bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjuvant trastuzumab and vinorelbine for early-stage HER2+ breast cancer
Authors: McLaughlin Shannon , Nakajima Erika , Bar Yael , Hutchinson Jennifer A. , Shin Jennifer , Moy Beverly , Isakoff Steven J. , Bardia Aditya , Kuter Irene , Spring Laura M.
Published: January 2023

Background:

The single-arm phase II APT trial established trastuzumab and paclitaxel (TH) as the standard adjuvant regimen for small human epidermal growth factor receptor 2 (HER2+) tumors. However, paclitaxel causes alopecia and has high rates of neuropathy and hypersensitivity reactions. In patients with metastatic HER2+ breast cancer (BC), the combination of trastuzumab and vinorelbine (TV) is effective and well tolerated. There is a need for alternative non-anthracycline/taxane-based regimens for patients with HER2+ early-stage BC, especially for those with contraindications or who wish to avoid side effects of taxane-based regimens. Here we describe our institutional experience with adjuvant TV for patients with early-stage HER2+ BC.

Methods:

Clinicopathological characteristics, treatment details, and outcomes of patients with localized HER2+ BC treated with adjuvant TV from 2007 to 2021 at a large academic medical institution were collected. Study endpoints included invasive disease-free survival (IDFS), overall survival (OS), and safety/tolerability. IDFS and OS were measured from start date of TV treatment to date of event/last follow-up and date of death/last follow-up, respectively.

Results:

A total of 30 patients were treated with TV. All patients received trastuzumab at standard dosing and vinorelbine at a starting dose of 25 mg/m2 either on days 1/8 or on days 1/8/21 (weekly) of a 21-day cycle with four planned cycles. Median age at diagnosis was 59 years (range: 36–81). 90.3% of patients had anatomic pathologic stage IA BC and 9.7% stage IIA BC. Of the 30 patients, 24 of them opted to pursue TV due to concerns related to alopecia, neuropathy, and other toxicities, and 6 switched from treatment with TH to TV due to toxicities. Eight patients experienced neutropenia with no cases of febrile neutropenia. No patients experienced alopecia or long-term neuropathy. With a median follow-up of 68 months (5.7 years), the 5-year IDFS rate was 90.9%, with one local and one distant recurrence. The 5-year OS was 100%.

Conclusions:

Trastuzumab in combination with vinorelbine in the adjuvant, early-stage setting for low-risk HER2+ BC demonstrated clinical efficacy and appeared to be well tolerated. TV warrants further evaluation as an alternative regimen to TH for patients with early-stage HER2+ BC.
Disparity in the era of personalized medicine for epithelial ovarian cancer
Authors: Devlin Michael-John , Miller Rowan E.
Published: January 2023

The treatment of high-grade serous ovarian cancer and high-grade endometrioid ovarian cancer has seen significant improvements in recent years, with BRCA1/2 and homologous recombination status guiding a personalized approach which has resulted in improved patient outcomes. However, for other epithelial ovarian cancer subtypes, first-line treatment remains unchanged from the platinum–paclitaxel trials of the early 2000s. In this review, we explore novel therapeutic approaches being adopted in the treatment of clear cell, mucinous, carcinosarcoma and low-grade serous ovarian cancer and the biological rational behind them. We discuss why such disparities exist, the challenges faced in conducting dedicated trials in these rarer histologies and look towards new approaches being adopted to overcome them.
Military spending and economic development: A theoretical note
Authors: Watterton Joshua J.
Published: January 2023

Eisenhower once highlighted the growing undemocratic influence of the ‘military-industrial-complex’ (1961) and the enormous opportunity cost associated with it (1953). Since the late-1990s, military spending around the world has been growing but, despite its overall significance, research on it has not followed suit. There remains no consensus on the economic effects of military spending, both in the sense of economic dynamism and whether it ‘crowds-out’ other forms of state spending, like welfare spending. Understanding such primarily depends on how the relationship between the economy and the state is theoretically understood. The present paper outlines in brief three theoretical schools on the state-economy nexus, ultimately arguing that state-backed military spending should be situated as a countertendency to the ‘law of the tendency of the rate of profit to fall’.
Imaging findings in a case of leptomeningeal myelomatosis, a rare but critical central nervous system complication of multiple myeloma
Authors: Parillo Marco , Vaccarino Federica , Quattrocchi Carlo Cosimo
Published: January 2023

Leptomeningeal myelomatosis is a rare complication of multiple myeloma (<1% of the patients). There was an increase in the incidence of leptomeningeal myelomatosis during the last decade; the prognosis of leptomeningeal myelomatosis remains poor, (overall median survival from the time of diagnosis of 2 months). We discuss a rare case of a monoclonal gammopathy evolving into multiple myeloma and finally into a rapidly progressing leptomeningeal disease. A 76 year-old woman in hematologic follow-up for advanced stage multiple myeloma in sixth-line treatment had an episode of generalized tonic-clonic seizure with sphincter release followed by altered state of consciousness. The unenhanced head CT scan showed a mild enlargement of the ventricular system without intra-axial or extra-axial hemorrhages nor significant changes in brain parenchyma. The subsequent contrast-enhanced brain MRI revealed a widespread nodular leptomeningeal enhancement characterized by contrast-enhancement of the pia mater extended into the subarachnoid spaces of the sulci and cisterns, involving supra- and sub-tentorial regions and the statoacoustic nerve in the inner ear canal bilaterally. The fluid-attenuated inversion recovery MRI images demonstrated an abnormally elevated signal within the sulci in the parieto-occipital regions. The radiological diagnosis of leptomeningeal myelomatosis was made. The patient died 4 days after the examination. In patients with long-lasting multiple myeloma and onset of neurological signs or symptoms, a contrast-enhanced brain MRI should be performed to assess the actual burden of central nervous system involvement in leptomeningeal myelomatosis; CT may provide a clue to the diagnosis when progressive enlargement of the ventricles over time is noted.
User-centred design of a clinical decision support system for palliative care: Insights from healthcare professionals
Authors: Blanes-Selva Vicent , Asensio-Cuesta Sabina , Doñate-Martínez Ascensión , Pereira Mesquita Felipe , García-Gómez Juan M.
Published: January 2023

Objective:

Although clinical decision support systems (CDSS) have many benefits for clinical practice, they also have several barriers to their acceptance by professionals. Our objective in this study was to design and validate The Aleph palliative care (PC) CDSS through a user-centred method, considering the predictions of the artificial intelligence (AI) core, usability and user experience (UX).

Methods:

We performed two rounds of individual evaluation sessions with potential users. Each session included a model evaluation, a task test and a usability and UX assessment.

Results:

The machine learning (ML) predictive models outperformed the participants in the three predictive tasks. System Usability Scale (SUS) reported 62.7  ±  14.1 and 65  ±  26.2 on a 100-point rating scale for both rounds, respectively, while User Experience Questionnaire – Short Version (UEQ-S) scores were 1.42 and 1.5 on the −3 to 3 scale.

Conclusions:

The think-aloud method and including the UX dimension helped us to identify most of the workflow implementation issues. The system has good UX hedonic qualities; participants were interested in the tool and responded positively to it. Performance regarding usability was modest but acceptable.
Quantitative Magnetic Resonance Imaging–Based Tendon Healing of Different Regions of the Shoulder: Comparison Between the Suture-Bridge and Single-Row Techniques
Authors: Xie Yuxue , Li Xiangwen , Liu Shaohua , Hu Yiwen , Chen Ye , Liu Shiyin , Wu Puye , Tao Hongyue , Chen Shuang
Published: January 2023

Background:

Rotator cuff retears occur more often at the proximal region with the suture-bridge (SB) technique than at the typical footprint region with the single-row (SR) technique. Few longitudinal clinical trials have focused on the postoperative tendon quality of the repaired rotator cuff at different regions between the 2 techniques.

Purpose:

To compare tendon healing of the proximal and distal regions between the SB and SR techniques.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were consecutive patients who underwent arthroscopic rotator cuff repair and undertook clinical and magnetic resonance imaging (MRI) examinations at 3, 6, and 12 months postoperatively between 2016 and 2017. These patients were divided into the SB and SR groups according to the technique used. The repaired tendon was segmented into distal and proximal regions on ultrashort echo time–T2* mapping images. Clinical outcomes (Constant score, American Shoulder and Elbow Surgeons score, Fudan University Shoulder Score, and visual analog scale for pain) and MRI-based tendon healing (T2* values) of different regions were compared between the 2 groups. The differences in T2* values and clinical scores were determined by 1-way analysis of variance for repeated measurements.

Results:

A total of 31 patients (17 in SB group and 14 in SR group) were included. At 12-month follow-up, significant improvements from preoperatively were achieved for all patients in all clinical scores ( P < .001 for all). No significant between-group differences were found in T2* values of the distal region at any time point; however, the mean T2* value of the proximal region at 3 months was significantly higher in the SB group compared with the SR group ( P = .03). This difference became nonsignificant at subsequent follow-up time points.

Conclusion:

Significant clinical improvements over time can be expected in the first year after arthroscopic rotator cuff repair. In the early postoperative period, higher T2* values in the proximal region of the repaired tendon (representing inferior tendon quality) were seen with the SB technique compared with the SR technique; however, this phenomenon was resolved over time.
Musical Emotion Categorization with Vocoders of Varying Temporal and Spectral Content
Authors: Harding Eleanor E. , Gaudrain Etienne , Hrycyk Imke J. , Harris Robert L. , Tillmann Barbara , Maat Bert , Free Rolien H. , Başkent Deniz
Published: January 2023

While previous research investigating music emotion perception of cochlear implant (CI) users observed that temporal cues informing tempo largely convey emotional arousal (relaxing/stimulating), it remains unclear how other properties of the temporal content may contribute to the transmission of arousal features. Moreover, while detailed spectral information related to pitch and harmony in music — often not well perceived by CI users— reportedly conveys emotional valence (positive, negative), it remains unclear how the quality of spectral content contributes to valence perception. Therefore, the current study used vocoders to vary temporal and spectral content of music and tested music emotion categorization (joy, fear, serenity, sadness) in 23 normal-hearing participants. Vocoders were varied with two carriers (sinewave or noise; primarily modulating temporal information), and two filter orders (low or high; primarily modulating spectral information). Results indicated that emotion categorization was above-chance in vocoded excerpts but poorer than in a non-vocoded control condition. Among vocoded conditions, better temporal content (sinewave carriers) improved emotion categorization with a large effect while better spectral content (high filter order) improved it with a small effect. Arousal features were comparably transmitted in non-vocoded and vocoded conditions, indicating that lower temporal content successfully conveyed emotional arousal. Valence feature transmission steeply declined in vocoded conditions, revealing that valence perception was difficult for both lower and higher spectral content. The reliance on arousal information for emotion categorization of vocoded music suggests that efforts to refine temporal cues in the CI user signal may immediately benefit their music emotion perception.
Power Centres in Governance of Higher Education
Authors: Bhushan Sudhanshu
Published: January 2023

Rules and rationalities are the bases of analysis in rules determined governance model. Power as the ability to influence decision-making and the influence of power centres are not sufficiently examined in the literature on the governance of higher education. The article locates various centres of power in the functioning of universities and how they affect decision-making. The study is located in a large province of India with a population of 130 million with over a dozen of universities and over 700 colleges affiliated with the universities. The study finds that conflict among power centres affects the decision-making and determines governance in an amorphous way. The leadership challenge is to create a communicative process by which the conflicts are resolved and unity of purposes of governance is established. However, conflict resolution itself is embedded in social and political structures. From a case study of the governance of a province in India, I observe the chaos in the governance of universities. However, depending on the intensity of the conflict or the resolution of the conflict the experiences of governance may vary in different contexts. I argue that power centres in the governance of higher education are useful instrument to study the governance of universities.
Transcriptome analysis of aphid-resistant and susceptible near isogenic lines reveals candidate resistance genes in cowpea (Vigna unguiculata)
Authors: MacWilliams Jacob R. , D. Nabity Paul , Mauck Kerry E. , Kaloshian Isgouhi
Published: January 2023

Background

Cowpea (Vigna unguiculata) is a crucial crop for regions of the world that are prone to both heat and drought; however, the phytotoxic cowpea aphid (Aphis craccivora) impairs plant physiology at low population levels. Both antibiotic and antixenotic forms of resistance to the aphid have been mapped to two quantitative trait loci (QTLs) and near isogenic lines (NILs). The molecular mechanism for this resistance response remains unknown.

Results

To understand the genes underlying susceptibility and resistance, two cowpea lines with shared heritage were infested along a time course and characterized for transcriptome variation. Aphids remodeled cowpea development and signaling relative to host plant resistance and the duration of feeding, with resource acquisition and mobilization determining, in part, susceptibility to aphid attack. Major differences between the susceptible and resistant cowpea were identified including two regions of interest housing the most genetic differences between the lines. Candidate genes enabling aphid resistance include both conventional resistance genes (e.g., leucine rich repeat protein kinases) as well as multiple novel genes with no known orthologues.

Conclusions

Our results demonstrate that feeding by the cowpea aphid globally remodels the transcriptome of cowpea, but how this occurs depends on both the duration of feeding and host-plant resistance. Constitutive expression profiles of the resistant genotype link aphid resistance to a finely-tuned resource management strategy that ultimately reduces damage (e.g., chlorosis) and delays cell turnover, while impeding aphid performance. Thus, aphid resistance in cowpea is a complex, multigene response that involves crosstalk between primary and secondary metabolism.
Multiple linear regression model for improving accuracy of capsulorhexis size calculation in femtosecond laser-assisted cataract surgery for adults: a retrospective single-center study
Authors: Akaishi Miki , Teshigawara Takeshi , Hata Seiichiro , Meguro Akira , Mizuki Nobuhisa
Published: January 2023

Background

Differences between programmed capsulorhexis diameter and actual resulting capsulorhexis diameter (ARCD) are commonly encountered in femtosecond laser-assisted cataract surgery (FLACS). The purpose of this study was to identify the preoperative ophthalmic variables influencing capsulorhexis diameter index (CDI) in FLACS for adults and create a multiple linear regression model for obtaining a more accurate capsulorhexis diameter.

Methods

This retrospective study involved sixty-seven eyes of 44 patients who received FLACS and intraocular lens implantation. The ARCD was measured using anterior segment swept-source optical coherence tomography (CASIA 2). Keratometry (K1, K2 and average K), anterior chamber depth (ACD), lens thickness (LT), anterior chamber width (ACW), white-to-white (WTW), curvature radius of anterior lens capsule (Front R) and axial length (AL) were all measured preoperatively. Based on the derived data, LT/ACW, LT/AL, LT/ACD and LT/ACW/Front R were calculated. The ratio of the programmed capsulorhexis diameter and ARCD was defined as the CDI. Correlation analysis was conducted to examine the relationship between preoperative variables listed above and the CDI. Multiple linear regression analysis was applied to select the most influential preoperative variables on CDI.

Results

ACD, LT, ACW, Front R, AL, LT/ACW, LT/AL, LT/ACD, and LT/ACW/Front R showed significant correlation with CDI. Front R and LT/ACW/Front R were selected as constants in the multiple linear regression model using stepwise variable selection. The following equation represents the multiple linear regression model: CDI = 1.306–4.516 × LT/ACW/FrontR-0.011 × Front R, when P < 0.0001, adjusted R-squared = 0.919, variance inflation factor = 8.389, and Durbin-Watson ratio = 1.846.

Predicted postoperative capsulorhexis diameter (PPCD) equation was created based on CDI equation as follows: PPCD = programmed capsulorhexis diameter × 1.306–4.516 × LT/ACW/FrontR-0.011 × Front R.

Conclusion

Front R and LT/ACW/Front R were found to be the most significant influencing factors of capsulorhexis size. CDI and PPCD calculation equations presented in this study may be useful in setting up more accurate programmed capsulorhexis diameter for FLACS in adults, resulting in a precise ARCD.
Associations between the food environment and food and drink purchasing using large-scale commercial purchasing data: a cross-sectional study
Authors: Kalbus Alexandra , Cornelsen Laura , Ballatore Andrea , Cummins Steven
Published: January 2023

Background

Evidence for an association between the local food environment, diet and diet-related disease is mixed, particularly in the UK. One reason may be the use of more distal outcomes such as weight status and cardiovascular disease, rather than more proximal outcomes such as food purchasing. This study explores associations between food environment exposures and food and drink purchasing for at-home and out-of-home (OOH) consumption.

Methods

We used item-level food and drink purchase data for London and the North of England, UK, drawn from the 2019 Kantar Fast Moving Consumer Goods panel to assess associations between food environment exposures and household-level take-home grocery (n=2,118) and individual-level out-of-home (n=447) food and drink purchasing. Density, proximity and relative composition measures were created for both supermarkets and OOH outlets (restaurants and takeaways) using a 1 km network buffer around the population-weighted centroid of households’ home postcode districts. Associations between food environment exposure measures and frequency of take-home food and drink purchasing, total take-home calories, calories from fruits and vegetables, high fat, salt and sugar products, and ultra-processed foods (UPF), volume of take-home alcoholic beverages, and frequency of OOH purchasing were modelled using negative binomial regression adjusted for area deprivation, population density, and individual and household socio-economic characteristics.

Results

There was some evidence for an inverse association between distance to OOH food outlets and calories purchased from ultra-processed foods (UPF), with a 500 m increase in distance to the nearest OOH outlet associated with a 1.1% reduction in calories from UPF (IR=0.989, 95%CI 0.982–0.997,p=0.040). There was some evidence for region-specific effects relating to purchased volumes of alcohol. However, there was no evidence for an overall association between food environment exposures and take-home and OOH food and drink purchasing.

Conclusions

Despite some evidence for exposure to OOH outlets and UPF purchases, this study finds limited evidence for the impact of the food environment on household food and drink purchasing. Nonetheless, region-specific effects regarding alcohol purchasing indicate the importance of geographical context for research and policy.
Geographic variation and sociodemographic correlates of prescription psychotropic drug use among children and youth in Ontario, Canada: a population-based study
Authors: Antoniou Tony , McCormack Daniel , Kitchen Sophie , Pajer Kathleen , Gardner William , Lunsky Yona , Penner Melanie , Tadrous Mina , Mamdani Muhammad , Juurlink David N. , Gomes Tara
Published: January 2023

Background

Population-based research examining geographic variability in psychotropic medication dispensing to children and youth and the sociodemographic correlates of such variation is lacking. Variation in psychotropic use could reflect disparities in access to non-pharmacologic interventions and identify potentially concerning use patterns.

Methods

We conducted a population-based study of all Ontario residents aged 0 to 24 years who were dispensed a benzodiazepine, stimulant, antipsychotic or antidepressant between January 1, 2018, and December 31, 2018. We conducted small-area variation analyses and identified determinants of dispensing using negative binomial generalized estimating equation models.

Results

The age- and sex-standardized rate of psychotropic dispensing to children and youth was 76.8 (range 41.7 to 144.4) prescriptions per 1000 population, with large variation in psychotropic dispensing across Ontario’s census divisions. Males had higher antipsychotic [rate ratio (RR) 1.40; 95% confidence interval (CI) 1.36 to 1.44) and stimulant (RR 1.75; 95% CI 1.70 to 1.80) dispensing rates relative to females, with less use of benzodiazepines (RR 0.85; 95% CI 0.83 to 0.88) and antidepressants (RR 0.81; 95% CI 0.80 to 0.82). Lower antipsychotic dispensing was observed in the highest income neighbourhoods (RR 0.72; 95% CI 0.70 to 0.75) relative to the lowest. Benzodiazepine (RR 1.12; 95% CI 1.01 to 1.24) and stimulant (RR 1.11; 95% CI 1.01 to 1.23) dispensing increased with the density of mental health services in census divisions, whereas antipsychotic use decreased (RR 0.82; 95% CI 0.73 to 0.91). The regional density of child and adolescent psychiatrists and developmental pediatricians (RR 1.00; 95% CI 0.99 to 1.01) was not associated with psychotropic dispensing.

Conclusion

We found significant variation in psychotropic dispensing among young Ontarians. Targeted investment in regions with long wait times for publicly-funded non-pharmacological interventions and novel collaborative service models may minimize variability and promote best practices in using psychotropics among children and youth.
Changes in the probability of hysterectomy in the city of Mainz and Mainz-Bingen region, Germany
Authors: Tanaka Luana F. , Schoffer Olaf , König Jochem , Weyer-Elberich Veronika , Blettner Maria , Klug Stefanie J.
Published: January 2023

Background

To assess the hysterectomy probability by calendar period and age, the overall and the age-specific prevalence of hysterectomy in women aged 30–65 years.

Methods

Baseline data (2005–2007) from the population-based MARZY study conducted in Mainz and Mainz-Bingen, Germany, were analysed. 6429 women aged 30–65 years were asked whether they had undergone a hysterectomy and the date and indication of the procedure. We calculated the 5-year age-specific prevalence of hysterectomy and estimated the probability of undergoing a hysterectomy combining two approaches: 1) Kaplan–Meier and 2) Inverse probability weighting (IPW). We assessed potential changes over calendar periods by simulating survival curves, having hysterectomy as the event, employing a Cox proportional hazard model.

Results

Data on hysterectomy were available for 4719 women. Of these, 961 (20.4%) had undergone a hysterectomy between 1960 and 2006. The hysterectomy prevalence was highest among the 60–64 year-olds (40.7%). The IPW-corrected probability of having a hysterectomy up to the age of 65 years was 36.4%. The age-specific probability of hysterectomy increased from 0.1% (20–24 years), peaking at 45–49 years (7.8%) and declining thereafter to less than 5% among women aged 50 and older. Over time, women were hysterectomised at an increasingly older age. Most hysterectomies (86.7%) were done due to benign disease.

Conclusions

A shift to older age at hysterectomy with an advancing calendar period likely reflects changes in clinical practice in Germany.

Trial registration

Landesärztekammer Rheinland-Pfalz: 837.438.03 (4100).
A noninvasive model discriminating significant histological changes in treatment-naive chronic hepatitis B patients with normal ALT
Authors: Teng Jiaming , Du Yanan , Visalath Phimphone , Zhou Tianhui , Du Bingying , Zhang Qin , Cai Wei
Published: January 2023

Background

Traditionally part of chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) are recommended to antiviral therapy referring to liver biopsy. However, liver biopsy is an invasive method with various potential complications. A noninvasive model was established in the study to evaluate liver histology and to identify the need of antiviral therapy.

Methods

A total of 614 liver biopsied CHB patients with ALT less than upper limit of normal from 2 centers were retrospectively analyzed. They were divided into a training cohort and a validation cohort. A noninvasive model to predict the significant liver histological changes was established and validated.

Results

The results of analysis showed that ALT, Age, platelet (PLT) and liver stiffness (LS) were independent risk factors for significant liver injury. The model was established based on the 4 indexes, with the area under the curve of 0.85 and 0.87 in training cohort and validation cohort. Meanwhile, 2 cut-off scores were selected. By applying the low cut-off score (− 0.207), patients without significant liver injury could be identified with high accuracy, with negative predictive value of 72.7% and 73.7% in training and validation cohorts. By applying the high cut-off score (0.537), the presence of significant liver injury could be diagnosed with high accuracy, with positive predictive value of 90.3% and 88.8% in the training and validation cohorts. By applying the model, liver biopsy would have been avoided in 87.6% (538/614) patients, with correct prediction in 87.9% (473/538).

Conclusion

The novel noninvasive model composed of ALT, Age, PLT, LS can correctly assess liver histology in CHB patient with normal ALT, which helps to determine the need of antiviral therapy without liver biopsy.
Screening and identification of potential key biomarkers for glucocorticoid-induced osteonecrosis of the femoral head
Authors: Chen Dan , Zhong Duming , Mei Runhong , Qian Shida , Wang Peng , Chen Kaiyun , Yu Xuefeng
Published: January 2023

Background

Glucocorticoid-induced osteonecrosis of the femoral head (GIONFH) is a common disease in osteoarticular surgery, with a high disability rate, which brings great physical and mental pain and economic burden to patients. Its specific pathogenesis has not been fully demonstrated, and there is a lack of recognized effective biomarkers for earlier detection and prompt treatment. This has become an urgent clinical problem for orthopedic scholars.

Materials and methods

We downloaded the gene expression profile dataset GSE123568 from the Gene Expression Omnibus database, used STRING and Cytoscape to carry out module analysis and built a gene interaction network. The four core genes most related to GIONFH in this network were ultimately found out by precise analysis and animal experiment were then conducted for verification. In this verification process, thirty-six New Zealand white rabbits were randomly divided into blank control group, model group and drug group. Except for the blank control group, the animal model of GIONFH was established by lipopolysaccharide and methylprednisolone, while the drug group was given the lipid-lowering drugs for intervention as planned. The rabbits were taken for magnetic resonance imaging at different stages, and their femoral head specimens were taken for pathological examination, then the expression of target genes in the femoral head specimens of corresponding groups was detected. Validation methods included RT-PCR and pathological examination.

Results

A total of 679 differential genes were selected at first, including 276 up-regulated genes and 403 down-regulated genes. Finally, four genes with the highest degree of correlation were screened. Animal experiment results showed that ASXL1 and BNIP3L were in low expression, while FCGR2A and TYROBP were highly expressed.

Conclusion

Through animal experiments, it was confirmed that ASXL1, BNIP3L, FCGR2A and TYROBP screened from the comparative analysis of multiple genes in the database were closely related to GIONFH, which is important for early diagnosis of Glucocorticoid-induced osteonecrosis of the femoral head.
CenterTransFuser: radar point cloud and visual information fusion for 3D object detection
Authors: Li Yan , Zeng Kai , Shen Tao
Published: January 2023

Sensor fusion is an important component of the perception system in autonomous driving, and the fusion of radar point cloud information and camera visual information can improve the perception capability of autonomous vehicles. However, most of the existing studies ignore the extraction of local neighborhood information and only consider shallow fusion between the two modalities based on the extracted global information, which cannot perform a deep fusion of cross-modal contextual information interaction. Meanwhile, in data preprocessing, the noise in radar data is usually only filtered by the depth information derived from image feature prediction, and such methods affect the accuracy of radar branching to generate regions of interest and cannot effectively filter out irrelevant information of radar points. This paper proposes the CenterTransFuser model that makes full use of millimeter-wave radar point cloud information and visual information to enable cross-modal fusion of the two heterogeneous information. Specifically, a new interaction called cross-transformer is explored, which cooperatively exploits cross-modal cross-multiple attention and joint cross-multiple attention to mine radar and image complementary information. Meanwhile, an adaptive depth thresholding filtering method is designed to reduce the noise of radar modality-independent information projected onto the image. The CenterTransFuser model is evaluated on the challenging nuScenes dataset, and it achieves excellent performance. Particularly, the detection accuracy is significantly improved for pedestrians, motorcycles, and bicycles, showing the superiority and effectiveness of the proposed model.
On some new quantum trapezoid-type inequalities for q-differentiable coordinated convex functions
Authors: Wannalookkhee Fongchan , Nonlaopon Kamsing , Sarikaya Mehmet Zeki , Budak Hüseyin , Ali Muhammad Aamir
Published: January 2023

In this paper, we establish several new inequalities forq-differentiable coordinated convex functions that are related to the right side of Hermite–Hadamard inequalities for coordinated convex functions. We also show that the inequalities proved in this paper generalize the results given in earlier works. Moreover, we give some examples in order to demonstrate our main results.
Existence and stability analysis for a class of fractional pantograph q-difference equations with nonlocal boundary conditions
Authors: Lachouri Adel , Samei Mohammad Esmael , Ardjouni Abdelouaheb
Published: January 2023

In this present manuscript, by applying fractional quantum calculus, we study a nonlinear fractional pantograph q-difference equation with nonlocal boundary conditions. We prove the existence and uniqueness results by using the well-known fixed-point theorems of Schaefer and Banach. We also discuss the Ulam–Hyers stability of the mentioned pantograph q-difference problem. Lastly, the paper includes pertinent examples to support our theoretical analysis and justify the validity of the results.
General Anesthetics in CAncer REsection Surgery (GA-CARES) randomized multicenter trial of propofol vs volatile inhalational anesthesia: protocol description
Authors: Bennett-Guerrero Elliott , Romeiser Jamie L. , DeMaria Samuel , Nadler Jacob W. , Quinn Timothy D. , Ponnappan Sanjeev K. , Yang Jie , Sasson Aaron R.
Published: January 2023

Background

Studies indicate that patients can be “seeded” with their own cancer cells during oncologic surgery and that the immune response to these circulating cancer cells might influence the risk of cancer recurrence. Preliminary data from animal studies and some retrospective analyses suggest that anesthetic technique might affect the immune response during surgery and hence the risk of cancer recurrence. In 2015, experts called for prospective scientific inquiry into whether anesthetic technique used in cancer resection surgeries affects cancer-related outcomes such as recurrence and mortality. Therefore, we designed a pragmatic phase 3 multicenter randomized controlled trial (RCT) called General Anesthetics in Cancer Resection (GA-CARES).

Methods

After clinical trial registration and institutional review board approval, patients providing written informed consent were enrolled at five sites in New York (NY) State. Eligible patients were adults with known or suspected cancer undergoing one of eight oncologic surgeries having a high risk of cancer recurrence. Exclusion criteria included known or suspected history of malignant hyperthermia or hypersensitivity to either propofol or volatile anesthetic agents. Patients were randomized (1:1) stratified by center and surgery type using REDCap to receive either propofol or volatile agent for maintenance of general anesthesia (GA). This pragmatic trial, which seeks to assess the potential impact of anesthetic type in “real world practice”, did not standardize any aspect of patient care. However, potential confounders, e.g., use of neuroaxial anesthesia, were recorded to confirm the balance between study arms. Assuming a 5% absolute difference in 2-year overall survival rates (85% vs 90%) between study arms (primary endpoint, minimum 2-year follow-up), power using a two-sided log-rank test with type I error of 0.05 (no planned interim analyses) was calculated to be 97.4% based on a target enrollment of 1800 subjects. Data sources include the National Death Index (gold standard for vital status in the USA), NY Cancer Registry, and electronic harvesting of data from electronic medical records (EMR), with minimal manual data abstraction/data entry.

Discussion

Enrollment has been completed (n = 1804) and the study is in the follow-up phase. This unfunded, pragmatic trial, uses a novel approach for data collection focusing on electronic sources.

Trial registration

Registered (NCT03034096) on January 27, 2017, prior to consent of the first patient on January 31, 2017.
Primary hyperparathyroidism presenting as acute hypercalcemic crisis: A case report
Authors: Gill Gia , Agrawal Veena , Kerr Paul
Published: January 2023

Background

Hyperparathyroid crisis, or “parathyroid storm” is a rare manifestation of primary hyperparathyroidism, characterized by sudden onset of symptomatic, severe hypercalcemia (> 3.5 mmol/L). Hemorrhage into a parathyroid adenoma has rarely been reported as an inciting or associated event. We present a case of hemorrhage into a longstanding adenoma presenting with acute onset of profound hypercalcemia and associated complications.

Case presentation

A 60-year-old male presented to hospital with sudden onset of confusion, muscle weakness, and ataxia. Initial labs showed serum calcium 4.79 mmol/L, parathyroid hormone 2043 ng/L; creatinine 364 μmol/L. Review of the patient's medical history indicated a 4-year history of recurrent nephrolithiasis, but no prior documented calcium levels. The hypercalcemia did not respond to 5 days of aggressive medical management with fluid resuscitation, denosumab and calcitonin, and later pamidronate and cinacalcet. He continued to deteriorate, requiring intubation and continuous renal replacement therapy. Imaging demonstrated 4.8 cm cystic right paratracheal mass; Technetium (Tc99m) Sestamibi scintigraphy was non-localizing. Urgent parathyroidectomy was completed, revealing a 5 × 3.3 × 1.8 cm hemorrhagic, atypical hypercellular parathyroid. Unfortunately, the patient died from complications from anticoagulation therapy for treatment of deep vein thrombosis 4 weeks after admission. His renal function had not recovered at the time of his death.

Conclusion

This case gives potential insight into the etiology of hyperparathyroid crisis, and the difficulty in achieving control of hypercalcemia with medical means. Surgical intervention is the definitive management in these cases and should be considered urgently.

Graphical abstract
Dysfunction of the glutamatergic photoreceptor synapse in the P301S mouse model of tauopathy
Authors: Arouche-Delaperche L. , Cadoni S. , Joffrois C. , Labernede G. , Valet M. , César Q. , Dégardin J. , Girardon S. , Gabriel C. , Krantic S. , Picaud S.
Published: January 2023

Tauopathies, including Alzheimer’s disease, are characterized by retinal ganglion cell loss associated with amyloid and phosphorylated tau deposits. We investigated the functional impact of these histopathological alterations in the murine P301S model of tauopathy. Visual impairments were demonstrated by a decrease in visual acuity already detectable at 6 months, the onset of disease. Visual signals to the cortex and retina were delayed at 6 and 9 months, respectively. Surprisingly, the retinal output signal was delayed at the light onset and advanced at the light offset. This antagonistic effect, due to a dysfunction of the cone photoreceptor synapse, was associated with changes in the expression of the vesicular glutamate transporter and a microglial reaction. This dysfunction of retinal glutamatergic synapses suggests a novel interpretation for visual deficits in tauopathies and it highlights the potential value of the retina for the diagnostic assessment and the evaluation of therapies in Alzheimer’s disease and other tauopathies.
The making of black inks in an Arabic treatise by al-Qalalūsī dated from the 13th c.: reproduction and characterisation of iron-gall ink recipes
Authors: Díaz Hidalgo Rafael Javier , Córdoba Ricardo , Grigoryan Hermine , Vieira Márcia , Melo Maria J. , Nabais Paula , Otero Vanessa , Teixeira Natércia , Fani Sara , Al-Abbady Hossam
Published: January 2023

For the first time, this paper systematises the medieval preparation of black writing inks found in the important thirteenth century Andalusian technical treatise written by Muhammad ibn Idrīs ibn al-Qalalūsī (1210–1308). We present the Arabic version of this extraordinary text (‘The gifts of the wise men on the curiosities of the substances’), and its first English translation, as well as discuss key aspects of the processes that remain missing or are unclear indications. In this work, we studied the iron gall inks based on galls, where no other phenolic source is present. In this pedagogical treatise, the recipes for these black iron-gall inks are organised and classified by the gallnuts extraction method used: boiling (decoction), squeezing and infusion, with water being the only solvent used. The inks selected were reproduced and characterised through a multi-analytical approach. Quantification was performed by HPLC–DAD (high performance liquid chromatography with diode array detectors in the UV–VIS), showing that gallic acid is a minor compound in the gall extracts prepared following al-Qalalūsī instructions. In all the recipes, the higher concentration compounds in the gall extracts are the gallotannins pentagalloylglucose and hexagalloylglucose, ranging from 79 to 50% of the phenolic compounds. This supports the results of Raman and infrared spectroscopies. A comparison with medieval Iberian recipes was also done, which served to reinforce our previous results that show water as the sole solvent extracts with much lower yields than mixed solvents (water plus white wine or vinegar).
Building a large dam: identifying the relationship between catchment area and slope using the confidence ellipse approach
Authors: Liu Suning , Chen Ji , Li Jiaye , Li Tiejian , Shi Haiyun , Sivakumar Bellie
Published: January 2023

With the population projections indicating continued growth during this century, construction of large dams can be considered as one of the best available options to meet the future increases in water, food, and energy demands. While there are reports that thousands of large dams will be built in the near future, a key question is: what are the appropriate conditions for selecting the sites for these dams? The site of a large dam should be carefully evaluated based on many factors, such as socioeconomic development, water resources availability, topographic characteristics, and environmental impacts. This study aims to partly address the above question through identifying the relationship between two topographic characteristics (i.e., catchment area and slope) of a river reach to build a large dam based on the 30-m-resolution global drainage networks. The information about 2815 existing large dams from the Global Reservoir and Dam (GRanD) database is collected for analysis. The confidence ellipse approach is introduced to establish the quantitative relationship between these two variables, which is then used to evaluate the site selection of a large dam from the perspective of topographic characteristics. The results show that: (1) each large dam can well correspond to the nearest river reach in the global drainage networks and (2) the logarithmic values of catchment area and slope can be well described by a confidence ellipse, which is obtained based on the means, standard deviations, and Pearson correlation coefficients of the two variables. The outcomes of this study will be of great value for policymakers to have a more comprehensive understanding of large dam development in future.
Engaging stakeholders to develop a suicide prevention learning module for Louisiana firearm training courses
Authors: Houtsma Claire , Powers Jeffrey , Raines Amanda M. , Bailey Matthew , Barber Catherine , True Gala
Published: January 2023

Background

Firearm suicide is a significant public health problem in the United States of America among the general and veteran populations. Broad-based preventive strategies, including lethal means safety, have been emphasized as a key approach to suicide prevention. Prior research has identified ways to improve the reach and uptake of lethal means safety messages. However, few resources have been created with these lessons in mind.

Methods

Louisiana firearm owners and instructors were recruited through a larger project, Veteran-Informed Safety Intervention and Outreach Network, as well as a publicly available database of firearm instructors to participate in focus groups to provide feedback on an existing suicide prevention learning module (developed in Utah) for use by firearm instructors. Their feedback was used to adapt the module, which included a brief video and PowerPoint presentation. Firearm owners and instructors were then invited back for another round of focus groups to provide feedback on this adapted learning module. Team-based rapid qualitative analysis was conducted to identify themes across transcripts from these four focus groups.

Results

Firearm owners and instructors agreed on several key themes, including the importance of messenger relatability and aligning the lethal means safety message with firearm owner values. Feedback suggested these themes were adequately addressed in the adapted learning module and contributed to overall module acceptability. The final theme, present across the original and adapted learning modules (i.e., Utah and Louisiana), was openness to further information and training on firearm suicide prevention.

Conclusion

Consistent with a public health approach to suicide prevention, the current study used stakeholder engagement to develop a suicide prevention learning module perceived as representative, accurate, and acceptable to Louisiana firearm owners and instructors. These findings can be used to inform firearm suicide prevention efforts in other states.
Jejunal intussusception and perforation due to enteric muco-submucosal elongated polyp: a case report and literature review
Authors: Kikuchi Ryosuke , Emoto Shigenobu , Nozawa Hiroaki , Sasaki Kazuhito , Murono Koji , Abe Shinya , Sonoda Hirofumi , Shinozaki-Ushiku Aya , Ishihara Soichiro
Published: January 2023

Background

A muco-submucosal elongated polyp is a non-neoplastic growth composed of mucosa and submucosa. Although muco-submucosal elongated polyps are commonly reported in the large intestine, they are rare in the small intestine, in which they are called enteric muco-submucosal elongated polyps. We herein present a case of jejunal intussusception and perforation due to an enteric muco-submucosal elongated polyp.

Case presentation

A 46-year-old woman presented with abdominal pain and vomiting. Computed tomography revealed jejunal intussusception, which was reduced via a nasointestinal ileus tube. Oral double-balloon endoscopy showed an elongated polyp in the proximal jejunum. The patient refused surgical resection and thus, the polyp was monitored. Six months later, the patient was readmitted with the recurrence of jejunal intussusception and underwent emergency surgery. Intraoperative findings revealed an intussuscepted bowel with an elongated polyp and multiple perforations in the proximal jejunum. We resected approximately 90 cm of the bowel, including the intussuscepted segment and perforated sites. The pedunculated polyp, which was 60 mm in length, was located on the oral side of the resected specimen. Histopathologically, the polyp was covered by normal mucosa and the submucosa consisted of edematous loose connective tissue. The histopathological diagnosis confirmed an enteric muco-submucosal elongated polyp.

Conclusions

Symptomatic patients with enteric muco-submucosal elongated polyps may be at risk of complications, as observed in the present case, and need to undergo timely resection.