bluuebunny/crossref_metadata_2025 huggingface dataset:
Typical Metabolic Pattern of 18F-FDG PET in Anti-NMDAR Encephalitis in the Acute and Subacute Phases and its correlation with T2 FLAIR-MRI features
Authors: Yuan Leilei , Mao Guangjuan , Zhang Yudi , Xu Yang , Chen Qian , Shan Baoci , Cui Tao , Ai Lin
Published: February 2023

Background/aims: Early diagnosis of Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis with non-invasive imaging modalities benefiting is crucial to guarantee prompt treatments decision-making and good prognosis for patients. The present study aimed to explore the correlation of MRI features with brain metabolism characteristics of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) and to describe the metabolic patterns in Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis at acute or subacute phase. Twenty-four patients with anti-NMDAR encephalitis confirmed by serum and/or CSF tests at acute or subacute phase, 9 females and 15 males, with an age range of 6-80 years, were enrolled in this retrospective study as encephalitis group. 18F-FDG PET and MRI findings of all patients were investigated and interpreted with visual analysis. Chi-square test was performed to compare the diagnostic sensitivity between MRI and PET. Independent sample t-test was used to compare the standardized uptake value ratio (SUVR) of each ROI between the encephalitis group and control group, which consisted of 24 age- and gender-matched healthy volunteers.
Results: The diagnostic sensitivity of FDG PET (23/24, 95.83%) was higher than that of MRI (18/24, 75.00%) in acute or subacute anti-NMDAR encephalitis patients with statistically significant difference (P＜0.05). Three categories of abnormalities shown on T2 FLAIR, including shallow of sulci and swelling of brain tissue, increased signal in the sulci, increased signal on brain gray matter or adjacent white matter presented hypermetabolism on PET, excepting increased signal in brain linear structure with hypometabolism of the basal ganglia on PET.
Conclusion: Anteroposterior glucose metabolism gradient (frontal-temporal/parietal-occipital) is proved to be a typical pattern of anti-NMDAR encephalitis at the acute and subacute phases in both visual and statistical testing. Interestingly, the pattern is also commonly found in the anterior and posterior portions of the parietal lobe and cingular cortex, which may be a potential indicator for the diagnosis of this disorder. In addition, MRI is an important and reliable neuroimaging modality to assist in the correct evaluation of activity changes on 18F-FDG PET.
A spatiotemporal dissolved oxygen prediction model based on graph attention networks suitable for missing data
Authors: Fang Yamin , Liu Hui
Published: February 2023

The evaluation and forecasting of water quality are crucial for the prevention and management of water pollution. The majority of the current water quality prediction techniques only take into account a single site. Moreover, there are a huge number of missing values in the monitored water quality data, which prevents the model from functioning correctly. To address these problems, a spatiotemporal prediction framework based on graph attention network (GAN) appropriate for missing data is developed. First, a module based on Neural Controlled Differential Equations (NCDE) is employed to deal with missing data. Then, an improved GAN is utilized to establish the spatiotemporal link of the data on water quality. A new iterative optimization method based on a k-nearest neighbor graph is proposed to enhance the performance of the graph model. To enhance the model's ability to handle multiple features, Shapley additive explanations (SHAP) is applied to evaluate the importance of features, and then multiple features is screened, and they are fused through GRU. Moreover, a fused graph attention mechanism is proposed to improve the robustness of GAN against noise. According to the experimental results, the proposed framework outperforms other models, and the model maintains stable performance for missing data. The spatiotemporal prediction method established in this paper can be a potential strategy to expand the water quality prediction model library.
A Box-Behnken design-based chemometric approach to optimize the degradation of hydroxychloroquine in water media using the Fe(0)/S2O2-8/UV system
Authors: BENDJEFFAL Hacene , Mamine Hadjer , Boukachabia Mourad , Aloui Amel , Metidji Toufek , Djebli Abdelkrim , Bouhedja Yacine
Published: February 2023

The huge utilization of hydroxychloroquine in autoimmune infections led to an abnormal increment in its concentration in wastewater, which can pose a real risk to the environment, necessitating the development of a pretreatment technique. In order to do this, we are interested in researching how hydroxychloroquine degrades in contaminated water. The main goal of this investigation is to optimize the operating conditions for the hydroxychloroquine degradation in water using Fe(0)/S2O2-8/UV system. To get adequate removal of HCQ, a chemometric method based on the Box–Behnken design was applied to optimize the influence of the empirical parameters selected including Fe(0) dose, S2O2-8 concentration, pH, and initial HCQ concentration. The quadratic regression model representing the HCQ removal rate (η%) was evolved and validated by ANOVA. The optimal conditions as a result of the above-mentioned trade-off between the four input variables, with η(%) as the dependent output variable, were captured using RSM methodology and the composite desirability function approach. For HCQ full decomposition, the optimal values of the operating factors are as follows: S2O2-8 dose: 194.309 mgL-1; Fe(0) Quantity: 198.83mgL-1 ; pH=2.017 and HCQ initial dose of 296.406mgL-1. Under these conditions, the HCQ removal rate, achieved after 60 minutes of reaction, attained 98.95%.
Strategy with machine learning models for precise assembly using programming by demonstration
Authors: Bai Ye , Hsieh Sheng-Jen
Published: February 2023

Programming by Demonstration(PBD) applies in the industry as a method of human-robot collaboration for assembly, such as placing, inserting, and screwing; however, PBD has not received much attention in commercial electronic product assembly. There is little work on integrating a strategy to optimize trajectory planning, which is an initial step of PBD. Most recent related works improving PBD performance focus on taking care of numerous demonstration samples from motion-sensing devices under time consumption, distance, and other related criteria. However, it is necessary to integrate a strategy to optimize the performance of precise assembly tasks. We proposed a framework with two custom algorithms to pre-process and classify contactless demonstration performance in this research work. It verified that these algorithms could more effectively generate optimal motion paths in criteria of distance, smoothness, and trajectory variance than canonical methods. Machine learning methods, including the Convolutional neural network(CNN), Artificial Neural Network(ANN), and Support Vector Machine(SVM), are feasible to predict the further performance that the best motion path with accuracy ranging from 80% to 85% accuracy. Also, CNN performs better than ANN and SVM. Among CNN methods, the DarkNet yields the highest accuracy rate of 85%. Future work includes the hybrid CNN/ANN algorithm, which may yield higher accuracy in prediction. Also, the proposed algorithms may apply to robots with dual assembly arms which mimic human arms.
Highly Efficient Biosynthesis of Salidroside by a UDP-glucosyltransferase-catalyzed Cascade Reaction
Authors: Li Guosi , Xu Qilin , Hu Nan , Liu Xinyang , Jiang Yiqi , Xue Hailong , Zang Yongjun , Zhu Fucheng
Published: February 2023

Objective Salidroside is an important plant-derived aromatic compound with diverse biological properties. The main objective of this study was to synthesize salidroside from tyrosol using UDP-glucosyltransferase (UGT) with in situ regeneration of UDP-glucose (UDPG).
Results The UDP-glucosyltransferase 85A1 (UGT85A1) from Arabidopsis thaliana,which showed high activity and regioselectivity towards tyrosol, was selected for the production of salidroside. Then, an in vitro cascade reaction for in situ regeneration of UDPG was constructed by coupling UGT85A1 to sucrose synthase from Glycine max (GmSuSy). The optimal UGT85A1-GmSuSy activity ratio of 1:2 was determined to balance the efficiency of salidroside production and UDP-glucose regeneration. Different cascade reaction conditions for salidroside production were also determined. Under the optimized condition, salidroside was produced at a titer of 6.0 g/L with a corresponding molar conversion of 99.6% and a specific productivity of 199.1 mg/L/h in a continuous feeding reactor.
Conclusion This is the highest salidroside titer ever reported so far using biocatalytic approach.
Attenuated Dengue Virus PV001-DV Induces Oncolytic Tumor Cell Death and Potent Immune Responses
Authors: Goldufsky Josef W. , Daniels Preston , Williams Michael D. , Gupta Kajal , Lyday Bruce , Chen Tony , Singh Geeta , Kaufman Howard L. , Zloza Andrew , Marzo Amanda Lee
Published: February 2023

Background
Viral therapies developed for cancer treatment have classically prioritized direct oncolytic effects over their immune activating properties. However, recent clinical insights have challenged this longstanding prioritization and have shifted the focus to more immune-based mechanisms. Through the potential utilization of novel, inherently immune-stimulating, oncotropic viruses there is a therapeutic opportunity to improve anti-tumor outcomes through virus-mediated immune activation. PV001-DV is an attenuated strain of Dengue virus (DEN-1 #45AZ5) with a favorable clinical safety profile that also maintains the potent immune stimulatory properties characterstic of Dengue virus infection.
Methods
In this study, we utilized tumor killing and immune multiplex assays to examine the anti-tumor effects of PV001-DV as a potential novel cancer immunotherapy.
Results
In vitro assays demonstrated that PV001-DV possesses the ability to directly kill human melanoma cells lines as well as patient melanoma tissue ex vivo. Importantly, further work demonstrated that, when patient peripheral blood mononuclear cells (PBMCs) were exposed to PV001-DV, a substantial induction in the production of apoptotic factors and immunostimulatory cytokines was detected. When tumor cells were cultured with the resulting soluble mediators from these PBMCs, rapid cell death of melanoma and breast cancer cell lines was observed. These soluble mediators also increased dengue virus binding ligands and immune checkpoint receptor, PD-L1 expression.
Conclusions
The direct tumor-killing and immune-mediated tumor cytotoxicity facilitated by PV001-DV contributes support of its upcoming clinical evaluation in patients with advanced melanoma who have failed prior therapy.
Empiric transarterial embolization in angiographically negative lower gastrointestinal bleeding using vessel tracking and 3D navigation tools: report of 2 patients
Authors: Hermie Laurens , Defreyne Luc
Published: February 2023

Background: Recently, an empiric Cone-beam Computed Tomography (CBCT)-guided transarterial embolization (TAE) technique has been investigated for lower gastrointestinal bleeding (LGIB). Although this empirical strategy reduced the rate of rebleeding in hemodynamically unstable patients compared to a ‘wait and see’ strategy, the specified technique is challenging and time-consuming.
Case presentation: We present two methods to perform a prompt empiric TAE in LGIB when catheter angiography is negative. Based on the pre-procedural Computed Tomography Angiography bleeding site and using vessel detection and navigation software tools that are integrated in contemporary angiosuites, the culprit bleeding artery could be targeted with only one selective intraprocedural CBCT acquisition.
Conclusion: The proposed techniques is promising to reduce procedure time and facilitate the implementation of empiric CBCT-guided TAE in clinical practice when angiography is negative.
Variability of Land Tenure, Land Rights and Land Acquisition Methods Among Male and Female Farmers in Irrigation Sector of Gombe and Bornu States, Nigeria
Authors: Ayoola J. B. , Sani R. M. , Ayoola G. B. , Dzever D. , Zaman E. Y. , Sani M. , Adoka T. , Moses A. U. , Yunusa M.Y. , Abu G. A. , Abu O.
Published: February 2023

This study determined the variability of socio-economic characteristics, land rights, land tenure and method of land acquisition among land users in the Dadin kowa irrigation scheme area of Gombe and Borno States, Nigeria. The study adopted a multi-stage sampling technique; 2 LGAs, 6 villages and 300 households were systematically selected in stages. Households specific information was collected using structured questionnaires. A combination of analytical tools employed in the analyses includes descriptive statistics (means, frequencies and percentages), and inferential statistics (t/z tests). The results showed that 29.0% of the respondents were aged 31–40 years; while those within the ages of 20–30, 41–50, 51–60 and above 60 years age brackets constituted 17.0%, 16.3%, 16.0% and 19.3% respectively. Similarly, the sex segregation of households shows that majority of the respondents (95.3%) were male while 4.7% of the respondents were of the female category. Similarly, 24.7% of the respondents had household size of 7–10 persons while 21.0% and 20.0% had a household size of 3–6 and 11–14 persons respectively. Also, 61.3% of the respondents belong to one form of cooperative body or the other. The results indicated that, the rights include the rights to sell, rent, graze, bequeath, and use as religious center. The land tenure systems include family inheritance (92.3%), individual ownership by purchase (79%), renting (78%); while individual ownership through gift, leasing, and government allocation ranked 4th ,5th and 6th respectively. Land acquisition by inheritance was most common among males than females (69.3 and 27.7% respectively); the chi-square value indicated significant variability at 1% probability level. Similarly, land acquisition through buying, renting and through government allocation was more common among the male users (59.5, 58.8, and 22.3%) correspondingly. Results also indicated an average farm size of 0.9 ha and 0.3ha for male and female respectively, and a significant difference with T-value of -4.231 at 1% probability. The study concluded that women are more involved in agriculture in the considered gender categories. The most common land ownership structure among both females and males is inheritance. Land holding in number of plots and farm size are higher among males than females in the study area. Recommendations include the need for gender mainstreaming in transforming the irrigation systems, enlightenment of land users to embrace membership of farmers associations and more women friendly agro practices should be the focus of extension services.
Glypican-3 targeted positron emission tomography detects sub-centimeter tumors in a xenograft model of hepatocellular carcinoma
Authors: Labadie Kevin P. , Lehnert Adrienne L , Kenoyer Aimee L , Hamlin Donald K , Ludwig Andrew D. , Utria Alan F. , Daniel Sara K. , Mihailovic Tara N. , Prossnitz Alexander , Orozco Johnnie J. , Li Yawen , Wilbur D. Scott , Miyaoka Robert S. , Park James O.
Published: February 2023

BACKGROUND
Early intrahepatic recurrence is common after surgical resection of hepatocellular carcinoma (HCC) and leads to increased morbidity and mortality. Insensitive and nonspecific diagnostic imaging contributes to EIR and results in missed treatment opportunities. In addition, novel modalities are needed to identify targets amenable for targeted molecular therapy. In this study, we evaluated a zirconium-89 radiolabeled glypican-3 (GPC3) targeting antibody conjugate (89Zr-αGPC3) for use in positron emission tomography (PET) for detection of small, GPC3+ HCC in an orthotopic murine model.
Athymic nu/J mice received hepG2, a GPC3+ human HCC cell line, into the hepatic subcapsular space. Tumor-bearing mice were imaged by PET/computerized tomography (CT) 4 days after tail vein injection of 89Zr-αGPC3. Livers were then excised for the tumors to be identified, measured, bisected, and then serially sectioned at 500mm increments. Sensitivity and specificity of PET/CT for 89Zr-αGPC3-avid tumors was assessed using tumor confirmation on histologic sections as the gold standard.
RESULTS
In tumor-bearing mice, 89Zr-αGPC3 avidly accumulated in the tumor within four hours of injection with ongoing accumulation over time. There was minimal off-target deposition and rapid bloodstream clearance. Thirty eight of 43 animals had identifiable tumor on histologic analysis. 89Zr-αGPC3 immuno-PET detected all 38 histologically confirmed tumors with a sensitivity of 100%, with the smallest tumor detected measuring 330mm in diameter. Tumor-to-liver ratios of 89Zr-αGPC3 uptake were high, creating excellent spatial resolution for ease of tumor detection on PET/CT. Two of five tumors that were observed on PET/CT were not identified on histologic analysis, yielding a specificity of 60%.
CONCLUSIONS
89Zr-αGPC3 avidly accumulated in GPC3+ tumors with minimal off-target sequestration. 89Zr-αGPC3 immuno-PET yielded a sensitivity of 100% and detected sub-millimeter tumors. This technology may improve diagnostic sensitivity of small HCC and select GPC3+ tumors for targeted therapy. Human trials are warranted to assess its impact.
Activation of ET/ETR axis in myocardial tissue characterizes heart failure induced by experimental autoimmune myocarditis
Authors: Yang Peng , Wu Yujing , Tian Qingshan , Li Fangfei , Tang Jiangfeng , Zheng Zhenzhong
Published: February 2023

Background: Endothelial dysfunction is characterized by an imbalance between endothelium-derived vasodilatory and vasoconstrictive effects and may play an important role in the development of heart failure. More and more studies have shown that endothelial-derived NO-mediated vasodilation is attenuated in heart failure patients. However, the role of ET-1 and its receptors in heart failure remains controversial. The aim of this study is to determine whether ET-1 and its receptor are activated in myocarditis and heart failure, and to explore the role of ET-1/ETR in heart failure.
Methods: HE staining was used to detect myocardial inflammatory infiltration and myocarditis score, echocardiography to evaluate cardiac function, ELISA to detect serum ET-1 level, and immunohistochemistry and western blot to detect ETAR and ETBR expression in myocardial tissue of rats with myocarditis heart failure.
Results: PCM-induced EAM rats tended to reach peak inflammation after 3 weeks of immunization and develop stable chronic HF at week 8 of immunization. Echocardiography was performed on day 21 and 56 of PCM-immunized rats, LVEDd and LVEDs were significantly increased in the EAM group compared to the control group at 3 weeks and 8 weeks while EF and FS were significantly reduced. Therefore, autoimmune myocarditis can induce both acute and chronic heart failure through a PCM-induced autoimmune myocarditis model. Moreover, HE staining revealed that inflammation persisted in EAM-induced acute and chronic heart failure. Serum ET-1 level detected by ELISA method was significantly increased. And immunohistochemistry and western blot indicated that ETAR, and ETBR protein expression in myocardial tissue were significantly elevated in acute heart failure and chronic heart failure.
Conclusions: The ET-1/ETR axis were activated in both EAM-induced acute heart failure and chronic heart failure. The ET-1/ETR axis were positively correlated with heart failure and can be used as biomarkers to characterize heart failure.
Multi-clade neutralizing antibodies against H1 influenza A viruses of swine and humans by sequential vaccinations with divergent H1N1 strains
Authors: Reeth Kristien Van , Parys Anna , Gracia Jose Carlos Mancera , Trus Ivan , Chiers Koen , Mead Philip , Liu Sean , Palese Peter , Krammer Florian , Vandoorn Elien
Published: February 2023

Vaccines that protect against any H1N1 influenza A virus strain would be advantageous for use in pigs and humans. Here, we try to induce a pan-H1N1 antibody response in pigs by sequential vaccination with antigenically divergent H1N1 strains. Adjuvanted whole inactivated vaccines are given intramuscularly in various two- and three-dose regimens. Three doses of heterologous monovalent H1N1 vaccine result in seroprotective neutralizing antibodies against 71% of a diverse panel of human and swine H1 strains, detectable antibodies against 88% of strains, and sterile cross-clade immunity against two heterologous challenge strains. This strategy outperforms any two-dose regimen and is as good or better than giving three doses of matched trivalent vaccine. Neutralizing antibodies are H1-specific, and the second heterologous booster enhances reactivity with conserved epitopes in the HA head. We show that even the most traditional influenza vaccines can offer surprisingly broad protection, if they are administered in an alternative way.
Having trust in the PrEP provider is crucial to more accurate self-reported adherence among South African and Zimbabwean adolescent girls and young women in the open- label HPTN 082 study
Authors: Beauchamp Geetha , Donnell Deborah , Hosek Sybil , Anderson Peter L , Chan Kwun C. G. , Dye Bonnie J. , Mgodi Nyaradzo , Bekker Linda-Gail , Delany-Moretlwe Sinead , Celum Connie
Published: February 2023

Background

Trust is an important cornerstone of patient-provider communication. Accurate reporting of pre-exposure prophylaxis (PrEP) adherence is vital for providers to determine who needs adherence support, especially adolescent girls, and young women (AGYW) who are disproportionately affected by newly diagnosed HIV infections.

Methods

We examined if trust in the PrEP provider was associated with concordance between patient-reported adherence and intracellular tenofovir-diphosphate (TFV-DP) in dried blood spots. The patient-reported adherence response ‘In the past month, how often did you take the tablet?’ was dichotomized as ‘high’ if the response was every day or most days, and ‘low’ if some days or not many days or never. The biomarker marker evidence of adherence was defined as ‘high’ if TFV-DP ≥ 700, and ‘low’ if < 350 fmol/punch.

Results

The HPTN 082, an open-label PrEP demonstration study enrolled 451 AGYW (ages16-25 years) from 2016–2018 in Cape Town and Johannesburg, South Africa, and Harare, Zimbabwe. Of the 427 AGYW who initiated PrEP in the HPTN-082 open-label PrEP demonstration study, 354 (83%) had month three patient-reported adherence responses and TFV-DP measurement. AGYW who reported trust in their providers were almost four-fold (aOR 3.72, 95% CI 1.20-11.51) more likely to have high self-reported adherence and high TFV-DP concentrations (concordant adherent) compared to those who reported high adherence but had low TFV-DP concentrations (discordant non-adherent).

Conclusion

Education and training to build trusting relationships between providers and AGYW may lead to more accurate reporting of PrEP adherence. With accurate reporting, adequate support can be provided to bolster adherence.
Trial Registration: ClinicalTrials.gov Identifier: NCT02732730 (11/04/2016)
Measures of multiple deprivation and visual field loss in glaucoma clinics in England: lessons from big data
Authors: Rathore Mehal , Shweikh Yusrah , Kelly Stephen , Crabb David P
Published: February 2023

BACKGROUND/OBJECTIVES:
To examine the association between multiple deprivation with late diagnosis and rapid worsening of glaucoma in patients in English hospital eye services (HES).
METHODS:
602 439 visual fields (VFs) were extracted from five regionally different glaucoma clinics in England. Mean Deviation (MD) worse than −12 dB was used as a surrogate definition for advanced VF loss at diagnosis in patients with ≥2 reliable VF records. MD loss worse than -1 dB per year was used to define rapid VF progression in patients with ≥6 VFs. Patient data were stratified into deciles of the Index of Multiple Deprivation (IMD) from residential postcodes.
RESULTS:
There was an association between IMD and advanced VF loss at diagnosis in 44 956 patients with 18% (293/1608) and 11% (771/6929) in the most and least deprived IMD decile respectively. Age-corrected odds ratio (OR) for having advanced VF loss at entry into HES was 1.42 (95% confidence interval [CI] 1.21-1.67) and 0.75 (95% CI: 0.66-0.85) in the most and least deprived IMD decile respectively (reference=fifth decile). In 15 094 patients with follow up data (median [interquartile range] of 6.9 [4.5,10.0] years) the proportion having rapid VF progression did not differ across the IMD spectrum.
CONCLUSION:
Large-scale VF data from clinics indicates that glaucoma severity at presentation to English HES is associated with levels of multiple deprivation. We found no evidence to suggest likelihood of having rapid VF progression during follow-up is associated with IMD; this hints at equity of glaucoma care and outcomes once patients are in English HES.
Implementation Evaluation of a Teledermatology Virtual Clinic at an Academic Medical Center
Authors: Kheterpal Meenal , Borre Ethan D. , Nicholas Matilda W. , Cooner Edward W. , Phinney Donna , Gagnon Kelly , Zullig Leah L. , King Heather A. , Malcolm Elizabeth J. , Chen Suephy C.
Published: February 2023

Background
Teledermatology (TD) is an evidence-based practice that may increase access to dermatologic care. We sought to evaluate implementation of TD at four Duke primary care practices.
Methods
We implemented a hybrid TD program where trained primary care providers (PCPs) sent referrals with clinical and dermatoscopic images to dermatology. Patients were seen by dermatologists over video visit within days, and dermatologists managed the patient plan. We evaluated implementation using the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework using electronic health record data. Implementation barriers and facilitators were collected through surveys (n = 24 PCPs, n = 10 dermatologists, n = 10 dermatology residents).
Results
At four PCP clinics throughout 9/1/2021-4/30/2022 there were 218 TD referrals. Video visits occurred on average 7.5 days after referral and 18/18 patients completing the post-visit survey were satisfied. Adoption varied between clinics, with one placing 22% of all dermatology referrals as TD and another placing 2%. The primary PCP barriers to TD were time burdens, lack of fit in clinic flow, and discomfort with image taking. Top-endorsed potential facilitating interventions included allowing for rash referrals without dermoscopy and assurance for clinical evaluation within 3 days.
Conclusions
Addressing TD process fit into PCP clinic flow and reducing time burdens may increase PCP uptake of TD.
Individual identification of endangered amphibians using deep learning and smartphone images: case study of the Japanese giant salamander (Andrias japonicus)
Authors: Takaya Kosuke , Taguchi Yuki , Ise Takeshi
Published: February 2023

Information obtained via individual identification is invaluable for ecology and conservation. Physical tags, such as PIT tags and GPS, have been used for individual identification; however, their impact on animal behavior and survival rates is unclear and the tags may become lost. Although non-invasive methods that do not affect the target species (such as manual photoidentification) are available, these techniques utilize stripes and spots that are unique to the individual, which requires training, and applying them to large datasets is challenging. Many studies that have applied deep learning for identification have focused on species-level identification; however, few have addressed individual-level identification. In this study, we developed an image-based identification method with deep learning using the head spot of the Japanese giant salamander (Andrias japonicus), an endemic and endangered species in Japan. We trained and evaluated the dataset collected over two days from 11 individuals in captivity, including 7,075 images from the smartphone camera. Photographing was conducted three times a day at approximately 11:00 (morning), 15:00 (evening), and 18:00 (afternoon). As a result, individual identification by EfficientNet-V2 achieved 99.86% accuracy, 0.99 Kappa coefficient, and 0.99 F1 score. Performance was lower in the evening than in the morning or afternoon when trained and evaluated at each photographing time. This method does not require direct contact with the target species, and the effect on the animals is minimal; moreover, individual-level information can be obtained under natural conditions. In the future, smartphone images can be applied to citizen science surveys and individual-level big data collection, which is difficult to perform using current methods.
Early Use of Low-dose Ticagrelor-based Dual Antiplatelet Therapy and Clinical Outcomes in Patients Undergoing Percutaneous Coronary Interventions for Complex Lesions
Authors: Lee Yonggu , Shin Jeong-Hun , Seo Suk Min , Choi Ik Jun , Lee Jong-Young , Lee Jun-Won , Park Mahn-Won , Kang Tae Soo , Choi Woong Gil , Jeon Ki-Hyun , Lim Hong-Seok , Joo Hyung Joon , Rhee Sang Jae , Seo Jae-Bin , Park Myung Soo , Park Sang-Ho , Lim Young-Hyo
Published: February 2023

Ticagrelor-based dual antiplatelet therapy (TDAPT) provides potent antiplatelet inhibition but may increase the bleeding risk in Asian populations. We investigated the impact of the early use of low-dose TDAPT (l-TDAPT; 120 mg) on clinical outcomes in Korean patients undergoing percutaneous coronary intervention (PCI). A multicenter prospective clinical cohort study was conducted with patients on standard-dose TDAPT (s-TDAPT; 180 mg) after PCI for complex lesions. A major adverse cardiovascular event (MACE) was defined as a composite of cardiovascular death, myocardial infarction, stroke, and repeat revascularization. A net clinical event (NCE) was defined as a composite of bleeding events and MACEs. Among the 772 patients on s-TDAPT, 115 (14.8%) switched to l-TDAPT within 6 months. Common reasons for the regimen changes were switching as planned (38.8%), dyspnea (25.5%), and bleeding (23.6%). A multivariate Cox proportional hazard model (CPH) showed that the risks of MACE, bleeding events, and NCE were not different between the l-TDAPT and s-TDAPT groups during the entire follow-up period and beyond 6 months after PCI. Multivariate time-varying CPH also showed similar results. De-escalation with low-dose ticagrelor within 6 months after PCI is feasible and safe even in patients with complex lesions harboring a high ischemic event risk.
Relationship between self-reported chewing ability and incidents of stroke in Japanese community-dwelling older adults
Authors: Katayose Ryo , Okura Mika , Kinoshita Ayae , Arai Hidenori , Ogita Mihoko
Published: February 2023

Purpose: This 4-year prospective observational study aimed to examine the relationship between self-reported chewing ability and incidents of stroke in community-dwelling older adults in Japan.
Methods: A total of 5,093 adults aged 65 years and older who were neither disabled nor living in long-term care facilities completed the baseline survey in April 2013. In February 2017, a follow-up survey was conducted for 3,606 older adults who were not disabled and had not died. All data were obtained from self-reported questionnaires. Participants were classified into a normal or an impaired chewing ability group. Using multivariable logistic regression analysis, odds ratios and 95% confidential intervals were calculated for the risk of stroke, adjusting for sex, age, physical activities, BMI, medications, and wearing a denture.
Results: The final analysis included 2,099 participants with no history of cardiovascular disease or severe hypertension in 2013, excluding those with missing main data. During the 4-year follow-up period, the incidence of stroke was 2.8% and 3.6% for the normal chewing ability group and 5.9% and 4.7% for the impaired chewing ability group in participants 65–74 years old and 75 years old or older, respectively. The adjusted ORs were 2.29 for chewing ability impairment, 8.57 with mobility impairment, and 4.09 with cognitive impairment; however, there were no significant differences in participants 75 years old or older, except for those with a physical impairment.
Conclusion: Our results suggested that impaired chewing ability independently predicted stroke, especially for those with physical or cognitive frailty in a community.
Does patient and public involvement impact public health decision-making? A 10-year retrospective analysis of public consultation in Brazil
Authors: Lopes Ana Carolina de Freitas , NOVAES HILLEGONDA MARIA DUTILH , DE SOÁREZ PATRÍCIA COELHO
Published: February 2023

Background: The aim of this work is to characterize the processes associated with patient and public involvement (PPI) in the form of public consultations (PC) during the first 10 years of operation of the National Committee for Health Technology Incorporation in the Unified Health System (Conitec) of Brazil and to identify factors associated with changes in Conitec’s recommendations following these PC.
Methods: This cross-sectional study analysed all processes related to the adoption of technology that took place in Brazil between 2012 and 2021 based on technical reports and self-reported information collected from PC participants. A multiple logistic regression model identified factors associated with changes in Conitec’s recommendations following PC.
Results: A total of 479 technical reports were published, of which 83% (n=400) were submitted to PC. Demands were made mainly by applicants from the state (n=262; 55%), regarding the adoption of medicines (n=367; 77%), in which context neoplasms and infectious diseases were the most frequent indications (n=66; 14% for each). A total of 264 (55%) processes resulted in a final recommendation in favour of introducing the technology. Over the period of 10 years, 196,483 contributions were received in response to PC. The largest volume of contributions was made by patients and their families or representatives (n=99,082; 50.4%), females (122,895; 67%), white individuals (129,165; 70.8%) and individuals between the ages of 25 and 59 years (145,364; 79.9%). Alteration of the preliminary recommendation occurred in 13% (n=53) of the PC, with a higher proportion of recommendations being altered from 2017 onwards. Increased participation by patients had a significant impact on the alteration of the preliminary recommendation (Odds Ratio 3.87, 95% CI 1.33-13.35, p=0.02).
Conclusions: It is necessary to develop PPI mechanisms that are more dialogical and less vulnerable to political contexts with the aim of establishing a more equitable and accountable health system.
Soft Labeling and Expectation-Maximization Algorithm to the Learning Problem of Uncertain Labeling in Vehicular Networks
Authors: ALAYA Bechir , Sellami Lamaa
Published: February 2023

The supervised and semi-supervised learning framework does not always correspond to the situations encountered in vehicular networks. The labeling work is therefore often laborious and expensive. This is why the development of solutions to deal with imperfect labels was of particular interest to us during this research article. We introduce in this paper the formulation of the classification problem when the information available on the labels of the examples used for learning is imperfect. We also present an efficient way to solve classification problems, even when some of the labels provided to learn the classification function are wrong. Furthermore, we present our work on the extension of statistical learning methods in the environment of vehicular networks. To build an expectation-maximization (EM) algorithm capable of optimizing the marginal log-likelihood of the observed data, the path we will take follows the classic approach encountered in the probabilistic framework. Different experiments were carried out to analyze the behavior of our algorithm when “soft” labels in vehicles are used. These experiences have allowed us in particular to highlight the contribution of "soft" labels in this context to represent information on the reliability of the labels and thus significantly improve the performance of vehicular networks.
Assessing the Accuracy and Reliability of AI-Generated Medical Responses: An Evaluation of the Chat-GPT Model
Authors: Johnson Douglas , Goodman Rachel , Patrinely J , Stone Cosby , Zimmerman Eli , Donald Rebecca , Chang Sam , Berkowitz Sean , Finn Avni , Jahangir Eiman , Scoville Elizabeth , Reese Tyler , Friedman Debra , Bastarache Julie , Heijden Yuri van der , Wright Jordan , Carter Nicholas , Alexander Matthew , Choe Jennifer , Chastain Cody , Zic John , Horst Sara , Turker Isik , Agarwal Rajiv , Osmundson Evan , Idrees Kamran , Kiernan Colleen , Padmanabhan Chandrasekhar , Bailey Christina , Schlegel Cameron , Chambless Lola , Gibson Mike , Osterman Travis , Wheless Lee
Published: February 2023

Background: Natural language processing models such as ChatGPT can generate text-based content and are poised to become a major information source in medicine and beyond. The accuracy and completeness of ChatGPT for medical queries is not known.
Methods: Thirty-three physicians across 17 specialties generated 284 medical questions that they subjectively classified as easy, medium, or hard with either binary (yes/no) or descriptive answers. The physicians then graded ChatGPT-generated answers to these questions for accuracy (6-point Likert scale; range 1 – completely incorrect to 6 – completely correct) and completeness (3-point Likert scale; range 1 – incomplete to 3 - complete plus additional context). Scores were summarized with descriptive statistics and compared using Mann-Whitney U or Kruskal-Wallis testing.
Results: Across all questions (n=284), median accuracy score was 5.5 (between almost completely and completely correct) with mean score of 4.8 (between mostly and almost completely correct). Median completeness score was 3 (complete and comprehensive) with mean score of 2.5. For questions rated easy, medium, and hard, median accuracy scores were 6, 5.5, and 5 (mean 5.0, 4.7, and 4.6; p=0.05). Accuracy scores for binary and descriptive questions were similar (median 6 vs. 5; mean 4.9 vs. 4.7; p=0.07). Of 36 questions with scores of 1-2, 34 were re-queried/re-graded 8-17 days later with substantial improvement (median 2 vs. 4; p<0.01).
Conclusions: ChatGPT generated largely accurate information to diverse medical queries as judged by academic physician specialists although with important limitations. Further research and model development are needed to correct inaccuracies and for validation.
Erianin inhibits the growth of uveal melanoma cells by regulating VEGF secretion
Authors: SUN HAO , LI JIAO , ZHANG XI , LI NA , GUO BIN , WANG XING-RONG
Published: February 2023

Objective: To investigate the effect of erianin on uveal melanoma cells and its underlying mechanism. Erianin is a broad-spectrum antitumor compound, and whether it is effective in uveal melanoma cells is unclear.
Methods: B16F10 cells (murine melanoma cells) were divided into 4 experimental groups and 1 control group. The control group was not treated with drugs, and the experimental groups were treated with 3.125 μmol·L-1, 6.25 μmol·L-1, 12.5 μmol·L-1, and 25 μmol·L-1 erianin. A real-time cell electronic analysis system (RT-CES) and CCK-8 assay were used to investigate the effects of different doses of erianin on the growth of uveal melanoma cells. The VEGF-A mRNA expression in uveal melanoma cells was detected by RT‒PCR. ELISAs were used to study the effect of erianin on VEGF-A secretion in uveal melanoma cells. Flow cytometry was used to investigate the effect of erianin on the cell cycle and apoptosis of uveal melanoma cells and its possible mechanism.
Results: Uveal melanoma cells in the experimental group (3.125 μmol·L-1, 6.25 μmol·L-1, 12.5 μmol·L-1, and 25 μmol·L-1) were treated with erianin for 24 h, and the cell survival rate decreased to 93.93 ± 0.26%, 89.46 ± 2.50%, 64.30 ± 2.45% and 35.06 ± 1.40%, respectively. Erianin downregulated VEGF-A mRNA expression in cells and inhibited the level of VEGF-A in uveal melanoma cells, and the experimental group (25 μmol·L-1) had the most obvious inhibitory effect. In addition, compared with those of the control group, the apoptosis rates of the experimental groups (3.125 μmol·L-1, 6.25 μmol·L-1, 12.5 μmol·L-1, and 25 μmol·L-1) increased from 0% to 7.29%, 8.25%, 10.04%, and 35.67%, respectively, after 24 h of erianin intervention. The proportion of cells in G1 phase increased from 38.31% to 39.40%, 41.45%, 49.03%, and 59.24%, and the differences were statistically significant (P<0.05).
Conclusions: Erianin has a significant inhibitory effect on uveal melanoma cells, and its mechanism is to inhibit the level of VEGF and induce apoptosis and S-phase arrest of cells in a concentration-dependent manner.
Identification of the prognostic factors of patients with diabetic foot ulcer treated with tibial cortex transverse transport surgery
Authors: Yang Sijie , Pan Kaixiang , Qin Wencong , Su Hongjie , Hou Jun , Liu Kaibing , Hua Qikai , Zhao Jinming
Published: February 2023

Objectives: The aim of this study was to establish a clinical prediction model to predict the prognosis of diabetic foot ulcer (DFU) patients treated with tibial cortex transverse transport surgery (TTT).
Methods: This was a single-center, retrospective study. The clinical data and inspection results were collected by following up on DFU patients hospitalized at the First Affiliated Hospital of Guangxi Medical University and treated with TTT surgery. 202 patients’ clinical data were collected finally and they were divided into two groups according to Wagner’s grading classification. The indicators related to the severity of DFU and with the time of wound healing after surgery were confirmed through logistic regression and Lasso regression analysis. In addition, a clinical prediction model was established. Finally, the intersection of the two sets of indicators yielded the indicators related to wound severity and the postoperative healing time.
Results: 202 patients were separated into Wagner 2/3 group(n=135,mean age 62.40±9.68 years) and Wagner 4 group(n=67, mean age 61.12±9.07 years).After the student’s t-test, Lasso regression, and Logistic regression analysis, three factors were identified to describe the severity of the DFU between the two groups: platelet-to-lymphocyte ratio (PLR) (OR: 0.992, 95% CI: 0.987-0.998), monocyte-to-neutrophil ratio (MNR) (OR: 0.000, 95% CI: 0.000-0.050), Hemoglobin (HGB) (OR: 0.965, 95% CI: 0.938-0.992). Univariate COX regression analysis determined 12 factors (PLR, MNR, ect) related to the healing time after the operation.
Conclusions: PLR and MNR were factors related to DFU severity and prognosis after TTT surgery.
Exploring Health Information System Resilience During COVID-19 Pandemic: Case Studies from Norway, Sri Lanka & Rwanda
Authors: Amarakoon Pamod Madusanka , Gundersen Ragnhild Bassøe , Muhire Andrew , Utvik Vetle Alvenes , Braa Jørn
Published: February 2023

The study aims at exploring health system resilience by defining the scope on health information systems, one of the six building blocks of the health system. The empirical evidence is derived using qualitative data collection and analysis in the context of Norway, Sri Lanka and Rwanda during the COVID-19 pandemic. The case studies elicit bounce back and bounce forward properties as well as the agility as major attributes of resilience present across the countries. Existing local capacity, networking and collaborations, flexible digital platforms and enabling antecedent conditions are identified as socio-technical determinants of information system resilience based on the case studies across the countries.
Evidence for the formation of fused aromatic ring structures in an organic soil profile in the early diagenesis
Authors: Gamage Jeewan , Longstaffe James , Gillespie Adam , Lo Andy , Voroney Paul
Published: February 2023

The presence of fused aromatic ring (FAR) structures in soil define the stability of the recalcitrant soil organic matter (RSOM). FAR are important skeletal features in RSOM that contribute to its extended residence time. During the early diagenesis, FAR are formed through condensation and polymerization of biomolecules produced during plant residue and microbial product decay. Molecular level characterization of the RSOM extracted from an organic soil profile gives important insights into the formation of FAR. Advanced solid-state 13C nuclear magnetic resonance (NMR) spectroscopy, including recoupled long-range C−H dipolar dephasing experiments on extracted humic acids (HA) showed that they contain diagenetically formed FAR different from charcoal and lignin. Peaks characteristic of FAR are observed at all depths in the soil profile, with a greater prevalence observed in the HA extracts from the clay soil layer at the bottom. In the clay soil layer, 78% of the aromatic carbon was non-protonated, and this was 2.2-fold higher than the topsoil. These data further strengthen our understanding of the humification process that could occur in early diagenesis and help explain the importance of incorporating diagenesis as an important phenomenon for long-term carbon sequestration in soil.
Raman Spectroscopy and Topological MachineLearning for Cancer Grading
Authors: Conti Francesco , Mario D'Acunto , Caudai Claudia , Colantonio Sara , Gaeta Raffaele , Moroni Davide , Pascali Maria Antonietta
Published: February 2023

In the last decade, Raman Spectroscopy is establishing itself as a highly promising technique for the classification of tumour tissues as it allows to obtain the biochemical maps of the tissues under investigation, making it possible to observe changes among different tissues in terms of biochemical constituents (proteins, lipid structures, DNA, vitamins, and so on).In this paper, we aim to show that techniques emerging from the cross-fertilization of persistent homology and machine learning can support the classification of Raman spectra extracted from cancerous tissues for tumour grading. In more detail, topological features of Raman spectra and machine learning classifiers are trained in combination as an automatic classification pipeline in order to select the best-performing pair. The case study is the grading of chondrosarcoma in four classes: cross and leave-one-out validations have been used to assess the classification accuracy of the method. Also, the best classification models are tested on new data, showing excellent accuracy, even compared with existing literature. The added value of such results is that the model for the prediction of the chondrosarcoma grading could easily be implemented in clinical practice, possibly integrated into the acquisition system.