bluuebunny/crossref_metadata_2025 huggingface dataset:
Additively manufactured controlled porous orthopedic joint replacement designs to reduce bone stress shielding: a systematic review
Authors: Safavi Sarah , Yu Yihang , Robinson Dale L. , Gray Hans A. , Ackland David C. , Lee Peter V. S.
Published: January 2023

Background

Total joint replacements are an established treatment for patients suffering from reduced mobility and pain due to severe joint damage. Aseptic loosening due to stress shielding is currently one of the main reasons for revision surgery. As this phenomenon is related to a mismatch in mechanical properties between implant and bone, stiffness reduction of implants has been of major interest in new implant designs. Facilitated by modern additive manufacturing technologies, the introduction of porosity into implant materials has been shown to enable significant stiffness reduction; however, whether these devices mitigate stress-shielding associated complications or device failure remains poorly understood.

Methods

In this systematic review, a broad literature search was conducted in six databases (Scopus, Web of Science, Medline, Embase, Compendex, and Inspec) aiming to identify current design approaches to target stress shielding through controlled porous structures. The search keywords included ‘lattice,’ ‘implant,’ ‘additive manufacturing,’ and ‘stress shielding.’

Results

After the screening of 2530 articles, a total of 46 studies were included in this review. Studies focusing on hip, knee, and shoulder replacements were found. Three porous design strategies were identified, specifically uniform, graded, and optimized designs. The latter included personalized design approaches targeting stress shielding based on patient-specific data. All studies reported a reduction of stress shielding achieved by the presented design.

Conclusion

Not all studies used quantitative measures to describe the improvements, and the main stress shielding measures chosen varied between studies. However, due to the nature of the optimization approaches, optimized designs were found to be the most promising. Besides the stiffness reduction, other factors such as mechanical strength can be considered in the design on a patient-specific level. While it was found that controlled porous designs are overall promising to reduce stress shielding, further research and clinical evidence are needed to determine the most superior design approach for total joint replacement implants.
Analysis of surgical strategies and efficacy in the treatment of Os odontoideum with atlantoaxial dislocation
Authors: Yang Baohui , Lu Teng , He Xijing , Li Haopeng
Published: January 2023

Background

There are many classification systems for atlantoaxial dislocation (AAD). Among these systems, the definitions of irreducible AAD remain vague, and its treatments are not unified.

Objective

To explore the surgical strategies and efficacy for the treatment of os odontoideum (OO) with AAD.

Methods

The clinical data of 56 OO patients with AAD who underwent surgery from January 2017 to June 2021 were retrospectively analyzed. AAD was classified into four types, Type I and type II were treated with posterior fixation and fusion. Type III received posterior fixation and fusion after irreducible dislocations were converted to reducible dislocations by translateral mass release or transoral release. Type IV required transoral release for conversion into reducible dislocations before posterior fixation and fusion. The operation time, blood loss, and complications were recorded. The preoperative and postoperative neurological function changes were assessed using the Japanese Orthopedic Association (JOA) score. Postoperative fusion status was assessed by X-ray.

Results

There were 40 cases of type I-II, 14 cases of type III, and two cases of type IV AAD. The operation times of single posterior fixation and fusion, combined translateral mass release and combined transoral release were 130.52 ± 37.12 min, 151.11 ± 16.91 min and 188.57 ± 44.13 min, the blood loss were 162.63 ± 58.27 mL, 235.56 ± 59.94 mL, 414.29 ± 33.91 mL, respectively. One patient with type III died, one with type III underwent revision surgery due to infection, and three patients with type I had further neurological deterioration after operation. fifty-five patients were followed up for 12–24 months. The follow-up results showed that enough decompression was achieved and that fixation and fusion were effective. The JOA score increased from 9.58 ± 1.84 points preoperative to 13.09 ± 2.68 points at 3 months after operation, 14.07 ± 2.83 points at 6 months and 14.25 ± 2.34 at 12 months after operation, all significant differences compared with preoperative results (P < 0.05).

Conclusion

OO patients with irreducible AAD can be treated by translateral mass release or transoral release combined with posterior fixation and fusion, while some of those with bony fusion can be treated by transoral release combined with posterior fixation and fusion.
Quality of life improvements following one year of setmelanotide in children and adult patients with Bardet–Biedl syndrome: phase 3 trial results
Authors: Forsythe Elizabeth , Haws Robert M. , Argente Jesús , Beales Philip , Martos-Moreno Gabriel Á. , Dollfus Hélène , Chirila Costel , Gnanasakthy Ari , Buckley Brieana C. , Mallya Usha G. , Clément Karine , Haqq Andrea M.
Published: January 2023

Background

Bardet–Biedl syndrome is a rare genetic disease associated with hyperphagia and early-onset, severe obesity. There is limited evidence on how hyperphagia and obesity affect health-related quality of life in patients with Bardet–Biedl syndrome, and on how management of these symptoms may influence disease burden. This analysis evaluated changes in health-related quality of life in adults and children with Bardet–Biedl syndrome in a Phase 3 trial following 1 year of setmelanotide treatment (ClinicalTrials.gov identifier: NCT03746522).

Methods

Patients with Bardet–Biedl syndrome and obesity received 52 weeks of treatment with setmelanotide and completed various self-reported health-related quality of life measures. Patients aged < 18 years or their caregiver completed the Pediatric Quality of Life Inventory (PedsQL; meaningful improvement, 4.4-point change); adults aged ≥ 18 years completed the Impact of Weight on Quality of Life Questionnaire-Lite (IWQOL-Lite; meaningful improvement range, 7.7–12-point change). Descriptive outcomes were reported in patients with data both at active treatment baseline and after 52 weeks of treatment.

Results

Twenty patients (< 18 years, n = 9; ≥ 18 years, n = 11) reported health-related quality of life at baseline and 52 weeks. For children and adolescents, PedsQL score mean change from baseline after 52 weeks was + 11.2; all patients with PedsQL impairment at baseline (n = 4) experienced clinically meaningful improvement. In adults, IWQOL-Lite score mean change from baseline was + 12.0. Of adults with IWQOL-Lite impairment at baseline (n = 8), 62.5% experienced clinically meaningful improvement. In adults, IWQOL-Lite score was significantly correlated with changes in percent body weight (P = 0.0037) and body mass index (P = 0.0098).

Conclusions

After 1 year of setmelanotide, patients reported clinically meaningful improvements across multiple health-related quality of life measures. This study highlights the need to address the impaired health-related quality of life in Bardet–Biedl syndrome, and supports utility of setmelanotide for reducing this burden.

Trial Registration NCT03746522. Registered November 19, 2018, https://clinicaltrials.gov/ct2/show/NCT03746522.
Dynamic chromatin regulatory programs during embryogenesis of hexaploid wheat
Authors: Zhao Long , Yang Yiman , Chen Jinchao , Lin Xuelei , Zhang Hao , Wang Hao , Wang Hongzhe , Bie Xiaomin , Jiang Jiafu , Feng Xiaoqi , Fu Xiangdong , Zhang Xiansheng , Du Zhuo , Xiao Jun
Published: January 2023

Background

Plant and animal embryogenesis have conserved and distinct features. Cell fate transitions occur during embryogenesis in both plants and animals. The epigenomic processes regulating plant embryogenesis remain largely elusive.

Results

Here, we elucidate chromatin and transcriptomic dynamics during embryogenesis of the most cultivated crop, hexaploid wheat. Time-series analysis reveals stage-specific and proximal–distal distinct chromatin accessibility and dynamics concordant with transcriptome changes. Following fertilization, the remodeling kinetics of H3K4me3, H3K27ac, and H3K27me3 differ from that in mammals, highlighting considerable species-specific epigenomic dynamics during zygotic genome activation. Polycomb repressive complex 2 (PRC2)-mediated H3K27me3 deposition is important for embryo establishment. Later H3K27ac, H3K27me3, and chromatin accessibility undergo dramatic remodeling to establish a permissive chromatin environment facilitating the access of transcription factors tocis-elements for fate patterning. Embryonic maturation is characterized by increasing H3K27me3 and decreasing chromatin accessibility, which likely participates in restricting totipotency while preventing extensive organogenesis. Finally, epigenomic signatures are correlated with biased expression among homeolog triads and divergent expression after polyploidization, revealing an epigenomic contributor to subgenome diversification in an allohexaploid genome.

Conclusions

Collectively, we present an invaluable resource for comparative and mechanistic analysis of the epigenomic regulation of crop embryogenesis.
Profiles of autism characteristics in thirteen genetic syndromes: a machine learning approach
Authors: Bozhilova Natali , Welham Alice , Adams Dawn , Bissell Stacey , Bruining Hilgo , Crawford Hayley , Eden Kate , Nelson Lisa , Oliver Christopher , Powis Laurie , Richards Caroline , Waite Jane , Watson Peter , Rhys Hefin , Wilde Lucy , Woodcock Kate , Moss Joanna
Published: January 2023

Background

Phenotypic studies have identified distinct patterns of autistic characteristics in genetic syndromes associated with intellectual disability (ID), leading to diagnostic uncertainty and compromised access to autism-related support. Previous research has tended to include small samples and diverse measures, which limits the generalisability of findings. In this study, we generated detailed profiles of autistic characteristics in a large sample of > 1500 individuals with rare genetic syndromes.

Methods

Profiles of autistic characteristics based on the Social Communication Questionnaire (SCQ) scores were generated for thirteen genetic syndrome groups (Angelman n = 154, Cri du Chat n = 75, Cornelia de Lange n = 199, fragile X n = 297, Prader–Willi n = 278, Lowe n = 89, Smith–Magenis n = 54, Down n = 135, Sotos n = 40, Rubinstein–Taybi n = 102, 1p36 deletion n = 41, tuberous sclerosis complex n = 83 and Phelan–McDermid n = 35 syndromes). It was hypothesised that each syndrome group would evidence a degree of specificity in autistic characteristics. To test this hypothesis, a classification algorithm via support vector machine (SVM) learning was applied to scores from over 1500 individuals diagnosed with one of the thirteen genetic syndromes and autistic individuals who did not have a known genetic syndrome (ASD; n = 254). Self-help skills were included as an additional predictor.

Results

Genetic syndromes were associated with different but overlapping autism-related profiles, indicated by the substantial accuracy of the entire, multiclass SVM model (55% correctly classified individuals). Syndrome groups such as Angelman, fragile X, Prader–Willi, Rubinstein–Taybi and Cornelia de Lange showed greater phenotypic specificity than groups such as Cri du Chat, Lowe, Smith–Magenis, tuberous sclerosis complex, Sotos and Phelan-McDermid. The inclusion of the ASD reference group and self-help skills did not change the model accuracy.

Limitations

The key limitations of our study include a cross-sectional design, reliance on a screening tool which focuses primarily on social communication skills and imbalanced sample size across syndrome groups.

Conclusions

These findings replicate and extend previous work, demonstrating syndrome-specific profiles of autistic characteristics in people with genetic syndromes compared to autistic individuals without a genetic syndrome. This work calls for greater precision of assessment of autistic characteristics in individuals with genetic syndromes associated with ID.
Monkeypox epidemic at the door: should we remain idly by or prepare strongly?
Authors: Al-Kuraishy Hayder M. , Al-Gareeb Ali I. , Hetta Helal F. , Alexiou Athanasios , Papadakis Marios , Batiha Gaber El-Saber
Published: January 2023

Monkeypox (MPX) is a common zoonotic disease caused by a double-strand DNA MPX virus (MPXV). MPX was considered a sporadic rare disease causing a mild disease with a low capacity to spread among humans. The clinical picture of human MPX highly resembles smallpox, though early lymphadenopathy in human MPX is the distinguishing sign not present in smallpox. The incubation period is 1–3 weeks, and fever, headache, joint pain, myalgia, and nausea for about 3 days. Skin lesions that appear 1–3 days following fever and lymphadenopathy usually appear simultaneously on the face and periphery. By cross-reactivity and protection, the smallpox vaccine produced 85% protection against infection with Orthopoxviruses, including MPX. Antiviral drugs like tecovirimate and brincidofovir could be effective agents against the development of MPX. MPX epidemics are less reported and described as other life-threatening epidemics, leading to an unclear picture of this disease’s pathogenesis, epidemiology, and management. With the recent wide range of MPX outbreaks, immense research is mandatory to revise the importance of MPX pathogenesis and risk for epidemic development worldwide. Therefore, this critical study aimed to review MPX's pathogenesis, epidemiology, and management with possible repurposed drugs.
Dynamical inertial extragradient techniques for solving equilibrium and fixed-point problems in real Hilbert spaces
Authors: Panyanak Bancha , Khunpanuk Chainarong , Pholasa Nattawut , Pakkaranang Nuttapol
Published: January 2023

In this paper, we propose new methods for finding a common solution to pseudomonotone and Lipschitz-type equilibrium problems, as well as a fixed-point problem for demicontractive mapping in real Hilbert spaces. A novel hybrid technique is used to solve this problem. The method shown here is a hybrid of the extragradient method (a two-step proximal method) and a modified Mann-type iteration. Our methods use a simple step-size rule that is generated by specific computations at each iteration. A strong convergence theorem is established without knowing the operator’s Lipschitz constants. The numerical behaviors of the suggested algorithms are described and compared to previously known ones in many numerical experiments.
Feasibility and effects of cognitive–motor exergames on fall risk factors in typical and atypical Parkinson’s inpatients: a randomized controlled pilot study
Authors: Jäggi Salome , Wachter Annina , Adcock Manuela , de Bruin Eling D. , Möller Jens Carsten , Marks Detlef , Schweinfurther Raoul , Giannouli Eleftheria
Published: January 2023

Background

People with Parkinson`s disease (PD) often suffer from both motor and cognitive impairments. Simultaneous motor and cognitive training stimulates neurobiological processes which are important especially for people with PD. The aim of this study is to test the feasibility and effects of simultaneous cognitive–motor training in form of exergames in the setting of inpatient rehabilitation of persons with PD.

Methods

Forty participants (72.4 ± 9.54 years; Hoehn and Yahr stage 1–4) were randomly assigned to either the intervention group, which trained five times a week in addition to the conventional rehabilitation program, or the control group, which underwent the standard rehabilitation treatment only. Primary outcome was feasibility (measured by adherence rate, attrition rate, occurrence of adverse events, system usability scale (SUS), and NASA TLX score). In addition, various cognitive (Go/No-Go test, reaction time test (RTT), color word interference test (D-KEFS) and Trail Making Test A and B (TMT)) and motor (preferred gait speed, maximum gait speed, dual-task gait speed, Short Physical Performance Battery (SPPB), Timed Up and Go (TUG) and 5 times Sit-to-Stand (5xStS)) tests were conducted before and after the intervention phase in order to determine training effects

Results

Adherence rate was 97%, there were just two dropouts due to reasons unrelated to the study and there were no adverse events. The mean NASA TLX value was 56.2 and the mean value of the SUS was 76.7. Significant time–group interaction effects were observed for the 5xStS, the SPPB, the RTT, the Go/No-Go test and the D-KEFS 2.

Discussion

Exergaming, as applied in this study, showed to be feasible, safe and likely effective for the improvement of cognitive and motor functions of PD inpatients. Because of this future randomized controlled trials with a main focus on testing the efficacy of this new intervention are warranted.

Trial registration: The study has been registered at ClinicalTrials.gov (ID: NCT04872153).
The relationship between fatigue, sleep quality, resilience, and the risk of postpartum depression: an emphasis on maternal mental health
Authors: Baattaiah Baian A. , Alharbi Mutasim D. , Babteen Nouf M. , Al-Maqbool Haneen M. , Babgi Faten A. , Albatati Ashar A.
Published: January 2023

Background

Several factors can contribute to the development of postpartum depression (PPD) and negatively affect mothers’ mental and physical well-being. The objective of this study was to determine the relationship between fatigue, sleep quality, resilience, and the risk of PPD development.

Methods

A cross-sectional study was conducted using an online questionnaire distributed to mothers during their postpartum period. The risk of PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), postpartum fatigue (PPF) was assessed using the Fatigue Severity Scale (FSS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and resilience was assessed using the Brief Resilience Scale (BRS). The Pearson correlation coefficient was calculated to determine the relationship between the study variables. Simple and multiple linear regression analyses were performed to explain the contributions of PPF, sleep quality, and resilience as independent predictors of PPD development.

Results

A total of 1409 postpartum women were included in the analysis, with 75% of the participants reporting a risk of PPD, 61% reporting PPF, 97% reporting having sleep problems, and 36% being in the “low resilience level” category. In terms of correlations, the scores of FSS and the PSQI showed moderate positive relationships with the EPDS scores (r = 0.344 and r = 0.447, respectively,p = .000). The BRS scores were negatively associated with the EPDS scores (r = −0.530,p = 0.000). Fatigue, sleep quality, and resilience were predictors of depressive symptoms (β = 0.127, β = 0.262, and β = −0.393, respectively, R2 = 0.37,p = 0.000). The association remained significant in the regression model after adjusting for mother’s age, mother’s BMI, child’s age, smoking status, full-term pregnancy, having a chronic disease, and taking anti-depressant.

Conclusions

Mothers with higher levels of fatigue, poor sleep quality, and low resilience levels were at high risk of developing PPD. Healthcare providers should identify these factors and thus set better rehabilitation goals to improve overall maternal health.
Exploring the performance of magnetic methacrylic acid-functionalized β-cyclodextrin adsorbent toward selected phenolic compounds
Authors: Mamman S. , Yaacob S. F. F. S. , Raoov M. , Mehamod F. S. , Zain N. N. M. , Suah F. B. M.
Published: January 2023

In this study, the removal of bisphenol A (BPA), 2,4-dinitrophenol (2,4-DNP), and 2,4-dichlorophenol (2,4-DCP) using a new magnetic adsorbent methacrylic acid-functionalized β-cyclodextrin (Fe3O4@MAA-βCD) was evaluated. The materials were characterized by Fourier transform infrared spectroscopy, scanning electron microscope, transmission electron microscopy, and X-ray diffraction. The batch adsorption experiments optimized and evaluated various operational parameters such as pH, contact time, sorbent dosage, initial concentration, and temperature. The result shows that DNP possessed the most excellent affinity toward Fe3O4@MAA-βCD adsorbents compared to BPA and DCP. Also, BPA showed the lowest removal and was used as a model analyte for further study. The adsorption kinetic data revealed that the uptake of these compounds follows the pseudo-second order. Freundlich and Halsey isotherms best-fitted the adsorption equilibrium data. The desorption process was exothermic and spontaneous, and a lower temperature favored the adsorption. Furthermore, hydrogen bonding, inclusion complexion, and π–π interactions contributed to the selected phenolic compound’s adsorption.
A randomized controlled trial of a 14-day mindfulness ecological momentary intervention (MEMI) for generalized anxiety disorder
Authors: Zainal Nur Hani , Newman Michelle G.
Published: January 2023

Background

Little is known about whether brief mindfulness ecological momentary interventions (MEMIs) yield clinically beneficial effects. This gap exists despite the rapid growth of smartphone mindfulness applications. Specifically, no prior brief MEMI has targeted generalized anxiety disorder (GAD). Moreover, although theories propose that MEMIs can boost executive functioning (EF), they have largely gone untested. Thus, this randomized controlled trial (RCT) aimed to address these gaps by assessing the efficacy of a 14-day smartphone MEMI (versus self-monitoring placebo [SMP]).

Method

Participants with GAD were randomly assigned to either condition (68 MEMI and 42 SMP). MEMI participants exercised multiple core mindfulness strategies and were instructed to practice mindfulness continually. Comparatively, SMP participants were prompted to practice self-monitoring and were not taught any mindfulness strategies. All prompts occurred five times a day for 14 consecutive days. Participants completed self-reports and neuropsychological assessments at baseline, posttreatment, and 1-month follow-up (1MFU). Piecewise hierarchical linear modeling analyses were conducted.

Results

MEMI (versus SMP) produced greater pre-1MFU reductions in GAD severity and perseverative cognitions (between-group d = 0.393–0.394) and stronger improvements in trait mindfulness and performance-based inhibition (d = 0.280–0.303). Further, MEMI (versus SMP) led to more considerable pre- to posttreatment reduction in state-level depression and anxiety and more mindfulness gains (d = 0.50–1.13). Overall, between-treatment effects were stronger at pre-1MFU than pre- to posttreatment for trait-level than state-level treatment outcome measures.

Conclusions

Preliminary findings suggest that the beneficial effect of an unguided brief MEMI to target pathological worry, trait mindfulness, and EF is modest yet potentially meaningful. Other theoretical and clinical implications were discussed.
Amorphous alumina supercapacitors with voltage-charging performance
Authors: Fukuhara Mikio , Yokotsuka Tomonori , Hashida Toshiyuki , Yamaguchi Koji , Fujima Nobuhisa
Published: January 2023

The electric storage effect of fast charging by voltage application for amorphous alumina (cAAO) supercapacitors fabricated using a crystalline aluminum alloy was investigated in terms of charging/discharging behaviors and AC impedance. The mechanism for the electrical storage of a cAAO supercapacitor was proposed based on the coupling of electrons on Al atoms and positively charged holes in Al vacancies, using an electric double-layer model containing an electrolyte with an electrical resistivity of 6.3 × 105Ωcm. The supercapacitor demonstrated fast charging at a voltage application of up to 500 V.
Multi-terminal Josephson junctions: A road to topological flux networks
Authors: Peralta Gavensky Lucila , Usaj Gonzalo , Balseiro C. A.
Published: January 2023

Multi-terminal Josephson junctions were recently proposed as a versatile and tunable platform to emulate topological Bloch-like Hamiltonians in arbitrary dimensions. In this perspective article, we will give a brief overview of the subject and recognize these mesoscopic devices as realizations of topological flux networks as the ones envisioned by Avron and coworkers in their seminal works on the early days of the quantum Hall effect. We summarize the current state-of-the-art theoretical and experimental research regarding these Josephson devices, highlighting recent developments and giving an outlook on current trends.
Trends in Reimbursement and Approach Selection for Lumbar Arthrodesis
Authors: Pennington Zach , Michalopoulos Giorgos D. , Wahood Waseem , El Sammak Sally , Lakomkin Nikita , Bydon Mohamad
Published: January 2023

BACKGROUND:

Changes in reimbursement policies have been demonstrated to correlate with clinical practice.

OBJECTIVE:

To investigate trends in physician reimbursement for anterior, posterior, and combined anterior/posterior (AP) lumbar arthrodesis and relative utilization of AP.

METHODS:

We queried the American College of Surgeons National Surgical Quality Improvement Project registry for anterior, posterior, and AP lumbar arthrodeses during 2010 and 2020. Work relative value units per operative hour (wRVUs/h) were calculated for each procedure. Trends in reimbursement and utilization of the AP approach were assessed with linear regression. Subgroup analyses of age and underlying pathology of AP arthrodesis were also performed.

RESULTS:

During 2010 and 2020, AP arthrodesis was associated with significantly higher average wRVUs/h compared with anterior and posterior arthrodesis (AP = 17.4, anterior = 12.4, posterior = 14.5). The AP approach had a significant yearly increase in wRVUs/h (coefficient = 0.48, P = .042), contrary to anterior (coefficient = −0.01, P = .308) and posterior (coefficient = −0.13, P = .006) approaches. Utilization of AP approaches over all arthrodeses increased from 7.5% in 2010 to 15.3% in 2020 (yearly average increase 0.79%, P < .001). AP fusions increased significantly among both degenerative and deformity cases (coefficients 0.88 and 1.43, respectively). The mean age of patients undergoing AP arthrodesis increased by almost 10 years from 2010 to 2020. Rates of major 30-day complications were 2.7%, 3.1%, and 3.5% for AP, anterior, and posterior arthrodesis, respectively.

CONCLUSION:

AP lumbar arthrodesis was associated with higher and increasing reimbursement (wRVUs/h) during the period 2010 to 2020. Reimbursement for anterior arthrodesis was relatively stable, while reimbursement for posterior arthrodesis decreased. The utilization of the combined AP approach relative to the other approaches increased significantly during the period of interest.
Surgical Management of Peripheral Nerve Pathology in Patients With Neurofibromatosis Type 2
Authors: Peyre Matthieu , Tran Suzanne , Parfait Béatrice , Bernat Isabelle , Bielle Franck , Kalamarides Michel
Published: January 2023

BACKGROUND:

Neurofibromatosis type 2 (NF2) is rare genetic disorder mainly characterized by the development of central nervous system lesions, but peripheral nerve pathology may also cause high morbidity including pain, motor, and sensory loss.

OBJECTIVE:

To describe the tumor burden of patients with peripheral nerve pathology in NF2 including peripheral neuropathies and schwannomas and the results of surgery in the latter group.

METHODS:

We conducted a retrospective chart review of all patients with NF2 followed up at our NF2 Reference Center to include all patients suffering from peripheral nerve pathology. Tumor detection relied on focal MRIs based on symptoms.

RESULTS:

Thirty-four patients harboring 105 peripheral nerve schwannomas and 1 perineurioma were included. Schwannomas were mainly located in major nerves (n = 74, 71%) compared with subcutaneous (n = 23, 22%) and intramuscular (n = 8, 7%) cases. Most schwannomas (81/90-90%) were classical discrete tumors while multinodular cases represented only 9 cases (10%). During follow-up, 63 (60%) tumors were operated in 24 patients, including 39 schwannomas of major nerves. A complete resection was achieved in most of the cases (52/63, 83%) with a complete relief of preoperative pain in most patients (57/60, 95%). Persistent motor deficits (5/39, 13%) were mostly encountered in patients operated from multinodular schwannomas (4/5, 80%). Six patients had an associated peripheral neuropathy with 5 cases of pseudo-Charcot-Marie-Tooth–associated amyotrophy.

CONCLUSION:

Surgery remains a safe and effective method of treating peripheral nerve schwannoma-associated pain in NF2, with the exception of rare multinodular tumors. Special attention should be drawn to patients harboring severely debilitating neuropathies and perineuriomas.
Surgical Decompression of Traumatic Cervical Spinal Cord Injury: A Pilot Study Comparing Real-Time Intraoperative Ultrasound After Laminectomy With Postoperative MRI and CT Myelography
Authors: Chryssikos Timothy , Stokum Jesse A. , Ahmed Abdul-Kareem , Chen Chixiang , Wessell Aaron , Cannarsa Gregory , Caffes Nicholas , Oliver Jeffrey , Olexa Joshua , Shea Phelan , Labib Mohamed , Woodworth Graeme , Ksendzovsky Alexander , Bodanapally Uttam , Crandall Kenneth , Sansur Charles , Schwartzbauer Gary , Aarabi Bizhan
Published: January 2023

BACKGROUND:

Decompression of the injured spinal cord confers neuroprotection. Compared with timing of surgery, verification of surgical decompression is understudied.

OBJECTIVE:

To compare the judgment of cervical spinal cord decompression using real-time intraoperative ultrasound (IOUS) following laminectomy with postoperative MRI and CT myelography.

METHODS:

Fifty-one patients were retrospectively reviewed. Completeness of decompression was evaluated by real-time IOUS and compared with postoperative MRI (47 cases) and CT myelography (4 cases).

RESULTS:

Five cases (9.8%) underwent additional laminectomy after initial IOUS evaluation to yield a final judgment of adequate decompression using IOUS in all 51 cases (100%). Postoperative MRI/CT myelography showed adequate decompression in 43 cases (84.31%). Six cases had insufficient bony decompression, of which 3 (50%) had cerebrospinal fluid effacement at >1 level. Two cases had severe circumferential intradural swelling despite adequate bony decompression. Between groups with and without adequate decompression on postoperative MRI/CT myelography, there were significant differences for American Spinal Injury Association motor score, American Spinal Injury Association Impairment Scale grade, AO Spine injury morphology, and intramedullary lesion length (IMLL). Multivariate analysis using stepwise variable selection and logistic regression showed that preoperative IMLL was the most significant predictor of inadequate decompression on postoperative imaging (P = .024).

CONCLUSION:

Patients with severe clinical injury and large IMLL were more likely to have inadequate decompression on postoperative MRI/CT myelography. IOUS can serve as a supplement to postoperative MRI/CT myelography for the assessment of spinal cord decompression. However, further investigation, additional surgeon experience, and anticipation of prolonged swelling after surgery are required.
Invention of an Online Interactive Virtual Neurosurgery Simulator With Audiovisual Capture for Tactile Feedback
Authors: Kiyofuji Satoshi , Kin Taichi , Saito Toki , Koike Tsukasa , Takeda Yasuhiro , Uchida Tatsuya , Sato Katsuya , Shono Naoyuki , Niwa Ryoko , Furuta Yasuyuki , Saito Nobuhito
Published: January 2023

BACKGROUND:

Present neurosurgical simulators are not portable.

OBJECTIVE:

To maximize portability of a virtual surgical simulator by providing online learning and to validate a unique psychometric method (“audiovisual capture”) to provide tactile information without force feedback probes.

METHODS:

An online interactive neurosurgical simulator of a posterior petrosectomy was developed. The difference in the hardness of compact vs cancellous bone was presented with audiovisual effects as inclinations of the drilling speed and sound based on engineering perspectives. Three training methods (the developed simulator, lectures and review of slides, and dissection of a 3-dimensional printed temporal bone model [D3DPM]) were evaluated by 10 neurosurgical residents. They all first attended a lecture and were randomly allocated to 2 groups by the training D3DPM (A: simulator; B: review of slides, no simulator). In D3DPM, objective measures (required time, quality of completion, injury scores of important structures, and the number of instructions provided) were compared between groups. Finally, the residents answered questionnaires.

RESULTS:

The objective measures were not significantly different between groups despite a younger tendency in group A (graduate year −2.4 years, 95% confidence interval −5.3 to 0.5, P = .081). The mean perceived hardness of cancellous bone on the simulator was 70% of that of compact bone, matching the intended profile. The simulator was superior to lectures and review of slides in feedback and repeated practices and to D3DPM in adaptability to multiple learning environments.

CONCLUSION:

A novel online interactive neurosurgical simulator was developed, and satisfactory validity was shown. Audiovisual capture successfully transmitted the tactile information.
Safety, Feasibility, and Efficacy of Additional Extraventricular Anterior Commissurotomy With Corpus Callosotomy
Authors: Kosugi Kenzo , Yoshitomi Munetake , Takayama Yutaro , Iijima Keiya , Kimura Yuiko , Kaneko Yuu , Toda Masahiro , Iwasaki Masaki
Published: January 2023

BACKGROUND:

Corpus callosotomy (CC) is a palliative neurosurgical procedure for patients with intractable epilepsy and without resectable focal epileptogenic lesions. Anterior commissurotomy (AC) has been historically performed with CC. However, the efficacy and safety of adding AC to CC remain unknown.

OBJECTIVE:

To describe the surgical technique of extraventricular AC and retrospectively investigate its clinical efficacy and safety by assessing patients who underwent CC with and without AC.

METHODS:

AC has been added to CC at our institution since 2018. Fifty-five consecutive patients who received total callosotomy from 2016 to 2020 were included and categorized into 2 groups: 26 patients with additional AC and 29 patients without additional AC. Seizure outcome 1 year after surgery were compared between groups for assessing the efficacy of adding AC. The perioperative factors were compared for assessing the safety and feasibility.

RESULTS:

Seizure reduction rate (50% and 60%; P = .60) and disappearance of drop attacks (42% and 58%; P = .25) were not significantly different between CC and CC + AC groups. No statistical group differences were found in intraoperative estimated blood loss, number of days to first oral intake, duration of postoperative intravenous hydration, and length of hospital stay.

CONCLUSION:

Disconnection of the anterior commissure is a feasible and relatively safe procedure. This study failed to show the significant efficacy of adding AC to CC. However, further investigation is needed to prove its efficacy in ameliorating epilepsy.
Splashed E-box and AP-1 motifs cooperatively drive regeneration response and shape regeneration abilities
Authors: Tamaki Teruhisa , Yoshida Takafumi , Shibata Eri , Nishihara Hidenori , Ochi Haruki , Kawakami Atsushi
Published: January 2023

Injury triggers a genetic program that induces gene expression for regeneration. Recent studies have identified regeneration-response enhancers (RREs); however, it remains unclear whether a common mechanism operates in these RREs. We identified three RREs from the zebrafish fn1b promoter by searching for conserved sequences within the surrounding genomic regions of regeneration-induced genes and performed a transgenic assay for regeneration response. Two regions contained in the transposons displayed RRE activity when combined with the −0.7 kb fn1b promoter. Another non-transposon element functioned as a stand-alone enhancer in combination with a minimum promoter. By searching for transcription factor-binding motifs and validation by transgenic assays, we revealed that the cooperation of E-box and activator protein 1 motifs is necessary and sufficient for regenerative response. Such RREs respond to variety of tissue injuries, including those in the zebrafish heart and Xenopus limb buds. Our findings suggest that the fidelity of regeneration response is ensured by the two signals evoked by tissue injuries. It is speculated that a large pool of potential enhancers in the genome has helped shape the regenerative capacities during evolution.
Hox genes in development and beyond
Authors: Hubert Katharine A. , Wellik Deneen M.
Published: January 2023

Hox genes encode evolutionarily conserved transcription factors that are essential for the proper development of bilaterian organisms. Hox genes are unique because they are spatially and temporally regulated during development in a manner that is dictated by their tightly linked genomic organization. Although their genetic function during embryonic development has been interrogated, less is known about how these transcription factors regulate downstream genes to direct morphogenetic events. Moreover, the continued expression and function of Hox genes at postnatal and adult stages highlights crucial roles for these genes throughout the life of an organism. Here, we provide an overview of Hox genes, highlighting their evolutionary history, their unique genomic organization and how this impacts the regulation of their expression, what is known about their protein structure, and their deployment in development and beyond.
Transitions in development – an interview with Samira Musah
Authors: Eve Alex
Published: January 2023

Samira Musah is an Assistant Professor in the Departments of Biomedical Engineering and Medicine at Duke University, USA. Samira's research focuses on leveraging pluripotent stem cells, bioengineering and organ-on-a-chip technologies to understand more about human kidney development, disease and therapy. We met with Samira over Microsoft Teams to hear more about her path to independence, mentors and her love of yoga.
Cytochrome c1-like is required for mitochondrial morphogenesis and individualization during spermatogenesis in Drosophila melanogaster
Authors: Chen Meng-Yan , Duan Xin , Wang Qian , Ran Mao-Jiu , Ai Hui , Zheng Ya , Wang Yu-Feng
Published: January 2023

The Drosophila testis is an excellent system for studying the process from germ stem cells to motile sperm, including the proliferation of male germ cells, meiosis of primary spermatocytes, mitochondrial morphogenesis, and spermatid individualization. We previously demonstrated that ocnus (ocn) plays an essential role in male germ cell development. Among those genes and proteins whose expression levels were changed as a result of ocn knockdown, cytochrome c1-like (cyt-c1L) was downregulated significantly. Here, we show that cyt-c1L is highly expressed in the testis of D. melanogaster. Knockdown or mutation of cyt-c1L in early germ cells of flies resulted in male sterility. Immunofluorescence staining showed that cyt-c1L knockdown testes had no defects in early spermatogenesis; however, in late stages, in contrast to many individualization complexes (ICs) composed of F-actin cones that appeared at different positions in control testes, no actin cones or ICs were observed in cyt-c1L knockdown testes. Furthermore, no mature sperm were found in the seminal vesicle of cyt-c1L knockdown testes whereas the control seminal vesicle was full of mature sperm with needle-like nuclei. cyt-c1L knockdown also caused abnormal mitochondrial morphogenesis during spermatid elongation. Excessive apoptotic signals accumulated in the base of cyt-c1L knockdown fly testes. These results suggest that cyt-c1L may play an important role in spermatogenesis by affecting the mitochondrial morphogenesis and individualization of sperm in D. melanogaster.
Μορφές τέχνης σε δημόσιους χώρους (public spaces) γύρω από τις Πρέσπες
Authors: Βουδούρη Ασπασία
Published: January 2023

Αντικείμενο της έρευνας αποτελεί η μελέτη της εικονογραφίας του τοπίου των λιμνών των Πρεσπών, ως ενός παράγοντα που οδηγεί σε εικαστικές αφορμές από την εποχή της Pop Art μέχρι τη σύγχρονη εποχή της ψηφιακής εικόνας. Το ερευνητικό ερώτημα αφορά στη διερεύνηση της επίδρασης του τοπίου των λιμνών των Πρεσπών στην ανάπτυξη μορφών τέχνης. Ειδικότερα, η Δ.Δ. επικεντρώνεται, με αφορμή την παρατήρηση, στην καταγραφή και ερμηνεία του φυσικού γεωγραφικού χώρου του τριεθνούς σημείου των Βαλκανίων, τις λίμνες των Πρεσπών, ως αισθητικού ερεθίσματος αποτύπωσης ενός αφηγηματικού «κάδρου» οπτικής επικοινωνίας. Επιδιώκει την εισαγωγή μιας καινοτόμου μεθόδου επικοινωνίας μέσω της τέχνης, λαμβάνοντας ως πεδίο μελέτης και εφαρμογής τους παραλίμνιους οικισμούς της Μεγάλης Πρέσπας. Η λειτουργία του φυσικού τοπίου μπορεί να ενεργοποιήσει πρακτικές, δράσεις και συμμετοχικά έργα τέχνης που σχηματοποιούν ένα ιδιαίτερο τοπομορφικό εικαστικό, αλλά και ευρύτερο, διάλογο μεταξύ των χωρών Ελλάδας, Αλβανίας και Βόρειας Μακεδονίας. Διαμεσολαβητής του διαλόγου αυτού είναι η περίπτωση της Περιπατητικής Τέχνης (Walking Art), που δίνει τη δυνατότητα στους δημιουργούς να διευρύνουν τις αισθητικές τους εμπειρίες. Η αξιολόγηση των στοιχείων της έρευνας δημιουργεί την ανάγκη σχεδιασμού μιας ενιαίας οπτικής ταυτότητας στο τριεθνές γεωγραφικό σημείο γύρω από τις Πρέσπες. Η Δ.Δ. υποστηρίζει τη μετάβαση σε μια νέα εποχή κατά την οποία η Περιπατητική Τέχνη θα αποτελέσει ένα συνεκτικό μέσο ενίσχυσης των δεσμών των κοινωνικών ομάδων αυτού του τόπου επιτρέποντας και υποβοηθώντας την εναργέστερη συμβίωσή τους.
Στατιστική μελέτη των νοσοκομειακών δεικτών ως εργαλεία για τη σύνταξη των ετήσιων οικονομικών προϋπολογισμών τους
Authors: Ζαζά Παρασκευή
Published: January 2023

Η χρηματοδότηση των δημόσιων νοσοκομείων είναι ένα ζήτημα που έχει απασχολήσει έντονα τα συστήματα υγείας τις τελευταίες δεκαετίες. Τα δημόσια νοσοκομεία ανήκουν στους μη κερδοσκοπικούς οργανισμούς και ως τέτοιοι, χρηματοδοτούνται πλήρως από τις κυβερνήσεις, παρέχοντας στις περισσότερες χώρες δωρεάν ιατρική περίθαλψη στους ασθενείς, καλύπτοντας τα έξοδα και τους μισθούς από την κρατική αποζημίωση. Αρκετές μελέτες σε διάφορες χώρες έχουν επιχειρήσει να διερευνήσουν τον πιθανό ρόλο και τη συμβολή των νοσοκομειακών και κλινικών δεδομένων στις συνολικές οικονομικές απαιτήσεις τους προκειμένου να διασφαλίζονται πιο δίκαιες κατανομές των οικονομικών πόρων που είναι προορισμένοι για την υγεία. Τα τελευταία χρόνια έχουν υιοθετηθεί διάφορα μοντέλα χρηματοδότησης ανά τον κόσμο. Τα πιο χρησιμοποιούμενα από αυτά είναι τα ημερήσια νοσήλια, οι σφαιρικοί προϋπολογισμοί και η χρηματοδότηση βάσει δραστηριότητας. Οι τρόποι υιοθέτησης κάθε ενός από αυτά τα μοντέλα ξεχωριστά ή σε συνδυασμό ποικίλει από χώρα σε χώρα ενώ πολλές είναι οι προκλήσεις που αντιμετωπίζονται στη πορεία, εντοπίζοντας αδυναμίες και πλεονεκτήματα. Αυτό που επιχειρήθηκε στην παρούσα μελέτη είναι να βρεθεί ένας εναλλακτικός τρόπος εκτίμησης των αναγκαίων χρηματοδοτήσεων για τα δημόσια νοσοκομεία, στο πλαίσιο των σφαιρικών προϋπολογισμών, ανεξάρτητα από το μείγμα περιστατικών που διαχειρίζεται το καθένα από αυτά, με βάση τα χαρακτηριστικά τους (μέγεθος, ειδικότητα, τοποθεσία, μονάδες εντατικής θεραπείας, αριθμός εργαζομένων κ.λπ.) και την ετήσια παραγωγή τους (ασθενείς, ημέρες νοσηλείας, αριθμός χειρουργικών επεμβάσεων, εργαστηριακές εξετάσεις κ.λπ.) Χρησιμοποιήθηκαν οικονομικά και λειτουργικά δεδομένα από 121 δημόσια νοσοκομεία της Ελλάδας για μια περίοδο 2 ετών (2018-2019) και αξιολογήθηκε με ανάλυση παλινδρόμησης η συμβολή των περιγραφικών και λειτουργικών δεδομένων στο συνολικό λειτουργικό κόστος. Δεδομένου ότι υπήρχαν διαθέσιμες επαναλαμβανόμενες μετρήσεις από τα ίδια νοσοκομεία κατά τη διάρκεια των ετών, χρησιμοποιήθηκαν μέθοδοι κατάλληλες για διαχρονική ανάλυση δεδομένων και αναπτύχθηκαν τρία μοντέλα πρόβλεψης. Ένα μοντέλο για τον υπολογισμό του ετήσιου λειτουργικού κόστους των κύριων νοσοκομειακών δαπανών, ένα μοντέλο για την πρόβλεψη των ενεργειακών δαπανών και ένα για την πρόβλεψη του κόστους διαχείρισης και των παραγόμενων ποσοτήτων μολυσματικών αποβλήτων των νοσοκομείων. Και τα τρία μοντέλα είχαν συντελεστές προσδιορισμού R² ≈ 0,95, 0,87 και 0,85 αντίστοιχα. Τα συγκεκριμένα έτη επιλέχθηκαν επειδή ήταν έτη με κανονικές συνθήκες λειτουργίας, σε αντίθεση με εκείνα του 2020 και 2021 κατά τα οποία η λειτουργία των νοσοκομείων σε όλο τον κόσμο επηρεάστηκε σημαντικά λόγω της πανδημίας του COVID-19. Στο πλαίσιο αυτής επιχειρήθηκε η αναζήτηση τυχόν συσχετίσεων πληθυσμιακών δεδομένων, οικονομικών δεδομένων και υγειονομικών - νοσοκομειακών δεδομένων με τα επίπεδα θνησιμότητας σε 37 χώρες μέλη του Οργανισμού Οικονομικής Συνεργασίας και Ανάπτυξης, τα αποτελέσματα της οποίας παρουσιάζονται στο παράρτημα αυτής της διατριβής.
Genetic evolution and cellular interactions within the tumour microenvironment determine glioblastoma progression
Authors: Shard Chloe , Alexander Kimberley L. , Gan Hui K. , Gomez Guillermo A.
Published: January 2023

Glioblastoma (GBM) is the most aggressive form of primary brain cancer, with 5-year survival rates of less than 5%. Clinical management of GBM has not changed in the last 15 years, and current treatment approaches combine surgical resection, followed by radiotherapy and chemotherapy. Tragically, tumour recurrence is inevitable. Still, very little is known about how tumours evolve in response to therapy and become treatment resistant. In 2019, The Glioma Longitudinal AnalySiS (GLASS) consortium curated extensive, publicly accessible genomic profiling data captured from matched primary and recurrent tumours across 222 patients, along with comprehensive clinical annotations. Recently, this longitudinal genomic data resource was expanded by integrating matching transcriptomic and genomic data from 304 adult patients with isocitrate dehydrogenase (IDH)-wild-type and IDH-mutant glioma captured at two or more time points (Varn et al., 2022). This has enabled new insights into the dynamic changes in transcriptional programs, cellular compositions and microenvironment interactions within these brain tumours. In this commentary, we will focus on recurrent high-grade IDHwt and the implications of these findings for targeting tumour-microenvironment interactions that may pave new pathways for developing therapies for this type of brain tumour.
A SET OF MEASURES FOR FIRE PROTECTION OF BREATHING VALVES OF ABOVEGROUND TANKS IN TANK FARMS
Authors: Ivanov Andrey
Published: January 2023

The article discusses the shortcomings in providing fire protection for the breathing fittings of ground tanks at oil and oil products storage and pro-cessing facilities. A set of measures for their protection is proposed, the im-plementation of which will reduce the economic and environmental conse-quences of a fire at such facilities.