bluuebunny/crossref_metadata_2025 huggingface dataset:
Interleukin-6 on postoperative day three as an early predictor of infections following laparoscopic gastric cancer resection
Authors: Huang Yongzhou , Yang Lei , Yang Wenchang , Zhou Pei , Jiang Qi , Liu Weizhen , Yin Yuping , Zeng Xiangyu , Zhang Peng , Tao Kaixiong
Published: March 2024

Background

To investigate the role of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) as early predictors of infectious complications after laparoscopic gastric cancer surgery.

Methods

Patients who underwent laparoscopic gastric cancer surgery between January 2020 and June 2022 were retrospectively enrolled. IL-6, PCT, and CRP levels were assessed before surgery and on postoperative days (PODs) 3 and 5. Differences in serum IL-6, PCT, and CRP levels between the infected and non-infected groups were compared. The diagnostic accuracy was determined using the area under the receiver operating characteristic curve (AUC).

Results

A total of 206 patients were enrolled, and 21 patients (10.19%) developed postoperative infections. Serum IL-6, PCT, and CRP levels in the infected group were significantly higher than those in the non-infected group on PODs 3 and 5. IL-6 with an optimal cutoff value of 84.00 pg/mL (AUC 0.84), PCT with an optimal cutoff value of 1.39 ng/mL (AUC 0.80), CRP with an optimal cutoff value of 150.00 mg/L (AUC 0.76) on POD 3 had superior diagnostic accuracy in predicting postoperative infections. Multivariate analysis identified PCT and IL-6 levels on POD 3 as independent risk factors, the AUC of the combination of IL-6 and PCT was 0.89. The Delong test showed no difference between the AUC of IL-6 alone and IL-6 combined with PCT prediction (P = 0.07, Z = 1.81).

Conclusions

IL-6 level on POD 3 is an excellent predictor of infectious complications following laparoscopic gastric cancer surgery. Patients with IL-6 levels lower than 84.00 pg/mL on POD 3 can ensure safe early discharge with a low probability of infection.
The challenges in diagnosing isolated epididymal tuberculosis (TB) in an adolescent male: a case report
Authors: Cesilia Citra , Nugraha Harry Galuh , Siregar Safendra , Nataprawira Heda Melinda
Published: March 2024

Background

Genitourinary tuberculosis (GUTB) is a common form of extrapulmonary TB (EPTB) in children. An example of GUTB is epididymal TB, which usually presents unspecific chronic clinical manifestations. Definitive diagnosis can be conducted based on bacteriologic confirmation and histopathologic results, but this is challenging due to the paucibacillary nature of EPTB. Therefore, we reported the challenges in diagnosing isolated epididymal TB in an adolescent male.

Case presentation

A 16-year-old male presented to respirology clinic with painful swelling of the left scrotum for 3 months before visiting to the hospital. The symptoms were associated with persistent coughing for 2 months, and physical examination of the left scrotum showed swelling accompanied by cardinal signs. A palpable hard mass was found on the left scrotum, with firm borders, measuring 7 × 4 cm. Laboratory examination and tumor markers were within normal limits, although leukocyturia was found, and the urine culture was negative. Genital ultrasound (US) showed epididymitis sinistra with septal hydrocele, while magnetic resonance imaging (MRI) indicated inhomogeneous left epididymitis with bilateral inguinal lymph node enlargement. Although TB evaluation presented a negative purified protein derivative (PPD) test and bacteriologic examination, chest X-ray (CXR) showed perihilar lymphadenopathy. Based on the clinical and radiologic results suggesting TB, the patient was diagnosed with isolated epididymal TB and received quadruple antituberculosis therapy (ATT) for 6 months. After treatment, the left testicle size started to shrink and was equal to the right testicle, also, there were no signs of inflammation, the body weight increased by 5 kg, and cough disappeared. Sperm analysis at the end of treatment indicated teratozoospermia, which was subsequently treated by the urologic surgery department.

Conclusions

Biopsy and bacteriologic confirmation for TB epididymitis were challenging to perform in the clinical setting. Epididymal TB should be considered in adolescent males with complaints of chronic scrotal swelling and pain. Clinical judgment based on history taking, physical examination, and radiologic features supporting TB features could be helpful in accurate and fast diagnosis for favorable outcome.
Knowledge and attitude towards preconception care and associated factors among women of reproductive age with chronic disease in Amhara region referral hospitals, Ethiopia, 2022
Authors: Demeke Muluken , Yetwale Fisseha , Mulaw Zerfu , Yehualashet Daniel , Gashaw Anteneh , Agegn Mengistie Berihun
Published: March 2024

Introduction

Preconception care (PCC) is an important window to target maternal morbidity and mortality, especially for women with chronic diseases. However, little is known about knowledge and attitudes towards preconception care among women with chronic disease. Therefore, this study aimed to assess knowledge and attitude towards preconception care and associated factors among women of reproductive age with chronic disease in Amhara region referral hospitals, Ethiopia, 2022.

Method

A multicenter cross-sectional study was conducted in Amhara region referral hospitals from April 15 to June 1, 2022. A total 828 women of reproductive age with chronic disease in four referral hospitals were selected using a stratified and systematic random sampling technique. Data was collected by using a structured interviewer-administered questionnaire and chart review. Bivariate and multivariable logistic regression analyses were carried out. An Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was computed to see the strength of association between outcome and independent variables. P-value < 0.05 was considered as statistically significant.

Results

This study found that 55.6% of respondents had a good knowledge of preconception care, and 50.2% had a good attitude towards PCC. Formal education (AOR: 1.997, 95% CI: 1.247, 3.196), primiparity (AOR: 2.589, 95% CI: 1.132, 5.921), preconception counseling (AOR: 3.404, 95% CI: 2.170, 5.340), duration of disease ≥ 5 years (AOR: 6.495, 95% CI: 4.091, 10.310) were significantly associated with knowledge of PCC. Older age (≥ 35years) (AOR: 2.143, 95% CI: 1.058, 4.339), secondary education and above (AOR: 2.427, 95% CI: 1.421, 4.146), history of modern family planning use (AOR: 2.853 95% CI: 1.866, 4.362), preconception counseling (AOR: 2.209, 95% CI: 1.429, 3.414) and good knowledge of PCC (AOR: 20.629, 95% CI: 12.425, 34.249) were significantly associated with attitude towards PCC.

Conclusions

Women’s knowledge and attitude towards preconception care were found to be low. Important measures include promoting secondary education and carrying out awareness campaigns, incorporating preconception counseling into routine medical follow-up care, and encouraging the use of modern family planning methods.
Analysis of ten-year teaching evaluation of oral microbiology lab curriculum
Authors: Xu Yu , Ding Xingji , Wang Wenhui , Li Yazhuo , Nie Min
Published: March 2024

Background

Based on the updated teaching philosophy of oral microbiology, Wuhan University School of Stomatology initiated a reform in the teaching of oral microbiology in 2009. As part of this reform, an oral microbiology laboratory course was introduced to cultivate students' fundamental skills, professional competence, comprehensive abilities, and innovation capabilities through experimental design. This paper provides thorough examination of the teaching experiment findings from 2013 to 2022, a ten-year timeframe, building on earlier data.

Methods

The curriculum targets fourth-year undergraduate students in a five-year program and adopts a cooperative learning approach. The experimental teaching mainly involves four parts: plaque collection and processing, isolation and cultivation of dental plaque bacteria, staining and biochemical identification of dental plaque bacteria. This article presents a comprehensive analysis of the student experiment results from 2013 to 2022. Statistical analysis was conducted using the chi-square test to assess whether there were any differences in students' experimental grades between different years. A significance level of P < 0.05 was considered statistically significant. Additionally, we evaluated the impact of teaching methods and educational systems on improving students' practical skills and overall innovative abilities.

Results

The performance of 664 undergraduate students showed improvement in the oral microbiology laboratory course, with a noticeable decrease in the proportion of "C" grades in Experiments 2, 3, and 4 compared to Experiment 1. These results indicate that the laboratory course enhanced students' academic achievements, aiding their understanding and mastery of course content, and received positive feedback from the students.

Conclusion

This lab curriculum, through systematic laboratory teaching and practical experience, contributes to the enhancement of students' professional skills and research abilities. It fosters students' interest in scientific research and improves the quality of dental education.
Perception of the operation theater learning environment and related factors among anesthesia students in Ethiopian higher education teaching hospitals: a multicenter cross-sectional study
Authors: Wubshet Habtemariam , Agegnehu Abatneh Feleke , Workie Misganaw Mengie , Addisu Yonas
Published: March 2024

Introduction

Operation theater learning involves three key elements: clinical work, learning, and the environment. There is little evidence regarding the operating theatre learning environment for anesthesia trainees. Identifying the overall perception of the operation theater learning environment helps to establish an efficient operation theater learning environment and produce competent anesthesia professionals.

Objective

The aim of this study was to assess the perceptions of the operating theater learning environment and associated factors among undergraduate anesthesia students in Ethiopian higher education teaching hospitals from April to May 2023.

Methods

A multicenter cross-sectional study was conducted on 313 undergraduate anesthesia students who began operation room clinical practice at 13 higher education teaching hospitals. The data were entered into EpiData version 4.6. A generalized ordered logistic regression model was used to analyze and identify factors associated with the operating theater learning environment using STATA software version MP17.

Results

The findings of this study revealed that 45.05%,26.52%), 23% and 5.43% of the participants reported having desirable, moderately desirable, very desirable and undesirable perceptions of the operating theater learning environment, respectively, from highest to lowest. Preoperative discussion (AOR = 4.98 CI = 1.3–18.8), lack of teaching facilities (AOR = 0.16 CI = 0.03–0.75), noise from played music (AOR = 0.22 CI = 0.07–0.63), absence of tutors (AOR = 0.03 CI = 0.01–0.22), respect for students (AOR = 3.44 CI = 1.6–7.2), roll modeling for students (AOR = 3.23 CI = 1.5–6.8) and strict supervision of students (AOR = 0.24 CI = 0.07–0.88) were significantly associated with perceptions of the operation theater learning environment, with 95% CIs.

Conclusion

No study participant agreed that the operation theater learning environment in operation theatres was very undesirable. A lack of teaching facilities at the OR, a lack of tutors from the OR, noise from played music in the OR, a tutor respecting their student, a tutor role model for their student, a preoperative discussion with a tutor and strict supervision of the student are strongly associated with the operation theatre learning environment.
What are the views of Quebec and Ontario citizens on the tiebreaker criteria for prioritizing access to adult critical care in the extreme context of a COVID-19 pandemic?
Authors: Calderon Ramirez Claudia , Farmer Yanick , Frolic Andrea , Bravo Gina , Gaucher Nathalie Orr , Payot Antoine , Opatrny Lucie , Poirier Diane , Dahine Joseph , L’Espérance Audrey , Downar James , Tanuseputro Peter , Rousseau Louis-Martin , Dumez Vincent , Descôteaux Annie , Dallaire Clara , Laporte Karell , Bouthillier Marie-Eve
Published: March 2024

Background

The prioritization protocols for accessing adult critical care in the extreme pandemic context contain tiebreaker criteria to facilitate decision-making in the allocation of resources between patients with a similar survival prognosis. Besides being controversial, little is known about the public acceptability of these tiebreakers. In order to better understand the public opinion, Quebec and Ontario’s protocols were presented to the public in a democratic deliberation during the summer of 2022.

Objectives

(1) To explore the perspectives of Quebec and Ontario citizens regarding tiebreakers, identifying the most acceptable ones and their underlying values. (2) To analyze these results considering other public consultations held during the pandemic on these criteria.

Methods

This was an exploratory qualitative study. The design involved an online democratic deliberation that took place over two days, simultaneously in Quebec and Ontario. Public participants were selected from a community sample which excluded healthcare workers. Participants were first presented the essential components of prioritization protocols and their related issues (training session day 1). They subsequently deliberated on the acceptability of these criteria (deliberation session day 2). The deliberation was then subject to thematic analysis.

Results

A total of 47 participants from the provinces of Quebec (n = 20) and Ontario (n = 27) took part in the online deliberation. A diverse audience participated excluding members of the healthcare workforce. Four themes were identified: (1) Priority to young patients - the life cycle - a preferred tiebreaker; (2) Randomization - a tiebreaker of last resort; (3) Multiplier effect of most exposed healthcare workers - a median acceptability tiebreaker, and (4) Social value – a less acceptable tiebreaker.

Conclusion

Life cycle was the preferred tiebreaker as this criterion respects intergenerational equity, which was considered relevant when allocating scarce resources to adult patients in a context of extreme pandemic. Priority to young patients is in line with other consultations conducted around the world. Additional studies are needed to further investigate the public acceptability of tiebreaker criteria.
Enhancing automated lower limb rehabilitation exercise task recognition through multi-sensor data fusion in tele-rehabilitation
Authors: Ettefagh Alireza , Roshan Fekr Atena
Published: March 2024

Background

Tele-rehabilitation is the provision of physiotherapy services to individuals in their own homes. Activity recognition plays a crucial role in the realm of automatic tele-rehabilitation. By assessing patient movements, identifying exercises, and providing feedback, these platforms can offer insightful information to clinicians, thereby facilitating an improved plan of care. This study introduces a novel deep learning approach aimed at identifying lower limb rehabilitation exercises. This is achieved through the integration of depth data and pressure heatmaps. We hypothesized that combining pressure heatmaps and depth data could improve the model’s overall performance.

Methods

In this study, depth videos and body pressure data from an accessible online dataset were used. This dataset comprises data from 30 healthy individuals performing 7 lower limb rehabilitation exercises. To accomplish the classification task, three deep learning models were developed, all based on an established 3D-CNN architecture. The models were designed to classify the depth videos, sequences of pressure data frames, and combination of depth videos and pressure frames. The models’ performance was assessed through leave-one-subject-out and leave-multiple-subjects-out cross-validation methods. Performance metrics, including accuracy, precision, recall, and F1 score, were reported for each model.

Results

Our findings indicated that the model trained on the fusion of depth and pressure data showed the highest and most stable performance when compared with models using individual modality inputs. This model could effectively identify the exercises with an accuracy of 95.71%, precision of 95.83%, recall of 95.71%, and an F1 score of 95.74%.

Conclusion

Our results highlight the impact of data fusion for accurately classifying lower limb rehabilitation exercises. We showed that our model could capture different aspects of exercise movements using the visual and weight distribution data from the depth camera and pressure mat, respectively. This integration of data provides a better representation of exercise patterns, leading to higher classification performance. Notably, our results indicate the potential application of this model in automatic tele-rehabilitation platforms.
Impact of an oral care subsidization reform on intersectional inequities in self-rated oral health in Sweden
Authors: Anticona Cynthia , Suominen Anna Liisa , Holgerson Pernilla Lif , Gustafsson Per E
Published: March 2024

Background

Oral health in Sweden is good at the population level, but seemingly with persisting or increasing inequities over the last decades. In 2008, a major Swedish reform introduced universal partial subsidies to promote preventive care and reduce the treatment cost for patients with extensive care needs. This study aimed to apply an intersectional approach to assess the impact of the 2008 subsidization reform on inequities in self-rated oral health among adults in Sweden over the period 2004–2018.

Methods

Data from 14 national surveys conducted over 2004–2018 were divided into three study periods: pre-reform (2004–2007), early post-reform (2008–2012) and late post-reform (2013–2018). The final study population was 118,650 individuals aged 24–84 years. Inequities in self-rated oral health were examined by intersectional analysis of individual heterogeneity and discriminatory accuracy across 48 intersectional strata defined by gender, age, educational level, income, and immigrant status.

Results

Overall, the prevalence of poor self-rated oral health decreased gradually after the reform. Gender-, education- and income-related inequities increased after the reform, but no discernible change was seen for age- or immigration-related inequities. The majority of intersectional strata experienced patterns of persistently or delayed increased inequities following the reform.

Conclusions

Increased inequities in self-rated oral health were found in most intersectional strata following the reform, despite the seemingly positive oral health trends at the population level. Applying an intersectional approach might be particularly relevant for welfare states with overall good oral health outcomes but unsuccessful efforts to reduce inequities.
Clinical effectiveness of a multitarget urine DNA test for urothelial carcinoma detection: a double-blinded, multicenter, prospective trial
Authors: Wu Junlong , Lin Yuda , Yang Kaiwei , Liu Xiao , Wang Huina , Yu Tingting , Tao Ran , Guo Jing , Chen Libin , Cheng Huanqing , Lou Feng , Cao Shanbo , Yu Wei , Hu Hailong , Ye Dingwei
Published: March 2024

Urine-based testing is promising for noninvasive diagnosis of urothelial carcinoma (UC) but has suboptimal sensitivity for early-stage tumors. Herein, we developed a multitarget urine tumor DNA test, UI-Seek, for UC detection and evaluated its clinical feasibility. The prediction model was developed in a retrospective cohort (n = 382), integrating assays for FGFR3 and TERT mutations and aberrant ONECUT2 and VIM methylation to generate a UC-score. The test performance was validated in a double-blinded, multicenter, prospective trial (n = 947; ChiCTR2300076543) and demonstrated a sensitivity of 91.37% and a specificity of 95.09%. The sensitivity reached 75.81% for low-grade Ta tumors and exceeded 93% in high-grade Ta and higher stages (T1 to T4). Simultaneous identification of both bladder and upper urinary tract tumors was enabled with sensitivities exceeding 90%. No significant confounding effects were observed regarding benign urological diseases or non-UC malignancies. The test showed improved sensitivities over urine cytology, the NMP22 test, and UroVysion FISH alongside comparable specificities. The single-target accuracy was greater than 98% as confirmed by Sanger sequencing. Post-surgery UC-score decreased in 97.7% of subjects. Overall, UI-Seek demonstrated robust performance and considerable potential for the early detection of UC.
Two cases of venous thromboembolism in siblings after splenectomy due to a novel PROC gene mutation
Authors: Zhang Yunfang , Wang Bo , Bai Yuxin , Wang Anxin
Published: March 2024

Background

Venous thromboembolism(VTE)is a common multifactorial disease. Anticoagulant protein deficiency is the most usual hereditary thrombophilia in the Chinese people, which includes protein C(PC), protein S and antithrombin deficiencies.

Case presentation

A retrospective analysis was conducted on clinical manifestations, laboratory tests, genetic information, and other relevant data of siblings diagnosed with VTE in 2020 at the Department of Pediatrics of Shenzhen Second People’s Hospital. The proband, a 12-year-old female, was admitted to the hospital in December 2020 with a complaint of pain in the left lower limb for four days. The examination found that the PC activity was 53%, and B-ultrasound showed bilateral thrombosis of the great saphenous vein in the thigh segment. The proband’s younger brother, a 10-year-old male, was admitted to the hospital in January 2021 due to right lower limb pain for two weeks. PC activity is 40%. B-ultrasound showed superficial venous thrombosis in the left lower limb and upper limb. Both siblings suffered from thalassemia and underwent splenectomy before recurrent thrombosis occurred. The proband’s mother was asymptomatic, and her PC activity was 45%. Both cases were treated with warfarin anticoagulation, and their symptoms improved. The proband’s mother was found to have a heterozygous mutation at this locus through Sanger sequencing.

Conclusion

Protein C deficiency should be considered for venous thromboembolism in childhood. The heterozygous mutation 1204 A > G in PROC exon 9 in this family is reported for the first time.
A meta-analysis and trial sequential analysis of randomised controlled trials comparing nonoperative and operative management of chest trauma with multiple rib fractures
Authors: Hisamune Ryo , Kobayashi Mako , Nakasato Karin , Yamazaki Taiga , Ushio Noritaka , Mochizuki Katsunori , Takasu Akira , Yamakawa Kazuma
Published: March 2024

Background

Operative treatment of traumatic rib fractures for better outcomes remains under debate. Surgical stabilization of rib fractures has dramatically increased in the last decade. This study aimed to perform a systematic review and meta-analysis of randomised controlled trials (RCTs) to assess the effectiveness and safety of operative treatment compared to conservative treatment in adult patients with traumatic multiple rib fractures.

Methods

A systematic literature review was performed according to the preferred reporting items for systematic reviews and meta-analyses guidelines. We searched MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials and used the Cochrane Risk-of-Bias 2 tool to evaluate methodological quality. Relative risks with 95% confidence interval (CI) were calculated for outcomes: all-cause mortality, pneumonia incidence, and number of mechanical ventilation days. Overall certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, with trial sequential analysis performed to establish implications for further research.

Results

From 719 records, we included nine RCTs, which recruited 862 patients. Patients were assigned to the operative group (received surgical stabilization of chest wall injury, n = 423) or control group (n = 439). All-cause mortality was not significantly different (RR = 0.53; 95% CI 0.21 to 1.38, P = 0.35, I2 = 11%) between the two groups. However, in the operative group, duration of mechanical ventilation (mean difference -4.62; 95% CI -7.64 to -1.60, P < 0.00001, I2 = 94%) and length of intensive care unit stay (mean difference -3.05; 95% CI -5.87 to -0.22; P < 0.00001, I2 = 96%) were significantly shorter, and pneumonia incidence (RR = 0.57; 95% CI 0.35 to 0.92; P = 0.02, I2 = 57%) was significantly lower. Trial sequential analysis for mortality indicated insufficient sample size for a definitive judgment. GRADE showed this meta-analysis to have very low to low confidence.

Conclusion

Meta-analysis of large-scale trials showed that surgical stabilization of multiple rib fractures shortened the duration of mechanical ventilation and reduced the incidence of pneumonia but lacked clear evidence for improvement of mortality compared to conservative treatment. Trial sequential analysis suggested the need for more cases, and GRADE highlighted low certainty, emphasizing the necessity for further targeted RCTs, especially in mechanically ventilated patients.

Systematic review registration: UMIN Clinical Trials Registry UMIN000049365.
Postoperative hyper-inflammation as a predictor of poor outcomes in patients with acute type A aortic dissection (ATAAD) undergoing surgical repair
Authors: Luo Yuan-Xi , Matniyaz Yusanjan , Tang Yu-Xian , Xue Yun-Xing , Jiang Yi , Pan Ke , Lv Zhi-Kang , Fan Zhi-Wei , Wang Kuo , Zhang Hai-Tao , Zhang He , Wang Wen-Zhe , Pan Tuo , Wang Dong-Jin , Fan Fu-Dong
Published: March 2024

Background

Postoperative hyper-inflammation is a frequent event in patients with acute Stanford type A aortic dissection (ATAAD) after surgical repair. This study's objective was to determine which inflammatory biomarkers could be used to make a better formula for identifying postoperative hyper-inflammation, and which risk factors were associated with hyper-inflammation.

Methods

A total of 405 patients were enrolled in this study from October 1, 2020 to April 1, 2023. Of these patients, 124 exhibited poor outcomes. In order to investigate the optimal cut-off values for poor outcomes, logistic and receiver operating characteristic analyses were performed on the following parameters on the first postoperative day: procalcitonin (PCT), C-reactive protein (CRP), interleukin-6 (IL-6), and systemic immune-inflammation index (SII). These cut-off points were used to separate the patients into hyper-inflammatory (n = 52) and control (n = 353) groups. Finally, the logistic were used to find the risk factors of hyper-inflammatory.

Results

PCT, CRP, IL-6, and SII were independent risk factors of poor outcomes in the multivariate logistic model. Cut-off points of these biomarkers were 2.18 ng/ml, 49.76 mg/L, 301.88 pg/ml, 2509.96 × 109/L respectively. These points were used to define postoperative hyper-inflammation (OR 2.97, 95% CI 1.35–6.53, P < 0.01). Cardiopulmonary bypass (CPB) > 180 min, and deep hypothermia circulatory arrest (DHCA) > 40 min were the independent risk factors for hyper-inflammation.

Conclusions

PCT > 2.18, CRP > 49.76, IL-6 > 301.88, and SII < 2509.96 could be used to define postoperative hyper-inflammation which increased mortality and morbidity in patients after ATAAD surgery. Based on these findings, we found that CPB > 180 min and DHCA > 40 min were separate risk factors for postoperative hyper-inflammation.
Comparing a pre-defined versus deep learning approach for extracting brain atrophy patterns to predict cognitive decline due to Alzheimer’s disease in patients with mild cognitive symptoms
Authors: Arvidsson Ida , Strandberg Olof , Palmqvist Sebastian , Stomrud Erik , Cullen Nicholas , Janelidze Shorena , Tideman Pontus , Heyden Anders , Åström Karl , Hansson Oskar , Mattsson-Carlgren Niklas
Published: March 2024

Background

Predicting future Alzheimer’s disease (AD)-related cognitive decline among individuals with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) is an important task for healthcare. Structural brain imaging as measured by magnetic resonance imaging (MRI) could potentially contribute when making such predictions. It is unclear if the predictive performance of MRI can be improved using entire brain images in deep learning (DL) models compared to using pre-defined brain regions.

Methods

A cohort of 332 individuals with SCD/MCI were included from the Swedish BioFINDER-1 study. The goal was to predict longitudinal SCD/MCI-to-AD dementia progression and change in Mini-Mental State Examination (MMSE) over four years. Four models were evaluated using different predictors: (1) clinical data only, including demographics, cognitive tests and APOE ε4 status, (2) clinical data plus hippocampal volume, (3) clinical data plus all regional MRI gray matter volumes (N = 68) extracted using FreeSurfer software, (4) a DL model trained using multi-task learning with MRI images, Jacobian determinant images and baseline cognition as input. A double cross-validation scheme, with five test folds and for each of those ten validation folds, was used. External evaluation was performed on part of the ADNI dataset, including 108 patients. Mann-Whitney U-test was used to determine statistically significant differences in performance, with p-values less than 0.05 considered significant.

Results

In the BioFINDER cohort, 109 patients (33%) progressed to AD dementia. The performance of the clinical data model for prediction of progression to AD dementia was area under the curve (AUC) = 0.85 and four-year cognitive decline was R2 = 0.14. The performance was improved for both outcomes when adding hippocampal volume (AUC = 0.86, R2 = 0.16). Adding FreeSurfer brain regions improved prediction of four-year cognitive decline but not progression to AD (AUC = 0.83, R2 = 0.17), while the DL model worsened the performance for both outcomes (AUC = 0.84, R2 = 0.08). A sensitivity analysis showed that the Jacobian determinant image was more informative than the MRI image, but that performance was maximized when both were included. In the external evaluation cohort from ADNI, 23 patients (21%) progressed to AD dementia. The results for predicted progression to AD dementia were similar to the results for the BioFINDER test data, while the performance for the cognitive decline was deteriorated.

Conclusions

The DL model did not significantly improve the prediction of clinical disease progression in AD, compared to regression models with a single pre-defined brain region.
Hybrid modeling design patterns
Authors: Rudolph Maja , Kurz Stefan , Rakitsch Barbara
Published: March 2024

Design patterns provide a systematic way to convey solutions to recurring modeling challenges. This paper introduces design patterns for hybrid modeling, an approach that combines modeling based on first principles with data-driven modeling techniques. While both approaches have complementary advantages there are often multiple ways to combine them into a hybrid model, and the appropriate solution will depend on the problem at hand. In this paper, we provide four base patterns that can serve as blueprints for combining data-driven components with domain knowledge into a hybrid approach. In addition, we also present two composition patterns that govern the combination of the base patterns into more complex hybrid models. Each design pattern is illustrated by typical use cases from application areas such as climate modeling, engineering, and physics.
AGV monocular vision localization algorithm based on Gaussian saliency heuristic
Authors: Fu Heng , Hu Yakai , Zhao Shuhua , Zhu Jianxin , Liu Benxue , Yang Zhen
Published: March 2024

To address the issues of poor detection accuracy and the large number of target detection model parameters in existing AGV monocular vision location detection algorithms, this paper presents an AGV vision location method based on Gaussian saliency heuristic. The proposed method introduces a fast and accurate AGV visual detection network called GAGV-net. In the GAGV-net network, a Gaussian saliency feature extraction module is designed to enhance the network’s feature extraction capability, thereby reducing the required output for model fitting. To improve the accuracy of target detection, a joint multi-scale classification and detection task header are designed at the stage of target frame regression to classification. This header utilizes target features of different scales, thereby enhancing the accuracy of target detection. Experimental results demonstrate a 12% improvement in detection accuracy and a 27.38 FPS increase in detection speed compared to existing detection methods. Moreover, the proposed detection network significantly reduces the model’s size, enhances the network model’s deployability on AGVs, and greatly improves detection accuracy.
Pulsed radiofrequency on peripheral nerve as a rehabilitation aid
Authors: Bongiorno Giulia , Biancuzzi Helena , Dal Mas Francesca , Bednarova Rym , Vittori Alessandro , Miceli Luca
Published: March 2024

The work described below explores the field of the effects of pulsed radiofrequency for pain relief purposes. While the effects of this technique on pain modulation (A-delta and C fibers) are relatively well-known, little has been written yet about the potential of pulsed radiofrequency interactions with other fibers. The proposed algorithm, specifically elaborated, investigates the effect of this technique on neuromuscular fatigue, through a surface electromyographic study of the femoral nerve of a patient with residual pain after knee arthroplasty surgery, before and after the treatment. This work yields a preliminary result that is encouraging for subsequent large-scale studies.
Carrying Trans Forward
Authors: Blackston Dylan McCarthy
Published: March 2024

What utility does trans hold and carry forward at this politically and ecologically volatile moment, when increasingly prevalent legal restrictions are preventing trans people from accessing gender affirming and reproductive health care and seeking to disallow our presence in public life altogether? Taking an autoethnographic approach to exploring trans life and scholarship across generations, this essay poses trans*plantation as a framework for navigating complex questions about how life comes to be defined and whose lives come to hold value or not over time.
Transcestral Gathering
Authors: tong isola
Published: March 2024

This article meditates on the urgency and importance of gathering within the framework of trans lineages and place-making. The article focuses on advocating self-determined pathways for Filipinos in California by examining the effects of migration on their sense of belonging. It highlights the need for self-directed decolonial strategies and the exploration of trans lineages as a means of finding wholeness and connection in the face of intersecting challenges of violence against trans people of color and the environment. Drawing inspiration from the historical role of babaylans (Indigenous spiritual leaders) in resisting colonial power in the Philippines, the article proposes the concept of transcestral gathering as a form of resistance through community-based cultural production and trans* sociality.
The Sexological Floorplan
Authors: Lubin Joan , Vaccaro Jeanne
Published: March 2024

This essay animates the concept-metaphor of the sexological floorplan across sites of sexological self-reflection in its incipient institutional form to propose a model of trans study. We begin by speculating on the relationship between the history of sexological incorporation and the hesitant institutionality of trans study. In the context of a racially segregated postwar American culture reorganizing its senses of normative gender and moral sexual practice, the sexological project to limn the category “trans” became a site of interaction between multiple vectors of social experience and varieties of scientific classification. This essay considers four women differently subjected to sexological scrutiny on the basis of sex, and tracks how that sexual basis articulates with gender, race, and sexuality to map the floorplan of institutionalizing sexual knowledge. We consider four women whose circulation through and labor within the Kinsey Institute for Sex Research, Inc., maps the terrain of sexology's bids for credibility. Their respective roles in the business of sexology (the public face of gender transformation, a working housewife, a sympathetic social scientist, a long-suffering librarian) and respective racial, gender, and sexual identities made each differently disposed to and differently subjected to sexological ways of looking. By attending to each of these figures in turn, a view onto the sexological floorplan emerges with social and historical density, overlaid with the labors of self-determination inside the architectures of scientific capture.
Games Have Always Been Trans
Authors: Chow Jeremy
Published: March 2024

This essay explores the critical relationships among trans studies, game studies, and the environmental humanities to evaluate trans ecological media. I center two distinct gaming sites: a board game, Wingspan, and a social media phenomenon, Bowsette, based on Nintendo's video game, Super Mario Bros. These media tacitly incorporate tranimality into their ludic matrices. Within Wingspan, trans reproduction (male birds laying eggs) becomes the skeleton key to success. As a trans femme icon, Bowsette emerges through fan art and social media to imagine a means for Mario's nemesis, Bowser, to transition into a romantic partner as a result of a mushroom super crown. The opportunity to play with trans birds, turtles, and fungi on digital and analog platforms makes evident that games have always been trans.
Fbrsl1 is required for heart development in Xenopus laevis and de novo variants in FBRSL1 can cause human heart defects
Authors: Berger Hanna , Gerstner Sarah , Horstmann Marc-Frederik , Pauli Silke , Borchers Annette
Published: March 2024

De novo truncating variants in fibrosin-like 1 (FBRSL1), a member of the AUTS2 gene family, cause a disability syndrome, including organ malformations such as heart defects. Here, we use Xenopus laevis to investigate whether Fbrsl1 plays a role in heart development. Xenopus laevis fbrsl1 is expressed in tissues relevant for heart development, and morpholino-mediated knockdown of Fbrsl1 results in severely hypoplastic hearts. Our data suggest that Fbrsl1 is required for the development of the first heart field, which contributes to the ventricle and the atria, but not for the second heart field, which gives rise to the outflow tract. The morphant heart phenotype could be rescued using a human N-terminal FBRSL1 isoform that contains an alternative exon, but lacks the AUTS2 domain. N-terminal isoforms carrying patient variants failed to rescue. Interestingly, a long human FBRSL1 isoform, harboring the AUTS2 domain, also did not rescue the morphant heart defects. Thus, our data suggest that different FBRSL1 isoforms may have distinct functions and that only the short N-terminal isoform, appears to be critical for heart development.
MAP3K1 regulates female reproductive tract development
Authors: Kimura Eiki , Mongan Maureen , Xiao Bo , Christianto Antonius , Wang Jingjing , Carreira Vinicius S. , Bolon Brad , Zhang Xiang , Burns Katherine A. , Biesiada Jacek , Medvedovic Mario , Puga Alvaro , Xia Ying
Published: March 2024

Mitogen-activated protein 3 kinase 1 (MAP3K1) has a plethora of cell type-specific functions not yet fully understood. Herein, we describe a role for MAP3K1 in female reproductive tract (FRT) development. MAP3K1 kinase domain-deficient female mice exhibited an imperforate vagina, labor failure and infertility. These defects corresponded with shunted Müllerian ducts (MDs), the embryonic precursors of FRT, that manifested as a contorted caudal vagina and abrogated vaginal–urogenital sinus fusion in neonates. The MAP3K1 kinase domain is required for optimal activation of the Jun-N-terminal kinase (JNK) and cell polarity in the MD epithelium, and for upregulation of WNT signaling in the mesenchyme surrounding the caudal MD. The MAP3K1-deficient epithelial cells and MD epithelium had reduced expression of WNT7B ligands. Correspondingly, conditioned media derived from MAP3K1-competent, but not -deficient, epithelial cells activated a TCF/Lef-luciferase reporter in fibroblasts. These observations indicate that MAP3K1 regulates MD caudal elongation and FRT development, in part through the induction of paracrine factors in the epithelium that trans-activate WNT signaling in the mesenchyme.
Πειραματική μελέτη της επιβίωσης αυτόλογου λίπους που μεταμοσχεύεται σε μυοδερμικό κρημνό του πλατέως ραχιαίου μυός
Authors: Τσιμπώνης Αντώνιος
Published: March 2024

Σκοπός: Η μεταφορά αυτόλογου λίπους αποτελεί ιδανική επανορθωτική μέθοδο τόσο σε επεμβάσεις αποκατάστασης όσο και σε αισθητικές επεμβάσεις. Η τελική επιβίωση του λίπους που μεταμοσχεύεται αποτελεί αντικείμενο εκτεταμένης μελέτης τα τελευταία έτη. Στόχος της πειραματικής μας μελέτης είναι να εκτιμηθεί το ποσοστό επιβίωσης του λίπους όταν εγχύεται στον υποδόριο ή τον μυϊκό ιστό σε ακτινοβολημένα και μη ακτινοβολημένα πειραματόζωα, χρησιμοποιώντας ένα πειραματικό μοντέλο προσομοίωσης μιας μεθόδου αποκατάστασης μαστού μετά μαστεκτομή, του μυοδερματικού κρημνού του πλατύ ραχιαίου ενισχυμένου με λίπος. Μέθοδοι – Υλικό: Στη μελέτη μας χρησιμοποιήθηκαν τριάντα πειραματόζωα (επίμυες), χωρισμένοι σε πέντε ομάδες (Α, Β, Γ, Δ και Ε). Διαφορετικοί όγκοι λίπους (1 ml, 2 ml και 5 ml) εγχύθηκαν συνολικά σε τρεις περιοχές λήπτες (υποδόριο, πλατύ ραχιαίο, μείζονα θωρακικό) στις ομάδες Α, Β και Γ, αντίστοιχα. Μετεγχειρητική ακτινοβολία χορηγήθηκε σε ζώα της ομάδας Δ (2 ml ενέσιμο λίπος). Τα ζώα της ομάδας Ε δεν υποβλήθηκαν σε μεταμόσχευση λίπους (μάρτυρες). Όλα τα ζώα θυσιάστηκαν την 8η εβδομάδα και δείγματα από τον υποδόριο ιστό, τον ΠΡ και τον ΜΘ εξετάστηκαν ιστολογικά και με ανοσοϊστοχημικές μεθόδους προκειμένου να εκτιμηθεί η συνολική επιβίωση του λίπους. Αποτελέσματα: Τα αποτελέσματά μας έδειξαν ότι ο μείζων θωρακικός μυς ήταν το υπόστρωμα που παρείχε τα υψηλότερα ποσοστά επιβίωσης λιποκυττάρων, ανεξάρτητα από την ποσότητα του μεταμοσχευμένου λίπους, ακολουθούμενο από τον πλατύ ραχιαίο μυ και, τέλος, την δερματική νησίδα του κρημνού. Στους υποδόριους ιστούς, ο αυξημένος όγκος του μεταμοσχευμένου λίπους δεν αντιστοιχούσε σε αυξημένη ενσωμάτωση λιποκυττάρων. Η ακτινοβόληση των ιστών του ξενιστή οδήγησε σε στατιστικά σημαντική μείωση των επιζώντων λιποκυττάρων και στις τρεις περιοχές λήπτες (p<0,001). Συμπεράσματα: Τα λιποκύτταρα ενσωματώνονται καλύτερα όταν ο ιστός του ξενιστή έχει αυξημένη αγγείωση, επομένως οι μύες αποτελούν ιδανικό υπόστρωμα για την επιβίωση των λιποκυττάρων. Όπως αναμενόταν, η ακτινοβολία μειώνει σημαντικά την επιβίωση του λίπους τόσο στον μυϊκό όσο και στον υποδόριο ιστό.
Τα αναθηματικά ανάγλυφα της Πελοποννήσου
Authors: Καπουράνης Αινείας
Published: March 2024

Στην παρούσα μελέτη συγκεντρώνεται και παρουσιάζεται κριτικά ένας ικανός αριθμός ανάγλυφα κοσμημένων λίθινων στηλών, οι οποίες είχαν ανατεθεί σε διάφορες περιοχές της Πελοποννήσου, από την αρχαϊκή εποχή μέχρι και την εποχή της ρωμαϊκής ισχύος. Μέσω της τεχνοτροπικής, τυπολογικής και εικονογραφικής ανάλυσης, καθώς και της ερμηνευτικής πραγμάτευσης των αναγλύφων επιχειρείται η αποσαφήνιση και η κατανόηση του άρρηκτα συνδεδεμένου θρησκευτικού (λατρευτικού) πλαισίου, όπως αυτό διαμορφώθηκε με την πάροδο των αιώνων. Συγκεκριμένα, επιχειρείται η συγκέντρωση κατά το δυνατόν περισσότερων αναγλύφων όπως αυτά δημοσιεύτηκαν είτε σε ανασκαφικές αναφορές, είτε στο πλαίσιο γενικότερων πραγματειών για τη λατρεία θεών και ηρώων, ή, τέλος, σε αυτοτελή επιστημονικά άρθρα. Παράλληλα, μετά από άδεια των αρμόδιων εφορειών αρχαιοτήτων, πραγματοποιήθηκε επιτόπια αυτοψία στους αρχαιολογικούς χώρους και τις αποθήκες των μουσείων και μελετήθηκε αδημοσίευτο υλικό, το οποίο συσχετίστηκε με τα ήδη γνωστά ευρήματα, προσφέροντας μία επανεκτίμηση στην ερμηνεία της εικονογραφίας τους, όπως αυτή προκύπτει αφενός από τη μυθική αφήγηση και αφετέρου από τη θρησκευτική και πολιτική πραγματικότητα της εκάστοτε εποχής. Μετά το πρώτο (εισαγωγικό) κεφάλαιο, η επισκόπηση των αναγλύφων πραγματοποιείται ανά γεωγραφική περιοχή, εκκινώντας από βορρά με την Κορινθία, την Αργολίδα, την Αχαΐα και την Αρκαδία και καταλήγοντας στις δύο ευρείες νότιες επικράτειες της Μεσσηνίας και της Λακωνίας. Σε κάθε περιοχή πραγματοποιούνται συνοπτικές εισαγωγές για την ιστορική και την αρχαιολογική της εξέλιξη καθώς και για την εικονογραφία των θεών και των ηρώων και έπειτα η εξέταση επικεντρώνεται στις ανάγλυφες στήλες, για τις οποίες επιχειρείται η ένταξή τους σε ένα ευρύτερο θρησκευτικό (λατρευτικό) πλαίσιο, συμπληρώνοντας τις γραμματειακές πηγές ή αποτελώντας την μόνη ένδειξη όταν αυτές απουσιάζουν. Η συμπερασματική αναφορά στο συγκεντρωμένο υλικό εστιάζει σε ορισμένα ζητήματα όπως αυτά των τοπικών "σχολών" και εργαστηρίων και της αναλογίας των ευρισκομένων αναγλύφων ανά πόλεις και εποχές.
Study of anaemia in pregnancy and low birth weight in fluoride endemic area of Western Rajasthan: a cohort study
Authors: Bhardwaj Pankaj , Mantri Neha , Joshi Nitin Kumar , Suthar Praveen , Sharma Praveen , Purohit Purvi , Singh Pratibha , Shekhar Shashank , Khandelwal Shweta , Dandabathula Giribabu , Raghav Pankaja Ravi , Ramawat Nikky , Jain Sanjeev , Patil Manoj , Gaidhane Abhay , Quazi Syed Zahiruddin , Saxena Deepak
Published: March 2024

Background Fluoride is a noxious element known to destroy gastrointestinal mucosa, leading to erythrocytes’ destruction and causing anaemia. The birth weight of newborn babies is a significant indicator of a child’s vulnerability to the risk of childhood diseases and chances of existence. Methods This prospective cohort study was planned to find linkages between fluorosis and the low-birth weight of newborn babies with anaemic mothers. Antenatal mothers until the 20th week of gestation were followed up till delivery in the Antenatal Clinic of a District Hospital in one of the known fluoride-endemic districts (Nagaur) and the other not-so-endemic district (Jodhpur) of Western Rajasthan. Results Around 19% of the newborn in Jodhpur and around 22% in Nagaur had low birth weight. Mean fluoride values in water samples were measured to be 0.57 (range from 0.0 to 2.7 PPM) in Jodhpur and 0.7 (range from 0.0 to 3.4 PPM) in Nagaur. Conclusions Thus, in fluoride endemic areas, other factors should be included besides iron and folic acid supplementation for improving anaemia in pregnant women. This calls for assessing the effectiveness of de-fluoridation activities along with the area’s most common indigenous food practices.