bluuebunny/crossref_metadata_2025 huggingface dataset:
Neuromorphic place cells
Authors: Chen Zhaoqi , Nasrallah Alia , Etienne-Cummings Ralph
Published: May 2024

A neuromorphic simultaneous localization and mapping (SLAM) system shows potential for more efficient implementation than its traditional counterpart. At the mean time a neuromorphic model of spatial encoding neurons in silicon could provide insights on the functionality and dynamic between each group of cells. Especially when realistic factors including variations and imperfections on the neural movement encoding are presented to challenge the existing hypothetical models for localization. We demonstrate a mixed-mode implementation for spatial encoding neurons including theta cells, egocentric place cells, and the typical allocentric place cells. Together, they form a biologically plausible network that could reproduce the localization functionality of place cells observed in rodents. The system consists of a theta chip with 128 theta cell units and an FPGA implementing 4 networks for egocentric place cells formation that provides the capability for tracking on a 11 by 11 place cell grid. Experimental results validate the robustness of our model when suffering from as much as 18% deviation, induced by parameter variations in analog circuits, from the mathematical model of theta cells. We provide a model for implementing dynamic neuromorphic SLAM systems for dynamic-scale mapping of cluttered environments, even when subject to significant errors in sensory measurements and real-time analog computation. We also suggest a robust approach for the network topology of spatial cells that can mitigate neural non-uniformity and provides a hypothesis for the function of grid cells and the existence of egocentric place cells.
Becoming Professional
Authors: Hebbar N. Nandini
Published: May 2024

This chapter marks a move from models of education to its contents (and discontents). Particular attention has been paid to the way university pedagogy has evolved to mould a new prototype of the private-sector engineer—fluent in English, familiar with global lifestyles, and skilled in management strategies. Training in this model has been adopted widely in engineering colleges under pressure to produce graduates who are ‘employable’, and not merely proficient in the manufacture and use of technology. Though students critique aspects of this training as being incompatible with local social mores (which the college enforces in everyday life), they also learn to focus on the self as the key locus of change. Existing class and caste inequalities are often reproduced and people with existing cultural and social capital are often determined to be more ‘employable’, contributing to a widening gap between those with capital and those without it.
Engineering Aspirations and Lives of Youth
Authors: Hebbar N. Nandini
Published: May 2024

The concluding chapter revisits some of the key understandings arrived through the ethnographic research and shows the realities of higher education in contemporary India. Despite the manifold increase in the number of institutions and the subsequent entry of a large number of first-generation learners, hierarchies and inequalities are largely reproduced. Women are able to enter education only under conditions that enhance their families’ respectability. Groups that do not have explicit markers of cultural and social capital struggle to find employment. Neither upward mobility nor personal success nor transformations sought through entry into engineering colleges are easily achieved. The case studies help to make clear some of the seeming paradoxes such as why despite a drastic increase in women’s access to higher education, their enrolment in the workforce is at an all-time low; why young men and women struggle to find jobs despite having a professional education degree, and why even marriage choices are often made along the grain of caste.
rNMPID: a database for riboNucleoside MonoPhosphates in DNA
Authors: Yang Jingcheng , Sun Mo , Ran Zihan , Yang Taehwan , Kundnani Deepali L , Storici Francesca , Xu Penghao
Published: May 2024

Motivation

Ribonucleoside monophosphates (rNMPs) are the most abundant non-standard nucleotides embedded in genomic DNA. If the presence of rNMP in DNA cannot be controlled, it can lead to genome instability. The actual regulatory functions of rNMPs in DNA remain mainly unknown. Considering the association between rNMP embedment and various diseases and cancer, the phenomenon of rNMP embedment in DNA has become a prominent area of research in recent years.

Results

We introduce the rNMPID database, which is the first database revealing rNMP-embedment characteristics, strand bias, and preferred incorporation patterns in the genomic DNA of samples from bacterial to human cells of different genetic backgrounds. The rNMPID database uses datasets generated by different rNMP-mapping techniques. It provides the researchers with a solid foundation to explore the features of rNMP embedded in the genomic DNA of multiple sources, and their association with cellular functions, and, in future, disease. It also significantly benefits researchers in the fields of genetics and genomics who aim to integrate their studies with the rNMP-embedment data.

Availability and implementation

rNMPID is freely accessible on the web at https://www.rnmpid.org.
Network depth affects inference of gene sets from bacterial transcriptomes using denoising autoencoders
Authors: Kion-Crosby Willow , Barquist Lars
Published: May 2024

The increasing number of publicly available bacterial gene expression data sets provides an unprecedented resource for the study of gene regulation in diverse conditions, but emphasizes the need for self-supervised methods for the automated generation of new hypotheses. One approach for inferring coordinated regulation from bacterial expression data is through neural networks known as denoising autoencoders (DAEs) which encode large datasets in a reduced bottleneck layer. We have generalized this application of DAEs to include deep networks and explore the effects of network architecture on gene set inference using deep learning. We developed a DAE-based pipeline to extract gene sets from transcriptomic data in Escherichia coli, validate our method by comparing inferred gene sets with known pathways, and have used this pipeline to explore how the choice of network architecture impacts gene set recovery. We find that increasing network depth leads the DAEs to explain gene expression in terms of fewer, more concisely defined gene sets, and that adjusting the width results in a tradeoff between generalizability and biological inference. Finally, leveraging our understanding of the impact of DAE architecture, we apply our pipeline to an independent uropathogenic E.coli dataset to identify genes uniquely induced during human colonization.

Availability and implementation

https://github.com/BarquistLab/DAE_architecture_exploration.
Chainsaw: protein domain segmentation with fully convolutional neural networks
Authors: Wells Jude , Hawkins-Hooker Alex , Bordin Nicola , Sillitoe Ian , Paige Brooks , Orengo Christine
Published: May 2024

Motivation

Protein domains are fundamental units of protein structure and play a pivotal role in understanding folding, function, evolution, and design. The advent of accurate structure prediction techniques has resulted in an influx of new structural data, making the partitioning of these structures into domains essential for inferring evolutionary relationships and functional classification.

Results

This article presents Chainsaw, a supervised learning approach to domain parsing that achieves accuracy that surpasses current state-of-the-art methods. Chainsaw uses a fully convolutional neural network which is trained to predict the probability that each pair of residues is in the same domain. Domain predictions are then derived from these pairwise predictions using an algorithm that searches for the most likely assignment of residues to domains given the set of pairwise co-membership probabilities. Chainsaw matches CATH domain annotations in 78% of protein domains versus 72% for the next closest method. When predicting on AlphaFold models, expert human evaluators were twice as likely to prefer Chainsaw’s predictions versus the next best method.

Availability and implementation

github.com/JudeWells/Chainsaw.
Importance of resection margin after resection of colorectal liver metastases in the era of modern chemotherapy: population-based cohort study
Authors: Östrand Emil , Rystedt Jenny , Engstrand Jennie , Frühling Petter , Hemmingsson Oskar , Sandström Per , Sternby Eilard Malin , Tingstedt Bobby , Buchwald Pamela
Published: May 2024

Background

Resection margin has been associated with overall survival following liver resection for colorectal liver metastasis. The aim of this study was to examine how resection margins of 0.0 mm, 0.1–0.9 mm and ≥1 mm influence overall survival in patients resected for colorectal liver metastasis in a time of modern perioperative chemotherapy and surgery.

Methods

Using data from the national registries Swedish Colorectal Cancer Registry and Swedish National Quality Registry for Liver, Bile Duct and Gallbladder Cancer, patients that had liver resections for colorectal liver metastasis between 2009 and 2013 were included. In patients with a narrow or unknown surgical margin the original pathological reports were re-reviewed. Factors influencing overall survival were analysed using a Cox proportional hazard model.

Results

A total of 754 patients had a known margin status, of which 133 (17.6%) patients had a resection margin <1 mm. The overall survival in patients with a margin of 0 mm or 0.1–0.9 mm was 42 (95% c.i. 31 to 53) and 48 (95% c.i. 35 to 62) months respectively, compared with 75 (95% c.i. 65 to 85) for patients with ≥1 mm margin, P < 0.001. Margins of 0 mm or 0.1–0.9 mm were associated with poor overall survival in the multivariable analysis, HR 1.413 (95% c.i. 1.030 to 1.939), P = 0.032, and 1.399 (95% c.i. 1.025 to 1.910), P = 0.034, respectively.

Conclusions

Despite modern chemotherapy the resection margin is still an important factor for the survival of patients resected for colorectal liver metastasis, and a margin of ≥1 mm is needed to achieve the best possible outcome.
Foundations first: the unchanging significance of cleansing in the era of fourth-generation retinoids
Authors: Chow Yan Ching , Siripanich Chawalpat , Ali Faisal R
Published: May 2024

The onset of fourth-generation retinoids such as trifarotene marks an advancement in acne therapy, and applications are still being elucidated. However, clinicians should not dismiss the importance of simple, nonpharmacological measures such as regular skin cleansing and the use of moisturizers, reaffirming their crucial place in the holistic management of both acne and other dermatological conditions.
Coronary revascularization and sex differences in cardiovascular mortality after myocardial infarction in 12 high and middle-income European countries
Authors: Cenko Edina , Yoon Jinsung , Bergami Maria , Gale Chris P , Vasiljevic Zorana , Vavlukis Marija , Kedev Sasko , Miličić Davor , Dorobantu Maria , Badimon Lina , Manfrini Olivia , Bugiardini Raffaele
Published: May 2024

Background

Existing data on female sex and excess cardiovascular mortality after myocardial infarction (MI) mostly come from high-income countries (HICs). This study aimed to investigate how sex disparities in treatments and outcomes vary across countries with different income levels.

Methods

Data from the ISACS Archives registry included 22 087 MI patients from 6 HICs and 6 middle-income countries (MICs). MI data were disaggregated by clinical presentation: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). The primary outcome was 30-day mortality.

Results

Among STEMI patients, women in MICs had nearly double the 30-day mortality rate of men [12.4% vs. 5.8%; adjusted risk ratio (RR) 2.30, 95% CI 1.98–2.68]. This difference was less pronounced in HICs (6.8% vs. 5.1%; RR 1.36, 95% CI 1.05–1.75). Despite more frequent treatments and timely revascularization in MICs, sex-based mortality differences persisted even after revascularization (8.0% vs. 4.1%; RR 2.05, 95% CI, 1.68–2.50 in MICs and 5.6% vs. 2.6%; RR 2.17, 95% CI, 1.48–3.18) in HICs. Additionally, women from MICs had higher diabetes rates compared to HICs (31.8% vs. 25.1%, standardized difference = 0.15). NSTEMI outcomes were relatively similar between sexes and income groups.

Conclusions

Sex disparities in mortality rates following STEMI are more pronounced in MICs compared to HICs. These disparities cannot be solely attributed to sex-related inequities in revascularization. Variations in mortality may also be influenced by sex differences in socioeconomic factors and baseline comorbidities.
Poor-Quality Daily Social Encounters, Daily Stress, and Subjective Cognitive Decline Among Older Adults
Authors: Jang Heejung , Hill Nikki L , Turner Jennifer R , Bratlee-Whitaker Emily , Jeong Mijin , Mogle Jacqueline
Published: May 2024

Background and Objectives

Although prior research has shown that social relationships and daily stress are strongly associated with cognitive function, few studies have explored the link between the quality of daily social encounters and subjective cognitive decline (SCD). The present study explores whether the quality of older adults’ daily social encounters is associated with SCD through daily stress.

Research Design and Methods

This study used data from 254 adults aged 70 or older (Mage = 76.5 years, SD = 4.4; 67.7% women) who completed the Einstein Aging Study, a 2-week experience sampling study. Multilevel mediation analyses were conducted to account for daily measurements nested within individuals. We tested the indirect effect of the quality of daily social encounters on SCD through daily stress levels.

Results

There was a significant positive association between ambivalent and neutral social encounters and daily stress levels at both the within- and between-person levels. Between-person daily stress was, in turn, associated with greater SCD. Specifically, there was a significant indirect path from ambivalent social encounters to SCD through daily stress.

Discussion and Implications

This study contributes to a more detailed understanding of how the quality of daily social encounters can influence cognition via increased exposure to daily stress. The findings suggest that emotional support may be crucial to preserving perceptions of older adults’ cognitive functioning.
Among Medicare beneficiaries, Affordable Care Act coverage expansions reduced utilization of ambulatory care, particularly among duals
Authors: Sachs Rebecca , Duchovny Noelia , Varcie Joshua , White Chapin
Published: May 2024

We leveraged local area variation in the size of the Affordable Care Act (ACA) expansions of Medicaid and nongroup coverage and measured changes in Medicare utilization and spending from 2010 through 2018 using the universe of Medicare fee-for-service claims. We found that the ACA coverage expansions led to decreases in the share of Medicare beneficiaries receiving ambulatory care and decreases in spending per beneficiary on ambulatory care. The reductions in ambulatory care were larger among beneficiaries enrolled in both Medicare and Medicaid (“duals”). Our results suggest that coverage expansions may lead to congestion and reduced access to physicians for those who are continuously insured.
Genomic prediction and genome-wide association study using combined genotypic data from different genotyping systems: application to apple fruit quality traits
Authors: Minamikawa Mai F , Kunihisa Miyuki , Moriya Shigeki , Shimizu Tokurou , Inamori Minoru , Iwata Hiroyoshi
Published: May 2024

With advances in next-generation sequencing technologies, various marker genotyping systems have been developed for genomics-based approaches such as genomic selection (GS) and genome-wide association study (GWAS). As new genotyping platforms are developed, data from different genotyping platforms must be combined. However, the potential use of combined data for GS and GWAS has not yet been clarified. In this study, the accuracy of genomic prediction (GP) and the detection power of GWAS increased for most fruit quality traits of apples when using combined data from different genotyping systems, Illumina Infinium single-nucleotide polymorphism array and genotyping by random amplicon sequencing-direct (GRAS-Di) systems. In addition, the GP model, which considered the inbreeding effect, further improved the accuracy of the seven fruit traits. Runs of homozygosity (ROH) islands overlapped with the significantly associated regions detected by the GWAS for several fruit traits. Breeders may have exploited these regions to select promising apples by breeders, increasing homozygosity. These results suggest that combining genotypic data from different genotyping platforms benefits the GS and GWAS of fruit quality traits in apples. Information on inbreeding could be beneficial for improving the accuracy of GS for fruit traits of apples; however, further analysis is required to elucidate the relationship between the fruit traits and inbreeding depression (e.g. decreased vigor).
Active Adaptive Strategies of Mallard Feet in Response to Changes in Wetness and Compactness of the Sand Terrain
Authors: Han Dianlei , Hu Jinrui , Liu Hairui , Ren Lizhi , Tong Zhiqian
Published: May 2024

Synopsis

Mallards (Anas platyrhynchos) exhibit exceptional locomotive abilities in diverse terrains, such as beaches, swamps, and tidal flats. This capability is primarily attributed to their unique webbed toe structure and cooperative locomotion posture of their feet. Therefore, this study aims to further delve into the active adaptive strategies of mallard feet in response to diverse external environmental conditions. Six adult male mallards were selected for this research. Their locomotion on sandy surfaces with differing wetness levels and varying degrees of compaction were captured using a high-speed camera, and analysis of instantaneous and continuous changes in the primary joint angles of the mallards’ feet, including the toe-webbed opening and closing angles, the tarsometatarsal-phalangeal joint (TMTPJ), and the intertarsal joint (ITJ). It was found that on loose sandy surfaces, increasing wetness expanded the ground contact area of the mallards’ feet. This led to greater flexion at the TMTPJ joint during mid-stance, accompanied by decreased flexion of the ITJ during touch-down and mid-stance. Conversely, on compacted sand, increasing wetness resulted in a reduced foot effect area and lessened ITJ flexion at both touch-down and mid-stance. Furthermore, on looser sand, the ground contact area of the mallards’ feet decreased, with an increase in ITJ buckling at touch-down. During the swing phase, sand wetness and compactness effected minimally on the feet of the mallards. On dry and loose sand ground, mallards will contract their second and fourth toes with webbing upon ground contact, covering and compacting the sand beneath, while increasing ITJ flexion to mitigate sinking. This adaptation reduces the energy expended on sand and enhances body stability. In wet and compacted sand conditions, mallards expand their second and fourth toes upon ground contact and reduce ITJ flexion. Therefore, this coordinated foot and ITJ locomotion offers mallards a natural advantage when moving on various environmental media.
Activated clotting time value as an independent predictor of postoperative bleeding and transfusion
Authors: Pereira Rafael Maniés , Magueijo Diogo , Guerra Nuno Carvalho , Correia Catarina Jacinto , Rodrigues Anabela , Nobre Ângelo , Brito Dulce , Moita Luís Ferreira , Velho Tiago R
Published: May 2024

OBJECTIVES

Activated clotting time (ACT) is commonly used to monitor anticoagulation during cardiac surgeries. Final ACT values may be essential to predict postoperative bleeding and transfusions, although ideal values remain unknown. Our aim was to evaluate the utility of ACT as a predictor of postoperative bleeding and transfusion use.

METHODS

Retrospective study (722 patients) submitted to surgery between July 2018–October 2021. We compared patients with final ACT < basal ACT and final ACT ≥ basal ACT and final ACT < 140 s with ≥140 s. Continuous variables were analysed with the Wilcoxon rank-sum test; categorical variables using Chi-square or Fisher's exact test. A linear mixed regression model was used to analyse bleeding in patients with final ACT < 140 and ≥140. Independent variables were analysed with binary logistic regression models to investigate their association with bleeding and transfusion.

RESULTS

Patients with final ACT ≥ 140 s presented higher postoperative bleeding than final ACT < 140 s at 12 h (P = 0.006) and 24 h (**P = 0.004). Cardiopulmonary bypass (CPB) time [odds ratio (OR) 1.009, 1.002–1.015, 95% confidence interval (CI)] and masculine sex (OR 2.842,1.721–4.821, 95% CI) were significant predictors of bleeding. Patients with final ACT ≥ 140 s had higher risk of UT (OR 1.81, 1.13–2.89, 95% CI; P = 0.0104), compared to final ACT < 140 s. CPB time (OR 1.019,1.012–1.026, 95% CI) and final ACT (OR 1.021,1.010–1.032, 95% CI) were significant predictors of transfusion. Female sex was a predictor of use of transfusion, with a probability for use of 27.23% (21.84–33.39%, 95% CI) in elective surgeries, and 60.38% (37.65–79.36%, 95% CI) in urgent surgeries, higher than in males.

CONCLUSIONS

Final ACT has a good predictive value for the use of transfusion. Final ACT ≥ 140 s correlates with higher risk of transfusion and increased bleeding. The risk of bleeding and transfusion is higher with longer periods of CPB. Males have a higher risk of bleeding, but females have a higher risk of transfusion.
Informing the Need for a SARS-CoV-2 Booster Based on the Immune Responses Among Young Healthy Adults to Variants Circulating in Late 2023
Authors: Nguyen Huy C , Lal Kerri G , Balinsky Corey A , Hontz Robert D , Lin Jin , Beye Matthew J , Smith Lauren , Pan Li , Cheng Ying , Fox Isabella , Lizewski Stephen E , Foo Hayley S , Krebs Shelly J , Sun Peifang , Letizia Andrew G
Published: May 2024

Background

COVID-19 remains a global public health challenge due to new immune-evasive SARS-CoV-2 variants and heterogeneous immunity.

Methods

In this cross-sectional study, we evaluated the adaptive immune responses in US active duty personnel who completed a COVID-19 primary vaccine series and had heterogenous SARS-CoV-2 vaccination and infection histories to 3 previously dominant variants (ancestral, Delta, BA.5) and 3 circulating variants (XBB.1.5, EG.5, and BA.2.86) in late 2023. Analyses were based on the most recent exposure in terms of timing (within or beyond 12 months) and type (vaccine or infection).

Results

Significant reduction was observed in binding antibodies, neutralization antibodies, memory B cells, and CD8+ T cells against circulating variants when compared with previous variants. The reduction in antibody response was more pronounced in those whose most recent exposure was >12 months from enrollment. In contrast, the CD4+ T-cell response was largely consistent across all tested variants. The type of most recent exposure was not a significant factor in determining the magnitude of current immune responses.

Conclusions

Administration of the XBB.1.5-based booster is likely to enhance cross-reactive humoral responses against SARS-CoV-2 circulating lineages. Ongoing surveillance of immune responses to emerging variants is needed for informing vaccine composition and timing.
pH selects for distinct N2O-reducing microbiomes in tropical soil microcosms
Authors: Sun Yanchen , Yin Yongchao , He Guang , Cha Gyuhyon , Ayala-del-Río Héctor L , González Grizelle , Konstantinidis Konstantinos T , Löffler Frank E
Published: May 2024

Nitrous oxide (N2O), a greenhouse gas with ozone destruction potential, is mitigated by the microbial reduction to dinitrogen catalyzed by N2O reductase (NosZ). Bacteria with NosZ activity have been studied at circumneutral pH but the microbiology of low pH N2O reduction has remained elusive. Acidic (pH < 5) tropical forest soils were collected in the Luquillo Experimental Forest in Puerto Rico, and microcosms maintained with low (0.02 mM) and high (2 mM) N2O assessed N2O reduction at pH 4.5 and 7.3. All microcosms consumed N2O, with lag times of up to 7 months observed in microcosms with 2 mM N2O. Comparative metagenome analysis revealed that Rhodocyclaceae dominated in circumneutral microcosms under both N2O feeding regimes. At pH 4.5, Peptococcaceae dominated in high-N2O, and Hyphomicrobiaceae in low-N2O microcosms. Seventeen high-quality metagenome-assembled genomes (MAGs) recovered from the N2O-reducing microcosms harbored nos operons, with all eight MAGs derived from acidic microcosms carrying the Clade II type nosZ and lacking nitrite reductase genes (nirS/K). Five of the eight MAGs recovered from pH 4.5 microcosms represent novel taxa indicating an unexplored N2O-reducing diversity exists in acidic tropical soils. A survey of pH 3.5–5.7 soil metagenome datasets revealed that nosZ genes commonly occur, suggesting broad distribution of N2O reduction potential in acidic soils.
Impact of removing ESBL status labelling from culture reports on the use of carbapenems for non-bacteraemic patients diagnosed with ESBL-positive urinary tract infections
Authors: Menendez Alvarado Lourdes R , Margulis Landayan Alice , Williams Kelsey N , Frederick Corey M , Zhang Zhenwei , Gauthier Timothy P
Published: May 2024

Objectives

To evaluate carbapenem prescribing rates for initial definitive treatment of urinary tract infections and clinical outcomes before and after removing ESBL status labels on antibiotic susceptibility reports.

Methods

This was a retrospective cohort study of adult patients treated for at least 48 h for an ESBL-producing/ceftriaxone-resistant Enterobacterales urinary tract infection. ESBL status reporting ceased in September 2022 for a network of seven community hospitals within the USA. The primary endpoint was the rate of carbapenem prescribing for initial definitive treatment of urinary tract infections. Secondary endpoints included total days of therapy for initial definitive treatment with carbapenems, clinical cure rates, time to transition to oral antibiotic therapy for initial definitive treatment, rate of guideline-compliant therapy, rate of relapsed infection within 30 days, 30 day readmission rate, and 30 day all-cause in-hospital mortality.

Results

Of 3055 patients screened, 199 were included in the pre group and 153 were included in the post group. The rate of carbapenem prescribing for initial definitive treatment was 156 patients (78%) in the pre group, compared with 93 patients (61%) in the post group (P = <0.01). Days of therapy for initial definitive therapy with carbapenem was 620 in the pre group compared with 372 in the post group (P < 0.01). There was no difference between other secondary outcomes.

Conclusions

Removing ESBL status labels from laboratory reports reduced carbapenem use for initial definitive treatment of urinary tract infections from 78% to 61% (P < 0.01) without impacting clinical outcomes.
Association between diabetes and subsequent malignancy risk among older breast cancer survivors
Authors: Hardell Kaitlyn N Lewis , Schonfeld Sara J , Ramin Cody , Vo Jacqueline B , Morton Lindsay M
Published: May 2024

Type II diabetes is associated with cancer risk in the general population but has not been well studied as a risk factor for subsequent malignancies among cancer survivors. We investigated the association between diabetes and subsequent cancer risk among older (66-84 years), 1-year breast cancer survivors within the linked Surveillance Epidemiology and End Results (SEER)-Medicare database using Cox regression analyses to quantify hazard ratios (HR) and corresponding 95% confidence intervals (95% CI). Among 133 324 women, 29.3% were diagnosed with diabetes before or concurrent with their breast cancer diagnosis, and 10 452 women developed subsequent malignancies over a median follow-up of 4.3 years. Diabetes was statistically significantly associated with liver (HR = 2.35, 95% CI = 1.48 to 3.74), brain (HR = 1.94, 95% CI = 1.26 to 2.96), and thyroid cancer risks (HR = 1.38, 95% CI = 1.01 to 1.89). Future studies are needed to better understand the spectrum of subsequent cancers associated with diabetes and the role of diabetes medications in modifying subsequent cancer risk, alone or in combination with cancer treatments.
Digital Targeting: Artificial Intelligence, Data, and Military Intelligence
Authors: King Anthony
Published: May 2024

It is widely believed that we are on the brink of another military revolution. Today, states are actively seeking to harness the power of AI for military advantage. The question of AI is therefore of profound concern to security studies scholars concerned with global issues. Up to now, the literature has tended to concentrate on AI-enabled lethal autonomous weapons; scholars have been fascinated by the possible appearance of autonomous drone swarms and their implications for security, conflict, and war. This article takes an alternative view. It argues that AI has already begun to play a significant role in military operations and is likely to be more important in the future. However, the attention to lethal autonomous weapons is exaggerated. The armed forces have principally employed AI, not to automate weapons but to help process data. AI has been used to augment military intelligence. Above all, the armed forces have harnessed AI to accelerate and improve military targeting. The article explores two recent cases where the armed forces have used data and AI to target: COVID testing in Liverpool in 2020 and the US’s Security Assistance Group-Ukraine in the Ukraine War in 2022.
Optimizing crown density and volume estimation across two coniferous forest types in southern China via Boruta and Cubist methods
Authors: Ding Zhi-Dan , Sun Zhao , Xie Yun-Hong , Qiao Jing-Jing , Liang Rui-Ting , Chen Xin , Hussain Khadim , Sun Yu-Jun
Published: May 2024

Quantifying forest stand parameters is crucial in forestry research and environmental monitoring because it provides important factors for analyzing forest structure and comprehending forest resources. And the estimation of crown density and volume has always been a prominent topic in forestry remote sensing. Based on GF-2 remote sensing data, sample plot survey data and forest resource survey data, this study used the Chinese fir (Cunninghamia lanceolata (Lamb.) Hook.) and Pinus massoniana Lamb. as research objects to tackle the key challenges in the use of remote sensing technology. The Boruta feature selection technique, together with multiple stepwise and Cubist regression models, was used to estimate crown density and volume in portions of the research area’s stands, introducing novel technological methods for estimating stand parameters. The results show that: (i) the Boruta algorithm is effective at selecting the feature set with the strongest correlation with the dependent variable, which solves the problem of data and the loss of original feature data after dimensionality reduction; (ii) using the Cubist method to build the model yields better results than using multiple stepwise regression. The Cubist regression model’s coefficient of determination (R2) is all more than 0.67 in the Chinese fir plots and 0.63 in the P. massoniana plots. As a result, combining the two methods can increase the estimation accuracy of stand parameters, providing a theoretical foundation and technical support for future studies.
A scoping review of the current state of video in the use of training of cardiac surgeons in LMICs protocol
Authors: Garg Sakshi , Mojarad Sanam Maharaj , Shah Aishwarya , Kumar Niraj S
Published: May 2024

Background

The lack of quality cardiac surgery training programmes in low- and middle-income countries (LMICs) has been widely recognized as a significant barrier to delivering high-quality and accessible cardiac surgical care. This paper aims to discuss the potential role of leveraging video technology as an adjunct to cardiac surgery training in LMICs. Leveraging video technology allows cardiac surgeons in LMICs to potentially gain exposure quickly to a broader range of procedures, which they otherwise would not have received owing to the lack of facilities and trainers in their individual countries.

Objective

The primary aim of the review is to assess the current use of video-related modalities in surgeon training in LMICs. Secondary aims include identifying potential use of video-related modalities in cardiac surgeon training in LMICs and identifying barriers to use of video-related modalities in cardiac surgeon training in LMICs.

Design

This protocol has been designed in accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A systematic search with the following terms ‘low-and-middle-income countries’, ‘video technologies’ and ‘education and cardiac surgery’ was carried on SCOPUS, MEDLINE, EMBASE and WHO Medical Indicus databases. Studies will be screened by two independent assessors using the designed inclusion and exclusion criteria, with conflicts resolved by a third party.

Conclusion

This review will provide a wide review on the available literature on the use of video in cardiac surgery training in LMICs, and act as a base to kickstart future research in this area.
Preoperative stereotactic radiosurgery for patients with 1–4 brain metastases: A single-arm phase 2 trial outcome analysis (NCT03398694)
Authors: Agrawal Namita , Shireman Jack M , Shiue Kevin , Kamer Aaron , Boyd LaKeisha , Zang Yong , Mukherjee Neel , Miller James , Kulwin Charles , Cohen-Gadol Aaron , Payner Troy , Lin Chih-Ta , Savage Jesse J , Lane Brandon , Bohnstedt Bradley , Lautenschlaeger Tim , Saito Naoyuki , Shah Mitesh , Watson Gordon , Dey Mahua
Published: May 2024

Background

Stereotactic radiosurgery (SRS) following surgical resection is the standard of care for patients with symptomatic oligo brain metastasis (BM), however, it is associated with 10–15% local failure. Targeting a resection cavity is imprecise, thus preoperative radiosurgery where the target is well-defined may be superior, however, the efficacy of preoperative SRS has not yet been tested in a clinical trial.

Methods

We conducted a phase 2, single-arm trial of preoperative SRS followed by surgical resection in patients with 1–4 symptomatic oligo BMs (NCT03398694) with the primary objective of measuring 6-month local control (LC). SRS was delivered to all patients utilizing a gamma knife or linear accelerator as per RTOG-9005 dosing criteria [Shaw E, Scott C, Souhami L, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys. 2000;47(2):291–298] based on tumor diameter with the exception that the largest lesion diameter treated was 5 cm with 15 Gy with all SRS treatment given in single fraction dosing.

Results

The trial screened 50 patients, 48 patients were treated under the protocol and 32 patients completed the entire follow-up period. Of all the patients who completed the follow-up period, the primary endpoint of 6-month LC was 100% (95% CI: 0.891–1.000; P = .005). Secondary endpoints, presented as medians, were overall survival (17.6 months), progression-free survival (5.3 months), distant in-brain failure (40.8% at 1 year), leptomeningeal failure (4.8% at 1 year), and radiation necrosis (7.7% at 1 year).

Conclusions

Our data confirms superior local control in patients who received preoperative SRS when compared to historical controls. Further study with a larger randomized cohort of patients is warranted to fully understand the benefits of preoperative SRS.
The Lifetime Health and Economic Burden of Smokeless Tobacco use in Bangladesh, India, and Pakistan: Results From ASTRAMOD
Authors: Coyle Kathryn , Singh Prashant Kumar , Kaushik Ravi , Huque Rumana , Khan Zohaib , Mehrotra Ravi , Siddiqi Kamran , Pokhrel Subhash
Published: May 2024

Introduction

Under the current policy landscapes, the lifetime health and economic burden of smokeless tobacco (ST) products, consumed by over 297 million ST users in South Asia, is unknown. The aim of this study was to estimate the lifetime health effects and costs attributable to current and future ST use in Bangladesh, India, and Pakistan where the majority of ST users live.

Aims and Methods

We developed a Markov-based state-transition model (ASTRAMOD) to predict the lifetime costs of treatment of four diseases (oral, pharyngeal, esophageal cancers, and stroke) and disability-adjusted life years (DALYs), attributable to the current and future use of ST under existing ST policy scenario. Country-specific Global Adult Tobacco Surveys, life tables, and meta-analyses of South Asian and South East Asian studies were used to populate the model. A probabilistic sensitivity analysis evaluated the uncertainty in model predictions.

Results

If there were no change in the current ST policies, the lifetime ST-attributable treatment costs would be over US$19 billion in India, over US$1.5 billion in Bangladesh, and over US$3 billion in Pakistan. For all countries, the attributable costs are higher for younger cohorts with costs declining with increasing age for those over 50. The model predicted that a typical 15-year-old male adoloscent would gain 0.07–0.18 life years, avert 0.07–0.19 DALYs, and generate a cost-savings of US$7–21 on healthcare spending if ST policies were changed to eliminate ST use.

Conclusions

Policy interventions aimed at decreasing the uptake of ST and increasing quitting success have the potential to substantially decrease the economic and health burden of ST.

Implications

This study provides the most comprehensive estimates of the lifetime health and economic burden of ST by 5-year age and sex cohorts. This is also the first study that highlights the scale of health and economic burden of ST in Bangladesh, India, and Pakistan if there were no changes in the current ST policies. Policymakers and practitioners can use the reported data to justify their decisions to improve current ST policies and practices in their country. Researchers can use the ASTRAMOD methodology to estimate the impact of future ST policy changes.
Recurrence of Diabetic Foot Complications: A Domino Effect Leading to Lethal Consequences—Insights From a National Longitudinal Study
Authors: Hsu Chun-Chien , Lai Hsi-Yu , Lin Hung-Yu , Pan Sung-Ching , Cheng Nai-Chen , Chen Liang-Kung , Hsiao Fei-Yuan , Lin Shu-Wen
Published: May 2024

Background

Foot complications are common in people with diabetes mellitus (DM), leading to increased health care utilization, heightened mortality risk, and notable recurrence rates even after treatment. This retrospective cohort study aimed to investigate the impact of repeated occurrence of DM-related foot complications on the risk of all-cause mortality and to identify the potential risk factors associated with repeated events.

Methods

People with DM admitted with foot complications (ulcer, skin and soft tissue infection, or osteomyelitis) from 2012 to 2014 were identified from Taiwan's National Health Insurance Research Database, with a 3-year follow-up for repeated events. We categorized the study subjects based on their cumulative number of hospital admissions with foot complications. Logistic regression was conducted to explore the potential risk factors associated with repeated diabetic foot events. Kaplan-Meier curves and Cox proportional hazard models were used to examine the associations between repeated diabetic foot events and all-cause mortality.

Results

In this study, 28 754 eligible individuals were enrolled and classified into 3 groups: no repeated diabetic foot events (76.1%), 1 repeated event (16.0%), and 2 or more repeated events (7.9%). Logistic regression revealed that advanced age, male sex, congestive heart failure, dyslipidemia, hypertension, nephropathy, retinopathy, neuropathy, peripheral vascular disease, diabetes-related preventable hospitalizations, and outpatient visits due to diabetic foot were significantly associated with repeated events of diabetic foot complications. Compared with those with no repeated events, the adjusted hazard ratios for all-cause mortality were 1.26 (95% CI, 1.19–1.34) for 1 repeated event and 1.36 (95% CI, 1.26–1.47) for 2 or more repeated events.

Conclusions

The significant association between repeated diabetic foot and elevated mortality risk highlights the critical necessity for proactive and targeted patient care within clinical practice. More research to delve into the predictive factors related to the repeated occurrence of diabetic foot is needed to provide additional insights for prevention strategies.
Artificial intelligence as a second reader for screening mammography
Authors: Nakai Etsuji , Miyagi Yumi , Suzuki Kazuhiro , Scoccia Pappagallo Alessandro , Kayama Hiroki , Matsuba Takehito , Yang Lin , Xu Shawn , Kelly Christopher , Najafi Ryan , Kohlberger Timo , Golden Daniel , Uddin Akib , Nakamura Yusuke , Kokubu Yumi , Takahashi Yoko , Ueno Takayuki , Oguchi Masahiko , Ohno Shinji , Ledsam Joseph R
Published: May 2024

Background

Artificial intelligence (AI) has shown promise in mammography interpretation, and its use as a second reader in breast cancer screening may reduce the burden on health care systems.

Purpose

To evaluate the performance differences between routine double read and an AI as a second reader workflow (AISR), where the second reader is replaced with AI.

Materials and Methods

A cohort of patients undergoing routine breast cancer screening at a single center with mammography was retrospectively collected between 2005 and 2021. A model developed on US and UK data was fine-tuned on Japanese data. We subsequently performed a reader study with 10 qualified readers with varied experience (5 reader pairs), comparing routine double read to an AISR workflow.

Results

A “test set” of 4,059 women (mean age, 56 ± 14 years; 157 positive, 3,902 negative) was collected, with 278 (mean age 55 ± 13 years; 90 positive, 188 negative) evaluated for the reader study. We demonstrate an area under the curve =.84 (95% confidence interval [CI], 0.805-0.881) on the test set, with no significant difference to decisions made in clinical practice (P = .32). Compared with routine double reading, in the AISR arm, sensitivity improved by 7.6% (95% CI, 3.80-11.4; P = .00004) and specificity decreased 3.4% (1.42-5.43; P = .0016), with 71% (212/298) of scans no longer requiring input from a second reader. Variation in recall decision between reader pairs improved from a Cohen kappa of κ = .65 (96% CI, 0.61-0.68) to κ = .74 (96% CI, 0.71-0.77) in the AISR arm.

Conclusion

AISR improves sensitivity, reduces variability and decreases workload compared to routine dual screening.
Towards the DSM-6: Results of a Survey of Experts on the Reintroduction of First-Rank Symptoms as Core Criteria of Schizophrenia and on Redefining Hallucinations
Authors: Moritz Steffen , Borgmann Lisa , Heinz Andreas , Fuchs Thomas , Gallinat Jürgen
Published: May 2024

Background

Diagnostic criteria for mental disorders are subject to change. This is particularly true for schizophrenia, whose diagnostic criteria in the current DSM-5 bear little resemblance to what Kraepelin once named “dementia praecox” and Bleuler termed “the schizophrenias.” The present study reports results from a survey of experts on two core topics of schizophrenia: (a) whether subsequent editions of the DSM should once again give the Schneiderian first-rank symptoms (FRS; eg, thought broadcasting) the prominent role they had in the DSM-IV and (b) whether the currently quite narrow definition of hallucinations in the DSM-5 requiring them to be vivid and clear and have the full force and impact of normal perceptions should be broadened to incorporate perceptual-like phenomena that the individual can differentiate from proper perceptions but still perceives as real and externally generated.

Hypothesis

The aim of the survey was to learn about experts’ opinions with no clear hypotheses.

Study Design

International experts on schizophrenia were recruited via various sources and invited to participate in a short online survey. The final sample comprised 136 experts with a subgroup of 53 experts with verified identity and at least 6 years of clinical and/or research experience.

Study Results

Slightly more experts voted in favor (49.3%) of returning FRS to the prominent role they had in earlier versions of the DSM than against (34.6%). Approximately four out of five experts agreed that the definition of hallucinations in the DSM should be expanded. According to the results, alongside internal symptoms that are phenomenologically indistinguishable from true perceptions, sensory intrusions that the holder is convinced were inserted from another source (ie, not self-generated) should be included in the definition.

Conclusions

While a large majority of experts recommend a change in the definition of hallucinations, the experts’ opinions on FRS are more mixed. We hope that this article will stimulate future studies targeting the diagnostic relevance of these symptoms and encourage discussion about the definition of core psychotic symptoms and the diagnostic criteria for the upcoming edition of the DSM.
Race and Religion in Everyday Life: Antisemitism, Islamophobia, and Christian Privilege Among Female Converts in the Netherlands
Authors: Schrijvers Lieke L
Published: May 2024

This article analyzes how the intersections of race and religion impact the experiences of women converting to Judaism, Christianity, or Islam in the Netherlands. It builds on the innovative historical and philosophical work by scholars who call attention to the intersections of race and religion. In ethnographic studies of female converts such entanglements of race and religion have primarily been noted in the case of white converts in Islam. However, research into race and racialization among Christian and Jewish female converts is rare, and a comparative approach even rarer. A bottom-up comparative approach, I argue, has the potential to critically examine not only the positions of religio-racialized minorities, but also the mechanisms of religious/racial hegemony at work in Western Europe. The article thus explores how becoming a religious minority impacts one’s sense of belonging to the nation and how processes of racialization, specifically antisemitism and Islamophobia, impact the conversion process.