bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in the Gastrointestinal Microbiome between Patients with Type A aortic dissection and Patients with Primary Hypertension
Authors: Yang Bo , Shen Zhiying , Wang Mingliang , Mei LuGang , Wu Yang , Yu Xuefei
Published: April 2024

Background: The gastrointestinal microbiome (GM) influences various bodily systems through bacterial translocation or metabolism. Previous research has linked GM dysbiosis to the development of conditions such as coronary atherosclerotic heart disease, abdominal aortic aneurysm, and other cardiovascular ailments. The pathogenesis of Type A Aortic Dissection (TAAD) is complex, and few studies have reported on the role of the GM in the pathogenesis of TAAD.
Methods: To elucidate the involvement of the GM in TAAD pathogenesis, fecal samples were obtained from TAAD patients and individuals with Primary Hypertension (PH), serving as which composed the control group. Subsequently, the abundance and composition of the GM were evaluated via 16S rDNA high-throughput sequencing.
Results: The results revealed a notable difference in the GM structure between the TAAD group and the PH group. Additionally, LEfSe analysis revealed that Bacteroidetes dysbiosis contributed the most to GM dysbiosis in TAAD patients, suggesting that Bacteroidetes may play an important role in the pathogenesis of TAAD.
Conclusions: Compared to patients with PH, patients with TAAD are significantly dysbiotic in gut microbiota composition, providing new mechanistic insights into the pathogenesis of TAAD.
Screening resistant germplasms and quantitative trait locus mapping of resistance to Tomato chlorosis virus
Authors: Gao Wenzheng , Wang Zhirong , Dong Chenchen , Wei Kai , Chen Yifan , Qiu Zhuoyao , Pan Yuanyuan , Liu Ziteng , Li Xin , Du Yongchen , Huang Zejun , li Junming , Wang Xiaoxuan
Published: April 2024

Tomato chlorosis virus (ToCV) is an emerging plant virus, posing a substantial threat to the cultivation of economically vital vegetable crops, particularly tomato (Solanum lycopersicum). Despite its substantial impact on crop yield, resistant or tolerant tomato germplasms have not been well-documented, and the genetic basis of resistance to ToCV remains poorly understood. In this study, two wild accessions that were immune to ToCV and five accessions that were highly resistant to ToCV were identified from 58 tomato accessions. Additionally, a novel method was developed for evaluating resistance to ToCV in tomatoes and observed that tomatoes exhibited typical pathological features on day 15 and day 30 after ToCV inoculation, referred to as Stage 1 and Stage 2, respectively. Using quantitative trait locus (QTL) sequencing in conjunction with classical QTL approaches, ToCV resistance loci were identified in two F2 populations derived from the crosses between SG11 (susceptible) and LA1028(resistant) and between SP15 (susceptible) and LA0444(resistant). Genetic analysis indicated that resistance to ToCV in the wild-type ToCV-resistant tomato accessions LA1028 and LA0444 was quantitative and mainly governed by four loci (Qtc1.1 and Qtc11.1 from LA1028 and Qtc7.1and Qtc9.1from LA0444). Subsequently, transcriptome analysis of three resistant accessions (LA2157, LA0444, and LA1028) and two susceptible accessions (SG11 and SP15) revealed unique differentially expressed genes and specific biological processes at the two stages of ToCV infection. This study provides new resistant germplasms and potential genetic resources for ToCV resistance, which can be valuable in tomato molecular breeding programs to obtain resistant varieties.
Efficacy of Metformin-Cabergoline compared to Metformin Monotherapy for Management of PCOS with Hyperprolactinemia– A Systematic Review and Meta-analysis
Authors: Kumar Aakash , Nazim Ahsan , Maheshwari Mahveer , Kumari Nisha , Kumar Purneet , Lohana Chandar Kanta , Kala Deep , Ali Khansa , Raj Hem , Islam Hamza , Islam Rabia , riaz monazza
Published: April 2024

Background
Metformin plays a major part in the treatment of polycystic ovarian syndrome (PCOS). Trials are being conducted to compare the effectiveness of combination of metformin with cabergoline in the treatment of hyperprolactinemia and polycystic ovarian syndrome.
Objectives
The purpose of this study is to compare the effectiveness of metformin monotherapy and combination therapy with cabergoline vs metformin for the management of PCOS with hyperprolactinemia.
Methodology
An extensive search up until January 23rd, 2024 of electronic databases (PubMed, Registry of Controlled Clinical Trials, Web of Sciences, SCOPUS) to find pertinent studies. An analysis was conducted with both observational data and randomized clinical trials (RCTs). To compute the standard mean difference (SMD), weighted mean difference (WMD), odds ratio (OR), and 95% confidence interval (CI), RevMan (v5.3) was utilized. Primary outcomes that were assessed included body-mass index (BMI), regular menstruation, weight change, prolactin, testosterone, and dehydroepiandrosterone-sulfate (DHEAS) levels.
Results
Three randomized controlled trials and one observational study, taking a total patient population of n = 535, were part of our final analysis. Prolactin (SMD = -3.23 95%Cl:(-4.90, -1.55)) and DHEAS levels (SMD = -0.27 95%Cl:(-0.52, -0.01)) were significantly lower in the metformin and cabergoline combination therapy group; monthly regularity was also significantly higher (OR = 3.07 95%Cl:(2.09, 4.51)). Statistically, there was no significant difference in weight, BMI, or testosterone levels.
Conclusions
In the treatment of PCOS, the combination of metformin and cabergoline significantly lowers prolactin levels and encourages regular menstrual cycles. Although metformin has the potential to suppress testosterone levels, more investigation is required to determine how combination therapy affect DHEAS and testosterone levels. It's interesting to note that while neither intervention had a substantial impact on weight or BMI, metformin and cabergoline combination therapy outperformed metformin monotherapy in terms of supporting regular menstrual cycles. Customized therapy approaches are essential, and large-scale trials involving a variety of groups are required to comprehend the safety and effectiveness of treatments.
Assessing the Impact of Cooking on Bioactive Compounds in Tomato Sauces with Added Tomato Pomace: A Chemometric Study
Authors: Perez Maria , González-Coria Johana , Mesirca-Prevedello Camilla , Lozano-Castellón Julián , Casadei Enrico , Valli Enrico , López-Yerena Anallely , Jaime-Rodríguez Carolina , Pinto Diana , Illan Montse , Torrado Xavier , Romanyà Joan , Vallverdú-Queralt Anna , Bendini Alessandra , Lamuela-Raventós Rosa M.
Published: April 2024

The disposal of waste from widely consumed foods, such as tomatoes, poses a considerable challenge for the agro-industry. Tomato pomace (TP), a by-product of tomato processing consisting of peels and seeds, is an underutilized source of bioactive compounds with potential application in the food sector. In this work, a factorial experiment was designed to compare three culinary techniques, Thermomix® and Roner® food processing and traditional pan-frying, for the preparation of tomato sauces, enriched or not with TP, applying two temperatures and two cooking times. A multivariate analysis was performed on all the results obtained for the studied metabolites. The addition of TP significantly increased the content of bioactive compounds in the tomato sauce, especially phenolic compounds. OPLS-DA models were generated, using cooking technique, temperature, and time as discriminant factors. The culinary technique had a greater effect on the phenolic content than cooking temperature or duration time. During processing in the Thermomix®, but not the Roner®, bioactive components were released from tomato into the sauce to a similar extent as traditional pan-frying. Although no significant increase in bioactive compounds was found when using the Roner®, this technique proved effective in preserving the volatile fraction of the sauce. The two new cooking home technologies evaluated, comparing with the classical pan frying, have different effect on the tomato sauce preparation; while the Thermomix ®, increased significatively the amount of bioactive compounds, the Roner® increased the amount of volatile compounds.
Construction of Prediction Model Integrating the Radiomics Features of Segmented Clots for Risk Stratification in Acute Pulmonary Embolism
Authors: Shen Rui , Guo Youmin , Shen Cong
Published: April 2024

Objective
Acute pulmonary embolism (APE) is a major cardiovascular disease, the risk stratification is challenging. This study aims to investigate the feasibility of developing a prediction model for risk stratification of APE patients based on radiomics features of the clots.
Materials and Methods
Computer tomography pulmonary angiography images from 66 APE patients (50% of males, 51.5% of age > 60 years) with different risk levels (33 high-risk and 33 non-high-risk) were analyzed retrospectively. Qanadli and Mastora index was used for evaluating the obstruction degree manually. Radiomics features were extracted from the clots. Independent t-test, least absolute shrinkage selection operator (LASSO) and correlation matrix were used to select the most discriminative features. Support vector machine (SVM), Gaussian Naïve Bayes (GNB), K-Nearest Neighbor (KNN), Decision Tree (DT), Random Forest (RF) and Multi-layer Perceptron-neural net (MLP-NN) were used to build risk stratification models. Mean accuracy and its standard deviation of a 10-fold-cross-validation and the correct rate of these six classifiers were evaluated and compared.
Results
1737 radiomics features were extracted from the segmented clots. 16 features, including 5 shape-based features, 8 texture-based features and 3 histogram-based features, were identified as the most discriminative features after eliminating redundant and irrelevant ones. Mean accuracies and their standard deviations showed that MLP-NN had the best performance (0.9042 ± 0.3029), followed by GNB (0.8625 ± 0.3334), SVM (0.8542 ± 0.4070), RF (0.8542 ± 0.3787), KNN (0.8292 ± 0.3038) and DT (0.7667 ± 0.3122), while the GNB model can predict the highest number of the high risk APE patients. MLP-NN yielded the highest correct prediction rate (86.36%), followed by GNB (84.85%), SVM (84.85%), RF (81.82%) and KNN (81.82%), all improved over the clinical scoring systems of Qanadli and Mastora scoring Indices (72.73% and 77.27%).
Conclusions
The radiomics features combined with MLP-NN can be potentially applied in the clinical risk stratification process to assist the treatment decision for APE patients.
Laser Interstitial Thermal Therapy (LITT) for Pediatric Low-Grade Glioma – Case Presentations And Lessons Learned
Authors: Strauss Ido , Gabay Segev , Roth Jonathan
Published: April 2024

Background:

The surgical treatment of brain tumors has developed over time, offering customized strategies for patients and their specific lesions. One of the most recent advances in pediatric neuro-oncological surgery is laser interstitial thermal therapy (LITT). However, its effectiveness and indications are still being evaluated. The aim of this work is to review the current literature on LITT for pediatric low-grade gliomas (pLGG) and evaluate our initial results in this context.

Methods:

We retrospectively reviewed our pediatric neurosurgery database for patients who received LITT treatment between November 2019 and December 2023. We collected data on the indications for LITT, technical issues during the procedure, and clinical and radiological follow-up.

Results:

Three patients underwent 5 LITT procedures for pLGG. The lesion was thalamo-peduncular in one patient, cingulate in one, and deep parietal in one patient. Two patients had a previous open resection done and were diagnosed with pLGG. One patient underwent a stereotaxic biopsy during the LITT procedure that was non-diagnostic. The same patient underwent a later open resection of the tumor in the cingulate gyrus. There were no surgical complications and all patients were discharged home on the first post-operative day. The follow-up period was between 20 and 40 months. Radiological follow-up showed a progressive reduction of the tumor in patients with LGG.

Conclusion:

Laser interstitial thermal therapy is a minimally invasive treatment that shows promise in treating deep-seated pLGG in children. The treatment has demonstrated a reduction in tumor volume and the positive results continue over time. LITT can be used as an alternative treatment for tumors located in areas that are difficult to access surgically or in cases where other standard treatment options have failed.
Transparency in Computer-Aided Breast Cancer Diagnosis Tool Development: A CBIS-DDSM Case Study
Authors: Liao Ling , Aagaard Eva
Published: April 2024

Accessible mammography datasets and innovative machine learning techniques are at the front line for computer-aided breast cancer diagnosis. However, the opacity surrounding private datasets and the unclear methodology behind the selection of subset images from publicly available databases for model training and testing, coupled with the arbitrary incompleteness or inaccessibility of code, markedly intensifies the obstacles in replicating and validating the model's efficacy. These challenges, in turn, erect barriers for subsequent researchers striving to learn and advance in this field. To address these limitations, we provide a pilot codebase covering the entire image preprocessing to model construction and evaluation pipeline, utilizing publicly available Curated Breast Imaging Subset of Digital Database for Screening Mammography (CBIS-DDSM) mass subset, including both full images and regions of interests (ROIs). The pipeline achieves an area under the receiver operating characteristic curve (AUROC) of 86.3% [95% CI: 0.842, 0.885], representing the state of the art performance for benign and malignant classification with selected mammography images. Collectively, our efforts hold promise in accelerating global software development for breast cancer diagnosis by leveraging our codebase and structure, while also integrating other advancements in the field.
The role of short journey transportation in the spreading of swine pathogens and antimicrobial-resistant bacteria
Authors: Masserdotti Marta , Formenti Nicoletta , Donneschi Anna , Guarneri Flavia , Scali Federico , Romeo Claudia , Giacomini Enrico , Bertasio Cristina , Boniotti Maria Beatrice , Alborali Giovanni Loris , Luzzago Camilla
Published: April 2024

Background: The transport of live pigs poses a risk to on-farm biosecurity. Trucks can carry pathogens with significant economic and health impacts, including antimicrobial-resistant (AMR) bacteria. This study aimed to investigate the microbiological contamination of trucks before and after loading, focusing on AMR bacteria and other major pathogens transmissible through faeces. Samples were collected by swabbing the internal surface of disinfected empty trucks at farm entry (‘clean’) and after loading (‘dirty’), and were tested for total plate count (TPC), specific bacteria and viruses. Escherichia coli isolates were also phenotypically and molecularly tested for the presence of extended-spectrum β-lactamase (ESBL), other β-lactamases (AmpC) and carbapenemase.
Results: Bacterial counts (both TPC and Enterobacteriaceae count) and the probability of testing positive for E. coli, ESBL/AmpC-producing E. coli and Rotavirus A varied significantly depending on the truck condition, being significantly higher in “dirty” than in “clean” trucks. Despite a non-significant difference, positivity to Rotavirus B showed the same tendency. Conversely, the truck condition had no effect on Rotavirus C. Salmonella spp., PRRSV, and carbapenemase-producing E. coli were detected only in samples collected on “dirty” trucks.
Conclusions: Although the prevalence of most agents in ‘clean’ samples was close to zero, the relatively frequent occurrence of E. coli and some rotaviruses highlights the importance of improving sanitisation procedures. The detection of ESBL/AmpC- and carbapenemase-producing E. coli was of particular concern. These findings confirm the role of trucks in spreading pathogens of concern and AMR, highlighting the importance of effective monitoring and proper sanitisation procedures.
Characteristics of esotropia in Japanese adults: a retrospective evaluation of 105 patients who underwent esotropia surgery at Inoue Memorial Hospital
Authors: Yokoyama Akiko , Iwase Takehito , Watanabe Kana , Kurosawa Yuri
Published: April 2024

Background
This study evaluated etiological factors, changes in alignment angle post-surgery, and binocular vision function improvement in Japanese adults with esotropia.
Methods
This retrospective study included 105 patients with esotropia who underwent surgery at our hospital. We reviewed the medical records to determine the causes of esotropia, patient motivation for surgery, changes in alignment angle post-surgery, improvement in binocular vision function, and correlation between the operated muscle length and corrected eye alignment angle. The alternate prism cover test was performed to assess the angle of misalignment. Binocular vision function was determined using the Titmus Stereo Test, major amblyoscope, Bagolini striated lenses test, and an afterimage test. One-to-four muscle surgery, involving medial rectus muscle recession or lateral rectus muscle resection, was performed.
Results
The etiologies included acquired progressive esotropia with myopia (n = 51); congenital esotropia (n = 6); partial accommodative esotropia (n = 5); cerebral infarction or cerebral breeding (n = 5); sagging eye syndrome (SES) (n = 5); brain tumors (n = 3); sensory esotropia (n = 2); consecutive esotropia after exotropia surgery (n = 2); face trauma (n = 1); Duane syndrome (n = 1); and unknown origin (n = 24). Eye alignment improved in all patients. However, four patients needed a second operation. Binocular vision function improved in patients with acquired progressive esotropia with myopia; partial accommodative esotropia; cerebral infarction or cerebral breeding; SES; and brain tumors. Binocular vision function was unchanged in patients with sensory and congenital esotropia.
Conclusions
Esotropia surgery in adults can lead to improved eye alignment and binocular vision function. However, the patients with sensory esotropia and congenital esotropia were unable to acquire binocular vision function.
Pediatric providers’ knowledge and practice of Metered Dose Inhalation techniques in Addis Ababa
Authors: Weldetsadik Abate Yeshidinber , Worku Edlawit
Published: April 2024

Background
Aerosol therapy is the cornerstone of treatment for childhood respiratory disorders including asthma. Inhaled medications can be delivered by Metered Dose Inhaler (MDI), Dry Powder Inhaler (DPI), or nebulizers. There are limited data on the knowledge and practice of MDI techniques among pediatric providers in Ethiopia. We evaluated the knowledge and practice of MDI techniques in pediatric providers’ in a tertiary center in Addis Ababa.
Methods
Cross-sectional study was conducted at St. Paul’s Hospital Millennium Medical College among nurses, residents and interns working in the department of pediatrics. We assessed the knowledge and practice of the providers’ MDI techniques in children. The study was done from April 2021 to August 2021. Structured questionnaire and a standardized tool were used for data collection, and data was analyzed using SPSS version 26.
Results
A total of 143 pediatric providers (139 (93.7%) between 24–34 years, 82(57.3%) female) were included in the study. Majority (68(48%)) were pediatric residents. Among the healthcare providers, only 81 (57%) had good knowledge on MDI medication administration techniques in children. The practice of inhalation was appropriate in 95 (66) % of the healthcare providers (HCP) with a mean practice score of 3.08 (Standard Deviation, SD 0.34). The most frequent error (54%) was failure to hold breath after inhalation. Failure to inhale appropriately for the device (29%), and not waiting for 30–60 seconds before next dose (25%) were the other common errors of practice. On multivariable analysis, no variables were associated with knowledge and practice of inhalation therapy.
Conclusion
Our study documented low level of knowledge and practice of pediatric healthcare providers towards MDI administration techniques in children but no independent predictors were identified with the knowledge and skill of the providers. Training of inhalation therapy should be provided to all pediatric providers to optimize MDI administration, and education for children and their caregivers.
A retrospective, multicentric, nationwide analysis of the impact of splenectomy on survival of pancreatic cancer patients
Authors: Kießler Maximilian , Jäger Carsten , Reyes Carmen Mota , Pergolini Ilaria , Schorn Stephan , Göß Rüdiger , Safak Okan , Martignoni Marc E. , Novotny Alexander R. , Uhl Waldemar , Werner Jens , Ghadimi Michael , Hartwig Werner , Ruppert Reinhard , Keck Tobias , Bruns Christiane , Oldhafer Karl-Jürgen , Schnitzbauer Andreas , Germer Christoph-Thomas , Sommer Florian , Mees Sören Torge , Brunner Maximilian , Köninger Jörg , Glowka Tim R. , Kalff Jörg C. , Reißfelder Christoph , Bartsch Detlef K. , Kraus Thomas , Padberg Winfried , Piso Pompiliu , Lammers Bernhard J. , Rudolph Hagen , Moench Christian , Farkas Stefan , Friess Helmut , Ceyhan Güralp O. , Demir Ihsan Ekin
Published: April 2024

Objective
Splenectomy is regularly performed in total and distal pancreatectomy due to technical reasons, lymph node dissection and radicality of the operation. However, the spleen serves as an important organ for competent immune function, and its removal is associated with an increased incidence of cancer and a worse outcome in some cancer entities1–3. The impact of splenectomy in pancreatic cancer is not fully resolved4,5.
Methods
We therefore compared the outcome of 193 pancreatic cancer patients who underwent total or distal pancreatectomy with (Sp) or without splenectomy (NoSp) between 2015 and 2021 using the StuDoQ|Pancreas registry of the German Society for General and Visceral Surgery. In addition, we integrated our data into the existing literature in a meta-analysis of studies on splenectomy in pancreatic cancer patients.
Results
There was no difference between the Sp and NoSp groups regarding histopathological parameters, number of examined or affected lymph nodes, or residual tumor status. We observed a significantly prolonged survival in pancreatic cancer patients who underwent total pancreatectomy, when a spleen-preserving operation was performed (median survival: 9.6 vs. 17.3 months, p = 0.03). In this group, splenectomy was identified as an independent risk factor for shorter overall survival [HR (95%CI): 2.4 (1.18–4.9)]. In a meta-analysis of the existing literature in combination with our data, we confirmed splenectomy as a risk factor for a shorter overall survival in pancreatic cancer patients undergoing total pancreatectomy, distal pancreatectomy, or pancreatic head resection [HR (95%CI): 1.53 (1.11–1.95)].
Conclusion
Whenever technically possible, preservation of the spleen should be considered during total pancreatectomy for resection of pancreatic cancer, as the spleen seems to affect the long-term survival in this subgroup. The immunological reasons behind this observation deserve further investigation.
The TELEhealth Shared decision-making Coaching and Navigation in Primary carE (TELESCOPE) intervention: a study protocol for delivering shared decision-making for lung cancer screening by patient navigators
Authors: Tan Naomi Q. P. , Lowenstein Lisa M. , Douglas Elisa E. , Silva Jeanne , Bershad Joshua M. , An Jinghua , Shete Sanjay S. , Steinberg Michael B. , Ferrante Jeanne M. , Clark Elizabeth C. , Natale-Pereira Ana , Sahu Novneet N. , Hastings Shirin E. , Hoffman Richard M. , Volk Robert J. , Kinney Anita Y.
Published: April 2024

Background Lung cancer screening (LCS) can reduce lung cancer mortality but has potential harms for patients. A shared decision-making (SDM) conversation about LCS is required by the Centers for Medicare & Medicaid Services (CMS) for LCS reimbursement. To overcome barriers to SDM in primary care, this protocol describes a telehealth decision coaching intervention for LCS in primary care clinics delivered by patient navigators. The objective of the study is to evaluate the effectiveness of the intervention and its implementation potential, compared with an enhanced usual care (EUC) arm. Methods Patients (n = 420) of primary care clinicians (n = 120) are being recruited to a cluster randomized controlled trial. Clinicians are randomly assigned to 1) TELESCOPE intervention: prior to an upcoming non-acute clinic visit, patients participate in a telehealth decision coaching session about LCS delivered by trained patient navigators and nurse navigators place a low-dose CT scan (LDCT) order for each TELESCOPE patient wanting LCS, or 2) EUC: patients receive enhanced usual care from a clinician. Usual care is enhanced by providing clinicians in both arms with access to a Continuing Medical Education (CME) webinar about LCS and an LCS discussion guide. Patients complete surveys at baseline and 1-week after the scheduled clinic visit to assess quality of the SDM process. Re-navigation is attempted with TELESCOPE patients who have not completed the LDCT within 3 months. One month before being due for an annual screening, TELESCOPE patients whose initial LCS showed low-risk findings are randomly assigned to receive a telehealth decision coaching booster session with a navigator or no booster. Electronic health records are abstracted at 6, 12 and 18 months after the initial decision coaching session (TELESCOPE) or clinic visit (EUC) to assess initial and annual LCS uptake, imaging results, follow-up testing for abnormal findings, cancer diagnoses, treatment, and tobacco treatment referrals. This study will evaluate factors that facilitate or interfere with program implementation using mixed methods. Discussion We will assess whether a decision coaching and patient navigation intervention can feasibly support high-quality SDM for LCS and guideline-concordant LCS uptake for patients in busy primary care practices serving diverse patient populations. Trial Registration: This study was registered at ClinicalTrials.gov (NCT05491213) on August 4, 2022.
Assessing Survival in Non-Small Cell Lung Cancer Brain Metastases After Stereotactic Radiosurgery: Before and After the Start of the Targetable Mutation Era
Authors: Cole Kyril L. , Earl Emma R. , Findlay Matthew C. , Sherrod Brandon A. , Tenhoeve Samuel A. , Kunzman Jessica , Cannon Donald M. , Akerley Wallace , Burt Lindsay , Seifert Seth B. , Goldman Matthew , Jensen Randy L.
Published: April 2024

Purpose
Targeted treatment options for non-small cell lung cancer (NSCLC) brain metastases (BM) may be combined with stereotactic radiosurgery (SRS) to optimize survival. We assessed patient outcomes after SRS for NSCLC BMs, identifying survival trajectories associated with targetable mutations.
Methods
In this retrospective cross-sectional analysis, we reviewed patient charts from 2001–2021. We analyzed median overall survival of patients who received ≥ 1 SRS courses for BM from NSCLC with and without targetable mutations. We evaluated patient demographics, targetable mutations, and all treatments performed and their relationship on survival.
Results
Among the 235 patients included, 88 (37.5%) had targetable mutations—primarily EGFR (39.4%), KRAS (23.4%), and ALK (15.9%)—and 147 (62.5%) did not. Patients with targetable mutations were more often female (63.6%, p < .001) and nonsmokers (59.1%, p < .001) and received more systemic therapies (median 3 vs. 2, p < .001) and SRS courses (mean 1.56 vs. 1.32, p = .020). Patients with targetable mutations had lower mortality rates (72.7% vs. 90.5%, p < .001) and longer median overall survival (23.2 vs. 7.4 months, p < .001). Long-term survival was best predicted by SRS with resection in patients with non-targetable mutations (OR 3.284 [95% CI 1.075–10.03], p = .037), whereas systemic therapy with SRS appeared the best option for targetable mutation patients.
Conclusion
The presence of targetable mutations enhances survival in patients receiving SRS for NSCLC BM, particularly when used with systemic therapies. Long-term survival for patients without targetable mutations was greatest when SRS was used with surgical resection. These results inform best practices for managing NSCLC BM patients based on driver mutation status.
Evaluation of Baja Peninsula seaweeds against plant pathogens
Authors: González-Castro Ana Laura , Rojas-Contreras Maurilia , Romero-Bastidas Mirella , Águila-Ramírez Ruth Noemí , Rangel-Dávalos Carlos , Arce-Amezquita Pablo Misael
Published: April 2024

The widespread use of synthetic pesticides to control pests has generated serious consequences on the environment and human health. Currently, efforts focused on the search for new pesticides with less impact on the environment have been doubled. Marine algae synthesize compounds with activity against various agricultural pests (insects, nematodes, and fungi); however, marine pesticides are an underdeveloped alternative. This represents an opportunity to explore new sources of compounds. The objective of this work is to evaluate the antimicrobial, nematicidal and insecticidal activity of seaweed extracts against pathogens of agricultural importance. Therefore, seaweeds were collected from different locations at the Baja California peninsula, Mexico, and ethanolic extracts were obtained. The antibacterial and antifungal activity against five phytopathogenic strains and Fusarium oxysporum was evaluated by disc diffusion on agar. Nematicidal activity was assessed by egg hatching inhibition on Meloidogyne incognita and insecticidal activity against maize weevil Sitophilus zeamais. Regarding the antibacterial potential, Laurencia johnstonii, Asparagopsis taxiformis and Dictyota dichotoma showed higher inhibition against all the strains. Padina concrescens exhibited the highest percentage of egg hatching inhibition against M. incognita (59%) followed by L. johnstonii (48%). All the seaweeds cause mortality of S. zeamais. However, the highest insecticidal activity was found on L. johnstonii (71.9%). Red and brown seaweeds showed in general higher content of total phenolic compounds. Red and brown seaweed showed great potential for the control of phytopathogens through appropriate agricultural practices. However, further research is necessary to identify the active compounds.
Test-Retest performance of [18F]MK-6240 tau burden and relative delivery indices in cognitively normal older subjects using PET/MRI
Authors: Lois Cristina , Fu Jessie Fanglu , Salvatore Andrew N. , Garimella Arun H , Huell Derek , Sari Hasan , Garcia David Izquierdo , Mercaldo Nathaniel A , Dickerson Bradford , Johnson Keith A , Catana Ciprian , Price Julie C
Published: April 2024

Background: Accurate interpretation of quantitative PET outcomes hinges on understanding the test-retest variability (T-RT). Previous studies of the tau-PET ligand [18F]MK-6240 reported adequate T-RT performance of tau burden estimates over a short-term 21-day and over a longer-term 6-month T-RT period, primarily involving Alzheimer’s disease (AD) and cognitively normal (CN) subjects, respectively. However, several T-RT characteristics have not yet been reported, particularly in older CN (oCN) subjects. Here, we investigate the short-term T-RT performance of dynamic [18F]MK-6240 outcomes in a group largely consisting of oCN. We report T-RT for uptake in potential reference regions, for extracerebral off-target signal, and for estimates of tau burden and relative delivery indices in tau-bearing target regions.
Eight participants (7 oCN, 1 AD) underwent baseline dynamic [18F]MK-6240 PET/MRI (Biograph mMR) and a retest follow-up PET/MRI scan within approximately 3 weeks. T-RT was evaluated using absolute percentage differences and interclass correlation coefficients (ICC) in three groups of regions: 1) potential reference regions using standardized-uptake-values 90-110 minutes post-injection (SUV90-110min); 2) target regions using SUV ratios (SUVR90-110min), distribution volume ratios (DVR), and relative delivery (R1); and 3) extracerebral region using SUVR90-110min. A voxel-based partial volume correction (PVC) was applied. T-RT was evaluated with and without PVC.
Results: In oCN subjects, the SUV90-110min T-RT in the evaluated reference regions ranged from 6-11% (ICC > 0.9); target region T-RT was similar for SUVR90-110min (4-9%, ICC: 0.62-0.97), DVR (3-6%, ICC: 0.66-0.92), and R1 (3-11%, ICC: 0.77-0.92). PVC had minimal impact on reference region SUV90-110min T-RT, but increased target region T-RT variability (SUVR90-110min: 10-26%; DVR: 6-15%; R1: 4-14%). Extracerebral SUVR90-110min exhibited higher T-RT variability (~12%, ICC: 0.85) than other target regions (average 6%) and increased to ~15% after PVC.
Conclusion: Our findings are consistent with previous reports and provide further evidence of acceptable [18F]MK-6240 T-RT in low-signal oCN subjects. Our results suggest [18F]MK-6240 is suitable for detecting early tau deposition and longitudinal changes over time, and further support the viability of [18F]MK-6240 R1 to evaluate longitudinal changes in perfusion. However, the extracerebral signal exhibited higher T-RT variability than other target and reference regions and may affect their signal.
Double Stigma Among Pregnant Adolescents Living With HIV in Northern Uganda: A Pilot Cross-Sectional Study
Authors: Olum Ronald , Mukasa Barbara , Geng Elvin , Nakasujja Noeline
Published: April 2024

Background
Despite a global decline in HIV/AIDS incidence, adolescent girls and young women in sub-Saharan Africa remain disproportionately affected. Pregnant adolescents living with HIV/AIDS (ALWHIV) in Uganda may experience dual stigma from their HIV status and pregnancy. However, this remains unexplored, limiting targeted interventions. This study assessed the burden and factors associated with stigma among pregnant ALWHIV in Northern Uganda.
Methods
We analyzed baseline data from a pilot quasi-experimental study conducted between June and September 2023 at two tertiary hospitals to evaluate the feasibility of group therapy. All pregnant adolescents aged 10–19 with a confirmed diagnosis of HIV/AIDS were enrolled consecutively after informed consent. Stigma was determined using the HIV-stigma scale for children (HSS-10) and adolescent pregnancy stigma scale, and composite scores were normalized to a scale of 0–100 for comparison. Linear regression models were used to identify factors associated with HIV and pregnancy stigma in STATA 18.0.
Results
A total of 40 pregnant ALWHIV, 20 from each facility, were enrolled. The mean participant age was 18.2 years (SD: 0.9), 95% were school dropouts, and 60% were married or cohabiting. About 35% acquired HIV/AIDS perinatally, while 37.5% had a prior pregnancy. The median HIV-stigma score was 29/40 (IQR: 26–32), and the mean pregnancy stigma score was 46.5/75.0 (SD: 9.7). HIV stigma score was significantly higher than the adolescent pregnancy stigma score (median difference: 10.0%, p = 0.001), and pregnancy stigma had a strong positive correlation with HIV stigma (ρ = 0.67, p < 0.0001). HIV stigma was significantly associated with not living with a spouse/partner (adjusted β: 8.51, 95% CI: 0.17, 16.85, p = 0.046) and rural residence (β: 11.65, 95% CI: 2.36, 20.94, p = 0.046). Pregnancy stigma was significantly associated with not living with a spouse/partner (β: 15.51, 95% CI: 5.94, 25.08, p = 0.002) and not receiving support with domestic tasks at home (β: 13.84, 95% CI: 3.59, 24.08, p = 0.009).
Conclusion
Pregnant ALWHIV in our study faced significant stigma to HIV/AIDS and pregnancy, and this is significantly associated with not living with the marital partner. Those in rural settings also experienced higher HIV stigma, while those experiencing pregnancy stigma were more likely not to be receiving support with domestic tasks at home. Further research is needed on comprehensive support programs to alleviate the burden and enhance maternal and child health outcomes.
Diagnostic value and clinical validation of Acute Thyrotoxic Myopathy Symptom Score in acute thyrotoxic myopathy
Authors: Zhang Yun , Wu Chunjiao , Wang Tingliang , Chen Xuelan , Li Qiaoli , Liang Xinghuan , Yang Haiyan , Huang Zhenxing , Li Li , Xian Jing , Zhou Jia , Qin Yingfen , Lu Decheng , Luo Zuojie
Published: April 2024

Objectives
Acute thyrotoxic myopathy (ATM) is characterized by bulbar paralysis and limb myasthenia on the basis of hyperthyroidism, which can cause respiratory failure, coma and death. However, the diagnosis of ATM is challenging. The purpose of this study was to develop a symptom rating scale called the Acute Thyrotoxic Myopathy Symptom Score (ATMSS) to assist in the early diagnosis of ATM in clinical practice.
Methods
(1) the ATM reference sample was constructed by searching for patients diagnosed with ATM or thyrotoxic bulbar palsy in the PubMed, Embase and Web of Science databases (ATM cohort); (2) the ATMSS was formulated based on the ATM cohort after multidisciplinary discussion; and (3)51 patients with ATM and 49 patients with Graves' disease (GD) were enrolled in the study. (4) Receiver operating characteristic (ROC) curve analysis was applied to appraisal diagnostic value of the ATMSS for differentiating patients with ATM from patients with GD. (5) We also evaluated the correlation between ATMSS score and age, sex, thyroid function and thyroid-related antibody.
Results
The ATMSS score showed better diagnostic value at an optimal cut-off value of 5.5 [area under the curve (AUC) = 0.979; 95% confidence interval (CI) = 0.956-1; p < 0.0001; sensitivity = 94.1%; specificity = 93.9%]. The ATMSS score was positively correlated with free triiodothyronine (FT3) [Spearman correlation coefficient (rs) = 0.422, p < 0.001] and free thyroxine (FT4) (rs=0.497, p < 0.001).
Conclusions
We developed a symptom rating scale named the ATMSS, which is effective in diagnosing ATM, ATMSS score is positively correlated with thyroid function. ATMSS can be used as an additional tool for diagnosing ATM.
Preparation of thermally stable cementitious mortar incorporating multiwall carbon Nano- tube and carbon waste from aluminium production industry
Authors: Khater Hisham M. , Gharieb Mahmoud
Published: April 2024

The main purpose of this paper is to carry out a comparative investigation into the performance of multiwall carbon nanotube (MWCNT) and carbon wastes that are derived from the production of aluminum in the creation of thermally stable cementitious mortar. In Egypt, carbon waste is produced as a by-product of the aluminum industry and it is identified by its nano-scale dimensions. The cement mortar is produced by using a combination of blended cement (CEMIII) and sand that passes through a 1 mm sieve, with different ratios of both MWCNT and C-waste ranging from 0.1% to 0.7%. The addition of MWCNT and c-waste leads to an enhancement in compressive strength values up to 0.1%, resulting in values of approximately 70MPa and 75 MPa at 90 days, respectively. The findings validate the superior physical and mechanical properties of c-waste as compared to MWCNT, in addition to its lower production cost in comparison to precious MWCNT. The cement mortar demonstrates increased resistance to high temperatures when exposed to firing temperatures up to 700 degrees, achieving measurements of about 60 MPa and 63 MPa for MWCNT and carbon waste, respectively. The results also confirm the higher thermal stability of carbon waste when compared to MWCNT, despite both exceeding the limits specified for thermal resistance in mortar, which is 60 MPa.
An Experimental Evaluation of Horizontal Pod Autoscaler for Diverse Machine Learning Workloads in Kubernetes
Authors: Joyce Josephine Eskaline , Sebastian Shoney
Published: April 2024

Kubernetes, a container orchestration platform available as open source, ensures high availability and scalability by employing various autoscaling mechanisms such as Horizontal Pod Autoscaler (HPA), Vertical Pod Autoscaler (VPA), and Cluster Autoscaler (CA). Playing a pivotal role in ensuring a smooth service experience, HPA dynamically adjusts the number of replicas (pods) by scaling up or down. Kubernetes actively monitors essential Resource metrics, such as CPU and memory usage for pods. This study explores HPA through a series of diverse experiments to offer valuable insights into its operational behaviour across various machine learning (ML) applications. We analyze and provide insights into the behavior of HPA across various machine learning model based applications. Lastly, we delve into the significance of custom metrics collection for specific ML applications, offering deeper insights and lessons learned.
A numerical study of the surface water using levels of the organic pollution indexes: comparative characteristics and educational opportunities
Authors: Biedunkova Olha , Kuznietsov Pavlo , Korbutiak Vasyl
Published: April 2024

The current study investigates different approaches to calculating the organic pollution index of water and comparing the obtained numerical levels using statistical methods with the environmental assessment of the state. The object of the current study is the Styr River water at two sampling sites before and after the point source of pollution, namely, the water discharge of the power plant. The paper explores the possibilities for teaching the topic of environmental pollution by organic substances and allows students to gain practical knowledge of environmental assessment and data comparison. Moreover, statistical methods, including correlation analysis, were used in the research because of their ability to assess variations in river water quality and identify potential sources of water pollution. The author's conclusions obtained as a result of this study can be used when teaching environmental issues to students. The strengths of this study are that it focuses on environmental issues.
Gastrointestinal Histoplasmosis: Unveiling the Colon Cancer Facade in Crohn's Disease
Authors: Ayoub Malek , Alharfi Mohammad , Polamraju Vinathi , Alhobayb Tamara , Byrnes Kathleen , Gremida Anas
Published: April 2024

Background: The therapeutic landscape for inflammatory bowel diseases (IBD) has expanded with the advent of tumor necrosis factor-α (TNF) inhibitors, yet hurdles persist despite these strides. One such challenge arises from the increased vulnerability to opportunistic infections, notably histoplasmosis. Although histoplasmosis typically resolves on its own in individuals with healthy immune systems, its unconventional gastrointestinal manifestations in IBD patients can pose a diagnostic conundrum.
Case presentation: Here, we delve into the narrative of a 72-year-old woman diagnosed with Crohn's disease on infliximab monotherapy presented with escalating lower abdominal discomfort, nausea, vomiting, bloody diarrhea, and unintended weight loss over the preceding four weeks. Magnetic resonance enterography (MRE) highlighted a 5 cm thickened wall and restricted diffusion in the transverse colon, raising suspicions of malignancy. Colonoscopy revealed a sizable 15 mm deep and cratered transverse colon ulcer, prompting concern for colon cancer. However, a biopsy from the ulcer only revealed acute nonspecific inflammation. Given the patient's deteriorating condition and persistent neoplasm suspicion, she underwent total abdominal colectomy with ileorectal anastomosis. Surgical pathology confirmed multifocal transmural fungal colitis, consistent with histoplasmosis.
Conclusion: Clinicians should have a high index of suspicion for fungal colitis in patients previously in remission on immunosuppressive therapy and caution against dismissing histoplasmosis solely based on negative biopsy results. Repeated biopsy may be warranted to ensure comprehensive evaluation and accurate diagnosis.
Comparing strategies for genomic predictions in interspecific biparental populations: a case study with the Rubus genus
Authors: Silva Allison Vieira , Prado Melina , Campos Gabriela Romêro , Borges Karina Lima Reis , Yassue Rafael Massahiro , Husein Gustavo , Sposito Marcel Bellato , Amorim Lilian , Crossa José , Fritsche-Neto Roberto
Published: April 2024

Genomic selection (GS) is becoming increasingly widespread and applied due to the promising results obtained, cost savings in generating single nucleotide polymorphism (SNP) markers, and the development of statistical models that allow to improve the analysis robustness and accuracy. GS might shorten the selection cycle, which has a major impact, especially for perennial species. The composition and size of the training population have a major influence on GS, which poses challenges for interspecific biparental populations. Another factor is the use of different reference genomes from other species to perform SNP calling, which could make it possible to explore variability in interspecific crosses comprehensively. Late leaf rust is a disease caused by the pathogen Acculeastrum americanum, and the rare reports on genetic resistance to this pathogen are related to the species Rubus occidentalis, which leads to the need for interspecific hybridizations, aiming to combine the fruit quality of R. idaeus with the resistance of R. occidentalis. Given the above, we evaluated the effect of different reference genomes on the SNP markers discovery, as well as training population optimization (TPO) strategies on the accuracy of genomic predictions, namely the CV-α, leaving-one-family-out (LOFO), pairwise families, and stratified k-fold. The composition of the training set in a stratified manner, together with a matrix of markers combined with the reference genomes, increased the model's predictive capacity. These results corroborate that genomic prediction aligned with SNP calling and training population optimization strategies can significantly increase genetic gains in interspecific biparental crosses.
Critical incidents experienced by medicine interns in pandemics: A qualitative study at a South American medical school
Authors: Armijo Soledad , Franzoy Marcela Castillo , Lombardo Valentina Fuentes , Agurto Francisca Parra
Published: April 2024

Background
Critical Incidents (CI) during clinical practice can provide relevant information regarding students' stress, weaknesses in the teaching process, psychological safety, and the healthcare system. This study aimed to determine the elements considered by students to be CI during the COVID-19 pandemic in Chile.
Methods
This qualitative study was conducted on a sample of voluntary medical interns. Data production techniques were documentary analysis of the CI described in portfolios and two focus groups. Two researchers performed a reflexive thematic analysis of the CI and the focus groups. The Institutional Ethics Committee approved the research protocol.
Results
Twenty-four interns voluntarily participated. The coding process identified 22 definitive codes that were synthesized into nine subthemes and three themes that described types of CIs, factors that influence them, and effects generated by CI. The main findings were that CI were mainly related to non-Covid pathologies, causing negative emotions. They were cases of high biopsychosocial complexity, in which the ethical dimension of difficult decisions or "questionable" or "unacceptable" behaviors emerges. Some CI were linked to the human relationship between students and teachers or between the health team, or communication with patients and their families. Elements related to hospital organization were less described. The adaptations, learning, and reflections referred to the intern's professional role, ethics, communication skills, and self-care; and were produced autonomously, with little teaching support.
Discussion
CI analysis allows interns to reflect and imagine how to bring learnings into their future practice. The primary emotions associated with CI were negative, and their adaptations were autonomous. The school could improve with more teacher support and better role models to manage CI and support the interns' mental health better. One important topic to address is if the teachers are really available and prepared to be supportive, or if they are part of the causes of the CI.