bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a classification of hematologic neoplasms in the era of precision medicine
Authors: Cazzola Mario , Sehn Laurie H.
Published: July 2022

The recently developed International Consensus (IC) classification of hematologic neoplasms is primarily based on input from clinical advisory committees composed of pathologists, hematologists, oncologists, and genomic scientists. Morphology continues to represent a fundamental element in the definition of hematologic neoplasms. Acknowledging that the abnormal morphology is a result of dysregulated hematopoiesis driven by somatic gene mutations or altered expression, the IC classification considers genomic features more extensively. Defining nosologic entities based on underlying molecular mechanism(s) of disease is fundamental for enabling the development of precision treatments. Because translational and clinical research continuously advance the field, the classification of hematologic neoplasms will need to be regularly refined and updated; the basic question is what mechanism should be used for this purpose. Scientific hematopathology societies, in collaboration with hematology societies, should be primarily responsible for establishing a standing International Working Group, which would in turn collaborate with the World Health Organization (WHO)/International Agency for Research on Cancer (IARC) to realize and disseminate the classification. The current classification, with its strong morphology component, represents a basis for refinement. Through data sharing, the creation of large comprehensive patient data sets will allow the use of methods of inference, including statistical analyses and machine learning models, aimed at further identifying distinct disease subgroups. A collaborative clinico-pathologic review process will provide a mechanism for updating pathologic and genomic criteria within a clinical context. An interactive Web-based portal would make the classification more immediately available to the scientific community, while providing accessory features that enable the practical application of diagnostic, prognostic, and predictive information.
Improved Dynamics Model of Locomotive Traction Motor with Elasticity of Rotor Shaft and Supporting Bearings
Authors: Liu Yuqing , Chen Zaigang , Ning Jieyu , Wang Kaiyun , Zhai Wanming
Published: July 2022

The locomotive traction motor is described as a rotor-bearing system coupling the kinetic equations of the traction shaft and its support bearings with the determination of their elastic deformations in this study. Under the effect of excitations induced by the dynamic rotor eccentric distance and time-varying mesh stiffness, the elastic structure deformations of the shaft and support bearings are formulated in the vibration environment of the locomotive. In addition, the nonlinear contact forces between the components of the rolling bearing, the lubricating oil film, and radial clearance are comprehensively considered in this study. The results indicate that the elastic deformations of the shaft and bearings can change the dynamic responses of the traction motor and its support bearings. There are large differences between the ranges of the rotor motion calculated by the rigid and the flexible traction motor models when the intensified wheel-rail interaction is considered. With the increase of the rotor eccentricity, the results underscore the role of the elasticity of traction shaft and support bearings in dynamic researches of the traction motor. The critical value of the initial eccentric distance for the rub-impact phenomenon decreases from 1.23 mm to 1.15 mm considering the flexible effect of the shaft and bearings. This dynamics model of the traction motor can provide more accurate and reasonable simulation results for correlational dynamic researches.
Development of Texture Mapping Approaches for Additively Manufacturable Surfaces
Authors: Verma Bhupesh , Zarei Omid , Zhang Song , Schleifenbaum Johannes Henrich
Published: July 2022

Additive manufacturing (AM) technologies have been recognized for their capability to build complex components and hence have offered more freedom to designers for a long time. The ability to directly use a computer-aided design (CAD) model has allowed for fabricating and realizing complicated components, monolithic design, reducing the number of components in an assembly, decreasing time to market, and adding performance or comfort-enhancing functionalities. One of the features that can be introduced for boosting a component functionality using AM is the inclusion of surface texture on a given component. This inclusion is usually a difficult task as creating a CAD model resolving fine details of a given texture is difficult even using commercial software packages. This paper develops a methodology to include texture directly on the CAD model of a target surface using a patch-based sampling texture synthesis algorithm, which can be manufactured using AM. Input for the texture generation algorithm can be either a physical sample or an image with heightmap information. The heightmap information from a physical sample can be obtained by 3D scanning the sample and using the information from the acquired point cloud. After obtaining the required inputs, the patches are sampled for texture generation according to non-parametric estimation of the local conditional Markov random field (MRF) density function, which helps avoid mismatched features across the patch boundaries. While generating the texture, a design constraint to ensure AM producibility is considered, which is essential when manufacturing a component using, e.g., Fused Deposition Melting (FDM) or Laser Powder Bed Fusion (LPBF). The generated texture is then mapped onto the surface using the developed distance and angle preserving mapping algorithms. The implemented algorithms can be used to map the generated texture onto a mathematically defined surface. This paper maps the textures onto flat, curved, and sinusoidal surfaces for illustration. After the texture mapping, a stereolithography (STL) model is generated with the desired texture on the target surface. The generated STL model is printed using FDM technology as a final step.
Cutting Behavior of Cortical Bone in Different Bone Osteon Cutting Angles and Depths of Cut
Authors: Luo Yuanqiang , Ren Yinghui , Shu Yang , Mao Cong , Zhou Zhixiong , Bi Z. M.
Published: July 2022

Cortical bone is semi-brittle and anisotropic, that brings a challenge to suppress vibration and avoid undesired fracture in precise cutting process in surgeries. In this paper, a novel analytical model is proposed to represent cortical bone cutting processes. The model is utilized to predict the chip formations, material removal behavior and cracks propagation under varying bone osteon cutting angles and depths. Series of orthogonal cutting experiments were conducted on cortical bone to investigate the impact of bone osteon cutting angle and depth of cut on cutting force, crack initialization and propagation. The observed chip morphology highly agreed with the prediction of chip formation based on the analytical model. The curly, serrated, grainy and powdery chips formed when the cutting angle was set as 0°, 60°, 90°, and 120°, respectively. Cortical bone were removed dominantly by shearing at a small depth of cut from 10 to 50 μm, and by a mixture of pealing, shearing, fracture and crushing at a large depth of cut over 100 μm at different bone osteon angles. Moreover, its fracture toughness was calculated based on measured cutting force. It is found that the fluctuation of cutting force is suppressed and the bone material becomes easy to remove, which attributes to lower fracture toughness at bone osteon cutting angle 0°. When the cutting direction develops a certain angle to bone osteon, the fracture toughness increases then the crack propagation is inhibited to some extent and the fluctuation of cutting force comparatively decreases. There is a theoretical and practical significance for tools design and operational parameters choice in surgeries.
Batch effect detection and correction in RNA-seq data using machine-learning-based automated assessment of quality
Authors: Sprang Maximilian , Andrade-Navarro Miguel A. , Fontaine Jean-Fred
Published: July 2022

Background

The constant evolving and development of next-generation sequencing techniques lead to high throughput data composed of datasets that include a large number of biological samples. Although a large number of samples are usually experimentally processed by batches, scientific publications are often elusive about this information, which can greatly impact the quality of the samples and confound further statistical analyzes. Because dedicated bioinformatics methods developed to detect unwanted sources of variance in the data can wrongly detect real biological signals, such methods could benefit from using a quality-aware approach.

Results

We recently developed statistical guidelines and a machine learning tool to automatically evaluate the quality of a next-generation-sequencing sample. We leveraged this quality assessment to detect and correct batch effects in 12 publicly available RNA-seq datasets with available batch information. We were able to distinguish batches by our quality score and used it to correct for some batch effects in sample clustering. Overall, the correction was evaluated as comparable to or better than the reference method that uses a priori knowledge of the batches (in 10 and 1 datasets of 12, respectively; total = 92%). When coupled to outlier removal, the correction was more often evaluated as better than the reference (comparable or better in 5 and 6 datasets of 12, respectively; total = 92%).

Conclusions

In this work, we show the capabilities of our software to detect batches in public RNA-seq datasets from differences in the predicted quality of their samples. We also use these insights to correct the batch effect and observe the relation of sample quality and batch effect. These observations reinforce our expectation that while batch effects do correlate with differences in quality, batch effects also arise from other artifacts and are more suitably  corrected statistically in well-designed experiments.
Impaired time-distance reconfiguration patterns in Alzheimer's disease: a dynamic functional connectivity study with 809 individuals from 7 sites
Authors: Du Kai , Chen Pindong , Zhao Kun , Qu Yida , Kang Xiaopeng , Liu Yong ,   the Multi-center Alzheimer Disease Imaging Consortium, Zhang Xi , Zhou Yuying , Han Ying , Wang Qing
Published: July 2022

Background

The dynamic functional connectivity (dFC) has been used successfully to investigate the dysfunction of Alzheimer's disease (AD) patients. The reconfiguration intensity of nodal dFC, which means the degree of alteration between FCs at different time scales, could provide additional information for understanding the reconfiguration of brain connectivity.

Results

In this paper, we introduced a feature named time distance nodal connectivity diversity (tdNCD), and then evaluated the network reconfiguration intensity in every specific brain region in AD using a large multicenter dataset (N = 809 from 7 independent sites). Our results showed that the dysfunction involved in three subnetworks in AD, including the default mode network (DMN), the subcortical network (SCN), and the cerebellum network (CBN). The nodal tdNCD inside the DMN increased in AD compared to normal controls, and the nodal dynamic FC of the SCN and the CBN decreased in AD. Additionally, the classification analysis showed that the classification performance was better when combined tdNCD and FC to classify AD from normal control (ACC = 81%, SEN = 83.4%, SPE = 80.6%, and F1-score = 79.4%) than that only using FC (ACC = 78.2%, SEN = 76.2%, SPE = 76.5%, and F1-score = 77.5%) with a leave-one-site-out cross-validation. Besides, the performance of the three classes classification was improved from 50% (only using FC) to 53.3% (combined FC and tdNCD) (macro F1-score accuracy from 46.8 to 48.9%). More importantly, the classification model showed significant clinically predictive correlations (two classes classification: R = −0.38, P < 0.001; three classes classification: R = −0.404, P < 0.001). More importantly, several commonly used machine learning models confirmed that the tdNCD would provide additional information for classifying AD from normal controls.

Conclusions

The present study demonstrated dynamic reconfiguration of nodal FC abnormities in AD. The tdNCD highlights the potential for further understanding core mechanisms of brain dysfunction in AD. Evaluating the tdNCD FC provides a promising way to understand AD processes better and investigate novel diagnostic brain imaging biomarkers for AD.
Integrative analysis of the steroidal alkaloids distribution and biosynthesis of bulbs Fritillariae Cirrhosae through metabolome and transcriptome analyses
Authors: Lu Qiuxia , Li Rui , Liao Jiaqing , Hu Yuqin , Gao Yundong , Wang Mingcheng , Li Jian , Zhao Qi
Published: July 2022

Background

Bulbus Fritillariae Cirrhosae (BFC) is an endangered high-altitude medicine and food homology plant with anti-tumor, anti-asthmatic, and antitussive activities as it contains a variety of active ingredients, especially steroidal alkaloids. Bulbus Fritillariae Thunbergia (BFT) is another species of Fritillaria that grows at lower altitude areas. Production of plant-derived active ingredients through a synthetic biology strategy is one of the current hot topics in biological research, which requires a complete understanding of the related molecular pathways. Our knowledge of the steroidal alkaloid biosynthesis in Fritillaria species is still very limited.

Results

To promote our understanding of these pathways, we performed non-target metabolomics and transcriptome analysis of BFC and BFT. Metabolomics analysis identified 1288 metabolites in BFC and BFT in total. Steroidal alkaloids, including the proposed active ingredients of Fritillaria species peimine, peimisine, peiminine, etc., were the most abundant alkaloids detected. Our metabolomics data also showed that the contents of the majority of the steroidal alkaloids in BFC were higher than in BFT. Further, our comparative transcriptome analyses between BFC and BFT identified differentially expressed gene sets among these species, which are potentially involved in the alkaloids biosynthesis of BFC.

Conclusion

These findings promote our understanding of the mechanism of steroidal alkaloids biosynthesis in Fritillaria species.
Comparative transcriptomics identifies candidate genes involved in the evolutionary transition from dehiscent to indehiscent fruits in Lepidium (Brassicaceae)
Authors: Gramzow Lydia , Klupsch Katharina , Fernández-Pozo Noé , Hölzer Martin , Marz Manja , Rensing Stefan A. , Theißen Günter
Published: July 2022

Background

Fruits are the seed-bearing structures of flowering plants and are highly diverse in terms of morphology, texture and maturation. Dehiscent fruits split open upon maturation to discharge their seeds while indehiscent fruits are dispersed as a whole. Indehiscent fruits evolved from dehiscent fruits several times independently in the crucifer family (Brassicaceae). The fruits of Lepidium appelianum, for example, are indehiscent while the fruits of the closely related L. campestre are dehiscent. Here, we investigate the molecular and genetic mechanisms underlying the evolutionary transition from dehiscent to indehiscent fruits using these two Lepidium species as model system.

Results

We have sequenced the transcriptomes and small RNAs of floral buds, flowers and fruits of L. appelianum and L. campestre and analyzed differentially expressed genes (DEGs) and differently differentially expressed genes (DDEGs). DEGs are genes that show significantly different transcript levels in the same structures (buds, flowers and fruits) in different species, or in different structures in the same species. DDEGs are genes for which the change in expression level between two structures is significantly different in one species than in the other. Comparing the two species, the highest number of DEGs was found in flowers, followed by fruits and floral buds while the highest number of DDEGs was found in fruits versus flowers followed by flowers versus floral buds. Several gene ontology terms related to cell wall synthesis and degradation were overrepresented in different sets of DEGs highlighting the importance of these processes for fruit opening. Furthermore, the fruit valve identity genes FRUITFULL and YABBY3 were among the DEGs identified. Finally, the microRNA miR166 as well as the TCP transcription factors BRANCHED1 (BRC1) and TCP FAMILY TRANSCRIPTION FACTOR 4 (TCP4) were found to be DDEGs.

Conclusions

Our study reveals differences in gene expression between dehiscent and indehiscent fruits and uncovers miR166, BRC1 and TCP4 as candidate genes for the evolutionary transition from dehiscent to indehiscent fruits in Lepidium.
Addition of silicon to boron foliar spray in cotton plants modulates the antioxidative system attenuating boron deficiency and toxicity
Authors: de Souza Júnior Jonas P. , de M Prado Renato , Campos Cid N. S. , Sousa Junior Gilmar S. , Oliveira Kevein R. , Cazetta Jairo O. , Gratão Priscila L.
Published: July 2022

Background

Boron (B) nutritional disorders, either deficiency or toxicity, may lead to an increase in reactive oxygen species production, causing damage to cells. Oxidative damage in leaves can be attenuated by supplying silicon (Si). The aim of this study was to assess the effect of increasing foliar B accumulation on cotton plants to determine whether adding Si to the spray solution promotes gains to correct deficiency and toxicity of this micronutrient by decreasing oxidative stress via synthetizing proline and glycine-betaine, thereby raising dry matter production.

Results

B deficiency or toxicity increased H2O2 and MDA leaf concentration in cotton plants. H2O2 and MDA leaf concentration declined, with quadratic adjustment, as a function of increased leaf B accumulation. Proline and glycine-betaine leaf concentration increased under B-deficiency and B-toxicity. In addition, production of these nonenzymatic antioxidant compounds was greater in plants under toxicity, in relation to deficient plants. Adding Si to the B spray solution reduced H2O2 and MDA concentration in the plants under nutrient deficiency or toxicity. Si reduced H2O2, primarily in B-deficient plants. Si also increased proline and glycine-betaine concentration, mainly in plants under B toxicity. Dry matter production of B-deficient cotton plants increased up to an application of 1.2 g L− 1 of B. The critical B level in the spray solution for deficiency and toxicity was observed at a concentration of 0.5 and 1.9 g L− 1 of B, respectively, in the presence of Si, and 0.4 and 1.9 g L− 1 of B without it. In addition, the presence of Si in the B solution raised dry matter production in all B concentrations evaluated in this study.

Conclusion

Our findings demonstrated that adding Si to a B solution is important in the foliar spraying of cotton plants because it increases proline and glycine-betaine production and reduces H2O2 and MDA concentration, in addition to mitigating the oxidative stress in cotton plants under B deficiency or toxicity.
The importance of elderly people knowing basic first-aid measures
Authors: Dolenc Šparovec Eva , Slabe Damjan , Eržen Ivan , Kovačič Uroš
Published: July 2022

Background

In the event of a sudden illness or injury, elderly individuals are often dependent on self-help and mutual assistance from partners. With poor access to medical services during natural and other disasters, the importance of first aid knowledge of elderly individuals increases even more. We assessed the opinions of different generations of Slovenian population regarding the importance of knowing the basic first aid measures. In addition, we aimed to examine the knowledge of first aid in the most common emergencies that threaten elderly people’s health and lives, focusing on the knowledge of elderly.

Methods

A structured questionnaire was conducted with a representative Slovenian adult population (n = 1079). Statistically significant differences in average ratings of the importance of first aid knowledge were compared among different age groups with one-way ANOVA followed by a post hoc test. Significant differences in percentages of correct answers in particular cases of health conditions between different age groups were determined using the χ 2 test followed by post hoc tests.

Results

Slovenes are well aware of the importance of first aid knowledge and feel personally responsible for acquiring this knowledge. The general opinion is that older retirees need less first aid knowledge than individuals in younger populations. We found a high level of knowledge about symptoms and first aid measures for some of the most common health conditions that occur in old age. The level of knowledge in the group of the oldest respondents was comparable with that of younger age groups. However, their recognition of health conditions was also somewhat worse, especially when recognising the symptoms and signs of hypoglycaemia and heart attack. Most of the tested knowledge did not depend on a person’s age but on the time since that person was last educated in first aid.

Conclusions

The knowledge of people older than 80 years is somewhat poorer than that in the younger population, mainly because too much time has passed since they were last educated in first aid. Public awareness of first aid needs to be increased and appropriate guidelines should be given with a focus on the elderly population.
Interaction between baseline HBV loads and the prognosis of patients with HCC receiving anti-PD-1 in combination with antiangiogenic therapy undergoing concurrent TAF prophylaxis
Authors: Hu Xiaoyun , Li Rong , Li Qi , Zang Mengya , Yuan Guosheng , Chen Jinzhang
Published: July 2022

Background

A high baseline hepatitis B virus (HBV) load has always been listed as an exclusion criterion for programmed cell death-1 (PD-1) inhibitor-associated therapy in clinical trials, as the interaction between HBV load and anti-PD-1/PD-L1 therapy with anti HBV therapy remains controversial.

Methods

We retrospectively enrolled 70 unresectable HCC patients who were seropositive for HBsAg and accepted tenofovir alafenamide fumarate (TAF) therapy before anti-PD-1 in combination with an antiangiogenic treatment. Patients were divided into a low HBV DNA group (≤ 2000 IU/ml) and a high HBV DNA group (> 2000 IU/ml) according to the baseline HBV DNA levels. Tumour response and progression-free survival (PFS) were compared, and univariate and multivariate Cox analyses were performed to identify potential risk factors for PFS. The incidences of HBV reactivation and HBV-associated hepatitis were also recorded.

Results

48 patients were assigned to the low group and the remaining 22 patients were assigned to the high group. The objective response rates (ORRs), disease control rates (DCRs), and PFS between the two groups showed no significant difference (P = 0.761, 0.552, and 0.784, respectively). The results of Cox analyses revealed that there was no relationship between baseline HBV load and PFS. Additionally, HBV reactivation occurred in only 2 patients (2.9%), and no patient experienced HBV-related hepatic impairment when given a continuous TAF treatment.

Conclusions

Baseline HBV loads do not affect the prognosis of HCC patients receiving anti-PD-1 in combination with an antiangiogenic therapy, while PD-1 inhibitors do not aggravate HBV reactivation and hepatic impairment in patients simultaneously subjected to TAF prophylaxis.
Computed tomography imaging features of malignant ‘triton’ tumor to facilitate its clinical diagnosis: report of two cases
Authors: Li Yuan , Peng Qiling , Jiang Ning , Molloy David P. , Zeng Chun , Wu Qingchen
Published: July 2022

Background

Malignant ‘triton’ tumor is an extremely rare subtype of malignant periphery nerve sheath tumors. Clinical diagnosis of malignant triton tumor is difficult before surgery due to its low incidence and the lack of knowledge. Therefore, to describe and summarize the CT imaging characteristics of malignant triton tumor is of great assistance for early and preoperative diagnosis.

Case presentation

Two cases suspected of MTT by CT scan before operation were closely observed. The diagnosis of malignant triton tumor was eventually confirmed by immunochemical assay, which verified speculation of CT scans. Huge, irregular, well-circumscribed lobulated mass-like shadows can be observed from these patients by CT scans. Besides, heterogeneity of density within the body of tumor was well-established by CT scans, together with linear septum. Meanwhile, CT scans demonstrated that calcifications were remarkable at the margin of tumor body.

Conclusions

Some CT image features from two cases were presented as a reference for the preoperative consideration of MTT: (i) enormity of mass-like shadow; (ii) presence of well-circumscribed lobulated shape; (iii) septum within the well-defined mass accompanied with hemorrhage, necrosis and cystic changes as well as calcification, especially within neurofibromatosis type 1 patients.
Chorioretinal thickness and retinal pigment epithelial degeneration of fellow eyes in patients with unilateral neovascular age-related macular degeneration with subretinal drusenoid deposits
Authors: Kang Dongwan , Yoon Eun Gyu , Nam Ki Tae , Yun Cheolmin
Published: July 2022

Background

We sought to investigate the chorioretinal thickness and retinal pigment epithelial (RPE) degenerative features of eyes with early age-related macular degeneration (AMD) and subretinal drusenoid deposits (SDDs) according to the presence of macular neovascularization (MNV) in the fellow eyes.

Methods

We classified 70 eyes into two groups of 47 eyes with non-neovascular AMD and 23 eyes with neovascular AMD, respectively, according to the presence of MNV in the fellow eyes. The mean macular retinal, ganglion cell–inner plexiform layer (GCIPL), and choroidal thickness values and RPE features of the 6-mm-diameter zone were compared. RPE degeneration was defined as a lesion with an incomplete RPE and outer retinal atrophy (iRORA) or attenuated RPE reflectivity with diffuse basal laminar deposits, which was defined as when the eye showed an attenuated RPE line with granular features and mixed reflectivity in combination with sub-RPE deposits with a lesion ≥ 1,000 µm in length.

Results

Mean retinal, GCIPL, and choroidal thickness values (286.69 ± 15.02 µm, 64.36 ± 4.21 µm, and 156.11 ± 33.10 µm) of the neovascular AMD group were greater than those (278.61 ± 13.96 µm, 61.44 ± 4.63 µm, and 133.59 ± 34.33 µm) of the non-neovascular AMD group (all P < 0.05). RPE degeneration was more prevalent in the neovascular AMD group (65.2%) than the non-neovascular AMD group (38.3%; P = 0.034). Greater mean GCIPL and choroidal thickness values and the presence of RPE degeneration were associated with type 3 MNV in fellow eyes (all P < 0.05).

Conclusions

Different degenerative features according to MNV in fellow eyes of patients with AMD and SDDs suggest that variable degenerative features might be present during disease progression and have an association with the phenotype.
Correlates of preschoolers’ screen time in China: parental factors
Authors: Wang Xinyao , Wu Yan , Yao Chunhua , Wu Xiangting , Ruan Yuqian , Ye Sunyue
Published: July 2022

Background

With the advent of the electronic age, the prolonged screen time (ST) of preschoolers in China is relatively high and is on the rise, which is likely to affect preschoolers’ physical and mental health. This study aimed to explore the factors influencing ST in preschoolers, especially the role of parental factors, and to provide a basis for the prevention, control, and intervention of ST in preschoolers in China.

Methods

A questionnaire was completed by the parents of 1,546 preschoolers from four kindergartens in Pinghu City, Zhejiang Province, China, and a multivariate logistic regression model was used to analyze the correlates of excessive ST in preschoolers.

Results

A total of 43.8% of preschoolers aged 3 to 6 years, of which 50.3% were boys and 49.7% were girls, had > 1 h/day of ST. Older preschoolers, greater screen accessibility, greater frequency of eating in front of a screen, longer ST of parents, and unclear rules of screen-based behavior were the risk factors for ST being > 1 h/day (P < 0.05). After additional adjusting of maternal correlates, the relationship between the ST of fathers and ST of preschoolers was still significant (P < 0.01), and the dose–effect relationship was also observed (P < 0.001).

Conclusion

Prolonged parental ST (especially of fathers) and lack of rules for screen behavior were independent risk factors for prolonged preschoolers’ ST in this study.
Psychometric properties of the Adolescent Resilience Questionnaire (ARQ) in a sample of Swedish adolescents
Authors: Nilsson Doris , Svedin Carl Göran , Hall Frida , Kazemi Emelie , Dahlström Örjan
Published: July 2022

Background

The importance of resilience, and interest in it, has increased markedly in recent years, based on the need to understand why some children and young people have a resilience to stress that others lack. At the same time, there has been a lack of instruments to measure resilience. The aim of this study was to translate the Adolescent Resilience Questionnaire (ARQ) into Swedish and investigate the psychometrics of this Swedish version.

Methods

A normative sample of 616 students aged 15–17 was recruited through the school system in five different communities. Students filled out a digitalised composite form consisting of ARQ and three other standardised questionnaires, the Sense of Coherence Scale-13 (Soc-13), the Rosenberg Self-Esteem Scale (RSES) and the Relationship Questionnaire (RQ).

Results

The ARQ, with five domains and twelve subscales, showed good alpha coefficients α = .95 for the total scale and subscales ranging between α = .70 to .91, except for the subscales Emotional insight (α = 0.69) and Empathy/Tolerance (α = .61). The convergent validity, which was tested for the first time in this study, was good, especially with the Internal Domain for both SOC-13 and RSES. The confirmatory factor analysis showed a satisfactory construct validity. Finally, some gender differences were seen, with boys scoring higher on the total ARQ scale.

Conclusion

The study shows that the Swedish translation of ARQ has satisfactory psychometric properties. The ARQ could therefore be used as a tool for adolescents when evaluating the importance of resilience.
The use of borderline personality disorder severity index-iv feedback in adjusting borderline personality disorder treatment: therapists and patients perspectives
Authors: de Wilde Brand Odette , Clarke Sharon , Arntz Arnoud
Published: July 2022

Background

Previous research has emphasized the importance of therapists giving Routine Outcome Monitoring (ROM) feedback to their patients. It has been shown that several factors influence therapists’ tendency to provide ROM feedback to their patients.

Methods

In this qualitative study, using a semi-structured interview followed by thematic analysis using Atlas.ti, we focused on experiences of therapists and patients with a disorder specific ROM instrument: the Borderline Personality Disorder Severity Index-IV (BPDSI-IV). Ten patients with a borderline personality disorder who had been in Mentalization Based Treatment (MBT) and ten MBT-therapists treating patients with a borderline personality disorder were interviewed.

Results

Qualitative analysis revealed that patients experienced benefits of ROM using the BPDSI-IV. Patients gained more insight in and recognition of their borderline personality disorder symptoms. They also felt more understood by the therapist because they got an opportunity to explain their symptoms in a different way than in a regular therapy session. Therapists shared they didn’t always use all the ROM outcomes as serious feedback for adjusting treatment. They preferred to use the BPDSI-IV over the other ROM instruments, because the BPDSI-IV is disorder specific, which gives insight into the treatment course of the patient.

Conclusions

Experiences of both patients and therapists with the BPDSI-IV were positive. It seems to be valuable and promising for healthcare institutions to evaluate treatment with a disorder specific ROM instrument.
Global trends in total fertility rate and its relation to national wealth, life expectancy and female education
Authors: Cheng Haoyue , Luo Wenliang , Si Shuting , Xin Xing , Peng Zhicheng , Zhou Haibo , Liu Hui , Yu Yunxian
Published: July 2022

Objectives

Along with the development of the times and progress of the society, the total fertility rate (TFR) markedly changed in each country. Therefore, it is critical to describe the trend of TFR and explore its influencing factors. However, previous studies did not consider the time lag and cumulative effect in the associations between the influencing factors and TFR. Thus, our study aimed to analyze the associations from a new dimension.

Methods

The study was employed using national-level data from the World Bank and United Nations Development Programme. Distributed lag non-linear models with 5-year lag were used to examine the independent associations between the relevant factors and TFR.

Results

The cumulative exposure-TFR curves were inverted U-shaped for log gross domestic product (GDP) per capita and life expectancy at birth, while the cumulative exposure-response curves were approximately linear for female expected years of schooling and human development index (HDI). However, it is worth noting that in the developed regions, TFR increased slightly with the high level of GDP per capita, female expected years of schooling and HDI.

Conclusions

Nowadays, with the growth of GDP per capita, life expectancy at birth, female expected years of schooling and HDI, TFR are on a drastic downward trend in most regions. Besides, with the development of society, when levels of the factors continued to increase, TFR also showed a slight rebound. Therefore, governments, especially those in developing countries, should take measures to stimulate fertility and deal with a series of problems caused by declining TFR.
Exploring the economics of public health intervention scale-up: a case study of the Supporting Healthy Image, Nutrition and Exercise (SHINE) cluster randomised controlled trial
Authors: Brown Vicki , Tran Huong , Williams Joanne , Laws Rachel , Moodie Marj
Published: July 2022

Background

The costs and benefits of an intervention within the intervention testing phase may differ from those experienced when that intervention is implemented and delivered at scale. Yet limited empirical work has been undertaken to explore how economic constructs related to implementation and scale-up might have an impact on intervention cost. The aim of this study was to explore the potential economic impacts of implementation and scale-up on a healthy weight and body image intervention tested in a Type II translational research trial.

Methods

The Supporting Healthy Image, Nutrition and Exercise (SHINE) study is a cluster randomised controlled trial, aiming to deliver universal education about healthy nutrition, physical activity and wellbeing behaviours to adolescents in Australian secondary schools. Data on the cost of the intervention were collected alongside the trial using standard micro-costing techniques. Semi-structured interviews were conducted with key intervention stakeholders to explore the potential economic impacts of implementation and scale-up. Thematic content analysis was undertaken by two authors.

Results

Fifteen intervention group schools participated in the 8-week online intervention targeting students in 2019 (99 Grade 7 classes; 2,240 students). Booster sessions were delivered during one class session in Grades 8 and 9, in 2020 and 2021 respectively. Time costs of intervention delivery and co-ordination comprised the majority (90%) of intervention cost as per the trial, along with costs associated with travel for intervention training and equipment. Themes related to the benefit of the intervention emerged from interviews with six intervention stakeholders, including the potential for economies of scale afforded by online delivery. Contextual themes that may have an impact on intervention implementation and scale included acceptability across all school sectors, availability and reliability of IT infrastructure for intervention delivery and variations in population characteristics. A number of key alterations to the intervention program emerged as important in supporting and sustaining intervention scale-up. In addition, significant implementation costs were identified if the intervention was to be successfully implemented at scale.

Conclusions

The findings from this study provide important information relevant to decisions on progression to a Type III implementation trial, including budget allocation, and will inform modelled economic evaluation.
Association of psychological factors with limb disability in patients with cervical radiculopathy: comparison with carpal tunnel syndrome
Authors: Daliri B.O. Mahla , Khorasani Hamidreza Mazloum , Olia Neda Daliri Beirak , Azhari Amin , Shakeri Mohammadtaghi , Moradi Ali
Published: July 2022

Background

Regarding musculoskeletal conditions, patient’s psychological distress, are shown to be associated with higher disability. Cervical radiculopathy (CR) and carpal tunnel syndrome (CTS), are two conditions caused by entrapment of cervical nerve roots and carpal median nerve, respectively. This study aims to investigate the association of psychological factors including depression, anxiety, and pain catastrophizing, with measures of upper limb patient-reported and performance-based disability, in patients with CR, and compare the obtained results with our similar study on CTS.

Methods

In a cross-sectional study, we recruited 92 patients with CR, and investigated their disability level using patient-reported questionnaires (Quick Disabilities of the Arm, Shoulder and Hand (DASH) and pain Likert Scale) and by measuring grip and pinch strength. We also assessed their psychological status with Hospital Anxiety and Depression Scale questionnaire for depression (HADS-D) and anxiety (HADS-A) and also Pain Catastrophizing Scale (PCS) tools. We performed correlational coefficient analysis between disability and psychological scores and regression analysis of dependent variables (Pain, DASH, grip and pinch scores) and independent (psychological) variables. Finally, Z observed value was calculated to compare correlational coefficients between two diseases of CTS and CR.

Results

The results of the correlational coefficient analysis indicate that all three HADS-A, HADS-D and PCS scores correlated with DASH score (r = 0.49, 0.37, 0.38 for HADS-A, HADS-D and PCS, respectively; p < 0.001 for all three). HADS-A also significantly correlated with VAS pain score (r = 0.41, P < 0.001) and grip strength (r = − 0.25, P = 0.016). Linear regression analysis revealed that anxiety has a notable value for DASH and VAS pain scores as well as grip strength. Fisher’s r correlation coefficient to z transformation, revealed that there was no difference between two diseases of CTS and CR in terms of the resulted r coefficients from correlational coefficient analysis between disability and psychological distress.

Conclusion

It is concluded that psychological disorders are associated with disability in CR patients, with anxiety also correlating with objective disability parameter of grip strength. Finally, both CTS and CR patients’ disabilities associate with anxiety, depression, and catastrophysing thinking in a similar manner.

Level of evidence

Level IV (cross-sectional study).
Creatinine-to-cystatin C ratio as a marker of sarcopenia for identifying osteoporosis in male patients with type 2 diabetes mellitus
Authors: Dai Huifang , Xu Jing
Published: July 2022

Background

Type 2 diabetes mellitus (T2DM) is associated with the increased incidence rate of sarcopenia and osteoporosis. Serum creatinine-to-cystatin C ratio (CCR) is a novel and simple tool which can be used as an index of sarcopenia. This study aims to investigate the association between CCR and osteoporosis as well as bone mineral density (BMD) in T2DM patients.

Methods

Four hundred eighteen T2DM patients were recruited, including 166 females and 252 males. General information, BMD data and laboratory data were collected. The correlation between CCR, BMD, bone metabolism markers and osteoporosis was explored by spearman correlation, receiver-operating characteristic (ROC) curve analysis and multiple regression analysis.

Results

Spearman correlation analysis showed that there was a positive correlation between CCR and BMD as well as serum calcium in male patients (r = 0.181–0.381, P < 0.01), but such correlation was not found in the female group. In multivariate regression analysis, it was found that there was a significant correlation between CCR and BMD of total lumbar spine, hip as well as femoral neck in male patients. ROC curve showed that the optimal cut-off value of CCR for predicting osteoporosis in male patients was 6.73 with the sensitivity of 88% and specificity of 63%.

Conclusion

In male T2DM patients, CCR was negatively correlated with osteoporosis and positively correlated with BMD.
Diagnosis and minimally invasive treatment of type III choledochal cysts
Authors: Wu Guang-zhen , Wu Qing-yuan , Zhao Zhi-hao , Wang Meng
Published: July 2022

Background

Type III choledochal cysts (CCs) are the rarest and least well-characterized of the five variants of biliary cysts. Only a few relevant studies have been conducted and a gold standard treatment for type III CCs is still lacking because of their scarcity. An unusual case of type III CC with choledochocele at the end of the distal common bile duct (CBD) with no bulging of the duodenum is presented here.

Case presentation

A 61-year-old woman presented to our department with repeated upper abdominal pain for one year. Laboratory examination revealed abnormal liver function and a slight increase in the white blood cell (WBC) count and proportion of neutrophils. In an MRCP of the patient, the distal CBD was found to have a cystic structure indicative of a type III CC. Endoscopic retrograde cholangiopancreatograpy (ERCP) revealed cystic findings compatible with Todani type III CCs. However, duodenoscopy did not show a bulge in the duodenum so laparoscopic cholecystectomy and Roux-en-Y hepaticojejunostomy were performed. In her 6-month follow-up, the patient reported that recovery from the operation was uneventful.

Conclusions

ERCP has become the gold standard for diagnosing type III CCs. Type III CCs can be treated minimally invasively with laparoscopic cholecystectomy and Roux-en-Y hepaticojejunostomy.
RETRACTED ARTICLE: The role of acute care surgeons in treating rib fractures—a retrospective cohort study from a single level I trauma center
Authors: Wang Chia-Cheng , Chen Szu-An , Cheng Chi-Tung , Tee Yu-San , Chan Sheng-Yu , Fu Chih-Yuan , Liao Chien-An , Hsieh Chi-Hsun , Kuo Ling-Wei
Published: July 2022

Background

Rib fractures are the most common thoracic injury in patients who sustained blunt trauma, and potentially life-threatening associated injuries are prevalent. Multi-disciplinary work-up is crucial to achieving a comprehensive understanding of these patients. The present study demonstrated the experience of an acute care surgery (ACS) model for rib fracture management from a single level I trauma center over 13 years.

Methods

Data from patients diagnosed with acute rib fractures from January 2008 to December 2020 were collected from the trauma registry of Chang Gung Memorial Hospital (CGMH). Information, including patient age, sex, injury mechanism, Abbreviated Injury Scale (AIS) in different anatomic regions, injury severity score (ISS), index admission department, intensive care unit (ICU) length of stay (LOS), total admission LOS, mortality, and other characteristics of multiple rib fracture, were analyzed. Patients who received surgical stabilization of rib fractures (SSRF) were analyzed separately, and basic demographics and clinical outcomes were compared between acute care and thoracic surgeons.

Results

A total of 5103 patients diagnosed with acute rib fracture were admitted via the emergency department (ED) of CGMH in the 13-year study period. The Department of Trauma and Emergency Surgery (TR) received the most patients (70.8%), and the Department of Cardiovascular and Thoracic Surgery (CTS) received only 3.1% of the total patients. SSRF was initiated in 2017, and TR performed fixation for 141 patients, while CTS operated for 16 patients. The basic demographics were similar between the two groups, and no significant differences were noted in the outcomes, including LOS, LCU LOS, length of indwelling chest tube, or complications. There was only one mortality in all SSRF patients, and the patient was from the CTS group.

Conclusions

Acute care surgeons provided good-quality care to rib fracture patients, whether SSRF or non-SSRF. Acute care surgeons also safely performed SSRF. Therefore, we propose that the ACS model may be an option for rib fracture management, depending on the deployment of staff in each institute.
Creating sparser prediction models of treatment outcome in depression: a proof-of-concept study using simultaneous feature selection and hyperparameter tuning
Authors: Rost Nicolas , Brückl Tanja M. , Koutsouleris Nikolaos , Binder Elisabeth B. , Müller-Myhsok Bertram
Published: July 2022

Background

Predicting treatment outcome in major depressive disorder (MDD) remains an essential challenge for precision psychiatry. Clinical prediction models (CPMs) based on supervised machine learning have been a promising approach for this endeavor. However, only few CPMs have focused on model sparsity even though sparser models might facilitate the translation into clinical practice and lower the expenses of their application.

Methods

In this study, we developed a predictive modeling pipeline that combines hyperparameter tuning and recursive feature elimination in a nested cross-validation framework. We applied this pipeline to a real-world clinical data set on MDD treatment response and to a second simulated data set using three different classification algorithms. Performance was evaluated by permutation testing and comparison to a reference pipeline without nested feature selection.

Results

Across all models, the proposed pipeline led to sparser CPMs compared to the reference pipeline. Except for one comparison, the proposed pipeline resulted in equally or more accurate predictions. For MDD treatment response, balanced accuracy scores ranged between 61 and 71% when models were applied to hold-out validation data.

Conclusions

The resulting models might be particularly interesting for clinical applications as they could reduce expenses for clinical institutions and stress for patients.