bluuebunny/crossref_metadata_2025 huggingface dataset:
MnFe2O4-NH2-HKUST-1, MOF magnetic composite, as a novel sorbent for efficient dye removal: fabrication, characterization and isotherm studies
Authors: Mohammadnejad Masoumeh , Alizadeh Sedigheh
Published: April 2024

Dye in industrial wastewater is one of the most serious environmental concerns due to its potentially harmful effects on human health. Many industrial dyes are carcinogenic, toxic and teratogenic. Removal and recovery of hazardous dyes from the effluents requires efficient adsorbents. In this study, magnetic adsorbent MnFe2O4-NH2-HKUST-1 was synthesized to remove methylene blue and crystal violet dyes from aqueous solutions. The synthesized adsorbent was characterized using FTIR, XRD, BET, VSM, SEM, TGA and Zeta potential techniques. The effect of different parameters such as pH, contact time, and adsorbent dosage on the removal of dyes was investigated. The dye adsorption process was investigated by UV–Vis spectrophotometry. The maximum adsorbent capacity was obtained as 149.25 mg/g for methylene blue and 135.13 mg/g for crystal violet. The adsorption equilibrium isotherm and kinetic models were plotted and results showed that the adsorption process for both dyes is a collection of physical and chemical adsorption based on langmuir and freundlich isotherm models, and follows the pseudo-second-order adsorption kinetics. This study shows that magnetic adsorbent MnFe2O4-NH2-HKUST-1 has a good potential for removal of methylene blue and crystal violet dyes from water in a short time (5 min) and it is easily separated from the solution by a magnetic field due to its magnetic property.
Eye movement function captured via an electronic tablet informs on cognition and disease severity in Parkinson’s disease
Authors: Koch Nils A. , Voss Patrice , Cisneros-Franco J. Miguel , Drouin-Picaro Alexandre , Tounkara Fama , Ducharme Simon , Guitton Daniel , de Villers-Sidani Étienne
Published: April 2024

Studying the oculomotor system provides a unique window to assess brain health and function in various clinical populations. Although the use of detailed oculomotor parameters in clinical research has been limited due to the scalability of the required equipment, the development of novel tablet-based technologies has created opportunities for fast, easy, cost-effective, and reliable eye tracking. Oculomotor measures captured via a mobile tablet-based technology have previously been shown to reliably discriminate between Parkinson’s Disease (PD) patients and healthy controls. Here we further investigate the use of oculomotor measures from tablet-based eye-tracking to inform on various cognitive abilities and disease severity in PD patients. When combined using partial least square regression, the extracted oculomotor parameters can explain up to 71% of the variance in cognitive test scores (e.g. Trail Making Test). Moreover, using a receiver operating characteristics (ROC) analysis we show that eye-tracking parameters can be used in a support vector classifier to discriminate between individuals with mild PD from those with moderate PD (based on UPDRS cut-off scores) with an accuracy of 90%. Taken together, our findings highlight the potential usefulness of mobile tablet-based technology to rapidly scale eye-tracking use and usefulness in both research and clinical settings by informing on disease stage and cognitive outcomes.
Number of positive lymph nodes affects oncologic outcomes in cN0 mucoepidermoid carcinoma of the major salivary gland
Authors: Chang Le , Wang Yingnan , Wang Zhen , Xiao Di , Song Qi
Published: April 2024

The survival significance of the number of positive lymph nodes in salivary gland carcinoma remains unclear. Thus, the current study aimed to determine the effect of the number of positive lymph nodes on disease-specific survival (DSS) and overall survival (OS) in cN0 mucoepidermoid carcinoma (MEC) of the major salivary gland. Patients surgically treated for MEC of the major salivary gland between 1975 and 2019 were retrospectively enrolled from the surveillance, epidemiology, and end results database. The total population was randomly divided into training and test groups (1:1). Primary outcome variables were DSS and OS. Prognostic models were constructed based on the independent prognostic factors determined using univariate and multivariate Cox analyses in the training group and were validated in the test group using C-index. A total of 3317 patients (1624 men and 1693 women) with a mean age of 55 ± 20 years were included. The number of positive lymph nodes was an independent prognostic factor for both DSS and OS, but the effect began when at least two positive lymph nodes for DSS and three positive lymph nodes for OS were found. Predictive models for DSS and OS in the training group had C-indexes of 0.873 (95% confidence interval [CI] 0.853–0.893) and 0.835 (95% CI 0.817–0.853), respectively. The validation of the test group showed C-indexes of 0.877 (95% CI 0.851–0.902) for DSS and 0.820 (95% CI 0.798–0.842) for OS. The number of positive lymph nodes was statistically associated with survival in cN0 major salivary gland MEC. The current prognostic model could provide individualized follow-up strategies for patients with high reliability.
Scaling theory of fractal complex networks
Authors: Fronczak Agata , Fronczak Piotr , Samsel Mateusz J. , Makulski Kordian , Łepek Michał , Mrowinski Maciej J.
Published: April 2024

We show that fractality in complex networks arises from the geometric self-similarity of their built-in hierarchical community-like structure, which is mathematically described by the scale-invariant equation for the masses of the boxes with which we cover the network when determining its box dimension. This approach—grounded in both scaling theory of phase transitions and renormalization group theory—leads to the consistent scaling theory of fractal complex networks, which complements the collection of scaling exponents with several new ones and reveals various relationships between them. We propose the introduction of two classes of exponents: microscopic and macroscopic, characterizing the local structure of fractal complex networks and their global properties, respectively. Interestingly, exponents from both classes are related to each other and only a few of them (three out of seven) are independent, thus bridging the local self-similarity and global scale-invariance in fractal networks. We successfully verify our findings in real networks situated in various fields (information—the World Wide Web, biological—the human brain, and social—scientific collaboration networks) and in several fractal network models.
Post-stroke arrhythmia could be a potential predictor for post-stroke depression
Authors: Xu Tao , Dong Fangying , Zhang Muhua , Wang Kewu , Xu Tian , Xia Shudong , Feng Chao
Published: April 2024

Post-stroke depression (PSD) is regarded as the consequence of multiple contributors involving the process of cognition, mood and autonomic system, with the specific mechanism unclear yet. As a common type of stroke-heart syndromes, post-stroke arrhythmia shared some common pathogenesis with PSD. We presumed that post-stroke arrhythmia might be an early distinguishable marker for the presence of PSD and aimed to verity their association in this study. Patients with first-ever ischemic stroke were enrolled. The presence of post-stroke ectopic arrhythmia and the symptoms of arrhythmia were recorded with anti-arrhythmia drugs prescribed when necessary. Patients were followed up 3 months later to identify their presence and severity of PSD using Hamilton Depression Scale (HAMD) and also presence and severity of arrhythmia. Characteristics including the prevalence of various types of arrhythmias were compared between PSD and non-PSD groups. The HAMD scores were compared between patients with and without arrhythmia in PSD group. Logistic regression was used to identify the independent predictor of PSD. Patients with PSD had higher prevalence of post-stroke arrhythmia especially newly-detected arrhythmia, symptomatic arrhythmia and poor-controlled arrhythmia. In PSD group, patients of post-stroke arrhythmia had higher scores of HAMD than those without arrhythmia. Presence of newly-detected, symptomatic and poor-controlled arrhythmias were independent predictor of PSD. post-stroke arrhythmia especially newly-detected arrhythmia and symptomatic arrhythmia could be an early predictor of PSD. Successful control of arrhythmia was associated with reduced prevalence and severity of PSD.
One-year visual and anatomical outcomes of intravitreal faricimab injection for neovascular age-related macular degeneration after prior brolucizumab treatment
Authors: Takahashi Hironori , Inoda Satoru , Takahashi Hidenori , Takahashi Ryota , Hashimoto Yuto , Yoshida Hana , Kawashima Hidetoshi , Yanagi Yasuo
Published: April 2024

This single-center retrospective cohort study analyzed the 1-year real-world treatment outcomes of 63 consecutive eyes (of 60 patients) with neovascular age-related macular degeneration (nAMD) that were switched from intravitreal brolucizumab (IVBr) to intravitreal faricimab (IVF) and managed on a treat-and-extend regimen with discontinuation criteria. After the switch, patients opted to continue IVF, to switch back to IVBr, or receive photodynamic therapy (PDT). Thirty-eight patients continued IVF, 16 patients were switched back to IVBr, 2 patients received PDT, and 4 patients paused treatment. Best-corrected visual acuity (BCVA), central subfield thickness (CST), subfoveal choroidal thickness (sf-CT), and injection intervals were compared immediately before and 1 year after the initial IVF. Whereas there was no change in BCVA and CST; 0 [− 0.0969 to 0.125, P = 0.58], − 1.5 [− 27.8 to 13.5, P = 0.11] µm, respectively, sf-CT decreased significantly; − 19.5 [− 45.5 to 7.75, P = 0.015] µm. The patients switched back showed no significant change in sf-CT. The injection interval extended significantly in the IVF continuation and the switch-back group (2.0 and 3.0 weeks, respectively; [P = 0.0007 and 0.0078]) in eyes with a pre-switching interval of less than 12 weeks. Faricimab shows promise as a safe and effective alternative to brolucizumab for treating nAMD.
Enhanced potent immunosuppression of intracellular adipose tissue-derived stem cell extract by priming with three-dimensional spheroid formation
Authors: Kamprom Witchayapon , Tangporncharoen Rattanawan , Vongthaiwan Nuttapoom , Tragoonlugkana Patcharapa , Phetfong Jitrada , Pruksapong Chatchai , Supokawej Aungkura
Published: April 2024

Immunomodulatory properties of mesenchymal stem cells are widely studied, supporting the use of MSCs as cell-based therapy in immunological diseases. This study aims to generate cell-free MSC extract and improves their immunomodulatory potential. Intracellular extracts were prepared from adipose-derived stem cells (ADSC) spheroid via a freeze-thawing method. The immunomodulatory capacities of ADSC spheroid extracts were investigated in vitro, including lymphocyte proliferation, T regulatory cell expansion, and macrophage assays. A comparative study was conducted with ADSC monolayer extract. The key immunomodulatory mediators presented in ADSC extract were identified. The results revealed that ADSC spheroid extract could suppress lymphocyte activation while enhancing T regulatory cell expansion. Immunomodulatory molecules such as COX-2, TSG-6, and TGF-β1 were upregulated in ADSC priming via spheroid culture. Selective inhibition of COX-2 abrogates the effect of ADSC extract on inducing T regulatory cell expansion. Thus, ADSC spheroid extract gains high efficacy in regulating the immune responses which are associated in part by COX-2 generation. Furthermore, ADSC spheroid extract possessed a potent anti-inflammation by manipulation of TNF-α production from LPS-activated macrophage. Our current study has highlighted the opportunity of using cell-free extracts from adipose tissue-derived mesenchymal stem cells spheroid as novel immunomodulators for the treatment of immunological-associated diseases.
Employing supervised machine learning algorithms for classification and prediction of anemia among youth girls in Ethiopia
Authors: Zemariam Alemu Birara , Yimer Ali , Abebe Gebremeskel Kibret , Wondie Wubet Tazeb , Abate Biruk Beletew , Alamaw Addis Wondmagegn , Yilak Gizachew , Melaku Tesfaye Masreshaw , Ngusie Habtamu Setegn
Published: April 2024

In developing countries, one-quarter of young women have suffered from anemia. However, the available studies in Ethiopia have been usually used the traditional stastical methods. Therefore, this study aimed to employ multiple machine learning algorithms to identify the most effective model for the prediction of anemia among youth girls in Ethiopia. A total of 5642 weighted samples of young girls from the 2016 Ethiopian Demographic and Health Survey dataset were utilized. The data underwent preprocessing, with 80% of the observations used for training the model and 20% for testing. Eight machine learning algorithms were employed to build and compare models. The model performance was assessed using evaluation metrics in Python software. Various data balancing techniques were applied, and the Boruta algorithm was used to select the most relevant features. Besides, association rule mining was conducted using the Apriori algorithm in R software. The random forest classifier with an AUC value of 82% outperformed in predicting anemia among all the tested classifiers. Region, poor wealth index, no formal education, unimproved toilet facility, rural residence, not used contraceptive method, religion, age, no media exposure, occupation, and having more than 5 family size were the top attributes to predict anemia. Association rule mining was identified the top seven best rules that most frequently associated with anemia. The random forest classifier is the best for predicting anemia. Therefore, making it potentially valuable as decision-support tools for the relevant stakeholders and giving emphasis for the identified predictors could be an important intervention to halt anemia among youth girls.
Effectiveness of carbon dioxide emission target is linked to country ambition and education level
Authors: Zheng Yuheng , Shan Rui , Xu Wangtu , Qiu Yueming
Published: April 2024

In response to the Paris Agreement, a growing number of countries, 123 in total, have committed to carbon reduction targets. While existing research has assessed various policies’ effectiveness in achieving these targets, the potential of the act of goal-setting itself as a policy instrument has been underexplored. Here we leveraged a comprehensive panel dataset spanning 163 countries from 2011 to 2022 and employed a rigorous difference-in-difference model. Empirical findings reveal that both proposing carbon reduction targets and setting higher targets effectively reduce emissions intensity. The mechanism driving the impact of carbon reduction targets on CO2 emissions centers on the level of education, rather than renewable energy capacity, requiring further investigation to the mechanism. Subsequent analysis establishes connections between target levels and renewable energy capacity. Our results advocate for dynamic updates of carbon reduction targets aligned with renewable energy capacity when formulating climate objectives.
Construction of BaTiO3–TiO2 hollow sphere heterojunctions for enhanced microwave dynamic therapy in cancer treatment
Authors: Chen Yaodong , Cai Fangyu , Liu Yadong , Fan Wenwen , Wang Jingjie , Yin Guolin , Ren Jiayi , Cao Jingwei , Fu Yongming , Chen Jie
Published: April 2024

BaTiO3–TiO2 hollow spheres were synthesized for efficient MWDT in cancer treatment, enabling precise tumor elimination with minimal damage to healthy tissues by enhancing production of ROSs upon microwave triggering.
Adsorption of nucleotides and nucleic acids on goethite nanoparticles: mode, sites and relationship with phosphate and non-phosphate structures
Authors: Feng Huajun , Ma Shanshan , Chen Zaiming , Li Yungui , Wang Meizhen , Ding Yangcheng
Published: April 2024

The impact of iron (hydr)oxide adsorption on nucleotides and nucleic acids (NNAs) in the environment varies.
Phytoremediation as a green and sustainable prospective method for heavy metal contamination: a review
Authors: Islam Md. Merajul , Saxena Neha , Sharma Deepa
Published: April 2024

Cleaning up heavy metal-polluted soil through various mechanisms of phytoremediation is an economical, aesthetically beautiful, and environmentally responsible alternative to chemical or physicochemical approaches for heavy metal decontamination.
Prussian blue analogue derived from leather waste as a bifunctional catalyst in zinc–air batteries
Authors: Liu Meng-yu , Shen Shi-yi , Guo Jia-hua , Zhu Ze-yu , Zha Bao-li , Wu Jiansheng , Pei Wen-Bo , Ren Xiao-Ming , Huo Fengwei
Published: April 2024

A bifunctional catalyst derived from leather waste for use in zinc–air batteries.
ZnCl2 activated mesoporous carbon from rice straw: optimization of its synthetic process and its application as a highly efficient adsorbent for amoxicillin
Authors: Sangon Suwiwat , Kotebantao Kanokwan , Suyala Theerakan , Ngernyen Yuvarat , Hunt Andrew J. , Supanchaiyamat Nontipa
Published: April 2024

An optimized and efficient zinc chloride-based activation of rice straw yielded highly mesoporous carbons with an exceptional ability to adsorb the antibiotic amoxicillin. The maximum adsorption capacity was found to be as high as 1308 mg g−1.
Strength–ductility materials by engineering a coherent interface at incoherent precipitates
Authors: Mao Dongxin , Xie Yuming , Meng Xiangchen , Ma Xiaotian , Zhang Zeyu , Sun Xiuwen , Wan Long , Volodymyr Korzhyk , Huang Yongxian
Published: April 2024

In the quest for excellent light-structural materials that can withstand mechanical extremes for advanced applications, design and control of microstructures beyond current material design strategies have become paramount.
Copper-catalyzed remote double functionalization of allenynes
Authors: Song Yulong , Fu Chunling , Zheng Jian , Ma Shengming
Published: April 2024

A copper-catalyzed highly regioselective remote boryl- or silyl-cupration of allenynes, providing an efficient protocol for the synthesis of conjugated allene-substituted alkenyl boronates or silanes, has been developed.
Palliative procedures for malignant gastric outlet obstruction: a network meta-analysis
Authors: Tran Khoi Van , Vo Nguyen-Phong , Nguyen Hung Song , Vo Nhi Thi , Thai Thi Bao Trang , Pham Vu Anh , Loh El-Wui , Tam Ka-Wai
Published: April 2024

Background The optimal treatment for malignant gastric outlet obstruction (GOO) remains uncertain. This systematic review aimed to comprehensively investigate the efficacy and safety of four palliative treatments for malignant GOO: gastrojejunostomy, endoscopic ultrasound-guided gastroenterostomy (EUS-GE), stomach-partitioning gastrojejunostomy (PGJ), and endoscopic stenting.

Methods We searched PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform for randomized controlled trials (RCTs) and cohort studies comparing the four treatments for malignant GOO. We included studies that reported at least one of the following clinical outcomes: clinical success, 30-day mortality, reintervention rate, or length of hospital stay. Evidence from RCTs and non-RCTs was naïve combined to perform network meta-analysis through the frequentist approach using an inverse variance model. Treatments were ranked by P score.

Results This network meta-analysis included 3617 patients from 4 RCTs, 4 prospective cohort studies, and 32 retrospective cohort studies. PGJ was the optimal approach in terms of clinical success and reintervention (P scores: 0.95 and 0.90, respectively). EUS-GE had the highest probability of being the optimal treatment in terms of 30-day mortality and complications (P scores: 0.82 and 0.99, respectively). Cluster ranking to combine the P scores for 30-day mortality and reintervention indicated the benefits of PGJ and EUS-GE (cophenetic correlation coefficient: 0.94; PGJ and EUS-GE were in the same cluster).

Conclusion PGJ and EUS-GE are recommended for malignant GOO. PGJ could be the alternative choice in centers with limited resources or in patients who are unsuitable for EUS-GE.
Fraturas atípicas de metatarso: Relato de cinco casos clínicos
Authors: Vasconcelos José Wanderley , Souza Naraja Menezes de , Leite Leopoldina Milanez da Silva , Júnior José Alonso Rodrigues Chaves
Published: April 2024

Fraturas atípicas são bem elucidadas quando ocorrem no fêmur e tem relação com o uso de bifosfonatos. A terapia prolongada com esse medicamento leva a uma supressão excessiva do remodelamento ósseo, o que torna o osso mais quebradiço. Em geral, são fraturas atraumáticas ou causadas por trauma mínimo. Este tipo de fratura é também relatada em outros sítios ósseos, como o metatarso. Alguns relatos e estudos referentes às fraturas atípicas de metatarso já foram publicados, mas outras investigações são necessárias para que essa fraturas sejam mais bem compreendidas e recebam o devido diagnóstico, tratamento e conduta.

No presente trabalho, relatam-se cinco casos de pacientes que apresentaram fratura de metatarso durante terapia com bifosfonatos. Todos os pacientes eram do sexo feminino, tinham osteoporose como doença pré-existente, faziam uso de bifosfonatos, apresentaram fraturas atraumáticas ou causadas por trauma mínimo, e o exame de imagem revelou fratura metadiafisária transversa de eixo de quinto metatarso com espessamento do córtex lateral, características de imagem semelhantes aos critérios utilizados pela American Society for Bone and Mineral Research (ASMBR) para definir fraturas atípicas de fêmur.
Luxação total fechada do tálus sem fratura de tornozelo: Relato de caso
Authors: Arellano Rubén Daniel , Arellano Daniel Orlando , Arellano Diego Fernando , Becerra José Ángel , Ramírez José Arturo
Published: April 2024

Relatamos o caso de uma mulher de 61 anos que deu entrada no pronto-socorro após cair de uma escada. A paciente foi diagnosticada com luxação talar total fechada, sem fratura do tálus ou do tornozelo. O cirurgião indicou uma redução aberta após uma tentativa frustrada de redução fechada. Aos seis meses de acompanhamento, a paciente relata dor branda e descarga parcial de peso sem desconforto; exames de tomografia computadorizada e ressonância magnética não mostraram evidências de necrose avascular ou colapso ósseo.
Safety and Efficacy of Overdilation of 10 mm Viatorr Transjugular Intrahepatic Portosystemic Shunt Stents Using 12 mm Balloons
Authors: Tahir Muhammad Mohid , Lewis Trevor K. , Ali Aamir , Hsu Michael , Weinstein Jeffrey L. , Ahmed Muneeb , Sarwar Ammar
Published: April 2024

Objective The aim of this study was to evaluate overdilation of 10-mm standard and 8–10 mm controlled-expansion Viatorr stents to 12 mm during transjugular intrahepatic portosystemic shunt (TIPS) placement when insufficient reduction (<50%) in portosystemic gradient (PSG) is achieved with standard 10 mm dilation.

Materials and Methods It is a single-institution, institutional review board-approved, retrospective review of TIPS (2013–2022) to identify patients in the overdilation group (12 mm dilation of a 10-mm stent) and a control group (10 mm dilation of a 10-mm stent) matched for age, indication, stent type, Model for End-Stage Liver Disease (MELD) score, pre-TIPS PSG, and variceal embolization. Stent diameter, technical success, clinical outcomes, and adverse events were assessed for both groups.

Results TIPS was created for the overdilation group (n = 35, 57 ± 11 years, 69% male; MELD: 14 ± 5) and control group (n = 35, 57 ± 11 years, 83% male; MELD: 14 ± 5). Overdilation to 12 mm adequately reduced PSG by more than 50% (55 vs. 65% in the control group, p = 0.11). The stent diameter was larger in the overdilation group on cross-sectional imaging (9.8 ± 0.2 vs. 9.5 ± 0.4 mm, p < 0.001), with an estimated 57% higher volume flow rate (p = 0.002). Patients were followed for a median of 11.3 months (range: 0.03–75) and 15.6 months (range: 0.03–106) in the overdilation and control groups, respectively. There was an equivalent rate of ascites resolution (56 vs. 63%, p = 0.68) and rebleeding (13 vs. 17%, p = 0.82) in the overdilation and control groups, with a similar risk of new-onset hepatic encephalopathy (41 vs. 33%, p = 0.51) and TIPS occlusion (11 vs. 9%, p = 0.69). Overdilation did not result in any instance of stent fracture.

Conclusion Overdilation of 10-mm Viatorr stents with 12 mm balloons may provide benefit by potentially reducing PSG further for patients initially having inadequate PSG reduction with short-term safety.
Exploring the Potentials of Large Language Models in Vascular and Interventional Radiology: Opportunities and Challenges
Authors: Togunwa Taofeeq Oluwatosin , Ajibade Abdulquddus , Uche-Orji Christabel , Olatunji Richard
Published: April 2024

The increasing integration of artificial intelligence (AI) in healthcare, particularly in vascular and interventional radiology (VIR), has opened avenues for enhanced efficiency and precision. This narrative review delves into the potential applications of large language models (LLMs) in VIR, with a focus on Chat Generative Pre-Trained Transformer (ChatGPT) and similar models. LLMs, designed for natural language processing, exhibit promising capabilities in clinical decision-making, workflow optimization, education, and patient-centered care. The discussion highlights LLMs' ability to analyze extensive medical literature, aiding radiologists in making informed decisions. Moreover, their role in improving clinical workflow, automating report generation, and intelligent patient scheduling is explored. This article also examines LLMs' impact on VIR education, presenting them as valuable tools for trainees. Additionally, the integration of LLMs into patient education processes is examined, highlighting their potential to enhance patient-centered care through simplified and accurate medical information dissemination. Despite these potentials, this paper discusses challenges and ethical considerations, including AI over-reliance, potential misinformation, and biases. The scarcity of comprehensive VIR datasets and the need for ongoing monitoring and interdisciplinary collaboration are also emphasized. Advocating for a balanced approach, the combination of LLMs with computer vision AI models addresses the inherently visual nature of VIR. Overall, while the widespread implementation of LLMs in VIR may be premature, their potential to improve various aspects of the discipline is undeniable. Recognizing challenges and ethical considerations, fostering collaboration, and adhering to ethical standards are essential for unlocking the full potential of LLMs in VIR, ushering in a new era of healthcare delivery and innovation.
Combined Treatment of Native Femoropopliteal Occlusions in Chronic Limb-Threatening Ischemia Using Atherectomy Debulking and a New Sirolimus Drug-Coated Balloon (SELUTION SLR)
Authors: Sumner Joseph , Patel Sajal , Theodoulou Iakovos , Thulasidasan Narayanan , Gkoutzios Panos , Ahmed Irfan , Saratzis Athanasios , Diamantopoulos Athanasios
Published: April 2024

Objective The aim of this study was to report the primary outcomes of a pilot study investigating the safety and efficacy of sirolimus drug-coated balloons (SELUTION) for endovascular postatherectomy treatment of native occluded femoropopliteal lesions in patients with chronic limb-threatening ischemia (CLTI).

Materials and Methods This study analyzes a cohort of CLTI patients with femoropopliteal artery occlusions treated with combined rotational atherectomy and postatherectomy angioplasty using the SELUTION device. The primary outcome measures were amputation-free survival (AFS) defined as time to major limb (above ankle) amputation of the index leg or death from any cause. Secondary outcome measures included technical success, overall survival, major amputation of the index leg, major adverse limb event (MALE) defined as major amputation or any further major revascularization intervention of the treated segment during the follow-up period and primary patency at 12 months.

Results Between April 2021 and January 2022, nine patients (mean age: 64.0 ± 8.4, 66.7% male) with femoropopliteal occlusive lesions (mean lesion length: 141.1mm, range: 40–400) were treated with the above-combined approach. Technical success was 100%. At 12 months, the AFS was 88.9%, with one death and zero major amputations (88.9% survival and 100% limb salvage, respectively); only two patients (22.2%) suffered a MALE; primary patency was 75%. No adverse events related to the sirolimus drug-coated balloon nor to the atherectomy device were observed.

Conclusion Combining sirolimus drug-coated balloon and atherectomy for treatment of femoropopliteal occlusions in CLTI patients is a safe and effective approach achieving satisfactory patency and adverse event rates.
Wide-Neck Renal Artery Aneurysm Managed with Neuro-Retrievable Stent-Assisted Coil Embolization
Authors: Choksi Eshani J. , Kaushik Shivam , Tummala Venkat
Published: April 2024

Endovascular management of narrow-necked aneurysms has traditionally been with coil embolization; however, wide-necked aneurysms have been more difficult to treat due to risk of distal coil migration or intrusion into a parent vessel. We describe the case of a 76-year-old female who presented with a left-sided renal artery aneurysm and 11 mm aneurysm neck. Renal arteriography of the superior pole branch was performed, lower pole was stented, and a retrievable stent was placed in the inferior branch for the purpose of stent-assisted coiling. Penumbra detachable coils were deposited through the stent struts to jail them in with successful embolization of the aneurysm. Endovascular treatment of wide-neck renal artery aneurysms has the potential to be a successful treatment alternative in patients where surgical intervention is contraindicated. Additional studies should be performed to determine the versatility and extent of success in coil embolization for wide-neck aneurysms.
Outcome of Secondary Interval Rheolytic Thrombectomy after Localized Intra-Arterial Catheter-Directed Thrombolysis through Power-Pulse Spray Technique in Cases of Partially Successful or Failed Primary Rheolytic Thrombectomy
Authors: Sahoo Biswajit , Mohanty Satyapriya , Sathia Siddhartha , Mahapatra Rudra Pratap , Nayak Manoj Kumar , Panda Ritesh , Panigrahi Manas Kumar , Mishra Sourav Kumar , Sasmal Prakash Kumar , Kumar Pankaj , Ali S. Manawar , Deep Bag Nerbadyswari , Majumdar Saroj Kumar Das , Barik Sandip Kumar , Devi Sujata , Pitchaimuthu Arunprakash
Published: April 2024

Objectives The aim of this study was to evaluate the safety and effectiveness of secondary interval AngioJet rheolytic thrombectomy after localized intra-arterial catheter-directed thrombolysis (CDT) through power-pulse spray (PPS) technique in partially successful or failed primary AngioJet rheolytic thrombectomy cases of acute and subacute peripheral artery thrombosis.

Materials and Methods This retrospective study included 12 acute (< 2 weeks) and subacute (2–4 weeks) peripheral arterial thrombosis patients who underwent primary thrombectomy alone without CDT and patients who received secondary thrombectomy after CDT through PPS at our institute between May 2022 and December 2022. Technical success, procedure-related complications (local and systemic), amputations, and 1-year patency were evaluated.

Results The angiographic success after primary thrombectomy was evaluated in 12 patients (9 acute and 3 subacute), and the results were categorized into three groups. Of 12 patients, complete success, partial success, and failure were noted in three (25%), five (41.7%), and four (33.3%) patients, respectively, after primary thrombectomy alone. Complete luminal patency was restored in all nine cases of partial success and failure in postprimary thrombectomy through adjunctive PPS thrombolysis and secondary thrombectomy. Technical and clinical success was achieved in all patients (100%). Transient hemoglobinuria was seen in five (41.7%) patients, and all had long-segment occlusion. At 1 year follow-up, no reocclusion, limb loss, or death was noted.

Conclusion Complete success after primary thrombectomy was more likely in the setting of short-segment occlusion and small-caliber arteries. In patients with partial success or failure after the primary thrombectomy alone, secondary thrombectomy may be performed after the adjuvant PPS thrombolysis to achieve complete recanalization.
Antithrombotic Therapy for Inferior Vena Cava Stenting of Malignant Inferior Vena Cava Syndrome: A Questionnaire Study of Japan Interventional Radiology Study Group (JIVROSG)
Authors: Ozawa Mizuki , Sone Miyuki , Sugawara Shunsuke , Arai Yasuaki , Kusumoto Masahiko
Published: April 2024

Purpose The aim of this study was to evaluate the differences in antithrombotic therapy policies for inferior vena cava (IVC) stent placement among institutions and interventional radiologists in Japan.

Materials and Methods The cross-sectional online-based questionnaire was conducted between December 2022 and January 2023, and a total of 114 institutions were included in this study. The questionnaire contained eight questions that were grouped into three sections: (1) whether IVC stents have been performed or not, (2) the number of IVC stent placements, and (3) the basic strategy of antithrombotic therapy for pre-, intra-, and post-IVC stent placement.

Results Of the 114 institutions, 38 responses (33%) were collected. Twenty-four of the 38 institutions (63%) had performed IVC stent placement during the study period. The mean number of IVC stent placements during the study period was 3.4 cases per institution. The most frequently selected antithrombotic therapeutic strategies pre-, intra-, and post-stenting were no antithrombotic therapy (62.5%), anticoagulation therapy (54.2%), and no antithrombotic therapy (41.7%).

Conclusion This study has revealed there is no consensus regarding antithrombotic therapy for IVC stent placement in Japan. The results of this study may contribute to our understanding of the status of antithrombotic therapy for IVC stent placement. Future prospective studies are warranted to clarify the periprocedural antithrombotic therapy for IVC stent placement.
Pharmacokinetics of Edoxaban 15 mg in Very Elderly Patients with Nonvalvular Atrial Fibrillation: A Subanalysis of the ELDERCARE-AF Study
Authors: Yamashita Takeshi , Igawa Yoshiyuki , Fukuzawa Masayuki , Hayashi Takuya , Hennig Stefanie , Okumura Ken
Published: April 2024

Background We evaluated the pharmacokinetics (PK) of low-dose (15 mg) edoxaban in very elderly patients (≥80 years) with nonvalvular atrial fibrillation (NVAF) and high bleeding risk.

Methods This subanalysis of the phase 3, randomized, double-blind, placebo-controlled, multicenter ELDERCARE-AF study evaluated edoxaban plasma concentrations and compared them with the Japanese population of the ENGAGE AF-TIMI 48 and Japanese severe renal impairment (SRI) studies.

Results The PK analysis population included 451 patients, 53.8% of whom concomitantly used antiplatelet drugs, 41.0% had SRI, and 38.0% had low body weight. Edoxaban plasma concentrations at trough and 1 to 3 hours post-dose in ELDERCARE-AF were 17.3 ± 13.9 (n = 427) and 93.3 ± 57.8 ng/mL (n = 447), respectively. These values were slightly higher than the 15 mg group in ENGAGE AF-TIMI 48 (n = 79; 12.4 ± 12.1 and n = 115; 78.7 ± 45.0 ng/mL, respectively), lower than the ENGAGE AF-TIMI 48 high-dose reduced to 30 mg group (n = 83; 25.1 ± 36.6 and n = 111; 150 ± 91.6 ng/mL, respectively), but similar to the Japanese SRI study (n = 39; 18.4 ± 11.2 and n = 40; 96.8 ± 48.3 ng/mL, respectively). ELDERCARE-AF patients with SRI and low body weight (≤45 kg) had higher concentrations than those without, and those taking antiplatelet drugs had lower concentrations than those who were not.

Conclusion PK data support edoxaban 15 mg once daily for very elderly NVAF patients with high bleeding risk, with caution for patients with SRI and/or low body weight.
Trans-splenic Approach for Transjugular Intrahepatic Portosystemic Shunt (TIPS) Creation in Patients with Portal Vein Thrombosis
Authors: Boumezrag Maryam , Lynskey George , Sabri Saher
Published: April 2024

Purpose The aim of this study was to evaluate the safety and efficacy of using a trans-splenic approach for transjugular intrahepatic portosystemic shunt (TIPS) creation in patients with portal vein thrombosis. (PVT).

Material and Methods A retrospective review was performed on 36 consecutive patients with PVT who underwent TIPS using a trans-splenic approach from February 2018 to June 2021. Preprocedural data including demographic information and Model for End-Stage Liver Disease (MELD) scores were obtained. Outcomes measured included technical success, clinical success, complications, and survival.

Results Technical success was achieved in 32 of 36 patients (89%). During the follow-up period, 16 of 32 (50%) required secondary TIPS interventions, most of which were planned as part of a staged procedure. 30/32 (94%) had stent patency on their most recent follow-up, with a median follow-up of 164 days. No patients had variceal bleeding following TIPS. 12 of 32 (38%) patients underwent successful transplant after TIPS. Anatomical portal vein end-to-end anastomosis was achieved in 11/12 (92%) patients.

Conclusion The trans-splenic approach to TIPS is a reliable alternative to traditional TIPS in patients with PVT and provides high technical and clinical success rates. This technique can also be utilized to improve future liver transplant outcomes by facilitating anatomic portal vein end-to-end anastomoses.
Effects of onabotulinum toxin type A injections in patients with Meige's syndrome
Authors: Duarte Alexia , Coutinho Léo , Germiniani Francisco Manoel Branco , Teive Hélio Afonso Ghizoni
Published: April 2024

Background Meige's syndrome is a type of facial dystonia characterized by the simultaneous occurrence of blepharospasm and oromandibular dystonia. Although botulinum toxin type A (OBTA) injections are the standard treatment, evidence of their effectiveness and safety in this scenario is still lacking.

Objective Our research aimed to evaluate the improvement and occurrence of side effects following injections of onabotulinum toxin type A (OBTA) in patients with Meige's syndrome.

Methods Patients with Meige's syndrome undergoing botulinum toxin injections were enrolled in this study. We assessed dystonia intensity before and 14 days after OBTA injection using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) to measure the response of symptoms in the eyes (blepharospasm) and mouth (oromandibular dystonia). Other variables, such as dosage, side effects, and demographic data, were also recorded.

Results The study included 41 participants, with a mean age of 67.7 years and a female-to-male ratio of 3.5:1. The mean BFMDRS score before the injections was 8.89, and after 14 days, it was 2.88. The most reported side effect was ptosis, with a 7.3% incidence. OBTA significantly reduced dystonia severity (p < 0.0001). The clinical response for the blepharospasm component was superior to the oromandibular dystonia component.

Conclusion Our results support that OBTA seems to be an effective and safe therapeutic option for treating Meige's syndrome. The effect of OBTA was more pronounced in the treatment of blepharospasm than in oromandibular dystonia.
The sural-sparing pattern in clinical variants and electrophysiological subtypes of Guillain-Barré syndrome
Authors: Castro Vinicius Furtado da Silva , Oliveira Roberto Teodoro Gurgel de , Santos João Daniel Lima dos , Mendes Ramon de Souza , Pessoa Neto Agábio Diógenes , Fidelix Emanuela Coriolano , Dourado Júnior Mário Emílio Teixeira
Published: April 2024

Background Guillain-Barré syndrome (GBS) is the most common cause of acute flaccid paralysis worldwide and can be classified into electrophysiological subtypes and clinical variants.

Objective This study aimed to compare the frequency of the sural-sparing pattern (SSP) in subtypes and variants of GBS.

Methods This retrospective cohort study analyzed clinical and electrophysiological data of 171 patients with GBS hospitalized in public and private hospitals of Natal, Rio Grande do Norte, Brazil, between 1994 and 2018; all cases were followed up by the same neurologist in a reference neurology center. Patients were classified according to electrophysiological subtypes and clinical variants, and the SSP frequency was compared in both categories. The exact Fisher test and Bonferroni correction were used for statistical analysis.

Results The SSP was present in 53% (57 of 107) of the patients with acute inflammatory demyelinating polyradiculoneuropathy (AIDP), 8% (4 of 48) of the patients with axonal subtypes, and 31% (5 of 16) of the equivocal cases. The SSP frequency in the AIDP was significantly higher than in the axonal subtypes (p < 0.0001); the value was kept high after serial electrophysiological examinations. Only the paraparetic subtype did not present SSP.

Conclusion The SSP may be present in AIDP and axonal subtypes, including acute motor axonal neuropathy, but it is significantly more present in AIDP. Moreover, the clinical variants reflect a specific pathological process and are correlated to its typical electrophysiological subtype, affecting the SSP frequency.
Changing Nature of Endoleak in a Patient of Superior Mesenteric Artery Aneurysm Treated with Endovascular Stent Graft
Authors: Nandi Debanjan , Malhi Amarinder Singh , Kumar Sanjeev
Published: April 2024

A man in his early thirties with complaints of abdominal pain for 1 week was diagnosed with a fusiform, partially thrombosed aneurysm of the superior mesenteric artery (SMA), which was treated with an endovascular stent graft. Three months later, when the patient again presented with abdominal pain, there was an endoleak of type III as detected by computed tomography and digital subtraction angiography. This was treated by in-stent balloon angioplasty with complete resolution of the endoleak. The patient again presented 1 month later with abdominal pain, with a residual sac posterior to the stent, detected on digital subtraction angiography, which was confirmed to be type II endoleak as it was getting filled by one of the jejunal branches of SMA. This was treated by glue embolization of the patent component of the aneurysm after selectively cannulating the branch vessel. This case highlights changing nature of endoleak as a complication of SMA stenting.
Bilateral Uterine Artery Embolization as a Rescue Method in a Rare Case of Cervical Ectopic Pregnancy
Authors: Gupta Pooja , Rekha B. S. V. B. , Yadav Deep , Rasheed Mohd , Jain Charu
Published: April 2024

Cervical pregnancy, being the second rarest form of ectopic pregnancy after abdominal pregnancy, is a difficult clinical entity to diagnose and manage in a young primigravida with no identifiable risk factors or associated symptoms. Further, early intervention is of utmost importance owing to the deleterious complications and high mortality associated with it if not addressed to. It is also difficult to choose a particular management approach for this out of the available options. We report a case of 23-year-old primigravida with 8 weeks of gestation, asymptomatic and with no underlying risk factors, diagnosed with cervical pregnancy during a routine antenatal scan. She was successfully managed with bilateral uterine artery embolization in conjunction with systemic methotrexate followed by suction and evacuation.
Understanding Caudal Dysplasia Sequence: Three Case Reports
Authors: Kansal Monica , Dasgupta Sanheeta , Aujla Tanveer , Gupta Manju , Kumar Gaurav
Published: April 2024

Caudal dysplasia or caudal regression sequence is a congenital malformation that is characterized by maldevelopment of the lower half of the body with variable involvement of the gastrointestinal, genitourinary, skeletal, and nervous system. Most cases are sporadic and associated with the presence of a single umbilical artery. We report three cases with varying morphological spectrum of caudal dysplasia diagnosed during the first trimester ultrasound.
Early identification of patients at risk for iron-deficiency anemia using deep learning techniques
Authors: Garduno-Rapp Nelly Estefanie , Ng Yee Seng , Weon Jenny L , Saleh Sameh N , Lehmann Christoph U , Tian Chenlu , Quinn Andrew
Published: April 2024

Objectives

Iron-deficiency anemia (IDA) is a common health problem worldwide, and up to 10% of adult patients with incidental IDA may have gastrointestinal cancer. A diagnosis of IDA can be established through a combination of laboratory tests, but it is often underrecognized until a patient becomes symptomatic. Based on advances in machine learning, we hypothesized that we could reduce the time to diagnosis by developing an IDA prediction model. Our goal was to develop 3 neural networks by using retrospective longitudinal outpatient laboratory data to predict the risk of IDA 3 to 6 months before traditional diagnosis.

Methods

We analyzed retrospective outpatient electronic health record data between 2009 and 2020 from an academic medical center in northern Texas. We included laboratory features from 30,603 patients to develop 3 types of neural networks: artificial neural networks, long short-term memory cells, and gated recurrent units. The classifiers were trained using the Adam Optimizer across 200 random training-validation splits. We calculated accuracy, area under the receiving operating characteristic curve, sensitivity, and specificity in the testing split.

Results

Although all models demonstrated comparable performance, the gated recurrent unit model outperformed the other 2, achieving an accuracy of 0.83, an area under the receiving operating characteristic curve of 0.89, a sensitivity of 0.75, and a specificity of 0.85 across 200 epochs.

Conclusions

Our results showcase the feasibility of employing deep learning techniques for early prediction of IDA in the outpatient setting based on sequences of laboratory data, offering a substantial lead time for clinical intervention.
The Effects of Dehumanizing and Humorous Language in Social Protests on Behavioral Expressions of Support
Authors: Karpinska-Krakowiak Malgorzata , Pierzgalski Michal
Published: April 2024

Little is still known about how the language used in social protests affects people’s behavioral expressions of support. This study aims to bridge this gap and investigates the impact of dehumanizing and humorous language employed by protesters in their slogans on the decisions of other individuals to join or openly support such protests. Two experiments were conducted, revealing that exposure to dehumanizing language did not significantly alter the likelihood of supporting protests compared to non-dehumanizing language. However, when combined with humor, dehumanizing language had a positive effect on behavioral expressions of support. In the second experiment we replicated this effect and revealed the mechanism behind it: humor diminished the perceived violence associated with a message containing dehumanizing language, thus increasing the likelihood of individuals acting upon and supporting the social protest. These findings shed light on the factors influencing the varying levels of support observed across different social movements.