bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Processing of Scene Layout Depends on Naturalistic Depth of Field
Authors: Gandolfo Marco , Nägele Hendrik , Peelen Marius V.
Published: January 2023

Boundary extension is a classic memory illusion in which observers remember more of a scene than was presented. According to predictive-processing accounts, boundary extension reflects the integration of visual input and expectations of what is beyond a scene’s boundaries. According to normalization accounts, boundary extension rather reflects one end of a normalization process toward a scene’s typically experienced viewing distance, such that close-up views give boundary extension but distant views give boundary contraction. Here, across four experiments ( N = 125 adults), we found that boundary extension strongly depends on depth of field, as determined by the aperture settings on a camera. Photographs with naturalistic depth of field led to larger boundary extension than photographs with unnaturalistic depth of field, even when distant views were shown. We propose that boundary extension reflects a predictive mechanism with adaptive value that is strongest for naturalistic views of scenes. The current findings indicate that depth of field is an important variable to consider in the study of scene perception and memory.
Hyperglycemia-induced endothelial exosomes trigger trophoblast dysregulation and abnormal placentation through PUM2-mediated repression of SOX2
Authors: Zhu Aibing , Qi Suwan , Li Wenjuan , Chen Dashu , Zheng Xiaomin , Xu Jianjuan , Feng Yaling
Published: January 2023

Background

Hyperglycemia is closely related to adverse pregnancy outcomes including pre-eclampsia (PE), a life-threatening complication with a substantial morbidity and mortality. However, the pathogenesis of abnormal placentation in gestational diabetes mellitus (GDM)-associated PE remains elusive.

Method

Here we isolated exosomes from the human umbilical vein endothelial cells (HUVECs) treated with normal level of glucose (NG) and high levels of glucose (HG). The exosomes were added to HTR-8a/SVneo cells, a trophoblast cell line. High-throughput RNA-sequencing was performed to analyzed the changed RNAs in the exosomes and exosome-treated HTR-8a/SVneo cells. HTR-8a/SVneo cell phenotypes were evaluated from the aspects of cell proliferation, cell invasion and DNA damage.

Results

After treatment with HG, the changed RNAs in exosomes was enriched in RNA stabilization and oxidative stress. The altered RNAs in the HTR-8a/SVneo cells treated with exosomes from HG-induced HUVECs were enriched in pathways related to cell adhesion, migration, DNA damage response and angiogenesis. The HG-induced exosomes impaired the proliferation and invasion of HTR-8a cells and caused the DNA damage. HG up-regulated PUM2 in the exosomes and exosome-treated HTR-8a/SVneo cells. PUM2 interacted with SOX2 mRNA, resulting in the mRNA degradation. Overexpression of SOX2 prevented the damage to HTR-8a/SVneo cells caused by the exosomes from HG-induced HUVECs.

Conclusions

We demonstrate that high glucose-induced endothelial exosomes mediate abnormal phenotypes of trophoblasts through PUM2-mediated repression of SOX2. Our results reveal a novel regulatory mechanism of hyperglycemia in development of abnormal placentation and provide potential targets for preventing adverse pregnancy outcomes.
Stakeholders’ Views on Information Needed in a Patient Decision Aid for Microtia Reconstruction
Authors: Ronde E.M. , van de Lücht Veronique A.P. , Lachkar N. , Ubbink Dirk T. , Breugem Corstiaan C.
Published: January 2023

Objective

To assess which information about microtia and the possible reconstructive options health care providers (HCPs), patients and parents believe should be included in a patient decision aid (PtDA).

Design

A mixed-methods study comprised of an online survey of HCPs and focus group discussions with patients and parents.

Participants

Survey respondents were members of the International Society for Auricular Reconstruction (ISAR). Focus group participants were patients with microtia and their parents, recruited through the microtia outpatient clinic at Amsterdam UMC, and through a Dutch patient organization for cleft and craniofacial conditions.

Methods

An online, investigator-made survey was sent to ISAR members in December 2021. Semi-structured focus group discussions were held in February 2022. Quantitative results were summarized, and qualitative results were thematically grouped.

Results

Thirty-two HCPs responded to the survey (response rate 41%). Most respondents (n = 24) were plastic surgeons, who had a median of 15 years of experience (IQR: 7-23 years). Two focus groups were held with a total of five patients and two parents. HCPs, patients and parents generally agreed on the information needed in a PtDA, emphasizing the importance of realistic expectation management. Patients and parents also considered psychosocial and functional outcomes, patient experiences, as well as patients’ involvement in decision-making important.

Conclusions

A PtDA for microtia reconstruction should target all patients with microtia, and include information on at least technique-related information, expected esthetic results, possible adverse effects, psychosocial and functional outcomes and patient experiences. Preference eliciting questions should be developed for both pediatric patients and their parents.
Non-Invasive Hemodynamic Monitoring using near Infrared Frequency Domain Photon Migration in Rabbit Hemorrhagic Shock Model
Authors: Hanna N.M. , Mina-Araghi R. , Lee J. , Cerussi A. , Krutzik H. Poggemeyer, M. , Jones B. , Tromberg B. , Brenner M.
Published: January 2023

Background

Currently, there are no reliable, accurate, non-invasive methods of assessing hemodynamic parameters, tissue hemoglobin, and 0, content for physiologic monitoring. Recent advances in the field of optical diagnostics have lead to new imaging modalities capable of evaluating regional in-vivo tissue composition using its optical properties. The advantage of Frequency Domain Photon Migration (FDPM) over previously studied bulk NIR spectroscopy is that it allows for quantitative measurements of both light absorption and scattering in tissues. Devices based on FDPM principles have the potential to accurately and non-invasively monitor hemodynamics and other parameters in patients with shock and physiologic disturbances.

Purpose

This study investigated FDPM methods for monitoring shock and the response to treatment with volume expansion and pressors in a hemorrhagic rabbit model. The sensitivity of this monitoring method for discriminating changes in hemodynamic parameters compared to traditional invasive monitoring devises, as well as the ability to accurately measure hemoglobin and tissue 0, was assessed.

Methods

New Zealand White (NZW) rabbits (n=25) were used in this study. Aprototype FDPM device developed in our laboratory was used. Aprobe was placed on the inner thigh of the rabbits. The rabbits underwent concurrent traditional invasive monitoring including cardiac output (CO), pulmonary arterial pressure (PA), systemic blood pressure via arterial line, hemoglobin, and arterial and venous blood gases. Hemorrhage was performed via a syringe either in stages or in a single step. After measurements were obtained the animals were resuscitated with vasopressors, or with crystalloid solution.

Results

The FPDM measurements of tissue hemoglobin (Hb), Oxyhemoglobin (HbO,), water content and tissue 0, saturation were obtained. The tissue Hb (r=0.7) and oxygen content (r=0.6) closely correlated with the measurements made with invasive methods. The FDPM measurements also correlated with CO. Conclusion: Broad-bandwidth FDPM may be a reliable, accurate and non-invasive means of monitoring patients with hemorrhagic shock and their response to treatment. FDPM may potentially be adapted for use in early shock recognition for triage or in settings where aggressive invasive monitoring is problematic.
Hemodynamic Effects of the Angiotensin-Converting Enzyme Inhibitor, Ramipril, in Patients with Mild to Moderate Aortic Stenosis and Preserved Left Ventricular Function
Authors: O'Brien Kevin D. , Zhao Xue-Qiao , Shavelle David M. , Caulfield Michael T. , Letterer Rebecca A. , Kapadia Samir R. , Probstfield Jeffrey L , Otto Catherine M.
Published: January 2023

Background

Angiotensin-converting enzyme (ACE) inhibitor use is presumed to be contraindicated in patients with aortic stenosis (AS). We determined the hemodynamic effects of ACE inhibitors in patients with mild to moderate aortic stenosis (AS) and preserved left ventricular function.

Methods

Thirteen elderly patients (mean [SD] age = 65 [17] years), with mild to moderate AS (aortic jet velocity 2.5–4.0 m/s), normal left ventricular and renal function, and no clinical coronary artery disease, were enrolled in a single-center, open-label trial comparing the hemodynamic effects at baseline and following titration of ramipril to a maximum dose of 7.5 mg twice daily. Patients were identified from echocardiography laboratory logs. Despite a presumed contraindication to ACE inhibitor use in AS patients, 30% (71 of 235) of patients otherwise meeting inclusion or exclusion criteria were excluded owing to current ACE inhibitor use. Patients were monitored with weekly clinic visits, biweekly laboratory tests, and monthly echocardiograms.

Results

There were no significant changes from baseline to week 8 in echocardiographic parameters, including mean (SD) aortic jet velocity [2.9 (0.4) vs 2.9 (0.4) m/s], calculated aortic transvalvular gradient [18 (6) vs 18 (6) mm Hg], or cardiac output [5.5 (1.2) vs 6.0 (2.1) L/min], or significant changes in blood pressure or heart rate. Early discontinuations were for asymptomatic low blood pressure (one patient) or a reversible creatinine increase of 0.3 mg/dL (one patient).

Conclusions

Short-term treatment with up to 7.5 mg twice daily of ramipril was well tolerated in patients with mild to moderate AS and preserved left ventricular function. A surprisingly high proportion of patients with documented AS were already receiving ACE inhibitors.
Methylphenidate Does Not Improve Cognitive Function in Healthy Sleep-Deprived Young Adults
Authors: Bray Christopher L. , Cahill Kevin S. , Oshier Joseph T. , Peden Carmen S. , Theriaque Douglas W. , Flotte Terence R. , Stacpoole Peter W.
Published: January 2023

Background

Abuse of methylphenidate, a treatment of attention-deficit/hyperactivity disorder, is reported to be increasing among students for the purpose of improving cognition.

Methods

A single capsule, containing methylphenidate (20 mg) or placebo, was administered to healthy young adults orally following 24 hours of sleep deprivation. Measurements included percent change in score from sleep-deprived baseline on four standardized tests of cognitive function: Hopkins Verbal Learning, Digit Span, Modified Stroop, and Trail Making tests. Measurements also included percent changes in blood pressure and heart rate from sleep-deprived baseline and plasma methylphenidate concentration.

Results

Differences in cognitive test performance were not observed between intervention groups. In subjects receiving methylphenidate, mean percent changes from baseline for systolic blood pressure and heart rate were increased relative to placebo between 90 and 210 minutes following capsule administration (maximum increases of 9.45% and 11.03%, respectively). The timing of peak differences in physiologic measures did not correlate with peak serum methylphenidate concentrations. Exit questionnaire ratings of “capsule effect” and perceived performance on the postcapsule administration of the most challenging cognitive test were both higher ( p = .044 and p = .009, respectively) for the methylphenidate group than for the placebo group. Conclusions: Cognitive improvement among sleep-deprived young adults was not observed following methylphenidate administration. Benefits perceived by abusers may relate to increased confidence and sense of well-being, as well as to sympathetic nervous system stimulation. Moreover, methylphenidate administration results in physiologic effects that could be harmful to certain individuals.
The association of glycated hemoglobin A1c with coronary artery disease, myocardial infarction, and severity of coronary lesions
Authors: Wei Yuanyuan , Li Wenyuan , Luan Hui , Tuerhongjiang Gulinigaer , Yuan Zuyi , Wu Yue
Published: January 2023

Glycated hemoglobin A1c (HbA1c) has been recognized as a predictor of cardiovascular events. However, the relationship between HbA1c and coronary artery disease (CAD) in the Chinese population has yet to be systematically explored. In addition, factors associated with HbA1c were generally analyzed linearly, thereby failing to appreciate more complex nonlinear associations. The study aimed to evaluate the relationship between the HbA1c value and the presence and severity of coronary artery stenosis. A total of 7192 consecutive patients who underwent coronary angiography were enrolled. Their biological parameters, including HbA1c, were measured. The severity of coronary stenosis was evaluated using Gensini score. After correcting for baseline confounding factors, a multivariate logistic regression analysis was used to evaluate the relationship between HbA1c and CAD severity. Restricted cubic splines were applied to explore the relation of HbA1c with the presence of CAD, myocardial infarction (MI), and the severity of coronary lesions. HbA1c was significantly associated with the presence and severity of CAD in patients without diagnosed diabetes (odds ratio: 1.306, 95% confidence interval: 1.053–1.619, p = 0.015). Spline analysis showed a U-shaped association of HbA1c with the presence of MI. Both HbA1c > 7.2% and HbA1c < 5.7% were associated with the presence of MI. In conclusion, HbA1c value was highly associated with the severity of coronary artery stenosis in the whole study population, and in CAD patients without diagnosed diabetes. Compared with patients with HbA1c levels between 6.0% and 7.0%, HbA1c < 5.7% and HbA1c > 7.2% were associated with higher presence of MI.
The correlation between serum creatine kinase with low muscle mass in type 2 diabetes patients
Authors: Hu Wenchao , Ma Yingqiang , He Lanjie , Xing Dongming
Published: January 2023

Creatine kinase (CK), the key enzyme in regulating energy metabolism, is demonstrated to be correlated with insulin resistance. Type 2 diabetes mellitus (T2DM) is considered as a risk factor for developing low muscle mass. The purpose of this investigation was to evaluate whether serum CK is associated with low muscle mass in T2DM patients. This cross-sectional study enrolled a consecutive population of 1086 T2DM patients recruited from the inpatients in our department. Dual-energy X-ray absorptiometry was utilized to detect the skeletal muscle index (SMI). In all, 117 males (20.24%) and 72 females (16.51%) showed low muscle mass in T2DM patients. CK was associated with a reduced risk of low muscle mass in male and female T2DM patients. SMI was correlated with age, duration of diabetes, body mass index (BMI), diastolic blood pressure (DBP), triglyceride, high-density lipoprotein cholesterol, and CK in male subjects analyzed using linear regression. Linear regression analysis showed that SMI was correlated with age, BMI, DBP, and CK in female subjects. In addition, CK was correlated with BMI and fasting plasma glucose in male and female T2DM groups. CK is inversely correlated with low muscle mass in T2DM patients.
Bearing fault diagnosis method based on comprehensive information divergence and improved BP-AdaBoost algorithm
Authors: Zhao ChenCheng , Liang HaiYing , Shan Yue , Liu Yang , Chen HaiYang , Cui NingYuan , Bao KuiYuan , Yin ZiJian
Published: January 2023

Bearings are an important part of rotating systems, and the long-term safe operation of mechanical equipment utilizing bearings is closely related to the bearing state; so, bearing fault diagnosis is of great significance. In this paper, a bearing fault diagnosis method based on comprehensive information divergence and improved BP (back propagation)-AdaBoost algorithm is proposed. First, the time domain, frequency domain, and time-frequency domain features under different states of the bearing are extracted to form a feature set. Then, the importance of each feature in fault classification is obtained by using the comprehensive information divergence index, and the feature sequence with decreasing importance is obtained. Finally, the most important features are selected as the input of the improved BP-AdaBoost classification model to train and obtain the bearing fault classification model. The experimental results show that the method has a good identification effect on bearing faults, and the stability of the model is high.
Machine learning-based damage sensing and self-healing of carbon fiber/nylon composites via addressable conducting networks
Authors: Yu Myeong-Hyeon , Lee Ji-Seok , Kim Hak-Sung
Published: January 2023

In this work, addressable conducting network (ACN) was used for the damage sensing and self-healing of continuous carbon fiber reinforced nylon composite (CFRP). The machine-learning was used for accurate damage sensing by training the resistance change of composites along ACN due to their structural damage. Also, self-healing of the carbon fiber composite material was performed by applying the electrical current to generate local heating through the detected damage location. The self-healing conditions such as the current input pairs of ACN and amount of the electrical current were determined through the artificial neural network (ANN)-based machine-learning technique. As a result, high-accuracy damage sensing based on machine learning with ACN was conducted, and self-healing with a healing efficiency of 98% could be achieved.
The Rise of Extracellular Vesicles as New Age Biomarkers in Cancer Diagnosis: Promises and Pitfalls
Authors: Bamankar Suraj , Londhe Vaishali Yogesh
Published: January 2023

Cell-to-cell interactions in the intricate microenvironment of tissue have a significant impact on the progression of cancer at every stage. Both cancer cells and stromal cells are responsible for the secretion of soluble chemical compounds as well as membrane-encased components, which both influence and govern the cell-to-cell interactions within the micro-environment of tumor cells. These membrane structures are identified as extracellular vesicles (EVs), which include exosomes and microvesicles. These nanosized vesicles are made up of bilayered proteolipids and have dimensions ranging from 50 to 1000 nm. It has been speculated that extracellular vesicles that originate from cancer cells perform a variety of functions in the development and progression of cancer which may involve the transport of regulatory materials, such as oncogenic proteins between nearby cells and to distant biological locations. In addition, their level in the serum of cancer patients is noticeably higher than those of healthy controls. The release of extracellular vesicles into the extracellular space is a continual process in both healthy and diseased cells. These extracellular vesicles hold molecular signatures that are defining features of health as well as disease. And hence, the EVs present in biological fluids provide unparalleled and noninvasive access to the necessary molecular details about the health status of the cells. Recent discoveries about these complex extracellular organelles have accelerated the discovery of cancer-specific biological markers as well as the development of unique diagnostic tools based on extracellular vesicles. In this mini-review, we aim to highlight the hopes and hypes associated with the applications of extracellular vesicles as biomarkers for cancer diagnosis.
Development and Psychometric Evaluation of a Chinese Instrument of Knowledge, Attitude and Preventive Practice on Dementia Care in Macao
Authors: WONG Sio Mui , ZENG Wen , LO Iek Long , LAM Chong , LOU Hong Lei
Published: January 2023

Background

Very few instruments to integrate knowledge, attitude and practice into dementia care as a holistic perspective were available to the Chinese.

Method

This article documented the development of a 30-item self-administered Chinese instrument of knowledge, attitude and preventive practice on dementia care and reported the results of psychometric testing among 1500 Chinese in Macao Special Administrative Region (SAR), including 234 primary health professionals, 272 staff working at day-care centers and nursing homes, 586 high school students and 408 community-dwelling older people. The Chinese instrument was developed through literature review and committee review. The psychometric methods were used to evaluate the reliability and validity of the Chinese instrument as measures of knowledge, attitude and preventive practice on dementia care for the Chinese.

Results

The preliminary results indicated that the Content Validity Index of the Chinese instrument was .973 and Cronbach’s alpha coefficient of the Chinese instrument was .842, among which Knowledge subscale, Attitude subscale and Preventive Practice subscale were .749, .633 and .845 respectively. The means and standard deviation were 65.13 ± 24.56 for Knowledge subscale, 74.76 ± 8.37 for Attitude subscale, 73.22 ± 14.05 for Preventative Practice subscale, and 70.99 ± 11.27 for the Chinese instrument.

Conclusion

The 30-item self-administered Chinese instrument of knowledge, attitude and preventive practice on dementia care had satisfied the psychometric evaluation well enough to warrant further use, and could also have particular implications for other Chinese populations all over the world.
Classification of BCI Multiclass Motor Imagery Task Based on Artificial Neural Network
Authors: Echtioui Amira , Zouch Wassim , Ghorbel Mohamed , Mhiri Chokri , Hamam Habib
Published: January 2023

Motor imagery (MI) signals recorded by electroencephalography provide the most practical basis for conceiving brain-computer interfaces (BCI). These interfaces offer a high degree of freedom. This helps people with motor disabilities communicate with the device by tackling a sequence of motor imagery tasks. However, the extracting user-specific features and increasing the accuracy of the classifier remain as difficult tasks in MI-based BCI. In this work, we propose a new method using artificial neural network (ANN) enhancing the performance of the motor imagery classification. Feature extraction techniques, like time domain parameters, band power features, signal power features, and wavelet packet decomposition (WPD), are studied and compared. Four classification algorithms are implemented which are Quadratic Discriminant Analysis, k-Nearest Neighbors, Linear Discriminant Analysis, and proposed ANN architecture. We added Batch Normalization layers to the proposed ANN architecture to improve the learning time and accuracy of the neural network. These layers also alleviate the effect of weight initialization and the addition of a regularization effect on the network. Our proposed method using ANN architecture achieves 0.5545 of kappa and 58.42% of accuracy on the BCI Competition IV-2a dataset. Our results show that the modified ANN method, with frequency and spatial features extracted by WPD and Common Spatial Pattern, respectively, offers a better classification compared to other current methods.
Latent Code Identification (LACOID): A Machine Learning-Based Integrative Framework [and Open-Source Software] to Classify Big Textual Data, Rebuild Contextualized/Unaltered Meanings, and Avoid Aggregation Bias
Authors: González Canché Manuel S.
Published: January 2023

Labeling or classifying textual data and qualitative evidence is an expensive and consequential challenge. The rigor and consistency behind the construction of these labels ultimately shape research findings and conclusions. A multifaceted methodological conundrum to address this challenge is the need for human reasoning for classification that leads to deeper and more nuanced understandings; however, this same manual human classification comes with the well-documented increase in classification inconsistencies and errors, particularly when dealing with vast amounts of documents and teams of coders. An alternative to human coding consists of machine learning-assisted techniques. These data science and visualization techniques offer tools for data classification that are cost-effective and consistent but are prone to losing participants’ meanings or voices for two main reasons: (a) these classifications typically aggregate all texts configuring each input file (i.e., each interview transcript) into a single topic or code and (b) these words configuring texts are analyzed outside of their original contexts. To address this challenge and analytic conundrum, we present an analytic framework and software tool, that addresses the following question: How to classify vast amounts of qualitative evidence effectively and efficiently without losing context or the original voices of our research participants and while leveraging the nuances that human reasoning bring to the qualitative and mixed methods analytic tables? This framework mirrors the line-by-line coding employed in human/manual code identification but relying on machine learning to classify texts in minutes rather than months. The resulting outputs provide complete transparency of the classification process and aid to recreate the contextualized, original, and unaltered meanings embedded in the input documents, as provided by our participants. We offer access to the database ( González Canché, 2022e ) and software required ( González Canché, 2022a , Mac https://cutt.ly/jc7n3OT , and Windows https://cutt.ly/wc7nNKF ) to replicate the analyses. We hope this opportunity to become familiar with the analytic framework and software, may result in expanded access of data science tools to analyze qualitative evidence (see also González Canché 2022b , 2022c , 2022d , for related no-code data science applications to classify and analyze qualitative and textual data dynamically).
An investigation of maternal psychological status of children with congenital talipes equinovarus treated with the Ponseti method
Authors: Dong Wentao , Shi Ningning , Wen Chunyu , Zhang Yong
Published: January 2023

Objectives:

To investigate maternal psychological status of children with congenital talipes equinovarus in different periods, and to clarify the influence on maternal psychological status of congenital talipes equinovarus treated with the Ponseti method.

Methods:

Sixty-seven mothers of children with congenital talipes equinovarus were investigated. Self-rating Depression Scale and Self-rating Anxiety Scale were used to evaluate the psychological stress of the mothers at different periods. Paired-samples t-test was used to analyze the results.

Results:

The mothers of 67 children with congenital talipes equinovarus ranged from 25 to 38 years old, with an average of 33.5 years old. Before prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 42.537 ± 10.476, and the average score of Self-rating Depression Scale was 47.254 ± 12.846; after prenatal diagnosis of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 54.224 ± 13.050, and the average score of Self-rating Depression Scale was 57.403 ± 13.649 points. Before the postpartum treatment of congenital talipes equinovarus, the average score of Self-rating Anxiety Scale was 53.388 ± 12.716, the average score of Self-rating Depression Scale was 56.284 ± 13.617; after the treatment of congenital talipes equinovarus with the Ponseti method, the average score of Self-rating Anxiety Scale was 47.731 ± 12.259, and the average score of Self-rating Depression Scale was 51.910 ± 13.878 points. The above differences were statistically significant (P < 0.001).

Conclusion:

The prenatal diagnosis of congenital talipes equinovarus will increase the maternal psychological stress, and the maternal psychological status will be significantly improved after the deformity of congenital talipes equinovarus is corrected effectively by the Ponseti method.

Level of evidence:

level III, retrospective study.
Antipsychotic drugs may contribute to venous thromboembolism – a case report and review literature
Authors: Hajjiah Adnan , Maadarani Ossama , Bitar Zouheir , Alfasam Khaled , Hanna Boutros , Elhabibi Mohamad
Published: January 2023

Summary

Use of antipsychotic drugs has been associated with increased risk of venous thromboembolism in several observational studies with unclear mechanism. We present a case of a patient who experienced a significant event of venous thromboembolism after a few months exposure to atypical antipsychotic drug for his bipolar mood disorders.
The effect of cladribine on immunoglobulin levels compared to B cell targeting therapies in multiple sclerosis
Authors: Lycett Mitchell J , Lea Rodney A , Maltby Vicki E , Min Myintzu , Lechner-Scott Jeannette
Published: January 2023

Background

Cladribine is a useful therapeutic option in RRMS with moderate to high disease activity. Its oral formulation and tolerability make it a useful alternative to infusion therapies. Cladribine is known to deplete CD19+ B lymphocytes, but its effect on immunoglobulin subsets is unclear.

Objective

To identify whether cladribine therapy in pwMS reduces immunoglobulin subset levels as a surrogate marker of infection risk.

Methods

A ‘real-world’ retrospective analysis of 341 pwMS presenting to a single tertiary centre between March 2017 and July 2021. Differences in immunoglobulin levels between cladribine, other disease-modifying therapies and no active treatment were assessed using a univariate ANOVA.

Results

Three hundred and forty-one patients had immunoglobulin levels assessed, with 29 patients treated with cladribine. The mean IgG, IgM and IgA levels on cladribine therapy were 10.44 ± 0.40, 0.99 ± 0.09 and 2.04 ± 0.18 g/L respectively. These were not significantly different from patients not on active treatment. There was a statistically significant reduction in IgG and IgM levels for patients treated with ocrelizumab (9.37 ± 0.19 and 0.68 ± 0.04 g/L) and natalizumab (8.72 ± 0.53 and 0.69 ± 0.12 g/L) compared to patients not on treatment.

Conclusion

Cladribine therapy for RRMS was not associated with immunoglobulin subset deficiencies. This is contrasted to ocrelizumab and natalizumab which demonstrate significant reductions in both IgG and IgM levels.
Prevalence and Management of Hiatal Hernia Found on Imaging During Lung Cancer Screening
Authors: Rahman Uzma , Till Brian , Thosani Darshak S. , Ruane Brooke , Muse Emily , Barta Julie , Grenda Tyler , Evans Nathaniel R. , Okusanya Olugbenga T.
Published: January 2023

Background:

Lung cancer screening has led to the discovery of many incidental findings including hiatal hernias (HH). However, the clinical significance and work up of these HH varies widely and there is no standardized approach toward follow-up studies or interventions. Therefore, we sought to identify the prevalence, symptoms, and describe our approach toward management of incidentally found HH on lung cancer screening CT scans.

Methods:

We conducted a retrospective chart review of patients who had HH incidentally found on their lung cancer screening CT scans, at our institution between June 2021 and January 2022. We then analyzed the collected data to determine the prevalence of HH in lung cancer screening patients, presence of symptoms, and management of these HH.

Results:

About 638 patients underwent lung cancer screening, of which 8.8% (n = 56) were found to have HH. Although 64.3% of patients with HH were symptomatic, 51.8% had not seen a gastroenterologist and 64.3% never had prior esophagogastroduodenoscopy. Of the patients with HH, 25% were evaluated by a thoracic surgeon based on symptoms or type of HH, and 10.7% qualified for surgical intervention. Patients not eligible for surgical intervention were referred to gastroenterology for follow-up.

Conclusions:

Hiatal hernias are common incidental findings on lung cancer screening CT scans. Many of these patients with HH are symptomatic and some have large HH. Therefore, these patients should be referred to specialists who can monitor their symptoms, initiate appropriate work-up when needed, and offer medical or surgical treatment when indicated.
The Challenge of Exposing and Ending Health Inequalities through Social and Policy Change: Canadian Experiences
Authors: Borras Arnel M.
Published: January 2023

The Canadian health system is often perceived as excellent. However, a closer examination of the political economy of health in Canada shows a radically different picture. It is a picture of persistent inequality and a history of the inability to address such inequality. Despite numerous public policy interventions to address preventable health inequalities—that is, health inequities—this societal problem persists. This research addresses how and why health inequities, especially class, race/ethnicity, and gender health inequities, persist in Canada and how to reduce such differences through public policy action. To address these questions, I performed a critical realist review, focusing on the political economy of health and policy change. Then I conducted a thematic analysis of the interview data gathered from 23 semi-structured interviews with leading Canadian policy academics, activists, and advocates. The results demonstrate that the capitalist economic system; the co-constitutives of capitalism, namely colonialism, racism, and sexism; and maldistributive public policies primarily cause health inequities in Canada. Canada's health inequities reduction requires pushing for redistributive public policies; uniting and strengthening labor unions, civil society groups, and social movements; and engaging in electoral politics. Reducing health inequities may involve struggling within and against capitalism and struggling for socialism.
A phase 2 clinical trial of combined BRAF/MEK inhibition for BRAFV600E-mutated multiple myeloma
Authors: Giesen Nicola , Chatterjee Manik , Scheid Christof , Poos Alexandra M. , Besemer Britta , Miah Kaya , Benner Axel , Becker Nicole , Moehler Thomas , Metzler Ivana , Khandanpour Cyrus , Seidel-Glaetzer Andrea , Trautmann-Grill Karolin , Kortüm K. Martin , Müller-Tidow Carsten , Mechtersheimer Gunhild , Goeppert Benjamin , Stenzinger Albrecht , Weinhold Niels , Goldschmidt Hartmut , Weisel Katja , Raab Marc S.
Published: January 2023

Activating BRAF mutations are found in a small subset of patients with newly diagnosed multiple myeloma, but prevalence increases in late-stage, refractory disease, and the mutations are associated with adverse outcome. This prospective single-arm, open-label, multicenter phase 2 trial assessed the efficacy and safety of combined BRAF/MEK inhibition, using encorafenib and binimetinib, in patients with relapsed/refractory multiple myeloma (RRMM) carrying a BRAFV600E mutation. Patients received 450 mg encorafenib once daily and binimetinib 45 mg twice daily. The primary end point was the overall response rate achieved within the first year after start of treatment according to International Myeloma Working Group criteria. Twelve RRMM patients with a median of 5 prior lines of therapy were enrolled. The overall response rate was 83.3%, with 10 patients achieving at least a partial response. The median progression-free survival was 5.6 months, and overall survival was 55% at 24 months. Emerging resistance to therapy was driven by RAS mutations and structural variants involving the BRAF locus. This is the first prospective clinical trial to demonstrate that combined BRAF/MEK inhibition is highly effective in patients with BRAFV600E-mutated RRMM, and it represents a successful targeted precision medicine approach in this disease. This trial was registered at www.clinicaltrials.gov as #NCT02834364.
Experimental Research on the Surface Quality of Milling Contour Bevel Gears
Authors: Wu Mingyang , Zhang Jianyu , Ma Chunjie , Zhang Yali , Cheng Yaonan
Published: January 2023

Contour bevel gears have the advantages of high coincidence, low noise and large bearing capacity, which are widely used in automobile manufacturing, shipbuilding and construction machinery. However, when the surface quality is poor, the effective contact area between the gear mating surfaces decreases, affecting the stability of the fit and thus the transmission accuracy, so it is of great significance to optimize the surface quality of the contour bevel gear. This paper firstly analyzes the formation process of machined surface roughness of contour bevel gears on the basis of generating machining method, and dry milling experiments of contour bevel gears are conducted to analyze the effects of cutting speed and feed rate on the machined surface roughness and surface topography of the workpiece. Then, the surface defects on the machined surface of the workpiece are studied by SEM, and the causes of the surface defects are analyzed by EDS. After that, XRD is used to compare the microscopic grains of the machined surface and the substrate material for diffraction peak analysis, and the effect of cutting parameters on the microhardness of the workpiece machined surface is investigated by work hardening experiment. The research results are of great significance for improving the machining accuracy of contour bevel gears, reducing friction losses and improving transmission efficiency.
Machine learning to analyse omic-data for COVID-19 diagnosis and prognosis
Authors: Liu Xuehan , Hasan Md Rakibul , Ahmed Khandaker Asif , Hossain Md Zakir
Published: January 2023

Background

With the global spread of COVID-19, the world has seen many patients, including many severe cases. The rapid development of machine learning (ML) has made significant disease diagnosis and prediction achievements. Current studies have confirmed that omics data at the host level can reflect the development process and prognosis of the disease. Since early diagnosis and effective treatment of severe COVID-19 patients remains challenging, this research aims to use omics data in different ML models for COVID-19 diagnosis and prognosis. We used several ML models on omics data of a large number of individuals to first predict whether patients are COVID-19 positive or negative, followed by the severity of the disease.

Results

On the COVID-19 diagnosis task, we got the best AUC of 0.99 with our multilayer perceptron model and the highest F1-score of 0.95 with our logistic regression (LR) model. For the severity prediction task, we achieved the highest accuracy of 0.76 with an LR model. Beyond classification and predictive modeling, our study founds ML models performed better on integrated multi-omics data, rather than single omics. By comparing top features from different omics dataset, we also found the robustness of our model, with a wider range of applicability in diverse dataset related to COVID-19. Additionally, we have found that omics-based models performed better than image or physiological feature-based models, proving the importance of the omics-based dataset for future model development.

Conclusions

This study diagnoses COVID-19 positive cases and predicts accurate severity levels. It lowers the dependence on clinical data and professional judgment, by leveraging the utilization of state-of-the-art models. our model showed wider applicability across different omics dataset, which is highly transferable in other respiratory or similar diseases. Hospital and public health care mechanisms can optimize the distribution of medical resources and improve the robustness of the medical system.
Creation of new germplasm resources, development of SSR markers, and screening of monoterpene synthases in thyme
Authors: Sun Meiyu , Zhu Li , Zhang Yanan , Liu Ningning , Zhang Jinzheng , Li Hui , Bai Hongtong , Shi Lei
Published: January 2023

Background

Thyme derived essential oil and its components have numerous applications in pharmaceutical, food, and cosmetic industries, owing to their antibacterial, antifungal, and antiviral properties. To obtain thyme essential oil with different terpene composition, we developed new germplasm resources using the conventional hybridization approach.

Results

Phenotypic characteristics, including essential oil yield and composition, glandular trichome density, plant type, and fertility, of three wild Chinese and seven European thyme species were evaluated. Male-sterile and male-fertile thyme species were crossed in different combinations, and two F1 populations derived from Thymus longicaulis (Tl) × T. vulgaris ‘Fragrantissimus’ (Tvf) and T. vulgaris ‘Elsbeth’ (Tve) × T. quinquecostatus (Tq) crosses were selected, with essential oil yield and terpene content as the main breeding goals. Simultaneously, simple sequence repeat (SSR) primers were developed based on the whole-genome sequence of T. quinquecostatus to authenticate the F1 hybrids. A total of 300 primer pairs were selected, and polymerase chain reaction (PCR) was carried out on the parents of the two hybrid populations (Tl, Tvf, Tve, and Tq). Based on the chemotype of the parents and their F1 progenies, we examined the expression of genes encoding two γ-terpinene synthases, one α-terpineol synthase, and maybe one geraniol synthase in all genotypes by quantitative real-time PCR (qRT-PCR).

Conclusion

We used hybridization to create new germplasm resources of thyme, developed SSR markers based on the whole-genome sequence of T. quinquecostatus, and screened the expression of monoterpene synthase genes in thyme. The results of this study provide a strong foundation for the creation of new germplasm resources, construction of the genetic linkage maps, and identification of quantitative trait loci (QTLs), and help gain insight into the mechanism of monoterpenoids biosynthesis in thyme.
Development of a novel tool: a nomogram for predicting in-hospital mortality of patients in intensive care unit after percutaneous coronary intervention
Authors: Yuan Miao , Ren Bin Cheng , Wang Yu , Ren Fuxian , Gao Dengfeng
Published: January 2023

Backgrounds

Increased risk of in-hospital mortality is critical to guide medical decisions and it played a central role in intensive care unit (ICU) with high risk of in-hospital mortality after primary percutaneous coronary intervention (PCI). At present，most predicting tools for in-hospital mortality after PCI were based on the results of coronary angiography, echocardiography, and laboratory results which are difficult to obtain at admission. The difficulty of using these tools limit their clinical application. This study aimed to develop a clinical prognostic nomogram to predict the in-hospital mortality of patients in ICU after PCI.

Methods

We extracted data from a public database named the Medical Information Mart for Intensive Care (MIMIC III). Adult patients with coronary artery stent insertion were included. They were divided into two groups according to the primary outcome (death in hospital or survive). All patients were randomly divided into training set and validation set randomly at a ratio of 6:4. Least absolute shrinkage and selection operator (LASSO) regression was performed in the training set to select optimal variables to predict the in-hospital mortality of patients in ICU after PCI. The multivariate logistical analysis was performed to develop a nomogram. Finally, the predictive efficiency of the nomogram was assessed by area under the receiver operating characteristic curve (AUROC)，integrated discrimination improvement (IDI), and net reclassification improvement (NRI), and clinical net benefit was assessed by Decision curve analysis (DCA).

Results

A total of 2160 patients were recruited in this study. By using LASSO, 17 variables were finally included. We used multivariate logistic regression to construct a prediction model which was presented in the form of a nomogram. The calibration plot of the nomogram revealed good fit in the training set and validation set. Compared with the sequential organ failure assessment (SOFA) and scale for the assessment of positive symptoms II (SAPS II) scores, the nomogram exhibited better AUROC of 0.907 (95% confidence interval [CI] was 0.880-0.933, p <  0.001) and 0.901 (95% CI was 0.865-0.936, P <  0.001) in the training set and validation set, respectively. In addition, DCA of the nomogram showed that it could achieve good net benefit in the clinic.

Conclusions

A new nomogram was constructed, and it presented excellent performance in predicting in-hospital mortality of patients in ICU after PCI.
Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials
Authors: Yang Xiaoli , Zhang Yu , Chen Yong , Xu Mingxing , Lei Xue , Fu Qiang
Published: January 2023

Background

Laparoscopic cholecystectomy is the gold standard surgical procedure for treating gallstone disease. Despite it being minimally invasive, various medications and methods are used to alleviate postoperative pain, and some patients still experience moderate-to-severe pain. This is a crucial problem that must be solved to avoid chronic pain. As part of postoperative multimodal analgesia, regional block is being increasingly applied in surgery under ultrasound guidance. We aimed to evaluate the analgesic effect of erector spinae plane block in adult patients undergoing laparoscopic cholecystectomy.

Methods

PubMed, Cochrane Library, EMBASE, and Web of Science were searched for randomized controlled trials investigating the efficacy of erector spinae plane block on postoperative pain after laparoscopic cholecystectomy. The primary outcome was the postoperative pain score. The secondary outcomes were the cumulative intraoperative and postoperative opioid consumption at 24 h, incidence of postoperative nausea and vomiting, and shoulder pain after surgery. The results were pooled using the fixed- or random-effects model with Review Manager 5.3.

Results

Fifteen randomized controlled trials involving 947 patients were included in the analysis. Postoperative pain score in the erector spinae plane block group was lower than that in the control group at postoperative 12 h (MD − 0.81, 95% CI − 1.1 to − 0.51, p < 0.00001) and 24 h (MD − 0.41, 95% CI − 0.62 to − 0.19, p = 0.0002). Cumulative opioid consumption was lower in the erector spinae plane block group than in the control group at postoperative 24 h (MD − 7.88, 95% CI − 10.17 to − 5.58, p < 0.00001). The erector spinae plane block group also experienced a lower incidence of postoperative nausea and vomiting than the control group. Opioid consumption and the incidence of postoperative nausea and vomiting were similar between the erector spinae plane block group and other block groups, including the oblique subcostal transversus abdominis plane block and quadratus lumborum block groups.

Conclusions

Ultrasound-guided erector spinae plane block provides effective postoperative analgesia in adults undergoing laparoscopic cholecystectomy.