bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Allograft Versus Bioactive Glass-Ceramic Cage in Anterior Cervical Discectomy and Fusion: A Randomized Controlled Study
Authors: Liu Yanting , Park Chan Woong , Pholprajug Phattareeya , Suvithayasiri Siravich , Kim Jung Hoon , Lee Chorong , Kim Eun , Kim Jin-Sung
Published: November 2023

Study design

A randomized controlled trial.

Objective

The aim of this study is to compare the efficacy of allografts and bioactive glass-ceramic (BG) cages for anterior cervical discectomy and fusion (ACDF) in treating cervical degenerative disc disease.

Methods

We conducted a single-center, randomized controlled trial between August 2017 and August 2022. Participants were randomized into two groups, and consecutive patients requiring ACDF were randomly assigned to receive either the allograft cage or the BG cage. The surgical outcomes measured included pain levels, neck disability, surgical details, and radiological assessments.

Results

Of the 45 assessed, 40 participants were included, with 18 in the allograft cage group and 22 in the BG cage group. By the 12-month follow-up, both groups exhibited significant improvements in pain levels and disability scores, with no notable intergroup differences. Over 85% of patients in both groups were satisfied with their outcomes. Radiological assessments revealed stability in the cervical spine with both cage types post intervention. Although both materials showed a trend toward increased subsidence over time, the difference between them was not statistically significant. Fusion rates were comparable between the groups at 12 months, with BG cage showing a slightly higher early fusion rate at 6 months. No significant differences were observed between the two groups in terms of complications.

Conclusions

Both allograft and BG cages are effective in ACDF surgeries for cervical degenerative disc disease, with both contributing to substantial postoperative improvements. Differences in disc height, interspinous motion, and subsidence were not significant in the last follow-up, indicating both materials' suitability for clinical use. Future research with a larger cohort and longer follow-up is needed to confirm these preliminary findings.
“Living in These Two Places Really Shaped My Life”: Examining Multimodal Playlist Assignments in Social Studies and Language Arts Methods Courses
Authors: Neville Mary L. , Popielarz Kaitlin E.
Published: November 2023

In this article, the authors consider the use of a “Playlist of My Life Assignment” in helping social studies (SS) and English language arts (ELA) teacher candidates (TCs) conceptualize multimodal and humanizing SS and ELA curricula. The Playlist Assignment asked teacher candidates to center the music, texts, land, spaces, and places that are most important to them, and potentially relate these back to their own pedagogies as SS and ELA teachers. Taken from two qualitative studies of two teacher education courses at two separate, large research universities in the U.S. Southwest, this article examines teacher candidates’ understandings of their disciplines as humanizing and multimodal, and as centered in their and their students’ communities, through the Playlist Assignment. Data included the Playlist Assignment, curated by TCs in each methods course, and TCs’ class response journals. TCs offered profound texts they carried within them throughout their lives, demonstrating (1) their multimodal disruptions of the definition of a “text” and (2) the empowering and limiting effect of life texts for humanizing curricula. This work has implications for SS and ELA teacher educators interested in supporting teacher candidates as they conceptualize multimodal and humanizing curricula with and for their future students.
Severe Thrombocytopenia after PCI: Think GP IIb/IIIa Receptor Antagonist Induced rather than Heparin-induced Thrombocytopenia
Authors: Adhikari Usnish , Nair Krishna Kumar Mohanan
Published: November 2023

Acute thrombocytopenia in Acute Coronary Syndrome patients may pose a diagnostic challenge due to multifactorial etiologies. It is a recognized, but rare complication of treatment with glycoprotein IIb/IIIa receptor antagonists, which are commonly used in the management of Acute Coronary Syndrome. Diagnosis is made after ruling out other common causes, one of them being Heparin-induced thrombocytopenia. Management includes discontinuation of GPRA & in severe cases might require steroids. We present a case of a 38-year-old gentleman with acute inferior wall MI, who developed glycoprotein IIb/IIIa receptor antagonists-induced acute symptomatic thrombocytopenia.
Implementing the Self-Determined Learning Model of Instruction in Culturally Responsive Ways
Authors: Alsaeed Abdulaziz H. , Shogren Karrie A. , Raley Sheida K. , Kurth Jennifer A. , Scott LaRon A.
Published: November 2023

Being self-determined can improve in- and post-school outcomes for all students, including racially and ethnically marginalized students with disabilities. The Self-Determined Learning Model of Instruction (SDLMI) is a flexible model of instruction educators can use to promote self-directed goal setting and attainment based on each student’s strengths, assets, family values, cultural knowledge, and learning needs to enhance self-determination. This article describes how educators can implement the SDLMI using culturally responsive teaching practices, building on the assets of all students to enhance self-determination and related goal attainment outcomes by focusing on setting and working toward goals that are culturally responsive in general education classrooms.
Space Connected, Emotion Shared: Investigating Users of Digital Chinese Cultural Heritage
Authors: Tong Qingyan , Cui Jie , Ren Baiyi
Published: November 2023

Empowered by the Internet and digital technology, Chinese cultural heritage can intuitively convey its historical stories and share its esthetic art with online users via “social  +  intelligence  +  sharing.” Using a survey (N  =  783) and semi structured interview (N  =  20), adapting and extending the theoretical framework of the third space and interactive ritual chain, this paper analyzes online users’ perceptions, emotions, and actions toward digital Chinese cultural heritage. The results indicate that the technology-enabled communication of digital cultural heritage can construct a kind of third cultural space (immersion & interculturality) where the interactive ritual chain can continuously drive and superimpose online users’ emotional energy. Such emotional energy is a kind of common human emotion that can transcend nationalities. During this process, traditional Chinese culture, popular culture, and global culture are connected.
CAR T-cell therapy in multiple myeloma: mission accomplished?
Authors: Rasche Leo , Hudecek Michael , Einsele Hermann
Published: November 2023

B-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T cells are the most potent treatment against multiple myeloma (MM). Here, we review the increasing body of clinical and correlative preclinical data that support their inclusion into firstline therapy and sequencing before T-cell–engaging antibodies. The ambition to cure MM with (BCMA-)CAR T cells is informed by genomic and phenotypic analysis that assess BCMA expression for patient stratification and monitoring, steadily improving early diagnosis and management of side effects, and advances in rapid, scalable CAR T-cell manufacturing to improve access.
Use of infection control measures in people with chronic lung disease: mixed methods study
Authors: Jones Arwel W. , King Bill E. , Cumella Andrew , Hopkinson Nicholas S. , Hurst John R. , Holland Anne E.
Published: November 2023

Background

The introduction of community infection control measures during the COVID-19 pandemic was associated with a reduction in acute exacerbations of lung disease. We aimed to understand the acceptability of continued use of infection control measures among people with chronic lung disease and to understand the barriers and facilitators of use.

Methods

Australian adults with chronic lung disease were invited to an online survey (last quarter of 2021) to specify infection control measures they would continue themselves post-pandemic and those they perceived should be adopted by the community. A subset of survey participants were interviewed (first quarter of 2022) with coded transcripts deductively mapped to the COM-B model and Theoretical Domains Framework.

Results

193 people (COPD 84, bronchiectasis 41, interstitial lung disease 35, asthma 33) completed the survey. Physical distancing indoors (83%), handwashing (77%), and avoidance of busy places (71%) or unwell family and friends (77%) were measures most likely to be continued. Policies for the wider community that received most support were those during the influenza season including hand sanitiser being widely available (84%), wearing of face coverings by healthcare professionals (67%) and wearing of face coverings by the general population on public transport (66%). Barriers to use of infection control measures were related to physical skills, knowledge, environmental context and resources, social influences, emotion, beliefs about capabilities and beliefs about consequences.

Conclusions

Adults with chronic lung diseases in Australia are supportive of physical distancing indoors, hand hygiene, and avoidance of busy places or unwell family and friends as long-term infection control measures.
ERS International Congress 2023: highlights from the Basic and Translational Sciences Assembly
Authors: Reddy Karosham Diren , Bizymi Nikoleta , Schweikert Anja , Ananth Sachin , Lim Clarice X. , Lodge Katharine M. , Joannes Audrey , Ubags Niki , van der Does Anne M. , Cloonan Suzanne M. , Mailleux Arnaud , Mansouri Nahal , Reynaert Niki L. , Heijink Irene H. , Cuevas-Ocaña Sara
Published: November 2023

Early career members of Assembly 3 (Basic and Translational Sciences) of the European Respiratory Society (ERS) summarise the key messages discussed during six selected sessions that took place at the ERS International Congress 2023 in Milan, Italy. Aligned with the theme of the congress, the first session covered is “Micro- and macro-environments and respiratory health”, which is followed by a summary of the “Scientific year in review” session. Next, recent advances in experimental methodologies and new technologies are discussed from the “Tissue modelling and remodelling” session and a summary provided of the translational science session, “What did you always want to know about omics analyses for clinical practice?”, which was organised as part of the ERS Translational Science initiative's aims. The “Lost in translation: new insights into cell-to-cell crosstalk in lung disease” session highlighted how next-generation sequencing can be integrated with laboratory methods, and a final summary of studies is presented from the “From the transcriptome landscape to innovative preclinical models in lung diseases” session, which links the transcriptome landscape with innovative preclinical models. The wide range of topics covered in the selected sessions and the high quality of the research discussed demonstrate the strength of the basic and translational science being presented at the international respiratory conference organised by the ERS.
ERS International Congress 2023: highlights from the Respiratory Infections Assembly
Authors: Bindo Francesco , Fumagalli Giovanni , Myroniuk-Konstantynovych Kiarina , Papadopoulou Efthymia , Paróczai Dóra , Perea Lidia , Pollock Jennifer , Popovych Oleksandra , Premuda Chiara , Long Merete B. , Keir Holly R.
Published: November 2023

The 2023 European Respiratory Society Congress took place on a hybrid platform, with participants joining online and in-person in Milan, Italy. The congress welcomed over 20 000 attendees, bringing together exciting updates in respiratory science and medicine from around the world. In this article, early career members of Assembly 10 (Respiratory Infections) summarise a selection of sessions across a broad range of topics, including presentations on bronchiectasis, nontuberculous mycobacteria, tuberculosis, cystic fibrosis and coronavirus disease 2019.
A seed expansion-based method to identify essential proteins by integrating protein–protein interaction sub-networks and multiple biological characteristics
Authors: Zhao He , Liu Guixia , Cao Xintian
Published: November 2023

Background

The identification of essential proteins is of great significance in biology and pathology. However, protein–protein interaction (PPI) data obtained through high-throughput technology include a high number of false positives. To overcome this limitation, numerous computational algorithms based on biological characteristics and topological features have been proposed to identify essential proteins.

Results

In this paper, we propose a novel method named SESN for identifying essential proteins. It is a seed expansion method based on PPI sub-networks and multiple biological characteristics. Firstly, SESN utilizes gene expression data to construct PPI sub-networks. Secondly, seed expansion is performed simultaneously in each sub-network, and the expansion process is based on the topological features of predicted essential proteins. Thirdly, the error correction mechanism is based on multiple biological characteristics and the entire PPI network. Finally, SESN analyzes the impact of each biological characteristic, including protein complex, gene expression data, GO annotations, and subcellular localization, and adopts the biological data with the best experimental results. The output of SESN is a set of predicted essential proteins.

Conclusions

The analysis of each component of SESN indicates the effectiveness of all components. We conduct comparison experiments using three datasets from two species, and the experimental results demonstrate that SESN achieves superior performance compared to other methods.
Resection of intracardiac leiomyoma originating from the inferior vena cava through a single median sternotomy incision using a silk suture snare technique: a case report
Authors: Xie Ting , Masroor Matiullah , Liu Cong , Lin Shengxiong , Song Jing , Wang Zhengping , Chen Xuan
Published: November 2023

Background

Intracardiac leiomyoma is a rare benign right heart tumor that usually extends from the intravenous system. The patient often has a history of uterine leiomyoma.

Case presentation

We report a 46-year-old female patient who presented to us with exertional dyspnea, chest tightness, and shortness of breath for two weeks and had a history of uterine leiomyoma resection. Echocardiography showed a pedunculated solid mass in the right heart with the pedicle attached to the inferior vena cava. The surgery was performed under cardiopulmonary bypass established through the femoral artery and vein with a probable diagnosis of leiomyoma. The tumor was removed by ingenious surgical technique: a snare made of silk suture in which the tumor’s pedicle was trapped, and the tumor with its pedicle was carefully removed with the help of a scalpel along the silk suture. The histopathology report confirmed the diagnosis of intravenous leiomyoma. The postoperative course was uneventful and the patient was discharged a week later.

Conclusion

Intracardiac leiomyoma is a rare benign smooth muscle tumor. Surgery is the mainstay of treatment with different surgical approaches available. It is possible to completely remove cardiac leiomyomas through sternotomy without the need for an abdominal incision if the leiomyoma is originated in the inferior vena cava not far from the right atrium.
Barriers and facilitators to self-measured blood pressure monitoring among US-resettled Arab refugees with hypertension: a qualitative study
Authors: Bridi Lana , Albahsahli Behnan , Bencheikh Nissma , Baker Dania Abu , Godino Job G. , O’Laughlin Kelli N. , Al-Rousan Tala
Published: November 2023

Background

Minoritized communities including refugees are at an increased risk of poorly controlled hypertension. Evidence indicates that self-measured blood pressure monitoring (SMBP) is an effective method to improve blood pressure control in patients with hypertension. However, it has not been studied among refugee populations. The objective of this study is to examine barriers and facilitators to SMBP among Arab refugees resettled in the United States (US) with diagnosed hypertension.

Methods

A total of 109 participants were recruited through a Federally Qualified Health Center system that is a major provider of healthcare to refugees in San Diego, California. Participants completed a questionnaire and were interviewed using in-depth, semi-structured interviews. Interviews were transcribed and translated, and data were coded using inductive thematic analysis and organized based on the theory of care-seeking behavior.

Results

Several barriers to engaging in effective SMBP monitoring were identified. Clinical and sociodemographic barriers included reliance on public monitors and poor hypertension literacy. Psychosocial barriers of affect, norms, and habits included fear and anxiety from hypertension, cultural stigma of illness, and conditional SMBP with symptoms, respectively. Utility psychosocial barriers included lack of SMBP prioritization in treatment and perceived inaccuracy of home monitors. Family members’ support with home monitoring served as an important facilitator to SMBP.

Conclusions

There are several barriers to effective SMBP among the US-resettled Arab refugee population that may reflect unique cultural and care-seeking behaviors. Tailored public health and clinical interventions are needed to support refugee patients and providers to improve hypertension self-management behaviors for this unique population.
Renal CIC-LEUTX rearranged sarcoma with multiple pulmonary metastases: a case report and literature review
Authors: Tang Ying , Lu Xialiang , Zhan Rui
Published: November 2023

Background

CIC-rearranged sarcomas (CRS) are a group of heterogeneous tumors which mostly occur in the soft tissues of limbs and trunk, and are highly invasive with poor prognosis. Here, we describe a rare case of CRS that occurred in the left kidney with a CIC-LEUTX rearrangement.

Case presentation

A 45-year-old male was admitted to hospital with a dry cough for more than two months without obvious cause. Physical examination and laboratory tests revealed no notable abnormality. The CT scan demonstrated a mass in the left kidney and multiple nodules in both lungs. The percutaneous core needle biopsy showed similar histomorphology and immunophenotype of small round cell malignant tumors. Genetic test revealed a CIC-LEUTX gene fusion.

Conclusions

We present a rare primary renal CRS with multiple pulmonary metastases, and LEUTX is confirmed as the fusion partner of CIC gene for the first time in a renal case.
A cognitive behavioural group treatment for somatic symptom disorder: a pilot study
Authors: Jongsma Katherine , Darboh Bri Susanna , Davis Sasha , MacKillop Emily
Published: November 2023

Background

Somatic symptom disorder (SSD) presents challenges to the healthcare system, including frequent medical visits, lack of symptom relief experienced by individuals with this condition, high associated medical costs, and patient dissatisfaction. This study examined the utility of a novel, low-barrier, brief cognitive behavioural therapy (CBT) group intervention for individuals with SSD.

Methods

Participants were referred by their mental health providers or self-referral. Each participant underwent a telephone screen and in-person psychological and neuropsychological screen. Two cycles of the CBT-based group (n = 30), each consisting of six weekly two-hour sessions, were facilitated at a large outpatient mental healthcare facility in Ontario, Canada. The final sample consisted of 13 individuals of whom 11 completed the treatment. Clinical outcome measures were administered pre-, mid- and post-group, including the Generalized Anxiety Disorder–7, Perceived Stress Scale–4, Pain Self-Efficacy Questionnaire, Pain Disability Index, Revised Illness Perception Questionnaire, and sections of the Patient Health Questionnaire. Six healthcare utilization metrics were collected from electronic medical records at six months pre- and post-group. Paired samples t-tests were used to examine pre- to post-group differences in participants’ somatic symptoms, psychological functioning, health, and degree of healthcare utilization.

Results

When comparing pre- and post- group, we observed reductions in the mean scores for somatic symptom severity, depressive symptomatology, anxiety, perceived stress, and perceived disability related to pain. The change in depressive symptomatology yielded a small effect size (d = 0.30). Further, we observed downward trends across participants’ pre- to post-group healthcare utilization, with small effect sizes observed for hospital admission (d = 0.36), days admitted to hospital (d = 0.47), and inpatient consults (d = 0.42). Differences between pre- and post-group measures of somatic symptom severity, psychological functioning, health, or healthcare utilization did not reach significance.

Conclusions

Current findings provide support for the potential effectiveness of an abbreviated CBT group for individuals with SSD in reducing psychiatric symptomatology. Further research is recommended, including randomized control trials, cost-benefit analyses, and comparisons between abbreviated versus longer-duration treatment programs for SSD.

Trial registration

Not applicable.
Impact of health-related behavioral factors on participation in a cervical cancer screening program: the lifelines population-based cohort
Authors: Castañeda Kelly M. , Sidorenkov Grigory , Mourits Marian J. E. , van der Vegt Bert , Siebers Albert G. , Vermeulen Karin M. , Schuuring Ed , Wisman G. Bea A. , de Bock Geertruida H.
Published: November 2023

Background

Regular participation in cervical cancer screening is critical to reducing mortality. Although certain sociodemographic factors are known to be associated with one-time participation in screening, little is known about other factors that could be related to regular participation. Therefore, this study evaluated the association between health-related behavioral factors and regular participation in cervical cancer screening.

Methods

The Lifelines population-based cohort was linked to data for cervical cancer screening from the Dutch Nationwide Pathology Databank. We included women eligible for all four screening rounds between 2000 and 2019, classifying them as regular (4 attendances), irregular (1–3 attendances), and never participants. Multinomial logistic regression was performed to evaluate the association between behavioral factors and participation regularity, with adjustment made for sociodemographic factors.

Results

Of the 48,325 included women, 55.9%, 35.1%, and 9% were regular, irregular, and never screening participants. After adjustment for sociodemographic factors, the likelihood of irregular or never screening participation was increased by smoking, obesity, marginal or inadequate sleep duration, alcohol consumption and low physical activity, while it was decreased by hormonal contraception use.

Conclusion

An association exists between unhealthy behavioral factors and never or irregular participation in cervical cancer screening.
HIV/AIDS knowledge level, awareness of public health centers and related factors: a cross-sectional study among Brazilians in Japan
Authors: Nagai Shiho , Kitahara Teruyo , Kito Katsuyuki , Hitosugi Masahito
Published: November 2023

Background

Accurate information is essential so that HIV infection can be detected in time for initiation of HIV/AIDS treatment. Immigrants are at high risk for delayed HIV testing and diagnosis, but foreign residents in Japan also seem to face barriers to accessing HIV/AIDS care. We aimed to assess their knowledge level of HIV/AIDS and awareness of public health centers in Japan (PHCs), and to explore factors related to these items.

Methods

We conducted a cross-sectional study of Brazilians, the largest group of foreigners living in Shiga, using an anonymous, self-administered questionnaire survey in Brazilian Portuguese and Japanese via the Internet and mail. A multiple logistic regression analysis was used to examine the factors related to “Knowledge of HIV/AIDS” and “Awareness of PHCs”.

Results

A total 182 Brazilians responded. More than half of them were beginners in Japanese. Most respondents were familiar with HIV/AIDS, but only 58% knew the existence of PHCs, and only 25% knew that HIV testing is available at PHCs free of charge and anonymously. A multiple logistic regression analysis showed that PHCs were less recognized by those with intermediate (odds ratio: 5.70, 95% confidence interval: 1.53–21.23) and beginner (odds ratio: 6.81, 95% confidence interval: 1.98–23.45) Japanese proficiency than by those with advanced.

Conclusions

This survey revealed the knowledge level of HIV/AIDS and awareness of PHC among Brazilians in Shiga. Their lack of awareness of PHCs due to language barriers may lead to delays in HIV testing among them. Therefore, it is important for PHCs to disseminate information about medical services related to HIV/AIDS in Portuguese and plain Japanese to facilitate their access to HIV testing. However, PHC efforts alone are not enough. Medical interpreters who are familiar with Brazilian culture and customs, and the clinics that employ them, could help the Brazilian community and PHCs to overcome the language barrier and provide efficient and appropriate medical care to Brazilians. This would be one way to eliminate delays in HIV testing for Brazilians in Shiga.
Prevalence and a correlation analysis of discoid meniscus and femoral trochlear dysplasia
Authors: Qiao Yi , Zhang Xiuyuan , Wu Chenliang , Xu Caiqi , Sun Zhenkui , Zhao Jinzhong , Zhao Song
Published: November 2023

Background

Discoid meniscus (DM) and femoral trochlear dysplasia (FTD) are common knee disorders. Both as congenital malformation, whether there is a connection between them is unclear and the research on their prevalence in the general population is inadequate. This study aimed to investigate the prevalence of FTD and DM in the general population through a large sample size, and to explore the relationship between them.

Study design

Retrospective study.

Methods

Patients undergoing knee magnetic resonance imaging (MRI) examinations at our outpatient clinic were screened and 1003 patients were enrolled in DM group with 989 patients in non-DM (NDM) group. The type of DM and FTD was classified with Watanabe classification and Dejour’s classification, respectively. The prevalence of FTD and DM in the general population and the relationship between them were evaluated.

Results

The prevalence of DM and FTD was 10.0% and 14.5%, respectively. The overall percentage of FTD was higher in DM group (P < 0.001). The DM group has a higher percentage of all types of FTD except type D (P < 0.05), and a higher percentage of both low- and high-grade FTD (P < 0.001). There were 633 cases of type I DM and 370 cases of type II DM. The overall percentage of FTD was not significantly different between the two types (P = 0.106). No significant difference was detected for all types of FTD except type B (P < 0.05). The Type I DM group has a significant higher percentage of high-grade FTD than Type II group (P < 0.05).

Conclusion

Patients with a DM are more likely to have FTD regardless of the type of DM, while those with a type I DM are more prone to have a high grade FTD.
Expanding general practice with interprofessional teams: a mixed-methods patient perspective study
Authors: Abelsen Birgit , Pedersen Kine , Løyland Hanna Isabel , Aandahl Emilie
Published: November 2023

Background

Across healthcare systems, current health policies promote interprofessional teamwork. Compared to single-profession general practitioner care, interprofessional primary healthcare teams are expected to possess added capacity to care for an increasingly complex patient population. This study aims to explore patients’ experiences when their usual primary healthcare encounter with general practice shifts from single-profession general practitioner care to interprofessional team-based care.

Methods

Qualitative and quantitative data were collected through interviews and a survey among Norwegian patients. The interviews included ten patients (five women and five men) aged between 28 and 89, and four next of kin (all women). The qualitative analysis was carried out using thematic analysis and a continuity framework. The survey included 287 respondents, comprising 58 per cent female and 42 per cent male participants, aged 18 years and above. The respondents exhibited multiple diagnoses and often a lengthy history of illness. All participants experienced the transition to interprofessional teamwork at their general practitioner surgery as part of a primary healthcare team pilot.

Results

The interviewees described team-based care as more fitting and better coordinated, including more time and more learning than with single-profession general practitioner care. Most survey respondents experienced improvements in understanding and mastering their health problems.

Multi-morbid elderly interviewees and interviewees with mental illness shared experiences of improved information continuity. They found that important concerns they had raised with the nurse were known to the general practitioner and vice versa.

None of the interviewees expressed dissatisfaction with the inclusion of a nurse in their general practitioner relationship. Several interviewees noted improved access to care. The nurse was seen as a strengthening link to the general practitioner. The survey respondents expressed strong agreement with being followed up by a nurse. The interviewees trusted that it was their general practitioner who controlled what happened to them in the general practitioner surgery.

Conclusion

From the patients’ perspective, interprofessional teamwork in general practice can strengthen management, informational, and relational continuity. However, a prerequisite seems to be a clear general practitioner presence in the team.
Clinical features, genomic profiling, and outcomes of adult patients with unifocal Langerhans cell histiocytosis
Authors: Lang Min , Cai Hua-cong , Lin He , Chang Long , Dai Jia-wen , Chen Jia , Duan Ming-hui , Zhou Dao-bin , Goyal Gaurav , Cao Xin-xin
Published: November 2023

Background

Langerhans cell histiocytosis (LCH) is a rare highly heterogeneous histiocytosis, which can be divided into single system and multiple system disease according to site of involvement. There is a paucity of studies examining unifocal LCH in adults in the molecular era.

Results

We retrospectively analysed records from 70 patients with unifocal LCH. The median age at diagnosis was 36 years (18–69). The most common organ involved was the bone (70.0%), followed by pituitary gland (7.1%). Target gene sequencing of lesion tissues was performed on 32 of the 70 patients. MAPK/PI3K pathway alterations were observed in 78.1% of the patients; the most common mutations included BRAFV600E (28.1%), MAP2K1 (18.8%) and PIK3CA (9.4%). After a median follow-up time of 39.4 months (0.7–211.8), 10 (14.3%) patients developed disease progression, of whom 4 had local recurrence, 2 progressed to single-system multifocal and 4 progressed to multiple system LCH. The 3-year progression-free survival (PFS) was 81.9%. Univariate analysis showed that age < 30 years at diagnosis was associated with worse 3-year PFS (52.2% vs. 97.0%, p = 0.005). The 3-year overall survival was 100%.

Conclusions

In our large cohort of adults with unifocal LCH, we found that prognosis of unifocal LCH in adults was very good, and age < 30 years at diagnosis was associated with increased relapse risk.
The hidden toll of war: a comprehensive study of orthopedic injuries in Yemen
Authors: Hutaif Mohammad , Al Moaish Abdullah , Soliman Mosleh , Al-fadliy Anwar
Published: November 2023

Background

Yemen has been experiencing a protracted civil war and humanitarian crisis since 2015, which has resulted in many war-related injuries. However, there is a lack of data on the epidemiology, characteristics, and outcomes of these injuries, especially the orthopedic ones. This study aimed to describe the war-related orthopedic injuries in Yemen and their impact on the patients’ health and function.

Methods

This was a retrospective study based on medical records and trauma registries of 3930 patients who were admitted to three major trauma centers in Sana’a city with war-related orthopedic injuries from January 2015 to December 2020. We collected data on demographics, injury mechanisms, injury types and locations, surgical procedures, complications, mortality, and functional outcomes using the Musculoskeletal Function Assessment questionnaire. We used descriptive and inferential statistics to analyze the data and performed a logistic regression analysis to identify the factors associated with mortality.

Results

Most of the patients were young males and civilians who suffered from complex and severe injuries involving multiple body regions, especially the lower extremities. The main mechanisms of injury were gunshot wounds, blast injuries, and landmine explosions. The patients required multiple surgical procedures and implants, and had high rates of complications and mortality. The most common complications were infection, nonunion, malunion, and amputation. The most common cause of death was sepsis. The functional outcomes were poor, as indicated by the high mean MFA score. The logistic regression analysis showed that older age, blast injuries, spine injuries, vascular injuries, and infection were significant predictors of mortality.

Conclusion

This study provides valuable information on the war-related orthopedic injuries in Yemen and their impact on the patients’ health and function. It also identifies some areas for future research, such as exploring the risk factors for infection and nonunion/malunion, evaluating the effectiveness and cost-effectiveness of different surgical procedures and implants, assessing the long-term outcomes and quality of life of the patients, and developing novel strategies to enhance bone and soft-tissue healing.
Genome-wide prediction of pathogenic gain- and loss-of-function variants from ensemble learning of a diverse feature set
Authors: Stein David , Kars Meltem Ece , Wu Yiming , Bayrak Çiğdem Sevim , Stenson Peter D. , Cooper David N. , Schlessinger Avner , Itan Yuval
Published: November 2023

Gain-of-function (GOF) variants give rise to increased/novel protein functions whereas loss-of-function (LOF) variants lead to diminished protein function. Experimental approaches for identifying GOF and LOF are generally slow and costly, whilst available computational methods have not been optimized to discriminate between GOF and LOF variants. We have developed LoGoFunc, a machine learning method for predicting pathogenic GOF, pathogenic LOF, and neutral genetic variants, trained on a broad range of gene-, protein-, and variant-level features describing diverse biological characteristics. LoGoFunc outperforms other tools trained solely to predict pathogenicity for identifying pathogenic GOF and LOF variants and is available athttps://itanlab.shinyapps.io/goflof/.
Diagnostic validity of specific immunoglobulin E levels to alpha-gal in alpha-gal syndrome: a cross-sectional analysis
Authors: Germán-Sánchez Adrián , Alonso-Llamazares Ana , García-González Fernando , Matala-Ahmed Bakai , Melgar-Reyes Ceny Solani , Antepara-Ercoreca Ignacio
Published: November 2023

Background

The diagnosis of Alpha-gal Syndrome (AGS) is based on the presence of symptoms after being exposed to potential sources of alpha-gal together with values ​​of specific IgE (sIgE) to alpha-gal ≥ 0.1 kUA/L or ≥ 0.35 kUA/L. The aim of this study was to evaluate the diagnostic validity of sIgE levels to alpha-gal ≥ 0.1 kUA/L for identifying AGS.

Methods

This was a cross-sectional analysis of adult patients with available data on sIgE levels to alpha-gal, classified into two groups according to the presence (Group 1) or absence (Group 2) of symptoms after being exposed to potential sources of alpha-gal. Values of sIgE to alpha-gal ≥ 0.1 kUA/l were considered a positive result. A descriptive analysis of internal and external validity parameters was performed in the entire population and adjusted by sex.

Results

The study included 33 individuals in Group 1 and 65 in Group 2, with a mean age of around 47 years. The analysis of internal validity parameters revealed a high sensitivity, specificity, and positive probability ratio, with higher sensitivity in men and higher specificity in women. The analysis of external validity parameters showed a high negative predictive value and global value in all populations and both sexes. However, the positive predictive value was relatively high in men, but low in women.

Conclusions

Our results suggest that sIgE levels ≥ 0.1 kUA/L may be a useful tool for the diagnosis of AGS, although other factors and diagnostic techniques should also be considered.
Deep convolutional architectures for extrapolative forecasts in time-dependent flow problems
Authors: Bhatt Pratyush , Kumar Yash , Soulaïmani Azzeddine
Published: November 2023

Physical systems whose dynamics are governed by partial differential equations (PDEs) find numerous applications in science and engineering. The process of obtaining the solution from such PDEs may be computationally expensive for large-scale and parameterized problems. In this work, deep learning techniques developed especially for time-series forecasts, such as LSTM and TCN, or for spatial-feature extraction such as CNN, are employed to model the system dynamics for advection-dominated problems. This paper proposes a Convolutional Autoencoder(CAE) model for compression and a CNN future-step predictor for forecasting. These models take as input a sequence of high-fidelity vector solutions for consecutive time steps obtained from the PDEs and forecast the solutions for the subsequent time steps using auto-regression; thereby reducing the computation time and power needed to obtain such high-fidelity solutions. Non-intrusive reduced-order modeling techniques such as deep auto-encoder networks are utilized to compress the high-fidelity snapshots before feeding them as input to the forecasting models in order to reduce the complexity and the required computations in the online and offline stages. The models are tested on numerical benchmarks (1D Burgers’ equation and Stoker’s dam-break problem) to assess the long-term prediction accuracy, even outside the training domain (i.e. extrapolation). The most accurate model is then used to model a hypothetical dam break in a river with complex 2D bathymetry. The proposed CNN future-step predictor revealed much more accurate forecasting than LSTM and TCN in the considered spatiotemporal problems.
Differentiating primary central nervous system lymphoma from glioblastoma by time-dependent diffusion using oscillating gradient
Authors: Kamimura Kiyohisa , Nakano Tsubasa , Hasegawa Tomohito , Nakajo Masanori , Yamada Chihiro , Kamimura Yoshiki , Akune Kentaro , Ejima Fumitaka , Ayukawa Takuro , Nagano Hiroaki , Takumi Koji , Nakajo Masatoyo , Higa Nayuta , Yonezawa Hajime , Hanaya Ryosuke , Kirishima Mari , Tanimoto Akihide , Iwanaga Takashi , Imai Hiroshi , Feiweier Thorsten , Yoshiura Takashi
Published: November 2023

Background

This study aimed to elucidate the impact of effective diffusion time setting on apparent diffusion coefficient (ADC)-based differentiation between primary central nervous system lymphomas (PCNSLs) and glioblastomas (GBMs) and to investigate the usage of time-dependent diffusion magnetic resonance imaging (MRI) parameters.

Methods

A retrospective study was conducted involving 21 patients with PCNSLs and 66 patients with GBMs using diffusion weighted imaging (DWI) sequences with oscillating gradient spin-echo (Δeff = 7.1 ms) and conventional pulsed gradient (Δeff = 44.5 ms). In addition to ADC maps at the two diffusion times (ADC7.1 ms and ADC44.5 ms), we generated maps of the ADC changes (cADC) and the relative ADC changes (rcADC) between the two diffusion times. Regions of interest were placed on enhancing regions and non-enhancing peritumoral regions. The mean and the fifth and 95th percentile values of each parameter were compared between PCNSLs and GBMs. The area under the receiver operating characteristic curve (AUC) values were used to compare the discriminating performances among the indices.

Results

In enhancing regions, the mean and fifth and 95th percentile values of ADC44.5 ms and ADC7.1 ms in PCNSLs were significantly lower than those in GBMs (p = 0.02 for 95th percentile of ADC44.5 ms, p = 0.04 for ADC7.1 ms, and p < 0.01 for others). Furthermore, the mean and fifth and 95th percentile values of cADC and rcADC were significantly higher in PCNSLs than in GBMs (each p < 0.01). The AUC of the best-performing index for ADC7.1 ms was significantly lower than that for ADC44.5 ms (p < 0.001). The mean rcADC showed the highest discriminating performance (AUC = 0.920) among all indices. In peritumoral regions, no significant difference in any of the three indices of ADC44.5 ms, ADC7.1 ms, cADC, and rcADC was observed between PCNSLs and GBMs.

Conclusions

Effective diffusion time setting can have a crucial impact on the performance of ADC in differentiating between PCNSLs and GBMs. The time-dependent diffusion MRI parameters may be useful in the differentiation of these lesions.
Stroke survivors’ preferences on assessing patient-reported outcome measures
Authors: Schmidt Richard , Geisler Daniela , Urban Daniela , Pries Rebecca , Franzisket Christina , Voigt Christian , Ivanova Galina , Neumuth Thomas , Classen Joseph , Wagner Markus , Michalski Dominik
Published: November 2023

Background

To assess quality of life and unmet needs after stroke, patient-reported outcome measures (PROMs) have gained increasing attention. However, patients’ perspectives on assessing PROMs remain unclear, potentially hindering implementation into clinical practice. Therefore, this study explored patients’ preferences on assessing PROMs after ischemic stroke.

Methods

A paper-based questionnaire was sent to stroke survivors treated at the Department of Neurology, University of Leipzig, Germany. Health-related quality of life (HRQoL, EQ-5D-5L) and preferences regarding different aspects of data collection to assess PROMs were investigated and linked to socio-demographic and medical characteristics.

Results

158 persons were contacted and 80 replies were subsequently analyzed. Mean age was 70.16 years and mean HRQoL was 68.79 (visual analogue scale with a theoretical maximum of 100). Participants showed positive attitudes towards PROMs as they saw potential to improve care of other patients (n = 66/79; 83.54%) or to improve their own situation (n = 53/74; 71.62%). Participants preferred an annual interview after stroke (n = 39/80; 48.75%) and would preferably spend 15–30 min (n = 41/79; 51.90%) to answer a written survey (n = 69/80; 86.25%). The initially treating clinic was preferred as initiator of such surveys (n = 43/79; 54.43%). Stratification revealed that participants with more than 1 h of daily digital media usage preferred email as way of communication.

Conclusions

For the first time, this study showed individual preferences on assessing PROMs after ischemic stroke, focusing on the way, time interval, duration, and initiation site of surveys. These insights might help to successfully implement PROMs after stroke and subsequently detect unmet needs and deficits in stroke care.
Correlation of tibial tuberosity–trochlear groove distance, anterolateral ligament injury, and the type of trochlear dysplasia with the grade of anterior cruciate ligaments tear
Authors: Loupatty Florensia , Sukmaningtyas Hermina , Novriansyah Robin , Satoto Bambang , Prihharsanti Christina Hari Nawangsih , Baskoro Nurdopo
Published: November 2023

Background

The anterior cruciate ligament (ACL) is the most frequently injured ligament. The grade of ACL tear on magnetic resonance imaging (MRI) can help determine the ACL injury treatment. Lateralization of the tibial tubercle is indicated by an increase in the distance of the tibial tuberosity–trochlear groove (TT-TG). Anterolateral ligament (ALL) injury affects a high degree of pivot shift in the knee joint with ACL deficiency. Trochlear dysplasia (TD) is a congenital morphological deformity of the femoral trochlea. An increase in the TT-TG distance, as well as the presence of ALL injuries and TD, can elevate the likelihood of experiencing ACL injuries. This study aims to analyze the correlation of TT-TG distance, ALL injury, and type of TD with the grade of ACL tear through MRI.

Methods

This analytical cross-sectional study was conducted from November 2021 to June 2022 at RSUP Dr. Kariadi Hospital, Semarang. The ACL tear was divided into three degrees. The Schoettle or the Nizić method was used to measure the TT-TG distance. ALL injuries were evaluated by looking at the integrity of the ligament. TD assessment was according to the Dejour classification.

Results

A total of 50 subjects participated in the study. The TT-TG distance for grade I ACL tears was 5.90–14.6 mm (22%), 1.69–18.30 mm (44%) for grade II, and 1.01–14.10 mm (34%) for grade III. The ANOVA test showed no significant relationship between the TT-TG distance and the degree of ACL tear (p = 0.146). ALL injuries were found in six study subjects: One subject (16.7%) had grade I ACL tear, three subjects (50%) had grade II, and two subjects (33.3%) had grade III. The Chi-square test showed no significant correlation between ALL injuries and the degree of ACL tear (p = 0.930). Most subjects did not experience TD (78%), while 20% experienced TD type A and 2% experienced TD type B. In type A TD, 50% of ACL tears were grade I, 30% grade II, and 20% grade III. Among all subjects with TD type B, only one was found to have a grade III ACL tear. Based on the Chi-square test, there was no significant correlation between TD type and the degree of ACL tear (p = 0.110).

Conclusions

There is no significant correlation between the tibial tuberosity–trochlear groove distance, ALL injury, and type of trochlear dysplasia with the grade of ACL tear.
Mechanisms by which the intestinal microbiota affects gastrointestinal tumours and therapeutic effects
Authors: He Jikai , Li Haijun , Jia Jiaqi , Liu Yang , Zhang Ning , Wang Rumeng , Qu Wenhao , Liu Yanqi , Jia Lizhou
Published: November 2023

The intestinal microbiota is considered to be a forgotten organ in human health and disease. It maintains intestinal homeostasis through various complex mechanisms. A significant body of research has demonstrated notable differences in the gut microbiota of patients with gastrointestinal tumours compared to healthy individuals. Furthermore, the dysregulation of gut microbiota, metabolites produced by gut bacteria, and related signal pathways can partially explain the mechanisms underlying the occurrence and development of gastrointestinal tumours. Therefore, this article summarizes the latest research progress on the gut microbiota and gastrointestinal tumours. Firstly, we provide an overview of the composition and function of the intestinal microbiota and discuss the mechanisms by which the intestinal flora directly or indirectly affects the occurrence and development of gastrointestinal tumours by regulating the immune system, producing bacterial toxins, secreting metabolites. Secondly, we present a detailed analysis of the differences of intestinal microbiota and its pathogenic mechanisms in colorectal cancer, gastric cancer, hepatocellular carcinoma, etc. Lastly, in terms of treatment strategies, we discuss the effects of the intestinal microbiota on the efficacy and toxic side effects of chemotherapy and immunotherapy and address the role of probiotics, prebiotics, FMT and antibiotic in the treatment of gastrointestinal tumours. In summary, this article provides a comprehensive review of the pathogenic mechanisms of and treatment strategies pertaining to the intestinal microbiota in patients with gastrointestinal tumours. And provide a more comprehensive and precise scientific basis for the development of microbiota-based treatments for gastrointestinal tumours and the prevention of such tumours.