bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental Health Staff’s Perspectives on Tapering of Antipsychotic Medication: A Focus Group Study
Authors: Roed Kickan , Buus Niels , Nielsen Jimmi , Christensen Puk S. , Midtgaard Julie
Published: September 2023

Contemporary practices of long-term antipsychotic maintenance treatment for schizophrenia are being challenged, and clinicians must consider the possibilities of reducing long-term maintenance use. However, research indicates that people with schizophrenia receive little support from mental health staff to reduce antipsychotic medication. This article reports a study which aimed to investigate interdisciplinary mental health staff’s accounts of tapering of antipsychotic medication and to explore different positions that mental health staff assign to themselves and others. Six focus groups were conducted with 39 mental health staff from outpatient clinics, inpatient units, forensic mental health units, and community mental health services. The data analysis combined analyses of the interactions during focus groups and the thematic content. Results were considered from a discourse analytic perspective considering the function and consequence of accounts applied by the mental health staff. The mental health staff accounted for their perspectives on tapering from the following three distinctive positions: 1) No, patients will eventually realize that they need the medication, 2) Yes, but tapering means running a big risk of relapse in symptoms, and 3) Yes, we need to welcome risks to support personal recovery. Our findings indicated that there was reluctance among interdisciplinary mental health staff to let service users make decisions and limited possibilities for people with schizophrenia to have their request for tapering of their antipsychotic medication met by mental health staff.
A coda wave interferometry to characterize and evaluate the powder debonding damage of solid propellant: Experimental investigation and discrete element simulation
Authors: Pan Yu , Yang Deze , Qu Wenzhong , Chu Xihua
Published: September 2023

The debonding of solid filler powder and binder matrix is the main form of damage for composite solid propellant. This study proposes a coda wave interference (CWI) analysis method to quantitatively characterize and evaluate the internal powder debonding damage of composite solid propellant by experiment and discrete element simulation. In order to verify the validity of numerical simulation, the discrete element method (DEM) samples to simulate the powder debonding damage of solid propellant are established, and the DEM simulation and micro-CT scanning experiment are carried out. The micro-experimental and DEM results prove the efficiency and accuracy of DEM samples in modeling the damage behaviors of solid propellant specimens. Furthermore, in order to quantitatively characterize and evaluate powder debonding damage of solid propellant, using CWI method to analyze the damage states of solid propellants in the experiment and DEM simulation of tension. Two coda evaluation parameters based on different damage states are proposed, and the relationship curves of coda evaluation parameters and tensile strain are obtained. Though the analysis of the curve results of experiment and DEM simulation, the validity of CWI is demonstrated. The coda evaluation parameters can quantitatively identify and judge the accumulation process of initial damage, the appearance of micro holes and the failure point of propellant.
Closing the digital gap for remote First Nations communities: 5G and beyond?
Authors: Featherstone Daniel , Thomas Julian , Holcombe-James Indigo , Ormond-Parker Lyndon
Published: September 2023

5G is described as a step change in mobile delivery. While it has the potential to provide significant benefits to remote First Nations communities and homelands in Australia, the current market-driven model of 5G deployment building outward from urban and regional centres risks increasing existing digital inequalities. A new Closing the Gap target aimed at digital equity for First Nations people by 2026 provides a critical lens to assess the impact of new technologies on digital inclusion for vulnerable populations. This article draws on findings and case studies from the Mapping the Digital Gap research to analyse the potential benefits, risks and limitations of 5G in closing the digital gap across remote Australia. Alternative communications solutions combined with co-design principles may be more effective in addressing remote First Nations communities’ needs. The authors call for more holistic policy and targeted programs to improve digital inclusion for remote First Nations people.
Revenants in the marketplace: A hauntology of retrocorporation
Authors: James Sophie , Cronin James , Patterson Anthony
Published: September 2023

Drawing upon a cultural-historical reading of the witch, we discuss how modern capitalism is chronically haunted by obstreperous vestiges of what preceded it yet remains proficient in assimilating all that returns to challenge it. By adapting and extending a theoretical toolkit informed by Jacques Derrida and Mark Fisher, we trace market and state administrators’ co-optation of the primeval witch figure and her ideological trappings: initially, to expropriate those who threatened incipient modernising structures; later, to provoke increasingly secularised subjects towards consumption; and eventually, to calibrate rather than obviate capitalist expansion so that it remains aligned with consumer interests. Introducing the new concepts of ‘retrocorporation’ and ‘marketplace revenant’, we discuss how long-foreclosed, ancient imaginaries become re-invoked and re-programmed to perpetuate capitalism’s dominance. Our message for the nascent tradition of ‘Terminal Marketing’ is that the collision and collusion of past and future has the potential to ossify capitalist realism in the present.
Influence of alkali treated cellulose nanoparticles filled starch-based bioplastic films and their effect on thermal and mechanical properties
Authors: Olusanya John Olumide , Turup Pandurangan Mohan , Kanny Krishnan
Published: September 2023

In this study, structural, thermal, mechanical and water uptake properties on the influence of alkaline treated cellulose nanoparticles (CNPs) filled starch-based bioplastic film is examined. Starch-based bioplastic films filled with alkaline treated CNPs at various concentration (0 to 5 wt%) were prepared by solution casting method. Thermal properties of film series are examined by Differential Scanning Calorimetry (DSC) and Thermogravimetry analysis (TGA) method. Alkaline treated CNPs addition induces crystallization to the bioplastic film. Degradation onset temperature ( Don), 10% mass loss ( T10) and 50% mass loss ( T50) values show the positive effect of CNPs addition into the biopolymer matrix with improved thermal stability. Tensile result shows that about 2.5 times increased is observed in 2 wt% CNPs filled bioplastic films. Water uptake result shows that the alkaline treated CNPs starch-based bioplastic film limit the biopolymer dissolution time and extended the breaking down of the bioplastic film. Leading to about 2.5 times reduced equilibrium water mass uptake is observed in 3 wt% CNPs filled bioplastic film when compared with unfilled bioplastic film.
Misogynist incels gone mainstream: A critical review of the current directions in incel-focused research
Authors: Czerwinsky Allysa
Published: September 2023

Misogynist incels have been at the fore of academic, professional and mainstream discussions in recent years. Drawing on a systematic review of 47 studies, as well as my own experience with researching current misogynist and exit-curious incels, this paper explores the strengths and weaknesses of the contemporary incel-focused literature. It summarises and critiques the foundational knowledge that underpins our understanding of the current incel community, conceptualised into themes of incels as oppressors, incels as oppressed and incels as threat. Importantly, this paper interrogates the usefulness of our working definition of the term ‘incel’, calling for greater specificity in the language we use to define, theorise and explain the subsets of the incel community under study. In line with a call for more precise language in empirical works, I explore several areas for future research that will help broaden our understanding of the complexities and contradictions within the broader incelosphere.
The use of technology in the assessment and monitorization of a season in a professional padel player: A case study
Authors: Carnero-Diaz Angel , Pecci Javier , Reverte-Pagola Gonzalo , Da Silva-Grigoletto Marzo Edir
Published: September 2023

Training process in elite padel players is influenced by travels and competitions density. The irregularity in the workloads, as well as demands of the season, could affect the musculoskeletal structures. Strength training has a protective role against the injury incidence, but the competitive context does not always allow adequate periodization of training and thus achieve adaptations. The aim of this study is to analyze, using technological tools, if improvements in player’s fitness are accompanied by improvements in sport performance through a case study. An elite padel player was analyzed during the 2021 season. Physical fitness was evaluated using different technological tools. Athlete monitoring was carried out using self-reported forms and sport performance was assessed through the results obtained in the World Padel Tour ranking at the end of the season. During the training process, multidimensional training was carried out in order to achieve the maximum availability of specific loads through coadjuvant training. Results of the assessment show slight improvements in all fitness tests. Assessment of sport performance reports an increased number of victories and a better position in the professional ranking. Musculoskeletal improvements helped the athlete’s workload tolerance, allowing overall improvement in padel performance. The training approach from this study has shown to be effective in maintaining or even improving force-producing capacity in lower and upper limbs, force-velocity relationship, agility and sport performance, despite the high competitive density. This work provides coaches with a practical approach to assess, monitor and design a competitive season for an elite padel player.
Using machine learning to determine the positions of professional soccer players in terms of biomechanical variables
Authors: Yagin Fatma Hilal , Hasan Uday CH , Clemente Filipe Manuel , Eken Ozgur , Badicu Georgian , Gulu Mehmet
Published: September 2023

This study aimed to predict professional soccer players’ positions with machine learning according to certain locomotor demands. Data from 20 male professional soccer players (five defenders, eight midfielders, and seven attackers) from the same team were tracked daily with a global navigation satellite system. A total of 1910 individual training sessions were recorded. The 10-fold cross-validation method was used. Soccer player positions were predicted using predictive models created with random forest (RF), gradient boosting tree, bagging classification, and regression trees algorithms, and the results were evaluated with comprehensive performance measures. Ratios and an importance plot were used to analyze the importance of the variables according to their contributions to the estimation. The findings show that the RF model achieved 100% accuracy, which means that RF can predict all player positions (100%). Running distance (26.5%), total distance (17.2%), and player load (15.8%) were the three variables that contributed the most to the estimation of the RF model and were the most important factor in distinguishing player positions. Consequently, our proposed machine learning approach (RF model) can reduce false alarms and player mispositioning.
Navigating the challenges of invasive pulmonary aspergillosis in lung cancer treatment: a propensity score study
Authors: Kuo Chin-Wei , Lin Chien-Yu , Wei Sheng-Huan , Chou Yun-Tse , Chen Chian-Wei , Tsai Jeng-Shiuan , Su Po-Lan , Lin Chien-Chung
Published: September 2023

Background:

Invasive pulmonary aspergillosis (IPA) can negatively impact cancer patients’ survival. It remains uncertain whether IPA’s impact on patient outcomes varies by treatment approach in advanced lung cancer.

Objectives:

To explore the association between IPA and outcomes in patients with advanced lung cancer receiving different treatments.

Design:

A retrospective cohort study.

Methods:

We enrolled patients with advanced-stage lung cancer between 2013 and 2021 at a college hospital in Taiwan and used the 2021 European Organization for Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium consensus for IPA diagnosis. Multivariable logistic regression was used to identify the IPA risk factors. We compared overall survival (OS) and postgalactomannan (GM) test survival between the IPA and control groups using multivariable Cox proportional hazards regression and the Kaplan–Meier method with propensity score matching (PSM).

Results:

Among 2543 patients with advanced-stage lung cancer, 290 underwent a GM test, of which 34 (11.7%) were diagnosed with IPA. Patients undergoing chemotherapy (HR = 4.02, p = 0.027) and immunotherapy [hazard ratio (HR) = 3.41, p = 0.076] tended to have IPA. Compared to the control group, the IPA group had shorter median OS (14.4 versus 9.9 months, p = 0.030) and post-GM test survival (4.5 versus 1.9 months, p = 0.003). IPA was associated with shorter OS (log-rank p = 0.014 and 0.018 before and after PSM, respectively) and shorter 1-year and 2-year survival post-GM test (HR = 1.65 and 1.66, respectively). Patients receiving chemotherapy or immunotherapy had a shorter post-GM test survival if they had IPA.

Conclusions:

IPA tended to be diagnosed more frequently in patients receiving chemotherapy or immune checkpoint inhibitors. Patients diagnosed with IPA are associated with shorter survival. Larger cohort studies are needed to verify the observations.
Mitral facies—a classic feature of chronic mitral stenosis: A case report
Authors: Ginting Munte Fatwiadi Apulita , Ahmadi Adhytya Pratama , Fauziah Mira , Hasanah Dian Yaniarti
Published: September 2023

Mitral facies is a classical feature of chronic mitral stenosis (MS) that commonly associated with low cardiac output and pulmonary hypertension. A 44-year-old woman presented with 10-year history of refractory right heart failure. We noted distinctive malar rash appearance on her face known as “mitral facies.” An echocardiogram revealed severe MS and other significant valve involvement with typical characteristics of rheumatic valvular heart disease. Doppler measurement showed decreased cardiac output and severe pulmonary hypertension in this patient. The mitral facies could be an alarming sign of a more severe and advanced form of MS. It also can be a marker of impaired cardiac output and concomitant severe pulmonary hypertension.
Traditional farm tools observed from an ecological and health perspective
Authors: Chen Mu
Published: September 2023

All walks of life actively promoted emerging technologies when modern agricultural science and technology from the West were introduced to China in the late Qing Dynasty. Despite agricultural machinery being highly popular during the more than 100 years since, traditional farm tools have not been completely replaced and have instead gradually become symbols representing traditional farming culture. From the perspective of ecology and health, this paper discusses the values, scientific notions and corresponding styles of production and life associated with traditional agricultural tools as well as the multicultural values regarding traditional agricultural culture in modern society in China.
DNA Methylation in Cancer: Epigenetic View of Dietary and Lifestyle Factors
Authors: Maleknia Mohsen , Ahmadirad Nooshin , Golab Fereshteh , Katebi Yasmina , Haj Mohamad Ebrahim Ketabforoush Arsh
Published: September 2023

Background:

Alterations in DNA methylation play an important role in cancer development and progression. Dietary nutrients and lifestyle behaviors can influence DNA methylation patterns and thereby modulate cancer risk.

Introduction:

To comprehensively review available evidence on how dietary and lifestyle factors impact DNA methylation and contribute to carcinogenesis through epigenetic mechanisms.

Materials and methods:

A literature search was conducted using PubMed to identify relevant studies published between 2005 and 2022 that examined relationships between dietary/lifestyle factors and DNA methylation in cancer. Studies investigating the effects of dietary components (eg, micronutrients, phytochemicals), physical activity, smoking, and obesity on global and gene-specific DNA methylation changes in animal and human cancer models were included. Data on specific dietary/lifestyle exposures, cancer types, DNA methylation targets and underlying mechanisms were extracted.

Results:

Multiple dietary and lifestyle factors were found to influence DNA methylation patterns through effects on DNA methyltransferase activity, methyl donor availability, and generation of oxidative stress. Altered methylation of specific genes regulating cell proliferation, apoptosis, and inflammation were linked to cancer development and progression.

Conclusion:

Dietary and lifestyle interventions aimed at modulating DNA methylation have potential for both cancer prevention and treatment through epigenetic mechanisms. Further research is needed to identify actionable targets for nutrition and lifestyle-based epigenetic therapies.
Identification and verification of plasma protein biomarkers that accurately identify an ectopic pregnancy
Authors: Beer Lynn A. , Yin Xiangfan , Ding Jianyi , Senapati Suneeta , Sammel Mary D. , Barnhart Kurt T. , Liu Qin , Speicher David W. , Goldman Aaron R.
Published: September 2023

Background

Differentiating between a normal intrauterine pregnancy (IUP) and abnormal conditions including early pregnancy loss (EPL) or ectopic pregnancy (EP) is a major clinical challenge in early pregnancy. Currently, serial β-human chorionic gonadotropin (β-hCG) and progesterone are the most commonly used plasma biomarkers for evaluating pregnancy prognosis when ultrasound is inconclusive. However, neither biomarker can predict an EP with sufficient and reproducible accuracy. Hence, identification of new plasma biomarkers that can accurately diagnose EP would have great clinical value.

Methods

Plasma was collected from a discovery cohort of 48 consenting women having an IUP, EPL, or EP. Samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) followed by a label-free proteomics analysis to identify significant changes between pregnancy outcomes. A panel of 14 candidate biomarkers were then verified in an independent cohort of 74 women using absolute quantitation by targeted parallel reaction monitoring mass spectrometry (PRM-MS) which provided the capacity to distinguish between closely related protein isoforms. Logistic regression and Lasso feature selection were used to evaluate the performance of individual biomarkers and panels of multiple biomarkers to predict EP.

Results

A total of 1391 proteins were identified in an unbiased plasma proteome discovery. A number of significant changes (FDR ≤ 5%) were identified when comparing EP vs. non-EP (IUP + EPL). Next, 14 candidate biomarkers (ADAM12, CGA, CGB, ISM2, NOTUM, PAEP, PAPPA, PSG1, PSG2, PSG3, PSG9, PSG11, PSG6/9, and PSG8/1) were verified as being significantly different between EP and non-EP in an independent cohort (FDR ≤ 5%). Using logistic regression models, a risk score for EP was calculated for each subject, and four multiple biomarker logistic models were identified that performed similarly and had higher AUCs than models with single predictors.

Conclusions

Overall, four multivariable logistic models were identified that had significantly better prediction of having EP than those logistic models with single biomarkers. Model 4 (NOTUM, PAEP, PAPPA, ADAM12) had the highest AUC (0.987) and accuracy (96%). However, because the models are statistically similar, all markers in the four models and other highly correlated markers should be considered in further validation studies.
Reversible cardiac function and left ventricular hypertrophy in a Chinese man with mitochondrial myopathy: a case report
Authors: Wu Guiping , Han Yijun , Zhao Lifeng , Zhang Hong , Fan Xiuzhao , Li Weiqin , Che Xiaowen , Zhou Yun
Published: September 2023

Background

Mitochondrial myopathies (MMs) are a group of multi-system diseases caused by abnormalities in mitochondrial DNA (mtDNA) or mutations of nuclear DNA (nDNA). The diagnosis of mitochondrial myopathy (MM) is reliant on the combination of history and physical examination, muscle biopsy, histochemical studies, and next-generation sequencing. Patients with MMs have diverse clinical manifestations. In the contemporary literature, there is a paucity of reports on cardiac structure and function in this rare disease. We report a Chinese man with MM accompanied with both acute right heart failure and left ventricular hypertrophy.

Case presentation

A 49-year-old man presented with clinical features suggestive of MM, i.e., ophthalmoparesis, weakness of the pharyngeal and extremity muscles, and respiratory muscles which gradually progressed to respiratory insufficiency. He had a family history of mitochondrial myopathy. He had increased levels of serum creatine kinase and lactate. Muscle biopsy of left lateral thigh revealed 8% ragged red fibers (RRF) and 42% COX-negative fibers. Gene sequencing revealed a novel heterozygote TK2 variant (NM_001172644: c.584T>C, p.Leu195Pro) and another heterozygous variant (NM_004614.4:c.156+958G>A; rs1965661603) in the intron of TK2 gene. Based on these findings, we diagnosed the patient as a case of MM. Echocardiography revealed right heart enlargement, pulmonary hypertension, left ventricular hypertrophy, and thickening of the main pulmonary artery and its branches. The patient received non-invasive ventilation and coenzyme Q10 (CoQ10). The cardiac structure and function were restored at 1-month follow-up.

Conclusions

This is the first report of reversible cardiac function impairment and left ventricular hypertrophy in a case of adult-onset MM, nocturnal hypoxia is a potential mechanism for left ventricular hypertrophy in patients with MM.
Value of Echocardiography and Cardiac Magnetic resonance in assessing left ventricular function in breast and gastric cancer patients after Anthracycline Chemotherapy
Authors: Jin Chao-long , Shi Xue-gong , Wang Ting-ting , Li Hong-wen , Zhang Ding-Xin , Sheng Zhe , Xiao Jie , Yu Yong-Qiang
Published: September 2023

Background

Echocardiography (ECHO) and cardiac magnetic resonance imaging (MRI) are used to observe changes in the left ventricular structure in patients with breast and gastric cancer after 6 cycles of chemotherapy. Based on the observed values, we aimed to evaluate the cardiotoxicity of anthracyclines in cancer patients and to analyze the consistency of the two examination methods in assessing left ventricular function after chemotherapy.

Methods

From January 2020 to January 2022, the data of 80 patients with malignant tumors who received anthracycline chemotherapy (breast cancer, n = 40; gastric cancer, n = 40) and 40 healthy volunteers (Control group) were retrospectively collected. Serum high-sensitivity cardiac troponin T (hs-cTnT) levels were detected by an automatic immunoassay analyzer. Left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were measured by cardiac MRI and 2-dimensional ECHO using the biplane Simpson’s method.

Results

Compared with baseline values, serum high-sensitivity cardiac troponin T (hs-cTnT) levels were significantly increased in patients with breast cancer and gastric cancer after 6 cycles of chemotherapy (P < 0.05). In addition, LVEDV, LVESV and LVEF measured with MRI were higher than those detected by ECHO in cancer patients after 6 cycles of chemotherapy (P < 0.05). And the Bland-Altman plot analysis showed that LVEDV, LVESV and LVEF measured by the two examination methods were in good agreement.

Conclusion

Breast and gastric cancer patients exhibited elevated levels of hs-cTnT after 6 cycles of chemotherapy, indicating potential cardiotoxicity. Additionally, cardiac MRI and 2-dimensional ECHO showed good agreement in assessing left ventricular function, with ECHO tending to underestimate volume measurements compared to MRI.
A nomogram model for predicting malnutrition among older hospitalized patients with type 2 diabetes: a cross—sectional study in China
Authors: Ran Qian , Zhao Xili , Tian Jiao , Gong Siyuan , Zhang Xia
Published: September 2023

Background

Malnutrition remains a pervasive issue among older adults, a prevalence that is markedly higher among those diagnosed with diabetes. The primary objective of this study was to develop and validate a risk prediction model that can accurately identify instances of malnutrition among elderly hospitalized patients with type 2 diabetes mellitus (T2DM) within a Chinese demographic.

Methods

This cross-sectional study was conducted between August 2021 and August 2022, we enrolled T2DM patients aged 65 years and above from endocrinology wards. The creation of a nomogram for predicting malnutrition was based on risk factors identified through univariate and multivariate logistic regression analyses. The predictive accuracy of the model was evaluated by the receiver operating characteristic curve (ROC),the area under the ROC (AUC), the concordance index (C-index), and calibration curves.

Results

The study included a total of 248 older T2DM patients, with a recorded malnutrition prevalence of 26.21%. The identified critical risk factors for malnutrition in this cohort were body mass index, albumin, impairment in activities of daily living, dietary habits, and glycosylated hemoglobin. The AUC of the nomogram model reached 0.914 (95% CI: 0.877—0.951), with an optimal cutoff value of 0.392. The model demonstrated a sensitivity of 80.0% and a specificity of 88.5%. Bootstrap-based internal verification results revealed a C-index of 0.891, while the calibration curves indicated a strong correlation between the actual and predicted malnutrition risks.

Conclusions

This study underscores the critical need for early detection of malnutrition in older T2DM patients. The constructed nomogram represents a practical and reliable tool for the rapid identification of malnutrition among this vulnerable population.
Risk factors of peripheral venous catheter-related complication and infection in children with bronchopneumonia
Authors: Li Hong-mei , Wan Li-li , Jin Cai-xiang , Zhang Guo-ying , Yang Hui , Zhang Xiao-yu
Published: September 2023

Objective

To investigate the risk factors associated with the peripheral venous catheter-related complication and infection in children with bronchopneumonia.

Methods

A total of 185 patients were divided into case group (n = 114) and control group (n = 71) according to the presence of catheter-related infection and complications related to indwelling needle. We performed a multivariate logistic regression analysis to explore the risk factors associated with the infection.

Results

Age was divided into 4 categories (0 < age ≤ 1, 1 < age ≤ 3, 3 < age ≤ 6, age > 6). The case group had a higher percentage of patients with 0 < age ≤ 1 than the control group (21% vs. 9.7%) and the age distribution was significant different between the two groups (P = 0.045). The case group had a longer retention time than the control group (≥ 3 days: 56% vs. 35%,P < 0.001). The results of binary logistics regression analysis revealed that the indwelling time and indwelling site were the factors that influenced the complications or bacterial infection. Among the three indwelling sites, the hand is more prone to infection and indwelling needle-related complications than the head (OR: 2.541, 95% CI 1.032 to 6.254, P = 0.042). The longer the indwelling time, the more likely the infection and indwelling needle related complications (OR: 2.646, 95% CI 1.759 to 3.979, P< 0.001).

Conclusion

Indwelling time and indwelling site are the influencing factors of complications or bacterial infection, which should be paid more attention to prevent the catheter-related infection in children with bronchophenumonia.
Differential expression of biomarkers in saliva related to SARS-CoV-2 infection in patients with mild, moderate and severe COVID-19
Authors: Verdiguel-Fernández Lázaro , Arredondo-Hernández Rene , Mejía-Estrada Jesús Andrés , Ortiz Adolfo , Verdugo-Rodríguez Antonio , Orduña Patricia , Ponce de León-Rosales Samuel , Calva Juan José , López-Vidal Yolanda
Published: September 2023

Background

Severe COVID-19 is a disease characterized by profound dysregulation of the innate immune system. There is a need to identify highly reliable prognostic biomarkers that can be rapidly assessed in body fluids for early identification of patients at higher risk for hospitalization and/or death. This study aimed to assess whether differential gene expression of immune response molecules and cellular enzymes, detected in saliva samples of COVID-19 patients, occurs according to disease severity staging.

Methods

In this cross-sectional study, subjects with a COVID-19 diagnosis were classified as having mild, moderate, or severe disease based on clinical features. Transcripts of genes encoding 6 biomarkers, IL-1β, IL-6, IL-10, C-reactive protein, IDO1 and ACE2, were measured by RT‒qPCR in saliva samples of patients and COVID-19-free individuals.

Results

The gene expression levels of all 6 biomarkers in saliva were significantly increased in severe disease patients compared to mild/moderate disease patients and healthy controls. A significant strong inverse relationship between oxemia and the level of expression of the 6 biomarkers (Spearman’s correlation coefficient between -0.692 and -0.757; p < 0.001) was found.

Conclusions

Biomarker gene expression determined in saliva samples still needs to be validated as a potentially valuable predictor of severe clinical outcomes early at the onset of COVID-19 symptoms.
The use of real time strain endometrial elastosonography plus endometrial thickness and vascularization flow index to predict endometrial receptivity in IVF treatments: a pilot study
Authors: Stanziano Antonio , Bianchi Francesco Paolo , Caringella Anna Maria , Cantatore Clementina , D’Amato Antonio , Vitti Angela , Cortone Anna , Vitagliano Amerigo , D’Amato Giuseppe
Published: September 2023

Background

The usefulness of endometrium strain elastosonography (SE) for the evaluation of endometrial receptivity in women undergoing in vitro fertilization (IVF) remains controversial. The objective of this prospective, observational study was to evaluate the correlation between endometrial thickness (EMT) and its related strain (ESR) on the day of ovulation triggering (hCG-d) and in vitro fertilization outcomes. Additionally, 3D Power Doppler vascular indices (3DPDVI) were also analysed.

Methods

We included all the patients undergoing fresh IVF-single blastocyst transfer cycle from January 2021 to August 2021 at our center. On hCG-d, after B-mode scanning was completed to measure the EMT, the mode was changed to elastosonography to evaluate the ESR (ratio between endometrial tissue and the myometrium below). At the end of examination, the Endometrial Volume (EV) and 3DPDVI (vascularization index [VI], flow index [FI] and vascularization flow index [VFI]), were assessed. Statistical analysis was completed using STATA MP16 software.

Results

A total number of 57 women were included. Based on the EMT on hCG-d, women were divided into two groups, Group 1: <7 mm and Group 2 ≥ 7 mm. Women with EMT < 7 mm had a significantly higher ESR (p = 0.004) and lower pregnancy rate (p = 0.04). Additionally, low ESR values were correlated with high VFI values (rho = -0.8; 95% CI = -0.9- -0.6; p < 0.0001) and EMT ≥ 7 mm could be predicted by low ESR (OR = 0.01; 95% CI = 0.01–0.30; p = 0.008, area under the ROC curve: 0.70). After all, in multiple logistic regression analysis, low values of ESR (p = 0.050) and high values of EMT (p = 0.051) on hCG-d had borderline statistical effects on pregnancy rate.

Conclusions

The ESR may be useful to improve the ultrasound evaluation of the endometrial quality in infertile women candidates to IVF/ICS. Given the small sample size of our study, the usefulness of strain elastosonography in this patients, needs further investigation.
Improving diagnosis and prognosis of lung cancer using vision transformers: a scoping review
Authors: Ali Hazrat , Mohsen Farida , Shah Zubair
Published: September 2023

Background

Vision transformer-based methods are advancing the field of medical artificial intelligence and cancer imaging, including lung cancer applications. Recently, many researchers have developed vision transformer-based AI methods for lung cancer diagnosis and prognosis.

Objective

This scoping review aims to identify the recent developments on vision transformer-based AI methods for lung cancer imaging applications. It provides key insights into how vision transformers complemented the performance of AI and deep learning methods for lung cancer. Furthermore, the review also identifies the datasets that contributed to advancing the field.

Methods

In this review, we searched Pubmed, Scopus, IEEEXplore, and Google Scholar online databases. The search terms included intervention terms (vision transformers) and the task (i.e., lung cancer, adenocarcinoma, etc.). Two reviewers independently screened the title and abstract to select relevant studies and performed the data extraction. A third reviewer was consulted to validate the inclusion and exclusion. Finally, the narrative approach was used to synthesize the data.

Results

Of the 314 retrieved studies, this review included 34 studies published from 2020 to 2022. The most commonly addressed task in these studies was the classification of lung cancer types, such as lung squamous cell carcinoma versus lung adenocarcinoma, and identifying benign versus malignant pulmonary nodules. Other applications included survival prediction of lung cancer patients and segmentation of lungs. The studies lacked clear strategies for clinical transformation. SWIN transformer was a popular choice of the researchers; however, many other architectures were also reported where vision transformer was combined with convolutional neural networks or UNet model. Researchers have used the publicly available lung cancer datasets of the lung imaging database consortium and the cancer genome atlas. One study used a cluster of 48 GPUs, while other studies used one, two, or four GPUs.

Conclusion

It can be concluded that vision transformer-based models are increasingly in popularity for developing AI methods for lung cancer applications. However, their computational complexity and clinical relevance are important factors to be considered for future research work. This review provides valuable insights for researchers in the field of AI and healthcare to advance the state-of-the-art in lung cancer diagnosis and prognosis. We provide an interactive dashboard onlung-cancer.onrender.com/.
Exploratory study of an anti-PD-L1/TGF-β antibody, TQB2858, in patients with refractory or recurrent osteosarcoma and alveolar soft part sarcoma: a report from Chinese sarcoma study group (TQB2858-Ib-02)
Authors: Xie Lu , Liang Xin , Xu Jie , Sun Xin , Liu Kuisheng , Sun Kunkun , Li Yuan , Tang Xiaodong , Li Xianan , Zhan Xing , Niu Xiaohui , Guo Wei
Published: September 2023

Background

Novel and effective immunotherapies are required for refractory or recurrent sarcomas. Transforming growth factor-beta (TGF-β) is a diverse regulatory and fibrogenic protein expressed in multiple sarcoma tumors that promotes epithelial-mesenchymal transition and excessive deposition of extracellular matrix. This study evaluated the efficacy and safety of the anti-PD-L1/TGF-β antibody TQB2858 in patients with refractory osteosarcoma and alveolar soft part sarcoma (ASPS).

Methods

This single-arm phase 1b exploratory study included patients with refractory osteosarcoma or ASPS who had previously undergone at least two lines of systemic therapy. Patients were administered 1200 mg of TQB2858 once every 3 weeks. The primary endpoint was objective response rate (ORR), with null and alternative hypotheses of ORR ≤5% and ≥20%, respectively. Exploratory biomarker analyses using immunohistochemistry (IHC) staining (for PD-L1 and TGF-β) were performed on pre-treatment tumor samples.

Results

Eleven eligible patients were included in this study. TQB2858 did not demonstrate evidence of efficacy as 0/5 osteosarcomas had any objective response, while 2/6 ASPS showed a partial response. The median progression-free survivals were 1.51 (1.38, Not Evaluable) and 2.86 (1.38, Not Evaluable) months for the osteosarcoma and ASPS groups, respectively. None of the administered cycles met the criteria for unacceptable toxicity. Other Grade 3 toxicities included abnormal liver function and elevation of γ-glutamyl transferase. IHC analysis revealed that functional enrichment in the TGF-β pathway or PD-L1 was not associated with treatment outcomes.

Conclusions

The combination of PD-L1 and TQB2858 did not significantly improve the ORR in patients with recurrent osteosarcoma. However, it improved immunogenic responses in ASPS, even after progression upon anti-PD-1/PD-L1 therapy, with an acceptable safety profile. IHC profiling with pathway enrichment analysis may not have any predictive value for survival outcomes.

Trial registration

Prospectively registered in the Ethical Review Committee of Peking University People’s Hospital. The trial registration number is 2021PHA105-001 and 2021PHA140-001 and the registration date was March 2, 2022.

ClinicalTrials.gov Identifier CTR20213001 and CTR20220390
Comparative analysis of clinical features of lower respiratory tract infection with respiratory syncytial virus and influenza virus in adults: a retrospective study
Authors: Tian Jiahua , Liu Congyue , Wang Xunling , Zhang Ling , Zhong Guoying , Huang Guichuan , Wang Hongping , Hu Hao , Gong Ling , Liu Daishun
Published: September 2023

Background

Respiratory syncytial virus (RSV) infection in adults remains less recognized and understood, both socially and clinically, compared to influenza virus infection. This retrospective study aims to delineate and compare the clinical manifestations of adult RSV and influenza virus infections in the lower respiratory tract, thereby enhancing awareness of RSV lower respiratory tract infection and providing strategic insights for its prevention and treatment.

Methods

Clinical data from January 2019 to December 2020 were analyzed for 74 patients with RSV and 129 patients with influenza A/B virus lower respiratory tract infections who were admitted to respiratory or intensive care units. All patients had complete clinical data with positive IgM and negative IgG viral antibodies. Comparison parameters included onset timing, baseline data, clinical manifestations, supplementary examination results, treatment methods, and prognosis, while logistic regression was employed to ascertain the correlation of clinical features between the two patient groups.

Results

In comparison to the influenza group, the RSV group presented less frequently with fever at admission but exhibited a higher incidence of dyspnea and wheezing on pulmonary auscultation (P < 0.01). RSV infection was more prevalent among patients with underlying diseases, particularly chronic obstructive pulmonary disease (COPD) and demonstrated a higher probability of co-infections, most notably with Mycoplasma (P < 0.01). The RSV group had significantly higher lymphocyte counts (P < 0.01) and exhibited more incidences of pleural thickening, pulmonary fibrosis, and emphysema (P < 0.05). The use of non-invasive mechanical ventilation was more common, and hospital stays were longer in the RSV group compared to the influenza group (P < 0.05). Logistic multivariate regression analysis further revealed that age and tachypnea incidence were significantly higher in the RSV group (P < 0.05).

Conclusion

Compared to influenza virus infection, adults with COPD are more susceptible to RSV infection. Moreover, RSV infection elevates the risk of co-infection with Mycoplasma and may lead to conditions such as pleural thickening, pulmonary fibrosis, and emphysema. The requirement for non-invasive mechanical ventilation is higher in RSV-infected patients, who also tend to have longer hospital stays. Therefore, greater awareness and preventive strategies against RSV infection are imperative.
Assessing young adults' menopause knowledge to increase understanding of symptoms and help improve quality of life for women going through menopause; a student survey
Authors: Patel Vaishvi , Ross Sue , Sydora Beate C.
Published: September 2023

Background

Due to menopause being a largely invisible and under-discussed topic in wider society, women often deal with menopause-related complications on their own. Social support and awareness have been shown to reduce negative menopausal experiences; however, lack of menopause knowledge, particularly among younger people, may deter support for women suffering from menopause symptoms. This study aims to assess the level of knowledge young adults have on menopause to be able to create interventions that target knowledge gaps and increase understanding of women’s experiences and difficulties during their menopause transition.

Methods

We created an electronic questionnaire based on menopause literature and guidelines from Menopause Societies. It was pilot-tested on young people in the target group age (n = 14; 7 male and 7 female), menopause clinicians (n = 5), and women experiencing menopause (n = 4). The final survey included questions on participant demographics, general menopause knowledge, and options to support menopause management and was distributed through university student newsletters. Responses over a two week period were collected anonymously. Descriptive statistics were applied to characterize participants, define menopause knowledge, and identify gaps. Chi-squared statistics was used for group comparison, and open questions were analyzed using qualitative content analysis.

Results

Survey responses were collected from 828 students; the average age was 22.1 ± 5.1 and 83.6% were female. Participants belonged to all faculties and included students from a variety of family settings and living conditions. Knowledge questions revealed a good understanding of the basic menopause physiology for most respondents, but there were gaps in understanding of symptoms and symptom management. Female sex and personal connection to menopausal women had a positive effect on the degree of menopause knowledge. Both males and females reported increased knowledge confidence at the end of the survey.

Conclusion

Our survey provides evidence that young adults of both sexes have a general baseline knowledge of menopause and its symptoms and are open to learning strategies to help support menopausal women. Our findings will assist in developing targeted educational resources to increase social support and awareness, reduce stigma and improve the quality of life for menopausal women, and help prepare younger women for their future menopause journey.
A nomogram for predicting sepsis-associated delirium: a retrospective study in MIMIC III
Authors: Gu Qiong , Yang Shucong , Fei DanTing , Lu Yuting , Yu Huijie
Published: September 2023

Objective

To develop a nomogram for predicting the occurrence of sepsis-associated delirium (SAD).

Materials and methods

Data from a total of 642 patients were retrieved from the Medical Information Mart for Intensive Care (MIMIC III) database to build a prediction model. Multivariate logistic regression was performed to identify independent predictors and establish a nomogram to predict the occurrence of SAD. The performance of the nomogram was assessed in terms of discrimination and calibration by bootstrapping with 1000 resamples.

Results

Multivariate logistic regression identified 4 independent predictors for patients with SAD, including Sepsis-related Organ Failure Assessment(SOFA) (p = 0.004; OR: 1.131; 95% CI 1.040 to 1.231), mechanical ventilation (P < 0.001; OR: 3.710; 95% CI 2.452 to 5.676), phosphate (P = 0.047; OR: 1.165; 95% CI 1.003 to 1.358), and lactate (P = 0.023; OR: 1.135; 95% CI 1.021 to 1.270) within 24 h of intensive care unit (ICU) admission. The area under the curve (AUC) of the predictive model was 0.742 in the training set and 0.713 in the validation set. The Hosmer − Lemeshow test showed that the model was a good fit (p = 0.471). The calibration curve of the predictive model was close to the ideal curve in both the training and validation sets. The DCA curve also showed that the predictive nomogram was clinically useful.

Conclusion

We constructed a nomogram for the personalized prediction of delirium in sepsis patients, which had satisfactory performance and clinical utility and thus could help clinicians identify patients with SAD in a timely manner, perform early intervention, and improve their neurological outcomes.
Fluoride-activated photothermal system for promoting bacteria-infected wound healing
Authors: Du Yuanchun , Liu Zekai , Yang Qingxin , Zhen Deshuai , Liu Yu , Feng Guangfu
Published: September 2023

Although photothermal therapy (PTT) employing nanozymes has shown excellent antibacterial potential, excessive heating generally harms host cells and hinders recovery. Herein, we report an innovative technique for acquiring the programmed temperature by managing the catalytic activity of nanozymes. The photothermal system of CeO2 + F− + TMB can obtain precise photothermal temperature by adjusting the concentration of fluoride ions under near-infrared irradiation. At the optimized photothermal temperature, the photothermal system affords fine photothermal antibacterial treatment with high-efficiency antibacterial effects against Staphylococcus aureus and Escherichia coli in vitro. In vivo wound healing experiments confirm that the system can effectively promote fibroblast proliferation, angiogenesis and collagen deposition with remarkable wound healing efficiency. This strategy offers a novel design concept for creating a new generation of PTT and opens the way for the creation of alternative antibiotics.