bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy, safety, and molecular response predictors of oral ixazomib and short-course rituximab in untreated iNHL
Authors: Graf Solomon A. , Lynch Ryan C. , Ujjani Chaitra S. , Gooley Ted A. , Rasmussen Heather , Coffey David G. , Cowan Andrew J. , Smith Stephen D. , Shadman Mazyar , Warren Edus H. , Libby Edward N. , Greninger Alexander L. , Fromm Jonathan R. , Gopal Ajay K.
Published: November 2022

Patients with indolent B-cell non-Hodgkin lymphoma (iNHL) generally require treatment but experience normal survival, emphasizing the need for simpler, safer therapies. Proteasome inhibitors target aberrant signaling pathways within iNHL and have manageable toxicities. We evaluated the oral proteasome inhibitor ixazomib as initial monotherapy, and combined with rituximab, for first-line treatment of iNHL. Treatment-naïve patients with iNHL needing therapy received oral ixazomib 4 mg weekly until progressive disease or unacceptable adverse events. A 4-week course of rituximab was added during month 7. The primary end point was overall response rate (ORR) during the ixazomib monotherapy window. Correlations included gene expression profiling and response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Thirty-three patients with follicular lymphoma (FL) (n = 20), marginal zone lymphoma (n = 7), and other iNHL were treated with a median follow-up of 30.3 months. During the 6-month ixazomib window, the ORR was 24%, including 35% in FL. The best ORR over the entire study period was 52% overall and 65% in FL; complete response was achieved in 33% and 45%, respectively. The median duration of response was 25.8 months (range, 0-49.7), and the 24-month progression-free and overall survival rates were 51% (95% confidence interval [CI], 32-67) and 91% (95% CI, 74-97), respectively. Ixazomib was well tolerated. Baseline downregulation of proteasome genes, PSMB9 (P = .03) and PSMB8 (P = .007), were associated with response. All evaluated patients generated anti-S antibodies to SARS-CoV-2 vaccination, with a median of 254.9 binding arbitrary unit per mL. Ixazomib demonstrated efficacy alone and with short-course rituximab in untreated iNHL while exhibiting favorable toxicity, convenience, and retention of the B-cell immune response. This trial is registered at www.clinicaltrials.gov as NCT02339922.
Comparative analysis of detoxification-related gene superfamilies across five hemipteran species
Authors: Volonté Mariano , Traverso Lucila , Estivalis Jose Manuel Latorre , Almeida Francisca Cunha , Ons Sheila
Published: November 2022

Background

Hemiptera is one of the most speciose orders of insects, and the most speciose considering Hemimetabola. Through their evolutive history, hemipterans with different feeding habits have adapted to deal with different chemical challenges. Three major gene families are involved in xenobiotic detoxification in insects: the cytochromes P450 (CYPs), carboxyl/cholinesterases (CCEs), and glutathione transferases (GSTs). Here we perform a comparative analysis on the complement of these gene superfamilies across five hemipteran species; four heteropterans (the pentatomid plant feedersNezara viridulaandHalyomorpha halys; the hematophagousCimex lectularius, Cimicidae, andRhodnius prolixus,Reduviidae), and one Auchenorrhyncha plant feeder (Nilaparvata lugens).

Results

Our results point to an expansion of several enzyme families associated with xenobiotic detoxification in heteropterans with respect to other species and the existence of a dynamic evolution pattern including CYP3 clan, hormone and pheromone processing class in the CCE superfamily, and sigma class in GST superfamily. Other detoxification-related families are reduced in the hemipteran species analyzed here: reduction or even absence of epsilon class and reduced delta class in GST superfamily; absence of mitochondrial CYP12 family; absence of CYP9 family in CYP3 clan; and reduction or even absence of some dietary/detoxification groups of CCEs. Interestingly, the most polyphagous species analyzed here (H. halys) is also the one that presents the largest repertoire of detoxification enzymes. Gene cluster analysis suggests that this could be due to gene duplication events.

Conclusions

The evolutionary analysis performed here reveals characteristics that are both common and particular for heteropterans. The composition and organization of detoxification-related gene families could shed light on evolutionary forces that shaped their divergence. These families are important for both the detoxification of diet products and for conferring tolerance or resistance to synthetic insecticides. Furthermore, we present the first comprehensive analysis of detoxification gene superfamilies inN. viridula, an understudied species in spite of its economic relevance as a crop pest. The information obtained is of interest for basic insect science as well as for the control of harmful species and the management of insecticide resistance.
A risk scoring system for advanced colorectal neoplasia in high-risk participants to improve current colorectal cancer screening in Tianjin, China
Authors: Yuan Zhen , Wang Shuyuan , Liu Zhaoce , Liu Yanfei , Wang Yuqi , Han Youkui , Gao Weifeng , Liu Xinyu , Li Hongzhou , Zhang Qinghuai , Ma Hong , Wang Junying , Wei Xiaomeng , Zhang Xipeng , Cui Wei , Zhang Chunze
Published: November 2022

Background

Given the limited effectiveness of the current Chinese colorectal cancer (CRC) screening procedure, adherence to colonoscopy remains low. We aim to develop and validate a scoring system based on individuals who were identified as having a high risk in initial CRC screening to achieve more efficient risk stratification and improve adherence to colonoscopy.

Methods

A total of 29,504 screening participants with positive High-Risk Factor Questionnaire (HRFQ) or faecal immunochemical test (FIT) who underwent colonoscopy in Tianjin from 2012–2020 were enrolled in this study. Binary regression analysis was used to evaluate the association between risk factors and advanced colorectal neoplasia. Internal validation was also used to assess the performance of the scoring system.

Results

Male sex, older age (age ≥ 50 years), high body mass index (BMI ≥ 28 kg/m2), current or past smoking and weekly alcohol intake were identified as risk factors for advanced colorectal neoplasm. The odds ratios (ORs) for significant variables were applied to construct the risk score ranging from 0–11: LR, low risk (score 0–3); MR, moderate risk (score 4–6); and HR, high risk (score 7–11). Compared with subjects with LR, those with MR and HR had ORs of 2.47 (95% confidence interval, 2.09–2.93) and 4.59 (95% confidence interval, 3.86–5.44), respectively. The scoring model showed an outstanding discriminatory capacity with a c-statistic of 0.64 (95% confidence interval, 0.63–0.65).

Conclusions

Our results showed that the established scoring system could identify very high-risk populations with colorectal neoplasia. Combining this risk score with current Chinese screening methods may improve the effectiveness of CRC screening and adherence to colonoscopy.
A case of ischemic stroke with hemorrhagic transformation associated with essential thrombocythemia and JAK-2 V617F mutation
Authors: Yan Ran , Mi Donghua , Qiu Xin , Li Zixiao
Published: November 2022

Background

Essential thrombocythemia (ET) is a rare cause of stroke. The V617F mutation in the Janus kinase 2 (JAK2) gene is one of the most typical mutations in ET and has been shown to be a risk factor for stroke, especially in younger people. However, to date, there have been few reports of intracranial thrombotic and hemorrhagic complications in patients with ET. Herein, we present a case of JAK2 gene mutation-associated ET in a patient who developed both ischemic and hemorrhagic stroke, and discuss potential underlying mechanisms.

Case presentation

A 45-year-old Chinese male presented to our center with gradually developing weakness of the right limbs for 3 months. A computed tomography scan of the brain showed an area of infarction with hemorrhage in the left subcortical and corona radiata regions. High-resolution magnetic resonance imaging revealed a thrombosis on the surface of the atherosclerotic plaque. Digital subtraction angiography revealed an insect bite-like change in the C1 branch of the left internal carotid artery, which caused up to 50% stenosis. Blood tests showed continued elevation of the platelet and white blood cell counts. After consultation with a hematologist, a bone marrow biopsy was performed, which revealed proliferative bone marrow changes with numerous megakaryocytes and proliferative but mature granulocytes. Further genetic testing revealed a positive JAK2-V617F mutation. Therefore, the diagnosis of ET was confirmed according to the World Health Organization (WHO) 2016 diagnostic criteria. Finally, we decided to administer aspirin and hydroxyurea. The patient remained stroke free and the platelet levels were normal throughout the 1-year follow-up period.

Conclusions

JAK2 mutations affect the proliferation and differentiation of blood cells through the JAK, signal transducer and activator of transcription pathway, which leads to changes in platelets and macrophages, and an increase in neutrophil extracellular traps, which may explain the patient’s ischemic and hemorrhagic changes. Further investigation of the underlying mechanisms may change the treatment strategy for such patients in the future.
Higher reinfection rate after two-stage revision arthroplasty in patients with refractory diabetes mellitus: a retrospective analysis with a minimum ten-year follow up
Authors: Lin Yu-Chih , Lin Yi-Hsuan , Chou Jian-Hong , Lo Yu-Tai , Chang Chih-Hsiang , Lee Sheng-Hsun , Lin Sheng-Hsuan
Published: November 2022

Background

Treatment protocols for two-stage revision arthroplasty with diabetes mellitus (DM) have not yet been established. The control of glycated hemoglobin (HbA1c) in two-stage revision arthroplasty is still debated. This study aimed to clarify the importance of preoperative HbA1c levels before each stage of revision arthroplasty and to analyze the risk factors for reinfection.

Methods

Five hundred eighty-eight patients suffered from first-time PJI and was treated in our institute from January 1994 to December 2010 were reviewed. The mean follow-up time was 13.8 (range, 10.2–24.8) years. Patients underwent two-stage revision arthroplasty with DM at presentation were included. The endpoint of the study was reinfection of the revision arthroplasty. Demographic, survivorship, and surgical variables were also analyzed.

Results

Eighty-eight patients were identified and grouped by HbA1c level before the first stage surgery: Groups 1 and 2 had HbA1c levels < 7% and ≥ 7%, respectively. Reinfection was identified in 4.55% (2/44) and 18.18% (8/44) of the patients in Groups 1 and 2, respectively. Survivorship analysis revealed correction of the HbA1c before the final stage of revision arthroplasty as an independent factor (p < 0.001). The identified risks for reinfection were HbA1c levels ≥ 7% before final-stage surgery, ≥ 3 stages of revision arthroplasty, and extended-spectrum beta-lactamase (ESBL)-Escherichia coli PJI.

Conclusion

The HbA1c level before the final stage of revision arthroplasty could affect staged revision arthroplasty outcomes. Therefore, the necessity of postponing the elective final-stage revision arthroplasty procedure for HbA1c control should be further investigated in the future.
A survey of resident physicians’ perceptions of competency-based education in standardized resident training in China: a preliminary study
Authors: Chen Qi , Li Ming , Wu Na , Peng Xue , Tang GuangMin , Cheng Heng , Hu LiuLing , Yang Bin , Liao ZhongLi
Published: November 2022

Background

Understanding resident physicians’ perceptions of competency-based medical education(CBME) may help improve approaches for implementing such education in standardized resident training (SRT). We conducted surveys of residents in China to identify their perceptions of CBME and determine the degree to which such education impacts their career plans.

Methods

Questionnaire contained a total of 24 questions, which were answered using multiple choice or yes/no, was distributed to residents who were undergoing SRT, regardless of specialty, at 7 accredited training bases located across six provinces of China. The survey aimed to investigate residents’ reasons for participating in SRT, perceptions of CBME, interest in receiving CBME-associated courses, and attitudes towards CBME.

Results

Overall, 441 residents completed the questionnaire.17.7% (78/441) responded “no clear objective” before the participated in SRT. Only 3.9% (17/441) fully understood the objectives, training contents, and assessment system of the current “competency-based” standardized training program for residents in China. Residents ranked clinical skills and patient care, interpersonal communication, and professionalism, as the three most important competencies. Most were interested in the CBME residency programs. 90.7% felt that implementing CBME could help them clarify their professional direction and improve their career planning.

Conclusion

Residents had positive perceptions of the incorporation of CBME into SRT. Administrators, educational leaders, and clinical faculty should seek to further publicize and increase the popularity of CBME.
Automatic ovarian tumors recognition system based on ensemble convolutional neural network with ultrasound imaging
Authors: Hsu Shih-Tien , Su Yu-Jie , Hung Chian-Huei , Chen Ming-Jer , Lu Chien-Hsing , Kuo Chih-En
Published: November 2022

Background

Upon the discovery of ovarian cysts, obstetricians, gynecologists, and ultrasound examiners must address the common clinical challenge of distinguishing between benign and malignant ovarian tumors. Numerous types of ovarian tumors exist, many of which exhibit similar characteristics that increase the ambiguity in clinical diagnosis. Using deep learning technology, we aimed to develop a method that rapidly and accurately assists the different diagnosis of ovarian tumors in ultrasound images.

Methods

Based on deep learning method, we used ten well-known convolutional neural network models (e.g., Alexnet, GoogleNet, and ResNet) for training of transfer learning. To ensure method stability and robustness, we repeated the random sampling of the training and validation data ten times. The mean of the ten test results was set as the final assessment data. After the training process was completed, the three models with the highest ratio of calculation accuracy to time required for classification were used for ensemble learning pertaining. Finally, the interpretation results of the ensemble classifier were used as the final results. We also applied ensemble gradient-weighted class activation mapping (Grad-CAM) technology to visualize the decision-making results of the models.

Results

The highest mean accuracy, mean sensitivity, and mean specificity of ten single CNN models were 90.51 ± 4.36%, 89.77 ± 4.16%, and 92.00 ± 5.95%, respectively. The mean accuracy, mean sensitivity, and mean specificity of the ensemble classifier method were 92.15 ± 2.84%, 91.37 ± 3.60%, and 92.92 ± 4.00%, respectively. The performance of the ensemble classifier is better than that of a single classifier in three evaluation metrics. Moreover, the standard deviation is also better which means the ensemble classifier is more stable and robust.

Conclusion

From the comprehensive perspective of data quantity, data diversity, robustness of validation strategy, and overall accuracy, the proposed method outperformed the methods used in previous studies. In future studies, we will continue to increase the number of authenticated images and apply our proposed method in clinical settings to increase its robustness and reliability.
Longitudinal evolution of motor and non-motor symptoms in early-stage multiple system atrophy: a 2-year prospective cohort study
Authors: Zhang Lingyu , Hou Yanbing , Cao Bei , Wei Qianqian , Ou Ruwei , Liu Kuncheng , Lin Junyu , Yang Tianmi , Xiao Yi , Chen Yongping , Song Wei , Zhao Bi , Shang Huifang
Published: November 2022

Background

The progression of motor and non-motor symptoms (NMS) and the sensitivity of each item of the Unified Multiple System Atrophy Rating Scale (UMSARS) to change remain unclear in Chinese patients with early-stage multiple system atrophy (MSA). We investigated the evolution of motor symptoms and NMS in early-stage MSA and the sensitivity of each item included in the UMSARS to change over a 2-year follow-up.

Methods

Motor symptoms and NMS were recorded at baseline and at 1- and 2-year follow-ups based on the UMSARS and the NMS scale. Generalized estimating equation models were used. The sensitivity of an item included in the UMSARS to change was assessed by calculating a standardized effect using the mean annual change divided by the standard deviation of the change.

Results

We enrolled 246 consecutive patients with MSA and 97 MSA completed the 2-year follow-up. The mean total UMSARS score increased by 11.90 and 22.54 points at the 1- and 2-year follow-ups, respectively. UMSARS-I items associated with motor functions were more sensitive to change and those associated with autonomic dysfunction showed less sensitivity to change. Items 4 (tremor at rest), 5 (action tremor), and 3 (ocular motor dysfunction) of the UMSARS-II were less sensitive to change. The prevalence and severity of NMS significantly increased over the 2-year follow-up.

Conclusions

We observed significant progression in motor symptoms and NMS in patients with early-stage MSA. Our results provide useful information to support the revision of the UMSARS.
Circular RNA circPTPRF promotes the progression of GBM via sponging miR-1208 to up-regulate YY1
Authors: Zhou Jiang , Wang Chengbin , Liu Yingliang , Cui Daming , Wang Zhenlin , Jiang Yang , Gao Liang
Published: November 2022

Glioblastoma (GBM) is the most common primary malignant tumor in the brain, and its robust proliferation and invasion abilities reduce the survival time of patients. Circular RNAs (circRNAs) play an essential role in various tumors, such as regulating tumor cell proliferation, apoptosis, invasion, metastasis, and other progressive phenotypes through different mechanisms. Finding novel circRNAs may significantly contribute to the prognosis of GBM and provide the basis for the targeted therapy of GBM. In this study, we found circPTPRF is a novel circRNA that has never been studied, which was highly expressed in GBM and is closely related to poor patient prognoses. After knockdown or overexpression in glioma cell lines (U87 and LN229) and glioma stem cells (GSCs), we identified that circPTPRF could promote proliferation, invasion, and neurospheres formation abilities of GBM via in vitro and in vivo experiments. Mechanisms, miR-1208 was confirmed as a target of circPTPRF, and miR-1208 can also target the 3’UTR of YY1, and they were proved by luciferase reporter, western blotting (WB), qPCR and RNA immunoprecipitation (RIP) assays. The following rescue experiments demonstrated that circPTPRF was a miR-1208 sponge for upregulating YY1 expression to promote proliferation, invasion and neurosphere formation abilities of GBM in vitro. In conclusion, the circPTPRF/miR-1208/YY1 axis can regulate GBM progression. CircPTPRF may play an essential role in GBM diagnosis and prognostic prediction and be an important molecular target for GBM therapy.
HMOX1 STR polymorphism and malaria: an analysis of a large clinical dataset
Authors: Hamilton Fergus , Mitchell Ruth , Cunnington Aubrey , Ghazal Peter , Timpson Nicholas J.
Published: November 2022

Background

Inducible expression of heme oxygenase-1 (encoded by the geneHMOX1) may determine protection from heme released during malaria infections. A variable length, short tandem GT(n) repeat (STR) inHMOX1that may influence gene expression has been associated with outcomes of human malaria in some studies. In this study, an analysis of the association between variation at the STR inHMOX1on severe malaria and severe malaria subtypes is presented in a large, prospectively collected dataset (MalariaGEN).

Methods

The HMOX1 STR was imputed using a recently developed reference haplotype panel designed for STRs. The STR was classified by total length and split into three alleles based on an observed trimodal distribution of repeat lengths. Logistic regression was used to assess the association between this repeat on cases of severe malaria and severe malaria subtypes (cerebral malaria and severe malarial anaemia). Individual analyses were performed for each MalariaGEN collection site and combined for meta-analysis. One site (Kenya), had detailed clinical metadata, allowing the assessment of the effect of the STR on clinical variables (e.g. parasite count, platelet count) and regression analyses were performed to investigate whether the STR interacted with any clinical variables.

Results

Data from 17,960 participants across 11 collection sites were analysed. In logistic regression, there was no strong evidence of association between STR length and severe malaria (Odds Ratio, OR: 0.96, 95% confidence intervals 0.91–1.02 per ten GT(n) repeats), although there did appear to be an association at some sites (e.g., Kenya, OR 0.90, 95% CI 0.82–0.99). There was no evidence of an interaction with any clinical variables.

Conclusions

Meta-analysis suggested that increasing HMOX1 STR length is unlikely to be reliably associated with severe malaria. It cannot be ruled out that repeat length may alter risk in specific populations, although whether this is due to chance variation, or true variation due to underlying biology (e.g., gene vs environment interaction) remains unanswered.
Significance of nested PCR testing for the detection of low-density malaria infection amongst febrile patients from the Malaria Elimination Demonstration Project in Mandla, Madhya Pradesh, India
Authors: Singh Akansha , Singh Mrigendra P. , Bhandari Sneha , Rajvanshi Harsh , Nisar Sekh , Telasey Vinay , Jayswar Himanshu , Mishra Ashok K. , Das Aparup , Kaur Harpreet , Lal Altaf A. , Bharti Praveen K.
Published: November 2022

Background

Low-density malaria infections (LDMI) are defined as infections that are missed by the rapid diagnostic test (RDT) and/or microscopy which can lead to continued transmission and poses a challenge in malaria elimination efforts. This study was conducted to investigate the prevalence of LDMI in febrile cases using species-specific nested Polymerase Chain Reaction (PCR) tests in the Malaria Elimination Demonstration Project, where routine diagnosis was conducted using RDT.

Methods

Every 10th fever case from a cross-sectional community based fever surveillance was tested with RDT, microscopy and nested PCR. Parasite DNA was isolated from the filter paper using Chelex based method. Molecular diagnosis by nested PCR was performed targeting 18SrRNA gene forPlasmodiumspecies.

Results

The prevalence of malaria was 2.50% (436/17405) diagnosed by PCR, 1.13% (196/17405) by RDT, and 0.68% (118/ 17,405) by microscopy. Amongst 17,405 febrile samples, the prevalence of LDMI was 1.51% (263/17405) (95% CI 1.33–1.70), which were missed by conventional methods. Logistic regression analysis revealed that illness during summer season [OR = 1.90 (p < 0.05)] and cases screened within three days of febrile illness [OR = 5.27 (p < 0.001)] were the statistically significant predictors of LDMI.

Conclusion

The prevalence of malaria among febrile cases using PCR was 2.50% (436/17405) as compared to 1.13% (196/17405) by RDT. Higher number of the LDMI cases were found in subjects with ≤ 3 days mean duration of reported fever, which was statistically significant (p < 0.001). This observation suggests that an early detection of malaria with a more sensitive diagnostic method or repeat testing of the all negative cases may be useful for curtailing malaria transmission. Therefore, malaria elimination programme would benefit from using more sensitive and specific diagnostic methods, such as PCR.
Development of the Penn Healthy Diet screener with reference to adult dietary intake data from the National Health and Nutrition Examination Survey
Authors: Compher Charlene W. , Quinn Ryan , Burke Frances , Piccinin Doris , Sartor Linda , Lewis James D. , Wu Gary D.
Published: November 2022

Background

There is a need for a feasible, user-friendly tool that can be employed to assess the overall quality of the diet in U.S. clinical settings. Our objectives were to develop the Penn Healthy Diet (PHD) screener, evaluate screener item correlations with Healthy Eating Index (HEI)-2015 components, and develop a simple scoring algorithm.

Methods

National Health and Nutrition Examination Survey (NHANES) 2017–18 dietary recall data in adults were used to define food examples in screener food groups based on components of the HEI-2015, Diet Approach to Stop Hypertension, and Alternative Mediterranean diet approaches. Instrument Content Validity Index (I-CVI) was used to evaluate the clarity and relevance of the screener. Patient acceptability was evaluated by completion time and response rates. NHANES 2017–18 food recall data were used to simulate responses to the screener items, which were evaluated for association with HEI-2015 components. A scoring algorithm was developed based on screener items moderately or strongly associated with HEI-2015 components. Reproducibility was tested using NHANES 2015–16 data.

Results

The screener had strong clarity (I-CVI = 0.971) and relevance for nutrition counseling (I-CVI = 0.971). Median (IQR) completion time was 4 (3–5) minutes on paper and 4 (4–8) minutes online, and 73% of patients invited online completed the survey. Based on simulated NHANES participant screener responses, 15 of the 29 screener items were moderately or strongly associated with HEI-2015 components, forming the basis of the scoring algorithm with a range of 0–63 points, where higher score indicates a healthier diet. The median (IQR) screener and HEI-2015 scores were 14.96 (11.99–18.36) and 48.96 (39.51–59.48), respectively. The simulated PHD score was highly correlated with the HEI-2015 score (Spearman rho 0.75) in NHANES 2017–18 and confirmed in NHANES 2015–16 data (Spearman rho 0.75).

Conclusions

The Penn Healthy Diet screener may be a useful tool for assessing diet quality due to its acceptable content validity, ease of administration, and ability to distinguish between servings of key food groups associated with a healthy versus unhealthy diet according to the HEI-2015. Additional research is needed to further establish the instrument’s validity, and to refine a scoring algorithm.
HPV knowledge and vaccine acceptability: a survey-based study among parents of adolescents (KAPPAS study)
Authors: López Noelia , de la Cueva Ignacio Salamanca , Taborga Elena , de Alba Auxiliadora Fernández , Cabeza Inés , Raba Reyes Mazas , Marès Josep , Company Patricia , Herrera Bruno , Cotarelo Manuel
Published: November 2022

Background

Human papillomavirus (HPV) infection is recognized as one of the major causes of infection-related cancer worldwide. In Spain, the HPV vaccination program started in 2007 and until 2022, it targeted 12-year-old girls.

Methods

This was a cross-sectional, multicenter survey-based research carried out at 24 pediatric offices to describe HPV knowledge and vaccine acceptability in parents of children aged between 9 and 14 years-old in Spain. Parents were randomly selected from the medical records following specific quotas to ensure representativeness. The survey included five sections that aim to collect information about sociodemographic characteristics, knowledge of HPV, knowledge and acceptability of vaccines in general, HPV vaccination knowledge and HPV vaccine acceptability. Each section was constituted by a number of close questions with different answer options. Specific scores were assigned to each possible answer to these questions. Based on these scores, four composite variables were created to assess HPV knowledge, HPV vaccine knowledge, HPV vaccine acceptability and vaccines knowledge and acceptability in general. A latent class analysis was performed to identify different group of respondents according to their HPV vaccine acceptability.

Results

A total of 1405 valid surveys were included, with 86.19% of the respondents being mothers. The mean score of HPV knowledge was 28.92 out of 40 (maximum value) (95% CI 28.70–29.20) and the mean score of HPV vaccine acceptability was 3.37 out of 5 (maximum value). One third of parents still need more information to take a final decision about HPV vaccination in their children. Parents perceived that females were more likely to become infected than males and tended to associate HPV infection mainly with cervical cancer, showing a. a lack of information about other HPV-related diseases affecting males.

Conclusions

This study results highlight the need for future actions and educational initiatives to raise awareness of HPV consequences in both genders and to contribute to achieving the elimination of HPV-related diseases beyond cervical cancer.
TRial to Assess Implementation of New research in a primary care Setting (TRAINS): study protocol for a pragmatic cluster randomised controlled trial of an educational intervention to promote asthma prescription uptake in general practitioner practices
Authors: Alyami Rami A. , Simpson Rebecca , Oliver Phillip , Julious Steven A.
Published: November 2022

Background

There is a marked increase in unscheduled care visits in school-aged children with asthma after returning to school in September. This is potentially associated with children not taking their asthma preventer medication during the school summer holidays. A cluster randomised controlled trial (PLEASANT) was undertaken with 1279 school-age children in 141 general practices (71 on intervention and 70 on control) in England and Wales. It found that a simple letter sent from the family doctor during the school holidays to a parent with a child with asthma, informing them of the importance of taking asthma preventer medication during the summer relatively increased prescriptions by 30% in August and reduced medical contacts in the period September to December. Also, it is estimated there was a cost-saving of £36.07 per patient over the year. We aim to conduct a randomised trial to assess if informing GP practices of an evidence-based intervention improves the implementation of that intervention.

Methods/design

The TRAINS study—TRial to Assess Implementation of New research in a primary care Setting—is a pragmatic cluster randomised implementation trial using routine data. A total of 1389 general practitioner (GP) practices in England will be included into the trial; 694 GP practices will be randomised to the intervention group and 695 control group of usual care. The Clinical Practice Research Datalink (CPRD) will send the intervention and obtain all data for the study, including prescription and primary care contacts data. The intervention will be sent in June 2021 by postal and email to the asthma lead and/or practice manager. The intervention is a letter to GPs informing them of the PLEASANT study findings with recommendations. It will come with an information leaflet about PLEASANT and a suggested reminder letter and SMS text template.

Discussion

The trial will assess if informing GP practices of the PLEASANT trial results will increase prescription uptake before the start of the school year. The hope is that the intervention will increase the implementation of PLEASANT work and then increase prescription uptake during the summer holiday prior to the start of school.

Trial registration

ClinicalTrials.gov ID: NCT05226091
Ring stage classification of Babesia microti and Plasmodium falciparum using optical diffraction 3D tomographic technique
Authors: Mazigo Ernest , Jun Hojong , Oh Jeonghun , Malik Wasiq , Louis Johnsy Mary , Kim Tong-Soo , Lee Se Jin , Na Sunghun , Chun Wanjoo , Park Won Sun , Park Yong-Keun , Han Eun-Taek , Kim Min-Jae , Han Jin-Hee
Published: November 2022

Background

Babesia is an intraerythrocytic parasite often misdiagnosed as a malaria parasite, leading to inappropriate treatment of the disease especially in co-endemic areas. In recent years, optical diffraction tomography (ODT) has shown great potential in the field of pathogen detection by quantification of three-dimensional (3D) imaging tomograms. The 3D imaging of biological cells is crucial to investigate and provide valuable information about the mechanisms behind the pathophysiology of cells and tissues.

Methods

The early ring stage of P. falciparum were obtained from stored stock of infected RBCs and of B. microti were obtained from infected patients during diagnosis. The ODT technique was applied to analyze and characterize detailed differences between P. falciparum and B. microti ring stage at the single cell level. Based on 3D quantitative information, accurate measurement was performed of morphological, biochemical, and biophysical parameters.

Results

Accurate measurements of morphological parameters indicated that the host cell surface area at the ring stage in B. microti was significantly smaller (140.2 ± 17.1 µm2) than that in P. falciparum (159.0 ± 15.2 µm2), and sphericities showed higher levels in B. microti-parasitized cells (0.66 ± 0.05) than in P. falciparum (0.60 ± 0.04). Based on biochemical parameters, host cell hemoglobin level was significantly higher and membrane fluctuations were respectively more active in P. falciparum-infected cells (30.25 ± 2.96 pg; 141.3 ± 24.68 nm) than in B. microti (27.28 ± 3.52 pg; 110.1 ± 38.83 nm). The result indicates that P. falciparum more actively altered host RBCs than B. microti.

Conclusion

Although P. falciparum and B. microti often show confusable characteristics under the microscope, and the actual three-dimensional properties are different. These differences could be used in differential clinical diagnosis of erythrocytes infected with B. microti and P. falciparum.

Graphical Abstract
Interpleural location of chest drain on ultrasound excludes pneumothorax and associates with a low degree of chest drain foreshortening on the antero-posterior chest X-ray
Authors: Maly Michal , Mokotedi Masego Candy , Svobodova Eva , Flaksa Marek , Otahal Michal , Stach Zdenek , Rulisek Jan , Brozek Tomas , Porizka Michal , Balik Martin
Published: November 2022

Background

The role of chest drain (CD) location by bedside imaging methods in the diagnosis of pneumothorax has not been explored in a prospective study yet.

Methods

Covid-19 ARDS patients with pneumothorax were prospectively monitored with chest ultrasound (CUS) and antero-posterior X-ray (CR) performed after drainage in the safe triangle. CD foreshortening was estimated as a decrease of chest drain index (CDI = length of CD in chest taken from CR/depth of insertion on CD scale + 5 cm). The angle of inclination of the CD was measured between the horizontal line and the CD at the point where it enters pleural space on CR.

Results

Of the total 106 pneumothorax cases 80 patients had full lung expansion on CUS, the CD was located by CUS in 69 (86%), the CDI was 0.99 (0.88–1.06). 26 cases had a residual pneumothorax after drainage (24.5%), the CD was located by CUS in 31%, the CDI was 0.76 (0.6–0.93),p < 0.01. The risk ratio for a pneumothorax in a patient with not visible CD between the pleural layers on CUS and an associated low CDI on CR was 5.97,p˂0.0001. For the patients with a steep angle of inclination (> 50°) of the CD, the risk ratio for pneumothorax was not significant (p < 0.17). A continued air leak from the CD after drainage is related to the risk for a residual pneumothorax (RR 2.27,p = 0.003).

Conclusion

Absence of a CD on CUS post drainage, low CDI on CR and continuous air leak significantly associate with residual occult pneumothorax which may evade diagnosis on an antero-posterior CR.
The growth characteristics and lignans contents of Schisandra chinensis fruits from different cultivation regions
Authors: Lee Dong Hwan , Park Youngki , Jang Jun Hyuk , Son Yonghwan , Kim Ji Ah , Lee Sun-Young , Kim Hyun-Jun
Published: November 2022

We developed and validated an optimized method for quantifying lignans using ultra-performance liquid chromatography (UPLC) and performs correlation analysis of growth characteristics and contents of lignans. The methods for determining lignans were validated by measuring the linearity, limit of detection (LOD), limit of quantification (LOQ), accuracy, and precision using UPLC. All calibration curves showed good linearity (r2 ≥ 0.9998) within the tested ranges. The limit of detection (LOD) and limit of quantification (LOQ) were 0.003–0.02 µg/mL and 0.01–0.07 µg/mL, respectively. The precision of analysis was less than 3%. The recoveries of quantified compounds ranged from 98.4 to 101.68%. Growth characteristics of fruits were negatively correlated with content of total marker compounds. The results of this study can be used to quality-control of S. chinensis fruits used as medicinal raw materials.
Lessons from the Chinese imperial examination system
Authors: O’Sullivan Barry , Cheng Liying
Published: November 2022

In this paper, we set out to explore the world’s first major standardised examination system. In the field of language testing and assessment, works such as measured words (Spolsky, 1995), measured constructs (Weir, Vidakovic & Galaczi, 2013), and Cambridge English exams — the first hundred years (Hawkey & Milanovic, 2013) all point to the fact that contemporary tests reflect many years of accumulated knowledge and practice. Perhaps more importantly, they also remind us of the social and educational impact of the tests we develop. With this in mind, we explore the very first example of a standardised examination system — the Chinese imperial examination system (the Kējǔ — in Chinese Hanyu Pinyin 科举).
A brief survey on big data: technologies, terminologies and data-intensive applications
Authors: Abdalla Hemn Barzan
Published: November 2022

The technical advancements and the availability of massive amounts of data on the Internet draw huge attention from researchers in the areas of decision-making, data sciences, business applications, and government. These massive quantities of data, known as big data, have many benefits and applications for researchers. However, the use of big data consumes a lot of time and imposes enormous computational complexity. This survey describes the significance of big data and its taxonomy and details the basic terminologies used in big data. It also discusses the technologies used in big data applications as well as their various complexities and challenges. The survey focuses on the various techniques presented in the literature to restrain the issues associated with big data. In particular, the review concentrates on big data techniques in accordance with processing, security, and storage. It also discusses the various parameters associated with big data, such as availability and velocity. The study analyses big data terminologies and techniques in accordance with several factors, such as year of publication, performance metrics, achievement of the existing models, and methods utilized. Finally, this review article describes the future direction of research and highlights big data possibilities and solicitations with a detailed sketch of the big data processing frameworks.
Comparison of protocols with respiratory-gated (4D) motion compensation in PET/CT: open-source package for quantification of phantom image quality
Authors: Martinez-Movilla Andrea , Mix Michael , Torres-Espallardo Irene , Teijeiro Elena , Bello Pilar , Baltas Dimos , Martí-Bonmatí Luis , Carles Montserrat
Published: November 2022

Background

Patient’s breathing affects the quality of chest images acquired with positron emission tomography/computed tomography (PET/CT) studies. Movement correction is required to optimize PET quantification in clinical settings. We present a reproducible methodology to compare the impact of different movement compensation protocols on PET image quality. Static phantom images were set as reference values, and recovery coefficients (RCs) were calculated from motion compensated images for the phantoms in respiratory movement. Image quality was evaluated in terms of: (1) volume accuracy (VA) with the NEMA phantom; (2) concentration accuracy (CA) by six refillable inserts within the electron density CIRS phantom; and (3) spatial resolution (R) with the Jaszczak phantom. Three different respiratory patterns were applied to the phantoms. We developed an open-source package to automatically analyze VA, CA and R. We compared 10 different movement compensation protocols available in the Philips Gemini TF-64 PET/CT (4-, 6-, 8- and 10-time bins, 20%-, 30%-, 40%-window width in Inhale and Exhale).

Results

The homemade package provided RC values for VA, CA and R of 102 PET images in less than 5 min. Results of the comparison of the 10 different protocols demonstrated the feasibility of the proposed method for quantifying the variations observed qualitatively. Overall, prospective protocols showed better motion compensation than retrospective. The best performance was obtained for the protocol Exhale 30% (0.3 s after maximum Exhale position and window width of 30%) with RC$$_{VA}=1.6\pm 1.3$$

VA

=
1.6
±
1.3

, RC$$_{CA}=0.90\pm 0.09$$

CA

=
0.90
±
0.09

and RC$$_{R}=0.6 \pm 0.4$$

R

=
0.6
±
0.4

. Among retrospective protocols, 8 Phase protocol showed the best performance.

Conclusion

We provided an open-source package able to automatically evaluate the impact of motion compensation methods on PET image quality. A setup based on commonly available experimental phantoms is recommended. Its application for the comparison of 10 time-based approaches showed that Exhale 30% protocol had the best performance. The proposed framework is not specific to the phantoms and protocols presented on this study.
Surgical approach for appendicitis in neutropenia: a case report and review of the literature
Authors: Uthayanan Ushanthan , Kolb Walter , Schmied Bruno , Bischofberger Stephan
Published: November 2022

Background

Acute appendicitis is a common abdominal pathology, particularly in younger patients presenting with abdominal pain. The clinical presentation is typically characterized by right lower quadrant pain (with local peritonitis) accompanied by fever and nausea. In neutropenic patients it is challenging to diagnose acute appendicitis. It is much more challenging because the characteristic symptoms are different, and diagnosis may be delayed or missed.

Case presentation

We present the case of a 33-year-old Caucasian male patient with fever, abdominal pain, and an absolute granulocyte count of 0 × 109/L. Abdominal CT demonstrated an uncomplicated acute appendicitis. We initiated a conservative in-hospital treatment with intravenous antibiotic therapy and simultaneous bone marrow stimulation, with close monitoring. On day three, there was evidence of monocyte increase, one of the first signs of bone marrow regeneration, and delayed laparoscopic appendectomy was performed. The perioperative and postoperative course was uneventful.

Conclusion

We discuss the different treatment strategies in patients with neutropenia presenting with acute appendicitis (i.e., conservative management, delayed appendectomy, and immediate appendectomy) based on our experience and a review of the literature. In summary, delayed laparoscopic appendectomy at the onset of granulocyte regeneration under antibiotic and G-CSF therapy represents a viable surgical option for adults as well as for children and should be discussed compared with conservative therapy.
Government intervention model based on behavioral heterogeneity for China’s stock market
Authors: Zhou Zhong-Qiang , Li Jie , Zhang Wei , Xiong Xiong
Published: November 2022

Active government intervention is a striking characteristic of the Chinese stock market. This study develops a behavioral heterogeneous agent model (HAM) comprising fundamentalists, chartists, and stabilizers to investigate investors’ dynamic switching mechanisms under government intervention. The model introduces a new player, the stabilizer, into the HAM as a proxy for the government. We use the model to examine government programs during the 2015 China stock market crash and find that it can replicate the dynamics of investor sentiment and asset prices. In addition, our analysis of two simulations, specifically the data-generating processes and shock response analysis, further corroborates the key conclusion that our intervention model not only maintains market stability but also promotes the return of risk asset prices to their fundamental values. The study concludes that government interventions guided by the new HAM can alleviate the dilemma between reducing price volatility and improving price efficiency in future intervention programs.
Exploring the “how” in research partnerships with young partners by experience: lessons learned in six projects from Canada, the Netherlands, and the United Kingdom
Authors: Nguyen Linda , van Oort Bente , Davis Hanae , van der Meulen Eline , Dawe-McCord Claire , Franklin Anita , Gorter Jan Willem , Morris Christopher , Ketelaar Marjolijn
Published: November 2022

Background

Involvement of young partners by experience in research is on the rise and becoming expected practice. However, literature on how to promote equitable and meaningful involvement of young people is scarce. The purpose of this paper is to describe and reflect on different approaches between researchers and young partners by experience based on six research projects conducted in Canada, Netherlands, and United Kingdom.

Methods

From six exemplar research projects, at least one researcher and one young partner by experience were asked to collaboratively (1) describe the project; (2) summarise the values and practicalities of the project; and (3) reflect on their partnership. Thematic analysis was applied to the findings from these reflective exercises, which included meeting summaries, recordings, and notes.

Results

All projects shared similar values, including mutual respect between all team members. Young partners were offered a variety of opportunities and approaches to being involved, for example in recruiting participants, co-analysing or (co-)presenting results. Supports were provided to the teams in a variety of ways, including organizing accessible meetings and having dedicated facilitators. Regular and proactive communication was encouraged by using asynchronous modes of communication, establishing reference documents, and a personal approach by facilitators. Facilitators aimed to tailor the needs of all team members by continuously discussing their preferred roles in the project. While most projects did not offer formal research training, various learning and skill development opportunities were provided throughout, including presenting skills or advocacy training.

Conclusion

With this paper, we demonstrated the value of reflection, and we invite others to reflect on their partnerships and share their lessons learned. Our recommendations for involvement of young people in research are: (1) Remember that it is okay to not know what the partnership might look like and there is no single recipe of how to partner; (2) Take the time to invest in partnerships; (3) Provide ongoing opportunities to reflect on partnerships; (4) Consider how to balance the power dynamics; and (5) Consider how to incorporate diversity in the background of young partners in research.