bluuebunny/crossref_metadata_2025 huggingface dataset:
Intussusception revealing right colonic adenocarcinoma in a 61-year-old woman: a case report
Authors: Ali Mohamed Osama Mohamed , Mohamed Noon Idris Abdelrahman , Ahmed Ahmed Abdelfattah Eltomelhussein , Basher Mohamed Osman Suliman , Mohamed Samya Abbas Abdelrazig , Elgemaabi Osama Mohieldin
Published: July 2023

Introduction

Adult Intussusception is an uncommon diagnosis, with one to three cases occurring in a population of 1,000,000 per year, primarily due to underlying pathological lead points, of which 70% are malignant. Lipoma is the most common benign tumour, and primary adenocarcinoma is the most common malignant one. Early diagnosis and treatment are essential to reducing poor outcomes, including ischemia, perforation, and sepsis. Computed tomography imaging is a modality of choice for diagnosis. With a diagnostic accuracy of up to 100% and a specificity of up to 71%. Surgical intervention is the definitive treatment, and the decision is taken according to the situation.

Case presentation

A 61-year-old Black African female presented to our surgical casualty with intermittent colicky abdominal pain for 1 month. After that, she started to experience abdominal swelling in the right iliac fossa. A CT scan confirmed the presence of colo-colic Intussusception, cecum-ascending-transverse colon. Laparotomy was scheduled, and a right hemicolectomy was done accordingly. Diagnosis of adenocarcinoma (Dukes stage B2) was made histologically.

Conclusion

Intussusception in adults is a challenging diagnosis requiring high clinical suspicion and has a high incidence of fatal complications. Colonic cancer can be worsening by any infection and chronic medical problem. CT imaging is the lifesaving modality of choice for diagnosis. Good patient outcomes depend on timely diagnosis and recruitment of a multi-disciplinary team.
Mapping and systematic appraisal of umbrella reviews in epidemiological research: a protocol for a meta-epidemiological study
Authors: Belbasis Lazaros , Brooker Robin D , Zavalis Emmanuel , Pezzullo Angelo Maria , Axfors Cathrine , Ioannidis John PA
Published: July 2023

Introduction

Umbrella review is one of the terms used to describe an overview of systematic reviews. During the last years, a rapid increase in the number of umbrella reviews on epidemiological studies has been observed, but there is no systematic assessment of their methodological and reporting characteristics. Our study aims to fill this gap by performing a systematic mapping of umbrella reviews in epidemiological research.

Methods

We will perform a meta-epidemiological study including a systematic review in MEDLINE and EMBASE to identify all the umbrella reviews that focused on systematic reviews of epidemiological studies and were published from inception until December 31, 2022. We will consider eligible any research article which was designed as an umbrella review and summarized systematic reviews and meta-analyses of epidemiological studies. From each eligible article, we will extract information about the research topic, the methodological characteristics, and the reporting characteristics. We will examine whether the umbrella reviews assessed the strength of the available evidence and the rigor of the included systematic reviews. We will also examine whether these characteristics change across time.

Discussion

Our study will systematically appraise the methodological and reporting characteristics of published umbrella reviews in epidemiological literature. The findings of our study can be used to improve the design and conduct of future umbrella reviews, to derive a standardized set of reporting and methodological guidelines for umbrella reviews, and to allow further meta-epidemiological work.

Systematic review registration

osf.io/sxzc6
Complex systems approaches to the adaptability of human functions and behavior in health, aging, and chronic diseases: protocol for a meta-narrative review
Authors: Hognon Louis , Heraud Nelly , Varray Alain , Torre Kjerstin
Published: July 2023

Background

Evaluating the adaptability of human functions and behavior has become a subject of growing interest due to aging populations and the increased prevalence of chronic diseases. Various research traditions, based on complex systems theories, have addressed the adaptability of human functions and behavior. However, despite the different research traditions, no review has so far compared them to provide a reliable and useful synthetic tool. Based on an adapted methodology, study objectives are to refine common and divergent traits in the way adaptability of the human functions and behavior has been studied via complex system approaches, with a special focus on aging and chronic diseases. In order to meet this objective, we will use the methodology of the meta-narrative review, and we present in this article the protocol that we will follow.

Methods

The meta-narrative review explores the contrasting and complementary ways in which researchers have studied a subject in order to synthesize information and extract theoretical and applied recommendations. In order to carry out this protocol, we detail our methodology of article extraction, coding, and synthesis. We present the six main stages of our review, from the planning stage to the recommendation stage, and the way we will implement the six principles that underpin the construction of a meta-narrative review.

Discussion

The use of a meta-narrative review methodology will yield greater visibility and comprehension of the adaptability of human functions and behavior studied via complex systems-based approaches. In a broader perspective, this paper is also geared to help future researchers carry out a meta-narrative review by highlighting the main challenges encountered and anticipated as well as elements to be taken into account before starting such a project.
A conceptual architecture for simulating blockchain-based IoT ecosystems
Authors: Albshri Adel , Alzubaidi Ali , Alharby Maher , Awaji Bakri , Mitra Karan , Solaiman Ellis
Published: July 2023

Recently, the convergence between Blockchain and IoT has been appealing in many domains including, but not limited to, healthcare, supply chain, agriculture, and telecommunication. Both Blockchain and IoT are sophisticated technologies whose feasibility and performance in large-scale environments are difficult to evaluate. Consequently, a trustworthy Blockchain-based IoT simulator presents an alternative to costly and complicated actual implementation. Our primary analysis finds that there has not been so far a satisfactory simulator for the creation and assessment of blockchain-based IoT applications, which is the principal impetus for our effort. Therefore, this study gathers the thoughts of experts about the development of a simulation environment for blockchain-based IoT applications. To do this, we conducted two different investigations. First, a questionnaire is created to determine whether the development of such a simulator would be of substantial use. Second, interviews are conducted to obtain participants’ opinions on the most pressing challenges they encounter with blockchain-based IoT applications. The outcome is a conceptual architecture for simulating blockchain-based IoT applications that we evaluate using two research methods; a questionnaire and a focus group with experts. All in all, we find that the proposed architecture is generally well-received due to its comprehensive range of key features and capabilities for blockchain-based IoT purposes.
Effects of opioid-free total intravenous anesthesia on postoperative nausea and vomiting after treatments of lower extremity wounds: protocol for a randomized double-blind crossover trial
Authors: Zhu Ya-juan , Wang Dan , Long Yu-qin , Qian Long , Liu Hong , Ji Fu-hai , Peng Ke
Published: July 2023

Background

Postoperative nausea and vomiting (PONV) are common after general anesthesia and surgery. This study aims to compare the effects of total intravenous opioid-free anesthesia (OFA) with conventional opioid-based anesthesia (OBA) on PONV in patients following treatments for wounds of lower extremities.

Methods

This randomized, double-blind, crossover trial will include a total of 72 adult patients scheduled for at least two separate surgical treatments of lower extremity wounds under general anesthesia. Patients will be randomized to 1 of 2 anesthesia sequences of OFA and OBA. Patients in sequence 1 will receive OFA in the first treatment procedure and OBA in the second procedure, while patients in sequence 2 will receive the two anesthesia regimens in the reverse order. The washout period is at least 5 days. OFA will be delivered with intravenous esketamine, lidocaine, dexmedetomidine, and propofol. OBA will be delivered with intravenous sufentanil and propofol. The primary endpoint is the incidence of PONV within the first 48 h postoperatively. The secondary endpoints are the severity of PONV, antiemetic rescue therapy, postoperative pain scores, the worst pain, need for rescue analgesia, postoperative sedation, hypotension, bradycardia, hypertension, tachycardia, hypoxemia, psychotomimetic or dissociative effects, time to extubation, and length of postanesthesia care unit stay. Patients who complete two surgical procedures with designated anesthesia regimens will be included in the final analyses.

Discussion

This crossover trial will determine whether total intravenous OFA reduces PONV in patients following treatments for lower extremity wounds. The results of this trial will also represent an important step to understand the benefits and possible risks of OFA in surgical patients.

Trial registration

Chinese Clinical Trial Registry (ChiCTR2200061511).
Comprehensive analysis of necroptosis-related lncRNA signature with potential implications in tumor heterogeneity and prediction of prognosis in clear cell renal cell carcinoma
Authors: Lin Hang , Qu Lingzhi , Chen Guanqiu , Zhang Chunfang , Lu Liqing , Chen Yongheng
Published: July 2023

Background

Necroptosis has been reported to play a critical role in occurrence and progression of cancer. The dysregulation of long non-coding RNAs (lncRNAs) is associated with the progression and metastasis of clear cell renal cell carcinoma (CCRCC). However, research on necroptosis-related lncRNAs in the tumor heterogeneity and prognosis of CCRCC is not completely unclear. This study aimed to analysis the tumor heterogeneity among CCRCC subgroups and construct a CCRCC prognostic signature based on necroptosis-related lncRNAs.

Methods

Weighted gene co-expression network analysis (WGCNA) was performed to identify necroptosis-related lncRNAs. A preliminary classification of molecular subgroups was performed by non-negative matrix factorization (NMF) consensus clustering analysis. Comprehensive analyses, including fraction genome altered (FGA), tumor mutational burden (TMB), DNA methylation alterations, copy number variations (CNVs), and single nucleotide polymorphisms (SNPs), were performed to explore the potential factors for tumor heterogeneity among the three subgroups. Subsequently, we constructed a predictive signature by multivariate Cox regression. Nomogram, calibration curves, decision curve analysis (DCA), and time-dependent receiver-operating characteristics (ROC) were used to validate and evaluate the signature. Finally, immune correlation analyses, including immune-related signaling pathways, immune cell infiltration status and immune checkpoint gene expression level, were also performed.

Results

Seven necroptosis-related lncRNAs were screened out by WGCNA, and three subgroups were classified by NMF consensus clustering analysis. There were significant differences in survival prognosis, clinicopathological characteristics, enrichments of immune-related signaling pathway, degree of immune cell infiltration, and expression of immune checkpoint genes in the various subgroups. Most importantly, we found that 26 differentially expressed genes (DEGs) among the 3 subgroups were not affected by DNA methylation alterations, CNVs and SNPs. On the contrary, these DEGs were associated with the seven necroptosis-related lncRNAs. Subsequently, the identified RP11-133F8.2 and RP11-283G6.4 by multivariate Cox regression analysis were involved in the risk model, which could serve as an independent prognostic factor for CCRCC. Finally, qRT-PCR confirmed the differential expression of the two lncRNAs.

Conclusions

These findings contributed to understanding the function of necroptosis-related lncRNAs in CCRCC and provided new insights of prognostic evaluation and optimal therapeutic strategy for CCRCC.
Trends in in ovo sexing technologies: insights and interpretation from papers and patents
Authors: Corion Matthias , Santos Simão , De Ketelaere Bart , Spasic Dragana , Hertog Maarten , Lammertyn Jeroen
Published: July 2023

Numerous researchers and institutions have been developing in ovo sexing technologies to improve animal welfare by identifying male embryos in an early embryonic stage and disposing of them before pain perception. This review gives a complete overview of the technological approaches reported in papers and patents by performing a thorough search using Web of Science and Patstat/Espacenet databases for papers and patents, respectively. Based on a total of 49 papers and 115 patent families reported until May 2023 worldwide, 11 technology categories were defined: 6 non-optical and 5 optical techniques. Every category was described for its characteristics while assessing its potential for application. Next, the dynamics of the publications of in ovo sexing techniques in both paper and patent fields were described through growth curves, and the interest or actual status was visualized using the number of paper citations and the actual legal status of the patents. When comparing the reported technologies in papers to those in patents, scientific gaps were observed, as some of the patented technologies were not reported in the scientific literature, e.g., ion mobility and mass spectrometry approaches. Generally, more diverse approaches in all categories were found in patents, although they do require more scientific evidence through papers or industrial adoption to prove their robustness. Moreover, although there is a recent trend for non-invasive techniques, invasive methods like analyzing DNA through PCR or hormones through immunosensing are still being reported (and might continue to be) in papers and patents. It was also observed that none of the technologies complies with all the industry requirements, although 5 companies already entered the market. On the one hand, more research and harmony between consumers, industry, and governments is necessary. On the other hand, close monitoring of the market performance of the currently available techniques will offer valuable insights into the potential and expectations of in ovo sexing techniques in the poultry industry.
Impact of depression on the perception of fatigue and information processing speed in a cohort of multiple sclerosis patients
Authors: Biasi Madia M. , Manni Alessia , Pepe Ilaria , Abbatantuono Chiara , Gasparre Daphne , Iaffaldano Pietro , Simone Marta , De Caro Maria F. , Trojano Maria , Taurisano Paolo , Paolicelli Damiano
Published: July 2023

Background

Information processing speed is commonly impaired in people with multiple sclerosis (PwMS). However, depression and fatigue can affect the cognitive profile of patients: fatigue has a negative impact from the disease’s earliest stage and a reduced information processing speed is often associated with higher levels of depression. Therefore, the aim of this study was to investigate the correlations between information processing speed and physical fatigue in a cohort of Italian PwMS from a single center, considering the effect of depression.

Methods

Two hundred (W = 128; mean age = 39.83 years; SD = 11.86) PwMS, from the Bari University Hospital, underwent testing for processing speed (Symbol Digit Modalities Test [SDMT]), fatigue level (Fatigue Severity Scale [FSS]), and depression (Beck’s Depression Inventory [BDI]).

Results

Statistically significant correlations emerged between SDMT and FSS, SDMT and BDI, FSS and BDI. Mediation analyses revealed that while physical fatigue had no significant direct negative effect on information processing speed (z=-0.891; p > 0.05), depression predicted the relationship between fatigue and information processing speed (z=-2.181; p < 0.05).

Conclusion

Our findings showed that cognitive performance at SDMT was not affected by patients’ perceived level of physical fatigue, but by depression. The presence of a high BDI score mediates the physical fatigue on cognitive performance impact.
Have the cake and eat it too: Differential Privacy enables privacy and precise analytics
Authors: Subramanian Rishabh
Published: July 2023

Existing research in differential privacy, whose applications have exploded across functional areas in the last few years, describes an intrinsic trade-off between the privacy of a dataset and its utility for analytics. Resolving this trade-off critically impacts potential applications of differential privacy to protect privacy in datasets even while enabling analytics using them. In contrast to the existing literature, this paper shows how differential privacy can be employed toprecisely—not approximately—retrievethe analytics on the original dataset. We examine, conceptually and empirically, the impact of noise addition on the quality of data analytics. We show that the accuracy of analytics following noise addition increases with the privacy budget and the variance of the independent variable. Also, the accuracy of analytics following noise addition increases disproportionately with an increase in the privacy budget when the variance of the independent variable is greater. Using actual data to which we add Laplace noise, we provide evidence supporting these two predictions. We then demonstrate ourcentral thesisthat, once the privacy budget employed for differential privacy is declared and certain conditions for noise addition are satisfied, the slope parameters in the original dataset can beaccurately retrievedusing the estimates in the modified dataset of the variance of the independent variable and the slope parameter. Thus, differential privacy can enable robust privacy as well asprecisedata analytics.
Estimation of brain amyloid accumulation using deep learning in clinical [11C]PiB PET imaging
Authors: Ladefoged Claes Nøhr , Anderberg Lasse , Madsen Karine , Henriksen Otto Mølby , Hasselbalch Steen Gregers , Andersen Flemming Littrup , Højgaard Liselotte , Law Ian ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: July 2023

Introduction

Estimation of brain amyloid accumulation is valuable for evaluation of patients with cognitive impairment in both research and clinical routine. The development of high throughput and accurate strategies for the determination of amyloid status could be an important tool in patient selection for clinical trials and amyloid directed treatment. Here, we propose the use of deep learning to quantify amyloid accumulation using standardized uptake value ratio (SUVR) and classify amyloid status based on their PET images.

Methods

A total of 1309 patients with cognitive impairment scanned with [11C]PIB PET/CT or PET/MRI were included. Two convolutional neural networks (CNNs) for reading-based amyloid status and SUVR prediction were trained using 75% of the PET/CT data. The remaining PET/CT (n = 300) and all PET/MRI (n = 100) data was used for evaluation.

Results

The prevalence of amyloid positive patients was 61%. The amyloid status classification model reproduced the expert reader’s classification with 99% accuracy. There was a high correlation between reference and predicted SUVR (R2 = 0.96). Both reference and predicted SUVR had an accuracy of 97% compared to expert classification when applying a predetermined SUVR threshold of 1.35 for binary classification of amyloid status.

Conclusion

The proposed CNN models reproduced both the expert classification and quantitative measure of amyloid accumulation in a large local dataset. This method has the potential to replace or simplify existing clinical routines and can facilitate fast and accurate classification well-suited for a high throughput pipeline.
A time-based double-sided readout concept of 100 mm LYSO:Ce,Ca fibres for future axial TOF-PET
Authors: Weindel Konstantin , Nadig Vanessa , Herweg Katrin , Schulz Volkmar , Gundacker Stefan
Published: July 2023

Background

Positron emission tomography (PET) requires a high signal-to-noise ratio (SNR) to improve image quality, with time-of-flight (TOF) being an effective way to boost the SNR. However, the scanner sensitivity and resolution must be maintained. The use of axially aligned 100-mm LYSO:Ce,Ca scintillation crystals with double-sided readout has the potential of ground-breaking TOF and sensitivity, while reducing parallax errors through depth-of-interaction (DOI) estimation, and also allowing a reduction in the number of readout channels required, resulting in cost benefits. Due to orientation, these fibres may also facilitate the integration of TOF-PET with magnetic resonance imaging (MRI) in hybrid imaging systems. The challenge of achieving a good spatial resolution with such long axial fibres is directly related to the achievable TOF resolution. In this study, the timing performance and DOI resolution of emerging high-performance materials were investigated to assess the merits of this approach in organ-dedicated or total-body/large-scale PET imaging systems.

Methods

LYSO:Ce,Ca scintillation fibres of 20 mm and 100 mm length were tested in various operating and readout configurations to determine the best achievable coincidence time resolution (CTR) and DOI resolution. The tests were performed using state-of-the-art high-frequency (HF) readout and commercially available silicon photomultipliers (SiPMs) from Broadcom Inc.

Results

For the 100-mm fibre, an average CTR performance of $$137 \pm 1$$

137
±
1

ps FWHM and an average depth-of-interaction resolution within the fibre of $$12.3 \pm 0.5$$

12.3
±
0.5

mm FWHM could be obtained. The 20-mm fibre showed a sub-100 ps CTR of $$98 \pm 1$$

98
±
1

ps FWHM and a fibre resolution of $$8.5 \pm 0.2$$

8.5
±
0.2

mm FWHM in the double-sided readout configuration.

Conclusion

With modern SiPMs and crystals, a double-sided readout of long fibres can achieve excellent timing resolution and field-advancing TOF resolution, outperforming commercial PET systems. With 100-mm fibres, an electronic channel reduction of about a factor 2.5 is inherent, with larger reduction factors conceivable, which can lead to lower production costs. The spatial resolution was shown to be limited in the axial direction with 12 mm, but is defined to 3 mm in all other directions. Recent SiPM and scintillator developments are expected to improve on the time and spatial resolution to be investigated in future prototypes.
From reading style to cognitive style and its possible application: an eye-tracking and CFT approach
Authors: Lu Wei-lun , Dostálová Nicol , Lacko David , Šašinková Alžběta , Šašinka Čeněk
Published: July 2023

Reading strategies and cognitive styles have been the objective of many researchers. However, the relation between these two concepts remains unclear. This paper is focusing on three goals. Firstly, we verify the reliability of the eye-tracking indicators of risky and conservative reading style. Secondly, we aim to explore an additional eye-tracking pattern that may reflect the reading style on the global level. Thirdly, we explore the relationship between reading style and the holistic/analytic cognitive style. The study is based on a combination of Compound Figure Test (CFT) as a main tool for analyzing cognitive style and eye-tracking study consisting of several text stimuli related to verify reading style patterns. Results showed stability across the reading tasks, which validates for the usefulness and reliability of original Rayner’s as well as the new additional eye-tracking metrics. The stability of the eye-tracking metrics allows us to treat them as a behavioral profile in information processing that may be viewed as a stable personality trait known as reading style. However, the eye-tracking results and the CFT global preference score did not show a detectably close relation between cognitive style and reading style. In conclusion, we also discuss the possibility of applying these eye-tracking patterns to foreign language material design.
Atypical cholangiocytes derived from hepatocyte-cholangiocyte transdifferentiation mediated by COX-2: a kind of misguided liver regeneration
Authors: Lan Tian , Tai Yang , Zhao Chong , Xiao Yang , Yang Zhu , Zhang Linhao , Gan Can , Dai Wenting , Tong Huan , Tang Chengwei , Huang Zhiyin , Gao Jinhang
Published: July 2023

Background

Hepatocyte-cholangiocyte transdifferentiation (HCT) is a potential origin of proliferating cholangiocytes in liver regeneration after chronic injury. This study aimed to determine HCT after chronic liver injury, verify the impacts of HCT on liver repair, and avoid harmful regeneration by understanding the mechanism.

Methods

A thioacetamide (TAA)-induced liver injury model was established in wild-type (WT-TAA group) and COX-2 panknockout (KO-TAA group) mice. HCT was identified by costaining of hepatocyte and cholangiocyte markers in vivo and in isolated mouse hepatocytes in vitro. The biliary tract was injected with ink and visualized by whole liver optical clearing. Serum and liver bile acid (BA) concentrations were measured. Either a COX-2 selective inhibitor or a β-catenin pathway inhibitor was administered in vitro.

Results

Intrahepatic ductular reaction was associated with COX-2 upregulation in chronic liver injury. Immunofluorescence and RNA sequencing indicated that atypical cholangiocytes were characterized by an intermediate genetic phenotype between hepatocytes and cholangiocytes and might be derived from hepatocytes. The structure of the biliary system was impaired, and BA metabolism was dysregulated by HCT, which was mediated by the TGF-β/β-catenin signaling pathway. Genetic deletion or pharmaceutical inhibition of COX-2 significantly reduced HCT in vivo. The COX-2 selective inhibitor etoricoxib suppressed HCT through the TGF-β-TGFBR1-β-catenin pathway in vitro.

Conclusions

Atypical cholangiocytes can be derived from HCT, which forms a secondary strike by maldevelopment of the bile drainage system and BA homeostasis disequilibrium during chronic liver injury. Inhibition of COX-2 could ameliorate HCT through the COX-2-TGF-β-TGFBR1-β-catenin pathway and improve liver function.
Psychometric evaluation of a patient-reported outcomes instrument for congenital thrombotic thrombocytopenic purpura
Authors: Oladapo Abiola , Ito Diane , Rodriguez Ana María , Philpott Stephanie , Krupnick Robert , Allen Veleka , Hibbard Christopher , Scully Marie , Ewenstein Bruce
Published: July 2023

Background

Congenital thrombotic thrombocytopenic purpura (cTTP) is an ultra-rare, life-threatening hereditary disorder that causes patients to experience significant morbidity and decreased health-related quality of life (HRQoL). A cTTP disease-specific patient-reported outcome (PRO) instrument that is reflective of patients’ experiences with the disorder does not currently exist. The objective of this study was to evaluate and validate the psychometric properties of the Congenital Thrombotic Thrombocytopenic Purpura–Patient Experience Questionnaire (cTTP-PEQ), developed using a literature review, interviews with expert clinicians, and qualitative concept elicitation and cognitive debriefing interviews.

Methods

This prospective, observational study (NCT03519672) was conducted with patients diagnosed with cTTP currently receiving treatment. Patients were enrolled through investigator sites and direct-to-patient recruitment. Individuals completed electronic self-administered PRO measures, including the cTTP-PEQ, at baseline and Day 14 (+ up to 10 days). The cTTP-PEQ consisted of five multi-item domains (Pain/Bruising, Cognitive Impairment, Visual Impairment, Mood, Treatment Burden) and three single-item domains (Fatigue, Headache, Activity Limitation), and assessed symptoms and impact of cTTP in the previous 24 h, 7 days, and 2 weeks. Convergent and discriminant validity were evaluated using Spearman’s rank correlation coefficients. Known-groups validity was assessed between patient groups separated by Patient Global Impression of Severity (PGI-S; normal vs. mild/moderate/severe). Internal reliability was assessed using Cronbach’s alpha. Test–retest reliability was assessed using intraclass correlation coefficients (ICCs).

Results

Thirty-six patients participated in this study. Convergent validity was confirmed with high-to-moderate correlations (r ≥ 0.4) for 12/15 hypothesized relationships between pairs of domains and/or total scores. Discriminant validity was confirmed with low correlations (r < 0.3) observed for 5/7 hypothesized relationships. Known-groups validity was confirmed with significant differences (p ≤ 0.05) in mean cTTP-PEQ scores between the two PGI-S groups for most domains and items at both timepoints. Cronbach’s alpha was 0.88 at baseline and 0.91 at Day 14, confirming internal consistency of the instrument. Test–retest reliability was also confirmed with a high ICC (0.96).

Conclusion

This study validates the psychometric properties of the novel cTTP-PEQ for use in research and clinical practice to assess HRQoL among patients with cTTP. This instrument will be particularly useful when assessing cTTP disease burden and the impact of new treatments.
Macroanatomical investigations of the skulls of both genders of Heliosciurus gambianus (Gambian sun squirrel) and Funisciurus anerythrus (Thomas’s rope squirrel)
Authors: Igado Olumayowa Olawumi , Femi-Akinlosotu Omowumi Moromoke , Akibu Afeez Olumide
Published: July 2023

Background

The skull shape and morphometry have been used by several researchers to differentiate and classify species, breeds and also to age the specimen. This study highlights details of the gross morphometry of the skulls of two species of squirrels, Heliosciurus gambianus and Funisciurus anerythrus, using both sexes.

Results

A total of thirty-one (31) linear morphometric parameters were measured on each skull specimen, relating to individual bones. Results were presented as mean ± standard deviation with significant difference at (P < 0.05). Linear measurements were similar in both genders, although some were negligibly higher in females (51.61% in H. gambianus, 70.96% in F anerythrus); no statistically significant difference was observed (P > 0.05). In spite of the similarity in shape, size and linear morphometric values obtained in both species, Pearson’s correlation analysis of the skull height with other measured parameters gave widely differing results. Correlation data obtained may be used to understand better the pattern of the skull development in these squirrels, as well as how it differs from those obtained in other mammals. Examination of the dentition revealed a varied dental formula across the two species, relating to the presence or absence of the upper and lower premolars.

Conclusions

The results obtained in this study may find application in the fields of comparative anatomy and forensics as well as provide basis for future research in ageing, skull development and feeding patterns in these species.
Bamboo shoots: an exploration into its culinary heritage in India and its nutraceutical potential
Authors: Acharya Biswajeet , Behera Amulyaratna , Sahu Prafulla Kumar , Dilnawaz Fahima , Behera Suchismeeta , Chowdhury Bimalendu , Mishra Durga Prasad
Published: July 2023

Bamboo shoots are a unique and versatile ingredient that has been a part of traditional cuisine and medicine in India for centuries. This review article provides an overview of the culinary heritage of bamboo shoots in India, with a particular focus on the Northeast region. The article discusses the traditional methods of consumption and processing of bamboo shoots, along with the various traditional recipes that use bamboo shoots. The article also explores the nutraceutical potential of bamboo shoots and its bioactive components, along with the role of hydrogen cyanide in bamboo shoots. Furthermore, the impact of bamboo shoots on human health is analyzed. The review concludes with future prospects and the need for further research to fully understand the potential of bamboo shoots as a source of food and medicine.
Imaging of HER2 detected receptor expression positive breast cancer: from detection to interpretation
Authors: Mansour Sahar , Abdullah Engy , Mohamed Eman Hosny , Gomaa Mohammed Mohammed Mohammed
Published: July 2023

Background

Aggressive invasion, high recurrence rate, and poor prognosis are common features of the human epidermal growth factor receptor-2 (HER2)-enriched breast cancer, yet on the other side, it shows significantly reduced activity in response to therapy. We aimed to find combinations of features at imaging modalities that could predict breast cancer HER2-enriched molecular subtype in a sample of screening and symptomatic patients.

Methods

The study is a retrospective analysis including breast lesions proved to be cancer with HER2 detected receptor expression positive (n = 346) whether pure or expressed with other receptors (i.e., luminal B subtype). All carcinomas were examined by digital mammography and high-resolution breast ultrasound. Some cases (n = 148, 48.5%) were considered for further evaluation by contrast enhanced mammography or dynamic post-contrast MR imaging (n = 116, 33.5%) in case there was a diagnosis debate and/or a precise estimation of cancer multiplicity is needed.

Results

Six features were suggestive of HER-enriched carcinoma on mammogram and/or ultrasound; (1) irregular shape mass, (2) indistinct margin, (3) associate fine pleomorphic microcalcifications, (4) asymmetry of global distribution, (5) hypoechoic pattern on ultrasound and (6) enlarged pathological nodes. There was a significant correlation between HER2-enriched subtype and presence of fine pleomorphic calcifications (p = < 0.02) of segmental distribution (p = < 0.002) and asymmetry of global distribution (p = < 0.001).

Contrast-based studies' dominant feature was the non-mass appearance of regional/diffuse distribution. Medium initial contrast uptake and wash out fate were the common curve pattern (p = < 0.001).

Conclusions

Luminal B and HER2 enriched are both HER 2 overexpression breast cancer subtypes, yet there are certain key features more specific for HER2 enriched subtype in conventional and contrast-based imaging. Knowledge of such features could help interpretation and differentiation between HER2 positive subtypes to benefit from the early stratification of management and aid the therapeutic decisions in case receptor testing is not readily available.
An Unexpected Case of Cutaneous Vasculitis Following Zoledronic Acid Infusion
Authors: Zahedi Bita , Wallace Zachary S , Côté Maya McEwen , Yu Elaine W
Published: July 2023

We report a case of isolated cutaneous small vessel vasculitis (SVV) occurring after zoledronic acid (Zol) infusion in a 58-year-old postmenopausal woman with a history of sleeve gastrectomy. This was the patient's first exposure to a bisphosphonate medication. Within minutes of the Zol infusion, she developed an episode of diffuse watery diarrhea. Although the diarrheal symptoms resolved quickly, she experienced nonsteroidal anti-inflammatory drug–responsive generalized myalgias and skin tenderness in her abdomen and extremities within a few hours. These symptoms progressed in severity over the next 5 days, and she developed nonblanching, palpable purpura extending from the ankles to the knees. Prior to Zol, labs showed sufficient 25-hydroxyvitamin D and calcium as well as normal renal and liver function. On day 10, laboratory tests revealed aspartate transaminase twice and alanine transaminase thrice the upper limit of normal. The patient was diagnosed with cutaneous SVV, with a timeline highly suggestive of an idiosyncratic reaction to Zol. She was successfully treated with a prednisone taper. No prior cases of Zol-induced cutaneous vasculitis have been reported, although there are a handful of reported cases of giant cell arteritis and urticarial vasculitis after bisphosphonate therapy. Clinicians should be aware that isolated cutaneous SVV may be a rare complication of Zol.
Using Preanesthesia Clinic Visits to Improve Advance Directives Completion: An Interrupted Time Series Analysis
Authors: Tooba Rubabin , Rose Susannah , Modlin Charles , Liang Chen , Mascha Edward J. , Perez-Protto Silvia
Published: July 2023

BACKGROUND:

Advance directives documentation can increase the likelihood that patient’s wishes are respected if they become incapacitated. Unfortunately, completion rates are suboptimal overall, and disparities may exist, especially for vulnerable groups. We assessed whether implementing an initiative to standardize advance directives discussions during preanesthesia visits was associated with changes in rates of advance directives completion over time, and whether the association depends on race, insurance type, or income.

METHODS:

We conducted a before-after interrupted time series evaluation between January 1, 2015 and June 30, 2019 in a single-center, outpatient preanesthesia clinic. Participants were adults who visited the preanesthesia clinic at Cleveland Clinic and had >1 comorbidity before a noncardiac surgery of either medium or high risk. The intervention in March of 2017 consisted of training staff to help patients complete and witness advance directives documents during visits. We measured advance directives completion, by race, payor, and income (using the 2019 Federal Poverty Line). We assessed the confounder-adjusted association between intervention (pre versus post) and proportion of patients completing advanced directives over time using segmented regression to compare slopes between periods and assess changes at start of the intervention. We used similar models to assess whether changes depended on race, insurance type, or income level.

RESULTS:

We included 26,368 visits from 22,430 patients. We analyzed financial status for 16,788 visits from 14,274 patients who had address data. There were 11,242 (43%) visits preintervention and 15,126 (57%) visits postintervention. Crude completion rates for advance directives increased from 29% to 78%, with odds of completion an estimated 18 times higher than preintervention (odds ratio [95% CI] of 18 [16–21]; P < 0.001). Regarding race, Black patients had lower completion rates preintervention than White patients, although the gap steadily closed after the intervention (P = .001). Postintervention, both race groups immediately increased, with no difference in amount of increase (P = .17) or postintervention change in slope difference (P = .17). Regarding insurance, patients with Medicaid had lower preintervention completion rates than those with private. Intervention was associated with increases in both groups, but the difference in slopes (P = .43) or proportions (P = .23) between the groups did not change after intervention. Regarding the Federal Poverty Line, the completion rate gap between those below (<100%) and above (139%–400%) narrowed by approximately half (0.51: 95% CI, 0.27–0.98; P = .04).

CONCLUSIONS:

Standardizing advance directives discussions during preanesthesia visits was associated with more patients completing advance directives, particularly in vulnerable patient groups.
The Relationship Between Contraceptive Method Use and Return of Fecundity Among Women Attempting Pregnancy in Low- and Middle-Income Countries
Authors: Gemmill Alison , Bradley Sarah E. K. , Berger Blair O. , Bell Suzanne O.
Published: July 2023

One of the most common barriers to using effective family planning methods is the belief that hormonal contraceptives and contraceptive devices have adverse effects on future fertility. Recent evidence from high-income settings suggests that some hormonal contraceptive methods are associated with delays in return of fecundity, yet it is unclear if these findings generalize to low- and middle-income populations, especially in regions where the injectable is widely used and pressure to bear children is significant. Using reproductive calendar data pooled across 47 Demographic and Health Surveys, we find that the unadjusted 12-month probability of pregnancy for women attempting pregnancy after discontinuing traditional methods, condoms, the pill, and the IUD ranged from 86% to 91%. The 12-month probability was lowest among those who discontinued injectables and implants, with approximately 1 out of 5 women not becoming pregnant within one year after discontinuation. Results from multivariable analysis showed that compared with users of either periodic abstinence or withdrawal, users of the pill, IUD, injectable, and implant had lower fecundability following discontinuation, with the largest reductions occurring among women who used injectables and implants. These findings indicate that women's concerns about potential short-term reductions in fecundity following contraceptive use are not unfounded.
Answering Our Nation's Call: A Solution for Military Neurosurgery Wartime Readiness Through Civilian Collaboration
Authors: Dewar Callum D. , Sindelar Brian D. , Hooten Kristopher G.
Published: July 2023

Military-civilian partnerships have built the foundation for US neurosurgery as we see it today. Each conflict throughout history has led to expansion within the field of neurosurgery, benefiting civilian patients and those in uniform. Despite the field's growth during wartime, military neurosurgical case volume declines during peacetime, and as a result, important knowledge gained is at risk of being lost. The current landscape of military neurosurgery reflects the relative peacetime for the US-World relationship. Because of this peacetime, the surgical case volume and experience of the military neurosurgeon are declining rapidly. In addition to providing a history of military-civilian partnerships in neurosurgery, we have analyzed the declining case volume trends at a single military treatment facility with neurosurgical capabilities. We compared the case volume of a military neurosurgeon at a civilian partnered location with their previous volume at a military treatment facility and analyzed current trends in wartime readiness by Neurosurgery Knowledge, Skills and Abilities metrics. We believe that military civilian partnerships hold the key to scaffolding the experience to maintain the wartime readiness in the military neurosurgical community.
ngsJulia: population genetic analysis of next-generation DNA sequencing data with Julia language
Authors: Mas-Sandoval Alex , Jin Chenyu , Fracassetti Marco , Fumagalli Matteo
Published: July 2023

A sound analysis of DNA sequencing data is important to extract meaningful information and infer quantities of interest. Sequencing and mapping errors coupled with low and variable coverage hamper the identification of genotypes and variants and the estimation of population genetic parameters. Methods and implementations to estimate population genetic parameters from sequencing data available nowadays either are suitable for the analysis of genomes from model organisms only, require moderate sequencing coverage, or are not easily adaptable to specific applications. To address these issues, we introduce ngsJulia, a collection of templates and functions in Julia language to process short-read sequencing data for population genetic analysis. We further describe two implementations, ngsPool and ngsPloidy, for the analysis of pooled sequencing data and polyploid genomes, respectively. Through simulations, we illustrate the performance of estimating various population genetic parameters using these implementations, using both established and novel statistical methods. These results inform on optimal experimental design and demonstrate the applicability of methods in ngsJulia to estimate parameters of interest even from low coverage sequencing data. ngsJulia provide users with a flexible and efficient framework for ad hoc analysis of sequencing data.ngsJulia is available from: https://github.com/mfumagalli/ngsJulia.
A socio-legal imperative of domestic violence prohibition in Africa vis-a-vis Nigerian legal structure for sexually abused women
Authors: AINA-PELEMO Adetutu Deborah , Olujobi Olusola Joshua , YEBISI EBENEZER TUNDE
Published: July 2023

Domestic violence is a major issue globally. It is one of the most heinous crimes which has and still results in numerous deaths, still receives the least amount of attention, and its negative influence is being underrated. In Africa, it is customarily acceptable for a woman to be beaten by her husband as a form of discipline, and Nigeria is not an exception. To think otherwise, that it cannot be socially acceptable and legally upheld for a man to beat his wife as a form of discipline, is to deny an existing reality. Section 282 of the Nigerian Penal Code encourages men to beat their wives when necessary. This form of permissible violence is often viewed as a family issue. Hence women are reluctant to speak up about their experiences. The stigma that usually follows speaking up or voicing out is better imagined than experienced. This study, therefore, provides credible information on domestic violence incidents in Nigeria and Africa. The methodology utilised is the doctrinal legal research method with reports from existing literature and tertiary data sources such as newspapers and website sources. It discusses legislation enacted to prevent and prohibit domestic violence in Nigeria and how influential they have been on the nation at large. By way of comparative analysis, we examine domestic violence occurrences in some selected African countries and the European continents concerning Nigeria. It also delves into the violation of the principles of gender equality by some Nigerian customs and traditional practices. This study then makes recommendations on how to address the issue. Through its insightful engagement, this study found, among others, that domestic violence is widespread in Africa and that a national law prohibiting the act and holding perpetrators accountable is not only imperative in Nigeria but across the African continent.
Agent-based models under uncertainty
Authors: Stepanov Vladimir , Ferson Scott
Published: July 2023

Background: Monte Carlo (MC) is often used when trying to assess the consequences of uncertainty in agent-based models (ABMs). However, this approach is not appropriate when the uncertainty is epistemic rather than aleatory, that is, when it represents a lack of knowledge rather than variation. The free-for-all battleship simulation modelled here is inspired by the children’s battleship game, where each battleship is an agent.

Methods: The models contrast an MC implementation against an interval implementation for epistemic uncertainty. In this case, our epistemic uncertainty is in the form of an uncertain radar. In the interval method, the approach occludes the status of the agents (ships) and precludes an analyst from making decisions about them in real-time.

Results: In a highly uncertain environment, after many time steps, there can be many ships remaining whose status is unknown. In contrast, any MC simulation invariably tends to conclude with a small number of the remaining ships after many time steps. Thus, the interval approach misses the quantitative conclusion. However, some quantitative results are generated by the interval implementation, e.g. the identities of the surviving ships, which are revealed to be nearly mutual with the MC implementation, though with fewer identities in total compared to MC.

Conclusions: We have demonstrated that it is possible to implement intervals in an ABM, but the results are broad, which may be useful for generating the overall bounds of the system but do not provide insight on the expected outcomes and trends.