bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical implications of DNA methylation-based integrated classification of histologically defined grade 2 meningiomas
Authors: Ehret Felix , Perez Eilís , Teichmann Daniel , Meier Sandra , Geiler Carola , Zeus Cosmas , Franke Helene , Roohani Siyer , Wasilewski David , Onken Julia , Vajkoczy Peter , Schweizer Leonille , Kaul David , Capper David 
Published: May 2024

AbstractThe combination of DNA methylation analysis with histopathological and genetic features allows for a more accurate risk stratification and classification of meningiomas. Nevertheless, the implications of this classification for patients with grade 2 meningiomas, a particularly heterogeneous tumor entity, are only partially understood. We correlate the outcomes of histopathologically confirmed grade 2 meningioma with an integrated molecular-morphologic risk stratification and determine its clinical implications. Grade 2 meningioma patients treated at our institution were re-classified using an integrated risk stratification involving DNA methylation array-based data, copy number assessment and TERT promoter mutation analyses. Grade 2 meningioma cases according to the WHO 2021 criteria treated between 2007 and 2021 (n = 100) were retrospectively analyzed. The median clinical and radiographic follow-up periods were 59.8 and 54.4 months. A total of 38 recurrences and 17 deaths were observed. The local control rates of the entire cohort after 2-, 4-, and 6-years were 84.3%, 68.5%, and 50.8%, with a median local control time of 77.2 months. The distribution of the integrated risk groups were as follows: 31 low, 54 intermediate, and 15 high risk cases. In the multivariable Cox regression analysis, integrated risk groups were significantly associated with the risk of local recurrence (hazard ratio (HR) intermediate: 9.91, HR high-risk: 7.29, p < 0.01). Gross total resections decreased the risk of local tumor progression (HR gross total resection: 0.19, p < 0.01). The comparison of 1p status and integrated risk groups (low vs. intermediate/high) revealed nearly identical local control rates within their respective subgroups. In summary, only around 50% of WHO 2021 grade 2 meningiomas have an intermediate risk profile. Integrated molecular risk stratification is crucial to guide the management of patients with grade 2 tumors and should be routinely applied to avoid over- and undertreatment, especially concerning the use of adjuvant radiotherapy.
Successful treatment for pseudoaneurysm following distal pancreatectomy with celiac axis resection without postoperative pancreatic fistula: a case report
Authors: Fukuda Kaito , Koyama Ken , Kyoden Yusuke 
Published: May 2024

Abstract
Background
Distal pancreatectomy with celiac axis resection (DP–CAR) represents an innovative surgical approach for locally advanced pancreatic body cancer in cases involving celiac axis invasion. However, this procedure carries significant perioperative risks, including arterial aneurysms and organ ischemia. Understanding these risks is crucial for optimizing patient outcomes and guiding treatment decisions.

Case presentation
This case report describes a unique case of a 74-year-old male patient who was diagnosed with locally advanced pancreatic body cancer with invasion of the celiac and splenic arteries. He underwent DP–CAR after six cycles of chemotherapy. His postoperative course was uneventful without any evidence of postoperative pancreatic fistula. However, at the 10-month postoperative follow-up, pseudoaneurysm was incidentally detected in the anterior superior pancreaticoduodenal artery by follow-up computed tomography. It was successfully treated with coil embolization. He had no signs of tumor recurrence or relapse of pseudoaneurysm formation 2 years postoperatively. This case report discusses the potential risks of pseudoaneurysm formation in patients undergoing DP–CAR due to hemodynamic changes. We emphasize the significance of close monitoring in such cases.

Conclusions
The case highlights the importance of recognizing and managing potential complications associated with DP–CAR in patients with pancreatic cancer. Despite its effectiveness in achieving complete resection, DP–CAR carries inherent risks, including the development of pseudoaneurysms. Vigilant surveillance and prompt intervention are crucial for optimizing patient outcomes and minimizing postoperative complications.
Promotion of practical technology of the thermal management system for cylindrical power battery
Authors: Li Ge 
Published: May 2024

AbstractAmidst the industrial transformation and upgrade, the new energy vehicle industry is at a crucial juncture. Power batteries, a vital component of new energy vehicles, are currently at the forefront of industry competition with a focus on technological innovation and performance enhancement. The operational temperature of a battery significantly impacts its efficiency, making the design of a reliable Thermal Management System (TMS) essential to ensure battery safety and stability. Cylindrical power batteries are widely utilized in the industry. This article outlines the four main structures and their drawbacks of TMS for cylindrical power batteries. Among these structures, air cooling falls short in meeting high heat dissipation requirements. Liquid cooling is expensive, intricate, and adds considerable weight. Phase Change Materials (PCM) are not yet prevalent in practical applications. Similarly, heat pipes are relatively uncommon in large high-power battery packs. To better align with the new energy vehicle industry’s demands for top-notch performance, cost-effectiveness, eco-friendliness, and reliability, this paper strongly recommends delving deeper into composite cooling solutions. The construction of an economically viable and fully optimized composite cooling method is poised to become a significant scientific challenge for future research endeavors.
CYP19A1 Expression Is Controlled by mRNA Stability of the Upstream Transcription Factor AP-2γ in Placental JEG3 Cells
Authors: Kotomura Naoe , Shimono Yohei , Ishihara Satoru 
Published: May 2024

Abstract
CYP19A1 encodes aromatase, which converts testosterone to estrogen, and is induced during placental maturation. To elucidate the molecular mechanism underlying this function, histone methylation was analyzed using the placental cytotrophoblast cell line, JEG3. Treatment of JEG3 cells with 3-deazaneplanocin A, an inhibitor of several methyltransferases, resulted in increased CYP19A1 expression, accompanied by removal of the repressive mark H3K27me3 from the CYP19A1 promoter. However, this increase was not observed in cells treated with GSK126, another specific inhibitor for H3K27me3 methylation. Expression of TFAP2C, which encodes AP-2γ, a transcription factor that regulates CYP19A1, was also elevated on 3-deazaneplanocin A treatment. Interestingly, TFAP2C messenger RNA (mRNA) was readily degraded in JEG3 cells but protected from degradation in the presence of 3-deazaneplanocin A. TFAP2C mRNA contained N6-methyladenosines, which were reduced on drug treatment. These observations indicate that the TFAP2C mRNA undergoes adenosine methylation and rapid degradation, whereas 3-deazaneplanocin A suppresses methylation, resulting in an increase in AP-2γ levels. We conclude that the increase in AP-2γ expression via stabilization of the TFAP2C mRNA is likely to underlie the increased CYP19A1 expression.
Operative Nuances of Capsular Dissection Techniques and Capsule Morphology in Pituitary Adenomas: Past 1-Year Case Experiences of a Tertiary Center
Authors: Yilmaz Eren , Uzuner Ayse , Ceylan Ecem Cemre , Yildirim Pinar , Duman Ozturk Seda , Emengen Atakan , Gokbel Aykut , Caklili Melih , Cabuk Burak , Anik Ihsan , Ceylan Savas 
Published: May 2024

BACKGROUND AND OBJECTIVES:
The widespread use of endoscope and increased surgical experiences in pituitary adenomas (PAs) has raised the expectations for higher resection and cure rates. The subject that will meet this expectation in all types of adenomas is the capsule and its dissection. The purpose of this study was to go beyond the commonly mentioned pseudocapsule definition for small-sized adenomas in previous studies and to describe the capsule structure in different morphologies present in pituitary adenomas of all sizes. This includes detailing the nuances of capsular dissection (CD) and presenting postoperative surgical outcomes through the experiences of a high-volume tertiary center.

METHODS:
In our center, 534 patients underwent endoscopic trans-sphenoidal surgery because of pituitary adenoma in 2022 by the same surgeon. The data of the patients were examined retrospectively. The surgical techniques applied were grouped as adenoma resection only, capsular resection after internal debulking, and direct extracapsular resection.

RESULTS:
CD was performed in 275 (51.5%) patients. The gross total resection (GTR) rate in nonsecretory adenomas with and without CD was 90.7% (97/107) and 90.7% (97/107), respectively. The remission rate in secretory adenomas with and without CD was 81.0% (136/168) and 44.0% (67/152), respectively. When the patients were examined in 2 groups as those who underwent CD and those who did not, the application of CD had a positive predictive value in terms of GTR/remission (P: .036). Capsule thickness was not found to be statistically significant depending on tumor subtype, size, and aggressiveness, but capsule thickness was statistically significant in terms of total capsular resection (P: .045).

CONCLUSION:
The morphology of the capsule, tumor size/subtype/consistency, and patient-specific factors are crucial for the selection of the surgical technique to be applied. It is possible to increase the GTR/remission rates in adenomas of all sizes by capsule dissection. Moreover, performing CD does not contribute significantly to the development of potential complications in such cases.
Learning Curve of Robotic End-to-Side Microanastomoses
Authors: Rabbin-Birnbaum Corinne , Wiggan Daniel D. , Sangwon Karl L. , Negash Bruck , Gutstadt Eleanor , Rutledge Caleb , Baranoski Jacob , Raz Eytan , Shapiro Maksim , Sharashidze Vera , Riina Howard A. , Nelson Peter Kim , Liu Albert , Choudhry Osamah , Nossek Erez 
Published: May 2024

BACKGROUND AND OBJECTIVES:
Robotics are becoming increasingly widespread within various neurosurgical subspecialties, but data pertaining to their feasibility in vascular neurosurgery are limited. We present our novel attempt to evaluate the learning curve of a robotic platform for microvascular anastomoses.

METHODS:
One hundred and sixty one sutures were performed and assessed. Fourteen anastomoses (10 robotic [MUSA-2 Microsurgical system; Microsure] and 4 hand-sewn) were performed by the senior author on 1.5-mm caliber tubes and recorded with the Kinevo 900 (Zeiss) operative microscope. We separately compared interrupted sutures (from needle insertion until third knot) and running sutures (from needle insertion until loop pull-down). Average suture timing across all groups was compared using an unpaired Student's t test. Exponential smoothing (α = 0.2) was then applied to the robotic data sets for validation and a second set of t tests were performed.

RESULTS:
We compared 107 robotic sutures with 54 hand-sewn sutures. There was a significant difference between the average time/stitch for the robotic running sutures (n = 55) and the hand-sewn running sutures (n = 31) (31.2 seconds vs 48.3 seconds, respectively; P-value = .00052). Exponential smoothing (α = 0.2) reinforced these results (37.6 seconds vs 48.3 seconds; P-value = .014625). Average robotic running times surpassed hand-sewn by the second anastomosis (38.8 seconds vs 48.3 seconds) and continued to steadily decrease with subsequent stitches. The average of the robotic interrupted sutures (n = 52) was significantly longer than the hand-sewn (n = 23) (171.3 seconds vs 70 seconds; P = .000024). Exponential smoothing (α = 0.2) yielded similar results (196.7 seconds vs 70 seconds; P = .00001). However, average robotic interrupted times significantly decreased from the first to the final anastomosis (286 seconds vs 105.2 seconds; P = .003674).

CONCLUSION:
Our results indicate the learning curve for robotic microanastomoses is short and encouraging. The use of robotics warrants further study for potential use in cerebrovascular bypass procedures.
ISOLATED ANKLE FUSION FOR FAILED TOTAL ANKLE ARTHROPLASTY USING A SPINE CAGE AND ANTERIOR PLATING CONSTRUCT
Authors: Miller D. , Senthi S. , Winson I. 
Published: May 2024

BackgroundTotal ankle replacements (TARs) are becoming increasingly more common in the treatment of end stage ankle arthritis. As a consequence, more patients are presenting with the complex situation of the failing TAR. The aim of this study was to present our case series of isolated ankle fusions post failed TAR using a spinal cage construct and anterior plating technique.MethodsA retrospective review of prospectively collected data was performed for 6 patients that had isolated ankle fusions performed for failed TAR. These were performed by a single surgeon (IW) between March 2012 and October 2014. The procedure was performed using a Spinal Cage construct and grafting in the joint defect and anterior plating. Our primary outcome measure was clinical and radiographic union at 1 year. Union was defined as clinical union and no evidence of radiographic hardware loosening or persistent joint lucent line at 1 year.ResultsThe mean follow-up was 37.3 months (SD 13.2). Union was achieved in 5 of the 6 patients (83%). One patient had a non-union that required revision fusion incorporating the talonavicular joint that successfully went on to unite across both joints. Another patient had radiographic features of non-union but was clinically united and asymptomatic and one required revision surgery for a bulky symptomatic lateral malleolus with fused ankle joint.ConclusionThe failing TAR presents a complex clinical situation. After removal of the implant there is often a large defect which if compressed leads to a leg length discrepancy and if filled with augment can increase the risk of non-union. Multiple methods have been described for revision, with many advocating fusion of both the ankle joint and subtalar joint. We present our case series using a spinal cage and anterior plating that allows preservation of the subtalar joint and a high rate of union.
ANKLE FRACTURE FIXATION IN THE OVER 60'S: FIBULAR-PRO-TIBIA VERSUS HINDFOOT NAILING
Authors: Eyre-Brook A. , Ring J. , Gadd R. , Davies H. , Chadwick C. , Davies M. , Blundell C. 
Published: May 2024

IntroductionAnkle fractures in the elderly are an increasing problem with our aging population. Options for treatment include non-operative and operative with a range of techniques available. Failure of treatment can lead to significant complications, morbidity and poor function. We compared the outcomes of two operative techniques, intramedullary hindfoot nailing (IMN) and fibular-pro-tibia fixation (FPT). This is the largest analysis of these techniques and there are no comparative studies published.MethodWe retrospectively reviewed patients over the age of 60 with ankle fractures who were treated operatively between 2012 and 2017. We identified 1417 cases, including 27 patients treated with IMN and 41 treated with FPT. Age, sex, co-morbidities and injury pattern were collected. Primary outcome was re-operation rate. Secondary outcomes included other complications, length of stay and functional status.ResultsThe IMN group had a higher average co-morbidity score compared with the FPT group (estimated 10-year survival, 21% vs 53%, p=0.03). Re-operation rate was higher in the IMN group compared with FPT (12 v 1, p< 0.0001). There were more complications in the IMN group compared with the FPT group (23 v 11, p< 0.0001). Length of stay was longer in the IMN group (17 v 29 days, p=0.02). Mobility tended to return to baseline in the FPT patients but decreased in the IMN patients.ConclusionOutcomes were worse in the IMN group compared with the FPT group in terms of re-operation, complications and length of stay. However, the IMN group tended to have increased comorbidities and poorer soft tissues. We believe that both techniques have a role in the management of elderly ankle fractures, but patient selection is key. We suggest FPT should be the first-choice technique when soft tissues permit. We discuss the indications, risks and benefits of each method based on our experience and literature review.
Enhanced terahertz vibrational absorption spectroscopy using an integrated high-Q resonator
Authors: Hou Zhibo , Chen Liao , Liu Rongwu , Zhang Chi , Wu Xiaojun , Zhang Xinliang 
Published: May 2024

The terahertz (THz) absorption spectrum is a powerful method to identify substances. The improvement focuses on sensitivity and recovery ability. Here, we demonstrate enhanced THz vibrational absorption spectroscopy based on an on-chip THz whispering gallery mode resonator (THz-WGMR). A THz-WGMR with high Q can store energy and enhance the interaction between the THz waves and the target substances to capture the unique absorption fingerprint information. Therefore, it possesses significant sensitivity to identify trace amounts of substances. As a proof of concept, lactose powder and glucose powder are applied to demonstrate the effectiveness of our approach in recovering fingerprint absorption spectroscopy. Compared with a straight waveguide, the high sensitivity of the THz-WGMR is illustrated. The change of the transmissivity caused by the lactose reaches 7.8 dB around 532 GHz for the THz-WGMR, while only 1.4 dB for the straight waveguide, demonstrating the state-of-the-art sensing performance in fingerprint absorption recovery. We believe the proposed integrated THz-WGMR will promote the THz identification of tiny fingerprint substances.
Phase-modulated multi-foci microscopy for rapid 3D imaging
Authors: Wang Weiqi , Gong Li , Huang Zhiwei 
Published: May 2024

3D imaging technology is pivotal in monitoring the functional dynamics and morphological alterations in living cells and tissues. However, conventional volumetric imaging associated with mechanical z-scanning encounters challenges in limited 3D imaging speed with inertial artifact. Here, we present a unique phase-modulated multi-foci microscopy (PM3) technique to achieve snapshot 3D imaging with the advantages of extended imaging depths and adjustable imaging intervals between each focus in a rapid fashion. To accomplish the tasks, we utilize a spatial light modulator (SLM) to encode the phases of the scattered or fluorescence light emanating from a volumetric sample and then project the multiple-depth images of the sample onto a single charge-coupled device camera for rapid 3D imaging. We demonstrate that the PM3 technique provides ∼55-fold improvement in imaging depth in polystyrene beads phantom compared to the depth of field of the objective lens used. PM3 also enables the real-time monitoring of Brownian motion of fluorescent beads in water at a 15 Hz volume rate. By precisely manipulating the phase of scattered light on the SLM, PM3 can pinpoint the specific depth information in living zebrafish and rapidly observe the 3D dynamic processes of blood flow in the zebrafish trunk. This work shows that the PM3 technique developed is robust and versatile for fast 3D dynamic imaging in biological and biomedical systems.
Unpacking the ‘black box’ of suicide: A latent class analysis predicting profiles of suicidal ideation in a longitudinal cohort of adolescent girls from India
Authors: Patel Anushka R. , Dixon Kelly E. , Nadkarni Abhijit 
Published: May 2024

IntroductionIndian women account for 37% of global suicide-related deaths. As suicide is a growing concern among adolescent girls, identifying the social determinants of suicide with this group targeted prevention. We selected social determinants that include intersectional identities and broader syndemics; we then used longitudinal data from a prospective cohort of adolescent girls from Northern India to classify them into unique profiles across multiple socioecological levels.MethodsGirls aged 10–19 (N= 11,864) completed self-report questionnaires measuring socio-demographic and trauma exposure variables. At three-year follow-up, they were asked to indicate current suicidal ideation (SI). We conducted latent class analysis (LCA) to classify profiles and then predicted risk of current SI at three-year follow-up.ResultsLCA supported a four-class solution: a ‘privileged’ class (Class 1;n= 1,470), a ‘modal’ class (Class 2;n= 7,449), an ‘intergenerational violence’ class (Class 3;n= 2,113), and a ‘psychological distress’ class (Class 4;n= 732). Classes significantly predicted odds ratios (OR) for SI at follow up; women in Class 4 were associated with the greatest likelihood of SI (OR 1.84, 95% CI 1.38, 2.47), suggesting that psychological distress factors confer greatest risk.ConclusionResults of the distinct classes of risk and protective factors indicate targets for policy-level interventions. Disrupting cycles of psychological distress and substance use, increasing access to behavioral interventions, and intervening to mitigate intergenerational violence may be particularly impactful with this population.
Variability in antivenom neutralization of Mexican viperid snake venoms
Authors: Guadarrama-Martínez Alid , Neri-Castro Edgar , Boyer Leslie , Alagón Alejandro 
Published: May 2024

Background
Each year, 3,800 cases of snakebite envenomation are reported in Mexico, resulting in 35 fatalities. The only scientifically validated treatment for snakebites in Mexico is the use of antivenoms. Currently, two antivenoms are available in the market, with one in the developmental phase. These antivenoms, produced in horses, consist of F(ab’)2 fragments generated using venoms from various species as immunogens. While previous studies primarily focused on neutralizing the venom of the Crotalus species, our study aims to assess the neutralization capacity of different antivenom batches against pit vipers from various genera in Mexico.

Methodology
We conducted various biological and biochemical tests to characterize the venoms. Additionally, we performed neutralization tests using all three antivenoms to evaluate their effectiveness against lethal activity and their ability to neutralize proteolytic and fibrinogenolytic activities.

Results
Our results reveal significant differences in protein content and neutralizing capacity among different antivenoms and even between different batches of the same product. Notably, the venom of Crotalus atrox is poorly neutralized by all evaluated batches despite being the primary cause of envenomation in the country’s northern region. Furthermore, even at the highest tested concentrations, no antivenom could neutralize the lethality of Metlapilcoatlus nummifer and Porthidium yucatanicum venoms. These findings highlight crucial areas for improving existing antivenoms and developing new products.

Conclusion
Our research reveals variations in protein content and neutralizing potency among antivenoms, emphasizing the need for consistency in venom characteristics as immunogens. While Birmex neutralizes more LD50 per vial, Antivipmyn excels in specific neutralization. The inability of antivenoms to neutralize certain venoms, especially M. nummifer and P. yucatanicum, highlights crucial improvement opportunities, given the medical significance of these species.