bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a novel food exchange system for Chinese pregnant women
Authors: Ding Ye , Li Genyuan , Zhang Man , Shao Yingying , Wu Jieshu , Wang Zhixu
Published: December 2023

Background

The dietary nutritional status of pregnant women is critical for maintaining the health of both mothers and infants. Food exchange systems have been employed in the nutritional guidance of patients in China, although their application in the dietary guidance of healthy pregnant women is quite limited. This study aimed to develop a novel food exchange system for Chinese pregnant women (NFES-CPW) and evaluate the relative validation of its application.

Methods

NFES-CPW covers approximately 500 types of food from ten categories and has more elaborate food portion sizes. It established a recommendation index for guiding food selection and used energy, water content, and protein as the exchange basis to balance the supply of energy and important nutrients throughout pregnancy. Furthermore, dietitians used the NFES-CPW and traditional food exchange system to generate new recipes based on the sample recipe. There were 40 derived recipes for each of the two food exchange methods. The food consumption, energy, and key nutrients of each recipe were calculated, and the differences between the two food exchange systems were compared using the Wilcoxon rank sum test or the Chi-square test.

Results

The results revealed that compared to those derived from traditional food exchange system, the NFES-CPW derived recipes had a better dietary structure, as evidenced by the intakes of whole-grain cereals, beans excluding soybeans, potatoes, fruits, fish, shrimp and shellfish, as well as eggs (P < 0.05), which were more conducive to reaching the recommended range of balanced dietary pagoda. After calculating energy and nutrients, although these two food exchange systems have similar effects on the dietary energy and macronutrient intake of pregnant women, the intake of micronutrients in NFES-CPW derived recipes was significantly higher than that from the traditional food exchange system, which was more conducive to meeting the dietary requirements of pregnant women. The outstanding improvement are primarily vitamin A, vitamin B2, folic acid, vitamin B12, vitamin C, calcium, iron, and iodine (P < 0.05). Moreover, when compared to recipes obtained from the traditional food exchange system, the error ranges of energy and most nutrients were significantly reduced after employing the NFES-CPW.

Conclusions

Therefore, NFES-CPW is an appropriate tool that adheres to Chinese dietary characteristics and can provide suitable dietary guidance to pregnant women.
The transition of human resources for health information systems from the MDGs into the SDGs and the post-pandemic era: reviewing the evidence from 2000 to 2022
Authors: McQuide Pamela A. , Brown Andrew N. , Diallo Khassoum , Siyam Amani
Published: December 2023

Background

This review paper offers a policy-tracing trend analysis of national experiences among low- and middle-income countries in strengthening human resources for health information systems (HRHIS). This paper draws on evidence from the last two decades and applies a modified Bardach’s policy analysis framework. A timely review of the evidence on HRHIS and underlying data systems is needed now more than ever, given the halfway mark of the Global Strategy on Human Resources for Health: Workforce 2030 and the protracted COVID-19 pandemic and other global health emergencies, over and above the increasing need for health and care workers to provide essential health services.

Main text

Considering World Health Assembly resolutions and HRH-related global developments between 2000 and 2022, we targeted peer-reviewed and gray literature covering the inception, impact, bottlenecks, and gaps of HRHIS. We also considered results from a Bill and Melinda Gates Foundation-funded project that assessed HRH data systems in 21 countries and the use of HRH data and information for policy, planning, and management. Aligned with the National Health Workforce Accounts (NHWA), we identify priority themes related to digital priorities for HRHIS and governance/leadership and present case studies of five countries that pursued different pathways to successfully develop their HRHIS.

Summary conclusion

Over the last two decades, considerable progress has been achieved through a scaled-up implementation of HRHIS combined with the skills needed to analyze and use data, sustain systems functionality, and make systematic improvements over time. Global health development aid investments and technical innovations have led to advancements in HRHIS, district health information software (DHIS2), and partner collaborations during the HIV/AIDS, Ebola, and COVID-19 crises. Although the progressive implementation of NHWA continues to steer country-level efforts through standardized indicators and regular reporting, traditional challenges remain, such as data systems fragmentation, lack of interoperability between systems, and underutilization of reported data. Encouragingly, some countries demonstrate strong governance and leadership capacities and others strong HRHIS digital capacities. Both HRH and health service data are needed to inform on-demand decisions during times of emergencies and pandemics as well as during routine essential health services delivery. Evidence-based examples from distinctive countries demonstrate that reliable HRHIS is achievable for better planning and management of the health and care workforce.
Reactivity of the ventromedial prefrontal cortex, but not the amygdala, to negative emotion faces predicts greed personality trait
Authors: Deng Kun , Jin Weipeng , Jiang Keying , Li Zixi , Im Hohjin , Chen Shuning , Du Hanxiao , Guan Shunping , Ge Wei , Wei Chuqiao , Zhang Bin , Wang Pinchun , Zhao Guang , Chen Chunhui , Liu Liqing , Wang Qiang
Published: December 2023

This study explored whether amygdala reactivity predicted the greed personality trait (GPT) using both task-based and resting-state functional connectivity analyses (ntotal = 452). In Cohort 1 (n = 83), task-based functional magnetic resonance imaging (t-fMRI) results from a region-of-interest (ROI) analysis revealed no direct correlation between amygdala reactivity to fearful and angry faces and GPT. Instead, whole-brain analyses revealed GPT to robustly negatively vary with activations in the right ventromedial prefrontal cortex (vmPFC), supramarginal gyrus, and angular gyrus in the contrast of fearful + angry faces > shapes. Moreover, task-based psychophysiological interaction (PPI) analyses showed that the high GPT group showed weaker functional connectivity of the vmPFC seed with a top-down control network and visual pathways when processing fearful or angry faces compared to their lower GPT counterparts. In Cohort 2, resting-state functional connectivity (rs-FC) analyses indicated stronger connectivity between the vmPFC seed and the top-down control network and visual pathways in individuals with higher GPT. Comparing the two cohorts, bilateral amygdala seeds showed weaker associations with the top-down control network in the high group via PPI analyses in Cohort 1. Yet, they exhibited distinct rs-FC patterns in Cohort 2 (e.g., positive associations of GPT with the left amygdala-top-down network FC but negative associations with the right amygdala-visual pathway FC). The study underscores the role of the vmPFC and its functional connectivity in understanding GPT, rather than amygdala reactivity.
Quartets enable statistically consistent estimation of cell lineage trees under an unbiased error and missingness model
Authors: Han Yunheng , Molloy Erin K.
Published: December 2023

Cancer progression and treatment can be informed by reconstructing its evolutionary history from tumor cells. Although many methods exist to estimate evolutionary trees (called phylogenies) from molecular sequences, traditional approaches assume the input data are error-free and the output tree is fully resolved. These assumptions are challenged in tumor phylogenetics because single-cell sequencing produces sparse, error-ridden data and because tumors evolve clonally. Here, we study the theoretical utility of methods based on quartets (four-leaf, unrooted phylogenetic trees) in light of these barriers. We consider a popular tumor phylogenetics model, in which mutations arise on a (highly unresolved) tree and then (unbiased) errors and missing values are introduced. Quartets are then implied by mutations present in two cells and absent from two cells. Our main result is that the most probable quartet identifies the unrooted model tree on four cells. This motivates seeking a tree such that the number of quartets shared between it and the input mutations is maximized. We prove an optimal solution to this problem is a consistent estimator of the unrooted cell lineage tree; this guarantee includes the case where the model tree is highly unresolved, with error defined as the number of false negative branches. Lastly, we outline how quartet-based methods might be employed when there are copy number aberrations and other challenges specific to tumor phylogenetics.
Comparative evaluation of multi-fold rib and structural iliac bone grafts in single-segment thoracic and thoracolumbar spinal tuberculosis: clinical and radiological outcomes
Authors: Luo Yuanrui , Chen Hua , Xiu Peng , Zeng Jiancheng , Song Yueming , li Tao
Published: December 2023

Objective

To compare clinical and radiological outcomes of multi-fold rib and structural iliac bone grafts, the primary autologous graft techniques in anterolateral-only surgery for single-segment thoracic and thoracolumbar spinal tuberculosis.

Methods

This retrospective study included 99 patients treated from January 2014 to March 2022, categorized into 64 with multi-fold rib grafts (group A) and 35 with structural iliac bone grafts (group B). Outcomes assessed included hospital stay, operation time, intraoperative blood loss, postoperative drainage, complications, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index (ODI), bone fusion time, and the American Spinal Injury Association (ASIA) impairment scale grade. Segmental kyphotic angle and intervertebral height were measured radiologically before surgery and follow-up.

Results

The mean follow-up was 63.50 ± 26.05 months for group A and 64.97 ± 26.43 months for group B (P > 0.05). All patients had achieved a clinical cure. Group A had a shorter operation time (P = 0.004). Within one week post-surgery, group B reported higher VAS scores (P < 0.0001). Neurological performance and quality of life significantly improved in both groups. No significant differences were observed in segmental kyphotic angle and intervertebral height between the groups pre- and postoperatively (P > 0.05). However, group A showed a greater segmental kyphotic angle at the final follow-up, while group B had better maintenance of kyphotic angle correction and intervertebral height (P < 0.05). Bone fusion was achieved in all patients without differences in fusion time (P > 0.05).

Conclusions

Multi-fold rib grafts resulted in shorter operation times and less postoperative pain, while structural iliac bone grafts provided better long-term maintenance of spinal alignment and stability, suggesting their use in cases where long-term outcomes are critical.
Prevalence of depression and anxiety in patients with Tourette syndrome; 1997 to 2022: a systematic review and meta-analysis
Authors: Abbasi Parvin , Tanhaie Sepideh , Kazeminia Mohsen
Published: December 2023

Tourette Syndrome (TS) is a disorder in which the patient has a history of multiple motor and vocal tics. Depression and anxiety are common in these patients. The results of the studies show different prevalence of these disorders in patients with TS. So, the objective of the present study was to liken the prevalence of depression and anxiety in patients with TS by systematic review and meta-analysis. The present study was conducted according to PRISMA guidelines during 1997–2022. The articles were obtained from Scopus, Embase, PubMed, Web of Science (WoS) and Google Scholar databases. I2 was used to investigate heterogeneity between studies. Data were analyzed by comprehensive meta-analysis software (Version 2). Finally, 12 articles with a sample size of n = 3812 were included in the study. As a result of combining the results of the studies, the total estimate of the prevalence of depression and anxiety in patients with TS was 36.4% (95% confidence interval: 21.1–54.9%) and 53.5% (95% confidence interval: 39.9–66.6%), respectively. The results of meta-regression showed that by increasing mean age (9–31.5 years), the prevalence of depression and anxiety in patients with TS increased significantly (P<0.001). The results of the present study showed that the prevalence of depression and anxiety was high in patients with TS. Therefore, it is suggested that health officials and policy makers design measures to prevent and control these disorders.
Age-dependent genetic regulation of osteoarthritis: independent effects of immune system genes
Authors: Kenny Jacob , Mullin Benjamin H. , Tomlinson William , Robertson Brett , Yuan Jinbo , Chen Weiwei , Zhao Jinmin , Pavlos Nathan J. , Walsh John P. , Wilson Scott G. , Tickner Jennifer , Morahan Grant , Xu Jiake
Published: December 2023

Objectives

Osteoarthritis (OA) is a joint disease with a heritable component. Genetic loci identified via genome-wide association studies (GWAS) account for an estimated 26.3% of the disease trait variance in humans. Currently, there is no method for predicting the onset or progression of OA. We describe the first use of the Collaborative Cross (CC), a powerful genetic resource, to investigate knee OA in mice, with follow-up targeted multi-omics analysis of homologous regions of the human genome.

Methods

We histologically screened 275 mice for knee OA and conducted quantitative trait locus (QTL) mapping in the complete cohort (> 8 months) and the younger onset sub-cohort (8–12 months). Multi-omic analysis of human genetic datasets was conducted to investigate significant loci.

Results

We observed a range of OA phenotypes. QTL mapping identified a genome-wide significant locus on mouse chromosome 19 containing Glis3, the human equivalent of which has been identified as associated with OA in recent GWAS. Mapping the younger onset sub-cohort identified a genome-wide significant locus on chromosome 17. Multi-omic analysis of the homologous region of the human genome (6p21.32) indicated the presence of pleiotropic effects on the expression of the HLA − DPB2 gene and knee OA development risk, potentially mediated through the effects on DNA methylation.

Conclusions

The significant associations at the 6p21.32 locus in human datasets highlight the value of the CC model of spontaneous OA that we have developed and lend support for an immune role in the disease. Our results in mice also add to the accumulating evidence of a role for Glis3 in OA.
Analytical Performance Assessment of Deteriorated Prestressed Concrete Beams
Authors: Kim Tae-Hoon
Published: December 2023

In this paper, a new approach is developed to numerically evaluate the structural performance of deteriorated prestressed concrete beams using the finite element analysis application RCAHEST (Reinforced Concrete Analysis in Higher Evaluation System Technology). A prestressing steel element was modified to represent the interaction between deteriorated concrete and prestressing steel. Considering the corrosion effects—as shown by the reduction of the prestressing steel section and loss of bond—a nonlinear material model was proposed for deteriorated prestressed concrete behavior. The modified damage index is intended to provide a numerical method for quantifying the structural performance of deteriorated prestressed concrete beams. The analytical procedure developed for the performance evaluation of deteriorated beams was validated by comparison with the credible test results, thereby enabling a more reliable and rational prestressed concrete beams design process.
Engraftment of essential functions through multiple fecal microbiota transplants in chronic antibiotic-resistant pouchitis—a case study using metatranscriptomics
Authors: Deng Zhi-Luo , Pieper Dietmar H. , Stallmach Andreas , Steube Arndt , Vital Marius , Reck Michael , Wagner-Döbler Irene
Published: December 2023

Background

Ileal pouch-anal anastomosis (IPAA) is the standard of care after total proctocolectomy for ulcerative colitis (UC). Around 50% of patients will experience pouchitis, an idiopathic inflammatory condition. Antibiotics are the backbone of treatment of pouchitis; however, antibiotic-resistant pouchitis develops in 5–10% of those patients. It has been shown that fecal microbiota transplantation (FMT) is an effective treatment for UC, but results for FMT antibiotic-resistant pouchitis are inconsistent.

Methods

To uncover which metabolic activities were transferred to the recipients during FMT and helped the remission, we performed a longitudinal case study of the gut metatranscriptomes from three patients and their donors. The patients were treated by two to three FMTs, and stool samples were analyzed for up to 140 days.

Results

Reduced expression in pouchitis patients compared to healthy donors was observed for genes involved in biosynthesis of amino acids, cofactors, and B vitamins. An independent metatranscriptome dataset of UC patients showed a similar result. Other functions including biosynthesis of butyrate, metabolism of bile acids, and tryptophan were also much lower expressed in pouchitis. After FMT, these activities transiently increased, and the overall metatranscriptome profiles closely mirrored those of the respective donors with notable fluctuations during the subsequent weeks. The levels of the clinical marker fecal calprotectin were concordant with the metatranscriptome data. Faecalibacterium prausnitzii represented the most active species contributing to butyrate synthesis via the acetyl-CoA pathway. Remission occurred after the last FMT in all patients and was characterized by a microbiota activity profile distinct from donors in two of the patients.

Conclusions

Our study demonstrates the clear but short-lived activity engraftment of donor microbiota, particularly the butyrate biosynthesis after each FMT. The data suggest that FMT triggers shifts in the activity of patient microbiota towards health which need to be repeated to reach critical thresholds. As a case study, these insights warrant cautious interpretation, and validation in larger cohorts is necessary for generalized applications. In the long run, probiotics with high taxonomic diversity consisting of well characterized strains could replace FMT to avoid the costly screening of donors and the risk of transferring unwanted genetic material.
13-Valent pneumococcal conjugate vaccines vaccination innovative strategy in Weifang City, China: a case study
Authors: Wang Jiachen , Wang Yujue , Xu Ruoyu , Zhang Ting , Jiang Yanyan , Wang Yuanyuan , Wang Yi , Du Yuanze , Sun Wenxue , Deng Kai , Yang Weizhong , Wang Zengwu , Feng Luzhao , Wang Chunping
Published: December 2023

The World Health Organization (WHO) prioritizes pneumococcal disease as a vaccine-preventable disease and recommends the inclusion of pneumococcal conjugate vaccines (PCV) in national immunization programs worldwide. However, PCV is not included in the National Immunization Program in China and has low vaccination coverage due to its high cost. To address this, Weifang City implemented an innovative strategy for a 13-valent PCV (PCV13) on June 1, 2021. This strategy aimed to provide one dose of PCV13 free of charge for children aged 6 months to 2 years in registered households and to adopt a commercial insurance model with one dose of PCV13 free of charge in 2023 for children over 2 years old. The Health Commission of Weifang and other departments conducted a comprehensive investigation and considered various factors, such as vaccine effectiveness, safety, accessibility, vaccine price, and immunization schedules, for eligible children (under 5 years old). Stakeholder opinions were also solicited before implementing the policy. The Commission negotiated with various vaccine manufacturers to maximize its negotiating power and reduce vaccine prices. The implementation plan was introduced under the Healthy Weifang Strategy. Following the implementation of this strategy, the full course of vaccination coverage increased significantly from 0.67 to 6.59%. However, vaccination coverage is still lower than that in developed countries. Weifang's PCV13 vaccination innovative strategy is the first of its kind in Chinese mainland and is an active pilot of non-immunization program vaccination strategies. To further promote PCV13 vaccination, Weifang City should continue to implement this strategy and explore appropriate financing channels. Regions with higher levels of economic development can innovate the implementation of vaccine programs, broaden financing channels, improve accessibility to vaccination services, and advocate for more localities to incorporate PCV13 into locally expanded immunization programs or people-benefiting projects. A monitoring and evaluation system should also be established to evaluate implementation effects.

Graphical Abstract
Transformation of non-neuritic into neuritic plaques during AD progression drives cortical spread of tau pathology via regenerative failure
Authors: Tsering Wangchen , Hery Gabriela P. , Phillips Jennifer L. , Lolo Kiara , Bathe Tim , Villareal Jonathan A. , Ruan Isabelle Y. , Prokop Stefan
Published: December 2023

Extracellular amyloid-β (Aβ) plaques and intracellular aggregates of tau protein in form of neurofibrillary tangles (NFT) are pathological hallmarks of Alzheimer’s disease (AD). The exact mechanism how these two protein aggregates interact in AD is still a matter of debate. Neuritic plaques (NP), a subset of Aβ plaques containing dystrophic neurites (DN), are suggested to be unique to AD and might play a role in the interaction of Aβ and tau. Quantifying NP and non-NP in postmortem brain specimens from patients with increasing severity of AD neuropathological changes (ADNC), we demonstrate that the total number of Aβ plaques and NP increase, while the number of non-NP stagnates. Furthermore, investigating the correlation between NP and NFT, we identified unexpected brain region-specific differences when comparing cases with increasingly more severe ADNC. In neocortical regions NFT counts increase in parallel with NP counts during the progression of ADNC, while this correlation is not observed in hippocampus. These data support the notion that non-NP are transformed into NP during the progression of ADNC and indicate that NP might drive cortical NFT formation. Next, using spatial transcriptomics, we analyzed the gene expression profile of the microenvironment around non-NP and NP. We identified an upregulation of neuronal systems and Ca-dependent event pathways around NP compared to non-NP. We speculate that the upregulation of these transcripts may hint at a compensatory mechanism underlying NP formation. Our studies suggest that the transformation of non-NP to NP is a key event in ADNC progression and points to regenerative failure as a potential driving force of this process.
Effect of rapid cefpodoxime disk screening for early detection of third-generation cephalosporin resistance in Escherichia coli and Klebsiella pneumoniae bacteremia
Authors: Sakai Mikiyasu , Sakai Takamasa , Nagata Yuki , Komai Hiroko , Miyake Yoshio , Watariguchi Toshitaka , Kawabata Atsushi , Ohtsu Fumiko
Published: December 2023

Background

Several methods have been reported for detecting resistance genes or phenotypic testing on the day of positive blood culture in Escherichia coli or Klebsiella pneumoniae bacteremia. However, some facilities have not introduced these methods because of costs or other reasons. Toyota Kosei Hospital introduced cefpodoxime (CPDX) rapid screening on May 7, 2018, to enable early detection of third-generation cephalosporin resistance. In this study, we aimed to evaluate the effects of intervention with an Antimicrobial Stewardship Team using CPDX rapid screening.

Methods

Cefotaxime (CTX)-resistant E. coli or K. pneumoniae bacteremia cases were selected retrospectively and divided into two groups: the pre-CPDX screening (June 1, 2015, to May 6, 2018) and CPDX screening groups (July 7, 2018, to August 31, 2021). The primary outcome was the proportion of cases in which modifications were made to the administration of susceptible antimicrobial agents within 24 h of blood culture-positive reports.

Results

Overall, 63 patients in the pre-CPDX screening group and 84 patients in the CPDX screening group were eligible for analysis. The proportion of patients who modified to susceptible antimicrobial agents within 24 h of blood culture-positive reports was significantly increased in the CPDX screening group compared to that in the pre-CPDX screening group (6.3% vs. 22.6%, p = 0.010).

Conclusion

The results demonstrated that in CTX-resistant E. coli or K. pneumoniae bacteremia, CPDX rapid screening increased the proportion of early initiation of appropriate antimicrobial agents.
Saudi undergraduate EFL learners’ attitudes toward using textism in their academic writing
Authors: Ambreen Fatima , Ozdemir Burhan , El-Dakhs Dina Abdel Salam
Published: December 2023

Textism, which refers to the special language used in text messaging, is widely used in several forms of communication, such as texting, online chatting and emails. This increased use of textism has alarmed the media and the public because this special language can impact the academic writing of the younger generation. This paper aimed at exploring the attitudes of undergraduate Saudi learners of English as a foreign language (EFL) toward using textism in their academic writing. (115) students of different levels of language proficiency completed a survey about the use of textism across several modalities and recipients. Additionally, (240) student essays were analyzed to identify the potential use of textism in student writing. The results showed that students are generally conscious of the appropriate contexts for the use of textism. However, when it comes to the actual use of textism in writing, low-proficient students tend to produce more textism than those who are at medium and high levels of writing competence.
Exercise-induced desaturation during a six-minute walk test is associated with poor clinical outcomes in patients with pulmonary arterial hypertension
Authors: Choi Jung Hyun , Shin Myung-Jun , Lee Byeong-Ju , Park Jae-Hyeong
Published: December 2023

Background

The six-minute walk test (6MWT) is an established exercise test for patients with pulmonary arterial hypertension (PAH), affording insight into both exercise intolerance and overall prognosis. Despite the widespread application of the 6MWT, the prognostic implications of exercise-induced desaturation (EID) during this test has been inadequately studied in PAH patients. Thus, we evaluated the occurrence of EID and its prognostic significance in PAH patients.

Methods

We analyzed PAH patients in a single-center cohort from April 2016 to March 2021. EID was defined as a reduction in oxygen saturation exceeding 4% from the baseline or to below 90% at any point during the test.

Results

We analyzed 20 PAH patients in this cohort, primarily consisting of 16 females with an average age of 48.4 ± 13.3 years. Among them, ten exhibited EID. Baseline characteristics, echocardiographic data and right heart catheterization data were similar between the two groups. However, total distance (354.3 ± 124.4 m vs. 485.4 ± 41.4 m, P = 0.019) and peak oxygen uptake (12.9 ± 3.2 mL/kg⋅min vs. 16.4 ± 3.6 mL/kg⋅min, P = 0.019) were significantly lower in the EID group. During the total follow-up duration of 51.9 ± 25.7 months, 17 patients had at least one adverse clinical event (2 deaths, 1 lung transplantation, and 13 hospital admissions). The presence of EID was associated with poor clinical outcome (hazard ratio = 6.099, 95% confidence interval = 1.783–20.869, P = 0.004).

Conclusions

During the 6MWT, EID was observed in a half of PAH patients and emerged as a significant prognostic marker for adverse clinical events.

Graphical Abstract
Deep learning models for automatic tumor segmentation and total tumor volume assessment in patients with colorectal liver metastases
Authors: Wesdorp Nina J. , Zeeuw J. Michiel , Postma Sam C. J. , Roor Joran , van Waesberghe Jan Hein T. M. , van den Bergh Janneke E. , Nota Irene M. , Moos Shira , Kemna Ruby , Vadakkumpadan Fijoy , Ambrozic Courtney , van Dieren Susan , van Amerongen Martinus J. , Chapelle Thiery , Engelbrecht Marc R. W. , Gerhards Michael F. , Grunhagen Dirk , van Gulik Thomas M. , Hermans John J. , de Jong Koert P. , Klaase Joost M. , Liem Mike S. L. , van Lienden Krijn P. , Molenaar I. Quintus , Patijn Gijs A. , Rijken Arjen M. , Ruers Theo M. , Verhoef Cornelis , de Wilt Johannes H. W. , Marquering Henk A. , Stoker Jaap , Swijnenburg Rutger-Jan , Punt Cornelis J. A. , Huiskens Joost , Kazemier Geert
Published: December 2023

Background

We developed models for tumor segmentation to automate the assessment of total tumor volume (TTV) in patients with colorectal liver metastases (CRLM).

Methods

In this prospective cohort study, pre- and post-systemic treatment computed tomography (CT) scans of 259 patients with initially unresectable CRLM of the CAIRO5 trial (NCT02162563) were included. In total, 595 CT scans comprising 8,959 CRLM were divided into training (73%), validation (6.5%), and test sets (21%). Deep learning models were trained with ground truth segmentations of the liver and CRLM. TTV was calculated based on the CRLM segmentations. An external validation cohort was included, comprising 72 preoperative CT scans of patients with 112 resectable CRLM. Image segmentation evaluation metrics and intraclass correlation coefficient (ICC) were calculated.

Results

In the test set (122 CT scans), the autosegmentation models showed a global Dice similarity coefficient (DSC) of 0.96 (liver) and 0.86 (CRLM). The corresponding median per-case DSC was 0.96 (interquartile range [IQR] 0.95–0.96) and 0.80 (IQR 0.67–0.87). For tumor segmentation, the intersection-over-union, precision, and recall were 0.75, 0.89, and 0.84, respectively. An excellent agreement was observed between the reference and automatically computed TTV for the test set (ICC 0.98) and external validation cohort (ICC 0.98). In the external validation, the global DSC was 0.82 and the median per-case DSC was 0.60 (IQR 0.29–0.76) for tumor segmentation.

Conclusions

Deep learning autosegmentation models were able to segment the liver and CRLM automatically and accurately in patients with initially unresectable CRLM, enabling automatic TTV assessment in such patients.

Relevance statement

Automatic segmentation enables the assessment of total tumor volume in patients with colorectal liver metastases, with a high potential of decreasing radiologist’s workload and increasing accuracy and consistency.

Key points

• Tumor response evaluation is time-consuming, manually performed, and ignores total tumor volume.

• Automatic models can accurately segment tumors in patients with colorectal liver metastases.

• Total tumor volume can be accurately calculated based on automatic segmentations.

Graphical Abstract
Enhancing chili pepper (Capsicum annuum L.) resistance and yield against powdery mildew (Leveillula taurica) with beneficial bacteria
Authors: Hussein Mohamed A. M. , Abdel-Aal Ahmed M. K. , Rawa Muhyaddin J. , Mousa Magdi A. A. , Moustafa Yasser M. M. , Abo-Elyousr Kamal A. M.
Published: December 2023

Background

Leveillula taurica is an obligate pathogen that causes powdery mildew on chili pepper (Capsicum annuum L.) which is considered one of the most serious diseases for the crop.

Results

Leveillula taurica was isolated from infected pepper plants in Assiut Governorate, Egypt. Pathogenicity test was performed, and it was found that the pathogen can cause the symptoms of powdery mildew on the pepper plant. Under greenhouse conditions, treatment with Bacillus thuringiensis MW740161.1, Pseudomonas fluorescens, and Bacillus subtilis cultures resulted in a significant reduction in conidial germination of the pathogen (69.07, 29.55, and 19.58%, respectively). Spraying chili pepper plants with the microorganisms effectively reduced the powdery mildew's disease severity. Also, treatment with the bacterial strains resulted in a significant (P 0.05%) increase in the yield of chili pepper. Based on the findings, it appears that the use of B. thuringiensis, as foliar spraying, significantly induced resistance of chili pepper plants against L. taurica and stimulated many biochemical functions in the plant. Also, it increased the crop yield compared to all other treatments.

Conclusions

This study recommends B. thuringiensis as a viable alternative to harmful pesticides, and it is feasible to formulate an appropriate fungicide for the sustainable green production of chili peppers. The B. thuringiensis can increase the resistance of chili pepper plant to L. taurica the causal pathogen of powdery mildew.
A review on decompressive craniectomy for traumatic brain injury: the mainstay method for neurotrauma patients
Authors: Janjua Tariq , Narvaez Alexis R. , Florez-Perdomo William A. , Guevara-Moriones Natalia , Moscote-Salazar Luis Rafael
Published: December 2023

Raised intracranial pressure is common leading cause of mortality in patients suffering from a traumatic craniocerebral injury. Currently, head injury constitutes a major public health problem across the world. Decompressive craniectomy is currently emerging as a preferred treatment strategy for patients suffering from refractory intracranial hypertension, which is unresponsive to appropriate neurocritical care management. The meticulous execution of decompressive craniectomy requires an understanding of anatomy, the pathogenesis of raised intracranial pressure, meticulous surgical technique, proper planning in association with the competent anesthetic team and paramedical staff to provide improved neurological outcome, and a significant reduction in mortality and morbidity. We provide a review of the status and appropriate review of this surgical procedure.
Enhancing waterlogging tolerance in cotton through agronomic practices
Authors: Zhang Yanjun , Dong Hezhong
Published: December 2023

Recent publications have highlighted significant progress in utilizing agronomic interventions to alleviate waterlogging stress in cotton production. Based on these advancements, we provide a concise comment on the effects and underlying mechanisms of various strategies such as utilizing stress-tolerant cotton varieties, applying nitric oxide (NO), and implementing ridge intertillage. Finally, we recommend a combination of measures to enhance cotton's ability to withstand waterlogging and reduce yield losses.
Comprehensive integrated analysis of MR and DCE-MR radiomics models for prognostic prediction in nasopharyngeal carcinoma
Authors: Li Hailin , Huang Weiyuan , Wang Siwen , Balasubramanian Priya S. , Wu Gang , Fang Mengjie , Xie Xuebin , Zhang Jie , Dong Di , Tian Jie , Chen Feng
Published: December 2023

Although prognostic prediction of nasopharyngeal carcinoma (NPC) remains a pivotal research area, the role of dynamic contrast-enhanced magnetic resonance (DCE-MR) has been less explored. This study aimed to investigate the role of DCR-MR in predicting progression-free survival (PFS) in patients with NPC using magnetic resonance (MR)- and DCE-MR-based radiomic models. A total of 434 patients with two MR scanning sequences were included. The MR- and DCE-MR-based radiomics models were developed based on 289 patients with only MR scanning sequences and 145 patients with four additional pharmacokinetic parameters (volume fraction of extravascular extracellular space (ve), volume fraction of plasma space (vp), volume transfer constant (Ktrans), and reverse reflux rate constant (kep) of DCE-MR. A combined model integrating MR and DCE-MR was constructed. Utilizing methods such as correlation analysis, least absolute shrinkage and selection operator regression, and multivariate Cox proportional hazards regression, we built the radiomics models. Finally, we calculated the net reclassification index and C-index to evaluate and compare the prognostic performance of the radiomics models. Kaplan-Meier survival curve analysis was performed to investigate the model’s ability to stratify risk in patients with NPC. The integration of MR and DCE-MR radiomic features significantly enhanced prognostic prediction performance compared to MR- and DCE-MR-based models, evidenced by a test set C-index of 0.808 vs 0.729 and 0.731, respectively. The combined radiomics model improved net reclassification by 22.9%–52.6% and could significantly stratify the risk levels of patients with NPC (p = 0.036). Furthermore, the MR-based radiomic feature maps achieved similar results to the DCE-MR pharmacokinetic parameters in terms of reflecting the underlying angiogenesis information in NPC. Compared to conventional MR-based radiomics models, the combined radiomics model integrating MR and DCE-MR showed promising results in delivering more accurate prognostic predictions and provided more clinical benefits in quantifying and monitoring phenotypic changes associated with NPC prognosis.
Hypersonic aerodynamic force balance using temperature compensated semiconductor strain gauges
Authors: Qiu Huacheng , Yang Yanguang , Sun Peng , Chao Genming , Wu Yousheng , Chen Yingdong
Published: December 2023

Metal foil strain gauges remain the state-of-the-art transducers for wind tunnel balances. While strain gauge technology is very mature, piezoresistive semiconductor sensors offer alternatives that are worth exploring to assess their unique benefits, such as better strain resolution and accuracy, which would enable balances to be designed with higher factors to safety and hence longer fatigue lifetimes. A new three-component balance, based on temperature compensated semiconductor strain gauges, is designed, calibrated and tested in a hypersonic low density wind tunnel. The static accuracy of the semiconductor balance is calibrated better than 0.3% FS, and the dynamic accuracy of the balance is established using a HB-2 standard model in a Mach 12 hypersonic flow. Good experimental repeatability is confirmed to be better than 2.5% FS, and the effectiveness of the balance is demonstrated by comparing the forces and moments of measured data with computational fluid dynamics simulations, as well as reference wind tunnel results under similar conditions.
Experimental design for a novel co-flow jet airfoil
Authors: Jiang Hao , Yao Weigang , Xu Min
Published: December 2023

The Co-flow Jet (CFJ) technology holds significant promise for enhancing aerodynamic efficiency and furthering decarbonization in the evolving landscape of air transportation. The aim of this study is to empirically validate an optimized CFJ airfoil through low-speed wind tunnel experiments. The CFJ airfoil is structured in a tri-sectional design, consisting of one experimental segment and two stationary segments. A support rod penetrates the airfoil, fulfilling dual roles: it not only maintains the structural integrity of the overall model but also enables the direct measurement of aerodynamic forces on the test section of the CFJ airfoil within a two-dimensional wind tunnel. In parallel, the stationary segments are designed to effectively minimize the interference from the lateral tunnel walls. The experimental results are compared with numerical simulations, specifically focusing on aerodynamic parameters and flow field distribution. The findings reveal that the experimental framework employed is highly effective in characterizing the aerodynamic behavior of the CFJ airfoil, showing strong agreement with the simulation data.
IL-4/IL-4 Ab complex enhances the accumulation of both antigen-specific and bystander CD8 T cells in mouse lungs infected with influenza A virus
Authors: Park Hi Jung , Choi Eun Ah , Choi Sung Min , Choi Young-Ki , Lee Jae Il , Jung Kyeong Cheon
Published: December 2023

Background

Unlike conventional T cells, innate and virtual-memory CD8 T cells in naïve mice acquire their memory phenotypes and functions in the absence of antigenic encounters in a cytokine-dependent manner. The relevant cytokines include interleukin-4 (IL-4), type I interferon, and interleukin-15 (IL-15). Moreover, exogenous IL-4 can also induce de novo generation and/or expansion of the virtual-memory CD8 T cell population. In this study, we investigated whether exogenous IL-4 could enhance the immune response to a viral infection.

Results

In vivo administration of IL-4 and an anti-IL-4 antibody complex (IL-4C) increased CXCR3 expression in both memory and naïve phenotype CD8 T cells in the absence of antigenic stimulation, and protected mice from lethal influenza infection. Flow cytometric analysis of lung-infiltrating immune cells on day 5 after virus infection revealed higher numbers of antigen-specific and bystander CD8 T cells in IL-4C-treated mice than in control mice. In particular, the bystander CD8 T cells were a naïve or evident memory phenotypes. Crucially, an anti-CXCR3 blocking antibody abrogated this IL-4C effect, reflecting that the increased accumulation of CD8 T cells in the lungs after IL-4C treatment is dependent on CXCR3.

Conclusions

These data demonstrate that exogenous IL-4C plays a protective role by enhancing CXCR3-dependent migration of CD8 T cells into influenza-infected lungs.
Acetabular cup positioning in primary routine total hip arthroplasty—a review of current concepts and technologies
Authors: Sai Sathikumar Aravind , Jacob George , Thomas Appu Benny , Varghese Jacob , Menon Venugopal
Published: December 2023

Introduction

Total hip arthroplasty (THA) has revolutionized the treatment of hip joint arthritis. With the increased popularity and success of the procedure, research has focused on improving implant survival and reducing surgical complications. Optimal component orientation has been a constant focus with various philosophies proposed. Regardless of the philosophy, achieving an accurate acetabular position for each clinical scenario is crucial. In this paper, we review the recent developments in improving the accuracy and ideal positioning of the acetabular cup in routine primary THA.

Methodology

A review of the recent scientific literature for acetabular cup placement in primary THA was performed, with available evidence for safe zones, spinopelvic relationship, preoperative planning, patient-specific instrumentation, navigation THA and robotic THA.

Conclusion

Though the applicability of Lewinnek safe zones has been questioned with an improved understanding of spinopelvic relationships, its role remains in positioning the acetabular cup in a patient with normal spinopelvic alignment and mobility. Evaluation of spinopelvic relationships and accordingly adjusting acetabular anteversion and inclination can significantly reduce the incidence of dislocation in patients with a rigid spine. In using preoperative radiography, the acetabular inclination, anteversion and intraoperative pelvic position should be evaluated. With improving technology and the advent of artificial intelligence, superior and more accurate preoperative planning is possible. Patient-specific instrumentation, navigated and robotic THA have been reported to improve accuracy in acetabular cup positioning as decided preoperatively but any significant clinical advantage over conventional THA is yet to be elucidated.
Patient-reported outcomes measurement information system instruments in knee arthroplasty patients: a systematic review of the literature
Authors: Czerwonka Natalia , Gupta Puneet , Desai Sohil S. , Hickernell Thomas R. , Neuwirth Alexander L. , Trofa David P.
Published: December 2023

Background

The purpose of this study is to provide a systematic review of the literature pertaining to Patient-Reported Outcome Measurement Information System (PROMIS) validation and utilization as an outcomes metric in total knee arthroplasty (TKA) patients. This is the first systematic review on PROMIS use in total knee arthroplasty patients.

Methods

A systematic search of the Pubmed/MEDLINE and Embase databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study characteristics, patient demographics, psychometric properties (Pearson and Spearman correlation) with legacy patient-reported outcome measurement (PROM) instruments, floor and ceiling effects, responsiveness, and minimum clinically important difference (MCID) and PROMIS outcomes were recorded and analyzed.

Results

Fifteen studies investigating PROMIS in 11,140 patients were included. The weighted-average Pearson correlation coefficient comparing PROMIS domains with legacy patient-reported outcome measurements in total knee arthroplasty patients was 0.62 [standard error (SE) = 0.06] and the weighted-average Spearman correlation comparing PROMIS domains with legacy patient-reported outcome measurements in total knee arthroplasty patients was 0.59 (SE = 0.06), demonstrating moderate-to-strong correlation and validity. There were no differences in weighted average floor [0.03% (SE = 3.1) versus 0% (SE = 0.1) versus 0.01% (SE = 1.1); p = 0.25] or ceiling effects [0.01% (SE = 0.7) versus 0.02% (SE = 1.4) versus 0.04% (SE = 3.5); p = 0.36] between PROMIS and legacy instruments. The weighted average for percentage of patients achieving MCID was 59.1% for global physical health (GPH), 26.0% for global mental health (GMH), 52.7% for physical function (PF), 67.2% for pain interference (PI), and 37.2% for depression.

Conclusion

Notably, PROMIS global physical health, physical function, and pain interference were found to be significantly responsive, with PROMIS pain interference most effectively capturing clinical improvement as evidenced by the achievement of MCID.
A rare presentation of measles and post-measles complications in a neonate: case report
Authors: Sharma Suraksha Ramakrishna , Sawant Vishal , Save Sushma Uttam , Kondekar Alpana Santosh
Published: December 2023

Background

Measles is a common infection in children. Measles infection in children less than 6 months of age is very rare since maternal antibodies play a major role in the prevention of the disease.

Case presentation

Here we present a rare case of a 34-day-old infant, who had a history of fever with a rash on the 18th day of life and significant history of measles contact with mother and elder brother. The patient presented to us with septic shock and multiorgan involvement in the form of pneumonia, acute gastroenteritis with severe dehydration, mucopurulent conjunctivitis, and post-measles encephalitis. The patient had a strong measles contact and epidemiological linkage to the measles epicenter, Govandi (a locality in the Mumbai region of western India), so measles IgM antibody was obtained which were significantly raised.

The patient was successfully revived from this critical presentation with early and appropriate resuscitation, timely ionotropic support, and the use of empirical broad-spectrum antibiotics. The patient required intensive unit care for four days and was started on feeds and discharged after 12 days of hospital stay. On follow-up, the patient is doing well and gaining weight.

Conclusion

Uncommon presentation and the epidemiology of the disease should alert the clinician of having a high index of suspicion. Early intervention and prompt treatment can help reduce morbidity and mortality.