bluuebunny/crossref_metadata_2025 huggingface dataset:
Disparities in Overall Survival Rates for Cancers across Income Levels in the Republic of Korea
Authors: Jeong Su-Min , Jung Kyu-Won , Park Juwon , Lee Hyeon Ji , Shin Dong Wook , Suh Mina
Published: August 2024

Background: The overall survival rates among cancer patients have been improving. However, the increase in survival is not uniform across socioeconomic status. Thus, we investigated income disparities in the 5-year survival rate (5YSR) in cancer patients and the temporal trends. Methods: This study used a national cancer cohort from 2002 to 2018 that was established by linking the Korea Central Cancer Registry and the National Health Insurance Service (NHIS) claim database to calculate the cancer survival rate by income level in the Republic of Korea. Survival data were available from 2002 onward, and the analysis was based on the actuarial method. We compared the survival of the earliest available 5-year period of 2002–2006 and the latest available 5-year period of 2014–2018, observing until 31 December 2021. Income level was classified into six categories: Medical Aid beneficiaries and five NHIS subtypes according to insurance premium. The slope index of inequality (SII) and relative index of inequality were used to measure absolute and relative differences in 5YSR by income, respectively. Results: The 5YSR between the 2002–2006 and 2014–2018 periods for all cancers improved. A significant improvement in 5-year survival rates (5YSR) over the study period was observed in lung, liver, and stomach cancer. The SII of survival rates for lung (17.5, 95% confidence interval (CI) 7.0–28.1), liver (15.1, 95% CI 10.9–19.2), stomach (13.9, 95% CI 3.2–24.7), colorectal (11.4, 95% CI 0.9–22.0), and prostate (10.7, 95% CI 2.5–18.8) cancer was significantly higher, implying higher survival rates as income levels increased. The SII for lung, liver, and stomach cancer increased, while that of thyroid, breast, cervical, prostate, and colorectal cancer decreased over the study period. Conclusions: Although substantial improvement in the 5YSR was observed across cancer types and income levels from 2002 to 2018, this increase was not uniformly distributed across income levels. Our study revealed persistent income disparities in the survival of cancer patients, particularly for lung and liver cancer.
Anti-Allergic and Anti-Inflammatory Signaling Mechanisms of Natural Compounds/Extracts in In Vitro System of RBL-2H3 Cell: A Systematic Review
Authors: Rana Tekan S. , Bansode Rishipal R. , Williams Leonard L.
Published: August 2024

Various extracts are tested for anti-allergic or anti-inflammatory properties on in vitro models. RBL-2H3 cells are widely used in allergic or immunological studies. FCεRI and its downstream signaling cascades, such as MAPK, NF-κB, and JAK/STAT signaling pathways, are important allergic or inflammatory signaling mechanisms in mast and basophil cells. This systematic review aims to study common signaling pathways of the anti-allergic or anti-inflammatory compounds on RBL-2H3 cells. We selected the relevant research articles published after 2015 from the PubMed, Scopus, Science Direct and Web of Science databases. The risk of bias of the studies was assessed based on the modified CONSORT checklist for in vitro studies. The cell lines, treatments, assay, primary findings, and signaling pathways on RBL-2H3 cells were extracted to synthesize the results. Thirty-eight articles were included, and FCεRI and its downstream pathways, such as Lyn, Sky, PLCγ, and MAPK, were commonly studied. Moreover, the JAK/STAT pathway was a potential signaling mechanism in RBL-2H3 cells. However, the findings based on RBL-2H3 cells needed to be tested along with human mast cells to confirm its relevance to human health. In conclusion, a single plant extract may act as an anti-inflammatory reagent in RBL-2H3 cells via multiple signaling pathways besides the MAPK signaling pathway.
Targeting Cleavage of C-Terminal Fragment of Cytoskeletal Filamin A in Cancers
Authors: Cakici Ozgur , Bandaru Sashidar , Lee Grace Yankun , Mustafa Dyar , Akyürek Levent M.
Published: August 2024

Human cancers express altered levels of actin-binding cytoskeletal filamin A (FLNA) protein. FLNA in mammals consists of an actin-binding domain at its N-terminus that is followed by 24 immunoglobulin-like repeat modules interrupted by two hinge regions between repeats 15–16 and 23–24. Cleavage of these hinge regions produces a naturally occurring C-terminal 90 kDa fragment of FLNA (FLNACT) that physically interacts with multiple proteins with diverse functions. This cleavage leads to actin cytoskeleton remodeling, which in turn contributes to cellular signaling, nucleocytoplasmic shuttling of transcriptional factors and nuclear receptors, and regulation of their transcriptional activities that are important for initiation and progression of cancers. Therefore, recent studies have proposed blocking FLNA cleavage as a means of cancer therapy. Here, we update how FLNA cleavage has been targeted by different approaches and their potential implications for future treatment of human cancers.
The Relationship between Maternal Smoking and Infant Birth Weight: Improving Accuracy through Urine Cotinine Analysis and Effective Medical Record Strategies
Authors: Vojisavljevic Danica , Rudd Donna , Smith Roger , Kandasamy Yogavijayan
Published: August 2024

Objective: We conducted a study to determine if antenatally collected maternal urine cotinine (a metabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure during pregnancy. This was a prospective longitudinal cohort of mother–infant dyads. Only term singleton pregnancies were included. The primary outcome measure was the correlation between maternal urine cotinine and infant birth weight. Methods: We analysed data from 238 mother–neonate dyads. Smoking habits were recorded during routine prenatal check-ups and urine samples were collected to measure cotinine and creatinine levels. Results: Urine cotinine was detected in 50.4% (120/238) of women from the whole cohort, but only 16% (38/238) self-reported as smokers (chi-square 39.7, p < 0.0001), and these women had significantly smaller babies (p = 0.010). There was a significant negative correlation between maternal urine cotinine and birth weight (Spearman’s coefficient = −0.0226, p = 0.013). Female babies born to women with nicotine in their urine were significantly smaller (p = 0.001). Conclusions: Infant birth weight significantly reduced in mothers with exposure to nicotine during pregnancy. The number of women exposed to nicotine during late pregnancy (measured in urine) was markedly higher than self-reported and national smoking percentages, suggesting an urgent need for an improvement in medical record reporting on smoking habits to better assess neonatal outcomes.
EuroQol Toddler and Infant Populations (EQ-TIPS): Age-Related Differences in Performance
Authors: Verstraete Janine , Amien Razia , Herdien Lasse
Published: August 2024

Objectives: The EQ-TIPS was developed to measure the Health-Related Quality of Life in infants/toddlers. Considering the rapid development in this period, this study aimed to investigate age-related variations in EQ-TIPS performance. Methods: Data from 551 infants/toddlers living with a health condition were analysed. Infants/toddlers were grouped by age: 0–6 months (n = 100), 6–12 months (n = 95), 12–24 months (n = 147), and 36–48 months (n = 97). Differences in item responses and item correlations across age groups were calculated by Kruskal–Wallis and Spearman’s correlations, respectively. Results: The report of problems was significantly higher for movement, play, and communication in the 36–48-month group compared to the 0–6-month group. There were strong correlations (r > 0.50) across all age groups between play and movement and communication and social interaction/play; neither pain nor eating showed a clear pattern of association. Conclusions: There is an age-related difference in the reporting of items linked to developmental milestones (movement, play, and communication) with most problems reported in the 36–48-month group when deviation from peers and continued dependence on caregivers is notable. Consideration should be given to including broader examples of play in the EQ-TIPS. Redefining the items to represent social communication and/or (social) emotion, rather than communication and social interaction, may be warranted. Future research should explore the psychometric performance of items to further inform item inclusion and/or revision.
Adaptation and Coping Strategies of Women to Reduce Food Insecurity in an Era of Climate Change: A Case of Chireya District, Zimbabwe
Authors: Magwegwe Everjoy , Zivengwa Taruberekerwa , Zenda Mashford
Published: August 2024

The research investigated how women employ various adaptation and coping mechanisms to alleviate food insecurity resulting from the impacts of climate change. The documentation of the debate on the role of women in adaptation and coping with climate change is relatively limited. Climate change’s effect on food security in semi-arid areas could potentially increase the population of individuals residing in severe poverty. Over the past three decades, Africa’s sub-tropics have experienced irregular rainfall and prolonged droughts, which have negatively affected agriculture and food production. This research utilized a combination of qualitative and quantitative approaches within a mixed-method design, guided by the pragmatic paradigm. Based on the results of the study, water harvesting/dam construction and income generating projects (IGPs) were identified as the most effective coping strategies for women. This study recommends implementing awareness campaigns to educate women farmers about the negative effects of climate change and the need for integrated and comprehensive capacity-building frameworks. By understanding the challenges women face in adapting to and coping with climate change, it is hoped that more effective and sustainable solutions can be developed.
Quantitative Measurement of Rotation in Phalangeal Fracture Malunion Using Computed Tomography Imaging—“Linkage Simulation”
Authors: Yoneda Hidemasa , Iwatsuki Katsuyuki , Saeki Masaomi , Murayama Atsuhiko , Takahashi Nobunori , Yamamoto Michiro , Hirata Hitoshi
Published: August 2024

Malunion of thumb and finger fractures causes problems in the cosmetic and functional aspects of the hand. Malunion of phalangeal fractures usually manifests as a combination of rotational deformities in the coronal, sagittal, and transverse planes, and corrective osteotomy is performed on the planes that cause these problems. Quantification of the deformity is essential for precise osteotomy and is difficult to perform in the transverse plane, even with radiography or computed tomography. Thus, we developed a technique called linkage simulation for the quantitative measurement of rotational deformities for surgical planning. In this procedure, finger extension and flexion can be simulated based on the predicted rotational axis of the joint, which is useful for determining the appropriate correction. Furthermore, by performing a reduction simulation in the software, it is possible to simulate the surgery and predict the postoperative results. This paper reports the details of this technique.
Comparison of Current International Guidelines on Premature Ejaculation: 2024 Update
Authors: Romano Lorenzo , Arcaniolo Davide , Spirito Lorenzo , Quattrone Carmelo , Bottone Francesco , Pandolfo Savio Domenico , Barone Biagio , Napolitano Luigi , Ditonno Francesco , Franco Antonio , Crocetto Felice , Romero-Otero Javier , Autorino Riccardo , De Sio Marco , Manfredi Celeste
Published: August 2024

Premature ejaculation (PE) is a common male sexual dysfunction that can cause significant distress in the patient and partner. This study aimed to compare the current international guidelines on PE to highlight their similarities and differences. We examined the latest guidelines from the European Association of Urology (EAU), American Urological Association/Sexual Medicine Society of North America (AUA/SMSNA), and International Society of Sexual Medicine (ISSM) by comparing definitions, classifications, epidemiology, pathophysiology, and recommendations on diagnosis and therapy. The quality of guidelines was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) Global Rating Scale (GRS). We found significant variations in the definitions of PE and recommendations on management of patients. The EAU guidelines were the most recent, the AUA/SMSNA guidelines lacked detail in some areas, and the ISSM guidelines were the most complete but also the least updated. The search for a unified definition and the development of standardized diagnostic and therapeutic pathways remain concrete issues to improve the management of patients with PE worldwide.
Objective and Subjective Outcomes Following Radiofrequency of Inferior Turbinates in Patients with Sleep-Disordered Breathing
Authors: Pendolino Alfonso Luca , Unadkat Samit , Cheong Ryan Chin Taw , Patel Ankit , Ferreira Joshua , Scarpa Bruno , Andrews Peter J.
Published: August 2024

Background: Nasal obstruction is a frequent problem amongst patients with sleep-disordered breathing (SDB). Radiofrequency of the inferior turbinates (RFIT) is commonly utilized for inferior turbinate (IT) reduction but its effectiveness in SDB patients remains unproven. We aim to evaluate long-term objective and subjective nasal, olfactory and sleep outcomes following RFIT in SDB patients. Methods: Patients were assessed at baseline (T0) and at 3 months (T1), 6 months (T2) and 12 months (T3) following RFIT. At T0, T1, T2 and T3, the patients underwent objective assessments of their nasal airways and smell function and an evaluation of their quality-of-life, sinonasal, olfactory and sleep symptoms. Sleep studies were carried out at T0 and T2. Results: Seventeen patients (with a median age of 42 years) underwent RFIT. A statistically significant objective and subjective improvement of the patients’ nasal airways was demonstrated at T1. No other statistically significant changes were observed in the patients’ nasal airways, smell, sleep study parameters or patient-reported outcomes at the other follow-ups. A multivariate analysis confirmed a statistically significant influence of age (older), sex (male), a higher BMI, the presence of septal deviation and the presence of allergic rhinitis in some of the studies’ parameters. A statistically significant objective and subjective improvement of the patients’ nasal airways was confirmed in the fitted model when considering the influence of the available variables. Conclusions: Our study confirms that the benefits of RFIT alone in SDB patients are limited and possibly only in the short-term period. Patient-related variables can potentially influence the final outcomes.
Clinical Significance of Combined Density and Deep-Learning-Based Texture Analysis for Stratifying the Risk of Short-Term and Long-Term Breast Cancer in Screening
Authors: Vilmun Bolette Mikela , Napolitano George , Lauritzen Andreas , Lynge Elsebeth , Lillholm Martin , Nielsen Michael Bachmann , Vejborg Ilse
Published: August 2024

Assessing a woman’s risk of breast cancer is important for personalized screening. Mammographic density is a strong risk factor for breast cancer, but parenchymal texture patterns offer additional information which cannot be captured by density. We aimed to combine BI-RADS density score 4th Edition and a deep-learning-based texture score to stratify women in screening and compare rates among the combinations. This retrospective study cohort study included 216,564 women from a Danish populations-based screening program. Baseline mammograms were evaluated using BI-RADS density scores (1–4) and a deep-learning texture risk model, with scores categorized into four quartiles (1–4). The incidence rate ratio (IRR) for screen-detected, interval, and long-term cancer were adjusted for age, year of screening and screening clinic. Compared with subgroup B1-T1, the highest IRR for screen-detected cancer were within the T4 category (3.44 (95% CI: 2.43–4.82)−4.57 (95% CI: 3.66–5.76)). IRR for interval cancer was highest in the BI-RADS 4 category (95% CI: 5.36 (1.77–13.45)−16.94 (95% CI: 9.93–30.15)). IRR for long-term cancer increased both with increasing BI-RADS and increasing texture reaching 5.15 (4.31–6.16) for the combination of B4-T4 compared with B1-T1. Deep-learning-based texture analysis combined with BI-RADS density categories can reveal subgroups with increased rates beyond what density alone can ascertain, suggesting the potential of combining texture and density to improve risk stratification in breast cancer screening.
Concurrent Chronic Exertional Compartment Syndrome and Popliteal Artery Entrapment Syndrome
Authors: Bellomo Tiffany R. , Hsu Connie , Bolla Pavan , Mohapatra Abhisekh , Kotler Dana Helice
Published: August 2024

Exertional leg pain occurs with notable frequency among athletes and poses diagnostic challenges to clinicians due to overlapping symptomatology. In this case report, we delineate the clinical presentation of a young collegiate soccer player who endured two years of progressive bilateral exertional calf pain and ankle weakness during athletic activity. The initial assessment yielded a diagnosis of chronic exertional compartment syndrome (CECS), predicated on the results of compartment testing. However, her clinical presentation was suspicious for concurrent type VI popliteal artery entrapment syndrome (PAES), prompting further radiographic testing of magnetic resonance angiography (MRA). MRA revealed severe arterial spasm with plantarflexion bilaterally, corroborating the additional diagnosis of PEAS. Given the worsening symptoms, the patient underwent open popliteal entrapment release of the right leg. Although CECS and PAES are both known phenomena that are observed in collegiate athletes, their co-occurrence is uncommon owing to their different pathophysiological underpinnings. This case underscores the importance for clinicians to be aware that the successful diagnosis of one condition does not exclude the possibility of a secondary, unrelated pathology. This case also highlights the importance of dynamic imaging modalities, including point-of-care ultrasound, dynamic MRA, and dynamic angiogram.
Polygenic Risk Score (PRS) Combined with NGS Panel Testing Increases Accuracy in Hereditary Breast Cancer Risk Estimation
Authors: Tsoulos Nikolaos , Papadopoulou Eirini , Agiannitopoulos Konstantinos , Grigoriadis Dimitrios , Tsaousis Georgios N. , Bouzarelou Dimitra , Gogas Helen , Troupis Theodore , Venizelos Vassileios , Fountzilas Elena , Theochari Maria , Ziogas Dimitrios C. , Giassas Stylianos , Koumarianou Anna , Christopoulou Athina , Busby George , Nasioulas George , Markopoulos Christos
Published: August 2024

Breast cancer (BC) is the most prominent tumor type among women, accounting for 32% of newly diagnosed cancer cases. BC risk factors include inherited germline pathogenic gene variants and family history of disease. However, the etiology of the disease remains occult in most cases. Therefore, in the absence of high-risk factors, a polygenic basis has been suggested to contribute to susceptibility. This information is utilized to calculate the Polygenic Risk Score (PRS) which is indicative of BC risk. This study aimed to evaluate retrospectively the clinical usefulness of PRS integration in BC risk calculation, utilizing a group of patients who have already been diagnosed with BC. The study comprised 105 breast cancer patients with hereditary genetic analysis results obtained by NGS. The selection included all testing results: high-risk gene-positive, intermediate/low-risk gene-positive, and negative. PRS results were obtained from an external laboratory (Allelica). PRS-based BC risk was computed both with and without considering additional risk factors, including gene status and family history. A significantly different PRS percentile distribution consistent with higher BC risk was observed in our cohort compared to the general population. Higher PRS-based BC risks were detected in younger patients and in those with FH of cancers. Among patients with a pathogenic germline variant detected, reduced PRS values were observed, while the BC risk was mainly determined by a monogenic etiology. Upon comprehensive analysis encompassing FH, gene status, and PRS, it was determined that 41.90% (44/105) of the patients demonstrated an elevated susceptibility for BC. Moreover, 63.63% of the patients with FH of BC and without an inherited pathogenic genetic variant detected showed increased BC risk by incorporating the PRS result. Our results indicate a major utility of PRS calculation in women with FH in the absence of a monogenic etiology detected by NGS. By combining high-risk strategies, such as inherited disease analysis, with low-risk screening strategies, such as FH and PRS, breast cancer risk stratification can be improved. This would facilitate the development of more effective preventive measures and optimize the allocation of healthcare resources.
The Overlooked Floppy Eyelid Syndrome: From Diagnosis to Medical and Surgical Management
Authors: Scarabosio Anna , Surico Pier Luigi , Patanè Luca , Tambasco Damiano , Kahale Francesca , Zeppieri Marco , Parodi Pier Camillo , Coassin Marco , Di Zazzo Antonio
Published: August 2024

Floppy Eyelid Syndrome (FES) is an underdiagnosed ocular condition characterized by the abnormal laxity of the upper eyelids, often leading to chronic eye irritation and redness. This review provides an in-depth examination of FES, covering its pathophysiology, clinical presentation, and diagnostic and therapeutic approaches. We discuss the potential etiological factors, including genetic predispositions and associations with ocular and systemic conditions such as obesity, obstructive sleep apnea, keratoconus, and glaucoma. Diagnostic strategies are outlined, emphasizing the importance of thorough clinical examinations and specific tests for an efficacious grading and assessment of FES. Management of FES ranges from conservative medical treatments to surgical interventions for more severe cases and should be driven by a comprehensive and multidisciplinary approach. Herein, we illustrate the practical aspects of diagnosing and managing this condition. This comprehensive review aims to enhance the recognition and treatment of FES, ultimately improving the quality of life for affected patients.
The Possible Associations between Tauopathies and Atherosclerosis, Diabetes Mellitus, Dyslipidemias, Metabolic Syndrome and Niemann–Pick Disease
Authors: Fryncel Aleksandra , Madetko-Alster Natalia , Krępa Zuzanna , Kuch Marek , Alster Piotr
Published: August 2024

Clinical evaluation and treatment of tauopathic syndromes remain a challenge. There is a growing interest in theories concerning their possible associations with metabolic diseases. The possible connection between those diseases might be linked with cerebrovascular dysfunction. The endothelial cell damage and impairment of the blood–brain barrier observed in atherosclerosis or diabetes may play a role in contributing to tauopathic syndrome development. Additionally, the inflammation evoked by pathological metabolic changes may also be involved in this process. Multiple cases indicate the coexistence of metabolic disorders and tauopathic syndromes. These findings suggest that modifying the evolution of metabolic and cerebrovascular diseases may impact the course of neurodegenerative diseases. Obtained data could indicate the possible benefits of introducing routine carotid artery sonography, revascularization operation or antihypertensive medications among patients at high risk for tauopathies. This review has identified this understudied area, which is currently associated with several diseases for which there is no treatment. Due to the pathomechanisms linking metabolic diseases and tauopathies, further investigation of this area of research, including cohort studies, is recommended and may provide new pharmacological perspectives for treatment.
Enhancing the Clinical Utility of Radiomics: Addressing the Challenges of Repeatability and Reproducibility in CT and MRI
Authors: Teng Xinzhi , Wang Yongqiang , Nicol Alexander James , Ching Jerry Chi Fung , Wong Edwin Ka Yiu , Lam Kenneth Tsz Chun , Zhang Jiang , Lee Shara Wee-Yee , Cai Jing
Published: August 2024

Radiomics, which integrates the comprehensive characterization of imaging phenotypes with machine learning algorithms, is increasingly recognized for its potential in the diagnosis and prognosis of oncological conditions. However, the repeatability and reproducibility of radiomic features are critical challenges that hinder their widespread clinical adoption. This review aims to address the paucity of discussion regarding the factors that influence the reproducibility and repeatability of radiomic features and their subsequent impact on the application of radiomic models. We provide a synthesis of the literature on the repeatability and reproducibility of CT/MR-based radiomic features, examining sources of variation, the number of reproducible features, and the availability of individual feature repeatability indices. We differentiate sources of variation into random effects, which are challenging to control but can be quantified through simulation methods such as perturbation, and biases, which arise from scanner variability and inter-reader differences and can significantly affect the generalizability of radiomic model performance in diverse settings. Four suggestions for repeatability and reproducibility studies are suggested: (1) detailed reporting of variation sources, (2) transparent disclosure of calculation parameters, (3) careful selection of suitable reliability indices, and (4) comprehensive reporting of reliability metrics. This review underscores the importance of random effects in feature selection and harmonizing biases between development and clinical application settings to facilitate the successful translation of radiomic models from research to clinical practice.
Prognostic Value of Dynamic Segmented Neutrophil to Monocyte (SeMo) Ratio Changes in Patients with Moderate to Severe Traumatic Brain Injury
Authors: Chang Lin , Lin Yu-Jun , Tsai Ching-Hua , Rau Cheng-Shyuan , Hsu Shiun-Yuan , Hsieh Ching-Hua
Published: August 2024

Background: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in trauma patients, necessitating reliable prognostic tools. The segmented neutrophil-to-monocyte (SeMo) ratio, indicative of the inflammatory response, has emerged as a valuable biomarker. This study evaluates the prognostic value of dynamic changes in the SeMo ratio in predicting outcomes for patients with moderate to severe TBI. Methods: A retrospective analysis was conducted on data from 1118 TBI patients admitted to the surgical intensive care unit at a level I trauma center between January 2009 and December 2020. Patients were selected based on an Abbreviated Injury Scale (AIS) score ≥ 3 in the head region. Initial and follow-up SeMo ratios were calculated upon admission and 48–72 h later, respectively. The dynamic SeMo ratio was defined as the difference between the second and initial SeMo ratios. Statistical analyses included receiver operating characteristic (ROC) curve analysis to determine the optimal threshold for mortality prediction, and comparative analysis of clinical outcomes. Results: The study cohort included 121 deceased and 997 surviving patients. Deceased patients had significantly higher second SeMo ratios (20.9 ± 16.1 vs. 15.8 ± 17.2, p = 0.001) and dynamic SeMo ratios (2.4 ± 19.8 vs. −2.1 ± 19.5, p = 0.019) than those survival patients. In the multivariate analysis, the dynamic SeMo is a significant independent risk factor for in-hospital mortality (OR 1.01, 95%CI: 1.01–1.03, p = 0.031). The optimal cut-off for the dynamic SeMo ratio was 5.96, above which patients exhibited higher mortality (21.4% vs. 8.5%, p < 0.001), higher adjusted mortality (adjusted odds ratio: 2.98; 95% confidence interval: 1.95–4.56; p = 0.005), and longer hospital stays (23.6 days vs. 19.7 days, p = 0.005). Discussion: Dynamic SeMo ratio changes serve as a prognostic marker for in-hospital mortality and hospital stay duration in moderate to severe TBI patients. A higher dynamic SeMo ratio indicates increased risk, highlighting the importance of early monitoring and intervention. Future prospective studies should validate these findings and explore integration with other biomarkers for enhanced prognostication.
Cognitive Impairment in Cerebral Small Vessel Disease Is Associated with Corpus Callosum Microstructure Changes Based on Diffusion MRI
Authors: Dobrynina Larisa A. , Kremneva Elena I. , Shamtieva Kamila V. , Geints Anastasia A. , Filatov Alexey S. , Gadzhieva Zukhra Sh. , Gnedovskaya Elena V. , Krotenkova Marina V. , Maximov Ivan I.
Published: August 2024

The cerebral small vessel disease (cSVD) is one of the main causes of vascular and mixed cognitive impairment (CI), and it is associated, in particular, with brain ageing. An understanding of structural tissue changes in an intact cerebral white matter in cSVD might allow one to develop the sensitive biomarkers for early diagnosis and monitoring of disease progression. Purpose of the study: to evaluate microstructural changes in the corpus callosum (CC) using diffusion MRI (D-MRI) approaches in cSVD patients with different severity of CI and reveal the most sensitive correlations of diffusion metrics with CI. Methods: the study included 166 cSVD patients (51.8% women; 60.4 ± 7.6 years) and 44 healthy volunteers (65.9% women; 59.6 ± 6.8 years). All subjects underwent D-MRI (3T) with signal (diffusion tensor and kurtosis) and biophysical (neurite orientation dispersion and density imaging, NODDI, white matter tract integrity, WMTI, multicompartment spherical mean technique, MC-SMT) modeling in three CC segments as well as a neuropsychological assessment. Results: in cSVD patients, microstructural changes were found in all CC segments already at the subjective CI stage, which was found to worsen into mild CI and dementia. More pronounced changes were observed in the forceps minor. Among the signal models FA, MD, MK, RD, and RK, as well as among the biophysical models, MC-SMT (EMD, ETR) and WMTI (AWF) metrics exhibited the largest area under the curve (>0.85), characterizing the loss of microstructural integrity, the severity of potential demyelination, and the proportion of intra-axonal water, respectively. Conclusion: the study reveals the relevance of advanced D-MRI approaches for the assessment of brain tissue changes in cSVD. The identified diffusion biomarkers could be used for the clarification and observation of CI progression.
Left Ventricular Reverse Remodeling after Surgical Aortic Valve Replacement for Aortic Regurgitation—An Explorative Study
Authors: Arnold Zsuzsanna , Elnekheli Alexander , Geisler Daniela , Aschacher Thomas , Lenz Verena , Winkler Bernhard , Moidl Reinhard , Grabenwöger Martin
Published: August 2024

Background: The timing of treatment for chronic aortic valve regurgitation (AR), especially in asymptomatic patients, is gaining attention since less invasive strategies have become available. The aim of the present study was to evaluate left ventricular reverse remodeling after aortic valve replacement (AVR) for severe AR. Methods: Patients (n = 25) who underwent surgical AVR for severe AR with left ventricular ejection fraction (LVEF) less than 55% were included in this study. Preprocedural and follow-up clinical and echocardiographic measurements of LVEF and left ventricular (LV) diameters were retrospectively analyzed. Results: Mean LVEF increased significantly following surgical AVR (p < 0.0001). LV diameters showed a clear regression (p = 0.0088). Younger patients and those receiving a mechanical valve tended to have less improved LVEF on follow-up than patients over 60 years or the ones who were implanted with a biological prosthesis (p = 0.0239 and p = 0.069, respectively). Gender had no effect on the degree of LVEF improvement (p = 0.4908). Conclusions: We demonstrated significant LV reverse remodeling following AVR for AR. However, more data are needed on LV functional and geometrical improvement comparing the different types of valve prostheses to provide an optimal treatment strategy.
Effectiveness of an Acupuncture Steam-Warming Eye Mask on Dry Eye Disease in Visual Display Terminal Users: A Prospective Randomized Controlled Trial
Authors: Lee Chia-Yi , Yang Shun-Fa , Hsiao Ching-Hsi , Sun Chi-Chin , Chang Chao-Kai , Huang Jing-Yang , Hwang Yih-Shiou
Published: August 2024

We aim to evaluate the effectiveness of an acupuncture steam-warming eye mask (ASEM) on dry eye disease (DED) in visual display terminal (VDT) users. This prospective randomized clinical trial included VDT users with DED-related features who were randomly assigned to the ASEM group (ASEM for 2 weeks, 20 participants) or the steam-warming eye mask (SEM) group (SEM for 2 weeks, 20 participants). The tear film break-up time (TBUT), Schirmer test, tear meniscus height, ocular surface staining scores, eyelid and meibomian gland exam, subjective symptoms, and quality of life (QoL) scores before and after treatment were collected. A generalized linear mixed model was applied to compare the improvement of symptoms and signs between the two groups. After the 2-week treatment, all the subjective symptoms and questionnaire scores in the ASEM group improved significantly (all p < 0.05), whereas the feelings of relaxation, comfortable, and refreshment did not change in the SEM group (both p > 0.05). The TBUT, tear meniscus height, and meibum quality in the lower eyelid were significantly better in the ASEM group than the SEM group (all p < 0.05), whereas no significant changes were observed in the Schirmer test and ocular surface staining scores. Compared with the SEM group, the ASEM group experienced a stronger feeling of refreshment (p = 0.013), lower sensation of ocular discharge (p = 0.031), higher TBUT (p = 0.045), better meibomian gland expressibility of both eyelids (both p < 0.05), and better meibum quality of both eyelids (both p < 0.05), even after adjustments for age and sex. In conclusion, comparing with SEM, ASEM can improve some subjective DED symptoms, tear film stability, and meibum status in VDT users.
The COVID-19 Pandemic and Emergencies in Otolaryngology–Head and Neck Surgery: An Analysis of Patients Presenting to Emergency Rooms in South-West Germany: A Bi-Center Study
Authors: Wolpert Stephan , Knoblich Nora , Holderried Martin , Becker Sven , Schade-Mann Thore
Published: August 2024

This study was designed to examine the changes in emergency room visits in otolaryngology, head and neck surgery, during the COVID-19 pandemic. The study included 11,277 patients who presented to a tertiary care hospital (ER) and an emergency practice (EP) during on-call hours in the first half of 2018, 2019, and 2020. The epidemiologic parameters, diagnoses, and level of urgency were recorded using a four-step scale. A comparison was made between the pre-pandemic years and 2020. The findings revealed a significant decrease in the frequency of ER visits in the second quarter of 2020 compared to 2019 (ER: 30.8%, EP: 37.8%), mainly due to the fact that there were significantly fewer patients, with low levels of urgency. Certain diagnoses, such as epistaxis (−3.0%) and globus sensation (−3.2%), were made at similar frequencies to 2019, while inflammatory diseases like skin infections (−51.2%), tonsillitis (−55.6%), sinusitis (−59%), and otitis media (−70.4%) showed a significant reduction. The study concludes that patients with a low triage level were less likely to visit the ER during the early stages of the pandemic, but some diagnoses were still observed at comparable rates. This suggests a disparity in perception between patients and ER staff regarding urgency. Many of the issues discussed were also emphasized in the 2024 proposal by the German Ministry of Health to reform emergency care in Germany.
Awareness of Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPMs) among Northern Italian Dentists: A Questionnaire Survey
Authors: Bardellini Elena , Conti Giulio , Veneri Federica , Majorana Alessandra , Amadori Francesca
Published: August 2024

Background: The purpose of this study was to assess the awareness of molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPMs) among dental practitioners in Northern Italy, and to gather data on the occurrence of these conditions in their paediatric patients. Methods: A cross-sectional study was conducted using a structured online questionnaire administered through Google Forms. The survey comprised 10 single-choice questions addressing the occurrence of MIH and HSPM in caries-free patients aged 6–9 years. Results: A total of 315 dentists participated in the survey, yielding a response rate of 31.5%. The majority of respondents reported that 1–25% of their paediatric patients exhibited HSPMs. Among this group, 43.62% of respondents observed MIH in 1–25% of cases. Conclusion: The findings from this survey suggest a consistent perception of MIH and HSPMs among dental practitioners, aligning with known prevalence data and indicating recognition of these conditions within the dental community in Northern Italy.
Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review
Authors: Pestana de Vasconcelos Natália , Martins Isabel Silva , Afonso Américo Santos , Braga Ana Cristina , Pina-Vaz Irene
Published: August 2024

Osteoporosis is a common systemic bone disorder in the elderly, characterized by low bone mineral density and deterioration of bone structure. Apical periodontitis is an inflammatory response to the microbial infection of root canals, typically characterized by apical bone destruction surrounding the tooth’s apex. This systematic review aimed to determine if osteoporosis affects the prevalence of apical periodontitis in adults. PRISMA guidelines have been followed. It included randomized clinical trials, cross-sectional, cohort, and case-control studies, and excluded non-relevant investigations and various secondary sources. A comprehensive search was performed in PubMed, Scopus, and Web of Science, until 13 March 2024. The Newcastle–Ottawa Scale was used to assess the quality of the three selected studies: two cross-sectional studies and one case-control study. One investigation only included post-menopausal women recruited at a dental university clinic, the other integrated data from the total hospital patients’ population, and the third selected patients referred to the university dental clinic from the university hospital. The findings varied: one study noted a marginal association between low bone mineral density and apical periodontitis, another found a significant association, and the third, with the lowest risk of bias, reported no link. The main limitations were the scarcity of eligible studies and their overall quality. The review was registered in the PROSPERO database (CRD42024523705), applied strict inclusion criteria and thorough searches by experienced and independent reviewers. There is no strong evidence that adult individuals with osteoporosis have a higher probability of developing apical periodontitis. However, clinicians should remain cautious of osteoporosis’s potential impact on apical periodontitis development.
Olive Tree Segmentation from UAV Imagery
Authors: Prousalidis Konstantinos , Bourou Stavroula , Velivassaki Terpsichori-Helen , Voulkidis Artemis , Zachariadi Aikaterini , Zachariadis Vassilios
Published: August 2024

This paper addresses the challenge of olive tree segmentation using drone imagery, which is crucial for precision agriculture applications. We tackle the data scarcity issue by augmenting existing detection datasets. Additionally, lightweight model variations of state-of-the-art models like YOLOv8n, RepViT-SAM, and EdgeSAM are combined into two proposed pipelines to meet computational constraints while maintaining segmentation accuracy. Our multifaceted approach successfully achieves an equilibrium among model size, inference time, and accuracy, thereby facilitating efficient olive tree segmentation in precision agriculture scenarios with constrained datasets. Following comprehensive evaluations, YOLOv8n appears to surpass the other models in terms of inference time and accuracy, albeit necessitating a more intricate fine-tuning procedure. Conversely, SAM-based pipelines provide a significantly more streamlined fine-tuning process, compatible with existing detection datasets for olive trees. However, this convenience incurs the disadvantages of a more elaborate inference architecture that relies on dual models, consequently yielding lower performance metrics and prolonged inference durations.
DFly: A Publicly Auditable and Privacy-Preserving UAS Traffic Management System on Blockchain
Authors: Baptista Frederico , Dehez-Clementi Marina , Detchart Jonathan
Published: August 2024

The integration of Unmanned Aircraft Systems (UASs) into the current airspace poses significant challenges in terms of safety, security, and operability. As an example, in 2019, the European Union defined a set of rules to support the digitalization of UAS traffic management (UTM) systems and services, namely the U-Space regulations. Current propositions opted for a centralized and private model, concentrated around governmental authorities (e.g., AlphaTango provides the Registration service and depends on the French government). In this paper, we advocate in favor of a more decentralized and transparent model in order to improve safety, security, operability among UTM stakeholders, and legal compliance. As such, we propose DFly, a publicly auditable and privacy-preserving UAS traffic management system on Blockchain, with two initial services: Registration and Flight Authorization. We demonstrate that the use of a blockchain guarantees the public auditability of the two services and corresponding service providers’ actions. In addition, it facilitates the comprehensive and distributed monitoring of airspace occupation and the integration of additional functionalities (e.g., the creation of a live UAS tracker). The combination with zero-knowledge proofs enables the deployment of an automated, distributed, transparent, and privacy-preserving Flight Authorization service, performed on-chain thanks to the blockchain logic. In addition to its construction, this paper details the instantiation of the proposed UTM system with the Ethereum Sepolia’s testnet and the Groth16 ZK-SNARK protocol. On-chain (gas cost) and off-chain (execution time) performance analyses confirm that the proposed solution is a viable and efficient alternative in the spirit of digitalization and offers additional security guarantees.
The Economic Decision of International Migration: Two Empirical Evidences from the United States and Canada
Authors: Park Jiyoung , Lee Seongwoo , Park Jonghoon
Published: August 2024

This study investigated whether economic motivations are a key factor in international migration decisions. Applying the selectivity-corrected expected income for migrants and stayers, the difference in expected income for an individual in origin and destination countries was analyzed. This study used data from the U.S. and Canada to empirically test the role of income gaps in migration decisions. The main difficulty in analyzing the role of the gaps lies in collecting both income streams for the same individual, since once an individual migrates to a different country, their potential income in the origin country cannot be observed; and vice versa for stayers. Therefore, directly applying the average income of migrants (conditionally relying on their observed characteristics) to estimate the income of stayers if they had migrated results in a biased estimate of stayers’ income. Hence, there is a need to account for selectivity in the migration decision and calculate selectivity-corrected income. The key finding in this study is that the expected income gap is positively associated with, and statistically significant for, international migration decisions for the U.S. and Canada. One of the main reasons may be the easy transfer of labor skills between countries that have similar labor environments and cultural backgrounds.
Empirical Analysis of Demand for Sukuk in Uzbekistan
Authors: Asadov Alam
Published: August 2024

Islamic finance (IF) holds significant potential for economic development and the enhancement of financial inclusion in Uzbekistan. Sukuk, as a key Islamic capital market instrument and Shari’ah-compliant investment alternative, plays an important role in this context. However, the demand for sukuk and its determinants are not well understood by policymakers and industry practitioners in Uzbekistan. This study aims to address this research gap by utilizing an ordinal logit model on primary data collected through a survey of 196 individuals from diverse demographic and professional backgrounds, with varying levels of IF and capital market knowledge and experience. The regression results indicate that factors such as prior investment experience, knowledge of sukuk, and a strong inclination toward Shari’ah-compliant investments positively influence an individual’s intent to buy sukuk. Conversely, we found that residents of Tashkent (the capital city) are less likely to invest in sukuk compared to residents of other regions in Uzbekistan or those residing abroad. Based on this study’s findings, several essential policy and practical recommendations are provided to relevant stakeholders.
DKA-RG: Disease-Knowledge-Enhanced Fine-Grained Image–Text Alignment for Automatic Radiology Report Generation
Authors: Yin Heng , Wu Wei , Hao Yongtao
Published: August 2024

Automatic radiology report generation is a task that combines artificial intelligence and medical information processing, and it fully relies on computer vision and natural language processing techniques. Nowadays, automatic radiology report generation is still a very challenging task because it requires semantically adequate alignment of data from two modalities: radiology images and text. Existing approaches tend to focus on coarse-grained alignment at the global level and do not take into account the disease characteristics of radiology images at fine-grained semantics, which results in the generated reports potentially omitting key disease diagnostic descriptions. In this work, we propose a new approach, disease-knowledge-enhanced fine-grained image–text alignment for automatic radiology report generation (DKA-RG). The method combines global and disease-level alignment, thus facilitating the extraction of fine-grained disease features by the model. Our approach also introduces a knowledge graph to inject medical domain expertise into the model. Our proposed DKA-RG consists of two training steps: the image–report alignment stage and the image-to-report generation stage. In the alignment stage, we use global contrastive learning to align images and texts from a high level and also augment disease contrastive learning with medical knowledge to enhance the disease detection capability. In the report generation stage, the report text generated from the images is more accurate in describing the disease information thanks to sufficient alignment. Through extensive quantitative and qualitative experiments on two widely used datasets, we validate the effectiveness of our DKA-RG on the task of radiology report generation. Our DKA-RG achieves superior performance on multiple types of metrics (natural language generation and clinical efficacy metrics) compared to existing methods, demonstrating that the method can improve the reliability and accuracy of automatic radiology report generation systems.