Miracle-dz/UniFAR-FTUs huggingface dataset:
A phase III randomized clinical trial comparing sentinel node biopsy with no retroperitoneal node dissection in apparent early-stage endometrial cancer – ENDO-3: ANZGOG trial 1911/2020

Background Sentinel node biopsy is a surgical technique to explore lymph nodes for surgical staging of endometrial cancer, which has replaced full retroperitoneal lymph node dissection. However, the effectiveness of sentinel node biopsy, its value to patients, and potential harms compared with no-node dissection have never been shown in a randomized trial. Primary Objectives Stage 1 will test recovery from surgery. Stage 2 will compare disease-free survival at 4.5 years between patients randomized to sentinel node biopsy versus no retroperitoneal node dissection. Study Hypothesis The primary hypothesis for stage 1 is that treatment with sentinel node biopsy will not cause detriment to patient outcomes (lymphedema, morbidity, loss of quality of life) and will not increase treatment-related morbidity or health services costs compared with patients treated without a retroperitoneal node dissection at 12 months after surgery. The primary hypothesis for stage 2 is that disease-free survival at 4.5 years after surgery in patients without retroperitoneal node dissection is not inferior to those receiving sentinel node biopsy. Trial Design This phase III, open-label, two-arm, multistage, randomized non-inferiority trial (ENDO-3) will determine the value of sentinel node biopsy for surgical management of endometrial cancer. Patients with endometrial cancer are randomized to receive: (1) laparoscopic/robotic hysterectomy, bilateral salpingo-oophorectomy with sentinel node biopsy or (2) laparoscopic/robotic hysterectomy, bilateral salpingo-oophorectomy without retroperitoneal node dissection. In stage 1, 444 patients will be enrolled to demonstrate feasibility and quality of life. If this is demonstrated, we will enroll another 316 patients in stage 2. Major Inclusion and Exclusion Criteria Inclusion criteria include women aged 18 years or older with histologically confirmed endometrial cancer; clinical stage 1, who meet the criteria for laparoscopic or robotic total hysterectomy and bilateral salpingo-oophorectomy. Patients with uterine mesenchymal tumors are excluded. Primary Endpoints The endpoint for stage 1 is surgical recovery, with the proportion of patients returning to usual daily activities at 3 months post-surgery as measured with the EQ-5D. Stage 2 is disease-free survival at 4.5 years. Sample Size 760 participants (both stages). Estimated Dates for Completing Accrual and Presenting Results Stage 1 commenced in January 2021 and is planned to be completed in December 2024 when 444 participants have completed 12 months' follow-up. Stage 2 will enroll a further 316 participants for a total of 760 patients. Trial Registration NCT04073706.
Algorithms and Protocols Enhancing Mobility Support for Wireless Sensor Networks Based on Bluetooth and Zigbee

Mobile communication systems are experiencing a huge growth. While traditional communication paradigms deal with fixed networks, mobility raises a new set of questions, techniques, and solutions. This work focuses on wireless sensor networks (WSNs) where each node is a mobile device. The main objectives of this thesis have been to develop algorithms and protocols enabling WSNs with a special interest in overcoming mobility support limitations of standards such as Bluetooth and Zigbee. The contributions of this work may be divided in four major parts related to mobility support. The first part describes the implementation of local positioning services in Bluetooth since local positioning is not supported in Bluetooth v1.1. The obtained results are used in later implemented handover algorithms in terms of deciding when to perform the handover. Moreover local positioning information may be used in further developed routing protocols. The second part deals with handover as a solution to overcome the getting out of range problem. Algorithms for handover have been implemented enabling mobility in Bluetooth infrastructure networks. The principal achievement in this part is the significant reduction of handover latency since sensor cost and quality of service are directly affected by this parameter. The third part solves the routing problems originated with handovers. The main contribution of this part is the impact of the Bluetooth scatternet formation and routing protocols, for multi-hop data transmissions, in the system quality of service. The final part is a comparison between Bluetooth and Zigbee in terms of mobility support. The main outcome of this comparison resides on the conclusions, which can be used as a technology election guide.The main scientific contribution relies on the implementation of a mobile WSN with Bluetooth v1.1 inside the scope of the ”Multi Monitoring Medical Chip (M3C) for Homecare Applications” European Union project (Sixth Framework Program (FP6) Reference: 508291) offering multi-hop routing support and improvements in handover latencies with aid of local positioning services.
ASPHALT AGING IN TEXAS ROADS AND TEST SECTIONS

In 1982-1983, test sections were laid at three Texas locations using five asphalt sources and two grades. Not all combinations were used at all locations and two roads failed early, but results are reported on 16 sections. These roads were cored in 1984, 1985, and 1987. Viscosities, penetrations, voids, gel permeation chromatography (GPC), and Fourier transform infrared (FT-IR) analyses were run. Voids and aging are strongly correlated whether the aging is measured by a viscosity aging index, growth in carbonyl peak, or GPC. Although GPC, carbonyl peak, and sulfoxide generally increase with age, sulfoxide and other aging indexes are poorly correlated. Growth in sulfoxide correlates weakly with sulfur content. In general, the number of voids reveals large ranges in asphalt performance. Asphalts showing nearly the same aging index at low numbers of voids might differ several-fold at high numbers of voids. When comparison was possible, higher viscosity grades resulted in greater aging. Results also were obtained for several south Texas highways, ranging in age from 5 to 19 years. Although original tank asphalt, hot-mix, and early cores were not available for study, recovered asphalt properties from highway-aged cores followed trends similar to those for the test sections with respect to viscosity, penetration, FT-IR, and GPC measurements.
DNA Methylation Abnormalities and Altered Whole Transcriptome Profiles after Switching from Combustible Tobacco Smoking to Heated Tobacco Products

Background: The use of heated tobacco products (HTP) has increased exponentially in Japan since 2016; however, their effects on health remain a major concern. Methods: Tsuruoka Metabolome Cohort Study participants (n = 11,002) were grouped on the basis of their smoking habits as never smokers (NS), past smokers (PS), combustible tobacco smokers (CS), and HTP users for <2 years. Peripheral blood mononuclear cells were collected from 52 participants per group matched to HTP users using propensity scores, and DNA and RNA were purified from the samples. DNA methylation (DNAm) analysis of the 17 smoking-associated DNAm biomarker genes (such as AHRR, F2RL3, LRRN3, and GPR15), as well as whole transcriptome analysis, was performed. Results: Ten of the 17 genes were significantly hypomethylated in CS and HTP users compared with NS, among which AHRR, F2RL3, and RARA showed intermediate characteristics between CS and NS; nonetheless, AHRR expression was significantly higher in CS than in the other three groups. Conversely, LRRN3 and GPR15 were more hypomethylated in HTP users than in NS, and GPR15 expression was markedly upregulated in all the groups when compared with that in NS. Conclusions: HTP users (switched from CS <2 years) display abnormal DNAm and transcriptome profiles, albeit to a lesser extent than the CS. However, because the molecular genetic effects of long-term HTP use are still unknown, long-term molecular epidemiologic studies are needed. Impact: This study provides new insights into the molecular genetic effects on DNAm and transcriptome profiles in HTP users who switched from CS.
Clinical outcomes of light therapy in hospitalized patients – A systematic review

ABSTRACT Light therapy and the effects on biological function have been known and investigated for decades. Light therapy is used to compensate for the lack of exposure to sunlight, which is thought to be linked to major depressive disorder with seasonal patterns. It is applied as sessions with bright light mimicking natural sunlight. Lack of bright light during daytime is not the only factor to maintain the circadian rhythm, also lack of exposure to bright light at night is important. A new modality called naturalistic light shows promise, mimicking daylight by dynamically changing intensity and wavelengths throughout the day. Evidence of clinical effects, besides bright light effects on depression, is still limited, especially in hospital populations, and present review aims to extract results of the effect of any optical light intervention on hospitalized patients. Through database search, 29 trials were included, of which 8 trials used a variation of naturalistic light. Trials were heterogeneous regarding designs, populations, interventions, methods and outcomes. In 14 out of 17 studies investigating sleep duration, quality and circadian alignment, along with decreased fatigue and improved mood in daytime, light therapy had a significant effect. Circadian rhythm and rhythmicity were affected as well. The effect on mood and cognition was inconsistent across studies. Trials showed more significant outcomes when conducted in non-intensive care units and with duration >5 days. Lux was reported in and compared across 24 studies and did not appear to be correlated to outcome, rather the distribution of wavelengths should be considered when conducting trials in the future. Of the 8 trials investigating naturalistic light, 4 trials had significant outcomes and 3 had adverse outcomes compared to one in the standard light regime. The overall effect of light therapy is beneficial, but evidence for the effect of naturalistic light is still insufficient to be recommended before other modalities. Future research in this area should be conducted in facilities where naturalistic light is installed, with a focus on the spectral distribution.
Mother-daughter communication about puberty in Egypt

Abstract Parental communication during puberty can be a protective factor for adolescents. In Egypt, girls have poor access to sexual and reproductive health services and there is a lack of information on puberty in school curricula. Yet little is known about girls’ other sources of information about puberty, including communication with mothers. We analysed 29 in-depth interviews with young mothers of girls in Greater Cairo to better understand mother-daughter communication about puberty. We examine respondents’ motivations for communication with their daughters, the type of messages they provided or expected to provide, and barriers to mother-daughter communication, paying particular attention to intergenerational dynamics with respect to how women learn about puberty. We found that while mothers wanted to, and did, play a primary role in communicating with girls about puberty, discussions were constrained by lack of information and embarrassment. Mothers were more open to discussing some aspects of puberty, such as hygiene, than others. Conversations may also be delayed due to social norms about what is appropriate for girls to know and when. Messages were often fear-based and embedded in norms that stigmatised girls’ sexuality. Programmes and interventions targeting mothers’ knowledge and communication skills around puberty should be adapted and tested in the context of Egypt.
Initial Institutional Experience with 18F-Fluciclovine PET-CT in Biochemical Recurrence of Prostate Cancer

The state of Mississippi has a huge burden of cancer, including prostate cancer (PCa). The state ranks at or near the top in mortality from some of the most common cancers, including PCa. To meet this challenge, there is an urgent need to direct clinical research management efforts in the detection of early recurrent disease. This article is an effort in that endeavor. 18F-fluciclovine is an amino acid analog approved by the Food and Drug Administration for use as a radiotracer in positron emission tomography in men with suspected PCa recurrence following prior treatment. The purpose of this study was to investigate the initial institutional experience with 18F-fluciclovine in the evaluation of PCa biochemical recurrence. Objectives 18F-fluciclovine (fluciclovine) is an amino acid analog approved by the Food and Drug Administration for use as a radiotracer in positron emission tomography (PET) in men with biochemical recurrence of suspected prostate cancer. The purpose of this study was to investigate the initial institutional experience with 18F-fluciclovine in the evaluation of prostate cancer with biochemical recurrence. Methods This study was a retrospective review of 135 patients who underwent 18F-fluciclovine PET-computed tomography (PET-CT) at a single institution from August 2018 through January 2020. Prognostic information, including prostate-specific level antigen (PSA) at the time of diagnosis, initial risk, initial Gleason score, and initial stage, was reviewed as well as the PSA level at the time of the scan. The images were reviewed by two radiologists with fellowship training in nuclear medicine and additional training to interpret the fluciclovine studies. A minority of studies were reviewed by a third fellowship-trained radiologist under the guidance of the two nuclear medicine–trained radiologists. In cases with abnormal radiopharmaceutical uptake in lymph nodes, the short-axis dimension of the lymph node or largest lymph node with abnormal uptake was noted. If CT or bone scan was performed within 4 months of the 18F-fluciclovine PET-CT, findings on the alternate imaging were compared with the results of the 18F-fluciclovine PET-CT. Results Our institutional positivity rate was 75.6%, with 64 (67.4%) patients with metastatic disease and 71 (52.6%) patients with local recurrence detected by fluciclovine. As expected, the rate of positive examinations increased with increasing PSA values measured at the time of imaging (P < 0.001). Of the 54 patients with nodal disease, 35 had nonpathologically enlarged lymph nodes measuring <1 cm in maximum short-axis dimension. In more than half of the patients in this study, with conventional imaging, fluciclovine either discovered otherwise undetectable metastatic disease or suggested the presence of local recurrence. Conclusions Our single-institution experience with 18F-fluciclovine PET-CT has the largest number of patients to date in the literature and demonstrates the ability of fluciclovine to help guide clinical management in the detection of early recurrent disease.
Accurate classification of plasma cell dyscrasias is achieved by combining artificial intelligence and flow cytometry

Monoclonal gammopathy of unknown significance (MGUS), smouldering multiple myeloma (SMM), and multiple myeloma (MM) are very common neoplasms. However, it is often difficult to distinguish between these entities. In the present study, we aimed to classify the most powerful markers that could improve diagnosis by multiparametric flow cytometry (MFC). The present study included 348 patients based on two independent cohorts. We first assessed how representative the data were in the discovery cohort (123 MM, 97 MGUS) and then analysed their respective plasma cell (PC) phenotype in order to obtain a set of correlations with a hypersphere visualisation. Cluster of differentiation (CD)27 and CD38 were differentially expressed in MGUS and MM (P < 0·001). We found by a gradient boosting machine method that the percentage of abnormal PCs and the ratio PC/CD117 positive precursors were the most influential parameters at diagnosis to distinguish MGUS and MM. Finally, we designed a decisional algorithm allowing a predictive classification ≥95% when PC dyscrasias were suspected, without any misclassification between MGUS and SMM. We validated this algorithm in an independent cohort of PC dyscrasias (n = 87 MM, n = 41 MGUS). This artificial intelligence model is freely available online as a diagnostic tool application website for all MFC centers worldwide (https://aihematology.shinyapps.io/PCdyscrasiasToolDg/).
Injury mechanism of pedestrians impact test with a sport-utility vehicle and mini-van

Pedestrian accidents make up nearly 30% of traffic accidents in Japan; therefore, measures have been taken to abate the number of casualties. In recent years, it has been noticed that the type of injury depends on the car type, especially on the front car-body shape. Having studied the whole body behavior and injury of pedestrians in the case of accidents caused by sedan cars, a whole body impact experiment was conducted of pedestrians (post mortem human subjects) in the cases of sport utility vehicle (SUV) and mini-van using test specimens in order to examine the differences of injury that might be caused by the difference in the front car-body shape. As a result, not only the impact behaviors of the pedestrians when collided with a SUV or a mini-van but also the accelerated velocity that appeared on various parts of the body were identified. In addition, the results indicated that the trajectory of the head and the injuries were different from those in the past impact experiments of pedestrians using sedan cars. Basic data necessary for the analysis of injury mechanism of pedestrian accidents caused by SUV and mini-van were obtained which may be used for the injury-reproducing simulation using human models. For the covering abstract see ITRD E144229.
Longitudinal associations between self-reported attachment dimensions and neurostructural development from adolescence to early adulthood

ABSTRACT The existing literature suggests that individual differences in attachment may be associated with differential trajectories of structural brain development. In addition to maturation during infancy and childhood, developmental trajectories are characteristic of adolescence, a period marked by increasingly complex interpersonal relationships and significant neurostructural and functional plasticity. It remains to be examined whether attachment prospectively relates to neurostructural developmental trajectories during adolescence. In this longitudinal study, we investigated whether self-reported attachment dimensions of anxiety (AX) and avoidance (AV) could predict elements of cortical thickness (CT) and subcortical volume (SV) trajectories in 95 typically developing adolescents (12–19 years old at study baseline). Self-reported scores of AX and AV were obtained at study baseline, and neurostructural development was assessed at baseline and three timepoints over the four following years. Self-reported AX and AV were associated with steeper CT decreases in prefrontal cortical and cortical midline structures as well as anterior temporal cortex, particularly in participants younger at study baseline. Regarding SV, preliminary differential associations were observed between developmental trajectories and attachment dimensions. Our study suggests that interindividual differences in attachment contribute to shaping neurodevelopmental trajectories for several cortical and subcortical structures during adolescence and young adulthood.
Incidence of syphilis infection and syphilis-related care utilization among adolescents and young adults living with HIV

Background Incidence of syphilis has been rising in recent years and disproportionately affects young adults, racial/ethnic minority men, and people living with HIV. This study describes patterns of syphilis infection and syphilis-related care utilization among adolescents and young adults living with HIV (AYALH) in Philadelphia. Methods We conducted a retrospective cohort study of AYALH receiving care at an adolescent-specialty clinic who received a syphilis test and/or benzathine penicillin for syphilis treatment from 2011 to 2018 (N = 335). Syphilis incidence rates were calculated by baseline demographic characteristics and by calendar year. Recurrent survival analysis was used to explore how demographic and neighborhood-level factors were associated with incident syphilis and syphilis-related care utilization. Results Syphilis-related care was provided 145 times and there were 109 episodes of confirmed syphilis among 83 unique participants between 2011 and 2018. The overall syphilis incidence rate was 13.50 (95% CI: 10.9–16.5) cases per hundred person-years. Participants assigned male sex at birth had higher hazards of infection (HR: 6.12, 95% CI: 1.53–24.48), while older participants (HR: 0.64, 95% CI: 0.58–0.72) and those living further from the clinic had lower hazards of infection (HR: 0.97, 95% CI: 0.94–1.00). Race, insurance status, neighborhood diversity index, and neighborhood social disadvantage index were not associated with hazard of infection or syphilis-related care utilization. Conclusions Our study found high incidence of syphilis infection among a cohort of AYALH. Integrating comprehensive sexually transmitted infection prevention services into HIV care and improving syphilis prevention services in communities with high syphilis rates should be a priority in future intervention work.
Fibrous dysplasia patients with and without craniofacial involvement report reduced quality of life inclusive of stigma, depression, and anxiety

Objectives Fibrous dysplasia is a rare bone disorder that causes deformity, fractures, and pain that typically manifests in childhood and persists as a chronic illness. This study evaluates adult patients with fibrous dysplasia and McCune Albright syndrome to determine whether their quality of life differs from the general population and varies in relation to disease severity and lesion location. Methods This study uses data from the online self-report Fibrous Dysplasia Foundation Patient Registry and operationalizes quality of life using PRO measures: SF-36, Hospital Anxiety and Depression scale, Neuro-Quality of Life Stigma scale, and the Brief Pain Inventory. Results One hundred and ninety seven adults, 90% white, 84% women, constitute the sample. Mean scores for all SF-36 domains and the Neuro Q stigma scale were significantly below population benchmarks. A large minority registered moderate to severe levels of anxiety and depression. Group differences were not significant across most of the SF-36 domains but were associated with experienced stigma. Discussion This study demonstrates a social psychological impact of fibrous dysplasia on adults, in those with and without craniofacial involvement and with mild and severe forms of the disease. Clinical treatment should encompass assessment of quality of life issues and ensure access to psychosocial treatment resources for all fibrous dysplasia/McCune-Albright syndrome patients.
The Effects of Collaborative Technology Appropriation on Group Outcomes

Groups are increasingly utilizing collaborative technologies to facilitate distributed work processes. While these groups are assembled based upon the task knowledge possessed by their members, collaborative technology adoption decisions are often made at an organizational level, where the members’ knowledge of the technology is necessarily discounted. However, in this paper we argue that a group’s knowledge of collaborative technology will impact the manner in which the technology is appropriated. Further, the manner in which a group uses collaborative technology will impact its ability to unlock the task knowledge embedded in individual group members; a critical factor in determining group outcomes in distributed environments. In short, a group’s know-how regarding the collaborative technology can unlock its know-what regarding the task. We argue that focusing on task knowledge while ignoring technological knowledge will prevent organizations from fully leveraging group knowledge in virtual settings.