bluuebunny/crossref_metadata_2025 huggingface dataset:
Characterization and Control of Carbon Nanotube Doping
Authors: Zeevi Gilad , Gilardi Carlo , Li Shengman , Passlack Matthias , Pitner Gregory , Mitra Subhasish , Li Shengman
Published: August 2024

Carbon nanotube FETs show great promise for beyond-Si and monolithic 3D electronics, however there are still fundamental questions to explore. In particular, controlled N- and P- doping is a fundamental process module which can be used to engineer semiconductor resistance in un-gated regions such as the contact or extension, as well as optimize band-to-band tunneling leakage [1-4]. To-date both N- and P- doping has been demonstrated for CNT, but the optimal strategies for doping control and carrier density quantification have not been determined. In this work, we present a study of N- and P- doping using solid-state dopants and doping control strategy using a dielectric barrier of tunable thickness. A TCAD evaluation reveals the tradeoffs between carrier density and mobility for increasing dielectric barrier thickness, and reveals the critical role of dielectric constant in optimizing performance of spacer doping [5]. Multiple characterization approaches under evaluation help to correlate doping strength to experimentally measurable quantities with insight into the doping mechanisms. Finally, we will summarize potential approaches for improving doping control and quantification, and progress towards integration of the doping in highly-scaled high-performance carbon nanotube FETs [6].

[1] Z. Zhang, et al., “Complementary carbon nanotube metal-oxide-semiconductor field-effect transistors with localized solid-state extension doping,” Nature Electronics, 2023.

[2] Q. Lin, et al., “Band-to-band Tunneling Leakage Current Characterization and Projection in Carbon Nanotube Transistors,” ACS Nano, 2023.

[3] G. Zeevi, et al., “PN Junction and band to band tunneling in carbon nanotube transistors at room temperature,” Nanotechnology, 2021.

[4] L. Liyanage, et al., “VLSI-compatible carbon nanotube doping technique with low work-function metal oxides,” Nano Letters, 2014.

[5] C. Gilardi et al., “Barrier Booster for Remote Extension Doping and its DTCO for 1D & 2D FETs”, IEDM 2023

[6] S.Li, et al., “High-performance and low parasitic capacitance CNT MOSFET: 1.2 mA/μm at VDS of 0.75 V by self-aligned doping in sub-20 nm spacer,” IEDM 2023.
Endothelial PHD2 deficiency induces apoptosis resistance and inflammation via AKT activation and AIP1 loss independent of HIF2α
Authors: Wang Shuibang , Awad Keytam S. , Chen Li-Yuan , Siddique Mohammad A. H. , Ferreyra Gabriela A. , Wang Caroline L. , Joseph Thea , Yu Zu-Xi , Takeda Kazuyo , Demirkale Cumhur Y. , Zhao You-Yang , Elinoff Jason M. , Danner Robert L.
Published: August 2024

HIF activation alone does not conclusively lead to human PH, suggesting that HIF-independent signaling may also contribute to hypoxia-induced PH. This study demonstrated that PHD2 silencing-induced pseudohypoxia in human lung endothelial cells suppresses apoptosis and activates STAT, effects that persist despite HIF2α inhibition or knockdown and are attributed to AKT and ERK activation, JNK inhibition, and AIP1 loss. These findings align with observations in lung endothelial cells and tissues from PAH rodent models and patients.
A Case of Personality and Behavioral Changes with Frontotemporal and Cerebellar Atrophy on MRI with Corresponding Hypometabolism on FDG‐PET
Authors: Selig Megan , Lee Gloria , Lebowitz Brian , Franceschi Dinko , Absar Nicole
Published: August 2024

Background. The differential diagnosis of a patient with cognitive, behavioral, and motor symptoms is broad. There is much overlap between neurocognitive disorders due to frontotemporal dementia and other subcortical dementia. A less known diagnosis, cerebellar cognitive affective syndrome (CCAS), should also be considered. Case History. A 29‐year‐old female presented with ataxia and left‐sided weakness. CSF showed oligoclonal bands, and MRI showed multiple white matter lesions with some atrophy. She was diagnosed with multiple sclerosis (MS). At age 35, she developed frontal lobe symptoms and executive dysfunction; she was diagnosed with MS with bipolar disorder. Neuropsychological evaluation at that time showed significant deficits in multiple cognitive domains. Subsequent MRI showed progressive frontotemporal atrophy, and FDG‐PET uncovered hypometabolism in the frontotemporal lobes and cerebellum. At age 38, her behavior worsened with aggression, and she was started on olanzapine. She responded well with decreased agitation and improved motivation and attention. Compared with previous scans, most recent MRI and FDG‐PET showed interval increase in cerebellar atrophy with increase in hypometabolism in the cerebellum, respectively. Conclusion. Based on cerebellar, affective, and subcortical cognitive examination findings, our diagnosis is probable CCAS. The cerebellum should be considered as a possible etiology of frontal subcortical cognitive impairment.
Establishment, Prediction, and Validation of a Nomogram for Cognitive Impairment in Elderly Patients With Diabetes
Authors: Wu Sensen , Pan Dikang , Wang Hui , Guo Julong , Zhang Fan , Ning Yachan , Gu Yongquan , Guo Lianrui
Published: August 2024

Objective: The purpose of this study is to establish a predictive model of cognitive impairment in elderly people with diabetes.

Methods: We analyzed a total of 878 elderly patients with diabetes who were part of the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014. The data were randomly divided into training and validation cohorts at a ratio of 6:4. The least absolute shrinkage and selection operator (LASSO) logistic regression analysis to identify independent risk factors and construct a prediction nomogram for cognitive impairment. The performance of the nomogram was assessed using receiver operating characteristic (ROC) curve and calibration curve. Decision curve analysis (DCA) was performed to evaluate the clinical utility of the nomogram.

Results: LASSO logistic regression was used to screen eight variables, age, race, education, poverty income ratio (PIR), aspartate aminotransferase (AST), blood urea nitrogen (BUN), serum uric acid (SUA), and heart failure (HF). A nomogram model was built based on these predictors. The ROC analysis of our training set yielded an area under the curve (AUC) of 0.786, while the validation set showed an AUC of 0.777. The calibration curve demonstrated a good fit between the two groups. Furthermore, the DCA indicated that the model has a favorable net benefit when the risk threshold exceeds 0.2.

Conclusion: The newly developed nomogram has proved to be an important tool for accurately predicting cognitive impairment in elderly patients with diabetes, providing important information for targeted prevention and intervention measures.
Influence of Microfin Tube on Heat Transfer during Flow Boiling of R134a Refrigerant
Authors: Vidhyarthi Neeraj Kumar , Deb Sandipan , Gajghate Sameer Sheshrao , Cardoso Elaine Maria , Das Mantu , Pal Sagnik , Das Ajoy Kumar
Published: August 2024

This research looks into the domination of flow boiling on the efficiency and sustainability of refrigeration and air conditioning systems. Specifically, it focuses on the characteristics related with heat transfer of refrigerant R134a within both smooth and microfin tubes, each having 9.52 mm outer diameter. The features of microfin tube have distinct configuration with a 46° apex angle and a 22° helix angle, resulting in a surface area 1.62 times greater in comparison to smooth tube. Through a comprehensive experimental analysis, the study examines the influence of key parameters (mass flux; saturation temperature; heat flux; and average vapor quality) on heat transfer coefficients (HTCs). Notably, the HTC exhibits significant enhancements at mass flux of G = 125 kg m⁻2·s⁻1, encountering challenges related to dry‐out at elevated vapor quality levels. The results reveal that microfin tubes consistently outperform smooth tubes, exhibiting heat transfer coefficients up to 270% higher across various operational conditions. Furthermore, the experimental data are rigorously validated through computation analysis with authentic flow boiling heat transfer models, demonstrating strong agreement.
NUAK1-Mediated Phosphorylation of NADK Mitigates ROS Accumulation to Promote Osimertinib Resistance in Non–Small Cell Lung Carcinoma
Authors: Lin Wei , Wang Na , Wu Shihao , Diao Mingxin , Huang Quanfu , Li Kuo , Mei Peiyuan , Wang Xiaojun , Liao Yongde , Meng Yunchong
Published: August 2024

Osimertinib, a third generation epidermal growth factor receptor tyrosine kinase inhibitor, is approved as a first-line therapy in patients with advanced non–small cell lung carcinoma (NSCLC) with EGFR-activating mutations or the T790M resistance mutation. However, the efficacy of osimertinib is limited due to acquired resistance, highlighting the need to elucidate resistance mechanisms to facilitate the development of improved treatment strategies. Here, we screened for significantly upregulated genes encoding protein kinases in osimertinib-resistant NSCLC cells and identified NUAK1 as a pivotal regulator of osimertinib resistance. NUAK1 was highly expressed in osimertinib-resistant NSCLC and promoted the emergence of osimertinib resistance. Genetic or pharmacological blockade of NUAK1 restored the sensitivity of resistant NSCLC cells to osimertinib in vitro and in vivo. Mechanistically, NUAK1 directly interacted with and phosphorylated nicotinamide adenine dinucleotide kinase (NADK) at serine 64 (S64), which mitigated osimertinib-induced accumulation of reactive oxygen species (ROS) and contributed to the acquisition of osimertinib resistance in NSCLC. Furthermore, virtual drug screening identified T21195 as an inhibitor of NADK-S64 phosphorylation, and T21195 synergized with osimertinib to reverse acquired resistance by inducing ROS accumulation. Collectively, these findings highlight the role of the NUAK1-NADK axis in governing osimertinib resistance in NSCLC and indicate the potential of targeting this axis as a strategy for circumventing resistance.

Significance: Phosphorylation of NADK by NUAK1 diminishes ROS accumulation and confers resistance to osimertinib, identifying NUAK1-NADK signaling as a potential therapeutic target for improving the response to EGFR inhibition in lung cancer.
Associations between Dietary Patterns and Incident Colorectal Cancer in 114,443 Individuals from the UK Biobank: A Prospective Cohort Study
Authors: Skulsky Samuel L. , Koutoukidis Dimitrios A. , Carter Jennifer L. , Piernas Carmen , Jebb Susan A. , Gao Min , Astbury Nerys M.
Published: August 2024

Background:

Diet–disease association studies increasingly use dietary patterns (DP) to account for the complexity of the exposure. We assessed if a DP associated with type 2 diabetes mellitus, cardiovascular disease, and all-cause mortality is also associated with colorectal cancer.

Methods:

We used reduced rank regression on 24-hour recall data to identify DPs, explaining the maximum variation in four nutrient-response variables: energy density, saturated fatty acids, free sugars, and fiber density. Cox proportional hazards models examined prospective associations between DP adherence (coded in a continuous scale as z-scores as well as in quintiles) and incident colorectal cancer. Subgroup analyses were conducted for tumor site, age, and sex.

Results:

After exclusions, 1,089 colorectal cancer cases occurred in 114,443 participants over a median follow-up of 8.0 years. DP1 was characterized by increased intake of chocolate and confectionery; butter; low-fiber bread; red and processed meats; and alcohol, as well as low intake of fruits, vegetables, and high-fiber cereals. After accounting for confounders, including body mass, there were positive linear associations between DP1 and incident overall colorectal cancer (HR of quintile 5 vs. 1, 1.34; 95% confidence interval, 1.16–1.53, Ptrend = 0.005) and rectal cancer (HR of quintile 5 vs. 1, 1.58; 95% confidence interval, 1.27–1.96, Ptrend = 0.009) but not for proximal or distal colon cancers. No DP2–colorectal cancer association was observed.

Conclusions:

A DP previously associated with cardiometabolic disease is also associated with incident colorectal cancer, especially rectal cancers.

Impact:

These consistent associations of particular food groups with both cardiometabolic disease and this diet-related cancer strengthen the evidence base for holistic population dietary guidelines to prevent ill-health.
Upgrading of Grade Group 1 Prostate Cancer at Prostatectomy: Germline Risk Factors in a Prospective Cohort
Authors: Liss Michael A. , Zeltser Nicole , Zheng Yingye , Lopez Camden , Liu Menghan , Patel Yash , Yamaguchi Takafumi N. , Eng Stefan E. , Tian Mao , Semmes Oliver J. , Lin Daniel W. , Brooks James D. , Wei John T. , Klein Eric A. , Tewari Ashutosh K. , Mosquera Juan Miguel , Khani Francesca , Robinson Brian D. , Aasad Muhammad , Troyer Dean A. , Kagan Jacob , Sanda Martin G. , Thompson Ian M. , Boutros Paul C. , Leach Robin J.
Published: August 2024

Background:

Localized prostate tumors show significant spatial heterogeneity, with regions of high-grade disease adjacent to lower grade disease. Consequently, prostate cancer biopsies are prone to sampling bias, potentially leading to underestimation of tumor grade. To study the clinical, epidemiologic, and molecular hallmarks of this phenomenon, we conducted a prospective study of grade upgrading: differences in detected prostate cancer grade between biopsy and surgery.

Methods:

We established a prospective, multi-institutional cohort of men with grade group 1 (GG1) prostate cancer on biopsy who underwent radical prostatectomy. Upgrading was defined as detection of GG2+ in the resected tumor. Germline DNA from 192 subjects was subjected to whole-genome sequencing to quantify ancestry, pathogenic variants in DNA damage response genes, and polygenic risk.

Results:

Of 285 men, 67% upgraded at surgery. PSA density and percent of cancer in pre-prostatectomy positive biopsy cores were significantly associated with upgrading. No assessed genetic risk factor was predictive of upgrading, including polygenic risk scores for prostate cancer diagnosis.

Conclusions:

In a cohort of patients with low-grade prostate cancer, a majority upgraded at radical prostatectomy. PSA density and percent of cancer in pre-prostatectomy positive biopsy cores portended the presence of higher-grade disease, while germline genetics was not informative in this setting. Patients with low-risk prostate cancer, but elevated PSA density or percent cancer in positive biopsy cores, may benefit from repeat biopsy, additional imaging or other approaches to complement active surveillance.

Impact:

Further risk stratification of patients with low-risk prostate cancer may provide useful context for active surveillance decision-making.
Table 1 from Exploring Disparities in Pancreatic Ductal Adenocarcinoma Outcomes among Asian and Pacific Islander Subgroups
Authors: Wu Christopher , McLeod M. Chandler , Song Zhixing , Chen Herbert , Rose John Bart , Bhatia Smita , Gillis Andrea
Published: August 2024

Demographic characteristics of Asian subpopulations in patients with PDAC
Figure 1 from Exploring Disparities in Pancreatic Ductal Adenocarcinoma Outcomes among Asian and Pacific Islander Subgroups
Authors: Wu Christopher , McLeod M. Chandler , Song Zhixing , Chen Herbert , Rose John Bart , Bhatia Smita , Gillis Andrea
Published: August 2024

Kaplan–Meier survival curves for the Asian subgroup analysis.
Table 1 from Yttrium-90 Induces an Effector Memory Response with Neoantigen Clonotype Expansion: Implications for Immunotherapy
Authors: Núñez Kelley , Sandow Tyler , Gimenez Juan , Hibino Mina , Cohen Ari , Thevenot Paul
Published: August 2024

90Y induced changes in T cell phenotypes based on target response rate
Figure S3 from FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: August 2024

Figure S3 – Western Blot data from USC100 following treatment with FLT3-A192, CD99-A192 and Co-Assembled CD99-A192 and FLT3-A192.
Figure S1 from FLT3/CD99 Bispecific Antibody–Based Nanoparticles for Acute Myeloid Leukemia
Authors: Ali Atham , Phan Alvin , Vaikari Vijaya , Park Mincheol , Pospiech Mateusz , Chu Ryan , Meng Yiting , MacKay J. Andrew , Alachkar Houda
Published: August 2024

Figure S1 – Flow Panels of Annexin and PI staining of U937 Cells following treatment with FLT3-A192, CD99-A192 and Co-Assembled CD99-A192 and FLT3-A192.
Data from Exploring Disparities in Pancreatic Ductal Adenocarcinoma Outcomes among Asian and Pacific Islander Subgroups
Authors: Wu Christopher , McLeod M. Chandler , Song Zhixing , Chen Herbert , Rose John Bart , Bhatia Smita , Gillis Andrea
Published: August 2024

Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a challenging malignancy with known disparities in outcomes across ethnicities. Studies specifically investigating PDAC in Asian populations are sparse, overlooking the rich diversity within this group. This research seeks to fill that gap by examining survival differences across the broad spectrum of Asian ethnicities, acknowledging the complexity and varied experiences within these communities. Utilizing the National Cancer Database from 2004 to 2019, we categorized patients into East Asian, Southeast Asian, South Asian, and Pacific Islander groups. Non-Asians or Pacific Islanders were excluded. Overall survival was analyzed using a Cox hazards model. The study consisted of 13,254 patients. Most patients were East Asian (59.4%, n = 7,866). Southeast Asians exhibited the poorest survival in unadjusted analysis (HR, 1.32; 95% confidence interval, 1.23–1.42; P < 0.001) compared with South Asians who exhibited the best survival. Multivariable analysis revealed significantly worse survival for East Asians and Pacific Islanders relative to South Asians, whereas Southeast Asians’ results were not significantly different. Asian subgroup differences notably affect PDAC outcomes. Research on genetic and cultural aspects, especially in Southeast Asians, and tackling health disparities are crucial for enhancing survival in this diverse disease.
Significance:
This study highlights the significant survival disparities among Asian subgroups with pancreatic cancer, utilizing a large national database. By differentiating among East Asian, Southeast Asian, South Asian, and Pacific Islander groups, it underscores the need for tailored research and healthcare approaches. Addressing these differences is essential for developing culturally sensitive interventions and potentially improving outcomes in a disease that uniquely affects these diverse populations.
Conditioned Medium of Infrapatellar Fat Stem Cells Alleviates Degradation of Chondrocyte Extracellular Matrix and Delays Development of Osteoarthritis
Authors: He Shiping , Wang Shihan , Liu Ruizhou , Chen Hui , Wang Qiang , Jia Dazhou , Chen Longchi , Dai Jihang , Li Xiaolei
Published: August 2024

Introduction: Osteoarthritis (OA) is a prevalent clinical chronic degenerative condition characterized by the degeneration of articular cartilage. Currently, drug treatments for OA come with varying degrees of side effects, making the development of new therapeutic approaches for OA imperative. Mesenchymal stem cells (MSCs) are known to mitigate the progression of OA primarily through paracrine effects. The conditioned medium (CM) derived from MSCs encapsulates a variety of paracrine factors secreted by these cells. Methods: In this study, we investigated the effect of the CM of infrapatellar fat pad-derived MSCs (IPFSCs) on OA in vitro and in vivo, as well as and the potential underlying mechanisms. We established three experimental groups: the normal group, the OA group, and the CM intervention group. In vitro experiments, we used methods such as qPCR, Western blot, immunofluorescence, and flow cytometry to detect the impact of CM on OA chondrocytes. In vivo experiments, we evaluated the changes in the knee joints of OA rats after intra-articular injection of CM treatment. Results: The results showed that injection of CM into the knee joint inhibited OA development in a rat model induced by destabilization of the medial meniscus and anterior cruciate ligament transection. The CM increased the deposition of extracellular matrix-related components (type II collagen and Proteoglycan). The activation of PI3K/AKT/NF-κB signaling pathway was induced by IL-1β in chondrocytes, which was finally inhibited by CM-IPFSCs treatment. Conclusion: In summary, IPFSCs-CM may have therapeutic potential for OA.
Association between Bilateral Vertebral Artery Blood Flow Changes and Posterior Circulation Infarction in Patients with Severe Intracranial Stenosis
Authors: Yuan Xiaofeng , Yan Yanhong , Zhang Yan , Cai Xinyi , Hui Pinjing
Published: August 2024

Introduction: The objective of this study was to explore the association between net vertebral artery flow volume (NVAFV), calculated through color duplex ultrasonography, and posterior circulation infarction (PCI) in patients with severe intracranial vertebral artery (VA) stenosis. Methods: 234 patients with severe intracranial VA stenosis (≥70%) were categorized into the PCI group (n = 139) and the non-PCI group (n = 95) based on cranial MRI diagnosis. The correlation between NVAFV and CT perfusion data was analyzed, and the occurrence of PCI under diverse PCI mechanisms was also investigated. Multifactorial logistic regression and stratified analysis was performed to analyze the association between NVAFV and PCI. Lastly, generalized additive models and smooth curve fitting was utilized to outline relationship between NVAFV and PCI. Results: NVAFV showed a significant correlation with cerebral blood flow, mean transmit time, and time to peak. In the large artery atherosclerosis mechanism, a reduction in NVAFV correlated with a gradual rise in PCI cases (p = 0.002), while this trend lacked significance in the branch artery occlusive disease mechanism (p = 0.993). In the fully adjusted model, each 10 mL/min increase in NVAFV reduced PCI incidence by 11% (OR 0.890, 95% CI 0.840–0.943, p < 0.001), Sensitivity analysis showed similar results; NVAFV presented different PCI risks among various glucose level subgroups, the OR (95% CI) for PCI was 0.788 (0.684, 0.906) in low-glucose group (T1), 0.968 (0.878, 1.066) in moderate-glucose group (T2), and 0.886 (0.801, 0.979) in high-glucose group (T3). Smooth curve fitting demonstrated a linear negative association between NVAFV and PCI. Conclusion: NVAFV demonstrated an association with PCI in patients with severe intracranial VA stenosis, it can serve as a reference for identifying high-risk populations of PCI; however, it must be considered in combination with glucose.
Clinical and Multimodal Imaging Study to Differentiate Amelanotic Choroidal Lesions
Authors: Desai Arjun , Sahoo Niroj , Tyagi Mudit , Raval Vishal
Published: August 2024

Introduction: The aim of this study was to differentiate amelanotic choroidal lesions – amelanotic choroidal melanoma, choroidal metastasis, and choroidal granuloma using multimodal imaging. Methods: Retrospective comparative chart review was done. Patients diagnosed with the abovementioned choroidal lesions from 2015 to 2022 were included. Baseline lesion morphology and retinal layer changes on optical coherence tomography (OCT), lesion echogenicity and dimensions on ocular ultrasonography (USG), fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), and indocyanine green angiography (ICG-A) patterns and findings were assessed. Results: Twelve eyes with melanoma, 22 eyes with metastasis, and 9 eyes with granuloma were included. On OCT, 83% of melanomas and 67% of granulomas, and 68% of metastasis had dome-shaped choroidal lesions. Presence of intraretinal fluid (IRF) and shaggy photoreceptors was 94% (95% CI: 79–99%) and 90% (95% CI: 74–98%) specific to differentiate melanomas from other choroidal lesions (AUC >0.75, p < 0.05). Similarly, presence of incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA) was 77% (95% CI: 55–92%) sensitive and 77% (95% CI: 53–92%) specific (AUC = 0.8, p+ 0.03) and presence of lumpy-bumpy choroid was 55% (95% CI: 32–76%) sensitive and 95% (95% CI: 76–99%) specific (AUC = 0.75, p = 0.04) to distinguish metastasis from other choroidal lesions. Mean height: base ratio was more in melanoma compared to metastasis (0.54 ± 0.22 vs. 0.43 ± 0.12, p = 0.17) and both were hyperechoic on USG. On FAF, 100% metastasis and 60% granulomas were hypoAF, whereas 100% melanomas were hypoAF. Majority choroidal lesions were hyperfluorescent on FFA. Double vascular circulation was observed in melanomas (50%). On ICG-A, all choroidal lesions were hypofluorescent. Conclusion: Clinical and multimodal imaging features such as the presence of IRF, shaggy photoreceptors, iRORA, and lumpy-bumpy choroid can help diagnose and differentiate amelanotic choroidal lesions, thereby avoiding the need for choroidal biopsy. Further larger studies are needed to devise a standard imaging protocol to validate our findings.
Neurosurgical Management of Rubinstein-Taybi Syndrome: An Institutional Experience
Authors: Shanahan Regan M. , Hudson Joseph S. , Piazza Martin G. , Kehinde Faith , Anand Sharath Kumar , Ortiz Damara , Madan-Khetarpal Suneeta , Greene Stephanie
Published: August 2024

Introduction: Rubinstein-Taybi syndrome (RTS) is a rare genetic condition with a distinctive set of physical features. This case series reports a single institutional experience of RTS cases, highlighting the role of neurosurgery in the comprehensive management of RTS patients. Methods: A retrospective review of patients with genetically confirmed RTS presenting between 2010 and 2023 at Children’s Hospital of Pittsburgh was performed. Patient demographics, genetic profile, clinical symptoms, radiographic characteristics, and neurosurgical management were recorded for all patients. Results: Twenty-one patients (13 females, 8 males) aged 0 to 22 years presented for formal genetic counseling and diagnosis. Twenty patients (95%) had CREBBP pathogenic variants (RTS type 1), and 1 patient (5%) had EP300 pathogenic variants (RTS type 2). Ten patients (48%) had a low-lying conus medullaris, and 3 patients (30%) underwent subsequent spinal cord detethering. Four patients (19%) had a Chiari malformation, and three (75%) underwent Chiari decompression surgeries. One patient (5%) had Chiari-associated syringomyelia. Conclusions: RTS patients have an increased rate of tethered cord syndrome requiring detethering. The incidence of symptomatic Chiari I malformation requiring decompression has not been previously reported. The RTS series presented here demonstrates a high incidence of symptomatic Chiari I malformation in addition to tethered cord syndrome.
The Effect of Postoperative Analgesia on the Day-Case Rate of Laparoscopic Cholecystectomy: A Randomised Pilot Study of the Laparoscopic-Assisted Right Subcostal Transversus Abdominis Plane Block plus Local Anaesthetic Wound Infiltration versus Local Anaesthetic Wound Infiltration only
Authors: Di Mauro Davide , Reece-Smith Alex , Njere Ikechukwu , Hubble Sheena , Manzelli Antonio
Published: August 2024

Objective: The transversus abdominis plane (TAP) block and local anaesthetic infiltration (LAI) of port sites provide adequate analgesia after laparoscopic cholecystectomy (LC). Little is known if the two techniques affect the day-case (DC) rate of LC. We tested the appropriateness of the research design in view of a larger randomised controlled trial (RCT) – laparoscopic-assisted right subcostal TAP block plus local anaesthetic wound infiltration (STALA) versus LAI. Subjects and Methods: Sixty patients having DC LC were randomised into STALA and LAI. Participants received bupivacaine 0.5% 30 mL. Pain scores were evaluated with the Visual Analogue Scale (VAS) score, at 1 h post-surgery and at discharge. Need of postoperative intravenous (IV) opioids, DC rate, and Quality of Recovery-15 questionnaires were compared between groups and were considered as measures of efficacy of the interventions and follow-up in a definitive trial. Results: Twenty-nine participants were randomised to STALA, and 31 to LAI. Subjects in LAI group were all women (p = 0.0007) and younger (43.8 vs. 37.7 years, p = 0.023). Median VAS scores were 0 versus 1 at 1 h (p = 0.60), 0 versus 1.5 at discharge (p = 0.55). The need of IV opioids was 15/29 (51.7%) versus 13/31 (41.9%; p = 0.60). The DC rate was 93.1% versus 93.5% (p = 0.39). Fifty (83.3%) participants responded the questionnaires. Conclusions: The laparoscopically guided right subcostal TAP block provided no additional benefit to LAI on pain control after LC and DC rate. Despite the appropriate design, our findings do not support a larger RCT.
Multiphasic Acute Disseminated Encephalomyelitis with a Temporal Gap of 26 Years: A Case Report with Novel Presentation
Authors: Asif Muhammad Hamza , Butt Armeen , Riaz Khadija , Shahzad Faizan , Asif Maimoonah , Farhan Muhammad , Ahmed Waqas , Shami Besher
Published: August 2024

Introduction: Acute disseminated encephalomyelitis (ADEM) is an acute autoimmune demyelinating disease of the central nervous system that typically follows an acute viral infection or post-vaccination. It is more common in children than in adults and is characterized by widespread demyelination of the white matter of the brain and spinal cord. ADEM typically presents as a monophasic illness. Multiphasic ADEM has been an emerging topic with case reports highlighting the importance of the need for further investigation and literature on this topic. Multiphasic ADEM in adults is a rare presentation with an atypical course that can cause a delay in diagnosis leading to disability in patients. Case Presentation: Multiple case reports have shown the presence of multiphasic ADEM without an established cause, emphasizing the importance of additional insight and data in this context. This is a unique case of multiphasic ADEM in a 59-year-old male with a temporal gap of 26 years with an idiopathic cause. He was suffering from many neurologic symptoms involving his upper and lower extremities and level of consciousness, and after he was diagnosed with ADEM, he was commenced on steroids and achieved a marked improvement in his clinical status. Conclusion: Rarely, ADEM can present with recurrence or multiple phases, which requires prompt diagnosis and treatment. These phases may or may not be preceded by an identifiable trigger. Most patients respond well to steroids. However, further studies are required to achieve a good understanding and guidelines when dealing with such cases.
Hypertension Severity as Quantified by Hypertension Daily Dose and Blood Pressure With Risk of Stroke in REGARDS
Authors: Loo Ying K. , Wilkinson Katherine , Harkness Tyler , Howard George , Howard Virginia J. , Judd Suzanne E. , Zakai Neil A. , Muntner Paul , Min Lillian , Oparil Suzanne , Plante Timothy B.
Published: August 2024

Background

It is unknown how blood pressure (BP) relates to stroke risk across levels of hypertension daily dose (HDD)‐quantified antihypertensive medication intensity.

Methods and Results

The REGARDS (Reasons for Geographic and Racial Differences in Stroke) study enrolled 30 239 participants from the 48 contiguous US states in 2003 to 2007 with in‐person follow‐up in 2013 to 2016 (Visit 2). We included those without prior stroke at Visit 2, treating this visit as T
0
. Biannual phone calls and medical record review ascertained incident stroke events. Cox proportional hazard models estimated the hazard ratio (HR) of incident stroke by treatment intensity defined by systolic BP stages and HDD groupings. There were 344 stroke events over a median 5.5 years. Relative to systolic BP <120 mm Hg and no antihypertensive medications, the stroke HR was 2.86 (95% CI, 1.68–4.85) for systolic BP 140 to 159 mm Hg and HDD tertile 2, 2.33 (1.37–3.97) for systolic BP 140 to 159 mm Hg and HDD tertile 3, 3.08 (1.20–7.88) for systolic BP ≥160 mm Hg and HDD tertile 2, and 3.66 (1.61–8.30) for systolic BP ≥160 mm Hg and HDD tertile 3. Stroke risk was similar across HDD levels for people with systolic BP <140 mm Hg.

Conclusions

Among adults without prior stroke, systolic BP ≥140 mm Hg and HDD tertile ≥2 was associated with greater stroke risk. For adults with BP <140 mm Hg, stroke risk was similar despite cumulative dose of antihypertensive medications used. These findings support the practice of BP‐lowering medications to mitigate stroke risk.
Hypertension Prevalence, Treatment, and Control 90 Days After Acute Stroke Among Mexican American and Non‐Hispanic White Adults
Authors: Springer Mellanie V. , Levine Deborah A. , Han Dehua , Lisabeth Lynda D. , Morgenstern Lewis B. , Brook Robert D. , Brown Devin L. , Zahuranec Darin B. , Meurer William J. , Case Erin , Whitney Rachael
Published: August 2024

Background

High blood pressure (BP) increases recurrent stroke risk.

Methods and Results

We assessed hypertension prevalence, treatment, control, medication adherence, and predictors of uncontrolled BP 90 days after ischemic or hemorrhagic stroke among 561 Mexican American and non‐Hispanic White (NHW) survivors of stroke from the BASIC (Brain Attack Surveillance in Corpus Christi) cohort from 2011 to 2014. Uncontrolled BP was defined as average BP ≥140/90 mm Hg at 90 days poststroke. Hypertension was uncontrolled BP or antihypertensive medication prescribed or hypertension history. Treatment was antihypertensive use. Adherence was missing zero antihypertensive doses per week. We investigated predictors of uncontrolled BP using logistic regression adjusting for patient factors. Median (interquartile range) age was 68 (59–78) years, 64% were Mexican American, and 90% of strokes were ischemic. Overall, 94.3% of survivors of stroke had hypertension (95.6% Mexican American versus 92.0% non‐Hispanic White;
P
=0.09). Of these, 87.9% were treated (87.3% Mexican American versus 89.1% non‐Hispanic White;
P
=0.54). Among the total population, 38.3% (95% CI, 34.4%–42.4%) had uncontrolled BP. Among those with uncontrolled BP prescribed an antihypertensive, 84.5% reported treatment adherence (95% CI, 78.8%–89.3%). Uncontrolled BP 90 days poststroke was less likely in patients with stroke who had a primary care physician (adjusted odds ratio [aOR], 0.45 [95% CI, 0.24–0.83];
P
=0.01), greater stroke severity (aOR per‐1‐point‐higher National Institutes of Health Stroke Scale score, 0.96 [95% CI, 0.93–0.99];
P
=0.02), or more depressive symptoms (aOR per‐1‐point‐higher Personal Health Questionnaire Depression Scale‐8 score, 0.95 [95% CI, 0.92–0.99] among those with a history of hypertension at baseline;
P
=0.009).

Conclusions

Greater than one third of survivors of stroke have uncontrolled BP at 90 days poststroke in this population‐based study. Interventions are needed to improve BP control after stroke.
Exercise‐Induced Cardiac Troponin I Elevation Is Associated With Regional Alterations in Left Ventricular Strain in High‐Troponin Responders
Authors: Erevik Christine Bjørkvik , Kleiven Øyunn , Frøysa Vidar , Bjørkavoll‐Bergseth Magnus , Chivulescu Monica , Klæboe Lars Gunnar , Dejgaard Lars , Auestad Bjørn , Skadberg Øyvind , Melberg Tor , Urheim Stig , Haugaa Kristina , Edvardsen Thor , Ørn Stein
Published: August 2024

Background

The implications of exercise‐induced cardiac troponin elevation in healthy individuals are unclear. This study aimed to determine if individuals with a high exercise‐induced cardiac troponin I (cTnI) response have alterations in myocardial function following high‐intensity endurance exercise compared with normal‐cTnI responders.

Methods and Results

Study individuals were recruited from previous participants in a 91‐km mountain bike cycling race (the North Sea Race) and were classified as high‐ (n=34) or normal‐cTnI responders (n=25) based on maximal cTnI values after the recruitment race. The present study exposed all participants to 2 prolonged high‐intensity exercises: a combined lactate threshold and cardiopulmonary exercise test and repeated participation in the North Sea Race. Echocardiography was performed before, immediately after, and 24 hours following exercise. All study individuals (n=59) had normal coronary arteries, and were aged 51±10 years; 46 (74%) were men. There were no differences in baseline characteristics between the high‐ and normal‐cTnI responders. Maximal cTnI levels 3 hours after exercise were significantly higher in the high‐ compared with normal‐cTnI group (
P
<0.001–0.027). Following exercise, there were no differences in global ventricular function between the 2 groups. In contrast, high‐cTnI responders had significantly lower regional strain in the anteroseptal segments following exercise, with more profound changes after the race.

Conclusions

High‐cTnI responders had lower anteroseptal segmental strain shortly after exercise than normal‐cTnI responders. However, there were no permanent alterations in myocardial strain, indicating no short‐ or long‐term adverse consequences of these exercise‐induced alterations in myocardial function.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02166216.
Physical Activity Modifies the Risk of Incident Cardiac Conduction Disorders Upon Inflammation: A Population‐Based Cohort Study
Authors: Zhao Haiyan , Li Man , Wu Dan , Chen Shuohua , Zhu Chenrui , Lan Yulong , Liu Hongmin , Wu Yuntao , Wu Shouling
Published: August 2024

Background

Emerging evidence suggests a central role for inflammation in cardiac conduction disorder (CCD). It is unknown whether habitual physical activity could modulate the inflammation‐associated risks of incident CCD in the general population.

Methods and Results

This population‐based cohort was derived from the China Kailuan study, including a total of 97 192 participants without prior CCD. The end points included incident CCD and its subcategories (atrioventricular block and bundle‐branch block). Systemic inflammation was indicated by the monocyte‐to‐lymphocyte ratio (MLR). Over a median 10.91‐year follow‐up, 3747 cases of CCD occurred, with 1062 cases of atrioventricular block and 2697 cases of bundle‐branch block. An overall linear dose‐dependent relationship was observed between MLR and each study end point (all
P
‐nonlinearity≥0.05). Both higher MLR and physical inactivity were significantly associated with higher risks of conduction block. The MLR‐associated risks of developing study end points were higher in the physically inactive individuals than in those being physically active, with significant interactions between MLR levels and physical activity for developing CCD (
P
‐interaction=0.07) and bundle‐branch block (
P
‐interaction<0.05) found. Compared with those in MLR quartile 2 and being physically active, those in the highest MLR quartile and being physically inactive had significantly higher risks for all study end points (1.42 [95% CI, 1.24–1.63], 1.62 [95% CI, 1.25–2.10], and 1.33 [95% CI, 1.13–1.56], respectively, for incident CCD, atrioventricular block, and bundle‐branch block).

Conclusions

MLR should be a biomarker for the risk assessment of incident CCD. Adherence to habitual physical activity is favorable for reducing the MLR‐associated risks of CCD.
Ultrafast Cooling With Total Liquid Ventilation Mitigates Early Inflammatory Response and Offers Neuroprotection in a Porcine Model of Cardiac Arrest
Authors: Abi Zeid Daou Yara , Watanabe Naoto , Lidouren Fanny , Bois Antoine , Faucher Estelle , Huet Hélène , Hutin Alice , Jendoubi Ali , Surenaud Mathieu , Hue Sophie , Nadeau Mathieu , Perrotto Sandrine , Libardi Mickaël , Ghaleh Bijan , Micheau Philippe , Bruneval Patrick , Cariou Alain , Kohlhauer Matthias , Tissier Renaud
Published: August 2024

Background

Brain injury is one of the most serious complications after cardiac arrest (CA). To prevent this phenomenon, rapid cooling with total liquid ventilation (TLV) has been proposed in small animal models of CA (rabbits and piglets). Here, we aimed to determine whether hypothermic TLV can also offer neuroprotection and mitigate cerebral inflammatory response in large animals.

Methods and Results

Anesthetized pigs were subjected to 14 minutes of ventricular fibrillation followed by cardiopulmonary resuscitation. After return of spontaneous circulation, animals were randomly subjected to normothermia (control group, n=8) or ultrafast cooling with TLV (TLV group, n=8). In the latter group, TLV was initiated within a window of 15 minutes after return of spontaneous circulation and allowed to reduce tympanic, esophageal, and bladder temperature to the 32 to 34 °C range within 30 minutes. After 45 minutes of TLV, gas ventilation was resumed, and hypothermia was maintained externally until 3 hours after CA, before rewarming using heat pads (0.5 °C–1 °C/h). After an additional period of progressive rewarming for 3 hours, animals were euthanized for brain withdrawal and histological analysis. At the end of the follow‐up (ie, 6 hours after CA), histology showed reduced brain injury as witnessed by the reduced number of Fluroro‐Jade C‐positive cerebral degenerating neurons in TLV versus control. IL (interleukin)‐1ra and IL‐8 levels were also significantly reduced in the cerebrospinal fluid in TLV versus control along with cerebral infiltration by CD3+ cells. Conversely, circulating levels of cytokines were not different among groups, suggesting a discrepancy between local and systemic inflammatory levels.

Conclusions

Ultrafast cooling with TLV mitigates neuroinflammation and attenuates acute brain lesions in the early phase following resuscitation in large animals subjected to CA.
Eye-Movement Suppression in the Visual World Paradigm
Authors: Laurinavichyute Anna , Ziubanova Anastasia , Lopukhina Anastasiya
Published: August 2024

Eye movements in the visual world paradigm are known to depend not only on linguistic input but on such factors as task, pragmatic context, affordances, etc. However, the degree to which eye movements may depend on task rather than on linguistic input is unclear. The present study for the first time tests how task constraints modulate eye movement behavior in the visual world paradigm by probing whether participants could refrain from looking at the referred image. Across two experiments with and without comprehension questions (total N = 159), we found that when participants were instructed to avoid looking at the referred images, the probability of fixating these reduced from 58% to 18% while comprehension scores remained high. Although language-mediated eye movements could not be suppressed fully, the degree of possible decoupling of eye movements from language processing suggests that participants can withdraw at least some looks from the referred images when needed. If they do so to different degrees in different experimental conditions, comparisons between conditions might be compromised. We discuss some cases where participants could adopt different viewing behaviors depending on the experimental condition, and provide some tentative ways to test for such differences.
Gigantochloa lako (Poaceae, Bambusoideae), a new combination for a horticulturally important bamboo species from Southeast Asia
Authors: CAI ZHUO-YU , WIDJAJA ELIZABETH ANITA , XIA NIAN-HE , WONG KHOON MENG
Published: August 2024

Bambusa lako, known in horticulture as Timor black bamboo, described without flowering material initially, is a common ornamental bamboo in Southeast Asia because of its moderate size and purplish-black culms when matured. During specimen examination at the Herbarium of the Singapore Botanic Gardens, a flowering collection of B. lako came to our attention. After careful dissection and comparison, we found that the reproductive characters resembled the genus Gigantochloa rather than Bambusa, such as short rachilla segments that do not disarticulate, terminal vestigial florets and filament tubes. Therefore, the floral features were supplemented and a new combination Gigantochloa lako was proposed.
The identity of Luperus metallicus Jacoby, 1894 (Coleoptera: Chrysomelidae: Galerucinae)
Authors: BEZDĚK JAN
Published: August 2024

Luperus metallicus Jacoby, 1894, known from the Indonesian islands Bali, Sumbawa, Adonara and Timor, is redescribed and transferred to the genus Charaea Baly, 1878. Color photos of the habitus, body details, and drawings of the genitalia are presented.
An illustrated and annotated catalogue of type specimens of Gelechiidae (Lepidoptera) in the Royal Museum for Central Africa (Tervuren, Belgium), with taxonomic changes
Authors: BIDZILYA OLEKSIY V. , RAJAEI HOSSEIN
Published: August 2024

Type specimens of 24 species of Gelechiidae described by E. Meyrick and J. Ghesquière deposited in the Royal Museum for Central Africa are discussed. Adult specimens and genitalia of type specimens are illustrated. Genitalia structures are described for most species. The taxonomic position of each species is reviewed, and the following new combinations are proposed: Stomopteryx achyrobathra (Meyrick, 1933), comb. nov., transferred from Aristotelia; Brachmia cirrhopa (Meyrick, 1938), comb. nov., transferred from Proteodoxa; Helcystogramma leucopla (Meyrick, 1938), comb. nov. and Helcystogramma neuroplecta (Meyrick, 1938), comb. nov., transferred from Brachmia; Helcystogramma synclepta (Meyrick, 1938), comb. nov., transferred from Metaplatyntis; Dichomeris craspedotis (Meyrick, 1937), comb. nov., transferred from Trichotaphe; Dichomeris leontovitchi (Ghesquière, 1940), comb. nov., transferred from Cymotricha; Dichomeris pammiges (Ghesquière, 1940), comb. nov., transferred from Gaesa; Dichomeris symbolistis (Meyrick, 1938), comb. nov., transferred from Adoxotricha; Dichomeris opalina (Ghesquière, 1940), comb. nov., transferred from Prasodryas; Dichomeris phaeothina (Ghesquière, 1940), comb. nov., transferred from Trichotaphe; Leuronoma allomima (Meyrick, 1938), comb. nov., transferred from Gelechia; Photodotis modulatrix (Meyrick, 1938), comb. nov., transferred from Aristotelia. Six new synonyms on the generic and the species level are established: Proteodoxa Meyrick, 1938, syn. nov. of Brachmia Hübner, 1825; Metaplatyntis Meyrick, 1938, syn. nov. of Helcystogramma Zeller, 1877; Adoxotricha Meyrick, 1938, syn. nov. of Dichomeris Hübner, 1818; Gelechia ochrocorys Meyrick, 1936, syn. nov. of Armatophallus exoenota (Meyrick, 1918); Phthorimaea tristrigata Meyrick, 1938, syn. nov. of Scrobipalpa ergasima (Meyrick, 1916); Brachmia leucospora Meyrick, 1938, syn. nov. of Scrobipalpa subroseata (Meyrick, 1932). Lectotypes are designated for Proteodoxa cirrhopa Meyrick, 1938 and Epithectis phaeomicta Meyrick, 1936. The latter species is excluded from Epithectis Meyrick, 1895 but no current genus is available. The monotypic genus Paltoloma Ghesquière, 1940 (type species P. paleata Ghesquière, 1940) is removed from the family Gelechiidae, transferred to the family Lecithoceridae and provisionally placed near Notioseus Park, 2018.
Descriptions of three new species of Lycaenidae (Lepidoptera: Papilionoidea) from Parc National de Nouabalé-Ndoki, Republic of Congo with additional notes on little-known species
Authors: TAKANO HITOSHI
Published: August 2024

Three new species of Lycaenidae, Falcuna nouabaleensis sp. nov., Anthene sangha sp. nov. and Neurellipes smithi sp. nov. are described from material collected during recent African Natural History Research Trust expeditions to Parc National de Nouabalé-Ndoki in northern Republic of Congo. Several other interesting taxa were also sampled including the unknown male of Ornipholidotos ghesquierei Libert, 2005 and a short series of unidentified female Pilodeudorix Druce, 1891 specimens near P. catori (Bethune-Baker, 1903) which are all illustrated. The distribution of species in this area of Central Africa is discussed in relation to the biogeography of the interfluvial region between the Sangha and Congo Rivers.