bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding the secondary outcomes of international travel measures during the covid-19 pandemic: a scoping review of social impact evidence
Authors: Lee Kelley , Zhumatova Salta , Worsnop Catherine Z. , Bazak Ying Liu
Published: August 2024

Background

Assessment of the effective use of international travel measures during the COVID-19 pandemic has focused on public health goals, namely limiting virus introduction and onward transmission. However, risk-based approaches includes the weighing of public health goals against potential social, economic and other secondary impacts. Advancing risk-based approaches thus requires fuller understanding of available evidence on such impacts.

Methods

We conducted a scoping review of existing studies of the social impacts of international travel measures during the COVID-19 pandemic. Applying a standardized typology of travel measures, and five categories of social impact, we searched 9 databases across multiple disciplines spanning public health and the social sciences. We identified 26 studies for inclusion and reviewed their scope, methods, type of travel measure, and social impacts analysed.

Results

The studies cover a diverse range of national settings with a strong focus on high-income countries. A broad range of populations are studied, hindered in their outbound or inbound travel. Most studies focus on 2020 when travel restrictions were widely introduced, but limited attention is given to the broader effects of their prolonged use. Studies primarily used qualitative or mixed methods, with adaptations to comply with public health measures. Most studies focused on travel restrictions, as one type of travel measure, often combined with domestic public health measures, making it difficult to determine their specific social impacts. All five categories of social impacts were observed although there was a strong emphasis on negative social impacts including family separation, decreased work opportunities, reduced quality of life, and inability to meet cultural needs. A small number of countries identified positive social impacts such as restored work-life balance and an increase in perceptions of safety and security.

Conclusions

While international travel measures were among the most controversial interventions applied during the COVID-19 pandemic, given their prolonged use and widespread impacts on individuals and populations, there remains limited study of their secondary impacts. If risk-based approaches are to be advanced, involving informed choices between public health and other policy goals, there is a need to better understand such impacts, including their differential impacts across diverse populations and settings.
Outcomes and prognosis of postpartum hemorrhage according to management protocol: an 11-year retrospective study from two referral centers
Authors: Jung Ye Won , Kim Jin , Shin Won Kyo , Song Soo Youn , Choi Jae Sung , Hyun Suk Hwan , Ko Young Bok , Lee Mina , Kang Byung Hun , Kim Bo Young , Min Jin Hong , In Yong Nam , Jung Sang Min , Oh Se Kwang , Yoo Heon Jong
Published: August 2024

Background

No standard treatment guidelines have been established for postpartum hemorrhage (PPH). We aimed to assess the differences in outcomes and prognoses between patients with PPH who underwent surgical and non-surgical treatment.

Methods

This retrospective study included 230 patients diagnosed with PPH at two referral hospitals between August 2013 and October 2023. The patients were divided into non-surgical (group 1, n = 159) and surgical intervention groups (group 2, n = 71). A subgroup analysis was performed by dividing the surgical intervention group into immediate (n = 45) and delayed surgical intervention groups (n = 26).

Results

Initial lactic acid levels and shock index were significantly higher in group 2 (2.85 ± 1.37 vs. 4.54 ± 3.63 mmol/L, p = 0.001, and 0.83 ± 0.26 vs. 1.10 ± 0.51, p < 0.001, respectively). Conversely, initial heart rate and body temperature were significantly lower in group 2 (92.5 ± 21.0 vs. 109.0 ± 28.1 beat/min, p < 0.001, and 37.3 ± 0.8 °C vs. 37.0 ± 0.9 °C, p = 0.011, respectively). Logistic regression analysis identified low initial body temperature, high lactic acid level, and shock index as independent predictors of surgical intervention (p = 0.029, p = 0.027, and p = 0.049, respectively). Regarding the causes of PPH, tone was significantly more prevalent in group 1 (57.2% vs. 35.2%, p = 0.002), whereas trauma was significantly more prevalent in group 2 (24.5% vs. 39.4%, p = 0.030). Group 2 had worse overall outcomes and prognoses than group 1. The subgroup analysis showed significantly higher rates of uterine atony combined with other causes, hysterectomy, and disseminated intravascular coagulopathy in the delayed surgical intervention group than the immediate surgical intervention group (42.2% vs. 69.2%, p = 0.027; 51.1% vs. 73.1%, p = 0.049; and 17.8% vs. 46.2%, p = 0.018, respectively).

Conclusions

Patients with PPH presenting with increased lactic acid levels and shock index and decreased body temperature may be surgical candidates. Additionally, immediate surgical intervention in patients with uterine atony combined with other causes of PPH could improve prognosis and reduce postoperative complications.
Prevalence and factors associated with unhealthy metabolic status according to body mass index: analysis of a national nutritional survey
Authors: Vera-Ponce Víctor Juan , Zuzunaga-Montoya Fiorella E. , Vásquez-Romero Luisa Erika Milagros , Loayza-Castro Joan A. , Iturregui Paucar Cori Raquel , Vigil-Ventura Enrique , Gutiérrez De Carrillo Carmen Inés
Published: August 2024

Introduction

Although obesity substantially influences public health owing to related comorbidities, it has been discovered that the incidence of such issues is not directly related to obesity but to the patient’s unhealthy metabolic status (MUS) independent of the body mass index (BMI).

Objectives

To describe the prevalence of UMS overall and according to BMI and determine the factors associated with it.

Methods

A cross-sectional analytical study was used based on the analysis of secondary databases called the Life Stage Nutritional Surveillance Survey (VIANEV). Participants were selected in two stages, finally obtaining 885 participants. UMS was defined based on the criteria of the Adult Treatment Panel III used to define metabolic status in a set of 5 parameters, if the subject presented two or more alterations it was considered UMS. Six groups were formed according to BMI: metabolically healthy, average weight (MHNW) and unhealthy (MUNW), metabolically healthy, overweight (MHOW) and unhealthy (MUOW), metabolically healthy, obese (MHO) and unhealthy (MUO).).

Results

The total prevalence of UMS was 73.11%, with MUNW, MUOW, and MUO being 47.90%, 80.34%, and 96.44%, respectively. Only 5.31% did not present any metabolic alteration. The multivariable analysis found variations globally according to sex, age, marital status, geographical region, smoking habit, and altitude.

Conclusions

A high prevalence of UMS was observed in Peru, indicating that BMI alone is not a sufficient indicator of metabolic status. These findings suggest that strategies should be prioritized to address the growing problem of UMS, considering the particularities of each subpopulation and using a multifaceted approach that addresses modifiable and non-modifiable risk factors.
Understanding machine learning applications in dementia research and clinical practice: a review for biomedical scientists and clinicians
Authors: Wang Yihan , Liu Shu , Spiteri Alanna G. , Huynh Andrew Liem Hieu , Chu Chenyin , Masters Colin L. , Goudey Benjamin , Pan Yijun , Jin Liang
Published: August 2024

Several (inter)national longitudinal dementia observational datasets encompassing demographic information, neuroimaging, biomarkers, neuropsychological evaluations, and muti-omics data, have ushered in a new era of potential for integrating machine learning (ML) into dementia research and clinical practice. ML, with its proficiency in handling multi-modal and high-dimensional data, has emerged as an innovative technique to facilitate early diagnosis, differential diagnosis, and to predict onset and progression of mild cognitive impairment and dementia. In this review, we evaluate current and potential applications of ML, including its history in dementia research, how it compares to traditional statistics, the types of datasets it uses and the general workflow. Moreover, we identify the technical barriers and challenges of ML implementations in clinical practice. Overall, this review provides a comprehensive understanding of ML with non-technical explanations for broader accessibility to biomedical scientists and clinicians.
The radiologist’s role in detecting systemic anticancer therapy-related interstitial lung disease: an educational review
Authors: Dinkel Julien , Kneidinger Nikolaus , Tarantino Paolo
Published: August 2024

Systemic anticancer therapies (SACTs) are the leading cause of drug-induced interstitial lung disease (ILD). As more novel SACTs become approved, the incidence of this potentially life-threatening adverse event (AE) may increase. Early detection of SACT-related ILD allows for prompt implementation of drug-specific management recommendations, improving the likelihood of AE resolution and, in some instances, widening the patient’s eligibility for future cancer treatment options. ILD requires a diagnosis of exclusion through collaboration with the patient’s multidisciplinary team to rule out other possible etiologies of new or worsening respiratory signs and symptoms. At Grade 1, ILD is asymptomatic, and thus the radiologist is key to detecting the AE prior to the disease severity worsening. Planned computed tomography scans should be reviewed for the presence of ILD in addition to being assessed for tumor response to treatment, and when ILD is suspected, a high-resolution computed tomography (HRCT) scan should be requested immediately. An HRCT scan, with < 2-mm slice thickness, is the most appropriate method for detecting ILD. Multiple patterns of ILD exist, which can impact patient prognosis. The four main patterns include acute interstitial pneumonia / acute respiratory distress syndrome, organizing pneumonia, hypersensitivity pneumonitis, and non-specific interstitial pneumonia; their distinct radiological features, along with rarer patterns, are discussed here. Furthermore, HRCT is essential for following the course of ILD and might help to determine the intensity of AE management and the appropriateness of re-challenging with SACT, where indicated by drug-specific prescribing information. ILD events should be monitored closely until complete resolution.

Critical relevance statement

The incidence of potentially treatment-limiting and life-threatening systemic anticancer therapy-related interstitial lung disease (SACT-related ILD) events is likely increasing as more novel regimens become approved. This review provides best-practice recommendations for the early detection of SACT-related ILD by radiologists.

Key Points

Radiologists are crucial in detecting asymptomatic (Grade 1) ILD before severity/prognosis worsens.

High-resolution computed tomography is the most appropriate method for detecting ILD.

Drug-induced ILD is a diagnosis of exclusion, involving a multidisciplinary team.

Familiarity with common HRCT patterns, described here, is key for prompt detection.

Physicians should highlight systemic anticancer therapies (SACTs) with a known risk for interstitial lung diseases (ILD) on scan requisitions.

Graphical Abstract
Femoral head decentration on hip MRI: comparison between imaging planes, methods of contrast administration, and hip deformities
Authors: Schmaranzer Florian , Becker Tadeus A. , Heimann Alexander F. , Roshardt Jose , Schwab Joseph M. , Murphy Stephen B. , Steppacher Simon D. , Tannast Moritz , Lerch Till D.
Published: August 2024

Objectives

To compare the prevalence of femoral head decentration (FHD) on different MR imaging planes in patients undergoing direct/indirect hip MR arthrography (MRA) with asymptomatic controls and to evaluate its association with osseous deformities.

Methods

IRB-approved retrospective single-center study of symptomatic hips undergoing direct or indirect hip MRA at 3 T. Asymptomatic participants underwent non-contrast hip MRI at 3 T. FHD was defined as a continuous fluid layer between the acetabulum and femoral head and assessed on axial, sagittal and radial images. The association of intra-articular/intra-venous contrast agents and the prevalence of FHD was evaluated. The association of FHD with osseous deformities and joint damage was assessed using multiple logistic regression analysis.

Results

Three-hundred ninety-four patients (447 hips, mean age 31 ± 9 years, 247 females) were included and compared to 43 asymptomatic controls (43 hips, mean age 31 ± 6 years, 26 females). FHD was most prevalent on radial images and more frequent in symptomatic hips (30% versus 2%, p < 0.001). FHD prevalence was not associated with the presence/absence of intra-articular contrast agents (30% versus 22%, OR = 1.5 (95% CI 0.9–2.5), p = 0.125). FHD was associated with hip dysplasia (OR = 6.1 (3.3–11.1), p < 0.001), excessive femoral torsion (OR = 3.0 (1.3–6.8), p = 0.010), and severe cartilage damage (OR = 3.6 (2.0–6.7), p < 0.001).

Conclusion

While rare in asymptomatic patients, femoral head decentration in symptomatic patients is associated with osseous deformities predisposing to hip instability, as well as with extensive cartilage damage.

Critical relevance statement

Decentration of the femoral head on radial MRA may be interpreted as a sign of hip instability in symptomatic hips without extensive cartilage defects. Its presence could unmask hip instability and yield promise in surgical decision-making.

Key Points

The best method of identifying femoral head decentration is radial MRI.

The presence/absence of intra-articular contrast is not associated with femoral head decentration.

Femoral head decentration is associated with hip deformities predisposing to hip instability.

Graphical Abstract
Dihydroartemisinin restores the immunogenicity and enhances the anticancer immunosurveillance of cisplatin by activating the PERK/eIF2α pathway
Authors: Li Yumei , Ma Pei , Li Jingxia , Wu Feng , Guo Mengfei , Zhou E , Song Siwei , Wang Sufei , Zhang Shuai , Jin Yang
Published: August 2024

Background

Immunosurveillance is pivotal in the effectiveness of anticancer therapies and tumor control. The ineffectiveness of cisplatin in activating the immunosurveillance is attributed to its lack of adjuvanticity resulting from its inability to stimulate endoplasmic reticulum stress. Dihydroartemisinin demonstrates the anti-tumor effects through various mechanisms, including the activation of the endoplasmic reticulum stress. This study aimed to develop a novel strategy to enhance the immunogenicity of dying tumor cells by combining cisplatin with dihydroartemisinin, thereby triggering effective anti-tumor immunosurveillance and improving the efficacy of cisplatin in clinical practice.

Methods

Lewis lung carcinoma (LLC) and CT26 colon cancer cell lines and subcutaneous tumor models were used in this study. The importance of immunosurveillance was validated in both immunocompetent and immunodeficient mouse models. The ability of dihydroartemisinin and cisplatin therapy to induce immunogenic cell death and tumor growth control in vivo was validated by prophylactic tumor vaccination and therapeutic tumor models. The underlying mechanism was elucidated through the pharmaceutical or genetic intervention of the PERK/eIF2α pathway in vitro and in vivo.

Results

Dihydroartemisinin enhanced the generation of reactive oxygen species in cisplatin-treated LLC and CT26 cancer cells. The combination treatment of dihydroartemisinin with cisplatin promoted cell death and ensured an optimal release of damage-associated molecular patterns from dying cancer cells, promoting the phagocytosis of dendritic cells. In the tumor vaccination model, we confirmed that dihydroartemisinin plus cisplatin treatment induced immunogenic cell death. Utilizing immunocompetent and immunodeficient mouse models, we further demonstrated that the combination treatment suppressed the tumor growth of CT26 colon cancer and LLC lung cancer, leading to an improved prognosis through the restoration of cytotoxic T lymphocyte responses and reinstatement of anti-cancer immunosurveillance in vivo. Mechanistically, dihydroartemisinin restored the immunogenicity of cisplatin by activating the adjuvanticity of damage-associated molecular patterns, such as calreticulin exposure, through the PERK/eIF2α pathway. Additionally, the inhibition of eIF2α phosphorylation attenuated the anti-tumor efficiency of C + D in vivo.

Conclusions

We highlighted that dihydroartemisinin acts as an immunogenic cell death rescuer for cisplatin, activating anticancer immunosurveillance in a PERK/eIF2α-dependent manner and offering a strategy to enhance the anti-tumor efficacy of cisplatin in clinical practice.
The netball injury evidence base: a scoping review of methodologies and recommendations for future approaches
Authors: Horne Sara , Shaheen Aliah Faisal , Baltzopoulos Bill , Hills Laura
Published: August 2024

Background

Netball is a sport with a large participation base and a high risk of injuries. Effective injury prevention strategies are dependent upon a clear understanding of injury issues, aetiology and mechanisms, requiring robust research methodologies to ensure a reliable evidence base. This scoping review aims to identify the characteristics and range of netball injury research methodologies, to inform recommendations for future research.

Methods

A systematic search of SPORTDiscus, MEDLINE, CINAHL and Academic Search Complete, PubMed, Scopus and Web of Science, from 1985 to May 2023 identified relevant studies. Inclusion criteria included peer-reviewed studies assessing injury incidence, aetiology and mechanisms in netball.

Results

Following screening, 65 studies were included (68% descriptive epidemiology, 32% analytic epidemiology). Descriptive epidemiology reported data from hospital/clinic and insurance databases (57%) and netball competitions (43%). Only two studies used ongoing, systematic injury surveillance in netball cohorts, and significant heterogeneity existed in study designs, data collection methods, injury definitions and injury incidence rates calculations. Studies assessed a limited number of risk factors (descriptive competition studies: median: n = 4; analytic studies median:n = 6), with 76% using a simplistic reductionist approach to determine causality. Basic descriptions and retrospective recall of injury mechanisms reduced accuracy. Only two studies conducted comprehensive assessments of injury mechanisms using video-based methods.

Conclusion

To establish an accurate netball injury evidence base, future research should prioritise the development of reliable, continuous surveillance systems. The International Olympic Committee (IOC) consensus statement guidelines are recommended for accurate injury data collection and reporting. A multifactorial approach should be adopted to assess the complex interaction between multiple risk factors, player load and the injury inciting event. Comprehensive descriptions of injury mechanisms using video methods, alongside descriptions from medical staff are recommended. This information is crucial for developing targeted prevention strategies.
Will fire-smart landscape management buffer the effects of climate and land-use changes on fire regimes?
Authors: Sil Ângelo , Azevedo João C. , Fernandes Paulo M. , Honrado João P.
Published: August 2024

Background

Long-term farmland abandonment has increased fuel build-up in many Euro-Mediterranean mountainous regions. The high fuel hazard in these landscapes, combined with ongoing climate change, is increasing the frequency of extreme wildfires, thus altering contemporary fire regimes. Mitigating the loss of the landscape’s capacity to regulate large and intense fires is crucial to prevent future harmful effects of fires. As such, effective strategies to manage these fire-prone landscapes are needed. Yet, further understanding of their performance under global change scenarios is required. This study assessed the effects of fire-smart management strategies on future landscape dynamics, fire regulation capacity (FRC), and fire regime in a Mediterranean fire-prone mountainous landscape in Portugal (30,650 ha) undergoing long-term land abandonment and climate change scenarios. For that, we applied the LANDIS-II model under climate change scenarios (RCP 4.5 and 8.5) and long-term farmland abandonment (2020–2050) according to three fire-smart management strategies focused on fire prevention compared with a business-as-usual (BAU) strategy based on fire suppression.

Results

Future fire activity and land dynamics resulted in changes that fostered landscape heterogeneity and fragmentation and favoured fire-adapted forests and agroforestry systems while decreasing the dominance of shrublands and croplands. FRC decreased over time, particularly under RCP 8.5 and the BAU strategy. In turn, fire-smart strategies better prevented large and intense fires than the BAU strategy, but their effectiveness decreased under RCP 8.5. The loss of FRC resulted in increased burned area and fire frequency, which predicts a shift from contemporary fire regimes but more markedly under RCP 8.5 and in the BAU strategy.

Conclusions

Fire-smart strategies outperformed BAU in averting current fire regime intensification. Merging forest- and silvopasture-based management is the most promising approach in taming the effects of climate and farmland abandonment on future fire activity. Our study underlines that planning and management policies in fire-prone Mediterranean mountain landscapes must integrate fire-smart strategies to decrease landscape fuel hazard and buffer the impact of global change on future fire regimes.
Investigation of Applicability of Non-sintered Cement Mortar for Precast Concrete by Steam Curing
Authors: Na Hyeong-Won , Hyung Won-Gil
Published: August 2024

Non-sintered cement (NSC) mortar was developed using only industrial by-products, such as ground granulated blast furnace slag, classes C and F fly ashes, and slaked lime. The characteristics of different NSC mortar formulations were investigated, as well as their applicability for use in forming precast concrete products. X-ray diffraction and scanning electron microscope analyses were performed to examine the internal structure of the different formulations. Overall, the developed NSC mortar satisfied the existing quality standards in terms of strength performance and absorption rate. Therefore, it is expected to be highly applicable as a raw material for production of the desired cement products.
Genomic and induction evidence for bacteriophage contributions to sargassum-bacteria symbioses
Authors: Stiffler Alexandra K. , Hesketh-Best Poppy J. , Varona Natascha S. , Zagame Ashley , Wallace Bailey A. , Lapointe Brian E. , Silveira Cynthia B.
Published: August 2024

Background

Symbioses between primary producers and bacteria are crucial for nutrient exchange that fosters host growth and niche adaptation. Yet, how viruses that infect bacteria (phages) influence these bacteria-eukaryote interactions is still largely unknown. Here, we investigate the role of viruses on the genomic diversity and functional adaptations of bacteria associated with pelagic sargassum. This brown alga has dramatically increased its distribution range in the Atlantic in the past decade and is predicted to continue expanding, imposing severe impacts on coastal ecosystems, economies, and human health.

Results

We reconstructed 73 bacterial and 3963 viral metagenome-assembled genomes (bMAGs and vMAGs, respectively) from coastalSargassum natansVIII and surrounding seawater.S.natansVIII bMAGs were enriched in prophages compared to seawater (28% and 0.02%, respectively).RhodobacteralesandSynechococcusbMAGs, abundant members of theS.natansVIII microbiome, were shared between the algae and seawater but were associated with distinct phages in each environment. Genes related to biofilm formation and quorum sensing were enriched inS.natansVIII phages, indicating their potential to influence algal association in their bacterial hosts. In-vitro assays with a bacterial community harvested from sargassum surface biofilms and depleted of free viruses demonstrated that these bacteria are protected from lytic infection by seawater viruses but contain intact and inducible prophages. These bacteria form thicker biofilms when growing on sargassum-supplemented seawater compared to seawater controls, and phage induction using mitomycin C was associated with a significant decrease in biofilm formation. The induced metagenomes were enriched in genomic sequences classified as temperate viruses compared to uninduced controls.

Conclusions

Our data shows that prophages contribute to the flexible genomes ofS.natansVIII-associated bacteria. These prophages encode genes with symbiotic functions, and their induction decreases biofilm formation, an essential capacity for flexible symbioses between bacteria and the alga. These results indicate that prophage acquisition and induction contribute to genomic and functional diversification during sargassum-bacteria symbioses, with potential implications for algae growth.
(S)-3-(3,4-Dihydroxybenzyl) piperazine-2,5-dione (cyclo-Gly-L-DOPA or CG-Nio-CGLD) peptide loaded in Chitosan Glutamate-Coated Niosomes as anti-Colorectal cancer activity
Authors: Piri-Gharaghie Tohid , Ghourchian Hedieh , Rezaeizadeh Golnoosh , Kabiri Hamidreza , Rajaei Negin , Dhiaa Aya Mohammed , Ghajari Ghazal , Bahari Roghayeh
Published: August 2024

Background

Colorectal cancer (CRC), now the second most prevalent malignant tumor worldwide, is more prevalent in young adults. In recent decades, there has been progress in creating anti-colorectal cancer medications, including cytotoxic compounds.

Objectives

Novel anticancer drugs are needed to surmount existing obstacles. A recent study investigated the effectiveness of novel formulations in preventing colorectal cancer.

Methods

During this study, we assessed a new kind of niosome called cyclo-Gly-L-DOPA (CG-Nio-CGLD) made from chitosan glutamate. We evaluated the anti-colorectal cancer properties of CG-Nio-CGLD utilizing CCK-8, invasion assay, MTT assay, flow cytometry, and cell cycle analysis. The transcription of genes associated with apoptosis was analyzed using quantitative real-time PCR. At the same time, the cytotoxicity of nanomaterials on both cancer and normal cell lines was assessed using MTT assays. Novel anticancer drugs are needed to surmount existing obstacles. A recent study investigated the effectiveness of newly developed formulations in preventing colorectal cancer.

Results

The Nio-CGLD and CG-Nio-CGLD were spherical mean diameters of 169.12 ± 1.87 and 179.26 ± 2.17 nm, respectively. Entrapment efficiency (EE%) measurements of the Nio-CGLD and CG-Nio-CGLD were 63.12 ± 0.51 and 76.43 ± 0.34%, respectively. In the CG-Nio-CGLD group, the percentages of early, late, necrotic, and viable CL40 cells were 341.93%, 23.27%, 9.32%, and 25.48%. The transcription of the genes PP53, cas3, and cas8 was noticeably higher in the treatment group compared to the control group (P > 0.001). Additionally, the treatment group had lower BCL2 and survivin gene expression levels than the control group (P < 0.01). Additionally, CG-Nio-CGLD formulations demonstrated a biocompatible nanoscale delivery mechanism and displayed little cytotoxicity toward the CCD 841 CoN reference cell line.

Conclusion

These findings indicate that chitosan-based noisome encapsulation may enhance the effectiveness of CG-Nio-CGLD formulations in fighting cancer.
Redefining prostate cancer risk stratification: a pioneering strategy to estimate outcome based on Ki67 immunoscoring
Authors: Albuquerque-Castro Ângela , Macedo-Silva Catarina , Oliveira-Sousa Rúben , Constâncio Vera , Lobo João , Carneiro Isa , Henrique Rui , Jerónimo Carmen
Published: August 2024

Accurate prostate cancer (PCa) patient diagnosis and risk assessment are key to ensure the best outcome. Currently, low- and favorable intermediate-risk PCa patients may be offered AS due to the indolent nature of the disease. Nonetheless, deciding between active surveillance and curative-intent treatment remains an intricate task, as a subset of these patients may eventually progress, enduring poorer prognosis. Herein, we sought to construct risk calculators based on cancer biomarkers, enabling more accurate discrimination among patients which may benefit from active interventions.

Ki67 immunoscore, GSTP1 and KLF8 promoter methylation levels (me) were assessed in PCa tissues. Study endpoints included overall and biochemical recurrence-free (BCR) survival. Combination with relevant clinicopathological parameters allowed for construction of graphical calculating tools (nomograms).

Higher Ki67 index correlated with worse BCR-free survival, whereas higher KLF8me levels were associated with improved overall survival, especially in patients with lower-grade tumors. GSTP1me levels had no prognostic value. Among prognostic models tested, a BCR-risk calculator – ProstARK (including Ki67 and clinicopathologic parameters) – disclosed 79.17% specificity, 66.67% sensitivity, 55% positive predictive value, 86% negative predictive value, and 75.76% accuracy. Similar results were found using an independent PCa biopsy cohort, validating its prognostication ability.

Combining clinicopathologic features and Ki67 index into a risk calculator enables easy and accurate implementation of a novel PCa prognostication tool. This nomogram may be useful for a more accurate selection of patients for active surveillance protocols. Nonetheless, validation in a larger, multicentric, set of diagnostic PCa biopsies is mandatory for further confirmation of these results.
Automated early detection of acute retinal necrosis from ultra-widefield color fundus photography using deep learning
Authors: Wang Yuqin , Yang Zijian , Guo Xingneng , Jin Wang , Lin Dan , Chen Anying , Zhou Meng
Published: August 2024

Background

Acute retinal necrosis (ARN) is a relatively rare but highly damaging and potentially sight-threatening type of uveitis caused by infection with the human herpesvirus. Without timely diagnosis and appropriate treatment, ARN can lead to severe vision loss. We aimed to develop a deep learning framework to distinguish ARN from other types of intermediate, posterior, and panuveitis using ultra-widefield color fundus photography (UWFCFP).

Methods

We conducted a two-center retrospective discovery and validation study to develop and validate a deep learning model called DeepDrARN for automatic uveitis detection and differentiation of ARN from other uveitis types using 11,508 UWFCFPs from 1,112 participants. Model performance was evaluated with the area under the receiver operating characteristic curve (AUROC), the area under the precision and recall curves (AUPR), sensitivity and specificity, and compared with seven ophthalmologists.

Results

DeepDrARN for uveitis screening achieved an AUROC of 0.996 (95% CI: 0.994–0.999) in the internal validation cohort and demonstrated good generalizability with an AUROC of 0.973 (95% CI: 0.956–0.990) in the external validation cohort. DeepDrARN also demonstrated excellent predictive ability in distinguishing ARN from other types of uveitis with AUROCs of 0.960 (95% CI: 0.943–0.977) and 0.971 (95% CI: 0.956–0.986) in the internal and external validation cohorts. DeepDrARN was also tested in the differentiation of ARN, non-ARN uveitis (NAU) and normal subjects, with sensitivities of 88.9% and 78.7% and specificities of 93.8% and 89.1% in the internal and external validation cohorts, respectively. The performance of DeepDrARN is comparable to that of ophthalmologists and even exceeds the average accuracy of seven ophthalmologists, showing an improvement of 6.57% in uveitis screening and 11.14% in ARN identification.

Conclusions

Our study demonstrates the feasibility of deep learning algorithms in enabling early detection, reducing treatment delays, and improving outcomes for ARN patients.
Stellate ganglion block: what else is necessary to include in the treatment of subarachnoid hemorrhage patients?
Authors: Welling Leonardo C. , Rabelo Nicollas Nunes , de Sena Barbosa Mateus Gonçalves , Messias Beatriz Rodrigues , Pinto Carolina Guimarães , Figueiredo Eberval Gadelha
Published: August 2024

Cerebral vasospasm is determined as a temporary narrowing of cerebral arteries a few days after an aneurysmal subarachnoid hemorrhage. The onset of this vascular event usually evolves with new neurological deficits or progression of ischemic areas. The success of interventions to treat or revert this condition is not satisfying. In addition to cerebral vasospasm, early brain injury plays an important role as a contributor to subarachnoid hemorrhage’s mortality. In this sense, stellate ganglion block appears as an alternative to reduce sympathetic system’s activation, one of the main pathophysiological mechanisms involved in brain injury. Over the past few years, there is growing evidence that stellate ganglion block can contribute to decline patient morbidity from subarachnoid hemorrhage. Is it time to include this procedure as a standard treatment after aneurysm rupture?
Revisiting frequency-smoothing encryption: new security definitions and efficient construction
Authors: Chen Haobin , Yang Yue , Lv Siyi
Published: August 2024

Deterministic encryption (DET) allows for fast retrieval of encrypted information, but it would cause significant leakage of frequency information of the underlying data, which results in an array of inference attacks. Simply replacing DET with fully randomized encryption is often undesirable in the scenario of an encrypted database since it incurs a large overhead in query and storage. Frequency Smoothing Encryption (FSE) is a practical encryption scheme to protect frequency information. Current FSE constructions still fall short of efficiency and a reasonable security definition. We revisit FSE and propose two security definitions from both theoretical and practical perspectives. Furthermore, we adopt a novel partitioning strategy to construct a new FSE scheme to improve performance. Experimental results show that compared with others, our scheme achieves excellent query performance while attaining security against inference attacks.
The effect of using the hip exoskeleton assistive (HEXA) robot compared to conventional physiotherapy on clinical functional outcomes in stroke patients with hemiplegia: a pilot randomized controlled trial
Authors: Mamipour Hamed , Hoseini Seyed Ali , Negahban Hossein , Moradi Ali , Hojjati Amir , Rezaeitalab Fariborz , Torshizian Mohammadreza , Mehrali Arefeh , Parsa Mohammad , Kardan Iman , Tabesh Hamed , Hassankhani Ebrahim Ghayem , Akbarzadeh Alireza
Published: August 2024

Trial design

This study is a pilot randomized clinical trial aimed to investigate the effect of using Hip Exoskeleton Assistive (HEXA) robot compared to conventional physiotherapy on the quality of walking, disability, and quality of life of stroke patients with hemiplegia.

Methods

In this study, 24 patients were randomly assigned to the intervention group (robotic physiotherapy with HEXA robot), or control group (conventional physiotherapy). In each session, both groups received 30 min of conventional physiotherapy including electrotherapy and conventional exercises, and then the intervention group did gait training for 30 min with the HEXA robot and the control group for 30 min without the HEXA robot. The treatment program was 12 sessions, 3 times a week. Before the 1st and after the 12th sessions, both groups were evaluated for walking quality, disability, and quality of life.

Results

The results showed that the main effect of time was significant (P < 0.05) in all outcomes and patients in both groups achieved significant improvement in all outcomes after the intervention. The main effect of the group was also significant in the outcomes of 6MWT (P < 0.05) and TUG (P < 0.05), and the intervention group patients experienced more distance and speed in these two tests. This study was approved by the ethics committee of Mashhad University of Medical Sciences (IR.MUMS.FHMPM.REC.1400.079 dated 28th Jan 2022). The trial was registered with the clinical trials site of www.IRCT.ir (IRCT20210730052024N1) on January 28th 2022.

Conclusion

It seems that the HEXA robot can effectively improve walking capacity and speed.
Harnessing 3D seismic data for mapping natural CO2 distribution: Paving the way for future CCS/CCUS implementation in the Lower Talang Akar Formation, Jabung Block, South Sumatra Basin
Authors: Alamsyah Muhammad Noor , Sukmono Sigit , Winardhi Sonny , Wicaksono  , Fitrianto Teguh , Sulistyanto Arno Germanndaputra
Published: August 2024

Hydrocarbon reservoirs saturated with CO2 are naturally widespread in the Lower Talang Akar Formation (LTAF) and deposited in the Jabung Block, South Sumatra Basin, Indonesia. The different CO2 saturation contents stored in the reservoirs pose a challenge to planning future carbon capture and storage (CCS) and carbon capture, utilization, and storage (CCUS) in the area. This study integrates poststack 3D seismic data and existing wells in the western part of the Jabung Block. It utilizes seismic attribute methods such as sum of negative amplitude, relative impedance, variance, and ant tracking to predict the origin, saturation, and distribution of CO2-saturated hydrocarbon accumulations in the sandstone reservoirs of the LTAF. The results show that CO2 originated from the Betara Deep source rock in the study area's eastern side and migrated to the reservoirs through major northwest–southeast-trending fault zones. The saturation of CO2 in the reservoirs is mainly controlled by the distance from the source and the reservoir depths, faulting, and fracturing intensity. The fields closer to the Betara source rock tend to be filled with higher contents of CO2 saturation. The results provide valuable guidance in CO2 identification and mapping for future CCS and CCUS implementation in the study area.
Systematic Review: Dementia Post-Diagnostic Support in UK Rural Communities: Experiences of People Living With Dementia, Informal Caregivers, and Healthcare Professionals
Authors: Bilkey Danielle , Businge Ellena
Published: August 2024

Aims

The aim of this systematic review is to identify and describe the experiences, barriers and provision of post-diagnostic support in UK rural areas; from the perspective of people living with dementia, healthcare professionals and informal family caregivers.

Background

People living with dementia in rural areas experience numerous barriers to accessing post-diagnostic support.

Methods

Systematic Review.

Systematic searches will be conducted in the following databases; SCOPUS, PubMed, PsychINFO and CINAHL Plus. Systematic review tool Rayyan.ai will be used to screen titles and abstracts, prior to full-text review. Following data extraction, The Critical Appraisal Skills Programme (CASP) tool will be used to appraise the quality of studies and assess risk of bias. The data will be deductively analysed through the lens of the Candidacy Framework's 6 dimensions, with a secondary inductive analysis capturing any themes that fall outside of the framework.

Results

242 papers have been screened by first and second reviewer. 15 papers included. Papers still being analysed for full review. Will be complete by March 2024.

Conclusion

This systematic review will help improve understanding of the rural barriers and experiences of post-diagnostic support, and allow researchers and stakeholders to develop and optimise specially tailored dementia interventions in line with the needs of people residing in UK rural communities.

First reviewer: Danielle Bilkey, Second Reviewer: Dr Ellena Businge, Supervisor: Dr Nicolas Farina.
Living Alongside an Eating Disorder: A Qualitative Exploration of the Experiences of People in the UK Who Have an Adult Family Member Living With an Eating Disorder
Authors: Gill Laura
Published: August 2024

Aims

Eating disorders do not only affect the person who is suffering, but also their family. This qualitative study aims to understand the impacts on individuals who have an adult family member with an eating disorder, and what support they seek for their own well-being.

Methods

A convenience sample of 11 volunteer participants (10 family members and 1 charity worker) from the United Kingdom (UK) were recruited for interviews. Four UK eating disorder charities assisted with outreach by sharing the Participant Information Sheet to their service users. Semi-structured interviews were conducted between February and March 2023. Interviews lasted on average 54 minutes and were recorded on video call (n = 9) or face-to-face on the University of Edinburgh campus (n = 2). Transcripts were analysed using thematic analysis, following a grounded-theory constructivist approach.

Results

Participants discussed how their lives were changed by engaging with the care of their family member, leading to a shift in family dynamics and a change in understanding of what it means to be a ‘normal’ family. Most interviewees perceived their relative's eating disorder as a negative disruption to their own life, however one participant said that it had no negative impact on his well-being at all. Conflict in the household was a regular outcome, with four interviewees all using the phrase “treading on eggshells”. Siblings of adults with an eating disorder were described by their parents as being excluded from the family due to the ongoing parental focus on the healing of their child. Some participants accessed support groups and social media to connect with other families working through similar challenges.

Conclusion

Having an adult family member with an eating disorder impacts the wider social network of the family. This dissertation argues that the socially constructed meanings of ‘care’ and ‘normality’, alongside the social relations with people placed in similar positions, inform the lived experiences of these individuals. This study's newfound illness narrative of ‘normality’ theorises that some people do not strive to help their relative with an eating disorder because it has already constructed the meaning of their normal life. Future research should aim to recruit a greater variation of participants, including more fathers, children, and siblings. This work endeavours to increase awareness of the support which families need during this time. It therefore opens the opportunity to consider how existing resources and services, both in healthcare and the third-sector, can be improved in the future.
Exploring the Attribution of Responsibility to Patients Diagnosed With Personality Disorders
Authors: Glover Lauren
Published: August 2024

Aims

This interdisciplinary research explored how responsibility is attributed to patients with personality disorders (PDs). The attribution of responsibility to this group has been extensively discussed by philosophers, and appears to be associated with negative attitudes towards the diagnosis amongst clinicians. This research aimed to both examine the philosophical literature available on this topic, and to explore how future clinicians make judgements of these patients’ responsibility.

A qualitative study was conducted to answer the following four research questions:

1.

What do medical students think responsibility means in the context of healthcare?

2.

What factors influence when medical students consider patients with mental health disorders, in particular PDs, responsible for their behaviours?

3.

How responsible do medical students consider patients with PDs for their behaviours in comparison to patients with other mental health conditions?

4.

Do medical students think that responsibility attributions could affect the stigmatisation of the condition and patient care?

Methods

Seven in-depth semi-structured interviews were conducted, involving the discussion of a case report. Interviews had a mean length of 53 minutes. They were then transcribed, coded, and thematic analysis of the data was undertaken. Four main themes were identified: understanding of responsibility, the factors affecting responsibility attribution, stigma and responsibility attribution, and the role of the clinician and the healthcare service.

Results

It was found that medical students considered similar conditions and factors in attributing responsibility to those identified in the philosophical literature. However, several important practical concerns about responsibility attribution in practice were raised, including the possible impact on the therapeutic relationship, difficulties in separating responsibility and blame, and the impact comorbidities and misdiagnoses can have on attributions. Participants believed that stigma towards the diagnosis remains prevalent amongst healthcare professionals, due to stereotypes of these patients being manipulative, and insufficient education about the condition. Additionally, participants highlighted that patient responsibility may be reduced when clinicians and the healthcare service fail to meet their own responsibilities to these patients.

Conclusion

Future research into how other groups of healthcare professionals attribute responsibility is recommended, alongside research into how improved education could reduce stigma and inform responsibility attribution. It is suggested that further education is provided to healthcare professionals about the condition, and more support is offered to those working with patients with PDs to reduce stigma and make the attribution of responsibility fairer to these patients.