bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel nomogram model to predict in-hospital mortality in patients with acute type A aortic dissection after surgery
Authors: Zhou Yifei , Fan Rui , Jiang Hongwei , Liu Renjie , Huang Fuhua , Chen Xin
Published: June 2024

Background

Acute type A aortic dissection is a dangerous disease that threatens public health. In recent years, with the progress of medical technology, the mortality rate of patients after surgery has been gradually reduced, leading that previous prediction models may not be suitable for nowadays. Therefore, the present study aims to find new independent risk factors for predicting in-hospital mortality and construct a nomogram prediction model. Methods: The clinical data of 341 consecutive patients in our center from 2019 to 2023 were collected, and they were divided into two groups according to the death during hospitalization. The independent risk factors were analyzed by univariate and multivariate logistic regression, and the nomogram was constructed and verified based on these factors. Results: age, preoperative lower limb ischemia, preoperative activated partial thromboplastin time (APTT), preoperative platelet count, Cardiopulmonary bypass (CPB) time and postoperative acute kidney injury (AKI) independently predicted in-hospital mortality of patients with acute type A aortic dissection after surgery. The area under the receiver operating characteristic curve (AUC) for the nomogram was 0.844. The calibration curve and decision curve analysis verified that the model had good quality. Conclusion: The new nomogram model has a good ability to predict the in-hospital mortality of patients with acute type A aortic dissection after surgery.
Challenges for gene therapy in the financial sustainability of health systems: a scoping review
Authors: Ossandon Hugo , Armijo Nicolás , Vargas Constanza , Repetto Gabriela M. , Espinoza Manuel Antonio
Published: June 2024

Aim

To review the available evidence about the strategies implemented or proposed for coverage or reimbursement for currently approved gene therapies.

Methods

A scoping review was conducted to analyze the evidence published during the years 2016 to 2023. The main search criteria were coverage or reimbursement of gene therapy by healthcare systems. The eligible articles were those that described or proposed a financing model used to provide coverage in the various systems around the world.

Results

The study identified 279 publications, and after removing duplicates and screening for eligibility, 10 were included in the study. The results show that various financing models have been proposed, including subscription-based payment models, outcome-based payment models, and amortization strategies. However, several barriers to implementing these models were identified, such as deficiencies in informatics systems for data collection, changes in laws or regulations, the lack of accessible clinical endpoints and administrative costs.

Conclusion

This scoping review provides an overview of financing strategies for gene therapies. Gene therapies can cure rare or previously intractable diseases, but their high cost can make access difficult. Publishing experiences with these models can help evaluate their use and gather more evidence for their effectiveness.
Synthesis of metformin-derived fluorescent quantum dots: uptake, cytotoxicity, and inhibition in human breast cancer cells through autophagy pathway
Authors: Akbari Ali , Nemati Mohadeseh , Lighvan Zohreh Mehri , Khanamiri Fereshteh Nazari , Rezaie Jafar , Rasmi Yousef
Published: June 2024

Background

Breast cancer remains a challenge for physicians. Metformin, an antidiabetic drug, show promising anticancer properties against cancers. An emerging quantum dot (QD) material improves therapeutic agents’ anticancer and imaging properties. QD are nano-sized particles with extreme application in nanotechnology captured by cells and accumulated inside cells, suggesting bioimaging and effective anticancer outcomes. In this study, a simple one-pot hydrothermal method was used to synthesize fluorescent metformin-derived carbon dots (M-CDs) and then investigated the cytotoxic effects and imaging features on two human breast cancer cell lines including, MCF-7 and MDA-MB-231 cells.

Results

Results showed that M-CDs profoundly decreased the viability of both cancer cells. IC50 values showed that M-CDs were more cytotoxic than metformin either 24–48 h post-treatment. Cancer cells uptake M-CDs successfully, which causes morphological changes in cells and increased levels of intracellular ROS. The number of Oil Red O-positive cells and the expression of caspase-3 protein were increased in M-CDs treated cells. Authophagic factors including, AMPK, mTOR, and P62 were down-regulated, while p-AMPK, Becline-1, LC3 I, and LC3 II were up-regulated in M-CDs treated cells. Finally, M-CDs caused a decrease in the wound healing rate of cells.

Conclusions

For the first, M-CDs were synthesized by simple one-pot hydrothermal treatment without further purification. M-CDs inhibited both breast cancer cells through modulating autophagy signalling.

Graphical Abstract
Epigenetic regulation of major histocompatibility complexes in gastrointestinal malignancies and the potential for clinical interception
Authors: Tovar Perez Jorge Enrique , Zhang Shilan , Hodgeman William , Kapoor Sabeeta , Rajendran Praveen , Kobayashi Koichi S. , Dashwood Roderick H.
Published: June 2024

Background

Gastrointestinal malignancies encompass a diverse group of cancers that pose significant challenges to global health. The major histocompatibility complex (MHC) plays a pivotal role in immune surveillance, orchestrating the recognition and elimination of tumor cells by the immune system. However, the intricate regulation of MHC gene expression is susceptible to dynamic epigenetic modification, which can influence functionality and pathological outcomes.

Main body

By understanding the epigenetic alterations that drive MHC downregulation, insights are gained into the molecular mechanisms underlying immune escape, tumor progression, and immunotherapy resistance. This systematic review examines the current literature on epigenetic mechanisms that contribute to MHC deregulation in esophageal, gastric, pancreatic, hepatic and colorectal malignancies. Potential clinical implications are discussed of targeting aberrant epigenetic modifications to restore MHC expression and 0 the effectiveness of immunotherapeutic interventions.

Conclusion

The integration of epigenetic-targeted therapies with immunotherapies holds great potential for improving clinical outcomes in patients with gastrointestinal malignancies and represents a compelling avenue for future research and therapeutic development.
Impact of sex and socioeconomic status on the likelihood of surgery, hospitalization, and use of medications in inflammatory bowel disease: a systematic review and meta-analysis
Authors: Rasmussen Nathalie Fogh , Moos Caroline , Gregersen Laura Helene Keiding , Hikmat Zainab , Andersen Vibeke , Green Anders , Jess Tine , Madsen Gunvor Iben , Pedersen Andreas Kristian , Petersen Sofie Ronja , Kjeldsen Lene Juel
Published: June 2024

Background

Inflammatory bowel diseases (IBDs) are associated with high healthcare utilization. This systematic review aimed to summarize what is known about the impact of sex, income, and education on the likelihood of bowel surgery, hospitalization, and use of corticosteroids and biologics among patients with IBD.

Methods

We used EMBASE, MEDLINE, CINAHL, and Web of Science to perform a systematic literature search. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random effects meta-analysis for the impact of sex on the likelihood of surgery and hospitalization. In addition, we performed subgroup analyses of the effect of IBD type (Crohn’s disease or ulcerative colitis) and age. Finally, meta-regression was undertaken for the year of publication.

Results

In total, 67 studies were included, of which 23 studies were eligible for meta-analysis. In the main meta-analysis, male sex was associated with an increased likelihood of bowel surgery (HR 1.42 (95% CI 1.13;1.78), which was consistent with the subgroup analysis for UC only (HR 1.78, 95% CI 1.16; 2.72). Sex did not impact the likelihood of hospitalization (OR 1.05 (95% CI 0.86;1.30), although the subgroup analysis revealed an increased likelihood of hospitalization in CD patients (OR 1.42, 95% CI 1.28;1.58). In 9 of 10 studies, no significant sex-based differences in the use of biologics were reported, although in 6 of 6 studies, female patients had lower adherence to biologics. In 11 of 13 studies, no significant sex-based difference in the use of corticosteroids was reported. The evidence of the impact of income and education on healthcare utilization was sparse and pointed in different directions. The substantial heterogeneity between studies was explained, in part, by differences in IBD type and age.

Conclusions

The results of this systematic review indicate that male patients with IBD are significantly more likely to have surgery than female patients with IBD but are not, overall, more likely to be hospitalized, whereas female patients appear to have statistically significantly lower adherence to biologics compared to male patients. Thus, clinicians should not underestimate the impact of sex on healthcare utilization. Evidence for income- and education-based differences remains sparse.

Systematic review registration

PROSPERO CRD42022315788.
Non-invasive brain stimulation for treatment-resistant schizophrenia: protocol of a systematic review and network meta-analysis
Authors: Siafis Spyridon , Lorenz Carolin , Wu Hui , Zhu Yikang , Schneider-Thoma Johannes , Bighelli Irene , Li Chunbo , Hansen Wulf-Peter , Padberg Frank , Salanti Georgia , Leucht Stefan
Published: June 2024

Background

Non-invasive brain stimulation (NIBS) is a promising intervention for treatment-resistant schizophrenia. However, there are multiple available techniques and a comprehensive synthesis of evidence is lacking. Thus, we will conduct a systematic review and network meta-analysis to investigate the comparative efficacy and safety of NIBS techniques as an add-on to antipsychotics for treatment-resistant schizophrenia.

Methods

We will include single- and double-blind randomized-controlled trials (RCT) comparing any NIBS technique with each other or with a control intervention as an add-on to antipsychotics in adult patients with treatment-resistant schizophrenia. We will exclude studies focusing on predominant negative symptoms, maintenance treatment, and single sessions. The primary outcome will be a change in overall symptoms, and secondary outcomes will be a change in symptom domains, cognitive performance, quality of life, functioning, response, dropouts, and side effects. We will search for eligible studies in previous reviews, multiple electronic databases and clinical trial registries from inception onwards. At least two independent reviewers will perform the study selection, data extraction, and risk of bias assessment. We will measure the treatment differences using standardized mean difference (SMD) and odds ratio (OR) for continuous and dichotomous outcomes, respectively. We will conduct pairwise and network meta-analysis within a frequentist framework using a random-effects model, except for rare event outcomes where we will use a fixed-effects Mantel–Haenszel method. We will investigate potential sources of heterogeneity in subgroup analyses. Reporting bias will be assessed with funnel plots and the Risk of Bias due to Missing Evidence in Network meta-analysis (ROB-MEN) tool. The certainty in the evidence will be evaluated using the Confidence in Network Meta-analysis (CINeMA) approach.

Discussion

Our network meta-analysis would provide an up-to-date synthesis of the evidence from all available RCTs on the comparative efficacy and safety of NIBS for treatment-resistant schizophrenia. This information could guide evidence-based clinical practice and improve the outcomes of patients.

Systematic review registration

PROSPERO-ID CRD42023410645.
Body image and social appearance anxiety in patients with cancer undergoing radiotherapy: a cross-sectional study
Authors: Arıkan Fatma , Kartöz Funda , Karakuş Zeynep , Altınışık Müge , Özer Zeynep , Korcum Şahin Aylin Fidan
Published: June 2024

Background

The body image of patients with cancer can be negatively affected due to treatment toxicities. Changes in body image may cause patients to experience social appearance anxiety. This study aimed to evaluate the body image and social appearance anxiety of patients with cancer undergoing radiotherapy.

Methods

The cross-sectional study was conducted with 153 patients with cancer undergoing radiotherapy in a university hospital. The data were collected with a Patient Information Form, the Body Image Scale, and the Social Appearance Anxiety Scale and the Radiation Therapy Oncology Group Skin Toxicity Criteria.

Results

Patients’ mean body image score was 15.18 ± 8.26 (min = 0, max = 30), mean social appearance anxiety score was 45.29 ± 14.50 (min = 16, max = 80). Patients with low education levels and low-income levels had higher body image and social appearance anxiety scores (p < 0.01). Body image and social appearance anxiety scores were found to be higher in patients with advanced cancer, grade III-IV skin toxicity, pain, fatigue, and constipation (p < 0.05).

Conclusions

Radiotherapy may negatively affect body image and social appearance anxiety. Assessments of body image and social appearance anxiety regularly before, during, and after treatment are essential. Psychosocial support should be provided to patients to reduce body image and social appearance anxiety and increase their well-being. Patients with cancer especially those who have low income and education levels, advanced cancer stage and skin toxicity, and suffer from pain, fatigue, constipation, etc. should be supported by methods such as counseling and social support groups.
Artistic heritage conservation: the relevance and cultural value of Guangzhou clan building paintings to traditional rituals from a kinship perspective through perceptual assessment and data mining
Authors: Li Weicong , Ma Shangbing , Shi Wenwen , Lin Haopai , Liu Yueling , Cui Yitong , Ao Jinghui
Published: June 2024

The study of clan paintings reveals a shift in perspective from art aesthetics to cultural connotations to cultural identity, yet literature seldom discusses the relationship between art and kinship culture. Taking the murals of ancestral hall architecture in Guangzhou as an example, this paper utilizes text mining to identify factors influencing its decorative art. It reveals the traditional rites' artistic expression through dimensions of characters' demeanor and the transmission of content values, offering a fresh perspective for heritage value research. Findings: (1) themes and implications are mostly oriented towards positive value transmission, transitioning from idealistic layman life to the realism of lower-class existence, emphasizing humanization; (2) the extroverted portrayal of characters contrasts with the dignified, restrained etiquette of traditional rites, with some characters' portrayal and facial expressions exuding approachability; (3) murals conveying positive emotions are mostly related to longevity, auspiciousness, fortune, and heroic deeds, while those conveying negative emotions mainly involve elderly male figures, reflecting a content bias related to characters; (4) historical allusion murals with complex content reduce the emotional resonance and arousal efficiency of the viewer; (5) incomplete mural content increases negative emotions in perceivers, highlighting the impact of mural preservation on emotional resonance. To delve into the formation of clan painting art, it is essential not only to interpret the diversity of its patterns but also to demonstrate the representation of its social attributes in decorative art. The formation of clan painting decorative art exhibits kinship cultural attributes, epitomizing the essence of traditional ceremonial thought.
Estimating mandibular growth stage based on cervical vertebral maturation in lateral cephalometric radiographs using artificial intelligence
Authors: Shoari Sajjad Alipour , Sadrolashrafi Seyed Vahid , Sohrabi Aydin , Afrouzian Reza , Ebrahimi Pooya , Kouhsoltani Maryam , Soltani Minou Kouh
Published: June 2024

Introduction

Determining the right time for orthodontic treatment is one of the most important factors affecting the treatment plan and its outcome. The aim of this study is to estimate the mandibular growth stage based on cervical vertebral maturation (CVM) in lateral cephalometric radiographs using artificial intelligence. Unlike previous studies, which use conventional CVM stage naming, our proposed method directly correlates cervical vertebrae with mandibular growth slope.

Methods and materials

To conduct this study, first, information of people achieved in American Association of Orthodontics Foundation (AAOF) growth centers was assessed and after considering the entry and exit criteria, a total of 200 people, 108 women and 92 men, were included in the study. Then, the length of the mandible in the lateral cephalometric radiographs that were taken serially from the patients was calculated. The corresponding graphs were labeled based on the growth rate of the mandible in 3 stages; before the growth peak of puberty (pre-pubertal), during the growth peak of puberty (pubertal) and after the growth peak of puberty (post-pubertal). A total of 663 images were selected for evaluation using artificial intelligence. These images were evaluated with different deep learning-based artificial intelligence models considering the diagnostic measures of sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV). We also employed weighted kappa statistics.

Results

In the diagnosis of pre-pubertal stage, the convolutional neural network (CNN) designed for this study has the higher sensitivity and NPV (0.84, 0.91 respectively) compared to ResNet-18 model. The ResNet-18 model had better performance in other diagnostic measures of the pre-pubertal stage and all measures in the pubertal and post-pubertal stages. The highest overall diagnostic accuracy was also obtained using ResNet-18 model with the amount of 87.5% compared to 81% in designed CNN.

Conclusion

The artificial intelligence model trained in this study can receive images of cervical vertebrae and predict mandibular growth status by classifying it into one of three groups; before the growth spurt (pre-pubertal), during the growth spurt (pubertal), and after the growth spurt (post-pubertal). The highest accuracy is in post-pubertal stage with the designed networks.
Computing grounded theory: a quantitative method to develop theories
Authors: Chen Zhuo , Chen Yunsong
Published: June 2024

The inductive logic of grounded theory and the principle of avoiding theoretical preconceptions are significantly different from the deductive logic and hypothesis testing of traditional quantitative research. Based on the limitations of theory production in quantitative research, this paper proposes a Computing Grounded Theory (CGT) approach that directly quantitatively assists theories. With the help of machine learning and attribution algorithms, CGT identifies variables that have not been the focus of previous studies based on the predictive power of the independent variables to propose new theoretical hypotheses, following the principle that causality is a sufficient and unnecessary condition for predictability. This paper systematically discusses CGT’s basic idea, logical premise, and methodological foundation while providing an empirical example. This method bridges the gap in the theoretical production of quantitative research and is of great value in theory, discipline, knowledge systems and social governance.
Double burden of malnutrition and its socio-demographic determinants among children and adolescents in Malaysia: National Health And Morbidity Survey 2019
Authors: Lai Wai Kent , Palaniveloo Lalitha , Mohd Sallehuddin Syafinaz , Ganapathy Shubash Shander
Published: June 2024

Introduction

Malaysia faces the threat of a double burden of malnutrition where undernutrition and overweight (including obesity) coexist in the same population. This study aimed to determine the anthropometric assessment among children and adolescents aged 5 to 17 years and its association with socio-demographic factors.

Methods

Data were extracted from the National Health and Morbidity Survey conducted in 2019. This cross-sectional survey applied a two-stage stratified sampling design. Socio-demographic characteristics were obtained. Weight and height were measured, age- and sex-specific standard scores for height and BMI were calculated to establish individual’s anthropometric assessment. Having either stunting or thinness was considered undernutrition, while being overweight (including obesity) was considered overnutrition. If someone had undernutrition and/or overnutrition, they were classified as having malnutrition. The prevalence was determined using complex sampling analysis, while the association was assessed through logistic regression. The analysis included a total of 3,185 respondents.

Results

The prevalence of stunting, thinness, overweight and obesity among the respondents aged 5 to 17 years was 12.7%, 10.0%, 15.0% and 14.8%, respectively. The overall prevalence of malnutrition was 48.3%. Respondents residing in rural had 1.35 times more likelihood of experiencing undernutrition [AOR = 1.35, 95% CI (1.04, 1.77)] compared to their urban counterparts. Boys exhibited a greater likelihood of being overweight and obese than girls [AOR = 1.40, 95% CI (1.13, 1.73)]. Respondents aged 10 to 14 years were 1.37 times more likely to be overnutrition than those aged 5 to 9 years old [AOR = 1.37, 95% CI (1.09, 1.73)].

Conclusion

There is growing evidence of the increasing prevalence of coexistence of undernutrition along with overweight and obesity among children and adolescents in Malaysia. Moving forward, greater initiatives and efforts are required to formulate strategies for planning and implementing programs and policies to expedite progress in improving nutrition.
Body image of university students: a systematic review of the characteristics of interventions
Authors: Huguenin Felipe Machado , de Almeida Vitor Alexandre Rabelo , Rodrigues Marcus Vinícius Freitas , Ferreira Maria Elisa Caputo , Morgado Fabiane Frota da Rocha
Published: June 2024

Background

Body image is the mental representation of the body and can be influenced by cognitive, biological, behavioral, sociocultural, and environmental factors. University students often encounter challenges related to it.

Objective

This systematic review examined interventions aimed at holistically developing a positive body image within this population.

Methods

The PRISMA 2020 guidelines and the PICO method were employed to identify, select, assess, and synthesize studies. The consulted databases included Scopus, Web of Science, and PsycINFO, with inclusion criteria targeting body image interventions for university students aged 18 to 39. Study quality was evaluated using the QATSDD tool.

Results

Twenty-one relevant studies were identified, primarily from the United States, mostly employing quantitative methods, with a focus on female participants. Various intervention strategies were utilized, including cognitive-behavioral approaches, media literacy, and physical/resistance training, with a growing use of technology like mobile applications. The majority of studies reported effective outcomes, such as reduced body dissatisfaction and increased self-esteem following interventions. Nevertheless, literature gaps were identified, such as the scarcity of formative interventions and limited use of qualitative approaches.

Conclusion

While technology in interventions offers promising opportunities, careful assessments and judicious selection of evaluation instruments are fundamental for reliable results. Future research should focus on addressing identified gaps, such as exploring more formative interventions and incorporating qualitative methodologies to provide a more comprehensive understanding of the effectiveness of body image interventions among university students.
Spontaneous posterior fossa hemorrhage: profile and functional outcome in patients attending Tanta stroke unit
Authors: Nassar Mahmoud Hamed , Fouda Basem Hamdy , Elsaid Ahmed Safwat Abd ElMohsen , Bahnasy Wafik Said , El-Seidy Ehab Ahmed Shawky , Kishk Ahmed Mustafa
Published: June 2024

Background

The most dangerous and least curable type of stroke is spontaneous intracerebral hemorrhage (ICH), and prognosis is highly correlated with location and size in the posterior fossa. The objective of this work was to estimate the frequency of posterior fossa hemorrhage (PFH) in Tanta University Hospitals, as well as identify functional outcomes and mortality in PFH.

Methods

This study was performed on 33 posterior fossa hemorrhagic patients and 119 posterior ischemic stroke patients (PCIS) submitted to the CT brain and the MRI brain, using the following scales: GCS and NIHSS, and the intracerebral hemorrhage scale (ICH score).

Results

Posterior fossa hemorrhage (PFH) represents 16.83% of total hemorrhagic stroke in the ER. Vertigo and DCL are more common in PFH (60.6%, 48.4%) than in PCIS. 82% of PFH patients had hypertension (HTN) hemorrhage. The cerebellum is the most common site for PFH (48%), pontine (24%), thalamic (18%), and midbrain (9%). PFH had unfavorable outcomes in 55% of the studied patients; the MRS mean was 4; and 39% died in the follow-up.

Conclusion

Posterior fossa hemorrhage is a potentially serious neurovascular emergency associated with complex symptomatology. PFH demonstrates diverse prognoses depending on the location of the intracerebral hemorrhage and the size of the hematoma.
Gossen’s first law in the modeling for demand side management: a thorough heat pump case study with deep learning based partial time series data generation
Authors: Li Chang , Brecher Gina , Kovačević Jovana , Çakmak Hüseyin K. , Förderer Kevin , Matthes Jörg , Hagenmeyer Veit
Published: June 2024

Gossen’s First Law describes the law of diminishing marginal utility. This paper aims to further verify the proposed hypothesis that Gossen’s First Law also holds in the modeling for Demand Side Management (DSM) with a thorough heat pump case study. The proposed hypothesis states that in general the complexity-utility relationship in the field of DSM modeling could be represented by a diminishing marginal utility curve. On the other hand, in data based modeling, when utilizing a large dataset for validation, the data integrity is critical to the reliability of the results. However, the absence of partial time series data may occur during the measurement due to missing sensors or IT related issues. In this work, an extensive real-world open dataset of a ground source heat pump is utilized for the case study. In the raw data, one key variable namely the flow rate is missing. Thus, three different algorithms based on machine learning and deep learning architectures namely Random Forest (RF), Long Short-Term Memory (LSTM) and Transformer are applied to predict the flow rate by utilizing an open loop forecasting. The raw data are first pre-processed with a time interval of one hour and then used for training, validation and forecast. Furthermore, a modified persistence model as the baseline is also defined. The predicted flow rate using LSTM yields the lowest error of 7.47$$\%$$
%
nMAE and 10.56$$\%$$
%
nRMSE respectively. The forecast results are then utilized in the following step of modeling of a heat pump use case. With the introduced quantification method for complexity and a modified version for utility, we further verify the proposed hypothesis with a longer time horizon of 7 days.
Predicting acute complications in endoscopic retrograde cholangiopancreatography based on the severity and onset of post-procedural pain
Authors: Ejtehadi Fardad , Shahramian Iraj , Befrouei Mojtaba Khademi , Sivandzadeh Gholam Reza , Taghavi Seyed Alireza , Niknam Ramin , Tahani Masoud
Published: June 2024

Background

Endoscopic retrograde cholangiopancreatography (ERCP), a standard procedure used for diagnosing and treating pancreaticobiliary disorders, has the highest rate of complications among endoscopic procedures. We aimed to evaluate the association of post-ERCP pain onset and its severity with the development of acute complications.

Methods

This cross-sectional study included 172 candidates for ERCP who were referred to Namazi Hospital, Shiraz, from January 21, 2021, to January 21, 2022. Demographic features of the participants, including age and gender, were recorded. ERCP indications, complications during and after ERCP, and narcotic requirements were also noted. Post-ERCP pain severity was evaluated using a 10-point visual analogue scale (VAS), with 0 indicating no pain and 10 indicating the worst pain. Pain severity was evaluated twice: once by the physician and once by the patient. The interval between the procedure and the onset of pain was also recorded.

Results

Out of the 172 participants of this study with a mean age of 53.77 ± 20.20 years, 98 (57%) were male. The most typical indication of ERCP was common bile duct stone (36%). Complications during and after ERCP occurred in 2.3% and 2.9%, respectively, with retroperitoneal/sphincterotomy perforation (1.2%) being the most common post-ERCP complication. Post-ERCP pain score (both by patient and physician) was significantly higher in patients with complications compared to those without complications (P < 0.001). The interval between the ERCP procedure and the onset of pain was significantly shorter in patients with post-ERCP complications (P = 0.003). Also, a significantly higher percentage of patients with complications required narcotics (40% vs 1.2%, P = 0.004).

Conclusions

Although the presence of post-ERCP pain may not necessarily be indicative of complications, post-ERCP pain severity and onset, as well as narcotic requirement, appear to be associated with the development of post-ERCP complications.
Comparative study of UV spectroscopy, RP-HPLC and HPTLC methods for quantification of antiviral drug lamivudine in tablet formulation
Authors: Somkuwar Komal , Sabale Prafulla , Sawale Vaibhav , Rahangdale Priya
Published: June 2024

Background

In the current study, estimation of lamivudine (LMU) by UV spectroscopy, reverse-phase HPLC (RP-HPLC) and HPTLC methods in tablet formulation was developed, and comparative studies between the methods were investigated by analytical results and statistical test analysis of variance (ANOVA) to find out best method. In the UV spectral method, LMU was quantified at 271 nm absorption maxima using methanol as the solvent. In the RP-HPLC method, the Shimadzu C18 column (250 mm × 4.6 mm i.d., 5 µm particle size) was employed for chromatographic separation. The mobile phase used consists of methanol: water (70:30 v/v) in an isocratic mode with a 1.0 mL/min flow rate. In the HPTLC method, the chromatogram was developed on a pre-coated plate of silica gel 60 F254 with a mobile phase composition of chloroform: methanol (8:2 v/v). The quantification was performed at an absorbance mode of 271 nm by densitometry. The methods were validated according to the International Conference on Harmonization (ICH) guideline Q2 (R1). The degradation conditions were employed as per ICH guidelines Q1A(R2) and Q1B which include acid, alkaline, neutral, thermal and photostability to determine the intrinsic stability of the drug in varied environmental conditions.

Results

LMU absorption maxima was found to be 271 nm. The retention time of LMU was 3.125 min, and the total analysis time was 5 min. The Rf value of LMU was 0.49–0.62. The methods were linear within 2–12 μg/mL range. The correlation coefficient (r2) for UV, HPLC and HPTLC was 0.9980, 0.9993 and 0.9988, and percent recoveries were calculated as 98.40–100.52%, 99.27–101.18% and 98.01–100.30%, respectively, with percentage relative standard deviation (RSD) less than 2% showing that methods were precise and accurate.

Conclusion

Developed UV, RP-HPLC and HPTLC methods are free from intervention caused by excipients present in tablets and thus can be used for regular quantitative analysis of LMU in tablet formulation. Based on analytical results and statistical tests, ANOVA, it is inferred that the HPLC method is best for LMU quantification tablet formulation due to its high reproducibility, good retention time and sensitivity; it has a higher percent recovery and has less analysis time, i.e., 5 min. The degradation peaks were well separated from the LMU peak indicating stability of the HPLC method.
Accuracy of Glucagon Testing Across Transition in Young Adults With Childhood-Onset GH Deficiency
Authors: Fava Daniela , Guglielmi Davide , Pepino Carlotta , Angelelli Alessia , Casalini Emilio , Varotto Carolina , Panciroli Marta , Tedesco Caterina , Camia Tiziana , Naim Alessandro , Allegri Anna Elsa Maria , Patti Giuseppa , Napoli Flavia , Gastaldi Roberto , Parodi Stefano , Salerno Mariacarolina , Maghnie Mohamad , Di Iorgi Natascia
Published: June 2024

Context

The 2019 American Association of Clinical Endocrinologists guidelines suggested peak GH-cutoffs to glucagon test (GST) of ≤3 and ≤1 µg/L in the diagnosis of permanent GH deficiency (GHD) during the transition phase.

Objective

The aim of the study was to evaluate the accuracy of GST compared to insulin tolerance test (ITT) in the definition of GHD at adult height achievement.

Patients and methods

Ninety-seven subjects with childhood-onset GHD (median age, 17.39 years) underwent ITT, GST, and IGF-1 testing; 44 subjects were idiopathic (isolated GHD), 35 moderate organic GHD (0-2 hormone deficiencies) and 18 severe organic GHD (≥3 hormone deficiencies).

Results

Bland and Altman analysis showed a high consistency of GH peak measures after ITT and GST. Receiver operating characteristic analysis identified 7.3 μg/L as the optimal GH peak cutoff to GST [95% confidence interval (CI) 4.15-8.91; sensitivity 95.7%, specificity 88.2%, positive predictive value (PPV) 88.0%, negative predictive value (NPV) 95.7%] able to correctly classify 91.8% of the entire cohort while 5.8 μg/L was the best GH peak cutoff able to correctly classify 91.4% of moderate organic GHD patients (95% CI 3.16-7.39; sensitivity 96.0%, specificity 80.0%, PPV 92.3%, NPV 88.9%). Patients with ≥3 hormone deficiencies showed a GH peak <5 μg/L at ITT and <5.8 μg/L at GST but 1. The optimal cutoff for IGF-1 was −1.4 SD score (95% CI −1.94 to 0.77; sensitivity 75%, specificity 94%, PPV 91.7%, NPV 81.0%) that correctly classified 85.1% of the study population.

Conclusion

A GH peak to GST <5.8 μg/L represents an accurate diagnostic cutoff for young adults with childhood-onset GHD and high pretest probability of permanent GHD.
A Novel Kidney Failure Prediction Model in Individuals With CKD: Impact of Serum Bilirubin Levels
Authors: Inoguchi Toyoshi , Okui Tasuku , Nojiri Chinatsu , Yamashita Takanori , Nakayama Masaru , Haruyama Naoki , Fukuizumi Kunitaka , Wakata Yoshifumi , Nakashima Naoki
Published: June 2024

Context

Predicting the progression of chronic kidney disease (CKD) to end-stage kidney disease (ESKD) is crucial for improving patient outcomes.

Objective

To reveal the highly predictive activity of serum bilirubin levels for the progression of CKD to ESKD, and to develop and validate a novel ESKD prediction model incorporating serum bilirubin levels.

Methods

We assessed the relative importance of 20 candidate predictors for ESKD, including serum bilirubin levels, in a CKD cohort (15 ≤ estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m2), and subsequently developed a prediction model using the selected variables. The development cohort comprised 4103 individuals with CKD who underwent follow-up at Kyushu University Hospital, Japan, from 2008 to 2018. The primary outcome was incident ESKD, defined as an eGFR < 15 mL/min/1.73 m2, chronic dialysis, or renal transplantation.

Results

The mean follow-up time was 7.0 ± 4.2 years, during which 489 individuals (11.9%) progressed to ESKD. The Cox proportional hazard model selected eGFR, serum bilirubin, proteinuria, age, diabetes, gender, hypertension, serum albumin, and hemoglobin in order of their importance. The predictive performance of the model was optimized by incorporating these 9 variables in discrimination evaluated by time-dependent area under the curve (AUC). This model also demonstrated excellent calibration. Additionally, this model exhibited excellent predictive performance in both discrimination (2-year AUC: 0.943, 5-year AUC: 0.935) and calibration in a validation cohort (n = 2799).

Conclusion

Serum bilirubin levels were strong predictors for the progression of CKD to ESKD. Our novel model that incorporates serum bilirubin levels could accurately predict ESKD in individuals with CKD.
Evaluation of positioning accuracy, radiation dose and image quality: artificial intelligence based automatic versus manual positioning for CT KUB
Authors: Kundu Souradip , Nayak Kaushik , Kadavigere Rajagopal , Pendem Saikiran , . Priyanka
Published: June 2024

Background Recent innovations are making radiology more advanced for patient and patient services. Under the immense burden of radiology practice, Artificial Intelligence (AI) assists in obtaining Computed Tomography (CT) images with less scan time, proper patient placement, low radiation dose (RD), and improved image quality (IQ). Hence, the aim of this study was to evaluate and compare the positioning accuracy, RD, and IQ of AI-based automatic and manual positioning techniques for CT kidney ureters and bladder (CT KUB). Methods This prospective study included 143 patients in each group who were referred for computed tomography (CT) KUB examination. Group 1 patients underwent manual positioning (MP), and group 2 patients underwent AI-based automatic positioning (AP) for CT KUB examination. The scanning protocol was kept constant for both the groups. The off-center distance, RD, and quantitative and qualitative IQ of each group were evaluated and compared. Results The AP group (9.66±6.361 mm) had significantly less patient off-center distance than the MP group (15.12±9.55 mm). There was a significant reduction in RD in the AP group compared with that in the MP group. The quantitative image noise (IN) was lower, with a higher signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the AP group than in the MP group (p<0.05). Qualitative IQ parameters such as IN, sharpness, and overall IQ also showed significant differences (p< 0.05), with higher scores in the AP group than in the MP group. Conclusions The AI-based AP showed higher positioning accuracy with less off-center distance (44%), which resulted in 12% reduction in RD and improved IQ for CT KUB imaging compared with MP.
Data Management Plan for a rapid response sub-study of an existing cohort. The Irish Longitudinal Study on Ageing (TILDA) COVID-19 sub-study
Authors: Ward Mark , Clarke Niamh , McLoughlin Sinéad , Golden Darach , Kenny Rose Anne
Published: June 2024

A Data Management Plan (DMP) is a formal document that outlines the management and stewardship of data generated over the lifecycle of a research project from data collection, and governance structures, to the long-term preservation of data outputs. DMPs are an important feature of good research practice. Our aim is to provide details of the development of a DMP that others can learn from and adapt to their specific needs. Our DMP was developed as part of a COVID-19 sub-study of The Irish Longitudinal Study on Ageing (TILDA), titled “Altered lives in a time of crisis: preparing for recovery from the impact of the COVID-19 pandemic on the lives of older adults”. TILDA is a longitudinal study of community-dwelling older adults. In 2009/2010, an initial nationally representative sample of 8,500 adults aged 50 years and older were selected. The sample for the COVID-19 study were recruited from this existing sample. The objective of the sub-study was to document the lives and experiences of older adults during the COVID-19 pandemic to better understand the effect of the pandemic and public health responses on their well-being. This DMP describes the study design and objectives; data collection tools and procedures; data preparation; data storage and security; data sharing and preservation; and ethical and legal considerations within the European Union and Irish Health Research legislative context. Responsible data governance in Ireland is complex, requiring adherence to both European and Irish legislation. Implementation of the Health Information Bill (2023) may bring further complexities to this context. It is therefore crucial that researchers, data stewards, and other practitioners, share their expertise freely, as we have done here, so that others can learn from their experiences and the health research community can develop standards of best practice.
The genome sequence of a cranefly, Tipula (Savtshenkia) confusa van der Wulp, 1883
Authors: Sivell Duncan ,   Natural History Museum Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life Management, Samples and Laboratory team,   Wellcome Sanger Institute Scientific Operations: Sequencing Operations,   Wellcome Sanger Institute Tree of Life Core Informatics team,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: June 2024

We present a genome assembly from an individual male Tipula confusa (cranefly; Arthropoda; Insecta; Diptera; Tipulidae). The genome sequence is 728.1 megabases in span. Most of the assembly is scaffolded into 5 chromosomal pseudomolecules, including the X and Y sex chromosomes. The mitochondrial genome has also been assembled and is 16.94 kilobases in length.
Polis e architettura
Authors: Renato Nicolini
Published: June 2024

L’autore tesse un ragionamento che ribalta il modo consueto di guardare al rapporto tra architettura e città. Si chiede, non cosa può fare l'architettura per la città, ma: cosa può fare la città, intesa come insieme di cittadini e istituzioni, per l'architettura nell'epoca della globalizzazione e della comunicazione di massa? Ricordando per tale via l'esperienza eccezionale delle “Estati romane”.
Glossario per la città europea
Authors: Yannis Tsiomis
Published: June 2024

Il concetto di “città in estensione” di Giuseppe Samonà è l'occasione per riflettere sul significato del fenomeno urbano oggi. L’autore lo fa attraverso nove punti, da “estensione” a “polisemia”, passando per “scala”, “metodo” e “funzione”, che diventano i termini di un nuovo glossario ragionato per la città europea, per un approccio cosciente allo studio e al progetto di quello che lui chiama “il dilemma territoriale”.
La città nell'università. L'esperienza Mastercampus
Authors: Andrea Matta
Published: June 2024

Il ruolo fondamentale che oggi assume l’istituzione universitaria nei confronti della città europea richiede un ripensamento dei luoghi nei quali essa si insedia. Uno di questi è il campus. L’esperienza svolta all’interno del progetto Mastercampus stimola il ragionamento rispetto ad alcuni elementi chiave per comprendere questo tipo insediativo e la relazione che instaura con la città di riferimento, alla luce delle nuove esigenze ed opportunità europee.
In viaggio verso il progetto. La “partecipazione” nell’insegnamento dell'architettura
Authors: Paolo Strina
Published: June 2024

Recensione al testo: Autore: Paola Veronica Dell'Aira Titolo: Il “Banco di prova”. Sottotitolo: Esperienze di didattica partecipata Lingua: italiano Collana: Passo per Passo. Percorsi di apprendimento in architettura Editore: Aracne Caratteristiche: formato 15x21 cm, brossura, b/n e colori ISBN: 9788825516814 Anno: 2018
Abitare lo spazio attraverso archetipi. Letture delle opere di Kahn e Mies
Authors: Giuseppe Verterame
Published: June 2024

Recensione del testo Autori: Federica Visconti, Renato Capozzi Titolo: Kahn e Mies Sottotitolo: Tre modi dell’abitare Lingua: italiano Collana: Theoria, architettura, città Editore: Clean, Napoli Caratteristiche: formato 12x17 cm, 96 pagine, brossura, bianco e nero ISBN: 978-88-8497-722-9 Anno: 2019
Luoghi elastici e progetto intermedio.
Authors: Paola Scala  , Grazia Pota
Published: June 2024

Molte delle riflessioni architettoniche e urbane concepite durante e dopo la pandemia COVID sembrano alludere all’invenzione di nuovi paradigmi di sviluppo alternativi all’idea di città e di metropoli globale. Ma è davvero possibile questa risposta o, ancora una volta, tra l’architettura e la realtà si sta generando uno iato difficile da colmare? In quest’articolo si prova ad affrontare il tema della città post covid a partire da quella esistente e in particolare dalle periferie, da quei quartieri costruiti su un’idea di standard che nasce proprio dal rapporto architettura- salute dove però, molto spesso, il progetto sia delle abitazioni che degli spazi pubblici ha determinato luoghi astratti che rendono difficile la costruzione di reti sociali.
La città e il sogno
Authors: Yehuda Emmanuel Safran
Published: June 2024

Il saggio si articola in un lungo racconto che prende avvio da una raccolta di indizi riguardo l’origine ed il funzionamento del nostro immaginario. Dove risiedono le immagini che hanno dato forma alle grandi utopie urbane? Che rapporto intercorre tra invenzione ed entropia (inclusa la variante “batailliana” della dépanse), quale spazio hanno il libero arbitrio ed il determinismo tecnico-scientifico nel progetto della società presente e futura? Il saggio ci accompagna nella ricerca impossibile di una risposta, avanzando tra le pieghe della filosofia, dell’arte e della letteratura. Si tratta, in altre parole, di un racconto sui limiti della ragione e della natura assiomatica della conoscenza.
Il caso di Mosul. Tra lettura urbana e ricostruzione
Authors: Tommaso Lolli
Published: June 2024

Ciò che rende interessante uno studio urbano di Mosul non è tanto lo stato emergenziale in cui versa la città, ricorrendo a soluzioni temporanee ed emergenziali, ma una auto-interrogazione sul verso senso della ricostruzione urbana. Ricostruzione né come soluzione dettata dalla necessità, ma nemmeno come apologia della reiterazione e della restaurazione. La lettura che si vuole proporre è quella di annoverare le distruzioni (e conseguenti ricostruzioni) nei processi propri della dinamica delle città, e pertanto uno studio delle stesse dinamiche da cui desumere processi generativi tipici. Iniziando quindi da uno studio del contesto, una vera e propria lettura critica, fino alla formazione di un vocabolario appropriato, si analizzeranno alcune modalità di approccio alle ricostruzioni urbane attraverso riferimenti procedurali e progettuali.
Cento modi di giocare con lo spazio. Le architetture educative di Giancarlo Mazzanti
Authors: Francesca Serrazanetti
Published: June 2024

L’architettura, per Giancarlo Mazzanti, è come un gioco: nel significato più ampio e versatile del termine ‘play’, è qualcosa che si agisce. È uno spazio che si può plasmare e trasformare, e che più è aperto alla manipolazione, più può essere compreso dagli abitanti. Giancarlo Mazzanti “gioca” con la composizione come processo aperto e partecipativo. Se questo termine è trasversale a tutto il lavoro dello studio colombiano, trova una sua peculiare applicazione nella realizzazione di spazi educativi. L’approccio pedagogico di Loris Malaguzzi guida il progetto: lo spazio è un “terzo insegnante” che entra in relazione con le attività e i “cento linguaggi” dei bambini, partecipando ai processi educativi. Attraverso il riferimento ai progetti di alcuni asili realizzati dallo studio, l’articolo tratta il tema degli spazi educativi pensati come dispositivi di crescita: il valore degli spazi educativi, soprattutto in contesti emergenziali come quello delle periferie urbane colombiane, porta a concepire l’architettura stessa come disciplina che ha lo scopo di creare ambienti che siano educativi in sé.