bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurodevelopment and early pharmacological interventions in Fragile X Syndrome
Authors: Milla Luis A. , Corral Lucia , Rivera Jhanpool , Zuñiga Nolberto , Pino Gabriela , Nunez-Parra Alexia , Cea-Del Rio Christian A.
Published: August 2023

Fragile X Syndrome (FXS) is a neurodevelopmental disorder and the leading monogenic cause of autism and intellectual disability. For years, several efforts have been made to develop an effective therapeutic approach to phenotypically rescue patients from the disorder, with some even advancing to late phases of clinical trials. Unfortunately, none of these attempts have completely succeeded, bringing urgency to further expand and refocus research on FXS therapeutics. FXS arises at early stages of postnatal development due to the mutation and transcriptional silencing of the Fragile X Messenger Ribonucleoprotein 1 gene (FMR1) and consequent loss of the Fragile X Messenger Ribonucleoprotein (FMRP) expression. Importantly, FMRP expression is critical for the normal adult nervous system function, particularly during specific windows of embryogenic and early postnatal development. Cellular proliferation, migration, morphology, axonal guidance, synapse formation, and in general, neuronal network establishment and maturation are abnormally regulated in FXS, underlying the cognitive and behavioral phenotypes of the disorder. In this review, we highlight the relevance of therapeutically intervening during critical time points of development, such as early postnatal periods in infants and young children and discuss past and current clinical trials in FXS and their potential to specifically target those periods. We also discuss potential benefits, limitations, and disadvantages of these pharmacological tools based on preclinical and clinical research.
Discrimination of Dendropanax morbifera via HPLC fingerprinting and SNP analysis and its impact on obesity by modulating adipogenesis- and thermogenesis-related genes
Authors: Awais Muhammad , Akter Reshmi , Boopathi Vinothini , Ahn Jong Chan , Lee Jung Hyeok , Mathiyalagan Ramya , Kwak Gi-Young , Rauf Mamoona , Yang Deok Chun , Lee Geun Sik , Kim Yeon-Ju , Jung Seok-Kyu
Published: August 2023

Dendropanax morbifera (DM), a medicinal plant, is rich in polyphenols and commonly used to treat cancer, inflammation, and thrombosis. However, to date, no study has been conducted on DM regarding the enormous drift of secondary metabolites of plants in different regions of the Republic of Korea and their effects on antiobesity, to explore compounds that play an important role in two major obesity-related pathways. Here, we present an in-depth study on DM samples collected from three regions of the Republic of Korea [Jeju Island (DMJ), Bogildo (DMB), and Jangheung (DMJG)]. We used high-performance liquid chromatography (HPLC) and multivariate component analyses to analyze polyphenol contents (neochlorogenic acid, chlorogenic acid, cryptochlorogenic acid, and rutin), followed by discrimination of the samples in DMJG using single nucleotide polymorphism and chemometric analysis. In silico and in vitro evaluation of major compounds found in the plant extract on two major anti-obesity pathways (adipogenesis and thermogenesis) was carried out. Furthermore, two extraction methods (Soxhlet and ultrasound-assisted extraction) were used to understand which method is better and why. Upon quantifying plant samples in three regions with the polyphenols, DMJG had the highest content of polyphenols. The internal transcribed region (ITS) revealed a specific gel-based band for the authentication of DMJG. PCA and PLS-DA revealed the polyphenol’s discriminative power of the region DMJG. The anti-obesity effects of plant extracts from the three regions were related to their polyphenol contents, with DMJG showing the highest effect followed by DMJ and DMB. Ultrasound-assisted extraction yielded a high number of polyphenols compared to that of the Soxhlet method, which was supported by scanning electron microscopy. The present work encourages studies on plants rich in secondary metabolites to efficiently use them for dietary and therapeutic purposes.
Influence of food emulsifiers on cellular function and inflammation, a preliminary study
Authors: Dufrusine Beatrice , Di Lisio Chiara , Maurizio Andrea , Sallese Michele , De Laurenzi Vincenzo , Dainese Enrico
Published: August 2023

Emulsifiers are extensively used as food additives and their consumption is increasing in Western countries. However, so far only few studies examined their potential effects on intestinal cellular functions and gut inflammation. The aim of this preliminary analysis was to study the emulsifiers and their concentrations capable of causing cellular damage compared to extra virgin olive oil (EVOO). We tested two commonly used emulsifiers (EMI, EMII) and EVOO on Caco-2 cells, derived from a colon carcinoma and widely used as a model of the intestinal inflammation. The diphenyltetrazolium bromide test MTT and clonogenic assay were used to study the effect of emulsifiers on cell viability. Cell migration was determined by the wound-healing assay. The inflammation was studied by measuring the levels of interleukin 6 (IL-6) and monocyte chemoattractant protein-1/C–C motif chemokine ligand 2 (CCL2), multifunctional cytokines with a major role in the acute-phase response. Furthermore, we analyzed the effect of conditioned media of Caco-2 cells treated with EMs on macrophages activation. In conclusion, our preliminary data provide evidence that EMs increase the proliferation and migration rate of Caco-2 cells. Moreover, Caco-2 cells treated with EMs enhance the IL-6 and CCL2 release and activated macrophages, supporting their role as proinflammatory molecules.
Pediatric heart failure with preserved ejection fraction, a review
Authors: Quennelle Sophie , Bonnet Damien
Published: August 2023

Diastolic dysfunction refers to a structural or functional abnormality of the left ventricle, resulting in impaired filling of the heart. Severe diastolic dysfunction can lead to congestive heart failure even when the left ventricle systolic function is normal. Heart failure with preserved ejection fraction (HFpEF) accounts for nearly half of the hospitalizations for acute heart failure in the adult population but the clinical recognition and understanding of HFpEF in children is poor. The condition is certainly much less frequent than in the adult population but the confirmatory diagnosis of diastolic dysfunction in children is also challenging. The underlying causes of HFpEF in children are diverse and differ from the main cause in adults. This review addresses the underlying causes and prognostic factors of HFpEF in children. We describe the pulmonary hypertension profiles associated with this cardiac condition. We discuss diagnosis difficulties in clinical practice, and we provide a simplified diagnostic algorithm for HFpEF in children.
Leaf resistance to Botrytis cinerea in wild tomato Solanum habrochaites depends on inoculum composition
Authors: You Yaohua , Astudillo-Estévez Iván , Essenstam Bert , Qin Si , van Kan Jan A. L.
Published: August 2023

Tomato (Solanum lycopersicum) cv. Moneymaker (MM) is very susceptible to the grey mould Botrytis cinerea, while quantitative resistance in the wild species Solanum habrochaites (accession LYC4) has been reported. In leaf inoculation assays, an effect of nutrient and spore concentration on disease incidence was observed. Resistance in LYC4 leaves was manifested as a high incidence of tiny black, dispersed spots which did not expand (“incompatible interaction”) and was pronounced when B. cinerea was inoculated at high spore density (1000 spores/µL) in medium with 10 mM sucrose and 10 mM phosphate buffer. Under the same condition, a high frequency of expanding lesions was observed on MM leaves (“compatible interaction”). Remarkably, inoculation of LYC4 with a high spore density in medium with higher concentrations of sucrose and/or phosphate as well as lower spore density (30 spores/µL) in medium with low sucrose and phosphate, all resulted in a higher percentage of expanding lesions. The lesion sizes at 3 days post inoculation differed markedly between all these inoculation conditions. This inoculation method provides a convenient tool to study mechanisms that determine the distinction between compatible and incompatible interactions between B. cinerea and a host plant.
A first look at the ability to use genomic prediction for improving the ratooning ability of sugarcane
Authors: Islam Md. Sariful , Corak Keo , McCord Per , Hulse-Kemp Amanda M. , Lipka Alexander E.
Published: August 2023

The sugarcane ratooning ability (RA) is the most important target trait for breeders seeking to enhance the profitability of sugarcane production by reducing the planting cost. Understanding the genetics governing the RA could help breeders by identifying molecular markers that could be used for genomics-assisted breeding (GAB). A replicated field trial was conducted for three crop cycles (plant cane, first ratoon, and second ratoon) using 432 sugarcane clones and used for conducting genome-wide association and genomic prediction of five sugar and yield component traits of the RA. The RA traits for economic index (EI), stalk population (SP), stalk weight (SW), tonns of cane per hectare (TCH), and tonns of sucrose per hectare (TSH) were estimated from the yield and sugar data. A total of six putative quantitative trait loci and eight nonredundant single-nucleotide polymorphism (SNP) markers were associated with all five tested RA traits and appear to be unique. Seven putative candidate genes were colocated with significant SNPs associated with the five RA traits. The genomic prediction accuracies for those tested traits were moderate and ranged from 0.21 to 0.36. However, the models fitting fixed effects for the most significant associated markers for each respective trait did not give any advantages over the standard models without fixed effects. As a result of this study, more robust markers could be used in the future for clone selection in sugarcane, potentially helping resolve the genetic control of the RA in sugarcane.
Exploring perceived restoration, landscape perception, and place attachment in historical districts: insights from diverse visitors
Authors: Li Jiaying , Luo Junjie , Deng Tangmin , Tian Jingwen , Wang Hongcheng
Published: August 2023

Improving the quality of the built environment to enhance people’s mental health is gaining traction across various fields, precipitating valuable actions on the wave of “Healthy China 2030” initiative. While ample studies have confirmed the benefits of interaction with natural or green spaces, the investigation into the restorative potential in urban built settings remains notably underexplored. In this study, we focused on historical districts, conducting a questionnaire survey to evaluate the restorative experiences of individuals visiting these sites. We used Partial Least Square-Structural Equation Modelling (PLS-SEM) to analyze a conceptual model that encompasses landscape perception, place attachment, and perceived restoration, with a specific focus on detecting the mediating role of place attachment and the moderating influence of visitor groups. The results showed that landscape perception significantly influenced the perceived restoration, which contained the indirect effect pathway through place dependence and place identity, as well as the potent direct impact of landscape perception. Moreover, employing a multi-group analysis (MGA), we discerned that different visitor groups partially moderate the relationship between landscape perception, place attachment, and perceived restoration. This study validates the restorative features in historic districts and highlights the importance of cognitive-emotional bond in promoting psychological restoration.
Oral language comprehension of young adults with low-level reading comprehension
Authors: Bar-Kochva Irit , Vágvölgyi Réka , Schrader Josef , Nuerk Hans-Christoph
Published: August 2023

Significant difficulties in reading comprehension, despite attendance of compulsory schooling, are a worldwide phenomenon. While previous research on adults with low literacy skills focused primarily on their reading ability, less is known about their oral language skills. In this Brief Research Report, we present an investigation of the listening comprehension skills of a selected group of German-speaking young adults, whose reading comprehension is at a primary school level (n = 32, ages 16 to 19  years). In addition, the relationship between listening comprehension and reading comprehension, beyond word reading skills, was tested. Standardized tests of reading and listening comprehension in the German language were administered. The average performance of the group in the listening comprehension tasks was below the level expected by age and educational level. In addition, when entered into a stepwise regression equation, listening comprehension, but not word reading, explained a significant amount of variance in reading comprehension. This pattern of relationship differs from previous findings in studies of adults struggling to read the opaque English orthography. Whether orthographic transparency explains this discrepancy should be further tested in cross-orthography studies with larger samples of adults with low literacy skills.
Long-term use of benzodiazepines in chronic insomnia: a European perspective
Authors: Soyka Michael , Wild Imane , Caulet Bérangère , Leontiou Chrysoula , Lugoboni Fabio , Hajak Göran
Published: August 2023

Chronic insomnia occurs in ~10% of the general population and has numerous negative health effects. The recommended first line treatment of cognitive behavior therapy for insomnia is not widely available for patients in Europe, so pharmacotherapies such as benzodiazepine receptor agonist agents (benzodiazepines and Z-drugs) are commonly used. However, their use is only recommended for ≤4 weeks due to unproven long-term efficacy in treatment of chronic insomnia, and the risk of tolerance, and the potential for dependence and misuse. In Europe, recommendations limiting the use of benzodiazepines (lowest dose and shortest duration) in chronic insomnia are not always followed, likely due to the lack of approved effective alternative therapies. Here we present a recent pilot survey of the pharmacological treatment landscape in chronic insomnia in five European countries (France, Germany, Italy, Spain, and the United Kingdom) and physicians’ attitude toward treatment. The results suggest that benzodiazepines and Z-drugs are the most widely used treatments in chronic insomnia and are being used for longer than their recommended duration. Country variations in prescription rates were observed. Due to the known association between long-term benzodiazepine use and potential for developing dependence, further analysis of the literature was performed on the use and misuse of benzodiazepines. The results show that long-term use of benzodiazepines is associated with multiple consequences of treatment, including dependence, but also that previous use of benzodiazepines may increase the risk of opioid use disorder.
Association between per- and polyfluoroalkyl substances and risk of hypertension: a systematic review and meta-analysis
Authors: Xiao Fang , An Ziwen , Lv Junli , Sun Xiaoyi , Sun Heming , Liu Yi , Liu Xuehui , Guo Huicai
Published: August 2023

Background

Existing evidence indicates that exposure to per- and polyfluoroalkyl substances (PFASs) may increase the risk of hypertension, but the findings are inconsistent. Therefore, we aimed to explore the relationship between PFASs and hypertension through this systematic review and meta-analysis.

Methods

We searched PubMed, Embase, and the Web of Science databases for articles published in English that examined the relationship between PFASs and hypertension before 13 August 2022. The random effects model was used to aggregate the evaluation using Stata 15.0 for Windows. We also conducted subgroup analyses by region and hypertension definition. In addition, a sensitivity analysis was carried out to determine the robustness of the findings.

Results

The meta-analysis comprised 15 studies in total with 69,949 individuals. The risk of hypertension was substantially and positively correlated with exposure to perfluorooctane sulfonate (PFOS) (OR = 1.31, 95% CI: 1.14, 1.51), perfluorooctanoic acid (PFOA) (OR = 1.16, 95% CI: 1.07, 1.26), and perfluorohexane sulfonate (PFHxS) (OR = 1.04, 95% CI: 1.00, 1.09). However, perfluorononanoic acid (PFNA) exposure and hypertension were not significantly associated (OR = 1.08, 95% CI: 0.99, 1.17).

Conclusion

We evaluated the link between PFASs exposure and hypertension and discovered that higher levels of PFOS, PFOA, and PFHxS were correlated with an increased risk of hypertension. However, further high-quality population-based and pathophysiological investigations are required to shed light on the possible mechanism and demonstrate causation because of the considerable variability.

Systematic review registration

https://www.crd.york.ac.uk/prospero/ PROSPERO, registration number: CRD 42022358142.
Occupational heat stress, heat-related effects and the related social and economic loss: a scoping literature review
Authors: De Sario Manuela , de'Donato Francesca Katherine , Bonafede Michela , Marinaccio Alessandro , Levi Miriam , Ariani Filippo , Morabito Marco , Michelozzi Paola
Published: August 2023

Introduction

While there is consistent evidence on the effects of heat on workers' health and safety, the evidence on the resulting social and economic impacts is still limited. A scoping literature review was carried out to update the knowledge about social and economic impacts related to workplace heat exposure.

Methods

The literature search was conducted in two bibliographic databases (Web of Science and PubMed), to select publications from 2010 to April 2022.

Results

A total of 89 studies were included in the qualitative synthesis (32 field studies, 8 studies estimating healthcare-related costs, and 49 economic studies). Overall, consistent evidence of the socioeconomic impacts of heat exposure in the workplace emerges. Actual productivity losses at the global level are nearly 10% and are expected to increase up to 30–40% under the worst climate change scenario by the end of the century. Vulnerable regions are mainly low-latitude and low- and middle-income countries with a greater proportion of outdoor workers but include also areas from developed countries such as southern Europe. The most affected sectors are agriculture and construction. There is limited evidence regarding the role of cooling measures and changes in the work/rest schedule in mitigating heat-related productivity loss.

Conclusion

The available evidence highlights the need for strengthening prevention efforts to enhance workers' awareness and resilience toward occupational heat exposure, particularly in low- and middle-income countries but also in some areas of developed countries where an increase in frequency and intensity of heat waves is expected under future climate change scenarios.
Communicating natural hazard risks to Chinese visitors: a case study from New Zealand
Authors: Cui Aviva , Fountain Joanna , Espiner Stephen
Published: August 2023

Introduction

Research has shown that tourists are vulnerable to natural hazards during their travels. For this reason, communicating potential natural hazard risks to tourists prior to, and during, their journeys plays an important role in helping visitors safely navigate the natural hazards they may encounter. Tourists have different levels of vulnerability, depending on a range of personal, cultural and experiential factors, so risk communication must be appropriately targetted to particular markets. This research investigates supply side stakeholders' perceptions of the awareness of, and preparedness for, natural hazard risks amongst Chinese visitors to the West Coast of the South Island (Aotearoa New Zealand), and assesses the effectiveness of current risk communication processes and content for Chinese visitors.

Methods

The research questions are addressed through semi-structured interviews with representatives of government agencies and tourism businesses directly and/or indirectly involved in managing Chinese tourists' experiences and risk communication in the region, and supplemented with documentary analysis of strategy documents, social media and website resources

Results

Applying a Mental Models Approach, results reveal that informants have relatively similar perspectives on Chinese tourists' awareness of natural hazard risks, irrespective of the nature of their interaction with the Chinese market, however there are some differences in their views of who should be responsible for risk communcation, and when and how that should be delivered.

Discussion

Chinese tourists' awareness and preparedness for natural hazards tends to be influenced by contextual differences more than cultural differences, and this is better understood by tourism stakeholders with personal contact with these tourists. There are perceived barriers to improving natural hazard risk preparedness, including the over-reliance on signage, and tourism stakeholders' reticence about sharing too much information about natural hazard risks with potential, or actual, visitors.
Exploring the user experience (UX) of a multi-window augmented reality environment
Authors: Sinlapanuntakul Pitch , Korentsides Jenna , Chaparro Barbara S.
Published: August 2023

Augmented reality is an emergent form of technology that allows users to interact with and manipulate virtual objects and information integrated into the physical environment. Whether it is replying to browser-based emails or playing a game, completing such tasks in augmented reality requires the use of hand-tracking gestures or interactions. With the anticipated growth of this technology, future users may experience it for extended periods with a variety of applications (e.g., metaverse). This study explores the perceptions and user experience of individuals when interacting with and maneuvering in a multi-window augmented reality environment, using a range of hand-tracking interactions. The results provide both qualitative and quantitative insights into these interactions, highlighting the impact of perceived usability, subjective user experience, perceived difficulty, and perceived workload on task completion.
Case report: Ethylene glycol intoxication presenting as a mimic of acute stroke: a report of three cases
Authors: Héja Máté , Oláh László
Published: August 2023

Stroke is a major cause of death and disability presenting with acute focal neurological symptoms of vascular origin. Several other disorders may cause symptoms similar to a stroke, referred to as stroke mimics. The misdiagnosis of stroke mimics may lead to potentially harmful treatments, including thrombolysis. Intoxication is a rare, but possible, cause of stroke mimic. We present three cases of ethylene glycol poisoning presenting as an acute stroke mimic within the time window of thrombolytic therapy. Two of three patients (a 54-year-old male and a 78-year-old male) had dysarthria, nystagmus, and truncal ataxia on admission. The third patient with a history of chronic alcoholism presented after an epileptic seizure with mixed aphasia and confusion. Non-contrast cerebral computed tomography and computed tomography angiography were negative in all three cases. As stroke could not be excluded in any of the patients, thrombolysis was performed. However, after some hours, two of the three patients developed agitation, somnolence, and hyperventilation. One patient's consciousness deteriorated rapidly, and he became comatose and tetraplegic. A blood gas analysis showed acidosis in two of the three patients, and toxicological screening revealed ethylene glycol intoxication in all three cases. Due to the appropriate treatment, two of the three patients became symptom-free; however, one of the three patients died. Our cases show that ethylene glycol intoxication in its early phase may mimic acute stroke, resulting in unnecessary thrombolytic therapy. Symptoms not characteristic of a stroke, such as hyperventilation, agitation, and disturbance of consciousness, may appear later and warn of intoxication. The final diagnosis of ethylene glycol intoxication can be established by severe metabolic acidosis and toxicological screening. Close monitoring of symptoms might contribute to the early recognition of ethylene glycol intoxication and its effective treatment.
The Role of Business Students’ Entrepreneurial Intention and Technology Preparedness in the Digital Age
Authors: Biclesanu Isabelle , Savastano Marco , Chinie Cătălina , Anagnoste Sorin
Published: August 2023

Innovative digital technologies, together with new sustainable practices, push for new business models and skillsets, pressuring companies to adapt to external change in order to gain competitive advantage. Higher education institutions could offer support. More than 20% of university graduates in the European Union study “business, administration or law”, with some of them being future top-level managers and entrepreneurs. This paper aims to provide an understanding of the factors shaping business students’ perspectives and decisions in the modern business landscape. It reunites their career preferences, personality characteristics and knowledge regarding technology’s utility for business and compares them between two cohorts (i.e., first year bachelor students and second year master students). The results of an online survey with a sample of 154 respondents show that business students’ entrepreneurial intention is influenced by their entrepreneurial confidence, their boldness when considering risks, as well as by being further along their educational journey. While almost 80% of business students are daring, oriented toward results and confident in their entrepreneurial abilities, and around 50% would feel most comfortable having their own business, approximately half of first year bachelor students and 14% of second year master students tend to be “not sure” regarding how eight out of ten modern technologies mentioned in this paper (i.e., robotic process automation, big data, artificial intelligence, computer vision, industrial robots, internet of things, virtual reality, enterprise resource planning) could improve a company’s innovation and performance.
Alternative Antimicrobial Irrigation Strategies for the Treatment of Infections in Children: A Review of the Existing Literature
Authors: Di Chiara Costanza , Ponzoni Matteo , Piché-Renaud Pierre-Philippe , Mengato Daniele , Giaquinto Carlo , Morris Shaun K. , Donà Daniele
Published: August 2023

As a synergistic treatment approach with systemic antimicrobial therapy or a systemic antibiotic-sparing strategy, the local administration of antimicrobial agents has been proposed as an alternative route for complicated infections. With the rationale of concentrating the active principle in the desired target site, avoiding potentially toxic systemic levels and bypassing anatomical and physiological barriers, local irrigation or infusion of antibiotics may effectively shorten the antimicrobial therapy course and reduce both infection-related and systemic therapy-related complications. Although evidence from the adult population supports its use in selected patients with an acceptable safety profile, data specifically focused on the pediatric population are limited. To provide a rapid and easily accessible tool for clinical practice, we synthesized the most relevant evidence on the use of local antimicrobial agents in common severe infections in children: meningitis, mediastinitis, pleural infections, recurrent urinary infections, and peritonitis. A literature search was performed using predefined combined keywords through an electronic research database (PubMed). Described molecules, dosages, routes, treated age groups, and related efficacy have been summarized for prompt application to clinical practice. It should, however, be noted that the evidence for the pediatric population remains limited, and the local administration of several molecules remains off-label. A careful multidisciplinary and patient-tailored evaluation, as well as a rational use of available guidelines, should always be the basis of clinical decision making in settings where local administration of antibiotics may be considered.
Effect of External Compression on the Thermal Runaway of Lithium-Ion Battery Cells during Crush Tests: Insights for Improved Safety Assessment
Authors: Hahn Alexander , Doose Stefan , Saathoff Daniel , Kwade Arno
Published: August 2023

To gain better understanding of the safety behavior of lithium-ion batteries under mechanical stress, crush tests are performed and reported in literature and in standards. However, many of these tests are conducted without the use of a cell clamping device, whereas external pressure is applied to the cell in a battery module in applications such as in an electric vehicle. The objective of this manuscript is to determine the effect of differing external compression on the thermal runaway of battery cells. Therefore, in this study, crush tests are performed with a hemispherical punch in a battery cell test chamber on commercially available 5 Ah pouch cells in a clamping device at four different normal stresses. The results are compared to cells that are free to expand with gas evolution. It is shown that applying compression to the cells not only results in a greater reproducibility of the experiments but that it also affects the thermal runaway process itself. With decreasing clamping stresses, the reaction time of the thermal runaway is increased by up to 19%, and the mass ejection is decreased by up to 10%, which, in turn, strongly influences the measurable gas concentrations by up to 80%. Based on this, a defined clamping compression was selected to obtain comparable results for different cell formats.
Clinical Stability of Bespoke Snowman Plates for Fixation following Sagittal Split Ramus Osteotomy of the Mandible
Authors: Byun Soo-Hwan , Park Sang-Yoon , Yi Sang-Min , Park In-Young , On Sung-Woon , Jeong Chun-Ki , Kim Jong-Cheol , Yang Byoung-Eun
Published: August 2023

Maxillofacial skeletal surgery often involves the use of patient-specific implants. However, errors in obtaining patient data and designing and manufacturing patient-specific plates and guides can occur even with accurate virtual surgery. To address these errors, bespoke Snowman plates were designed to allow movement of the mandible. This study aimed to compare the stability of bespoke four-hole miniplates with that of a bespoke Snowman plate for bilateral sagittal split ramus osteotomy (SSRO), and to present a method to investigate joint cavity changes, as well as superimpose virtual and actual surgical images of the mandible. This retrospective study included 22 patients who met the inclusion criteria and underwent orthognathic surgery at a university hospital between 2015 and 2018. Two groups were formed on the basis of the plates used: a control group with four-hole bespoke plates and a study group with bespoke Snowman plates. Stability was assessed by measuring the condyle–fossa space and superimposing three-dimensional virtual surgery images on postoperative cone-beam computed tomography (CBCT) scans. No significant differences were observed in the condyle–fossa space preoperatively and 1 year postoperatively between the control and study groups. Superimposing virtual surgery and CBCT scans revealed minimal differences in the landmark points, with no variation between groups or timepoints. The use of bespoke Snowman plates for stabilizing the mandible following SSRO exhibited clinical stability and reliability similar to those with bespoke four-hole plates. Additionally, a novel method was introduced to evaluate skeletal stability by separately analyzing the condyle–fossa gap changes and assessing the mandibular position.
SeizFt: Interpretable Machine Learning for Seizure Detection Using Wearables
Authors: Al-Hussaini Irfan , Mitchell Cassie S.
Published: August 2023

This work presents SeizFt—a novel seizure detection framework that utilizes machine learning to automatically detect seizures using wearable SensorDot EEG data. Inspired by interpretable sleep staging, our novel approach employs a unique combination of data augmentation, meaningful feature extraction, and an ensemble of decision trees to improve resilience to variations in EEG and to increase the capacity to generalize to unseen data. Fourier Transform (FT) Surrogates were utilized to increase sample size and improve the class balance between labeled non-seizure and seizure epochs. To enhance model stability and accuracy, SeizFt utilizes an ensemble of decision trees through the CatBoost classifier to classify each second of EEG recording as seizure or non-seizure. The SeizIt1 dataset was used for training, and the SeizIt2 dataset for validation and testing. Model performance for seizure detection was evaluated using two primary metrics: sensitivity using the any-overlap method (OVLP) and False Alarm (FA) rate using epoch-based scoring (EPOCH). Notably, SeizFt placed first among an array of state-of-the-art seizure detection algorithms as part of the Seizure Detection Grand Challenge at the 2023 International Conference on Acoustics, Speech, and Signal Processing (ICASSP). SeizFt outperformed state-of-the-art black-box models in accurate seizure detection and minimized false alarms, obtaining a total score of 40.15, combining OVLP and EPOCH across two tasks and representing an improvement of ~30% from the next best approach. The interpretability of SeizFt is a key advantage, as it fosters trust and accountability among healthcare professionals. The most predictive seizure detection features extracted from SeizFt were: delta wave, interquartile range, standard deviation, total absolute power, theta wave, the ratio of delta to theta, binned entropy, Hjorth complexity, delta + theta, and Higuchi fractal dimension. In conclusion, the successful application of SeizFt to wearable SensorDot data suggests its potential for real-time, continuous monitoring to improve personalized medicine for epilepsy.
Evaluation of Single Dose and Fractionated Dose of I-131 Radiolabeled Nanoparticles for Triple-Negative Breast Cancer Treatment
Authors: Marshall Suphalak Khamruang , Kaewpradit Nutnicha , Mudmarn Tavadee , Buathong Jirassaya , Sriwirote Palmuk
Published: August 2023

Combination chemotherapy is still the standard clinical care for triple-negative breast cancer (TNBC). However, sodium iodide symporter (NIS) uptake by TNBC has opened the potential of NIS as a molecular target for radioiodine theranostic treatments. Radiolabeled poly(lactic-co-glycolic) acid nanocarrier (NINP) was developed for NIS targeted delivery of I-131 to MDA-MB-231 cells to overcome I-131 low uptake in cancer cells and rapid clearance. The NINP diameter of 237 nm has good particle size uniformity and excellent particle stability. Radiochemical purity, radioactive stability, and radiolabeling yield of NINPs over 72 h were >95%. Cytotoxicity confirmed fractionated NINPs over 72 h to be more effective in cell death than single-dose NINP and both single and fractionated Na131I. Cellular uptake in a three-dimensional spheroid confirmed that NINP fractionated-dose achieved ~4.8-fold-higher mean fluorescent intensity than Na131I and ~2.7-fold greater reduction in cell viability compared to single-dose. The NINP fractionated-dose initiated greater cellular DNA damage to cells than single-dose NINP, resulting in inhibition of cell cycle progression, resulting in cell cycle progression being inhibited by cyclin-dependent kinases, which play a vital role in the control of MDA-MB-231 cell cycle. NINPs are biocompatible with blood, and were found to have no negative impact on red blood cells.
Embolisation Using Microvascular Plugs for Peripheral Applications: Technical Results and Mid-Term Outcomes
Authors: Mailli Rémy , Chevallier Olivier , Mazit Amin , Malakhia Alexandre , Falvo Nicolas , Loffroy Romaric
Published: August 2023

The Micro Vascular Plug® (MVP, Medtronic) is a mechanical embolic agent available in small sizes that allows for distal embolisation. The objective of this retrospective observational single-centre study was to assess MVP embolisation procedures performed at a university hospital. The 33 patients who underwent MVP embolisation in 2021 were included (mean age, 64; 24 males and 9 females). The primary endpoint was technical success, which was defined as a full first-attempt occlusion with one or more MVPs, as documented on the end-of-procedure angiogram. In all patients, 51 MVPs were used overall, with other embolic agents in 23 of the 33 cases (usually coils and/or glue); 22 of the 33 procedures were emergent for bleeding and 11 were planned for other indications. Of the three technical failures, two were due to an angled target artery configuration precluding microcatheterisation and one to failure of the device to release from its wire. The technical success rate was thus 90.9%. No patient experienced MVP migration or other major complications. Five patients had recurrent clinical symptoms; in four cases, the cause was collateral development, and in one case, the cause was incomplete initial embolisation. No instances of recanalisation were documented during the short follow-up of 12 months, for a 100% secondary clinical success rate. At our tertiary-level centre, the MVP was both effective and safe for peripheral applications. Interventional radiologists should be conversant with the techniques and indications of MVP embolisation.
Autoimmune Encephalitis—A Multifaceted Pathology
Authors: Neațu Monica , Jugurt Ana , Covaliu Anca , Davidescu Eugenia Irene , Popescu Bogdan Ovidiu
Published: August 2023

Autoimmune encephalitis is a complex and multifaceted pathology that involves immune-mediated inflammation of the brain. It is characterized by the body’s immune system attacking the brain tissue, leading to a cascade of inflammatory processes. What makes autoimmune encephalitis vast is the wide range of causes, mechanisms, clinical presentations, and diagnostic challenges associated with the condition. The clinical presentations of autoimmune encephalitis are broad and can mimic other neurological disorders, making it a challenging differential diagnosis. This diverse clinical presentation can overlap with other conditions, making it crucial for healthcare professionals to maintain a high level of suspicion for autoimmune encephalitis when evaluating patients. The diagnostic challenges associated with autoimmune encephalitis further contribute to its vastness. Due to the variable nature of the condition, there is no definitive diagnostic test that can confirm autoimmune encephalitis in all cases. In this context, personalized patient management is crucial for achieving favorable outcomes. Each patient’s treatment plan should be tailored to their specific clinical presentation, underlying cause, and immune response. Our objective is to raise awareness about the frequent yet underdiagnosed nature of autoimmune encephalitis by sharing five cases we encountered, along with a brief literature review.
Assessing Nurses’ Knowledge and Attitudes towards Cancer Pain Management in Oman
Authors: Zaabi Adhari Al , Al-Saadi Maeen , Alaswami Husain , Al-Musalami Atika
Published: August 2023

Cancer care in the Gulf Cooperation Countries, including Oman, faces challenges due to increasing incidence and late-stage diagnoses. Cancer patients at later stages suffer complex symptoms, pain being a prominent one. Access to adequate pain relief is a global problem, including in the Middle East, where palliative care is lacking. Nurses play a crucial role in pain assessment and management but often lack the necessary training, resulting in inadequate relief and prolonged hospital stays. This study aims to examine the knowledge and attitudes of nurses in a national cancer center toward the management of cancer pain, with the goal of identifying any gaps in their knowledge. This is a cross-sectional descriptive study conducted among nurses at the national cancer center in the Royal Hospital. The Nurses’ Knowledge and Attitudes Survey Regarding Pain (NKASRP) was used to determine the pain-related knowledge and attitudes of the nurses. Out of 150 registered nurses, 118 participated in this study (78% response rate). The mean NKASRP score was 49.6%. Half of the participants (50%) had a poor level of knowledge and attitude, 46% had fair knowledge and attitude, and only five participants (4%) had a good level of knowledge and attitude. A statistically significant association existed between knowledge and education level, years of experience caring for cancer patients, and prior pain management training (p < 0.05). A low level of knowledge and attitude among nurses in cancer pain management is a significant challenge in providing comprehensive cancer care. Adequate training of nurses in cancer pain management is essential to providing effective pain management and improving the quality of life of cancer patients.
Graft Survivals after Reconstruction Using Tumor-Bearing Frozen Bone in the Extremities
Authors: Miwa Shinji , Yamamoto Norio , Hayashi Katsuhiro , Takeuchi Akihiko , Igarashi Kentaro , Bangcoy Martin Louie S. , Taniguchi Yuta , Morinaga Sei , Asano Yohei , Tsuchiya Hiroyuki
Published: August 2023

Tumor-bearing frozen autografts have been widely used for reconstruction of bone defects caused by tumor resection. However, some patients undergo removal of the grafted bone due to surgical site infection, tumor recurrence, or fractures of the grafted bone. In this retrospective cohort study, predictive factors for graft survival were investigated in 123 patients who underwent reconstructions using a tumor-bearing frozen autograft after bone tumor resection of the extremities. To determine the independent predictors of graft survival, the association between various parameters and graft survival was investigated. The graft survival rates were 83.2% at 5 years and 70.2% at 10 years. Among the 123 frozen autografts, 25 (20.3%) were removed because of complications. In univariate analyses, male sex, BMI of ≥23.6, tibia, and chemotherapy were significantly associated with poor graft survival, whereas the pedicle/hemicortical freezing procedure was significantly associated with better graft survival. Multivariate analysis using the Cox proportional hazards regression model revealed that BMI of ≥23.6 (HR, 3.4; p = 0.005), tibia (HR, 2.3; p = 0.047), and freezing procedure (HR, 0.3; p = 0.016) were independently associated with graft survival. Based on the results, pedicle or hemicortical freezing techniques are recommended in cases where these techniques can be applied.
Stereotactic Radiation Therapy of Single Brain Metastases: A Literature Review of Dosimetric Studies
Authors: Chambrelant Isabelle , Jarnet Delphine , Bou-Gharios Jolie , Le Fèvre Clara , Kuntz Laure , Antoni Delphine , Jenny Catherine , Noël Georges
Published: August 2023

Stereotactic radiotherapy (SRT) plays a major role in treating brain metastases (BMs) and can be delivered using various equipment and techniques. This review aims to identify the dosimetric factors of each technique to determine whether one should be preferred over another for single BMs treatment. A systematic literature review on articles published between January 2015 and January 2022 was conducted using the MEDLINE and ScienceDirect databases, following the PRISMA methodology, using the keywords “dosimetric comparison” and “brain metastases”. The included articles compared two or more SRT techniques for treating single BM and considered at least two parameters among: conformity (CI), homogeneity (HI) and gradient (GI) indexes, delivery treatment time, and dose-volume of normal brain tissue. Eleven studies were analyzed. The heterogeneous lesions along with the different definitions of dosimetric indexes rendered the studied comparison almost unattainable. Gamma Knife (GK) and volumetric modulated arc therapy (VMAT) provide better CI and GI and ensure the sparing of healthy tissue. To conclude, it is crucial to optimize dosimetric indexes to minimize radiation exposure to healthy tissue, particularly in cases of reirradiation. Consequently, there is a need for future well-designed studies to establish guidelines for selecting the appropriate SRT technique based on the treated BMs’ characteristics.
Kv2.1 Channels Prevent Vasomotion and Safeguard Myogenic Reactivity in Rat Small Superior Cerebellar Arteries
Authors: Här Kristina , Lysenko Natalia N. , Dimitrova Daniela , Schlüter Torsten , Zavaritskaya Olga , Kamkin Andrej G. , Mladenov Mitko , Grisk Olaf , Köhler Ralf , Gagov Hristo , Schubert Rudolf
Published: August 2023

Vascular smooth muscle voltage-gated potassium (Kv) channels have been proposed to contribute to myogenic autoregulation. Surprisingly, in initial experiments, we observed that the Kv2 channel inhibitor stromatoxin induced vasomotion without affecting myogenic tone. Thus, we tested the hypothesis that Kv2 channels contribute to myogenic autoregulation by fine-tuning the myogenic response. Expression of Kv2 channel mRNA was determined using real-time PCR and ‘multiplex’ single-cell RT-PCR. Potassium currents were measured using the patch-clamp technique. Contractile responses of intact arteries were studied using isobaric myography. Expression of Kv2.1 but not Kv2.2 channels was detected in intact rat superior cerebellar arteries and in single smooth muscle cells. Stromatoxin, a high-affinity inhibitor of Kv2 channels, reduced smooth muscle Kv currents by 61% at saturating concentrations (EC50 36 nmol/L). Further, stromatoxin (10–100 nmol/L) induced pronounced vasomotion in 48% of the vessels studied. In vessels not exhibiting vasomotion, stromatoxin did not affect myogenic reactivity. Notably, in vessels exhibiting stromatoxin-induced vasomotion, pressure increases evoked two effects: First, they facilitated the occurrence of random vasodilations and/or vasoconstrictions, disturbing the myogenic response (24% of the vessels). Second, they modified the vasomotion by decreasing its amplitude and increasing its frequency, thereby destabilizing myogenic tone (76% of the vessels). Our study demonstrates that (i) Kv2.1 channels are the predominantly expressed Kv channels in smooth muscle cells of rat superior cerebellar arteries, and (ii) Kv2.1 channels provide a novel type of negative feedback mechanism in myogenic autoregulation by preventing vasomotion and thereby safeguarding the myogenic response.