bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI radiomics based on deep learning automated segmentation to predict early recurrence of hepatocellular carcinoma
Authors: Wei Hong , Zheng Tianying , Zhang Xiaolan , Wu Yuanan , Chen Yidi , Zheng Chao , Jiang Difei , Wu Botong , Guo Hua , Jiang Hanyu , Song Bin
Published: May 2024

Objectives

To investigate the utility of deep learning (DL) automated segmentation-based MRI radiomic features and clinical-radiological characteristics in predicting early recurrence after curative resection of single hepatocellular carcinoma (HCC).

Methods

This single-center, retrospective study included consecutive patients with surgically proven HCC who underwent contrast-enhanced MRI before curative hepatectomy from December 2009 to December 2021. Using 3D U-net-based DL algorithms, automated segmentation of the liver and HCC was performed on six MRI sequences. Radiomic features were extracted from the tumor, tumor border extensions (5 mm, 10 mm, and 20 mm), and the liver. A hybrid model incorporating the optimal radiomic signature and preoperative clinical-radiological characteristics was constructed via Cox regression analyses for early recurrence. Model discrimination was characterized with C-index and time-dependent area under the receiver operating curve (tdAUC) and compared with the widely-adopted BCLC and CNLC staging systems.

Results

Four hundred and thirty-four patients (median age, 52.0 years; 376 men) were included. Among all radiomic signatures, HCC with5 mmtumorborderextensionandliver showed the optimal predictive performance (training set C-index, 0.696). By incorporating this radiomic signature, rim arterial phase hyperenhancement (APHE), and incomplete tumor “capsule,” a hybrid model demonstrated a validation set C-index of 0.706 and superior 2-year tdAUC (0.743) than both the BCLC (0.550; p < 0.001) and CNLC (0.635; p = 0.032) systems. This model stratified patients into two prognostically distinct risk strata (both datasets p < 0.001).

Conclusion

A preoperative imaging model incorporating the DL automated segmentation-based radiomic signature with rim APHE and incomplete tumor “capsule” accurately predicted early postsurgical recurrence of a single HCC.

Critical relevance statement

The DL automated segmentation-based MRI radiomic model with rim APHE and incomplete tumor “capsule” hold the potential to facilitate individualized risk estimation of postsurgical early recurrence in a single HCC.

Key Points

A hybrid model integrating MRI radiomic signature was constructed for early recurrence prediction of HCC.

The hybrid model demonstrated superior 2-year AUC than the BCLC and CNLC systems.

The model categorized the low-risk HCC group carried longer RFS.

Graphical Abstract
Splenic artery pseudoaneurysm; a cause or consequence: a case report
Authors: Abbas Aymen , Mahmoud Fatma , Gaba Waqar
Published: May 2024

Background

Splenic artery pseudoaneurysm is a rare complication of recurrent pancreatitis usually presenting as an incidental finding on abdominal computed tomography.

Case presentation

We present the case of a 66-year-old north African male with a known history of previous pancreatitis who presented with upper gastrointestinal bleeding along with recurrent epigastric pain for 3 days. Investigations did not reveal any particular pancreatitis etiology. Computed tomography of the abdomen with contrast showed splenic artery pseudoaneurysm along with findings suggestive of acute pancreatitis. Upper and lower endoscopies failed to identify gastrointestinal the bleed source. The patient underwent intervention radiology embolization of the aneurysm sac with multiple coils via right retrograde common femoral artery–celiac access. The patient was discharged with a plan for capsule endoscopy in outpatient setting.

Conclusion

Splenic artery pseudoaneurysm is a life-threatening complication and carries a high mortality rate if left untreated. Prompt identification through various imaging modalities, followed by urgent intervention, is crucial to avoid adverse outcomes.
Cigarette smoke impairs the hematopoietic supportive property of mesenchymal stem cells via the production of reactive oxygen species and NLRP3 activation
Authors: Park Hyun Sung , Lee Byung-Chul , Chae Dong-Hoon , Yu Aaron , Park Jae Han , Heo Jiyoung , Han Myoung Hee , Cho Keonwoo , Lee Joong Won , Jung Ji-Won , Dunbar Cynthia E. , Oh Mi-Kyung , Yu Kyung-Rok
Published: May 2024

Background

Mesenchymal stem cells (MSCs) play important roles in tissue homeostasis by providing a supportive microenvironmental niche for the hematopoietic system. Cigarette smoking induces systemic abnormalities, including an impeded recovery process after hematopoietic stem cell transplantation. However, the role of cigarette smoking-mediated alterations in MSC niche function have not been investigated.

Methods

In the present study, we investigated whether exposure to cigarette smoking extract (CSE) disrupts the hematopoietic niche function of MSCs, and pathways impacted. To investigate the effects on bone marrow (BM)-derived MSCs and support of hematopoietic stem and progenitor cells (HSPCs), mice were repeatedly infused with the CSE named 3R4F, and hematopoietic stem and progenitor cells (HSPCs) supporting function was determined. The impact of 3R4F on MSCs at cellular level were screened by bulk-RNA sequencing and subsequently validated through qRT-PCR. Specific inhibitors were treated to verify the ROS or NLRP3-specific effects, and the cells were then transplanted into the animal model or subjected to coculture with HSPCs.

Results

Both direct ex vivo and systemic in vivo MSC exposure to 3R4F resulted in impaired engraftment in a humanized mouse model. Furthermore, transcriptomic profile analysis showed significantly upregulated signaling pathways related to reactive oxygen species (ROS), inflammation, and aging in 3R4F-treated MSCs. Notably, ingenuity pathway analysis revealed the activation of NLRP3 inflammasome signaling pathway in 3R4F-treated MSCs, and pretreatment with the NLRP3 inhibitor MCC950 rescued the HSPC-supporting ability of 3R4F-treated MSCs.

Conclusion

In conclusion, these findings indicate that exposure to CSE reduces HSPCs supportive function of MSCs by inducing robust ROS production and subsequent NLRP3 activation.
The safety profile of mesenchymal stem cell therapy administered through intrathecal injections for treating neurological disorders: a systematic review and meta-analysis of randomised controlled trials
Authors: Mesa Bedoya Luz Estella , Camacho Barbosa Jhyld Carolaind , López Quiceno Lucas , Barrios Arroyave Freddy , Halpert Karolynn , España Peña Julián Andrés , Salazar Uribe Juan Carlos
Published: May 2024

Background

Based on previous in vivo studies and human trials, intrathecal cell delivery is a safe and relevant therapeutic tool for improving patient's quality of life with neurological conditions. We aimed to characterise the safety profile of intrathecally delivered Mesenchymal stem cells (MSCs).

Methods

Ovid MEDLINE, Embase, Scopus, Cochrane Library, KCI-Korean Journal Database, and Web of Science. Databases were searched from their inception until April 13, 2023. Randomised Controlled Trials (RCTs) that compared intrathecal delivery of MSCs to controls in adult populations were included. Adverse events (AEs) were pooled and meta-analysed using DerSimonian-Laird random effects models with a correction factor 0.5 added to studies with zero count cells. Pooled AEs were described using Risk ratio (RR) and 95% confidence intervals (95% CI). Then, a random-effects meta-regress model on study-level summary data was performed to explore the relationship between the occurrence of AEs and covariates thought to modify the overall effect estimate. Finally, publication bias was assessed.

Results

303 records were reviewed, and nine RCTs met the inclusion criteria and were included in the quantitative synthesis (n = 540 patients). MSCs delivered intrathecally, as compared to controls, were associated with an increased probability of AEs of musculoskeletal and connective tissue disorders (categorised by Common Terminology Criteria for Adverse Events—CTCAE version 5.0) (RR: 1.61, 95% CI 1.19–2.19, I2 = 0%). The random-effects meta-regress model suggested that fresh MSCs increased the probability of occurrence of AEs compared to cryopreserved MSCs (RR: 1.554; p-value = 0.048; 95% CI 1.004–2.404), and the multiple-dose, decreased the probability of AEs by 36% compared to single doses (RR: 0.644; p-value = 0.048; 95% CI 0.416–0.996); however, univariate random effects meta-regression models revealed a not significant association between the occurrence of AEs from MSCs intrathecal delivery and each covariate.

Conclusions

Intrathecal delivery of MSCs was associated with a slight increase in AEs associated with musculoskeletal and connective tissue disorders, albeit without serious AEs. We conclude that intrathecal MSCs delivery is safe for patients with neurological conditions. However, further high-quality, large-scale RCTs are needed to confirm these findings.
Quantum support vector machine for forecasting house energy consumption: a comparative study with deep learning models
Authors: K Karan Kumar , Nutakki Mounica , Koduru Suprabhath , Mandava Srihari
Published: May 2024

The Smart Grid operates autonomously, facilitating the smooth integration of diverse power generation sources into the grid, thereby ensuring a continuous, reliable, and high-quality supply of electricity to end users. One key focus within the realm of smart grid applications is the Home Energy Management System (HEMS), which holds significant importance given the fluctuating availability of generation and the dynamic nature of loading conditions. This paper presents an overview of HEMS and the methodologies utilized for load forecasting. It introduces a novel approach employing Quantum Support Vector Machine (QSVM) for predicting periodic power consumption, leveraging the AMPD2 dataset. In the establishment of a microgrid, various factors such as energy consumption patterns of household appliances, solar irradiance, and overall load are taken into account in dataset creation. In the realm of load forecasting in Home Energy Management Systems (HEMS), the Quantum Support Vector Machine (QSVM) stands out from other methods due to its unique approach and capabilities. Unlike traditional forecasting methods, QSVM leverages quantum computing principles to handle complex and nonlinear electricity consumption patterns. QSVM demonstrates superior accuracy by effectively capturing intricate relationships within the data, leading to more precise predictions. Its ability to adapt to diverse datasets and produce significantly low error values, such as RMSE and MAE, showcases its efficiency in forecasting electricity load consumption in smart grids. Moreover, the QSVM model’s exceptional flexibility and performance, as evidenced by achieving an accuracy of 97.3% on challenging datasets like AMpds2, highlight its distinctive edge over conventional forecasting techniques, making it a promising solution for enhancing forecasting accuracy in HEMS.The article provides a brief summary of HEMS and load forecasting techniques, demonstrating and comparing them with deep learning models to showcase the efficacy of the proposed algorithms.
Simultaneous detection of influenza A, B and respiratory syncytial virus in wastewater samples by one-step multiplex RT-ddPCR assay
Authors: Zafeiriadou Anastasia , Kaltsis Lazaros , Thomaidis Nikolaos S. , Markou Athina
Published: May 2024

Background

After the occurrence of the COVID-19 pandemic, detection of other disseminated respiratory viruses using highly sensitive molecular methods was declared essential for monitoring the spread of health-threatening viruses in communities. The development of multiplex molecular assays are essential for the simultaneous detection of such viruses even at low concentrations. In the present study, a highly sensitive and specific multiplex one-step droplet digital PCR (RT-ddPCR) assay was developed for the simultaneous detection and absolute quantification of influenza A (IAV), influenza B (IBV), respiratory syncytial virus (RSV), and beta-2-microglobulin transcript as an endogenous internal control (IC B2M).

Results

The assay was first evaluated for analytical sensitivity and specificity, linearity, reproducibility, and recovery rates with excellent performance characteristics and then applied to 37 wastewater samples previously evaluated with commercially available and in-house quantitative real-time reverse transcription PCR (RT-qPCR) assays. IAV was detected in 16/37 (43%), IBV in 19/37 (51%), and RSV in 10/37 (27%) of the wastewater samples. Direct comparison of the developed assay with real-time RT-qPCR assays showed statistically significant high agreement in the detection of IAV (kappa Cohen’s correlation coefficient: 0.834, p = 0.001) and RSV (kappa: 0.773, p = 0.001) viruses between the two assays, while the results for the detection of IBV (kappa: 0.355, p = 0.27) showed good agreement without statistical significance.

Conclusions

Overall, the developed one-step multiplex ddPCR assay is cost-effective, highly sensitive and specific, and can simultaneously detect three common respiratory viruses in the complex matrix of wastewater samples even at low concentrations. Due to its high sensitivity and resistance to PCR inhibitors, the developed assay could be further used as an early warning system for wastewater monitoring.
WuMKG: a Chinese painting and calligraphy multimodal knowledge graph
Authors: Wan Jing , Zhang Hao , Zou Jun , Zou Ao , Chen Yubin , Zeng Qingyang , Li Xinrong , Wang Qiya
Published: May 2024

Chinese Painting and Calligraphy (ChP&C) holds significant cultural value, representing integral aspects of both Chinese culture and global art. A considerable amount of ChP&C works are dispersed worldwide. With the emergence of digital humanities, a vast collection of cultural artifacts data is now available online. However, the online databases of these artifacts remain decentralized and diverse, posing significant challenges to their effective organization and utilization. Addressing this, our paper focuses on the Wu Men School of Painting and proposes a framework for constructing a multimodal knowledge graph for the ChP&C domain. We construct the domain ontology by analyzing the ChP&C knowledge schema. Then, we acquire knowledge from diverse data sources, including textual and visual information. To enhance data collection around collecting historical context and subject matter, we propose methods for seal extraction and subject extraction specific to ChP&C. We validate the effectiveness of these methods on the constructed dataset. Finally, we construct the Wu Men Multimodal Knowledge Graph (WuMKG) and implement applications such as cross-modal retrieval, knowledge-based question-answering and visualization.
A future scenario earthquake and ground motion hazards for Kathmandu, Nepal
Authors: Koketsu Kazuki , Miyake Hiroe , Okumura Koji , Suzuki Haruhiko
Published: May 2024

Since Nepal is an earthquake-prone country due to the collision of the Indian and Eurasian plates, it is crucial for its capital of Kathmandu to evaluate ground motion hazards from a future large earthquake. For this purpose, we constructed a realistic scenario earthquake with realistic rupture parameters in a likely location. To obtain the location, a new distribution of the rupture zones of large historical earthquakes along the Main Himalayan Thrust (MHT) was obtained by integrating the distribution from a previous study and the results of trench surveys. Global Navigation Satellite System observations indicated that the plate boundary is strongly coupled from the southern boundary of the MHT to a depth of approximately 10 km and there is almost no lateral change in the coupling. This implies that all regions along the MHT have similar rates of strain increase. Therefore, it is most probable that the rupture zone of the oldest previous event will rupture as a scenario earthquake. In the new distribution, the 1255 earthquake is the oldest. However, large earthquakes occurred in 1934 and 2015 within its rupture zone. Thus, we adopted the area obtained by removing the 1934 and 2015 rupture zones from the western part of the 1255 rupture zone. The relationship between the rupture area size and seismic moment of the 2015 earthquake lies between the scaling formulas for crustal earthquakes and plate-boundary earthquakes, but is closer to the former. Therefore, using this and the scheme for characterized source models, we determined realistic rupture parameters. We then simulated broadband ground motions in Kathmandu using these rupture parameters, our 3-D velocity structure models, and a hybrid method combining the finite-difference method and the stochastic Green’s function method. We obtained the peak ground accelerations (PGAs) of simulated ground motions, and calculated the seismic intensities in the Modified Mercalli intensity scale from the PGAs as indexes of hazards for Kathmandu. Intensities IX coincide with the center of the Kathmandu Valley, and intensities VIII and VII are found in the area surrounded by the sedimentary boundary and the southernmost part of the valley.

Graphical abstract
Willingness to join community-based health insurance and its associated factors among households in Nekemte City, Ethiopia. A community-based cross-sectional study
Authors: Begna Olkeba , Gemede Habtamu Fekadu , Motuma Aboma , Shibiru Tesfaye , Tilahun Temesgen , Bobo Firew Tekle , Fite Meseret Belete
Published: May 2024

Introduction

Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, the prevalence of household willingness to join the community-based health insurance (CBHI) program and its associated factors are less explored in urban area. Therefore, this study was aimed to assess the prevalence of willingness to join community-based health insurance program and its associated factors among households in Nekemte City, Ethiopia.

Methods

A community-based cross-sectional study was conducted on 422 randomly selected households in Nekemte City, Ethiopia. Bivariate and multivariable analyses were performed to see the association between the independent and outcome variables using binary logistic regression model. Association was described using an adjusted odd ratio (AOR) and a 95% confidence interval (CI). Finally, p-value < 0.05 was considered the cut-off point for declaring a significant.

Results

Among 422 study participants, 320 (75.83%) [95% CI = 71.5-79.8%)] of the households were willing to join community-based health insurance program. The willingness to join for community-based health insurance was 3.11 times more likely among households who were in the richest quintile (AOR = 3.11; 95% CI = 1.08–8.93), 3.4 times more likely among those who were merchants (AOR = 3.40;1.33, 8.69), 2.52 times more likely among those who had history of chronic illness in the household (AOR = 2.52; 95% CI = 1.43–4.45), 4.09 times more likely among those who had the awareness about the scheme (AOR = 4.09; 95% CI = 1.97–8.47) and 3.29 times more likely among those who had the experience of borrow for medical care (AOR = 3.29; 95% CI = 1.48–7.30).

Conclusion

Nearly three fourth of the households were willing to join community-based health insurance program, however, about one fourth of households were not willing, which is a significant public health problem. Being merchant, having awareness about the scheme, being in the richest wealth quintile, having experience of borrowing for medical care, and having history of chronic illness in the household were factors found to be significantly associated with willingness to join community based health insurance in the study area. Therefore, strengthening awareness creation at community level about the benefit package and principle of the program would increase their demand for the community-based health insurance scheme.
Socioeconomic determinants of early childhood development: evidence from Pakistan
Authors: Akram Shahla , Zahid Feroz , Pervaiz Zahid
Published: May 2024

This study investigates the socioeconomic determinants of early childhood development (ECD) in Pakistan by utilizing the data of sixth wave of the Multiple Indicator Cluster Survey (MICS) conducted in the four provinces of the country. The findings of the study reveal that mother’s education, father’s education, economic status of the household as measured by household’s wealth index quintile, region of residence (province), child’s gender, disability, nutrition and the practices used by the adult members of the household to discipline child are important determinants of ECD. The study highlights the crucial role of family background and importance of addressing the issue of malnutrition to foster child development.
Leaders’ experiences of embedding a simulation-based education programme in a teaching hospital: an interview study informed by normalisation process theory
Authors: Szabo Rebecca A. , Molloy Elizabeth , Allen Kara J. , Francis Jillian , Story David
Published: May 2024

There is limited research on the experiences of people in working to embed, integrate and sustain simulation programmes. This interview-based study explored leaders’ experiences of normalising a simulation-based education programme in a teaching hospital. Fourteen known simulation leaders across Australia and North America were interviewed. Semi-structured interviews were analysed using reflexive thematic analysis sensitised by normalisation process theory, an implementation science theory which defines ‘normal’ as something being embedded, integrated and sustained. We used a combined social and experiential constructivist approach. Four themes were generated from the data: (1) Leadership, (2) business startup mindset, (3) poor understanding of simulation undermines normalisation and (4) tension of competing objectives. These themes were interlinked and represented how leaders experienced the process of normalising simulation. There was a focus on the relationships that influence decision-making of simulation leaders and organisational buy-in, such that what started as a discrete programme becomes part of normal hospital operations. The discourse of ‘survival’ was strong, and this indicated that simulation being normal or embedded and sustained was still more a goal than a reality. The concept of being like a ‘business startup’ was regarded as significant as was the feature of leadership and how simulation leaders influenced organisational change. Participants spoke of trying to normalise simulation for patient safety, but there was also a strong sense that they needed to be agile and innovative and that this status is implied when simulation is not yet ‘normal’. Leadership, change management and entrepreneurship in addition to implementation science may all contribute towards understanding how to embed, integrate and sustain simulation in teaching hospitals without losing responsiveness. Further research on how all stakeholders view simulation as a normal part of a teaching hospital is warranted, including simulation participants, quality and safety teams and hospital executives. This study has highlighted that a shared understanding of the purpose and breadth of simulation is a prerequisite for embedding and sustaining simulation. An approach of marketing simulation beyond simulation-based education as a patient safety and systems improvement mindset, not just a technique nor technology, may assist towards simulation being sustainably embedded within teaching hospitals.
Effect of emphysema on AI software and human reader performance in lung nodule detection from low-dose chest CT
Authors: Sourlos Nikos , Pelgrim GertJan , Wisselink Hendrik Joost , Yang Xiaofei , de Jonge Gonda , Rook Mieneke , Prokop Mathias , Sidorenkov Grigory , van Tuinen Marcel , Vliegenthart Rozemarijn , van Ooijen Peter M. A.
Published: May 2024

Background

Emphysema influences the appearance of lung tissue in computed tomography (CT). We evaluated whether this affects lung nodule detection by artificial intelligence (AI) and human readers (HR).

Methods

Individuals were selected from the “Lifelines” cohort who had undergone low-dose chest CT. Nodules in individuals without emphysema were matched to similar-sized nodules in individuals with at least moderate emphysema. AI results for nodular findings of 30–100 mm3 and 101–300 mm3 were compared to those of HR; two expert radiologists blindly reviewed discrepancies. Sensitivity and false positives (FPs)/scan were compared for emphysema and non-emphysema groups.

Results

Thirty-nine participants with and 82 without emphysema were included (n = 121, aged 61 ± 8 years (mean ± standard deviation), 58/121 males (47.9%)). AI and HR detected 196 and 206 nodular findings, respectively, yielding 109 concordant nodules and 184 discrepancies, including 118 true nodules. For AI, sensitivity was 0.68 (95% confidence interval 0.57–0.77) in emphysema versus 0.71 (0.62–0.78) in non-emphysema, with FPs/scan 0.51 and 0.22, respectively (p = 0.028). For HR, sensitivity was 0.76 (0.65–0.84) and 0.80 (0.72–0.86), with FPs/scan of 0.15 and 0.27 (p = 0.230). Overall sensitivity was slightly higher for HR than for AI, but this difference disappeared after the exclusion of benign lymph nodes. FPs/scan were higher for AI in emphysema than in non-emphysema (p = 0.028), while FPs/scan for HR were higher than AI for 30–100 mm3 nodules in non-emphysema (p = 0.009).

Conclusions

AI resulted in more FPs/scan in emphysema compared to non-emphysema, a difference not observed for HR.

Relevance statement

In the creation of a benchmark dataset to validate AI software for lung nodule detection, the inclusion of emphysema cases is important due to the additional number of FPs.

Key points

• The sensitivity of nodule detection by AI was similar in emphysema and non-emphysema.

• AI had more FPs/scan in emphysema compared to non-emphysema.

• Sensitivity and FPs/scan by the human reader were comparable for emphysema and non-emphysema.

• Emphysema and non-emphysema representation in benchmark dataset is important for validating AI.

Graphical Abstract
An improved GNSS ambiguity best integer equivariant estimation method with Laplacian distribution for urban low-cost RTK positioning
Authors: Liu Ying , Liu Wanke , Zhang Xiaohong , Liang Yantao , Tao Xianlu , Ma Liye
Published: May 2024

The integer least squares (ILS) estimation is commonly used for carrier phase ambiguity resolution (AR). More recently, the best integer equivariant (BIE) estimation has also attracted an attention for complex application scenarios, which exhibits higher reliability by a weighted fusion of integer candidates. However, traditional BIE estimation with Gaussian distribution (GBIE) faces challenges in fully utilizing the advantages of BIE for urban low-cost positioning, mainly due to the presence of outliers and unmodeled errors. To this end, an improved BIE estimation method with Laplacian distribution (LBIE) is proposed, and several key issues are discussed, including the weight function of LBIE, determination of the candidates included based on the OIA test, and derivation of the variance of LBIE solutions for reliability evaluation. The results show that the proposed LBIE method has the positioning accuracy similar to the BIE using multivariate t-distribution (TBIE), and significantly outperforms the ILS-PAR and GBIE methods. In an urban expressway test with a Huawei Mate40 smartphone, the LBIE method has positioning errors of less than 0.5 m in three directions and obtains over 50% improvements compared to the ILS-PAR and GBIE methods. In an urban canyon test with a low-cost receiver STA8100 produced by STMicroelectronics, the positioning accuracy of LBIE in three directions is 0.112 m, 0.107 m, and 0.252 m, respectively, with improvements of 17.6%, 27.2%, and 26.1% compared to GBIE, and 23.3%, 28.2%, and 30.6% compared to ILS-PAR. Moreover, its computational time increases by 30–40% compared to ILS-PAR and is approximately half of that using TBIE.
Alleviative effect of betaine against copper oxide nanoparticles-induced hepatotoxicity in adult male albino rats: histopathological, biochemical, and molecular studies
Authors: Hashim Asmaa R. , Bashir Dina W. , Rashad Eman. , Galal Mona K. , Rashad Maha M. , Deraz Nasrallah M. , Drweesh Elsayed A. , El-Gharbawy S. M.
Published: May 2024

Background

Copper oxide nanoparticles (CuO-NPs) have gained interest due to their availability, efficiency, and their cost-effectiveness. Betaine is an essential methyl donor and takes part in various physiological activities inside the body; it is found to have protective and curative effects against various liver diseases. The present study aimed to evaluate the hepatotoxic effect of CuO-NPs on adult male albino rats and the ability of betaine to alleviate such hepatotoxicity.

Methods

Forty adult male albino Wister rats were grouped into 4 groups (10 rats/group): group I a negative control, group II (CuO-NPs) injected with CuO-NPs intra peritoneal by insulin needle (0.5 mg/kg/day), group III (betaine + CuO-NPs) administered betaine orally by gavage needle (250 mg/kg/day 1 h before CuO-NPs) and CuO-NPs (0.5 mg/kg/day) finally, group IV (betaine) administered betaine orally by gavage needle (250 mg/kg/day) for consecutive 28 days. Blood and liver samples were gathered and processed for biochemical, molecular, histopathological, and immunohistochemical investigations.

Results

Group II displayed a marked rise in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and malondialdehyde (MDA) levels. Furthermore, there is an excessive upregulation of the inflammatory biomarkers interleukin1 beta (IL-1β) and tumor necrosis factor-alpha (TNF-α). On the other hand, substantial reduction in glutathione (GSH) levels and significant downregulation at glutathione peroxidase (GPx) mRNA gene expression. Regarding the histopathological deviations, there were severe congestion, dilatation and hyalinization of blood vessels, steatosis, hydropic degeneration, hepatocytic necrosis, increased binucleation, degenerated bile ducts, hyperplasia of ducts epithelial lining, and inflammatory cells infiltration. Immunohistochemically, there was a pronounced immunoreactivity toward IL-1β. Luckily, the pre-administration of betaine was able to mitigate these changes. MDA was dramatically reduced, resulting in the downregulation of IL-1β and TNF-α. Additionally, there was a considerable rise in GSH levels and an upregulation of GPx. Histopathological deviations were substantially improved as diminished dilatation, hyalinization and congestion of blood vessels, hepatocytes, and bile ducts are normal to some extent. In addition, IL-1β immunohistochemical analysis revealed marked decreased intensity.

Conclusion

Betaine can effectively reduce the hepatotoxicity caused by CuO-NPs via its antioxidant properties and its ability to stimulate the cell redox system.
Acoustic wave simulation in strongly heterogeneous models using a discontinuous Galerkin method
Authors: Cao Wenzhong , Zhang Wei , Wang Weitao
Published: May 2024

In recent years, the discontinuous Galerkin method (DGM) has been rapidly developed for the numerical simulation of seismic waves. For wavefield propagation between two adjacent elements, it is common practice to apply a numerical flux to the boundary of each element to propagate waves between adjacent elements. Several fluxes, including the center, penalty, local Lax-Friedrich (LLF), upwind, and Rankine-Hugoniot jump condition-based (RH condition) fluxes, are widely used in numerical seismic wave simulation. However, some fluxes do not account for media differences between adjacent elements. Although different fluxes have been successfully used in DGM for many velocity models, it is unclear whether they can produce sufficiently accurate or stable results for strongly heterogeneous models, such as checkerboard models commonly used in tomographic studies. We test different fluxes using the acoustic wave equation. We analyze the accuracy of the penalty, LLF, upwind, and RH-condition fluxes based on the results of the numerical simulations of the homogeneous and two-layer models. We conduct simulations using checkerboard models, and the results indicate that the LLF, penalty, and upwind fluxes may have instability problems in heterogeneous models with long-time simulations. We observe instability issues in the LLF, penalty, and upwind fluxes when the wave-impedance contrast is high at the media interface. However, the results of the RH-condition flux remain consistently stable. The series of numerical examples presented in this work provide insights into the characteristics and application of fluxes for seismic wave modeling.
Someone is to blame: the impact of suicide on the mind of the bereaved (including clinicians)
Authors: Gibbons Rachel
Published: May 2024

This paper presents an emerging understanding of the psychodynamics of suicide loss, derived from over 1500 accounts of suicide bereavement shared by families, friends and clinicians. It identifies clear patterns in the responses of the bereaved, particularly the formation of delusional narratives that often place them at the centre of blame for the death. These narratives have a profound impact on well-being, increase the risk of mental illness and elevate the likelihood of death by suicide. They not only cause harm to the bereaved but also permeate and distort our systemic and societal responses. Understanding why suicide unleashes such painful and dangerous forces helps mitigate the widespread harm and distress that often follows such a death. This knowledge also enables us to effectively and compassionately support those bereaved.
Is it now time to prepare psychiatry for a psychedelic future?
Authors: Nutt David , Crome Ilana , Young Allan H.
Published: May 2024

Australia has just rescheduled two drugs controlled under the United Nations Psychotropic Drug Conventions, psilocybin and MDMA, as treatments for treatment-resistant depression and post-traumatic stress disorder respectively. This feature explores the reasons for these developments, the opportunities and challenges they provide to psychiatry communities and how along with health systems these communities might respond to these developments.
Integrating Palliative Care and Hematologic Malignancies: Bridging the Gaps for Our Patients and Their Caregivers
Authors: El-Jawahri Areej , Webb Jason A. , Hannon Breffni , Zimmermann Camilla
Published: May 2024

Patients with hematologic malignancies (HMs) struggle with immense physical and psychological symptom burden, which negatively affect their quality of life (QOL) throughout the continuum of illness. These patients are often faced with substantial prognostic uncertainty as they navigate their illness course, which further complicates their medical decision making, especially at the end of life (EOL). Consequently, patients with HM often endure intensive medical care at the EOL, including frequent hospitalization and intensive care unit admissions, and they often die in the hospital. Our EOL health care delivery models are not well suited to meet the unique needs of patients with HMs. Although studies have established the role of specialty palliative care for improving QOL and EOL outcomes in patients with solid tumors, numerous disease-, clinician-, and system-based barriers prevail, limiting the integration of palliative care for patients with HMs. Nonetheless, multiple studies have emerged over the past decade identifying the role of palliative care integration in patients with various HMs, resulting in improvements in patient-reported QOL, symptom burden, and psychological distress, as well as EOL care. Importantly, these studies have also identified active components of specialty palliative care interventions, including strategies to promote adaptive coping especially in the face of prognostic uncertainty. Future work can leverage the knowledge gained from specialty palliative care integration to develop and test primary palliative care interventions by training clinicians caring for patients with HMs to incorporate these strategies into their clinical practice.
Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer—Cyclin-Dependent Kinase 4 and 6 Inhibitors: ASCO Guideline Rapid Recommendation Update
Authors: Freedman Rachel A. , Caswell-Jin Jennifer L. , Hassett Michael , Somerfield Mark R. , Giordano Sharon H. ,   for the Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer Guideline Expert Panel, Chavez-MacGregor Mariana , Comander Amy H. , Dayao Zoneddy , Eisen Andrea , Freedman Rachel A. , Gopalakrishnan Ragisha , Graff Stephanie L. , Hassett Michael J. , King Tari A. , Lyman Gary H. , Rice Maupin Gillian , Perkins Cheryl L. , Telli Melinda L. , Trudeau Maureen E. , Wolff Antonio C. , Giordano Sharon H.
Published: May 2024

ASCO Rapid Recommendation Updates highlight revisions to select ASCO guideline recommendations as a response to the emergence of new and practice-changing data. The rapid updates are supported by an evidence review and follow the guideline development processes outlined in the ASCO Guideline Methodology Manual . The goal of these articles is to disseminate updated recommendations, in a timely manner, to better inform health practitioners and the public on the best available cancer care options. Guidelines and updates are not intended to substitute for independent professional judgment of the treating provider and do not account for individual variation among patients. See appendix for disclaimers and other important information ( Appendix 1 and Appendix 2 , online only).
Genetic Associations With C-peptide Levels Before Type 1 Diabetes Diagnosis in At-risk Relatives
Authors: Triolo Taylor M , Parikh Hemang M , Tosur Mustafa , Ferrat Lauric A , You Lu , Gottlieb Peter A , Oram Richard A , Onengut-Gumuscu Suna , Krischer Jeffrey P , Rich Stephen S , Steck Andrea K , Redondo Maria J
Published: May 2024

Objective

We sought to determine whether the type 1 diabetes genetic risk score-2 (T1D-GRS2) and single nucleotide polymorphisms are associated with C-peptide preservation before type 1 diabetes diagnosis.

Methods

We conducted a retrospective analysis of 713 autoantibody-positive participants who developed type 1 diabetes in the TrialNet Pathway to Prevention Study who had T1DExomeChip data. We evaluated the relationships of 16 known single nucleotide polymorphisms and T1D-GRS2 with area under the curve (AUC) C-peptide levels during oral glucose tolerance tests conducted in the 9 months before diagnosis.

Results

Higher T1D-GRS2 was associated with lower C-peptide AUC in the 9 months before diagnosis in univariate (β = −.06, P < .0001) and multivariate (β = −.03, P = .005) analyses. Participants with the JAZF1 rs864745 T allele had lower C-peptide AUC in both univariate (β = −.11, P = .002) and multivariate (β = −.06, P = .018) analyses.

Conclusion

The type 2 diabetes-associated JAZF1 rs864745 T allele and higher T1D-GRS2 are associated with lower C-peptide AUC before diagnosis of type 1 diabetes, with implications for the design of prevention trials.
Acute and Long-Term Management of Blunt Cerebrovascular Injury at a Quaternary Referral Level 1 Trauma Center: The Memphis Experience and Comparison of a New Scoring System
Authors: Motiwala Mustafa , Nguyen Vincent N. , Orr Taylor , Parikh Kara A. , Miller Lindsey Erin , Barats Michael , Roach Jordan T. , Himel Sean , Mulpur Bhageeradh , Khattar Nicolas K. , Kerwin Andrew J. , Croce Martin , Arthur Adam , Inoa-Acosta Violiza , Nickele Christopher , Hoit Daniel , Elijovich Lucas , Goyal Nitin , Khan Nickalus R.
Published: May 2024

BACKGROUND AND OBJECTIVES:

The management of blunt cerebrovascular injuries (BCVIs) remains an important topic within trauma and neurosurgery today. There remains a lack of consensus within the literature and significant variation across institutions. The purpose of this study was to evaluate management of BCVI at a large, tertiary referral trauma center.

METHODS:

Institutional Review Board approval was obtained to conduct a retrospective review of patients with BCVI at our Level 1 Trauma Center. Computed tomography angiography was used to identify BCVI for each patient. Patient information was collected, and statistical analysis was performed. With the included risk factors for ischemic complications, a novel scoring system based on ischemic risk, the “Memphis Score,” was developed and evaluated to grade BCVI.

RESULTS:

Two hundred seventeen patients with BCVI from July 2020 to August 2022 were identified. The most common mechanism of injury was motor vehicle collision (141, 65.0%). Vertebral arteries were the most common vessel injured (136, 51.1%) with most injuries occurring at a high cervical location (101, 38.0%). Denver Grade 1 injuries (89, 33.5%) and a Memphis Score of 1 were most frequent (172, 64.6%), and initial anticoagulation with heparin drip was initiated 56.7% of the time (123). Endovascular treatment was required in 24 patients (11.1%) and was usually performed in the first 48 hours (15, 62.5%). While Denver Grade (P = .019) and Memphis Score (P < .00001) were significantly higher in those patients undergoing endovascular treatment, only the Memphis Score demonstrated a significant difference between those patients who had stroke or worsening on follow-up imaging and those who did not (P = .0009).

CONCLUSION:

Although BCVI management has improved since early investigative efforts, institutions must evaluate and share their data to help clarify outcomes. The novel “Memphis Score” presents a standardized framework to communicate ischemic risk and guide management of BCVI.
Caffeine Attenuates Exacerbated Central Fatigue during Moderate-Intensity Cycling Exercise in Women with Fibromyalgia
Authors: SCHAMNE JULIO CEZAR , DE SOUZA DOS SANTOS PAMELA , CAVALCANTE VICTOR HENRIQUE VIEIRA , GONÇALVES FELIPPI , BERTUZZI ROMULO , PEREIRA GLEBER , DOS SANTOS PAIVA EDUARDO , OKUNO NILO MASSARU , LIMA-SILVA ADRIANO EDUARDO
Published: May 2024

Purpose

To compare the development of fatigability during a moderate-intensity cycling exercise between women with fibromyalgia (FM) and control women (CON) after acute ingestion of caffeine and placebo.

Methods

Ten FM and 10 CON women performed a 30-min moderate-intensity cycling exercise 1 h after the ingestion of a capsule containing either caffeine or a placebo. Fatigability and its central and peripheral determinants were determined via changes from pre- to post-15 and post-30 min of exercise in maximal voluntary isometric contractions, voluntary activation (VA), and quadriceps potentiated twitch torque (Q
tw-pot), respectively. Heart rate, muscle oxygen saturation, perceptive responses, mood state, localized and widespread pain, and sleepiness were also monitored during and after exercise.

Results

There was a time versus group interaction for maximal voluntary isometric contraction and VA (P < 0.001) but not for Q
tw-pot (P = 0.363), indicating a greater rate of fatigability development, mainly caused by central mechanisms, in the FM than in the CON group. There was also a main effect of condition for VA (P = 0.011), indicating that caffeine attenuates central mechanisms of fatigability in both groups. Caffeine ingestion also increased muscle oxygenation, perceived vigor, and energy, and decreased leg muscle pain, sleepiness, and perceived fatigue in both groups. However, caffeine improved perceived pleasure/displeasure and exercise adherence likelihood only in the FM group.

Conclusions

Compared with CON, women with FM present a greater rate of fatigability during exercise, mainly of central origin. Caffeine seems to be a promising bioactive to counteract the central mechanisms of fatigability and improve the exercise experience among FM women.
The Effect of Unequal Crank Arm Lengths and Cycling-Specific Prostheses for Recreational Riders with a Transtibial Amputation
Authors: ALLEN STEPHEN P. , DIAZ GABRIELA B. , GRABOWSKI ALENA M.
Published: May 2024

Recreational cyclists with a transtibial amputation (TTA) exhibit kinematic and kinetic asymmetries between their biological and affected legs, which may worsen efficiency. Use of unequal crank arm lengths and/or a cycling-specific prosthesis (CSP) could reduce mechanical asymmetries and improve efficiency.

Purpose

We determined the effects of shorter affected side (AS) crank arm lengths and cycling with two different prostheses on joint and crank power, asymmetry, and net efficiency.

Methods

Twelve participants with a TTA rode at 1.5 W·kg−1 with equal (175 mm) and shorter AS crank arms (160, 165, 170 mm) using a daily-use prosthesis and CSP. We used statistical parametric mapping to determine differences in instantaneous joint and crank power between prostheses and linear mixed-effects models to compare average joint and crank power, asymmetry, and net efficiency.

Results

Shorter AS crank arm lengths reduced the magnitude of peak positive (P ≤ 0.001) and negative (P < 0.001) crank power on the AS. Use of a CSP increased the magnitude of peak positive knee power (P < 0.001) and decreased the magnitude of peak negative crank power (P < 0.001) on the AS compared with a daily-use prosthesis. Shorter AS crank arm lengths while using a CSP reduced average hip joint (P = 0.014) and hip transfer (P = 0.025) power asymmetry from 35% to 20% and 118% to 62%, respectively. However, we found no significant differences in AS average joint or crank power, knee joint or crank power asymmetry, or net efficiency.

Conclusions

Cycling at 1.5 W·kg−1 with unequal crank arm lengths and CSP improves hip joint power and hip transfer power asymmetry but does not alter crank asymmetry or net efficiency for recreational cyclists with a TTA.
Η τοποειδική χωρική πρακτική ως πεδίο σύζευξης τέχνης και αρχιτεκτονικής στο έργο των Aldo Van Eyck, Daniel Buren, Dan Graham, Maria Nordman, Rachel Whiteread
Authors: Μανδηλάρη Αγγελική
Published: May 2024

Η παρούσα μελέτη συνιστά παρουσίαση και θεωρητικό συσχετισμό παραδειγμάτων τοποειδικής πρακτικής στον αστικό ιστό και στο ευρύτερο αστικό τοπίο και εστιάζει στη λειτουργία του τοποειδικού έργου ως υλική εισαγωγή και ως μηχανισμό ανακατασκευής του αστικού αρχιτεκτονικού περιβάλλοντος σε πραγματικό και σε νοητικό επίπεδο. Κάθε περίπτωση εξετάζεται ως μια διαφορετική εκδοχή σύζευξης τέχνης και αρχιτεκτονικής ως προς το νόημα και τους τρόπους έκφρασής της αλλά και ως προς την εξερεύνηση της τοποθεσίας με βάση τις κατηγορίες του ειδικού, του σχεσιακού και των διαφορετικών εμφανίσεών αυτών. Από τη στιγμή που το τοποειδικό έργο αφορά καταρχήν στη σχέση μέρους και συνόλου, ειδικού και γενικού, τα γενικά ερώτηματα τα οποία η έρευνα επιχειρεί να απαντήσει είναι τα εξής: Τι είδους συναρθρώσεις υλοποιούνται σε κάθε περίπτωση ανάμεσα στο έργο και στο συγκείμενο και σε ποιες νέες προσλήψεις και αντιλήψεις του χώρου οδηγούν; Πώς διαφοροποιείται η σχέση έργου και συγκείμενου και πώς αυτή διαμορφώνεται γύρω από τις έννοιες της παρουσίας και της διαφάνειας; Σε τι βαθμό το τοποειδικό έργο στην περίπτωση ενσωμάτωσης του αρχιτεκτονικού μπορεί να λειτουργήσει ως πεδίο έκφρασης και μεταφορικής υλοποίησης της κοινωνικής διάστασης της αρχιτεκτονικής με την έννοια της συνδιαμόρφωσής της με την κοινωνική χωρικότητα; Σε τι βαθμό στο πεδίο της ειδικής τοποειδικής συνθήκης σύζευξης τέχνης και αρχιτεκτονικής η αρχιτεκτονική μπορεί να προσεγγίσει τη διαφεύγουσα συνθήκη του αστικού; Η επιλογή έργων από διαφορετικές δεκαετίες της περιόδου του δεύτερου μισού του 20ου αιώνα στοχεύει στην ανάδειξη του διαφορετικού λεξιλογίου και των διαφορετικών εκφραστικών εργαλείων τα οποία κάθε φορά επιστρατεύονται στο πλαίσιο της τοποειδικής συνθήκης και της αναζήτησης νέων μορφών ανακατασκευής, επανα-ιδιοποίησης και επανα-εννοιολόγησης του χώρου ως κοινωνικού και συλλογικού τόπου. Εντούτοις, στόχο της παρούσας έρευνας και της συγκεκριμένης επιλογής παραδειγμάτων δεν αποτελεί ο εντοπισμός και η ανάδειξη διαφορετικών κατηγοριών τοποειδικής χωρικής πρακτικής αλλά αντίθετα η προβληματικοποίηση κοινών θεωρητικών εννοιών μέσα από διαφορετικούς τρόπους έκφρασης και υλοποίησης καθώς και η ανάδειξη νέων ενδεχόμενων κατευθύνσεων των εννοιών αυτών.