bluuebunny/crossref_metadata_2025 huggingface dataset:
Deletion of the Aryl Hydrocarbon Receptor in Endothelial Cells Improves Ischemic Angiogenesis in Chronic Kidney Disease
Authors: Palzkill Victoria , Tan Jianna , Yang Qingping , Morcos Juliana , Laitano Orlando , Ryan Terence
Published: May 2024

Background: Chronic kidney disease (CKD) is a strong yet underappreciated risk factor for peripheral arterial disease (PAD) that exacerbates disease progression and increases risk for limb amputation and cardiovascular mortality. An estimated 25-35% of CKD patients develop PAD, but mechanistic data linking these two pathologies is limited. Several tryptophan-derived uremic metabolites are retained in the blood and tissues as a consequence of CKD and are endogenous ligands of the aryl hydrocarbon receptor (AHR), a ligand-activated transcription factor that has been shown to regulate angiogenesis. Hypothesis: We tested the hypothesis that endothelial cell-specific conditional deletion of the AHR would enhance ischemic limb outcomes in mice with CKD and femoral artery ligation (FAL). Methods: Twelve-week-old male and female endothelium-specific AHR knockout mice (AHRecKO) and AHR floxed mice (AHRfl/fl, Cre-negative control) were fed 0.2% adenine to induce CKD or casein control diet (n=10/group/sex) prior to undergoing FAL to induce limb ischemia. Laser Doppler flowmetry was used to measure limb perfusion. Isometric contraction of the tibialis anterior in-situ via nerve stimulus was performed to measure muscle function. Skeletal muscle mitochondrial respiratory function and H2O2 production were evaluated. Primary endothelial cells were isolated from male and female wildtype mice and treated with known AHR ligand indoxyl sulfate (IS) under hypoxic conditions to uncover sex-dependent differences in AHR activating potential. Results: In male mice with CKD, endothelium-specific ablation of the AHR resulted in significant increases in percentage of perfused capillaries within the ischemic limb (AHRecKO 73.41% ± 4.80% vs AHRfl/fl 64.75% ± 8.325%; p= 0.0074), improved laser Doppler perfusion recovery in the paw and gastrocnemius muscle, and larger myofiber cross-sectional area ( p=0.0258) compared to AHRfl/fl mice. However, these improvements did not translate to improved muscle contractile function. In contrast, deletion of the AHR in female mice with CKD had no significant impact on major outcome measures. Primary cells from male mice treated with IS had significantly higher expression of the AHR controlled gene Cyp1a1 ( p=0.026) compared to cells from female mice. Conclusion: Endothelium-specific deletion of the AHR improved ischemic angiogenesis in male, but not female, mice with CKD. These data reveal sex-dependent differences in AHR activating potential within endothelial cells that exist in the absence of sex hormones.

This study was supported by National Institutes of Health (NIH) grant R01-HL149704 (T.E.R.).

This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.
Bilateral Spontaneous Pneumothoraces in a Case of Tricuspid Valve Endocarditis and Septic Emboli: A Rare Complication
Authors: Chan Nim , Dunn Bryan
Published: May 2024

Acute hypoxemic respiratory failure from infective endocarditis with septic emboli has been attributed to the vicious cycle of tissue damage and inflammatory cytokine response. Spontaneous pneumothorax is a rare complication and can be a late‐onset presentation despite appropriate antibiotic therapy. We present a rare case of bilateral spontaneous pneumothoraces in a patient with tricuspid valve endocarditis and septic pulmonary emboli. We suspect that the profound inflammatory response from two different bacterial pathogens and the peripheral location of the septic thrombosis are the basis of the development of bilateral pneumothorax development in our patient.
A Novel Technique for Facial Recognition Based on the GSO-CNN Deep Learning Algorithm
Authors: Al-Abboodi Rana H. , Al-Ani Ayad A.
Published: May 2024

Face recognition is one of the important elements that can be used for securing the facilities, emotion recognition, sentiment exploration, fraud analysis, and traffic pattern analysis. Intelligent face recognition has yielded excellent accuracy in a controlled environment whereas vice versa in an uncontrolled environment. However, conventional methods can no longer satisfy the demand at present due to their low recognition accuracy and restrictions on many occasions. This study proposed an optimal deep learning-based face recognition system that improves the security of the model developed in the IoT cloud environment. Initially, the dataset of images was gathered from the public repository. The captured images are explored using image processing techniques like image preprocessing employing the Gaussian filter technique for removing the noise and smoothing the image. The histogram of oriented gradients (HOGs) is used for the image segmentation. The processed images are preserved at the cloud service layer. Extract features were linked to facial activities using the spatial-temporal interest point (STIP). On the other hand, the extracted feature vectors are investigated using galactic swarm optimization (GSO) techniques that give optimized feature vectors. The necessary features are selected using the gray level co-occurrence matrix (GLCM), which separates the statistical texture features. The GSO output is fed into the deep convolutional neural network (DCNN) that effectively trains the captured face images. This will allow the effectiveness of the GSO-CNN technique to be assessed in terms of recognition accuracy, recall, precision, and error rate.
Significance of Scapular Fracture Existence in Blunt Chest Trauma: A Retrospective Cohort Study
Authors: Hefny Ashraf F. , Mansour Nirmin A. , Hefny Mohamed A. , Masuadi Emad , Al Bahri Shadi , Elkamhawy Ashraf A. , Saber Khalid S.
Published: May 2024

Background. Scapular fracture is a rare encounter in blunt trauma patients. The scapula is surrounded by strong groups of muscles offering good protection for the bone. Therefore, a high-energy trauma is needed to cause a scapular fracture. We aim to study scapular fractures and their relation to injury severity and mortality in blunt chest trauma (BCT) patients. Methods. We retrospectively collected data from all patients with BCT who were admitted to our hospital from December 2014 through January 2017. The injury details of all BCT patients were retrieved from the trauma registry of the hospital and were supplemented by patients’ electronic files for missing information. Collected data included demography, mechanism of injury, vital signs, Glasgow Coma Score (GCS) on admission, injured body regions, management, Injury Severity Score (ISS), New Injury Severity Score (NISS), length of hospital stay (LOS), and mortality. Results. During the study period, 669 patients had BCT. Scapular fracture was present in 29 (4.3%) of the BCT patients. The scapular fracture was missed by chest X-ray in 35.7% of the patients; however, it was accurately diagnosed by computed tomography (CT) scan of the chest. Neck injury was significantly higher in patients with scapular fracture compared with patients without fracture (p<0.001). ISS and NISS were significantly higher in patients with scapular fractures compared to other patients without fractures (p=0.04 and p=0.003 Mann–Whitney U test, respectively). Two patients with scapular fractures died due to severe associated injuries (the overall mortality was 9.6%). Conclusions. Scapular fracture in BCT patients indicates a high-energy type of trauma. Compared to a chest X-ray, CT scan was more accurate for the diagnosis of scapular fracture. Associated injuries are the main cause of trauma-related mortality rather than the direct effect of the fractured scapula. Particular attention and meticulous evaluation should be paid to head and neck injuries to avoid missing injuries.
Absence of Epidermal Antibodies in Stevens–Johnson Syndrome/Toxic Epidermal Necrolysis Patients but Beware of Single Positive Results
Authors: Diercks Gilles F. H. , Meijer Joost M. , Bolling Maria C. , Scholtens-Jaegers Sonja M. H. J. , Bremer Jeroen , Horvath Barbara
Published: May 2024

Background. Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and potentially life-threatening mucocutaneous blistering diseases that clinically can resemble autoimmune bullous diseases. Moreover, it has been shown that autoantibodies against epidermal proteins are present in SJS/TEN. Objectives. To establish the presence of antibodies against desmosomal and hemidesmosomal proteins in confirmed SJS/TEN patients. Methods. Serum of SJS/TEN patients diagnosed based on clinical criteria, e.g., epidermal detachment with erosions and severe mucosal lesions, (suspicion of) a culprit drug, and matching histologic results was evaluated by various techniques, e.g., indirect immunofluorescence on monkey esophagus, salt split skin and rat bladder, immunoblotting (IB) and immunoprecipitation (IP), ELISAs against desmogleins and BP180, keratinocyte footprint assay, and keratinocyte binding assay. Results. A total of 28 patients were included in this study, 15 men and 13 women with a mean age of 56 years. In most patients, none of the serological tests were positive. In two patients, an elevated DSG3 titer was found suspicious for pemphigus vulgaris. Three patients had elevated NC16a titers, suggesting bullous pemphigoid. However, in all these patients, no other tests were positive and in these patients, the biopsy for direct immunofluorescence showed no evidence for an autoimmune bullous disease. Three patients showed reactivity against rat bladder rat bladder; these were, however, completely negative for A2ML1, envoplakin, and periplakin in the IB as well as the IP. Conclusions. Serological analysis for desmosomal and hemidesmosomal antibodies is reliable to rule an autoimmune bullous disease in patients with suspected SJS/TEN. However, one should not rely on one single test method since false positive results can occur. Moreover, this study also makes it less plausible that antibodies against desmosomal and/or hemidesmosomal components are involved in the pathogenesis of SJS/TEN.
A Neural Network Based on a Nonsmooth Equation for a Box Constrained Variational Inequality Problem
Authors: Wang Yanan , Lin Shuang , Zhang Jie , Qiu Chen
Published: May 2024

The variational inequality framework holds significant prominence across various domains including economic finance, network transportation, and game theory. In addition, a novel approach utilizing a neural network model is introduced in the current work to address a box constrained variational inequality problem. Initially, the original problem is reformulated into a nonsmooth equation, following which the neural network model is meticulously devised to tackle this reformulated equation. This study comprehensively investigated inherent characteristics and properties of this neural network model. In addition, employing the Lyapunov function method, stability analysis of the neural network model proposed is rigorously demonstrated in the Lyapunov sense. Furthermore, the efficacy of the proposed technique is substantiated through numerical simulations, providing empirical support for its applicability and effectiveness.
Routine Surveillance of Upper Urinary Tract Imaging for Diagnosing Upper Urinary Tract Urothelial Cancer Recurrence in Patients with Nonmuscle Invasive Bladder Cancer
Authors: Nishimura Nobutaka , Miyake Makito , Miyamoto Tatsuki , Shimizu Takuto , Fujii Tomomi , Morizawa Yosuke , Hori Shunta , Gotoh Daisuke , Nakai Yasushi , Torimoto Kazumasa , Tanaka Nobumichi , Fujimoto Kiyohide
Published: May 2024

Background. Although routine surveillance imaging to examine upper urinary tract urothelial cancer recurrence during follow-up of nonmuscle invasive bladder cancer is recommended, its necessity remains invalidated. A single-institute long-term follow-up cohort study to evaluate the clinical impact of routine surveillance imaging and identify risk factors for upper urinary tract urothelial cancer recurrence after nonmuscle invasive bladder cancer treatment was conducted. Methods and Materials. A retrospective chart review of 864 patients with primary nonmuscle invasive bladder cancer who underwent initial transurethral resection of bladder tumor between 1980 and 2020 was conducted. The opportunities to diagnose its recurrence were examined. Moreover, oncological outcomes included upper urinary tract urothelial cancer recurrence-free survival and overall survival. Results. Of 864 patients, 19 (2.2%) experienced upper urinary tract urothelial cancer recurrence. Among 19 patients, recurrence was detected through routine imaging in 12 (63.2%), cystoscopy in 2 (10.5%), urine cytology in 2 (10.5%), and presence of gross hematuria in 1 (5.3%). All patients had high- or highest-risk NMIBC at diagnosis of primary nonmuscle invasive bladder cancer. On multivariate Fine-Gray proportional regression analyses, a tumor size of ≥30 mm and carcinoma in situ were independently associated with short upper urinary tract urothelial cancer recurrence-free survival (P=0.040 and 0.0089, respectively). Conclusion. Most patients experiencing upper urinary tract urothelial cancer recurrence were diagnosed by routine surveillance imaging, suggesting its clinical importance, especially for patients with nonmuscle invasive bladder cancer accompanied by a tumor size of ≥30 mm and carcinoma in situ.
Facilitating Utilization of Evidence-Informed Management by Nurse Managers in Healthcare Facilities: An Integrative Literature Review
Authors: Chetty Diane Roobasoundhrie , ten Ham-Baloyi Wilma , van Rooyen Dalena R. M. , Du Plessis Allison Herlene , Naidoo Joanne
Published: May 2024

Background and Objectives. The scarce empirical and scientific information concerning evidence-informed management reports various benefits for nurse managers, including reduced staff turnover, enhanced working environments, and improved patient outcomes and policy implementation. This review summarizes best available evidence on facilitating utilization of evidence-informed management practices by nurse managers in healthcare facilities. The review could assist in a comprehensive overview of determinants that could assist nurse managers’ successful utilization of evidence-informed management. Methods. An integrative review of the literature was conducted, including peer-reviewed articles published between 2010 and 2022. The databases used were BioMed Central, CINAHL Complete, MEDLINE Complete, PubMed (via EBSCOhost), the Complimentary Index (Taylor and Francis, Elsevier, Wiley, and Springer), Sabinet, ScienceDirect, and Scopus, followed by a manual search using Google Scholar and a citation search. Johns Hopkins Nursing Evidence-based Practice Research and non-Research evidence tools were used for appraisal. Thematic analysis was used to synthesize the extracted data. Results. Based on thirteen determinants influencing nurse managers’ utilization of evidence-informed management practices, three themes were identified from a total of thirteen relevant studies: (1) Nurse manager determinants in utilization of evidence-informed management (Microlevel); (2) Organizational determinants in utilization of evidence-informed management (Mesolevel); (3) External stakeholders and context determinants of utilization of evidence-informed management practices (Macrolevel). Conclusion. The themes were found to be interconnected and interdependent, facilitating the effective utilization of evidence-informed management by nurse managers at micro-, meso-, and macrolevels, but highlight the need for strengthening health systems and support. Future studies are required to provide a more comprehensive understanding of the determinants influencing nurse managers’ utilization of evidence-informed management practices. Implications for Nursing Management. For nurse managers to optimally utilize evidence-informed management, executive management and policymakers require to provide resources and support such as continuous education, incentives, effective communication, funding structures, and ownership.
Outcome in 12 Dogs with Chronic Radiographic Cranial Tibial Subluxation after Tibial Plateau Leveling Osteotomy (2019-2021)
Authors: Harrison Jacqueline M. , Muir Peter
Published: May 2024

Objective. The objective of this study was to examine outcomes in dogs with cruciate ligament rupture (CR) that had chronic radiographic cranial tibial subluxation at the time of osteotomy healing after tibial plateau leveling osteotomy (TPLO). Study Design. Retrospective case analysis of 12 dogs with prospective follow-up. Four of the 12 dogs were prospectively studied 12-24 months after surgery to assess long-term radiographic and clinical outcomes. Results. Three of the 4 dogs showed improvement in radiographic cranial tibial subluxation at long-term follow-up. In the other dog, minimally improved cranial tibial subluxation was associated with severe lameness. At long-term follow-up, gait analysis in 3 dogs with improved subluxation showed the symmetry of weight-bearing within 10% for peak vertical force, and no clinically lameness. Preoperative tibial plateau angle (TPA) and radiographic osteoarthritis in dogs with prospective follow-up and all dogs treated with TPLO surgery in the study period were not significantly different. Conclusion. Dogs with chronic radiographic cranial tibial subluxation are acceptable candidates for TPLO. Radiographic improvement in stifle reduction may take more than 10 weeks. The dog with long-term persistent subluxation also had a higher TPA over time, suggestive of ineffective surgical correction with TPLO and treatment failure.
Evaluation of the Efficacy and Safety of Intravenous Immunoglobulin (IVIG) in Moderate-to-Severe Hospitalized COVID-19 Patients: A Randomized, Open-Label Parallel-Group Study
Authors: Gautam Sachin , Mawari Govind , Daga Mradul Kumar , Kumar Naresh , Singh Harpreet , Garg Sandeep , Kumar Suresh , Gajendrakumar Monika , Golani Mahak , Rohatgi Ishan , Sarkar Sayan , Kaushik Shubham , Jha Manish Kumar , Mehra Sweety
Published: May 2024

Purpose. Since February 2020, the world has been overwhelmed by the SARS-CoV-2 outbreak, and several patients suffered interstitial pneumonia and respiratory failure requiring mechanical ventilation, threatening the capability of healthcare systems to handle this amount of critical cases. Intravenous immunoglobulins (IVIG) possess potential immunomodulatory properties beneficial for COVID-19 patients, yet evidence supporting IVIG as adjunctive therapy remains sparse. This study evaluated the outcomes of adjunctive IVIG with the standard of care (SoC) in moderate-to-severe COVID-19 patients. Methods. This randomized study included 59 moderate-to-severe COVID-19 patients with known comorbidities. One arm (n = 33) received high-dose IVIG (400 mg/kg/day) within 48 hours for five days alongside SoC, while the other arm (n = 26) received SoC, comprising steroids, enoxaparin, and remdesivir. The primary endpoint was clinical improvement, as measured by the National Early Warning Score 2 (NEWS2) and discharged/death proportions. Secondary outcomes included IVIG safety, hospitalization duration, changes in oxygen saturation, inflammatory markers, IgG titer, CTSS (CT severity score), and radiological findings. Results. There was an improvement in the NEWS2 at the end of treatment in the IVIG arm (5.67 vs. 5.96). A significant absolute effect improvement (Day 1 vs. Day 9) was seen in serum LDH, D-dimer, hs-CRP, IL-6, CTSS, procalcitonin, respiratory rate, and chest radiographic findings. SARS-CoV-2 IgG titer increased significantly in the IVIG arm. There was a statistically significant reduction in mortality in the IVIG group (5 vs. 10). Conclusion. IVIG was a safe and effective adjunctive therapy to SoC treatment in moderate-to-severe COVID-19 patients needing ventilatory support. Furthermore, studies are required to validate our findings. This trial is registered with CTRI/2021/05/033622.
Behaviour Analysis of Modeling and Model Evaluating Methods in System Identification for a Multiprocess Station
Authors: Beula A. Annie Steffy , Peter Geno , Alexander Stonier Albert , Vignesh K. Ezhil , Ganji Vivekananda
Published: May 2024

Systems are designed to perform specific task by giving certain input which produces the required output in an orderly manner known as process. The input, output, and the state variables should be known that will help in interacting with the system. The relation between these variables can be brought out by building a model that resembles or expresses the original performance of the system. The parameters of the model are estimated using the least squares approximation, maximum likelihood, maximum log-likelihood, and Bayesian parameter estimation methods by utilizing the experimental data from the multiprocess station. The selected parameters are converted to nine different transfer function models that represent the given dynamic system. The models framed are analyzed by the criterion curve technique using seven criterion functions evaluating the fitness of the model. Order of the model is found from Hankel matrix representation methods such as singular value decomposition and determinant method. Response of the models is compared with the original response to choose the best fit model by calculating ISE standard. All the above methods are used to model the system without physical and theoretical laws which is known as system identification.
The Second and Fourth Moments of Discrete Gaussian Distributions over Lattices
Authors: Zhao Wei , Qian Guoyou
Published: May 2024

Let Λ be an n-dimensional lattice. For any n-dimensional vector c and positive real number s, let Ds,c and DΛ,s,c denote the continuous Gaussian distribution and the discrete Gaussian distribution over Λ, respectively. In this paper, we establish the exact relationship between the second and fourth moments centered around c of the discrete Gaussian distribution DΛ,s,c and those of the continuous Gaussian distribution Ds,c, respectively. This provides a quantization form of the result obtained by Micciancio and Regev on the second and fourth moments of discrete Gaussian distribution. Using the relationship, we also derive an uncertainty principle for Gaussian functions, which extend the result of Zheng, Zhao, and Xu. Our proof is based on combination of the idea of Micciancio and Regev and the idea of Zheng, Zhao, and Xu, where the main tool is high-dimensional Fourier transform.
Modified Bitumen Materials from Kazakhstani Oilfield
Authors: Sagitova Guzaliya Faritovna , Ainabekov Nurzhan Bauyrzhanovich , Daurenbek Nazarbek Mukhaddasuly , Assylbekova Dina Duisenbekkyzy , Sadyrbayeva Ainur Slambekovna , Bitemirova Aliya Erkegulovna , Takibayeva Gulchekhra Abdyrakhmanovna
Published: May 2024

The oil bitumen BND 90/130, produced at the “LLP SP Caspi Bitum” with the modifier, which consists of copolymer of ethylene with butyl acrylate and glycidyl methacrylate taken in an amount of 0.5–1.6 wt%, and the tire reclaim (4–20 wt%), which is the destructate of mesh elastomers of different chemical nature, was modified; possibility of using the developed bitumen-elastomer binders in road asphalt concrete was justified. Modification of bitumen with a copolymer of ethylene with butyl acrylate and glycidyl methacrylate leads to an improvement in the properties of road bitumen: the softening point, hardness, deformability at low temperatures, elasticity, and adhesion to metal and mineral filler increase. It was shown that ethylene with butyl acrylate and glycidyl methacrylate chemically interacts with the functional groups of bitumen asphaltenes through the epoxy group of glycidyl methacrylate. Analysis of the spectra and group composition indicates an increased content of high molecular weight asphaltenes in the modified bitumen with a slight increase in structuring resins. It has been established that bitumen modified with rubber crumbs of 0.6–1.0 mm in size has high elasticity. The most effective composition of a bitumen-regenerated composite material based on tire reclaim has been determined. In terms of the totality of physicochemical and operational characteristics and comparative cost, the most acceptable is the bitumen-regenerated composition (with a regenerate content of 20%) and is superior in the complex of properties to bitumen modified with an optimal content of ethylene with butyl acrylate and glycidyl methacrylate (1.6%). The technology for modifying bitumen with tire reclaim is less time-consuming, more economically profitable, and environmentally effective, since it utilizes large-tonnage waste of worn-out tires. The resulting bitumen-polymer compositions have a high positive set of properties: softening point, hardness, elasticity, frost resistance, and low-temperature characteristics.
Development of a Multivariable Risk Prediction Tool to Predict Adverse Outcomes among Children with Type 1 Diabetes: A Pilot Study
Authors: Lieu Fiona , Martin Wrivu N. , Birt Stewart , Mattes Joerg , McGee Richard G.
Published: May 2024

Background. Children and adolescents with type 1 diabetes mellitus (T1DM) are frequently hospitalised for severe hypoglycaemia, hyperglycaemia, and diabetic ketoacidosis (DKA). While several risk factors have been recognised, clinically identifying these children at high risk of acute decompensation remains challenging. Objective. To develop a risk prediction model to accurately estimate the risk of acute healthcare utilisation due to severe hypoglycaemia, hyperglycaemia, and DKA in children and adolescents with T1DM. Materials and Methods. Using a retrospective dataset, baseline demographic and clinical data were collected from patients (<18 years) seen at a regional paediatric diabetes clinic from 1 January 2018 to 1 January 2020. The outcome was the number of emergency department presentations or hospital admissions for severe hypoglycaemia, hyperglycaemia, and DKA across the study period. Variables that were significant in univariate analysis were entered into a multivariable model. Receiver operator characteristic (ROC) curves assessed the model’s discrimination and generated cut-offs for risk group stratification (low, medium, and high). Kaplan–Meier survival analysis measured time to acute healthcare utilisation across the risk groups. Results. Our multivariable risk prediction model consisted of five predictors (continuous glucose monitoring device, previous acute healthcare utilisation, missed appointments, and child welfare services involvement and socioeconomic status). The model exhibited good discrimination (area under the ROC = 0.81), accurately stratified children into low-, medium-, and high-risk groups, and demonstrated significant differences between median time to healthcare utilisation. Conclusion. Our model identified patients at an increased risk of acute healthcare utilisation due to severe hypoglycaemia, hyperglycaemia, and DKA.
Utilizing the Optimal Auxiliary Function Method for the Approximation of a Nonlinear Long Wave System considering Caputo Fractional Order
Authors: Iqbal Aaqib , Nawaz Rashid , Hina Hina , Ahmad Abdulaziz Garba , Emadifar Homan
Published: May 2024

In this article, we explore the utilization of the Caputo derivative and the Riemann–Liouville (R–L) fractional integral to analyze the optimal auxiliary function method for approximating fractional nonlinear long waves. Approximate long wave equation with a distinct dispersion relation offers the most accurate description of shallow water wave properties. Various methods, including the Adomian decomposition technique, the variational iteration method, the optimum homotopy asymptotic method, and the new iterative technique, have been employed and compared to those obtained using the fractional-order approximate long wave equation. The results of our study indicate that the optimal auxiliary function method is highly successful and practically simple, achieving better and more rapid convergence after just one repetition. This method is recognized as an efficient approach, demonstrating high precision in solving intriguing and intricate problems. Furthermore, it proves to be more time and resource efficient than other relevant analytical techniques, leading to significant savings in both volume and time. Compared to the Adomian decomposition technique, the new iterative technique, the variational iteration method, and the optimum homotopy asymptotic method, the suggested technique is extremely accurate computationally. It is also easy to analyze and solve fractionally linked nonlinear complex phenomena that arise in science and technology. We present the numerical and graphical findings that support these conclusions.
Label-Free Ratiometric Homogeneous Electrochemical Strategy Based on Exonuclease III-Aided Signal Amplification for Facile and Rapid Detection of miR-378
Authors: Fan Bingyuan , Wang Qian , Wang Shan , Gao Yahui , Liang Yan , Pan Jinru , Fu Xinrui , Li Li , Meng Wei
Published: May 2024

MiR-378 is abnormally expressed in various cancers, such as hepatocellular carcinoma, renal cell carcinoma, and nonsmall cell lung cancer. Here, we developed a label- and immobilization-free ratiometric homogeneous electrochemical strategy based on exonuclease III (Exo III) for the facile and rapid determination of miR-378. Two 3′-protruding hairpin DNA probes (HPs) are designed in this strategy. Doxorubicin (DOX) and potassium ferrocyanide (Fe2+) were used as label-free probes to produce a response signal (IDOX) and a reference signal (IFe2+) in the solution phase. When no target was present in the solution, the HP was stable, most of the DOX was intercalated in the stem of the HP, and the diffusion rate of DOX was significantly reduced, resulting in reduced electrochemical signal response. When miR-378 was present, double-cycle signal amplification triggered by Exo III cleavage was initiated, ultimately disrupting the hairpin structures of HP1 and HP2 and releasing a large amount of DOX into the solution, yielding a stronger electrochemical signal, which was low to 50 pM. This detection possesses excellent selectivity, demonstrating high application potential in biological systems, and offers simple and low-cost electrochemical detection for miR-378.
Hypercalcemia and Bone Metastasis in a Case of Large Cell Neuroendocrine Carcinoma With Unknown Primary
Authors: Yetiskul Ekrem , Salak Jordyn , Arafa Fatema , Agarwal Alaukika , Matra Amanda , Niazi Muhammad , Odaimi Marcel
Published: May 2024

Large cell neuroendocrine carcinoma (LCNEC) constitutes a rare subset of highly undifferentiated malignancies known for their aggressive nature. Although these tumors commonly originate in the lungs and gastrointestinal tract, their potential occurrence is not restricted to specific anatomical sites, giving rise to a variety of symptoms. Notably, cases of neuroendocrine tumors (NETs) with an unidentified primary source exhibit a graver prognosis and shorter survival periods compared to those with clearly identified origins. NETs frequently demonstrate a propensity to metastasize, spreading to diverse anatomical regions such as the liver, lungs, lymph nodes, and bones, illustrating their aggressive nature and the complexity of their management. In this context, we present the case of a 59-year-old male who sought medical attention in the emergency department due to right upper quadrant (RUQ) abdominal pain. Initial diagnostic assessments revealed significantly elevated liver function tests and severe hypercalcemia. A right upper quadrant ultrasound (RUQ US) was subsequently performed, which revealed heterogeneous hepatic echotexture with innumerable echogenic masses, suggesting a metastatic process. A computed tomography (CT) scan was then ordered to evaluate further the RUQ US findings, which showed numerous hypovascular liver masses, raising concerns of malignancy. A liver biopsy confirmed a diagnosis of LCNEC with an unidentified primary source.
LASIK Videos on TikTok: A Content Analysis of the Top 100 Videos
Authors: Haddad Firas F. , Saade Joanna S.
Published: May 2024

Introduction. Social media has increasingly become a prominent source of health information. Platforms like TikTok that allow for videos to reach millions of viewers have become among the most common platforms to share and receive health information. Laser in situ keratomileusis (LASIK) videos and patients’ experiences are commonly discussed on social media. The quality of these videos remains to be assessed. The aim of this study is to evaluate the content, quality, and reach of the top 100 videos related to LASIK eye surgery on TikTok. Methods. Video quality was assessed using the DISCERN, JAMA, and GQS instruments which have all been proven to be both reliable and valid. Results. 100 videos were included in the study. Results showed that the videos have an immense reach with a total view count of 245 million views and 21.9 million likes. Two thirds of the videos were posted by personal accounts as compared ophthalmologists that only constituted 26% of the content. Healthcare professionals produced higher quality videos compared to nonhealthcare professionals (p<0.0001) although there was no significant difference in video duration (p=0.18). Increased duration, view count, comments, shares, saves, and views/day were all associated with increased DISCERN score and quality of the videos. Educational videos were of higher quality compared to entertainment videos, and videos outlining the procedure details had the highest quality score. Conclusions. LASIK videos on TikTok have established a wide reach, whereby viewers are highly interacting and viewing these videos. It appeared that viewers interacted more with the higher quality videos. Ophthalmologists approximately only contributed to a quarter of the videos analyzed in this study. This highlights the need for ophthalmologists to establish a presence on TikTok and produce high quality videos.
Associations of Area-Level and Parental Individual-Level Social Deprivation with Glycemic Control over Time among Children with Type 1 Diabetes in France: A Longitudinal Cohort Study
Authors: Morard Isaline , Barat Pascal , Bailhache Marion
Published: May 2024

Background. Poor glycemic control in patients with type 1 diabetes (T1D) is associated with greater social deprivation. However, the evidence is inconsistent in terms of the type of social deprivation (individual-level or area-level) and whether glycemic control changes over time. Here, we investigated the impacts of individual-level and area-level social deprivation on the glycated hemoglobin (HbA1c) trajectory from the time of T1D diagnosis. Materials and Methods. We retrospectively analyzed a cohort of children who were diagnosed with T1D between 2017 and 2020 at Bordeaux University Hospital. Social deprivation was assessed using both parental individual indicator (EPICES score) and ecological indicator (European Deprivation Index (EDI) score). Piecewise linear mixed-effects models were used to estimate the effects of social deprivation on HbA1c trajectory. Results. We included 168 patients. The most-deprived group included 29% and 22% of all patients, as revealed by the respective EPICES and EDI scores. The two indicators were poorly correlated. The short-term decrease in HbA1c level tended to be smaller in the most-deprived patients over the first 4 months after diagnosis than in other patients (slope difference of 2.68% per year compared with the slope among the least-deprived patients, P=0.056). The long-term trajectory was influenced by area-level deprivation (EDI score); the least-deprived patients (quintile 1) exhibited more stable mean HbA1c levels. Conclusions. Social deprivation may partially explain poor glycemic control in some patients; both short-term individual deprivation and long-term area-level deprivation may be involved. Further research is needed to determine how to integrate this information into a therapeutic strategy.
Multiobjective Optimization of Hard Turning on OHNS Steel Using Desirability and TOPSIS Approaches
Authors: Manikandan C. , Rajeswari B. , Mohan Dhanesh G. , Aravind R. M.
Published: May 2024

Machining hard materials with 45–48 HRC is difficult in turning operation because of the improvident cutting parameter selections for the operation. The OHNS (AISI/SAE-01–48HRC) steel is mainly preferred for the production of shafts, gears, cams, and press tools. The OHNS material was turned at a dry state using VP-coated carbide inserts. The seventeen experimental trials were designed by central composite design (CCD) with different levels of cutting parameters, like feed rate, cutting speed, and depth of cut. Design Expert-11 software desirability approach and TOPSIS (Technique for Order Preference by Simulating the Ideal Solution) were used to analyse the experimental results to obtain a single optimal solution that defines better results on metal removal rate (MRR) and surface finish (Ra). RSM solution with 81.3% desirability, the cutting speed of 60 m/min, feed rate of 0.08 mm/rev, and depth of cut 1 mm as the optimal cutting parameters; similarly, TOPSIS algorithm calculation identifies the cutting parameter combinations, such as 40 m/min cutting speed, 0.09 mm/rev feed rate, and 1 mm depth cut to enrich the quality of the machined steel; however, the desirability approach cutting parameter setting is better for the surface finish achievement, while TOPSIS solution is better to obtain significant MRR. The confirmation test results validated for the predicted values of both approaches; as such, the experimental results were maintained better convenience than the predicted one. For the optimum cutting parameter combinations, an MRR of 22.032 gm/min and surface roughness of 0.781 μm were obtained at 60 m/min cutting speed, 0.08 mm/rev feed rate, and 1 mm depth of cut.
Organizational Factors Associated with Regulation Noncompliance in Home Care Services and Service Housing Facilities: An Exploratory Cross‐Sectional Study
Authors: Corneliusson Laura , Ruotsalainen Salla , Pesonen Tiina , Sulander Juhani , Sinervo Timo
Published: May 2024

Rationale. Recent studies have highlighted organizational issues, work stressors, and moral distress as prevalent problems among staff working within care services for older people, but factors influencing regulatory compliance in care services for older people are currently uncharted. Aims and Objectives. The aim of this exploratory study was to investigate how organizational factors, the clinical characteristics of the clients, and perceived organizational factors are associated with staff regulation noncompliance within home care services and service housing facilities. Methods. A self‐report survey was sent to practical and registered nurses working in home care services and service housing in Finland in October 2021. The sample consisted of 352 home care and 555 service housing staff members. Separate models were calculated for home care services and service housing facilities. The data were analyzed using logistic regression models. CROSS reporting guidelines were followed. Results. The results show that in service housing facilities, higher numbers of disruptions, lower team autonomy, and working for a private employer increased the odds of regulation noncompliance. In home care services, higher numbers of visits during a day, higher numbers of disruptions, and lower team autonomy increased the odds of regulation noncompliance, while attending to clients requiring less resources decreased the odds of regulation noncompliance. Perceived lack of time and resources were influential factors in both contexts. Conclusion. Allocating more time to attend to tasks, ensuring adequate staffing, as well as supporting team autonomy, may increase regulation compliance within care services for older people.
Assessment of Macrovascular Invasion in Advanced Hepatocellular Carcinoma: Clinical Implications and Treatment Outcomes with Systemic Therapy
Authors: Inoue Masanori , Ogasawara Sadahisa , Kobayashi Kazufumi , Okubo Tomomi , Itokawa Norio , Obu Masamichi , Fujimoto Kentaro , Unozawa Hidemi , Yumita Sae , Fujiwara Kisako , Nakagawa Miyuki , Kanzaki Hiroaki , Koroki Keisuke , Kiyono Soichiro , Nakamura Masato , Kanogawa Naoya , Kondo Takayuki , Nakamoto Shingo , Nagashima Kengo , Itobayashi Ei , Atsukawa Masanori , Koma Yoshihiro , Azemoto Ryosaku , Kato Naoya
Published: May 2024

Introduction: Macrovascular invasion (MVI) is a strong prognostic factor for advanced hepatocellular carcinoma (HCC). The current criteria for radiological assessment are unclear in evaluating the impact of MVI on systemic therapy. In this study, we standardized the assessment of MVI and validated its clinical relevance. Methods: Clinical data were collected from patients with advanced HCC and MVI who received first-line systemic therapy at four medical centers in Japan. First, we used MVI progressive disease (MVI-PD) to track MVI progression and Response Evaluation Criteria in Solid Tumors version 1.1 progressive disease (RECIST v1.1-PD) to evaluate tumor enlargement other than MVI and the appearance of new lesions. Next, we assessed the prognostic value of MVI-PD and RECIST v1.1-PD. Results: Of the 207 advanced HCC patients with MVI, 189 received appropriate imaging evaluation. Forty (21.2%) patients had MVI-PD and RECIST v1.1-PD, 51 (27.0%) had prior MVI-PD, and 61 (32.3%) had prior RECIST v1.1-PD. In a landmark analysis, the prognosis of 163 patients who survived more than 3 months was analyzed based on the assessment of imaging response during the first 3 months. The median overall survival (OS) was 5.4 months in those who had MVI-PD and RECIST v1.1-PD, 7.4 months in those who had RECIST v1.1-PD only, 7.2 months in those who had MVI-PD only, and 19.7 months in patients who had neither (p < 0.001). The correlation coefficients between progression-free survival and OS in patients with appropriate imaging assessments were similar for MVI-PD (0.515) and RECIST v1.1-PD (0.498). Conclusion: Our findings demonstrate the link between MVI progression and poor OS in systemic therapy for advanced HCC, emphasizing the importance of an accurate method for assessing MVI progression.
p53 and Vimentin Double Immunostaining to Differentiate between High-Grade Urothelial Carcinoma Cells and Benign Atypical Cells
Authors: Ose Hiroko , Nakamura Akihiro , Nukaya Takuhisa , Sofue Tadashi , Haba Reiji , Itoh Tomoo , Kamoshida Shingo , Ohsaki Hiroyuki
Published: May 2024

Introduction: Urine cytology is an indispensable test for detecting high-grade urothelial carcinoma (HGUC); however, the distinction between HGUC cells and morphologically similar benign atypical cells poses clinical challenges. In this study, we performed double immunostaining for p53 and vimentin to establish a diagnostic method to accurately distinguish HGUC cells from benign atypical cells. Methods: This study included 41 cases of HGUC, 11 of urolithiasis, and 22 of glomerular disease diagnosed histopathologically or clinically. After preparing urine cytology specimens from voided urine samples, p53 immunostaining was performed, and the p53-positive intensity and p53 positivity rate were calculated. Subsequently, vimentin immunostaining was performed on the same specimens to calculate the rate of vimentin positivity. Results: The HGUC cell group had a mean p53-positive intensity of 2.40, a mean p53 positivity rate of 73.2%, and a mean vimentin positivity rate of 5.1%. In contrast, the mean p53-positive intensity, p53 positivity rate, and vimentin positivity rate were 1.63, 36.7%, and 66.2%, respectively, in the benign atypical cell group. There were significant differences between the two groups for each parameter. Moreover, two multiple logistic regression models combining the results of these three parameters exhibited higher sensitivity and specificity than solely assessing the p53-positive intensity, positivity rate, and vimentin positivity rate. Conclusion: Since double immunostaining with p53 and vimentin distinguishes HGUC cells from benign atypical cells, it could be to improve the diagnostic accuracy of urine cytology.
Reseña de libro ¿Qué hay más allá de la juventud? Una lectura desde las políticas del acontecimiento
Authors: Patiño Castañeda Yazmín Andrea
Published: May 2024

El Investigador Jorge Eliécer Martínez reúne en este libro cuatro ensayos ya publicados cuyo eje es el tema de la niñez y juventud. Se constituye sin duda en un referente a partir del cual la juventud es vista como una categoría contemporánea desde la cual se puede abordar la teoría social. La puesta en escena de este planteamiento va más allá de la descripción de la juventud como una categoría del desarrollo humano y se convierte en una invitación para que el lector asuma una postura crítica, desde la cual reflexione y elabore sus propias interpretaciones.

La lectura histórica de las teorías de la juventud que hace Jorge Eliécer Martínez se construye a partir de tres conceptos esenciales: desmodernización, cuyos referentes son autores como Alain Touraine y Anthony Giddens; multitud, desarrollado desde los aportes de Michael Hardt y Antonio Negri; y políticas del acontecimiento, vistas desde las concepciones de Mauricio Lazzarato y Rossana Reguillo. Por ser este un ejercicio de síntesis académica, el lector puede encontrar elementos que en su búsqueda investigativa le permiten transitar del ámbito de la teoría al de la práctica, para desde allí, realizar una pregunta fundamental desde la cual pueda movilizar su lugar político como investigador social a partir de la categoría juventud.
Association of Hypertensive Disorders of Pregnancy With Coronary Microvascular Dysfunction 8 to 10 Years After Delivery
Authors: Countouris Malamo E. , Catov Janet M. , Zhu Jianhui , de Jong Nikki , Brands Judith , Chen Xucai , Parks W. Tony , Berlacher Kathryn L. , Gandley Robin E. , Straub Adam C. , Villanueva Flordeliza S.
Published: May 2024

BACKGROUND:

Hypertensive disorders of pregnancy (HDP) are associated with subsequent adverse cardiac remodeling and cardiovascular disease. The role of myocardial microvascular disease among individuals with HDP and left ventricular (LV) remodeling as a potential link to cardiovascular disease is unknown. We aimed to determine whether individuals with HDP history have coronary microvascular dysfunction measured by coronary flow reserve 8 to 10 years after delivery and whether microvascular dysfunction correlates with LV remodeling.

METHODS:

Individuals with pregnancies delivered from 2008 to 2010 underwent burst-replenishment myocardial contrast echocardiography (2017–2020) to quantify myocardial perfusion at rest and during dobutamine stress. Video intensity versus time data were used to derive β, the rate of rise of video intensity, a correlate for myocardial blood flow. Coronary flow reserve was calculated as the ratio of β at peak stress to β at rest, averaged across LV myocardial regions of interest.

RESULTS:

We studied 91 individuals (aged 38±6 and 9.1±0.9 years postdelivery) and 19 with a history of HDP. Individuals with coronary microvascular dysfunction (coronary flow reserve <2.0; n=13) had a higher proportion of HDP (46.2% versus 16.7%;
P
=0.026) and higher prepregnancy body mass index, baseline heart rate, and hemoglobin A1c compared with those without microvascular dysfunction. The association of coronary flow reserve and HDP was attenuated after adjusting for cardiometabolic factors (
P
=0.133). In exploratory subgroup analyses, individuals with both LV remodeling (relative wall thickness >0.42) and HDP (n=12) had the highest proportion of microvascular dysfunction (41.7% versus +HDP-LV remodeling [n=7] 14.3%; −HDP+LV remodeling [n=26] 7.7%;
P
=0.0498).

CONCLUSIONS:

In this small study, HDP history is associated with coronary microvascular dysfunction 1 decade after delivery, findings that may, in part, be driven by metabolic factors including obesity and diabetes. Microvascular dysfunction may contribute to cardiovascular disease among individuals with a history of HDP.