Symptomatic chronic subdural hematoma (cSDH) is amongst the most frequent neurological diseases with an upward trend due to an aging society and development in the field of anticoagulation therapies. Lately, subgaleal drainages and middle meningeal artery (MMA) embolization have been introduced to the standard armamentarium as treatment options for cSDH patients. Vascular anomalies, such as internal carotid artery (ICA) occlusion with spontaneous extra-intracranial anastomoses, usually lead to forfeiting embolization treatment from patients. This report presents a case of a 67-year-old male with a repeated recurrence of cSDH in conjunction with a history of middle cerebral artery territory stroke and consecutive platelet inhibition therapy. The patient was initially treated with a burr hole plus subgaleal and subdural drainage upon revision surgery. Due to repeated recurrence, MMA embolization was considered, even though an extra-intracranial anastomosis was present on angiography. The patient was deemed to be fully recovered three months after intervention and no further intervention was needed. We can conclude that MMA embolization is a feasible option also in patients with recurrent cSDH after territorial infarction secondary to ICA occlusion with present extra-intracranial anastomoses.

Cell division cycle-associated (CDCA) genes are dysregulated in carcinomas. Our study aims to identify similarities and differences of the clinical roles of CDCAs in breast cancer (BRCA) and to explore their potential mechanisms. In GEPIA, compared to normal tissues, expressions of CDCAs were higher in BRCA and sub-types. In addition, CDCAs were significantly positively related to stages and predicted worse survival in BRCA. In CancerSEA, expression levels of most CDCAs were strongly positively related to cell cycle, DNA damage, DNA repair, and proliferation. In TIMER, CDCAs were linked with immune infiltration levels of BRCA, including Dendritic cell, B cell and so on, and were positively related to most of the common markers of immune cells, especially CD38 of B cell and IL12RB2 of Th1. In GeneMANIA, there were complex interactions and co-expression relationships between CDCAs and cell division-associated genes. In addition, CDCA1, CDCA3, CDCA5, CDCA6 and CDCA8 had a high proportion of amplification in BRCA, and CDCA1, CDCA2, CDCA5, CDCA7 and CDCA8 had high levels of body DNA methylation. Among 11 transcription factors possibly combining promoters of all CDCAs, FOXP3 and YY1 were significantly higher in BRCA in comparison to normal tissues, and both had a positive relationship with all CDCAs in GEPIA and IHC. In addition, silencing FOXP3 or YY1 decreased levels of CDCAs in MDA-MB-231. In summary, CDCAs have various similarities in clinical functions, functional states, immune infiltration, and mechanisms, and they may become novel potential biomarkers for BRCA.

The main challenge facing current energy management strategies for extended-range electric vehicles is effectively balancing power demand and energy utilization to enhance fuel economy under complex and variable driving conditions. Therefore, to optimize the distribution between the two energy sources of extended-range electric vehicles and improve their fuel economy, this paper proposes an energy management strategy incorporating speed prediction. Firstly, the long short-term memory neural network speed prediction scheme is investigated, and its effectiveness under different cyclic conditions is verified. Secondly, the four hyperparameters of the long short-term memory neural network structure were optimized using the sparrow algorithm (SA) to further enhance the prediction accuracy of the long short-term memory speed prediction algorithm. After optimization, the mean square deviation and mean absolute error are reduced by 46.46% and 54.46%, respectively, compared with the pre-optimization period. Finally, an energy management strategy based on speed prediction was designed using the sparrow algorithm-long short-term memory model. The results show that the speed prediction-based energy management strategy reduces fuel consumption by 6.05% and 3.50% under the New European Driving Cycle and World Light Vehicle Test Cycle conditions, respectively, compared to the rule-based hybrid control strategy.

Vangl2, a core component of the PCP signaling pathway, serves as a scaffold protein on the cell membrane, playing a crucial role in organizing protein complexes. Cilia, dynamic structures on the cell surface, carry out a wide range of functions. Research has highlighted a bidirectional regulatory interaction between Vangl2 and cilia, underscoring their interconnected roles in cellular processes. This relationship is demonstrated by the localization of Vangl2 at the base and proximal regions of cilia, where it plays essential roles in ciliary positioning, asymmetric distribution, and ciliogenesis. In contrast, the absence of cilia can disrupt Vangl2-mediated signal transduction processes. This review offers a narrative review of recent research on Vangl2's function in cilia and examines the regulatory effects of cilia on Vangl2-mediated signaling.

Coronary artery disease (CAD) remains a significant global health burden, characterized by the narrowing or blockage of coronary arteries. Treatment decisions are often guided by angiography-based scoring systems, such as the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) and Gensini scores, although these require invasive procedures. This study explores the potential of electrocardiography (ECG) as a noninvasive diagnostic tool for predicting CAD severity, alongside traditional risk factors.

To explore the prevalence and risk factors of carotid artery (CA) stenosis among subclavian steal syndrome (SSS) patients and to record their prognoses.

This study aims to analyze anatomical parameters of the transmission route of sigmoid sinus tinnitus (SST) to explore its mechanism and speculate on possible responsible anatomical abnormalities.

This study investigated the fungal contamination profile of cocoa beans from cocoa-growing regions in Ghana, with particular emphasis on the potential impact of ochratoxigenic species.

Electrolyte imbalance management is crucial in diverse clinical scenarios, with intravenous potassium repletion often required. High-concentration infusions can pose severe complications if extravasation occurs, leading to phlebitis, local tissue damage, or in severe cases, cutaneous necrosis. This risk is elevated in geriatric patients due to factors like reduced tissue elasticity and sensitivity. We report a case of phlebitis and skin necrosis in an elderly woman after peripheral KCl infusion (6% [800 mmol/L]). A woman in her early 70 s presented with obstructive jaundice and critically low potassium levels. A peripheral intravenous administration of 6% KCl was initiated to rectify hypokalemia. Due to superficial venous site selection and the patient's reduced sensitivity, phlebitis developed unnoticed, leading to cutaneous necrosis. Management involved medication discontinuation, cannula removal, application of a magnesium sulfate dressing, limb elevation, and a hydrogel dressing. Despite initial necrosis, wound debridement, ongoing dressings, and moderate hand exercises led to a complete wound resolution. This case underscores the importance of careful selection and monitoring of infusion sites during administration of irritant solutions like concentrated KCl, particularly in geriatric patients. Patient-specific factors, pharmacological implications, and the necessity for adequate vascular assessment are emphasized. Further, the case highlights the necessity for prompt and multifaceted management strategies to handle complications, including patient and caregiver education, careful wound management, and proactive nursing care. The event underscores the need for established protocols regarding the administration of high-risk drugs to prevent severe sequelae.

The aim of this study was to evaluate the efficacy and safety of the Ahmed glaucoma valve in pediatric patients with refractory glaucoma.

Retail involves directly delivering goods and services to end consumers. Natural disasters and epidemics/pandemics have significant potential to disrupt supply chains, leading to shortages, forecasting errors, price increases, and substantial financial strains on retailers. The COVID-19 pandemic highlighted the need for retail sectors to prepare for crisis impacts on sales forecasts by regularly assessing and adjusting sales volumes, consumer behavior, and forecasting models to adapt to changing conditions.

The diagnostic boundaries between schizophrenia and bipolar disorder are controversial due to the ambiguity of psychiatric nosology. From this perspective, it is noteworthy that formal thought disorder has historically been considered pathognomonic of schizophrenia. Given that human thought is partially based on language, we can hypothesize that alterations in language may help differentiate between schizophrenia and bipolar disorder.

Evaluating the mechanical-anatomical alignment and angles of the knee joint is crucial for athletes. We aimed to analyse the relationship between lower extremity bone alignment and the importance of the Q angle (QA) in male athletes.

This study presents a novel integration of two advanced deep learning models, U-Net and EfficientNetV2, to achieve high-precision segmentation and rapid classification of pathological images. A key innovation is the development of a new heatmap generation algorithm, which leverages meticulous image preprocessing, data enhancement strategies, ensemble learning, attention mechanisms, and deep feature fusion techniques. This algorithm not only produces highly accurate and interpretatively rich heatmaps but also significantly improves the accuracy and efficiency of pathological image analysis. Unlike existing methods, our approach integrates these advanced techniques into a cohesive framework, enhancing its ability to reveal critical features in pathological images. Rigorous experimental validation demonstrated that our algorithm excels in key performance indicators such as accuracy, recall rate, and processing speed, underscoring its potential for broader applications in pathological image analysis and beyond.

The recent severe acute respiratory syndrome coronavirus 2 pandemic has clearly exemplified the need for broad-spectrum antiviral (BSA) medications. However, previous outbreaks show that about one year after an outbreak, interest in antiviral research diminishes and the work toward an effective medication is left unfinished. Martin et al. endeavored to support the early stages of focused BSA development by creating the Small Molecule Antiviral Compound Collection (SMACC), which is publicly available online at https://smacc.mml.unc.edu. SMACC is a highly curated database with over 32,500 entries of chemical compounds tested in both phenotypic and target-based assays across 13 viruses from the NIAID's list of emerging infectious diseases/pathogens. The authors advise judicious use of knowledge collections such as SMACC and recommend users critically evaluate retrieved data and resulting hypotheses prior to experimental testing. When used correctly, SMACC-like databases may serve as a reference for medicinal chemists and virologists working to develop novel BSA medications. To summarize, we emphasize the importance of data curation for both novel outbreak prediction and development of BSAs against these outbreaks.

In this feasibility study, firstly, we aimed to assess whether intramuscular pH (IMpH) could be measured with a glass-tipped electrode. Secondly, we aimed to explore whether we could monitor changes in skeletal muscle pH before and throughout static (isometric) and after dynamic (treadmill) exercise, comparing individuals with intermittent claudication (IC) to a group of healthy controls.

Firefighters are exposed to the risk of burns at fire scenes. In 2020, the National Fire Agency of the Republic of Korea surveyed 50,527 firefighters and identified 242 burn-related incidents. The body parts affected by these burns were the hands (28.51%), ears (10.74%), and neck (10.33%), with hands and facial areas accounting for ∼50% of all burns. This trend implies that gloves and hoods do not provide sufficient protection against burns. Firefighters alternate between activity and rest during firefighting operations to enhance mission efficiency. However, the accumulated heat in their hood and gloves from these repeated cycles has not been considered thus far. This study investigated thermal accumulation patterns based on the moisture content of hoods and gloves, reflecting repeated cycles of work and rest for firefighters. Consequently, heat accumulation occurred in a dry state in both the hood and gloves, and the degree of heat storage was higher in the hood. The glove stored heat even when wet because of its multilayer structural characteristics. These results suggest that repeated activities (work-rest) with gloves and hoods under dry/wet conditions can generate residual heat and heat accumulation, causing burns on the hand and face. This study clearly demonstrated the impact of the moisture conditions of gloves and hoods in repetitive situations where they are exposed to relatively low levels of heat radiation and are then subject to rest periods. The results of this study are expected to be valuable in designing new protective gear to prevent burn injuries and developing efficient firefighting tactics.

Primary solitary extramedullary plasmacytoma is a malignant neoplasm characterized by the monoclonal proliferation of plasma cells outside the bone marrow. The tumor rarely occurs in the sinonasal tract, accounting for about 4% of all non-epithelial sinonasal tumors. Herein, the authors describe a rare case of sinonasal extramedullary plasmacytoma in a 33-year-old man who presented with a 3-month history of progressively increasing nasal mass, causing obstruction. A CT scan showed a soft tissue mass measuring 5*8*3 cm in the right and left nasal cavities, obstructing the nasal airway. The mass extended to the right maxillary sinus. Histopathology and immunohistochemical tests confirmed it to be plasmacytoma. Lymphomas with prominent plasmacytic differentiation and multiple myeloma workups were negative. The patient initially refused treatment. After counseling, the patient consented to undergo surgery and later radiotherapy treatment. At one-year follow-up, the patient is disease-free with no signs of recurrence. Plasmacytomas are either medullary or extramedullary neoplasms. The latter are extremely rare tumors, more commonly presenting in the submucosal tissue of the upper respiratory tract. A mass or swelling causing nasal or pharyngeal symptoms is by far the most common presentation of this entity in the head and neck region. Because these lesions are radiosensitive, radiotherapy is a recommended treatment approach. Further studies are needed to better understand the prognosis and effective treatment regimens.

Zika virus (ZIKV) is a flavivirus of significant epidemiological importance, utilizing various transmission strategies and infecting "immune privileged tissues" during both the pre- and postnatal periods. One such transmission method may involve extracellular vesicles (EVs). EVs can travel long distances without degrading, carrying complex messages that trigger different responses in recipient cells. They can easily cross specialized tissue barriers, such as the placental barrier and the blood-brain barrier, which protects the central nervous system. It is known that some viruses can hijack and exploit the EVs biogenesis machinery to package regulatory elements, viral segments, and even complete viral genomes. This allows them to evade the immune system, amplify their tropism, and enhance their spread. ZIKV likely uses EVs produced by infected cells to insert its genomic RNA or parts of it. This mechanism can ensure viral entry and infection of the nervous tissue, partly explaining its broad viral tropism and silent persistence in various tissues and organs for months. This narrative review summarizes the main features of ZIKV and EVs, highlighting the most recent evidence on the involvement and effects of EVs during ZIKV infection. It also discusses the possibility of EVs acting as carriers of ZIKV through the nervous tissue.

The physician order for life-sustaining treatment has been implemented in clinical practice for several years. However, the determination that a patient is in the terminal phase of life, a prerequisite for the withdrawal of life-sustaining treatment, lacks objective criteria. This study aimed to evaluate whether hyperlactatemia could serve as a reliable objective indicator for determining the terminal phase.

Endometrial cancer (EC) is a malignant tumor with various histological subtypes and molecular phenotypes. The evaluation of drug resistance is important for cancer treatment. Progesterone resistance is the major challenge in EC. Knowledge of drug resistance in EC is important in the development of novel therapies.