bluuebunny/crossref_metadata_2025 huggingface dataset:
Real-world utilization of guideline-directed genetic testing in inherited cardiovascular diseases
Authors: Longoni Mauro , Bhasin Kanchan , Ward Andrew , Lee Donghyun , Nisson McKenna , Bhatt Sucheta , Rodriguez Fatima , Dash Rajesh
Published: October 2023

Background

Cardiovascular disease continues to be the leading cause of death globally. Clinical practice guidelines aimed at improving disease management and positively impacting major cardiac adverse events recommend genetic testing for inherited cardiovascular conditions such as dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), long QT syndrome (LQTS), hereditary amyloidosis, and familial hypercholesterolemia (FH); however, little is known about how consistently practitioners order genetic testing for these conditions in routine clinical practice. This study aimed to assess the adoption of guideline-directed genetic testing for patients diagnosed with DCM, HCM, LQTS, hereditary amyloidosis, or FH.

Methods

This retrospective cohort study captured real-world evidence of genetic testing from ICD-9-CM and ICD-10-CM codes, procedure codes, and structured text fields of de-identified patient records in the Veradigm Health Insights Ambulatory EHR Research Database linked with insurance claims data. Data analysis was conducted using an automated electronic health record analysis engine. Patient records in the Veradigm database were sourced from more than 250,000 clinicians serving over 170 million patients in outpatient primary care and specialty practice settings in the United States and linked insurance claims data from public and private insurance providers. The primary outcome measure was evidence of genetic testing within six months of condition diagnosis.

Results

Between January 1, 2017, and December 31, 2021, 224,641 patients were newly diagnosed with DCM, HCM, LQTS, hereditary amyloidosis, or FH and included in this study. Substantial genetic testing care gaps were identified. Only a small percentage of patients newly diagnosed with DCM (827/101,919; 0.8%), HCM (253/15,507; 1.6%), LQTS (650/56,539; 1.2%), hereditary amyloidosis (62/1,026; 6.0%), or FH (718/49,650; 1.5%) received genetic testing.

Conclusions

Genetic testing is underutilized across multiple inherited cardiovascular conditions. This real-world data analysis provides insights into the delivery of genomic healthcare in the United States and suggests genetic testing guidelines are rarely followed in practice.
Sex differences and estrogen effects in cardiac mitochondria in human aortic stenosis and in the mouse heart
Authors: Fliegner Daniela , Ellieva Alexandra , Angelov Anja , Petrov Georgi , Regitz-Zagrosek Vera
Published: October 2023

Introduction

Sex differences in the adaptation to pressure overload have been described in humans, as well as animal models, and have been related to sex-specific expression of mitochondrial genes. We therefore tested whether sex differences in cardiac mitochondrial respiration exist in humans with aortic stenosis (AS). We also examined whether these potential differences may be at least partially due to sex hormones by testing if mitochondrial respiration is affected by estrogen (17ß-estradiol (E2)).

Methods

Consecutive patients undergoing transapical aortic valve implantation (TAVI) (women, n = 7; men, n = 10) were included. Cardiac biopsies were obtained during TAVI and used directly for mitochondrial function measurements. Male and female C57BL/6J mice (n = 8/group) underwent sham surgery or gonadectomy (GDX) at the age of 2 months. After 14 days, mice were treated once with intraperitoneally injected vehicle (placebo), 17ß-estradiol (E2), estrogen receptor alpha (ERα) agonist [propyl pyrazole triol (PPT)], or ER beta (ERβ) agonist (BAY-1214257). Thereafter, mitochondrial measurements were performed directly in cardiac skinned fibers from isolated left ventricles and musculus solei.

Results

Mitochondrial State-3 respiration was higher in female than that in male human heart biopsies (15.0 ± 2.30 vs. 10.3 ± 2.05 nmol/mL/min/mg, p< 0.05). In the mouse model, mitochondrial State-3 respiration decreased significantly after GDX in female (27.6 ± 1.55 vs. 21.4 ± 1.71 nmol/mL/min/mg; p< 0.05) and male hearts (30.7 ± 1,48 vs. 23.7 ± 2,23 nmol/mL/min/mg; p< 0.05). In ovariectomized female mice, E2 and ERβ-agonist treatment restored the State-3 respiration to intact placebo level, whereas ERα-agonist treatment did not modulate State-3 respiration. The treatment with E2, ERα-, or ERβ-agonist did not modulate the State-3 respiration in GDX male mice.

Conclusion

We identified sex differences in mitochondrial respiration in the diseased human heart. This is in alignment with known sex differences in the gene expression and proteome level at the functional level. E2 and ERβ affect cardiac mitochondrial function in the mouse model, suggesting that they may also contribute to the sex differences in the human heart. Their roles should be further investigated.
Risk analysis of waterlogging in a big city based on a bow-tie Bayesian network model, using the megacity of Wuhan as an example
Authors: Li Jiao , Liu Juan , Wu Tiancheng , Peng Qianxi , Cai Chun
Published: October 2023

At present, the global urbanization process is accelerating, with the climate changing constantly and extreme weather increasing. In this background, urban flood disasters caused by rainstorms frequently occur in China. Therefore, a disaster risk analysis model based on a bow-tie Bayesian network was established to analyze the risk of waterlogging disasters. First, the waterlogging accident was analyzed, the intermediate and basic events that caused the accident were identified, and the accident tree was drawn. According to the intuitive nature of the fault tree, it was transformed into a Bayesian network, and in the meantime, a posteriori probability analysis of nodes was performed to further obtain the critical importance of basic events. By analyzing the importance of the basic events of waterlogging disasters, the key basic events that lead to disasters were proposed. Finally, the bow-tie model was used to analyze the importance of the hazards, and a strategy for the prevention and control of accidents was proposed. The results show that the major accident node of urban waterlogging accidents is the unsafe state of the urban environment, and the management and control of the urban environment should be strengthened to improve the prevention and control of urban waterlogging, e.g., pre-disaster prevention.
Fish life-history traits predict abundance-occupancy patterns in artificial lakes
Authors: Miranda L. E.
Published: October 2023

Life-history traits of a species have been postulated as a factor in abundance and occupancy patterns. Understanding how traits contribute to the ubiquity and rarity of taxa can facilitate the development of effective conservation policy by establishing a connection between species requirements and resource. The goal was to evaluate fish assemblages in artificial lakes for evidence of the abundance-occupancy patterns reported in natural environments and, if evident, to explore if observed patterns of abundance and occupancy could be attributed to species traits. Fish abundance and occupancy were estimated over 1990–2018 in 22 artificial lakes impounded within the Tennessee River basin, USA. Consistent with reports for many other taxonomic groups in natural environments, there was a positive association amidst 114 fish species between abundance and occupancy in artificial lakes (R2 = 0.78). This result indicates that the fish assemblages that develop in these anthropized environments follow the fundamental abundance-occupancy patterns uncovered in natural environments, despite assemblages having been disfigured by the dramatic rearrangement of habitats brought by impoundment. Moreover, a redundancy analysis focusing mostly on reproductive and habitat traits adequately predicted abundance-occupancy patterns of fish assemblages in artificial lakes (R2 = 0.69). Species abundance-occupancy is influenced by the interplay between life-history traits and habitat availability, even in artificial lakes, and by extension, possibly other artificial ecosystems.
Expanded population of low-density neutrophils in juvenile idiopathic arthritis
Authors: Parackova Zuzana , Zentsova Irena , Bloomfield Marketa , Klocperk Adam , Horvath Rudolf , Malcova Hana , Cebecauerova Dita , Sediva Anna
Published: October 2023

Introduction

Juvenile idiopathic arthritis (JIA), a clinically variable disease characterized by autoimmune arthritis, affects children, and its immunopathology remains elusive. Alterations in neutrophil biology play an important role in this disease. In the present study, we aimed to explore the features of low-density neutrophils (LDNs) in patients with JIA.

Methods

Gene expression of peripheral blood mononuclear cells (PBMCs) from children with distinct subtypes of JIA was analyzed by NanoString Immunology panel. Presence of LDNs was ascertained by flow cytometry and the release of neutrophil-associated products were analyzed by LUMINEX.

Results

LDNs were detected in patients’ peripheral blood mononuclear cells (PBMCs) after density gradient centrifugation. Transcriptomic analysis of JIA PBMCs revealed that genes related to neutrophil degranulation were markedly upregulated. The number of LDNs and level of their degranulation products increased in patients’ PBMCs and correlated with serum calprotectin, but not with disease activity, sedimentation rate and C-reactive protein (CRP) levels. The phenotypes of LDNs varied from those of normal-density neutrophils and healthy donor LDNs. Phenotypical analysis revealed LDNs are immature and primed population with decreased suppressive capacity. A negative correlation between surface proteins CD62L, CD66b, and CD11b and the number of inflamed joints/JADAS was established.

Conclusion

Our results describe LDNs as primed, degranulated, immature cells with impaired suppressive activities. This work thus contributes to the increasing body of evidence that LDNs in JIA are altered and their role in the disease immunopathogenesis and possible clinical associations should be investigated further.
Clinical outcomes and timing on the combination of focal radiation therapy and immunotherapy for the treatment of brain metastases
Authors: Antelo Gabriela , Comas Silvia , Casas Francesc , Valduvieco Izaskun , Barreto Tanny , Laplana María , Mases Joel , Oses Gabriela , Mollà Meritxell
Published: October 2023

Introduction

Radiotherapy is one of the standard treatments for brain metastases (BM). Over the past years, the introduction of immunotherapy as routine treatment for solid tumors has forced investigators to review and evaluate how it would interact with radiation. Radiation and Immunotherapy have shown a synergic effect activating the host’s immune system and enhancing treatment response. The combinatory effect on BM is currently under investigation.

Methods

Data published on Pubmed to determine toxicity, survival, treatment characteristics and timing on the combination of radiotherapy and immunotherapy for the treatment of BM has been reviewed.

Results

Mostly retrospective reviews report an improvement of intracranial progression free survival (iPFS) when combining radioimmunotherapy for BM patients. Two systematic reviews and meta-analysis and one phase II prospective trial also report a benefit on iPFS without an increase of toxicity. Among the published literature, the definition of concurrency is heterogeneous, being one month or even narrowed intervals correlated to better clinical outcomes. Toxicity due to concurrent radioimmunotherapy, specifically symptomatic radionecrosis, is also directly analyzed and reported to be low, similar to the toxicity rates secondary to stereotactic radiosurgery alone.

Conclusion

Radiation combined with immunotherapy has shown in predominantly retrospective reviews a synergic effect on the treatment of BM. The concurrent combination of radioimmunotherapy is a feasible therapeutic strategy and seems to improve clinical outcomes, especially iPFS, when delivered within <30 days. Larger prospective and randomized studies are needed to establish reliable outcomes, best delivery strategies and toxicity profile.
Automated EuroFlow approach for standardized in-depth dissection of human circulating B-cells and plasma cells
Authors: Delgado Alejandro H. , Fluxa Rafael , Perez-Andres Martin , Diks Annieck M. , van Gaans-van den Brink Jacqueline A. M. , Barkoff Alex-Mikael , Blanco Elena , Torres-Valle Alba , Berkowska Magdalena A. , Grigore Georgiana , van Dongen J .J .M. , Orfao Alberto
Published: October 2023

Background

Multiparameter flow cytometry (FC) immunophenotyping is a key tool for detailed identification and characterization of human blood leucocytes, including B-lymphocytes and plasma cells (PC). However, currently used conventional data analysis strategies require extensive expertise, are time consuming, and show limited reproducibility.

Objective

Here, we designed, constructed and validated an automated database-guided gating and identification (AGI) approach for fast and standardized in-depth dissection of B-lymphocyte and PC populations in human blood.

Methods

For this purpose, 213 FC standard (FCS) datafiles corresponding to umbilical cord and peripheral blood samples from healthy and patient volunteers, stained with the 14-color 18-antibody EuroFlow BIgH-IMM panel, were used.

Results

The BIgH-IMM antibody panel allowed identification of 117 different B-lymphocyte and PC subsets. Samples from 36 healthy donors were stained and 14 of the datafiles that fulfilled strict inclusion criteria were analysed by an expert flow cytometrist to build the EuroFlow BIgH-IMM database. Data contained in the datafiles was then merged into a reference database that was uploaded in the Infinicyt software (Cytognos, Salamanca, Spain). Subsequently, we compared the results of manual gating (MG) with the performance of two classification algorithms -hierarchical algorithm vs two-step algorithm- for AGI of the cell populations present in 5 randomly selected FCS datafiles. The hierarchical AGI algorithm showed higher correlation values vs conventional MG (r2 of 0.94 vs. 0.88 for the two-step AGI algorithm) and was further validated in a set of 177 FCS datafiles against conventional expert-based MG. For virtually all identifiable cell populations a highly significant correlation was observed between the two approaches (r2>0.81 for 79% of all B-cell populations identified), with a significantly lower median time of analysis per sample (6 vs. 40 min, p=0.001) for the AGI tool vs. MG, respectively and both intra-sample (median CV of 1.7% vs. 10.4% by MG, p<0.001) and inter-expert (median CV of 3.9% vs. 17.3% by MG by 2 experts, p<0.001) variability.

Conclusion

Our results show that compared to conventional FC data analysis strategies, the here proposed AGI tool is a faster, more robust, reproducible, and standardized approach for in-depth analysis of B-lymphocyte and PC subsets circulating in human blood.
The MHC Associated Peptide Proteomics assay is a useful tool for the non-clinical assessment of immunogenicity
Authors: Jankowski Wojciech , Kidchob Christopher , Bunce Campbell , Cloake Edward , Resende Ricardo , Sauna Zuben E.
Published: October 2023

The propensity of therapeutic proteins to elicit an immune response, poses a significant challenge in clinical development and safety of the patients. Assessment of immunogenicity is crucial to predict potential adverse events and design safer biologics. In this study, we employed MHC Associated Peptide Proteomics (MAPPS) to comprehensively evaluate the immunogenic potential of re-engineered variants of immunogenic FVIIa analog (Vatreptacog Alfa). Our finding revealed the correlation between the protein sequence affinity for MHCII and the number of peptides identified in a MAPPS assay and this further correlates with the reduced T-cell responses. Moreover, MAPPS enable the identification of “relevant” T cell epitopes and may contribute to the development of biologics with lower immunogenic potential.
Experimental study on strength and failure characteristics of mortar specimens with prefabricated cracks under uniaxial and triaxial stress
Authors: Pan Xuwei , Wan Li , Jiang Tong , Jia Yanchang , Zhang Shuo
Published: October 2023

Cracks in rock masses have adverse effects on their mechanical characteristics and the stability of rock mass engineering. For this experiment, uniaxial compression and true triaxial compression unloading tests were conducted on mortar specimens. The strength of the specimens was the lowest when the dip angle of the crack was 45°. Under uniaxial compression, the failure mode was mainly tensile failure. With an increase in the crack dip angle of the specimens, the types of cracks changed from shear to tensile cracks. Under true triaxial compression, the confining pressure considerably increased the strength and deformation characteristics of the specimens and weakened the influence of the crack dip angle on the strength. The failure mode when the crack dip angle was 15° was mainly tensile. The failure mode when the crack dip angles were 45° and 75° was mainly tensile–shear composite. With the increase in the crack dip angle, the failure degree of the specimens was more severe. Under the triaxial unloading confining, the failure mode was mainly shear. Compared with uniaxial compression, the failure degree of the specimens was more severe under true triaxial compression and true triaxial unloading. The innovation of this experiment is the use of a special mold to prepare specimens. We recommend that scholars conduct experimental and numerical simulation studies on different crack geometries.
Longbie capsules reduce bone loss in the subchondral bone of rats with comorbid osteoporosis and osteoarthritis by regulating metabolite alterations
Authors: Liang Guihong , Zhao Jinlong , Zhao Di , Dou Yaoxing , Huang Hetao , Yang Weiyi , Zhou Guanghui , Gu Zhuoxu , Pan Jianke , Liu Jun
Published: October 2023

Background and objective

With the development of global population aging, comorbidity (≥2 diseases) is a common health problem among elderly people. Osteoarthritis (OA) and osteoporosis (OP) are common in elderly individuals. There is a lack of drug therapy for OA and OP comorbidities. The purpose of this study was to explore the efficacy and mechanism of Longbie capsule (LBJN), which contains various plant herbs, in treating OA and OP comorbidities (OA + OP) in rats using metabolomics techniques.

Methods

We created an OA + OP rat model through bilateral oophorectomy combined with meniscus instability surgery. Thirty SD rats were randomly divided into five groups (six in each group), namely, the sham group, OA group, OA + OP group, LBJN low-dose group (0.625 g/kg, OA + OP+LB-L group) and LBJN high-dose group (1.25 g/kg, OA + OP+LB-H group). After 8 weeks of intervention, we used micro-CT to detect bone microstructure status, ELISA to measure bone metabolism indicators, and UPLC–MS technology for metabolomics analysis. Finally, the screened differentially expressed metabolites were subjected to Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and functional enrichment analysis.

Results

The micro-CT results showed that LBJN significantly improved the bone mineral density (BMD) and bone quality of subchondral bone in OA + OP rats, and LBJN regulated the expression of bone alkaline phosphatase (BALP), osteoprotegerin (OPG), and tartrate-resistant acid phosphatase (TRACP) in serum to maintain bone metabolism balance. Metabolomics analysis showed that the metabolic trajectory of OA + OP rats after intervention in the OA + OP+LB-H group showed significant changes, and 107 potential biomarkers could be identified. Among them, 50 metabolites were upregulated (such as zeranol) and 57 were downregulated (such as vanillactic acid). The KEGG functional enrichment results indicated that the differentially expressed metabolites are mainly involved in amino acid metabolism, lipid metabolism, and carbohydrate metabolism. The KEGG pathway enrichment results indicated that LBJN may exert therapeutic effects on OA + OP rats by regulating the cAMP signaling pathway, and the FoxO signaling pathway.

Conclusion

LBJN can maintain bone metabolism balance by regulating serum lipid metabolism, amino acid metabolism, carbohydrate metabolism, and estrogen, thereby reducing bone loss in subchondral bone, which may be a potential mechanism through which LBJN treats OA + OP.
Immunoinformatic exploration of a multi-epitope-based peptide vaccine candidate targeting emerging variants of SARS-CoV-2
Authors: Kumar K. M. , Karthik Yalpi , Ramakrishna D. , Balaji S. , Skariyachan Sinosh , Murthy T. P. Krishna , Sakthivel Kunnathur Murugesan , Alotaibi Badriyah S. , Shukry Mustafa , Sayed Samy M. , Mushtaq Muntazir
Published: October 2023

Many countries around the world are facing severe challenges due to the recently emerging variants of SARS-CoV-2. Over the last few months, scientists have been developing treatments, drugs, and vaccines to subdue the virus and prevent its transmission. In this context, a peptide-based vaccine construct containing pathogenic proteins of the virus known to elicit an immune response was constructed. An analysis of the spike protein-based epitopes allowed us to design an “epitope-based subunit vaccine” against coronavirus using the approaches of “reverse vaccinology” and “immunoinformatics.” Computational experimentation and a systematic, comprehensive protocol were followed with an aim to develop and design a multi-epitope-based peptide (MEBP) vaccine candidate. Our study attempted to predict an MEBP vaccine by introducing mutations of SARS-CoV-2 (Delta, Lambda, Iota, Omicron, and Kappa) in Spike glycoprotein and predicting dual-purpose epitopes (B-cell and T-cell). This was followed by screening the selected epitopes based on antigenicity, allergenicity, and population coverage and constructing them into a vaccine by using linkers and adjuvants. The vaccine construct was analyzed for its physicochemical properties and secondary structure prediction, and a 3D structure was built, refined, and validated. Furthermore, the peptide-protein interaction of the vaccine construct with Toll-like receptor (TLR) molecules was performed. Immune profiling was performed to check the immune response. Codon optimization of the vaccine construct was performed to obtain the GC content before cloning it into the E. coli genome, facilitating its progression it into a vector. Finally, an in-silico simulation of the vaccine–protein complex was performed to comprehend its stability and conformational behavior.
Alterations of neural activity in the prefrontal cortex associated with deficits in working memory performance
Authors: Li Sihai , Rosen Matthew C. , Chang Suha , David Samuel , Freedman David J.
Published: October 2023

Working memory (WM), a core cognitive function, enables the temporary holding and manipulation of information in mind to support ongoing behavior. Neurophysiological recordings conducted in nonhuman primates have revealed neural correlates of this process in a network of higher-order cortical regions, particularly the prefrontal cortex (PFC). Here, we review the circuit mechanisms and functional importance of WM-related activity in these areas. Recent neurophysiological data indicates that the absence of these neural correlates at different stages of WM is accompanied by distinct behavioral deficits, which are characteristic of various disease states/normal aging and which we review here. Finally, we discuss emerging evidence of electrical stimulation ameliorating these WM deficits in both humans and non-human primates. These results are important for a basic understanding of the neural mechanisms supporting WM, as well as for translational efforts to developing therapies capable of enhancing healthy WM ability or restoring WM from dysfunction.
An autonomous mobile robot path planning strategy using an enhanced slime mold algorithm
Authors: Zheng Ling , Hong Chengzhi , Song Huashan , Chen Rong
Published: October 2023

Introduction

Autonomous mobile robot encompasses modules such as perception, path planning, decision-making, and control. Among these modules, path planning serves as a prerequisite for mobile robots to accomplish tasks. Enhancing path planning capability of mobile robots can effectively save costs, reduce energy consumption, and improve work efficiency. The primary slime mold algorithm (SMA) exhibits characteristics such as a reduced number of parameters, strong robustness, and a relatively high level of exploratory ability. SMA performs well in path planning for mobile robots. However, it is prone to local optimization and lacks dynamic obstacle avoidance, making it less effective in real-world settings.

Methods

This paper presents an enhanced SMA (ESMA) path-planning algorithm for mobile robots. The ESMA algorithm incorporates adaptive techniques to enhance global search capabilities and integrates an artificial potential field to improve dynamic obstacle avoidance.

Results and discussion

Compared to the SMA algorithm, the SMA-AGDE algorithm, which combines the Adaptive Guided Differential Evolution algorithm, and the Lévy Flight-Rotation SMA (LRSMA) algorithm, resulted in an average reduction in the minimum path length of (3.92%, 8.93%, 2.73%), along with corresponding reductions in path minimum values and processing times. Experiments show ESMA can find shortest collision-free paths for mobile robots in both static and dynamic environments.
Beyond the surface: analyzing etomidate and propofol as anesthetic agents in electroconvulsive therapy—A systematic review and meta-analysis of seizure duration outcomes
Authors: Akhtar Syed M. M. , Saleem Syed Z. , Rizvi Syed H. A. , Raja Sandesh , Asghar Muhammad Sohaib
Published: October 2023

Background

Electroconvulsive therapy (ECT) is a widely used treatment for severe psychiatric disorders such as schizophrenia, depression, and mania. The procedure involves applying brief electrical stimulation to induce a seizure, and anesthesia is used to ensure sedation and muscle relaxation. Finding the right anesthetic agent with minimal side effects, especially on seizure duration, is crucial for optimal outcomes because seizure duration is an important factor in the effectiveness of ECT, but the anesthetic agents used can affect it.

Objective

This systematic review and meta-analysis aimed to pool the results of all relevant studies comparing the two induction agents, etomidate and propofol, for motor and electroencephalogram (EEG) seizure duration outcomes.

Methods

A comprehensive literature search was conducted in the PubMed, Medline, and Cochrane Library databases to identify the relevant articles. The primary outcome measures were motor and EEG seizure durations. Statistical power was ensured by performing heterogeneity, publication bias, sensitivity analysis, and subgroup analysis. Standard mean difference and 95% confidence intervals were calculated for continuous outcomes, and a random-effects model was used.

Results

A total of 16 studies were included in this meta-analysis, comprising 7 randomized control trials (RCTs), 7 crossover trials, and 2 cohorts. The overall motor seizure duration was statistically significantly longer with etomidate than with propofol. The overall result for EEG seizure duration was also longer with the use of etomidate over propofol and was statistically significant. In addition, subgrouping was performed based on the study design for both outcomes, which showed insignificant results in the cohort's subgroup for both outcomes, while the RCTs and crossover subgroups supported the overall results. Heterogeneity was assessed through subgrouping and sensitivity analysis.

Conclusion

Our meta-analysis found that etomidate is superior to propofol in terms of motor and EEG seizure duration in ECT, implying potentially better efficacy. Hence, etomidate should be considered the preferred induction agent in ECT, but larger studies are needed to further validate our findings.
Neural correlation of speech envelope tracking for background noise in normal hearing
Authors: An HyunJung , Lee JeeWon , Suh Myung-Whan , Lim Yoonseob
Published: October 2023

Everyday speech communication often occurs in environments with background noise, and the impact of noise on speech recognition can vary depending on factors such as noise type, noise intensity, and the listener’s hearing ability. However, the extent to which neural mechanisms in speech understanding are influenced by different types and levels of noise remains unknown. This study aims to investigate whether individuals exhibit distinct neural responses and attention strategies depending on noise conditions. We recorded electroencephalography (EEG) data from 20 participants with normal hearing (13 males) and evaluated both neural tracking of speech envelopes and behavioral performance in speech understanding in the presence of varying types of background noise. Participants engaged in an EEG experiment consisting of two separate sessions. The first session involved listening to a 12-min story presented binaurally without any background noise. In the second session, speech understanding scores were measured using matrix sentences presented under speech-shaped noise (SSN) and Story noise background noise conditions at noise levels corresponding to sentence recognitions score (SRS). We observed differences in neural envelope correlation depending on noise type but not on its level. Interestingly, the impact of noise type on the variation in envelope tracking was more significant among participants with higher speech perception scores, while those with lower scores exhibited similarities in envelope correlation regardless of the noise condition. The findings suggest that even individuals with normal hearing could adopt different strategies to understand speech in challenging listening environments, depending on the type of noise.
A non-contact interactive system for multimodal surgical robots based on LeapMotion and visual tags
Authors: Zhang Xinkang , Wang Jie , Dai Xiaokun , Shen Shu , Chen Xinrong
Published: October 2023

In recent years, the integration of robots in minimally invasive surgery has gained significant traction in clinical practice. However, conventional contact-based human-computer interaction poses the risk of bacterial infection, significantly limiting the role of robots in surgery. To address this limitation, we propose an innovative interaction method rooted in gestures and visual tags, allowing surgeons to control and fine-tune surgical robots without physical contact with the environment. By encoding the six gestures collected using LeapMotion, we can effectively control the surgical robot in a non-contact manner. Moreover, utilizing Aruco technology, we have accurately identified the 3D spatial position of the visual label, and developed 12 fine-tuning operations to refine surgical instruments. To evaluate the applicability of our proposed system in surgery, we designed a relevant experimental setup. In the experiment, we achieved enough precision. These results demonstrate that our system meets the clinical standard, providing doctors with a non-contact and flexible means of interacting with robots during surgery.
A scoring system categorizing risk factors to evaluate the need for ventriculoperitoneal shunt in pediatric patients after brain tumor resection
Authors: Guo Zhong-Yin , Zhong Zi-An , Peng Peng , Liu Yang , Chen Feng
Published: October 2023

Objectives

To develop a scoring system based on independent predictors of the need for ventriculoperitoneal (VP) shunt after brain tumor resection in pediatric patients.

Methods

A total of 416 pediatric patients (≤ 14 years old) with brain tumors who underwent surgery were randomly assigned to the training (n = 333) and validation cohorts (n = 83). Based on the implementation of VP shunt, the training cohort was divided into the VP shunt group (n = 35) and the non-VP shunt group (n = 298). Univariate and multivariate logistic analyses were performed. A scoring system was developed based on clinical characteristics and operative data, and scores and corresponding risks were calculated.

Results

Age < 3 (p = 0.010, odds ratio [OR] = 3.162), blood loss (BL) (p = 0.005, OR = 1.300), midline tumor location (p < 0.001, OR = 5.750), preoperative hydrocephalus (p = 0.001, OR = 7.044), and total resection (p = 0.025, OR = 0.284) were identified as independent predictors. The area under the curve (AUC) of the scoring system was higher than those of age < 3, BL, midline tumor location, preoperative hydrocephalus, and total resection (0.859 vs. 0.598, 0.717, 0.725, 0.705, and 0.555, respectively; p < 0.001). Furthermore, the scoring system showed good performance in the validation cohort (AUC = 0.971). The cutoff value for predictive scores was 5.5 points, which categorized patients into low risk (0-5 points) and high risk (6-14 points) groups.

Conclusions

Our scoring system, integrating age < 3, BL, midline tumor location, preoperative hydrocephalus, and total resection, provides a practical evaluation. Scores ranging from 6 to 14 points indicate high risk.
A systematic study of the performance of machine learning models on analyzing the association between semen quality and environmental pollutants
Authors: Lu Lu , Qian Ying , Dong Yihang , Su Han , Deng Yunxin , Zeng Qiang , Li He
Published: October 2023

Human exposure to Phthalates, a family of chemicals primarily used to enhance the flexibility and durability of plastics, could lead to a decline in semen quality. Extensive studies have been performed to investigate the associations between semen quality and exposure to environmental pollutants, such as phthalates. However, these early studies mainly focus on using conventional statistical methods, such as simple and efficient multi-variable linear regression methods, to perform the analysis, which may not be effective in analyzing these complex multi-variable associations. Herein, we perform a systematic study of the performance of different machine learning methods in analyzing these associations. We will use data from a cohort of 1070 Chinese males from Hubei province who provided repeated urine samples to measure phthalate metabolites. In addition, phthalate metabolites in semen are also evaluated as a biomarker to give a more direct metric. We also incorporate patient demographics and administered medications into the analysis. Overall, six machine learning models, including linear and non-linear models, are implemented to analyze associations among thirty-one features and five metrics of the quality of the semen. The performance of the models is evaluated based on root-mean-square deviation through 10-fold cross-validation. Our investigations show that the performance of different models is varied when employed to study different metrics that represent the quality of the semen. Therefore, a systematic study of the patients’ data with various machine learning models is essential in improving the quantitative analysis in discovering the critical environmental pollutants that dictate the quality of semen. We hope this study could provide guidance of employing machine learning models in the future investigation of the impact of various pollutants on semen quality.
Applied high-intensity interval cardio yoga improves cardiometabolic fitness, energetic contributions, and metabolic flexibility in healthy adults
Authors: Park So-Young , Yang Woo-Hwi
Published: October 2023

Purpose: Currently, there is no interventional approach to increase the intensity of Surya Namaskar a popular hatha yoga sequence used worldwide. Therefore, this study investigated how tempo-based high-intensity interval cardio yoga (HIICY) and traditional interval hatha yoga (TIHY) affects cardiometabolic fitness in active adults.

Methods: Twenty physically active male and female individuals were randomly separated into HIICY (5 males, 5 females, 1.5 s tempo) and TIHY (5 males, 5 females, 3 s tempo) groups. The intervention included twelve exercise sessions for 4 weeks in both groups. Participants conducted a ramp test to determine their maximal oxygen uptake (V˙O2max), maximal velocity at V˙O2max (vV˙O2max), and maximal heart rate (HRmax). Afterward, they performed a 10-min high-intensity cardio yoga test (HICYT) to determine heart rate (HRpeak and HRmean), oxygen uptake (V˙O2peak and V˙O2mean), respiratory exchange ratio (RER), blood lactate concentrations (La−peak and ∆La−), fat and carbohydrate oxidations (FATox, CHOox), and energetic contributions (oxidative; WOxi, glycolytic; WGly, and phosphagen; WPCr, total energy demand; WTotal).

Results:V˙O2max and vV˙O2max showed time and group × time interactions (p < 0.01, p < 0.0001, p < 0.001, respectively). V˙O2max after HIICY was significantly higher than in pre-testing and following TIHY (p < 0.001, p < 0.0001, respectively). V˙O2peak, V˙O2mean, RER, HRpeak, and HRmean during the 10-min HICYT showed significant time effects (p < 0.05). ∆La− indicated a group × time interaction (p < 0.05). Group x time interaction effects for FATox at the fourth and sixth minute were observed (p < 0.05, respectively). Absolute (kJ) and relative (%) WOxi, WGly, and WTotal showed time and group × time interaction effects (p < 0.05, p < 0.01, respectively). Furthermore, %WGly was reduced following HIICY (p < 0.05). Additionally, V˙O2max and vV˙O2max were highly correlated with WOxi in kJ (r = 0.91, 0.80, respectively). Moderate to high correlations were observed among CHOox, FATox, and absolute V˙O2max (r = 0.76, 0.62, respectively).

Conclusion: A 4-week period of HIICY improved cardiometabolic fitness, oxidative capacity, and metabolic flexibility compared with TIHY, in physically active adults. Therefore, HIICY is suitable as HY-specific HIIT and time-efficient approach for relatively healthy individuals.
Mentalizing in individuals with state and trait risk for psychosis: a systematic review
Authors: De Salve Francesca , Rossi Chiara , Oasi Osmano
Published: October 2023

Background

Mentalization is an umbrella concept defined as the ability to interpret one’s and others’ mental states. Previous studies have hypothesized that mentalization may be a crucial resilience factor that significantly moderates the likelihood of developing psychotic disorders in individuals with both state and trait risk factors for the illness.

Purpose

The study reviews the role of mentalizing abilities (e.g., reflective functioning, Theory of Mind (ToM), and metacognition) in young adults with At-Risk Mental States (ARMS) and schizotypal traits. Specifically, the objective is to include articles that (a) evaluate the links between low mentalizing and both state (ARMS/CHR) and trait (schizotypy) risk for psychosis (b) compare the differences in mentalizing abilities between individuals with ARMS, schizotypy, full-blown psychosis, and healthy controls.

Method

Electronic databases (PsycINFO, PubMed, Scopus, and Google Scholar) were used to search for articles, while Rayyan was employed to facilitate the screening and selection of studies. Eligible studies are original English-language; peer-reviewed research articles on populations that met validated risk diagnostic criteria for psychosis, ARMS, and healthy controls; empirical studies evaluating the association or differences between psychotic risk and mentalizing abilities. Non-English language studies, the ones not considering state or trait risk for psychosis, and qualitative studies were excluded. After the application of the PRISMA checklist and the inclusion and exclusion criteria previously mentioned, 10 articles were extracted. The systematic review has been registered on Prospero (CRD42023397594).

Results

Low levels of reflective functioning and metacognition may predict a transition to psychosis. In addition, reflective functioning and metacognitive impairments are associated with attenuated psychotic symptoms in both state risk groups and in non-clinical individuals with schizotypal traits. Concerning ToM tasks, mixed results emerged.

Conclusion

The results obtained from the review suggest that the application of strategies to attenuate maladaptive metacognitive beliefs and low mentalization may be equally effective in improving psychotic symptoms. The assessment of mentalization and metacognition could potentially provide additional prognostic value over factors predisposing to psychosis. Good mentalization and metacognition functioning should be considered as protective factors able to minimize the transition to psychosis.
Cost comparison of in-person and telehealth modalities for a suicide safety planning group intervention: interim results from the “Project Life Force” randomized clinical trial
Authors: Raciborski Rebecca A. , Hamerling-Potts Kyra K. , Mitchell Emily L. , Sullivan Sarah R. , Kapil-Pair Nidhi , Landes Sara J. , Jager-Hyman Shari , Goodman Marianne
Published: October 2023

Suicide prevention is a clinical priority for the US Veterans Health Administration. Evidence-based interventions, including developing a suicide safety plan, are recommended practices and are becoming more widespread. Adaptations to further augment safety planning include a manualized group intervention (Project Life Force, PLF) that combines safety planning with the teaching of skills to maximize use of the plan. A multi-year randomized controlled trial to test efficacy of PLF compared to treatment as usual is currently in progress. However, approximately a year into the study, in-person groups were converted to telehealth groups due to the COVID-19 pandemic. This study compares the per-veteran cost of PLF when delivered in-person versus by telehealth using preliminary trial data from the first 2.5 years of the trial. Cost to deliver PLF was obtained from the Veterans Health Administration’s Managerial Cost Accounting data, which relies on activity-based costing. We found no significant differences in the average number of sessions or average group size between in-person and telehealth. However, the cost per group session was lower for the telehealth modality and this led to significant overall per-veteran savings. While efficacy data comparing from the two arms is still underway and we await the ongoing RCT results, our interim cost analysis highlights potential savings with the telehealth modality.
Instrument shank-assisted ovariohysterectomy: a randomized clinical trial of surgical and pain alleviation efficiency of a single-person modified technique
Authors: Ziaei Darounkolaei Navid , Mousavi Kiasary Seyed Mohamad Sadegh , Behzadi Amirhoushang , Nabavi Mosavi Niki , Ferdowsi Shima Mahmoodi
Published: October 2023

Objectives

To evaluate a modified ovariohysterectomy (OHE) technique performed by a single person and compare it with the conventional method based on time efficiency, trauma, and postoperative pain.

Methods

In a prospective, randomized, experimental study, 18 healthy, large, deep-chested, mixed-breed intact female dogs were randomly allocated to conventional (n = 9) and instrument shank-assisted (n = 9) groups. On the basis of video recordings, the various surgical step durations were analyzed: total surgery time (TST), pedicle intervention time (PIT), suspensory release time (SRT), shanking time (ShT), clamping time (ClpT), ligating time (LigT), and closure time (CT). The Glasgow composite pain scale short-form (GCMPS-SF), university of Melbourne pain scale (UMPS), and Visual Analogue Scales (VAS) were used to measure pain. C-reactive protein (CRP) fluctuation was also investigated. These evaluations were completed before and 6, 24, 48, and 72 h postoperatively.

Results

Instrument shank-assisted OHE was less time-consuming than conventional OHE (p= 0.005), improved PIT by 30.7% (6.44 min for both pedicles,p= 0.014), and correlated strongly with TST (ρ= 0.862,p= 0.003 and ρ = 0.955,p= 0.000, respectively). The two method’s surgical step durations were also TST = 47.40 ± 9.9 vs. 34.70 ± 6.7 min, PIT = 20.96 ± 5.78 vs. 14.52 ± 3.73 min, SRT = 78.97 ± 69.10 vs. ShT = 20.39 ± 8.18 s (p= 0.035), ClpT = 50.66 ± 45.04 vs. 63.55 ± 37.15 s (p= 0.662), LigT = 12.82 ± 3.37 vs. 8.02 ± 3.11 min (p= 0.005), and CT = 16.40 ± 4.5 vs. 11.60 ± 2.5 min (p= 0.013), respectively. While both techniques inflicted pain on the animals, the novel approach resulted in a reduction of pain at T6 (GCMPS-SF,p= 0.015 and VAS,p= 0.002), T24 (UMPS,p= 0.003), and T48 (GCMPS-SF,p= 0.015 and UMPS,p= 0.050). Both methods exhibited a peak in CRP level after 24 h, which subsequently returned to baseline after 48 h. However, the shank-assisted method demonstrated a significantly lower reduction in CRP level at the 48-h compared to the other group (p = 0.032).

Conclusion

Instrument shank-assisted technique permitted ovarian removal without an assistant, less damage to animals and reducing its time when compared to a conventional technique, and resulting in an alternative that causes less surgical stress and fatigue. Further research with a larger population size is required to determine the serum CRP levels as an alternative pain biomarker.
Screening for Cervical Cancer in Pregnancy
Authors: Kumari Sarita
Published: October 2023

Cervical cancer remains a leading cause of cancer related morbidity and mortality in low/low-middle income countries. Lack of screening is the leading cause of cases being diagnosed in advanced stages and screening is still opportunistic in a majority of these countries. Hospital visits during pregnancy provides a window of opportunity to screen these susceptible women and reduce the burden of disease. Screening women during pregnancy is not practiced widely due to concerns of pregnancy loss, bleeding and a lack of clear information among patients as well as healthcare professionals.
FenceTalk: Exploring False Negatives in Moving Object Detection
Authors: Lin Yun-Wei , Liu Yuh-Hwan , Lin Yi-Bing , Hong Jian-Chang
Published: October 2023

Deep learning models are often trained with a large amount of labeled data to improve the accuracy for moving object detection in new fields. However, the model may not be robust enough due to insufficient training data in the new field, resulting in some moving objects not being successfully detected. Training with data that is not successfully detected by the pre-trained deep learning model can effectively improve the accuracy for the new field, but it is costly to retrieve the image data containing the moving objects from millions of images per day to train the model. Therefore, we propose FenceTalk, a moving object detection system, which compares the difference between the current frame and the background image based on the structural similarity index measure (SSIM). FenceTalk automatically selects suspicious images with moving objects that are not successfully detected by the Yolo model, so that the training data can be selected at a lower labor cost. FenceTalk can effectively define and update the background image in the field, reducing the misjudgment caused by changes in light and shadow, and selecting images containing moving objects with an optimal threshold. Our study has demonstrated its performance and generality using real data from different fields. For example, compared with the pre-trained Yolo model using the MS COCO dataset, the overall recall of FenceTalk increased from 72.36% to 98.39% for the model trained with the data picked out by SSIM. The recall of FenceTalk, combined with Yolo and SSIM, can reach more than 99%.