bluuebunny/crossref_metadata_2025 huggingface dataset:
A new heuristic method for solving unbalanced multi-objective assignment problem
Authors: Fouad Faten , Kassam Alla Eldin H , Al-Zubaidi Sawsan S
Published: November 2024

In the era of globalization, institutions face increasing challenges in effectively managing their resources to achieve diverse and differentiated objectives. The unbalanced multi-objective assignment problem reflects these challenges, as the distribution of limited resources requires achieving a balance between objectives such as minimizing time, cost, etc. In this study, an application case in the industrial field of rolling process was investigated, where the objective of the assignment problem is to minimize total assignment. In order to tackle this problem, the multi-objective problem was addressed by converting it into a single-objective problem through the weighted sum method by assigning a weight to each objective. A new heuristic method was then applied to solve the unbalanced single-objective assignment problem where the machines were loaded with more than one job. The Hungarian method was also used to solve the problem in order to assess the proposed method, and the outcomes were then compared. The proposed method proved efficient as it reduced idle time by 28%, increased machine efficiency by 5% and reduced costs by an average of 15%.
Reallocations of Time Between Sleep, Sedentary Behavior, and Physical Activity and Their Associations With 24-Hour Blood Pressure
Authors: Boudreaux Benjamin D , Schwartz Joseph E , Romero Emily K , Diaz Keith M
Published: November 2024

Background

The 24-h activity cycle (24H-ACT) (sleep, sedentary behavior, light physical activity, and moderate to vigorous physical activity) may have deleterious or beneficial associations with 24-h blood pressure (24H-BP).

Purpose

Estimate the short-term associated changes in 24H-BP with acutely replacing 30 min/d from one behavior of the 24H-ACT to other behaviors in employed adults.

Methods

Participants (N = 659) wore an ambulatory blood pressure monitor and two accelerometers (waist and wrist) to measure 24H-BP and the 24H-ACT.

Results

Replacing 30 min of sedentary behavior with 30 min of sleep was associated with lower 24-h mean systolic [ß = −0.32 mm Hg per 0.5 h (95% CI: −0.58, 0.06)] and diastolic [ß = −0.31 mm Hg per 0.5 h (95% CI: −0.50, −0.12)] blood pressure. Replacing 30 min of light physical activity with 30 min of sleep was associated with lower 24-h mean systolic [ß = −0.30 mm Hg per 0.5 h (95% CI: −0.62, 0.03,)] and diastolic blood pressure [ß = −0.34 mm Hg per 0.5 h (95% CI: −0.58, −0.11)]. No other time reallocations between 24H-ACT behaviors were associated with changes in 24H-BP.

Conclusion

Replacing time in sedentary behavior or light physical activity with sleep may provide small short-term reductions in that day’s 24H-BP.
Improving Access to Dementia Care in the Era of Monoclonal Antibody Treatments for Alzheimer’s Disease: a Pilot Clinical Protocol Using Abbreviated Neuropsychological Assessment
Authors: Naini Savana M , Thompson Ryan C , Rossetti Maria Agustina , Gallagher Virginia T , Manning Carol A , Fuchs Kathleen , D’Abreu Anelyssa , Prachar Tanya , Reilly Shannon E
Published: November 2024

Objective

To meet the growing demand for timely diagnosis in the new era of disease-modifying medications for Alzheimer’s disease (AD), the present study aimed to reduce clinic wait times by developing and refining an abbreviated neuropsychological battery to assess individuals with a suspected amnestic process (i.e., Early-Stage AD Pathway).

Method

Early-Stage AD Pathway patients were referred by an internal neurology provider who determined that the patient had: (1) an amnestic clinical presentation, (2) a normal neurological examination, and (3) a Montreal Cognitive Assessment total score between 18 and 25. These patients were scheduled for a 2-h neuropsychological evaluation, including a brief clinical interview and an abbreviated testing battery. We evaluated n = 19 patients in the Early-Stage AD Pathway and compared them to 114 older adults referred via traditional clinic procedures (i.e., General Clinic).

Results

Most individuals evaluated via the Early-Stage AD Pathway were diagnosed with mild cognitive impairment (MCI; 68.4%) or mild dementia (21.1%) through the neuropsychological evaluation. Rate of diagnosis of MCI/dementia was comparable between groups. The average number of days between initial referral and completion of the neuropsychological evaluation was significantly lower (Mdiff = 145.8 days, U = 1867.500, p < 0.001) for the Early-Stage AD Pathway group than for the General Clinic group, as the former could be scheduled more flexibly.

Conclusions

Implementing an abbreviated neuropsychological assessment process significantly reduced the time between referral and evaluation to identify individuals who may be eligible for emerging pharmacological treatments for AD and/or non-pharmacological interventions in a timely manner.
Application of radiomics features in differential diagnosis of odontogenic cysts
Authors: İçöz Derya , Çetin Bilgün , Dinç Kevser
Published: November 2024

Objectives

Cysts in jaws may have similar radiographic features. However, it is important to clarify the diagnosis prior to surgery. The aim of this study was to compare the radiomic features of radicular cysts (RCs), dentigerous cysts (DCs), and odontogenic keratocysts (OKCs) as a non-invasive diagnostic alternative to biopsy.

Methods

In total, 161 odontogenic cysts diagnosed histopathologically (55 RCs, 53 DCs, and 53 OKCs) were included in the present study. Each cyst was semi-automatically segmented on CBCT images, and radiomic features were extracted by an observer. A second observer repeated 20% of the evaluations and the radiomic features. Those achieving an inter-observer agreement level above 0.850 were included in the study. Consequently, five shape-based and 22 textural features were investigated in the study. Statistical analysis was performed comparing both three cyst features and making pairwise comparisons.

Results

All features included in the study showed statistical differences between cysts, with the exception of one textural feature (NGTDM coarseness) (P < .05). However, only one shape-based feature (shericity) and one textural feature (GLSZM large area emphasis) were statistically different in pairwise comparisons of all three cysts (P < .05).

Conclusion

Radiomics features of the RCs, DCs, and OKCs showed significant differences, and may have the potential to be used as a non-invasive method in the differential diagnosis of cysts.
Transgenerational effects of imidacloprid on Sclerodermus alternatusi (Hymenoptera: Bethylidae) based on age-stage, two-sex life table
Authors: Zhang Bingchuan , Wang Xue , Chen Zaiyan , He Shulin , Xu Shan , Li Fei , Zhou Cao
Published: November 2024

Imidacloprid is a widely used insecticide for controlling piercing-sucking pests. However, its impact on nontarget insects must not be ignored. In this study, we assessed the effects of sublethal dose of imidacloprid on Sclerodermus alternatusi (Hymenoptera: Bethylidae), which is an important predator of many pests. The data indicate that imidacloprid at LD10 (0.1468 ng active ingredient per insect) and LD30 (0.2376 ng active ingredient per insect) significantly reduced the longevity and fecundity of the F0 generation of S. alternatusi. However, the adult female longevity of the F1 generation of the LD10 dose group showed a significant increase, and the LD30 dose group showed a nonsignificant increase. The study found that as the imidacloprid dose increased, the intrinsic rate of increase (r) decreased, while the mean generation time (T) increased. The imidacloprid groups also showed a decrease in age-stage specific survival rate (Sxj) and age-specific survival rate (lx). However, the female age-specific survival rate (fx4) showed an increasing and then decreasing trend for all treatments. The study found that imidacloprid had an impact on the longevity of S. alternatusi in the F0 generation and extended the mean generation time (T) in the F1 generation. However, it had negative effects on population growth parameters. These findings can be used as a basis for developing integrated pest management strategies.
Diaphragm ultrasound and diaphragmatic 2D speckle tracking imaging in acute heart failure: a case series
Authors: Fayssoil Abdallah , Boisson De Chazournes Pierre , Hauguel-Moreau Marie , Mansart Arnaud , Mansencal Nicolas
Published: November 2024

Background

Respiratory muscle function can be affected in patients with heart failure. Ultrasound can be used to assess diaphragm, the main inspiratory muscle. Speckle tracking imaging is an imaging technology providing the evaluation of tissue deformation during contraction. We aimed to evaluate the contribution of traditional echography and 2D speckle tracking imaging in the evaluation and monitoring of patients with acute heart failure (AHF).

Case summary

We report a series of four cases of AHF. Diaphragm ultrasound coupled with diaphragm 2D speckle tracking imaging was performed at admission and after decongestive therapy, in cardiac intensive care unit. Patients, at admission, disclosed higher diaphragm 2D strain value and higher diaphragm inspiratory motion value in the context of higher cardiac loading that significantly decrease after decongestive therapy, except for one patient. Diaphragm motion remained less than 10 mm (weakness), despite medical therapy in Cases 2, 3, and 4. Among them, 3 months later, one patient (Case 3) experienced an episode of AHF.

Discussion

Diaphragm ultrasound coupled with diaphragm 2D speckle tracking imaging is feasible and may be used to monitor respiratory status patients with AHF.
A novel inner-branched stent-graft to overcome narrowed lumen in branched endovascular aneurysm repair
Authors: Zacà Sergio , Di Stefano Lucia , De Santis Claudio , Attolini Stefano , Passabì Maria Cristina , De Michele ViKy , Cucci Andrea Sante , Angiletta Domenico
Published: November 2024

A narrowed patent aortic lumen (<25 mm) represents a challenging scenario frequently observed during thoraco-abdominal and abdominal aortic pathologies involving the visceral vessels. The paper aims to describe the characteristics of a novel tapered-shape inner-branched custom-made stent-graft designed to specifically address the narrowed patent aortic lumen and its applicability in a wider spectrum of aortic scenarios at the reno-visceral segment.
Counting chicks before they hatch: extending the observed lifetime to better characterize evolutionary processes in the wild
Authors: Evans Simon R , Postma Erik
Published: November 2024

Evolutionary theorists have emphasized for over half a century that population sampling must be conducted at the intergenerational boundary if the distinct effects of selection and inheritance are to be reliably quantified, with individuals recognized at the point of conception and lifetime reproductive success (LRS) defined as the total number of zygotic offspring produced per zygote. However, in those species whose ecology is otherwise well-suited to individual-level population studies, the prenatal part of an individual’s life is often difficult to observe. While uncertainty has long surrounded the fertilization status of unhatched bird eggs—hatching failure can arise through fertilization failure or prenatal mortality—2 recent studies show fertilization failure to be extremely rare within 2 of the most popular avian study species. As such, unhatched eggs are highly reliable indicators of prenatal mortality. Although the generality of these results remains unclear, they demonstrate that prenatality can be incorporated into the observable lifespan of free-living animals. This allows zygotic LRS to be retrospectively quantified using historical nest observations and facilitates a more complete characterization of the evolutionary dynamics of wild populations.
The chromosome-level genome assembly of an endangered herbBergenia scopulosaprovides insights into local adaptation and genomic vulnerability under climate change
Authors: Yang Yi-Xin , Wang Meng , Wu Xuan-Ye , Zhou Ya-Ni , Qiu Jie , Cai Xia , Li Zhong-Hu
Published: November 2024

Background

Global climate change poses severe threats to biodiversity and ecosystem stability. Rapid climate oscillations potentially lead to species geographic range shifts, population declines, and even extinctions. The rare and endangered species, being critical components of regional biodiversity, hold the key to understanding local adaptation and evolutionary processes shaping species distributions. Therefore, assessing the evolutionary mechanisms of local adaptation and population vulnerability under climate change is crucial for developing conservation strategies of endangered species.

Results

In this study, we assembled a high-quality, chromosome-level genome of the rare and endangered herb Bergenia scopulosa in the Qinling Mountains in East Asia and resequenced 37 individual genomes spanning its entire geographic distributional ranges. By integrating population genetics, landscape genomics, and climate datasets, a substantial number of adaptive single-nucleotide polymorphism loci associated with climate variables were identified. The genotype–environment association analysis showed that some cold-tolerant genes have played pivotal roles in cold environmental adaptation of B. scopulosa. These findings are further corroborated through evolutionary analysis of gene family and quantitative PCR validation. Population genomic analysis revealed 2 distinct genetic lineages in B. scopulosa. The western lineage showed higher genomic vulnerability and more rare cold-tolerance alleles, suggesting its heightened sensitivity to impending climate shifts, and should be given priority conservation in the management practices.

Conclusions

These findings provide novel insights into local adaptation and genomic vulnerability of B. scopulosa under climate change in the Qinling Mountains in East Asia. Additionally, the study also offers valuable guidance for formulating conservation strategies for the rare and endangered plants.
Perspectives of Malaysian community pharmacists on challenges and barriers to smoking cessation programme: a qualitative study
Authors: Lio Ee Lee , Maharajan Mari Kannan , Rajiah Kingston
Published: November 2024

Objectives

Smoking remains a significant public health concern, necessitating effective smoking cessation interventions. This study explores the barriers community pharmacists face in delivering smoking cessation services in Malaysia and potential solutions to improve their contribution to public health.

Methods

This qualitative study employed purposive and snowball sampling to recruit community pharmacists in Malaysia. Semi-structured interviews were conducted, exploring pharmacists’ perspectives on barriers, counselling approaches, follow-up strategies, and opinions on smoking cessation services. Thematic analysis was employed to identify key themes and sub-themes.

Key findings

Three main themes emerged from the data analysis: barriers, counselling and enhancing follow-up, and pharmacists’ opinions on professional fees. Under the theme of barriers, sub-themes included underutilization by the public, poor follow-up by customers, time constraints, lack of educational materials and support, and customer perception. The counselling and enhancing follow-up theme encompassed shared decision-making, motivational intervention, follow-up via phone calls or messaging apps, and providing rebate vouchers. Pharmacists’ opinions on professional fees revealed mixed perspectives, with some advocating for fees to recognize the professional service provided, while others expressed concerns about access barriers.

Conclusions

Community pharmacists face challenges in delivering smoking cessation services, such as underutilization, poor follow-up, time constraints, and affordability. However, strategies like shared decision-making and proactive communication can enhance effectiveness. Addressing professional fees and collaborative efforts are essential to optimising these services.
Evaluation of a Multi-Instant Multimodal Artificial Intelligence System Supporting Interpretive and Noninterpretive Functions
Authors: Pacilè Serena , Germaine Pauline , Sclafert Caroline , Bertinotti Thomas , Fillard Pierre , Singla Long Svati
Published: November 2024

Objective

Artificial intelligence (AI) has been shown to hold promise for improving breast cancer screening, offering advanced capabilities to enhance diagnostic accuracy and efficiency. This study aimed to evaluate the impact of a multimodal multi-instant AI-based system on the diagnostic performance of radiologists in interpreting mammograms.

Methods

We designed a multireader multicase study taking into account the evaluation of both interpretive and noninterpretive tasks. The study was approved by an institutional review board and is compliant with HIPAA. The dataset included 90 cancer-proven and 150 negative cases. The overall diagnostic performance was compared between the unaided vs aided reading condition. Intraclass correlation coefficient (ICC), Fleiss’s kappa, and accuracy were used to quantify the agreement and performance on noninterpretive tasks. Reading time and perceived fatigue were used as comprehensive metrics to assess the efficiency of readers.

Results

The average area under the receiver operating characteristic curve increased by 7.4% (95% CI, 4.5%-10%) with the concurrent assistance of the AI system (P <.001). On average, readers found 8% more cancers in the assisted reading condition. The ICC went from 0.6 (95% CI, 0.55-0.65) in the unassisted condition to 0.74 (95% CI, 0.70-0.78) for readings done with AI (P <.001). An overall decrease of 24% in reading time and a reduction in perceived fatigue was also found.

Conclusion

The incorporation of this AI system, capable of handling multiple image type, prior mammograms, and multiple outputs, improved the diagnostic proficiency of radiologists in identifying breast cancer while also reducing the time required for combined interpretive and noninterpretive tasks.
Small bowel obstruction secondary to impacted pancreatic necrosum through a spontaneous duodenal fistula: a first in the literature
Authors: Laczko Dora , Skanes Stephanie , Hocking David , Peck David , Hawel Jeffrey D , Hilsden Richard
Published: November 2024

A 58-year-old man presented with alcohol-induced acute pancreatitis. Imaging revealed complete necrosis of the pancreatic parenchyma. After initial non-operative management, the patient developed a duodenal ulcer and an upper gastrointestinal bleed and later spontaneously formed a fistula between the pancreas and the first segment of the duodenum. Through this fistula, the entire pancreatic necrosum migrated to the distal small bowel, where it became entrapped as a bezoar, causing a high-grade small bowel obstruction. The patient then proceeded to laparotomy, where the obstruction was resolved by removing the necrosum through an enterotomy. No surgical intervention to the pancreatic bed or duodenum was required, and he was ultimately discharged home on insulin and pancreatic enzymes. This is the first reported case in the medical literature of a spontaneous duodenal fistula leading to small bowel obstruction due to a bezoar of pancreatic necrosum.
Safety and efficacy of laparoscopic sleeve gastrectomy post simultaneous kidney and pancreas transplant
Authors: Alqahtani Awadh , Almayouf Mohammad , Billa Srikar , Alsarraj Omar
Published: November 2024

Few reports in the literature explore the efficacy of bariatric surgery in patients post simultaneous kidney and pancreas transplant (SKPT). This case report entails a patient who had SKPT because of end-stage renal disease and type I diabetes. The transplant failed, and the patient gained weight. The report explains the approach and the outcome of laparoscopic sleeve gastrectomy in this patient as a preparation for a re-transplant. The patient was having grade 2 obesity, insulin-dependent, on hemodialysis, and had obstructive sleep apnea on bilevel positive airway pressure. A multidisciplinary team approach was implemented, and the procedure was completed with no immediate postoperative complications. The patient lost ~10 kg and was able to stop insulin.
“It Hurts Right There.”: Focal, Ongoing Back Pain in a 48-Year-Old
Authors: Standaert Christopher J.
Published: November 2024

It is very difficult to diagnose a specific cause of low back pain (LBP) in most people presenting for care. X-rays commonly show age-related changes which have no association with LBP. History, physical examination, and spinal imaging can identify significant pathology, such as fracture or infection, but are not particularly helpful in identifying sources of pain. As there is no reliable means of permanently resolving pain from any spinal structure, it is more harmful than helpful to tell patients that they have discogenic, facet, or sacroiliac pain, as we do not know that such a statement is true, nor can we “fix” the problem. Fear and psychosocial stressors may amplify the perceived importance of identifying a “pain generator,” which is then tied to the expectation of a “cure.” A convenient but false biological narrative can lead to an extensive, wasteful, and potentially harmful search for that cure.
“I Just Had Surgery, but I Hurt Again.”: Back and Leg Pain 4 Months after Back Surgery
Authors: Watson Alex , Standaert Christopher J.
Published: November 2024

Recurrent pain after lumbar microdiscectomy is relatively common with a finite differential diagnosis. Approximately 10% of patients undergoing microdiscectomy experience complications, and 7% require reoperation within 12 months. Given the frequency and potential severity of postoperative complications, patients with persistent, progressive, or severe symptoms following a microdiscectomy (or other spine surgery) warrant prompt diagnostic evaluation. Such patients should be screened with basic laboratory studies including a complete blood count, erythrocyte sedimentation rate, and C-reactive protein to evaluate for infection, standing lumbar spine X-rays (including flexion/extension views)—and possibly MRI. Issues that can arise in the weeks or months following lumbar spine surgery include recurrent disc herniation, instability of the spine, infection, arachnoiditis, and epidural fibrosis. It is important to accurately diagnose any of these conditions, as treatment for all varies. Hematoma, dural leak, infection, new neurologic deficit, or instability require emergent evaluation and referral to a spine surgeon.
Accretion disc dynamics in extragalactic black hole X-ray binaries: a comprehensive study of M33 X–7, NGC 300 X–1, and IC 10 X–1
Authors: Bhuvana G R , Nandi Anuj
Published: November 2024

Extragalactic black hole X-ray binaries (BH-XRBs) are the most intriguing X-ray sources as some of them are ‘home’ to the most massive stellar-mass BHs ever found. In this work, we conduct a comprehensive study of three massive, eclipsing extragalactic BH-XRBs i.e. M33X-7, NGC300X-1, and IC10X-1 and using entire X-ray observations available from XMM–Newton and NuSTAR till date. Preliminary analysis using diskbb and power-law models shows that the sources have steep spectra and sub-Eddington luminosities (L<0.69 L$_{\mathrm{ Edd}}$), with major flux contribution from non-thermal component, resembling the relatively uncharted steep power-law state (SPL). To understand the accretion disc properties in this state, we explore alternate modelling scenario that reveals the presence of a ‘hot’ ($kT_{\mathrm{ in}}=1\!-\!2$ keV) slim-disc (diskpbb) with radial temperature profile $T(r)\propto r^{-p}$ ($p=0.5\!-\!0.66$), along with a cooler ($kT_{\mathrm{ in}}=0.1\!-\!0.2$ keV) standard thermal disc (diskbb). We carry out the continuum-fitting method using relativistic slim-disc model (slimbh) and estimate the mass range of M33 X–7, NGC300X-1, and IC10X-1 is to be 9–15 M$_{\odot }$, 9–28 M$_{\odot }$, and 10–30 M$_{\odot }$, respectively. Further, eclipse periods are determined by modelling the light curve, using which we estimate the size of the eclipsing bodies. Modelling of the eclipse spectra revealed the complete obscuration of soft spectral component during eclipse, implying the emission of hard component from an extended accretion region. Based on our findings, we provide an inference on geometry of accretion disc in these wind-fed systems and compare their properties with the other two extragalactic BH-XRBs.
Impact of tumor-treating fields on the survival of Japanese patients with newly diagnosed glioblastoma: A multicenter, retrospective cohort study
Authors: Kanamori Masayuki , Tsuzuki Shunsuke , Shibahara Ichiyo , Saito Kuniaki , Shimoda Yoshiteru , Tanaka Kazuhiro , Yamaguchi Shigeru , Natsumeda Manabu , Matsutani Tomoo , Hanihara Mitsuto , Nakada Mitsutoshi , Kuroda Jun-Ichiro , Matsuda Masahide , Yoshimoto Koji , Yonezawa Ushio , Sonoda Yukihiko , Takano Koji , Yonezawa Hajime , Otani Yoshihiro , Nakahara Yukiko , Uchida Masashi , Nonaka Masahiro , Mineharu Yohei , Kitamura Yohei , Yamashita Shinji , Yamauchi Takahiro , Miyake Yohei , Deguchi Shoichi , Beppu Takaaki , Tamura Kaoru , Koizumi Shinichiro , Hirose Yuichi , Asano Kenichiro , Hiruta Ryo , Kinoshita Manabu , Miyake Keisuke , Nakayama Noriyuki , Inoue Akihiro , Ono Takahiro , Sasaki Takahiro , Akiyama Yukinori , Fukami Shinjiro , Yoshino Atsuo , Kawanishi Yu , Asanome Taku , Yamaguchi Takuhiro , Takahashi Masamichi , Yamasaki Fumiyuki , Arakawa Yoshiki , Narita Yoshitaka
Published: November 2024

Background

The EF-14 clinical trial demonstrated the safety and efficacy of tumor-treating fields (TTFields) for newly diagnosed glioblastoma. This study aimed to clarify the current status, safety, and efficacy of TTFields in Japanese patients who meet the EF-14 inclusion criteria.

Methods

This was a multicenter retrospective cohort study. Background, treatment, and outcome data of patients who satisfied the inclusion criteria of the EF-14 trial were collected from 45 institutions across Japan. The rate, determinants, and current status of TTField use, including its safety and efficacy in terms of progression and survival, were retrospectively investigated. This study was conducted in accordance with the STROBE checklist.

Results

Among the 607 patients enrolled, 70 were excluded due to progressive disease during radiation and temozolomide therapy, age > 80 years old, and Karnofsky Performance Status score of <70. Among the remaining 537 patients, 210 (39%) underwent TTField treatment. Multivariate analysis revealed younger age and spouse as a caregiver as significant factors for TTField use. The compliance rate of TTField use exceeded 75% in 60% of patients, with a median TTField usage duration of 11 months. Skin disorders requiring medical treatment occurred in 56% of patients. Multivariate Cox proportional hazards analysis in the whole series and propensity score-matched analysis revealed that TTField use was not a prognostic factor for progression-free survival (PFS) or overall survival (OS).

Conclusions

TTField use did not have a substantial effect on either PFS or OS in Japanese patients with glioblastoma, despite compliance rates comparable to those observed in the EF-14.
The impact of immune-related adverse events on survival outcomes in a racially diverse population, with a focus on non-Hispanic Black patients
Authors: Radwan Amr , Jani Chinmay T , Al Omari Omar , Patel Mohini , Burns Laura , Mackay Zoe , Li Liuping , Mahdaviani Kiana , Davidson Arielle , Weinberg Janice , Everett Peter C , Suzuki Kei , Mak Kimberley S , Kulke Matthew H , Tapan Umit
Published: November 2024

Introduction

The development of immune-related adverse events (irAEs) has been associated with improved survival outcomes in non-small cell lung cancer (NSCLC). However, this association’s extent across race and ethnicity remains uncertain. We evaluated the association between the development of irAEs and treatment outcomes across racially diverse groups treated at a safety net hospital.

Methods

A retrospective chart review was performed to identify patients with advanced NSCLC treated between 2015 and 2020. The incidence of irAEs across racial subgroups was compared using logistic regression analysis. Cox regression analysis was performed to evaluate the association between the development of irAEs and treatment outcomes.

Results

We identified 138 NSCLC patients treated with immune checkpoint inhibitors (ICIs), of whom 50% identified as non-Hispanic Black (NHB). Incidence of irAEs was 28%, with no significant difference between NHB and other racial groups. However, females [OR 2.3, 95% CI, (1.1-4.8)] and patients with Medicaid or MassHealth insurance had a higher incidence of irAEs [OR 2.7 (1.2-5.7)]. Additionally, patients with irAEs had a lower risk of disease progression (multivariable HR 0.46, 95% CI, 0.23-0.92) compared to those without irAEs. The association between irAEs and improved progression free survival (PFS) in NHB patients was similar to the other racial group [median PFS 246 vs 181 days; HR 0.87 (0.58-1.29)].

Conclusion

We demonstrated a similar incidence of irAEs in NHB patients with NSCLC as compared to other racial groups. Patients who developed irAEs experienced significantly improved survival outcomes. This association remained independent of race and ethnicity, underscoring the importance of providing unbiased treatment recommendations.
Unlocking the optimization of electrical properties of epoxy-carbon nanotube composites modified with waste eggshell particles via the Taguchi-Grey method
Authors: Dinneya-Onuoha Ekele , Aigbodion Victor Sunday , Ogbodo Agbo Alfred
Published: November 2024

Advanced electronics demand materials that combine high thermal conductivity with enhanced electrical properties, yet achieving these improvements simultaneously poses significant challenges. This research employs the Taguchi-Grey methodology to explore the synergistic effects of dielectric elements and the high thermal conductivity of epoxy-based composites reinforced with carbon nanotubes (CNTs) and repurposed eggshell particles (ESp). Composite production involved solution blending, followed by evaluations of dielectric constant, thermal conductivity, and sample morphology. Under optimal conditions—1 wt% ESp, 2.5 wt% CNTs, curing at 90°C for 6 h—substantial increases in electrical and thermal conductivity of 19.130% and 94.27%, respectively, were achieved. These enhancements are attributed to the synergistic interaction between dielectric materials and CNTs, as well as the uniform CNT dispersion facilitated by the repurposed eggshells. The 95% confidence level confirmed a strong alignment between the predicted and experimental grey relational grades (GRG), validating the identified optimal parameters. This study demonstrates the potential of using repurposed eggshells to produce conductive polymers with uniformly dispersed CNTs, significantly enhancing thermal conductivity. These findings suggest a promising approach for sustainable, high-performance dielectric materials for electronic applications.
The transcription factor GhMYB4 represses lipid transfer and sucrose transporter genes and inhibits fiber cell elongation in cotton
Authors: Duan Yujia , Shang Xiaoguang , Wu Ruoxue , Yu Yujia , He Qingfei , Tian Ruiping , Li Weixi , Zhu Guozhong , Guo Wangzhen
Published: November 2024

Cotton (Gossypium hirsutum) fiber is a highly elongated single cell with a thickened cell wall. MYB transcription factors are important regulators of plant cell elongation; however, the molecular mechanism involved in regulating fiber elongation remains to be explored. Here, we present evidence that the R2R3-MYB transcription factor GhMYB4 negatively regulates cotton fiber cell elongation by suppressing the expression of 2 crucial genes previously reported to affect fiber development: lipid transfer protein 4 (GhLTP4) and sucrose transporter 12 (GhSWEET12). GhMYB4 is preferentially expressed in elongating fiber cells. Knockdown of GhMYB4 in cotton results in longer fiber cells, whereas overexpression of GhMYB4 in Arabidopsis leads to reduced plant height and root length. Transcriptomic and lipidomic analyses revealed that GhMYB4 is involved in coordinating 3 interconnected biological processes, namely lipid content regulation, auxin signaling, and sugar metabolism. Additionally, we showed that GhMYB4 inhibits the expression of GhLTP4 and GhSWEET12 by binding to the MYB cis-element (TTTAGTG) in their respective promoters. Interestingly, basic helix-loop-helix transcription factor 105 (GhbHLH105) and MYB transcription factor 212 (GhMYB212) counteract the inhibitory effects of GhMYB4 on the expression of GhLTP4 and GhSWEET12, respectively. These findings provide insights into the complex molecular mechanisms regulating plant cell elongation.
Modulation of microtubule dynamics by monovalent ions
Authors: Fernandes Simon , Aumeier Charlotte
Published: November 2024

The microtubule cytoskeleton is a dynamic network essential for many cellular processes, influenced by physicochemical factor, such as temperature, pH, dimer concentration, and ionic environment. In this study, we used in vitro reconstitution assays to examine the effects of four monovalent ions (Na+, K+, Cl−, and Ac−) on microtubule dynamics, uncovering distinct effects for each ion. Na+ was found to increase microtubule dynamicity by raising catastrophe frequency, polymerization and depolymerization speeds, and ultimately reducing microtubule lifetime by 80%. Conversely, Ac− boosts microtubule nucleation and stabilizes microtubules by increasing rescue frequency and preventing breakages, resulting in longer microtubules with extended lifetimes. Cl− appeared to potentiate the effects of Na+, while K+ had minimal impact on microtubule dynamic parameters. These findings demonstrate that Na+ and Ac− have opposing effects on microtubule dynamics, with Na+ destabilizing and Ac− stabilizing the microtubule structure. This ionic impact is mainly through modulation of tubulin–tubulin interactions rather than affecting the hydrolysis rate. In conclusion, ion identity plays a crucial role in modulating microtubule dynamics. Understanding the ionic environment is essential for microtubule-related research, as it significantly influences microtubule behavior, stability, and interactions with other proteins.
Targeting chromatin modifying complexes in acute myeloid leukemia
Authors: Schurer Alexandra , Glushakow-Smith Shira G , Gritsman Kira
Published: November 2024

Acute myeloid leukemia (AML) is a devastating hematologic malignancy with high rates of relapse, which can, in part, be attributed to the dysregulation of chromatin modifications. These epigenetic modifications can affect the capacity of hematopoietic cells to self-renew or differentiate, which can lead to transformation. Aberrant histone modifications contribute to the derepression of self-renewal genes such as HOXA/B and MEIS1 in committed hematopoietic progenitors, which is considered a key mechanism of leukemogenesis in MLL-rearranged (MLL-r) and NPM1-mutated AML. As regulators of some of the key histone modifications in this disease, the menin-KMT2A and polycomb repressive (PRC1/2) complexes have been identified as promising targets for the treatment of AML. This review explores recent discoveries of how leukemic cells hijack these complexes and their interactions with other chromatin regulators to promote disease progression. We also discuss inhibitors targeting these complexes that have demonstrated therapeutic efficacy in preclinical and clinical studies and propose novel therapeutic combinations targeting the KMT2A and PRC1/2 broader interacting networks to overcome issues of resistance to existing monotherapies.
Insights into RNA‐mediated pathology in new mouse models of Huntington's disease
Authors: Wozna‐Wysocka Magdalena , Jazurek‐Ciesiolka Magdalena , Przybyl Lukasz , Wronka Dorota , Misiorek Julia Oliwia , Suszynska‐Zajczyk Joanna , Figura Grzegorz , Ciesiolka Adam , Sobieszczanska Paula , Zeller Anna , Niemira Magdalena , Switonski Pawel Michal , Fiszer Agnieszka
Published: November 2024

Huntington's disease (HD) is a neurodegenerative polyglutamine (polyQ) disease resulting from the expansion of CAG repeats located in the ORF of the huntingtin gene (HTT). The extent to which mutant mRNA‐driven disruptions contribute to HD pathogenesis, particularly in comparison to the dominant mechanisms related to the gain‐of‐function effects of the mutant polyQ protein, is still debatable. To evaluate this contribution in vivo, we generated two mouse models through a knock‐in strategy at the Rosa26 locus. These models expressed distinct variants of human mutant HTT cDNA fragment: a translated variant (HD/100Q model, serving as a reference) and a nontranslated variant (HD/100CAG model). The cohorts of animals were subjected to a broad spectrum of molecular, behavioral, and cognitive analysis for 21 months. Behavioral testing revealed alterations in both models, with the HD/100Q model exhibiting late disease phenotype. The rotarod, static rod, and open‐field tests showed some motor deficits in HD/100CAG and HD/100Q model mice during the light phase, while ActiMot indicated hyperkinesis during the dark phase. Both models also exhibited certain gene deregulations in the striatum that are related to disrupted pathways and phenotype alterations observed in HD. In conclusion, we provide in vivo evidence for a minor contributory role of mutant RNA in HD pathogenesis. The separated effects resulting from the presence of mutant RNA in the HD/100CAG model led to less severe but, to some extent, similar types of impairments as in the HD/100Q model. Increased anxiety was one of the most substantial effects caused by mutant HTT RNA.
Barriers to Effective Infection Prevention in the Neonatal Intensive Care Unit
Authors: Weser Veronica U. , Crocker Abigail , Murray Thomas S. , Wright Jayson , Truesdell Erin J.K. , Ciaburri Rebecca , Marks Asher M. , Martinello Richard A. , Hieftje Kimberly D.
Published: November 2024

Background:

Infection prevention (IP) behaviors such as hand hygiene (HH) and mobile device disinfection are important to reduce the risk of infection transmission from both family members and hospital staff to critically ill neonates.

Purpose:

To inform the design of educational interventions to improve both patient family and staff IP behaviors, we engaged separate groups of nurses and family members to understand perceptions about the spread of infection and barriers to implementing effective IP strategies.

Methods:

This was a qualitative study using focus groups to gather data from neonatal nurses and patient family members. Data were triangulated with hospital-wide survey data and analyzed using inductive content analysis.

Results:

Twelve nurses and 4 patient family members participated. Themes related to communication about IP between staff and family members emerged: stakeholders expressed discomfort with the timing and nature of just-in-time HH education. These communication challenges contributed to stress levels within the neonatal intensive care unit. This finding was reflected in the hospital-wide survey.

Implications for Practice and Research:

Steps should be taken to improve communication about IP behaviors between patient family members and frontline staff. Reducing nurse burden of providing just-in-time HH reminders to patient family members through increased IP education may decrease stress and facilitate IP behaviors. This has the potential to decrease infection spread and improve patient outcomes. The development of interventions targeting stakeholder communication is therefore warranted, but additional research is needed to understand the timing and process for delivery of the educational material.
Impact of colorectal cancer screening by primary tumor location in a real-world setting in Japan
Authors: Makiuchi Takeshi , Zha Ling , Kitamura Tetsuhisa , Sobue Tomotaka , Ogawa Toshio
Published: November 2024

The objective of this retrospective observational study was to investigate the impact of fecal occult blood test (FOBT) as colorectal cancer (CRC) screening by primary tumor location. We compared the risk of requiring treatment for advanced disease and total medical costs per patient between CRC patients who underwent FOBT within 1 year before initial treatment for CRC and those who did not, using the JMDC Claims database, large-scale health insurance claims and checkup data in Japan. Treatment for advanced disease was defined as (1) nonendoscopic therapy or (2) chemotherapy or radiotherapy, performed during the follow-up period. A total of 1194 participants with CRC (right-sided, 22.2%; left-sided, 60.4%) who initiated treatment between 2010 and 2016 and underwent health checkups within 1 year before the initial treatment were enrolled and followed up for an average of 46.1 months. A significantly lowered risk ratio (RR) of chemotherapy or radiotherapy and total medical costs were observed in FOBT group for left-sided CRC [RR = 0.78 (95% confidence interval, 0.63–0.97), mean and median costs = 4.1 vs. 5.6 and 2.4 vs. 2.9 million JPY; P = 0.018], while they were not observed for right-sided CRC [RR = 0.88 (95% confidence interval, 0.61–1.28), mean and median costs = 4.0 vs. 4.1 and 2.7 vs. 2.9 million JPY; P = 0.995]. This study demonstrated the improved outcomes by FOBT for left-sided CRC, whereas its impact was limited for right-sided CRC.
Artificial intelligence in ophthalmology
Authors: Khossravi Ava S. , Chen Qingyu , Adelman Ron A.
Published: November 2024

Purpose of review

To review role of artificial intelligence in medicine.

Recent findings

Artificial intelligence is continuing to revolutionize access, diagnosis, personalization of medicine, and treatment in healthcare. As a matter of fact, artificial intelligence contributed to the research that resulted in 2024 Nobel Prizes in physics, chemistry, and economics. We are only at the tip of the iceberg in utilizing the abilities of artificial intelligence in medicine to improve accuracy of diagnoses and to enhance patient outcomes. Artificial intelligence has allowed better image analysis, prediction of progression of disease, personalized treatment plans, incorporations of genomics, and improved efficiency in care and follow-up utilizing home monitoring. In ocular health diagnosis and treatment of diabetic retinopathy, macular degeneration, glaucoma, corneal infections, and ectasia are only a few examples of how the power of artificial intelligence has been harnessed. Even though there are still challenges that need more work in the areas of patient privacy, Health Insurance Portability and Accountability Act (HIPAA) compliance, reliability, and development of regulatory frameworks, artificial intelligence has revolutionized and will continue to revolutionize medicine.

Artificial intelligence is enhancing medical diagnosis and treatment, as well as access and prevention. Ocular imaging, visual outcome, optics, intraocular pressure, and data points will continue to see growth it the field of artificial intelligence.
Critical care nutrition: a Bayesian re-analysis of trial data
Authors: Angeloni Natalia Alejandra , Angriman Federico , Adhikari Neill K.J.
Published: November 2024

Purpose of review

Nutritional support and optimal glucose control are key components of care during critical illness, yet evidence surrounding their use remains conflicting, making translation into clinical practice challenging. This review explores Bayesian methods to enhance the interpretation of frequentist critical care trials, particularly for interventions with inconclusive outcomes.

Recent findings

Bayesian re-analysis frameworks may clarify conflicting evidence in critical care, thus enhancing interpretability and supporting clinical decision-making. This review focuses on the Bayesian re-analysis of three recent trials with indeterminate results for mortality – NUTRIREA-3, EFFORT Protein, and TGC-Fast – that examined the effects of enteral nutrition and glucose control strategies.

We re-analyzed the mortality outcomes of these trials within a Bayesian framework, contrasting our findings with the original trial results to illustrate how Bayesian methods can enhance the clinical applicability of trial outcomes. Although Bayesian and frequentist analyses generally agree on the direction and magnitude of effect, Bayesian methods offer the advantage of providing posterior probabilities of benefit and harm, thus identifying promising and potentially harmful interventions. This review underscores the value of Bayesian analysis in re-evaluating clinical trial data and guiding clinical practice.
Diagnostic performance of fluorine-18-fluorodeoxyglucose PET/MRI for detection of disease recurrence in differentiated thyroid cancer: a compartment-based analysis
Authors: Özkan Elgin , Ünal Sena , Akkuş Pinar , Peker Elif , Araz Mine , Dursun Ecenur , Soydal Cigdem , Yilmazer Zorlu Nil Sezer , Gökcan Mustafa Kursat , Erdoğan Murat Faik , Yavuz Yasemin , Küçük Nuriye Ozlem
Published: November 2024

Objectives

The objective of this study is to evaluate the diagnostic performance of neck fluorodeoxyglucose (FDG) PET/MRI in addition to whole-body PET/computed tomography (CT) and to compare it with MRI in the detection of suspicion of disease relapse in patients with differentiated thyroid cancer (DTC) who underwent total thyroidectomy and radioactive iodine therapy.

Methods

Twenty-nine patients with DTC who underwent whole-body 18F-FDG PET/CT followed by neck PET/MRI because of increased serum thyroglobulin (Tg) or anti-Tg antibody levels and negative 131I whole-body scan were included. At least 6 months of clinical and radiological (neck ultrasound) follow-up or histopathological examination results were accepted as the gold standard. Lesion and compartment-based analyses were performed to evaluate the diagnostic performances of PET/CT, MRI, and PET/MRI. In addition, changes of clinical management were evaluated.

Results

On lesion-based analysis, for PET/CT, MRI, and PET/MRI: sensitivity: 33.3, 33.3, and 37%; specificity: 90.1, 87.9, and 95.9%; accuracy: 87.5, 85.4, and 93.2 were calculated, respectively. Specificity of PET/MRI was significantly superior to PET/CT and MRI (P of0.001); however, sensitivity of PET/MRI was not significant to PET/CT and MRI (P of0.05). On compartment-based analysis, specificity of PET/MRI and MRI were comparable but significantly superior to PET/CT at levels 1 and 2; however, specificity of PET/CT and PET/MRI were comparable but significantly superior than MRI, especially at levels 3, 4, and 5.

Conclusion

PET/MRI especially helps in the accurate exclusion of findings that are suspicious on PET/CT and MRI, and has the potential to change the clinical management by identifying uncertain neck findings.
The role of living donor liver transplantation in colorectal cancer liver metastases
Authors: Rajendran Luckshi , Sapisochin Gonzalo , Cattral Mark
Published: November 2024

Purpose of review

Despite technical and therapeutic advances, only 20–40% of patients with colorectal liver metastases (CRLM) have resectable disease. Historically, the remaining patients with unresectable, liver-only CRLM would receive palliative chemotherapy, with a median survival of 8 months.

Recent findings

Liver transplantation has emerged as a viable option for selected patients with CRLM. This advancement stems from improved understanding of tumour genomics and biology and better patient selection criteria. The results of recent prospective clinical trials have further ignited enthusiasm for liver transplantation as a viable therapeutic option. Living donor liver transplantation (LDLT) offers several advantages over deceased donor liver transplantation (DDLT) for this disease, including reduced wait-time and optimized timing and coordination of oncologic therapy. On-going LDLT clinical trials have demonstrated favourable outcomes as compared with other liver transplantation indications. However, there is no established consensus or standardization in the implementation of LDLT for CRLM, beyond trials and centre-specific protocols.

LDLT is an excellent therapeutic option in highly selected patients with CRLM. Refining prognostic factors and selection criteria will help to further optimize the utility and broaden the acceptance and implementation of LDLT for patients with CRLM.