bluuebunny/crossref_metadata_2025 huggingface dataset:
Poster 156: Intraobserver and Interobserver Reliability in Glenoid Track Measurement
Authors: Magee Anthony , Mccadden Austin , Min Kyong , Daner William , Zhou Liang , Bottoni Craig , Wake Jeffrey , Bermudez Alexys , Horng Jonathan , Bickley Ryan , Ahn Hyeong
Published: October 2024

Objectives:

The purpose of our study was to determine the accuracy and reliability of measuring on- and off-track lesions within our institution using the circle line method.

Methods:

Electronic medical records between 2009 and 2019 were reviewed for active-duty military personnel who underwent a Latarjet or had recurrent dislocations of the shoulder joint. Advanced imaging (CT and/or MRI) was reviewed for glenoid and humeral head bone loss; patients with both glenoid and humeral head bone loss were included in the study. Measurement of the Hill-Sachs lesion (HSL) was standardized prior to the start of the study and measured as described by Di Giacomo.

Results:

All surgeons completed the review of all 38 images for 2 measurements. Intraobserver reliability was shown to have moderate reliability amongst all reviewers (intraclass correlation coefficient [ICC] = 0.459; p < 0.001). The kappa (κ) value for interobserver reliability amongst all reviewers was moderate for glenoid diameter (ICC = 0.567; 95% CI, 0.474-0.663), moderate for glenoid defect (ICC = 0.61; 95% CI, 0.517-0.702), poor for HSL (ICC = 0.328; 95% CI, 0.232-0.441), moderate for glenoid track (ICC = 0.668; 95% CI, 0.584-0.75) and fair for HSL on- and off-track assessment (κ = 0.267, p < 0.001).

Conclusions:

The intraobserver reliability of measuring advanced imaging for shoulder instability using the circle line method is overall good; however, the interobserver reliability is moderate to poor.
Poster 160: Preoperative MRI Underestimates Shoulder Labral Injuries Compared with Diagnostic Arthroscopy
Authors: Herman Zachary , Fox Michael , Reddy Rajiv , Carlos Noel Bien , Kowdley Devan , Chang Audrey , Lin Albert
Published: October 2024

Objectives:

To compare the overall agreement in the magnitude of shoulder labral injuries between preoperative MRI and assessment at the time of diagnostic arthroscopy.

Methods:

A retrospective chart review was performed of patients undergoing primary arthroscopic labral repair procedures between February 2018 and February 2023. Exclusion criteria included prior ipsilateral shoulder surgery, MRI study performed at outside health system, and incomplete documentation of labral tear location. Age, gender, and dates of injury, imaging, and surgery were recorded. Radiology and operative reports were reviewed to record the location and extent of the labral tear using conventional clock-face coordinates. Tear locations were further classified as either anterior (2-6 o’clock), posterior (6-10 o’clock), or superior (10-2 o’clock). MRI studies were performed by 1.5-Tesla scanner and all radiology reports were performed by fellowship-trained musculoskeletal radiologists at a single health system. Subgroup analysis of labral tear size on radiology interpretation was performed between MRI arthrogram (MRA) and conventional MRI studies.

Results:

A total of 138 subjects (mean age 25.8 years, 73% male) met criteria for inclusion in this study. Of the included subjects, 105 underwent MRI arthrogram and 33 underwent conventional MRI studies. The average time from initial injury to MRI was 153.4 days and the average time from MRI to surgical intervention was 66.8 days. The average total recorded labral tear size in clock-face coordinates was significantly greater on diagnostic arthroscopy compared with the radiologist MRI interpretation (4.4 vs 3.6, p<0.01). The average labral tear size in the posterior region was also significantly greater on diagnostic arthroscopy (2.4 vs 1.6, p<0.01). The average labral tear size in the anterior (2.5 vs 2.2, p=0.08) and superior (1.6 vs 1.5, p=0.29) regions was greater on diagnostic arthroscopy but did not reach statistical significance. The difference in total and posterior tear size remained significant in both the arthrogram and conventional MRI subgroups. Subjects undergoing MRI arthrogram had a significantly greater reported size of anterior labral tears in clock-face coordinates compared with conventional MRI (2.7 vs 2.0, p=0.03), but did not reach significance for the posterior (p=0.40), superior (p=0.31), and the overall global labrum (p=0.29).

Conclusions:

MRI significantly underestimate the overall size of labral tears in setting of shoulder instability, particularly in the posterior labrum. Surgeons should account for potential underestimation of true labral injury during preoperative planning for surgical management of shoulder instability.
Poster 202: Preoperative Abduction Weakness Predicts Delayed Achievement of Clinically Significant Outcomes Following Gluteus Medius and/or Minimus Repair
Authors: Wright-Chisem Joshua , Vogel Michael , Alvero Alexander , Nho Shane
Published: October 2024

Objectives:

To (1) define the time to achievement of clinically significant outcomes (CSOs) following primary gluteus medius and/or minimus repair and (2) identify predictors of delayed CSO achievement.

Methods:

Patients who underwent primary gluteus medius and/or minimus repair between January 2012 and January 2020 with complete preoperative, 6-month, 1-year, and 2-year Hip Outcome Score – Activities of Daily Living (HOS-ADL) were retrospectively identified. Cohort-specific minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were calculated. The time to achievement of MCID and PASS were analyzed using Kaplan-Meier survival analysis. Multivariate stepwise cox proportional hazards regressions were used to identify predictors of delayed MCID and PASS achievement.

Results:

Fifty primary gluteus medius and/or minimus repairs were identified (age 59.4 ± 9.7 years old, BMI 27.9 ± 6.2 kg/m2, 94% female patients). Tears were partial thickness (78%) and involved both the gluteus medius and minimus tendons (60%) in most cases. Endoscopic and open repair were performed in 70% and 30% of cases, respectively. Labral repair was performed in 30% of cases. Most patients achieved MCID by 5.66 months and PASS by 11.03 months. The 2-year cumulative probability of MCID and PASS achievement was 92.7% and 66.7%, respectively. Preoperative abduction weakness on physical exam predicted delayed achievement of MCID (HR = 2.27, CI 1.04 – 4.96) and PASS (HR = 3.89, CI 1.34 – 11.28).

Conclusions:

Findings from this study demonstrate that most patients undergoing primary gluteus medius and/or minimus repair achieved MCID by 6 months and PASS by 12 months. Preoperative abduction weakness on physical exam predicted delayed achievement of MCID and PASS.
Poster 212: Ischial Tuberosity Avulsion Fractures: Treatment and Return to Sport in Athletes with Displaced Fragments
Authors: Heyworth Benton , Saleet Jayon , Heyworth Benton , Novais Eduardo , Yen Yi-Meng , Kocher Mininder , Micheli Lyle
Published: October 2024

Objectives:

Ischial tuberosity avulsion fractures are relatively rare injuries that typically occur in young athletes during activity. Some of these patients may experience significant morbidity, often through chronic pain and changes in sports participation. The influence of fragment displacement on optimal treatment and proper return to sport protocol has not been well investigated. This study sought to evaluate the relationship between displacement and both choice of treatment and time to return to sport.

Methods:

Retrospective analysis of ischial tuberosity avulsion fractures in pediatric patients between 2010-2021 at Boston Children’s Hospital was completed. Information regarding demographics, treatment, and recovery were extracted from individual patient charts. Plain radiographs and magnetic resonance imaging (MRI) were analyzed in order to measure fragment displacement at the ischial apophysis. Treatment protocol, return to sport (RTS) time, and complications were analyzed.

Results:

Eighty-eight patients with a diagnosis of an ischial tuberosity avulsion fracture were identified. Of these, 64 (73%) were treated non-operatively, 8 (9%) were treated acute operatively (within 6 weeks), and 16 (18%) were treated chronic operatively (>6 weeks). Imaging for measurement of fragment displacement was available for 86 (98%) of patients. The median displacement was 0.2cm for the non-operative group, 2.2cm for the acute operative group, and 1.5 for the chronic operative group. Of the 86 patients with available imaging, 67 (78%) had a RTS time. The median RTS was 3.6 months in the non-operative group, 5.5 months in the acute operative group, and 13.3 months in the chronic operative group.

Conclusions:

In this retrospective cohort study, nearly all fractures with displacement >= 1.0cm were surgically treated, either acutely or at a delayed time point. All patients that underwent acute operation had displacement > 1.0cm, while 87% of those undergoing delayed operation had displacements > 1.0cm. Those treated non-operatively returned to sport about 1 month earlier than those undergoing acute operation, and several months prior to those who underwent delayed surgical intervention. This data suggests that patients with displacement less than 1.0cm may be successfully treated through non-operative treatment and those with displacement greater than this should undergo operative treatment in the acute period to optimize outcome and return to sport.
Poster 218: Localized Acetabular Bone Density Distributions Are Altered in Unilateral Femoral Acetabular Impingement
Authors: Telfer Scott , Kanani Mohammed , Begur Anjana , Hagen Mia S.
Published: October 2024

Objectives:

Femoral acetabular impingement (FAI) can lead to bony and cartilage changes at the joint, and it has been suggested that changes in bone mineral density in the acetabulum may correlate with osteoarthritic degeneration of the hip. In this study, we aimed to use opportunistic quantitative computed tomography (QCT) to map density distributions across the acetabular region in patients with unilateral FAI and determine if there were differences between the affected and unaffected side. Furthermore, we assessed if these differences in density distributions were associated with radiographic measures of FAI.

Methods:

Twenty patients (age 31.9 (SD 9.2), 13 female) who underwent surgery for unilateral FAI and had an associated CT scan of both hips were included in this retrospective study. Both sides of the pelvis were segmented, and 3D models were created. Estimated bone density values were mapped across the bone models via QCT. A thin-spline semi-landmarking approach was used to allow density values at equivalent anatomical points to be compared within patients and across the group. With the contralateral side used as the control, differences in bone density between sides were calculated. A mixed effect linear regression model was used to determine if there were associations between the localized bone density and radiographic measures of Tonnis grade, alpha angle, lateral center edge angle (LCEA), and cross over sign, while controlling for age and sex. To visualize the data, density changes and statistical results were color-mapped to the bone models.

Results:

Overall, several regions of the acetabulum were found to have increased bone density in the affected side compared to the contralateral (Figure 1). Specifically, the anterior-superior parts of the acetabular rim appeared to be most affected, along with the posterosuperior region (Figure 2). Limited associations were found between localized density and the clinical variables, with the most notable finding being a region of the superior rim that was found to be associated with the alpha angle (Figure 3).

Conclusions:

FAI leads to distinct patterns of bone density changes around the acetabulum, although there is still variability at the level of the individual patient. It is unclear whether these changes in bone density may be related to the underlying condition, alterations in the patient’s mechanics due to pain, or a combination of these factors. Providing detailed density maps of the bony anatomy may also assist surgical providers in planning interventions. Further research may elucidate the relationship between bone density changes and long-term degeneration of the joint.
Poster 259: Effect of Current Osteochondral Allograft Harvesting Techniques on Regional Chondrocyte Viability
Authors: Elias Tristan J. , Haneberg Erik , Morgan Vince K. , Allahabadi Sachin , Walker Alexandra B. , Beals Corey T. , Cole Brian J. , Yanke Adam B.
Published: October 2024

Objectives:

Chondrocyte viability directly correlates with the clinical success of osteochondral allograft (OCA) transplantation. It is not known how OCA plug harvest with a powered reamer affects the chondrocyte viability in a human model, or how to best mitigate potential thermal damage. The purpose of this study was to investigate the effect of distal femoral OCA plug harvest and recipient site preparation on regional cell viability when using handheld saline irrigation versus saline submersion.

Methods:

Thirteen clinical-grade femoral hemicondyles (JRF Ortho) were used in this study. For each condyle, four samples were harvested: (1) 5 mm control piece of cartilage, (2) 15 mm OCA donor plug harvested with a powered coring reamer and concurrent handheld saline irrigation (“Traditional”), (3) 15 mm OCA donor plug harvested while submerged under normal saline (“Submerged”), and (4) 5 mm cartilage from the peripheral rim of a recipient socket created with a 15 mm cannulated counter bore reamer to a total depth of 7 mm (“Recipient”). Samples were stained using Calcein and Ethidium. Live-dead images were acquired using a confocal microscope. ImageJ was used to calculate live cell percentages for the whole plugs. Additionally, the 15 mm diameter plugs were divided into the central 5 mm and the peripheral 5 mm for comparison of regional cell viability. The live/dead cell percentages were compared between all groups using Friedman tests. Cell viability was determined to be significantly different if P < 0.05.

Results:

Compared to the Submerged group, Traditional plugs had significantly lower percentages of live cells across the whole plug (61.42% ± 4.98% vs. 71.54% ± 4.82%; P=0.003), in the plug center (62.38% ± 6.11% vs. 72.76% ± 5.86%; P=0.005), and the plug edges (60.91% ± 4.75% vs. 70.93% ± 4.51%; P=0.003). The Traditional plugs had significantly less live cells in all regions compared to Control (77.51% ± 9.23%; P<0.0001 for all regions). There were no significant differences in cell viability between Control and Submerged plugs (whole: P=0.590; center: P=0.713; edge: P=0.799).There were no intra-group regional differences between the central and peripheral 5 mm plug regions for Traditional ( P=0.108) or Submerged ( P=0.061). Recipient (61.10% ± 5.02%) had significantly lower cell viability compared to Control ( P<0.001) and Submerged ( P=0.009) but was equivalent to traditional ( P=0.990).

Conclusions:

There is a significant amount of chondrocyte death induced by donor OCA plug harvesting with traditional handheld irrigation that is mitigated by harvesting while submerged under saline. Similarly, there is a significant amount of cell death experienced at the periphery of the recipient OCA socket. Mitigating this damage may help improve edge integration of OCA transplants.
Epidemiology of severe asthma in children: a systematic review and meta-analysis
Authors: Manti Sara , Magri Paola , De Silvestri Annalisa , De Filippo Maria , Votto Martina , Marseglia Gian Luigi , Licari Amelia
Published: October 2024

Background

Severe asthma significantly impacts a minority of children with asthma, leading to frequent symptoms, hospitalisations and potential long-term health consequences. However, accurate global data on severe asthma epidemiology is lacking. This study aims to address this gap, providing data on severe asthma epidemiology, regional differences and associated comorbidities.

Methods

We conducted a rigorous systematic review and meta-analysis following a registered protocol (PROSPERO CRD42023472845). We searched PubMed, Scopus and Web of Science for cohort or cross-sectional studies published since 2003, evaluating severe asthma incidence and prevalence in children. Study quality and risk of bias were assessed using STROBE guidelines.

Results

Nine studies investigating European children with asthma (aged 5–18 years) were included in the meta-analysis. No significant publication bias was found. The overall severe asthma prevalence in children with asthma was 3% (95% CI 1–6; I2=99.9%; p<0.001), with no significant difference between males and females. Prevalence estimates varied significantly depending on the diagnostic criteria used (Global Initiative for Asthma: 6%; European Respiratory Society/American Thoracic Society: 1%; other: 3%). Because none of the examined studies were prospectively designed, incidence rates could not be determined.

Conclusions

This systematic review and meta-analysis provide the first robust assessment of severe asthma prevalence among European children. Our findings underscore the need for comprehensive research to address knowledge gaps in severe asthma, including determining incidence rates, standardising definitions, investigating regional differences and evaluating comorbidities and treatment strategies.
Growth, phytochemical, and phytohormonal responses of basil to different light durations and intensities under constant daily light integral
Authors: Eghbal Elyas , Aliniaeifard Sasan , Mehrjerdi Mahboobeh Zare , Abdi Sahar , Hassani Seyedeh Batool , Rassaie Tina , Gruda Nazim S.
Published: October 2024

Horticulture in controlled environments has been increasingly used to tackle limitations on crop production. As a crucial environmental factor, light regulate plant growth and metabolism. In the present study, basil plants were subjected to different light durations and intensities considering constant daily light integral (DLI). The lighting environment included 200, 300, and 400 µmol m− 2 s− 1 intensities for 18, 12, and 9 h, respectively. DLI amounted to 12.96 mol m− 2 d− 1 among all light treatments (LI200 for 18 h, LI300 for 12 h, and LI400 for 9 h). Half of the plants under each light treatment were exposed to 30 µmol m− 2 s− 1 of far-red light. The results indicated the general negative impact of LI400/9 on the growth of basils. Exposure to far-red light hurt the growth of the shoot, while it enhanced stem and petiole elongation. This effect was due to higher gibberellin accumulation, which resulted in shade avoidance responses. Exposure to far-red light also reduced anthocyanin and flavonoid contents, as two important nutritional components. Soluble carbohydrates increased, while storage carbohydrates decreased by increasing lighting duration/decreasing light intensity or by far-red light inclusion. The lowest antioxidant activity was detected in LI400/9. In the LI200/18, the highest level of auxin and the lowest level of cytokinin were detected, while the LI300/12 exhibited the highest level of gibberellin hormone. Low light intensity and long photoperiod enhanced plant biomass and phytochemical production and are recommended for basil production in controlled environments.
Predictive model for identification of gangrenous or perforated appendicitis in adults: a multicenter retrospective study
Authors: Liang Yun , Sailai Maimaitiaili , Ding Rui , Yimamu Baihitiyaer , kazi Tayierjiang , He Ming , Liu Zehui , Lin Junyu , Liu Yile , Deng Chaolun , Huang Jiangtao , Zhang Xingwei , Chen Zheng , Su Yonghui
Published: October 2024

Background

Gangrene and perforation are severe complications of acute appendicitis, associated with a higher mortality rate compared to uncomplicated appendicitis. Accurate preoperative identification of Gangrenous or perforated appendicitis (GPA) is crucial for timely surgical intervention.

Methods

This retrospective multicenter study includes 796 patients who underwent appendectomy. Univariate and multivariate logistic regression analyses are used to develop a nomogram model for predicting GPA based on laboratory tests and computed tomography (CT) findings. The model is validated using an external dataset.

Results

Seven independent predictors were included in the nomogram: white blood cell count, lymphocyte count, D-dimer, serum glucose, albumin, maximum outer diameter of the appendix, and presence of appendiceal fecalith. The nomogram achieved good discrimination and calibration in both the training and testing sets. In the training set, the AUC was 0.806 (95%CI: 0.763–0.849), and the sensitivity and specificity were 82.1% and 66.9%, respectively. The Hosmer-Lemeshow test showed good calibration (P = 0.7378). In the testing set, the AUC was 0.799 (95%CI: 0.741–0.856), and the sensitivity and specificity were 70.5% and 75.3%, respectively. Decision curve analysis (DCA) confirmed the clinical utility of the nomogram.

Conclusion

The laboratory test-CT nomogram model can effectively identify GPA patients, aiding in surgical decision-making and improving patient outcomes.
Identifying group metacognition associated with medical students’ teamwork satisfaction in an online small group tutorial context
Authors: Chao Chia-Ter , Chiu Yen-Lin , Tsai Chiao-Ling , Lin Mong-Wei , Yang Chih-Wei , Ho Chiao-Chi , Hsu Chiun , Chen Huey-Ling
Published: October 2024

Background

Collaborative learning is an essential pedagogy in medical education, within which small group learning constitutes an integral component. Online small group teaching has been widely applied and blended with in-person sessions in the aftermath of the Covid-19 pandemic. This study examined whether group metacognition was associated with teamwork satisfaction in an online small group teaching curriculum for medical students.

Methods

We enrolled medical students of the 2nd and 4th years during the 2021 fall semester after they participated in 3 consecutive sessions of online small group tutorials (SGTs), which have been implemented in our medical school for more than 20 years. The students completed a group metacognitive scale (GMS) and a teamwork satisfaction scale (TSS) after the sessions. We analyzed whether group metacognition in 4 dimensions (knowledge of cognition, planning, evaluating, and monitoring) could be connected with medical students’ teamwork satisfaction using partial least squares-structural equation modeling (PLS-SEM).

Results

A total of 263 medical students participated in this study. Both GMS and TSS exhibited good reliability and validity. Three of the 4 dimensions of group metacognition (cognition, planning, and evaluating) positively correlated with teamwork satisfaction (path coefficients 0.311, 0.279, and 0.21; p = 0.002, 0.002, and 0.043, respectively) following the online SGT curriculum, whereas the monitoring dimension did not (path coefficient 0.087; p = 0.357). The model achieved an adjusted R square of 0.683.

Conclusion

We discovered that group metacognition correlated positively with better teamwork satisfaction, supporting the importance of group metacognitive competency for online collaborative learning.
Personal responsibility for health in Bulgarian public health law and social legislation
Authors: Aleksandrova-Yankulovska Silviya , Steger Florian
Published: October 2024

Background

In the last decades all health systems have experienced a lack of resources. Against this background, the idea of ​​applying personal responsibility of the patient as a criterion for allocation of resources (PRCAR) is gaining increasing attention. Bulgarian healthcare reform has been marked by the implementation of many new strategies, that grounded our scientific interest towards investigating PRCAR in Bulgarian public health law and social legislation.

Methods

Through a search of national legal databases 7 documents were selected and subjected to content analysis.

Results

Prospective responsibility was found in two and retrospective responsibility - in three documents, two of which imposed explicit penalties on the patient. Two documents did not distinguish between the types of patient responsibility. PRCAR was found to be controversial through the prism of the social justice principle. The discussion was conducted through the perspectives of evidence translation of research to law, particularities of social cohesion in Bulgaria, and the interpretation of principles of public health ethics.

Conclusion

Although PRCAR was traceable in Bulgarian legislation, no supporting arguments for its introduction were deduced. The applicability of PRCAR should be further studied and wider public debate should be initiated.
Evaluation of Praziquantel effectiveness in treating Nile tilapia clinostomid infections and its relationships to fish health and water quality
Authors: Mahdy Olfat A. , Attia Marwa M. , Shaheed Iman B , Abdelsalam Mohamed , Elgendy Mamdouh Y. , Salem Mai A.
Published: October 2024

This study aimed to conduct a multidisciplinary investigation integrating detailed morphology, molecular characterization, water parameters, histopathology alteration, and the trials of treatment of Clinostomum spp. In this study, 300 Nile tilapia (Oreochromis niloticus) were collected from the farmed and wild Nile River at Al Bahr Al Aazam, Giza Governorate to assess Clinostomid infection prevalence. Fish and water samples were collected from private fish farms, and water drains at Dakahlia, and Giza, Egypt. Analysis of the water revealed inadequate water quality, particularly in the fish farms. Snails and piscivorous birds were abundant at fish collection sites. The recovered Clinostomid MCs morphological characteristics and COI gene sequence analysis identified them as Clinostomum complanatum, C. phalacrocoracis, and Euclinostomum heterostomum. Clinostomid MCs disturbed the fish’s hematological and biochemical blood parameters. Bath treatment of parasitized fish with praziquantel (2 mg/L for 24 h) revealed a significant reduction in the number of vital MCs vs. infected fish (non-treated). Praziquantel (PZQ) is an effective and safe therapy for controlling Clinostomid infections affecting farmed Nile tilapia. The current findings indicate a link between poor environmental conditions and Clinostomum infections in tilapia. The study highlights the impacts of Clinostomid MCs on fish health and recommends bath treatment with PZQ as an efficient control method for these dangerous parasites to protect human and fish health.
Influence of future climate scenarios using CMIP 5 data on malaria transmission in India
Authors: Peri Subrahmanya Hari Prasad
Published: October 2024

Background

Vector-borne diseases, such as malaria, pose a significant global threat, and climatological factors greatly influence their intensity. Tropical countries, like India, are particularly vulnerable to such diseases, making accurate estimation of malaria risk crucial.

Methods

This study utilized the well-known Vector-borne Disease Community Model, VECTRI, developed by the International Centre for Theoretical Physics in Trieste. The model was implemented to estimate malaria’s Entomological Inoculation Rate (EIR). Future climatic prediction datasets, including CMIP 5 and population data sets, were used as inputs for the analysis. Three RCP scenarios are considered (Representative Concentration Pathways are climate change scenarios that project radiative forcing to 2100 due to future greenhouse gas concentrations). The projections covered the period from 1 Jan, 2020, to 31 Dec, 2029.

Results

The estimated mean EIR for the years 2020–2029 ranged, and a significant decline in malaria risk was observed with all RCP 2.6, 4.5, and 8.5 scenarios. Each year 0.3 to 2.6 [min–max] EIR/person/day decline is observed with a strong decline in man rainfall ranging from 5 to 17 [min–max] mm/year and associated high temperatures ranging from 0.03 to 0.06 [min–max] °C/year. During the post-monsoon period, August to November were identified as highly prone to malaria transmission. Spatial analysis revealed that the east coast of India faced a higher vulnerability to malaria risk, which kept increasing through RCP scenarios. Thus, it is essential to exercise caution, especially in areas with heavy rainfall.

Conclusion

This research provides valuable insights for policy-makers, highlighting the need to implement future strategies to mitigate malaria risk effectively. By utilizing these findings, appropriate measures can be taken to combat the threat posed by malaria and protect public health.
Evaluating the effects of short-term low temperature on the growth and development of Trichopria drosophilae based on the age–stage two-sex life table
Authors: Chen Qiang , Zhang Jinlong , Tian Ye , Li Juan , Ning Weizhi , Chen Guohua , Zhang Xiaoming
Published: October 2024

Background

The effects of low temperatures on parasitic wasps are crucial for maintaining farmland biodiversity and enhancing biological control, especially given the implications of global warming and frequent extreme cold events.

Methods

We studied the effects of different low temperatures (−8 ± 1 °C, −4 ± 1 °C, 0 ± 1 °C, 4 ± 1 °C, and 8 ± 1 °C) on the mating frequency and duration of male adults of Trichopria drosophilae and the number of pupae beaten by female adults, and constructed the age–stage two-sex life table of T. drosophilae.

Results

This study found that male T. drosophilae adults exposed to low temperatures for 12 h significantly altered their mating behavior, peaking between 15:00 and 17:00. As the temperature dropped during the exposure, both the mating frequency of T. drosophilae and the duration of pupal beating were affected. The survival rate of female adults dropped from 39.55% at 8 °C to just 21.17% at −8 °C. Low-temperature treatment shortened the development period and lifespan for T. drosophilae adults. They developed 4.71 days faster and had a total lifespan that was 10.66 days shorter than those in the control group after being exposed to −8 °C. Furthermore, the average number of eggs laid by females at −8 °C was 4.46 less than that at 8 °C and 6.16 less than that in the control group, which laid an average of 21.55 eggs. The net reproductive rate (R0) of T. drosophilae decreased with lower temperatures, reaching a low of 23.64 at −8 °C. Conversely, the intrinsic growth rate (rm) actually increased as temperatures dropped, with the lowest value being 0.21 at −8 °C.

Conclusions

The findings indicate that short-term exposure to low temperatures hampers the growth and population increase of T. drosophilae, thereby reducing their effectiveness as biological control agents.

Graphical Abstract
Uptake of biosimilars in China: a retrospective analysis of the case of trastuzumab from 2018 to 2023
Authors: Wu Qiyou , Wang Zhitao , Fu Yihan , Luo Ren , Sun Jing
Published: October 2024

Background

The Chinese biosimilar industry has demonstrated rapid growth in recent years. Limited evidence is available about biosimilar uptake at the national level. This study aimed to assess biosimilar uptake in the case of trastuzumab and to explore potential factors influencing the biosimilar penetration at national and provincial levels.

Methods

This study employed an interrupted time series analysis to assess the level and trend changes of national trastuzumab originator consumption and the overall trastuzumab consumption after the price reduction of the originator and the introduction of the first biosimilar using the China Hospital Pharmacy Audit procurement data from March 2018 to February 2023. A latent class trajectory model (LCTM) was also adopted to estimate the biosimilar penetration across 30 provincial-level administrative divisions (PLADs). Based on the LCTM grouping results, provincial characteristics were analyzed.

Results

After rapid growth, the penetration of biosimilars demonstrated a moderate ascending trend at the national level, reaching 27% in February 2023. Following the introduction of the first biosimilar in July 2021, the consumption of the originator decreased by 0.5% per month (P = 0.008), and the growth rate of overall trastuzumab consumption decreased by 1.1% per month (P = 0.014). LCTM fit the best when the number of trajectory classes was two, dividing 30 PLADs into a group demonstrating a faster increase in biosimilar penetration and the other with a slower increase. The PLADs in the fast-increasing group had a higher proportion of the population covered by the national basic health insurance, a lower proportion of the urban population, a lower proportion of the population covered by the urban employee health insurance program, a lower gross domestic product per capita, a lower total health expenditure per capita, and a lower out-of-pocket expenditure.

Conclusions

The uptake of trastuzumab biosimilars in China was lower compared with major European countries. The introduction of trastuzumab biosimilars presented a substitutional effect. Perceptions of physicians and patients, the medicines procurement model, competition from other biologics, and health insurance payment methods may influence biosimilar uptake. Enhancing a comprehensive understanding of biosimilars among physicians and patients, including biologics with biosimilars in the national pooled procurement, and implementing provider payment reforms could foster biosimilar penetration.
Segmentation-based quantitative measurements in renal CT imaging using deep learning
Authors: Koukoutegos Konstantinos , ’s Heeren Richard , De Wever Liesbeth , De Keyzer Frederik , Maes Frederik , Bosmans Hilde
Published: October 2024

Background

Renal quantitative measurements are important descriptors for assessing kidney function. We developed a deep learning-based method for automated kidney measurements from computed tomography (CT) images.

Methods

The study datasets comprised potential kidney donors (n = 88), both contrast-enhanced (Dataset 1 CE) and noncontrast (Dataset 1 NC) CT scans, and test sets of contrast-enhanced cases (Test set 2, n = 18), cases from a photon-counting (PC)CT scanner reconstructed at 60 and 190 keV (Test set 3 PCCT, n = 15), and low-dose cases (Test set 4, n = 8), which were retrospectively analyzed to train, validate, and test two networks for kidney segmentation and subsequent measurements. Segmentation performance was evaluated using the Dice similarity coefficient (DSC). The quantitative measurements’ effectiveness was compared to manual annotations using the intraclass correlation coefficient (ICC).

Results

The contrast-enhanced and noncontrast models demonstrated excellent reliability in renal segmentation with DSC of 0.95 (Test set 1 CE), 0.94 (Test set 2), 0.92 (Test set 3 PCCT) and 0.94 (Test set 1 NC), 0.92 (Test set 3 PCCT), and 0.93 (Test set 4). Volume estimation was accurate with mean volume errors of 4%, 3%, 6% mL (contrast test sets) and 4%, 5%, 7% mL (noncontrast test sets). Renal axes measurements (length, width, and thickness) had ICC values greater than 0.90 (p < 0.001) for all test sets, supported by narrow 95% confidence intervals.

Conclusion

Two deep learning networks were shown to derive quantitative measurements from contrast-enhanced and noncontrast renal CT imaging at the human performance level.

Relevance statement

Deep learning-based networks can automatically obtain renal clinical descriptors from both noncontrast and contrast-enhanced CT images. When healthy subjects comprise the training cohort, careful consideration is required during model adaptation, especially in scenarios involving unhealthy kidneys. This creates an opportunity for improved clinical decision-making without labor-intensive manual effort.

Key Points

Trained 3D UNet models quantify renal measurements from contrast and noncontrast CT.

The models performed interchangeably to the manual annotator and to each other.

The models can provide expert-level, quantitative, accurate, and rapid renal measurements.

Graphical Abstract
Virtual reality in stroke recovery: a meta-review of systematic reviews
Authors: Khan Ammar , Imam Yahia Z. , Muneer Mohamed , Al Jerdi Salman , Gill Sumanjit K.
Published: October 2024

Background

Virtual Reality (VR) is an emerging technology in post stroke recovery. However, its precise role in stroke rehabilitation is not well defined. The aim of this paper is to conduct an overview of systematic reviews on the role of VR in stroke rehabilitation.

Methods

A meta-review with results from a search of 7 databases from inception till 5th December 2022 with subsequent quality appraisal was conducted. The primary outcome was to produce a narrative review on the efficacy of VR versus usual or other care in stroke recovery. Data was synthesized in a descriptive fashion and high-quality systematic reviews were emphasized. The AMSTAR-2 tool was used for quality assessment of the included studies.

Results

Evidence from high-quality systematic reviews suggests that there is benefit from VR in upper limb, lower limb, gait, and balance recovery particularly when additive to conventional therapy. There is also limited evidence to suggest that VR has a positive effect in those with impaired cognition.

Conclusion

VR is safe and effective as an adjunct to conventional therapy for adults after stroke and should be used routinely for upper and lower limb motor recovery. Further high-quality studies that evaluate its efficacy and explore ways to increase its positive impact in areas such as cognition are required. There is also a scope for the development of stroke-specific virtual environments. (PROSPERO registration # CRD42022372926).
α-Mangostin-phytosomes as a plausible nano-vesicular approach for enhancing cytotoxic activity on SKOV-3 ovarian cancer cells
Authors: Alamoudi Abdulmohsin J. , Badr-Eldin Shaimaa M. , Ahmed Osama A. A. , Elbehairi Serag Eldin I. , Alfaifi Mohammad Y. , Asfour Hani Z. , Mohamed Gamal A. , Ibrahim Sabrin R. M. , Abdel-Naim Ashraf B. , Abdallah Hossam M.
Published: October 2024

Background

α-Mangostin is a major xanthone in Garcinia mangostana L. (Clusiaceae) pericarps. It has promising anti-proliferative potential in different cancer cells; however, it has poor oral bioavailability. Phytosomes are used as a novel nano-based drug delivery system. The aim of this research was to enhance the anti-proliferative potency of α-mangostin by formulating it as α-mangostin-phytosome (α-M-PTMs) and assessing its impact on SKOV-3 ovarian cancer cells in comparison to pure α-mangostin.

Results

The size and entrapment efficiency of the proposed formulation were optimized using Box–Behnken statistics. The optimized formula was characterized using transmission electron microscope. The binding of α-mangostin to phospholipids was confirmed using Fourier-transform infrared (FTIR) spectroscopy. The optimized α-mangostin-phytosomes formula exhibited enhanced anti-proliferative activity with reference to raw α-mangostin. This was further substantiated by assessing the cell cycle phases that indicated an accumulation of SKOV-3 cells in the sub-G1 phase. Annexin-V staining revealed enhanced apoptotic activity in α-mangostin-phytosome-treated cells. This was associated with upregulation of CASP3 (Caspase-3), BAX (BCL2 Associated X, Apoptosis Regulator) and TP53 as well as down-regulation of BCL2 mRNA (B-Cell Leukemia/Lymphoma 2). Moreover, our data indicated enhanced ROS (Reactive oxygen species) production, cytochrome-C release, and disturbed MMP (mitochondrial membrane potential).

Conclusion

Encapsulation of α-mangostin in a phytosome nano-formula enhances its anti-proliferative effects in SKOV-3 cells via, at least in part, inducing mitochondrial apoptotic cell death.
Temporal insights into mega-events and waterfront industrial heritage transformation: a case study of Shanghai’s Huangpu River industrial zone
Authors: Wang Kaixuan
Published: October 2024

This research examines the evolution and renewal of Shanghai’s Huangpu River industrial zone after the 2010 Shanghai Expo, with a temporal focus on the profound changes and development philosophies driven by this mega-event. By investigating emblematic case studies along the Huangpu River, such as the transformative 80,000-ton silo, the Shanghai Museum of Contemporary Art, and the Long Museum, this research articulates how mega-events serve as pivotal moments for reimagining and repurposing industrial heritage. In the wake of the 2010 Shanghai Expo, these industrial relics emerged as focal points of urban regeneration, embodying the tensions and synergies between historical preservation and contemporary urban development. This study explores the temporal layers—from the event’s catalytic role to enduring legacies—and reveals how time influences the trajectory of urban spaces and the community’s connection to them. Through this temporal lens, the paper analyses the redevelopment process, assessing how these initiatives have reconfigured the industrial waterfront into a dynamic cultural landscape. The findings offer a dynamic perspective on the temporal dimensions that underpin the redevelopment of industrial heritage sites, providing insights into how such spaces can be continuously activated and symbiotically integrated into the fabric of the city. This paper aims to contribute to a broader understanding of the complexities involved in harnessing industrial heritage for mega-events, with implications for future urban planning and heritage conservation strategies.
A prediction analysis testing if internet-delivered cognitive-behaviour therapy is most suitable for the milder cases of pediatric obsessive-compulsive disorder
Authors: Aspvall Kristina , Mataix-Cols David , Melin Karin , Norlin Lisa , Serlachius Eva , Andersson Erik
Published: October 2024

Background

Common clinical sense would suggest that individuals with milder obsessive-compulsive disorder (OCD) symptoms should be the most suitable for guided internet-delivered cognitive behaviour therapy (CBT), with more intensive forms of treatment reserved for more severe or complex cases.

Results

In this secondary data analysis of a non-inferiority clinical trial comparing internet-delivered CBT with in-person CBT for young people with OCD (N = 152), we found that higher baseline symptom severity predicted worse treatment outcomes in the in-person group but not the internet-delivered CBT group. Additional analyses showed that among individuals with milder symptoms, internet-delivered CBT was associated with worse outcomes than in-person CBT.

Conclusions

If replicated, these results would question the axiom that internet-delivered CBT is most suitable for milder cases.

Trial registration

The original trial was registered at ClinicalTrials.gov ID NCT03263546. Date of registration 2017–08–28.
Three Versus Six Months of Adjuvant Oxaliplatin-Containing Chemotherapy for Patients With Stage III Colorectal Cancer: A Contemporary Real-World Analysis
Authors: Krishnan Tharani , Leung Emily , Solar Vasconcelos Joao Paulo , Lim Howard , Loree Jonathan M. , Davies Janine , Gill Karamjit , Gill Sharlene
Published: October 2024

PURPOSE

Based on the International Duration Evaluation of Adjuvant Chemotherapy analysis, 3 months of adjuvant chemotherapy with capecitabine and oxaliplatin (CAPOX) is an option for stage III colorectal cancer (colorectal cancer [CRC]), with cost and toxicity benefits. We examined the patterns of uptake of CAPOX versus fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and chemotherapy duration in a contemporary real-world cohort of patients in Canada.

METHODS

The provincial pharmacy database was used to identify patients with resected stage III CRC receiving adjuvant chemotherapy between January 2021 and December 2022. Demographic, tumor, and treatment information was collected and compared.

RESULTS

Of 452 patients, 234 (52%) and 218 (48%) were planned to receive 3 and 6 months of chemotherapy, respectively. Within the 3-month group, 226 (97%) received CAPOX. Within the 6-month group, there was a 51%-49% split between CAPOX and FOLFOX. Age >70 years (
P
= .039), well/moderately differentiated (
P
= .005), and low-risk disease (
P
< .0001) were significantly associated with 3 months. Performance status, ileostomy, or preexisting neuropathy did not affect treatment choice. Of patients planned for 6 months, 29% had low-risk disease, with 52% of these receiving CAPOX. Patients receiving 6 months were more likely to report neuropathy (68
v
36%,
P
< .0001) and to stop oxaliplatin early (54
v
31%,
P
< .0001). The most likely reason for early adjuvant discontinuation was neuropathy in the 6-month group and gastrointestinal toxicity in the 3-month group (
P
< .0001). Irrespective of duration, mean time from consult to starting chemotherapy was longer for FOLFOX versus CAPOX (24
v
19 days,
P
= .007).

CONCLUSION

In this contemporary cohort, 6 months chemotherapy is still being offered to patients with low-risk disease and is associated with more neuropathy. Exploration of patient preferences and resource costs may improve adoption of reduced duration adjuvant CAPOX in stage III CRC.
An NMR-Based Metabolic Signature to Identify Clinically Significant Prostate Cancer in Patients Undergoing Biopsy
Authors: Ladurner Michael , Ameismeier Tobias , Klocker Helmut , Steiner Eberhard , Hauffe Helga , Aigner Gerhard P , Neuwirt Hannes , Böld Tina , Strathmeyer Selina , Heidegger Isabel , Drettwan Diana , Eder Iris E
Published: October 2024

Context

Despite clinical suspicion of prostate cancer (PCa), 20% to 25% of patients exhibit a tumor-negative biopsy result.

Objective

This work aimed to assess the serum metabolic profile of clinically significant (cs) compared to clinically insignificant (ci) PCa or benign (Be) patients.

Methods

A total of 1078 serum samples were analyzed. Nuclear magnetic resonance (NMR) spectroscopy was used to quantify 73 metabolites; random forest was used for the model algorithm.

Results

We identified a 22-metabolite panel, which discriminated csPCa (International Society of Urological Pathology [ISUP] 2-5, n = 328) from ciPCa (ISUP 1, n = 101) and Be patients (negative biopsy, n = 649) with a higher performance when combined with the standard clinical parameters age, prostate-specific antigen (PSA), and percentage free PSA (%fPSA) (area under the curve [AUC] 0.84) than the clinical parameters alone (AUC 0.73). Our study further revealed significant dysregulations of the urea cycle and the choline pathway along with changes in tricarboxylic acid cycle, cholesterol metabolism, and a significant increase of the inflammation marker glycoprotein acetyls B in csPCa patients. In particular, ornithine and dimethylglycine were the 2 most important features to discriminate csPCa from Be + ciPCa with significantly higher ornithine and lower dimethylglycine levels in patients with csPCa (ornithine: 63.7 ± 26.5 µmol/L, dimethylglycine: 12.6 ± 6.3 µmol/L; P < .001) compared to Be + ciPCa patients (ornithine: 50.3 ± 31.6 µmol/L, dimethylglycine: 14.9 ± 7.7 µmol/L).

Conclusion

This study discovered a 22-metabolite panel to discriminate patients with csPCa from Be + ciPCa patients when combined with age, PSA, and %fPSA. It may therefore be used as a supportive biomarker to reduce the number of unnecessary biopsies and also to identify novel therapeutic targets in the future.