bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced gastric cancer classification and quantification interpretable framework using digital histopathology images
Authors: Zubair Muhammad , Owais Muhammad , Mahmood Tahir , Iqbal Saeed , Usman Syed Muhammad , Hussain Irfan
Published: September 2024

Recent developments have highlighted the critical role that computer-aided diagnosis (CAD) systems play in analyzing whole-slide digital histopathology images for detecting gastric cancer (GC). We present a novel framework for gastric histology classification and segmentation (GHCS) that offers modest yet meaningful improvements over existing CAD models for GC classification and segmentation. Our methodology achieves marginal improvements over conventional deep learning (DL) and machine learning (ML) models by adaptively focusing on pertinent characteristics of images. This contributes significantly to our study, highlighting that the proposed model, which performs well on normalized images, is robust in certain respects, particularly in handling variability and generalizing to different datasets. We anticipate that this robustness will lead to better results across various datasets. An expectation-maximizing Naïve Bayes classifier that uses an updated Gaussian Mixture Model is at the heart of the suggested GHCS framework. The effectiveness of our classifier is demonstrated by experimental validation on two publicly available datasets, which produced exceptional classification accuracies of 98.87% and 97.28% on validation sets and 98.47% and 97.31% on test sets. Our framework shows a slight but consistent improvement over previously existing techniques in gastric histopathology image classification tasks, as demonstrated by comparative analysis. This may be attributed to its ability to capture critical features of gastric histopathology images better. Furthermore, using an improved Fuzzy c-means method, our study produces good results in GC histopathology picture segmentation, outperforming state-of-the-art segmentation models with a Dice coefficient of 65.21% and a Jaccard index of 60.24%. The model’s interpretability is complemented by Grad-CAM visualizations, which help understand the decision-making process and increase the model’s trustworthiness for end-users, especially clinicians.
Variability of marine heatwaves’ characteristics and assessment of their potential drivers in the Baltic Sea over the last 42 years
Authors: Bashiri Behzad , Barzandeh Amirhossein , Männik Aarne , Raudsepp Urmas
Published: September 2024

This study examined Baltic Sea Marine Heatwaves (MHWs) using 42 years of satellite-derived sea surface temperature (SST) data. We found that MHWs in warmer months are more intense but shorter compared to MHWs in cooler months. Also, MHWs predominantly affect offshore areas in warmer months, whereas MHWs predominantly impacting coastal seas in cooler months, especially along the eastern coast. Our analysis of interannual variability revealed that, unlike in many other basins worldwide, Baltic MHWs tend to maintain a constant intensity, while their spatial extent has significantly increased over the last few decades. Shortwave radiation notably influences MHW intensity and spatial extent, with additional impacts from longwave radiation in cooler months and latent heat flux in warmer months. Northern Hemisphere teleconnections exhibit stronger correlations with MHWs in the Baltic Sea compared to global-scale climate oscillations, with the Eastern Atlantic pattern having a particularly significant effect on MHW variability in the region.
Evolution of a biological thermocouple by adaptation of cytochrome c oxidase in a subterrestrial metazoan, Halicephalobus mephisto
Authors: Guerin Megan N. , Ellis TreVaughn S. , Ware Mark J. , Manning Alexandra , Coley Ariana A. , Amini Ali , Igboanugo Adaeze G. , Rothrock Amaya P. , Chung George , Gunsalus Kristin C. , Bracht John R.
Published: September 2024

In this study, we report a biological temperature-sensing electrical regulator in the cytochrome c oxidase of the Devil Worm, Halicephalobus mephisto. This extremophile metazoan was isolated 1.3 km underground in a South African goldmine, where it adapted to heat and potentially to hypoxia, making its mitochondrial sequence a likely target of adaptational change. We obtained the complete mitochondrial genome sequence of this organism and show through dN/dS analysis evidence of positive selection in H. mephisto cytochrome c oxidase subunits. Seventeen of these positively selected amino acid substitutions were located in proximity to the H- and K-pathway proton channels of the complex. Surprisingly, the H. mephisto cytochrome c oxidase completely shuts down at low temperatures (20 °C), leading to a 4.8-fold reduction in the transmembrane proton gradient (ΔΨm) compared to optimal temperature (37 °C). Direct measurement of oxygen consumption found a corresponding 4.6-fold drop at 20 °C compared to 37 °C. Correspondingly, the lifecycle of H. mephisto takes four times longer at low temperature than at higher. This elegant evolutionary adaptation creates a finely-tuned mitochondrial temperature sensor, allowing this ectothermic organism to maximize its reproductive success across varying environmental temperatures.
Imaging genetics of language network functional connectivity reveals links with language-related abilities, dyslexia and handedness
Authors: Amelink Jitse S. , Postema Merel C. , Kong Xiang-Zhen , Schijven Dick , Carrión-Castillo Amaia , Soheili-Nezhad Sourena , Sha Zhiqiang , Molz Barbara , Joliot Marc , Fisher Simon E. , Francks Clyde
Published: September 2024

Language is supported by a distributed network of brain regions with a particular contribution from the left hemisphere. A multi-level understanding of this network requires studying its genetic architecture. We used resting-state imaging data from 29,681 participants (UK Biobank) to measure connectivity between 18 left-hemisphere regions involved in multimodal sentence-level processing, as well as their right-hemisphere homotopes, and interhemispheric connections. Multivariate genome-wide association analysis of this total network, based on genetic variants with population frequencies  >1%, identified 14 genomic loci, of which three were also associated with asymmetry of intrahemispheric connectivity. Polygenic dispositions to lower language-related abilities, dyslexia and left-handedness were associated with generally reduced leftward asymmetry of functional connectivity. Exome-wide association analysis based on rare, protein-altering variants (frequencies <1%) suggested 7 additional genes. These findings shed new light on genetic contributions to language network organization and related behavioural traits.
Cyclopamine modulates smoothened receptor activity in a binding position dependent manner
Authors: Kim Kihong , Bansal Prateek D. , Shukla Diwakar
Published: September 2024

Cyclopamine, a natural alkaloid, can act as an agonist when it binds to the Cysteine-Rich Domain (CRD) of Smoothened receptor and as an antagonist when it binds to the Transmembrane Domain (TMD). To study the effect of cyclopamine binding to each site experimentally, mutations in the other site are required. Hence, simulations are critical for understanding the WT activity due to binding at different sites. Using multi-milliseconds long aggregate MD simulations combined with Markov state models and machine learning, we explore the dynamic behavior of cyclopamine’s interactions with different domains of WT SMO. A higher population of the active state at equilibrium, a lower free energy barrier of ~2 kcal/mol, and expansion of hydrophobic tunnel to facilitate cholesterol transport agrees with cyclopamine’s agonistic behavior when bound to CRD. A higher population of the inactive state at equilibrium, a higher free energy barrier of ~4 kcal/mol and restricted hydrophobic tunnel shows cyclopamine’s antagonistic behavior when bound to TMD. With cyclopamine bound to both sites, there is a slightly larger inactive population at equilibrium and an increased free energy barrier (~3.5 kcal/mol) exhibiting an overall weak antagonistic effect. These findings show cyclopamine’s domain-specific modulation of SMO regulates Hedgehog signaling and cholesterol transport.
The chromatin landscape of high-grade serous ovarian cancer metastasis identifies regulatory drivers in post-chemotherapy residual tumour cells
Authors: Croft W. , Pounds R. , Jeevan D. , Singh K. , Balega J. , Sundar S. , Williams A. , Ganesan R. , Kehoe S. , Ott S. , Zuo J. , Yap J. , Moss P.
Published: September 2024

Disease recurrence following chemotherapy is a major clinical challenge in ovarian cancer (OC), but little is known regarding how the tumour epigenome regulates transcriptional programs underpinning chemoresistance. We determine the single cell chromatin accessibility landscape of omental OC metastasis from treatment-naïve and neoadjuvant chemotherapy-treated patients and define the chromatin accessibility profiles of epithelial, fibroblast, myeloid and lymphoid cells. Epithelial tumour cells display open chromatin regions enriched with motifs for the oncogenic transcription factors MEIS and PBX. Post chemotherapy microenvironments show profound tumour heterogeneity and selection for cells with accessible chromatin enriched for TP53, TP63, TWIST1 and resistance-pathway-activating transcription factor binding motifs. An OC chemoresistant tumour subpopulation known to be present prior to treatment, and characterised by stress-associated gene expression, is enriched post chemotherapy. Nuclear receptors RORa, NR2F6 and HNF4G are uncovered as candidate transcriptional drivers of these cells whilst closure of binding sites for E2F2 and E2F4 indicate post-treated tumour having low proliferative capacity. Delineation of the gene regulatory landscape of ovarian cancer cells surviving chemotherapy treatment therefore reveals potential core transcriptional regulators of chemoresistance, suggesting novel therapeutic targets for improving clinical outcome.
Human 8-oxoguanine glycosylase OGG1 binds nucleosome at the dsDNA ends and the super-helical locations
Authors: You Qinglong , Feng Xiang , Cai Yi , Baylin Stephen B. , Li Huilin
Published: September 2024

The human glycosylase OGG1 extrudes and excises the oxidized DNA base 8-oxoguanine (8-oxoG) to initiate base excision repair and plays important roles in many pathological conditions such as cancer, inflammation, and neurodegenerative diseases. Previous structural studies have used a truncated protein and short linear DNA, so it has been unclear how full-length OGG1 operates on longer DNA or on nucleosomes. Here we report cryo-EM structures of human OGG1 bound to a 35-bp long DNA containing an 8-oxoG within an unmethylated Cp-8-oxoG dinucleotide as well as to a nucleosome with an 8-oxoG at super-helical location (SHL)-5. The 8-oxoG in the linear DNA is flipped out by OGG1, consistent with previous crystallographic findings with a 15-bp DNA. OGG1 preferentially binds near dsDNA ends at the nucleosomal entry/exit sites. Such preference may underlie the enzyme’s function in DNA double-strand break repair. Unexpectedly, we find that OGG1 bends the nucleosomal entry DNA, flips an undamaged guanine, and binds to internal nucleosomal DNA sites such as SHL-5 and SHL+6. We suggest that the DNA base search mechanism by OGG1 may be chromatin context-dependent and that OGG1 may partner with chromatin remodelers to excise 8-oxoG at the nucleosomal internal sites.
Photon upconversion crystals doped bacterial cellulose composite films as recyclable photonic bioplastics
Authors: Bharmoria Pankaj , Naimovičius Lukas , Abol-Fotouh Deyaa , Miroshnichenko Mila , Lekavičius Justas , De Luca Gabriele , Saeed Umair , Kazlauskas Karolis , Candau Nicolas , Baronas Paulius , Roig Anna , Moth-Poulsen Kasper
Published: September 2024

Biopolymers currently utilized as substitutes for synthetic polymers in photonics applications are predominantly confined to linear optical color responses. Herein we expand their applications in non-linear optics by integrating with triplet-triplet annihilation photon upconversion crystals. A photon upconverting biomaterial is prepared by cultivating Pd(II) meso-tetraphenyl tetrabenzoporphine: 9,10-diphenyl anthracene (sensitizer: annihilator) crystals on bacterial cellulose hydrogel that serves both as host and template for the crystallization of photon upconversion chromophores. Coating with gelatin improves the material’s optical transparency by adjusting the refractive indices. The prepared material shows an upconversion of 633 nm red light to 443 nm blue light, indicated by quadratic to linear dependence on excitation power density (non-linearly). Notably, components of this material are physically dis-assembled to retrieve 66 ± 1% of annihilator, at the end of life. Whereas, the residual clean biomass is subjected to biodegradation, showcasing the sustainability of the developed photonics material.
Synergistic effects of Fe and Ag doping on the structural and optical properties of a TiO2 thin film: a dual function platform for hydrogen generation and dye degradation
Authors: Khedulkar Akhil Pradiprao , Bolloju S. , Pradhan L. K. , Pandit Bidhan , Nakate Umesh T. , Mahato S. S. , Mahata S.
Published: September 2024

The global population is increasing at an alarming pace, leading to a rapid surge in industrialization and concomitant environmental degradation.
Thiolate-mediated photoreduction and aerobic oxidation cycles in a bismuth–bismuth oxide nanosystem towards thiol-to-disulfide photocatalytic transformation
Authors: Wang Tingting , Yu Nan , Liu Xianglong , Lu Zhiwei , Yang Guowei , Wang Junli
Published: September 2024

Bi–Bi2O3 photoredox cycles, which run via UV-blue light-sensitive bismuth(iii) thiolates (Bi(SR)3) and dissolved reactive oxygen, play a catalytic role in the net thiol-to-disulfide production.
Dopamine-integrated all-hydrogel multi-electrode arrays for neural activity recording
Authors: Zeng Mingze , Ding Jie , Tian Yuan , Zhang Yusheng , Liu Xiaoyin , Chen Zhihong , Sun Jing , Wu Chengheng , Yin Huabing , Wei Dan , Fan Hongsong
Published: September 2024

A four-layer all-hydrogel neural electrode, utilizing dual-strategy for PEDOT:PSS phase separation and polyphenol chemistry for interlayer adhesion, captures ECoG in epileptic rats, demonstrating its potential for advanced neuroscience applications.
A bifunctional [Ch][Triz] ionic liquid catalyst for CO2 transformation into quinazoline-2,4(1H,3H)-diones under mild conditions
Authors: Gao Xiang , Zhao Jiajia , Liu Jiao , Deng Yuehua , Gao Ying , Wang Fei , Li Yanrui
Published: September 2024

[Ch][Triz] IL was effective for catalyzing the synthesis of quinazoline-2,4(1H,3H)-diones via cyclization of CO2 and 2-aminobenzonitriles under mild conditions (0.1 MPa, 30–50 °C), and a series of products were obtained in high yields.
Exploration of structural influences on the ferroelectric switching characteristics of ferroelectric thin-film transistors
Authors: Yang Hyojin , Park Sejun , Yun Sanghyuk , Kim Haesung , Lee Haneul , Park Min-Kyu , Choi Sung-Jin , Kim Dae Hwan , Kim Dong Myong , Kwon Dongseok , Bae Jong-Ho
Published: September 2024

An HZO/IGZO FeFET has been comprehensively analyzed using capacitor test element groups, which showed that the contact region determines the memory window and exhibits an oxygen vacancy-related imprint near the bottom gate and charge trapping.
Significant adsorption enhancements driven by pore microenvironment tuning for efficient C2H2/C2H4 separation in a chemically stable Ni7-cluster-based framework
Authors: Wang Yunli , Zhang Rizhao , Xue Jin-Peng , Chai Yuqiao , Li Bao , Li Jia
Published: September 2024

This study presents a stable Ni7-cluster MOF with enhanced adsorption through pore microenvironment tuning. Two types of guest-free frameworks achieve C2H2/C2H4 separation, providing deep insights into separation mechanisms.
BCl3 catalyzed Z-selective intramolecular chlorocarbamoylation of alkynes/allenes
Authors: Yang Zhantao , Chen Linlin , Zhao Yuhang , Chen Qianhui , Zhao Wanjun , Li Linfei , Zhang Boxuan , Xie Hua , Kong Xiangtao , Yang Chun-Hua
Published: September 2024

A metal-free chlorocarbamoylation of alkynes/allenes catalyzed by BCl3 was described.
Graphene-sustained bipolar covalent organic framework for symmetric supercapacitors and capacitive deionization systems with superior performance
Authors: Xu Liming , Liu Yong , Li Yuquan , Xuan Xiaoyang , Xu Xingtao , Gong Zhiwei , Pan Likun
Published: September 2024

DQHBA-COF with bipolar redox-active centers was grown in situ on the conductive graphene surface, endowing symmetric supercapacitors and capacitive deionization systems with a high ion storage capacity and excellent cycling durability.
Photocaging of amino acids and short peptides by arylidenethiazoles: mechanism, photochemical characteristics and biological behaviour
Authors: Gagarin Aleksey A. , Minin Artem S. , Shevyrin Vadim A. , Benassi Enrico , Belskaya Nataliya P.
Published: September 2024

Novel biocompatible photocleavable protective groups for photocaging of amino acids and peptides have been synthesised. The mechanism of effective release of biomolecules has been studied in detail.
Application of a NADH-modified ZnO electron transport layer in high performance organic solar cells
Authors: Li Hongye , Yang Song , Yu Huangzhong
Published: September 2024

A novel ZnO:NADH composite electron transport layer is constructed, and the efficiency of organic solar cells (OSCs) with PM6:L8-BO as the active layer has improved from 17.43% to 18.21%.
An efficient multi‐probe enabled midfield over‐the‐air test method for 5G base station antenna pattern reconstruction
Authors: An Xudong , Wang Yiwen , Zhang Qinjuan , Wang Weimin , Liu Yuanan
Published: September 2024

With the accelerated deployment of 5G massive multi‐input multi‐output (MIMO)‐structured base stations (BSs), accurate and efficient testing of massive MIMO arrays is essential to ensure that the 5G massive MIMO antenna array can perform as expected. The increasing trend of both antenna element and array physical size makes massive MIMO antenna pattern measurement in the direct‐far‐field OTA environment unrealistic due to the signal attenuation, long measurement time, and ultra‐high test system construction cost. Therefore, the necessity of a compact, efficient, low‐complex, yet accurate OTA test method is evident, especially for 5G massive MIMO BS arrays. This paper proposes a novel multi‐probe‐enabled midfield (MF) OTA test method for 5G massive MIMO devices in compact measurement settings where antenna pattern measurement can be efficiently performed. The detailed theoretical analysis for the 5G massive MIMO array MF antenna pattern reconstruction method is presented, and the simulated validation results based on the typical 5G BS antenna arrays are provided and analysed, which demonstrate the effectiveness of the proposed MF OTA test method and can provide insights into the radio frequency parametric measurement for 5G massive MIMO devices.
Distributed flexible resource regulation strategy for residential communities based on deep reinforcement learning
Authors: Xu Tianyun , Chen Tao , Gao Ciwei , Song Meng , Wang Yishen , Yuan Hao
Published: September 2024

In an era characterized by the rapid proliferation of distributed flexible resources (DFRs), the development of customized energy management and regulation strategies has attracted significant interest from the field. The inherent geographical dispersion and unpredictability of these resources, however, pose substantial barriers to their effective and computationally tractable regulation. To address these impediments, this paper proposes a deep reinforcement learning‐based distributed resource energy management strategy, taking into account the inherent physical and structural constraints of the distribution network. This proposed strategy is modelled as a sequential decision‐making framework with a Markov decision process, informed by physical states and external information. In particular, targeting the community energy management system for critical public infrastructure and community holistic benefits maximization, the proposed approach proficiently adapts to fluctuations in resource variability and fluctuating market prices, ensuring intelligent regulation of distributed flexible resources. Simulation and empirical analysis demonstrate that the proposed deep reinforcement learning‐based strategy can improve the economic benefits and decision‐making efficiency of distributed flexible resource regulation while ensuring the security of distribution network power flow.
Recovering chemical bimodalities in observed edge-on stellar disks: Insights from AURIGA simulations
Authors: Pinna Francesca , Grand Robert J. J. , Martig Marie , Fragkoudi Francesca
Published: September 2024

The well-known bimodal distribution of Milky Way disk stars in the [α/Fe]–metallicity plane is often used to define thick and thin disks. In external edge-on galaxies, there have been attempts to identify this type of bimodality using integral field spectroscopy (IFS) data. However, for unresolved stellar populations, observations only contain integrated information, making these studies challenging. We assessed the ability to recover chemical bimodalities in IFS observations of edge-on galaxies, using 24 Milky Way-mass galaxies from the AURIGA zoom-in cosmological simulations. We first analyzed the distribution of single stellar particles in the [Mg/Fe]–[Fe/H] plane, finding that bimodality is frequent but not ubiquitous and often unclear. Then we produced mock IFS [Mg/Fe] and [Fe/H] maps of galaxies seen edge on, and considered integrated stellar-population properties (projected and spatially binned). We investigated how the distribution of stars in the [Mg/Fe]–[Fe/H] plane is affected by edge-on projection and spatial binning. Bimodality is preserved, while distributions change their shapes. Naturally, broad distributions of individual star particles are narrowed into smaller [Mg/Fe] and [Fe/H] ranges for spatial bins. We observe continuous distributions from high [Mg/Fe] and low [Fe/H], to lower [Mg/Fe] values and higher [Fe/H]. Despite being continuous, these distributions are bimodal in most cases. The overlap in [Fe/H] is small, and different [Mg/Fe] components show up as peaks instead of sequences (even when the latter are present for individual particles). The larger the spatial bins, the narrower the [Mg/Fe]–[Fe/H] distribution. This narrowing helps amplify the density of different [Mg/Fe] peaks, often leading to a clearer bimodality in mock IFS observations than for original star particles. We also assessed the correspondence of chemical bimodalities with the distinction between geometric thick and thin disks. Their individual particles have different distributions, but mostly overlap in [Mg/Fe] and [Fe/H]. However, integrated properties of geometric thick and thin disks in mock maps do mostly segregate into different regions of the [Mg/Fe]–[Fe/H] plane. In bimodal distributions, they correspond to the two distinct peaks. Our results show that this approach can be used for bimodality studies in future IFS observations of edge-on external galaxies.
Prävention orofazialer DysfunktionenOrale Entwicklung als
Chance
Authors: Furtenbach Mathilde
Published: September 2024

Prävention von myofunktionellen Störungen ist immer auch Prävention von Zahn- und
Kieferfehlstellungen. Die Erfahrungen in der logopädischen Praxis konnten
zeigen, dass das Wissen über die vollständige orale Entwicklung allgemein eher
gering ist und vor allem der Einfluss des Umweltfaktors (Epigenetik) über die
Nahrungsaufnahme und den Modus des Atmens kaum thematisiert wird. Eltern würden
manches anders machen, „wenn sie es früher gewusst hätten“.

Die häufigsten Dysfunktionen, die in der logopädischen Praxis beobachtet werden,
weisen auf Defizite und Störfaktoren in den beiden ersten Lebensjahren hin. Der
letzte Abschnitt ist den 7 Funktionen gewidmet, die für die orale Entwicklung
von Bedeutung sind. Wenn bedacht wird, dass ein großer Anteil von Dysgnathien
ätiologisch exogen hervorgerufen wird, und kaum ein Kind ein eugnathes Gebiss
hat, lohnt es sich, über neue Wege und Möglichkeiten der Prävention
nachzudenken.

Das motivierte mich, für Eltern und für alle möglichen Fachleute und für
Interessierte einen handlichen, reich bebilderten Ratgeber zusammenzustellen,
der die Bedeutung der oralen Funktionen Atmen, Saugen, Explorieren, Kauen,
Schlucken und Sprechen in den ersten Lebensjahren beschreibt [6]. Die 7 oralen
Funktionen stellen einen Leitfaden dar, der Information und Orientierung gibt.
Orale Entwicklung soll als Chance gesehen werden, die ergriffen werden kann.

Diese Idee könnte die Grundlage für einen ausbaufähigen Aufklärungsprozess sein,
der sich mit der Prävention von myofunktionellen Störungen und Zahn- und
Kieferfehlstellungen beschäftigt. Damit soll auch das Gespräch mit den Eltern,
unter den Fachdisziplinen und mit Personen, die mit kleinen Kindern arbeiten
oder leben, gefördert oder erleichtert werden.
Complete Clinical Orthodontics: Überblick über die
Behandlungsmechanik
Authors: Secchi Antonino G.
Published: September 2024

Die Behandlungsmechanik war für praktisch tätige Kieferorthopäden schon immer von
besonderem Interesse. Von Anfang an wurde nach den besten, schnellsten,
konsistenteren und einfachsten Möglichkeiten gesucht, Zahnfehlstellungen bei
Patienten zu korrigieren. Diese kontinuierliche Suche hat es ermöglicht, dass
neue Technologien, wenn auch manchmal langsam, in unserer täglichen Praxis
Eingang finden, bis sie schließlich zur Routine werden. Daher verändert sich
unsere Arbeitsweise immer wieder durch neue Materialien, Verbesserungen im
Gerätedesign und innovative Ideen und Technologien. Für den modernen
Kieferorthopäden ist es wichtig, über aktuelle Änderungen informiert zu sein, um
für sich das Beste auszuwählen.

In jüngere Zeit hat es bei festsitzenden kieferorthopädischen Apparaturen eine
interessante Vermischung von Technologien gegeben, die schon seit Jahrzehnten
existieren, wie beispielsweise die Straight-Wire-Technik (SWA) [1–4],
selbstligierende Brackets (SLB) [5] und wärmeaktivierte Drahtbögen mit geringer
Auslenkung. Diese Integration stellt meiner Meinung nach eine Verbesserung dar,
die bei richtiger Anwendung die kieferorthopädische Praxis erleichtern kann. Das
Hauptanliegen dieses Artikels ist es, die Konzepte der Behandlungsmechanik im
CCO-System vorzustellen. Ich werde einige wichtige Merkmale der interaktiven SLB
besprechen, die, kombiniert mit bestimmten Bögen und in einer bestimmten
Abfolge, dabei helfen können, unterschiedliche Arten von Fehlstellungen zu
korrigieren. In diesem Zusammenhang werden wichtige Merkmale der interaktiven
SLB, eine bestimmte Methode (CCO Rx), sowie die 3 Phasen der Behandlungsmechanik
besprochen. Außerdem werden Themen wie die Koordination der Zahnbögen, die
Nivellierung der Okklusionsebene und vertikale Probleme angesprochen.
Management of Therapeutic-intensity Unfractionated Heparin: A Narrative Review on Critical Points
Authors: Gouin-Thibault Isabelle , Mansour Alexandre , Hardy Michael , Guéret Pierre , de Maistre Emmanuel , Siguret Virginie , Cuker Adam , Mullier François , Lecompte Thomas
Published: September 2024

Nowadays, unfractionated heparin (UFH) use is limited to selected patient groups at high risk of both bleeding and thrombosis (patients in cardiac surgery, in intensive care unit, and patients with severe renal impairment), rendering its management extremely challenging, with many unresolved questions despite decades of use.

In this narrative review, we revisit the fundamental concepts of therapeutic anticoagulation with UFH and address five key points, summarizing controversies underlying the use of UFH and discussing the few recent advances in the field: (1) laboratory tests for UFH monitoring have significant limitations; (2) therapeutic ranges are not well grounded; (3) the actual influence of antithrombin levels on UFH's anticoagulant activity is not well established; (4) the concept of UFH resistance lacks supporting data; (5) scarce data are available on UFH use beyond acute venous thromboembolism.

We therefore identified key issues to be appropriately addressed in future clinical research: (1) while anti-Xa assays are often considered as the preferred option, we call for a vigorous action to improve understanding of the differences between types of anti-Xa assays and to solve the issue of the usefulness of added dextran; (2) therapeutic ranges for UFH, which were defined decades ago using reagents no longer available, have not been properly validated and need to be confirmed or reestablished; (3) UFH dose adjustment nomograms require full validation.
Inherited Variants in the COL11A, COL1A, COL5A1, COMP, GSTM1 Genes
and the Risk of Carpal Tunnel Syndrome
Authors: Zyluk Andrzej , Debniak Tadeusz , Flicinski Filip , Rudnicka Helena
Published: September 2024

The pathogenesis of most cases of carpal tunnel syndrome is not clearly defined.
There are some aspects of the disease that suggest a potential effect of genetic
predispositions. Mutations (variants) within the genes encoding various subtypes
of collagen synthesis, oligomerisation in the endoplasmic reticulum and
inactivation of reactive oxygen species may be involved in the development of
carpal tunnel syndrome. The objective of this study was to determine the role of
DNA alterations within the COL11A, COL1A, COL5A1, COMP and GSTM1 genes in the
pathogenesis of carpal tunnel syndrome based on a Polish population. Study
design. In the discovery phase, a total of 96 patients with familial aggregation
of CTS were genotyped using a Next Generation Sequencing panel in order to find
possible mutations within the studied genes. The potential pathogenicity of the
detected variants was investigated using the predictions of several in-silico
algorithms and the TaqMan technology. In the association phase of the study, a
group of 345 CTS patients and 1035 healthy controls were genotyped. Results. A
total of 35 splice-site or exonic non-synonymous variants were detected by NGS.
We did not identify any clearly pathogenic or likely pathogenic alternations.
The 30 variants were identified as benign or likely benign. Five missense
changes were predicted as VUS and selected for association study. The COL5A1
c.1595 C>T (p.Ala532Val) was detected in one out of 345 cases and three out
of 1035 controls (P=1, OR=1); this indicates that the variant is a neutral
alteration. Four remaining variants – c.2840 C>A, c.5395 G>A,
c.1331 C>G, c.1590 C>A – were present in none out of the 345 CTS patients
and none out of 1035 controls. Conclusion. The main finding of this study was
that there was no independent association between the variants of five examined
genes and carpal tunnel syndrome. Four uncertain variants were identified that
seem to be extremely rare in the Polish population.
Neonatal Outcomes at 2 Years following Expectant Management of Previable Premature Prelabor Rupture of Membranes at a Single Center
Authors: Cate Jennifer J.M. , Chu Allison , Lambert Katherine , Sugrue Ronan , Wheeler Sarahn , Grace Matthew R. , Adams William A. , Dotters-Katz Sarah
Published: September 2024

Previable premature prelabor rupture of membranes (pPPROM) can lead to significant maternal and neonatal morbidity and mortality. Limited literature exists describing long-term outcomes in neonates surviving pPPROM. Our study describes 2-year survival and outcomes after expectantly managed pPPROM at a single, tertiary, academic center. This is a retrospective review including individuals with pPPROM defined as membrane rupture before 240/7 weeks who were candidates and opted for expectant management at a single tertiary academic center between 2013 and 2022. Patients were included if they delivered after 22 weeks. Patients opting for termination, with contraindication to expectant management or who chose expectant management without planned neonatal resuscitation at birth were excluded. Electronic records of patients and associated neonates were reviewed for demographic information, PPROM management, and neonatal outcomes at 2 years including gastrointestinal, respiratory, cognitive, motor, and hearing or vision issues. Descriptive statistical analysis was performed. Of 111 pregnancies with pPPROM, 50(45%) pregnant individuals met inclusion criteria (46 singletons; 4 multiples [3 twins, 1 set of quads]). Of 46 singletons, 31 (67%) survived to 2 years with 1(3%) alive but less than 2 years. In 3/4 (75%) twin gestations, both twins survived to 2 years. A total of 3/4 (75%) quadruplets survived to 2 years. Most surviving infants (95.0%, n = 38) had at least one documented adverse outcome. A total of 55.0% (n = 22) of neonates had gross motor delay, and 77.5% (n = 31) had documented speech delay. Most had respiratory issues with reactive airway disease most common (22.5% n = 9). Gastrointestinal issues were common with gastrostomy tube in 32.5% (n = 13) and short gut syndrome in 15% (n = 6). Over half of neonates with expectantly managed pPPROM survived with high rates of adverse outcomes with over half with documented gross motor and speech delay present at 2 years. Respiratory and gastrointestinal issues were also common. These data provide information for important patient counseling on long-term outcomes in expectantly managed pPPROM.

Key Points
Messen und Trainieren therapeutischer Kompetenzen
Authors: Gumz Antje
Published: September 2024

Der Artikel gibt einen Überblick über unsere Forschungsansätze zu therapeutischen
Kompetenzen im Hinblick auf drei übergeordnete Fragestellungen. Die erste
Fragestellung befasst sich damit, wie ein kompetenter Umgang mit der Übertragung
und Gegenübertragung im Kontext von Alliance Ruptures gelingt. Diesbezügliche
Forschungen zum Allianzfokussierten Training sowie zur subjektiven
Gegenübertragung werden vorgestellt. Im Bereich der zweiten Fragestellung geht
es um allgemeine interpersonelle Kompetenzen von Therapeuten. Unsere hierzu
skizzierten Forschungsansätze betreffen das Konstrukt der interpersonellen
Fähigkeiten (Facilitative Interpersonal Skills, FIS) und das Messen dieser
Fähigkeiten mit der FIS-Übung. In diesem Themenbereich fokussieren wir auch
darauf, mit welchen Eigenschaften hohe interpersonelle Fähigkeiten einhergehen
und durch welche linguistischen und phonetischen Merkmale Therapeutenäußerungen
gekennzeichnet sind, die als interpersonell kompetent eingestuft werden. Zudem
untersuchen wir die Neigung von Therapeuten, ihre interpersonellen Fähigkeiten
zu überschätzen (Self-Assessment Bias). Die dritte Fragestellung betrifft die
therapeutische Kompetenz, Techniken anzuwenden und hilfreiche
Veränderungsprozesse entstehen zu lassen. Vorgestellt werden ein Instrument zum
Erfassen verbaler Techniken (Psychodynamische Interventionsliste) sowie unsere
Forschungsansätze, die auf das Beschreiben und Messen von Veränderungsprinzipien
(Mediators of change) fokussieren.
Solvent-Free Approaches for the Synthesis of Lophine Derivatives
Authors: Desai Shiv R. , Modha Sachin G.
Published: September 2024

Solvent-free synthesis comes with many advantages such as cost reduction, waste reduction, ease of operation, sustainability, environmentally benign operations, etc. These benefits have prompted many chemists to develop new protocols for solvent-free synthesis of various interesting chemical compounds. One such class of compounds is 2,4,5-triarylimidazoles, commonly known as lophines due to their applications in materials science, chemo- and bio-sensors, and pharmacology. This article focuses on solvent-free synthesis of lophine derivatives via different protocols, including the use of inorganic-, organic-, and biocatalysts; solid-supported catalysts; microwave-mediated heating; and grinding.
Strategies for the Total Synthesis of Fucoxanthin from a Commercial Perspective
Authors: Gupta Sayan Dutta , Pan Cheol-Ho
Published: September 2024

Fucoxanthin, the light-harvesting pigment of various algae, has shown promising biological activity in pre-clinical and clinical models. It has also received marketing approval as a nutraceutical and cosmetic ingredient in the USA and other countries. The commercial synthesis of this natural ingredient assumes significance because of various drawbacks (low yield, patent infringement, longer duration of cultivation, etc.) associated with its extraction and isolation procedures. This review is intended to provide an appraisal of the total syntheses of fucoxanthin reported to date along with a detailed explanation of the commercially viable approach. Finally, we briefly discuss the future of research for the total synthesis of fucoxanthin.
Catalyst-Controlled Strategies to Override the Bond Dissociation Energy-Driven Selectivity of Benzylic C(sp3)–H Insertions
Authors: Sircoglou Marie , Dauban Philippe , Brunard Erwan , Boquet Vincent , Bissonnier Théo , Saget Tanguy , Carrizo E. Daiann Sosa
Published: September 2024

Catalytic C(sp3)–H insertion reactions of arylalkanes generally proceed at the benzylic position as a consequence of the lower bond dissociation energy (BDE) of the corresponding C–H bond. This account gives a brief overview of recent studies aimed at designing catalyst-controlled amination reactions to go beyond this BDE-driven selectivity. They permit the selective conversion of neutral C–H bonds with a BDE greater than 95 kcal mol–1 for the formation of alkylamines.

1 Introduction

2 Catalyst-Controlled Site-Selective C–H Insertion Reactions

3 Catalyst-Controlled Intermolecular Amination of Nonactivated C–H Bonds of Arylalkanes

4 Conclusion
Second Recurrence of Aggressive Angiomyxoma of Labia Majora in a 34-Year-Old Woman: A Case Report and Review of Literature
Authors: Shrigiriwar Mansi , Singh Shobhana
Published: September 2024

Aggressive angiomyxoma (AAM) is a rare, slow-growing, benign neoplasm with high recurrence and local invasion. It is usually asymptomatic and frequently presents as a mass affecting the perineal and pelvic regions of women in reproductive age group. We present a rare case of a 34-year-old woman with second recurrence of a giant AAM arising from labia majora. The patient presented with a slow-growing pedunculated mass (around 20 × 12 cm) over the right labia majora for the past 1 year. In the last 10 years, she was operated on two different occasions (2013 and 2015) for similar lesion and was a confirmed case of AAM. Ultrasound of the lesion and magnetic resonance imaging of the abdominopelvic region was suggestive of recurrent AAM. The patient underwent en bloc dissection of the tumor with negative margin. Histopathological examination confirmed the diagnosis of recurrent AAM. En bloc dissection with negative margin leads to complete removal of tumor mass. However, long-term follow-up with annual magnetic resonance imaging is advised.
Green Endoscopy and Sustainable Practices: A Scoping Review
Authors: Koo Thai Hau , Tee Vincent , Lee Yeong Yeh , Roslan Nur Sakinah , Ibrahim Yusof Shuaib
Published: September 2024

Objectives The emergence of “green endoscopy” arises from the increasing global need to reform environmental sustainability due to climate change. Our review aimed to provide current evidence surrounding green endoscopy on sustainable issues including environmental impact, innovations, guidelines, policies, future directions, and recommendations.

Materials and Methods A scoping review was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews guidelines. Full-text English articles from established databases were screened for eligibility criteria and analyzed.

Results Out of 7,892 identified articles, 28 met all the eligibility criteria. Key findings include (1) the significant environmental impact of single-use items in current endoscopic practices; (2) there are emerging green innovations in endoscopy, such as reusable instruments, eco-friendly sterilization methods, and energy-efficient technologies; (3) guidelines and green policies are increasingly available to provide clinical guidance and framework for health care facilities; (4) model institutions can provide case studies and examples of implementing green endoscopy; and (5) unified efforts from all stakeholders are needed to address challenges, including cost-effectiveness.

Conclusion A paradigm shift toward green endoscopy is clearly in place and should be driven by the need to reduce environmental impact, be cost-effective, and not sacrifice patient safety.
Vinblastine-Induced Posterior Reversible Encephalopathy Syndrome in Pediatric Hodgkin Lymphoma
Authors: Siddartha Thippeswamy K. M. , Sindgikar Seema Pavaman , Sheety Vijith
Published: September 2024

Posterior reversible encephalopathy syndrome (PRES) is a critical care scenario seen with several etiologies. We report a pediatric case of Hodgkin lymphoma presenting with paraneoplastic features of nephrotic syndrome (NS). Diagnosis was confirmed with positron emission tomography-computed tomography scan and immunohistochemistry of the tissue biopsy. Remission for NS was achieved within a week of starting chemotherapy (ABVD–adriamycin, bleomycin, vinblastine, and dacarbazine). After the second cycle, he developed headache, seizures, and hypertension, requiring intensive care management. Magnetic resonance imaging brain was suggestive of PRES. The condition was managed with antihypertensives, antiepileptics, and supportive care. Considering all the risk factors for PRES including the drug, vinblastine, further chemotherapy was administered with only ABD regimen. The child attained complete remission after six cycles of chemotherapy and did not have any further episodes of hypertension or seizures. This case highlights the rare complication of vinblastine in a complicated lymphoid malignancy.
Evolution of Robotics in Neurosurgery
Authors: Shaikh Salman T. , Dwarakanath T.A. , Moiyadi Aliasgar V.
Published: September 2024

Technology and neurosurgery have gone hand in hand since a long time. Technological development of robotics in neurosurgery over the last couple of decades has been rapid, yet it still has a long way to go before it becomes a “routine” element of the standard neurosurgical procedure. Apart from the obvious advantages they have over humans, that is, precision, consistency, endurance, and reproducibility, robots also provide additional freedom of movement beyond what is anatomically feasible for humans. Since its first practical application in 1985, the promise of robotics has spurred development and design of numerous such devices for application in neurosurgery. In the current era, the role of robots in neurosurgery is limited to programming movements and planning trajectories for deep cranial targets, biopsies, spinal screw placements, deep brain stimulation, and stereotactic radiosurgery. This narrative, nonsystematic review discusses the evolution of various robotic systems, with a focus on their neurosurgical applications.
Cauda Equina Cavernous Angioma
Authors: Jacob Adrian Jamesraj , Mangaleswaran Balamurugan , Jacob Sheba , M.K Saranraj
Published: September 2024

Cavernous angiomas are rare vascular lesions, most occurring supratentorially, with spinal cavernomas being even rarer. They have a varied magnetic resonance imaging (MRI) appearance which is usually not diagnostic. A 42-year-old man presented with progressive low backache for the past 5 years and was found to have a mild right ankle weakness. MRI showed an intradural extramedullary lesion at the L1 vertebral body level. Intraoperatively, a dark reddish-blue mulberry-like lesion was found attached to a nerve root that had to be sacrificed during the excision. Histopathology confirmed that it was a cavernous angioma and the patient had no added deficits postoperatively. Cauda equina cavernomas are extremely rare and hence not thought of as a differential preoperatively. They are relatively simple to remove but will mostly need the sacrifice of the adherent nerve root. Most cases do well postoperatively with stable deficits and some improving.
Investigating the Thickness of the Deltoid Free Flap Using Ultrasonography and Clinical Application in Foot and Hand Soft-Tissue Defect Reconstruction
Authors: Ngoc-Huyen Nguyen , The-Hoang Nguyen , Quang-Vinh Nguyen , Staudenmaier Rainer
Published: September 2024

Background Although the deltoid flap is widely described as a thin flap, no studies have reported on the measurement of its thickness. Thus, this study aimed to measure deltoid flap thickness at different points using brightness-mode ultrasonography and report our initial clinical experience.

Methods This study included 36 adults (26 males and 10 females; mean age: 34 years) with 72 healthy deltoid regions. Ultrasonography was employed to measure flap thickness at eight designated positions. The ultrasonography results were also applied clinically in 30 patients to evaluate its compatibility.

Results The mean deltoid flap thickness was 5.14 ± 0.81 mm, with the thickest point being the emerging point of the flap pedicle. The subcutaneous fat gradually thinned toward the shoulder. No significant differences in the subcutaneous fat layer thickness were observed between the right and left sides, different ages, or the two sexes. Body mass index was the most critical factor related to flap thickness (p < 0.001). All deltoid free flaps were successfully transferred, resulting in good or excellent final clinical outcomes.

Conclusion The ultrasonography results suggest harvesting the deltoid flap upward toward the shoulder area and across the acromion from the emerging position of the flap pedicle to optimize flap thinness. The results showed that besides the flaps that have been clinically well established, the deltoid flap should be considered a valuable alternative for reconstructing limb soft-tissue defects, particularly where thin flaps are required and favorable aesthetic results are crucial.
Efficacy of Ketamine as an Adjuvant to Scalp Block for Hemodynamic Stability in Patients Undergoing Elective Craniotomy for Supratentorial Glioma: A Prospective Randomized Controlled Trial
Authors: Kaushal Ashutosh , Pathak Sharmishtha , Gupta Priyanka , Talwar Praveen , Jain Anuj , Karna Sunaina Tejpal
Published: September 2024

Introduction Scalp nerve block (SNB) attenuates the hemodynamic response to pin insertion and delivers excellent postoperative analgesia. This study aimed to evaluate the efficacy of SNB using ketamine as an adjuvant to bupivacaine on perioperative hemodynamic responses and postoperative pain in patients undergoing craniotomy for supratentorial glioma.

Materials and Methods Sixty patients were randomized into two groups. They were given scalp nerve block either with bupivacaine and saline (group S) or bupivacaine and ketamine (group K). Primary outcome was to compare the change in mean arterial pressure (MAP) and heart rate (HR) at defined time points from baseline. Secondary outcomes included time to request for first analgesia, total analgesic consumption in intraoperative and postoperative periods till 24 hours, and numeric rating scale pain score at various time points in postoperative period till 24 hours.

Results Fifty-seven patients were included in analysis. HR and MAP were comparable intraoperatively till closure. As soon as closure began, a significant increase in HR (group K vs. group S, 69.76 ± 9.03 vs. 93.96 ± 9.98, p-value = < 0.0001) and MAP (group K vs. group S, 79.4 ± 4.12 vs. 87.17 ± 12.67, p-value = 0.002) was noted in group S patients. This increase persisted in the postoperative period as well. The median total opioid consumed during intraoperative period in group K was 200 mcg versus 300 mcg in group S, p-value < 0.0001.

Conclusion Adding ketamine as an adjuvant to bupivacaine for SNB not only provides significant hemodynamic stability but also reduces both intra- and postoperative analgesic consumption.