bluuebunny/crossref_metadata_2025 huggingface dataset:
Teachers and educators’ experiences and perceptions of artificial-powered interventions for autism groups
Authors: Li Guang , Zarei Mohammad Amin , Alibakhshi Goudarz , Labbafi Akram
Published: April 2024

Background

Artificial intelligence-powered interventions have emerged as promising tools to support autistic individuals. However, more research must examine how teachers and educators perceive and experience these AI systems when implemented.

Objectives

The first objective was to investigate informants’ perceptions and experiences of AI-empowered interventions for children with autism. Mainly, it explores the informants’ perceived benefits and challenges of using AI-empowered interventions and their recommendations for avoiding the perceived challenges.

Methodology

A qualitative phenomenological approach was used. Twenty educators and parents with experience implementing AI interventions for autism were recruited through purposive sampling. Semi-structured and focus group interviews conducted, transcribed verbatim, and analyzed using thematic analysis.

Findings

The analysis identified four major themes: perceived benefits of AI interventions, implementation challenges, needed support, and recommendations for improvement. Benefits included increased engagement and personalized learning. Challenges included technology issues, training needs, and data privacy concerns.

Conclusions

AI-powered interventions show potential to improve autism support, but significant challenges must be addressed to ensure effective implementation from an educator’s perspective. The benefits of personalized learning and student engagement demonstrate the potential value of these technologies. However, with adequate training, technical support, and measures to ensure data privacy, many educators will likely find integrating AI systems into their daily practices easier.

Implications

To realize the full benefits of AI for autism, developers must work closely with educators to understand their needs, optimize implementation, and build trust through transparent privacy policies and procedures. With proper support, AI interventions can transform how autistic individuals are educated by tailoring instruction to each student’s unique profile and needs.
Pediatric-type high-grade gliomas with PDGFRA amplification in adult patients with Li-Fraumeni syndrome: clinical and molecular characterization of three cases
Authors: Kibe Yuji , Ohka Fumiharu , Aoki Kosuke , Yamaguchi Junya , Motomura Kazuya , Ito Eiji , Takeuchi Kazuhito , Nagata Yuichi , Ito Satoshi , Mizutani Nobuhiko , Shiba Yoshiki , Maeda Sachi , Nishikawa Tomohide , Shimizu Hiroki , Saito Ryuta
Published: April 2024

Li-Fraumeni syndrome (LFS) is an autosomal dominant tumor predisposition syndrome caused by heterozygous germline mutations or deletions in the TP53 tumor suppressor gene. Central nervous system tumors, such as choroid plexus tumors, medulloblastomas, and diffuse gliomas, are frequently found in patients with LFS. Although molecular profiles of diffuse gliomas that develop in pediatric patients with LFS have been elucidated, those in adults are limited. Recently, diffuse gliomas have been divided into pediatric- and adult-type gliomas, based on their distinct molecular profiles. In the present study, we investigated the molecular profiles of high-grade gliomas in three adults with LFS. These tumors revealed characteristic histopathological findings of high-grade glioma or glioblastoma and harbored wild-type IDH1/2 according to whole exome sequencing (WES). However, these tumors did not exhibit the key molecular alterations of glioblastoma, IDH-wildtype such as TERT promoter mutation, EGFR amplification, or chromosome 7 gain and 10 loss. Although WES revealed no other characteristic gene mutations or copy number alterations in high-grade gliomas, such as those in histone H3 genes, PDGFRA amplification was found in all three cases together with uniparental disomy of chromosome 17p, where the TP53 gene is located. DNA methylation analyses revealed that all tumors exhibited DNA methylation profiles similar to those of pediatric-type high-grade glioma H3-wildtype and IDH-wildtype (pHGG H3-/IDH-wt), RTK1 subtype. These data suggest that high-grade gliomas developed in adult patients with LFS may be involved in pHGG H3-/IDH-wt. PDGFRA and homozygous alterations in TP53 may play pivotal roles in the development of this type of glioma in adult patients with LFS.
Beyond inundation: a comprehensive assessment of sea level rise impact on coastal cultural heritage in China
Authors: Chen Zihua , Gao Qian , Li Xiaowei , Yang Xiaohui , Wang Zhenbo
Published: April 2024

The rise in sea levels, driven by global climate change, poses a significant threat to cultural heritage in coastal regions. Traditional risk assessment methods, focusing on direct inundation, often fail to consider the crucial impact of socio-economic factors, which are significantly vulnerable to sea level rise. To bridge this gap, this study introduces an innovative Sea Level Rise Cultural Heritage Impact Assessment Model (SLR-CHIA Model), a novel approach that integrates both land inundation and socio-economic aspects. This comprehensive model evaluates potential risks to various types of cultural heritage in coastal China, including intangible cultural heritage, relics, and traditional villages. The study’s findings are striking: (1) About 7.79% of coastal villages, 53.94% of relics, and 2.53% of intangible cultural heritage are potentially at high risk in a 100-year sea level rise event; (2) Relics in the Eastern coast and villages in the Southern coast are most vulnerable; (3) Different types of cultural heritage rely on diverse principal factors for protection, resulting in varied risk levels under sea level rise conditions. The SLR-CHIA Model provides a vital methodological framework for evaluating cultural heritage risks in other global regions.
State cannabis laws and cannabis positivity among fatally injured drivers
Authors: Leavitt Thea Clare , Chihuri Stanford , Li Guohua
Published: April 2024

Background

As of November 8, 2023, 24 states and the District of Columbia have legalized cannabis for both recreational and medical use (RMCL-states), 14 states have legalized cannabis for medical use only (MCL-states) and 12 states have no comprehensive cannabis legislation (NoCL-states). As more states legalize cannabis for recreational use, it is critical to understand the impact of such policies on driving safety.

Methods

Using the 2019 and 2020 Fatality Analysis Reporting System data, we performed multivariable logistic regression modeling to explore the association between state level legalization status and cannabis positivity using toxicological testing data for 14,079 fatally injured drivers. We performed a sensitivity analysis by including multiply imputed toxicological testing data for the 14,876 eligible drivers with missing toxicological testing data.

Results

Overall, 4702 (33.4%) of the 14,079 fatally injured drivers tested positive for cannabis use. The prevalence of cannabis positivity was 30.7% in NoCL-states, 32.8% in MCL-states, and 38.2% in RMCL-states (p < 0.001). Compared to drivers fatally injured in NoCL-states, the adjusted odds ratios of testing positive for cannabis were 1.09 (95% confidence interval: 0.99, 1.19) for those fatally injured in MCL-states and 1.54 (95% confidence interval: 1.34, 1.77) for those fatally injured in RMCL-states. Sensitivity analysis yielded similar results.

Conclusions

Over one-third of fatally injured drivers tested positive for cannabis use. Drivers fatally injured in states with laws permitting recreational use of cannabis were significantly more likely to test positive for cannabis use than those in states without such laws. State medical cannabis laws had little impact on the odds of cannabis positivity among fatally injured drivers.
Extracting value from total-body PET/CT image data - the emerging role of artificial intelligence
Authors: Shiyam Sundar Lalith Kumar , Gutschmayer Sebastian , Maenle Marcel , Beyer Thomas
Published: April 2024

The evolution of Positron Emission Tomography (PET), culminating in the Total-Body PET (TB-PET) system, represents a paradigm shift in medical imaging. This paper explores the transformative role of Artificial Intelligence (AI) in enhancing clinical and research applications of TB-PET imaging. Clinically, TB-PET’s superior sensitivity facilitates rapid imaging, low-dose imaging protocols, improved diagnostic capabilities and higher patient comfort. In research, TB-PET shows promise in studying systemic interactions and enhancing our understanding of human physiology and pathophysiology. In parallel, AI’s integration into PET imaging workflows—spanning from image acquisition to data analysis—marks a significant development in nuclear medicine. This review delves into the current and potential roles of AI in augmenting TB-PET/CT’s functionality and utility. We explore how AI can streamline current PET imaging processes and pioneer new applications, thereby maximising the technology’s capabilities. The discussion also addresses necessary steps and considerations for effectively integrating AI into TB-PET/CT research and clinical practice. The paper highlights AI’s role in enhancing TB-PET’s efficiency and addresses the challenges posed by TB-PET’s increased complexity. In conclusion, this exploration emphasises the need for a collaborative approach in the field of medical imaging. We advocate for shared resources and open-source initiatives as crucial steps towards harnessing the full potential of the AI/TB-PET synergy. This collaborative effort is essential for revolutionising medical imaging, ultimately leading to significant advancements in patient care and medical research.
The implications of single-cell RNA-seq analysis in prostate cancer: unraveling tumor heterogeneity, therapeutic implications and pathways towards personalized therapy
Authors: Feng De-Chao , Zhu Wei-Zhen , Wang Jie , Li Deng-Xiong , Shi Xu , Xiong Qiao , You Jia , Han Ping , Qiu Shi , Wei Qiang , Yang Lu
Published: April 2024

In recent years, advancements in single-cell and spatial transcriptomics, which are highly regarded developments in the current era, particularly the emerging integration of single-cell and spatiotemporal transcriptomics, have enabled a detailed molecular comprehension of the complex regulation of cell fate. The insights obtained from these methodologies are anticipated to significantly contribute to the development of personalized medicine. Currently, single-cell technology is less frequently utilized for prostate cancer compared with other types of tumors. Starting from the perspective of RNA sequencing technology, this review outlined the significance of single-cell RNA sequencing (scRNA-seq) in prostate cancer research, encompassing preclinical medicine and clinical applications. We summarize the differences between mouse and human prostate cancer as revealed by scRNA-seq studies, as well as a combination of multi-omics methods involving scRNA-seq to highlight the key molecular targets for the diagnosis, treatment, and drug resistance characteristics of prostate cancer. These studies are expected to provide novel insights for the development of immunotherapy and other innovative treatment strategies for castration-resistant prostate cancer. Furthermore, we explore the potential clinical applications stemming from other single-cell technologies in this review, paving the way for future research in precision medicine.
Retrospective case series of high-density silicone oil (Oxane HD) in severe proliferative vitreorretinal retinal detachment patients
Authors: Oliveira Ramon Antunes De , Pesquero Vinicius Oliveira , Ribeiro Lucas Zago , Polizelli Murilo Ubukata , Silva Aalec Rinhel Souza Ferreira Da , Moraes Nilva Simeren Bueno De , Fernandes Rodrigo Antonio Brant , Junior Octaviano Magalhaes , Maia Mauricio
Published: April 2024

Background

Describe complications and clinical outcomes of heavy silicone oil (HSO) Oxane HD® use as an alternative to overcome the challenges of performing vitrectomy to treat tractional and rhegmatogenous retinal detachments with proliferative vitreoretinopathy (PVR).

Methods

A retrospective, observational study was performed on patients from one center from August 2014 to Aug 2023. It was included patients who underwent surgery using HSO Oxane HD® to treat rhegmatogenous retinal detachment with PVR or mixed tractional and rhegmatogenous diabetic retinal detachment. Severely ill patients who could not attend to follow up were excluded. The primary outcome was successful retinal attachment at first postoperative month. A descriptive analysis was performed.

Results

Among the 31 patients, 29 (93.5%) underwent surgeries due to rhegmatogenous retinal detachment and two (6.5%) for diabetic retinal detachment. The primary anatomic success was achieved in 27 (87.1%) patients. At the final visit, 17 (56.6%) had vision better than 20/400 (range, 20/30 to light perception). The vision was stable or improved in 22 (76.8%) patients at the end of follow-up. Nineteen (61.3%) patients required hypotensive eye drops after HSO use and twelve (38.7%) still required hypotensive eye drops at the final follow-up; three (9.7%) patients required additional glaucoma surgeries.

Conclusions

HSO is safe and useful for complex retinal detachments cases specially with inferior tears and PVR. Ocular hypertension is frequent and usually clinically controlled with hypotensive eyedrops. Close postoperatively follow-up is advised due to the ocular complications, particularly elevated intraocular pressure and emulsification.
Anesthesia management of laparoscopic right colectomy in an older patient with postoperative tetralogy of Fallot with residual anomaly
Authors: Mori Satori , Ito Hisakatsu , Sugimoto Sadamu , Hibi Daisuke , Kameyama Akiyo , Kawakami Masaaki , Takazawa Tomonori
Published: April 2024

Background

Diversity in hemodynamics of adult congenital heart disease necessitates a case-by-case selection of appropriate surgical and anesthetic options. However, previous case reports regarding the management of laparoscopic surgery in adult patients with congenital heart disease are limited.

Case presentation

A 72-year-old man who underwent a laparoscopic right colectomy for colon cancer had a residual ventricular septal defect and right ventricular outflow tract obstruction despite post-repair of tetralogy of Fallot. Pulmonary hypertension or right ventricular dysfunction was not observed. The preoperative pulmonary to systemic blood flow ratio (Qp/Qs) was 2.3. After positive pressure ventilation and insufflation, the amount of left-to-right ventricular shunting decreased, and the Qp/Qs approached 1.0, as calculated from pulmonary arterial and systemic arterial blood gas analysis.

Conclusions

Laparoscopic surgery might be tolerable in patients with tetralogy of Fallot who have preserved the right ventricular function, left-to-right ventricular shunting, and no high pulmonary vascular resistance.
Occipital abscess developed after endovascular AVM treatment with liquid embolizing agent: case report
Authors: Yuksek Muhammed Erkam , Gul Busra , Kenan Mehmet , Erdi Mehmet Fatih , Yıldırım Seyfullah , Guney Ahmet Onder , Keskin Fatih
Published: April 2024

Background

In arteriovenous malformations, endovascular embolization was first used in the 1960s to occlude feeding vessels. In recent years, the success of endovascular treatments has increased. Thus, the use of endovascular therapy in the treatment of arteriovenous malformation has become widespread. Recently, it is the primary treatment method or an adjunctive treatment to surgery. The development of intracranial abscess after endovascular treatment with a liquid embolizing agent has been reported very rarely in the literature. In this article, a case of intracerebral abscess that developed after endovascular treatment with a liquid embolizing agent was presented.

Case Presentation

A 24-year-old male patient was admitted to the hospital with the complaints of dizziness and syncope. Arteriovenous malformation was observed in radiological imaging. Endovascular treatment for the AVM was performed. He was admitted to the hospital with similar complaints 2 months after the treatment. An abscess was observed around the AVM in the patient's cranial imaging. Infected materials in the mall were surgically removed, and the abscess was drained. After antibiotic treatment, the patient was discharged with full recovery.

Conclusion

Due to the recent popularity of endovascular treatment methods, the incidence of abscess formation after embolization may change in the near future. Further research should be done to prevent this serious complication.
Outcome associated with use of winged expandable titanium cage following cervical corpectomy: an institutional experience
Authors: Prakash Anand , Bharti Rohit , Chauhan Ganesh , Dutta Gautam , Sahay Chandra Bhushan
Published: April 2024

Background

In patients with spinal cord compression behind the cervical vertebra who presented with myelopathy, one of the treatment modalities is anterior cervical corpectomy followed by insertion of graft or implant. Autogenous bone graft has been the choice of implant for corpectomy in the past, but due to donor site complications, it has been majorly replaced with other implants like titanium made expandable and non-expandable cages. Studies on titanium made implants for cervical compressive myelopathy have mostly focused on expandable cages with separate plates. Studies on hybrid cages and winged expandable titanium cages with (WETC) are lacking, especially in patients with poor Nurick grade. Here, we present clinical outcomes and side effects of WETC use following cervical corpectomy in 81 participants from a tertiary care center from Eastern India with 6 months of follow-up.

Results

We observed a considerable improvement in clinical outcomes which was measured using Nurick grade as mean scores changed from 4.06 ± 0.85 during the pre-operative stage to 2.85 ± 1.16 post-operation (P < 0.05). There was also a considerable improvement in the pain status as in the pre-operative stage there were three patients with mild pain, 53 with moderate and 25 with severe pain, but post-operation there were 53 patients with mild pain, only two with moderate pain and none with severe pain (P < 0.00001). In these participants, we observed that post-surgical Nurick grade was not associated with age, gender or time since first symptoms but was strongly associated with pre-surgical Nurick grade at P < 0.05.

Conclusion

With WETC (in situ plate), we were able to obtain good outcomes with less serious complication in patients with poor Nurick grade. As size of implant is prefixed and can be expanded in WETC, it takes relatively less time to insert, thus leading to shorter operative time. With good endplate preparation and avoiding over expansion of cage, WETC avoids complications.
Ultrasonographic and power doppler parameters of nails fail to differentiate between onychodystrophy in patients with psoriasis vulgaris or psoriatic arthritis
Authors: Tanaka Anber Ancel , Werner Betina , Bragatto Annelise Correa Bueno , Skare Thelma Larocca , Stadler Bárbara
Published: April 2024

Background

Nail involvement is frequent in patients with psoriasis (Pso) and psoriatic arthritis (PsA) and there is a relationship between nail involvement and inflammation of the enthesis. The main objective of the present study is to describe the ultrasound findings and clinical characteristics of nails from patients with psoriasis and psoriatic arthritis with and without nail dystrophy.

Methods

A cross-sectional study including consecutive patients with PsO and PsA was carried out. The study patients were divided into 4 groups, totaling 120 participants. Group 1: patients with psoriasis vulgaris and clinically normal nails; Group 2: patients with psoriasis vulgaris and onychodystrophy; Group 3: patients with psoriatic arthritis and clinically normal nails; Group 4: patients with psoriatic arthritis and onychodystrophy; All patients were submitted to dermatological and rheumatological clinical analysis. Ultrasound examinations was performed by a single examiner, blinded to all clinical data, with ultrasound high resolution, in B-mode or gray-scale (GS), Power Doppler (PD) and Spectral Doppler.

Results

A significant difference was found between the groups regarding the variable Psoriasis Area and Severity Index (PASI) (p = 0.008) and body surface area (BSA) (p = 0.005), with patients with psoriatic arthritis having lower PASI and BSA compared to patients with only cutaneous psoriasis. A positive relationship was found with the average ultrasound thickness of the nail bed and the Nail Psoriasis Severity Index (NAPSI) in correlation analysis (rho = 0.344). When we grouped patients with psoriasis and psoriatic arthritis, there was no significant difference between the cutaneous psoriasis groups and the psoriatic arthritis groups in terms of nail plate GS (p = 0.442), nail bed PD (p = 0.124).

Conclusion

Greater nail bed thickness indicates early psoriatic nail disease, as confirmed in our study correlating NAPSI with nail bed thickness. Ultrasonography is a low-cost exam, promising in the evaluation, showing that the ultrasound grayscale is consistent with those who have dystrophic nails, but it can’t distinguish psoriasis from psoriatic arthritis, even in those with nail dystrophy.
Yields, growth and water use under chemical topping in relations to row configuration and plant density in drip-irrigated cotton
Authors: Wang Xuejiao , Hu Yanping , Ji Chunrong , Chen Yongfan , Sun Shuai , Zhang Zeshan , Zhang Yutong , Wang Sen , Yang Mingfeng , Ji Fen , Guo Yanyun , Li Jie , Zhang Lizhen
Published: April 2024

Background

Water deficit is an important problem in agricultural production in arid regions. With the advent of wholly mechanized technology for cotton planting in Xinjiang, it is important to determine which planting mode could achieve high yield, fiber quality and water use efficiency (WUE). This study aimed to explore if chemical topping affected cotton yield, quality and water use in relation to row configuration and plant densities.

Results

Experiments were carried out in Xinjiang China, in 2020 and 2021 with two topping method, manual topping and chemical topping, two plant densities, low and high, and two row configurations, i.e., 76 cm equal rows and 10+66 cm  narrow-wide rows, which were commonly applied in matching harvest machine. Chemical topping increased seed cotton yield, but did not affect cotton fiber quality comparing to traditional manual topping. Under equal row spacing, the WUE in higher density was 62.4% higher than in the lower one. However, under narrow-wide row spacing, the WUE in lower density was 53.3% higher than in higher one (farmers’ practice). For machine-harvest cotton in Xinjiang, the optimal row configuration and plant density for chemical topping was narrow-wide rows with 15 plants m-2 or equal rows with 18 plants m-2.

Conclusion

The plant density recommended in narrow-wide rows was less than farmers’ practice and the density in equal rows was moderate with local practice. Our results provide new knowledge on optimizing agronomic managements of machine-harvested cotton for both high yield and water efficient.
Chronic cough in children: an evidence-based clinical practice guideline adapted for the use in Egypt using ‘Adapted ADAPTE’
Authors: Fouda Eman Mahmoud , Shaaban Hala Hamdi , Elattar Mona Mohsen , Mostafa Abla Saleh , Hamed Dina H. , Saleh Aya Samir Mohamed , Ishak Sally Raafat , Hamed Tarek , Mohamed Magda Hassab Allah , Hussien Shahenaz Mohamoud , Rashad Mohamed Mahmoud , Elnady Hala Gouda , Metwally Hoda M. Salah El Din , Elghaffar Laila Abd , Reda Sherif , Abdel Baky Ashraf , Omar Tarek , Amer Yasser , Sarhan Dina Tawfeek , Refay Amira S. El ,   On behalf of the Egyptian Pediatric Clinical Practice Guidelines Committee (EPG)
Published: April 2024

Background

We recently adopted a guideline for chronic cough in children in the Egyptian health system. Adapting clinical practice guidelines (CPGs) to the local healthcare setting is a valid alternative to de-novo development that can improve their uptake and implementation without demanding a substantial drain on resources. The objective of this study was to adapt evidence-based recommendations from global high-quality CPGs for children with a chronic cough to suit the Egyptian healthcare context.

Methods

We followed the Adapted ADAPTE methodological framework for guideline adaptation. This process includes three phases: set-up, adaptation, and finalization. A guideline adaptation group (GAG) and an external review group including clinical content experts and methodologists conducted the process.

Results

The GAG adapted 10 sections of recommendations from three original CPG(s) including (i) the American College of Chest Physicians (ACCP) 2006–2020, (ii) the European Respiratory Society (ERS) 2019, (iii) the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI) 2018. A set of CPG implementation tools was added to enhance implementability including an algorithm, a slide presentation for clinical diagnosis, investigations and treatment of chronic cough, patient education, and online resources.

Conclusion

The adapted CPG provides pediatricians and related healthcare workers with applicable evidence-based recommendations for chronic cough in children in Egypt. The project also highlighted the utility of Adapted ADAPTE and the invaluable collaboration between the clinical and methodological experts for the adaptation of pediatric national guidelines.
Organizing the dissemination and implementation field: who are we, what are we doing, and how should we do it?
Authors: Buchanan Gretchen J. R. , Filiatreau Lindsey M. , Moore Julia E.
Published: April 2024

Two decades into its tenure as a field, dissemination and implementation (D&I) scientists have begun a process of self-reflection, illuminating a missed opportunity to bridge the gap between research and practice—one of the field’s foundational objectives. In this paper, we, the authors, assert the research-to-practice gap has persisted, in part due to an inadequate characterization of roles, functions, and processes within D&I. We aim to address this issue, and the rising tension between D&I researchers and practitioners, by proposing a community-centered path forward that is grounded in equity.

We identify key players within the field and characterize their unique roles using the translational science spectrum, a model originally developed in the biomedical sciences to help streamline the research-to-practice process, as a guide. We argue that the full translational science spectrum, from basic science research, or “T0,” to translation to community, or “T4,” readily applies within D&I and that in using this framework to clarify roles, functions, and processes within the field, we can facilitate greater collaboration and respect across the entire D&I research-to-practice continuum. We also highlight distinct opportunities (e.g., changes to D&I scientific conference structures) to increase regular communication and engagement between individuals whose work sits at different points along the D&I translational science spectrum that can accelerate our efforts to close the research-to-practice gap and achieve the field’s foundational objectives.
Efficacy and safety of ciprofol versus propofol for induction and maintenance of general anesthesia: a systematic review and meta-analysis
Authors: Hudaib Muhammad , Malik Hurais , Zakir Syeda Javeria , Rabbani Samra , Gnanendran Dhanushan , Syed Abdul Rehman Shah , Suri Noor Fatima , Khan Javeria , Iqbal Arham , Hussain Nowal , Abdullah Muhammad , Kumar Satesh , Khatri Mahima , Varrassi Giustino
Published: April 2024

Background

Propofol has been the gold standard for anesthesia induction and maintenance due to its rapid onset and favorable pharmacokinetic properties. However, the search for alternative agents with improved safety and efficacy has led to the emergence of ciprofol (HSK3486), a structural analog of propofol. This systematic review and meta-analysis aim to comprehensively assess the safety and efficacy of ciprofol compared to propofol for anesthesia induction and maintenance in adult patients undergoing surgical procedures.

Methods

This study included only double-arm RCTs in which participants were aged eighteen or older undergoing surgery. For the statistical analysis of the extracted data, we employed RevMan 5.4.1.

Results

Ciprofol demonstrated a promising trend of higher anesthesiologists’ satisfaction during the induction phase (MD 0.14, 95%, CI − 0.28 to 0.56, p = 0.51), whereas Propofol was favored during maintenance. Propofol also exhibited advantages with a shorter time to successful anesthesia induction (MD 0.08 min, 95% CI 0.00 to 0.15, p = 0.04), and quicker attainment of full alertness (MD 0.11 min, 95% CI − 1.29 to 1.52, p = 0.87), suggesting its efficiency in clinical practice. Importantly, there were no significant disparities in the success rate of anesthesia.

Conclusion

Both ciprofol and propofol demonstrate comparable efficacy and safety for anesthesia induction and maintenance in adult patients undergoing surgery. While propofol provides a faster onset of induction, ciprofol exhibits advantages in terms of pain management. Clinicians should consider these findings when selecting anesthetic agents, and tailoring choices to individual patient needs and clinical scenarios.
Editorial on common mental health disorders and cognitive decline in a longitudinal Down syndrome cohort
Authors: Tromans Samuel J. , Desarkar Pushpal
Published: April 2024

This editorial discusses a study by Idris and colleagues, where the authors investigated the impact of common mental disorders (CMDs) among patients with Down syndrome, with respect to development of clinical features of Alzheimer's disease.
Evidence-based brief interventions targeting acute mental health presentations for children and adolescents: systematic review
Authors: Eapen Valsamma , Gerstl Brigitte , Ahinkorah Bright Opoku , John James Rufus , Hawker Patrick , Nguyen Thomas P. , Brice Febe , Winata Teresa , Bowden Michael
Published: April 2024

Background

Brief intervention services provide rapid, mobile and flexible short-term delivery of interventions to resolve mental health crises. These interventions may provide an alternative pathway to the emergency department or in-patient psychiatric services for children and young people (CYP), presenting with an acute mental health condition.

Aims

To synthesise evidence on the effectiveness of brief interventions in improving mental health outcomes for CYP (0–17 years) presenting with an acute mental health condition.

Method

A systematic literature search was conducted, and the studies’ methodological quality was assessed. Five databases were searched for peer-reviewed articles between January 2000 and September 2022.

Results

We synthesised 30 articles on the effectiveness of brief interventions in the form of (a) crisis intervention, (b) integrated services, (c) group therapies, (d) individualised therapy, (e) parent–child dyadic therapy, (f) general services, (g) pharmacotherapy, (h) assessment services, (i) safety and risk planning and (j) in-hospital treatment, to improve outcomes for CYP with an acute mental health condition. Among included studies, one study was rated as providing a high level of evidence based on the National Health and Medical Research Council levels of evidence hierarchy scale, which was a crisis intervention showing a reduction in length of stay and return emergency department visits. Other studies, of moderate-quality evidence, described multimodal brief interventions that suggested beneficial effects.

Conclusions

This review provides evidence to substantiate the benefits of brief interventions, in different settings, to reduce the burden of in-patient hospital and readmission rates to the emergency department.
Re: investigating the impact of financial concerns on symptoms of depression in UK healthcare workers: data from the UK REACH nationwide cohort study
Authors: Croak Bethany , Lamb Danielle , Stevelink Sharon A. M.
Published: April 2024

This editorial comments on the paper by Martin McBride and the UK REACH team (published in 2023) investigating financial concerns in UK healthcare workers and depressive symptoms. The research concludes that reporting future financial concerns at baseline increased the odds of depressive symptoms at follow-up around 18 months later. We discuss these findings in the context of the cost-of-living crisis and pay disputes within the NHS, important policy implications and directions for future research.
Envisioning Academic Global Oncologists: Proposed Competencies for Global Oncology Training From ASCO
Authors: Bourlon Maria T. , Bhatt Ami S. , Lopes Gilberto , Asirwa Fredrick Chite , Eniu Alexandru E. , Loehrer Patrick J. , Shulman Lawrence N. , Close Julia , Von Roenn Jamie , Tibbits Michal , Pyle Doug , Gralow Julie R.
Published: April 2024

Recognizing the rising incidence, prevalence, and mortality of cancer in low- and middle-resource settings, as well as the increasingly international profile of its membership, ASCO has committed to expanding its engagement at a global level. In 2017, the ASCO Academic Global Oncology Task Force sought to define the potential role for ASCO in supporting global oncology as an academic field. A set of recommendations to advance the status of global oncology as an academic discipline were created through a consensus-based process involving participation by a diverse group of global oncology and global health practitioners; these recommendations were then published. The recommendations included developing a set of global oncology competencies for trainees and faculty interested in a career in academic global oncology. Here, we describe the global oncology competencies developed by this task force. These competencies consist of knowledge and skills needed in general global health as well as cancer-specific care and research, including understanding global cancer health disparities, defining unique resources and needs in low- and middle-resource settings, and promoting international collaboration. Although the competencies were originally developed for US training programs, they are intended to be widely applicable globally. By formalizing the training of oncologists and supporting career pathways in the field of global oncology, we can make progress in achieving global equity in cancer care and control.
Impact of Propofol Exposure on Neurocognitive Outcomes in Children With High-Risk B ALL: A Children's Oncology Group Study
Authors: Alexander Sarah , Kairalla John A. , Gupta Sumit , Hibbitts Emily , Weisman Hannah , Anghelescu Doralina , Winick Naomi J. , Krull Kevin R. , Salzer Wanda L. , Burke Michael J. , Gore Lia , Devidas Meenakshi , Embry Leanne , Raetz Elizabeth A. , Hunger Stephen P. , Loh Mignon L. , Hardy Kristina K.
Published: April 2024

PURPOSE

Many children treated for ALL develop long-term neurocognitive impairments. Increased risk of these impairments is associated with treatment and demographic factors. Exposure to anesthesia is an additional possible risk factor. This study evaluated the impact of cumulative exposure to anesthesia on neurocognitive outcomes among a multicenter cohort of children with ALL.

METHODS

This study was embedded in AALL1131, a Children's Oncology Group phase III trial for patients with high-risk B-ALL. In consenting patients age 6-12 years, prospective uniform assessments of neurocognitive function were performed during and at 1 year after completion of therapy. Exposure to all episodes of anesthetic agents was abstracted. Multivariable linear regression models determined associations of cumulative anesthetic agents with the primary neurocognitive outcome reaction time/processing speed (age-normed) at 1 year off therapy, adjusting for baseline neurocognitive score, age, sex, race/ethnicity, insurance status (as a proxy for socioeconomic status), and leukemia risk group.

RESULTS

One hundred and forty-four children, 76 (52.8%) males, mean age of 9.1 (min-max, 6.0-12.0) years at diagnosis, underwent a median of 27 anesthetic episodes (min-max, 1-37). Almost all patients were exposed to propofol (140/144, 97.2%), with a mean cumulative dose of 112.3 mg/kg. One year after therapy, the proportion of children with impairment ( Z-score ≤–1.5) was significantly higher compared with a normative sample. In covariate-adjusted multivariable analysis, cumulative exposure to propofol was associated with a 0.05 Z-score decrease in reaction time/processing speed per each 10 mg/kg propofol exposure ( P = .03).

CONCLUSION

In a multicenter and uniformly treated cohort of children with B-ALL, cumulative exposure to propofol was an independent risk factor for impairment in reaction time/processing speed 1 year after therapy. Anesthesia exposure is a modifiable risk, and opportunities to minimize propofol use should be considered.
Phase II Study of Erdafitinib in Patients With Tumors With FGFR Amplifications: Results From the NCI-MATCH ECOG-ACRIN Trial (EAY131) Subprotocol K1
Authors: Gong Jun , Mita Alain C. , Wei Zihan , Cheng Heather H. , Mitchell Edith P. , Wright John J. , Ivy S. Percy , Wang Victoria , Gray Robert C. , McShane Lisa M. , Rubinstein Larry V. , Patton David R. , Williams P. Mickey , Hamilton Stanley R. , Alva Ajjai S. , Tricoli James V. , Conley Barbara A. , Arteaga Carlos L. , Harris Lyndsay N. , O'Dwyer Peter J. , Chen Alice P. , Flaherty Keith T.
Published: April 2024

PURPOSE

Despite fibroblast growth factor receptor ( FGFR) inhibitors being approved in tumor types with select FGFR rearrangements or gene mutations, amplifications of FGFR represent the most common FGFR alteration across malignancies. Subprotocol K1 (EAY131-K1) of the National Cancer Institute-MATCH platform trial was designed to evaluate the antitumor efficacy of the oral FGFR1-4 inhibitor, erdafitinib, in patients with tumors harboring FGFR1-4 amplification.

METHODS

EAY131-K1 was an open-label, single-arm, phase II study with central confirmation of presence of FGFR1-4 amplification in tumors. Patients with urothelial carcinoma were excluded. Enrolled patients received oral erdafitinib at a starting dose of 8 mg once daily continuously with escalation to 9 mg once daily continuously, on the basis of predefined time point assessments of phosphate levels, until disease progression or intolerable toxicity. The primary end point was centrally assessed objective response rate (ORR), with key secondary end points being 6-month progression-free survival (PFS6), PFS, overall survival (OS), and safety.

RESULTS

Thirty-five patients were enrolled into this study with 18 included in the prespecified primary efficacy analysis. The median age of the 18 patients was 60 years, and 78% had received ≥3 previous lines of therapy. There were no confirmed responses to erdafitinib; however, five patients experienced stable disease (SD) as best response. One patient with an FGFR1-amplified breast cancer had a prolonged PFS >168 days (5.5 months). The median PFS was 1.7 months (90% CI, 1.1 to 1.8 months) and the median OS was 4.2 months (90% CI, 2.3 to 9.3 months). The estimated PFS6 rate was 13.8% (90% CI, 3.3 to 31.6). The majority of toxicities were grade 1 to 2 in nature, although there was one grade 5 treatment-related adverse event.

CONCLUSION

Erdafitinib did not meet its primary end point of efficacy as determined by ORR in treatment-refractory solid tumors harboring FGFR1-4 amplifications. Our findings support that rearrangements and gene mutations, but not amplifications, of FGFR remain the established FGFR alterations with approved indications for FGFR inhibition.
Deep Learning Analysis With Gray Scale and Doppler Ultrasonography Images to Differentiate Graves’ Disease
Authors: Baek Han-Sang , Kim Jinyoung , Jeong Chaiho , Lee Jeongmin , Ha Jeonghoon , Jo Kwanhoon , Kim Min-Hee , Sohn Tae Seo , Lee Ihn Suk , Lee Jong Min , Lim Dong-Jun
Published: April 2024

Context

Thyrotoxicosis requires accurate and expeditious differentiation between Graves’ disease (GD) and thyroiditis to ensure effective treatment decisions.

Objective

This study aimed to develop a machine learning algorithm using ultrasonography and Doppler images to differentiate thyrotoxicosis subtypes, with a focus on GD.

Methods

This study included patients who initially presented with thyrotoxicosis and underwent thyroid ultrasonography at a single tertiary hospital. A total of 7719 ultrasonography images from 351 patients with GD and 2980 images from 136 patients with thyroiditis were used. Data augmentation techniques were applied to enhance the algorithm's performance. Two deep learning models, Xception and EfficientNetB0_2, were employed. Performance metrics such as accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and F1 score were calculated for both models. Image preprocessing, neural network model generation, and neural network training results verification were performed using DEEP:PHI® platform.

Results

The Xception model achieved 84.94% accuracy, 89.26% sensitivity, 73.17% specificity, 90.06% PPV, 71.43% NPV, and an F1 score of 89.66 for the diagnosis of GD. The EfficientNetB0_2 model exhibited 85.31% accuracy, 90.28% sensitivity, 71.78% specificity, 89.71% PPV, 73.05% NPV, and an F1 score of 89.99.

Conclusion

Machine learning models based on ultrasound and Doppler images showed promising results with high accuracy and sensitivity in differentiating GD from thyroiditis.
Establishment of an intragastric surgical model using C57BL/6 mice to study the vaccine efficacy of OMV-based immunogens against Helicobacter pylori
Authors: Das Sanjib , Halder Prolay , Banerjee Soumalya , Mukhopadhyay Asish Kumar , Dutta Shanta , Koley Hemanta
Published: April 2024

Chronic gastritis is one of the major symptoms of gastro-duodenal disorders typically induced by Helicobacter pylori (H. pylori). To date, no suitable model is available to study pathophysiology and therapeutic measures accurately. Here, we have presented a successful surgical infection model of H. pylori-induced gastritis in C57BL/6 mice that resembles features similar to human infection. The proposed model does not require any preparatory treatment other than surgical intervention. C57BL/6 mice were injected with wild-type SS1 (Sydney strain 1, reference strain) directly into the stomach. Seven days post infection, infected animals showed alterations in cytokine responses along with inflammatory cell infiltration in the lamina propria, depicting a prominent inflammatory response due to infection. To understand the immunogenicity and protective efficacy, the mice were immunized with outer membrane vesicles (OMVs) isolated from an indigenous strain with putative virulence factors of H. pylori [A61C (1), cag+/vacA s1m1]. In contrast to the non-immunized cohort, the OMV-immunized cohort showed a gradual increase in serum immunoglobulin(s) levels on the 35th day after the first immunization. This conferred protective immunity against subsequent challenge with the reference strain (SS1). Direct inoculation of H. pylori into the stomach influenced infection in a short time and, more importantly, in a dose-dependent manner, indicating the usefulness of the developed model for pathophysiology, therapeutic and prophylactic studies.
Dynamic Hippo pathway activity underlies mesenchymal differentiation during lung alveolar morphogenesis
Authors: Chaudhry Fatima N. , Michki Nigel S. , Shirmer Dain L. , McGrath-Morrow Sharon , Young Lisa R. , Frank David B. , Zepp Jarod A.
Published: April 2024

Alveologenesis, the final stage in lung development, substantially remodels the distal lung, expanding the alveolar surface area for efficient gas exchange. Secondary crest myofibroblasts (SCMF) exist transiently in the neonatal distal lung and are crucial for alveologenesis. However, the pathways that regulate SCMF function, proliferation and temporal identity remain poorly understood. To address this, we purified SCMFs from reporter mice, performed bulk RNA-seq and found dynamic changes in Hippo-signaling components during alveologenesis. We deleted the Hippo effectors Yap/Taz from Acta2-expressing cells at the onset of alveologenesis, causing a significant arrest in alveolar development. Using single cell RNA-seq, we identified a distinct cluster of cells in mutant lungs with altered expression of marker genes associated with proximal mesenchymal cell types, airway smooth muscle and alveolar duct myofibroblasts. In vitro studies confirmed that Yap/Taz regulates myofibroblast-associated gene signature and contractility. Together, our findings show that Yap/Taz is essential for maintaining functional myofibroblast identity during postnatal alveologenesis.
Differences in Lymph Node Metastases Patterns Among Non-pancreatic Periampullary Cancers and Histologic Subtypes: An International Multicenter Retrospective Cohort Study and Systematic Review
Authors: Uijterwijk Bas A. , Lemmers Daniël H. , Fusai Giuseppe Kito , Zerbi Alessandro , Salvia Roberto , Sparrelid Ernesto , White Steven , Björnsson Bergthor , Mavroeidis Vasileios K. , Roberts Keith J. , Mazzola Michele , Cabús Santiago Sánchez , Soonawalla Zahir , Korkolis Dimitris , Serradilla Mario , Pessaux Patrick , Luyer Misha , Mowbray Nicholas , Ielpo Benedetto , Mazzotta Alessandro , Kleeff Jorg , Boggi Ugo , Muñoz Miguel Angel Suarez , Goh Brian K. P. , Andreotti Elena , Wilmink Hanneke , Ghidini Michele , Zaniboni Alberto , Verbeke Caroline , Adsay Volkan , Bianchi Denise , Besselink Marc G. , Abu Hilal Mohammed ,   For the International Study Group on Non-Pancreatic Periampullary Cancer (ISGACA), Nappo Gennaro , Ghorbani Poya , Malleo Giuseppe , Lancelotti Francesco , Napoli Niccolò , Robinson Stuart , Khalil Khalid , Val Alejandro Ramirez-Del , Mortimer Matthew C. M. , Al-Sarireh Bilal , Koh Ye Xin , Bhogal Ricky , Serrablo Alejandro , Gayet Brice , Johansen Karin , Ramaekers Mark , Giani Alessandro
Published: April 2024

Background

Standard lymphadenectomy for pancreatoduodenectomy is defined for pancreatic ductal adenocarcinoma and adopted for patients with non-pancreatic periampullary cancer (NPPC), ampullary adenocarcinoma (AAC), distal cholangiocarcinoma (dCCA), or duodenal adenocarcinoma (DAC). This study aimed to compare the patterns of lymph node metastases among the different NPPCs in a large series and in a systematic review to guide the discussion on surgical lymphadenectomy and pathology assessment.

Methods

This retrospective cohort study included patients after pancreatoduodenectomy for NPPC with at least one lymph node metastasis (2010–2021) from 24 centers in nine countries. The primary outcome was identification of lymph node stations affected in case of a lymph node metastasis per NPPC. A separate systematic review included studies on lymph node metastases patterns of AAC, dCCA, and DAC.

Results

The study included 2367 patients, of whom 1535 had AAC, 616 had dCCA, and 216 had DAC. More patients with pancreatobiliary type AAC had one or more lymph node metastasis (67.2% vs 44.8%; P < 0.001) compared with intestinal-type, but no differences in metastasis pattern were observed. Stations 13 and 17 were most frequently involved (95%, 94%, and 90%). Whereas dCCA metastasized more frequently to station 12 (13.0% vs 6.4% and 7.0%, P = 0.005), DAC metastasized more frequently to stations 6 (5.0% vs 0% and 2.7%; P < 0.001) and 14 (17.0% vs 8.4% and 11.7%, P = 0.015).

Conclusion

This study is the first to comprehensively demonstrate the differences and similarities in lymph node metastases spread among NPPCs, to identify the existing research gaps, and to underscore the importance of standardized lymphadenectomy and pathologic assessment for AAC, dCCA, and DAC.