bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of globalization with the burden of opioid use disorders 2019. A country-level analysis using targeted maximum likelihood estimation
Authors: Barbalat Guillaume , Reddy Geeta , Franck Nicolas
Published: October 2023

Background

The “opioid crisis” has been responsible for hundreds of thousands deaths in the US, and is at risk of dissemination worldwide. Within-country studies have demonstrated that the rise of opioid use disorders (OUD) is linked to increased access to opioid prescriptions and to so-called “diseases of despair”. Both have been related to the emergence of globalization policies since the 1980s. First, globalized countries have seen a reorganization of healthcare practices towards quick and easy answers to complex needs, including increased opioid prescriptions. Second, despair has gained those suffering from the mutations of socio-economic systems and working conditions that have accompanied globalization policies (e.g. delocalization, deindustrialization, and the decline of social services). Here, using data with high quality ratings from the Global Burden of Disease database, we evaluated the country-based association between four levels of globalization and the burden of OUD 2019.

Results

The sample included 87 countries. Taking into account potential country-level confounders, we found that countries with the highest level of globalization were associated with a 31% increase in the burden of OUD 2019 compared to those with the lowest level of globalization (mean log difference: 0.31; 95%CI, 0.04–0.57; p = 0.02). Additional analyses showed a significant effect for low back pain (mean log difference: 0.07; 95%CI, 0.02–0.12; p = 0.007). In contrast, despite sharing some of the risk factors of OUD, other mental and substance use disorders did not show any significant relationship with globalization. Finally, socio-cultural de jure globalization, which compiles indicators related to gender equality, human capital and civil rights, was specifically associated with the burden of OUD (mean log difference: 0.49; 95%CI: 0.23,0.75; p < 0.001).

Conclusions

These findings suggest that OUD may have inherent underpinnings linked to globalization, and more particularly socio-cultural aspects of globalization. Key factors may be increased rights to access prescriptions, as well as increased feelings of despair related to the erosion of local cultures and widening educational gaps.
A scoping review of equity-focused implementation theories, models and frameworks in healthcare and their application in addressing ethnicity-related health inequities
Authors: Gustafson Papillon , Abdul Aziz Yasmin , Lambert Michelle , Bartholomew Karen , Rankin Nicole , Fusheini Adam , Brown Rachel , Carswell Peter , Ratima Mihi , Priest Patricia , Crengle Sue
Published: October 2023

Background

Inequities in implementation contribute to the unequal benefit of health interventions between groups of people with differing levels of advantage in society. Implementation science theories, models and frameworks (TMFs) provide a theoretical basis for understanding the multi-level factors that influence implementation outcomes and are used to guide implementation processes. This study aimed to identify and analyse TMFs that have an equity focus or have been used to implement interventions in populations who experience ethnicity or ‘race’-related health inequities.

Methods

A scoping review was conducted to identify the relevant literature published from January 2011 to April 2022 by searching electronic databases (MEDLINE and CINAHL), the Dissemination and Implementation model database, hand-searching key journals and searching the reference lists and citations of studies that met the inclusion criteria. Titles, abstracts and full-text articles were screened independently by at least two researchers. Data were extracted from studies meeting the inclusion criteria, including the study characteristics, TMF description and operationalisation. TMFs were categorised as determinant frameworks, classic theories, implementation theories, process models and evaluation frameworks according to their overarching aim and described with respect to how equity and system-level factors influencing implementation were incorporated.

Results

Database searches yielded 610 results, 70 of which were eligible for full-text review, and 18 met the inclusion criteria. A further eight publications were identified from additional sources. In total, 26 papers describing 15 TMFs and their operationalisation were included. Categorisation resulted in four determinant frameworks, one implementation theory, six process models and three evaluation frameworks. One framework included elements of determinant, process and evaluation TMFs and was therefore classified as a ‘hybrid’ framework. TMFs varied in their equity and systems focus. Twelve TMFs had an equity focus and three were established TMFs applied in an equity context. All TMFs at least partially considered systems-level factors, with five fully considering macro-, meso- and micro-level influences on equity and implementation.

Conclusions

This scoping review identifies and summarises the implementation science TMFs available to support equity-focused implementation. This review may be used as a resource to guide TMF selection and illustrate how TMFs have been utilised in equity-focused implementation activities.
Comparison between calcaneus quantitative ultrasound and the gold standard DXA in the ability to detect osteoporosis in chronic obstructive pulmonary disease patients
Authors: Chanprasertpinyo Wandee , Punsawad Chuchard , Khwanchuea Rapheeporn , Sukkriang Naparat , Yincharoen Pirada , Rerkswattavorn Chaiwat
Published: October 2023

Background

Osteoporosis is a prevalent comorbidity in patients with COPD that is usually underrecognized and hence, undertreated. Compared to the gold standard dual-energy X-ray absorptiometry (DXA), calcaneus quantitative ultrasound (QUS) is less expensive, more portable, and more accessible, especially in less developed countries. The aim of this study was to investigate the ability of calcaneus QUS to screen and prescreen for osteoporosis in patients with COPD.

Methods

This cross-sectional study enrolled 67 males older than 50 years with clinically stable COPD. DXA scans of the lumbar spine (L2–4) and femoral neck were performed. QUS of the right calcaneus (AOS-100) was used to assess the broadband ultrasound attenuation (BUA), speed of sound (SOS), osteo sono-assessment index (OSI), and T-score. When the T-score was ≤  − 2.5, osteoporosis was diagnosed by both DXA and QUS.

Results

Forty-eight patients (71.6%) had DXA T-scores ≤  − 2.5 at either the lumbar spine or femoral neck. All QUS parameters (BUA, SOS, OSI, and T-score) could discriminate DXA-determined osteoporosis (the area under the curve varied from 0.64 to 0.83). The QUS T-score was significantly moderately correlated with the DXA T-score at both the femoral neck (r = 0.55) and lumbar spine (r = 0.52). The sensitivity and specificity of QUS in identifying osteoporosis were 10.4% and 94.7%, respectively. The positive and negative predictive values were 83.3% and 29.5%, respectively. When a QUS T-score of 0.09 was used as the cutoff, the sensitivity exceeded 90%, and 15% of the DXA scans were not warranted.

Conclusions

The sensitivity and specificity of calcaneus QUS were not sufficient for QUS to be used as an alternative to DXA for osteoporosis screening. However, QUS may be useful for prescreening before DXA to identify COPD patients who have either a high or low likelihood of osteoporosis. Consequently, QUS reduces the need for DXA referral.
First-line nivolumab plus ipilimumab for unresectable MPM in China: a cost-effectiveness analysis
Authors: Yang Liu , Song Xiaobing , Zeng Wanxian , Zheng Zhiwei , Lin Wenqiang
Published: October 2023

Background

The regimen of nivolumab plus ipilimumab (NI) has been recommended by the National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology-Malignant Pleural Mesothelioma (Version 1.2022) and Chinese Guidelines for the Clinical Diagnosis and Treatment of Malignant Pleural Mesothelioma (2021 edition) as the first-line treatment for Malignant Pleural Mesothelioma (MPM). But whether immunotherapy has a financial advantage over conventional chemotherapy (pemetrexed plus cisplatin/carboplatin, C) is uncertain.

Methods

Based on survival and safety data from the CheckMate 743 clinical trial (NCT02899299), a partitioned survival model was constructed using TreeAge Pro2022 software. The model cycle was set to 1 month and the study period was 10 years. The output indicators included total cost, quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were used to assess the robustness of the results, considering only direct medical costs.

Results and discussion

The ICER for group NI versus Group C was $375,656/QALY in all randomized patients, $327,943/QALY in patients with epithelioid histology, and $115,495/QALY in patients with non-epithelioid histology. The ICERs of all three different populations all exceeded the willingness-to-pay threshold (three times the per capita gross domestic product of China in 2021). The results of univariate sensitivity analysis showed that the price of pemetrexed and nivolumab had great influence on the analysis results. The results of the probabilistic sensitivity analysis show that the probability of the NI scheme being more economical in all three different populations was 0.

What is new and conclusion

From the perspective of the Chinese healthcare system, in patients with unresectable MPM, NI has no economic advantage over C.
Current trials in erythropoietic protoporphyria: are placebo controls ethical?
Authors: Barman-Aksözen Jasmin , Andreoletti Mattia , Blasimme Alessandro
Published: October 2023

A new active substance called “dersimelagon” (MT-7117) is being tested as an alternative treatment option for Erythropoietic protoporphyria (EPP). At the moment, dersimelagon is being tested both in the US and in Europe in a phase III placebo-controlled RCT. However, given the availability of an already approved treatment option for EPP the use of a placebo arm is questionable from an ethics point of view. We analyze the issue and suggest that a noninferiority active-control trial without placebo is an ethically and scientifically more valid design to test the efficacy of dersimelagon as well as other EPP treatments.
Mental health of South Korean adolescents in the COVID-19 Era: Web-based survey focused on suicide-related factors
Authors: Kim Sang Mi , Jeong Yeong Mi , Park Hye Seon , Choi Sulki
Published: October 2023

Background

The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted many aspects of life. Measures for preventing the spread of COVID-19 (e.g., school lockdowns, remote and hybrid classes, group and outdoor activity restrictions, and social distancing in the classroom and meal time) could have led to adolescents to experience anxiety and depressive symptoms. Such mental health impacts could increase the risk of suicidal ideation in this population. Moreover, according to a report by the Organization for Economic Co-operation and Development, although the total number of suicide deaths in South Korea decreased in 2021, the suicide rate of those aged 10–29 years increased. One factor affecting the result is adolescent mental health by COVID-19. This study examines the mental health status of South Korean adolescents amid the prolonged COVID-19 pandemic, and identifies and analyzes predictors of suicidal ideation, suicide planning, and suicide attempts.

Methods

The study used data from 54,948 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-based Survey. Based on their responses to suicide-related questions, the sample was divided into a healthy group, suicide-ideation group, suicide-planning group, and suicide-attempt group. The descriptive statistics of these groups were then analyzed. An analysis of covariance, post-hoc tests, and multiple logistic regression analysis were performed on the four groups.

Results

Overall, 6.9% of the participants reported suicidal ideation, 2.2% reported planning suicide, and 1.9% reported attempting suicide in the previous 12 months.

Conclusions

During the prolonged COVID-19 pandemic, there is a strong need for various individualized programs that identify and intervene to support adolescents at risk of suicide by accurately assessing their mental health risk factors, such as stress, sadness and despair, loneliness, and generalized anxiety disorder. Accordingly, it is necessary to develop and distribute a mental health and well-being curriculum, strengthen suicide prevention programs and support services, expand mental health diagnostic tests, and school-based mental health programs.
Data-driven identification of total RNA expression genes for estimation of RNA abundance in heterogeneous cell types highlighted in brain tissue
Authors: Huuki-Myers Louise A. , Montgomery Kelsey D. , Kwon Sang Ho , Page Stephanie C. , Hicks Stephanie C. , Maynard Kristen R. , Collado-Torres Leonardo
Published: October 2023

We define and identify a new class of control genes for next-generation sequencing called total RNA expression genes (TREGs), which correlate with total RNA abundance in cell types of different sizes and transcriptional activity. We provide a data-driven method to identify TREGs from single-cell RNA sequencing data, allowing the estimation of total amount of RNA when restricted to quantifying a limited number of genes. We demonstrate our method in postmortem human brain using multiplex single-molecule fluorescent in situ hybridization and compare candidate TREGs against classic housekeeping genes. We identify AKT3 as a top TREG across five brain regions.
The evolution and mutational robustness of chromatin accessibility in Drosophila
Authors: Khodursky Samuel , Zheng Eric B. , Svetec Nicolas , Durkin Sylvia M. , Benjamin Sigi , Gadau Alice , Wu Xia , Zhao Li
Published: October 2023

Background

The evolution of genomic regulatory regions plays a critical role in shaping the diversity of life. While this process is primarily sequence-dependent, the enormous complexity of biological systems complicates the understanding of the factors underlying regulation and its evolution. Here, we apply deep neural networks as a tool to investigate the sequence determinants underlying chromatin accessibility in different species and tissues ofDrosophila.

Results

We train hybrid convolution-attention neural networks to accurately predict ATAC-seq peaks using only local DNA sequences as input. We show that our models generalize well across substantially evolutionarily diverged species of insects, implying that the sequence determinants of accessibility are highly conserved. Using our model to examine species-specific gains in accessibility, we find evidence suggesting that these regions may be ancestrally poised for evolution. Using in silico mutagenesis, we show that accessibility can be accurately predicted from short subsequences in each example. However, in silico knock-out of these sequences does not qualitatively impair classification, implying that accessibility is mutationally robust. Subsequently, we show that accessibility is predicted to be robust to large-scale random mutation even in the absence of selection. Conversely, simulations under strong selection demonstrate that accessibility can be extremely malleable despite its robustness. Finally, we identify motifs predictive of accessibility, recovering both novel and previously known motifs.

Conclusions

These results demonstrate the conservation of the sequence determinants of accessibility and the general robustness of chromatin accessibility, as well as the power of deep neural networks to explore fundamental questions in regulatory genomics and evolution.
The effectiveness of telehealth gait retraining in addition to standard physical therapy treatment for overuse knee injuries in soldiers: a protocol for a randomized clinical trial
Authors: Crowell Michael S. , Brindle Richard A. , Miller Erin M. , Reilly Nicholas , Ford Kevin R. , Goss Donald L.
Published: October 2023

Introduction

Running is the most common cardiovascular exercise in the military. However, there is a high incidence of running-related overuse injuries that reduces military readiness. Gait retraining is a common intervention to treat running-related injuries, but the high cost of equipment and lack of clinician expertise and availability reduces utilization. Gait retraining intervention in a telehealth format might improve feasibility. The purpose of this randomized clinical trial is to determine the effectiveness of a telehealth gait retraining intervention on pain, self-reported function, and biomechanical risk factors for injury in service members who present to a Military Health System physical therapy clinic with an overuse knee injury.

Methods

This is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels: telehealth gait retraining intervention with standard of care or only standard of care) and time (3 levels: baseline, 10 weeks or post-intervention, 14 weeks). Participants between the ages of 18 to 60 years will be included if they report knee pain during and/or after running to be anywhere from a 3 to a 7 on the numerical pain rating scale and demonstrate a rearfoot strike pattern. The primary dependent variables are as follows: (1) pain (worst pain during and/or after running) and (2) foot strike pattern (conversion rate from rearfoot to non-rearfoot foot strike pattern during running). Secondary outcomes include patient self-reported function and running biomechanics.

Discussion

The effectiveness of a telehealth gait retraining intervention to reduce pain and modify foot strike pattern is not known. The results of this study may help determine the effectiveness and feasibility of a telehealth gait retraining intervention to reduce pain, change foot strike, improve function, and improve running gait biomechanics.

Trial registration

ClinicalTrials.gov, NCT04269473. Registered 05 February 2020.
Effects of empagliflozin on serum uric acid level of patients with type 2 diabetes mellitus: a systematic review and meta‐analysis
Authors: You Yinyuan , Zhao Yu , Chen Mujuan , Pan Ying , Luo Zhenhui
Published: October 2023

Background

Serum uric acid levels are higher in patients with type 2 diabetes and prediabetes compared to healthy individuals, and hyperuricemia causes a significant rate of complications and mortality through heart and kidney diseases. Accordingly, the present systematic review and meta-analysis aimed to investigate the effect of empagliflozin on serum uric acid levels.

Materials and methods

Electronic databases, including PubMed, Scopus, Web of Science, Cochrane, and Google Scholar, were used to search papers until May 22, 2023. Data analysis was conducted by STATA Version 14, and P-value < 0.05 were considered statistically significant.

Results

The results obtained from the combination of 12 studies with 7801 samples of diabetic patients indicated that in the empagliflozin group, the serum uric acid levels of the patients decreased ([standardized mean difference (SMD): − 1.97 (95%CI − 3.39, − 0.55)], Systolic blood pressure (SBP) [SMD: − 2.62 (95%CI − 3.87, − 1.37)] and diastolic blood pressure (DBP) [SMD: − 0.49 (95%CI − 0.68, − 0.29)]). On the other side, empagliflozin treatment did not affect the patients’ HbA1c levels ([SMD: − 2.85 (95%CI − 6.14, 0.45)], eGFR [SMD: 0.78 (95%CI − 0.63, 2.18)], creatinine [SMD:0.11 (95%CI − 0.10, 0.31)], LDL [SMD: 0.14 (95%CI − 0.43, 0.71)], and HDL [SMD:1.38 (95%CI − 0.22, 2.99)]). Compared with the placebo, empagliflozin was more effective in reducing the uric acid levels ([SMD: − 1.34 (95%CI − 2.05, − 0.63)], SBP [SMD: − 2.11 (95%CI − 3.89, − 0.33)], and HbA1c [SMD: − 1.04 (95%CI − 1.95, − 0.13)]). Moreover, compared with sitagliptin also, empagliflozin was more effective in reducing uric acid levels ([SMD: − 1 (95%CI − 1.78, − 0.22)], and creatinine [SMD: − 1.60 (95%CI − 2.28, − 0.92)]) and increasing eGFR levels [SMD: 0.99 (95%CI: 0.37, 1.62)] of the patients. Compared with dapagliflozin also, empagliflozin caused a reduction in eGFR level [SMD: − 0.45 (95%CI − 0.82, − 0.08)].

Conclusion

Empagliflozin treatment was effective in controlling diabetic patients’ hyperuricemia and hypertension.
Contribution quality evaluation of table tennis match by using TOPSIS-RSR method - an empirical study
Authors: Yin Huagen , Chen Xia , Zhou Yanxiang , Xu Jiali , Huang Duo
Published: October 2023

This paper aims to evaluate the contribution quality of table tennis matches comprehensively and explore the ranking characteristics of evaluation results and the rationality of grading. Through the application of the documentation method, videos, Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) and Rank Sum Ratio (RSR), the contribution quality evaluation index system of table tennis matches was established. After then, the technical and tactical performances of 38 matches between H (anonymous), who is currently highly concerned and active in the international table tennis world from 2018 to 2020 were comprehensively evaluated. According to research results, H had 8 matches with the Ci value > 0.5 in serve rounds, 4 with the Ci value > 0.5 in receive rounds, and 5 with the RSR value > 0.6 in the comprehensive strength. These findings were generally consistent with the final match results. Furthermore, Pearson Correlation showed that the three indicators were significantly correlated with competition performance (CP) (P < 0.01). Each race could be divided into four grades, and there was a very significant difference among them by variance test (F = 60.281, P < 0.01). Meanwhile, SNK pairwise comparison between four grades had statistical significance (P < 0.05). Therefore, researchers could conclude that the combination of TOPSIS and RSR could objectively and accurately reflect the contribution quality of table tennis matches. This method could be promoted and applied in the competition performance evaluation of other net games.
The effect of glatiramer acetate, IFNβ-1a, fingolimod, and dimethyl fumarate on the expression of T-bet, IFN-γ, and MEG3 in PBMC of RRMS patients
Authors: Dabbaghi Rozhin , Safaralizadeh Reza , Rahmani Shima , Barpour Nesa , Hosseinpourfeizi Mohammadali , Rajabi Ali , Baradaran Behzad
Published: October 2023

Objective

Multiple sclerosis (MS) is a progressing neurodegenerative disease marked by chronic central nervous system inflammation and degeneration.This study investigates gene expression profiles of T-box transcription factor TBX21 (T-bet), interferon-gamma (IFN-γ), and long non-coding RNA MEG3 in peripheral blood mononuclear cells (PBMCs) from treatment-naïve Relapsing-Remitting Multiple Sclerosis patients (RRMS), healthy controls, and RRMS patients on different Disease Modifying Therapies (DMTs). The aim is to understand the role of T-bet, IFN-γ, and MEG3 in MS pathogenesis and their potential as diagnostic and therapeutic targets.

Results

Elevated T-bet expression is observed in treatment-naïve RRMS patients compared to healthy individuals. RRMS patients treated with Interferon beta-1alpha (IFNβ-1a) and fingolimod exhibit downregulated T-bet and MEG3 expression levels, respectively, with more pronounced effects in females. Healthy individuals show a moderate positive correlation between T-bet and MEG3 and between IFN-γ and T-bet. In RRMS patients treated with Glatiramer Acetate (GA), a strong positive correlation is observed between MEG3 and IFN-γ. Remarkably, RRMS patients treated with Dimethyl Fumarate (DMF) exhibit a significant positive correlation between T-bet and MEG3. These findings underscore the diagnostic potential of T-bet in RRMS, warranting further exploration of MEG3, T-bet, and IFN-γ interplay in RRMS patients.
Cheminformatics Microservice: unifying access to open cheminformatics toolkits
Authors: Chandrasekhar Venkata , Sharma Nisha , Schaub Jonas , Steinbeck Christoph , Rajan Kohulan
Published: October 2023

In recent years, cheminformatics has experienced significant advancements through the development of new open-source software tools based on various cheminformatics programming toolkits. However, adopting these toolkits presents challenges, including proper installation, setup, deployment, and compatibility management. In this work, we present the Cheminformatics Microservice. This open-source solution provides a unified interface for accessing commonly used functionalities of multiple cheminformatics toolkits, namely RDKit, Chemistry Development Kit (CDK), and Open Babel. In addition, more advanced functionalities like structure generation and Optical Chemical Structure Recognition (OCSR) are made available through the Cheminformatics Microservice based on pre-existing tools. The software service also enables developers to extend the functionalities easily and to seamlessly integrate them with existing workflows and applications. It is built on FastAPI and containerized using Docker, making it highly scalable. An instance of the microservice is publicly available at https://api.naturalproducts.net. The source code is publicly accessible on GitHub, accompanied by comprehensive documentation, version control, and continuous integration and deployment workflows. All resources can be found at the following link: https://github.com/Steinbeck-Lab/cheminformatics-microservice.

Graphical Abstract
A Review of Intelligent Verification System for Distribution Automation Terminal based on Artificial Intelligence Algorithms
Authors: Li Hongwei , Xu Qiyuan , Wang Qilin , Tang Bin
Published: October 2023

Artificial intelligence (AI) plays a key role in the distribution automation system (DAS). By using artificial intelligence technology, it is possible to intelligently verify and monitor distribution automation terminals, improve their safety and reliability, and reduce power system operating and maintenance costs. At present, researchers are exploring a variety of application methods and algorithms of the distribution automation terminal intelligent acceptance system based on artificial intelligence, such as machine learning, deep learning and expert systems, and have made significant progress. This paper comprehensively reviews the existing research on the application of artificial intelligence technology in distribution automation systems, including fault detection, network reconfiguration, load forecasting, and network security. It undertakes a thorough examination and summarization of the major research achievements in the field of distribution automation systems over the past few years, while also analyzing the challenges that this field confronts. Moreover, this study elaborates extensively on the diverse applications of AI technology within distribution automation systems, providing a detailed comparative analysis of various algorithms and methodologies from multiple classification perspectives. The primary aim of this endeavor is to furnish valuable insights for researchers and practitioners in this domain, thereby fostering the advancement and innovation of distribution automation systems.
Chinese expert consensus on Bruton tyrosine kinase inhibitors in the treatment of B-cell malignancies
Authors: Song Yuqin , Wu Shang-Ju , Shen Zhixiang , Zhao Donglu , Chan Thomas Sau Yan , Huang Huiqiang , Qiu Lugui , Li Jianyong , Tan Tran-der , Zhu Jun , Song Yongping , Huang Wei-Han , Zhao Weili , Liu Herman Sung Yu , Xu Wei , Chen Naizhi , Ma Jun , Chang Cheng-Shyong , Tse Eric Wai Choi
Published: October 2023

Targeted therapy with Bruton tyrosine kinase (BTK) inhibitors have revolutionized the treatment of patients with various B-cell malignancies. BTK inhibitors such as ibrutinib, zanubrutinib, orelabrutinib, and acalabrutinib have shown good clinical efficacy and better safety profiles than those of traditional chemotherapy and chemoimmunotherapy regimens. Multiple studies on new BTK inhibitors are ongoing, which may provide more therapeutic options for the treatment of B-cell malignancies. Considering the unmet need of evidence on BTK inhibitors in all clinical settings and to standardize the use of BTK inhibitors available in mainland China, Taiwan, Hong Kong, and Macau regions, this consensus has been formulated for the treatment of various B-cell malignancies based on the clinical practice and available evidences on the use of BTK inhibitors. The recommendations of this consensus will provide guidance to physicians and clinical researchers on the effective treatment of B-cell malignancies with BTK inhibitors.
Accelerating into Immunization Agenda 2030 with momentum from China’s successful COVID-19 vaccination campaign during dynamic COVID Zero
Authors: Rodewald Lance E.
Published: October 2023

China's immunization programs conducted a unified, tightly coordinated COVID-19 vaccination campaign during the dynamic COVID Zero period that reached well over 90% of the population with vaccines having > 90% effectiveness against serious-to-fatal COVID-19. The campaign was eight times the size of the annual routine national immunization program, administering 3.4 billion doses of vaccines while monitoring vaccine coverage, acceptability, safety, and effectiveness. Every asset of the routine immunization program had to be strengthened and expanded to attain high coverage and reach hundreds of millions of adults who had not been vaccinated since childhood. Program strengthening and expansion were in directions aligned with the World Health Organization's Immunization Agenda 2030, which has a vision that "everyone, everywhere, at every age fully benefits from vaccines for good health and well-being" and requires reaching all children, adolescents, and adults with lifesaving vaccines. Momentum from this campaign should not be lost but should be invested into achieving what is possible with a properly resourced national immunization program that is now proven to be capable of reaching everyone in the world’s largest country throughout the life course, and to do so with all vaccines recommended by the World Health Organization.

Graphical Abstract
Stressful life events and resilience in individuals with and without a history of eating disorders: a latent class analysis
Authors: Lie Selma Øverland , Wisting Line , Stedal Kristin , Rø Øyvind , Friborg Oddgeir
Published: October 2023

Background

Eating disorders (EDs) are associated with a range of stressful life events, but few have investigated protective factors that may affect these associations. The current study used mixture modelling to describe typologies in life stress exposure and availability of protective resources in individuals with and without eating disorders (EDs).

Methods

A case – control sample (n = 916) completed measures of stressful life events, resilience protective factors, emotion regulation, and symptoms of EDs, depression and anxiety. We conducted latent class analyses to identify subgroups of stress exposure and profile analyses of emotional regulation and resilience. The resulting two latent variables were combined to explore effects on ED status and symptomatology, depression, and anxiety as distal outcome variables.

Results

We identified four classes of stressful life events (generally low, some abuse/bullying, sexual/emotional assaults, and high adversity). For protective resources, we identified six profiles that ranged from low to higher levels of protection with variations in social/family resources. The latent protection variable contributed more strongly to the distal outcomes than the latent stress variable, but did not moderate the latent stress and distal outcome variable relationships. Profiles characterized by lower protective resources included higher proportions of individuals with a lifetime ED, and were associated with higher scores on all symptom measures.

Conclusions

Intra- and interpersonal protective resources were strongly associated with lifetime EDs and current mental health symptom burden after accounting for stressful event exposure, suggesting protective factors may be useful to target in the clinical treatment of patients with ED.
Synergistic mechanism of Bacillus subtilis Czk1 combined with propiconazole and tebuconazole mixtures against Pyrrhoderma noxium
Authors: Gu Zi-wei , Yin Jian-hang , Wu He , Liang Yan-qiong , Wu Wei-huai , Lu Ying , Li Rui , Tan Shi-bei , He Chun-ping , Yi Ke-xian
Published: October 2023

Background

Brown root rot disease is one of the devastating diseases in the rubber production process. It is not easy to be detected in the early stage of the disease. Our early research revealed that the rubber tree brown root rot fungus Pyrrhoderma noxium Pn006 was effectively inhibited by Bacillus subtilis Czk1 and 25% propiconazole–tebuconazole, and that the two agents might work in synergy. Therefore, in this investigation, we used non-targeted metabolomic method to evaluate the synergistic mechanism of B. subtilis Czk1 and 25% propiconazole–tebuconazole on Pyrrhoderma noxium Pn006.

Results

Metabolomics analysis identified 708 unique metabolic markers, including mainly lipids and lipid-like molecules, organic acids, alcohols, ketones, alkaloids and their derivatives, nucleotides and their analogues, benzene ring compounds and amino acids and their derivatives. Further screening identified 105 key metabolic markers that could be potential biomarkers to reveal the mechanism of biocontrol bacteria and chemical fungicides combination synergy. Three key metabolic pathways were found in pathway enrichment, including linolenic acid metabolism, benzoic acid degradation, and valine, leucine and isoleucine degradation.

Conclusions

The mechanism might be related to the influence of the energy supply and cell functional integrity of pathogenic fungal cells.

Critical relevance statement A metabolomic method was utilized to investigate the synergistic effects of B. subtilis Czk1 and 25% propiconazole–tebuconazole use on Pyrrhoderma noxium Pn006.

Graphical Abstract
Classification of the equatorial plasma bubbles using convolutional neural network and support vector machine techniques
Authors: Thanakulketsarat Thananphat , Supnithi Pornchai , Myint Lin Min Min , Hozumi Kornyanat , Nishioka Michi
Published: October 2023

Equatorial plasma bubble (EPB) is a phenomenon characterized by depletions in ionospheric plasma density being formed during post-sunset hours. The ionospheric irregularities can lead to disruptions in trans-ionospheric radio systems, navigation systems and satellite communications. Real-time detection and classification of EPBs are crucial for the space weather community. Since 2020, the Prachomklao radar station, a very high frequency (VHF) radar station, has been installed at Chumphon station (Geographic: 10.72° N, 99.73° E and Geomagnetic: 1.33° N) and started to produce radar images ever since. In this work, we propose two real-time plasma bubble detection systems based on support vector machine techniques. Two designs are made with the convolutional neural network (CNN) and singular value decomposition (SVD) used for feature extraction, the connected to the support vector machine (SVM) for EPB classification. The proposed models are trained using quick look (QL) plot images from the VHF radar system at the Chumphon station, Thailand, in 2017. The experimental results show that the combined CNN-SVM model, using the RBF kernel, achieves the highest accuracy of 93.08% while the model using the polynomial kernel achieved an accuracy of 92.14%. On the other hand, the combined SVD-SVM models yield the accuracies of 88.37% and 85.00% for RBF and polynomial kernels of SVM, respectively.

Graphical Abstract
The effects of various penalty parameter values in Q.Clear algorithm for rectal cancer detection on 18F-FDG images using a BGO-based PET/CT scanner: a phantom and clinical study
Authors: Sadeghi Fatemeh , Sheikhzadeh Peyman , Farzanehfar Saeed , Ghafarian Pardis , Moafpurian Yalda , Ay Mohammadreza
Published: October 2023

Background

The Q.Clear algorithm is a fully convergent iterative image reconstruction technique. We hypothesize that different PET/CT scanners with distinct crystal properties will require different optimal settings for the Q.Clear algorithm. Many studies have investigated the improvement of the Q.Clear reconstruction algorithm on PET/CT scanner with LYSO crystals and SiPM detectors. We propose an optimum penalization factor (β) for the detection of rectal cancer and its metastases using a BGO-based detector PET/CT system which obtained via accurate and comprehensive phantom and clinical studies.

Methods

18F-FDG PET-CT scans were acquired from NEMA phantom with lesion-to-background ratio (LBR) of 2:1, 4:1, 8:1, and 15 patients with rectal cancer. Clinical lesions were classified into two size groups. OSEM and Q.Clear (βvalue of 100–500) reconstruction was applied. In Q.Clear, background variability (BV), contrast recovery (CR), signal-to-noise ratio (SNR), SUVmax, and signal-to-background ratio (SBR) were evaluated and compared to OSEM.

Results

OSEM had 11.5–18.6% higher BV than Q.Clear usingβvalue of 500. Conversely, RC from OSEM to Q.Clear usingβvalue of 500 decreased by 3.3–7.7% for a sphere with a diameter of 10 mm and 2.5–5.1% for a sphere with a diameter of 37 mm. Furthermore, the increment of contrast using aβvalue of 500 was 5.2–8.1% in the smallest spheres compared to OSEM. When theβvalue was increased from 100 to 500, the SNR increased by 49.1% and 30.8% in the smallest and largest spheres at LBR 2:1, respectively. At LBR of 8:1, the relative difference of SNR betweenβvalue of 100 and 500 was 43.7% and 44.0% in the smallest and largest spheres, respectively. In the clinical study, asβincreased from 100 to 500, the SUVmax decreased by 47.7% in small and 31.1% in large lesions. OSEM demonstrated the least SUVmax, SBR, and contrast. The decrement of SBR and contrast using OSEM were 13.6% and 12.9% in small and 4.2% and 3.4%, respectively, in large lesions.

Conclusions

Implementing Q.Clear enhances quantitative accuracies through a fully convergent voxel-based image approach, employing a penalization factor. In the BGO-based scanner, the optimalβvalue for small lesions ranges from 200 for LBR 2:1 to 300 for LBR 8:1. For large lesions, the optimalβvalue is between 400 for LBR 2:1 and 500 for LBR 8:1. We recommendedβvalue of 300 for small lesions andβvalue of 500 for large lesions in clinical study.
Radiographic and histological evaluation of bone formation induced by rhBMP-2-incorporated biomimetic calcium phosphate material in clinical alveolar sockets preservation
Authors: Sun Yuanyuan , Xu Chunfeng , Wang Mingjie , Wei Lingfei , Pieterse Herman , Wu Yiqun , Liu Yuelian
Published: October 2023

Purpose

We assessed the efficiency of low-dose recombinant human bone morphogenetic protein-2 (rhBMP-2) incorporated biomimetic calcium phosphate on β-tricalcium phosphate (β-TCP) (rhBMP-2/BioCaP/β-TCP) on bone formation in a model of socket preservation using cone beam computed tomography (CBCT) scanning and histological examination.

Methods

Forty patients undergoing minimally invasive single-root tooth extraction for dental implantation were randomized to three groups according to the material used for socket preservation: filling with rhBMP-2/BioCaP/β-TCP, β-TCP, or natural healing (kept unfilled) (controls). The alveolar sockets (including the control group) were covered by two-layer collagen membranes and sutured. Two CBCT scans were taken, one immediately after socket preservation procedure (baseline) and another 6 weeks later. Gray values (GVs) obtained from CBCT were recorded. During insertion of the dental implant, biopsies were taken and analyzed histologically for new bone formation, residual material, and unmineralized bone tissue at the core of the biopsy.

Results

The mean (± standard deviation) changes of GVs of the CBCT scans at the central area of filled materials were as follows: 373.19 ± 157.16 in the rhBMP-2/BioCaP/β-TCP group, 112.26 ± 197.25 in the β-TCP group, and -257 ± 273.51 in the control group. The decrease of GVs in the rhBMP-2/BioCaP/β-TCP group as compared with the β-TCP group was statistically significant (P < 0.001). Differences in new bone formation (P = 0.006) were also found: 21,18% ± 7.62% in the rhBMP-2/BioCaP/β-TCP group, 13.44% ± 6.03% in the β-TCP group, and 9.49% ± 0.08% in controls. The residual material was10.04% ± 4.57% in the rhBMP-2/BioCaP/β-TCP group vs. 20.60% ± 9.54%) in the β-TCP group (P < 0.001). Differences in unmineralized bone tissue (P < 0.001) were also found (68.78% ± 7.67%, 65.96% ± 12.64%, and 90.38% ± 7.5% in the rhBMP-2/BioCaP/β-TC, β-TCP, and control groups, respectively).

Conclusions

This study shows that rhBMP-2/BioCaP/β-TCP is a promising bone substitute with fast degradation and potent pro-osteogenic capacity that can be useful for socket preservation in implant dentistry.

Trial registration: ChiCTR, ChiCTR2000035263. Registered 5 August 2020, https://www.chictr.org.cn/ChiCTR2000035263.

Graphical Abstract
A case of lymphatic flow evaluation using indocyanine green fluorescence imaging for recurrence of anastomotic site after laparoscopic right hemicolectomy
Authors: Sato Keita , Yamauchi Yosuke , Takahashi Koji
Published: October 2023

Background

Anastomotic recurrence of colorectal cancer is rare, but reoperation improves prognosis. However, there is no clear evidence regarding the extent of dissection, and there are few reports on the details of surgery. We used intraoperative lymphatic flow imaging with indocyanine green (ICG) fluorescence as a reference to determine the range of additional resection.

Case presentation

The patient was a 75-year-old man who underwent laparoscopic right hemicolectomy and extracorporeal functional terminal anastomosis for ascending colon cancer 4 years ago. Histopathological examination revealed a well-differentiated tubular adenocarcinoma, T4aN0M0, pathological stageIIB. During follow-up, anemia was observed, and colonoscopy indicated anastomotic recurrence, so additional laparoscopic resection was performed. Intraoperatively, ICG was injected into the anastomotic site, and the operation proceeded under near-infrared light observation. Lymphatic vessels along the middle colonic artery were visualized down to the root of the vessel. Using this as an indicator, the vessel was ligated from the root. Using the fact that the lymphatic vessels were also depicted in the small intestinal mesentery on the oral side of the anastomosis as an indicator, the small intestine and mesentery were resected about 7 cm from the anastomosis.

Conclusions

The optimal surgical approach for anastomotic recurrence of colorectal cancer has not been defined. Intraoperative ICG fluorescence imaging can provide images of lymphatic flow from the site of recurrence and may be an indicator of lymph node dissection in the case of anastomotic recurrence.
A case of laparoscopic appendectomy for appendiceal bleeding
Authors: Nakashima Takuya , Sano Bun , Ikawa Aiko , Tawada Kakeru , Shinoda Tomohito , Ohno Shinya , Tachikawa Reo
Published: October 2023

Background

Appendiceal bleeding is very rare, accounting for about 0.4% of all lower gastrointestinal bleeding. We present a case of laparoscopic appendectomy in a patient with a diagnosis of appendiceal bleeding.

Case presentation

A 71-year-old man came to our hospital with a complaint of bloody stools. He had progressive anemia and persistent fresh bloody stools, so he underwent lower gastrointestinal endoscopy. Active bleeding was confirmed from the orifice of the appendix, but the bleeding could not be stopped even with clips, so an emergency laparoscopic appendectomy was performed. His postoperative course was good, and he was discharged on the third postoperative day. Although the pathology results did not allow identification of the source of the bleeding, an appendiceal diverticulum was observed, and appendiceal diverticular bleeding was suspected.

Conclusion

Appendiceal bleeding is often difficult to stop endoscopically, so appendectomy should be performed as soon as possible.
Enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda: a qualitative study
Authors: Tekakwo Atkinson , Nabirye Rose Chalo , Nantale Ritah , Oguttu Faith , Nambozo Brendah , Wani Solomon , Musaba Milton W. , Mukunya David , Epuitai Joshua
Published: October 2023

Background

Male involvement plays a critical role in the utilization of various sexual and reproductive health services. We explored enablers and barriers of male involvement in the use of modern family planning methods in Eastern Uganda.

Methods

This was a qualitative study in Mbale, Eastern Uganda done between November and December 2022. We conducted three group discussions comprising of four participants each, with male partners and eight key informant interviews with midwives. We followed a group discussion guide during the group discussions and an interview guide during the key informant interviews to explore enablers and barriers of male involvement in the use of modern family planning methods. All the interviews and group discussions were audio-recorded with permission from the participants, transcribed verbatim, and analyzed following thematic content analysis approach.

Results

Two sub-themes emerged from the analysis; perceived enablers and barriers. The perceived enablers included positive attitude, subjective norms, need to support the woman, mutual consent, limited resources and expected benefits of reducing gender-based violence and sexually transmitted infections. Lack of male partner consent, busy work engagement, social stigma, religious prohibition, desire for many children and gender roles incompatibility hindered male partner involvement in family planning. Fear of side effects and misconceptions, unconducive hospital environment in form of mistreatment, family planning considered a female’s issue, and lack of consideration of male partner needs in family planning clinic were additional barriers to male involvement.

Conclusion

Male involvement in family planning was related to positive attitude and subjective norms towards family planning, mutual consent, and recognition for limited resources to support a large family size. Lack of male partner approval, fear of side effects and misconceptions, unconducive hospital environment and social, cultural and religious prohibitions discouraged male partner involvement in family planning. Community based approaches to family planning sensitization, such as community education campaigns, may be an important step toward reducing barriers to male involvement in the use of modern family planning methods.