bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mapping Sources of Assisted Dying Regulation in Belgium: A Scoping Review of the Literature
Authors: Archer Madeleine , Willmott Lindy , Chambaere Kenneth , Deliens Luc , White Ben P 
Published: November 2023

Belgium has over 20 years of experience regulating assisted dying (AD). While much research considers this end-of-life practice, no studies have comprehensively analysed the various sources of regulation that govern it, including law, professional standards, and ethics. A scoping review identified all sources of regulation that guide AD practice, and their regulatory functions. Databases and reference lists were searched for records which met inclusion criteria between 11/2/22 and 25/3/22. Existing scholarship was used to identify sources of regulation, and thematically analyse their functions. Of the initial sample of 1364 records, 107 were included. Six sources of regulation were identified: law, policies, professional standards, training, advisory documents, and system design. Three regulatory functions were identified: prescribing conduct, scaffolding to support practice, and monitoring the system. The Belgian AD regulatory framework is multifaceted, complex, and fragmented. Providers must navigate and reconcile numerous sources of guidance providing this form of end-of-life care.
Culture expansion of primary human nasal epithelial cells (NEC) isolated with a nasal scraping spoon
Authors: Hangjin Li , Junting Yin , Yiqin Wang , Hui Qu , Shen Yu , Jizhe Wang 
Published: November 2023

Objective To obtain high-purity nasal epithelial cells (NEC) while avoiding the irritation experienced by patients during nasal biopsies. Methods This prospective, observational study enrolled patients undergoing surgical treatment for nasal septum deviation. After general anaesthesia, a novel nasal scraping spoon was used to collect epithelial cells from the mid-part of the inferior turbinate. The cells were evenly plated on six-well plates coated with rat tail collagen. The morphology and growth of the cells were observed at different time-points using an inverted phase-contrast microscope. Immunofluorescent staining of cytokeratin 18 was used to identify NEC. Ki67 staining was used to check cell viability. Results This study collected samples from 19 patients during a short procedure. No postoperative complications were observed. Cell samples ranging from 8.31 × 105 to 2.04 × 106 cells/sample were obtained. The culture model was suitable for primary NEC culture as demonstrated by the faster proliferation (5–7 days). There was no fungal or bacterial contamination. Immunofluorescent staining confirmed the presence and proliferative activity of NEC in the cultures. Conclusion A novel nasal scraping spoon provided an easy sampling method, avoided nasal injuries and psychological barriers to sampling and sufficient viable NEC to establish primary cultures.
In vitro culture of muscle cells derived from myofascial trigger points
Authors: Liu Lin , Huang Qiang-Min , Liu Qing-Guang 
Published: November 2023

Objective: To examine for the in vitro existence of contractile nodules on the taut band of muscle fibers where myofascial trigger points (MTrPs) are located (using cell culture). Methods: Sixteen male Sprague–Dawley rats (7 weeks old) were randomly divided into experimental and control groups. A blunt striking injury and eccentric exercise were applied to the gastrocnemius muscle of rats in the experimental group once a week for 8 weeks to establish an MTrP model. Subsequently, the rats were reared normally and rested for 4 weeks. After modeling, the skeletal muscles at the MTrPs (and non-MTrPs at the same anatomical position) were extracted from the two groups of rats for in vitro cell culture experiments of single muscle fibers. Potential contractile nodules in the MTrP group were exposed to different concentrations of acetylcholinesterase, whereas non-MTrP cells were exposed to acetylcholine. The morphological changes of muscle cells in each group were observed. Results: By culturing MTrP cells in vitro, large contractile nodules remained in single MTrP muscle fibers, whereas some contractile nodules were twisted and deformed. After the addition of different acetylcholinesterase concentrations, no obvious morphological changes were observed in the contractile nodules in the MTrP group. After the non-MTrP cells were exposed to different acetylcholine concentrations, no significant morphological changes were observed in the single muscle fibers. Conclusion: MTrP cells can continue to maintain contractile morphology in vitro, but whether the recovery of such contractile nodules is related to acetylcholine remains uncertain.
Reperfusion of retinal nonperfusion by neovascular-vascular anastomosis in proliferative diabetic retinopathy
Authors: Shiraki Akihiko , Tsuboi Kotaro , Wakabayashi Taku , Shiraki Nobuhiko , Nishida Kohji 
Published: November 2023

Background Retinal nonperfusion is a significant cause of vision loss in patients with proliferative diabetic retinopathy (PDR). Therefore, reperfusion of a nonperfusion has been a matter of strong interest, but few previous studies have demonstrated the potential benefits of reperfusion. Case reports Here, we report longitudinal optical coherence tomography angiographic analysis of two cases of PDR, in which the retinal neovascularization (RNV) that developed in response to retinal ischemia formed anastomoses with pre-existing physiological retinal vessels, resulting in both superficial and deep capillary reperfusion within the nonperfusion. We named this interesting finding “neovascular-vascular anastomosis.” Retinal reperfusion due to neovascular-vascular anastomosis differed from recanalization, defined as reperfusion of once-occluded blood vessels, and has not been reported previously. Conclusion Our observation highlights the potential of RNV to rescue retinal ischemia by the formation of neovascular-vascular anastomoses.
Spontaneous bilateral corneal perforation in ocular Rosacea
Authors: Pellegrini Francesco , Vincigiuerra Agatino , Maria Antonio De 
Published: November 2023

Purpose To report a rare case of a 19-year-old girl who presented with spontaneous bilateral corneal perforation in a setting of ocular rosacea Methods Ocular rosacea was diagnosed and treated with doxycycline. Cyanoacrylate glue was applied to treat corneal perforations. Results At six months follow up there is good healing, visual acuity has improved, anterior chamber is deep with no Seidel. Conclusions Rosacea is a multifactorial disease with an unclear pathophysiology. The ocular manifestations of rosacea (ocular rosacea) may occur without skin involvement, are not specific and can range from mild blepharitis to sight-threatening conditions. This case shows how ocular rosacea can lead to serious vision-threatening complications with mild symptoms. Cyanoacrylate glue and systemic antibiotic treatment are effective treatments.
A New Method for Common Femoral Arterial Access Using a Mixed Reality–Assisted Technique on a Phantom Model
Authors: Hatzl Johannes , Henning Daniel , Hartmann Niklas , Böckler Dittmar , Uhl Christian 
Published: November 2023

Purpose: The purpose of this study was to investigate the technical feasibility and usability of a mixed reality (MiR)-assisted common femoral arterial (CFA) access technique using a sonography-assisted registration method. Materials and Methods: A total of 60 CFA punctures were performed on a phantom model by 2 observers. Thirty punctures were performed using MiR (MiR group) and 30 punctures were performed using a conventional sonography-guided access procedure (control group). In the MiR group, a virtual object was created based on a computed tomography (CT) angiography scan of the model and registered to the physical patient in an MiR environment utilizing a software prototype that allowed registration based on a sonography scan. Positional error assessment encompassed 4 measurements using cone beam CT scans: (1) distance of the needle tip to the centerline, (2) distance of the needle entry site from the mid-level of the ostium of the profound femoral artery, (3) angle of entry of the needle in coronal, and (4) sagittal planes. Technical success rates as well as positional errors were compared between both groups. In addition, the usability of the system was assessed according to the system usability scale (SUS). Results: Technical success was 96.7% and 100% in the MiR and control groups, respectively. The median distance between the needle tip and the centerline was 3.0 (interquartile range [IQR]: 2.0–4.6) in the MiR group and 3.2 mm (IQR: 2.3–3.9) (p=0.63) in the control group. Similarly, the median distance from the needle entry site to the mid-level of the ostium of the profound femoral artery was 3.0 mm (IQR: 2.0–5.0) in the MiR group and 4.5 mm (IQR: 2.0–7.8) (p=0.18) in the control group. The median coronal angles of needle entry were 7.5° (IQR: 6–11) and 6° (IQR: 2–12) (p=0.13), and the median sagittal angles were 50° (IQR: 47–51) and 51° (IQR: 50–55) (p<0.01) in the MiR and control groups, respectively. The mean SUS score provided by both observers was 51.3. Conclusion: The feasibility of an MiR-assisted CFA access technique could be demonstrated on a phantom model. Further studies are needed to investigate the technique beyond phantom model experiments and in different anatomical settings. Clinical Impact This study demonstrates the technical feasibility of a Mixed-Reality-assisted common femoral arterial access procedure on a phantom model. The positional accuracy was comparable to a conventional sonography-guided technique. However, there are several limitations that need to be resolved prior to potential implementation into clinical practice. Further studies are needed to investigate its performance beyond phantom model experiments and the prototypical application requires further technical refinement to increase its usability.
Facial Lacerations Related to Recreational Activities: A National 10-Year Evaluation From US Emergency Departments
Authors: Hauc Sacha C. , Huelsboemer Lioba , Lewis Katelyn , Hosseini Helia , Williams Mica , Rivera Jean Carlo , Alperovich Michael 
Published: November 2023

Study Design This study serves as a nationally representative retrospective cohort of U.S emergency department visits related to facial lacerations caused by recreational activities. Objective The aim of this work is to offer a representative sample of facial laceration and identify the recreational activities associated with the highest risk of such injuries. Methods We conducted aretrospectivestudy of patients reported to the National Electronic Injury Surveillance System (NEISS) which collects information on injuries related to consumer products. Patients were included in our dataset from the time period of 2012 to 2021 if they sustained a facial laceration that was caused by a recreational activity. Results Our findings reveal 2,383,761 facial lacerations between the study period examined. Young male white adults were more likely to sustain a facial laceration related to recreational activities. Injuries related to exercise equipment were also more likely seen in male patients. The most common cause of facial lacerations was associated with bicycles and basketball. Conclusions This study found that young white adults are notably prone to facial lacerations, with recreational activities such as bicycling and basketball accounting for the majority of cases. Understanding these statistics is pivotal for implementing targeted strategies to prevent these injuries and their associated consequences.
Histopathological examination of characteristic brain MRI findings in acute hyperammonemic encephalopathy: A case report and review of the literature
Authors: Denk CH , Kunzmann J , Maieron A , Wöhrer A , Quinot V , Oberndorfer S 
Published: November 2023

Introduction Acute hyperammonemic encephalopathy is associated with distinct brain MRI findings, namely, hyperintensity in T2-weighted sequences as well as restricted diffusion in diffusion-weighted imaging with accentuation in the insular cortex and cingulate gyrus. The pathophysiology and the histopathological correlates of these characteristic MRI findings are largely unknown. Case report We present a 57-year-old male with a history of chronic alcohol abuse, liver cirrhosis and portal hypertension, and a clinical syndrome (variceal bleeding, depression of consciousness, seizures), elevated plasma ammonia levels, and characteristic brain MRI abnormalities suggestive of acute hyperammonemic encephalopathy. A postmortem histopathological examination revealed extensive hypoxic ischemic encephalopathy without evidence for metabolic encephalopathy. No episodes of prolonged cerebral hypoxemia were documented throughout the course of the disease. We conducted a review of the literature, which exhibited no reports of hyperammonemic encephalopathy in association with characteristic brain MRI findings and a consecutive histopathological examination. Conclusion This is the first report of a patient with acute hyperammonemic encephalopathy together with characteristic brain MRI findings and a histopathological correlation. Although characteristic MRI findings of acute hyperammonemic encephalopathy were present, a histopathological examination revealed only hypoxic pathology without signs of metabolic encephalopathy.
Serum α-Klotho level, lung function, airflow obstruction and inflammatory markers in US adults
Authors: Han Yueh-Ying , Celedón Juan C. , Forno Erick 
Published: November 2023

Backgroundα-Klotho is a pleiotropic protein that may have anti-oxidative and anti-inflammatory properties in the lung, but its role in airflow obstruction or lung function is largely unknown.MethodsThis was a cross-sectional study of 6046 adults aged 40–79 years in the US National Health and Nutrition Examination Survey (NHANES) 2007–2012. We used multivariable logistic or linear regression to examine the relation between serum α-Klotho level and airflow obstruction, defined as forced expiratory volume in 1 s (FEV1) <80% of predicted and FEV1/forced vital capacity (FVC) ratio <0.70; FEV1, FVC and FEV1/FVC as percentage of predicted; and inflammatory markers in blood (white blood cell count, eosinophils, neutrophils and C-reactive protein (CRP)).Resultsα-Klotho levels in the second to fourth quartiles (Q2–Q4) were associated with significantly decreased odds of airflow obstruction (adjusted OR for Q2–Q4versuslowest quartile (Q1) 0.54 (95% CI 0.35–0.81)) in never-smokers and ex-smokers with <10 pack-years of smoking, but not in current smokers or ex-smokers with ≥10 pack-years of smoking. In all participants, each unit increment in log10-transformed α-Klotho level was significantly associated with 5.0% higher FEV1% pred and 3.7% higher FVC % pred. Higher α-Klotho was also associated with lower eosinophils, neutrophils and CRP in participants both with and without airflow obstruction.ConclusionsHigher serum α-Klotho is associated with lower inflammatory markers and higher lung function in adults with and without airflow obstruction, and with decreased odds of airflow obstruction in never-smokers and ex-smokers with <10 pack-years of smoking. Further studies are warranted to replicate our findings and evaluate underlying mechanisms.
Evidence for a pre-Himalayan metamorphism in the High Himalayan Crystalline of the Miyar Valley (NW India)
Authors: Robyr Martin 
Published: November 2023

AbstractMost of the tectonic, metamorphic and geochronological data suggest that the Himalaya is essentially the consequence of a single orogenic cycle associated with the India-Asia collision during the Cenozoic era. Therefore, metamorphic assemblages and tectonic structures across the Himalayan range are systematically considered as post-collisional geological records. However, over the last decades, several observations arguing for geological events predating the continental collision have become increasingly recurrent in the literature. Nevertheless, although some of these arguments are thoroughly documented, they are unduly ignored in the construction of models drawing the tectono-metamorphic evolution of the Himalayan range. Yet, the occurrence of a pre-Himalayan history would have considerable consequences on the classical models for the building of the Himalaya. The recent discovery of inclusions of staurolite crystals in greenschist facies garnets from the Miyar Valley in Upper Lahul region (Himachal Pradesh; NW India) revives the debate on the existence of a pre-Himalayan metamorphism. Indeed, the occurrence of high-temperature staurolites included in greenschist facies garnets suggests that the High Himalayan Crystalline rocks experienced an amphibolite facies metamorphism prior the predominant Himalayan greenschist facies metamorphism observed in this part of the range. In this study, phase petrology, microtectonic investigations combined with preexisting geochronological data infer that the crystallization of the included staurolite predates the growth of Himalayan garnets. These original data bring new arguments to bear on the long lasting debate of the existence of a Pre-Himalayan orogenic cycle. They lead to the conclusion that the growth of staurolite predates the continental collision between India and Asia and reflects a metamorphic event that belongs to a pre-Himalaya orogenic cycle.
Heat-induced female biased sex ratio during development is not mitigated after prolonged thermal selection
Authors: Santos Marta A. , Antunes Marta A. , Grandela Afonso , Carromeu-Santos Ana , Quina Ana S. , Santos Mauro , Matos Margarida , Simões Pedro 
Published: November 2023

Abstract
Background
The negative impacts of climate change on biodiversity are consistently increasing. Developmental stages are particularly sensitive in many ectotherms. Moreover, sex-specific differences in how organisms cope with thermal stress can produce biased sex ratios upon emergence, with potentially major impacts on population persistence. This is an issue that needs investigation, particularly testing whether thermal selection can alleviate sex ratio distortions in the long-term is a critical but neglected issue. Here, we report an experiment analyzing the sex ratio patterns at different developmental temperatures in Drosophila subobscura populations subjected to long-term experimental evolution (~ 30 generations) under a warming environment.

Results
We show that exposure to high developmental temperatures consistently promotes sex ratio imbalance upon emergence, with a higher number of female than male offspring. Furthermore, we found that thermal selection resulting from evolution in a warming environment did not alleviate such sex ratio distortions generated by heat stress.

Conclusions
We demonstrate that heat stress during development can lead to clear sex ratio deviations upon emergence likely because of differential survival between sexes. In face of these findings, it is likely that sex ratio deviations of this sort occur in natural populations when facing environmental perturbation. The inability of many insects to avoid thermal shifts during their (more) sessile developmental stages makes this finding particularly troublesome for population subsistence in face of climate warming events.
Effects of bleeding of Actinidia arguta (Sieb. & Zucc) Planch. ex miq. on its plant growth, physiological characteristics and fruit quality
Authors: Jiang Yaxuan , Lei Pei , Ma Le , Dong Kun , Zhang Yu , Zhao Jia , Guo Xinyu , Liu Jianxin , Li Wei , Tao Lei , Meng Fanjuan 
Published: November 2023

AbstractBleeding is as particularly a serious phenomenon in Actinidia arguta and has important effects on this plant’s growth and development. Here we used A. arguta to study the effects of bleeding on the growth and development of leaves and fruits after a bleeding episode. We detect and analyze physiological indices of leaves and fruit after bleeding. The result revealed that the relative electrical conductivity and malondialdehyde (MDA) of leaves increased in treatment. Nitro blue tetrazolium chloride (NBT) and 3,3-diaminobenzidine (DAB) staining revealed the accumulation of reactive oxygen species (ROS) in leaves after bleeding. The chlorophyll content and photosynthetic parameter of plants were also decreased. In fruits, pulp and seed water content decreased after the damage, as did fruit vitamin C (Vc), soluble sugar content, and soluble solids content (SSC); the titratable acid content did not change significantly. We therefore conclude that bleeding affects the physiological indices of A. arguta. Our study provides a theoretical basis for understanding the physiological changes of A. arguta after bleeding episodes and laying a timely foundation for advancing research on A. arguta bleeding and long-term field studies should be executed in order to gain insights into underlying mechanisms.
Triglyceride glucose-waist circumference: the optimum index to screen nonalcoholic fatty liver disease in non-obese adults
Authors: Li Shuying , Feng Li , Ding Jie , Zhou Weihong , Yuan Tangbin , Mao Jiangfeng 
Published: November 2023

Abstract
Background
Non-alcoholic fatty liver disease (NAFLD) is easily neglected in the non-obese population. TyG index (triglyceride glucose Index) and TG/HDL-c (triglyceride to high-density lipoprotein cholesterol) are new indicators to evaluate insulin resistance (IR). Fibroscan is a non-invasive way to assess hepatic steatosis [by control attenuation parameters (CAP)] and fibrosis [by liver stiffness measurement (LSM)].The purpose of this study was to explore the correlation of TyG and its combination with obesity indicators [TyG-waist circumference (WC), TyG-body mass index (BMI)] and TG/HDL-c with CAP and LSM.

Method
One thousand seven hundred seventy-six adults (age ≥ 20 years, BMI < 30 kg/m2) in the National Health and Nutrition Examination Survey (NHANES) 2017–2018 were included. The correlations of CAP and LSM to the indexes were assessed by generalized linear models.. Receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic capability of the indicators on NAFLD and liver stiffness.

Results
Survey-weighted percentage of NAFLD in non-obese was 38.6%. In the fully adjusted models, there were positive associations of TyG, TyG-BMI, TyG-WC and TG/HDL-c to CAP, with the βs of 24.810, 0.704, 0.29 and 2.983 (all p < 0.05), respectively. There were positive associations of TyG, TyG-BMI, TyG-WC, and TG/HDL-c to NAFLD, with ORs of 3.387, 1.03, 1.010 and 1.281 ((all p < 0.05)).The positive association was detected for TG/HDL-c and TyG-WC and LSM with βs of 0.057 and 0.004(p = 0.021 and p = 0.003).TyG-WC were positively associated with liver stiffness with OR of 1.006(95%CI = 1.002, 1.012). Furthermore, the TyG-WC had the strongest diagnostic capability (ROC = 0.806; 95%CI: 0.785–0.826) on NAFLD in non-obese participants, with a specificity of 0.737 and sensitivity of 0.746.

Conclusion
In US non-obese population, the TyG, TyG-BMI, TyG-WC, and TG/HDL-c are positively correlated with CAP and NAFLD. TyG-WC has clinical importance in identifying NAFLD in the non-obese population.