bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Risk Factors for Cervical Adjacent Segment Disease and Analysis of the Clinical Effect of Revision Surgery: A Minimum of 5 Years’ Follow-Up
Authors: Wei Zihan , Yang Sizhen , Zhang Ying , Ye Jiawen , Chu Tong-wei
Published: July 2023

Study Design

A retrospective study was performed.

Objective

To investigate the prevalence and risk factors for adjacent segment disease (ASD) after anterior cervical discectomy and fusion (ACDF) and the clinical efficacy of revision surgery.

Method

A total of 219 patients treated with ACDF were analyzed retrospectively. Demographic characteristics, including age, sex, body mass index (BMI) and bone mineral density (BMD), and radiographic measurements, including C2-C7 cervical sagittal vertical axis (cSVA), T1 slope (T1S), thoracic inlet angle (TIA) and C2-C7 Cobb angle, were analyzed. Modified Japanese Orthopaedic Association (mJOA) score and visual analog scale (VAS) score were used to evaluate patient function. Parameters were analyzed with Student's t test, and potential risk factors for ASD were further analyzed with multivariate logistic regression analysis.

Results

The incidence of ASD after ACDF surgeries was 21%. The severity of osteoporosis, BMI and C2-C7 cSVA were significantly higher in the ASD group than in the NASD group ( P < .05). The preoperative and postoperative TIAs were lower in the ASD group ( P < .05). Multivariate logistic regression analysis showed that a high BMI, severe osteoporosis and a high C2-C7 cSVA were risk factors for ASD after ACDF ( P < .05). The postoperative TIA and postoperative T1S were also correlated with ASD ( P < .05).

Conclusion

Patients with a high BMI, severe osteoporosis, and a large C2-C7 cSVA after ACDF have a higher risk of ASD, while a large T1S and TIA may be protective factors. In addition, revision surgery can restore cervical spine balance in patients with ASD and promote better clinical outcomes.
Seronegative Atypical Anti-Glomerular Basement Membrane Glomerulonephritis Associated With Thrombotic Microangiopathy: Case Report and Literature Analysis
Authors: Roy Sasmit , Hou Jean , Chourasia Prabal , Yalamanchili Anish , Basuli Debargha , Errabelli Praveen Kumar , Sai Yarram Samanvitha , Ayala Raul , Adapa Sreedhar
Published: July 2023

Anti-glomerular basement membrane (GBM) antibody nephritis is defined by linear immunofluorescence staining of GBM by immunoglobulin G (IgG), typically associated with GBM rupture, fibrinoid necrosis, and crescent formation. Clinically, the patients present with rapidly worsening renal function, often with hematuria. Typical renal pathologic findings include necrotizing and crescentic glomerulonephritis. In contrast, thrombotic microangiopathy (TMA) is characterized by microvascular thrombosis, which can also lead to acute kidney injury. Thrombotic microangiopathy is associated with some systemic diseases and has characteristic clinical features of microangiopathic hemolytic anemia, platelet consumption, and multiple organ failure. Anti-GBM nephritis associated with TMA has rarely been reported. We describe an unusual case of atypical anti-GBM disease without crescent formation or necrosis but with light microscopic and ultrastructural features consistent with endothelial cell injury and glomerular-limited TMA.
Amyloidoma and Plasmacytoma Presented as a Solitary Lung Nodule in a Patient of Multiple Myeloma With AL-Amyloidosis: A Case Report and Review of Literature
Authors: Yadav Ruchi , Sun Lishi , Cheema Akhtar , Yadav Vivek , Wang Jen Chin
Published: July 2023

Nodular amyloidoma in the lungs is a rare entity, also the occurrence of extramedullary plasmacytoma (EMP) in the lungs is rare. To have concomitant EMP and amyloidoma presented as a single lung mass is even rarer. There was only one similar case reported in the abstract form previously. Our case did not respond to many novel chemotherapy agents, suggesting that this combination of amyloidoma and plasmacytoma belonged to a poor prognosis entity, requiring different treatment modalities, such as early bone marrow transplantation or CART (chimeric antigen receptors T) therapy.
Systemic Lupus Erythematosus in Disguise: Acute Pancreatitis as Initial Presentation
Authors: Abughazaleh Saeed , Alsakarneh Saqr , Hattar Mariana , Jaber Fouad , Palmer Quinton , Ghoz Hassan
Published: July 2023

Macrophage activation syndrome (MAS) can rarely coexist with lupus pancreatitis. We report on a 20-year-old woman with abdominal pain, nausea, and vomiting. Laboratories were notable for pancytopenia, elevated liver enzymes, elevated ferritin, lipase, and triglycerides. Chest and abdominal computerized tomography (CT) scans revealed bilateral axillary lymphadenopathy, patchy lower lobe consolidations, small pleural effusions, ascites, and splenomegaly. Peritoneal fluid cytology showed lymphocytes and histiocytes with hemophagocytic changes. Immunological workup met the criteria for systemic lupus erythematosus (SLE). Pulse-dosed steroids relieved her condition. Given the high mortality rate associated with MAS, early detection of concomitant pancreatitis and MAS in the context of underlying SLE is critical.
Clinical, Radiographic, and MRI Evaluation of All-Inside Medial Meniscus Posterior Root Repair via Suture Fixation to the Posterior Cruciate Ligament Versus Partial Meniscectomy: Results at 3-Year Follow-up
Authors: Su Jiarong , Wan Hongyan , Pang Yingchang , Lu Yanli , Liang Jiaming , Yan Zhigang , Xu Sibo , Sun Tiezheng
Published: July 2023

Background:

Medial meniscus posterior root tears (MMPRTs) disrupt the integrity and hoop tension of the meniscus, leading to cartilage degeneration and accelerated osteoarthritis (OA) progression. The management of patients with MMPRT is controversial, and the efficacy of different treatment options is unclear.

Purpose:

To compare the clinical, radiographic, and magnetic resonance imaging (MRI) outcomes of patients with MMPRT between trans–posterior cruciate ligament (trans-PCL) all-inside repair and partial meniscectomy.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We identified patients with MMPRT who underwent trans-PCL all-inside repair (group AR) or partial meniscectomy (group PM) between 2015 and 2019 at a single institution. The trans-PCL all-inside repair was performed by suturing the torn meniscus root to the PCL fibers. Patient-reported outcomes as well as radiographic and MRI outcomes were collected at baseline and final follow-up. Clinical failure was defined as conversion to total knee arthroplasty (TKA), and Kaplan-Meier survival analysis was used to investigate the survival rates of patients with different surgical procedures.

Results:

Included were 29 patients in group AR and 31 patients in group PM (mean age, 62.69 and 60.68 years, respectively; mean follow-up, 2.91 ± 1.33 and 3.45 ± 1.50 years, respectively). There were no differences in baseline patient characteristics between the groups. All patient-reported outcome scores improved significantly in both groups at the final follow-up. When we compared final outcomes between the groups, group AR had less joint space narrowing ( P = .010), less Kellgren-Lawrence OA grade progression ( P = .002), and less medial meniscal extrusion (MME; P = .002) than group PM. In addition, group AR showed less progression of bone marrow lesions and cartilage lesions ( P < .05) than group PM. The rate of conversion to TKA was 6.90% in group AR and 29.0% in group PM. The 5-year survival rates in the AR and PM groups were 82.6% and 59.8%, respectively ( P = .153).

Conclusion:

Trans-PCL all-inside repair for MMPRTs was associated with greater improvement in clinical function, better radiographic results, less MME and cartilage degeneration, and a lower rate of subsequent TKA compared with partial meniscectomy.
Braking before the curve and accelerating inside? Exploration, countercyclical behavior, and SMEs’ resilience during economic downturns
Authors: Safón Vicente , Iborra María
Published: July 2023

Some studies have provided empirical evidence that firms’ high growth rates just before economic crises are negatively associated with resilience. Other authors have observed that firms that grow fast in the early phases of an external crisis are generally more resilient. This countercyclical behavior is less common in small- and medium-sized enterprises (SMEs), and literature has not delved into the underlying factors that facilitate SMEs’ countercyclical strategies. Firm exploration is defined as a firm’s willingness to experiment, take risks, be flexible, and accept variation. Our thesis is that exploration acts as a countercyclical factor by slowing down a firm’s growth before the external shock takes effect, favoring growth during the crisis, and providing better resilience outcomes. We find support for our hypotheses from a sample of 2,081 manufacturing medium-sized enterprises.

Jel Classification: M10 GENERAL
The Political Ramifications of Judicial Institutions: Establishing a Link between Dobbs and Gender Disparities in the 2022 Midterms
Authors: Sommer Udi , Rappel-Kroyzer Or , Adamczyk Amy , Lerner Lindsay , Weiner Anna
Published: July 2023

In the American system of government, courts are designed to operate within the legal sphere, with limited political interference. Is it possible, though, that a behavior that is at the heart of the political process can be influenced directly by a judicial decision? Focusing on voter registration big data for the universe of voters in North Carolina around the time of Dobbs v. Jackson Women’s Health Organization, the authors assess the roles of gender, political party affiliation, and age in voter registration. North Carolina is the only state whose voter registry has the necessary granularity over time and information needed. Women and Democrats were more likely to register to vote after information about the ruling was released, suggesting that Dobbs influenced their behavior. This effect on voter registration gender gap was unique to June 2022, unlike previous midterm election years (2014 and 2018). Interrupted time-series analyses lend further support to these findings.
Mafia: An Experiential Learning Game for OB Topics
Authors: Zare Mortaza , Stauffer Joseph , Alinejadfarshi Mina
Published: July 2023

This article discusses the benefits of using Mafia—a fun, interactive, low-cost, and easy-to-learn role-playing game—to explore organizational behavior (OB) topics. We explain how Mafia can be used in the classroom to discuss OB topics, including dynamics of teamwork, disagreement and conflict, decision-making, trust, roles, and communication. We share our experience playing Mafia in three undergraduate-level class sessions and provide recommendations, based on experiential learning and critical thinking principles, for instructors interested in playing this game. Overall, students enjoyed the sessions and provided some interesting insight in the debriefing, demonstrating the suitability of this game to discuss OB concepts.
Innovations as Art: Using the Childhood Magic of Play-Doh™ to Craft Entrepreneurial Ideas
Authors: Brazeal Deborah V. , Krueger Norris , Van Esch Chantal
Published: July 2023

Once assumed the sole province of musicians and artists, creativity classes abound in business schools as a critical component of entrepreneurship curricula. The exercises explained in this article, designed for a creativity or entrepreneurship class, but equally applicable for strategic management or even engineering classes, address the ubiquitous question of how to recognize and stimulate potentially lucrative ideas. Two exercises are sequentially paired to help students first identify business opportunities and then imaginatively craft potentially feasible business ideas. The Zeitgeist Exercise allows students to brainstorm business trends and radical innovations using PESTEL, then list or draw their observations on an expansive whiteboard, thereby capturing the intellectual climate of our times. The tactile nature of Play-Doh ™ Exercise encourages students to playfully explore solutions to opportunities identified in the first exercise. Students may mold trademarks or artifacts that symbolize their innovation or the innovation itself.
Employer calling: Incidence and worker-level effects of on-call work in Germany
Authors: Borah Melanie , Fackler Daniel , Stegmaier Jens , Weigt Eva
Published: July 2023

Using data from the German Socio-Economic Panel (SOEP), we analyse the incidence and worker-level consequences of on-call work, a work arrangement that allows employers to adjust their employees’ working times flexibly to the workload. We find that around 4%–5% of the workforce was employed in on-call work between 2014 and 2019. On-call workers are on average less educated, have lower tenure and more unemployment experience. They are also more often employed in marginal part-time jobs and smaller firms. On-call workers have a higher discrepancy between contractual and actual working hours and a higher probability of having no working hours stipulated in their contracts, which points towards less security regarding working hours and expected incomes. We also find evidence for lower wages and decreased subjective well-being along various dimensions but these results only apply to women and not to men.

JEL Classification:

J80, J28, J31
Cyclones and violence against civilians: Evidence from the Cabo Delgado insurgency
Authors: Bagozzi Benjamin E , Benson Thomas S , Koren Ore
Published: July 2023

Do natural shocks increase insurgent rates of civilian victimization? We consider one case of a natural shock that directly affected an ongoing rebellion, Mozambique’s Cabo Delgado insurgency, where in recent years an insurgency with few societal ties and an extremist, pro-Islamic State ideology has engaged in multiple attacks on civilians. Our assessment employs both time series analysis and qualitative evaluations. Our focus is on the effects of cyclones—a climatic event whose rates are predicted to intensify over the coming decades—on this insurgency’s use of violence against civilians. In contrast to several past studies of natural shocks in conflict zones and strategic violence against civilians, our findings suggest that in contexts of insurgencies that do not have a strong local support base and where the group purports an extremist transnational ideology, natural shocks may lead to more violence against civilians.
Genomic evidence indicates small island-resident populations and sex-biased behaviors of Hawaiian reef Manta Rays
Authors: Whitney Jonathan L. , Coleman Richard R. , Deakos Mark H.
Published: July 2023

Background

Reef manta rays (Mobula alfredi) are globally distributed in tropical and subtropical seas. Their life history traits (slow growth, late maturity, low reproductive output) make them vulnerable to perturbations and therefore require informed management strategies. Previous studies have reported wide-spread genetic connectivity along continental shelves suggesting high gene flow along continuous habitats spanning hundreds of kilometers. However, in the Hawaiian Islands, tagging and photo-identification evidence suggest island populations are isolated despite proximity, a hypothesis that has not yet been evaluated with genetic data.

Results

This island-resident hypothesis was tested by analyzing whole mitogenome haplotypes and 2048 nuclear single nucleotide polymorphisms (SNPs) between M. alfredi (n = 38) on Hawaiʻi Island and Maui Nui (the 4-island complex of Maui, Molokaʻi, Lānaʻi and Kahoʻolawe). Strong divergence in the mitogenome (ΦST = 0.488) relative to nuclear genome-wide SNPs (neutral FST = 0.003; outlier FST = 0.186), and clustering of mitochondrial haplotypes among islands provides robust evidence that female reef manta rays are strongly philopatric and do not migrate between these two island groups. Combined with restricted male-mediated migration, equivalent to a single male moving between islands every 2.2 generations (~ 64 years), we provide evidence these populations are significantly demographically isolated. Estimates of contemporary effective population size (Ne) are 104 (95% CI: 99–110) in Hawaiʻi Island and 129 (95% CI: 122–136) in Maui Nui.

Conclusions

Concordant with evidence from photo identification and tagging studies, these genetic results indicate reef manta rays in Hawaiʻi have small, genetically-isolated resident island populations. We hypothesize that due to the Island Mass Effect, large islands provide sufficient resources to support resident populations, thereby making crossing deep channels separating island groups unnecessary. Small effective population size, low genetic diversity, and k-selected life history traits make these isolated populations vulnerable to region-specific anthropogenic threats, which include entanglement, boat strikes, and habitat degradation. The long-term persistence of reef manta rays in the Hawaiian Islands will require island-specific management strategies.
Performance metrics for models designed to predict treatment effect
Authors: Maas C. C. H. M. , Kent D. M. , Hughes M. C. , Dekker R. , Lingsma H. F. , van Klaveren D.
Published: July 2023

Background

Measuring the performance of models that predict individualized treatment effect is challenging because the outcomes of two alternative treatments are inherently unobservable in one patient. The C-for-benefit was proposed to measure discriminative ability. However, measures of calibration and overall performance are still lacking. We aimed to propose metrics of calibration and overall performance for models predicting treatment effect in randomized clinical trials (RCTs).

Methods

Similar to the previously proposed C-for-benefit, we defined observed pairwise treatment effect as the difference between outcomes in pairs of matched patients with different treatment assignment. We match each untreated patient with the nearest treated patient based on the Mahalanobis distance between patient characteristics. Then, we define the Eavg-for-benefit, E50-for-benefit, and E90-for-benefit as the average, median, and 90th quantile of the absolute distance between the predicted pairwise treatment effects and local-regression-smoothed observed pairwise treatment effects. Furthermore, we define the cross-entropy-for-benefit and Brier-for-benefit as the logarithmic and average squared distance between predicted and observed pairwise treatment effects. In a simulation study, the metric values of deliberately “perturbed models” were compared to those of the data-generating model, i.e., “optimal model”. To illustrate these performance metrics, different modeling approaches for predicting treatment effect are applied to the data of the Diabetes Prevention Program: 1) a risk modelling approach with restricted cubic splines; 2) an effect modelling approach including penalized treatment interactions; and 3) the causal forest.

Results

As desired, performance metric values of “perturbed models” were consistently worse than those of the “optimal model” (Eavg-for-benefit ≥ 0.043 versus 0.002, E50-for-benefit ≥ 0.032 versus 0.001, E90-for-benefit ≥ 0.084 versus 0.004, cross-entropy-for-benefit ≥ 0.765 versus 0.750, Brier-for-benefit ≥ 0.220 versus 0.218). Calibration, discriminative ability, and overall performance of three different models were similar in the case study. The proposed metrics were implemented in a publicly available R-package “HTEPredictionMetrics”.

Conclusion

The proposed metrics are useful to assess the calibration and overall performance of models predicting treatment effect in RCTs.
Over-prescription of short-acting β2-agonists remains a serious health concern in Kenya: results from the SABINA III study
Authors: Chakaya Jeremiah , Mecha Jared , Beekman Maarten
Published: July 2023

Background

Despite a high asthma burden in Kenya, insights into asthma management practices, including prescription of short-acting β2-agonists (SABAs), are lacking. Therefore, this study describes patient demographics, disease characteristics, and asthma treatment patterns in the Kenyan cohort of the SABA use IN Asthma (SABINA) III study.

Methods

Patients with asthma (aged ≥ 12 years) with medical records containing data for ≥ 12 months prior to the study visit from 19 sites across Kenya were included in this cross-sectional study and classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma [GINA] recommendations) and practice type (primary/specialist care). Data on severe exacerbation history, prescribed asthma treatments, and over-the-counter (OTC) SABA purchases in the 12 months before the study visit and asthma symptom control at the time of the study visit were collated using electronic case report forms. All analyses were descriptive in nature.

Results

Overall, 405 patients were analyzed (mean age, 44.4 years; female, 68.9%), of whom 54.8% and 45.2% were enrolled by primary care clinicians and specialists, respectively. Most patients were classified with mild asthma (76.0%, GINA treatment steps 1−2) and were overweight or obese (57.0%). Only 19.5% of patients reported full healthcare reimbursement, with 59% receiving no healthcare reimbursement. The mean asthma duration of patients was 13.5 years. Asthma was partly controlled/uncontrolled in 78.0% of patients, with 61.5% experiencing ≥ 1 severe exacerbation in the preceding 12 months. Crucially, 71.9% of patients were prescribed ≥ 3 SABA canisters, defined as over-prescription; 34.8% were prescribed ≥ 10 SABA canisters. Additionally, 38.8% of patients purchased SABA OTC, of whom 66.2% purchased ≥ 3 SABA canisters. Among patients with both SABA purchases and prescriptions, 95.5% and 57.1% had prescriptions for ≥ 3 and ≥ 10 SABA canisters, respectively. Inhaled corticosteroids (ICS), ICS with a long-acting β2-agonist fixed-dose combination, and oral corticosteroid bursts were prescribed to 58.8%, 24.7%, and 22.7% of patients, respectively.

Conclusions

SABA over-prescription occurred in almost three-quarters of patients, with over one-third of patients purchasing SABA OTC. Therefore, SABA over-prescription is a major public health concern in Kenya, underscoring an urgent need to align clinical practices with latest evidence-based recommendations.
Understanding geriatric models of care for older adults living with HIV: a scoping review and qualitative analysis
Authors: Kokorelias Kristina Marie , Grosse Anna , Zhabokritsky Alice , Sirisegaram Luxey
Published: July 2023

Background

Advances in Human Immunodeficiency Virus (HIV) treatment have reduced mortality rates and consequently increased the number of individuals with HIV living into older age. Despite this, people aged 50 years and older have been left behind in recent HIV treatment and prevention campaigns, and a gold-standard model of care for this population has not yet been defined. Developing evidence-based geriatric HIV models of care can support an accessible, equitable, and sustainable HIV health care system that ensures older adults have access to care that meets their needs now and in the future.

Methods

Guided by Arksey & O’Malley (2005)’s methodological framework, a scoping review was conducted to determine the key components of, identify gaps in the literature about, and provide recommendations for future research into geriatric models of care for individuals with HIV. Five databases and the grey literature were systematically searched. The titles, abstracts and full texts of the search results were screened independently in duplicate. Data were analyzed using a qualitative case study and key component analysis approach to identify necessary model components.

Results

5702 studies underwent title and abstract screening, with 154 entering full-text review. 13 peer-reviewed and 0 grey literature sources were included. Most articles were from North America. We identified three primary model of care components that may improve the successful delivery of geriatric care to people living with HIV: Collaboration and Integration; Organization of Geriatric Care; and Support for Holistic Care. Most articles included some aspects of all three components.

Conclusion

To provide effective geriatric care to older persons living with HIV, health services and systems are encouraged to use an evidence-based framework and should consider incorporating the distinct model of care characteristics that we have identified in the literature. However, there is limited data about models in developing countries and long-term care settings, and limited knowledge of the role of family, friends and peers in supporting the geriatric care of individuals living with HIV. Future evaluative research is encouraged to determine the impact of optimal components of geriatric models of care on patient outcomes.
A phase II study of gemcitabine and docetaxel combination in relapsed metastatic or unresectable locally advanced synovial sarcoma
Authors: Tansir Ghazal , Rastogi Sameer , Kumar Akash , Barwad Adarsh , Mridha Asit R. , Dhamija Ekta , Shamim Shamim A. , Bhatnagar Sushma , Bhoriwal Sandeep
Published: July 2023

Synovial sarcoma (SS) is one of the commonest non-rhabdomyosarcoma soft tissue sarcoma with limited treatment options in the relapsed and advanced settings. The combination of gemcitabine and docetaxel has demonstrated its role predominantly in leiomyosarcoma and pleomorphic sarcomas but has not been prospectively studied in SS. This trial assesses the efficacy, tolerability and quality of life (QoL) with this regimen in metastatic/unresectable locally advanced relapsed SS.

Patients and methods This was a single-arm, two-stage, phase II, investigator-initiated interventional study among patients with metastatic or unresectable locally advanced SS who had progressed after at least one line of chemotherapy. Gemcitabine 900 mg/m2 on days 1 and 8 and docetaxel 75 mg/m2 on day 8 were administered intravenously every 21 days. The primary endpoint was 3-month progression-free rate (PFR); overall survival (OS), progression-free survival (PFS), overall response rate (ORR), safety and quality of life (QoL) constituted the secondary endpoints.

Results Twenty-two patients were enrolled between March 2020 and September 2021 and the study had to be closed early due to slow accrual. The study population comprised of 18 (81.8%) patients with metastatic disease and 4 (18.2%) patients with locally advanced, unresectable disease. The most common primary sites of disease were extremity in 15 (68%) and the median number of lines of prior therapies received was 1 (range 1–4). 3-month PFR was 45.4% (95% CI 24.8–66.1) and ORR was 4.5%. Median progression-free survival (PFS) was 3 months (95% CI 2.3–3.6) and median OS was 14 months (95% CI 8.9–19.0). 7 (31.8%) patients experienced grade 3 or worse toxicities, including anemia (18%), neutropenia (9%) and mucositis (9%). QoL analysis demonstrated significant decline in certain functional and symptom scales, while financial and global health scales remained stable.

Conclusion This is the first prospective study on the combination of gemcitabine and docetaxel performed specifically in patients with advanced, relapsed SS. Although the accrual of patients could not be completed as planned, the therapy did produce clinically meaningful outcomes and met its primary endpoint of 3-month PFR. This result, along with the manageable toxicity profile and stable global health status on QoL analysis, should encourage further studies.

Trial registration This trial was prospectively registered under the Clinical Trials Registry of India on 26/02/2020 (Registration number: CTRI/2020/02/023612).
Deep learning–based radiomic nomograms for predicting Ki67 expression in prostate cancer
Authors: Deng Shuitang , Ding Jingfeng , Wang Hui , Mao Guoqun , Sun Jing , Hu Jinwen , Zhu Xiandi , Cheng Yougen , Ni Genghuan , Ao Weiqun
Published: July 2023

Background

To explore the value of a multiparametric magnetic resonance imaging (MRI)-based deep learning model for the preoperative prediction of Ki67 expression in prostate cancer (PCa).

Materials

The data of 229 patients with PCa from two centers were retrospectively analyzed and divided into training, internal validation, and external validation sets. Deep learning features were extracted and selected from each patient’s prostate multiparametric MRI (diffusion-weighted imaging, T2-weighted imaging, and contrast-enhanced T1-weighted imaging sequences) data to establish a deep radiomic signature and construct models for the preoperative prediction of Ki67 expression. Independent predictive risk factors were identified and incorporated into a clinical model, and the clinical and deep learning models were combined to obtain a joint model. The predictive performance of multiple deep-learning models was then evaluated.

Results

Seven prediction models were constructed: one clinical model, three deep learning models (the DLRS-Resnet, DLRS-Inception, and DLRS-Densenet models), and three joint models (the Nomogram-Resnet, Nomogram-Inception, and Nomogram-Densenet models). The areas under the curve (AUCs) of the clinical model in the testing, internal validation, and external validation sets were 0.794, 0.711, and 0.75, respectively. The AUCs of the deep models and joint models ranged from 0.939 to 0.993. The DeLong test revealed that the predictive performance of the deep learning models and the joint models was superior to that of the clinical model (p < 0.01). The predictive performance of the DLRS-Resnet model was inferior to that of the Nomogram-Resnet model (p < 0.01), whereas the predictive performance of the remaining deep learning models and joint models did not differ significantly.

Conclusion

The multiple easy-to-use deep learning–based models for predicting Ki67 expression in PCa developed in this study can help physicians obtain more detailed prognostic data before a patient undergoes surgery.
Cardiovascular fitness is associated with child adiposity at 5 years of age: findings from the ROLO longitudinal birth cohort study
Authors: Geraghty Aisling A. , O’Brien Eileen C. , Callanan Sophie , Mehegan John , McAuliffe Fionnuala M.
Published: July 2023

Background

Cardiovascular fitness is strongly linked with metabolic risk; however, research is limited in preschool children. Although there is currently no simple validated measure of fitness in preschool children, heart rate recovery has been highlighted as an easily accessible and non-invasive predictor of cardiovascular risk in school-aged children and adolescents. We aimed to investigate whether heart rate recovery was associated with adiposity and blood pressure in 5-year-olds.

Study design

This is a secondary analysis of 272 5-year-olds from the ROLO (Randomised cOntrol trial of LOw glycaemic index diet in pregnancy to prevent recurrence of macrosomia) Kids study. Three-minute step tests were completed by 272 participants to determine heart rate recovery duration. Body mass index (BMI), circumferences, skinfold thickness, heart rate, and blood pressure were collected. Independent t-tests, Mann-Whitney U, and Chi-square tests were used to compare participants. Linear regression models examined associations between heart rate recovery and child adiposity. Confounders included child sex, age at study visit, breastfeeding, and perceived effort in the step test.

Results

The median (IQR) age at the study visit was 5.13 (0.16) years. 16.2% (n = 44) had overweight and 4.4% (n = 12) had obesity based on their BMI centile. Boys had a quicker mean (SD) heart rate recovery after the step test than girls (112.5 (47.7) seconds vs. 128.8 (62.5) seconds, p = 0.02). Participants with a slower recovery time (> 105 s) had higher median (IQR) sum of skinfolds (35.5 (11.8) mm vs. 34.0 (10.0) mm, p = 0.02) and median (IQR) sum of subscapular and triceps skinfold (15.6 (4.4) mm vs. 14.4 (4.0) mm, p = 0.02) compared to participants with a quicker recovery time. After adjusting for confounders (child sex, age at study visit, breastfeeding, effort in the step test), linear regression analyses revealed heart rate recovery time after stepping was positively associated with sum of skinfolds (B = 0.034, 95% CI: 0.01, 0.06, p = 0.007).

Conclusion

Child adiposity was positively associated with heart rate recovery time after the step test. A simple stepping test could be used as a non-invasive and inexpensive fitness tool in 5-year-olds. Additional research is needed to validate the ROLO Kids step test in preschool children.
Tools for measuring individual self-care capability: a scoping review
Authors: El-Osta Austen , Sasco Eva Riboli , Barbanti Evelina , Webber Iman , Alaa Aos , Karki Manisha , Asmar Marie line El , Idriss Haitham , Almadi Mashael , Massoud Farah , Alboksmaty Ahmed , Majeed Azeem
Published: July 2023

Background

Our ability to self-care can play a crucial role in the prevention, management and rehabilitation of diverse conditions, including chronic non-communicable diseases. Various tools have been developed to support the measurement of self-care capabilities of healthy individuals, those experiencing everyday self-limiting conditions, or one or more multiple long-term conditions. We sought to characterise the various non-mono-disease specific self-care measurement tools for adults as such a review was lacking.

Objective

The aim of the review was to identify and characterise the various non-mono-disease specific self-care measurement tools for adults. Secondary objectives were to characterise these tools in terms of their content, structure and psychometric properties.

Design

Scoping review with content assessment.

Methods

The search was conducted in Embase, PubMed, PsycINFO and CINAHL databases using a variety of MeSH terms and keywords covering 1 January 1950 to 30 November 2022. Inclusion criteria included tools assessing health literacy, capability and/or performance of general health self-care practices and targeting adults. We excluded tools targeting self-care in the context of disease management only or indicated to a specific medical setting or theme. We used the Seven Pillars of Self-Care framework to inform the qualitative content assessment of each tool.

Results

We screened 26,304 reports to identify 38 relevant tools which were described in 42 primary reference studies. Descriptive analysis highlighted a temporal shift in the overall emphasis from rehabilitation-focused to prevention-focused tools. The intended method of administration also transitioned from observe-and-interview style methods to the utilisation of self-reporting tools. Only five tools incorporated questions relevant to the seven pillars of self-care.

Conclusions

Various tools exist to measure individual self-care capability, but few consider assessing capability against all seven pillars of self-care. There is a need to develop a comprehensive, validated tool and easily accessible tool to measure individual self-care capability including the assessment of a wide range of self-care practices. Such a tool could be used to inform targeted health and social care interventions.
Epidemiological differences between the sexes in adolescent patients with lumbar spondylolysis: a single-institution experience in Japan
Authors: Asai Reo , Tatsumura Masaki , Gamada Hisanori , Okuwaki Shun , Eto Fumihiko , Nagashima Katsuya , Takeuchi Yousuke , Funayama Toru , Mammoto Takeo , Hirano Atsushi , Yamazaki Masashi
Published: July 2023

Background

Lumbar spondylolysis, a common identifiable cause of low back pain in young athletes, reportedly has a higher incidence rate in males. However, the reason for its higher incidence in males is not clear. This study aimed to investigate the epidemiological differences between the sexes in adolescent patients with lumbar spondylolysis.

Methods

A retrospective study was conducted in 197 males and 64 females diagnosed with lumbar spondylolysis. These patients visited our institution from April 2014 to March 2020 with their main complaint being low back pain, and they were followed-up until the end of their treatment. We investigated associations between lumbar spondylosis, their background factors, and characteristics of the lesions and analyzed their treatment results.

Results

Males had a higher prevalence of spina bifida occulta (SBO) (p = 0.0026), more lesions with bone marrow edema (p = 0.0097), and more lesions in the L5 vertebrae (p = 0.021) than females. The popular sports disciplines were baseball, soccer, and track and field in males, and volleyball, basketball, softball in females. The dropout rate, age at diagnosis, bone union rate, and treatment period did not differ between the sexes.

Conclusion

Lumbar spondylolysis was more common in males than in females. SBO, bone marrow edema, and L5 lesions were more frequent in males, and sports discipline varied between the sexes.
The feasibility of a new self-guided pedicle tap for pedicle screw placement: an anatomical study
Authors: Liu Yongtao , Zhou Xiaoji , Li Yuan , Wang Peng
Published: July 2023

Purpose

To investigate the safety and accuracy of applying a new self-guided pedicle tap to assist pedicle screw placement.

Methods

A new self-guided pedicle tap was developed based on the anatomical and biomechanical characteristics of the pedicle. Eight adult spine specimens, four males and four females, were selected and tapped on the left and right sides of each pair of T1-L5 segments using conventional taps (control group) and new self-guided pedicle taps (experimental group), respectively, and pedicle screws were inserted. The screw placement time of the two groups were recorded and compared using a stopwatch. The safety and accuracy of screw placement were observed by CT scanning of the spine specimens and their imaging results were graded according to the Heary grading criteria.

Results

Screw placement time of the experimental group were (5. 73 ± 1. 18) min in thoracic vertebrae and (5. 09 ± 1. 31) min in lumbar vertebrae respectively. Screw placement time of the control group were respectively (6. 02 ± 1. 54) min in thoracic vertebrae and (5.51 ± 1.42) min in lumbar vertebrae. The difference between the two groups was not statistically significant (P > 0. 05). The Heary grading of pedicle screws showed 112 (82.35%) Heary grade I screws and 126 (92.65%) Heary grade I + II screws in the experimental group, while 96 (70.59%) Heary grade I screws and 112 (82.35%) Heary grade I + II screws in the control group.The difference between the two groups was statistically significant (P < 0.05).

Conclusion

The new self-guided pedicle tap can safely and accurately place thoracic and lumbar pedicle screws with low-cost and convenient procedure,which indicates a good clinical application value.
Identification and characterization of sugar-regulated promoters in Chaetomium thermophilum
Authors: Reislöhner Sven , Schermann Geza , Kilian Max , Santamaría-Muñoz Daniela , Zimmerli Christian , Kellner Nikola , Baßler Jochen , Brunner Michael , Hurt Ed
Published: July 2023

The thermophilic fungus Chaetomium thermophilum has been used extensively for biochemical and high-resolution structural studies of protein complexes. However, subsequent functional analyses of these assemblies have been hindered owing to the lack of genetic tools compatible with this thermophile, which are typically suited to other mesophilic eukaryotic model organisms, in particular the yeast Saccharomyces cerevisiae. Hence, we aimed to find genes from C. thermophilum that are expressed under the control of different sugars and examine their associated 5’ untranslated regions as promoters responsible for sugar-regulated gene expression. To identify sugar-regulated promoters in C. thermophilum, we performed comparative xylose- versus glucose-dependent gene expression studies, which uncovered a number of enzymes with induced expression in the presence of xylose but repressed expression in glucose-supplemented media. Subsequently, we cloned the promoters of the two most stringently regulated genes, the xylosidase-like gene (XYL) and xylitol dehydrogenase (XDH), obtained from this genome-wide analysis in front of a thermostable yellow fluorescent protein (YFP) reporter. With this, we demonstrated xylose-dependent YFP expression by both Western blotting and live-cell imaging fluorescence microscopy. Prompted by these results, we expressed the C. thermophilum orthologue of a well-characterized dominant-negative ribosome assembly factor mutant, under the control of the XDH promoter, which allowed us to induce a nuclear export defect on the pre-60S subunit when C. thermophilum cells were grown in xylose- but not glucose-containing medium. Altogether, our study identified xylose-regulatable promoters in C. thermophilum, which might facilitate functional studies of genes of interest in this thermophilic eukaryotic model organism.
Orthodontic treatment of traumatically avulsed maxillary central incisors with bimaxillary dentoalveolar protrusion in an adult female: a case report
Authors: Yu Xiaotong , Duan Xiaoni , Zhi Cheng , Jiang Yilin , Chen Ziyi , Zhang Chunxiang
Published: July 2023

Background

Clinicians agree that obtaining and retaining good treatment results for missing maxillary central incisors owing to trauma is not easy. Management of adult patients with permanent maxillary central incisor loss who visit the clinic with high expectations for aesthetics and function pose a significant diagnostic dilemma. Therefore, esthetic and functional outcomes should be taken into consideration when deciding the proper treatment method. The treatment described in this study aimed to reestablish smile esthetics by proposing an effective multidisciplinary clinical approach that includes orthodontic-prosthetic-periodontal procedures, optimally reduced lip protrusion, center dental midlines, and establishment of stable occlusion.

Case presentation

The patient was a 19-year-old adult female with bimaxillary arch protrusion who had been wearing removable dentures for several years since the loss of her maxillary central permanent incisors. A multidisciplinary treatment including the extraction of two mandibular primary premolars was adopted. The treatment plan consisted of orthodontic space closure by shifting the adjacent teeth towards the central incisor spaces combined with appropriate morphologic remodeling and gingival reshaping to obtain good aesthetic and functional results. The duration to complete the orthodontic treatment was 35 months. Clinical and radiographic results after treatment suggested smile harmony with an improvement in the facial profile, good function of the occlusion, and a positive effect on bone remodeling in the area of the missing incisors during orthodontic tooth movement.

Conclusions

This clinical case illustrated the necessity for using multidisciplinary methods involving orthodontic, prosthodontic, and periodontic procedures to treat an adult female patient with bimaxillary arch protrusion and long-term absence of anterior teeth due to severe trauma.
Is automatic cephalometric software using artificial intelligence better than orthodontist experts in landmark identification?
Authors: Ye Huayu , Cheng Zixuan , Ungvijanpunya Nicha , Chen Wenjing , Cao Li , Gou Yongchao
Published: July 2023

Background

To evaluate the techniques used for the automatic digitization of cephalograms using artificial intelligence algorithms, highlighting the strengths and weaknesses of each one and reviewing the percentage of success in localizing each cephalometric point.

Methods

Lateral cephalograms were digitized and traced by three calibrated senior orthodontic residents with or without artificial intelligence (AI) assistance. The same radiographs of 43 patients were uploaded to AI-based machine learning programs MyOrthoX, Angelalign, and Digident. Image J was used to extract x- and y-coordinates for 32 cephalometric points: 11 soft tissue landmarks and 21 hard tissue landmarks. The mean radical errors (MRE) were assessed radical to the threshold of 1.0 mm,1.5 mm, and 2 mm to compare the successful detection rate (SDR). One-way ANOVA analysis at a significance level of P < .05 was used to compare MRE and SDR. The SPSS (IBM-vs. 27.0) and PRISM (GraphPad-vs.8.0.2) software were used for the data analysis.

Results

Experimental results showed that three methods were able to achieve detection rates greater than 85% using the 2 mm precision threshold, which is the acceptable range in clinical practice. The Angelalign group even achieved a detection rate greater than 78.08% using the 1.0 mm threshold. A marked difference in time was found between the AI-assisted group and the manual group due to heterogeneity in the performance of techniques to detect the same landmark.

Conclusions

AI assistance may increase efficiency without compromising accuracy with cephalometric tracings in routine clinical practice and research settings.
Factors associated with uptake of human papilloma virus vaccine among school girls aged 9–14 years in Lira City northern Uganda: a cross-sectional study
Authors: Nakayita Renniter Mirembe , Benyumiza Deo , Nekesa Catherine , Misuk Ivan , Kyeswa Julius , Nalubuuka Aisha , Murungi Tom , Udho Samson , Kumakech Edward
Published: July 2023

Background

Cervical cancer is the most common Human Papilloma Virus (HPV)-related disease among women. Since 2008, HPV vaccination has been routinely recommended for pre-adolescent and adolescent girls in Uganda as the primary preventive measure for cervical cancer. However, in Uganda, most especially in Lira district, there is limited literature on HPV vaccination uptake and associated factors among girls aged 9-14years. This study assessed the uptake of HPV vaccine and associated factors among in-school girls aged 9–14 years in Lira City, northern Uganda.

Methods

A cross-sectional study was conducted among 245 primary school girls aged 9–14 years in Lira City, northern Uganda. Multistage sampling technique was used to sample eligible participants and data was collected using interviewer administered questionnaire. Data was analysed using SPSS version 23.0. Descriptive statistics and multivariate logistic regression at 95% level of significance were used to identify the level of HPV vaccine uptake and predictors respectively.

Results

HPV vaccination uptake was at 19.6% (95% CI,14.8–25.1) among the school girls aged 9–14 years in Lira City, northern Uganda. The mean age of the girls was 12.11 (± 1.651) years. Predictors that were independently associated with HPV vaccine uptake included; recommendation from health worker [aOR 9.09, 95% CI (3.19–25.88), P ≤ 0.001], taught about cervical cancer at school [aOR,12.56, 95% CI (4.60–34.28), P ≤ 0.001], and exposure to outreach clinics [aOR, 4.41, 95% CI (1.37–14.19), P = 0.013].

Conclusion

The study found that one in five of the school girls in Lira City, northern Uganda. received HPV vaccine. Girls who were taught about cervical cancer at school, exposure to outreach clinics and received health worker recommendation had more odds of receiving HPV vaccine than their counter parts. The Ministry of Health should strengthen school based cervical cancer education, awareness raising about HPV vaccination and health worker recommendations to improve HPV vaccine uptake among school girls in Uganda.