bluuebunny/crossref_metadata_2025 huggingface dataset:
Neonatal hyperekplexia: a non-epileptic paroxysmal movement disorder with a novel homozygous mutation in the GLRB gene, a seizure mimic
Authors: Fatima Hera , Shabnam Shabnam , Tripathi Shalini , Kumar Mala
Published: October 2024

A male baby born out of consanguineous marriage (third degree) to a primigravida mother presented to our hospital on day 21 of life as his third hospitalisation with jerky movements, respiratory distress and refusal to feed. The baby had blood culture-positive sepsis, which was treated adequately. He was given antiseizure therapy for jerky movements, but there was no response to multiple antiseizure therapy, and then pyridoxine was added. A significant response was noted with the addition of clonazepam. Neuroimaging and electroencephalogram were normal. The whole exome sequencing suggested a homozygous mutation (frameshift variant c.97delA in exon 2 of the GLRB gene) associated with hyperekplexia 2, resulting in the amino acid substitution p.Lys34fs*27.
Status and influencing factors of knowledge, attitudes and practices relating to screening for breast and cervical cancer among rural women aged 40–65 years in China: a cross-sectional study
Authors: Liao Yuexia , Ye Linfei , Cai Qian , Song Huizi , Zhao Yuqiu , Shang Xingchen , Tian Ting
Published: October 2024

Objectives

The objectives are to investigate the status of knowledge, attitudes and practices (KAP) and to identify factors related to KAP towards breast and cervical cancer screening among rural Chinese women aged 40–65 years.

Design and setting

This cross-sectional study was conducted from July to September 2020 in rural areas of eastern China.

Participants

This study involved 301 rural women aged 40–65 years.

Variables and outcomes

The questionnaire included demographic information and the KAP related to breast and cervical cancer screening. Multivariate linear regression analysis was used for the multifactor analysis.

Results

A total of 301 rural women aged 40–65 years participated in the survey. The overall score of KAP was (62.41±11.24), and the scores of each KAP domain relating to screening for breast and cervical cancer among participants in rural areas were (1.82±0.97), (44.52±7.20) and (16.06±4.56), respectively. The following factors were significantly associated with the total KAP Score relating to breast and cervical cancer screening among rural women aged 40–65 years, explaining 35% of the variance (p<0.001): aged 50–54 (β=−0.160, 95% CI −7.403 to −0.794), aged 55–59 (β=−0.266, 95% CI −10.763 to −3.757), aged 60–65 (β=−0.243, 95% CI −12.504 to −4.331), junior high school (β=0.186, 95% CI 1.287 to 7.064), housewife (β=0.172, 95% CI 0.849 to 6.868), other work (β=0.171, 95% CI 3.818 to 15.044), annual household income ranging from 50 000 to 79 999 (β=0.281, 95% CI 3.887 to 10.458) and annual household income≥80 000 (β=0.330, 95% CI 4.735 to 11.554).

Conclusions

The status of KAP related to breast and cervical cancer screening still requires improvement. Measures to enhance the participation of the two-cancer screening should be provided to rural women aged between 50 and 65 years with lower education level and lower annual household income, especially women who are farmers.
Perceptions of hearing loss and hearing technology among the general public and healthcare providers: a scoping review
Authors: Dillard Lauren K , Mishra Pallavi , Der Carolina M , Chadha Shelly
Published: October 2024

Objectives

Synthesise literature related to perceptions of hearing loss and hearing technology (hearing aids, cochlear implants) among the general public and healthcare providers who do not specialise in ear and hearing care.

Design

Scoping review.

Data sources

We searched three databases (PubMed, Scopus, Ovid Medline) in August 2023 for peer-reviewed articles from inception to 2023.

Eligibility criteria

Peer-reviewed articles or grey literature published in English or Spanish and that were observational or mixed methods were eligible for inclusion. Studies were included if they presented results from original research focused on perceptions of hearing loss and/or hearing technology among the general public and/or healthcare providers who do not specialise in ear and hearing care.

Data extraction and synthesis

Two reviewers extracted and verified study data, which are synthesised in tables and in the text.

Results

Twenty-nine peer-reviewed articles were included, 21 of which focused on samples of the general public and 8 on samples of healthcare providers. Perceptions about persons with hearing loss and the use of hearing technology are varied but often negative. The general public and healthcare providers often perceive hearing loss as less serious than other health conditions, including other sensory impairments. In many settings worldwide, the perception that non-biomedical factors, such as curses or evil spirits, can cause hearing loss is common. Importantly, studies showed training that aimed to raise awareness about hearing loss might improve negative or inaccurate perceptions of hearing loss and hearing technology.

Conclusions

Perceptions of hearing loss and hearing technology are varied but often misinformed and negative. Such information could inform initiatives to raise awareness and change behaviours guided by those perceptions. Ultimately, changing the public’s and healthcare providers’ perceptions of hearing loss could encourage individuals with hearing loss to seek hearing care in a timely and appropriate manner.
Pragmatic randomised trial assessing the impact of peer comparison and therapeutic recommendations, including repetition, on antibiotic prescribing patterns of family physicians across British Columbia for uncomplicated lower urinary tract infections
Authors: Carney Greg , Maclure Malcolm , Patrick David M , Otte Jessica , Ambasta Anshula , Thompson Wade , Dormuth Colin
Published: October 2024

Objective

To evaluate the impact of a personalised audit and feedback prescribing report (AF) and brief educational summary (ES) on empiric treatment of uncomplicated lower urinary tract infections (UTIs) by family physicians (FPs).

Design

Cluster randomised control trial.

Setting

The intervention was conducted in British Columbia, Canada between 23 September 2021 and 28 March 2022.

Participants

We randomised 5073 FPs into a standard AF and ES intervention arm (n=1691), an ES-only arm (n=1691) and a control arm (n=1691).

Interventions

The AF contained personalised and peer-comparison data on first-line antibiotic prescriptions for women with uncomplicated lower UTI and key therapeutic recommendations. The ES contained detailed, evidence-based UTI management recommendations, incorporated regional antibiotic resistance data and recommended nitrofurantoin as a first-line treatment.

Main outcome measures

Nitrofurantoin as first-line pharmacological treatment for uncomplicated lower UTI, analysed using an intention-to-treat approach.

Results

We identified 21 307 cases of uncomplicated lower UTI among the three trial arms during the study period. The impact of receiving both the AF and ES increased the relative probability of prescribing nitrofurantoin as first-line treatment for uncomplicated lower UTI by 28% (OR 1.28; 95% CI 1.07 to 1.52), relative to the delay arm. This translates to additional prescribing of nitrofurantoin as first-line treatment, instead of alternates, in an additional 8.7 cases of uncomplicated UTI per 100 FPs during the 6-month study period.

Conclusion

AF prescribing data with educational materials can improve primary care prescribing of antibiotics for uncomplicated lower UTI.

Trial registration number

NCT05817253.
Evidence gaps in conservative non-pharmacological interventions and guideline implementation for high-burden non-communicable diseases: protocol for an overview of reviews
Authors: Döding Rebekka , Braun Tobias , Ehrenbrusthoff Katja , Elsner Bernhard , Kopkow Christian , Lange Toni , Lüdtke Kerstin , Jung Andres , Miller Clint , Owen Patrick J , Saueressig Tobias , Schäfer Axel , Schäfer Robin , Schleimer Tim , Shala Rilind , Szikszay Tibor , Zebisch Jochen , Belavý Daniel L
Published: October 2024

Non-communicable diseases (NCDs) represent a high burden for the society and affected individuals. Conservative non-pharmacological interventions play a first-line role in the treatment and management of most NCDs. Systematic reviews (SRs) provide the highest level of evidence and significantly influence clinical decision-making. The primary aim of this study is to provide an overview of the evidence on the effectiveness of recommended conservative non-pharmacological interventions for highly burdensome NCDs. The secondary aim is to provide an overview of the evidence for guideline implementation. A literature search was performed in Medline (PubMed), EMBASE and Cochrane CENTRAL. Six reviewers will, in duplicate, independently screen and select studies following eligibility criteria. The population will include individuals with NCDs from disease categories chosen based on WHO burden of disease data and the importance of conservative rehabilitation for their management. Eligible interventions will encompass conservative non-pharmacological approaches recommended by clinical practice guidelines (ie, physical, psychological and education/advice). Eligible comparator will include no or minimal intervention and other competitive interventions. Outcomes will comprise proposed core outcomes for the respective diseases, including patient-reported (eg, pain) and performance-based (eg, physical functioning) outcomes. SRs published in the last 5 years as peer-reviewed journal article in the English language will be eligible. The overview will be reported in accordance with the Preferred Reporting Items for Overviews of reviews.
Total replacement of maize with raw or heat-treated sweet cassava tuber meal on productive performance and egg quality parameters in Jumbo quail hens from 6 to 14 weeks of age
Authors: Gazi Athenkosi , Mnisi Caven Mguvane
Published: October 2024

The impact of complete replacement of maize with raw or heat-treated sweet cassava ( Manihot esculenta) tuber meal (CTM) on productive performance and egg quality of Jumbo quail hens was determined. A total of 240, 6-week-old hens were randomly allocated to 60 cages (4 birds/cage) and assigned to five experimental diets with 12 replicates each. The diets were a standard layer mash diet without CTM (CON) and a standard layer mash diet in which 100% maize was replaced with raw (CTMR), boiled (CTMB), autoclaved (CTMA), and oven-dried CTM (CTMO). The highest overall feed intake, body weight gain, and final body weight ( P < 0.05) was observed from the CON group while the lowest was from the CTMB group. Overall FCR and mortality were not significantly influenced by the diets. Fourteen-week-old hens on CON had a higher ( P < 0.05) rate of lay than CTMR. Eggs from CON had the brightest yolk colour values than all the treatment groups. Moreover, eggs from CON had the least shape index than those from CTMO. Diet CTMA promoted heavier ( P < 0.05) eggshells than CTMR. Jumbo quail hens reared on maize-based diet showed better performance followed by autoclaving treatment, whereas boiling treatment compromised performance traits.
Study of cosmic evolution admitting thermodynamic analysis
Authors: Sharif M. , Gul M. Zeeshan , Fatima Nusrat
Published: October 2024

This article examines the cosmic evolution in the framework of symmetric teleparallel theory, characterized by the function of non-metricity scalar $$(\mathcal {Q})$$

(
Q
)

. We use the e-folding number and reconstruction method with a suitable parametrization of the scale factor to obtain the functional form of symmetric teleparallel theory. Using this reconstructed model, we examine the behavior of different cosmographic parameters to demonstrate the bouncing scenarios of the cosmos by considering the contraction and expansion phases of cosmos before and after the bouncing point, respectively. It is found that the null energy condition is violated which shows that the singularity issue can be resolved in this extended theoretical framework. Moreover, we observe that the acceleration occurs near the bouncing point and the reconstructed model aligns with the current cosmic expansion. Finally, we check the validity of second law of thermodynamics in the bouncing framework of our model.
Pseudoscalar mesons from a PNJL model at zero temperature
Authors: Aguirre R. M. , Lourenço O.
Published: October 2024

We study pseudoscalar $$\pi $$
π
, K and $$\eta $$
η
meson properties, such as masses and couplings, in dense matter at zero temperature. We use a recently proposed phenomenological quark model, known as the PNJL0, which takes into account the confinement/deconfinement phase transition by means of the traced Polyakov loop ($$\varPhi $$
Φ
) which serves as an order parameter at zero temperature. We consider two different scenarios, namely, symmetric quark matter with equal chemical potentials for all the flavors, and the beta equilibrated matter. In the latter case the hadron-quark phase transition is implemented by a two model approach. For the hadron side we use a relativistic mean-field model with density dependent couplings. We show that $$\varPhi $$
Φ
induces abrupt changes in the mesons properties with gap sizes regulated by the phenomenological gluonic sector of the model.
A novel discrete-time approach to the continuous-time SIS dynamics
Authors: Chao Naipeng , Wu Xingtong , Liu Gang , Zhou Ming-Yang , Liao Hao , Mao Rui
Published: October 2024

Despite extensive efforts to the continuous-time Markov process of the susceptible–infected–susceptible (SIS) model, there remains a dearth of efficient methods for numerically simulating the continuous-time spreading paths in complex networks using discrete-time simulations. In typical discrete-time approaches to the SIS model, time is discretized into small uniform intervals, and synchronous updating schemes are commonly employed to update the states of nodes. However, in this study, we demonstrate that the synchronous updating scheme introduces undesired noise, such as period-doubling and chaotic behaviors, into the spreading paths, diverging from the continuous-time SIS model. Additionally, we observe that the classical synchronous discrete-time scheme underestimates the spreading ability as compared to the corresponding continuous-time SIS model, a discrepancy that is dependent on the length of the time intervals. Leveraging the Taylor formalism, we propose a novel synchronous discrete-time updating method that addresses these issues associated with the classical synchronous discrete-time scheme. Importantly, our proposed method achieves high accuracy regardless of the length of the time intervals, which can be further exploited to enhance simulation speed. Experiments in both artificial and real networks show that our method approximates the continuous-time spreading paths better and costs less computing time than the classical discrete-time synchronous method.
Improved Vicsek model based on two exponential coupling functions
Authors: Lu Xinbiao , Wu Wen , Han Changjiang , Zhang Wentao , Zhan Gaofan , Wu Xiaolong
Published: October 2024

In order to speed up the consensus of the Vicsek model, existing studies assign different coupling strengths according to the inter-particle Euclidean distance, which effectively reduces the convergence step. In this paper, we propose two new coupling functions, resulting in two improved Vicsek models. Improved Model I introduces the exponential Relu coupling function into the original Vicsek model, and Improved Model II introduces the exponential Swish coupling function into the original Vicsek model. Simulations show that both improved Vicsek models have fewer convergence steps than the original improved Vicsek model based on the coupling function. With different system parameters, the number of convergence steps is smaller than the original improved Vicsek model based on the coupling function. In addition, the number of convergence steps further decreases when the exponent increases and then gradually remains constant. The improved Vicsek model II also achieves better results in resisting noise.
Emergent universe from an unstable de Sitter phase
Authors: Burkmar Molly , Bruni Marco
Published: October 2024

In the Emergent scenario, the Universe should evolve from a nonsingular state replacing the typical singularity of General Relativity, for any initial condition. For the scalar field model by Ellis and Maartens [Class. Quantum Grav. 21 (2003) 223] we show that only a set of measure zero of trajectories leads to emergence, either from a static state (an Einstein model), or from a de Sitter state. Assuming a scenario based on CDM interacting with a Dark Energy fluid, we show that in general flat and open models expand from a nonsingular unstable de Sitter state at high energies; for some closed models this state is a transition phase with a bounce, other closed models are cyclic. A subset of these models are qualitatively in agreement with the observable Universe, accelerating at high energies, going through a matter-dominated decelerated era, then accelerating toward a de Sitter phase.
Advancing Session-Based Recommendations with Atten-Mixer+: Dynamic and Adaptive Multi-Level Intent Mining
Authors: Zhang Peiyan , Guo Jiayan , Li Chaozhuo , Kang Liying , Kim Jaeboum , Xu Jie , Zhang Xi , Zhang Yan , Wang Haohan , Kim Sunghun
Published: October 2024

Session-based recommendation (SBR) systems, traditionally reliant on complex graph neural networks (GNNs), often face challenges with marginal performance improvements despite increased model complexity. In this paper, we dissect the classical GNN-based SBR models and empirically find that the sophisticated GNN propagations might be redundant, given the readout module plays a significant role in GNN-based models. Based on this observation, we introduce Atten-Mixer+, an advanced iteration of our previously developed Multi-Level Attention Mixture Network (Atten-Mixer). Atten-Mixer+ forgoes GNN propagation in favor of a dynamic and adaptive readout process, tailored to the unique characteristics of each session. Different from the vanilla version, Atten-Mixer+ features the Adaptive Intent Scaler (AIS) layer, which dynamically determines the depth of multi-level user intent analysis, and a soft allocation approach for generating user intent queries across entire user interaction sequences. This innovative design allows Atten-Mixer+ to capture a nuanced and comprehensive understanding of user behaviors, overcoming the limitations of fixed-length analysis. Empirical evaluations on benchmark datasets highlight Atten-Mixer+'s superior efficiency and effectiveness, marking a significant step forward in the predictive accuracy of session-based recommendation systems.
HeritageSite AR: Design and Evaluation of a Mobile Augmented Reality Exploration Game for a Chinese Heritage Site
Authors: Xu Ningning , Li Yue , Liang Jiachen , Shuai Kexiang , Li Yuwen , Yan Jiaqi , Zhang Cheng , Dong Yiping
Published: October 2024

This article explores the use of a mobile Augmented Reality (AR) exploration game to enhance immersive storytelling and enrich cultural experiences. Specifically, we present the prototype design and evaluation of HeritageSite AR, an AR exploration game for a Chinese heritage site known as the
Relics of Arhat Monastery and Twin Pagoda
, or
Shuangta
. To develop the AR game for use in heritage sites, we employed a holistic approach, beginning with a review of technical means for cultural application development. We then conducted semi-structured interviews with domain experts and administered an online survey to identify user requirements and design goals, which informed our prototype design. An evaluation study showed positive feedback regarding the impact of game design on meaningful and playful cultural heritage site experience and identified areas for potential refinements in future iterations. We discuss the implications and lessons learned for our future work, which may also interest researchers and practitioners exploring the use of AR technologies and game design in heritage site contexts.
New Worlds Arise: Online Trust and Safety
Authors: Tyler Tom R. , Meares Tracey L. , Katsaros Matt
Published: October 2024

Over the past two decades around the world, people's social lives are increasingly occurring within online digital spaces. Throughout this transition, social media platforms have been struggling to govern an increasing number of complex social phenomena that have carried over from our offline world to these new social platforms, ranging from bullying and harassment to the sale of illicit goods. In their attempts to build out systems to govern these issues, many platforms have drawn inspiration from models borrowed from the offline world familiar to criminologists. In this review, we draw attention to the field of online trust and safety. We provide an overview of the ways platforms have developed tools and systems to govern the people, content, and interactions that take place on their platforms while also looking at the way the field itself has developed rapidly over the past few years. Lastly, we look at research that exposes opportunities for promising paths forward to govern these digital social spaces, highlighting the ways that criminology research can positively contribute toward building vital online communities.
Counterfactuality and Mood
Authors: von Prince Kilu
Published: October 2024

This review article presents the current state of research on counterfactual expressions and contexts. It focuses on the relationship between formal semantic and typological approaches. This leads to a special emphasis on counterfactual expressions outside of conditional clauses and the role of counterfactual expressions in modal meanings such as weak necessity.
Psychological Determinants of Health Behavior
Authors: Hagger Martin S.
Published: October 2024

This review provides a critical overview of current evidence on psychological health behavior determinants and its value in informing intervention and future determinants research. The review begins with work labeling and classifying the myriad of determinants available in the extant research to arrive at core groups of determinants. Next, the conceptual bases of these determinant groups are identified, and the weight of the evidence for their purported effects on health behavior, including belief-based determinants (e.g., outcome expectancies, capacity beliefs), determinants representing self-regulatory capacity (e.g., planning, action control) and nonconscious processes (e.g., habit, implicit cognition), and dispositional determinants (e.g., personality, regulatory control), is critically evaluated. The review also focuses on the theory-based mechanisms underpinning determinant effects and moderating conditions that magnify or diminish them. Finally, the review recommends a shift away from research on determinants as correlates, outlines how determinants can inform intervention development and mechanisms of action tests, suggests alternatives to predominant individualist approaches, and proposes future research directions.
Morality in Our Mind and Across Cultures and Politics
Authors: Gray Kurt , Pratt Samuel
Published: October 2024

Moral judgments differ across cultures and politics, but they share a common theme in our minds: perceptions of harm. Both cultural ethnographies on moral values and psychological research on moral cognition highlight this shared focus on harm. Perceptions of harm are constructed from universal cognitive elements—including intention, causation, and suffering—but depend on the cultural context, allowing many values to arise from a common moral mind. This review traces the concept of harm across philosophy, cultural anthropology, and psychology, then discusses how different values (e.g., purity) across various taxonomies are grounded in perceived harm. We then explore two theories connecting culture to cognition—modularity and constructionism—before outlining how pluralism across human moral judgment is explained by the constructed nature of perceived harm. We conclude by showing how different perceptions of harm help drive political disagreements and reveal how sharing stories of harm can help bridge moral divides.
Unifying Principles of Generalization: Past, Present, and Future
Authors: Wu Charley M. , Meder Björn , Schulz Eric
Published: October 2024

Generalization, defined as applying limited experiences to novel situations, represents a cornerstone of human intelligence. Our review traces the evolution and continuity of psychological theories of generalization, from its origins in concept learning (categorizing stimuli) and function learning (learning continuous input-output relationships) to domains such as reinforcement learning and latent structure learning. Historically, there have been fierce debates between approaches based on rule-based mechanisms, which rely on explicit hypotheses about environmental structure, and approaches based on similarity-based mechanisms, which leverage comparisons to prior instances. Each approach has unique advantages: Rules support rapid knowledge transfer, while similarity is computationally simple and flexible. Today, these debates have culminated in the development of hybrid models grounded in Bayesian principles, effectively marrying the precision of rules with the flexibility of similarity. The ongoing success of hybrid models not only bridges past dichotomies but also underscores the importance of integrating both rules and similarity for a comprehensive understanding of human generalization.
Muscular, temporal, and spatial responses to shoulder exosuit assistance during functional tasks
Authors: Burch Kaleb , Higginson Jill
Published: October 2024

Shoulder exosuits assist arm function, but it is not understood how assistance affects motion. We evaluated spatiotemporal movement features and muscle activity during assisted and unassisted arm motions. Introducing the exosuit caused individuals to let their arms follow assistive forces. Furthermore, individuals learned to use the exosuit with practice by moving more quickly to reduce cumulative effort and by activating assistance earlier. These results demonstrate that individuals adapt exosuit-assisted motion to reduce effort.
Bayesian inference in arm posture perception
Authors: Peviani Valeria C. , Joosten Manon G. A. , Miller Luke E. , Medendorp W. Pieter
Published: October 2024

We modeled the perception of arm posture as a Bayesian computation. A VR posture-matching task was used to empirically test this Bayesian model. The Bayesian model including a nonuniform postural prior well explained individual participants’ biases in arm posture matching.
A New Approach to the Existence of Best Proximity Points With R‐Functions in the Framework of w‐Distances
Authors: Gabeleh Moosa , Safari-Hafshejani Akram , Markin Jack
Published: October 2024

In this paper, we present a new approach to check the existence of best proximity points for R‐proximal contractions in the framework of metric spaces equipped with a w0‐distance and present elementary proofs of recent results by using the corresponding fixed point problems without the continuity assumption of the considered self‐mapping. We also discuss on cyclic Geraghty contractions and resolve the problem of the existence and convergence of the best proximity point for such a class of mappings.
Concordance and Clinical Outcomes Improvement Following Oral Hygiene Motivation: A Systematic Review and Report of the Workshop of the Italian Societies of Dental Hygiene
Authors: Abbinante Antonia , Antonacci Anna , Antonioni Michela , Butera Andrea , Castaldi Matteo , Cotellessa Silvia , Di Marco Caterina , Gangale Martina , Izzetti Rossana , Luperini Maurizio , Maiorani Carolina , Nardi Gianna Maria , Ravoni Alice , Sabatini Silvia , Sestito Sandro , Virno Augusta , Graziani Filippo
Published: October 2024

Aim: A workshop on concordance and oral hygiene was held in February 2024. To address the topic, a systematic review aimed at investigating the effectiveness of motivational interventions in improving oral hygiene and focusing on periodontal clinical indices outcomes was designed.

Materials and Methods: A comprehensive literature search was conducted across PubMed and Scopus electronic databases to identify relevant articles published up to 2024. Inclusion criteria encompassed studies comparing motivational interventions targeting oral hygiene behaviours, with a focus on periodontal clinical indices. Twelve articles meeting the eligibility criteria were selected for analysis. Quality assessment and data extraction were performed systematically.

Results: The synthesis of findings from the selected studies revealed a consistent positive effect of motivational interventions on periodontal clinical indices. These interventions encompassed various strategies, including educational sessions, personalized feedback and motivational interviewing. Improvement in indices such as plaque index (PI), gingival index (GI) and periodontal probing depth was observed following motivational interventions, despite the variety of motivational protocols employed.

Conclusion: Motivational interventions are effective in enhancing oral hygiene practices and improving periodontal clinical indices. Tailored motivational approaches can serve as valuable tools in promoting oral health behaviours among individuals, potentially reducing the risk of periodontal diseases. Further research is warranted to explore the long‐term sustainability and scalability of motivational interventions in diverse populations and settings.
New‐Onset Focal to Bilateral Tonic‐Clonic Seizure Following COVID‐19 Vaccination
Authors: Phua Chun Seng , Raymond Azman Ali , Bhaskar Shalini
Published: October 2024

An 18‐year‐old male presented with new‐onset focal to bilateral tonic‐clonic seizures 5 days after receiving the first dose of COVID‐19 vaccine. 3 days later, an identical seizure occurred lasting 1 min, leading to an acute presentation to the hospital. In hospital, the patient was loaded with intravenous phenytoin and started on levetiracetam with no further seizure recurrence. CT venogram and scalp EEG were unremarkable. MRI brain revealed generalised atrophy with mild bilateral hippocampal atrophy. The patient was maintained on 500 mg levetiracetam twice daily and advised to proceed with subsequent doses of vaccination. Vaccinations have been associated with breakthrough seizures. In this case, COVID‐19 vaccination possibly unmasked an underlying predisposition for epilepsy.
A Method for Adaptively Enhancing Foggy Low‐Illumination Image
Authors: Bi Lihua , Zhang Wenjiao , Zhu Jinjuan , Li Canlin
Published: October 2024

Due to the influence of the foggy weather, the increase of dust particles in the air affects the atmospheric scattering, resulting in the image degradation in the foggy low‐illumination environment, such as blurred content and low contrast. This study proposes an adaptive image enhancement method for foggy low‐illuminance image based on the proposed adaptive gamma correction and adaptive multiscale retinex (MSR). The proposed enhancement method firstly converts the foggy low‐illumination image into HSI space and then performs the proposed adaptive gamma correction on its luminance component through estimating the light component of the image based on the retinex theory. After converting the obtained intermediate image back into RGB space, the proposed adaptive MSR is performed on it to obtain the final enhanced image. For the proposed adaptive gamma correction and adaptive MSR, an effective fitness function is designed to select the optimal scale value by virtue of particle swarm optimization (PSO) algorithm. The experiments show that the proposed method has better effect on improving the sharpness and contrast of the image, compared with the typical algorithms. The processing results of the proposed method have an average increase of 12.16% in information entropy, an average increase of 220.52% in average gradient, and an average increase of 111.63% in visual contrast, compared with the original foggy image.
FDA Approval Summary: Teclistamab–A Bispecific CD3 T-Cell Engager for Patients with Relapsed or Refractory Multiple Myeloma
Authors: Baines Andrea C. , Kanapuru Bindu , Zhao Jay , Price Lauren S.L. , Zheng Nan , Konicki Robyn , Manning Michael L. , Gehrke Brenda J. , Theoret Marc R. , Gormley Nicole J.
Published: October 2024

On October 25, 2022, the FDA granted accelerated approval to teclistamab-cqyv (TECVAYLI; Janssen Biotech) for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent, and an anti-CD38 mAb. Substantial evidence of effectiveness was obtained from the MajesTEC-1 trial, a phase I/II, single-arm, open-label, multicenter study. Patients received step-up doses of teclistamab at 0.06 and 0.3 mg/kg followed by 1.5 mg/kg subcutaneously once weekly until disease progression or unacceptable toxicity. An overall response rate of 61.8% was observed, with a complete response or better rate of 28.2%. Cytokine release syndrome occurred in 72% of patients, and neurologic toxicity occurred in 57%, including immune effector cell–associated neurotoxicity syndrome in 6%. Due to the risk of cytokine release syndrome and neurologic toxicity, including immune effector cell–associated neurotoxicity syndrome, the US Prescribing Information for teclistamab includes a boxed warning, and teclistamab is available only through a restricted program under a risk evaluation and mitigation strategy. Here, we summarize the data and FDA review supporting the accelerated approval of teclistamab, a B-cell maturation antigen–directed bispecific antibody that was the first bispecific CD3 T-cell engager approved for treatment of multiple myeloma.
Figure 6 from Blocking Tryptophan Catabolism Reduces Triple-Negative Breast Cancer Invasive Capacity
Authors: Kuo Li-Wei , Crump Lyndsey S. , O’Neill Kathleen , Williams Michelle M. , Christenson Jessica L. , Spoelstra Nicole S. , Roy Micaela Kalani , Argabright Amy , Reisz Julie A. , D’Alessandro Angelo , Boorgula Meher P. , Goodspeed Andrew , Bickerdike Mike , Bitler Benjamin G. , Richer Jennifer K.
Published: October 2024

KD of TDO2 reduces TNBC cell invasion except when IDO1 increases in a compensatory manner, and pharmacologic inhibition of TDO2/IDO1 reduces invasion and is synergistic with AhR inhibition. A, Invasion assay of scramble control (shSCR) or TDO2-KD (shTDO2) BT549. B, Invasion assays following pretreatment and maintaining with 10 µmol/L AT-0174, 10 µmol/L AhR inhibitor StemRegenin, or combination on BT549 shTDO2-98 (IDO1 comp) cells. C, BT549 cells under attached and suspension conditions were treated with 10 µmol/L of AT-0174 or StemRegenin. D, BT549 cells were treated with or without 10 µmol/L KYN in combination with 10 µmol/L AT-0174 and 10 µmol/L StemRegenin. E, Invasion inhibition (%) of BT549 cells treated with three doses (0.1, 1, and 10 µmol/L) of AT-0174, StemRegenin, or combination. Synergy score was calculated using SynergyFinder with the input of invasion inhibition. F, TDO2 and IDO1 protein expression in TNBC cell lines. G, MDA-MB-231 cells were treated with vehicle (DMSO) control, 10 µmol/L AT-0174, 10 µmol/L StemRegenin, 10 µmol/L epacadostat, or combination. All treatments were conducted for 48 hours, and the invasion through Cultrex was assayed by transwell for 24 hours. Invaded cells were stained with 0.5%/25% (v/v) crystal violet/methanol, dissolved in 10% acetic acid, and absorbance was measured. Data are displayed as mean ± SD with t test or one-way ANOVA analysis. *, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001.
Figure 4 from Blocking Tryptophan Catabolism Reduces Triple-Negative Breast Cancer Invasive Capacity
Authors: Kuo Li-Wei , Crump Lyndsey S. , O’Neill Kathleen , Williams Michelle M. , Christenson Jessica L. , Spoelstra Nicole S. , Roy Micaela Kalani , Argabright Amy , Reisz Julie A. , D’Alessandro Angelo , Boorgula Meher P. , Goodspeed Andrew , Bickerdike Mike , Bitler Benjamin G. , Richer Jennifer K.
Published: October 2024

AT-0174, a dual TDO2/IDO1 inhibitor, decreases TRP catabolism in anchorage-independent TNBC cells expressing TDO2 or IDO1 and reduces both formyl-KYN or KYN. A, Schematic of experimental design. B and E, TRP; C and F, formyl-KYN; D and G, KYN levels in cells and conditioned media of MDA-MB-453 or BT549 following suspension culture with or without 1 µmol/L and 10 µmol/L of TDO2/IDO1 inhibitor AT-0174 treatment (H). BT549 shTDO2-98 (IDO1 comp) was treated with 10 µmol/L AT-0174, 10 µmol/L TDO2 inhibitor 680C91, or 10 µmol/L IDO1 inhibitor epacadostat. I, KYN levels of MDA-MB-231 treated with vehicle (DMSO) control, 10 µmol/L AT-0174, or 10 µmol/L epacadostat. All treatments above were conducted for 48 hours, and conditioned media were analyzed for TRP catabolites and shown as peak area. Data are displayed as mean ± SEM by one-way ANOVA analysis. *, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001.
Figure 3 from Blocking Tryptophan Catabolism Reduces Triple-Negative Breast Cancer Invasive Capacity
Authors: Kuo Li-Wei , Crump Lyndsey S. , O’Neill Kathleen , Williams Michelle M. , Christenson Jessica L. , Spoelstra Nicole S. , Roy Micaela Kalani , Argabright Amy , Reisz Julie A. , D’Alessandro Angelo , Boorgula Meher P. , Goodspeed Andrew , Bickerdike Mike , Bitler Benjamin G. , Richer Jennifer K.
Published: October 2024

KD of TDO2 can increase IDO1 expression and activity in a compensatory manner. Stable genetic KD TDO2 (shTDO2) or scramble control (shSCR) in BT549 cells. A, Immunoblot of TDO2 and IDO1. B, Catabolite level shown in peak area (mean ± SEM) of formyl-KYN and KYN as measured by steady-state metabolomics in conditioned media from BT549 with shTDO2 or shSCR control. C, Activated AhR-regulated genes CYP1A1 and CYP1B1 with and without shTDO2. Data are displayed as mean ± SD with one-way ANOVA analysis. *, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001.
Figure 1 from Blocking Tryptophan Catabolism Reduces Triple-Negative Breast Cancer Invasive Capacity
Authors: Kuo Li-Wei , Crump Lyndsey S. , O’Neill Kathleen , Williams Michelle M. , Christenson Jessica L. , Spoelstra Nicole S. , Roy Micaela Kalani , Argabright Amy , Reisz Julie A. , D’Alessandro Angelo , Boorgula Meher P. , Goodspeed Andrew , Bickerdike Mike , Bitler Benjamin G. , Richer Jennifer K.
Published: October 2024

Inflammatory cytokines induce heterogeneous TDO2 expression in TNBC cells. A, IHC of TDO2 protein in MDA-MB-453 cells treated with vehicle or 10 ng/mL IL1β + TNFα for 48 hours. B, TDO2 protein in MDA-MB-453 treated with IL1β + TNFα or vehicle control for 48 hours and detected by immunoblotting. C, t-SNE graph showing TDO2 in scRNA-seq on MDA-MB-453 cells treated with vehicle or IL1β + TNFα for 48 hours. D, Volcano plot showing gene fold change following vehicle or IL1β + TNFα treatment (P < 0.05; FDR < 0.05) with twofold or greater up- (red) or downregulated (blue) gene sets. E, Significant upregulated/downregulated genes identified using GSEA. F, scRNA-seq expression of TRP catabolism–associated genes TDO2, KMO, and KYNU in MDA-MB-453 treated with vehicle or IL1β + TNFα. G,TDO2 measured by qRT-PCR in three TNBC cell lines in response to vehicle or IL1β + TNFα treatment. Data are displayed as mean ± SD by two-way ANOVA analysis. *, P < 0.05; **, P < 0.01; ***, P < 0.001; ****, P < 0.0001. KMO, kynurenine 3-monooxygenase; NES, normalized enrichment score; t-SNE, t-distributed stochastic neighbor embedding; UMAP, Uniform Manifold Approximation and Projection.
Evaluation of Physiological Variables Determining Time-to-Mortality after Stroke-Associated Pneumonia
Authors: Kishore Amit K. , Heal Calvin , Onochie-Williams Anna , Jamil Husam , Smith Craig J.
Published: October 2024

Introduction: Stroke-associated pneumonia (SAP) frequently complicates stroke and is associated with significant mortality. Clinicians often use physiological variables within the National Early Warning Score (NEWS) when diagnosing and prescribing antibiotics for SAP, but little is known of its association with mortality. We investigated the relationship of the NEWS 2 score and its components (respiratory rate, heart rate, temperature, oxygen requirement, oxygen saturation, and alertness level) prior to antibiotic initiation, with time-to-mortality in SAP. Methods: We included patients with SAP (n = 389) from a single hyperacute stroke unit. Diagnosis of SAP was made if pneumonia occurred within 7 days of hospital admission. Kaplan-Meier survival curves were generated to assess NEWS 2 parameters influencing survival at pre-defined time periods (1 year and 5 years). The association of these parameters on time-to-mortality were analysed using multivariable Cox-regression models to account for a set of pre-specified potential confounders. Results: The median age was 80 years (71–87 years) and median NIHSS was 7 (IQR 4–17). Mortality within 1 year was 52.4% and 65.8% within 5 years. In the multivariable analyses, time-to-mortality was independently associated with respiratory rate (heart rate [HR] 1.04, 95% confidence intervals [CI] 1.01–1.08, p = 0.009) and total NEWS 2 score (HR 1.13, 95% CI 1.06–1.21, p < 0.001). Conclusions: In patients with SAP, higher respiratory rate and total NEWS 2 score prior to antibiotic initiation were independently associated with time-to-mortality. Further studies are warranted to identify potential opportunities for intervention and ultimately guide treatment to improve outcomes in SAP patients.
Trichoscopy of Pemphigus Vulgaris and Foliaceus on Black Scalp
Authors: Benez-Miller Marcela Duarte , Gripp Alexandre , Melo Daniel Fernandes , Machado Carla Jorge , Sar-Pomian Marta , Azulay-Abulafia Luna
Published: October 2024

Introduction: Pemphigus foliaceus (PF) and pemphigus vulgaris (PV) are bullous diseases characterized by loss of keratinocyte adhesion, easily ruptured blisters, and erosions. The scalp is involved in up to 60% of patients due to the high concentration of antigens in hair follicles. Trichoscopy has been studied in bullous diseases. However, research on pemphigus trichoscopy remains scarce. This study aimed to analyze the main trichoscopic features of pemphigus on the black scalp, a topic poorly appraised thus far. Methods: Ten male and 8 female patients were enrolled, evenly distributed between PV (aged 16–59) and PF (aged 20–72), with Fitzpatrick phototypes equal to or greater than IV. Scalp evaluations were conducted using digital dermoscopy, with 20-to-70-fold magnification. Our results were compared with original research on Caucasian scalp pemphigus. Results: Our study identified the previously published and also novel trichoscopic features. Our patients exhibited higher percentages (p < 0.05) of eight classic structures, considering both PF and PV; PF only; PV only. Aside from yellow dots (p = 0.002), our sample showed no statistically significant differences between the PV and PF groups in black patients. Conclusion: Peculiarities of black scalp trichoscopy did not interfere in the diagnosis of pemphigus. Trichoscopy should be a routine diagnostic tool in patients with bullous scalp diseases, especially in the early stages, and to guide biopsy. To our knowledge, this is the first study focused on trichoscopy of pemphigus affecting black scalp. It indicates that, among other findings, yellow dots may be a relevant hallmark of scalp PV.
Sex Differences in Kidney Health and Disease
Authors: Harvey Brian J. , Alvarez de la Rosa Diego
Published: October 2024

Background: Sex differences exist in kidney physiology and disease which are underpinned by the biological actions of the sex hormones estrogen, progesterone and testosterone. In this review, we present an up-to-date discussion of the hormonal and molecular signalling pathways implicated in sex differences in kidney health and disease. Summary: Estrogen and progesterone have protective effects on renal blood flow, glomerular filtration rate and nephron ion and water reabsorptive processes, whereas testosterone tends to compromise these functions. The biological effects of estrogen appear to be the most important in reinforcing kidney function and protecting against kidney diseases in females. The actions of estrogen are myriad but all tend to bolster kidney physiology to maintain a steady-state and adaptable extracellular fluid volume (ECFV) and blood pressure. Estrogen safeguards ECFV homeostasis by stimulating renal epithelial sodium channel (ENaC) and water channel (AQP2) expression and transport function. Renal maintenance of ECFV within narrow physiological limits is a first-line of defense against hypertension and lowers the risk of cardiovascular disease in women. The estrogenic and XX chromosome basis for a female advantage are evident in a wide range of kidney diseases including acute kidney injury, chronic kidney disease, end-stage kidney disease, diabetic kidney disease, and polycystic kidney disease. The molecular mechanisms involve estrogen regulation of nephron ion and water transport, genetic immunogenic responses, activation of the protective arm of the renin angiotensin-aldosterone system and XX chromosome reinforcement of immune responses. Kidney disease can also predispose patients to cancer and women are protected in renal cancer with lower incidence, morbidity, and mortality than age-matched men with the disease. Key Messages: This review underscores the importance of incorporating sex-specific considerations into clinical practice and basic research to bridge the gap in understanding and addressing biological sex disparities in kidney disease and renal cancer.
Acute Gastric Dilatation: A Retrospective Case Series from a Single Institution
Authors: Bathobakae Lefika , Bashir Rammy , Venero Sophia , Wilkinson Tyler , Yuridullah Ruhin , Cavanagh Yana , Baddoura Walid
Published: October 2024

Introduction: Acute gastric dilatation (AGD) is a massive distension of the stomach caused by the accumulation of gas, gastric secretions, or food material. AGD is a radiological diagnosis with no clear etiopathogenesis and is often misdiagnosed owing to a lack of clear diagnostic criteria and physician awareness. Case Presentation: In this case series, we describe the clinical presentations and outcomes of 4 patients with AGD. Three (75%) of the patients were female, and one (25%) was male. The patients’ ages ranged from 53 to 84 years, with an average age of 73.5 years. Abdominal pain, nausea, and vomiting were the most frequently reported complaints. Two (50%) patients had cancer, one (25%) had an acquired duodenal stenosis, and the fourth patient experienced an ileus. Conclusion: AGD is a surgical emergency with a 50–100% mortality rate; thus, prompt diagnosis and management are crucial. Herein, we describe a case series of AGDs that were diagnosed and managed at our institution. We aim to raise awareness about this fatal yet underrecognized clinical entity.