bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling Skipped Items in Cognitive Diagnostic Assessments
Authors: Liang Lidan , Lu Jing , Zhang Jiwei , Cheng Guanghui
Published: October 2024

In cognitive diagnosis assessments, examinees frequently skip some items due to various reasons, such as time constraints, lack of confidence, or the perception of item difficulty. These skipped items are usually due to lacking specific cognitive attributes or knowledge structures. However, many research studies conventionally rely on complete-case analysis, potentially compromising the validity of results by ignoring skipped items. This omission can lead to invalid inferences about the attributes profiles of examinees and introduce bias into item parameters. This study aims to develop statistical models for effectively handling missing data resulting from skipped items. Specifically, we employ an item response theory model for missing indicators and utilize the deterministic inputs, noisy “and” gate (DINA) model to describe cognitive item responses. Furthermore, we introduce a higher-order structure to describe the correlation between the higher-order ability parameters and skipping propensity parameters and the correlation of the item parameters. The proposed new model fills the gaps in missing data handling, providing a more precise evaluation for the examinees who skip items and yielding more accurate research results. This enhances our understanding of cognitive processes and strengthens support for educational policies, aligning them better with student needs and optimizing decision-making.
Revisit English Learner Autonomy Among Chinese Non-English Major Students During the COVID-19 Lockdown
Authors: Li Shikun , Li Guofang
Published: October 2024

As the primary and immediate learning context, schools are underrepresented in learner autonomy studies. Scholars’ concerns over the intricate nature of schools lead to inadequate attention on the medium of learner autonomy development. To fill this research gap, a convergent mixed method design included a self-developed questionnaire, and four semi-structured interviews were employed to examine the non-English major sophomores’ learner autonomy during the COVID-19 pandemic. The triangulation of quantitative and qualitative evidence yielded that between a public and a private university, there was a statistically significant difference in English as a foreign language (EFL)s’ motivation for autonomous learning during the COVID-19 lockdown. But other than the degree of motivation, no difference was captured regarding EFLs’ belief and knowledge of autonomous English learning, as well as their metacognitive knowledge. Overall, EFLs were confident about their capacity to do autonomous English learning but engaged in a few systematical autonomous English learning during the COVID-19 pandemic. Based on the results, discussions over Chinese EFLs’ learner autonomy and possible explanations for the motivation differences are included. Pedagogy implications and limitations are elaborated on at the end. Plain Language Summary Using a mixed method design, this study reveals the English as a foreign language (EFL) learner autonomy and the role of schools in differentiating it, during the COVID-19 pandemic. The triangulation of quantitative and qualitative data yielded that despite mainfesting confidence in their capacity for autonomous learning, Chinese EFL learners did not engage in active, systematic autonomous language learning during the lockdowns. The motivation for autonomous English learning differed between universities, with learners from the less prestigious private University Qiu demonstrating more motivation than EFLs from the top public University Nan. The study contributes to understanding EFL learner autonomy during a challenging time of school lockdowns and their motivation issues. It highlights the discrepancy between learners’ self-reported autonomy and engagement in independent language learning. Additionally, it challenges the assumption that learners from prestigious universities would exhibit higher motivation for autonomous learning, showing that motivation can vary depending on the university context.
Determinants of Tax Compliance Behavior: A Case Study in Ethiopia
Authors: Adem Mohammed , Desta Tahir , Girma Bizuneh
Published: October 2024

Policymakers and tax authorities in developing countries face challenges in comprehending the determinants of tax-compliance behavior. This study employs empirical investigation to explore the factors that influence taxpayers’ voluntary and enforced tax compliance behaviors. Data were collected through a survey questionnaire distributed to 400 taxpayers using simple random sampling and analyzed using an ordered logit model. The results validate the assumptions of the slippery slope framework, showing that trust significantly impacts voluntary tax compliance and that a strong tax authority’s power contributes to more enforced tax compliance in Ethiopia. Additionally, the interaction between trust and power has a more significant effect on enforced tax compliance. This study also emphasizes the importance of improving trust in increasing tax compliance. Moreover, factors such as equity, fairness, tax knowledge, effective tax usage, and taxpayer morale contribute to tax compliance. By identifying factors that contribute to tax compliance, the findings of this research provide valuable insights for tax authorities in Ethiopia and other developing countries in devising strategies to combat tax evasion. This includes implementing a fair tax regime, enhancing the perceived value of public services financed by tax payments, increasing tax knowledge activities to help people understand the importance of paying taxes, and fortifying frameworks to minimize extravagant spending for maintaining public trust and ensuring effective and efficient use of taxpayers’ money.
An Empirical Study on K-Pop Livecast Concerts in Cinema: The Next Best Experience to a Real Live Concert?
Authors: Wang Yuanyuan , Limb Seong-Joon
Published: October 2024

This study examines participants’ experiences of K-pop livecast concerts, a new phenomenon where audiences watch live-streamed online concerts together in cinemas. The study is in three stages—social media analysis, qualitative interview, and quantitative questionnaire survey—each generates knowledge on the experience in different dimensions. The first two stages lay the foundation for the final test of the service quality model, which illustrates the effect of service quality factors and artist attachment on satisfaction and repurchase intention. The results show that content quality, convenience, and physical interaction affect satisfaction, among which physical interaction has the strongest effect. Fandom is vital in determining repurchase intention regardless of satisfaction with the current livecast concert participation. This study predicts that livecast concerts will enjoy continuous popularity post-COVID-19 and provides practical insights into future strategies for operating and marketing livecast shows.
The Roles of Corporate Social Responsibility and Perceived Organizational Support on Employee Loyalty in the Vietnamese Public Sector
Authors: Bui Hien Thi Thao , Nguyen Vo Hien Chau , Le Ngoc Anh Khoa , Dang Ngoc Thu Hien , Khoi Nguyen Phuoc Nguyen
Published: October 2024

Employee loyalty is crucial for an organization’s success, especially during economic recovery after the COVID-19 pandemic. This research aims to develop a framework of employee loyalty for the public sector, examining the relationship between corporate social responsibilities (CSR), perceived organizational support (POS), organizational identification, and employee well-being. The research addresses the gap in the literature on employee loyalty in public sector organizations and provides valuable insights into the mediating roles of employee well-being and organizational identification in enhancing employee loyalty in the Vietnamese public sector. The findings of this study showed that both CSR and POS positively impact organizational identification and employee well-being. Also, organizational identification and employee well-being play mediating roles in the relationship between CSR, POS, and employee loyalty. However, there is an insignificant relationship between POS and employee loyalty in the Vietnam public sector context. By combining both social identity theory and organizational support theory perspectives, this research offers a more integrated and holistic approach to understanding the path from CSR and POS to employee loyalty, providing managers and policymakers with a more concrete perception of the value and role of CSR and POS in building long-term trustworthy relationships with employees.
Teachers’ Perceptions of Mathematics-Related Barriers for Students With Visual Impairments
Authors: Ookeditse Goitse B. , Garegae Kgomotso Getrude
Published: October 2024

Mathematics is crucial in science, technology, and engineering career paths for all individuals, including Students with Visual Impairments. This study examined teachers’ perceptions of experiences and challenges that primary and secondary school Students with Visual Impairments faced concerning the learning of mathematics in Botswana. A descriptive survey research design was used in this study and data was collected from 84 participants. Mann Whitney U and Kruskal-Wallis tests were used to determine differences in teachers’ perceptions by position and school type respectively. Moreover, content analysis was used to summarize responses to open-ended questions. Teachers perceived that Students with Visual Impairments experienced barriers in key areas such as concept development and problem-solving, braille literacy, resources and support, instructions and modifications, and attitudes and the learning environment. Significant differences were noted among teachers’ perceptions based on whether they taught at a primary or secondary school. It is recommended that mathematics interventions for SWVIs should include creating a supportive learning environment, as well as collaboration within schools, between schools, and with external entities.
An Introspection into IPO Pricing and Post-listing Performance of Indian Fintech Companies
Authors: Roy Prasenjit , Biswas Shubhra , Gupta Arindam
Published: October 2024

The study examines the extent of initial public offering (IPO) underpricing of the Fintech companies and compares the same with the non-Fintech companies. The study also conducts post-listing performance of Fintech companies using listing gains, profitability margin, and valuation multiple over 3 years. The overall study, which spans from 2007 to 2022, indicates that the extent of IPO underpricing of Fintech companies is marginally higher than that of the non-Fintech companies. The results reveal that investors suffered a drip in the listing gains during the post-listing period. Further, during the post-listing phase, the Fintech companies have been able to post a continuous profit and also could sustain with a steady valuation multiple. The findings of the study postulate that the Fintech companies need to focus on implementing the right strategies to reduce the uncertainty and discontent among the investing community. Thus, the companies need to look forward to building up investor confidence in the upcoming days with improved performance. The significant implication of the study brings out that the policymakers need to contemplate framing norms for eradicating discontent and instilling confidence in the investors toward the Fintech companies over a longer time horizon of the primary market investment.
Examining the triple impact of eco-intellectual capital on the financial, social and environmental sustainability performance of SMEs in emerging economies
Authors: Antwi-Boateng Cosmos , Asumah Sampson , Kumi Ernest , Ansu-Mensah Peter
Published: October 2024

The way business has been conducted in modern times has traversed the need to achieve financial gains. Globally, it has become imperative for organisations to thrive competitively on the basis of ecologically conciousness and sustainability. Hence, the primary aim of this investigation is to determine how Eco-Intellectual Capital (EIC) influences the sustainability performance of small and medium enterprises (SMEs). The study made use of primary data and employed a quantitative research approach using a survey for data collection. The main data collection instrument used was a structured questionnaire. Data for the study were solicited from a group of 500 employees and owners managing SMEs in Ghana. Data collected from the questionnaires were analysed using IBM SPSS Statistics version 24 and IBM SPSS AMOS (26.0) Graphics. The results showed that EIC had a favourable effect on the social and environmental dimensions of sustainability performance. On the economic (financial) dimension, however, the effect was not significant. Aside from magnifying Eco-Intellectual Capital and Sustainability Performance literature, this research study is one of the few that looks at how green human, structural and relational capital work together to improve the economic, social and environmental sustainability of SMEs in emerging economies.
Body mass index trajectories from birth to early adulthood and lung function development
Authors: Wang Gang , Hallberg Jenny , Merid Simon Kebede , Kumar Ashish , Klevebro Susanna , Habchi Baninia , Chaleckis Romanas , Wheelock Craig E. , Hernandez-Pacheco Natalia , Ekström Sandra , Janson Christer , Kull Inger , Bergström Anna , Melén Erik
Published: October 2024

Background

Few studies have investigated the influence of body mass index (BMI) trajectories on lung function covering the entire growth period.

Methods

We conducted a prospective study using data from the Swedish BAMSE birth cohort. Latent class mixture modelling was employed to examine the diversity in BMI z-scores from birth to 24 years of age. Participants with four or more BMI z-scores were included (n=3204, 78.4%). Pre-bronchodilator spirometry was tested at 8, 16 and 24 years, while post-bronchodilator spirometry, multiple-breath nitrogen washout (for lung clearance index) and urinary metabolomics data were assessed at 24 years.

Results

Six distinct BMI development groups were identified. Compared to the stable normal BMI group, the accelerated increasing BMI group exhibited reduced pre- and post-bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio z-scores (pre: β= −0.26, 95% CI −0.44– −0.08; post: β= −0.22, 95% CI −0.39– −0.05), along with elevated lung clearance index (0.30, 95% CI 0.22–0.42) at 24 years. The persistent high BMI group demonstrated lower FEV1(−0.24, 95% CI −0.42– −0.05) and FVC (−0.27, 95% CI −0.45– −0.01) z-score growth between 16 and 24 years, and elevated lung clearance index (0.20, 95% CI 0.03–0.39) at 24 years. However, those impairments were not observed in the accelerated resolving BMI group. Conversely, the persistent low BMI group displayed persistently decreased FEV1and FVC from 8 to 24 years, as well as decreased lung function growth. Additionally, histidine-related metabolites were associated with pre- and post-bronchodilator FEV1(hypergeometric false discovery rate=0.008 and <0.001, respectively).

Conclusions

Early interventions aiming for normal BMI during childhood may contribute to improved lung health later in life.
20-year trends in excess costs of COPD
Authors: Amegadzie Joseph Emil , Mehareen Jeenat , Khakban Amir , Joshi Phalgun , Carlsten Chris , Sadatsafavi Mohsen
Published: October 2024

Background

Several major risk factors for COPD, such as population ageing, smoking rates and air pollution levels, are rapidly changing, causing inevitable changes in the population burden of COPD. We determined the excess direct costs of COPD and their trend from 2001 to 2020.

Methods

Using administrative health data from British Columbia, Canada, we created a retrospective matched cohort of physician-diagnosed COPD patients and non-COPD individuals. Excess direct medical costs (in 2020 Canadian dollars (CAD)) were estimated by analysing hospital records, outpatient services, medications and community care services. Comorbidity classes were assessed using International Classification of Diseases codes. Excess COPD costs were estimated as the adjusted difference in direct medical costs between the COPD and non-COPD cohorts.

Results

There were 208 554 and 404 703 individuals in the COPD and non-COPD cohorts, respectively (47.8% female; mean baseline age 69.1 and 68.2 years, respectively). Direct medical costs for COPD were CAD 9224 per patient-year compared to CAD 3396 per patient-year for non-COPD, giving rise to excess costs of CAD 5828 (95% CI 5759–5897) per patient-year. Excess costs increased by 48% over the study period. Excess costs due to comorbidities were CAD 3588 (95% CI 3554–3622) per patient-year, with cardiovascular-related conditions alone exceeding the costs attributed to COPD (CAD 1375versus904 per patient-year).

Conclusions

Despite multifaceted prevention and management initiatives, COPD-related economic burden is increasing, with the majority of costs due to comorbid conditions. Rising per-patient costs, combined with the flat or increasing prevalence of COPD in many jurisdictions, indicates a significant increase in COPD burden.
Targeting neutrophil serine proteases in bronchiectasis
Authors: Chalmers James D. , Mall Marcus A. , Chotirmall Sanjay H. , O'Donnell Anne E. , Flume Patrick A. , Hasegawa Naoki , Ringshausen Felix C. , Watz Henrik , Xu Jin-Fu , Shteinberg Michal , McShane Pamela J.
Published: October 2024

Persistent neutrophilic inflammation is a central feature in both the pathogenesis and progression of bronchiectasis. Neutrophils release neutrophil serine proteases (NSPs), such as neutrophil elastase (NE), cathepsin G and proteinase 3. When chronically high levels of free NSP activity exceed those of protective antiproteases, structural lung destruction, mucosal-related defects, further susceptibility to infection and worsening of clinical outcomes can occur. Despite the defined role of prolonged, high levels of NSPs in bronchiectasis, no drug that controls neutrophilic inflammation is licensed for the treatment of bronchiectasis. Previous methods of suppressing neutrophilic inflammation (such as direct inhibition of NE) have not been successful; however, an emerging therapy designed to address neutrophil-mediated pathology, inhibition of the cysteine protease cathepsin C (CatC, also known as dipeptidyl peptidase 1), is a promising approach to ameliorate neutrophilic inflammation, since this may reduce the activity of all NSPs implicated in bronchiectasis pathogenesis, and not just NE. Current data suggest that CatC inhibition may effectively restore the protease–antiprotease balance in bronchiectasis and improve disease outcomes as a result. Clinical trials for CatC inhibitors in bronchiectasis have reported positive phase III results. In this narrative review, we discuss the role of high NSP activity in bronchiectasis, and how this feature drives the associated morbidity and mortality seen in bronchiectasis. This review discusses therapeutic approaches aimed at treating neutrophilic inflammation in the bronchiectasis lung, summarising clinical trial outcomes and highlighting the need for more treatment strategies that effectively address chronic neutrophilic inflammation in bronchiectasis.
Deciphering the variation in cuticular hydrocarbon profiles of six European honey bee subspecies
Authors: Rodríguez-León Daniel Sebastián , Uzunov Aleksandar , Costa Cecilia , Elen Dylan , Charistos Leonidas , Galea Thomas , Gabel Martin , Scheiner Ricarda , Pinto M. Alice , Schmitt Thomas
Published: October 2024

The Western honey bee (Apis mellifera) subspecies exhibit local adaptive traits that evolved in response to the different environments that characterize their native distribution ranges. An important trait is the cuticular hydrocarbon (CHC) profile, which helps to prevent desiccation and mediate communication. We compared the CHC profiles of six European subspecies (A. m. mellifera, A. m. carnica, A. m. ligustica, A. m. macedonica, A. m. iberiensis, and A. m. ruttneri) and investigated potential factors shaping their composition. We did not find evidence of adaptation of the CHC profiles of the subspecies to the climatic conditions in their distribution range. Subspecies-specific differences in CHC composition might be explained by phylogenetic constraints or genetic drift. The CHC profiles of foragers were more subspecies-specific than those of nurse bees, while the latter showed more variation in their CHC profiles, likely due to the lower desiccation stress exerted by the controlled environment inside the hive. The strongest profile differences appeared between nurse bees and foragers among all subspecies, suggesting an adaptation to social task and a role in communication. Foragers also showed an increase in the relative amount of alkanes in their profiles compared to nurses, indicating adaptation to climatic conditions.
Quinic acid protects against the development of Huntington’s disease in Caenorhabditis elegans model
Authors: El Din Reem Hossam , Thabit Sara
Published: October 2024

Background

Quinic acid (QA), a cyclitol and cyclohexanecarboxylic acid, is a natural product that is present and can be isolated from edible herbals like tea, coffee and several fruits and vegetables. It was previously reported that QA exerted antioxidant and neuroprotective activity against dementia. However, it was not tested for its neuroprotective potential against Huntington’s disease (HD). Since aging related disorders are greatly linked to oxidative stress conditions, we focused on testing the oxidative stress resistant activity and protective effect of QA against the development of HD by using the multicellular Caenorhabditis elegans (C. elegans) worm model.

Methods

Firstly, QA was tested for its oxidative stress resistant properties. In survival assay, wild type and mutant skn-1 and daf-16 worms were exposed to oxidative stress conditions by using H2O2. Activation of SKN-1 pathway and expression of its downstream genes gcs-1 and gst-4 were also tested. Secondly, the effect of QA was evaluated on HD by testing its ability to decrease the formation of polyQ150 aggregates. Furthermore, its effect on the accumulation of polyglutamine (polyQ35 and polyQ40 aggregates) was tested.

Results

Here we report that QA could improve the survival of C. elegans after exposure to oxidative stress caused by H2O2 while also exerting antioxidant effects through the activation of SKN-1/Nrf2 pathway. Moreover, QA could be a potential candidate to protect against HD due to its effects on decreasing the formation of polyQ150, polyQ35 and polyQ40 aggregates.

Conclusions

This study highlights the importance of QA as a natural compound in defending against oxidative stress and the development of neurodegenerative diseases like HD.
[11C]Metoclopramide PET can detect a seizure-induced up-regulation of cerebral P-glycoprotein in epilepsy patients
Authors: Biali Myriam El , Breuil Louise , Jackwerth Matthias , Mairinger Severin , Weber Maria , Wölfl-Duchek Michael , Bamminger Karsten , Rausch Ivo , Nics Lukas , Hacker Marcus , Rodrigo Sebastian , Bouilleret Viviane , Zeitlinger Markus , Pataraia Ekaterina , Tournier Nicolas , Bauer Martin , Langer Oliver
Published: October 2024

Background

P-glycoprotein (P-gp) is an efflux transporter which is abundantly expressed at the blood-brain barrier (BBB) and which has been implicated in the pathophysiology of various brain diseases. The radiolabelled antiemetic drug [11C]metoclopramide is a P-gp substrate for positron emission tomography (PET) imaging of P-gp function at the BBB. To assess whether [11C]metoclopramide can detect increased P-gp function in the human brain, we employed drug-resistant temporal lobe epilepsy (TLE) as a model disease with a well characterised, regional P-gp up-regulation at the BBB.

Methods

Eight patients with drug-resistant (DRE) TLE, 5 seizure-free patients with drug-sensitive (DSE) focal epilepsy, and 15 healthy subjects underwent brain PET imaging with [11C]metoclopramide on a fully-integrated PET/MRI system. Concurrent with PET, arterial blood sampling was performed to generate a metabolite-corrected arterial plasma input function for kinetic modelling. The choroid plexus was outmasked on the PET images to remove signal contamination from the neighbouring hippocampus. Using a brain atlas, 10 temporal lobe sub-regions were defined and analysed with a 1-tissue-2-rate constant compartmental model to estimate the rate constants for radiotracer transfer from plasma to brain (K1) and from brain to plasma (k2), and the total volume of distribution (VT = K1/k2).

Results

DRE patients but not DSE patients showed significantly higher k2 values and a trend towards lower VT values in several temporal lobe sub-regions located ipsilateral to the epileptic focus as compared to healthy subjects (k2: hippocampus: +34%, anterior temporal lobe, medial part: +28%, superior temporal gyrus, posterior part: +21%).

Conclusions

[11C]Metoclopramide PET can detect a seizure-induced P-gp up-regulation in the epileptic brain. The efflux rate constant k2 seems to be the most sensitive parameter to measure increased P-gp function with [11C]metoclopramide. Our study provides evidence that disease-induced alterations in P-gp expression at the BBB can lead to changes in the distribution of a central nervous system-active drug to the human brain, which could affect the efficacy and/or safety of drugs. [11C]Metoclopramide PET may be used to assess or predict the contribution of increased P-gp function to drug resistance and disease pathophysiology in various brain diseases.

Trial registration

EudraCT 2019-003137-42. Registered 28 February 2020.
Quantitative lung ultrasound findings correlate with radial alveolar count in experimental bronchopulmonary dysplasia
Authors: Catozzi Chiara , Modena Angelo , Storti Matteo , Ricci Francesca , Villetti Gino , De Luca Daniele
Published: October 2024

We investigated the relationship between the degree of alveolarization and ultrasound-assessed lung aeration in a validated preterm rabbit model of experimental bronchopulmonary dysplasia (BPD). Lung ultrasound findings were heterogeneously abnormal and consisted of zones with interstitial, interstitial-alveolar or consolidated patterns. The median radial alveolar count was 10.1 [8.4–11.5], 7.8 [6.1–9] and 7.3 [1.8–10.1] in rabbits with interstitial, interstitial-alveolar or consolidated ultrasound pattern, respectively (overall p = 0.036). Alveolar count and lung ultrasound score were significantly correlated (ρ = − 0.044 (95%CI: − 1; − 0.143), p = 0.009; τ-b = − 0.362 (95%CI: − 0.6; − 0.1), p = 0.017).
Software-assisted structured reporting and semi-automated TNM classification for NSCLC staging in a multicenter proof of concept study
Authors: Heimer Maurice M. , Dikhtyar Yevgeniy , Hoppe Boj F. , Herr Felix L. , Stüber Anna Theresa , Burkard Tanja , Zöller Emma , Fabritius Matthias P. , Unterrainer Lena , Adams Lisa , Thurner Annette , Kaufmann David , Trzaska Timo , Kopp Markus , Hamer Okka , Maurer Katharina , Ristow Inka , May Matthias S. , Tufman Amanda , Spiro Judith , Brendel Matthias , Ingrisch Michael , Ricke Jens , Cyran Clemens C.
Published: October 2024

Objectives

In this multi-center study, we proposed a structured reporting (SR) framework for non-small cell lung cancer (NSCLC) and developed a software-assisted tool to automatically translate image-based findings and annotations into TNM classifications. The aim of this study was to validate the software-assisted SR tool for NSCLC, assess its potential clinical impact in a proof-of-concept study, and evaluate current reporting standards in participating institutions.

Methods

A framework for SR and staging of NSCLC was developed in a multi-center collaboration. SR annotations and descriptions were used to generate semi-automated TNM classification. The SR and TNM classification tools were evaluated by nine radiologists on n = 20 representative [18F]FDG PET/CT studies and compared to the free text reporting (FTR) strategy. Results were compared to a multidisciplinary team reference using a generalized linear mixed model (GLMM). Additionally, participants were surveyed on their experience with SR and TNM classification.

Results

Overall, GLMM analysis revealed that readers using SR were 1.707 (CI: 1.137–2.585) times more likely to correctly classify TNM status compared to FTR strategy (p = 0.01) resulting in increased overall TNM correctness in 71.9% (128/178) of cases compared to 62.8% (113/180) FTR. The primary source of variation in classification accuracy was explained by case complexity. Participants rated the potential impact of SR and semi-automated TNM classification as positive across all categories with improved scores after template validation.

Conclusion

This multi-center study yielded an effective software-assisted SR framework for NSCLC. The SR and semi-automated classification tool improved TNM classification and were perceived as valuable.

Critical relevance statement

Software-assisted SR provides robust input for semi-automated rule-based TNM classification in non-small-cell lung carcinoma (NSCLC), improves TNM correctness compared to FTR, and was perceived as valuable by radiology physicians.

Key Points

SR and TNM classification are underutilized across participating centers for NSCLC staging.

Software-assisted SR has emerged as a promising strategy for oncologic assessment.

Software-assisted SR facilitates semi-automated TNM classification with improved staging accuracy compared to free-text reports in NSCLC.

Graphical Abstract
Effects of physical therapy modalities for motor function, functional recovery, and post-stroke complications in patients with severe stroke: a systematic review update
Authors: Roesner Katrin , Scheffler Bettina , Kaehler Martina , Schmidt-Maciejewski Bianca , Boettger Tabea , Saal Susanne
Published: October 2024

Background

Physical therapy interventions play a crucial role in the daily care of patients recovering from severe stroke. However, the efficacy of these interventions and associated modalities, including duration, intensity, and frequency, have not been fully elucidated. In 2020, a systematic review reported the beneficial effects of physical therapy for patients with severe stroke but did not assess therapeutic modalities. We aim to update the current evidence on the effects of physical therapy interventions and their modalities in relation to the recovery phase in people with severe stroke in a hospital or inpatient rehabilitation facility.

Methods

We searched CENTRAL, MEDLINE, Web of Science, and three other relevant databases between December 2018 and March 2021 and updated the search between April 2021 and March 2023. ClinicalTrials.gov and ICTRP for searching trial registries helped to identify ongoing RCTs since 2023. We included individual and cluster randomized controlled trials in the English and German languages that compared physical therapy interventions to similar or other interventions, usual care, or no intervention in a hospital or rehabilitation inpatient setting. We screened the studies from this recent review for eligibility criteria, especially according to the setting. Critical appraisal was performed according to the Cochrane risk-of-bias tool 2.0. The data were synthesized narratively.

Results

The update identified 15 new studies, cumulating in a total of 30 studies (n = 2545 participants) meeting the eligibility criteria. These studies reported 54 outcomes and 20 physical therapy interventions. Two studies included participants during the hyperacute phase, 4 during the acute phase,18 during the early subacute phase, and 3 in the late subacute phase. Three studies started in the chronic phase. Summarised evidence has revealed an uncertain effect of physical therapy on patient outcomes (with moderate to low-quality evidence). Most studies showed a high risk of bias and did not reach the optimal sample size. Little was stated about the standard care and their therapy modalities.

Discussion

There is conflicting evidence for the effectiveness of physical therapy interventions in patients with severe stroke. There is a need for additional high-quality studies that also systematically report therapeutic modalities from a multidimensional perspective in motor stroke recovery. Due to the high risk of bias and the generally small sample size of the included studies, the generalizability of the findings to large and heterogeneous volumes of outcome data is limited.

Systematic review registration

PROSPERO CRD42021244285.
A thematic analysis of the subjective experiences of mothers with borderline personality disorder who completed Mother-Infant Dialectical Behaviour Therapy: a 3-year follow-up
Authors: Giles Alexandra , Sved Williams Anne , Webb Stephanie , Drioli-Phillips Phoebe , Winter Amelia
Published: October 2024

Background

Perinatal borderline personality disorder (BPD) is a common condition in perinatal mental health settings with few specialised treatment options, and little is known about the enduring effects of available treatment programs. This study explored the follow-up experiences of women with BPD after completing Mother-Infant Dialectical Behaviour Therapy (MI-DBT).

Methods

Semi-structured interviews were conducted with eight women who had completed MI-DBT 3 years prior. Reflexive Thematic Analysis was used to analyse the interviews to gain a richer understanding of these mothers’ lived experience.

Results

A thematic analysis generated four main themes which indicated that participants found that MI-DBT improved their ability to hold their child in mind, be aware of their own internal state and behaviours, manage their own emotional reactions and stay calm, and manage interpersonal interactions within adult relationships. Mothers with perinatal borderline personality disorder also highlighted the need for ongoing support in the context of parenting.

Conclusions

This study is the first of its kind to explore the longer-term experiences of mothers following such an intervention, giving voice to this vulnerable group of women. The findings of this study provide a greater understanding of the complex challenges experienced as part of parenting for mothers with borderline personality disorder, and provides both insight into mothers’ experiences of life after MI-DBT and the impact of the program on their lives. The clinical and research implications of the study’s findings are discussed.

Trial registration

This research was retrospectively registered on 07/03/2024, ACTRN12624000225516.
Diabetic macular edema (DME): dissecting pathogenesis, prognostication, diagnostic modalities along with current and futuristic therapeutic insights
Authors: Sakini Ahmed Sermed Al , Hamid Abdulrahman Khaldoon , Alkhuzaie Zainab A. , Al-Aish Sandra Thair , Al-Zubaidi Shahad , Tayem Abduljaber A’Ed , Alobi Mohammed Ayad , Sakini Anne Sermed Al , Al-Aish Rami Thair , Al-Shami Khayry , Hanifa Hamdah , Khunda Sara S.
Published: October 2024

One of the most common health concerns disturbing people within working years globally is diabetes mellitus (DM). One well-known consequence of DM is vascular damage, which can manifest as macro- and microangiopathy affecting the ocular retina. Therefore, Diabetic macular edema (DME) is a major sight-threatening complication of diabetic retinopathy (DR) worldwide. It is the most prevalent cause of significant vision impairment in diabetic patients. Long-term vision loss can be avoided by following early DME treatment guidelines in everyday life. Hence, there are various therapeutic approaches for DME management. Currently, the first-line treatment for DME is anti-VEGF family drugs, such as ranibizumab, brolucizumab, bevacizumab, and aflibercept. Nevertheless, relapses of the disease, inadequate response, and resistance during anti-VEGF therapy are still seen because of the intricate pathophysiological foundation of the disease. Consequently, there is an excellent requirement for therapeutic approaches to advance and become better at controlling diseases more satisfactorily and require fewer treatments overall. We conducted a thorough literature search in the current review to present a comprehensive overview of the primary data about the current DME therapeutic agents. We also covered the novel advances in DME management and probable future treatments being investigated and developed. This review recommended that Large clinical trials should afford sufficient evidence to support these innovative treatment modalities.
Transfer learning classification of suspicious lesions on breast ultrasound: is there room to avoid biopsies of benign lesions?
Authors: De Marco Paolo , Ricciardi Valerio , Montesano Marta , Cassano Enrico , Origgi Daniela
Published: October 2024

Background

Breast cancer (BC) is the most common malignancy in women and the second cause of cancer death. In recent years, there has been a strong development in artificial intelligence (AI) applications in medical imaging for several tasks. Our aim was to evaluate the potential of transfer learning with convolutional neural networks (CNNs) in discriminating suspicious breast lesions on ultrasound images.

Methods

Transfer learning performances of five different CNNs (Inception V3, Xception, Densenet121, VGG 16, and ResNet50) were evaluated on a public and on an institutional dataset (526 and 392 images, respectively), customizing the top layers for the specific task. Institutional images were contoured by an expert radiologist and processed to feed the CNNs for training and testing. Postimaging biopsies were used as a reference standard for classification. The area under the receiver operating curve (AUROC) was used to assess diagnostic performance.

Results

Networks performed very well on the public dataset (AUROC 0.938–0.996). The direct generalization to the institutional dataset resulted in lower performances (max AUROC 0.676); however, when tested on BI-RADS 3 and BI-RADS 5 only, results were improved (max AUROC 0.792). Good results were achieved on the institutional dataset (AUROC 0.759–0.818) and, when selecting a threshold of 2% for classification, a sensitivity of 0.983 was obtained for three of five CNNs, with the potential to spare biopsy in 15.3%–18.6% of patients.

Conclusion

In conclusion, transfer learning with CNNs may achieve high sensitivity and might be used as a support tool in managing suspicious breast lesions on ultrasound images.

Relevance statement

Transfer learning is a powerful technique to exploit the performances of well-trained CNNs for image classification. In a clinical scenario, it might be useful for the management of suspicious breast lesions on breast ultrasound, potentially sparing biopsy in a non-negligible number of patients.

Key Points

Properly trained CNNs with transfer learning are highly effective in differentiating benign and malignant lesions on breast ultrasound.

Setting clinical thresholds increased sensitivity.

CNNs might be useful as support tools in managing suspicious lesions on breast ultrasound.

Graphical Abstract
Launching Austria’s One Health network: paving the way for transdisciplinary collaborations
Authors: Desvars-Larrive Amélie , Burger Pamela , Khol Johannes Lorenz , Posautz Annika , Schernhammer Eva , Kutalek Ruth , Puspitarani Gavrila Amadea , Schlippe Justicia Lia , Springer David Niklas , Ernst Damien , Sohm Cynthia , Pontel de Almeida Anna , Schobesberger Hermann , Knauf Sascha , Walzer Chris
Published: October 2024

In the post-COVID-19 era, stakeholders, including policymakers, funders, and the public, are increasingly seeking for a cross-sectoral systems-based approach to health risks extending beyond conventional measures. Anchored on three health pillars -human, animal, and environmental- One Health offers a promising framework to effectively address this demand. While some nations have already implemented national One Health strategic plans, European countries, in general, are lagging behind the global agenda. On 22 February 2024, an initiative was launched in Austria toward addressing this gap, bringing together multiple sectors and disciplines, marking the initial step in creating a national One Health network. The workshop emphasized the importance of enhancing One Health education and addressed key topics, such as incorporating the environmental pillar of One Health as well as socio-economic and cultural drivers to further our understanding of outbreaks, and establishing trusted communication channels, including data sharing, between disciplines and sectors. Identified challenges encompassed the need for more funding of transdisciplinary research. Opportunities for advancement include initiating local One Health projects and showcasing their positive impacts. Moving forward, efforts will focus on establishing a mature and globally connected One Health framework in Austria and supporting the integration of One Health aspects into education curricula, research programs, and policies.
Assessment of meniscal extrusion with ultrasonography: a systematic review and meta-analysis
Authors: Boksh Khalis , Shepherd Duncan E. T. , Espino Daniel M. , Shepherd Jenna , Ghosh Arijit , Aujla Randeep , Boutefnouchet Tarek
Published: October 2024

Background

Magnetic resonance imaging (MRI) is the imaging of choice for meniscal extrusion (ME). However, they may underappreciate the load-dependent changes of the meniscus. There is growing evidence that weight-bearing ultrasound (WB US) is more suitable, particularly in revealing occult extrusion. We therefore perform a systematic review and meta-analysis on the validity and reliability of US in diagnosing extrusion. Furthermore, we explored whether it detects differences in extrusion between loaded and unloaded positions and those with pathological (osteoarthritis and meniscal injury) and healthy knees.

Methods

The Cochrane Controlled Register of Trials, PubMed, Medline, and Embase were used to perform a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Data pertaining to intra- and interrater reliability of US in measuring meniscal extrusion (ME), its correlation with magnetic resonance imaging (MRI), and head-to-head comparison of potential factors to influence ME were included [loading versus unloading position; osteoarthritis (OA) or pathological menisci (PM) versus healthy knees; mild versus moderate–severe knee OA]. Pooled data were analyzed by random or fixed-effects models.

Results

A total of 31 studies were included. Intraclass correlation coefficients (ICC) for intra- and interrater reliability were minimum 0.94 and 0.91, respectively. The correlation between US and MRI was (r = 0.76). US detected ME to be greater in the loaded position in all knees (healthy, p < 0.00001; OA, p < 0.00001; PM, p = 0.02). In all positions, US detected greater extrusion in OA (p < 0.0003) and PM knees (p = 0.006) compared with healthy controls. Furthermore, US revealed greater extrusion in moderate–severe OA knees (p < 0.00001).

Conclusions

This systematic review suggests ultrasonography can play an important role in the measurement of meniscal extrusion, with results comparable to that of MRI. However, to what extent it can differentiate between physiological and pathological extrusion requires further investigation, with an absolute cutoff value yet to be determined. Nevertheless, it is an appropriate investigation to track the progression of disease in those with meniscal pathologies or osteoarthritis. Furthermore, it is a feasible investigation to evaluate the meniscal function following surgery.

Level of evidence: IV, Systematic review of level III–IV evidence.
Association of MnSOD (rs4880) and GPx1 (rs1050450) with diabetic nephropathy: a meta-analysis
Authors: Begum Farhana , Lakshmanan Karpagavel
Published: October 2024

Background

Microvascular complications of diabetes including retinopathy, nephropathy, and neuropathy are those long-term complications that affect small blood vessels. Diabetic nephropathy (DN) is characterized by persistent microalbuminuria. A meta-analysis of case–control studies aims to examine the relationship between MnSOD (rs4880) and GPx1 (rs1050450) and the risk of DN.

Methods

Various databases such as Web of Science, PubMed, Springer Link, Cochrane Library, Science Direct, Embase, and Google Scholar were utilized to extract relevant studies. The statistical software MedCalc version 22.009 was acquired to accomplish the meta-analysis of the included studies.

Results

A significant association was found between two SNPs (rs4880 and rs1050450) and DN in the homozygous recessive model [95% confidence interval (CI) 0.97–2.41, odds ratio (OR) TT vs CC = 1.53, P = 0.06] and heterozygous model [95% CI 0.92–1.97, OR CT vs CC = 1.35, P = 0.12], while there was no association with the other genetic models. A significant association between rs4880 and DN was perceived in the Asian population [95% CI 1.24–2.03, OR = 1.6, P < 0.001], meanwhile the studies among Caucasian group showed insignificant association [95% CI 0.87–1.32, OR = 1.07, P = 0.5]. On the other hand, the association between rs1050450 and DN was significant [95% CI 3.80–13.01, OR = 7.04, P < 0.001] and insignificant [95% CI 0.96–2.28, OR = 1.48, P = 0.07] among Asian and Caucasian population, respectively.

Conclusion

To date, this meta-analysis could be the first to contribute a panoramic exploration of the MnSOD and GPx1 polymorphic association with DN. The results of the study contemplate the data presently accessible from the literature and can be employed as an influential lead for future research.
Characterization of mitochondrial DNA mutations in colorectal cancer progression by in silico approach and use as potential biomarkers for diagnosis and prognosis
Authors: Gadicherla Ramya , Rai Niraj , Othayoth Rajath , Kamma Srinivasulu
Published: October 2024

Background

Mitochondrial DNA variants are significant contributors to cancer progression, as evidenced by numerous findings. This study focuses on characterizing mitochondrial DNA mutations in colorectal cancer progression and their potential as biomarkers.

Methodology

Next generation sequencing technology was employed to analyze mitochondrial DNA variants in tumor and adjacent normal tissues from 25 patients with colon/rectal cancer. In silico prediction tools (SIFT, Polyphen2, Mutation Assessor, and SNP&GO) were utilized to assess the pathogenicity of these variants. Additionally, homology modeling of mutated protein structures was conducted, and molecular dynamic simulations were performed to assess the impact of mutation on protein function.

Results

Eighteen variants were identified across most tumor tissue samples, located in genes from Complex I, IV, and V. Among the identified variants, the V302M and S461 mutations in the MT-ND5 gene and L137F and L220P mutations in the ATP6 gene were predicted to be deleterious, potentially affecting protein function. 3D structural analysis of both wild-type and mutant proteins of MT-ND5 revealed changes in flexibility for the V302M and S461G mutations. The MT-ATP6 mutations L135F and L220P disrupt the interactions with surrounding residues and affect the overall function of protein. Further changes in protein dynamics of the mutated proteins by molecular dynamic simulations also indicate the effects; the mutations have on protein function.

Conclusion

MT-ND5 and MT-ATP6 variants could serve as potential biomarkers and drug targets in colorectal cancer. This study underscores the significance of mitochondrial DNA variants in cancer progression.