bluuebunny/crossref_metadata_2025 huggingface dataset:
Lightweight Food Recognition via Aggregation Block and Feature Encoding
Authors: Yang Yancun , Min Weiqing , Song Jingru , Sheng Guorui , Wang Lili , Jiang Shuqiang
Published: July 2024

Food image recognition has recently been given considerable attention in the multimedia field in light of its possible implications on health. The characteristics of the dispersed distribution of ingredients in food images put forward higher requirements on the long-range information extraction ability of neural networks, leading to more complex and deeper models. Nevertheless, the lightweight version of food image recognition is essential for improved implementation on end devices and sustained server-side expansion. To address this issue, we present Aggregation Feature Net (AFNet), a lightweight network that is capable of effectively capturing both global and local features from food images. In AFNet, we develop a novel convolution based on a residual model by encoding global features through row-wise and column-wise information integration. Merging aggregation block with classic local convolution yields a framework that works as the backbone of the network. Based on the efficient use of parameters by the aggregation block, we constructed a lightweight food image recognition network with fewer layers and a smaller scale, assisted by a new type of activation function. Experimental results on four popular food recognition datasets demonstrate that our approach achieves state-of-the-art performance with higher accuracy and fewer FLOPs and parameters. For example, in comparison to the current state-of-the-art model of MobileViTv2, AFNet achieved 88.4% accuracy of the top-1 level on the ETHZ Food-101 dataset, with similar parameters and FLOPs but 1.4% more accuracy. The source code will be provided in supplementary materials.
Some New Improvements for Fractional Hermite–Hadamard Inequalities by Jensen–Mercer Inequalities
Authors: Alshehri Maryam Gharamah Ali , Hyder Abd-Allah , Budak Hüseyin , Barakat Mohamed A.
Published: July 2024

This article’s objective is to introduce a new double inequality based on the Jensen–Mercer (JM) inequality, known as the Hermite–Hadamard–Mercer inequality. We use the (JM) inequality to build a number of generalized trapezoid‐type inequalities. Moreover, in addition to the (JM) inequality, we also use the Hölder inequality and the power mean inequality. Finally, a few examples are given to highlight the main points of our outcomes.
Janerin, a Sesquiterpene Lactone, Enhances the Apoptosis of Human Leukemia Cell Lines via the Intrinsic Pathway
Authors: Roustazadeh Abazar , Khakdan Fatemeh , Shakeri Abolfazl , Erfanian Saiedeh , Javanmardi Sasan , Parveh Abdolhakim , Moradzadeh Maliheh
Published: July 2024

Background. Still, cancer remains to be one of the main causes of death globally. Sesquiterpene lactones (SLs) appeared to have remarkable pharmacologic properties, particularly as anticancer. This study evaluated the cytotoxicity and apoptogenic potential of Janerin and its underlying mechanism in HL60, THP‐1, and Jurkat leukemia cell lines vs. normal peripheral blood mononuclear cells (PBMCs). Methods. The viability of leukemia and PBMCs following treatment with Janerin (2.5–20 μM) and doxorubicin (2 μM, as the positive control) for 48 h was determined via the resazurin assay. The apoptotic cells were determined by annexin V and propidium iodide test. Also, the genes expressions involved in apoptosis were detected by real‐time PCR. Results. Janerin reduced cell viability in leukemia cells in a dose‐dependent manner with no significant toxicity toward normal PBM cells. Janerin significantly increased apoptosis in leukemia cells after 48 h of treatment. In these cells, the expressions of p21, p53, CASP3, CASP9, and Bax/Bcl2 ratio were significantly elevated, whereas CASP8 remained unchanged (p < 0.01). It was suggested that the intrinsic pathway was the mechanism by which Janerin induced apoptosis in HL60, THP‐1, and Jurkat leukemia cells in a time‐ and dose‐dependent manner. Conclusion. The findings imply that Janerin might be a suitable substitute for doxorubicin in leukemia patients.
Supplementary Video S1 from LesionTracker: Extensible Open-Source Zero-Footprint Web Viewer for Cancer Imaging Research and Clinical Trials
Authors: Urban Trinity , Ziegler Erik , Lewis Rob , Hafey Chris , Sadow Cheryl , Van den Abbeele Annick D. , Harris Gordon J.
Published: July 2024

This is a video of the operations of the LesionTracker software.
Supplementary Figure S4 from Obesogenic High-Fat Diet and MYC Cooperate to Promote Lactate Accumulation and Tumor Microenvironment Remodeling in Prostate Cancer
Authors: Boufaied Nadia , Chetta Paolo , Hallal Tarek , Cacciatore Stefano , Lalli Daniela , Luthold Carole , Homsy Kevin , Imada Eddie L. , Syamala Sudeepa , Photopoulos Cornelia , Di Matteo Anna , de Polo Anna , Storaci Alessandra Maria , Huang Ying , Giunchi Francesca , Sheridan Patricia A. , Michelotti Gregory , Nguyen Quang-De , Zhao Xin , Liu Yang , Davicioni Elai , Spratt Daniel E. , Sabbioneda Simone , Maga Giovanni , Mucci Lorelei A. , Ghigna Claudia , Marchionni Luigi , Butler Lisa M. , Ellis Leigh , Bordeleau François , Loda Massimo , Vaira Valentina , Labbé David P. , Zadra Giorgia
Published: July 2024

Supplementary Figure S4 shows the effect of obesogenic high-fat diet on glycolytic enzymes and HIF-1 alpha in vivo.
Supplementary Figure S3 from Obesogenic High-Fat Diet and MYC Cooperate to Promote Lactate Accumulation and Tumor Microenvironment Remodeling in Prostate Cancer
Authors: Boufaied Nadia , Chetta Paolo , Hallal Tarek , Cacciatore Stefano , Lalli Daniela , Luthold Carole , Homsy Kevin , Imada Eddie L. , Syamala Sudeepa , Photopoulos Cornelia , Di Matteo Anna , de Polo Anna , Storaci Alessandra Maria , Huang Ying , Giunchi Francesca , Sheridan Patricia A. , Michelotti Gregory , Nguyen Quang-De , Zhao Xin , Liu Yang , Davicioni Elai , Spratt Daniel E. , Sabbioneda Simone , Maga Giovanni , Mucci Lorelei A. , Ghigna Claudia , Marchionni Luigi , Butler Lisa M. , Ellis Leigh , Bordeleau François , Loda Massimo , Vaira Valentina , Labbé David P. , Zadra Giorgia
Published: July 2024

Supplementary Figure S3 shows a graphical representation of key metabolic pathways altered by MYC alone or by obesogenic HFD in WT and MYC-transformed DLP.
Supplementary Figure S10 from Obesogenic High-Fat Diet and MYC Cooperate to Promote Lactate Accumulation and Tumor Microenvironment Remodeling in Prostate Cancer
Authors: Boufaied Nadia , Chetta Paolo , Hallal Tarek , Cacciatore Stefano , Lalli Daniela , Luthold Carole , Homsy Kevin , Imada Eddie L. , Syamala Sudeepa , Photopoulos Cornelia , Di Matteo Anna , de Polo Anna , Storaci Alessandra Maria , Huang Ying , Giunchi Francesca , Sheridan Patricia A. , Michelotti Gregory , Nguyen Quang-De , Zhao Xin , Liu Yang , Davicioni Elai , Spratt Daniel E. , Sabbioneda Simone , Maga Giovanni , Mucci Lorelei A. , Ghigna Claudia , Marchionni Luigi , Butler Lisa M. , Ellis Leigh , Bordeleau François , Loda Massimo , Vaira Valentina , Labbé David P. , Zadra Giorgia
Published: July 2024

Supplementary Figure S10 shows the output of human-based deconvolution model QuanTIseq.
Supplementary Figure S1 from Obesogenic High-Fat Diet and MYC Cooperate to Promote Lactate Accumulation and Tumor Microenvironment Remodeling in Prostate Cancer
Authors: Boufaied Nadia , Chetta Paolo , Hallal Tarek , Cacciatore Stefano , Lalli Daniela , Luthold Carole , Homsy Kevin , Imada Eddie L. , Syamala Sudeepa , Photopoulos Cornelia , Di Matteo Anna , de Polo Anna , Storaci Alessandra Maria , Huang Ying , Giunchi Francesca , Sheridan Patricia A. , Michelotti Gregory , Nguyen Quang-De , Zhao Xin , Liu Yang , Davicioni Elai , Spratt Daniel E. , Sabbioneda Simone , Maga Giovanni , Mucci Lorelei A. , Ghigna Claudia , Marchionni Luigi , Butler Lisa M. , Ellis Leigh , Bordeleau François , Loda Massimo , Vaira Valentina , Labbé David P. , Zadra Giorgia
Published: July 2024

Supplementary Figure S1 shows the systemic effects of HFD.
Supplementary Video S1 from Platform for Quantitative Evaluation of Spatial Intratumoral Heterogeneity in Multiplexed Fluorescence Images
Authors: Spagnolo Daniel M. , Al-Kofahi Yousef , Zhu Peihong , Lezon Timothy R. , Gough Albert , Stern Andrew M. , Lee Adrian V. , Ginty Fiona , Sarachan Brion , Taylor D. Lansing , Chennubhotla S. Chakra
Published: July 2024

THRIVE computer resource.
Data from CRAVAT 4: Cancer-Related Analysis of Variants Toolkit
Authors: Masica David L. , Douville Christopher , Tokheim Collin , Bhattacharya Rohit , Kim RyangGuk , Moad Kyle , Ryan Michael C. , Karchin Rachel
Published: July 2024

Abstract
Cancer sequencing studies are increasingly comprehensive and well powered, returning long lists of somatic mutations that can be difficult to sort and interpret. Diligent analysis and quality control can require multiple computational tools of distinct utility and producing disparate output, creating additional challenges for the investigator. The Cancer-Related Analysis of Variants Toolkit (CRAVAT) is an evolving suite of informatics tools for mutation interpretation that includes mutation mapping and quality control, impact prediction and extensive annotation, gene- and mutation-level interpretation, including joint prioritization of all nonsilent mutation consequence types, and structural and mechanistic visualization. Results from CRAVAT submissions are explored in an interactive, user-friendly web environment with dynamic filtering and sorting designed to highlight the most informative mutations, even in the context of very large studies. CRAVAT can be run on a public web portal, in the cloud, or downloaded for local use, and is easily integrated with other methods for cancer omics analysis. Cancer Res; 77(21); e35–38. ©2017 AACR.
Data from The ISB Cancer Genomics Cloud: A Flexible Cloud-Based Platform for Cancer Genomics Research
Authors: Reynolds Sheila M. , Miller Michael , Lee Phyliss , Leinonen Kalle , Paquette Suzanne M. , Rodebaugh Zack , Hahn Abigail , Gibbs David L. , Slagel Joseph , Longabaugh William J. , Dhankani Varsha , Reyes Madelyn , Pihl Todd , Backus Mark , Bookman Matthew , Deflaux Nicole , Bingham Jonathan , Pot David , Shmulevich Ilya
Published: July 2024

Abstract
The ISB Cancer Genomics Cloud (ISB-CGC) is one of three pilot projects funded by the National Cancer Institute to explore new approaches to computing on large cancer datasets in a cloud environment. With a focus on Data as a Service, the ISB-CGC offers multiple avenues for accessing and analyzing The Cancer Genome Atlas, TARGET, and other important references such as GENCODE and COSMIC using the Google Cloud Platform. The open approach allows researchers to choose approaches best suited to the task at hand: from analyzing terabytes of data using complex workflows to developing new analysis methods in common languages such as Python, R, and SQL; to using an interactive web application to create synthetic patient cohorts and to explore the wealth of available genomic data. Links to resources and documentation can be found at www.isb-cgc.org. Cancer Res; 77(21); e7–10. ©2017 AACR.
Figure S2 from Putrescine Supplementation Limits the Expansion of pks+ Escherichia coli and Tumor Development in the Colon
Authors: Oliero Manon , Cuisiniere Thibault , Ajayi Ayodeji S. , Gerkins Claire , Hajjar Roy , Fragoso Gabriela , Calvé Annie , Vennin Rendos Hervé , Mathieu-Denoncourt Annabelle , Dagbert François , De Broux Éric , Loungnarath Rasmy , Schwenter Frank , Sebajang Herawaty , Ratelle Richard , Wassef Ramses , Richard Carole , Duperthuy Marylise , Gravel Andrée E. , Vincent Antony T. , Santos Manuela M.
Published: July 2024

Figure S2 shows the effects of putrescine supplementation on cell proliferation
Transcranial Direct Current Stimulation for Food Craving in Women Affected by Overweight and Obesity: A Randomized Controlled Trial
Authors: Araújo de Oliveira Figueirêdo Heverton , Silva-Filho Edson , Felipe Cavalcante Antônio , Pegado Rodrigo , Cecília Queiroz de Medeiros Anna
Published: July 2024

Introduction: Craving is a multifactorial behavior caused by central circuit imbalance. The proposed treatments involve exercise and reduced food intake. However, the treatments frequently fail. This study aimed to investigate the effect of 10 consecutive sessions of anodal transcranial direct current stimulation over the right dorsolateral prefrontal cortex on food craving and eating consumption of women affected by overweight and obesity. Methods: A randomized double-blind controlled trial with 50 volunteers was divided into two groups (active-tDCS: n = 25 and sham-tDCS: n = 25). There were a total of 10 consecutive tDCS sessions (2 mA, for 20 min) with an F4 anodal-F3 cathodal montage. We evaluated the effects on eating behavior (food craving, uncontrolled eating, emotional eating, and cognitive restriction), food consumption (calories and macronutrients), and anthropometric and body composition variables (weight, body mass index, waist circumference, and body fat percentage). Results: There were no statistically significant results between groups at the baseline regarding sociodemographic and clinical characteristics. Also, there was no significant interaction between time versus group for any of the variables studied. Treatment with tDCS was well tolerated and there were no serious adverse effects. Conclusions: In women affected by overweight and obesity with food cravings, 10 sessions of F4 (anodal) and F3 (cathodal) tDCS did not produce changes in eating behavior, food consumption, and anthropometric and body composition.
Does a Vertebrate Morphotype of Pallial Subdivisions Really Exist?
Authors: Yamamoto Kei , Estienne Pierre , Bloch Solal
Published: July 2024

Background: Comparative neuroanatomists have long sought to determine which part of the pallium in nonmammals is homologous to the mammalian neocortex. A number of similar connectivity patterns across species have led to the idea that the basic organization of the vertebrate brain is relatively conserved; thus, efforts of the last decades have been focused on determining a vertebrate “morphotype” – a model comprising the characteristics believed to have been present in the last common ancestor of all vertebrates. Summary: The endeavor to determine the vertebrate morphotype has been riddled with controversies due to the extensive morphological diversity of the pallium among vertebrate taxa. Nonetheless, most proposed scenarios of pallial homology are variants of a common theme where the vertebrate pallium is subdivided into subdivisions homologous to the hippocampus, neocortex, piriform cortex, and amygdala, in a one-to-one manner. We review the rationales of major propositions of pallial homology and identify the source of the discrepancies behind different hypotheses. We consider that a source of discrepancies is the prevailing assumption that there is a single “morphotype of the pallial subdivisions” throughout vertebrates. Instead, pallial subdivisions present in different taxa probably evolved independently in each lineage. Key Messages: We encounter discrepancies when we search for a single morphotype of subdivisions across vertebrates. These discrepancies can be resolved by considering that several subdivisions within the pallium were established after the divergence of the different lineages. The differences of pallial organization are especially remarkable between actinopterygians (including teleost fishes) and other vertebrates. Thus, the prevailing notion of a simple one-to-one homology between the mammalian and teleost pallia needs to be reconsidered.
From Health Communication to Health Literacy: A Comprehensive Analysis of Relevance and Strategies
Authors: Caeiros Patrícia , Ferreira Patrícia Pita , Chen-Xu José , Francisco Rita , de Arriaga Miguel Telo
Published: July 2024

Health literacy, the ability to obtain and comprehend health knowledge, is essential to promote health and reduce disparities. Health communication aims to improve health by ensuring an effective understanding and application of health information. Despite current challenges, there are many opportunities for improving communication in the health literacy practice. Promoting communication in health literacy is essential in empowering individuals, improving outcomes, and reducing healthcare disparities. Effective communication enables access, comprehension, and informed decision-making of individuals and communities regarding their health, strengthening their central role in promoting health literacy. This paper highlights the challenges and opportunities in today’s world, especially in a post-pandemic era, dominated by infodemic and social media influencers, while providing solutions, encompassing professional training of health professionals on communication, digital skills, and an overarching strategy across health institutions. Translating knowledge into health-promoting behaviors and well-being can only be effective by accounting for communication in health literacy.
Intraocular Surgery for Retinoblastoma: An Evaluation of Current Evidence
Authors: Gurney Sam Peter , Abbott Joseph , Millen Gerard , Jenkinson Helen , Parulekar Manoj
Published: July 2024

Background: Retinoblastoma (Rb) is the most common intraocular malignancy of childhood. The prognosis in Rb directly relates to the spread of disease beyond the eye, particularly to the central nervous system. Therefore, until the recent past, surgically entering an eye with active or recently active Rb was absolutely contraindicated in most centres around the world due to the risk of iatrogenic extraocular spread. Summary: In this review article, we explore the role of intraocular surgery in Rb. We describe the techniques which have been developed in order to safely deliver chemotherapeutic agents into the eye, both intravitreal and intracameral. We discuss the role of vitrectomy and endoresection for treatment of vitreous seeds and active retinal tumours. In the context of previously treated Rb, we outline various surgical interventions performed to improve visual outcomes or to manage the ocular sequelae of the disease. In particular, we review the various techniques used to maximise the safety of cataract, retinal and glaucoma surgery in children with a history of Rb. Key Messages: The role of intraocular surgery in Rb is now well established, particularly in the delivery of chemotherapeutic agents or in the presence of previously treated diseases. The role of intraocular surgery in eyes with active Rb is less well established and remains the subject of much debate. However, it is likely that with further development of safer surgical techniques, the indications and modalities will continue to broaden.
The Relationship between Thyroid Hormones and Insulin Resistance in Polycystic Ovary Syndrome Women
Authors: Hao Xuefei , Ma Jing , Zhang Li , Meng Tiantian , Ma Qianqian
Published: July 2024

Objective: This study aimed to investigate the changes in thyroid hormones in the serum of patients with polycystic ovary syndrome (PCOS) and their correlation with insulin resistance. Design: This is a retrospective study. Participants: 84 patients having insulin resistance and 76 patients without insulin resistance were included. 90 women without history of PCOS were selected as a healthy control group. Settings: This study was conducted at Shijiazhuang Fourth Hospital. Methods: Blood samples were collected from each group on days 3–5 of their menstrual cycle, and their triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH) levels were analyzed and compared between groups. Results: We investigated the changes of serum thyroid hormones in patients with PCOS and their correlation with insulin resistance. We found that serum levels of T3 and T4 were significantly decreased, while TSH levels were significantly increased in PCOS patients compared with HCs. Moreover, we found that patients with insulin resistance had significantly lower levels of serum T3 and T4 and higher levels of TSH compared to those PCOS participants without insulin resistance. Limitations: This study was a retrospective and single-center study, which had selection bias, information bias, and confounding variables may affect the accuracy and reliability of the conclusion. Conclusions: Insulin resistance negative correlates with their serum T3, T4, and positive correlates with their TSH levels. Our results develop a combined test model with the serum T3, T4, and TSH levels for the clinical diagnosis of insulin resistance in PCOS women.
Value-Based Healthcare: A Primer for the Dermatologist
Authors: Balak Deepak M.W. , Deprez Elfie , Hilhorst Niels Timo , Hoorens Isabelle , Gutermuth Jan , Bos Willem Jan W. , Lambert Jo
Published: July 2024

Background: Value-based healthcare (VBHC) is an increasingly employed strategy to transform healthcare organizations into economically sustainable systems that deliver high-value care. In dermatology, the need for VBHC is evident as chronic skin diseases require long-term, often expensive treatments. This narrative review aims to introduce dermatologists to the principles and implementation of VBHC. Summary: VBHC emphasizes maximizing outcomes that are directly relevant to patients. Key components of VBHC include a systematic assessment of standardized patient-relevant outcomes by using core outcome sets and measurement of healthcare cost for the individual patient. Systematic reporting and comparing of risk-adjusted outcomes across the full cycle of care for a specific condition provide benchmarked feedback and actionable insights to promote high-value care and reduce low-value care. VBHC aims to organize care around the patient in condition-specific and team-based integrated practice units with multidisciplinary collaboration, utilize information technology platforms to enable digital data monitoring, reduce cost, and eventually reform payment systems to support bundled payments for the overall care cycle. VBHC implementation in practice necessitates the establishment of a systematic framework for outcome-based quality improvement, the incorporation of value and outcomes in shared decision-making practices, and the cultivation of a value-centric culture among healthcare professionals through continuous training. Key Messages: Dermatologists can benefit from implementing VBHC principles in their practice. An essential step toward value-driven dermatological care is to start measuring outcomes relevant for patients for each patient, which is lacking partly due to the absence of core outcome sets developed for clinical practice. By reducing low-value care and emphasizing optimal patient-centered outcomes, VBHC has the potential to improve the quality of care and ensure cost containment. Efforts are needed to enhance the development and uptake of VBHC in dermatological clinical practice to realize these benefits.
Cutaneous Reactions in Pediatric Patients Treated with MEK Inhibitors: A Retrospective Single-Center Study
Authors: Friedland Rivka , Glick Mirit , Amitay-Laish Iris , Toledano Helen
Published: July 2024

Introduction: Mitogen-activated extracellular signal-regulated kinase (MEK) inhibitors are in use for several indications for adults and children. Cutaneous toxicities are among the most common adverse effects. We aimed to describe the spectrum of cutaneous adverse events, its frequency, and severity in a cohort of pediatric patients. Methods: We reviewed all records of patients in our tertiary treatment center treated with MEK inhibitors between January 2016 and January 2023 for all indications. Results: Among 33 patients, 76% reported cutaneous adverse effects. The highest prevalence was in the group of patients treated with trametinib (90%), followed by the group treated with selumetinib (50%) and the group treated with a combination of trametinib and B-Raf proto-oncogene serine/threonine-protein kinase inhibitor (dabrafenib, 34%). Xerosis, dermatitis, paronychia, and hair heterochromia were most frequently reported. Severity was graded 1 or 2 for most adverse events, and 237 visits to the dermatology clinic related to these adverse events were recorded. Conclusions: Cutaneous adverse events are common in the pediatric population as in adults, but the clinical spectrum is different. Although considered mild, multiple dermatological consultations reflect the distress caused by these events. Dermatologists have a central role in the multidisciplinary care of pediatric patients receiving these agents.
TES and SLC40A1 as Potential Biomarkers for Predicting Survival in T-Cell Acute Lymphoblastic Leukemia
Authors: Zeng Xiangyou , Liu Kaifan , Xu Ruohao , Zhang Lenghe , Lai Peilong , Du Xin , Weng Jianyu
Published: July 2024

Introduction: Identifying patients with high-risk T-cell acute lymphoblastic leukemia (T-ALL) is crucial for personalized therapy; however, the lack of robust biomarkers hinders prognosis assessment. To address this issue, our study aimed to screen and validate genes whose expression may serve as predictive indicators of outcomes in T-ALL patients while also investigating the underlying molecular mechanisms. Methods: Differentially expressed genes (DEGs) between T-ALL patients and healthy controls were identified by integrating data from three independent public datasets. Functional annotation of these DEGs and protein-protein interactions were also conducted. Further, we enrolled a prospective cohort of T-ALL patients (n = 20) at our center, conducting RNA-seq analysis on their bone marrow samples. Survival-based univariate Cox analysis was employed to identify gene expressions related to survival, and an intersection algorithm was sequentially applied. Furthermore, we validated the identified genes using cases from the Therapeutically Applicable Research to Generate Effective Treatments database, plotting Kaplan-Meier curves for secondary validation. Results: Through the integration of survival-related genes with DEGs identified in T-ALL, our analysis revealed six T-ALL-specific genes, the expression levels of which were linked to prognostic value. Notably, the independent prognostic value of SLC40A1 and TES expression levels was confirmed in both an external cohort and a prospective cohort at our center. Conclusion: In summary, our preliminary study indicates that the expression levels of TES and SLC40A1 genes show promise as potential indicators for predicting survival outcomes in T-ALL patients.
Role of Pap Smear Cervical Cytology in the Diagnosis of Extrauterine Malignancies: Largest Study of 104 Cases from Tertiary Care Cancer Centre in India
Authors: Tandon Arshi , Kaur Kanwalpreet , Shah Majal , Trivedi Priti
Published: July 2024

Introduction: Extrauterine malignancies in cervical samples are rarely seen. It is important to differentiate these cells from those of primary uterine malignancies to determine appropriate line of further investigations and management. Literature on these lesions is limited largely restricted to case reports. The aim of the present study was to study the spectrum and cytomorphological features of extrauterine malignancies in cervical Pap smears. Materials and Methods: It is a retrospective and descriptive study conducted in Department of Cytopathology from January 2019 to July 2023. All cases of extrauterine malignancies with available cytology material were included in this study. All cases of primary uterine malignancies, i.e., uterine corpus or cervix confirmed by clinical, radiological, and histopathological examination were excluded. Results: 104 out of 11,674 cytology Pap smears were those of extrauterine malignancy. Diagnosis of extrauterine malignancy was given in 47.1% cases, 30.9% were reported as positive for malignancy without giving the possibility of an extrauterine origin, and 22.0% were reported as atypical glandular cells only. In 56 cases where Pap smear was the first investigation which led to the diagnosis. Most common extrauterine malignancy was adenocarcinoma principally from ovarian, colorectal, and vaginal origin. Other epithelial malignancies noted were urothelial carcinoma and invasive breast carcinoma. Among non-epithelial malignancies, we reported vaginal mucosal melanoma, cutaneous melanoma, acute leukaemia, and anaplastic large cell lymphoma. Conclusion: High index of suspicion, presence of squamous and glandular elements with no atypical features, and occasional clusters of cells with marked atypia and usually no necrosis in the background are helpful cytomorphological clues to raise suspicion for extrauterine malignancy. Correlation with serology, radiology, and immunocytochemistry can help in reaching final diagnosis.
Bridging the Gap between Dermatology and Psychiatry: A Review on Quality of Life in Trichotillomania and Special Considerations in Management
Authors: Onyemachi Jane , Nguyen Caroline , Nguyen Lynchi , Chukwuma Olivia , Muñoz-Gonzalez Ayezel
Published: July 2024

Background: Trichotillomania (TTM), also known as hair pulling disorder, is a chronic disorder that often leads to considerable emotional distress and functional impairment in affected individuals. Despite the strong underlying psychiatric component of TTM, the majority of individuals suffering from TTM initially may present to dermatologists because of their hair loss. This necessitates awareness and early recognition of TTM as well as familiarity with the unique considerations for its management. Summary: This study reviews the limited literature regarding quality of life in TTM, the methodologies employed to assess quality of life, and further explores the necessity of an interdisciplinary clinical approach to treatment. Several studies included in this review demonstrated the significant degree to which TTM reduces quality of life. Multiple treatment modalities for TTM have been successfully used in the literature that incorporate a comprehensive approach to management and ultimately address the underlying psychiatric component of TTM. Key Messages: TTM significantly reduces the quality of life in affected individuals. Successful management of TTM requires an interdisciplinary approach that bridges dermatology and psychiatry. Screening tools that assess the impact of TTM on quality of life are clinically useful and essential for early diagnosis and optimal management.
γδT Cells Induce the Inflammatory Response of Human Fibroblast-Like Synoviocytes Directly or by Stimulating B Cells to Activate IL-17/STAT3 Signaling Pathway
Authors: He Fang , Yu Juan , Ma Sha , Zhao Weiqing , Zhang Mingxing , Wang Juan , Zhang Chunpan , Wu Jiangping , Zhu Lixuan
Published: July 2024

Introduction: Rheumatoid arthritis (RA) combined with hashimoto thyroiditis (HT) is an important cause of various fatal comorbidities of RA. There is no precise conclusion about the cause of this disease. Methods: Peripheral blood and synovial tissue were collected from healthy participants, patients with RA, and patients with both RA and HT. Immunofluorescence staining and Pearson correlation analysis were used to detect the levels of γδTCR and the correlation between IL-17 and p-STAT3, respectively. ELISA, chemiluminescence assays, qRT-PCR and Western blot were performed to detect the levels of IgG, IgM, IFN-γ, IL-1β, TNF-α, Tg-Ab, Tpo-Ab, IL-17, IL-2, p-SATA3, and STAT3, respectively. Results: There was increased proportion of γδT cells, IL-17, and p-STAT3 levels in RA and HT patients. IL-17 was positively correlated with p-STAT3. γδT cells significantly promoted the expression of IgG, Tg-Ab, Tpo-Ab, and IL-17. When γδT and human fibroblast-like synoviocytes (FLSs) were co-cultured, the levels of IL-2, IFN-γ, IL-1β, TNF-α, and IL-17 were increased, and the IL-17/STAT3 signaling pathway was activated. When IL-17-silenced γδT cells and STAT3-silenced FLSs were co-cultured, the levels of IL-1β and TNF-α in FLSs were significantly decreased. Furthermore, when STAT3-silenced FLSs were added to the co-culture medium of B cells and γδT cells, the levels of IL-1β and TNF-α were also decreased significantly. Conclusion: γδT cells induced RA directly or by stimulating B cells to activate STAT3 through IL-17.
European Portuguese Version of the Game Addiction Scale-7: Factor Structure and Psychometric Properties
Authors: Massano-Cardoso Ilda , Nogueira Filipa , Carvalho Figueiredo Sofia , Galhardo Ana
Published: July 2024

Introduction: Game addiction (GA) can be described as a compulsive and excessive usage of computers or video games that causes emotional and or social problems. The current study tested the factor structure and psychometric properties of the European Portuguese Game Addiction Scale (GAS-7-PT) short version. Methods: The sample encompassed 375 participants, 233 women (62.1%) and 142 men (37.9%), with a mean age of 21.71 (standard deviation = 5.82) years old. Participants completed a set of self-report measures online: the GAS-7-PT, the Scale of Involvement in Video Games and the Patient Health Questionnaire-4. Results: Confirmatory factor analyses confirmed a biological sex invariant single-factor structure with a very good fit to the data. The GAS-7-PT showed good reliability and test-retest reliability. Correlations with related and unrelated measures suggested convergent validity, and partial correlation results pointed to incremental validity. Men showed significantly higher scores than women. Conclusion: The GAS-7-PT is a self-report instrument with suitable psychometric properties for clinical and research contexts. The availability of a European Portuguese version confirms the GAS-7 robust consistency and allows further cross-cultural clinical research.
Association between Perivascular Spaces Burden and Future Stroke Risk in Ischemic Stroke and Transient Ischemic Attack: A Systematic Review and Meta-Analysis
Authors: Lei Hanhan , Wu Xiaomin , Ambler Gareth , Werring David , Fang Shuangfang , Lin Huiyin , Huang Huapin , Liu Nan , Du Houwei
Published: July 2024

Introduction: This meta-analysis aimed to explore the association of perivascular spaces (PVS) burden with the risks of future stroke events and mortality in patients with ischemic stroke and transient ischemic attack (TIA). Methods: We systematically searched PubMed, Embase, and Cochrane database from inception to December 31, 2023. We included eligible studies that reported adjusted estimated effects for future intracranial hemorrhage (ICH), ischemic stroke, and mortality with baseline PVS burden in patients with ischemic stroke and TIA. Data were pooled using an inverse-variance method for the fixed effects (FE) model and a restricted maximum likelihood method for the random effects (RE) model. Results: Thirteen observational studies (5 prospective, 8 retrospective) were included, comprising 20,256 patients. Compared to 0–10 PVS at basal ganglia (BG-PVS), a higher burden (>10) of BG-PVS was significantly associated with an increased risk of future ICH (adjusted hazards ratio [aHR] 2.79, 95% confidence interval [CI]: 1.16–6.73, RE model; aHR 2.14, 95% CI: 1.34–3.41, FE model; I2 = 64%, n = 17,084 from four studies) followed up for at least 1 year. There was no significant association between >10 BG-PVS and ICH within 7 days after reperfusion therapy (adjusted odds ratio [aOR] 1.69, 95% CI: 0.74–3.88, RE model; aOR 1.43, 95% CI: 0.89–2.88, FE model; I2 = 67%, n = 1,176 from four studies). We did not detect a significant association of recurrent ischemic stroke, mortality, or disability with BG-PVS burden. Neither >10 PVS at centrum semiovale (CSO-PVS) nor increasing CSO-PVS burden was significantly associated with the risk of future intracranial hemorrhage or ischemic stroke recurrence. Conclusions: Current evidence suggests that a higher BG-PVS burden may be associated with an increased risk of future ICH in patients with ischemic stroke and TIA.
Prognostic Impact of High-Molecular-Weight von Willebrand Factor Multimer Ratio in Classical Low-Flow Low-Gradient Aortic Stenosis
Authors: Kellermair Joerg , Blessberger Hermann , Ott Helmut W. , Kammler Juergen , Kiblboeck Daniel , Reiter Christian , Grund Michael , Steinwender Clemens , Saeed Sahrai
Published: July 2024

Introduction: High-molecular-weight (HMW) von Willebrand factor (VWF) multimer deficiency occurs in classical low-flow, low-gradient (LF/LG) aortic stenosis (AS) due to shear force-induced proteolysis. The prognostic value of HMW VWF multimer deficiency is unknown. Therefore, we sought to evaluate the impact of HMW VWF multimer deficiency on clinical outcome. Methods: In this prospective research study, a total of 83 patients with classical LF/LG AS were included. All patients underwent dobutamine stress echocardiography to distinguish true-severe (TS) from pseudo-severe (PS) classical LF/LG AS. HMW VWF multimer ratio was calculated using densitometric Western blot band quantification. The primary endpoint was all-cause mortality. Results: Mean age was 79 ± 9 years, and TS classical LF/LG AS was diagnosed in 73% (n = 61) and PS classical LF/LG AS in 27% (n = 22) of all patients. Forty-six patients underwent aortic valve replacement (AVR) and 37 were treated conservatively. During a mean follow-up of 27 ± 17 months, 47 deaths occurred. Major bleeding complications after AVR (10/46; 22%) were more common in patients with HMW VWF multimer ratio <1 (8/17; 47%) in comparison to patients with a normal multimer pattern (2/29; 7%) at baseline (p = 0.003). In a multivariable Cox regression analysis, HMW VWF multimer deficiency was a predictor of all-cause mortality (HR: 3.02 [95% CI: 1.31–6.96], p = 0.009) in the entire cohort. This association was driven by higher mortality rates in the AVR group (multivariable-adjusted HR: 9.4; 95% CI 2.0–43.4, p = 0.004). Conclusions: This is the first study to demonstrate the predictive value of HMW VWF multimer ratio for risk stratification in patients with classical LF/LG AS. HMW VWF multimer deficiency was associated with an increased risk of all-cause mortality and major bleeding complications after AVR.
Electrical and Magnetic Neuromodulation Technologies and Brain-Computer Interfaces: Ethical Considerations for Enhancement of Brain Function in Healthy People – A Systematic Scoping Review
Authors: Ploesser Markus , Abraham Mickey Ellis , Broekman Marike Lianne Daphne , Zincke Miriam Tanja , Beach Craig Aaron , Urban Nina Beatrix , Ben-Haim Sharona
Published: July 2024

Introduction: This scoping review aimed to synthesize the fragmented evidence on ethical concerns related to the use of electrical and magnetic neuromodulation technologies, as well as brain-computer interfaces for enhancing brain function in healthy individuals, addressing the gaps in understanding spurred by rapid technological advancements and ongoing ethical debates. Methods: The following databases and interfaces were queried: MEDLINE (via PubMed), Web of Science, PhilPapers, and Google Scholar. Additional references were identified via bibliographies of included citations. References included experimental studies, reviews, opinion papers, and letters to editors published in peer-reviewed journals that explored the ethical implications of electrical and magnetic neuromodulation technologies and brain-computer interfaces for enhancement of brain function in healthy adult or pediatric populations. Results: A total of 23 articles were included in the review, of which the majority explored expert opinions in the form of qualitative studies or surveys as well as reviews. Two studies explored the view of laypersons on the topic. The majority of evidence pointed to ethical concerns relating to a lack of sufficient efficacy and safety data for these new technologies, with the risks of invasive procedures potentially outweighing the benefits. Additionally, concerns about potential socioeconomic consequences were raised that could further exacerbate existing socioeconomic inequalities, as well as the risk of changes to person and environment. Conclusion: This scoping review highlights a critical shortage of ethical research on electrical and magnetic neuromodulation technologies and brain-computer interfaces for enhancement of brain function in healthy individuals, with key concerns regarding the safety, efficacy, and socioeconomic impacts of neuromodulation technologies. It underscores the urgent need for integrating ethical considerations into neuroscientific research to address significant gaps and ensure equitable access and outcomes.
A Pilot Study Characterization of the Scalp Microbiome in Central Centrifugal Cicatricial Alopecia Shows Shift in Corynebacterium
Authors: Pyle Hunter J. , Dyson Taylor , Gadre Aditi , Harris-Tryon Tamia A. , Aguh Crystal
Published: July 2024

Introduction: Aberrant fibrosis in central centrifugal cicatricial alopecia (CCCA) is thought to be driven by persistent low-grade inflammation, but the source of inflammation is unclear. Alterations in the scalp microbiota may contribute to inflammation and thus provide a target for therapeutic intervention. We sought to compare the bacterial and fungal cutaneous scalp microbiota in patients with CCCA versus controls. Methods: Six patients with CCCA and seven controls were sampled at the vertex scalp. 16S rRNA sequencing of V3-V4 region and internal transcribed spacer amplicon sequencing was used to compare bacterial and fungal microbiomes. Results: A significantly higher relative abundance of Corynebacterium was noted in patients with CCCA versus controls. No significant difference in scalp fungal or bacterial microbiota composition was observed. Limitations: V3-V4 sequencing can be limited in detection of major skin bacterial species. Conclusion: CCCA is characterized by a distinct bacterial microbiome community and high relative abundances of Corynebacterium. Future studies should characterize the relationship between Corynebacterium and scalp inflammation and the role it may play in the progression of CCCA.
Periostin predicts all-cause mortality in male but not female end-stage renal disease patients on hemodialysis
Authors: Li Xitong , Liu Yvonne , Hocher Johann-Georg , Chu Chang , Reichetzeder Christoph , Kalk Philipp , Szakallova Angelika , Chen Xin , Krämer Bernhard K. , Tepel Martin , Hocher Berthold
Published: July 2024

Background: Periostin is a matricellular protein. Elevated serum concentrations of periostin have been reported in patients with various cardiovascular diseases, including heart failure. Patients with end-stage renal disease have a substantially increased risk for cardiovascular diseases. However, there is a lack of clinical studies to clarify the prognostic significance of systemic periostin on all-cause mortality in patients with end-stage renal disease on hemodialysis.

Methods: 313 stable end-stage renal disease patients were recruited and followed for five years concerning all-cause mortality. At baseline, we collected blood samples and clinical data. Serum periostin concentrations were measured using a certified ELISA.

Results: The optimal cut-off value for serum periostin regarding all-cause mortality, calculated through ROC analysis, was 777.5 pmol/l. Kaplan-Meier survival analysis using this cut-off value demonstrated that higher periostin concentrations are linked to higher all-cause mortality (log-rank test: P = 0.002). Subgroup analysis revealed that serum periostin concentrations only affected all-cause mortality in male but not in female patients (P = 0.002 in male patients and P = 0.474 in female patients). Multivariate Cox regression analyses, adjusted for confounding factors, likewise showed that elevated serum periostin concentrations were positively associated with all-cause mortality in male (P = 0.028) but not in female patients on hemodialysis (P = 0.313).

Conclusion: Baseline serum periostin is an independent risk factor for all-cause mortality in male patients with chronic renal disease on hemodialysis.
Global Adrenal Insufficiency in Two Independent Patients Carrying the Same Homozygous c.172A>G, p.(Thr58Ala) Mutation in the TBX19 Gene
Authors: Holterhus Paul-Martin , Roll Claudia , Gaida Barbara , Richter-Unruh Annette , Kulle Alexandra E. , Kaschta Daniel , Hartmann Michaela F. , Wudy Stefan A. , Reinehr Thomas
Published: July 2024

Introduction: TBX19 mutations cause isolated ACTH-deficiency. While this classically results in severe hypocortisolism, potential consequences for mineralocorticoid biosynthesis have not been described to date. Liquid chromatography mass spectrometry (LC-MS/MS) and gas chromatography mass spectrometry (GC-MS) allow novel insights into the steroid metabolism of pediatric endocrine diseases. Case Presentation: Patient 1 (female) presented right after birth with hypoglycemia and hyponatremia (minimum sodium 126 mmol/L). She recovered under therapy with hydrocortisone, fludrocortisone and initial NaCl. Patient 2 (male) presented after birth with prolonged cholestatic jaundice. Only at the age of 3.5 months, repeated episodes of hypoglycemia occurred. Both patients showed severely reduced ACTH. LC-MS/MS analyses on plasma samples demonstrated combined reduced glucocorticoid- and mineralocorticoid biosynthesis confirmed by GC-MS analyses on spot urine. In contrast to patient 1, patient 2 (currently 8 years old) never suffered from hyponatremia. Both patients carry the same homozygous c.172A>G, p.(Thr58Ala) mutation in the TBX19 gene proving isolated ACTH-deficiency. Conclusion: Isolated ACTH-deficiency can be associated with reduced mineralocorticoids and hyponatremia. We hypothesize that sufficient pituitary ACTH secretion is an important predisposition for regular adrenal mineralocorticoid biosynthesis.
Psychological Benefits of a Preoperative Educational Bridging Program for Bariatric Surgery: Does Face-to-Face versus Videoconference-Based Delivery Make a Difference?
Authors: Lau Teresa , Schild Sandra , Klos Bea , Schraml Jessica , Archid Rami , Stengel Andreas , Nieß Andreas , Erz Gunnar , Zipfel Stephan , Mack Isabelle
Published: July 2024

Introduction: Short educational programs prior to metabolic and bariatric surgery (MBS) provide information to prepare patients adequately for surgery and subsequent changes. Our knowledge of the beneficial effects of these programs on stabilizing and improving mental health of patients with obesity awaiting surgery is incomplete. The objective of this study was to assess the effects of a group-based educational program before MBS on three key factors: (i) patients’ mental health, (ii) the program’s perceived helpfulness from the patients’ perspective, and (iii) the effectiveness of delivering the program online via videoconferencing. Methods: Validated questionnaires for anxiety, depression, stress, and quality of life before and after the program were assessed. Additionally, participants’ perspectives of benefits were assessed. Two subgroups, one participating in face-to-face classes, the other participating online via videoconferencing, were compared. Results: Three hundred five patients with obesity waiting for MBS participated in the program. The dropout rate was 3%. On mean average, symptoms of anxiety (−1.1 units [SD 4.6], p < 0.001), depression (−0.9 units [SD 4.6], p < 0.001), and stress (−4.6 units [SD 15.6], p < 0.001) improved, while physical quality of life (+1.7 units [SD 9.7], p = 0.016) and body weight (−0.3 kg [SD 8.7], p = 0.57) remained stable. Patients perceived the program as very beneficial. The results were similar between delivery methods (face-to-face vs. videoconferencing). Conclusion: The educational program proved to be effective in bridging the gap in preoperative preparation while also stabilizing participants’ mental health. In addition, participants perceived the program as supportive. Online participation via video conferencing can be offered as an equivalent option to face-to-face classes.