bluuebunny/crossref_metadata_2025 huggingface dataset:
De-escalating radiotherapy in HPV-positive oropharyngeal squamous cell carcinoma: how much is too little?
Authors: Dodhia Vikash Hiteshkumar , Penny Fiona , Shanmugasundaram Ramkumar , Patel Nimesh
Published: January 2024

Oropharyngeal squamous cell carcinoma (OPSCC) had a rapidly increasing incidence rate in high-income countries, with a significant increase in cases related to human papilloma virus (HPV). HPV-positive (HPV+) OPSCC has shown better survival rates compared with HPV-negative (HPV-) cases, prompting investigations into de-escalation strategies to reduce or change chemoradiotherapy protocols. We present a case of a patient with HPV+ OPSCC who discontinued chemoradiotherapy after 2 weeks, effectively receiving a de-escalated dose of 18 Gy over nine fractions and only one cycle of cisplatin, subsequently undergoing curative surgical resection with no residual disease in the radiotherapy field 14 years later. This case challenges the concept of standard radiotherapy dosing in HPV+ OPSCC and discusses the implications on future de-escalation trials.
Prolonged cord separation in a newborn: a rare case of an unusual epithelialised umbilical cord
Authors: Destinval Christelle , Ranke-Chrétien Aline , Lemelle Jean-Louis
Published: January 2024

A female full-term neonate, accompanied by her parents, was referred to the paediatric surgery department on the day of after birth. She presented with a 9 cm length pathological umbilical cord, of which the first 7 cm was red and wet, with ulceration, necrosis and healing areas. The patient never had a fever. Abdominal palpation showed no umbilical hernia and abdominal Doppler ultrasound was normal. After several days of disinfection, by biseptine antiseptic solution, and a monthly follow-up, most of the umbilical cord fell out. It only remained a 4 cm length navel consisting of 2 cm of excessive skin and 2 cm of mucous tissue. The lesion was surgically excised at 6 months old. The patient was discharged on postoperative day 1. The results of the histology confirmed the diagnosis of an epithelialised umbilical cord. The 1-month follow-up was uneventful.
Successful treatment with ivabradine for haemodynamically unstable junctional ectopic tachycardia occurring early after ST-elevation myocardial infarction
Authors: Numao Yoshimi , Otsuka Tatsuhiko , Nuki Toshiaki , Ohta Hiroshi
Published: January 2024

Junctional ectopic tachycardia (JET) is a relatively uncommon arrhythmia predominantly observed in infancy, often occurring after congenital heart surgery. Although JET is rare in adults, it can occur in the presence of myocardial ischaemia. We describe a woman in her early 70s who presented with multivessel ST-segment elevation myocardial infarction and underwent percutaneous coronary intervention on left anterior descending artery and right coronary artery. She developed JET on the second day, resulting in haemodynamic compromise. Despite initial treatment attempts including amiodarone and beta-blocking agents proving insufficient in controlling JET, we successfully managed by administering ivabradine. Subsequently, she was discharged with recovered cardiac function without recurrence of JET. JET often proves refractory to multiple antiarrhythmic agents and can lead to unfavourable outcomes. Several case reports have demonstrated the effectiveness of ivabradine in treating JET during infancy, which can also be an effective therapeutic option for adult without adversely affecting haemodynamics.
The role of local health officers in advancing public health and primary care integration: lessons from the ongoing Universal Health Coverage reforms in the Philippines
Authors: de Claro Vergil , Lava Juan Bernardo , Bondoc Clemencia , Stan Laurentiu
Published: January 2024

The COVID-19 pandemic has highlighted the persistent fragmentation of health systems and has amplified the necessity for integration. This issue is particularly pronounced in decentralise settings, where fragmentation is evident with poor coordination that impedes timely information sharing, efficient resource allocation and effective response to health threats. It is within this context that the Philippine Universal Health Care law introduced reforms focusing on equitable access and resilient health systems through intermunicipal cooperation, enhancing primary care networks and harnessing digital health technologies—efforts that underline the demand for a comprehensively integrated healthcare system. The WHO and the global community have long called for integration as a strategy to optimise healthcare delivery. The authors contend that at the core of health system integration lies the need to synchronise public health and primary care interventions to enhance individual and population health. Drawing lessons from the implementation of a pilot project in the Philippines which demonstrates an integrated approach to delivering COVID-19 vaccination, family planning and primary care services, this paper examines the crucial role of local health officers in the process, offering insights and practical lessons for engaging these key actors to advance health system integration. These lessons may hold relevance for other low-ncome and middle-income economies pursuing similar reforms, providing a path forward towards achieving universal health coverage.
Cognitive impairment and liver fibrosis in non-alcoholic fatty liver disease
Authors: Parikh Neal S , Wahbeh Farah , Tapia Christopher , Ianelli Mallory , Liao Vanessa , Jaywant Abhishek , Kamel Hooman , Kumar Sonal , Iadecola Costantino
Published: January 2024

Background

Data regarding the prevalence and phenotype of cognitive impairment in non-alcoholic fatty liver disease (NAFLD) are limited.

Objective

We assessed the prevalence and nature of cognitive deficits in people with NAFLD and assessed whether liver fibrosis, an important determinant of outcomes in NAFLD, is associated with worse cognitive performance.

Methods

We performed a prospective cross-sectional study. Patients with NAFLD underwent liver fibrosis assessment with transient elastography and the following assessments: Cognitive Change Index, Eight-Item Informant Interview to Differentiate Aging and Dementia Questionnaire (AD8), Montreal Cognitive Assessment (MoCA), EncephalApp minimal hepatic encephalopathy test and a limited National Institutes of Health Toolbox battery (Flanker Inhibitory Control and Attention Test, Pattern Comparison Test and Auditory Verbal Learning Test). We used multiple linear regression models to examine the association between liver fibrosis and cognitive measures while adjusting for relevant covariates.

Results

We included 69 participants with mean age 50.4 years (SD 14.4); 62% were women. The median liver stiffness was 5.0 kilopascals (IQR 4.0–6.9), and 25% had liver fibrosis (≥7.0 kilopascals). Cognitive deficits were common in people with NAFLD; 41% had subjective cognitive impairment, 13% had an AD8 >2, 32% had MoCA <26 and 12% had encephalopathy detected on the EncephalApp test. In adjusted models, people with liver fibrosis had modestly worse performance only on the Flanker Inhibitory Control and Attention Task (β=−0.3; 95% CI −0.6 to –0.1).

Conclusion

Cognitive deficits are common in people with NAFLD, among whom liver fibrosis was modestly associated with worse inhibitory control and attention.
Energy drink consumption and sleep parameters in college and university students: a national cross-sectional study
Authors: Kaldenbach Siri , Hysing Mari , Strand Tor A , Sivertsen Børge
Published: January 2024

Objectives

To investigate the frequency of energy drink (ED) consumption, and the association between ED consumption and selected sleep characteristics and parameters in Norwegian college and university students. We also explored whether these associations varied based on sex.

Design

Cross-sectional.

Setting

Data were gathered from the SHOT2022 study (Students’ Health and Well-being Study), a national survey.

Participants

53 266 students, aged 18–35 years, enrolled in higher education in Norway (2022).

Main outcome measures

Estimated marginal means were computed from general linear models investigating the association between ED consumption and continuous sleep outcomes, while log-link binomial regression analysis was used for dichotomous sleep outcomes of sleep measures. All models were adjusted for age.

Results

Among the participants, 4.7% of men and 3.3% of women reported consuming ED daily. The frequency of ED consumption was inversely associated with sleep duration and sleep efficiency, while a direct association was observed with the frequency of ED consumption and sleep patterns such as sleep onset latency and wake after sleep onset across sexes. The strongest association was found between daily ED consumption and short sleep duration where men had a risk ratio (RR) of 2.07; 95% CI 1.77 to 2.42, and women had a RR of 1.87; 95% CI 1.64 to 2.14.

Conclusion

ED consumption was a strong determinant for negative sleep outcomes. Even small amounts of ED were associated with poorer sleep outcomes, which warrant more attention towards the consequences of consuming ED among college and university students.
Post-traumatic stress disorders in women victims-survivors of intimate partner violence: a mixed-methods pilot study in a French coordinated structure
Authors: Roland Noemie , Delmas Noëlla , El Khoury Fabienne , Bardou Alice , Yacini Leila , Feldmann Laure , Hatem Ghada , Mahdjoub Sarah , Bardou Marc
Published: January 2024

Objectives

This study aimed to examine the prevalence of post-traumatic stress disorder (PTSD) in victims-survivors of intimate partner violence (IPV) consulting at the specialised and original facility ‘Maison des Femmes’ (MdF) or in two close municipal health centres (MHCs).

Design

A mixed-methods study using a convergent parallel design from July 2020 to June 2021.

Setting/participants

A questionnaire was proposed to women aged 18 years and over having suffered from IPV, in the MdF and in two MHCs. We also conducted qualitative interviews with a subsample of the women, asking for victim-survivors’ perceptions of the effect of the MdF’s care.

Primary and secondary outcome measures

The presence of a PTSD using the PTSD self-report checklist of symptoms, possibility of reaching women by phone 6 months after the inclusion visit, level of self-rated global health, number of emergency visits in the past 6 months, substances use, readiness to change and safety behaviours.

Results

A total of 67 women (mean age: 34 years (SD=9.7)) responded to our questionnaire. PTSD diagnosis was retained for 40 women (59.7%). Around 30% of participants self-rated their global health as bad. Less than 30% (n=18) of women were regular smokers, and only 7.5% of participants had a problematic alcohol use (Alcohol Use Disorders Identification Test-Consumption score ≥4), 19.4% women used psychotropic drugs. Six months after inclusion, half of participants had been reached by phone. Analysis of the qualitative interviews clarified victim-survivors’ perceptions of the MdF’s specific care: social networking, multidisciplinary approach, specialised listening, healthcare facilities, evasion and ‘feeling at home’.

Conclusions

The high prevalence of PTSD at inclusion was nearly the same between the three centres. This mixed-methods comparison will serve as a pilot study for a larger comparative trial to assess the long-term impact of the MdF’s specialised care on victims-survivors’ mental health, compared with the care of uncoordinated structures.

Trial registration number

NCT04304469.
Outpatient paracentesis for the management of ovarian hyperstimulation syndrome: study protocol for the STOP-OHSS randomised controlled trial
Authors: White David Alexander , Pye Clare , Ridsdale Katie , Dimairo Munyaradzi , Mooney Cara , Wright Jessica , Young Tracey Anne , Cheong Ying C , Drakeley Andrew , Mathur Raj , O'Cathain Alicia , Desoysa Lauren , Sizer Anya , Lumley Elizabeth , Chatters Robin , Metwally Mostafa
Published: January 2024

Introduction

Ovarian hyperstimulation syndrome (OHSS) is the most significant short-term complication of pharmacological ovarian stimulation. Symptoms range from mild abdominal discomfort to rare complications such as renal failure, thromboembolism and respiratory distress syndrome.

Currently, clinical practice typically involves monitoring the patient until the condition becomes severe, at which point they are admitted to hospital, where drainage of ascitic fluid (paracentesis) may take place. Preliminary studies have indicated that earlier outpatient paracentesis may reduce the progression of OHSS and prevent hospitalisation in women.

Methods and analysis

This UK, multicentre, pragmatic, two-arm, parallel-group, adaptive (group sequential with one interim analysis), open-label, superiority, confirmatory, group sequential, individually randomised controlled trial, with internal pilot will assess the clinical and cost-effectiveness and safety of outpatient paracentesis versus conservative management (usual care) for moderate or severe OHSS. 224 women from 20 National Health Service and private fertility units will be randomised (1:1) and followed up for up to 13.5 months. The primary outcome is the rate of OHSS related hospital admission of at least 24 hours within 28 days postrandomisation. The primary analysis will be an intention to treat with difference in hospitalisation rates as measure of treatment effect. Secondary outcomes include time to resolution of symptoms, patient satisfaction, adverse events and cost-effectiveness. A qualitative substudy will facilitate the feasibility of recruitment. Participant recruitment commenced in June 2022.

Ethics and dissemination

London—Southeast Research Ethics Committee approved the protocol (reference: 22/LO/0015). Findings will be submitted to peer-reviewed journals and abstracts to relevant national and international conferences, as well as being disseminated to trial participants and patient groups.

Trial registration number

ISRCTN71978064.
Bladder sparing by short-course radiotherapy combined with toripalimab in high-risk/extremely high-risk non-muscle invasive bladder cancer (HOPE-04): study protocol for a single-arm, prospective, phase II trial
Authors: Wen Feng , Lin Tianhai , Zhang Peng , Zeng Hao , Wei Qiang , Shen Yali
Published: January 2024

Introduction

Radical cystectomy remains the standard treatment for intravesical Bacille Calmette-Guerin (BCG) unresponsive non-muscle invasive bladder cancer (NMIBC) because potential bladder-preserving therapies are not well established. Combination of radiotherapy with programmed death-1 (PD-1) antibody may offer an optional bladder preservation treatment for high-risk/extremely high risk NMIBC. Hence, the current study aims to investigate the safety and efficacy of short-course radiotherapy (5×5 Gy) and toripalimab (PD-1 antibody) as a novel bladder sparing treatment in this population.

Methods and analysis

HOPE-04 is an open-label, single-arm, phase II study, designed to evaluate the safety and efficacy of short-course radiotherapy and toripalimab in patients with high-risk/extremely high risk NMIBC. Fifty-five patients with pathological and imaging diagnosed NMIBC with or without BCG treatment will be recruited. Radiotherapy of 5×5 Gy will be given to the whole bladder followed by a focal tumour bed boost and concomitant administration of toripalimab of 240 mg intravenous infusion every 21 days for 12 cycles (about 1 year). The primary endpoints are disease-free survival and safety. The secondary endpoint is overall survival. Additional indicators include implementation rate of salvage surgery and quality of life.

Ethics and dissemination

This trial has been approved by the Ethics Committee of West China Hospital, Sichuan University. Trial findings will be disseminated via peer reviewed journals and conference presentations.

Trial registration number

Chinese Ethics Committee of Registering Clinical Trials (ChiCTR2200059970).
Patient-reported outcome and experience measures (POEM) of a community-based glaucoma clinic in Cambridge, UK: an observational study
Authors: Charlesworth Emily , Jolly Jasleen Kaur , Farrell Sarah , Bourne Rupert , Pardhan Shahina
Published: January 2024

Objectives

Glaucoma care demand in UK hospitals has exploded in recent years. This has resulted in a push to community (shared, virtual, etc) care models to reduce the burden on hospital systems and on patients. The study aimed to ascertain patient’s experiences around various aspects of their care delivered in community clinics.

Design

Observational study.

Setting

Glaucoma Community Clinic, Cambridge, UK.

Participants

Ninety-six consecutive patients (M:F 47:49, mean age 70±12 years), recruited from July to September 2022.

Outcome measures

Patients completed a modified glaucoma patient-reported outcome and experience measure (POEM) regarding their clinic experience and perspective on their diagnosis, treatment and fear of blindness. Patient’s thoughts of feeling safe under the community clinical team were gathered. Patient demographics including age, gender, postcodes and education history were used to find their corresponding Lower-Layer Super Output Areas and socioeconomic status.

Results

Patients had positive perceptions of their clinic experience. Ninety-six per cent of patients reported that their experience of attending the community clinic was comfortable, and 93% (n=92) felt the experience was the same as expected from the hospital. Feeling safe under the clinician team produced a mean Visual Analogue Scale (VAS) score of 90 (SD 15) and feeling care was organised produced a mean VAS score of 87 (SD 17). Age, gender, disease characteristics and socioeconomic status had no influence on perceived experience. Patients aged <60 years had significantly lower understanding of their diagnosis compared with older groups (p=0.027, η2=0.076), as did suspect glaucoma patients when compared with primary open glaucoma patients (p=0.045, η2=0.085).

Conclusions

A large majority of patients expressed a positive experience, felt safe under the care of their clinical team and their care was well organised. Relatively younger patients (<60 years) and those with no confirmed diagnosis would likely benefit from more consultation time and educational materials to improve their understanding of glaucoma.
Detection of fibrosing interstitial lung disease-suspected chest radiographs using a deep learning-based computer-aided detection system: a retrospective, observational study
Authors: Ukita Jumpei , Nishikiori Hirotaka , Hirota Kenichi , Honda Seiwa , Hatanaka Kiwamu , Nakamura Ryoji , Ikeda Kimiyuki , Mori Yuki , Asai Yuichiro , Chiba Hirofumi , Ogaki Keisuke
Published: January 2024

Objectives

To investigate the effectiveness of BMAX, a deep learning-based computer-aided detection system for detecting fibrosing interstitial lung disease (ILD) on chest radiographs among non-expert and expert physicians in the real-world clinical setting.

Design

Retrospective, observational study.

Setting

This study used chest radiograph images consecutively taken in three medical facilities with various degrees of referral. Three expert ILD physicians interpreted each image and determined whether it was a fibrosing ILD-suspected image (fibrosing ILD positive) or not (fibrosing ILD negative). Interpreters, including non-experts and experts, classified each of 120 images extracted from the pooled data for the reading test into positive or negative for fibrosing ILD without and with the assistance of BMAX.

Participants

Chest radiographs of patients aged 20 years or older with two or more visits that were taken during consecutive periods were accumulated. 1251 chest radiograph images were collected, from which 120 images (24 positive and 96 negative images) were randomly extracted for the reading test. The interpreters for the reading test were 20 non-expert physicians and 5 expert physicians (3 pulmonologists and 2 radiologists).

Primary and secondary outcome measures

The primary outcome was the comparison of area under the receiver-operating characteristic curve (ROC-AUC) for identifying fibrosing ILD-positive images by non-experts without versus with BMAX. The secondary outcome was the comparison of sensitivity, specificity and accuracy by non-experts and experts without versus with BMAX.

Results

The mean ROC-AUC of non-expert interpreters was 0.795 (95% CI; 0.765 to 0.825) without BMAX and 0.825 (95% CI; 0.799 to 0.850) with BMAX (p=0.005). After using BMAX, sensitivity was improved from 0.744 (95% CI; 0.697 to 0.791) to 0.802 (95% CI; 0.754 to 0.850) among non-experts (p=0.003), but not among experts (p=0.285). Specificity and accuracy were not changed after using BMAX among either non-expert or expert interpreters.

Conclusion

BMAX was useful for detecting fibrosing ILD-suspected chest radiographs for non-expert physicians.

Trial registration number

jRCT1032220090.
Impact of different corticosteroids on severe community-acquired pneumonia: a systematic review and meta-analysis
Authors: See Xin Ya , Wang Tsu Hsien , Chang Yu-Cheng , Lo Juien , Liu Weitao , Choo Cheryn Yu Wei , Lee Yu-Che , Ma Kevin Sheng Kai , Chiang Cho-Hsien , Hsia Yuan Ping , Chiang Cho-Hung , Chiang Cho-Han
Published: January 2024

Objectives

Randomised controlled trials (RCTs) have demonstrated conflicting results regarding the effects of corticosteroids on the treatment of severe community-acquired pneumonia (CAP). We aimed to investigate the efficacy and safety of different corticosteroids on patients who were hospitalised for severe CAP.

Methods

We performed a systematic search through PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Scopus from inception to May 2023. The primary outcome was all-cause mortality. Data analysis was performed using a random-effects model.

Results

A total of 10 RCTs comprising 1962 patients were included. Corticosteroids were associated with a lower rate of all-cause mortality (risk ratio (RR), 0.70 (95% CI 0.54 to 0.90); I2=0.00%). When stratified into different corticosteroid types, hydrocortisone was associated with an approximately 50% lower mortality risk (RR, 0.48 (95% CI 0.32 to 0.72); I2=0.00%). However, dexamethasone, methylprednisolone or prednisolone were not associated with an improvement in mortality. Furthermore, hydrocortisone was associated with a reduction in the rate of mechanical ventilation, acute respiratory distress syndrome, shock and duration of intensive care unit stay. These trends were not observed for dexamethasone, methylprednisolone or prednisolone. Corticosteroids were not associated with an increased risk of adverse events including gastrointestinal bleeding, secondary infection or hyperglycaemia.

Conclusions

The use of hydrocortisone, but not other types of corticosteroids, was associated with a reduction in mortality and improvement in pneumonia outcomes among patients hospitalised with severe CAP.

PROSPERO registration number

CRD42023431360.
Implementing hamstring injury prevention programmes remotely: a randomised proof of concept trial
Authors: Behan Fearghal P , van Dyk Nicol , Rane Lance , Thorne Emma , Banaghan Alexa , Gilsenan Kevin , Whyte Enda Francis
Published: January 2024

Objectives

This study aimed to (1) compare the effectiveness of a Nordic hamstring exercise (NHE) versus single-leg Romanian deadlift (SLRDL) exercise programme on a hamstring injury risk surrogate; (2) compare the muscle soreness experienced by both exercise programmes; and (3) assess compliance to remote injury prevention exercise protocols through video software.

Methods

Twenty participants (10 women and 10 men: 21.45±1.6 years; 176±23 cm; 70±10 kg) were randomised into an NHE or SLRDL programme for 6 weeks. Single-leg hamstring bridge (SLHB), a hamstring injury surrogate, was the primary outcome for exercise efficacy. Muscle soreness and exercise adherence were also assessed. Significance was set at p<0.05.

Results

Both exercises increased SLHB performance resulting in an overall effect (p=0.013) with no effect for group (p=0.470) and no interaction effect (p=0.709), indicating both groups improved but there was no difference in improvement between interventions. There was no difference in muscle soreness between groups (p=0.087). Finally, both groups had 100% adherence to the programme.

Conclusions

Both the NHE and SLRDL are equally effective in increasing SLHB performance and demonstrate a similar level of muscle soreness. This suggests that SLRDL may be a viable option as a preventative exercise to mitigate the risk of hamstring injury. Finally, implementing injury prevention programmes remotely has the potential to enhance adherence.
A similar injury profile observed in franchise men’s and women’s cricket in England and Wales: injury surveillance analysis from the first three ‘The Hundred’ competitions
Authors: Williams Amy , Peirce Nicholas , Griffin Steve , Langley Ben , Warren Anna , Wedatilake Thamindu , Goggins Luke , McKay Carly D , Stokes Keith A , Williams Sean
Published: January 2024

Objectives

To describe the injury profile of a novel format cricket competition (‘The Hundred’) and compare injury incidence and prevalence between the men’s and women’s competitions.

Methods

Medical staff prospectively collected injury data from the eight men’s and women’s teams during the 2021–2023 competitions. Injury definitions and incidence calculations followed the international consensus statement.

Results

In the men’s competition, 164 injuries were recorded, compared with 127 in the women’s competition. Tournament injury incidence was 36.6 (95% CI 31.4 to 42.7) and 32.5 (95% CI 27.3 to 38.7)/100 players/tournament in the men’s and women’s competition, respectively. Non-time-loss incidence (men’s 26.6 (95% CI 22.2 to 31.8), women’s 24.6 (95% CI 20.1 to 30.0)/100 players/tournament) was higher than time-loss incidence (men’s 10.0 (95% CI 7.5 to 13.5), women’s 7.9 (95% CI 5.6 to 11.3)/100 players/tournament). Injury prevalence was 2.9% and 3.6% in the men’s and women’s competitions, respectively. Match fielding was the most common activity at injury in both competitions. The thigh and hand were the most common body location time-loss injury in the men’s and women’s competitions, respectively.

Conclusion

A similar injury profile was observed between the men’s and women’s competition. Preventative strategies targeting thigh injuries in the men’s competition and hand injuries in the women’s competition would be beneficial. Compared with published injury rates, ‘The Hundred’ men’s presents a greater risk of injury than Twenty20 (T20), but similar to one-day cricket, with ‘The Hundred’ women’s presenting a similar injury risk to T20 and one-day cricket. Additional years of data are required to confirm these findings.
Intermediate catheter use is associated with complete occlusion and dense packing in coil embolization of unruptured cerebral aneurysms: a propensity score matched study
Authors: Fuga Michiyasu , Ishibashi Toshihiro , Aoki Ken , Tachi Rintaro , Irie Koreaki , Kato Naoki , Kan Issei , Hataoka Shunsuke , Nagayama Gota , Sano Tohru , Tanaka Toshihide , Murayama Yuichi
Published: January 2024

Background

An intermediate catheter (IMC) can improve the maneuverability and stability of the microcatheter.

Objective

To investigate the efficacy and safety of using an IMC in triaxial systems for coil embolization of unruptured cerebral aneurysms (UCAs).

Methods

A total of 2430 consecutive saccular UCAs (2259 patients) that underwent initial coil embolization at three institutions between November 2003 and May 2023 were retrospectively reviewed. Patients were classified into two groups: with IMC (IMC(+)) and without IMC (IMC(−)). To investigate whether IMC use increased the rate of complete occlusion and the packing density, a propensity score-matched analysis was used to control for clinical, anatomical, and procedural features.

Results

Ultimately, 595 (24.5%) coil embolization used an IMC. Propensity score matching was successful for 424 paired IMC(+) and IMC(−) aneurysms. Compared with the IMC(−) group, the IMC(+) group had significantly higher rate of Raymond-Roy Occlusion Classification class 1 immediately after treatment (30.0% vs 20.8%, P=0.003) and at 6 months (28.8% vs 20.0%, P=0.004) and a higher volume embolization ratio (27.2% (SD 6.5%) vs 25.9% (SD 6.2%), P=0.003). Re-treatment rates were not significantly different between the two groups (0.7% vs 0.2%, P=0.624). No significant differences in the incidences of ischemic and hemorrhagic complications and IMC-related parent artery dissection were found between the two groups.

Conclusion

Use of IMCs in triaxial systems can provide effective and safe support in coil embolization of UCAs because complete occlusion and dense coil packing can be achieved without increased complications.
Aneurysm healing following treatment with biodegradable embolization materials: assessment in a rat sidewall aneurysm model
Authors: Nevzati Edin , Rey Jeannine , Spiessberger Alexander , Moser Manuel , Roethlisberger Michel , Grüter Basil Erwin , Widmer Hans Rudolf , Coluccia Daniel , Marbacher Serge
Published: January 2024

Background

Biodegradable materials that dissolve after aneurysm healing are promising techniques in the field of neurointerventional surgery. We investigated the effects of various bioabsorable materials in combination with degradable magnesium alloy stents and evaluated aneurysm healing in a rat aneurysm model.

Methods

Saccular aneurysms were created by end-to-side anastomosis in the abdominal aorta of Wistar rats. Untreated arterial grafts were immediately transplanted (vital aneurysms) whereas aneurysms with loss of mural cells were chemically decellularized before implantation. All aneurysms were treated with biodegradable magnesium stents. The animals were assigned to vital aneurysms treated with stent alone or decellularized aneurysms treated with stent alone, detachable coil, or long-term or short-term biodegradable thread. Aneurysm healing, rated microscopically and macroscopically at follow-up days 7 and 21, was defined by both neointima formation and absence of aneurysm volume increase over time.

Results

Of 56 animals included, significant increases in aneurysm volume 7 days after surgery were observed in aneurysms with vital and decellularized walls treated with a stent only (P=0.043 each group). Twenty-one days after surgery an increase in aneurysm volume was observed in decellularized aneurysms treated with long- and short-term biodegradable threads (P=0.027 and P=0.028, respectively). Histological changes associated with an increase in aneurysm volume were seen for aneurysm wall inflammation, periadventitial fibrosis, and luminal thrombus.

Conclusions

An increase in aneurysm volume was associated with an absence of intrasaccular embolization material (early phase) and the breakdown of intrasaccular biodegradable material over time (late phase). Thrombus remnant and aneurysm wall inflammation promote aneurysm volume increase.
High-density lipoprotein cholesterol subfraction HDL2 is associated with improved endothelial function in systemic lupus erythematosus
Authors: Lee Ainsley Ryan Yan Bin , Yau Chun En , Chua Cheryl Kai Ting , Cheng Wan Ling , Chia Avery Joy Li , Wong Shi Yin , Kow Nien Yee , Gong Lingli , Lee Bernett Teck Kwong , Ling Lieng Hsi , Mak Anselm , Loh Tze Ping , Tay Sen Hee
Published: January 2024

Objective

Patients with systemic lupus erythematosus (SLE) have increased risk of premature atherosclerosis but the exact mechanisms remains unclear. Flow-mediated dilatation (FMD) is an established non-invasive assessment of vascular endothelial function. Lipoprotein subfractions may be better predictors of FMD than conventional cholesterol measurements. We tested the hypothesis that lipoprotein subfractions are independently associated with FMD.

Methods

Forty-one consecutive adult patients with SLE without known cardiovascular risk factors or disease were recruited in this cross-sectional study. Endothelial function and early atherosclerosis were assessed by brachial FMD and common carotid artery (CCA) intima-media thickness (IMT). High-density lipoprotein (HDL)/low-density lipoprotein (LDL) subfractions were measured. Machine learning models were also constructed to predict FMD and CCA IMT.

Results

Median FMD was 4.48% (IQR 5.00%) while median IMT was 0.54 mm (IQR 0.12 mm). Univariate analysis showed lower LDL1 (r=−0.313, p<0.05) and higher HDL2 subfractions (r=0.313, p<0.05) were significantly associated with higher log-transformed FMD. In a multiple linear regression model, HDL2 (β=0.024, SE=0.012, p<0.05) remained an independent predictor of higher FMD after adjusting for age, body mass index, LDL1 and systolic blood pressure. The machine learning model included parameters such as HDL2 (positive association), prednisolone dose, LDL cholesterol and LDL1 for prediction of FMD (r=0.433, p<0.01). Age, LDL cholesterol and systolic blood pressure were independently associated with higher CCA IMT after adjusting for body mass index and HDL2.

Conclusions

HDL 2, a large HDL particle, was independently associated with greater FMD and may be a biomarker of vascular health in SLE.
Neuraxial pathology and regional anesthesia: an education guide to decision-making
Authors: Avellanal Martin , Riquelme Irene , Ferreiro Antonio , Boezaart Andre , Reina Miguel Angel
Published: January 2024

In current clinical practice, spinal anesthesia and analgesia techniques—including epidural and subarachnoid procedures—are frequently executed without imaging like X-ray or epidurography. Unrecognized spinal pathology has resulted in serious morbidity in the context of performing neuraxial anesthesia. Typically, preoperative consultations incorporate a patient’s medical history but lack a detailed spinal examination or consideration of recent MRI or CT scans. In contrast, within the domain of pain clinics, a multidisciplinary approach involving anesthesiologists and neuroradiologists is common. Such collaborative settings rely on exhaustive clinical history and scrutinization of recent imaging studies, which may influence the decision to proceed with invasive spinal interventions. There are no epidemiological data concerning rates of the different baseline pathologies that would potentially pose morbidity risks from neuraxial procedures, but the most common among these is canal stenosis, which significantly affects almost 20% of people over 60 years of age. This paper aims to elucidate these critical findings and advocate for incorporating meticulous preoperative assessments for individuals slated for spinal anesthesia or analgesia procedures, thereby attempting to mitigate potential risks.
Differential nerve blockade to explain anterior thoracic analgesia without sensory blockade after an erector spinae plane block may be wishful thinking
Authors: Sivakumar Ranjith Kumar , Luckanachanthachote Chayapa , Karmakar Manoj Kumar
Published: January 2024

Ultrasound-guided erector spinae plane block (ESPB) is currently used as a component of multimodal analgesic regimen in a multitude of indications but the mechanism by which it produces anterior thoracic analgesia remains a subject of controversy. This is primarily the result of ESPB’s failure to consistently produce cutaneous sensory blockade (to pinprick and cold sensation) over the anterior hemithorax. Nevertheless, ESPB appears to provide ‘clinically meaningful analgesia’ in various clinical settings. Lately, it has been proposed that the discrepancy between clinical analgesia and cutaneous sensory blockade could be the result of differential nerve blockade at the level of the dorsal root ganglion. In particular, it is claimed that at a low concentration of local anesthetic, the C nerve fibers would be preferentially blocked than the Aδ nerve fibers. However, the proposal that isolated C fiber mediated analgesia with preserved Aδ fiber mediated cold and pinprick sensation after an ESPB is unlikely, has never been demonstrated and, thus, without sufficient evidence, cannot be attributed to the presumed analgesic effects of an ESPB.
Conventional cytogenetics and microsatellite chromosomal distribution in social wasp Mischocyttarus cassununga (Ihering, 1903) (Vespidae, Polistinae, Mischocyttarini)
Authors: Novaes Camila Moura , Teixeira Gisele Amaro , Juris Eydyeliana Month , Lopes Denilce Meneses
Published: January 2024

Cytogenetics has allowed the investigation of chromosomal diversity and repetitive genomic content in wasps. In this study, we characterized the karyotype of the social wasp Mischocyttarus cassununga using conventional cytogenetics and chromosomal mapping of repetitive sequences. This study was undertaken to extend our understanding of the genomic organization of repetitive DNA in social wasps and is the first molecular cytogenetic insight into the genus Mischocyttarus. The karyotype of M. cassununga had a chromosome number of 2 n = 64 for females and n = 32 for males. Constitutive heterochromatin exhibited three distribution patterns: centromeric and pericentromeric regions along the smaller arms and extending almost the entire chromosome. The major ribosomal DNA sites were located on chromosome pair in females and one chromosome in males. Positive signals for the microsatellite probes (GA) n and (GAG) n were observed in the euchromatic regions of all chromosomes. The microsatellites, (CGG) n, (TAT) n, (TTAGG) n, and (TCAGG) n were not observed in any region of the chromosomes. Our results contrast with those previously obtained for Polybia fastidiosuscula, which showed that the microsatellites (GAG) n, (CGG) n, (TAT) n, (TTAGG) n, and (TCAGG) n are located predominantly in constitutive heterochromatin. This suggests variations in the diversity and chromosomal organization of repetitive sequences in the genomes of social wasps.
On the simulation of a wing with detached end-plates using an actuator line based on an anisotropic Gaussian kernel
Authors: Breault Marc-Antoine , Rochefort Philippe , Dumas Guy
Published: January 2024

The results of an actuator line method (ALM) using an anisotropic Gaussian kernel for both, velocity sampling and force projection, are compared to the wall-resolved results of a NACA 0015 rectangular wing at an angle of attack of 10°. The rectangular wing is simulated both, with and without, detached end-plates to show that the ALM is capable of accounting for the presence of a narrow gap of 0.01 c between the tip of the wing and the end-plate. The anisotropic kernel shape is varied in the chordwise, thickness-wise, and spanwise directions for different grid sizes and number of actuating points. The body forces are truncated and regularized to enforce proper spacing between the actuating line and the end-plate. ALM and wall-resolved results are compared on the basis of the integrated lift and drag coefficients, the sectional lift and drag coefficients, as well as the tip vortex core size, position, and circulation. Recommendations are made regarding the optimal kernel shape for a given number of actuating points and mesh resolution.
Implications of a Simpson–Visser solution in Verlinde’s framework
Authors: Filho A. A. Araújo
Published: January 2024

This study focuses on investigating a regular black hole within the framework of Verlinde’s emergent gravity. In particular, we explore the main aspects of the modified Simpson–Visser solution. Our analysis reveals the presence of a unique physical event horizon under certain conditions. Moreover, we study the thermodynamic properties, including theHawkingtemperature, the entropy, and the heat capacity. Based on these quantities, our results indicate several phase transitions. Geodesic trajectories for photon-like particles, encompassing photon spheres and the formation of black hole shadows, are also calculated to comprehend the behavior of light in the vicinity of the black hole. Additionally, we also provide the calculation of the time delay and the deflection angle. Corroborating our results, we include an additional application in the context of high-energy astrophysical phenomena: neutrino energy deposition. Finally, we investigate the quasinormal modes using third-order WKB approximation.
Stochastic gravitational wave background from the collisions of dark matter halos
Authors: Yan Qiming , Ren Xin , Zhao Yaqi , Saridakis Emmanuel N.
Published: January 2024

We investigate the effect of the dark matter (DM) halos collisions, namely collisions of galaxies and galaxy clusters, through gravitational bremsstrahlung, on the stochastic gravitational wave background. We first calculate the gravitational wave signal of a single collision event, assuming point masses and linear perturbation theory. Then we proceed to the calculation of the energy spectrum of the collective effect of all dark matter collisions in the Universe. Concerning the DM halo collision rate, we show that it is given by the product of the number density of DM halos, which is calculated by the extended Press–Schechter (EPS) theory, with the collision rate of a single DM halo, which is given by simulation results, with a function of the linear growth rate of matter density through cosmological evolution. Hence, integrating over all mass and distance ranges, we finally extract the spectrum of the stochastic gravitational wave background created by DM halos collisions. As we show, the resulting contribution to the stochastic gravitational wave background is of the order of$$h_{c} \approx 10^{-29}$$hc≈10-29in the band of$$f \approx 10^{-15} Hz$$f≈10-15Hz. However, in very low frequency band, it is larger. With current observational sensitivity it cannot be detected.
The quantum Carnot-like heat engine: The level degenerate case
Authors: Yuan Yang Yang , Gu Qiang
Published: January 2024

The two-level quantum heat engines have been studied extensively. Before that, the optimization of most heat engines was mainly concentrated in non-degenerate cases. We consider the level degeneracy, then calculate the maximum operation time and the irreversible dissipation coefficient of the two-level system under the scheme of linear tuned levels. In the high-temperature limit, we find that the level degeneracy affects the maximum power of the two-level heat engine. Especially in the case of the same degeneracy of the ground state and the excited state, the influence is the greatest. In addition, we also show that the degeneracy does not affect the efficiency at maximum power and the consistent relation of the two-level Carnot-like heat engine.
Gallium phosphide nanoribbon-based carbon monoxide sensors: insights from first principles study
Authors: Singh Neelesh Pratap , Ghosh Jayanta , Jaiswal Neeraj K.
Published: January 2024

The priority of research efforts over the past two decades has been focused on the effective detection of harmful gases and the development of small, efficient, and reliable nanodimensional sensors. The adsorption of carbon monoxide (CO) gas molecules on zigzag gallium phosphide nanoribbons (zGaPNRs) has been studied using first-principle calculations within the context of Density Functional Theory (DFT). Here, we have evaluated the potential of single-atom thick zGaPNRs in different configurations of nanoribbons for the detection of CO. Many possible configurations of studying the CO molecule adsorption on zGaPNRs have been explored. It is established that the interaction of CO molecules has an impact on the electrical and transport properties of zGaPNRs. The H-GaP-H is the most stable structure with the binding energy ([Formula: see text]) of −5.70[Formula: see text]eV. The stability is compromised with CO adsorption with CO-GaP-CO being the least stable structure. Pristine structure is semiconducting with the energy band gap ([Formula: see text]) of −3.95[Formula: see text]eV. The computed sensitivity (S) values are found to be highest for Co-GaPNRs with the S value of [Formula: see text] and the least sensitive structure is H-GaP-CO with the computed S as [Formula: see text]. Additionally, it is noted that CO molecules always establish a stable chemical bond with the nanoribbon edges through the C-side. The unique behavior is revealed by the transport characteristics, which demonstrates that when CO adsorption occurs near the Ga edge, the current magnitude is noticeably greater. Our research demonstrates the potential of specific CO adsorption and detection for the development of nanosensors.
Instability analysis of swirling cylindrical Rivlin–Ericksen viscoelastic fluid–viscous fluid interface with heat and mass transfer
Authors: Srija R. , Singh Abhishek Kumar , Awasthi Mukesh Kumar , Yadav Dhananjay , Nair Sanjith Bharatharajan
Published: January 2024

The applications of swirling interfaces with heat and mass transfer are diverse and impactful, spanning industries from energy and manufacturing to healthcare and environmental protection. This study focuses on the stability of such interfaces where a viscous fluid interacts with a Rivlin–Ericksen (RE) viscoelastic fluid, undergoing heat and mass transfer. In this paper, the fluids are enclosed between two cylinders, one stationary and the other rotating. Mathematical equations are solved using potential flow theory. The interface stability is assessed using a normal mode procedure, leading to a second-order polynomial equation. The study finds that swirling flow reduces perturbation amplification, especially when heat and mass transfer occur simultaneously. However, the viscoelastic nature of the Rivlin–Ericksen fluid destabilizes the interface. Overall, this research provides valuable insights into complex fluid behavior with applications across industries.
Efficient passive GDQLL scrutinization of an advanced steady EMHD mixed convective nanofluid flow problem via Wakif–Buongiorno approach and generalized transport laws
Authors: Alghamdi Metib , Wakif Abderrahim , Muhammad Taseer
Published: January 2024

Owing to the practical importance of nanofluids and their adjustable thermal capabilities, this study intends to develop a robust generalized differential quadrature local linearization (GDQLL) algorithm for examining realistically the heat and mass aspects of electrically conducting nanofluids during their non-Darcian laminar motion nearby a convectively heating vertical surface of an active electromagnetic actuator (i.e., Riga plate). By invoking Wakif–Buongiorno model and Oberbeck–Boussinesq approximations along with other generalized transport laws (i.e., Cattaneo–Christov and non-Fick’s laws) and Grinberg’s concept, a set of gigantic partial differential equations is stated appropriately in the sense of the boundary layer approximations for describing exhaustively the present EMHD mixed convective nonhomogeneous flow under the passive control strategy of nanoparticles within the nanofluidic medium. Operationally, the dimensionless differential forms of the governing boundary equations are derived properly by introducing reasonable mathematical adjustments into the preliminary formulation. In this case, the differential complexity of the leading differential structure is reduced to a nonlinear coupled system of ordinary differential equations, whose discrete numerical solutions are computed perfectly via a well-structured GDQLL algorithm. As foremost outcomes, it is demonstrated that the nanofluid motion and its surface thermal enhancement rate can be reinforced significantly through the thermal strengthening in the convective heating and mixed convective process as well as via the electromagnetic improvement in the driven aspect of Lorentz’s forces.
Non-Hermitian dynamics from Hermitian systems: Do-it-yourself
Authors: Villegas-Martínez Braulio M. , Soto-Eguibar Francisco , Moya-Cessa Héctor M. , Hojman Sergio A. , Asenjo Felipe A.
Published: January 2024

We show that several Hamiltonians that are [Formula: see text] symmetric may be taken to Hermitian Hamiltonians via a non-unitary transformation and vice versa. Therefore, a recipe to produce tractable non-Hermitian Hamiltonians is given (a set of instructions to do it yourself). We also show that for some specific Hamiltonians such non-unitary transformations may be associated, via a fractional-Wick rotation, to complex time.