bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Credit Market Development on Auditor Choice: Evidence from Banking Deregulation
Authors: DE FRANCO GUS , GUAN YUYAN , ZHOU YIBIN , ZHU XINDONG
Published: December 2023

We exploit the staggered state‐level adoption of the Riegle‐Neal Interstate Banking and Branching Efficiency Act (IBBEA) to examine how banking deregulation and the resulting increase in bank competition affect firms’ auditor choices. We find that an exogenous increase in the degree of interstate branch banking deregulation leads to a reduction in firms’ propensity to engage a Big N or industry expert auditor. This main result, when combined with our cross‐sectional analyses, offers evidence suggesting that deregulation leads to less demand for higher quality auditors because (1) firms have increased access to credit, which reduces the benefits of higher audit quality; (2) entering banks’ lending expertise substitutes for higher quality financial statements; (3) incumbent banks with less lending expertise seek to protect their rents by preferring that borrowers provide lower quality financial statement information; and (4) external stakeholders delegate their monitoring to banks to a greater degree, resulting in less demand for higher quality financial statements. As such, our study sheds light on how the U.S. credit market's infrastructure shapes firms’ auditor choice decisions.
Distinct karyotypic and mutational landscape in trisomy AML
Authors: Lam Stephen S. Y. , Tsui Sze P. , Fung C. Y. , Saw Nicole Y. , Javed Asif , Ip Alvin H. W. , Ma Edmond S. K. , Leung Anskar Y. H.
Published: December 2023

Trisomy karyotype occurs in 5%–10% of AML. Its mutational landscape and prognostic significance are not well defined. A cohort of 156 trisomy AML patients was analysed, with reference to 615 cytogenetically normal (CN) AML patients. Trisomy AML showed distinct mutational landscape with more prevalent SMC1A, N/KRAS, ASXL1 and BCOR but fewer CEBPAbZIP and NPM1 mutations in patients ≤60, and fewer NPM1 mutations in those >60. NRAS mutations were associated with poor outcome in trisomy AML, whereas DNMT3A and FLT3‐ITD mutations had neutral effect. Trisomy AML appeared biologically distinct from CN‐AML.
What attachment scholars can learn from research on Black family resilience
Authors: Stern Jessica A. , Coard Stephanie Irby , Barbarin Oscar A. , Cassidy Jude
Published: December 2023

Within a sociohistorical context of racism‐related physical and emotional threats, Black families in the United States have developed sources of resilience to promote children's safety and positive development. Yet research on Black family resilience has rarely been integrated into one of the most influential theories of child development: attachment theory. In this article, we propose specific ways that attachment scholars can learn from research on Black family resilience to enrich models of parent–child relationships, focusing on three sources of resilience: culturally specific parental protections (e.g., “The Talk,” preparation for bias), extended caregiving networks (e.g., natural mentors, fictive kin, spiritual community), and racial‐ethnic identity development (e.g., racial pride messages to protect against social denigration). We argue that including insights from research on the resilience of Black children and families in the face of racism‐related threats across generations can substantially advance current understanding of caregiving, attachment, and positive child development in context.
Impact of rapid on‐site evaluation in expediting the fast investigative lung cancer pathway
Authors: Fowell Andrew , Khan Kashif
Published: December 2023

Objective

EBUS‐TBNA is a method of acquiring tissue samples from intrathoracic lymph nodes and central intrathoracic tumours in patients suspected of having lung cancer. Rapid on‐site evaluation (ROSE) denotes assessing tissue samples during EBUS (or bronchoscopy), providing instant feedback on sample adequacy and provisional cytomorphological diagnosis. Sector multidisciplinary team (MDT) discussion can then make informed treatment decisions, with confirmatory immunohistochemistry being finalised before provision of final treatment. Currently, impact of ROSE on length of time patients spend on the lung cancer diagnostic pathway remains unclear.

Methods

We retrospectively evaluated the impact of ROSE on the length of time between patients' EBUS/bronchoscopy procedures and discussion at sector MDT, referred to as time to treatment decision (TTD), at our institution. Additionally, we assessed impact of ROSE on number of passes (number of times nodes/masses were sampled) per procedure.

Results

The mean TTD was 77.9% shorter (p = 0.001) with ROSE present than when absent. Patients who received ROSE spend 34.3% less time (p = 0.028) on lung cancer diagnostic pathway overall. There was a significant reduction in number of passes in non‐malignant nodes with ROSE present (2.23) than when absent (3.14) (p < 0.001). With ROSE present there was a significantly greater number of passes at malignant sites (5.07) than non‐malignant sites (2.23) (p < 0.001).

Conclusions

These findings support conclusions made in our institution's previous study, that utilisation of ROSE reduces TTD. ROSE also allows safe advancement through nodes with low suspicion of malignant involvement, focusing time on sampling nodes/masses of greater suspicion.
MGP‐1 Plagioclase: A Potential Element and Sr Isotope Reference Material for In Situ Microanalysis
Authors: Jia Lihui , Ma Xi , Wu Shitou , Li Youlian , Yuan Jiangyan , Mao Qian , Li Xiaoguang , Chen Yi
Published: December 2023

Plagioclase, one of the most common rock‐forming minerals, can provide useful information on the crystallisation environment, magmatic evolution and thermal history of host rocks. Owing to matrix effects, trace element and Sr isotope in situ measurements in plagioclase have been hindered by a shortage of reference materials for quality control and method validation. A natural plagioclase sample from Madagascar was evaluated for its feasibility as a reference material for Sr isotope and element determination. Measurement results from EPMA, LA‐ICP‐MS and LA‐MC‐ICP‐MS indicate that MGP‐1 plagioclase is homogeneous at the μm–mm scale with respect to major elements (RSD < 4%), most trace elements (RSD < 15%), and 87Sr/86Sr ratio (2s = 0.00013). Major and trace elements were also determined using XRF and solution ICP‐MS, showing good agreement within 10% from in situ measurement results. The 87Sr/86Sr ratio obtained by TIMS ranged from 0.703441 to 0.703477, with a mean value of 0.703459 (2s = 0.000028), consistent with the LA‐MC‐ICP‐MS mean value. Reference values and uncertainties for major and trace elements and 87Sr/86Sr ratio are presented in this study. Consequently, the MGP‐1 plagioclase can be used as a reference material for in situ measurement of trace elements and 87Sr/86Sr ratios, contributing to research on the formation and evolution of micro‐zoned plagioclase and host rocks.
Non‐invasive markers of inflammation in alcohol‐associated liver disease: A scoping review
Authors: Fahoum Khalid , Ying Xiaohan , Magahis Patrick T , Ross Joshua , Basu Elora , Shen Nicole T , Baltich Nelson Becky , Brown Robert S , Jesudian Arun B
Published: December 2023

Clinical manifestations of liver inflammation in alcohol‐associated liver disease (ALD) can range from asymptomatic to severe alcoholic hepatitis. While biopsy is the gold standard for identifying liver inflammation, it is an invasive procedure with risks of bleeding, visceral damage, and infection. We aim to establish the state of the current literature on non‐invasive markers of inflammation in ALD. We searched Ovid MEDLINE, Embase, and the Cochrane Library for original studies on the association between one or more non‐invasive biomarker(s) and histological inflammation or hepatitis in ALD patients. Exclusion criteria were lack of histological data, abstract only, non‐English‐language articles, and animal studies. Two independent reviewers screened abstracts, reviewed full texts, and extracted data from included papers. Our search identified 8051 unique studies. Title and abstract screening resulted in 563 studies, and full‐text screening resulted in 31 studies for final inclusion. The majority were single‐center observational cohorts with an average sample size of 124. Review of these studies identified 44 unique biomarkers and 8 calculated scores associated with histological inflammation and/or hepatitis, in addition to a metabolomic panel of 468 metabolites. Six studies examined diagnostic accuracy for histological inflammation and/or hepatitis. The highest area under the receiver operating characteristic curve was 0.932 using a model based on four metabolites. This review highlights the available literature on non‐invasive markers of inflammation in ALD. There is a dearth of studies that evaluate the diagnostic accuracy of these biomarkers, and larger studies are needed to confirm findings identified in small cohorts.
Development and validation of a Chinese version chronic wound health‐related quality of life instrument: A methodological study
Authors: Hung Chang‐Chiao , Chen Chien‐Ming , Chang Ya‐Hui , Lee Shiao‐Haung , Chang Chia‐Hao , Chen Yea‐Jyh
Published: December 2023

Aims and Objectives

To develop a Chinese version of a chronic wound health‐related quality of life (QoL) instrument and to examine the psychometric properties of this instrument.

Background

Existing QoL instruments are not tailored to the linguistic and cultural characteristics of Chinese‐speaking patients; a version addressing this gap will increase clinical understanding of their healthcare experience and may help guide chronic wound care.

Design

A methodological study.

Methods

The method advanced by DeVellis (2017) was used to develop the instrument. An initial pool of 38 items was created. To optimize scale length and test reliability and validity, exploratory and confirmatory factor analyses were conducted. A total of 23 items formed the final pool. After two rounds of expert discussions, the average content validity index of the final 23 items was .89.

Results

A total of 226 patients completed the instrument and were divided into two groups for further analysis. Exploratory factor analysis revealed that 15 items remained in four factors (social activity restrictions, physical and psychological disturbance, wound burden and daily life limitation), which accounted for 64.87% of the variance. Confirmatory factor analysis revealed an acceptable fit of the hypothesized factor structure and the convergent and discriminant validities were achieved. Cronbach's α coefficients for each factor were .807, .773, .799 and .713, respectively.

Conclusion

The Chinese version of a chronic wound health‐related QoL instrument consists of 15 items in four subscales and demonstrates good reliability and validity.

Relevance to Clinical Practice

This instrument can be used intermittently or continuously to evaluate the treatment effect of chronic wounds by assessing health‐related QoL. Scholars in Chinese‐speaking regions may find this culturally compatible instrument useful when conducting studies related to chronic wounds.

Patient or Public Contribution

Two hundred twenty‐six participants provided their perspectives on health‐related QoL.
Effect of different preparation designs of minimally invasive occlusal onlays on the accuracy of different intraoral scanners: An in vitro study
Authors: Ashraf Khadija , Ebeid Kamal , Salah Tarek
Published: December 2023

Purpose

The aim of this in vitro study was to assess and compare three different preparation designs of minimally invasive occlusal onlays on the trueness and precision of three different intraoral scanners under two different scanning conditions.

Materials and Methods

Three maxillary premolars were prepared in three different designs and divided accordingly into three groups, Group 1: Anatomical (n = 60), Group 2: Flat (n = 60), and Group 3: Ferrule (n = 60). The samples were then further divided into subgroups according to scanners as subgroup A: Medit i500 (n = 20), subgroup B: 3Shape TRIOS 4 (n = 20), and subgroup C: Cerec Primescan (n = 20). Last, the samples were further divided according to scanning conditions: Division i: As prepared (n = 10) and Division ii: Sprayed – scan spray (n = 10). An industrial 3D scanner was used to obtain the reference STL files. Accuracy was assessed in terms of trueness and precision and recorded in terms of root mean square in micrometers. Numerical data were explored for normality using Shapiro‐Wilk test and were analyzed using 3‐way ANOVA followed by Tukey's post hoc test.

Results

Regarding trueness, 3‐way ANOVA showed that all tested variables had a significant effect on trueness. Significant interactions were found between the different variables (p < 0.001). For preparation design the highest value was found in ferrule preparation (27.88 ± 7.11), followed by flat preparation (22.99 ± 7.56), while the lowest value was found in anatomical preparation (18.83 ± 5.71) (p < 0.001). For scanner type, the highest value was found in Primescan (25.36 ± 10.66), followed by TRIOS 4 (22.75 ± 5.98), while the lowest value was found in Medit i500 (21.59 ± 5.03) (p < 0.001). As for the scanning condition, sprayed samples (26.54 ± 8.24) had a significantly higher value than non‐sprayed samples (19.93 ± 5.53) (p < 0.001). Regarding precision, both preparation design and scanner type had a significant effect on precision. Scanning conditions had no significant effect. There was a significant interaction between the three tested variables (p = 0.012).

Conclusions

Anatomical preparation of minimally invasive occlusal onlays produced the most accurate scans. Within the tested preparation designs, Medit i500 and 3Shape TRIOS 4 have better trueness than Cerec Primescan. Cerec Primescan is more precise than 3Shape TRIOS 4 and Medit i500 Scan spray application causes a higher deviation in the trueness of the tested intraoral scanners while it does not affect their precision.
Economics is beautiful!
Authors: Block Walter E.
Published: December 2023

Economics is beautiful, and all undergraduates who love and revere beauty should major in this dismal science. Beauty is defined, for present purposes as cooperation, coordination, teamwork, togetherness, inclusiveness, and assists in sports. The greater the number of people participating in the “team,” the more gorgeous is the cooperation. The less central direction, whether implicit or explicit, other things equal, the greater is the loveliness of the coordination. The economy, that which economists study, beats all the competition, as, at least ideally, it encompasses the most people on the “team” (all of us!) with the least outside direction. Well, none at all, given full free enterprise with no central planning whatsoever. That, at least, would be the extreme degree of economic freedom.
Opium Price Shocks and Prescription Opioids in the USA*
Authors: Deiana Claudio , Giua Ludovica , Nisticò Roberto
Published: December 2023

We investigate the effect of international opium price shocks on the per capita dispensation of prescription opioids in the USA. Using quarterly county‐level data for 2002q4–2016q4, three main results emerge. First, reductions in opium prices significantly increase the quantity of opioids prescribed, and more so in counties with a larger pre‐existing market for pain relief, as captured by the incidence of mining sites. Second, the increase involves only natural and semi‐synthetic, but not fully‐synthetic, opioids, suggesting that the effect is moderated by the amount of raw material contained in the products. The impact is larger prior to 2010, when overdose deaths were more related to the use of legally prescribed opioids. Third, advertising expenses, stock prices and the profits of opioid producers increase following negative opium price shocks, suggesting an important role of supply‐side economic incentives.
Comprehensive orthodontic treatment using miniscrews and digital rehabilitation in a patient with severe recessive dystrophic epidermolysis bullosa
Authors: Véliz Méndez Sebastián , Baeza Paredes Mauricio , Olivares Antonio , Vicuña María José , Krämer Strenger Susanne M.
Published: December 2023

Introduction

Epidermolysis bullosa (EB) is a rare genetic disorder characterized by skin fragility and blister formation. The phenotypic presentation is broad with four major types, being Recessive Dystrophic EB (RDEB) the most severe, including oral anomalies such as severe microstomia, ankyloglossia, vestibule obliteration and occlusal anomalies, turning orthodontic treatment into a challenge.

Aim

This case report aims to present the comprehensive treatment of a patient with severe RDEB, including periodontal surgery, orthodontic fixed braces with mini‐screws and oral rehabilitation with anterior veneers.

Case Report

A 27‐year‐old female patient with severe RDEB received orthodontic treatment in the upper jaw to improve malalignment and anterior crossbite. After 13 months of treatment with fixed appliances, miniscrews were placed in the anterior segment to intrude and procline the upper incisors. Oral surgery was performed to increase the vestibule depth of the upper lip. Once edge‐to‐edge occlusion was obtained, anterior veneers were placed to improve aesthetic and stabilize occlusion, especially with the lack of posterior support.

Discussion

The multidisciplinary treatment approach, involving orthodontic treatment, periodontal surgery and oral rehabilitation, played a crucial role in achieving favorable results. This case highlights the successful use of miniscrews as a viable orthodontic approach for patients with severe RDEB.
Minimizing early catheter failure using a risk stratification model for peritoneal dialysis
Authors: Sun Lulu , Cheng Chuan , Wang Yuqin , Luo Changqing , Ye Mingzhu , Sun Jing , Zhang Chun , Yao Lijun , Jiang Huajun
Published: December 2023

Background

Early catheter failure is the main reason for peritoneal dialysis (PD) failure, which often causes patients to withdraw from PD. Reducing the early catheter failure is critical to increase the acceptance of PD. The purpose of our study was to establish a risk stratification model to minimize early catheter failure.

Methods

A retrospective study with patients underwent PD catheter placement from January 2013 to March 2022 was conducted. The primary outcome event was early catheter failure. Univariate and multivariable logistic regression were performed to select potential risk predictors. A risk stratification model and a clinical procedure were established. The effectiveness of the model was evaluated by external validation.

Results

A total of 432 patients were finally enrolled in the study. The risk for early catheter failure was associated with younger age (odds ratio [OR], 0.930; 95% confidence interval [95% CI], 0.884 to 0.972; p = 0.002), lower body mass index (BMI) (OR, 0.797; 95% CI, 0.629 to 0.964; p = 0.036), and lower albumin (ALB) levels (OR, 0.881; 95% CI, 0.782 to 0.985; p = 0.036). The risk stratification model was established and performed great discrimination capability with AUC of 0.832 (cut‐off value: 0.061, sensitivity: 0.853, specificity: 0.812). The model proved to be effective in external validation; the rate of early catheter failure was dropped off from 4.1% to 0%.

Conclusions

We established an effective risk stratification model, by which patients with high risk of early catheter failure could be precisely identified. The clinical procedure based on the model was proved to be helpful to minimize early catheter failure.
Is Just Moving Enough for Girls? The Moderation Role of Gross Motor Development Level in the Association Between Physical Activity and Cognition
Authors: Páez-Herrera Jacqueline , Hurtado-Almonacid Juan , Mello Julio B. , Sobarzo Catalina , Plaza-Arancibia Paula , Kain-Berkovic Juliana , Leyton Barbara , Soto-Sánchez Johana , Leiva–Guerrero Verónica , Batalla–Flores Albert
Published: December 2023

Purpose: Our objective is to describe the moderating effect of the level of gross motor development on the relationship between physical activity (PA) level and visual perception/memory in girls. Methods: This is a quantitative cross-sectional study with a randomized sample of 85 girls (mean age 7.11 ± 0.74) from Chile. The following models were tested: interaction between PA (light: Model 1; moderate–vigorous: Model 2; vigorous: Model 3; and total PA: Model 4) and motor development level associated with visual perception/memory. Variables that showed interaction were tested according to the Johnson-Newman. Results: The Model 2 explains 13% of visual perception/memory and the Model 4 explains 15%, indicating that the motor development level is a moderator of this relationship. Conclusions: Collectively, our results present evidence that girls with a high level of gross motor skills have a stronger relationship between total PA (and also only moderate–vigorous activity) and visual perception/memory.
Human-specific features and developmental dynamics of the brain N-glycome
Authors: Klarić Thomas S. , Gudelj Ivan , Santpere Gabriel , Novokmet Mislav , Vučković Frano , Ma Shaojie , Doll Hannah M. , Risgaard Ryan , Bathla Shveta , Karger Amir , Nairn Angus C. , Luria Victor , Bečeheli Ivona , Sherwood Chet C. , Ely John J. , Hof Patrick R. , Sousa André M. M. , Josić Djuro , Lauc Gordan , Sestan Nenad
Published: December 2023

Comparative “omics” studies have revealed unique aspects of human neurobiology, yet an evolutionary perspective of the brain N-glycome is lacking. We performed multiregional characterization of rat, macaque, chimpanzee, and human brain N-glycomes using chromatography and mass spectrometry and then integrated these data with complementary glycotranscriptomic data. We found that, in primates, the brain N-glycome has diverged more rapidly than the underlying transcriptomic framework, providing a means for rapidly generating additional interspecies diversity. Our data suggest that brain N-glycome evolution in hominids has been characterized by an overall increase in complexity coupled with a shift toward increased usage of α(2-6)–linked
N
-acetylneuraminic acid. Moreover, interspecies differences in the cell type expression pattern of key glycogenes were identified, including some human-specific differences, which may underpin this evolutionary divergence. Last, by comparing the prenatal and adult human brain N-glycomes, we uncovered region-specific neurodevelopmental pathways that lead to distinct spatial N-glycosylation profiles in the mature brain.
First-in-human study to evaluate the safety, tolerability, and population pharmacokinetic/pharmacodynamic target attainment analysis of FL058 alone and in combination with meropenem in healthy subjects
Authors: Huang Zhiwei , Yang Xinyi , Jin Yi , Yu Jicheng , Cao Guoying , Wang Jingjing , Hu Yingying , Dai Jingyi , Wu Jufang , Wei Qiong , Tian Yan , Yu Shuyan , Zhu Xu , Mao Xiaomeng , Liu Wei , Liang Hong , Zheng Shansong , Ju Yunfei , Wang Zenghua , Zhang Jing , Wu Xiaojie
Published: December 2023

FL058 is a novel diazabicyclooctane β-lactamase inhibitor. This first-in-human study evaluated the safety, tolerability, and population pharmacokinetic (PK)/pharmacodynamic target attainment analysis of FL058 alone and in combination with meropenem in healthy subjects. The results showed that the maximum tolerated dose of FL058 was 3,000 mg after single-dose infusion. FL058 in combination with meropenem did not cause any grade 3 or higher adverse event when the dose was escalated up to 1,000 mg/2,000 mg. FL058 exposure PK parameters showed dose proportionality. FL058 was excreted primarily in urine. No significant PK interaction was found between FL058 and meropenem. Population PK model analysis indicated that the PK profiles of FL058 and meropenem were consistent with the two-compartment model. The impact of covariates, creatinine clearance, concomitant use of meropenem, body weight, sex, and FL058 dose, on FL058 exposure was less than 10%. FL058/meropenem combination was safe and well tolerated up to a 1,000-mg/2,000-mg dose in healthy adults. The recommended minimum dose of FL058/meropenem combination was 500 mg/1,000 mg by intravenous infusion over 2 h every 8 h based on target attainment analysis. The good safety, tolerability, and satisfactory PK profiles of FL058 alone and in combination with meropenem in this first-in-human study will support further clinical development of FL058 in combination with meropenem in patients with target infections (ClinicalTrials.gov identifiers: NCT05055687, NCT05058118, and NCT05058105).
Seven genome sequences of bacterial, environmental isolates from Pony Lake, Antarctica
Authors: Foreman Christine M. , Smith Heidi J. , Dieser Markus
Published: December 2023

Dissolved organic matter (DOM) in Antarctic inland waters is unique in that its precursor molecules are microbially derived and lack the chemical signature of higher plants. Here, we report the genomic sequences of seven environmental, bacterial isolates from Pony Lake, Antarctica, to explore the genetic potential linked to DOM processing.
Starter Culture Development and Innovation for Novel Fermented Foods
Authors: Gänzle Michael G. , Monnin Ludovic , Zheng Jinshui , Zhang Lingxiao , Coton Monika , Sicard Delphine , Walter Jens
Published: December 2023

Interest in fermented foods is increasing because fermented foods are promising solutions for more secure food systems with an increased proportion of minimally processed plant foods and a smaller environmental footprint. These developments also pertain to novel fermented food for which no traditional template exists, raising the question of how to develop starter cultures for such fermentations. This review establishes a framework that integrates traditional and scientific knowledge systems for the selection of suitable cultures. Safety considerations, the use of organisms in traditional food fermentations, and the link of phylogeny to metabolic properties provide criteria for culture selection. Such approaches can also select for microbial strains that have health benefits. A science-based approach to the development of novel fermented foods can substantially advance their value through more secure food systems, food products that provide health-promoting microbes, and the provision of foods that improve human health.
CO2 Impact on Methane Pyrolysis as a Key Issue of Using Biogas as an Educt: A Theoretical Study
Authors: Durán Inés , Dietrich Benjamin , Hofberger Christoph , Stoppel Leonid , Uhlenbruck Neele , Wetzel Thomas
Published: December 2023

Dry reforming of methane (DRM) has attracted great interest for the production of syngas and/or hydrogen in a more environmentally friendly way. It is especially advantageous in this case to use biogas—as a mixture of methane, CO2, and traces of further gases—as a feedstock replacement for natural gas. Nevertheless, industrial implementation of DRM is currently limited because of its inherent process restrictions. The biggest challenge of dry reforming is the deposition of carbon on the catalyst, known as “coking.” The focus of this theoretical study is to evaluate the feasibility of a biogas dry reforming process in a liquid metal (Sn) bubble column reactor. This technology has already been proven suitable for methane pyrolysis to obtain hydrogen, preventing issues related to reactor clogging or catalyst deactivation caused by carbon deposition. Results show that at high operating temperatures and atmospheric pressure, a product gas primarily composed of H2 and CO would be obtained. CO2 and water vapor may also be present in the final product depending on the operating conditions. The molten tin inside the reactor would, according to the presented theoretical considerations, not be affected by the formation of carbides and oxides. Additionally, the syngas composition (the H2 : CO ratio) could be adjusted by using different CH4 : CO2 feed ratios.
Exploring the Effect of Image Enhancement Techniques with Deep Neural Networks on Direct Urinary System X‐Ray (DUSX) Images for Automated Kidney Stone Detection
Authors: Kilic Ugur , Karabey Aksakalli Isil , Tumuklu Ozyer Gulsah , Aksakalli Tugay , Ozyer Baris , Adanur Senol
Published: December 2023

In diagnosing kidney stone disease, clinical specialists often apply medical imaging techniques such as CT, X‐Ray and US. Among these imaging techniques, X‐Ray is frequently chosen as the primary examination method in emergency services due to its low cost, accessibility, and low radiation levels. However, interpreting the X‐Ray images by inexperienced specialists can be challenging due to the low image quality and the presence of noise. In this study, we propose a computer‐aided diagnosis system based on deep neural networks to assist clinical specialists in detecting kidney stones using Direct Urinary System X‐Ray (DUSX) images. Firstly, in consultation with clinical specialists, we created a new dataset composed of 630 DUSX images and presented it publicly. We also defined preprocessing steps that incorporate image enhancement techniques such as GF, LoG, BF, HE, CLAHE, and CBC to enable deep neural networks to perceive the images more clearly. With these techniques, we considered the noise reduction in the DUSX images and enhanced the poor quality, especially in terms of contrast. For each preprocessing step, we created models to detect kidney stones using YOLOv4 and Mask R‐CNN architectures, which are common CNN‐based object detectors. We examined the effects of the preprocessing steps on these models. To the best of our knowledge, the combination of BF and CLAHE which is called CBC in this study, has not been applied before in the literature to enhance DUSX images. In addition, this study is the first in its field in which the YOLOv4 and Mask R‐CNN architectures have been used for the detection of kidney stones. The experimental results demonstrated the most accurate method is the YOLOv4 model, which includes the CBC preprocessing step, as the result model. This model shows that the accuracy rate, precision, recall, and F1‐score were found as 96.1%, 99.3% 96.5%, and 97.9% respectively in the test set. According to these performance metrics, we expect that the proposed model will help to reduce the unnecessary radiation exposure and associated medical costs that come with CT scans.
Awareness and Disposal Practices of Medicines among the Community in Hawassa City, Ethiopia
Authors: Woldamicael Bekele Daniel , Dadebo Elias , Tilahun Girma , Gebremariam Zinabu
Published: December 2023

Despite the enormous benefits medicines provide to humanity, their improper disposal frequently leads to detrimental consequences on the environment. Lack of awareness and malpractices concerning expired, leftover, or unused (ELU) medicines have become concerns worldwide. This study assessed community awareness and practices regarding the disposal of ELU medicines in Hawassa City, Ethiopia. A community-based descriptive cross-sectional survey design was used among the urban population of Hawassa City. Multistage sampling procedures were employed to select 405 household (HH) respondents, and purposive sampling techniques were used to select key experts (KEs) and key informants (KIs). A pretested questionnaire was designed for HHs, KEs, and KIs. The results of the study showed that analgesics and antibiotics, used in 52 and 27% of the HHs, respectively, were the most commonly consumed medicines in this city. The vast majority (95.5%) of the HHs did not store expired medicines but disposed of them. Only 10% of the HHs were well informed on how to dispose of ELU medicines. Most (70%) KEs and KIs revealed that there were no awareness-creation mechanisms for the safe disposal of ELU medicines. A significantly high

p
 
<
 
0.05

percentage (76%) of the HH respondents who were well informed on how to dispose of ELU medicines had higher education, but most (95%) of them indicated that they would not be willing to be involved in “ELU-take-back” programs even if there had been such a mechanism. Field observations confirm significant amounts of medical waste improperly discarded in various areas, including the shores of Lake Hawassa near Hawassa City. The study has shown that awareness of the management of ELU medicines is critically lacking in the community of Hawassa City, posing environmental and human health risks. Moreover, the majority of households practice unsafe disposal of ELU medicines, leading to human health threats and environmental risk.
Quality of Life and Psychometric Characteristics of Syrian Refugee Physicians Who Migrated to Turkey: A Cross-Sectional Study
Authors: Keskin Ahmet , Dagcioglu Basri Furkan
Published: December 2023

Background. The concept of migration comes with various problems, affecting the quality of life and psychological state of immigrants. This study aimed to investigate the quality of life and depression and anxiety states of physicians who immigrated to Turkey after the civil war that started in Syria in 2011. Methods. In this cross-sectional study, a sociodemographic questionnaire form, the short version of the World Health Organization’s quality of life assessment tool (WHOQOL-BREF), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were applied to Syrian doctors who received integration training to work in refugee health centers established for immigrants in Turkey. Results. A total of 570 participants were included in the study. The median scores of WHOQOL-BREF domains of the participants were 75 for DOM1 (min: 25, max: 100, IQR: 18), 69 for DOM2 (min: 6, max: 100, IQR: 25), 69 for DOM3 (min: 0, max: 100, IQR: 19), and 63 for DOM4 (min: 0, max: 94, IQR: 19). The median BDI score of the participants was 7 (min: 0, max: 41, IQR: 8), and the median BAI score was 5 (min: 0, max: 50, IQR: 8). Having primary care experience, having knowledge about the Turkish healthcare system, believing that they can adapt to work in refugee health centers, and not having a plan to return to their country were found to be associated with a higher score in at least one of the WHOQOL-BREF subdomains. Planning to turn back their country was significantly associated with higher BAI scores. Conclusions. The overall quality of life of most refugee physicians in Turkey was high, and the BDI and BAI scores were also below the threshold values. Further qualitative studies that allow in-depth analyses may reveal underlying factors for this situation.
What Are the Barriers to Telerehabilitation in the Treatment of Musculoskeletal Diseases?
Authors: Franco José Bassan , Maximino Luciana Paula , Secchi Leonardo Luiz Barretti , Antonelli Bianca Caseiro , Blasca Wanderleia Quinhoneiro
Published: December 2023

Introduction: Musculoskeletal-related chronic pain is one of the most disabling in the world, with knee osteoarthrosis (OA) being one of the main causes of functional limitation and chronic pain among people over 45 years of age. In view of this, the expansion of telehealth services, including telerehabilitation, allows less restricted access to health services, reducing expenses and saving time. Purpose: The aim of the study was to verify the barriers to the implementation of telerehabilitation in the treatment of chronic musculoskeletal diseases compared to face-to-face rehabilitation. Data Source: The data were obtained from PubMed, Scopus, the Virtual Health Library (VHL), Cochrane, and the Web of Science databases. Methods: This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines to answer the PICOT question, “What are the barriers to implementing a telerehabilitation program for older people with knee osteoarthritis?”. The risk of bias was analyzed using the Review Manager program (RevMan). A search for articles was conducted and included only randomized clinical trials with older people with knee OA, selected by two blinded authors, according to inclusion and exclusion criteria, without publication time restriction, in the PROSPERO registry CRD42022316488. Results: The barriers to telerehabilitation have been overcome with the diversification of means of communication, the various possible ways of monitoring these patients from a distance, and the scheduling of face-to-face assessments and reassessments. The results presented in this review indicate that the barriers to implementing treatment protocols have been overcome, leading to clinical results which showed that there were no differences between the telerehabilitation and face-to-face groups for the clinical condition investigated. Conclusion: The barriers to telerehabilitation, which were more related to Internet access, telecommunication devices, personal relationships, and adequate monitoring of the exercise protocol, were overcome by diversifying the means of communication and delivering the exercise protocol for the implementation of telerehabilitation.
A Clear Cell Sarcoma Case: A Diagnostic and Treatment Challenge, with a Promising Response to Trabectedin
Authors: Galera Mar , Álvarez Rosa , Arregui Marta , Paniagua Miguel , Álvarez Ana , González Crisostomo Raphael Angelo , Díazgranados Adriana , Gutiérrez Natalia , Calles Antonio , Agra Carolina
Published: December 2023

Introduction: Clear cell sarcoma (CCS) is a rare and aggressive soft tissue sarcoma. CCS is characterized by the translocation t(12;22) (q13;q12), involving the fusion of EWSR1 and ATF1 genes, and less frequently the fusion gene EWSR1-CREB1. Usually, CCSs are considered poorly responsive to conventional chemotherapy. However, trabectedin has shown activity against translocation-related sarcomas. Furthermore, preclinical results suggest that trabectedin is a promising antitumor agent for CCS, potentially inducing melanocytic differentiation. Case Presentation: We report the case of a challenging anatomopathological diagnosis in a patient with an aggressive metastatic CCS. Following the diagnosis of CCS, the patient experienced a clinical and radiological tumor response to trabectedin after four lines of treatment. Conclusion: This is a novel report of CCS treated with trabectedin that resulted in a partial response and suggests the need for further research on trabectedin as a therapeutic option for CCS.
Fulminant Marginal Keratitis Induced by Atezolizumab, a Programmed Death Ligand 1 Inhibitor for Lung Cancer
Authors: Yamamoto Masashi , Yamada Masakazu , Kusumi Yumi , Fukui Masaki , Shigeyasu Chika
Published: December 2023

Introduction: With the increasing use of immune checkpoint inhibitors, ocular adverse events have gained attention. We describe a case of atypical keratitis presumably induced by atezolizumab, a programmed cell death ligand 1 inhibitor. Case Presentation: A 73-year-old Japanese woman developed ring-shaped marginal infiltrations with epithelial breakdown of the corneas in both eyes. The patient had advanced small cell lung cancer and had received intravenous carboplatin, etoposide, and atezolizumab. She was treated with topical administration of 0.1% sodium phosphate betamethasone and 0.5% moxifloxacin six times daily. On day 14 following initial presentation, marked reduction of bilateral corneal infiltration was observed. During the succeeding cycles of chemotherapy, marginal keratitis did not recur, and then, the topical steroid was gradually tapered. Conclusions: Cancer immunotherapy, including atezolizumab, may lead to active T-cell recruitment into the cornea, which result in autoimmune corneal keratitis. We believe that this report is informative to both ophthalmologists and oncologists involved in the treatment of patients receiving cancer immunotherapy.
A Male Child with Infantile Epilepsy due to a Mosaic Missense Variant of PCDH19
Authors: Parmeggiani Giulia , Minardi Raffaella , Boni Antonella , Pruccoli Jacopo , Pini Antonella , Licchetta Laura , Bisulli Francesca , Graziano Claudio , Seri Marco
Published: December 2023

Background: Pathogenic variants of PCDH19, located on the X-chromosome (Xq22.1), cause a rare epileptic encephalopathy with speech and development delay, seizures, behavioral and psychiatric problems. The specific underlying pathogenic mechanism is known as “cellular interference” that results in affected heterozygous females, normal hemizygous males and affected mosaic males but its functioning is not yet clear. Objectives: Reporting new cases of affected males is considered useful to a deeper insight. Subject and Method: We present the case of a three-year-old boy with early-onset seizures at 3 months of age, mild cognitive impairment, partial control of seizures with levetiracetam, normal brain imaging. Results: The patient has a mosaic pathogenic variant c.698A>G (p.Asp233Gly) in PCDH19 assessed by Next Generation Sequencing analysis. We have compared his characteristics with the genotypes and phenotypes of 34 PCDH19 mosaic males earlier reported in the literature. Finally, we have summarized today’s knowledge about phenotype-genotype correlation and pharmacological response in these patients. Conclusions: Our report confirms that the clinical picture of mosaic affected males, resembling that of females, can show a wide variability in severity of disease and underlines a stringent need to improve therapeutic approaches and to collect data on long-term follow-up.
NSCLC: Unabhängige prädiktive Marker für Langzeitansprechen auf kombinierte Immuntherapie identifizieren
Authors: Möller Miriam , Schütte Wolfgang
Published: December 2023

Introduction: Combination immunotherapy is widely used in clinical practice as the first-line treatment for advanced non-small-cell lung cancer (NSCLC). However, predictive factors associated with long-term response to combination immunotherapy have not been well investigated. Herein, we compared the clinical findings, including systemic inflammatory nutritional biomarkers, between responders and nonresponders to combination immunotherapy. In addition, we investigated the predictive factors associated with long-term response to combination immunotherapy. Methods: This study included a total of 112 previously untreated advanced NSCLC patients who received combination immunotherapy at eight institutions in Nagano prefecture between December 2018 and April 2021. The responders were defined as those who achieved progression-free survival for 9 months or longer with combined immunotherapy. We evaluated predictive factors associated with long-term response, and the favorable prognostic predictors associated with overall survival (OS) using statistical analyses. Results: The responder and nonresponder groups included 54 and 58 patients, respectively. Compared with the nonresponder group, the responder group had significantly younger age (p = 0.046), higher prognostic nutritional index (44.8 vs. 40.7, p = 0.010), lower C-reactive protein/albumin ratio (CAR) (0.17 vs. 0.67, p = 0.001), and a higher rate of complete plus partial response (83.3% vs. 34.5%, p < 0.001). The area under the curve and optimal cut-off value for CAR were 0.691 and 0.215, respectively. The CAR and best objective response were identified as independent favorable prognostic predictors associated with OS in the multivariate analyses.
Lokal fortgeschrittene Magen- und AEG-Tumoren: Neue Entwicklungen in der perioperativen Therapie
Authors: Heinrich Kathrin , Weiss Lena
Published: December 2023

PURPOSE: High pathologic complete response (pCR) rates and comparably good survival data were seen in a phase II trial combining perioperative fluorouracil, leucovorin, oxaliplatin, and docetaxel (FLOT) chemotherapy with trastuzumab for resectable, esophagogastric adenocarcinoma (EGA). The current trial evaluates the addition of trastuzumab and pertuzumab to FLOT as perioperative treatment for human epidermal growth factor receptor 2–positive resectable EGA. METHODS: In this multicenter, randomized phase II/III trial, patients with human epidermal growth factor receptor 2–positive, resectable EGA (≥ clinical tumor 2 or clinical nodal–positive) were assigned to four pre- and postoperative cycles of either FLOT alone (arm A) or combined with trastuzumab and pertuzumab, followed by nine cycles of trastuzumab/pertuzumab (arm B). The primary end point for the phase II part was the rate of pCR. RESULTS: The trial was closed prematurely, without transition into phase III, after results of the JACOB trial were reported. Eighty-one patients were randomly assigned (A: 41/B: 40) during the phase II part. The pCR rate was significantly improved with the trastuzumab/pertuzumab treatment (A: 12%/B: 35%; P = .02). Similarly, the rate of pathologic lymph node negativity was higher with trastuzumab/pertuzumab (A: 39%/B: 68%), whereas the R0 resection rate (A: 90%/B: 93%) and surgical morbidity (A: 43%/B: 44%) were comparable. Moreover, the inhouse mortality was equal in both arms (overall 2.5%). The median disease-free survival was 26 months in arm A and not yet reached in arm B (hazard ratio, 0.58; P = .14). After a median follow-up of 22 months, the median overall survival was not yet reached (hazard ratio, 0.56; P = .24). Disease-free survival and overall survival rates at 24 months were 54% (95% CI, 38 to 71) and 77% (95% CI, 63 to 90) in arm A and 70% (95% CI, 55 to 85) and 84% (95% CI, 72 to 96) in arm B, respectively. More ≥ grade 3 adverse events were reported with trastuzumab/pertuzumab, especially diarrhea (A: 5%/B: 41%) and leukopenia (A: 13%/B: 23%).
Impact of Fruit and Fruit Juice on Death and Disease Incidence: A Sex‐Specific Longitudinal Analysis of 18 603 Adults
Authors: Xu Xiaoyue , Grafenauer Sara , Barr Margo L. , Schutte Aletta E.
Published: December 2023

Background

The health benefits of fruits are well established, but fruit juice has been more controversial. Fruit and juice are often ingested with other foods, which prompted our investigation to determine whether fruit consumed as juice may negate the beneficial effects of consuming whole fruit in people with cardiovascular disease.

Methods and Results

We retrospectively analyzed data from a population‐based study in Australia (the 45 and Up Study) linked with hospitalization and mortality data up to September 2018. Kaplan‐Meier survival estimates and Cox proportional hazards models were used to examine effects of fruit, fruit juice, and the combination of fruit and fruit juice in relation to death and disease incidence among men and women living with cardiovascular disease. A total of 7308 deaths occurred among 18 603 participants diagnosed with cardiovascular disease over a 13‐year follow‐up. After multivariable adjustment, inadequate fruit intake (hazard ratio [HR], 1.12 [95% CI, 1.01–1.24]) and high fruit juice intake (HR, 1.26 [95% CI, 1.12–1.41]) predicted all‐cause mortality in women. Also, high fruit juice intake plus either adequate fruit intake (HR, 1.18 [95% CI, 1.02–1.37]) or inadequate fruit intake (HR, 1.43 [95% CI, 1.21–1.69]) predicted mortality in women. No relationships were found in men after multivariable adjustments. Also, we found no prognostic value for fruit and fruit juice intake on disease incidence.

Conclusions

In adults with cardiovascular disease, we found that fruit juice (in combination with adequate or inadequate fruit intake) predicted mortality in women but not in men. These effects became less clear when focusing on disease incidence.