bluuebunny/crossref_metadata_2025 huggingface dataset:
Machine learning for automating subjective clinical assessment of gait impairment in people with acquired brain injury – a comparison of an image extraction and classification system to expert scoring
Authors: Mobbs Ashleigh , Kahn Michelle , Williams Gavin , Mentiplay Benjamin F. , Pua Yong-Hao , Clark Ross A.
Published: July 2024

Background

Walking impairment is a common disability post acquired brain injury (ABI), with visually evident arm movement abnormality identified as negatively impacting a multitude of psychological factors. The International Classification of Functioning, Disability and Health (ICF) qualifiers scale has been used to subjectively assess arm movement abnormality, showing strong intra-rater and test-retest reliability, however, only moderate inter-rater reliability. This impacts clinical utility, limiting its use as a measurement tool. To both automate the analysis and overcome these errors, the primary aim of this study was to evaluate the ability of a novel two-level machine learning model to assess arm movement abnormality during walking in people with ABI.

Methods

Frontal plane gait videos were used to train four networks with 50%, 75%, 90%, and 100% of participants (ABI: n = 42, healthy controls: n = 34) to automatically identify anatomical landmarks using DeepLabCut™ and calculate two-dimensional kinematic joint angles. Assessment scores from three experienced neurorehabilitation clinicians were used with these joint angles to train random forest networks with nested cross-validation to predict assessor scores for all videos. Agreement between unseen participant (i.e. test group participants that were not used to train the model) predictions and each individual assessor’s scores were compared using quadratic weighted kappa. One sample t-tests (to determine over/underprediction against clinician ratings) and one-way ANOVA (to determine differences between networks) were applied to the four networks.

Results

The machine learning predictions have similar agreement to experienced human assessors, with no statistically significant (p < 0.05) difference for any match contingency. There was no statistically significant difference between the predictions from the four networks (F = 0.119; p = 0.949). The four networks did however under-predict scores with small effect sizes (p range = 0.007 to 0.040; Cohen’s d range = 0.156 to 0.217).

Conclusions

This study demonstrated that machine learning can perform similarly to experienced clinicians when subjectively assessing arm movement abnormality in people with ABI. The relatively small sample size may have resulted in under-prediction of some scores, albeit with small effect sizes. Studies with larger sample sizes that objectively and automatically assess dynamic movement in both local and telerehabilitation assessments, for example using smartphones and edge-based machine learning, to reduce measurement error and healthcare access inequality are needed.
A multi-step approach to overcome challenges in the management of head and neck lymphatic malformations, and response to treatment
Authors: Trevisan Valentina , De Corso Eugenio , Viscogliosi Germana , Onesimo Roberta , Cina Alessandro , Panfili Marco , Perri Lucrezia , Agazzi Cristiana , Giorgio Valentina , Rigante Donato , Vento Giovanni , Papacci Patrizia , Paradiso Filomena Valentina , Silvaroli Sara , Nanni Lorenzo , Resta Nicoletta , Castori Marco , Galli Jacopo , Paludetti Gaetano , Zampino Giuseppe , Leoni Chiara
Published: July 2024

Background

Lymphatic malformations are vascular developmental anomalies varying from local superficial masses to diffuse infiltrating lesions, resulting in disfigurement. Patients’ outcomes range from spontaneous regression to severe sequelae notwithstanding appropriate treatment. The current classification guides, in part, clinicians through the decision-making process, prognosis prediction and choice of therapeutic strategies. Even though the understanding of molecular basis of the disease has been recently improved, a standardized management algorithm has not been reached yet.

Results

Here, we report our experience on five children with different lymphatic anomalies of the head and neck region treated by applying a multidisciplinary approach reaching a consensus among specialists on problem-solving and setting priorities.

Conclusions

Although restitutio ad integrum was rarely achieved and the burden of care is challenging for patients, caregivers and healthcare providers, this study demonstrates how the referral to expert centres can significantly improve outcomes by alleviating parental stress and ameliorating patients’ quality of life. A flow-chart is proposed to guide the multidisciplinary care of children with LMs and to encourage multidisciplinary collaborative initiatives to implement dedicated patients’ pathways.
The impact of ICOSL/ICOS pathway-regulated long non-coding RNAs on liver fibrosis in mice infected with Schistosoma japonicum
Authors: Huang Ping , Xu Jing , Jiang Suqin , Zhang Yanan , Wang Xinyi , Xiong Chunrong , Xia Chaoming
Published: July 2024

Background

The primary pathogenic mechanism of schistosomiasis-associated liver fibrosis involves the deposition of schistosome eggs, leading to the formation of liver egg granulomas and subsequent liver fibrosis. Hepatic stellate cells are abnormally activated, resulting in excessive collagen deposition and fibrosis development. While specific long non-coding RNAs (lncRNAs) have been associated with fibrotic processes, their roles in schistosomiasis-associated liver fibrosis remain unclear.

Methods

Our previous research indicated that downregulating the ICOSL/ICOS could partially alleviate liver fibrosis. In this study, we established a schistosomiasis infection model in C57BL/6 and ICOSL knockout (KO) mice, and the liver pathology changes were observed at various weeks postinfection (wpi) using hematoxylin and eosin and Masson’s trichrome staining. Within the first 4 wpi, no significant liver abnormalities were observed. However, mice exhibited evident egg granulomas and fibrosis in their livers at 7 wpi. Notably, ICOSL-KO mice had significantly smaller pathological variations compared with simultaneously infected C57BL/6 mice. To investigate the impact of lncRNAs on schistosomiasis-associated liver fibrosis, quantitative real-time polymerase chain reaction (RT-qPCR) was used to monitor the dynamic changes of lncRNAs in hepatic stellate cells of infected mice.

Results

The results demonstrated that lncRNA-H19, -MALAT1, -PVT1, -P21 and -GAS5 all participated in liver fibrosis formation after schistosome infection. In addition, ICOSL-KO mice exhibited significantly inhibited expression of lncRNA-H19, -MALAT1 and -PVT1 after 7 wpi. In contrast, they showed enhanced expression of lncRNA-P21 and -GAS5 compared with C57BL/6 mice, influencing liver fibrosis development. Furthermore, small interfering RNA transfection (siRNA) in JS-1 cells in vitro confirmed that lncRNA-H19, -MALAT1, and -PVT1 promoted liver fibrosis, whereas lncRNA-P21 and -GAS5 had the opposite effect on key fibrotic molecules, including α- smooth muscle actin and collagen I expression.

Conclusions

This study uncovers that ICOSL/ICOS may play a role in activating hepatic stellate cells and promoting liver fibrosis in mice infected with Schistosoma japonicum by dynamically regulating the expression of specific lncRNAs. These findings offer potential therapeutic targets for schistosomiasis-associated liver fibrosis.

Graphical Abstract
DNA methylation-mediated suppression of TUSC1 expression regulates the malignant progression of esophagogastric junction cancer
Authors: Liu Zhiqiang , Xia Ganshu , Liang Xiaolong , Li Baozhong , Deng Jingyu
Published: July 2024

Background

Esophagogastric junction cancer (EJC) refers to malignant tumors that develop at the junction between the stomach and the esophagus. TUSC1 is a recently identified tumor suppressor gene known for its involvement in various types of cancer. The objective of this investigation was to elucidate the regulatory influence of DNA methylation on TUSC1 expression and its role in the progression of EJC.

Methods

Bioinformatics software was utilized to analyze the expression of TUSC1, enriched pathways, and highly methylated sites in the promoter region. TUSC1 expression in EJC was assessed using quantitative reverse transcription polymerase chain reaction (qRT-PCR), western blot (WB), and immunohistochemistry. Methylation-specific PCR was employed to detect the methylation level of TUSC1. To analyze the effects of TUSC1 and 5-AZA-2 on tumor cell proliferation, migration, invasion, cell cycle, and apoptosis, several assays including CCK-8, colony formation, transwell, and flow cytometry were conducted. The expression of MDM2 was assessed using qRT-PCR and WB. WB detected the expression of p53, and p-p53, markers for EJC cell proliferation, epithelial-mesenchymal transition, and apoptosis. The role of TUSC1 in tumor occurrence in vivo was examined using a xenograft mouse model.

Results

TUSC1 expression was significantly downregulated in EJC. Overexpression of TUSC1 and treatment with 5-AZA-2 inhibited the malignant progression of EJC cells. In EJC, low methylation levels promoted the expression of TUSC1. Upregulation of TUSC1 suppressed the expression of MDM2 and activated the p53 signaling pathway. Inactivation of this pathway attenuated the inhibitory effect of TUSC1 overexpression on EJC cell proliferation, migration, invasion, and other behaviors. Animal experiments demonstrated that TUSC1 overexpression inhibited EJC tumor growth and metastasis in vivo.

Conclusion

TUSC1 was commonly downregulated in EJC and regulated by methylation. It repressed the malignant progression of EJC tumors by mediating the p53 pathway, suggesting its potential as a diagnostic and therapeutic target for EJC.
Adult sex change leads to extensive forebrain reorganization in clownfish
Authors: Parker Coltan G. , Gruenhagen George W. , Hegarty Brianna E. , Histed Abigail R. , Streelman Jeffrey T. , Rhodes Justin S. , Johnson Zachary V.
Published: July 2024

Background

Sexual differentiation of the brain occurs in all major vertebrate lineages but is not well understood at a molecular and cellular level. Unlike most vertebrates, sex-changing fishes have the remarkable ability to change reproductive sex during adulthood in response to social stimuli, offering a unique opportunity to understand mechanisms by which the nervous system can initiate and coordinate sexual differentiation.

Methods

This study explores sexual differentiation of the forebrain using single nucleus RNA-sequencing in the anemonefish Amphiprion ocellaris, producing the first cellular atlas of a sex-changing brain.

Results

We uncover extensive sex differences in cell type-specific gene expression, relative proportions of cells, baseline neuronal excitation, and predicted inter-neuronal communication. Additionally, we identify the cholecystokinin, galanin, and estrogen systems as central molecular axes of sexual differentiation. Supported by these findings, we propose a model of sexual differentiation in the conserved vertebrate social decision-making network spanning multiple subtypes of neurons and glia, including neuronal subpopulations within the preoptic area that are positioned to regulate gonadal differentiation.

Conclusions

This work deepens our understanding of sexual differentiation in the vertebrate brain and defines a rich suite of molecular and cellular pathways that differentiate during adult sex change in anemonefish.
Estimating the synthetic accessibility of molecules with building block and reaction-aware SAScore
Authors: Chen Shuan , Jung Yousung
Published: July 2024

Synthetic accessibility prediction is a task to estimate how easily a given molecule might be synthesizable in the laboratory, playing a crucial role in computer-aided molecular design. Although synthesis planning programs can determine synthesis routes, their slow processing times make them impractical for large-scale molecule screening. On the other hand, existing rapid synthesis accessibility estimation methods offer speed but typically lack integration with actual synthesis routes and building block information. In this work, we introduce BR-SAScore, an enhanced version of SAScore that integrates the available building block information (B) and reaction knowledge (R) from synthesis planning programs into the scoring process. In particular, we differentiate fragments inherent in building blocks and fragments to be derived from synthesis (reactions) when scoring synthetic accessibility. Compared to existing methods, our experimental findings demonstrate that BR-SAScore offers more accurate and precise identification of a molecule's synthetic accessibility by the synthesis planning program with a fast calculation time. Moreover, we illustrate how BR-SAScore provides chemically interpretable results, aligning with the capability of the synthesis planning program embedded with the same reaction knowledge and available building blocks.

Scientific contribution

We introduce BR-SAScore, an extension of SAScore, to estimate the synthetic accessibility of molecules by leveraging known building-block and reactivity information. In our experiments, BR-SAScore shows superior prediction performance on predicting molecule synthetic accessibility compared to previous methods, including SAScore and deep-learning models, while requiring significantly less computation time. In addition, we show that BR-SAScore is able to precisely identify the chemical fragment contributing to the synthetic infeasibility, holding great potential for future molecule synthesizability optimization.
Silibinins and curcumin as promising ligands against mutant cystic fibrosis transmembrane regulator protein
Authors: Akram Areeba , Sakhawat Azra , Ghani Muhammad Usman , Khan Muhammad Umer , Rehman Raima , Ali Qurban , Jin-liang Peng , Ali Daoud
Published: July 2024

Cystic Fibrosis Transmembrane Regulator (CFTR) is a significant protein that is responsible for the movement of ions across cell membranes. The cystic fibrosis (CF) occur due to the mutations in the CFTR gene as it produces the dysfunctional CFTR protein. The sequence of CFTR protein as a target structure was retrieved from UniProt and PDB database. The ligands selection was performed through virtual screening and top 3 ligands choose out of 65 ligands silibinins, curcumin, demethoxycurcumin were selected with a reference drug Trikafta (R*). According to docking, ADMET analyses, the natural ligands (Silibinins and Curcumin) displayed best binding energy, pharmacokinetic and free toxicity than other natural compounds and reference drug (R*). An MD simulation for 200 ns was also established to ensure that natural ligands (Silibinins and Curcumin) attached to the target protein favorably and dynamically, and that protein–ligand complex stability was maintained. It is concluded that silibinins and curcumins have a better capacity to decrease the effect of mutant CFTR protein through improved trafficking and the restoration of original function. In conclusion, in silico studies demonstrate the potential of silibinins and curcumin as therapeutic agents for cystic fibrosis, particularly for the D614G mutated protein. Their ability to increase CFTR function while reducing cellular stress and inflammation, together with their favorable safety profile and accessibility could make them valuable additions to cystic fibrosis treatment options. Further experimental and clinical validation will be required to fully realize their potential and include them into effective therapy regimens.
Effectiveness of a culturally tailored HIV intervention in promoting PrEP among black women who use drugs in community supervision programs in New York City: a randomized clinical trial
Authors: Goddard-Eckrich Dawn , McCrimmon Tara , Bond Keosha , Chang Mingway , Hunt Timothy , Hall Jennifer , Russo Mary , Ramesh Vineha , Johnson Karen A. , Downey Dget L. , Wu Elwin , El-Bassel Nabila , Gilbert Louisa
Published: July 2024

Background

In the U.S. there are significant racial and gender disparities in the uptake of pre-exposure prophylaxis (PrEP). Black Americans represented 14% of PrEP users in 2022, but accounted for 42% of new HIV diagnoses in 2021 and in the South, Black people represented 48% of new HIV diagnoses in 2021 but only 21% of PrEP users in 2022. Women who use drugs may be even less likely than women who do not use drugs have initiated PrEP. Moreover, women involved in community supervision programs (CSP) are less likely to initiate or use PrEP, More PrEP interventions that focus on Black women with recent history of drug use in CSPs are needed to reduce inequities in PrEP uptake.

Methods

We conducted a secondary analysis from a randomized clinical trial with a sub-sample (n = 336) of the total (N = 352) participants from the parent study (E-WORTH), who tested HIV negative at baseline were considered PrEP-eligible. Black women were recruited from CSPs in New York City (NYC), with recent substance use. Participants were randomized to either E-WORTH (n = 172) an HIV testing plus, receive a 5-session, culturally-tailored, group-based HIV prevention intervention, versus an HIV testing control group (n = 180). The 5 sessions included an introduction to PrEP and access. This paper reports outcomes on improved awareness of PrEP, willingness to use PrEP, and PrEP uptake over the 12-month follow-up period. HIV outcomes are reported in a previous paper.

Results

Compared to control participants, participants in this study assigned to E-WORTH had significantly greater odds of being aware of PrEP as a biomedical HIV prevention strategy (OR = 3.25, 95% CI = 1.64–6.46, p = 0.001), and indicated a greater willingness to use PrEP as an HIV prevention method (b = 0.19, 95% CI = 0.06–0.32, p = 0.004) over the entire 12-month follow-up period.

Conclusions

These findings underscore the effectiveness of a culturally-tailored intervention for Black women in CSP settings in increasing awareness, and intention to initiate PrEP. Low uptake of PrEP in both arms highlight the need for providing more robust PrEP-on-demand strategies that are integrated into other services such as substance abuse treatment.

Trial Registration

ClinicalTrials.gov Identifier: NCT02391233.
Process validation and preclinical development of a new PET cerebral blood flow tracer [11C]MMP for initial clinical trials
Authors: Toyohara Jun , Tago Tetsuro , Sakata Muneyuki
Published: July 2024

Background

2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) is commonly used for diagnosis of dementia because brain glucose metabolism reflects neuronal activity. However, as [18F]FDG is an analogue of glucose, accumulation of tracer in the brain is affected by plasma glucose levels. In contrast, cerebral blood flow (CBF) tracers are theoretically unaffected by plasma glucose levels and are therefore expected to be useful alternatives for the diagnosis of dementia in patients with diabetes. The techniques currently used for CBF imaging using single photon emission computed tomography (SPECT) and [15O]H2O positron emission tomography (PET), but these are limited by their insufficient resolution and sensitivity for regional brain imaging, especially in patients with brain atrophy. N-isopropyl-4-[11C]methylamphetamine ([11C]MMP) is a possible CBF tracer with high resolution and sensitivity that exhibits comparable performance to that of [15O]H2O in conscious monkey brains. We performed process validation of the radiosynthesis and preclinical development of [11C]MMP prior to clinical translation.

Results

The decay-corrected yields of [11C]MMP at the end of synthesis were 41.4 ± 6.5%, with 99.7 ± 0.3% radiochemical purity, and 192.3 ± 22.5 MBq/nmol molar activity. All process validation batches complied with the product specifications. The acute toxicity of MMP was evaluated at a dose of 3.55 mg/kg body weight, which is 10,000 times the potential maximum clinical dose of [11C]MMP. The acute toxicity of [11C]MMP injection at 150 or 200 times, to administer a postulated dose of 740 MBq of [11C]MMP, was also evaluated after the decay-out of 11C. No acute toxicity of MMP and [11C]MMP injection was found. No mutagenic activity was observed for MMP. The effective dose calculated according to the Medical Internal Radiation Dose (MIRD) method was 5.4 µSv/MBq, and the maximum absorbed dose to the bladder wall was 57.6 µGy/MBq. MMP, a derivative of phenylalkylamine, showed binding to the sigma receptor, but had approximately 1/100 of the affinity of existing sigma receptor imaging agents. The affinity for other brain neuroreceptors was low.

Conclusions

[11C]MMP shows acceptable pharmacological safety at the dose required for adequate PET imaging. The potential risk associated with [11C]MMP PET imaging is well within the acceptable dose limit.
Evaluating diagnostic accuracy of an RT-PCR test for the detection of SARS-CoV-2 in saliva
Authors: Samsunder Natasha , Sivro Aida , Hassan-Moosa Razia , Lewis Lara , Kara Zahra , Baxter Cheryl , Karim Quarraisha Abdool , Karim Salim Abdool , Kharsany Ayesha B. M. , Naidoo Kogieleum , Ngcapu Sinaye
Published: July 2024

Background and objective

Saliva has been proposed as a potential more convenient, cost-effective, and easier sample for diagnosing SARS-CoV-2 infections, but there is limited knowledge of the impact of saliva volumes and stages of infection on its sensitivity and specificity.

Methods

In this study, we assessed the performance of SARS-CoV-2 testing in 171 saliva samples from 52 mostly mildly symptomatic patients (aged 18 to 70 years) with a positive reference standard result at screening. The samples were collected at different volumes (50, 100, 300, and 500 µl of saliva) and at different stages of the disease (at enrollment, day 7, 14, and 28 post SARS-CoV-2 diagnosis). Imperfect nasopharyngeal (NP) swab nucleic acid amplification testing was used as a reference. We used a logistic regression with generalized estimating equations to estimate sensitivity, specificity, PPV, and NPV, accounting for the correlation between repeated observations.

Results

The sensitivity and specificity values were consistent across saliva volumes. The sensitivity of saliva samples ranged from 70.2% (95% CI, 49.3–85.0%) for 100 μl to 81.0% (95% CI, 51.9–94.4%) for 300 μl of saliva collected. The specificity values ranged between 75.8% (95% CI, 55.0–88.9%) for 50 μl and 78.8% (95% CI, 63.2–88.9%) for 100 μl saliva compared to NP swab samples. The overall percentage of positive results in NP swabs and saliva specimens remained comparable throughout the study visits. We observed no significant difference in cycle number values between saliva and NP swab specimens, irrespective of saliva volume tested.

Conclusions

The saliva collection offers a promising approach for population-based testing.
Novel use of hot biopsy forceps for removal of tracheobronchial stent-related granulation tissue
Authors: Pahuja Sourabh , Bajad Pradeep , Khanna Arjun , Agarwal Satyam
Published: July 2024

Patients with malignant central airway obstruction often present with dyspnea and sometimes with frank respiratory failure. Airway stenting has become a routine modality in the management of these patients. A correctly placed airway stent will give good relief in dyspnea and respiratory failure and will even improve the patient's ECOG (Eastern Cooperative Oncology Group) performance score. The common complications associated with stents are migration, fracture, infection, and obstruction by tumors, granulation tissue, and secretions. These complications are more pronounced with metallic stents. Surveillance bronchoscopy should ideally be done in these patients at least 4–6 weeks post-stent insertion. Removal of granulation tissue has been attempted with modalities like lasers, Argon plasma coagulation, cryotherapy, and snare electrocautery. Here, we present a novel case of post-stent granulation tissue, which was removed and debulked with the help of electrocoagulation bronchoscopy biopsy forceps (hot biopsy forceps).

Conclusion Hot biopsy forceps can be safely and easily used for the removal of granulation tissue in patients post-tracheobronchial stent insertion.
Assessing Patient Perspectives and the Health Equity of a Digital Cancer Symptom Remote Monitoring and Management System
Authors: Mooney Kathi , Beck Susan L. , Wilson Christina , Coombs Lorinda , Whisenant Meagan , Moraitis Ann Marie , Sloss Elizabeth A. , Alekhina Natalya , Lloyd Jennifer , Steinbach Mary , Nicholson Bridget , Iacob Eli , Donaldson Gary
Published: July 2024

PURPOSE

People with cancer experience poorly controlled symptoms that persist between treatment visits. Automated digital technology can remotely monitor and facilitate symptom management at home. Essential to digital interventions is patient engagement, user satisfaction, and intervention benefits that are distributed across patient populations so as not to perpetuate inequities. We evaluated Symptom Care at Home (SCH), an automated digital platform, to determine patient engagement, satisfaction, and whether intervention subgroups gained similar symptom reduction benefits.

METHODS

358 patients with cancer receiving a course of chemotherapy were randomly assigned to SCH or usual care (UC). Both groups reported daily on 11 symptoms and completed the SF36 (Short Form Health Survey) monthly. SCH participants received immediate automated self-care coaching on reported symptoms. As needed, nurse practitioners followed up for poorly controlled symptoms.

RESULTS

The average participant was White (83%), female (75%), and urban-dwelling (78.6%). Daily call adherence was 90% of expected days. Participants reported high user satisfaction. SCH participants had lower symptom burden than UC in all subgroups: age, sex, race, income, residence type, diagnosis, and stage (all P < .001 effect size 0.33-0.65), except for stages I and II cancers. Non-White and lower-income SCH participants gained a higher magnitude of symptom reduction than White participants and higher-income participants. Additionally, SCH men gained higher SF36 mental health (MH) benefit. There were no differences on other SF36 indices.

CONCLUSION

Participants were highly satisfied and consistently engaged the SCH platform. SCH men gained large MH improvements, perhaps from increased comfort in sharing concerns through automated interactions. Although all intervention subgroups benefited, non-White participants and those with lower income gained higher symptom reduction benefit, suggesting that systematic care through digital tools can overcome existing disparities in symptom care outcomes.
Exploring the Gut Microbiota: Key Insights Into Its Role in Obesity, Metabolic Syndrome, and Type 2 Diabetes
Authors: Sasidharan Pillai Sabitha , Gagnon Charles A , Foster Christy , Ashraf Ambika P
Published: July 2024

The gut microbiota (GM), comprising trillions of microorganisms in the gastrointestinal tract, is a key player in the development of obesity and related metabolic disorders, such as type 2 diabetes (T2D), metabolic syndrome (MS), and cardiovascular diseases. This mini-review delves into the intricate roles and mechanisms of the GM in these conditions, offering insights into potential therapeutic strategies targeting the microbiota. The review elucidates the diversity and development of the human GM, highlighting its pivotal functions in host physiology, including nutrient absorption, immune regulation, and energy metabolism. Studies show that GM dysbiosis is linked to increased energy extraction, altered metabolic pathways, and inflammation, contributing to obesity, MS, and T2D. The interplay between dietary habits and GM composition is explored, underscoring the influence of diet on microbial diversity and metabolic functions. Additionally, the review addresses the impact of common medications and therapeutic interventions like fecal microbiota transplantation on GM composition. The evidence so far advocates for further research to delineate the therapeutic potential of GM modulation in mitigating obesity and metabolic diseases, emphasizing the necessity of clinical trials to establish effective and sustainable treatment protocols.
Extended Length of Stay After Mechanical Thrombectomy for Stroke: A Single-Center Analysis of 703 Patients
Authors: Roy Joanna M. , Majmundar Shyam , Patel Shray , Fuleihan Antony , Musmar Basel , El Naamani Kareem , Tjoumakaris Stavropoula I. , Gooch M. Reid , Rosenwasser Robert H. , Jabbour Pascal M.
Published: July 2024

BACKGROUND AND OBJECTIVES:

Mechanical thrombectomy (MT) is crucial for improving functional outcomes for acute ischemic stroke. Length of stay (LOS) is a reimbursement metric implemented to incentivize value-based care. Our study aims to identify predictors of LOS in patients undergoing MT at a high-volume center in the United States.

METHODS:

This was a retrospective study of patients who underwent MT at a single institution from 2017 to 2023. Patients who experienced mortality during their course of hospital stay were excluded from this study. Extended LOS (eLOS) was defined as the upper quartile (≥75th) of the median duration of hospital stay. Univariate and multivariate analyses were performed, with P values < .05 denoting statistical significance.

RESULTS:

Seven hundred three patients met criteria for inclusion. The median age of the cohort was 72 years (IQR: 61-82), and 57.2% was female. The median LOS was 6, IQR: 4-10. A total of 28.9% of the cohort (n = 203) patients experienced eLOS. The multivariate regression model identified age (odds ratio [OR]: 0.98, 95% CI: 0.97-0.99), diabetes mellitus (OR: 1.68, 95% CI: 1.15-2.44), and hemorrhagic transformation of stroke (OR: 2.89, 95% CI: 0.39-0.90) as predictors of eLOS, whereas antiplatelet use before admission (OR: 0.55, 95% CI: 0.34-0.89) and higher baseline modified Rankin Scale before stroke were associated with lower odds (OR: 0.59 [0.39-0.90]; P < .05) of eLOS.

CONCLUSION:

By identifying predictors of eLOS, we provide a foundation for targeted interventions aimed at optimizing post-thrombectomy care pathways and improving patient outcomes. The implications of our study extend beyond clinical practice, offering insights into healthcare resource utilization, reimbursement strategies, and value-based care initiatives.
A guide to selecting high-performing antibodies for human Midkine for use in Western blot and immunoprecipitation
Authors: Ayoubi Riham , Southern Kathleen , Laflamme Carl ,   NeuroSGC/YCharOS Collaborative Group
Published: July 2024

Midkine is a secreted protein that acts as a growth factor or cytokine involved in cell survival and inflammatory processes. It accumulates in amyloid plaques, which are hallmarks of Alzheimer’s Disease (AD). The reproducibility of Midkine research would be enhanced if the community had access to well-characterized anti-Midkine antibodies. In this study, we characterized 8 commercial Midkine antibodies for Western blot and immunoprecipitation, using a standardized experimental protocol based on comparing read-outs in a knockout cell line and isogenic parental control. These studies are part of a larger, collaborative initiative seeking to address the antibody reproducibility issue by characterizing commercially available antibodies for human proteins and publishing the results openly as a resource for the scientific community. While use of antibodies and protocols vary between laboratories, we encourage readers to use this report as a guide to select the most appropriate antibodies for their specific needs.
In vitro analysis of quercetin-like compounds from mistletoe Dendrophthoe pentandra (L.) Miq as a potential antiviral agent for Newcastle disease
Authors: Mochamad Lazuardi , Malarvili Selvaraja , Jasmine Khairat , Lim Vuanghao
Published: July 2024

Background Recent evidence suggests that some flavonoid compounds obtained from crude methanol extract of mistletoe leaves (Dendrophthoe pentandra L. Miq), also known as Benalu Duku (BD), have antimicrobial effects. Thus, the plant has the potential to eliminate viruses that may cause outbreaks in chicken farms. This study aimed to prove the in vitro ability of flavonoid compounds, namely quercetin-like compounds (QLCs), to eliminate field viruses, specifically the Newcastle disease virus (NDV). Methods This research was performed in two stages. An in vitro test was used with a post-test of the control groups designed at a significance of 0.05. BD leaves (5 kg) were extracted using a maceration method with methanol and then separated into hexane, chloroform, ethyl acetate, and methanol fractions. The final extracted products were separated using semi-preparative high-performance liquid chromatography (HPLC) to obtain QLCs. The QLCs were identified and compared with quercetin using HPLC, proton and carbon nuclear magnetic resonance spectrometry, Fourier transform infrared spectrophotometry and ultra-performance liquid chromatography-mass spectrometry. The activity of QLCs was tested in vitro against the NDV at a virulence titter of 10−5 Tissue Culture Infectious Dose 50% (TCID50) in chicken kidney cell culture. Results Solutions of 0.05% (w/v) QLCs were discovered to have antiviral activity against NDVs, with an average cytopathogenic effect antigenicity at a 10−5 dilution (p<0.05). Conclusions QLCs from flavonoids from the leaves of BD have in vitro antiviral bioactivity against NDV at a virulence titter of 10-5 Tissue Culture Infectious Dose 50% (TCID50) in chicken kidney cell culture. QLCs may have the potential to be developed as medicinal compounds for the treatment of other human or animal viral infections.
Analysis of internet educational websites on tobacco cessation: A content analysis
Authors: Avinash B R , Chengappa Kaveri , Shenoy Ramya , Rao Ashwini , Pai Mithun , Rajesh G
Published: July 2024

Background There have been significant changes in the lifestyles of individuals in the past few decades, which has led to increased morbidity and mortality worldwide. Both smoking and chewing forms of tobacco are highly prevalent, especially in India, and are implicated as causes of diseases, including oropharyngeal carcinomas. Effective tobacco cessation techniques and sources can help overcome addiction and reduce the disease burden in society. The aim was to evaluate the quality and readability of contents of various sources on an internet website about tobacco cessation. Objectives i) To evaluate the readability of internet content (Google) regarding tobacco cessation using Flesch–Kincaid readability tests and the quality of internet content (Google) by using the JAMA benchmark, HONcode and DISCERN questionnaire. Methods A content review was employed to screen the content of the Google search engine for educational tobacco cessation websites, and the top 50 websites were selected according to criteria and reviewed by two reviewers. The readability of the internet content (Google) regarding tobacco cessation was evaluated using Flesch–Kincaid readability tests. The quality of the screened sites was evaluated by using the JAMA benchmark, HONcode and DISCERN questionnaire, and the readability and quality of the screened websites were correlated using the above instruments. Results FK readability ease was found to be 49% standard and 30% easy. The FK grade test found that 33% of the content could be easily understood by < 5th grade. All 4 JAMA benchmarks were met by 23% of websites, and authorship was the least fulfilled criterion. Correlation analysis revealed a significant association between FK ease score and FK grade score. Conclusions The Read-ability Ease and Read-ability Grade Levels of the websites related to tobacco cessation were not standard, and few websites fulfilled the JAMA benchmarks and had HONcode certification.
The use of medicinal marijuana for treating Cerebral Palsy: a literature review
Authors: McDonough Daniel , Charles James , Shaw Trent
Published: July 2024

Background Recent studies have established that Medicinal Marijuana (MM) is beneficial in the treatment of spasms, sleep, and pain in adult patients with varying medical diagnoses and symptoms. However, MM has rarely been used for the treatment of Cerebral Palsy (CP) complications in adults. The aim of this systematic literature review was to explore MM interventions globally, with a focus on identifying the best practice with MM for the treatment of complications of CP. Methods A systematic literature search was performed using keywords and synonyms related to MM treatment and CP complications. Inclusions and exclusions were scoped to scholarly peer reviewed academic literature published 2019 to 2021 located in the Deakin Library collection. A screening process confirmed criteria adherence and identified additional papers in referencing. The papers were appraised and evaluated to ensure selections do not have perceived or actual bias. Results From 409 publications, 27 papers were selected for review because they investigated the benefits of MM treatment for patients with sleep, pain, and spasm complications. There was no literature found on the use of MM for adults with CP. Discussion Recent research has demonstrated that with an informed understanding of MM treatment adult patients with varying medical diagnoses and symptoms can use MM to manage sleep disruption and improve relaxation. Therefore, there are potential benefits for the use of MM in treating spasticity, pain, sleep, quality of life, and social and emotional wellbeing in adult patients with CP. No funding was sort or provided for this review and the results are specific to adults with CP, so they are not to be generalized to other populations.
Case Report: Acquired Hemophilia by the presence of anti-factor VII autoantibodies associated with an antiphospholipid syndrome: a case report and review of literature
Authors: Abida Houssem , Arfaoui Bilel , Gueddiche Nour El Houda , Ajili Faida , Sayhi Sameh , Ben Abdelhafidh Nadia
Published: July 2024

Introduction Acquired hemophilia is a rare disease characterized by the presence of neutralizing autoantibodies against hemostasis factors, most often factor VII. However, a few cases of anti-factor VII (FVII) autoantibodies have been reported in the literature. We report a case in this regard. Case report A 28-year-old woman with no family or personal history presented with a severe hemorrhagic syndrome made of very abundant metrorrhagia with multiple compressive cervical hematomas, associated with pulmonary embolism and thrombosis. of the right external iliac vein. On the biological assessment, the patient presented with an undetectable PT with a factor VII titer less than 6%. The hemorrhagic syndrome was aggravated by infusions of activated factor VII (FVIIa) with the appearance of hemoptysis and hematomas in all four limbs. Etiological assessment concluded the presence of anti-factor VII autoantibodies as well as circulating lupus anticoagulant. Other antiphospholipid syndrome (APS) antibodies as well as antibodies against other hemostasis factors were absent. A treatment combining corticosteroid therapy (1mg per kg per day of prednisone) and Mycophenolate mofetil (MMF) (3g) was initiated. Faced with the persistence of the hemorrhagic syndrome, rituximab was administered according to the rheumatological protocol (1g on D1 and 1g on D15). Metrorrhagia improved initially but recurred with the resumption of menstruation with a drop in hemoglobin from 9 to 7 g/dl. Plasmapheresis sessions were attempted but thromboses on the catheters occurred each time. Immunoglobulin (IVIg) courses were administered. No anticoagulant was administered. TP increased to 23%. Levels of neutralizing antibodies fell from 512 to 2 IBU at the last follow-up at five months from the bleeding event. The circulating lupus anticoagulant was present on the follow-up test after 12 weeks, thus confirming the diagnosis of APS. Conclusion Our patient presents an extremely rare case of acquired haemophilia. The combination of corticosteroid therapy, conventional and biological immunosupressives, IVIG and plasmapheresis saved the patient. In the absence of consensus on the treatment, it remains adapted according to the severity of the haemorrhagic syndrome and the associated comorbidities.
Evolution of local structures in alkali-borate glasses
Authors: Kerner Richard ,   Sorbonne-Université, dos Santos-Loff Dina Maria , Rosa Ana Cristina ,   Universidade de Coimbra
Published: July 2024

We analyze the dependence of the relative proportion of various characteristic clusters in binary alkali borate glasses on modifier concentration x. Pure B2O3 glass contains, according to various estimates, from 75% up to 85% of boron atoms inside boroxol rings, wih the remaining boron atoms in between, linking the boroxol rings via oxygen bonds. The addition of Na2O modifier creates four-coordinated borons, but the resulting network glass remains totally connected. We study local transformations that lead to the creation of new configurations such as tetraborates, pentaborates, diborates, etc., and set forth a nonlinear differential system similar to the Lotka–Volterra equations. The resulting density curves of various local configurations as functions of x are obtained. Then the average rigidity is evaluated, enabling us to compute the glass transition temperature Tg(x) for a given value of x.
La figura del neuroeducador y la enseñanza musical
Authors: Rojo Gutiérrez Rubén
Published: July 2024

A lo largo de esta perspectiva, se emprende un análisis exhaustivo de las propuestas educativas focalizadas en la figura del neuroeducador y el entorno educativo asociado a las artes. Aunque la diversidad y originalidad de las obras en lengua española sobre neuroeducación brindan una visión alentadora del panorama educativo, la abordaje de las asignaturas artísticas en el sistema educativo, junto con su notable influencia en los propios autores, subraya la necesidad imperante de iniciar diálogos con miras a garantizar la evaluación científica de las disciplinas artísticas y la implementación lógica de las ideas obtenidas. Asimismo, se pone de manifiesto la importancia de reevaluar de manera reflexiva el perfil del neuroeducador y la configuración de su formación, en aras de perfeccionar la eficacia y pertinencia de su rol en el futuro del ámbito educativo.
The Voice Within: Chinese Muslims, Ethnic Identity, and Self-Representation in Hui Microfilms
Authors: Zeng Li
Published: July 2024

ABSTRACT: The Hui (Chinese Muslims) have been either absent from or misrepresented in mainstream cinema in China. Between 2007 and 2016, a group of young Hui filmmakers actively used the wei dianying (often translated as “micro-film”) format to explore Hui identity, tradition, and everyday life. Through a close analysis of representative films, this article argues that Hui micro-films challenge mainstream representations, actively constructing the Hui’s ethno-religious identity and negotiating the tension between their twin identities—Chinese and Muslim—in a context in which the state enforces secularization and assimilation. This study shifts the existing literature’s focus on negative representation of the Hui in films by Han filmmakers to empowering narratives from the Hui themselves.
Elite Management before Autocratic Leader Succession: Evidence from North Korea
Authors: Goldring Edward , Ward Peter
Published: July 2024

abstract: How do dictators prepare for succession? Scholars have studied the determinants of succession, but we know little about the mechanisms, including elite management, of how succession occurs. The authors argue that incumbents prepare for succession by building a power base of elites outside their inner circle, for their preferred successor; doing so helps the successor to stabilize the regime. The authors test this argument by examining preparations for succession in the prominent but puzzling case of North Korea under Kim Jong Il, leveraging the plausibly exogenous shock that Kim suffered—a stroke—that caused him to prepare for succession. Quantitative analysis of 1,573 leadership events under Kim between 1994 and 2011, with original biographical data on 230 North Korean elites, supports the argument. Qualitative evidence of elites’ roles after Kim’s death is consistent with the argument’s logic. Rather than being atypical, as North Korea is often portrayed, the findings apply to other personalist autocracies.
Industrialization and Democracy
Authors: Van Noort Sam
Published: July 2024

abstract: This article provides a new theory about the relationship between economic development and democracy. The author argues that a larger share of employment in manufacturing—that is, a higher level of industrialization—makes mass mobilization both more likely to occur and more costly to suppress. This in turn increases the power of the masses vis-à-vis autocratic elites, making democracy more likely. Novel manufacturing employment data for 145 countries over 170 years (1845–2015) suggest that industrialization is strongly correlated with democracy, even after accounting for income, equality, education, and urbanization. Unlike with many other socioeconomic determinants, the effect of industrialization is robust to country and time fixed effects, occurs on both transitions to and consolidations of democracy, is present in both the short and long run, and is equally large after 1945. Results from a novel instrument and several sensitivity analyses suggest that the correlation is unlikely to be spurious.
Extended-period AOSLO imaging in the living human retina without pupil dilation: a feasibility study
Authors: Cui Jiahe , Villamil Maria , Schneider Allie C. , Lawton Penelope F. , Young Laura K. , Booth Martin J. , Smithson Hannah E.
Published: July 2024

In vivo imaging using an adaptive optics scanning laser ophthalmoscope (AOSLO) is challenging, especially over extended periods. Pharmacological agents, administered as eye drops, are commonly used to dilate the pupil and paralyse accommodation, to improve image quality. However, they are contraindicated in some scenarios. Here, we evaluate the feasibility and reproducibility of performing AOSLO imaging without pharmacological pupil dilation over 1.5 hours with visual stimulation. Through statistical analysis and theoretical modelling using a dataset of retinal and pupil images collected from six healthy, young, near-emmetropic participants between the ages of 20–30 years, we validate that the retinal image quality does not change significantly with time in the experimental session (p = 0.33), and that pupil size has a strong effect on image quality but is not the only contributing factor.
Effective linear regimes in plasmonic three-wave mixing
Authors: Stefanini Luca , Ramaccia Davide , Bilotti Filiberto , Fardad Shima , Salandrino Alessandro
Published: July 2024

The theory of parametric resonances induced by three-wave mixing processes in planar plasmonic structures coupled to second order nonlinear crystals is investigated in detail. The system under study involves a pump field interacting with two counterpropagating surface plasmon polaritons (SPPs), where the permittivity of the dielectric medium is modulated by the pump field’s amplitude. Two distinct linear regimes are identified: linearity in time at the onset of the parametric resonance and linearity with respect to the pump amplitude in the steady state. The former emerges at the onset of the parametric resonance but is suppressed over longer time intervals due to second order interactions that lead to nonlinearity. Conversely, the latter rises thanks to the induction of an effective third order nonlinearity that forces the SPPs’ amplitudes to have a linear relationship with the pump amplitude.