bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting the time to get back to work using statistical models and machine learning approaches
Authors: Bouliotis George , Underwood M. , Froud R.
Published: November 2024

Background

Whether machine learning approaches are superior to classical statistical models for survival analyses, especially in the case of lack of proportionality, is unknown.

Objectives

To compare model performance and predictive accuracy of classic regressions and machine learning approaches using data from the Inspiring Families programme.

Methods

The Inspiring Families programme aims to support members of families with complex issues to return to work. We explored predictors of time to return to work with proportional hazards (Semi-Parametric Cox in Stata) and (Flexible Parametric Parmar-Royston in Stata) against the Survival penalised regression with Elastic Net penalty (scikit-survival), (conditional) Survival Forest algorithm (pySurvival), and (kernel) Survival Support Vector Machine (pySurvival).

Results

At baseline we obtained data on 61 binary variables from all 3161 participants. No model appeared superior, with a low predictive power (concordance index between 0.51 and 0.61). The median time for finding the first job was about 254 days. The top five contributing variables were ‘family issues and additional barriers’, ‘restriction of hours’, ‘available CV’, ‘self-employment considered’ and ‘education’. The Harrell’s Concordance index was range from 0.60 (Cox model) to 0.71 (Random Survival Forest) suggesting a better fit for the machine learning approaches. However, the comparison for predicting median time on a selected scenario based showed only minor differences.

Conclusion

Implementing a series of survival models with and without proportional hazards background provides a useful insight as well as better interpretation of the coefficients affected by non-linearities. However, that better fit does not translate to substantially higher predictive power and accuracy from using machine learning approaches. Further tuning of the machine learning algorithms may provide improved results.
Let this be a safe place: a qualitative study into midwifery care for forcibly displaced women in the Netherlands
Authors: Tankink J. B. , Verschuuren A. E. H. , de Graaf J. P. , Feijen-de Jong E. I. , van der Lans P. J. A. , van den Muijsenbergh M. E. T. C. , Franx A. , Goodarzi B.
Published: November 2024

Background

Forcibly displaced women in the Netherlands face increased chances of perinatal mortality and other adverse pregnancy and childbirth outcomes compared to the resident country population, which has been linked to suboptimal care. This study was conducted to gain insights from the experiences of Dutch midwives to inform and enhance the provision of tailored and equitable care for forcibly displaced women.

Methods

We conducted a qualitative study using semistructured interviews with community midwives who provide care for forcibly displaced women (asylum seekers and recognized refugees) in the Netherlands. Through thematic analysis, we identified the barriers midwives encounter in providing care and explored their strategies for navigating these barriers, aiming to inform recommendations that advance equitable care provision.

Results

Interviews with eleven midwives revealed barriers across three thematic levels: (1) the interactional level, where barriers related to language and interpreters, cultural differences, and building trust impeded positive interactions between midwives and forcibly displaced women; (2) the organizational level, where barriers concerning relocations of asylum seekers, delays in accessing care, and interdisciplinary collaboration impeded optimal care; and (3) the contextual level, where barriers related to women’s housing conditions, the resettlement process and the mental health of forcibly displaced women impeded midwives’ to respond to clients’ needs. These levels of barriers culminated in a core theme of imbalance between midwives’ expanded responsibilities and the limited resources and strategies available to them in care for forcibly displaced women. This imbalance forced midwives into multiple roles, increased both the practical and emotional burden on them, and undermined their ability to provide optimal, equitable care.

Conclusions

To enhance the provision of equitable pregnancy and childbirth care for forcibly displaced women in the Netherlands, it is crucial to target the imbalance between the responsibilities that midwives bear and the resources available to them. This requires dismantling barriers at the interactional, organizational and contextual level of care through targeted policy interventions. Structural determinants that perpetuate the imbalance in midwives’ work and restrict their scope of influence, such as restrictive migration policies that contribute to socioeconomic marginalization and poor housing conditions, need to be addressed. Ultimately, midwives themselves require more support and education to recognize and combat injustices in pregnancy and childbirth care for forcibly displaced women.
Concordance between immunohistochemistry and MSI analysis for detection of MMR/MSI status in colorectal cancer patients
Authors: Faizee Muhammad Ishaque , Talib NorLelawati A. , Hamdan Asmah Hanim Bt. , Abdullah Nor Zamzila Bt. , Rahimi Bilal Ahmad , Haidary Ahmed Maseh , Saadaat Ramin , Hanifi Ahmed Nasir
Published: November 2024

Background

Recently, screening of colorectal cancer (CRC) patients for mismatch repair/microsatellite instability (MMR/MSI) status is widely practiced due to its potential predictive and prognostic roles and a screening tool to reveal Lynch Syndrome (LS). The purpose of the study was to evaluate concordance between immunohistochemistry (IHC) and MSI analysis methods for detection of MMR/MSI status in colorectal cancer patients in Kuantan, Pahang.

Methods

Fifty selected CRC cases of deficient mismatch repair (dMMR) and proficient mismatch repair (pMMR) which were identified immunohistochemically in the previous study were subjected to MSI analysis. MSI Analysis System 1.2 (Promega) was utilized.

Results

The results of MSI analysis method showed MSI-High: 26% (13/50), MSI-Low: 6% (3/50), and Microsatellite Stable: 68% (34/50). The concordance was perfect (0.896, Kappa value) between MSI analysis and IHC methods for the assessment of MMR/MSI status in CRC patients. The discordance was only 4% (2/50). MSI analysis identified all dMMR cases determined by IHC except one case. The obtained frequency of dMMR and pMMR patients was 11.4% (14/123) and 88.6% (109/123) by IHC method, respectively.

Conclusion

Our findings support the universal practice of evaluating the MMR/MSI status in all newly diagnosed CRC patients. Based on the perfect concordance of two methods, the method of choice is based on the availability of expertise and equipments. IHC is highly appreciable method due to its feasibility and reproducibility.
The development for emerging biomarkers of lymphangioleiomyomatosis
Authors: Huang Liting , Xiao Ying , Yang Lulu , Ren Siying
Published: November 2024

Abstract 抽象

Lymphangioleiomyomatosis (LAM) is a rare, slowly progressing, low-grade metastatic tumor primarily affecting women. Currently, vascular endothelial growth factor–D (VEGF-D) is the only validated diagnostic biomarker, enabling diagnosis of LAM without the need for lung biopsy in appropriate clinical settings. However, VEGF-D concentrations are normal in about 30% of patients, rendering it insufficient for diagnosing all cases of LAM. There remains a need to identify more non-invasive, safe, sensitive, and specific biomarkers associated with LAM. Therefore, it is imperative to explore novel non-invasive, safe, and specific diagnostic methods for LAM. This article aims to review biomarkers associated with LAM, including potential biomarkers newly discovered or showing advancements in classical biomarkers widely used in LAM, and discuss their application in LAM diagnosis, assessment of disease severity, prediction of treatment response, and prognosis.淋巴管平滑肌瘤病 （LAM） 是一种罕见的、进展缓慢的低级别转移性肿瘤，主要影响女性。目前，血管内皮生长因子-D （VEGF-D） 是唯一经过验证的诊断生物标志物，无需在适当的临床环境中进行肺活检即可诊断 LAM。然而，约 30% 患者的 VEGF-D 浓度正常，不足以诊断所有 LAM 病例。仍然需要确定与 LAM 相关的更多无创、安全、敏感和特异性的生物标志物。因此，当务之急是探索新型无创、安全和特异性的 LAM 诊断方法。本文旨在回顾与 LAM 相关的生物标志物，包括新发现的潜在生物标志物或显示出 LAM 中广泛使用的经典生物标志物的进展，并讨论它们在 LAM 诊断、疾病严重程度评估、治疗反应预测和预后中的应用。
Differential effects of thiamine and ascorbic acid in clusters of septic patients identified by latent variable analysis
Authors: Legouis David , Monard Céline , Ourahmoune Aimad , Sgardello Sebastian , Quintard Hervé , Criton Gilles , Sangla Frederic , Schneider Antoine
Published: November 2024

Background

Thiamine and ascorbic acid have been proposed to mitigate the devastating consequences of sepsis and septic shock. To date, randomized controlled trials have failed to demonstrate a benefit of these therapies and heterogeneity of treatment effect is suspected. In this study, we aimed at assessing the heterogeneity of treatment effect of thiamine (B1) and the combination of B1 plus ascorbic acid (AA + B1) in critically ill patients with sepsis.

Methods

We conducted a bi-centric retrospective cohort study. All adult patients admitted to the ICU with sepsis or septic shock between January 2012 and August 2022 were included. Patient clusters were identified using latent variable analysis based on demographics and physiological variables obtained within 24 h of admission. Within each cluster and using inverse probability weighted Cox models, we compared in-hospital mortality between patients who received standard treatment (control), standard treatment plus B1 (B1 group), and standard treatment plus a combination of thiamine and ascorbic acid (AA + B1 group).

Results

A total of 3465 septic patients were included, 2183, 1054 and 228 in the standard, B1 and AA + B1 groups respectively. Five clusters of patients were identified in an unsupervised manner. The “Cluster Severe” included the most severely ill patients, the “Cluster Resp” patients presented with predominantly respiratory failure, the “Cluster Old” included elderly patients with multiple comorbidities, the “Cluster Fit” patients were young, healthy with low severity indices and “Cluster Liver” included patients with predominant liver failure. B1 treatment was associated with different outcomes across the five clusters. It was associated with a lower in-hospital mortality in the “Cluster Severe” and “Cluster Resp”. On the other hand, the combination of thiamine and ascorbic acid was not associated with reduced mortality in any cluster but an increased mortality in”Cluster Old”.

Conclusions

These results reinforce the lack of efficacy of the combination of AA + B1 reported in recent trials and even raise concerns about potential harm in older patients with comorbidities. On the contrary, we reported improved ICU survival associated with B1 supplementation in the most severe patients and those with predominant respiratory failure, supporting the need for further trials in this specific population.
Socio-affective communication in Tph2-deficient rat pups: communal nesting aggravates growth retardation despite ameliorating maternal affiliation deficits
Authors: Wang Tianhua , Homberg Judith R. , Boreggio Laura , Samina Marta C. F. , Castro Rogério C. R. , Kolk Sharon M. , Alenina Natalia , Bader Michael , Dai Jinye , Wöhr Markus
Published: November 2024

Background

A lack of serotonin (also known as 5-hydroxytryptamine, 5-HT) in the brain due to deficiency of the rate-limiting enzyme in 5-HT synthesis, tryptophan hydroxylase 2 (TPH2), was recently reported to result in impaired maternal affiliation across species, including mice, rats, and monkeys. In rodents, this was reflected in a lack of preference for maternal odors and reduced levels of isolation-induced ultrasonic vocalizations (USV), possibly contributing to a severe growth retardation phenotype.

Methods

Here, we tested whether growth retardation, maternal affiliation deficits, and/or impairments in socio-affective communication caused by Tph2 deficiency can be rescued through early social enrichment in rats. To this aim, we compared male and female Tph2−/− knockout and Tph2+/− heterozygous rat pups to Tph2+/+ wildtype littermate controls, with litters being randomly assigned to standard nesting (SN; one mother with her litter) or communal nesting (CN; two mothers with their two litters).

Results

Our results show that Tph2 deficiency causes severe growth retardation, together with moderate impairments in somatosensory reflexes and thermoregulatory capabilities, partially aggravated by CN. Tph2 deficiency further led to deficits in socio-affective communication, as evidenced by reduced emission of isolation-induced USV, associated with changes in acoustic features, clustering of subtypes, and temporal organization. Although CN did not rescue the impairments in socio-affective communication, CN ameliorated the maternal affiliation deficit caused by Tph2 deficiency in the homing test. To close the communicative loop between mother and pup, we assessed maternal preference and showed that mothers display a preference for Tph2+/+ controls over Tph2−/− pups, particularly under CN conditions. This is consistent with the aggravated growth phenotype in Tph2−/− pups exposed to the more competitive CN environment.

Conclusion

Together, this indicates that CN aggravates growth retardation despite ameliorating maternal affiliation deficits in Tph2-deficient rat pups, possibly due to reduced and acoustically altered isolation-induced USV, hindering efficient socio-affective communication between mother and pup.
Contrast-enhanced US Bosniak Classification: intra- and inter-rater agreement, confounding features, and diagnostic performance
Authors: Jin Dong-dong , Zhuang Bo-wen , Lin Ke , Zhang Nan , Qiao Bin , Xie Xiao-yan , Xie Xiao-hua , Wang Yan
Published: November 2024

Background

The contrast-enhanced US (CEUS) Bosniak classification, proposed by the European Federation for Ultrasound in Medicine and Biology (EFSUMB) in 2020, predicts malignancy in cystic renal masses (CRMs). However, intra- and inter-rater reproducibility for CEUS features has not been well investigated.

Purpose

To explore intra- and inter-rater agreement for US features, identify confounding features, and assess the diagnostic performance of CEUS Bosniak classification.

Materials and methods

This retrospective study included patients with complex CRMs who underwent CEUS examination from January 2013 to August 2023. Radiologists (3 experts and 3 novices) evaluated calcification, echogenic content, wall, septa, and internal nodules of CRMs using CEUS Bosniak classification. Intra- and inter-rater agreements were assessed using the Gwet agreement coefficient (Gwet’s AC). Linear regression identified features associated with discrepancies in Bosniak category assignment. Diagnostic performance was evaluated using the area under the receiver operating characteristic curve (AUC).

Results

A total of 103 complex CRMs were analyzed in 103 patients (mean age, 50 ± 15 years; 66 males). Intra-rater agreement for the Bosniak category was substantial to almost perfect (Gwet’s AC 0.73–0.87). Inter-rater agreement was substantial for the Bosniak category (Gwet’s AC 0.75) and moderate to almost perfect for US features (Gwet’s AC 0.44–0.94). Nodule variation (i.e., absence vs. obtuse margin vs. acute margin) explained 84% of the variability in the Bosniak category assignment. CEUS Bosniak classification showed good diagnostic performance, with AUCs ranging from 0.78 to 0.90 for each rater.

Conclusions

CEUS Bosniak classification demonstrated substantial intra- and inter-rater reproducibility and good diagnostic performance in predicting the malignancy potential of CRMs. Nodule variations significantly predicted differences in Bosniak category assignments.

Critical relevance statement

Contrast-enhanced US Bosniak classification reliably predicts malignancy in cystic renal masses, demonstrating substantial reproducibility and diagnostic accuracy. This improves clinical decision-making and patient management.

Key Points

Intra- and inter-rater reproducibility for contrast-enhance US features for Bosniak classification have not been well investigated.

Substantial inter-rater agreements for the Bosniak category and variable agreements for determining imaging features were found.

Contrast-enhanced US Bosniak classification is reproducible and has good diagnostic performance for predicting malignancy in cystic renal masses.

Graphical Abstract
Ultra-high gradient performance 3-Tesla MRI for super-fast and high-quality prostate imaging: initial experience
Authors: Bischoff Leon M. , Endler Christoph , Krausewitz Philipp , Ellinger Joerg , Klümper Niklas , Isaak Alexander , Mesropyan Narine , Kravchenko Dmitrij , Nowak Sebastian , Kuetting Daniel , Sprinkart Alois M. , Mürtz Petra , Pieper Claus C. , Attenberger Ulrike , Luetkens Julian A.
Published: November 2024

Objectives

To implement and evaluate a super-fast and high-quality biparametric MRI (bpMRI) protocol for prostate imaging acquired at a new ultra-high gradient 3.0-T MRI system.

Methods

Participants with clinically suspected prostate cancer prospectively underwent a multiparametric MRI (mpMRI) on a new 3.0-T MRI scanner (maximum gradient strength: 200 mT/m, maximum slew rate: 200 T/m/s). The bpMRI protocol was extracted from the full mpMRI protocol, including axial T2-weighted and diffusion-weighted (DWI) sequences (b0/800, b1500). Overall image quality was rated by two readers on a five-point Likert scale from (1) non-diagnostic to (5) excellent. PI-RADS 2.1 scores were assessed by three readers separately for the bpMRI and mpMRI protocols. Cohen’s and Fleiss’ κ were calculated for PI-RADS agreement between protocols and interrater reliability between readers, respectively.

Results

Seventy-seven male participants (mean age, 66 ± 8 years) were included. Acquisition time of the bpMRI protocol was reduced by 62% (bpMRI: 5 min, 33 ± 21 s; mpMRI: 14 min, 50 ± 42 s). The bpMRI protocol showed excellent overall image quality for both the T2-weighted (median score both readers: 5 [IQR: 4–5]) and DWI (b1500) sequence (median score reader 1: 4 [IQR: 4–5]; reader 2: 4 [IQR: 4–4]). PI-RADS score agreement between protocols was excellent (Cohen’s κ range: 0.91–0.95 [95% CI: 0.89, 0.99]) with an overall good interrater reliability (Fleiss’ κ, 0.86 [95% CI: 0.80, 0.92]).

Conclusion

Ultra-high gradient MRI allows the establishment of a high-quality and rapidly acquired bpMRI with high PI-RADS agreement to a full mpMRI protocol.

Trials registration

Clinicaltrials.gov, NCT06244680, Registered 06 February 2024, retrospectively registered, https://classic.clinicaltrials.gov/ct2/show/NCT06244680.

Critical relevance statement

A novel 3.0-Tesla MRI system with an ultra-high gradient performance enabled high-quality biparametric prostate MRI in 5.5 min while achieving excellent PI-RADS agreement with a standard multiparametric protocol.

Key Points

Multi- and biparametric prostate MRIs were prospectively acquired utilizing a maximum gradient of 200 mT/m.

Super-fast biparametric MRIs showed excellent image quality and had high PI-RADS agreement with multiparametric MRIs.

Implementation of high gradient MRI in clinical routine allows accelerated and high-quality biparametric prostate examinations.

Graphical Abstract
Impact of uncertainty quantification through conformal prediction on volume assessment from deep learning-based MRI prostate segmentation
Authors: Gade Marius , Nguyen Kevin Mekhaphan , Gedde Sol , Fernandez-Quilez Alvaro
Published: November 2024

Objectives

To estimate the uncertainty of a deep learning (DL)-based prostate segmentation algorithm through conformal prediction (CP) and to assess its effect on the calculation of the prostate volume (PV) in patients at risk of prostate cancer (PC).

Methods

Three-hundred seventy-seven multi-center 3-Tesla axial T2-weighted exams from biopsied males (66.64 $$\pm$$
±
 7.47 years) at risk of PC were retrospectively included in the study. Assessment of PV based on PI-RADS 2.1 ellipsoid formula ($${{{\rm{PV}}}}_{{ref}}$$

PV

r
e
f

) was available for included patients. Prostate segmentations were obtained from a DL model and used to calculate the PV ($${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

). CP was applied at a confidence level of 85% to flag unreliable pixel segmentations of the DL model. Subsequently, the PV ($${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

) was calculated when disregarding uncertain pixel segmentations. Agreement between $${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

and $${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

was evaluated against the reference standard $${{{\rm{PV}}}}_{{ref}}$$

PV

r
e
f

. Intraclass correlation coefficient (ICC) and Bland–Altman plots were used to assess the agreement. The relative volume difference (RVD) was used to evaluate the PV calculation accuracy, and the Wilcoxon Signed-Rank Test was used to assess statistical differences. A p-value < 0.05 was considered statistically significant.

Results

Conformal prediction significantly reduced RVD when compared to the DL algorithm (RVD = − 2.81 $$\pm$$
±
 8.85 and RVD = −8.01 $$\pm$$
±
 11.50). $${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

showed a significantly larger agreement than $${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

when using the reference standard $${{{\rm{PV}}}}_{{ref}}$$

PV

r
e
f

(mean difference (95% limits of agreement) $${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

: 1.27 mL (− 13.64; 16.17 mL) $${{{\rm{PV}}}}_{{DL}}$$

PV

D
L

: 6.07 mL (− 14.29; 26.42 mL)), with an excellent ICC ($${{{\rm{PV}}}}_{{CP}}$$

PV

C
P

: 0.97 (95% CI: 0.97 to 0.98)).

Conclusion

Uncertainty quantification through CP increases the accuracy and reliability of DL-based PV assessment in patients at risk of PC.

Critical relevance statement

Conformal prediction can flag uncertain pixel predictions of DL-based prostate MRI segmentation at a desired confidence level, increasing the reliability and safety of prostate volume assessment in patients at risk of prostate cancer.

Key Points

Conformal prediction can flag uncertain pixel predictions of prostate segmentations at a user-defined confidence level.

Deep learning with conformal prediction shows high accuracy in prostate volumetric assessment.

Agreement between automatic and ellipsoid-derived volume was significantly larger with conformal prediction.

Graphical Abstract
Post-traumatic intraosseous sheath development of the extensor carpi radials brevis tendon: a case report
Authors: Hinrichs Seela , Snellings Rich , Scholte Ryan
Published: November 2024

Background

Complications from closed treatment in children are rare but can include growth disturbances and deformities. This case report presents a unique, post-traumatic growth deformity in the distal radius, where the extensor carpi radialis brevis tendon developed an interosseous course.

Case presentation

A 49-year-old Caucasian male presented with chronic, dull pain in the radiodorsal aspect of the right wrist, worsened by weightbearing and terminal flexion and extension. The patient had a history of a distal radius fracture from a motor vehicle accident in adolescence, which was treated nonsurgically. Current X-rays showed a lucent process along the distal lateral radius without aggressive features. Magnetic resonance imaging revealed the extensor carpi radialis brevis tendon in an interosseous position within the distal dorsal lateral radius, with a longitudinal tear of the tendon. A noncontrast computed tomography scan confirmed a complete bone bridge along the tendon’s interosseous component, limiting potential surgical access. The patient, found to have a positive Antinuclear Antibody (ANA), was treated with prednisone and later with methotrexate and folic acid, which alleviated symptoms.

Conclusions

This case highlights a rare post-traumatic deformity following a distal radius fracture, where the extensor carpi radialis brevis tendon formed an intraosseous sheath. It underscores the importance of considering unique anatomical changes when planning surgical interventions. This is the first reported case of an interosseous tendon sheath development around a tendon postdistal radius fracture, expanding the spectrum of known complications.
Porcine parvovirus infection induces necroptosis of porcine placental trophoblast cells via a ZBP1-mediated pathway
Authors: Xu Ning , Du Qian , Cheng Yijiao , Nie Lichen , Ma Peipei , Feng Dingwen , Huang Yong , Tong Dewen
Published: November 2024

Porcine parvovirus (PPV) infection induces germ cell death, leading to reproductive disorders in first-pregnant sows. Porcine placental trophoblast cells (PTCs) are the major target of PPV, and we have previously found that PPV infection leads to the death of PTCs by a non-apoptotic process, which may be related to PPV pathogenicity. The Z-nucleic acid-binding protein 1 (ZBP1) is often activated after virus invasion and mediates subsequent cell death. Here, we found that PPV infection induced ZBP1-mediated necroptosis of porcine PTCs in the presence of the apoptosis inhibitor, AC-DEVD-CHO. ZBP1 expression was upregulated during PPV infection, and ZBP1 knockout or RNA interference significantly reduced its expression along with the PPV-induced necroptosis. We discovered that RIPK3 and MLKL, but not Caspase-8, were involved in downstream signaling of ZBP1 during PPV infection; the phosphorylation levels of RIPK3 and MLKL were enhanced, but Caspase-8 was not significantly cleaved. The knockout of RIPK3 and MLKL significantly reduced the PPV infection-induced necroptosis of porcine PTCs. RIPK3 knockout did not affect the PPV infection-induced upregulation of ZBP1 expression, but blocked the activation of MLKL. MLKL knockout did not affect the upregulation of ZBP1 expression and RIPK3 phosphorylation during PPV infection. UV-inactivated PPV induced significantly less necroptosis of porcine PTCs than non-irradiated PPV. A PPV strain with a mutation in the translation initiation codon was still able to induce necroptosis of PTCs through the ZBP1/RIPK3/MLKL pathway. These results provide new insights into the pathogenic mechanism of PPV infection and suggest that PPV infection of porcine PTCs induces necroptosis through the viral DNA-dependent ZBP1/RIPK3/MLKL pathway.
The benefit of early acupuncture within 7 days for neurological outcomes in ischemic stroke patients after cardiac surgery
Authors: Kuan Chia-Hsuan , Tseng Chi-Nan , Huang Tse-Hung , Yang Chien-Chung , Chen Yu-Sheng
Published: November 2024

Background

Stroke is a critical complication of cardiac surgery that results in increased mortality and morbidity. Limited treatment options are available for patients with severe neurological deficits, such as impaired consciousness. Acupuncture is a well-known integrative management method for stroke patients. However, there are no extensive reports discussing the benefit of acupuncture in stroke patients after cardiac surgery. The aim of this study was to demonstrate the role of acupuncture in the neurological recovery of these patients and to identify the factors that provide greater benefit.

Methods

This self-controlled case series utilized inpatient data from stroke patients after cardiac surgery who received acupuncture in a single center from 2013 to 2019. The primary outcomes included the Glasgow Coma Scale, muscle strength grading scale, and Barthel Index. Wilcoxon signed-rank test was used to compare the neurological differences between pre-acupuncture and post-acupuncture.

Results

Fifty-one patients who met the criteria showed significant improvement of the severity of neurological impairment, including the Glasgow Coma Scale, muscle strength grading scale, and Barthel Index (p < 0.05). The group that underwent aortic dissection repair and the group that started acupuncture within 7 days after stroke showed greater improvement (p < 0.01). No adverse events were reported. Three patients with profound neurological impairment who received acupuncture intervention were described.

Conclusions

Acupuncture has a potential benefit in improving neurological impairment and reducing mortality in stroke patients after cardiac surgery, especially within 7 days of the event. Further larger prospective studies with control groups are needed to provide convincing evidence.
Large language model doctor: assessing the ability of ChatGPT-4 to deliver interventional radiology procedural information to patients during the consent process
Authors: Hofmann Hayden L. , Vairavamurthy Jenanan
Published: November 2024

Purpose

The study aims to evaluate how current interventional radiologists view ChatGPT in the context of informed consent for interventional radiology (IR) procedures.

Methods

ChatGPT-4 was instructed to outline the risks, benefits, and alternatives for IR procedures. The outputs were reviewed by IR physicians to assess if outputs were 1) accurate, 2) comprehensive, 3) easy to understand, 4) written in a conversational tone, and 5) if they were comfortable providing the output to the patient. For each criterion, outputs were measured on a 5-point scale. Mean scores and percentage of physicians rating output as sufficient (4 or 5 on 5-point scale) were measured. A linear regression correlated mean rating with number of years in practice. Intraclass correlation coefficient (ICC) measured agreement among physicians.

Results

The mean rating of the ChatGPT responses was 4.29, 3.85, 4.15, 4.24, 3.82 for accuracy, comprehensiveness, readability, conversational tone, and physician comfort level, respectively. Percentage of physicians rating outputs as sufficient was 84%, 71%, 85%, 85%, and 67% for accuracy, comprehensiveness, readability, conversational tone, and physician comfort level, respectively. There was an inverse relationship between years in training and output score (coeff = -0.03413, p = 0.0128); ICC measured 0.39 (p = 0.003).

Conclusions

GPT-4 produced outputs that were accurate, understandable, and in a conversational tone. However, GPT-4 had a decreased capacity to produce a comprehensive output leading some physicians to be uncomfortable providing the output to patients. Practicing IRs should be aware of these limitations when counseling patients as ChatGPT-4 continues to develop into a clinically usable AI tool.
A novel wall interference correction method for airfoil
Authors: Wei Binbin , Gao Yongwei , Qiao Ruiyang , Hu Shuling
Published: November 2024

Corrections for wind tunnel experimental results are crucial when accounting for tunnel wall interference. This study introduces a new method, the non-uniform wall pressure signature method (NUWPSM), which is designed to address tunnel wall interference in airfoil. The improved wall pressure signature method (WPSM), an enhanced version of the WPSM, is developed to address the velocity disparities and systematic errors in pressure measurements between with and without model conditions. Furthermore, the NUWPSM considers the non-uniformity of the flow induced by the limited far-field effect in wind tunnel experiments. Utilizing experimental data from three different scaled models of the WA210 airfoil, the efficacy of both the Improved WPSM and NUWPSM is verified. Results indicate that the Improved WPSM exhibits superior capabilities in simulating the distribution of axial induced velocity along the wall compared to the traditional WPSM. Additionally, both the Improved WPSM and NUWPSM demonstrate comparable abilities in correcting tunnel wall interference, achieving precise corrections within an angle of attack range of −180° to +180°. Notably, the NUWPSM effectively captures the velocity non-uniformity induced by the limited far-field effect, thereby extending its applicability to a broader range of scenarios. Furthermore, the NUWPSM showcases enhanced robustness by eliminating human intervention in the singularity quantity and distribution.
The Dlk1-Dio3 noncoding RNA cluster coordinately regulates mitochondrial respiration and chromatin structure to establish proper cell state for muscle differentiation
Authors: Pinheiro Amanda , Petty Christopher A. , Stephens Chelsea E. , Cabrera Kevin , Palanques-Tost Eric , Gower Adam C. , Marano Madison , Leviss Ethan M. , Boberg Matthew J. , Mahendran Jawahar , Bock Payton M. , Fetterman Jessica L. , Naya Francisco J.
Published: November 2024

The coordinate regulation of metabolism and epigenetics to establish cell state-specific gene expression patterns during lineage progression is a central aspect of cell differentiation, but the factors that regulate this elaborate interplay are not well-defined. The imprinted Dlk1-Dio3 noncoding RNA (ncRNA) cluster has been associated with metabolism in various progenitor cells, suggesting it functions as a regulator of metabolism and cell state. Here, we directly demonstrate that the Dlk1-Dio3 ncRNA cluster coordinates mitochondrial respiration and chromatin structure to maintain proper cell state. Stable mouse muscle cell lines were generated harboring two distinct deletions in the proximal promoter region, resulting in either greatly upregulated or downregulated expression of the entire Dlk1-Dio3 ncRNA cluster. Both mutant lines displayed impaired muscle differentiation along with dysregulated structural gene expression and abnormalities in mitochondrial respiration. Genome-wide chromatin accessibility and histone methylation patterns were also severely affected in these mutants. Our results strongly suggest that muscle cells are sensitive to Dlk1-Dio3 ncRNA dosage, and that the cluster coordinately regulates metabolic activity and the epigenome to maintain proper cell state in the myogenic lineage.
Abca4, mutated in Stargardt disease, is required for structural integrity of cone outer segments
Authors: Willoughby John J. , Jensen Abbie M.
Published: November 2024

Stargardt disease (STGD), the leading cause of inherited childhood blindness, is primarily caused by mutations in the ABCA4 gene; yet, the underlying mechanisms of photoreceptor degeneration remain elusive, partly due to limitations in existing animal disease models. To expand our understanding, we mutated the human ABCA4 paralogues abca4a and abca4b in zebrafish, which has a cone-rich retina. Our study unveiled striking dysmorphology and elongation of cone outer segments (COS) in abca4a;abca4b double mutants, alongside reduced phagocytosis by the retinal pigmented epithelium (RPE). We report that zebrafish Abca4 protein forms a distinctive stripe along the length of COS, suggesting a potential structural role. We further show that, in wild-type zebrafish, outer segments of cone cells constitutively present externalized phosphatidylserine, an apoptotic ‘eat-me’ signal, and that this pattern is disrupted in abca4a;abca4b double mutants, potentially contributing to reduced RPE phagocytic activity. More broadly, constitutive presentation of the ‘eat-me’ signal by COS − if conserved in humans – might have important implications for other retinal degenerative diseases, including age-related macular degeneration. Our zebrafish model provides novel insights into cone dysfunction and presents a promising platform for unraveling the mechanisms of STGD pathogenesis and advancing therapeutic interventions.
Perfil de ocorrência da COVID-19 em uma instituição de ensino superior privada da área de saúde do interior de Minas Gerais, Brasil, 2020‒2021
Authors: Cimino Pereira Filho Júlio César , Ribeiro do Amaral Deivid , Marques Campos Jonatan , Stelmo da Silva Marcio Heitor , Fernandes Herbert José , Orleans da Costa José , Bergamaschine Mata Diz Juliano , Mayrink de Oliveira Dulcilene
Published: November 2024

Objetivo: apresentar um panorama epidemiológico dos casos de COVID-19 em uma escola médica privada de Minas Gerais, Brasil. Métodos: estudo transversal de série temporal que utilizou dados da Comissão de Biossegurança de uma escola médica. Os dados foram coletados durante 13 meses (outubro/2020−outubro2021) em uma população de 900 indivíduos. Foram registrados os casos-contatos, -suspeitos e-confirmados de COVID-19. Um caso-contato foi considerado quando o indivíduo permaneceu no mesmo ambiente de um caso-confirmado, sem utilização de máscara facial. Um caso-suspeito foi considerado quando o indivíduo possuía sinais/sintomas sugestivos, sem um teste laboratorial confirmatório. Um caso-confirmado foi determinado por meio de testes laboratoriais confirmatórios. Os dados foram analisados por meio de estatística descritiva, cálculo de taxas e correlação-r. Resultados: no período avaliado, foram registradas 1.291 notificações, com 147 casos-confirmados (média de 11,3±1,3 casos). Não houve correlação entre o número de casos-contatos e -suspeitos ou -confirmados. Houve uma correlação positiva entre o número de casos-suspeitos e-confirmados (r=0,59; p=0,03). A taxa mensal de casos-confirmados variou entre 0,3−2,1 por 100 pessoas-mês. A incidência acumulada de casos-confirmados foi de 16,3 por 100 pessoas. Conclusão: evidencia-se um adequado controle sanitário local, com número reduzido de casos-confirmados durante os 13 meses avaliados. Esses achados podem ser úteis para outras escolas médicas na condução de crises sanitárias futuras.
LEGISLATIVE BASIS OF NOBLE ESTATE SELF-GOVERNMENT IN TULA PROVINCE IN THE SECOND HALF OF THE XIX CENTURY – BEGINNING OF THE XX CENTURY
Authors: Kazachenko Vladislav V.
Published: November 2024

Background. Historically, the nobility in the Russian Empire was a privileged class and the support of the autocracy. Modernization bourgeois-democratic reforms of the 1860-1870s influenced all spheres of society, including the nobility, which sought to maintain its privileged position, which could not but affect the transformation of the legislative foundations of estate self-government bodies. In the article, the author suggests that, despite the fact that the autocracy was interested in maintaining the position of the nobility, it was forced to make changes to the legislation regulating the activities of noble self-government. The legislation of the Tula province reflected all-Russian trends, but had some features.
The purpose of the study is to identify the general and specific features in the formation of the legislative foundations of noble self-government in the Tula province in the second half of the 19th - early 20th centuries, and their competencies.
Materials and methods. The main research method is historical-genetic and historical-comparative. The article is based on the analysis of legislative acts of the 19th - early 20th centuries and office work materials of noble assemblies.
Research results. The fundamental similarity of the all-Russian legislative foundations and the Tula province was established. Before the Great Reforms, noble assemblies were important local government bodies, protecting the political and economic interests of the nobility. After the reforms of the 1860-1870s, their powers were reduced, limited to economic issues and maintaining genealogical books, but the nobles continued to occupy key positions in the zemstvo administration until 1917. In the Tula province, the principles of noble self-government were based on Russian legislation. The peculiarity of the changes in the legislative foundations of the Tula nobility was that the Assembly opposed the reduction of the property qualification. The main functions of the Assembly in the post-reform period remained the maintenance of genealogical books, the issuance of certificates of noble status, charity and guardianship of nobles who had cooled off without care. In the post-reform period, the noble self-government had significant competencies and the necessary resources to support them.
STRUCTURAL AND GRAMMATICAL FEATURES OF ADJECTIVAL PHRASEOLOGICAL UNITS IN THE RUSSIAN AND ENGLISH LANGUAGES
Authors: Bibik Elena A.
Published: November 2024

Background. Identifying the structural and grammatical features of the adjectival phraseological units both in Russian and English is significant in regard to exploring the peculiarities of the linguistic system and the national-cultural context of the languages under study, which makes it possible to further study the peculiarities concerning the use and functioning of phraseological units and paroemias.
Purpose. To identify the structural and grammatical features of the adjectival phraseological units in the Russian and English languages.
Materials and methods. The descriptive method was applied based both on the results of the analysis and synthesis over the theoretical material as well as the method of contextual analysis of the practical materials presented in the paper, namely adjectival phraseological units obtained by the method of random selection.
Results. As a result of the structural and grammatical peculiarities analysis of the Russian and English paroemias under study we can conclude that the existing differences in their expression are connected first of all with the fact that the most important in the syntactic typology of languages relation 'subject - action - object' is expressed in the languages under study in different ways, due to the peculiarities of the syntactic structure of each language, which is a special relationship between the structural and semantic components of the sentence. From the perspective of the mode and means of expression the Russian language is inflective, and the English language is analytic.
Despite some differences, the adjectival phraseological units in the languages under study have significant similarities in their structure and grammar, which can be explained by the common laws of the language organization and universality of the logical categories behind its formation.
Practical implications. The results of the presented work are relevant to the research concerning the peculiarities of adjectival phraseological units, as well as adjectives in Russian and English paroemias.
THE SOCIO-CULTURAL VALUE OF TECHNOLOGY IN THE CONTEXT OF TEMPORAL ACCELERATION AND GAMIFICATION OF REALITY
Authors: Pluzhnikova Natalia N. , Gribova Anastasiya V.
Published: November 2024

Background. In the context of digitalization of reality, the analysis of the essence of technology, which is associated with the transformation of modern socio-cultural processes, acquires special scientific significance. Technology is no longer considered exclusively as a technological phenomenon. Acceleration of socio-cultural dynamics processes leads to an expansion of the understanding of technology by including the sphere of technology in all spheres of modern human life. This process is most clearly demonstrated by the example of the development of the cyber-gaming industry, which allows us to substantiate the essence of the value approach to the analysis of technology.
Purpose. Analysis of the essence and relationship of technology with the processes of socio-cultural dynamics using the example of the development of the modern cyber-gaming industry.
Materials and methods. The authors used general scientific analytical tools, as well as a survey method. The anonymous survey involved respondents without specifying gender from 14 to 35 years old, who are active consumers of cyber games, who were asked one open question, which presupposed a detailed answer in free form. Quantitative indicators were used as an element of describing the dynamics of socio-cultural changes for the analysis of the concept of technology.
Results. A digital game can be considered as a cyber-sociocultural phenomenon that determines and sets a specific rhythm for the flow of sociocultural processes, as well as human life. It also acts as a necessary element of sociocultural dynamics and can itself be considered as a dynamic process indicating the relationship between technology and sociocultural dynamics. As a result of the analysis of cyber games, technology acquires a sociocultural value, in which technology can be considered not only as an object or as a process of human activity, but also as a degree of human development, mastery of reality in game and virtual forms. The process of technology development has both internal determinants underlying technological logic and external ones associated with the logic of sociocultural dynamics.
EXPRESSION OF FEMALE IDENTITY THROUGH VERBAL MANIFESTATION (ON THE BASIS OF THE QUEEN’S GAMBIT BY W. TEVIS)
Authors: Vinnik Evgeniya I.
Published: November 2024

Background. The article discusses the problem of female identity’s formation in the modern context determined by the worldview of postmodernism. The relevance of this study is due to the urgent need for theoretical understanding and practical scrutiny of the linguistic role as means of constructing gender through the verb.
Purpose. The study is aimed to ascertain the dynamics of female identity’s formation in literary text through verbal presentation.
Materials and methods. The survey is based on: the definitional analysis of gender tendencies, problems of female genius, contextual observation of speech material of the fictional work, as well as linguistic facts interpretation and collation, statistical data manipulation.
Results. The hypothesis of potential dynamics of the female identity’s formation in the literary text through the verbal semantic space’s analysis of the novel The Queen’s Gambit by W. Tevis (1900 manifestations) is justified.
Practical implications. The research outcome can find the application in systematic scrutiny of the verb/ verbals usage in the textual space as a means of gender aspect implementation.
ETHNIC IDENTITY IN URBAN AND RURAL SPACES: KEY INDICATORS OF HISTORICAL AND CULTURAL HERITAGE (ON THE EXAMPLE OF THE ALTAI KAZAKHS)
Authors: Derendyaeva Anna D. , Mikhalevskaya Daria A.
Published: November 2024

Background. In recent years, the study of multinational regions of the Russian Federation has become relevant, in the development of which various strategies and practices are observed in preserving their historical and cultural heritage. At the same time, the study of local communities, namely individual ethnic groups, is of particular interest. It is becoming important to study how the institution of heritage influences the processes of identity formation in these communities, whether it differs in urban and rural environments.
Purpose. Analysis of the influence of the institute of historical and cultural heritage on the processes of preserving ethnic identity in urban and rural spaces, as well as identifying key indicators of identity.
Materials and methods. The article presents and analyzes the results of an ethnographic study conducted by scientists and staff of the Altai State University in April-May 2024. The main research method was a sociological survey of representatives of the Kazakh ethnic group, namely residents of the «two Altais»: Altai Krai (Barnaul, Kirey and Mirabilit) and the Altai Republic (Gorno-Altaysk, Kosh-Agach, Zhana-aul). In addition, the theoretical part of the work is based on the concepts of studying ethnic groups: primordialism, constructivism and ethnosymbolism.
Results. The obtained data were processed using the SPSS statistical analysis program, and comparative and content analyses were also conducted. The authors of the study noted key indicators of ethnic identity directly related to historical and cultural heritage: 1) historical narratives, 2) national language, 3) symbolic events, 4) traditions and customs, 5) household items, and 6) gastronomic culture. It is shown that ethnic identity is more stable in the rural environment. Both in urban and rural spaces, the phenomenon of "intersection of local cultures" is forming.