bluuebunny/crossref_metadata_2025 huggingface dataset:
A survey of Paediatric Radiology Artificial Intelligence
Authors: Kelly Brendan S , Clifford Simon M , Judge Conor S , Bollard Stephanie M , Healy Gerard M , Hughes Hannah , Colleran Gabrielle C , Rod J.E. , Lee Edward H , Prolo Laura M , Yeom Kristen W , Lawlor Aonghus , Killeen Ronan P
Published: September 2024

Background

Artificial intelligence (AI) applications in paediatric radiology present unique challenges due to diverse anatomy and physiology across age groups. Advancements in AI algorithms, particularly deep learning techniques, show promise in improving diagnostic accuracy.

Objectives

To survey trends in AI research in paediatric radiology. To evaluate use cases, tasks, research methodologies and underlying data. To identify potential biases and future directions.

Methods

A systematic search of paediatric radiology AI studies published from 2015 to 2021 was conducted following the PRISMA guidelines and the Cochrane Collaboration Handbook. The search included papers utilizing AI techniques for radiological diagnosis or intervention in patients aged under 18. Narrative synthesis was used due to methodological heterogeneity.

Results

A total of 292 articles were included, with an increasing annual trend in the number of published articles. Neuroradiology and musculoskeletal radiology were the most common subspecialties. MRI was the dominant imaging modality, with segmentation and classification as the most common tasks. Retrospective cohort studies constituted the majority of research designs. Data quality and quantity varied, as did the choice of research design, data sources, and evaluation metrics.

Conclusions

AI literature in paediatric radiology shows rapid growth, with advancements in various subspecialties and tasks. However, potential biases and data quality issues highlight the need for rigorous research design and evaluation to ensure the generalisability and reliability of AI models in clinical practice. Future research should focus on addressing these biases and improving the robustness of AI applications in paediatric radiology.
COVID-19 prevention with alternate vaccine boosting frequencies for multiple-sclerosis patients undergoing therapy with beta-interferon, dimethyl fumarate, natalizumab, or teriflunomide
Authors: Dornburg Alex , Hassler Hayley B. , Townsend Jeffrey P.
Published: September 2024

Multiple-sclerosis patients undergoing treatment with disease-modifying therapies exhibit diverse immune responses to COVID-19 vaccinations. However, guidance on how specific treatments influence infection risks and optimal vaccination schedules remains limited. This study integrates data on vaccine-induced and infection-derived antibody responses to predict cumulative probabilities of breakthrough infections in untreated multiple-sclerosis patients and those treated with interferon, dimethyl fumarate, natalizumab, or teriflunomide. Using antibody dynamics and augmented logistic regression models, we evaluated the effectiveness of different Pfizer-BioNTech BNT162b2 booster schedules.

Our findings reveal that annual boosters effectively reduce infection risks for untreated multiple-sclerosis patients, lowering their cumulative risk by more than half over two years. Among treated patients, booster vaccinations generally provide protection comparable to that of untreated patients, although treatment-specific variations in immunity are evident. For patients on interferon, annual boosters yield an even greater reduction in risk. Patients treated with dimethyl fumarate or natalizumab benefit significantly from boosters, though they experience moderately higher risks compared to untreated patients.

This study underscores the importance of tailored booster schedules for MS patients, taking into account disease-modifying-therapy-specific effects on immunity. Our analysis provides actionable insights for mitigating SARS-CoV-2 risks in this vulnerable population until broader long-term infection data are available. These findings aim to guide clinicians in optimizing care for multiple-sclerosis patients in the context of ongoing COVID-19 vaccination strategies.

Practice Points

Tailor Booster Schedules:Annual COVID-19 boosters are recommended for untreated MS patients and those on interferon, dimethyl fumarate, natalizumab, or teriflunomide; Bi-annual boosters would further reduce infection risk.

Address Risks for Immunosuppressed Patients:For patients on highly immunosuppressive treatments (e.g., fingolimod, ocrelizumab, rituximab), recognize diminished vaccine efficacy and consider supplemental measures for risk mitigation.

Promote Booster Adherence and Education:Encourage timely booster adherence and educate patients on the benefits of tailored vaccination schedules, while keeping in mind the potential antiviral properties of specific therapies.
Secular trends of incidence and prevalence of parkinsonism and subtypes: A cohort study in the United Kingdom
Authors: Chen Xihang , Barclay Nicola L. , Pineda-Moncusí Marta , Sabaté Martí Català , Molina-Porcel Laura , Man Wai Yi , Delmestri Antonella , Prieto-Alhambra Daniel , Jödicke Annika M. , Newby Danielle
Published: September 2024

Background

While summarized under the umbrella term “Parkinsonism”, several subtypes with different etiologies exist, including Parkinson’s Disease, Vascular Parkinsonism and Drug-induced Parkinsonism. However, evidence on their incidence and prevalence remains limited.

Objectives

To evaluate secular trends of incidence and prevalence of parkinsonism, Parkinson’s Disease, Vascular Parkinsonism, and Drug-induced Parkinsonism from 2007 to 2021 in the United Kingdom.

Methods

We used primary care data, Clinical Practice Research Datalink GOLD, from the United Kingdom. Individuals were included if they were registered from January 2007 to December 2021 with at least one year of prior observation. Incidence and prevalence were calculated on a yearly basis with 95% confidence intervals and then stratified by age and sex.

Results

From 2007 to 2019, the incidence of parkinsonism and Parkinson’s Disease decreased, with Parkinson’s Disease incidence dropping from 35.86 (95% confidence interval: 34.22 – 37.56) to 31.40 (29.40 – 33.50) per 100,000 person-years. The prevalence of parkinsonism and Parkinson’s Disease increased from 0.22% (0.22% - 0.23%) and 0.21% (0.21% - 0.22%) in 2007 to peak in 2016 with 0.25% (0.25% - 0.26%) and 0.23% (0.23% - 0.24%) respectively. The number of Vascular Parkinsonism diagnoses have increased from 2010, whereas incidence and prevalence of Drug-induced Parkinsonism remained stable. Incidence and prevalence increased with age and were generally higher in males, except for Drug-induced Parkinsonism, which was slightly higher in females.

Conclusions

Given its association with aging, parkinsonism and these subtypes continue to present an increasing challenge to our aging society.
RiskPath: Explainable deep learning for multistep biomedical prediction in longitudinal data
Authors: de Lacy Nina , Ramshaw Michael , Lam Wai Yin
Published: September 2024

Highlights

Many diseases are increasingly conceptualized as multifactorial, progressive processes

Robust prediction of progressive disease courses can advance risk stratification and treatment targeting

RiskPath provides optimizable timeseries AI to predict progressive disease with longitudinal cohort data

Enhanced explainability and functionality facilitates risk pathway mapping and compact models

The Bigger Picture

Identifying persons at elevated risk for a disease outcome is a key prerequisite for targeting interventions to improve health. Current risk stratification tools for common diseases are aging and achieve only moderate performance. Moreover, many diseases are increasingly recognized to be complex outcomes where individual risk is determined not by a single effect modifier but by time-dependent interactions among many contributory factors over the lifecourse. There is an urgent need to improve individual-level prediction for progressive diseases and understand how multifactorial risks interact over time so that risk stratification and accompanying prevention and intervention strategies can be targeted earlier and more effectively in the disease course.

Many diseases are the end outcomes of multifactorial risks that interact and increment over months or years. Timeseries AI methods have attracted increasing interest given their ability to operate on native timeseries data to predict disease outcomes. Instantiating such models in risk stratification tools has proceeded more slowly, in part limited by factors such as structural complexity, model size and explainability. Here, we present RiskPath, an explainable AI toolbox that offers advanced timeseries methods and additional functionality relevant to risk stratification use cases in classic and emerging longitudinal cohorts. Theoretically-informed optimization is integrated in prediction to specify optimal model topology or explore performance-complexity tradeoffs. Accompanying modules allow the user to map the changing importance of predictors over the disease course, visualize the most important antecedent time epochs contributing to disease risk or remove predictors to construct compact models for clinical applications with minimal performance impact.
Combining evidence from human genetic and functional screens to identify pathways altering obesity and fat distribution
Authors: Baya Nikolas A. , Sur Erdem Ilknur , Venkatesh Samvida S. , Reibe Saskia , Charles Philip D. , Navarro-Guerrero Elena , Hill Barney , Lassen Frederik Heymann , Claussnitzer Melina , Palmer Duncan S. , Lindgren Cecilia M.
Published: September 2024

Overall adiposity and body fat distribution are heritable traits associated with altered risk of cardiometabolic disease and mortality. Performing rare variant (minor allele frequency<1%) association testing using exome-sequencing data from 402,375 participants in the UK Biobank (UKB) for nine overall and tissue-specific fat distribution traits, we identified 19 genes where putatively damaging rare variation associated with at least one trait (Bonferroni-adjustedP<1.58×10-7) and 52 additional genes at FDR≤1% (P≤4.37×10-5). These 71 genes exhibited higher (P=3.58×10-18) common variant prioritisation scores than genes not significantly enriched for rare putatively damaging variation, with evidence of monotonic allelic series (dose-response relationships) among ultra-rare variants (minor allele count≤10) in 22 genes. Five of the 71 genes have cognate protein UKB Olink data available; all five associated (P<3.80×10-6) with three or more analysed traits. Combining rare and common variation evidence, allelic series and proteomics, we selected 17 genes for CRISPR knockout in human white adipose tissue cell lines. In three previously uncharacterised target genes, knockout increased (two-sidedt-testP<0.05) lipid accumulation, a cellular phenotype relevant for fat mass traits, compared to Cas9-empty negative controls:COL5A3(fold change [FC]=1.72,P=0.0028),EXOC7(FC=1.35,P=0.0096), andTRIP10(FC=1.39,P=0.0157); furthermore, knockout ofSLTMresulted in reduced lipid accumulation (FC=0.51,P=1.91×10-4). Integrating across population-based genetic andin vitrofunctional evidence, we highlight therapeutic avenues for altering obesity and body fat distribution by modulating lipid accumulation.
Hypothalamic Gliosis is Associated With Multiple Cardiovascular Disease Risk Factors
Authors: Lo Justin , Melhorn Susan J , Kee Sarah , Olerich Kelsey LW , Huang Alyssa , Yeum Dabin , Beiser Alexa , Seshadri Sudha , De Carli Charles , Schur Ellen A
Published: September 2024

Background

Hypothalamic gliosis is mechanistically linked to obesity and insulin resistance in rodent models. We tested cross-sectional associations between radiologic measures of hypothalamic gliosis in humans and clinically relevant cardiovascular disease risk factors, as well as prevalent coronary heart disease.

Methods

Using brain MRI images from Framingham Heart Study participants (N=867; mean age, 55 years; 55% females), T2 signal intensities were extracted bilaterally from the region of interest in the mediobasal hypothalamus (MBH) and reference regions in the amygdala (AMY) and putamen (PUT). T2 signal ratios were created in which greater relative T2 signal intensity suggests gliosis. The primary measure compared MBH to AMY (MBH/AMY); a positive control ratio (MBH/PUT) also assessed MBH whereas a negative control (PUT/AMY) did not. Outcomes were BMI, HDL-C, LDL-C, fasting triglycerides, and the presence of hypertension (n=449), diabetes mellitus (n=66), metabolic syndrome (n=254), or coronary heart disease (n=25). Dietary risk factors for gliosis were assessed in a prospective analysis. Statistical testing was performed using linear or logistic regression.

Results

Greater MBH/AMY T2 signal ratios were associated with higher BMI (β = 21.5 [95% CI, 15.4– 27.6];P<0.001), higher fasting triglycerides (β = 1.1 [95% CI, 0.6–1.7];P<0.001), lower HDL-C (β = –20.8 [95% CI, –40.0 to –1.6];P=0.034), and presence of hypertension (odds ratio, 1.2 [95% CI, 1.1–1.4];P=0.0088), and the latter two were independent of BMI. Findings for diabetes mellitus were mixed and attenuated by adjusting for BMI. Metabolic syndrome was associated with MBH/AMY T2 signal ratios (odds ratio, 1.3 [95% CI, 1.1–1.6];P<0.001). Model results were almost uniformly confirmed by the positive control ratios, whereas negative control ratios that did not test the MBH were unrelated to any outcomes (allP≥0.05). T2 signal ratios were not associated with prevalent coronary heart disease (allP>0.05), but confidence intervals were wide. Self-reported percentages of macronutrient intake were not consistently related to future T2 signal ratios.

Conclusions

Using a well-established study of cardiovascular disease development, we found evidence linking hypothalamic gliosis to multiple cardiovascular disease risk factors, even independent of adiposity. Our results highlight the need to consider neurologic mechanisms to understand and improve cardiometabolic health.
High Seroprevalence toAedes-borne arboviruses in Ethiopia: a Cross-sectional Survey in 2024
Authors: Parker Daniel M. , Haileselassie Werissaw , Hailemariam Temesgen Sisay , Workenh Arsema , Workineh Salle , Wang Xiaoming , Lee Ming-Chieh , Yan Guiyun
Published: September 2024

Aedes-borne diseases infect millions of people each year. In the last decade several arbovirus outbreaks have been reported in Ethiopia. Arbovirus diagnosis and surveillance is lacking and the true burden is unknown. In this study we conducted a seroprevalence survey using a commercially available test kit that that tests for immunological responses to IgM and IgG for dengue (DENV), Zika (ZIKV), and chikungunya (CHIKV) viruses in Dire Dawa city, eastern Ethiopia. We found a high IgG seroprevalence for DENV (76%), CHIKV (44%), and ZIKV (38%), and <20% IgM seropositivity across all viruses. As a comparison, we conducted serosurveillance in Addis Ababa, the national capital with no reported history of arbovirus outbreaks. The highest seropositivity we found was to IgM for DENGV at approximately 3%. Our results suggest both past and recent widespread exposure to these arboviruses, underscoring the need for improved surveillance and public health interventions in Ethiopia.
End Stage Kidney Disease in Cystic Fibrosis
Authors: Stevanovic Mirjana , MacKenzie Todd A , Zimmerman Asha , Graber Martha L
Published: September 2024

Background

Cystic fibrosis (CF) is a multisystem autosomal recessive disease caused by mutations in the cystic fibrosis transduction regulator (CFTR). The CFTR is expressed in all renal tubular segments. Tubular functional abnormalities as well as renal histologic changes are recognized in people with cystic fibrosis (CF). Chronic kidney disease (CKD) occurs in CF at greater frequency than in the non-CF population. The prevalence and characteristics of end stage kidney disease (ESKD) in the cystic fibrosis population have not previously been described.

Methods

We used data supplied by the US Renal Data System (USRDS) to compare persons with ESKD and CF with those with ESKD who did not have a diagnosis of CF. We used linear and logistic regression, propensity score-matched Kaplan-Meier survival curves, and log-rank tests.

Results

The prevalence of ESKD was approximately thirty times higher than predicted in the general US population. Diabetes was more frequently a diagnosis in people with CF, but was approximately half as frequently the primary cause of ESKD than in those without CF. Complications of transplantation, particularly of lung, were rarely the cause of ESKD in those without CF but were the second most frequent etiology of ESKD in people with CF. Drugs and medications, interstitial nephritis and acute kidney injury (AKI) were more frequent primary causes in those with CF. Hypertension, cystic kidney disease, and glomerulonephritis were less frequent in those with CF. Mortality and survival with ESKD were not significantly different between those with CF and ESKD and those with ESKD who did not have CF. Diabetes mellitus and complications of lung transplantation as the primary cause of ESKD, but not lung transplant status, were associated with significantly shorter survival with ESKD in people with CF.

Conclusions

People living with CF have a markedly higher prevalence of ESKD than the general United States population. The profile of primary causes of ESKD differed significantly from that of the non-CF population. Diabetes mellitus was approximately half as frequently the primary cause of ESKD in those with CF. Complications of solid organ transplant, particularly lung, were the second most frequent primary cause of ESKD in people with CF. Survival with ESKD was not significantly different between those who did and did not have CF. The diagnosis of diabetes mellitus, and complications of lung transplantation as the primary cause of ESKD, but not lung transplant status, were associated with significantly shorter survival with ESKD in people with CF. It is our aim that these findings will promote awareness of kidney disease in persons living with CF and will encourage prevention of acute kidney injury (AKI), early detection and intervention in CKD, and preemptive referral to nephrology and transplant centers.
The central response of electroacupuncture for anxiety in people with obesity based on resting-state functional magnetic resonance imaging: a protocol for a randomized, blinded, sham-controlled trial
Authors: Shu Qi , Peng Qiumei , Duan Wenxiu , Zhang Fan , Yu Qing , Cai Ronglin
Published: September 2024

Introduction

Obesity is a problem that is increasing worldwide and anxiety is a major psychological disorder associated with obesity. Electroacupuncture (EA) has been proved to be a feasible treatment for obesity and anxiety respectively in clinical practice. However, to date, there are no data on EA’s effectiveness on anxiety for people with obesity. Therefore, this study aims to evaluate the efficacy and safety of EA for anxiety in people with obesity, and to observe the brain functional status of patients and the intervention effects of EA on brain function by functional magnetic resonance imaging (fMRI).

Methods and analysis

This study is a randomized, blinded, sham-controlled and clinical trial. 72 obesity patients from two hospitals with anxiety will be randomly divided into EA group and control group in 1:1 ratio by using a random number table. Patients in EA group will receive EA treatment at specific acupoints with penetrating needling for 8 weeks. The control group will receive Park’s acupuncture with non- penetrating needling. Weight, waist, BMI (Body Mass Index), SAS (Self-rating Anxiety Scale), STAI (State-Trait Anxiety Inventory) and PSQI (Pittsburgh Sleep Quality Index) will be performed before, after 8-week treatments and at one-month follow-up in patients. Objective metabolic parameters such as triglyceride, total cholesterol, fasting blood glucose, ghrelin, leptin, cortisol and adrenocorticotropic hormone will also be detected before and after 8-week intervention. 20 patients will be randomly selected from EA group and control group, respectively, before treatment, and 20 paired healthy participants will be recruited at the same time. The 20 patients will be scanned by fMRI before and after treatment while the other 20 healthy participants will be scanned only at baseline. Regional homogeneity, amplitude of low-frequency fluctuation and resting-state-functional-connectivity will be carried out to compare the dysfunctional brain regions between patients and healthy participants, as well as the differences between two groups of patients after treatment.

Ethics and dissemination

The study protocol has been approved by the Hospital Ethics Committee of Second Affiliated Hospital of Anhui University of Chinese Medicine (2023-zj-42). Informed consent will be obtained prior to starting study- ralated procedures. The results will be disseminated in peer-reviewed journals and at scientific conferences.

Trail Registration number

Chinese Clinical Trail Registry. ChiCTR2400083594, registered 29 April 2024.
The potential global impact and cost-effectiveness of next-generation influenza vaccines: a modelling analysis
Authors: Goodfellow Lucy , Procter Simon R , Koltai Mihaly , Waterlow Naomi R , Filipe Johnny A N , Wong Carlos K H , van Leeuwen Edwin ,   WHO Technical Advisory Group for the Full Value of Influenza Vaccines Assessment, Eggo Rosalind M , Jit Mark
Published: September 2024

Background

Next-generation influenza vaccines (NGIVs) are in development and have the potential to achieve greater reductions in influenza burden, with resulting widespread health and economic beneﬁts. Understanding the prices at which their market can be sustained and which vaccination strategies may maximise impact and cost-effectiveness, particularly in low- and middle-income countries, can provide a valuable tool for vaccine development and investment decision-making at a national and global level. To address this evidence gap, we projected the health and economic impact of NGIVs in 186 countries and territories.

Methods and Findings

We inferred current influenza transmission parameters from World Health Organization (WHO) FluNet data in regions deﬁned by their transmission dynamics, and projected thirty years of influenza epidemics, accounting for demographic changes. Vaccines considered included current seasonal vaccines, vaccines with increased efficacy, duration, and breadth of protection, and universal vaccines, deﬁned in line with the WHO Preferred Product Characteristics. We estimated cost-effectiveness of different vaccination scenarios using novel estimates of key health outcomes and costs.

NGIVs have the potential to substantially reduce influenza burden: compared to no vaccination, vaccinating 50% of children aged under 18 annually prevented 1.3 (95% uncertainty range (UR): 1.2-1.5) billion infections using current vaccines, 2.6 (95% UR: 2.4-2.9) billion infections using vaccines with improved efficacy or breadth, and 3.0 (95% UR: 2.7-3.3) billion infections using universal vaccines. In many countries, NGIVs were cost-effective at higher prices than typically paid for existing seasonal vaccines. However, cross-subsidy may be necessary for improved vaccines to be cost-effective in lower income countries.

This study is limited by the availability of accurate data on influenza incidence and influenza-associated health outcomes and costs. Furthermore, the model involves simplifying assumptions around vaccination coverage and administration, and does not account for societal costs or budget impact of NGIVs. How NGIVs will compare to the vaccine types considered in this model when developed is unknown. We conducted sensitivity analyses to investigate key model parameters.

Conclusions

This study highlights the considerable potential health and economic beneﬁts of NGIVs, but also the variation in cost-effectiveness between high-income and low- and middle-income countries. This work provides a framework for long-term global cost-effectiveness evaluations, and contributes to a full value of influenza vaccines assessment to inform recommendations by WHO, providing a pathway to developing NGIVs and rolling them out globally.
Population-level Impact of HPV Vaccination On the Incidence of Genital Warts in Sweden
Authors: Astorga Alsina Ana Martina , Herweijer Eva , Lei Jiayao
Published: September 2024

Background

Sweden introduced HPV vaccination in 2006, administered through opportunistic, subsidized, catch-up and school-based programs. Notably, genital warts (GW) are the first observable clinical outcome following infection by HPV-6/11, targeted by vaccination. We aim to gain knowledge of the population incidence of GW in Sweden and evaluate its change throughout vaccination programs.

Methods

This ecological study used Swedish registers to obtain national population data and cases of genital warts from 2006-2018 in men and women aged 15-44. We used Poisson models to evaluate GW incidence change after vaccination in reference to a pre-vaccination period, stratified by age and sex. As well as, to estimate incidence change of GW in birth cohorts eligible for different vaccination programs compared to a pre-vaccination cohort. Finally, we estimated GW cases averted in each vaccinated cohort.

Results

The incidence of GW decreased during periods following HPV vaccination. In 2016-2018, over a decade after vaccination availability, incidence decreased by 89% (95% CI 83-93), 73% (95% CI 71-75), 50% (95% CI 43-56) and 20% (95% CI 10-28) in women aged 15-19, 20-24, 25-29 and 30-34, respectively. A similar reduction was observable in men, although of lesser magnitude. We estimated 18,890 and 12,343 GW cases averted among vaccinated cohorts of women and men, respectively.

Conclusions

We report on population-level decreases of GW incidence in women and men following increased vaccination coverage. Cohorts eligible for school-based vaccination recorded the largest decrease in GW incidence in Sweden to date. For the period under study, decreases among men could be attributed to herd effects.
Effectiveness of Antimicrobial Photodynamic Therapy Versus Doxycycline in the Treatment of Periodontitis on Glycaemic Control and Periodontal Parameters in Adults with Type 2 Diabetes Mellitus
Authors: Abbott Maisie , Mackenzie Louise
Published: September 2024

Background

This meta-analysis aimed to compare the efficacy of antimicrobial photodynamic therapy (aPDT) with systemic doxycycline, as adjunctive treatments to scaling and root planing (SRP) for treating periodontitis in patients with type 2 diabetes mellitus (T2DM).

Methods

A search across electronic databases including PubMed, Scopus, CENTRAL, OVID EMBASE and OVID MEDLINE was carried out to identify relevant randomised controlled trials (RCTs), comparing aPDT or doxycycline combined with SRP, versus SRP alone. Data were pooled using random-effects models and indirect comparisons were retrieved using the Chi2 test for subgroup differences, to assess the impact of these treatments on glycated haemoglobin (HbA1c), probing depth (PD), and clinical attachment level (CAL).

Results

Eight RCTs were included. aPDT with SRP showed a significant reduction in probing depth compared to doxycycline (MD = -0.55 mm, 95% CI: -1.03 to -0.07; p = 0.02). A significant difference between the two subgroups was found (p = 0.04), suggesting aPDT was more effective. No significant differences were found for HbA1c or CAL between the two interventions.

Conclusions

The findings suggest that aPDT may offer greater benefits for the treatment of periodontitis in T2DM patients. This suggests that aPDT could potentially be a non-antibiotic alternative to doxycycline. However, as neither treatment influenced HbA1c, clinicians should not rely on periodontal therapy for glycaemic control.

Layperson summary

People with type 2 diabetes have a higher risk of getting gum disease because their bodies can’t manage blood sugar levels well. When people with type 2 diabetes get gum disease, the swelling in their gums makes it even harder to control their blood sugar levels, making their diabetes worse. Type 2 diabetics sometimes don’t respond well to regular gum treatments so dentists will also give them antibiotics to treat the gum disease. But when antibiotics are used too often, they can stop working. This is called antibiotic resistance and it’s a big problem in healthcare. Therefore, this study wanted to test if adding a special light therapy to regular gum treatments could replace using antibiotics. The results from this study found that the light therapy was better at healing parts of the gums compared to antibiotics. However, neither treatment made a big difference in blood sugar levels. This is important because it means that the light therapy could replace antibiotics for treating gum disease, reducing the problem of antibiotic resistance. However, more research is needed to see if these treatments could have any beneficial effect on blood sugar levels.
A Deep Learning Based Smartphone Application for Early Detection of Nasopharyngeal Carcinoma Using Endoscopic Images
Authors: Yue Yubiao , Zeng Xinyu , Lin Huanjie , Xu Jialong , Zhang Fan , Zhou KeLin , Li Li , Li Zhenzhang
Published: September 2024

Nasal endoscopy is crucial for the early detection of nasopharyngeal carcinoma (NPC), but its accuracy relies significantly on the physician’s expertise, posing challenges for primary healthcare providers. Here, we retrospectively analysed 39,340 nasal endoscopic white-light images from three high-incidence NPC centres, utilising eight advanced deep learning models to develop an Internet-enabled smartphone application, “Nose-Keeper”, that can be used for early detection of NPC and five prevalent nasal conditions and assessment of healthy individuals. Our App demonstrated a remarkable overall accuracy of 92.27% (95% Confidence Interval (CI): 90.66%-93.61%). Notably, its sensitivity and specificity in NPC detection achieved 96.39% and 99.91%, respectively, outperforming nine experienced otolaryngologists. Explainable artificial intelligence was employed to highlight key lesion areas, improving Nose-Keeper’s decision-making accuracy and safety. Nose-Keeper can assist primary healthcare providers in diagnosing NPC and related diseases efficiently, offering a valuable resource for people in high-incidence NPC regions to manage nasal cavity health effectively.
Increased atherogenicity in mood disorders: a systematic review, meta-analysis and meta-regression
Authors: Jirakran Ketsupar , Almulla Abbas F. , Jaipinta Thapanee , Vasupanrajit Asara , Jansem Priabprat , Tunvirachaisakul Chavit , Dzhambazova Elizabet , Stoyanov Drozdstoj St. , Maes Michael
Published: September 2024

Background

Major depressive disorder (MDD) and bipolar disorder (BD) often coexist with metabolic syndrome. Both are linked to increased atherogenicity and a higher risk of cardiovascular diseases.

Objectives

This meta-analysis seeks to evaluate the relationship between atherogenic indices and mood disorders (MDD/BD), while identifying the most effective atherogenic biomarkers for mood disorders.

Methods

This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched electronic databases, including PubMed, Google Scholar, and Web of Science, for articles published up to August 1, 2024.

Results

In this meta-analysis, 85 eligible studies (14 on BD and 71 on MDD) were included, covering 70,856 participants: 18,738 patients and 52,118 healthy controls. Patients with mood disorders showed significant increases (p < 0.001) in the Castelli Risk Index 2 (CRI2), Atherogenic Index of Plasma (AIP), and (triglyceride or TG + low-density lipoprotein + very low-density lipoprotein)/(high-density lipoprotein cholesterol or HDL + Apolipoprotein A or ApoA) ratio, but not CRI1 and ApoB/ApoA ratio. Significant lower HDL and lecithin: cholesterol acyltransferase activity, and higher TG levels were observed in mood disordered patients compared with controls. There were no significant differences between MDD and BD patients. Most included studies lacked the most essential information on the inclusion and exclusion of important confounders.

Conclusions

AIP is the most effective atherogenicity index for mood disorders. Regular lipid profiling and metabolic syndrome screening are crucial in mood disorders. Early intervention with lipid-lowering therapies is recommended to prevent the worsening of atherogenicity and disease progression.
Acute psilocybin and ketanserin effects on cerebral blood flow: 5-HT2AR neuromodulation in healthy humans
Authors: Larsen Kristian , Lindberg Ulrich , Ozenne Brice , McCulloch Drummond E. , Armand Sophia , Madsen Martin K. , Johansen Annette , Stenbæk Dea S. , Knudsen Gitte M. , Fisher Patrick M.
Published: September 2024

Psilocin, the active metabolite of psilocybin, is a psychedelic and agonist at the serotonin 2A receptor (5-HT2AR) that has shown positive therapeutic effects for brain disorders such as depression. To elucidate the brain effects of psilocybin, we directly compared the acute effects of 5-HT2AR agonist (psilocybin) and antagonist (ketanserin) on cerebral blood flow (CBF) using pseudo-continuous arterial spin labelling magnetic resonance imaging (MRI) in a single-blind, cross-over study in 28 healthy participants. We evaluated associations between plasma psilocin level (PPL) or subjective drug intensity (SDI) and CBF. We also evaluated drug effects on internal carotid artery (ICA) diameter using time-of-flight MRI angiography. PPL and SDI were significantly negatively associated with regional and global CBF (∼11.5% at peak drug effect, p<0.0001). CBF did not significantly change following ketanserin (2.3%, p=0.35). Psilocybin induced a significantly greater decrease in CBF compared to ketanserin in the parietal cortex (pFWER<0.0001). ICA diameter was significantly decreased following psilocybin (10.5%, p<0.0001) but not ketanserin (−0.02%, p=0.99). Our data support an asymmetric 5-HT2AR modulatory effect on CBF and provide the first in vivo human evidence that psilocybin constricts the ICA, which has important implications for understanding the neurophysiological mechanisms underlying its acute effects.
Social media use and exposure to pro-tobacco content: a comparison of sexual identity and gender in young adults in California
Authors: Ganz Ollie , Gonsalves Nishi J. , Talbot Eugene M. , Donaldson Scott I. , Jeong Michelle , Allem Jon-Patrick
Published: September 2024

Introduction

Given the rapidly changing media landscape and tobacco marketplace, timely data on media consumption and exposure to pro-tobacco content across media channels among lesbian, gay, and bisexual (LGB) young adults is imperative for developing counter-messaging and public education campaigns for these individuals.

Methods

Using 2023 data from young adults in California, this study examined how social media use differed across media channels for heterosexual and LGB young adults, by gender identity. Exposure to pro-tobacco content across media channels between heterosexual and LGB young adults, by gender identity was also compared.

Results

Findings from a representative sample of young adults in California showed that more LGB young adults reported using Tumblr and fewer reported using Facebook and Snapchat, compared with heterosexual young adults, among both males and females. Additionally, social media use differed by gender identity. For example, use of Reddit was more common among LGB versus heterosexual females, but there were no differences by sexual identity among males. Exposure to tobacco marketing was more common among LGB females compared with heterosexual females, but this was not the case for males. Exposure to user-generated e-cigarette content, and self-reported visits to e-cigarette websites, were more common among LGB females compared to heterosexual females.

Conclusions

These findings highlight the importance of treating LGB individuals as a heterogeneous group. As such, anti-tobacco campaigns designed for LGB individuals that leverage social media will want to consider which social media platforms are most used among their target audience, ensuring maximum campaign reach.
Comprehensive Analysis of Therapeutic Strategies Using Mesenchymal Stem Cell-Derived Exosomes in Preclinical Models of Osteoarthritis
Authors: Mukherjee Riya , Pandey Ramendra Pati , Gunjan  , Himanshu  , Wang Ing-Kae , Hsieh Sing-Ying , Chang Chung-Ming
Published: September 2024

Background

Osteoarthritis (OA) is a common degenerative disease affecting people and animals, resulting in persistent pain and joint deformities. Its growing prevalence presents considerable difficulties to public health and veterinary care systems worldwide. Despite substantial research, the molecular pathways underlying OA pathogenesis remain poorly understood, limiting the development of effective treatment strategies. Exosomes, or small endosomal membrane microvesicles, have emerged as intriguing vehicles for intercellular communication and medicinal administration in a variety of illnesses, including OA. However, their efficacy and action methods in preclinical OA models require additional exploration.

Methods

We analyzed several databases from 2016 to 2023 for original studies on exosome treatment in preclinical OA models. The inclusion criteria included studies that used exosomes generated from mesenchymal stem cells (MSCs) in both human and animal models of OA. Thematic synthesis and data extraction were used to examine research features, dosage administration techniques, and efficacy results. The quality of included studies was assessed using recognized criteria, and statistical analysis was performed to determine the efficacy of exosome treatment in decreasing Osteoarthritis Research Society International (OARSI) scores.

Results

Our study comprised thirteen peer-reviewed articles that included both human and animal models of OA. Most trials used bone marrow MSC-derived exosomes administered intra-articularly. The analysis of OARSI scores revealed a considerable reduction in joint deterioration following exosome therapy. Source analysis demonstrated that exosome treatment originating from human and animal MSCs was consistently effective. However, an assessment of study quality revealed potential biases and limitations, emphasizing the need for more research to validate these findings and refine therapy options for OA management.

Abstract Figure

Graphical Abstract
Self-reported health 50 years later among Children and Adolescents who experienced The Scorched Earth tactics in Finnmark county, Norway, in World War II, 1944/45
Authors: Pedersen Marit , Alsaker Elin , Lund Eiliv
Published: September 2024

Background

Most of Finnmark county in Norway was burned down during World War II by the German troops on order from Hitler, the scorched earth tactic. More than 50 000 were evacuated, but 23 000 disobeyed and stayed the winter 1944/45 in caves, turf huts and underneath boats. The purpose of this study was to examine among those being children and adolescents at that time, the effect of place of residence, nutrition and self-reported health consequences of wartime experiences on current self-reported health 50 years later.

Material and methods

In connection with the cardio-vascular screening study in Finnmark 1996/97 nine questions regarding health status and experiences during World War II were included in a questionnaire. Altogether 3.471 persons born between 1925 and 1944 responded to the questions: 64% response rate. The dependant variables in the analysis were current self-reported health.

Results

In a multivariate analysis those who reported reduction in health due to the war had a higher risk of having poor self-reported health at time of screening; OR=2.7 (95% confidence interval 2.1-3.5). Place of residence 1944/45 in Finnmark was a borderline significant risk factor, while lack of food was associated with reduced self-reported health.

Conclusion

Despite the long period of time between World War II and the present screening, a relation between the experience from the war and having a poor self-evaluated health status today was found. The study indicates long-term health consequences of warfare on the civilian population, but due to the cross-sectional design further prospective studies are necessary.
Recommendations on surveillance for recurrence in asymptomatic patients following surgery in 16 common cancer types: a systematic review
Authors: Harrison Hannah , Shah Bhumi K. , Khan Faris , Batley Carley , Re Chiara , Rossi Sabrina H. , Stimpson Georgia , Gilmore Eamonn , White Ellie , Kler-Sangha Sofia , Espressivo Aufia , Pan Z. Sienna , Rujedawa Tanzil , Lamb Benjamin W. , Succony Laura , Lam Shi , Zacharia Bincy M. , Lucey Rebecca , Fulton Alexander J. P. , Kaludova Dimana , Balakrishnan Anita , Usher-Smith Juliet A. , Stewart Grant D.
Published: September 2024

Objectives

To identify and compare guidelines which make recommendations surveillance for the detection of recurrence for 16 common solid cancers after initial treatment with curative intent in asymptomatic patients.

Design

We conducted a systematic review, combining search results from two electronic databases (MEDLINE, EMBASE) and one guideline organisation website (NICE), as well as using expert consultation and manual searching. Screening and data extraction were carried out by multiple reviewers. We collected data from each guideline on the recommendations for surveillance and the use of risk-stratification. Findings were compared between cancer types and regions. Text mining was used to extract statements commenting on the evidence for surveillance.

Results

We identified 123 guidelines across 16 cancer types. Almost all guidelines (n=115, 93.5%) recommend routine surveillance for recurrent disease in asymptomatic patients after initial treatment. Around half (n=59, 51.3%) recommend indefinite or lifelong surveillance. The most common modality of surveillance was cross-sectional imaging. Risk-stratification of the frequency, length, and mode of surveillance was widespread, with most of the guidelines (n=92, 74.8%) recommending that surveillance be adapted based on assessment of patient risk. More than a third of the included guidelines (n=50, 39.0%) provided incomplete or vague recommendations about surveillance. For fourteen of the included cancers, we found statements in the guidelines indicating that there is no evidence that surveillance improves survival.

Conclusions

Although specific details of follow-up schedules vary, common challenges were identified across the 16 included cancer types. These include heterogeneity between recommendations for the same cancer type, vague or non-specific recommendation and a lack of cited evidence to support use of surveillance to improve outcomes for patients. Challenges in generating evidence in this area remain, however, increased availability to linked health records may provide a way forward for researchers.

Registration

Protocol published on PROSPERO in 2021 (ID: CRD42021289625)
MRISeqClassifier: A Deep Learning Toolkit for Precise MRI Sequence Classification
Authors: Pan Jinqian , Chen Qi , Sun Chengkun , Liang Renjie , Bian Jiang , Xu Jie
Published: September 2024

Magnetic Resonance Imaging (MRI) is a crucial diagnostic tool in medicine, widely used to detect and assess various health conditions. Different MRI sequences, such as T1-weighted, T2-weighted, and FLAIR, serve distinct roles by highlighting different tissue characteristics and contrasts. However, distinguishing them based solely on the description file is currently impossible due to confusing or incorrect annotations. Additionally, there is a notable lack of effective tools to differentiate these sequences. In response, we developed a deep learning-based toolkit tailored for small, unrefined MRI datasets. This toolkit enables precise sequence classification and delivers performance comparable to systems trained on large, meticulously curated datasets. Utilizing lightweight model architectures and incorporating a voting ensemble method, the toolkit enhances accuracy and stability. It achieves a 99% accuracy rate using only 10% of the data typically required in other research. The code is available athttps://github.com/JinqianPan/MRISeqClassifier.
Bibliometric Analysis of Perioperative Organ Injury: Insights into the State of Basic Science Research
Authors: Wang Jinlian , Li Hui , Ju Changqing , Liang Yafen , Eltzschig Holger , Liu Hongfang
Published: September 2024

Perioperative organ injury represents a significant clinical challenge, leading to severe and often long-term complications for patients undergoing surgery. Despite its critical importance, the basic science underlying these injuries remains underexplored. This study employs bibliometric analysis to assess the research landscape of perioperative organ injury, focusing on key conditions such as myocardial infarction, ischemia-reperfusion injury, heart failure, acute respiratory distress syndrome (ARDS), perioperative lung injury, liver ischemia-reperfusion injury, ischemic acute kidney injury, and perioperative stroke. By analyzing publication trends, citation patterns, and research themes, this study aims to provide insights into the current state of basic science research in this field, highlighting gaps and opportunities for future investigations.
An Analysis of Transgender Crowdfunding in the Context of State-Led Anti-Transgender Legislation
Authors: Nagpal Meera , Wang Julia , Mahapatra Anjali , Chintapally Neha , Butler Christi
Published: September 2024

This study investigates the impact of anti-transgender legislation on the use of crowdfunding platforms by transgender and gender diverse (TGD) individuals in the United States. Using data from 349 GoFundMe campaigns created between March and June 2022, we analyzed the reasons for seeking funding and their potential correlation with state-level anti-transgender policies. Our findings reveal that 61% of campaigns originated from states with proposed or enacted anti-transgender legislation, with 19.5% coming from states posing significant barriers to healthcare services for TGD individuals. The most common reasons for crowdfunding included housing (44.7%), living expenses (35.5%), and gender-affirming surgeries (28.1%). Notably, campaigns from anti-transgender states showed a significant correlation with explicitly mentioning hostile state environments (Φ = 0.2843, p < 0.0001) and seeking relocation (Φ = 0.2040, p = 0.0001). These results highlight the profound impact of discriminatory legislation on TGD individuals, forcing many to seek alternative financial support for basic needs and essential medical care. This research underscores the urgent need for more inclusive healthcare policies and support systems for the TGD community.
Online46: online cognitive assessments in elderly cohorts - the British 1946 birth cohort case study
Authors: Cai Ziyuan , Giunchiglia Valentina , Street Rebecca , Giovane Martina Del , Lu Kirsty , Popham Maria , Wong Andrew , Murray-Smith Heidi , Richards Marcus , Crutch Sebastian , Hellyer Peter J. , Schott Jonathan M , Hampshire Adam
Published: September 2024

INTRODUCTION

Online assessments are scalable and cost-effective for detecting cognitive changes, especially in elderly cohorts with limited mobility and higher vulnerability to neurological conditions. However, determining the uptake, adherence, and usability of these assessments in older adults, who may have less experience with mobile devices is crucial.

METHODS

1,776 members (aged 77) of the MRC National Survey of Health and Development (NSHD) were invited to complete 13 online cognitive tasks. Adherence was measured through task compliance, while uptake (consent, attempt, completion) was linked to health and sociodemographic factors. Usability was evaluated through qualitative feedback.

RESULTS

This study’s consent (56.9%), attempt (80.5%), and completion (88.8%) rates are comparable to supervised NSHD sub-studies. Significant predictors of uptake included education, sex, handedness, cognitive scores, weight, smoking, alcohol consumption, and disease burden.

DISCUSSION

With key recommendations followed, online cognitive assessments are feasible, with good adherence, and usability in older adults.