bluuebunny/crossref_metadata_2025 huggingface dataset:
Rib detection using pitch-catch ultrasound and classification algorithms for a novel ultrasound therapy device
Authors: Kaiser Claire R. W. , Tuma Adam B. , Zebarjadi Maryam , Zachs Daniel P. , Organ Anna J. , Lim Hubert H. , Collins Morgan N.
Published: November 2023

Background

Noninvasive ultrasound (US) has been used therapeutically for decades, with applications in tissue ablation, lithotripsy, and physical therapy. There is increasing evidence that low intensity US stimulation of organs can alter physiological and clinical outcomes for treatment of health disorders including rheumatoid arthritis and diabetes. One major translational challenge is designing portable and reliable US devices that can be used by patients in their homes, with automated features to detect rib location and aid in efficient transmission of energy to organs of interest. This feasibility study aimed to assess efficacy in rib bone detection without conventional imaging, using a single channel US pitch-catch technique integrated into an US therapy device to detect pulsed US reflections from ribs.

Methods

In 20 healthy volunteers, the location of the ribs and spleen were identified using a diagnostic US imaging system. Reflected ultrasound signals were recorded at five positions over the spleen and adjacent ribs using the therapy device. Signals were classified as between ribs (intercostal), partially over a rib, or fully over a rib using four models: threshold-based time domain classification, threshold-based frequency domain classification, logistic regression, and support vector machine (SVM).

Results

SVM performed best overall on the All Participants cohort with accuracy up to 96.25%. All models’ accuracies were improved by separating participants into two cohorts based on Body Mass Index (BMI) and re-fitting each model. After separation into Low BMI and High BMI cohorts, a simple time-thresholding approach achieved accuracies up to 100% and 93.75%, respectively.

Conclusion

These results demonstrate that US reflection signal classification can accurately provide low complexity, real-time automated onboard rib detection and user feedback to advance at-home therapeutic US delivery.
Predicting foodborne pathogens and probiotics taxa within poultry-related microbiomes using a machine learning approach
Authors: Ayoola Moses B. , Pillai Nisha , Nanduri Bindu , Rothrock Jr Michael J. , Ramkumar Mahalingam
Published: November 2023

Background

Microbiomes that can serve as an indicator of gut, intestinal, and general health of humans and animals are largely influenced by food consumed and contaminant bioagents. Microbiome studies usually focus on estimating the alpha (within sample) and beta (similarity/dissimilarity among samples) diversities. This study took a combinatorial approach and applied machine learning to microbiome data to predict the presence of disease-causing pathogens and their association with known/potential probiotic taxa. Probiotics are beneficial living microorganisms capable of improving the host organism’s digestive system, immune function and ultimately overall health. Here, 16 S rRNA gene high-throughput Illumina sequencing of temporal pre-harvest (feces, soil) samples of 42 pastured poultry flocks (poultry in this entire work solely refers to chickens) from southeastern U.S. farms was used to generate the relative abundance of operational taxonomic units (OTUs) as machine learning input. Unique genera from the OTUs were used as predictors of the prevalence of foodborne pathogens (Salmonella, Campylobacter and Listeria) at different stages of poultry growth (START (2–4 weeks old), MID (5–7 weeks old), END (8–11 weeks old)), association with farm management practices and physicochemical properties.

Result

While we did not see any significant associations between known probiotics and Salmonella or Listeria, we observed significant negative correlations between known probiotics (Bacillus and Clostridium) and Campylobacter at the mid-time point of sample collection. Our data indicates a negative correlation between potential probiotics and Campylobacter at both early and end-time points of sample collection. Furthermore, our model prediction shows that changes in farm operations such as how often the houses are moved on the pasture, age at which chickens are introduced to the pasture, diet composition and presence of other animals on the farm could favorably increase the abundance and activity of probiotics that could reduce Campylobacter prevalence.

Conclusion

Integration of microbiome data with farm management practices using machine learning provided insights on how to reduce Campylobacter prevalence and transmission along the farm-to-fork continuum. Altering management practices to support proliferation of beneficial probiotics to reduce pathogen prevalence identified here could constitute a complementary method to the existing but ineffective interventions such as vaccination and bacteriophage cocktails usage. Study findings also corroborate the presence of bacterial genera such as Caloramator, DA101, Parabacteroides and Faecalibacterium as potential probiotics.
Association of OXTR polymorphism (rs53576) with depression: a meta-analysis
Authors: Eid Moez , Derevyanchuk Ekaterina G. , Butenko Elena V.
Published: November 2023

Background

Depression is a common psychiatric disorder that negatively affects mood and thoughts. Association studies of OXTR polymorphisms with depression have been performed repeatedly. However, the results of these studies were inconsistent. The aim of the present study was to perform a meta-analysis of case–control studies that have investigated the relationship between the OXTR polymorphism (rs53576) and depression risk.

Methods

Four databases, PubMed, ScienceDirect, Springer Link, and Google Scholar, were searched, and a total of 10 studies were involved in the meta-analysis. ReviewManager (RevMan) 5.4 software was used to perform a meta-analysis of the eligible studies.

Results

A significant association between OXTR rs53576 and depression was found in the recessive model (Odds Ratio (OR) AA vs. AG + GG = 1.28, 95% Confidence Interval (CI) [1.02–1.59], P = 0.03), while there was no association with the other two genetic models (dominant model: OR AA + AG vs. GG = 1.01, 95% CI [0.87–1.18], P = 0.87; allelic model: OR A vs. G = 0.95, 95% CI [0.83–1.09], P = 0.46). A significant association was observed in the Caucasian populations (OR 1.29, 95% CI [1.01, 1.64], P = 0.04), while the Asian populations showed no significant association (OR 1.22, 95% CI [0.71, 2.09], P = 0.48).

Conclusions

This meta-analysis is to date the first to provide a comprehensive investigation of the association of the OXTR rs53576 polymorphism with depression, and its results reflect the data currently available from the literature and can serve as a guide for further research.
Does energy efficiency, renewable energy and effective capital promote economic growth in the emerging 7 economies? New evidence from CS-ARDL model
Authors: Deka Abraham , Ozdeser Huseyin , Seraj Mehdi , Kadir Musbau Omotola
Published: November 2023

Gross Domestic Product is regarded as the major indicator which determines the standards of living in a country. Consequently, energy use is far regarded as one of the major determinants of economic growth in an economy. However, fossil fuel energy greatly contributes to environmental degradation, global warming and the spread of various diseases. The present-day research is aimed at examining the effect of energy efficiency, renewable energy and effective capital on Gross Domestic Product in the emerging seven countries (Brazil, Russia, Mexico, Turkiye, Indonesia, China and India), during the period 1990 to 2019. The main novelty of the research is that it examines the effect of effective capital on Gross Domestic Product, a study which has not been done. Effective capital which is the combined effect of energy and physical capital in the production process is inevitable in raising economic growth. Additionally, the effect of energy efficiency on economic growth in the emerging seven countries has been partially investigated. The findings of this research are robust and unique to those of past researches, because Cross-sectional Augmented Autoregressive Distributive Lag technique which is strong in the presence of cross-sectional dependence, heterogeneity and dynamics is employed. The outcomes provided in this research shows that, energy efficiency and effective capital significantly promotes economic growth, while non-renewable energy provides significant positive effect in the short-run, with no significant effect in the long-run. This study recommends the efficient utilization of energy, ensuring that each single unit of energy employed produces the highest possible output.
Osteosarcoma of the sphenoid sinus extending to ethmoid sinus—report of a rare case with review of literature giving special emphasis on treatment and outcome
Authors: Mehta Rupa , Ponnuvelu Sahana , Kuotsu Ruuzeno , Nagarkar Nitin M.
Published: November 2023

Background

Osteosarcoma usually arises from primitive bone-forming mesenchymal cells. Metaphyseal growth plates of long bones are the usually affected site. Though it is the most common primary bone malignancy, only 6–10% of osteosarcomas are craniofacial. In the sinonasal region, the commonly involved sites reported in the literature are maxillary and ethmoid sinus. Sphenoid sinus has been the least commonly involved site among the paranasal sinuses and only a handful of cases have been reported.

Methods

A rare case of osteosarcoma involving the sphenoid and ethmoid sinus was presented to our institute and he was managed surgically and with postoperative chemotherapy. Further, an internet-based literature search was conducted to detect cases of osteosarcoma involving sphenoid sinus only as well as combined sphenoid and ethmoid sinus.

Results

About 13 articles (13 patients), which fulfilled our inclusion and exclusion criteria were included in our study. Out of the 14 patients (including the present case), 5 patients (100%) who underwent both modes of adjuvant therapy were alive during the final follow-up. On the other hand, among those who received single adjuvant therapy, only one patient was alive (33.3%) and two patients died (66.6%).

Conclusion

Osteosarcomas are highly malignant primary bone neoplasms with rare occurrence in the head and neck region. It constitutes a therapeutic challenge because of its anatomical location and the known side effects of chemotherapy. Timely intervention with a multidisciplinary approach is necessary to avoid death in these patients.
Extra pulmonary versus pulmonary presentation of COVID-19 patients: comparative study
Authors: Esmaeel Hend M. , Mohamed Hamdy S. , Khalaf Asmaa R. , Mahmoud Hamza A. , Gadallah Doaa
Published: November 2023

Background

The respiratory system is the most frequently affected system by COVID-19. However, a variety of extra-pulmonary systems can be influenced by COVID-19 with subsequent morbidity and mortality.

Aim

This study aim is to report the most frequent extra pulmonary presentations of COVID-19 with comparison to patients with primary pulmonary presentation. Risk factors for ICU admission in both groups were examined.

Methods

In this prospective comparative cross-sectional study, detailed demographics, medical history, clinical assessment, and computed tomography (CT) scan of the chest were done to all recruited patients with COVID-19.

Result

This study included a total of 1664 confirmed COVID-19 patients. The patients were categorized into two groups. Patients with pulmonary manifestations included 716 patients while 948 patients presented with extrapulmonary manifestations. Patients in the extrapulmonary group were older. The prevalence of certain chronic comorbid conditions was higher in the extra pulmonary group as cardiac, CNS, hepatic, and renal diseases, while chronic respiratory disorders were more prevalent in the pulmonary group (P value: < 0.0001). No significant difference in CT severity score between both groups. CORAD 5 was predominant in the pulmonary group (P value: < 0.0001). Most cases in both groups required hospital admission either inward or in ICU with higher frequency of ICU admission was observed in the pulmonary group. The significant risk factors for ICU admission in both groups were critically ill category of patients, CT severity, low oxygen saturation level, and the presence of comorbid chronic disease (P < 0.0001 with adjusted Odds ratio). CNS, cardiac, renal, and metabolic dysfunctions exert significant risk for ICU admission in the extrapulmonary group.

Conclusion

Atypical or non-respiratory manifestations could be the presentation of a respiratory pathogen as reported in COVID-19. Our work highlights the extrapulmonary presentation of COVID-19. Older male patients were more prone to present with extra pulmonary symptoms. CNS, cardiac, renal, and metabolic dysfunctions were the most affected systems. This could impact the level of care required for patient management and the extent of resource utility.
A comprehensive review on thermal management of electronic devices
Authors: Dhumal Amol R. , Kulkarni Atul P. , Ambhore Nitin H.
Published: November 2023

In the field of electronics thermal management (TM), there has already been a lot of work done to create cooling options that guarantee steady-state performance. However, electronic devices (EDs) are progressively utilized in applications that involve time-varying workloads. Therefore, the TM systems could dissipate the heat generated by EDs; however, there seemed to be a necessity for a design that would contain temperature rise within an acceptable range for limiting hot spots and managing thermal transients induced by higher-frequency operating cycles. Heat dissipation issues become more significant when miniaturization in electronics increases. More effective TM often results in enhanced reliability as well as a longer life expectancy for devices. Hence, this paper explicates the TM of EDs, the comparison of cooling methods, the comparison of convections for TM on EDs, the heat source (HS) mounted on the substrate board, and optimization techniques to optimize the size and position of HSs mounted on the substrate board. This paper also analyzes the TM technologies on different EDs from 2014 to 2023 and the comparison of the thermal conductance of EDs with two types of phase change materials (PCMs) and pin-fin heat pipes (HPs).
Contrast echocardiography: a practical guideline from the British Society of Echocardiography
Authors: Hampson Reinette , Senior Roxy , Ring Liam , Robinson Shaun , Augustine Daniel X. , Becher Harald , Anderson Natasha , Willis James , Chandrasekaran Badrinathan , Kardos Attila , Siva Anjana , Leeson Paul , Rana Bushra S. , Chahal Navtej , Oxborough David
Published: November 2023

Ultrasound contrast agents (UCAs) have a well-established role in clinical cardiology. Contrast echocardiography has evolved into a routine technique through the establishment of contrast protocols, an excellent safety profile, and clinical guidelines which highlight the incremental prognostic utility of contrast enhanced echocardiography. This document aims to provide practical guidance on the safe and effective use of contrast; reviews the role of individual staff groups; and training requirements to facilitate its routine use in the echocardiography laboratory.
Successful surgical treatment for primary cardiac angiosarcoma: a case report
Authors: Suehiro Yasuo , Kajiyama Tetsuya , Satoh Ayaka , Uemura Hisashi , Nakagawa Takaya , Matsue Hajime , Satoh Hisashi , Takase Naoto , Doi Hiroshi
Published: November 2023

Background

Primary cardiac angiosarcomas are extremely rare and their prognosis is poor. Surgical resection is the first-line treatment; however, no clear standard of care has been clearly established because of the rarity of these tumors.

Case presentation

A 61-year-old man who had presented with dyspnea on exertion was referred to our hospital. Contrast-enhanced computed tomography revealed massive pericardial effusion and a 40-mm enhanced mass adherent to the anterior wall of the right atrium and involving the right coronary artery. Having diagnosed the mass as a cardiac tumor, we resected the mass under the guidance of epi-cardiac echocardiography guidance, which showed continuity between the tumor and the right atrium, reconstructed the right atrial free wall with a bovine pericardial patch, and performed coronary artery bypass grafting to the right coronary artery using the great saphenous vein. The right atrial wall was resected with adequate tumor-free margin. On the right ventricular side, we resected the right atrial wall 1 cm from the tumor, 2 cm from the atrioventricular groove. Because hemodynamic deterioration occurred after aortic declamping, intra-aortic balloon pumping and veno-arterial extracorporeal membrane oxygenation were instituted. Postoperatively, circulatory support devices were removed safely, and the patient was discharged on the 25th postoperative day. Histopathological examination of the surgical specimens resulted in a diagnosis of angiosarcoma, with positive surgical margins. Chemotherapy and radiotherapy (69 Gy in 30 fractions) were therefore initiated after discharge. To date, the patient has been alive and well with no recurrence of tumor for 4 years and 10 months since surgery.

Discussion

This case study suggests the usefulness of multimodality treatment comprising surgical resection and adjuvant therapy, for cardiac angiosarcoma.
Blinatumomab for First-Line Treatment of Children and Young Persons With B-ALL
Authors: Hodder Angus , Mishra Avijeet K. , Enshaei Amir , Baird Susan , Bhuller Kaljit , Elbeshlawi Ismail , Bonney Denise , Clesham Katherine , Cummins Michelle , Vedi Aditi , Gibson Brenda , George Lindsay , Ingham Danielle , Jigoulina Galina , Lancaster Donna , Lindsay Katherine , Madni Majid , Malone Andrea , Mitchell Bethany , Moppett John , Motwani Jayashree , Moorman Anthony V. , Patrick Katharine , Samrin Lamia , Tewari Sanjay , Thakur Indu , O'Connor David , Samarasinghe Sujith , Vora Ajay
Published: November 2023

PURPOSE

We tested whether blinatumomab (Blina) is effective as a toxicity-sparing alternative to first-line intensive chemotherapy in children and young persons (CYP) with B-ALL who were chemotherapy-intolerant or chemotherapy-resistant.

METHODS

Data were collected for consecutive CYP (age 1-24 years) with Philadelphia chromosome–positive or Philadelphia chromosome–negative B-ALL who received Blina as first-line therapy. Blina was given as replacement for postremission intensive chemotherapy to patients with chemotherapy intolerance or resistance. Blina responders received further chemotherapy (Blin-CT) or first remission hematopoietic stem-cell transplant (Blin-HSCT) if indicated. Event-free survival (EFS) and overall survival (OS) of the Blin-CT group were compared with those of matched controls treated with standard chemotherapy in the UKALL 2003 trial. Events were defined as death, relapse, or secondary cancer.

RESULTS

From February 2018 to February 2023, 105 patients were treated, of whom 85 were in the Blin-CT group and 20 were in the Blin-HSCT group. A majority of Blin-CT patients received Blina for chemotherapy intolerance (70 of 85, 82%), and the group had a higher-risk profile than unselected patients with B-ALL. Blina was well tolerated with only one patient having a grade 3/4–related toxicity event, and of the 60 patients who were minimal residual disease–positive pre-Blina, 58 of 60 (97%) responded. At a median follow-up of 22 months, the 2-year outcomes of the 80 matched Blin-CT group patients were similar to those of 192 controls (EFS, 95% [95% CI, 85 to 98] v 90% [95% CI, 65 to 93] and OS, 97% [95% CI, 86 to 99] v 94% [95% CI, 89 to 96]). Of the 20 in the HSCT group, three died because of transplant complications and two relapsed.

CONCLUSION

Blina is safe and effective in first-line treatment of chemotherapy-intolerant CYP with ALL.
Psychological Outcomes in Adolescent and Young Adult Cancer Survivors
Authors: McGrady Meghan E. , Willard Victoria W. , Williams AnnaLynn M. , Brinkman Tara M.
Published: November 2023

The diagnosis of cancer during adolescent and young adulthood (AYA) may alter the development and psychological trajectory of survivors across their lifespan. The current review focuses broadly on emotional health, social functioning, health behaviors, and cancer-related cognitive impairment (CRCI) among AYA survivors. Overall, AYA survivors appear to be at elevated risk of emotional distress symptoms, mood and anxiety disorders, suicide, and mental health care service utilization compared with individuals without a cancer history. Difficulties with social relationships and reduced achievement of expected social outcomes including educational attainment and employment have been reported. Despite risk for health-related morbidities, including subsequent neoplasms, many AYA survivors do not engage in health behaviors at the recommended levels for physical activity, diet, or tobacco and alcohol use. Although CRCI has not been comprehensively characterized in this population, subgroups of AYA survivors appear to be at risk for experiencing CRCI, including survivors of central nervous system tumors, Hodgkin lymphoma, testicular, and breast cancer. Across each considered domain of psychological functioning, intervention efforts have largely focused on acceptability and feasibility with an increasing focus on e/mHealth approaches. Future research should include multiphase studies, including randomized controlled trials designed to evaluate intervention efficacy and effectiveness. It is imperative that psychological interventions consider the unique needs of AYA survivors by developmental stage and across multiple levels of influence (patient, support system, institution, and health care system).
Long-Term Follow-Up of the Response-Adapted Intergroup EORTC/LYSA/FIL H10 Trial for Localized Hodgkin Lymphoma
Authors: Federico Massimo , Fortpied Catherine , Stepanishyna Yana , Gotti Manuel , van der Maazen Richard , Cristinelli Caterina , Re Alessandro , Plattel Wouter , Lazarovici Julien , Merli Francesco , Specht Lena , Schiano de Colella Jean-Marc , Hutchings Martin , Versari Annibale , Edeline Véronique , Stamatoulas Aspasia , Girinsky Theodore , Ricardi Umberto , Aleman Berthe , Meulemans Bart , Tonino Sanne , Raemaekers John , André Marc
Published: November 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.

The primary analysis of the Early positron emission tomography (ePET) Response–Adapted Treatment in localized Hodgkin Lymphoma H10 Trial demonstrated that in ePET-negative patients, the risk of relapse increased when involved-node radiotherapy (INRT) was omitted and that in ePET-positive patients, switching from doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) to bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPesc) significantly improved 5-year progression-free survival (PFS). Here, we report the final results of a preplanned analysis at a 10-year follow-up. In the favorable (F) ePET-negative group, the 10-year PFS rates were 98.8% versus 85.4% (hazard ratio [HR], 13.2; 95% CI, 3.1 to 55.8; P value for noninferiority = .9735; difference test P < .0001) in favor of ABVD + INRT; in the unfavorable (U) ePET-negative group, the 10-year PFS rates were 91.4% and 86.5% (HR, 1.52; 95% CI, 0.84 to 2.75; P value for noninferiority = .8577; difference test P = .1628). In ePET-positive patients, the difference in terms of PFS between standard ABVD and intensified BEACOPPesc was no longer statistically significant (HR, 0.67; 95% CI, 0.37 to 1.20; P = .1777). In conclusion, the present long-term analysis confirms that in ePET-negative patients, the omission of INRT is associated with lower 10-year PFS. Instead, in ePET-positive patients, no significant difference between standard and experimental arms emerged although intensification with BEACOPPesc was safe, with no increase in late adverse events, namely, second malignancies.
Publicly Funded Cancer Care: Are Adjuvant Therapies Prioritized Over Treatment of Metastatic Cancer? The Israeli Experience
Authors: Hammerman Ariel , Azran Carmil , Topol Yael , Landsberger Daniel , Liebermann Nicky , Siegelmann-Danieli Nava
Published: November 2023

PURPOSE

In Israel, a public committee advises which new medications should be reimbursed subject to an annual budget allocation. The committee considers clinical trial outcomes, professional societies' preferences, projected budget impacts, and other social and ethical aspects. The Israeli oncologists' society places a strong emphasis on prioritizing adjuvant therapies because of their potential to advance cure. In 2023, several novel adjuvant therapies were suggested for national funding. Our objective was to ascertain whether Israeli decision makers have embraced the practice of prioritizing budgets for therapies with curative intent over late-disease therapy.

METHODS

We collected data on all proposed cancer therapies for the 2023 update: indications, treatment settings, European Society for Medical Oncology-Magnitude of Clinical Benefit Scale (ESMO-MCBS) score, and whether accepted for reimbursement. The rates of acceptance were compared between drugs in curative and noncurative settings. Data were extracted from the official Israeli Ministry of Health publications and ESMO-MCBS website.

RESULTS

Seven of the eight proposed therapies with curative intent received reimbursement approval (88%), in contrast to 11 of the 55 therapies for advanced/metastatic stages (20%). Among all advanced disease therapies with a high ESMO-MCBS score of 4, only four of 16 (25%) secured reimbursement approval.

CONCLUSION

Our analysis revealed that during the 2023 reimbursement deliberations, Israeli policymakers embraced the prioritization of potentially curative therapies over treatments for incurable cancers, including several interventions that have demonstrated significant improvements in overall survival and/or quality of life. Introducing objective cost-effectiveness measures as a guiding framework for comparing competing medications may offer some resolution to this complex challenge.
Polycystic Ovary Syndrome Physiologic Pathways Implicated Through Clustering of Genetic Loci
Authors: Stamou Maria I , Smith Kirk T , Kim Hyunkyung , Balasubramanian Ravikumar , Gray Kathryn J , Udler Miriam S
Published: November 2023

Context

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder, with disease loci identified from genome-wide association studies (GWAS) having largely unknown relationships to disease pathogenesis.

Objective

This work aimed to group PCOS GWAS loci into genetic clusters associated with disease pathophysiology.

Methods

Cluster analysis was performed for 60 PCOS-associated genetic variants and 49 traits using GWAS summary statistics. Cluster-specific PCOS partitioned polygenic scores (pPS) were generated and tested for association with clinical phenotypes in the Mass General Brigham Biobank (MGBB, N = 62 252). Associations with clinical outcomes (type 2 diabetes [T2D], coronary artery disease [CAD], and female reproductive traits) were assessed using both GWAS-based pPS (DIAMANTE, N = 898,130, CARDIOGRAM/UKBB, N = 547 261) and individual-level pPS in MGBB.

Results

Four PCOS genetic clusters were identified with top loci indicated as following: (i) cluster 1/obesity/insulin resistance (FTO); (ii) cluster 2/hormonal/menstrual cycle changes (FSHB); (iii) cluster 3/blood markers/inflammation (ATXN2/SH2B3); (iv) cluster 4/metabolic changes (MAF, SLC38A11). Cluster pPS were associated with distinct clinical traits: Cluster 1 with increased body mass index (P = 6.6 × 10−29); cluster 2 with increased age of menarche (P = 1.5 × 10−4); cluster 3 with multiple decreased blood markers, including mean platelet volume (P = 3.1 ×10−5); and cluster 4 with increased alkaline phosphatase (P = .007). PCOS genetic clusters GWAS-pPSs were also associated with disease outcomes: cluster 1 pPS with increased T2D (odds ratio [OR] 1.07; P = 7.3 × 10−50), with replication in MGBB all participants (OR 1.09, P = 2.7 × 10−7) and females only (OR 1.11, 4.8 × 10−5).

Conclusion

Distinct genetic backgrounds in individuals with PCOS may underlie clinical heterogeneity and disease outcomes.
Cardiovascular Risk Markers in Adults With Adrenal Incidentaloma and Mild Autonomous Cortisol Secretion
Authors: Chen Angela X , Radhakutty Anjana , Drake Sophie M , Kiu Andrew , Thompson Campbell H , Burt Morton G
Published: November 2023

Context

Many adrenal adenomas exhibit mild autonomous cortisol secretion (MACS). Although MACS is associated with increased cardiovascular mortality, the underlying mechanisms are not fully defined.

Objective

To investigate mechanisms that may link MACS and cardiovascular mortality in adults with adrenal adenoma.

Design

Cross-sectional study.

Patients

Twenty adults with adrenal adenoma and MACS and 20 controls with nonfunctioning adrenal adenoma.

Methods

Reactive hyperemia index (RHI) was measured by peripheral artery tonometry and 24-hour ambulatory blood pressure monitoring (24h AMBP) was performed. Indices of insulin secretion and sensitivity were estimated by measuring glucose and insulin fasting and following a mixed meal.

Main outcome measure

The primary outcome was the difference in RHI between participants with MACS vs nonfunctioning adrenal adenoma.

Results

The average cortisol after 1-mg dexamethasone and urinary free cortisol were higher in patients with MACS. There was no significant difference in fasting RHI (2.0 [interquartile range (IQR) 1.6-2.4] vs 2.0 [IQR 1.7-2.2, P = .72), but postprandial RHI was higher in patients with MACS (2.2 [1.8-2.7] vs 1.8 [1.5-2.2], P = .04). 24-hour ambulatory blood pressure monitoring and Matsuda index were not significantly different in the groups. Fasting glucose and glucose area under the curve after the mixed meal were higher and insulinogenic index was lower in participants with MACS.

Conclusion

Adults with adrenal adenoma and MACS do not have fasting endothelial dysfunction and postprandial endothelial function may be better. These patients have fasting and postprandial hyperglycemia with lower insulin secretion, which may underlie the association between MACS and increased cardiovascular mortality.
Risk and Incidence of Endocrine Immune-Related Adverse Effects Under Checkpoint Inhibitor Mono- or Combination Therapy in Solid Tumors: A Meta-Analysis of Randomized Controlled Trials
Authors: Vardarli Irfan , Tan Susanne , Brandenburg Tim , Weidemann Frank , Görges Rainer , Herrmann Ken , Führer Dagmar
Published: November 2023

Context

Few meta-analyses on incidence of endocrine immune-related adverse effects (eirAEs) have been published and many trials have been published since.

Objective

We performed a comprehensive meta-analysis with updated literature to assess risk and incidence of eirAEs of any grade and grade 3 to 5 by immune checkpoint inhibitor (ICI) monotherapy or combination therapy in solid tumors.

Methods

An electronic search using PubMed/Medline, Embase, and the Cochrane Library was performed. Randomized controlled studies (RCTs) assessing eirAEs under ICI monotherapy or ICI combination therapy were selected. Stata software (v17) was used for statistical analyses and risk of bias was evaluated using Review Manager version 5.3.

Results

A total of 69 RCTs with 80 independent reports, involving 42 886 patients, were included in the study. Meta-analysis revealed the following pooled estimates for risk ratio and incidence, respectively: for any grade hypothyroidism 7.81 (95% CI, 5.68-10.74, P < .0001) and 7.64% (95% CI, 6.23-9.17, P < .0001); significantly increased also for hyperthyroidism, hypophysitis/hypopituitarism, and adrenal insufficiency; and for insulin-dependent diabetes mellitus 1.52 (95% CI, 1.07-2.18, P = .02), and 0.087% (95% CI, 0.019-0.189, P = .0006), respectively. Meta-regression showed that combination of ICIs (nivolumab plus ipilimumab; durvalumab plus tremelimumab) is an independent risk factor for any grade hypophysitis/hypopituitarism, and that ICI agent is an independent factor of risk for adrenal insufficiency, but that cancer type is not an independent risk factor for eirAEs.

Conclusion

We showed that risk, independent from cancer type, and incidence of eirAEs are substantially increased with ICI therapy. Combination of ICIs increases risk for eirAEs, especially for hypophysitis/hypopituitarism.
The United States’ Record-Low Child Poverty Rate in International and Historical Perspective: A Research Note
Authors: Parolin Zachary , Filauro Stefano
Published: November 2023

In 2021, the federal government of the United States expanded a set of income transfers that led to strong reductions in child poverty. This research note uses microdata from more than 50 countries and U.S. data spanning more than 50 years to place the 2021 child poverty rate in historical and international perspective. We demonstrate that whether using the Supplemental Poverty Measure (SPM), relative poverty measures, or an absolute poverty measure, the U.S. child poverty rate in 2021 was at its lowest level since at least 1967. The U.S. tax and transfer system reduced the 2021 SPM child poverty rate by more than 75% relative to the pre-tax/transfer child poverty rate; this reduction was three times the mean reduction effect between 1967 and 2019. These policy changes improved the country's standing from having a relative poverty rate twice that of Germany's in 2019 to the same as Germany's in 2021. Moreover, the U.S. progressed from reducing child poverty at less than half the rate of Norway in 2019 to a rate comparable to Norway in 2021. However, the U.S. success was temporary: after the expiration of the 2021 income provisions, the child poverty rate doubled and returned to being higher than in most other high-income countries.
Role of Concurrent Ultrasound Surveillance of Sentinel Node-Positive Node Fields in Melanoma Patients Having Routine Cross-Sectional Imaging
Authors: Gjorup Caroline A. , Woodford Rachel , Li Isabel , Carlino Matteo S. , Ch’ng Sydney , Chung David , Hsiao Edward , Lo Serigne N. , London Kevin , Long Georgina V. , Menzies Alexander M. , Nieweg Omgo E. , Pennington Thomas E. , Rtshiladze Michael A. , Saw Robyn P. M. , Scolyer Richard A. , Shannon Kerwin F. , Spillane Andrew J. , Stretch Jonathan R. , Thompson John F. , Varey Alexander H. R. , van Akkooi Alexander C. J.
Published: November 2023

Purpose

In sentinel node-positive (SN+ve) melanoma patients, active surveillance with regular ultrasound examination of the node field has become standard, rather than completion lymph node dissection (CLND). A proportion of these patients now receive adjuvant systemic therapy and have routine cross-sectional imaging (computed tomography [CT] or positron emission tomography [PET]/CT). The role of concurrent ultrasound (US) surveillance in these patients is unclear. The purpose of our study was to describe the modality of detection of nodal recurrence in SN+ve node fields.

Methods

SN+ve melanoma patients who did not undergo CLND treated at a single institution from January 1, 2016 to December 31, 2020 were included.

Results

A total of 225 SN+ve patients with a median follow-up of 23 months were included. Of these, 119 (53%) received adjuvant systemic therapy. Eighty (36%) developed a recurrence at any site; 24 (11%) recurred first in the SN+ve field, of which 12 (5%) were confirmed node field recurrence only at 2 months follow-up. The nodal recurrences were first detected by ultrasound in seven (3%), CT in seven (3%), and PET/CT in seven (3%) patients. All nodal recurrences evident on US were also evident on PET/CT and vice versa.

Conclusions

The high rate of recurrences outside the node field and the identification of all US-detected nodal recurrences on concurrent cross-sectional imaging modalities suggest that routine concurrent ultrasound surveillance of the node-positive field may be unnecessary for SN+ve melanoma patients having routine cross-sectional imaging.
A Single Test Protocol to Establish the Full Spectrum of Exercise Intensity Prescription
Authors: IANNETTA DANILO , MACKIE MARY Z. , KEIR DANIEL A. , MURIAS JUAN M.
Published: November 2023

Via the identification of the ramp-specific gas exchange threshold (GET) and respiratory compensation point (RCP), the recently validated step–ramp–step (SRS) protocol enables the prediction of the power outputs at the lactate threshold and maximal metabolic steady state.

Purpose

We aimed to test the extended capabilities of the SRS protocol by validating its capacity to predict the power outputs for targeted metabolic rates (V̇O2) and time-to-task failure (T
lim) within the heavy- and severe-intensity domain, respectively.

Methods

Fourteen young individuals completed (i) an SRS protocol from which the power outputs at GET and RCP (RCPCORR), and the work accruable above RCPCORR, defined as W′RAMP, were derived; (ii) one heavy-intensity bout at a power output predicted to elicit a targeted V̇O2 equidistant from GET and RCP; and (iii) four severe-intensity trials at power outputs predicted to elicit targeted T
lim at minutes 2.5, 5, 10, and 13. These severe-intensity trials were also used to compute the constant-load–derived critical power and W´ (W′CONSTANT).

Results

Targeted (2.41 ± 0.52 L·min−1) and measured (2.43 ± 0.52 L·min−1) V̇O2 at the identified heavy-intensity power output (162 ± 43 W) were not different (P = 0.71) and substantially concordant (CCC = 0.95). Likewise, targeted and measured T
lim for the four identified severe-intensity power outputs were not different (P > 0.05), and the aggregated coefficient of variation was 10.7% ± 8.9%. The derived power outputs at RCPCORR (192 ± 53 W) and critical power (193 ± 53 W) were not different (P = 0.65) and highly concordant (CCC = 0.99). There were also no differences between W′RAMP and W′CONSTANT (P = 0.51).

Conclusions

The SRS protocol can accurately predict power outputs to elicit discrete metabolic rates and exercise durations, thus providing, with time efficiency, a high precision for the control of the metabolic stimulus during exercise.
Impact of COVID‐19 on Indonesia stock portfolio allocation based on a technical & fundamental approach using a machine learning algorithm
Authors: Riyadhi Atha Fitrah , Atok R. Mohamad
Published: November 2023

Background: COVID-19 has had a negative impact on economic growth in Indonesia and affected the level of investment uncertainty in the Indonesian capital market. Leading stocks with large market capitalization and included in the LQ45 stock index on the Indonesia Stock Exchange (IDX) were also affected by the COVID-19 pandemic, which was corrected by -15% from the pre-pandemic period. This significant decline has a direct negative impact on capital market investors, so as to avoid the Black Swan event that occurred due to the recession, investors need to diversify their portfolios.

Methods: Therefore, this study aims to assist investors in better portfolio diversification, especially in the face of the pandemic by using the clustering method. Clustering was carried out on 35 stocks that are members of LQ45 Index from January 1, 2019 to December 31, 2020 based on business fundamental and technical indicators stocks using the K-Means Clustering algorithm.

Results: The clustering found that LQ45 stocks are grouped into 4 clusters, each of which have different unique characteristics. Furthermore, the results are used as a reference in stock portfolio allocation where the stocks which have the best sharpe ratio from each selected cluster will be selected to form a portfolio.

Conclusion: Portfolio performance testing throughout the market period in 2021 show that formed portfolios are  having excellent performance because it has a high positive return and  looks much better compared to the LQ45 index as a macro evaluation. In addition, portfolios have also been well diversified, as evidenced by the low correlation value of its inter-stock correlation.
Control study of Musca domestica (Diptera, Muscidae) in Misan Province
Authors: Alsaad Rasha
Published: November 2023

Background Houseflies are the most common type of Diptera, specifically Muscidae, worldwide, representing more than 90% of all species. This family has over 170 genera and 4200 species, but a few are of medical significance. This study aimed to estimate and assessing the measures to control and prevent grow-up inside houses and flying of the housefly (Musca domestica Linnaeus, 1758) in Misan. Methods The study occurred over 12 months, from December 2020 to December 2021. Using plastic containers, Musca domestica were collected from all potential breeding sites in the study region (inside and around houses). Sticky oil paper and traps were used to collect the insects. The collected insects were transferred to sealed plastic containers and then to the laboratory of the Department of Microbiology. Out of 200 randomly selected houses, 150 (75%) contained insects. Light traps and sticky oil papers were the most effective control measures, with 26.7% and 25.9% of the Musca domestica collected from these methods, respectively. The ratio of male (233) to female (456) Musca was 1:2, with a significant difference between the frequencies (P<0.05). A large population of houseflies was collected during the hot season (501, 72.7%), whereas fewer Musca were collected during the cold months (188, 27.3%), with a strongly significant difference (P<0.05). The percentage of HI was 54.4%, the CI was 21.9%, and the BI was 79.9%. The overall larval densities (LD) were at a medium level. Conclusions Misan has a high density of Musca domestica, with females being more prominent than males. Hot climate, humid sites, and dirty places are responsible for the breeding of houseflies. The overall larval density was medium. Therefore, the risk of transmitting infectious diseases by houseflies is high within the boundaries of Misan province, and effective control parameters should include measures like light traps and sticky oil.
Time-related changes in the knowledge of HIV/AIDS among followers of various religions in India
Authors: Khalid Amna , Qaisar Rizwan , Ahmad Firdos , Hussain M. Azhar , Karim Asima
Published: November 2023

Background The public knowledge levels about Human Immunodeficiency-Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) have been assessed in previous studies; however, time-related trends in association with socio-demographic standards among the followers of major religions in India are not known. Objectives We assessed the 2005-06, 2015-16, and 2019-21 demographic and health survey (DHS) data from India to investigate trends in the levels of knowledge of HIV/AIDS among Hindus, Muslims, and Christians in relation to standard socio-demographic variables over a period of 16 years. Methods The age range of the population was 15-54 years (n=611,821). The HIV/AIDS-related knowledge was assessed by developing a composite index based on ten questions about several aspects of HIV/AIDS, such as the mode of spread. We applied Chi-square and Kruskal-Wallis tests to investigate whether people had heard about HIV/AIDS and their overall HIV knowledge in relation to several socio-demographic standards. Results Generally, a higher increase in knowledge level was found between the first and second DHS surveys (2006-2016) as compared to between the second and third DHS surveys (2016-2021). We found the highest increase in the level of HIV/AIDS knowledge among Christian women followed by Hindus, whereas Muslims had the least increase over 16 years. Being a female, uneducated, poor, previously married, or having rural residence were associated with the highest increase in the knowledge of HIV/AIDS. Conclusion Christian women had the highest increase in HIV/AIDS-related knowledge then came Christian men and followers of other religions. We also found the highest increase in HIV/AIDS-related knowledge among the poorest, uneducated, and rural residents. Our findings may help formulate public health strategies targeting various less knowledgeable groups to reduce the incidence of HIV/AIDS.
Towards inventory control excellence: An innovative approach based on a web-based platform
Authors: Ramos-Miller Miguel , Pacheco Alex
Published: November 2023

Background Inventory management in educational institutions presents unique challenges due to the diverse sources of information and the need for improved team collaboration. This research aims to enhance inventory processes in educational institutions by leveraging information technology to optimize efficiency and ensure data integrity and reliability. Methods The study employed a five-phase methodology to develop a web-based inventory optimization system. The initial phase involved a comprehensive analysis of inventory requirements, considering multiple data sources and team needs. Subsequently, in the planning phase, requirements were prioritized, and tasks with corresponding deadlines were established. The implementation phase adhered to the requirements outlined in the planning phase, utilizing appropriate information technologies to ensure efficient and reliable operation. A thorough system review was conducted to assess the achievement of each requirement’s objectives, with necessary adjustments made as needed. Finally, following the completion of the previous phases, the developed software was deployed, and additional testing was conducted to ensure proper functionality. Results Following the implementation of the web-based system, significant improvements were observed: an 85.51% increase in efficiency for goods searches, streamlining the process and reducing location times; a 90.31% enhancement in goods registration, ensuring greater accuracy and data reliability; an 83.11% improvement in annual goods report generation, simplifying reporting and offering a clearer view of the inventory. Overall, the inventory process experienced an 86.31% improvement, leading to enhanced efficiency and collaboration among administrative and teaching staff. The utilization of information technology reduced inventory processing times and ensured the uniqueness and reliability of information. Conclusions This research focuses specifically on optimizing inventory management in educational institutions through information technology. The study’s uniqueness lies in its tailored web-based system designed to address the specific needs of educational institutions. The results demonstrate the effectiveness of this approach and its positive impact on inventory management.