bluuebunny/crossref_metadata_2025 huggingface dataset:
Targeting EGFR Exon 20 Insertion Mutations in Non-small-Cell Lung Cancer: Changes in Treatment Strategies are Coming
Authors: Liu Haoli , Qin Jing , Qian Xinyu
Published: October 2024

Epidermal growth factor receptor ( EGFR) exon 20 insertion (ex20ins) mutations are the third most frequent EGFR mutation type, following only exon 19 deletions and exon 21 L858R point mutations. EGFR ex20ins mutations are found in approximately 4%-12% of all EGFR-positive non-small cell lung cancers (NSCLCs). Unlike classical EGFR mutations, EGFR ex20ins mutations display remarkable subtype diversity and heterogeneity. Patients harboring these mutations generally have an inferior prognosis because of insensitivity to conventional treatment approaches such as immunotherapy, chemotherapy, and targeted therapy. Consequently, there remains a significant unmet medical need for efficacious treatments. Recently, amivantamab and sunvozertinib have demonstrated notable efficacy as first-line treatments, and several other promising novel targeted drugs are also challenging the status quo of traditional first-line platinum-based chemotherapy regimens. These developments are anticipated to further improve survival outcomes for NSCLC patients with EGFR ex20ins mutations. Hence, this review summarizes the epidemiology, molecular attributes, detection methodologies, and therapeutic advancements for EGFR ex20ins mutations in NSCLC, and briefly discusses the mechanisms of drug resistance.
Risk Factors and Clinical Prediction Modeling of Preoperative Asymptomatic Lower Extremity Venous Thrombosis in Patients with Knee Osteoarthritis
Authors: Duan Jincai , Xiao Tianjie , Qin Wei , Xing Tianyou , Wang Zhihui , Wu Di , Du Yuanliang
Published: October 2024

Background

The aim of this study was to develop and validate a prediction model for predicting the risk of preoperative asymptomatic lower extremity venous thrombosis (LEVT) in patients with knee osteoarthritis (KOA).

Methods

Patients with KOA diagnosed at our hospital between March 2022 and July 2023 were included in this study. Five factors were identified as independent risk factors for the development of preoperative asymptomatic LEVT in patients with KOA by univariate and multivariate logistic regression analysis and a prediction model was constructed by analyzing the results. The performance of the model was evaluated using receiver operating characteristic (ROC) curves. The accuracy of the model and its predictive ability were evaluated using calibration curves. The clinical application value of the prediction model was evaluated using decision curve analysis (DCA).

Results

A total of 354 patients diagnosed with KOA were included in the study. Multivariate logistic regression analysis revealed HDL <1.03 mmol/L ( P = 0.004), LDL ( P = 0.039), Na+ ( P = 0.032), Ca2+ ( P = 0.024), and D-dimer >0.55 mg/L ( P = 0.049) were the independent risk factors for the occurrence of preoperative asymptomatic LEVT in patients with KOA. The combined-variable ROC curve suggested greater predictability and accuracy (AUC = 0.843, specificity = 90.3%, sensitivity = 71.4%). The calibration curve showed good model agreement and DCA suggested good clinical value of the model.

Conclusion

Low HDL, high LDL, Na+, Ca2+, and D-dimer levels can be used as independent risk factors for the preoperative prediction of asymptomatic LEVT in patients with KOA, and the present study also provides a simple prediction model for clinicians and patients.
Advancements and Challenges in the Image-Based Diagnosis of Lung and Colon Cancer: A Comprehensive Review
Authors: Patharia Pragati , Sethy Prabira Kumar , Nanthaamornphong Aziz
Published: October 2024

Image-based diagnosis has become a crucial tool in the identification and management of various cancers, particularly lung and colon cancer. This review delves into the latest advancements and ongoing challenges in the field, with a focus on deep learning, machine learning, and image processing techniques applied to X-rays, CT scans, and histopathological images. Significant progress has been made in imaging technologies like computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET), which, when combined with machine learning and artificial intelligence (AI) methodologies, have greatly enhanced the accuracy of cancer detection and characterization. These advances have enabled early detection, more precise tumor localization, personalized treatment plans, and overall improved patient outcomes. However, despite these improvements, challenges persist. Variability in image interpretation, the lack of standardized diagnostic protocols, unequal access to advanced imaging technologies, and concerns over data privacy and security within AI-based systems remain major obstacles. Furthermore, integrating imaging data with broader clinical information is crucial to achieving a more comprehensive approach to cancer diagnosis and treatment. This review provides valuable insights into the recent developments and challenges in image-based diagnosis for lung and colon cancers, underscoring both the remarkable progress and the hurdles that still need to be overcome to optimize cancer care.
Hyperuricemia and Associated Factors in Adult Cardiac Patients in Western Oromia, Ethiopia
Authors: Addisu Bedasa , Sefew Asnakew Tesfahun , Milkit Abiyu , Hika Amanuel , Kelem Amanuel , Hirigo Agete Tadewos
Published: October 2024

Background:

Individuals who have hyperuricemia are at increased risk of cardiovascular diseases due to factors such as endothelial dysfunction, insulin resistance, and increased production of oxygen-free radicals. However, data on the prevalence and predictors of hyperuricemia among adults with cardiac diseases in Ethiopia are limited.

Methods:

A cross-sectional study was conducted on 269 participants at the Ambo University referral hospital from June to September, 2022. Participant demographics and relevant data were obtained through convenient sampling. Hyperuricemia was defined according to the manufacturer’s cutoff criteria. Data entry and analysis were conducted using SPSS 25. The association between the outcome and explanatory variables was assessed using a binary logistic regression model.

Results:

Of the study participants, 56.9% were male. The mean age of participants was 51.1 years (±15.8). The prevalence of hyperuricemia was 43.1% (95% CI: 37.1-49.1). Males presented a significantly higher prevalence of hyperuricemia compared to females (23.4% vs 19.7%, P = .026). Males had 2.9 times higher odds of hyperuricemia compared to females. Significant associations with the prevalence of hyperuricemia were found for individuals with a BMI ⩾30 kg/m2, age ⩾54 years, and male gender, with adjusted odds ratios (95% CI) of 2.3 (1.7-5.2), 2.9 (2.2-5.9), and 3.56 (2.1-12.8), respectively. Additionally, smoking, dyslipidemia, and waist circumference were also significantly associated with the prevalence of hyperuricemia.

Conclusions:

Nearly half of the cardiac patients in the study were diagnosed with hyperuricemia. These findings underscores the importance of early identification and treatment of hyperuricemia, alongside lifestyle and behavioral modifications, to maintain the quality of life in this specific population.
The determinants of public gender egalitarianism at the national level: Empirical evidence from unbalanced panel regressions
Authors: Woo Byung-Deuk , Ryu Ki Eun
Published: October 2024

How can we explain the variations in public attitudes towards gender equality across different countries? While many scholars have focused on the individual-level factors influencing public gender egalitarianism, there has been limited examination of national-level attributes. Based on world society theory and constructivist approaches, our study investigates how women’s empowerment at both the national and international levels interplays and impacts public perceptions of gender equality. Analysing data from 112 countries from 1980 to 2018, our findings from panel regression models indicate that women’s descriptive representation, regime durability, and the ratification of international women’s rights treaties positively influence public gender egalitarianism. Furthermore, interaction models reveal that democratic contexts amplify the positive effects of women’s descriptive representation, and a higher percentage of women in legislatures enhances the impact of INGOs on public attitudes towards gender equality.
Impact of off-road engine electrification through EGR pumping on CO2, soot, and NOx emissions reductions during steady-state operating conditions
Authors: Ahmad Zar Nigar , Kakani Raghav , Willoughby Audrey , Adekanbi Michael , Holloway Eric , Haaland Eric , Evers Matt , Loesch Adam , Bagal Nilesh , McCarthy James , Shaver Gregory
Published: October 2024

Off-road vehicles are emphasizing brake thermal efficiency improvements to meet upcoming diesel emission standards set by the California Air Resources Board (CARB), aiming for enhanced engine and vehicle component efficiency. CARB is implementing regulations demanding a 90% reduction in oxides of nitrogen (NOx) emissions compared to current EPA Tier 4 standards, extending to off-highway vehicles by 2031. The experimental study described in this paper investigated how high-efficiency turbocharging (HET) and electric 48 V EGR pumping (EGRP) enable improved fuel efficiency in a 13.6 L off-road Diesel engine during steady-state operation. The integration of a 48 V EGR Pump enables the complete use of the high-efficiency turbo, encompassing both fuel reduction and NOx mitigation, at reduced engine delta pressure (exhaust—intake manifold pressure). Fuel consumption reductions in excess of 8% at low-speed/high-loads, nearly 5% on the torque curve at 1200 rpm, and 1.6%–3.1% in high-speed/high-load scenarios were demonstrated. NOx levels were generally similar to or lower than the baseline. Soot emissions remained comparable to or lower than the baseline. Open cycle efficiency (OCE) was improved across all points studied. Closed cycle efficiency improved under specific conditions, particularly at low-speed/high-load scenarios for which advanced injection timing could be used as a result of improved EGR flow control with the EGR pump. The OCE improvements were driven by reduced pumping work, with primary attribution to the high-efficiency turbocharger. The EGR pump played a pivotal role in maintaining engine-out NOx levels, especially under conditions where the conventional high-pressure EGR system would have been limited due to reduced pressure differentials between the intake and exhaust manifold (as a result of the high-efficiency turbocharging).
A novel HI construction method based on healthy-state data training for rotating machinery components
Authors: Song Hongliang , Sun Yi , Gao Hongli , Guo Liang , Wu Tingting
Published: October 2024

In predictive maintenance for rotating machinery components, constructing health indicators is crucial for improving operational efficiency and extending the equipment lifespan. However, traditional processes of building health indicators face two significant challenges: the high cost of collecting full lifecycle data and the requirement for the operating conditions of the equipment to remain consistent with those under which the indicators were developed. These limitations make health indicators expensive and time-consuming to construct and use. This article proposed a health indicator developed based on the Joint Principal Component Cumulative Empirical Distribution Model (JPCCED-HI) to overcome these challenges. This innovative method utilizes only healthy state data, combining principal component analysis with the empirical cumulative distribution function to construct a health indicator that ranges from 0 to 1, thereby eliminating the reliance on complete lifecycle data and relaxing the requirements for specific operating conditions. The effectiveness and practical benefits of JPCCED-HI are illustrated through two detailed case studies. In the first case study, we explore the impact of different parameter settings on model performance and evaluate its anti-interference capabilities in high-noise environments based on a gearbox dataset. This study demonstrates the model’s robustness in maintaining accurate health assessments despite external noise. The second case study employs a publicly available bearing dataset to compare the JPCCED-HI method against other models trained on health-stage data. This analysis reveals the superior performance of JPCCED-HI in trendability and scale similarity, affirming its effectiveness in various operational conditions. These case studies not only prove the adaptability and robustness of JPCCED-HI but also highlight its potential as a scalable solution for real-time health monitoring and predictive maintenance in industrial applications.
Love, God, and perfection in Spinoza: Comments on Steven Nadler
Authors: LeBuffe Michael
Published: October 2024

In building his account of human blessedness in Ethics 5, Spinoza offers two closely related conceptions of the love of God: the love toward God and the intellectual love of God. While Steven Nadler maintains that these loves are different affects, I argue that these are different descriptions of the same thing: any instance of the active affect that is a love toward God is at the same time an instance of the intellectual love of God. Spinoza’s views about society and its importance for education and human perfection are, I argue, nicely compatible with this account of the love of God, which suggests that all human beings possess, albeit in different degrees, the same sort of knowledge of God.
Athletes’ perceptions towards genetic testing — an explorative qualitative study among endurance athletes and their coaches
Authors: Konopka Magdalena Johanna , Leerschool Anna Roos , Gopalakrishna Gowri , Wesselius Anke , Rietjens Gerard , Zeegers Maurice P.
Published: October 2024

There is growing interest among professional athletes and their support staff in utilising genetic testing to enhance sports performance. However, the perceptions of athletes and coaches regarding genetic testing for training purposes remain largely unexplored. To address this gap, the present interview study investigated the perceptions of athletes and coaches towards genetic testing. Sixteen professional cyclists and triathletes (and their five coaches) participated in semi-structured online interviews after having received their genetic test results. The in-depth interviews were video-recorded, transcribed, translated, and analysed using reflexive thematic analysis by two independent researchers in MAXQDA. Positive perceptions were mainly linked to the potential added value of genetic testing for sports, the importance of counselling, and the necessity for further research. Negative perceptions were mainly linked to incorrect interpretations and conclusions, the use of genetic tests for talent selection, the reliability and usability of results, confirmation bias, fear of stigma, privacy concerns, and costs. Overall, there is a positive perception towards genetic testing among athletes and coaches, emphasising its potential to personalise training programmes. Although some participants highlighted the risks and limitations associated with genetic testing, these concerns were less common. It is suggested that counselling should accompany genetic testing to help athletes and coaches comprehend both the limitations and potential benefits of genetic testing.
Feasibility, safety and efficacy of endoscopic single-operator cholangioscopy: a retrospective single-center study
Authors: Büringer Karsten , Schempf Ulrike , Fusco Stefano , Wichmann Dörte , Stüker Dietmar , Götz Martin , Malek Nisar P. , Werner Christoph R.
Published: October 2024

Background:

Endoscopic retrograde cholangiopancreaticography (ERCP) is the standard endoscopic procedure for the diagnosis and treatment of diseases of the pancreas and bile ducts. Cholangioscopy provides direct visualization of the bile ducts. It offers the possibility of more detailed diagnostic and therapeutic indications. Today, cholangioscopy is often performed as a single-operator (SOC) procedure.

Objectives:

We were interested in the clinical efficacy of our SOC procedure in comparison with published studies, and performed this retrospective data analysis of all our consecutive patients from 2016 to 2022 to analyze the feasibility, safety, and efficacy of SOC.

Design and Methods:

A retrospective single-center analysis of patients undergoing SOC at a tertiary center from 2016 to 2022 ( N = 196) was performed. Demographic data, indication for SOC, exam-specific data, efficacy, and complications were included. Sensitivity and specificity for diagnosing indeterminate biliary strictures were calculated.

Results:

The most common indications for SOC were indeterminate biliary strictures ( n = 117; 60%), treatment of biliary stones ( n = 45; 23%), and other indications ( n = 34; 17%), for example, foreign body removal or intraoperative SOC. In 97% of the SOC ( n = 191), the procedure was technically successful. The diagnostic or therapeutic goal was achieved in 91% of SOC ( n = 173). In the subgroup where the SOC result was confirmed by subsequent surgery ( n = 93), sensitivity was 86%, specificity 99%, and SOC treatment of stones was successful in 89%. Complications occurred in (20%; n = 37). The majority of these patients ( n = 18; 10%) had minor bleeding requiring no intervention.

Conclusion:

SOC is an effective and safe procedure that should be the standard of care when primary diagnostic and/or therapeutic ERCP has failed. The sensitivity and specificity for determining the dignity of biliary strictures and the efficacy for the treatment of difficult-to-treat stones are reproducibly very high.
Outcomes of treatment cessation after switching to subcutaneous vedolizumab treatment in inflammatory bowel diseases
Authors: Bacsur Péter , Resál Tamás , Sarlós Patrícia , Iliás Ákos , Dalma Sümegi Liza , Kata Diána , Dávid Anett , Farkas Bernadett , Ivány Emese , Bálint Anita , Bősze Zsófia , Fábián Anna , Bor Renáta , Szepes Zoltán , Afif Waqqas , Bessissow Talat , Farkas Klaudia , Lakatos Péter L. , Molnár Tamás
Published: October 2024

Background:

The usability of subcutaneous vedolizumab (s.c. VDZ) treatment in inflammatory bowel diseases (IBD; ulcerative colitis (UC), Crohn’s disease (CD)) has been proven via clinical trials while real-world data collection is ongoing.

Objectives:

Our study evaluates the effectiveness, safety, patients’ preferences, and psychological factors associated with s.c. VDZ treatment, after switching from intravenous (i.v.) formulation.

Design:

Prospective, multicenter cohort study including IBD patients switching from i.v. VDZ to s.c. treatment and were evaluated over 52 weeks.

Methods:

Serum VDZ levels and C-reactive protein (CRP) were measured at the baseline and w52. At w12, a questionnaire on the patient’s satisfaction and psychological characteristics was administered. The primary outcome was the drug persistence rate (cessation was due to loss of response (LOR), adverse events, patient request, and other causes) at w52, while the secondary outcomes were the changes in the clinical corticosteroid-free remission (CSFR) and biochemical remission (BR; CRP ⩽ 5 mg/L) rates, safety issues, serum drug levels, patients’ preferences, and psychological features.

Results:

In total, 70 IBD patients were evaluated (32 CD patients, 38 UC patients; male/female ratio: 41.4%; median age: 43.2 years). In the CD group, 81.3% were in CSFR and 65.6% were in BR, while in the UC group, 71.7% were in CSFR and 69.4% were in BR. Overall, 17.1% of the patients ceased s.c. VDZ treatment after a median of 26.2 (interquartile range 20–47) weeks. LOR was registered in 3/12 ceased patients. In addition, CSFR and BR rates were stable, while serum VDZ levels increased by w52 ( p < 0.001).

Conclusion:

The transition from i.v. to s.c. VDZ treatment was effective, the overall persistence rate was associated with high serum drug levels, and no novel safety issues were reported. Although s.c. administration after induction can save resources, some patients still insisted on i.v. VDZ treatment, due to its proven formulation.
Targeting the MET gene: unveiling therapeutic opportunities in immunotherapy within the tumor immune microenvironment of non-small cell lung cancer
Authors: Ye Lisha , Wang Wenjing , Li Huihui , Ji Yongling , Le Xiuning , Xu Xiaoling
Published: October 2024

Non-small cell lung cancer (NSCLC) represents the most prevalent histological subtype of lung cancer. Within this disease, the MET gene emerges as a critical therapeutic target, exhibiting various forms of dysregulation. Although MET tyrosine kinase inhibitors, HGF/c-MET targeting antibodies, and antibody-drug conjugates constitute the primary treatment modalities for patients with MET-altered NSCLC, numerous questions remain regarding their optimal application. The advent of immunotherapy holds promise for enhancing therapeutic outcomes in patients with MET-altered NSCLC. MET mutations can reshape the tumor immune microenvironment of NSCLC by reducing tumor immunogenicity, inducing exhaustion in immune-activated cells, and promoting immune evasion, which are crucial for modulating treatment responses. Furthermore, we emphasize the promising synergy of immunotherapy with emerging treatments and the challenges and opportunities in refining these approaches to improve patient outcomes.
Relocating occupation: A critical environmental justice analysis of the US military migration from Okinawa to Guåhan
Authors: Rudge Kieren , Perez Sophia , Cutter Georgia , Kammerer Viv
Published: October 2024

The US military buildup across the Pacific is an ongoing colonial project reproducing oppressive power structures, human rights violations, and systemic environmental injustices. As the United States bolsters its Pacific presence, islands and peoples living on them are particularly vulnerable. However, not all places face overtly growing military-colonial occupations. Following decades of substantial military presence in Okinawa, 2024 marks the beginning of a precarious troop withdrawal from the Japanese prefecture. This significant reduction in Marine Corps personnel is the result of decades of political activism by Okinawans, who have continually resisted occupation and longstanding patterns of violence and oppression. Yet these military forces are not just leaving, they are relocating. The withdrawal coincides with 5,000 Marines and a new base coming to Guåhan (Guam), a territory where about 30% of land is under military control. This article examines these processes of military buildup and relocation through a critical environmental justice lens. We expand upon research on these issues by centering the critical environmental justice pillars concerning intersectionality, multiple scales, state power, and indispensability. We analyze the interconnections between Okinawa and Guåhan and argue that environmental justice scholarship must consider global geopolitics, interconnectivity, and sovereignty to adequately approach environmental movements in the Pacific region. In addition, we demonstrate that environmental justice victories in non-self-governing territories remain vulnerable to reversal and we advocate for inter-island coalition-building to avoid passing environmental harms from one island to another.
Depression and associated factors among adult breast cancer patients attending at selected public hospital in Addis Ababa, Ethiopia
Authors: Sebro Etalemahu , Biranu Endalkchew , Nigussie Altaye , Gebremedhin Tadesse , Sisay Million Molla , Shaweno Tamrat
Published: October 2024

Background:

Depression is a major public health problem among adult breast cancer patients. Although there are few studies on depression, data were mainly from a single center and the potential risk factors were not exhaustively addressed. Thus, we aimed to investigate the prevalence of depression and risk factors among adult breast cancer patients at two big hospitals in Addis Ababa.

Objective:

To assess depression and its associated factors among breast cancer patients attending public hospitals in Addis Ababa, Ethiopia, in 2021.

Methods:

An institution-based cross-sectional study was conducted among adult patients with breast cancer attending at Tikur Anbessa Specialized Hospital and St. Paul’s Hospital Millennium Medical College from June to July 2021. Simple random sampling was used to obtain a sample size of 318. Data were collected using the standard Patient Health Questionnaire-9, structured questionnaire interviews, and chart reviews. SPSS version 25 was used for analysis; the correlation between independent and dependent variables was evaluated using a logistic regression model. Each analysis regarded a p-value less than 0.05 as statistically significant.

Result:

The mean age of the participants was 43.1 ± 11.3 years. The prevalence of depression among adult breast cancer patients was 33 (10.6%), and according to the patient health questionnaires (PHQ)-9 score categorization, 116 (37.3%) were minor, 28 (9%) were moderate, and 5 (1.6%) had moderate severity. The duration of diagnosis was <12 months and stage 2 breast cancer was more protective against depression than stage 4 breast cancer. A lower monthly income and poor social support were significantly associated with depression.

Conclusion:

The prevalence of depression was moderate among adult patients with breast cancer; the stage of cancer, duration of diagnosis, income, and poor social support were significantly associated with depression, emphasizing the value of counseling.
Pharmacists perspectives on challenges and facilitators in initiating medications take-back program in Indonesia: A qualitative study
Authors: Alfian Sofa D , Azzahra Annisa M , Khoiry Qisty A , Griselda Meliana , Puspitasari Irma M , Abdulah Rizky
Published: October 2024

Objective:

The establishment of a medication take-back program is an important intervention to prevent the improper disposal of expired or unused household medications. However, such a program has not been established in Indonesia. A significant step in establishing the program is to gain a better understanding of pharmacists’ perspectives on the associated challenges and facilitators. Therefore, this study aimed to explore pharmacists’ perspectives on the associated challenges and facilitators in initiating medications take-back program in Indonesia.

Methods:

This qualitative study was conducted through Key Informant Interviews with a purposive sample of nine pharmacists working in community health centers (CHC) in Bandung City, Indonesia. The discussions were transcribed, coded, and analyzed using Atlas.ti9 software.

Results:

Pharmacists’ perspectives on initiating medications take-back program were categorized into two main themes, including challenges and facilitators. The identified challenges comprised a lack of personnel, financial constraints, geographical constraints, lack of facilities, and inadequate knowledge. Meanwhile, the facilitators included the good responsibility of pharmacists, incentives, and convenient locations.

Conclusion:

The identified challenges and facilitators should be considered when initiating medication take-back programs in Indonesia.
Infraspinatus muscle necrosis in a cat with primary hyperaldosteronism
Authors: Otani Go , Ohta Hiroshi
Published: October 2024

Case summary

Persistent and progressive weakness secondary to hypokalaemia, that is, hypokalaemic polymyopathy, is one of the most common clinical signs of primary hyperaldosteronism (PHA). Herein, we report a case of PHA with infraspinatus muscle necrosis. A 5-year-old castrated male domestic shorthair cat presented with a history of polyuria and polydipsia, decreased activity, staggering gait, difficulty in jumping and inward rotation of both forelimbs. Blood examination revealed hypokalaemia, increased serum creatinine kinase activity and high serum aldosterone concentration. Abdominal ultrasonography and CT revealed an enlarged right adrenal gland. Post-contrast thoracic CT showed peripheral contrast enhancement and a non-enhanced centre in the bilateral infraspinatus muscles. From the day of initial presentation, the cat was started on oral potassium replacement therapy. On day 17, the right adrenal gland was surgically resected and the left infraspinatus muscle was biopsied. Histopathological examination confirmed the presence of an adrenocortical adenoma in the right adrenal gland and necrosis of the muscle fibres in the left infraspinatus muscle. On day 29, all clinical signs had disappeared, and the serum potassium concentration, creatinine kinase activity and aldosterone concentration had normalised. On day 57, atrophy of the bilateral infraspinatus muscles was noted, but there was no evidence of any posture or gait abnormalities.

Relevance and novel information

To the authors’ knowledge, this is the first report of possible infraspinatus muscle necrosis in a cat with PHA. It is also possible that the infrinatus muscle necrosis with hypokalaemic polymyopathy secondary to PHA was caused by compartment syndrome in the cat described here.
Transformer-based active learning for multi-class text annotation and classification
Authors: Afzal Muhammad , Hussain Jamil , Abbas Asim , Hussain Maqbool , Attique Muhammad , Lee Sungyoung
Published: October 2024

Objective

Data-driven methodologies in healthcare necessitate labeled data for effective decision-making. However, medical data, particularly in unstructured formats, such as clinical notes, often lack explicit labels, making manual annotation challenging and tedious.

Methods

This paper introduces a novel deep active learning framework designed to facilitate the annotation process for multiclass text classification, specifically using the SOAP (subjective, objective, assessment, plan) framework, a widely recognized medical protocol. Our methodology leverages transformer-based deep learning techniques to automatically annotate clinical notes, significantly easing the manual labor involved and enhancing classification performance. Transformer-based deep learning models, with their ability to capture complex patterns in large datasets, represent a cutting-edge approach for advancing natural language processing tasks.

Results

We validate our approach through experiments on a diverse set of clinical notes from publicly available datasets, comprising over 426 documents. Our model demonstrates superior classification accuracy, with an F1 score improvement of 4.8% over existing methods but also provides a practical tool for healthcare professionals, potentially improving clinical documentation practices and patient care.

Conclusions

The research underscores the synergy between active learning and advanced deep learning, paving the way for future exploration of automatic text annotation and its implications for clinical informatics. Future studies will aim to integrate multimodal data and large language models to enhance the richness and accuracy of clinical text analysis, opening new pathways for comprehensive healthcare insights.
Hip Fracture Patterns, Hospital Course, and Mortality Differ Between Males and Females
Authors: Doxey Stephen A. , Kibble Kendra , Kleinsmith Rebekah M. , Huyke-Hernández Fernando A. , Switzer Julie A. , Cunningham Brian P.
Published: October 2024

Introduction

The purpose of this study was to describe how hip fractures differentially affect male and female patients regarding fracture pattern, hospital course, and postoperative course.

Materials and Methods

This retrospective case series was performed in a metropolitan healthcare system involving 2996 hip fracture patients >59 years old who underwent surgical management (eg, intramedullary nail, hemiarthroplasty, percutaneous pinning, etc.). Male patients were matched to female patients using 1:2 nearest neighbor matching on the basis of age and Charlson Comorbidity Index. Outcomes of interest included AO/OTA fracture classification, 30- and 90-day readmission, and 30-day and 1-year mortality rates.

Results

The cohort was predominantly female (64.5%). Female patients were more likely to sustain a type 31A fracture compared to males ( P = .016). The average CCI was higher for males vs females (3.0 ± 2.5 vs 2.6 ± 2.3, P < .001). Males were more likely to be readmitted at 30 ( P < .001) and 90 ( P = .015) days after discharge. The 30-day mortality was higher for males vs females (6.6% vs 4.5%, P = .015). Approximately 19.9% of male patients vs 15.1% of females died within a year of surgery ( P < .001). The average time to surgery was longer for males vs females (23.8 ± 18.8 vs 22.5 ± 21.9 h, P = .048). Males were more likely to die within a year if they underwent surgery >24 h after admission ( P = .029).

Discussion

Hip fractures have different implications for male and female patients. With age, the incidence of IT fractures increased in females, while it decreased in males. On average, males with hip fractures are sicker than females, which likely contributes to the longer time to surgery as well as increased readmission and mortality rates seen in males.

Conclusions

Male and female hip fracture patients are not similar in baseline health status, fracture pattern, or postoperative morbidity and mortality. Orthogeriatricians and other providers that care for this patient population should be aware of these differences when implementing treatment strategies to optimize the recovery of their patients, and while educating patients and their families about postoperative expectations.
Determinants of Usefulness and Ease of Use for Top Service Users Using the Technology Acceptance Model: The Moderating Role of Content Diversity
Authors: Sun Kyung-A , Moon Joonho
Published: October 2024

This study aims to ensure the accountability of the technology acceptance model in the domain of over-the-top (OTT) service. As antecedents of usefulness, content diversity, content uniqueness, content recommendation, and ease of use were employed. The determinants of ease of use include easy registration and navigability. Additionally, this work examines the moderating effect of content diversity on the relationship between usefulness and intention to use. This study used Amazon Mechanical Turk to collect the data. The number of observations is 398. The results showed that content diversity, content recommendation, and ease of use significantly affected usefulness. Moreover, easy registration and navigability significantly affected ease of use. Attitude is also positively influenced by usefulness. Attitude and usefulness are positively associated with intention to use. Furthermore, this study revealed a significant moderating effect of accountability on information overload.
Keep the Influencers! Exploring How Sacrifice Enhances “Creator Self-Identity” and Providing Practical Recommendations by the Marketing Mix: An Exploratory Study
Authors: Chen Wei-Ting , Hsieh Ming-Huei
Published: October 2024

This study aims to assist social media platforms that rely on user-generated content in identifying effective strategies to motivate and retain high-quality influencers (content creators). The authors employed “participant observation” and “semi-structured in-depth interviews.” Firstly, the primary author engaged in self-media management for nearly 7 years, experiencing and exploring various aspects of influencers’ live as a content creator. Through detailed note-taking and documentation, valuable insider perspectives were provided. Secondly, preliminary interviews with 10 content creators who met the study’s criteria were conducted, and five most representative influencers were selected for further “semi-structured in-depth interviews,” which were recorded and videotaped. The authors compiled all research data, coded it, and analyzed it using “thematic analysis.” The study found that “creator self-identity” constructed during social media content creation helps influencers (content creators) overcome challenges and sustain their efforts. Three methods to strengthen “creator self-identity” were identified: (1) sacrifice, (2) sense-making positive feedback, and (3) identity community interaction. The theoretical contribution of this study lies in the perspective that “moderate self-sacrifice can, in turn, reinforce creators’ self-identity,” enriching existing literature. In terms of practical contributions, the study applied the “marketing mix (6P)” framework with the findings to provide systematic, applicable recommendations for social media platform managers. Finally, the study’s originality and deep insider perspective on the influencer community make it a noteworthy and significant contribution to the field.
Virtual Reality in the Tourism Sector: A Bibliometric Systematic Literature Review of the Development and Future Trends
Authors: Phoong Seuk Wai , Phoong Seuk Yen , Khek Shi Ling
Published: October 2024

This study examines the evolving trend of virtual reality within the tourism industry by applying a bibliometric systematic review technique. Bibliometric analysis is harnessed for both performance and mapping analyses, while the review technique is employed to elucidate the nuanced landscape of virtual reality in the tourism sector. A comprehensive dataset of 472 articles retrieved from the Web of Science spanning 1995 to 2022 forms the basis of this investigation, with Biblioshiny and VOSviewer serving as bibliometric tools. The findings underscore the People’s Republic of China as the foremost contributor to publications in this domain. Particularly noteworthy is the preeminence of the Tourism Management journal, with an average citation of 78.82. Notably, the literature predating the COVID-19 pandemic predominantly focused on virtual tourism’s application, implications, and impacts. However, a discernible shift occurred in post-pandemic publications, emphasizing virtual reality in tourism to augment user satisfaction. Of paramount significance is the consensus within the research community highlighting the substantial benefits of implementing virtual reality, particularly in elevating users’ visualization experiences. This study holds the potential to provide invaluable insights for policymakers and funding agencies, elucidating the instrumental role of virtual reality in shaping the landscape of the tourism sector.
Enterprise ESG Performance, Digital Transformation, and Firm Performance: Evidence from China
Authors: Zheng Xiuzhi , Bu Qianqian
Published: October 2024

Enterprise environmental, social, and governance (ESG) performance and digital transformation are of great value for enhancing firm performance. Based on data from A-share listed companies in China from 2016 to 2022, a regression model was constructed to verify the influence of ESG performance on company performance under digital transformation. Research suggests that ESG performance enhances firm performance and that enterprise innovation has an intermediary effect, which is adjusted by digital transformation. Digital transformation provides “big data technology” and other means to effectively and intelligently promote enterprise innovation and enhance the role of ESG performance in promoting enterprise performance. Heterogeneity indicates that, compared to state-owned, high-tech, and heavily polluting firms, the ESG performance of non-state-owned, high-tech, and non-heavily polluting enterprises has a stronger effect on firm performance. These conclusions are of significant importance to the ESG performance, digital transformation, and sustainable and high-quality development of enterprises.
Physical and mechanical properties assessment of glass ionomer cements modified with TiO2 and Mg-doped hydroxyapatite nanoparticles
Authors: Ramić Bojana , Cvjetićanin Milica , Bajkin Branislav , Drobac Milan , Milanović Marija , Rajnović Dragan , Krstonošić Veljko , Veljović Đorđe
Published: October 2024

High viscosity glass ionomer cements (GICs) are widely used in various clinical applications, being particularly effective in atraumatic restorative treatment (ART) due to the synergistic interaction between the material and the technique. However, the inadequate mechanical properties of GICs raise concerns regarding the predictability and longevity of these restorations in areas exposed to occlusal stress. Various modifications of the powder components have been proposed to improve the mechanical strength of GICs to withstand occlusal loading during mastication. In this in vitro study, we investigated whether the nanoparticles (NPs) added to commercially available GICs could fulfill this requirement, which would likely broaden the spectrum of their potential clinical applications. Two commercially available GIC powders (Fuji IX and Ketac Molar), modified by the addition of 5 wt.% TiO2, MgHAp100 or MgHAp1000 NPs, were incorporated into the corresponding liquid in an appropriate ratio, and the mixed cements were evaluated in terms of fracture toughness, flexural strength, Vickers microhardness and rheological tests and compared with the original material. Fuji IX containing 5 wt.% MgHAp100 NPs had lower flexural strength, while Ketac Molar with 5 wt.% TiO2 NPs showed increased fracture toughness. Vickers microhardness increased in Fuji IX following the addition of 5 wt.% TiO2 and MgHAp100 but decreased in Ketac Molar comprising 5 wt.% MgHAp100 ( p < 0.05). Achieving a predictable bond between NPs and cement matrix, as well as ensuring a uniform distribution of the NPs within the cement, are critical prerequisites for enhancing the mechanical performance of the original cement.
Cross-Cultural Adaptation and Validation of the Thai Version of the Knee Injury and Osteoarthritis Outcome Score for Patellofemoral Pain and Osteoarthritis (KOOS-PF)
Authors: Reosanguanwong Kongpob , Suphakitchanusan Wasaphon , Lertwanich Pisit
Published: October 2024

Background:

The Knee injury and Osteoarthritis Outcome Score for patellofemoral pain and osteoarthritis (KOOS-PF) is a condition-specific patient-reported outcome measure that is used to evaluate patients with patellofemoral pain.

Purpose:

To translate the KOOS-PF into the Thai language, to make necessary adaptations to a Thai cultural context, and to assess the measurement properties of the Thai version of the KOOS-PF (TH-KOOS-PF) using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

This study was conducted between December 2021 and May 2023. Language translation of the KOOS-PF was performed according to guidelines for the cross-cultural adaptation of self-report measures. Eligible participants aged 18 to 50 years were asked to complete various patient-reported outcome measures including the TH-KOOS-PF at 3 time points: baseline, 2 weeks after baseline for test-retest reliability analysis, and 2 months after baseline for responsiveness assessment.

Results:

The KOOS-PF was successfully translated and culturally adapted to create the TH-KOOS-PF. A total of 86 participants (mean age, 37.0 ± 8.1 years; 59.3% female) with patellofemoral pain participated in the validation process. Construct validity of the TH-KOOS-PF was demonstrated by confirmation of all a priori hypotheses. The standardized Cronbach alpha coefficient was 0.88 (95% CI, 0.83-0.91), which indicated good internal consistency. Test-retest reliability was high, with an intraclass correlation coefficient of 0.87 (95% CI, 0.77-0.92). The TH-KOOS-PF demonstrated good responsiveness, as evidenced by all predefined hypotheses’ being confirmed, and there were no floor or ceiling effects. Using an anchor-based approach, the minimal clinically important difference was 11.6 points.

Conclusion:

The results of this study revealed the TH-KOOS-PF to be a valid, reliable, and responsive tool for assessing Thai patients with patellofemoral pain. The TH-KOOS-PF will be useful in both clinical and research settings.
The Difference in Achilles Tendon Loading within Immobilizing Boots Based on Ankle Angle, Boot Type, and Walking Speed
Authors: Hullfish Todd J. , Woods Madison M. , Kwon Michelle P. , Boakye Lorraine A.T. , Humbyrd Casey Jo , Baxter Josh R.
Published: October 2024

Background:

Achilles tendon rupture is an increasingly common injury treated with progressive rehabilitation in an immobilizing boot. However, it is poorly understood how ankle angle, boot type, and walking speed affect Achilles tendon loading.

Hypothesis:

These different parameters would affect Achilles tendon loading in terms of (from greatest to least) ankle angle constraint, immobilization style, boot construction, and walking speed.

Study Design:

Descriptive laboratory study

Methods:

Ten healthy young adults (8 women and 2 men; age, 21 ± 2 years; body mass index, 21.5 ± 3.0 kg/m2) walked in 3 different immobilizing boots at self-selected slow, medium, and fast walking speeds. The authors estimated Achilles tendon loading using a 3-part instrumented insole within the immobilizing boot. The authors averaged tendon load across every stride for each condition and calculated 2-sided bootstrap confidence intervals. Peak tendon loading was compared across all boots, ankle angles, and walking speeds.

Results:

All boots and immobilization styles decreased tendon loading with respect to shod walking. Immobilization angle had the largest effect on tendon loading, followed by boot construction, and finally walking speed.

Conclusion:

Ankle angle, boot type, and walking speed can be modified to change loading progression during rehabilitation.

Clinical Relevance:

Understanding how immobilization affects tendon loading will enable clinicians to modify rehabilitation to improve functional outcomes.
Changes in Prevalence and Phenotype of Hypertension in Children Suspected of Hypertension Using the 2022 American Heart Association Guidelines
Authors: Nimkarn Norrarath , Pirojsakul Kwanchai , Chantarogh Songkiat , Saisawat Pawaree , Tangnararatchakit Kanchana
Published: October 2024

Objective

The American Heart Association (AHA) launched the 2022 guidelines for the diagnosis of hypertension (HT) by ambulatory blood pressure monitoring (ABPM). The present study aimed to evaluate the impacts of the 2022 AHA guidelines on the changes in the prevalence and phenotype of HT in children suspected of HT.

Methods

Consecutive 100 children aged 6 to 20 suspected of HT who underwent 24-hour ABPM were recruited. The patients were separated into 3 groups: escalated, de-escalated, and unchanged. Demographic data were compared between the 3 groups. Logistic regression analysis was performed to evaluate the factors associated with the escalation in the diagnosis of HT.

Results

The present study revealed that the prevalence of HT, including sustained and masked HT, increased from 48% by the 2014 AHA guidelines to 65% by the 2022 AHA guidelines. Patients in the escalated group tended to have a higher proportion of male gender, with an older age and a taller height compared to those in the de-escalated group. Multivariate analysis showed that height was the only factor associated with the escalation in the diagnosis of HT [OR 1.09 (1.01-1.19), P-value .04]. Five out of 6 (83.3%) patients in the escalated group with available echocardiographic results had left ventricular hypertrophy (LVH).

Conclusion

Using the 2022 AHA guidelines resulted in more detection of patients with HT, and almost 30% of the escalated group had LVH. This finding supports using the 2022 AHA guidelines to detect children at risk of developing cardiovascular diseases early.
Reflecting on 50 years of long-term potentiation: Insights from the Royal Society’s LTP50 conference
Authors: Mitchell-Heggs Rufus , Tse Dorothy
Published: October 2024

On November 20–21 2023, the Royal Society in London hosted a landmark scientific meeting led by Professor Wickliffe C Abraham, Professor Timothy VP Bliss, Professor Graham L Collingridge, and Professor Richard GM Morris. The conference, commemorating the 50th anniversary of the discovery of Long-Term Potentiation, focused on discussing the latest research and developments in the field of synaptic plasticity. We have invited former presidents of the British Neuroscience Association, Professor Graham Collingridge CBE FRS and Professor Richard Morris CBE FRS, for interviews.