bluuebunny/crossref_metadata_2025 huggingface dataset:
Nine-Week Versus One-Year Trastuzumab for Early Human Epidermal Growth Factor Receptor 2–Positive Breast Cancer: 10-Year Update of the ShortHER Phase III Randomized Trial
Authors: Conte PierFranco , Bisagni Giancarlo , Piacentini Federico , Sarti Samanta , Minichillo Santino , Anselmi Elisa , Aieta Michele , Gebbia Vittorio , Schirone Alessio , Musolino Antonino , Garrone Ornella , Beano Alessandra , Rimanti Anita , Giotta Francesco , Turletti Anna , Miglietta Federica , Dieci Maria Vittoria , Vicini Roberto , Balduzzi Sara , D'Amico Robert , Guarneri Valentina
Published: September 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned coprimary or secondary analyses are not yet available. Clinical trial updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

We present the final analysis of the phase III noninferiority, randomized ShortHER trial comparing 9 weeks versus 1 year of adjuvant trastuzumab with chemotherapy in patients with human epidermal growth factor receptor 2–positive (HER2+) early breast cancer (BC). Women with HER2+ BC were randomly assigned to anthracycline-taxane combinations plus 1-year trastuzumab (arm A, long) or 9-week trastuzumab (arm B, short). Here, we report the second coprimary end point overall survival (OS), updated disease-free survival (DFS), and outcomes according to hormone receptor status, age, and nodal status. At a median follow-up of 9 years, 10-year DFS is 77% versus 78% in the long versus short arm, respectively. Ten-year OS is 89% versus 88% in the long versus short arm, respectively. 10-year DFS rates in the long versus short arm according to nodal status are N0 81% versus 85%; N1-3 77% versus 79%; and N4+ 63% versus 53%. Ten-year OS rates in long versus short arm according to nodal status are N0 89% versus 95%%; N1-3 92% versus 89%; and N4+ 84% versus 64%. The updated analysis of the ShortHER trial shows that 1-year trastuzumab is the standard treatment for patients with HER2+ early BC as noninferiority cannot be claimed. However, numerically, the differences for the patients at low or intermediate risk (N0/N1-3) is negligible, while patients with N4+ have a clear benefit with 1-year trastuzumab.
Sociodemographic Inequities in Telemedicine Use Among US Patients Initiating Treatment in Community Cancer Centers During the Ongoing COVID-19 Pandemic, 2020-2022
Authors: Guadamuz Jenny S. , Wang Xiaoliang , Royce Trevor J. , Calip Gregory S.
Published: September 2023

PURPOSE

Although telemedicine was seen as a way to improve cancer care during the coronavirus disease (COVID-19) pandemic, there is limited information regarding inequities in its uptake. This study assessed sociodemographic factors associated with telemedicine use among patients initiating treatment for 20 common cancers.

METHODS

This retrospective cohort study used deidentified electronic health record–derived patient data from a nationwide network of community cancer practices, linked to area-level Census information. We included adults (age 18 years and older) who initiated first-line systemic cancer treatment between March 2020 and December 2022 (follow-up through March 2023). Exposures include race/ethnicity, insurance status, and area-level social determinants of health (eg, block group socioeconomic status [SES]). The outcome was telemedicine use within 90 days after treatment initiation. Associations were examined using logistic regression models adjusted for age, sex, performance status, stage, and cancer type.

RESULTS

This study included 36,993 patients (48.6% women; median age, 69 years), of whom 15.1% used telemedicine services. Black (12.2%; odds ratio [OR], 0.78 [95% CI, 0.70 to 0.88]) and uninsured (9.2%; OR, 0.59 [95% CI, 0.48 to 0.73]) patients were less likely to use telemedicine services than their White and well-insured counterparts (14.5% and 15.0%, respectively). Patients in rural (9.7%; OR, 0.54 [95% CI, 0.46 to 0.57]), suburban (11.8%; OR, 0.67 [95% CI, 0.61 to 0.74]), and low SES areas (9.9%; OR, 0.39 [95% CI, 0.35 to 0.43]) were less also likely to use telemedicine than their counterparts in urban (16.6%) or high SES (21.6%) areas.

CONCLUSION

Nearly one sixth of patients initiating cancer treatment during the pandemic used telemedicine, but there were substantial inequities. The proliferation of telemedicine may perpetuate cancer care inequities if marginalized populations do not have equitable access.
Aerodynamics of the square-back Ahmed body under rainfall conditions
Authors: Mazellier N. , Obligado M.
Published: September 2023

We report an experimental investigation about the aerodynamics of a simplified road vehicle, the so-called square-back Ahmed body, under rainfall conditions. A particular emphasis is put on the evolution of the body base pressure distribution with respect to the operating conditions. It is found that rainfall significantly damps both mean base pressure drag and wake dynamics in comparison to dry conditions.
Post-Thyroidectomy Development of Posterior Reversible Encephalopathy Syndrome (PRES) Due to Calcium Over-Replacement
Authors: Papalou Olga , Tavernaraki Ekaterini , Tsagarakis Stylianos , Vassiliadi Dimitra Argyro
Published: September 2023

Posterior reversible encephalopathy syndrome (PRES) represents a distinct neurological entity characterized by a range of neurological signs and symptoms (seizures, headache, visual abnormalities, altered consciousness, and/or focal neurological signs) and typical neuroimaging findings reflecting reversible subcortical vasogenic edema, usually in the setting of blood pressure fluctuations, cytotoxic drugs, autoimmune disorders, and eclampsia. Here we present a case of a 61-year-old woman, with a history of recent total thyroidectomy and postoperative hypoparathyroidism, who was admitted to the Emergency Department with generalized seizures. Although in this clinical setting, hypocalcemia is expected as the most possible underlying pathogenic factor for triggering seizures, the patient was diagnosed with iatrogenic hypercalcemia and milk-alkali syndrome. A brain magnetic resonance imaging (MRI) demonstrated cortical swelling and fluid-attenuated inversion recovery (FLAIR) signal abnormalities in both occipital, parietal, and right frontal lobes, consistent with PRES. The patient’s encephalopathy resolved after resolution of hypercalcemia; she had no neurological deficits on discharge, while she was restarted on lower doses of calcium for hypoparathyroidism. This case illustrates the challenges imposed by postoperative hypoparathyroidism and highlights that PRES is a rare but serious complication of hypercalcemia of which endocrinologists should be aware.
Consensus-Based Development of a Global Registry for Traumatic Brain Injury: Establishment, Protocol, and Implementation
Authors: Joannides Alexis J. , Korhonen Tommi K. , Clark David , Gnanakumar Sujit , Venturini Sara , Mohan Midhun , Bashford Thomas , Baticulon Ronnie , Bhagavatula Indira Devi , Esene Ignatius , Fernández-Méndez Rocío , Figaji Anthony , Gupta Deepak , Khan Tariq , Laeke Tsegazeab , Martin Michael , Menon David , Paiva Wellingson , Park Kee B. , Pattisapu Jogi V. , Rubiano Andres M. , Sekhar Vijaya , Shabani Hamisi K. , Sichizya Kachinga , Solla Davi , Tirsit Abenezer , Tripathi Manjul , Turner Carole , Depreitere Bart , Iaccarino Corrado , Lippa Laura , Reisner Andrew , Rosseau Gail , Servadei Franco , Trivedi Rikin A. , Waran Vicknes , Kolias Angelos , Hutchinson Peter
Published: September 2023

BACKGROUND AND OBJECTIVES:

Global disparity exists in the demographics, pathology, management, and outcomes of surgically treated traumatic brain injury (TBI). However, the factors underlying these differences, including intervention effectiveness, remain unclear. Establishing a more accurate global picture of the burden of TBI represents a challenging task requiring systematic and ongoing data collection of patients with TBI across all management modalities. The objective of this study was to establish a global registry that would enable local service benchmarking against a global standard, identification of unmet need in TBI management, and its evidence-based prioritization in policymaking.

METHODS:

The registry was developed in an iterative consensus-based manner by a panel of neurotrauma professionals. Proposed registry objectives, structure, and data points were established in 2 international multidisciplinary neurotrauma meetings, after which a survey consisting of the same data points was circulated within the global neurotrauma community. The survey results were disseminated in a final meeting to reach a consensus on the most pertinent registry variables.

RESULTS:

A total of 156 professionals from 53 countries, including both high-income countries and low- and middle-income countries, responded to the survey. The final consensus-based registry includes patients with TBI who required neurosurgical admission, a neurosurgical procedure, or a critical care admission. The data set comprised clinically pertinent information on demographics, injury characteristics, imaging, treatments, and short-term outcomes. Based on the consensus, the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry was established.

CONCLUSION:

The GEO-TBI registry will enable high-quality data collection, clinical auditing, and research activity, and it is supported by the World Federation of Neurosurgical Societies and the National Institute of Health Research Global Health Program. The GEO-TBI registry (https://geotbi.org) is now open for participant site recruitment. Any center involved in TBI management is welcome to join the collaboration to access the registry.
Transvenous Embolization of Dural Arteriovenous Fistulas Through the Galenic (Deep Venous) System: Multicenter Case Series and Meta-Analysis
Authors: Srinivasan Visish M. , Karahalios Katherine , Colasurdo Marco , Rhodenheiser Emmajane , Scherschinski Lea , Lazaro Tyler T. , Cortez Gustavo , Gross Bradley A. , Kühn Anna Luisa , Puri Ajit , Winkler Ethan A. , Catapano Joshua S. , Akamatsu Yosuke , Thomas Ajith , Hanel Ricardo A. , Wakhloo Ajay , Jadhav Ashutosh P. , Ducruet Andrew F. , Albuquerque Felipe C. , Kan Peter
Published: September 2023

BACKGROUND AND OBJECTIVES:

Arteriovenous fistulas involving the deep venous system have often been treated with microsurgery or transarterial embolization. Increasing familiarity with transvenous navigation and improved endovascular access systems may facilitate transvenous embolization (TVE) for these rare and challenging lesions.

METHODS:

We performed a retrospective study of neurointerventional databases of 6 high-volume centers. We identified all cases of arteriovenous fistulas with deep transvenous embolizations for arteriovenous fistula. Details regarding demographics, fistula characteristics, treatment considerations, clinical outcomes, and fistula occlusion were obtained and analyzed. The meta-analysis used the same inclusion criteria.

RESULTS:

Seventeen cases of TVE were identified. The most common reasons for TVE included prior treatment failure with microsurgery (n = 2) or transarterial embolization (n = 3) or inaccessible arterial pedicles (n = 4). For patients with full clinical outcome data (n = 14), 2 patients had worsened modified Rankin Scale, 8 patients had no change, and 4 were improved at a median clinical follow-up of 3.5 months. Angiographic obliteration was achieved in 15/17 cases (88.2%). In 1 case, catheterization around a sharp turn in the basal vein of Rosenthal could not be performed. In another case, despite successful TVE, there was residual lesion which was treated 1 year later by microsurgical clipping and excision.

CONCLUSION:

Transvenous approaches for embolization of deep arteriovenous fistulas have become possible with modern endovascular catheter systems and liquid embolics. These lesions can be treated safely and effectively through endovascular approaches, which may spare patients the traversal of deep structures needed for microsurgical approaches to these regions. The outcomes of TVE are comparable with published outcomes of microsurgical interruption.
The Endoscopic Lateral Transorbital Approach for the Removal of Select Sphenoid Wing and Middle Fossa Meningiomas. Surgical Technique and Short-Term Outcomes
Authors: Carnevale Joseph A. , Rosen Kate U. , Chae John K. , Pandey Abhinav , Bander Evan D. , Godfrey Kyle , Schwartz Theodore H.
Published: September 2023

BACKGROUND AND OBJECTIVE:

The endoscopic lateral transorbital approach (eLTOA) is a relatively new approach to the skull base that has only recently been applied in vivo in the management of complex skull base pathology. Most meningiomas removed with this approach have been in the spheno-orbital location. We present a series of select purely sphenoid wing and middle fossa meningiomas removed through eLTOA. The objective here was to describe the selection criteria and results of eLTOA for a subset of sphenoid wing and middle fossa meningiomas.

METHODS:

This is a retrospective study based on a prospectively maintained database of consecutive cases of eLTOA operated on at our institution by the lead author. The cohort's clinical and radiographic characteristics and outcome are presented.

RESULTS:

Five patients underwent eLTOA to remove 3 sphenoid wing and 2 middle fossa meningiomas. The mean tumor volume was 11.9 cm3. Gross total resection was achieved in all cases. There were no intraoperative complications. Postoperatively, there was one case of subretinal hemorrhage, which was corrected by open vitrectomy repair, and one case of cerebrospinal fluid leak, which resolved with lumbar drainage. Three patients presented with visual impairment, 1 improved, 1 remained stable, and 1 worsened, but returned to stable after vitrectomy repair. All patients have been free of disease at a median follow-up of 8.9 months.

CONCLUSION:

eLTOA provides a direct minimal access corridor to certain well-selected sphenoid wing and middle fossa meningiomas. eLTOA minimizes brain retraction and provides a high rate of gross total resection. Meningiomas appropriately selected based on size, type, and location of dural attachment, and the eLTOA is a safe, rapid, and highly effective procedure with acceptable morbidity.
The Inaugural “Century” of Mixed Reality in Cranial Surgery: Virtual Reality Rehearsal/Augmented Reality Guidance and Its Learning Curve in the First 100-Case, Single-Surgeon Series
Authors: Jean Walter C. , Piper Keaton , Felbaum Daniel R. , Saez-Alegre Miguel
Published: September 2023

BACKGROUND AND OBJECTIVE:

Virtual reality (VR) refers to a computer-generated three-dimensional space in which a surgeon can interact with patient-specific anatomic models for surgical planning. Augmented reality (AR) is the technology that places computer-generated objects, including those made in VR, into the surgeon's visual space. Together, VR and AR are called mixed reality (MxR), and it is gaining importance in neurosurgery. MxR is helpful for selecting and creating templates for an optimal surgical approach and identifying key anatomic landmarks intraoperatively. By reporting our experience with the first 100 consecutive cases planned with VR and executed with AR, our objective is to detail the learning curve and encountered obstacles while adopting the new technology.

METHODS:

This series includes the first 100 consecutive complex cranial cases of a single surgeon for which MxR was intended for use. Effectiveness of the VR rehearsal and AR guidance was analyzed for four specific contributions: (1) opening size, (2) precise craniotomy placement, (3) guidance toward anatomic landmarks or target, and (4) antitarget avoidance. Seventeen cases in the study cohort were matched with historical non-MxR cases for comparison of outcome parameters. The cases in which MxR failed were plotted over time to determine the nature of the “learning curve.”

RESULTS:

AR guidance was abandoned in eight operations because of technical problems, but problem-free application of MxR increased between the 44th and 63rd cases. This provides some evidence of proficiency acquisition in between. Comparing the 17 pairs of matched MxR and non-MxR cases, no statistically significant differences exist in the groups regarding blood loss, length of stay nor duration of surgery. Cases where MxR had above-expectation performances are highlighted.

CONCLUSION:

MxR is a powerful tool that can help tailor operations to patient-specific anatomy and provide efficient intraoperative guidance without additional time for surgery or hospitalization.
PUF-8, a C. elegans ortholog of the RNA-binding proteins PUM1 and PUM2, is required for robustness of the cell death fate
Authors: Xu Jimei , Jiang Yanwen , Sherrard Ryan , Ikegami Kyoko , Conradt Barbara
Published: September 2023

During C. elegans development, 1090 somatic cells are generated, of which 959 survive and 131 die, many through apoptosis. We present evidence that PUF-8, a C. elegans ortholog of the mammalian RNA-binding proteins PUM1 and PUM2, is required for the robustness of this ‘survival and death’ pattern. We found that PUF-8 prevents the inappropriate death of cells that normally survive, and we present evidence that this anti-apoptotic activity of PUF-8 is dependent on the ability of PUF-8 to interact with ced-3 (a C. elegans ortholog of caspase) mRNA, thereby repressing the activity of the pro-apoptotic ced-3 gene. PUF-8 also promotes the death of cells that are programmed to die, and we propose that this pro-apoptotic activity of PUF-8 may depend on the ability of PUF-8 to repress the expression of the anti-apoptotic ced-9 gene (a C. elegans ortholog of Bcl2). Our results suggest that stochastic differences in the expression of genes within the apoptosis pathway can disrupt the highly reproducible and robust survival and death pattern during C. elegans development, and that PUF-8 acts at the post-transcriptional level to level out these differences, thereby ensuring proper cell number homeostasis.
Cables1 links Slit/Robo and Wnt/Frizzled signaling in commissural axon guidance
Authors: Zuñiga Nikole R. , Dumoulin Alexandre , Vaccaro Giuseppe , Stoeckli Esther T.
Published: September 2023

During neural circuit formation, axons navigate from one intermediate target to the next, until they reach their final target. At intermediate targets, axons switch from being attracted to being repelled by changing the guidance receptors on the growth cone surface. For smooth navigation of the intermediate target and the continuation of their journey, the switch in receptor expression has to be orchestrated in a precisely timed manner. As an alternative to changes in expression, receptor function could be regulated by phosphorylation of receptors or components of signaling pathways. We identified Cables1 as a linker between floor-plate exit of commissural axons, regulated by Slit/Robo signaling, and the rostral turn of post-crossing axons, regulated by Wnt/Frizzled signaling. Cables1 localizes β-catenin, phosphorylated at tyrosine 489 by Abelson kinase, to the distal axon, which in turn is necessary for the correct navigation of post-crossing commissural axons in the developing chicken spinal cord.
Response of cells and tissues to shear stress
Authors: Espina Jaime A. , Cordeiro Marilia H. , Milivojevic Milan , Pajić-Lijaković Ivana , Barriga Elias H.
Published: September 2023

Shear stress is essential for normal physiology and malignancy. Common physiological processes – such as blood flow, particle flow in the gut, or contact between migratory cell clusters and their substrate – produce shear stress that can have an impact on the behavior of different tissues. In addition, shear stress has roles in processes of biomedical interest, such as wound healing, cancer and fibrosis induced by soft implants. Thus, understanding how cells react and adapt to shear stress is important. In this Review, we discuss in vivo and in vitro data obtained from vascular and epithelial models; highlight the insights these have afforded regarding the general mechanisms through which cells sense, transduce and respond to shear stress at the cellular levels; and outline how the changes cells experience in response to shear stress impact tissue organization. Finally, we discuss the role of shear stress in collective cell migration, which is only starting to be appreciated. We review our current understanding of the effects of shear stress in the context of embryo development, cancer and fibrosis, and invite the scientific community to further investigate the role of shear stress in these scenarios.
Structural Changes in the Anuran Mandibular Arch during Metamorphosis, with reference to Rana Temporaria.
Authors: Pusey H. K.
Published: September 2023

The chondrocranium and the mandibular arch have been studied in seven stages. A summary of the changes in the mandibular arch during metamorphosis is given on p. 517 et seq. These changes are discussed on p. 522 et seq. A summary of the homologies which can be established or suggested by a study of the stages is given on p. 531. There are four new suggestions. The temporal region of the skulls of Ascaphus, Lio-pelma, and Aly tes are redescribed on p. 531, and are discussed on p. 538. Ascaphus is shown to possess (in the adult) separate trigeminal and facial foramina divided by a prefacial commissure; a post-palatine commissure; with less certainty, a complete basitrabecular process articulating with a true basal process; and a trigeminal foramen divided possibly by the root of the ascending process. Liopelma is shown to possess the above structures except for the divided trigeminal foramen, with the difference that the root of the basitrabecular process has been lost. Alytes, Bombinator, and Discoglossus each possess a prefacial commissure. In them, and in all the other Anura, the isolated outer end of the basitrabecular process is probably represented as the pseudobasal process (Gaupp’s basal process). The structures described in sections 5, 6, and 7 of this summary have not previously been given these homologies. The change from the Ascaphus to the Ranid type of temporal arrangement is shown to be due to a collecting together of the branches of nerves V and VII into a single pro-otic foramen. Kruijtzer’s theory of the hyoid suspension of the mandibular arch is criticized. An interpretation is given of the probable evolution of the tadpole mandibular apparatus, and of the metamorphic changes required to produce the adult skull.
Reproduction in Lebistes Reticulatus
Authors: Purser G. L.
Published: September 2023

In the course of some experiments which I have begun with Lebistes reticulatus (Peters) Eegan, observations upon its method of reproduction have led to the discovery of a number of extraordinary facts which are of sufficient importance to be embodied in a short paper.
Federated learning for medical imaging radiology
Authors: Rehman Muhammad Habib ur , Hugo Lopez Pinaya Walter , Nachev Parashkev , Teo James T , Ourselin Sebastin , Cardoso M Jorge
Published: September 2023

Federated learning (FL) is gaining wide acceptance across the medical AI domains. FL promises to provide a fairly acceptable clinical-grade accuracy, privacy, and generalisability of machine learning models across multiple institutions. However, the research on FL for medical imaging AI is still in its early stages. This paper presents a review of recent research to outline the difference between state-of-the-art [SOTA] (published literature) and state-of-the-practice [SOTP] (applied research in realistic clinical environments). Furthermore, the review outlines the future research directions considering various factors such as data, learning models, system design, governance, and human-in-loop to translate the SOTA into SOTP and effectively collaborate across multiple institutions.
EU, PROFESSOR(?!): DILEMAS DE UM PROFESSOR UNIVERSITÁRIO EM INÍCIO DE CARREIRA EM TEMPOS DE PANDEMIA DA COVID-19
Authors: Anjo José Edemir da Silva
Published: September 2023

Este caso para ensino foi construído com a intenção de ser utilizado para promover um debate com discussões e reflexões a respeito das escolhas metodológicas na prática docente, por meio dos dilemas contextualizados no início da carreira docente. Este caso é indicado para os cursos em nível de pós-graduação Lato sensu em cursos da área de metodologia de ensino e prática docente no contexto universitário em administração. Com particular atenção ao uso do método caso para ensino, espera-se que o docente consiga identificar o processo de aprendizado na aplicação dessa metodologia; observar as condições de utilização e adaptação do método caso para ensino e avaliar os impactos e as condições de adoção de métodos de ensino centrados nos discentes. Por meio deste trabalho, deseja-se que os envolvidos na atividade possam analisar o impacto da estratégia adotada de ensino, suas implicações, assim como a compreensão de suas competências pedagógicas na formação docente.
The neuroprotective role of hamartin (TSC-1) in cerebral ischemia
Authors: Θεμιστοκλής Κωνσταντίνος
Published: September 2023

Εισαγωγή: Η hamartin (TSC-1) είναι μια ενδογενής νευροπροστατευτική πρωτεΐνη που βρέθηκε ότι συμμετέχει στην αντοχή των νευρώνων της περιοχής CA3 του ιππόκαμπου επιμύων, μετά από καθολική ισχαιμία του εγκεφάλου τους. Ο κύριος μηχανισμός της νευροπροστατευτικής δράσης της hamartin συντελείται μέσω προαγωγής της παραγωγικής αυτοφαγίας. Η βασική ερευνητική υπόθεση του παρόντος πειράματος είναι, αν η υπερέκφραση της hamartin στο δεξιό εγκεφαλικό ημισφαίριο επιμύων Wistar θα έχει την ίδια νευροπροστατευτική δράση μετά από εστιακή εγκεφαλική ισχαιμία. Υλικό και Μέθοδος: Συνολικά 32 αρσενικοί και θηλυκοί επίμυες Wistar υποβλήθηκαν σε εστιακή ισχαιμία του δεξιού ημισφαίριου τους, με το μοντέλο της παρωδικής απόφραξης της μέσης εγκεφαλικής αρτηρίας με ενδοαυλικό ράμμα. Μεταξύ αυτών, 8 επίμυες είχαν υπερεκφρασμένη την hamartin στο δεξιό τους ημισφαίριο, μετά από στερεοτακτική έγχυση με αδενοϊό που κωδικοποιεί την πρωτεΐνη αυτή. Επίσης, σε 8 επίμυες έγινε έγχυση PBS, σε 8 επίμυες έγινε έγχυση GFP και σε 8 επίμυες δεν πραγματοποιήθηκε έγχυση ουσίας στο δεξιό εγκεφαλικό ημισφαίριο. Η λειτουργική κατάσταση των επιμύων αξιολογήθηκε με συμπεριφορικές δοκιμασίες και πιο συγκεκριμένα με την δοκιμασία του κυλίνδρου και με την δοκιμασία αφαίρεσης κολλητικής ταινίας, πριν και 48 ώρες μετά το ισχαιμικό εγκεφαλικό επεισόδιο. Αποτελέσματα: Η ομάδα των επιμύων με υπερεκφρασμένη την πρωτεΐνη hamartin (TSC-1) παρουσίασε 25% βελτιωμένο ποσοστό θνησιμότητας μετά το εγκεφαλικό επεισόδιο, χωρίς το εύρημα αυτό να είναι στατιστικά σημαντικό. Η ίδια ομάδα επιμύων όμως, παρουσίασε σημαντικά βελτιωμένο ποσοστό ασυμμετρίας των πρόσθιων άκρων (19%) καθώς και σημαντικά αυξημένη κινητικότητα (45 βήματα) μετά το εγκεφαλικό επεισόδιο, σε σύγκριση με την ομάδα Μαρτύρων, PBS και GFP, οι οποίες είχαν αυξημένο ποσοστό ασυμμετρίας και μειωμένη κινητικότητα (52% και 20.2 βήματα), (61% και 13.4 βήματα) και (51% και 16.6 βήματα) αντιστοίχως. Τέλος, οι επίμυες της ομάδας TSC-1 αναγνώρισαν και αφαίρεσαν την κολλητική ταινία στο αριστερό παρετικό πρόσθιο άκρο τους σε σημαντικά λιγότερο χρόνο και με μέσο όρο 49,3 και 170 δευτερόλεπτα αντιστοίχως. Αντίθετα, οι επίμυες της ομάδας Μαρτύρων, PBS και GFP αναγνώρισαν και αφαιρούσαν την ταινία σε 158,2 και 292,6, 181,4 και 290,3 και σε 194,2 και 291,4 δευτερόλεπτα αντιστοίχως. Συμπεράσματα: Η υπερέκφραση της πρωτεΐνης hamartin στο δεξιό εγκεφαλικό ημισφαίριο επιμύων, είχε ως αποτέλεσμα το σημαντικά βελτιωμένο ποσοστό ασυμμετρίας, καθώς και βελτιωμένη την κινητικότητα και αισθητικοκινητική λειτουργία 48 ώρες μετά από εστιακό εγκεφαλικό επεισόδιο στην κατανομή της μέσης εγκεφαλικής αρτηρίας. Κρίνεται απαραίτητη η διεξαγωγή περεταίρω πειραμάτων ώστε να επιβεβαιωθούν τα αρχικά μας ευρήματα, καθώς και για να αξιολογηθεί εάν η hamartin αποτελεί πιθανή φαρμακευτική ουσία για μελλοντικές νευροπροστατευτικές κλινικές δοκιμές.
Case Report: Optical coherence tomography angiography findings in radiation retinopathy
Authors: Ammari Wafa , Zaghdoudi Asma , Berriche Olfa , Messaoud Riadh
Published: September 2023

We reported the observation of a 31-year-old female followed for a nasopharyngeal carcinoma since 2009, treated by locoregional radiotherapy, with a cumulative dose of 75 Gray. The patient presented with a progressive decline in bilateral vision. Ophthalmologic examination revealed bilateral dry eye, posterior subcapsular cataract, radiation retinopathy, and optic neuropathy. The patient presented all ocular complications of radiotherapy. The most severe was radiation retinopathy. Performing optic coherence tomography angiography (OCT-A) earlier could have speeded up the diagnosis and led to a better prognosis.

The OCT-A showed more pronounced macular edema in the right eye, and revealed enlargement of the central avascular zone and loss of the deep and superficial retinal vascular network. The patient received three consecutive monthly intravitreal injections of anti-vascular endothelial growth factor. Yet, we noted a non-improved visual acuity.

The aim of this case report was to present the contribution of OCT-A in the diagnosis of radiation maculopathy and attribute these changes to ischemia at the level of the retinal vascular network.
Whole body vibration and rider comfort determination of an electric two-wheeler test rig
Authors: Krishna Keerthan , Hegde Sriharsha , G T Mahesha , Shenoy B Satish
Published: September 2023

Background: Two-wheeled vehicles are the major mode of transportation in India. Such vehicles are exposed to excessive vibration on the road when compared to four-wheeled vehicles. However, the research on the reduction of whole body vibration in the case of two-wheelers is not explored in detail. The present study predicts rider comfort in the case of an electric two-wheeler as per ISO 2631-1.

Methods: An electric two-wheeler test rig is used in the study. The values of acceleration from the test rig in running conditions are obtained by using NI LabVIEW 2016. The drive cycle of the electric vehicle (EV) test rig is controlled by Sync sols’ EV lab software.  Obtaining the root mean square  (RMS) acceleration from running the test setup, it is compared with the ISO 2631 standard to obtain the rider comfort.

Results: Loading area, traction motor, base mount, and suspension were found to be the strategic points of vibration. RMS acceleration of 0.2 g to 3.29 g obtained at these points are prone to cause discomfort for the rider. Vehicle speed, road profile, and duration of exposure were found to be important parameters affecting the rider’s comfort. A maximum of 3.28 g amplitude was observed at the loading area at no load condition. The loading area, which corresponds to a rider’s seat in actual vehicle, is important and reduction of these vibrations make the ride comfortable for the rider. Suspension and base mount of the test rig are found to be uncomfortable observing the RMS acceleration.

Conclusions:  A suitable damping technique design is very much essential in reducing these vibrations and improve the rider comfort, as many more non-deterministic vibrations are prone to cause dis-comfort in case of actual on road riding conditions.
Comparative study of Nishaamalaki and metformin in obese patients of type 2 diabetes mellitus (Madhumeha): A study protocol
Authors: Chhabra Aman , Kuchewar Vaishali , Joshi Twinkle
Published: September 2023

Background: Poor synthesis of insulin by beta cells present in the pancreas combined with resistance of insulin in peripheral organs is referred to as type 2 diabetes mellitus. Insulin resistance leads to an increase in plasma fatty acids, which reduces transfer of glucose within the cells of muscles and increases breakage of lipids, resulting in an increase in hepatic glucose production. Nishamalaki (a formulation of turmeric and Indian gooseberry) is suggested in the therapy of all kinds of Madhumeha (diabetes mellitus) in Ayurveda classics. Turmeric and Indian gooseberry are the two main ingredients. Both are considered as effective medicines in the management of Madhumeha individually as well as in combined form.

Aim: To compare the efficacy of Nishaamalaki and metformin in obese patients of type2 diabetes mellitus.

Methods: The study will include 60 obese type 2 diabetes mellitus patients who were distributed into two distinct categories, each with 30 patients. Nishamalaki Churna with honey 3gm two times a day before food with warm water for 60 days in Group N (Experimental Group) and 500 mg metformin tablets twice daily before meals for 60 days in Group M (Control Group). Every 15th day, an assessment was made (15th, 30th, 45th and 60th day).

Results: Objective outcomes will be assessed. Conclusion: From this study protocol, it can be depicted that the trial formulation of turmeric and Indian gooseberry (Nisha-amalaki) is as effective in obese patients suffering from type- 2 diabetes mellitus as compared to metformin tablets.
Dissecting Loneliness in the Digital Age: An Insight into the Experiences of Medical Students Amid and Beyond the COVID-19 Pandemic
Authors: Nashwan Abdulqadir J. , Alahmad Rawan , Abu Afifeh Ghazi , Abu Afifeh Nour
Published: September 2023

In this review, we explore the multifaceted issue of loneliness among medical students, with particular emphasis on the unique challenges posed by the COVID-19 pandemic and the digital age. Medical students face an especially demanding academic environment, and the pandemic has significantly exacerbated feelings of isolation and distress. The review examines distinct loneliness profiles and risk factors and emphasizes the urgent need for targeted interventions to support mental well-being. We also probe into the complex relationship between loneliness and the use of digital platforms, assessing the nuances of social media interactions pre- and post-pandemic. This includes an evaluation of both the positive and negative impacts of virtual medical teaching and the role of passive and active social media use in mitigating or exacerbating feelings of loneliness. The review provides insights into the psychological impact of the pandemic on medical students and how it intersects with loneliness, revealing a multifaceted problem that requires careful consideration and tailored support. This narrative review contributes valuable perspectives to medical education and mental health by synthesizing current research and highlighting gaps in our understanding. It calls for further research and the development of specific interventions that recognize medical students' unique needs, especially in the context of a post-COVID era. Overall, the findings presented here offer a foundational guide for educators, policy-makers, and mental health professionals seeking to address loneliness and foster well-being among medical students in our rapidly changing world.
Older adults’ experience of neuropsychological assessments for dementia screening in South India: a qualitative study
Authors: DU Bharath , Jones Steven , Bailey Jan , S Poornima Rao , Chandra Mina , Vaitheswaran Sridhar , K S Shaji , Goswami Satyapal Puru , Spector Aimee , Fisher Emily , G Satish , Krishna Murali
Published: September 2023

Background: In community settings, neuropsychological assessment is the most commonly employed method for early recognition of dementia. However, little is known about the experience and perspectives of older adults when they undertake neuropsychological assessments in low-and middle-income countries (LMICs), including India. 

Methods: We conducted semi-structured interviews for 11 individuals (aged between 64 and 88 years) who had undergone cognitive assessment in the CST International (Cognitive Stimulation Therapy- International) study and were free from dementia. The transcripts were analysed manually utilising Interpretative Phenomenological Analysis to develop key themes.  

Results: When data were analysed three superordinate themes (experiences related to the process, content and outcomes) each with a set of subordinate themes emerged. 

Conclusions: This study highlights the need for a thorough planning of pre-assessment briefing for equipping participants with adequate information related to the neuropsychological assessment: its indication, length of procedure, contents of the test, possible outcomes, medical implications of those outcomes, possible therapeutic options if diagnosed with lower cognitive function.  We discuss our findings in relation to extant knowledge and explore issues clinicians should consider when conducting neuropsychological assessments in LMIC settings.
A Fredholm alternative for elliptic equations with interior and boundary nonlinear reactions
Authors: Maroncelli Daniel , Rivas Mauricio A.
Published: September 2023

In this paper we study the existence of solutions to the following generalized nonlinear two-parameter problem
\begin{equation*}
a(u, v) = \lambda b(u, v) + \mu m(u, v) + \varepsilon F(u, v),
\end{equation*}
for a triple $(a, b, m)$ of continuous, symmetric bilinear forms
on a real separable Hilbert space $V$ and nonlinear form $F$.
This problem is a natural abstraction of nonlinear problems that occur for
a large class of differential operators, various elliptic pde's with nonlinearities
in either the differential equation and/or the boundary conditions being
a special subclass.
First, a Fredholm alternative for the associated linear two-parameter eigenvalue problem is developed, and then this is used to construct a nonlinear version of the Fredholm alternative.
Lastly, the Steklov-Robin Fredholm equation is used to exemplify the abstract results.
Ground state solution for a class of supercritical Hénon equation with variable exponent
Authors: Feng Xiaojing
Published: September 2023

This paper is concerned with the following supercritical Hénon equation with variable exponent
$$
\begin{cases}
-\Delta u=|x|^{\alpha}|u|^{2^*_\alpha-2+|x|^\beta}u&\text{in } B,\\
u=0 &\text{on } \partial B,
\end{cases}
$$%
where $B\subset\mathbb{R}^N$ $(N\geq 3)$ is the unit ball, $\alpha\!> \!0$,
$ 0\!< \!\beta\!< \!\min\{(N\!+\!\alpha)/2,N\!-\!2\}$ and $2^*_\alpha=({2N+2\alpha})/({N-2})$.
We obtain the existence of positive ground state solution by applying the mountain
pass theorem, concentration-compactness principle and approximation techniques.
A class of singular $k_i$-Hessian systems
Authors: Feng Meiqiang
Published: September 2023

Our main objective of this article is to investigate a class of singular $k_i$-Hessian
systems. Among others, we obtain new theorems on the existence and multiplicity
of positive radial solutions. Several nonexistence theorems are also derived.
How Does Risk Hedging Impact Operations? Insights from a Price-Setting Newsvendor Model
Authors: Wang Liao , Yao Jin , Zhang Xiaowei
Published: September 2023

If a financial asset’s price movement impacts a firm’s product demand, the firm can respond to the impact by adjusting its operational decisions. For example, in the automotive industry, automakers decrease the selling prices of fuel-inefficient cars when the oil price rises. Meanwhile, the firm can implement a risk-hedging strategy using the financial asset jointly with its operational decisions. Motivated by this, we develop and solve a general risk-management model integrating risk hedging into a price-setting newsvendor. The optimal hedging strategy is calculated analytically, which leads to an explicit objective function for optimizing price and “virtual production quantity” (VPQ). (The latter determines the service level—that is, the demand-fulfillment probability.) We find that hedging generally reduces the optimal price when the firm sets the target mean return as its production-only maximum expected profit. With the same condition on the target mean return, hedging also reduces the optimal VPQ when the asset price trend positively impacts product demand; meanwhile, it may increase the VPQ by a small margin when the impact is negative. We construct the return-risk efficient frontier that characterizes the optimal return-risk trade-off. Our numerical study using data from a prominent automotive manufacturer shows that the markdowns in price and reduction in VPQ are small under our model and that the hedging strategy substantially reduces risk without materially reducing operational profit.

This paper was accepted by Kay Giesecke, finance.

Funding: Financial support from the Hong Kong Research Grants Council [General Research Fund 17200521] is gratefully acknowledged.

Supplemental Material: The data files and e-companion are available at https://doi.org/10.1287/mnsc.2023.4942 .
Depredadores en la ciudad
Authors: Sánchez-Vidal Rafael O.
Published: September 2023

Las presas y los depredadores buscan superar a su adversario. El éxito de uno representa el fracaso del otro, por lo tanto, ambos deben superarse en términos de eficacia y supervivencia. Pero hoy las reglas del juego han cambiado y ahora no sólo deben superarse entre sí; ahora también deben adaptarse a un ambiente perturbado por los seres humanos.
¡Viva México! ¡Vivan sus mamíferos!
Authors: Cab-Sulub Leticia , Moreno-Figueroa Luis Daniel
Published: September 2023

Sabemos que México es un país megadiverso, pero poco conocemos sobre la diversidad biológica que le proporciona este título. En este breve texto indagaremos en la diversidad y distribución de los mamíferos mexicanos terrestres.
All-fiber laser system for all-optical 87Rb Bose Einstein condensate to space application
Authors: Li Lin , Zhou Cuiyun , Xiong Wei , Huang Minjie , Fang Su , Xu Xingping , Ji Jingwei , Gao Min , Song Tieqiang , Hong Yi , Liang Zhaogang , Chen Dijun , Hou Xia , Zhou Xiaoji , Chen Xuzong , Chen Weibiao , Wang Bin , Li Tang , Liu Liang
Published: September 2023

In the development of the Cold Atom Physics Research Rack (CAPR) on board the Chinese Space Station, the laser system plays a critical role in preparing the all-optical 87Rb Bose–Einstein condensates (BECs). An all-fiber laser system has been developed for CAPR to provide the required optical fields for atom interaction and to maintain the beam pointing in long-term operation. The laser system integrates a 780 nm fiber laser system and an all-fiber optical control module for sub-Doppler cooling, as well as an all-fiber 1064 nm laser system for evaporative cooling. The high-power, single-frequency 780 nm lasers are achieved through rare-Earth doped fiber amplification, fiber frequency-doubling, and frequency stabilization technology. The all-fiber optical control module divides the output of the 780 nm laser system into 15 channels and regulates them for cooling, trapping, and probing atoms. Moreover, the power consistency of each pair of cooling beams is ensured by three power tracking modules, which is a prerequisite for maintaining stable MOT and molasses. A high-power, compact, controlled-flexible, and highly stable l064 nm all-fiber laser system employing two-stage ytterbium-doped fiber amplifier (YDFA) technology has been designed for evaporative cooling in the optical dipole trap (ODT). Finally, an all-optical 87Rb BEC is realized with this all-fiber laser system, which provides an alternative solution for trapping and manipulating ultra-cold atoms in challenging environmental conditions.
Triple-output phase unwrapping network with a physical prior in fringe projection profilometry
Authors: Zhu Xinjun , Zhao Haomiao , Song Limei , Wang Hongyi , Guo Qinghua
Published: September 2023

Deep learning has been attracting more and more attention in the phase unwrapping of fringe projection profilometry (FPP) in recent years. In order to improve the accuracy of the deep-learning-based unwrapped phase methods from a single fringe pattern, this paper proposes a single-input triple-output neural network structure with a physical prior. In the proposed network, a single-input triple-output network structure is developed to convert the input fringe pattern into three intermediate outputs: the wrapped phase, the fringe order, the coarse unwrapped phase, and the final output high-precision unwrapped phase from the three outputs. Moreover, a new, to the best of our knowledge, loss function is designed to improve the performance of the model using a physical prior about these three outputs in FPP. Numerous experiments demonstrated that the proposed network is able to improve the accuracy of the unwrapped phase, which can also be extended to other deep learning phase unwrapping models.
Propagation of asymmetric optical vortex beams through turbulence and evolution of their OAM spectra
Authors: Acevedo Cristian Hernando , Eshaghi Mahdi , Dogariu Aristide
Published: September 2023

In the realm of wave propagation through turbulent media, the spectrum of the orbital angular momentum of optical vortex beams is known to undergo symmetric broadening. However, the evolution of beams that are initially azimuthally asymmetric represents a distinct phenomenon. In this work, we have developed an analytical model describing the propagation of asymmetric OAM beams through the so-called Kolmogorov turbulence. Our results describe how the perturbation strength and the initial beam properties lead to a nonsymmetric spectrum of OAM modes. These findings lay the groundwork for further use of asymmetric fields that propagate in inhomogeneous media and their applications such as communications and sensing.
Hyper-entanglement between pulse modes and frequency bins
Authors: Chiriano Fabrizio , Ho Joseph , Morrison Christopher L. , Webb Jonathan W. , Pickston Alexander , Graffitti Francesco , Fedrizzi Alessandro
Published: September 2023

Hyper-entanglement between two or more photonic degrees of freedom (DOF) can enhance and enable new quantum protocols by allowing each DOF to perform the task it is optimally suited for. Here we demonstrate the generation of photon pairs hyper-entangled between pulse modes and frequency bins. The pulse modes are generated via parametric downconversion in a domain-engineered crystal and subsequently entangled to two frequency bins via a spectral mapping technique. The resulting hyper-entangled state is characterized and verified via measurement of its joint spectral intensity and non-classical two-photon interference patterns from which we infer its spectral phase. The protocol combines the robustness to loss, intrinsic high dimensionality and compatibility with standard fiber-optic networks of the energy-time DOF with the ability of hyper-entanglement to increase the capacity and efficiency of the quantum channel, already exploited in recent experimental applications in both quantum information and quantum computation.
Power transfer efficiency for obstructed wireless links using Bessel beams
Authors: Pimenta Ravel C. M. , Soriano Gabriel , Paschaloudis Konstantinos D. , Ettorre Mauro , Zerrad Myriam , Amra Claude
Published: September 2023

The power transfer efficiency of a partially obstructed wireless link operating in the Fresnel region is studied in this work. The wireless link consists of two equal apertures, axially aligned, radiating weakly-diffractive beams (truncated Bessel beams). A metallic obstacle is considered along the propagation path of the radiated beam to analyze its impact on the power transfer efficiency with respect to a clear line of sight link. The power transfer efficiency in the obstructed case is derived by resorting to a scattered field formulation. In the proposed approach, the distance between the apertures is considered larger than their radius, which is also bigger than the operating wavelength. A paraxial approximation is then applied to the formulation. Numerical results validate the proposed approach. It appears that the transverse propagation constant of the Bessel Beam and resulting non-diffractive range strongly affects the distance of operation of the wireless link in both the clear and obstructed cases. In addition, we observe how the self-healing property of Bessel beams preserves the efficiency of the partially obstructed link by establishing a resilient link under defined conditions for the propagating beam and size of the obstruction.