bluuebunny/crossref_metadata_2025 huggingface dataset:
Differentiation of multiple brain metastases and glioblastoma with multiple foci using MRI criteria
Authors: Müller Sebastian Johannes , Khadhraoui Eya , Ernst Marielle , Rohde Veit , Schatlo Bawarjan , Malinova Vesna
Published: January 2024

Objective

Glioblastoma with multiple foci (mGBM) and multiple brain metastases share several common features on magnetic resonance imaging (MRI). A reliable preoperative diagnosis would be of clinical relevance. The aim of this study was to explore the differences and similarities between mGBM and multiple brain metastases on MRI.

Methods

We performed a retrospective analysis of 50 patients with mGBM and compared them with a cohort of 50 patients with multiple brain metastases (2–10 lesions) histologically confirmed and treated at our department between 2015 and 2020. The following imaging characteristics were analyzed: lesion location, distribution, morphology, (T2-/FLAIR-weighted) connections between the lesions, patterns of contrast agent uptake, apparent diffusion coefficient (ADC)-values within the lesion, the surrounding T2-hyperintensity, and edema distribution.

Results

A total of 210 brain metastases and 181 mGBM lesions were analyzed. An infratentorial localization was found significantly more often in patients with multiple brain metastases compared to mGBM patients (28 vs. 1.5%, p < 0.001). A T2-connection between the lesions was detected in 63% of mGBM lesions compared to 1% of brain metastases. Cortical edema was only present in mGBM. Perifocal edema with larger areas of diffusion restriction was detected in 31% of mGBM patients, but not in patients with metastases.

Conclusion

We identified a set of imaging features which improve preoperative diagnosis. The presence of T2-weighted imaging hyperintensity connection between the lesions and cortical edema with varying ADC-values was typical for mGBM.
Efficacy of differential reinforcement of other behaviors therapy for tic disorder: a meta-analysis
Authors: Mohamed Zakaria Ahmed , Xue Yang , Bai Miaoshui , Dong Hanyu , Jia Feiyong
Published: January 2024

Introduction

Recently, studies on behavioral tic suppression techniques have gained popularity as opposed to pharmacological alternatives that often have potentially dangerous side effects. Differential Reinforcement of Other Behaviors therapy (DRO) is one such behavioral technique whose efficacy in tic suppression has been experimentally demonstrated albeit in studies with very few patients, and lacking statistical power. Here, we conducted a meta-analysis of these studies to improve their overall power and explore whether DRO intervention is really effective for tic suppression.

Materials and methods

PubMed, Embase, PsycINFO, and Cochrane Library were searched from inception to August 30, 2023. Only original interventional studies that examined the efficacy of DRO for tic suppression were included.

Results

A total of 8 no control interventional studies involving 79 children with tic disorders were recruited. Most of the children had moderate tic severity. The pooled mean Yale Global Tic Severity Scale (YGTSS) score was 24.64 (95% CI: 21.99 – 30.12, p =  < 0.00001, I2 = 87%). In terms of efficacy of the DRO technique for tic suppression, the results showed that DRO was effective in reducing tic frequency among the children. The pooled standardized mean difference (SMD) was -10.25 (95% CI: -14.71 – -5.79, p =  < 0.00001) with I2 = 94%.

Conclusion

In conclusion, this study revealed that DRO is potentially an effective tic suppression technique for temporarily managing tic disorder. It also showed that DRO could be employed for both moderate and severe tic disorders. However, the technique bears crucial limitations that limit its implementation outside of experimental settings. More studies are needed to address these limitations and improve its applicability in the real world.
Proficiency testing of diagnosis in histopathology and immunohistochemistry of breast pathology in China: results from a pilot work of National Single Disease Quality Control Program for breast cancer
Authors: Xue Xuemin , Guo Lei , Guo Changyuan , Li Lin , Yang Lin , Wang Xin , Rao Wei , Yuan Pei , Mu Jiali , Li Jiangtao , Wang Bingning , Zhou Quan , Yang Wentao , Liu Yueping , Xue Weicheng , Jia Rujing , Yang Wenjing , Ying Jianming
Published: January 2024

Aim

Pathologists are currently supposed to be aware of both domestic and international guidelines for breast cancer diagnosis, but it is unclear how successfully these guidelines have been integrated into routine clinical practice in China. Thus, this national proficiency testing (PT) scheme for breast pathology was set up to conduct a baseline assessment of the diagnostic capability of pathologists in China.

Methods

This national PT plan is designed and implemented according to the “Conformity assessment—General requirements for proficiency testing” (GB/T27043—2012/ISO/IEC 17043:2010). Five cases of breast cancer with six key items, including histologic type, grade, ER, PR, HER2, and Ki67, were selected for testing among 96 participants. The final PT results were published on the website of the National Quality Control Center for Cancer (http://117.133.40.88:3927/cn/col22/362).

Results

Our study demonstrated that the median PT score was 89.5 (54–100). Two institutions with scores < 67 were deemed unacceptable. The accuracy of histologic type, ER, PR, HER2, and Ki67 was satisfactory (all > 86%). However, the histologic grade showed low accuracy (74.0%). The unacceptable results mainly included incorrect evaluation of histologic grade (36.7%), inaccurate evaluation of ER/PR/HER2/Ki67 (28.2%), incorrect identification of C-AD as IBC-NST (15.7%), inappropriate use of 1+/2+/3+ rather than staining percentage for ER/PR (6.1%), misclassification of ER/PR < 1% weak expression as positive staining (1.4%), and no evaluation of histologic grade in ILC, MC, and IMC (5.8%).

Conclusions

our nationwide PT program exhibited a satisfactory baseline assessment of the diagnostic capability of pathologists in China. More importantly, we identify some areas for further improvement.
Bone reconstruction with modified Masquelet technique in open distal femoral fractures: a case series
Authors: Kalantar Seyed Hadi , Saffar Hana , Hoveidaei Amir Human
Published: January 2024

Background

Large bone defects require complex treatment, multidisciplinary resources, and expert input, with surgical procedures ranging from reconstruction and salvage to amputation. The aim of this study was to provide the results of a case series of open comminuted intra-articular distal femoral fractures with significant bone loss that were managed by early fixation using anatomical plates and a modified Masquelet technique with the addition of surgical propylene mesh.

Methods

This retrospective study included all patients referred to our institution with OTA/AO C3 distal femur open fractures and meta-diaphyseal large bone loss between April 2019 and February 2021. We treated the fractures with irrigation and debridement, acute primary screw and plate fixation in the second look operation, and Masquelet method using shell-shaped antibiotic beads supplemented by propylene surgical mesh to keep the cements in place. The second step of the procedure was conducted six to eight weeks later with bone grafting and mesh augmentation to contain bone grafts. Surprisingly, hard callus formation was observed in all patients at the time of the second stage of Masquelet procedure.

Results

All five patients’ articular and meta-diaphyseal fractures with bone loss healed without major complications. The average union time was 159 days. The mean knee range of motion was 5–95 degrees. The average Lower Extremity Functional Score (LEFS) was 49 out of 80.

Conclusions

Combination of early plate fixation and the modified Masquelet technique with polypropylene mesh is an effective method for managing large bone defects in open intra-articular distal femoral fractures with bone loss, resulting in shorter union time possibly associated with the callus formation process. This technique may also be applicable to the management of other similar fractures specially in low-income and developing areas.
Factors associated with pain and functional impairment five years after total knee arthroplasty: a prospective observational study
Authors: Olsen Unni , Sellevold Vibeke Bull , Gay Caryl L. , Aamodt Arild , Lerdal Anners , Hagen Milada , Dihle Alfhild , Lindberg Maren Falch
Published: January 2024

Background

Few studies have evaluated the associations between preoperative factors and pain and physical function outcomes after total knee arthroplasty (TKA) from a mid-term perspective. Identification of such factors is important for optimizing outcomes following surgery. Thus, we examined the associations between selected preoperative factors and moderate to severe pain and pain-related functional impairment as measured using the Brief Pain Inventory (BPI), five years after TKA in patients with knee osteoarthritis.

Methods

In this prospective observational study, all patients scheduled for primary unilateral TKA for osteoarthritis were consecutively recruited. Preoperative factors identified from previous meta-analyses were included to assess their associations with pain severity and pain-related functional impairment five years after TKA. Pain severity was the primary outcome, while pain-related functional impairment was the secondary outcome. The BPI was used to evaluate outcomes five years post-TKA. Statistically significant factors from univariate regressions were entered into a multiple logistic regression model to identify those with the strongest associations with pain severity or pain-related functional impairment five years after TKA.

Results

A total of 136 patients were included, with a mean age of 67.7 years (SD 9.2) and a majority being female (68%). More severe preoperative pain (OR = 1.34, 95% CI [1.03 to 1.74]), more painful sites (OR = 1.28., 95% CI [1.01 to 1.63]), and more severe anxiety symptoms (OR = 1.14., 95% CI [1.01 to 1.28]) were associated with increased likelihood of moderate to severe pain five years after TKA surgery, while more severe osteoarthritis (OR = 0.13, 95% CI [0.03 to 0.61]) was associated with reduced likelihood of moderate to severe pain five years after TKA. More severe anxiety symptoms (OR = 1.25, 95% CI [1.08 to 1.46]) were also associated with increased likelihood of moderate to severe pain-related functional impairment five years after surgery, while male sex (OR = 0.23, 95% CI [0.05 to 0.98]) was associated with reduced likelihood of pain-related functional impairment five years after surgery.

Conclusion

The identified preoperative factors should be included in larger prognostic studies evaluating the associations between preoperative factors and mid-term pain severity and physical function outcomes after TKA surgery.
Laparoscopic orchidopexy for the treatment of cryptorchidism in adults: a description of the technique and outcomes
Authors: Han Hu , Li Jiaxing , Lei Hong-en , Yin Hang , Tian Long
Published: January 2024

Background

There are few studies on cryptorchidism in adults, and its treatment is still controversial.

Methods

To summarize the surgical strategy and clinical efficacy of laparoscopic orchidopexy for the treatment of cryptorchidism in adults, 37 adult cryptorchidism patients were retrospectively analyzed between September 2017 and February 2022. All 37 patients underwent laparoscopic orchidopexy, of whom 33 underwent inguinal hernia repair without tension. The intraoperative procedures and surgical techniques were recorded in detail. Preoperative examination and regular postoperative review of color Doppler ultrasound, and reproductive hormone, alpha-fetoprotein, human chorionic gonadotropin, and lactate dehydrogenase levels were performed.

Results

All testes descended successfully into the scrotum, including 25 through the inguinal route and 12 through Hesselbach’s triangle route. No intraoperative or postoperative complications were observed. The follow-up time was 38.6 (± 19.4) months, and no evidence of testicular malignancy was found during the follow-up period. After analyzing the reproductive hormone levels at 1 year postoperatively in 28 patients with more than 1 year of follow-up, it was found that the patients had a significant increase in testosterone levels and a decrease in follicle-stimulating hormone levels after surgery. None of the patients showed any significant improvement in semen quality after surgery.

Conclusion

Our study suggests that laparoscopic orchidopexy is a safe and feasible surgical procedure for the treatment of cryptorchidism in adults, especially high cryptorchidism, which is difficult to treat. After comprehensive consideration, preserving the testis should be preferred for treating cryptorchidism in adults to maximize the protection of the patient’s reproductive hormone secretion function.
Structure based docking and biological evaluation towards exploring potential anti-cancerous and apoptotic activity of 6-Gingerol against human prostate carcinoma cells
Authors: Khan Habiba , Azad Iqbal , Arif Zeeshan , Parveen Shama , Kumar Saurabh , Rais Juhi , Ansari Jamal Akhtar , Nasibullah Malik , Kumar Sudhir , Arshad Md
Published: January 2024

Background

6-Gingerol (6-G) is the primary active phytocomponent of ginger and has been shown to regulate multiple targets against cancer and its treatment. Androgen receptors (ARs) remain critical in the progression of prostate cancer (PCa). This study focuses on investigating 6-G as a promising anti-cancerous agent that inhibits AR activity significantly.

Methods

In this study, molecular docking simulation was done to investigate the binding affinity of 6-G and control drug Bicalutamide (BT) against oncogenic AR and tumor suppressor estrogen receptor β (ERβ). The crystal structure of AR and ERβ was retrieved from Protein Data Bank (PDB) and docked with 3D Pubchem structures of 6-G using iGEMDOCK and AutoDock. Further in vitro study was done to evaluate the antioxidant, anti-cancerous, apoptotic, and wound healing potential of 6-G.

Results

The result displays that 6-G shows good binding affinity with AR and ERβ. Condensation of the nucleus, change in mitochondrial membrane potential (MMP) and the ability to induce reactive oxygen species (ROS) were done in human PCa PC-3 cells. Results from the MTT assay demonstrated that 6-G and control drug BT showed significant (p < 0.01) dose and time dependent inhibition of human PCa PC-3 cells. 6-G increased the ROS generation intracellularly and decreased the MMP, and cell migration in treated PCa PC-3 cells. 6-G treated cells showed fragmented, condensed chromatin and nuclear apoptotic bodies.

Conclusions

Thus, this study validates 6-G as a potential drug candidate against human PCa. However, further study of the anticancer potency of 6-G has to be done before its use for PCa treatment.
Exploring the care experiences of hemodialysis nurses: from the cultural sensitivity approach
Authors: Jui-Chin Hsu , Fen-Fang Chung , Tso-Ying Lee , Pao-Yu Wang , Mei-Hsiang Lin
Published: January 2024

Background

Culturally sensitive care has been identified as a best-practice approach for improving health outcomes. Hemodialysis patients require culturally sensitive care because it involves totally changing their previous life. The purpose of this study was to explore the subjective experiences of hemodialysis nurses in providing culturally sensitive care to hemodialysis patients.

Methods

A qualitative study was carried out in the hemodialysis center of a teaching hospital in northern Taiwan. Purposive sampling and semi-structured interview guidelines were employed to interview 23 hemodialysis nurses. The interviews were recorded and transcribed verbatim, and the resulting data were analyzed and summarized using content analysis by constant comparative methods.

Results

Hemodialysis nurses exhibited the characteristics for delivering culturally sensitive care, which comprised five aspects: finding the true meaning of the behavior of the participants, recognizing and honoring individual psychological states, culturally sensitive communication in line with patients’ values, customizing care content through cultural transformation strategies, and empowerment rather than prohibition.

Conclusions

The findings of this study on the culturally sensitive care provided by hemodialysis nurses can be utilized by nursing educators and administrators as a reference to develop and enhance the nursing education related to culturally sensitive care for hemodialysis professionals.
The role of psychosocial well-being and emotion-driven impulsiveness in food choices of European adolescents
Authors: Do Stefanie , Didelez Vanessa , Börnhorst Claudia , Coumans Juul M.J. , Reisch Lucia A. , Danner Unna N. , Russo Paola , Veidebaum Toomas , Tornaritis Michael , Molnár Dénes , Hunsberger Monica , De Henauw Stefaan , Moreno Luis A. , Ahrens Wolfgang , Hebestreit Antje ,   on behalf of the IDEFICS/I.Family consortia
Published: January 2024

Background

It is unclear whether a hypothetical intervention targeting either psychosocial well-being or emotion-driven impulsiveness is more effective in reducing unhealthy food choices. Therefore, we aimed to compare the (separate) causal effects of psychosocial well-being and emotion-driven impulsiveness on European adolescents’ sweet and fat propensity.

Methods

We included 2,065 participants of the IDEFICS/I.Family cohort (mean age: 13.4) providing self-reported data on sweet propensity (score range: 0 to 68.4), fat propensity (range: 0 to 72.6), emotion-driven impulsiveness using the UPPS-P negative urgency subscale, and psychosocial well-being using the KINDLR Questionnaire. We estimated, separately, the average causal effects of psychosocial well-being and emotion-driven impulsiveness on sweet and fat propensity applying a semi-parametric doubly robust method (targeted maximum likelihood estimation). Further, we investigated a potential indirect effect of psychosocial well-being on sweet and fat propensity mediated via emotion-driven impulsiveness using a causal mediation analysis.

Results

If all adolescents, hypothetically, had high levels of psychosocial well-being, compared to low levels, we estimated a decrease in average sweet propensity by 1.43 [95%-confidence interval: 0.25 to 2.61]. A smaller effect was estimated for fat propensity. Similarly, if all adolescents had high levels of emotion-driven impulsiveness, compared to low levels, average sweet propensity would be decreased by 2.07 [0.87 to 3.26] and average fat propensity by 1.85 [0.81 to 2.88]. The indirect effect of psychosocial well-being via emotion-driven impulsiveness was 0.61 [0.24 to 1.09] for average sweet propensity and 0.55 [0.13 to 0.86] for average fat propensity.

Conclusions

An intervention targeting emotion-driven impulsiveness, compared to psychosocial well-being, would be marginally more effective in reducing sweet and fat propensity in adolescents.
Towards a standardized program of transitional care for adolescents with juvenile idiopathic arthritis for Turkey: a national survey study
Authors: Sözeri Betül , Şahin Nihal , Açarı Ceyhun , Avar Aydın Pinar Ozge , Baba Ozge , Bağlan Esra , Bakkaloğlu Sevcan , Bakırcı Sibel , Bilginer Yelda , Bozkaya Burcu Yücel , Çağlayan Şengül , Çakan Mustafa , Çakmak Figen , Coşkuner Taner , Demir Ferhat , Demirkan Fatma Gül , Doğantan Şeyda , Adıgüzel Dündar Hatice , Ersözlü Emine Duygu , Gücenmez Sercan , Gürler Oğuz , İşgüder Rana , Küçük Adem , Kalyoncu Mukaddes , Kılıç Levent , Kılıç Sara Şebnem , Kısaoğlu Hakan , Paç Kısaarslan Ayşenur , Kızıldağ Zehra , Kurtuluş Duygu , Özdel Semanur , Öztürk Kübra , Şenol Pelin , Tanatar Ayşe , Taşkın Sema Nur , Tuncer Kuru Fatma , Türkuçar Serkan , Ulu Kadir , Ünsal Erbil , Yazıcı Ayten , Gezgin Yıldırım Deniz , Yüksel Selçuk , Kasapçopur Özgür , Özen Seza , Aktay Ayaz Nuray , Sönmez Hafize Emine
Published: January 2024

Background

Juvenile idiopathic arthritis (JIA) is a prevalent childhood chronic arthritis, often persisting into adulthood. Effective transitional care becomes crucial as these patients transition from pediatric to adult healthcare systems. Despite the concept of transitional care being recognized, its real-world implementation remains inadequately explored. This study aims to evaluate the thoughts and practices of healthcare providers regarding transitional care for JIA patients.

Methods

A cross-sectional survey was conducted among pediatric and adult rheumatologists in Turkey. Based on the American Academy of Pediatrics’ six core elements of transitional care, the survey included 86 questions. The respondents’ demographic data, attitudes towards transitional care, and practical implementation were assessed.

Results

The survey included 48 rheumatologists, with 43.7% having a transition clinic. The main barriers to establishing transition programs were the absence of adult rheumatologists, lack of time, and financial constraints. Only 23.8% had a multidisciplinary team for transition care. Participants agreed on the importance of coordination and cooperation between pediatric and adult healthcare services. The timing of the transition process varied, with no consensus on when to initiate or complete it. Participants advocated for validated questionnaires adapted to local conditions to assess transition readiness.

Conclusions

The study sheds light on the challenges and perspectives surrounding transitional care for JIA patients in Turkey. Despite recognized needs and intentions, practical implementation remains limited due to various barriers. Cultural factors and resource constraints affect the transition process. While acknowledging the existing shortcomings, the research serves as a ground for further efforts to improve transitional care and ensure better outcomes for JIA patients transitioning into adulthood.
An aging-related immune landscape in the hematopoietic immune system
Authors: Lv Jianjie , Zhang Chun , Liu Xiuxing , Gu Chenyang , Liu Yidan , Gao Yuehan , Huang Zhaohao , Jiang Qi , Chen Binyao , He Daquan , Wang Tianfu , Xu Zhuping , Su Wenru
Published: January 2024

Background

Aging is a holistic change that has a major impact on the immune system, and immunosenescence contributes to the overall progression of aging. The bone marrow is the most important hematopoietic immune organ, while the spleen, as the most important extramedullary hematopoietic immune organ, maintains homeostasis of the human hematopoietic immune system (HIS) in cooperation with the bone marrow. However, the overall changes in the HIS during aging have not been described. Here, we describe a hematopoietic immune map of the spleen and bone marrow of young and old mice using single-cell sequencing and flow cytometry techniques.

Results

We observed extensive, complex changes in the HIS during aging. Compared with young mice, the immune cells of aged mice showed a marked tendency toward myeloid differentiation, with the neutrophil population accounting for a significant proportion of this response. In this change, hypoxia-inducible factor 1-alpha (Hif1α) was significantly overexpressed, and this enhanced the immune efficacy and inflammatory response of neutrophils. Our research revealed that during the aging process, hematopoietic stem cells undergo significant changes in function and composition, and their polymorphism and differentiation abilities are downregulated. Moreover, we found that the highly responsive CD62L + HSCs were obviously downregulated in aging, suggesting that they may play an important role in the aging process.

Conclusions

Overall, aging extensively alters the cellular composition and function of the HIS. These findings could potentially give high-dimensional insights and enable more accurate functional and developmental analyses as well as immune monitoring in HIS aging.
Inequalities in unmet health care needs under universal health insurance coverage in China
Authors: Wu Jingxian , Yang Yongmei , Sun Ting , He Sucen
Published: January 2024

Background

Expanding health insurance is a critical step towards universal health coverage due to its positive effect on reducing unmet health care needs and enhancing equitable access to health care. Despite previous studies on the socioeconomic factors associated with unmet health care needs, few studies have analysed the inequalities in such needs and the impact of universal health insurance coverage on addressing them. This study aimed to measure the contribution of social health insurance (SHI) coverage to inequalities in financially and non-financially constrained unmet health care needs among middle-aged and elderly Chinese adults.

Methods

The study data were obtained from the China Health and Retirement Longitudinal Study (2011–2015). A total of 11,592 respondents reporting outpatient care needs and 6320 reporting inpatient care needs were included. The concentration index (CI) was employed to measure the extent of income-related inequalities in unmet health care needs. A decomposition method based on a probit model was used to investigate the contribution of SHI to the inequalities.

Results

The incidence rates of unmet outpatient needs due to financial and non-financial constraints were 4.68% and 24.78%, respectively; these rates were 18.69% and 15.73% for unmet inpatient needs. The CIs of unmet outpatient needs due to financial and non-financial constraints were − 0.1872 and 0.0195, respectively; these values were − 0.1558 and 0.0352 for unmet inpatient needs. The percentages of the contribution of SHI to the CIs of financially constrained unmet outpatient and inpatient needs were 0.2639% and 1.8898%, respectively. Moreover, the percentages of the contribution of SHI to the CIs of non-financially constrained unmet outpatient and inpatient needs were − 0.4513% and − 6.4192%, respectively.

Conclusion

The universal coverage of SHI in China increased pro-poor inequalities in financially constrained unmet health care needs but decreased pro-rich inequalities in non-financially constrained unmet needs. Additionally, the contribution of SHI to inequalities in financially constrained unmet needs for inpatient care was stronger than that for outpatient care. Policy-makers are advised to introduce favourable reimbursement policies for patients with poor socioeconomic conditions and address both financial and non-financial barriers to promote equitable access to health care for the entire population.
Weight stigma in healthcare settings: the experience of Arab and Jewish bariatric surgery candidates in Israel
Authors: Zahra-Zeitoun Yara , Elran-Barak Roni , Salameh-Dakwar Rawan , Froylich Dvir , Sroka Gideon , Assalia Ahmed , Latzer Yael
Published: January 2024

Background

Weight-related stigma and discrimination are prevalent in our society with adverse biopsychosocial outcomes to people with obesity and morbid obesity. Studies suggest that weight bias in healthcare settings are quite prevalent, but there have been, as far as we know, lack of studies examining prevalence and correlates of weight bias experiences among bariatric surgery candidates in Israel. We aim to understand the nature and prevalence of weight stigma among bariatric surgery candidates. To identify differences between Jewish and Arab candidates. To examine the impact of weight stigma experiences on weight bias internalization (WBI).

Methods

A cross-sectional study was performed among 117 adult bariatric surgery candidates from three hospitals in northern Israel (47.8% Jews, 82.4% females, average BMI 42.4 ± 5.2 Kg/meter2). Patients who agreed to participate completed a structured questionnaire on the same day that the bariatric surgery committee met. WBI was measured using a validated 10-item scale. Experiences of weight stigma were measured using items adapted from prior international studies.

Results

About two thirds of the participants had at least one experience of weight stigma (teased, treated unfairly, or discriminated against because of their weight). As many as 75% of participants reported that weight served as a barrier to getting appropriate health care and as many as half of participants felt in the last year that a doctor judged them because of their weight. No significant differences were found between Arabs and Jews in the prevalence of weight stigma experiences and WBI. However, a trend towards more stigma experiences among Jews was noted. WBI was predicted by female gender and experiences of weight stigma, both in general and within healthcare settings.

Conclusions

Weight stigma towards bariatric surgery candidates in Israel is quite prevalent, and specifically in healthcare settings. It is important to adopt policy actions and intervention programs to improve awareness to this phenomenon among the general public and specifically among healthcare providers, as many healthcare providers may be unaware of the adverse effect of weight stigma and of ways in which they are contributing to the problem. Future studies may validate our findings using larger sample size and longitudinal design.
Strategies for enhancing the representation of women in clinical trials: an evidence map
Authors: Goldstein Karen M. , Kung Lindsay Chi Yan , Dailey Susan Alton , Kroll-Desrosiers Aimee , Burke Colleen , Shepherd-Banigan Megan , Lumsden Rebecca , Sims Catherine , Schexnayder Julie , Patel Dhara , Cantrell Sarah , Sheahan Kate L. , Gierisch Jennifer M.
Published: January 2024

Background

Equitable sex- and gender-based representation in clinical trials is an essential step to ensuring evidence-based care for women. While multi-institutional actions have led to significant improvements in the inclusion of women in trials, inequity persists in areas like sex-neutral cancers and cardiovascular disease. We sought to identify strategies described or evaluated to boost the inclusion of women in clinical trials.

Methods

We used evidence mapping methodology to examine the breadth of relevant literature. We developed an a priori protocol and followed reporting guidance from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis where applicable. We searched MEDLINE® (via PubMed) and EMBASE (via Elsevier) databases from inception through April 4, 2023, and used standardized procedures incorporating duplication and data verification. We included articles that described strategies to improve the recruitment and retention of women in clinical trials.

Results

We identified 122 articles describing recruitment and retention strategies for 136 trials (377,595 women). Only one article distinguished between the sex and gender identity of participants, and none defined their use of the terms such as “women” or “female”. The majority of articles (95%) described recruitment for only women, and 64% were conducted in the USA. Ninety-two articles (75%) described strategies in the context of sex-specific conditions (e.g., gynecologic diagnosis). The majority of included articles evaluated a behavioral intervention (52%), with 23% evaluating pharmacologic interventions and 4% invasive interventions. The most common trial phase for reported strategies was during outreach to potential participants (116 articles), followed by intervention delivery (76), enrollment (40), outcomes assessment (21), analysis and interpretation (3), and dissemination (4). We describe specific types of strategies within each of these phases.

Conclusions

Most of the existing literature describing strategies to improve the inclusion of women draws from trials for sex-specific conditions and is largely related to outreach to potential participants. There is little information about how and if studies have attempted to proportionally increase the inclusion of women in trials with both men and women or those focused on invasive and pharmacologic interventions. Future work in this area should focus on how to increase the participation of women in mixed-sex studies and on those areas with remaining inequities in trial participation.
Time series forecasting model for non-stationary series pattern extraction using deep learning and GARCH modeling
Authors: Han Huimin , Liu Zehua , Barrios Barrios Mauricio , Li Jiuhao , Zeng Zhixiong , Sarhan Nadia , Awwad Emad Mahrous
Published: January 2024

This paper presents a novel approach to time series forecasting, an area of significant importance across diverse fields such as finance, meteorology, and industrial production. Time series data, characterized by its complexity involving trends, cyclicality, and random fluctuations, necessitates sophisticated methods for accurate forecasting. Traditional forecasting methods, while valuable, often struggle with the non-linear and non-stationary nature of time series data. To address this challenge, we propose an innovative model that combines signal decomposition and deep learning techniques. Our model employs Generalized Autoregressive Conditional Heteroskedasticity (GARCH) for learning the volatility in time series changes, followed by Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) for data decomposition, significantly simplifying data complexity. We then apply Graph Convolutional Networks (GCN) to effectively learn the features of the decomposed data. The integration of these advanced techniques enables our model to fully capture and analyze the intricate features of time series data at various interval lengths. We have evaluated our model on multiple typical time-series datasets, demonstrating its enhanced predictive accuracy and stability compared to traditional methods. This research not only contributes to the field of time series forecasting but also opens avenues for the application of hybrid models in big data analysis, particularly in understanding and predicting the evolution of complex systems.
Metabolomic analysis of the serum and urine of rats exposed to diazinon, dimethoate, and cypermethrin alone or in combination
Authors: Liang Yu-Jie , Long Ding-Xin , Wang Shanshan , Wang Hui-Ping , Wu Yi-Jun
Published: January 2024

Background

Multiple pesticides are often used in combination for plant protection and public health. Therefore, it is important to analyze the physiological changes induced by multiple pesticides exposure. The objective of this study was to investigate the combined toxicity of the widely-used organophosphorus and pyrethroid pesticides diazinon, dimethoate, and cypermethrin.

Methods

Male Wistar rats were administrated by gavage once daily with the three pesticides individual or in combination for consecutive 28 days. The metabolic components of serum and urine samples were detected by using 1H nuclear magnetic resonance (NMR)-based metabolomics method. Histopathological examination of liver and kidneys and serum biochemical determination were also carried out.

Results

The results showed that after the 28-day subacute exposure, serum glutamic transaminase and albumin were significantly increased and blood urea nitrogen was significantly decreased in the rats exposed to the mixture of the pesticides compared with the control rats, suggesting that the co-exposure impaired liver and kidney function. Metabolomics analysis indicated that the indicators 14 metabolites were statistically significant altered in the rats after the exposure of the pesticides. The increase in 3-hydroxybutyric acid in urine or decrease of lactate and N-acetyl-L-cysteine in serum could be a potentially sensitive biomarker of the subchronic combined effects of the three insecticides. The reduction level of 2-oxoglutarate and creatinine in urine may be indicative of dysfunction of liver and kidneys.

Conclusion

In summary, the exposure of rats to pesticides diazinon, dimethoate, and cypermethrin could cause disorder of lipid and amino acid metabolism, induction of oxidative stress, and dysfunction of liver and kidneys, which contributes to the understanding of combined toxic effects of the pesticides revealed by using the metabolomics analysis of the urine and serum profiles.
Genetic prediction of antihyperglycemic drug targets and risk of epilepsy: a mendelian randomisation study
Authors: Zhou Kaiping , Yang Huan , Xie Zhihao , Wang Weiping , Qu Zhenzhen
Published: January 2024

A connection between diabetes and an increased risk of epilepsy has been suggested by observational studies. Animal studies have also shown that antihyperglycemic drugs can improve seizures. However, it is unclear whether antihyperglycemic drugs have a causal role in epilepsy in humans. To investigate this potential causal relationship, a Mendelian randomisation study was conducted using International League Against Epilepsy data as the discovery set and FinnGen data as the replication set. It was discovered that three antidiabetic drug target genes, ETFDH, CYP21A2 and CYP2D6, were involved in the occurrence of epilepsy. In particular, ETFDH was identified as a target gene in both the discovery set (inverse variance weighting [IVW], odds ratio [OR] = 1.018, 95% confidence interval [CI], 1.004–1.033, p = 0.009) and replication set (IVW, OR = 1.074, 95% CI, 1.034–1.114, p = 0.00016), and CYP21A2 was identified in the discovery set (IVW, OR = 1.029, 95% CI, 1.005–1.053, p = 0.016) and replication set (IVW, OR = 1.057, 95% CI, 1.001–1.116, p = 0.045) as having a causal association with an increased risk of epilepsy. Conversely, the CYP2D6 gene was found to be a protective factor for epilepsy in both the discovery set (IVW, OR = 0.0984, 95% CI, 0.969–0.998, p = 0.025) and replication set (IVW, OR = 0.977, 95% CI, 0.955–1.000, p = 0.046). A search of DrugBank revealed that metformin, an anti-glucose drug, is an inhibitor of the ETFDH gene and may have a potential therapeutic effect on epilepsy.
Instance segmentation on distributed deep learning big data cluster
Authors: Elhmadany Mohammed , Elmadah Islam , Abdelmunim Hossam E.
Published: January 2024

Distributed deep learning is a promising approach for training and deploying large and complex deep learning models. This paper presents a comprehensive workflow for deploying and optimizing the YOLACT instance segmentation model as on big data clusters. OpenVINO, a toolkit known for its high-speed data processing and ability to optimize deep learning models for deployment on a variety of devices, was used to optimize the YOLACT model. The model is then run on a big data cluster using BigDL, a distributed deep learning library for Apache Spark. BigDL provides a high-level programming interface for defining and training deep neural networks, making it suitable for large-scale deep learning applications. In distributed deep learning, input data is divided and distributed across multiple machines for parallel processing. This approach offers several advantages, including the ability to handle very large data that can be stored in a distributed manner, scalability to decrease processing time by increasing the number of workers, and fault tolerance. The proposed workflow was evaluated on virtual machines and Azure Databricks, a cloud-based platform for big data analytics. The results indicated that the workflow can scale to large datasets and deliver high performance on Azure Databricks. This study explores the benefits and challenges of using distributed deep learning on big data clusters for instance segmentation. Popular distributed deep learning frameworks are discussed, and BigDL is chosen. Overall, this study highlights the practicality of distributed deep learning for deploying and scaling sophisticated deep learning models on big data clusters.
Integration of onchocerciasis morbidity management and disability prevention services in the healthcare system in Tanzania: a call for action and recommendations
Authors: Mushi Vivian , Mmbando Bruno P. , Colebunders Robert
Published: January 2024

Onchocerciasis is among the Neglected Tropical Diseases (NTDs) responsible for dermatological, ophthalmological, and neurological manifestations. With the ongoing burden of onchocerciasis clinical manifestations, morbidity management, and disability prevention services are required to alleviate the suffering of the affected populations. Unfortunately, despite the ongoing transmission of onchocerciasis, morbidity management, and disability prevention services are limited in Tanzania. Therefore, this article highlights the concept of onchocerciasis morbidity management and disability prevention, along with the significance of its adoption in the healthcare system in Tanzania. We further provide recommendations on where and how to start.
Proposal of an innovative MCDA evaluation methodology: knowledge discovery through rank reversal, standard deviation, and relationship with stock return
Authors: Baydaş Mahmut , Elma Orhan Emre , Stević Željko
Published: January 2024

Financial performance analysis is of vital importance those involved in a business (e.g., shareholders, creditors, partners, and company managers). An accurate and appropriate performance measurement is critical for decision-makers to achieve efficient results. Integrated performance measurement, by its nature, consists of multiple criteria with different levels of importance. Multiple Criteria Decision Analysis (MCDA) methods have become increasingly popular for solving complex problems, especially over the last two decades. There are different evaluation methodologies in the literature for selecting the most appropriate one among over 200 MCDA methods. This study comprehensively analyzed 41 companies traded on the Borsa Istanbul Corporate Governance Index for 10 quarters using SWARA, CRITIC, and SD integrated with eight different MCDA method algorithms to determine the position of Turkey's most transparent companies in terms of financial performance. In this study, we propose "stock returns" as a benchmark in comparing and evaluating MCDA methods. Moreover, we calculate the "rank reversal performance of MCDA methods". Finally, we performed a "standard deviation" analysis to identify the objective and characteristic trends for each method. Interestingly, all these innovative comparison procedures suggest that PROMETHEE II (preference ranking organization method for enrichment of evaluations II) and FUCA (Faire Un Choix Adéquat) are the most suitable MCDA methods. In other words, these methods produce a higher correlation with share price; they have fewer rank reversal problems, the distribution of scores they produce is wider, and the amount of information is higher. Thus, it can be said that these advantages make them preferable. The results show that this innovative methodological procedure based on 'knowledge discovery' is verifiable, robust and efficient when choosing the MCDA method.
Characterizing extreme drought and wetness in Guangdong, China using global navigation satellite system and precipitation data
Authors: Zhu Hai , Chen Kejie , Chai Haishan , Ye Yuanbin , Liu Wenjian
Published: January 2024

As global temperature rises, the frequency of extreme climate events, e.g., severe droughts and floods, has increased significantly and caused severe damage over the past years. To this regard, precipitation efficiency, a crucial meteorological parameter, could provide valuable insights for a better understanding of the patterns and characteristics of these extreme events. In this study, taking Guangdong province as an exemplary region, we first obtained long-term and high-resolution historical records of precipitation efficiency by integrating the observations from a dense network of Global Navigation Satellite System (GNSS) stations with precipitation data, and then characterized the extreme drought and wetness through climate indices. We found a distinct seasonal trend in precipitation efficiency in Guangdong, with annual fluctuations ranging from 10 to 25%. Notably, precipitation efficiency is higher in proximity to the Pearl River Delta Plain and gradually decreases towards the east and west. The occurrence of anomalous peaks and valleys in precipitation efficiency generally corresponds to dry and wet conditions, respectively. A total of 9 extreme wet events and 6 dry events occurred from January 2007 to May 2022, with durations from 3 to 6 months. Our results also demonstrated that both wet and dry frequencies exhibit an increasing trend with the expansion of the time scale, and the frequency of extreme events near the Pearl River Delta Plain surpasses that of other regions. Furthermore, the propagation time from meteorological anomalies to agricultural and hydrological anomalies is about 3 months. The periodic characteristics of meteorological anomalies are identified as the primary driver for other anomalous periodic patterns. Our work unveils the long-term dynamic behavior of precipitation efficiency, as well as the characteristics of extreme drought and wetness events in the regions characterized by intricate land–atmosphere interactions.
Temperature Differences Between Controlled Primary Hypothyroidism and Healthy Patients: An Exploratory Study
Authors: Romero-Ibarguengoitia Maria Elena , Garza-Silva Arnulfo , Rivera-Cavazos Andrea , Morales-Rodriguez Devany Paola , González-Peña Omar Israel , Barco-Flores Irene Antonieta , Manilla-Muñoz Edgar , Villarreal-Leal Enrique , González-Cantú Arnulfo
Published: January 2024

Introduction

Hypothyroidism is conventionally treated with replacement therapy through levothyroxine (LT4). Despite the improvement in symptoms, cold intolerance persists in some patients. The present study aims to determine whether there is a difference in temperature perception and skin temperature between patients with primary controlled hypothyroidism (PCH) and a group of healthy controls matched for body mass index and age. Secondarily we aimed to determine difference in quality of life.

Methodology

Skin temperature measurements were performed in both groups, both in the central and peripheral regions of the body. In addition, subjects were asked about their perception of temperature in a temperature-controlled room; anthropometric measurements were taken, their quality of life was assessed using the ThyPRO-39, and a thyroid hormone profile was performed.

Results

Eleven patients in the PCH group and 30 patients in the control group were studied. It was found that the group with PCH presented a significantly lower palmar temperature than the control group [mean (SD) of 32.05 (1.79) vs 33.10 (1.30) oC, P = .046]. A mediation model showed a direct effect. Temperature perception was equal between groups. The median (interquartile range) of ThyPRO was 8 (5.2) points in the control group vs 21.8 (13.5) in the group of controlled hypothyroidism, P < .001.

Discussion

These results suggest that, despite LT4 treatment, patients continue to present abnormalities in thermogenesis-related thermogenesis, and this may be due to a lack of hormonal adaptation to environmental changes and physiological demands, leading to lower body temperatures and increased sensitivity to cold.