bluuebunny/crossref_metadata_2025 huggingface dataset:
The deformities of acute diaphyseal clavicular fractures: a three-dimensional analysis
Authors: Chao Yi-Hsuan , Chou Ying-Chao , Lin Chun-Li
Published: May 2023

Background

Although minimally invasive surgeries have gained popularity in many orthopaedic fields, minimally invasive approaches for diaphyseal clavicular fracture have not been widely performed, which is attributed to difficulties in performing a closed reduction of fracture deformities of a curved bone in a three-dimensional space. The goal of this study was to investigate the radiographic parameters of fracture deformities in a three-dimensional space and to identify the risk factors for deformities.

Methods

The computed tomography images of 100 patients who sustained a clavicle fracture were included. Five parameters were used to analyze the deformities: change in clavicle length, fracture displacement, and fragment rotation around the X, Y, Z axes. The change in length was assessed using the length of the endpoint line. The displacement was assessed using the distance between the fracture midpoints. The rotation deformities were assessed using the Euler angles. The correlation between the parameters was evaluated with the Pearson correlation coefficient. The risk factors were evaluated using univariable analysis and multiple regression analysis.

Results

The average change in length was − 5.3 ± 8.3 mm. The displacement was 11.8 ± 7.1 mm. The Euler angles in the Z-Y-X sequences were -1 ± 8, 1 ± 8, and − 8 ± 13 degrees. The correlation coefficient between the change in length and the displacement was − 0.724 (p < 0.001). The variables found to increase the risk of shortening and displacement were right-sided fracture (p = 0.037), male sex (p = 0.015), and multifragmentary type (p = 0.020). The variables found to increase the risk of rotation deformity were the number of rib fractures (p = 0.001) and scapula fracture (p = 0.025).

Conclusions

There was a strong correlation between shortening and displacement. The magnitude of anterorotation around the X axis was greater than the magnitude of retraction around the Z axis and depression around the Y axis. The risk factors for shortening and displacement included right-sided fracture, male sex, and multifragmentary type. The risk factor for retraction around the Z axis was the number of rib fractures, and the risk factor for depression around the Y axis was scapula fracture. These results could be useful adjuncts in guiding minimally invasive surgical planning for diaphyseal clavicular fractures.
Determinants of maternal and neonatal PFAS concentrations: a review
Authors: McAdam Jordan , Bell Erin M.
Published: May 2023

Per- and polyfluoroalkyl substances (PFAS) are used for their properties such as stain and water resistance. The substances have been associated with adverse health outcomes in both pregnant mothers and infants, including pre-eclampsia and low birthweight. A growing body of research suggests that PFAS are transferred from mother to fetus through the placenta, leading to in utero exposure. A systematic review was performed using the PubMed database to search for studies evaluating determinants of PFAS concentrations in blood matrices of pregnant mothers and neonates shortly after birth. Studies were included in this review if an observational study design was utilized, exposure to at least one PFAS analyte was measured, PFAS were measured in maternal or neonatal matrices, at least one determinant of PFAS concentrations was assessed, and results such as beta estimates were provided. We identified 35 studies for inclusion in the review and evaluated the PFAS and determinant relationships among the factors collected in these studies. Parity, breastfeeding history, maternal race and country of origin, and household income had the strongest and most consistent evidence to support their roles as determinants of certain PFAS concentrations in pregnant mothers. Reported study findings on smoking status, alcohol consumption, and pre-pregnancy body mass index (BMI) suggest that these factors are not important determinants of PFAS concentrations in pregnant mothers or neonates. Further study into informative factors such as consumer product use, detailed dietary information, and consumed water sources as potential determinants of maternal or neonatal PFAS concentrations is needed. Research on determinants of maternal or neonatal PFAS concentrations is critical to estimate past PFAS exposure, build improved exposure models, and further our understanding on dose–response relationships, which can influence epidemiological studies and risk assessment evaluations. Given the potential for adverse outcomes in pregnant mothers and neonates exposed to PFAS, it is important to identify and understand determinants of maternal and neonatal PFAS concentrations to better implement public health interventions in these populations.
Carbon dots-mediated synthesis of gold nanodendrites with extended absorption into NIR-II window for in vivo photothermal therapy
Authors: Liu Guoyong , Wang Shuxian , Wang Shumin , Wu Rongrong , Li Hui , Zha Menglei , Song Jibin , Yin Yuxin , Li Kai , Mu Jing , Shi Yu
Published: May 2023

Background

Photothermal therapy (PTT) in the second near-infrared (NIR-II) window has attracted extensive attention due to the benefits in high maximum permissible exposure and penetration depth. Current photothermal agents generally show a broadband absorption accompanied by a gradual attenuation of absorption in the NIR-II window, leading to poor effect of PTT. It remains a great challenge to gain photothermal agents with strong and characteristic absorption in NIR-II regions. To overcome this problem, based on carbon dots (CDs)-mediated growth strategy, we proposed a simple and feasible approach to prepare plasmonic gold nanodendrites (AuNDs) with NIR-II absorption to enhance the therapeutic effect of PTT.

Results

By rationally regulating the size and branch length of AuNDs, the AuNDs exhibited a broadband absorption from 300 to 1350 nm, with two characteristic absorption peaks located at 1077 and 1265 nm. The AuNDs demonstrated desired optical photothermal conversion efficiency (38.0%), which was further applied in NIR-II photoacoustic imaging (PAI) and PTT in human colon cancer cells (HCT 116)-tumor-bearing mice model. The tumor cells could be effectively eliminated in vivo under 1064 nm laser irradiation by the guidance of PAI.

Conclusions

We reported a simple but powerful synthetic method to obtain the unique AuNDs with strong and characteristic absorption peaks in the NIR-II window. This study provides a promising solution to tuning the growth of nanoparticles for bioimaging and phototherapy in the NIR-II window.

Graphical Abstract
Advanced glycation end-products and its soluble receptor are not independent predictors of incident dysglycaemia or metabolic syndrome in women with polycystic ovary syndrome: a prospective observational study
Authors: Tong Yu Wing , Ko Jennifer Ka Yee , Lam Karen Siu Ling , Tam Sidney , Lee Vivian Chi Yan , Ho Pak Chung , Ng Ernest Hung Yu , Li Raymond Hang Wun
Published: May 2023

Background

To evaluate the association of serum advanced glycation end-products (AGEs) and its soluble receptor of AGE (sRAGE) levels with dysglycaemia and metabolic syndrome in women with polycystic ovary syndrome (PCOS).

Methods

This was an analysis of a cohort of women with PCOS who were prospectively recruited for a longitudinal observational study on their endocrine and metabolic profile between January 2010 and December 2013. The association of serum AGEs and sRAGE levels with dysglycaemia and metabolic syndrome at the second-year visit (the index visit) and the sixth-year visit (the outcome visit) were determined. Comparisons of continuous variables between groups were made using the Mann–Whitney U-test. Spearman test was used for correlation analysis. Multivariate binary logistic regression analysis was employed to identify the factors independently associated with the outcome events.

Results

A total of 329 women were analysed at the index visit. Significantly lower serum levels of sRAGE (both p < 0.001), but no significant difference in AGEs, were observed in those with dysglycaemia or metabolic syndrome. At the outcome visit, those with incident metabolic syndrome had a significantly lower initial serum sRAGE levels (p = 0.008). The association of serum sRAGE with dysglycaemia and metabolic syndrome at the index visit was no longer significant in multivariate logistic regression after controlling for body mass index, free androgen index and homeostatic model assessment for insulin resistance (HOMA-IR). sRAGE was also not significantly associated with incident metabolic syndrome at the outcome visit on multivariate logistic regression.

Conclusions

Serum sRAGE levels are significantly lower in women with PCOS who have dysglycaemia or metabolic syndrome, and in those developing incident metabolic syndrome in four years. However, it does not have a significant independent association with these outcome measures after adjusting for body mass index, free androgen index and HOMA-IR.
25KDa branched polyethylenimine increases interferon-γ production in natural killer cells via improving translation efficiency
Authors: Ko Eun-Su , Choi Seung Hee , Lee Minwook , Park Kyung-Soon
Published: May 2023

Background

Ex vivo cultivation is a promising strategy for increasing the number of NK cells and enhancing their antitumor activity prior to clinical application. Recent studies show that stimulation with 25KDa branched polyethylenimine (25KbPEI) generates NK cells with enhanced antitumor activity. To better understand how 25KbPEI primes NK cells, we explored the mechanism underlying increase in production of IFN-γ.

Methods

Chemical priming was performed on NK-92MI cells by incubating them with 5 μg/ml of 25KbPEI. The production of IFN-γ was evaluated by RT-qPCR, ELISA, and Flow cytometry. By evaluating the effect of pharmacological inhibition of ERK/mTOR-eIF4E signaling pathways on IFN-γ translation, the function of these signaling pathways in IFN-γ translation was examined. To comprehend the level of 25KbPEI activity on immune-related components in NK cells, RNA sequencing and proteomics analyses were conducted.

Results

25KbPEI enhances the production of IFN-γ by NK cells without transcriptional activation. Activation of ERK and mTOR signaling pathways was found to be associated with 25KbPEI-mediated calcium influx in NK cells. The activation of ERK/mTOR signaling was linked to the phosphorylation of 4E-BP1, which resulted in the activation of translation initiation complex and subsequent IFN-γ translation. Analysis of RNA sequencing and proteomics data revealed that the activity of 25KbPEI to improve translation efficiency in NK cells could be extended to additional immune-related molecules.

Conclusions

This study provides substantial insight into the process by which 25KbPEI primes NK cells. Our data demonstrated that the 25KbPEI mediated activation of ERK/mTOR signaling and subsequent stimulation of eIF4E is the primary mechanism by which the chemical stimulates translation of IFN-γ in NK cells.
Qualitative assessment of providers’ experiences with a segmentation counseling tool for family planning in Niger
Authors: MacLachlan Ellen , Agali Balki Ibrahim , Maytan-Joneydi Amelia , Chaibou Sanoussi , Garba Souleymane Amadou , Halidou Illiassou Chaibou , Speizer Ilene S. , Nouhou Abdoul Moumouni
Published: May 2023

Introduction

This study examines experiences with a family planning segmentation counseling tool that is used during the provision of family planning services. Based on answers to a series of questions, women are segmented into one of five categories of family planning users and counseled based on their identified segment. This study aimed to qualitatively assess provider perspectives on implementation of the tool.

Methods

Semi-structured in-depth interviews took place in the Dosso region of Niger among 16 family planning providers who had been trained in segmentation and were currently using the segmentation tool. The facilities chosen for interviews were part of a larger mixed methods study assessing the impact of using the segmentation approach. Interview questions focused on training, supervision, how segmentation occurs at the health facility, how segmentation changes provider–client interactions, and any difficulties faced with implementation. Interviews were translated and transcribed into French and data were coded and thematically analyzed.

Results

All providers in the study reported positive outcomes associated with segmentation. While providers acknowledged that the segmentation approach added time to the clinic visit, they did see the benefit of this extra time in providing more meaningful interactions between clients and providers, leaving clients with a deeper understanding of family planning and of the different methods available. The implementation of the tool did not change other aspects of service delivery, except that a segmentation sheet was required to be filled in and kept in each patient’s file. Difficulties reported included translating the segmentation tool questions into local languages, training enough health care providers and avoiding stock outs of the segmentation sheets.

Conclusion

The segmentation process is of benefit to family planning clients in Niger and the scale-up of the strategy could bring higher quality services to women. If this approach is brought to scale the implementation challenges uncovered need to be addressed, especially adequate training. Further research is needed to determine if segmentation leads to changes in family planning use outcomes.
Psychosocial impacts of the COVID-19 pandemic from a cross-sectional Survey of people living with HIV in Washington, DC
Authors: Monroe Anne K. , Kulie Paige E. , Byrne Morgan E. , Wilbourn Brittany C. , Barth Shannon K. , Resnik Jenna B. , Huebner David M. , Horberg Michael A. , Castel Amanda D. , Greenberg Alan E. ,   the DC Cohort Executive Committee
Published: May 2023

Background

COVID-19 has not only taken a staggering toll in terms of cases and lives lost, but also in its psychosocial effects. We assessed the psychosocial impacts of the COVID-19 pandemic in a large cohort of people with HIV (PWH) in Washington DC and evaluated the association of various demographic and clinical characteristics with psychosocial impacts.

Methods

From October 2020 to December 2021, DC Cohort participants were invited to complete a survey capturing psychosocial outcomes influenced by the COVID-19 pandemic. Some demographic variables were also collected in the survey, and survey results were matched to additional demographic data and laboratory data from the DC Cohort database. Data analyses included descriptive statistics and multivariable logistic regression models to evaluate the association between demographic and clinical characteristics and psychosocial impacts, assessed individually and in overarching categories (financial/employment, mental health, decreased social connection, and substance use).

Results

Of 891 participants, the median age was 46 years old, 65% were male, and 76% were of non-Hispanic Black race/ethnicity. The most commonly reported psychosocial impact categories were mental health (78% of sample) and financial/employment (56% of sample). In our sample, older age was protective against all adverse psychosocial impacts. Additionally, those who were more educated reported fewer financial impacts but more mental health impacts, decreased social connection, and increased substance use. Males reported increased substance use compared with females.

Conclusions

The COVID-19 pandemic has had substantial psychosocial impacts on PWH, and resiliency may have helped shield older adults from some of these effects. As the pandemic continues, measures to aid groups vulnerable to these psychosocial impacts are critical to help ensure continued success towards healthy living with HIV.
On latches in biological systems: a comparative morphological and functional study of the retinaculum and the dens lock in Collembola
Authors: Rillich Birk , Oliveira Fábio G. L.
Published: May 2023

Background

Springtails have the ability to jump using morphological structures consisting of a catapult, the furca, and a latching system constructed with interaction of the retinaculum and the dens lock. The retinaculum engages in the furca at the dens lock in order to form a spring mechanism. They exhibit diversified morphological traits that serve as adaptations to a variety of terrestrial strata and aquatic surface environments. This comparative morphofunctional study centered on the retinaculum and the furcular region of the dens lock aims to describe the morphological variation between taxa and provide insights into the functional dynamics of the latching mechanism at work in the jumping apparatus. Using SEM, µCT and cLSM, we compared representatives of Collembola taxa, Poduromorpha (Neanura muscorumandPodura aquatica), Symphypleona (Dicyrtomina ornata) and Neelipleona (Megalothorax minimus), and examined extracts of the environment in which they were collected.

Results

A retinaculum is absent inN. muscorum, although vestigial muscles were found. Abdominal musculature varies significantly, being more abundant in springtails with clear segmentation (N. muscorumandP. aquatica), and reduced in springtails with fused segmentation (D. ornataandM. minimus). The M.a-ret varies as regards architecture and point of connection with the ramus, which is lateral inP. aquaticaand median in the other species studied. The number of teeth in the retinaculum ramus also varies between three inM. minimusand four in the other species. The dens lock of all species studied has two locks and two furrows.

Conclusions

The retinaculum and dens lock interact in a key-lock relationship. The latching and unlatching mechanism from the retinaculum and dens lock appear to be similar in all the taxa examined, occurring by muscle force. This leads us to question the hypothesis that hemolymph pressure may be a force generator in jumping. We offer a reconstruction of the ground pattern of the retinaculum and dens lock and, in addition, an explanation of their functioning and the interaction between them. Finally, we frame the interaction between the retinaculum and the dens lock as a latch in a biological system, a mechanism which functions by force of physical contact.
Metastases to the kidney from primary lung cancer : clinicopathological analysis of six cases in a single center
Authors: Lian Hui , Pan Xinyu , Hong Bo , Min Jie , Huang Fengbo
Published: May 2023

Objectives

Cancer metastasis to the kidney is a rare event. We retrospectively analyzed clinicopathologic characteristics in 6 cases of diagnosed renal metastases from primary lung cancer. We also provide clinical follow-up data and brief review of the literature.

Methods

Immunohistochemistry was used to evaluate the expression of TTF-1, NapsinA, CK7, CK(AE1/AE3), P63, P40, CgA, PAX-8, GATA3 and Ki-67 in primary tumor and metastases. Additionally, the clinical characteristics, imaging features, diagnosis, and treatment were analyzed.

Results

With the help of immunohistochemistry and combined clinical history, we found four cases were lung adenocarcinomas, one case was lung squamous cell carcinoma, and the other case was lung small cell carcinoma metastases to the kidney.The patients were all male by gender and had a mean age of 62 years, and metastasis to the left kidney were more universal. Most of the tumors histological grade originating from the lung were poorly-moderately differentiated, and the time to metastasis to the kidney was relatively short for squamous lung cancer and small cell lung cancer, while the time to metastasis for lung adenocarcinoma was related to its degree of differentiation. Overall, we found the prognosis of lung cancer patients with renal metastases were poor especially with multi-site metastases.

Conclusions

Distinguishing primary and secondary tumors of the kidney is essential to guide treatment and prevent unnecessary surgery, so clinical information, radiology, histological correlation of the primary tumor, and immunohistochemical findings help the pathologist determine correct diagnosis.
Study design and protocol of a stepped wedge cluster randomized trial using a practical implementation strategy as a model for hypertension-HIV integration — the MAP-IT trial
Authors: Aifah Angela A. , Hade Erinn M. , Colvin Calvin , Henry Daniel , Mishra Shivani , Rakhra Ashlin , Onakomaiya Deborah , Ekanem Anyiekere , Shedul Gabriel , Bansal Geetha P. , Lew Daphne , Kanneh Nafesa , Osagie Samuel , Udoh Ememobong , Okon Esther , Iwelunmor Juliet , Attah Angela , Ogedegbe Gbenga , Ojji Dike
Published: May 2023

Background

As people living with HIV (PLWH) experience earlier and more pronounced onset of noncommunicable diseases (NCDs), advancing integrated care networks and models in low-resource-high-need settings is critical. Leveraging current health system initiatives and addressing gaps in treatment for PLWH, we report our approach using a late-stage (T4) implementation research study to test the adoption and sustainability of a proven-effective implementation strategy which has been minimally applied in low-resource settings for the integration of hypertension control into HIV treatment. We detail our protocol for the Managing Hypertension Among People Living with HIV: an Integrated Model (MAP-IT) trial, which uses a stepped wedge cluster randomized trial (SW-CRT) design to evaluate the effectiveness of practice facilitation on the adoption of a hypertension treatment program for PLWH receiving care at primary healthcare centers (PHCs) in Akwa Ibom State, Nigeria.

Design

In partnership with the Nigerian Federal Ministry of Health (FMOH) and community organizations, the MAP-IT trial takes place in 30 PHCs. The i-PARiHS framework guided pre-implementation needs assessment. The RE-AIM framework will guide post-implementation activities to evaluate the effect of practice facilitation on the adoption, implementation fidelity, and sustainability of a hypertension program, as well as blood pressure (BP) control. Using a SW-CRT design, PHCs sequentially crossover from the hypertension program only (usual care) to hypertension plus practice facilitation (experimental condition). PHCs will recruit and enroll an average of 28–32 patients to reach a maximum of 960 PLWH participants with uncontrolled hypertension who will be followed longitudinally for BP outcomes.

Discussion

Given the need for integrated NCD-HIV care platforms in low-resource settings, MAP-IT will underscore the challenges and opportunities for integrating hypertension treatment into HIV care, particularly concerning adoption and sustainability. The evaluation of our integration approach will also highlight the potential impact of a health systems strengthening approach on BP control among PLWH.

Trial registration

Clinicaltrials.gov (NCT05031819). Registered on 2nd September 2021.
Development and validation of a radiomics model of magnetic resonance for predicting liver metastasis in resectable pancreatic ductal adenocarcinoma patients
Authors: Huang Yuzhou , Zhou Shurui , Luo Yanji , Zou Jinmao , Li Yaqing , Chen Shaojie , Gao Ming , Huang Kaihong , Lian Guoda
Published: May 2023

Background

Nearly one fourth of patients with pancreatic ductal adenocarcinoma (PDAC) occur to liver metastasis after surgery, and liver metastasis is a risk factor for prognosis for those patients with surgery therapy. However, there is no effective way to predict liver metastasis post-operation.

Method

Clinical data and preoperative magnetic resonance imaging (MRI) of PDAC patients diagnosed between July 2010 and July 2020 were retrospectively collected from three hospital centers in China. The significant MRI radiomics features or clinicopathological characteristics were used to establish a model to predict liver metastasis in the development and validation cohort.

Results

A total of 204 PDAC patients from three hospital centers were divided randomly (7:3) into development and validation cohort. Due to poor predictive value of clinical features, MRI radiomics model had similar receiver operating characteristics curve (ROC) value to clinical-radiomics combing model in development cohort (0.878 vs. 0.880, p = 0.897) but better ROC in validation dataset (0.815 vs. 0.732, p = 0.022). Radiomics model got a sensitivity of 0.872/0.750 and a specificity of 0.760/0.822 to predict liver metastasis in development and validation cohort, respectively. Among 54 patients randomly selected with post-operation specimens, fibrosis markers (α-smooth muscle actin) staining was shown to promote radiomics model with ROC value from 0.772 to 0.923 (p = 0.049) to predict liver metastasis.

Conclusion

This study developed and validated an MRI-based radiomics model and showed a good performance in predicting liver metastasis in resectable PDAC patients.
MiR-217 regulates autophagy through OPG/RANKL/RANK in giant cell tumors
Authors: Meng Chenyang , Jiang Boyong , Liu Wanlin , Wang Lianjuan , Zhao Zhenqun , Bai Rui , Zhao Yan
Published: May 2023

Background

Increasing evidence suggests that microRNAs (miRNAs) play a crucial role in cancer development and progression. Our previous study showed remarkably lower levels of miR-217 in GCT cells and tissues, and miR-217 re-expression inhibited the occurrence and development of GCT in vitro; however, the associated mechanisms remain unknown. Thus, this study aimed to explore the mechanisms underlying the proliferation inhibitory effect of miR-217 in GCT cells.

Methods

The proliferative potential of the GCT cells was measured with an MTT assay and BrdU straining. Changes in GCT cell migration and invasion was assessed by a transwell assay. Finally, Western blot and RT-PCR assays were employed to evaluate OPG/RANKL/RANK signaling pathway-related protein expression.

Results

The excessive upregulation of miR-217 markedly suppressed GCT cell proliferation and tumorigenesis both in vitro and in vivo. miR-217 overexpression could inhibit the OPG/RANKL/RANK signaling pathway in vitro and in vivo. Furthermore, ALP activity was significantly decreased in GCT cells following miR-217 treatment. Importantly, miR-217 could inhibit autophagy-related protein expression and autophagosome/autolysosome formation in GCT cells and tissues.

Conclusion

These results suggest that miR-217 upregulation could inhibit the occurrence and development of GCT by blocking autophagy. These findings offer an effective therapeutic target to improve the survival rates of patients with CGT in the future.
Total hip arthroplasty for failed internal fixation of femoral neck fracture: a retrospective study with 2–14 years’ follow-up of 345 patients
Authors: Lu Hanpeng , Zhu Niu , Ling Tingxian , Cao Jian , Xu Hong , Zhou Kai , Zhao Enze , Zhou Zongke
Published: May 2023

Objectives

The purpose of this study was to analyze mid- to long-term outcomes of total hip arthroplasty (THA) following failed internal fixation of femoral neck fracture.

Methods

This study retrospectively analyzed 345 patients with femoral neck fracture who underwent THA after failure of internal fixation at our hospital between January, 2003 and December, 2019. Patients older than 55 years (n = 175) and patients no older than 55 years (n = 170) were compared in terms of complications and survival rates during follow-up, which lasted a mean of 6 years.

Results

The two age groups showed similarly low incidence of complications and similarly long periods of survival without revision surgery. Only three younger patients and two older patients underwent revision surgery during follow-up. The two groups showed similarly high survival rates at the end of follow-up (> 93%). Younger patients showed significantly bettter Harris hip score at last follow-up (90.2 vs. 88.1 points, p < 0.001) without clinically significant difference, but they required THA significantly earlier after internal fixation (4.4 vs. 6.8 years, p < 0.001).

Conclusions

THA after failed internal fixation of femoral neck fracture is a well tolerated and effective procedure in older and younger patients.
Novel computational biology modeling system can accurately forecast response to neoadjuvant therapy in early breast cancer
Authors: Peterson Joseph R. , Cole John A. , Pfeiffer John R. , Norris Gregory H. , Zhang Yuhan , Lopez-Ramos Dorys , Pandey Tushar , Biancalana Matthew , Esslinger Hope R. , Antony Anuja K. , Takiar Vinita
Published: May 2023

Background

Generalizable population-based studies are unable to account for individual tumor heterogeneity that contributes to variability in a patient’s response to physician-chosen therapy. Although molecular characterization of tumors has advanced precision medicine, in early-stage and locally advanced breast cancer patients, predicting a patient’s response to neoadjuvant therapy (NAT) remains a gap in current clinical practice. Here, we perform a study in an independent cohort of early-stage and locally advanced breast cancer patients to forecast tumor response to NAT and assess the stability of a previously validated biophysical simulation platform.

Methods

A single-blinded study was performed using a retrospective database from a single institution (9/2014–12/2020). Patients included: ≥ 18 years with breast cancer who completed NAT, with pre-treatment dynamic contrast enhanced magnetic resonance imaging. Demographics, chemotherapy, baseline (pre-treatment) MRI and pathologic data were input into the TumorScope Predict (TS) biophysical simulation platform to generate predictions. Primary outcomes included predictions of pathological complete response (pCR) versus residual disease (RD) and final volume for each tumor. For validation, post-NAT predicted pCR and tumor volumes were compared to actual pathological assessment and MRI-assessed volumes. Predicted pCR was pre-defined as residual tumor volume ≤ 0.01 cm3 (≥ 99.9% reduction).

Results

The cohort consisted of eighty patients; 36 Caucasian and 40 African American. Most tumors were high-grade (54.4% grade 3) invasive ductal carcinomas (90.0%). Receptor subtypes included hormone receptor positive (HR+)/human epidermal growth factor receptor 2 positive (HER2+, 30%), HR+/HER2− (35%), HR−/HER2+ (12.5%) and triple negative breast cancer (TNBC, 22.5%). Simulated tumor volume was significantly correlated with post-treatment radiographic MRI calculated volumes (r = 0.53, p = 1.3 × 10–7, mean absolute error of 6.57%). TS prediction of pCR compared favorably to pathological assessment (pCR: TS n = 28; Path n = 27; RD: TS n = 52; Path n = 53), for an overall accuracy of 91.2% (95% CI: 82.8% – 96.4%; Clopper–Pearson interval). Five-year risk of recurrence demonstrated similar prognostic performance between TS predictions (Hazard ratio (HR): − 1.99; 95% CI [− 3.96, − 0.02]; p = 0.043) and clinically assessed pCR (HR: − 1.76; 95% CI [− 3.75, 0.23]; p = 0.054).

Conclusion

We demonstrated TS ability to simulate and model tumor in vivo conditions in silico and forecast volume response to NAT across breast tumor subtypes.
High-throughput deep learning variant effect prediction with Sequence UNET
Authors: Dunham Alistair S. , Beltrao Pedro , AlQuraishi Mohammed
Published: May 2023

Understanding coding mutations is important for many applications in biology and medicine but the vast mutation space makes comprehensive experimental characterisation impossible. Current predictors are often computationally intensive and difficult to scale, including recent deep learning models. We introduce Sequence UNET, a highly scalable deep learning architecture that classifies and predicts variant frequency from sequence alone using multi-scale representations from a fully convolutional compression/expansion architecture. It achieves comparable pathogenicity prediction to recent methods. We demonstrate scalability by analysing 8.3B variants in 904,134 proteins detected through large-scale proteomics. Sequence UNET runs on modest hardware with a simple Python package.
Robotic-assisted surgery for prostatectomy – does the diffusion of robotic systems contribute to treatment centralization and influence patients’ hospital choice?
Authors: Kuklinski David , Vogel Justus , Henschke Cornelia , Pross Christoph , Geissler Alexander
Published: May 2023

Background

Between 2008 and 2018, the share of robotic-assisted surgeries (RAS) for radical prostatectomies (RPEs) has increased from 3 to 46% in Germany. Firstly, we investigate if this diffusion of RAS has contributed to RPE treatment centralization. Secondly, we analyze if a hospital’s use of an RAS system influenced patients’ hospital choice.

Methods

To analyze RPE treatment centralization, we use (bi-) annual hospital data from 2006 to 2018 for all German hospitals in a panel-data fixed effect model. For investigating RAS systems’ influence on patients’ hospital choice, we use patient level data of 4614 RPE patients treated in 2015. Employing a random utility choice model, we estimate the influence of RAS as well as specialization and quality on patients’ marginal utilities and their according willingness to travel.

Results

Despite a slight decrease in RPEs between 2006 and 2018, hospitals that invested in an RAS system could increase their case volumes significantly (+ 82% compared to hospitals that did not invest) contributing to treatment centralization. Moreover, patients are willing to travel longer for hospitals offering RAS (+ 22% than average travel time) and for specialization (+ 13% for certified prostate cancer treatment centers, + 9% for higher procedure volume). The influence of outcome quality and service quality on patients’ hospital choice is insignificant or negligible.

Conclusions

In conclusion, centralization is partly driven by (very) high-volume hospitals’ investment in RAS systems and patient preferences. While outcome quality might improve due to centralization and according specialization, evidence for a direct positive influence of RAS on RPE outcomes still is ambiguous. Patients have been voting with their feet, but research yet has to catch up.
A call to readjust the Israeli school feeding program
Authors: Nitzan Dorit
Published: May 2023

The COVID-19 pandemic challenged the food and nutrition security status of thousands of children in Israel. This commentary argues that policymakers should urgently readjust the Israeli school feeding program based on experts’ advice. Children should have the right to select food items, grow the items, prepare the meals, and clean and care for the waste together. They should eat as a community in suitable school dining rooms. Access to the school feeding program should also be ensured during emergencies, school closures, isolation and quarantine, treatment, and rehabilitation of children. The food provided through the program should be integrated into the food baskets of their families, aimed at improving their households’ food and nutrition security. It is important to activate a universal school feeding program that does not differentiate, separate, and stigmatize children, their households, their communities, and their schools. The United States National School Lunch Program is briefly reviewed, highlighting the importance of the program's routine monitoring, evaluation, and improvement. Engaging the children in planning the meals and in the production, preparedness, provision, and waste management processes are key to improving their involvement, health literacy and promotion, and their families’ resilience. Implementing a holistic Food System Approach, including school gardening and “Farm to School,” is suggested. It is recommended to urgently formulate a modern, universal, and comprehensive Israeli Food and Nutrition Security Plan, with a dedicated chapter for the upgraded School Feeding Programe with a section on its implementation in emergency preparedness, response, and Resilience. It should be anchored in the Food Systems framework and the One Health Approach.
Anchor-free object detection in remote sensing images using a variable receptive field network
Authors: Fu Shenshen , He Yifan , Du Xiaofeng , Zhu Yi
Published: May 2023

Object detection is one of the essential tasks in computer vision, with most detection methods relying on a limited number of sizes for anchor boxes. However, the boundaries of particular composite objects, such as ports, highways, and golf courses, are ambiguous in remote sensing images, and therefore, it is challenging for the anchor-based method to accommodate the substantial size variation of the objects. In addition, the dense placement of anchor boxes imbalances the positive and negative samples, which affects the end-to-end architecture of deep learning methods. Hence, this paper proposes a single-stage object detection model named Xnet to address this issue. The proposed method designs a deformable convolution backbone network used in the feature extraction stage. Compared to the standard convolution, it adds learnable parameters for dynamically analyzing the boundary and offset of the receptive field, rendering the model more adaptable to size variations within the same class. Moreover, this paper presents a novel anchor-free detector that classifies objects in feature images point-by-point, without relying on anchor boxes. Several experiments on the large remote sensing dataset DIOR challenging Xnet against other popular methods demonstrate that our method attains the best performance, surpassing by 4.7% on the mAP (mean average precision) metric.
Research on structural sound source localization method by neural network
Authors: Huang Xiufeng , Xu Rongwu , Yu Wenjing , Peng Tao
Published: May 2023

To solve problems related to much calculation to adapt to complex scenes in traditional structural sound source localization, this paper proposes a method based on neural network. The structural sound source at other positions was stimulated by successively striking 36 grid centers on the surface of the plate. The time delay between different accelerometer signals was considered as the input, and the location of the predicted sound source was considered as the output. The influence of the number of test sets and epoch training times on sound source localization accuracy was discussed. These results show that with the increase in the epoch training times, the number of test set decreases, and the number of training set increases, increasing the sound source localization accuracy of backpropagation neural network. However, these error conditions will frequently appear due to the overfitting phenomenon. When the epoch is trained to 50,000 times, and the quantity of the test set is 4, the backpropagation neural network has the best localization accuracy with an order of magnitude of 10−3 in error, and the localization error scope of the plate is between 0.01 and 0.1 m.
On qualitative analysis of boundary value problem of variable order fractional delay differential equations
Authors: Shah Kamal , Ali Gauhar , Ansari Khursheed J. , Abdeljawad Thabet , Meganathan M. , Abdalla Bahaaeldin
Published: May 2023

Variable order differential equations are the natural extension of the said area. In many situations, such problems have the ability to describe real-world problems more concisely. Therefore, keeping this validity in mind, we have considered a class of boundary value problems (BVPs) under the variable order differentiation. For the suggested problems, we have developed the existence and uniqueness (EU) by using some fixed point results due to Banach and Schauder. Sufficient adequate results have been established for the required need. Some stability results have also been elaborated based on the concepts of Ulam, Hyers, and Rassias. Proper examples have also been provided with detailed analysis to verify our results.
Stochastic Gradient Descent long short-term memory based secure encryption algorithm for cloud data storage and retrieval in cloud computing environment
Authors: Suganya M. , Sasipraba T.
Published: May 2023

With the increasing rise of distributed system technologies, one of the most pressing problems facing the digital world is ensuring the security of sensitive and confidential data during transport and storage, which is also regarded as one of the most critical difficulties facing cloud computing. Numerous techniques exist for enhancing data security in the cloud computing storage environment. Encryption is the most important method of data protection. Consequently, several accessible encryption strategies are utilized to provide security, integrity, and authorized access by employing modern cryptographic algorithms. Cloud computing is an innovative paradigm widely accepted as a platform for storing and analysing user data. The cloud is accessible via the internet, exposing the data to external and internal threats. Cloud Service Providers (CSPs) must now implement a secure architecture to detect cloud intrusions and safeguard client data from hackers and attackers. This paper combines Stochastic Gradient Descent long short-term memory (SGD-LSTM) and Blow Fish encryption to detect and prevent unauthorized cloud access. User registration, intrusion detection, and intrusion prevention are the three phases of the planned system. The SGD-LSTM classifier predicts cloud data access and prevents unauthorized cloud access. In the data access phase, cloud data access is managed by authenticating the authorized user with the Blowfish encryption algorithm. Comparing the proposed classifier to existing classifiers demonstrates that it detects abnormal access accurately. The experimental outcomes enhanced data security, which can be utilized to protect cloud computing applications. The experimental results of the suggested SGD-LSTM algorithm indicated a high level of protection, as well as a considerable improvement in security and execution speed when compared to algorithms that are often used in cloud computing.
Determinants of pneumonia among under-five children in Oromia region, Ethiopia: unmatched case-control study
Authors: Yadate Olana , Yesuf Aman , Hunduma Fufa , Habtu Yitagesu
Published: May 2023

Background

Pneumonia is the single largest infectious disease that causes more under-five morbidity and mortality than any other infectious disease in the world, including Ethiopia. The aim of this study is to assess determinants of pneumonia among under-five children in the South West Shewa Zone, Oromia Region, Ethiopia, 2021.

Methods

We used an unmatched case-control study design from March 15 to April 30, 2021, in the South West Shewa Zone, Ethiopia. A sample of 398 (199 cases and 199 controls) participated in the study. Trained data collectors through a pre-tested structured questionnaire collected data. We used Epi Info to enter data and analyzed using SPSS version 23. We described our data using descriptive statistics. We identified predictors of pneumonia using logistic regression analysis. We declared predictors of pneumonia at a P-value of 0.05 or less.

Results

Breastfeeding for less than 6 months [AOR:3.51, 95%CI:(1.12,11.00)], lack of Vitamin A supplementation [AOR:3.56,95%CI:(1.58, 8.05)], history of URTI [AOR:9.66, 95%CI:(4.69,19.87)], family child care practices [AOR:6.46, 95%CI, (2.83,14.76)], sleeping with three to five persons in a room [AOR:2.90, 9%CI: (1.23,6.84)], having above five persons in a room [AOR: 3.88, 95%CI: 1.02,14.77), use of wood as a source of fuel [AOR = 3.02 95% CI: 1.41,6.46)] and not opening windows [AOR:2.56 95%CI: (1.21,5.41)] were independent factors of pneumonia among under five children.

Conclusion

Pneumonia is associated with breastfeeding for less than 6 months, lack of vitamin A supplementation, history of URTI, types of childcare practice, indoor overcrowding, use of wood as a source of fuel, and not opening windows. Therefore, exclusive breastfeeding, improving vitamin A supplementation, early control of respiratory tract infection through promoting good hygiene and ventilation strategies in crowded homes, and promoting how to reduce indoor air pollution through affordable clean stoves will be relevant interventions to reduce under-five pneumonia.
A new, alternative risk score for sarcopenia in Chinese patients with type 2 diabetes mellitus
Authors: He Qinghua , Wang Xiuzhi , Yang Caizhe , Zhuang Xiaoming , Yue Yanfen , Jing Hongjiang , Hu Jing , Sun Mingxiao , Guo Lixin
Published: May 2023

Objective

To develop a new, alternative sarcopenia risk score to screen for sarcopenia in type 2 diabetes patients in China and to demonstrate its validity.

Research design and methods

The data for this study came from a multicenter, cross-sectional study that had been designed to estimate the prevalence of sarcopenia among adults with type 2 diabetes and had been conducted in several hospitals in Beijing, China. A total of 1125 participants were randomly divided into two groups: an exploratory population and a validation population. A multivariable logistic regression model using the backward stepwise likelihood ratio method to estimate the probability of sarcopenia was fitted with candidate variables in the exploratory population. A new, alternative sarcopenia risk score was developed based on the multivariable model. The internal and external validations were performed in the exploratory and validation populations. The study was registered at Chinese Clinical Trial Registry (ChiCTR-EOC-15006901).

Results

The new, alternative sarcopenia risk score included five variables: age, gender, BMI, total energy intake per day, and the proportion of calories supplied by protein. The score ranged from − 2 to 19. The area under the receiver operating characteristic (ROC) curve of the risk score for the prediction of sarcopenia in type 2 diabetes patients was 0.806 (95% CI 0.741–0.872) and 0.836 (95% CI 0.781–0.892) in the exploratory and validation populations, respectively. At the optimal cutoff value of 12, the sensitivity and specificity of the score for the prediction of sarcopenia were 70.9% and 81.0% in the exploratory population and 53.7% and 88.8% in the validation population, respectively. The Hosmer–Lemeshow goodness-of-fit test showed a good calibration with the risk score in external validation (χ2 = 4.459, P = 0.813).

Conclusions

The new, alternative sarcopenia risk score appears to be an effective screening tool for identification of sarcopenia in Chinese patients with type 2 diabetes in clinical practice.

Clinical trial registration Chinese Clinical Trial Registry, ChiCTR-EOC-15006901.
Locked down with my eating disorder: a retrospective study on the impact of COVID-19 lockdown on adolescents with eating disorders
Authors: Borsarini Bianca , Pappaianni Edoardo , Micali Nadia
Published: May 2023

Background

Negative effects of COVID-19 lockdowns have been reported in adult patients with feeding and eating disorders (FED) whereas evidence of its impact on young clinical populations is still limited and somewhat inconsistent. The present study aims to investigate the effect of the first COVID-19 lockdown on a range of FED symptoms in children and adolescents: (a) already receiving treatment in our specialist service for FED when the pandemic hit, and (b) prospectively evaluated in our service from October 2020 to July 2021.

Methods

Out of sixty-one eligible patients with a broad spectrum of FED invited, forty-five young patients (aged 11–18) consented to participate and were included. An ad-hoc survey, consisting of open questions, multiple choice questions, yes/no questions, and a symptoms checklist, was administered online.

Results

About half of the participants (46.7%) reported a positive effect of lockdown on FED symptomatology. Patients with anorexia nervosa (AN) reported the highest rate of symptomatology worsening (58.6%). Younger patients (11–13 years) showed a greater improvement of symptoms compared to older ones (14–18 years of age). COVID-19 lockdown was identified as the precipitating factor for FED onset in 60.7% of newly evaluated patients.

Conclusions

Evidence from our investigation points out that although the COVID-19 pandemic was a precipitating factor for a FED for many active and newly referred patients, it had a positive impact on youth who were already in treatment and younger participants.