bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction and optimization of indirect shoot regeneration of Passiflora caerulea using machine learning and optimization algorithms
Authors: Jafari Marziyeh , Daneshvar Mohammad Hosein
Published: August 2023

Background

Optimization of indirect shoot regeneration protocols is one of the key prerequisites for the development of Agrobacterium-mediated genetic transformation and/or genome editing in Passiflora caerulea. Comprehensive knowledge of indirect shoot regeneration and optimized protocol can be obtained by the application of a combination of machine learning (ML) and optimization algorithms.

Materials and methods

In the present investigation, the indirect shoot regeneration responses (i.e., de novo shoot regeneration rate, the number of de novo shoots, and length of de novo shoots) of P. caerulea were predicted based on different types and concentrations of PGRs (i.e., TDZ, BAP, PUT, KIN, and IBA) as well as callus types (i.e., callus derived from different explants including leaf, node, and internode) using generalized regression neural network (GRNN) and random forest (RF). Moreover, the developed models were integrated into the genetic algorithm (GA) to optimize the concentration of PGRs and callus types for maximizing indirect shoot regeneration responses. Moreover, sensitivity analysis was conducted to assess the importance of each input variable on the studied parameters.

Results

The results showed that both algorithms (RF and GRNN) had high predictive accuracy (R2 > 0.86) in both training and testing sets for modeling all studied parameters. Based on the results of optimization process, the highest de novo shoot regeneration rate (100%) would be obtained from callus derived from nodal segments cultured in the medium supplemented with 0.77 mg/L BAP plus 2.41 mg/L PUT plus 0.06 mg/L IBA. The results of the sensitivity analysis showed the explant-dependent impact of exogenous application of PGRs on indirect de novo shoot regeneration.

Conclusions

A combination of ML (GRNN and RF) and GA can display a forward-thinking aid to optimize and predict in vitro culture systems and consequentially cope with several challenges faced currently in Passiflora tissue culture.
Approaches and styles of mothers in sex education process of children and the related factors
Authors: Nesfechi Elnaz Faraji , Pouralizadeh Moluk , Khalesi Zahra Bostani , Maroufizadeh Saman
Published: August 2023

Introduction

Sex education supports the development of suitable sexual behaviors in children. However, due to the limitations of sexual issues in Iran, parents may have different sex education styles. This study aimed to assess the styles of mothers in the sex education process of children and the related factors.

Methods

In a cross-sectional study, from March to May 2021, 306 mothers with a 4–12-year-old child who were referred to the comprehensive health service centers in Rasht city were entered into the study by a convenience sampling method. The tool was a questionnaire of parents' sex education styles. Data analysis was performed with independent t-tests, one-way ANOVA, Pearson's correlation coefficient, and the multiple linear regression model using SPSS software version 16.

Results

The majority of the mothers had a mean age of 36.2 ± 6.4 years. The score of the authoritarian sex education style was significantly higher than the other styles (P < 0.001). According to the multivariate analysis, 40.6% of the changes in the strict style (R2 = 0.406), 32.7% of the changes in the permissive style (R2 = 0.327), and 36.1% of the changes in the authoritative style (R2 = 0.361) were explained by the personal characteristics of the participants.

Conclusion

The authoritative style was a dominant sex education style. Identifying the factors associated with types of child sex education styles has an important role in promoting the health of children and the community. It is recommended that nursing policymakers identify related factors of sex education styles in mothers of different cultures, and therefore, implement training programs for empowering mothers.
Women with PCOS who undergo IVF: a comprehensive review of therapeutic strategies for successful outcomes
Authors: Kotlyar Alexander M. , Seifer David B.
Published: August 2023

Polycystic ovarian syndrome (PCOS) is a widespread syndrome that poses unique challenges and constraints to the field of assisted reproductive technology. This condition is the most common cause of anovulation among infertile couples. Debate exists over the best therapeutic course of action when patients with PCOS proceed to IVF. In this review, we evaluate the best-performing and safest methods of IVF preparation, ovarian stimulation, trigger method for maturation of stimulated egg growth, and planning for embryo transfer. Pre-IVF considerations include being aware of individual AMH and vitamin D levels as well as BMI prior to selecting an ovarian stimulation protocol. Numerous supplements such as myo-inositol complement the benefits of lifestyle change and may enhance IVF performance including oocyte yield and pregnancy rate. Concerning stimulation protocols, antagonist cycles with the judicious use of GnRH agonist trigger, pre-treatment with metformin and vitamin D repletion may help mitigate the accompanied risk of ovarian hyperstimulation syndrome (OHSS). Following ovarian stimulation, PCOS patients typically undergo programmed frozen embryo transfer (FET) cycles which are more conducive for women with irregular cycles, but likely carry a higher risk of hypertensive disorders of pregnancy. However, newer stimulated FET protocols using Letrozole may offer improved outcomes. Overall, patients with PCOS require careful individual tailoring of their IVF cycle to achieve optimal results.
Strategies for maintaining and strengthening the health care workers during epidemics: a scoping review
Authors: Valiee Sadra , Zarei Jelyani Zahra , Kia Mohammad , Jajarmizadeh Ali , Delavari Sajad , Shalyari Naseh , Ahmadi Marzaleh Milad
Published: August 2023

Introduction

During epidemics such as COVID-19, healthcare workers (HCWs) face several challenges, leading to a shortage and weakening of human resources. To address this issue, employing effective strategies is essential in maintaining and strengthening human resources during outbreaks. This study aimed to gather and classify strategies that could retain and strengthen human health resources during epidemics.

Methods

In this scoping review, all studies published about strategies for maintaining and strengthening HCWs in epidemics were collected from 4 international databases, including PubMed, Embase, Scopus, and Web of Science. The English language articles published after 2000 up until June 2022 recommended specific strategies regarding the research question. Then, they were analyzed and classified according to thematic analysis based on Braun and Clarke 6 phases protocols.

Results

In total, 9405 records were screened, of which 59 articles were included, and their full texts were reviewed. Fifty factors were identified and classified into five themes: Instruction, Protection, Supporting, Caring, and Communication. Most of the suggestions were conducted in high-income countries and related to the Supporting theme.

Discussion

The majority of strategies discussed in the literature addressed only one or two aspects of human resources. This study provides a holistic perspective on these issues by providing a thematic map of different strategies for strengthening and maintaining HCWs during epidemics. Considering the multidimensionality of human nature, it is suggested that policymakers and managers of health systems provide facilities that simultaneously address a wide range of needs.
The role of MSCs and CAR-MSCs in cellular immunotherapy
Authors: Yan Lun , Li Jing , Zhang Cheng
Published: August 2023

Chimeric antigen receptors (CARs) are widely used by T cells (CAR-T cells), natural killer cells dendritic cells and macrophages, and they are of great importance in cellular immunotherapy. However, the use of CAR-related products faces several challenges, including the poor persistence of cells carrying CARs, cell dysfunction or exhaustion, relapse of disease, immune effector cell-associated neurotoxicity syndrome, cytokine release syndrome, low efficacy against solid tumors and immunosuppression by the tumor microenvironment. Another important cell therapy regimen involves mesenchymal stem cells (MSCs). Recent studies have shown that MSCs can improve the anticancer functions of CAR-related products. CAR-MSCs can overcome the flaws of cellular immunotherapy. Thus, MSCs can be used as a biological vehicle for CARs. In this review, we first discuss the characteristics and immunomodulatory functions of MSCs. Then, the role of MSCs as a source of exosomes, including the characteristics of MSC-derived exosomes and their immunomodulatory functions, is discussed. The role of MSCs in CAR-related products, CAR-related product-derived exosomes and the effect of MSCs on CAR-related products are reviewed. Finally, the use of MSCs as CAR vehicles is discussed.

Graphical Abstract
Balance assessment in selected stages of Parkinson’s disease using trend change analysis
Authors: Wodarski Piotr , Jurkojć Jacek , Michalska Justyna , Kamieniarz Anna , Juras Grzegorz , Gzik Marek
Published: August 2023

Background

Balance disorders in patients diagnosed with Parkinson’s disease (PD) are associated with a change in balance-keeping strategy and reflex disorders which regulate the maintenance of vertical body posture. Center of foot pressure (COP) displacement signals were analyzed during quiet standing experiments to define such changes. The research aimed to apply stock exchange indices based on the trend change analyses to the assessment of a level of the Parkinson disease progression on the grounds of the analysis of the COP signals.

Methods

30 patients in two stages of PD, 40 elderly participants, and 20 individuals at a young age were studied. Each person was subjected to 3 measurements with open and closed eyes. A technical analysis of the COP displacement signal was performed, and the following quantities were determined: indices related to the number of trend changes (TCI), indices defining a mean time (TCI_dT), and mean displacement (TCI_dS) and mean velocity (TCI_dV) between such changes.

Results

The results indicate a higher TCI value for PD than for aged-matched control group (p < 0.05). In the case of PD patients, there was also an increase in the TCI_dS value by 2–5 mm, which mainly contributed to the increase in TCI_dV. Statistically significant differences for the TCI_dT values occurred between all groups in which differences in the average COP velocity were noted.

Conclusions

The TCI and TCI_dV results obtained for the healthy participants enabled the development of indices supporting PD diagnostics. The causes of the TCI_dV changes in patients were determined, i.e., whether they resulted from an increase in the TCI_dT or TCI_dS between the moments of trend changes indicated by the developed algorithm. The developed methodology provides new information on the impact of PD on the strategy of maintaining balance, which was impossible to obtain using currently used analyses.

Trial registration The conducted research is an observational study and does not include a health care intervention. Participants gave their consent to participate in the research and the procedure was approved by the Institutional Bioethics Committee.
A 16-year retrospective study of vascular anomalies in the head and neck region
Authors: Leyman Bernard , Govaerts Dries , Dormaar Jakob Titiaan , Meeus Jan , Bila Michel , Coropciuc Ruxandra , Willaert Robin , Politis Constantinus
Published: August 2023

Depending on the diagnostic modality, the classification of vascular anomalies varies and so does the nomenclature. The ‘International Society for the Study of Vascular Anomalies’ (ISSVA) is the most widely accepted classification in the literature and is mainly based on the radiologic and clinical presentation. The aim of this article is to review the clinical practice of diagnosis and treatment of vascular anomalies in the head and neck region in a university hospital, with special focus on the nomenclature.

All patients with a vascular anomaly presenting to the department of oral and maxillofacial surgery were reviewed in a retrospective manner. Nomenclature, diagnostic process, lesion characteristics, treatment and outcome were examined. The lesions were (re)classified according to the ISSVA classification.

A total of 185 patients were identified, of which 12.4% (n = 23) had a congenital anomaly. After reclassification, the most common lesions were venous malformations (n = 47, 25.4%), followed by lobular capillary hemangiomas (n = 17, 9.2%). A group of 39 anomalies could not be further specified. One hundred and one patients (54,6%) received treatment, of which 93 were treated surgically (92,1% of treated patients). Endovascular treatment was considered in 41 patients but applied in only eight. This strict selection led to a low a complication rate.

We provide an overview of the clinical practice in the management of vascular anomalies in a university hospital. The histology report is a source of miscommunication because clinicians use the ISSVA classification, while pathologists use the WHO classification. Every professional involved should be aware of the differences in classification and nomenclature.
Segmentation and counting of wheat spike grains based on deep learning and textural feature
Authors: Xu Xin , Geng Qing , Gao Feng , Xiong Du , Qiao Hongbo , Ma Xinming
Published: August 2023

Background

Grain count is crucial to wheat yield composition and estimating yield parameters. However, traditional manual counting methods are time-consuming and labor-intensive. This study developed an advanced deep learning technique for the segmentation counting model of wheat grains. This model has been rigorously tested on three distinct wheat varieties: ‘Bainong 307’, ‘Xinmai 26’, and ‘Jimai 336’, and it has achieved unprecedented predictive counting accuracy.

Method

The images of wheat ears were taken with a smartphone at the late stage of wheat grain filling. We used image processing technology to preprocess and normalize the images to 480*480 pixels. A CBAM-HRNet wheat grain segmentation counting deep learning model based on the Convolutional Block Attention Module (CBAM) was constructed by combining deep learning, migration learning, and attention mechanism. Image processing algorithms and wheat grain texture features were used to build a grain counting and predictive counting model for wheat grains.

Results

The CBAM-HRNet model using the CBAM was the best for wheat grain segmentation. Its segmentation accuracy of 92.04%, the mean Intersection over Union (mIoU) of 85.21%, the category mean pixel accuracy (mPA) of 91.16%, and the recall rate of 91.16% demonstrate superior robustness compared to other models such as HRNet, PSPNet, DeeplabV3+ , and U-Net. Method I for spike count, which calculates twice the number of grains on one side of the spike to determine the total number of grains, demonstrates a coefficient of determination R2 of 0.85, a mean absolute error (MAE) of 1.53, and a mean relative error (MRE) of 2.91. In contrast, Method II for spike count involves summing the number of grains on both sides to determine the total number of grains, demonstrating a coefficient of determination R2 of 0.92, an MAE) of 1.15, and an MRE) of 2.09%.

Conclusions

Image segmentation algorithm of the CBAM-HRNet wheat spike grain is a powerful solution that uses the CBAM to segment wheat spike grains and obtain richer semantic information. This model can effectively address the challenges of small target image segmentation and under-fitting problems in training. Additionally, the spike grain counting model can quickly and accurately predict the grain count of wheat, providing algorithmic support for efficient and intelligent wheat yield estimation.
TFE3 nuclear expression as a novel biomarker of ovarian sclerosing stromal tumors and associated with its histological morphology
Authors: Zhao Li , Yang Zhongfeng , Zhou Yan , Liu Yuping , Luo Qiuping , Jiang Qingping , Wang Hui , Wang Na
Published: August 2023

Sclerosing stromal tumors of the ovary are benign and tend to occur in youthful women with lobular structures at low frequencies. Three types of cells, including luteinized cells, short spindle myoid cells, and intermediate cells, are found in the lobules which abundant in the blood vessels. Currently, immunohistochemistry is used to detect normal follicles, sclerosing stromal tumors, granulosa cell tumors, and fibromas/thecomas. Our research results showed that transcription factor enhancer 3 (TFE3) was moderate to strong positive in the theca interna layer of normal follicles. TFE3 was expressed in seven out of eight sclerosing stromal tumors, mainly in luteinized cells. It did not express in 20 granulosa cell tumors. Of the nine fibromas/thecomas, TFE3 was weakly staining in 2 cases and negative in the remaining 7 cases. The expression of TFE3 was also weak in only one microcystic stromal tumor. 8 cases of sclerosing stromal tumors were analyzed by FISH using a TFE3 separation probe, and the results were negative. In short, as a nuclear transcription protein, TFE3 specifically expressed in sclerosing stromal tumors and could serve as a new marker for the diagnosis and differential diagnosis of sclerosing stromal tumors. Moreover, we speculate that TFE3 will promotes the formation of the vascular plexus after entry into the nucleus, which can further explain why sclerosing stromal tumors are different from other ovary sex-cord stromal tumors.
The antipsychotic medications aripiprazole, brexpiprazole and cariprazine are off-target respiratory chain complex I inhibitors
Authors: Hardy Rachel E. , Chung Injae , Yu Yizhou , Loh Samantha H. Y. , Morone Nobuhiro , Soleilhavoup Clement , Travaglio Marco , Serreli Riccardo , Panman Lia , Cain Kelvin , Hirst Judy , Martins Luis M. , MacFarlane Marion , Pryde Kenneth R.
Published: August 2023

Antipsychotic drugs are the mainstay of treatment for schizophrenia and provide adjunct therapies for other prevalent psychiatric conditions, including bipolar disorder and major depressive disorder. However, they also induce debilitating extrapyramidal syndromes (EPS), such as Parkinsonism, in a significant minority of patients. The majority of antipsychotic drugs function as dopamine receptor antagonists in the brain while the most recent ‘third’-generation, such as aripiprazole, act as partial agonists. Despite showing good clinical efficacy, these newer agents are still associated with EPS in ~ 5 to 15% of patients. However, it is not fully understood how these movement disorders develop. Here, we combine clinically-relevant drug concentrations with mutliscale model systems to show that aripiprazole and its primary active metabolite induce mitochondrial toxicity inducing robust declines in cellular ATP and viability. Aripiprazole, brexpiprazole and cariprazine were shown to directly inhibit respiratory complex I through its ubiquinone-binding channel. Importantly, all three drugs induced mitochondrial toxicity in primary embryonic mouse neurons, with greater bioenergetic inhibition in ventral midbrain neurons than forebrain neurons. Finally, chronic feeding with aripiprazole resulted in structural damage to mitochondria in the brain and thoracic muscle of adultDrosophila melanogasterconsistent with locomotor dysfunction. Taken together, we show that antipsychotic drugs acting as partial dopamine receptor agonists exhibit off-target mitochondrial liabilities targeting complex I.
Clinicopathological features of dysembryoplastic neuroepithelial tumor: a case series
Authors: Rahim Shabina , Ud Din Nasir , Abdul-Ghafar Jamshid , Chundriger Qurratulain , Khan Poonum , Ahmad Zubair
Published: August 2023

Background

Dysembryoplastic neuroepithelial tumors are rare benign supratentotrial epilepsy-associated glioneuronal tumors of children and young adults. Patients have a long history of seizures. Proper surgical resection achieves long term seizure control. We describe the clinicopathological features of dysembryoplastic neuroepithelial tumor cases reported in our practice and review the published literature.

Methods

All cases of Pakistani ethnicity were diagnosed between 2015 and 2021 were included. Slides were reviewed and clinicopathological features were recorded. Follow-up was obtained. Extensive literature review was conducted.

Results

Fourteen cases were reported. There were 12 males and 2 females. Age range was 9–45 years (mean 19 years). Majority were located in the temporal and frontal lobes. Duration of seizures prior to resection ranged from 2 months to 9 years with mean and median duration of 3.2 and 3 years, respectively. Histologically, all cases demonstrated a multinodular pattern, specific glioneuronal component, and floating neurons. Simple and complex forms comprised seven cases each. No significant nuclear atypia, mitotic activity, or necrosis was seen. Ki-67 proliferative index was very low. Cortical dysplasia was noted in adjacent glial tissue in four cases. Follow-up ranged from 20 to 94 months. Seizures continued following resection in all but one case but were reduced in frequency and intensity. In one case, seizures stopped completely following surgery.

Conclusion

Clinicopathological features were similar to those in published literature. However, a marked male predominance was noted in our series. Seizures continued following resection in all but one case but were reduced in frequency and intensity. This series will help raise awareness among clinicians and pathologists in our part of the world about this seizure-associated tumor of children and young adults.
The existence, uniqueness, and stability results for a nonlinear coupled system using ψ-Caputo fractional derivatives
Authors: R Poovarasan , Kumar Pushpendra , Govindaraj V. , Murillo-Arcila Marina
Published: August 2023

In this article, we use coupled boundary conditions on a nonlinear system with ψ-Caputo fractional derivatives to derive new conclusions on the solution’s existence, uniqueness, and stability. We use the well-known tools of fixed-point theory to establish the proposed results. We give an example to verify the theoretical findings. The proposed existence, uniqueness, and stability analyses considering the ψ-Caputo fractional derivative are the novelty of this article.
A GATE simulation study for dosimetry in cancer cell and micrometastasis from the 225Ac decay chain
Authors: Koniar Helena , Miller Cassandra , Rahmim Arman , Schaffer Paul , Uribe Carlos
Published: August 2023

Background

Radiopharmaceutical therapy (RPT) with alpha-emitting radionuclides has shown great promise in treating metastatic cancers. The successive emission of four alpha particles in the 225Ac decay chain leads to highly targeted and effective cancer cell death. Quantifying cellular dosimetry for 225Ac RPT is essential for predicting cell survival and therapeutic success. However, the leading assumption that all 225Ac progeny remain localized at their target sites likely overestimates the absorbed dose to cancer cells. To address limitations in existing semi-analytic approaches, this work evaluates S-values for 225Ac’s progeny radionuclides with GATE Monte Carlo simulations.

Methods

The cellular geometries considered were an individual cell (10 µm diameter with a nucleus of 8 µm diameter) and a cluster of cells (micrometastasis) with radionuclides localized in four subcellular regions: cell membrane, cytoplasm, nucleus, or whole cell. The absorbed dose to the cell nucleus was scored, and self- and cross-dose S-values were derived. We also evaluated the total absorbed dose with various degrees of radiopharmaceutical internalization and retention of the progeny radionuclides 221Fr (t1/2 = 4.80 m) and 213Bi (t1/2 = 45.6 m).

Results

For the cumulative 225Ac decay chain, our self- and cross-dose nuclear S-values were both in good agreement with S-values published by MIRDcell, with per cent differences ranging from − 2.7 to − 8.7% for the various radionuclide source locations. Source location had greater effects on self-dose S-values than the intercellular cross-dose S-values. Cumulative 225Ac decay chain self-dose S-values increased from 0.167 to 0.364 GyBq−1 s−1 with radionuclide internalization from the cell surface into the cell. When progeny migration from the target site was modelled, the cumulative self-dose S-values to the cell nucleus decreased by up to 71% and 21% for 221Fr and 213Bi retention, respectively.

Conclusions

Our GATE Monte Carlo simulations resulted in cellular S-values in agreement with existing MIRD S-values for the alpha-emitting radionuclides in the 225Ac decay chain. To obtain accurate absorbed dose estimates in 225Ac studies, accurate understanding of daughter migration is critical for optimized injected activities. Future work will investigate other novel preclinical alpha-emitting radionuclides to evaluate therapeutic potency and explore realistic cellular geometries corresponding to targeted cancer cell lines.
Spatio-chromatic vision with multifocal diffractive intraocular lens
Authors: Millan Maria S. , Clavé Laura , Torrents Aurora , Armengol Jesús , Vega Fidel
Published: August 2023

Background

This study aims to detect alterations in the spatio-chromatic pseudophakic vision produced by multifocal diffractive intraocular lenses (IOLs) and provides a physical interpretation.

Methods

In vitro characterization of the imaging performance of two diffractive IOLs: AT LISA Tri (Zeiss) and FineVision (PhysIOL) in on-bench model eye illuminated with red (R, 625 nm), green (G, 530 nm) and blue (B, 455 nm) lights. We used the metrics: energy efficiency (EE), area under the modulation transfer function, longitudinal chromatic aberration (LCA), and halo intensity. Through-focus (TF) analysis and calculation of the expected defocus curve under white (W) daylight were included. In vivo visual acuity (VA) of 50 pseudophakics (60 eyes) was assessed under W, R, G, B lights at far and near. Two clinical experiments evaluated LCA and R, G, B TF-EE effects on pseudophakic vision and their relative importance.

Results

Clinical mean VA values under W light agreed with the predicted values at far and near for both IOLs. LCA measurements and R, G, B TF-EE curves were consistent with their lens design based on the 0th and 1st diffraction orders operative for far and near vision, respectively. LCA effects were compensated at near but noticed at far (− 0.75 D under B light). We detected strong asymmetry in visual resolution depending on the object distance and the illuminating wavelength—red predominance at far, blue predominance at near—in consistency with the TF-EE measurements.

Conclusions

Diffractive multifocal IOL designs produce asymmetries in the spatio-chromatic vision of pseudophakics beyond the alterations strictly due to LCA. VA asymmetry for far/near object distance under R and B illumination is clinically detectable in subjects implanted with IOLs with 0th and 1st diffraction orders for far and near vision, respectively. Such VA asymmetry cannot be explained solely from the influence of defocus, as would be derived from a chromatic difference of power, but mainly from the wavelength dependence of the EE.
Open banking and inclusive finance in the European Union: perspectives from the Dutch stakeholder ecosystem
Authors: Preziuso Massimo , Koefer Franziska , Ehrenhard Michel
Published: August 2023

In the European Union (EU), the revised Payment Services Directive (PSD2) aims to provide more convenient and customized financial products through open banking (OB) platforms. However, little attention has been paid to the role of OB in improving the financial well-being of the growing number of the EU’s underserved groups, which currently constitute approximately a quarter of its population. This study examines how the PSD2 and OB impact inclusive finance in the EU based on the perspectives of the Netherlands’ ecosystem, one of the leaders in the EU’s financial technology (FinTech) landscape. A fundamental distinction can be drawn between the OB users and the ecosystem’s players. Regarding the impact of financial services on the users’ inclusivity, while the PSD2 strengthens the infrastructure necessary for financial inclusion, many challenges remain, mainly because it was not designed for this purpose. This study identifies several areas of improvement that include adjustments to the know your customer and anti-money laundering processes for underserved customers, innovative ways to communicate the PSD2’s potential, and the regulation of technology providers’ activities to build trust. Meanwhile, from the ecosystem’s position, there is a need to strengthen and improve microfinance regulation according to the opportunities provided by the PSD2 to support microfinance institutions (MFIs) in scaling up and reaching underserved clients across borders with innovative services. OB improvements can also be achieved by organizations formed by MFIs and FinTechs in collaboration with banks. Such hybrid institutions will combine the best features of each of them: knowledge of the needs of local underserved clients from MFIs, technological innovations from FinTechs, and large and trusted customer bases, infrastructures, and access to institutional investments and governments from banks. Finally, an EU inclusive OB sector depends on the centrality of trusted regulators as coordination bodies.
Predictors and dynamic online nomogram for postoperative delayed hyponatremia after endoscopic transsphenoidal surgery for pituitary adenomas: a single-center, retrospective, observational cohort study with external validation
Authors: Cai Xiangming , Zhang An , Zhao Peng , Liu Zhiyuan , Aili Yiliyaer , Zeng Xinrui , Geng Yuanming , Du Chaonan , Yuan Feng , Zhu Junhao , Yang Jin , Tang Chao , Cong Zixiang , Liu Yuxiu , Ma Chiyuan
Published: August 2023

Background

Postoperative delayed hyponatremia (PDH) is a major cause of readmission after endoscopic transsphenoidal surgery (eTSS) for pituitary adenomas (PAs). However, the risk factors associated with PDH have not been well established, and the development of a dynamic online nomogram for predicting PDH is yet to be realized. We aimed to investigate the predictive factors for PDH and construct a dynamic online nomogram to aid in its prediction.

Methods

We analyzed the data of 226 consecutive patients who underwent eTSS for PAs at the Department of Neurosurgery in Jinling Hospital between January 2018 and October 2020. An additional 97 external patients were included for external validation. PDH was defined as a serum sodium level below 137 mmol/L, occurring on the third postoperative day (POD) or later.

Results

Hyponatremia on POD 1–2 (OR = 2.64, P = 0.033), prothrombin time (PT) (OR = 1.78, P = 0.008), and percentage of monocytes (OR = 1.22, P = 0.047) were identified as predictive factors for PDH via multivariable logistic regression analysis. Based on these predictors, a nomogram was constructed with great discrimination in internal validation (adjusted AUC: 0.613–0.688) and external validation (AUC: 0.594–0.617). Furthermore, the nomogram demonstrated good performance in calibration plot, Brier Score, and decision curve analysis. Subgroup analysis revealed robust predictive performance in patients with various clinical subtypes and mild to moderate PDH.

Conclusions

Preoperative PT and the percentage of monocytes were, for the first time, identified as predictive factors for PDH. The dynamic nomogram proved to be a valuable tool for predicting PDH after eTSS for PAs and demonstrated good generalizability. Patients could benefit from early identification of PDH and optimized treatment decisions.
Bilateral sudden sensorineural hearing loss due to subcortical cerebral hemorrhage in a patient with Moyamoya disease: case report
Authors: Elmarawany Mohamed Nabil
Published: August 2023

Background

Moyamoya disease (MMD) is a chronic cerebrovascular occlusive disease that can results in a variety of neurological deficits. We describe a very rare presentation of MMD in the form of bilateral sudden sensorineural hearing loss after a second attack of subcortical cerebral haemorrhage.

Case presentation

A 44-year-old female presented with bilateral sudden sensorineural hearing loss (SSNHL) secondary to an acute intracerebral haemorrhage in the left temporoparietal region. She had a previous haemorrhagic event in the right temporoparietal region two years ago. The two haemorrhagic events have apparently led to interruption of the auditory pathways bilaterally, resulting in sudden complete deafness. Digital subtraction angiography was done, and it showed bilateral occlusion of the internal carotid arteries, with the abnormal anastomotic vascular network at the base of the brain characteristic for MMD.

Conclusions

Subcortical hemorrhage due to MMD is a potential cause of bilateral SSNHL that can be diagnosed with early proper imaging. Bilateral damage of the auditory pathways is the likely cause of cortical deafness in this clinical scenario.
Formulation of low glycaemic index biscuits suitable for diabetics from unripe banana, okra, and stevia leaves / jujube fruit
Authors: Ngaha Wilfred Damndja , Tchabo William , Matsinkou Rosane Soh , Nyame Lola Kangue , Fombang Edith Nig
Published: August 2023

Biscuits are the largest category of consumed snacks among bakery products, but their simple sugar and fat high content associate to low fiber content make them unsuitable for diabetics. This study aimed to formulate biscuits with low glycaemic index from the blend of unripe banana, okra and stevia leaves or jujube fruit for diabetics. To achieve this goal, unripe banana, fresh okra, stevia leaves and jujube fruits were purchased from a main market in Ngaoundere and processed into flours. Proximate composition of the flours was determined, and then, Design Expert software was used to formulate two different blends, Banana/Okra/Stevia (BOS) and Banana/Okra/Jujube (BOJ). According to the results of preliminary sensory tests done in the laboratory, three biscuits with stevia (BOS1, BOS2, BOS3), three biscuits with jujube (BOJ1, BOJ2, BOJ3), and a witness biscuit with table sugar as sweetener were formulated. After the physicochemical characterisation of formulated biscuits, animal experimentation was carried out in order to evaluate the postprandial evolution of blood glucose in rats after having ingested the biscuits, and the Glycaemic Index (GI) of produced biscuits. A hedonic test with 30 consumers was done, parameters assessed including colour, texture, taste, flavour, and overall acceptability. The results obtained show that unripe banana is mostly made of complex carbohydrates, while okra and stevia are good sources of fibers, confirming their importance in diabetic’s diet. All the biscuits produced with stevia and jujube did not raise the blood glucose compared to the witness biscuit made with table sugar. Biscuits produced with stevia leaves had a lower GI than those produced with jujube fruit among the biscuits produced with stevia leaves, BOS2 had the lowest GI, then the lowest increase of postprandial blood glucose in rats, and was the most appreciated by the consumers in terms of appearance, flavour, taste and overall acceptability. Therefore, BOS2 could be recommended as snack for diabetics.

Graphical Abstract
Diffusion tensor imaging in characterization of cervical lymphadenopathy
Authors: Ramadan Zainab A. , Razek Ahmed Abdel
Published: August 2023

Background

It is important to differentiate cervical lymph nodes. So, this study aims to assess the ability of diffusion tensor imaging (DTI) in differentiating cervical lymphadenopathy (LNs).

Materials and methods

This retrospective study was done upon 100 patients with cervical LNs who had DTI over a year period. The fractional anisotropy (FA) and the mean diffusivity (MD) values of LNs were measured.

Results

This study was done upon 100 patients (the mean age 45 ± 2 years (standard deviation [SD]), 63 men). The mean MD and FA of the malignant LNs (0.83 ± 0.14 × 10−3 mm2/s, 0.26 ± 0.07) were significantly different; (P = 0.001) than those of benign LNs (1.32 ± 0.33 × 10–3 mm2/s, 0.22 ± 0.09). MD of 0.94 × 10–3 mm2/s and FA of 0.21 were used to discriminate malignant and benign LNs, AUC 0.892 and 0.758, and 84% and 71% accuracy, respectively. Combined parameters revealed AUC of 0.914 and 81%. The mean MD and FA of the metastatic LNs (0.86 ± 0.12 × 10–3 mm2/s, 0.25 ± 0.07) were statistically different; (P = 0.001, 0.03) than those of lymphomatous nodes (0.66 ± 0.13 × 10–3 mm2/s, 0.28 ± 0.02). The AUC of the MD and FA used to distinguish metastatic from lymphomatous nodes was 0.82, 0.711, (0.71 × 10–3 mm2/s, 0.27) cutoff values, and 95.3%, 73.4% accuracy, respectively. Combined parameters revealed 0.824 AUC, 95.3% accuracy, 98.2% sensitivity, and 75% specificity. There was a significant statistical difference in MD between well-moderately (P = 0.001) versus poorly differentiated metastatic LNs and stages I and II (P = 0.018) versus stages III and IV of metastatic cervical LNs.

Conclusions

Combining FA and MD is a promising technique that can play a major role in distinguishing different categories of cervical LNs.
Social prescribing: an inadequate response to the degradation of social care in mental health
Authors: Poole Rob , Huxley Peter
Published: August 2023

Social prescribing is poorly defined and there is little evidence for its effectiveness. It cannot address the social determinants of mental health and it is unlikely to produce enduring change for that part of the population that suffers the worst physical and mental health, namely the most deprived and marginalised. It has emerged at a time of growing health inequity. This has occurred alongside the neglect of social care and of the social aspects of mental health intervention. Social prescribing gives a false impression of addressing social factors, and as such is counterproductive. We can do better than this.
Histology-Based Prediction of Therapy Response to Neoadjuvant Chemotherapy for Esophageal and Esophagogastric Junction Adenocarcinomas Using Deep Learning
Authors: Hörst Fabian , Ting Saskia , Liffers Sven-Thorsten , Pomykala Kelsey L. , Steiger Katja , Albertsmeier Markus , Angele Martin K. , Lorenzen Sylvie , Quante Michael , Weichert Wilko , Egger Jan , Siveke Jens T. , Kleesiek Jens
Published: August 2023

PURPOSE

Quantifying treatment response to gastroesophageal junction (GEJ) adenocarcinomas is crucial to provide an optimal therapeutic strategy. Routinely taken tissue samples provide an opportunity to enhance existing positron emission tomography-computed tomography (PET/CT)–based therapy response evaluation. Our objective was to investigate if deep learning (DL) algorithms are capable of predicting the therapy response of patients with GEJ adenocarcinoma to neoadjuvant chemotherapy on the basis of histologic tissue samples.

METHODS

This diagnostic study recruited 67 patients with I-III GEJ adenocarcinoma from the multicentric nonrandomized MEMORI trial including three German university hospitals TUM (University Hospital Rechts der Isar, Munich), LMU (Hospital of the Ludwig-Maximilians-University, Munich), and UME (University Hospital Essen, Essen). All patients underwent baseline PET/CT scans and esophageal biopsy before and 14-21 days after treatment initiation. Treatment response was defined as a ≥35% decrease in SUVmax from baseline. Several DL algorithms were developed to predict PET/CT-based responders and nonresponders to neoadjuvant chemotherapy using digitized histopathologic whole slide images (WSIs).

RESULTS

The resulting models were trained on TUM (n = 25 pretherapy, n = 47 on-therapy) patients and evaluated on our internal validation cohort from LMU and UME (n = 17 pretherapy, n = 15 on-therapy). Compared with multiple architectures, the best pretherapy network achieves an area under the receiver operating characteristic curve (AUROC) of 0.81 (95% CI, 0.61 to 1.00), an area under the precision-recall curve (AUPRC) of 0.82 (95% CI, 0.61 to 1.00), a balanced accuracy of 0.78 (95% CI, 0.60 to 0.94), and a Matthews correlation coefficient (MCC) of 0.55 (95% CI, 0.18 to 0.88). The best on-therapy network achieves an AUROC of 0.84 (95% CI, 0.64 to 1.00), an AUPRC of 0.82 (95% CI, 0.56 to 1.00), a balanced accuracy of 0.80 (95% CI, 0.65 to 1.00), and a MCC of 0.71 (95% CI, 0.38 to 1.00).

CONCLUSION

Our results show that DL algorithms can predict treatment response to neoadjuvant chemotherapy using WSI with high accuracy even before therapy initiation, suggesting the presence of predictive morphologic tissue biomarkers.
Effect of intravenous thrombolysis combined with endovascular treatment on vascular recanalization rate and peak systolic velocity in patients with acute cerebral infarction
Authors: Zheng Hui , Zheng Bo , Yang Shu , Mou Xin , Zhang Xuan , Huang Huiyiing , Wu Xiaoping
Published: August 2023

Objectives: To investigate the efficacy of intravenous thrombolysis (IVT) combined with endovascular treatment (EVT) on vascular recanalization rate and peak systolic velocity (PSV) in patients with acute cerebral infarction (ACI).

Methods: A retrospective observational study was conducted from January 2019 to December 2021 in Chengdu First People’s Hospital. The clinical data of 96 patients with ACI were reviewed and the patients were assigned to either the control group (IVT alone, n=54) or the observation group (IVT+EVT, n=42). The vascular recanalization rate, PSV, neurological function, modified Rankin Scale (mRS) score and major adverse cardiovascular events (MACE) were compared between groups.

Results: The vascular recanalization rate and PSV in the observation group were higher than the control group (P<0.05). The NIHSS scores of the observation group at 24 hour, one week and one month after treatment were significantly lower than those of the control group (P<0.05). The mRS scores of the observation group were significantly lower than the control group after treatment (P<0.05), while there was no difference in the incidence of MACE between groups (P>0.05).

Conclusions: IVT combined with EVT can improve the vascular recanalization rate and PSV in patients with ACI, which is worthy of promotion in clinical practice.

doi: https://doi.org/10.12669/pjms.39.5.7573

How to cite this: Zheng H, Zheng B, Yang S, Mou X, Zhang X, Huang H, et al. Effect of intravenous thrombolysis combined with endovascular treatment on vascular recanalization rate and peak systolic velocity in patients with acute cerebral infarction. Pak J Med Sci. 2023;39(5):---------.  doi: https://doi.org/10.12669/pjms.39.5.7573

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Αυτά που μετράμε κι αυτά που μετράνε: Κατηγορίες ταυτότητας και πολιτισμού στις απογραφές πληθυσμού
Authors: Νοταράς Ανδρέας
Published: August 2023

Το άρθρο αυτό προσεγγίζει το ζήτημα των ταξινομητικών κατηγοριών ταυτότητας και της συμπερίληψής τους σε απογραφές και έρευνες μέτρησης. Σε παγκόσμιο επίπεδο παρατηρούνται διαφορετικές παραδόσεις και επιλογές. Στην Ελλάδα τα στοιχεία της γλώσσας, της θρησκείας και της εθνοτικής ταύτισης απουσιάζουν από τις απογραφές. Στον επιστημονικό διάλογο έχει τονιστεί ιδιαίτερα ο επιτελεστικός χαρακτήρας της ταξινόμησης και η υποστασιοποίηση και πραγμοποίηση που παράγει η μέτρηση. Η σχετική συζήτηση αφήνει όμως αθέατες τις συνέπειες της αντίθετης επιλογής. Χρειαζόμαστε τέτοια δεδομένα και, αν ναι, με τι χαρακτηριστικά; Πώς μπορούμε να αντιμετωπίσουμε τους υπαρκτούς μεθοδολογικούς και θεωρητικούς περιορισμούς και τους πολιτικούς κινδύνους που ελλοχεύουν;
Extensive Restorations of Arched Stone Bridges: the Examples of Plaka Bridge in Greece and Stari Most in Bosnia and Herzegovina
Authors: Tzoumas Vasileios
Published: August 2023

In the last thirty years, Europe has experienced two major destructions of important monuments of its cultural heritage. They are both related to the collapse of stone-built, arched bridges, which were closely linked to the history and evolution of the bridging areas. 

In 1993, the historic Mostar Bridge (Bosnia and Herzegovina), built in 1566 by the Ottoman architect Mimar Hajrudin, almost completely collapsed, bridging the Neretva River. The cause of the collapse was the relentless bombardement of Mostar during the Yugoslav war (1992-1995). In 2015, the entire central arch and almost 90% of the eastern pier of Plaka’s bridge in Tzoumerka collapsed, following extreme weather events and a rise in the level of the Arachthos River. The bridge was erected in 1866 by master builder Kostas Bekas. The restoration of these bridges were complex, high-tech projects, and posed great challenges, being global innovations. 

This article gives a brief presentation of the two bridges, and analyzes the administrative and technical framework for their restoration. The purpose of this article is to compare and evaluate common and non-common features of the two projects, since the innovative ways of restoring them can be methodological models for the restoration of similar structures.
Post-earthquake assessment of monumental building in Croatia by 3Muri software
Authors: Zarnic Roko , Rajcic Vlatka
Published: August 2023

Abstract. A series of earthquakes in and close to city of Zagreb, Croatia during the 2020 severely damaged the masonry cultural heritage buildings built in the 19th century. The article presents the assessment of post-earthquake design of retrofitting of damaged historic masonry structure of the former synagogue in city of Sisak, Croatia erected in 1890. The former synagogue was severely damaged during the recent earthquake. For the purposes of the post-earthquake retrofitting and strengthening, an analysis of the damaged and retrofitted structure has been carried out to justify the selected retrofitting measures that included a partial reconstruction of heavily damaged structure. The equivalent frame model based on the discretization in terms of piers and spandrels was created (SEM - Structural Elements Model) to obtain the simulation of earthquake response of structure using the 3Muri 13.9 software. In this paper the procedure and results of the analysis of seismic resistance of the strengthened structure is presented because of the successful cooperation of structural engineers, architects and conservators.