bluuebunny/crossref_metadata_2025 huggingface dataset:
“I’m Totally Different”-Developmental Processes Underlying the Recurrent Construction of Identity Content Within Everyday Interactions.
Authors: Gmelin J.H. , de Jonge P. , Kunnen E.S.
Published: December 2024

Background/Aim: Little is known about how emerging adults explore, negotiate and consolidate the meanings of their identities in peer interactions. This study examined the recurrent construction of identity claims within everyday interactions in the pursuit of local conversational goals. Methods: Six emerging adults were paired in dyads for three video-recorded conversations about ‘dating, romance, and sex’. Transcripts of the interactions were analyzed using Iterative Micro-Identity Content Analysis. Results: Recurrent identity claims included operations on identity content at three different levels. These real-time processes facilitate the formation and modification of socially relevant identity categories. Conclusion: Identity exploration may emerge from the immediate social business of everyday interactions, in which emerging adults both actively and passively contribute to the development of identity content. We highlight the tension between agency and constraints driving identity development. Future research should address the link between real-time identity processes and more long-lasting psychosocial outcomes.
Investigation of Abdominoplasty Without General Anesthesia: A Scoping Review
Authors: Zhou Ted , Hubbard Madeline E. , Huq Nasimul S.
Published: December 2024

Introduction: Abdominoplasty is a common aesthetic surgical procedure primarily performed under general anesthesia (GA). However, GA is aerosol-generating and involves extended immobilization associated with systemic complications like venous thromboembolisms (VTEs). There is increasing interest in performing abdominoplasties without GA because of potential lower complication rates and shorter postoperative recovery time. This review sought to summarize all available literature on the safety and outcomes of abdominoplasty performed without GA. Methods: A scoping review was conducted with no date limits in October 2023 encompassing Medline, Embase, Web of Science, and CINAHL. The type of anesthesia was separated into 3 categories: conscious or intravenous (IV) sedation, regional anesthetic blocks (RAB: spinal and epidural), and local anesthesia (direct local infiltration and field blocks). Results: A total of 28 studies were included. Safety data was reported for abdominoplasty alone ( n = 6), with liposuction ( n = 14), or both ( n = 1). The employed anesthesia methods were IV and local ( n = 13), RAB and local ( n = 3), IV and RAB ( n = 2), IV and RAB and local ( n = 2), and IV only ( n = 1). A total of 48 379 patients were identified, with 30 cases of VTEs reported. Two studies reported GA conversion rates between 4.8% and 6.0%. A total of 11 studies assessed abdominoplasty outcomes, highlighting high patient satisfaction and low postoperative pain. The majority of analyzed studies had a “high” or “critical” risk of bias. Conclusion: Our review provides preliminary evidence that performing abdominoplasty without GA is safe and feasible. Additional high-quality studies are necessary to further validate our findings and to develop a standardized approach.
The United States, Europe, and the Global Compacts: Honoring the Right to Remain and the Right to Migrate
Authors: Appleby J. Kevin
Published: December 2024

Executive Summary

The adoption of the Global Compacts on Migration and Refugees in 2019 by the UN General Assembly marked a significant achievement, providing two essential frameworks from which UN Member States could fashion their future immigration and refugee policies.

Since their adoption, however, the number of forcibly displaced in the world has increased significantly, prompting receiving nations, such as the United States and the European countries, to rely more on deterrence-based enforcement initiatives to reduce the number of migrants arriving at their borders. At the same time, the number of migrant deaths, both on sea and land, have increased, as desperate migrants, asylum-seekers, and refugees have attempted to find new homes in industrialized nations.

This paper analyzes the migration policies adopted by the United States and Europe in the nearly six years since the Global Compacts were adopted and provides an assessment about how these receiving nations have adapted to the rising number of forcibly displaced in the world, and whether, in doing so, their policies have been consistent with the provision of both Compacts. The paper finds that:

• Both the US and Europe have instituted enforcement policies that violate the spirit, if not the intent, of the two Compacts, and, in some cases, undermine international human rights standards;

• Both the US and Europe have attempted to balance their enforcement-related approaches with the creation of legal avenues and immigrant integration policies, consistent with the two Compacts, but their efforts, to date, have been insufficient to the need;

• The US has made significant strides in introducing policies to protect refugee-like populations, but has failed to protect asylum-seekers in need of protection who arrive at the US-Mexico border;

• Europe has relied on bilateral agreements and restrictive laws to deter migrants from reaching European shores, while at the same time supported sending and transit countries with development assistance;

• Both the US and Europe have a mixed record with regard to preserving the principles of the right to remain and the right to migrate, a record which must be improved in the years ahead.
A Qualitative Analysis of Student Perspectives of Their Post-secondary Nutrition and Dietetics Program, Courses, and Instructors: Applying a Critical Pedagogies Perspective
Authors: Waugh Anne , Riediger Natalie D. , Russell Constance , Parker Barbara , Bombak Andrea
Published: December 2024

Postsecondary dietetics education is in a time of transition in Canada and specifically in Manitoba. We sought to qualitatively investigate this cohort’s perspectives on the University of Manitoba’s dietetics program. In 2020/21, interviews were conducted with undergraduate dietetics students as well as dietetics interns and graduate students who had recently completed the undergraduate dietetics program. We recruited 25 participants, all of whom self-identified as female, with 60% identifying as white, with an average age of 25 years old. Informed by critical pedagogy, our analysis yielded four themes: motivations for studying dietetics; learning outside the classroom; development of critical awareness; and uncertain career futures and training improvements. Social media featured in each of the themes, particularly in how it exposed participants to various social justice movements. While students acknowledged developing more critical awareness in their programs, they nonetheless felt a disconnect between what they perceived they needed to learn and what was taught. Participants also described uncertainty associated with the future directions of their program or career. Analysis of their perspectives reveal ways dietetics and dietetics education could further incorporate critical pedagogies that highlight social justice issues, enhancing the field’s potential to contribute to public health and health promotion. In this time of transition for dietetics education in Manitoba, drawing inspiration from perspectives of this cohort, there is an opportunity for dietetics and pedagogy to evolve. There is also potential to apply critical pedagogy to analyze trainee perspectives of other health professional education and training programs.
Usability and Accessibility of Shoulder Instability and Open Latarjet Surgery OPEMS for Persons With Disabilities
Authors: Singh Rana S Shamtej , Ghahremani Jacob Sina , Navarro Ronald Arnold
Published: December 2024

The Web Content Accessibility Guidelines (WCAGs) provide website development requirements with users’ cognitive/sensory limitations in mind. The purpose of this study was to assess the accessibility and usability of shoulder instability surgery and open Latarjet surgery online patient education materials (OPEMs) for persons with disabilities based on WCAG compliance. OPEMs were evaluated for search engine optimization, content, design, performance, accessibility, overall scores, body text contrast ratios, and compliance error count at increasing WCAG standard levels. Analysis suggested that OPEMs across both search terms scored poorly in WCAG compliance scores and had significant increases in the number of compliance errors as standards became more stringent. These results suggest that orthopedic OPEMs place unnecessary cognitive and physical loads on users with disabilities, warranting greater scrutiny of the availability and accessibility of orthopedic OPEMs.
Using “Mini-Mock Trials” to Explore the Legalities and Ethics of Federal Court Cases
Authors: Skowronski Mark S. , Shivarajan Sridevi
Published: December 2024

This experiential exercise outlines a mini-mock trial designed to educate students on the legalities and ethics surrounding disability discrimination. Using a real U.S. federal court case and court documents, students explore a managerial issue through role-play and active learning, gaining skills in legal reasoning and ethical decision-making. This exercise is suitable for undergraduate courses in organizational behavior, HR management, I/O psychology, business ethics, and the legal environment of business.
A study on Dongba manuscripts from the perspective of cultural geography
Authors: Yang Linjun , He Ting
Published: December 2024

Dongba manuscripts are traditional Chinese texts written in pictographic Dongba script. The Dongba script likely originated in the early Tang dynasty, and no later than the Northern Song dynasty in the 11th century. The distribution of the Dongba manuscripts corresponds to the distribution of the eastern and western dialects of the Naxi ethnic group. Dongba manuscripts from different regions exhibit significant differences in character forms and writing styles, displaying regional characteristics. Dongba manuscripts are categorized into four regions based on their distribution: the first region features small characters, simple strokes, and a rustic style; the second region features round and delicate characters with even strokes; the third region mainly features three-line scripts with concise strokes and clear writing and with varying spacing; the fourth region features more annotated characters, denser lines, reduced spacing between characters, and a variety of ways to convey meaning and pronunciation. The geographical distribution of Dongba manuscripts is closely related to surrounding ethnic groups such as the Han, Tibetan, Bai, and Lisu.
Weathering energy geographies: Engineering meteorology in the North Atlantic
Authors: Groupp Emilia
Published: December 2024

This article traces how the development of meteorology in the North Atlantic during the twentieth century relied on the expansion of electrical infrastructures, which in turn were dependent on meteorological knowledge production. Specifically, it follows the engagements between a subset of actors—electrical engineers and meteorologists—who collaborated between the 1930s and 1960s and founded the field of Engineering Meteorology in order to make meteorological knowledge applicable to energy industry concerns. Through examining the modes of knowing and doing that emerged through these collaborations, this article traces the ways in which understandings of weather came to be embedded in the design, management, and modification of energy infrastructures. It further illustrates how the entanglements between engineering and meteorology shaped pollution trajectories and environmental violence, resulting in lasting implications for how energy geographies are weathered differently across time and space. In bringing together decolonial and feminist engagements with weather and energy, this article proposes a new approach to thinking about the weather-energy-society nexus by exploring how energy geographies and weather worlds are co-produced, a framework I call weathering energy geographies.
Detection of failures in electrode-photovoltaic cell junctions through two-dimensional wavelet analysis of electroluminescence images
Authors: Carbonó dela Rosa Mario Eduardo , Mateo-Romero Héctor Felipe , Alonso-Gómez Victor , Ngungu Victor Ndeti , Nava Rocío , Morales Aragonés José Ignacio , Plaza Alberto Redondo , González-Rebollo Miguel Ángel , Fandiño Isaza Jesús Rafael , Cardeñoso-Payo Valentín
Published: December 2024

This study applies a two-dimensional discrete wavelet transform (2D-DWT) analysis using a biorthogonal filter, followed by a continuous analysis employing an anisotropic Cauchy wavelet, on electroluminescence (EL) images of polycrystalline and monocrystalline silicon photovoltaic (PV) cells under varying current levels. The wavelet-based approach facilitates the identification of electrode-cell interfaces defects that are not readily visible in EL imaging alone. Our findings reveal that cells with poor soldering at electrode interfaces exhibit up to a 16.3% reduction in maximum normalized power (MNP), directly correlating with reduced current density across certain busbars. The quantitative improvements in defect detection underscore the method's efficacy in addressing power inconsistencies tied to internal PV cell failures. This technique shows promise as a non-invasive diagnostic tool for assessing PV cell performance and structural integrity.
Heme promotes venetoclax resistance in multiple myeloma through MEK-ERK signaling and purine biosynthesis
Authors: Nair Remya , Vu An H. , Freer Abigail K. , Bhatia Karanpreet S. , Wang Dongxue , Savani Milan R. , Matulis Shannon M. , Lonial Sagar , Jaye David L. , Boise Lawrence H. , Seo Seung-Yong , Corson Timothy W. , Nooka Ajay K. , Bhatt Shruti , McBrayer Samuel K. , Gupta Vikas A. , Hu Xin , Barwick Benjamin G. , Reddi Amit R. , Shanmugam Mala
Published: December 2024

We previously demonstrated that reduced intrinsic electron transport chain (ETC) activity predicts and promotes sensitivity to the B-cell lymphoma 2 (BCL-2) antagonist, venetoclax (Ven), in multiple myeloma (MM). Heme, an iron-containing prosthetic group and metabolite, is fundamental to maintaining ETC activity. Interrogation of the cyclin D1 group 2 subgroup of MM from the Relating Clinical Outcomes in MM to Personal Assessment of Genetic Profile (CoMMpass) trial (NCT01454297), which can be used as a proxy for Ven-sensitive MM (VS MM), shows reduced expression of the conserved heme biosynthesis pathway gene signature. Consistent with this, we identified that VS MM exhibits reduced heme biosynthesis and curiously elevated hemin (oxidized heme) uptake. Supplementation with hemin or protoporphyrin IX (heme lacking iron) promotes Ven resistance, whereas targeting ferrochetalase, the penultimate enzyme involved in heme biosynthesis, increases Ven sensitivity in cell lines and primary MM cells. Mechanistically, heme-mediated activation of prosurvival rapidly accelerated fibrosarcoma-rat sarcoma virus–mitogen-activated protein kinase (MEK) signaling and metabolic rewiring, increasing de novo purine synthesis, were found to contribute to heme-induced Ven resistance. Cotargeting BCL-2 and myeloid cell leukemia-1 suppresses heme-induced Ven resistance. Interrogation of the Multiple Myeloma Research Foundation CoMMpass study of patients shows increased purine and pyrimidine biosynthesis to corelate with poor progression-free survival and overall survival. Elevated heme and purine biosynthesis gene signatures were also observed in matched relapse refractory MM, underscoring the relevance of heme metabolism in therapy-refractory MM. Overall, our findings reveal, for the first time, a role for extrinsic heme, a physiologically relevant metabolite, in modulating proximity to the apoptotic threshold with translational implications for BCL-2 antagonism in MM therapy.
Inter- and intracellular mitochondrial communication: signaling hubs in aging and age-related diseases
Authors: Zhang Meng , Wei Jin , He Chang , Sui Liutao , Jiao Chucheng , Zhu Xiaoyan , Pan Xudong
Published: December 2024

Mitochondria are versatile and complex organelles that can continuously communicate and interact with the cellular milieu. Deregulated communication between mitochondria and host cells/organelles has significant consequences and is an underlying factor of many pathophysiological conditions, including the process of aging. During aging, mitochondria lose function, and mitocellular communication pathways break down; mitochondrial dysfunction interacts with mitochondrial dyscommunication, forming a vicious circle. Therefore, strategies to protect mitochondrial function and promote effective communication of mitochondria can increase healthy lifespan and longevity, which might be a new treatment paradigm for age-related disorders. In this review, we comprehensively discuss the signal transduction mechanisms of inter- and intracellular mitochondrial communication, as well as the interactions between mitochondrial communication and the hallmarks of aging. This review emphasizes the indispensable position of inter- and intracellular mitochondrial communication in the aging process of organisms, which is crucial as the cellular signaling hubs. In addition, we also specifically focus on the status of mitochondria-targeted interventions to provide potential therapeutic targets for age-related diseases.

Graphical Abstract
Informing the decision-making process for potential PMT/vPvM chemicals through the adoption of a risk-based prioritization framework: the ZeroPM approach
Authors: Gouin Todd , Bitsch Annette , van Duursen Majorie , Escher Sylvia E. , Hamers Timo
Published: December 2024

A risk-based strategy is presented aimed at prioritizing chemicals screened as potential persistent, mobile and toxic (PMT) or very persistent and very mobile (vPvM) substances. Prioritization is done to strengthen the decision-making process regarding actions that might be taken against chemicals screened as potential PMT/vPvM substances. Such actions can range from acquiring additional data aimed at reducing uncertainties in toxicological effect concentrations or internal exposure concentrations to—in case of acceptable uncertainty—suggesting compounds for prevention and/or removal measures in order to limit future exposure. The prioritization strategy is developed within the ZeroPM project and applies a variety of tools, including in silico and in vitro models for exposure and toxicity hazard assessment. These tools will be applied to chemicals identified as PMT/vPvM substances, with a preliminary emphasis on substances belonging to three chemical classes, i.e. perfluorinated compounds, triazines and triazoles. Here we describe the ZeroPM approach providing a proof-of-principle illustrative example, based on data-rich substances, results from which demonstrate how prioritization can be achieved using a risk-based approach that uses data obtained from new approach methodologies (NAMs) and environmental exposure concentrations, obtained either through modelling or monitoring studies. Results are communicated using a risk-based prioritization matrix, which can be used to help to communicate prioritization needs, such as identifying data gaps or for guiding actions aimed at mitigating exposure. The precision and accuracy of the prioritization matrix is evaluated using several data-rich chemicals, which identifies perfluorooctanoic acid and perfluorooctane sulfonic acid as high priority, due to a combination of toxicity and exposure estimates, whereas atrazine and melamine are observed at lower priority. The proposed risk-based prioritization framework thus represents a complementary source of information that should help support regulatory decision-making for PMT/vPvM substances.
Subconjunctival dirofilariasis in a healthy subject: a case report
Authors: Aghajani Amirhossein , Rajabi Mohammad Taher , Rafizadeh Seyed Mohsen , Rahmanikhah Elham , Samiee Reza , Abdol Homayuni Mohammad Reza , Zand Amin
Published: December 2024

Purpose

To report a case of subconjunctival dirofilariasis presenting as an inflammatory mass-like lesion in a healthy individual.

Case presentation

A 20-year-old male with a recent history of wildlife exposure in a rural village presented with an inflammatory subconjunctival mass in his left eye. The lesion was surgically excised, and histopathological examination confirmed the presence of an immature nematode of Dirofilaria immitis. The patient was treated with oral ivermectin for two weeks postoperatively. After two months, the lesion had almost completely resolved, and no recurrence was observed during the 6-month follow-up.

Conclusions

Given the rarity of ocular dirofilariasis and its diverse presentations in different ocular and adnexal structures, prompt and complete excision followed by meticulous histopathological evaluation is crucial to guide appropriate management and achieve favorable outcomes.
Predicted breeding values for relative scrapie susceptibility for genotyped and ungenotyped sheep
Authors: Eiríksson Jón H. , Þórarinsdóttir Þórdís , Gautason Egill
Published: December 2024

Background

Scrapie is an infectious prion disease in sheep. Selective breeding for resistant genotypes of the prion protein gene (PRNP) is an effective way to prevent scrapie outbreaks. Genotyping all selection candidates in a population is expensive but existing pedigree records can help infer the probabilities of genotypes in relatives of genotyped animals.

Results

We used linear models to predict allele content for the various PRNP alleles found in Icelandic sheep and compiled the available estimates of relative scrapie susceptibility (RSS) associated with PRNP genotypes from the literature. Using the predicted allele content and the genotypic RSS we calculated estimated breeding values (EBV) for RSS. We tested the predictions on simulated data under different scenarios that varied in the proportion of genotyped sheep, genotyping strategy, pedigree recording accuracy, genotyping error rates and assumed heritability of allele content. Prediction of allele content for rare alleles was less successful than for alleles with moderate frequencies. The accuracy of allele content and RSS EBV predictions was not affected by the assumed heritability, but the dispersion of prediction was affected. In a scenario where 40% of rams were genotyped and no errors in genotyping or recorded pedigree, the accuracy of RSS EBV for ungenotyped selection candidates was 0.49. If only 20% of rams were genotyped, or rams and ewes were genotyped randomly, or there were 10% pedigree errors, or there were 2% genotyping errors, the accuracy decreased by 0.07, 0.08, 0.03 and 0.04, respectively. With empirical data, the accuracy of RSS EBV for ungenotyped sheep was 0.46–0.65.

Conclusions

A linear model for predicting allele content for the PRNP gene, combined with estimates of relative susceptibility associated with PRNP genotypes, can provide RSS EBV for scrapie resistance for ungenotyped selection candidates with accuracy up to 0.65. These RSS EBV can complement selection strategies based on PRNP genotypes, especially in populations where resistant genotypes are rare.
NERVE 2.0: boosting the new enhanced reverse vaccinology environment via artificial intelligence and a user-friendly web interface
Authors: Conte Andrea , Gulmini Nicola , Costa Francesco , Cartura Matteo , Bröhl Felix , Patanè Francesco , Filippini Francesco
Published: December 2024

Background

Vaccines development in this millennium started by the milestone work on Neisseria
meningitidis B, reporting the invention of Reverse Vaccinology (RV), which allows to identify vaccine candidates (VCs) by screening bacterial pathogens genome or proteome through computational analyses. When NERVE (New Enhanced RV Environment), the first RV software integrating tools to perform the selection of VCs, was released, it prompted further development in the field. However, the problem-solving potential of most, if not all, RV programs is still largely unexploited by experimental vaccinologists that impaired by somehow difficult interfaces, requiring bioinformatic skills.

Results

We report here on the development and release of NERVE 2.0 (available at: https://nerve-bio.org) which keeps the original integrative and modular approach of NERVE, while showing higher predictive performance than its previous version and other web-RV programs (Vaxign and Vaxijen). We renewed some of its modules and added innovative ones, such as Loop-Razor, to recover fragments of promising vaccine candidates or Epitope Prediction for the epitope prediction binding affinities and population coverage. Along with two newly built AI (Artificial Intelligence)-based models: ESPAAN and Virulent. To improve user-friendliness, NERVE was shifted to a tutored, web-based interface, with a noSQL-database to consent the user to submit, obtain and retrieve analysis results at any moment.

Conclusions

With its redesigned and updated environment, NERVE 2.0 allows customisable and refinable bacterial protein vaccine analyses to all different kinds of users.
Genome-wide association studies unveil major genetic loci driving insecticide resistance in Anopheles funestus in four eco-geographical settings across Cameroon
Authors: Gadji Mahamat , Kengne-Ouafo Jonas A. , Tchouakui Magellan , Wondji Murielle J. , Mugenzi Leon M. J. , Hearn Jack , Boyomo Onana , Wondji Charles S.
Published: December 2024

Background

Insecticide resistance is jeopardising malaria control efforts in Africa. Deciphering the evolutionary dynamics of mosquito populations country-wide is essential for designing effective and sustainable national and subnational tailored strategies to accelerate malaria elimination efforts. Here, we employed genome-wide association studies through pooled template sequencing to compare four eco-geographically different populations of the major vector, Anopheles funestus, across a South North transect in Cameroon, aiming to identify genomic signatures of adaptive responses to insecticides.

Results

Our analysis revealed limited population structure within Northern and Central regions (FST<0.02), suggesting extensive gene flow, while populations from the Littoral/Coastal region exhibited more distinct genetic patterns (FST>0.049). Greater genetic differentiation was observed at known resistance-associated loci, resistance-to-pyrethroids 1 (rp1) (2R chromosome) and CYP9 (X chromosome), with varying signatures of positive selection across populations. Allelic variation between variants underscores the pervasive impact of selection pressures, with rp1 variants more prevalent in Central and Northern populations (FST>0.3), and the CYP9 associated variants more pronounced in the Littoral/Coastal region (FST =0.29). Evidence of selective sweeps was supported by negative Tajima’s D and reduced genetic diversity in all populations, particularly in Central (Elende) and Northern (Tibati) regions. Genomic variant analysis identified novel missense mutations and signatures of complex genomic alterations such as duplications, deletions, transposable element (TE) insertions, and chromosomal inversions, all associated with selective sweeps. A 4.3 kb TE insertion was fixed in all populations with Njombe Littoral/Coastal population, showing higher frequency of CYP9K1 (G454A), a known resistance allele and TE upstream compared to elsewhere.

Conclusion

Our study uncovered regional variations in insecticide resistance candidate variants, emphasizing the need for a streamlined DNA-based diagnostic assay for genomic surveillance across Africa. These findings will contribute to the development of tailored resistance management strategies crucial for addressing the dynamic challenges of malaria control in Cameroon.
Unintentional medication discrepancies at care transitions: prevalence and their impact on post-discharge emergency visits in critically ill older adults
Authors: Park Jiyoung , Kim A Jeong , Cho Eun-Jung , Cho Yoon Sook , Jun Kwanghee , Jung Yoon Sun , Lee Ju-Yeun
Published: December 2024

Background

Unintentional medication discrepancies during care transitions pose a significant risk for medication errors, particularly in critically ill older patients. This study aimed to investigate the prevalence of such discrepancies during care transitions and their impact on post-discharge emergency department (ED) visits in this patient population.

Methods

This retrospective cross-sectional study included patients aged 65 and older who were on chronic medications and admitted to the intensive care units of emergency departments (ED-ICUs) between 2019 and 2020. We evaluated unintentional medication discrepancies, including omissions or changes in medication type, dose, frequency, formulation, or administration route without clear clinical justification during care transition. The association between these discrepancies and post-discharge ED visits was analyzed using a multivariable Cox-proportional hazard model.

Results

Of the 339 patients analyzed, 68% encountered unintentional medication discrepancies at some point during care transitions, with prevalence of 35% at admission, 20% during transfer, and 49% at discharge. After adjusting for confounding factors, patients with unintentional medication discrepancies had a twofold higher risk of ED visits within 30 days of discharge (HR = 2.13, 95% CI = 1.06–4.30).

Conclusion

This study demonstrated a substantial prevalence of unintentional medication discrepancies among critically ill older adults during care transitions, significantly increasing the risk of ED visits within a month of discharge. The findings highlight the crucial need for systematic identification and management of medication discrepancies throughout the care transition process to enhance patient safety.
The AxBioTick study – immune gene expression signatures in human skin bitten by Borrelia-infected versus non-infected ticks
Authors: Berthén Nellie Carlströmer , Cronhjort Samuel , Nordberg Marika , Lindgren Per-Eric , Larsson Marie , Wilhelmsson Peter , Sjöwall Johanna
Published: December 2024

Background

Borrelia infection is caused by Borrelia burgdorferi sensu lato and transmitted by Ixodes ricinus ticks, a common tick-borne infection in Northern Europe. The establishment of Borrelia infection depends on transmission of the spirochetes, as well as the immune response generated in the skin after a bite. Here we aim to investigate the local immune response in the skin after a tick bite and assess the possible direct effects of Borrelia, by applying gene expression analysis of the immune response in skin exposed to Borrelia-infected and non-infected ticks, respectively.

Methods

Skin biopsies from the study participants were taken 7–10 days after the tick-bite. The ticks and skin biopsies were analysed by real-time PCR for Borrelia spp. and other tick-borne pathogens. Dermal transcriptome profiles derived from RNA sequencing with focus on immune system regulation were created. In addition, we performed enrichment analysis of dermal transcriptome profiles with focus on immune system regulation.

Results

Skin biopsies exposed to a Borrelia-positive tick induced an overall higher expression of immune-related genes. Cytokines involved in the regulation of T-cell and macrophage activation, pro-inflammatory regulators and Toll-like receptor 2, 3 and 7 involved in pathogen recognition were upregulated in skin exposed to Borrelia, although Borrelia DNA was not detected in the biopsies.

Conclusion

The evidence of upregulation of genes in Borrelia exposed skin suggests an influence on the immune system of ticks and spirochetes. Characterization of Borrelia-associated gene expression signatures in the skin could contribute to future diagnostics and increase our understanding of the development of various manifestations of Borrelia infection.
Novel neural network classification of maternal fetal ultrasound planes through optimized feature selection
Authors: Rathika S. , Mahendran K. , Sudarsan H. , Ananth S. Vijay
Published: December 2024

Ultrasound (US) imaging is an essential diagnostic technique in prenatal care, enabling enhanced surveillance of fetal growth and development. Fetal ultrasonography standard planes are crucial for evaluating fetal development parameters and detecting abnormalities. Real-time imaging, low cost, non-invasiveness, and accessibility make US imaging indispensable in clinical practice. However, acquiring fetal US planes with correct fetal anatomical features is a difficult and time-consuming task, even for experienced sonographers. Medical imaging using AI shows promise for addressing current challenges. In response to this challenge, a Deep Learning (DL)-based automated categorization method for maternal fetal US planes are introduced to enhance detection efficiency and diagnosis accuracy. This paper presents a hybrid optimization technique for feature selection and introduces a novel Radial Basis Function Neural Network (RBFNN) for reliable maternal fetal US plane classification. A large dataset of maternal–fetal screening US images was collected from publicly available sources and categorized into six groups: the four fetal anatomical planes, the mother's cervix, and an additional category. Feature extraction is performed using Gray-Level Co-occurrence Matrix (GLCM), and optimization methods such as Particle Swarm Optimization (PSO), Grey Wolf Optimization (GWO), and a hybrid Particle Swarm Optimization and Grey Wolf Optimization (PSOGWO) approach are utilized to select the most relevant features. The optimized features from each algorithm are then input into both conventional and proposed DL models. Experimental results indicate that the proposed approach surpasses conventional DL models in performance. Furthermore, the proposed model is evaluated against previously published models, showcasing its superior classification accuracy. In conclusion, our proposed approach provides a solid foundation for automating the classification of fetal US planes, leveraging optimization and DL techniques to enhance prenatal diagnosis and care.
Deep superpixel generation and clustering for weakly supervised segmentation of brain tumors in MR images
Authors: Yoo Jay J. , Namdar Khashayar , Khalvati Farzad
Published: December 2024

Purpose

Training machine learning models to segment tumors and other anomalies in medical images is an important step for developing diagnostic tools but generally requires manually annotated ground truth segmentations, which necessitates significant time and resources. We aim to develop a pipeline that can be trained using readily accessible binary image-level classification labels, to effectively segment regions of interest without requiring ground truth annotations.

Methods

This work proposes the use of a deep superpixel generation model and a deep superpixel clustering model trained simultaneously to output weakly supervised brain tumor segmentations. The superpixel generation model’s output is selected and clustered together by the superpixel clustering model. Additionally, we train a classifier using binary image-level labels (i.e., labels indicating whether an image contains a tumor), which is used to guide the training by localizing undersegmented seeds as a loss term. The proposed simultaneous use of superpixel generation and clustering models, and the guided localization approach allow for the output weakly supervised tumor segmentations to capture contextual information that is propagated to both models during training, resulting in superpixels that specifically contour the tumors. We evaluate the performance of the pipeline using Dice coefficient and 95% Hausdorff distance (HD95) and compare the performance to state-of-the-art baselines. These baselines include the state-of-the-art weakly supervised segmentation method using both seeds and superpixels (CAM-S), and the Segment Anything Model (SAM).

Results

We used 2D slices of magnetic resonance brain scans from the Multimodal Brain Tumor Segmentation Challenge (BraTS) 2020 dataset and labels indicating the presence of tumors to train and evaluate the pipeline. On an external test cohort from the BraTS 2023 dataset, our method achieved a mean Dice coefficient of 0.745 and a mean HD95 of 20.8, outperforming all baselines, including CAM-S and SAM, which resulted in mean Dice coefficients of 0.646 and 0.641, and mean HD95 of 21.2 and 27.3, respectively.

Conclusion

The proposed combination of deep superpixel generation, deep superpixel clustering, and the incorporation of undersegmented seeds as a loss term improves weakly supervised segmentation.
The association between gestational diabetes and fear of childbirth: a longitudinal register study
Authors: Savard Josephine , Pauck Bernhardsen Guro , Mykkänen Anu , Keski-Nisula Leea , Lehto Soili Marianne
Published: December 2024

Background

Gestational diabetes mellitus is a common condition known to be associated with pregnancy complications, larger fetus size and depression, and may therefore lead to increased concerns linked to childbirth. We sought to determine whether gestational diabetes mellitus is linked to fear of childbirth, and whether the possible association is mediated by depressive symptoms.

Methods

This study includes women who gave birth at the Kuopio University Hospital between 2019–2022 and had reported their level of fear of childbirth after gestational week 28 (n = 3293). Two outcome measures of fear of childbirth were used: self-rated intensity on a visual analogue scale, and obstetrician-confirmed diagnosis. Gestational diabetes mellitus was diagnosed based on plasma glucose concentrations in fasting state (≥ 5.3 mmol/l) and after a 75 g glucose load (one hour: ≥ 10.0 mmol/l, two hours: ≥ 8.6 mmol/l). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess depressive symptoms in the third trimester. We performed logistic and linear regression analyses while adjusting for possible confounding factors and examined the controlled direct effect by including depressive symptoms in the model.

Results

Gestational diabetes mellitus was associated with increased risk of fear of childbirth diagnosis (OR = 1.42, 95% CI 1.11─1.73) and higher levels of fear of childbirth (B = 0.31, 95% CI 0.09─0.53), but the associations were attenuated and no longer significant after further adjustments for body mass index and health behaviors (OR = 1.22, 95% CI 0.91─1.5; B = 0.11, 95% CI -0.13─0.35). Inclusion of depressive symptoms in the model attenuated the non-significant estimates further.

Conclusions

The observed association between fear of childbirth and gestational diabetes mellitus in previous studies may result from the lack of adjustments for confounding factors.
Evaluating causal associations of chronotype with pregnancy and perinatal outcomes and its interactions with insomnia and sleep duration: a mendelian randomization study
Authors: Yang Qian , Magnus Maria C. , Kilpi Fanny , Santorelli Gillian , Soares Ana Goncalves , West Jane , Magnus Per , Håberg Siri E. , Tilling Kate , Lawlor Deborah A , Borges M Carolina , Sanderson Eleanor
Published: December 2024

Background

Observational studies suggested chronotype was associated with pregnancy and perinatal outcomes. Whether these associations are causal is unclear. Our aims are to use Mendelian randomization (MR) to explore (1) associations of evening preference with stillbirth, miscarriage, gestational diabetes, hypertensive disorders of pregnancy, perinatal depression, preterm birth and offspring birthweight; and (2) differences in associations of insomnia and sleep duration with those outcomes between chronotype preferences.

Methods

We conducted two-sample MR using 105 genetic variants reported in a genome-wide association study (N = 248,100) to instrument for lifelong predisposition to evening- versus morning-preference. We generated variant-outcome associations in European ancestry women from UK Biobank (UKB, N = 176,897), Avon Longitudinal Study of Parents and Children (ALSPAC, N = 6826), Born in Bradford (BiB, N = 2940) and the Norwegian Mother, Father and Child Cohort Study (MoBa, N = 57,430), and extracted equivalent associations from FinnGen (N = 190,879). We used inverse variance weighted (IVW) as main analysis, with weighted median and MR-Egger as sensitivity analyses. Relying on the individual participant data from UKB, ALSPAC, BiB and MoBa, we also conducted IVW analyses of insomnia and sleep duration on the pregnancy and perinatal outcomes, stratified by genetically predicted chronotypes.

Results

In IVW and sensitivity analyses, we did not find robust evidence of associations of chronotype with the outcomes. Insomnia was associated with a higher risk of preterm birth among evening preference women (odds ratio 1.61, 95% confidence interval: 1.17, 2.21), but not among morning preference women (odds ratio 0.87, 95% confidence interval: 0.64, 1.18), with an interaction P-value = 0.01. There was no evidence of interactions between insomnia and chronotype on other outcomes, or between sleep duration and chronotype on any outcomes.

Conclusions

This study raises the possibility of a higher risk of preterm birth among women with insomnia who also have an evening preference. Our findings warrant replications due to imprecise estimates.
Changes in essential cancer medicines and association with cancer outcomes: an observational study of 158 countries
Authors: Ul Haq Moizza Zia , Heredia Camila , Buadu Adelaide , Rizvi Amal , Workentin Aine , Persaud Nav
Published: December 2024

Background

Cancer is a major cause of mortality worldwide, and differences in cancer mortality rates between countries are, in part, due to differences in access to cancer care, including medicines. National essential medicines lists (NEMLs) play a role in prioritization of healthcare expenditure and access to medicines. We examined the association between amenable cancer mortality and listing medicines used in the management of eight cancers (non-melanoma skin, uterine, breast, Hodgkin lymphoma, colon, leukemia, cervical, and testicular) in national essential medicines lists of 158 countries and summarized changes to the inclusion of cancer treatments in NEMLs.

Methods

We conducted a cross-sectional examination of NEMLs for 158 countries, which were obtained in May 2023. We identified medicines used to treat each of the eight cancers and determined the number of medicines listed by NEMLs for each cancer. We conducted multiple linear regressions to examine the association between the number of medicines listed on the NEMLs and cancer mortality.

Results

We found associations between cancer medicine listing and outcomes for six of the eight examined cancers (non-melanoma skin cancer (p = 0.001), uterine cancer (p = 0.006), breast cancer (p = 0.001), Hodgkin lymphoma (p = 0.021), colon cancer (p = 0.006), and leukemia (p = 0.002)), when adjusting for healthcare expenditure and population size.

Conclusion

There was an association between listing cancer medicines on NEMLs and cancer mortality. Further research is required to explore how cancer mortality may be impacted by other cancer interventions, as well as policies to improve equitable access to cancer care.
Cancer and Syria in conflict: a systematic review
Authors: Basha Lena , Ahmed Hamza , Hamze Mohamed , Ali Amaar Awais , Alahdab Fares , Marzouk Manar , Sullivan Richard , Abbara Aula
Published: December 2024

Background

Armed conflict can disrupt oncology care profoundly, resulting in worsened health outcomes for cancer patients. Syria has endured armed conflict for over a decade, resulting in a severe breakdown of its healthcare services. The aim of this systematic review was to assess the available evidence on the burden of cancer and oncology services in Syria and how they have been affected during the conflict.

Methods

Eight academic and six grey literature databases were searched for English- and Arabic-language studies published from March 2011 until February 2024. Studies reporting any outcomes relating to the burden of cancer or the state of oncology services in wartime Syria were considered for inclusion, although case reports and scoping reviews were excluded. A narrative synthesis of findings was performed.

Results

Of 5,801 studies identified, 28 studies from academic (23) and grey literature (5) were eligible. Papers which reported on the burden of cancer showed an overall increase in cancer incidence and mortality between 2012 and 2022 (most recent data available). Most services were noted to be concentrated in Syria’s capital, Damascus. The main identified themes related to the challenges of providing oncology services with staff shortages, chemotherapeutic drug shortages, insufficient radiotherapy services, and a lack of screening and palliative care noted.

Conclusion

There is insufficient high-quality exploration of the burden of cancer and the state of oncology services across Syria in academic and grey literature. Syria’s health system is divided, creating disparities in access to oncology services, most of which are concentrated in Damascus, exacerbating pre-existing inequalities. The sparsity of robust data reinforces the need for high-quality data, including the use of national or other cancer registries with data from all regions of Syria, including those under opposition control. As the country rebuilds its healthcare systems, policymakers should focus on addressing inequities in oncology service availability to support equity of services.
Comparison between clinician and machine learning prediction in a randomized controlled trial for nonsuicidal self-injury
Authors: Pontén Moa , Flygare Oskar , Bellander Martin , Karemyr Moa , Nilbrink Jannike , Hellner Clara , Ojala Olivia , Bjureberg Johan
Published: December 2024

Background

Nonsuicidal self-injury is a common health problem in adolescents and associated with future suicidal behavior. Predicting who will benefit from treatment is an urgent and a critical first step towards personalized treatment approaches. Machine-learning algorithms have been proposed as techniques that might outperform clinicians’ judgment. The aim of this study was to explore clinician predictions of which adolescents would abstain from nonsuicidal self-injury after treatment as well as how these predictions match machine-learning algorithm predictions.

Methods

Data from a recent trial evaluating an internet-delivered emotion regulation therapy for adolescents with nonsuicidal self-injury was used. Clinician predictions of which patients would abstain from nonsuicidal self-injury (measured using the youth version of Deliberate Self-harm Inventory) were compared to a random forest model trained on the same available data from baseline assessments.

Results

Both clinician (accuracy = 0.63) and model-based (accuracy = 0.67) predictions achieved significantly better accuracy than a model that classified all patients as reaching NSSI remission (accuracy = 0.49 [95% CI 0.41 to 0.58]), however there was no statistically significant difference between them. Adding clinician predictions to the random forest model did not improve accuracy. Emotion dysregulation was identified as the most important predictor of nonsuicidal self-injury absence.

Conclusions

Preliminary findings indicate comparable prediction accuracy between clinicians and a machine-learning algorithm in the psychological treatment of nonsuicidal self-injury in youth. As both prediction approaches achieved modest accuracy, the current results indicate the need for further research to enhance the predictive power of machine-learning algorithms. Machine learning model indicated that emotion dysregulation may be of importance in treatment planning, information that was not available from clinician predictions.

Trial Registration

NCT03353961||https://www.clinicaltrials.gov/, registered 2017–11-21.

Preregistration at Open Science Framework: https://osf.io/vym96/.