bluuebunny/crossref_metadata_2025 huggingface dataset:
AFEX-Net: Adaptive feature extraction convolutional neural network for classifying computerized tomography images
Authors: Zahedi Nasab Roxana , Mohseni Hadis , Montazeri Mahdieh , Ghasemian Fahimeh , Amin Sobhan
Published: February 2024

Purpose

Deep convolutional neural networks are favored methods that are widely used in medical image processing due to their demonstrated performance in this area. Recently, the emergence of new lung diseases, such as COVID-19, and the possibility of early detection of their symptoms from chest computerized tomography images has attracted many researchers to classify diseases by training deep convolutional neural networks on lung computerized tomography images. The trained networks are expected to distinguish between different lung indications in various diseases, especially at the early stages. The purpose of this study is to introduce and assess an efficient deep convolutional neural network, called AFEX-Net, that can classify different lung diseases from chest computerized tomography images.

Methods

We designed a lightweight convolutional neural network called AFEX-Net with adaptive feature extraction layers, adaptive pooling layers, and adaptive activation functions. We trained and tested AFEX-Net on a dataset of more than 10,000 chest computerized tomography slices from different lung diseases (CC dataset), using an effective pre-processing method to remove bias. We also applied AFEX-Net to the public COVID-CTset dataset to assess its generalizability. The study was mainly conducted based on data collected over approximately six months during the pandemic outbreak in Afzalipour Hospital, Iran, which is the largest hospital in Southeast Iran.

Results

AFEX-Net achieved high accuracy and fast training on both datasets, outperforming several state-of-the-art convolutional neural networks. It has an accuracy of [Formula: see text] and [Formula: see text] on the CC and COVID-CTset datasets, respectively, with a learning speed that is 3 times faster compared to similar methods due to its lightweight structure. AFEX-Net was able to extract distinguishing features and classify chest computerized tomography images, especially at the early stages of lung diseases.

Conclusion

The AFEX-Net is a high-performing convolutional neural network for classifying lung diseases from chest CT images. It is efficient, adaptable, and compatible with input data, making it a reliable tool for early detection and diagnosis of lung diseases.
Happiness and Sadness in Adolescents’ Instagram Direct Messaging: A Neural Topic Modeling Approach
Authors: Verbeij Tim , Beyens Ine , Trilling Damian , Valkenburg Patti M.
Published: February 2024

We investigated the expressions of happiness and sadness in adolescents’ direct messages (DMs) on Instagram. Using neural topic modeling ( BERTopic), we analyzed 211,778 DMs belonging to 96 adolescents, who donated data from 101 Instagram accounts. Results showed that (1) expressions of happiness were more than four times more prevalent than expressions of sadness; (2) the number of DMs containing expressions of happiness and expressions of sadness were highly correlated; (3) there are temporal trends in the expression of happiness and sadness in adolescents’ DMs, and there are individual differences in these trends; and (4) there is no significant between- or within-person relationship between the number of DMs containing expressions of happiness and sadness and adolescents’ well-being.
Dichotomous rhetoric and purposeful silencing: Contradictions of Czech and Polish post-2015 migration policy vis-à-vis immigration from South Asia
Authors: Mucha Zbyněk
Published: February 2024

Immigration became an especially thorny and publicly discussed issue with the so-called Refugee Crisis beginning in 2015. The stance of the Czech and Polish governments was dominated by strong anti-Muslim and anti-immigration rhetoric. Still, both countries have witnessed a steady increase in mainly short-term immigration from various Asian countries such as Bangladesh or Pakistan ever since. This paper analyses Czech and Polish migration policies against the backdrop of a historically constructed notion of anti-illegal immigration policy, and category of temporary migration, coupled with the problematic nature of debt-financed migration in Asia. Drawing on ethnographic fieldwork in Czechia and Poland (2018-2021), in-depth and semi-structured interviews with migration experts, academic and grey literature, official documents, and the method of Accidental ethnography, this paper argues that silencing of actual labor immigration in political communication while employing anti-migration rhetoric represents a discursive gap typical for liberal democracies. It further concludes that rendering migrant labor as a temporary commodity and turning a blind eye on recruitment of international migrants represents a continuity practice of migrant labor subordination within the nation-state, originating during colonialism and the advent of capitalism in the nineteenth century.
Music Therapy as a Topic in Medical Education: Course Concept and Student Evaluation of an Elective Course for Medical Students
Authors: Kobus Susann , Felderhoff-Mueser Ursula , Lainka Elke , Fandrey Joachim , Benson Sven
Published: February 2024

OBJECTIVES

Music therapy has been proven as a safe and well-established intervention in healthcare to relieve symptoms and improve quality of life. While music therapy is already established in several settings to supplement medical care, there is a lack of integration in the field of medical education.

METHODS

We report on the implementation and evaluation of a teaching concept for a five-day-intensive-course on music therapy. The course was offered as an elective course for medical students at the University Duisburg-Essen. At the end of the course, students filled out a free text questionnaire to assess the students’ perception of the course, and additionally answered standardized questions by the structured EVALuna online evaluation tool of the University of Duisburg-Essen.

RESULTS

All students (N = 35) who participated in the music therapy course between September 2019 and March 2023 completed the questionnaires and N = 21 students filled out the EVALuna. Most students (89%) chose the course because of their interest in alternative and supportive therapy options to improve patients’ well-being. About 46% had previous musical experience and passion and fun with music and 37% of the students were interested in the interdisciplinary academic subject that combined music and medicine. EVALuna online evaluation reflected high satisfaction with the course.

CONCLUSION

Due to the well-proven effectiveness and evidence of music therapy as well as the positive perception of medical students, music therapy should be further established in medical care and medical education.
Feeding time(s): Patient urgency and the careful temporalities of antimicrobial resistance
Authors: Enticott Gareth , O’Mahony Kieran
Published: February 2024

This paper seeks to understand how caring for new-born livestock is made possible, which practices of care are privileged and to what effect? These aims are situated in attempts to promote the prudent use of antibiotics amongst livestock farmers to prevent antimicrobial resistance. In focusing on the rearing of new-born calves on dairy and beef farms in England and Wales, the paper reveals how care is configured by different temporal orders, the tensions between different temporalities of care, the reasons for them and the strategies employed by calf rearers to manage these tensions. Drawing on the concept of the ‘timescape’, the paper shows how calf care temporalities are relationally enacted and configured by materials, infrastructures and technologies. Common (productivist) agricultural temporalities of care emphasise speed, urgency and efficiency. However, by analysing the practice of feeding colostrum and ‘tubing’ – the forced feeding of calves via a tube inserted into the oesophagus – we highlight how these rapid caring temporalities conflict with the slower, patient skills of calf rearing. At the same time, however, we show how care is rendered fluid as calf rearers find ways of accommodating seemingly discordant temporalities – what we call ‘patient urgence’ – allowing different temporalities to co-exist within agricultural timescapes. Nevertheless, we show how these practices of accommodation are themselves the result of a productivist temporal order that marginalises calves and calf rearers. We argue that these timescapes point to the need for broader structural and cultural changes within agriculture to reduce the use of antibiotics.
An Interesting Case of Bigeminy with Presyncope
Authors: Mondal Sudipta , Bandyopadhyay Dipanjan
Published: February 2024

We present a case of bigeminal rhythm where a critical evaluation of underlying rhythm abnormality is important to differentiate escape-capture bigeminy from escape-echo bigeminy, and to decide further management plans.
Tyrosine kinase inhibitor response of ABL-class acute lymphoblastic leukemia: the role of kinase type and SH3 domain
Authors: van Outersterp Inge , Tasian Sarah K. , Reichert Caitlin E. J. , Boeree Aurélie , de Groot-Kruseman Hester A. , Escherich Gabriele , Boer Judith M. , den Boer Monique L.
Published: February 2024

Acute lymphoblastic leukemia (ALL) with fusions of ABL-class tyrosine kinase genes other than BCR::ABL1 occurs in ∼3% of children with ALL. The tyrosine kinase genes involved in this BCR::ABL1-like (Ph-like) subtype include ABL1, PDGFRB, ABL2, and CSF1R, each of which has up to 10 described partner genes. ABL-class ALL resembles BCR::ABL1-positive ALL with a similar gene expression profile, poor response to chemotherapy, and sensitivity to tyrosine kinase inhibitors (TKIs). There is a lack of comprehensive data regarding TKI sensitivity in the heterogeneous group of ABL-class ALL. We observed variability in TKI sensitivity within and among each ABL-class tyrosine kinase gene subgroup. We showed that ALL samples with fusions for any of the 4 tyrosine kinase genes were relatively sensitive to imatinib. In contrast, the PDGFRB-fused ALL samples were less sensitive to dasatinib and bosutinib. Variation in ex vivo TKI response within the subset of samples with the same ABL-class tyrosine kinase gene was not associated with the ALL immunophenotype, 5′ fusion partner, presence or absence of Src-homology-2/3 domains, or deletions of IKZF1, PAX5, or CDKN2A/B. In conclusion, the tyrosine kinase gene involved in ABL-class ALL is the main determinant of TKI sensitivity and relevant for specific TKI selection.
Thrombotic events associated with low baseline direct oral anticoagulant levels in atrial fibrillation: the MAS study
Authors: Testa Sophie , Palareti Gualtiero , Legnani Cristina , Dellanoce Claudia , Cini Michela , Paoletti Oriana , Ciampa Antonio , Antonucci Emilia , Poli Daniela , Morandini Rossella , Tala Maurizio , Chiarugi Paolo , Santoro Rita Carlotta , Iannone Angela Maria , De Candia Erica , Pignatelli Pasquale , Faioni Elena Maria , Chistolini Antonio , Esteban Maria del Pilar , Marietta Marco , Tripodi Armando , Tosetto Alberto
Published: February 2024

Although effective and safe, treatment with direct oral anticoagulants (DOAC) in atrial fibrillation (AF) is still associated with thrombotic complications. Whether the measurement of DOAC levels may improve treatment efficacy is an open issue. We carried out the observational, prospective, multicenter Measure and See (MAS) study. Blood was collected 15 to 30 days after starting DOAC treatment in patients with AF who were followed-up for 1 year. Plasma samples were centralized for DOAC level measurement. Patients’ DOAC levels were converted into drug/dosage standardized values to allow a pooled analysis in a time-dependent, competitive-risk model. The measured values were transformed into standardized values (representing the distance of each value from the overall mean) by subtracting the DOAC-specific mean value from the original values and dividing by the standard deviation. Trough and peak DOAC levels were assessed in 1657 and 1303 patients, respectively. In total, 21 thrombotic complications were recorded during 1606 years of follow-up (incidence of 1.31% of patients per year). Of 21 thrombotic events, 17 occurred in patients whose standardized activity levels were below the mean of each DOAC (0); the incidence was the highest (4.82% of patients per year) in patients whose standardized values were in the lowest class (−1.00 or less). Early measurement of DOAC levels in patients with AF allowed us to identify most of the patients who, having low baseline DOAC levels, subsequently developed thrombotic complications. Further studies are warranted to assess whether thrombotic complications may be reduced by measuring baseline DOAC levels and modifying treatment when indicated. This trial was registered at www.ClinicalTrials.gov as #NCT03803579.
Tribological Behaviors of Electroless Nickel-Boron Coating on Titanium Alloy Surface
Authors: Jia Yao , Lai Jianping , Yu Jiaxin , Qi Huimin , Zhang Yafeng , He Hongtu
Published: February 2024

Titanium alloys are excellent structural materials in engineering fields, but their poor tribological properties limit their further applications. Electroless plating is an effective method to enhance the tribological performance of alloys, but it is difficult to efficiently apply to titanium alloys, due to titanium alloy’s strong chemical activity. In this work, the electroless Nickel-Boron (Ni-B) coating was successfully deposited on the surface of titanium alloy (Ti-6AL-4V) via a new pre-treatment process. Then, linearly reciprocating sliding wear tests were performed to evaluate the tribological behaviors of titanium alloy and its electroless Ni-B coatings. It was found that the Ni-B coatings can decrease the wear rate of the titanium alloy from 19.89×10−3 mm3 to 0.41×10−3 mm3, which attributes to the much higher hardness of Ni-B coatings. After heat treatment, the hardness of Ni-B coating further increases corresponding to coating crystallization and hard phase formation. However, heat treatment does not improve the tribological performance of Ni-B coating, due to the fact that higher brittleness and more severe oxidative wear exacerbate the damage of heat-treated coatings. Furthermore, the Ni-B coatings heat-treated both in air and nitrogen almost present the same tribological performance. The finding of this work on electroless coating would further extend the practical applications of titanium alloys in the engineering fields.
Alteration of chromosome structure impacts gene expressions implicated in pancreatic ductal adenocarcinoma cells
Authors: Han Wenrui , Shi Detong , Yang Qiu , Li Xinxin , Zhang Jian , Peng Cheng , Yan Fang
Published: February 2024

Background

Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy with a five-year survival rate of approximately 10%. Genetic mutations are pivotal drivers in PDAC pathogenesis, but recent investigations also revealed the involvement of non-genetic alterations in the disease development. In this study, we undertook a multi-omics approach, encompassing ATAC-seq, RNA-seq, ChIP-seq, and Hi-C methodologies, to dissect gene expression alterations arising from changes in chromosome accessibility and chromatin three-dimensional interactions in PDAC.

Results

Our findings indicate that chromosomal structural alterations can lead to abnormal expressions on key genes during PDAC development. Notably, overexpression of oncogenes FGFR2, FOXA2, CYP2R1, and CPOX can be attributed to the augmentation of promoter accessibility, coupled with long-range interactions with distal elements. Additionally, our findings indicate that chromosomal structural alterations caused by genomic instability can lead to abnormal expressions in PDACs. As an example, by analyzing chromosomal changes, we identified a putative oncogenic gene, LPAR1, which shows upregulated expression in both PDAC cell lines and clinical samples. The overexpression is correlated with alterations in LPAR1-associated 3D genome structure and chromatin state. We further demonstrated that high LPAR1 activity is required for enhanced PDAC cell migration in vitro.

Conclusions

Collectively, our findings reveal that the chromosomal conformational alterations, in addition to the well-known genetic mutations, are critical for PDAC tumorigenesis.
Genome assembly of Medicago truncatula accession SA27063 provides insight into spring black stem and leaf spot disease resistance
Authors: Botkin Jacob R. , Farmer Andrew D. , Young Nevin D. , Curtin Shaun J.
Published: February 2024

Medicago truncatula, model legume and alfalfa relative, has served as an essential resource for advancing our understanding of legume physiology, functional genetics, and crop improvement traits. Necrotrophic fungus, Ascochyta medicaginicola, the causal agent of spring black stem (SBS) and leaf spot is a devasting foliar disease of alfalfa affecting stand survival, yield, and forage quality. Host resistance to SBS disease is poorly understood, and control methods rely on cultural practices. Resistance has been observed in M. truncatula accession SA27063 (HM078) with two recessively inherited quantitative-trait loci (QTL), rnpm1 and rnpm2, previously reported. To shed light on host resistance, we carried out a de novo genome assembly of HM078. The genome, referred to as MtHM078 v1.0, is comprised of 23 contigs totaling 481.19 Mbp. Notably, this assembly contains a substantial amount of novel centromere-related repeat sequences due to deep long-read sequencing. Genome annotation resulted in 98.4% of BUSCO fabales proteins being complete. The assembly enabled sequence-level analysis of rnpm1 and rnpm2 for gene content, synteny, and structural variation between SBS-resistant accession SA27063 (HM078) and SBS-susceptible accession A17 (HM101). Fourteen candidate genes were identified, and some have been implicated in resistance to necrotrophic fungi. Especially interesting candidates include loss-of-function events in HM078 because they fit the inverse gene-for-gene model, where resistance is recessively inherited. In rnpm1, these include a loss-of-function in a disease resistance gene due to a premature stop codon, and a 10.85 kbp retrotransposon-like insertion disrupting a ubiquitin conjugating E2. In rnpm2, we identified a frameshift mutation causing a loss-of-function in a glycosidase, as well as a missense and frameshift mutation altering an F-box family protein. This study generated a high-quality genome of HM078 and has identified promising candidates, that once validated, could be further studied in alfalfa to enhance disease resistance.
Physical symptoms and anxiety and depression in older patients with advanced cancer in China: a network analysis
Authors: Tang Mo , Su Zhongge , He Yi , Pang Ying , Zhou Yuhe , Wang Yu , Lu Yongkui , Jiang Yu , Han Xinkun , Song Lihua , Wang Liping , Li Zimeng , Lv Xiaojun , Wang Yan , Yao Juntao , Liu Xiaohong , Zhou Xiaoyi , He Shuangzhi , Zhang Yening , Song Lili , Li Jinjiang , Wang Bingmei , Tang Lili
Published: February 2024

Background

Little is understood about the association between psychosomatic symptoms and advanced cancer among older Chinese patients.

Methods

This secondary analysis was part of a multicenter cross-sectional study based on an electronic patient-reported outcome platform. Patients with advanced cancer were included between August 2019 and December 2020 in China. Participants (over 60 years) completed the MD Anderson Symptom Inventory (MDASI) and Hospital Anxiety and Depression Scale (HADS) to measure symptom burden. Network analysis was also conducted to investigate the network structure, centrality indices (strength, closeness, and betweenness) and network stability.

Results

A total of 1022 patients with a mean age of 66 (60–88) years were included; 727 (71.1%) were males, and 295 (28.9%) were females. A total of 64.9% of older patients with advanced cancer had one or more symptoms, and up to 80% had anxiety and depression. The generated network indicated that the physical symptoms, anxiety and depression symptom communities were well connected with each other. Based on an evaluation of the centrality indices, ‘distress/feeling upset’ (MDASI 5) appears to be a structurally important node in all three networks, and ‘I lost interest in my own appearance’ (HADS-D4) had the lowest centrality indices. The network stability was relatively high (> 0.7).

Conclusion

The symptom burden remains high in older patients with advanced cancer in China. Psychosomatic symptoms are highly interactive and often present as comorbidities. This network can be used to provide targeted interventions to optimize symptom management in older patients with advanced cancer in China.

Trial registration

Chinese Clinical Trial Registry (ChiCTR1900024957), registered on 06/12/2020.
The severity of andropause symptoms and its relationship with social well-being among retired male nurses: a preliminary cross-sectional study
Authors: Nikjou Roya , Ajri-Khameslou Mehdi , Jegargoosheh Shiva , Momeni Parisa , Nemati-Vakilabad Reza
Published: February 2024

Background

Andropause is a syndrome that occurs due to decreased androgen levels in men. Various aspects of health, such as social well-being, can affect andropause status during men’s retirement. This study aimed to determine the severity of andropause symptoms and its relationship with social well-being among retired male nurses.

Methods

This preliminary cross-sectional study was conducted on 284 retired male nurses in Ardabil (northwest of Iran). The participants were selected through the census sampling method. Data were collected using a demographic information form, the Male Andropause Symptoms Self-Assessment Questionnaire (MASSQ), and the Social Well-Being Scale (SWBS). Data were analyzed using SPSS software (version 22.0).

Results

The study found that the overall mean scores of the severity of andropause symptoms and social well-being among retired male nurses were 57.24 ± 12.62 (range = 35–91) and 94.54 ± 12.77 (range = 75–123), respectively. The highest and lowest mean scores between dimensions of social well-being were related to social contribution (20.26 ± 2.47) and social acceptance (15.26 ± 2.77), respectively. Multiple linear regression analysis revealed that subscales of social well-being, age, marital status, and spouse’s menopause were predictors of the severity of andropause symptoms among retired male nurses. The selected predictors accounted for 53.1% of the total variance in severity of andropause symptoms (F = 36.613,p < 0.001).

Conclusion

The results showed a moderate to severe prevalence of andropause among retired male nurses and a significant association between andropause and social well-being. The study suggests further research to examine sexual orientation and other factors that may affect andropause in retired male nurses.
Clinical success of anti-infective combination therapy compare to monotherapy in patients with carbapenem-resistant Pseudomonas aeruginosa infection: a 10-years retrospective study
Authors: Chen Jialong , Lin Jing , Weng Jianzhen , Ju Yang , Li Yanming
Published: February 2024

Background

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection has become a major public health concern. The recommendations for monotherapy and combination therapy in the current guidelines lack sufficient evidence to support them. The primary objective of this study is to determine the effectiveness of anti-Infective combination therapy compared to monotherapy in achieving clinical success in patients with CRPA infection and risk factors of clinical failure of monotherapy.

Methods

A retrospective study from Medical Information Mart for Intensive Care IV (MIMIC-IV) was conducted. We included adults with infections caused by CRPA. The outcomes of this study were clinical success, complete clinical success, and 28-day all-cause mortality.

Results

A total of 279 subjects were finally enrolled. The rate of clinical success for combination therapy was higher than that for monotherapy (73.1% versus 60.4%, p=0.028). Compared to clinical failure patients, patients in the clinical success group were more likely to die within 28 days after CRPA was found (48.3% versus 3.6%, p<0.001). In a multivariate logistic regression analysis, monotherapy was found to be significantly correlated with clinical success (OR, 0.559, 95% CI, 0.321-0.976; p = 0.041).

Conclusion

Combination therapy is more effective for CRPA infection patients, especially those whose SOFA score is ≥ 2 or whose Charlson comorbidity index is ≥ 6.
A clinical 3D pointing test differentiates spatial memory deficits in dementia and bilateral vestibular failure
Authors: Gerb J. , Brandt T. , Dieterich M.
Published: February 2024

Background

Deficits in spatial memory, orientation, and navigation are often neglected early signs of cognitive impairment or loss of vestibular function. Real-world navigation tests require complex setups. In contrast, simple pointing at targets in a three-dimensional environment is a basic sensorimotor ability which provides an alternative measure of spatial orientation and memory at bedside. The aim of this study was to test the reliability of a previously established 3D-Real-World Pointing Test (3D-RWPT) in patients with cognitive impairment due to different neurodegenerative disorders, bilateral vestibulopathy, or a combination of both compared to healthy participants.

Methods

The 3D-RWPT was performed using a static array of targets in front of the seated participant before and, as a transformation task, after a 90-degree body rotation around the yaw-axis. Three groups of patients were enrolled: (1) chronic bilateral vestibulopathy (BVP) with normal cognition (n = 32), (2) cognitive impairment with normal vestibular function (n = 28), and (3) combined BVP and cognitive impairment (n = 9). The control group consisted of age-matched participants (HP) without cognitive and vestibular deficits (n = 67). Analyses focused on paradigm-specific mean angular deviation of pointing in the azimuth (horizontal) and polar (vertical) spatial planes, of the preferred pointing strategy (egocentric or allocentric), and the resulting shape configuration of the pointing array relative to the stimulus array. Statistical analysis was performed using age-corrected ANCOVA-testing with Bonferroni correction and correlation analysis using Spearman’s rho.

Results

Patients with cognitive impairment employed more egocentric pointing strategies while patients with BVP but normal cognition and HP used more world-based solutions (pBonf 5.78 × 10-3**). Differences in pointing accuracy were only found in the azimuth plane, unveiling unique patterns where patients with cognitive impairment showed decreased accuracy in the transformation tasks of the 3D-RWPT (pBonf < 0.001***) while patients with BVP struggled in the post-rotation tasks (pBonf < 0.001***). Overall azimuth pointing performance was still adequate in some patients with BVP but significantly decreased when combined with a cognitive deficit.

Conclusion

The 3D-RWPT provides a simple and fast measure of spatial orientation and memory. Cognitive impairment often led to a shift from world-based allocentric pointing strategy to an egocentric performance with less azimuth accuracy compared to age-matched controls. This supports the view that cognitive deficits hinder the mental buildup of the stimulus pattern represented as a geometrical form. Vestibular hypofunction negatively affected spatial memory and pointing performance in the azimuth plane. The most severe spatial impairments (angular deviation, figure frame configuration) were found in patients with combined cognitive and vestibular deficits.
Causal effects of endometriosis on SLE, RA and SS risk: evidence from meta-analysis and Mendelian randomization
Authors: Tang Tianyou , Zhong Yi , Xu Sipei , Yu Huilin
Published: February 2024

Background

Endometriosis is an underdiagnosed disorder that affects an estimated 6-10% of women of reproductive age. Endometriosis has been reported in epidemiological studies to be associated with autoimmune diseases. However, the relationship remains controversial.

Methods

A meta-analysis of observational studies was undertaken to evaluate the risk of autoimmune diseases in patients with endometriosis. The relevant studies were retrieved via the databases Medline, Embase and Web of Science until July 20, 2023. Mendelian randomization (MR) was subsequently utilized to scrutinize the causal influence of genetic predisposition toward endometriosis on three autoimmune diseases.

Results

The meta-analysis findings revealed a relationship between endometriosis and the onset of SLE (cohort studies: RR = 1.77, 95% confidence interval (CI): 1.47–2.13, I2 = 0%; Case-control and cross-sectional studies: OR = 5.23, 95% CI: 0.74–36.98, I2 = 98%), RA (cohort studies: RR = 2.18, 95% CI: 1.85–2.55, I2 = 92%; Case-control and cross-sectional studies: OR = 1.40, 95% CI: 1.19–1.64, I2 = 0%) and SS (cohort studies: RR = 1.49, 95% CI: 1.34–1.66, I2 = 0%). Similarly, in our MR study, the results of the inverse-variance-weighted (IVW) model suggested that genetic predisposition to endometriosis was causally associated with an increased risk for SLE (OR = 1.915, 95% CI: 1.204–3.045, p = 0.006) and RA (OR = 1.005, 95% CI: 1.001–1.009, p = 0.014).

Conclusions

Both our meta-analysis and MR study indicate that endometriosis increases the risk of autoimmune diseases. These findings not only broaden our understanding of the genetic mechanisms underlying the comorbidity of endometriosis and autoimmune diseases, but also offer a new strategy for autoimmune disease prevention.
Social factors and age play a significant role in cervical cancer and advanced-stage disease among Danish women
Authors: Bønløkke Sara , Blaakær Jan , Steiniche Torben , Iachina Maria
Published: February 2024

Background

For cervical cancer (CC), the implementation of preventive strategies has the potential to make cervical cancer occurrence and death largely avoidable. To better understand the factors possibly responsible for cervical cancer, we aimed to examine possible differences in age and social parameters as well as screening status between women with low- or high-stage cervical cancer and matched controls.

Methods

Through the Danish Cancer Registry (DCR), women diagnosed with cervical cancer in Denmark between 1987 and 2016 were included. These were age- and residence-matched in a 1:5 ratio with controls from the general female population. The study population was sub grouped into a low-stage subpopulation with women with early-stage cervical cancer and matched controls and a high-stage subpopulation with women with late-stage cervical cancer and matched controls. Age and social parameters were compared within the subpopulations as well as between low- and high-stage cases. For part of the study population, screening attendance was examined to compare differences in adherence.

Results

Overall, we found that the risk of cervical cancer is significantly increased in socially disadvantaged women and not least non-attenders in screening. Interestingly, the high-stage subpopulation was significantly older than the low-stage subpopulation (p < 0.001), and when examining the impact of age further, we found that for cervical cancer cases, the risk of having low-stage disease decreases significantly with increasing age, whereas the risk of having high-stage disease increases significantly with increasing age. In the screening cohort, significantly less cases than controls were attenders in screening with the most pronounced differences seen in the old subpopulation (women aged 50–64 years) and in the high-stage subpopulation (p-values all < 0.001). Interestingly, when examining the risk of CC for attenders and non-attenders, we demonstrated that many social parameters continue to influence the risk of cervical cancer, even in women attending screening.

Conclusions

Older women, socially disadvantaged women, and non-attenders in screening are particularly vulnerable in terms of developing cervical cancer, especially high-stage disease. Therefore, improvements in the participating rate in screening as well as a revision of the current screening guidelines are needed.
Surrogacy of one-year survival for overall survival in advanced hepatocellular carcinoma
Authors: Jin Yuzhi , Ren Hui , Yue Qianhua , Wu Wei , Liu Chuan , Guo Yixuan , Zhao Peng
Published: February 2024

Background

The increasing number of sequential treatments complicates the evaluation of overall survival (OS) in clinical trials for hepatocellular carcinoma (HCC), therefore, reliable surrogate endpoints (SEs) are required. This study aimed to evaluate the surrogacy of progression-free survival (PFS) and one-year (1-yr) milestone survival for OS in HCC trials.

Methods

We systematically searched databases for randomized clinical trials that evaluated systemic treatments for advanced HCC. Individual patient data were reconstructed to calculate the 1-yr survival rate. We adopted a two-stage meta-analytic validation model to evaluate the correlation between SEs and OS, and the correlation between treatment effects on SEs and OS. The hazard ratio (HR) was calculated to assess the treatment effects on PFS and OS, and the 1-yr survival ratio was calculated to evaluate the treatment effects on the 1-yr milestone survival.

Results

Thirty-two HCC trials involving 13,808 patients were included. A weak correlation was detected between the median PFS and median OS (R2 = 0.32), whereas the correlation improved between PFS HR and OS HR (R2 = 0.58). We identified strong correlations between the 1-yr survival rate and median OS and between the 1-yr survival ratio and OS HR (R2 = 0.74 and 0.65, respectively). In subgroup analyses, PFS HR strongly correlated with OS HR in trials relevant to immune checkpoint inhibitors (ICIs). Although the correlation remained weak between PFS and OS even in trials with PFS HR ≤ 0.6, the 1-yr survival rate and 1-yr survival ratio were strong surrogates for median OS and OS HR, respectively (R2 = 0.77 and 0.75).

Conclusions

One-year milestone survival outperformed PFS as a SE for OS in HCC, indicating the application of 1-yr survival as a secondary endpoint. In particular, PFS HR was a potential SE for OS HR in the ICI trials.
Association between in-country migration and HIV infection among transgender women from northeastern Brazil: a respondent-driven sampling survey
Authors: Leite Beo Oliveira , Magno Laio , Bastos Francisco Inacio , Dourado Ines
Published: February 2024

Background

Migration is common among transgender women (TGW), often driven by the desire to escape stigma, find acceptance, establish new connections, access body modifications, or enter new avenues of sex work. Given the heightened mobility of TGW, they are mostly vulnerable to human immunodeficiency virus (HIV) due to migration. This study aimed to evaluate the association between in-country migration and HIV infection among TGW in Northeast Brazil.

Methods

The DIVAS was a cross-sectional, multicity study investigating risk behaviors and sexually transmitted infections (STI) among TGW in 2016–2017. A total of 864 TGW were recruited through respondent-driven sampling from three capital cities in Northeast Brazil. Logistic regression estimating odds ratios (OR) and 95% confidence intervals (CI) was used to assess the relationship between in-country migration and HIV infection.

Results

The prevalence of HIV among TGW was 24.5%, 21.4% among those aged 18–34 and 36.1% among those ≥ 35 years old. In-country migration increased the odds of HIV infection among TGW aged 18–34 years (OR = 1.84; 95%CI:1.04–3.27) and even higher among those aged ≥ 35y old (OR = 3.08; 95%CI:1.18–8.04).

Conclusions

These data reinforce the pressing need for public health policies that provide comprehensive access and strategies for demand creation for HIV/AIDS prevention and care for TGW who are already highly vulnerable to infection.
Complex interplay of science reasoning and vaccine hesitancy among parents in Shanghai, China
Authors: Zhang Felicia , Ren Jia , Garon Colin , Huang Zhuoying , Kubale John , Wagner Abram L.
Published: February 2024

The psychosocial underpinnings of vaccine hesitancy are complex. Research is needed to pinpoint the exact reasons why people hesitate to vaccinate themselves or their children against vaccine-preventable diseases. One possible reason are concerns that arise from a misunderstanding of vaccine science. We examined the impact of scientific reasoning on vaccine hesitancy and human papillomavirus (HPV) vaccination intent through a cross-sectional study of parents of vaccine-eligible children (N = 399) at immunization clinics in Shanghai, China. We assessed the relationship between science reasoning and both vaccine hesitancy and HPV vaccine acceptance using general additive models. We found a significant association between scientific reasoning and education level, with those with less than a high school education having a significantly lower scientific reasoning that those with a college education (ß = -1.31, p-value = 0.002). However, there was little evidence of a relationship between scientific reasoning and vaccine hesitancy. Scientific reasoning therefore appears not to exert primary influence on the formation of vaccine attitudes among the respondents surveyed. We suggest that research on vaccine hesitancy continues working to identify the styles of reasoning parents engage in when determining whether or not to vaccinate their children. This research could inform the development and implementation of tailored vaccination campaigns.
Association of the triglyceride-glucose index with the occurrence and recurrence of colorectal adenomas: a retrospective study from China
Authors: Li Jiaoyan , Chen Jingfeng , Liu Haoshuang , Yan Su , Wang Youxiang , Xing Miao , Ding Suying
Published: February 2024

Background

Resection of colorectal adenoma (CRA) prevents colorectal cancer; however, recurrence is common. We aimed to assess the association of the triglyceride-glucose (TyG) index with CRA occurrence and recurrence.

Methods

Data from 3392 participants at a hospital in China from 2020 to 2022 were analyzed. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). A restricted cubic spline was used to fit TyG index dose‒response curves to recurrent adenomas. The discriminatory power of TyG index for predicting later recurrence was assessed with the area under the receiver operating characteristic (ROC) curve in 170 patients with a TyG index at initial adenoma diagnosis.

Results

One thousand five hundred ninety-six adenoma and 1465 normal participants were included in the occurrence analysis, and 179 recurrent and 152 nonrecurrent participants were included in the recurrence analysis. The TyG mutation was an independent risk factor for CRA occurrence and recurrence. After adjusting for confounders, the risk of adenoma in the participants in Q2, Q3, and Q4 groups of TyG was 1.324 (95% CI 1.020–1.718), 1.349 (95% CI 1.030–1.765), and 1.445 (95% CI 1.055–1.980) times higher than that of the Q1, respectively, and the risk of recurrence in the Q3 and Q4 groups was 2.267 (95% CI 1.096–4.691) and 2.824 (95% CI 1.199–6.648) times in Q1 group. Multiple logistic regression showed that the highest quartile of the TyG index was associated with a greater risk of advanced adenoma recurrence (OR 4.456, 95% CI 1.157–17.164), two or more adenomas (OR 5.079, 95% CI 1.136–22.714 [after removal of TyG index extreme values]), and proximal colon or both adenomas (OR 3.043, 95% CI 1.186–7.810). Subgroup analysis revealed that the association was found to be present only in participants of all age groups who were either male or without obesity, hyperglycemia, hypertension, or dyslipidemia (p < 0.05). ROC curves illustrated that the TyG index had good predictive efficacy for identifying recurrence, especially for patients with two or more adenomas (AUC 0.777, 95% CI 0.648–0.907).

Conclusions

An increase in the TyG index is associated with an increased risk of adenoma occurrence and recurrence, with a stronger association with the latter.
Effect of thermocycling on surface topography and fracture toughness of milled and additively manufactured denture base materials: an in-vitro study
Authors: Abdul-Monem Mohamed M. , Hanno Kenda I.
Published: February 2024

Background

Studies investigating thermocycling effect on surface topography and fracture toughness of resins used in digitally manufactured denture bases are few. The study aimed to assess the impact of thermocycling on surface topography and fracture toughness of materials used for digitally manufactured denture bases.

Methods

Water sorption, solubility, hardness, surface roughness, and fracture toughness of both three-dimensional (3D)-printed and computer-aided design, computer-aided manufacturing (CAD-CAM) milled specimens (n = 50) were assessed both prior to and following 2000 thermocycles, simulating 2 years of clinical aging. Surface hardness (n = 10) was measured using a Vickers hardness testing machine, surface roughness (n = 10) was determined by a contact profilometer, and fracture toughness (n = 20) was measured using the 3-point bend test, then studying the fractured surfaces was done via a scanning electron microscope (SEM). Prior to and following thermocycling, water sorption and solubility (n = 10) were assessed. Normally distributed data was tested using two-way repeated ANOVA and two-way ANOVA, while Mann Whitney U test and the Wilcoxon signed ranks test were used to analyze data that was not normally distributed (α < 0.05).

Results

Following thermocycling, Vickers hardness and fracture toughness of both groups declined, with a significant reduction in values of the 3D-printed resin (P < .001). The 3D-printed denture base resins had a rougher surface following thermocycling with a significant difference (P < .001). The sorption and solubility of water of both materials were not affected by thermocycling.

Conclusions

Before and after thermocycling, milled specimens had lower surface roughness and a greater degree of hardness and fracture toughness than 3D-printed specimens. Thermocycling lowered hardness and fracture toughness, and increased surface roughness in both groups, but had no effect on water sorption and solubility.
Clinical and microbiological efficacy of intra-pocket application of diode laser in grade C periodontitis: a randomized controlled clinical trial
Authors: Anwar Souzy Kamal , Hafez Amira Mohamed , Roshdy Yara Safwat
Published: February 2024

Background

Periodontitis is a microbially induced disease destroying structures anchoring teeth to jaw bones. Although metronidazole in combination with spiramycin is the effective conventional treatment of stage III grade C periodontitis, it has several systemic side effects. Laser therapy is widely used nowadays as an adjunct to scaling and root planing (SRP) to modulate inflammatory host response and eradicate microbes, due to bactericidal and detoxifying effects. Since microbiological analysis is one of the diagnostic methods identifying periodontal risk; our research aimed to investigate the efficacy of intra-pocket application of diode laser (980 nm) versus antibiotic therapy in enhancing clinical and microbiological parameters in stage III grade C periodontitis.

Methods

A randomized controlled clinical trial was conducted on fifty patients with stage III grade C periodontitis, divided equally into two groups. We managed test group by SRP with intra-pocket application of diode laser (980 nm) and the control group by SRP with systemic antibiotic administration (spiramycin and metronidazole). Then, we measured periodontal pocket depth (PPD) and clinical attachment loss (CAL) for both groups, before treatment (baseline), four and twelve weeks after. Moreover, we collected gingival crevicular fluid from both groups at baseline, four and twelve weeks after treatment and analyzed by real-time polymerase chain reaction to detect the relative count of Aggregatibacter actinomycetemcomitans and Porhyromonas gingivalis.

Results

Compared to baseline, all assessed clinical and microbiological parameters attested improvement at the end of the study period in each group individually with no significant difference between the two studied groups. Although, at twelve weeks, flare up of bacterial levels was detected with systemic antibiotic administration.

Conclusion

Laser therapy can be considered as an effective treatment modality in stage III grade C periodontitis, avoiding the systemic antibiotic side effects and solving the recurrence problems due to bacterial resistance by long term usage.

Trial registration

NCT05222737 retrospectively on 03/02/2022, Clinicaltrial.gov.
Paying attention to attention: a program evaluation of faculty-delivered mindfulness-based attention training to optimize wellness and professionalism in medical students
Authors: Gunsilius Chloe Zimmerman , Price Malena M. , Rogers Scott L. , Flynn Ellen , Jha Amishi P.
Published: February 2024

Background

As physician distress rises, medical schools must provide programs to counter such distress at the earliest stages of training. Mindfulness training (MT) is one intervention that can alleviate stress during medical school. However, framing MT around wellness alone misses the opportunity to connect core cognitive and psychological capacities strengthened by MT to professional goals and skill acquisition inherent to successful medical training. Here, we highlight how the attentional components of MT align with students’ goals of becoming attending physicians while promoting academic, psychological, and interpersonal flourishing. MT courses that focus on strengthening attentional capacities can intuitively link academic and professional development with wellness, appealing to a wide array of students.

Methods

We iteratively recontextualized an existing short-form mindfulness training program for high-stress pre-professionals, known as Mindfulness Based Attention Training (MBAT), to the medical school context (MBAT-Rx). MBAT-Rx was offered by physician trainers to first-year medical students at Warren Alpert Medical School of Brown University as a tool for improving study habits and focus in addition to the development of both self-care and patient care strategies. MBAT-Rx consists of weekly, two-hour sessions over four weeks, with 10–15 min of daily mindfulness practice between sessions. At the end of the four weeks, students submitted voluntary program evaluation responses detailing their experience of the program.

Results

Optional program evaluation responses (n = 67) highlight that students found the program to be useful for their academic success and ability to pay attention, their interpersonal relationships, and their psychological health. By framing MT as an opportunity to boost core attentional capacities and connecting this to professional and academic goals in addition to wellness, MBAT-Rx appealed to a wide variety of students.

Conclusions

Our ongoing work suggests that framing MT as both a professional development and wellness promotion tool, taught by physicians themselves, and structured around students’ time demands, may be a successful model for medical schools looking to increase the impact of their mindfulness offerings. Such programs are needed to equip medical students to navigate the demands of a challenging healthcare training landscape.