bluuebunny/crossref_metadata_2025 huggingface dataset:
Lymph Node Cluster Dissection After Carbon Nanoparticles Injection Enhances the Retrieval Number in Colorectal Cancer
Authors: Liu Lu , Li Xi , Hu Yulin , Sun Jingyue , Chen Jielin , Xiao Desheng , Wu Wei , Xie Bin
Published: December 2022

For colorectal cancer patients, NCCN recommended that at least 12 lymph nodes should be detected since the number and metastases status of lymph nodes played an important role in the treatment and prognostic. Carbon nanoparticles have been proved to be an efficient lymph node tracer.
Faced with the clinical problem of insufficient lymph nodes in colorectal cancer, we proposed a lymph node cluster (D3, D2 and D1) dissection method combined with carbon nanoparticle injection. In our study, patients were divided into 2 groups (CNP and control). All lymph nodes of each patient
were collected and made into hematoxylin-eosin sections to observe their size, staining appearance and metastasis status under the microscope. As a result, the total lymph nodes in CNP group were greatly higher than control group (51.45 vs. 29.62, P = 0.000), especially micro LNs and
positive micro LNs. Compared with D2 and D1 stations, fewer lymph nodes were found in D3, and it was the same for cancer metastasis status. In CNP group, most lymph nodes got black for quick visualization. In conclusion, lymph node cluster dissection combined with carbon nanoparticles could
enhance the number of lymph node retrieval.
Adoption of Computed Tomography Image via Nano Contrast Agent in the Diagnosis and Treatment of Arrhythmia Patients
Authors: Luo Lidan , Zhang Bin
Published: December 2022

To explore the function and specific adoption of nano contrast agent in computed tomography (CT) images of patients with arrhythmia. In this study, the control group received general CT examination, and the test group received preoperative injection of nano contrast agent. All patients
were scanned by retrospective electrocardiogram (ECG)-gated helical scanning, after which the coronary artery reconstruction and analysis were performed in a dedicated image post-processing workstation. Compared with the control group, there were decreases in heart rate variability, multistage
reconstruction requirement, ECG editing requirement, and the undiagnosed segment ratio during CT scanning in the test group, while the proportion of diagnosable segments and diagnosable patients increased; the average duration of CT image postprocessing in the test group was higher than that
in the control group. The nano contrast agent could improve the quality of CT images of some patients with arrhythmia, and the improvement was different in patients with different types of arrhythmia. The overall CT image quality and post-processing of patients with arrhythmia were improved
by nano contrast agent, and this experiment laid a foundation for the clinical adoption of nano contrast agent in CT image detection and pointed out the direction for subsequent clinical research.
Bone Regeneration in Osteoporosis via Carbon Nanotube-Based Bone Morphogenetic Protein-2
Authors: Sui Yi , Yusufu Aierpati , Nian Kaiwei , Li Xin , Shi Wenhua , Cheng Bo , Shen Bin
Published: December 2022

We constructed a bone morphogenetic protein 2 (BMP-2)@Carbon nanotube (CNT) delivery system to explore the feasibility of a nanodrug delivery system in the treatment of osteoporosis (OP). Osteoblasts were cultured and OP mouse models were constructed to evaluate the osteogenesis of
nano-BMP-2 in OP therapy. In physicochemical property tests, we found that BMP-2 was effectively loaded into CNT to form nanoparticles (NPs) with a particle size of 100 nm. Additionally, we found that nano-BMP-2 had good stability and could effectively prolong BMP-2 release time. In cellular
experiments, we found that nano-BMP-2 could penetrate osteoblasts more effectively than BMP-2 alone, and with the increase of BMP-2 loading, the amount of BMP-2 penetrating osteoblasts increased with an optimal loading of 100 μg. We determined that nano-BMP-2 could increase proliferation
activity of osteoblasts to better promote OP repair. In our vivo experiments, we found that nano-BMP-2 was effectively excreted through the kidney and mainly distributed in bone tissue. Moreover, CNT effectively prolonged the half-life of BMP-2 and was safe to introduce through intramuscular
injection and did not cause obvious inflammatory reactions. Following treatment, nano-BMP-2 increased body weight, femur weight, and femoral head diameter in OP mouse models. Furthermore, bone trabecular was arranged in a close and orderly fashion and was uniform in thickness in OP mice treated
with nano-BMP-2. OP mice had improved bone mineral density, trabecular thickness, trabecular number, and cortical bone thickness in their metaphyseal regions, implying nano-BMP-2 treatment led to improved OP symptoms. Therefore, BMP-2@CNT may be a beneficial choice for treatment of OP.
Numerical Simulation for Flow and Heat Transfer of a Nanofluid Over Lubricated Stretchable Surface
Authors: Sadiq Muhammad Noveel , Sajid Muhammad , Abbas Tasawar , Mahmood Khalid , Bashir Sammar , Mahmood Waqar
Published: December 2022

The lubricants mostly used in industry have non-Newtonian properties and adhere to a variety of constitutive connections. The power law lubricant, which follows the Ostwald model and is widely used in engineering lubrication, is one of them. In this study the flow analysis of nanofluid
in the vicinity of a stagnation point over a lubricated stretching surface has been investigated. The lubrication is provided by a thin layer of variable thickness of power-law fluid. Impact of thermophoresis and Brownian motion is also investigated. To acquire the dimensionless governing
equations utilized an appropriate transformation. A newly developed powerful numerical procedure known as Legendre wavelet spectral collocation method (LWSCM) has been employed to acquire the similar solution. A comparison in the special cases between the published and present results substantiate
the obtained solutions. Addition of the lubrication enhances the fluid velocity and reduces the temperature of the nanofluid at the stretchable surface.
A Review Study for a Twisted Tube Heat Exchanger
Authors: Abdul Razzaq Ali k. , Mushatet Khudheyer S.
Published: December 2022

They are considering the increasing demand and urgent need in different industries and the importance of heat exchangers imposed the development of heat exchangers to increase heat transfer and increase general performance, reducing volume and cost. The essential heat exchanger used
in many industries is the double tube heat exchanger. This type has been distinguished by its simplicity and wide use in recent years. Several improvement methods have been applied, including passive, active, and compound techniques. Passive technologies change the geometry of heat exchangers
and are one of the most effective processes to increase overall heat performance. Besides, the hybridization of flow liquids is one of the most critical approaches to increase heat transfer as nanofluids. This review discusses and analyzes the evolution of heat exchangers and methods for improving
passive heat transmission. In addition, experimental and numerical research that used nanofluids in heat exchangers was discussed. Moreover, different twisted shapes of the heat exchanger tubes (elliptical and oval, square, and triangle) were studied, which generated secondary eddy flow that
increases the intensity of turbulence and mixing, thus improving heat transfer. Also, additives inside heat exchanger tubes include twisted tapes, ribs, and conical rings. The engagement between the Nusselt number and the coefficient of friction was also offered.
Experimental Analysis of Heat Transfer in a Triple Tube Heat Exchanger with Spring Turbulator Using CuO/Water Nanofluid
Authors: Kumar Rajan , Chandra Prakash , Singh Harsimranjot
Published: December 2022

An Experiment has been performed to find out effect of coiled spring turbulators on the heat transfer and pressure drop in a triple tube heat exchanger using water and CuO/water (0.8%vol/vol) as working media. Two spring turbulators having pitch 5 mm and 10 mm with a common wire diameter
of 1 mm are being used. The experiment was carried out under turbulent flow at different Reynolds numbers varying between 4000 to 16,000. In this experiment, the variation in the rate of heat transfer and friction factor have been analyzed for parallel and counter flow arrangements. The combination
of the lower-pitched insert with CuO attained the maximum heat transfer increment in the counter flow pattern. For counter flow arrangement, augmentation in Nusselt number for a triple tube with lower spring pitch with CuO nanofluid is 63.33%, which is higher in comparison to the plain triple
tube with water as working fluid. The maximum thermal performance value is observed for plain tube with CuO nanofluid having the value 1.04 at Reynolds number of 4000.
Mixed Convective Flow in Horizontal Rectangular Enclosure with a Wall Heat Source: A Numerical Study
Authors: Ambethkar V. , Basumatary L. R.
Published: December 2022

In this work, we have investigated the heat transfer of a mixed convective flow in horizontal rectangular enclosure having a wall heat source. For the purpose of computing stable and convergent numerical solutions of the flow variables, the governing equations along with the boundary
conditions are solved by using the upwind finite volume scheme and a modified SIMPLE algorithm. For discussing the heat transfer from the bottom wall of the enclosure, the average Nusselt numbers are computed from relevant empirical correlations existing in the literature. These correlations
are in the range of 1708 ≤ Ra ≤ 108 and 1708 ≤ Ra ≤ 3.5×109 in terms of different Rayleigh numbers for the Newtonian fluids such as air and water. Numerical solutions obtained from this study are compared with available benchmark solutions.
Identity and Career: An Analysis of Emerging Meteorologists’ Narratives
Authors: Rosen Zoey
Published: December 2022

The narratives of emerging adults, such as university students, can reveal aspects of their professional and academic identities that explain their career paths. While narrative has been studied as a tool in the meteorological classroom, narrative has not been used to study why students choose to become meteorologists. This study aims to identify the narrative features about what draws students to pursue meteorology as a career and reflect upon how the telling of these narratives can help career counselors and other stakeholders, like universities, to understand this discipline of students. This study is a qualitative textual analysis of N = 34 video clips of meteorology students from around the United States submitted for the 2020 AMS Student Conference welcome video, #MyFieldMyStory campaign. The findings show that formative experiences like early childhood memories, mediated experiences with the weather, and family interactions were major life themes in the students’ stories. Other reasons students chose this career path were concerns over local climatic effects, a desire to control their course of study, curiosity stemming from internships and research opportunities, confidence from their personal math/science propensity in school, and a commitment to do work that can mitigate the effects of severe weather or inform people of impending threats. The students’ narratives also showed optimism around future jobs and graduate school, as well as an exploration of their identity through finding their passion in this career path. This study is an interesting initial delve into narratively analyzing stories from emerging meteorologists.
Book review: Sadhna Arya, Gaining Ground: The Changing Contours of Feminist Organising in Post-1990s India
Authors: Gopal Meena
Published: December 2022

Sadhna Arya, Gaining Ground: The Changing Contours of Feminist Organising in Post-1990s India, Women Unlimited, 2020, 273 pp., ₹650, ISBN 9789385606281 (Paperback).
Nykaa: A Keen Contest in Beauty Products Retailing
Authors: Krishna Malay , Arora Samridhi
Published: December 2022

In 2019, Nykaa was recognized as India’s undisputed beauty product sales queen. Since its inception in 2012 as a niche e-commerce website, Nykaa has evolved rapidly. By 2019, Nykaa opened its 50th retail store, with plans for another 150; it had expanded into new customer segments (salon owners and men) and forged new partnerships (e.g. with Bollywood celebrities). In a manner reminiscent of a judo player, Nykaa had outmanoeuvred much larger sellers, such as Amazon, and was close to a one-billion-dollar valuation by the end of 2019. Nykaa now faced an even more exciting set of opportunities and challenges. Nykaa’s recent decision to ramp up a new business-fashion faced scepticism. Sceptics questioned whether Nykaa’s omnichannel model could work in India’s fiercely contested fashion market in 2019. Nykaa also faced a growing challenge in its core market from purplle.com—an online marketplace for beauty products. While tracing the causes for Nykaa’s success in the beauty market, the case highlights the need for senior management to re-evaluate and evolve the company’s strategy.
I’m Skinny, I’m Worth More: Fashion Models’ Experiences of Aesthetic Labor and Its Impact on Body Image and Eating Behaviors
Authors: Fixsen Alison , Kossewska Magdalena , Bardey Aurore
Published: December 2022

The fashion industry has been critiqued for promoting ultra-thin bodies, yet the relationship between models’ aesthetic labor and eating disorder (ED) development is unclear. Using interpretive phenomenological analysis, we explored the lived experiences of nine female fashion models including metaphors they used to describe body perceptions and eating behaviors. Four superordinate themes emerged: Shaped for the industry; The body as a market product; Food restriction (“it’s almost glamorized”); Toward a healthier modelhood. Models’ career trajectories were those of lost childhoods, punitive body rules, inadequate dietary advice, and self-regulated food restriction. Models were “shaped” by agents from an early age to conform to the industry’s body rules irrespective of the physiological and psychological consequences. A “toxic” side to this aesthetic industry was depicted; agents were judged callous and money-focused, while idioms like, “feeling like a piece of meat” and “being a hanger of clothes” conveyed a deep sense of degradation and objectification. Ideas instilled at a formative age continued to influence self-image and eating patterns into maturity, pointing to an industrial element to the construction of eating disorders. Our study highlights how infantilization, sexism, and other unethical elements become normalized in poorly regulated industries such as fashion, with dire consequences for the health and wellbeing of employees. Model agencies should recognize the impact of occupational edicts and poor communication on young recruits in a sensitive phase of personality development. Finally, we advocate for more acknowledgment and further investigation into eating disorder construction commercial/industrial side.
The Pursuit of Medical Care for Female Victims of Nonfatal Strangulation at the Time of Police Response
Authors: Wilkes Nicole
Published: December 2022

Survivors of nonfatal strangulation face a number of physical health consequences, some of which can be fatal if untreated. Despite the known health risks and connections to delayed fatalities, little is known about strangulation and victims’ pursuit of medical care. Using data collected from prosecutors’ case files ( n = 143), this study attempts to understand what factors contribute to victims receiving medical attention following a nonfatal strangulation assault reported to police. Findings indicate that the suspect disrupting an emergency call increases the likelihood of the victim pursuing medical care. Implications are discussed.
Characteristics and value of ‘meaningful activity’ for people living with dementia in residential aged care facilities: “You’re still part of the world, not just existing”
Authors: Tierney Laura , MacAndrew Margaret , Doherty Kathleen , Fielding Elaine , Beattie Elizabeth
Published: December 2022

Most residential aged care facilities support residents to participate in activities and the importance of activities that are suited to individual preferences and abilities is widely acknowledged. Participating in activities, including those considered to be ‘meaningful’ has the potential to improve residents’ quality of life. However, what makes activities meaningful for people living with dementia in residential aged care facilities is unclear. The aim of this study was to understand the key characteristics of ‘meaningful activity’ in residential aged care facilities and the perceived value of residents participating in these activities. Using a qualitative study design, this study explored ‘meaningful activities’ from the perspectives of people living with dementia in residential aged care facilities, their family members and staff. Across four residential aged care facilities, residents (n = 19) and family members (n = 17) participated in individual interviews while staff (n = 15) participated in focus group interviews. Interviews were recorded, transcribed and analysed using a qualitative content analysis approach. Participant responses suggest that the meaning of an activity is subjective, varying over time and between individuals. Key characteristics of an activity that makes it meaningful include being enjoyable, social and engaging, aligning with the persons’ interests, preferences, and abilities. To be considered meaningful, activities need to do more than occupy the person. The activity needs to be linked to a personally relevant goal and an aspect of the individuals’ identity. Participating in ‘meaningful activities’ was perceived as valuable to encourage participation and socialising, provide a sense of normality for residents and improve their wellbeing. The findings of this study further our understanding of the concept of ‘meaningful activity’ for people living with dementia in residential aged care facilities. Understanding the key attributes of ‘meaningful activity’ can also provide practical guidance for those supporting people with dementia to participate in these types of activities.
The belt and road initiative, joint intellectual capital development towards industry value added of a partner economy
Authors: Malik Tariq H
Published: December 2022

The BRI (Belt and Road Initiative) project is about to complete its 10 years, and its growth and legitimacy have invoked a wider interest leading to competing arguments about whether it serves any benefits to any BRI partner countries. Opponents contend that BRI serves China’s economic and political purpose without contributing to the partner economy. We attempt to settle this contention by exploring the empirical evidence on CPEC (China-Pakistan Economic Corridor), a pilot project of the BRI project that highlights the intellectual development of nations, science and technology progress and socioeconomic development. Socioeconomic theories explain that interactive structures contribute to the partner’s science, technology, and industrial development. Following these assumptions, we raised the empirical question: does the joint Sino-Pak publication predict an increase in Pakistan’s IVA (industry value added) in the post-BRI versus the pre-BRI period? We integrated publications from 27 disciplines from 2012 to 2020 ( N = 243) and linked them to the IVA of Pakistan (estimated by the World Bank). Our robust analysis reveals strong support for the main hypothesis. First, Chinese science positively predicts Pakistan’s IVA, and it negatively predicts the IVA of a non-BRI partner. Second, joint science productivity positively predicts Pakistan’s IVA but not of the non-BRI partner. Third, science productivity predicts Pakistan’s IVA more in the post-BRI period than in the pre-BRI period. In short, Pakistan’s industrial added value through the development of the Chinese contribution to the intellectual development of Pakistan supports this argument, settling the outstanding issue of socioeconomic development of the BRI system. It reduces uncertainty and confusion created by narratives in popular literature of a rhetorical nature. Overall, the study provides a basis for future research and policy.
We Don’t Sleep on Rainy Nights
Authors: Jayarajan Athira , Gangadharan Nidheesh
Published: December 2022

Despite years of social mobility, indigenous people in India stand low in most development indices, and the substandard living conditions make them highly vulnerable to natural disasters. In this communication, we unfold the vulnerabilities and coping strategies of the Paniya tribal community of Kerala during the unusual rain and flood that the state faced in 2018 and 2019. The vulnerability arises primarily from food scarcity, malnutrition, low physical well-being, unemployment and financial instability. Climate change and related events seem to heighten the prevailing exposure of the indigenous community, and women are generally more vulnerable to the impacts of natural disasters. The study also points out the psychological impact of the flood and the various coping mechanisms adopted over individual and community levels to alleviate the effect. The community members have an optimistic outlook towards life, even after experiencing catastrophic floods and landslides. Nevertheless, this outlook is not a visionary outcome of the rehabilitation process but rather an optionless strategy for the community to get along.
A prospective randomized study of different height of operation table for tracheal intubation with videolaryngoscopy in ramped position
Authors: Kang Dongho , Bae Hong-Beom , Choi Yun Ha , Bom Joon-suk , Kim Joungmin
Published: December 2022

Background

Previous studies have reported that the ramped position provides a better laryngoscopic view, reduces tracheal intubation time, and increases the success rate of endotracheal intubation. However, the patient’s head height changes while in the ramped position, which in turn changes the relative positions of the patient and intubator. Thus, making these changes may affect the efficiency of tracheal intubation; however, few studies have addressed this problem. This study analyzed intubation time and conditions during tracheal intubation using videolaryngoscope in the ramped position.

Methods

This prospective study included 144 patients who were scheduled to receive general anesthesia for surgeries involving orotracheal intubation. The participants were randomly allocated to either the nipple or umbilical group according to the table height. Mask ventilation was assessed using the Warters grading scale. Tracheal intubation was performed using a McGrath MAC laryngoscope. The total intubation time, laryngoscopy time, tube insertion time, and difficulty of intubation (IDS score) were measured.

Results

The umbilical group had a significantly shorter laryngoscopy time (10 ± 3 vs. 16 ± 4 s), tube insertion time (18 ± 4 vs. 24 ± 6 s), and total intubation time (28 ± 5 vs. 40 ± 7 s) compared to the nipple group. No significant difference in the difficulty of mask ventilation was observed between the two groups. The IDS score was higher in the nipple than umbilical group.

Conclusion

The lower (umbilical) table level reduced the intubation time and difficulty of videolaryngoscopy compared to the higher (nipple) table level.

Trial registration

This study was registered at KCT0005987, 11/03/2021, Retrospectively registered.
Quality of observational studies of clinical interventions: a meta-epidemiological review
Authors: Grosman Sergei , Scott Ian A.
Published: December 2022

Background

This meta-epidemiological study aimed to assess methodological quality of a sample of contemporary non-randomised clinical studies of clinical interventions.

Methods

This was a cross-sectional study of observational studies published between January 1, 2012 and December 31, 2018. Studies were identified in PubMed using search terms ‘association’, ‘observational,’ ‘non-randomised’ ‘comparative effectiveness’ within titles or abstracts. Each study was appraised against 35 quality criteria by two authors independently, with each criterion rated fully, partially or not satisfied. These quality criteria were grouped into 6 categories: justification for observational design (n = 2); minimisation of bias in study design and data collection (n = 11); use of appropriate methods to create comparable groups (n = 6); appropriate adjustment of observed effects (n = 5); validation of observed effects (n = 9); and authors interpretations (n = 2).

Results

Of 50 unique studies, 49 (98%) were published in two US general medical journals. No study fully satisfied all applicable criteria; the mean (+/−SD) proportion of applicable criteria fully satisfied across all studies was 72% (+/− 10%). The categories of quality criteria demonstrating the lowest proportions of fully satisfied criteria were measures used to adjust observed effects (criteria 20, 23, 24) and validate observed effects (criteria 25, 27, 33). Criteria associated with ≤50% of full satisfaction across studies, where applicable, comprised: imputation methods to account for missing data (50%); justification for not performing an RCT (42%); interaction analyses in identifying independent prognostic factors potentially influencing intervention effects (42%); use of statistical correction to minimise type 1 error in multiple outcome analyses (33%); clinically significant effect sizes (30%); residual bias analyses for unmeasured or unknown confounders (14%); and falsification tests for residual confounding (8%). The proportions of fully satisfied criteria did not change over time.

Conclusions

Recently published observational studies fail to fully satisfy more than one in four quality criteria. Criteria that were not or only partially satisfied were identified which serve as remediable targets for researchers and journal editors.
Test concordance and diagnostic accuracy of three serological assays for detection of anti-SARS-CoV-2 antibody: result from a population-based sero-epidemiological study in Delhi
Authors: Misra Puneet , Kant Shashi , Guleria Randeep , Ahmad Mohammad , Mandal Suprakash , Chaturvedi P. K. , Medigeshi Guruprasad R. , Meena Suneeta , Rai Sanjay Kumar , Rahman Anisur , Sangral Meenu , Yadav Kapil , Bairwa Mohan , Haldar Partha
Published: December 2022

Background

Several methodological tests are available to detect SARS-CoV-2 antibody. Tests are mostly used in the aid of diagnosis or for serological assessment. No tests are fully confirmatory and have variable level of diagnostic ability. We aimed at assessing agreement with three serological tests: quantitative anti receptor binding domain ELISA (Q-RBD), qualitative ELISA (WANTAI SARS-CoV-2 Ab) and qualitative chemiluminescence assay (CLIA).

Methods

This study was a part of a large population based sero-epidemiological cohort study. Participants aged 1 year or older were included from 25 randomly selected clusters each in Delhi urban (urban resettlement colony of South Delhi district) and Delhi rural (villages in Faridabad district, Haryana). Three type of tests were applied to all the baseline blood samples. Result of the three tests were evaluated by estimating the total agreement and kappa value.

Results

Total 3491 blood samples collected from March to September, 2021, out of which 1700 (48.7%) from urban and 1791 (51.3%) from rural. Overall 44.1% of participants were male. The proportion of sero-positivity were 78.1%, 75.2% and 31.8% by Wantai, QRBD and CLIA tests respectively. The total agreement between Wantai and QRBD was 94.5%, 53.1% between Wantai and CLIA, and 56.8% between QRBD and CLIA. The kappa value between these three tests were 0.84 (95% CI 0.80–0.87), 0.22 (95% CI 0.19–0.24) and 0.26 (95% CI 0.23–0.28).

Conclusions

There was strong concordance between Wantai and QRBD test. Agreement between CLIA with other two tests was low. Wantai and QRBD tests measuring the antibody to same S protein can be used with high agreement based on the relevant scenario.
Experiencing motherhood as a blind mother in the Greater Accra Region of Ghana; a qualitative study
Authors: Acheampong Angela Kwartemaa , Marfo Margaret , Aziato Lydia
Published: December 2022

Background

Females in developing countries are likely to suffer from visual impairment more than their male counterparts. People living with blindness or any other form of disability also have the right to reproduce and care for their children like all other humans. There is paucity of literature in the experiences of blind mothers in Ghana. Therefore, this study explored the experiences of blind mothers as they navigated the process of motherhood.

Methods

Qualitative exploratory descriptive design was used to conduct the study. Nineteen blind mothers were interviewed individually. Permission was sought for data to be audiotaped, transcribed and content analyzed inductively.

Results

Three main themes emerged from the data: mothering role and difficulties (sub-themes; feeding, disciplining and protection), mothering challenges (sub-themes; discrimination and prejudice, financial distress and psychological distress) and coping strategies (prayer, children and self-motivation). Most of the mothers reported difficulties in playing their roles in the areas of feeding, disciplining and protection. Challenges were poverty, discrimination, prejudices on their ability to be mothers and psychological distresses such as depression. They coped with their challenges with prayers, self motivation and the hope they had in their children.

Conclusion

A lot of public education is needed to make the lives of people living with disability better. Health professionals must be trained to treat blind mothers with dignity and respect.
Automatic segmentation of hepatic metastases on DWI images based on a deep learning method: assessment of tumor treatment response according to the RECIST 1.1 criteria
Authors: Liu Xiang , Wang Rui , Zhu Zemin , Wang Kexin , Gao Yue , Li Jialun , Zhang Yaofeng , Wang Xiangpeng , Zhang Xiaodong , Wang Xiaoying
Published: December 2022

Background

Evaluation of treated tumors according to Response Evaluation Criteria in Solid Tumors (RECIST) criteria is an important but time-consuming task in medical imaging. Deep learning methods are expected to automate the evaluation process and improve the efficiency of imaging interpretation.

Objective

To develop an automated algorithm for segmentation of liver metastases based on a deep learning method and assess its efficacy for treatment response assessment according to the RECIST 1.1 criteria.

Methods

One hundred and sixteen treated patients with clinically confirmed liver metastases were enrolled. All patients had baseline and post-treatment MR images. They were divided into an initial (n = 86) and validation cohort (n = 30) according to the examined time. The metastatic foci on DWI images were annotated by two researchers in consensus. Then the treatment responses were assessed by the two researchers according to RECIST 1.1 criteria. A 3D U-Net algorithm was trained for automated liver metastases segmentation using the initial cohort. Based on the segmentation of liver metastases, the treatment response was assessed automatically with a rule-based program according to the RECIST 1.1 criteria. The segmentation performance was evaluated using the Dice similarity coefficient (DSC), volumetric similarity (VS), and Hausdorff distance (HD). The area under the curve (AUC) and Kappa statistics were used to assess the accuracy and consistency of the treatment response assessment by the deep learning model and compared with two radiologists [attending radiologist (R1) and fellow radiologist (R2)] in the validation cohort.

Results

In the validation cohort, the mean DSC, VS, and HD were 0.85 ± 0.08, 0.89 ± 0.09, and 25.53 ± 12.11 mm for the liver metastases segmentation. The accuracies of R1, R2 and automated segmentation-based assessment were 0.77, 0.65, and 0.74, respectively, and the AUC values were 0.81, 0.73, and 0.83, respectively. The consistency of treatment response assessment based on automated segmentation and manual annotation was moderate [K value: 0.60 (0.34–0.84)].

Conclusion

The deep learning-based liver metastases segmentation was capable of evaluating treatment response according to RECIST 1.1 criteria, with comparable results to the junior radiologist and superior to that of the fellow radiologist.
Exosome-transmitted circ_002136 promotes hepatocellular carcinoma progression by miR-19a-3p/RAB1A pathway
Authors: Yuan Peng , Song Jinhua , Wang Fei , Chen Baoan
Published: December 2022

Background

Circular RNAs (circRNAs) are enriched in exosomes and are extremely stable. Exosome-mediated intercellular transfer of specific biologically active circRNA molecules can drive the transformation of the tumor microenvironment and accelerate or inhibit the local spread and multifocal growth of hepatocellular carcinoma (HCC). In this study, we explored in depth about the biological roles of HCC cell-derived exosomes and exosome-transported circRNAs on HCC in vivo and in vitro.

Methods

Exosomes extracted from HCC cells (Huh7 and HA22T) were characterized using transmission electron microscopy, nanoparticle size tracer analysis, and western blotting. Exosomes were observed for endocytosis using fluorescent labeling. The effects of HCC cell-derived exosomes and the circ_002136 they carried on cell growth, metastasis and apoptosis were determined by CCK-8 assay, transwell assay, flow cytometry analysis and TUNEL staining, respectively. The expressions of circ_002136, miR-19a-3p and RAB1A were detected by quantitative RT-PCR (qRT-PCR). Targeted binding between miR-19a-3p and circ_002136 or RAB1A was predicted and verified by bioinformatics analysis, dual-luciferase reporter and RNA pull-down experiments. The in vivo effect of circ_002136 was determined by constructing a xenograft tumor model.

Results

The findings revealed that Huh7 and HA22T exosomes conferred enhanced viability as well as invasive ability to recipient HCC cells. Circ_002136 was shown for the first time to be differentially upregulated in HCC tissues and cells and transferred by HCC cell-derived exosomes. More importantly, selective silencing of circ_002136 depleted the malignant biological behaviors of HCC exosome-activated Huh7 and HA22T cells. Depletion of circ_002136 in vivo effectively retarded the growth of HCC xenograft tumors. Furthermore, a well-established circ_002136 ceRNA regulatory network was constructed, namely circ_002136 blocked miR-19a-3p expression, elevated RAB1A expression activity and stimulated HCC development. Finally, high levels of circ_002136 or RAB1A, as well as low levels of miR-19a-3p, negatively affected HCC patient survival.

Conclusion

The study on circ_002136 provides good data to support our insight into the mechanism of to-be-silenced circRNA as a therapeutic agent in the progression of HCC.
To what extent do Australian child and youth health, and education wellbeing policies, address the social determinants of health and health equity?: a policy analysis study
Authors: Littleton Clare , Reader Caitlin
Published: December 2022

Background

Children and youth are an important population group requiring specific policies to address their needs. In Australia, most children and youth are doing well, however, certain equity groups are not. To address child and youth health equity in policy, applying a social determinants of health approach is considered best practice. For over 10 years governments in Australia have been called upon to address the social determinants of health, however, there has been limited action. Health and education departments are typically most involved in policy development for children and youth. To date, there have been limited systematic analyses of Australian child and youth health policies, and selected education wellbeing policies, with a social determinants of health and health equity focus and this study aims to contribute to addressing this gap.

Methods

Policy analysis was conducted across 26 Australian child and youth health policies, and selected education wellbeing policies. We used an existing prior coding framework to understand the extent the social determinants of health and health equity were addressed. All policies were strategic level and only included if dated 2009 onwards.

Results

Across 26 selected policies only 10% of strategies addressed the social determinants of health, demonstrating a lack of policy action. However, there is relatively even focus on all developmental stages, and an increased focus on youth. Equity is acknowledged across most policies with some groups receiving more attention including Aboriginal and Torres Strait Islander children. The social determinants of health addressed, to some degree, include early childhood development, education, parental workplace conditions, healthy settings, and housing, those least mentioned include public transport and regulation.

Conclusion

This study demonstrates a lack of policy action on the social determinants of health within Australian child and youth health policy, and selected education wellbeing policies. Rather, the application of a siloed, and predominantly acute care approach. However, there is recognition of equity across all policies; an emphasis on housing as a determinant of health; and a link between health and education departments through education wellbeing policies, specifically addressing the issue of mental health.
Caries detection with tooth surface segmentation on intraoral photographic images using deep learning
Authors: Park Eun Young , Cho Hyeonrae , Kang Sohee , Jeong Sungmoon , Kim Eun-Kyong
Published: December 2022

Background

Intraoral photographic images are helpful in the clinical diagnosis of caries. Moreover, the application of artificial intelligence to these images has been attempted consistently. This study aimed to evaluate a deep learning algorithm for caries detection through the segmentation of the tooth surface using these images.

Methods

In this prospective study, 2348 in-house intraoral photographic images were collected from 445 participants using a professional intraoral camera at a dental clinic in a university medical centre from October 2020 to December 2021. Images were randomly assigned to training (1638), validation (410), and test (300) datasets. For image segmentation of the tooth surface, classification, and localisation of caries, convolutional neural networks (CNN), namely U-Net, ResNet-18, and Faster R-CNN, were applied.

Results

For the classification algorithm for caries images, the accuracy and area under the receiver operating characteristic curve were improved to 0.813 and 0.837 from 0.758 to 0.731, respectively, through segmentation of the tooth surface using CNN. Localisation algorithm for carious lesions after segmentation of the tooth area also showed improved performance. For example, sensitivity and average precision improved from 0.890 to 0.889 to 0.865 and 0.868, respectively.

Conclusion

The deep learning model with segmentation of the tooth surface is promising for caries detection on photographic images from an intraoral camera. This may be an aided diagnostic method for caries with the advantages of being time and cost-saving.
Frequency of cervical premalignant lesions in the gynecologic patients of a tertiary hospital in Mogadishu, Somalia
Authors: Kurtay Sabri , Ali Khadija Yusuf , Hussein Ahmed Issak
Published: December 2022

Background

Cervical cancer is the fourth most common cancer worldwide and is the most frequently diagnosed cancer in 23 countries and the most common cause of death in 36 countries, mostly from Sub-Saharan African countries. Cervical screening is a key element to reduce the incidence and mortality of cervical cancer. Cancer screening is low in Sub-Saharan Africa. This study aims to provide information about cervical premalignant lesions frequency in Somalia.

Methods

The pathology results of cervicovaginal smear samples obtained from patients aged 25–65 years who applied to the gynecology outpatient clinic between October 5 and December 5, 2021 were analyzed retrospectively. SPSS 22.0 was used for the statistical analysis of the data.

Result

Among the 497 results, 63 premalignant lesions were detected. The rate of premalignant lesions (63/497) was found to be 12.3%. The most common premalignant lesion was atypical squamous cells of undetermined significance (ASC-US).

Conclusion

In this study, the frequency of cervical premalignant lesions in Somalia was found to be higher than in the literature. Vaccination, screening, and early diagnosis are the most important components in the fight against cervical cancer. Access to vaccination, screening, and early diagnosis, which are the most important components in the fight against cervical cancer in Somalia, will be possible with the cooperation of the national health system and international organizations.
The impact of working in COVID-19 hospital on indonesian nurses’ mental health and wellbeing: a qualitative study
Authors: Asa Gregorius Abanit , Fauk Nelsensius Klau , Ratu Melkianus , Ward Paul Russell
Published: December 2022

Background

The outbreak of coronavirus disease (COVID-19) has impacted the lives of more than 580 million people and killed more than six million people globally. Nurses are one of the most impacted groups as they are at the frontline to fight against the virus and to try to save the lives of everyone affected. The present study aimed to explore the impact of working in COVID-19 wards on the mental health and wellbeing of nurses in the early stage of the pandemic in a hospital in East Nusa Tenggara, Indonesia.

Methods

A qualitative study was conducted with 22 nurses, recruited using purposive sampling. Data collection was conducted from April to May 2022 and data analysis was guided by qualitative framework analysis.

Results

The findings show that nurses experienced a range of mental health impacts including fear of being infected and infecting loved ones; fear of early death; psychological distress related to the conflict between the lack of personal protective equipment (PPE) and both professionalism and moral responsibility for patients; stress due to long waiting period to know the result of the COVID-19 tests; stress and worry due to public indifference and lack of role models; the negative impact of community doubt and distrust around COVID-19; and distress due to stigma and discrimination towards nurses caring for COVID-19 patients and their families.

Conclusions

The current findings indicate further psychological intervention programs to support nurses, especially the ones in resource poor settings and enhance their psychological resilience.
The development of the concept of return-on-investment from large-scale quality improvement programmes in healthcare: an integrative systematic literature review
Authors: Thusini S’thembile , Milenova Maria , Nahabedian Noushig , Grey Barbara , Soukup Tayana , Chua Kia-Chong , Henderson Claire
Published: December 2022

Background

Return on Investment (ROI) is increasingly being used to evaluate financial benefits from healthcare Quality Improvement (QI). ROI is traditionally used to evaluate investment performance in the commercial field. Little is known about ROI in healthcare. The aim of this systematic review was to analyse and develop ROI as a concept and develop a ROI conceptual framework for large-scale healthcare QI programmes.

Methods

We searched Medline, Embase, Global health, PsycInfo, EconLit, NHS EED, Web of Science, Google Scholar using ROI or returns-on-investment concepts (e.g., cost–benefit, cost-effectiveness, value). We combined this terms with healthcare and QI. Included articles discussed at least three organisational QI benefits, including financial or patient benefits. We synthesised the different ways in which ROI or return-on-investment concepts were used and discussed by the QI literature; first the economically focused, then the non-economically focused QI literature. We then integrated these literatures to summarise their combined views.

Results

We retrieved 10 428 articles. One hundred and two (102) articles were selected for full text screening. Of these 34 were excluded and 68 included. The included articles were QI economic, effectiveness, process, and impact evaluations as well as reports and conceptual literature. Fifteen of 68 articles were directly focused on QI programme economic outcomes. Of these, only four focused on ROI. ROI related concepts in this group included cost-effectiveness, cost–benefit, ROI, cost-saving, cost-reduction, and cost-avoidance. The remaining articles mainly mentioned efficiency, productivity, value, or benefits. Financial outcomes were not the main goal of QI programmes. We found that the ROI concept in healthcare QI aligned with the concepts of value and benefit, both monetary and non-monetary.

Conclusion

Our analysis of the reviewed literature indicates that ROI in QI is conceptualised as value or benefit as demonstrated through a combination of significant outcomes for one or more stakeholders in healthcare organisations. As such, organisations at different developmental stages can deduce benefits that are relevant and legitimate as per their contextual needs.

Trial registration

Review registration: PROSPERO; CRD42021236948.
Impact evaluation of long-lasting insecticidal nets distribution campaign on malaria cases reported at outpatient departments across all the regions in Ghana
Authors: Afagbedzi Seth Kwaku , Alhassan Yakubu , Guure Chris
Published: December 2022

Background

Malaria remains the biggest public health challenge globally, and Ghana is among the 15 highest burden malaria countries in the world, with 2% of global malaria cases and 3% deaths in 2019. This study sought to assess the impact of mass LLIN distribution campaign on malaria morbidity using all health facilities outpatient data across 15 regions of Ghana.

Methods

Data for this study was obtained from the DHIMS2 for health facilities providing OPD and malaria services in Ghana. This was an ecological study that employed the difference-in-difference approach to assess the change in proportion of uncomplicated confirmed malaria cases among OPDs in all types of health facilities in Ghana between 2015 and 2019 following the mass distribution campaign of LLINs in 2018. Malaria cases at the OPDs before and after the free LLIN mass distribution exercise were evaluated.

Results

The trend of the proportion of OPD cases that were confirmed uncomplicated malaria cases increased from 14.8% in 2015 to 18.9% in 2019 at the national level. The average proportion of malaria cases among OPDs in Ghana in 2019 reduced against the expected by − 3.76% (95% CI − 4.69 to − 2.84], p<0.001) among all cases, − 4.52% (95% CI [− 5.70 to − 3.34], p<0.001) among children under-fives years, − 4.10% (95% CI − 5.3 to 2.9], p<0.001) among female children under-five and − 5.18% (95% CI [− 6.33 to − 4.02], p<0.001) among male children under-five. The reduction on the average proportion of malaria cases among OPDs varied significantly across regions and the type of health facilities.

Conclusion

The mass distribution of LLINs across Ghana in 2018 can be associated with reduction in the proportion of malaria cases among OPDs across health facilities in Ghana. The study recommends the biannual mass distribution campaigns especially in the high-density regions.