bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of MRI for standardized lymph nodes assessment in breast cancer: are we ready for Node-RADS?
Authors: Pediconi Federica , Maroncelli Roberto , Pasculli Marcella , Galati Francesca , Moffa Giuliana , Marra Andrea , Polistena Andrea , Rizzo Veronica
Published: June 2024

Objectives

The Node-RADS score was recently introduced to offer a standardized assessment of lymph node invasion (LNI). We tested its diagnostic performance in accurately predicting LNI in breast cancer (BC) patients with magnetic resonance imaging. The study also explores the consistency of the score across three readers.

Materials and methods

A retrospective study was conducted on BC patients who underwent preoperative breast contrast-enhanced magnetic resonance imaging and lymph node dissection between January 2020 and January 2023. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value were calculated for different Node-RADS cut-off values. Pathologic results were considered the gold standard. The overall diagnostic performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC). A logistic regression analysis was performed. Cohen’s Kappa analysis was used for inter-reader agreement.

Results

The final population includes 192 patients and a total of 1134 lymph nodes analyzed (372 metastatic and 762 benign). Increasing the Node-RADS cut-off values, specificity and PPV rose from 71.4% to 100% and 76.7% to 100%, respectively, for Reader 1, 69.4% to 100% and 74.6% to 100% for Reader 2, and from 64.3% to 100% and 72% to 100% for Reader 3. Node-RADS > 2 could be considered the best cut-off value due to its balanced performance. Node-RADS exhibited a similar AUC for the three readers (0.97, 0.93, and 0.93). An excellent inter-reader agreement was found (Kappa values between 0.71 and 0.83).

Conclusions

The Node-RADS score demonstrated moderate-to-high overall accuracy in identifying LNI in patients with BC, suggesting that the scoring system can aid in the identification of suspicious lymph nodes and facilitate appropriate treatment decisions.

Clinical relevance statement

Node-RADS > 2 can be considered the best cut-off for discriminating malignant nodes, suggesting that the scoring system can effectively help identify suspicious lymph nodes by staging the disease and providing a global standardized language for clear communication.

Key Points

Axillary lymphadenopathies in breast cancer are crucial for determining the disease stage.

Node-RADS was introduced to provide a standardized evaluation of breast cancer lymph nodes.

RADS > 2 can be considered the best cut-off for discriminating malignant nodes.
Dietary and genetic determinants of non-alcoholic fatty liver disease in coronary heart disease patients
Authors: Heerkens Luc , Geleijnse Johanna M. , van Duijnhoven Fränzel J. B.
Published: June 2024

Purpose

A healthy diet reduces the risk of non-alcoholic fatty liver disease (NAFLD) in the general population, especially in individuals who are genetically predisposed to NAFLD. Little is known in patients who suffered from a myocardial infarction (MI). We examined the interaction between diet quality and genetic predisposition in relation to NAFLD in post-MI patients.

Methods

We included 3437 post-MI patients from the Alpha Omega Cohort. Diet quality was assessed with adherence to the Dutch Healthy Diet index 2015 (DHD15-index). A weighted genetic risk score (GRS) for NAFLD was computed using 39 genetic variants. NAFLD prevalence was predicted using the Fatty Liver Index. Prevalence ratios (PR) with 95% confidence intervals of DHD15-index and GRS in relation to NAFLD were obtained with multivariable Cox proportional hazards models. The interaction between DHD15-index and GRS in relation to NAFLD was assessed on an additive and multiplicative scale.

Results

Patients had a mean age of 69 (± 5.5) years, 77% was male and 20% had diabetes. The DHD15-index ranged from 28 to 120 with a mean of 73. Patients with higher diet quality were less likely to suffer from NAFLD, with a PR of 0.76 (0.62, 0.92) for the upper vs lower quintile of DHD15-index. No association between the GRS and NAFLD prevalence was found (PR of 0.92 [0.76, 1.11]). No statistically significant interaction between the DHD15-index and GRS was observed.

Conclusion

In Dutch post-MI patients, adherence to the Dutch dietary guidelines was associated with a lower prevalence of NAFLD, as assessed by the FLI. This association was present regardless of genetic predisposition in this older aged cohort.
Low magnesium in conjunction with high homocysteine increases DNA damage in healthy middle aged Australians
Authors: Dhillon Varinderpal S. , Deo Permal , Fenech Michael
Published: June 2024

Purpose

Magnesium is one of the most common elements in the human body and plays an important role as a cofactor of enzymes required for DNA replication and repair and many other biochemical mechanisms including sensing and regulating one-carbon metabolism deficiencies. Low intake of magnesium can increase the risk of many diseases, in particular, chronic degenerative disorders. However, its role in prevention of DNA damage has not been studied fully in humans so far. Therefore, we tested the hypothesis that magnesium deficiency either on its own or in conjunction with high homocysteine (Hcy) induces DNA damage in vivo in humans.

Methods

The present study was carried out in 172 healthy middle aged subjects from South Australia. Blood levels of magnesium, Hcy, folate and vitamin B12 were measured. Cytokinesis-Block Micronucleus cytome assay was performed to measure three DNA damage biomarkers: micronuclei (MN), nucleoplasmic bridges (NPBs) and nuclear buds (NBuds) in peripheral blood lymphocytes.

Results

Data showed that magnesium and Hcy are significantly inversely correlated with each other (r = − 0.299, p < 0.0001). Furthermore, magnesium is positively correlated both with folate (p = 0.002) and vitamin B12 (p = 0.007). Magnesium is also significantly inversely correlated with MN (p < 0.0001) and NPB (p < 0.0001). Individuals with low magnesium and high Hcy exhibited significantly higher frequency of MN and NPBs compared to those with high magnesium and low Hcy (p < 0.0001). Furthermore, there was an interactive effect between these two factors as well in inducing MN (p = 0.01) and NPB (p = 0.048).

Conclusions

The results obtained in the present study indicate for the first time that low in vivo levels of magnesium either on its own or in the presence of high Hcy increases DNA damage as evident by higher frequencies of MN and NPBs.
Malonate given at reperfusion prevents post-myocardial infarction heart failure by decreasing ischemia/reperfusion injury
Authors: Abe Jiro , Vujic Ana , Prag Hiran A. , Murphy Michael P. , Krieg Thomas
Published: June 2024

The mitochondrial metabolite succinate is a key driver of ischemia/reperfusion injury (IRI). Targeting succinate metabolism by inhibiting succinate dehydrogenase (SDH) upon reperfusion using malonate is an effective therapeutic strategy to achieve cardioprotection in the short term (< 24 h reperfusion) in mouse and pig in vivo myocardial infarction (MI) models. We aimed to assess whether inhibiting IRI with malonate given upon reperfusion could prevent post-MI heart failure (HF) assessed after 28 days. Male C57BL/6 J mice were subjected to 30 min left anterior coronary artery (LAD) occlusion, before reperfusion for 28 days. Malonate or without-malonate control was infused as a single dose upon reperfusion. Cardiac function was assessed by echocardiography and fibrosis by Masson’s trichrome staining. Reperfusion without malonate significantly reduced ejection fraction (~ 47%), fractional shortening (~ 23%) and elevated collagen deposition 28 days post-MI. Malonate, administered as a single infusion (16 mg/kg/min for 10 min) upon reperfusion, gave a significant cardioprotective effect, with ejection fraction (~ 60%) and fractional shortening (~ 30%) preserved and less collagen deposition. Using an acidified malonate formulation, to enhance its uptake into cardiomyocytes via the monocarboxylate transporter 1, both 1.6 and 16 mg/kg/min 10 min infusion led to robust long-term cardioprotection with preserved ejection fraction (> 60%) and fractional shortening (~ 30%), as well as significantly less collagen deposition than control hearts. Malonate administration upon reperfusion prevents post-MI HF. Acidification of malonate enables lower doses of malonate to also achieve long-term cardioprotection post-MI. Therefore, the administration of acidified malonate upon reperfusion is a promising therapeutic strategy to prevent IRI and post-MI HF.
Nonmetric sex estimation in a contemporary Indonesian population: a validation study using clinical pelvic MSCT scans
Authors: Lye Ridhwan , Obertová Zuzana , Bachtiar Nur Amelia , Franklin Daniel
Published: June 2024

Klales et al. (2012) is a popular standard for the estimation of skeletal sex. Since its publication, a number of studies have demonstrated that population-specific applications of Klales improve classification accuracy. However, it has also been shown that age appears to affect the expression of dimorphism in the pelvis across the lifespan. As such, the present study examines the accuracy of Klales, and the modified global standard of Kenyhercz et al. (2017), in a contemporary Indonesian population, including quantifying the effect of age. Pelvic multi-slice CT scans of 378 individuals (213 female; 165 male) were analysed in OsiriX®. Both standards were tested and Indonesian-specific models thereafter derived.

When applied to the Indonesian sample, both the Klales and Kenyhercz standards resulted in lower classification accuracy relative to the original studies. In considering the Indonesian-specific models, the ventral arc was the most accurate for the classification of sex, at 93.3% with a − 3.0% sex bias. The accuracy of the three-trait model was 94.4%, with a − 5.5% sex bias. Age was shown to significantly affect the distribution of pelvic trait scores. As such, age-dependent models were also derived, with the standard for individuals between 30 and 49 years the most accurate, at 93.1% and a sex bias of − 4.0%. Accuracy was lower in individuals aged ≥ 50 years, at 91.3% and a sex bias of 4.1%. These findings support the importance of establishing population-specific standards and to facilitate improved accuracy and capabilities for forensic practitioners in Indonesia.
Development and psychometric evaluation of the type 1 diabetes mellitus self-management scale for parents
Authors: Ceran Merve Aşkın , Bektaş Murat , Eklioğlu Beray Selver
Published: June 2024

Background/aim

Diabetes has become a global epidemic, necessitating effective self-management strategies. This is particularly crucial for parents of children with type 1 diabetes mellitus, as they must make numerous daily decisions and perform complex care activities. Therefore, the aim of this study was to develop a comprehensive diabetes self-management scale specifically for parents of children with type 1 diabetes. This scale aims to holistically address behaviors impacting diabetes self-management and to evaluate its psychometric properties.

Materials and methods

A methodological, correlational, and cross-sectional study was conducted with a sample of 190 parents of children with type 1 diabetes mellitus. The scale items were reviewed by five experts to ensure they adequately covered the parents' evaluation of their children's diabetes self-management. Following this, a Turkish language expert assessed the draft scale for language accuracy, comprehensibility, and grammar. The data were analyzed using descriptive statistics (numbers and percentages), Cronbach's α reliability coefficient, factor analysis, and correlation analysis.

Results

The Cronbach's alpha for the overall scale was 0.893, and the Cronbach's alpha for the subscales was between 0.757 and 0.845. The item-total score correlations ranged between 0.408 and 0.660 (p < .05). The exploratory factor analysis showed that the scale explained 61.427% of the total variance, and the factor loadings of items ranged from 0.574 to 0.859. The confirmatory factor analysis also showed that the factor loadings of the scale items ranged from 0.574 to 0.859.

Conclusion: The validity and reliability analyses revealed that the scale is a valid and reliable measurement tool for the Turkish culture.
Approximate and Randomized Algorithms for Computing a Second Hamiltonian Cycle
Authors: Deligkas Argyrios , Mertzios George B. , Spirakis Paul G. , Zamaraev Viktor
Published: June 2024

In this paper we consider the following problem: Given a Hamiltonian graph G, and a Hamiltonian cycle C of G, can we compute a second Hamiltonian cycle $$C^{\prime } \ne C$$

C
′

≠
C

of G, and if yes, how quickly? If the input graph G satisfies certain conditions (e.g. if every vertex of G is odd, or if the minimum degree is large enough), it is known that such a second Hamiltonian cycle always exists. Despite substantial efforts, no subexponential-time algorithm is known for this problem. In this paper we relax the problem of computing a second Hamiltonian cycle in two ways. First, we consider approximating the length of a second longest cycle on n-vertex graphs with minimum degree $$\delta $$
δ
and maximum degree $$\Delta $$
Δ
. We provide a linear-time algorithm for computing a cycle $$C^{\prime } \ne C$$

C
′

≠
C

of length at least $$n-4\alpha (\sqrt{n}+2\alpha )+8$$

n
-
4
α
(

n

+
2
α
)
+
8

, where $$\alpha = \frac{\Delta -2}{\delta -2}$$

α
=

Δ
-
2

δ
-
2

. This results provides a constructive proof of a recent result by Girão, Kittipassorn, and Narayanan in the regime of $$\frac{\Delta }{\delta } = o(\sqrt{n})$$

Δ
δ

=
o

(

n

)

. Our second relaxation of the problem is probabilistic. We propose a randomized algorithm which computes a second Hamiltonian cycle with high probability, given that the input graph G has a large enough minimum degree. More specifically, we prove that for every $$0<p\le 0.02$$

0
<
p
≤
0.02

, if the minimum degree of G is at least $$\frac{8}{p} \log \sqrt{8}n + 4$$

8
p

log

8

n
+
4

, then a second Hamiltonian cycle can be computed with probability at least $$1 - \frac{1}{n}\left( \frac{50}{p^4} + 1 \right) $$

1
-

1
n

50

p
4

+
1

in $$poly(n) \cdot 2^{4pn}$$

p
o
l
y

(
n
)

·

2

4
p
n

time. This result implies that, when the minimum degree $$\delta $$
δ
is sufficiently large, we can compute with high probability a second Hamiltonian cycle faster than any known deterministic algorithm. In particular, when $$\delta = \omega (\log n)$$

δ
=
ω
(
log
n
)

, our probabilistic algorithm works in $$2^{o(n)}$$

2

o
(
n
)

time.
Ambulatory blood pressure parameters and their association with albuminuria in adolescents with type 1 diabetes mellitus
Authors: Sołtysiak Jolanta , Skowrońska Bogda , Maćkowiak-Lewandowicz Katarzyna , Blumczyński Andrzej , Elżbieta Kaczmarek , Ostalska-Nowicka Danuta , Zachwieja Jacek
Published: June 2024

Background

This study aimed to evaluate the blood pressure (BP) status, including arterial stiffness parameters, hemodynamic indicators, circadian profile, and its association with albuminuria in adolescents with type 1 diabetes mellitus (DM1).

Methods

The analysis included 46 patients, with diabetes duration of 7.38 ± 3.48 years. Ambulatory blood pressure monitoring (ABPM) was conducted using an oscillometric device, the Mobil-O-Graph, which is a Pulse Wave Analysis Monitor.

Results

Hypertension (HT) was diagnosed in 31 adolescents (67% of patients), primarily due to isolated nocturnal BP (21 cases, 68% of HT cases). The HT group exhibited significantly increased diastolic load (DL). Pulse wave velocity (PWV, a measure of arterial stiffness) values showed a strong correlation with both peripheral systolic BP (r = 0.954) and central systolic BP (r = 0.838). Additionally, non-dipping status was found in 61% of the HT group. Urinary albumin excretion (UAE) was positively correlated with diastolic BP (particularly nocturnal) peripheral and central BP, DL, heart rate, augmentation index (AIx@75), and nocturnal total vascular resistance (TVR). Diastolic non-dippers exhibited a significant increase in UAE.

Conclusions

Hypertension is a common complication in adolescents with type 1 diabetes mellitus, primarily caused by elevated nocturnal diastolic BP. Albuminuria is mainly associated with diastolic BP, especially during the nocturnal period and in cases of diastolic non-dipping status. The association of UAE with AIx@75 and nocturnal TVR suggests the presence of early-stage vascular disease in diabetic adolescents.

Graphical abstract
Health-related quality of life in rural cancer survivors compared with their urban counterparts: a systematic review
Authors: Latham S. , Leach M. J. , White V. M. , Webber K. , Jefford M. , Lisy K. , Davis N. , Millar J. L. , Evans S. , Emery J. D. , IJzerman M. , Ristevski E.
Published: June 2024

Purpose

We conducted a systematic review to describe health-related quality of life (HRQOL) in rural cancer survivors (RCS), and compare HRQOL between RCS and urban cancer survivors (UCS).

Method

We searched Medline, Embase, CINAHL Plus, and PsycINFO for studies with HRQOL in adult cancer survivors living in rural, regional, remote, and urban areas, who had completed definitive primary cancer treatment, without evidence of residual disease. Where available, we used normative and clinically important values to ascribe meaning to HRQOL data.

Findings

Fifteen studies (16 papers) were included. Most were from the US (n = 8) and reported on breast cancer survivors (n = 9). Six HRQOL instruments, collecting data across 16 domains, were used. Three instruments were specific to the survivorship phase. Normative and clinical data were available for 12 studies. Compared with normative populations, RCS had clinically worse physical HRQOL (6/12 studies), better social/family (5/7), and functional (3/6) HRQOL, and there were no differences in emotional or/mental HRQOL (9/12). In six studies with rural–urban comparator groups and normative and clinically important data, RCS and UCS had clinically worse physical (3/6 and 2/6, respectively) and better social/family (3/4 and 2/4 studies, respectively) HRQOL than normative populations. Functional HRQOL was better in RCS (2/4 studies) than UCS and normative populations. In 3/6 studies, there were no clinical differences in emotional or/mental HRQOL between RCS, UCS, and normative populations.

Conclusion

Overall, HRQOL is not clearly better or worse in RCS than UCS. Future research should include different tumor types, rural residents, and survivorship-specific HRQOL instruments.
Clinical features of audible upper airway secretions (“death rattle”) in patients with cancer in the last days of life
Authors: Davies Andrew , Waghorn Melanie , Skene Simon
Published: June 2024

Purpose

Audible upper airway secretions (“death rattle”) is a common problem in cancer patients at the end-of-life. However, there is little information about its clinical features.

Methods

This is a secondary analysis of a cluster randomised trial of clinically-assisted hydration in cancer patients in the last days of life. Patients were assessed 4 hourly for end-of-life problems (including audible secretions), which were recorded as present or absent, excepting restlessness/agitation, which was scored using the modified Richmond Agitation and Sedation Scale. Patients were followed up until death.

Results

200 patients were recruited, and 186 patients died during the study period. Overall, 54.5% patients developed audible secretions at some point during the study, but only 34.5% patients had audible secretions at the time of death. The prevalence of audible secretions increased the closer to death, with a marked increase in the last 12–16 h of life (i.e. the prevalence of audible secretions was highest at the time of death). Of those with audible secretions at the time of death, 24 had had a previous episode that had resolved. Development of audible secretions was not associated with use of clinically-assisted hydration, but there was an association between audible secretions and restlessness/agitation, and audible secretions and pain. However, most patients with audible secretions were not restless/agitated, or in pain, when assessed.

Conclusion

Audible secretions (“death rattle”) are common in cancer patients at the end-of-life, but their natural history is extremely variable, with some patients experiencing multiple episodes during the terminal phase (although not necessarily experiencing an episode at the time of death).
Gene selection based on recursive spider wasp optimizer guided by marine predators algorithm
Authors: Osama Sarah , Ali Abdelmgeid A. , Shaban Hassan
Published: June 2024

Detecting tumors using gene analysis in microarray data is a critical area of research in artificial intelligence and bioinformatics. However, due to the large number of genes compared to observations, feature selection is a central process in microarray analysis. While various gene selection methods have been developed to select the most relevant genes, these methods’ efficiency and reliability can be improved. This paper proposes a new two-phase gene selection method that combines the ReliefF filter method with a novel version of the spider wasp optimizer (SWO) called RSWO-MPA. In the first phase, the ReliefF filter method is utilized to reduce the number of genes to a reasonable number. In the second phase, RSWO-MPA applies a recursive spider wasp optimizer guided by the marine predators algorithm (MPA) to select the most informative genes from the previously selected ones. The MPA is used in the initialization step of recursive SWO to narrow down the search space to the most relevant and accurate genes. The proposed RSWO-MPA has been implemented and validated through extensive experimentation using eight microarray gene expression datasets. The enhanced RSWO-MPA is compared with seven widely used and recently developed meta-heuristic algorithms, including Kepler optimization algorithm (KOA), marine predators algorithm (MPA), social ski-driver optimization (SSD), whale optimization algorithm (WOA), Harris hawks optimization (HHO), artificial bee colony (ABC) algorithm, and original SWO. The experimental results demonstrate that the developed method yields the highest accuracy, selects fewer features, and exhibits more stability than other compared algorithms and cutting-edge methods for all the datasets used. Specifically, it achieved an accuracy of 100.00%, 94.51%, 98.13%, 95.63%, 100.00%, 100.00%, 92.97%, and 100.00% for Yeoh, West, Chiaretti, Burcyznski, leukemia, ovarian cancer, central nervous system, and SRBCT datasets, respectively.
Dynamic and thermodynamic characteristics of warm-sector rainstorms caused by the southwest china vortex in sichuan basin
Authors: Zhou Chunhua , Li Yueqing
Published: June 2024

Using automatic rainfall station and ERA5 reanalysis data, the Southwest China vortex (SWCV) processes that induce warm-sector rainstorms in the Sichuan Basin were analyzed, their environmental field and dynamic thermal characteristics were researched through physical diagnosis and dynamic synthesis, and the development mechanism was discussed. The results showed that for the warm-sector rainstorms caused by the SWCV (SWCV-WR), the general circulation backgrounds can could be divided into three types: upper trough-vortex (Type I), plateau shear line (Type II), and short-wave trough (Type III) types. Regarding the aspects of the maintenance of the SWCV, duration of the warm-sector rainstorms, and maximum hourly precipitation intensity, the influence of Type I is the most evident, followed by Types II and III for SWCV-WR. The vertical structure of the SWCV is shallow and inclined to the west with height, but the positive vorticity of Types I and II can reach up to 200 hPa for SWCV-WR. The pseudo-equivalent potential temperature in the vortex area is greater than 354 K, which is accompanied by an upward-energy tongue, and shallow secondary circulation occurs on the eastern side of the SWCV, promoting vortex development. Regarding the thermodynamic characteristics of SWCV, Type I is the strongest, followed by Type III, and Type II is the weakest. The water vapor supply in different types of SWCV-WR is not only closely related to the strength of water vapor transport in the Bay of Bengal, but also to the variations in water vapor transport caused by the influence of different water vapor sources, such as the South China Sea and western Pacific Ocean, during its transportation. For SWCV-WR, the vorticity advection presents an uneven east-west positive and negative distribution. Under the dynamic forcing, the positive vorticity on the east side of SWCV of Types I and II (III) is enhanced (weakened), while that on the west side is weakened (enhanced). Different atmospheric vorticity variations have different significant effects on the three types of SWCV-WR. Under the spatial non-uniform heating, the horizontal non-uniform heating effect on the different types of SWCV-WR has regional differences, while the vertical non-uniform heating effect has the largest effect on the spatial non-uniform heating and a positive heating effect on the three types of SWCV-WR. Therefore, the spatial non-adiabatic heating effect, particularly the vertical non-uniform heating effect, is an important mechanism for the development and evolution of SWCV and SWCV-WR.
On the value of hydrochemical data for the interpretation of flow and transport processes in the Baget karst system, France
Authors: Richieri Beatrice , Bittner Daniel , Sivelle Vianney , Hartmann Andreas , Labat David , Chiogna Gabriele
Published: June 2024

Continuous hourly time series of hydrochemical data can provide insights into the subsurface dynamics and main hydrological processes of karst systems. This study investigates how high-resolution hydrochemical data can be used for the verification of robust conceptual event-based karst models. To match the high temporal variability of hydrochemical data, the LuKARS 2.0 model was developed on an hourly scale. The model concept considers the interaction between the matrix and conduit components to allow a flexible conceptualization of binary karst systems characterized by a perennial spring and intermittent overflow as well as possible surface water bypassing the spring. The model was tested on the Baget karst system, France, featuring a recharge area defined by the coexistence of karst and nonkarst areas. The Morris screening method was used to investigate parameter sensitivity, and to calibrate the model according to the Kling-Gupta Efficiency (KGE). Model verification was performed by considering additional hydrochemical constraints with the aim of representing the internal dynamics of the systems, i.e., water contributions from the various compartments of the conceptual model. The hydrochemical constraints were defined based on high-temporal resolution time series of SO42− and HCO3−. The results of this study show that the simulation with the highest KGE among 9,000 model realizations well represents the dynamics of the spring discharge but not the variability of the internal fluxes. The implementation of hydrochemical constraints facilitates the identification of realizations reproducing the observed relative increase in the flow contribution from the nonkarst area.
Spontaneous intracerebral hemorrhage – patients retrospectively consent to fibrinolytic surgery despite poor neurological outcome and reduced health-related quality of life
Authors: Schwiddessen Regina , Malinova Vesna , von Steinbüchel Nicole , Mielke Dorothee , Rohde Veit , von der Brelie Christian
Published: June 2024

Spontaneous intracerebral hemorrhage (ICH) might lead to devastating consequences. Nonetheless, subjective interpretation of life circumstances might vary. Recent data from ischemic stroke patients show that there might be a paradox between clinically rated neurological outcome and self-reported satisfaction with quality of life. Our hypothesis was that minimally invasive surgically treated ICH patients would still give their consent to stereotactic fibrinolysis despite experiencing relatively poor neurological outcome. In order to better understand the patients’ perspective and to enhance insight beyond functional outcome, this is the first study assessing disease-specific health-related quality of life (hrQoL) in ICH after fibrinolytic therapy. We conducted a retrospective analysis of patients with spontaneous ICH treated minimally invasive by stereotactic fibrinolysis. Subsequently, using standardized telephone interviews, we evaluated functional outcome with the modified Rankin Scale (mRS), health-related Quality of Life with the Quality of life after Brain Injury Overall scale (QOLIBRI-OS), and assessed retrospectively if the patients would have given their consent to the treatment. To verify the primary hypothesis that fibrinolytic treated ICH patients would still retrospectively consent to fibrinolytic therapy despite a relatively poor neurological outcome, we conducted a chi-square test to compare good versus poor outcome (mRS) between consenters and non-consenters. To investigate the association between hrQoL (QOLIBRI-OS) and consent, we conducted a Mann-Whitney U-test. Moreover, we did a Spearman correlation to investigate the correlation between functional outcome (mRS) and hrQoL (QOLIBRI-OS). The analysis comprised 63 data sets (35 men, mean age: 66.9 ± 11.8 years, median Hemphill score: 3 [2-3]). Good neurological outcome (mRS 0–3) was achieved in 52% (33/63) of the patients. Patients would have given their consent to surgery retrospectively in 89.7% (52/58). These 52 consenting patients comprised all 33 patients (100%) who achieved good functional outcome and 19 of the 25 patients (76%) who achieved poor neurological outcome (mRS 4–6). The mean QOLIBRI-OS value was 49.55 ± 27.75. A significant association between hrQoL and retrospective consent was found (p = 0.004). This study supports fibrinolytic treatment of ICH even in cases when poor neurological outcome would have to be assumed since subjective perception of deficits could be in contrast with the objectively measured neurological outcome. HrQoL serves as a criterion for success of rtPa lysis therapy in ICH.
Stoma associated complications after diverting loop ileostomy, end ileostomy or split stoma formation after right sided colectomy—a retrospective cohort study (StoComSplit Analysis)
Authors: Wiesler B. , Hirt L. , Guenin M.-O. , Steinemann D. C. , von Flüe M. , Müller-Stich B. , Glass T. , von Strauss und Torney M.
Published: June 2024

Background

For high-risk patients receiving right-sided colectomy, stoma formation is a safety strategy. Options are anastomosis with loop ileostomy, end ileostomy, or split stoma. The aim is to compare the outcome of these three options.

Methods

This retrospective cohort study included all patients who underwent right sided colectomy and stoma formation between January 2008 and December 2021 at two tertial referral centers in Switzerland. The primary outcome was the stoma associated complication rate within one year.

Results

A total of 116 patients were included. A total of 20 patients (17%) underwent primary anastomosis with loop ileostomy (PA group), 29 (25%) received an end ileostomy (ES group) and 67 (58%) received a split stoma (SS group).

Stoma associated complication rate was 43% (n = 21) in PA and in ES group and 50% (n = 34) in SS group (n.s.). A total of 30% (n = 6) of patients in PA group needed reoperations, whereas 59% (n = 17) in ES and 58% (n = 39) in SS group had reoperations (P = 0.07). Wound infections occurred in 15% (n = 3) in PA, in 10% (n = 3) in ES, and in 30% (n = 20) in SS group (P = 0.08). A total of 13 patients (65%) in PA, 7 (24%) in ES, and 29 (43%) in SS group achieved stoma closure (P = 0.02). A total of 5 patients (38%) in PA group, 2 (15%) in ES, and 22 patients (67%) in SS group had a stoma-associated rehospitalization (P < 0.01).

Conclusion

Primary anastomosis and loop ileostomy may be an option for selected patients. Patients with end ileostomies have fewer stoma-related readmissions than those with a split stoma, but they have a lower rate of stoma closure.

Clinical trial registration

Trial not registered.
Statin use is associated with a lower risk of all-cause death in patients with breast cancer treated with anthracycline containing regimens: a global federated health database analysis
Authors: Bucci Tommaso , Gue Ying , Dobson Rebecca , Palmieri Carlo , Pignatelli Pasquale , Lip Gregory Y. H.
Published: June 2024

Anthracyclines are associated with enhanced oxidative stress responsible for adverse events in patients with breast cancer. However, no study has investigated the potential anti-inflammatory role of statins in counteracting anthracycline toxicity. In this retrospective study utilizing a federated health network (TriNetX), patients with breast cancer (ICD code C50) treated with anthracyclines were categorized into two groups: statin users (for at least 6 months); and statin non-users. The primary outcome was the 5-year risk of all-cause death. Secondary outcomes were the risk of myocardial infarction, stroke, atrial fibrillation, ventricular arrhythmias, heart failure, and pulmonary embolism. Cox-regression analyses were used to produce hazard ratios (HRs) and 95% confidence intervals (CI) following 1:1 propensity score matching (PSM). We identified 3,701 statin users (68.8 ± 10.4 years) and 37,185 statin non-users (59.6 ± 12.8 years). After PSM, the 5-year risk of all-cause death was significantly lower in statin users (HR 0.82, 95% CI 0.74–0.91) compared to statins non-users. Analyzing the risk for secondary outcomes, only the risk of stroke was significantly increased in statin users (HR 1.27, 95% CI 1.01–1.61), while no associations were found for the other cardiovascular events. The risk of all-cause death in statin users was the lowest during the first year after the anthracycline’s initiation. No significant difference was found between lipophilic and hydrophilic statins. In patients with breast cancer treated with anthracyclines, statin use is associated with a reduced risk of all-cause death. Prospective studies are needed to investigate the potential beneficial effect of statin initiation in cancer patients without other indications.
The allocation of FIFA World Cup slots based on the ranking of confederations
Authors: Csató László , Kiss László Marcell , Szádoczki Zsombor
Published: June 2024

Qualifications for several world championships in sports are organised such that distinct sets of teams play in their own tournament for a predetermined number of slots. Inspired by a recent work studying the problem with the tools from the literature on fair allocation, this paper provides an alternative approach based on historical matches between these sets of teams. We focus on the FIFA World Cup due to the existence of an official rating system and its recent expansion to 48 teams, as well as to allow for a comparison with the already suggested allocations. Our proposal extends the methodology of the FIFA World Ranking to compare the strengths of five confederations. Various allocations are presented depending on the length of the sample, the set of teams considered, as well as the frequency of rating updates. The results show that more European and South American teams should play in the FIFA World Cup. The ranking of continents by the number of deserved slots is different from the ranking implied by FIFA policy. We recommend allocating at least some slots transparently, based on historical performances, similar to the access list of the UEFA Champions League.
The COP9 signalosome stabilized MALT1 promotes Non-Small Cell Lung Cancer progression through activation of NF-κB pathway
Authors: Wang Yinghui , Deng Xuyi , Xie Jing , Lu Tianhao , Qian Rui , Guo Zhi , Zeng Xin , Liao Jing , Ding Zhenhua , Zhou Meijuan , Niu Xinli
Published: June 2024

MALT1 has been implicated as an upstream regulator of NF-κB signaling in immune cells and tumors. This study determined the regulatory mechanisms and biological functions of MALT1 in non-small cell lung cancer (NSCLC). In cell culture and orthotopic xenograft models, MALT1 suppression via gene expression interference or protein activity inhibition significantly impaired malignant phenotypes and enhanced radiation sensitivity of NSCLC cells. CSN5, the core subunit of COP9 signalosome, was firstly verified to stabilize MALT1 via disturbing the interaction with E3 ligase FBXO3. Loss of FBXO3 in NSCLC cells reduced MALT1 ubiquitination and promoted its accumulation, which was reversed by CSN5 interference. An association between CSN5/FBXO3/MALT1 regulatory axis and poor prognosis in NSCLC patients was identified. Our findings revealed the detail mechanism of continuous MALT1 activation in NF-κB signaling, highlighting its significance as predictor and potential therapeutic target in NSCLC.

Graphical Abstract
“I start to doubt whether any of my actions will matter”: youth activists’ experiences and expressions of the emotions associated with climate change
Authors: Zurba Melanie , Baum-Talmor Polina , Woodgate Roberta L. , Busolo David , Park Andrew , Mendritzki Erica , Binkley Lisa
Published: June 2024

This study provides insights on the ways that youth express and process the emotions arising from their involvement in climate action. The specific objectives were to: (1) understand the ways youth come to know, conceptualize and reflect on climate change, (2) explore how youth’s emotions in response to climate change impacts their everyday lives; and (3) determine the modalities in which youth are expressing and processing such emotions. We used a grounded theory approach and the photovoice interview method to elicit participant’s views on climate-change-related emotions and interviews were analysed using qualitative data analysis software according to a grounded theory approach. The study resulted in identifying key themes, as well as supports for youth experiencing difficult emotions associated with climate change.
Patterns of Mental Health Service Utilisation: A Population-Based Linkage of Over 17 Years of Health Administrative Records
Authors: Lee Crystal Man Ying , Chai Kevin , McEvoy Peter M. , Graham-Schmidt Kyran , Rock Daniel , Betts Kim S. , Manuel Justin , Coleman Mathew , Meka Shiv , Alati Rosa , Robinson Suzanne
Published: June 2024

A cross-sectoral partnership was formed in 2021 in support of the recommendations in an audit on access to state-funded mental health services. In this first paper, we aimed to describe the demographic and service utilisation of adults with a mental health diagnosis in the Western Australian state-funded health system from 2005 to 2021. Inpatient, emergency department, specialised (ambulatory) community mental health service, and death records were linked in individuals aged ≥ 18 years with a mental health diagnosis in Western Australia. Altogether, 392,238 individuals with at least one mental health service contact between 1st January 2005 and 31st December 2021 were included for analysis. Females, Aboriginal and/or Torres Strait Islander people, and those who lived outside major cities or in the most disadvantaged areas were more likely to access state-funded mental health services. While the number of individuals who accessed community mental health services increased over time (from 28,769 in 2005 to 50,690 in 2021), the percentage increase relative to 2005 was notably greater for emergency department attendances (127% for emergency department; 76% for community; and 63% for inpatient). Conditions that contributed to the increase for emergency department were mainly alcohol disorder, reaction to severe stress and adjustment disorders, and anxiety disorders. Sex differences were observed between conditions. The pattern of access increased for emergency department and the community plus emergency department combination. This study confirmed that the patterns of access of state-funded mental health services have changed markedly over time and the potential drivers underlying these changes warrant further investigation.
A Probabilistic Evaluation of Surface Loading and Concentration as Metrics for Post Structural Fire Assessment Soot Sampling Data
Authors: Spicer R. Christopher
Published: June 2024

Surface sampling and laboratory analysis for soot/combustion particulates was conducted following a fire at an education/research facility in the southwest United States. This provided a bank of data by which to probabilistically evaluate the behavior of soot loading (counts/mm2) and relative soot concentration (percent ratio; %R) as useful metrics for quantifying differences in soot impact across a building. Surface tape sampling and analysis via light microscopy were conducted via industry standard protocols, and resulting data from various building zones were selected to construct various comparisons. The performance of counts/mm2 and %R as metrics to identify differences in soot impact for each comparison was assessed by comparing inference generated by traditional Student’s t test, Mann Whitney U rank comparison (MW), and the directly calculated axiomatic probability associated with difference in detection (pΔfd). The fourteen (14) comparisons in which a significant difference was inferred via pΔfd was similarly indicated via Student’s t and/or MW in only four (4) instances. Further, approximately one half of the comparisons generated different inference via pΔfd for counts/mm2 and %R, with the former demonstrating better discriminatory ability. In broad view, the heuristic concept of comparing numerical “soot levels” (e.g., average) by either metric was not generally suitable for the distribution of the data. In contrast, pΔfd avoids the statistical bias imposed by traditional statistical inference, and ultimately the efficacy of post fire comparative surface sampling is as dependent upon the metric and inference model utilized as it is on the sampling and laboratory analytical protocols.
From Anekānta-vāda to Sarva-tantra-sva-tantra: Pluralism About Views and Philosophical Systems
Authors: Shevchenko Dimitry
Published: June 2024

This article discusses the unique practice of many philosophers in classical India to write on several philosophical and religious systems, each time adopting a sympathetic point of view for a different tradition. The article describes the development of this phenomenon in the context of interreligious debates between Buddhists, Jains, and Brahmins in the course of three distinct historical periods, transitioning from pluralism about views to pluralism about philosophical systems and culminating in the ideal of sarva-tantra-sva-tantra, a polyvocal philosopher and a polymath. Contrary to such approaches as nihilism, agnosticism, skepticism, and dogmatism, pluralism about views and systems was an attempt to justify the acceptance of several competing schools of thought. The article demonstrates that varieties of pluralism about views and systems played a role in forming and broadening philosophical alliances to defeat religious rivals, but also enhanced the scholarly reputation of erudite thinkers capable of “proving and refuting any system by will.”
Teacher attitudes towards streaming in mathematics education
Authors: Sweeney Amelia , Reid O’Connor Bronwyn
Published: June 2024

In this study, teacher attitudes towards streaming in New South Wales (NSW), Australia were explored. This mixed methods research surveyed 30 secondary mathematics teachers. Findings indicated that NSW teachers had experience teaching both mixed-attainment and streamed mathematics classes, however streaming was the prevalent practice. Teachers believed streaming was the ideal method of grouping students in mathematics, allowing for better management of workloads and resulting in less behavioural issues. Teachers also believed that streaming positively impacted the academic outcomes of perceived high-ability students. However, there were mixed findings in teachers’ beliefs about the overall impacts of streaming on perceived low-ability students. While, teachers felt that streaming was able to better meet the academic needs of perceived low-ability students, the negative impacts of streaming on the wellbeing of these students was also noted. Overall, we argue that findings indicate that further exploration is needed into ways in which streaming can be made more equitable as it appears to currently be an intractable practice in Australia and other international settings.
Both Enantiomers of 2-Hydroxyglutarate Modulate the Metabolism of Cultured Human Neuroblastoma Cells
Authors: Gondáš Eduard , Baranovičová Eva , Bystrický Peter , Šofranko Jakub , Evinová Andrea , Dohál Matúš , Hatoková Zuzana , Murín Radovan
Published: June 2024

Elevated levels of D-2-hydroxyglutarate (D-2HG) and L-2-hydroxyglutarate (L-2HG) in the brain are associated with various pathological conditions, potentially contributing to neurological symptoms and neurodegeneration. Previous studies on animal models have revealed their capability to interfere with several cellular processes, including mitochondrial metabolism. Both enantiomers competitively inhibit the enzymatic activity of 2-oxoglutarate-dependent dioxygenases. These enzymes also execute several signaling cascades and regulate the level of covalent modifications on nucleic acids or proteins, e.g., methylation, hydroxylation, or ubiquitination, with an effect on epigenetic regulation of gene expression, protein stability, and intracellular signaling. To investigate the potential impact of 2HG enantiomers on human neuronal cells, we utilized the SH-SY5Y human neuroblastoma cell line as a model. We employed proton nuclear magnetic resonance (1H-NMR) spectroscopy of culture media that provided high-resolution insights into the changes in the content of metabolites. Concurrently, we performed biochemical assays to complement the 1H-NMR findings and to estimate the activities of lactate and 3-hydroxybutyrate dehydrogenases. Our results reveal that both 2HG enantiomers can influence the cellular metabolism of human neuroblastoma cells on multiple levels. Specifically, both enantiomers of 2HG comparably stimulate anaerobic metabolism of glucose and inhibit the uptake of several essential amino acids from the culture media. In this respect, both 2HG enantiomers decreased the catabolism capability of cells to incorporate the leucine-derived carbon atoms into their metabolism and to generate the ketone bodies. These results provide evidence that both enantiomers of 2HG have the potential to influence the metabolic and molecular aspects of human cells. Furthermore, we may propose that increased levels of 2HG enantiomers in the brain parenchyma may alter brain metabolism features, potentially contributing to the etiology of neurological symptoms in patients.
A Perron–Frobenius type result in Banach algebras via asymptotic closeness to a cone
Authors: Herzog Gerd , Kunstmann Peer
Published: June 2024

For an element a of a Banach algebra (scaled to spectral radius 1) we prove that the spectral radius is contained in the spectrum, if the sequence of powers $$(a^k)$$

(

a
k

)

is asymptotically not too far from a normal cone.