bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment outcome of bridge mechanical thrombectomy with different IV-tPA dosages in the standard and extended time window in real-world practice
Authors: Liu Hao-Te , Deng Wen-Chun , Chang Ching-Wen , Wu Yi Ming , Wong Ho-Fai , Chang Chien-Hung , Yeap Mun-Chun , Chen Ching-Chang , Chen Chung-Ting , Huang Yu-Ting , Chen Yao-Liang
Published: August 2024

Background

Differences of treatment outcome between full or reduced dose of tissue plasminogen activator (tPA) for bridge mechanical thrombectomy (MT) in the extended time window have not been clearly established. We aimed to present real-world results of bridge MT with different tPA dosages in the standard and extended windows.

Materials and methods

Patients with anterior circulation stroke treated with MT between 2017 and 2021 at two stroke referral centers were retrospectively reviewed. Bridge MT with tPA were categorized as full (0.9 mg/kg) or reduced (<0.9 mg/kg) dose. Standard window (SW) cohort was defined as MT performed within 6 h of acute ischemic stroke onset, while those beyond 6 h as the extended window (EW) cohort. 90 days Modified Rankin Scale (mRS) score, technical treatment success, in-hospital mortality, and post-treatment hemorrhage were analyzed.

Results

A total of 423 patients met the inclusion criteria, 218 of which treated in the SW, while 205 treated in the EW. Within the SW cohort, the full-dose tPA group demonstrated a higher proportion of good functional outcome (GFO) at 90 days (mRS0-3) versus reduced (49% vs 21%, p = 0.0358). The overall GFO of SW was higher than that of the EW cohort (33% vs 20%, p = 0.0480). Within the EW cohort, GFO was similar between full and reduced dose groups. Successful reperfusion rate was lower in SW versus EW cohorts (39% vs 58%, p = 0.0199).

Conclusion

In real-world practice, the GFO of bridge MT is better than MT alone. The tPA dosage is not a determining factor of GFO in EW MT.
From planetary scenarios to planetary sensing: Models, observations, and political legibility
Authors: Pendergrass Drew
Published: August 2024

This paper explores the political uses of images generated by Earth System science. It argues that images of possible climate futures, maps of potential worlds of heatwaves and wildfires, are made legible to policymakers by an alliance with a class of climate-economy models that associate scientific estimates of climate impacts with a prescribed international policy and technology mix. While environmental models have successfully mobilized policymakers in the past by providing images of “planetary scenarios” accompanying different emissions pathways, with climate change a political actor outside the administrative state is required to overcome the entrenchment of fossil capital. The paper suggests such actors are empowered not by the rhetoric of scenario modeling but by the emerging practice of “planetary sensing,” where activists and stakeholders directly mobilize the planetary images generated by Earth System science as they work to evacuate prisons, track pollutants, and repair pipelines.
Problem-solving? No, problem-opening! A method to reframe and teach data ethics as a transdisciplinary endeavour
Authors: Calzati Stefano , Ploeger Hendrik
Published: August 2024

Starting from the recognition of the limits of today's common essentialist and axiological understandings of data and ethics, in this article we make the case for an ecosystemic understanding of data ethics (for the city) that accounts for the inherent value-laden entanglements and unintended (both positive and negative) consequences of the development, implementation, and use of data-driven technologies in real-life contexts. To operationalize our view, we conceived and taught a master course titled ‘Ethics for the data-driven city’ delivered within the Department of Urbanism at the Delft University of Technology. By endorsing a definition of data as a sociotechnical process, of ethics as a collective practice, and of the city as a complex system, the course enacts a transdisciplinary approach and problem-opening method that compel students to recognize and tackle the unavoidable multifacetedness of all ethical stances, as well as the intrinsic open-endedness of all tech solutions, thus seeking a fair balance for the whole data-driven urban environment. The article discusses the results of the teaching experience, which took the form of a research-and-design workshop, alongside the students’ feedback and further pedagogical developments.
Effect of spinal orthoses on osteoporotic elderly patients kyphosis, back muscles strength, balance and osteoporotic vertebral fractures: (A systematic review and meta-analysis)
Authors: Keshavarzi Fatemeh , Arazpour Mokhtar
Published: August 2024

In this review and meta-analysis, we aimed to investigate the effect of spine orthotics in osteoporotic patients. The relationship between osteoporosis, osteoporotic vertebral fractures (OVFs), and age-related hyperkyphosis has made this effect unclear. We believe that taking participants’ conditions into consideration may help to alleviate this controversy. The electronic database includes Web of Science, PubMed, Cochrane Library, Medline, and ClinicalTrials.gov . For English language literature was searched up to March 2023, and 34 articles were included in the review and 15 article had sufficient quality for meta-analysis based on the methodology quality index. There was no significant effect found from using either rigid or soft orthoses alone during the acute phase of one level (OVFs). Both semi-rigid and weighted orthoses have shown a positive significant effect on thoracic kyphosis angle and back extensor muscle strength in osteoporotic or older hyperkyphotic patients. The results of this review indicate that using a soft or rigid orthosis alone does not have a superior effect in the acute phase of one-level (OVFs) compared to not using an orthosis. However, using a semi-rigid or weighted orthosis in osteoporotic or hyperkyphotic older adults with or without (OVFs) can benefit thoracic kyphosis angle, back muscle strength, and balance.
Experience of Caregivers for Older Adults in Rural Ethiopia: Challenges and Available Social Support for Family Caregivers in Co-Residential Living Arrangement
Authors: Mefteh Kidus Yenealem , Gashaw Shambel Desale , Hailu Tilahun Assefa , Hussien Seid Hassen
Published: August 2024

Family and kinship care is a common way of caring for older adults, particularly in rural Ethiopia, where institutional care arrangements are nonexistent. Moreover, the majority of studies on family caregivers of older adults were conducted in western cultures, which makes it difficult to understand family caregivers in the Ethiopian context. This study aims at exploring the experience of family caregivers for older adults in a co-residential setting. Specifically, it focuses on answering caregiving challenges and available social supports for family caregivers in a co-residential living arrangement. This study used a qualitative research method employing phenomenology to understand the lived experience of family caregivers for older adults in rural northwestern Ethiopia. Data were collected through a semi-structured interview with eight purposefully selected family caregivers of rural older adults. Regarding family caregivers’s challenges and available social supports, four themes emerged from the collected data. These are economic challenges, the incongruence of older adult needs and caregiving capacity, work-caregiving conflict, work-social life conflict, and the presence of social support from different individuals and community-based institutions. In addition to strengthening caregiver support environments, it’s critical to develop the capacity of family caregivers through training, economic support, and the integration of family caregivers with health extension workers.
Vitamin D serum levels in patients with systemic sclerosis and very early systemic sclerosis (VEDOSS)
Authors: Cuomo Giovanna , Trotta Maria Consiglia , D’Amico Giovanbattista , Di Vico Claudio , Iandoli Carlo , Perretta Danilo , Naclerio Caterina , Nava Tiziana , Cozzolino Domenico , Romano Ciro
Published: August 2024

Introduction:

Vitamin D may be capable of interfering with the pathophysiological pathways involved in systemic sclerosis, by virtue of its well-known immunomodulatory effects. In this study, we aimed at evaluating the differences and the correlations between vitamin D levels in systemic sclerosis patients versus patients with very early systemic sclerosis.

Methods:

One hundred twenty-six patients (80 definite systemic sclerosis and 46 very early systemic sclerosis) were included in this case control study. Anthropometric, clinical, biochemical, and instrumental data were recorded and correlated with serum vitamin D levels.

Results:

Briefly, systemic sclerosis patients and very early systemic sclerosis subjects significantly differed for telangectasias, scleredema, autoantibody profile, and videocapillaroscopic pattern. In addition, the mean vitamin D levels were significantly lower in systemic sclerosis patients when compared to those of very early systemic sclerosis subjects. When systemic sclerosis patients were divided into two groups, that is, those with ⩽20 ng/ml versus >20 ng/ml vitamin D serum levels, significantly higher serum vitamin D levels were observed in patients with a lesser skin and vascular involvement. With regard to very early systemic sclerosis subjects, who exhibited baseline satisfactory vitamin D levels, only the autoantibody profile was found to correlate with vitamin D serum levels.

Conclusion:

Vitamin D serum levels were found to be generally satisfactory in very early systemic sclerosis subjects, but they were reduced in systemic sclerosis patients. Advanced skin and microvascular involvement were found to predispose to hypovitaminosis D. Due to the well-documented immunomodulatory properties of vitamin D, studies are needed to determine whether vitamin D supplementation may prevent the subsequent evolution of very early systemic sclerosis into definite systemic sclerosis.
Evaluating Urban Services in Neighbourhoods Through the Inequality Lens in Khulna City, Bangladesh: A Geographic Information System Approach
Authors: Islam G.M. Towhidul , Almaimani Ayad Khalid , Rahaman Khan Rubayet
Published: August 2024

This article delineates the development of an integrated assessment tool to understand inequality in the provision of urban services among neighbourhoods in Khulna city, Bangladesh. The study considers eight key indicators to evaluate basic urban services related to the physical environment of the city. We use primary and secondary sources of information as well as geographic information system (GIS) to summarise the results in a scientific fashion. Additionally, we adopt the analytic hierarchy process (AHP) technique to distribute weights among the considered indicators and categorise the neighbourhoods as ‘good’, ‘average’ or ‘poor’ in terms of service availability. Results from the study demonstrate that a majority of the neighbourhoods lack basic urban services. Only 10 per cent of the neighbourhoods are equipped with basic urban services, whereas 74 per cent face difficulties with ‘average’ quality of services and nearly 16 per cent of neighbourhoods fail to provide basic services to city dwellers. Our study may be useful to development authorities, city corporations and local governments to visualise the neighbourhoods struggling for basic urban services and bring them under immediate attention to deliver the required resources. Further, the study provides an assessment model to understand urban service inequality in cities with similar characteristics in other parts of the world.
RSSDI Research Retreat 2024
Authors: Seshadri Krishna , Parikh Rakesh
Published: August 2024

RSSDI research retreat is a conference dedicated to research in the field of diabetes. In addition to KOLs presenting their research work, selected authors who have published original work in the field of diabetes are invited to present their work. This conference also has multiple workshops on various aspects of clinical research and manuscript writing.
Secretome of brain microvascular endothelial cells promotes endothelial barrier tightness and protects against hypoxia-induced vascular leakage
Authors: Loiola Rodrigo Azevedo , Hachani Johan , Duban-Deweer Sophie , Sevin Emmanuel , Bugno Paulina , Kowalska Agnieszka , Rizzi Eleonora , Shimizu Fumitaka , Kanda Takashi , Mysiorek Caroline , Mazurek Maciej , Gosselet Fabien
Published: August 2024

Cell-based therapeutic strategies have been proposed as an alternative for brain and blood vessels repair after stroke, but their clinical application is hampered by potential adverse effects. We therefore tested the hypothesis that secretome of these cells might be used instead to still focus on cell-based therapeutic strategies. We therefore characterized the composition and the effect of the secretome of brain microvascular endothelial cells (BMECs) on primary in vitro human models of angiogenesis and vascular barrier. Two different secretome batches produced in high scale (scHSP) were analysed by mass spectrometry. Human primary CD34+-derived endothelial cells (CD34+-ECs) were used as well as in vitro models of EC monolayer (CMECs) and blood–brain barrier (BBB). Cells were also exposed to oxygen–glucose deprivation (OGD) conditions and treated with scHSP during reoxygenation. Protein yield and composition of scHSP batches showed good reproducibility. scHSP increased CD34+-EC proliferation, tubulogenesis, and migration. Proteomic analysis of scHSP revealed the presence of growth factors and proteins modulating cell metabolism and inflammatory pathways. scHSP improved the integrity of CMECs, and upregulated the expression of junctional proteins. Such effects were mediated through the activation of the interferon pathway and downregulation of Wnt signalling. Furthermore, OGD altered the permeability of both CMECs and BBB, while scHSP prevented the OGD-induced vascular leakage in both models. These effects were mediated through upregulation of junctional proteins and regulation of MAPK/VEGFR2. Finally, our results highlight the possibility of using secretome from BMECs as a therapeutic alternative to promote brain angiogenesis and to protect from ischemia-induced vascular leakage.
Personalizing travel behaviour change interventions using the trans-theoretical model and multimodality data
Authors: Lowe Warnakulasooriya Umesh Ashen , Lades Leonhard , Carroll Páraic
Published: August 2024

Introduction

Behaviourally informed soft policies, such as nudges, have become popular in areas like health, environment, and energy use as cost-effective instruments to change behaviour and decision-making. However, the effectiveness of soft policies in the transport sector is modest at best. One reason for this relative ineffectiveness might be their one-size-fits-all nature, and personalizing soft interventions has been suggested to increase their effectiveness. The Trans-theoretical Model (TTM) suggests that people progress through five stages of behavioural change, from pre-contemplating a behaviour to maintaining the behaviour, and behavioural interventions could be designed for specific stages. However, it is not always feasible to conduct surveys to place people at different stages of the TTM.

Methods

This paper explores whether it is possible to use multimodality data taken from a travel diary to place people at different stages of the TTM. The analysis uses an existing dataset from 826 respondents that includes self-reported TTM stages regarding cycling and data on multimodality. In the analysis, the multimodality data are used to allocate respondents to categories and assign them to TTM stages. The performances of the stage assignment approaches are evaluated using the self-reported TTM data and confusion matrices.

Findings

The accuracy of the allocation of participants to TTM stages using multimodality data is approximately 75%. The accuracy is higher for early stages (pre-contemplation) and later stages (maintenance) of the TTM. A data-driven approach to dealing with multimodality data performs slightly better than an approach that relies on pre-defined categorization.

Conclusion

The paper suggests that it will be possible in the future to personalise behavioural interventions according to the stages of the TTM even in the absence of self-reported survey data that classifies people to TTM stages if objective multimodality data are available.
lncRNAs involved in the Shade Avoidance Syndrome (SAS) in Arabidopsis thaliana
Authors: García-López Irving Jair , Vélez-Ramírez Aarón I. , Gillmor C. Stewart , Fernandez-Valverde Selene L.
Published: August 2024

Background

Plant long non-coding RNAs (lncRNAs) have important regulatory roles in responses to various biotic and abiotic stresses, including light quality. However, no lncRNAs have been specifically linked to the Shade Avoidance Response (SAS).

Results

To better understand the involvement of lncRNAs in shade avoidance, we examined RNA-seq libraries for lncRNAs with the potential to function in the neighbor proximity phenomenon in Arabidopsis thaliana (A. thaliana). Using transcriptomes generated from seedlings exposed to high and low red/far-red (R/FR) light conditions, we identified 13 lncRNA genes differentially expressed in cotyledons and 138 in hypocotyls. To infer possible functions for these lncRNAs, we used a ‘guilt-by-association’ approach to identify genes co-expressed with lncRNAs in a weighted gene co-expression network. Of 34 co-expression modules, 10 showed biological functions related to differential growth. We identified three potential lncRNAs co-regulated with genes related to SAS. T-DNA insertions in two of these lncRNAs were correlated with morphological differences in seedling responses to increased FR light, supporting our strategy for computational identification of lncRNAs involved in SAS.

Conclusions

Using a computational approach, we identified multiple lncRNAs in Arabidopsis involved in SAS. T-DNA insertions caused altered phenotypes under low R/FR light, suggesting functional roles in shade avoidance. Further experiments are needed to determine the specific mechanisms of these lncRNAs in SAS.
High relative cerebral blood volume is associated with good long term clinical outcomes in acute ischemic stroke: a retrospective cohort study
Authors: Strinitz Marc , Zimmer Claus , Berndt Maria , Wunderlich Silke , Boeckh-Behrens Tobias , Maegerlein Christian , Sepp Dominik
Published: August 2024

Background

Endovascular therapy for acute ischemic stroke has been shown to be highly effective in selected patients. However, the ideal criteria for patient selection are still debated. It is well known that collateral flow is an important factor, but the assessment is often subjective and time-consuming. Relative cerebral blood volume (rCBV) is a putative indicator of collateral capacity and can be quickly and easily determined by automated quantitative analysis. We investigated the relationship between rCBV of the affected region and clinical outcome in patients with acute ischemic stroke after endovascular therapy.

Methods

We conducted a retrospective study on consecutive patients between January 2017 and May 2019. Patients with acute ischemic stroke of the anterior circulation who underwent imaging including computed tomography perfusion and were treated with mechanical thrombectomy (MT) were eligible for inclusion. rCBV was calculated automatically with RAPID software by dividing the average cerebral blood volume (CBV) of the affected region (time-to-maximum (Tmax) > 6 s) by the CBV of the unaffected contralateral side. The primary outcome was determined by the modified Rankin Scale (mRS) after 90 days. Good clinical outcome was defined as mRS ≤ 2. We compared means, performed mono- and multivariate logistical regression and calculated a receiver operating characteristic (ROC)-analysis to determine the ideal cutoff value to predict clinical outcomes.

Results

155 patients were enrolled in this study. 66 patients (42.58%) had good clinical outcomes. Higher rCBV was associated with good clinical outcome (p < 0.001), even after adjustment for the patients’ status according to mRS and National Institute of Health Stroke Scale (NIHSS) age and Alberta stroke program early computed tomography score (ASPECTS) at baseline (p = 0.006). ROC-analysis revealed 0.650 (confidence interval: 0.616–0.778) as the optimal cutoff value.

Conclusion

Higher rCBV at baseline is associated with good clinical long-term outcomes in patients with acute ischemic stroke treated by MT. In this study we provide the biggest collective so far that gives evidence that rCBV can be a valuable tool to identify patients who might benefit from MT and are able give a threshold to help to offer patients MT in borderline cases.
Pregnancy complications and autoimmune diseases in women: systematic review and meta-analysis
Authors: Singh Megha , Fayaz Fathima Fazla Ahamed , Wang Jingya , Wambua Steven , Subramanian Anuradha , Reynolds John A. , Nirantharakumar Krishnarajah , Crowe Francesca ,   on behalf of MuM-PreDiCT
Published: August 2024

Background

Pregnancy complications might lead to the development of autoimmune diseases in women. This review aims to summarise studies evaluating the association between pregnancy complications and the development of autoimmune diseases in women.

Methods

Medline, CINAHL, and Cochrane databases were searched up to January 2024. Nineteen pregnancy complications and 15 autoimmune conditions were included. Title, abstract, full-text screening, data extraction, and quality assessment were performed by two reviewers independently. Data were synthesised using narrative and quantitative methods. Results were presented using odds ratios (OR), relative risks (RR), incidence rate ratios (IRR), and 95% confidence intervals (CI).

Results

Thirty studies were included. One study reported composite exposure to pregnancy complications had a risk of any autoimmune disease RR 3.20 (2.90–3.51) compared to women without pregnancy complications. Women with hyperemesis gravidarum had a higher risk of developing coeliac disease (n = 1) IRR 1.98 (1.27–2.94), Crohn’s disease (n = 1) IRR 1.61 (1.25–2.04), psoriasis (n = 1) IRR 1.33 (1.01–1.71), and rheumatoid arthritis (n = 2) IRR 1.35 (1.09–1.64). Miscarriage associated with subsequent diagnosis of Sjogren syndrome (n = 2) IRR 1.33 (1.06–2.81) and rheumatoid arthritis (n = 4) OR 1.11 (1.04–1.20). Gestational hypertension/preeclampsia was linked with the development of systemic sclerosis (n = 2) IRR 2.60 (1.10–4.60) and T1DM (n = 2) IRR 2.37 (2.09–2.68). Stillbirth associated with composite autoimmune conditions (n = 2) RR 5.82 (95% CI 4.87–6.81) and aIRR 1.25 (1.12–1.40). Postpartum psychosis was associated with autoimmune thyroid disease (n = 1) aIRR2.26 (1.61–2.90).

Conclusions

Women with pregnancy complications subsequently had a higher risk of being diagnosed with autoimmune conditions. Whether this is due to pre-existing undiagnosed health conditions or being causally linked to pregnancy complications is not known.
DNA polymerase swapping in Caudoviricetes bacteriophages
Authors: Yutin Natalya , Tolstoy Igor , Mutz Pascal , Wolf Yuri I. , Krupovic Mart , Koonin Eugene V.
Published: August 2024

Background

Viruses with double-stranded (ds) DNA genomes in the realm Duplodnaviria share a conserved structural gene module but show a broad range of variation in their repertoires of DNA replication proteins. Some of the duplodnaviruses encode (nearly) complete replication systems whereas others lack (almost) all genes required for replication, relying on the host replication machinery. DNA polymerases (DNAPs) comprise the centerpiece of the DNA replication apparatus. The replicative DNAPs are classified into 4 unrelated or distantly related families (A-D), with the protein structures and sequences within each family being, generally, highly conserved. More than half of the duplodnaviruses encode a DNAP of family A, B or C. We showed previously that multiple pairs of closely related viruses in the order Crassvirales encode DNAPs of different families.

Methods

Groups of phages in which DNAP swapping likely occurred were identified as subtrees of a defined depth in a comprehensive evolutionary tree of tailed bacteriophages that included phages with DNAPs of different families. The DNAP swaps were validated by constrained tree analysis that was performed on phylogenetic tree of large terminase subunits, and the phage genomes encoding swapped DNAPs were aligned using Mauve. The structures of the discovered unusual DNAPs were predicted using AlphaFold2.

Results

We identified four additional groups of tailed phages in the class Caudoviricetes in which the DNAPs apparently were swapped on multiple occasions, with replacements occurring both between families A and B, or A and C, or between distinct subfamilies within the same family. The DNAP swapping always occurs “in situ”, without changes in the organization of the surrounding genes. In several cases, the DNAP gene is the only region of substantial divergence between closely related phage genomes, whereas in others, the swap apparently involved neighboring genes encoding other proteins involved in phage genome replication. In addition, we identified two previously undetected, highly divergent groups of family A DNAPs that are encoded in some phage genomes along with the main DNAP implicated in genome replication.

Conclusions

Replacement of the DNAP gene by one encoding a DNAP of a different family occurred on many independent occasions during the evolution of different families of tailed phages, in some cases, resulting in very closely related phages encoding unrelated DNAPs. DNAP swapping was likely driven by selection for avoidance of host antiphage mechanisms targeting the phage DNAP that remain to be identified, and/or by selection against replicon incompatibility.
Randomised controlled trial of a psychotherapeutic intervention to improve quality of life and other outcomes in people who repeatedly self-harm: FReSH START study protocol
Authors: Farley K. , Copsey B. , Wright-Hughes A. , Farrin A. , Bojke C. , McMillan D. , Graham C. D. , Mattock R. , Brennan C. A. , Gates C. , Martin A. , Dowse A. , Horrocks J. , House A. O. , Guthrie E. A.
Published: August 2024

Background

Self-harm is a major public health challenge, and repeated self-harm is common in those attending hospital following an episode. Evidence suggests psychological interventions could help people who self-harm, but few definitive studies have assessed their clinical and cost-effectiveness. Repeated self-harm is associated with poor quality of life, depression, suicide and increased health service costs which justify the development of psychotherapeutic interventions tailored for people with repeated self-harm.

Methods

FReSH START is a multicentre individually 1:1 randomised controlled trial evaluating the clinical and cost-effectiveness of standard care plus psychological therapy or standard care alone for adults (≥ 18 years) presenting at an emergency department (ED) with repeated self-harm. Recruiting 630 participants, it includes an internal pilot, economic evaluation and process evaluation. The intervention will be delivered by mental health staff working in acute settings, with experience of assessing and managing risk in people presenting to emergency services with self-harm. Staff will be trained and supervised to deliver one of three specially adapted therapies: psychodynamic interpersonal therapy, cognitive behavioural therapy or acceptance and commitment therapy. Participants allocated to the intervention will receive one of the adapted therapies according to therapist allocation for up to 6 months via 12 weekly, one to one, 45–50-min sessions. The primary outcome is quality of life measured by the Clinical Outcomes in Routine Evaluation Outcome Measure at 12 months post-randomisation. Secondary outcomes include suicidal intent, depression and cost-effectiveness. Data are collected using hospital attendance records and online/postal/telephone questionnaires at 6 and 12 months post-randomisation, with resource use additionally collected at 3 and 9 months.

Discussion

This protocol outlines a randomised controlled trial to investigate whether modified therapies are cost-effective and improve quality of life for people who repeatedly self-harm. Few interventions are proven to be deliverable in the NHS for this population. This study is strengthened by the involvement of qualified mental health workers experienced in managing risk as therapists.

Trial registration

Registered on August 03, 2021.

IRAS number: 297939.

ISRCTN: https://doi.org/10.1186/ISRCTN73357210.

REC reference: 21/EE/0145.

Sponsor: University of Leeds.
Prediction of extracapsular extension of prostate cancer by MRI radiomic signature: a systematic review
Authors: Guerra Adalgisa , Wang Helen , Orton Matthew R. , Konidari Marianna , Papanikolaou Nickolas K. , Koh Dow Mu , Donato Helena , Alves Filipe Caseiro
Published: August 2024

The objective of this review is to survey radiomics signatures for detecting pathological extracapsular extension (pECE) on magnetic resonance imaging (MRI) in patients with prostate cancer (PCa) who underwent prostatectomy.

Scientific Literature databases were used to search studies published from January 2007 to October 2023.

All studies related to PCa MRI staging and using radiomics signatures to detect pECE after prostatectomy were included.

Systematic review was performed according to Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA). The risk of bias and certainty of the evidence was assessed using QUADAS-2 and the radiomics quality score.

From 1247 article titles screened, 16 reports were assessed for eligibility, and 11 studies were included in this systematic review. All used a retrospective study design and most of them used 3 T MRI. Only two studies were performed in more than one institution. The highest AUC of a model using only radiomics features was 0.85, for the test validation. The AUC for best model performance (radiomics associated with clinical/semantic features) varied from 0.72–0.92 and 0.69–0.89 for the training and validation group, respectively. Combined models performed better than radiomics signatures alone for detecting ECE. Most of the studies showed a low to medium risk of bias.

After thorough analysis, we found no strong evidence supporting the clinical use of radiomics signatures for identifying extracapsular extension (ECE) in pre-surgery PCa patients. Future studies should adopt prospective multicentre approaches using large public datasets and combined models for detecting ECE.

Critical relevant statement

The use of radiomics algorithms, with clinical and AI integration, in predicting extracapsular extension, could lead to the development of more accurate predictive models, which could help improve surgical planning and lead to better outcomes for prostate cancer patients.

Protocol of systematic review registration

PROSPERO CRD42021272088. Published: https://doi.org/10.1136/bmjopen-2021-052342.

Key Points

Radiomics can extract diagnostic features from MRI to enhance prostate cancer diagnosis performance.

The combined models performed better than radiomics signatures alone for detecting extracapsular extension.

Radiomics are not yet reliable for extracapsular detection in PCa patients.

Graphical Abstract
Hepatic focal nodular hyperplasia during follow-up of patients after cyclophosphamide- or oxaliplatin-based chemotherapy: differentiation from liver metastasis
Authors: Yang Fan , Peng Wenjing , Chen Shuang , Wan Lijuan , Zhao Rui , Liu Xiangchun , Ye Feng , Zhang Hongmei
Published: August 2024

Objectives

Newly detected hepatic nodules during follow-up of cancer survivors receiving chemotherapy may pose a diagnostic dilemma. We investigated a series of hepatic focal nodular hyperplasia (FNH) diagnosed by either typical MRI features and follow-up or pathology in cancer survivors.

Methods

This retrospective study evaluated 38 patients with tumours who developed new hepatic FNH after cyclophosphamide-based (n = 19) and oxaliplatin-based (n = 19) chemotherapies. The main tumour types were breast cancer (n = 18) and colorectal cancer (n = 17). MRI findings, clinical features, and temporal evolution of all target hepatic lesions (n = 63) were reported. In addition, the two chemotherapy drug groups were compared.

Results

The median interval between chemotherapy completion and FNH detection was 30.4 months (12.9, 49.4). Six patients underwent biopsy or surgery, while the remaining patients were diagnosed based on typical MRI features and long-term follow-up. Among the patients, 60.5% (23/38) presented with multiple nodules and 63 target lesions were detected. The median size of target lesions was 11.5 mm (8.4, 15.1). The median follow-up time was 32.5 months (21.2, 48.6), and 15 patients experienced changes in their lesions during the follow-up period (11 increased and 4 decreased). The cyclophosphamide-based treatment group had a younger population, a greater proportion of females, and a shorter time to discovery than the oxaliplatin-based chemotherapy group (all p ≤ 0.016).

Conclusions

FNH may occur in cancer survivors after cyclophosphamide- or oxaliplatin-based chemotherapy. Considering a patient’s treatment history and typical MRI findings can help avoid misdiagnosis and unnecessary invasive treatment.

Clinical relevance statement

When cancer survivors develop new hepatic nodules during follow-up, clinicians should think of the possibility of focal nodular hyperplasia in addition to liver metastasis, especially if the cancer survivors were previously treated with cyclophosphamide or oxaliplatin.

Key Points

Cancer survivors, after chemotherapy, can develop hepatic focal nodular hyperplasia.

Cyclophosphamide and oxaliplatin are two chemotherapeutic agents that predispose to focal nodular hyperplasia development.

Focal nodular hyperplasia occurs at shorter intervals in patients treated with cyclophosphamide.

Graphical Abstract
Global burden of breast cancer and attributable risk factors in 204 countries and territories, from 1990 to 2021: results from the Global Burden of Disease Study 2021
Authors: Sha Rui , Kong Xiang-meng , Li Xin-yu , Wang Ya-bing
Published: August 2024

Background and objective

Breast cancer is a leading cause of morbidity and mortality among women worldwide. This study aimed to assess the global burden of breast cancer and identify attributable risk factors across 204 countries and territories from 1990 to 2021.

Methods

Using data from the Global Burden of Disease Study 2021, we analyzed the incidence, mortality, disability-adjusted life years (DALYs), and risk factors associated with breast cancer. We obtained and analyzed the age-standardized incidence rate (ASIR), age-standardized death rate (ASDR), and age-standardized DALYs rate from 1990 to 2021. We assessed geographical variations and the impact of the Socio-demographic Index (SDI) using regression analysis and stratification by SDI quintiles. Additionally, we estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study.

Results

Globally, breast cancer incident cases increased from 875,657 in 1990 to 2,121,564 in 2021. The ASIR rose from 16.42 to 26.88 per 100,000 (95% CI: 1.54–1.60). High SDI regions showed the highest ASIR (66.89 per 100,000 in 2021), while Low SDI regions had the lowest (6.99 per 100,000 in 2021). The global ASDR decreased from 10.42 to 8.54 per 100,000, and the age-standardized DALYs rate decreased from 313.36 to 261.5 per 100,000 between 1990 and 2021. However, these improvements were not uniform across SDI regions. Risk factors included high body-mass index, alcohol use, tobacco, and high fasting plasma glucose, with variations across SDI regions.

Conclusion

The global burden of breast cancer has increased significantly from 1990 to 2021, with disparities observed across SDI regions. While high SDI areas show improvements in mortality and DALYs, lower SDI regions face increasing burdens. Targeted interventions addressing modifiable risk factors and improving healthcare access in less developed regions are crucial for reducing the global impact of breast cancer.
Don’t believe them! Reducing misinformation influence through source discreditation
Authors: Ecker Ullrich K. H. , Prike Toby , Paver Antonia B. , Scott Rosie J. , Swire-Thompson Briony
Published: August 2024

Misinformation often continues to influence people’s reasoning even after it has been corrected. Therefore, an important aim of applied cognition research is to identify effective measures to counter misinformation. One frequently recommended but hitherto insufficiently tested strategy is source discreditation, that is, attacking the credibility of a misinformation source. In two experiments, we tested whether immediate source discreditation could reduce people’s subsequent reliance on fictional event-related misinformation. In Experiment 1, the discreditation targeted a person source of misinformation, pointing to a conflict of interest. This intervention was compared with a commonly employed message-focused correction and a combination of correction and discreditation. The discreditation alone was effective, but less effective than a correction, with the combination of both most effective. Experiment 2 compared discreditations that targeted a person versus a media source of misinformation, pointing either to a conflict of interest or a poor track record of communication. Discreditations were effective for both types of sources, although track-record discreditations were less effective when the misinformation source was a media outlet compared to a person. Results demonstrate that continued influence of misinformation is shaped by social as well as cognitive factors and that source discreditation is a broadly applicable misinformation countermeasure.
Correcting fake news headlines after repeated exposure: memory and belief accuracy in younger and older adults
Authors: Kemp Paige L. , Loaiza Vanessa M. , Kelley Colleen M. , Wahlheim Christopher N.
Published: August 2024

The efficacy of fake news corrections in improving memory and belief accuracy may depend on how often adults see false information before it is corrected. Two experiments tested the competing predictions that repeating fake news before corrections will either impair or improve memory and belief accuracy. These experiments also examined whether fake news exposure effects would differ for younger and older adults due to age-related differences in the recollection of contextual details. Younger and older adults read real and fake news headlines that appeared once or thrice. Next, they identified fake news corrections among real news headlines. Later, recognition and cued recall tests assessed memory for real news, fake news, if corrections occurred, and beliefs in retrieved details. Repeating fake news increased detection and remembering of corrections, correct real news retrieval, and erroneous fake news retrieval. No age differences emerged for detection of corrections, but younger adults remembered corrections better than older adults. At test, correct fake news retrieval for earlier-detected corrections was associated with better real news retrieval. This benefit did not differ between age groups in recognition but was greater for younger than older adults in cued recall. When detected corrections were not remembered at test, repeated fake news increased memory errors. Overall, both age groups believed correctly retrieved real news more than erroneously retrieved fake news to a similar degree. These findings suggest that fake news repetition effects on subsequent memory accuracy depended on age differences in recollection-based retrieval of fake news and that it was corrected.
Cue relevance drives early quitting in visual search
Authors: Moher Jeff , Delos Reyes Anna , Drew Trafton
Published: August 2024

Irrelevant salient distractors can trigger early quitting in visual search, causing observers to miss targets they might otherwise find. Here, we asked whether task-relevant salient cues can produce a similar early quitting effect on the subset of trials where those cues fail to highlight the target. We presented participants with a difficult visual search task and used two cueing conditions. In the high-predictive condition, a salient cue in the form of a red circle highlighted the target most of the time a target was present. In the low-predictive condition, the cue was far less accurate and did not reliably predict the target (i.e., the cue was often a false positive). These were contrasted against a control condition in which no cues were presented. In the high-predictive condition, we found clear evidence of early quitting on trials where the cue was a false positive, as evidenced by both increased miss errors and shorter response times on target absent trials. No such effects were observed with low-predictive cues. Together, these results suggest that salient cues which are false positives can trigger early quitting, though perhaps only when the cues have a high-predictive value. These results have implications for real-world searches, such as medical image screening, where salient cues (referred to as computer-aided detection or CAD) may be used to highlight potentially relevant areas of images but are sometimes inaccurate.
Non-invasive CT radiomic biomarkers predict microsatellite stability status in colorectal cancer: a multicenter validation study
Authors: Bodalal Zuhir , Hong Eun Kyoung , Trebeschi Stefano , Kurilova Ieva , Landolfi Federica , Bogveradze Nino , Castagnoli Francesca , Randon Giovanni , Snaebjornsson Petur , Pietrantonio Filippo , Lee Jeong Min , Beets Geerard , Beets-Tan Regina
Published: August 2024

Background

Microsatellite instability (MSI) status is a strong predictor of response to immunotherapy of colorectal cancer. Radiogenomic approaches promise the ability to gain insight into the underlying tumor biology using non-invasive routine clinical images. This study investigates the association between tumor morphology and the status of MSI versus microsatellite stability (MSS), validating a novel radiomic signature on an external multicenter cohort.

Methods

Preoperative computed tomography scans with matched MSI status were retrospectively collected for 243 colorectal cancer patients from three hospitals: Seoul National University Hospital (SNUH);

Netherlands Cancer Institute (NKI); and Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Italy (INT). Radiologists delineated primary tumors in each scan, from which radiomic features were extracted. Machine learning models trained on SNUH data to identify MSI tumors underwent external validation using NKI and INT images. Performances were compared in terms of area under the receiving operating curve (AUROC).

Results

We identified a radiomic signature comprising seven radiomic features that were predictive of tumors with MSS or MSI (AUROC 0.69, 95% confidence interval [CI] 0.54−0.84, p = 0.018). Integrating radiomic and clinical data into an algorithm improved predictive performance to an AUROC of 0.78 (95% CI 0.60−0.91, p = 0.002) and enhanced the reliability of the predictions.

Conclusion

Differences in the radiomic morphological phenotype between tumors MSS or MSI could be detected using radiogenomic approaches. Future research involving large-scale multicenter prospective studies that combine various diagnostic data is necessary to refine and validate more robust, potentially tumor-agnostic MSI radiogenomic models.

Relevance statement

Noninvasive radiomic signatures derived from computed tomography scans can predict MSI in colorectal cancer, potentially augmenting traditional biopsy-based methods and enhancing personalized treatment strategies.

Key Points

Noninvasive CT-based radiomics predicted MSI in colorectal cancer, enhancing stratification.

A seven-feature radiomic signature differentiated tumors with MSI from those with MSS in multicenter cohorts.

Integrating radiomic and clinical data improved the algorithm’s predictive performance.

Graphical Abstract
Automated peripheral nerve segmentation for MR-neurography
Authors: Beste Nedim Christoph , Jende Johann , Kronlage Moritz , Kurz Felix , Heiland Sabine , Bendszus Martin , Meredig Hagen
Published: August 2024

Background

Magnetic resonance neurography (MRN) is increasingly used as a diagnostic tool for peripheral neuropathies. Quantitative measures enhance MRN interpretation but require nerve segmentation which is time-consuming and error-prone and has not become clinical routine. In this study, we applied neural networks for the automated segmentation of peripheral nerves.

Methods

A neural segmentation network was trained to segment the sciatic nerve and its proximal branches on the MRN scans of the right and left upper leg of 35 healthy individuals, resulting in 70 training examples, via 5-fold cross-validation (CV). The model performance was evaluated on an independent test set of one-sided MRN scans of 60 healthy individuals.

Results

Mean Dice similarity coefficient (DSC) in CV was 0.892 (95% confidence interval [CI]: 0.888–0.897) with a mean Jaccard index (JI) of 0.806 (95% CI: 0.799–0.814) and mean Hausdorff distance (HD) of 2.146 (95% CI: 2.184–2.208). For the independent test set, DSC and JI were lower while HD was higher, with a mean DSC of 0.789 (95% CI: 0.760–0.815), mean JI of 0.672 (95% CI: 0.642–0.699), and mean HD of 2.118 (95% CI: 2.047–2.190).

Conclusion

The deep learning-based segmentation model showed a good performance for the task of nerve segmentation. Future work will focus on extending training data and including individuals with peripheral neuropathies in training to enable advanced peripheral nerve disease characterization.

Relevance statement

The results will serve as a baseline to build upon while developing an automated quantitative MRN feature analysis framework for application in routine reading of MRN examinations.

Key Points

Quantitative measures enhance MRN interpretation, requiring complex and challenging nerve segmentation.

We present a deep learning-based segmentation model with good performance.

Our results may serve as a baseline for clinical automated quantitative MRN segmentation.

Graphical Abstract
Assessment of the ecological status of an ancient reservoir using macroinvertebrate assemblage and water quality parameters
Authors: Amusan Babatunde Omokunle , Adeleke Sikiru Oladimeji , Koleosho Ayorinde Fola
Published: August 2024

Background

Atori Reservoir, located in the heart of southwestern Nigeria, is a tribute to the region's historical significance and natural splendor. Its establishment as a reservoir in 1935 marked a water resource management watershed in the region, transforming Atori into one of Nigeria’s oldest and most important waterbodies. Despite its ancient age and indisputable importance, the exact ecological state of Atori Reservoir has been shrouded in mystery for decades. This study was necessitated by a paucity of information on the ecological status of Atori Reservoir.

Results

The study identified 953 macroinvertebrates belonging to four classes, distributed across nine orders and nineteen families within Atori Reservoir. Among these, the class Insecta exhibited the highest diversity, while Melanoides tuberculata, a member of the Mollusca class, emerged as the dominant species. Despite the diverse macroinvertebrate community, the physicochemical parameters of the water raised concerns. Elevated values of total dissolved solids and conductivity indicated poor water quality, which was further reflected in the predominance of pollution-tolerant species and the absence of pollution-sensitive ones. Canonical correspondence analysis highlighted potential correlations between macroinvertebrates and water quality variables, yet statistical significance was lacking, as demonstrated by the Monte Carlo permutation test.

Conclusion

This study sheds light on the ecological state of Atori Reservoir, revealing a diverse macroinvertebrate community but highlighting concerns regarding water quality. The study also emphasizes the pressing need for improved management practices to safeguard the ecological health of Atori Reservoir, given the critical role it plays in the region's ecosystem and local communities.