bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in upper body posture between patients with lumbar spine syndrome and healthy individuals under the consideration of sex, age and BMI
Authors: Holzgreve Fabian , Nazzal Celine , Nazzal Rasem , Golbach Rejane , Groneberg David A. , Maurer-Grubinger Christian , Wanke Eileen M. , Ohlendorf Daniela
Published: February 2024

Background

Work-related forced postures, such as prolonged standing work, can lead to complaints in the lower back. Current research suggests that there is increased evidence of associations between patients with low back pain (LBP) and reduced lordosis in the lumbar spine and generally less spinal tilt in the sagittal plane. The aim of this study is to extend the influence of LBP to other parameters of upper body posture in standing, taking into account the rotational and frontal planes.

Methods

The study included a no-LBP group (418 males, 412 females, aged 21–65 years) and an LBP group (138 subjects: 80 females, 58 males, aged 18–86 years) with medically diagnosed lumbar spine syndrome (LSS). The “ABW BodyMapper” back scanner from ABW GmbH in Germany was used for posture assessment using video raster stereography. Statistical analyses employed two-sample t-tests or Wilcoxon-Mann-Whitney-U tests to assess the relationship between the LBP/no-LBP groups and back posture parameters. Linear and logarithmic regressions were used with independent variables including group, sex, height, weight and body mass index (BMI). Significance level: α = 0.05 (95% confidence).

Results

The regression analysis showed that sagittal parameters of the spine (sagittal trunk decline, thoracic and lumbar bending angle, kyphosis and lordosis angles) depend primarily on sex, age, BMI, height and/or weight but not on group membership (LBP/no-LBP). In the shoulder region, a significant dependency between group membership and scapular rotation was found. In the pelvic region, there were only significant dependencies in the transverse plane, particularly between pelvic torsion and BMI, weight, height and between pelvic rotation and group membership, age and sex.

Conclusion

No difference between the patients and healthy controls were found. In addition, sex appears to be the main influencing factor for upper body posture. Other influencing factors such as BMI, height or weight also seem to have a significant influence on upper body posture more frequently than group affiliation.
Unifying duplication episode clustering and gene-species mapping inference
Authors: Górecki Paweł , Rutecka Natalia , Mykowiecka Agnieszka , Paszek Jarosław
Published: February 2024

We present a novel problem, called MetaEC, which aims to infer gene-species assignments in a collection of partially leaf-labeled gene trees labels by minimizing the size of duplication episode clustering (EC). This problem is particularly relevant in metagenomics, where incomplete data often poses a challenge in the accurate reconstruction of gene histories. To solve MetaEC, we propose a polynomial time dynamic programming (DP) formulation that verifies the existence of a set of duplication episodes from a predefined set of episode candidates. In addition, we design a method to infer distributions of gene-species mappings. We then demonstrate how to use DP to design an algorithm that solves MetaEC. Although the algorithm is exponential in the worst case, we introduce a heuristic modification of the algorithm that provides a solution with the knowledge that it is exact. To evaluate our method, we perform two computational experiments on simulated and empirical data containing whole genome duplication events, showing that our algorithm is able to accurately infer the corresponding events.
Enhancing surgical performance in cardiothoracic surgery with innovations from computer vision and artificial intelligence: a narrative review
Authors: Constable Merryn D. , Shum Hubert P. H. , Clark Stephen
Published: February 2024

When technical requirements are high, and patient outcomes are critical, opportunities for monitoring and improving surgical skills via objective motion analysis feedback may be particularly beneficial. This narrative review synthesises work on technical and non-technical surgical skills, collaborative task performance, and pose estimation to illustrate new opportunities to advance cardiothoracic surgical performance with innovations from computer vision and artificial intelligence. These technological innovations are critically evaluated in terms of the benefits they could offer the cardiothoracic surgical community, and any barriers to the uptake of the technology are elaborated upon. Like some other specialities, cardiothoracic surgery has relatively few opportunities to benefit from tools with data capture technology embedded within them (as is possible with robotic-assisted laparoscopic surgery, for example). In such cases, pose estimation techniques that allow for movement tracking across a conventional operating field without using specialist equipment or markers offer considerable potential. With video data from either simulated or real surgical procedures, these tools can (1) provide insight into the development of expertise and surgical performance over a surgeon’s career, (2) provide feedback to trainee surgeons regarding areas for improvement, (3) provide the opportunity to investigate what aspects of skill may be linked to patient outcomes which can (4) inform the aspects of surgical skill which should be focused on within training or mentoring programmes. Classifier or assessment algorithms that use artificial intelligence to ‘learn’ what expertise is from expert surgical evaluators could further assist educators in determining if trainees meet competency thresholds. With collaborative efforts between surgical teams, medical institutions, computer scientists and researchers to ensure this technology is developed with usability and ethics in mind, the developed feedback tools could improve cardiothoracic surgical practice in a data-driven way.
Perceval sutureless bioprosthesis versus Perimount sutured bioprosthesis for aortic valve replacement in patients with aortic stenosis: a retrospective, propensity-matched study
Authors: Kapadia Sharan J , Salmasi Mohammed Yousuf , Zientara Alicja , Roussin Isabelle , Quarto Cesare , Asimakopoulos George
Published: February 2024

Background

Rapid-deployment aortic valve replacement (RDAVR) is an alternative to conventional AVR (cAVR) for aortic stenosis. Benefits include a reduction in operative times, facilitation of minimal access surgery and superior haemodynamics compared to conventional valves. However, further evidence is required to inform guidelines, preferably in the form of propensity-matched studies that include mid-term follow-up data.

Methods

This was a single-centre, retrospective, propensity-matched cohort study comparing the Perceval and conventional Perimount Magna Ease valve for short- and mid-term clinical parameters and size-matched mid-term echocardiographic parameters (n = 102 in both groups) from 2014 to 2020. Data were extracted from a nationally managed dataset.

Results

There were no demographic differences between the matched groups. The Perceval group had shorter cross-clamp time (Perceval 62 [49–81] minutes; Perimount 79 [63–102] minutes, P < 0.001), shorter bypass time (Perceval 89 [74–114] minutes; Perimount 104 [84–137] minutes, P < 0.001), and more frequent minimally-invasive approaches (Perceval 28%; Perimount 5%, P < 0.001). Size-matched haemodynamics showed initially higher gradients in the Perceval group, but haemodynamics equalised at 12 + months. The Perceval group had a more favourable % change in the left ventricular posterior wall dimension at 2 + years (Perceval − 4.8 ± 18; Perimount 17 ± 2).

Conclusions

The Perceval facilitated shorter operations, which may benefit intermediate-high-risk, elderly patients with comorbidities requiring concomitant procedures. It also facilitated minimally invasive surgery. Size-matched haemodynamic performance was similar at mid-term follow-up, with the Perceval possibly better facilitating regression of left ventricular hypertrophy.
Record of strep throat infections in Italy: what is needed to know about penicillin allergy? The point of view from the Italian Society of Pediatric Allergy and Immunology (SIAIP)
Authors: De Filippo Maria , Klain Angela , Brambilla Ilaria , Caimmi Silvia , Castagnoli Riccardo , Indolfi Cristiana , Dinardo Giulio , Licari Amelia , Martelli Alberto , Tosca Maria Angela , Votto Martina , Marseglia Gian Luigi , del Giudice Michele Miraglia
Published: February 2024

Notifications of invasive group A streptococcal (iGAS) infections have significantly increased in many European Countries compared to the previous season. In Italy, there has been an increase in streptococcal pharyngitis and scarlet fever cases since January 2023, which sparked concerns about a GAS epidemic in the pediatric population. This rise may be ascribed to the GAS infection season that began earlier than usual (off-season outbreak) and the increase in the spread of respiratory viruses and viral coinfections that raised the risk of iGAS disease. Moreover, this phenomenon was also facilitated by increased travel after reduced GAS circulation during the COVID-19 pandemic.

The increase in cases of GAS disease has raised some critical issues regarding the potential reactions to administering amoxicillin, the first-line antibiotic therapy, many of which have been erroneously labeled as “allergy."

For these reasons, the Italian Society of Pediatric Allergy and Immunology (SIAIP) intends to provide simple clinical indications to help pediatricians manage GAS pharyngitis, discerning the allergic from non-allergic drug hypersensitivity.
Long-term effects of SARS-CoV-2 infection in hospitalized children: findings from an Italian single-center study
Authors: Calcaterra Valeria , Tagi Veronica Maria , D’Auria Enza , Lai Alessia , Zanelli Sara , Montanari Chiara , Biganzoli Elia Maria , Marano Giuseppe , Borghi Elisa , Massa Valentina , Riva Agostino , Zuccotti Gianvincenzo
Published: February 2024

Background

Limited evidence exists regarding the association between COVID-19 and Long COVID manifestations in children, particularly concerning variants of concern (VOCs). We aimed to characterize a cohort of pediatric patients hospitalized with confirmed acute SARS-CoV-2 and monitor them for Long COVID symptoms. Additionally, it seeks to explore any potential correlations between VOCs and clinical symptoms.

Methods

We conducted a prospective study involving children hospitalized from November 2021 to March 2023, with confirmed acute SARS-CoV-2 infection. A telephone survey was conducted at 3-6-12 months after discharge.

Results

We included 167 patients (77 F/90 M). Upon hospital admission, 95.5% of patients presented as symptomatic. Regarding patients for whom it was feasible to determine the SARS-CoV-2 variant (n = 51), the Delta variant was identified in 11 children (21.6%) and Omicron variant in the remaining 40 patients (78.4%: 27.5% BA.1 variant; 15% BA.2 variant; 57.5% BA.5 variant). 19 patients (16.5%) reported experiencing at least one symptom indicative of Long COVID (weight loss 31.6%, inappetence 26.3%, chronic cough 21.1%, fatigue 21.1%, and sleep disturbances, wheezing, abdominal pain and mood disorders 15.8%). In only 4 patients with Long COVID we could identified a specific SARS-CoV-2 variant (3 Omicron: 2 BA.1 and 1 BA.2; 1 Delta).

Conclusions

this study underscores that long COVID is a significant concern in the pediatric population. Our data reinforce the importance of continuously monitoring the impact of long-COVID in infants, children, and adolescents. A follow-up following SARS-CoV-2 infection is therefore advisable, with symptom investigation tailored to the patient’s age.
Genome sequencing as a generic diagnostic strategy for rare disease
Authors: Schobers Gaby , Derks Ronny , den Ouden Amber , Swinkels Hilde , van Reeuwijk Jeroen , Bosgoed Ermanno , Lugtenberg Dorien , Sun Su Ming , Corominas Galbany Jordi , Weiss Marjan , Blok Marinus J. , Olde Keizer Richelle A. C. M. , Hofste Tom , Hellebrekers Debby , de Leeuw Nicole , Stegmann Alexander , Kamsteeg Erik-Jan , Paulussen Aimee D. C. , Ligtenberg Marjolijn J. L. , Bradley Xiangqun Zheng , Peden John , Gutierrez Alejandra , Pullen Adam , Payne Tom , Gilissen Christian , van den Wijngaard Arthur , Brunner Han G. , Nelen Marcel , Yntema Helger G. , Vissers Lisenka E. L. M.
Published: February 2024

Background

To diagnose the full spectrum of hereditary and congenital diseases, genetic laboratories use many different workflows, ranging from karyotyping to exome sequencing. A single generic high-throughput workflow would greatly increase efficiency. We assessed whether genome sequencing (GS) can replace these existing workflows aimed at germline genetic diagnosis for rare disease.

Methods

We performed short-read GS (NovaSeq™6000; 150 bp paired-end reads, 37 × mean coverage) on 1000 cases with 1271 known clinically relevant variants, identified across different workflows, representative of our tertiary diagnostic centers. Variants were categorized into small variants (single nucleotide variants and indels < 50 bp), large variants (copy number variants and short tandem repeats) and other variants (structural variants and aneuploidies). Variant calling format files were queried per variant, from which workflow-specific true positive rates (TPRs) for detection were determined. A TPR of ≥ 98% was considered the threshold for transition to GS. A GS-first scenario was generated for our laboratory, using diagnostic efficacy and predicted false negative as primary outcome measures. As input, we modeled the diagnostic path for all 24,570 individuals referred in 2022, combining the clinical referral, the transition of the underlying workflow(s) to GS, and the variant type(s) to be detected.

Results

Overall, 95% (1206/1271) of variants were detected. Detection rates differed per variant category: small variants in 96% (826/860), large variants in 93% (341/366), and other variants in 87% (39/45). TPRs varied between workflows (79–100%), with 7/10 being replaceable by GS. Models for our laboratory indicate that a GS-first strategy would be feasible for 84.9% of clinical referrals (750/883), translating to 71% of all individuals (17,444/24,570) receiving GS as their primary test. An estimated false negative rate of 0.3% could be expected.

Conclusions

GS can capture clinically relevant germline variants in a ‘GS-first strategy’ for the majority of clinical indications in a genetics diagnostic lab.
Variation vs. specialization: the dose-time-effect of technical and physiological variety in the development of elite swimmers
Authors: Born Dennis-Peter , Lorentzen Jenny , Björklund Glenn , Stöggl Thomas , Romann Michael
Published: February 2024

Objective

It is heavily discussed whether larger variety or specialization benefit elite performance at peak age. Therefore, this study aimed to determine technical (number of different swimming strokes) and physiological (number of different race distances) variety required to become an international-class swimmer (> 750 swimming points) based on 1′522′803 race results.

Results

Correlation analyses showed lower technical variety in higher ranked swimmers (P < 0.001), yet with small effects (0.11–0.30). However, Poisson distribution revealed dose-time-effects and specified number of swimming strokes required during each age group. Specifically, freestyle swimmers showed highest chances when starting to compete in three to four swimming strokes but reduced their variety to three swimming strokes at the ages of 12/13yrs with another transition to two swimming strokes at the ages of 19/21yrs (female/male swimmers, respectively). Although both sexes showed similar specialization pattern throughout their career, earlier specialization was generally evident in female compared to male swimmers. At peak performance age, freestyle was most frequently combined with butterfly. Swimmers who either kept competing in all five swimming strokes or focused on only one at the beginning of their careers showed lowest probability of becoming an international-class swimmer. Physiological variety increased during junior age but declined again to three race distances towards elite age.
The use of synaptic biomarkers in cerebrospinal fluid to differentiate behavioral variant of frontotemporal dementia from primary psychiatric disorders and Alzheimer’s disease
Authors: Das Shreyasee , van Engelen Marie-Paule E. , Goossens Julie , Jacobs Dirk , Bongers Bram , Fieldhouse Jay L. P. , Pijnenburg Yolande A. L. , Teunissen Charlotte E. , Vanmechelen Eugeen , Verberk Inge M. W.
Published: February 2024

Background

Lack of early molecular biomarkers in sporadic behavioral variants of frontotemporal dementia (bvFTD) and its clinical overlap with primary psychiatric disorders (PPD) hampers its diagnostic distinction. Synaptic dysfunction is an early feature in bvFTD and identification of specific biomarkers might improve its diagnostic accuracy. Our goal was to understand the differential diagnostic potential of cerebrospinal fluid (CSF) synaptic biomarkers in bvFTD versus PPD and their specificity towards bvFTD compared with Alzheimer’s disease (AD) and controls. Additionally, we explored the association of CSF synaptic biomarkers with social cognition, cognitive performance, and disease severity in these clinical groups.

Methods

Participants with probable bvFTD (n = 57), PPD (n = 71), AD (n = 60), and cognitively normal controls (n = 39) with available CSF, cognitive tests, and disease severity as frontotemporal lobar degeneration-modified clinical dementia rating scale (FTLD-CDR) were included. In a subset of bvFTD and PPD cases, Ekman 60 faces test scores for social cognition were available. CSF synaptosomal-associated protein 25 (SNAP25), neurogranin (Ng), neuronal pentraxin 2 (NPTX2), and glutamate receptor 4 (GluR4) were measured, along with neurofilament light (NfL), and compared between groups using analysis of covariance (ANCOVA) and logistic regression. Diagnostic accuracy was assessed using ROC analyses, and biomarker panels were selected using Wald’s backward selection. Correlations with cognitive measures were performed using Pearson’s partial correlation analysis.

Results

NPTX2 concentrations were lower in the bvFTD group compared with PPD (p < 0.001) and controls (p = 0.003) but not compared with AD. Concentrations of SNAP25 (p < 0.001) and Ng (p < 0.001) were elevated in patients with AD versus those with bvFTD and controls. The modeled panel for differential diagnosis of bvFTD versus PPD consisted of NfL and NPTX2 (AUC = 0.96, CI: 0.93–0.99, p < 0.001). In bvFTD versus AD, the modeled panel consisted of NfL, SNAP25, Ng, and GluR4 (AUC = 0.86, CI: 0.79–0.92, p < 0.001). In bvFTD, lower NPTX2 (Pearson’s r = 0.29, p = 0.036) and GluR4 (Pearson’s r = 0.34, p = 0.014) concentrations were weakly associated with worse performance of total cognitive score. Lower GluR4 concentrations were also associated with worse MMSE scores (Pearson’s r = 0.41, p = 0.002) as well as with worse executive functioning (Pearson’s r = 0.36, p = 0.011) in bvFTD. There were no associations between synaptic markers and social cognition or disease severity in bvFTD.

Conclusion

Our findings of involvement of NTPX2 in bvFTD but not PPD contribute towards better understanding of bvFTD disease pathology.
Comparison contrast-enhanced CT with contrast-enhanced US in diagnosing combined hepatocellular-cholangiocarcinoma: a propensity score-matched study
Authors: Yang Jie , Zhang Yun , Bao Wu-yong-ga , Chen Yi-di , Jiang Hanyu , Huang Jia-yan , Zeng Ke-yu , Song Bin , Huang Zi-xing , Lu Qiang
Published: February 2024

Objectives

To develop and compare noninvasive models for differentiating between combined hepatocellular-cholangiocarcinoma (cHCC-CCA) and HCC based on serum tumor markers, contrast-enhanced ultrasound (CEUS), and computed tomography (CECT).

Methods

From January 2010 to December 2021, patients with pathologically confirmed cHCC-CCA or HCC who underwent both preoperative CEUS and CECT were retrospectively enrolled. Propensity scores were calculated to match cHCC-CCA and HCC patients with a near-neighbor ratio of 1:2. Two predicted models, a CEUS-predominant (CEUS features plus tumor markers) and a CECT-predominant model (CECT features plus tumor markers), were constructed using logistic regression analyses. Model performance was evaluated by the area under the curve (AUC), sensitivity, specificity, and accuracy.

Results

A total of 135 patients (mean age, 51.3 years ± 10.9; 122 men) with 135 tumors (45 cHCC-CCA and 90 HCC) were included. By logistic regression analysis, unclear boundary in the intratumoral nonenhanced area, partial washout on CEUS, CA 19-9 > 100 U/mL, lack of cirrhosis, incomplete tumor capsule, and nonrim arterial phase hyperenhancement (APHE) volume < 50% on CECT were independent factors for a diagnosis of cHCC-CCA. The CECT-predominant model showed almost perfect sensitivity for cHCC-CCA, unlike the CEUS-predominant model (93.3% vs. 55.6%, p < 0.001). The CEUS-predominant model showed higher diagnostic specificity than the CECT-predominant model (80.0% vs. 63.3%; p = 0.020), especially in the ≤ 5 cm subgroup (92.0% vs. 70.0%; p = 0.013).

Conclusions

The CECT-predominant model provides higher diagnostic sensitivity than the CEUS-predominant model for CHCC-CCA. Combining CECT features with serum CA 19-9 > 100 U/mL shows excellent sensitivity.

Critical relevance statement

Combining lack of cirrhosis, incomplete tumor capsule, and nonrim arterial phase hyperenhancement (APHE) volume < 50% on CECT with serum CA 19-9 > 100 U/mL shows excellent sensitivity in differentiating cHCC-CCA from HCC.

Key points

1. Accurate differentiation between cHCC-CCA and HCC is essential for treatment decisions.

2. The CECT-predominant model provides higher accuracy than the CEUS-predominant model for CHCC-CCA.

3. Combining CECT features and CA 19-9 levels shows a sensitivity of 93.3% in diagnosing cHCC-CCA.

Graphical Abstract
Neuroimaging features of primary central nervous system post-transplantation lymphoproliferative disorder following hematopoietic stem cell transplant in patients with β-thalassemia: a case series and review of literature
Authors: Yang Xueqing , Deng Xi , Wu Meiqing , Chen Sean W. , Jiang Muliang , Long Liling , Chen Bihong T.
Published: February 2024

Purpose

Primary central nervous system post-transplantation lymphoproliferative disorder (PCNS-PTLD) is a rare but serious complication of hematopoietic stem cell transplantation (HSCT) in patients with severe β-thalassemia. This study aimed to assess the clinical presentation, pathological characteristics, neuroimaging findings, and treatment strategies in patients with β-thalassemia who developed PCNS-PTLD and to compare a case series from our transplant center to reported cases from literature.

Methods

We retrospectively reviewed our hospital database and identified four cases of pathologically confirmed PCNS-PTLD without a history of systemic PTLD in patients with severe β-thalassemia after HSCT. We also performed a relevant literature review on PCNS-PTLD.

Results

The median time from transplantation to diagnosis of PCNS-PTLD was 5.5 months. Intracerebral lesions were usually multiple involving both supratentorial and infratentorial regions with homogeneous or rim enhancement. All patients had pathologically confirmed PCNS-PTLD with three patients having diffuse large B-cell lymphoma and the fourth patient having plasmacytic hyperplasia. There was low response to treatment with a median survival of 83 days.

Conclusion

PCNS-PTLD should be considered in the differential diagnosis of patients with β-thalassemia who had an intracranial lesion on neuroimaging after HSCT.

Critical relevance statement

This case series with a comprehensive review of neuroimaging and clinical characteristics of children with primary central nervous system post-transplantation lymphoproliferative disorder should advance our understanding and improve management of this rare yet severe complication following transplant for β-thalassemia.

Key points

• We assessed clinical presentation, treatment strategies, and neuroimaging characteristics of PCNS-PTLD in patients with β-thalassemia after transplantation.

• Patients with β-thalassemia may have post-transplantation lymphoproliferative disorder presenting as brain lesions on neuroimaging.

• Neuroimaging findings of the brain lesions are helpful for prompt diagnosis and proper management.

Graphical Abstract
Radiation reduction for interventional radiology imaging: a video frame interpolation solution
Authors: Tang Zhijiang , Xiong Qiang , Wu Xuantai , Xu Tianyi , Shi Yuxuan , Xu Ximing , Xu Jun , Wang Ruijue
Published: February 2024

Purpose

The aim of this study was to diminish radiation exposure in interventional radiology (IR) imaging while maintaining image quality. This was achieved by decreasing the acquisition frame rate and employing a deep neural network to interpolate the reduced frames.

Methods

This retrospective study involved the analysis of 1634 IR sequences from 167 pediatric patients (March 2014 to January 2022). The dataset underwent a random split into training and validation subsets (at a 9:1 ratio) for model training and evaluation. Our approach proficiently synthesized absent frames in simulated low-frame-rate sequences by excluding intermediate frames from the validation subset. Accuracy assessments encompassed both objective experiments and subjective evaluations conducted by nine radiologists.

Results

The deep learning model adeptly interpolated the eliminated frames within IR sequences, demonstrating encouraging peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM) results. The average PSNR values for angiographic, subtraction, and fluoroscopic modes were 44.94 dB, 34.84 dB, and 33.82 dB, respectively, while the corresponding SSIM values were 0.9840, 0.9194, and 0.7752. Subjective experiments conducted with experienced interventional radiologists revealed minimal discernible differences between interpolated and authentic sequences.

Conclusion

Our method, which interpolates low-frame-rate IR sequences, has shown the capability to produce high-quality IR images. Additionally, the model exhibits potential for reducing the frame rate during IR image acquisition, consequently mitigating radiation exposure.

Critical relevance statement

This study presents a critical advancement in clinical radiology by demonstrating the effectiveness of a deep neural network in reducing radiation exposure during pediatric interventional radiology while maintaining image quality, offering a potential solution to enhance patient safety.

Key points

• Reducing radiation: cutting IR image to reduce radiation.

• Accurate frame interpolation: our model effectively interpolates missing frames.

• High visual quality in terms of PSNR and SSIM, making IR procedures safer without sacrificing quality.

Graphical Abstract
Pediatric spinal ependymoma with chromothripsis of chromosome 6: a case report and review of the literature
Authors: Scott Keela R. , Gener Melissa A. , Repnikova Elena A.
Published: February 2024

Background

Ependymomas are the third most common central nervous system tumor in the pediatric population; however, spinal ependymomas in children are rare. Ependymomas affecting the spinal cord most frequently occur in adults of 20–40 years of age. The current World Health Organization classification system for ependymomas is now composed of ten different entities based on histopathology, location, and molecular studies, with evidence that the new classification system more accurately predicts clinical outcomes.

Case presentation

We present the case of a 16-year-old Caucasian female patient with a history of type 2 neurofibromatosis with multiple schwannomas, meningioma, and spinal ependymoma. Chromosome analysis of the harvested spinal ependymoma tumor sample revealed a 46,XX,−6,+7,−22,+mar[16]/46,XX[4] karyotype. Subsequent OncoScan microarray analysis of the formalin-fixed paraffin-embedded tumor sample confirmed + 7, −22 and clarified that the marker chromosome represents chromothripsis of the entire chromosome 6 with more than 100 breakpoints. Fluorescent in situ hybridization and microarray analysis showed no evidence of MYCN amplification. The final integrated pathology diagnosis was spinal ependymoma (central nervous system World Health Organization grade 2 with no MYCN amplification.

Conclusion

This case adds to the existing literature of pediatric patients with spinal ependymomas and expands the cytogenetic findings that may be seen in patients with this tumor type. This case also highlights the value of cytogenetics and microarray analysis in solid tumors to provide a more accurate molecular diagnosis.
Approximating fixed points of weak enriched contractions using Kirk’s iteration scheme of higher order
Authors: Zhou Mi , Saleem Naeem , Abbas Mujahid
Published: February 2024

In this paper, we introduce two types of weak enriched contractions, namely weak enriched $\mathcal{F}$
F
-contraction, weak enriched $\mathcal{F^{\prime}}$

F
′

-contraction, and k-fold averaged mapping based on Kirk’s iterative algorithm of order k. The types of contractions introduced herein unify, extend, and generalize several existing classes of enriched and weak enriched contraction mappings. Moreover, K-fold averaged mappings can be viewed as a generalization of the averaged mappings and double averaged mappings. We then prove the existence of a unique fixed point of the k-fold averaged mapping associated with weak enriched contractions introduced herein. We study necessary conditions that guarantee the equality of the sets of fixed points of the k-fold averaged mapping and weak enriched contractions. We show that an appropriate Kirk’s iterative algorithm can be used to approximate a fixed point of a k-fold averaged mapping and of the two weak enriched contractions. We also study the well-posedness, limit shadowing property, and Ulam–Hyers stability of the k-fold averaged mapping. We provide necessary conditions that ensure the periodic point property of each illustrated weak enriched contraction. Some examples are presented to show that our results are a potential generalization of the comparable results in the existing literature.
Generalized fixed points for fuzzy and nonfuzzy mappings in strong b-metric spaces
Authors: Kanwal Shazia , Işık Hüseyin , Waheed Sana
Published: February 2024

The main purpose of this research article is to generalize Kannan-type fixed-point (FP) theorems for single-valued mappings and Chatterjea-type FP result for fuzzy mappings (FMs) in the context of complete strong b-metric spaces (MSs). Moreover, fuzzy FPs are established for Suzuki-type fuzzy contraction in the setting of complete strong b-MSs. The conclusions are supported by nontrivial examples to enhance the validity of the results obtained in this study. In addition, previous findings have been made as corollaries from the relevant literature. The numerous implications that this technique has across the literature improve and integrate our findings. Applications of some of the results obtained are also incorporated.
Enhanced mechanism to prioritize the cloud data privacy factors using AHP and TOPSIS: a hybrid approach
Authors: Khan Mohammad Zunnun , Shoaib Mohd , Husain Mohd Shahid , Ul Nisa Khair , Quasim Mohammad. Tabrez
Published: February 2024

Cloud computing is a new paradigm in this new cyber era. Nowadays, most organizations are showing more reliability in this environment. The increasing reliability of the Cloud also makes it vulnerable. As vulnerability increases, there will be a greater need for privacy in terms of data, and utilizing secure services is highly recommended. So, data on the Cloud must have some privacy mechanisms to ensure personal and organizational privacy. So, for this, we must have an authentic way to increase the trust and reliability of the organization and individuals The authors have tried to create a way to rank things that uses the Analytical Hieratical Process (AHP) and the Technique for Order Preference by Similarity to the Ideal Solution (TOPSIS). Based on the result and comparison, produce some hidden advantages named cost, benefit, risk and opportunity-based outcomes of the result.

In this paper, we are developing a cloud data privacy model; for this, we have done an intensive literature review by including Privacy factors such as Access Control, Authentication, Authorization, Trustworthiness, Confidentiality, Integrity, and Availability. Based on that review, we have chosen a few parameters that affect cloud data privacy in all the phases of the data life cycle. Most of the already available methods must be revised per the industry’s current trends. Here, we will use Analytical Hieratical Process and Technique for Order Preference by Similarity to the Ideal Solution method to prove that our claim is better than other cloud data privacy models. In this paper, the author has selected the weights of the individual cloud data privacy criteria and further calculated the rank of individual data privacy criteria using the AHP method and subsequently utilized the final weights as input of the TOPSIS method to rank the cloud data privacy criteria.
Introduction and spread of vancomycin-resistant Enterococcus faecium (VREfm) at a German tertiary care medical center from 2004 until 2010: a retrospective whole-genome sequencing (WGS) study of the molecular epidemiology of VREfm
Authors: Caplunik-Pratsch Aila , Kieninger Bärbel , Donauer Veronika A. , Brauer Johanna M. , Meier Vanessa M. K. , Seisenberger Corinna , Rath Anca , Loibl Daniel , Eichner Anja , Fritsch Jürgen , Schneider-Brachert Wulf
Published: February 2024

Background

In most of Europe and especially in Germany, there is currently a concerning rise in the number of hospital-acquired infections due to vancomycin-resistant Enterococcus faecium (VREfm). Therefore, there is a need to improve our understanding of the way VREfm spreads in hospitals. In this study, we investigated the molecular epidemiology of VREfm isolates from the first appearance at our university hospital in 2004 until 2010. There is only very scarce information about the molecular epidemiology of VREfm from this early time in Germany.

Methods

Our analysis includes all available first VREfm isolates of each patient at our tertiary care center collected during the years 2004–2010. If available, additional consecutive VREfm isolates from some patients were analyzed. We used multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST) for the analysis and description of nosocomial transmission pathways as well as the detection of outbreaks.

Results

VREfm isolates from 158 patients and 76 additional subsequent patient isolates were included in the analysis. Until 2006, detections of VREfm remained singular cases, followed by a peak in the number of VREfm cases in 2007 and 2008 with a subsequent decline to baseline in 2010. MLST and cgMLST analysis show significant changes in the dominant sequence types (STs) and complex types (CTs) over the study period, with ST192 and ST17 being responsible for the peak in VREfm cases in 2007 and 2008. The four largest clusters detected during the study period are comprised of these two STs. Cluster analysis shows a focus on specific wards and departments for each cluster. In the early years of this study (2004–2006), all analyzed VREfm stemmed from clinical specimens, whereas since 2007, approximately half of the VREfm were detected by screening. Of the 234 VREfm isolates analyzed, 96% had a vanB and only 4% had a vanA resistance genotype.

Conclusions

This retrospective study contributes significant knowledge about regional VREfm epidemiology from this early VREfm period in Germany. One remarkable finding is the striking dominance of vanB-positive VREfm isolates over the entire study period, which is in contrast with countrywide data. Analysis of cgMLST shows the transition from sporadic VRE cases at our institution to a sharp increase in VRE numbers triggered by oligoclonal spread and specific outbreak clusters with the dominance of ST192 and ST17.
Factors affecting the length of hospital stay for total knee arthroplasty in Japan: a retrospective study using the diagnosis procedure combination database
Authors: Hara Kentaro , Kanda Masato , Kobayashi Yoshio , Miyamoto Takashi , Inoue Takahiro
Published: February 2024

Background

We aimed to evaluate the length of hospital stay following total knee arthroplasty to determine the impact of relevant factors using data from the Diagnosis Procedure Combination database.

Methods

This was a retrospective observational study. The study cohort included 5,831 patients who had osteoarthritis of the knee and had undergone total knee replacement between February 2018 and October 2022 at 38 hospitals.

Results

Multivariate analysis showed that the factors influencing the length of stay included: age (p < 0.001), height (p < 0.001), weight (p = 0.049), body mass index (p = 0.008), Barthel index (p < 0.001), method of anesthesia (p < 0.001), bone transplant (p = 0.010), timing of postoperative rehabilitation (p < 0.001), atrial fibrillation (p < 0.001), chronic pain (p < 0.001), and number of institutionally treated cases (p < 0.001) (r = 0.451, p < 0.001).

Conclusions

Shorter or longer hospital stays were found to be associated with the patients’ background characteristics and facility-specific factors; these can lead to more accurate estimates of the length of hospital stay and appropriate allocation of resources.
Strategies and difficulties during students’ construction of data visualizations
Authors: Chang Hsin-Yi , Chang Yen-Jung , Tsai Meng-Jung
Published: February 2024

Background

Data visualizations transform data into visual representations such as graphs, diagrams, charts and so forth, and enable inquiries and decision-making in many professional fields, as well as in public and economic areas. How students’ data visualization literacy (DVL), including constructing, comprehending, and utilizing adequate data visualizations, can be developed is gaining increasing attention in STEM education. As fundamental steps, the purpose of this study was to understand common student difficulties and useful strategies during the process of constructing data visualization so that suggestions and principles can be made for the design of curricula and interventions to develop students’ DVL.

Methods

This study engaged 57 college and high school students in constructing data visualizations relating to the topic of air quality for a decision-making task. The students’ difficulties and strategies demonstrated during the process of data visualization were analyzed using multiple collected data sources including the students’ think-aloud transcripts, retrospective interview transcripts, and process videos that captured their actions with the data visualization tool. Qualitative coding was conducted to identify the students’ difficulties and strategies. Epistemic network analysis (ENA) was employed to generate network models revealing how the difficulties and strategies co-occurred, and how the college and high school students differed.

Results

Six types of student difficulties and seven types of strategies were identified. The strategies were further categorized into non-, basic- and high-level metavisual strategies. About three-quarters of the participants employed basic or high-level metavisual strategies to overcome the technological and content difficulties. The high school students demonstrated a greater need to develop content knowledge and representation skills, whereas the college students needed more support to know how to simplify data to construct the best data visualizations.

Conclusions and implications

The study specified metacognition needed for data visualization, which builds on and extends the cognitive model of drawing construction (CMDC) and theoretical perspectives of metavisualization. The results have implications for developing students’ data visualization literacy in STEM education by considering the difficulties and trajectories of metacognitive strategy development, and by addressing the different patterns and needs demonstrated by the college and high school students.
Optimization of Clostridium beijerinckii semi-solid fermentation of rape straw to produce butyric acid by genome analysis
Authors: Kou Hui , Zheng Jia , Ye Guangbin , Qiao Zongwei , Zhang Kaizheng , Luo Huibo , Zou Wei
Published: February 2024

Butyric acid is a volatile saturated monocarboxylic acid, which is widely used in the chemical, food, pharmaceutical, energy, and animal feed industries. This study focuses on producing butyric acid from pre-treated rape straw using simultaneous enzymatic hydrolysis semi-solid fermentation (SEHSF). Clostridium beijerinckii BRM001 screened from pit mud of Chinese nongxiangxing baijiu was used. The genome of C. beijerinckii BRM001 was sequenced and annotated. Using rape straw as the sole carbon source, fermentation optimization was carried out based on the genomic analysis of BRM001. The optimized butyric acid yield was as high as 13.86 ± 0.77 g/L, which was 2.1 times higher than that of the initial screening. Furthermore, under optimal conditions, non-sterile SEHSF was carried out, and the yield of butyric acid was 13.42 ± 0.83 g/L in a 2.5-L fermentor. This study provides a new approach for butyric acid production which eliminates the need for detoxification of straw hydrolysate and makes full use of the value of fermentation waste residue without secondary pollution, making the whole process greener and more economical, which has a certain industrial potential.

Graphical Abstract
A soft, scalable and adaptable multi-contact cuff electrode for targeted peripheral nerve modulation
Authors: Paggi Valentina , Fallegger Florian , Serex Ludovic , Rizzo Olivier , Galan Katia , Giannotti Alice , Furfaro Ivan , Zinno Ciro , Bernini Fabio , Micera Silvestro , Lacour Stéphanie P.
Published: February 2024

Background

Cuff electrodes target various nerves throughout the body, providing neuromodulation therapies for motor, sensory, or autonomic disorders. However, when using standard, thick silicone cuffs, fabricated in discrete circular sizes, complications may arise, namely cuff displacement or nerve compression, due to a poor adaptability to variable nerve shapes and sizes encountered in vivo. Improvements in cuff design, materials, closing mechanism and surgical approach are necessary to overcome these issues.

Methods

In this work, we propose a microfabricated multi-channel silicone-based soft cuff electrode with a novel easy-to-implant and size-adaptable design and evaluate a number of essential features such as nerve-cuff contact, nerve compression, cuff locking stability, long-term integration and stimulation selectivity. We also compared performance to that of standard fixed-size cuffs.

Results

The belt-like cuff made of 150 μm thick silicone membranes provides a stable and pressure-free conformal contact, independently of nerve size variability, combined with a straightforward implantation procedure. The adaptable design and use of soft materials lead to limited scarring and demyelination after 6-week implantation. In addition, multi-contact designs, ranging from 6 to 16 electrodes, allow for selective stimulation in models of rat and pig sciatic nerve, achieving targeted activation of up to 5 hindlimb muscles.

Conclusion

These results suggest a promising alternative to classic fixed-diameter cuffs and may facilitate the adoption of soft, adaptable cuffs in clinical settings.
What do you think it means? Using cognitive interviewing to improve measurement in implementation science: description and case example
Authors: Patel-Syed Zabin , Becker Sara , Olson Miranda , Rinella Hailey , Scott Kelli
Published: February 2024

Pragmatic measures are essential to evaluate the implementation of evidence-based interventions. Cognitive interviewing, a qualitative method that collects partner feedback throughout measure development, is particularly useful for developing pragmatic implementation measures. Measure developers can use cognitive interviewing to increase a measure’s fit within a particular implementation context. However, cognitive interviewing is underused in implementation research, where most measures remain “homegrown” and used for single studies. We provide a rationale for using cognitive interviewing in implementation science studies and illustrate its use through a case example employing cognitive interviewing to inform development of a measurement-based care protocol for implementation in opioid treatment programs. Applications of cognitive interviewing, including developing a common language with partners and collecting multi-level feedback on assessment procedures, to improve measurement in implementation science are discussed.
The impact of climate risk disclosure on financial performance, financial reporting and risk management: evidence from Egypt
Authors: Megeid Nevine Sobhy Abdel
Published: February 2024

Where Egypt stand with climate related-risk disclosures and why stakeholders and organizations require such information? This research aims to measure the climate risk disclosure level in Egyptian companies and to investigate its determinants. As unfavorable climatic circumstances create systemic risk for businesses throughout the whole global economy, this research examine how the disclosure of climate change risks affects the financial performance, financial reporting, and risk management. Few studies analyze how climate-related risk affects the financial performance of publicly traded companies in Egypt. This research applies regression models using both quantitative and qualitative methodologies. The information was gleaned from the 2019 through 2022 financial statements of 25 publicly traded companies. According to statistical analysis, there is a significant positive association between the financial performance, financial reporting, and risk management of industrial organizations and the disclosure of climate change. The findings show that the financial markets require precise, thorough, and high-quality information about the effects of climate change. This encompasses the threats and chances posed by increasing temperatures, climate-related legislation, and new technology in our rapidly evolving global environment.
Market volatility and crisis dynamics: a comprehensive analysis of U.S., China, India, and Pakistan stock markets with oil and gold interconnections during COVID-19 and Russia–Ukraine war periods
Authors: Khan Muhammad Niaz
Published: February 2024

The objective of this paper is to explore the interconnectedness of volatility among the stock markets of U.S., China, India, and Pakistan in conjunction with oil and gold markets. Employing the novel Time-Varying Parameter Vector Autoregression (TVP-VAR) model for assessing connectedness, the study scrutinizes key patterns of dependency and interrelation between these markets. Furthermore, this study investigates the dynamic connectedness during the global health crisis due to COVID-19 and the geopolitical crisis due to Russia–Ukraine war periods to identify the changes in their relationship following the two crises episodes. The findings underscore the significance of volatility transmissions emanating from the U.S., a developed market, in shaping these dynamic linkages. It is observed that oil and gold returns play a limited role as sources of shocks for market returns in China, India, and Pakistan, suggesting a relatively lower contribution of oil and gold to equity market volatility. The results also emphasize the safe-haven characteristics of gold during periods of crisis such as the COVID-19 pandemic and the Russia–Ukraine war. Moreover, the study indicates that the volatility transmissions during the COVID-19 pandemic are more pronounced compared to the Russia–Ukraine war crisis. These findings hold notable implications for both investors and policymakers, emphasizing the need for a nuanced understanding of market dynamics and the development of risk-averse strategies, particularly in times of crisis.