bluuebunny/crossref_metadata_2025 huggingface dataset:
LAMN port-site metastasis after laparoscopic oophorectomy for a presumed ovarian tumour treated with CRS and HIPEC
Authors: Abramov Roi , Ashkenazi Itamar , Hoffman Aviad L
Published: July 2024

Low-grade appendiceal mucinous neoplasm (LAMN) may culminate as a mucin-secreting disease known as pseudomyxoma peritonei (PMP). Once the diagnosis of LAMN and PMP is made, cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS and HIPEC) are indicated.

Herein, we present a female patient in her 50s who was diagnosed with an ovarian mass for which she underwent laparoscopic oophorectomy. As the pathology of the ovary showed a tumour of gastrointestinal origin, she then underwent CRS and HIPEC with a final pathology of LAMN. Six weeks later, a mucinous lesion confined to the abdominal wall was detected on a postoperative CT. Suspected for port-site metastasis at the laparoscopic trocar site, we treated this lesion using the same principles of treatment as the intra-abdominal disease. The abdominal wall mass was surgically resected, and the cavity created was irrigated with mitomycin C. On 30 months of follow-up, the patient had no evidence of disease.
Solitary liver metastasis from adenoid cystic carcinoma of the submandibular gland
Authors: Brincat Svetlana Doris , Cassar Noel
Published: July 2024

Adenoid cystic carcinoma (ACC) is a rare tumour of the salivary glands characterised by distant metastases, mainly to lungs and bone. Isolated metastasis to the liver is unusual. We present the case of a woman with an ACC of the submandibular gland (pT1N0) who underwent radical submandibular gland excision and selective neck dissection. Preoperative imaging identified a liver lesion with features suggestive of a haemangioma. Two-year postoperatively, a surveillance CT neck/trunk showed an increase in size of the left liver lobe lesion. Subsequent MR liver and US-guided biopsy confirmed the lesion to be metastatic ACC. The patient underwent a successful left lateral liver sectionectomy. She remains disease-free 2.5 years after her liver resection. A literature search revealed only four other similar cases. This report highlights that even early-stage ACCs of the salivary gland may present with synchronous solitary liver metastasis which can be effectively treated with curative surgery.
Williams–Beuren syndrome diagnosis in an infant with atypical chromosome 7 microdeletion
Authors: Olowu Adekunle A
Published: July 2024

This patient is an infant with Williams–Beuren syndrome (WBS) who was diagnosed at 2 months of age. He was born by caesarean section with a low birth weight (LBW) of 2.1 kg and was small for gestational age. His para 1+1 (1 alive) mother in her mid-30s had intrauterine growth restriction during pregnancy. On examination at birth, he appeared phenotypically normal, but at 2 weeks old, he had subtle phenotypic features of WBS of fused filtrum, ulnar deviation of fingers and wide anterior fontanelle, a systolic murmur and mild gaseous distension of the abdomen.

All neonatal reflexes were normal. The author saw this patient at 6 months of age at the well-baby clinic for his 6-month vaccinations during which examination revealed periorbital fullness. Investigations including chromosomal microarray analysis confirmed the diagnosis of WBS. Laboratory tests were essentially normal except for raised creatinine, chloride and liver aspartate transaminase and viral serology that showed reactive cytomegalovirus antibody IgG, rubella antibody IgG, toxoplasma IgG and positive herpes simplex virus type 1 IgG. Echocardiography revealed mild pulmonary artery stenosis. ECG revealed right ventricular hypertrophy. Abdominal ultrasonography was normal and so was cranial sonography. This is a unique case of early diagnosis of WBS in an infant with atypical chromosome 7 deletion in Qatar, Middle East. The patient is undergoing further multidisciplinary follow-up.
Complete response to chemotherapy in a 6-year survivor of metastatic pancreatic cancer
Authors: Burke Cynthia E , Eng Nina L , Yee Nelson S , Peng June S
Published: July 2024

A woman in her 40s underwent evaluation for abdominal pain, jaundice and acholic stools and was diagnosed with metastatic pancreatic head adenocarcinoma. She was enrolled in a clinical trial investigating the benefits of ibrutinib with nab-paclitaxel and gemcitabine, and subsequently received modified FOLFIRINOX. Over the course of 6 years on chemotherapy, she experienced complete regression of the pancreatic and liver lesions, as well as normalisation of her tumour markers. She has been off chemotherapy for 6 months with no evidence of disease and normal tumour markers. Despite advances in chemotherapy and surgical options, metastatic pancreatic adenocarcinoma continues to carry a grim prognosis. This case report demonstrates a rare case of a long-term survivor of unresectable metastatic pancreatic adenocarcinoma treated with chemotherapy alone.
Switching from Dose-Intensified intravenous to SubCutaneoUS infliximab in Inflammatory Bowel Disease (DISCUS-IBD): protocol for a multicentre randomised controlled trial
Authors: Little Robert D , McKenzie Jo , Srinivasan Ashish , Hilley Patrick , Gilmore Robert B , Chee Desmond , Sandhu Manjeet , Saitta Daniel , Chow Elizabeth , Thin Lena , Walker Gareth J , Moore Gregory T , Lynch Kate , Andrews Jane , An Yoon K , Bryant Robert V , Connor Susan J , Garg Mayur , Wright Emily K , Hold Georgina , Segal Jonathan P , Boussioutas Alex , De Cruz Peter , Ward Mark G , Sparrow Miles P
Published: July 2024

Introduction

A substantial proportion of patients with inflammatory bowel disease (IBD) on intravenous infliximab require dose intensification. Accessing additional intravenous infliximab is labour-intensive and expensive, depending on insurance and pharmaceutical reimbursement. Observational data suggest that subcutaneous infliximab may offer a convenient and safe alternative to maintain disease remission in patients requiring dose-intensified infliximab. A prospective, controlled trial is required to confirm that subcutaneous infliximab is as effective as dose-intensified intravenous infliximab, to identify predictors of disease flare and to establish the role of subcutaneous infliximab therapeutic drug monitoring.

Methods and analysis

The DISCUS-IBD trial is an investigator-initiated, prospective, multicentre, randomised, open-label non-inferiority study comparing the rate of disease flares in participants randomised to continue dose-intensified intravenous infliximab to those switched to subcutaneous infliximab after 48 weeks. Participants are adult patients with IBD in sustained corticosteroid-free remission on any regimen of dose-intensified infliximab up to a maximum of 10 mg/kg 4-weekly intravenously. Participants allocated to intravenous infliximab will continue infliximab at the same dose-intensified regimen they were receiving at study enrolment. Subcutaneous infliximab dosing will be stratified by prior intravenous infliximab dosing. Clinical (Harvey-Bradshaw Index, partial Mayo score), biochemical (C reactive protein, faecal calprotectin), pharmacokinetic (drug-level±antidrug antibodies) and qualitative data are collected 12-weekly until study conclusion at week 48. 13 sites across Australia will participate in recruitment to reach a calculated sample size of 120 participants.

Ethics and dissemination

Multisite ethics approval was obtained from the Health District Human Research Ethics Committee (HREC) at The Alfred Hospital under a National Mutual Acceptance (NMA) agreement (HREC/90559/Alfred-2022; Local Reference: Project 618/22, version 1.6, 2 March 2023). Findings will be reported at national and international gastroenterology meetings and published in peer-reviewed journals. DISCUS-IBD was prospectively registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR) prior to commencing recruitment.

Trial registration number

ACTRN12622001458729.
Effects of hydromorphone-based patient-controlled intravenous analgesia on postoperative hypoxaemia: a randomised controlled non-inferiority clinical trial
Authors: Ma Yumei , Feng Xiangying , Yan Nong , Deng Zhuomin , Luo Jialin , Lin Jingjing , Zheng Ziyu , Mu Xiaoxiao , Yang Xuan , Du Jiejuan , Meng Yang , Dong Hailong , Nie Huang
Published: July 2024

Objective

This study aimed to compare the effects of patient-controlled intravenous analgesia (PCIA) with and without low-basal infusion on postoperative hypoxaemia.

Design

A randomised parallel-group non-inferiority trial.

Setting

The trial was conducted at a grade-A tertiary hospital from December 2021 to August 2022.

Participants

160 adults undergoing gastrointestinal tumour surgery and receiving postoperative PCIA.

Interventions

Participants randomly received a low-basal (0.1 mg/hour of hydromorphone) or no-basal infusion PCIA for postoperative 48 hours.

Primary and secondary outcome measures

Primary outcome was area under curve (AUC) per hour for hypoxaemia, defined as pulse oxygen saturation (SpO2) <95%. Secondary outcomes included: AUC per hour at SpO2<90% and <85%, hydromorphone consumption, ambulation time and analgesic outcomes up to 48 hours after surgery.

Results

Among 160 randomised patients, 159 completed the trial. An intention-to-treat analysis showed that AUC per hour (SpO2<95%) was greater in the low-basal infusion group compared with the no-basal infusion group, with a median difference of 0.097 (95% CI 0.001 to 0.245). Non-inferiority (margin: ratio of means (ROM) of 1.25) was not confirmed since the ROM between the two groups was 2.146 (95% CI 2.138 to 2.155). Hydromorphone consumption was higher in the low-basal group than in the no-basal group (median: 5.2 mg versus 1.6 mg, p<0.001). Meanwhile, there were no differences in the AUC values at the other two hypoxaemia thresholds, in ambulation time, or pain scores between the groups.

Conclusions

Among the patients receiving hydromorphone PCIA after gastrointestinal tumour resection, low-basal infusion was inferior to no-basal infusion PCIA for postoperative hypoxaemia at SpO2<95% up to 48 hours after surgery.

Trial registration number

ChiCTR2100054317.
Li–Yorke Chaos in Linear Systems with Weak Topology on Hilbert Spaces
Authors: Yang Qigui , Zhu Pengxian
Published: July 2024

This paper investigates the Li–Yorke chaos in linear systems with weak topology on Hilbert spaces. A weak topology induced by bounded linear functionals is first constructed. Under this weak topology, it is shown that the weak Li–Yorke chaos can be equivalently measured by an irregular or a semi-irregular vector, which are utilized to establish criteria for the weak Li–Yorke chaos of diagonalizable operators, Jordan blocks, and upper triangular operators. In particular, for a linear operator that can be decomposed into a direct sum of finite-dimensional Jordan blocks, it is Li–Yorke chaotic in weak topology if its point spectrum contains a pair of real opposite eigenvalues with absolute values not less than 1, or a pair of complex conjugate eigenvalues with moduli not less than 1. Interestingly, as a specific example of upper triangular operator, the existence of Li–Yorke chaos in weak topology can be derived for a class of linear operators expressed as the direct sum of finite-dimensional Jordan blocks and a strongly irreducible operator.
Periodic Orbit Dividing Surfaces in a Quartic Hamiltonian System with Three Degrees of Freedom – II
Authors: Montoya Francisco Gonzalez , Katsanikas Matthaios , Wiggins Stephen
Published: July 2024

In prior studies [ Katsanikas & Wiggins , 2021a , 2021b , 2023a , 2023b ], we introduced two methodologies for constructing Periodic Orbit Dividing Surfaces (PODS) tailored specifically for Hamiltonian systems with three or more degrees of freedom. These approaches, as described in the aforementioned papers, were applied to a quadratic Hamiltonian system in its normal form with three degrees of freedom. Within this framework, we provide a more intricate geometric characterization of this entity within the family of 4D toratopes which elucidates the structure of the dividing surfaces discussed in these works. Our analysis affirmed the nature of this construction as a dividing surface with the property of no-recrossing. These insights were derived from analytical findings tailored to the Hamiltonian system discussed in these publications. In this series of papers, we extend our previous findings to quartic Hamiltonian systems with three degrees of freedom. We establish the no-recrossing property of the PODS for this class of Hamiltonian systems and explore their structural aspects. Additionally, we undertake the computation and examination of the PODS in a coupled scenario of quartic Hamiltonian systems with three degrees of freedom. In the initial paper [ Gonzalez Montoya et al. ,  2024 ], we employed the first methodology for constructing PODS, while in this paper, we utilize the second methodology for the same purpose.
A Noise Validation for Quantum Circuit Scheduling Through a Service-Oriented Architecture
Authors: Romero-Álvarez Javier , Alvarado-Valiente Jaime , Casco-Seco Jorge , Moguel Enrique , Garcia-Alonso Jose , Murillo Juan M.
Published: July 2024

Progress in the realm of quantum technologies is paving the way for a multitude of potential applications across different sectors. However, the reduced number of available quantum computers, their technical limitations, and the high demand for their use are posing some problems for developers and researchers. Mainly, users trying to execute quantum circuits on these devices are usually facing long waiting times in the task queues. In this context, this work proposes a Service-Oriented architecture to reduce waiting times and optimize quantum computer usage by scheduling the circuits from different users into combined circuits that are executed at the same time. To validate this proposal, different widely known quantum algorithms have been selected and executed in combined circuits. The obtained results are then compared with the results of executing the same algorithms in an isolated way. This allowed us to measure the impact of the use of the scheduler against quantum noise. Among the obtained results, it has been possible to verify that the noise suffered by executing a combination of circuits through the proposed scheduler does not critically affect the outcomes.
A Polyvocal Approach to Virtual Heritage: An Immersive Case Study
Authors: Franke Isabel F. , Conte Stefania D. , Libbi Claudia A. , De Boer Victor , Hartmann Tilo
Published: July 2024

Large parts of museum collections, particularly in the Netherlands, are a legacy of the colonial past, guiding people’s societal perceptions of cultures and histories. There have been increasing efforts to ensure that museums acknowledge and reveal to visitors the multiple (e.g., cultural) meanings and contexts attached to objects in these collections. We address this as an effort to increase
polyvocality
. The present work contributes to the effort to emphasize, but objectively acknowledge, multiple (perhaps conflicting) perspectives attached to cultural resources. We provide a measurement to assess polyvocality amongst individuals and a case study including an adaptive, polyvocal exhibition design. The developed Virtual Reality (VR) exhibition curates the flag of Suriname (1975—today), in which participants interactively encountered multiple perspectives on the flag’s colors and, in three different sceneries, learned how those relate to Suriname’s history. Our quantitative findings (obtained among a smaller sample of
N

\(=\)

20) revealed that the experience fostered a polyvocal mindset, which is supported by our qualitative analyses highlighting key polyvocal elements in the virtual environment. In sum, the present approach further explicates the polyvocality construct, proposes ways of assessing a polyvocal mindset, and recommends design principles to tailor polyvocality-enhancing VR applications.
SSAT: Active Authorization Control and User’s Fingerprint Tracking Framework for DNN IP Protection
Authors: Xue Mingfu , Wu Yinghao , Zhang Leo Yu , Gu Dujuan , Zhang Yushu , Liu Weiqiang
Published: July 2024

As training a high-performance deep neural network (DNN) model requires a large amount of data, powerful computing resources and expert knowledge, protecting well-trained DNN models from intellectual property (IP) infringement has raised serious concerns in recent years. Most existing methods using DNN watermarks to verify the ownership of the models after IP infringement occurs, which is reactive in the sense that they cannot prevent unauthorized users from using the model in the first place. Different from these methods, in this article, we propose an active authorization control and user’s fingerprint tracking method for the IP protection of DNN models by utilizing sample-specific backdoor attack. The proposed method inversely and multiplely exploits sample-specific trigger as the key to implement authorization control for DNN model, in which the generated triggers are imperceptible and sample-specific for clean images. Specifically, a U-Net model is used to generate backdoor instances. Then, the target model is trained on the clean images and backdoor instances, which are inversely labeled as wrong classes and correct classes, respectively. Only authorized users can use the target model normally by pre-processing the clean images through the U-Net model. Moreover, the images processed by the U-Net model will contain unique fingerprint that can be extracted to verify and track the corresponding user’s identity. This article is the first work that utilizes the sample-specific backdoor attack to implement active authorization control and user’s fingerprint management for DNN model under black-box scenarios. Extensive experimental results on ImageNet dataset and YouTube Aligned Face dataset demonstrate that the proposed method is effective in protecting the DNN model from unauthorized usage. Specifically, the protected model has a low inference accuracy (1.00%) for unauthorized users, while maintaining a normal inference accuracy (97.67%) for authorized users. Besides, the proposed method can achieve 100% fingerprint tracking success rates on both the ImageNet and YouTube Aligned Face datasets. Moreover, it is demonstrated that the proposed method is robust against fine-tuning attack, pruning attack, pruning attack with retraining, reverse-engineering attack, adaptive attack, and JPEG compression attack. The code is available at
https://github.com/nuaaaisec/SSAT
.
Action-aware Linguistic Skeleton Optimization Network for Non-autoregressive Video Captioning
Authors: Chen Shuqin , Zhong Xian , Zhang Yi , Zhu Lei , Li Ping , Yang Xiaokang , Sheng Bin
Published: July 2024

Non-autoregressive video captioning methods generate visual words in parallel but often overlook semantic correlations among them, especially regarding verbs, leading to lower caption quality. To address this, we integrate action information of highlighted objects to enhance semantic connections among visual words. Our proposed Action-aware Language Skeleton Optimization Network (ALSO-Net) tackles the challenge of extracting action information across frames, improving understanding of complex context-dependent video actions and reducing sentence inconsistencies. ALSO-Net incorporates a linguistic skeleton tag generator to refine semantic correlations and a video action predictor to enhance verb prediction accuracy in video captions. We also address issues of unsatisfactory caption length and quality by jointly optimizing different levels of motion prediction loss. Experimental evaluation on prominent video captioning datasets demonstrates that ALSO-Net outperforms baseline methods by a significant margin and achieves competitive performance compared to state-of-the-art autoregressive methods with smaller model complexity and faster inference time.
Deep Plug-and-Play Non-Iterative Cluster for 3D Global Feature Extraction
Authors: Li Zhenyu , Gao Shanshan , Mao Deqian , Song Shouwen , Li Lei , Zhou Yuanfeng
Published: July 2024

Efficient and accurate point cloud feature extraction is crucial for critical tasks such as 3D recognition and semantic segmentation. However, existing global feature extraction methods for 3D data often require designing different models for different input types (point clouds, voxels, and maps). This article proposes an efficient plug-and-play non-iterative clustering method (NICM) to establish a unified point cloud global feature extraction paradigm suitable for any input type to solve the above problems. The core idea of the NICM is to construct the connection between a single point and other global points based only on the cosine similarity between center points to achieve global feature extraction, which has linear complexity characteristics and can be combined with any existing feature extraction model. Additionally, to better integrate the features extracted by NICM and the original model, this article designs an adaptive feature fusion module is designed based on the gate unit, which retains similar features and effectively fuses dissimilar features based on their importance to downstream tasks. We have applied our method to downstream tasks such as point cloud recognition, part segmentation and scene segmentation. Sufficient experiments have proven that our method can provide comprehensive and robust features for the original model, and effectively improve the performance of downstream tasks.
Detection of Urea in Human Blood using Graphene-Based Amperometric Biosensor
Authors: Huang Yu-Ming , Lin Jia-Chuan , Settu Kalpana
Published: July 2024

Urea being an essential clinical analyte, its early and easy detection would be helpful in preventing various diseases. In this study, a graphene-based screen-printed enzymatic biosensor was fabricated for the blood urea detection by amperometric method. The electrode surface was modified with urease and glutamate dehydrogenase (Urs-GLDH) enzymes for sensitive and selective detection of urea with a wide detection range. The diffusion coefficient and the electron transfer rate constant of the screen-printed graphene electrode (SPGE) was found to be 8.53 × 10−7 cm2 s−1 and 7.58

×

10−5 cm s−1, respectively. The proposed graphene-based enzymatic urea biosensor can detect urea ranging from 2.5 to 30 mM with a sensitivity of 10.59 μA·mM−1·cm−2. The reliability of this enzymatic biosensor was confirmed by measuring urea in human blood and the results showed excellent agreement with the clinical testing method. Hence, the graphene-based biosensor described herein could provide rapid, sensitive, and selective detection of urea with low-cost and simple fabrication. In conclusion, this urea detection approach could be a promising method for developing feasible low-cost clinical diagnostic systems.
Sensitive Electrochemical Sensor for Gallic Acid Determination in Honey Based on g-C3N4/AuNPs Modified Carbon Paste Electrode
Authors: Abbasi-Qazaani Zahra , Rafiee-Pour Hossain-Ali , Shourian Mostafa
Published: July 2024

Gallic acid (GA) is a well-known polyphenol that occurs naturally in plants and is used as a chemical marker or standard antioxidant in analytical research. Here, a carbon paste electrode was modified with a nanocomposite of graphitic carbon nitride and gold nanoparticles (g-C3N4/AuNPs/CPE). The g-C3N4/AuNPs was characterized by Fourier transform infrared spectroscopy, X-ray diffraction, energy-dispersive X-ray spectroscopy, and scanning electron microscopy. Electrochemical impedance spectroscopy, cyclic voltammetry, and differential pulse voltammetry methods were used to investigate the electrochemical behavior of GA on the electrode. EIS analysis exhibited lower charge-transfer resistance in g-C3N4/AuNPs/CPE than CPE; 250 vs 1500 Ω, respectively. The g-C3N4/AuNPs/CPE was used to GA sensing with limit of detection and linear response range of 0.025 and 0.16–4.10 μM, respectively via DPV. Then, the GA content in Iranian honey samples with different floral origins such as Ziziphus, Barberry, Thyme, Astragalus, Eucalyptus and Coriander was successfully determined. According to result, the fabricated electrochemical sensor could be useful for GA evaluation in food samples.
Novel Green Screen-Printed Potentiometric Sensor for Monitoring Antihistamine Drug Chlorphenoxamine HCl in Various Matrices
Authors: Ashraf Ahmed , El-Zeany Badr A. , Sedik Ghada A. , Rostom Yasmin , Badr ElDin Norhan
Published: July 2024

The pharmaceutical sector is seeking cost-effective analyzers that deliver precise, real-time data. This study aims to establish a correlation between the pharmaceutical industry and advancements in solid-contact ion-selective electrodes for quantifying chlorphenoxamine hydrochloride (CPX) concentration in various matrices. A comparative analysis of the performance between solid contact and liquid contact sensors showed that solid contact sensors outperformed their liquid contact counterparts in terms of durability, handling, and ease of integration. A sensor was developed using MWCNT and calix[8]arene as ionophore, resulting in a Nernstian potentiometric response for CPX across a linear range of 5.0 × 10−5 to 1.0 × 10−8 M. The slope of the response was 57.89 ± 0.77 mV/decade, and the standard potential was determined to be 371.9 ± 0.8 mV. The developed sensor exhibits notable intrinsic advantages, such as a rapid response time of 12 ± 2 s and an extended lifespan of 3 months. The sensor exhibiting optimal performance has been effectively employed for the analysis of CPX in different matrices, including pharmaceutical formulations, urine, and plasma. The developed method underwent validation in compliance with ICH requirements. Finally, the method’s greenness and whiteness were evaluated using five different tools and successfully compared to those obtained from the established reported method.
Aloe Vera Drink Fortification with Free and Microcapsulated Pumpkin Seed Protein Hydrolysate
Authors: Nooshi Manjili Zeinab , Sadeghi Mahoonak Alireza , Ghorbani Mohammad , Shahiri Tabarestani Hoda
Published: July 2024

Pumpkin seeds are by‐products that are discarded as household and agricultural waste or used as animal feed. Pumpkin seeds have many nutritional properties, especially antioxidant activity. Therefore, they have the potential to be used as foods with appropriate bioactive characteristics. Encapsulation is an effective method for protecting bioactive compounds. To strengthen the alginate hydrogel network, chitosan coating was used. After that, different concentrations (50, 100, and 150 mg per 100 ml drink) of free and microcapsulated pumpkin seed protein hydrolysate (PSPH) were added to aloe drink to investigate its antioxidant activity and its physicochemical properties during storage at refrigerator temperature (30 days at 4°C). According to the results, pancreatin hydrolysates showed higher antioxidant activities (52.6% DPPH, 91.1% iron chelation activity, and 1.0 (absorbance at 695 nm) total antioxidant activity), so this sample was chosen as the core material for encapsulation. The encapsulation efficiency of plain alginate and chitosan‐alginate beads was 71.63 ± 2.15% and 81.4 ± 2.8%, respectively. The results of the drink analysis showed that by adding PSPH, bitterness rose. On the other hand, by increasing the concentration of beads, acidity decreased (0.15 ± 0.02%); also, pH (4.45 ± 0.05), dissolved particles (19.7 ± 0.83), ash (0.34 ± 0.05%), color intensity (0.62 ± 0.15), and antioxidant activity (50.4 ± 1.5% and 47.5 ± 1.3%, respectively, in DPPH and Fe chelation activity) increased. However, with the increase in free protein hydrolysate concentration, acidity (0.34 ± 0.05%), dissolved particles (19.8 ± 0.87), ash (0.36 ± 0.05%), color intensity (0.88 ± 0.2), and antioxidant activity (56.5 ± 1.8% and 50.1 ± 1.5%, respectively, in DPPH and Fe chelation activity) increased but pH (3.45 ± 0.04) decreased. Additionally, it should be noted that the decrease in antioxidant activity and pH and increase in acidity in the samples containing protein hydrolysate occurred at a higher speed than the samples containing beads. By adding chitosan‐alginate microcapsules to drinks, all microbial tests were negative, and PSPH in higher concentrations could inhibit microbial growth. Above all, the results showed the positive effect of adding multilayer hydrogels on increasing shelf life and improving the taste and antioxidant properties of aloe vera drinks.
Supplementary Video S1 from Cistrome Cancer: A Web Resource for Integrative Gene Regulation Modeling in Cancer
Authors: Mei Shenglin , Meyer Clifford A. , Zheng Rongbin , Qin Qian , Wu Qiu , Jiang Peng , Li Bo , Shi Xiaohui , Wang Binbin , Fan Jingyu , Shih Celina , Brown Myles , Zang Chongzhi , Liu X. Shirley
Published: July 2024

Cistrome Cancer overview.
Supplementary Data from Cistrome Cancer: A Web Resource for Integrative Gene Regulation Modeling in Cancer
Authors: Mei Shenglin , Meyer Clifford A. , Zheng Rongbin , Qin Qian , Wu Qiu , Jiang Peng , Li Bo , Shi Xiaohui , Wang Binbin , Fan Jingyu , Shih Celina , Brown Myles , Zang Chongzhi , Liu X. Shirley
Published: July 2024

Supplementary Data include: 1, Supplementary Methods: a detailed description of data processing, computational analysis, and web interface functions; 2, Supplementary References; 3, Supplementary Figures 1-6: Fig. S1: Cancer sample reclustering; Fig. S2: Cancer type reannotation; Fig. S3: TF target prediction in cancer; Fig. S4: Snapshot of the Cistrome Cancer TF target prediction webpage; Fig. S5: FOXM1, a pan-cancer active TF; Fig. S6: Distinct patterns of immune cell infiltration in kidney and colorectal cancers; and 4, Supplementary Table 1: Cancer Type Abbreviations.
Association between Pathological Narcissism and Emotion Dysregulation: A Systematic Review
Authors: Blay Martin , Cham Marie-Aude , Duarte Miguel , Ronningstam Elsa
Published: July 2024

Introduction: Pathological narcissism (PN) can be defined as the compromised and fluctuating ability to regulate self-esteem, the latter depending on external validation, admiration, or enhancement, all resulting in grandiose (e.g., self-enhancement, aggressiveness, manipulation) or vulnerable (e.g., depression, anxiety, self-criticism, avoidance) dysfunctional reactions when confronting with self-esteem threats. A link has been suggested between PN and emotion dysregulation (ED), but to date, no systematic review has been conducted. Methods: We conducted a systematic review of the literature published until February 2024 studying the association between PN (with or without a diagnosis of narcissistic personality disorder) and ED, divided in two domains: emotion regulation difficulties and strategies. Results: Twenty-two studies were included in our analysis. Altogether, the available data are insufficient to conclude on the link between grandiose narcissism and emotion regulation difficulties in non-clinical population (notably due to different patterns of associations depending on the scale used to assess narcissism). However, the small number of studies conducted in clinical population seems to indicate a possible absence of association between the two constructs. On the other side, there is considerable evidence for the existence of a positive association between vulnerable narcissism and emotion regulation difficulties, regardless of the scale used to assess narcissism and the type of population considered. Finally, regarding emotion regulation strategies, data are too scarce to draw any conclusion, even though there seems to be a trend toward positive association between narcissistic vulnerability and expressive suppression. Conclusion: ED seems to be highly associated with narcissistic vulnerability. Given that every patient suffering from PN may experience vulnerable states, we believe that ED should be considered as an important part of psychoeducation programs and psychotherapeutic treatments designed for this population.
An Empirical-Phenomenological Exploration of Anderssein (Feeling Different) in Schizophrenia: Being in-between Particular and Universal
Authors: Stephensen Helene , Urfer-Parnas Annick , Parnas Josef
Published: July 2024

Introduction: In this paper, we wish to elucidate alterations of basic existential and intersubjective configurations in schizophrenia spectrum disorders (SSD) through the phenomenon of Anderssein (“feeling different”). Anderssein is an important yet neglected notion from German psychiatry, referring to a specific sense of feeling profoundly different from others occurring in SSD. Although phenomenological-psychopathological research mentions it as an aspect of the core disturbance of SSD (namely, “self-disorders”), the phenomenon has not yet been explored in empirical or theoretical detail. Method: We present material from a phenomenological-empirical study on the mode and onset of psychosis based on qualitative interviews with 25 patients with SSD. Results: Most of the participants in our study report having felt fundamentally and often ineffably different since childhood and articulate it as a sense of existing “outside” of the shared reality. Intersubjective reality appears progressively unreal or inauthentic, and simultaneously, the patient’s intimate, subjective sphere is permeated by an alien otherness. Importantly, this outside position should be understood carefully as it is often accompanied by the sense of being invaded by social rules, other people’s thoughts, or emotions. Incipient psychosis is described as a gradual extension of precedent alterations of the structures of (inter)subjectivity. Conclusion: We conceptualize the ontological feature of Anderssein as an altered “being in-between” – that is, some sort of halting of the dynamic movement between particularity and intersubjectivity. Finally, we discuss the critical implications of these results for research into the “onset” of schizophrenia.
Efficacy and Safety of Hydrocortisone, Ascorbic Acid, and Thiamine Combination Therapy for the Management of Sepsis and Septic Shock: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Authors: Deng Jiawen , Zuo Qi Kang , Venugopal Kaden , Hung Jay , Zubair Areeba , Blais Sara , Porter Victoria , Moskalyk Myron , Heybati Kiyan
Published: July 2024

Introduction: This systematic review aimed to assess the efficacy and safety of hydrocortisone, ascorbic acid, and thiamine (HAT) combination therapy in patients with sepsis and septic shock. Methods: We conducted a database search in MEDLINE, Embase, CENTRAL, Web of Science, and CNKI for randomised controlled trials (RCTs) comparing HAT against placebo/standard of care or against hydrocortisone in sepsis/septic shock patients. Outcomes included mortality, ICU/hospital length of stay (LOS), vasopressor durations, mechanical ventilation durations, change in SOFA at 72 h, and adverse events. RCT results were pooled in random-effects meta-analyses. Quality of evidence was assessed using GRADE. Results: Fifteen RCTs (N = 2,594) were included. At 72 h, HAT reduced SOFA scores from baseline (mean difference [MD] −1.16, 95% confidence interval [CI]: −1.58 to −0.74, I2 = 0%) compared to placebo/SoC, based on moderate quality of evidence. HAT also reduced the duration of vasopressor use (MD −18.80 h, 95% CI: −23.67 to −13.93, I2 = 64%) compared to placebo/SoC, based on moderate quality of evidence. HAT increased hospital LOS (MD 2.05 days, 95% CI: 0.15–3.95, I2 = 57%) compared to placebo/SoC, based on very low quality of evidence. HAT did not increase incidence of adverse events compared to placebo/SoC. Conclusions: HAT appears beneficial in reducing vasopressor use and improving organ function in sepsis/septic shock patients. However, its advantages over hydrocortisone alone remain unclear. Future research should use hydrocortisone comparators and distinguish between sepsis-specific and comorbidity- or care-withdrawal-related mortality.
Endoscopic Resection of Neoplasia in the Lower GI Tract: A Clinical Algorithm
Authors: O'Sullivan Timothy , Bourke Michael J.
Published: July 2024

Background: Colorectal cancer is a highly prevalent malignancy and a significant driver of cancer mortality and health-related expenditure worldwide. Polyp removal reduces the incidence and mortality of colorectal cancer. In 2024, endoscopists have an array of resection modalities at their disposal. Each technique requires a unique skillset and has individual advantages and limitations. Consequently, resection in the colorectum requires an evidence-based algorithm approach that considers these factors. Summary: A literature review of endoscopic resection for colonic neoplasia was conducted. Best supporting scientific evidence was summarized for the endoscopic resection of diminutive polyps, large ≥20 mm lesions and polyps containing invasive cancer. Factors including resection modality, complications and lesion selection were explored to inform an algorithm approach to colorectal resection. Key Messages: Endoscopic resection in the colorectum is not a one-size-fits-all approach. Detailed understanding of polyp size, location, morphology and predicted histology are critical factors that inform appropriate endoscopic resection practice.
Predictors of Poststroke Cognitive Decline among Stroke Survivors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis
Authors: Munye Aytenew Tigabu , Demis Kebede Solomon , Necho Asferie Worku , Asnakew Sintayehu
Published: July 2024

Introduction: Stroke is a devastating medical disorder associated with significant morbidity and mortality among adults and the elderly worldwide. Although numerous primary studies have been conducted to determine the pooled predictors of poststroke cognitive decline among stroke survivors in Sub-Saharan Africa, these studies presented inconsistent findings. Hence, the review aimed to determine the pooled predictors of poststroke cognitive decline among stroke survivors in Sub-Saharan Africa. Methods: The eligible studies were accessed through Google Scholar, Scopus, PubMed, and Web of Science databases. A manual search of the reference lists of included studies was performed. A weighted inverse-variance random-effects model was used to determine the pooled predictors of poststroke cognitive decline among stroke survivors in Sub-Saharan Africa. Results: A total of 1,710 stroke survivors from 10 primary studies were included in the final meta-analysis. Increased age (≥45 years) (adjusted odds ratio [AOR] = 1.32, 95% CI: 1.13, 1.54), lower educational level (AOR = 4.58, 95% CI: 2.98, 7.03), poor functional recovery (AOR = 1.75, 95% CI: 1.42, 2.15), and left hemisphere stroke (AOR = 4.88, 95% CI: 2.98, 7.99) were significantly associated with poststroke cognitive decline. Conclusions: Increased age, lower educational level, poor functional recovery, and left hemisphere stroke were the pooled independent predictors of poststroke cognitive decline in Sub-Saharan Africa Healthcare providers, and other concerned bodies should give attention to these risk factors as the early identification may help to improve the cognitive profile of stroke survivors.
Influence of Early Total Enteral Feeding in Preterm Infants with Respiratory Distress Syndrome
Authors: Anand Rohit , Nangia Sushma
Published: July 2024

Introduction: Providing adequate nutrition in the management of preterm infants has been challenging. The objective of this secondary analysis of data from the randomized trial comparing “less invasive surfactant therapy (LISA) with InSurE method of surfactant administration” is to demonstrate the feasibility of early total enteral feeding (ETEF) in hemodynamically stable preterm neonates on respiratory support and to examine the factors associated with failure of ETEF. Methods: Secondary analysis of a randomized controlled trial comparing “LISA versus InSurE among preterm infants between 26 and 34 weeks of gestation” enrolled 150 infants with 117 being hemodynamically stable. ETEF without any parenteral supplementation was started on day 1 of life using the mother’s own milk (MoM) or donor human milk (<32 weeks of GA) and MoM or preterm formula (33–34 weeks of GA). The data were analyzed to assess the proportion of babies developing feed intolerance and/or necrotizing enterocolitis (NEC) and factors associated with failure of ETEF. All Infants were assessed for the day of attainment of full enteral feeding defined as receiving and tolerating 150 mL/kg of enteral feeds per day. Results: Out of these 117 babies, 102 tolerated ETEF, and 15 had one or more episodes of FI requiring total parenteral nutrition, but none developed NEC till discharge or death. On the assessment of possible factors associated with ETEF failure, there were no differences in baseline characteristics but statistically significantly increased incidence of culture-positive sepsis as well as the requirement of antibiotic therapy for possible sepsis (early as well as late-onset sepsis) in babies with failure of ETEF. The babies who tolerated ETEF achieved full enteral feeding (150 mL/kg/day) significantly earlier (5.48 ± 1.1 days) compared to those with ETEF failure (7 ± 3.4 days) (p 0.001). The time to regain birth weight was earlier in the ETEF group without significant differences in growth parameters. There was also a reduction in the duration of hospital stay in babies who tolerated ETEF, but both these results were not statistically significant. Conclusion: ETEF is feasible in preterm neonates with respiratory distress syndrome who are on respiratory support. It resulted in earlier attainment of full enteral feeds and decreased the incidence of sepsis with reduced antibiotic usage.
The Role of Ureaplasma Species in Prenatal and Postnatal Morbidity of Preterm Infants: Current Concepts
Authors: Silwedel Christine , Laube Mandy , Speer Christian P. , Glaser Kirsten
Published: July 2024

Background: Ureaplasma species are considered commensals of the adult urogenital tract. Yet, in pregnancy, Ureaplasma parvum and Ureaplasma urealyticum have been associated with chorioamnionitis and preterm birth. In preterm infants, Ureaplasma respiratory tract colonization has been correlated with the development of bronchopulmonary dysplasia and has been implicated in the pathogenesis of other complications of prematurity. Controversies on the impact of Ureaplasma exposure on neonatal morbidity, however, remain, and recommendations for screening practices and therapeutic management in preterm infants are missing. Summary: In this review, we outline clinical and experimental evidence of Ureaplasma-driven fetal and neonatal morbidity, critically examining inconsistencies across some of the existing studies. We explore underlying mechanisms of Ureaplasma-associated neonatal morbidity and discuss gaps in the current understanding including the interplay between Ureaplasma and the maternal urogenital tract and the preterm airway microbiome. Ultimately, we highlight the importance of adequate diagnostics and review the potential efficacy of anti-infective therapies. Key Messages: There is strong evidence that perinatal Ureaplasma exposure is causally related to the development of bronchopulmonary dysplasia, and there are conclusive data of the role of Ureaplasma in the pathogenesis of neonatal central nervous system infection. Observational and experimental findings indicate immunomodulatory capacities that might promote an increased risk of secondary infections. The burden of Ureaplasma exposure is inversely related to gestational age – leaving the tiniest babies at highest risk. A better knowledge of contributing pathogen and host factors and modulating conditions remains paramount to define screening and treatment recommendations allowing early intervention in preterm infants at risk.
Nomogram to Estimate the Risk of Chronic Kidney Disease-Associated Pruritus in Patients with End-Stage Renal Disease Undergoing Peritoneal Dialysis: Model Development and Validation Study
Authors: Gu Wen , Zhang Ming , Liang Changna , Ma Shaohui , Wang Xiaopei , Yuan Huijie , Luo Zhaoyao , Lv Jing
Published: July 2024

Introduction: Chronic kidney disease-associated pruritus (CKD-aP) frequently occurs in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD) and presents a therapeutic challenge to physicians owing to the diversity of its pathogenesis. Herein, we developed and validated a nomogram model for individualized risk estimation of CKD-aP and investigated the possible causes of CKD-aP in PD patients. Methods: We retrospectively screened patients with CKD-aP who underwent PD between 2021 and 2023 at the First Affiliated Hospital of Xi’an Jiaotong University Peritoneal Dialysis Center. Nomograms for each outcome were computed from multivariate logistic regression models with the least absolute shrinkage and selection operator regression and univariate logistic regression for variable selection. The discriminative ability was estimated by Harrell’s C-index, and the accuracy was assessed graphically with a calibration curve plot. Models were validated internally using bootstrapping and externally by calculating their performance on a validation cohort. Decision curve analysis was used to assess the model’s clinical usefulness. Results: In all, a total of 487 patients were entered in the analysis, including 325 in the development cohort and 162 in the validation cohort. The final nomogram incorporated five variables: age, interleukin-6, hemoglobin, residual urine volume, and renal Kt/V. The C-index of the model was 0.733 (95% CI: 0.679–0.787), and the calibration curve was a straight line with a slope close to 1. Both internal and external validations confirmed the model’s good performance, with C-index of 0.725 (95% CI: 0.662–0.774) and 0.706 (95% CI: 0.623–0.789), respectively. Decision curve analysis showed that the nomogram had good clinical benefits. Conclusion: Our study proposes a nomogram model for CKD-aP risk assessment in ESRD patients with PD. This nomogram might help in clinical decision-making and evidence-based selection of therapy.
Mobile Health: Potenziale und Herausforderungen in der medizinischen Versorgung
Authors: Link Hartmut
Published: July 2024

Background: Mobile health (mhealth) is gaining interest, with mobile devices and apps being ever more available among medical facilities and patients. However, in the field of radiation oncology, the medical benefits of mhealth apps are still underexplored. As an additional approach to patient care during radiotherapy, we designed a mobile treatment surveillance app based on patient-reported outcomes. Objective: We aimed to examine the feasibility of app-based treatment surveillance in patients undergoing radiotherapy (RT). Alongside technical practicability and acceptance, we assessed patient satisfaction and quality of life during treatment. Methods: This prospective single-center study was performed at Heidelberg University Hospital between August 2018 and January 2020. During RT we measured patients' quality of life, symptoms, and treatment satisfaction. Respective questionnaires (EORTC QLQ-C30 with diagnosis-specific modules, RAND PSQ-18) were presented to patients via a mobile app running on a designated tablet device. The primary endpoint was determined by the fraction of patients who completed at least 80% of the items. Secondary endpoints were disease-related quality of life and patient satisfaction. Results: A total of 49 cancer patients (14 breast, 13 pelvic, 12 lung, 10 prostate) were eligible for analysis. 79.6% (95% confidence interval: 66.4-88.5%; n = 39) of all patients completed at least 80% of the items received by the mobile app. A mean of 227.5 ± 48.25 questions were answered per patient. Breast cancer patients showed the highest rate of answered questions, with 92.9% (n = 13) completing at least 80% of the items.