bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic management of gastric ectopic pancreas with repeated ulcerations and bleeding: A case report
Authors: Kimura Tomoya , Minato Yohei , Banjoya Susumu , Iida Toshifumi , Furuta Koichi , Nagae Shinya , Ito Yohei , Yamazaki Hiroshi , Takeuchi Nao , Takayanagi Shunya , Kimoto Yoshiaki , Kano Yuki , Sakuno Takashi , Ono Kohei , Miura Sakiko , Morikawa Teppei , Ohata Ken
Published: January 2024

A 25‐year‐old man was referred to our center for investigation of a gastric submucosal tumor and an ulcer that had developed on its oral side. Endoscopic ultrasonography findings suggested the presence of an ectopic pancreas, and treatment with an oral proton pump inhibitor was planned for the ulcer. Over the subsequent 3 years, the patient endured recurring epigastric pain and episodes of passing black stools. Emergency endoscopy revealed that the morphology of the gastric submucosal tumor had transformed into a pedunculated polyp‐like morphology with a bleeding ulcer at the apex of the lesion. Endoscopic hemostasis using hemostatic forceps was performed. However, the patient continued to pass black stools. In light of the persistent symptoms and unique morphology of the lesion, endoscopic resection was attempted as a curative approach. The lesion was excised by hot snare polypectomy. Post‐treatment, the patient exhibited no signs of recurrence, marking a successful resolution. Three months later, a gastroduodenal endoscopy showed that the excised site had undergone scar formation without recurrence of the lesion. This case holds significant clinical value as it demonstrates the efficacy of a minimally invasive treatment strategy in managing repeated bleeding ulcerations of an ectopic pancreas, ultimately achieving a complete cure.
Quantitative analysis of hydropower potential in the upper Beas basin using geographical information system and MIKE 11 Nedbor Afrstromnings Model (NAM)
Authors: Kumar Mohit , Tiwari Reet Kamal , Kumar Kamal , Rautela Kuldeep Singh , Safi Sabia
Published: January 2024

The present study aims to identify potential locations for small‐scale hydroelectric power (HEP) stations in hilly regions for the purpose of generating renewable energy. A rainfall‐runoff (R‐R) model of the Beas River catchment was established using the MIKE 11 NAM to estimate the available discharge. The model was calibrated and validated over the period of June‐2015–May‐2018 and June‐2018–May‐2020, respectively, using daily observed discharge data at the Pandoh Dam site. The model exhibited good performance with a coefficient of determination (R2) of 0.82 during calibration and 0.70 during validation and a water balance of −0.01% and −18%, respectively. However, Lmax, CK1, CK2 and CQOF are found most sensitive parameters during the calibration. Further, thirteen major streams of order five or higher were selected for the assessment of hydropower potential, resulting in the identification of 131 potential run‐of‐river (ROR) hydropower sites. The hydropower potential at two proposed sites, Bhang SHEP (9 MW) and Raison SHEP (18 MW), was estimated to be 11 and 15 MW, respectively, using 90% dependable flow. The results demonstrate the effectiveness of using Digital Elevation Model (DEM) and Geographic Information System (GIS) techniques for determining hydropower potential in ungauged basins in the Himalayas.
Nanoparticles for stimulation of neutrophil extracellular trap‐mediated immunity
Authors: Vaseruk Anna , Bila Galyna , Bilyy Rostyslav
Published: January 2024

Neutrophil extracellular traps (NETs) have been identified as triggers for a self‐limited inflammatory reaction upon contact with nanoparticles within our bodies. This typically results in entrapping potentially harmful nano‐ or micro‐objects following an immune burst. The demand for potent adjuvants has led to research on particulate‐based adjuvants, particularly those that act via NET formation. Various particles, including hydrophobic nanoparticles, needle‐like microparticles, and other natural and artificial crystals, have been shown to induce NET formation, eliciting a robust humoral and cellular immune response toward co‐injected antigens. The NET formation was found to be the basis of the efficient use of alum as a vaccine adjuvant. Thus, nanoparticles with specific surface properties serve as NET‐stimulating adjuvants. In this mini‐review, we aim to summarize the current knowledge about the surface properties of particulate objects and the molecular pathways involved in inducing NET formation by neutrophils. Additionally, we discuss the potential use of nanoparticles for activating neutrophils in the tissues and the exploitation of such activation for enhancing vaccine adjuvants.
PIEZO1‐mediated mechanosensing governs NK‐cell killing efficiency and infiltration in three‐dimensional matrices
Authors: Yanamandra Archana K. , Zhang Jingnan , Montalvo Galia , Zhou Xiangda , Biedenweg Doreen , Zhao Renping , Sharma Shulagna , Hoth Markus , Lautenschläger Franziska , Otto Oliver , del Campo Aránzazu , Qu Bin
Published: January 2024

Natural killer (NK) cells play a vital role in eliminating tumorigenic cells. Efficient locating and killing of target cells in complex three‐dimensional (3D) environments are critical for their functions under physiological conditions. However, the role of mechanosensing in regulating NK‐cell killing efficiency in physiologically relevant scenarios is poorly understood. Here, we report that the responsiveness of NK cells is regulated by tumor cell stiffness. NK‐cell killing efficiency in 3D is impaired against softened tumor cells, whereas it is enhanced against stiffened tumor cells. Notably, the durations required for NK‐cell killing and detachment are significantly shortened for stiffened tumor cells. Furthermore, we have identified PIEZO1 as the predominantly expressed mechanosensitive ion channel among the examined candidates in NK cells. Perturbation of PIEZO1 abolishes stiffness‐dependent NK‐cell responsiveness, significantly impairs the killing efficiency of NK cells in 3D, and substantially reduces NK‐cell infiltration into 3D collagen matrices. Conversely, PIEZO1 activation enhances NK killing efficiency as well as infiltration. In conclusion, our findings demonstrate that PIEZO1‐mediated mechanosensing is crucial for NK killing functions, highlighting the role of mechanosensing in NK‐cell killing efficiency under 3D physiological conditions and the influence of environmental physical cues on NK‐cell functions.
Cobalt‐Catalyzed Hydrogenation and Deuteration Reactions of Bicyclic Alkenes in an Aqueous Environment
Authors: Pounder Austin , van der Zalm Joshua , Chen Aicheng , Tam William
Published: January 2024

Herein, we report cobalt‐catalyzed hydrogenation and deuteration reactions of bicyclic alkenes using H2O and D2O as the sole hydrogen and deuterium sources, respectively, employing Zn or Mn as a metal reductant. Lewis‐acid co‐catalysts were found to promote the reaction whilst simultaneously catalyzing transesterification processes. Use of 1 atm of H2 allows for catalytic loading of the metal reductant. In all cases, the reaction operated with high functional‐group tolerance and produced reduced products in high yield.
Multifunctional Organic Salt Regulated SnO2 Electron Transport Layer/Perovskite Interface for High Air‐Stable Perovskite Solar Cells
Authors: Ye Peihan , Liu Xingchong , Peng Xian , Li Haimin , Zhao Weikang , Wang Hanyu , Zhang Xiaoyan , Hu Yuchao
Published: January 2024

Rationally adjusting the interface between SnO2 electron transport layer (ETL) and the perovskite (PVK) buried surface plays a key role in achieving efficient and stable PVK solar cells (PSCs). Herein, a cost‐effective organic salt, 5‐bromo‐6‐chloro‐3‐indolyl sulfate potassium salt (SPS), used as an interface modifier is deposited on the SnO2 ETL. SPS has played a multifunctional role in ETL and PVK layer: 1) the highly electronegative SO4− group of SPS can be adsorbed on the surface of SnO2 films, resulting in the energy levels of the PVK layer and SnO2 ETL becomes more compatible. 2) The lower contact angle of the modified SnO2 film is conducive to the formation of pinhole‐free PVK films. 3) The functional groups in SPS are helpful for the decrease of defect density in the PVK films. As a consequence, the defect density reduces from 8.17 × 1015 to 5.57 × 1015 cm−3. The power conversion efficiency (PCE) of modified PSCs increases from 19.82% to 21.33%. Furthermore, the unencapsulated modified devices retain 91.7% of the initial PCE after 624 h. These results indicate that using SPS as a multifunctional interface modifier is a promising strategy to achieve efficient and stable PSCs.
The sound of silence: Quantification of typical absence seizures by sonifying EEG signals from a custom‐built wearable device
Authors: Borges Daniel Filipe , Fernandes João , Soares Joana Isabel , Casalta‐Lopes João , Carvalho Daniel , Beniczky Sándor , Leal Alberto
Published: January 2024

Objective

To develop and validate a method for long‐term (24‐h) objective quantification of absence seizures in the EEG of patients with childhood absence epilepsy (CAE) in their real home environment using a wearable device (waEEG), comparing automatic detection methods with auditory recognition after seizure sonification.

Methods

The waEEG recording was acquired with two scalp electrodes. Automatic analysis was performed using previously validated software (Persyst® 14) and then fully reviewed by an experienced clinical neurophysiologist. The EEG data were converted into an audio file in waveform format with a 60‐fold time compression factor. The sonified EEG was listened to by three inexperienced observers and the number of seizures and the processing time required for each data set were recorded blind to other data. Quantification of seizures from the patient diary was also assessed.

Results

Eleven waEEG recordings from seven CAE patients with an average age of 8.18 ± 1.60 years were included. No differences in the number of seizures were found between the recordings using automated methods and expert audio assessment, with significant correlations between methods (ρ > .89, p < .001) and between observers (ρ > .96, p < .001). For the entire data set, the audio assessment yielded a sensitivity of .830 and a precision of .841, resulting in an F1 score of .835.

Significance

Auditory waEEG seizure detection by lay medical personnel provided similar accuracy to post‐processed automatic detection by an experienced clinical neurophysiologist, but in a less time‐consuming procedure and without the need for specialized resources. Sonification of long‐term EEG recordings in CAE provides a user‐friendly and cost‐effective clinical workflow for quantifying seizures in clinical practice, minimizing human and technical constraints.
Characterization of alcohol‐related seizures in withdrawal syndrome
Authors: Kádár Bettina Kata , Gajdics Janka , Pribék Ildikó Katalin , Andó Bálint , Lázár Bence András
Published: January 2024

Objective

Alcohol‐related seizures (ARS) are one of the most important consequences of alcohol withdrawal syndrome (AWS). However, demographic and clinical characteristics, and furthermore, the relationship of ARS with delirium tremens (DT), have not yet been evaluated in detail. Therefore, the aim of the present study was to reveal the correlates of ARS and examine the interaction of ARS with the occurrence of DT and with the severity of AWS.

Methods

In the retrospective study (Study 1) 2851 medical charts of inpatient admissions characterized by AWS and DT were listed. Demographic and clinical variables of ARS were assessed. In the follow‐up study (Study 2), patients admitted with AWS without (N = 28) and with (N = 18) ARS were enrolled. Study 1 was performed between 2008 and 2023, and Study 2 was performed in 2019 in Hungary. To determine the severity of AWS, the Clinical Institute Withdrawal Assessment Scale for Alcohol, Revised (CIWA‐Ar) was used. ARS is a provoked, occasional seizure; therefore, patients with epilepsy syndrome were excluded from the two studies. Statistical analyses were performed by the means of chi‐square tests, multinomial logistic regressions, mixed ANOVA, and derivation.

Results

The occurrence of DT, the history of ARS, and somatic co‐morbidities were found to be risk factors for the appearance of ARS. ARS was proved to be a risk factor for the development of DT. In the follow‐up study, there was no difference in the decrease of CIWA‐Ar scores between the groups.

Significance

Our present findings support the likelihood of kindling, which is one of the most important mechanisms underlying the development of ARS, but do not directly prove its presence. Additionally, our results revealed that the severity of AWS is not influenced by the presence of ARS.

Plain Language Summary

Provoked, occasional seizures during AWS are defined as ARS. In the present study, predictors and interactions of these seizures with DT—the most severe form of withdrawal—and with the severity of withdrawal were examined in retrospective and follow‐up studies. The present study shows that a history of withdrawal seizures, the occurrence of DT, and somatic comorbidities are predictors of the development of seizures. Furthermore, our findings suggest that the presence of seizures does not influence the severity of withdrawal.
Synthesis and flame‐retardant analysis of a novel P/N containing flame retardant on epoxy resin composites
Authors: Soni Vishal , Dahiya Jai Bhagwan
Published: January 2024

A new reactive flame‐retardant N′‐(1‐(4‐hydroxyphenyl)‐1‐(6‐oxido‐6H‐dibenzo[c,e][1,2]oxaphosphinin‐6‐yl)ethyl) benzohydrazide (DOPO‐BD) was synthesized via a two‐step reaction involving the Schiff base reaction between benzohydrazide and 4‐hydroxy acetophenone, followed by a reaction between the imine‐based condensation product and 9, 10‐dihydro‐9‐oxa‐10‐phosphaphenanthrene‐10‐oxide (DOPO). The chemical structure of DOPO‐BD was well characterized by Fourier transform infrared spectra (FTIR), 1H, 13C, 31P NMR, and high‐resolution mass spectrometry (HRMS). The DOPO‐BD was utilized as a reactive flame retardant and co‐hardener in DGEBA/DDS. The epoxy composites of varying phosphorus weight percentages were synthesized. UL‐94 and LOI tests were used to investigate the flammability of composites. The epoxy composites retained good transparency, which was measured by UV–vis spectroscopy. Thermogravimetric analysis (TGA) observed an increase in the thermal stability of epoxy composites in a higher temperature range with increased char yield. In the UL‐94 and LOI tests, EP/DOPO‐BD(1.5%P) sample gave a V‐0 rating and 30% LOI value. The cone calorimeter test indicated a decrease in total heat released (THR), peak of heat release rate (pHRR), and total smoke production (TSP) for EP/DOPO‐BD(1.5%P) in comparison with epoxy (EP). The mechanical properties and glass transition temperature (Tg) of the epoxy composites were determined by Dynamic mechanical analysis (DMA), which showed an increase in storage modulus and a decrease in Tg.
Assessment of implicit adaptive mesh‐free CFD modelling
Authors: Zhang Tao , Barakos George N.
Published: January 2024

This work presents details and assesses implicit and adaptive mesh‐free CFD modelling approaches, to alleviate laborious mesh generation in modern CFD processes. A weighted‐least‐squares‐based, mesh‐free, discretisation scheme was first derived for the compressible RANS equations, and the implicit dual‐time stepping was adopted for improved stability and convergence. A novel weight balancing concept was introduced to improve the mesh‐free modelling on highly irregular point clouds. Automatic point cloud generations based on strand and level‐set points were also discussed. A novel, polar selection approach, was also introduced to establish high‐quality point collocations. The spatial accuracy and convergence properties were validated using 2D and 3D benchmark cases. The impact of irregular point clouds and various point collocation search methods were evaluated in detail. The proposed weight balancing and the polar selection approaches were found capable of improving the mesh‐free modelling on highly irregular point clouds. The mesh‐free flexibility was then exploited for adaptive modelling. Various adaptation strategies were assessed using simulations of an isentropic vortex, combining different point refinement mechanisms and collocation search methods. The mesh‐free modelling was then successfully applied to transonic aerofoil simulations with automated point generation. A weighted pressure gradient metric prioritising high gradient regions with large point sizes was introduced to drive the adaptation. The mesh‐free adaptation was found to effectively improve the shock resolution. The results highlight the potential of mesh‐free methods in alleviating the meshing bottleneck in modern CFD.
Should it stay, or swerve? Trading off lives in dilemma situations involving autonomous cars
Authors: Habla Wolfgang , Kataria Mitesh , Martinsson Peter , Roeder Kerstin
Published: January 2024

Using a representative survey with 1317 individuals and 12,815 moral decisions, we elicit Swedish citizens' preferences on how algorithms for self‐driving cars should be programmed in cases of unavoidable harm to humans. Participants' choices in different dilemma situations (treatments) show that, at the margin, the average respondent values the lives of passengers and pedestrians equally when both groups are homogeneous and no group is to blame for the dilemma. In comparison, the respondent values the lives of passengers more when the pedestrians violate a social norm, and less when the pedestrians are children. Furthermore, we explain why the average respondent in the control treatment needs to be compensated with two to six passengers spared in order to sacrifice the first pedestrian, even though she values the lives of passengers and pedestrians equally at the margin. We conclude that respondents' choices are highly contextual and consider the age of the persons involved and whether these persons have complied with social norms.
The direct and spillover effects of diabetes diagnosis on lifestyle behaviours
Authors: Thomas Rhys Llewellyn , Mentzakis Emmanouil
Published: January 2024

Using blood sample data we exploit an arbitrary cut‐off of diabetes risk and through a fuzzy regression kink design we estimate the effect of a diabetes diagnosis on own and partner health‐related behaviours. Diabetes diagnosis increases the probability of exercising, both for those diagnosed with diabetes and their partner. We also conduct mediation analysis which suggests that joint household participation is the channel behind this effect. Our results have significant implications for the understanding of the channels that induce behavioural change, and household decision making, as well as, for the evaluation of diabetes related policies.
Early outcomes of osteofascial versus osteocutaneous fibula free flap mandibular reconstruction
Authors: Shilo Shahaf , Muhanna Nidal , Fliss Dan M. , Horowitz Gilad , Warshavsky Anton , Mansour Jobran , Ianculovici Clariel , Fliss Ehud , Barnea Yoav , Zaretski Arik , Yanko Ravit
Published: January 2024

Background

This study compares early outcomes of osteofascial fibula free flap (OF‐FFF) with donor‐site primary closure and osteocutaneous (OC) FFF with donor‐site skin grafting in segmental mandibular reconstruction.

Methods

A retrospective chart review of FFF mandibular reconstruction patients (2006–2022) divided into OF‐FFF and OC‐FFF groups. Clinical data, operative parameters, and early postoperative outcomes (≤ 90 days) were analyzed.

Results

The study included 67 patients (39 OF‐FFF, 28 OC‐FFF). OF‐FFF had significantly lower donor‐site complications (12.8% vs. 53.6%, p < 0.001) and revision surgeries (7.7% vs. 35.7%, p = 0.004) compared to OC‐FFF. Recipient‐site (28.2% vs. 25%, p = 0.77) and flap (15.4% vs. 17.9%, p > 0.99) complications were comparable.

Conclusions

OF‐FFF mandibular reconstruction with donor‐site primary closure is a safe and reliable technique associated with superior donor‐site and comparable flap and recipient‐site outcomes to OC‐FFF, thus may be considered as a viable alternative to OC‐FFF for selected patients.
CDK6 protein expression is associated with disease progression and treatment resistance in multiple myeloma
Authors: Steinhart Johannes , Möller Peter , Kull Miriam , Krönke Jan , Barth Thomas F. E.
Published: January 2024

Multiple myeloma (MM) is a heterogeneous malignancy of plasma cells. Despite improvement in the prognosis of MM patients after the introduction of many new drugs in the past decades, MM remains incurable since most patients become treatment‐resistant. Cyclin‐dependent kinase 6 (CDK6) is activated in many types of cancer and has been associated with drug resistance in MM. However, its association with disease stage, genetic alterations, and outcome has not been systematically investigated in large cohorts. Here, we analyzed CDK6 expression using immunohistochemistry in 203 formalin‐fixed paraffin‐embedded samples of 146 patients and four healthy individuals. We found that 61.5% of all MM specimens express CDK6 at various levels. CDK6 expression increased with the progression of disease with a median of 0% of CDK6‐positive plasma cells in monoclonal gammopathy of undetermined significance (MGUS) (n = 10) to 30% in newly diagnosed MM (n = 78) and up to 70% in relapsed cases (n = 55). The highest median CDK6 was observed in extramedullary myeloma (n = 12), a highly aggressive manifestation of MM. Longitudinal analyses revealed that CDK6 is significantly increased in lenalidomide‐treated patients but not in those who did not receive lenalidomide. Furthermore, we observed that patients who underwent lenalidomide‐comprising induction therapy had significantly shorter progression‐free survival when their samples were CDK6 positive. These data support that CDK6 protein expression is a marker for aggressive and drug‐resistant disease and describes a potential drug target in MM.
Pathogenicity Prediction of GABAA Receptor Missense Variants
Authors: Wang Ya‐Juan , Vu Giang H. , Mu Ting‐Wei
Published: January 2024

Variants in the genes encoding gamma‐aminobutyric acid type A (GABAA) receptor subunits are associated with epilepsy. To date, over 1000 clinical variants have been identified in these genes. However, the majority of these variants lack functional studies and their clinical significance is uncertain although accumulating evidence indicates that proteostasis deficiency is the major disease‐causing mechanism. Here, we apply two state‐of‐the‐art modeling tools, namely AlphaMissense and Rhapsody to predict the pathogenicity of saturating missense variants in genes that encode the major subunits of GABAA receptors in the central nervous system, including GABRA1, GABRB2, GABRB3, and GABRG2. We demonstrate that the predicted pathogenicity correlates well between AlphaMissense and Rhapsody. In addition, AlphaMissense pathogenicity score correlates modestly with plasma membrane expression, peak current amplitude, and GABA potency of the variants that have available experimental data. Furthermore, almost all annotated pathogenic variants in the ClinVar database are successfully identified from the prediction, whereas uncertain variants from ClinVar partially due to the lack of experimental data are differentiated into different pathogenicity groups. The pathogenicity prediction of GABAA receptor missense variants provides a resource to the community as well as guidance for future experimental and clinical investigations.
Nanopore Direct RNA Sequencing for Modified Uridine Nucleotides Yields Signals Dependent on the Physical Properties of the Modified Base
Authors: Fleming Aaron M. , Dingman Justin C. , Wu Yizhou , Hoon Spencer S. , Burrows Cynthia J.
Published: January 2024

Sequencing for RNA modifications with the nanopore direct RNA sequencing platform provides ionic current levels, helicase dwell times, and base call data that differentiate the modifications from the canonical form. Herein, model RNAs were synthesized with site‐specific uridine (U) base modifications that enable the study of increasing an alkyl group size, halogen identity, or a change in base acidity to impact the nanopore data. The analysis concluded that increases in alkyl size trend with greater current blockage but a similar change in base‐call error was not found. The addition of a halogen series to C5 of U revealed that the current levels recorded a trend with the water‐octanol partition coefficient of the base, as well as the base call error. Studies with U modifications that are deprotonated (i. e., anionic) under the sequencing conditions gave broad current levels that influenced the base call error. Some modifications led to helicase dwell time changes. These insights provide design parameters for modification‐specific chemical reagents that can shift nanopore signatures to minimize false positive reads, a known issue with this sequencing approach.
Quantitative proteomics study of carnosine effect in an animal model of Western diet‐induced nonalcoholic fatty liver disease
Authors: Moreto Fernando , Garcia Jéssica Leite , Ferreira Ana Lúcia dos Anjos , Radrezza Silvia , Costa Mariane Róvero , Romualdo Guilherme Ribeiro , Grandini Nubia Alves , Aldini Giancarlo , Correa Camila Renata , D'Amato Alfonsina
Published: January 2024

The nonalcoholic fatty liver disease (NAFLD), which is closely related to westernized dietary (WD) patterns, displays a rising epidemiological and economic burden. Since there is no pharmacological therapy approved for this disease, mechanistic studies are warranted. In this work, we investigated the action of carnosine (CAR), a natural dipeptide with several protection roles against oxidative stress in the liver of NAFLD rats. NAFLD was induced by WD‐rich sugars and fat, verifying the histological evidence of steatosis. As intraperitoneal administration of CAR reversed liver steatosis, the protein profiles of NAFLD liver and CAR NAFLD liver were evaluated by label‐free proteomics approach. A total of 2531 proteins were identified and the 230 and 276 were significantly up‐ and downregulated, respectively, by CAR treatment of NAFLD rats and involved in fundamental pathways such as oxidative stress and lipid metabolism. Perilipin 2 and apolipoprotein E, components of the plasma membrane of vesicle, resulted in highly downregulated in the CAR‐treated NAFLD liver. The advanced bioanalytical approach demonstrated the efficacy of CAR in overcoming the main symptoms of NAFLD, ameliorating the steatosis in the liver.
Exosomal circ_0037104 derived from Hu‐MSCs inhibits cholangiocarcinoma progression by sponging miR‐620 and targeting AFAP1
Authors: Yuan Zilin , Xiong Ba , Liu Lie , Lu Yifan , Liu Yueping , Wang Gang , Qian Yang , Diao Bo , Tu Mingzhong
Published: January 2024

Exosomes are membrane‐enclosed nanovesicles that shuttle active cargoes, such as circular RNAs (circRNAs) and microRNAs (miRNAs), between different cells. Human umbilical cord‐derived mesenchymal stem cells (Hu‐MSCs) can migrate to tumor sites and exert complex functions throughout tumor progression. In this study, we successfully isolated Hu‐MSCs from human umbilical cords based on their surface marker expression. Hu‐MSC‐derived exosomes significantly reduced the invasion, migration, and proliferation of cholangiocarcinoma (CCA) cells. Furthermore, circ_0037104 was downregulated in CCA and inhibited the proliferation and metastasis of CCA cells. Then, we investigated the effect of Hu‐MSC‐derived exosomal circ_0037104 on CCA. Circ_0037104 mainly regulates miR‐620 and enhances APAF1 expression, inhibiting CCA cell proliferation and metastasis. Overall, Hu‐MSC exosomal circ_0037104 contributes to the progression and stemness of CCA cells via miR‐620/APAF1. In conclusion, Hu‐MSC‐derived exosomal circ_0037104 sponges miR‐620 directly and negatively targets APAF1 to suppress CCA.
Chemical bonding in Uranium‐based materials: A local vibrational mode case study of Cs 2UO 2Cl 4 and UCl 4 crystals
Authors: Bodo Filippo , Erba Alessandro , Kraka Elfi , Moura Renaldo T.
Published: January 2024

The Local Vibrational Mode Analysis, initially applied to diverse molecular systems, was extended to periodic systems in 2019. This work introduces an enhanced version of the LModeA software, specifically designed for the comprehensive analysis of two and three‐dimensional periodic structures. Notably, a novel interface with the Crystal package was established, enabling a seamless transition from molecules to periodic systems using a unified methodology. Two distinct sets of uranium‐based systems were investigated: (i) the evolution of the Uranyl ion (UO) traced from its molecular configurations to the solid state, exemplified by CsUOCl and (ii) Uranium tetrachloride (UCl) in both its molecular and crystalline forms. The primary focus was on exploring the impact of crystal packing on key properties, including IR and Raman spectra, structural parameters, and an in‐depth assessment of bond strength utilizing local mode perspectives. This work not only demonstrates the adaptability and versatility of LModeA for periodic systems but also highlights its potential for gaining insights into complex materials and aiding in the design of new materials through fine‐tuning.
Accommodations for disabilities in dental education: A focus on technical standards and clinical skills
Authors: Reuben Jayne S. , Hashmani Khairunisa , Perez Mitzy , Gyurko Robert , Kang Mary , Cooke Matthew R.
Published: January 2024

Providing disability‐based accommodations is a multifaceted process that must balance the needs of dental students and their institutions. Reasonable accommodations must not compromise patient safety or cause an undue burden on the student or institution. Therefore, more creative approaches must be considered as the number of individuals and the types of learning disabilities have increased in recent years. In the clinical setting, providing accommodations also requires detailed advanced planning and collaboration to maintain program quality. However, current technical standards (TS) may serve as a barrier to entry into the health professions for people with disabilities. These individuals remain substantially underrepresented in dentistry despite bringing unique perspectives and experiences that can contribute to a diverse workforce of culturally proficient practitioners. In response, many schools have adopted a “functional” approach to TS that emphasizes a student's abilities rather than their limitations. In addition, innovative assistive technologies coupled with the application of critical pedagogy and universal design learning practices that engage people with the widest possible range of capabilities allows equitable approaches for learning and assessment while maintaining professional standards.
Sarcopenia and frailty in inflammatory bowel disease: Emerging concepts and evidence
Authors: Neelam Pardhu B , Sharma Alka , Sharma Vishal
Published: January 2024

Sarcopenia is a condition marked by progressive loss of skeletal muscle mass and function while frailty is a multidimensional concept characterized by diminished physiological reserve and increased vulnerability to stressors. Both of these were previously considered as related to aging and shown to impact the quality of life and carry prognostic significance. Emerging data show that both sarcopenia and frailty carry similar relevance in chronic illness. Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and malnourishment, both of which contribute to the development of sarcopenia by increasing protein breakdown and reducing protein synthesis. The coexistence of frailty further compounds the clinical complexity of IBD patients. Published evidence suggests a bidirectional association with IBD contributing to muscle wasting, while the resultant sarcopenia and frailty could further exacerbate the disease course. Sarcopenia and frailty are independently associated with adverse outcomes, including hospitalizations, increased surgical interventions, and surgical complications. As therapeutic strategies for IBD evolve, understanding the nuanced relationship between inflammatory bowel disease, sarcopenia, and frailty is crucial for devising holistic management. Comprehensive care should encompass not only disease‐modifying therapies but also interventions targeting frailty and sarcopenia, as they have been shown to have a significant impact not only on the disease course but also on the quality of life. Future research could focus on further elucidating underlying mechanisms, simple screening strategies, and developing targeted interventions to improve the overall quality of life for individuals grappling with the complex interplay of IBD, sarcopenia, and frailty.
Disorders of vesicular trafficking presenting with recurrent acute liver failure: NBAS, RINT1, and SCYL1 deficiency
Authors: Peters Bianca , Dattner Tal , Schlieben Lea D. , Sun Tian , Staufner Christian , Lenz Dominic
Published: January 2024

Among genetic disorders of vesicular trafficking, there are three causing recurrent acute liver failure (RALF): NBAS, RINT1, and SCYL1‐associated disease. These three disorders are characterized by liver crises triggered by febrile infections and account for a relevant proportion of RALF causes. While the frequency and severity of liver crises in NBAS and RINT1‐associated disease decrease with age, patients with SCYL1 variants present with a progressive, cholestatic course. In all three diseases, there is a multisystemic, partially overlapping phenotype with variable expression, including liver, skeletal, and nervous systems, all organ systems with high secretory activity. There are no specific biomarkers for these diseases, and whole exome sequencing should be performed in patients with RALF of unknown etiology. NBAS, SCYL1, and RINT1 are involved in antegrade and retrograde vesicular trafficking. Pathomechanisms remain unclarified, but there is evidence of a decrease in concentration and stability of the protein primarily affected by the respective gene defect and its interaction partners, potentially causing impairment of vesicular transport. The impairment of protein secretion by compromised antegrade transport provides a possible explanation for different organ manifestations such as bone alteration due to lack of collagens or diabetes mellitus when insulin secretion is affected. Dysfunction of retrograde transport impairs membrane recycling and autophagy. The impairment of vesicular trafficking results in increased endoplasmic reticulum stress, which, in hepatocytes, can progress to hepatocytolysis. While there is no curative therapy, an early and consequent implementation of an emergency protocol seems crucial for optimal therapeutic management.
Characterization of halotolerant microalga isolated from waterlogged habitats: Deciphering the biochemical profiling and unraveling the molecular identity
Authors: Sharma Nishu , Kaur Manpreet , Gupta Phutela Urmila , Bhatia Surekha
Published: January 2024

The primary objective of this study was to comprehensively explore the biochemical profile of the novel halotolerant microalgae strain, biogas laboratory scenedesmus (BGLRS), previously isolated from waterlogged regions in the southwest zone of Punjab, India. To achieve this, three distinct drying methods viz. freeze‐drying, oven‐drying, and shade‐drying were employed and biochemical composition and antioxidant analyses on the microalgal biomass were conducted. Utilizing advanced analytical techniques, including high‐performance liquid chromatography (HPLC), inductively coupled plasma‐atomic emission spectroscopy (ICP‐AES), and gas chromatography‐mass spectroscopy (GC‐MS) on freeze‐dried biomass, its carbohydrate profile, micronutrient composition, and presence of bioactive compounds with potential therapeutic and nutraceutical significance were sought to unravel. Among the drying methods evaluated, freeze‐drying exhibited the most promising experimental results, prompting its selection for further investigation. Notably, ICP‐AES unveiled elevated concentrations of essential elements such as calcium, iron, magnesium, and phosphorus in BGLRS, with negligible traces of heavy metals, underscoring its safety for human consumption. GC‐MS analysis further divulged the existence of numerous biologically active compounds, indicating potential applications in medical and nutraceutical fields. Through molecular identification using sequencing of the internal transcribed spacer (ITS) region, a close taxonomic resemblance between BGLRS and Scenedesmus sp. MKB was established, solidifying its unique position within the microalgal taxonomy. The deposition of ITS sequences into the NCBI GenBank, obtaining accession number MN796425, attests to the rigor and transparency of this research. Overall, these findings strongly suggest that microalgae BGLRS possesses high‐quality biochemical attributes of significant therapeutic and nutraceutical importance.
Impact of corporate social responsibility on brand trust and brand loyalty: Case of Uber
Authors: Moon Joonho , Hwang Jinsoo , Lee Won Seok
Published: January 2024

The purpose of this research is to investigate the structural relationship between Uber corporate social responsibility (CSR), brand trust, and brand loyalty. Stakeholder theory is the theoretical foundation of the study. The CSR subdimensions of eco‐friendliness, quarantine, user privacy, user safety, and driver well‐being are used. Amazon Mechanical Turk was employed for data collection. The number of observations is 405. A structural equation model was implemented to test the research hypotheses. This study demonstrated the accountability of stakeholder theory for Uber brand management by showing a significant link between quarantine, user privacy, user safety, driver well‐being, brand trust, and brand loyalty. This study contributes to the literature by validating the explanatory power of stakeholder theory in the case of Uber brand management.
Ecotourism branding in protected areas of Iran: Using an efficient hybrid multi‐criteria decision‐making method model
Authors: Tajer Elnaz , Demir Sara
Published: January 2024

Ecotourism, as a nature‐based sustainable tourism, raises awareness about the protection of natural and cultural landscape values. This study aims to determine the ecotourism criteria to develop strategies for a sustainable ecotourism branding in Golestan, located in the northeast of Iran. To reach this aim, Strengths‐Weaknesses‐Opportunities‐Threats (SWOT) analysis, multi‐criteria decision‐making methods consisting of Analytic Hierarchy Process (AHP), and Best and Worst Method (BWM) were integrated. The most appropriate ecotourism strategies for the branding of the study area were ranked according to their priorities. The results of this study reveal that among the 5 main and 20 sub ecotourism criteria, “having natural protected areas,” which is an opportunity, and “having ecological values,” which is a strength, were determined as the highest priority strategies for ecotourism branding. The methods and results of this quantitative‐based research present an exemplary hybrid model that prioritizes the strategies required for branding ecotourism in similar protected areas.
Development of Artificial Intelligence Image Classification Models for Determination of Umbilical Cord Vascular Anomalies
Authors: Calhoun Byron C. , Uselman Heather , Olle Eric W.
Published: January 2024

Objective

The goal of this work was to develop robust techniques for the processing and identification of SUA using artificial intelligence (AI) image classification models.

Methods

Ultrasound images obtained retrospectively were analyzed for blinding, text removal, AI training, and image prediction. After developing and testing text removal methods, a small n‐size study (40 images) using fastai/PyTorch to classify umbilical cord images. This data set was expanded to 286 lateral‐CFI images that were used to compare: different neural network performance, diagnostic value, and model predictions.

Results

AI‐Optical Character Recognition method was superior in its ability to remove text from images. The small n‐size mixed single umbilical artery determination data set was tested with a pretrained ResNet34 neural network and obtained and error rate average of 0.083 (n = 3). The expanded data set was then tested with several AI models. The majority of the tested networks were able to obtain an average error rate of <0.15 with minimal modifications. The ResNet34‐default performed the best with: an image‐classification error rate of 0.0175, sensitivity of 1.00, specificity of 0.97, and ability to correctly infer classification.

Conclusion

This work provides a robust framework for ultrasound image AI classifications. AI could successfully classify umbilical cord types of ultrasound image study with excellent diagnostic value. Together this study provides a reproducible framework to develop AI‐specific ultrasound classification of umbilical cord or other diagnoses to be used in conjunction with physicians for optimal patient care.
Long‐Term Outcomes and Revision Rates in Laryngeal Reinnervation
Authors: Torrecillas Vanessa F. , Hoffman Matthew R. , Schiffer Breanne , Keefe Katherine , Smith Marshall E.
Published: January 2024

Objectives

Nonselective laryngeal reinnervation is an effective procedure to improve voice quality after unilateral vocal fold paralysis. Few studies have captured long‐term outcome data, and the revision rate for this operation is currently unknown. The objective of this study is to describe the long‐term outcomes and revision rates of unilateral, nonselective reinnervation in pediatric and adult patients.

Methods

Patients who underwent laryngeal reinnervation from 2000 to 2022 with a single surgeon were identified for inclusion. Patients who underwent bilateral, super selective, deinnervation and reinnervation, and/or concurrent arytenoid adduction procedures were excluded. Outcome measures included maximum phonation time [MPT], voice handicap index score [VHI], patient‐reported percent normal voice, revision procedures, and complications. Data were compiled and analyzed using paired t‐tests, repeated measures analysis of covariance, and binary logistic regression analysis.

Results

One hundred thirty‐two patients underwent unilateral, nonselective ansa‐recurrent laryngeal nerve [RLN] laryngeal reinnervation. Reinnervation significantly improved MPT and patient‐reported percentage of normal voice and significantly decreased VHI. Eleven patients underwent revision procedures, corresponding to a revision rate of 8.3%. Additional procedures included medialization laryngoplasty [n = 3], medialization laryngoplasty with arytenoid adduction [n = 3] and injection augmentation greater than 1 year after reinnervation [n = 5]. The only factor associated with the need for additional surgery was time lapse from nerve injury to reinnervation. The overall complication rate was 6.8%; no patient required reintubation or tracheostomy.

Conclusion

Unilateral, nonselective laryngeal reinnervation can provide reliable improvement in vocal symptoms after recurrent laryngeal nerve injury. The revision rate after laryngeal reinnervation is favorable and comparable to framework surgery.

Level of Evidence

4 Laryngoscope, 134:3187–3192, 2024
The Effect of Noise on Deep Learning for Classification of Pathological Voice
Authors: Hasebe Koki , Fujimura Shintaro , Kojima Tsuyoshi , Tamura Keiichi , Kawai Yoshitaka , Kishimoto Yo , Omori Koichi
Published: January 2024

Objective

This study aimed to evaluate the significance of background noise in machine learning models assessing the GRBAS scale for voice disorders.

Methods

A dataset of 1406 voice samples was collected from retrospective data, and a 5‐layer 1D convolutional neural network (CNN) model was constructed using TensorFlow. The dataset was divided into training, validation, and test data. Gaussian noise was added to test samples at various intensities to assess the model's noise resilience. The model's performance was evaluated using accuracy, F1 score, and quadratic weighted Cohen's kappa score.

Results

The model's performance on the GRBAS scale generally declined with increasing noise intensities. For the G scale, accuracy dropped from 70.9% (original) to 8.5% (at the highest noise), F1 score from 69.2% to 1.3%, and Cohen's kappa from 0.679 to 0.0. Similar declines were observed for the remaining RBAS components.

Conclusion

The model's performance was affected by background noise, with substantial decreases in evaluation metrics as noise levels intensified. Future research should explore noise‐tolerant techniques, such as data augmentation, to improve the model's noise resilience in real‐world settings.

Level of Evidence

This study evaluates a machine learning model using a single dataset without comparative controls. Given its non‐comparative design and specific focus, it aligns with Level 4 evidence (Case‐series) under the 2011 OCEBM guidelines Laryngoscope, 134:3537–3541, 2024
Emerging phosphodiesterase inhibitors for treatment of neurodegenerative diseases
Authors: Xiang Yu , Naik Swapna , Zhao Liyun , Shi Jianyou , Ke Hengming
Published: January 2024

Neurodegenerative diseases (NDs) cause progressive loss of neuron structure and ultimately lead to neuronal cell death. Since the available drugs show only limited symptomatic relief, NDs are currently considered as incurable. This review will illustrate the principal roles of the signaling systems of cyclic adenosine and guanosine 3′,5′‐monophosphates (cAMP and cGMP) in the neuronal functions, and summarize expression/activity changes of the associated enzymes in the ND patients, including cyclases, protein kinases, and phosphodiesterases (PDEs). As the sole enzymes hydrolyzing cAMP and cGMP, PDEs are logical targets for modification of neurodegeneration. We will focus on PDE inhibitors and their potentials as disease‐modifying therapeutics for the treatment of Alzheimer's disease, Parkinson's disease, and Huntington's disease. For the overlapped but distinct contributions of cAMP and cGMP to NDs, we hypothesize that dual PDE inhibitors, which simultaneously regulate both cAMP and cGMP signaling pathways, may have complementary and synergistic effects on modifying neurodegeneration and thus represent a new direction on the discovery of ND drugs.
Recent advances in the adjunctive management of diabetic foot ulcer: Focus on noninvasive technologies
Authors: Wang Fen , Zhang Xiaoling , Zhang Jing , Xu Qinqin , Yu Xuefeng , Xu Anhui , Yi Chengla , Bian Xuna , Shao Shiying
Published: January 2024

Diabetic foot ulcer (DFU) is one of the most costly and serious complications of diabetes. Treatment of DFU is usually challenging and new approaches are required to improve the therapeutic efficiencies. This review aims to update new and upcoming adjunctive therapies with noninvasive characterization for DFU, focusing on bioactive dressings, bioengineered tissues, mesenchymal stem cell (MSC) based therapy, platelet and cytokine‐based therapy, topical oxygen therapy, and some repurposed drugs such as hypoglycemic agents, blood pressure medications, phenytoin, vitamins, and magnesium. Although the mentioned therapies may contribute to the improvement of DFU to a certain extent, most of the evidence come from clinical trials with small sample size and inconsistent selections of DFU patients. Further studies with high design quality and adequate sample sizes are necessitated. In addition, no single approach would completely correct the complex pathogenesis of DFU. Reasonable selection and combination of these techniques should be considered.
Mental health guide for election workers likely to receive heavy use in 2024
Authors: Enos Gary
Published: January 2024

Over the past several years, the perception of the role of an election official or poll worker has transitioned from a noble form of civic expression to a highly politicized position that could place the individual at personal risk. With the nation's politically charged atmosphere around elections unlikely to calm anytime soon, The Carter Center is renewing attention to its resource guide for the mental well‐being of election officials.