bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural Decoding of the Speech Envelope: Effects of Intelligibility and Spectral Degradation
Authors: MacIntyre Alexis Deighton , Carlyon Robert P. , Goehring Tobias
Published: August 2024

During continuous speech perception, endogenous neural activity becomes time-locked to acoustic stimulus features, such as the speech amplitude envelope. This speech–brain coupling can be decoded using non-invasive brain imaging techniques, including electroencephalography (EEG). Neural decoding may provide clinical use as an objective measure of stimulus encoding by the brain—for example during cochlear implant listening, wherein the speech signal is severely spectrally degraded. Yet, interplay between acoustic and linguistic factors may lead to top-down modulation of perception, thereby complicating audiological applications. To address this ambiguity, we assess neural decoding of the speech envelope under spectral degradation with EEG in acoustically hearing listeners ( n = 38; 18–35 years old) using vocoded speech. We dissociate sensory encoding from higher-order processing by employing intelligible (English) and non-intelligible (Dutch) stimuli, with auditory attention sustained using a repeated-phrase detection task. Subject-specific and group decoders were trained to reconstruct the speech envelope from held-out EEG data, with decoder significance determined via random permutation testing. Whereas speech envelope reconstruction did not vary by spectral resolution, intelligible speech was associated with better decoding accuracy in general. Results were similar across subject-specific and group analyses, with less consistent effects of spectral degradation in group decoding. Permutation tests revealed possible differences in decoder statistical significance by experimental condition. In general, while robust neural decoding was observed at the individual and group level, variability within participants would most likely prevent the clinical use of such a measure to differentiate levels of spectral degradation and intelligibility on an individual basis.
Exploring the Experience of Student Researchers and Family Partners Working as an Interdisciplinary Team
Authors: Berg Karsten , dos Santos Ribeiro Mariana , Huijer Hadiya , Whitford Sandi , Sattar Schroder , Compton Roslyn M.
Published: August 2024

Introduction

Many institutions seek to engage postsecondary students in research to grow future researchers. Despite this common goal, the means to achieve that end is often unknown creating difficulties for students as they seek out research opportunities.

Objective

This article will share first-hand reports on the experiences of graduate students, undergraduate students, and family partners following their engagement as an interdisciplinary research team.

Methods

This is a qualitative study using individual open-ended interviews with undergraduate students, graduate students, and patient family partners. The research was conducted using a Patient-Oriented Research approach. The transcripts were analyzed inductively by using Braun and Clarke's six phases of reflexive thematic analysis.

Results

Two themes were developed from the analysis. The theme of Benefits & Facilitators was developed based on the many positive thoughts, feelings, resiliency, and learning expressed by the students and family partners. The undergraduate students found the experience of “doing” research fulfilling and a great tool for learning how to better use research in practice. Within the second theme Perceived Hierarchy, undergraduate students described themselves as helpers, not responsible, and they did not have the power to make decisions.

Conclusion

Given the challenges identified in this study, future efforts in this approach should carefully consider the culture and how to best engage graduate students, undergraduate students, and family partners in research teams.
Medical complications during interhospital transfer for thrombectomy in patients with acute ischemic stroke
Authors: Mirkov Damjan , Jenetzky Ekkehart , Thieme Andrea S. , Qabalan Adeeb , Gumbinger Christoph , Wick Wolfgang , Ringleb Peter A. , Rizos Timolaos
Published: August 2024

Introduction:

Patients with acute ischemic stroke (AIS) and large-vessel occlusion are frequently transferred by emergency physicians (EPs) from primary to comprehensive stroke centers (CSC) for thrombectomy, particular when thrombolysed. Data on complications during such transfers are highly limited.

Patients and methods:

Consecutive AIS patients transferred between 01/2015 and 10/2021 to our CSC were included. Associations of major (MACO) and minor (MICO) complications with clinical and imaging data were assessed.

Results:

In total, 985 patients were included in the analysis (58.5% thrombolysed). MACO developed in 1.6%, MICO in 14.6%. Compared to patients without complications (NOCO), patients with MACO did not differ in terms of demographics, cerebrovascular risk factors, or site of vessel occlusion. They had more severe strokes ( p = 0.026), neurological worsening was more severe ( p = 0.008), and transport duration was longer ( p = 0.050) but geographical distances did not differ. Thrombolysed patients had any complication more often than patients without thrombolysis (20.3% vs 10.5%; p  < 0.001); however, this finding was driven by patients with MICO ( p  < 0.001) only (MACO: p = 0.804). No associations were observed between stroke severity and complications in either thrombolysed or nonthrombolysed patients. Neurological deterioration during transfer was observed in 21.2%, but multivariate analysis revealed no association with thrombolysis (OR 0.962; 95%CI 0.670–1.380, p = 0.832). Asymptomatic intracerebral hemorrhage was present in 1.1%, symptomatic in 0.1%.

Discussion and conclusion:

In this large cohort, no patient-specific factor increasing the risk of complications during interhospital transfer was identified. Specifically, our results do not indicate that thrombolysis increases MACO. Hence, interhospital transfer without EPs appears reasonable in most patients.
Voices from Within: A Tale of Caste and Oppression in Kashmir
Authors: Moochi Javid Ahmad
Published: August 2024

Caste and identity have continued to remain sensitive issues in India for a very long time, and being so, they often get mixed up with other issues of the time. Theorizing the margins needs to go beyond the ‘visible’ Dalits and needs to pursue the inclusion of the cultures of the ‘invisible’ castes and communities. The caste, sub-caste and other castes that are not part of the organized and unorganized institutions need to be taken up as a topic of research by academics. Academic studies on caste and class in the context of the Kashmir Valley are also not free from this limitation. Moreover, there is a common perception among the intellectuals as well as in the academic world that Kashmir as an Islamic society is free from caste violence, which is, of course not true. This study tries to describe the everyday struggle undertaken by the members of the fishermen community, one of the sub-castes among Hanjis (Water Dwellers), who experience discrimination, alienation and exclusion due to their poverty and identity. They have not only been exploited by their fellow beings but also by the state from time to time. This peculiar ethnic group has been closely attached to water instead of land for centuries, and the various facets of their lives demand thorough investigation. This article also endeavours to peep into the socio-economic conditions of this community, with special reference to continuity and change.
Dual Jeopardy: Managing Vaginismus in a Female Having a Partner Suffering from Psychotic Disorder
Authors: Grover Sandeep , Pilania Priyanka
Published: August 2024

Vaginismus is a complex condition to manage, and in the presence of a partner, management becomes more complex as it involves the engagement of both partners. Besides addressing vaginismus, the management may involve addressing additional issues such as marital disharmony, situational erectile dysfunction in the partner, infertility, mental morbidity, and other associated psychosocial problems. There is a lack of data on the management of vaginismus in a woman with a partner with a psychotic disorder. In this report, we describe a couple in which the female partner had vaginismus that led to a lack of consummation of marriage for six years, and the male partner had schizophrenia. We discuss the challenges faced in the successful management of vaginismus by using an eclectic approach.
Brief Overview of the Late-Breaking Trials Presented at ACC’24: Part 1
Authors: Nagula Praveen , Parvathareddy Krishna Mala Konda Reddy
Published: August 2024

In this journal scan, we provide a brief overview of the late-breaking trials presented at the American College of Cardiology (ACC) Conference held in Atlanta, Georgia, from April 6 to 8, 2024, and their relevance to our daily clinical practice. The trials are categorized under the following headings: A. Coronary Artery Disease (Ultimate DAPT, DanGer Shock, Reduce AMI, EMPACT-MI, ORBITA-COSMIC 2) B. Intravascular Imaging (Prevent trial, IVUS-DCB) C. Heart Failure (Relieve HF, Arise HF, Improve HCM, PROACT) D. Hypertension (Target BP1, KARDIA, Feel) E. Aortic Stenosis (Dedicate DZKH6, SMART)
Reversal of fortune: When the lopsided city falls (over)
Authors: DeVerteuil Geoffrey
Published: August 2024

In this extended meditation, I want to build on a key insight from my provocations around the lopsided city: that for all of its forward momentum, the lopsided city remains prone to falling over, of over-reach. This connects to an older interest in faded grandeur, entropy, cracks in the city, and ruins, while being careful to avoid wallowing in purely dystopian representations.
Revisiting research on the governance of interorganizational relationships
Authors: Reuer Jeffrey J.
Published: August 2024

This essay re-examines the literature on the governance of interorganizational relationships, focusing on the insights of alliance research using transaction cost economics. Despite substantial progress, challenges arise because research has not devoted attention to some mechanisms of governance (i.e., administrative controls and supporting legal institutions) compared with others (i.e., incentives). Parties can develop bespoke collaborative agreements that mix and match various mechanisms of governance along these dimensions, rather than accessing a typical bundle commonly associated with a discrete organizational form. This conclusion challenges the iconic governance continuum and surfaces new methodological opportunities for this research stream. The essay also challenges what we think we know by identifying a variety of omitted variable problems that often crop up in governance research (e.g., focusing on the cooperative context of collaboration while not attending to the competitive context, excluding critical administrative structures when studying the interplay between contracts and trust, assuming transactional attributes are exogenous rather than endogenous to a search process, failing to account for shifting institutional supports for collaboration, etc.). By clarifying what we know and do not know about alliance governance, the essay identifies some pathways for developing more reliable, cumulative knowledge on interorganizational relationships.
Preload Control Method of Threaded Fasteners: A Review
Authors: Yan Xing , Liu Zhifeng , Zheng Mingpo , Li Ying , Wang Yuezhen , Chen Wentao
Published: August 2024

Threaded fasteners are one of the most commonly used connection methods for mechanical structures. Its primary function is to generate appropriate clamping forces and fasten the connected parts. An inappropriate preload can cause loosening, fatigue fracture, and other problems. This will affect the safety and reliability of mechanical equipment. The precise control of the preload has become a critical issue in mechanical assembly processes. Over the past few decades, various tightening measures and methods have been proposed to address this issue. However, many problems continue to exist with practical applications that have not been reviewed comprehensively and systematically. First, various control methods were summarized systematically, and their advantages and disadvantages in engineering applications were analyzed. Torque control is the most widely used tightening method owing to its simple operation and low cost. Therefore, the research on the torque control method was summarized systematically from three aspects: the torque–preload correlation formula, effective friction radius, and friction characteristics during tightening. In addition, the special circumstances that may increase preload uncertainty were discussed. Finally, based on a summary of the current research status, the prospects for future research were discussed. This study would aid researchers in extensively understanding the problems in preload control.
Altered individual-level morphological similarity network in children with growth hormone deficiency
Authors: Cheng Yanglei , Lin Liping , Hou Weifeng , Qiu Huaqiong , Deng Chengfen , Yan Zi , Qian Long , Cui Wei , Li Yanbing , Yang Zhiyun , Chen Qiuli , Su Shu
Published: August 2024

Background

Accumulating evidences indicate regional grey matter (GM) morphology alterations in pediatric growth hormone deficiency (GHD); however, large-scale morphological brain networks (MBNs) undergo these patients remains unclear.

Objective

To investigate the topological organization of individual-level MBNs in pediatric GHD.

Methods

Sixty-one GHD and 42 typically developing controls (TDs) were enrolled. Inter-regional morphological similarity of GM was taken to construct individual-level MBNs. Between-group differences of topological parameters and network-based statistics analysis were compared. Finally, association relationship between network properties and clinical variables was analyzed.

Results

Compared to TDs, GHD indicated a disturbance in the normal small-world organization, reflected by increased Lp, γ, λ, σ and decreased Cp, Eglob (all PFDR < 0.017). Regarding nodal properties, GHD exhibited increased nodal profiles at cerebellum 4-5, central executive network-related left inferior frontal gyrus, limbic regions-related right posterior cingulate gyrus, left hippocampus, and bilateral pallidum, thalamus (all PFDR < 0.05). Meanwhile, GHD exhibited decreased nodal profiles at sensorimotor network -related bilateral paracentral lobule, default-mode network-related left superior frontal gyrus, visual network -related right lingual gyrus, auditory network-related right superior temporal gyrus and bilateral amygdala, right cerebellum 3, bilateral cerebellum 10, vermis 1-2, 3, 4-5, 6 (all PFDR < 0.05). Furthermore, serum markers and behavior scores in GHD group were correlated with altered nodal profiles (P ≤ 0.046, uncorrected).

Conclusion

GHD undergo an extensive reorganization in large-scale individual-level MBNs, probably due to abnormal cortico-striatal-thalamo-cerebellum loops, cortico-limbic-cerebellum, dorsal visual-sensorimotor-striatal, and auditory-cerebellum circuitry. This study highlights the crucial role of abnormal morphological connectivity underlying GHD, which might result in their relatively slower development in motor, cognitive, and linguistic functional within behavior problem performance.
Deep vein thrombosis in patients with stroke or transient ischemic attack presenting with patent foramen ovale: a retrospective observational study
Authors: Huber Charlotte , Stöbe Stephan , Hagendorff Andreas , Mühlberg Katja Sibylle , Hoffmann Karl-Titus , Isermann Berend , Wachter Rolf , von Dercks Nikolaus , Schmidt Richard , Pelz Johann Otto , Michalski Dominik
Published: August 2024

Objective

Deep vein thrombosis (DVT) is discussed as a source of embolism for cerebral ischemia in the presence of patent foramen ovale (PFO). However, previous studies reported varying rates of DVT in stroke patients, and recommendations for screening are lacking. This study aimed to characterize patients with stroke or transient ischemic attack (TIA) and concomitant PFO and explore the rate of DVT and associated parameters.

Methods

Medical records were screened for patients with stroke or TIA and echocardiographic evidence of PFO. Concomitant DVT was identified according to compression ultrasonography of the lower limbs. A variety of demographic, clinical, and laboratory parameters, the RoPE and Wells scores were compared between patients with and without DVT.

Results

Three-hundred-thirty-nine patients (mean age 61.2 ± 15.4 years, 61.1% male) with stroke or TIA and PFO, treated between 01/2015 and 12/2020, were identified. Stroke and TIA patients did not differ for demographic and vascular risk factors. DVT was found in 17 cases out of 217 (7.8%) with compression ultrasonography. DVT was associated with a history of DVT, cancer, previous immobilization, calf compression pain, calf circumference difference, and a few laboratory abnormalities, e.g., increased D-dimer. A multivariate regression model with stepwise backward selection identified the Wells score (odds ratio 35.46, 95%-confidence interval 4.71–519.92) as a significant predictor for DVT.

Conclusion

DVT is present in a relevant proportion of patients with cerebral ischemia and PFO, which needs to be considered for the individual diagnostic workup. The Wells score seems suitable for guiding additional examinations, i.e., compression ultrasonography.
Flow cytometric analysis for Ki67 assessment in formalin-fixed paraffin-embedded breast cancer tissue
Authors: Sato Natsuki , Tsujimoto Masahiko , Nakatsuji Masatoshi , Tsuji Hiromi , Sugama Yuji , Shimazu Kenzo , Shimoda Masafumi , Ishihara Hideki
Published: August 2024

Background

Pathologists commonly employ the Ki67 immunohistochemistry labelling index (LI) when deciding appropriate therapeutic strategies for patients with breast cancer. However, despite several attempts at standardizing the Ki67 LI, inter-observer and inter-laboratory bias remain problematic. We developed a flow cytometric assay that employed tissue dissociation, enzymatic treatment and a gating process to analyse Ki67 in formalin-fixed paraffin-embedded (FFPE) breast cancer tissue.

Results

We demonstrated that mechanical homogenizations combined with thrombin treatment can be used to recover efficiently intact single-cell nuclei from FFPE breast cancer tissue. Ki67 in the recovered cell nuclei retained reactivity against the MIB-1 antibody, which has been widely used in clinical settings. Additionally, since the method did not alter the nucleoskeletal structure of tissues, the nuclei of cancer cells can be enriched in data analysis based on differences in size and complexity of nuclei of lymphocytes and normal mammary cells. In a clinical study using the developed protocol, Ki67 positivity was correlated with the Ki67 LI obtained by hot spot analysis by a pathologist in Japan (rho = 0.756, P < 0.0001). The number of cancer cell nuclei subjected to the analysis in our assay was more than twice the number routinely checked by pathologists in clinical settings.

Conclusions

The findings of this study showed the application of this new flow cytometry method could potentially be used to standardize Ki67 assessments in breast cancer.
You talkin’ to me? Functional breed selection may have fundamentally influenced dogs’ sensitivity to human verbal communicative cues
Authors: Dobos Petra , Pongrácz Péter
Published: August 2024

Background

The ability to learn from humans via observation was considered to be equally present across properly socialized dogs. We showed recently that cooperative working breeds learned from a human demonstrator more effectively. We hypothesized that functional breed selection could affect sensitivity to human attention-eliciting behavior. Accordingly, we ran the first ever study on dogs that compared the effect of ostensive and neutral verbal communication in a social learning scenario. We used the detour paradigm around a transparent V-shaped fence with either ostensive (addressing the receiver both with words and specific, attention-eliciting prosody) or neutral speech (monotonous reciting of a short poem) demonstration. The other features (gestures, movement) of the demonstration sequence were kept identical between the two conditions. We tested (N = 70) companion dogs from 17 cooperative and 16 independent breeds in three 1-min trials. Subjects had to obtain the reward by detouring around the fence.

Results

Detour latencies of the cooperative dogs improved after both ostensive and neutral speech demonstrations. The independent dogs did not improve their detour latency in either of the conditions. Remarkably, ostensive verbal utterances elicited longer relative looking time towards the demonstrator, cooperative dogs looked longer at the demonstrator, and longer looking time resulted in more successful detours.

Conclusions

Our study provides the first indication that functional breed selection had a significant impact on dogs’ sensitivity to ostensive human communication, which, apart from being crucially important for social learning from humans, until now was considered as a uniformly present heritage of domestication in dogs.

Graphical Abstract
The impact of a child’s inborn error of metabolism: the parents’ perspectives on restrictions, discrimination, family planning, and emergency management
Authors: Harings Tanjana , Neininger Martina P. , Eisenhofer Simone , Thiele Alena G. , Kiess Wieland , Bertsche Astrid , Bertsche Thilo , Beblo Skadi
Published: August 2024

Background

To investigate the impact of children’s inborn error of metabolism (IEMs) on the children’s and their parents’ lives from the parents’ perspective. We focused on disease-related restrictions in various issues of daily life, experienced discrimination, parental family planning, and management of metabolic emergencies.

Methods

We conducted a questionnaire-based survey with 108 parents of 119 children with IEM who attended a metabolic outpatient clinic. The children were categorized into 4 cohorts, based on increasing disease severity (cohort 1: IEMs with lowest severity, cohort 4: IEMs with highest severity), and compared by using Tobit regressions.

Results

The severity of the child’s IEM was associated with an increase in the intensity of perceived restrictions from the parents’ perspective for themselves and their children in all aspects of life: in general, in contact with friends, in the pursuit of hobbies, in childcare/school/occupation, and due to emotional stress. The highest intensity of restrictions in all cohorts was found for the parents themselves in contact with friends (compared to cohort 1: cohort 2: c. 3.556,p = 0.002; cohort 3: c. 4.159,p = 0.003; cohort 4: c. 7.224,p < 0.001). Parents of 8% of children reported that their children were discriminated against because of IEM, with the highest proportion of affected children (43%) in cohort 4. Parental family planning decisions were influenced in 34% of parents, with fear of recurrence being a predominant aspect. Of the parents of children diagnosed with IEMs associated with metabolic emergencies, 68% stated that they felt well or very well prepared for the occurrence of a metabolic emergency, and 100% of parents were able to name the necessary action steps from memory. Nevertheless, 58% stated that they experienced an occurring emergency as rather or very stressful.

Conclusions

From the parents’ perspective, the intensity of restrictions increased with the severity of the child’s IEM. The study shows the high impact of IEM on parents of children with IEM and the daily challenges they face. These findings emphasize the importance of comprehensive support for parents of children with IEM.
The viral origins of breast cancer
Authors: Lawson James S. , Glenn Wendy K.
Published: August 2024

During the past two decades evidence has been developed that indicates a handful of viruses with known oncogenic capacity, have potential roles in breast cancer. These viruses are mouse mammary tumour virus (MMTV - the cause of breast cancer in mice), high-risk human papilloma viruses (HPV-the cause of cervical cancer), Epstein Barr virus (EBV-the cause of lymphomas and naso-pharyngeal cancer) and bovine leukemia virus (BLV - the cause of cancers in cattle). These viruses may act alone or in combination. Each of these viruses are significantly more prevalent in breast cancers than in normal and benign breast tissue controls. The odds ratios for the prevalence of these viruses in breast cancer compared to normal and benign breast controls, are based on case control studies - MMTV 13·40, HPV 5.56, EBV 4·43 and BLV 2·57. The odds ratios for MMTV are much greater compared to the other three viruses. The evidence for a causal role for mouse mammary tumour virus and high risk for cancer human papilloma viruses in human breast cancer is increasingly comprehensive. The evidence for Epstein Barr virus and bovine leukemia virus is more limited. Overall the evidence is substantial in support of a viral cause of breast cancer.
Delta-radiomics features of ADC maps as early predictors of treatment response in lung cancer
Authors: Heidt Christian M. , Bohn Jonas R. , Stollmayer Róbert , von Stackelberg Oyunbileg , Rheinheimer Stephan , Bozorgmehr Farastuk , Senghas Karsten , Schlamp Kai , Weinheimer Oliver , Giesel Frederik L. , Kauczor Hans-Ulrich , Heußel Claus Peter , Heußel Gudula
Published: August 2024

Objective

Investigate the feasibility of detecting early treatment-induced tumor tissue changes in patients with advanced lung adenocarcinoma using diffusion-weighted MRI-derived radiomics features.

Methods

This prospective observational study included 144 patients receiving either tyrosine kinase inhibitors (TKI, n = 64) or platinum-based chemotherapy (PBC, n = 80) for the treatment of pulmonary adenocarcinoma. Patients underwent diffusion-weighted MRI the day prior to therapy (baseline, all patients), as well as either + 1 (PBC) or + 7 and + 14 (TKI) days after treatment initiation. One hundred ninety-seven radiomics features were extracted from manually delineated tumor volumes. Feature changes over time were analyzed for correlation with treatment response (TR) according to CT-derived RECIST after 2 months and progression-free survival (PFS).

Results

Out of 14 selected delta-radiomics features, 6 showed significant correlations with PFS or TR. Most significant correlations were found after 14 days. Features quantifying ROI heterogeneity, such as short-run emphasis (p = 0.04(pfs)/0.005(tr)), gradient short-run emphasis (p = 0.06(pfs)/0.01(tr)), and zone percentage (p = 0.02(pfs)/0.01(tr)) increased in patients with overall better TR whereas patients with worse overall response showed an increase in features quantifying ROI homogeneity, such as normalized inverse difference (p = 0.01(pfs)/0.04(tr)). Clustering of these features allows stratification of patients into groups of longer and shorter survival.

Conclusion

Two weeks after initiation of treatment, diffusion MRI of lung adenocarcinoma reveals quantifiable tissue-level insights that correlate well with future treatment (non-)response. Diffusion MRI-derived radiomics thus shows promise as an early, radiation-free decision-support to predict efficacy and potentially alter the treatment course early.

Critical relevance statement

Delta-Radiomics texture features derived from diffusion-weighted MRI of lung adenocarcinoma, acquired as early as 2 weeks after initiation of treatment, are significantly correlated with RECIST TR and PFS as obtained through later morphological imaging.

Key Points

Morphological imaging takes time to detect TR in lung cancer, diffusion-weighted MRI might identify response earlier.

Several radiomics features are significantly correlated with TR and PFS.

Radiomics of diffusion-weighted MRI may facilitate patient stratification and management.

Graphical Abstract
Digital breast tomosynthesis in breast cancer screening: an ethical perspective
Authors: Rosenqvist Simon , Brännmark Johan , Dustler Magnus
Published: August 2024

Although digital breast tomosynthesis has higher sensitivity than digital mammography and at least as high specificity, digital mammography remains the most common method for conducting mammographic screening. At the same time, mammography systems are now delivered “DBT-ready” and can be used for either digital mammography or digital breast tomosynthesis. In this paper, we ask whether it is ethically permissible to use such equipment for digital mammography, given its lower sensitivity. We argue it is not, and that clinics are ethically required to use their DBT-ready equipment to screen with digital breast tomosynthesis whenever this is practically possible. Our argument relies on a comparison between digital breast tomosynthesis and a hypothesized improvement in the image quality of digital mammography.

Critical relevance statement

Women may lose out on the benefits of screening with digital breast tomosynthesis when DBT-ready equipment is used to screen with digital mammography; we argue that this practice is ethically problematic.

Key Points

Digital breast tomosynthesis finds more cases of breast cancer than digital mammography.

Mammography equipment can often be used to screen with both digital breast tomosynthesis and digital mammography.

When they can, clinics are ethically required to use existing equipment to screen with digital breast tomosynthesis instead of digital mammography.
Decoding MRI-informed brain age using mutual information
Authors: Li Jing , Lam Linda Chiu Wa , Lu Hanna
Published: August 2024

Objective

We aimed to develop a standardized method to investigate the relationship between estimated brain age and regional morphometric features, meeting the criteria for simplicity, generalization, and intuitive interpretability.

Methods

We utilized T1-weighted magnetic resonance imaging (MRI) data from the Cambridge Centre for Ageing and Neuroscience project (N = 609) and employed a support vector regression method to train a brain age model. The pre-trained brain age model was applied to the dataset of the brain development project (N = 547). Kraskov (KSG) estimator was used to compute the mutual information (MI) value between brain age and regional morphometric features, including gray matter volume (GMV), white matter volume (WMV), cerebrospinal fluid (CSF) volume, and cortical thickness (CT).

Results

Among four types of brain features, GMV had the highest MI value (8.71), peaking in the pre-central gyrus (0.69). CSF volume was ranked second (7.76), with the highest MI value in the cingulate (0.87). CT was ranked third (6.22), with the highest MI value in superior temporal gyrus (0.53). WMV had the lowest MI value (4.59), with the insula showing the highest MI value (0.53). For brain parenchyma, the volume of the superior frontal gyrus exhibited the highest MI value (0.80).

Conclusion

This is the first demonstration that MI value between estimated brain age and morphometric features may serve as a benchmark for assessing the regional contributions to estimated brain age. Our findings highlighted that both GMV and CSF are the key features that determined the estimated brain age, which may add value to existing computational models of brain age.

Critical relevance statement

Mutual information (MI) analysis reveals gray matter volume (GMV) and cerebrospinal fluid (CSF) volume as pivotal in computing individuals’ brain age.

Key Points

Mutual information (MI) interprets estimated brain age with morphometric features.

Gray matter volume in the pre-central gyrus has the highest MI value for estimated brain age.

Cerebrospinal fluid volume in the cingulate has the highest MI value.

Regarding brain parenchymal volume, the superior frontal gyrus has the highest MI value.

The value of mutual information underscores the key brain regions related to brain age.

Graphical Abstract
Successful conservative management of advanced pyogenic sternoclavicular joint arthritis with osteomyelitis and pulmonary infiltration: a case report
Authors: Sugihara Takahito , Sano Yoshifumi , Ueki Takashi , Ishimura Takao , Takeda Masashi , Kiriyama Yosuke , Mori Yu , Sakao Nobuhiko , Otani Shinji , Izutani Hironori
Published: August 2024

Background

Sternoclavicular joint arthritis is a rare condition that poses considerable diagnostic and therapeutic challenges, leading to severe complications and a high mortality rate. Although surgical interventions are often considered necessary for advanced cases, some reports have suggested that conservative management with antibiotic therapy can be effective in certain cases. However, to our knowledge, there are no reports of successful conservative treatment in cases exhibiting aggressive spread. This report highlights a case of advanced sternoclavicular joint arthritis with bone destruction and pulmonary infiltration, successfully treated conservatively with outpatient antibiotic therapy.

Case presentation

A 58-year-old Japanese male presented with a 1-month history of left-sided shoulder pain. Contrast-enhanced computed tomography showed abscess formation and clavicular bone destruction, with infiltrative shadows suggesting lung involvement. The diagnosis of sternoclavicular joint arthritis was made, and outpatient oral antibiotic therapy was initiated. The patient exhibited a marked reduction in inflammatory marker levels and symptoms, and antibiotic therapy was discontinued after 3 weeks, with no recurrence observed at a 4-month follow-up.

Conclusions

This case highlights that conservative management with antibiotics can be effective for treating advanced sternoclavicular joint arthritis, emphasizing the need for individualized management and further research into non-surgical treatment options.
Attracting medical school graduates to residency programs in remotely located hospitals: the challenge lies beyond financial incentives
Authors: Fried Shalev , Zloto Ofira , Doron Avia , Feldman Zeev , Belinsky Alexey , Segal Gad , Frenkel-Nir Yael , Afek Arnon
Published: August 2024

Background

Recruitment to residency programs in hospitals located in other than major hubs (“remotely located”) is a challenge in many countries. In 2011, the Israeli Ministry of Health launched a 10-year financial incentive to encourage physicians to enroll in residency programs in such hospitals. Nearly 1 billion New Israeli Shekels (260 million US$) were invested in that program which had only limited success. As a new physician association’s collective agreement is impending, we aimed to measure the effectiveness of selected incentives in attracting medical school graduates to residencies in remotely located hospitals.

Methods

This study included Israeli medical students in their final year of medical school. We used an online questionnaire with multiple-choice demographic questions and a 5-point Likert scale to gauge the effect of various incentives on their preference for residency location.

Results

Between July and November 2022, 522 students responded (405 studied in Israeli medical schools [out of 705 students] and 117 in foreign medical schools [out of 1936 students]). Forty-two percent had at least one clerkship in a remotely located hospital, and 24% had included at least one remotely located hospital among their top five choices for internship. Only 13% reported that they prefer a residency program in those institutions. The incentive selected by students as most persuasive was government assistance in acceptance to and financial support for a fellowship abroad, followed by a financial grant and fewer on-call hours. Only 7% of the students indicated that no incentive would influence them to choose a remotely located hospital for their residency training. Medical education in a remotely located university and the choice of at least one remotely located hospital among the top five choices for internship were significantly associated with positive incentive receptivity, whereas male sex and older age were associated with negative receptivity.

Conclusion

This study on the attitudes of Israeli medical school graduates toward incentives aimed at attracting them to residencies in remotely located institutions revealed that career development opportunities and assistance in obtaining fellowships might influence their choice.
Predicting early appropriate therapy for patients infected by carbapenem-resistant Gram-negative pathogens in intensive care units in Italy
Authors: Bassetti Matteo , Monti Gianpaola , Henriksen Anne Santerre , Longshaw Christopher
Published: August 2024

Background

Antibiotic resistance among Gram-negative bacteria in intensive care units (ICUs) is linked with high morbidity and mortality in patients. In this study, we estimated the therapeutic coverage of various antibiotics, focusing on cefiderocol and comparators, administered empirically against an infection of unknown origin in the ICU.

Methods

In the ARTEMIS surveillance study, susceptibilities of 624 Italian Gram-negative isolates to amikacin, aztreonam-avibactam, cefiderocol, ceftazidime-avibactam, ceftolozane-tazobactam, colistin, imipenem-relebactam, meropenem, and meropenem-vaborbactam were tested by broth microdilution, and results were interpreted by European Committee on Antimicrobial Susceptibility Testing breakpoints. The susceptibility rates from the ARTEMIS study were extrapolated to Gram-negative isolates obtained from 5,774 patients in Italian ICUs in 2021. The sum of the predicted susceptibilities of individual pathogens represented the overall likelihood of in vitro activity of each antibiotic as early targeted therapy for ICU patients.

Results

A total of 624 Italian Gram-negative isolates included 206 Pseudomonas aeruginosa, 138 Acinetobacter baumannii, 187 Klebsiella pneumoniae, and 93 Escherichia coli. Against A. baumannii, K. pneumoniae, P. aeruginosa, and E. coli, the overall susceptibility rates for cefiderocol were 87.7%, 96.8%, 99%, and 100%, respectively; and for comparator agents, 8.7–96.4%, 25.7–100%, 73.3–100%, and 89.2–100%, respectively. Among the subset of meropenem-resistant isolates, susceptibility rates of A. baumannii, K. pneumoniae, and P. aeruginosa to cefiderocol were 86.4%, 96.2% and 100%, respectively. Corresponding susceptibility rates to comparator agents were 0–96.8%, 0–100%, and 6.4–100%, respectively. There were no meropenem-resistant isolates of E. coli. The extrapolation of data to isolates from Italian ICUs showed that the highest likelihood of therapeutic coverage, both overall and among meropenem-resistant isolates, was reported for colistin (96.8% and 72.2%, respectively) and cefiderocol (95.7% and 71.4%, respectively). All other antibiotics were associated with a likelihood below 73% overall and between 0% and 41.4% for meropenem-resistant isolates.

Conclusions

Based on confirmed susceptibility rates and reported ICU prevalence of multiple Gram-negative species, cefiderocol showed a higher predicted therapeutic coverage and utility in ICUs compared with comparator beta-lactam–beta-lactamase inhibitor antibiotics. Cefiderocol may be a promising early treatment option for patients at high risk of carbapenem-resistant Gram-negative bacterial infections in the ICU.
Current status and future perspectives of platelet-derived extracellular vesicles in cancer diagnosis and treatment
Authors: Zhuang Tongtao , Wang Shenrong , Yu Xiaoqian , He Xiaoyun , Guo Hongbin , Ou Chunlin
Published: August 2024

Platelets are a significant component of the cell population in the tumour microenvironment (TME). Platelets influence other immune cells and perform cross-talk with tumour cells, playing an important role in tumour development. Extracellular vesicles (EVs) are small membrane vesicles released from the cells into the TME. They can transfer biological information, including proteins, nucleic acids, and metabolites, from secretory cells to target receptor cells. This process affects the progression of various human diseases, particularly cancer. In recent years, several studies have demonstrated that platelet-derived extracellular vesicles (PEVs) can help regulate the malignant biological behaviours of tumours, including malignant proliferation, resistance to cell death, invasion and metastasis, metabolic reprogramming, immunity, and angiogenesis. Consequently, PEVs have been identified as key regulators of tumour progression. Therefore, targeting PEVs is a potential strategy for tumour treatment. Furthermore, the extensive use of nanomaterials in medical research has indicated that engineered PEVs are ideal delivery systems for therapeutic drugs. Recent studies have demonstrated that PEV engineering technologies play a pivotal role in the treatment of tumours by combining photothermal therapy, immunotherapy, and chemotherapy. In addition, aberrant changes in PEVs are closely associated with the clinicopathological features of patients with tumours, which may serve as liquid biopsy markers for early diagnosis, monitoring disease progression, and the prognostic assessment of patients with tumours. A comprehensive investigation into the role and potential mechanisms of PEVs in tumourigenesis may provide novel diagnostic biomarkers and potential therapeutic strategies for treating human tumours.
The polder systems legacies in the early twentieth century affect the contemporary landscape in the Jianghan Plain of Hubei, China
Authors: Li Yikai , Dai Hemiao , Dai Zhiyun , Zhang Li
Published: August 2024

The long-term interaction between the environment and humans has significantly shaped contemporary landscapes worldwide. As a heritage landscape, the polder is essential for understanding the impact of the past human activities on contemporary landscape on low-lying area of land. In this case study, we reconstructed the regional spatial distribution of the polders in the early twentieth century and examined their coherence over the past century using historical maps and other materials in the Jianghan Plain. The results revealed several key findings: (1) In the early twentieth century, there were 1571 polders covering an area of 11,826.1 km2 with a perimeter of 17,035.9 km. (2) These polders exhibited a J-shaped distribution, with few large-scale polders despite their substantial areas. (3) The shape of these polders reflected an ability to balance human needs and the natural environment. (4) Considerable regional differences in these polders were attributed to centuries-old interactions between humans and the environment. (5) The remnants of these early twentieth century polders have had a lasting influence on the contemporary landscape, particularly in rural areas. This case study underscores how taking into account a broader historical perspective can enhance our understanding of present-day landscapes and, more importantly, the role that past human actions have played in shaping them.
Growth dynamics of lung nodules: implications for classification in lung cancer screening
Authors: Ocaña-Tienda Beatriz , Eroles-Simó Alba , Pérez-Beteta Julián , Arana Estanislao , Pérez-García Víctor M.
Published: August 2024

Background

Lung nodules observed in cancer screening are believed to grow exponentially, and their associated volume doubling time (VDT) has been proposed for nodule classification. This retrospective study aimed to elucidate the growth dynamics of lung nodules and determine the best classification as either benign or malignant.

Methods

Data were analyzed from 180 participants (73.7% male) enrolled in the I-ELCAP screening program (140 primary lung cancer and 40 benign) with three or more annual CT examinations before resection. Attenuation, volume, mass and growth patterns (decelerated, linear, subexponential, exponential and accelerated) were assessed and compared as classification methods.

Results

Most lung cancers (83/140) and few benign nodules (11/40) exhibited an accelerated, faster than exponential, growth pattern. Half (50%) of the benign nodules versus 26.4% of the malignant ones displayed decelerated growth. Differences in growth patterns allowed nodule malignancy to be classified, the most effective individual variable being the increase in volume between two-year-interval scans (ROC-AUC = 0.871). The same metric on the first two follow-ups yielded an AUC value of 0.769. Further classification into solid, part-solid or non-solid, improved results (ROC-AUC of 0.813 in the first year and 0.897 in the second year).

Conclusions

In our dataset, most lung cancers exhibited accelerated growth in contrast to their benign counterparts. A measure of volumetric growth allowed discrimination between benign and malignant nodules. Its classification power increased when adding information on nodule compactness. The combination of these two meaningful and easily obtained variables could be used to assess malignancy of lung cancer nodules.
Disparity of metatibial and metatarsal cuticular and sensory structures in Cixiidae (Hemiptera: Fulgoromorpha) with a metatibiotarsal diagnosis for the tribes
Authors: Brożek Jolanta , Stroiński Adam , Romaniak Anna , Bourgoin Thierry
Published: August 2024

A review of the cuticular and sensory metatibial and metatarsal structures in cixiid planthoppers (Hemiptera: Fulgoromorpha) is proposed, depicting both their strong disparity and the great diversity of the patterns observed. Terminology and definitions for these structures are provided. The so-called lateral teeth of the metatibia in fact are particular styloconic sensory structures, called spiniform sensilla in Cixiidae. The apical metatibiotarsal teeth are non-sensory cuticular expansions, often bearing one or several chaetic sensilla ventrally, generally distributed in an internal and an external group of three teeth each, in some instances separated by a diastema; innermost and outermost teeth are generally larger. On the first tarsomere seven to eight teeth generally occur in one row, although two rows are observed in Brixidiini. A strong diversity of conformations and patterns is observed in the second metatarsomere. A specific subdorsal sensillum, of platellar type, may be present in the first metatarsomere teeth for a few taxa. It is generally present in the second metatarsomere, either as a narrow-based acutellar sensillum or as a broad-based platellar sensillum according to the taxon. Scanning electron microscope (SEM) analyses of 54 species of cixiids from all described tribes of the family, supplemented by data from the literature, are used to provide a metatibiotarsal diagnosis for each of the tribes of Cixiidae. In the state of our knowledge of the sufficiently precise observations of metatibiotarsal structures in the Cixiidae which are available, and of the phylogeny of the group as a frame of reference for their interpretations, we note that the observed patterns are probably the result of multiple and independent convergences and evolutionary regressions. These occurred at all levels of cixiid classification. Although these patterns can be useful in the identification of taxa at a low taxonomic level, they would be less useful for phylogenetic approaches.