bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical application of virtual reality in patients with cardiovascular disease: state of the art
Authors: Micheluzzi Valentina , Navarese Eliano Pio , Merella Pierluigi , Talanas Giuseppe , Viola Graziana , Bandino Stefano , Idini Chiara , Burrai Francesco , Casu Gavino
Published: April 2024

Virtual reality offers a multisensory experience to patients, allowing them to hear, watch, and interact in a virtual environment. Immersive virtual reality is particularly suitable for the purpose of completely isolating patients from the external environment to transport them away from the suffering related to the disease. On this state of the art, we summarize the available literature on the effectiveness of virtual reality on various physical and psychological outcomes in patients with atherosclerotic cardiovascular disease. Virtual reality has been employed in the cardiovascular field in various settings such as cardiac rehabilitation, interventional cardiology, and cardiac surgery. This technology offers promising opportunities to improve several outcomes related to cardiovascular disease, but further research is needed to entirely capture its benefits and to standardize the intervention.
Changes in acromegaly comorbidities, treatment, and outcome over three decades: a nationwide cohort study
Authors: Rosendal Christian , Arlien-Søborg Mai Christiansen , Nielsen Eigil Husted , Andersen Marianne Skovsager , Feltoft Claus Larsen , Klose Marianne , Andreassen Mikkel , Bruun Niels Henrik , Jørgensen Jens Otto Lunde , Dal Jakob
Published: April 2024

Objective

To study the time-dependent changes in disease features of Danish patients with acromegaly, including treatment modalities, biochemical outcome, and comorbidities, with a particular focus on cancer and mortality.

Methods

Pertinent acromegaly-related variables were collected from 739 patients diagnosed since 1990. Data are presented across three decades (1990–1999, 2000–2009, and 2010–2021) based on the year of diagnosis or treatment initiation.

Results

Adenoma size and insulin-like growth factor I (IGF-I) levels at diagnosis did not differ significantly between study periods. The risk of being diagnosed with diabetes, heart disease, sleep apnea, joint disease, and osteoporosis increased from the 1990s to the later decades, while the mortality risk declined to nearly half. The risk of cancer did not significantly change. Treatment changed toward the use of more medical therapy, and fewer patients underwent repeat surgeries or pituitary irradiation. A statistically significant increase in the proportion of patients achieving IGF-I normalization within 3–5 years was observed over time (69%, 83%, and 88%). The proportion of patients with three or more deficient pituitary hormones decreased significantly over time.

Conclusion

Modern medical treatment regimens of acromegaly as well as increased awareness and improved diagnostics for its comorbidities have led to better disease control, fewer patients with severe hypopituitarism, and declining mortality in the Danish cohort of acromegaly patients. The risk of cancer did not increase over the study period.
Drag reduction of Clark-Y hydrofoil by biomimetic fish scale structure under the condition of biomimetic jet
Authors: Yan Hao , Xie Tengzhou , Li Jian , Fan Jinchuan , Dai Xinyue
Published: April 2024

Hydrofoil, as the basic shape of the fluid blade, is widely used in fluid transport and energy conversion. However, friction resistance and pressure differential resistance are generated in the hydrofoil flow process, resulting in substantial energy consumption and negatively affecting the economy. On this basis, we propose two drag-reducing structures based on Clark-Y hydrofoil. In the design process of the jet structure, we considered the bionic jet velocity, jet angle and jet structure position as the design parameters and obtained the optimal jet structure by using Taguchi method. Finally, the two schemes (Clark-Yori and Clark-Yopt) are numerically simulated using large eddy simulation. Results show that when Ujet = 1.44 m/s, θ = 3° and x = 18.6 mm, the jet structure can play a significant drag reduction effect. Compared with Clark-Yori, the drag coefficient of Clark-Yopt is reduced by 26.5%, and the lift drag ratio is increased by 16.4%. Compared with Clark-Yori, Clark-Yopt can reduce the wall shear stress of the leading edge of the hydrofoil, thereby diminishing the frictional resistance. Meanwhile, the jet structure can effectively balance the area of the low-pressure region on the suction side of the hydrofoil, significantly reducing the pressure differential resistance. Clark-Yopt can accelerate the vortex collapse that decreases turbulence intensity and turbulence resistance. Moreover, it can effectively block the near-wall reflux of hydrofoil and reduce the internal friction between the reflux and the main flow.
A two-stage robust configuration optimization model and solution algorithm for new flexibility resources considering uncertainty response characterization
Authors: Yang Hailin , Liu Fei , Yang Hui , Zhang Xiangcheng , Liu Liantao
Published: April 2024

As the proportion of new energy continues to increase, the safety and stability of the new power system are challenged, urgently requiring the allocation of new flexible resources. This paper proposes a two-stage robust capacity optimization model considering flexibility demand constraints. Firstly, the uncertain characteristics of new energy are described, and a model of flexible resource adjustment capacity is established. Then, uncertain parameters are introduced to construct a robust capacity optimization model considering supply-demand balance, solved by column constraint generation algorithm and KKT theorem. Finally, a power system in a certain region of China is selected as the simulation object for empirical analysis to verify the effectiveness of the constructed model. The results show that the two-stage robust configuration optimization model constructed in this paper can address the uncertainty of power system and the flexibility demand brought by new energy, and the planning results can achieve a balance between the safety and economy of the new power system.
Mule deer (Odocoileus hemionus) resource selection: trade-offs between forage and predation risk
Authors: Cain James W. , Kay Jacob H. , Liley Stewart G. , Gedir Jay V.
Published: April 2024

Ungulates commonly select habitat with higher forage biomass and or nutritional quality to improve body condition and fitness. However, predation risk can alter ungulate habitat selection and foraging behavior and may affect their nutritional condition. Ungulates often choose areas with lower predation risk, sometimes sacrificing higher quality forage. This forage–predation risk trade-off can be important for life history strategies and influences individual nutritional condition and population vital rates. We used GPS collar data from adult female mule deer (Odocoileus hemionus) and mountain lions (Puma concolor) to model mule deer habitat selection in relation to forage conditions, stalking cover and predation risk from mountain lions to determine if a forage-predation risk trade-off existed for mule deer in central New Mexico. We also examined mountain lion kill sites and mule deer foraging locations to assess trade-offs at a finer scale. Forage biomass and protein content were inversely correlated with horizontal visibility, hence associated with higher stalking cover for mountain lions, suggesting a forage-predation risk trade-off for mule deer. Mule deer habitat selection was influenced by forage biomass and protein content at the landscape and within home range spatial scales, with forage protein being related to habitat selection during spring and summer and forage biomass during winter. However, mule deer selection for areas with better foraging conditions was constrained by landscape-scale encounter risk for mountain lions, such that increasing encounter risk was associated with diminished selection for areas with better foraging conditions. Mule deer also selected for areas with higher visibility when mountain lion predation risk was higher. Mountain lion kill sites were best explained by decreasing horizontal visibility and available forage protein, suggesting that deer may be selecting for forage quality at the cost of predation risk. A site was 1.5 times more likely to be a kill site with each 1-meter decrease in visibility (i.e., increased stalking cover). Mule deer selection of foraging sites was related to increased forage biomass, further supporting the potential for a trade-off scenario. Mule deer utilized spatio-temporal strategies and risk-conditional behavior to reduce predation risk, and at times selected suboptimal foraging areas with lower predation risk.
Analysis of SIRT1 genetic variants in young Mexican individuals: relationships with overweight and obesity
Authors: Salazar-García S. , Ibáñez-Salazar A. , Lares-Villaseñor E. , Gaytan Pacheco Noemi , Uresti-Rivera E. , Portales-Pérez D. P. , De la Cruz-Mosso U. , Vargas-Morales J. M.
Published: April 2024

The high prevalence of obesity in Mexico starting from the early stages of life is concerning and represents a major public health problem. Genetic association studies have reported that single nucleotide variants (SNVs) in SIRT1, an NAD+-dependent deacetylase that plays an important role in the regulation of metabolic cellular functions, are associated with multiple metabolic disorders and the risk of obesity. In the present study, we analyzed the effect that the SNVs rs1467568 and rs7895833 of the SIRT1 gene may have on cardiometabolic risk factors in a young adult population from Mexico. A cross-sectional study was carried out with young adults between the ages of 18 and 25 who had a body mass index (BMI) greater than 18.5 kg/m2. This study included 1122 young adults who were classified into the normal weight (n = 731), overweight group (n = 277), and obesity group (n = 114) according to BMI of whom 405 and 404 volunteers were genotyped for rs1467568 and rs7895833 respectively using TaqMan probes through allelic discrimination assays. We found that the male sex carrying the G allele of rs7895833 had slightly lower BMI levels (p = 0.009). Furthermore, subjects carrying rs1467568 (G allele) showed a 34% lower probability of presenting with hyperbetalipoproteinemia where female carrying rs1467568 had lower levels of total cholesterol (p = 0.030), triglycerides (p = 0.026) and LDL cholesterol (p = 0.013). In conclusion, these findings suggest that the presence of both SNVs could have a non-risk effect against dyslipidemia in the Mexican population.
MASTer cell: chief immune modulator and inductor of antimicrobial immune response
Authors: Suárez Vázquez Tomás Alejandro , López López Nallely , Salinas Carmona Mario César
Published: April 2024

Mast cells have long been recognized for their involvement in allergic pathology through the immunoglobulin E (IgE)-mediated degranulation mechanism. However, there is growing evidence of other “non-canonical” degranulation mechanisms activated by certain pathogen recognition receptors. Mast cells release several mediators, including histamine, cytokines, chemokines, prostaglandins, and leukotrienes, to initiate and enhance inflammation. The chemical nature of activating stimuli influences receptors, triggering mechanisms for the secretion of formed and new synthesized mediators. Mast cells have more than 30 known surface receptors that activate different pathways for direct and indirect activation by microbes. Different bacterial strains stimulate mast cells through various ligands, initiating the innate immune response, which aids in clearing the bacterial burden. Mast cell interactions with adaptative immune cells also play a crucial role in infections. Recent publications revealed another “non-canonical” degranulation mechanism present in tryptase and chymase mast cells in humans and connective tissue mast cells in mice, occurring through the activation of the Mas-related G protein–coupled receptor (MRGPRX2/b2). This receptor represents a new therapeutic target alongside antibiotic therapy. There is an urgent need to reconsider and redefine the biological role of these MASTer cells of innate immunity, extending beyond their involvement in allergic pathology.
Investigation of the safety and protective efficacy of an attenuated and marker M. bovis-BoHV-1 combined vaccine in bovines
Authors: Zhang Sen , Liu Guoxing , Zhang Yisheng , Wang Chen , Xu Xiaowen , Zhao Yuhao , Xiang Zhijie , Wu Wenying , Yang Li , Chen Jianguo , Guo Aizhen , Chen Yingyu
Published: April 2024

Bovine respiratory disease (BRD) is one of the most common diseases in the cattle industry worldwide; it is caused by multiple bacterial or viral coinfections, of which Mycoplasma bovis (M. bovis) and bovine herpesvirus type 1 (BoHV-1) are the most notable pathogens. Although live vaccines have demonstrated better efficacy against BRD induced by both pathogens, there are no combined live and marker vaccines. Therefore, we developed an attenuated and marker M. bovis-BoHV-1 combined vaccine based on the M. bovis HB150 and BoHV-1 gG-/tk- strain previously constructed in our lab and evaluated in rabbits. This study aimed to further evaluate its safety and protective efficacy in cattle using different antigen ratios. After immunization, all vaccinated cattle had a normal rectal temperature and mental status without respiratory symptoms. CD4+, CD8+, and CD19+ cells significantly increased in immunized cattle and induced higher humoral and cellular immune responses, and the expression of key cytokines such as IL-4, IL-12, TNF-α, and IFN-γ can be promoted after vaccination. The 1.0 × 108 CFU of M. bovis HB150 and 1.0 × 106 TCID50 BoHV-1 gG-/tk- combined strain elicited the most antibodies while significantly increasing IgG and cellular immunity after challenge. In conclusion, the M. bovis HB150 and BoHV-1 gG-/tk- combined strain was clinically safe and protective in calves; the mix of 1.0 × 108 CFU of M. bovis HB150 and 1.0 × 106 TCID50 BoHV-1 gG-/tk- strain was most promising due to its low amount of shedding and highest humoral and cellular immune responses compared with others. This study introduces an M. bovis-BoHV-1 combined vaccine for application in the cattle industry.
Case report: Temozolomide induced hypermutation indicates an unfavorable response to immunotherapy in patient with gliomas
Authors: Liu Jiapeng , Hu Shuli , Jiang Haihui , Cui Yong
Published: April 2024

Background

Temozolomide (TMZ) is a key component in the treatment of gliomas. Hypermutation induced by TMZ can be encountered in routine clinical practice, and its significance is progressively gaining recognition. However, the relationship between TMZ-induced hypermutation and the immunologic response remains controversial.

Case presentation

We present the case of a 38-year-old male patient who underwent five surgeries for glioma. Initially diagnosed with IDH-mutant astrocytoma (WHO grade 2) during the first two surgeries, the disease progressed to grade 4 in subsequent interventions. Prior to the fourth surgery, the patient received 3 cycles of standard TMZ chemotherapy and 9 cycles of dose-dense TMZ regimens. Genomic and immunologic analyses of the tumor tissue obtained during the fourth surgery revealed a relatively favorable immune microenvironment, as indicated by an immunophenoscore of 5, suggesting potential benefits from immunotherapy. Consequently, the patient underwent low-dose irradiation combined with immunoadjuvant treatment. After completing 4 cycles of immunotherapy, the tumor significantly shrank, resulting in a partial response. However, after a 6-month duration of response, the patient experienced disease progression. Subsequent analysis of the tumor tissue obtained during the fifth surgery revealed the occurrence of hypermutation, with mutation signature analysis attributing TMZ treatment as the primary cause. Unfortunately, the patient succumbed shortly thereafter, with a survival period of 126 months.

Conclusion

Patients subjected to a prolonged regimen of TMZ treatment may exhibit heightened vulnerability to hypermutation. This hypermutation induced by TMZ holds the potential to function as an indicator associated with unfavorable response to immunotherapy in gliomas.
Systemic immune-inflammation index and all-cause and cause-specific mortality in sarcopenia: a study from National Health and Nutrition Examination Survey 1999-2018
Authors: Zeng Qing-Yue , Qin Yu , Shi Yi , Mu Xing-Yu , Huang Shi-Jun , Yang Yu-Hao , Liu Si-Min , An Zhen-Mei , Li Shuang-Qing
Published: April 2024

Background

Sarcopenia, common in the elderly, often linked to chronic diseases, correlates with inflammation.The association between SII and mortality in sarcopenia patients is underexplored, this study investigates this relationship in a U.S. adult cohort.

Methods

We analyzed 1999–2018 NHANES data, focusing on 2,974 adults with sarcopenia. Mortality outcomes were determined by linking to National Death Index (NDI) records up to December 31, 2019. Using a weighted sampling design, participants were grouped into three groups by the Systemic Immune-Inflammation Index (SII). We used Cox regression models, adjusting for demographic and clinical variables, to explore SII’s association with all-cause and cause-specific mortality in sarcopenia, performing sensitivity analyses for robustness.

Results

Over a median follow-up of 9.2 years, 829 deaths occurred. Kaplan-Meier analysis showed significant survival differences across SII groups. The highest SII group showed higher hazard ratios (HRs) for all-cause and cause-specific mortality in both crude and adjusted models. The highest SII group had a higher HR for all-cause(1.57, 1.25–1.98), cardiovascular(1.61, 1.00–2.58), cancer(2.13, 1.32–3.44), and respiratory disease mortality(3.21, 1.66–6.19) in fully adjusted models. Subgroup analyses revealed SII’s association with all-cause mortality across various demographics, including age, gender, and presence of diabetes or cardiovascular disease. Sensitivity analyses, excluding participants with cardiovascular diseases, those who died within two years of follow-up, or those under 45 years of age, largely reflected these results, with the highest SII group consistently demonstrating higher HRs for all types of mortality in both unadjusted and adjusted models.

Conclusion

Our study is the first to demonstrate a significant relationship between SII and increased mortality risks in a sarcopenia population.
Immunoglobulin-like transcript 2 as an impaired anti-tumor cytotoxicity marker of natural killer cells in patients with hepatocellular carcinoma
Authors: Sakata Toshihiro , Yoshio Sachiyo , Yamazoe Taiji , Mori Taizo , Kakazu Eiji , Aoki Yoshihiko , Aoyanagi Nobuyoshi , Okamoto Toru , Ito Takanori , Toyoda Hidenori , Kawaguchi Takumi , Ono Yoshihiro , Takahashi Yu , Taketomi Akinobu , Kanto Tatsuya
Published: April 2024

Introduction

Natural killer (NK) cells play a pivotal role in immune surveillance in the liver. We aimed to identify potential targets for NK cell-mediated immune intervention by revealing the functional molecules on NK cells in HCC patients.

Methods

To evaluate the impact of aging on NK cell phenotypes, we examined NK cells from healthy volunteers (HVs) of various ages. Because ILT2 expression on CD56dim NK cells increased with increasing age, we enrolled age-matched HCC patients and HVs. We determined the NK cell phenotypes in blood mononuclear cells (PBMCs) and intrahepatic lymphocytes (IHLs) from cancerous and non-cancerous tissues. We evaluated cytotoxicity and antibody-dependent cellular cytotoxicity (ADCC) of NK cells in vitro.

Results

ILT2-positive CD56dim NK cells in PBMCs were increased in HCC patients compared with HVs. In HCC patients, ILT2-positive CD56dim NK cells were increased in cancerous IHLs compared with non-cancerous IHLs and PBMCs. We examined the impact of macrophage migration inhibitory factor (MIF) on ILT2 expression in co-cultures of HCC cells and NK cells. The enhanced expression of ILT2 on CD56dim NK cells from HCC patients was inhibited by masking antibodies against MIF and CXCR4. ILT2-positive CD56dim NK cells exhibited lower capacities for cytotoxicity and ADCC than ILT2-negative cells, which were partially restored by ILT2 blockade.

Conclusions

In HCC patients, ILT2 is a signature molecule for cancerous CD56dim NK cells with impaired cytolytic capacity. The MIF-CXCR4 interaction is associated with ILT2 induction on CD56dim NK cells and ILT2 serves as a target for functional NK cell restoration.
Indices and methods for evaluating gross ecosystem product in sea areas: a case study in Changdao County, China
Authors: Li Wenwen , He Shuai , Chen Erwen , Xia Tao , Jin Yuemei , Tang Boping , Chen Shang
Published: April 2024

Introduction

Coastal nations heavily rely on their sea areas to achieve sustainable socioeconomic development. Sea areas offer abundant marine ecosystem products and services that are difficult to substitute with industrial goods. Although considerable research has been performed to evaluate the contribution offrom the marine ecosystems to human well-being, systematic and measurable indices are lacking.

Methods

To address this knowledge gap, ecosystem service theory was used to establish a framework for assessing the gross ecosystem product (GEP) of a sea area, which represents the total monetary value of final ecosystem products directly and indirectly used by people within a specific administrative jurisdiction in one year. To evaluate marine GEP, three primary indices, i.e., material products, regulating products, and cultural products, were employed, and they consist of eight secondary indices. Material products in the sea area include aquatic products and oxygen products; regulating products include carbon sequestration, climate regulation, waste treatment, and coastal protection; and cultural products include leisure and recreation, and seascape-added value. The marine GEP was calculated for the administrative sea areas of Changdao County, which is located in the Yellow Sea-Bohai Sea transitional zone.

Results and discussion

Our analysis indicated that from 2017 to 2019, the marine GEP in Changdao ranged between 32.59 and 33.35 billion Chinese yuan (CNY). Regulating products contributed two-thirds of this total value. However, over the three-year period, the marine GEP underwent a 5.64% decrease in Changdao. Specifically, the value of material products increased by 38.85% while that of regulating and cultural products decreased by 9.16% and 15.87%, respectively. Notably, the spatial distribution of ecosystem product values in Changdao displayed two prominent trends: (1) higher values along the coastal sea areas of islands and lower values in offshore sea areas; and (2) higher values in coastal areas of southern islands and lower values in coastal areas of northern islands. Marine GEP may serve as a comprehensive indicator for assessing the sustainability of marine ecosystem. Combining the assessment of both marine and terrestrial GEP facilitates an understanding of how marine and terrestrial ecosystems interact in coastal regions. Furthermore, the combined use of marine GEP and GDP helps better evaluate and sort the level of green development of coastal nations and regions.
The overlap rate influences the microstructure and properties of laser-cladded Fe-Ni-Ti composite coatings
Authors: Wang Zhen , Qi Changbao , Zhang Fengqin
Published: April 2024

The overlap rate has a significant impact on the quality and performance of laser cladding coatings. In order to prepare high wear-resistant laser cladding coatings. Single and multi-pass Fe-Ni-Ti composite coatings were prepared on the surface of 45 steel using a semiconductor laser. The microstructure and phase composition of the fusion layers were analyzed using metallographic microscopy, XRD diffraction, scanning electron microscopy, and energy dispersive spectrometry. Friction coefficients and microhardness of fusion layers with different overlap ratios were tested using a multifunctional surface performance tester and a microhardness tester. The wear performance of coatings with different overlap ratios was tested using a wear testing machine.The results indicate that when 6% Ti was simultaneously added to the Invar alloy matrix during the laser fusion of Fe-Ni-Ti alloy coatings, the phase composition of the fusion layer mainly consists of γ-[Fe, Ni] austenite, Fe3Ni2, α-Fe, and other metallic compounds. Simultaneously, in-situ formation of TiC reinforcement is dispersed in the matrix of γ-[Fe, Ni] solid solution. When the overlap ratio is 46%, the fusion layer exhibits a uniform, dense structure with fewer defects and higher coating hardness, resulting in improved wear resistance. At this point, the microhardness of the fusion layer is 450 HV, 1.5 times that of the substrate material and 2.2 times that of the base material. The friction coefficient on the coating surface is 0.412, with a percentage weight loss of 0.17%. The wear theory of the cladding layer is mainly adhesive wear, which also includes abrasive wear.
Design and evaluation of a web-based electronic health record for amblyopia
Authors: Naemi Roya , Akbarian Mina , Ebrahimi Maryam , Shahmoradi Leila , Masoomian Babak , Rezayi Sorayya
Published: April 2024

Introduction

Amblyopia, or lazy eye, is a type of visual impairment in which the eyesight is not complete, even with the use of glasses. For the treatment of this disease, accurate and continuous examinations are needed. Nowadays, patient-centered care, by relying on web-based electronic records for amblyopia, has the potential to reduce treatment costs, increase the quality of care, and improve the safety and effectiveness of treatment. Therefore, the purpose of this study is to design and evaluate an Electronic Health Record (EHR) for patients with amblyopia.

Methods

The present study is applied developmental research. Using a Morgan table as a sampling tool, a straightforward random sampling technique selected 150 records from 1,500 records that were free of flaws. The design of the electronic version proceeded in a cascading manner so that after the design of each part, it was presented to the amblyopia experts, and if approved, the next part was designed. To design this EHR, the C# programming language and MySQL database were used. A system evaluation was performed by entering and recording patient information. For this purpose, the standard Questionnaire of User Interaction Satisfaction (QUIS), consisting of 18 questions, was used.

Results

According to the amblyopia EHR data elements, the data of physician and patient, examinations, website members, and members’ roles were determined. After defining the fields and classes that explain the tables, the EHR was designed. The usability evaluation of the system showed that the mean selection of very good and good options by the users of EHRs was over 90%, indicating the patients’ acceptance of web-based EHRs.

Conclusion

The design of an EHR for amblyopia is an effective step toward integrating and improving the information management of these patients. It will also enable the storage and retrieval of patients’ information to reduce and facilitate the control of amblyopia complications.
Graphene growth from photo-polymerized bi-phenylthiol self-assembled monolayers
Authors: Zehra Tashfeen , Syari’ati Ali , Ivashenko Oleksii , Bignardi Luca , Van Dorp Willem F. , De Hosson Jeff T. M. , Rudolf Petra
Published: April 2024

We present an enhanced methodology for the synthesis of graphene, from photo-polymerized self-assembled monolayers (SAMs) of 1,1ʹ-biphenyl-4-thiol on both electropolished and oxidized copper substrates. The SAMs were subjected to a two-step process involving light-induced polymerization followed by annealing in a vacuum furnace to yield the two-dimensional solid. Comprehensive characterization using contact angle measurements, X-ray photoelectron spectroscopy, and Raman spectroscopy, as well as scanning electron and transmission electron microscopy, provided conclusive evidence of growth of single-layer graphene. Notably, our findings revealed superior quality graphene on oxidized copper substrates compared to their electropolished counterparts, highlighting the impact of substrate choice on the quality of the resultant material.
Designing for usability: development and evaluation of a portable minimally-actuated haptic hand and forearm trainer for unsupervised stroke rehabilitation
Authors: Rätz Raphael , Ratschat Alexandre L. , Cividanes-Garcia Nerea , Ribbers Gerard M. , Marchal-Crespo Laura
Published: April 2024

In stroke rehabilitation, simple robotic devices hold the potential to increase the training dosage in group therapies and to enable continued therapy at home after hospital discharge. However, we identified a lack of portable and cost-effective devices that not only focus on improving motor functions but also address sensory deficits. Thus, we designed a minimally-actuated hand training device that incorporates active grasping movements and passive pronosupination, complemented by a rehabilitative game with meaningful haptic feedback. Following a human-centered design approach, we conducted a usability study with 13 healthy participants, including three therapists. In a simulated unsupervised environment, the naive participants had to set up and use the device based on written instructions. Our mixed-methods approach included quantitative data from performance metrics, standardized questionnaires, and eye tracking, alongside qualitative feedback from semi-structured interviews. The study results highlighted the device's overall ease of setup and use, as well as its realistic haptic feedback. The eye-tracking analysis further suggested that participants felt safe during usage. Moreover, the study provided crucial insights for future improvements such as a more intuitive and comfortable wrist fixation, more natural pronosupination movements, and easier-to-follow instructions. Our research underscores the importance of continuous testing in the development process and offers significant contributions to the design of user-friendly, unsupervised neurorehabilitation technologies to improve sensorimotor stroke rehabilitation.
Increased cardiovascular risk in epilepsy
Authors: Gaertner Mark L. , Mintzer Scott , DeGiorgio Christopher M.
Published: April 2024

Epilepsy is associated with increased mortality. Cardiovascular disease confers a significant portion of this increased risk. Recently there is increased interest in the burden of cardiovascular mortality in people with epilepsy. This review discusses the most common cardiovascular risk factors and their association with epilepsy including obesity, diabetes mellitus, and hyperlipidemia. Hyperlipidemia related to the use of enzyme inducing anti-seizure medications is also discussed as a topic that is of particular importance to prescribers that have patients with comorbid cardiovascular risk and epilepsy. Heart rate variability (HRV) and its association with SUDEP is discussed as well as a contributor to vascular risk. Finally, the authors discuss a potential role for neurologists who treat epilepsy to engage closer with their patient's cardiovascular risk factors using available tools such as a the ASCVD score calculator to determine the overall risk of mortality, as well as acting upon this information to guide treatment approaches integrating the information provided in this review.
Comparison of muscle activity of the lower limbs while running on different treadmill models
Authors: Kaltenbach Christina , Gollhofer Albert , Nigg Benno M. , Asmussen Michael J.
Published: April 2024

Treadmill running is a common method of exercise and to study human locomotion. Research has examined the kinematics and kinetics of overground and treadmill running, but there has been less focus on the levels of muscle activity during treadmill running. We investigated if muscle activity is different while running overground compared to running on a variety of treadmills. A total of 11 healthy individuals ran at 3 speeds (2.6, 3.6, 4.5 m/s) under 4 different running conditions (3 treadmills, overground). The three treadmills included a typical home exercise treadmill, a midsize commercial research treadmill, and a large, instrumented research treadmill. Surface EMG of the tibialis anterior (TA), gastrocnemius medialis (GM), rectus femoris (RF) and biceps femoris (BF) muscles were measured for each running condition. The integrated EMG was computed for each running condition for the stance and swing phase, as well as 100 ms before and after the heel-strike. Friedman analysis revealed significant effects during the stance phase for GM and RF at all speeds, such that muscle activation was lower on the treadmills relative to overground. During the stance phase at faster speeds, the muscle activity was higher for the TA and lower for the BF while running on the different treadmills compared to overground running. Before heel-strike, the TA was significantly less active during treadmill compared to overground running at 2.6 m/s and the RF showed significantly higher activity at 3.6 m/s and 4.5 m/s while running on the different treadmills. Summarizing, differences were mainly observed between the different treadmill conditions relative to overground running. Muscle activation differences between the different treadmill conditions were observed at faster running speeds for RF during the pre-heel-strike phase only. Different types of treadmills with different mechanical properties affects the muscle activity during stance phase as well as in preparation to heel-strike. Additionally, the muscle activity is greater during overground compared to treadmill running during the stance phase for the GM, BF, and RF.
Interoceptive posture awareness and accuracy: a novel photographic strategy towards making posture actionable
Authors: Weiniger Steven P. , Schilaty Nathan D.
Published: April 2024

Interoception, sometimes referred to as the ‘hidden sense,’ communicates the state of internal conditions for autonomic energy regulation and is important for human motor control as well as self-awareness. The insula, the cortex of interoception, integrates internal senses such as hunger, thirst and emotions. With input from the cerebellum and proprioceptive inputs, it creates a vast sensorimotor network essential for static posture and dynamic movement. With humans being bipedal to allow for improved mobility and energy utilization, greater neuromotor control is required to effectively stabilize and control the four postural zones of mass (i.e., head, torso, pelvis, and lower extremities) over the base of support. In a dynamic state, this neuromotor control that maintains verticality is critical, challenging energy management for somatic motor control as well as visceral and autonomic functions. In this perspective article, the authors promote a simple series of posture photographs to allow one to integrate more accurate alignment of their postural zones of mass with respect to the gravity line by correlating cortical interoception with cognitive feedback. Doing this focuses one on their body perception in space compared to the objective images. Strengthening interoceptive postural awareness can shift the net result of each zone of postural mass during day-to-day movement towards stronger posture biomechanics and can serve as an individualized strategy to optimize function, longevity, and rehabilitation.
Scan-associated anxiety (scanxiety): the enigma of emotional breathing oscillations at 0.32 Hz (19 bpm)
Authors: Pfurtscheller Gert , Rassler Beate , Schwarz Gerhard , Klimesch Wolfgang
Published: April 2024

MRI-related anxiety in healthy participants is often characterized by a dominant breathing frequency at around 0.32 Hz (19 breaths per minute, bpm) at the beginning but in a few cases also at the end of scanning. Breathing waves at 19 bpm are also observed in patients with anxiety independently of the scanned body part. In patients with medically intractable epilepsy and intracranial electroencephalography (iEEG), spontaneous breathing through the nose varied between 0.24 and 0.37 Hz (~19 bpm). Remarkable is the similarity of the observed breathing rates at around 0.32 Hz during different types of anxiety states (e.g., epilepsy, cancer, claustrophobia) with the preferred breathing frequency of 0.32 Hz (19 bpm), which is predicted by the binary hierarchy model of Klimesch. This elevated breathing frequency most likely reflects an emotional processing state, in which energy demands are minimized due to a harmonic coupling ratio with other brain–body oscillations.
Full-body pose reconstruction and correction in virtual reality for rehabilitation training
Authors: Dai Xiaokun , Zhang Zhen , Zhao Shuting , Liu Xueli , Chen Xinrong
Published: April 2024

Existing statistical data indicates that an increasing number of people now require rehabilitation to restore compromised physical mobility. During the rehabilitation process, physical therapists evaluate and guide the movements of patients, aiding them in a more effective recovery of rehabilitation and preventing secondary injuries. However, the immutability of mobility and the expensive price of rehabilitation training hinder some patients from timely access to rehabilitation. Utilizing virtual reality for rehabilitation training might offer a potential alleviation to these issues. However, prevalent pose reconstruction algorithms in rehabilitation primarily rely on images, limiting their applicability to virtual reality. Furthermore, existing pose evaluation and correction methods in the field of rehabilitation focus on providing clinical metrics for doctors, and failed to offer patients efficient movement guidance. In this paper, a virtual reality-based rehabilitation training method is proposed. The sparse motion signals from virtual reality devices, specifically head-mounted displays hand controllers, is used to reconstruct full body poses. Subsequently, the reconstructed poses and the standard poses are fed into a natural language processing model, which contrasts the difference between the two poses and provides effective pose correction guidance in the form of natural language. Quantitative and qualitative results indicate that the proposed method can accurately reconstruct full body poses from sparse motion signals in real-time. By referencing standard poses, the model generates professional motion correction guidance text. This approach facilitates virtual reality-based rehabilitation training, reducing the cost of rehabilitation training and enhancing the efficiency of self-rehabilitation training.
Association between the relative abundance of phyla actinobacteria, vitamin C consumption, and DNA methylation of genes linked to immune response pathways
Authors: Noronha Natália Yumi , Noma Isabella Harumi Yonehara , Fernandes Ferreira Rafael , Rodrigues Guilherme da Silva , Martins Luzania dos Santos , Watanabe Lígia Moriguchi , Pinhel Marcela Augusta de Souza , Mello Schineider Isabelle , Diani Luísa Maria , Carlos Daniela , Nonino Carla Barbosa
Published: April 2024

Introduction

There is an emerging body of evidence that vitamin C consumption can modulate microbiota abundance and can also impact DNA methylation in the host, and this could be a link between diet, microbiota, and immune response. The objective of this study was to evaluate common CpG sites associated with both vitamin C and microbiota phyla abundance.

Methods

Six healthy women participated in this cohort study. They were divided into two groups, according to the amount of vitamin C they ingested. Ingestion was evaluated using the 24-h recall method. The Illumina 450 k BeadChip was used to evaluate DNA methylation. Singular value decomposition analyses were used to evaluate the principal components of this dataset. Associations were evaluated using the differentially methylated position function from the Champ package for R Studio.

Results and discussion

The group with higher vitamin C (HVC) ingestion also had a higher relative abundance of Actinobacteria. There was a positive correlation between those variables (r = 0.84, p = 0.01). The HVC group also had higher granulocytes, and regarding DNA methylation, there were 207 CpG sites commonly related to vitamin C ingestion and the relative abundance of Actinobacteria. From these sites, there were 13 sites hypomethylated and 103 hypermethylated. The hypomethylated targets involved the respective processes: immune function, glucose homeostasis, and general cellular metabolism. The hypermethylated sites were also enriched in immune function-related processes, and interestingly, more immune responses against pathogens were detected. These findings contribute to understanding the interaction between nutrients, microbiota, DNA methylation, and the immune response.
Case report: Envafolimab combined with Endostar in the treatment of advanced non-small cell lung cancer with malignant pleural effusion
Authors: Dong Changhong , Hu Chenxi , Jiang Yanting , Hui Kaiyuan , Jiang Xiaodong
Published: April 2024

Malignant pleural effusion (MPE) is one of the common complications of lung cancer. The quality of life and prognoses for MPE patients are significantly compromised. Controlling the production of MPE can relieve patients’ symptoms, improve their quality of life, and prolong their survival. This article presents a case of advanced non-small cell lung cancer (NSCLC) with MPE and negative driver genes. The patient received envafolimab and Endostar in combination, resulting in a complete reduction of MPE and durable clinical benefits. The exploratory use of this treatment method improved the quality of life of this patient and has the potential to prolong the survival of this patient.
Impact of pharmaceutical validation on prescribing errors in a neonatal intensive care unit. Randomised and controlled study
Authors: Canales-Siguero M. D. , García-Muñoz C. , Caro-Teller J. M. , Piris-Borregas S. , Martín-Aragón S. , Ferrari-Piquero J. M. , Moral-Pumarega M. T. , Pallás-Alonso C. R.
Published: April 2024

Purpose

To compare the frequency of electronic prescription errors when the prescription was validated by the clinical pharmacist vs. when it was not.

Methods

This prospective randomised controlled study was conducted in three phases. A randomised phase, in which patients were divided into control and intervention groups, and a pre- and post-intervention phase were consecutively performed to analyse the impact of pharmaceutical validation of prescriptions in a neonatal intensive care unit (NICU). This study was performed at a highly complex NICU at a tertiary hospital. All patients born during the study period who were admitted to the NICU, with a stay lasting ≥24 h, and received active pharmacological treatment were included in the study. Pharmaceutical validation was performed according to the paediatric pharmaceutical care model. A high level of validation was selected for this study. In the intervention group, discrepancies found during the review process were communicated to the medical team responsible for the patients and resolved on the same day.

Results

In total, 240 patients were included in this study. Sixty-two patients were allocated to the pre-intervention (n = 38) or post-intervention (n = 24) groups, and 178 patients were randomly sorted into two groups, control (n = 82 newborns) and intervention (n = 96 newborns). During the randomisation phase, the number of prescription errors detected was significantly lower in the intervention group than that in the control group (129 vs. 270; p < 0.001). Similarly, prescription errors reaching the patient were significantly reduced from 40% (n = 108) in the control group to 1.6% (n = 2) in the intervention group. In the pre- and post-intervention periods, the prescription lines containing prescription errors decreased from 3.4% to 1.5% (p = 0.005).

Conclusions

This study showed that the pharmaceutical validation process decreased both the number of errors in the electronic prescribing tools and the number of prescription errors reaching the patient.
Evaluation of cardiac pro-arrhythmic risks using the artificial neural network with ToR–ORd in silico model output
Authors: Mahardika T Nurul Qashri , Qauli Ali Ikhsanul , Marcellinus Aroli , Lim Ki Moo
Published: April 2024

Torsades de pointes (TdP) is a type of ventricular arrhythmia that can lead to sudden cardiac death. Drug-induced TdP has been an important concern for researchers and international regulatory boards. The Comprehensive in vitro Proarrhythmia Assay (CiPA) initiative was proposed that integrates in vitro testing and computational models of cardiac ion channels and human cardiomyocyte cells to evaluate the proarrhythmic risk of drugs. The TdP risk classification performance using only a single TdP metric may require some improvements because of information limitations and the instability of generalizing results. This study evaluates the performance of TdP metrics from the in silico simulations of the Tomek–O'Hara Rudy (ToR–ORd) ventricular cell model for classifying the TdP risk of drugs. We utilized these metrics as an input to an artificial neural network (ANN)-based classifier. The ANN model was optimized through hyperparameter tuning using the grid search (GS) method to find the optimal model. The study outcomes show an area under the curve (AUC) value of 0.979 for the high-risk category, 0.791 for the intermediate-risk category, and 0.937 for the low-risk category. Therefore, this study successfully demonstrates the capability of the ToR–ORd ventricular cell model in classifying the TdP risk into three risk categories, providing new insights into TdP risk prediction methods.
Current views of drought research: experimental methods, adaptation mechanisms and regulatory strategies
Authors: Wang Xiyue , Li Xiaomei , Zhao Wei , Hou Xiaomin , Dong Shoukun
Published: April 2024

Drought stress is one of the most important abiotic stresses which causes many yield losses every year. This paper presents a comprehensive review of recent advances in international drought research. First, the main types of drought stress and the commonly used drought stress methods in the current experiment were introduced, and the advantages and disadvantages of each method were evaluated. Second, the response of plants to drought stress was reviewed from the aspects of morphology, physiology, biochemistry and molecular progression. Then, the potential methods to improve drought resistance and recent emerging technologies were introduced. Finally, the current research dilemma and future development direction were summarized. In summary, this review provides insights into drought stress research from different perspectives and provides a theoretical reference for scholars engaged in and about to engage in drought research.