bluuebunny/crossref_metadata_2025 huggingface dataset:
“Here, I am More than Just Symptoms Combined”: Mental Health Services from the Perspective of Community Rehabilitation Groups
Authors: Hernández Felipe Agudelo , Loaiza Daniela Rojas , Marulanda Eduardo
Published: January 2024

In response to the rise in mental disorders, psychosocial and community approaches have been proposed, complementing traditional clinical services. The present research aimed to understand the perception of individuals attending community-based strategies regarding mental health services as part of the approach to mental disorders in Colombia. Two workshops were conducted with 30 individuals with mental disorders (depression, anxiety and bipolar disorder), who were members of community strategies. A thematic analysis was conducted. The theme resulting from the analysis shows Community mental health within the healthcare system, which consisted of categories such as Group Amplifying Actions for Health and Groups as Complementary to Other Forms of Care. It is emphasized that the healthcare system should establish bridges with community mental health strategies and actively engage in their strengthening processes to enhance the outcomes of pharmacological interventions and even psychotherapeutic interventions. Bidirectional learning approach is proposed between community-based mental health services and clinical settings within the healthcare system. Community strategies can make an important contribution to complex processes in the health system.
Monosomy 7/del(7q) cause sensitivity to inhibitors of nicotinamide phosphoribosyltransferase in acute myeloid leukemia
Authors: Eldfors Samuli , Saad Joseph , Ikonen Nemo , Malani Disha , Vähä-Koskela Markus , Gjertsen Bjørn T. , Kontro Mika , Porkka Kimmo , Heckman Caroline A.
Published: January 2024

Monosomy 7 and del(7q) (-7/-7q) are frequent chromosomal abnormalities detected in up to 10% of patients with acute myeloid leukemia (AML). Despite unfavorable treatment outcomes, no approved targeted therapies exist for patients with -7/-7q. Therefore, we aimed to identify novel vulnerabilities. Through an analysis of data from ex vivo drug screens of 114 primary AML samples, we discovered that -7/-7q AML cells are highly sensitive to the inhibition of nicotinamide phosphoribosyltransferase (NAMPT). NAMPT is the rate-limiting enzyme in the nicotinamide adenine dinucleotide salvage pathway. Mechanistically, the NAMPT gene is located at 7q22.3, and deletion of 1 copy due to -7/-7q results in NAMPT haploinsufficiency, leading to reduced expression and a therapeutically targetable vulnerability to the inhibition of NAMPT. Our results show that in -7/-7q AML, differentiated CD34+CD38+ myeloblasts are more sensitive to the inhibition of NAMPT than less differentiated CD34+CD38– myeloblasts. Furthermore, the combination of the BCL2 inhibitor venetoclax and the NAMPT inhibitor KPT-9274 resulted in the death of significantly more leukemic blasts in AML samples with -7/-7q than the NAMPT inhibitor alone. In conclusion, our findings demonstrate that AML with -7/-7q is highly sensitive to NAMPT inhibition, suggesting that NAMPT inhibitors have the potential to be an effective targeted therapy for patients with monosomy 7 or del(7q).
RNA N6-methyladenosine demethylase FTO targets MOXD1 promoting the malignant phenotype of gastric cancer
Authors: Lai Yuexing , Dong Hairong , Xu Ping , Wang Jing , Feng Wen , Zhao Zhenya , Sha Linyu
Published: January 2024

Background

The m6A modified demethylase FTO affects the progression of gastric cancer (GC), and the role mechanism of FTO in GC is still unclear. We, here, explored the role of FTO and unrevealed the mechanisms of its function in GC.

Methods

The expression and clinical prognosis of FTO in GC were examined via UALCAN and GEPIA online databases. Effect of FTO shRNA on GC cellular malignant phenotype were proved by CCK-8, Transwell, Wound healing assay and Flow cytometric assay. RNA-sequencing data of FTO depleted AGS cells were downloaded to analyze differentially expressed genes of FTO downstream. The GO and KEGG pathway enrichment were performed for the DEGs by DAVID. RT-qPCR and RIP-qPCR assay were applied to verify the MOXD1 mRNA and methylated mRNA in FTO shRNA group. The expression and clinical prognosis of MOXD1 in GC were explored via UALCAN, GEPIA and Kaplan-Meier plotter. The role and mechanism and of MOXD1 in GC cell lines were detected and analyzed.

Results

The expression of FTO was found to be elevated in GC tissues compared with normal tissues, and worse survival were strongly related to high expression of FTO in GC. FTO silencing suppressed the proliferation, migration and promoted apoptosis of GC cells. A total of 5856 DEGs were obtained in between NC and FTO depleted AGS cell groups, and involved in the cancer related pathways. Here, FTO targets MOXD1 mRNA and promotes its expression via m6A methylation. MOXD1 upregulation was associated to poor prognosis of GC. MOXD1 silencing suppressed the malignant phenotype of GC cells. MOXD1 activated cancer -related signaling pathway (MAPK, TGF-β, NOTCH and JAK/STAT).

Conclusions

Our study demonstrated that FTO silencing decreased MOXD1 expression to inhibit the progression of GC via m6A methylation modification. FTO/MOXD1 may be potential targets for the treatment and prognosis of GC.
Sustained virologic response improved the long-term health-related quality of life in patients with chronic hepatitis C: a prospective national study in China
Authors: Huang Rui , Shang Jia , Chen Hong , Li Jun , Xie Qing , Feng Jiajun , Wei Lai , Rao Huiying
Published: January 2024

Background

To investigate the trends in health-related quality of life (HRQoL) among hepatitis C virus (HCV) patients and to assess the longitudinal impact of antiviral therapy on their well-being.

Methods

In this prospective multicenter observational study in adults with HCV infection, sociodemographic, clinical characteristics and EQ-5D questionnaires were collected. Generalized estimating equation (GEE) models were used to assess the associations between these variables and changes in HRQoL over time.

Results

456 patients were included, with a median age of 46.5 (36.5–57.0) years, of which 262 (57.5%) were males and 44 (9.6%) had cirrhosis. 335 patients (73.5%) receiving antiviral therapy and 61.8% achieved sustained virologic response (SVR). The baseline EQ-5D utility and EQ-VAS were 0.916 ± 0.208 and 80.6 ± 13.0. In multivariable analysis of GEE estimation, achieving SVR24 was positively associated with EQ-5D utility (p = 0.000) and EQ-VAS (p = 0.000) over time. Age and income were shown to be significant predictors of EQ-5D utility, while gender, age and genotype were associated with EQ-VAS over time.

Conclusions

SVR improved long-term HRQoL in HCV patients in the first few years following viral clearance. Certain sociodemographic factors, such as gender, age, income as well as genotype, significantly influenced long-term changes in patients’ quality of life.

Trial registration

NCT01594554. Registration date: 09/05/2012.
Placental volume as a novel sign for identifying placenta accreta spectrum in pregnancies with complete placenta previa
Authors: Yue Yongfei , Wang Xiaoyan , Zhu Liping , Liu Chengfeng , Chen Dali , Lu Yanli , Liang Baoquan
Published: January 2024

Background

Placenta accreta spectrum (PAS) carries an increased risk of maternal-fetal mortality and morbidity, and magnetic resonance imaging (MRI) features for PAS have been used for preoperative identification. This study aims to investigate the role of placental volume evaluated by MRI in identifying PAS in pregnant women with complete placenta previa.

Methods

Totally 163 cases of complete placenta previa pregnant women with a history of cesarean section underwent MRI for suspected PAS were included. We categorized the patients into two groups according to the presence or absence of PAS, and the maternal-fetal perinatal outcomes and placental volume analyzed by 3D Slice software were compared.

Results

There were significantly more gravidity, parity, and number of previous cesarean delivery in the PAS group (P < 0.05). Significant differences were also found between the two groups with respect to the following baseline characteristics: gestational age at delivery, intraoperative blood loss, blood transfusion, and neonatal birth weight (P < 0.05). Of 163 women in the study, 7 (4.294%) required cesarean hysterectomy for high-grade PAS or pernicious bleeding during cesarean section, and PAS was confirmed with histologic confirmation in 6 (85.714%) cases. The placental volume in PAS group was greater than that in the non-PAS group (P < 0.05). With a threshold of more than 887 cm3, the sensitivity and specificity in identifying PAS were 85.531% and 83.907% respectively, with AUC 0.908 (95% CI: 0.853–0.948).

Conclusions

Placental volume may be a promising indicator of PAS in complete placenta previa patients with a history of cesarean section.
Upregulation of CENPM promotes breast carcinogenesis by altering immune infiltration
Authors: Tong Yanchu , Zhou Tongzhou , Wang Xiaokun , Deng Shun , Qin Lu
Published: January 2024

Background

The involvement of centromere protein M (CENPM) in various types of cancer has been established, however, its impact on breast cancer and immune infiltration remains unknown.

Methods

We examined the expression of CENPM in different cancer types by utilizing the Cancer Genome Atlas (TCGA) and Genotype Tissue Expression Pan-Cancer (GEO) databases. Using data from the TCGA, we examined the correlation between the expression of CENPM, the prognosis, and the clinicopathological features of individuals diagnosed with breast cancer. We conducted an enrichment analysis of CENPM using the clusterProfiler R software tool, utilizing data obtained from breast cancer patients and specimens at our institution. In addition to examining the correlation between CENPM expression and genes associated with immune checkpoints, the TIDE algorithm was employed to explore the potential of CENPM as a biomarker for immunotherapy in breast cancer. The impact of CENPM on the growth of breast cancer cells was evaluated through the utilization of the CCK8 test and the colony formation assay. The effect of CENPM on the migration of breast cancer cells was assessed using scratch and transwell assays.

Results

Research findings indicate that elevated levels of CENPM are linked to patient outcomes in breast cancer and various clinicopathological features. Furthermore, elevated levels of CENPM expression correlated with decreased levels of CD8 + T cells and mast cells, increased levels of Tregs and Th2, and reduced levels of CD8 + T cells. Additionally, the coexpression of CENPM with the majority of genes related to immune checkpoints indicates its potential to forecast the effectiveness of treatment in breast cancer. Suppression of CENPM hampers the growth and movement of breast tumor cells.

Conclusions

In summary, our study findings indicate that CENPM may serve as a cancer-causing gene in breast cancer and also as a biomarker for predicting the efficacy of immunotherapy.

The oncogene CENPM is associated with breast cancer and is involved in cell proliferation and immune infiltration.
CNN-based multi-modal radiomics analysis of pseudo-CT utilization in MRI-only brain stereotactic radiotherapy: a feasibility study
Authors: Yang Xin , Feng Bin , Yang Han , Wang Xiaoqi , Luo Huanli , Chen Liyuan , Jin Fu , Wang Ying
Published: January 2024

Background

Pseudo-computed tomography (pCT) quality is a crucial issue in magnetic resonance image (MRI)-only brain stereotactic radiotherapy (SRT), so this study systematically evaluated it from the multi-modal radiomics perspective.

Methods

34 cases (< 30 cm³) were retrospectively included (2021.9-2022.10). For each case, both CT and MRI scans were performed at simulation, and pCT was generated by a convolutional neural network (CNN) from planning MRI. Conformal arc or volumetric modulated arc technique was used to optimize the dose distribution. The SRT dose was compared between pCT and planning CT with dose volume histogram (DVH) metrics and gamma index. Wilcoxon test and Spearman analysis were used to identify key factors associated with dose deviations. Additionally, original image features were extracted for radiomic analysis. Tumor control probability (TCP) and normal tissue complication probability (NTCP) were employed for efficacy evaluation.

Results

There was no significant difference between pCT and planning CT except for radiomics. The mean value of Hounsfield unit of the planning CT was slightly higher than that of pCT. The Gadolinium-based agents in planning MRI could increase DVH metrics deviation slightly. The median local gamma passing rates (1%/1 mm) between planning CTs and pCTs (non-contrast) was 92.6% (range 63.5–99.6%). Also, differences were observed in more than 85% of original radiomic features. The mean absolute deviation in TCP was 0.03%, and the NTCP difference was below 0.02%, except for the normal brain, which had a 0.16% difference. In addition, the number of SRT fractions and lesions, and lesion morphology could influence dose deviation.

Conclusions

This is the first multi-modal radiomics analysis of CNN-based pCT from planning MRI for SRT of small brain lesions, covering dosiomics and radiomics. The findings suggest the potential of pCT in SRT plan design and efficacy prediction, but caution needs to be taken for radiomic analysis.
The characteristics of acute macular neuroretinopathy following COVID-19 infection
Authors: Feng Hui , Zhao Meng , Mo Jing , Cao Xusheng , Chen Weixin , Wang Hong
Published: January 2024

Background

In this study, we report a case series of acute macular neuroretinopathy (AMN) associated with COVID-19 infection.

Methods

This retrospective observational study was conducted at Beijing Tongren Hospital. We reviewed patients who were diagnosed with AMN within one month of testing positive for COVID-19 using real-time reverse transcription-polymerase chain reaction (RT-PCR).

Results

A total of 11 AMN patients (20 eyes) were included in the study. The mean age was 33.8 ± 12.6 years. The average interval between a positive COVID-19 PCR test and the onset of ocular symptoms was 2.8 ± 2.5 days. The mean follow-up period for the patients was 12.5 ± 3.8 weeks. Imaging characteristics of AMN patients following COVID-19 infection included areas of low reflectivity on near-infrared reflectance (NIR) imaging, hyperreflective lesions at the level of the outer plexiform layer (OPL) and outer nuclear layer (ONL) and disruption of the ellipsoid zone (EZ) on spectral domain optical coherence tomography (SD-OCT) B-scans. Visual field examinations revealed parafoveal scotomas that closely corresponded to the clinical lesions. Optical coherence tomography angiography (OCT-A) demonstrated impaired perfusion in the deep retinal vascular plexus. Fluorescein angiography (FA), indocyanine green angiography (ICGA), and spontaneous fundus autofluorescence showed no significant abnormalities. During follow-up, partial improvement in retinal lesions was observed in NIR imaging and SD-OCT in some patients, but a proportion of patients still exhibited persistent retinal damage and no improvement in visual field scotomas.

Conclusion

COVID-19-related AMN share similar clinical and imaging features with AMN due to other causes, as evidenced by the persistent presence of visual field scotomas over a longer duration.

Trail registration

https://www.chictr.org.cn/; identifier: ChiCTR2100044365
Co-design of a personalised digital intervention to improve vegetable intake in adults living in Australian rural communities
Authors: Livingstone Katherine Mary , Rawstorn Jonathan C , Alston Laura , Partridge Stephanie R , Bastian Amber , Dullaghan Kate , McNaughton Sarah A , Hendrie Gilly A , Blekkenhorst Lauren C , Maddison Ralph , Zhang Yuxin , Barnett Scott , Mathers John C , Godrich Stephanie L
Published: January 2024

Background

Diets low in vegetables are a main contributor to the health burden experienced by Australians living in rural communities. Given the ubiquity of smartphones and access to the Internet, digital interventions may offer an accessible delivery model for a dietary intervention in rural communities. However, no digital interventions to address low vegetable intake have been co-designed with adults living in rural areas. This paper describes the co-design of a digital intervention to improve vegetable intake with rural community members and research partners.

Methods

Active participants in the co-design process were adults ≥ 18 years living in three rural Australian communities (total n = 57) and research partners (n = 4) representing three local rural governments and one peak non-government health organisation. An iterative co-design process was undertaken to understand the needs (pre-design phase) and ideas (generative phase) of the target population. Eight online workshops and a community survey were conducted between July and December 2021. The MoSCoW prioritisation method was used to help participants identify the ‘Must-have, Should-have, Could-have, and Won’t-have or will not have right now’ features and functions of the digital intervention. Workshops were transcribed and inductively analysed using NVivo. Convergent and divergent themes were identified between the workshops and community survey to identify how to implement the digital intervention in the community.

Results

Consensus was reached on a concept for a digital intervention that addressed individual and food environment barriers to vegetable intake, specific to rural communities. Implementation recommendations centred on (i) food literacy approaches to improve skills via access to vegetable-rich recipes and healthy eating resources, (ii) access to personalisation options and behaviour change support, and (iii) improving the community food environment by providing information on and access to local food initiatives.

Conclusions

Rural-dwelling adults expressed preferences for personalised intervention features that can enhance food literacy and engagement with community food environments. This research will inform the development of the prototyping (evaluation phase) and feasibility testing (post-design phase) of this intervention.
The effectiveness of chitosan as a hemostatic in dentistry in patients with antiplatelet/anticoagulant therapy: systematic review with meta-analysis
Authors: Minervini Giuseppe , Franco Rocco , Marrapodi Maria Maddalena , Di Blasio Marco , Cicciù Marco , Ronsivalle Vincenzo
Published: January 2024

Hemorrhage control is a crucial aspect of dental procedures, and achieving efficient hemostasis remains a key challenge. The advent of hemostatic dressings has revolutionized the field of dentistry by providing effective and convenient solutions for managing bleeding in vari-ous dental scenarios. This article aims to provide an overview of hemostatic dressings, their mechanisms of action, and their diverse applications in dentistry. We applied the following Pop-ulation, Exposure, Comparator, and Outcomes (PICO) model to assess the document eligibility. A literature search was performed on major search engines, using keywords. At the end of the search, 3 articles were selected that matched the PICO. Three items were selected after the screen-ing process, and bleeding times were analyzed between the control group and the study group. The overall effect showed a substantial and statistically significant difference with bleeding time in favour of HDD-treated patients, showing that this garrison is very useful in controlling bleed-ing for patients taking anticoagulants and antiplatelets (Mean difference − 5.61; C.I. -5.70, − 5.52); Overall, hemostatic dressings have revolutionized the management of bleeding in dentistry, offering a promising solution to achieve optimal hemostasis, improve treatment outcomes, and enhance patient care, particularly Hemcon.
The flexural strength of 3D-printed provisional restorations fabricated with different resins: a systematic review and meta-analysis
Authors: Saini Ravinder S. , Gurumurthy Vishwanath , Quadri Syed Altafuddin , Bavabeedu Shashit Shetty , Abdelaziz Khalid M. , Okshah Abdulmajeed , Alshadidi Abdulkhaliq Ali F. , Yessayan Lazar , Mosaddad Seyed Ali , Heboyan Artak
Published: January 2024

Background

Three-dimensional (3D) printing technology has revolutionized dentistry, particularly in fabricating provisional restorations. This systematic review and meta-analysis aimed to thoroughly evaluate the flexural strength of provisional restorations produced using 3D printing while considering the impact of different resin materials.

Methods

A systematic search was conducted across major databases (ScienceDirect, PubMed, Web of Sciences, Google Scholar, and Scopus) to identify relevant studies published to date. The inclusion criteria included studies evaluating the flexural strength of 3D-printed provisional restorations using different resins. Data extraction and quality assessment were performed using the CONSORT scale, and a meta-analysis was conducted using RevMan 5.4 to pool results.

Results

Of the 1914 initially identified research articles, only 13, published between January 2016 and November 2023, were included after screening. Notably, Digital Light Processing (DLP) has emerged as the predominant 3D printing technique, while stereolithography (SLA), Fused Deposition Modeling (FDM), and mono-liquid crystal displays (LCD) have also been recognized. Various printed resins have been utilized in different techniques, including acrylic, composite resins, and methacrylate oligomer-based materials. Regarding flexural strength, polymerization played a pivotal role for resins used in 3D or conventional/milled resins, revealing significant variations in the study. For instance, SLA-3D and DLP Acrylate photopolymers displayed distinct strengths, along with DLP bisacrylic, milled PMMA, and conventional PMMA. The subsequent meta-analysis indicated a significant difference in flexure strength, with a pooled Mean Difference (MD) of − 1.25 (95% CI − 16.98 - 14.47; P < 0.00001) and a high I2 value of 99%, highlighting substantial heterogeneity among the studies.

Conclusions

This study provides a comprehensive overview of the flexural strength of 3D-printed provisional restorations fabricated using different resins. However, further research is recommended to explore additional factors influencing flexural strength and refine the recommendations for enhancing the performance of 3D-printed provisional restorations in clinical applications.
Mapping competency in public health training – experience of the Europubhealth consortium
Authors: Grimaud Olivier , Foucrier Mathilde , Czabanowska Kasia ,   for the Europubhealth Consortium, Barnes Sarah , Bauernfeind Ariane , Clemens Timo , Codd Mary , Donneau Anne-Françoise , Sowada Christoph , Keller Catherine , Gely-Pernot Aurore , Mueller Judith , Guevel Marie-Renée , Bodeau-Livinec Florence , Théault Laurence , Grimaud Olivier , Czabanowska Kasia
Published: January 2024

Background

Public health education aims at producing a competent workforce. The WHO-ASPHER framework proposes a set of relevant public health competencies organised in 10 sections (e.g. science practice, leadership, law policies and ethics etc). As part of the Europubhealth (EPH) consortium, eight universities collaborate for the delivery of a 2-year international public health master course. The training pathway includes a first “foundation” year, with a choice of four options (components), and a second “specialisation” year with a choice of seven components. In 2020, EPH consortium decided to use the WHO-ASPHER framework in order to map the competencies addressed and the level of proficiency targeted by each component of its master course.

Methods

An 84-item questionnaire covering the whole WHO-ASPHER framework was sent to the 11 EPH component coordinators, asking them to rate the proficiency levels targeted at the end of their courses. Answers from each coordinator were summarised by calculating mean proficiency levels for each of the 10 competency sections. We used Bland & Altman plots to explore heterogeneity of answers and then calculated transformed scores to account for rating heterogeneity. We use tabulation and a heat map to explore patterns of proficiency levels across components.

Results

There were differences in overall proficiency levels between years with, as expected, higher scores in year two. Year one components reached medium to high proficiency scores for the sections “science practice”, “health promotion” and “communication” with scores ranging from 2.6 to 3 (on a 1-low to 4-high scale). When compared with year one on a heat-map, year two components displayed more contrasted profiles, typically aiming for high proficiency level (i.e. scores above 3.5) on 3 out of the 10 sections of competencies. Except for the “collaborations and partnership” section, the training pathways offered by the EPH master course seem to offer opportunities for a high proficiency level in all domains of competencies.

Conclusions

The mapping proved a useful exercise to identify strengths and complementarities among the EPH consortium. The results suggest that the EPH master course is coherent and offers students opportunities to gain proficiency in most competencies relevant to public health practice.
Development and psychometric testing of a questionnaire for assessment of medical science educators’ adherence to ethical principles in virtual education: exploratory sequential mixed methods study
Authors: Mohammadi Fateme , Kouhpayeh Seyed Amin , Bijani Mostafa , Karimi Shahnaz , Rustaee Sanaz
Published: January 2024

Background

Principles of ethics are among the pillars of the teaching-learning system. Evaluation of educators’ adherence to principles of ethics in virtual education requires the use of reliable instruments. This study was carried out to develop and test the psychometric properties of a questionnaire for assessment of medical science educators’ adherence to principles of ethics in virtual education.

Methods

This is an exploratory sequential mixed methods study conducted in two parts. In the first stage (the qualitative phase), we used conventional content analysis to establish the concept of ethical principles in virtual education. Thus, 21 semi-structured, in-depth interviews were conducted with 21 medical science professors on a face-to-face basis from March 2022 to November 2022. Subsequently, we developed the items of the questionnaire based on a review of literature and semi-structured in-depth interviews. In the second stage (the quantitative phase), psychometric features of the questionnaire were evaluated using COSMIN criteria (face validity, content validity, construct validity and internal consistency).

Results

Construct validity was surveyed with exploratory and confirmatory factor analysis via completing the questionnaire by 300 medical science professors, who were selected using convenience sampling. The results of exploratory factor analysis yielded a factor loading of the 20 items of the questionnaire to range between 0.79 and 0.98, all the values being significant. The three factors of adherence to the principles of copyright, adherence to educational principles, and justice in evaluation, which were addressed by the instrument, were verified by satisfactory values. The confirmatory factor analysis (CFA) fitted the data well (χ2/df = 13), RMSEA = 0.01, CFI = 0.96, NFI = 0.97, and TLI = 0.99. The total interclass correlation (ICC) of the questionnaire was estimated to be 0.90. Moreover, the reliability of the instrument measured in terms of internal consistency was estimated 0.98.

Conclusion

The findings of the study indicated that the questionnaire we developed for evaluation of adherence to ethical principles of in virtual education was valid and reliable enough. Therefore, the managers in the education system can employ this instrument to assess medical science educators’ adherence to principles of ethics in virtual education.
Artificial intelligence-based analysis of the spatial distribution of abnormal computed tomography patterns in SARS-CoV-2 pneumonia: association with disease severity
Authors: Kataoka Yusuke , Tanabe Naoya , Shirata Masahiro , Hamao Nobuyoshi , Oi Issei , Maetani Tomoki , Shiraishi Yusuke , Hashimoto Kentaro , Yamazoe Masatoshi , Shima Hiroshi , Ajimizu Hitomi , Oguma Tsuyoshi , Emura Masahito , Endo Kazuo , Hasegawa Yoshinori , Mio Tadashi , Shiota Tetsuhiro , Yasui Hiroaki , Nakaji Hitoshi , Tsuchiya Michiko , Tomii Keisuke , Hirai Toyohiro , Ito Isao
Published: January 2024

Background

The substantial heterogeneity of clinical presentations in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia still requires robust chest computed tomography analysis to identify high-risk patients. While extension of ground-glass opacity and consolidation from peripheral to central lung fields on chest computed tomography (CT) might be associated with severely ill conditions, quantification of the central-peripheral distribution of ground glass opacity and consolidation in assessments of SARS-CoV-2 pneumonia remains unestablished. This study aimed to examine whether the central-peripheral distributions of ground glass opacity and consolidation were associated with severe outcomes in patients with SARS-CoV-2 pneumonia independent of the whole-lung extents of these abnormal shadows.

Methods

This multicenter retrospective cohort included hospitalized patients with SARS-CoV-2 pneumonia between January 2020 and August 2021. An artificial intelligence-based image analysis technology was used to segment abnormal shadows, including ground glass opacity and consolidation. The area ratio of ground glass opacity and consolidation to the whole lung (GGO%, CON%) and the ratio of ground glass opacity and consolidation areas in the central lungs to those in the peripheral lungs (GGO(C/P)) and (CON(C/P)) were automatically calculated. Severe outcome was defined as in-hospital death or requirement for endotracheal intubation.

Results

Of 512 enrolled patients, the severe outcome was observed in 77 patients. GGO% and CON% were higher in patients with severe outcomes than in those without. Multivariable logistic models showed that GGO(C/P), but not CON(C/P), was associated with the severe outcome independent of age, sex, comorbidities, GGO%, and CON%.

Conclusion

In addition to GGO% and CON% in the whole lung, the higher the ratio of ground glass opacity in the central regions to that in the peripheral regions was, the more severe the outcomes in patients with SARS-CoV-2 pneumonia were. The proposed method might be useful to reproducibly quantify the extension of ground glass opacity from peripheral to central lungs and to estimate prognosis.
Validation and interpretation of Pan-TRK immunohistochemistry: a practical approach and challenges with interpretation
Authors: Karakas Cansu , Giampoli Ellen J. , Love Tanzy , Hicks David G. , Velez Moises J.
Published: January 2024

Objectives

Actionable, solid tumor activating neurotrophic receptor tyrosine kinase (NTRK) fusions are best detected via nucleic acid-based assays, while Pan-TRK immunohistochemistry (IHC) serves as a reasonable screening modality. We describe a practical and cost-effective approach to validate pan-TRK and discuss challenges that may be encountered.

Methods

Pan-TRK Clone EPR17341 was validated in accordance with the 2014 consensus statements set forth by the College of American Pathologists. Confirmation of IHC results were guided by the European Society of Medical Oncology recommendations for standard methods to detect NTRK fusions.

Results

Within 36 samples, ETV6-NTRK3 (n = 8) and TPM4-NTRK3 (n = 1) fusions were confirmed. ETV6-NTRK3 fusion positive cases revealed cytoplasmic and nuclear staining. A TPM4-NTRK3 fusion positive high grade malignant peripheral nerve sheath tumor revealed diffuse cytoplasmic staining. A high grade ovarian serous carcinoma revealed focal punctate staining and revealed a non-actionable NTRK1 truncation at intron 2. Diffuse cytoplasmic staining was observed in a case of fusion-negative polymorphous adenocarcinoma. Wild-type expression of TRK in pulmonary meningothelial-like nodules was discovered following a false-positive IHC interpretation.

Conclusion

Pan-TRK IHC shows some utility as a diagnostic and surrogate marker for NTRK screening however, physiologic or non-specific expression may lead to false-positive results.
Ethnobotanical and ethnomedicinal research into medicinal plants in the Mt Stara Planina region (south-eastern Serbia, Western Balkans)
Authors: Jarić Snežana , Kostić Olga , Miletić Zorana , Marković Milica , Sekulić Dimitrije , Mitrović Miroslava , Pavlović Pavle
Published: January 2024

Background

Ethnobotanical research in Southeast Europe—one of the most important European hotspots for biocultural diversity—is significant for the acquisition of Traditional Ecological Knowledge related to plants as well as for encouraging the development of local environments. The current ethnobotanical research was conducted in the region of Mt Stara Planina (south-eastern Serbia), which is characterised by rich phytodiversity with a large number of endemic and relict plant species. The aim of the study was to document the diversity of uses of medicinal plants and of traditional knowledge on their therapeutic uses.

Methods

Ethnobotanical data was collected through both open and semi-structured interviews with locals. Fifty-one inhabitants were interviewed (26 men and 25 women), aged 30–91, and data was analysed by means of use reports, citation frequency, use values (UV), and the informant consensus factor (ICF).

Results

The study identified 136 vascular medicinal plant taxa and one lichen species belonging to 53 families and 116 genera. Lamiaceae (19), Rosaceae (18), and Asteraceae (17) had the highest species diversity. The plant parts most commonly used to make a variety of herbal preparations were the aerial parts (54 citations), leaves (35 citations), fruits (20 citations), flowers (18 citations), and roots (16 citations), while the most common forms of preparation were teas (60.78%), consumption of fresh tubers, leaves, roots, and fructus (6.86%), compresses (5.88%), juices (5.39%), decoctions (3.92%), ‘travarica’ brandy (3.92%), and syrups (2.45%). Of the recorded species, 102 were administered orally, 17 topically, and 18 both orally and topically. The plants with a maximum use value (UV = 1) wereAllium sativum, Allium ursinum, Gentiana asclepiadea, Gentiana cruciata, Gentiana lutea, Hypericum perforatum, Thymus serpyllumandUrtica dioica. The highest ICF value (ICF = 0.95) was recorded in the categories of Skin and Blood, Blood Forming Organs, and Immune Mechanism.

Conclusions

This study shows that medicinal plants in the research area are an extremely important natural resource for the local population as they are an important component of their health culture and provide a better standard of living.
New midpoint-type inequalities in the context of the proportional Caputo-hybrid operator
Authors: Demir İzzettin , Tunç Tuba
Published: January 2024

Fractional calculus is a crucial foundation in mathematics and applied sciences, serving as an extremely valuable tool. Besides, the new hybrid fractional operator, which combines proportional and Caputo operators, offers better applications in numerous fields of mathematics and computer sciences. Due to its wide range of applications, we focus on the proportional Caputo-hybrid operator in this research article. Firstly, we begin by establishing a novel identity for this operator. Then, based on the newfound identity, we establish some integral inequalities that are relevant to the left-hand side of Hermite–Hadamard-type inequalities for the proportional Caputo-hybrid operator. Furthermore, we show how the results improve upon and refine many previous findings in the setting of integral inequalities. Later, we present specific examples together with their related graphs to offer a better understanding of the newly obtained inequalities. Our results not only extend previous studies but also provide valuable viewpoints and methods for tackling a wide range of mathematical and scientific problems.
Perspectives of clinical stakeholders and patients from four VA liver clinics to tailor practice facilitation for implementing evidence-based alcohol-related care
Authors: Soyer Elena M. , Frost Madeline C. , Fletcher Olivia V. , Ioannou George N. , Tsui Judith I. , Edelman E. Jennifer , Weiner Bryan J. , Bachrach Rachel L. , Chen Jessica A. , Williams Emily C.
Published: January 2024

Background

Unhealthy alcohol use (UAU) is particularly dangerous for people with chronic liver disease. Liver clinics may be an important setting in which to provide effective alcohol-related care by integrating evidence-based strategies, such as brief intervention and medications for alcohol use disorder. We conducted qualitative interviews with clinical stakeholders and patients at liver clinics in four Veterans Health Administration (VA) medical centers to understand barriers and facilitators of integrating alcohol-related care and to support tailoring of a practice facilitation implementation intervention.

Methods

Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR). Interviews were transcribed and qualitatively analyzed using a Rapid Assessment Process (RAP) guided by the CFIR.

Results

We interviewed 46 clinical stakeholders and 41 patient participants and analyzed findings based on the CFIR. Clinical stakeholders described barriers and facilitators that ranged from operations/clinic resource-based (e.g., time and capacity, desire for additional provider types, referral processes) to individual perspective and preference-based (e.g., supportiveness of leadership, individual experiences/beliefs). Patient participants shared barriers and facilitators that ranged from relationship-based (e.g., trusting the provider and feeling judged) to resource and education-based (e.g., connection to a range of treatment options, education about impact of alcohol). Many barriers and facilitators to integrating alcohol-related care in liver clinics were similar to those identified in other clinical settings (e.g., time, resources, role clarity, stigmatizing beliefs). However, some barriers (e.g., fellow-led care and lack of integration of liver clinics with addictions specialists) and facilitators (e.g., presence of quality improvement staff in clinics and integrated pharmacists and behavioral health specialists) were more unique to liver clinics.

Conclusions

These findings support the possibility of integrating alcohol-related care into liver clinics but highlight the importance of tailoring efforts to account for variation in provider beliefs and experiences and clinic resources. The barriers and facilitators identified in these interviews were used to tailor a practice facilitation implementation intervention in each clinic setting.
CNN-IKOA: convolutional neural network with improved Kepler optimization algorithm for image segmentation: experimental validation and numerical exploration
Authors: Abdel-Basset Mohamed , Mohamed Reda , Alrashdi Ibrahim , Sallam Karam M. , Hameed Ibrahim A.
Published: January 2024

Chest diseases, especially COVID-19, have quickly spread throughout the world and caused many deaths. Finding a rapid and accurate diagnostic tool was indispensable to combating these diseases. Therefore, scientists have thought of combining chest X-ray (CXR) images with deep learning techniques to rapidly detect people infected with COVID-19 or any other chest disease. Image segmentation as a preprocessing step has an essential role in improving the performance of these deep learning techniques, as it could separate the most relevant features to better train these techniques. Therefore, several approaches were proposed to tackle the image segmentation problem accurately. Among these methods, the multilevel thresholding-based image segmentation methods won significant interest due to their simplicity, accuracy, and relatively low storage requirements. However, with increasing threshold levels, the traditional methods have failed to achieve accurate segmented features in a reasonable amount of time. Therefore, researchers have recently used metaheuristic algorithms to tackle this problem, but the existing algorithms still suffer from slow convergence speed and stagnation into local minima as the number of threshold levels increases. Therefore, this study presents an alternative image segmentation technique based on an enhanced version of the Kepler optimization algorithm (KOA), namely IKOA, to better segment the CXR images at small, medium, and high threshold levels. Ten CXR images are used to assess the performance of IKOA at ten threshold levels (T-5, T-7, T-8, T-10, T-12, T-15, T-18, T-20, T-25, and T-30). To observe its effectiveness, it is compared to several metaheuristic algorithms in terms of several performance indicators. The experimental outcomes disclose the superiority of IKOA over all the compared algorithms. Furthermore, the IKOA-based segmented CXR images at eight different threshold levels are used to train a newly proposed CNN model called CNN-IKOA to find out the effectiveness of the segmentation step. Five performance indicators, namely overall accuracy, precision, recall, F1-score, and specificity, are used to disclose the CNN-IKOA’s effectiveness. CNN-IKOA, according to the experimental outcomes, could achieve outstanding outcomes for the images segmented at T-12, where it could reach 94.88% for overall accuracy, 96.57% for specificity, 95.40% for precision, and 95.40% for recall.
The size of the Hill Sachs defect increases during reduction of a first time shoulder dislocation in older adults: a pilot study in 20 cases
Authors: Ruiz Ibán Miguel Angel , Pérez Expósito Roque , Vicente Bártulos Agustina , Vega Rodriguez Rosa , Ruiz Díaz Raquel , Diaz Heredia Jorge
Published: January 2024

Purpose

To evaluate if the size of Humeral Hill‐Sachs Defects (HSDs) increases during reduction in the emergency department (ED) in subjects that have a first‐time anterior shoulder dislocation.

Methods

Subjects more than 18 years old presenting to the ED a first‐time anterior shoulder dislocation were included. A computed tomography was performed prior to any reduction attempt (Pre‐CT). The shoulder was reduced in the emergency room with intraarticular lidocaine; if two attempts failed, the shoulder was reduced under anaesthesia. A second CT was performed after reduction of the shoulder (Post‐CT).

CT were evaluated using the Osirix software. A 3‐dimensional reconstruction of the humeral head was performed and the maximum width of the humeral defect, maximum depth of the humeral defect and total volume of the humeral defect were measured. The relative increase in size was calculated.

Results

Twenty subjects were included in the study. All subjects presented HSDs in the Pre‐CT that had a width of a median of 9.9(interquartile range:2.9)mm, a depth of 7.0(3.0]mm and a volume of 355(333)mm2. The HSD in the Post‐CT had a width of 10.9(3.0)mm (an increase of 7.23[8.5]%, significant differences, p = 0.0001) a depth of 7.2(2.7)mm (an increase of 9.93[20.7]%, significant differences, p < 0.0001) and a volume of 469(271) mm2 (an increase of 27.5[26.9]%, significant differences, p < 0.0001). There were size increases larger than 25% in 15/20 (75%) of subjects.

Conclusion

Standard reduction manoeuvres performed in a first‐time anterior shoulder dislocation increase the size of the HSD. This increase in size is larger than 25% in four out of five cases.

Level of evidence

IV, prospective cases series study.
Skin sensory alteration and kneeling ability following cruciate retaining total knee arthroplasty are not affected by the incision position: A randomised controlled trial of simultaneous bilateral surgery
Authors: Barroso Rosa Sergio , Wilkinson Matthew , McEwen Peter , Morse Levi , Grant Andrea , Doma Kenji , Haward Charles , Rikard‐Bell Matthew
Published: January 2024

Purpose

The purpose of this randomised controlled trial was to assess the impact of skin incision location on the patients’ ability to kneel.

Methods

A total of 29 patients undergoing bilateral total knee arthroplasty (58 knees) were randomised to receive a lateral or midline incision, with the contralateral limb receiving the alternative option. Cruciate retaining implants were used in all cases by three experienced arthroplasty surgeons. The primary outcome measures assessed functional ability to kneel using an innovative five‐point kneeling scale, preferred knee to kneel on and the area of cutaneous sensory loss around the incision at 6 weeks, 6 months and 12 months. Secondary outcome measures were the OKS, KOOS JR, FJS and EQ5D patient reported outcome measures (PROMS), length of surgical scar, overall knee preference and range of motion (ROM).

Results

There were no significant differences between the two groups for any primary or secondary outcome measures. Flexion range however, had a significant positive correlation with kneeling score (r = 0.335, p = 0.010). The kneeling score increased at each time point after surgery and was significantly greater at 12 months than preoperatively (2.7 v 3.5, p = 0.015). The area of sensory loss lateral to the incision was significantly less at 6 and 12 months than at 6 weeks (43.6cm2 and 40.1cm2 v 84.1cm2, p < 0.0001).

Conclusion

The ability to kneel following cruciate retaining total knee arthroplasty is not affected by the incision position but by time and flexion range. TKA improves the ability to kneel by 12 months post‐surgery. Sensory loss lateral to the incision reduces with time.

Level of evidence

Therapeutic Level 2.
The reimbursement system can influence the treatment choice and favor joint replacement versus other less invasive solutions in patients affected by osteoarthritis
Authors: De Marziani Luca , Boffa Angelo , Di Martino Alessandro , Andriolo Luca , Reale Davide , Bernasconi Alessio , Corbo Valentina Rita , de Caro Francesca , Delcogliano Marco , di Laura Frattura Giorgio , Di Vico Giovanni , Manunta Andrea Fabio , Russo Arcangelo , Filardo Giuseppe
Published: January 2024

Purpose

The aim of this study was to assess how physicians perceive the role of the reimbursement system and its potential influence in affecting their treatment choice in the management of patients affected by osteoarthritis (OA).

Methods

A survey was administered to 283 members of SIAGASCOT (Italian Society of Arthroscopy, Knee, Upper Limb, Sport, Cartilage and Orthopaedic Technologies), a National scientific orthopaedic society. The survey presented multiple choice questions on the access allowed by the current Diagnosis‐Related Groups (DRG) system to all necessary options to treat patients affected by OA and on the influence toward prosthetic solutions versus other less invasive options.

Results

Almost 70% of the participants consider that the current DRG system does not allow access to all necessary options to best treat patients affected by OA. More than half of the participants thought that the current DRG system favors the choice of prosthetic solutions (55%) and that it can contribute to the increase in prosthetic implantation at the expense of less invasive solutions (54%). The sub‐analyses based on different age groups, professional roles, and places of work allowed to evaluate the response in each specific category, confirming the findings for all investigated aspects.

Conclusions

This survey documented that the majority of physicians consider that the reimbursement system can influence the treatment choice when managing OA patients. The current DRG system was perceived as unbalanced in favor of the choice of the prosthetic solution, which could contribute to the increase in prosthetic implantation at the expense of other less invasive options for OA management.