bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparing exact eigenstates of the open XXZ chain on a quantum computer
Authors: Van Dyke John S , Barnes Edwin , Economou Sophia E , Nepomechie Rafael I
Published: December 2021

The open spin-1/2 XXZ spin chain with diagonal boundary magnetic fields is the paradigmatic example of a quantum integrable model with open boundary conditions. We formulate a quantum algorithm for preparing Bethe states of this model, corresponding to real solutions of the Bethe equations. The algorithm is probabilistic, with a success probability that decreases with the number of down spins. For a Bethe state of L spins with M down spins, which contains a total of

L

M

2

M

M
!

terms, the algorithm requires L + M
2 + 2M qubits.
Quantum optical analysis of squeezed state of light through dispersive non-Hermitian optical bilayers
Authors: Pilehvar Elnaz , Amooghorban Ehsan , Moravvej-Farshi Mohammad Kazem
Published: December 2021

We investigate the propagation of a normally incident squeezed coherent state of light through dispersive non-Hermitian optical bilayers, particularly at a frequency that the bilayers hold parity-time (𝒫𝒯) symmetry. To check the realization of 𝒫𝒯-symmetry in quantum optics, we reveal how dispersion and loss/gain-induced noises and thermal effects in such bilayers can affect quantum features of the incident light, such as squeezing and sub-Poissonian statistics. The numerical results show thermally induced noise at room temperature has an insignificant effect on the propagation properties in these non-Hermitian bilayers. Moreover, tuning the bilayers’ loss/gain strength, we show that the transmitted squeezed coherent states through the structure can retain to some extent their nonclassical characteristics, specifically for the frequencies far from the emission frequency of the gain layer. Furthermore, we demonstrate, only below a critical value of gain, quantum optical effective medium theory can correctly predict the propagation of quantized waves in non-Hermitian and 𝒫𝒯-symmetric bilayers.
BML: a versatile web server for bipartite motif discovery
Authors: Vahed Mohammad , Vahed Majid , Garmire Lana X
Published: December 2021

Motif discovery and characterization are important for gene regulation analysis. The lack of intuitive and integrative web servers impedes the effective use of motifs. Most motif discovery web tools are either not designed for non-expert users or lacking optimization steps when using default settings. Here we describe bipartite motifs learning (BML), a parameter-free web server that provides a user-friendly portal for online discovery and analysis of sequence motifs, using high-throughput sequencing data as the input. BML utilizes both position weight matrix and dinucleotide weight matrix, the latter of which enables the expression of the interdependencies of neighboring bases. With input parameters concerning the motifs are given, the BML achieves significantly higher accuracy than other available tools for motif finding. When no parameters are given by non-expert users, unlike other tools, BML employs a learning method to identify motifs automatically and achieve accuracy comparable to the scenario where the parameters are set. The BML web server is freely available at http://motif.t-ridership.com/ (https://github.com/Mohammad-Vahed/BML).
PRODeepSyn: predicting anticancer synergistic drug combinations by embedding cell lines with protein–protein interaction network
Authors: Wang Xiaowen , Zhu Hongming , Jiang Yizhi , Li Yulong , Tang Chen , Chen Xiaohan , Li Yunjie , Liu Qi , Liu Qin
Published: December 2021

Although drug combinations in cancer treatment appear to be a promising therapeutic strategy with respect to monotherapy, it is arduous to discover new synergistic drug combinations due to the combinatorial explosion. Deep learning technology holds immense promise for better prediction of in vitro synergistic drug combinations for certain cell lines. In methods applying such technology, omics data are widely adopted to construct cell line features. However, biological network data are rarely considered yet, which is worthy of in-depth study. In this study, we propose a novel deep learning method, termed PRODeepSyn, for predicting anticancer synergistic drug combinations. By leveraging the Graph Convolutional Network, PRODeepSyn integrates the protein–protein interaction (PPI) network with omics data to construct low-dimensional dense embeddings for cell lines. PRODeepSyn then builds a deep neural network with the Batch Normalization mechanism to predict synergy scores using the cell line embeddings and drug features. PRODeepSyn achieves the lowest root mean square error of 15.08 and the highest Pearson correlation coefficient of 0.75, outperforming two deep learning methods and four machine learning methods. On the classification task, PRODeepSyn achieves an area under the receiver operator characteristics curve of 0.90, an area under the precision–recall curve of 0.63 and a Cohen’s Kappa of 0.53. In the ablation study, we find that using the multi-omics data and the integrated PPI network’s information both can improve the prediction results. Additionally, the case study demonstrates the consistency between PRODeepSyn and previous studies.
scHFC: a hybrid fuzzy clustering method for single-cell RNA-seq data optimized by natural computation
Authors: Wang Jing , Xia Junfeng , Tan Dayu , Lin Rongxin , Su Yansen , Zheng Chun-Hou
Published: December 2021

Rapid development of single-cell RNA sequencing (scRNA-seq) technology has allowed researchers to explore biological phenomena at the cellular scale. Clustering is a crucial and helpful step for researchers to study the heterogeneity of cell. Although many clustering methods have been proposed, massive dropout events and the curse of dimensionality in scRNA-seq data make it still difficult to analysis because they reduce the accuracy of clustering methods, leading to misidentification of cell types. In this work, we propose the scHFC, which is a hybrid fuzzy clustering method optimized by natural computation based on Fuzzy C Mean (FCM) and Gath-Geva (GG) algorithms. Specifically, principal component analysis algorithm is utilized to reduce the dimensions of scRNA-seq data after it is preprocessed. Then, FCM algorithm optimized by simulated annealing algorithm and genetic algorithm is applied to cluster the data to output a membership matrix, which represents the initial clustering result and is taken as the input for GG algorithm to get the final clustering results. We also develop a cluster number estimation method called multi-index comprehensive estimation, which can estimate the cluster numbers well by combining four clustering effectiveness indexes. The performance of the scHFC method is evaluated on 17 scRNA-seq datasets, and compared with six state-of-the-art methods. Experimental results validate the better performance of our scHFC method in terms of clustering accuracy and stability of algorithm. In short, scHFC is an effective method to cluster cells for scRNA-seq data, and it presents great potential for downstream analysis of scRNA-seq data. The source code is available at https://github.com/WJ319/scHFC.
MetaLogo: a heterogeneity-aware sequence logo generator and aligner
Authors: Chen Yaowen , He Zhen , Men Yahui , Dong Guohua , Hu Shuofeng , Ying Xiaomin
Published: December 2021

Sequence logos are used to visually display conservations and variations in short sequences. They can indicate the fixed patterns or conserved motifs in a batch of DNA or protein sequences. However, most of the popular sequence logo generators are based on the assumption that all the input sequences are from the same homologous group, which will lead to an overlook of the heterogeneity among the sequences during the sequence logo making process. Heterogeneous groups of sequences may represent clades of different evolutionary origins, or genes families with different functions. Therefore, it is essential to divide the sequences into different phylogenetic or functional groups to reveal their specific sequence motifs and conservation patterns. To solve these problems, we developed MetaLogo, which can automatically cluster the input sequences after multiple sequence alignment and phylogenetic tree construction, and then output sequence logos for multiple groups and aligned them in one figure. User-defined grouping is also supported by MetaLogo to allow users to investigate functional motifs in a more delicate and dynamic perspective. MetaLogo can highlight both the homologous and nonhomologous sites among sequences. MetaLogo can also be used to annotate the evolutionary positions and gene functions of unknown sequences, together with their local sequence characteristics. We provide users a public MetaLogo web server (http://metalogo.omicsnet.org), a standalone Python package (https://github.com/labomics/MetaLogo), and also a built-in web server available for local deployment. Using MetaLogo, users can draw informative, customized and publishable sequence logos without any programming experience to present and investigate new knowledge on specific sequence sets.
The global prevalence of burnout among general practitioners: a systematic review and meta-analysis
Authors: Shen Xin , Xu Hongbin , Feng Jing , Ye Jun , Lu Zuxun , Gan Yong
Published: December 2021

Background

Burnout among general practitioners (GPs) has attracted the attention of more and more researchers. An adequate understanding the prevalence and related factors of burnout to prevent and reduce burnout is necessary. This study systematically measured the global prevalence of burnout among GPs.

Methods

Eligible original studies were identified from the PubMed, Ovid Embase, Ovid Medline (R), and Web of science databases. We searched the full-time period available for each database, up to 30 September 2021. The adjusted prevalence rate was estimated using a random-effects meta-analysis. The heterogeneity was evaluated using I2 statistic. Differences by study-level characteristics were estimated via subgroup analyses and meta-regression.

Results

A total of 16 cross-sectional studies with 7,595 participants were included. The pooled burnout rate showed 37%, 28%, and 26% of general GPs suffer from high emotional exhaustion (EE), high depersonalization (DP), and low personal exhaustion (PA), respectively. Groups comparisons found that high EE, high DP, and low PA rate data obtained from 2001 to 2009, high DP rate data obtained from Europe, low PA rate data obtained from high-quality studies had much higher rates.

Conclusions

This study demonstrated the prevalence of burnout in the GPs and alert health managers to tailor their strategies to retain this community. Targeted initiatives are needed to provide adequate GPs’ well-being and maintain primary health care.
Using system dynamics modelling to estimate the costs of relaxing health system constraints: a case study of tuberculosis prevention and control interventions in South Africa
Authors: Bozzani Fiammetta M , Diaconu Karin , Gomez Gabriela B , Karat Aaron S , Kielmann Karina , Grant Alison D , Vassall Anna
Published: December 2021

Health system constraints are increasingly recognized as an important addition to model-based analyses of disease control interventions, as they affect achievable impact and scale. Enabling activities implemented alongside interventions to relax constraints and reach the intended coverage may incur additional costs, which should be considered in priority setting decisions. We explore the use of group model building, a participatory system dynamics modelling technique, for eliciting information from key stakeholders on the constraints that apply to tuberculosis infection prevention and control processes within primary healthcare clinics in South Africa. This information was used to design feasible interventions, including the necessary enablers to relax existing constraints. Intervention and enabler costs were then calculated at two clinics in KwaZulu-Natal using input prices and quantities from the published literature and local suppliers. Among the proposed interventions, the most inexpensive was retrofitting buildings to improve ventilation (US$1644 per year), followed by maximizing the use of community sites for medication collection among stable patients on antiretroviral therapy (ART; US$3753) and introducing appointments systems to reduce crowding (US$9302). Enablers identified included enhanced staff training, supervision and patient engagement activities to support behaviour change and local ownership. Several of the enablers identified by the stakeholders, such as obtaining building permissions or improving information flow between levels of the health systems, were not amenable to costing. Despite this limitation, an approach to costing rooted in system dynamics modelling can be successfully applied in economic evaluations to more accurately estimate the ‘real world’ opportunity cost of intervention options. Further empirical research applying this approach to different intervention types (e.g. new preventive technologies or diagnostics) may identify interventions that are not cost-effective in specific contexts based on the size of the required investment in enablers.
Tensions in the communication of science advice on fish and fisheries: northern cod, species at risk, sustainable seafood
Authors: Hutchings Jeffrey A
Published: December 2021

Providing science-based advice can be challenging. Personal in its reflections, the story that follows asks throughout: What constitutes an appropriate model for the communication of science-based advice that best serves society? The first “front line,” in 1992, involved tenuous hypotheses on the collapse and recovery of Newfoundland's Northern cod (Gadus morhua), raising troubling questions about political influence on science-based advice and on its integrity. These questions subsequently motivated a critique written with two colleagues on the communication of science to decision-makers, provoking a telling invective from a government department in defence of the status quo. The story transitions to my 2000–2012 tenure as a member and then as chair of Canada's national body advising which species should be on the legally binding national at-risk register, illustrating how politically sensitive science-based advice can be objectively, effectively, and independently communicated, unfiltered by vested interests. Since 2009, I have served as independent science advisor on the sourcing of sustainable seafood to Canada's largest food retailer, providing a meaningful, impactful opportunity to advise their decision-makers. Science-based advice, free from political and advocacy-driven vested interests, is a requisite return for tax-supported investments in science. If provision of such advice is a “moral imperative,” as argued more than 60 years ago by C.P. Snow, then scientists are obliged to be the best advisors that we can be.
Partisanship in a Young Democracy: Evidence from Ghana
Authors: Stoecker Alexander
Published: December 2021

While past studies have put forward many reasons why partisanship in young African democracies should be considered weak, I show evidence that suggests the presence of strong and stable patterns of partisanship among ordinary citizens. Based on survey data from Ghana, I exploit the variation introduced by the close general elections of 2008 to compare perceptions and attitudes of party supporters when their preferred party is in power and when it is not in a Difference-in-differences setting. The results suggest that partisanship is both meaningful and prompts motivated reasoning among citizens. On the one hand, this can be seen as evidence for a stable party landscape and thus a more mature democracy, but on the other hand, partisan polarization may also obstruct effective governance. Furthermore, the analysis of attitudes towards democratic principles uncovers a double standard that carries the potential to negatively affect efforts towards the consolidation of democracy. A simple heterogeneity analysis indicates that improving education might reduce partisan polarization but will likely not erase it. The analysis further suggests that ethnic identities seem to exist alongside partisan identities, but still, strongly determine the strength of party attachment in Ghana. Future research on political behavior needs to acknowledge the presence of these partisan motives and continue to investigate the impact of partisanship on the further development of democratic institutions in African democracies.
Even employees are undertakings in the labour market, but granting social rights is not antitrust’s job
Authors: Maggiolino Mariateresa
Published: December 2021

The lively debate about the right of gig workers to bargain collectively stems from the idea that European Union (EU) competition law treats this group of workers worse than it treats employees. Namely, it is common to argue that employees, unlike gig workers, are permitted to conclude collective agreements because they are not undertakings and, therefore, not subject to EU competition law. In sharp contrast, by analysing the EU notion of undertaking, this article demonstrates—and this is the first of its theses—that in the labour market, which is the market that should matter in relation to the effects of collective agreements, employees are as much undertakings as any other worker, such as gig workers or other self-employed workers. The article further maintains that the reason employees are currently allowed to bargain collectively, while other workers are not, is to be found not within competition law, but outside it. At present, employees’ collective agreements are exempt from the application of EU competition law because employees enjoy the right to bargain collectively, among other social rights, and because the Court of Justice of the European Union has (rightly) recognized that the protection of these rights must trump the protection of competition. Consequently, this article argues, as its second thesis, that if Articles 151–161 TFEU were interpreted so as to grant social rights to workers other than employees, the collective agreements of gig workers and other under-protected self-employed workers would be exempt from EU competition law, as are those of employees. At the same time, however, this paper recognizes that, in the absence of such an interpretative turn, antitrust legislators and policy makers could aid gig workers and other under-protected self-employed workers by excluding them and their collective agreements from the scope of application of competition law. This—and here is the third thesis of the article—would not force the interpretation of antitrust notions and rules and would thus not require antitrust authorities and courts to use competition law to pursue goals different from the protection of efficiency and innovation.
Island = womb?—A corpus-based study on the island image in Mourning Becomes Electra
Authors: Zheng Fei , Cheng Yanqin
Published: December 2021

The island image is frequently seen in Eugene O’Neill’s plays. Based on a self-developed corpus, this paper explored the employment of the island image and its implication in the trilogy Mourning Becomes Electra. There are altogether three island-related words in the play: island(s) and isles. An analysis of these words in terms of the addresser, the addressee, and the dialogue situation, the lexical item showed that among all the thirty-nine occurrences of the island-words, nineteen appear in the dialogues involving Christine, the mother, and eighteen in dialogues involving Lavinia, the daughter. Based on the concordance and the relevant lexical item analysis, the authors found that the island was symbolic of the womb, a warm water/love-filled peaceful place residing in a woman. By further relating the use of this image to O’Neill’s own life, the authors concluded that the island image (together with the use of the image in O’Neill’s other plays) could be attributed to O’Neill’s yearning for love, especially maternal love, a theme Eugene O’Neill pursued lifelong. This paper thus offers substantial materials for the understanding of O’Neill’s obsession with the island image in his plays.
Patient preferences for cancer screening in chronic kidney disease: a best–worst scaling survey
Authors: James Laura J , Wong Germaine , Tong Allison , Craig Jonathan C , Howard Kirsten , Howell Martin
Published: December 2021

Background

Despite an increased cancer risk for patients with chronic kidney disease (CKD), uptake of cancer screening varies due to competing priorities and complex health-related issues. This study aimed to elicit the preferences and important attributes of cancer screening in patients with CKD.

Methods

An on-line best–worst scaling survey was used to ascertain the relative importance of 22 screening attributes among CKD patients using an incomplete block design. Preference scores (0–1) were calculated by multinomial logistic regression. Preference heterogeneity was evaluated.

Results

The survey was completed by 83 patients: 26 not requiring kidney replacement therapy, 20 receiving dialysis and 37 transplant recipients (mean age 59 years, 53% men, 75% prior to cancer screening). The five most important attributes were early detection {preference score 1.0 [95% confidence interval (CI) 0.90–1.10]}, decreased risk of cancer death [0.85 (0.75–0.94)], false negatives [0.71 (0.61–0.80)], reduction in immunosuppression if detected [0.68 (0.59–0.78)] and non-invasive interventions after positive results [0.68 (0.59–0.78)]. Preference heterogeneity reflected the stage of CKD. Immunosuppression reduction [mean difference 0.11 (95% CI 0.02–0.19)] and views of family/friends [0.10 (reference attribute)] were important for transplant recipients. Screening frequency [−0.18 (95% CI −0.26 to −0.10)] and overdiagnosis of harmless cancers [−0.14 (95% CI −0.22 to −0.10)] were important for dialysis patients.

Conclusion

Early detection, risk of cancer-related death, false negatives, immunosuppression reduction and non-invasive interventions following detection are important cancer screening considerations among CKD patients. Patient preferences are key to shared decision-making and individualized cancer screening.
Localized task-invariant emotional valence encoding revealed by intracranial recordings
Authors: Weisholtz Daniel S , Kreiman Gabriel , Silbersweig David A , Stern Emily , Cha Brannon , Butler Tracy
Published: December 2021

The ability to distinguish between negative, positive and neutral valence is a key part of emotion perception. Emotional valence has conceptual meaning that supersedes any particular type of stimulus, although it is typically captured experimentally in association with particular tasks. We sought to identify neural encoding for task-invariant emotional valence. We evaluated whether high-gamma responses (HGRs) to visually displayed words conveying emotions could be used to decode emotional valence from HGRs to facial expressions. Intracranial electroencephalography was recorded from 14 individuals while they participated in two tasks, one involving reading words with positive, negative, and neutral valence, and the other involving viewing faces with positive, negative, and neutral facial expressions. Quadratic discriminant analysis was used to identify information in the HGR that differentiates the three emotion conditions. A classifier was trained on the emotional valence labels from one task and was cross-validated on data from the same task (within-task classifier) as well as the other task (between-task classifier). Emotional valence could be decoded in the left medial orbitofrontal cortex and middle temporal gyrus, both using within-task classifiers and between-task classifiers. These observations suggest the presence of task-independent emotional valence information in the signals from these regions.
The economic consequences of major tax cuts for the rich
Authors: Hope David , Limberg Julian
Published: December 2021

The last 50 years has seen a dramatic decline in taxes on the rich across the advanced democracies. There is still fervent debate in both political and academic circles, however, about the economic consequences of this sweeping change in tax policy. This article contributes to this debate by utilizing a newly constructed indicator of taxes on the rich to identify all instances of major tax reductions on the rich in 18 Organisation for Economic Co-operation and Development (OECD) countries between 1965 and 2015. We then estimate the average effects of these major tax reforms on key macroeconomic aggregates. We find tax cuts for the rich lead to higher income inequality in both the short- and medium-term. In contrast, such reforms do not have any significant effect on economic growth or unemployment. Our results therefore provide strong evidence against the influential political–economic idea that tax cuts for the rich ‘trickle down’ to boost the wider economy.
Exploring annelids in the age of Enlightenment and beyond: classification and bioluminescence
Authors: Rota Emilia
Published: December 2021

The diversity of segmented worms was gradually recognized during the 18th century and referred to a special type of animal, distinct from insects and other groups. The relationship of microdriles with earthworms was suspected, thanks to the pioneering work of Rösel, Schäffer and Müller. However, annelids could not be diagnosed correctly, nor could any reliable classification be elaborated, as long as life forms were grouped by body shape, ‘degree of perfection’ (morphoanatomical or behavioural complexity), type of reproduction (sexual/asexual) or other aspects considered in isolation, as practised by Bonnet, Linnaeus and, later, Lamarck and Ehrenberg. The different attitude of Pallas and Cuvier, based on a rigorous anatomical/physiological evaluation, led to the unveiling of the interrelationships between the most varied forms and the specificities of the annelid body plan. In particular, Cuvier’s deep understanding of the internal structures of animals allowed him to recognize, at the close of the 18th century, the kinship between microdriles, megadriles and leeches. The reinterpretation of two episodes of oligochaete bioluminescence, one in France, the other, hitherto neglected, in Siberia, provides a good illustration of the state of knowledge of clitellates in the early 1770s. Neither species was named at the time, yet both were characterized sufficiently to be identified unequivocally today.
A lethargic child with COVID-19 infection
Authors: Yi Hyun J. , Ahern Brian J.
Published: December 2021

COVID-19 infection in children is less understood than COVID-19 infection in adults, and although it is believed to cause mild or asymptomatic infections, several cases of severe or atypical presentations have been reported. Children presenting with gastrointestinal symptoms, even those without respiratory symptoms, should raise the suspicion for possible COVID-19 infection. This case report describes a 20-month-old girl with a clear history of COVID-19 exposure whose acute abdomen and lethargy were diagnosed as COVID-19 infection complicated by intussusception.
The Top News Stories of 2021: Nursing: A Profession Reshaped by COVID-19
Authors: Roush Karen
Published: December 2021

The pandemic has brought new public awareness of nursing's role.
New Indication for Ruxolitinib
Authors: Aschenbrenner Diane S.
Published: December 2021

The kinase inhibitor ruxolitinib (Jakafi) is now approved to treat chronic graft-vs-host disease.
Unexpected Learning Opportunities for Nursing Students
Authors: Carey Sheri K. , Kies Joshua M.
Published: December 2021

Restrictions on groups and public gatherings during the COVID-19 pandemic have limited in-person learning experiences for nursing students. But the crisis has also led to unanticipated opportunities. In this article, we describe how participation in vaccination clinics at our university offered students occasions for experiential learning that aren't normally part of nursing education. Volunteering at these clinics allowed our students to practice important skills while participating in efforts to help mitigate the spread of the virus.
Understanding the Language of Health Reform
Authors: Rambur Betty , Pulcini Joyce
Published: December 2021

COVID-19 has accelerated the dialogue surrounding access to health insurance, including the potential for a public option, “Medicare for All,” or modification of the 2010 Affordable Care Act. A dizzying array of terms and assertions surround these health policy discussions, as well as misrepresentation and lack of specificity. This article offers a primer on contemporary reform terms and options that are likely to be prominent over the next several years and outlines some health care–related elements of the American Rescue Plan Act, a massive COVID-relief act passed in March 2021. The aim of this nonpartisan overview is to enhance nurses' understanding of these terms as a basis for effective participation in public policy and patient advocacy.
Are Reports of Pain, Disability, Quality of Life, Psychological Factors, and Central Sensitization Related to Outcomes of Quantitative Sensory Testing in Patients Suffering From Chronic Whiplash Associated Disorders?
Authors: Lenoir Dorine , Willaert Ward , Ickmans Kelly , Bernaers Lisa , Nijs Jo , Malfliet Anneleen , Danneels Lieven , Leysen Laurence , De Pauw Robby , Cagnie Barbara , Coppieters Iris , Meeus Mira
Published: December 2021

Background:

Chronic whiplash associated disorders (CWAD) are characterized by long-lasting symptoms of neck pain occurring after an acceleration-deceleration injury. Central sensitization (CS) has been suggested as the possible underlying mechanism for these symptoms, and is characterized by changes in the central nervous system. Besides CS, psychological factors are believed to play an important role in the experience of (chronic) pain.

Objective:

Investigating the relationships between self-reported pain, disability, quality of life, psychological factors, and symptoms of CS; and electrical-based quantitative sensory testing (QST) outcomes in CWAD patients. Secondly, to investigate the differences in QST between CWAD patients and pain-free controls.

Methods:

Seventy-two individuals with CWAD and 55 pain-free controls underwent electrical stimuli-based QST. Detection and pain thresholds (EPT), temporal summation (TS), and conditioned pain modulation were examined. Spearman correlation and linear mixed models analyses were performed to assess, respectively, the hypothesized associations and group differences in QST.

Results:

The Pain Catastrophizing magnification subscale correlated with the left wrist EPT (r=−0.332; P=0.004), and the Pain Anxiety Symptom Scale-20 with the left wrist (r=−0.325; P=0.005) and ankle (r=−0.330; P=0.005) EPT. TS at the ankle correlated with the CS inventory (r=0.303; P=0.010), Short Form 36 pain subscale (r=−0.325; P=0.005), and Illness Perception Questionnaire revised consequences subscale (r=0.325; P=0.005). EPTs left (P=0.011) and right wrist (P=0.023) were lower in the CWAD group, but conditioned pain modulation and TS did not differ between groups.

Conclusion:

QST outcomes relate to psychological constructs, rather than to self-reported pain intensity and distribution. Local hyperalgesia was found in individuals with CWAD, but no differences in endogenous pain facilitation nor inhibition.
Prevalence and renal prognosis of left ventricular diastolic dysfunction in non-dialysis chronic kidney disease patients with preserved systolic function
Authors: Borrelli Silvio , De Nicola Luca , Garofalo Carlo , Paoletti Ernesto , Lucà Sergio , Chiodini Paolo , Lucà Stefano , Peruzzu Nicola , Netti Antonella , Lembo Eugenio , Stanzione Giovanna , Conte Giuseppe , Minutolo Roberto
Published: December 2021

Background:

Left ventricular (LV) diastolic dysfunction is common in non-dialysis chronic kidney disease (ND-CKD) patients; however, the prevalence estimated according to the new diagnostic criteria as well as the prognostic role of diastolic dysfunction on CKD progression remain unknown.

Method:

We longitudinally evaluated consecutive ND-CKD patients and preserved systolic function (LV ejection fraction > 50%). According to the recently updated guidelines, LV diastolic dysfunction was assessed by four echocardiographic variables (annular e′ velocity, average mitral valve E-wave/e′ ratio, left atrial volume index and tricuspid regurgitation). Patients were classified as diastolic dysfunction, indeterminate and normal. Time-dependent estimated glomerular filtration rate (eGFR) change was assessed by mixed-effects regression model. Cumulative incidence of composite renal outcome (eGFR decline > 50% or chronic dialysis) was also estimated.

Results:

Among 140 patients (age 66.2 ± 14.5 years; 61% males; eGFR 39.8 ± 21.8 ml/min per 1.73m2; 43.6% diabetics), diastolic dysfunction occurred in 22.9%, indeterminate in 45.7% and normal in 31.4%. Prevalence of diastolic dysfunction was much lower than that estimated with older criteria (62.7%). Logistic regression (odds ratio, 95% confidence interval [CI]) showed that diastolic dysfunction was associated with lower eGFR (0.97, 0.94–0.99), older age (1.04, 1.01–1.06) and night-time systolic blood pressure (1.04, 1.00–1.07). Across 1702 eGFR measurements collected during a median follow-up of 4.6 years, eGFR decline (ml/min per 1.73m2; per year) was faster in patients with diastolic dysfunction (−2.12, 95% CI from −2.68 to −1.56) and in the indeterminate (11.2/100 pts per year) as compared to normal (−1.14, 95% CI from −1.64 to −0.63). Incidence of composite renal outcome was significantly higher in diastolic dysfunction (13.8/100 pts/year) than in normal group (3.5/100 pts per year)’.

Conclusion:

In ND-CKD population, LV diastolic dysfunction is less frequent than previously described and acts as independent predictor of CKD progression.
Therapeutic effect of acupuncture combined montelukast sodium on cough variant asthma in children
Authors: Zhou Xiuling , Zhang Ye , Liu Le , Feng Xiaochun , Zhang Hongshi
Published: December 2021

Background:

Cough variant asthma in children is a special type of asthma. Although there are many effective cases of combined acupuncture and western medicine in the clinical treatment of this kind of children, there is no standardized acupuncture combined with western medicine to evaluate the curative effect. Therefore, combined with existing reports, a systematic review and meta-analysis of acupuncture combined with montelukast sodium in the treatment of cough variant asthma in children were carried out to obtain conclusive results.

Methods:

The following electronic databases will be searched: PubMed, the Cochrane Library, Embase, Web of Science, Medline, CNKI, Chinese Biomedical Literature Database, VIP, and Wan Fang databases. We will consider articles published between database initiation and October 2021. We will use Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to acupuncture combined with montelukast sodium on cough variant asthma in children were included in this study. Language is limited to both Chinese and English. Research selection, data extraction, and research quality assessments were independently completed by two researchers. We then assessed the quality and risk of the included studies and observed the outcome measures.

Results:

This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with montelukast sodium on cough variant asthma in children.

Conclusion:

This systematic review will provide evidence to determine whether acupuncture combined with montelukast sodium is an effective and safe intervention for patients with cough variant asthma in children.

INPLASY Registration number:

INPLASY2021110006.
Quality of life and Q-TWiST were not adversely affected in Ewing sarcoma patients treated with combined anlotinib, irinotecan, and vincristine
Authors: Dong Sen , Sun Kunkun , Xie Lu , Xu Jie , Sun Xin , Ren Tingting , Huang Yi , Yang Rongli , Tang Xiaodong , Yang Fan , Gu Jin , Guo Wei
Published: December 2021

Background:

Combined treatment with anlotinib, irinotecan, as well as vincristine for advanced Ewing sarcoma (EWS) has been verified been effective in the prospective trial of Peking University People's Hospital EWS trial-02. We aimed to assess the dynamic changes in health-related quality of life (QoL) and the benefit-risk in quality-adjusted survival in current study.

Methods:

Twelve “pediatric” patients and 23 “adult” patients were enrolled. QoL was assessed with the EORTC QLQ-C30 for adults and PedsQL 3.0 Cancer Module for children and adolescents. The quality-adjusted time without symptoms of disease progression or toxicity of treatment (Q-TWiST) analysis was used to describe treatment results.

Results:

Progression-free survival was not accompanied by diminished QoL. Differences in scores on the QoL global health status and specific functioning before, during, and after treatment were not significantly different with time (P = .14 for adults and .91 for children). During treatment, there was a statistically insignificant trend towards improved QoL with reduced tumor burden (P = .14 for adults and .10 for children), but QoL significantly declined with progression of disease (P = .05 for adults and .04 for children). The most common adverse events were neutropenia (12.1%), leukopenia (16.6%), anemia (12.7%), and diarrhea (4.93%). Results across the trial analyses showed that the median time of Q-TWiST was 0.73 (interquartile range, 0–1.57) months, whereas the median time with toxicity before disease progression was 3.9 (interquartile range, 2.3, 6.1).

Conclusion:

QoL exhibited a trend towards improvement in accordance with high objective response in this trial with the receipt of combination therapy of anlotinib, vinsristine, and irinotecan for advanced EWS. The toxicity profile did not translate into significantly worse overall scores during treatment.
The diagnostic performance of dynamic contrast-enhanced MRI and its correlation with subtypes of breast cancer
Authors: Li Xun , Fu Peng , Jiang Ming , Zhang Jiaming , Tan Lun , Ai Tao , Li Xingrui
Published: December 2021

To evaluate diagnostic performance of perfusion-weighted imaging in differentiating benign from malignant breast lesions, and the correlation between the prognostic factors/subtypes of breast cancers and the perfusion parameters.

A total of 76 patients (59 cases with breast cancer) were included in our study. The Wilcoxon rank-sum test or the Kruskal–Wallis test were adopted for comparisons according to the dichotomous histopathologic prognostic factors or immunohistochemical subtypes. Receiver operating characteristic curves were used to determine the area under the curve (AUC) values for perfusion parameters to assess discrimination ability.

Confirming by pathology after operation, the percentage of benign lesions is 22.37% (17/76), malignant lesions (breast cancer) is 77.63% (59/76). According to puncture and pathological findings after operation, the standard of the molecular subtypes of breast cancer, triple negative account for 13.6% (8/59), non-triple negative account for 86.4% (51/59). The value of mean Ktrans and Kep were lower in benign than malignant lesions (P ≤ .001). The AUC of the 3 indicators are significantly improved after adjusting for age (AUC = 0.858 for Ktrans, AUC = 0.926 for Kep, and AUC = 0.827 for Ve). Moreover, the Ve index showed better discrimination performance than other indicators in identifying patients with triple-negative subtypes. Similarly, the identification ability came to the highest when combing Kep and Ve.

Perfusion parameters on dynamic enhanced magnetic resonance imaging are statistically significant in distinguishing benign from malignant breast lesion, and may potentially be used as biomarkers in discriminating patients with triple-negative molecular subtypes of breast cancer.
Development and validation of a prediction model for malignant pulmonary nodules
Authors: Ren Zhen , Ding Hongmei , Cai Zhenzhen , Mu Yuan , Wang Lin , Pan Shiyang
Published: December 2021

This study is to develop and validate a preoperative prediction model for malignancy of solitary pulmonary nodules. Data from 409 patients who underwent solitary pulmonary nodule resection at the First Affiliated Hospital of Nanjing Medical University, China between June 2018 and December 2020 were retrospectively collected. Then, the patients were nonrandomly split into a training cohort and a validation cohort. Clinical features, imaging parameters and laboratory data were then collected. Logistic regression analysis was used to develop a prediction model to identify variables significantly associated with malignant pulmonary nodules (MPNs) that were then included in the nomogram. We evaluated the discrimination and calibration ability of the nomogram by concordance index and calibration plot, respectively. MPNs were confirmed in 215 (52.6%) patients by a pathological examination. Multivariate logistic regression analysis identified 6 risk factors independently associated with MPN: gender (female, odds ratio [OR] = 2.487; 95% confidence interval [CI]: 1.313–4.711; P = .005), location of nodule (upper lobe of lung, OR = 1.126; 95%CI: 1.054–1.204; P < .001), density of nodule (pure ground glass, OR = 4.899; 95%CI: 2.572–9.716; P < .001; part-solid nodules, OR = 6.096; 95%CI: 3.153–14.186; P < .001), nodule size (OR = 1.193; 95%CI: 1.107–1.290; P < .001), GAGE7 (OR = 1.954; 95%CI: 1.054–3.624; P = .033), and GBU4–5 (OR = 2.576; 95%CI: 1.380–4.806; P = .003). The concordance index was 0.86 (95%CI: 0.83–0.91) and 0.88 (95%CI: 0.84–0.94) in the training and validation cohorts, respectively. The calibration curves showed good agreement between the predicted risk by the nomogram and real outcomes. We have developed and validated a preoperative prediction model for MPNs. The model could aid physicians in clinical treatment decision making.
Measurement of laryngeal elevation by automated segmentation using Mask R-CNN
Authors: Lee Hyun Haeng , Kwon Bo Mi , Yang Cheng-Kun , Yeh Chao-Yuan , Lee Jongmin
Published: December 2021

The methods of measuring laryngeal elevation during swallowing are time-consuming. We aimed to propose a quick-to-use neural network (NN) model for measuring laryngeal elevation quantitatively using anatomical structures auto-segmented by Mask region-based convolutional NN (R-CNN) in videofluoroscopic swallowing study. Twelve videofluoroscopic swallowing study video clips were collected. One researcher drew the anatomical structure, including the thyroid cartilage and vocal fold complex (TVC) on respective video frames. The dataset was split into 11 videos (4686 frames) for model development and one video (532 frames) for derived model testing. The validity of the trained model was evaluated using the intersection over the union. The mean intersections over union of the C1 spinous process and TVC were 0.73 ± 0.07 [0–0.88] and 0.43 ± 0.19 [0–0.79], respectively. The recall rates for the auto-segmentation of the TVC and C1 spinous process by the Mask R-CNN were 86.8% and 99.8%, respectively. Actual displacement of the larynx was calculated using the midpoint of the auto-segmented TVC and C1 spinous process and diagonal lengths of the C3 and C4 vertebral bodies on magnetic resonance imaging, which measured 35.1 mm. Mask R-CNN segmented the TVC with high accuracy. The proposed method measures laryngeal elevation using the midpoint of the TVC and C1 spinous process, auto-segmented by Mask R-CNN. Mask R-CNN auto-segmented the TVC with considerably high accuracy. Therefore, we can expect that the proposed method will quantitatively and quickly determine laryngeal elevation in clinical settings.
The BISAP score, NLR, CRP, or BUN: Which marker best predicts the outcome of acute pancreatitis?
Authors: Dancu Greta Maria , Popescu Alina , Sirli Roxana , Danila Mirela , Bende Felix , Tarta Cristi , Sporea Ioan
Published: December 2021

Acute pancreatitis is a common disease, and the mortality rate can be high. Thus, a risk assessment should be performed early to optimize treatment. We compared simple prognostic markers with the bedside index for severity in acute pancreatitis (BISAP) scoring system to identify the best predictors of severity and mortality.

This retrospective study stratified disease severity based on the revised Atlanta criteria. The accuracies of the markers for predicting severe AP (SAP) were assessed using receiver operating characteristic curves. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each marker. Multivariate logistic regression analyses were used to identify independent predictors of SAP and mortality.

The area under the curve (AUC) for the BISAP score was classified as fair for predicting SAP. The neutrophil-to-lymphocyte ratio at 48 hours (NLR48 h) and the C-reactive protein level at 48 hours (CRP48 h) had the best AUCs and were independently associated with SAP. When both criteria were met, the AUC was 0.89, sensitivity was 68%, and specificity was 92%. CRP48 h and hematocrit at 48 hours were independently associated with mortality.

NLR48 h and CRP48 h were independently associated with SAP but not superior to the BISAP score at admission. Assessing NLR48 h and CRP48H together was most suitable for predicting SAP. The CRP level was a good predictive marker for mortality.
Next-generation sequencing identified a novel CACNA1A I1379F variant in a familial hemiplegic migraine type 1 pedigree
Authors: Luan Huiyan , Zhang Lei , Zhang Sijin , Zhang Meng
Published: December 2021

Rationale:

Familial hemiplegic migraine (FHM) is a rare, autosomal dominant migraine with aura. CACNA1A encodes the α1A subunit of P/Q-type voltage-gated calcium channels, and its mutations have been associated with a wide spectrum of episodic and chronic neurological disorders, including FHM type 1 (FHM1).

Patient concerns:

A Chinese girl and some of her relatives who presented with hemiplegia with or without migraine were found to carry a novel heterozygous missense variant, I1379F, in CACNA1A by whole-exome sequencing. The variant consegregated with the disease and was predicted to be pathogenic.

Diagnosis:

The patient was diagnosed with FHM1 clinically and genetically.

Interventions:

Prophylactic therapy with flunarizine 5 mg daily was prescribed to the patient.

Outcomes:

Therapy with flunarizine was terminated after a few weeks. The intensity of the attacks was the same as before.

Lessons:

This case indicates that FHM should be considered when a patient manifests with episodic hemiplegia without migraine. In addition, genetic testing is an indispensable method to identify atypical attacks of hemiplegic migraine.
Slipped capital femoral epiphysis with hypopituitarism in adults
Authors: Niu Zhixin , Tang Jinshuo , Shen Xianyue , Xu Shenghao , Zhou Zhongsheng , Liu Tong , Zuo Jianlin
Published: December 2021

Rationale:

Slipped capital femoral epiphysis (SCFE) is a common disease in pediatric orthopedics. Most research on SCFE has focused on high-risk groups or the whole population, and studies focusing on adult SCFE patients are rare. In the present study, we report the case of an adult patient with SCFE.

Patient Concern:

A 37-year-old man presented to our clinic with persistent pain that was poorly localized to both hips, groin regions, and thighs for more than 1 year.

Diagnoses:

A bilateral hip X-ray examination was performed, and the femoral epiphyses were found to be unfused on both sides. Low levels of growth hormone (GH), insulin-like growth factor-1 (IGF-1), triiodothyronine (T3), thyroxine (T4), follicle-stimulating hormone, luteinizing hormone, estradiol, and testosterone, and high levels of thyroid-stimulating hormone, prolactin, and cortisol.

Interventions:

Hormone-substitution therapies (levothyroxine sodium to treat hypothyroidism and testosterone enanthate to treat hypogonadism) were prescribed. Total hip arthroplasty was performed to treat femoral epiphysis slippage.

Outcomes:

After 6 months of postoperative follow-up, the patient's gait improved significantly, and bilateral hip pain was relieved.

Lessons:

When treating adults with SCFE, clinicians must be alert to endocrine disorders. Comprehensive imaging evaluation is crucial for the accurate diagnosis and selection of an appropriate treatment.