bluuebunny/crossref_metadata_2025 huggingface dataset:
How understanding the limitations and risks of using ChatGPT can contribute to willingness to use
Authors: Al Murshidi Ghadah , Shulgina Galina , Kapuza Anastasiia , Costley Jamie
Published: August 2024

Generative Artificial Intelligence (GAI) holds promise for enhancing the educational experience by providing personalized feedback and interactive simulations. While its integration into classrooms would improve education, concerns about how students may use AI in the class has prompted research on the perceptions related to the intention to implement GAI, such as perceived benefits, limitations and associated risks in teaching and learning practices. This study examines the perceptions of GAI among 366 students in the United Arab Emirates based on survey results. To do that, initially factor analysis was utilized to identify the relevant scales, followed by comparing the mean values for each scale based on the extent of agreement with the statement regarding students' willingness to use ChatGPT. The study revealed a high awareness among respondents regarding the benefits, limitations, and risks of using ChatGPT. The research confirms that awareness of potential benefits is related to the intention to use ChatGPT in the future. Contrary to expectations, a positive relationship was found between awareness of limitations and the intention to use ChatGPT, challenging traditional views that limitations act as barriers. Similarly, awareness of risks is positively related to the willingness to use ChatGPT, suggesting a nuanced relationship between risk perception and technology adoption in education.The current study provides new insights into the importance of informing individuals about the limitations and risks of ChatGPT, in addition to its benefits, as these factors are closely related to making a positive decision regarding its further usage.
On the phase difference of ECH waves obtained from the interferometry observation by the Arase satellite
Authors: Taki Tomoe , Kurita Satoshi , Shinjo Airi , Fukasawa Ibuki , Nakamura Satoko , Kojima Hirotsugu , Kasahara Yoshiya , Matsuda Shoya , Matsuoka Ayako , Miyoshi Yoshizumi , Shinohara Iku
Published: August 2024

We analyzed electrostatic electron cyclotron harmonic waves observed by the interferometry observation mode of the Arase satellite. It is found that the magnitude of the phase difference varies with the satellite spin. The spin dependence of this phase difference was investigated by examining the trend of the spin dependence for the 84 events of interferometry observation of ECH waves. We found that they are divided into two categories. One is that the phase difference tends to show sinusoidal variations as a function of the angle $$\gamma _B$$

γ
B

between the ambient magnetic field projected on the spin plane and the electric field sensor. The other is that the phase difference is close to zero and does not depend on $$\gamma _B$$

γ
B

. A numerical model of interferometry observation of single plane wave is constructed to explain the observed phase differences. We performed the numerical calculations when the background magnetic field was oriented in the direction often observed in the Arase satellite. The result of the calculations shows the wave vector direction relates to the spin angle with the maximum phase difference. Using this relation, we show that it may be possible to estimate the wave vector direction of ECH waves from one-dimensional interferometry data. This is expected to enable more accurate estimates of phase velocity.

Graphical Abstract
Hallmarks of cancer in patients with heart failure: data from BIOSTAT-CHF
Authors: van den Berg P. F. , Yousif L. I. , Markousis-Mavrogenis G. , Shi C. , Bracun V. , Tromp J. , de Wit S. , Appels Y. , Screever E. M. , Aboumsallem J. P. , Ouwerkerk W. , van Veldhuisen D. J. , Silljé H. H. W. , Voors A. A. , de Boer R. A. , Meijers Wouter C.
Published: August 2024

Background

Within cardio-oncology, emerging epidemiologic studies have demonstrated a bi-directional relationship between heart failure (HF) and cancer. In the current study, we aimed to further explore this relationship and investigate the underlying pathophysiological pathways that connect these two disease entities.

Methods

We conducted a post-hoc analysis in which we identified 24 Gene Ontology (GO) processes associated with the hallmarks of cancer based on 92 biomarkers in 1960 patients with HF. We performed Spearman’s correlations and Cox-regression analyses to evaluate associations with HF biomarkers, severity and all-cause mortality.

Results

Out of a total of 24 GO processes, 9 biological processes were significantly associated with adverse clinical outcome. Positive regulation of mononuclear cell proliferation demonstrated the highest hazard for reaching the clinical endpoint, even after adjusting for confounders: all-cause mortality HR 2.00 (95% CI 1.17–3.42), p = 0.012. In contrast, negative regulation of apoptotic process was consistently associated with a lower hazard of reaching the clinical outcome, even after adjusting for confounders: all-cause mortality HR 0.74 (95% CI 0.59–0.95), p = 0.016. All processes significantly correlated with HF biomarkers, renal function and HF severity.

Conclusions

In patients with HF, GO processes associated with hallmarks of cancer are associated with HF biomarkers, severity and all-cause mortality.
Non-random distribution of Plasmodium Species infections and associated clinical features in children in the lake Victoria region, Kenya, 2012–2018
Authors: Omondi Protus , Musyoka Brian , Okai Takatsugu , Kongere James , Kagaya Wataru , Chan Chim W. , Ngara Mtakai , Kanoi Bernard N. , Kido Yasutoshi , Gitaka Jesse , Kaneko Akira
Published: August 2024

Background

While Plasmodium falciparum (Pf) stands out as the most lethal malaria parasite species in humans, the impact of other species should not be dismissed. Moreover, there is a notable lack of understanding of mixed-species infections and their clinical implications.

Methods

We conducted eight school-based cross-sectional malariometric surveys in the Lake Victoria region of western Kenya between January–February 2012 and September–October 2018. In each survey, a minimum of 100 children aged 3 to 15 years were randomly chosen from a school in Ungoye village on the mainland and as well as from each school selected in every catchment area on Mfangano island. Plasmodium infection was determined by microscopy and nested polymerase chain reaction (PCR). The multiple-kind lottery (MKL) model calculated the expected distribution of Plasmodium infections in the population and compared it to observed values using a chi-squared test (χ2).

Results

The Plasmodium prevalence was 25.9% (2521/9724) by microscopy and 51.1% (4969/9724) by PCR. Among all infections detected by PCR, Pf, P. malariae (Pm), and P. ovale (Po) mono-infections were 58.6%, 3.1%, and 1.8%, respectively. Pf/Pm, Pf/Po, Pm/Po, and Pf/Pm/Po co-infections were 23.5%, 4.3%, 0.1%, and 8.6%, respectively. MKL modelling revealed non-random distributions, with frequencies of Pf/Pm and Pf/Pm/Po co-infections being significantly higher than expected (χ2 = 3385.60, p < 0.001). Pf co-infections with Pm and Po were associated with a decreased risk of fever (aOR 0.64, 95% CI 0.46–0.83; p = 0.01) and increased risks of splenomegaly (aOR 12.79, 95% CI 9.69–16.9; p < 0.001) and anaemia (aOR 2.57, 95% CI 2.09–3.15; p < 0.001), compared to single-species infections.

Conclusion

This study sheds light on the potential interaction between Pf and Pm and/or Po. Given the clinical significance of mixed-species infections, improved diagnostics, and case management of Pm and Po are urgently needed.
Relative contribution of comorbid diseases to health-related quality of life in patients with Parkinson’s disease
Authors: Keränen Maija-Helena , Kytövuori Laura , Huhtakangas Juha , Kärppä Mikko , Majamaa Kari
Published: August 2024

Background

Multimorbidity is common in elderly people, and one of the major consequences of multimorbidity is low health-related quality of life (HRQoL). The aim of this study was to investigate the frequency of comorbid diseases in patients with Parkinson’s disease (PD) and to analyze their relative importance in HRQoL. The aim was also to examine agreement between the generic 15D questionnaire and the PD-specific Parkinson’s Disease Questionnaire (PDQ-8) to further validate 15D in the evaluation of HRQoL in patients with PD.

Methods

Patients with PD (N = 551) filled a questionnaire on comorbid diseases, and the 15D questionnaire yielding a 15-dimensional health profile and a score representing the overall HRQoL. Self-organizing map was used for an unsupervised pattern recognition of the health profiles. Relative importance analysis was used to evaluate the contribution of 16 comorbid diseases to the 15D score. The agreement between 15D and PDQ-8 questionnaires was studied in a subset of 81 patients that were examined clinically.

Results

533 patients (96.7%) reported comorbid diseases. The most affected dimensions in the 15D questionnaire were secretion, usual activities, discomfort and symptoms, and sexual activity. Self-organizing map identified three patterns of health profiles that included patients with high, low or transition HRQoL. The transition subgroup was similar to low HRQoL subgroup in non-motor dimensions. Sixteen comorbid diseases explained 33.7% of the variance in the 15D score. Memory deficit, depression, heart failure, and atrial fibrillation had the highest relative importance. The intraclass correlation coefficient between the generic 15D and the PD-specific PDQ-8 was 0.642 suggesting moderate reliability.

Conclusions

The most marked differences in HRQoL were in the dimensions of secretion, usual activities, and sexual activity. Pattern detection of 15D health dimensions enabled the detection of a subgroup with disproportionately poor HRQoL in non-motor dimensions. The comorbid diseases affecting most to HRQoL were memory deficit and depression. The generic 15D questionnaire can be used in the evaluation of HRQoL in PD patients.
Can items derived from international literature be used in national quality of life instruments? A qualitative study conceptualising the EQ-HWB in China
Authors: Zhang Guangjie , Yang Zhihao , Luo Nan , Wang Pei , Busschbach Jan
Published: August 2024

Introduction

The EQ Health and Wellbeing (EQ-HWB) is a new questionnaire for measuring quality of life (QoL) from a broad perspective. The items of the EQ-HWB were derived based on a ‘qualitative review’ of literature, which reported primarily on Western studies. It can be argued that the QoL is a cultural-related concept and therefore people from China have a different understanding of the QoL. This study aimed to explore whether Chinese citizens could understand the EQ-HWB’s candidate items and what they thought of those items. In doing so, we wanted to examine the face validity of the candidate items and explore if further cultural adaptation is necessary.

Methods

This research was part of the E-QALY project, in which 36 candidate items were selected for the EQ-HWB from a 97-item pool. In China, three interviewers investigated the face validity of these EQ-HWB candidate items in semi-structured qualitative face-to-face interviews. Respondents were invited to report ‘problems’ with regard to the interpretation of the items and these problems were grouped into themes. We explored to what extent those themes related to specific cultural aspects in China. We also classified the rates of reported problems for each item into three groups: 1) less than 20%, 2) from 20–50%, and 3) over 50%.

Results

For 17 items the rate of reported problems was less than 20%, 15 items fell into the second group (with 20 − 50%) and for 4 items the rate of problems reported was more than 50%. The thematic analysis revealed eight themes: ambiguous problems in the interpretation of 16 items; difficult to understand (11); contained a complex negative expression (10); examples used seemed inappropriate (7); misleading connotation in Chinese (2); long and complex (2); complex response options (1); and use of non-colloquial language (1).

Discussion

Our research shows that EQ-HWB candidate items require careful examination to make them more comprehensible. Most of the reported problem themes were generic problems related to the items, and only a few face validity issues appeared to relate to specific cultural aspects in China, even though most of the items were based on Western studies. Our findings are reassuring for the instrument’s international application, especially in China.
Exploring Ayurveda: principles and their application in modern medicine
Authors: Verma Sunil Kumar , Pandey Minakshi , Sharma Avinash , Singh Devendra
Published: August 2024

Background

The integration of Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH) with modern medicine aims to provide a more personalized and effective approach to healthcare. Ayurveda is a traditional medicine system in India that emphasizes the balance between mind, body, and spirit. It is based on the belief that every individual is unique and requires personalized treatment. The fundamental principles of Ayurveda revolve around maintaining equilibrium among three doshas: Vata (air and space), Pitta (fire and water), and Kapha (earth and water). Imbalances in these doshas are believed to cause diseases.

Main body of the abstract

The integration of Ayurveda with modern medicine seeks to utilize the best of both systems, focusing on using natural remedies and treatments that have been used for centuries in Ayurveda. The integration involves combining the strengths of both systems, including the use of Ayurvedic principles in modern medicine and the incorporation of modern medicine into Ayurvedic practices. Several studies have explored the efficacy of Ayurvedic treatments for various diseases, and the integration of Ayurvedic principles into modern medicine can provide a more comprehensive approach to patient care.

Short conclusion

Ayurveda is a traditional medical system deeply rooted in Indian culture that offers a holistic approach to healthcare. Its principles emphasize personalized treatment based on an individual's constitution. Integrating Ayurveda with modern medicine can enhance patient care by providing a more comprehensive approach towards health management. However, challenges exist regarding the standardization of Ayurvedic practices due to variations in formulations and the need for more scientific evidence for some treatments. Further studies are needed for validation purposes.
IQAGPT: computed tomography image quality assessment with vision-language and ChatGPT models
Authors: Chen Zhihao , Hu Bin , Niu Chuang , Chen Tao , Li Yuxin , Shan Hongming , Wang Ge
Published: August 2024

Large language models (LLMs), such as ChatGPT, have demonstrated impressive capabilities in various tasks and attracted increasing interest as a natural language interface across many domains. Recently, large vision-language models (VLMs) that learn rich vision–language correlation from image–text pairs, like BLIP-2 and GPT-4, have been intensively investigated. However, despite these developments, the application of LLMs and VLMs in image quality assessment (IQA), particularly in medical imaging, remains unexplored. This is valuable for objective performance evaluation and potential supplement or even replacement of radiologists’ opinions. To this end, this study introduces IQAGPT, an innovative computed tomography (CT) IQA system that integrates image-quality captioning VLM with ChatGPT to generate quality scores and textual reports. First, a CT-IQA dataset comprising 1,000 CT slices with diverse quality levels is professionally annotated and compiled for training and evaluation. To better leverage the capabilities of LLMs, the annotated quality scores are converted into semantically rich text descriptions using a prompt template. Second, the image-quality captioning VLM is fine-tuned on the CT-IQA dataset to generate quality descriptions. The captioning model fuses image and text features through cross-modal attention. Third, based on the quality descriptions, users verbally request ChatGPT to rate image-quality scores or produce radiological quality reports. Results demonstrate the feasibility of assessing image quality using LLMs. The proposed IQAGPT outperformed GPT-4 and CLIP-IQA, as well as multitask classification and regression models that solely rely on images.
Introduction to heirloom vegetables in Kyoto prefecture (Kyo-yasai), Japan
Authors: Mimura Yutaka
Published: August 2024

The group of vegetables known collectively as Kyo-yasai is a key part of food culture in Kyoto, once Japan’s capital city for over 1000 years. A favorable climate and other cultural influences enabled Kyo-yasai culture to flourish. This study reviews the history, work to preserve, and marketing of Kyo-yasai. It also summarizes the scientific research conducted in the past few decades concerning breeding, functionality, nutrition, and taxonomy to provide an overview of Kyo-yasai today. The first record of heirloom vegetables in Japan was in the third century. After Kyoto became the capital in 794, a variety of vegetables were gradually introduced, and these have been developed and selected as Kyo-yasai for many centuries now. However, F1 vegetable cultivars became the national norm after World War II, and Kyo-yasai faced the risk of extinction. Consequently, farmers, researchers, municipalities, and other groups decided to preserve Kyo-yasai. In 1974, the Kyoto prefectural government began preserving Kyo-yasai seeds. At the time it also defined 37 heirloom vegetables as ‘traditional Kyo-yasai.’ Additionally, agricultural cooperatives, wholesale markets, restaurants, and municipalities started to promote sales of Kyo-yasai. Furthermore, a breeding program was set up by Kyoto prefectural institutes looking at ways of improving cultivation suitability. Functional and taxonomical research by Kyoto Prefectural University and other organizations has revealed not only that Kyo-yasai has higher functionality overall compared than common F1 cultivars, but also the genomic uniqueness of Kyo-yasai. These efforts collectively improved our understanding of Kyo-yasai and promoted their production. The preservation of these heirloom vegetables has a clear benefit in that it would contribute to the diversity of species and food cultures.
Fermented foods of Southeast Asia other than soybean- or seafood-based ones
Authors: Surya Reggie
Published: August 2024

The region of Southeast Asia encompasses a group of countries that include Indonesia, Malaysia, Thailand, Cambodia, Vietnam, Laos, Singapore, Myanmar, Brunei, and the Philippines. Such a region is the home of diverse ethnic people and culture, including richness in terms of indigenous fermented foods. Among the fermented foods in Southeast Asia, only those made from soybeans and fish (or seafoods) have been the most reviewed and described in international scientific media. In addition, the knowledge about fermented foods in Southeast Asia seems to be scattered and rarely available in international peer-reviewed scientific journals. Therefore, it appears primordial to create a comprehensive review on fermented foods from Southeast Asia as a gastronomic heritage and introduce them toward an international academic audience. This review aims to explore the diversity of fermented foods from Southeast Asian nations and discuss their characteristics in several aspects, including biochemical, microbiological, ethnic, and cultural aspects. The fermented foods discussed in this review are divided into seven categories, including: (1) fermented starch products, (2) fermented alcoholic beverages and vinegar, (3) fermented vegetable and fruit products, (4) fermented non-soybean legumes, (5) fermented dairy products, (6) fermented meat products, and (7) other fermented foods from Southeast Asia. These fermented foods have been very little reviewed and discussed compared to the soybean- and seafood-based fermented products from Southeast Asia. It is expected that this review would provide a thorough explanation regarding fermented foods from Southeast Asia, become a reliable reference for scientific studies, and ultimately promote future research in ethnic food fermentation.
Multi-frequency smartphone positioning performance evaluation: insights into A-GNSS PPP-B2b services and beyond
Authors: Wang Jiale , Shi Chuang , Zheng Fu , Yang Cheng , Liu Xu , Liu Shuo , Xia Ming , Jing Guifei , Li Tuan , Chen Wu , Li Qingcheng , Hu Yong , Tian Yuan , Shan Yunfeng
Published: August 2024

In August 2023, Xiaomi unveiled the Redmi K60 Ultra, the first multi-frequency smartphone integrated with BeiDou-3 Navigation Satellite System Precise Point Positioning (PPP-B2b) services and employing PPP technology as the primary positioning method. The positioning enhancement service is provided by the Assisted Global Navigation Satellite System (A-GNSS) location platform developed by the China Academy of Information and Communications Technology. The signaling interaction between the server and the users strictly adheres to the Third Generation of Mobile Communications Technology Partnership Project Long-Term Evolution Positioning Protocol and the Open Mobile Alliance Secure User Plane Location framework. To comprehensively evaluate the Redmi K60 Ultra’s capabilities, this study designed six distinct experimental scenarios and conducted comprehensive research on multi-frequency and multi-GNSS observation noise, Time to First Fix (TTFF), as well as the performance of both GNSS-based and network-based positioning. Experimental results indicate that the GNSS chipset within the Redmi K60 Ultra has achieved a leading position in the consumer market concerning supported satellite constellations, frequencies, and observation accuracy, and is comparable to some low-cost GNSS receivers. A-GNSS positioning can reduce the TTFF from 30 to under 5 s, representing an improvement of over 85% in the cold start speed compared to a standalone GNSS mode. The positioning results show that the A-GNSS PPP-B2b service can achieve positioning performance with RMS errors of less than 1.5 m, 2.5 m, and 4 m in open-sky, realistic, and challenging urban environments. Compared to GNSS-based positioning, cellular network-based Observed Time Difference of Arrival (OTDOA) positioning achieves an accuracy ranging from tens to hundreds of meters in various experimental scenarios and currently functions primarily as coarse location determination. Additionally, this study explores the potential of the Three-Dimensional Mapping-Aided (3DMA) GNSS algorithm in detecting Non-Line-of-Sight signals and enhancing positioning performance. The results indicate that 3DMA PPP, as compared to conventional PPP, can significantly accelerate PPP convergence and improve positioning accuracy by over 30%. Consequently, 3D city models can be utilized as future assistance data for the A-GNSS location platform.
Exploring potential therapeutic strategy for hepatocellular carcinoma and COVID-19 using bioinformatics analysis
Authors: Tang Jiayan , Yang Zaiyong , Qin Huotang , Huang Yu , Li Minqing , Deng Qing , Li Ling , Li Xiaolong
Published: August 2024

Background

Hepatocellular carcinoma (HCC) constitutes an important contributor to fatalities. Coronavirus disease 2019 (COVID-19) frequently presents with complications such as respiratory distress, systemic inflammatory responses, and damage to various organs. Several studies have investigated the relationship between COVID-19 and mortality in patients with liver cancer, but there are few research on the relationship between them. This study is to explore the correlation between the two diseases and drugs treating them.

Methods

The Gene Expression Omnibus (GEO) database provides gene datasets of COVID-19 patients and HCC patients. Through differential gene analysis and weighted gene co-expression network analysis, we determined 223 genes represented in HCC and COVID-19. We then used functional annotation, protein–protein interaction network construction, predictive model development and verification, prognostic value analysis, and miRNA–gene network construction. Besides, we created a drug–hub–gene network by predicting possible medications that interact with hub genes using the Drug–Gene Interaction Database (DGIdb). Ultimately, we applied immunohistochemistry to ascertain the hub genes expression.

Results

This study revealed that eight core genes (RRM2, TPX2, DTL, CDT1, TYMS, CDCA5, CDC25C, and HJURP) co-existed in both HCC and COVID-19 and were differentially expressed in both HCC and normal tissues.CDC25C, RRM2, CDCA5, and HJURP had diagnostic value (AUC > 0.8) and prognostic value (adjusted P-value < 0.05). Genome enrichment analysis indicated that eight genes may function in liver cancer through engagement in the cell cycle, DNA replication, etc. In liver cancer samples, these genes were significantly and adversely associated with plasma cells while RRM2 was positively associated with neutrophil and NK cell activation and with dendritic cell resting. Using the miRNAnet database and DGIdb, 9 transcription factors, 7 miRNAs, and 51 drugs or molecular compounds were predicted to interact with the hub genes. Finally, RRM2 expression showed significant variation in clinical specimens, and analysis of the association of RRM2 with immunomodulators indicated that RRM2 was closely connected to MICB and CD276.

Conclusions

Our study revealed several metabolic genes related to HCC and COVID-19. Moreover, potential drugs related to central genes were predicted. These findings may provide new ideas for treating COVID-19 and HCC.
Assessment of liver fibrosis by transient elastography and procollagen III amino terminal propeptide in rheumatoid arthritis patients treated with methotrexate
Authors: Ghaleb Rasha M. , Mohamed Doaa M. , Zaki Zaki M. , Ameen Nadia F. El , Hamed Ahmed
Published: August 2024

Background

Methotrexate (MTX) is well known as the first-line therapy for rheumatoid arthritis (RA) patients. Its prolonged usage necessitates frequent assessing for adverse impacts, most importantly hepatotoxicity. Since there are no set standards for verifying liver damage in RA patients; transient elastography (TE) is emerged as a non-intrusive technique for identifying and evaluating liver fibrosis, alongside with serum procollagen III amino terminus propeptide (PIIINP). The objective of this study is to investigate liver fibrosis in 60 patients with RA patients on MTX therapy and 30 healthy individuals by TE and PIIINP, in addition, to recognize the prognostic indicators for liver fibrosis.

Results

This study compared 60 adult RA patients who had been on MTX for at least 1 year to 30 matched age and sex heathy individuals. Liver fibrosis was measured using TE and PIIINP. A cutoff point of 7.1 kPa was declared abnormal, suggesting substantial liver fibrosis, while PIIINP > 170 ng/ml indicating elevated PIIINP levels. Based on TE results, liver fibrosis was reported in 20 patients (33.3%) with 14 patients (23.3%) who had significant liver fibrosis, 4 patients (6.7%) had advanced liver fibrosis, and 2 patients (3.3%) had liver cirrhosis. Meanwhile, five of the controls had mild liver fibrosis with highly statistically significant difference between patients and controls. The patient group had significantly higher level of PIIINP when compared to the healthy group with a specificity and sensitivity for detecting liver fibrosis of 85% and 82.5%, respectively.

Conclusions

MTX usage in RA patients was correlated with an overall increase in liver fibrosis. Cumulative dosage of MTX, the presence of fatty liver and elevated serum PIIINP levels are all significant predictors of liver stiffness in RA. TE is organ specific and could be helpful in assessing true liver status rather than PIIINP level which is not organ specific. TE is superior to serum PIIINP and is recommended as a routine investigation for RA patients on MTX therapy particularly those with fatty liver.
Role of diffusion-weighted magnetic resonance imaging in detection of lymph node metastasis in rectal cancer
Authors: shimy Rehab Mohamed , Aly Asmaa Monir , Elshishtawy Samer Ali , Hassan Mona H. , Desouky Shimaa H. I. , Hanna Amir
Published: August 2024

Background

Rectal cancer is the most prevalent gastrointestinal tumor. Early diagnosis, accurate staging as well as early treatment are the keys for improving the five-year survival rate. The objective of this research is to assess the effectiveness of diffusion-weighted MRI (DWI) in identifying lymph nodes and distinguishing between benign and metastatic nodes throughout the first stage of primary rectal cancer.

Results

The study showed that mean ADC value was significantly higher in mucinous carcinoma (1.72 ± 0.36 × 10–3 mm2/sec) than that in non-mucinous carcinoma (0.981 ± 0.276 × 10–3 mm2/sec) with a cutoff value of (1.3 × 10–3) mm2/s which was the precise value to produce high sensitivity, specificity and accuracy of 93%, 94%, and 94%, respectively. ADC analysis showed either intermediate or low signal in 49 (70%) and high signal in 21 (30%) L.Ns. Mean ADC value showed a significant reduction in malignant L.Ns (1.01 ± 0.54 × 10–3 mm2/sec) compared to benign L.Ns (1.51 ± 0.51 × 10–3 mm2/sec), AUC of 0.674 (P = 0.008) and a cutoff value of 0.987 × 10–3 mm2/s with sensitivity, specificity and accuracy of 44.4%, 91.2% and 67.5%, respectively. The mean L.N /tumor ratio was 1.65 ± 0.73 in benign L.Ns and 1.06 ± 0.37 in malignant L.Ns.

Conclusions

In rectal cancer, there was a significant difference between benign and malignant L.Ns regarding diffusion result, L.Ns size, shape, and margin. The study demonstrated the effectiveness of DWI in diagnosing lymph node metastasis in colorectal cancer; true diffusion restriction was significantly noted in malignant L.Ns compared to benign L.Ns. Mean ADC value showed a significant reduction in malignant L.Ns compared to benign L.Ns. L.N/tumor ratio showed a significant reduction in malignant L.Ns compared to benign L.Ns.
The role of Shigella spp. in propagating bacillary dysentery in humans and the prominence of nanotechnology in disease prevention
Authors: Hmar El Bethel Lalthavel , Paul Sujata , Sharma Hemanta Kumar
Published: August 2024

Background

Shigellosis, also known as bacillary dysentery, is an acute infection of the intestine. The symptoms can vary from mild watery diarrhoea to severe inflammatory bacillary dysentery, which is characterized by fever, intense abdominal cramps, and the presence of blood and mucus in the stools. While the disease typically resolves on its own, it can become life-threatening in immunocompromised individuals or in the absence of adequate medical care.

Main body of the abstract

Shigella is the primary cause of bacillary dysentery worldwide. It is comprised of four distinct species—S. dysenteriae, S. flexneri, S. boydii, and S. sonnei—each with unique genomic characteristics and disease-causing abilities. Shigella spp. have developed resistance to multiple drugs and have also adapted well to the gut environment over time. They have become well-suited to infecting the human gut epithelial cells and causing dysentery. Consequently, numerous studies have investigated the potential application of nanotechnology in the treatment of shigellosis by leveraging its capability for drug delivery and targeted therapy, thereby improving effectiveness while reducing side effects.

Short conclusion

It is crucial to maintain ongoing surveillance and develop new strategies to effectively manage this issue. In this review, we shed light on the present comprehension of distinct Shigella spp. and their potential contribution to the pathogenesis of shigellosis, along with their interaction with the gut microbiota. We also provide insight into how nanotechnology may be a major factor in preventing shigellosis in the future.
Advanced statistical approaches for predicting pain after pediatric thoracotomy: a cross-sectional study using zero-inflated and Poisson models
Authors: Vittori Alessandro , Cascella Marco , Di Gennaro Piergiacomo , Marchetti Giuliano , Francia Elisa , Mascilini Ilaria , Tarquini Riccardo , Innamorato Massimo Antonio , Petrucci Emiliano , Marinangeli Franco , Coluccia Sergio , Picardo Sergio Giuseppe
Published: August 2024

Background

Thoracotomy is one of the surgical procedures most burdened by chronic post-operative pain. There is poor evidence regarding the possibility that even in pediatric patients, thoracotomy can be followed by post-operative pain. The primary objective of this analysis is to identify associations with home pain therapy, pain intensity, and possible protective factors acting on chronic pain in this population.

Methods

A retrospective cross-sectional study was conducted at Ospedale Pediatrico Bambino Gesù IRCCS. The study included pediatric patients undergoing thoracotomy. For statistical analyses, a logistic model and a zero-inflated strategy were implemented to explore associations and predict factors related to home-based analgesic therapy and pain intensity.

Results

Gender and age were identified as significant factors in the assignment of home therapy, with males having over seven times the risk compared to females (OR = 7.06, 95% CI = [2.11, 29.7]). At the last measurement, pain intensity was positively associated with age and the number of pain events during the week.

Conclusions

The study highlights significant factors influencing post-thoracotomy pain management in pediatric patients. These findings underscore the importance of tailored pain management strategies that consider gender and age to improve post-operative care and outcomes in pediatric thoracotomy patients.
Advancing digital healthcare in Somalia: a review of modern technologies and their implications
Authors: Ahmed Mohamed Mustaf , Dirie Najib Isse , Mohamud Abdirahman Khalif , Elmi Abdikadir Hussein , Musa Shuaibu Saidu , Alhammadi Omar Abdulkarim Saeed , Lemma Misha Abayneh , Uwamahoro Joselyne , Bananeza Roméo , Abdullahi Yinusa , Othman Zhinya Kawa , Hamid Mohammed Raihanatu , Kasimieh Omar , Labyad Safouane , Lucero-Prisno Don Eliseo
Published: August 2024

Somalia faces many challenges in providing adequate and accessible healthcare to its population, particularly in rural and remote areas. Lack of infrastructure, resources, and security hinders the delivery of quality health services and the prevention and control of diseases. However, modern technologies such as mobile phones, the Internet, and telemedicine offer new opportunities to digitize health care and improve health outcomes in Somalia. This paper explores the current state of healthcare in Somalia, the potential benefits, and challenges of using modern technologies to digitize healthcare, and the best practices and recommendations for implementing such technologies in the Somali context. This paper examines a telemedicine project that connects remote healthcare facilities with urban specialists. We assess its effectiveness and sustainability, showing its potential to improve healthcare in rural areas of Somalia. The review concludes that modern technologies can play a vital role in digitizing healthcare in Somalia, but they require careful planning, coordination, and evaluation to ensure their effectiveness and suitability.
Development and initial evaluation of a clinical prediction model for risk of treatment resistance in first-episode psychosis: Schizophrenia Prediction of Resistance to Treatment (SPIRIT)
Authors: Farooq Saeed , Hattle Miriam , Kingstone Tom , Ajnakina Olesya , Dazzan Paola , Demjaha Arsime , Murray Robin M. , Di Forti Marta , Jones Peter B. , Doody Gillian A. , Shiers David , Andrews Gabrielle , Milner Abbie , Nettis Maria Antonietta , Lawrence Andrew J. , van der Windt Danielle A. , Riley Richard D.
Published: August 2024

Background

A clinical tool to estimate the risk of treatment-resistant schizophrenia (TRS) in people with first-episode psychosis (FEP) would inform early detection of TRS and overcome the delay of up to 5 years in starting TRS medication.

Aims

To develop and evaluate a model that could predict the risk of TRS in routine clinical practice.

Method

We used data from two UK-based FEP cohorts (GAP and AESOP-10) to develop and internally validate a prognostic model that supports identification of patients at high-risk of TRS soon after FEP diagnosis. Using sociodemographic and clinical predictors, a model for predicting risk of TRS was developed based on penalised logistic regression, with missing data handled using multiple imputation. Internal validation was undertaken via bootstrapping, obtaining optimism-adjusted estimates of the model's performance. Interviews and focus groups with clinicians were conducted to establish clinically relevant risk thresholds and understand the acceptability and perceived utility of the model.

Results

We included seven factors in the prediction model that are predominantly assessed in clinical practice in patients with FEP. The model predicted treatment resistance among the 1081 patients with reasonable accuracy; the model's C-statistic was 0.727 (95% CI 0.723–0.732) prior to shrinkage and 0.687 after adjustment for optimism. Calibration was good (expected/observed ratio: 0.999; calibration-in-the-large: 0.000584) after adjustment for optimism.

Conclusions

We developed and internally validated a prediction model with reasonably good predictive metrics. Clinicians, patients and carers were involved in the development process. External validation of the tool is needed followed by co-design methodology to support implementation in early intervention services.
The subgroup analysis by age and geriatric assessment in a phase III study comparison of trastuzumab emtansine with trastuzumab, pertuzumab, and docetaxel in older patients with advanced stage HER2-positive breast cancer (JCOG1607 HERB TEA study).
Authors: Shimomura Akihiko , Tamura Kenji , Sasaki Keita , Sadachi Ryo , Suto Akihiko , Sawaki Masataka , Sagara Yasuaki , Yamamoto Naohito , Yoshiyama Tomoyuki , Hayashi Takako , Tokunaga Eriko , Yamanaka Takashi , Shimizu Chikako , Shien Tadahiko , Iwata Hiroji
Published: August 2024

1031

Background: The JCOG1607, HERB TEA Study, is a phase III trial that compared trastuzumab emtansine (T-DM1) with the HPD regimen (trastuzumab, pertuzumab, docetaxel) in older patients with advanced HER2-positive breast cancer. The primary objective was to confirm the non-inferiority of T-DM1 to HPD in overall survival (OS), with a margin of 1.35 for hazard ratio (HR). The trial was terminated early due to futility at the planned first interim analysis. T-DM1 didn't show non-inferiority to HPD in OS (HR 1.263; 95% confidence interval [CI], 0.677-2.357). Median progression-free survival (PFS) was 11.3 months for T-DM1 and 15.6 months for HPD (HR 1.373; 95% CI, 0.917-2.056). However, the condition of older patients varies widely, and we conducted a subgroup analysis to investigate the subgroup that could benefit from T-DM1 with fewer side effects as a first-line treatment. Methods: Subgroup analysis for OS and PFS involved 148 patients enrolled in JCOG1607, considering age and PS (<75 years old and PS 0,1 or <75 years old and PS 2 or ≥75 years old), Geriatric 8 (G8) score (≥15 or <15), Instrumental Activity of Daily Living (IADL) score (8 or <8), visceral/brain metastasis presence (with or without), and other factors. Results: Subgroup of <75 and PS 2 was not evaluable. For OS, HR of T-DM1 arm to HPD arm was 0.749 (95% CI: 0.310-1.808) in the group aged <75 years, while 2.867 (95%CI: 1.018-8.069) in the group aged ≥75 years (Table). G8 score and the IADL score did not show significant differences in HR for OS, although low G8 score group and low IADL score group tended to have higher OS in HPD arm than T-DM1 arm: HR of T-DM1 arm to HPD arm of 1.541 (95% CI: 0.755-3.142) in low G8 score group and 2.147 (95% CI: 0.656-7.025) in low IADL score group. For PFS, patients with visceral/brain metastasis had HR of T-DM1 arm to HPD arm of 1.794 (95% CI: 1.092-2.948). No other subgroup showed a significant difference in HR for PFS. Conclusions: No subgroups benefiting from T-DM1 as first-line treatment were identified. HPD remains the standard for advanced HER2-positive breast cancer, regardless of age (even in ≥75 years) G8 score, or IADL. Clinical trial information: UMIN000030783. [Table: see text]
Updated results from ALTER-S002: A single-arm multicenter trial of the combination of anlotinib with chemotherapy in patients with stage IIB classic osteosarcoma of the extremity.
Authors: Tang Fan , Zhou Yong , Ma Jie , Wang Dong , Zhang Bing , Luo Yi , Li Longqing , Liu Cuizhen , Nie Yuan , Min Li , Tu Chongqi
Published: August 2024

11529

Background: The overexpression of multiple tyrosine kinase receptors in osteosarcoma indicated a promising therapy targeting these receptors. Anlotinib is a multi-targeted tyrosine kinase inhibitor that potentially inhibits tumor angiogenesis. The combination of anti-angiogenic drugs with chemotherapeutic agents is proposed to act synergistically to achieve favorable tumor control, especially as the neoadjuvant therapy. We had reported the neoadjuvant therapy data of anlotinib in combination with chemotherapy for treatment-naive stage IIB classical osteosarcoma of the extremity in the 2023 ESMO congress. Here we report an update on the effectiveness and safety of the follow-up. Methods: In this open-label, single-arm, multicenter phase II clinical trial. Eligible patients(pts) were aged 12-40 years with histologically confirmed primary localized extremity classic osteosarcoma, stage IIB, operable. Pts received anlotinib (10mg, po, d1-14, q3w), doxorubicin (A) (20-25mg/m2 iv, d1-3, q3w) and cisplatin (P) (70-90mg/m2, iv, d1, q3w) for the first nine weeks. Pts underwent radical surgery after the exclusion of contraindications at week 10. After surgery, pts received A+P at weeks 12-14, and anlotinib plus A+P at weeks 15-20 with the drug dose unchanged. Since week 21, anlotinib (12mg, po, d1-14, q3w) monotherapy was maintained until week 104 or the occurrence of an EFS event. The primary endpoint was 24-month EFS rate, secondary endpoints were 36-month EFS rate, local recurrence rate, lung metastasis rate, 3-year OS rate and safety. Results: From May 2020 to Apr 2022, 52 eligible pts were enrolled, while 51 pts underwent surgery after 3 cycles of neoadjuvant therapy. At the data cut-off date (Oct. 2023), the median EFS was not reached, 12 and 24-month EFS rates were 84.18% (95% CI :70.82, 91.77) and 73.43% (95% CI :57.40, 84.21), respectively. The stratified analysis of EFS showed that the length and diameter of the target lesion are independent prognostic factors. The median OS was not reached, the 24-month OS rate was 95.92% (95% CI :84.65, 98.96). Among the 51 pts who underwent surgical treatment, 12(23.53%, 95% CI: 12.79, 37.49) pts experienced recurrence or metastasis. Most treatment-related adverse events (TRAEs) were grade 1-2. Grade 3/4 TRAEs (≥20%) included neutropenia (51.92%), leukopenia (38.46%), thrombocytopenia (36.54%) and anemia (32.69%). Conclusions: The updated results suggested that anlotinib combined with doxorubicin and cisplatin in the perioperative period showed favorable efficiency and manageable adverse events in Stage IIB classic osteosarcoma of the extremity. Clinical trial information: ChiCTR 2000033298.
Efficacy and safety of SHR-2554 in advanced epithelioid sarcoma: A phase 2 trial.
Authors: Zhou Yan , Ding Xiaomin , Zhang Yawen , Liang Jinrong , Xu Hongli , Tian Luyuan , Zhao Changhong , Hu Haiyan
Published: August 2024

11549

Background: Epithelioid sarcoma (ES) is a rare and aggressive subtype of soft-tissue sarcoma. The loss of SMARCB1 (INI1) expression which leads to oncogenic dependence on the transcriptional repressor EZH2 has been observed in over 90% of ES. Patients (pts) with metastatic ES have a poor prognosis. We investigated the efficacy and safety of SHR-2554, an oral selective EZH2 inhibitor, in pts with refractory ES. Methods: To be eligible for inclusion, pts had to fulfill the following criteria: 8 years or older; histologically confirmed advanced or metastatic ES with loss of INI1 or upregulated mRNA level of EZH2; progressive disease after at least one line of doxorubicin-containing chemotherapy; the presence of measurable disease according to RECIST 1.1; an ECOG performance status of 0-1. Pts received SHR2554 (350 mg, bid, po) until disease progression or unacceptable toxicity. The primary endpoint was progression-free rate at 12 weeks. A Simon two-stage design was applied. If there were 3 pts remaining progression-free at 12 weeks within the first 9 pts, the cohort would expand to 17 pts and the outcome would be positive if more than 7 pts remained progression-free at 12 weeks. Results: Between Jul 2021 and Dec 2023, a total of 17 pts were enrolled and received at least 1 dose of SHR-2554. The median age was 32 years (range 8-57) and 41.2% were males. 9 (52.9%) pts had received immunotherapy targeting PD-1/L1 and 6 (35.3%) pts had received anti-angiogenesis therapy before enrollment. The median line of previous treatment was 2 (range 1-4). Loss of INI1 was confirmed in 14 (82.4%) pts. Tumor response was evaluated in 14 pts at data cutoff. 9 (64.3%) of 14 pts remained progression-free at 12 weeks. The primary endpoint was met. Based on investigator assessment, 3 (21.4%) of 14 pts achieved partial response and 8 (57.1%) pts had stable disease as best response. Adverse events (AEs) were generally mild. The most common treatment-related hematological AEs were anaemia, platelet count decreased and hyperuricaemia. Conclusions: SHR-2554 showed promising efficacy and an acceptable safety profile in pts with refractory ES, warranting further investigation. Clinical trial information: ChiCTR2100046099.
An Indian real-world experience of intravenous fosnetupitant-palonosetron (IV NEPA) in preventing delayed and extended delayed CINV.
Authors: Barkate Hanmant V. , Pednekar Dr. Amullya , Shukla Pragya , Valame Shaunak , Nanda Siddhartha , Hanji Abhinandan , Shakya Naval Kishore , Verma Arun Kumar , Bhagat Sagar B , Patil Saiprasad , Bhushan Sumit
Published: August 2024

12070

Background: Although the reports suggest 15-25% cancer patients receiving highly- and moderately emetogenic chemotherapy (HEC and MEC) experience nausea and vomiting beyond day 5, majority of clinical trials focus on delayed chemotherapy induced nausea and vomiting (CINV) only during the first 5 days of treatment. Here we present a real world observational data with fixed combination of IntraVenous (Fos)NEtupitant and Palonosetron (IV NEPA) in preventing nausea/vomiting in delayed and extended delayed phase among patients receiving HEC/MEC. Methods: An open label, single arm, multicentre, phase IV prospective trial was conducted at six centres following individual Institutional Ethics Committee approval (CTRI/2023/04/051951). Patients in acute (0-24hrs), delayed (>24-120hrs), extended delayed (>120-240hrs) phases and extended overall phase (0-240hrs) were assessed for complete response (CR) (no vomiting and no need of rescue medication), complete protection (CP) [CR + no significant nausea (5mm to <25mm) on visual analogue scale], complete control (CC) [CR + no nausea (<5mm)] and safety. Results: Among 178 patients (Males-114, Females-64), 90 (50.56%) received HEC and 88 (49.44%) received MEC regimen. Cisplatin-Paclitaxel (19.10%) and Carboplatin-Paclitaxel (35.39%) were the most common HEC and MEC regimens respectively. Overall, CR in delayed and extended delayed phases were 93.26% and 96.07% respectively. Furthermore, CP and CC in delayed and extended delayed phases were 92.13% and 96.07% and 81.46% and 90.45% respectively (Table). In general, IV NEPA was well tolerated, as only 9.55% of patients experienced adverse events with 95.83% of them being mild in nature. Headache (2.25%) and injection site reactions (1.68%) were the most common adverse effect reported. Conclusions: IV NEPA demonstrated high efficacy and good tolerability in a real world Indian setting, exhibiting response rates of >92% in both delayed and extended delayed phases in patients receiving HEC/MEC regimens. Clinical trial information: CTRI/2023/04/051951. [Table: see text]