bluuebunny/crossref_metadata_2025 huggingface dataset:
Early prehabilitation reduces admissions and time in hospital in patients with newly diagnosed lung cancer
Authors: Phillips Iain , Deans Maria , Walton Abi , Vallet Mahéva , Mencnarowksi Julie , McMillan Debbie , Peacock Catriona , Hall Peter , O’Brien Fiona , Stares Mark , Mackean Melanie , Plant Tracie , Grecian Robert , Allan Lindsey , Petrie Rebecca , Blues Duncan , Haddad Suraiya , Barrie Colin
Published: April 2024

Objectives

Lung cancer is the leading cause of cancer death in the UK. Prehabilitation aims to maximise patient fitness and minimise the negative impact of anticancer treatment. What constitutes prehabilitation before non-surgical anticancer treatment is not well established. We present data from a pilot project of Early prehabilitation In lung Cancer.

Methods

All new patients with likely advanced lung cancer were offered prehabilitation at respiratory clinic, if fit for further investigation. Prehabilitation included assessment and appropriate intervention from a consultant in palliative medicine, registered dietitian and rehabilitation physiotherapist. Four objective endpoints were identified, namely admissions to hospital, time spent in the hospital, treatment rates and overall survival. Outcomes were to be compared with 178 prehab eligible historical controls diagnosed from 2019 to 2021.

Results

From July 2021 to June 2023, 65 patients underwent prehabilitation and 72% of patients underwent all 3 interventions. 54 patients had a stage 3 or 4 lung cancer. In the prehab group, fewer patients attended Accident and Emergency (31.5 vs 37.4 attendances per 100 patients) and fewer were admitted (51.9 vs 67.9) when compared with historical controls. Those receiving prehab spent a lot less time in the hospital (129.7 vs 543.5 days per 100 patients) with shorter admissions (2.5 vs 8 days). Systemic anticancer treatment rates increased in the short term but were broadly similar overall. Median survival was higher in the prehabilitation group (0.73 vs 0.41 years, p=0.046).

Conclusions

Early prehabilitation appears to reduce time spent in the hospital. It may improve survival. Further work is required to understand its full effect on treatment rates.
Angioembolization for splenic injuries: does it help? Retrospective evaluation of grade III–V splenic injuries at two level I trauma centers
Authors: Ahmad M Usman , Lee David , Tennakoon Lakshika , Chao Tiffany Erin , Spain David , Staudenmayer Kristan
Published: April 2024

Background

Splenic angioembolization (SAE) has increased in utilization for blunt splenic injuries. We hypothesized lower SAE usage would not correlate with higher rates of additional intervention or mortality when choosing initial non-operative management (NOM) or surgery.

Study design

Trauma registries from two level I trauma centers from 2010 to 2020 were used to identify patients aged >18 years with grade III–V blunt splenic injuries. Results were compared with the National Trauma Data Bank (NTDB) for 2018 for level I and II centers. Additional intervention or failure was defined as any subsequent SAE or surgery. Mortality was defined as death during admission.

Results

There were 266 vs 5943 patients who met inclusion/exclusion criteria at Stanford/Santa Clara Valley Medical Center (SCVMC) versus the NTDB. Initial intervention differed significantly between cohorts with the use of SAE (6% vs 17%, p=0.000). Failure differed significantly between cohorts (1.5% vs 6.5%, p=0.005). On multivariate analysis, failure in NOM was significantly associated with NTDB cohort status, age 65+ years, more than one comorbidity, mechanism of injury, grade V spleen injury, and Injury Severity Score (ISS) 25+. On multivariate analysis, failure in SAE was significantly associated with Shock Index >0.9 and 10+ units blood in 24 hours. On multivariate analysis, a higher risk of mortality was significantly associated with NTDB cohort status, age 65+ years, no private insurance, more than one comorbidity, mechanism of injury, ISS 25+, 10+ units blood in 24 hours, NOM, more than one hospital complications, anticoagulant use, other Abbreviated Injury Scale ≥3 abdominal injuries.

Conclusions

Compared with national data, our cohort had less SAE, lower rates of additional intervention, and had lower risk-adjusted mortality. Shock Index >0.9, grade V splenic injuries, and increased transfusion requirements in the first 24 hours may signal a need for surgical intervention rather than SAE or NOM and may reduce mortality in appropriately selected patients.

Level of evidence

Level II/III.
Comparative study of quarkonium transport in hot QCD matter
Authors: Andronic A. , Gossiaux P. B. , Petreczky P. , Rapp R. , Strickland M. , Blaizot J. P. , Brambilla N. , Braun-Munzinger P. , Chen B. , Delorme S. , Du X. , Escobedo M. A. , Ferreiro E. G. , Jaiswal A. , Rothkopf A. , Song T. , Stachel J. , Vander Griend P. , Vogt R. , Wu B. , Zhao J. , Yao X.
Published: April 2024

This document summarizes the efforts of the EMMI Rapid Reaction Task Force on “Suppression and (re)generation of quarkonium in heavy-ion collisions at the LHC”, centered around their 2019 and 2022 meetings. It provides a review of existing experimental results and theoretical approaches, including lattice QCD calculations and semiclassical and quantum approaches for the dynamical evolution of quarkonia in the quark-gluon plasma as probed in high-energy heavy-ion collisions. The key ingredients of the transport models are itemized to facilitate comparisons of calculated quantities such as reaction rates, binding energies, and nuclear modification factors. A diagnostic assessment of the various results is attempted and coupled with an outlook for the future.
INFLUENCE OF COOLING MEDIUM ON MICROSTRUCTURE AND MECHANICAL PROPERTIES IN FRICTION STIR PROCESSING OF MAGNESIUM ALLOY — A REVIEW
Authors: RATHINASURIYAN C. , SANKAR R. , PUVIYARASAN M. , SENTHIL KUMAR V. S. , PALANIKUMAR K.
Published: April 2024

Friction stir processing (FSP) is used for changing the microstructure and material properties improvement. In modern years, special attention is exposed by governing the temperature level, and is applied by various coolants spraying on the top surface of the sample during FSP. This review paper explores the impact of several cooling mediums such as normal water, cold water, hot water, and cryogenic on the temperature distribution, grain refinement, mechanical characteristics, and superplastic deformation behavior of FSP using various grades of magnesium (Mg) alloys. It also includes the corrosion rate and wear behavior of FSP on Mg alloys. Through the systematic review, it has been observed that refined grains were formed and the generation of intermetallic compounds was suppressed after FSP in underwater and cryogenic conditions, leading to a notable increase in strength. The higher tensile strength and elongation are exhibited while using cryogenic compared to water medium. This is due to a rapid cooling process, where the high temperature was short for the newly-formed grains to fully develop. This review not only concludes the key findings of the preceding research but also suggests future recommendations.
INFLUENCE OF SUBSTRATE TEMPERATURE ON THE MICROSTRUCTURE AND PROPERTIES OF CoCrFeNiNbx HIGH ENTROPY ALLOY COATINGS
Authors: HAO XUEHUI , CHEN JINGRU , ZOU XUEFENG , GUO YAQI , LI ZHIHAO , WANG CHANGZHENG
Published: April 2024

This work studies the effect of the substrate temperature on the microstructure and properties of CoCrFeNiNbx high entropy alloy (HEA) coatings fabricated by magnetron sputtering. The results indicate that all three CoCrFeNiNbx HEA coatings were composed of a simple FCC solid solution with a columnar structure. As the substrate temperature increased, Nb content in the FCC matrix increased while the grain size first decreased and then increased. Accordingly, CoCrFeNiNbx HEA coatings exhibited an increasing micro-hardness and a decreasing fracture toughness with the increasing substrate temperature. Moreover, CoCrFeNiNbx HEA coating deposited at 200∘ had better corrosion performance, which was due to its better surface quality and denser columnar structure compared to the other two coatings.
An Explore–Exploit Workload-Bounded Strategy for Rare Event Detection in Massive Energy Sensor Time Series
Authors: Ting Lo Pang-Yun , Chao Rong , Chang Chai-Shi , Chuang Kun-Ta
Published: April 2024

With the rise of Internet-of-Things devices, the analysis of sensor-generated energy time series data has become increasingly important. This is especially crucial for detecting rare events like unusual electricity usage or water leakages in residential and commercial buildings, which is essential for optimizing energy efficiency and reducing costs. However, existing detection methods on large-scale data may fail to correctly detect rare events when they do not behave significantly differently from standard events or when their attributes are non-stationary. Additionally, the capacity of computational resources to analyze all time series data generated by an increasing number of sensors becomes a challenge. This situation creates an emergent demand for a workload-bounded strategy. To ensure both effectiveness and efficiency in detecting rare events in massive energy time series, we propose a heuristic-based framework called
HALE
. This framework utilizes an explore–exploit selection process that is specifically designed to recognize potential features of rare events in energy time series.
HALE
involves constructing an attribute-aware graph to preserve the attribute information of rare events. A heuristic-based random walk is then derived based on partial labels received at each time period to discover the non-stationarity of rare events. Potential rare event data are selected from the attribute-aware graph, and existing detection models are applied for final confirmation. Our study, which was conducted on three actual energy datasets, demonstrates that the
HALE
framework is both effective and efficient in its detection capabilities. This underscores its practicality in delivering cost-effective energy monitoring services.
Cooperative Multi-Objective Bayesian Design Optimization
Authors: Mo George , Dudley John , Chan Liwei , Liao Yi-Chi , Oulasvirta Antti , Kristensson Per Ola
Published: April 2024

Computational methods can potentially facilitate user interface design by complementing designer intuition, prior experience, and personal preference. Framing a user interface design task as a multi-objective optimization problem can help with operationalizing and structuring this process at the expense of designer agency and experience. While offering a systematic means of exploring the design space, the optimization process cannot typically leverage the designer’s expertise in quickly identifying that a given “bad” design is not worth evaluating. We here examine a cooperative approach where both the designer and optimization process share a common goal and work in partnership by establishing a shared understanding of the design space. We tackle the research question: How can we foster cooperation between the designer and a systematic optimization process in order to best leverage their combined strength? We introduce and present an evaluation of a cooperative approach that allows the user to express their design insight and work in concert with a multi-objective design process. We find that the cooperative approach successfully encourages designers to explore more widely in the design space than when they are working without assistance from an optimization process. The cooperative approach also delivers design outcomes that are comparable to an optimization process run without any direct designer input but achieves this with greater efficiency and substantially higher designer engagement levels.
CANdid
: A Stealthy Stepping-stone Attack to Bypass Authentication on ECUs
Authors: Kulandaivel Sekar , Jain Shalabh , Guajardo Jorge , Sekar Vyas
Published: April 2024

A high-entropy source of randomness is an essential component in any secure protocol, required to ensure that protocol elements, such as cryptographic keys, nonces, or salts, are unpredictable for the attackers. Resource-constrained embedded devices, such as Electronic Control Units (ECUs) in modern vehicles, often utilize weak sources of randomness due to the unavailability of true sources of randomness. In this article, we illustrate the ability of a relatively simple adversary to exploit this weakness within ECUs of vehicles produced by major manufacturers. We demonstrate that the weakness can be exploited by the adversary on a real ECU to breach the protection of Unified Diagnostic Services (UDS) Security Access service and access restricted functionality of the UDS protocol. We develop CANdid, a stepping-stone attack strategy where an adversary with access to a non-critical ECU can utilize this weakness to maliciously reprogram an arbitrary critical ECU over the CAN bus.
CGKPN: Cross-Graph Knowledge Propagation Network with Adaptive Connection for Reasoning-Based Machine Reading Comprehension
Authors: Zhao Zhuo , Zhou Guangyou , Xie Zhiwen , Wu Lingfei , Huang Jimmy Xiangji
Published: April 2024

The task of machine reading comprehension (MRC) is to enable machine to read and understand a piece of text and then answer the corresponding question correctly. This task requires machine to not only be able to perform semantic understanding but also possess logical reasoning capabilities. Just like human reading, it involves thinking about the text from two interacting perspectives of semantics and logic. However, previous methods based on reading comprehension either consider only the logical structure of the text or only the semantic structure of the text and cannot simultaneously balance semantic understanding and logical reasoning. This single form of reasoning cannot make the machine fully understand the meaning of the text. Additionally, the issue of sparsity in composition presents a significant challenge for models that rely on graph-based reasoning. To this end, a cross-graph knowledge propagation network (CGKPN) with adaptive connection is presented to address the above issues. The model first performs self-view node embedding on the constructed logical graph and semantic graph to update the representations of the graphs. Specifically, a relevance matrix between nodes is introduced to adaptively adjust node connections in response to the challenge posed by sparse graph. Subsequently, CGKPN conducts cross-graph knowledge propagation on nodes that are identical in both graphs, effectively resolving conflicts arising from identical nodes in different views, and enabling the model to better integrate the logical and semantic relationships of the text through efficient interaction. Experiments on the two MRC datasets ReClor and LogiQA indicate the superior performance of our proposed model CGKPN compared to other existing baselines.
Knowledge-Enriched Prompt for Low-Resource Named Entity Recognition
Authors: Hou Wenlong , Zhao Weidong , Liu Xianhui , Guo Wenyan
Published: April 2024

Named Entity Recognition (NER) in low-resource settings aims to identify and categorize entities in a sentence with limited labeled data. Although prompt-based methods have succeeded in low-resource perspectives, challenges persist in effectively harnessing information and optimizing computational efficiency. In this work, we present a novel prompt-based method to enhance low-resource NER without exhaustive template tuning. First, we construct knowledge-enriched prompts by integrating representative entities and background information to provide informative supervision tailored to each entity type. Then, we introduce an efficient reverse generative framework inspired by question answering (QA), which avoids redundant computations. Finally, we reduce costs by generating entities from their types while retaining model reasoning capacity. Experiment results demonstrate that our method outperforms other baselines on three datasets under few-shot settings.
Advancements in diabetic kidney disease management: integrating innovative therapies and targeted drug development
Authors: Ghose Shaarav , Satariano Matthew , Korada Saichidroopi , Cahill Thomas , Shah Raghav , Raina Rupesh
Published: April 2024

Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease and affects approximately 40% of individuals with diabetes . Cases of DKD continue to rise globally as the prevalence of diabetes mellitus increases, with an estimated 415 million people living with diabetes in 2015 and a projected 642 million by 2040. DKD is associated with significant morbidity and mortality, representing 34% and 36% of all chronic kidney disease deaths in men and women, respectively. Common comorbidities including hypertension and ageing-related nephron loss further complicate disease diagnosis and progression. The progression of DKD involves several mechanisms including glomerular endothelial cell dysfunction, inflammation, and fibrosis. Targeting these mechanisms has formed the basis of several therapeutic agents. Renin-angiotensin-aldosterone system (RAAS) blockers, specifically angiotensin receptor blockers (ARBs), demonstrate significant reductions in macroalbuminuria. Sodium-glucose transporter type 2 (SGLT-2) inhibitors demonstrate kidney protection independent of diabetes control while also decreasing the incidence of cardiovascular events. Emerging agents including glucagon-like peptide 1 (GLP-1) agonists, anti-inflammatory agents like bardoxolone, and mineralocorticoid receptor antagonists show promise in mitigating DKD progression. Many novel therapies including monoclonal antibodies CSL346, lixudebart, and tozorakimab; mesenchymal stem/stromal cell infusion; and cannabinoid-1 receptor inverse agonism via INV-202 are currently in clinical trials and present opportunities for further drug development.
Rapid Analysis of Seven Polyamines in Nephotettix cincticeps by Using Ultra-Performance Liquid Chromatography-Triple Quadrupole Mass Spectrometry
Authors: Zhang Mingwen , Zhao Yunqiang , Wang Zongwen , Cheng Jintian
Published: April 2024

A fast, simple, and sensitive method for the simultaneous determination of seven polyamines in Nephotettix cincticeps was developed based on ultra-performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-3Q-MS) together with liquid phase extraction. Polyamines in insect samples were extracted with HClO4 solution and then were separated and detected by UPLC-3Q-MS, which was equipped with a hydrophilic interaction liquid chromatography column, within 5 min without any derivatization procedure. The method has been successfully used to detect 7 polyamines in healthy and difluormethylornithine-treated adults of Nephotettix cincticeps with a method limit of detection and the method limit of quantitation of 24–139 pg/mg and 82–464 pg/mg, respectively, an intraday and interday relative standard deviation (RSD, n = 5) of 1.97–6.00% and 2.08–5.92% respectively, and a recovery of 86–115%. The success of this study provided a reliable method for the rapid and high-throughput detection of polyamines in the insect sample.
The Weak (Gorenstein) Global Dimension of Coherent Rings with Finite Small Finitistic Projective Dimension
Authors: Alhazmy Khaled , Ahmed Almahdi Fuad Ali , El Haddaoui Younes , Mahdou Najib
Published: April 2024

The small finitistic dimension of a ring is determined as the supremum projective dimensions among modules with finite projective resolutions. This paper seeks to establish that, for a coherent ring R with a finite weak (resp. Gorenstein) global dimension, the small finitistic dimension of R is equal to its weak (resp. Gorenstein) global dimension. Consequently, we conclude some new characterizations for (Gorenstein) von Neumann and semihereditary rings.
A Study of the Early Cosmic Dynamics in a Multifield Model of Inflation and Curvature Perturbations
Authors: Mughal Muhammad Zahid , Khan Feroz , Awwad Fuad A. , Ismail Emad A. A.
Published: April 2024

In this work, we study the cosmological dynamics of the early universe by employing a small field potential in the context of multifield inflation. By investigating analytically the cosmological observables, such as the number of e-folds N, potential slow-roll parameters ϵV, ηV, and spectral index ns which carry significant information, we show that they impact the inflationary universe considerably. The tensor-to-scalar ratio concerning the curvature perturbation is worked out for the potential under consideration which is another significant observable and comes out to be nonnegative. In multifield models of inflation, both types of curvature and isocurvature perturbations exist, while, in the present work, during the slow-roll, isocurvature perturbations are suppressed and therefore can be neglected. The surviving perturbations which are due to the curvature only can be tackled suitably by a mechanism developed by Sasaki and Stewart known as Sasaki–Stewart formalism. The effect of augmenting the number of e-folds on the power spectrum through the spectral index and its impact on the observable parameters of the slow-roll inflationary phase is observed by carrying out the analysis. It is observed analytically that the spectrum of multifield inflation is effectively different than its corresponding single-field inflation. The field values and their masses affect the results profoundly at the time of horizon-crossing.
SIRT3 Negatively Regulates TFH-Cell Differentiation in Cancer
Authors: Hou Yueru , Cao Yejin , He Ying , Dong Lin , Zhao Longhao , Dong Yingjie , Niu Ruiying , Bi Yujing , Liu Guangwei
Published: April 2024

Follicular helper T (TFH) cells are essential for inducing germinal center (GC) reactions to mediate humoral adaptive immunity in tumors; however, the mechanisms underlying TFH-cell differentiation remain unclear. In this study, we found that the metabolism sensor sirtuin 3 (SIRT3) is critical for TFH-cell differentiation and GC formation during tumor development and viral infection. SIRT3 deficiency in CD4+ T cells intrinsically enhanced TFH-cell differentiation and GC reactions during tumor development and viral infection. Mechanistically, damaged oxidative phosphorylation (OXPHOS) compensatively triggered the NAD+–glycolysis pathway to provide a cellular energy supply, which was necessary for SIRT3 deficiency–induced TFH-cell differentiation. Blocking NAD+ synthesis–glycolysis signaling or recovering OXPHOS activities reversed the TFH-cell differentiation induced by SIRT3 deficiency. Moreover, the mTOR and hypoxia-inducible factor 1α (HIF1α) signaling axis was found to be responsible for TFH-cell differentiation induced by SIRT3 deficiency. HIF1α directly interacted with and regulated the activity of the transcription factor Bcl6. Thus, our findings identify a cellular energy compensatory mechanism, regulated by the mitochondrial sensor SIRT3, that triggers NAD+-dependent glycolysis during mitochondrial OXPHOS injuries and an mTOR–HIF1α–Bcl6 pathway to reprogram TFH-cell differentiation. These data have implications for future cancer immunotherapy research targeting SIRT3 in T cells.
The Loss of Spatiality and Temporality in Twilight Consciousness: The Emergence of Exogenous Psychosis Induced by Novel Psychoactive Substances
Authors: Ricci Valerio , Maina Giuseppe , Martinotti Giovanni
Published: April 2024

Background: The state of twilight consciousness is marked by a focused narrowing of awareness, maintaining vigilance and attention while simultaneously experiencing perceptual shifts in the surrounding environment. It is crucial to recognize that this twilight state represents not just a contraction but also an expansion of conscious experience. Summary: Substances of abuse, particularly new psychoactive substances, play a significant role in inducing this twilight state. They achieve this by deconstructing essential components of consciousness, such as the perception of time and space. Key Message: This paper aimed to explore the phenomenon of the twilight state of consciousness and shed light on how new psychoactive substances can alter the perception of time and space during this twilight phase, potentially triggering exogenous psychosis. This comprehensive inquiry employs a phenomenological approach to the study of consciousness, recognizing it as the primary tool for ascribing significance to this intricate yet often overlooked aspect of psychopathology.
Periarticular Proprioception: Analyzing the Three-Dimensional Structure of Corpuscular Mechanosensors in the Dorsal Part of the Scapholunate Ligament
Authors: Al Meklef Rami , Kacza Johannes , Kremer Thomas , Rein Susanne
Published: April 2024

Introduction: Sensory nerve endings transmit mechanical stimuli into afferent neural signals and form the basis of proprioception, giving rise to the self-perception of dynamic stability of joints. We aimed to analyze the three-dimensional structure of periarticular corpuscular sensory nerve endings in a carpal ligament to enhance our understanding of their microstructure. Methods: Two dorsal parts of the scapholunate ligament were excised from two human cadaveric wrist specimens. Consecutive cryosections were stained with immunofluorescence markers protein S100B, neurotrophin receptor p75, protein gene product 9.5 (PGP 9.5), and 4′,6-diamidino-2-phenylindole. Three-dimensional images of sensory nerve endings were obtained using confocal laser scanning microscopy, and subsequent analysis was performed using Imaris software. Results: Ruffini endings were characterized by a PGP 9.5-positive central axon, with a median diameter of 4.63 μm and a median of 25 cells. The p75-positive capsule had a range in thickness of 0.94 μm and 15.5 μm, consisting of single to three layers of lamellar cells. Ruffini endings were significantly smaller in volume than Pacini corpuscles or Golgi-like endings. The latter contained a median of three intracorpuscular structures. Ruffini endings and Golgi-like endings presented a similar structural composition of their capsule and subscapular space. The central axon of Pacini corpuscles was surrounded by S100-positive cells forming the inner core which was significantly smaller than the outer core, which was immunoreactive for p75 and PGP 9.5. Conclusion: This study reports new data regarding the intricate outer and intracorpuscular three-dimensional morphology of periarticular sensory nerve endings, including the volume, number of cells, and structural composition. These results may form a basis to differ between normal and pathological morphological changes in periarticular sensory nerve endings in future studies.
Comparison of Caudal Block and Sacral Erector Spina Block for Postoperative Analgesia following Pediatric Circumcision: A Double-Blind, Randomized Controlled Trial
Authors: Özen Volkan , Şahin Ayça Sultan , Ayyıldız Elif Aybike , Açık Mehmet Eren , Eyileten Tayfun , Özen Nurten
Published: April 2024

Introduction: Caudal block (CB) and erector spina plane block (ESPB) have been shown to provide effective postoperative analgesia following circumcision. Our aim was to compare the analgesic efficacy of sacral ESPB and CB, as well as the time to first analgesic requirement and postoperative complications. Methods: Patients aged 1–7 years in the ASA I-II group, who were scheduled for circumcision, were included in the study. Blocks were performed under general anesthesia before the operation. Postoperative pain was evaluated using the Face, Legs, Activity, Cry, and Consolability (FLACC) scores. Analgesic requirements in the first 24 h postsurgery, the time of first analgesia requirement, and postoperative complications were recorded. Results: A total number of 150 patients were included in the study. In the CB group, urinary retention was observed. No side effects were observed in the sacral ESPB group. The 4th and 6th h postoperative FLACC scores were lower in the ESP group. The number of analgesic consumption in the first 24 h postsurgery was significantly lower in the ESPB group (p < 0.001). Conclusion: Based on our results, sacral ESPB performed with ultrasonography is a simple and safe regional anesthesia method that can be used to provide effective postoperative analgesia for circumcision.
Development of the Blood Stasis Questionnaire for Gynecological Diseases: An Analytical Cross-Sectional Study
Authors: Kang Byoung-Kab , Jang Soobin , Ko Mi Mi , Jung Jeeyoun
Published: April 2024

Objectives: Blood stasis is the slowing or stagnation of blood and can cause metabolic, musculoskeletal, and gynecological diseases. This study developed the Blood Stasis Questionnaire for gynecological disease (BSQ-GD) by extracting clinical indicators related to gynecological diseases using the Blood Stasis Questionnaires I and II (BSQ-I and II, respectively) and analyzed the clinical data of a cross-sectional study. Patients and Methods: In total, 103 women aged between 25 and 65 years who met gynecological disease criteria were enrolled in this study. Blood stasis scores (BSS) were evaluated using the BSQ-II and categorized into BSS and non-BSS groups. To assess the reliability of BSQ-GD, the internal consistency coefficient was employed using Cronbach’s α. Furthermore, correlation analyses were conducted for the clinical symptoms related to gynecological diseases, and the discriminant validity was confirmed by comparing the two groups. The prediction accuracy was determined using logistic regression and the cut-off value of the BSQ-GD was established via the sensitivity and specificity calculations. Results: The BSQ-GD showed satisfactory internal consistency (Cronbach’s α coefficient = 0.71) and validity, with significant differences in mean scores between blood stasis (22.30 ± 3.34) and non-blood stasis (14.93 ± 3.49) groups. The cut-off value of the BSQ-GD score was 19 points when the Youden index (73.45) and the concordance probability (0.75) were at their maximum. The area under the receiver operating characteristic curve was approximately 96%, and the sensitivity and specificity of the diagnostic accuracy according to the cut-off value are 80.95% and 92.50%, respectively. Conclusion: The BSQ-GD can be an appropriate instrument to estimate blood stasis in patients with gynecological diseases; its diagnostic sensitivity according to the cut-off value is high.
A Hematoma in the Anterior Abdominal Muscle in a Woman Receiving Venlafaxine: A Literature Review of the Reports on Similar Cases
Authors: Boutari Chrysoula , Zarkada Evangelia , Vyzantiadis Athanasios , Vlachaki Efthymia , Mantzou Genovefa , Karipidou Cristine , Theodoridou Stamatia
Published: April 2024

Introduction: Venlafaxine (VEN) is a selective norepinephrine reuptake inhibitor (SNRI) that mainly helps treat major depressive disorder and anxiety and panic disorders. It works by inhibiting the reuptake of serotonin (5-hydroxytryptamine, 5-HT) and noradrenaline (NA) by presynaptic neurons. Additionally, VEN administration has been linked with a bleeding predisposition that may be due to the inhibition of NA and 5-HT uptake by platelets which have their own receptors on their surface and are implicated in platelet aggregation. Case Presentation: Herein, we report a case of a 54-year-old patient treated with VEN, who presented with a hematoma in the anterior abdominal muscle. We also present the observational studies and case reports highlighting the association of SNRIs use with various hemorrhagic complications ranging from gastrointestinal hemorrhage or vaginal bleeding to bleeding during or after surgery due to either thrombocytopenia or impaired platelet aggregation. Conclusion: Given the cases of either reductions in the platelet count or impairment of platelet activity accompanied by bleeding events, every clinician should be aware of these possible adverse effects when prescribing SNRIs.
Challenges and Pitfalls in Pancreatobiliary Cytopathology
Authors: Scarpa-Carniello Jose Victor , Siddiqui Momin T.
Published: April 2024

Introduction: The advances of minimally invasive endoscopy-guided procedures that usually yield limited diagnostic material changed pancreaticobiliary cytopathology into one of the most challenging areas of cytopathology given the abundance of differential diagnoses to be considered when dealing with limited specimens. Case Presentation: We describe a few challenging examples of potential pitfalls in pancreatobiliary cytopathology evaluation collected from a busy academic hospital (tertiary) center. Case 1 illustrates the challenges in handling paucicellular specimens from pancreatic solid lesions in which differential diagnoses may include acinar cell carcinoma, neuroendocrine tumors, adenocarcinoma, or even benign pancreatic tissue, among others. Case 2 illustrates the pitfalls in evaluating limited specimens from patients with chronic pancreatitis, specially when distinguishing exuberant reactive atypia from dysplastic changes is mandatory. Case 3 illustrates pitfalls in distinguishing malignancy from reactive changes in biliary brushing specimens from patients with primary sclerosing cholangitis. Finally, cases 4 and 5 highlight the importance of including the possibility of pancreatic metastasis in the differential diagnoses of some pancreatic lesions. Conclusion: Over time, there has been an increasing demand for pathologists to render diagnoses on limited specimens obtained through minimally invasive procedures which can be frequently challenging even for the most experienced professionals. In many difficult cases, salvaging additional material for a cell block can turn out to be extremely helpful given the possibility of utilizing additional ancillary tests for diagnostic confirmation.
An Acupuncture Protocol for the Treatment of Erectile Dysfunction: A Delphi Process
Authors: Lindén Dahle Merete , Alræk Terje , Musial Frauke
Published: April 2024

Introduction: Erectile dysfunction (ED) is a widespread disorder, and the worldwide incidence is rapidly increasing. Acupuncture, an intervention out of the spectrum of traditional Chinese medicine (TCM), has a long tradition as treatment for ED. Nonetheless, a best-practice treatment protocol is currently missing. A recent systematic review and meta-analysis confirmed a huge diversity of acupuncture treatments for ED and concluded that there is an urgent need to standardise acupuncture treatment for ED. Consequently, the authors conducted a Delphi process with the aim to achieve an expert consensus as a basis for the development of a best-practice protocol. Methods: The Delphi process consisted of four rounds of questionnaires with closed and open-ended questions. Eleven acupuncture experts participated. The therapeutic aim was defined as “to achieve an erection sufficient for sexual satisfaction.” Results: Consensus was achieved on 24 acupoints corresponding to 12 TCM syndromes. The syndromes were KI Yang xu, KI Yin xu, KI Qi xu, Ki and HT not harmonised, LR Qi Stagnation, LR Qi stagnation and Heat, Liver Blood xu, Liver Blood xu and Liver Qi stagnation, Damp-heat sinking to the lower Jiao5, HT and GB Qi xu, SP xu and HT Blood xu, Yin xu. The suggested optimal dose was between 11 and 15 treatments given once or twice a week. Conclusion: An expert consensus-based, semi-standardised best-practice treatment protocol for the treatment of ED was developed. Moreover, the Delphi process also revealed inconsistencies as to which signs and symptoms constitute a TCM syndrome. Further Delphi studies including a broader range of experts from various acupuncture traditions are needed to establish further agreement. Nonetheless, the best-practice protocol introduced in this study provides a first point of departure for the implementation of a more standardised treatment approach. Moreover, since a recent meta-analysis concluded that more high-quality clinical studies on the topic are needed, this study provides a first standardised acupuncture treatment protocol for ED.
Neuroprotective Effects of Intermittent Fasting in the Aging Brain
Authors: Dong Hao , Wang Shiyan , Hu Chenji , Wang Mao , Zhou Tao , Zhou Yue
Published: April 2024

Background: A major risk factor for neurodegenerative disorders is old age. Nutritional interventions that delay aging, such as calorie restriction (CR) and intermittent fasting (IF), as well as pharmaceuticals that affect the pathways linking nutrition and aging processes, have been developed in recent decades and have been shown to alleviate the effects of aging on the brain. Summary: CR is accomplished by alternating periods of ad libitum feeding and fasting. In animal models, IF has been shown to increase lifespan and slow the progression and severity of age-related pathologies such as cardiovascular and neurodegenerative diseases and cancer. According to recent research, dietary changes can help older people with dementia retain brain function. However, the mechanisms underlying the neuroprotective effect of IF on the aging brain and related questions in this area of study (i.e., the potential of IF to treat neurodegenerative disorders) remain to be examined. Key Messages: This review addresses the hypothesis that IF may have translational potential in protecting the aged brain while summarizing the research supporting the putative neuroprotective mechanisms of IF in animal models. Additionally, given the emerging understanding of the connection between aging and dementia, our investigations may offer a fresh perspective on the use of dietary interventions for enhancing brain function and preventing dementia in elderly individuals. Finally, the absence of guidelines regarding the application of IF in patients hampers its broad utilization in clinical practice, and further studies are needed to improve our knowledge of the long-term effects of IF on dementia before it can be widely prescribed. In conclusion, IF may be an ancillary intervention for preserving memory and cognition in elderly individuals.
Cytomorphological Insights into Embryonal Rhabdomyosarcoma: A Rare Case in the Middle Ear
Authors: Khan Adil Aziz , Ahuja Sana , Zaheer Sufian
Published: April 2024

Introduction: Rhabdomyosarcoma, though rare in the middle ear, necessitates prompt recognition for optimal management. They are malignant mesenchymal neoplasms arising from the embryonic mesenchymal cells of striated skeletal muscles. Case Presentation: We present a case of a 5-year-old child with massive right mastoid swelling and bloody ear discharge. Cytological examination via fine needle aspiration biopsy revealed features suggestive of a malignant mesenchymal tumor, confirmed on imaging and subsequent histopathology as embryonal rhabdomyosarcoma (ERMS) FNCLCC grade 2. Characteristic cytological findings included spindle-shaped cells in a myxoid stroma with tigroid background, aiding in early diagnosis. Despite radical mastoidectomy and adjuvant chemotherapy, ERMS in the middle ear remains challenging due to its aggressive nature and potential complications. Conclusion: This case underscores the importance of cytological evaluation in identifying rare soft tissue tumors like ERMS, facilitating timely intervention and improved outcomes. Early recognition and multidisciplinary management are crucial in addressing the complexities of ERMS in uncommon sites like the middle ear.
STEERING THE MICROBIOTA-GUT-BRAIN AXIS BY ANTIBIOTICS TO MODEL NEURO-IMMUNE-ENDOCRINE DISORDERS
Authors: Pérez-Morales Marcel , Bello-Medina Paola C. , González-Franco Diego A. , Díaz-Cintra Sofía , García-Mena Jaime , Pacheco-López Gustavo ,   on behalf of the Neuro-Psycho-Biota Consortium
Published: April 2024

Background: Over the last century, animal models have been employed to study the gut-brain axis and its relationship with physiological processes, including those necessary for survival, such as food intake regulation and thermoregulation; those involved in diseases, ranging from inflammation to obesity; and those concerned to the development of neurodegenerative diseases and neuropsychiatric disorders, such as Alzheimer’s disease and autism spectrum disorder, respectively. Summary: The gut microbiota has been recognized in the last decade as an essential functional component of this axis. Many reports demonstrate that the gut microbiota influences the development of a vast array of physiological processes. Experiments that use animal models to assess the effect of the gut microbiota on the brain and behavior may involve the acute or chronic administration of wide-spectrum antibiotics. Key Messages: This narrative review summarizes the beneficial or detrimental effects of antibiotics administered prenatally or postnatally to rodents during acute or chronic periods in a wide range of protocols. These include animal models of disease and behavioral paradigms of learning and memory, anxiety, obsessive-compulsive disorder, and autism spectrum disorder. Biomarkers and behavioral assays associated with antibiotic exposure are also included in this review.
Reformadores de classe média no Império brasileiro: a sociedade central de imigração
Authors: Hall Michael M.
Published: April 2024

(1º parágrafo do artigo)

O termo “classe média” tem uma acepçäo bastante ambigua, e o seu uso tem sido täo controvertido no Brasil como em outros paises do mundo. Diversos estudiosos já notaram que as mudangas económicas que ocorreram no final do século passado, em particular a expansão da economia de exportação, criaram certas condições no Brasil que causaram o crescimento de camadas sociais intermediárias compostas nem de trabalhadores manuais, nem de membros da elite latifundiária. A essa nova classe média, embora seja uma categoria quase residual na estrutura social, tem-se, não obstante, dado um papel importante em quase todas as principais mudanças sociais e políticas que aconteceram nos últimos anos do Império, inclusive na abolição da escravatura e na queda da monarquia. No entretanto, até agora são poucas as pesquisas que resultaram em informações detalhadas e precisas sobre as características desses novos grupos; daí ser util examinar aqui um caso particular de reformadores de classe média — o da Sociedade Central de Imigração .
Arrhythmia Burden Among Adult Patients With Congenital Heart Disease: A Population‐Based Study
Authors: Schamroth Pravda Nili , Kalter‐Leibovici Ofra , Nir Amiram , Lorber Avraham , Dadashev Alexander , Hirsch Rafael , Benderly Michal ,   for the Israeli Congenital Heart Disease Research Group
Published: April 2024

Background

A significant percentage of patients with congenital heart disease surviving into adulthood will develop arrhythmias. These arrhythmias are associated with an increased risk of adverse events and death. We aimed to assess arrhythmia prevalence, risk factors, and associated health care usage in a large national cohort of patients with adult congenital heart disease.

Methods and Results

Adults with a documented diagnosis of congenital heart disease, insured by Clalit and Maccabi health services between January 2007 and December 2011, were included. We assessed the associations between arrhythmia and subsequent hospitalization rates and death with mixed negative binomial and Cox proportional hazard models, respectively. Among 11 653 patients with adult congenital heart disease (median age, 47 years [interquartile range, 31–62]), 8.7% had a tachyarrhythmia at baseline, 1.5% had a conduction disturbance, and 0.5% had both. Among those without a baseline arrhythmia, 9.2% developed tachyarrhythmias, 0.9% developed a conduction disturbance, and 0.3% developed both during the study period. Compared with no arrhythmia (reference group), arrhythmia in the previous 6 months was associated with a higher multivariable adjusted hospitalization rate, 1.33‐fold higher than the rate of the reference group (95% CI, 1.00–1.76) for ventricular arrhythmia, 1.27‐fold higher (95% CI, 1.17–1.38) for atrial arrhythmias, and 1.33‐fold higher (95% CI, 1.04–1.71) for atrioventricular block. Atrial tachyarrhythmias were associated with an adjusted mortality hazard ratio (HR) of 1.65 (95% CI, 1.44–2.94), and ventricular tachyarrhythmias with a >2‐fold increase in mortality risk (HR, 2.06 [95% CI, 1.44–2.94]).

Conclusions

Arrhythmias are significant comorbidities in the adult congenital heart disease population and have a significant impact on health care usage and survival.
The juvenile hormone analogue, pyriproxifen, alters protein and fat composition of Tenebrio molitor larvae
Authors: Hill V. , Lopez-Viso C. , Brameld J. , Salter A. , Parr T.
Published: April 2024

Maximising the yield of product from livestock is common practice in the agriculture industry and there is potential to extend this practice to the emerging insect industry, to produce high-quality, sustainable protein. Tenebrio molitor larvae, commonly called yellow mealworms, were fed for 28 days on wheat bran containing the juvenile hormone analogue, pyriproxifen at either 2 mg pyriproxifen/kg wheat bran (JH-PL) or 15 mg pyriproxifen/kg wheat bran (JH-PH). As expected, pupation was inhibited in both pyriproxifen treated groups and significant changes in nutritional composition were observed. Pyriproxifen treated mealworms had a higher protein content per 100 grams of dried material, while fat content was reduced 68% in JH-PH compared to control. These changes were associated with an increase in moisture content and reduction in energy content. The fatty acid profile of extracted fat also displayed significant alterations, with pyriproxifen treated mealworms showing an increase in proportions of saturated fatty acids, reduction in oleic acid but no effect on linoleic acid. The amino acid composition also exhibited a change in composition as a result of pyriproxifen treatment, including an increase in the essential amino acid, lysine, in JH-PH treated mealworms. This change in amino acid profile was associated with a change in the protein composition as observed on SDS-PAGE, with the appearance of a new band identified as the egg-yolk protein, vitellogenin, which has lipid-transporter activity. Hence, pyriproxifen treatment of mealworms has a repartitioning effect, resulting in an increase in the proportion of protein and a decrease in fat on a dry matter basis, demonstrating that mealworm nutrient composition can be manipulated to provide a higher value feed ingredient.
Mellissa officinalis Leaf Aqueous Extract Green-Formulated Nanoparticles as a new Chemotherapeutic Drug in the Field of Healthcare and Nursing: Determination of Anti-Cancer, Antioxidant, and Cytotoxicity Effects
Authors: Fang Shan , Li Yuan , Wu Wenjuan , He Kun
Published: April 2024

Nanotechnology is increasingly transforming healthcare and patient care. It also affects the distribution of drugs. To adapt to these changes in drug delivery, doctors need to educate and prepare themselves. To achieve the right treatment, doctors and examiners need to understand the
metabolism and pharmacokinetics of nanomedicines. Also, researchers have confirmed the unique role of herbal nanoparticles in treating several cancers and their efficacy in healthcare and nursing. Herbal nanoparticles have demonstrated their efficacy across several Gram-positive and negative
bacteria and various types of cancers. Traditional carcinoma treatment options such as radiotherapy and chemotherapy have the potential to enhance the patient’s well-being in certain instances, but they are consistently linked to notable adverse reactions. The investigation involved
examining the efficacies of a tin nanoparticles green formulation created by Mellissa officinalis on human lung cancer cells. To assess the nanoparticles’ efficacy against lung cancer and their cytotoxicity against HUVEC cell line, the MTT examination was followed. The MTT results
indicated that a concentration of 220, 151, 125, and 174 μg/ml of nanoparticles are the IC50. Furthermore, the carcinoma cells survival rate decreased with increasing concentrations of nanoparticles, with no viable cells observed at a 1000 μg/ml concentration after 72 hours.
The highest cytotoxicity was observed at a 1000 μg/ml concentration. The study also revealed that the antioxidant activity peaked at 1000 μg/ml, exceeding 100%.