bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of machine learning to identify risk factors of birth asphyxia
Authors: Darsareh Fatemeh , Ranjbar Amene , Farashah Mohammadsadegh Vahidi , Mehrnoush Vahid , Shekari Mitra , Jahromi Malihe Shirzadfard
Published: March 2023

Background

Developing a prediction model that incorporates several risk factors and accurately calculates the overall risk of birth asphyxia is necessary. The present study used a machine learning model to predict birth asphyxia.

Methods

Women who gave birth at a tertiary Hospital in Bandar Abbas, Iran, were retrospectively evaluated from January 2020 to January 2022. Data were extracted from the Iranian Maternal and Neonatal Network, a valid national system, by trained recorders using electronic medical records. Demographic factors, obstetric factors, and prenatal factors were obtained from patient records. Machine learning was used to identify the risk factors of birth asphyxia. Eight machine learning models were used in the study. To evaluate the diagnostic performance of each model, six metrics, including area under the receiver operating characteristic curve, accuracy, precision, sensitivity, specificity, and F1 score were measured in the test set.

Results

Of 8888 deliveries, we identified 380 women with a recorded birth asphyxia, giving a frequency of 4.3%. Random Forest Classification was found to be the best model to predict birth asphyxia with an accuracy of 0.99. The analysis of the importance of the variables showed that maternal chronic hypertension, maternal anemia, diabetes, drug addiction, gestational age, newborn weight, newborn sex, preeclampsia, placenta abruption, parity, intrauterine growth retardation, meconium amniotic fluid, mal-presentation, and delivery method were considered to be the weighted factors.

Conclusion

Birth asphyxia can be predicted using a machine learning model. Random Forest Classification was found to be an accurate algorithm to predict birth asphyxia. More research should be done to analyze appropriate variables and prepare big data to determine the best model.
Perceptions on acceptability of the 2016 WHO ANC model among the pregnant women in Phalombe District, Malawi – a qualitative study using Theoretical Framework of Acceptability
Authors: Nyumwa Prince , Bula Agatha Kapatuka , Nyondo-Mipando Alinane Linda
Published: March 2023

Background

The World Health Organization introduced a new model of care, ‘The 2016 WHO ANC Model’ to overcome challenges encountered during the implementation of the Focused Antenatal Care Approach. For any new intervention to achieve its objective, it must be widely accepted by both the deliverers and recipients. Malawi rolled out the model in 2019 without carrying out acceptability studies. The objective of this study was to explore the perceptions of pregnant women and health care workers on the acceptability of 2016 WHO’s ANC model in Phalombe District, Malawi using the Theoretical Framework of Acceptability.

Methodology

We conducted a descriptive qualitative study between May and August 2021. The Theoretical Framework of Acceptability was used to guide the development of study objectives, data collection tools, and data analysis. We purposely conducted 21 in-depth interviews (IDIs) among pregnant women, postnatal mothers, a safe motherhood coordinator, and Antenatal care (ANC) clinic midwives, and two focus group discussions (FGDs) among Disease Control and Surveillance Assistants. All IDIs and FGDs were conducted in Chichewa, digitally recorded, and simultaneously transcribed and translated into English. Data was analysed manually using content analysis.

Results

The model is acceptable among most pregnant women and they reckoned that it would help reduce maternal and neonatal deaths. Support from a husband, peers, and health care workers facilitated acceptability of the model while the increased number of ANC contacts which resulted in fatigue and increased transportation cost incurred by the women was a deterrent.

Conclusion

This study has shown that most pregnant women have accepted the model despite facing numerous challenges. Therefore, there is a need to strengthen the enabling factors and address the bottlenecks in the implementation of the model. Furthermore, the model should be widely publicised so that both intervention deliverers and recipients of care implement the model as intended. This will in turn help to achieve the model’s aim of improving maternal and neonatal outcomes and creating a positive experience with health care among pregnant women and adolescent girls.
The effect of perceived spousal support on childbirth self-efficacy on pregnant women in turkey
Authors: Kucukkaya Burcu , Basgol Sukran
Published: March 2023

Background

Spousal support during pregnancy reduces the anxiety and stress of the pregnant women and increases the ability to cope with the problems experienced by the pregnant women. The study aimed to examine the effect of perceived spousal support on childbirth self-efficacy on pregnant women in Turkey.

Methods

This cross-sectional exploratory study was conducted on 524 pregnant women who volunteered to participate in the research by approving the shared online survey and distributed by sharing the online questionnaire created by the researchers on social media (such as Facebook and Instagram) forums or group pages between 20 June and 27 July 2022. Data were collected with an e-questionnaire including The Information Form prepared by examining the literature from the pregnant women who volunteered to participate, the Spouse Support Scale measures the perceived spousal support level and consists of 27 questions, and the Childbirth Self-Efficacy Scale measures women's self-confidence in childbirth and their ability to cope and consists of 32 questions in the study.

Results

The mean age of the pregnant women was 29.99 (5.62) and the mean week of gestation was 25.93 (7.72). It was determined that 11.5% of the pregnant women were related to their spouses, 78.2% were married voluntarily, 86.5% had knowledge about birth, and 74.6% had a planned pregnancy. The Spouse Support Scale (SSS) total score average was 66.06 (19.82), the emotional support sub-dimension mean score of SSS was 22.03 (6.63), the material support and information support sub-dimension mean score was 17.17 (5.12), appreciation support sub-dimension mean score was 19.52 (5.90) and social interest support sub-dimension mean score was 21.98 (10.18), while the total mean score of the Childbirth Self Efficacy Scale (CBSES) was 234.20 (108.14), CBSES's result expectation sub-dimension mean score was 116.98 (54.13), and proficiency expectation sub-dimension mean score was 117.22 (54.07). A statistically significant correlation was found between the total and sub-dimension mean scores of CBSES and the mean scores of the total and sub-dimension SSS in pregnant women (p < .001).

Conclusion

It was determined that perceived spousal support has an effect on birth self-efficacy in pregnant women in Turkey. Obstetrics nurses and midwives should support the spousal support and birth self-efficacy of pregnant women during pregnancy follow-up and delivery.
Using household survey data to explore the effects of the domiciliary environment on weight at birth: a multilevel mixed-effects analysis of the 2016 Ethiopian Demographic Health Survey
Authors: Tamene Aiggan , Habte Aklilu , Tagesse Mihretu , Sewalem Zablon Wale , Afework Abel
Published: March 2023

Background

Low birth weight (LBW) is associated with infant mortality and postpartum health complications. In previous studies, overall LBW has been found to be significantly associated with several sociodemographic factors, including ethnicity, maternal age, and family income. Few studies have evaluated the association between environmental risk factors and LBW rates. This study investigated the effect of pre-birth water, sanitation, and hygiene (WASH) and housing conditions on self-reported low birth weight.

Methods

The Ethiopian Demographic and Health Survey, which covered all administrative regions of Ethiopia from January to June 2016, provided data for this study. STATA version 16 was used to analyze 12,125 participants across weighted samples. Multivariable multilevel mixed-effect logistic regression analysis was conducted to determine the effects of each factor on the outcome while accounting for data clustering. The adjusted odds ratios and corresponding 95% confidence intervals were used to determine the statistical significance of the independent variables.

Results

One thousand five hundred and seventeen newborns, or 12.59% [95% CI (10.2- 15.3)], had low birth weights. When other factors were taken into account, the following factors were significantly associated with low birth weight: not using small-scale water treatment technology before using water [AOR (95% CI) 1.36 (1.08–2.23)], burning solid fuels for energy [AOR (95% CI) 1.99 (1.60–2.21)], living in homes with natural wall coverings [AOR (95% CI) 1.81 (1.47–2.21)], using a shared latrine within a woman's housing complex or compound [AOR (95% CI) 1.63(1.06–2.25)], and living in peripheral, isolated regions [AOR (95% CI) 1.38 (1.06–2.21)].

Conclusion

A little more than one out of every ten deliveries in Ethiopia was under normal (recommended) weight. This study shows that poor housing conditions and lack of household WASH infrastructure are independent predictors of poor birth outcomes among Ethiopian women, adding to the limited evidence that environmental factors within the domicile contribute to low birth weight. Interventions to address these issues may help lower the prevalence of LBW.
Feasibility and preliminary efficacy of a virtual reality intervention targeting distress and anxiety in primary brain tumor patients at the time of clinical evaluation: Study protocol for a phase 2 clinical trial
Authors: King Amanda L. , Acquaye-Mallory Alvina A. , Vera Elizabeth , Mendoza Tito , Reyes Jennifer , Stockdill Macy L. , Gilbert Mark R. , Armstrong Terri S.
Published: March 2023

Background

Primary brain tumor (PBT) patients experience higher levels of distress and anxiety than other solid tumor patients, particularly at the time of clinical evaluation when uncertainty about disease status is high (“scanxiety”). There is promising evidence supporting use of virtual reality (VR) to target psychological symptoms in other solid tumor patients, though PBT patients have not been studied extensively in this context. The primary aim of this phase 2 clinical trial is to establish the feasibility of a remote VR-based relaxation intervention for a PBT population, with secondary aims designed to determine preliminary efficacy of improving distress and anxiety symptoms.

Methods

PBT patients (N = 120) with upcoming MRI scans and clinical appointments who meet eligibility will be recruited to participate in a single arm trial conducted remotely through the NIH. Following completion of baseline assessments, participants will complete a 5-min VR intervention via telehealth using a head-mounted immersive device while under supervision of the research team. Following the intervention, over the course of 1 month patients can use VR at their discretion with follow-up assessments done immediately post-VR intervention, as well as 1 week and 4 weeks later. Additionally, a qualitative phone interview will be conducted to assess patient satisfaction with the intervention.

Discussion

Use of immersive VR is an innovative interventional approach to target distress and scanxiety symptoms in PBT patients who are at high risk for experiencing these symptoms leading into their clinical appointments. Findings from this study may inform design of a future multicenter randomized VR trial for PBT patients and may aid in development of similar interventions for other oncology populations.

Trial Registration

Clinicaltrials.gov (NCT04301089), registered 9 March 2020.
The influence of socioeconomic aspects and hospital case volume on survival in colorectal cancer in Saxony, Germany
Authors: Bogner Andreas , Weitz Jürgen , Piontek Daniela
Published: March 2023

Background

Colorectal cancer (CRC) is one of the most common types of cancer in Western civilization and responsible for a high number of yearly deaths. Long-term outcome is influenced by many factors, potentially including socioeconomic aspects like income, education, and employment. Furthermore, annual surgical case volume plays a major role in achieving good oncological results. In our retrospective study, we evaluated the effect of socioeconomic deprivation and hospital volume on overall survival (OS) in the federal state of Saxony, Germany.

Methods

All patients with CRC who underwent surgery in Saxony, Germany between 2010 and 2020 and were living in Saxony at the time of diagnosis were included in our retrospective analysis. Uni- and multivariate analyses were conducted considering age, sex, tumor localization, UICC tumor stage, surgical approach (open/laparoscopic), number of resected lymph nodes, adjuvant chemotherapy, year of surgery, and hospital case volume. In addition, our model was adjusted for social disparity using the German Index of Socioeconomic Deprivation (GISD).

Results

A total of 24,085 patients were analyzed (15,883 with colon cancer and 8,202 with rectal cancer). Age, sex, UICC tumor stage and tumor localization were distributed as expected for CRC. Median overall survival time was 87.9 months for colon cancer and 110.0 months for rectal cancer. Univariate analysis revealed laparoscopic surgery (colon and rectum P < 0.001), high case volume (rectum: P = 0.002) and low levels of socioeconomic deprivation (colon and rectum P < 0.001) to be significantly associated with better survival. In multivariate analyses, the associations of laparoscopic surgery (colon: HR = 0.76, P < 0.001; rectum: HR = 0.87, P < 0.01), and mid-low to mid-high socioeconomic deprivation (colon: HR = 1.18–1.22, P < 0.001; rectum: HR = 1.18–1.36, P < 0.001–0.01) remained statistically significant. Higher hospital case volume was associated with better survival only in rectal cancer (HR = 0.89; P < 0.01).

Conclusion

In Saxony, Germany, better long-term survival after CRC surgery was associated with low socioeconomic deprivation, laparoscopic surgery and partly with high hospital case volume. Thus, there is a need to reduce social differences in access to high-quality treatment and prevention and increase hospital patient volume.
ORGAVADS: establishment of tumor organoids from head and neck squamous cell carcinoma to assess their response to innovative therapies
Authors: Perréard Marion , Florent Romane , Divoux Jordane , Grellard Jean-Michel , Lequesne Justine , Briand Mélanie , Clarisse Bénédicte , Rousseau Nathalie , Lebreton Esther , Dubois Brice , Harter Valentin , Lasne-Cardon Audrey , Drouet Julien , Johnson Alisson , Le Page Anne-Laure , Bazille Céline , Jeanne Corinne , Figeac Martin , Goardon Nicolas , Vaur Dominique , Micault Emmanuel , Humbert Maxime , Thariat Juliette , Babin Emmanuel , Poulain Laurent , Weiswald Louis-Bastien , Bastit Vianney
Published: March 2023

Background

Radiotherapy is one of the cornerstones of the treatment of Head and Neck Squamous Cell Carcinomas (HNSCC). However, radioresistance is associated with a high risk of recurrence. To propose strategies (such as combinations with drugs) that could over intrinsic radioresistance, it is crucial to predict the response to treatment. Patient-Derived Tumor Organoids (PDTO) are in vitro tridimensional microtumors obtained from patient’ own cancer samples. They have been shown to serve as reliable surrogates of the tumor response in patients.

Methods

The ORGAVADS study is a multicenter observational trial conducted to investigate the feasibility of generating and testing PDTO derived from HNSCC for the evaluation of sensitivity to treatments. PDTO are obtained after dissociation of resected tumors remaining from tissues necessary for the diagnosis. Embedding of tumor cells is then performed in extracellular matrix and culture in medium supplemented with growth factors and inhibitors. Histological and immunohistochemical characterizations are performed to validate the resemblance between PDTO and their original tumor. Response of PDTO to chemotherapy, radiotherapy and innovating combinations are assessed, as well as response to immunotherapy using co-cultures of PDTO with autologous immune cells collected from patient blood samples. Transcriptomic and genetic analyses of PDTO allow validation of the models compared to patients’ own tumor and identification of potential predictive biomarkers.

Discussion

This study is designed to develop PDTO models from HNSCC. It will allow comparing the response of PDTO to treatment and the clinical response of the patients from whom they are derived. Our aim is to study the PDTO ability to predict the clinical response to treatment for each patient in view of a personalized medicine as well as to establish a collection of HNSCC models that will be useful for future innovative strategies evaluation.

Trial registration

NCT04261192, registered February 7, 2020, last amendment v4 accepted on June, 2021.
Analysis of connexin 43, connexin 45 and N-cadherin in the human sertoli cell line FS1 and the human seminoma-like cell line TCam-2 in comparison with human testicular biopsies
Authors: Schulz Birte , Schumacher Valérie , Ngezahayo Anaclet , Maier-Begandt Daniela , Schadzek Nadine , Wilhelm Jochen , Weidner Wolfgang , Pilatz Adrian , Fietz Daniela , Kliesch Sabine , Schnepel Nadine , Hambruch Nina , Rode Kristina , Langeheine Marion , Brehm Ralph
Published: March 2023

Background

Germ cell tumors are relatively common in young men. They derive from a non-invasive precursor, called germ cell neoplasia in situ, but the exact pathogenesis is still unknown. Thus, further understanding provides the basis for diagnostics, prognostics and therapy and is therefore paramount. A recently developed cell culture model consisting of human FS1 Sertoli cells and human TCam-2 seminoma-like cells offers new opportunities for research on seminoma. Since junctional proteins within the seminiferous epithelium are involved in cell organization, differentiation and proliferation, they represent interesting candidates for investigations on intercellular adhesion and communication in context with neoplastic progression.

Methods

FS1 and TCam-2 cells were characterized regarding gap-junction-related connexin 43 (Cx43) and connexin 45 (Cx45), and adherens-junction-related N-cadherin using microarray, PCR, Western blot, immunocytochemistry and immunofluorescence. Results were compared to human testicular biopsies at different stages of seminoma development via immunohistochemistry to confirm the cell lines’ representativeness. Furthermore, dye-transfer measurements were performed to investigate functional cell coupling.

Results

Cx43, Cx45 and N-cadherin mRNA and protein were generally detectable in both cell lines via qualitative RT-PCR and Western blot. Immunocytochemistry and immunofluorescence revealed a mainly membrane-associated expression of N-cadherin in both cell lines, but gene expression values were higher in FS1 cells. Cx43 expression was also membrane-associated in FS1 cells but barely detectable in TCam-2 cells. Accordingly, a high gene expression value of Cx43 was measured for FS1 and a low value for TCam-2 cells. Cx45 was primary located in the cytoplasm of FS1 and TCam-2 cells and revealed similar low to medium gene expression values in both cell lines. Overall, results were comparable with corresponding biopsies. Additionally, both FS1 and TCam-2 cells showed dye diffusion into neighboring cells.

Conclusion

The junctional proteins Cx43, Cx45 and N-cadherin are expressed in FS1 and TCam-2 cells at mRNA and/or protein level in different amounts and localizations, and cells of both lines are functionally coupled among each other. Concerning the expression of these junctional proteins, FS1 and TCam-2 cells are largely representative for Sertoli and seminoma cells, respectively. Thus, these results provide the basis for further coculture experiments evaluating the role of junctional proteins in context with seminoma progression.
A text-mining approach to study the real-world effectiveness and potentially fatal immune-related adverse events of PD-1 and PD-L1 inhibitors in older patients with stage III/IV non-small cell lung cancer
Authors: Abedian Kalkhoran Hanieh , Zwaveling Juliëtte , Storm Bert N. , van Laar Sylvia A. , Portielje Johanneke EA , Codrington Henk , Luijten Dieuwke , Brocken Pepijn , Smit Egbert F. , Visser Loes E.
Published: March 2023

Background

This study was designed to investigate the impact of age on the effectiveness and immune-related adverse events (irAEs) of programmed death-(ligand)1 [PD-(L)1] inhibitors in patients with non-small cell lung cancer (NSCLC) using a novel text-mining technique.

Methods

This retrospective study included patients with stage III/IV NSCLC treated with a PD-(L)1 inhibitor (nivolumab, pembrolizumab, atezolizumab and durvalumab) at Leiden University Medical Centre and Haga Teaching hospital, (both in The Netherlands) from September 2016 to May 2021. All the relevant data was extracted from the structured and unstructured fields of the Electronic Health Records using a novel text-mining tool. Effectiveness [progression-free survival (PFS) and overall survival (OS)] and safety (the incidence of nine potentially fatal irAEs and systemic corticosteroid requirement) outcomes were compared across age subgroups (young: < 65 years, Middle-aged: 65–74 years, and old: ≥ 75 years) after adjustment for confounding.

Results

Of 689 patients, 310 patients (45.0%) were < 65 years, 275 patients (39.9%) were aged between 65 and 74 years, and 104 patients (15.1%) were ≥ 75 years. There was no significant difference between younger and older patients regarding PFS (median PFS 12, 8, 13 months respectively; Hazard ratio (HR)middle-aged = 1.14, 95% CI 0.92–1.41; HRold = 1.10, 95% CI 0.78–1.42). This was also the case for OS (median OS 19, 14, 18 months respectively; HRmiddle-aged = 1.22, 95% CI 0.96–1.53; HRold = 1.10, 95% CI 0.79–1.52). Safety analysis demonstrated a higher incidence of pneumonitis among patients aged 65–74. When all the investigated irAEs were pooled, there was no statistically significant difference found between age and the incidence of potentially fatal irAEs.

Conclusions

The use of PD-(L)1 inhibitors is not associated with age related decrease of PFS and OS, nor with increased incidence of serious irAEs compared to younger patients receiving these treatments. Chronological age must therefore not be used as a predictor for the effectiveness or safety of ICIs.
Granulocyte-colony stimulating factor does not prevent in vitro cisplatin-induced germ cell reduction in immature human and mouse testis
Authors: Matilionyte Gabriele , Forsyth Grace , Guo Jingtao , Rimmer Michael P. , Hermann Brian P. , Anderson Richard A. , Mitchell Rod T.
Published: March 2023

Background

Currently there are no established fertility preservation options for pre-pubertal boys facing cancer treatment. Granulocyte-colony stimulating factor (G-CSF) treatment has been proposed to be chemoprotective against spermatogonial cell loss in an alkylating chemotherapy model of busulfan treated adult mice. Having previously shown that exposure to the alkylating-like chemotherapy cisplatin resulted in a reduction in germ cell numbers in immature human testicular tissues, we here investigate whether G-CSF would prevent cisplatin-induced germ cell loss in immature human and mouse (fetal and pre-pubertal) testicular tissues.

Methods

Organotypic in vitro culture systems were utilised to determine the effects of clinically-relevant concentrations of G-CSF in cisplatin-exposed immature testicular tissues. Human fetal (n = 14 fetuses) and mouse pre-pubertal (n = 4 litters) testicular tissue pieces were cultured and exposed to cisplatin or vehicle control for 24 hrs and analysed at 72 and 240 hrs post-exposure. Combined G-CSF and cisplatin exposure groups explored varying concentrations and duration of G-CSF supplementation to the culture medium (including groups receiving G-CSF before, during and after cisplatin exposure). In addition, effects of G-CSF supplementation alone were investigated. Survival of total germ cell and sub-populations were identified by expression of AP2γ and MAGE-A4 for human gonocytes and (pre)spermatogonia, respectively, and MVH and PLZF, for mouse germ cells and putative spermatogonial stem cells (SSCs) respectively, were quantified.

Results

Exposure to cisplatin resulted in a reduced germ cell number in human fetal and mouse pre-pubertal testicular tissues at 240 hrs post-exposure. Germ cell number was not preserved by combined exposure with G-CSF using any of the exposure regimens (prior to, during or after cisplatin exposure). Continuous supplementation with G-CSF alone for 14 days did not change the germ cell composition in either human or mouse immature testicular tissues.

Conclusions

This study demonstrates that exposure to G-CSF does not prevent cisplatin-induced germ cell loss in immature human and mouse testicular tissues in an in vitro system.
Clinicomics-guided distant metastasis prediction in breast cancer via artificial intelligence
Authors: Zhang Chao , Qi Lisha , Cai Jun , Wu Haixiao , Xu Yao , Lin Yile , Li Zhijun , Chekhonin Vladimir P. , Peltzer Karl , Cao Manqing , Yin Zhuming , Wang Xin , Ma Wenjuan
Published: March 2023

Background

Breast cancer has become the most common malignant tumour worldwide. Distant metastasis is one of the leading causes of breast cancer-related death. To verify the performance of clinicomics-guided distant metastasis risk prediction for breast cancer via artificial intelligence and to investigate the accuracy of the created prediction models for metachronous distant metastasis, bone metastasis and visceral metastasis.

Methods

We retrospectively enrolled 6703 breast cancer patients from 2011 to 2016 in our hospital. The figures of magnetic resonance imaging scanning and ultrasound were collected, and the figures features of distant metastasis in breast cancer were detected. Clinicomics-guided nomogram was proven to be with significant better ability on distant metastasis prediction than the nomogram constructed by only clinical or radiographic data.

Results

Three clinicomics-guided prediction nomograms on distant metastasis, bone metastasis and visceral metastasis were created and validated. These models can potentially guide metachronous distant metastasis screening and lead to the implementation of individualized prophylactic therapy for breast cancer patients.

Conclusion

Our study is the first study to make cliniomics a reality. Such cliniomics strategy possesses the development potential in artificial intelligence medicine.
Clinical outcomes in patients with solid tumors living in rural and urban areas followed via telemedicine: experience in a highly complex latin american hospital
Authors: Restrepo Juan Guillermo , Alarcón Juliana , Hernández Andrés , Sangiovanni Saveria , González Sofía , Gallego Kelly , Peña-Zárate Evelyn E. , Libreros-Peña Laura , Escobar María Fernanda
Published: March 2023

Background

Difficulties in cancer services access increase the burden of disease and mortality in rural areas, and telehealth can be a useful tool to address these inequalities.

Objective

We aimed to describe the outcomes of patients in rural and urban areas with solid tumors managed by oncologists through telemedicine.

Methods

We conducted a retrospective cohort study of patients with solid tumors from March to December 2020. A total of 1270 subjects with solid tumors were included, 704 living in urban areas and 566 in rural areas.

Results

The most frequent tumors were breast (51.8%) and prostate (12.4%). The trend of telemedicine care was similar for both populations; in-person care was more frequent in the urban population. There were no differences in referral to the emergency room, need for hospitalization, and mortality for both groups.

Conclusion

Telemedicine is a care modality that reduces barriers in the care of patients with solid tumors, evidencing similar outcomes regardless of living in rural or urban areas.
Relationship between tumor microbiota transcriptional activity and gene expression in breast cancer
Authors: Liu Enuo , Zhang Fan , Xu Tiansheng , Ye Luyi , Ma Sean Si Qian , Ji Zai-Si
Published: March 2023

Background

A few studies have reported the distribution of the microbiota in breast cancer tissues, but few reports have compared the microbiota in different subtypes of breast cancer tissue. Moreover, no study has reported on the relationship between the microbiota and gene expression in breast tumor.

Methods

Sections of formalin-fixed paraffin-embedded (FFPE) tissue were prepared from the breast tumors of 70 patients and were subjected to microarray analysis to identify gene expression profiles. The same total RNA samples were also used to analyze the microbiota activity in tumor tissues by performing 16 S rRNA sequencing and internal transcribed spacer (ITS) sequencing of reverse transcript cDNA with Illumina Miseq. Pearson’s correlation coefficient was used for calculating the correlation between microbial relative activity and gene expression.

Results

The microbiota transcriptional activity of 70 FFPE samples mainly consisted of the phyla Bacteroidetes, Firmicutes and Proteobacteria. Prevotella_9, Bacteroides and Alloprevotella were the most active genera in ER+/HER2-, ER+/HER2 + and ER-/HER2 + tumors, while triple-negative samples exhibited a higher activity of Lactobacillus. In ER-negative samples (triple-negative and ER-/HER2+), 479 genes, including the breast carcinogenesis genes phospholipase A2, histone cluster 2, Crk-like, and cyclin D1, were significantly positive associated with the activity of Lactobacillus.

Conclusion

This was the first study to clarify an association between the breast tumor microbiota transcriptional activity and the expression of carcinogenesis genes in ER-negative breast cancer. Changes in the microbiota of breast tissue induced by external factors might be one of the key causes of ER negative breast cancer.
Comparison of the efficacy of intravitreal Anti-VEGF versus intravitreal dexamethasone implant in treatment resistant diabetic Macular Edema
Authors: Koc Hakan , Alpay Atilla , Ugurbas Suat Hayri
Published: March 2023

Purpose

Comparison of the efficacy of monthly anti-VEGF versus dexamethasone (DEX) implant in patients with diabetic macular edema (DME) whose macular edema persists despite three doses of anti-VEGF therapy.

Materials and methods

This retrospective study included 94 eyes of 94 patients with central macular thickness (CMT) > 300 μm despite previously receiving three doses of anti-VGEF (aflibercept or ranibizumab) injections between January 2014 and January 2019. The patients were divided into four groups. The first and second groups were the patients who received three more doses of initial anti-VGEF treatment after the initial anti-VGEF treatment. The third and fourth groups were patients switched to intravitreal dexamethasone implants. Patients were followed up every month for six months after the injection. The primary outcome measures were best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) at six months.

Results

The mean age of the patients included in the study was 64.64 ± 7; there were 58 men (61.7%) and 36 women (38.3%). There was no statistically significant difference between the groups regarding age, stage of retinopathy, and lens status. When CMT, BCVA, and IOP were assessed among the four groups at the end of the sixth month, no statistical difference between the groups was found. There was no need for medical intervention despite the statistically significant increase in IOP at the end of the sixth month compared to the third month in the dexamethasone implanted groups. In contrast to the decrease in CMT, which was statistically significant in all four groups at the end of the sixth month compared to the third month, the increase in BCVA was not statistically significant in any of the four groups at the end of the sixth month.

Conclusion

According to the results of our study, there is no superiority between continuing with existing anti-VEGF or switching to a dexamethasone implant after three doses of anti-VEGF.
Optical bench evaluation of the effect of pupil size in new generation monofocal intraocular lenses
Authors: Alarcon Aixa , Canovas Carmen , Koopman Bram , Pande Milind V , Koch Douglas D , Piers Patricia
Published: March 2023

Background

A new generation of enhanced monofocal IOLs has been introduced to slightly increase the depth of focus as compared to standard monofocal IOLs. The purpose of this study is to evaluate the effect of pupil size on the through-focus optical performance of three new enhanced monofocal IOLs, designed to improve the range of vision as compared to standard monofocal IOLs.

Methods

Optical bench testing in white light was performed for different pupils, using an average cornea eye. Distance image quality was evaluated using Modulation Transfer Function (MTF) measurements. Through-focus Visual Acuity (VA) was simulated from these measurements (sVA). Three enhanced monofocal IOLs (ICB00, ISOPure, and RayOne-EMV) and three standard monofocal IOLs: two aspheric (ZCB00 and SN60WF) and one spherical (AAB00) were included.

Results

The enhanced monofocal IOLs provided an improvement in the intermediate sVA as compared to standard monofocal IOLs. For ICB00, the improvement was independent of the pupil size, while for the ISOPure and RayOne-EMV, the intermediate sVA improved with increased pupil size. Similar to the spherical monofocal IOL, the ISOPure and RayOne-EMV showed a strong correlation between improvement in intermediate sVA and reduction of distance sVA and MTF, and increasing pupil size. ICB00 provided the same distance sVA as the aspheric monofocal IOLs and the lowest variability in MTF with pupil size.

Conclusion

Optical bench results showed that the ISOPure and RayOne-EMV provide similar performance to a spherical monofocal IOL, with a strong pupil dependency for distance and intermediate vision. The other enhanced monofocal IOL, ICB00, provided a sustained improvement in simulated intermediate VA and maintained distance image quality comparable to that of the standard aspheric monofocal IOLs, even for larger pupils.
Corneal higher order aberrations by Sirius topography and their relation to different refractive errors
Authors: Salman Abdelrahman , Kailani Obeda , Ghabra Marwan , Omran Rana , Darwish Taym R. , Shaaban Rafea , Ibrahim Hussein , Alhaji Hala , Khalil Hussam
Published: March 2023

Purpose

To compare the root mean square (RMS) of anterior corneal higher-order aberrations (HOAs) in ametropic and emmetropic eyes.

Methods

This retrospective observational study was conducted at the Department of Ophthalmology, Tishreen University Hospital, Latakia, Syria. Study eyes were divided into four groups based on refractive error: mild-to-moderate myopia, hypermetropia, myopic astigmatism, and emmetropic eyes as controls. The following anterior corneal HOAs were evaluated using the Scheimpflug-Placido Sirius (CSO, Italy) tomographer over 6 mm pupil: Root mean square (RMS) total corneal HOAs, RMS trefoil, RMS coma and RMS spherical aberrations.

Results

RMS values of total HOAs, trefoil and coma showed statistically significant differences in all four groups (P < 0.05, all). HOAs were noted to be lowest in the control group (0.18 ± 0.09, 011 ± 0.08 and 0.09 ± 0.08 μm, respectively) and highest in the myopic astigmatism group (0.31 ± 0.16, 0.15 ± 0.12, 0.17 ± 0.14 μm, respectively). RMS spherical aberration was lowest in the astigmatism group (0.00 ± 0.16 μm) with a statistically significant difference from that in the control group (0.05 ± 0.07 μm, P = 0.049).

Conclusion

The mean RMS values of total HOAs, trefoil and coma were highest in the astigmatism group and lowest in the control group. However, spherical aberration was minimal in the astigmatism group. A better understanding and targeted treatment of higher-order aberrations in ametropic human eyes, and in particular eyes with astigmatism, may enhance visual quality and performance in the treatment of refractive errors. Recognising atypical HOAs may also assist in the early detection of pathological conditions such as keratoconus.
Orbitofrontal cholesterol granuloma masquerading as frontal sinus mucoceles: report of two cases
Authors: Li Ruimiao , Ren Mingyu , Wang Wenjing , Li Ruixin , Zhang Lili , Liu Limin
Published: March 2023

Background

Two cases of orbitofrontal cholesterol granuloma masquerading as frontal sinus mucoceles were reported to understand image findings, clinical and histopathologic features of orbitofrontal cholesterol granuloma to improve its diagnosis and treatment.

Case presentation

Two East Asian patients aged 41 and 27 without personal or familial medical or trauma history presented with the common complaint of proptosis and inferomedial displacement of the eyeballs. The computed tomography (CT) of both cases showed an irregularly shaped, well-defined lesion in the left frontal bone associated with bony erosion. The lesions resulted in the bone absorption of frontal bone and orbital roof, which extended into the superior orbital space. Anterior orbitotomy through subbrow incision by drainage and curettage resulted in a curative outcome. The histopathological examination revealed inflammatory granulation tissues, fibrous capsule wall, cholesterol clefts with altered blood pigments, and calcifications, consistent with the diagnosis of cholesterol granuloma. No recurrence was observed for one year after surgery in one case and three years in the other.

Conclusions

When the following features are observed: orbital CT exhibits cystic lesion with irregular bone destruction in the superolateral orbit, magnetic resonance imaging (MRI) depicts lesions are hyperintense signals on T1 weighted images (T1WI), and T2 weighted images(T2WI), and the contrast-enhanced imaging reveals that the most of tumor is showed a non-significant enhancement, orbitofrontal cholesterol granuloma should be considered.
Visual prognosis and surgical timing of Ahmed glaucoma valve implantation for neovascular glaucoma secondary to diabetic vitrectomy
Authors: Lee Jong Suk , Lee Young Bok , Kim Tae-Woo , Park Kyu Hyung
Published: March 2023

Background

Evaluate the visual outcomes of Ahmed glaucoma valve implantation (AGVI) in patients with neovascular glaucoma (NVG) who underwent diabetic vitrectomy and suggest appropriate AGVI timing.

Methods

Medical records of patients who underwent AGVI due to NVG after diabetic vitrectomy were reviewed. Successful intraocular pressure (IOP) control was defined as an IOP between 6 and 21 mmHg. Visual outcome was compared before NVG diagnosis and after AGVI, and the “favorable” visual outcome was defined as a postoperative deterioration in BCVA of less than 0.3 logMAR units compared to those before the development of NVG. Various factors including surgical timing were evaluated to identify the risk factors associated with unfavorable visual outcome.

Results

A total of 35 eyes were enrolled and divided into group 1(medically uncontrolled NVG group, IOP more than 30mmHg, 16 eyes) and group 2(NVG group responded well to the initial non-surgical treatment but eventually required AGVI, 19 eyes). Despite the favorable rate of normalization of post-AGVI IOP (85.7%), 43.8% in Group 1 and 26.3% in Group 2 showed unfavorable visual outcomes. In group 1, delayed surgical timing more than 1 week from the NVG diagnosis showed a significant association with unfavorable visual outcomes (P = 0.041). In group 2, poor patient compliance (follow up loss, refuse surgery) was the main factor of unfavorable visual outcomes.

Conclusion

When NVG occurs in patients with proliferative diabetic retinopathy after vitrectomy, physicians should be cautious not to delay the surgical intervention, especially in patients with IOP of 30 or more despite non-surgical treatment. Early AGVI within six days might be necessary to preserve useful vision in these patients.
Successive onset of Vogt-Koyanagi-Harada syndrome in father and son
Authors: Li Hougang , Sun Shuo , Zhang Yanrui , Liu Jinfeng , Zhao Xuzheng , Zhao Guixia
Published: March 2023

Background

Vogt‒Koyanagi‒Harada (VKH) disease is a multifactorial systemic autoimmune disorder against melanocytes that is characterized by panuveitis. Familial occurrence of VKH disease is rare. Here, we report two cases of a father and his son with characteristic manifestations of VKH disease.

Case presentation

A 53-year-old male with typical clinical symptoms of VKH disease was referred to Tangshan Eye Hospital. Examination showed the presence of ciliochoroidal effusion and exudative retinal detachment in both eyes. The patient was given intravenous methylprednisolone 120 mg for 2 days and intravenous methylprednisolone 80 mg for 1 day followed by 48 mg (1 mg/kg/day) oral methylprednisolone daily, accompanied by oral azathioprine 50 mg daily. Cycloplegic agent (0.5% tropicamide three times daily [TID]) was added. The patient was free of symptoms and recurrence within more than 1-year-follow-up period, the best corrected visual acuity (BVCA) was increased and maintained in both eyes with complete resolution of subretinal fluid. One year and nine months later, case 2 (his son) also presented with the typical clinical symptoms of VKH disease at 29 years of age. The son also recovered from VKH disease after routine and standard treatment.

Conclusions

To the best of our knowledge, this is the first VKH disease case report of a father-son relationship. Although genetic factors have been demonstrated to be involved in the pathogenesis of VKH disease, the different inheritance modes of VKH patients need to be further explored and studied.
Effects of disorganization of retinal inner layers for Idiopathic epiretinal membrane surgery: the surgical status and prognosis
Authors: Li Huanhuan , Zhang Conghui , Li Hui , Yang Shuai , Liu Yao , Wang Fang
Published: March 2023

Background

To compare the surgical status in idiopathic epiretinal membrane (IERM) patients with or without disorganization of retinal inner layers (DRIL) and to correlate with optical coherence tomography angiography (OCTA) and clinical data.

Methods

In 74 eyes from 74 patients with IERM treated by surgery with 12-month follow-up. According to the superficial hemorrhage, the patients were divided into group A (no macular bleeding), group B (macular parafoveal bleeding) and group C (macular foveal bleeding). Optical coherence tomography (OCT) were evaluated for presence of DRIL,central retina thickness and integrity of the inner/outer segment layer recorded at baseline and at 1, 3, 6, and 12 months postoperatively and best-corrected visual acuity (BCVA) was recorded simultaneously. OCTA was conducted at 12 months postoperatively. Main outcome measures is correlation between DRIL and superficial hemorrhage in membrane peeling,and BCVA and OCTA outcomes postoperatively.

Results

The rate of DRIL and BCVA had statistically significant differences between the three groups at the time points(baseline and 1, 3, 6, and 12 months after surgery), respectively (P < 0.001 for all). FD-300 value (P = 0.001)and DCP in all parafoveal regions (superior: P = 0.001; inferior: P = 0.002;Nasal: P = 0.014;Tempo: P = 0.004) in eyes with DRIL were lower than those without DRIL.There was a linear regression relationship between FD-300 and postoperative BCVA (P = 0.011).

Conclusion

IERM Patients with DRIL have more intraoperative adverse events and limited benefits from surgery which should be considered in the decision whether to perform mebrane peeling.OCT-A provides more detailed vascular information that extends our understanding of persistent DRIL.
Impact of postoperative choroidal detachment on trabeculectomy outcomes: a four-year comparative study
Authors: Yadgari Maryam , Ghanbarnia Mohammad Javad
Published: March 2023

Background

The aim of this study was to compare trabeculectomy outcomes in patients with and without post-operative serous choroidal detachment (CD) and establish an association between CD and trabeculectomy outcomes.

Methods

In this 4-year retrospective cohort study, medical records of glaucoma patients older than 18 who underwent primary trabeculectomy with Mitomycin-C between 2012 and 2020 were reviewed. Phakic eyes without history of any other intraocular surgery and with at least one year of follow-up were included in the study. Postoperative CD was defined as clinically visible CD developed within the first postoperative week. Cases were categorized into with and without CD and trabeculectomy outcomes were compared. Comparison was carried out using postoperative intraocular pressure (IOP), glaucoma medications and surgery success. Two levels of success were defined regardless of glaucoma medications; criteria A) 5 < IOP < 19 mmHg and criteria B) 5 < IOP < 16 mmHg. In addition to the defined IOP ranges, IOP reduction less than 20% from baseline and further glaucoma surgery were also counted as surgery failures.

Results

Total of 183 patients including 153 without CD (mean age 58.73 ± 11.40 years, mean IOP 23.7 ± 6.63 mmHg) and 30 with CD (59.00 ± 12.59 years, mean IOP 22.2 ± 3.83 mmHg) entered the study. Post-trabeculectomy mean IOPs were significantly higher in the CD group at all follow-up visits at year 1 through 4 (14.70, and 14.82 mmHg vs. 11.03, and 12.59 mmHg; p-value < 0.05). Similarly mean number of glaucoma medications was higher in the CD group at all follow-up visits (p-value > 0.001). Based on success criteria A, cumulative probability of success for patients with CD wasn’t significantly different compared to those without CD at years 1 through 4 (80.0%, and 69.6% vs. 88.2%, and 74.1% respectively; p-value > 0.05, log-rank). However, based on success criteria B, patients with CD had significantly lower cumulative probability of success at years 1 through 4 (50.0% and 8.9% vs. 79.7% and 59.8%, p-value < 0.001).

Conclusion

We established that early post-trabeculectomy serous choroidal detachment is associated with adverse surgery outcomes. Lower rate of surgery success and higher mean postoperative IOP and glaucoma medications were observed in patients with post-trabeculectomy choroidal detachment and this was more pronounced in patients who required more stringent IOP control (success definition 5 < IOP < 16 mmHg).
Examination of physical activity development in early childhood: protocol for a longitudinal cohort study of mother-toddler dyads
Authors: Welch Sarah B. , Honegger Kyle , O’Brien Megan , Capan Selin , Kwon Soyang
Published: March 2023

Background

Physical activity (PA) development in toddlers (age 1 and 2 years) is not well understood, partly because of a lack of analytic tools for accelerometer-based data processing that can accurately evaluate PA among toddlers. This has led to a knowledge gap regarding how parenting practices around PA, mothers’ PA level, mothers’ parenting stress, and child developmental and behavioral problems influence PA development in early childhood.

Methods

The Child and Mother Physical Activity Study is a longitudinal study to observe PA development in toddlerhood and examine the influence of personal and parental characteristics on PA development. The study is designed to refine and validate an accelerometer-based machine learning algorithm for toddler activity recognition (Aim 1), apply the algorithm to compare the trajectories of toddler PA levels in males and females age 1–3 years (Aim 2), and explore the association between gross motor development and PA development in toddlerhood, as well as how parenting practices around PA, mothers’ PA, mothers’ parenting stress, and child developmental and behavioral problems are associated with toddlerhood PA development (Exploratory Aims 3a-c).

Discussion

This study will be one of the first to use longitudinal data to validate a machine learning activity recognition algorithm and apply the algorithm to quantify free-living ambulatory movement in toddlers. The study findings will help fill a significant methodological gap in toddler PA measurement and expand the body of knowledge on the factors influencing early childhood PA development.