bluuebunny/crossref_metadata_2025 huggingface dataset:
Implications of the School Day on Health Behaviors for Children With Type 1 Diabetes: A Survey of Parent Perspectives During the COVID-19 Pandemic
Authors: March Christine A. , Siminerio Linda M. , Muzumdar Radhika H. , Libman Ingrid M.
Published: December 2021

Purpose

The purpose of this study is to survey parents of youth with type 1 diabetes during the COVID-19 pandemic with school closures to better understand the implications of the school day on health care behaviors.

Methods

A cross-sectional, online survey was distributed to parents of youth with type 1 diabetes ≤19 years of age in a large, academic diabetes center. Questions encompassed perceived changes in management behaviors and plans for return to school. Subgroup analysis compared parent responses by child’s age, reported stressors, and socioeconomic markers.

Results

Parents reported a worsening in their child’s diabetes health behaviors during school closures compared to what they perceived during a regular school day before the pandemic. More than half of parents reported feeling that their child was unable to maintain a normal routine, with particular implications for snacking between meals, daily physical activity, and sleep habits. Families with adolescents or those experiencing multiple pandemic-related stressors reported greater challenges. In open-ended responses, families highlighted difficulty in balancing school, work, and diabetes care and expressed concerns about the mental health repercussions of school closures for their children. Nearly half of parents reported being at least moderately worried about return to school, whereas only a minority reported seeking guidance from their diabetes provider.

Conclusions

Parent-reported disruptions of school-day routines frequently had adverse consequences for diabetes management in this population. These findings highlight the importance of a school-day routine for children with type 1 diabetes; during closures, families may benefit from mitigating strategies to maintain effective habits.
Sluzhenikinite, Pd15(Sb7-xSnx) 3 ≤ x ≤ 4, a new platinum group mineral (PGM) from the Oktyabrsk deposit, the Noril`sk deposits, Russia
Authors: Vymazalová Anna , Welch Mark D. , Laufek František , Kozlov Vladimir V. , Stanley Chris J. , Plášil Jakub
Published: December 2021

Sluzhenikinite, Pd15(Sb7–xSnx) with 3 ≤ x ≤ 4, is a new mineral discovered in the pegmatoidal galena–chalcopyrite massive ore from the Oktyabrsk mine, Oktyabrsk deposit of the Noril`sk deposits, Russia. Sluzhenikinite forms euhedral elongate lamellar crystals (100–150 μm long and 10–50 μm wide) associated with Au–Ag alloy, insizwaite and myrmekitic intergrowths of Pt–Pd minerals (stibiopalladinite, maslovite and sobolevskite), in close association of sperrylite and base-metal sulfides (galena, chalcopyrite, cubanite and pentlandite). In plane-polarised light, sluzhenikinite is pale brown with weak bireflectance, imperceptible pleochroism, and weak anisotropy with straw yellow to deep blue rotation tints; it exhibits no internal reflections. Reflectance values for sluzhenikinite in air (R1,R2 in %) are: 46.2, 46.5 at 470nm; 52.1, 52.2 at 546nm; 54.7, 55.1 at 589nm; and 57.8, 59.0 at 650nm. Thirteen electron-microprobe analyses of sluzhenikinite gave an average composition: Pd 65.06, Sn 15.60 and Sb 19.58, total 100.24 wt.%, corresponding to the formula Pd14.88(Sb3.92Sn3.20)Σ7.12 based on 22 atoms; the average of twenty-one energy dispersive spectroscopy analyses on co-type material gave: Pd 63.36, Pt 1.15, Sn 16.28 and Sb 19.21, total 100.00 wt.%, corresponding to the formula (Pd14.62Pt0.14)Σ14.76(Sb3.87Sn3.37)Σ7.24. The density, calculated on the basis of the empirical formula, is 11.22 g/cm3. The mineral is monoclinic, space group P21/m, with a = 7.5558(1), b = 29.2967(3), c = 7.5713(1) Å, β = 119.931(2)°, V = 1452.44(4) Å3 and Z = 4. The crystal structure was determined using data from single-crystal X-ray diffraction and demonstrates conclusively that the correct stoichiometry is Pd15(Sb,Sn)7, rather than Pd2(Sb,Sn); R1 = 0.035, wR2 = 0.073, GoF = 1.118 for 209 refined parameters and 4738 unique reflections. The mineral is named after Sergey Fedorovich Sluzhenikin, an expert on platinum-group minerals, particularly from the area of the type locality.
High frequency of enterotoxigenic Bacteroides fragilis and Enterococcus faecalis in the paraffin-embedded tissues of Iranian colorectal cancer patients
Authors: Khodaverdi Nasibeh , Zeighami Habib , Jalilvand Ahmad , Haghi Fakhri , Hesami Negar
Published: December 2021

Background

The association between specific bacteria and colorectal cancer (CRC) has been proposed. Only a few studies have, however, investigated this relationship directly in colorectal tissue with conflicting results. So, we aimed to quantitate Streptococcus gallolyticus, Fusobacterium spp, Enterococcus faecalis and enterotoxigenic Bacteroides fragilis (ETBF) in formalin-fixed and paraffin-embedded (FFPE) colorectal tissue samples of Iranian CRC patients and healthy controls.

Methods

A total of 80 FFPE colorectal tissue samples of CRC patients (n = 40) and healthy controls (n = 40) were investigated for the presence and copy number of above bacterial species using quantitative PCR. Relative quantification was determined using ΔΔCT method and expressed as relative fold difference compared to reference gene.

Results

Relative abundance and copy number of E. faecalis and ETBF were significantly higher in CRC samples compared to control group. E. faecalis was more prevalent than ETBF in tumor samples. Frequency of ETBF and E. faecalis in late stages (III/IV) of cancer was significantly higher than early stages (I/II). We did not detect a significant difference in abundance of S. gallolyticus and Fusobacterium spp between two groups.

Conclusion

Our study revealed the higher concentration of E. faecalis and ETBF in FFPE samples of CRC patients than controls. However, additional investigations on fecal and fresh colorectal cancer tissue samples are required to substantiate this correlation.
Rotten to the core: antivirals targeting the HIV-1 capsid core
Authors: McFadden William M. , Snyder Alexa A. , Kirby Karen A. , Tedbury Philip R. , Raj Monika , Wang Zhengqiang , Sarafianos Stefan G.
Published: December 2021

The capsid core of HIV-1 is a large macromolecular assembly that surrounds the viral genome and is an essential component of the infectious virus. In addition to its multiple roles throughout the viral life cycle, the capsid interacts with multiple host factors. Owing to its indispensable nature, the HIV-1 capsid has been the target of numerous antiretrovirals, though most capsid-targeting molecules have not had clinical success until recently. Lenacapavir, a long-acting drug that targets the HIV-1 capsid, is currently undergoing phase 2/3 clinical trials, making it the most successful capsid inhibitor to-date. In this review, we detail the role of the HIV-1 capsid protein in the virus life cycle, categorize antiviral compounds based on their targeting of five sites within the HIV-1 capsid, and discuss their molecular interactions and mechanisms of action. The diverse range of inhibition mechanisms provides insight into possible new strategies for designing novel HIV-1 drugs and furthers our understanding of HIV-1 biology.

Graphical Abstract
Associations between DNA methylation and BMI vary by metabolic health status: a potential link to disparate cardiovascular outcomes
Authors: Do Whitney L. , Nguyen Steve , Yao Jie , Guo Xiuqing , Whitsel Eric A. , Demerath Ellen , Rotter Jerome I. , Rich Stephen S. , Lange Leslie , Ding Jingzhong , Van Den Berg David , Liu Yongmei , Justice Anne E. , Guan Weihua , Horvath Steve , Assimes Themistocles L. , Bhatti Parveen , Jordahl Kristina , Shadyab Aladdin , Valencia Celina I. , Stein Aryeh D. , Smith Alicia , Staimez Lisa R. , Conneely Karen , Narayan K. M. Venkat
Published: December 2021

Background

Body mass index (BMI), a well-known risk factor for poor cardiovascular outcomes, is associated with differential DNA methylation (DNAm). Similarly, metabolic health has also been associated with changes in DNAm. It is unclear how overall metabolic health outside of BMI may modify the relationship between BMI and methylation profiles, and what consequences this may have on downstream cardiovascular disease. The purpose of this study was to identify cytosine-phosphate-guanine (CpG) sites at which the association between BMI and DNAm could be modified by overall metabolic health.

Results

The discovery study population was derived from three Women’s Health Initiative (WHI) ancillary studies (n = 3977) and two Atherosclerosis Risk in Communities (ARIC) ancillary studies (n = 3520). Findings were validated in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort (n = 1200). Generalized linear models regressed methylation β values on the interaction between BMI and metabolic health Z score (BMI × MHZ) adjusted for BMI, MHZ, cell composition, chip number and location, study characteristics, top three ancestry principal components, smoking, age, ethnicity (WHI), and sex (ARIC). Among the 429,566 sites examined, differential associations between BMI × MHZ and DNAm were identified at 22 CpG sites (FDR q < 0.05), with one site replicated in MESA (cg18989722, in the TRAPPC9 gene). Three of the 22 sites were associated with incident coronary heart disease (CHD) in WHI. For each 0.01 unit increase in DNAm β value, the risk of incident CHD increased by 9% in one site and decreased by 6–10% in two sites over 25 years.

Conclusions

Differential associations between DNAm and BMI by MHZ were identified at 22 sites, one of which was validated (cg18989722) and three of which were predictive of incident CHD. These sites are located in several genes related to NF-kappa-B signaling, suggesting a potential role for inflammation between DNA methylation and BMI-associated metabolic health.
DNA methylation mediates the association between breastfeeding and early-life growth trajectories
Authors: Briollais Laurent , Rustand Denis , Allard Catherine , Wu Yanyan , Xu Jingxiong , Rajan Samyukta Govinda , Hivert Marie-France , Doyon Myriam , Bouchard Luigi , McGowan Patrick O. , Matthews Steven , Lye Steven
Published: December 2021

Background

The role of breastfeeding in modulating epigenetic factors has been suggested as a possible mechanism conferring its benefits on child development but it lacks evidence. Using extensive DNA methylation data from the ALSPAC child cohort, we characterized the genome-wide landscape of DNA methylation variations associated with the duration of exclusive breastfeeding and assessed whether these variations mediate the association between exclusive breastfeeding and BMI over different epochs of child growth.

Results

Exclusive breastfeeding elicits more substantial DNA methylation variations during infancy than at other periods of child growth. At the genome-wide level, 13 CpG sites in girls (miR-21, SNAPC3, ATP6V0A1,DHX15/PPARGC1A,LINC00398/ALOX5AP,FAM238C,NATP/NAT2,CUX1,TRAPPC9,OSBPL1A,ZNF185,FAM84A,PDPK1) and 2 CpG sites in boys (IL16andNREP), mediate the association between exclusive breastfeeding and longitudinal BMI. We found enrichment of CpG sites located within miRNAs and key pathways (AMPK signaling pathway, insulin signaling pathway, endocytosis). Overall DNA methylation variation corresponding to 3 to 5 months of exclusive breastfeeding was associated with slower BMI growth the first 6 years of life compared to no breastfeeding and in a dose–response manner with exclusive breastfeeding duration.

Conclusions

Our study confirmed the early postnatal period as a critical developmental period associated with substantial DNA methylation variations, which in turn could mitigate the development of overweight and obesity from infancy to early childhood. Since an accelerated growth during these developmental periods has been linked to the development of sustained obesity later in life, exclusive breastfeeding could have a major role in preventing the risks of overweight/obesity and children and adults through DNA methylation mechanisms occurring early in life.
ADP-ribosyl transferase activity and gamma radiation cytotoxicity of Pseudomonas aeruginosa exotoxin A
Authors: Morgan Radwa N. , Saleh Sarra E. , Aboshanab Khaled M. , Farrag Hala A.
Published: December 2021

This work explores the ADP-ribosyltransferase activity of Pseudomonas (P.) aeruginosa exotoxin A using the guanyl hydrazone derivative, nitrobenzylidine aminoguanidine (NBAG) and the impact of gamma radiation on its efficacy. Unlike the conventional detection methods, NBAG was used as the acceptor of ADP ribose moiety instead of wheat germ extract elongation factor 2. Exotoxin A was extracted from P. aeruginosa clinical isolates and screened for toxA gene using standard PCR. NBAG was synthesized using aminoguanidine bicarbonate and 4-nitrobenzaldehyde and its identity has been confirmed by UV, FTIR, Mass and 13C-NMR spectroscopy. The ADP-ribosyl transferase activity of exotoxin A on NBAG in the presence of Nicotinamide adenine dinucleotide (NAD+) was recorded using UV spectroscopy and HPLC. In vitro ADP-ribosyl transferase activity of exotoxin A protein extract was also explored by monitoring its cytotoxicity on Hep-2 cells using sulforhodamine B cytotoxicity assay. Bacterial broths were irradiated at 5, 10, 15, 24 Gy and exotoxin A protein extract activity were assessed post exposure. Exotoxin A extract exerted an ADP-ribosyltransferase ability which was depicted by the appearance of a new ʎmax after the addition of exotoxin A to NBAG/NAD+ mixture, fragmentation of NAD+ and development of new peaks in HPLC chromatograms. Intracellular enzyme activity was confirmed by the prominent cytotoxic effects of exotoxin A extract on cultured cells. In conclusion, the activity of Exotoxin A can be monitored via its ADP-ribosyltransferase activity and low doses of gamma radiation reduced its activity. Therefore, coupling radiotherapy with exotoxin A in cancer therapy should be carefully monitored.
A study on the nutritional characteristics of some plants and their effects on ruminal microbial fermentation and protozoa population
Authors: Kazemi Mohsen , Moheghi Mohammad Mehdi , Tohidi Reza
Published: December 2021

We designed this project to determine the nutritional potential and ruminal microbial fermentation properties of eight rangeland plants (Dracocephalum moldavicaL.,Melissa officinalis L.,Ruta graveolens L.,Perovskia abrotanoidesKar.,Cichorium intybusL.,Borago officinalisL.,Peganum harmala L., andTeucrium polium L.) collected from the semi-arid region of Iran at two consecutive years (2019 and 2020) for ruminant diets.Medicago sativaas a common forage was also considered as control. We determined the chemical-mineral composition, buffering capacity, in vitro gas yield, ruminal fermentation, and protozoa population in a culture medium with the standard laboratory methods. A significant difference in chemical-mineral compounds was observed among the studied plants (p < 0.05). A lower crude protein range (6.28% forCichorium intybusL. to 18.4% forMelissa officinalis L.) was observed rather thanMedicago sativa(20.3%). The amount of calcium was highest inPeganum harmala L. (23.5–24.2 g/kg DM) and lowest inRuta graveolens L. (1.15–1.25 g/kg DM).Dracocephalum moldavicaL. exhibited the highest acid–base buffering capacity (235–242 mEq×10−3) among other plants. The highest decrease in total protozoa and other protozoan populations was observed whenPerovskia abrotanoidesKar. was added to the culture medium.Teucrium Polium L. had the greatest potential gas yield and its total volatile fatty acid was comparable withMedicago sativa. It seems that eight plants are nutritionally suitable for partial replacement of the conventional plants such asMedicago sativain diets of small ruminants, however dietary supplementation ofPeganum harmala L. due to its alkaloids content should be done with caution.
Critical appraisal of clinical practice guidelines for the management of COVID-19: protocol for a systematic review
Authors: Dhivagaran Thanansayan , Abbas Umaima , Butt Fahad , Arunasalam Luckshann , Chang Oswin
Published: December 2021

Background

In December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 was identified as the cause of an acute respiratory disease, coronavirus disease 2019 (COVID-19). Given the lack of validated treatments, there is an urgent need for a high-quality management of COVID-19. Clinical practice guidelines (CPGs) are one tool that healthcare providers may use to enhance patient care. As such, it is necessary that they have access to high-quality evidence-based CPGs upon which they may base decisions regarding the management and use of therapeutic interventions (TI) for COVID-19. The purpose of the proposed study is to assess the quality of CPGs that make management or TI recommendations for COVID-19 using the AGREE II instrument.

Methods

The proposed systematic review will identify CPGs for TI use and/or the management of COVID-19. The MEDLINE, EMBASE, CINAHL, and Web of Science databases, as well as the Guidelines International Network, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, and the World Health Organization websites, will be searched from December 2019 onwards. The primary outcome of this study is the assessed quality of the CPGs. The quality of eligible CPGs will be assessed using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. Descriptive statistics will be used to quantify the quality of the CPGs. The secondary outcomes of this study are the types of management and/or TI recommendations made. Inconsistent and duplicate TI and/or management recommendations made between CPGs will be compared across guidelines. To summarize and explain the findings related to the included CPGs, a narrative synthesis will also be provided.

Discussion

The results of this study will be of utmost importance to enhancing clinical decision-making among healthcare providers caring for patients with COVID-19. Moreover, the results of this study will be relevant to guideline developers in the creation of CPGs or improvement of existing ones, researchers who want to identify gaps in knowledge, and policy-makers looking to encourage and endorse the adoption of CPGs into clinical practice. The results of this review will be published in a peer-reviewed journal and presented at conferences.

Systematic review registration

International Prospective Register for Systematic Reviews (PROSPERO)—CRD42020219944
Overview of national health reporting in the EU and quality criteria for public health reports – results of the Joint Action InfAct
Authors: Thissen Martin , Seeling Stefanie , Achterberg Peter , Fehr Angela , Palmieri Luigi , Tijhuis Mariken J. , Unim Brigid , Ziese Thomas
Published: December 2021

Background

Health reporting shall provide up-to-date health-related data to inform policy-makers, researchers and the public. To this end, health reporting formats should be tailored to the needs and competencies of the target groups and provide comparable and high-quality information. Within the Joint Action on Health Information ‘InfAct’, we aimed at gaining an overview of health reporting practices in the EU Member States and associated countries, and developed quality criteria for the preparation of public health reports. The results are intended to facilitate making health information adequately available while reducing inequalities in health reporting across the EU.

Methods

A web-based desk research was conducted among EU Member States and associated countries to generate an overview of different formats of national health reporting and their respective target groups. To identify possible quality criteria for public health reports, an exploratory literature review was performed and earlier projects were analysed. The final set of criteria was developed in exchange with experts from the InfAct consortium.

Results

The web-based desk research showed that public health reports are the most frequently used format across countries (94%), most often addressed to scientists and researchers (51%), politicians and decision-makers (41%). However, across all reporting formats, the general public is the most frequently addressed target group. With regards to quality criteria for public health reports, the literature review has yielded few results. Therefore, two earlier projects served as main sources: the ‘Evaluation of National and Regional Public Health Reports’ and the guideline ‘Good Practice in Health Reporting‘from Germany. In collaboration with experts, quality criteria were identified and grouped into eight categories, ranging from topic selection to presentation of results, and compiled in a checklist for easy reference.

Conclusion

Health reporting practices in the EU are heterogeneous across Member States. The assembled quality criteria are intended to facilitate the preparation, dissemination and access to better comparable high-quality public health reports as a basis for evidence-based decision-making. A comprehensive conceptual and integrative approach that incorporates the policy perspective would be useful to investigate which dissemination strategies are the most suitable for specific requirements of the targeted groups.
Willingness of dentists in the United Arab Emirates to perform restorative and surgical treatments for patients infected with hepatitis C
Authors: Al-Amad Suhail H
Published: December 2021

Background

Dentists’ refusal to treat patients infected with hepatitis C (HCV) continues to raise ethical concerns, particularly in countries where HCV is prevalent. The aim of this cross-sectional study was to assess dentists’ willingness to treat patients infected with HCV and the socio-demographic variables that influence their decision.

Methods

An online questionnaire was disseminated to dentists practicing in the United Arab Emirates (UAE) and enquired about their willingness to perform two dental treatments: restorative and surgical, to patients infected with HCV, while hypothetically being equipped with optimal personal protective equipment. Binary logistic regression test was used to assess socio-demographic factors that predict dentists’ unwillingness decision.

Results

Two-hundred and forty-five dentists participated in this survey. Among those, 25.6 and 19.3% were unwilling to perform dental extractions and aerosol-generating restorative dental treatments for patients infected with HCV, respectively. Dentists’ clinical experience was a significant predictor of their unwillingness decision, with those of shorter clinical experience expressing greater reluctance than their counterparts (OR:1.61; 95% CI: 1.02–2.54; p = 0.042).

Conclusion

Patients infected with HCV who need dental care could face rejection by early career dentists, particularly if that treatment is a surgical one. Fresh dental graduates should be made aware of their ethical and legal responsibilities towards patients with infectious diseases, particularly HCV.
Cyberbullying detection: advanced preprocessing techniques & deep learning architecture for Roman Urdu data
Authors: Dewani Amirita , Memon Mohsin Ali , Bhatti Sania
Published: December 2021

Social media have become a very viable medium for communication, collaboration, exchange of information, knowledge, and ideas. However, due to anonymity preservation, the incidents of hate speech and cyberbullying have been diversified across the globe. This intimidating problem has recently sought the attention of researchers and scholars worldwide and studies have been undertaken to formulate solution strategies for automatic detection of cyberaggression and hate speech, varying from machine learning models with vast features to more complex deep neural network models and different SN platforms. However, the existing research is directed towards mature languages and highlights a huge gap in newly embraced resource poor languages. One such language that has been recently adopted worldwide and more specifically by south Asian countries for communication on social media is Roman Urdu i-e Urdu language written using Roman scripting. To address this research gap, we have performed extensive preprocessing on Roman Urdu microtext. This typically involves formation of Roman Urdu slang- phrase dictionary and mapping slangs after tokenization. We have also eliminated cyberbullying domain specific stop words for dimensionality reduction of corpus. The unstructured data were further processed to handle encoded text formats and metadata/non-linguistic features. Furthermore, we performed extensive experiments by implementing RNN-LSTM, RNN-BiLSTM and CNN models varying epochs executions, model layers and tuning hyperparameters to analyze and uncover cyberbullying textual patterns in Roman Urdu. The efficiency and performance of models were evaluated using different metrics to present the comparative analysis. Results highlight that RNN-LSTM and RNN-BiLSTM performed best and achieved validation accuracy of 85.5 and 85% whereas F1 score was 0.7 and 0.67 respectively over aggression class.
Object segmentation in cluttered environment based on gaze tracing and gaze blinking
Authors: Ratsamee Photchara , Mae Yasushi , Kamiyama Kazuto , Horade Mitsuhiro , Kojima Masaru , Arai Tatsuo
Published: December 2021

People with disabilities, such as patients with motor paralysis conditions, lack independence and cannot move most parts of their bodies except for their eyes. Supportive robot technology is highly beneficial in supporting these types of patients. We propose a gaze-informed location-based (or gaze-based) object segmentation, which is a core module of successful patient-robot interaction in an object-search task (i.e., a situation when a robot has to search for and deliver a target object to the patient). We have introduced the concepts of gaze tracing (GT) and gaze blinking (GB), which are integrated into our proposed object segmentation technique, to yield the benefit of an accurate visual segmentation of unknown objects in a complex scene. Gaze tracing information can be used as a clue as to where the target object is located in a scene. Then, gaze blinking can be used to confirm the position of the target object. The effectiveness of our proposed method has been demonstrated using a humanoid robot in experiments with different types of highly cluttered scenes. Based on the limited gaze guidance from the user, we achieved an 85% F-score of unknown object segmentation in an unknown environment.
Fault enhancement using probabilistic neural networks and Laplacian of a Gaussian filter: A case study in the Great South Basin, New Zealand
Authors: Mora Jose P. , Bedle Heather , Marfurt Kurt J.
Published: December 2021

Fault identification is critical in defining the structural framework for exploration and reservoir characterization studies. Interpreters routinely use edge-sensitive attributes to accelerate the manual picking process, in which the actual choice of a particular edge-sensitive attribute varies with the seismic data quality and with the reflectivity response of the faulted geologic formations. The cyan-magenta-yellow (CMY) color blending provides an effective way to combine the information content of two or three edge-sensitive attributes when more than one attribute is sensitive to faults. We have evaluated whether combining the information content of more than three attributes using probabilistic neural networks (PNNs) provides any additional uplift. We use training data consisting of manually picked faults on a coarse grid of 3D seismic lines, and then, we use an exhaustive search PNN to identify the optimal set of attributes to create a fault probability volume for a 3D survey acquired over the Great South Basin, New Zealand. We construct a suite of candidate attributes using our understanding of the attribute response to faults seen in the data and examples extracted from the published literature to use the list as the analyzed attributes. Using a subset of picked faults as training data, we evaluate which suite of attributes and hyperparameters exhibits the highest validation on the remaining training data. When used together, we find that volume aberrancy magnitude, gray-level cooccurrence matrix (GLCM) homogeneity, GLCM entropy, Sobel filter similarity, and envelope best predict the faults for this data set. The PNN supervised classification creates a seismic image volume that exhibits fault probabilities providing a simple combination of multiple seismic attributes. We also find that applying a directional Laplacian of a Gaussian and skeletonization filters to the PNN fault volumes provides a superior result to simple CMY blending techniques.
Machine-learning assisted interpretation: Integrated fault prediction and extraction case study from the Groningen gas field, Netherlands
Authors: Smith Stewart , Zimina Olesya , Manral Surender , Nickel Michael
Published: December 2021

Seismic fault detection using machine-learning techniques, in particular the convolution neural network (CNN), is becoming a widely accepted practice in the field of seismic interpretation. Machine-learning algorithms are trained to mimic the capabilities of an experienced interpreter by recognizing patterns within seismic data and classifying them. Regardless of the method of seismic fault detection, interpretation or extraction of 3D fault representations from edge evidence or fault probability volumes is routine. Extracted fault representations are important to the understanding of the subsurface geology and are a critical input to upstream workflows including structural framework definition, static reservoir and petroleum system modeling, and well planning and derisking activities. Efforts to automate the detection and extraction of geologic features from seismic data have evolved in line with advances in computer algorithms, hardware, and machine-learning techniques. We have developed an assisted fault interpretation workflow for seismic fault detection and extraction, demonstrated through a case study from the Groningen gas field of the Upper Permian, Dutch Rotliegend; a heavily faulted, subsalt gas field located onshore, northeast Netherlands. Supervised using interpreter-led labeling, we apply a 2D multi-CNN to detect faults within a 3D prestack depth migrated seismic data set. After prediction, we apply a geometric evaluation of predicted faults, using a principal component analysis to produce geometric attribute representations (strike azimuth and planarity) of the fault prediction. Strike azimuth and planarity attributes are used to validate and automatically extract consistent 3D fault geometries, providing geologic context to the interpreter and input to dependent workflows more efficiently.
Toward an Optimized Staging System for Pancreatic Ductal Adenocarcinoma: A Clinically Interpretable, Artificial Intelligence–Based Model
Authors: Bertsimas Dimitris , Margonis Georgios Antonios , Huang Yifei , Andreatos Nikolaos , Wiberg Holly , Ma Yu , Mcintyre Caitlin , Pulvirenti Alessandra , Wagner Doris , van Dam J. L. , Gavazzi Francesca , Buettner Stefan , Imai Katsunori , Stasinos Georgios , He Jin , Kamphues Carsten , Beyer Katharina , Seeliger Hendrik , Weiss Matthew J. , Kreis Martin , Cameron John L. , Wei Alice C. , Kornprat Peter , Baba Hideo , Koerkamp Bas Groot , Zerbi Alessandro , D'Angelica Michael , Wolfgang Christopher L.
Published: December 2021

PURPOSE

The American Joint Committee on Cancer (AJCC) eighth edition schema for pancreatic ductal adenocarcinoma treats T and N stage as independent factors and uses positive lymph nodes (PLNs) to define N stage, despite data favoring lymph node ratio (LNR). We used artificial intelligence–based techniques to compare PLN with LNR and investigate interactions between tumor size and nodal status.

METHODS

Patients who underwent pancreatic ductal adenocarcinoma resection between 2000 and 2017 at six institutions were identified. LNR and PLN were compared through shapley additive explanations (SHAP) analysis, with the best predictor used to define nodal status. We trained optimal classification trees (OCTs) to predict 1-year and 3-year risk of death, incorporating only tumor size and nodal status as variables. The OCTs were compared with the AJCC schema and similarly trained XGBoost models. Variable interactions were explored via SHAP.

RESULTS

Two thousand eight hundred seventy-four patients comprised the derivation and 1,231 the validation cohort. SHAP identified LNR as a superior predictor. The OCTs outperformed the AJCC schema in the derivation and validation cohorts (1-year area under the curve: 0.681 v 0.603; 0.638 v 0.586, 3-year area under the curve: 0.682 v 0.639; 0.675 v 0.647, respectively) and performed comparably with the XGBoost models. We identified interactions between LNR and tumor size, suggesting that a negative prognostic factor partially overrides the effect of a concurrent favorable factor.

CONCLUSION

Our findings highlight the superiority of LNR and the importance of interactions between tumor size and nodal status. These results and the potential of the OCT methodology to combine them into a powerful, visually interpretable model can help inform future staging systems.
Accuracy of Smartphone Images of the Cervix After Acetic Acid Application for Diagnosing Cervical Intraepithelial Neoplasia Grade 2 or Greater in Women With Positive Cervical Screening: A Systematic Review and Meta-Analysis
Authors: Allanson Emma R. , Phoolcharoen Natacha , Salcedo Mila P. , Fellman Bryan , Schmeler Kathleen M.
Published: December 2021

PURPOSE

Smartphones are used in cervical screening for visual inspection after acetic acid or Lugol's iodine (VIA/VILI) application to capture and share images to improve the sensitivity and interobserver variability of VIA/VILI. We undertook a systematic review and meta-analysis assessing the diagnostic accuracy of smartphone images of the cervix at the time of VIA/VILI (termed S-VIA) in the detection of precancerous lesions in women undergoing cervical screening.

METHODS

This systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies from January 1, 2010, to June 30, 2020, were assessed. MEDLINE/PubMed, Embase, CINAHL, Cochrane, and LILACS were searched. Cohort and cross-sectional studies were considered. S-VIA was compared with the reference standard of histopathology. We excluded studies where additional technology was added to the smartphone including artificial intelligence, enhanced visual assessment, and other algorithms to automatically diagnose precancerous lesions. The primary outcome was the accuracy of S-VIA for the diagnosis of cervical intraepithelial neoplasia grade 2 or greater (CIN 2+). Data were extracted, and we plotted the sensitivity, specificity, negative predictive value, and positive predictive value of S-VIA using forest plots. This study was prospectively registered with The International Prospective Register of Systematic Reviews:CRD42020204024.

RESULTS

Six thousand three studies were screened, 71 full texts assessed, and eight studies met criteria for inclusion, with six included in the final meta-analysis. The sensitivity of S-VIA for the diagnosis of CIN 2+ was 74.56% (95% CI, 70.16 to 78.95; I2 61.30%), specificity was 61.75% (95% CI, 56.35 to 67.15; I2 95.00%), negative predictive value was 93.71% (95% CI, 92.81 to 94.61; I2 0%), and positive predictive value was 26.97% (95% CI, 24.13 to 29.81; I2 61.3%).

CONCLUSION

Our results suggest that S-VIA has accuracy in the detection of CIN 2+ and may provide additional support to health care providers delivering care in low-resource settings.
Management of Stage III Non–Small-Cell Lung Cancer: ASCO Guideline
Authors: Daly Megan E. , Singh Navneet , Ismaila Nofisat , Antonoff Mara B. , Arenberg Douglas A. , Bradley Jeffrey , David Elizabeth , Detterbeck Frank , Früh Martin , Gubens Matthew A. , Moore Amy C. , Padda Sukhmani K. , Patel Jyoti D. , Phillips Tanyanika , Qin Angel , Robinson Clifford , Simone Charles B.
Published: December 2021

PURPOSE

To provide evidence-based recommendations to practicing clinicians on management of patients with stage III non–small-cell lung cancer (NSCLC).

METHODS

An Expert Panel of medical oncology, thoracic surgery, radiation oncology, pulmonary oncology, community oncology, research methodology, and advocacy experts was convened to conduct a literature search, which included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2021. Outcomes of interest included survival, disease-free or recurrence-free survival, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations.

RESULTS

The literature search identified 127 relevant studies to inform the evidence base for this guideline.

RECOMMENDATIONS

Evidence-based recommendations were developed to address evaluation and staging workup of patients with suspected stage III NSCLC, surgical management, neoadjuvant and adjuvant approaches, and management of patients with unresectable stage III NSCLC. Additional information is available at www.asco.org/thoracic-cancer-guidelines .
Utility of Continuous Glucose Monitoring vs Meal Study in Detecting Hypoglycemia After Gastric Bypass
Authors: Honka Henri , Chuang Janet , D’Alessio David , Salehi Marzieh
Published: December 2021

Context

Gastric bypass (GB) increases postprandial glucose excursion, which in turn can predispose to the late complication of hypoglycemia. Diagnosis remains challenging and requires documentation of symptoms associated with low glucose and relief of symptom when glucose is normalized (Whipple triad).

Objective

To compare the yield of mixed meal test (MMT) and continuous glucose monitoring system (CGMS) in detecting hypoglycemia after GB.

Setting

The study was conducted at General Clinical Research Unit, Cincinnati Children’s Hospital (Cincinnati, OH, USA).

Methods

Glucose profiles were evaluated in 15 patients with documented recurrent clinical hypoglycemia after GB, 8 matched asymptomatic GB subjects, and 9 healthy weight-matched nonoperated controls using MMT in a control setting and CGMS under free-living conditions.

Results

Patients with prior GB had larger glucose variability during both MMT and CGMS when compared with nonsurgical controls regardless of their hypoglycemic status. Sensitivity (71 vs 47%) and specificity (100 vs 88%) of MMT in detecting hypoglycemia was superior to CGMS.

Conclusions

Our findings indicate that a fixed carbohydrate ingestion during MMT is a more reliable test to diagnose GB-related hypoglycemia compared with CGMS during free-living state.
Temozolomide Nonresponsiveness in Aggressive Prolactinomas and Carcinomas: Management and Outcomes
Authors: Das Liza , Rai Ashutosh , Salunke Pravin , Ahuja Chirag Kamal , Sood Ashwani , Radotra Bishan Dass , Sood Ridhi , Korbonits Márta , Dutta Pinaki
Published: December 2021

Context

Temozolomide (TMZ) is endorsed as the treatment of choice in aggressive or malignant pituitary adenomas.

Objective

Herein we describe a case of an aggressive prolactinoma that was resistant to TMZ. We performed a literature review of similar nonresponsive, aggressive prolactinomas.

Methods

A 40-year-old woman presented with a giant prolactinoma that required cabergoline, transsphenoidal surgery, and radiotherapy to achieve near-normal prolactin and apparently no residual tumor. A year later, she presented with multiple cranial nerve involvement due to a recurrent tumor extending to the infratemporal fossa. She underwent transfrontal surgery, second radiotherapy, and was started on TMZ. Despite 8 cycles of temozolomide (200 mg/m2, 5/28-day cycle), she had progressive disease and ultimately succumbed to the disease. PubMed/MEDLINE, Google Scholar, and prior review articles were searched for manuscripts about patients with aggressive prolactinomas who had been treated with TMZ. Data on demography, duration of therapy, and management outcomes were analyzed in those with progressive disease.

Results

We identified 94 cases of patients with aggressive/malignant prolactinomas in the literature who had received TMZ. Progressive disease despite TMZ was present in 36 cases (38%). There was a male preponderance (65%) among these and 40% had aggressive prolactinomas, whereas the rest had carcinomas. Patients received a median of 8 cycles (interquartile range, 3.5-11.5) of TMZ. O6-methylguanine-DNA-methyltransferase (MGMT) immunostaining was negative in 35%. Overall mortality at the time of publication was 40%, at a duration varying from 2 to 20 years from diagnosis.

Conclusion

TMZ resistance in aggressive/malignant prolactinomas is challenging. Progressive disease on optimal TMZ treatment entails the use of newer agents.
Successful Resuscitation Following Intraoperative Acute Pulmonary Embolism With a Focus on Control of Bleeding After Thrombolytic Therapy: A Case Report
Authors: Suzuki Yasuyuki , Kadoya Fumito , Nishikawa Tomoaki , Saeki Hideyuki , Takubo Kenji , Nishida Katsuko
Published: December 2021

Acute pulmonary embolism is a serious perioperative complication. Current guidelines focus on hemodynamic stabilization and rapid restoration of pulmonary artery blood flow. However, various complications, most notably bleeding, are associated with treatment of the embolism. We report a case of acute pulmonary embolism with cardiopulmonary arrest during orthopedic surgery. Prompt thrombolysis and gaining control of both thrombolytic therapy-induced bleeding from the wound and a hepatic cyst enabled the patient to recover without neurological deficits.
Anesthetic Management of a Patient With an Implantable Hypoglossal Nerve Stimulator: A Case Report
Authors: Char Steven , Gajewski Michal
Published: December 2021

Obstructive sleep apnea (OSA) is a common condition, particularly in obese men and in those with an increased neck circumference. Management with a continuous positive airway pressure (CPAP) machine has been the mainstay of treatment over many years; although, it is not acceptable to all. Recently, innovative medical devices, such as hypoglossal nerve stimulators, have emerged and are now being increasingly utilized. We present a case report of a patient undergoing rotator cuff repair on the same side as the implanted device and our recommendations on the anesthetic management.
Elizabeth Crosby: Titan of Neuroanatomy and Friend of Neurosurgery
Authors: Saleh Sara , Holste Katherine , Chan Alvin , Muhlestein Whitney , Hsu Frank , Muraszko Karin
Published: December 2021

Elizabeth Crosby (1888-1983) is a beloved and well-respected titan of neuroanatomy. Her contributions to our understanding of neuroanatomy are rooted in her seminal text, The Comparative Anatomy of the Nervous System of Vertebrates, Including Man, published in 1936, which is a masterful and comprehensive account of comparative neuroanatomy. Her later texts, Correlative Neurosurgery and Correlative Anatomy of the Nervous System, are standard reference texts to this day. Her mentorship of graduate students, close work with the University of Michigan neurosurgery department, and the quality of her research and scientific publications were recognized with many awards, culminating in the National Medal of Science presented by President Carter in 1980.
Increased Gray Matter Density in the Right Mesencephalic Tegmentum Is Associated With Better Engel Classes I and II After Radiosurgery for Hypothalamic Hamartomas
Authors: Tuleasca Constantin , Hamdi Hussein , Daquin Géraldine , Villeneuve Nathalie , Chauvel Patrick , Lepine Anne , Bartolomei Fabrice , Régis Jean
Published: December 2021

BACKGROUND:

Hypothalamic hamartomas (HHs) are disabling congenital lesions, responsible for gelastic seizures frequently associated with catastrophic epilepsies, epileptogenic encephalopathy, and cognitive and psychiatric severe comorbidities. Stereotactic radiosurgery (SRS) is a well-established minimally invasive therapeutic approach.

OBJECTIVE:

To assess whether pretherapeutic gray matter density (GMD) correlates with seizure outcome.

METHODS:

We used voxel-based morphometry at whole-brain level, as depicted on pretherapeutic standard structural magnetic resonance neuroimaging. We examined 24 patients (10 male patients, 14 female patients; mean age, 12.7 yr; median, 9; range, 5.9-50) treated in Marseille University Hospital, France, between May 2001 and August 2018.

RESULTS:

Most relevant anatomic area predicting postoperative Engel classes I and II vs III and IV after SRS for HHs was mesencephalic tegmentum. Higher pretherapeutic GMD in this area was associated with better outcomes for seizure cessation. The only other statistically significant clusters were right cerebellar lobule VIIIb and VIIIa. Lower pretherapeutic GMD in both clusters correlated with better Engel class outcomes. GMD decreased with age in the left mediodorsal thalamus.

CONCLUSION:

Seizure cessation after SRS for HHs was associated with higher GMD in mesencephalic tegmental area, acknowledged to be involved in the neural control of explosive vocal behavior in animals. This area is connected by the mamillotegmental bundle to the lateral tuberal nucleus area of the hypothalamus, where HHs are known to rise. In the future, the detection of more gray matter in this “laugh” tegmental area based on pretherapeutic routine structural neuroimaging might help in patient selection for minimally invasive radiosurgery for HH.
Spine Surgery Under Spinal vs General Anesthesia: Prospective Analysis of Quality of Life, Fatigue, and Cognition
Authors: De Biase Gaetano , Gruenbaum Shaun E. , Quiñones-Hinojosa Alfredo , Abode-Iyamah Kingsley O.
Published: December 2021

BACKGROUND:

There has recently been increasing interest in the use of spinal anesthesia (SA) for spine surgery. The literature that compared spine surgery under SA vs general anesthesia (GA) focused on safety, perioperative outcomes, and costs.

OBJECTIVE:

To test if SA is associated with less postoperative fatigue, cognitive dysfunction, and better quality of life in patients undergoing lumbar spine surgery compared with GA.

METHODS:

We conducted a prospective nonrandomized study in patients undergoing elective lumbar spine surgery under SA or GA by a single surgeon. Fatigue was assessed with the fatigue visual analog scale scale (0-10) and Chalder Fatigue Scale, quality of life with Medical Outcomes Study 12-item Short Form (SF-12), and differences in cognition with Mini-Mental State Examination. Patients were baselined before surgery and assessed again 1 mo after surgery.

RESULTS:

Fifty patients completed the study, 25 underwent surgery under SA and 25 under GA. The groups were homogeneous for baseline clinical characteristics, with no differences in preoperative fatigue, quality of life, and cognition. At 1 mo after surgery, SA compared with GA had better fatigue scores: fatigue visual analog scale (2.9 ± 1.5 vs 5.9 ± 2.3 [P < .0001]) and Chalder Fatigue Scale (11.2 ± 3.1 vs 16.9 ± 3.9 [P < .0001]). One month postoperatively, we observed a significant difference in the SF-12 physical component, with SA having 38.8 ± 8.9 vs 29.4 ± 10.3 (P = .002). We did not observe significant postoperative differences in the SF-12 mental component or Mini-Mental State Examination.

CONCLUSION:

Our study demonstrates that SA offers unique patient-centered advantages to GA for elective spine surgery. One month after surgery, patients who received SA had less postoperative fatigue and better quality of life.