bluuebunny/crossref_metadata_2025 huggingface dataset:
Computer vision detects inflammatory arthritis in standardized smartphone photographs in an Indian patient cohort
Authors: Phatak Sanat , Chakraborty Somashree , Goel Pranay
Published: November 2023

Introduction

Computer vision extracts meaning from pixelated images and holds promise in automating various clinical tasks. Convolutional neural networks (CNNs), a deep learning network used therein, have shown promise in analyzing X-ray images and joint photographs. We studied the performance of a CNN on standardized smartphone photographs in detecting inflammation in three hand joints and compared it to a rheumatologist’s diagnosis.

Methods

We enrolled 100 consecutive patients with inflammatory arthritis with an onset period of less than 2 years, excluding those with deformities. Each patient was examined by a rheumatologist, and the presence of synovitis in each joint was recorded. Hand photographs were taken in a standardized manner, anonymized, and cropped to include joints of interest. A ResNet-101 backbone modified for two class outputs (inflamed or not) was used for training. We also tested a hue-augmented dataset. We reported accuracy, sensitivity, and specificity for three joints: wrist, index finger proximal interphalangeal (IFPIP), and middle finger proximal interphalangeal (MFPIP), taking the rheumatologist’s opinion as the gold standard.

Results

The cohort consisted of 100 individuals, of which 22 of them were men, with a mean age of 49.7 (SD 12.9) years. The majority of the cohort (n = 68, 68%) had rheumatoid arthritis. The wrist (125/200, 62.5%), MFPIP (94/200, 47%), and IFPIP (83/200, 41.5%) were the three most commonly inflamed joints. The CNN achieved the highest accuracy, sensitivity, and specificity in detecting synovitis in the MFPIP (83, 77, and 88%, respectively), followed by the IFPIP (74, 74, and 75%, respectively) and the wrist (62, 90, and 21%, respectively).

Discussion

We have demonstrated that computer vision was able to detect inflammation in three joints of the hand with reasonable accuracy on standardized photographs despite a small dataset. Feature engineering was not required, and the CNN worked despite a diversity in clinical diagnosis. Larger datasets are likely to improve accuracy and help explain the basis of classification. These data suggest a potential use of computer vision in screening and follow-up of inflammatory arthritis.
Pediatric intensive care unit treatment alters the diversity and composition of the gut microbiota and antimicrobial resistance gene expression in critically ill children
Authors: Xu Jiayue , Kong Xiangmei , Li Jiru , Mao Haoyun , Zhu Yueniu , Zhu Xiaodong , Xu Yaya
Published: November 2023

Introduction

Common critical illnesses are a growing economic burden on healthcare worldwide. However, therapies targeting the gut microbiota for critical illnesses have not been developed on a large scale. This study aimed to investigate the changes in the characteristics of the gut microbiota in critically ill children after short-term pediatric intensive care unit (PICU) treatments.

Methods

Anal swab samples were prospectively collected from March 2021 to March 2022 from children admitted to the PICU of Xinhua Hospital who received broad-spectrum antibiotics on days 1 (the D1 group) and 7 (the D7 group) of the PICU treatment. The structural and functional characteristics of the gut microbiota of critically ill children were explored using metagenomic next-generation sequencing (mNGS) technology, and a comparative analysis of samples from D1 and D7 was conducted.

Results

After 7 days of PICU admission, a significant decrease was noted in the richness of the gut microbiota in critically ill children, while the bacterial diversity and the community structure between groups remained stable to some extent. The relative abundance of Bacilli and Lactobacillales was significantly higher, and that of Campylobacter hominis was significantly lower in the D7 group than in the D1 group. The random forest model revealed that Prevotella coporis and Enterobacter cloacae were bacterial biomarkers between groups. LEfSe revealed that two Gene Ontology entries, GO:0071555 (cell wall organization) and GO:005508 (transmembrane transport), changed significantly after the short-term treatment in the PICU. In addition, 30 KEGG pathways were mainly related to the activity of enzymes and proteins during the processes of metabolism, DNA catabolism and repair, and substance transport. Finally, 31 antimicrobial resistance genes had significantly different levels between the D7 and D1 groups. The top 10 up-regulated genes were Erm(A), ErmX, LptD, eptB, SAT-4, tetO, adeJ, adeF, APH(3′)-IIIa, and tetM.

Conclusion

The composition, gene function, and resistance genes of gut microbiota of critically ill children can change significantly after short PICU treatments. Our findings provide a substantial basis for a better understanding of the structure and function of gut microbiota and their role in critical illnesses.
Comparative analysis of the biological characteristics and mechanisms of azole resistance of clinical Aspergillus fumigatus strains
Authors: Zeng Meng , Zhou Xue , Yang Chunhong , Liu Yanfei , Zhang Jinping , Xin Caiyan , Qin Gang , Liu Fangyan , Song Zhangyong
Published: November 2023

Aspergillus fumigatus is a common causative pathogen of aspergillosis. At present, triazole resistance of A. fumigatus poses an important challenge to human health globally. In this study, the biological characteristics and mechanisms of azole resistance of five A. fumigatus strains (AF1, AF2, AF4, AF5, and AF8) were explored. There were notable differences in the sporulation and biofilm formation abilities of the five test strains as compared to the standard strain AF293. The ability of strain AF1 to avoid phagocytosis by MH-S cells was significantly decreased as compared to strain AF293, while that of strains AF2, AF4, and AF5 were significantly increased. Fungal burden analysis with Galleria mellonella larvae revealed differences in pathogenicity among the five strains. Moreover, the broth microdilution and E-test assays confirmed that strains AF1 and AF2 were resistant to itraconazole and isaconazole, while strains AF4, AF5, and AF8 were resistant to voriconazole and isaconazole. Strains AF1 and AF2 carried the cyp51A mutations TR34/L98H/V242I/S297T/F495I combined with the hmg1 mutation S541G, whereas strains AF4 and AF8 carried the cyp51A mutation TR46/Y121F/V242I/T289A, while strain AF5 had no cyp51A mutation. Real-time quantitative polymerase chain reaction (RT-qPCR) analysis revealed differences in the expression levels of genes associated with ergosterol synthesis and efflux pumps among the five strains. In addition, transcriptomics, RT-qPCR, and the NAD+/NADH ratio demonstrated that the mechanism of voriconazole resistance of strain AF5 was related to overexpression of genes associated with energy production and efflux pumps. These findings will help to further elucidate the triazole resistance mechanism in A. fumigatus.
The analysis of Lactobacillus spp. distribution in the vaginal microbiota of Polish women with abnormal Pap smear result
Authors: Frąszczak Karolina , Barczyński Bartłomiej , Siwiec Radosław , Kondracka Adrianna , Malm Anna , Kotarski Jan , Witt Elzbieta , Korona-Głowniak Izabela
Published: November 2023

Introduction

A healthy vaginal microbiota is represented mainly by Lactobacillus spp. and plays a vital role in maintaining the functional balance in the vaginal environment. Scientists have drawn attention to possible correlations between the vaginal microbiome and gynecological neoplasms. Several recent studies have shown a potential link between the vaginal microbiome and the risk of developing cervical cancer from human papillomavirus (HPV) infection. This study aimed to compare the prevalence and abundance of various lactic acid bacteria species (LABs) in vaginal swabs from healthy controls and patients with abnormal Pap smear results.

Methods

The study included 100 women (79 patients with abnormal cervical Pap smear results and 21 controls) from whom vaginal swabs were collected. Real-time quantitative PCR was used to determine seven lactic acid bacteria (LAB) species and their quantities.

Results

Most patients were colonized by two Lactobacillus species, primarily Lactobacillus gasseri (93%) and L. crispatus (83%). Patient age and place of residence were associated with the diversity of LAB in the vaginal microbiota. The abundance of L. delbrueckii in the vaginal microbiota increased, whereas the abundance of L. gasseri abundance decreased, with patient age. Lactobacillus acidophilus and Limosilactobacillus fermentum were significantly more often detected in patients living in rural versus urban areas. Statistical analysis did not show any significant differences in LAB between groups of patients with various changes on smear tests.

Discussion

The degree of dysplastic changes in the endothelium or the presence of a group of atypical cervical stratified epithelial cells was not associated with significant changes in the studied vaginal bacteria.
Metabolomic profiling of Marek’s disease virus infection in host cell based on untargeted LC-MS
Authors: Wang Qingsen , Shi Bin , Yang Guifu , Zhu Xueying , Shao Hongxia , Qian Kun , Ye Jianqiang , Qin Aijian
Published: November 2023

Marek’s disease (MD) caused by Marek’s disease virus (MDV), poses a serious threat to the poultry industry by inducing neurological disease and malignant lymphoma in infected chickens. However, the underlying mechanisms how MDV disrupts host cells and causes damage still remain elusive. Recently, the application of metabolomics has shown great potential for uncovering the complex mechanisms during virus-host interactions. In this study, chicken embryo fibroblasts (CEFs) infected with MDV were subjected to ultrahigh-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry (UHPLC-QTOF-MS) and multivariate statistical analysis. The results showed that 261 metabolites were significantly altered upon MDV infection, with most changes occurring in amino acid metabolism, energy metabolism, nucleotide metabolism, and lipid metabolism. Notably, MDV infection induces an up-regulation of amino acids in host cells during the early stages of infection to provide the energy and intermediary metabolites necessary for efficient multiplication of its own replication. Taken together, these data not only hold promise in identifying the biochemical molecules utilized by MDV replication in host cells, but also provides a new insight into understanding MDV-host interactions.
Comparative diet-gut microbiome analysis in Crohn’s disease and Hidradenitis suppurativa
Authors: Cronin Peter , McCarthy Siobhan , Hurley Cian , Ghosh Tarini Shankar , Cooney Jakki C. , Tobin Ann-Marie , Murphy Michelle , O’Connor Eibhlís M. , Shanahan Fergus , O’Toole Paul W.
Published: November 2023

Introduction

The chronic inflammatory skin disease Hidradenitis suppurativa (HS) is strongly associated with Crohn’s Disease (CD). HS and CD share clinical similarities and similar inflammatory pathways are upregulated in both conditions. Increased prevalence of inflammatory disease in industrialised nations has been linked to the Western diet. However, gut microbiota composition and diet interaction have not been compared in HS and CD.

Methods

Here we compared the fecal microbiota (16S rRNA gene amplicon sequencing) and habitual diet of previously reported subjects with HS (n = 55), patients with CD (n = 102) and controls (n = 95).

Results and discussion

Patients with HS consumed a Western diet similar to patients with CD. Meanwhile, habitual diet in HS and CD was significantly different to controls. Previously, we detected differences in microbiota composition among patients with HS from that of controls. We now show that 40% of patients with HS had a microbiota configuration similar to that of CD, characterised by the enrichment of pathogenic genera (Enterococcus, Veillonella and Escherichia_Shigella) and the depletion of putatively beneficial genera (Faecalibacterium). The remaining 60% of patients with HS harboured a normal microbiota similar to that of controls. Antibiotics, which are commonly used to treat HS, were identified as a co-varying with differences in microbiota composition. We examined the levels of several inflammatory markers highlighting that growth-arrest specific 6 (Gas6), which has anti-inflammatory potential, were significantly lower in the 40% of patients with HS who had a CD microbiota configuration. Levels of the pro-inflammatory cytokine IL-12, which is a modulator of intestinal inflammation in CD, were negatively correlated with the abundance of health-associated genera in patients with HS. In conclusion, the fecal microbiota may help identify patients with HS who are at greater risk for development of CD.
Exploring the causal correlations between 486 serum metabolites and systemic lupus erythematosus: a bidirectional Mendelian randomization study
Authors: Li Li , Li Wenyu , Ma Qing , Lin Youkun , Cui Zhezhe
Published: November 2023

Objective: The observational association between circulating metabolites and systemic lupus erythematosus (SLE) has been well documented. However, whether the association is causal remains unclear. In this study, bidirectional Mendelian randomization (MR) was introduced to analyse the causal relationships and possible mechanisms.

Methods: We conducted a two-sample bidirectional MR study. A genome-wide association study (GWAS) with 7,824 participants provided data on 486 human blood metabolites. Outcome information was obtained from a large-scale GWAS summary, which contained 5,201 single nucleotide polymorphisms (SNPs) cases and 9,066 control cases of Europeans and yielded a total of 7,071,163 SNPs. The inverse variance weighted (IVW) model was recruited as the primary two-sample MR analysis approach, followed by sensitivity analyses such as the heterogeneity test, horizontal pleiotropy test, leave-one-out analysis, and linkage disequilibrium score (LDSC) regression.

Results: In this study, we discovered that 24 metabolites belonging to the lipid, carbohydrate, xenobiotic and amino acid superpathways may increase the risk of SLE occurrence (p < 0.05). In addition, the metabolic disorders of 51 metabolites belonging to the amino acid, energy, xenobiotics, peptide and lipid superpathways were affected by SLE (p < 0.05). Palmitoleate belonging to the lipid superpathway and isobutyrylcarnitine and phenol sulfate belonging to the amino acid superpathway were factors with two-way causation. The metabolic enrichment pathway of bile acid biosynthesis was significant in the forward MR analysis (p = 0.0435). Linolenic acid and linoleic acid metabolism (p = 0.0260), betaine metabolism (p = 0.0314), and glycerolipid metabolism (p = 0.0435) were the significant metabolically enriched pathways in the reverse MR analysis.

Conclusion: The levels of some specific metabolites may either contribute to the immune response inducing SLE, or they may be intermediates in the development and progression of SLE. These metabolites can be used as auxiliary diagnostic tools for SLE and for the evaluation of disease progression and therapeutic effects.
Carbonic anhydrase versatility: from pH regulation to CO2 sensing and metabolism
Authors: Supuran Claudiu T.
Published: November 2023

While the carbonic anhydrase (CA, EC 4.2.1.1) superfamily of enzymes has been described primarily as involved only in pH regulation for decades, it also has many other important functions. CO2, bicarbonate, and protons, the physiological substrates of CA, are indeed the main buffering system in organisms belonging to all life kingdoms; however, in the last period, relevant progress has been made in the direction of elucidating the involvement of the eight genetically distinct CA families in chemical sensing, metabolism, and several other crucial physiological processes. Interference with CA activity, both by inhibiting and activating these enzymes, has thus led to novel applications for CA inhibitors and activators in the field of innovative biomedicine and environment and health. In this perspective article, I will discuss the recent advances which have allowed for a deeper understanding of the biochemistry of these versatile enzymes and various applications of their modulators of activity.
A human-centered safe robot reinforcement learning framework with interactive behaviors
Authors: Gu Shangding , Kshirsagar Alap , Du Yali , Chen Guang , Peters Jan , Knoll Alois
Published: November 2023

Deployment of Reinforcement Learning (RL) algorithms for robotics applications in the real world requires ensuring the safety of the robot and its environment. Safe Robot RL (SRRL) is a crucial step toward achieving human-robot coexistence. In this paper, we envision a human-centered SRRL framework consisting of three stages: safe exploration, safety value alignment, and safe collaboration. We examine the research gaps in these areas and propose to leverage interactive behaviors for SRRL. Interactive behaviors enable bi-directional information transfer between humans and robots, such as conversational robot ChatGPT. We argue that interactive behaviors need further attention from the SRRL community. We discuss four open challenges related to the robustness, efficiency, transparency, and adaptability of SRRL with interactive behaviors.
Fuzzy super twisting mode control of a rigid-flexible robotic arm based on approximate inertial manifold dimensionality reduction
Authors: Qian Xiaoshan , Xu Lisha , Yuan Xinmei
Published: November 2023

Introduction

The control of infinite-dimensional rigid-flexible robotic arms presents significant challenges, with direct truncation of first-order modal models resulting in poor control quality and second-order models leading to complex hardware implementations.

Methods

To address these issues, we propose a fuzzy super twisting mode control method based on approximate inertial manifold dimensionality reduction for the robotic arm. This innovative approach features an adjustable exponential non-singular sliding surface and a stable continuous super twisting algorithm. A novel fuzzy strategy dynamically optimizes the sliding surface coefficient in real-time, simplifying the control mechanism.

Results

Our findings, supported by various simulations and experiments, indicate that the proposed method outperforms directly truncated first-order and second-order modal models. It demonstrates effective tracking performance under bounded external disturbances and robustness to system variability.

Discussion

The method's finite-time convergence, facilitated by the modification of the nonlinear homogeneous sliding surface, along with the system's stability, confirmed via Lyapunov theory, marks a significant improvement in control quality and simplification of hardware implementation for rigid-flexible robotic arms.
Reperfusion status and postoperative blood pressure in acute stroke patients after endovascular treatment
Authors: Xu Hongye , Li He , Zhang Ping , Gao Yuan , Liu Hanchen , Shen Hongjian , Hua Weilong , Zhang Lei , Li Zifu , Zhang Yongxin , Xing Pengfei , Zhang Xiaoxi , Yang Pengfei , Liu Jianmin
Published: November 2023

Background and purpose

An aggressive lowering of blood pressure (BP) could lead to neurological worsening, particularly of the area that has not been reperfused in acute stroke patients with large vessel occlusion (LVO). We sought to investigate the association of reperfusion status and BP course following mechanical thrombectomy (MT) with outcomes in LVO.

Materials and methods

Consecutive patients with LVO treated with MT between Jan 2020 to Jun 2021 were enrolled in a retrospective cohort study. Hourly systolic BP (SBP) and diastolic BP (DBP) were recorded for 72 h following MT and maximum SBP and DBP levels were identified. The Extended Thrombolysis in Cerebral Infarction (eTICI) scale was used to assess reperfusion extent. LVO patients were stratified in 2 groups based on reperfusion status: complete reperfusion (eTICI 3) and incomplete reperfusion (eTICI 2b/c). Three-month functional independence was defined as a modified Rankin Scale score of 0–2.

Results

A total of 263 acute ischemic stroke patients with LVO were retrospectively evaluated. Complete reperfusion was achieved in 210 patients (79.8%). Post-MT maximum SBP over 160 mmHg was significantly related to worse functional outcome (38.1% vs. 55.7%, p = 0.006), higher likelihood of in-hospital mortality and 3-month mortality (19.0% vs. 6.9%, p = 0.004, 27.4% vs. 14.3%, p = 0.012). No statistical correlation was found between reperfusion status and blood pressure level (p > 0.05). In patients with complete reperfusion, patients with an average BP 120-140 mmHg tends to have worse functional outcome compared with 100-120 mmHg (OR = 1.77, 95%CI: 0.97–3.23, p = 0.061).

Conclusion

High maximum SBP levels following MT are associated with an increased likelihood of 3-month functional dependence and mortality. An average BP of 100–120 mmHg tends to have better functional independence in completely reperfused patients. The effect of intensive BP control on incomplete reperfusion still warrants further investigations.
Nationwide emergency department visits for pediatric traumatic spinal cord injury in the United States, 2016–2020
Authors: Crispo James A. G. , Liu Lisa J. W. , Noonan Vanessa K. , Thorogood Nancy P. , Kwon Brian K. , Dvorak Marcel F. , Thibault Dylan , Willis Allison W. , Cragg Jacquelyn J.
Published: November 2023

Introduction

Traumatic spinal cord injury (tSCI) is a debilitating neurological condition resulting in lifelong disability for many individuals. The primary objectives of our study were to describe national trends in incident emergency department (ED) visits for tSCI among children (less than 21 years) in the United States, and to determine the proportion of visits that resulted in immediate hospitalization each year, including stratified by age and sex. Secondary objectives were to examine associations between select characteristics and hospitalization following tSCI, as well as to assess sports-related tSCIs over time, including by individual sport and geographic region.

Methods

We used the Healthcare Cost and Utilization Project Nationwide Emergency Department Sample to identify ED visits among children between January 2016 and December 2020 for incident tSCI. Diagnosis codes were used to identify tSCI and sports-related injury etiologies. Census Bureau data were used to approximate annual rates of pediatric ED visits for tSCI per 100,000 children. Unconditional logistic regression modeling assessed whether select factors were associated with hospital admission.

Results

We found that the annual ED visit rate for tSCI remained relatively stable between 2016 and 2020, with approximately 2,200 new all-cause pediatric ED visits for tSCI annually. Roughly 70% of ED visits for tSCI resulted in hospitalization; most ED visits for tSCI were by older children (15–20 years) and males, who were also more often admitted to the hospital. Notable secondary findings included: (a) compared with older children (15–20 years), younger children (10–14 years) were less likely to be hospitalized immediately following an ED visit for tSCI; (b) patient sex and race were not associated with hospital admission; and (c) American tackle football was the leading cause of sports-related ED visits for tSCI among children. Our findings also suggest that the proportion of sports-related tSCI ED visits may have increased in recent years.

Discussion

Future research should further examine trends in the underlying etiologies of pediatric tSCI, while assessing the effectiveness of new and existing interventions aimed at tSCI prevention.
TelePriming sentence production in aphasia
Authors: Lee Jiyeon , Keen Austin D. , Farr Ellis , Christ Sharon
Published: November 2023

Background

The application of videoconferencing to the assessment and treatment of aphasia has been rapidly increasing; however, there is a need to develop treatments targeting sentence production in persons with aphasia (PWA) that can be delivered through videoconferencing. Structural priming has received recent attention as a potential training method for PWA. We investigated the feasibility and efficacy of a collaborative structural priming task delivered via the internet, TelePriming, in facilitating sentence production in PWA and healthy adults.

Method

In Study 1, young adults (YA), older adults (OA), and PWA participated in a collaborative dialogue-like priming task through videoconferencing, taking turns with an interlocutor (experimenter) to describe transitive action pictures with the goal of finding matching pictures. We measured whether participants produced more passive sentences to describe their picture after hearing their interlocutor produce passive compared to active sentences (primes). In Study 2, we compared the data from the OA and PWA of Study 1 (TelePriming) to different groups of OA and PWA, who completed the same priming task in person.

Results

All three groups showed robust priming effects in Study 1, producing more passive sentences to describe target pictures after hearing the experimenter produce passive versus active sentences. In Study 2, when controlling for demographic information (age, education) and aphasia severity, TelePriming resulted in larger priming effects for OA and PWA, compared to the in-person priming task. Survey results revealed that both OA and PWA experienced increased comfort and satisfaction with using technology following the task.

Conclusion

Interactive message-structure alignment processes remain largely intact in PWA, and the positive effects of structural priming in a collaborative communicative task are not diminished by remote delivery. The findings demonstrate the feasibility and validity of TelePriming in OA and PWA, laying experimental groundwork for future use of TelePriming in the assessment and treatment of clinical populations with limited access to face-to-face sessions.
Visual integration across fixation: automatic processes are split but conscious processes remain unified in the split-brain
Authors: Pinto Yair , Villa Maria-Chiara , Siliquini Sabrina , Polonara Gabriele , Passamonti Claudia , Lattanzi Simona , Foschi Nicoletta , Fabri Mara , de Haan Edward H. F.
Published: November 2023

The classic view holds that when “split-brain” patients are presented with an object in the right visual field, they will correctly identify it verbally and with the right hand. However, when the object is presented in the left visual field, the patient verbally states that he saw nothing but nevertheless identifies it accurately with the left hand. This interaction suggests that perception, recognition and responding are separated in the two isolated hemispheres. However, there is now accumulating evidence that this interaction is not absolute; for instance, split-brain patients are able to detect and localise stimuli anywhere in the visual field verbally and with either hand. In this study we set out to explore this cross-hemifield interaction in more detail with the split-brain patient DDC and carried out two experiments. The aim of these experiments is to unveil the unity of deliberate and automatic processing in the context of visual integration across hemispheres. Experiment 1 suggests that automatic processing is split in this context. In contrast, when the patient is forced to adopt a conscious, deliberate, approach, processing seemed to be unified across visual fields (and thus across hemispheres). First, we looked at the confidence that DDC has in his responses. The experiment involved a simultaneous “same” versus “different” matching task with two shapes presented either within one hemifield or across fixation. The results showed that we replicated the observation that split brain patients cannot match across fixation, but more interesting, that DDC was very confident in the across-fixation condition while performing at chance-level. On the basis of this result, we hypothesised a two-route explanation. In healthy subjects, the visual information from the two hemifields is integrated in an automatic, unconscious fashion via the intact splenium, and this route has been severed in DDC. However, we know from previous experiments that some transfer of information remains possible. We proposed that this second route (perhaps less visual; more symbolic) may become apparent when he is forced to use a deliberate, consciously controlled approach. In an experiment where he is informed, by a second stimulus presented in one hemifield, what to do with the first stimulus that was presented in the same or the opposite hemifield, we showed that there was indeed interhemispheric transfer of information. We suggest that this two-route model may help in clarifying some of the controversial issues in split-brain research.
Influence of spatial frequency in visual stimuli for cVEP-based BCIs: evaluation of performance and user experience
Authors: Fernández-Rodríguez Álvaro , Martínez-Cagigal Víctor , Santamaría-Vázquez Eduardo , Ron-Angevin Ricardo , Hornero Roberto
Published: November 2023

Code-modulated visual evoked potentials (c-VEPs) are an innovative control signal utilized in brain-computer interfaces (BCIs) with promising performance. Prior studies on steady-state visual evoked potentials (SSVEPs) have indicated that the spatial frequency of checkerboard-like stimuli influences both performance and user experience. Spatial frequency refers to the dimensions of the individual squares comprising the visual stimulus, quantified in cycles (i.e., number of black-white squares pairs) per degree of visual angle. However, the specific effects of this parameter on c-VEP-based BCIs remain unexplored. Therefore, the objective of this study is to investigate the role of spatial frequency of checkerboard-like visual stimuli in a c-VEP-based BCI. Sixteen participants evaluated selection matrices with eight spatial frequencies: C001 (0 c/°, 1×1 squares), C002 (0.15 c/°, 2×2 squares), C004 (0.3 c/°, 4×4 squares), C008 (0.6 c/°, 8×8 squares), C016 (1.2 c/°, 16×16 squares), C032 (2.4 c/°, 32×32 squares), C064 (4.79 c/°, 64×64 squares), and C128 (9.58 c/°, 128×128 squares). These conditions were tested in an online spelling task, which consisted of 18 trials each conducted on a 3×3 command interface. In addition to accuracy and information transfer rate (ITR), subjective measures regarding comfort, ocular irritation, and satisfaction were collected. Significant differences in performance and comfort were observed based on different stimulus spatial frequencies. Although all conditions achieved mean accuracy over 95% after 2.1 s of trial duration, C016 stood out in terms user experience. The proposed condition not only achieved a mean accuracy of 96.53% and 164.54 bits/min with a trial duration of 1.05s, but also was reported to be significantly more comfortable than the traditional C001 stimulus. Since both features are key for BCI development, higher spatial frequencies than the classical black-to-white stimulus might be more adequate for c-VEP systems. Hence, we assert that the spatial frequency should be carefully considered in the development of future applications for c-VEP-based BCIs.
Use of non-invasive transcutaneous auricular vagus nerve stimulation: neurodevelopmental and sensory follow-up
Authors: Aljuhani Turki , Coker-Bolt Patricia , Katikaneni Lakshmi , Ramakrishnan Viswanathan , Brennan Alyssa , George Mark S. , Badran Bashar W. , Jenkins Dorothea
Published: November 2023

Objective

To assess the impact of non-invasive transcutaneous auricular vagal nerve stimulation (taVNS) paired with oral feeding on long-term neurodevelopmental and sensory outcomes.

Method

We tested 21 of 35 children who as infants were gastrostomy tube (G-tube) candidates and participated in the novel, open-label trial of taVNS paired with oral feeding. To evaluate possible effects on development at 18-months after infant taVNS, we performed the Bayley-III (n = 10) and Sensory Profile (SP-2, n = 12) assessments before the COVID pandemic, and Cognitive Adaptive Test (CAT), Clinical Linguistics and Auditory Milestone (CLAMS), Ages and Stages Questionnaire (ASQ), and Peabody Developmental Motor Scales-2 gross motor tests as possible during and after the pandemic. We compared outcomes for infants who attained full oral feeds during taVNS (‘responders’) or received G-tubes (‘non-responders’).

Results

At a mean of 19-months, taVNS ‘responders’ showed significantly better general sensory processing on the SP-2 than ‘non-responders’. There were no differences in other test scores, which were similar to published outcomes for infants who required G-tubes.

Conclusion

This is the first report of neurodevelopmental follow-up in infants who received taVNS-paired feeding. They had similar developmental outcomes as historical control infants failing oral feeds who received G-tubes. Our data suggests that infants who attained full oral feeds had better sensory processing.
Fat intake impairs the recovery of endothelial function following mental stress in young healthy adults
Authors: Baynham Rosalind , Weaver Samuel R. C. , Rendeiro Catarina , Veldhuijzen van Zanten Jet J. C. S.
Published: November 2023

Introduction

Mental stress has been identified as a trigger of cardiovascular events. A single episode of stress can induce acute impairments in endothelial function in healthy adults. Importantly, during stressful periods, individuals often resort to unhealthy behaviors, such as increased consumption of high-fat foods, which is also known to negatively impact endothelial function. Therefore, this study examined whether consumption of a high-fat meal would further exacerbate the negative effect of mental stress on vascular function.

Methods

In a randomized, counterbalanced, cross- over, postprandial intervention study, 21 healthy males and females ingested a high-fat (56.5 g fat) or a low-fat (11.4 g fat) meal 1.5 h before an 8-min mental stress task (Paced-Auditory-Serial-Addition-Task, PASAT). Plasma triglyceride (TAG) concentration was assessed pre-and post-meal. Forearm blood flow (FBF), blood pressure (BP), and cardiovascular activity were assessed pre-meal at rest and post-meal at rest and during stress. Endothelial function, measured by brachial flow-mediated dilatation (FMD) was assessed pre-meal and 30 and 90 min following mental stress.

Results

Plasma TAG concentration was significantly increased following the high-fat meal compared to the low-fat condition. Mental stress induced similar increases in peripheral vasodilation, BP, and cardiovascular activity, and impaired FMD 30 min post-stress, in both conditions. FMD remained significantly impaired 90 min following stress in the high-fat condition only, suggesting that consumption of fat attenuates the recovery of endothelial function following mental stress.

Discussion

Given the prevalence of fat consumption during stressful periods among young adults, these findings have important implications for dietary choices to protect the vasculature during periods of stress.
A multi-center prospective study of plant-based nutritional support in adult community-based patients at risk of disease-related malnutrition
Authors: Delsoglio Marta , Griffen Corbin , Syed Rakshan , Cookson Tobias , Saliba Hanorah , Vowles Amanda , Davies Samuel , Willey Nicola , Thomas Jennifer , Millen Nicola , Odeh Nour , Longstaff Jayne , Westran Naomi , Allan Lindsey , Offer Hannah , Howell Chloe , Sanders Meg , Gaffigan Kirsty , Garrett Kirby , Foster Sally , Salt Agnes , Carter Emily , Moore Sarah , Bergin Nick , Roper Jane , Alvarez Joe , Voss Christine , Connolly Teresa , MacDonald Clare , Thrower Tracey , Sills Darren , Baxter Janet , Manning Rhonda , Gray Lynsey , Voas Karen , Richardson Scot , Hurren Anne-Marie , Murphy Daniel , Blake Susan , McArdle Paul , Walsh Sinead , Booth Lucy , Albrich Louise , Ashley-Maguire Sarah , Allison Joanna , Brook Sarah , Capener Rebecca , Hubbard Gary P. , Stratton Rebecca J.
Published: November 2023

Introduction

There is an emerging need for plant-based, vegan options for patients requiring nutritional support.

Methods

Twenty-four adults at risk of malnutrition (age: 59 years (SD 18); Sex: 18 female, 6 male; BMI: 19.0 kg/m2 (SD 3.3); multiple diagnoses) requiring plant-based nutritional support participated in a multi-center, prospective study of a (vegan suitable) multi-nutrient, ready-to-drink, oral nutritional supplement (ONS) [1.5 kcal/mL; 300 kcal, 12 g protein/200 mL bottle, mean prescription 275 mL/day (SD 115)] alongside dietary advice for 28 days. Compliance, anthropometry, malnutrition risk, dietary intake, appetite, acceptability, gastrointestinal (GI) tolerance, nutritional goal(s), and safety were assessed.

Results

Patients required a plant-based ONS due to personal preference/variety (33%), religious/cultural reasons (28%), veganism/reduce animal-derived consumption (17%), environmental/sustainability reasons (17%), and health reasons (5%). Compliance was 94% (SD 16). High risk of malnutrition (‘MUST’ score ≥ 2) reduced from 20 to 16 patients (p = 0.046). Body weight (+0.6 kg (SD 1.2), p = 0.02), BMI (+0.2 kg/m2 (SD 0.5), p = 0.03), total mean energy (+387 kcal/day (SD 416), p < 0.0001) and protein intake (+14 g/day (SD 39), p = 0.03), and the number of micronutrients meeting the UK reference nutrient intake (RNI) (7 vs. 14, p = 0.008) significantly increased. Appetite (Simplified Nutritional Appetite Questionnaire (SNAQ) score; p = 0.13) was maintained. Most GI symptoms were stable throughout the study (p > 0.06) with no serious adverse events related.

Discussion

This study highlights that plant-based nutrition support using a vegan-suitable plant-based ONS is highly complied with, improving the nutritional outcomes of patients at risk of malnutrition.
Apatinib plus chemotherapy for non-metastatic osteosarcoma: a retrospective cohort study
Authors: Wang Jiaqiang , Zhang Fan , Dong Shuping , Yang Yang , Gao Fangfang , Liu Guancong , Zhang Peng , Wang Xin , Du Xinhui , Tian Zhichao
Published: November 2023

Background

Effective adjuvant therapy for osteosarcoma is necessary for improved outcomes. Previous studies demonstrated that apatinib plus doxorubicin-based chemotherapy may improve the efficacy of neoadjuvant therapy. This study aimed to clarify the effectiveness and safety of apatinib plus doxorubicin and cisplatin (AP) as neoadjuvant therapy for osteosarcoma.

Methods

The clinical data of osteosarcoma patients who underwent neoadjuvant therapy and surgery between August 2016 and April 2022 were retrospectively collected and analyzed. Patients were divided into two groups: the apatinib plus AP (apatinib + AP) group and the methotrexate, doxorubicin, and cisplatin (MAP) group.

Results

This study included 42 patients with nonmetastatic osteosarcoma (19 and 23 patients in the apatinib + AP and MAP groups, respectively). The 1- and 2-year disease-free survival rates in the apatinib + AP group were higher than those in the MAP group, but the difference was not significant (P=0.165 and 0.283, respectively). Some adverse events were significantly more common in the apatinib + AP group than in the MAP group, including oral mucositis (grades 3 and 4) (52.6% vs. 17.4%, respectively, P=0.023), limb edema (47.4% vs. 17.4%, respectively, P=0.049), hand-foot syndrome (31.6% vs. 0%, respectively, P=0.005), proteinuria (26.3% vs. 0%, respectively, P=0.014), hypertension (21.1% vs. 0%, respectively, P=0.035), and hypothyroidism (21.1% vs. 0%, respectively, P=0.035). No drug-related deaths occurred. There was no statistically significant difference in the incidence of postoperative complications between the groups (P>0.05).

Conclusion

The present study suggests that apatinib + AP may be a promising candidate for neoadjuvant therapy for osteosarcoma, warranting further validation in prospective randomized controlled clinical trials with long-term follow-up.
Prognostic value of preoperative albumin-to-alkaline phosphatase ratio in patients with surgically treated urological cancer: a systematic review and meta-analysis
Authors: Ren Shangqing , Wang Han , Yang Bo , Zheng Yang , Ou Yong , Bao Yige , Mao Yu , Feng Yunlin
Published: November 2023

Objective

A novel albumin-to-alkaline phosphatase ratio (AAPR) is associated with the prognosis of several cancers. In the present study, we evaluate the prognostic significance of perioperative AAPR in urological cancers.

Method

Relevant studies were searched comprehensively from CNKI, PubMed, Embase and Web of Science up to March 2023. The pooled hazard ratio (HR) and 95% confidence interval (CI) were extracted from each study to evaluate the prognostic value of perioperative AAPR in patients with surgically treated urological cancers.

Results

A total of 8 studies consisting of 3,271 patients were included in the final results. A low AAPR was significantly associated with a worse OS (HR=2.21; P<0.001), CSS (HR=2.61; P<0.001) and RFS/DFS (HR=2.87; P=0.001). Stratified by disease, a low AAPR was also associated with worse OS in renal cell carcinoma (HR=2.01; P<0.001), bladder cancer (HR=3.37; P<0.001) and upper tract urothelial carcinoma (HR=1.59; P=0.002).

Conclusion

In conclusion, low AAPR could serve as an unfavorable factor in patients with surgically treated urological cancers. Stratified by tumor type, the low AAPR was also associated with inferior survival. While more prospective and large-scale studies are warranted to validate our findings.
Targeting casein kinase 1 for cancer therapy: current strategies and future perspectives
Authors: Long Ngo Hoang , Lee Sook-Jeong
Published: November 2023

Casein Kinase 1 (CK1) is a family of serine/threonine protein kinases that play a crucial role in various cellular processes, including cell proliferation, survival, and metabolism. The dysregulation of CK1 expression has been implicated in the development and progression of several types of cancer, making it an attractive target for anticancer therapy. In this review, we provide an overview of the current strategies employed to target CK1 for cancer therapy and discuss the future perspectives in this field. We highlight the different approaches, including small molecule inhibitors, RNA interference, genome editing, and immunotherapies, which hold immense potential for targeted modulation of CK1 activity in cancer cells. Furthermore, we discuss the challenges associated with targeting CK1 and propose potential strategies to overcome these hurdles. Overall, targeting CK1 holds great promise as a therapeutic strategy for cancer treatment, and further research in this area is warranted.
A multi-centric evaluation of self-learning GAN based pseudo-CT generation software for low field pelvic magnetic resonance imaging
Authors: Prunaretty Jessica , Güngör Gorkem , Gevaert Thierry , Azria David , Valdenaire Simon , Balermpas Panagiotis , Boldrini Luca , Chuong Michael David , De Ridder Mark , Hardy Leo , Kandiban Sanmady , Maingon Philippe , Mittauer Kathryn Elizabeth , Ozyar Enis , Roque Thais , Colombo Lorenzo , Paragios Nikos , Pennell Ryan , Placidi Lorenzo , Shreshtha Kumar , Speiser M. P. , Tanadini-Lang Stephanie , Valentini Vincenzo , Fenoglietto Pascal
Published: November 2023

Purpose/objectives

An artificial intelligence-based pseudo-CT from low-field MR images is proposed and clinically evaluated to unlock the full potential of MRI-guided adaptive radiotherapy for pelvic cancer care.

Materials and method

In collaboration with TheraPanacea (TheraPanacea, Paris, France) a pseudo-CT AI-model was generated using end-to-end ensembled self-supervised GANs endowed with cycle consistency using data from 350 pairs of weakly aligned data of pelvis planning CTs and TrueFisp-(0.35T)MRIs. The image accuracy of the generated pCT were evaluated using a retrospective cohort involving 20 test cases coming from eight different institutions (US: 2, EU: 5, AS: 1) and different CT vendors. Reconstruction performance was assessed using the organs at risk used for treatment. Concerning the dosimetric evaluation, twenty-nine prostate cancer patients treated on the low field MR-Linac (ViewRay) at Montpellier Cancer Institute were selected. Planning CTs were non-rigidly registered to the MRIs for each patient. Treatment plans were optimized on the planning CT with a clinical TPS fulfilling all clinical criteria and recalculated on the warped CT (wCT) and the pCT. Three different algorithms were used: AAA, AcurosXB and MonteCarlo. Dose distributions were compared using the global gamma passing rates and dose metrics.

Results

The observed average scaled (between maximum and minimum HU values of the CT) difference between the pCT and the planning CT was 33.20 with significant discrepancies across organs. Femoral heads were the most reliably reconstructed (4.51 and 4.77) while anal canal and rectum were the less precise ones (63.08 and 53.13). Mean gamma passing rates for 1%1mm, 2%/2mm, and 3%/3mm tolerance criteria and 10% threshold were greater than 96%, 99% and 99%, respectively, regardless the algorithm used. Dose metrics analysis showed a good agreement between the pCT and the wCT. The mean relative difference were within 1% for the target volumes (CTV and PTV) and 2% for the OARs.

Conclusion

This study demonstrated the feasibility of generating clinically acceptable an artificial intelligence-based pseudo CT for low field MR in pelvis with consistent image accuracy and dosimetric results.
Diversities of disability caused by lung cancer in the 66 Belt and Road initiative countries: a secondary analysis from the Global Burden of Disease Study 2019
Authors: Zhu Zhenfeng , Ye Wenjing , Zhang Li , Jia Wenchang , Chen Binghong , Wang Qizhe , Cheng Xuelin , Yang Shijia , Zhang Zhaoyu , Ding Yibo , Li Xiaopan
Published: November 2023

Objectives

Due to the increase in life expectancy and the aging of the global population, the “Belt and Road” (“B&R”) countries are faced with varying degrees of lung cancer threat. The purpose of this study is to analyze the differences in the burden and trend of lung cancer disability in the “B&R” countries from 1990 to 2019 so as to provide an analytical strategic basis to build a healthy “B&R”.

Methods

Data were derived from the Global Burden of Disease 2019 (GBD 2019). Incidence, mortality, prevalence, the years lived with disability (YLDs), and disability-adjusted life years (DALYs) of lung cancer and those attributable to different risk factors were measured from 1990 to 2019. Trends of disease burden were estimated by using the average annual percent change (AAPC), and the 95% uncertainty interval (UI) was reported.

Results

China, India, and the Russian Federation were the three countries with the highest burden of lung cancer in 2019. From 1990 to 2019, the AAPC of incidence, prevalence, mortality, and DALYs generally showed a downward trend in Central Asia (except Georgia) and Eastern Europe, while in China, South Asia (except Bangladesh), most countries in North Africa, and the Middle East, the trend was mainly upward. The AAPC of age-standardized incidence was 1.33% (1.15%–1.50%); the AAPC of prevalence, mortality, and DALYs from lung cancer in China increased by 24% (2.10%–2.38%), 0.94% (0.74%–1.14%), and 0.42% (0.25%–0.59%), respectively. A downward trend of the AAPC values of age-standardized YLD rate in men was shown in the vast majority of “B&R” countries, but for women, most countries had an upward trend. For adults aged 75 years or older, the age-standardized YLD rate showed an increasing trend in most of the “B&R” countries. Except for the DALY rate of lung cancer attributable to metabolic risks, a downward trend of the DALY rate attributable to all risk factors, behavioral risks, and environmental/occupational risks was shown in the vast majority of “B&R” countries.

Conclusion

The burden of lung cancer in “B&R” countries varied significantly between regions, genders, and risk factors. Strengthening health cooperation among the “B&R” countries will help to jointly build a community with a shared future for mankind.