bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of hybrid composite with natural fillers for mechanical property and machinability study
Authors: S P Jani , A Sujin Jose , C Rajaganapathy , M Adam Khan 
Published: June 2023

The urge to build a more environmentally friendly future has motivated researchers to examine composites outside of synthetic fiber and continue to consider natural fibre polymer composite. This present research, the hybrid bio composite was developed by bio fillers and natural fibres. The preliminary investigation was done to examine the possibility of using natural fillers (palm and coconut shell) in natural fibre (hemp and basalt) reinforced polymer (NFRP) composite for manufacturing application. In that way initially mechanical (tensile and flexural) properties testing were done on four different combinations of NFRP by using palm and coconut shell particles, to their influence on mechanical properties (tensile stress 278 MPa and flexural stress 330 MPa). It was found that 5% wt. palm + coco shell fillers combination hybrid composite presented good results in mechanical properties. Then 5% wt. palm + coco fillers was added in the matrix phase of NFRP composite was developed and study the machinability properties by using Abrasive Water Jet Machining (AWJM). NFRP machining in the relationships of material removal rate (MRR), kerf angle and surface roughness has been experimentally examined for various process parameters (nozzle pressure, distance stand and transverse speed). The research values for quality properties (MRR, Kt and Ra) were analysis-based on the trimming factors by developing the Taguchi method. The influence of optimized input process parameters on quality features were examined by utilizing experiential models. From this study, it is noticeable that, filler material in natural fiber composites reduces the kerf angle and the low and very high traverse speed leads the wide disparity in kerf inclination. For obtaining the good surface roughness and material removal rate medium traverse speed and medium stand of distance is the significant parameter respectively and moreover impact of jet pressure on surface finish is 3 times lower than the impact supplied to the surface finish by traverse speed
The Feasibility of Web-Based Working Memory Training in Patients With Cancer Attending Inpatient Rehabilitation
Authors: Engan Harald , Skanke Frode , Dahl Vegar , Eimhjellen Ryen Eli Astrid , Lindgren Kersti , Aasvik Julie , Sandmæl Jon Arne 
Published: June 2023

Introduction: Cognitive complaints are common late effects in patients with cancer, and no standard treatment exists. Recent studies with several patient populations have indicated that there is potential to improve working memory (WM) via web-based WM training. However, the feasibility of including web-based WM training as part of inpatient cancer rehabilitation, in combination with unprompted home-based training, has not been studied. The aim of this study was to assess the feasibility of including web-based WM training (using Cogmed QM) during inpatient rehabilitation and its subsequent unprompted completion in a home-based setting. Methods: Patients with cancer who self-reported cognitive complaints were instructed to complete 25 Cogmed QM sessions during their 3-week inpatient multidisciplinary cancer rehabilitation and subsequently at home after discharge from rehabilitation. The feasibility was determined by assessing the study recruitment, adherence to the WM training, improvements in training tasks (compliance measure) and patient experiences by individual interviews. Results: Twenty-nine (27 women) of 32 eligible patients (89.6%) started WM training, 1 declined participation and 2 patients withdrew before WM training started. Twenty-six of 29 (89.6%) participants adhered to the intervention during rehabilitation, while 19 of 29 (65.5%) also adhered to the subsequent unprompted home-based intervention. All participants who completed the Cogmed QM sessions demonstrated improvements in the training tasks, as defined by the Cogmed Improvement Index (MD = 24.05, SD = 9.38, range 2-44, P < .011). Interview data suggested that practical limitations, including a lack of time, technical difficulties, difficulties finding a suitable disturbance-free environment and low motivation were barriers to completing the training at home. Conclusion: The findings show that it is feasible to include web-based WM training during inpatient multidisciplinary rehabilitation for adult patients with cancer with cognitive complaints. However, patient adherence to unprompted web-based WM training after discharge from rehabilitation was not optimal. Thus, future studies should consider the barriers to adherence and the need for supervision and social support to reinforce home-based training.
The Role of Long-Term Physical Activity in Relation to Cancer-Related Health Outcomes: A 12-Month Follow-up of the Phys-Can RCT
Authors: Mazzoni Anne-Sophie , Helgesen Bjørke Ann Christin , Stenling Andreas , Börjeson Sussanne , Sjövall Katarina , Berntsen Sveinung , Demmelmaier Ingrid , Nordin Karin 
Published: June 2023

Purpose: While moderate-to-vigorous intensity physical activity (MVPA) is associated with various health improvements shortly after completion of exercise interventions, it remains unclear which health benefits can be expected when MVPA levels are maintained in the long term in cancer survivors. We aimed to assess the associations of (1) MVPA level at 12-month follow-up and (2) long-term MVPA patterns (from immediately post-intervention to 12-month follow-up) with different cancer-related health outcomes. Methods: In the Physical training and Cancer (Phys-Can) RCT, 577 participants diagnosed with breast (78%), prostate (19%), or colorectal (3%) cancer were randomized to 6 months of exercise during curative cancer treatment. Accelerometer-assessed physical activity and outcome data (ie, cancer-related fatigue, health-related quality of life [HRQoL], anxiety and depression, functioning in daily life, cardiorespiratory fitness, sedentary time and sleep) were collected immediately post-intervention and at 12-month follow-up. Based on the sample’s median of MVPA immediately post-intervention (65 minutes/day) and the changes between the 2 measurement points, 4 categories with different long-term MVPA patterns were created: High & Increasing, High & Decreasing, Low & Increasing, and Low & Decreasing. Multiple linear regression analyses were performed for the analyses. Results: A total of 353 participants were included in the analyses. At 12-month follow-up, a higher MVPA level was significantly associated with lower fatigue in 3 domains (general fatigue [β = −.33], physical fatigue [β = −.53] and reduced activity [β = −.37]), higher cardiorespiratory fitness (β = .34) and less sedentary time (β = −.35). For long-term MVPA patterns, compared to the participants in the “Low & Decreasing” category, those in the “High & Increasing” category reported significantly lower fatigue in 3 domains (general fatigue [β = −1.77], physical fatigue [β = −3.36] and reduced activity [β = −1.58]), higher HRQoL (β = 6.84) and had less sedentary time (β = −1.23). Conclusion: Our results suggest that long-term physical activity is essential for improving health outcomes post-intervention in cancer survivors. Cancer survivors, including those who reach recommended MVPA levels, should be encouraged to maintain or increase MVPA post-intervention for additional health benefits. Trial registration: NCT02473003 (10/10/2014)
Full robotic endovascular treatment for various head and neck hemorrhagic lesions
Authors: Saber Hamidreza , Beaman Charles , Morales Jose , Kimball David , Kaneko Naoki , Tateshima Satoshi 
Published: June 2023

Background The use of robotics in neuro-interventional surgery is continuously expanding with promises to increase accuracy and safety. We have previously described the first human, full robotic intervention using the CorPath GRX Robotic System. Here we report a series of fully robotic interventions and outcomes using this robotic device for endovascular treatment of extracranial embolization. Methods The patient and disease characteristics, procedural details, and imaging outcomes of consecutive patients undergoing robotically assisted extracranial embolization between October 2021 and August 2022. Results Six patients underwent robotically assisted extracranial embolization of head and neck hemorrhagic lesions. Four patients presented with uncontrolled epistaxis or hemoptysis associated with nasopharyngeal tumors and one patient had epistaxis due to COVID-19 infection complications. All patients were treated with coil embolization and four patients were also treated with particles. All procedures were performed with robotic intervention, whereas four procedures required partial manual conversion. There was no morbidity or complications associated with the procedures and desired outcome was achieved in 100% of the procedures. Conclusion Our series support the feasibility of complete robotic intervention using the CorPath GRX System with accurate control of the guiding catheter, microcatheter, wire, and coil delivery with successful treatment of acute extracranial hemorrhagic lesions.
Middle meningeal artery embolization of septated chronic subdural hematomas
Authors: Martinez-Gutierrez Juan Carlos , D’Amato Salvatore A , Zeineddine Hussein A , Nahhas Michael I , Kole Matthew J , Kim Hyun Woo , Kim Youngran , Dawes Bryden H , Chen Peng Roc , Blackburn Spiros L , Sheth Sunil A , Spiegel Gary , Chen Ching-Jen , Mahapatra Ashutosh , Kitagawa Ryan S , Dannenbaum Mark J 
Published: June 2023

Introduction Middle meningeal artery embolization (MMAE) has emerged as a promising new treatment for patients with chronic subdural hematomas (cSDH). Its efficacy, however, upon the subtype with a high rate of recurrence—septated cSDH—remains undetermined. Methods From our prospective registry of patients with cSDH treated with MMAE, we classified patients based on the presence or absence of septations. The primary outcome was the rate of recurrence of cSDH. Secondary outcomes included a reduction in cSDH thickness, midline shift, and rate of reoperation. Results Among 80 patients with 99 cSDHs, the median age was 68 years (IQR 59–77) with 20% females. Twenty-eight cSDHs (35%) had septations identified on imaging. Surgical evacuation with burr holes was performed in 45% and craniotomy in 18.8%. Baseline characteristics between no-septations (no-SEP) and septations (SEP) groups were similar except for median age (SEP vs no-SEP, 72.5 vs. 65.5, p  = 0.016). The recurrence rate was lower in the SEP group (SEP vs. no-SEP, 3 vs. 16.7%, p = 0.017) with higher odds of response from MMAE for septated lesions even when controlling for evacuation strategy and antithrombotic use (OR = 0.06, CI [0.006–0.536], p = 0.012). MMAE resulted in higher mean absolute thickness reduction (SEP vs. no-SEP, −8.2 vs. −4.8 mm, p = 0.016) with a similar midline shift change. The rate of reoperation did not differ (6.2 vs. 3.1%, p = 0.65). Conclusion MMAE appears to be equal to potentially more effective in preventing the recurrence of cSDH in septated lesions. These findings may aid in patient selection.
Attenuation of immune activation in patients with multiple sclerosis on a wheat-reduced diet: a pilot crossover trial
Authors: Engel Sinah , Klotz Luisa , Wirth Timo , Fleck Ann-Katrin , Pickert Geethanjali , Eschborn Melanie , Kreuzburg Samia , Curella Valentina , Bittner Stefan , Zipp Frauke , Schuppan Detlef , Luessi Felix 
Published: June 2023

Background: Western lifestyle has been associated with an increase in relapsing–remitting multiple sclerosis (RRMS). In mice, dietary wheat amylase–trypsin inhibitors (ATIs) activate intestinal myeloid cells and augment T cell-mediated systemic inflammation. Objective: The aim of this study was to assess whether a wheat- and thus ATI-reduced diet might exert beneficial effects in RRMS patients with modest disease activity. Methods: In this 6-month, crossover, open-label, bicentric proof-of-concept trial, 16 RRMS patients with stable disease course were randomized to either 3 months of a standard wheat-containing diet with consecutive switch to a > 90% wheat-reduced diet, or vice versa. Results: The primary endpoint was negative, as the frequency of circulating pro-inflammatory T cells did not decrease during the ATI-reduced diet. We did, however, observe decreased frequencies of CD14+ CD16++ monocytes and a concomitant increase in CD14++ CD16− monocytes during the wheat-reduced diet interval. This was accompanied by an improvement in pain-related quality of life in health-related quality of life assessed (SF-36). Conclusion: Our results suggest that the wheat- and thus ATI-reduced diet was associated with changes in monocyte subsets and improved pain-related quality of life in RRMS patients. Thus, a wheat (ATI)-reduced diet might be a complementary approach accompanying immunotherapy for some patients. Registration: German Clinical Trial Register (No. DRKS00027967).
Lexical and syntactic deficits analyzed via automated natural language processing: the new monitoring tool in multiple sclerosis
Authors: Šubert Martin , Novotný Michal , Tykalová Tereza , Srpová Barbora , Friedová Lucie , Uher Tomáš , Horáková Dana , Rusz Jan 
Published: June 2023

Background: Impairment of higher language functions associated with natural spontaneous speech in multiple sclerosis (MS) remains underexplored. Objectives: We presented a fully automated method for discriminating MS patients from healthy controls based on lexical and syntactic linguistic features. Methods: We enrolled 120 MS individuals with Expanded Disability Status Scale ranging from 1 to 6.5 and 120 age-, sex-, and education-matched healthy controls. Linguistic analysis was performed with fully automated methods based on automatic speech recognition and natural language processing techniques using eight lexical and syntactic features acquired from the spontaneous discourse. Fully automated annotations were compared with human annotations. Results: Compared with healthy controls, lexical impairment in MS consisted of an increase in content words ( p = 0.037), a decrease in function words ( p = 0.007), and overuse of verbs at the expense of noun ( p = 0.047), while syntactic impairment manifested as shorter utterance length ( p = 0.002), and low number of coordinate clause ( p < 0.001). A fully automated language analysis approach enabled discrimination between MS and controls with an area under the curve of 0.70. A significant relationship was detected between shorter utterance length and lower symbol digit modalities test score ( r = 0.25, p = 0.008). Strong associations between a majority of automatically and manually computed features were observed ( r > 0.88, p < 0.001). Conclusion: Automated discourse analysis has the potential to provide an easy-to-implement and low-cost language-based biomarker of cognitive decline in MS for future clinical trials.
Clinical outcomes of a novel ‘all-suture’ fixation for valgus-impacted proximal humeral fractures
Authors: Brooker-Thompson Chad , Mohan Hariharan , Chotai Neil , Baring Toby 
Published: June 2023

Background Conventional techniques for the fixation of displaced proximal humeral fractures include the use of locking plates, intramedullary nailing, hemiarthroplasty and reverse shoulder replacement. Valgus-impacted fractures are a common subtype of proximal humeral fracture, but there are few publications concerning the outcomes of treatment. This study aims to review outcomes following an ‘all-suture’ technique for this fracture subtype without the use of transosseous sutures. Methods All patients over the age of 18 who presented with 3- or 4-part valgus-impacted proximal humeral fractures and who underwent ‘all-suture’ repair at our centre were included. We reviewed their post-operative imaging and collected data on post-operative complications and patient-reported outcome measures. Results We identified 15 patients who had undergone all-suture fixation. The cohort's mean age was 56. Eleven patients were female. Eight patients had 3-part fractures and seven patients had 4-part fractures. There were no major post-operative complications. All fractures united. The mean Oxford Shoulder Score was 43.7 and the mean Single Assessment Numerical Evaluation score was 85.9 at the final follow-up. Discussion Our results suggest that all-suture fixation of proximal humeral fractures presents an attractive alternative to conventional techniques, whilst avoiding complications relating to metalwork implantation.
Ibuprofen-Induced Renal Tubular Acidosis: Case Report on a Not-So-Basic Clinical Conundrum
Authors: Ghimire Anukul , Li David , Amin Leena 
Published: June 2023

Rationale: Renal tubular acidosis (RTA) is a cause of non-anion gap metabolic acidosis (NAGMA) that is infrequently diagnosed and is due to various underlying etiologies that impair the kidney’s ability to retain bicarbonate or excrete acid. Ibuprofen is an over-the-counter non-steroidal anti-inflammatory medication that is used by patients widely for a variety of reasons. Although it is well known that ibuprofen and other non-steroidal anti-inflammatory drugs may have nephrotoxic effects, the role of ibuprofen as a cause of RTA and hypokalemia is not well recognized. Presenting Concerns: A 66-year-old man with chemotherapy-treated lymphoma in remission and ongoing heavy ibuprofen use for chronic pain presented to hospital with a 1-week history of increasing lethargy and otherwise unremarkable review of systems. Investigations showed acute kidney injury, hypokalemia, hyperchloremia, and NAGMA with elevated urinary pH and positive urine anion gap. Diagnoses: The final diagnosis of distal RTA secondary to ibuprofen was made after ruling out gastrointestinal bicarbonate loss and additional secondary causes of RTA, including other medications, autoimmune conditions, and obstructive uropathy. Interventions: The patient was admitted and treated with intravenous sodium bicarbonate for 24 hours with correction of hypokalemia via oral supplementation. His ibuprofen-containing medication was discontinued. Outcomes: His acute kidney injury and electrolyte abnormalities resolved within 48 hours of initiating treatment with concurrent resolution of his lethargy. He was discharged home and advised to stop taking ibuprofen. Lessons Learned: We report a case of patient with hypokalemia and NAGMA secondary to ibuprofen and highlight the importance of monitoring for this side effect in patients taking ibuprofen.
Bone Morphological Characteristics as Risk Factors for Anterior Cruciate Ligament Injury: Comparison Between Contact and Noncontact Injury
Authors: Choi Nam-Hong , Lee Dong-Min , Victoroff Brian N. 
Published: June 2023

Background: Altered bone morphologies are considered risk factors for noncontact anterior cruciate ligament (ACL) injuries. Purpose/Hypothesis: This study aimed to investigate bone morphological characteristics as risk factors for ACL tears in contact injuries and compare these factors with those for noncontact ACL injuries. We hypothesized that altered bone morphologies would also be risk factors for contact ACL injury. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Enrolled were patients who underwent primary ACL reconstructions between January 2000 and December 2021 within 6 weeks after injury. Patients in the ACL group were classified according to injury mechanism (contact vs noncontact). During the same period, a control group of patients matched by age, height, and body mass index to the ACL group was selected. The lateral femoral condylar ratio (LFCR), notch width index (NWI), and lateral posterior tibial slope (PTS) were measured. Measured parameters were compared between the control, contact, and noncontact groups using analysis of variance. Results: There were 86 patients in the control group, 102 patients in the contact ACL group, and 105 patients in the noncontact ACL group. The demographic characteristics of the 3 groups did not differ significantly. The contact group had significantly higher LFCRs and lower NWIs compared with the control group ( P < .001 and P = .001, respectively). The noncontact group had significantly higher LFCRs and PTSs and lower NWIs compared with the control group ( P = .031; P < .001; and P < .001, respectively). The noncontact group had significantly higher PTSs and lower NWIs compared with the contact group ( P = .003 and P =.014, respectively). In the contact group, the LFCR, PTS, and NWI were significant risk factors for ACL tears (odds ratio [OR], 1.25 [ P < .001]; OR, 1.16 [ P = .008]; and OR, 1.27 [ P = .001], respectively), and in the noncontact group, the PTS and NWI were significant risk factors for ACL tears (OR, 1.20 [ P < .001]; OR, 1.59 [ P < .001], respectively). Conclusion: Altered bone morphological characteristics of the knee were found to be risk factors for ACL tears in contact injuries as well as noncontact injuries. Altered morphology has a more significant effect in noncontact ACL injuries.
Resistance mechanism to Notch inhibition and combination therapy in human T-cell acute lymphoblastic leukemia
Authors: Cao Linlin , Ruiz Buendía Gustavo A. , Fournier Nadine , Liu Yuanlong , Armand Florence , Hamelin Romain , Pavlou Maria , Radtke Freddy 
Published: June 2023

Abstract
Gain-of-function mutations in NOTCH1 are among the most frequent genetic alterations in T-cell acute lymphoblastic leukemia (T-ALL), highlighting the Notch signaling pathway as a promising therapeutic target for personalized medicine. Yet, a major limitation for long-term success of targeted therapy is relapse due to tumor heterogeneity or acquired resistance. Thus, we performed a genome-wide CRISPR-Cas9 screen to identify prospective resistance mechanisms to pharmacological NOTCH inhibitors and novel targeted combination therapies to efficiently combat T-ALL. Mutational loss of phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) causes resistance to Notch inhibition. PIK3R1 deficiency leads to increased PI3K/AKT signaling, which regulates cell cycle and the spliceosome machinery, both at the transcriptional and posttranslational level. Moreover, several therapeutic combinations have been identified, in which simultaneous targeting of the cyclin-dependent kinases 4 and 6 (CDK4/6) and NOTCH proved to be the most efficacious in T-ALL xenotransplantation models.