bluuebunny/crossref_metadata_2025 huggingface dataset:
Osteoporosis and Osteopenia – A Rising Healthcare Problem
Authors:   Department of Nuclear Medicine and Molecular Imaging, Neurospinal & Medical Institute, Karachi, Pakistan, Kamal Shahid
Published: July 2023

With Asia housing 75% of humanity, and the proportion of seniors rapidly climbing from 5.3% in 2015 to 9.3% by 2025, Osteoporosis is rapidly becoming a growing medical ailment in this part of the world too [1]. In Pakistan, though clear data on occurrence of hip fractures (osteoporotic) annually is not established, large ultrasound studies suggest that there may be more than 9 million people (7 million women, 2 million men) afflicted with Osteoporosis. It is expected that these estimates may very well cross 12 million by the year 2050 – becoming a major health burden. Low per capita income and high hospital costs further derail the earning capacity. Estimations indicate the population to cross 340 million by the year 2050, and of these 14.9% (50 million) will be over the age 60 years. A five year study from one hospital revealed a 2:1 female to male ratio of hip fracture cases, with 61 years being the average age of patients having osteoporotic fracture. This average age is lower than that reported in North America and Europe but matches data from India. Another study revealed 16% and 34% occurrence of osteoporosis and osteopenia respectively in females of age group 45 to 70 using ultrasound technique. Another study from KPK province estimated the numbers at 29 and 42% respectively. 75% of postmenopausal women from Peshawar seemed to be at risk of osteoporosis on a clinical risk score analysis [2-7].
Prevalencia de anticuerpos y vacunación contra SARS-CoV-2 en 2022 en México
Authors: Carnalla Martha , Basto-Abreu Ana , Stern Dalia , Colchero M Arantxa , Bautista-Arredondo Sergio , Alpuche-Aranda Celia M , Martínez-Barnetche Jesús , Romero-Martínez Martín , Cortés-Alcalá Ricardo , López-Martínez Irma , Aparicio-Antonio Rodrigo , Barrientos-Gutiérrez Tonatiuh
Published: July 2023

Objetivo. Describir la prevalencia de anticuerpos contra SARS-CoV-2, vacunación, barreras y rechazo a la vacunación Covid-19 en población mexicana. Material y métodos. Se utilizó información de los integrantes del hogar de uno y más años, incluidos en la Encuesta Nacional de Salud y Nutrición Continua 2022 (Ensanut Continua 2022) realizada de agosto-noviembre. Se estimó la prevalencia de anticuerpos antiproteínas N y S de SARS-CoV-2 en muestras de sangre capilar, dosis reportadas de vacunación a Covid-19 y las razones de barreras y rechazo a la vacunación. Resultados. La prevalencia de anticuerpos anti-N fue de 94.4% y de anti-S 98.1%. La prevalencia de anticuerpos anti-S fue mayor en personas vacunadas con una, dos o tres o más dosis que en no vacunadas. Dentro de la población elegible a vacunación, 20.2% no estaba vacunada, 16.2% tenía una dosis, 30% dos dosis y 33.6% tres dosis o más. El 11.2% de la población elegible rechazó la vacunación, 5.5% reportó una barrera y 3.2% reportó que la vacuna no había llegado a su localidad. Conclusión. La prevalencia de anticuerpos por infección natural y por vacunación Covid-19 es alta en México. Las variaciones de rechazo y barreras a la vacunación entre grupos de edad y regiones deben tomarse en cuenta para intensificar esfuerzos específicos para la vacunación.
Characterization of Multiphase Flow in Shale Oil Reservoirs Considering Multiscale Porous Media by High-Resolution Numerical Simulation
Authors: Lei Zhengdong , Li Junchao , Chen Zhewei , Dai Xu , Ji Dongqi , Wang Yuhan , Liu Yishan
Published: July 2023

Multiphase flow behavior in the complex porous media of lacustrine shale oil is critical to the oil production performance. Shale oil reservoir processes spatial spaces of multiscale porous media. In view of the mesoscopic scale, the fluids flow behaviors of shale oil reservoirs are significantly different from that of tight oil reservoirs and the multimedia flow fluxes in shale have to be reevaluated. Furthermore, upscaling methods from the mesoscopic scale to the macroscopic level as well as coupling methods of multimedia mass transfer have not been adequately established. Based on the multiple media model, such as organic-inorganic matter system and embedded discrete fracture model (DFM), this work proposes a multiscale porous media flow simulation method that is applicable for lacustrine shale oil reservoirs. In the model, various reservoir matrix and flow spaces, such as organic pores, intragranular pores, intergranular pores, and fracture networks composed of bedding fractures and hydraulic fractures, are included. Methods of mass flux conductivity estimations among multiscale media and the relevant upgrading methods are also proposed. Validation of the model is first conducted by the comparison of the oil production performance estimated by the proposed model and a theory solution, and the model is further compared to Gulong shale oil reservoir data to determine its availability in field application. The results show that the proposed simulation model is capable of accurately characterizing the multiphase flow characteristics in multiscale media in shale. It is further demonstrated that the proposed model significantly improves the simulation accuracy over the current nonupscaling models. Field study shows that, based on the accurate characterization of the complex flows in shale oil reservoirs, the research output can provide support for future development of the Gulong shale oil reservoir.
How does dental treatment affect oral health of patients received radiotherapy and bone-modifying agent: systematic review
Authors: AlSahman Roba , AlSahman Lujain , Alturiaki Sami
Published: July 2023

Background: Radiotherapy and bone-modifying agents are widely used to treat malignancies and metastases. Bone-modifying agents and radiation-related adverse effects on oral health detrimentally affect dental treatment outcomes. Two common complications occur during and after radiotherapy: bone-modifying medications, osteoradionecrosis, and osteonecrosis of the bones. Dental professionals play an important role in evaluating procedures that can potentially cause these complications.
Objective: This systematic review aimed to evaluate the effects of dental treatment on oral health in patients who had received radiotherapy and bone-modifying agents.
Methods: A comprehensive search was conducted using PubMed, Scopus, Web of Science, Embase, Medline, Proquest, and Cochrane Library from 2015-2023 following PRISMA guidelines.
Results: Eighteen articles, published between 2015 and 2023, were reviewed. Dental implants have been the main focus of attention in most studies, as radiation therapy can reduce the microhardness of enamel and dentin and increase the risk of osteoradionecrosis (ORN) and tooth failure. However, dental implants can still be successful with proper bone quality and implant techniques, and bisphosphonate therapy does not significantly affect implant failure.
Conclusion: The risk of developing osteonecrosis was not significant, but was increased by parenteral administration compared with oral administration. Bisphosphate is associated with deep pockets, higher bleeding index, and pulp obliteration.
Environmental Innovation, Ecological Footprint, and Environmental Rebound Effects: A Solution for or a Cause of Environmental Degradation?
Authors: Aydın Celil , Esen Ömer , Çetintaş Yağmur
Published: July 2023

This paper investigates the effect of environmental innovation on ecological footprint using a PSTR model. To examine this impact, a large panel dataset covering 26 EU economies1 for the period 1990–2010 is exploited. The estimated findings point out that below the threshold level, environmental pressure on per capita ecological footprint increase with environmental innovation, after exceeding the threshold level, the rate of increase in pressure is still positive but tends to decrease. Existing empirical results point to a rebound effect, which refers to offsetting the gains from environmental innovation by channeling them into production and consumption. This paper suggests that policymakers take into account that environmental innovations alone do not reduce pressure on Earth's ecosystems and their life-supporting services, but can provide resources to reduce this pressure.
[1] The list of 26 EU countries is in Table 1 in Appendix.
Practical lessons from the implementation of a surgical opioid reduction initiative in an integrated health system: a qualitative study among providers and patients
Authors: Schäfer Willemijn , Johnson Julie K. , Shallcross Meagan L. , Iroz Cassandra B. , Huang Reiping , Balbale Salva , Stulberg Jonah J.
Published: July 2023

Background
Surgical opioid overprescribing can result in long-term use or misuse. Between July 2018 and March 2019, the multicomponent intervention, Minimizing Opioid Prescribing in Surgery (MOPiS) was implemented in the general surgery clinics of five hospitals and successfully reduced opioid prescribing. To date, various studies have shown a positive outcome of similar reduction initiatives. However, in addition to evaluating the impact on clinical outcomes, it is important to understand the implementation process of an intervention to extend sustainability of interventions and allow for dissemination of the intervention into other contexts. This study aims to extract practical lessons through evaluation of the contextual factors impacting intervention implementation.
Methods
We conducted a qualitative study with semi-structured interviews held with providers and patients of the general surgery clinics of five hospitals of a single health system between March and November of 2019. Interview questions focused on how contextual factors affected implementation of the intervention. We coded interview transcripts deductively, using the Consolidated Framework for Implementation Research (CFIR) to identify the relevant contextual factors. Content analyses were conducted using a constant comparative approach to identify overarching themes.
Results
We interviewed 15 clinicians (e.g., surgeons, nurses), one quality representative, one scheduler and 28 adult patients and identified three key themes. First, we found high variability in the responses of clinicians and patients to the intervention. There was a strong need for intervention components to be locally adaptable, particularly for the format and content of the patient and clinician education materials. Second, surgical pain management should be recognized as a team sport. We identified specific gaps in the engagement of team members, including nurses. We also found that the hierarchical relationships between surgical residents and attendings impacted implementation. Finally, we found that established patient and clinician views on opioid prescribing were an important facilitator to effective implementation.
Conclusion
Successful implementation of a complex set of opioid reduction interventions in surgery requires locally adaptable elements of the intervention, a team-centric approach, and an understanding of patient and clinician views regarding changes being proposed.
Induction chemoimmunotherapy may improve outcomes to chemoradiotherapy for unresectable stage III NSCLC patients
Authors: Guan Song , Zhang Shufeng , Ren Kai , Li Xingyue , Li Xue , Zhao Lujun
Published: July 2023

Objective
Currently, the value of induction chemoimmunotherapy before chemoradiotherapy (CRT) in unresectable stage III non-small cell lung cancer (NSCLC) has not been established. This study aimed to investigate the role of induction chemoimmunotherapy for unresectable stage III NSCLC.
Patients and Methods
Patients diagnosed with stage III NSCLC who received CRT at Tianjin Cancer Hospital between August 2014 and December 2021 were retrospectively analysed. Based on induction chemoimmunotherapy or not, patients were allocated to I-CRT group or CRT group. Clinical outcomes including progression-free survival (PFS) and overall survival (OS) were estimated.
Results
A total of 255 patients were included, with 51 (20.0%) in the I-CRT group and 204 (80.0%) in the CRT group. The median PFS was 24.8 months in the I-CRT group vs. 12.6 months in the CRT group (p = 0.004), and the median OS was not reached (NR) vs. 32.4 months (p = 0.040). The multivariate analysis showed that induction chemoimmunotherapy was the independent factor favoring PFS (HR = 0.497, p = 0.003) and OS (HR = 0.459, p = 0.038). No significant differences were found in adverse effects (p > 0.05). The objective response rate (ORR) after induction chemoimmunotherapy was significantly higher than that after induction chemotherapy (56.9% vs. 22.2%, p = 0.000). Patients with induction chemoimmunotherapy before concurrent chemoradiotherapy had prolonged PFS (median NR vs. 14.9 months, p = 0.012) and OS (median NR vs. 26.5 months, p = 0.074) compared to those with induction chemotherapy.
Conclusion
Induction chemoimmunotherapy may improve outcomes to CRT and is well tolerated for unresectable stage III NSCLC patients. Prospective randomized trials need to be performed to further validate these findings.
Green Preparation of Flexible and Transparent SiO2-Fe2O3-PS film for Dye Adsorption and UV-Shielding Applications
Authors: Nath Abhijit , Mahato Mrityunjoy
Published: July 2023

A multifunctional green polymer nanocomposite (SiO2-Fe2O3-PS) film has been prepared using earth-abandoned and waste materials such as natural sand, waste expanded polystyrene (EPS), and pea eggplant fruit extract. SiO2 was prepared using natural sand by alkali fusion method, SiO2-Fe2O3 was prepared by microwave assisted green synthesis method and the SiO2-Fe2O3-PS film was prepared by solution casting method. The SiO2-Fe2O3 (20:80)-PS film shows the shielding efficiency of 91–100% in the wavelength range of 390 − 200 nm and transparency of 71% to visible light at 800 nm. The SiO2-Fe2O3 (50:50)-PS film shows maximum adsorption capacity of 61.2% to methylene blue (MB) dye. The UV-Vis peak position of SiO2 (326 nm) and Fe2O3 (276 nm) are in line with the literature. The peak position in SiO2-Fe2O3 at different wt% ratio, were found at 290 nm (10:90), 328 nm (20:80), and 292 nm (50:50), which are indicative of the formation of heterostructure. The XRD data of SiO2-Fe2O3 comprises sharp peaks of both components that confirm the heterostructure formation and its crystalline nature. The SiO2-Fe2O3-PS composite formation was confirmed by FTIR and FESEM. The film is hydrophilic in nature (contact angle of 75.96°) and shows maximum thermal stability upto 381.6 ℃ (SiO2-Fe2O3 (20:80)-PS). The adsorption experiment was carried out using a 50 mg catalyst either in powder or film form with 100 mL dye solution of concentration 20 mg/L, where equilibrium adsorption was achieved within 180 minutes. The adsorption efficiency of SiO2, Fe2O3, SiO2-Fe2O3 (20:80), SiO2-Fe2O3(50:50), and SiO2-Fe2O3(50:50)-PS are found to be 98.3%, 3.88%, 91.1%, 96.2%, and 61.2%, respectively. The MB dye adsorption process follows pseudo second order kinetics and is best fitted with the Langmuir isotherm model. The novel SiO2-Fe2O3-PS film is found to be low cost, green, and environmentally friendly with multifunctional applications in the area of UV shielding, visible transparent and dye adsorption.
Analysis of Tobacco Exposures and HR-HPV infection in American women：National Health and Nutrition Examination Survey
Authors: jiang liangzi , Ma Suting , Zhang Ge , Jiang Lingling , Yan Li
Published: July 2023

Nicotine is a known toxin, but its relationship with cervicovaginal high-risk human papillomavirus (HR-HPV) infection is uncertain. This study aimed to investigate whether tobacco exposure is associated with elevated cervicovaginal HR-HPV infection in US women, and if the strength of this association varies with the degree of exposure. Cross-sectional data from the 2011–2016 National Health and Nutrition Examination Survey (NHANES), which included a nationally representative sample of US women, were used for the study. Out of 12436 women aged 18–59 who participated in the interview, 3833 were ultimately enrolled in this study. Weighted logistic regression was used to estimate the link between tobacco exposure and cervicovaginal HR-HPV infection. The mean age of participants was 38.6 (SD 12.1) years, and non-Hispanic White individuals accounted for 37.3% of the sample. Those with any tobacco exposure tended to be younger (mean age 37.7 [SD 12.4] years vs 40.3 [11.2] years), non-Hispanic Black (27.8% vs. 15.1%), lower educated (41.8% vs. 29.4%), and have lower family income (39.9% vs. 23.5%). After adjustment, the odds of having HR-HPV infection were 1.32 (95% CI, 1.09–1.59) for those exposed to tobacco, remaining significant in multiple sensitivity analyses and across subgroups. This study, based on a nationally representative sample from the United States, suggests that tobacco exposure is a risk factor for elevated HR-HPV infection in women, highlighting the need for further research into reducing this modifiable risk factor.
Investigating the fracture behavior and energy absorption of new flexible hybrid biocomposites with soft and hard layers of rubber/lignin/CB and hemp fabric impregnated with matrix under high-velocity impact
Authors: ghiaskar ahmad , Nouri Mohammad Damghani
Published: July 2023

This paper compares the behavior and energy absorption of hybrid and conventional flexible composites with soft and hard rubber layers and fabrics impregnated with soft and hard matrix in different configurations of layer arrangement under high-velocity impact. For this purpose, two types of hard and soft rubber layers were produced by increasing the amount of lignin-carbon binary filler in rubber compounds. Also, a diluted hard and soft rubber matrix was used to impregnate the hemp fabric. The high-velocity impact test was performed by firing a hemispherical projectile on the proposed composites at a velocity range of 80 to 160 m/s. The effectiveness of diluted rubber matrix coating and rubber layer in terms of projectile velocity reduction, damage mechanism, absorption of the kinetic energy of composites, and the effect of different layer configurations on residual velocity have been presented and investigated. The results show that elastomer hardness significantly affects the ballistic performance of flexible composites. Also, by examining the position of hemp fabric and rubber layers in the arrangement of layers, it is clear that better performance is obtained for a hybrid composite with hard layers on both sides of the impact face and a soft layer in the middle. The damage mechanism in composites with hard layers through small inlet and outlet diameters and more protective margins shows an excellent ability to absorb energy and subsequently reduce the residual velocity of projectiles.
Effects of Gamma, Electron-Beam, and X-ray Radiation on
EVA/EVOH/EVA Films
Authors: Fifield Leonard , Ni Yelin , Bisel Tucker , Hasan Md Kamrul , Li Donghui , Fuchs Witold , Cooley Scott , Nichols Larry , Pharr Matt , Dupuy Nathalie , Marque Sylvain , Murphy Mark , Pillai Suresh , Dorey Samuel
Published: July 2023

Many polymer-based medical devices are sterilized by gamma irradiation. To reduce the use of cobalt-60 gamma-ray sources, transition from gamma ray to alternative irradiation technologies was proposed, namely electron beam (e-beam) and X-ray. A major impediment for such a transition is the knowledge gap in material compatibility with the different radiation sources. In this study, multi-layer films consisting of ethylene vinyl acetate (EVA) and ethylene vinyl alcohol (EVOH) components were irradiated to target doses of 30, 45, and 60 kGy by gamma-ray, e-beam, and X-ray sources. Effects of irradiation were evaluated on 12 material properties, and statistical comparisons between gamma irradiation and alternative technologies were conducted using the two one-sided t-test (or “equivalence test”) and classic t-test. Melting temperature and UV absorbance below 300 nm showed dose dependencies, while other investigated properties such as discoloration and mechanical durability did not change with dose up to 60 kGy. Based on these results, there is no material compatibility issue associated with the transition from gamma to e-beam or to X-ray as source of sterilization radiation of the studied multi-layer film.
An Analysis of the Mechanisms of Public Trust on Environmental Risk Response Behavior: Evidence from China
Authors: Lan Lan , Huang Tianjing , Du Yanqiang , Bao Cunkuan
Published: July 2023

The public's environmental risk coping behaviors affects the effectiveness of environmental risk management. This paper uses a structural equation model (SEM) to explore the mechanisms of public trust in governments and enterprises on different types of environmental risk coping behaviors (collaborative and confrontational behaviors) by using the residents, who live around the industrial area J and the waste incineration plant Q in city A in China, as the study population. This research adopts the theory of planned behavior (TPB) and some additional constructs (risk perception, interaction satisfaction) in the empirical tests to predict behavioral choices. The results show that public trust in governments has a positive influence on the intention to collaborate, and a lower level of public trust in governments and enterprises enhances the intention to adopt confrontational behaviors. Public trust in governments and enterprises can also indirectly influence the intention to collaborate through subjective norms, attitudes, and perceived behavioral control. Public trust in governments and enterprises can also influence the intention to confront through perceived behavioral control. The intention to confront is related to confrontational behaviors, but the intention to collaborate may not necessarily lead to collaborative behavior. Risk perception is not directly related to trust and the intention to collaborate, but risk perception and trust can alone influence to intention to confront. The reason for the public to adopt collaborative behavior is not that they perceive high risk, but that a high level of trust in the governments can increase the level of willingness to adopt collaborative behaviors. Government credibility plays an important role in guiding public risk coping behaviors. The findings of the study provide policy recommendations for guiding the public’s environmental risk coping behaviors.
Herbal medicine Huazhuo Tiaozhi granule ameliorates dyslipidemia via regulating DDX17 lactylation and miR-155-5p biogenesis
Authors: Yin Xiangjun , Li Min , Wang Yongzhi , Zhao Guifang , Yang Tao , Zhang Yuqing , Guo Jianbo , Meng Tiantian , Du Ruolin , Li Honglin , Wang Zhe , Zhang Jian , He Qingyong
Published: July 2023

Background
Huazhuo Tiaozhi granule (HTG) is a herbal medicine prescription, which is widely used in clinical practice for hypolipidemic effect. However, the molecular mechanism in treating dyslipidemia has not been well elucidated.
Results
In the clinical trial, a significant reduction in the levels of TC and LDL-C was observed in serum of dyslipidemia patients after HTG treatment without disruption of the levels of AST, ALT, BUN and Cr. Dyslipidemia rat model was induced by high-fat diet and treated with Xuezhikang (0.14g/kg/d) and HTG (9.33g crude herb/kg/d) by gavage, respectively for 8 weeks. The body weight and liver index were markedly downregulated in dyslipidemia rats after the treatment of Xuezhikang and HTG. HTG markedly ameliorated hyperlipidemia by significantly decreasing the levels of TC and LDL-C in serum and hepatic lipid accumulation. In vitro, lipid accumulation in L02 cells was alleviated after 20% HTG medicated serum treatment. Moreover, HTG sustains glycolytic rate analyzed by Seahorse assay. However, high lactylation was observed in a total of 198 proteins including RNA binding protein DDX17(K121) lactylation, HDAC1 (K412, K438), H2B (K6) and H4(K80) lactylation, which inhibited the biogenesis of miR-155-5p in vitro.
Conclusions
This study demonstrates that HTG is an effective and safe formula in treating dyslipidemia, which promoted lactylation level in hepatocytes resulting in retardation of miR-155-5p biogenesis.
Studying Importance of Charge Noise and Measurement Basis for Spin Qubit in Quantum Dot
Authors: Joshi Abhijeet
Published: July 2023

Quantum computation has evolved from a mere word proposed by Richard Feynman in 1980 to a physical reality in 2023. Semiconductor quantum dot spin qubit can hold 106 qubits on area of 1 cm2,clearly indicating a promising candidate for a scalable quantum computer. However, the platform has not scaled up because of lack of understanding of physics of system and noise. Here Lindblad master equation is used to understand the dynamics of charge noise and qubit. The phenomena of Quantum Collapse to a basis state and its physical implications have raised many fundamental questions in last 50 years. Nevertheless, there has not been much discussion in quantum computing community about what choice of basis can be the best to measure a qubit. In this article it is shown that how measuring different spin component of a quantum state provides different coherence time. The article provides a motivation for experimentalist to look into qubit measurement with ability to measure it in arbitrary basis.
From Voxels to Prognosis: AI-Driven Quantitative Chest CT Analysis Forecasts ICU Requirements in 78 COVID-19 Cases
Authors: Bumm Rudolf , Zaffino Paolo , Lasso Andras , Estépar Raúl San José , Pieper Steven , Wasserthal Jakob , Spadea Maria Francesca , Latshang Tsogyal , Kawel-Böhm Nadine , Wäckerlin Adrian , Werner Raphael , Hässig Gabriela , Furrer Markus , Kikinis Ron
Published: July 2023

Background: The current study aimed to investigate the distribution and extent of lung involvement in patients with COVID-19, assess the relationship between lung involvement and the need for intensive care unit (ICU) admission and compare the performance of computer analysis with the judgment of radiological experts.
Methods: A total of 81 patients from an open-source COVID database with confirmed COVID-19 infection were included in the study. Three patients were excluded. Lung involvement was assessed in 78 patients using computed tomography (CT) scans, and the extent of infiltration and collapse was quantified across various lung lobes and regions. The associations between lung involvement and ICU admission were analyzed. Additionally, the computer analysis of COVID-19 involvement was compared against the expert rating provided by a radiological expert.
Results: The results showed a higher degree of infiltration and collapse in the left lower lobe compared to the upper lobe (p < 0.05) and a similar pattern in the right lower lobes (p < 0.05). No significant difference was detected in the COVID-19-related involvement of the left and right lower lobes. The right middle lobes demonstrated lower involvement compared to the right lower lobes (p < 0.05). When examining the regions, no significant difference in COVID-19 involvement was found when comparing the anterior and posterior lungs. The middle third displayed greater COVID-19 involvement than the upper and lower thirds. Patients requiring ICU admission during their inpatient treatment exhibited significantly higher COVID-19 involvement in their lung parenchyma according to computer analysis, compared to patients who remained in general wards. Patients with more than 40% COVID-19 involvement were almost exclusively treated in intensive care. A high correlation was observed between computer detection of COVID-19 affections and expert rating by radiological experts.
Conclusion: The findings suggest that the extent of lung involvement, particularly in the lower lobes and middle third, may be associated with the need for ICU admission in patients with COVID-19. Computer analysis showed a high correlation with expert rating, highlighting its potential utility in clinical settings for assessing lung involvement. This information may help guide clinical decision-making and resource allocation during ongoing or future pandemics. Further studies with larger sample sizes are warranted to validate these findings.
Long-term trends of nasopharyngeal carcinoma mortality in China from 2006 to 2020 by region and sex: An age-period-cohort analysis
Authors: Guo Xinru , Cui Jiameng , Yuan Xin , Gao Zibo , Yu Ge , Wu Hao , Kou Changgui
Published: July 2023

Background: China has a high mortality from nasopharyngeal carcinoma (NPC). The NPC mortality trends in China from 2006 to 2020 were described and analyzed to understand its epidemiological characteristics by region and sexand to explore age, period, and cohort effects.
Methods: A joinpoint regression model was used to fit the standardized NPC mortality and age-specific mortality. The age-period-cohort model was used to investigate age, period, and cohort effects on the NPC mortality risk.
Results: The results showed that the NPC mortality rate in China has been declining steadily. From 2006 to 2020, the standardized NPC mortality rate in most age groups showed a significant downward trend. The annual percentage change was smaller in rural areas than in urban areas. The mortality risks of rural malesand rural females from 2016 to 2020 were 1.139 times and 1.080 times those from 2011 to 2015, respectively. The risk of NPC death in urban males born in 1984-1988 and in rural males born in 1979-1983 both showed an increasing trend.
Conclusions: The strategies for preventing and treating NPC in China were effective from 2006 to 2020, but the findings indicate that people in rural areas need more targeted interventions to reduce NPC deaths.
Menstrual blood-derived mesenchymal stem cells combined with collagen I gel as a regenerative therapeutic strategy for degenerated disc after discectomy
Authors: Yu Li , Wu Honghao , Hu Xiaojian , Wu Yuxu , Zhou Jinhong , Zeng Shumei , Yuan Li , Xiang Charlie , Feng Zhiyun
Published: July 2023

Background:
Annulus fibrosis (AF) defects have been identified as the primary cause of disc herniation relapse and subsequent disc degeneration following discectomy. Stem cell-based tissue engineering offers a promising approach for structural repair. Menstrual blood-derived mesenchymal stem cells (MenSCs), a type of adult stem cell, have gained attention as an appealing source for clinical applications due to their potential for structure regeneration, ease of acquisition, and low immunogenicity.
Methods:
The differential potential of MenSCs cocultured with AF cells was examined by the expression of collagen I, SCX, and CD146 using immunofluorescence. Western blot and ELISA were used to examine the expression of TGF-β and IGF-I in coculture system. An injectable gel containing MenSCs was fabricated and its repairment properties was evaluated in a discectomy animal model (Sprague-Dawley rats, males, 8 weeks old). Disc degeneration was assessed via magnetic resonance (MR) imaging and histological staining. Immunohistochemical analysis was performed to assess the expression of aggrecan, MMP13, TGF-β and IGF-I in disc. Apoptosis in the disc was evaluated using TUNEL staining.
Results:
Coculturing MenSCs with AF cells demonstrated their ability to express collagen I and biomarkers of AF cells. Moreover, the coculture system led to upregulation of the growth factors TGF-β and IGF-I. After 12 weeks, discs treated with MenSCs gel exhibited significantly lower Pffirrmann scores (2.29 ± 0.18), compared to discs treated with MenSCs (3.43 ± 0.37, p < 0.05) or gel (3.71 ± 0.29, p < 0.01) alone. There is significant higher MR index in disc treated with MenSCs gel than that treated with MenSCs (0.51 ± 0.05 vs 0.24 ± 0.04, p < 0.01) or gel (0.51 ± 0.05 vs 0.26 ± 0.06, p < 0.01) alone. Additionally, MenSCs gel demonstrated preservation of the structure of degenerated discs as indicated by histological scoring (5.43 ± 0.43 vs 9.71 ± 1.04 in MenSCs group and 10.86 ± 0.63 in gel group, both p < 0.01), increased aggrecan expression, and decreased MMP13 expression in vivo. Furthermore, the percentage of TUNEL-positive cells in the disc treated with MenSCs Gel (26.59%) was significantly lower than those treated with gel alone (55.77%, p < 0.01) and MenSCs alone (50.95%, p < 0.01). The expression of TGF-β and IGF-I was higher in discs treated with MenSCs gel or MenSCs alone than in those treated with gel alone.
Conclusion:
MenSCs embedded in collagen I gel has the potential to preserve the disc structure and prevent disc degeneration after discectomy, which was probably attributed to the paracrine of growth factors of MenSCs.
Improving Information Extraction from Pathology Reports using Named Entity Recognition
Authors: Zeng Ken G. , Dutt Tarun , Witowski Jan , GV Kranthi Kiran , Yeung Frank , Kim Michelle , Kim Jesi , Pleasure Mitchell , Moczulski Christopher , Lopez L. Julian Lechuga , Zhang Hao , Harbi Mariam Al , Shamout Farah E. , Major Vincent J. , Heacock Laura , Moy Linda , Schnabel Freya , Pak Linda M. , Shen Yiqiu , Geras Krzysztof J.
Published: July 2023

Pathology reports are considered the gold standard in medical research due to their comprehensive and accurate diagnostic information. Natural language processing (NLP) techniques have been developed to automate information extraction from pathology reports. However, existing studies suffer from two significant limitations. First, they typically frame their tasks as report classification, which restricts the granularity of extracted information. Second, they often fail to generalize to unseen reports due to variations in language, negation, and human error. To overcome these challenges, we propose a BERT (bidirectional encoder representations from transformers) named entity recognition (NER) system to extract key diagnostic elements from pathology reports. We also introduce four data augmentation methods to improve the robustness of our model. Trained and evaluated on 1438 annotated breast pathology reports, acquired from a large medical center in the United States, our BERT model trained with data augmentation achieves an entity F1-score of 0.916 on an internal test set, surpassing the BERT baseline (0.843). We further assessed the model's generalizability using an external validation dataset from the United Arab Emirates, where our model maintained satisfactory performance (F1-score 0.860). Our findings demonstrate that our NER systems can effectively extract fine-grained information from widely diverse medical reports, offering the potential for large-scale information extraction in a wide range of medical and AI research. We publish our code at https://github.com/nyukat/pathology_extraction.
Patient's punctuality in an outpatient clinic: the role of age, medical branch and geographical factors
Authors: Cerruti Benedetta , Garavaldi Davide , Lerario Alberto
Published: July 2023

Background
The efficiency of the management of an outpatient clinic largely depends on the administration of patient flows and waiting times increase costs and affect clinical quality. In this study, we verify if the visit acceptance times are influenced by demographic or geographical factors in a large cohort of patients referred to a city and suburban private outpatient multidisciplinary clinic.
Methods
We included all scheduled visits of patients aged from 18 to 75 years who arrived in 2021, 2022 and 2023 in our private outpatient clinics, consisting of 34 medical clinics scattered in Milan metropolitan city and hinterland. The variables collected were age, visit time, check-in time, address of the medical clinic and its distance from the closest underground station, patient typology (new business vs. follow-up patient), and the medical branch of the visit. Outcome is ’punctuality’, defined as visit time minus check-in time (in minutes).
Results
We considered a sample of 410.808 visits from January 2021 to April 2023. The majority of patients check-in early (84.4%) and we found that the percentage of punctual patients increases linearly with age. Earlier hours in the morning show the worst punctuality pattern as well as blood draws in the analysis of different medical branches. We also observed that patients who already had some activity recorded in our systems show the worst pattern of punctuality. No particular differences emerged considering the geographical location of the clinics.
Conclusions
Younger patients have worse punctuality than older patients. Moreover, earlier hour slots are the most disadvantaged and the medical specialty has an influence on the arrival habits. This data should be considered for better clinical quality and efficiency.
Recruitment Strategies and Consent Rates in a National Prospective Colorectal Cancer Screening Cohort: Results from Year 1 of the Voyage Study
Authors: Yost Kathleen J. , Carlson Rachel E. , Kirt Christine R. , Kirsch Emily J. , Kneedler Bonny , Laffin Jennifer J. , Sauver Jennifer L. St. , Rutten Lila J. Finney , Grimm Jessica A. , Olson Janet
Published: July 2023

Background: Adherence to recommended colorectal cancer (CRC) screening among US adults is below the public health target of 80%. The multi-target stool DNA assay (mt-sDNA) is a self-administered CRC screening test that may remove barriers to adherence. To improve understanding of long-term outcomes and the real-world impact of mt-sDNA screening, Mayo Clinic and Exact Sciences Laboratories are collaborating on a prospective cohort study of CRC incidence and mortality outcomes in individuals screened with mt-sDNA. We conducted an embedded experiment to identify the optimal incentive protocol for maximizing participation while managing study costs.
Methods: A subset of the opt-in cohort was randomized to receive postage stamps as a pre-consent incentive, or as a post-consent incentive after completion of the consent and questionnaire. Descriptive statistics from year one of recruitment, as well as the incentive experiment, are reported.
Results: During year 1 of the Voyage trial, a total of 600,258 individuals with mt-sDNA orders received at Exact Sciences Laboratories were randomly selected and invited to participate. Of those, 26,429 (4.4%) opted in, 14,365 of whom (54.3%) consented. The opt-in and consent samples were similar to the target population with respect to sex but differed by geographic residence and age (p<0.001). For the embedded incentive experiment, 2,333 were randomized to the pre-incentive arm while 2,342 were randomized to the post-incentive arm. Overall consent rate in the incentive trial was 56.4% (60.9% for the pre-consent incentive arm (1421/2333) vs. 52.0% for the post-consent incentive arm (1217/2432), p<0.001). A cost reduction was observed for the pre-consent incentive group. Higher response rates were seen among older vs. younger individuals, reflecting a common pattern in healthcare-related survey research participation. Age adjusted incidence rates for CRC have been shown to vary regionally; thus, adjustment for differential response by region will be important to ensure representativeness.
Conclusions: CRC incidence and mortality vary with age; thus, adjusting for differential participation by age will be important in analyses of Voyage data. Pre-consent incentive option was associated with a higher participation rate and lower costs, and will be used for the remainder of the study recruitment.
Trial Registration: NCT04124406; October 11th, 2019
NCOA4 mediated ferritinophagy induced ferroptosis regulates radiosensitivity and prognosis of glioma
Authors: Gao Lianxuan , Ren Chen , Hu Shushu , zeng Yingying , Tang Nan , Chen Chen , Feng Wenqing , Zhang Qinghua , Xie Dehuan , Tan Peixin , Liu Yantan , Du Shasha
Published: July 2023

Aims
Gliomas are generally resistant to ionizing radiation. Ferroptosis is an important cause of cancer cell death caused by ionizing radiation. However, it is not clear how ferroptosis regulates the radiosensitivity of glioma.
Methods
In vitro, we verified the effect of ferroptosis on radiosensitivity of glioma cells, and tested the effect of NCOA4-mediated ferritinophagy on ferroptosis. The effect of NCOA4 on the prognosis of glioma patients treated with radiotherapy was analyzed using public databases, and the possible action pathways of NCOA4 were analyzed by bioinformatics. In vivo experiments, we again verified the effect of ferroptosis on radiosensitivity of glioma and the radiosensitivity change of glioma after knocking down NCOA4.
Results
We have demonstrated through experiments that both ferroptosis and autophagy promote the radiosensitivity of glioma cells. Bioinformatics analysis shows that ferritinophagy selective cargo receptor NCOA4 is highly expressed in gliomas with good prognosis, while patients with low expression of NCOA4 have poor prognosis after radiotherapy. Meanwhile, through experimental verification, low expression of NCOA4 is associated with poor prognosis in gliomas, while high expression is associated with good prognosis. Through analysis of the NCOA4 related pathways, we demonstrate that NCOA4 regulates the radiosensitivity and prognosis of gliomas by regulating the key gene ACSL4 for ferroptosis sensitivity. Ferroptosis promotes radiosensitivity in gliomas and is dependent on NCOA4 mediated ferritinophagy.
Navigating relationship dynamics, pregnancy and fatherhood in the Bukhali trial: a qualitative study with men in Soweto, South Africa
Authors: Draper Catherine E , Motlhatlhedi Molebogeng , Mabasa Jackson , Headman Tshepang , Klingberg Sonja , Pentecost Michelle , Lye Stephen J , Norris Shane A , Nyati Lukhanyo H
Published: July 2023

Background: South Africa has a complex range of historical, social, political, and economic factors that have shaped fatherhood. In the context of the Bukhali randomised controlled trial with young women in Soweto, South Africa, a qualitative study was conducted with the male partners of young women who had become pregnant during the trial. This exploratory study aimed to explore individual perceptions around relationship dynamics, their partner’s pregnancy, and fatherhood of partners of young women in Soweto, South Africa.
Methods: Individual, in-depth interviews were conducted with male partners (fathers, n=19, 25-46 years old) of Bukhali participants. A thematic approach was taken to the descriptive and exploratory process of analysis, and three final themes and subthemes were identified: 1) relationship dynamics (nature of relationship, relationship challenges); 2) pregnancy (feelings about the pregnancy, effect of the pregnancy on their relationship, providing support during pregnancy; and 3) fatherhood (view of fatherhood, roles of fathers, influences on views and motivation, challenges of fatherhood).
Results: While most male participants were in a committed (“serious”) relationship with their female partner, less than half of them were cohabiting. Most reported that their partner’s pregnancy was not planned, and shared mixed feelings about the pregnancy (e.g., happy, excited, shocked, nervous), although their views about fatherhood were overwhelmingly positive. Many were concerned about how they would economically provide for their child and partner, particularly those who were unemployed. Participants identified both general and specific ways in which they provided support for their partner, e.g., being present, co-attending antenatal check-ups, providing material resources. For many, the most challenging aspect of fatherhood was having to provide financially. They seemed to understand the level of responsibility expected of them as a father, and that their involvement and presence related to love for and connection with their child. Participants’ responses indicated that there were some changes in the norms around fatherhood, suggesting that there is a possibility for a shift in the fatherhood narrative in their context.
Conclusions: These findings suggest that the complex array of factors influencing fatherhood in South Africa continue to play out in this generation, although promising changes are evident.
Purification Scheduling Control for Throughput Maximization in Quantum Networks
Authors: Xue Kaiping , Xiao Zirui , Li Jian , Yu Nenghai , Li Ruidong , Sun Qibin , Lu Jun
Published: July 2023

Quantum networks can establish End-to-End (E2E) entanglement connections between two arbitrary nodes for various quantum applications through entanglement swapping. To support quantum applications reliably, quantum networks should establish E2E entanglement connections with desired entanglement fidelity by performing entanglement purification. The existing works provide mechanisms for link-level purification, which, however, leads to low throughput because of lacking consideration on purifications at network-level. (That is, efficiently allocating scarce resources to jointly purify entanglements under the situation with multiple concurrent requests in a network remains a critical but unsolved problem.) To address this problem, we analyze the cost of purification, design the E2E fidelity calculation method in detail, and propose a novel approach called Purification Scheduling Control (PSC). The basic idea of PSC is to determine the appropriate purification through jointly optimizing purification and resource allocation processes based on conflict avoidance. We conduct extensive experiments showing that PSC can maximize throughput under the fidelity requirement. This solution should spur the development of more applied reliable routing designs for quantum networks, combining quantum error correction, quantum applications, and computer network theory.
Causes of death after first time venous thromboembolism
Authors: Lonnberg Frida , Roos Andreas , Farm Maria , Heurlin André , Okas Mantas , Gigante Bruna , Siddiqui Anwar J
Published: July 2023

Background: Causes of death after first time community-acquired venous thromboembolism (VTE) diagnosed in unselected patients at the emergency department (ED) was investigated.
Material and Methods: The study consists of all patients>18 years of age who had a visit for any medical reason to any of 5 different ED in Stockholm County, Sweden from 1st January 2016 to 31st December 2017. We have identified all patients with a first registered incident VTE; deep vein thrombosis (DVT) and/or pulmonary embolism (PE) during the study period.
Cox regression models were used to estimate hazards ratios (HR) with 95% confidence intervals (CIs) for all-cause mortality and cause-specific death in patients with DVT or PE using all other patients as the reference group.
Results: In total, 409,971 patients had an ED visit during the study period of whom 2% were diagnosed with VTE (DVT= 4,817, PE= 3,147). During a mean follow up of 2.6 years, 1265 (16%) and 25,191 (6.3%) patients died within the VTE and reference group, respectively. The adjusted risk of all-cause mortality was nearly double in patients with DVT (HR 1.7; 95% CI, 1.5-1.8) and 3-fold in patients with PE (HR 2.8; 95% CI, 2.6-3.0). While the risk of cancer related death was nearly 3-fold in patient with DVT (HR 2.7; 95% CI, 2.4-3.1), and 5-fold in PE (HR 4.6; 95% CI, 4.1-5.1 respectively). A diagnosis of PE at the ED visit was associated with a 50% increased risk of cardiovascular death (HR 1.50; 95% CI, 1.2-1.9).
Conclusion: Patients with VTE have a high risk of all-cause mortality including cardiovascular death. The study findings indicate that cardiovascular preventive measures have to be improved in patients with VTE.