bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic left hepatectomy for a patient with an absence of portal bifurcation using real-time imaging: a case report
Authors: Mizuno Shugo , Iizawa Yusuke , Tanemura Akihiro , Kaluba Benson , Noguchi Daisuke , Ito Takahiro , Hayasaki Aoi , Fujii Takehiro , Murata Yasuhiro , Kuriyama Naohisa , Kishiwada Masashi
Published: June 2024

Background

Absence of portal bifurcation is an extremely rare anomaly that should be recognized preoperatively, especially prior to a major hepatectomy.

Case presentation

A 45-year-old woman presented with abdominal pain, and abdominal computed tomography (CT) revealed dilatation of both the common bile duct (CBD) and intrahepatic bile duct (IHBD). Endoscopic retrograde cholangiopancreatography (ERCP) showed CBD and IHBD stones (B2 and B4). The CBD stones were removed, but the IHBD stones could not be, yet there was no evidence of malignancy at the site of IHBD stenosis. Enhanced CT revealed a dilated IHBD, while three-dimensional CT images showed the left portal vein running through the ventral side of the middle hepatic vein, which was diagnosed as the absence of portal vein bifurcation (APB). Laparoscopic left hepatectomy was successfully performed using real-time indocyanine green (ICG) fluorescence imaging.

Conclusion

Surgeons should be aware of the possibility of APB, a rare portal vein anomaly, before performing major hepatectomy. Real-time ICG fluorescence imaging may be helpful to ensure the precise anatomy of the liver during laparoscopic surgery.
Vitamin A-related nutrition knowledge gaps and predictors among caregivers of preschool children in Eastern Uganda: a cross-sectional study
Authors: Mangusho Gilbert , Njogu Eunice , Baingana Rhona Kezabu , David-Kigaru Dorcus Mbithe
Published: June 2024

Background

Vitamin A (VA) remains a core micronutrient as VA Deficiency (VAD) in children has persisted as a public health problem in parts of Africa with adverse effects. Caregivers of children are essential in the control of VAD; however, there is a paucity of data on their knowledge of VA, dietary sources, and VAD. This study sought to assess the level of VA-related nutrition knowledge (VANK) and its predictors among caregivers of preschool children in Eastern Uganda.

Methods

A cross-sectional analytical design was used. Both socio-demographic and knowledge and attitude (KA) data were collected using a structured questionnaire partly adapted from the FAO model Knowledge, Attitude and Practice (KAP) questionnaire. A sample size of 256 was used. Caregivers of 24–59 months-old children were selected from Bukwo District in Eastern Uganda using purposive and random sampling methods. Knowledge scores (%) based on responses to ten questions were determined and eventually classified as low (≤ 40%) and moderate or high (˃40%). Descriptive and inferential statistics were computed using SPSS (version 24). Logistic regression was used to identify predictors with p < 0.05 considered significant.

Results

The study had 247 caregivers with a mean age of 30.9 ± 7.7 years. The majority were female (90%), married, subsistence crop farmers and had primary-level education or lower. The mean VANK score was 18.9 ± 24.7%. Overall, most of the caregivers had low VANK as only about 20% had moderate or high. The proportions that knew the different aspects of VANK were correspondingly small. About half of the caregivers (46.6%) knew VA itself and only 27% knew any of its sources. Those who knew VAD, its causes, signs/symptoms and prevention measures were 31, 22, 13 and 24% respectively. The caregivers’ VANK was significantly associated with their overall VA-related attitude, age and level of education. However, education and age were the significant predictors.

Conclusion

Caregivers had very low VANK. They barely knew VA and its food sources or VAD. The main predictors of VANK were caregiver age and level of education. The study recommends education of caregivers about VA for effective VAD control which contributes to achievement of the Sustainable Development Goal (SDG) 2.
Expertise and Deceptive Movements in Sport
Authors: Raffan Ryan , Mann David , Savelsbergh Geert
Published: June 2024

Background

Deceptive movements occur when an actor seeks to fake, hide or delay kinematic information about their true movement outcomes. The purpose of deceptive movements is to impair the perception of opponents (the ‘observer’) to gain an advantage over them. We argue though that a lack of conceptual clarity has led to confusion about what deception is and in understanding the different approaches by which an actor can deceive their opponent. The aim of this article is to outline a conceptual framework for understanding deceptive movements in sport.

Main body

Adopting Interpersonal Deception Theory from the field of communication, we define deception as when an actor deliberately alters their actions in an attempt to impair the ability of an observer to anticipate their true action outcomes. Further, deception can be achieved either by what we define as deceit, the act of providing false information, or disguise, the act of concealing the action outcome. Skilled athletes often have actions that are difficult to anticipate, but an action is only classified as containing deception if the actor has explicit intent to deceive an observer. Having outlined the conceptual framework, we then review existing empirical findings on the skilled perception of deceptive movements considering the framework. This approach includes a critical evaluation of the mechanisms known to facilitate the perceptual ability to prevent being deceived, including a consideration of visual search strategies, confidence, the contribution of visual and motor experiences, and the influence of response biases and action capabilities on perceptual performance.

Conclusion

The distinction between deceit and disguise particularly helps to show that most research has examined deceit, with little known about how an actor can more effectively disguise their action, or about how an observer can improve their ability to anticipate the outcome of disguised actions. The insights help to identify fruitful areas for future research and outline implications for skill acquisition and performance enhancement.
Effect of Exercise Prior to Sedentary Behavior on Vascular Health Parameters: A Systematic Review and Meta-Analysis of Crossover Trials
Authors: Soto-Rodríguez Francisco Javier , Moya Alicia Peris , Bobadilla-Agouborde Carolina Javiera , Pérez-Mármol José Manuel
Published: June 2024

Background

Sedentary behavior has been shown to negatively affect parameters of endothelial function and central hemodynamics, both of which are closely associated with vascular health. Exercise prior to sedentary behavior has demonstrated potential as a preventive strategy to mitigate these detrimental effects. To evaluate the impact of exercise prior to sedentary behavior on vascular health parameters in the adult population, a systematic review and meta-analysis were conducted, synthesizing the available body of knowledge.

Methods

A literature search was carried out in 6 databases. For each outcome, standard error and mean difference or standardized mean difference were calculated, as appropriate. An analysis was performed using a random effects model with a 95% confidence interval, using the inverse variance statistical method. Risk of bias assessment was performed using ROB2 and considerations for crossover trials. The quality of evidence was assessed using the GRADE system.

Results

Exercise performed prior to prolonged sedentary behavior resulted in increased flow-mediated vasodilation at the first and third hours of sedentary time, compared with the control condition of sedentary behavior without prior exercise [MD: 1.51% (95% CI: 0.57 to 2.45) and MD: 1.36% (95% CI: 0.56 to 2.16), respectively]. Moreover, prior exercise led to increased shear rate at the first and third hours of sedentary time [MD: 7.70 s^−1 (95% CI: 0.79 to 14.61) and MD: 5.21 s^−1 (95% CI: 1.77 to 8.43), respectively]. Furthermore, it increased blood flow at the third hour [SMD: 0.40 (95%CI: 0.07 to 0.72)], compared with the control condition of prolonged sedentary behavior without prior exercise. Regarding hemodynamic parameters, exercise prior to prolonged sedentary behavior decreased mean arterial pressure during the first and third hours of sedentary behavior [MD: -1.94 mmHg (95% CI: -2.77 to -1.11) and MD: -1.90 mmHg (95% CI: -3.27 to -0.53), respectively], and an increase in heart rate during the first hour [MD: 4.38 beats per minute (95%CI: 2.78 to 5.98)] compared with the control condition of prolonged sedentary behavior without prior exercise.

Conclusions

The findings of this research suggest that prior exercise may prevent the impairment of vascular health parameters caused by sedentary behavior. However, the quality of the evidence was estimated as moderate. Therefore, further experimental studies and high-quality clinical trials are needed in this field to strengthen the results and conclusions drawn.

PROSPERO registration number

CRD42023393686.
Concussion and the Sleeping Brain
Authors: Donahue Catherine C. , Resch Jacob E.
Published: June 2024

Background

Emerging research has suggested sleep to be a modifier of the trajectory of concussion recovery in adolescent and adult populations. Despite the growing recognition of the relationship between sleep and concussion, the mechanisms and physiological processes governing this association have yet to be established.

Main Body

Following a concussion, a pathophysiologic cascade of events occurs, characterized by numerous factors including microglia activation, ionic imbalance, and release of excitatory neurotransmitters. Importantly, each of these factors plays a role in the regulation of the sleep-wake cycle. Therefore, dysregulation of sleep following injury may be a function of the diffuse disruption of cerebral functioning in the wake of both axonal damage and secondary physiological events. As the onset of sleep-related symptoms is highly variable following a concussion, clinicians should be aware of when and how these symptoms present. Post-injury changes in sleep have been reported in the acute, sub-acute, and chronic phases of recovery and can prolong symptom resolution, affect neurocognitive performance, and influence mood state. Though these changes support sleep as a modifier of recovery, limited guidance exists for clinicians or their patients in the management of sleep after concussion. This may be attributed to the fact that research has correlated sleep with concussion recovery but has failed to explain why the correlation exists. Sleep is a complex, multifactorial process and the changes seen in sleep that are seen following concussion are the result of interactions amongst numerous processes that regulate the sleep-wake cycle.

Short Conclusion

The assessment and management of sleep by identifying and considering the biological, sociological, and psychological interactions of this multifactorial process will allow for clinicians to address the dynamic nature of changes in sleep following concussion.
The Effect of Endurance Exercise on Semen Quality in Male Athletes: A Systematic Review
Authors: Aerts Alex , Temmerman Annelien , Vanhie Arne , Vanderschueren Dirk , Antonio Leen
Published: June 2024

Background

Endurance exercise has the potential to affect reproductive function, with amenorrhea in female athletes. However, most studies focus on women. Evidence on the association between endurance exercise and male fertility is limited.

Objective

To synthesise existing literature on exercise-induced alterations in semen parameters and to assess the clinical impact on male fertility.

Methods

Studies reporting on the association between semen parameters and endurance exercise in healthy men were eligible. Men attending fertility clinics were excluded. We searched MEDLINE (PubMed), Embase, SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov and International Clinical Trials Registry Platform (ICTRP) from their inception to May 28th 2022. JBI Critical Appraisal Tool was used to assess the potential risk of bias.

Results

Thirteen studies met inclusion criteria, reporting on 280 subjects. Eight articles reported on endurance runners, three on cyclists and four on triathletes. Four studies did not find any statistically significant sperm alterations. Five reported significant changes in semen parameters, but these were not clinically relevant, as semen parameters remained well above World Health Organisation (WHO) thresholds. Four articles reported a decrease in semen quality with potential clinical consequences as they found a reduced number of sperm cells exhibiting normal morphology in cyclists and triathletes and a greater amount of DNA fragmentation in triathletes.

Conclusion

Endurance exercise can have a negative effect on semen quality, although rarely with a clinically relevant impact on male fertility. Evidence is however limited, with poor quality of the included studies.

Registration: PROSPERO International prospective register of systematic reviews (CRD42022336753).
Effectiveness of additional topical antibiotics for recurrent or refractory exit-site infection: a case series
Authors: Asai Nao , Suzuki Yasuhiro , Asai Akimasa , Kinashi Hiroshi , Kamiya Keisuke , Hagita Junichiro , Matsuoka Naoya , Kawamura Suzuka , Fukui Sosuke , Kim Hangsoo , Yamaguchi Makoto , Katsuno Takayuki , Mizuno Masashi , Ishimoto Takuji , Ito Yasuhiko
Published: June 2024

Background

Japanese peritoneal dialysis (PD) guidelines do not suggest applying mupirocin/gentamicin ointment to the exit sites of PD patients to prevent exit-site infection (ESI). The guidelines do not mention topical antimicrobials as a treatment for ESI.

Methods

We retrospectively investigated the additional use of topical antibiotic ointments on patients receiving oral or intravenous antibiotics for recurrent and/or refractory ESI at Aichi Medical University and Nagoya University Hospitals between 2017 and 2022.

Results

A total of 13 patients (11 men, 2 women) were included in this study. Median age was 69.0 years, median duration of PD was 26.0 months, two patients had diabetes as a complication, and ESI incidence was 2.7 episodes per patient-year. Systemic antibacterial treatment had been administered for a median of 27.0 days before application therapy. Mupirocin was used in eight cases and gentamicin in five cases, with complete resolution in all cases. No adverse effects such as skin symptoms, antibiotic resistance, or non-tuberculous mycobacterial infections were observed. Cases were divided into two groups based on the duration of topical antibiotic use: short-term group < 90 days and long-term group ≥ 90 days. All patients in both groups achieved complete resolution, with no significant differences in time to resolution, number of recurrent ESIs, or occurrence of ESIs after discontinuation of application therapy.

Conclusion

Additional use of topical antibiotic for recurrent and/or refractory ESI appears safe and effective. This study suggests that future randomized controlled trials are warranted.
Impact of targeted drug administration and intermittent preventive treatment for forest goers using artesunate–pyronaridine to control malaria outbreaks in Cambodia
Authors: Lek Dysoley , Sokomar Nguon , Samphornarann Top , Rideout Jeanne , Hassan Saad El-Din , Bunkea Tol , Ath Saing Sam , Seng Rothpisey , Hustedt John , Peto Thomas J. , Hughes Jayme , Kimmen Ke , Dy Khoy , Adhikari Bipin
Published: June 2024

Introduction

The national malaria programme of Cambodia targets the rapid elimination of all human malaria by 2025. As clinical cases decline to near-elimination levels, a key strategy is the rapid identification of malaria outbreaks triggering effective action to interrupt local transmission. We report a comprehensive, multipronged management approach in response to a  2022 Plasmodium falciparum outbreak in Kravanh district, western Cambodia.

Methods

The provincial health department of Pursat in conjunction with the Center for Parasitology, Entomology and Malaria Control (CNM) identified villages where transmission was occurring using clinical records, and initiated various interventions, including the distribution of insecticide-treated bed nets, running awareness campaigns, and implementing fever screening with targeted drug administration. Health stations were set up at forest entry points, and later, targeted drug administrations with artesunate–pyronaridine (Pyramax) and intermittent preventive treatment for forest goers (IPTf) were implemented in specific village foci. Data related to adherence and adverse events from IPTf and TDA were collected. The coverage rates of interventions were calculated, and local malaria infections were monitored.

Results

A total of 942 individuals were screened through active fever surveillance in villages where IPTf and TDA were conducted. The study demonstrated high coverage and adherence rates in the targeted villages, with 92% (553/600) coverage in round one and 65% (387/600) in round two. Adherence rate was 99% (551/553) in round one and 98% (377/387) in round two. The study found that forest goers preferred taking Pyramax over repeated testing consistent with the coverage rates: 92% in round one compared to 65% in round two. All individuals reachable through health stations or mobile teams reported complete IPTf uptake. No severe adverse events were reported. Only six individuals reported mild adverse events, such as loss of energy, fever, abdominal pain, diarrhoea, and muscle aches. Two individuals attributed their symptoms to heavy alcohol intake following prophylaxis.

Conclusions

The targeted malaria outbreak response demonstrated high acceptability, safety, and feasibility of the selected interventions. Malaria transmission was rapidly controlled using the available community resources. This experience suggests the effectiveness of the programmatic response for future outbreaks.
Hopeful futures for refugees in higher education: cultivation, activation, and technology
Authors: Gallagher Michael , Nanyunja Sandra , Akello Martha , Mulondo Apollo , Miranda Juan-Jose
Published: June 2024

This paper discusses hopeful futures for higher education and the use of technology in realising those futures through the lens of refugee education in Uganda. Through an analysis of qualitative research done with refugee students and teachers participating in a blended bridging programme designed to prepare students for entry and success in higher education, this paper explores the interplay between contingency and positions of hope for refugee students in relation to higher education and further assimilation into civic society. Two themes emerged from the analysis that suggested a prioritarian orientation for higher education to realise a more hopeful future. First, hope renders as an act of cultivation as refugee students become exposed to new concepts and develop confidence in relation to them. Second, digital technologies broaden the cultivation of hope towards greater civic participation, even if access to higher education is not achieved. Third, hope correlates to action not necessarily as a linear progressive trajectory but as a diligent watchfulness for positive possibility. The implications for higher education are that taking a prioritarian lens for refugees in educational design engages with the contingencies that impact all, placing the sector deliberately in search of positive possibility in its orientation and design.
Relationship between pruritus and sleep in participants with primary biliary cholangitis in the Phase 2b GLIMMER trial
Authors: von Maltzahn Robyn , Mayo Marlyn J. , Smith Helen T. , Thompson April , Das Sugato , de Souza Andrea Ribeiro , Lisi Edoardo , Levy Cynthia , McLaughlin Megan M. , Jones David
Published: June 2024

Background

Cholestatic pruritus and fatigue are debilitating conditions associated with primary biliary cholangitis (PBC) and can significantly impact patients’ quality of life. Pruritus in PBC often worsens at night and patients frequently report sleep disturbance, which contributes to cognitive symptoms and fatigue. Linerixibat is an ileal bile acid transporter inhibitor in clinical development for the treatment of pruritus associated with PBC and was recently assessed versus placebo in the Phase 2b GLIMMER trial. This post-hoc analysis assesses the relationship between pruritus severity and sleep disturbance in participants of GLIMMER regardless of treatment group.

Methods

GLIMMER (NCT02966834), a multicenter, double-blind, randomized, placebo-controlled trial, recruited 147 patients with PBC and moderate-to-severe pruritus. Following 4 weeks single-blind placebo, patients (randomized 3:1) received linerixibat or placebo for 12 weeks (to Week 16). Participants graded their itch (twice daily) and its interference with sleep (once daily) in an electronic diary using a 0–10 numerical rating scale (NRS). Weekly and monthly itch scores were calculated as the mean of the worst daily itch score over the respective time period. At study visits, participants completed the 5-D itch scale and the PBC-40 quality of life questionnaire, both of which contain an item specific to itch-related sleep disturbance. The impact of pruritus on sleep was assessed post hoc through correlations between the changes in NRS, 5-D itch, and PBC-40.

Results

Strong correlations were found between change from baseline in weekly itch and sleep NRS scores (r = 0.88 [95% confidence interval (CI): 0.83; 0.91]) at the end of treatment (Week 16), as well as in monthly itch and sleep NRS scores (r = 0.84 [95% CI: 0.80; 0.87]). Patients with improved weekly pruritus score severity category demonstrated reduced perceived sleep interference on average. Itch responders (≥2-point improvement in weekly itch score from baseline) displayed larger improvements in weekly sleep NRS score, 5-D itch, and PBC-40 sleep items, than itch non-responders (<2-point improvement).

Conclusions

A strong correlation exists between changes in pruritus severity and sleep interference in patients with PBC; pruritus reduction could generate concomitant improvement in sleep.
Sex and age estimation with corneal topography parameters by using machine learning algorithms and artificial neural networks
Authors: Yilmaz Nesibe , Secgin Yusuf , Mercan Kadir
Published: June 2024

Background

The aim of this study, which was based on this hypothesis, was to estimate sex and age by using a machine learning algorithm (ML) and artificial neural networks (ANN) with parameters obtained from the eyeball. The study was conducted on corneal topography images of 155 women and 155 men aged between 6 and 87 who did not have surgical intervention or pathology in their eyeballs. In the study, the individuals were divided into four different age groups 6–17, 18–34, 35–55, and 56–87. Sex and age estimation was carried out by using the numerical data of parameters obtained as a result of corneal topography imaging in ML and ANN inputs.

Results

As a result of our study, in sex determination, a 0.98 accuracy rate (Acc) was obtained with the logistic regression algorithm, one of the ML algorithms, and 0.94 Acc was obtained with the MLCP model, one of the ANN algorithms; in age estimation, 0.84 Acc was obtained with RF algorithm, one of the ML algorithms. With the SHAP analyzer of the Random Forest algorithm, through which the effects of parameters on the overall result are evaluated, the parameter that made the highest contribution to sex estimation was found to be corneal volume, and the parameter that made the highest contribution to age estimation was found to be pupil Q parameter.

Conclusion

As a result of our study, it was found that parameters obtained from the eyeball showed a high accuracy in sex and age estimation.
Evidences of in vivo cytotoxic and apoptotic potential of anthelmintic phytochemical kaempferol derivative isolated from Lysimachia ramosa (Wall. ex Duby) in Wistar rats
Authors: Sarkar Ashish , Dev Deepjyoti , Roy Bishnupada
Published: June 2024

Background

Lysimachia ramosa (Wall. ex Duby) is a traditionally used medicinal plant in Meghalaya, a northeastern state of India. The people use the leaves of the plant to cure gastrointestinal worm infection. Kaempferol derivative, isolated from the leaves of the plant L. ramosa, was found to be the active anthelmintic compound in previous studies. The phytochemical present in the leaves causes alterations in the ultrastructure of the tegument of cestode, its glycogen content and tegumental enzymes. However, it has been found in the review of the literature that phytoproduct should be consumed in a limited dose during longtime treatment period to avoid any potential ill effects on the health of the consumers as many plant-based products are found to be toxic beyond a safe dose limit. Thereby, it becomes necessary to check the potential toxic effects of the active compound taking an animal model. Hence, the present study had been carried out to evaluate the toxicity of the active component on Wistar rats to find out the safe dose of the test compound for oral consumption through observations, if any, on chromosomal abnormalities, ultrastructural changes in bone marrow cells and apoptosis in liver and kidney.

Results

The result shows kaempferol derivative causes a significant rise in chromosomal abnormalities (2.83 ± 0.19%, 3.83 ± 0.11%) and a significant decline in mitotic indices (3.17 ± 0.02%, 3.10 ± 0.01%) upon treatment with 500 mg and 1000 mg/kg b.w. dosages. At this level, the number of micronucleated erythrocytes increases significantly in the animals (2.33 ± 0.33%, 3.15 ± 0.24%). Intercellular integrity and eosinophil in the bone marrow are observed to be deformed and damaged on treatment with 1000 mg compound/kg b.w. of animals. Apoptotic indices are seen to be increased significantly (3.12 ± 0.18%, 6.17 ± 0.17%) and (2.43 ± 0.13%, 4.17 ± 0.17%) for the liver and kidney, respectively, in the animals of higher-dose treatment groups.

Conclusions

The compound, kaempferol derivative in the present study, has been found to have cytotoxic and pro-apoptotic effects on the test animals beyond a certain dose, if consumed for longer period of time. Therefore, it can be concluded that kaempferol derivative extracted from Lysimachia ramosa should be tested for future trials on animals/humans at dose below 250 mg/kg body weight.
Handling and pathology reporting guidelines for bladder epithelial neoplasms – recommendations from the Brazilian Society of Pathology / Brazilian Society of Urology / Brazilian Society of Clinical Oncology
Authors: Athanazio Daniel Abensur , Amorim Luciana Schultz , da Cunha Isabela Werneck , Távora Fabio , Cavalcanti Marcela Santos , Bezerra Stephania Martins , Assis Emilio , da Silva Igor Campos , Korkes Fernando , Fernandes Roni , Morbeck Igor Protzner , Souza Vinicius Carrera , Leite Katia Ramos Moreira
Published: June 2024

The Brazilian Society of Pathology Guidelines Project aims to provide recommendations for clinicians and pathologists based on the best available scientific evidence. It reviews the currently available and emerging histopathological and molecular aspects of bladder cancer that are necessary for the best patient’s management. This paper is a result of a combined effort of the Brazilian Society of Pathology, the Brazilian Society of Urology, and the Brazilian Society of Clinical Oncology to call attention to the essential pre-analytical issues, the required clinical information and specimen handling to allow proper diagnosis, grading, staging and characterization of the molecular aspects of bladder epithelial neoplasms.
Place-based innovation for sustainable and resilient human systems
Authors: Rust Björn , Rust Sascha
Published: June 2024

This paper critically examines fail-fast culture and its compatibility with fragile contexts. It argues that to address complex global challenges, a nuanced ‘fail well’ approach is required. Drawing on the Gothenburg innovation ecosystem—among others—the paper highlights the importance of fostering partnerships between industry, government, non-government organisations, and higher education institutions to prepare emerging innovators for uncertain futures. Cross-sector cases emphasise the need for place-based, collaborative innovation, highlighting that successful innovation is non-linear and emerges through dynamic social processes and contextual influence. It calls for a shift in education towards inclusive, bidirectional pedagogies that integrate sustainability principles and systems thinking across disciplines. The paper concludes by advocating for a shift towards regionally focused, inclusive innovation cultures that prioritise context and community well-being over pursuing only economic goals. This approach is crucial for ensuring safe and just futures in the face of mounting global challenges.
Simulated deep CT characterization of liver metastases with high-resolution filtered back projection reconstruction
Authors: Wiedeman Christopher , Lorraine Peter , Wang Ge , Do Richard , Simpson Amber , Peoples Jacob , De Man Bruno
Published: June 2024

Early diagnosis and accurate prognosis of colorectal cancer is critical for determining optimal treatment plans and maximizing patient outcomes, especially as the disease progresses into liver metastases. Computed tomography (CT) is a frontline tool for this task; however, the preservation of predictive radiomic features is highly dependent on the scanning protocol and reconstruction algorithm. We hypothesized that image reconstruction with a high-frequency kernel could result in a better characterization of liver metastases features via deep neural networks. This kernel produces images that appear noisier but preserve more sinogram information. A simulation pipeline was developed to study the effects of imaging parameters on the ability to characterize the features of liver metastases. This pipeline utilizes a fractal approach to generate a diverse population of shapes representing virtual metastases, and then it superimposes them on a realistic CT liver region to perform a virtual CT scan using CatSim. Datasets of 10,000 liver metastases were generated, scanned, and reconstructed using either standard or high-frequency kernels. These data were used to train and validate deep neural networks to recover crafted metastases characteristics, such as internal heterogeneity, edge sharpness, and edge fractal dimension. In the absence of noise, models scored, on average, 12.2% ($$\alpha =0.012$$

α
=
0.012

) and 7.5% ($$\alpha =0.049)$$

α
=
0.049
)

lower squared error for characterizing edge sharpness and fractal dimension, respectively, when using high-frequency reconstructions compared to standard. However, the differences in performance were statistically insignificant when a typical level of CT noise was simulated in the clinical scan. Our results suggest that high-frequency reconstruction kernels can better preserve information for downstream artificial intelligence-based radiomic characterization, provided that noise is limited. Future work should investigate the information-preserving kernels in datasets with clinical labels.
Postpartum family planning among women attending maternal and child health centers in Assiut Governorate, Upper Egypt
Authors: Mohammed Heba M. , Zaky Maria A. , Hany Ahmed M.
Published: June 2024

Background

Postpartum family planning (PPFP) is important in helping couples to achieve their reproductive intentions. National surveys have consistently reported higher fertility, lower use of family planning (FP), and higher unmet needs for FP in Upper Egypt. This study aims to identify the factors associated with the use of PPFP in Assiut Governorate, Upper Egypt, and to assess the current status of integration of PPFP counseling in the existing maternal and child health services (MCH).

Methods

The study employed a cross-sectional study design, collecting data from 455 postpartum women aged 15 to 49 years in 4 primary health care (PHC) centers in Assiut Governorate, Upper Egypt. The women were interviewed using a structured questionnaire. The questionnaire consisted of 4 sections: the first section included the participants’ demographic characteristics; the second section included women’s obstetric history; the third section included questions about PPFP knowledge, attitude, past and current use of contraception; and the fourth section assessed the current status of integrating PPFP counseling within antenatal, natal, and postnatal services.

Results

In total, 54.5% of postpartum women were using a modern contraceptive method. The significant predictors of using PPFP methods were as follows: receiving information about PPFP from health care providers (AOR = 11.46, p < 0.001), better attitude towards PPFP (AOR = 10.54, p < 0.001), using modern FP methods (AOR = 6.98, p < 0.001), resumption of menstruation (AOR = 4.11, p < 0.001), older age (AOR = 2.15, p < 0.05), and better PPFP knowledge (AOR = 1.72, p < 0.001). Only 5.3%, 1.3%, and 3.5% received PPFP counseling during antenatal care (ANC), delivery, and the postpartum period, respectively.

Conclusions

Postpartum contraception use was associated with receiving PPFP counseling by health care providers and women’s knowledge and attitude regarding PPFP. However, FP counseling was not integrated with other MCH services. Updating the components of MCH services to include PPFP counseling during ANC, at delivery, and during the postpartum period should be prioritized by program planners and policymakers.
Effects of a comprehensive educational program on health behaviors and awareness of HIV, hepatitis B, and hepatitis C in men with substance use disorders
Authors: Sharifi Ehsan , Ghelbash Zakiye , Karami Amirhosein , Musarezaie Amir
Published: June 2024

Background

Poor adherence to health behaviors is one of the considerable challenges among drug users. This issue is especially noticeable among people who use injection methods for consumption, which increases the possibility of contracting HIV and hepatitis B and C. Therefore, it seems that adopting appropriate intervention approaches focusing on all dimensions of health-related behaviors to promote health behaviors is considered. As a result, in the present study, the effectiveness of a comprehensive educational program on promoting health behaviors and awareness of HIV, hepatitis B, and hepatitis C in drug users was investigated.

Methods

This pretest–posttest quasi-experimental study was performed. The participants were 81 men with substance use disorders residing in a rehabilitation center. The participants took part in four training workshops. The workshops focused on mental health, awareness of HIV, and hepatitis B and C with learner-centered approaches.

Results

According to the results, the mean score of the health behavior scale in the participants after receiving the intervention of the comprehensive program increased significantly (P < .001). Additionally, the analysis showed that 1 month after the end of the intervention, there was a significant increase in the AIDS, hepatitis B, and hepatitis C scale scores compared to before the intervention (P < .001).

Conclusion

Considering the adverse consequences of drug use, especially in users without social support, the need for education as a cost-effective approach to prevent diseases transmitted through high-risk behaviors such as HIV, and hepatitis B and C is considered a basic necessity.
Study of steroid-resistant nephrotic syndrome: a single center experience
Authors: Elbeltagi Youmna Ahmed Hassan , Kersh Mahmoud Mohi El Din El , Fathy Hanan Mohammad , Kamel Nancy Abdel-Salam
Published: June 2024

Background

Nephrotic syndrome (NS) is a disease with favorable outcomes in most cases. Failure to respond to steroids is one of the most important predictors of clinical outcome. We performed a retrospective study on 51 primary idiopathic SRNS cases presenting between January 2011 and June 2021 at Alexandria University Children’s Hospital (AUCH) by retrieving data from their clinic files. Cases with secondary causes of NS or suspected genetic causes were excluded from our study. Patients’ demographic data, clinical and laboratory findings at the time of presentation, complications occurring during the course of treatment, immunosuppressants used along with steroids, and outcomes at the last follow-up were recorded. The mean duration of follow-up was 5.67 ± 3.07 years.

Results

Our results showed that there was male predominance (2.9:1), the mean age at first presentation was 4.53 ± 3.03 years, and persistent hematuria and systemic hypertension were found in 41.6% and 57.1%, respectively.

The most common biopsy finding was MesPGN (37.3%). The most utilized immunosuppressant was cyclosporine (80.4%). Complete remission was fortunately the most prevalent outcome among our cases (52.2%).

Conclusions

Our study concluded that biopsy findings and thepresence of hematuria in SRNS cases are the most crucial factors in determining the final outcome. MCNS finding in biopsy is significantly correlated with complete remission (p value = 0.043). Persistent hematuria whether gross or microscopic was significantly correlated with unremitting disease (p value = 0.017).
Advancements in understanding the association of sepsis with heart rate variability in premature infants
Authors: Chi Di , Guo Wanxu , Liu Junjiao , Gao Wenhui , Wang Yuan , Zhang Yunfeng
Published: June 2024

Background

With the rapid development of perinatal medicine and neonatal resuscitation technology, neonatal mortality gradually reduces, but sepsis is still a neonatal critical illness and an important cause of death. The onset of sepsis in premature infants is insidious, and the clinical symptoms lack of specificity. The available laboratory tests exhibit limited sensitivity and specificity for diagnosis, and there is a certain degree of time lag. Therefore, it is particularly important to find a method for early detection of severe infection in premature infants.

Main body

Sepsis is the third leading cause of death with poor prognosis in infants. Early and accurate identification of sepsis are particularly important. Heart rate variability may present before clinical symptoms of sepsis. The study is to summarize the available data on the relationship between heart rate variability and development of sepsis in early infants.

We searched six database, PubMed, Web of Science, Embase, Cochrane Library, Wanfang, and CNKI, using the following terms for our search strategy (Infants, Newborn) OR (Newborn Infant) OR (Newborn Infants) OR (Newborns) OR (Newborn) OR (Neonate) OR (Neonates) AND (Sepsis) OR (Bloodstream Infection) OR (Bloodstream Infections) OR (Pyemia) OR (Pyemias) OR (Pyohemia) OR (Pyohemias) OR (Pyaemia) OR (Pyaemias) OR (Septicemia) OR (Septicemias) OR (Blood Poisoning) OR (Blood Poisonings) OR (Severe Sepsis) OR (Sepsis, Severe) AND (Heart Rate Variability). Premature infants would experience the reduction in heart rate variability before clinical symptoms of sepsis present.

Conclusion

The application of heart rate variability, a noninvasive monitoring method, to the identification and diagnosis of sepsis in premature infants can enable clinicians to identify, diagnose, and treat children with sepsis early, thereby reducing the mortality of premature infants and neurological damage.
Assessing the efficacy of 3D Dual-CycleGAN model for multi-contrast MRI synthesis
Authors: Mahboubisarighieh Ali , Shahverdi Hossein , Jafarpoor Nesheli Shabnam , Alipoor Kermani Mohammad , Niknam Milad , Torkashvand Mohanna , Rezaeijo Seyed Masoud
Published: June 2024

Background

This research presents a novel methodology for synthesizing 3D multi-contrast MRI images utilizing the 3D Dual-CycleGAN architecture. The performance of the model is evaluated on different MRI sequences, including T1-weighted (T1W), T1-weighted contrast-enhanced (T1c), T2-weighted (T2W), and FLAIR sequences.

Results

Our approach demonstrates proficient learning capabilities in transforming T1W images into target modalities. The proposed framework encompasses a combination of different loss functions including voxel-wise, gradient difference, perceptual, and structural similarity losses. These loss components, along with adversarial and dual cycle-consistency losses, contribute significantly to realistic and accurate syntheses. Evaluation metrics including MAE, PMAE, RMSE, PCC, PSNR, and SSIM are employed to assess the fidelity of synthesized images compared to their ground truth counterparts. Empirical results indicate the effectiveness of the 3D Dual-CycleGAN model in generating T1c images from T1W inputs with minimal average discrepancies (MAE of 2.8 ± 2.61) and strong similarity (SSIM of 0.82 ± 0.28). Furthermore, the synthesis of T2W and FLAIR images yields promising outcomes, demonstrating acceptable average discrepancies (MAE of 3.87 ± 3.32 for T2W and 3.82 ± 3.32 for FLAIR) and reasonable similarities (SSIM of 0.82 ± 0.28 for T2W and 0.80 ± 0.29 for FLAIR) relative to the original images.

Conclusions

These findings underscore the efficacy of the 3D Dual-CycleGAN model in generating high-fidelity images, with significant implications for diverse applications in the field of medical imaging.
Epithelioid pleural mesothelioma successfully treated with perioperative immunotherapy: a case report
Authors: Yamazaki Gaku , Fujiwara-Kuroda Aki , Muto Jun , Ujiie Hideki , Aragaki Masato , Furuta Megumi , Ohno Sakurako , Hatanaka Kanako C. , Hatanaka Yutaka , Matsuno Yoshihiro , Kato Tatsuya
Published: June 2024

Background

Pleural mesothelioma, characterized by a dismal prognosis even with multimodal therapy, has seen emerging interest in immune checkpoint inhibitors (ICIs) due to their demonstrated efficacy. Here, we present a case of epithelioid-type pleural mesothelioma with chest wall invasion treated with definitive ICI therapy, resulting in a remarkable pretreatment effect.

Case presentation

A 46-year-old man was diagnosed with an abnormal chest shadow on a medical check, and a computed tomography scan showed pleural thickening at the dorsal right upper chest wall. One of the nodules was suspected to have invaded the chest wall. A needle biopsy revealed epithelioid-type pleural mesothelioma. After five cycles of nivolumab plus ipilimumab, he underwent right pleurectomy/decortication (P/D). Pathological examination revealed a significant treatment effect, showing numerous lymphocytes infiltrating the tumor nodule and viable tumor cells localized at approximately 6 mm.

Conclusion

Although further accumulation of cases is required to evaluate the effectiveness and case selection, P/D after immunotherapy is a useful curative treatment option for advanced pleural mesothelioma.
Potential for use of tetris in the neonatal unit – a scoping review
Authors: Craig Victoria Elizabeth Mabel , McLaughlin Derek Francis , Devlin Karen P. , Higgins Aiveen , Boyle Breidge
Published: June 2024

Background

Playing Tetris is a relatively new concept when considering how to treat or prevent post-traumatic stress symptoms (PTSS). Benefits have been identified regarding how playing the game can influence traumatic memory processing and storage. However, the concept is under-explored and can potentially help populations who are at risk of and are known to experience post-traumatic stress, such as parents of preterm infants in the Neonatal Unit. The aim of the review was to establish if preterm parents playing Tetris was a feasible option to potentially minimise PTSS.

Method

A scoping review was conducted using PRISMA-ScR guidance. Databases searched were Cinahl, Medline and PsychInfo, over a 20 year period (2003-2023). Titles and abstracts were screened before analysis of full-text articles. A variety of clinical and experimental studies were examined, with differing trauma exposure experienced by participants.

Results

Thirteen articles were reviewed and four common themes identified. These were memory consolidation, playing Tetris and its effect on intrusive memories (IMs), the effect on the brain and the acceptability as a technique to minimize PTSS in clinical trials.

Conclusion

Tetris, in theory, is a first-aid intervention and has the potential to minimise the impact of trauma. Based on the findings of the review, Tetris has been effective in other clinical areas and deemed acceptable by participants. Therefore, Tetris is worthy of consideration for use in the population of preterm parents.
A phase II study of venetoclax (VEN) in combination with 10-day decitabine (DEC) in older/unfit pts with newly diagnosed (ND) or pts with relapsed/refractory (R/R) acute myeloid leukemia (AML), or high-risk myelodysplastic syndrome (HR-MDS).
Authors: Swaminathan Mahesh , Dinardo Courtney Denton , Maiti Abhishek , Pemmaraju Naveen , Ohanian Maro , Daver Naval Guastad , Garcia-Manero Guillermo , Issa Ghayas C. , Borthakur Gautam , Ravandi-Kashani Farhad , Montalban-Bravo Guillermo , Kadia Tapan M. , Alvarado Valero Yesid , Jabbour Elias , Short Nicholas James , Wierda William G. , Jain Nitin , Kornblau Steven Mitchell , Kantarjian Hagop M. , Konopleva Marina ,   Department of Leukemia
Published: June 2024

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Background: We report long-term results of phase 2 study of 10-day DEC and VEN (DEC10-VEN) in AML/HR-MDS. Methods: This single-institution study (NCT03404193) included intensive chemotherapy-ineligible pts >60y with ND de novo AML or secondary AML (sAML), or R/R AML, or HR-MDS. Induction therapy: DAC 20 mg/m2 IV x 10d + VEN days 1-28. VEN was stopped on day 21 if bone marrow blasts ≤5%. Consolidation included DEC IV x 5 days + VEN days 1-21, every 4-8 weeks as previously described (DiNardo et al. Lancet Haem. 2020). Primary endpoint was ORR. Secondary endpoints are duration of response, OS, RFS, and safety. Here, we report an update with 232 pts and results of HR-MDS/CMML cohort. Results: 232 pts were enrolled thus far (ND AML-86; sAML-49; R/R AML-76; HR-MDS/CMML-21). Median follow up is 39 mo (36-46 mo). Median age was 73y in ND AML and 64y in R/R AML (Table). Three-fourths of pts inAML cohort were adverse risk by ELN 2022 risk. CR/CRi rates in ND AML, sAML, and R/R AML were 92%, 53%, and 40% and ORR was 88%, 69%, 58%, respectively. Median OS was 12.3 mo in frontline (FL, ND (16.7 mo) and sAML (10.4 mo)) and 7.6 mo in R/R. Similarly, median RFS was 9.1 (ND-10 mo and sAML-6.4 mo) and 7.5 mo, respectively. Median time to ANC ≥500 x 109/L in cycle 1 was 41 days and Plt ≥50 x 109/L was 31 days in FL pts. 30-day mortality was 2% in FL and 5% in R/R cohort. 18% in FL and 22% in R/R cohort proceeded to SCT. In HR-MDS cohort, the median age was 71y; 18/21 pts had prior treatment. ASXL1 was the most frequent mutation. ORR was 52% (CR+CRi-33%). Median OS-12.1, RFS-7.3 mo. Median time to ANC ≥500 x 109/L was 55 and plt ≥50 x 109/L was 51 days. Most common grade 3/4 AEs were infection with neutropenia (38%), febrile neutropenia (32%), thrombocytopenia (17%), and neutropenia (15%), consistent with HMA + VEN experience. Conclusions: DEC10-VEN demonstrated expected safety and efficacy in a particularly high-risk cohort of ND and R/R pts, with no evidence that 10-days of DEC provides improved responses over standard 5-days DEC. Clinical trial information: NCT03404193 . [Table: see text]
Deriving Landauer's formula by using the master equation approach
Authors: Kolovsky Andrey R.
Published: June 2024

We revisit the problem of two-terminal transport of non-interacting Fermi particles in a mesoscopic device. First, we generalize the transport problem by taking into consideration relaxation processes in contacts (which are characterized by the contact self-thermalization rate γ) and then solve it by using the master equation approach. In the limit

the obtained results are shown to reproduce those of the Landauer theory. Thus, the presented analysis proves correspondence between the Landauer and master equation approaches to quantum transport —a problem which has been waiting for a solution for decades.