bluuebunny/crossref_metadata_2025 huggingface dataset:
Stroke incidence increases with diabetic retinopathy severity and macular edema in type 1 diabetes
Authors: Eriksson Marika I , Hietala Kustaa , Summanen Paula , Harjutsalo Valma , Putaala Jukka , Ylinen Anni , Hägg-Holmberg Stefanie , Groop Per-Henrik , Thorn Lena M ,   on behalf of the FinnDiane Study
Published: April 2024

Background

As the retina is suggested to mirror the brain, we hypothesized that diabetic retinopathy and macular edema are indicative of stroke risk in type 1 diabetes and sought to assess this association in individuals with type 1 diabetes.

Methods

We included 1,268 adult FinnDiane Study participants with type 1 diabetes (age 38.7 ± 11.8 years, 51.7% men vs. 48.3% women, and 31.5% had diabetic kidney disease), data on baseline diabetic retinopathy severity, and first stroke during our observational follow-up. Retinopathy was graded by the Early Treatment Diabetic Retinopathy Study (ETDRS) scale, and macular edema as clinically significant (CSME) or not. Strokes identified from registries were confirmed from medical files. Adjusted hazard ratios (HR) for stroke by retinopathy severity and CSME were calculated by Cox models adjusted for clinical confounders, including diabetic kidney disease.

Results

During median 18.0 (14.1–19.3) follow-up years, 130 strokes (96 ischemic, 34 hemorrhagic) occurred. With no–very mild (ETDRS 10–20) retinopathy as reference, the adjusted HR for stroke was 1.79 (95%CI 1.02–3.15) in non-proliferative (ETDRS 35–53), and 1.69 (1.02–2.82) in proliferative (ETDRS 61–85) retinopathy. Corresponding adjusted HR for ischemic stroke was 1.68 (0.91–3.10) in non-proliferative and 1.35 (0.77–2.36) in proliferative retinopathy. The adjusted HR for hemorrhagic stroke was 2.84 (0.66–12.28) in non-proliferative and 4.31 (1.16–16.10) in proliferative retinopathy. CSME did not increase HR for any stroke type after adjustment for clinical confounders (data not shown).

Conclusions

Stroke incidence increases with the severity of diabetic retinopathy independently of comorbid conditions, including diabetic kidney disease.
Limited resection is comparable to lobectomy for tumor size ≤ 2 cm pulmonary invasive mucinous adenocarcinoma
Authors: Lin Weikang , Su Hang , Xie Huikang , Xu Long , Wang Tingting , Wang Long , Hu Xuefei , Zhao Deping , Zhu Yuming , Wang Haifeng , Jiang Gening , Xie Dong , Chen Chang ,   on behalf of the Surgical Thoracic Alliance of Rising Star Group
Published: April 2024

Objectives

Invasive mucinous adenocarcinoma (IMA) has a rare incidence with better prognosis than nonmucinous adenocarcinoma. We aimed to investigate the prognosis between limited resection and lobectomy for patients with clinical stage IA IMA ≤ 2 cm.

Methods

Data were taken from two cohorts: In Shanghai Pulmonary Hospital (SPH) corhort, we identified 403 patients with clinical stage IA IMA who underwent surgery. In the SEER corhort, 480 patients with stage T1 IMA who after surgery were included. Recurrence-free survival (RFS) for SPH corhort, lung cancer–specific survival (LCSS) for the SEER corhort and overall survival (OS) for both corhort were compared between patients undergoing lobectomy and limited resection by Log-rank and Cox proportional hazard regression model.

Results

In SPH corhort, patients who underwent limited resection had equivalent prognosis than those underwent lobectomy (5-year RFS: 79.3% versus. 82.6%, p = 0.116; 5-year OS: 86.2% versus. 88.3%, p = 0.235). However, patients with IMA > 2 to 3 cm had worse prognosis than those with IMA ≤ 2 cm (5-year RFS: 73.7% versus. 86.1%, p = 0.007). In the analysis of IMA > 2 to 3 cm subgroup, multivariate analysis showed that limited resection was an independent risk factor of RFS (hazard ratio, 2.417; 95% confidence interval, 1.157–5.049; p = 0.019), while OS (p = 0.122) was not significantly different between two groups. For IMA ≤ 2 cm, limited resection was not a risk factor of RFS (p = 0. 953) and OS (p = 0.552). In the SEER corhort, IMA ≤ 2 cm subgroup, limited resection was equivalent prognosis in LCSS (p = 0.703) and OS (p = 0.830).

Conclusions

Limited resection could be a potential surgical option which comparable to lobectomy in patients with clinical stage IA IMA ≤ 2 cm.
Coordination of COVID-19 platform trials in Europe
Authors: Demotes Jacques , Simensen Victoria Charlotte , Ueda Keiko , Javaid Sareema , Garcia Paula , Aydin Burç , Røttingen John-Arne
Published: April 2024

To ensure optimal coordination of the EU-funded COVID-19 platform trials, a double coordination mechanism was established. It included the Trial Coordination Board (TCB) to promote the dialogue between investigators and relevant public health stakeholders and the Joint Access Advisory Mechanism (JAAM) to streamline access of new intervention arms to the platform trials. Both the TCB and the JAAM emerged as efficient instruments to promote cooperation and optimise the use of resources within EU-funded adaptive platform trials. In addition, an adaptive platform trial toolbox was developed to collect information and literature on challenges and solutions identified to date. The recently funded ‘Coordination MEchanism for Cohorts and Trials’ (CoMeCT) project will endeavour to make this model sustainable, with a further expansion to other emerging infectious diseases, as part of the governance of the current and future platform trials for pandemic preparedness. This example could serve as a model for platform trial coordination in other disease areas.
Efficacy and safety of antibiotics targeting Gram-negative bacteria in nosocomial pneumonia: a systematic review and Bayesian network meta-analysis
Authors: Luque Paz David , Chean Dara , Tattevin Pierre , Luque Paz Damien , Bayeh Betsega Assefa , Kouatchet Achille , Douillet Delphine , Riou Jérémie
Published: April 2024

Background

Multiple randomized controlled studies have compared numerous antibiotic regimens, including new, recently commercialized antibiotics in the treatment of nosocomial pneumonia (NP). The objective of this Bayesian network meta-analysis (NMA) was to compare the efficacy and the safety of different antibiotic treatments for NP.

Methods

We conducted a systematic search of PubMed, Medline, Web of Science, EMBASE and the Cochrane Library databases from 2000 through 2021. The study selection included studies comparing antibiotics targeting Gram-negative bacilli in the setting of NP. The primary endpoint was 28 day mortality. Secondary outcomes were clinical cure, microbiological cure and adverse events.

Results

Sixteen studies encompassing 4993 patients were included in this analysis comparing 13 antibiotic regimens. The level of evidence for mortality comparisons ranged from very low to moderate. No significant difference in 28 day mortality was found among all beta-lactam regimens. Only the combination of meropenem plus aerosolized colistin was associated with a significant decrease of mortality compared to using intravenous colistin alone (OR = 0.43; 95% credible interval [0.17–0.94]), based on the results of the smallest trial included. The clinical failure rate of ceftazidime was higher than meropenem with (OR = 1.97; 95% CrI [1.19–3.45]) or without aerosolized colistin (OR = 1.40; 95% CrI [1.00–2.01]), imipemen/cilastatin/relebactam (OR = 1.74; 95% CrI [1.03–2.90]) and ceftazidime/avibactam (OR = 1.48; 95% CrI [1.02–2.20]). For microbiological cure, no substantial difference between regimens was found, but ceftolozane/tazobactam had the highest probability of being superior to comparators. In safety analyses, there was no significant difference between treatments for the occurrence of adverse events, but acute kidney failure was more common in patients receiving intravenous colistin.

Conclusions

This network meta-analysis suggests that most antibiotic regimens, including new combinations and cefiderocol, have similar efficacy and safety in treating susceptible Gram-negative bacilli in NP. Further studies are necessary for NP caused by multidrug-resistant bacteria.

Registration PROSPERO CRD42021226603
Efficacy of non-instrumental Endodontic treatment in primary teeth: a systematic review of clinical randomized trials
Authors: Chouchene Farah , Oueslati Amira , Masmoudi Fatma , Baaziz Ahlem , Maatouk Fethi , Ghedira Hichem
Published: April 2024

Background

Endodontic therapy in pediatric dentistry is a challenging procedure, especially for special needs, uncooperative, and very young patients. A new conservative approach which is the non-instrumental endodontic treatment (NIET) has been developed to simplify the management of primary teeth requiring pulpectomy. This review aimed to compare the efficiency of NIET and conventional endodontic treatment in primary teeth.

Methods

Electronic databases including MEDLINE (via PubMed), Cochrane Library (CENTRAL), and Scopus without restrictions on publication year or publication language were searched. Only randomized clinical trials reporting clinical and radiographical outcomes of NIET and conventional pulpectomy on primary teeth were considered eligible.

Two reviewers extracted the data according to the PRISMA statement and assessed the bias risk using the revised Cochrane risk-of-bias tool and a meta-analysis was performed.

Results

From 3322 screened articles, seven articles meeting the inclusion criteria were included. The selected studies included 283 primary molars, of 213 children aged between 3 and 9 years, treated by NIET and conventional pulpectomy, and had follow-up periods ranging from 1 month to tooth exfoliation. Two studies reported good success rates for both the NIET technique and endodontic therapy with no statistically significant difference while three studies showed radiographical significant differences with a low success rate for the NIET technique. Only one study reported better outcomes in the pulpectomy group with statistically significant differences. The quantitative grouping of the included studies showed no significant differences between NIET and conventional endodontic therapy regarding clinical and radiographical success (p value > 0.05).

Conclusion

No difference between the NIET technique and the conventional endodontic therapy in primary molars requiring pulpectomy could be confirmed. Results of the present review need to be interpreted with caution since the quality of evidence according to the GRADE was considered as moderate to very low. Therefore, additional clinical trials on the NIET technique are recommended.
Epidemiology of perioperative RV dysfunction: risk factors, incidence, and clinical implications
Authors: Shelley Ben , McAreavey Rhiannon , McCall Philip
Published: April 2024

In this edition of the journal, the Perioperative Quality Initiative (POQI) present three manuscripts describing the physiology, assessment, and management of right ventricular dysfunction (RVD) as pertains to the perioperative setting. This narrative review seeks to provide context for these manuscripts, discussing the epidemiology of perioperative RVD focussing on definition, risk factors, and clinical implications. Throughout the perioperative period, there are many potential risk factors/insults predisposing to perioperative RVD including pre-existing RVD, fluid overload, myocardial ischaemia, pulmonary embolism, lung injury, mechanical ventilation, hypoxia and hypercarbia, lung resection, medullary reaming and cement implantation, cardiac surgery, cardiopulmonary bypass, heart and lung transplantation, and left ventricular assist device implantation. There has however been little systematic attempt to quantify the incidence of perioperative RVD. What limited data exists has assessed perioperative RVD using echocardiography, cardiovascular magnetic resonance, and pulmonary artery catheterisation but is beset by challenges resulting from the inconsistencies in RVD definitions. Alongside differences in patient and surgical risk profile, this leads to wide variation in the incidence estimate. Data concerning the clinical implications of perioperative RVD is even more scarce, though there is evidence to suggest RVD is associated with atrial arrhythmias and prolonged length of critical care stay following thoracic surgery, increased need for inotropic support in revision orthopaedic surgery, and increased critical care requirement and mortality following cardiac surgery. Acute manifestations of RVD result from low cardiac output or systemic venous congestion, which are non-specific to the diagnosis of RVD. As such, RVD is easily overlooked, and the relative contribution of RV dysfunction to postoperative morbidity is likely to be underestimated.

We applaud the POQI group for highlighting this important condition. There is undoubtedly a need for further study of the RV in the perioperative period in addition to solutions for perioperative risk prediction and management strategies. There is much to understand, study, and trial in this area, but importantly for our patients, we are increasingly recognising the importance of these uncertainties.
Enhanced cellular therapy: revolutionizing adoptive cellular therapy
Authors: Xu Meng-Yao , Zeng Na , Liu Chen-Qian , Sun Jian-Xuan , An Ye , Zhang Si-Han , Xu Jin-Zhou , Zhong Xing-Yu , Ma Si-Yang , He Hao-Dong , Hu Jia , Xia Qi-Dong , Wang Shao-Gang
Published: April 2024

Enhanced cellular therapy has emerged as a novel concept following the basis of cellular therapy. This treatment modality applied drugs or biotechnology to directly enhance or genetically modify cells to enhance the efficacy of adoptive cellular therapy (ACT). Drugs or biotechnology that enhance the killing ability of immune cells include immune checkpoint inhibitors (ICIs) / antibody drugs, small molecule inhibitors, immunomodulatory factors, proteolysis targeting chimera (PROTAC), oncolytic virus (OV), etc. Firstly, overcoming the inhibitory tumor microenvironment (TME) can enhance the efficacy of ACT, which can be achieved by blocking the immune checkpoint. Secondly, cytokines or cytokine receptors can be expressed by genetic engineering or added directly to adoptive cells to enhance the migration and infiltration of adoptive cells to tumor cells. Moreover, multi-antigen chimeric antigen receptors (CARs) can be designed to enhance the specific recognition of tumor cell-related antigens, and OVs can also stimulate antigen release. In addition to inserting suicide genes into adoptive cells, PROTAC technology can be used as a safety switch or degradation agent of immunosuppressive factors to enhance the safety and efficacy of adoptive cells. This article comprehensively summarizes the mechanism, current situation, and clinical application of enhanced cellular therapy, describing potential improvements to adoptive cellular therapy.
Effects of capture and GPS-tagging in spring on migration timing and reproduction in Pink-footed geese Anser brachyrhynchus
Authors: Schreven Kees H. T. , Madsen Jesper , Nolet Bart A.
Published: April 2024

Background

GPS-transmitters enable detailed study of animal behaviour but may impact the animals. Impacts vary from short-term stress and habituation to longer-term effects on e.g., migration and reproduction. To study impacts, ideally, true controls (i.e., uncaptured or untagged animals) are used, but unbiased assessments of their migration timing and breeding performance are challenging, especially in remote areas. Alternatively, quasi-controls can be used: individuals tagged longer ago, or the same tagged individuals but in later years. Quasi-controls reveal tagging effects that differ between the first and following years.

Results

We captured Pink-footed geese (Anser brachyrhynchus) in spring and summer and deployed GPS-transmitter neckbands. In spring, geese were caught with cannon or clap nets on stopovers in Norway and Finland, 2 weeks before departure to breeding areas in Svalbard and Novaya Zemlya. In summer, geese were rounded up during wing moult in Svalbard. First, we compared geese tagged recently in spring with geese tagged in spring or summer 1–4 years prior. Newly tagged geese migrated significantly later, by 2 days, than previously tagged geese, both at departure from the spring stopover and arrival to the breeding grounds, while migration duration did not differ. Breeding propensity and laying date did not differ, but nesting success tended to be lowered, resulting in a significantly lower annual probability to produce hatchlings in recently tagged geese than in previously tagged geese. Second, within individuals tagged in spring, spring migration advanced in their next year, suggesting delay in their first spring. This was likely not an ageing effect, as geese tagged in summer showed no advancing spring migration timing over the years. Third, in Svalbard, observed brood sizes of geese tagged in summer and untagged geese did not differ 1 year after tagging.

Conclusions

The capture and GPS-tagging of geese 2 weeks before spring departure delayed their spring migration and lowered their probability to produce hatchlings in that year. These effects lasted longer than previously reported week-long effects of GPS-tagging on time budgets in summer and of neck-banding on spring body condition. Additional study is needed to evaluate longer-term or permanent effects which remain undetected with quasi-controls.
Internet-based eHealth technology for emotional well-being among the older adults with a family cancer history: full mediation effects of health information self-efficacy and cancer fatalism
Authors: Lai Yuyuan Kylie , Ye Jizhou Francis , Ran Qiawen , Ao Harris Song
Published: April 2024

Background

Older adults with a family cancer history (FCH) face an increased cancer risk, which may adversely impact their emotional well-being. Internet-based eHealth technologies (IETs) provide a potential solution to this challenge. This study examines the influence of using IETs on the emotional well-being of older adults with FCH. It also delves into the mediating pathways through health information self-efficacy and cancer fatalism.

Methods

This study conducted a mediation analysis using data from the Health Information National Trends Survey (HINTS 6) collected from March 2022 to November 2022, focusing on older adults with FCH who had previously searched for cancer-related information (N = 1,280).

Results

In the mediation model, no positive direct associations between IETs usage and emotional well-being were found. Only health information self-efficacy and cancer fatalism were found to mediate the relationship between IETs usage and emotional well-being serially (β = 0.007, 95% CI [0.003, 0.012]).

Conclusions

The findings inform health information professionals and healthcare practitioners on enhancing the impact of IETs usage on individual health information self-efficacy, which mitigates cancer fatalism, contributing to better emotional well-being in the digital era.
What drives wild pig (Sus scrofa) movement in bottomland and upland forests?
Authors: Evans Tyler S. , Ellison Natasha , Boudreau Melanie R. , Strickland Bronson K. , Street Garrett M. , Iglay Raymond B.
Published: April 2024

Background

The wild pig (Sus scrofa) is an exotic species that has been present in the southeastern United States for centuries yet continues to expand into new areas dominated by bottomland and upland forests, the latter of which are less commonly associated with wild pigs. Here, we aimed to investigate wild pig movement and space use attributes typically used to guide wild pig management among multiple spatiotemporal scales. Our investigation focused on a newly invaded landscape dominated by bottomland and upland forests.

Methods

We examined (1) core and total space use using an autocorrelated kernel density estimator; (2) resource selection patterns and hot spots of space use in relation to various landscape features using step-selection analysis; and (3) daily and hourly differences in movement patterns between non-hunting and hunting seasons using generalized additive mixed models.

Results

Estimates of total space use among wild pigs (n = 9) were smaller at calculated core (1.2 ± 0.3 km2) and 90% (5.2 ± 1.5 km2) isopleths than estimates reported in other landscapes in the southeastern United States, suggesting that wild pigs were able to meet foraging, cover, and thermoregulatory needs within smaller areas. Generally, wild pigs selected areas closer to herbaceous, woody wetlands, fields, and perennial streams, creating corridors of use along these features. However, selection strength varied among individuals, reinforcing the generalist, adaptive nature of wild pigs. Wild pigs also showed a tendency to increase movement from fall to winter, possibly paralleling increases in hard mast availability. During this time, there were also increases in anthropogenic pressures (e.g. hunting), causing movements to become less diurnal as pressure increased.

Conclusions

Our work demonstrates that movement patterns by exotic generalists must be understood across individuals, the breadth of landscapes they can invade, and multiple spatiotemporal scales. This improved understanding will better inform management strategies focused on curbing emerging invasions in novel landscapes, while also protecting native natural resources.
Exploring the provenance of a Byzantine excavated assemblage of textile and leather finds by the application of instrumental analysis
Authors: Margariti Christina , Sava Gabriela , Vanden Berghe Ina , Filiou Daphne
Published: April 2024

Stereomicroscopy, Scanning Electron Microscopy-Energy Dispersive Spectroscopy (SEM–EDS), Fourier Transform Infrared spectroscopy with Attenuated Total Reflectance probe (FTIR-ATR), High Performance Liquid Chromatography with a Photodiode Array system (HPLC–PDA), X-ray Fluorescence spectroscopy (XRF), Zooarchaeology by Mass Spectrometry (ZooMS), and 14C dating were applied to an assemblage of textile and leather fragments that belong to the collection of the Byzantine & Christian Museum of Athens in Greece and lacked inventory information.The analyses applied, along with bibliographical research, yielded information on the materials, techniques and provenance of the find. The assemblage of finds consists of a gold thread embroidered silk satin, dyed with shellfish-purple; a gold strip-drawn wire embroidered silk tabby; a gold strip-drawn wire and red silk thread tapestry; a gold-thread embroidery on a tabby background; fragments of braided cord; and leather fragments. The material components could have been produced locally, in the area of the Byzantine Empire, though some of them indicate connections with India and/or China. The assemblage, dated between the mid AD 10th and mid eleventh century, was probably found in 1924 by Andreas Xygopoulos during the excavation of a tomb inside the church of Agia Sophia in Thessaloniki, Greece.
Intraoperative parathyroid hormone measurement pitfalls: parathyroid hormone spikes with carboxyl-terminal parathyroid hormone fragments in primary hyperparathyroidism—a case report
Authors: Yamashita Hiroyuki , Shindo Hisakazu , Yoshimoto Kouichi , Mori Yusuke , Fukuda Takashi , Tachibana Seigo , Takahashi Hiroshi , Sato Shinya
Published: April 2024

Background

Intraoperative parathyroid hormone (IOPTH) monitoring is a critical surgical adjunct for determining the extent of surgery for primary hyperparathyroidism (PHPT), with reported false-positive and false-negative rates of up to 10%. Surgeons must understand the parathyroid hormone (PTH) dynamics and select the appropriate IOPTH protocol and interpretation criteria for curative surgery.

Case presentation

We present the case of a 64-year-old woman with a large cystic parathyroid tumor and PHPT who experienced a significant delay in IOPTH decrease but was cured without additional surgery. The patient’s basal intact PTH was 96.2 pg/mL, which decreased to 93.3 pg/mL at 25 min and 72.4 pg/mL at 55 min after removal of the parathyroid tumor. In an attempt to elucidate its pathophysiology, 1–84 PTH levels were measured in stored serum. These results can also be attributed to the relatively low basal PTH levels, intact PTH spike, and high ratio of large carboxyl-terminal PTH fragments present. The patient had normal intact PTH and calcium levels at the 9-month postoperative visit.

Conclusions

As detailed reports on these phenomena are scarce, we discuss the causes of false-negative IOPTH results in terms of PTH production, secretion, metabolism, and differences in measurement methods to avoid unnecessary surgery.
A decision-making framework for the funding of shipping decarbonization initiatives in non-EU countries: insights from Türkiye
Authors: Baştuğ Sedat , Akgül Ersin Fırat , Haralambides Hercules , Notteboom Theo
Published: April 2024

The decarbonization of the shipping industry is a critical imperative in the global fight against climate change. Non-EU countries, being significant contributors to shipping emissions, play a crucial role in shaping the industry's sustainable future. However, securing funding for shipping decarbonization initiatives in these countries presents challenges, such as limited access to capital, lack of financial initiatives, political and regulatory uncertainties, technological risks, lack of local expertise, and the effects of global economic volatility. Addressing these challenges demands innovative strategies. The paper explores ways of effectively allocating funds for decarbonization projects in the shipping industry of non-EU countries, Türkiye in particular, using a structured decision-making framework tailored to their specific needs and challenges. We adopt the Moment Integrated Solution Method (THEMIS) to identify the “best” option from the range of alternative strategies identified in the framework. Our findings show that the use of incentive mechanisms is the most prioritized funding alternative, followed by the implementation of a sound Cap-and-Trade system and the promotion of strict local regulations to combat emissions. These imply that the prioritization of funding mechanisms, market-driven approaches, and more stringent regulation are key drivers in maritime decarbonization efforts. The Türkiye case study on strategies to achieve a greener maritime industry in developing countries also shows that securing funding for decarbonization requires a concerted effort by governments, private entities, and international organizations.
(No) Hope for the future? A design agenda for rewidening and rewilding higher education with utopian imagination
Authors: Nørgård Rikke Toft , Holflod Kim
Published: April 2024

This article argues for exploring, connecting, and applying utopian imagination, speculative design, and planetary thinking as a way forward for higher education to reimagine and move towards more hopeful planetary futures. It examines hopepunk and solarpunk perspectives on possible futures to propose a design agenda for rewidening and rewilding higher education and educational technology with utopian imagination. Firstly, the article outlines and develops a framework for wider and wilder futures in higher education, emerging from utopian thinking and desire. Secondly, it connects hopepunk with speculative design and solarpunk with planetary design to highlight and put forward rebellious strategies of hope in envisioning more preferable futures. Thirdly, it approaches the field of educational technology within the context of wide and wild education to establish four planetary orientations concerning educational technology: Higher Education for, in, with, and by the world. Taken together, the article proposes a design agenda for educational technology that integrates utopian imagination and solarpunk practices with planetary educational technology to catalyse the development of more preferable futures in a more-than-human world.
Pneumonic-type lung adenocarcinoma with KRAS G12V mutation and sustained response to Afatinib
Authors: Zhao Jie , Xu Jiachen , Qiu Tian , Wang Jie , Wang Zhijie
Published: April 2024

Background

Pneumonic-type lung adenocarcinoma (P-ADC) is a rare and challenging subtype of primary lung cancer that can be difficult to distinguish from pneumonia based on radiological images. Furthermore, no drugs are currently available that specifically target KRAS G12V.

Case presentation

Here we report a case of P-ADC with typical and informative imaging features throughout the course of the disease, including patchy shadows, high-density lesions with aerated bronchus, diffuse ground-glass opacities, and nodular shadows from computed tomography (CT) scan. The KRAS G12V mutation was detected using Next-generation sequencing (NGS). An individualized Afatinib-based therapeutic schedule was prescribed and achieved sustained response after multiple lines of treatment had failed.

Conclusion

Our case highlights the typical and dynamic changes in imaging features of P-ADC and provides an indicative treatment strategy for KRAS G12V-mutated lung adenocarcinoma.
Disruption of sleep by one night of in-home polysomnographic recording: a longitudinal actigraphy study of patients with chronic musculoskeletal pain and pain-free controls
Authors: Abeler Karin , Bergvik Svein , Friborg Oddgeir
Published: April 2024

Background

Patients with chronic pain frequently have comorbid sleep disturbances. Since improvement of sleep may alleviate both sleep problems and to some extent pain, sleep studies in this group becomes relevant. Polysomnography (PSG) is considered the gold standard for characterizing sleep; however, it is resource-demanding and may itself disrupt sleep due to the use of inconvenient equipment in unfamiliar sleep environments. To circumvent disruptive first night effect that may occur, sleep protocols may prescribe several nights of PSG to facilitate adaptation despite the equipment may still influence sleep on all nights. Moreover, the disruptive effects of polysomnography may vary between patient groups and healthy persons, yet have not previously been studied in patients with chronic pain. The present study aimed to assess whether sleep disruption during one night of in-home PSG was more severe in patients with chronic musculoskeletal pain compared to pain-free controls.

Method

Sleep was assessed by self-reported sleep quality and actigraphy measured sleep onset latency, sleep duration, wake after sleep onset and sleep efficiency during one night of in-home PSG and the following six nights in 56 patients and 53 pain-free participants. Additionally, sleep schedule was assessed by sleep onset time, wake up time and time in bed. The repeated sleep measures were analysed with mixed model regressions, comparing mean score changes between and within groups.

Results

A disruptive effect of PSG was evident for self-reported sleep quality and actigraphy measured sleep onset latency in both groups. These effects were however not significantly different between the groups, indicating comparable sensitivity to a single night of PSG between pain patients and pain-free controls.

Conclusion

These findings suggest that a singlenight in-home PSG protocol may be considered for case–control studies of patients with chronic pain.
Genetic diversity assessment of Trichoderma spp. isolated from various Egyptian locations using its gene sequencing marker, rep-PCR, and their cellulolytic activity
Authors: El-Sobky Muhammad Alaaeldin , Eissa Ragaa Abedlaziz , Abdel-Lateif Khalid Salah , Fahmi Abdelmegid Ibrahim , El-Zanaty Abdelfattah Mondy , Hassan Mohamed Mahmoud , Elsharkawy Mohsen Mohamed
Published: April 2024

Background

The phylogenetic relationships and phylogeny of twenty-six Trichoderma species collected from various Egyptian locations were investigated. The genetic diversity among the examined isolates was tested using the rep-PCR marker. Trichoderma species were screened for their cellulase activities.

Results

Three isolates demonstrated highly significant FPase activities, namely MNF-MAS-Tricho 1, MNF-MAS-Tricho 2, and MNF-MAS-Tricho 3 (0.50, 0.39, and 0.49 IU ml−1, respectively). MNF-MAS-Tricho1 showed the highest significant CMCase activity (0.80 IU ml−1). Concerning β-glucosidase, MNF-MAS-Tricho 1 was the highest (0.78 IU ml−1), while MNF-MSH-Trich 11 and MNF-MAS-Tricho 15 were the lowest (0.36 IU mL−1). The percentage of polymorphism ranged from 46.15 to 83.33%. (GTG)5 marker produced the greatest number of polymorphic loci (13 loci out of 18 loci) with about 83.33% polymorphism, followed by rep-10 with 69.2% polymorphism. Furthermore, the polymorphism information content (PIC) estimates ranged between 0.285 for Rep-10 and 0.340 for (GTG) 5 with an average of 0.306. The tested primers exhibited high discriminating and resolving powers.

Conclusion

The findings of this investigation were used to classify Trichoderma species, evaluate their genetic variability using ITS sequencing, rep-PCR, and measure their cellulase activities. These markers can facilitate more rapid and less complicated studies of Trichoderma population dynamics and evaluate their establishment after release into agricultural environments. The results will help to evaluate the genetic diversity of Trichoderma in future research.
Enhancing precision in vascular embolization: evaluating the effectiveness of the intentional early detachment technique with detachable coils in complex cases
Authors: Oka Shojiro , Kohno Shigeshi , Arizono Shigeki , Onishi Yasuyuki , Fumimoto Masaya , Yoshida Atsushi , Ishikura Reiichi , Ando Kumiko
Published: April 2024

Background

This study aimed to assess the effectiveness and versatility of an intentional early detachment technique with detachable coils in addressing challenging vascular embolization scenarios. This novel approach aims to provide an alternative method for achieving precise coil placement when standard methods of detachable coil placement are ineffective owing to vascular anatomy or limited available equipment.

Materials and methods

This retrospective study included 11 patients (nine males and two females; median age, 77 years) who underwent embolization procedures between October 2021 and December 2023 using the intentional early detachment technique through 1.6-Fr or 1.3-Fr microcatheters. In this technique, detachable coils were intentionally detached within the microcatheter and placed through saline flushing. The technique’s technical success, complications, and clinical success were evaluated.

Results

The technique was applied in three distinct scenarios: tortuous vascular anatomy (four cases), inadequate system backup (three cases), and 1.3-Fr microcatheter use (four cases). The technical and clinical success rates were 100%. No complications were observed, and no cases of coil migration or malpositioning.

Conclusion

The intentional early detachment technique is valuable for interventional radiologists and offers a solution for challenging vascular embolization scenarios. Its application is limited to specific circumstances; however, it can significantly enhance coil placement in complex cases, thereby contributing to improved patient care.

Graphical Abstract
Two putative calcium-dependent protein kinases are involved in the regulation of sugarcane defense genes
Authors: Li Xiangguo , Zhong Jiajie , Li Baiyang , Luo Yingfeng , Wang Kailun , Wang Yu , Ye Ziqin , Sun Lifan , Zhang Jinghan , Yang Liu , Wang Lixiang , Zhang Jie
Published: April 2024

Sugarcane is a primary sugar crop and an important source of bioenergy. Pathogens are the major factors affecting sugarcane yield and sugar content. However, the mechanisms of sugarcane defense regulation remain largely unknown, and research on prospective genetic targets for modification is scarce. As the main class of calcium sensors, calcium-dependent protein kinases (CDPKs/CPKs) play a crucial role in the immune regulatory network. Using sugarcane genomic data, we identified 229 putative ScCDPKs in primordial specie Saccharum officinarum. Searching the putative CDPKs in sugarcane cultivars from National Center for Biotechnology Information (NCBI), 12 putative ScCDPKs in cultivars were identified. Phylogenetic analysis revealed evolutionary relationships among these CDPKs in sugarcane cultivars and those in S. officinarum, Arabidopsis thaliana, and rice. Truncation mutants of ScCDPKs were introduced into the reporter system and examined for activity in inducing Sugarcane Pathogenesis Related Protein 1 (ScPR1). The results showed that truncated ScCDPK1 and ScCDPK8 induce higher expression of ScPR1 than full-length ScCDPK1 and ScCDPK8. Additionally, transient expression of truncated ScCDPK1 and ScCDPK8 exhibit stronger activity in sugarcane protoplasts for activation of ScPR1 and sugarcane Serine Protease Inhibitor (ScSPI). These results demonstrate that ScCDPK1 and ScCDPK8 possess auto-inhibitory activity. The findings of this study provide a basis for an in-depth study of the sugarcane CDPK gene family and lay the foundation for further genetic improvement.
Asymmetric gap balancing improves knee kinematic following primary total knee arthroplasty
Authors: Valpiana Pieralberto , Salvi Andrea Giordano , Ghirardelli Stefano , Bernardi Matteo , Petralia Giuseppe , Aloisi Giuseppe , Schaller Christian , Indelli Pier Francesco
Published: April 2024

Purpose

The purpose of this study was to demonstrate closer-to-normal knee kinematics following primary total knee arthroplasty (TKA) performed establishing asymmetric gap balancing intraoperatively.

Material and method

Two age-, sex-, BMI-matched groups of patients underwent medially stabilized TKA because of isolated knee disease. Group A (12 patients) underwent “unrestricted” kinematic alignment (uKA) according to Howell while group B (15 patients) received robot-assisted “simplified” KA (sKA) with an alignment goal (Hip-Knee-Ankle axis-HKA) ± 5° respect to the mechanical axis. Intraoperatively, in group B, the flexion gap at 90° was first set at an average of 1.5 mm (0–5 mm; SD 4.4 mm) tighter in the medial compartment with respect to the lateral; in the same way, the extension gap was then set at an average of 2.0 mm (0–4.5 mm; SD 3.1 mm) tighter in the medial compartment with respect to the lateral. All patients, including a non-arthritic cohort (group C: 5 controls) underwent gait analysis using an instrumented treadmill (WalkerView–WV) equipped with an instrumented belt armed with a 3D video camera. The WV software evaluated multiple spatiotemporal and kinematic parameters, including: (1) contact time (s); (2) knee ROM during gait cycle; (3) step length percentage with respect to total gait (%) and pure step length (cm). Statistical analyses included t-Test and ANOVA and were conducted by using SPSS.

Results

At the final FU, significant differences were noted during gait between the two TKA groups (uKA-sKA) and the controls. Both TKA groups showed superior mean contact time on the surgical knee (uKA 1 s; sKA 0.97 s) as compared to the controls (0.72 s) (P = 0.002) while no differences were found between them (P = 0.11). TKA groups showed a lower, maximum ROM in the surgical knee (mean uKA 36º; mean sKA 49º) relative to the controls (mean 57º) (P < 0.05) but a statistical difference was found between them (P = 0.003). Both TKA groups showed a higher step length percentage with respect to the total gait and a shorter step length on the surgical side (uKA: mean 8.28% and mean step length 35.5 cm; sKA: mean 8.38% and mean step length 34.6 cm) in comparison to the controls (mean 3.38%; mean step length 71.4 cm) (P < 0.05) while no statistical differences were found between them.

Conclusion

To our knowledge, this was the first study to exhibit the kinematic advantages of a slightly asymmetric gap balancing during KA TKA. Combining a medially-stabilized implant design and a surgical technique aiming to obtain a tighter medial compartment represents a promising approach to improve outcomes after TKA.

Graphical Abstract
Imaging in lingual abscess: a case report
Authors: Campos Oscar , Aris Ricardo , Santorcuato Francisca , Whittle Carolina , Figueroa Liberto , Pedregal Pedro
Published: April 2024

Background

Lingual abscess corresponds to an infection that manifests itself as a painful swelling in the tongue with purulent material inside. This is a rare entity and the information available in the literature is limited and based on clinical case reports. Therefore, the diagnosis, etiology, clinical manifestations, and treatment are not fully defined.

Case presentation

The aim of this work was to describe the imaging of a case of lingual abscess, focusing on imaging evaluation using ultrasound and computed tomography (CT), and comparing the diagnostic utility of both modalities in smaller lingual abscesses. This case was treated with antibiotics and adequate drainage was performed, with good evolution.

Conclusions

Tongue abscess is a rare pathology due to the various mechanisms that the tongue has to avoid infections; however, it is a diagnosis that we must consider. CT may be sufficient to diagnose it on imaging, but in smaller lesions, ultrasound with a high-frequency transducer provides more information.
Optimizing a transformer-based network for a deep-learning seismic processing workflow
Authors: Harsuko Randy , Alkhalifah Tariq
Published: April 2024

StorSeismic is a recently introduced model based on the transformer network to adapt to various seismic processing tasks through its pretraining and fine-tuning strategy. In the original implementation, StorSeismic uses a sinusoidal positional encoding (PE) and a conventional self-attention mechanism, borrowed from natural language processing applications. For seismic processing, they provide good results but also indicate limitations in efficiency and expressiveness. We develop modifications to these two key components, by using relative PE and low-rank attention matrices as replacements for the standard ones. Our changes are tested on processing tasks applied to realistic Marmousi and offshore field data as a sequential strategy, starting from denoising, direct-arrival removal, multiple attenuation, and finally root-mean-squared velocity ([Formula: see text]) prediction for normal moveout correction. We observe faster pretraining and competitive results on the fine-tuning tasks and, in addition, fewer parameters to train compared with the standard model.
Global, regional and national burdens of depression in adolescents and young adults aged 10–24 years, from 1990 to 2019: findings from the 2019 Global Burden of Disease study
Authors: Yang Cheng-hao , Lv Jia-jie , Kong Xiang-meng , Chu Feng , Li Zhi-bin , Lu Wei , Li Xin-yu
Published: April 2024

Background

Depression is a significant mental health concern affecting the overall well-being of adolescents and young adults. Recently, the prevalence of depression has increased among young people. Nonetheless, there is little research delving into the longitudinal epidemiology of adolescent depression over time.

Aims

To investigate the longitudinal epidemiology of depression among adolescents and young adults aged 10–24 years.

Method

Our research focused on young people (aged 10–24 years) with depression, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019. We explored the age-standardised prevalence, incidence and disability-adjusted life-years (DALYs) of depression in different groups, including various regions, ages, genders and sociodemographic indices, from 1990 to 2019.

Results

The prevalence, incidence and DALYs of depression in young people increased globally between 1990 and 2019. Regionally, higher-income regions like High-Income North America and Australasia recorded rising age-standardised prevalence and incidence rates, whereas low- or middle-income regions mostly saw reductions. Nationally, countries such as Greenland, the USA and Palestine reported the highest age-standardised prevalence and incidence rates in 2019, whereas Qatar witnessed the largest growth over time. The burden disproportionately affected females across age groups and world regions. The most prominent age effect on incidence and prevalence rates was in those aged 20–24 years. The depression burden showed an unfavourable trend in younger cohorts born after 1980, with females reporting a higher cohort risk than males.

Conclusions

Between 1990 and 2019, the general pattern of depression among adolescents varied according to age, gender, time period and generational cohort, across regions and nations.
Melanocortin-1 Receptor Expression as a Marker of Progression in Melanoma
Authors: Su David G. , Djureinovic Dijana , Schoenfeld David , Marquez-Nostra Bernadette , Olino Kelly , Jilaveanu Lucia , Kluger Harriet
Published: April 2024

PURPOSE

Melanocortin-1 receptor (MC1R) plays a critical role in human pigmentation and DNA repair mechanisms. MC1R-targeting agents are being investigated in clinical trials in patients with melanoma, yet large studies investigating the rate and degree of MC1R expression in primary and metastatic human melanoma tissue are lacking.

METHODS

Using tissue microarrays containing three large cohorts of 225 cases of benign nevi, 189 with primary melanoma, and 271 with metastatic melanoma, we applied quantitative immunofluorescence and immunohistochemistry to comprehensively study MC1R protein expression.

RESULTS

We show a stepwise elevation of MC1R expression in different stages of melanoma progression (nevi, primary, metastasis). Higher MC1R expression was seen in deeper (>1 mm) primary lesions and ulcerated lesions and was associated with shorter survival in primary and metastatic tumors. On multivariable analysis, Breslow thickness, male sex, and chronic sun exposure were independent predictors of worse overall survival in the primary melanoma cohort.

CONCLUSION

Our data suggest that MC1R might be a valuable drug target in aggressive melanoma. Additional studies are warranted to determine its functional significance in melanoma progression and its utility as a predictive biomarker in patients receiving MC1R-directed therapies.
Recurrent Falls Due to Hypoglycemia: Case of an IGF-2-producing Fibrous Tumor of the Pleura
Authors: Guijt Mathijs Cornelis , Heineman David J , Jonker Jacqueline Thérèse
Published: April 2024

This case report delineates the clinical presentation of a 77-year-old male who experienced falls and sustained a humerus fracture attributed to hypoglycemia. Despite the absence of insulin use and normal laboratory results for cortisol, TSH, blood count, and liver and kidney function, a fasting test revealed diminished C-peptide and insulin levels, ruling out insulinoma, exogenous insulin use, or β-cell hyperplasia. Subsequent laboratory investigations demonstrated lowered IGF-1 and elevated IGF-2 levels, indicative of an IGF-2-producing tumor as the etiology of the hypoglycemia. A positron emission tomography computed tomography scan identified a right-sided thoracic cavity tumor, prompting an open resection. Postoperatively, hypoglycemic episodes abated within 2 days, and pathology confirmed a 14.9-cm solitary fibrous tumor. Nonislet cell tumor hypoglycemia (NICTH), also known as Doege Potter syndrome, arises from aberrant production of IGF-2 or its precursors. Elevated IGF-2 levels induce hypoglycemia through heightened glucose uptake on binding to insulin receptors. The literature supports the efficacy of both surgical intervention and corticosteroids in managing NICTH. This case underscores the importance of considering NICTH as a rare etiology in unexplained hypoglycemia cases, advocating for the utility of fasting tests in diagnosis, and suggesting surgical resection as a viable treatment option when radical excision is feasible.