bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of deep learning for automated diagnosis and classification of hip dysplasia on plain radiographs
Authors: Magnéli Martin , Borjali Alireza , Takahashi Eiji , Axenhus Michael , Malchau Henrik , Moratoglu Orhun K. , Varadarajan Kartik M.
Published: February 2024

Background

Hip dysplasia is a condition where the acetabulum is too shallow to support the femoral head and is commonly considered a risk factor for hip osteoarthritis. The objective of this study was to develop a deep learning model to diagnose hip dysplasia from plain radiographs and classify dysplastic hips based on their severity.

Methods

We collected pelvic radiographs of 571 patients from two single-center cohorts and one multicenter cohort. The radiographs were split in half to create hip radiographs (n = 1022). One orthopaedic surgeon and one resident assessed the radiographs for hip dysplasia on either side. We used the center edge (CE) angle as the primary diagnostic criteria. Hips with a CE angle < 20°, 20° to 25°, and > 25° were labeled as dysplastic, borderline, and normal, respectively. The dysplastic hips were also classified with both Crowe and Hartofilakidis classification of dysplasia. The dataset was divided into train, validation, and test subsets using 80:10:10 split-ratio that were used to train two deep learning models to classify images into normal, borderline and (1) Crowe grade 1–4 or (2) Hartofilakidis grade 1–3. A pre-trained on Imagenet VGG16 convolutional neural network (CNN) was utilized by performing layer-wise fine-turning.

Results

Both models struggled with distinguishing between normal and borderline hips. However, achieved high accuracy (Model 1: 92.2% and Model 2: 83.3%) in distinguishing between normal/borderline vs. dysplastic hips. The overall accuracy of Model 1 was 68% and for Model 2 73.5%. Most misclassifications for the Crowe and Hartofilakidis classifications were +/- 1 class from the correct class.

Conclusions

This pilot study shows promising results that a deep learning model distinguish between normal and dysplastic hips with high accuracy. Future research and external validation are warranted regarding the ability of deep learning models to perform complex tasks such as identifying and classifying disorders using plain radiographs.

Level of Evidence

Diagnostic level IV
Evaluation of caffeic acid mucoadhesive tablets on minor recurrent aphthous stomatitis: a randomized, double-blind, placebo-controlled clinical trial
Authors: Salehi Maedeh , Saeedi Majid , Negarandeh Reza , Savabi Azin , Lotfizadeh Anahita , Hosseinnataj Abolfazl , Molania Tahereh
Published: February 2024

Background

Oral aphthous stomatitis is a chronic inflammatory condition. Numerous medications have been investigated to treat the symptoms of the disease. However, these days patients prefer herbal medicines due to lower side effects. Considering the anti-inflammatory, analgesic, and anti-oxidant properties of Caffeic acid and its few side effects, the aim of this study was to assess the impact of Caffeic acid on recurrent aphthous stomatitis (RAS). investigating the effect of caffeic acid mucoadhesive tablets on the size and pain intensity of the aphthous lesions.

Methods

in this double-blinded clinical trial study, 47 patients who met the inclusion criteria were selected by convenient sampling method. The patients were assigned to two groups randomly; the control group (placebo recipients) and the intervention group (Caffeic acid recipients). Patients were followed up for 7 days following the intervention. The diameter of the inflammatory lesion was measured in millimeters, and the pain intensity was recorded based on the VAS scale (Visual Analogue Scale). This trial was approved by the medical ethics committee of Mazandaran University of Medical Sciences (Ethical code: IR.MAZUMS.REC.1401.261) and received IRCT code of IRCT20220815055700N1on 03/09/2022.

Results

the diameter of the lesion in both groups decreased over time, and there was no significant difference between the intervention and control groups, except on the fifth day when the diameter of the lesion was significantly greater in the control group (P = 0.012). From the second day, the control group’s average pain intensity was significantly higher than the intervention group’s pain intensity (P < 0.05).

Conclusions

when comparing mucoadhesive tablets containing Caffeic acid and placebo, the findings demonstrated that Caffeic acid has a significant efficacy in reducing aphthous lesions’ diameter and pain intensity of the patients and are suggested for palliative oral aphthous lesions treatment since they showed significant anti-inflammatory and analgesic effects on recurrent aphthous stomatitis.
Effect of public health expenditure on maternal mortality ratio in the West African Economic and Monetary Union
Authors: Boundioa Jacques , Thiombiano Noël
Published: February 2024

Introduction

Maternal mortality in West African Economic and Monetary Union countries (WAEMU) is the highest compared with other regions in the world. The majority of health care sources in WAEMU are private and largely involve out-of-pocket expenditures, which may prevent healthcare access. Maternal mortality is an important indicator of the level of attention given to mothers before, during and after childbirth and thus of a system’s overall coherence and capacity for anticipation. Therefore, the objective of this study is to analyze the effects of public health expenditure on maternal mortality in WAEMU.

Methods

The study used panel data from the World Bank Development Indicators (WDI) from 1996 to 2018 covering 7 countries in the West African Economic and Monetary Union. The two-step least squares (2SLS) on health demand function was used to test the effect of public health expenditure on maternal mortality.

Results

Public health care spending showed a significant negative association with maternal mortality. However, private health expenditure was positively associated with maternal mortality.

Conclusion

Public health care expenditure remains a crucial component of reducing maternal mortality. In this region, the authorities need to increase public health spending to build more health centers and improve the equipment of existing infrastructures. Additionally, it is important to reduce the financial barriers for pregnant women. To this end, the operationalization of universal health insurance could help reduce these financial barriers by reducing direct household payments.
Views of healthcare professionals on complementary and alternative medicine use by patients with diabetes: a qualitative study
Authors: Alzahrani Abdulaziz S. , Greenfield Sheila M. , Shrestha Sunil , Paudyal Vibhu
Published: February 2024

Background

Recent estimates indicate that a significant proportion of diabetic patients globally, up to 51%, are utilizing complementary and alternative medicine (CAM). To improve patient-provider communication and optimize prescribed treatments, healthcare professionals (HCPs) must understand the factors associated with CAM use among diabetic patients. There is a dearth of literature on HCPs perspectives on CAM use by diabetic patients. This study explored HCPs knowledge, perspective, and views on their diabetic patients’ use of CAM.

Methods

Qualitative study using one-to-one semi-structured interviews conducted with 22 HCPs involved in the care of diabetic patients (6 endocrinologists, 4 general practitioners, 4 nurses and 8 pharmacists). Participants were recruited through general practices, community pharmacies and a diabetic centre in Saudi Arabia. Data were analyzed using thematic analysis.

Results

Five key themes resulted from the analysis. HCPs generally demonstrated negative perceptions toward CAM, particularly regarding their evidence-based effectiveness and safety. Participants described having limited interactions with diabetic patients regarding CAM use due to HCPs’ lack of knowledge about CAM, limited consultation time and strict consultation protocols. Participants perceived convenience as the reason why patients use CAM. They believed many users lacked patience with prescribed medications to deliver favourable clinical outcomes and resorted to CAM use.

Conclusions

HCPs have noted inadequate engagement with diabetic patients regarding CAM due to a lack of knowledge and resources. To ensure the safe use of CAM in diabetes and optimize prescribed treatment outcomes, one must address the communication gap by implementing a flexible consultation protocol and duration. Additionally, culturally sensitive, and evidence-based information should be available to HCPs and diabetic patients.
Relationship between stress hyperglycaemic ratio and incidence of in-hospital cardiac arrest in patients with acute coronary syndrome: a retrospective cohort study
Authors: Li Kui , Yang Xueyuan , Li Yunhang , Xu Guanxue , Ma Yi
Published: February 2024

Background

The stress hyperglycaemic ratio (SHR), a new marker that reflects the true hyperglycaemic state of patients with acute coronary syndrome (ACS), is strongly associated with adverse clinical outcomes in these patients. Studies on the relationship between the SHR and in-hospital cardiac arrest (IHCA) incidence are limited. This study elucidated the relationship between the SHR and incidence of IHCA in patients with ACS.

Methods

In total, 1,939 patients with ACS who underwent percutaneous coronary intervention (PCI) at the Affiliated Hospital of Zunyi Medical University were included. They were divided into three groups according to the SHR: group T1 (SHR ≤ 0.838, N = 646), group T2 (0.838< SHR ≤ 1.140, N = 646), and group T3 (SHR3 > 1.140, N = 647). The primary endpoint was IHCA incidence.

Results

The overall IHCA incidence was 4.1% (N = 80). After adjusting for covariates, SHR was significantly associated with IHCA incidence in patients with ACS who underwent PCI (odds ratio [OR] =  2.6800; 95% confidence interval [CI] =  1.6200–4.4300; p<0.001), and compared with the T1 group, the T3 group had an increased IHCA risk (OR =  2.1800; 95% CI =  1.2100–3.9300; p =  0.0090). In subgroup analyses, after adjusting for covariates, patients with ST-segment elevation myocardial infarction (STEMI) (OR =  3.0700; 95% CI =  1.4100–6.6600; p =  0.0050) and non-STEMI (NSTEMI) (OR =  2.9900; 95% CI =  1.1000–8.1100; p =  0.0310) were at an increased IHCA risk. After adjusting for covariates, IHCA risk was higher in patients with diabetes mellitus (DM) (OR =  2.5900; 95% CI =  1.4200–4.7300; p =  0.0020) and those without DM (non-DM) (OR =  3.3000; 95% CI =  1.2700–8.5800; p =  0.0140); patients with DM in the T3 group had an increased IHCA risk compared with those in the T1 group (OR =  2.4200; 95% CI =  1.0800–5.4300; p =  0.0320). The restriction cubic spline (RCS) analyses revealed a dose-response relationship between IHCA incidence and SHR, with an increased IHCA risk when SHR was higher than 1.773. Adding SHR to the baseline risk model improved the predictive value of IHCA in patients with ACS treated with PCI (net reclassification improvement [NRI]: 0.0734 [0.0058–0.1409], p =  0.0332; integrated discrimination improvement [IDI]: 0.0218 [0.0063–0.0374], p =  0.0060).

Conclusions

In patients with ACS treated with PCI, the SHR was significantly associated with the incidence of IHCA. The SHR may be a useful predictor of the incidence of IHCA in patients with ACS. The addition of the SHR to the baseline risk model had an incremental effect on the predictive value of IHCA in patients with ACS treated with PCI.
Simultaneous assessment of stress hyperglycemia ratio and glycemic variability to predict mortality in patients with coronary artery disease: a retrospective cohort study from the MIMIC-IV database
Authors: He Hao-ming , Zheng Shu-wen , Xie Ying-ying , Wang Zhe , Jiao Si-qi , Yang Fu-rong , Li Xue-xi , Li Jie , Sun Yi-hong
Published: February 2024

Background

Stress hyperglycemia and glycemic variability (GV) can reflect dramatic increases and acute fluctuations in blood glucose, which are associated with adverse cardiovascular events. This study aimed to explore whether the combined assessment of the stress hyperglycemia ratio (SHR) and GV provides additional information for prognostic prediction in patients with coronary artery disease (CAD) hospitalized in the intensive care unit (ICU).

Methods

Patients diagnosed with CAD from the Medical Information Mart for Intensive Care-IV database (version 2.2) between 2008 and 2019 were retrospectively included in the analysis. The primary endpoint was 1-year mortality, and the secondary endpoint was in-hospital mortality. Levels of SHR and GV were stratified into tertiles, with the highest tertile classified as high and the lower two tertiles classified as low. The associations of SHR, GV, and their combination with mortality were determined by logistic and Cox regression analyses.

Results

A total of 2789 patients were included, with a mean age of 69.6 years, and 30.1% were female. Overall, 138 (4.9%) patients died in the hospital, and 404 (14.5%) patients died at 1 year. The combination of SHR and GV was superior to SHR (in-hospital mortality: 0.710 vs. 0.689, p = 0.012; 1-year mortality: 0.644 vs. 0.615, p = 0.007) and GV (in-hospital mortality: 0.710 vs. 0.632, p = 0.004; 1-year mortality: 0.644 vs. 0.603, p < 0.001) alone for predicting mortality in the receiver operating characteristic analysis. In addition, nondiabetic patients with high SHR levels and high GV were associated with the greatest risk of both in-hospital mortality (odds ratio [OR] = 10.831, 95% confidence interval [CI] 4.494–26.105) and 1-year mortality (hazard ratio [HR] = 5.830, 95% CI 3.175–10.702). However, in the diabetic population, the highest risk of in-hospital mortality (OR = 4.221, 95% CI 1.542–11.558) and 1-year mortality (HR = 2.013, 95% CI 1.224–3.311) was observed in patients with high SHR levels but low GV.

Conclusions

The simultaneous evaluation of SHR and GV provides more information for risk stratification and prognostic prediction than SHR and GV alone, contributing to developing individualized strategies for glucose management in patients with CAD admitted to the ICU.
Novel lncRNAs LINC01221, RP11-472G21.2 and CRNDE are markers of differential expression in pediatric patients with T cell acute lymphoblastic leukemia
Authors: Sharma Pankaj , kaur Parminder , Bhatia Prateek , Trehan Amita , Sreedharanunni Sreejesh , Singh Minu
Published: February 2024

Introduction

Pediatric T-cell acute lymphoblastic leukemia (T-ALL) poses significant challenges due to its aggressive nature and resistance to standard treatments. Long non-coding RNAs (lncRNAs) have emerged as potential biomarkers and therapeutic targets in leukemia. This study aims to characterize the lncRNA landscape in pediatric T-ALL, identify specific lncRNAs signatures, and assess their clinical relevance.

Methods

RNA sequencing was performed on T-ALL patient and control samples. Differential expression analysis identified dysregulated lncRNAs and mRNAs. Functional enrichment analysis revealed potential roles of these lncRNAs in cancer pathogenesis. Validation of candidate lncRNAs was conducted using real-time PCR. Clinical correlations were assessed, including associations with patients’ clinical characteristics and survival outcomes.

Results

Analysis identified 674 dysregulated lncRNAs in pediatric T-ALL, with LINC01221 and CRNDE showing the most interactions in cancer progression pathways. Functional enrichment indicated involvement in apoptosis, survival, proliferation, and metastasis. Top 10 lncRNAs based on adjusted p value < 0.05 and Fold Change > 2 were selected for validation. Seven lncRNAs LINC01221, PCAT18, LINC00977, RP11-620J15.3, RP11-472G21.2, CTD-2291D10.4, and CRNDE showed correlation with RNA sequencing data. RP11-472G21.2 and CTD-2291D10.4 were highly expressed in T-ALL patients, with RP11-620J15.3 correlating significantly with better overall survival (p = 0.0007) at a median follow up of 32 months. The identified lncRNAs were further analysed in B-ALL patients. Distinct lncRNAs signatures were noted, distinguishing T-ALL from B-ALL and healthy controls, with lineage-specific overexpression of LINC01221 (p < 0.0001), RP11-472G21.2 (p < 0.001) and CRNDE (p = 0.04) in T-ALL.

Conclusion

This study provides insights into the lncRNA landscape of pediatric T-ALL, offering potential diagnostic and prognostic markers. RP11-620J15.3 emerges as a promising prognostic marker, and distinct lncRNAs signatures may aid in the differentiation of T-ALL subtypes. Further research with larger cohorts is warranted to validate these findings and advance personalized treatment strategies for pediatric T-ALL patients.
PHF6 loss reduces leukemia stem cell activity in an acute myeloid leukemia mouse model
Authors: Yuan Shengnan , Gao Mingming , Wang Yizhou , Lan Yanjie , Li Mengrou , Du Yuwei , Li Yue , Ju Wen , Huang Yujin , Yuan Ke , Zeng Lingyu
Published: February 2024

Acute myeloid leukemia (AML) is a malignant hematologic disease caused by gene mutations and genomic rearrangements in hematologic progenitors. The PHF6 (PHD finger protein 6) gene is highly conserved and located on the X chromosome in humans and mice. We found that PHF6 was highly expressed in AML cells with MLL rearrangement and was related to the shortened survival time of AML patients. In our study, we knocked out the Phf6 gene at different disease stages in the AML mice model. Moreover, we knocked down PHF6 by shRNA in two AML cell lines and examined the cell growth, apoptosis, and cell cycle. We found that PHF6 deletion significantly inhibited the proliferation of leukemic cells and prolonged the survival time of AML mice. Interestingly, the deletion of PHF6 at a later stage of the disease displayed a better anti-leukemia effect. The expressions of genes related to cell differentiation were increased, while genes that inhibit cell differentiation were decreased with PHF6 knockout. It is very important to analyze the maintenance role of PHF6 in AML, which is different from its tumor-suppressing function in T-cell acute lymphoblastic leukemia (T-ALL). Our study showed that inhibiting PHF6 expression may be a potential therapeutic strategy targeting AML patients.
The chief culprit of intractable hypoxemia: a case report of rare pulmonary arteriovenous fistula complicated with giant hemangioma
Authors: Wu Zhangmin , Zeng Chunyu , Wang Hongyong , Shi Weibin , Luo Xiaoli
Published: February 2024

Background

Pulmonary arteriovenous fistula (PAVF) is a rare disease, which can lead to the direct return of unoxidized venous blood to pulmonary veins and left heart, resulting in right-to-left shunt leading to hypoxia. Long term, the right-to-left shunt will cause severe pathophysiological changes in the patient’s body and pulmonary circulation, and the prognosis will be poor if PAVF is not treated timely.

Case presentation

Here, we report the case of a 71-year-old man who presented with chest tightness and shortness of breath. After a series of examinations, PAVF and giant hemangioma were diagnosed, which are difficult to operate.Transcatheter interventional therapy was initiated. The patient recovered on the third day after operation and was discharged smoothly. During the long-term follow-up of nearly 4 years after discharge, the general condition and quality of life of the patient basically returned to normal.

Conclusions

PAVF is rare but very important clinical problem. When the clinical manifestations of persistent unexplained hypoxia appear, it is necessary to fully consider the possibility of PAVF. Once the diagnosis of PAVF is clear, timely treatment is recommended to avoid deterioration of the disease and affecting the prognosis.
Aortic elastic fiber degeneration during acute type a aortic dissection and reverse aortic remodeling
Authors: Chen Trina , Kholova Ivana , Paavonen Timo , Mennander Ari
Published: February 2024

Background

Progression of proximal or distal aortic dilatation is defined as reverse aortic remodeling after surgery for acute type A aortic dissection (ATAAD) that may be dependent on aortic wall degeneration.

Methods

We investigated whether aortic wall degeneration is associated with reverse aortic remodeling leading to aortic reoperation after surgery for ATAAD. Altogether, 141 consecutive patients undergoing surgery for ATAAD at Tampere were evaluated. The resected ascending aortic wall at surgery was processed for 42 degenerative, atherosclerotic and inflammatory histological variables. Patients undergoing aortic reoperations (Redos) were compared with those without aortic reoperations (Controls) during a mean 4.9-year follow-up.

Results

Redos were younger than Controls (56 and 66 years, respectively, P < 0.001), and had less frequently previous cardiac surgery prior to ATAAD. Initial surgery encompassed replacement of the ascending aorta in the majority. There were 21 Redos in which one patient died during follow-up as compared with 51 deaths in Controls (log Rank P = 0.002). Histology of the aortic wall revealed increased elastic fiber fragmentation, loss, and disorganization in Redos as compared with Controls (2.1 ± 0.5 vs. 1.9 ± 0.5, Point score unit (PSU), P = 0.043 and 1.7 ± 0.8 vs. 1.2 ± 0.8, PSU, P = 0.016, respectively). Moderate atherosclerosis occurred less often in Redos vs. Controls (9.5% vs. 33%, PSU, P = 0.037, respectively).

Conclusions

According to this exploratory study, histopathology reveals distinctive aortic wall degeneration during ATAAD. Reverse aortic remodeling after ATAAD is associated with the presence of ascending aortic wall elastic fiber fragmentation, loss and disorganization during ATAAD.
Development and validation of parent-reported gastrointestinal health scale in MECP2 duplication syndrome
Authors: Pehlivan Davut , Aras Sukru , Glaze Daniel G. , Ak Muharrem , Suter Bernhard , Motil Kathleen J.
Published: February 2024

Background/aims

We aimed to develop a validated patient-reported Gastrointestinal Health Scale (GHS) specific to MECP2 Duplication Syndrome (MDS) to be used in clinical trials.

Methods

MDS parents completed a Gastrointestinal Health Questionnaire (GHQ) to investigate the most relevant and important items associated with gastrointestinal problems in MECP2-related disorders. Item reduction was executed according to EORTC guidelines. We performed reliability and validity studies for the finalized scale.

Results

A total of 106 surveys were eligible for item reduction and validation processes. The initial 55 items were reduced to 38 items based on parent responses, expert opinion, and initial confirmatory factor analysis (CFA). The final MDS-specific GHS included 38 items and 7 factors that underwent further reliability and validity assessments. The power of the study was at least 0.982. The Cronbach’s alphas of the instruments were General Health: 0.799, Eating-Chewing-Swallowing: 0.809, Reflux: 0.794, Motility: 0.762, Mood: 0.906, Medication: 0.595, Parenting: 0.942 and all items together: 0.928. The correlation coefficient between total and individual item scores ranged from 0.215 to 0.730. Because of the ordinal nature of the variables, the diagonal weighted least squares estimation (DWLS) method was used to execute the CFA and Structural Equation Modeling. The GHS had excellent model fit with the acceptable range of fit indices values.

Conclusions

We developed a parent-reported, reliable, and valid MDS-specific GHS. This scale can be utilized in clinical settings or as an outcome measure in translational and clinical research.
Traumatic events and posttraumatic stress symptoms in a treatment-seeking sample of Ukrainian children during the war
Authors: Pfeiffer Elisa , Garbade Maike , Sachser Cedric
Published: February 2024

Background

The Russian invasion of Ukraine resulted in a dramatic increase of children and adolescents being confronted with war and other traumatic experiences, which could result in an increase of trauma-related mental health disorders such as posttraumatic stress disorder (PTSD) in an entire generation. This study aims at reporting the prevalence of traumatic events, PTSD, and Complex PTSD (CPTSD) in children and adolescents seeking for mental health treatment since the Russian invasion. Additionally, the consistency of child and caregiver reported trauma, PTSD and CPTSD will be examined.

Methods

This study is part of the “TF-CBT Ukraine” project in which Ukrainian therapists were trained in assessing their patients via the “Child and Adolescent Trauma Screen” (CATS-2) before initiating trauma-focused treatment, if indicated. Altogether N = 200 Ukrainian children and adolescents (Mage = 12.01, range 4–21; 62.0% female) were included in the study between October 2022 and August 2023. Data were analysed descriptively, via t-tests and bivariate correlations.

Results

The children and adolescents reported on average four different traumatic events, most frequently war (n = 123; 68.7%), bullying threats (n = 71; 39.7%) and domestic violence (n = 68; 38.0%). Almost 70% (n = 123) of the participants fulfilled the DSM-5 PTSD criteria, 31% (n = 56) fulfilled the ICD-11 PTSD criteria and 21% (n = 38) the ICD-11 CPTSD criteria. Rates of PTSD were even higher in preschool children (95%). The comparisons of self-and caregiver reports on traumatic events and PTSD/CPTSD severity scores indicated moderate to high correlations between the patients and their caregivers (r = 0.710–0.767).

Conclusions

This study shows that Ukrainian children and adolescents starting treatment report a high number of traumatic events and trauma-related symptoms, which could have a long-lasting negative impact on their social-emotional development and quality of life. The implementation of evidence-based trauma-focused interventions for these children is therefore crucial.
Evaluation of an automated matching system of children and families to virtual mental health resources during COVID-19
Authors: Lo Ronda F , Schumacher Anett , LaForge-Mackenzie Kaitlyn , Cost Katherine Tombeau , Crosbie Jennifer , Charach Alice , Anagnostou Evdokia , Birken Catherine S. , Monga Suneeta , Korczak Daphne J.
Published: February 2024

Background

Children and their families often face obstacles in accessing mental health (MH) services. The purpose of this study was to develop and pilot test an electronic matching process to match children with virtual MH resources and increase access to treatment for children and their families during COVID-19.

Methods

Within a large observational child cohort, a random sample of 292 families with children ages 6–12 years were invited to participate. Latent profile analysis indicated five MH profiles using parent-reported symptom scores from validated depression, anxiety, hyperactivity, and inattention measures: (1) Average Symptoms, (2) Low Symptoms, (3) High Symptoms, (4) Internalizing, and (5) Externalizing. Children were matched with virtual MH resources according to their profile; parents received surveys at Time 1 (matching process explanation), Time 2 (match delivery) and Time 3 (resource uptake). Data on demographics, parent MH history, and process interest were collected.

Results

128/292 families (44%) completed surveys at Time 1, 80/128 families (63%) at Time 2, and a final 67/80 families (84%) at Time 3, yielding an overall uptake of 67/292 (23%). Families of European-descent and those with children assigned to the Low Symptoms profile were most likely to express interest in the process. No other factors were associated with continued interest or uptake of the electronic matching process. Most participating parents were satisfied with the process.

Conclusions

The electronic matching process delivered virtual MH resources to families in a time-efficient manner. Further research examining the effectiveness of electronically matched resources in improving children’s MH symptoms is needed.
Loss of Calponin 2 causes premature ovarian insufficiency in mice
Authors: Hsieh Tzu-Bou , Jin Jian-Ping
Published: February 2024

Background

Premature ovarian insufficiency (POI) is a condition defined as women developing menopause before 40 years old. These patients display low ovarian reserve at young age and difficulties to conceive even with assisted reproductive technology. The pathogenesis of ovarian insufficiency is not fully understood. Genetic factors may underlie most of the cases. Actin cytoskeleton plays a pivotal role in ovarian folliculogenesis. Calponin 2 encoded by the Cnn2 gene is an actin associated protein that regulates motility and mechanical signaling related cellular functions.

Results

The present study compared breeding of age-matched calponin 2 knockout (Cnn2-KO) and wild type (WT) mice and found that Cnn2-KO mothers had significantly smaller litter sizes. Ovaries from 4 weeks old Cnn2-KO mice showed significantly lower numbers of total ovarian follicles than WT control with the presence of multi-oocyte follicles. Cnn2-KO mice also showed age-progressive earlier depletion of ovarian follicles. Cnn2 expression is detected in the cumulus cells of the ovarian follicles of WT mice and colocalizes with actin stress fiber, tropomyosin and myosin II in primary cultures of cumulus cells.

Conclusions

The findings demonstrate that the loss of calponin 2 impairs ovarian folliculogenesis with premature depletion of ovarian follicles. The role of calponin 2 in ovarian granulosa cells suggests a molecular target for further investigations on the pathogenesis of POI and for therapeutic development.
Tissue of origin prediction for cancer of unknown primary using a targeted methylation sequencing panel
Authors: Sun Miaomiao , Xu Bo , Chen Chao , Zhu Youjie , Li Xiaomo , Chen Kuisheng
Published: February 2024

Rationale

Cancer of unknown primary (CUP) is a group of rare malignancies with poor prognosis and unidentifiable tissue-of-origin. Distinct DNA methylation patterns in different tissues and cancer types enable the identification of the tissue of origin in CUP patients, which could help risk assessment and guide site-directed therapy.

Methods

Using genome-wide DNA methylation profile datasets from The Cancer Genome Atlas (TCGA) and machine learning methods, we developed a 200-CpG methylation feature classifier for CUP tissue of origin prediction (MFCUP). MFCUP was further validated with public-available methylation array data of 2977 specimens and targeted methylation sequencing of 78 Formalin‐fixed paraffin‐embedded (FFPE) samples from a single center.

Results

MFCUP achieved an accuracy of 97.2% in a validation cohort (n = 5923) representing 25 cancer types. When applied to an Infinium 450 K array dataset (n = 1052) and an Infinium EPIC (850 K) array dataset (n = 1925), MFCUP achieved an overall accuracy of 93.4% and 84.8%, respectively. Based on MFCUP, we established a targeted bisulfite sequencing panel and validated it with FFPE sections from 78 patients of 20 cancer types. This methylation sequencing panel correctly identified tissue of origin in 88.5% (69/78) of samples. We also found that the methylation levels of specific CpGs can distinguish one cancer type from others, indicating their potential as biomarkers for cancer diagnosis and screening.

Conclusion

Our methylation-based cancer classifier and targeted methylation sequencing panel can predict tissue of origin in diverse cancer types with high accuracy.
Pachycormid fish fed on octobrachian cephalopods: new evidence from the ‘Schistes bitumineux’ (early Toarcian) of southern Luxembourg
Authors: Weis Robert , Delsate Dominique , Klug Christian , Argyriou Thodoris , Fuchs Dirk
Published: February 2024

A re-examination of the early Toarcian fish fossils preserved in public paleontological collections in Luxembourg revealed 70 specimens of large Toarcian pachycormid fish with an excellent three-dimensional preservation within calcareous nodules. Six of them are associated with octobrachian coleoid gladii in their oesophagus or stomach, an association not previously described from Luxembourg. The pachycormids are ascribed to Pachycormus macropterus (Blainville, 1818) and Saurostomus esocinus Agassiz, 1843 while the octobrachian gladii are ascribed to Teudopsis bollensis Voltz, 1836, Teudopsis sp. indet. and Loligosepiidae indet. The position and orientation of the gladii provide direct evidence of these fishes feeding on coleoids and thus a teuthophagous diet, rather than an accidental joint burial. Together with evidence from coeval deposits in Germany, these findings suggest that teuthophagy was a widespread feeding strategy at the base of the clade that contains the suspension-feeding pachycormid giants of the Jurassic–Cretaceous.
Biosynthetic ability of diverse basidiomycetous yeast strains to produce the natural antioxidant ergothioneine
Authors: Sato Shun , Saika Azusa , Ushimaru Kazunori , Koshiyama Tatsuyuki , Higashiyama Yukihiro , Fukuoka Tokuma , Morita Tomotake
Published: February 2024

Sixteen strains of basidiomycetous yeasts were evaluated for their capability to produce ergothioneine (EGT), an amino acid derivative with strong antioxidant activity. The cells were cultured in either two synthetic media or yeast mold (YM) medium for 72 h, after which cytosolic constituents were extracted from the cells with hot water. After analyzing the extracts via liquid chromatography-mass spectrometry (LC-MS), we found that all strains produced varying amounts of EGT. The EGT-producing strains, including Ustilago siamensis, Anthracocystis floculossa, Tridiomyces crassus, Ustilago shanxiensis, and Moesziomyces antarcticus, were subjected to flask cultivation in YM medium. U. siamensis CBS9960 produced the highest amount of EGT at 49.5 ± 7.0 mg/L after 120 h, followed by T. crassus at 30.9 ± 1.8 mg/L. U. siamensis was also cultured in a jar fermenter and produced slightly higher amounts of EGT than under flask cultivation. The effects of culture conditions, particularly the addition of precursor amino acids, on EGT production by the selected strains were also evaluated. U. siamensis showed a 1.5-fold increase in EGT production with the addition of histidine, while U. shanxiensis experienced a 1.8-fold increase in EGT production with the addition of methionine. These results suggest that basidiomycetous yeasts could serve an abundant source for natural EGT producers.
Virulent systemic feline calicivirus infection: a case report and first description in Ireland
Authors: Duclos Antoine A. , Guzmán Ramos Pedro J. , Mooney Carmel T.
Published: February 2024

Background

Virulent systemic feline calicivirus (VS-FCV) infection is an emerging disease. It is distinct from classic oronasal calicivirus infection as it manifests with unique systemic signs including severe cutaneous ulcerations, limb oedema, and high mortality, even in adequately vaccinated cats. Devastating epizootic outbreaks with hospital-acquired infections have been described in the United States, the United Kingdom, continental Europe and Australia with up to 54 cats affected in one outbreak and a mortality rate of up to 86%. This highly contagious and potentially fatal disease has not yet been reported in Ireland.

Case presentation

An 11-month-old male neutered vaccinated domestic shorthair cat was presented with a 10-day history of lethargy, decreased appetite and progressively worsening pitting oedema in all four limbs. The signs were first noted after another kitten from a high-density cat shelter was introduced in to the household. Additional physical examination findings included marked pyrexia, and lingual and cutaneous ulcers. Virulent systemic feline calicivirus was diagnosed based on compatible history and clinical signs, exclusion of other causes, and calicivirus isolation by RT-PCR both in blood and oropharyngeal samples. Negative calicivirus RT-PCR in blood following resolution of the clinical signs further supported the diagnosis.

Conclusion

This case represents the first known case of VS-FCV infection in Ireland. Given the severity of the clinical signs, and the high risk for epizootic outbreaks, Irish veterinarians should be aware of the disease to ensure prompt diagnosis and implementation of adequate preventive measures, in order to limit the threat that this disease represents for the wider cat population and particularly given the risk of hospital-acquired VS-FCV infection. Virulent systemic calicivirus should be suspected in cats with pyrexia of unknown origin, oedema or ulceration affecting the limbs or the face, and exposure to rescue cats from high-density households.
Autologous blood patch intraparenchymal injection reduces the incidence of pneumothorax and the need for chest tube placement following CT-guided lung biopsy: a systematic review and meta-analysis
Authors: Li Teng , Zhang Qiang , Li Wenjun , Liu Yun
Published: February 2024

Purpose

To assess the effectiveness of autologous blood patch intraparenchymal injection during CT-guided lung biopsies with a focus on the incidence of pneumothorax and the subsequent requirement for chest tube placement.

Methods

A comprehensive search of major databases was conducted to identify studies that utilized autologous blood patches to mitigate the risk of pneumothorax following lung biopsies. Efficacy was next assessed through a meta-analysis using a random-effects model.

Results

Of the 122 carefully analyzed studies, nine, representing a patient population of 4116, were incorporated into the final analysis. Conclusion deduced showed a noteworthy reduction in the overall incidence of pneumothorax (RR = 0.65; 95% CI 0.53–0.80; P = 0.00) and a significantly decline in the occasion for chest tube placement due to pneumothorax (RR = 0.45; 95% CI 0.32–0.64; P = 0.00).

Conclusions

Utilizing autologous blood patch intraparenchymal injection during the coaxial needle retraction process post-lung biopsy is highly effective in diminishing both the incidence of pneumothorax and consequent chest tube placement requirement.
All-trans retinoic acid alleviates transmissible gastroenteritis virus-induced intestinal inflammation and barrier dysfunction in weaned piglets
Authors: Pu Junning , Chen Daiwen , Tian Gang , He Jun , Zheng Ping , Huang Zhiqing , Mao Xiangbing , Yu Jie , Luo Yuheng , Luo Junqiu , Yan Hui , Wu Aimin , Yu Bing
Published: February 2024

Background

Transmissible gastroenteritis virus (TGEV) is one of the main pathogens causing severe diarrhea of piglets. The pathogenesis of TGEV is closely related to intestinal inflammation. All-trans retinoic acid (ATRA) is the main active metabolite of vitamin A, which has immunomodulatory and anti-inflammatory properties. However, it is unclear whether ATRA can alleviate TGEV-induced intestinal inflammation and barrier dysfunction in piglets. This study aimed to investigate the effects of ATRA on growth performance, diarrhea, intestinal inflammation and intestinal barrier integrity of TGEV-challenged piglets.

Methods

In a 19-d study, 32 weaned piglets were randomly divided into 4 treatments: Control group (basal diet), TGEV group (basal diet + TGEV challenge), TGEV + ATRA5 group (basal diet + 5 mg/d ATRA + TGEV challenge) and TGEV + ATRA15 group (basal diet + 15 mg/d ATRA + TGEV challenge). On d 14, piglets were orally administered TGEV or the sterile medium.

Results

Feeding piglets with 5 and 15 mg/d ATRA alleviated the growth inhibition and diarrhea induced by TGEV (P < 0.05). Feeding piglets with 5 and 15 mg/d ATRA also inhibited the increase of serum diamine oxidase (DAO) activity and the decrease of occludin and claudin-1 protein levels in jejunal mucosa induced by TGEV, and maintained intestinal barrier integrity (P < 0.05). Meanwhile, 5 mg/d ATRA feeding increased the sucrase activity and the expressions of nutrient transporter related genes (GLUT2 and SLC7A1) in jejunal mucosa of TGEV-challenged piglets (P < 0.05). Furthermore, 5 mg/d ATRA feeding attenuated TGEV-induced intestinal inflammatory response by inhibiting the release of interleukin (IL)-1β, IL-8 and tumor necrosis factor-α (TNF-α), and promoting the secretion of IL-10 and secretory immunoglobulin A (sIgA) (P < 0.05). Feeding 5 mg/d ATRA also down-regulated the expressions of Toll-like receptors and RIG-I like receptors signaling pathway related genes (TLR3, TLR4, RIG-I, MyD88, TRIF and MAVS) and the phosphorylation level of nuclear factor-κB-p65 (NF-κB p65), and up-regulated the inhibitor kappa B alpha (IκBα) protein level in jejunal mucosa of TGEV-challenged piglets (P < 0.05).

Conclusions

ATRA alleviated TGEV-induced intestinal barrier damage by inhibiting inflammatory response, thus improving the growth performance and inhibiting diarrhea of piglets. The mechanism was associated with the inhibition of NF-κB signaling pathway mediated by TLR3, TLR4 and RIG-I.

Graphical Abstract
Psychosocial factors associated with intention to pursue tertiary education among Malawian students: the moderating effect of mental health
Authors: Slekiene Jurgita , Chidziwisano Kondwani , Tilley Elizabeth
Published: February 2024

Background

In Sub Saharan Africa (SSA), approximately 9 million students are enrolled in tertiary education (TE), which is 4% of the total TE enrolment globally. Barriers to higher education in SSA are numerous: poverty, food insecurity, gender, and disability, while the COVID-19 pandemic has worsened the situation. Little is known about the psychosocial factors and underlying mechanisms associated with students’ intention to apply for TE. Using a psychological theory of behaviour change, our study investigated the psychosocial and context factors associated with the application to TE.

Methods

In a cross-sectional research study 821 interviews using researcher-administered questionnaires were conducted with secondary school students in rural and urban Blantyre, Malawi. A quantitative questionnaire based on the risks, attitudes, norms, abilities, and self-regulation (RANAS) model was used to assess psychosocial factors underlying application for TE. The Centre for Epidemiological Studies Depression Scale for Children (CES-DC) and household hunger scale were used to assess mental health and hunger respectively.

Results

More than half of the youth were at risk to develop depression (66.5%). Girls reported experiencing more depression symptoms than boys. Around 1 in every 5 interviewed youth lived in a home experiencing moderate or severe hunger. A higher intention to apply for TE was related to perceived vulnerability, affective beliefs (joy, happiness, excitement), injunctive (approval of others) and personal norms, self-efficacy, and commitment to apply. Factual knowledge about TE application was very limited. An intention to apply for TE and self-efficacy was positively associated with regular physical exercise, but negatively associated with mental health and hunger. However, mental health moderated the effects of physical exercise on the intention to apply for TE. We found significant differences between poor and good mental health groups on intention to apply for TE in perceived vulnerability, descriptive (behaviour of others) and personal norms, self-efficacy, maintenance self-efficacy and commitment factors. The results informed a behaviour change intervention strategy to increase students’ intention to apply for TE.

Conclusions

Our research findings are an important contribution to the long-term strategy of achieving the Sustainable Development Goals (SDGs) and contribute to the inclusion of vulnerable students with impaired mental health in higher education in Malawi and beyond.
Federated Freeze BERT for text classification
Authors: Galal Omar , Abdel-Gawad Ahmed H. , Farouk Mona
Published: February 2024

Pre-trained BERT models have demonstrated exceptional performance in the context of text classification tasks. Certain problem domains necessitate data distribution without data sharing. Federated Learning (FL) allows multiple clients to collectively train a global model by sharing learned models rather than raw data. However, the adoption of BERT, a large model, within a Federated Learning framework incurs substantial communication costs. To address this challenge, we propose a novel framework, FedFreezeBERT, for BERT-based text classification. FedFreezeBERT works by adding an aggregation architecture on top of BERT to obtain better sentence embedding for classification while freezing BERT parameters. Keeping the model parameters frozen, FedFreezeBERT reduces the communication costs by a large factor compared to other state-of-the-art methods. FedFreezeBERT is implemented in a distributed version where the aggregation architecture only is being transferred and aggregated by FL algorithms such as FedAvg or FedProx. FedFreezeBERT is also implemented in a centralized version where the data embeddings extracted by BERT are sent to the central server to train the aggregation architecture. The experiments show that FedFreezeBERT achieves new state-of-the-art performance on Arabic sentiment analysis on the ArSarcasm-v2 dataset with a 12.9% and 1.2% improvement over FedAvg/FedProx and the previous SOTA respectively. FedFreezeBERT also reduces the communication cost by 5$$\times$$
×
compared to the previous SOTA.
Two cases of pararenal artery aortic aneurysm treatment after pancreaticoduodenectomy and abdominal aortic aneurysm stent grafting
Authors: Yamazaki Kazuhiro , Minatoya Kenji , Sakamoto Kazuhisa , Kudo Masafumi , Fukumitsu Ken , Kobayashi Takashi , Okajima Hideaki
Published: February 2024

Background

Acute pancreatitis caused by surgical procedures may occur less frequently in surgeries for aortic aneurysm involving the abdominal branch. However, in such cases, the associated mortality rate increases significantly. There have been few reports on abdominal aortic aneurysm surgery after pancreatoduodenectomy; as such the incidence of postoperative pancreatitis remains unclear.

Case presentation

Two cases of pararenal artery aortic aneurysm after pancreaticoduodenectomy and endovascular aneurysm repair (EVAR) for an abdominal aortic aneurysm are reported. In the first case, a 74-year-old man was diagnosed with abdominal aortic aneurysm and duodenal cancer 6 years earlier and underwent pancreaticoduodenectomy after EVAR. Subsequently, the abdominal aorta expanded to 58 mm at the level of the renal artery proximal to the EVAR site. Graft replacement was performed through a left thoraco-retroperitoneal incision. However, the patient died from acute pancreatitis, believed to be caused by intraoperative manipulation. Given this initial experience, in the second case, a 77-year-old man had undergone a pancreaticoduodenectomy for a gastrointestinal stromal tumor 17 years earlier and EVAR for an abdominal aortic aneurysm 10 years earlier. The abdominal aorta had expanded to 50 mm immediately below the right renal artery on the proximal side of the EVAR. Subsequently, hematuria was noted, and he was diagnosed with right ureteral cancer. Autologous transplantation of the left kidney and EVAR was performed avoiding manipulation of the area around the pancreas and achieved good results. Combined right renal and ureteral resections were performed 20 days after EVAR.

Conclusions

While performing aortic surgery after pancreaticoduodenectomy, surgeons should avoid manipulating tissues around the pancreas.