bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical research report on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions (2022)
Authors: Wang Danlei , Shi Menglong , Hu Haiyin , Ma Yucong , Peng Dehui , Zhang Junhua , Fauci Alice Josephine , Ji Zhaochen
Published: June 2024

Objective:

The paper is to comprehensively summarize and analyze the basic situation and methodological quality of clinical randomized controlled trials (RCTs) of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions published in 2022, to provide evidence and reasonable suggestions for the advancement of clinical research and the formulation of policies and guidelines.

Methods:

The Evidence Database System of clinical evidence-based evaluation of traditional Chinese medicine was searched, and data from China National Knowledge Infrastructure (CNKI), PubMed, and other databases were supplemented. The search duration was from January 1, 2022, to December 31, 2022. RCTs of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were included as the source of clinical evidence, and published information, sample size, intervention, control measures, treatment course, methodological quality, and key link report were analyzed and evaluated.

Results:

A total of 1,464 RCTs of traditional Chinese patent medicines were included, which comprised 667 types of traditional Chinese patent medicines; “traditional Chinese patent medicines + Western medicine vs. Western medicine” was the most widely used intervention and control setting, involving 417 RCTs (28.48%). A total of 245 RCTs of traditional Chinese classic famous prescriptions were included, comprising 55 types of traditional Chinese classic famous prescriptions. “Decoction + conventional treatment vs. conventional treatment” was the most widely used intervention and control setting, with 87 RCTs (35.51%). Published RCTs on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were limited by the study design and implementation. Most “allocation concealment” and “blinding of patients and personnel” were rated as medium to high risk. There are insufficient reports on key research links such as experimental registration and ethical approval.

Conclusions:

The number of RCTs on traditional Chinese patent medicines has decreased in 2022, but there has been a slight improvement in the research quality and impact. There are relatively few studies on traditional Chinese classic famous prescriptions. Measures must be taken to improve clinical trial design, implementation, and reporting. Methodological experts should be invited to provide professional technical guidance on the trial design. In the research implementation process, attention should be paid to quality control, particularly the standardization of the randomized execution.
Application of radiomics for preoperative prediction of lymph node metastasis in colorectal cancer: a systematic review and meta-analysis
Authors: Abbaspour Elahe , Karimzadhagh Sahand , Monsef Abbas , Joukar Farahnaz , Mansour-Ghanaei Fariborz , Hassanipour Soheil
Published: June 2024

Background:

Colorectal cancer (CRC) stands as the third most prevalent cancer globally, projecting 3.2 million new cases and 1.6 million deaths by 2040. Accurate lymph node metastasis (LNM) detection is critical for determining optimal surgical approaches, including preoperative neoadjuvant chemoradiotherapy and surgery, which significantly influence CRC prognosis. However, conventional imaging lacks adequate precision, prompting exploration into radiomics, which addresses this shortfall by converting medical images into reproducible, quantitative data.

Methods:

Following PRISMA, Supplemental Digital Content 1 (http://links.lww.com/JS9/C77) and Supplemental Digital Content 2 (http://links.lww.com/JS9/C78), and AMSTAR-2 guidelines, Supplemental Digital Content 3 (http://links.lww.com/JS9/C79), we systematically searched PubMed, Web of Science, Embase, Cochrane Library, and Google Scholar databases until 11 January 2024, to evaluate radiomics models’ diagnostic precision in predicting preoperative LNM in CRC patients. The quality and bias risk of the included studies were assessed using the Radiomics Quality Score (RQS) and the modified Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Subsequently, statistical analyses were conducted.

Results:

Thirty-six studies encompassing 8039 patients were included, with a significant concentration in 2022–2023 (20/36). Radiomics models predicting LNM demonstrated a pooled area under the curve (AUC) of 0.814 (95% CI: 0.78–0.85), featuring sensitivity and specificity of 0.77 (95% CI: 0.69, 0.84) and 0.73 (95% CI: 0.67, 0.78), respectively. Subgroup analyses revealed similar AUCs for CT and MRI-based models, and rectal cancer models outperformed colon and colorectal cancers. Additionally, studies utilizing cross-validation, 2D segmentation, internal validation, manual segmentation, prospective design, and single-center populations tended to have higher AUCs. However, these differences were not statistically significant. Radiologists collectively achieved a pooled AUC of 0.659 (95% CI: 0.627, 0.691), significantly differing from the performance of radiomics models (P<0.001).

Conclusion:

Artificial intelligence-based radiomics shows promise in preoperative lymph node staging for CRC, exhibiting significant predictive performance. These findings support the integration of radiomics into clinical practice to enhance preoperative strategies in CRC management.
Comparing upfront surgery with neoadjuvant treatments in patients with resectable, borderline resectable or locally advanced pancreatic cancer: a systematic review and network meta-analysis of randomized clinical trials
Authors: He Jiaxin , Lv Na , Yang Zhenyi , Luo Yixuan , Zhong Wen , Wu Chunli
Published: June 2024

Background:

The aim was to explore the optimal neoadjuvant therapy strategy for resectable, borderline resectable, and locally advanced pancreatic cancer, in order to provide a theoretical basis for the development of new neoadjuvant treatment protocols for clinical use.

Patients and methods:

The authors reviewed literature titles and abstracts comparing three treatment strategies (neoadjuvant chemoradiotherapy, neoadjuvant chemotherapy, and upfront surgery) in PubMed, Embase, The Cochrane Library, Web of Science from 2009 to 2023 to estimate relative odds ratios for resection rate and hazard ratios (HRs) for overall survival (OS) in all include trials.

Results:

A total of nine studies involving 889 patients were included in the analysis. The treatment methods included upfront surgery, neoadjuvant chemotherapy, and neoadjuvant chemoradiotherapy followed by surgery. The network meta-analysis results demonstrated that neoadjuvant chemoradiotherapy followed by surgery was an effective approach in improving OS for resectable and borderline resectable pancreatic cancer (RPC) patients compared to upfront surgery (HR: 0.79, 95% CI: 0.64–0.98) and neoadjuvant chemotherapy (HR: 0.79, 95% CI: 0.64–0.98). Additionally, neoadjuvant chemoradiotherapy significantly increased the margin negative resection (R0) rate and pathological negative lymph node (pN0) rate in patients with resectable and borderline RPC. However, it is worth noting that neoadjuvant chemoradiotherapy increased the risk of grade 3 or higher treatment-related adverse events, including in patients with locally advanced pancreatic cancer.

Conclusions:

The current evidence suggests that neoadjuvant chemoradiotherapy followed by surgery is the optimal choice for treating patients with resectable and borderline RPC. Future research should focus on optimizing neoadjuvant chemoradiotherapy regimens to effectively improve OS while reducing the occurrence of adverse events.
Reductions in Prostate-Specific Antigen Screening During the COVID-19 Pandemic in a Universally Insured American Health System
Authors: Mani Vivitha , Banaag Amanda , Miura Sarah Selica T. , Munigala Satish , Coles Christian L. , Schoenfeld Andrew J. , Koehlmoos Tracey Pèrez
Published: June 2024

Purpose:

PSA testing is the primary method of screening for prostate cancer, although recommendations are varied. The COVID-19 pandemic diverted resources away from preventive screenings. We sought to examine alterations in PSA screening among TRICARE beneficiaries in the Military Health System (MHS) over the course of the pandemic.

Materials and Methods:

Using data from the MHS Data Repository, we executed a retrospective open cohort study of male TRICARE Prime beneficiaries aged 40 to 64 years during fiscal years 2018 to 2022. The study period was separated into 3 subperiods: prepandemic (October 1, 2017-February 28, 2020), early pandemic (March 1, 2020-September 30, 2020), and late pandemic (October 1, 2020-September 30, 2022).

Results:

We found a 73% reduction in PSA screenings in the early pandemic and 14% decrease in the late pandemic compared with prepandemic rates. Compared with White men aged 50 to 54 years, men younger than 50 years in all racial groups were less likely to receive screening. In both pandemic periods, all racial groups, except for Black men, were overall more likely than White men to receive screening. Men were more likely to seek PSA screening in the private sector during the pandemic compared with prepandemic times (early pandemic: 1.21 RR, 1.20-1.22 95% confidence interval [CI]; late pandemic: 1.20 RR, 1.19-1.20 95% CI).

Conclusions:

We found significant reductions in PSA screening over the course of the COVID-19 pandemic among TRICARE beneficiaries. While disparities appear less pronounced when compared with other preventive testing, targeted outreach is still necessary for certain sociodemographic groups.
Impact of Androgen Deprivation Therapy on Lumbar Spine Bone Health Using Quantitative Computed Tomography in a Propensity-Matched Cohort of Patients With Prostate Cancer
Authors: Sato Mototaka , Kashii Masafumi , Maekawa Takahiro , Mori Shunsuke , Umeda Shun , Kujime Yuma , Matsushita Makoto , Kamido Satoshi , Ueda Norichika , Nakayama Jiro , Tei Norihide , Miyake Osamu
Published: June 2024

Purpose:

Fragility fracture risk in patients with prostate cancer is an important issue. The purpose of this study was to accurately assess the impact of androgen deprivation therapy on lumbar spine bone loss using quantitative computed tomography in a propensity-matched cohort of patients with prostate cancer.

Materials and Methods:

Eighty-one patients with prostate cancer who underwent androgen deprivation therapy for 1 year were included. Thirty-nine of these patients were successfully propensity-matched with 39 of 68 patients from a control group who underwent robot-assisted radical prostatectomy without androgen deprivation therapy. Volumetric bone mineral density of trabecular bone in each vertebral body (L1-L4) was measured using quantitative computed tomography during staging and at 1 year after commencing treatment. The change in mean lumbar volumetric bone mineral density (L1-L4) was then calculated.

Results:

Propensity score matching successfully achieved comparable baseline patient characteristics and radiological parameters between the androgen deprivation therapy and control groups. In the androgen deprivation therapy group, the decrease in lumbar volumetric bone mineral density (L1-L4) was significantly greater with confirmed testosterone deficiency (−17.9 ± 12.0%) compared with the control group (−8.5 ± 10.8%, P < .001).

Conclusions:

This study observed a 17.9% reduction in volumetric lumbar bone mineral density (g/cm3) after 1 year of androgen deprivation therapy, exceeding previously reported values (g/cm2) obtained using dual-energy X-ray absorptiometry. The potential overestimation of lumbar spine bone mineral density measured by dual-energy X-ray absorptiometry in older patients with prostate cancer because of concomitant lumbar degenerative disease is a possible reason for this discrepancy. Androgen deprivation therapy may decrease vertebral bone mass and increase the risk of vertebral fractures more than urologists realize.
Speech Perception and Quality-of-Life Outcomes in Mandarin-Speaking Postlingual Deaf Adults With Cochlear Implant: Any Difference With the Intonation Language Users?
Authors: Ho Pei-Hsuan , Huang Po-Kai , Chen Pey-Yu , Chu Chia-Huei , Hsu Hsiao-Man , Chen Xiang-Xiang , Lin Hung-Ching
Published: June 2024

Objective

To evaluate the effects of related factors on long-term speech perception and quality-of-life (QoL) outcomes in postlingual deaf Mandarin-speaking adult cochlear implant (CI) recipients and to assess any differences between tone language and other intonation language CI adult users.

Study Design

Retrospective cases review

Setting

Tertiary referral center

Patients

Forty-five adult CI recipients (48 implanted ears).

Main Outcome Measures

Post-CI outcomes were evaluated after follow-ups of more than 24 months using speech perception tests and QoL questionnaires. We analyzed the related factors affecting CI outcomes.

Results

A shorter duration of profound deafness was predictive factors for better post-CI speech perception. Earlier implantation and better performance of vowel scores were predictive of better subjective improvements in social and emotional life. Post-CI vowel scores of over 56% indicated promising improvements in QoL.

Conclusion

Shorter duration of deafness could have better post-CI speech perception. Post-CI vowel scores instead of monosyllable words have the more potential to predict the QoL in Mandarin-speaking adult CI recipients.
Remote Delivery of Vestibular Rehabilitation for Vestibular Dysfunction: A Systematic Review
Authors: Perez-Heydrich Carlos A. , Creary-Miller Ilahi , Spann Marcus , Agrawal Yuri
Published: June 2024

Background

People with vestibular dysfunction encounter many obstacles when seeking vestibular rehabilitation treatment. Remote delivery of vestibular rehabilitation may offer a promising avenue for overcoming these barriers, ensuring uninterrupted and cost-effective care.

Objective

To evaluate clinical trials studying telerehabilitation and virtual reality devices as therapeutic interventions for individuals with vestibular dysfunction.

Methods

A PRISMA systematic review of PubMed, EMBASE, Cochrane, Web of Science, and SCOPUS was conducted for randomized controlled trials describing the use of remote care delivery for vestibular rehabilitation. Bias of studies was assessed with the revised Cochrane risk-of-bias tool (RoB2).

Results

The search identified 1,358 unique articles and 14 articles matched the search criteria. Study samples size ranged from 20 to 337, with mean ages ranging from 29.3 to 77.7 years. Interventions included telephone and online communication, exergaming devices, web-based applications, and head-mounted devices to deliver vestibular rehabilitation. Outcomes included validated questionnaires, objective clinical tests, and physical examinations.

Conclusions

The studies reviewed in this article reported greater or equivalent outcomes when incorporating remote care options as supplements or alternatives to standard care for patients with vestibular dysfunction. Further research is required to address limitations in these studies such as heterogeneity of control groups and cost-effectiveness of these interventions.
The Photon-Counting CT Enters the Field of Cochlear Implantation: Comparison to Angiography DynaCT and Conventional Multislice CT
Authors: Rak Kristen , Spahn Bjoern , Müller-Graff Franz-Tassilo , Engert Jonas , Voelker Johannes , Hackenberg Stephan , Hagen Rudolf , Petritsch Bernhard , Grunz Jan-Peter , Bley Thorsten , Neun Tilmann , Huflage Henner
Published: June 2024

Introduction

Cochlear duct length (CDL) measurement plays a role in the context of individualized cochlear implant (CI) surgery regarding an individualized selection and implantation of the CI electrode carrier and an efficient postoperative anatomy-based fitting process. The level of detail of the preoperative temporal bone CT scan depends on the imaging modality with major impact on CDL measurements and CI electrode contact position determination. The aim of this study was to evaluate the accuracy of perioperative CDL measurements and electrode contact determination in photon-counting CT (PCCT).

Methods

Ten human fresh-frozen petrous bone specimens were examined with a first-generation PCCT. A clinically applicable radiation dose of 27.1 mGy was used. Scans were acquired before and after CI insertion. Postoperative measurement of the CDL was conducted using an otological planning software and 3D-curved multiplanar reconstruction. Investigation of electrode contact position was performed by two respective observers. Measurements were compared with a conventional multislice CT and to a high-resolution flat-panel volume CT with secondary reconstructions.

Results

Pre- and postoperative CDL measurements in PCCT images showed no significant difference to high-resolution flat-panel volume CT. Postoperative CI electrode contact determination was also as precise as the flat-panel CT-based assessment. PCCT and flat-panel volume CT were equivalent concerning interobserver variability.

Conclusion

CDL measurement with PCCT was equivalent to flat-panel volume CT with secondary reconstructions. PCCT enabled highly precise postoperative CI electrode contact determination with substantial advantages over conventional multislice CT scanners.
The Sexual Health Clinic Role in Vaccine and Treatment Access During the 2022 Mpox Outbreak in King County, Washington
Authors: Karmarkar Ellora N. , Cannon Chase A. , Golden Matthew R. , Thibault Christina S. , Zinsli Kaitlin , Kim Joong , Pogosjans Sargis , Chow Eric J. , Herrmann Susannah O. , Ocbamichael Negusse , Ramchandani Meena S. , Dombrowski Julia C.
Published: June 2024

Background

Sexual health clinics (SHCs) were frontline providers in the 2022 US mpox public health response, although data on clinic-based mpox vaccine scale-up, diagnoses, and treatment are limited. We describe the role of a public health SHC in King County's mpox response between May 23, 2022, and October 31, 2022.

Methods

In July 2022, the SHC implemented a dedicated vaccine clinic and presumptive tecovirimat treatment (before laboratory confirmation) with on-site dispensation. We describe SHC's vaccine scale-up and contribution to clinical care by calculating the weekly number of vaccines administered by SHC and the total number of patients diagnosed and treated for mpox within SHC, and by comparing with countywide data. We calculated time from symptom onset to testing and time from testing to treatment, and assessed temporal changes in these metrics using linear regression.

Results

The SHC provided ≥1 vaccine doses to 7442 individuals (10,295 doses), administering 42% of the 24,409 vaccine doses provided countywide, with the greatest contribution in the first week of August (n = 1562, 58% of countywide vaccinations that week). Of 598 patients evaluated for mpox and tested, 178 (30%) tested positive (37% of countywide cases), and 152 (85% of SHC patients with mpox) received tecovirimat (46% of treatment countywide). Median time from symptom onset to testing decreased from 12 to 6 days (P = 0.045); time from testing to treatment decreased from 4.5 to 0 days (P < 0.001).

Conclusions

The SHC was central to mpox vaccination and treatment scale-up, particularly in the first months of the 2022 epidemic.
Integrating HIV Cluster Analysis in Everyday Public Health Practice: Lessons Learned From a Public Health–—Academic Partnership
Authors: Fulton John , Novitsky Vladimir , Gillani Fizza , Guang August , Steingrimsson Jon , Khanna Aditya , Hague Joel , Dunn Casey , Hogan Joseph , Howe Katharine , MacAskill Meghan , Bhattarai Lila , Bertrand Thomas , Bandy Utpala , Kantor Rami
Published: June 2024

Background:

The use of molecular HIV cluster analysis to supplement public health contact tracing has shown promise in addressing HIV outbreaks. However, the potential of HIV cluster analysis as an adjunct to daily, person-by-person HIV prevention efforts remains unknown. We documented lessons learned within a unique public health–academic partnership while guiding workaday HIV prevention efforts with near–real-time molecular cluster analysis.

Setting:

A public health-academic partnership in the State of Rhode Island, the United States.

Methods:

We recorded perceptions of our team of academicians and public health practitioners that were encountered in an 18-month study evaluating the integration of molecular cluster analysis with HIV contact tracing for public health benefit. The focus was on monthly conferences where molecular clustering of each new statewide diagnosis was discussed to facilitate targeted interventions and on attempted reinterviews of all newly HIV-diagnosed persons statewide whose HIV sequences clustered to increase partner naming.

Results:

Three main themes emerged: First, multidisciplinary conferences are substantially beneficial for gleaning actionable inferences from integrating molecular cluster analysis and public health data. Second, universal reinterviews were perceived to potentially have negative consequences but may be selectively beneficial. Third, the translation of cluster analysis into public health action is hampered by jurisdictional surveillance boundaries and within-jurisdictional data silos, across which data sharing is problematic.

Conclusions:

Insights from a statewide public health–academic partnership support integration of molecular HIV cluster analyses with public health efforts, which can guide public health activities to prevent transmission while identifying substantial barriers to integration, informing continued research.
Traumatic Thoracic Aortic Coarctation after Blunt Thoracic Aortic Injury Mandates Emergent Thoracic Endovascular Aortic Repair
Authors: Bhatt Maunil N. , Byerly Saskya , Filiberto Dina M. , Afzal Muhammad O. , Fabian Timothy C. , Croce Martin A. , Mitchell Erica L.
Published: June 2024

Objective:

This study sought to elucidate clinical and imaging findings predictive for malperfusion syndrome after blunt thoracic aortic injury (BTAI).

Background:

There is limited literature on malperfusion syndrome after BTAI, and the timing of thoracic endovascular aortic repair (TEVAR) in patients with this condition has not been defined.

Methods:

A retrospective analysis of prospectively collected data of patients with BTAI treated between January 2021 and October 2023. Clinical and thoracic aortic (TA) imaging data, time to TEVAR, in-hospital death, and malperfusion/reperfusion sequelae (paraplegia, renal/visceral/limb ischemia, and compartment syndromes) were assessed. Correlations between clinical and imaging findings, time to TEVAR, and outcomes were evaluated.

Results:

Of the 19,203 trauma patients evaluated, 13,717 (71%) had blunt injuries and 77 (0.6%) had BTAI. The majority (67.5%) were male, with a median age of 40 years (IQR: 33–55). TEVAR was performed in 42 (54.5%) patients. Seven (9.1%) patients presented with clinical and TA imaging criteria for traumatic thoracic aortic coarctation (TTAC), including diminished/absent femoral pulses and TA luminal narrowing of 50% to 99%. The median time to TEVAR was 9 (IQR: 5–32), 11, and 4 hours for all non-TTAC and TTAC BTAI patients, respectively (P=0.037). Only TTAC patients presented/developed malperfusion/reperfusion sequelae. In-hospital mortality rates were 7.8%, 5.8%, and 29% for all non-TTAC and TTAC BTAI patients, respectively (P=0.09). Aortic-related mortality occurred in only 2 (2.6%) TTAC patients.

Conclusions:

Patients with clinical and TA imaging manifestations of TTAC are predisposed to malperfusion/reperfusion sequelae if TEVAR is delayed. We recommend the emergent repair of all BTAIs with TTAC.
Coupling tensile test with LC-OCT and ultrasound imaging: investigation of the skin sublayers mechanical behaviour
Authors: Ammam Ianis , Guillermin Amaury , Ouillon Lucas , Vargiolu Roberto , Perrot Jean-Luc , Zahouani Hassan
Published: June 2024

The skin is an envelope that covers the entire body. Nowadays, understanding and studying the mechanical, biological and sensory properties of the skin is essential, especially in dermatology and cosmetology. The in-depth study of the skin’s mechanical behaviour is a highly intriguing challenge, enabling the differentiation of the behaviour of each layer. An extension device was developed to perform relaxation and extension tests to characterize the skin. The device has also been coupled with imaging tools (LC-OCT and ultrasound), allowing us to observe layer-by-layer deformations during the tests. Relaxation tests revealed significant skin anisotropy, as well as an influence of age and gender on skin viscoelastic parameters calculated from relaxation curves and a skin viscoelastic model. These tests also unveiled their ability to distinguish certain characteristic pathologies that alter the mechanical properties of the skin, such as scleroderma or heliodermatitis. Furthermore, the optical–mechanical coupling and deformation calculation through image analysis demonstrated that the skin layers exhibit distinct mechanical behaviours owing to their different structures. Finally, Poisson’s ratio of the skin was obtained by calculating the deformation in two directions for each layer.
Gene loss and relaxed selection of
plaat1
in vertebrates adapted to low-light environments
Authors: Drabeck Danielle H. , Wiese Jonathan , Gilbertson Erin , Arroyave Jairo , Stiassny Melanie L. J. , Alter S. Elizabeth , Borowsky Richard , Hendrickson Dean A. , Arcila Dahiana , McGaugh Suzanne E.
Published: June 2024

Gene loss is an important mechanism for evolution in low-light or cave environments where visual adaptations often involve a reduction or loss of eyesight. The
plaat
gene family encodes phospholipases essential for the degradation of organelles in the lens of the eye. These phospholipases translocate to damaged organelle membranes, inducing them to rupture. This rupture is required for lens transparency and is essential for developing a functioning eye.
Plaat3
is thought to be responsible for this role in mammals, while
plaat1
is thought to be responsible in other vertebrates. We used a macroevolutionary approach and comparative genomics to examine the origin, loss, synteny and selection of
plaat1
across bony fishes and tetrapods. We showed that
plaat1
(probably ancestral to all bony fish + tetrapods) has been lost in squamates and is significantly degraded in lineages of low-visual-acuity and blind mammals and fishes. Our findings suggest that
plaat1
is important for visual acuity across bony vertebrates, and that its loss through relaxed selection and pseudogenization may have played a role in the repeated evolution of visual systems in low-light environments. Our study sheds light on the importance of gene-loss in trait evolution and provides insights into the mechanisms underlying visual acuity in low-light environments.
No evidence for the consistent effect of supplementary feeding on home range size in terrestrial mammals
Authors: Olejarz Astrid , Podgórski Tomasz
Published: June 2024

Food availability and distribution are key drivers of animal space use. Supplemental food provided by humans can be more abundant and predictable than natural resources. It is thus believed that supplementary feeding modifies the spatial behaviour of wildlife. Yet, such effects have not been tested quantitatively across species. Here, we analysed changes in home range size owing to supplementary feeding in 23 species of terrestrial mammals using a meta-analysis of 28 studies. Additionally, we investigated the moderating effect of factors related to (i) species biology (sex, body mass and taxonomic group), (ii) feeding regimen (duration, amount and purpose), and (iii) methods of data collection and analysis (source of data, estimator and spatial confinement). We found no consistent effect of supplementary feeding on changes in home range size. While an overall tendency of reduced home range was observed, moderators varied in the direction and strength of the trends. Our results suggest that multiple drivers and complex mechanisms of home range behaviour can make it insensitive to manipulation with supplementary feeding. The small number of available studies stands in contrast with the ubiquity and magnitude of supplementary feeding worldwide, highlighting a knowledge gap in our understanding of the effects of supplementary feeding on ranging behaviour.
The paradigm of tax-reward and tax-punishment strategies in the advancement of public resource management dynamics
Authors: Wang Lichen , Liu Yuyuan , Guo Ruqiang , Zhang Liang , Liu Linjie , Hua Shijia
Published: June 2024

In contemporary society, the effective utilization of public resources remains a subject of significant concern. A common issue arises from defectors seeking to obtain an excessive share of these resources for personal gain, potentially leading to resource depletion. To mitigate this tragedy and ensure sustainable development of resources, implementing mechanisms to either reward those who adhere to distribution rules or penalize those who do not, appears advantageous. We introduce two models: a tax-reward model and a tax-punishment model, to address this issue. Our analysis reveals that in the tax-reward model, the evolutionary trajectory of the system is influenced not only by the tax revenue collected but also by the natural growth rate of the resources. Conversely, the tax-punishment model exhibits distinct characteristics when compared with the tax-reward model, notably the potential for bistability. In such scenarios, the selection of initial conditions is critical, as it can determine the system’s path. Furthermore, our study identifies instances where the system lacks stable points, exemplified by a limit cycle phenomenon, underscoring the complexity and dynamism inherent in managing public resources using these models.
Asynchronous haltere input drives specific wing and head movements in
Drosophila
Authors: Rauscher Michael J. , Fox Jessica L.
Published: June 2024

Halteres are multifunctional mechanosensory organs unique to the true flies (Diptera). A set of reduced hindwings, the halteres beat at the same frequency as the lift-generating forewings and sense inertial forces via mechanosensory campaniform sensilla. Though haltere ablation makes stable flight impossible, the specific role of wing-synchronous input has not been established. Using small iron filings attached to the halteres of tethered flies and an alternating electromagnetic field, we experimentally decoupled the wings and halteres of flying
Drosophila
and observed the resulting changes in wingbeat amplitude and head orientation. We find that asynchronous haltere input results in fast amplitude changes in the wing (hitches), but does not appreciably move the head. In multi-modal experiments, we find that wing and gaze optomotor responses are disrupted differently by asynchronous input. These effects of wing-asynchronous haltere input suggest that specific sensory information is necessary for maintaining wing amplitude stability and adaptive gaze control.
Role-reversed polyandry is associated with faster fast-Z in shorebirds
Authors: Wanders Kees , Chen Guangji , Feng Shaohong , Székely Tamás , Urrutia Arraxi O.
Published: June 2024

In birds, males are homogametic and carry two copies of the Z chromosome (‘ZZ’), while females are heterogametic and exhibit a ‘ZW’ genotype. The Z chromosome evolves at a faster rate than similarly sized autosomes, a phenomenon termed ‘fast-Z evolution’. This is thought to be caused by two independent processes—greater Z chromosome genetic drift owing to a reduced effective population size, and stronger Z chromosome positive selection owing to the exposure of partially recessive alleles to selection. Here, we investigate the relative contributions of these processes by considering the effect of role-reversed polyandry on fast-Z in shorebirds, a paraphyletic group of wading birds that exhibit unusually diverse mating systems. We find stronger fast-Z effects under role-reversed polyandry, which is consistent with particularly strong selection on polyandrous females driving the fixation of recessive beneficial alleles. This result contrasts with previous research in birds, which has tended to implicate a primary role of genetic drift in driving fast-Z variation. We suggest that this discrepancy can be interpreted in two ways—stronger sexual selection acting on polyandrous females overwhelms an otherwise central role of genetic drift, and/or sexual antagonism is also contributing significantly to fast-Z and is exacerbated in sexually dimorphic species.
The short-term impact of
Schistosoma mansoni
infection on health-related quality of life: implications for current elimination policies
Authors: Alonso Sergi , Arinaitwe Moses , Atuhaire Alon , Nankasi Andrina Barungi , Prada Joaquín M. , McIntosh Emma , Lamberton Poppy H. L.
Published: June 2024

The WHO aims to eliminate schistosomiasis as a public health problem by 2030. However, standard morbidity measures poorly correlate to infection intensities, hindering disease monitoring and evaluation. This is exacerbated by insufficient evidence on
Schistosoma
’s impact on health-related quality of life (HRQoL). We conducted community-based cross-sectional surveys and parasitological examinations in moderate-to-high
Schistosoma mansoni
endemic communities in Uganda. We calculated parasitic infections and used EQ-5D instruments to estimate and compare HRQoL utilities in these populations. We further employed Tobit/linear regression models to predict HRQoL determinants. Two-thirds of the 560 participants were diagnosed with parasitic infection(s), 49% having
S. mansoni
. No significant negative association was observed between HRQoL and
S. mansoni
infection status/intensity. However, severity of pain urinating (
β
= −0.106; s.e. = 0.043) and body swelling (
β
= −0.326; s.e. = 0.005), increasing age (
β
= −0.016; s.e. = 0.033), reduced socio-economic status (
β
= 0.128; s.e. = 0.032), and being unemployed predicted lower HRQoL. Symptom severity and socio-economic status were better predictors of short-term HRQoL than current
S. mansoni
infection status/intensity. This is key to disentangling the link between infection(s) and short-term health outcomes, and highlights the complexity of correlating current infection(s) with long-term morbidity. Further evidence is needed on long-term schistosomiasis-associated HRQoL, health and economic outcomes to inform the case for upfront investments in schistosomiasis interventions.
Effect of Chemotherapeutic Agents on Natural Transformation Frequency in Acinetobacter baylyi
Authors: Winter Macaulay Ralph , Vos Michiel , Buckling Angus , Johnsen Pål Jarle , Harms Klaus
Published: June 2024

Natural transformation is the ability of a bacterial cell to take up extracellular DNA which is subsequently available for recombination into the chromosome (or maintenance as an extrachromosomal element). Like other mechanisms of horizontal gene transfer, natural transformation is a significant driver for the dissemination of antimicrobial resistance. Recent studies have shown that many pharmaceutical compounds such as antidepressants and anti-inflammatory drugs can upregulate transformation frequency in the model species Acinetobacter baylyi. Chemotherapeutic compounds have been shown to increase abundance of antimicrobial resistance genes and increase colonisation rates of potentially pathogenic bacteria in patient gastrointestinal tracts, indicating an increased risk of infection and providing a pool of pathogenicity or resistance genes for transformable commensal bacteria. We here test for the effect of six cancer chemotherapeutic compounds on A. baylyi natural transformation frequency, finding two compounds, docetaxel and daunorubicin, to significantly decrease transformation frequency, and daunorubicin to also decrease growth rate significantly. Enhancing our understanding of the effect of chemotherapeutic compounds on the frequency of natural transformation could aid in preventing the horizontal spread of antimicrobial resistance genes.
Mangrovimonas cancribranchiae sp. nov., a novel bacterial species associated with the gills of the fiddler crab Cranuca inversa (Brachyura, Ocypodidae) from Red Sea mangroves
Authors: Yang Xinyuan , Garuglieri Elisa , Van Goethem Marc W. , Marasco Ramona , Fusi Marco , Daffonchio Daniele
Published: June 2024

Two bacteria, UG2_1T and UG2_2, were isolated from the gill tissues of the mangrove fiddler crab Cranuca inversa collected on the east coast of the Red Sea (Thuwal, Saudi Arabia). The cells are Gram-negative, rod-shaped, orange-pigmented, motile by gliding with no flagella, strictly aerobic, and grow at 20–37 °C (optimum, 28–35 °C), at pH 5.0–9.0 (optimum, pH 6.0–7.0), and with 1–11 % (w/v) NaCl (optimum, 2–4 %). They were positive for oxidase and catalase activity. Phylogenetic analysis based on 16S rRNA gene sequences indicated that isolates UG2_1T and UG2_2 belong to the genus Mangrovimonas, showing the highest similarity to Mangrovimonas spongiae HN-E26T (99.4 %). Phylogenomic analysis based on the whole genomes, independently using 49 and 120 concatenated genes, showed that strains UG2_1T and UG2_2 formed a monophyletic lineage in a different cluster from other type strain species within the genus Mangrovimonas. The genome sizes were 3.08 and 3.07 Mbp for UG2_1T and UG2_2, respectively, with a G+C content of 33.8 mol% for both strains. Values of average nucleotide identity and digital DNA–DNA hybridization between the strains and closely related species were 91.0 and 43.5 %, respectively. Chemotaxonomic analysis indicated that both strains had iso-C15 : 0 and iso-C15 : 1 G as dominant fatty acids, and the primary respiratory quinone was identified as MK-6. The major polar lipids comprised phosphatidylethanolamine, one unidentified glycolipid, one unidentified phospholipid, two unidentified aminolipids, and four unidentified lipids. Based on phylogenetic, phylogenomic, genome relatedness, phenotypic, and chemotaxonomical data, the two isolates represent a novel species within the genus Mangrovimonas, with the proposed name Mangrovimonas cancribranchiae sp. nov., and the type strain UG2_1T (=KCTC 102158T=DSM 117025T).
Solitary Lung Cavities on CT Imaging: Differentiating Malignant and Non-Malignant Diseases
Authors: Cosgun Zeliha
Published: June 2024

Background

This study aims to explore how radiological findings contribute to distinguishing between benign and malignant diseases in patients with solitary cavitary lesions detected on CT.

Methods

We retrospectively assessed lesion size, cavity wall thickness, and additional parenchymal findings in diagnosing benign or malignant disease in these patients. Our study investigated the incidence and etiology of solitary pulmonary cavities. CT scans were reviewed by a single radiologist with expertise in thoracic radiology. The study was conducted using two 64-multidetector CT systems, and measurements of lesion size and cavity wall thickness were recorded on axial images. Consolidation and centrilobular nodules were assessed based on predefined criteria. Receiver operating characteristic curves were generated to determine optimal cut-off points for distinguishing between malignant and non-malignant lesions based on cavity wall thickness.

Results

Non-malignant lesions accounted for 47.9% of cases, with active pulmonary tuberculosis being the most common diagnosis. In the malignant group, primary lung cancer predominated, squamous cell carcinoma being the most prevalent subtypes. Significant differences were noted between malignant and non-malignant cases regarding average maximum wall thickness and lesion diameter. Presence of perilesional consolidation or centrilobular nodules favored non-malignant diagnoses. Maximum wall thickness thresholds of 7.2 mm or 23 mm were most accurate in suggesting non-malignant and malignant etiologies, respectively.

Conclusions

In conclusion, CT findings revealed significant distinctions between malignant and non-malignant solitary lung cavities; benign lesions generally exhibited smaller and thinner cavity walls, with accompanying perilesional parenchymal findings observed in benign lesions of infectious origin but not in malignant lesions.
Interpretation of two-sample Mendelian randomization for binary exposures and outcome
Authors: Wu Zixuan , Wang Jingshu
Published: June 2024

Mendelian randomization (MR) employs genetic variations to infer causal effects of modifiable exposures on various outcomes, with two-sample MR using GWAS summary statistics from separate studies for exposure and outcome traits. However, challenges arise when either the exposure or outcome trait, or both, are binary. Conventional two sample MR methods assume a linear and homogeneous causal effect of the exposure on the outcome, which is unrealistic for binary traits. To address this, we propose a model that treats binary traits as dichotomized continuous traits. We show that summary statistics for a binary trait, derived from either logistic or linear regressions, maintain nearly proportional relationships to those from linear regressions on the underlying continuous trait, provided the associations between the continuous trait and a single SNP are limited. The ratio is also easily calculable given the prevalence of the binary trait. Consequently, MR frameworks on the underlying continuous traits can be resolved using summary statistics from binary traits. Our analytical approximations and simulations indicate that no modifications to two-sample MR methods are needed for binary traits, only an adjustment in the interpretation of results. This novel interpretation also extends to complex MR frameworks, enhancing the applicability of MR to binary and ordered categorical traits.
How well it works: Benchmarking performance of GPT models on medical natural language processing tasks
Authors: Rough Kathryn , Feng Hui , Milligan Paul B , Tombini Francesco , Kwon Tom , Zine El Abidine Khaldoun , Mack Christina D , Hughes Benjamin
Published: June 2024

Importance

The ability of large language models (LLMs) to generate high-quality, human-like text has been accompanied with speculation about their application in healthcare, alongside ethical and safety concerns.

Objective

Evaluate LLM performance on medical natural language processing (NLP) tasks, benchmarked against other commercially available tools.

Design

Observational study to evaluate and compare model performance. All models were commercially available and were evaluated without modification.

Setting

The Text Analysis Coding (TAC) 2017 challenge was used to assess ability to perform medical coding using standard MedDRA preferred terms. Text from 55 publicly available de-identified medical transcription reports were annotated to identify pre-defined medical concepts (age, disease/symptom, body structure, medication name, and medication dosage).

Participants

Publicly available, de-identified adverse event and medical transcription reports were used for evaluation.

Exposures

For each task, general LLMs (GPT-3.5-turbo, GPT-4) were compared to commercially available healthcare NLP tools (Microsoft Text Analytics for Health, Amazon Comprehend Medical, IQVIA API Marketplace).

Main Outcomes and Measures

For each NLP task, sensitivity, positive predictive value (PPV) and F1 score were calculated. Because GPT models had variable outputs, the range of metrics over 5 trials is reported.

Results

For MedDRA coding, GPT-4 had similar F1 score performance to healthcare NLP algorithms (GPT-4: 0.67 to 0.73; Microsoft Text Analytics for Health: 0.66, IQVIA API Marketplace: 0.72), while GPT-3.5-turbo had considerably lower performance (0.50 to 0.51). For medical information extraction, LLM performance varied widely across differing medical concepts; the highest F1 scores were for age (GPT-3.5-turbo: 0.82 to 0.83, GPT-4: 0.84 to 0.87) and medication name (GPT-3.5-turbo: 0.55 to 0.59, GPT-4: 0.70 to 0.76), while F1 scores for disease/symptom, body structure, and medication dosage were lower than those observed for the healthcare NLP tools. GPT-3.5-turbo and GPT-4 generally had lower sensitivity than comparators.

Conclusions and Relevance

In the absence of domain-specific fine tuning, GPT-4 performed similarly to healthcare-specific NLP tools on some tasks and less accurately on others; GPT-3.5-turbo was consistently less accurate than comparators. To maximize benefit and reduce risk of harm, robust quantitative evaluation for specific tasks should be performed prior to implementing LLMs in medical contexts.
Spatial data analysis and geodemographics for the prevalence of diabetes among adult population in Bangladesh
Authors: Mahdee Chowdhury Mashrur , Tabashsum Anika , Asha Most. Jannatul Ferdous , Khan Md. Ashraful Islam , Rahman Md. Aminur
Published: June 2024

Bangladesh, like most of the developing countries, is experiencing quite a substantial increase in the prevalence of noncommunicable diseases, such as diabetes. For both men and women, the prevalence of diabetes has been increasing in recent decades. The objective of this study is to determine if there are statistically significant geospatial inconsistencies in the prevalence of diabetes. Cross-sectional and spatial analysis was concluded using data on 12100 adults aged 18 years and older from the most recent Bangladesh Demographic and Health Survey (BDHS) 2017-18. The prevalence of diabetes is analyzed and visualized. Spatial autocorrelation was identified using Moran’s I. Hotspot analysis was also done using Moran’s I. The prevalence of diabetes is higher in men (10.52%) than women (9.50%); however, there are more diabetic women than men in the sample population. Among diabetic men and women, 37.11% (95% CI, 32.04-42.48) and 39.71% (95% CI, 35.47-44.12) respectively, are aware of their condition. Among them 33.29% men and 36.44% women are being treated for it. People living in Dhaka division (men: 15.62%, women: 13.31%) are more affected by diabetes than people living in other divisions. Increasing age, living in the highest wealth quintile, and being overweight or obese are positively associated with the increasing prevalence of diabetes. There also exists positive spatial autocorrelation (Moran’s I = 0.215, p=0.001). According to the Local Indicators of Spatial Association (LISA) cluster map, the hotspots are Dhaka and the central districts (10 districts), and the cold spots are the central of northside districts (7 districts). The findings demonstrate the added value of spatial analysis in healthcare system. And this research could help policymakers and healthcare organizations to plan and implement policies with the aim of attenuating the prevalence and risk of diabetes in Bangladesh.
Thymic self-recognition-mediated TCR signal strength modulates antigen-specific CD8+T cell pathogenicity in non-obese diabetic mice
Authors: Ho Chia-Lo , Yeh Li-Tzu , Liu Yu-Wen , Dong Jia-Ling , Sytwu Huey-Kang
Published: June 2024

Our understanding of autoimmune diabetes underscores the critical involvement of CD8+T cells recognizing islet-specific antigens. However, the influence of thymic positive selection on diabetogenic CD8+T cell development remains unclear. Using CD5 marker representing T-cell receptor (TCR) signal strength, we illustrated that naïve CD5hiCD8+T cells of non-obese diabetic (NOD) mice with enhanced TCR signals displayed predisposed differentiated/memory T cell traits with increased activation and proliferation upon TCR stimulation, compared to CD5locounterparts. Additionally, CD5hiCD8+T cells exhibited gene expression landscape similar to effector T cells and exacerbated disease in transfer model. Interestingly, the protective effects of transgenic phosphatase Pep expression, which lowers TCR signaling and diabetes incidence, were abolished in NOD strain 8.3 with high CD5 expression linked to increased thymic positive selection. Strikingly, TCR repertoire analysis identified higher frequencies of autoimmune disease-related clonotypes in naïve CD5hiCD8+cells, supporting that distinct effector functions arise from intrinsic TCR repertoire differences. Overall, CD5hiCD8+clones may be potential targets for autoimmune diabetes treatment.