bluuebunny/crossref_metadata_2025 huggingface dataset:
D-Dimer Trends Predict Recurrent Stroke in Patients with Cancer-Related Hypercoagulability
Authors: Fujinami Jun , Nagakane Yoshinari , Fujikawa Kei , Murata Shohei , Maezono Keiko , Ohara Tomoyuki , Mizuno Toshiki
Published: December 2023

Introduction: In patients with cancer-associated hypercoagulability (CAH)-related stroke, D-dimer trends after anticoagulant therapy may offer a biomarker of treatment efficacy. The purpose of this study was to clarify the association between D-dimer trends and recurrent stroke after anticoagulant therapy in patients with CAH-related stroke. Methods: We performed retrospective cohort study of consecutive patients with CAH-related stroke at two stroke centers from 2011 to 2020. The ratio of posttreatment to pretreatment D-dimer levels (post/pre ratio) was used as an indicator of D-dimer trends after anticoagulant therapy. Fine-Gray models were used to evaluate the association between post/pre ratio and recurrent stroke. Results: Among 360 acute ischemic stroke patients with active cancer, 73 patients with CAH-related stroke were included in this study. Recurrent stroke occurred in 13 patients (18%) during a median follow-up time of 28 days (interquartile range, 11–65 days). Multivariate analysis revealed that high post/pre ratio was independently associated with recurrent stroke (per 0.1 increase: hazard ratio 2.20, 95% confidence interval 1.61–3.01, p = 0.012). Conclusion: D-dimer levels after anticoagulant therapy were associated with recurrent stroke in CAH-related stroke patients. Patients with neutral trends in high D-dimer levels after anticoagulant therapy were at high risk of recurrent stroke.
Emergency removal of transplanted graft due to the failure of clinical treatment of serious acute rejection in case of small bowel transplantation: case report
Authors: Araujo Bruno Camargo Rocha Paim de , Rosati Maria Paula Arantes , Galvão Flavio Henrique Ferreira , Waisberg Daniel Reis , D’Albuquerque Luiz Augusto Carneiro
Published: December 2023

Introduction: Intestinal transplantation is a complex procedure that has become more common in recent years. It can be performed isolated or with other organs of the digestive tract, which characterizes a multivisceral transplantation. Its indication mainly involves patients with irreversible intestinal failure, submitted or not to an enterectomy, and who have complications from parenteral nutrition. Among the main difficulties after transplantation is the immunosuppressive therapy, since the small intestine is an extremely immunogenic organ. Insufficient immunosuppression may cause graft rejection, but excessive immunosuppression may lead to Graft vs. Host Disease, where the intestine’s own immune cells attack Host organs. In Brazil, however, the practical experience with this type of surgery and with the management of immunosuppressive therapy is restricted because of the reduced number of small bowel transplants performed. Objective: To report a case of small bowel transplantation with graft rejection and necessity of surgical removal of the graft. Case Report: A male patient, 21 years old, presented a complicated acute appendicitis in July 2015, being submitted to appendectomy and right colectomy. After the operation, he developed thrombosis and intestinal infarction. This complication affected more than 90% of the patient’s small bowel, requiring extensive enterectomy. The patient developed short bowel syndrome and relied on parenteral nutrition. After 7 months in the home parenteral nutrition regimen, the patient underwent small bowel transplantation due to complications of parenteral nutrition. Immunosuppressive therapy was based on the use of tacrolimus. The patient presented no intercurrences until the 6th postoperative month, when he developed systemic histoplasmosis, staying 33 days in the intensive care unit. He presented resolution of the condition with itraconazole. At the 18th postoperative month, he was admitted with fever and intense diarrhea. The ileoscopy examination showed intestinal ulcers and loss of villi. Graft biopsies were consistent with severe acute T cell mediated rejection. The patient was transferred to our institution to treat the rejection. The combined use of increased tacrolimus, pulse therapy with methylprednisolone, use of thymoglobulin and use of monoclonal antibody against tumor necrosis factor alpha were not effective. The patient`s general condition deteriorated and he had to be submitted to urgent removal of the transplanted graft. The patient returned to the parenteral nutrition regimen and underwent reconstruction of the digestive tract with anastomosis between jejunum and transverse colon 5 months after grafting. Currently, he is in outpatient follow-up using home parenteral nutrition.
A comparison of two bronchial anastomotic techniques in lung transplantation by means of tridimensional tomographic analysis:
Authors: Carvalhal Gnipper Guilherme , Dias Yuri Tebelskis Nunes , Nogueira Filho João Madison , Chate Rodrigo Caruso , Samano Marcos Naoyuki
Published: December 2023

Background: The objective of this study was to compare two different techniques of bronchial anastomosis in lungtransplant, assessing differences in bronchial narrowing post-surgery.Methods: The surgical team at our center switched between simple stitches to continuous suture to anastomose the anterior bronchial wall in lung transplant procedures. CT scans of the patients obtained three months after the surgery were subject to analysis. The cross section area of the airway at the point of anastomosis was compared with an average of the cross sections of the bronchus 5mm proximal and distal to the point of anastomosis, determining the anastomotic index (AI). Data of 32 bronchi anastomosed with continuous suture from 19 patients were compared to data of 37 bronchi anastomosedwith interrupted suture from 20 patients.Results: Multivariate analysis showed significant difference in bronchial diameter reduction between patients subjected to the two techniques, with no difference between the two sides in any of the groups. The bronchi anastomosed with simple stitches had a significantly larger AI than those anastomosed with running suture (mean AI 0.98 vs 0.82, p < 0.001). A significantly larger number of bronchi subjected to this method had their AI greater than 1 comparing to bronchi anastomosed with a running suture (13 vs 1, p < 0.001).Discussion: The use of simple stitches to join the anterior bronchial wall surpasses a running suture in terms of bronchial narrowing. The interrupted suture technique seems to result in a mechanical widening at the point of anastomosis.
Giant cerebral abscess in pediatric patient
Authors: Carvalho Gabriela de Oliveira , Costa Bruna Diuly Santos , Balsamão Cecília Braga , Gomes Izabela Caroline Prado , Mattos Letícia Luísa , Henriques José Gilberto de Brito
Published: December 2023

Introduction: Brain abscess is a focal infection consisting of purulent collection, encapsulated in the brain parenchyma. The term “giant” has a subjective character because there is no specific definition concerning the measure of the lesion. The most common etiology includes Streptococcus, Staphylococcus, gram-negative and the first two decades of life are the most affected age group. Its pathogenesis occurs by contiguity, hematogenous or metastasis. The clinical presentation is variable and requires treatment with antibiotic therapy and possible surgical approaches. Giant abscesses are rare and rarely occur without apparent clinical manifestations. Objective: Report a patient with a giant brain abscess who was diagnosed on a routine examination.
leading conduct in renovascular hypertension
Authors: Paula Bruna Marquez Rodrigues de , Sá Kamilla Mayr Martins , Sales Elizabeth Barbosa Oliveira
Published: December 2023

Introduction: The Renovascular hypertension (RH) is the leading cause of secondary hypertension. The main cause for RH is renal arterial stenosis and with early treatment is possible to reverse the clinical state. Therefore, the diagnosis and choice of a proper treatment are extremely important, especially in this pathology.Methodology: Thus, this paper aimed to conduct a narrative review, using articles from indexed journals and narrative and systematic reviews of Medline, SciELO and Cochrane CENTRAL databases, comparing comparing the use of stent in cirurgical intervention versus the use of medical drugs in the treatment of RH. Results: In none of the studies (RADAR, RAOOD) or systemic reviews or metaanalysee was observed the restoration of renal function. Discussion: The diseases occur due to decreased blood flow of the renal artery, usually by an atheroma plaque. The physiopathology of RH disease consists in the interaction between the renin-angiotensin-aldosterone system (RAAS), that when activated is responsible for sodium and volume retention, combined with other pressure systems such as Sympathetic Nervous System. RH treatment can be performed through drug therapy, mainly ACE inhibitors or through surgical intervention with stent placement. Conclusion: The conclusion observed was that the efficiency of the stent when combined with the use of pharmacos, obtaining an improvement in the clinical picture.
Participation of medical students in actions against COVID-19 for commitment and social responsibility
Authors: Souza Letícia Lima de , Nascimento Bruna Ilda Maria Joaquina do , Santos Luiza Silveira dos , Weber João Victor Lehmkuhl Azeredo , Hasenohr Jéssica dos Santos , Ferreira Júlia Anesi Saavedra Granato , Willmer William Frederic de Araújo
Published: December 2023

Introduction: To meet the demands and needs arising from COVID-19, the Universitary Hospital promoted volunteer activities among medical students in order to ensure Brazilian Unique Health System’s principles and guidelines at the health care service. The objective of this work is report the extension activities of the academic league students in a polyclinic linked to the unity. Methodology: This was an extension activity executed by 7 students from the second to the fifth year of the medical course, members of the academic league. The activity lasted five months, from March 2020 to July. Under the supervision of a multidisciplinary team, the students performed paramentation and disposal of personal protective equipment. Then, they were distributed to the screening care, testing and epidemiological surveillance departments. The procedures included data collection, rapid percutaneous testing, nasal swab testing for perform PCR-RT, following up of medical appointments and recording of confirmed cases on the Ministry of Health’s platform. In addition, they participated training in ultrasound handle and orotracheal intubation equipment usage training. The target audience were patients who were under regular treatment in the unit before the pandemic, as well as health professionals from diferent parts of the state with clinical symptoms suggestive of COVID-19. Results: The unit became a reference in the diagnosis, treatment and regulation of these patients for high complexity hospitals. In this feeling, of the volunteers participation was important in contributing to and assisting the health care service. Discussion: As a challenge, these individuals had the opportunity to go through the experience that is part of health professional’s routine that was explicitly evidenced in this pandemic scenario, especially in relation to work overload, stressful routine and contamination risk, including carrying it into the family environment. Conclusion: Despite the atypical scenario, the practical learning obtained about the SAR-COV-2 pathophysiology and other gripal syndromes differential diagnosis, besides the empathy strengthening in the doctor-patient relationship during the reception, were fundamental in the professional exercising, including integration with other careers that constitute body health.
Utilização da algometria e termografia infravermelha como instrumentos de avaliação da dor: uma revisão sistemática
Authors: Vitorino Cristiano Franco , Silva Natália Cristina de Oliveira Vargas e , Alfieri Fabio Marcon
Published: December 2023

A termografia infravermelha é uma técnica utilizada para diagnóstico complementar da dor, através da apresentação de imagens térmicas com uma câmera infravermelha que mensura a temperatura da superfície do corpo. A algometria de pressão é um método objetivo que busca quantificar a dor em pontos determinados. Ambas as técnicas vem sido empregadas para finalidades diagnósticas. Objetivo: Revisar a literatura acerca das publicações que abordaram a utilização da termografia e algometria em conjunto como instrumentos de avaliação da dor. Método: Trata-se de uma revisão sistemática nas bases de dados Pubmed, Bireme e Scielo utilizando os seguintes descritores: “thermography” AND “pain threshold”, e “termografia” AND “tolerância à dor”, sem limitação por data de publicação, em inglês e português, no mês de setembro de 2022. Os critérios de elegibilidade para os estudos foram: utilização da termografia em conjunto com a algometria na busca do desfecho variação da temperatura em processos dolorosos crônicos em seres humanos. Resultados: A busca resultou em trinta e dois estudos, e após a análise dos resumos, vinte e dois foram excluídos por não preencherem os critérios de inclusão, restando dez que foram lidos na íntegra e que compuseram a presente revisão. Conclusão:  Apesar da algometria e termografia se apresentarem como técnicas pragmaticamente válidas no estudo da dor, esta revisão mostrou que poucos estudos incluíram em seu desenho a combinação destas técnicas como instrumentos de avaliação.
Robotic gait training in patients with cerebral palsy: a retrospective analysis
Authors: Maglione Andréa Vancetto , Galvão Maria Cristina dos Santos , Ozu Márcia Harumi Uema , Misao Maria Harue , Narumia Lisa Carla
Published: December 2023

Objective: The present study sought to retrospectively evaluate the efficacy of robotic gait training in children with cerebral palsy (CP) gross motor function classification system (GMFCS) levels II, III and IV. Method: The medical records from 69 patients with CP, who participated in the Lokomat® protocol, were analyzed using a retrospective approach. The results from the Gross Motor Function Measure (GMFM), 6-minute walk test (6MinWT), 10-meter walk test (10MWT) and Timed Up and Go (TUG) test were analyzed before and after the protocol was administered. Results:  An improvement in GMFM was observed for all GMFCS levels. GMFCS level III patients showed a significant improvement in the 6MinWT (p= 0.01), and GMFCS level IV patients displayed a significant improvement in GMFM dimension B (p= 0.03). All tests showed a significant improvement when compared to their performance before the application of the protocol. Conclusion: The study suggests that all patients diagnosed with CP benefit from gait training, using the Lokomat® system, within their expected motor frame.
Importance of Health Policy and Systems Research for Strengthening Rehabilitation in Health Systems: a call to action to accelerate progress
Authors: Frontera Walter , Groote Wouter De , Ghaffar Abdul
Published: December 2023

During the last few decades, the field of rehabilitation has experienced substantial development, growth, and acceptance. Rehabilitation addresses the impact of a health condition on a person’s everyday life by optimizing their functioning and reducing their experience of disability. Rehabilitation expands the focus of health beyond preventative and curative care to ensure people with a health condition can remain as independent as possible and participate in education, work, and meaningful life roles.1 A definition of rehabilitation for research purposes has been recently published.2 Scientific and clinical research have generated a body of knowledge that strongly supports the use of many rehabilitation interventions with positive outcomes in various populations and health conditions.
The Role of International Trade Law in the Energy Transition
Authors: Asmelash Henok
Published: December 2023

The key to tackling climate change and other environmental concerns primarily lies in the transition away from fossil fuels. Making this transition happen in a just and timely manner requires rapid and radical changes not only to energy sources and technologies but also to the broader socioeconomic and legal assemblages that are built around energy production and consumption. International trade law is one of the critical legal assemblages that can help accelerate or hinder the energy transition. This article focuses on the multilateral trading system and examines the role of international trade law in the energy transition. It argues that existing international trade rules are more likely to impede than accelerate the energy transition and that urgent reform is necessary to ensure that international trade law plays a constructive role in the transition towards a sustainable energy future.
The European Investment Bank Complaints Mechanism: Its Potential and Limitations
Authors: Kula Ayşegül
Published: December 2023

The European Investment Bank Complaint Mechanism (EIB CM) reviews complaints about acts or omissions of the European Investment Bank (EIB) for non-compliance with the EIB’s obligation and proposes corrective solutions. This article analyzes the potential and limitations of the EIB CM as an accountability mechanism. It reviews the EIB CM’s case law related to the environmental and social impacts of financed projects and makes comparisons with the operating documents of the accountability mechanisms of other development banks. The analysis indicates that, despite several shortcomings, the complaints review of the EIB CM has significant potential.
Irrigated Agriculture Significantly Modifies Seasonal Boundary Layer Atmosphere and Lower-Tropospheric Convective Environment
Authors: Lachenmeier Emilee , Mahmood Rezaul , Phillips Chris , Nair Udaysankar , Rappin Eric , Pielke Roger A. , Brown William , Oncley Steve , Wurman Joshua , Kosiba Karen , Kaulfus Aaron , Santanello Joseph , Kim Edward , Lawston-Parker Patricia , Hayes Michael , Franz Trenton E.
Published: December 2023

Modification of grasslands into irrigated and nonirrigated agriculture in the Great Plains resulted in significant impacts on weather and climate. However, there has been lack of observational data–based studies solely focused on impacts of irrigation on the PBL and convective conditions. The Great Plains Irrigation Experiment (GRAINEX), conducted during the 2018 growing season, collected data over irrigated and nonirrigated land uses over Nebraska to understand these impacts. Specifically, the objective was to determine whether the impacts of irrigation are sustained throughout the growing season. The data analyzed include latent and sensible heat flux, air temperature, dewpoint temperature, equivalent temperature (moist enthalpy), PBL height, lifting condensation level (LCL), level of free convection (LFC), and PBL mixing ratio. Results show increased partitioning of energy into latent heat relative to sensible heat over irrigated areas while average maximum air temperature was decreased and dewpoint temperature was increased from the early to peak growing season. Radiosonde data suggest reduced planetary boundary layer (PBL) heights at all launch sites from the early to peak growing season. However, reduction of PBL height was much greater over irrigated areas than over nonirrigated croplands. Relative to the early growing period, LCL and LFC heights were also lower during the peak growing period over irrigated areas. Results note, for the first time, that the impacts of irrigation on PBL evolution and convective environment can be sustained throughout the growing season and regardless of background atmospheric conditions. These are important findings and applicable to other irrigated areas in the world.

Significance Statement

To meet the ever-increasing demand for food, many regions of the world have adopted widespread irrigation. The High Plains Aquifer (HPA) region, located within the Great Plains of the United States, is one of the most extensively irrigated regions. In this study, for the first time, we have conducted a detailed irrigation-focused land surface and atmospheric data collection campaign to determine irrigation impacts on the atmosphere. This research demonstrates that irrigation significantly alters lower atmospheric characteristics and creates favorable cloud and convection development conditions during the growing season. The results clearly show first-order impacts of irrigation on regional weather and climate and hence warrant further attention so that we can minimize negative impacts and achieve sustainable irrigation.
Review of machine learning and deep learning models for toxicity prediction
Authors: Guo Wenjing , Liu Jie , Dong Fan , Song Meng , Li Zoe , Khan Md Kamrul Hasan , Patterson Tucker A , Hong Huixiao
Published: December 2023

The ever-increasing number of chemicals has raised public concerns due to their adverse effects on human health and the environment. To protect public health and the environment, it is critical to assess the toxicity of these chemicals. Traditional in vitro and in vivo toxicity assays are complicated, costly, and time-consuming and may face ethical issues. These constraints raise the need for alternative methods for assessing the toxicity of chemicals. Recently, due to the advancement of machine learning algorithms and the increase in computational power, many toxicity prediction models have been developed using various machine learning and deep learning algorithms such as support vector machine, random forest, k-nearest neighbors, ensemble learning, and deep neural network. This review summarizes the machine learning- and deep learning-based toxicity prediction models developed in recent years. Support vector machine and random forest are the most popular machine learning algorithms, and hepatotoxicity, cardiotoxicity, and carcinogenicity are the frequently modeled toxicity endpoints in predictive toxicology. It is known that datasets impact model performance. The quality of datasets used in the development of toxicity prediction models using machine learning and deep learning is vital to the performance of the developed models. The different toxicity assignments for the same chemicals among different datasets of the same type of toxicity have been observed, indicating benchmarking datasets is needed for developing reliable toxicity prediction models using machine learning and deep learning algorithms. This review provides insights into current machine learning models in predictive toxicology, which are expected to promote the development and application of toxicity prediction models in the future.
Macrophage infiltration in 3D cancer spheroids to recapitulate the TME and unveil interactions within cancer cells and macrophages to modulate chemotherapeutic drug efficacy
Authors: Singh Khushwant , Gautam Pramod K.
Published: December 2023

Background

Recapitulating the tumor microenvironment (TME) in vitro remains a major hurdle in cancer research. In recent years, there have been significant strides in this area, particularly with the emergence of 3D spheroids as a model system for drug screening and therapeutics development for solid tumors. However, incorporating macrophages into these spheroid cultures poses specific challenges due to the intricate interactions between macrophages and cancer cells.

Methods

To address this issue, in this study, we established a reproducible healthy multicellular 3D spheroid culture with macrophage infiltrates in order to mimic the TME and modulate the drug’s efficacy on cancer cells in the presence of macrophages. A 3D spheroid was established using the human cancer cell line CAL33 and THP1 cell derived M0 macrophages were used as a source of macrophages. Cellular parameters including tumour metabolism, health, and mitochondrial mass were analysed in order to establish ideal conditions. To modulate the interaction of cancer cells with macrophage the ROS, NO, and H2O2 levels, in addition to M1 and M2 macrophage phenotypic markers, were analyzed. To understand the crosstalk between cancer cells and macrophages for ECM degradation, HSP70, HIF1α and cysteine proteases were examined in spheroids using western blotting and qPCR.

Results

The spheroids with macrophage infiltrates exhibited key features of solid tumors, including cellular heterogeneity, metabolic changes, nutrient gradients, ROS emission, and the interplay between HIF1α and HSP70 for upregulation of ECM degradading enzymes. Our results demonstrate that tumor cells exhibit a metabolic shift in the presence of macrophages. Additionally, we have observed a shift in the polarity of M0 macrophages towards tumor-associated macrophages (TAMs) in response to cancer cells in spheroids. Results also demonstrate the involvement of macrophages in regulating HIF-1α, HSP70, and ECM degradation cysteine proteases enzymes.

Conclusions

This study has significant implications for cancer therapy as it sheds light on the intricate interaction between tumor cells and their surrounding macrophages. Additionally, our 3D spheroid model can aid in drug screening and enhance the predictive accuracy of preclinical studies. The strength of our study lies in the comprehensive characterization of the multicellular 3D spheroid model, which closely mimics the TME.
Perspectives on implementing Individual Placement and Support (IPS) within primary health care settings for adults living in British Columbia, Canada
Authors: Kwan Amanda , Berinstein Stephany , Morris Jonathan , Barbic Skye
Published: December 2023

Background

Individual placement and support (IPS) is an evidence-based practice (EBP) designed to help people with severe mental illness re-enter the labour market. Implementing an IPS program within a new context (e.g., primary health care setting) to support populations that are complex and multi-barriered presents a set of unique challenges and considerations. This paper provides community-based perspectives that identify implementation strengths and challenges and highlights potential strategies aimed at addressing emergent barriers.

Methods

A case study was conducted across three community health centres in British Columbia (BC), Canada, where a novel IPS program was embedded within primary care services. Data collection consisted of open-ended surveys and focus groups with service providers directly involved in program implementation and their associated clinical and managerial support teams (n = 15). Using the updated Consolidated Framework for Implementation Research (CFIR) as a guide, we performed deductive thematic analysis to identify key areas impacting IPS implementation.

Results

Integration with existing health care systems and primary health care teams and support from leadership across all levels were identified as both key facilitators and barriers to implementation. Facilitators and barriers were identified across all domains, with those within innovation and process most easily addressed. Four cross-cutting themes emerged for promoting more integrated and sustainable program implementation: investing in pre-implementation activities, supporting a dynamic and flexible program, building from community experiences, and developing a system for shared knowledge.

Conclusions

Implementing an IPS program embedded within primary health care settings is complex and requires extensive planning and consultation with community-based service providers and decision-makers to achieve full integration. Future practice and policy decisions aimed at supporting employment and well-being should be made in collaboration with communities.
Acceptability of workplace choice architecture modification for healthy behaviours
Authors: Rantala Eeva , Vanhatalo Saara , Perez-Cueto Federico J. A. , Pihlajamäki Jussi , Poutanen Kaisa , Karhunen Leila , Absetz Pilvikki
Published: December 2023

Background

Altering the choice architecture of decision contexts can assist behaviour change, but the acceptability of this approach has sparked debate. Considering hypothetical interventions, people generally welcome the approach for promoting health, but little evidence exists on acceptance in the real world. Furthermore, research has yet to explore the implementers’ perspective, acknowledging the multidimensionality of the acceptability construct. Addressing these knowledge gaps, this study evaluated the acceptability of a quasi-experimental implementation-effectiveness trial that modified the worksite choice architecture for healthy eating and daily physical activity.

Methods

Fifty-three worksites participated in the 12-month intervention and implemented altogether 23 choice architecture strategies (Mdn 3/site), including point-of-choice prompts and changes to choice availability or accessibility. Retrospective acceptability evaluation built on deductive qualitative content analysis of implementer interviews (n = 65) and quantitative analysis of an employee questionnaire (n = 1124). Qualitative analysis examined implementers’ thoughts and observations of the intervention and its implementation, considering six domains of the Theoretical Framework of Acceptability: ethicality, affective attitude, burden, intervention coherence, opportunity costs, and perceived effectiveness. Quantitative analysis examined employees’ acceptance (7-point Likert scale) of eight specific intervention strategies using Friedman test and mixed-effects logistic regression.

Results

Implementers considered the choice architecture approach ethical for workplace health promotion, reported mostly positive affective attitudes to and little burden because of the intervention. Intervention coherence supported acceptance through increased interest in implementation, whereas low perceived utility and high intensity of implementation reduced cost acceptance. Perceived effectiveness was mixed and varied along factors related to the implementer, social/physical work environment, employer, and employee. Employees showed overall high acceptance of evaluated strategies (Mdn 7, IQR 6.4–7), though strategies replacing unhealthy foods with healthier alternatives appeared less supported than providing information or enhancing healthy option availability or accessibility (p-values < 0.02). Greater proportion of male employees per site predicted lower overall acceptance (OR 4.4, 95% CI 1.2–16.5).

Conclusions

Work communities appear to approve workplace choice architecture interventions for healthy eating and physical activity, but numerous factors influence acceptance and warrant consideration in future interventions. The study contributes with a theory-based, multidimensional evaluation that considered the perspectives of implementers and influenced individuals across heterogeneous real-world settings.
Analysis of immunophenotypic features in hyaline vascular type Castleman disease
Authors: Chang Yu , Ma Yu , Chang Chen , Li Wensheng
Published: December 2023

Background

Studies suggested that the immunophenotype of hyaline vascular type Castleman disease (HVCD) lacked characteristics, which was easy to be confused with other diseases.

Methods

From January 2010 to June 2022, 17 cases of HVCD were selected from the Department of Pathology of Shaanxi Provincial People’s Hospital and the Department of Pathology of Shaanxi Provincial Cancer Hospital. 13 cases of reactive hyperplastic lymph nodes (RHL) and 11 cases of follicular lymphoma (FL) were selected as the control group. All cases were performed CD3, CD20, CD21 and BCL2 immunohistochemical staining.

Results

(i) In 17 cases of HVCD, the negative area of BCL2 of germinal center was significantly smaller than the negative area of CD3 of germinal center. However, in 13 cases of RHL, the negative area of CD3 of germinal center was basically consistent with the negative area of germinal center of BCL2 of germinal center. In 11 cases of FL, in neoplastic follicles, the negative area of CD3 was basically consistent with the positive area of BCL2. The difference between HVCD group and other two groups of diseases was statistically significant (P < 0.05). (ii) In 17 cases of HVCD, the negative area of BCL2 of germinal center was significantly smaller than the follicular dendritic cell (FDC) meshworks expressed by CD21. However, in 13 cases of RHL, the FDC meshworks expressed by CD21 were basically consistent with the negative area of BCL2 of germinal center. In 11 cases of FL, in neoplastic follicles, the FDC meshworks expressed by CD21 was basically consistent with the positive area of BCL2. The difference between HVCD group and other two groups of disease was statistically significant (P < 0.05).

Conclusions

HVCD has unique immunophenotypic characteristics. The negative area of BCL2 of germinal center is significantly smaller than the negative area of CD3. The negative area of the BCL2 of germinal center is significantly smaller than the FDC meshworks expressed by CD21. These two immunophenotypic features in HVCD are very important in diagnosis and differential diagnosis.
Optimising child and adolescent mental health care – a scoping review of international best-practice strategies and service models
Authors: Jeindl Reinhard , Hofer Viktoria , Bachmann Christian , Zechmeister-Koss Ingrid
Published: December 2023

Background

Psychiatric disorders are among the most common health problems in children and adolescents, with a recent prevalence rise due to the COVID-19 pandemic. The increasing demand for service provision in this patient population, together with infrastructural, financial and staff limitations in child and adolescent mental health services, calls for an adaptation/advancement of current models of service provision. This review offers an internationally informed overview of best-practice child and adolescent mental health (CAMH) strategies and care models, with the aim of assisting decision-makers in implementing topical CAMH care models.

Methods

Using a pre-defined structured search strategy, we aimed to identify core topics within published CAMH strategies and care model documents from seven countries within the Global North, which represented a range of differing healthcare systems, geographical regions, and public health traditions. From the retrieved documents, we then systematically extracted data in an iterative process, and summarised these narratively by applying qualitative content analyses.

Results

Our search retrieved the following key components of CAMH strategies: awareness-raising activities, prevention/promotion, detection, treatment, telemedicine, care pathways, transitional psychiatry, vulnerable patient groups, user participation, infrastructure, workforce development, implementation, digital case management tools, and data acquisition/research. Recommendations for CAMH care organisation often followed a public mental health approach, with a focus on mental health promotion, cross-sectional organisation, and funding of CAMH care services. As key principles of best-practice CAMH care models, we identified increased flexibility of care settings, early intervention, and a strengths-oriented approach, with overarching mental health services research alongside.

Conclusion

In order to design robust models of CAMH care and to mitigate current shortcomings, actions on the policy level (e.g., CAMH strategy development with a focus on mental health promotion, installation of cross-sectoral governance), at the organisational level (e.g., re-organisation of treatment settings and pathways of care) and at the individual level (e.g., user involvement, workforce development) are recommended. To this purpose, we strongly advocate the use of cross-sectoral and participatory approaches for CAMH care structures with accompanying health services research.
Homogeneous oxidation of SO2 in the tail gas incinerator of sulfur recovery unit
Authors: Xi Zhao , Tong Ding , Honggang Chang , Jinjin Li
Published: December 2023

The formation and emission of sulfur trioxide (SO3) in sulfur recovery unit has received increasing attention due to its adverse effects on the operation of plant and environment. Due to the excess oxygen, high concentration of SO2 and high temperature, SO3 formation in the sulfur recovery unit tail gas incinerator may significantly increase. A small horizontal tube reactor was employed to simulate the homogeneous oxidation of SO2 in the tail gas incinerator. The SO3 concentration was measured with a controlled condensation method at the outlet of the reactor. The present work focuses on the gas-phase chemistry and examines the impact of different combustion parameters and atmospheres on the formation of SO3 in the tail gas incinerator. Experiment results show that the increased O2 and SO2 concentrations along with increasing temperature are favorable for enhancing SO3 formation over the range of tested parameters. The presence of water vapor has an enhancing effect of SO2 oxidation in the experiments conducted. No significant effect of CO2 was found to the oxidation of SO2.
Physical activity has a more beneficial effect on the risk of all-cause mortality in patients with metabolic syndrome than in those without
Authors: Lee Chang-Hoon , Han Kyung-Do , Kwak Min-Sun
Published: December 2023

Background

It has not been clarified whether physical activity (PA) has more benefit in terms of health outcomes, including mortality risk, among those with metabolic syndrome (MS) compared to those without. Therefore, the aim of this study is to elucidate whether regular PA has interaction with MS on health outcomes.

Methods

Participants with no underlying cardiovascular diseases who underwent national health screening in 2009 were included. According to the metabolic equivalent (MET)-minutes/week, the amount of PA among the participants was grouped as follows: Group 1 (0 MET-minutes/week), Group 2 (1–499), Group 3 (500–999), Group 4 (1000–1499), and Group 5 (≥ 1500). Multivariable Cox proportional hazard models were applied to evaluate the impacts of the amount of PA on health outcomes among those with and without MS. Health outcomes included all-cause mortality and incident cardiovascular diseases (CVDs).

Results

Of 9,628,109 total participants, 335,970 deaths occurred during a median 8.3-year follow-up. After adjustment for age, sex, smoking status, alcohol consumption, and body mass index, the higher the PA amount was, the lower the risk of all-cause mortality in both those with MS [adjusted hazard ratio (aHR) compared with Group 1, 0.86 (95% CI 0.85, 0.87) in Group 2; 0.82 (95% CI 0.81, 0.83) in Group 3; 0.75 (95% CI 0.74, 0.77) in Group 4; and 0.78 (95% CI 0.76, 0.80) in Group 5; P for trend < 0.001] and those without MS [aHR compared with Group 1, 0.87 (95% CI 0.86, 0.88) in Group 2; 0.84 (95% CI 0.83, 0.85) in Group 3, 0.79 (95% CI 0.78, 0.80) in Group 4, and 0.82 (95% CI 0.81, 0.84) in Group 5; P for trend < 0.001]. The beneficial effects of the amount of PA on all-cause mortality were larger among those with MS than among those without MS in a multiplicative interaction (P for interaction < 0.001). The results were similar in the analysis of the relationship between the PA amount and incident CVD.

Conclusions

More PA was associated with a lower risk of all-cause mortality, which was more prominent in those with MS than in those without MS. Physicians should emphasize more the importance of PA in patients with MS.
Deep learning-based segmentation of multisite disease in ovarian cancer
Authors: Buddenkotte Thomas , Rundo Leonardo , Woitek Ramona , Escudero Sanchez Lorena , Beer Lucian , Crispin-Ortuzar Mireia , Etmann Christian , Mukherjee Subhadip , Bura Vlad , McCague Cathal , Sahin Hilal , Pintican Roxana , Zerunian Marta , Allajbeu Iris , Singh Naveena , Sahdev Anju , Havrilesky Laura , Cohn David E. , Bateman Nicholas W. , Conrads Thomas P. , Darcy Kathleen M. , Maxwell G. Larry , Freymann John B. , Öktem Ozan , Brenton James D. , Sala Evis , Schönlieb Carola-Bibiane
Published: December 2023

Purpose

To determine if pelvic/ovarian and omental lesions of ovarian cancer can be reliably segmented on computed tomography (CT) using fully automated deep learning-based methods.

Methods

A deep learning model for the two most common disease sites of high-grade serous ovarian cancer lesions (pelvis/ovaries and omentum) was developed and compared against the well-established “no-new-Net” framework and unrevised trainee radiologist segmentations. A total of 451 CT scans collected from four different institutions were used for training (n = 276), evaluation (n = 104) and testing (n = 71) of the methods. The performance was evaluated using the Dice similarity coefficient (DSC) and compared using a Wilcoxon test.

Results

Our model outperformed no-new-Net for the pelvic/ovarian lesions in cross-validation, on the evaluation and test set by a significant margin (p values being 4 × 10–7, 3 × 10–4, 4 × 10–2, respectively), and for the omental lesions on the evaluation set (p = 1 × 10–3). Our model did not perform significantly differently in segmenting pelvic/ovarian lesions (p = 0.371) compared to a trainee radiologist. On an independent test set, the model achieved a DSC performance of 71 ± 20 (mean ± standard deviation) for pelvic/ovarian and 61 ± 24 for omental lesions.

Conclusion

Automated ovarian cancer segmentation on CT scans using deep neural networks is feasible and achieves performance close to a trainee-level radiologist for pelvic/ovarian lesions.

Relevance statement

Automated segmentation of ovarian cancer may be used by clinicians for CT-based volumetric assessments and researchers for building complex analysis pipelines.

Key points

• The first automated approach for pelvic/ovarian and omental ovarian cancer lesion segmentation on CT images has been presented.

• Automated segmentation of ovarian cancer lesions can be comparable with manual segmentation of trainee radiologists.

• Careful hyperparameter tuning can provide models significantly outperforming strong state-of-the-art baselines.

Graphical Abstract
SARS-CoV-2 induced urinary tract infection in an infant: a rare case
Authors: Habib Murad , Ahmed Mansoor , Raza Rafi , Babar Sibghatullah , Chaudhary Muhammad Amjad
Published: December 2023

Background

The incidence of SARS-CoV-2 infection in pediatric population is less than 7% that too when associated with a urinary tract infection, the presentation is very rare. There have been numerous case reports in adults and adolescent population but very few in pediatrics and none in our socioeconomic.

Case presentation

We present here the case of a 1-year-old boy with SARS-CoV-2 induced urinary tract infection whose urine biochemistry showed severe urinary tract infection but no hematuria. His COVID-PCR was positive. His chest radiograph showed bilateral lung infiltrates with peri-hilar lymphadenopathy. His computerized tomography scan showed infiltrates with lung fibrosis. He was admitted to the isolation ward, successfully managed, and discharged home after 5 days of in-hospital treatment.

Conclusion

Pediatricians and pediatric emergency physicians should be vigilant and well aware of the atypical presentation of SARS-CoV-2 infection in infants and children, as they can present with both gastrointestinal and renal manifestations. And once missed, the patient may end up with devastating complications.
Patients Age 40 Years and Younger With Multiple Myeloma Have the Same Prognosis as Older Patients: An Analysis of Real-World Patients' Evidence From Latin America
Authors: Martínez-Cordero Humberto , Peña Camila , Schutz Natalia Paola , Bove Virginia , Villano Fiorella , Beltran Cecilia , Donoso Javiera , López-Vidal Hernán , Roa Salinas Macarena Alejandra , Soto Pablo , Ochoa Paola , Duarte Patricio , Remaggi Guillermina , Corzo Ariel , Shanley Claudia , Lopresti Sergio , Orlando Sergio , Verri Verónica , Quiroga Luis Darío , Fantl Dorotea , Ramirez Jhoanna , Ospina-Idárraga Alejandro , Idrobo Henry , Quintero Guillermo , Gomez Rigoberto , Cantú-Martínez Omar , Gomez-Almaguer David , Ruiz-Arguelles Guillermo J. , Galvez-Cárdenas Kenny Mauricio , Salazar Luis Antonio , Novoa-Caicedo Isabella , Fuentes-Lacouture María Cynthia , Spirko Paola , Arbeláez María Isabel , Pereira Mario , Valdes Jaime , Vasquez Jule , von Glasenapp Alana , Riva Eloísa ,   on behalf of GELAMM (Grupo de Estudio Latinoamericano de Mieloma Múltiple)
Published: December 2023

PURPOSE

Multiple myeloma (MM) is a highly heterogeneous, incurable disease most frequently diagnosed in the elderly. Therefore, data on clinical characteristics and outcomes in the very young population are scarce.

PATIENTS AND METHODS

We analyzed clinical characteristics, response to treatment, and survival in 103 patients with newly diagnosed MM age 40 years or younger compared with 256 patients age 41-50 years and 957 patients age 51 years or older.

RESULTS

There were no statistical differences in sex, isotype, International Scoring System, renal involvement, hypercalcemia, anemia, dialysis, bony lesions, extramedullary disease, and lactate dehydrogenase (LDH). The most used regimen in young patients was cyclophosphamide, bortezomib, dexamethasone, followed by cyclophosphamide, thalidomide, dexamethasone and bortezomib, thalidomide, dexamethasone. Of the patients age 40 years or younger, only 53% received autologous stem-cell transplant (ASCT) and 71.1% received maintenance. There were no differences in overall survival (OS) in the three patient cohorts. In the multivariate analysis, only high LDH, high cytogenetic risk, and ASCT were statistically associated with survival.

CONCLUSION

In conclusion, younger patients with MM in Latin America have similar clinical characteristics, responses, and OS compared with the elderly.
Χαρτογράφηση βυθομετρίας και θαλάσσιων ενδιαιτημάτων σε παράκτια ύδατα με τη χρήση δεδομένων παρατήρησης της Γης
Authors: Δρακοπούλου Παρασκευή
Published: December 2023

Στόχος της παρούσης έρευνας είναι να διερευνήσει και να παρέχει ένα επιστημονικά τεκμηριωμένο πλαίσιο εφαρμογής των «δημοφιλέστερων» ημι-εμπειρικών αλγορίθμων ανάκτησης βαθυμετρίας από δορυφόρικά δεδομένα (SDB), του μοντέλου Lyzenga (1978, 1981, 1985, 2006) και του μοντέλου Stumpf et al. (2003), αποσκοπώντας στην παραγωγή αξιόπιστης, λεπτομερούς και χαμηλού κόστους αποτύπωσης των ρηχών παράκτιων περιοχών (βάθος έως 30 m). Η διερεύνηση των «συνθηκών» εφαρμογής τους υλοποιήθηκε σε τρεις περιοχές μελέτης στο Βόρειο, Κεντρικό και Νότιο Αιγαίο (Ελλάδα). Οι αλγόριθμοι εφαρμόστηκαν αφενός μεν σε ανομοιογενείς πυθμένες στη ζώνη έως 20-25 m στις τρεις περιοχές, αφετέρου δε σε ομοιογενείς - λαμβάνοντας υπόψη τον τύπο του υποστρώματος και τα θαλάσσια ενδιαιτήματα όπως προέκυψαν από την εφαρμογή μεθόδων ταξινόμησης εικόνας στις περιοχές έρευνας. Χρησιμοποιήθηκαν in situ δεδομένα βάθους και τύπου υποστρώματος για τη βαθμονόμηση και την επαλήθευση των αλγορίθμων και την αξιολόγηση της ακρίβειας των ανακτώμενων βαθών. Διερευνήθηκε επίσης η διασύνδεση του μεγέθους του δείγματος εκπαίδευσης των μοντέλων με τη ακρίβεια των αποτελεσμάτων της εφαρμογής τους. Τα αποτελέσματα έδειξαν ότι ο αριθμός και η κατανομή των δεδομένων εκπαίδευσης είναι σημαντικός και συνδέεται με την ακρίβεια των εκτιμήσεων. Η ακρίβεια των εκτιμήσεων βελτιώνεται, και για τα δύο μοντέλα, όταν εφαρμόζονται σε ομοιογενείς πυθμένες. Το μοντέλο Lyzenga φαίνεται να αποδίδει με μεγαλύτερη ακρίβεια τη βαθυμετρία συγκριτικά με το μοντέλο Stumpf σε κάθε περίπτωση – ομοιογενούς ή ετερογενούς πυθμένα. Και τα δύο μοντέλα στην περίπτωση ετερογενούς πυθμένα, παρουσιάζουν αδυναμία στην εκτίμηση της πολύ ρηχής ζώνης - έως 2 m, ενώ φαίνεται να αποδίδουν ικανοποιητικά σε βάθη έως 20m. Ωστόσο, όταν η εφαρμογή τους υλοποιείται σε ομοειδείς πυθμένες, αφενός η αποδοτικότητα στα αβαθή βελτιώνεται και αφετέρου αποδίδονται ικανοποιητικά βάθη έως και 25 m. Kαι οι δύο αλγόριθμοι σχετικά με το βέλτιστο αριθμό τιμών εκπαίδευσης, ακολουθούν το μοντέλο Ν: 10-20 ανά προγνωστικό παράγοντα για ετερογενείς πυθμένες, Προγνωστικός παράγων θεωρείται ο αριθμός των φασματικών ζωνών που συμμετέχουν στις μαθηματικές εκφράσεις των αλγορίθμων.