bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study on Radiation Level at the Treatment Plane Due to Induced Activity in Linear Accelerator Head
Authors: Varshney Sonal , Kumar Lalit , Dwivedi Umesh K. , Narayan Pradeep
Published: September 2024

Background:

The induced activity is produced in the target, monitor chamber, flattening filter (FF), collimating jaws, etc., when a high-energy photon beam is utilized for radiation therapy. This may result in add-on exposure to radiation professionals.

Objective:

This study aims to measure the radiation level (RL) at the treatment plane due to induced activity in the linear accelerator head.

Materials and Methods:

In this study, RLs were measured close to the isocenter (I), LINAC head (H), and 0.5 m lateral to the isocenter (L) inside the radiation bunker. The RLs were measured for field sizes (FS) 5 cm × 5 cm, 10 cm × 10 cm, 20 cm × 20 cm, 30 cm × 30 cm, and 40 cm × 40 cm, using 50, 100, 200, 300, 400, 500, and 1000 monitor units (MUs) at above said locations inside the bunker using 10 mega-voltage (MV), 10 MV FF free, and 15 MV radiation beam.

Results:

RL increases with an increase in FS and MUs at all mentioned locations inside the bunker, except for 40 cm × 40 cm FS. The present study shows that RL increases with an increase in radiation beam energy, and there was significant RL inside the bunker at the mentioned location, even after the 1 min of high-energy radiation exposure.

Conclusion:

Therefore, treatment with a high-energy beam should be scheduled in the later evening of the working day and the jaw should be closed to a minimum before entering the bunker and a sufficient time gap should be followed to minimize the additional exposure due to induced activation in high-energy treatment.
Artificial High- and Low-density Materials in Bone Mineral Densitometry Using Dual-energy X-ray Absorptiometry: A GATE Monte Carlo Simulation of “Black-hole” Artifact
Authors: Qutbi Mohsen
Published: September 2024

Objective:

The objective of the study was to evaluate the effect of artificial high- and low-density materials on Bone mineral density (BMD)scans in dual-energy X-ray absorptiometry (DXA) method and emergence of black-hole artifact through GATE Monte Carlo simulation.

Materials and Methods:

GATE Monte Carlo code was utilized to simulate the artifact encountered in clinical scans acquired by HOLOGIC® bone densitometer. Two simplified phantoms were designed. The first one was a rectangular box with six smaller cubes inside and the second one was a body torso. Materials of cubes were spine bone, polymethyl methacrylate (PMMA), barium sulfate suspension in water, stainless steel, titanium alloy, and gold. The torso phantom contained objects of 5 vertebrae, bowel and 3 small spherical objects near the surface of the torso as piercing objects on the abdominal wall, each overlying the vertebrae. Using 100 and 140 kVp, spectral X-rays were generated to simulate DXA. For both phantoms, two simulations were carried out. The pair of projections acquired for each phantom were then subtracted and analyzed by curve fitting techniques.

Results:

Except for spine bone, in which radio-opacity decreases with increasing spectral X-ray energy (from 100 to 140 kVp), other squares exhibit little changes over different energies. PMMA shows consistently very low radio-opacity. Four other materials (barium sulfate in water, stainless steel alloy, titanium alloy, and gold), all attenuate the X-ray photons substantially. Except for spine bone, other materials are barely noticeable in pairwise subtracted images. In torso phantom, piercing objects are visualized as “holes” in vertebrae.

Conclusion:

Both artificial high- and low-density materials, compared to bone, are eliminated during the subtraction of dual-energy X-ray profiles and therefore, can create black-hole artifact.
Whole Cancer Visualization using Gadobutrol-glucose Solution and 7.0 T Magnetic Resonance Imaging
Authors: Watanabe Manabu , Sato Eiichi , Sato Jiro , Ito Kazuki , Moriyama Hodaka , Hagiwara Osahiko , Enomoto Toshiyuki , Yoshida Ryoko , Hayakawa Susumu , Sato Yuichi , Yoshida Sohei , Yoshioka Kunihiro , Nitta Hiroyuki
Published: September 2024

Introduction:

Cancer tissue absorbs 3–8 times more glucose than normal tissue. Therefore, we developed a gadobutrol-glucose solution for 7.0T magnetic resonance imaging to visualize whole cancerous regions at high contrast.

Methods:

The contrast medium consists of gadobutrol and glucose solutions, and these solutions are mixed before the vein infusion. We used readily available solutions, and the concentrations of the gadobutrol and glucose solutions were 60% and 5.0%, respectively. To visualize the cancerous region, we used two rabbits with VX7 thigh cancer. First, vein injection was carried out using a gadobutrol-saline solution containing 0.3 ml gadobutrol, and T1-weighted imaging (T1WI) was performed. Twenty-four hours after the first experiment, we performed T1WI of the VX7-cancer region using 50.3 mL gadobutrol-glucose solution including 0.3 ml gadobutrol.

Results:

Compared with T1WI using the gadobutrol-saline solution, the signal intensity of the cancerous region substantially increased using the gadobutrol-glucose solution.

Conclusion:

We confirmed significant signal-intensity increases in the whole VX7-cancer region of a rabbit thigh utilizing vein infusion of gadobutrol-glucose solution since the gadobutrol molecules were absorbed throughout the cancerous region along with glucose molecules.
Validation of the Elekta Synergy Platform Linac at 6 MV Photon Beam using PRIMO Monte Carlo Software
Authors: Marzon Jan Risty Lucido , Convicto Vernie C. , Lapening Melbagrace A. , Berondo Andelson L. , Bacala Angelina M.
Published: September 2024

Aims:

The objective was to validate the initial beam parameters of the Davao Doctors Hospital’s 6 MV Elekta Synergy Platform linac, which performs to the specification of the commissioning data per our records using the gamma-index analysis toolkit integrated inside PRIMO software.

Materials and Methods:

In PRIMO, a sequence of optimization processes is performed, in which the measured and simulated percent depth dose (PDD) and lateral beam profiles at various depths are compared, using the stringent gamma-index passing rate at 1%/1 mm criteria (GPR11). Using four fields of sizes 3 cm × 3 cm, 4 cm × 4 cm, 5 cm × 5 cm, and 10 cm × 10 cm, the dose is calculated on a water phantom measuring 16.2 cm × 16.2 cm × 30.0 cm. In addition, one field of size 20 cm × 20 cm is used on a 50.0 cm × 50.0 cm × 30.0 cm water phantom with a bin size of 0.2 cm × 0.2 cm × 0.2 cm at a source-surface distance of 100.0 cm.

Results:

For PDD and beam profiles comparison at the largest field size, the 6.5 MeV initial electron beam energy, 0.25 MeV full-width-half-maximum energy, 0.20 cm focal spot size, and 3° beam divergence tuned configuration yield GPR11 values of 94.0% and 97.7% (PRIMO PDD and lateral beam profile at 200 mm scan depth, respectively) with a statistical uncertainty of 2.9%. For lower field sizes, the GPR11 values are consistent at more than 90% for the PDD, whereas GPR11 values of 80.3% and 70.6% for the lateral beam profiles (at 15 mm and 200 mm scan depths) at 10 cm × 10 cm and 5 cm × 5 cm, respectively. The percentage difference between the measured and simulated PDD
20,10 ratios of not more than 2.45% is observed in all field settings.

Conclusions:

These tuned beam parameters are remarkably in agreement with the suggested beam parameters listed on the PRIMO website for the 6 MV Elekta linac which was optimized with a different set of measurements.
Agar-based Phantom for Evaluating Targeting of High-intensity Focused Ultrasound Systems for Breast Ablation
Authors: Filippou Antria , Damianou Christakis
Published: September 2024

Aim:

Phantoms are often utilized for the preclinical evaluation of novel high-intensity focused ultrasound (HIFU) systems, serving as valuable tools for validating efficacy. In the present study, the feasibility of a homogeneous agar-based breast-shaped phantom as a tool for the preclinical evaluation of HIFU systems dedicated to breast cancer was assessed. Specifically, the effect of the increased phantom curvature on temperature increase was examined through sonications executed on two sides having varied curvatures.

Materials and Methods:

Assessment was performed utilizing a 1.1 MHz focused transducer. Sonications on the two phantom sides were executed at varied acoustical power in both a laboratory setting and inside a 1.5 T magnetic resonance imaging scanner. Sonications were independently performed on two identical phantoms for repeatability purposes.

Results:

Temperature changes between 7.1°C–34.3°C and 5.1°C–21.5°C were recorded within the decreased and increased curvature sides, respectively, for acoustical power of 3.75–10 W. High-power sonications created lesions which were approximately symmetrically formed around the focal point at the decreased curvature side, while they were shifted away from the focal point at the increased curvature side.

Conclusions:

The present findings indicate that increased curvature of the breast phantom results in deformed focal shapes and decreased temperatures induced at the focal area, thus suggesting treatment correction requirements in the form of focus control or accurate robotic movement. The developed breast-shaped phantom can be utilized as an evaluation tool of HIFU systems dedicated to breast cancer since it can visually verify the efficacy of any system.
Ultrasonic Sensor-based Water Leveling for Three-dimensional Water Phantom: Prototype Development
Authors: Kim Taehyung , Kim Jeongun , Kim Engchan
Published: September 2024

Objectives:

The purpose of this study was to develop a prototype for controlling the water level of a three-dimensional (3D) water phantom using ultrasound sensors and Arduino technology and evaluate its performance in setting up the 3D water phantom for radiation beam measurements.

Materials and Methods:

A prototype consisted of an Arduino Nano board and two types of ultrasound sensors (US015 and SR04). The accuracy of both sensors was tested at various distances and the performance was evaluated through statistical analysis. The distance measurement test was performed rigorously at intervals of 2 cm from 5 cm to 21 cm, measuring an average error and a maximum deviation for each sensor.

Results:

Both sensors demonstrated the measurement accuracy within 2 mm. When using the traditional and prototype-based setup methods, the measured photon and electron beam profiles did not show any significant difference. This result suggests the equivalent setup capability when using these two different 3D water phantom setup methods.

Conclusion:

The ultrasound sensor-based prototype is demonstrated as a more effective device in maintaining the 3D water phantom setup consistently compared to the traditional method, which is prone to human error, and it will aid in facilitating precise phantom setup during the commissioning and routine quality assurance (QA) of linear accelerators in radiotherapy clinics.
Assessment of Organ-at-risk Sparing in Esophageal Cancer: A Comparative Dosimetric Evaluation of Hybrid, Noncoplanar, and Coplanar RapidArc Plans
Authors: Zope Mukesh Kumar , Patil Deepali Bhaskar , Saroj Dinesh Kumar
Published: September 2024

Aim:

The purpose of this study is to improve the precision of radiation treatment and sparing of organ-at-risk (OAR) in patients with thoracic esophageal cancer (EC) affecting the heart, lung, and spinal cord. To improve and personalize cancer treatment plans, it assesses the dosimetric benefits of coplanar RapidArc (RAc), hybrid arc (RAHyb), and noncoplanar RapidArc (RAnc).

Materials and Methods:

Fourteen patients with EC were chosen for our investigation from our hospital’s database. RapidArc (RA) plan patients had already received treatment. Retrospectively, additional RAnc and RAHyb plans were made with a prescription dose of 50.4 Gy in 28 fractions for the planning target volume (PTV). A prescription dose of 95% of PTV was used, so that three different treatment planning procedures could be compared. The cumulative dose-volume histogram was used to analyze the plan quality indices homogeneity index (HI), conformity index (CI), conformation number (CN) as well as the OARs doses to the lung, heart, and spinal cord.

Results:

In comparison to RAc and RAnc techniques, the study indicated that RAHyb plans significantly increased D95%, CI and HI; Dmax and CN did not differ substantially. In addition, compared to RAc (lung: 16.15 ± 0.03 Gy and heart: 23.91 ± 4.67 Gy) and RAnc (lung: 15.24 ± 0.03 Gy and heart 23.82 ± 5.10 Gy) plans, RAHyb resulted in significantly lower mean lung doses (15.10 ± 0.03 Gy) and heart doses (21.33 ± 6.99 Gy). Moreover, the RAHyb strategy showed a statistically significant (P < 0.05) lower average MU (452.7) than both the RAc (517.5) and RAnc (566.2) plans.

Conclusion:

The D95%, conformity, and homogeneity indices were better for hybrid arc plans compared to RAc and RAnc plans. They also successfully managed to reduce the lung and heart doses as well as the mean MU per fraction.
Photon and Neutron Dose Estimation Using Monte Carlo Simulation in TrueBeam’s Room
Authors: Quoc Soai Dang , Fujibuchi Toshioh , Arakawa Hiroyuki , Hamada Keisuke
Published: September 2024

Purpose:

The distribution of neutron ambient dose equivalent within the TrueBeam 10 MV photon chamber was investigated.

Materials and Methods:

The research used particle and heavy ion transport code system (PHITS) code and JENDL-5.0 to simulate the neutron ambient dose equivalent on and around TrueBeam’s head. The simulated results were compared with the measured results using CR-39 detectors when TrueBeam radiated 5000 monitor units of 10 MV photons with field sizes 20 cm × 20 cm and 0.5 cm × 0.5 cm.

Results:

Out of field size, the neutron ambient dose equivalents of the 0.5 cm × 0.5 cm field size are higher than those values of the 20 cm × 20 cm field size from 4% to 30%. The differences between the simulated value and the measured value of the neutron ambient dose equivalents at all points out of field size are smaller than 20%.

Conclusion:

The neutron ambient dose equivalents, simulated with PHITS and JENDL-5.0, are satisfied with the measured neutron ambient dose equivalent.
Advancements and Applications of Three-dimensional Printing Technology in Surgery
Authors: Kanumilli Sri Lakshmi Devi , Kosuru Bhanu P. , Shaukat Faiza , Repalle Uday Kumar
Published: September 2024

Three-dimensional (3D) printing technology has revolutionized surgical practices, offering precise solutions for planning, education, and patient care. Surgeons now wield tangible, patient-specific 3D models derived from imaging data, allowing for meticulous presurgical planning. These models enhance surgical precision, reduce operative times, and minimize complications, ultimately improving patient outcomes. The technology also serves as a powerful educational tool, providing hands-on learning experiences for medical professionals and clearer communication with patients and their families. Despite its advantages, challenges such as model accuracy and material selection exist. Ongoing advancements, including bioactive materials and artificial intelligence integration, promise to further enhance 3D printing’s impact. The future of 3D printing in surgery holds potential for regenerative medicine, increased global accessibility, and collaboration through telemedicine. Interdisciplinary collaboration between medical and engineering fields is crucial for responsible and innovative use of this technology.
Impact of Plasma Focal Adhesion Kinase, Ephrin Receptor Type A4, and Adiponectin in Patients with Acute Myeloid Leukemia
Authors: Latif Noor Jalal , Al-Rubaie Haithem Ahmed
Published: September 2024

BACKGROUND:

Focal adhesion kinase (FAK), ephrin receptor type A4 (EphA4), and adiponectin (ADPN) are important indicators in inflammation, tumor growth, migration, and angiogenesis in some cancers. The predictive impact of their concentrations in acute myeloid leukemia (AML) patients to be identified remains. The research sought to explore the effect of FAK, EphA4, and ADPN as prognostic biomarkers, and their influence on patient survival, and to look for any potential correlation between their levels with hematological parameters in AML patients.

PATIENTS, MATERIALS, AND METHODS:

The study was carried out on 65 newly diagnosed adult de novo AML patients and 15 controls. Plasma levels were assayed by enzyme-linked immunosorbent assay at diagnosis. The overall survival (OS) was determined after 12 months.

RESULTS:

The FAK concentrations were significantly (P < 0.001) higher among AML patients than the controls. EphA4 level was insignificantly lower in AML patients than in control (P = 0.902), and insignificantly higher ADPN concentrations among AML patients than the control (P = 0.352). There were no significant differences between monocytic and nonmonocytic AML patients in FAK, EphA4, and ADPN levels. Regarding the OS, cases with lower than median levels of FAK were associated with a significant (P = 0.002) higher OS time in days, and cases with higher than median levels of EphA4 and ADPN had a significant (P = 0.007 and P = 0.039, respectively) higher OS time in days.

CONCLUSIONS:

FAK, EphA4, and ADPN can be used as noninvasive prognostic markers in AML patients with a possible role in AML pathogenesis, and resistance to chemotherapy.
Evaluation of the Possible Pathophysiological Role of Redox Status in Patients with Sickle Cell Anemia
Authors: Shanan Wiqar Fadheel , Thuwaini Mahdi Murshd , Khudhair Hasan Abd Ali
Published: September 2024

BACKGROUND:

The disease of sickle cell anemia (SCA) is an inherited blood disease that causes several complications, and oxidative stress (OS) may play a very important role in its complications and pathophysiology.

OBJECTIVE:

The aims of the study is to evaluate the possible pathophysiological role of some antioxidant and oxidant biomarkers within SCA patients and to evaluate the correlation of OS and atherogenic index of plasma (AIP) to predict the cardiovascular risk in SCA subjects.

MATERIALS AND METHODS:

A case–control research includes three study groups: SCA patients, sickle cell trait (SCT) subjects, and healthy controls (HCs). All study groups were evaluated for their serum catalase (CAT), serum superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA) as well as plasma triglycerides and high-density lipoprotein cholesterol. Data were collected, tabulated, and statistically analyzed using (SPSS) version 31 program. The frequencies, relative frequencies, and means were obtained as descriptive methods. The associations among parameters were obtained using the Chi-square statistical method.

RESULTS:

The results revealed significantly lower levels of serum SOD and GPx among sickle cell disease (SCD) and SCT subjects than the HCs, whereas the inverse findings were reported for CAT and AIP. However, the MDA results revealed a significantly higher level in SCD patients compared to SCT and HC. Furthermore, the levels of SOD and MDA were positively associated in all study groups, and the levels of GPx and MDA were negatively correlated in SCD and SCT groups. The AIP was positively correlated with MDA in the SCT group and negatively correlated with CAT in the SCD group.

CONCLUSIONS:

The conclusion of the study indicated the presence of an OS and antioxidant compensatory status in patients with SCD and the SCT subjects. The altered biomarkers in SCA patients made it clear that the impairment and generation of OS in this disease, as well as antioxidant biomarkers, are contributory factors toward cellular redox homeostasis. This addressed the aim of the study.
Relationship between Iron Deficiency Anemia and Depressive Disorder in Iraqi Sample Patients
Authors: Alkhalidi Fatima Abd Al-Kathem
Published: September 2024

INTRODUCTION:

Depression is considered one of the principles of debility in most of the world and the main share in general increased universal burden of diseases. The top important complication of depression from the point of the patient’s view is social and living problems, which lead to permanent disability.

THE OBJECTIVE OF THE STUDY:

Weight changes could occur with depression due to variability of appetite, so this study was to define the association between iron deficiency anemia (IDA) and depression disorders.

PATIENTS AND METHODS:

One hundred participants enrolled in the study with a mean age of 37 ± 8.2 years in this case–control study conducted in Diwanyiah Educational Hospital from February 1 to May 1, 2022, the study enrolled patients with depression features visiting the psychiatric clinic in the hospital selected as cases and matched age and sex selected from another clinic in the same hospital or attendant with patients as control.

RESULTS:

The mean age for healthy control was 36.3 years and for cases, it was 38.5 years; there were 64% of patients and 16% of healthy control had anemia, whereas, for depression, patients 32% not presenting with anemia and 84% of control had no anemia.

CONCLUSION:

This study highlights the association between IDA and depression disorder.
Neutrophil CD64 – A Reliable Predictive Marker of Sepsis in Adult Intensive Care Unit
Authors: Waykole Rohan , Nisal Amit Ravindra , Christopher Anu , Danu Nishtha , Nimbargi Ravindra C
Published: September 2024

BACKGROUND:

Sepsis poses a significant threat to adult patients admitted to intensive care units (ICUs), contributing to substantial morbidity and mortality. Neutrophil CD64 (nCD64) expression has been linked to inflammatory responses during infection or tissue injury, suggesting its potential as a predictive marker for sepsis.

MATERIALS AND METHODS:

We conducted a prospective analytical study over 2 years at a tertiary care hospital, enrolling 91 sepsis cases from the adult ICU. Alongside routine laboratory parameters, including complete blood count, prothrombin time, activated partial thromboplastin time, fibrinogen, C-reactive protein, and procalcitonin, the expression of nCD64 was analyzed using a Beckman Coulter Navios flow cytometer. Median fluorescence intensity (MFI) was calculated for these cases. Statistical analysis was performed using SPSS version 25.0 software, with a significance threshold of P < 0.05.

RESULTS:

MFI scores demonstrated a notable increase in diagnosed sepsis cases, as determined by clinical and biochemical parameters. Moreover, changes in MFI scores on Day 4 exhibited a correlation with other clinical and biochemical parameters, strengthening the association between nCD64 expression and sepsis severity.

CONCLUSION:

Our findings suggest that nCD64 serves as an independent prognostic factor in adult ICU sepsis patients. It offers a promising alternative to traditional sepsis markers for predicting patient outcomes, emphasizing its potential clinical utility in guiding therapeutic interventions and improving patient care in ICU settings.
Anemia and Iron Profile in Hemodialysis and Nonhemodialysis Patients with Chronic Kidney Disease
Authors: Al Sharifi Liqaa Mohammed , Haddawi Karrar Haider
Published: September 2024

BACKGROUND:

Chronic kidney disease (CKD) is a global health concern, with anemia being a significant complication. Anemia in CKD patients is multifactorial and often leads to poorer outcomes. Assessing the iron profile, including serum ferritin, iron, and transferrin saturation, is crucial for identifying absolute or functional iron deficiency anemia (IDA). An objective evaluation of the iron profile is essential for effective and comprehensive management of anemia.

MATERIALS AND METHODS:

The study involved 100 adult patients with CKD and anemia, who were divided into two groups based on age and sex. The patients were divided into two groups: one received regular hemodialysis (HD) 2–3 times per week, whereas the other received no dialysis or dialysis infrequently. Exclusion criteria included infections, inflammation, renal injury, neoplasms, acute hemolysis, and thalassemia.

RESULTS:

Anemia is a common complication in patients with CKD, both those on HD and non-HD. Among the types of anemia observed, 50% of HD patients and 72% of non-HD CKD patients have normochromic anemia. In addition, 46% of HD patients and 24% of non-HD patients have IDA. Specifically, 24% of HD patients have absolute IDA and 22% have functional IDA, compared to 12% of both absolute and functional IDA in non-HD CKD patients, with a significant statistical difference between the two groups. Furthermore, serum iron and transferrin saturation levels show significant differences between HD and non-HD CKD patients.

CONCLUSION:

Anemia, especially IDA in CKD patients undergoing HD, requires accurate diagnosis through transferrin saturation and serum iron levels, and customized treatment based on dialysis status and anemia type is crucial.
Rhomboid intercostal block with subserratus plane block versus thoracic paravertebral block in video‑assisted thoracoscopic surgery: a prospective randomized comparative study
Authors: Hegazy Mohammed A. , Sanad Mohammed , Awad Gehad , Kishta Mohamed , Elsaied Ahmed M. , Gad Mona
Published: September 2024

Background

Most anaesthesiologists consider thoracic paravertebral block (PVB) the main analgesic modality for providing analgesia following “video-assisted thoracoscopic surgery.” However, it carries a potential risk for neuro-axial injuries and pneumothorax. “Rhomboid intercostal with subserratus block” (RISS) is a relatively newer block technique that has been described to be effective and safe in such cases, with no previous studies comparing its efficacy to PVB. Herein, we compare these two blocks in patients undergoing video-assisted thoracoscopic surgery in our Egyptian tertiary care setting.

Patients and methods

Sixty-two patients were enrolled in our prospective trial, and they were randomly allocated into two groups: PVB group (n=31) and RISS (n=31). Postoperative fentanyl consumption was our primary outcome.

Results

Both blocks were associated with comparable intraoperative hemodynamic measurements, and most of these readings were within the normal reference values. Postoperative pain scores during rest were also comparable between the two blocks, and all recorded readings indicated mild to moderate pain intensity. In these cases, fentanyl consumption had mean values of 101.61±27.58 μg in the PVB group compared to 100.65±25.16 μg in the RISS group (P=0.886). No block-induced complications were encountered, and most patients were satisfied or highly satisfied with their analgesic regimen in both groups.

Conclusion

RISS provides an excellent alternative to thoracic PVB. Both block procedures have almost comparable intraoperative hemodynamics, duration of analgesia, fentanyl consumption, pain scores, and patient satisfaction.
Total intravenous anesthesia using remimazolam for primary lateral sclerosis
Authors: Nin Itsuhiro , Fujino Yoshihisa , Fujii Emi , Kato Hiromi
Published: September 2024

Primary lateral sclerosis (PLS) is an extremely rare neurodegenerative muscle disease of unknown cause. The choice of anesthesia for surgery in patients with neurodegenerative muscle disease is extremely important, as it may affect the patient’s prognosis. In this case report, we describe a 74-year-old man with PLS who underwent surgical closure of the larynx owing to repeated aspiration pneumonia. The surgery was performed without muscle relaxants and with total intravenous anesthesia using remimazolam, a relatively new, ultra-short-acting benzodiazepine sedative. The patient underwent surgery safely with no complications and had stable intraoperative hemodynamics. General anesthesia using remimazolam and remifentanil without muscle relaxants may be an appropriate anesthesia technique in patients with PLS who require surgery.
Exploring the Protective Effects of Xueshuantong Injection on Central Retinal Vein Occlusion
Authors: Chen Qiang , Zhang Jing , Liu Xin-Yu , Xu Kai , Guo Hui-Yi , Li Ya-Min , Guo Yu-Qing , Liang Li-Na
Published: September 2024

Objective:

This study aimed to assess the therapeutic effects of Xueshuantong (XST), a traditional Chinese medicine that has been studied for its protective effects on the cardiovascular system and anti-inflammatory properties, on central retinal vein occlusion (CRVO) in rabbits and rats.

Materials and Methods:

CRVO was induced in rabbits and rats by laser photocoagulation. The animals were then treated with different doses of XST or lyophilized XST (L). Color fundus photography, fundus fluorescein angiography, histological examination, TUNEL assay, and immunofluorescence staining were conducted to evaluate the therapeutic effects.

Results:

The study revealed that both XST and lyophilized XST injections exhibited therapeutic effects against CRVO in rabbits and rats. The drugs improved retinal lesions and structure and mitigated apoptosis of retinal cells to varying degrees. Additionally, downregulation of tumor necrosis factor-α and interleukin-6 within the retina was observed in both drug groups.

Conclusions:

The results indicate that XST injection exhibited significant protective effects against experimental CRVO by regulating angiogenesis and inflammation, suggesting its potential as an effective therapeutic strategy for treating CRVO.
Counterexamples and weak (1,1) estimates of wave operators for fourth-order Schrödinger operators in dimension three
Authors: Mizutani Haruya , Wan Zijun , Yao Xiaohua
Published: September 2024

This paper is dedicated to investigating the

L^{p}

-bounds of wave operators

W_{\pm}(H,\Delta^{2})

associated with fourth-order Schrödinger operators

H=\Delta^{2}+V

on

\mathbb{R}^{3}

with real potentials satisfying

|V(x)|\lesssim \langle x\rangle^{-\mu}

for some

\mu>0

. A recent work by Goldberg and Green (2021) has demonstrated that wave operators

W_{\pm}(H,\Delta^{2})

are bounded on

L^{p}(\mathbb{R}^{3})

for all

1
9

and zero is a regular point of

H

. In the paper, we aim to further establish endpoint estimates for

W_{\pm}(H,\Delta^{2})

in two significant ways. First, we provide counterexamples to illustrate the unboundedness of

W_{\pm}(H,\Delta^{2})

on the endpoint spaces

L^{1}(\mathbb{R}^{3})

and

L^{\infty}(\mathbb{R}^{3})

for non-zero compactly supported potentials

V

. Second, we establish weak

(1,1)

estimates for the wave operators

W_{\pm}(H,\Delta^{2})

and their dual operators

W_{\pm}(H,\Delta^{2})^{*}

in the case where zero is a regular point and

\mu>11

. These estimates depend critically on the singular integral theory of Calderón–Zygmund on a homogeneous space

(X,d\omega)

with a doubling measure

d\omega

.
Kick-start for metabolomics in liver disease
Authors: Guerra-Ruiz Armando
Published: September 2024

It is not complicated for the clinician to diagnose a patient with advanced fibrosis or liver cirrhosis when he has already presented some decompensation of his liver disease. However, it is in the earliest stages when the patient's prognosis can be modified the most. Since liver disease is generally asymptomatic, not invasive markers are of great relevance. In the era of omics, it is time for metabolomics to accompany genomics and proteomics, which are more established in the diagnostics and prognostics clinical toolbox. Metabolomics, understood as the comprehensive evaluation of the metabolites present in the organism in a specific physiological situation, has undoubted advantages in the study and identification of serum markers relevant to a specific pathology. Last year, I read with interest two articles published in this journal: “Baseline metabolites could predict responders with hepatitis B virus-related liver fibrosis for entecavir or combined with FuzhengHuayu tablet” by Dai et al and “Metabolomics in chronic hepatitis C: Decoding fibrosis grading and underlying pathways” by Ferrasi et al . Both papers illuminate the power of metabolomics to provide us with new tools in the management of liver disease. In this editorial, I comment on these studies and others, and note how they can contribute to our understanding of liver disease in more than one way.
Immune remodulation in pediatric inherited metabolic liver diseases
Authors: Wu Yi-Chi , Xiang Xue-Lin , Yong June-Kong , Li Meng , Li Lin-Man , Lv Zi-Cheng , Zhou Yi , Sun Xi-Cheng , Zhang Zi-Jie , Tong Huan , He Xiao-Ying , Xia Qiang , Feng Hao
Published: September 2024

Inherited metabolic liver diseases arise from genetic mutations that lead to disruptions in liver metabolic pathways and are predominantly observed in pediatric populations. The spectrum of genetic metabolic liver disorders is diverse, encompassing a range of conditions associated with aberrations in iron, copper, carbohydrate, lipid, protein, and amino acid metabolism. Historically, research in the domain of genetic metabolic liver diseases has predominantly concentrated on hepatic parenchymal cell alterations. Nevertheless, emerging studies suggest that inherited metabolic liver diseases exert significant influences on the immune microenvironment, both within the liver and systemically. This review endeavors to encapsulate the immunological features of genetic metabolic liver diseases, aiming to expand the horizons of researchers in this discipline, and to elucidate the underlying pathophysiological mechanisms pertinent to hereditary metabolic liver diseases and to propose innovative therapeutic approaches.
Hepatic ectopic pregnancy with hemorrhage secondary diaphragmatic adhesion: A case report
Authors: Yang Xiu-Ci , Fang Miao , Peng Yi-Gen , Wang Liang , Ju Rong
Published: September 2024

BACKGROUND

Primary abdominal pregnancy is an extremely rare form of ectopic pregnancy. Ectopic pregnancies that occur in the liver and diaphragm are even rarer, limited case reports are available in the literature.

CASE SUMMARY

A woman of childbearing age was transferred to the emergency department due to lumbar and abdominal pain radiating to the back toward the lower right. After a series of physical and auxiliary examinations, she was clinically diagnosed with hepatic ectopic pregnancy. Laparoscopic surgery was performed to remove the pregnancy tissue and achieve hemostasis. After a period of follow-up, the patient was successfully cured.

CONCLUSION

Paying attention to the patient's signs and utilizing imaging examination methods can help avoid missed diagnoses of liver pregnancy.
Removal Potentials of Heavy Metals by Cassava Peels, Parts of Pawpaw Plant, Coconut Husk, Guinea Corn Chaff, and Pineapple Peels from Bonny Light Crude Oil Polluted Soil
Authors: OKoro S. E. , Ogbonna S.
Published: September 2024

Removal of environmental contamination such as heavy metals in soil, water and environment is of great importance for human welfare. Hence, the objective of this paper is to comparatively evaluate the removal potentials of heavy metals by cassava peels, parts of pawpaw plant, coconut husk, guinea corn chaff, and pineapple peels from bonny light crude oil polluted soil using appropriate standard methods. Results obtained indicated significantly high levels of heavy metals in the untreated crude oil contaminated soil at weeks 1, 8 and 12. There was a significant (P<0.05) decreasing trend in heavy metal levels in the contaminated soil after treatment with the various agro-residues after the 12-week period. The highest reduction of the heavy metals was observed in the test Group treated with a combination of the agro-residues under study; Ni (46.8%), Pb (61%), Cr (46.3%), Cd (34.1%) and As (49.8%) reduction. The results showed that the agro-residues under study can effectively enhance microbial removal of heavy metals in crude oil polluted soil.
Effects of bean cake cooked in different packaging materials on hematological indices and kidney function of Wistar albino rats
Authors: Wali P.C. , Gbaranee L. , Onyeike E.N. , Belonwu D.C.
Published: September 2024

This research assessed the effect of bean cake packaged with different materials (Thaumococcus danielle leaf, aluminum foil and plastic plate) on the proximate composition, and the hematological indices and kidney function of Wistar rats. Twenty-five Wistar rats were grouped into five (5 rats per group). Group one was fed with cerelac, group two with commercial rat feed, group three with bean cake packaged in T. danielli leaf, group four with bean cake packaged in aluminum foil and group five fed with bean cake packaged in plastic plate and; all the groups were fed ad libitum for twenty eightdays. The results of the proximate analysis showed that bean cake is rich in carbohydrate (51%), protein (20%) and is a good source of Minerals. There was a significant difference among the Potassium  Sodium, Urea and Creatinine levels of the test animals and the control at p<0.05. However, there was no remarkable difference in the haematological indices of the Control and Test groups. The results of this research showed that packaging materials had no significant effect on haematological indices and kidney function of Wistar rats in 28 days and plastic retained more nutrients than other packaging material.
Evaluation of the chemical constituents and toxicological potentials of Asystasia vogeliana benth. leaf extract
Authors: Odekanyin O.O. , Adesanwo J.K. , Olawuni J.I. , Omolaso O. O. , Kolawole S. , Alende J.O. , Fasol I.
Published: September 2024

Majority of the tradomedicinal uses of Asystasia vogeliana lack scientific backing. Therefore, this study sought to investigate the phytochemical constituents and the toxicological potentials of methanolic leaf extract of Asystasia vogeliana in Swiss albino mice. Air-dried pulverized leaves (1248 g) of Asystasia vogeliana were extracted with methanol for 48 h. The extract was concentrated using rotary evaporator to obtain crude methanol extract (99.8 g). The extract was screened for phytochemicalconstituents and partitioned with n-exane and dichloromethane (DCM). The two fractions were subjected to GC-MS analysis. Acute toxicity study was conducted in Swiss albino mice based on standard procedures. Biochemical parameters were determined in the liver, kidney and blood of the animals. Flavonoids, steroids, saponins and triterpenes were detected in the extract. GC-MS analysis of the n-hexane fraction showed presence of n-hexadecanioc acid (24.01%) and 6-octadecenioc acid (36.68%) as major constituents while oxypurinol (15.68%), and 2,2- dimethylcyclohexan-1,3- dione dioxime (11.21%) were the main constituents in dichloromethane fraction. No mortality was recorded in the acute toxicity study. Liver and blood serum aspartate transaminase (AST) and alanine transaminase (ALT) activities increased across the group. The creatinine and urea content in the kidney and blood serum increased. The insignificant increase in creatinine and urea levels in the kidney and blood showed mild toxicity. Also, increase in AST and ALT level was noticed in the blood which showed liver injury. Therefore, the study concluded that the extract at the tested concentration is mildly nephrotoxic and hepatotoxic.
Characterization of the phytochemical constituents of methanol extract of Spondias mombin stem bark using high performance-liquid chromatography and gas chromatography mass spectroscopy
Authors: Ikponmwosa-Eweka O. , Omoregie E. S.
Published: September 2024

Spondias mombin is commonly used in traditional medicine to treat various ailments. This study was aimed to analyze the bioactive components of the methanol extract of S. mombin stem by High-performance liquid chromatography (HPLC) and Gas  Chromatography-Mass Spectroscopy (GC-MS). Quantitative analysis of the extract showed that it had appreciable quantities of flavonoids, phenols, tannins, and proanthocyanidins. The HPLC fingerprints of the extract also revealed the presence of flavonoids, tannins, saponins, alkaloids, other phenols, and steroids. The most prevalent flavonoids were the flavones, and the alkaloids present in high concentrations were ribalinidine and linamarin. Some other phenolics, such as resveratrol, ellagic acid, chlorogenic and pyrogallic, were in high concentration. The GC-MS data detected bioactive compounds; notably among them were 9,12 -octadecadienoic acid (linoleic acid), n-hexadecanoic acid, and 9-oxo nonanoic acid. This study has established the presence of bioactive chemicals in the methanol extract of S. mombin stem bark, and these phytochemicals could be responsible for the plant’s medicinal properties.
Natural Hydrogen, the Ultimate Green Energy: Current Status and Prospects
Authors: Park Minji , Choi Heera , Choi Handeul , Lee Chaeyun , Jung Sokhee P.
Published: September 2024

Natural hydrogen is green hydrogen that is naturally produced on Earth, that is, an energy source that does not emit carbon without using additional energy for production. Since carbon is emitted from the existing gray hydrogen and blue hydrogen, green hydrogen with perfect eco-friendliness has been required. Natural hydrogen is produced through four mechanisms: serpentinization, radioactive decomposition, magma gas removal, and rock destruction and can exist in the dissolved ․ content of fluid mammals. Representative sites discovered to date include Mali, Africa, Brazil, and Australia, and each topography has different characteristics. Although reserves are estimated using geochemical and geophysical exploration technologies, the reliability is not high because the deep hydrogen flow in various geological environments is not considered. Based on this, this study drew the following conclusions. 1) Hydrogen can realize carbon neutrality with high energy content and independence, but 2) economic feasibility cannot be evaluated due to the uncertainty of the reserves and current reserves of natural hydrogen. Therefore, 3) for commercial use, leakage detection technology is required along with an understanding of the mechanism for generating natural hydrogen.
Commentary on “Beyond infantile hemangiomas: A glimpse into overlapping rare syndromes emphasizing the vigilant screening for PHACE and LUMBAR syndromes”
Authors: E Negrón Marleine , Martinez Karla J. , Berríos Luis R.
Published: September 2024

Due to their complex etiology and pathogenesis, hemangioma-related syndromes, such as LUMBAR and PHACE, present diagnostic and therapeutic challenges. Despite advances, standardized diagnostic criteria, screening protocols, and treatment options still need to be developed. We report a rare case of a 1-month-old patient with nonspecific symptoms, including failure to thrive and poor feeding, associated with lumbosacral ulcers. The diagnosis revealed overlapping features of LUMBAR and PHACE syndromes, highlighting the broad phenotypic spectrum and suggesting a potential common etiology. This case underscores the need for heightened clinical suspicion among general practitioners, dermatologists, and vascular physicians to manage these conditions. Propranolol is widely used for treating infantile hemangiomas, but due to its side effects, alternative therapies need to be explored. Emerging treatments, such as Atenolol, Timolol, Carteolol, and pulsed dye lasers, offer promise but require further investigation. However, the most crucial aspect is the need for ongoing research into the mechanisms of action, clinical applications, and side effects of current and alternative treatments. This research is essential for developing a comprehensive, safe management algorithm for both low- and high-risk infantile hemangiomas. It demands sustained engagement and commitment from the medical and research communities, ultimately improving patient outcomes and advancing medical knowledge.
Artes de cura das rezadeiras do Alto Sertão paraibano: desafios e resistências na prática de saberes tradicionais na contemporaneidade
Authors: Assis Roberto Ramon Queiroz de , Soares Junior Azemar dos Santos
Published: September 2024

Este manuscrito trata sobre as artes de curar de rezadeiras do Alto Sertão paraibano na segunda metade do século XX ao início do XXI.  Evidenciamos aspectos da oralidade, processo de aprendizagem e aplicação das rezas. A espinha dorsal do texto busca refletir como os agentes de cura lidam com os contextos contemporâneos que implicam descrença nos saberes tradicionais de cura.  Para a construção do trabalho, optamos pelo uso da metodologia da história oral, tanto para análise como para a produção das fontes históricas. Para tanto, encontramos suporte nos escritos de Meihy e Holanda (2018); Garay (1997); Meihy e Seawright (2020) e Alberti (2004). Por fim, concluímos que as rezas de cura como uma prática social, se adapta aos contextos em que ocorrem. Na medida em que ela circula no tempo, espaços e sociedade, novos elementos são utilizados para dar sentido e coesão entre a cultura das rezas e aos seus adeptos.
Recompondo os sons do passado: a escuta de mulheres sobre a campanha De Pé no Chão Também se Aprende a Ler (1961-1964)
Authors: Oliveira Roselia Cristina de
Published: September 2024

A campanha educativa De Pé no Chão Também se Aprende a Ler foi criada no ano de 1961, durante a gestão municipal de Djalma Maranhão na cidade de Natal, visando erradicar o analfabetismo e valorizar a cultura popular. A iniciativa contou com a assessoria do educador Paulo Freire e com a mobilização de parte da juventude que ansiava por transformar a realidade através da educação. No tocante às atividades culturais, estas foram espelhadas no Movimento de Cultura Popular (MCP) de Recife/PE, envolvendo a colaboração de mulheres em atividades-chave da administração municipal. Com o golpe civil-militar de 1964, essas mulheres foram presas, acusadas de subversão, e tiveram suas vidas transformadas pelo recrudescimento do regime militar. Metodologicamente, o presente estudo envolveu a pesquisa histórica e a entrevista vinculadas à Análise Compreensiva do Discurso elaborada por Kaufmann (2013), tendo como base a escuta sensível de cinco mulheres, além da análise de documentos de governo e de periódicos locais. Como resultado, através da perspectiva das mulheres, desvelamos aspectos peculiares da implementação das atividades educacionais, notadamente o êxito da alfabetização de adultos na cidade de Natal e a conjuntura política, eivada pela polarização e por disputas pela hegemonia local.
Islam in Uzbekistan: Organization of the Muslim Board of Uzbekistan
Authors: Ugli Kurbonov
Published: September 2024

In Uzbekistan, religion is an integral part of the country's cultural and spiritual traditions and the basis of the spiritual maturity of the population. Today in Uzbekistan there are about 2300 religious organizations belonging to representatives of more than 130 nationalities and peoples and members of 16 religious denominations. People of different nationalities and religions live peacefully on the basis of the principle of tolerance. The government has been closely supporting the activities of each denomination. Muslim Board of Uzbekistan is one of the most influential non-governmental non-profit organizations in Uzbekistan. Ensuring the unity of believers and Muslims, clearly and correctly conveying Islamic rules to the people, creating facilities for obedience and worship, maintaining the ideological unity of Muslims, researching the historical heritage of our ancestors, carrying out charity work, and ensuring harmony in society. These are the main areas of activity of the Muslim Board of Uzbekistan.