differential diagnosis for young patients with long-term abdominal symptoms of unknown cause.
In vitro evaluation of the platelet adhesion and interferon-γ production capacity of mononuclear cells coming in contact with a hydrophilic polymer-embedded polysulfone dialyzer
Authors: Kurihara Yoshitaka , Kobayashi Kozue , Umehara Shigeharu , Tsukao Hiroshi , Kokubo Kenichi , Sakai Kiyotaka , Kubota Masaru , Kobayashi Hirosuke
Published: April 2024

Background

A polysulfone dialysis membrane containing both polyvinylpyrrolidone (PVP) and the novel hydrophilic polymer (NV polymer) has been developed in an attempt to modify the blood contact surface of the membrane. In the present study, we performed an in vitro evaluation of the NV polymer-embedded membrane (NV membrane), focusing on the adhesion of blood cells to the membrane and the interferon (IFN)-γ production capacity of peripheral blood mononuclear cells coming in contact with the membrane.

Methods

Two membranes, the NV membrane and the conventional membrane embedded with PVP alone (CX), were evaluated simultaneously by dividing the porcine blood obtained from the same animal into two portions. The blood cell adhesion to the membranes was evaluated by measuring the hemoglobin concentrations and lactate dehydrogenase (LDH) activities in the eluates extracted from the membranes. The IFN-γ production capacity in response to phytohemagglutinin stimulation of mononuclear cells coming in contact with either membrane was evaluated.

Results

Both the hemoglobin concentration and LDH activity, corrected by excluding erythrocytes from the eluate, were about 25% lower in the eluate from the NV membrane than in the eluate from the CX membrane. The IFN-γ production capacity of the mononuclear cells coming in contact with dialysis membrane remained unchanged for the case of the NV membrane, while it decreased for the case of the CX membrane.

Conclusions

A lower degree of adhesion of blood cells to the membrane and a lower degree of reduction in the IFN-γ production capacity of mononuclear cells coming in contact with the membrane were observed for the NV membrane, as compared with the PVP membrane, which may suggest improved biocompatibility of the NV membrane.
A prospective assessment of readiness to implement an early detection of cerebral palsy pathway in a neonatal intensive care setting using the PARIHS framework
Authors: Mulqueeney Amy , Battin Malcolm , McKillop Ann , Stott N. Susan , Allermo-Fletcher Angelica , Williams Sîan A.
Published: April 2024

Background

Early detection of cerebral palsy (CP) is possible through targeted use of assessment tools. Changes in practice are needed to facilitate this shift towards earlier diagnosis of CP in New Zealand. The aim of this study was to prospectively evaluate readiness to implement an early detection of CP pathway within a level 3 neonatal intensive care unit (NICU) setting prior to any implementation taking place. The PARIHS (Promoting Action on Research Implementation in Health Services) framework was engaged to assess readiness by highlighting determinants that influence implementation outcomes as either barriers or enablers.

Methods

A mixed methods approach was used. Firstly, an online staff survey assessed PARIHS sub-elements using Likert scores and free text with the intent to develop a baseline understanding of staff views. Secondly, focus groups were conducted to gain deeper understanding of barriers and enablers to implementation. Participants included health professionals involved in the first 6 months of life. Data were analysed to outline the barriers and enablers of implementation under the Evidence and Context constructs of the PARIHS framework.

Results

Twenty-seven participants completed the survey, and 20 participants participated in eight focus groups and two individual interviews. Quantitative (survey) findings found 65% agreement around the usefulness of research evidence on early CP detection; however, ≤ 45% felt current resources (i.e. human, financial and IT) were sufficient for implementation. Qualitative findings (survey and focus groups) highlighted key staff concerns around resources, family impact (creating unnecessary stress), and equity (barriers to participation). Staff wanted information regarding how international evidence translates to the local context and availability of timely follow-up services. Sub-elements within the Evidence and Context constructs were rated as either mixed or low (except for Evidence - Research, rated as high), overall indicating that Auckland NICU is at the early stages of readiness to implement the early CP detection pathway.

Conclusion

This work may resonate with other neonatal services preparing to implement CP early detection pathways. Resourcing has a major role in facilitating implementation of pathways and uncertainty about resources is a barrier to implementation. Ongoing focus on building consensus and funding is required to ensure optimal uptake.
Salvage Reirradiation for Locally Recurrent Prostate Cancer: Results From a Prospective Study With 7.2 Years of Follow-Up
Authors: Ekanger Christian , Helle Svein Inge , Reisæter Lars , Hysing Liv Bolstad , Kvåle Rune , Honoré Alfred , Gravdal Karsten , Pilskog Sara , Dahl Olav
Published: April 2024

PURPOSE

There are no well-established re-treatment options for local recurrence after primary curative radiation therapy for prostate cancer (PCa), as prospective studies with long-term follow-up are lacking. Here, we present results from a prospective study on focal salvage reirradiation with external-beam radiation therapy with a median follow-up of 7.2 years.

MATERIALS AND METHODS

From 2013 to 2017, 38 patients with biopsy-proven locally recurrent PCa >2 years after previous treatment and absence of grade 2-3 toxicity from the first course of radiation were included. The treatment was 35 Gy in five fractions to the MRI-based target volume and 6 months of androgen-deprivation therapy starting 3 months before radiation. The Phoenix criteria defined biochemical recurrence-free survival (bRFS), and toxicity was scored according to Radiation Therapy Oncology Group criteria.

RESULTS

Median age was 70 years, and median time from primary radiation to prostate-specific antigen (PSA) recurrence was 83 months. The actuarial 2-year and 5-year bRFS were 81% (95% CI, 69 to 94) and 58% (95% CI, 49 to 74), respectively. The actuarial 5-year local recurrence-free survival was 93% (95% CI, 82 to 100), metastasis-free survival was 82% (95% CI, 69 to 95), and overall survival was 87% (95% CI, 76 to 98). Two patients (5%) had durable grade 3 genitourinary toxicity, one combined with GI grade 3 toxicity. A PSA doubling time ≤6 months at salvage, a Gleason score >7, and a PSA nadir ≥0.1 ng/mL predicted a worse outcome.

CONCLUSION

Reirradiation with EBRT for locally recurrent PCa after primary curative radiation therapy is clinically feasible and demonstrated a favorable outcome with acceptable toxicity in this prospective study with long-term follow-up.
Recombinant PTH Infusion in a Child With Sanjad-Sakati Syndrome Refractory to Conventional Therapy
Authors: Bali Ibrahim , Al Khalifah Reem
Published: April 2024

Hypoparathyroidism is the most common endocrinological feature in children with Sanjad-Sakati syndrome. Treatment includes active vitamin D and calcium supplementation. Here, we report a case of a newborn with Sanjad-Sakati syndrome who had severe hypocalcemia since birth who responded to PTH subcutaneous pump infusion. The child was born at 35 weeks with hypocalcemia since the first day of life. The standard medical treatment proved ineffective for the newborn, necessitating the administration of unusually high doses of oral and IV calcium and vitamin D analogue for a 2 months. As a result, intermittent subcutaneous injections of PTH were commenced, resulting in an initial improvement in calcium levels, although this proved to be short-lived. Subsequently, a switch to continuous infusion via a Medtronic Vio pump was made, which unfortunately resulted in iatrogenic hypercalcemia, requiring management of hypercalcemia. Later, calcium carbonate and alfacalcidol were resumed at a lower dosage and continued to have average requirements for patients with hypoparathyroidism. PTH subcutaneous infusion can be highly effective in refractory hypocalcemia cases and can significantly impact the treatment course and facilitate hospital discharge as seen in our case. Careful dosage and monitoring are required to avoid iatrogenic hypercalcemia.
The Impact of Perilesional Heatsink Structures on Ablation Volumes in Laser Interstitial Thermal Therapy for Brain Metastases
Authors: Bhatia Shovan , Berke Chandler N. , Rivera Cameron A. , Cleri Nathaniel A. , Mahavadi Anil , Merenzon Martin A. , Khalafallah Adham M. , Levy Adam S. , Daggubati Lekhaj C. , Morell Alexis A. , Kaye Brandon , Sanchez Pier , Shah Ashish H. , Komotar Ricardo J. , Ivan Michael E.
Published: April 2024

BACKGROUND AND OBJECTIVES:

Laser interstitial thermal therapy (LITT) has demonstrated promise in surgical neuro-oncology because of its effectiveness in delivering precise thermal energy to lesions. The extent of ablation (EOA) is a prognostic factor in improving patient outcomes but is often affected by perilesional heatsink structures, which can lead to asymmetric ablations. The purpose of this study was to quantitatively evaluate the impact of various perilesional heatsink structures on the EOA in LITT for brain metastases.

METHODS:

Twenty-seven procedures for 22 unique patients with brain metastases fit the inclusion criteria. Intracranial heatsink structures were identified: sulci, meninges, cerebrospinal fluid (CSF) spaces, and vasculature. Asymmetric ablation was determined by measuring 3 pairs of orthogonal distances from the proximal, midpoint, and distal locations along the laser catheter to the farthest edge of the ablation zone bilaterally. Distances from the same points on the laser catheter to the nearest heatsink were also recorded. The Heatsink Effect Index was created to serve as a proxy for asymmetric ablation. Pearson correlations, t-tests, and analysis of variance were the statistical analyses performed.

RESULTS:

From the midpoint of the catheter, the 27 heatsinks were meninges (40.7%), sulci (22.2%), vasculature (22.2%), and CSF spaces (14.8%). Across all points along the catheter track, there was a significant generalized heatsink effect on asymmetric ablations (P < .0001). There was a negative correlation observed between asymmetric ablations and EOA from the midpoint of the laser catheter (r = −0.445, P = .020). Compared with sulci, CSF spaces trended toward a greater effect on asymmetric ablation volumes (P = .069).

CONCLUSION:

This novel quantitative analysis shows that perilesional heatsinks contribute to asymmetric ablations. CSF spaces trended toward higher degrees of asymmetric ablations. Importantly, neurosurgeons may anticipate asymmetric ablations preoperatively if heatsinks are located within 13.3 mm of the laser probe midpoint. These preliminary results may guide surgical decision-making in LITT for metastatic brain lesions.
Cardiorespiratory Fitness Is Impaired in Type 1 and Type 2 Diabetes: A Systematic Review, Meta-Analysis, and Meta-Regression
Authors: ALVARES THIAGO S. , DE SOUZA LEONARDO VICTOR MIRANDA , SOARES ROGÉRIO NOGUEIRA , LESSARD SARAH J.
Published: April 2024

Introduction

Low cardiorespiratory fitness (CRF) increases the risk of cardiovascular disease by up to eightfold and is one of the strongest predictors of mortality. Some studies demonstrate impaired CRF in people living with type 1 and type 2 diabetes compared with those without diabetes, whereas others demonstrate no diabetes-associated impairment in CRF.

Purpose

We aimed to determine whether diabetes can influence CRF and, if so, identify clinical associations underlying diabetes-associated exercise impairments.

Methods

Sixty-eight studies were included in the quantitative analysis. Standardized mean difference (SMD) was calculated and meta-analyses and meta-regressions were performed by using a random-effects model.

Results

Diabetes is associated with a large negative effect on CRF (SMD = −0.80, P < 0.001)—an effect that is partially mitigated, but still significant, in those with high physical activity levels (SMD = −0.50, P = 0.007). A sedentary lifestyle (SMD = −0.83, P = 0.007) and the presence of clinical complications related to diabetes (SMD = −1.66, P < 0.001) predict a greater magnitude of CRF reduction in people with diabetes compared with controls without diabetes. Both type 1 diabetes and type 2 diabetes are independently associated with impaired CRF compared with controls without diabetes; however, the effect is significantly greater in those type 2 diabetes (SMD = −0.97, P < 0.001). Meta-regression analysis demonstrates the effects of diabetes on CRF are primarily associated with HbA1c levels for type 1 diabetes (B = −0.07, P < 0.001) and body mass index for type 2 diabetes (B = −0.17, P = 0.005).

Conclusions

These data demonstrate a negative influence of diabetes on the key risk factor of low CRF and provide critical insight into specific clinical markers of low CRF associated with diabetes.
Case Report: Dichorionic twins pregnancy with placenta abruption
Authors: Raut Kajal , Thool Bali
Published: April 2024

Pregnancies involving dichorionic twins have been recognized for their distinct difficulties and complications. The care and outcomes of such pregnancies are further complicated by placental abruption, an uncommon but significant obstetric event. We describe a case of placental abruption in a dichorionic twin pregnancy, including the clinical manifestations, diagnosis, treatment, and prognosis of the mother and fetus. Pregnancies with two separate chorions, or dichorionic pregnancies, are a special type of multiple gestation. Early separation of the placenta from the uterine wall is a potentially fatal event that can have a major influence on the health of both the mother and fetus. It is a key complication of placental abruption. We describe a 32-year-old primigravida who complained of sudden onset abdominal pain and vaginal bleeding at 28 weeks of gestation. She had dichorionic twin pregnancy after 10 weeks of gestation, as determined by ultrasonography. The patient remained stable, and repeated ultrasounds verified that there was no further placental separation. The patient underwent an elective caesarean section at 35 weeks of gestation because of a higher risk of recurrent abruption. Two healthy newborns were delivered, and their weights were consistent with their gestational age.
Comparative study between efficacy of topical tofacitinib 2% ointment versus topical clobetasol propionate 0.05% ointment in hand eczema at a tertiary hospital in central India
Authors: Bhatt Drishti , Singh Dr Adarshlata
Published: April 2024

Background Hand eczema is a prevalent dermatological condition that significantly impacts the quality of life of affected individuals. Topical corticosteroids, such as Clobetasol Propionate, are commonly employed for management, but concerns regarding long-term use and potential side effects necessitate exploration of alternative treatments. This study protocol outlines a randomized controlled trial comparing the efficacy of topical Tofacitinib 2% ointment with Clobetasol Propionate 0.05% ointment in managing hand eczema. Methods The study will be a single-blinded, parallel-group, randomized controlled trial conducted at the Dermatology outpatient department of Acharya Vinoba Bhave Rural Hospital Sawangi Meghe, Wardha, from March 2023 to September 2025. Eligible participants diagnosed with hand eczema will be randomized into two groups: Group 1 will receive Clobetasol Propionate 0.05% ointment, and Group 2 will receive Tofacitinib 2% ointment. The primary outcome measure is the change from baseline in the Hand Eczema Severity Index (HECSI) score, assessed at two weeks and four weeks. Statistical analysis will utilize appropriate parametric and non-parametric tests, with a p-value <0.05 considered significant. Expected Outcome The study is anticipated to provide insights into the comparative efficacy and safety of Tofacitinib and Clobetasol Propionate in managing hand eczema. A favorable outcome for Tofacitinib could suggest its potential as an alternative or adjunctive therapy, offering a more targeted approach with fewer side effects. The findings may contribute to optimized treatment strategies for hand eczema, improving patient outcomes and guiding future research in dermatological therapeutics.
Modelling transmission dynamics and genomic diversity in a recombining parasite population
Authors: Kwiatkowski Dominic
Published: April 2024

The genomic diversity of a parasite population is shaped by its transmission dynamics but superinfection, cotranmission and recombination make this relationship complex and hard to analyse. This paper aims to simplify the problem by introducing the concept of a genomic transmission graph with three basic parameters: the effective number of hosts, the quantum of transmission and the crossing rate of transmission chains. This enables rapid simulation of coalescence times in a recombining parasite population with superinfection and cotransmission, and it also provides a mathematical framework for analysis of within-host variation. Taking malaria as an example, we use this theoretical model to examine how transmission dynamics and migration affect parasite genomic diversity, including the effective recombination rate and haplotypic metrics of recent common ancestry. We show how key transmission parameters can be inferred from deep sequencing data and as a proof of concept we estimate the Plasmodium falciparum transmission bottleneck. Finally we discuss the potential applications of this novel inferential framework in genomic surveillance for malaria control and elimination. Online tools for exploring the genomic transmission graph are available at d-kwiat.github.io/gtg.
Upbringing as a socio-cultural identity of the value systems of the basic culture of the individual and the traditional culture of society
Authors: Yakovlev Sergey
Published: April 2024

The formation of a socio-cultural identity of the basic culture of the individual to the norms of the traditional culture of society is the most important task of education. At the same time, in this article, the upbringing of a person is considered as a measure of the identity of the content of the value systems of the traditional culture of society and the basic culture of the pupil's personality. This article proposes an institutional model for the formation of socio-cultural identity. Sociocultural identification of the basic culture of a person is carried out at various levels of socialization according to common identification features, which include traditions, language and a system of values characterizing the traditional culture of society.
IS MEASURING FEMORAL LENGTHENING A RELIABLE TECHNIQUE FOR TRACKING HEIGHT GAIN IN COSMETIC INTRAMEDULLARY LENGTHENING PATIENTS?
Authors: Ramlawi Akram Al , McClure Philip , Assayag Michael
Published: April 2024

Introduction

The practice of limb lengthening using intramedullary nails has surged in popularity in recent years. Our study explores the relationship between femur lengthening and overall height gain in adults undergoing cosmetic limb lengthening with telescoping magnetic intramedullary lengthening nails (MILNs).

Materials & Methods

Demographic information, pre- and postoperative radiographic data, and secondary outcomes, such as mechanical angles and sagittal alignment, were analyzed for 42 adult femurs MILNs (PRECICE 2, NuVasive, Inc.). Height was assessed with a digital stadiometer. Limb lengthening was defined as the amount of nail distraction seen on a calibrated weight bearing X-ray at consolidation. mLDFA, mMPTA, MAD, AMA, and femoral sagittal bow were evaluated as secondary outcomes.

Results

Mean starting height was 163.5 cm (SD 10.4, range 137–179) Post -lengthening mean height increased to 171.1 cm (SD 10.1, range 146.7–185.3). Average height gain was 7.5 cm (SD 1.3 cm, range 5.1–9.5). Average femoral lengthening was 7.3 cm (SD 1.14, range 4.1–10.1). There were no statistically significant difference between height gain and femur lengthening. Secondary outcomes showed reductions in femoral sagittal bow and AMA.

Conclusions

We conclude that measuring femur lengthening is a reliable and accurate method of measuring gained height in deformity-free patients undergoing limb lengthening. We further reason that straightening of both femoral and spinal sagittal bow counteracts potential lengthening loss over the anatomical axis, versus mechanical axis lengthening.
OUTCOMES OF ACUTE ANKLE DISTRACTION FOR INTRA-ARTICULAR DISTAL TIBIAL AND PILON FRACTURES
Authors: Lineham Beth , Faraj Ara , Hammet Felix , Barron Elizabeth , Hadland Yvonne , Moulder Elizabeth , Muir Ross , Sharma Hemant
Published: April 2024

Introduction

Intra articular distal tibia fractures can lead to post-traumatic osteoarthritis. Joint distraction has shown promise in elective cases. However, its application in acute fractures remains unexplored. This pilot study aims to fill this knowledge gap by investigating the benefits of joint distraction in acute fractures.

Materials & Methods

We undertook a restrospective cohort study comprising patients with intra-articular distal tibia and pilon fractures treated with a circular ring fixator (CRF) at a single center. Prospective data collection included radiological assessments, Patient-Reported Outcome Measures (PROM), necessity for additional procedures, and Kellgren and Lawrence grade (KL) for osteoarthritis (OA).

137 patients were included in the study, 30 in the distraction group and 107 in the non-distraction group. There was no significant difference between the groups.

Results

Mean follow-up was 3.73 years. There was no significant difference between the groups in overall complications or need for further procedures. There was no significant difference in progression of KL between the groups (1.81 vs 2.0, p=0.38) mean follow up 1.90 years.

PROM data was available for 44 patients (6 distraction, 38 non-distraction) with a mean follow-up of 1.71 years. There was no significant difference in EQ5D (p=0.32) and C Olerud-H Molander scores (p=0.17).

Conclusions

This pilot study suggests that joint distraction is safe in the acute setting. However, the study's impact is constrained by a relatively small patient cohort and a short-term follow-up period. Future investigations should prioritise longer-term follow-ups and involve a larger patient population to more comprehensively evaluate the potential benefits of joint distraction in acute fractures.
CIRCULAR FRAME IN THE PRESENCE OF PRE-EXISTING ARTHROPLASTY: IS THERE AN UNACCEPTABLE RISK OF INFECTION?
Authors: Muscogliati Rodrigo , Muscogliati Eduardo , Groom William , Al-Zubaidi Osama , Afeez Adeniyi , Moulder Elizabeth , Muir Ross , Sharma Hemant
Published: April 2024

Introduction

Circular external frames (CEF) are commonly used for a wide variety of indications, often when other devices are not appropriate. Circular frames are particularly associated with pin-site infection (PSI). Currently there is a gap in the available literature surrounding the risk of frame use with in-situ prosthetic joints. This retrospective study investigated the incidence of prosthetic joint infection (PJI) in a series of patients with in-situ arthroplasties treated with CEF.

Materials & Methods

From a departmental database of 1052 frames performed from March 2007-March 2023, the outcomes of 34 patients (40 frames) with in-situ arthroplasties at the time of CEF were reviewed (mean follow-up 70 months). Patient identification was by review of all local and regional imaging. The primary outcome was development of PJI during or following CEF and subsequent need for surgical intervention. Secondary outcomes were development of superficial pin site or deep bone infection (without PJI).

Results

Of 40 frames used to treat 34 patients, no PJIs were detected. Average patient age was 67 (range 55–82). 22 had cardio-respiratory disease, 11 diabetes, 15 smoked and 8 were immunosuppressed. 53 arthroplasties were in situ at the time of treatment, 12 involving the same bone as the frame. Average time in frame was 253 days. 23 patients developed PSI, 2 required a further procedure for persistent deep bone infection not involving the arthroplasties.

Conclusions

Although this study involves a relatively low numbers of patients, our results are reassuring that circular frame management in patients with in-situ arthroplasty does not represent an unacceptable risk of PJI. We hope to promote these findings and encourage multi-centre collaboration to expand on the available evidence to better answer this important yet under-reported clinical question.
Synthetic spatial aperture holographic third harmonic generation microscopy
Authors: Farah Yusef , Murray Gabe , Field Jeff , Varughese Maxine , Wang Lang , Pinaud Olivier , Bartels Randy
Published: April 2024

Third harmonic generation (THG) provides a valuable, label-free
approach to imaging biological systems. To date, THG microscopy has
been performed using point-scanning methods that rely on intensity
measurements lacking phase information of the complex field. We report
the first demonstration, to the best of our knowledge, of THG
holographic microscopy and the reconstruction of the complex THG
signal field with spatial synthetic aperture imaging. Phase
distortions arising from measurement-to-measurement fluctuations and
imaging components cause optical aberrations in the reconstructed THG
field. We have developed an aberration-correction algorithm that
estimates and corrects these phase distortions to reconstruct the
spatial synthetic aperture THG field without optical aberrations.