bluuebunny/crossref_metadata_2025 huggingface dataset:
'Which treatment do you believe you received?' A randomised blinding feasibility trial of spinal manual therapy
Authors: Laguna Javier Muñoz , Kurmann Astrid , Hofstetter Léonie , Nyantakyi Emanuela , Braun Julia , Clack Lauren , Bang Heejung , Farshad Mazda , Foster Nadine E. , Puhan Milo A. , Hincapié Cesar A. , Group SALuBRITY Blinding Clinician
Published: June 2024

Background: Blinding is essential for mitigating biases in clinical trials. Our main objectives were to assess the feasibility of blinding: (1) participants randomly allocated to active or placebo-control spinal manual therapy (SMT) interventions, and (2) outcome assessors. We also explored blinding by levels of SMT experience and low back pain, and factors contributing to beliefs about assigned intervention.
Methods:A two-parallel-arm, single-centre, placebo-controlled, blinding feasibility trial. In April 2023, we randomised 81 adults with or without SMT experience or low back pain to either active (n = 40) or placebo-control SMT (n = 41). The primary outcome was participant blinding (beliefs about assigned intervention) using the Bang blinding index (BI) at two study visits. The Bang BI is chance-corrected and ranges from –1 (all incorrect beliefs) to 1 (all correct beliefs), with 0 indicating equal proportions of correct and incorrect beliefs. Secondary outcomes were blinding using an alternative BI, outcome assessor blinding, treatment credibility/expectancy, and factors contributing to beliefs about assigned intervention.
Results: Of 85 adults screened, 81 participants were randomised and 80 (99%) completed follow-up. At study visit 1, 50% of participants in the active (Bang BI: 0.50 [95% confidence interval (CI), 0.26 to 0.74]) and 37% in the placebo-control arm (0.37 [95% CI, 0.10 to 0.63]) had a correct belief about their assigned intervention, beyond chance. At study visit 2, BIs were 0.36 (0.08 to 0.64) and 0.29 (0.01 to 0.57) for participants in the active and placebo-control arms. BIs among outcome assessors suggested adequate blinding at both study visits (Active: 0.08 [-0.05 to 0.20] and 0.03 [-0.11 to 0.16]; Placebo-control: -0.12 [-0.24 to -0.00] and -0.07 [-0.21 to 0.07]). BIs varied by participant levels of SMT experience, and low back pain. Participants and outcome assessors described different factors contributing to their beliefs.
Conclusions: Adequate blinding of participants assigned to active SMT may not be feasible with the intervention protocol studied, whereas blinding of participants in the placebo-control arm may be feasible at the end of the study period. Blinding of outcome assessors seemed adequate. Further methodological work on blinding of SMT interventions is needed.
Trial registration number: NCT05778396
Misconceptions about Oral Health and Dentistry: Attitude of Clients at Yazd Dental School in 2023
Authors: Tabatabaei Seyed Hosein , Koshkeno Shahab Al-din Aboutalebi , sabaghzadegan farinaz
Published: June 2024

Background: There are various beliefs concerning oral and dental health among people, some of which do not have any scientific basis, thereby hindering the achievement of an optimal level of health in the community. This study explored attitude of clients presenting to School of Dentistry in Yazd, Iran, concerning some wrong beliefs towards oral health and dentistry in 2023.
Methods: In this descriptive-cross-sectional study, 300 clients who referred to Yazd Dental School in 2023 were selected by convenient sampling method. Data were collected using a valid and reliable questionnaire, imported into SPSS25, and analyzed using t-test, ANOVA, and linear regression.
Results: A total of 227 women and 73 men with a mean age of 31.45±12.17 years participated in this study. In terms of severity, the mean score of wrong attitude in the studied community was 44.83±6.03 in the average range. In terms of extent, 46.3 % of people had an wrong attitude on average. There was no statistically significant difference between the mean score of wrong attitude according to gender, types of age groups, types of occupations and media used in each of the subgroups. Yet, the difference between the mean score of wrong attitude of participants according to education level was significant. Linear regression suggested that none of the studied variables could significantly predict participants' wrong attitude towards dental treatments.
Conclusions: Based on the results of the present study, the amount of wrong beliefs about dentistry in the studied community was moderate in terms of severity and extent. Firstly, face-to-face advice is more powerful in strengthening people's attitude towards oral and dental health compared to technology; secondly, oral and dental health practitioners do not properly use the high capacity of media and especially social networks to inform the community. In the long term, the negative impact of wrong beliefs on the oral and dental health of the community can be gradually corrected with proper education at different levels, especially during education and at family level, and improve the health beliefs of the community. In the short and medium term, dentists can use the opportunity of mass media to increase awareness and improve the health beliefs of the community.
Splicing Factor 3b Subunit 4 (SF3B4) Promotes Proliferation of Gastric Cancer through Regulation of VDAC1
Authors: Li Dehong , Lu Yan , Yan Li , Yang Xingwen , Zhao Fenghui , Yang Xiaoyan , Yuan Xiumei , Lin Fugui , Yang Kehu
Published: June 2024

SF3B4 is a novel tumor related gene which is aberrantly expression in some malignant tumors. However, the role and mechanisms of SF3B4 in gastric cancer have not been explored. In this study, TMT-based quantitative proteomics and high content screening (HCS) revealed SF3B4 was strongly associated with GC. Immunohistochemistry revealed SF3B4 was upregulated in human gastric cancer tissues, and high SF3B4 expression was associated with shortened progression-free survival of patients. Further investigations indicated that the knockdown of SF3B4 could inhibit the proliferation and colony formation of GC cells while promoting cell apoptosis. Furthermore, knocking down SF3B4 could also inhibit the tumorigenicity of GC cells in vivo. RNA-sequencing followed by IPA was used to explore downstream of SF3B4 and identified VDAC1 as the potential target. Moreover, our study revealed that VDAC1 overexpression could alleviate the SF3B4 knockdown-induced inhibition of GC. Remarkably, we found for the first time that SF3B4 potentially facilitates the development of gastric cancer by exerting VDAC1-mediated effects on autophagy. SF3B4 promotes GC cell proliferation through regulate VDAC1 and may be a novel therapeutic target for GC.
Safflower CtFT Genes Orchestrating Flowering Time and Flavonoid Biosynthesis
Authors: Li Zhiling , Yu Lili , Umar Abdul Wakeel , Wang Jiaruo , Wang Nan , Zhang Min , Yao Na , Ahmad Naveed , Liu Xiuming
Published: June 2024

Background: Safflower thrives in dry environments but faces difficulties with flowering in wet and rainy summers. Flavonoids play a role in flower development and can potentially alleviate these challenges. Furthermore, the FLOWERING LOCUS T (FT) family of phosphatidylethanolamine-binding protein (PEBP) genes play a crucial role in the photoperiodic flowering pathway. However, their direct impact on flowering and flavonoid biosynthesis under different light duration is elusive.
Results: Utilizing the genome sequencing of Safflower (Jihong NO.1), the current study identifies three specific genes (CtFT1, CtFT2, and CtFT3) that exhibit upregulation in response to long-day conditions. The overexpression of CtFT2, displayed an early, whereas CtFT1 and CtFT3 late flowering phenotype in Arabidopsis thaliana. Interestingly, the transient overexpression of CtFT1 in safflower leaves caused early flowering, while overexpressing CtFT2 and CtFT3 led to late flowering. Additionally, overexpressing CtFT3 in Arabidopsis and CtFT1, CtFT2, and CtFT3 in safflower leaves, significantly increased flavonoid synthesis.
Conclusions: These findings showed that overexpression of CtFT genes could affect the flowering time and significantly increase the flavonoid content of safflower. The function of CtFT gene is different in safflower and Arabidopsis. This study provides valuable insights into the role of CtFT genes in flower formation and flavonoid synthesis in safflower, which may help in improving safflower breeding quality and its adaptability to diverse environmental conditions.
Towards Heterogeneous Agent Cooperation in Decentralized Multi-Agent Systems
Authors: Monon Jahir Sadik , Barua Deeparghya Dutta , Khan Md. Mosaddek
Published: June 2024

Multi-agent Reinforcement Learning (MARL) is gaining significance as a key framework for various sequential decision-making and control tasks. Unlike their single-agent counterparts, multi-agent systems necessitate successful cooperation among the agents. The deployment of these systems in real-world scenarios often requires decentralized training, heterogeneous agents, and learning from sparse environmental rewards. These challenges are more acute under partial observability and the lack of prior knowledge about agent heterogeneity. While notable studies use intrinsic motivation (IM) to address reward sparsity in decentralized settings, those dealing with heterogeneity typically assume centralized training, parameter sharing, and agent indexing. To address these issues, we propose the CoHet algorithm, which utilizes a novel Graph Neural Network (GNN) based intrinsic motivation to facilitate the learning of heterogeneous agent policies in decentralized settings under conditions of partial observability and reward sparsity. Evaluation of CoHet in the Multi-agent Particle Environment (MPE) and Vectorized Multi-Agent Simulator (VMAS) benchmarks demonstrates that it outperforms the state-of-the-art in a wide range of cooperative multi-agent scenarios. Our research is supplemented by an analysis of the impact of our agent dynamics model on the intrinsic motivation module, how the different variants of CoHet perform, and its robustness to an increasing number of heterogeneous agents.
Engagement with and impact of a mobile health app for childhood obesity prevention and management: a mixed methods study protocol
Authors: Milne-Ives Madison , Ananthakrishnan Ananya , Homer Sophie , Andrade Jackie , Meinert Edward
Published: June 2024

Background: Childhood obesity is a serious global health concern that affects around 20% of children worldwide. Digital health behaviour change interventions have the potential to improve behaviours that can contribute to childhood obesity, such as diet and physical activity, but often lack sufficient user engagement to achieve significant impact. The aim of this project is to develop evidence to better understand how users engage with digital interventions and how Behaviour Change Techniques can be leveraged to support engagement. Specifically, the study will examine the impact of a family-focused app for childhood obesity prevention on health behaviours, health outcomes, and communication between families and healthcare professionals.
Methods: A pre-post, mixed-methods evaluation will examine the impact of the NoObesity app on families’ physical activity and dietary behaviours and on healthcare professionals’ self-efficacy at communicating with families about childhood obesity. Secondary outcomes will include well-being, usability, and users’ engagement with and perceptions of the intervention. An initial sample of 1000 families (children and young people and their parents) and 180 healthcare professionals will be recruited to participate in the study, a subset of whom will be invited to qualitative semi-structured interviews. The study implementation and follow-up period will last for 6 months, with the outcomes measured at baseline and 3- and 6-months post-baseline. Quantitative outcomes will be compared over time using repeated-measures ANOVA and qualitative data will be analysed thematically and triangulated with app use data.
Discussion: Ethical approval was received from Newcastle University Faculty of Medical Science Ethics Committee (2688/41816) on 22 March, 2024. Recruitment and data collection are expected to begin in August 2024. The project’s key contributions will be to generate evidence of potential for a family-based digital intervention to support families’ health behaviour change and healthcare professionals’ confidence in their ability to support them and to improve our understanding of how particular Behaviour Change Techniques can be used to support engagement with the intervention and its target behaviours.
IoT Enabled Sustainable Health Monitoring System using Scheduling Approach and Priority Validation for Smart Healthcare Enhancement
Authors: Upadhyay Shrikant , Kumar Mohit , Upadhyay Aditi , Verma Sahil , . Kavita , Khurma Ruba Abu , Mallik Saurav , Shah Mohd Asif
Published: June 2024

In this article, we propose a health tracking system designed to aid patients and doctors within a hospital campus. We primarily focus on efficiency, trust ability and scalability of the healthcare system. In previous studies, scheduling methods such as shortest task first and first-come, first-served have been commonly assumed for IoT-dependent healthcare systems. However, these approaches have limitations when it comes to accommodating a wide range of requests and efficiently handling high-demand situations. Specifically, the inclusion of short procedures in such scheduling methods can result in prolonged task completion durations and poor performance in overloaded scenarios. To deal with such challenges we proposed an analytical framework of scheduling that offers service differentiation concerning delay-sensitive, tolerant packets and packet length for a short packet being transferred before long packets. The performance of the prioritized method has been compared with the existing scheduling approaches in terms of packet loss, latency tolerance, packet threshold, mean turndown etc. to analyze its sustainability. Also, the proposed model is analyzed using two existing protocols with different simulation parameters to aiming to identify the most suitable protocol for better management of the health monitoring system.
Parental Psychological Control and Depression in Chinese junior Middle School Students: A Moderated Mediation Model
Authors: Liu Hailun , Fu Lili , Liang Xianqi , Zhang Junhua , Zhang Li , Zhai Youhua
Published: June 2024

Background This study examines the mechanisms linking parental psychological control and depression among Chinese junior middle school students, focusing on the mediating role of psychological resilience and the moderating effect of school climate on this relationship.
Method A questionnaire survey was administered to 1991 middle-school students by using a self-developed depression scale, the psychological control sub questionnaire, the Chinese version of the Connor-Davidson Resilience Scale and the perceived school climate scale. Data analysis was performed using SPSS 26 software and SPSS PROCESS 3.3, involving descriptive statistics, correlation analysis, and the test of the moderated mediation model.
Results The findings indicate that (1) parental psychological control is a positive predictor of depression, and psychological resilience mediates this relationship; (2) in the mediation model involving psychological resilience, school climate moderates the latter half of the pathway and the overall mediating effect. Specifically, under a positive school climate, both the negative predictive effect of psychological resilience on depression and the indirect influence of parental psychological control on depression through psychological resilience were significantly stronger than those under a negative school climate.
Conclusion Results showed that parental psychological control could have indirect effect on depression via psychological resilience with school climate as a moderator in the mediating effect. This research contributes to understanding how family and school environments, along with individual characteristics, collectively influence the mental health of junior middle school students.
Bisphenol A in canned fruit and vegetable in Tehran, Iran: a health risk assessment Study
Authors: Hazrati-Raziabad Reza , Aslani Ramin , Shariatifar Nabi , Arabameri Majid , Sadighara Parisa , Khaniki Gholamreza Jahed
Published: June 2024

This study aimed to investigate bisphenol A (BPA) contents in canned fruit and vegetable samples using Gas Chromatography-Mass Spectrometry (GC-MS). The mean concentration of BPA in canned samples of lentils, apricots, cherries, pineapples, eggplant stew and green peas was 21.87, 4.52, 3.92, 1.86, 1.67 and 1.62 µg/kg, respectively. The level of BPA in the samples was within the standard level. The pH value in canned fruits varied from 3.6 to 4.7 (mean = 4.15) and in canned vegetables from 4.3 to 5.9 (mean = 5.21). The mean sugar content was 41.42% (range 38–48%) and the mean fat value was 24.234% (ranged 24.7–48%). Furthermore, health risks were assessed for Iranian adults, and children. The 95th percentile ADI values of BPA in canned fruit for adults and children were 6.12E-08, and 2.16E-07 mg/kg bw/day; and in canned vegetables were 1.78E-07, and 6.26E-07 mg/kg bw/day, respectively. The 95th percentile THQ values in canned fruit for adults and children were 1.48E-06, and5.24E-06; and in canned vegetable were 3.56E-06, and 1.27E-05, respectively and HQ was less than 1. The results show that exposure to BPA through the intake of this samples does not pose a serious risk to human health.
Adolescent obesity and short sleep duration as independent risk factors for hypertension
: a population-based cohort study
Authors: Kwak Hyo-Bum , Choi Youngju , Yook Jang-Soo , Cho Eun-Jeong , Jeong Ilyoung , Kim Junghoon , Asako Zempo-Miyaki , Chang Eunwook , Park Dong-Ho
Published: June 2024

Prevalence of hypertension in adolescents has increased worldwide and is considered a risk factor for hypertension and cardiovascular disease in adulthood. Although obesity and sleep deficiency increase this risk, the combined effects of these factors on hypertension remain unclear. This study aimed to examine the combined effects of obesity and sleep duration on hypertension in adolescents. This study was conducted using data from the 2016–2018 Korean National Health and Nutrition Examination Survey, which included a study population of 1,272 adolescents. The participants were categorized into four groups based on sleep duration and body mass index (BMI) percentiles: normal sleep and normal body mass group (reference; normal), only short sleep group (short sleep), only overweight/obesity group (overweight/obesity), and short sleep and overweight/obesity group (short sleep and overweight/obesity). Short sleep duration was defined as < 8 hours of average sleep duration, and overweight/obesity was defined as a BMI ≥ 85th percentile. Hypertension in adolescents was defined as a systolic blood pressure ≥ 130 mmHg or diastolic blood pressure ≥ 80 mmHg. The prevalence of hypertension was 9.2% among Korean adolescents. Short sleep duration with overweight/obesity were associated with a significantly increased risk of hypertension (odds ratio = 6.57; 95% confidence interval: 3.27–13.20) in adolescents, and controlling for the potential confounding variables only partially attenuated this relationship (odds ratio = 5.28; 95% confidence interval: 2.28–12.26). This study demonstrated that the coexistence of short sleep duration and obesity is associated with an increased risk of hypertension in Korean adolescents.
Incremental Financial Costs of Strengthening Large-Scale Programs to Improve Young Child Nutrition in Bangladesh, Ethiopia, and Vietnam: Retrospective Expenditure Analysis
Authors: Sanghvi Tina , Homan Rick , Nguyen Tuan , Mahmud Zeba , Walissa Tamirat , Nersesyan Marina , Preware Patricia , Frongillo Edward , Matheson Roger
Published: June 2024

Background
Inattention to young child growth and development in a transitioning global environment can undermine the foundation of human capital and future progress. Diets that provide adequate energy and nutrients are critical for children's physical and cognitive development from 6 to 23.9 months of age and beyond. Still, over 70% of young children do not receive foods with sufficient nutrition particularly in low-and-middle income countries. Program evaluations have documented the effectiveness of large-scale behavior change interventions to improve children’s diets, but the budgetary implications of programs are not known. This paper provides the incremental financial costs of strengthening three large-scale programs based on expenditure records from Bangladesh, Ethiopia, and Vietnam.
Results
The programs reached between one and 2.5 million mothers and children annually per country at unit costs of between $0.9 to $1.6 per mother and child reached. An additional 0.7 to 1.6 million persons who were influential in supporting mothers and achieving scale were also engaged. The largest cost component was counselling of mothers. Rigorous external impact evaluations showed that over 434,500 children benefitted annually from consuming a minimum acceptable diet in all countries combined, at an annual cost per country of $6.3 to $34.7 per child benefited.
Conclusions
Large scale programs to improve young children’s nutrition can be affordable for low- and middle-income countries. The study provides the incremental costs of selectively strengthening key program components in diverse settings with lessons for future budgeting. The costs of treating a malnourished child are several-fold higher than prevention through improved improving young children’s dietary practices. Differences across countries in program models, coverage, costs, and outcomes suggest that countries need a minimum investment of resources for strengthening high-reach service delivery and communication channels and engaging relevant behavioral levers and community support for mothers to achieve impact at scale.
Intelligent Vehicle Object Detection Based on Improved YOLOv7 Algorithm
Authors: Li Aijuan , Gong Chunpeng , Guo Dongjin , Du Guangkai , He Weikai , Zyrianov Vladimir
Published: June 2024

Intelligent driving of automobiles is based on environment awareness, and the technology that makes environment perception possible is target detection. Road traffic scenarios are complicated and variable, which can lead to issues including misdetection and omission of small objects and obscured areas. Furthermore, because to their limited processing capacity, intelligent cars must not only have a high detection accuracy and speed but also a low-complexity model in order to lessen their reliance on high-performance computing platforms. When compared to other lightweight models, the lightweight version of the YOLOv7 algorithm offers a lot of opportunity for improvement in terms of processing and parameter count. Thus, based on the enhanced YOLOv7 algorithm, this research suggests an intelligent vehicle target recognition technique. The YOLOv7-tiny network structure serves as the foundation for the addition of a small target detection layer, the introduction of a context aggregation module to enhance the feature extraction process and the model's capacity to detect small targets in complex scenarios, the reconfiguration of the SPPCSPC module to speed up detection, and the proposal of the P-ELEN module, which reduces the model's number of parameters and computation load, to lessen redundant computation and memory access. Nine sets of comparison tests, eight sets of ablation experiments, and detection effects are used to validate the enhanced YOLOv7 algorithm's detection performance. The experimental findings demonstrate that the enhanced YOLOv7 algorithm increases detection accuracy while simultaneously decreasing model complexity.
Lower MMP2, FLNA, CFL1 expressions favor invasive micropapillary carcinoma prognosis over ductal carcinoma of the breast
Authors: Wang Yidi , Zhang Jingyi , Wang Ying , Liu Yu , Shi Bohui , Li Xiaoqian , Zhang Huimin , He Jianjun
Published: June 2024

Purpose: The prognosis of invasive micropapillary carcinoma (IMPC) relative to invasive ductal carcinoma (IDC) of breast is contentious, despite its recognized aggressive clinical manifestations. This retrospective study aimed to explore the prognosis and underlying molecular mechanisms of IMPC.
Methods: We compared IMPC and IDC patients survival outcomes after PSM using the SEER database and constructed a nomogram for predicting IMPC overall survival (OS). IMPC-specific gene expression profiles were explored using microarray data from the GEO database. The top 10 genes in the PPI network with the highest degrees of connectivity were defined as hub genes and three of them were selected for validation by immunohistochemistry.
Results: IMPC patients had a better prognosis than IDC patients for both OS and BCSS. Multivariate analysis revealed that age, marital status, TN stage, ER status, and chemotherapy were independent prognostic factors for IMPC patients, which were used to construct the nomogram, with good performance in internal and external cohorts. A total of 294 DEGs were identified, with ten hub genes selected. MMP2, FLNA and CFL1, which are known to be associated with poor prognosis in breast cancer patients, were expressed at lower levels in IMPC patients than in IDC patients, indicating favorable outcomes in IMPC.
Conclusions: IMPC patients had a better prognosis than IDC patients, which may due to the lower expression of pro-oncogenic genes in IMPC, but the underlying mechanism needs further investigation.
The use of low-quality cotton-derived cellulose films as templates for in situ conductive polymer synthesis as promising biomaterials in biomedical applications
Authors: Demirci Sahin , Sahiner Mehtap , Rumi Shaida S. , Suner Selin S. , Abidi Noureddine , SAHINER NURETTIN
Published: June 2024

Due to the growing interest in biopolymer-based composites in many applications, noticeable devotion has been directed to natural polymer-derived products not only because of their renewable and eco-friendly characteristics but also for their versatility in processing conditions and cost-effectiveness in fabricating the final products. Here, we report the use of cellulose films (CFs) produced from low-quality cotton as a template for in situ synthesis of well-known conductive polymers, e.g., polyaniline (PANI) and polypyrrole (PPY) via oxidative polymerization. Three successive monomer loading/polymerization cycles of aniline (ANI) and pyrrole (PY) within CFs as PANI@CF or PPY@CF were carried out to increase the extent of conductive polymer content. The contact angle (CA) for three times ANI and PPY loaded and polymerized CFs as 3PANI@CF and 3PPY@CF were determined as 26.3 ± 2.8o and 42.3 ± 0.6o, respectively. As the electrical conductivity is increased with increased number of conductive polymer synthesis within CF, the higher conductivity values, 3x10− 4±8.1x10− 5 S.cm− 1 and 2.1x10− 3±5.8x10− 4 S.cm− 1, respectively were measured for 3PANI@CF and 3PPY@CF composites that were approximately 3.3K-fold and 30K-fold higher, respectively, compared to bare CF. It was also found that PANI@CF composites are hemolytic, whereas PPY@CF composites are not at 1 mg/mL concentrations. In the presence of 1 mg of CF-based conductive polymer composites, all PPY@CF composites exhibit better biocompatibility than PANI@CF composites on L929 fibroblast cells with 81 ± 9, 71 ± 8, and 70 ± 8% cell viability for 1PPY@CF, 2PPY@CF, and 3PPY@CF composites, respectively. Moreover, the minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC) of 3PPY@CF composites for Escherichia coli ATCC8739, Staphylococcus aureus ATCC6538 are determined as 2.5 and 5 mg/mL, whereas these values were estimated to 5 and 10 mg/mL for Candida albicans ATCC10231.
Pulmonary Embolism: Clinical profile and Outcomes
Authors: Andishmand Abbas , Sharifi Leila , Namayandeh Seyedeh Mahdieh
Published: June 2024

Background: Pulmonary embolism (PE) is a severe medical condition characterized by the occlusion of pulmonary blood vessels by a thrombus. This study aimed to offer a comprehensive understanding of the demographic characteristics, risk factors, and clinical manifestations of hospitalized patients with PE, as well as evaluate their short- to mid-term prognoses.
Methods: A total of 109 adult patients with a primary diagnosis of PE, admitted between 2018 and 2020, were included in the study.
Results: The patient cohort had a mean age of 59 years, with males accounting for 51.4% of the participants. The most prevalent symptom reported by patients was dyspnea, followed by chest pain. Pulmonary CT angiography was the primary diagnostic modality employed. Sub-massive PE constituted the most frequent subtype, with 61.5% of cases being provoked by embolisms. The majority of patients exhibited abnormal electrocardiogram (ECG) findings. Elevated levels of D-dimer and troponin were observed in the study population. In-hospital mortality was recorded at 10%, with several factors associated with increased mortality rates, including female gender (p = 0.029), provoked PE (p = 0.006), absence of thrombolytic therapy (p = 0.001), and left ventricular ejection fraction (LVEF) below 50% (p = 0.001). During the mid-term follow-up, the mortality rate rose to 22.8%, with advanced age emerging as a significant risk factor (p = 0.002). Thrombolytic therapy (p = 0.65), LVEF (p = 0.37), and pulmonary artery pressure (p = 0.33) did not exert a significant impact on mid-term mortality. The majority of patients were discharged with warfarin or novel oral anticoagulant (NOAC) therapy, and some exhibited impaired right ventricular function.
Conclusion: This study demonstrates that the absence of thrombolytic therapy in patients with massive embolism, along with the presence of risk factors such as immobility, malignancy, age over 65 years, and female gender, are significantly associated with short- and mid-term mortality in patients with pulmonary embolism.
Semantic segmentation feature fusion network based on transformer
Authors: Li Tianping , Cui Zhaotong , Zhang Hua
Published: June 2024

Convolutional neural networks have demonstrated efficacy in acquiring local features and spatial details; however, they struggle to obtain global information, which could potentially compromise the segmentation of important regions of an image. Transformer can increase the expressiveness of pixels by establishing global relationships between them. Moreover, some transformer-based self-attentive methods do not combine the advantages of convolution, which makes the model require more computational parameters. This work uses both Transformer and CNN structures to improve the relationship between image-level regions and global information to improve segmentation accuracy and performance in order to address these two issues and improve the semantic segmentation segmentation results at the same time. We first build a Feature Alignment Module (FAM) module to enhance spatial details and improve channel representations. Second, we compute the link between similar pixels using a Transformer structure, which enhances the pixel representation. Finally, we design a Pyramid Convolutional Pooling Module (PCPM) that both compresses and enriches the feature maps, as well as determines the global correlations among the pixels, to reduce the computational burden on the transformer. These three elements come together to form a transformer-based semantic segmentation feature fusion network (FFTNet). Our method yields 82.5% mIoU, according to experimental results based on the Cityscapes test dataset. Furthermore, we conducted various visualization tests using the Pascal VOC 2012 and Cityscapes datasets. The results show that our approach outperforms alternative approaches.
Metabolic syndrome is associated with PSA biochemical recurrence after radical prostatectomy: a prospective study with a minimum 5-year follow-up
Authors: Kontogiannis Stavros , Markantes Georgios , Obaidat Mohammed , Tsagkarakis Michail , Giannitsas Konstantinos , Perimenis Petros , Georgopoulos Neoklis , Athanasopoulos Anastasios
Published: June 2024

Purpose
Prostate cancer exhibits significant heterogeneity in terms of its aggressiveness. The precise role of metabolic syndrome in this variability remains unclear. This study will investigate the relationship between metabolic factors and their potential role in predicting the aggressiveness of prostate cancer.
Methods
This was a prospective study, enrolling consecutive patients undergoing radical prostatectomy. A comprehensive metabolic profile was established by measuring weight, height, body mass index, waist circumference, triglycerides, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and fasting glucose, as well as by recording the presence of hypertension, diabetes mellitus and metabolic syndrome. The minimum follow-up was five years after surgery. Aggressive prostate cancer was defined based on based on three criteria: post-operative Gleason score (GS) of 8 or higher, pT3 disease classification according to the TNM staging system, and PSA biochemical recurrence after surgery.
Results
In total, 91 patients were enrolled. The mean age and PSA were 64.8 years and 9.3 ng/dl, respectively. The median post-operative GS was 7. The median body mass index and waist circumference was 28.3 kg/m2 and 93 cm, respectively. Almost one third (29.6%) of the participants had metabolic syndrome. Waist circumference was associated positively with post-operative Gleason first grade (p = 0.041), while metabolic syndrome was associated positively with pT3 disease (p = 0.005). Kaplan-Meier analysis also revealed that patients with metabolic syndrome had significantly more likelihood for biochemical recurrence after radical prostatectomy (p = 0.025).
Conclusion
The current study observed a significant correlation between metabolic syndrome and aggressive prostate cancer characteristics within a cohort of patients undergoing radical prostatectomy. Therefore, patients with metabolic syndrome should be carefully observed after radical prostatectomy, as they seem to be at higher risk for recurrence.
Quantitative hemodynamics of draining veins in brain arteriovenous malformation: a preliminary study based on computational fluid dynamics
Authors: Ma Long , Chen Yu , Chen Pingting , Ma Li , Yan Debin , Li Ruinan , Li Zhipeng , Zhang Haibin , Han Heze , Yuan Kexin , Li Runting , Lin Fa , Zhao Yuanli , Chen Xiaolin
Published: June 2024

Objective:
This study initiated a preliminary computational fluid dynamics (CFD)-based study to investigate the relationship between quantitative hemodynamics of arteriovenous malformation (AVM) draining veins and rupture.
Methods:
The quantitative hemodynamics of AVM draining veins were generated from computed tomography angiography (CTA)-based steady-state CFD models. Morphological and hemodynamic parameters were compared between the ruptured and unruptured groups. The boundary conditions of the drainage vein were obtained from quantitative digital subtraction angiography (QDSA). The draining veins were divided into 15 consecutive segments to analyze the spatial distribution of the hemodynamic parameters by linear regression analysis.
Results:
From 11 AVMs, it was revealed that morphological parameters of drainage veins in ruptured and unruptured AVMs were similar. The intravascular pressure of the draining vein in the ruptured AVMs was significantly higher than those of the unruptured AVMs (pressure average: P = 0.006; pressure maximum: P = 0.045), and the WSS of the posterior segment was higher in ruptured AVMs (P = 0.045). WSS of draining veins in ruptured AVMs showed a linear increase trend with segmenting (R = 0.731, P < 0.001), and ruptured AVMs were more likely to be accompanied by high-velocity segments in the draining vein (40.0% vs. 14.7%, P = 0.037), especially in the posterior segment (P = 0.011).
Conclusion:
The draining veins of ruptured AVMs had significantly higher intravascular pressure and posterior segment WSS. WSS showed a linear increase with segmentation in ruptured AVMs, and they often had more high-velocity segments in the draining vein, especially in the posterior segment.
Comparison of continuous temperature measurement methods in the intensive care unit: standard bladder catheter measurements versus non-invasive transcutaneous sensor
Authors: Ehlers Ulrike Elisabeth , Ulmer Jens , Mirja Keller , Carsten Klein , Urs Pietsch
Published: June 2024

1.1 Purpose
Comparison of a wearable system for body core temperature measurement versus bladder and tympanic thermometers in an intensive care setting. Do continuous non-invasive sensors in the intensive care unit represent an alternative to current standard methods of invasive continuous bladder or low-invasive intermittent tympanic temperature measurement methods?
1.2 Method
Between May and September 2023, a comparative investigation involving 112 patients was conducted in a 20-bed surgical intensive care unit to assess various temperature probes, including those placed in the tympanic tube, bladder, and skin. To achieve this, a wireless non-invasive sensor system provided by greenTEG AG, Switzerland, was affixed to different body locations (clavicular and lateral chest) of each catheterized patient (equipped with a temperature probe) admitted to the intensive care unit. Furthermore, tympanic temperatures were recorded at specified intervals. The measurement duration ranged from a minimum of six hours to a maximum of six days, resulting in the analysis of a total of 355 simultaneous temperature measurements.
1.3 Results
In this study, a wearable temperature measurement system attached to two different body sites revealed a consistent negative bias compared to bladder temperature. In addition, the measurements were particularly influenced by body constitution. The tested system in all patients showed a mean absolute error (MAE) of 0.45°C for the lateral chest and 0.50°C for the clavicular position. Tympanic measurements had a mean absolute error of 0.35°C. In patients with body mass index (BMI) ≥ 25 the MAE increased to 0.5°C for the lateral chest and 0.56°C for the clavicular position. In contrast, the tympanic measurement had a reduced MAE of 0.32°C, which is well below this threshold when compared to bladder measurements.
1.4 Conclusion
The investigated system did not meet the clinically relevant acceptance criteria and showed low precision in correctly identifying fever episodes compared to invasive temperature probes, however its main advantage lies in its continuity and non-invasiveness. This makes it a potential alternative to intermittent tympanic measurement devices. In this study we were able to show, that in at least one subset of patients, the non-invasive and continuous device demonstrated a precision comparable to tympanic measurements.
1.5 Limitations
The accuracy of all non-invasive methods was lower than in previous studies, suggesting that the use of bladder temperature as reference and user related variations may have introduced additional errors.
Is Amniotomy a Risk Factor for Severe Perineal Trauma? -A Swedish Nationwide Register Study
Authors: Tallhage Sofia , Årestedt Kristofer , Schildmeijer Kristina , Oscarsson Marie
Published: June 2024

Background: Severe perineal trauma (SPT) is a serious complication with vaginal births, potentially leading to physical and psychological consequences for the woman. Amniotomy is a commonly used labour intervention with uncertain evidence. It was identified as a previously unrecognized risk factor for SPT in a recent Norwegian study. The aim of the thus study was therefore, to investigate whether amniotomy is a risk factor for SPT, and to examine whether the timing of performing amniotomy affects the occurrence of SPT in Swedish nulliparous and multiparous women.
Methods: This nationwide register-based study included 477 321 women who had given birth in 2017–2020. Data were collected from the Swedish Pregnancy Register in which most data is collected via direct transfer from medical records. The main outcome, SPT, was identified in the data by International Classification of Diseases (ICD-10) diagnosis codes O70.2 and O70.3. Multiple binary logistic regression analysis was used to estimate odds ratios, adjusted for other risk factors.
Results: The incidence of SPT in nulliparous was 5.1% and in multiparous women 0.9%. SPT was more common in both nulliparous and multiparous women who underwent amniotomy. Amniotomy increased the odds for SPT in the simple binary regression analysis for both nulliparous [OR 1.33; 95% CI, 1.28-1.38] and multiparous women [OR 1.12; 95% CI, 1.03-1.22]. This significance was lost in both nulliparous [OR 0.96; 95% CI, 0.87-1.07] and multiparous women [OR 0.83; 95% CI, 0.67-1.03] when analysed in the multiple binary logistic regression. An increasing duration between amniotomy and birth decreased the odds for SPT in nulliparous women. No association was found regarding the timing of amniotomy of occurrence of SPT in multiparous women.
Conclusions: SPT was more common in women who underwent amniotomy, however, when adjusted for other risk factors, amniotomy was not identified as a risk factor for SPT. Performing amniotomy near the birth in nulliparous women entailed an increased risk for SPT, indicating the importance of a controlled and slow birth of the baby, to prevent the severe complication of SPT.
Prevalence of Enterocytozoon hepatopenaei (EHP) in Penaeus monodon farms in India
Authors: B Naveen Rajeshwar , T Sathish Kumar , Jithendran K. P. , Bedekar Megha K. , Rajendran K. V.
Published: June 2024

Hepatopancreatic microsporidiosis caused by Enterocytozoon hepatopenaei (EHP) causes substantial economic losses to the shrimp farming industry. Despite the wide potential host range, most research on EHP was focused on Penaeus vannamei due to its widespread farming and severe growth retardation. However, there needs to be more available information on EHP infection in farmed tiger shrimp, P. monodon, especially considering its re-introduction and use of specific pathogen-free (SPF) seeds in India. A polymerase chain reaction-based (two-step PCR) survey was conducted to understand the prevalence of EHP in P. monodon farms across six states in India. Two different PCR assays, one specific to the spore wall protein (SWP) gene and the other targeting the SSU rRNA gene. While only 19 of 63 farms (30.15%) surveyed during the study revealed the presence of EHP using SWP-specific PCR, 38 farms (60.31%) were found to be positive with SSU rRNA PCR. However, only one of the farms showed EHP in the first step of PCR. The low level of infection, as indicated by the PCR analysis, was further validated and confirmed by histology and quantitative real-time PCR (qPCR). The EHP load ranged from 1.0 × 103 to 3.7 × 106 copies/ µg DNA, and histology of hepatopancreas showed only mild pathological changes and inclusion-like bodies similar to the developmental stages of EHP. Some of the samples showed bacteria-induced haemocyte infiltration and nodule formation. However, no microsporidian spores could be noticed in the histological sections. EHP SWP-specific PCR amplicons were sequenced, and phylogenetic analysis of the sequences showed similarity with earlier reported EHP strains from P. vannamei from Thailand, Latin America and India. A statistical epidemiological study to identify risk factors associated with EHP infection revealed that the presence of EHP infection in previous cultures, the use of wild seeds and continuous farming as potential risk factors and the use of SPF seeds and bleaching as protective factors. P. monodon is susceptible to EHP infection, yet the impact on the species is significantly lower than that reported in P. vannamei. The present report forms the latest report on the prevalence of EHP in P. monodon farms in India.
Homomorphic Encryption: An Application to Polygenic Risk Scores
Authors: knight elizabeth , Li Jiaqi , Jensen Mathew , Yolou Israel , Kockan Can , Gerstein Mark
Published: June 2024

Background: Polygenic risk scores (PRS) have emerged as a powerful tool in precision medicine, enabling personalized risk assessments for complex diseases. However, using sensitive genomic data in PRS calculations raises concerns about privacy and security. Fully Homomorphic Encryption (FHE) offers a promising solution by allowing computations on encrypted data, preserving the privacy of both genomic information and PRS models.
Methods: In this study, we present a novel application of FHE for secure and private PRS calculations using the CKKS protocol within the Lattigo library. Our approach involves a threeparty system: clients (doctors with sensitive genetic data), modelers developing a PRS (academics or a company), and evaluators (a ”local hospital” running the models while maintaining data confidentiality). We demonstrate the feasibility and accuracy of our protocol by applying it to synthetic datasets of various sizes and a robust 110k-SNP model for schizophrenia.
Results: The normal PRS calculation results are essentially identical to the encrypted calculation: between the two results R2 is .999 & MSE is 2.27 × 10−6. Moreover, while the encrypted calculation is roughly 1000 times slower than conventional non-encrypted ones (when only considering the core PRS calculation), it is quite feasible on a single-CPU node - e.g. running on ∼1100 individuals with ∼110k SNPS took six minutes and ∼65G memory on a laptop computer. In addition, we investigate the impact of encryption parameters (modulus) on this computational time and accuracy in detail.
Conclusion: Our approach enables secure PRS calculations on encrypted genomic data, addressing the pressing need for privacy-preserving solutions in the era of precision medicine. The ability to perform accurate risk assessments while maintaining patient confidentiality paves the way for broader adoption of PRS and personalized medicine in healthcare, particularly with the advent of large-scale computing power.
Development of a Survey Tool to Assess Emotional and Social Behavioral Competencies of Science Technology Engineering and Medicine (STEM) Graduate Students
Authors: Quinn Joann F. , Cola Philip A. , Cooper Melissa , Miller Casey W.
Published: June 2024

The underrepresentation of women and minority students in STEM graduate programs remains a significant challenge, compounded by biases in traditional admissions processes and barriers to effective mentoring and retention. This study develops and validates the Quinn Miller Competency Assessment (QMCA), a tool designed to assess emotional and social intelligence (ESI) competencies crucial for STEM graduate student success. The QMCA was created through an iterative process involving literature review, expert consultations, and empirical studies. It evaluates five key competencies: self-awareness, self-control, adaptability, achievement orientation, and teamwork. The tool's validity and reliability were tested using exploratory and confirmatory factor analyses on diverse samples of STEM graduate students and applicants. Results demonstrated strong construct validity and reliability, supporting the QMCA's use in both admissions and student development contexts, in conjunction with other measures. By providing a more holistic evaluation of applicants’ competencies, the QMCA aims to improve access and retention for underrepresented groups in STEM fields, fostering a more inclusive and diverse scientific community. Future research will focus on expanding the QMCA to include additional social competencies and testing its applicability across broader disciplines.