bluuebunny/crossref_metadata_2025 huggingface dataset:
Spray nozzle for topical anaesthesia during flexible bronchoscopy: a randomised controlled trial
Authors: Huang Chun-Ta , Chou Hsiao-Chen , Chang Hao-Chun , Yang Ching-Yao , Lin Shu-Yung , Chang Lih-Chyun , Tsai Tzu-Hsiu , Hsu Chia-Lin , Chien Jung-Yien , Ho Chao-Chi
Published: February 2024

Background

The effectiveness of using a spray nozzle to deliver lidocaine for superior topical airway anaesthesia during non-sedation flexible bronchoscopy (FB) remains a topic of uncertainty when compared with conventional methods.

Methods

Patients referred for FB were randomly assigned to receive topical lidocaine anaesthesiaviathe bronchoscope's working channel (classical spray (CS) group) or through a washing pipe equipped with a spray nozzle (SN group). The primary outcome was cough rate, defined as the total number of coughs per minute. Secondary outcomes included subjective perceptions of both the patient and operator regarding the FB process. These perceptions were rated on a visual analogue scale, with numerical ratings ranging from 0 to 10.

Results

Our study enrolled a total of 126 (61 CS group; 65 SN group) patients. The SN group exhibited a significantly lower median cough rate compared with the CS group (4.5versus7.1 counts·min−1; p=0.021). Patients in the SN group also reported less oropharyngeal discomfort (4.5±2.7versus5.6±2.9; p=0.039), better tolerance of the procedure (6.8±2.2versus5.7±2.7; p=0.011) and a greater willingness to undergo a repeat FB procedure (7.2±2.7versus5.8±3.4; p=0.015) compared with those in the CS group. From the operator's perspective, patient discomfort (2.7±1.7versus3.4±2.3; p=0.040) and cough scores (2.3±1.5versus3.2±2.4; p=0.013) were lower in the SN group compared with the CS group, with less disruption due to coughing observed among those in the SN group (1.6±1.4versus2.3±2.3; p=0.029).

Conclusions

This study illustrates that employing a spray nozzle for the delivery of lidocaine provides superior topical airway anaesthesia during non-sedation FB compared with the traditional method.
SFX-01 in hospitalised patients with community-acquired pneumonia during the COVID-19 pandemic: a double-blind, randomised, placebo-controlled trial
Authors: Long Merete B. , Abo-Leyah Hani , Giam Yan Hui , Vadiveloo Thenmalar , Hull Rebecca C. , Keir Holly R. , Pembridge Thomas , Alferes De Lima Daniela , Delgado Lilia , Inglis Sarah K. , Hughes Chloe , Gilmour Amy , Gierlinski Marek , New Benjamin J.M. , MacLennan Graeme , Dinkova-Kostova Albena T. , Chalmers James D.
Published: February 2024

Introduction

Sulforaphane can induce the transcription factor, Nrf2, promoting antioxidant and anti-inflammatory responses. In this study, hospitalised patients with community-acquired pneumonia (CAP) were treated with stabilised synthetic sulforaphane (SFX-01) to evaluate impact on clinical status and inflammation.

Methods

Double-blind, randomised, placebo-controlled trial of SFX-01 (300 mg oral capsule, once daily for 14 days) conducted in Dundee, UK, between November 2020 and May 2021. Patients had radiologically confirmed CAP and CURB-65 (confusion, urea >7 mmol·L-1, respiratory rate ≥30 breaths·min-1, blood pressure <90 mmHg (systolic) or ≤60 mmHg (diastolic), age ≥65 years) score ≥1. The primary outcome was the seven-point World Health Organization clinical status scale at day 15. Secondary outcomes included time to clinical improvement, length of stay and mortality. Effects on Nrf2 activity and inflammation were evaluated on days 1, 8 and 15 by measurement of 45 serum cytokines and mRNA sequencing of peripheral blood leukocytes.

Results

The trial was terminated prematurely due to futility with 133 patients enrolled. 65 patients were randomised to SFX-01 treatment and 68 patients to placebo. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was the cause of CAP in 103 (77%) cases. SFX-01 treatment did not improve clinical status at day 15 (adjusted OR 0.87, 95% CI 0.41–1.83; p=0.71), time to clinical improvement (adjusted hazard ratio (aHR) 1.02, 95% CI 0.70–1.49), length of stay (aHR 0.84, 95% CI 0.56–1.26) or 28-day mortality (aHR 1.45, 95% CI 0.67–3.16). The expression of Nrf2 targets and pro-inflammatory genes, including interleukin (IL)-6, IL-1β and tumour necrosis factor-α, was not significantly changed by SFX-01 treatment. At days 8 and 15, respectively, 310 and 42 significant differentially expressed genes were identified between groups (false discovery rate adjusted p<0.05, log2FC >1).

Conclusion

SFX-01 treatment did not improve clinical status or modulate key Nrf2 targets in patients with CAP primarily due to SARS-CoV-2 infection.
The incremental contribution of mobile cone-beam computed tomography to the tool–lesion relationship during shape-sensing robotic-assisted bronchoscopy
Authors: Husta Bryan C. , Menon Anu , Bergemann Reza , Lin I-Hsin , Schmitz Jaclyn , Rakočević Rastko , Nadig Tejaswi R. , Adusumilli Prasad S. , Beattie Jason A. , Lee Robert P. , Park Bernard J. , Rocco Gaetano , Bott Matthew J. , Chawla Mohit , Kalchiem-Dekel Or
Published: February 2024

Introduction

This study aims to answer the question of whether adding mobile cone-beam computed tomography (mCBCT) imaging to shape-sensing robotic-assisted bronchoscopy (ssRAB) translates into a quantifiable improvement in the tool–lesion relationship.

Methods

Data from 102 peripheral lung lesions with ≥2 sequential mCBCT orbital spins and from 436 lesions with 0–1 spins were prospectively captured and retrospectively analysed. The primary outcome was the tool–lesion relationship status across the first and the last mCBCT spins. Secondary outcomes included 1) the change in distance between the tip of the sampling tool and the centre of the lesion between the first and the last spins and 2) the per-lesion diagnostic yield.

Results

Compared to lesions requiring 0–1 spins, lesions requiring ≥2 spins were smaller and had unfavourable bronchus sign and intra-operative sonographic view. On the first spin, 54 lesions (53%) were designated as non-tool-in-lesion (non-TIL) while 48 lesions (47%) were designated as TIL. Of the 54 initially non-TIL cases, 49 (90%) were converted to TIL status by the last spin. Overall, on the last spin, 96 out of 102 lesions (94%) were defined as TIL and six out of 102 lesions (6%) were defined as non-TIL (p<0.0001). The mean distance between the tool and the centre of the lesion decreased from 10.4 to 6.6 mm between the first and last spins (p<0.0001). The overall diagnostic yield was 77%.

Conclusion

Targeting traditionally challenging lung lesions, intra-operative volumetric imaging allowed for the conversion of 90% of non-TIL status to TIL. Guidance with mCBCT resulted in a significant decrease in the distance between the tip of the needle to lesion centre.
On the Polygonal Wear Evolution of Heavy-Haul Locomotive Wheels due to Wheel/Rail Flexibility and Its Mitigation Measures
Authors: Yang Yunfan , Chai Feifan , Liu Pengfei , Ling Liang , Wang Kaiyun , Zhai Wanming
Published: February 2024

Wheel polygonal wear can immensely worsen wheel/rail interactions and vibration performances of the train and track, and ultimately, lead to the shortening of service life of railway components. At present, wheel/rail medium- or high-frequency frictional interactions are perceived as an essential reason of the high-order polygonal wear of railway wheels, which are potentially resulted by the flexible deformations of the train/track system or other external excitations. In this work, the effect of wheel/rail flexibility on polygonal wear evolution of heavy-haul locomotive wheels is explored with aid of the long-term wheel polygonal wear evolution simulations, in which different flexible modeling of the heavy-haul wheel/rail coupled system is implemented. Further, the mitigation measures for the polygonal wear of heavy-haul locomotive wheels are discussed. The results point out that the evolution of polygonal wear of heavy-haul locomotive wheels can be veritably simulated with consideration of the flexible effect of both wheelset and rails. Execution of mixed-line operation of heavy-haul trains and application of multi-cut wheel re-profiling can effectively reduce the development of wheel polygonal wear. This research can provide a deep-going understanding of polygonal wear evolution mechanism of heavy-haul locomotive wheels and its mitigation measures.
Association between BMI and osteoporotic fractures at different sites in Chinese women: a case-control retrospective study in Changsha
Authors: Li Hong-Li , Shen Yi , Tan Li-Hua , Fu Song-Bo , Guan Cong-Hui , Zhen Dong-Hu , Lv Hai-Hong , Wu Xi-Yu , Tang Xu-Lei
Published: February 2024

Background

Osteoporotic fractures are a growing problem in an aging society. The association between body mass index (BMI) and osteoporotic fractures varies by fracture site and ethnicity. Limited knowledge exists regarding this association in native Chinese, particularly utilizing local databases as reference sources.

Objective

To investigate the association between BMI and osteoporotic fractures at different sites in Chinese women.

Methods

Three thousand ninety-eight female patients with radiographic fractures and 3098 age- and sex-matched healthy controls without fractures were included in the study. Both of them underwent assessment using dual-energy X-ray absorptiometry (DXA), with BMD measurements calculated using our own BMD reference database. Participants were classified into underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 24.0 kg/m2), overweight (24 ≤ BMI < 28 kg/m2) and obese (BMI ≥ 28 kg/m2) according to the Chinese BMI classification standard.

Results

There were 2296 (74.1%) vertebral fractures, 374 (12.1%) femoral neck fractures, and 428 (13.8%) other types of fractures in the case group. Bone mineral density (BMD) was almost lower in the fracture groups compared to the control groups (p = 0.048 to < 0.001). Compared with normal weight, underweight had a protective effect on total [odds ratio (OR) = 0.61; 95% confidence interval (CI), 0.49 –0.75; P< 0.001], and lumbar fractures (OR = 0.52; 95% CI, 0.41 – 0.67; P < 0.001), while obesity was associated with an increased risk for total (OR = 2.26; 95% CI, 1.85 – 2.76; P < 0.001), lumbar (OR = 2.17; 95% CI, 1.72 – 2.73; P < 0.001), and femoral neck fractures (OR = 4.08; 95% CI, 2.18 – 7.63; P < 0.001). Non-linear associations were observed between BMI and fractures: A J-curve for total, lumbar, and femoral neck fractures, and no statistical change for other types of fractures. Underweight was found to be a risk factor for other types of fracturess after adjusting for BMD (OR = 2.29; 95% CI, 1.09 – 4.80; P < 0.001). Osteoporosis and osteopenia were identified as risk factors for almost all sites of fracture when compared to normal bone mass.

Conclusions

Underweight has a protective effect on total and lumbar spine fractures in Chinese women, while obesity poses a risk factor for total, lumbar, and femoral neck fractures. The effect of BMI on fractures may be mainly mediated by BMD.
Molecular mechanism of resveratrol promoting differentiation of preosteoblastic MC3T3-E1 cells based on network pharmacology and experimental validation
Authors: He Yu , Liu Fei , He Mingjuan , Long Fayu , Hu Ding , Chen Jingwen , Fang Miao , Wang Zhenlong
Published: February 2024

The purpose of this study was to investigate the mechanism by which resveratrol (Res) inhibits apoptosis and promotes proliferation and differentiation of pre-osteoblastic MC3T3-E1 cells, laying the groundwork for the treatment of osteoporosis (OP). The TCMSP database was used to find the gene targets for Res. The GeneCards database acquire the gene targets for OP. After discovering the potential target genes, GO, KEGG, and Reactome enrichment analysis were conducted. Verifying the major proteins involved in apoptosis can bind to Res using molecular docking. CCK8 measured the proliferative activity of mouse pre-osteoblasts in every group following Res intervention. Alkaline phosphatase staining (ALP) and alizarin red staining to measure the ability of osteogenic differentiation. RT-qPCR to determine the expression levels of Runx2 and OPG genes for osteogenic differentiation ability of cells. Western blot to measure the degree of apoptosis-related protein activity in each group following Res intervention. The biological processes investigated for GO of Res therapeutic OP involved in cytokine-mediated signaling pathway, negative regulation of apoptotic process, Aging, extrinsic apoptotic signaling pathway in absence of ligand, according to potential therapeutic target enrichment study. Apoptosis, FoxO signaling pathway, and TNF signaling pathway are the primary KEGG signaling pathways. Recactome pathways are primarily engaged in Programmed Cell Death, Apoptosis, Intrinsic Apoptotic Pathway, and Caspase activation via extrinsic apoptotic signaling pathways. This research established a new approach for Res treatment of OP by demonstrating how Res controls the apoptosis-related proteins TNF, IL6, and CASP3 to suppress osteoblast death and increase osteoclastogenesis.
Extracellular vesicles from UTX-knockout endothelial cells boost neural stem cell differentiation in spinal cord injury
Authors: Liu Yudong , Luo Zixiang , Xie Yong , Sun Yi , Yuan Feifei , Jiang Liyuan , Lu Hongbin , Hu Jianzhong
Published: February 2024

Background

Vascular endothelial cells are pivotal in the pathophysiological progression following spinal cord injury (SCI). The UTX (Ubiquitously Transcribed Tetratripeptide Repeat on Chromosome X) serves as a significant regulator of endothelial cell phenotype. The manipulation of endogenous neural stem cells (NSCs) offers a compelling strategy for the amelioration of SCI.

Methods

Two mouse models were used to investigate SCI: NSCs lineage-traced mice and mice with conditional UTX knockout (UTX KO) in endothelial cells. To study the effects of UTX KO on neural differentiation, we harvested extracellular vesicles (EVs) from both UTX KO spinal cord microvascular endothelial cells (SCMECs) and negative control SCMECs. These EVs were then employed to modulate the differentiation trajectory of endogenous NSCs in the SCI model.

Results

In our NSCs lineage-traced mice model of SCI, a marked decrease in neurogenesis was observed post-injury. Notably, NSCs in UTX KO SCMECs mice showed enhanced neuronal differentiation compared to controls. RNA sequencing and western blot analyses revealed an upregulation of L1 cell adhesion molecule (L1CAM), a gene associated with neurogenesis, in UTX KO SCMECs and their secreted EVs. This aligns with the observed promotion of neurogenesis in UTX KO conditions. In vivo administration of L1CAM-rich EVs from UTX KO SCMECs (KO EVs) to the mice significantly enhanced neural differentiation. Similarly, in vitro exposure of NSCs to KO EVs resulted in increased activation of the Akt signaling pathway, further promoting neural differentiation. Conversely, inhibiting Akt phosphorylation or knocking down L1CAM negated the beneficial effects of KO EVs on NSC neuronal differentiation.

Conclusions

In conclusion, our findings substantiate that EVs derived from UTX KO SCMECs can act as facilitators of neural differentiation following SCI. This study not only elucidates a novel mechanism but also opens new horizons for therapeutic interventions in the treatment of SCI.

Graphical Abstract
Impacts of metabolic disruption, body mass index and inflammation on cognitive function in post-COVID-19 condition: a randomized controlled trial on vortioxetine
Authors: Kwan Angela T.H. , Le Gia Han , Guo Ziji , Ceban Felicia , Teopiz Kayla M. , Rhee Taeho Greg , Ho Roger , Di Vincenzo Joshua D. , Badulescu Sebastian , Meshkat Shakila , Cao Bing , Rosenblat Joshua D. , Dev Donovan A. , Phan Lee , Subramaniapillai Mehala , McIntyre Roger S.
Published: February 2024

Background

Post-COVID-19 Condition (PCC), as defined by the World Health Organization (WHO), currently lacks any regulatory-approved treatments and is characterized by persistent and debilitating cognitive impairment and mood symptoms. Additionally, metabolic dysfunction, chronic inflammation and the associated risks of elevated body mass index (BMI) have been reported. In this study, we aim to investigate the efficacy of vortioxetine in improving cognitive deficits in individuals with PCC, accounting for the interaction of metabolic dysfunction, elevated inflammation and BMI.

Methods

This is a post-hoc analysis of an 8-week randomized, double-blind, placebo-controlled trial that was conducted among adults aged 18 years and older living in Canada who were experiencing WHO-defined PCC symptoms. The recruitment of participants began in November 2021 and concluded in January 2023. A total of 200 individuals were enrolled, where 147 were randomized in a 1:1 ratio to receive either vortioxetine (5–20 mg, n = 73) or placebo (n = 74) for daily treatment under double-blind conditions. The primary outcome measure was the change in the Digit Symbol Substitution Test (DSST) score from baseline to endpoint.

Results

Our findings showed significant effects for time (χ2 = 7.771, p = 0.005), treatment (χ2 = 7.583, p = 0.006) and the treatment x time x CRP x TG-HDL x BMI interaction (χ2 = 11.967, p = 0.018) on cognitive function. Moreover, the between-group analysis showed a significant improvement with vortioxetine at endpoint (mean difference = 0.621, SEM = 0.313, p = 0.047).

Conclusion

Overall, vortioxetine demonstrated significant improvements in cognitive deficits among individuals with baseline markers of metabolic dysfunction, elevated inflammation and higher BMI at endpoint as compared to placebo.

Trial Registration

NCT05047952 (ClinicalTrials.gov; Registration Date: September 17, 2021).
Attitudes, beliefs, and recommendations for persistent low back pain patients: cross-sectional surveys of students and faculty at a chiropractic college
Authors: Muller Ryan D. , Cooper Jesse , Gliedt Jordan A. , Pohlman Katherine A.
Published: February 2024

Background

While the use of chiropractic care for persistent low back pain (PLBP) is prevalent, chiropractors’ attitudes and beliefs related to PLBP patients are not fully understood. The purpose of this study was to assess the attitudes, beliefs and activity/work recommendations of students and faculty at a chiropractic college regarding PLBP patients.

Methods

The Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) and clinical vignettes were requested to be completed by chiropractic students and faculty at Parker University in April 2018. Higher HC-PAIRS scores indicate stronger beliefs that PLBP justifies disability and limitation of activities. Activity and work recommendations from clinical vignettes were rated as “adequate”, “neutral”, or “inadequate”, as defined in previous literature. Descriptive statistics, independent t-tests, and logistic regression were used to analyze results.

Results

Student and faculty response rates were 63.6% and 25.9%, respectively. Faculty mean HC-PAIRS scores (3.66 [SD:0.88]) were significantly lower than students’ (4.41 [SD:0.71]). The percentage of faculty providing “adequate” activity (62.1%) and work (41.0%) recommendations was significantly greater than the percentage of students (activity: 33.9%, work: 21.2%) (p < 0.05). Higher HC-PAIRS scores in students were associated with decreased odds of providing “adequate” activity and work recommendations.

Conclusions

Student and faculty attitudes and beliefs, and students’ activity/work recommendations were found to be dissimilar to those from similar studies and less congruent with CPG recommendations. Lower HC-PAIRS scores increased the odds of students providing “adequate” activity and work recommendations to patients with PLBP. Results from this study may help guide future research and training opportunities.
Cost-of-illness studies of inherited retinal diseases: a systematic review
Authors: Ng Qin Xiang , Ong Clarence , Yaow Clyve Yu Leon , Chan Hwei Wuen , Thumboo Julian , Wang Yi , Koh Gerald Choon Huat
Published: February 2024

Background

While health care and societal costs are routinely modelled for most diseases, there is a paucity of comprehensive data and cost-of-illness (COI) studies for inherited retinal diseases (IRDs). This lack of data can lead to underfunding or misallocation of resources. A comprehensive understanding of the COI of IRDs would assist governmental and healthcare leaders in determining optimal resource allocation, prioritizing funding for research, treatment, and support services for these patients.

Methods

Following PRISMA guidelines, a literature search was conducted using Medline, EMBASE and Cochrane databases, from database inception up to 30 Jun 2023, to identify COI studies related to IRD. Original studies in English, primarily including patients with IRDs, and whose main study objective was the estimation of the costs of IRDs and had sufficiently detailed methodology to assess study quality were eligible for inclusion. To enable comparison across countries and studies, all annual costs were standardized to US dollars, adjusted for inflation to reflect their current value and recalculated on a “per patient” basis wherever possible. The review protocol was registered in PROSPERO (registration number CRD42023452986).

Results

A total of nine studies were included in the final stage of systematic review and they consistently demonstrated a significant disease burden associated with IRDs. In Singapore, the mean total cost per patient was roughly US$6926/year. In Japan, the mean total cost per patient was US$20,833/year. In the UK, the mean total cost per patient with IRD ranged from US$21,658 to US$36,549/year. In contrast, in the US, the mean total per-patient costs for IRDs ranged from about US$33,017 to US$186,051 per year. In Canada, these mean total per-patient costs varied between US$16,470 and US$275,045/year. Non-health costs constituted the overwhelming majority of costs as compared to healthcare costs; 87–98% of the total costs were due to non-health costs, which could be attributed to diminished quality of life, poverty, and increased informal caregiving needs for affected individuals.

Conclusion

IRDs impose a disproportionate societal burden outside health systems. It is vital for continued funding into IRD research, and governments should incorporate societal costs in the evaluation of cost-effectiveness for forthcoming IRD interventions, including genomic testing and targeted therapies.
Prediction of clinically significant prostate cancer using radiomics models in real-world clinical practice: a retrospective multicenter study
Authors: Bao Jie , Qiao Xiaomeng , Song Yang , Su Yueting , Ji Libiao , Shen Junkang , Yang Guang , Shen Hailin , Wang Ximing , Hu Chunhong
Published: February 2024

Purpose

To develop and evaluate machine learning models based on MRI to predict clinically significant prostate cancer (csPCa) and International Society of Urological Pathology (ISUP) grade group as well as explore the potential value of radiomics models for improving the performance of radiologists for Prostate Imaging Reporting and Data System (PI-RADS) assessment.

Material and methods

A total of 1616 patients from 4 tertiary care medical centers were retrospectively enrolled. PI-RADS assessments were performed by junior, senior, and expert-level radiologists. The radiomics models for predicting csPCa were built using 4 machine-learning algorithms. The PI-RADS were adjusted by the radiomics model. The relationship between the Rad-score and ISUP was evaluated by Spearman analysis.

Results

The radiomics models made using the random forest algorithm yielded areas under the receiver operating characteristic curves (AUCs) of 0.874, 0.876, and 0.893 in an internal testing cohort and external testing cohorts, respectively. The AUC of the adjusted_PI-RADS was improved, and the specificity was improved at a slight sacrifice of sensitivity. The participant-level correlation showed that the Rad-score was positively correlated with ISUP in all testing cohorts (r > 0.600 and p < 0.0001).

Conclusions

This radiomics model resulted as a powerful, non-invasive auxiliary tool for accurately predicting prostate cancer aggressiveness. The radiomics model could reduce unnecessary biopsies and help improve the diagnostic performance of radiologists’ PI-RADS. Yet, prospective studies are still needed to validate the radiomics models further.

Critical relevance statement

The radiomics model with MRI may help to accurately screen out clinically significant prostate cancer, thereby assisting physicians in making individualized treatment plans.

Key points

• The diagnostic performance of the radiomics model using the Random Forest algorithm is comparable to the Prostate Imaging Reporting and Data System (PI-RADS) obtained by radiologists.

• The performance of the adjusted Prostate Imaging Reporting and Data System (PI-RADS) was improved, which implied that the radiomics model could be a potential radiological assessment tool.

• The radiomics model lowered the percentage of equivocal cases. Moreover, the Rad-scores can be used to characterize prostate cancer aggressiveness.

Graphical Abstract
Visual analysis method for unmanned pumping stations on dynamic platforms based on data fusion technology
Authors: Liu Zhen , Chen Sen , Zhang Zhaobo , Qin Jiahao , Peng Bao
Published: February 2024

As the scale of water conservancy projects continues to expand, the amount and complexity of analytical data have also correspondingly increased. At present, it is difficult to realize project management decision support based on a single data source, and most manual analysis methods not only have high labor costs, but also are prone to the risk of misjudgment, resulting in huge property losses. Based on this problem, this paper proposes visual analysis method for unmanned pumping stations on dynamic platforms based on data fusion technology. First, the method uses the transfer learning method to enable ResNet18 obtain generalization ability. Secondly, the method uses ResNet18 to extract image features, and outputs fixed length sequence data as the input of long short-term memory (LSTM). Finally, the method uses LSTM outputs the classification results. The experimental results demonstrate that the algorithm model can achieve an impressive accuracy of 99.032%, outperforming the combination of traditional feature extraction and machine learning methods. This model effectively recognizes and classifies images of pumping stations, significantly reducing the risk of accidents in these facilities.
Comparison of disease and economic burden between MRSA infection and MRSA colonization in a university hospital: a retrospective data integration study
Authors: Hirabayashi Aki , Yahara Koji , Oka Keisuke , Kajihara Toshiki , Ohkura Teruko , Hosaka Yumiko , Shibayama Keigo , Sugai Motoyuki , Yagi Tetsuya
Published: February 2024

Background

Although there is a growing concern and policy regarding infections or colonization caused by resistant bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), the prognosis of MRSA infections compared to that of methicillin-susceptible Staphylococcus aureus (MSSA) infections remains controversial. Moreover, there have not been any studies comparing both the burden of disease and its impact on the healthcare economy between MRSA infection and colonization while adjusting for confounding factors. These comparisons are crucial for developing effective infection control measures and healthcare policies. We aimed to compare the disease and economic burden between MRSA and MSSA infections and between MRSA infection and colonization.

Methods

We retrospectively investigated data of 496 in-patients with MRSA or MSSA infections and of 1178 in-patients with MRSA infections or MRSA colonization from a university hospital in Japan from 2016 to 2021. We compared in-hospital mortality, length of stay, and hospital charges between in-patients with MRSA and MSSA infections and those with MRSA infections and MRSA colonization using multiple regressions. We combined surveillance data, including all microbiological test results, data on patients with infections, treatment histories, and clinical outcomes, to create the datasets.

Results

There was no statistically significant difference in in-hospital mortality rates between matched MRSA vs. MSSA infections and MRSA infection vs. colonization. On the contrary, the adjusted effects of the MRSA infection compared to those of MSSA infection on length of stay and hospital charges were 1.21-fold (95% confidence interval [CI] 1.03–1.42, P = 0.019) and 1.70-fold (95% CI 1.39–2.07, P < 0.00001), respectively. The adjusted effects of the MRSA infection compared to those of MRSA colonization on length of stay and hospital charges were 1.41-fold (95% CI 1.25–1.58, P < 0.00001) and 1.53-fold (95% CI 1.33–1.75, P < 0.00001), respectively. Regarding confounding factors, hemodialysis or hemofiltration was consistently identified and adjusted for in the multiple regression analyses comparing MRSA and MSSA infections, as well as MRSA infection and MRSA colonization.

Conclusions

MRSA infection was associated with longer length of stay and higher hospital charges than both MSSA infection and MRSA colonization. Furthermore, hemodialysis or hemofiltration was identified as a common underlying factor contributing to increased length of stay and hospital charges.
Host starvation and in hospite degradation of algal symbionts shape the heat stress response of the Cassiopea-Symbiodiniaceae symbiosis
Authors: Toullec Gaëlle , Rädecker Nils , Pogoreutz Claudia , Banc-Prandi Guilhem , Escrig Stéphane , Genoud Christel , Olmos Cristina Martin , Spangenberg Jorge , Meibom Anders
Published: February 2024

Background

Global warming is causing large-scale disruption of cnidarian-Symbiodiniaceae symbioses fundamental to major marine ecosystems, such as coral reefs. However, the mechanisms by which heat stress perturbs these symbiotic partnerships remain poorly understood. In this context, the upside-down jellyfish Cassiopea has emerged as a powerful experimental model system.

Results

We combined a controlled heat stress experiment with isotope labeling and correlative SEM-NanoSIMS imaging to show that host starvation is a central component in the chain of events that ultimately leads to the collapse of the Cassiopea holobiont. Heat stress caused an increase in catabolic activity and a depletion of carbon reserves in the unfed host, concurrent with a reduction in the supply of photosynthates from its algal symbionts. This state of host starvation was accompanied by pronounced in hospite degradation of algal symbionts, which may be a distinct feature of the heat stress response of Cassiopea. Interestingly, this loss of symbionts by degradation was concealed by body shrinkage of the starving animals, resulting in what could be referred to as “invisible” bleaching.

Conclusions

Overall, our study highlights the importance of the nutritional status in the heat stress response of the Cassiopea holobiont. Compared with other symbiotic cnidarians, the large mesoglea of Cassiopea, with its structural sugar and protein content, may constitute an energy reservoir capable of delaying starvation. It seems plausible that this anatomical feature at least partly contributes to the relatively high stress tolerance of these animals in rapidly warming oceans.
The risk of mpox importation and subsequent outbreak potential in Chinese mainland: a retrospective statistical modelling study
Authors: Deng Xiaowei , Tian Yuyang , Zou Junyi , Yang Juan , Sun Kaiyuan , Yu Hongjie
Published: February 2024

Background

The 2022–2023 mpox (monkeypox) outbreak has spread rapidly across multiple countries in the non-endemic region, mainly among men who have sex with men (MSM). In this study, we aimed to evaluate mpox’s importation risk, border screening effectiveness and the risk of local outbreak in Chinese mainland.

Methods

We estimated the risk of mpox importation in Chinese mainland from April 14 to September 11, 2022 using the number of reported mpox cases during this multi-country outbreak from Global.health and the international air-travel data from Official Aviation Guide. We constructed a probabilistic model to simulate the effectiveness of a border screening scenario during the mpox outbreak and a hypothetical scenario with less stringent quarantine requirement. And we further evaluated the mpox outbreak potential given that undetected mpox infections were introduced into men who have sex with men, considering different transmissibility, population immunity and population activity.

Results

We found that the reduced international air-travel volume and stringent border entry policy decreased about 94% and 69% mpox importations respectively. Under the quarantine policy, 15–19% of imported infections would remain undetected. Once a case of mpox is introduced into active MSM population with almost no population immunity, the risk of triggering local transmission is estimated at 42%, and would rise to > 95% with over six cases.

Conclusions

Our study demonstrates that the reduced international air-travel volume and stringent border entry policy during the COVID-19 pandemic reduced mpox importations prominently. However, the risk could be substantially higher with the recovery of air-travel volume to pre-pandemic level. Mpox could emerge as a public health threat for Chinese mainland given its large MSM community.

Graphical Abstract
Further evidence of the association between social media use, eating disorder pathology and appearance ideals and pressure: a cross-sectional study in Norwegian adolescents
Authors: Dahlgren Camilla Lindvall , Sundgot-Borgen Christine , Kvalem Ingela Lundin , Wennersberg Anne-Louise , Wisting Line
Published: February 2024

Background

Few studies have investigated how the plethora of contemporary social media (SM) platforms relate to, and influence eating disorder (ED) pathology, appearance ideals and pressure to conform to these ideals in youth.

Methods

In this study, 1558 girls (53%) and boys (47%), predominantly within the 16–19 age range, completed an online questionnaire assessing SM use and perceived influence on appearance, ED pathology, internalization of appearance ideals and perceived appearance pressure.

Results

Results showed that ED pathology was common, particularly in girls, and that internalization of body ideals was gender specific, a thin ideal being more prevalent in girls, and a muscular ideal being more common in boys. Results also showed a strong association between ED pathology and perceived pressure to conform to these appearance ideals. One fourth of the participants reported spending four hours or more on SM daily, and 80% of girls reported that SM, particularly Instagram and TikTok, had a negative influence on how they felt about their appearance. These girls had significantly higher levels of ED pathology and reported higher levels of appearance pressure from the media.

Conclusion

A clear pattern of associations between photo- and video specific SM platforms, ED pathology, internalization of body ideals and perceived pressure was found in this study. Adolescent girls appeared to be particularly at risk. The results illustrate an imperative need to keep addressing the potential risks of SM use in adolescents, and to continue monitoring the effect of SM on young people’s view of themselves, their appearance, and their eating habits. Future studies should attempt to identify aspects of SM use that may be particularly detrimental for girls and boys in their formative years, but also those that may enhance adolescents’ satisfaction and appreciation of their body and appearance.

Trial registration: The study is registered in the Open Science Framework (Identifier: 10.17605/OSF.IO/5RB6P https://doi.org/10.17605/OSF.IO/5RB6P).
Automated segmentation of lesions and organs at risk on [68Ga]Ga-PSMA-11 PET/CT images using self-supervised learning with Swin UNETR
Authors: Yazdani Elmira , Karamzadeh-Ziarati Najme , Cheshmi Seyyed Saeid , Sadeghi Mahdi , Geramifar Parham , Vosoughi Habibeh , Jahromi Mahmood Kazemi , Kheradpisheh Saeed Reza
Published: February 2024

Background

Prostate-specific membrane antigen (PSMA) PET/CT imaging is widely used for quantitative image analysis, especially in radioligand therapy (RLT) for metastatic castration-resistant prostate cancer (mCRPC). Unknown features influencing PSMA biodistribution can be explored by analyzing segmented organs at risk (OAR) and lesions. Manual segmentation is time-consuming and labor-intensive, so automated segmentation methods are desirable. Training deep-learning segmentation models is challenging due to the scarcity of high-quality annotated images. Addressing this, we developed shifted windows UNEt TRansformers (Swin UNETR) for fully automated segmentation. Within a self-supervised framework, the model’s encoder was pre-trained on unlabeled data. The entire model was fine-tuned, including its decoder, using labeled data.

Methods

In this work, 752 whole-body [68Ga]Ga-PSMA-11 PET/CT images were collected from two centers. For self-supervised model pre-training, 652 unlabeled images were employed. The remaining 100 images were manually labeled for supervised training. In the supervised training phase, 5-fold cross-validation was used with 64 images for model training and 16 for validation, from one center. For testing, 20 hold-out images, evenly distributed between two centers, were used. Image segmentation and quantification metrics were evaluated on the test set compared to the ground-truth segmentation conducted by a nuclear medicine physician.

Results

The model generates high-quality OARs and lesion segmentation in lesion-positive cases, including mCRPC. The results show that self-supervised pre-training significantly improved the average dice similarity coefficient (DSC) for all classes by about 3%. Compared to nnU-Net, a well-established model in medical image segmentation, our approach outperformed with a 5% higher DSC. This improvement was attributed to our model’s combined use of self-supervised pre-training and supervised fine-tuning, specifically when applied to PET/CT input. Our best model had the lowest DSC for lesions at 0.68 and the highest for liver at 0.95.

Conclusions

We developed a state-of-the-art neural network using self-supervised pre-training on whole-body [68Ga]Ga-PSMA-11 PET/CT images, followed by fine-tuning on a limited set of annotated images. The model generates high-quality OARs and lesion segmentation for PSMA image analysis. The generalizable model holds potential for various clinical applications, including enhanced RLT and patient-specific internal dosimetry.
Development and validation of ultrasound-based radiomics model to predict germline BRCA mutations in patients with breast cancer
Authors: Deng Tingting , Liang Jianwen , Yan Cuiju , Ni Mengqian , Xiang Huiling , Li Chunyan , Ou Jinjing , Lin Qingguang , Liu Lixian , Tang Guoxue , Luo Rongzhen , An Xin , Gao Yi , Lin Xi
Published: February 2024

Background

Identifying breast cancer (BC) patients with germline breast cancer susceptibility gene (gBRCA) mutation is important. The current criteria for germline testing for BC remain controversial. This study aimed to develop a nomogram incorporating ultrasound radiomic features and clinicopathological factors to predict gBRCA mutations in patients with BC.

Materials and methods

In this retrospective study, 497 women with BC who underwent gBRCA genetic testing from March 2013 to May 2022 were included, including 348 for training (84 with and 264 without a gBRCA mutation) and 149 for validation(36 patients with and 113 without a gBRCA mutation). Factors associated with gBRCA mutations were identified to establish a clinicopathological model. Radiomics features were extracted from the intratumoral and peritumoral regions (3 mm and 5 mm) of each image. The least absolute shrinkage and selection operator regression algorithm was used to select the features and logistic regression analysis was used to construct three imaging models. Finally, a nomogram that combined clinicopathological and radiomics features was developed. The models were evaluated based on the area under the receiver operating characteristic curve (AUC), calibration, and clinical usefulness.

Results

Age at diagnosis, family history of BC, personal history of other BRCA-related cancers, and human epidermal growth factor receptor 2 status were independent predictors of the clinicopathological model. The AUC of the imaging radiomics model combining intratumoral and peritumoral 3 mm areas in the validation set was 0.783 (95% confidence interval [CI]: 0.702—0.862), which showed the best performance among three imaging models. The nomogram yielded better performance than the clinicopathological model in validation sets (AUC: 0.824 [0.755—0.894] versus 0.659 [0.563—0.755], p = 0.007).

Conclusion

The nomogram based on ultrasound images and clinicopathological factors performs well in predicting gBRCA mutations in BC patients and may help to improve clinical decisions about genetic testing.
A community-based advanced nurse practitioner-led integrated oncology care model for adults receiving oral anticancer medication: a pilot study
Authors: Richmond Janice P. , Kelly Mary Grace , Johnston Alison , Murphy Patrick J. , O’Connor Laura , Gillespie Paddy , Hobbins Anna , Alvarez-Iglesias Alberto , Murphy Andrew W.
Published: February 2024

Oral anti-cancer medications (OAMs) are being used increasingly within cancer care. OAMs offer the potential to improve patient convenience and increase hospital capacity. The clinical assessment for each cycle of OAMs requires specialist patient review often performed in hospital-based oncology units. Consequently, any potential improvement in patient expediency or increased hospital capacity that OAMs can offer is not realised. This study aimed to develop and pilot the specialist assessment of patients receiving OAMs by an Advanced Nurse Practitioner (ANP) in a community-based location.

The primary aim of this pilot study was to assess the feasibility of a community-based ANP-led integrated oncology care model for adults receiving OAMs in Ireland who met the pre-specified eligibility criteria. The objectives were to determine the feasibility of a definitive trial of this intervention by measuring patient safety, acceptability to patients and staff and cost of the new model of care.

This single-centre pilot study provided patient care (n = 37) to those receiving OAM therapies within a community setting for a 4-month period. Consent rate was high with no attrition other than for clinical reasons. There were 151 contacts with the sample during that time.

Results demonstrated that the ANP-led intervention and new model for OAM care was safe, highly acceptable to patients and staff and that related healthcare costs could be captured. Based on the success of this pilot study, the authors conclude that a community-based ANP-led integrated oncology care model for adults receiving OAMs is feasible, and a definitive trial is warranted.

Trial registration ISRCTN, ISRCTN10401455. Registered 30 November 2020.
How are texts analyzed in blockchain research? A systematic literature review
Authors: Zhuo Xian , Irresberger Felix , Bostandzic Denefa
Published: February 2024

This paper provides a systematic literature review of text analysis methodologies used in blockchain-related research to comprehend and synthesize existing studies across disciplines and define future research directions. We summarize the research scope, text data, and methodologies of 124 papers and identify the two most common combinations of these dimensions: (1) papers that focus on specific cryptocurrencies tend to apply sentiment analysis to instant user-generated content or news articles to discover the correlations between public opinion and market behavior, and (2) studies that examine the broad concept of blockchain with text data from documents published by companies tend to apply topic modeling techniques to explore classifications and trends in blockchain development. We discover five major research topics in the academic literature: relationship discovery, cryptocurrency performance prediction, classification and trend, crime and regulation, and perception of blockchain. Based on these findings, we highlight three potential research directions for researchers to select topics and implement suitable methodologies for text analysis.
A hybrid model for stock price prediction based on multi-view heterogeneous data
Authors: Long Wen , Gao Jing , Bai Kehan , Lu Zhichen
Published: February 2024

Literature shows that both market data and financial media impact stock prices; however, using only one kind of data may lead to information bias. Therefore, this study uses market data and news to investigate their joint impact on stock price trends. However, combining these two types of information is difficult because of their completely different characteristics. This study develops a hybrid model called MVL-SVM for stock price trend prediction by integrating multi-view learning with a support vector machine (SVM). It works by simply inputting heterogeneous multi-view data simultaneously, which may reduce information loss. Compared with the ARIMA and classic SVM models based on single- and multi-view data, our hybrid model shows statistically significant advantages. In the robustness test, our model outperforms the others by at least 10% accuracy when the sliding windows of news and market data are set to 1–5 days, which confirms our model’s effectiveness. Finally, trading strategies based on single stock and investment portfolios are constructed separately, and the simulations show that MVL-SVM has better profitability and risk control performance than the benchmarks.
Stock liquidity, financial constraints, and innovation in Chinese SMEs
Authors: Liu Wei , Suzuki Yoshihisa
Published: February 2024

This study investigates the relationship between stock liquidity and firm innovation for publicly traded growing small and medium-sized enterprises (SMEs) in China using both innovation input and output. We collected samples of 785 SMEs from China’s Shenzhen Growth Enterprises Market without the financial industry from 2010 to 2020. The empirical findings demonstrate a significant positive relationship between stock liquidity and both innovation input, as measured by R&D investments, and innovation output, as proxied by patenting activities. A series of robustness tests demonstrate the reliability of our results. Increased liquidity enhances SMEs' innovation mainly by alleviating financial constraints, whereas the mediating effect of mergers and acquisitions (M&A) is not apparent at the firm level. Furthermore, the inhibitory effect of blockholder ownership on firm innovation is weak. Further analysis reveals that this favorable impact can last for at least four years, with manufacturing SMEs benefiting the most. Our study shows that the innovation abilities of SMEs can be enhanced by improving stock liquidity, which is mainly driven by tackling financial constraints.