bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward evidence-based communication on overweight body mass index and mortality
Authors: Mathur Maya B. , Mathur Vandana S.
Published: May 2024

Background

Reducing overweight and obesity has been a longstanding focus of public health messaging and physician–patient interactions. Clinical guidelines by major public health organizations describe both overweight and obesity as risk factors for mortality and other health conditions. Accordingly, a majority of primary care physicians believe that overweight BMI (even without obesity) strongly increases mortality risk.

Main points

The current evidence base suggests that although both obese BMI and underweight BMI are consistently associated with increased all-cause mortality, overweight BMI (without obesity) is not meaningfully associated with increased mortality. In fact, a number of studies suggest modest protective, rather than detrimental, associations of overweight BMI with all-cause mortality. Given this current evidence base, clinical guidelines and physician perceptions substantially overstate all-cause mortality risks associated with the range of BMIs classified as “overweight” but not “obese.” Discrepancies between evidence and communication regarding mortality raise the question of whether similar discrepancies exist for other health outcomes.

Conclusions

Health communication that inaccurately conveys current evidence may do more harm than good; this applies to communication from health authorities to health practitioners as well as to communication from health practitioners to individual patients. We give three recommendations to better align health communication with the current evidence. First, recommendations to the public and health practitioners should distinguish overweight from obese BMI and at this time should not describe overweight BMI as a risk factor for all-cause mortality. Second, primary care physicians’ widespread misconceptions about overweight BMI should be rectified. Third, the evidence basis for other potential risks or benefits of overweight BMI should be rigorously examined and incorporated appropriately into health communication.
The effectiveness of a standardized tobacco cessation program on psychophysiological parameters in patients with addiction undergoing long-term rehabilitation: a quasi-experimental pilot study
Authors: Fuchshuber J. , Schöber H. , Wohlmuth M. , Senra H. , Rominger C. , Schwerdtfeger A. , Unterrainer H. F.
Published: May 2024

Background

Although there is a very high comorbidity between tobacco dependence and other addictive disorders, there are only few studies examining the implementation and outcomes of a tobacco cessation program in patients with addictive diseases. Therefore, the aim of this study is to investigate to what extent a standardized tobacco cessation program leads to improvements regarding psychological/physical parameters in patients with addiction undergoing therapy and whether there is a reduction in tobacco consumption.

Methods

The study took place in a therapeutic community specialized in addiction therapy. A total sample of 56 participants were non-randomly assigned to an intervention group (IG; n = 31) and a treatment as usual group (TAUG; n = 25). The IG participated in a 6-week tobacco cessation program, while the TAUG received no additional treatment. Both groups were assessed for changes in primary outcomes (tobacco dependence, smoked cigarettes per day (CPD), and general substance-related craving) and secondary outcomes (heart rate variability (HRV): root mean square of successive differences, self-efficacy, and comorbid psychiatric symptoms) at two measurement time points (pre- and post-treatment/6 weeks).

Results

We observed significant improvements in self-efficacy (F(1,53) = 5.86; p < .05; ηp2 = .11) and decreased CPD in the IG (β = 1.16, ρ < .05), while no significant changes were observed in the TAUG. No significant interaction effects were observed in psychiatric symptoms, general substance-related craving, and HRV.

Conclusions

The results highlight the potential benefit of an additional tobacco cessation program as part of a general addiction treatment. Although no improvements in the physiological domain were observed, there were significant improvements regarding self-efficacy and CPD in the IG compared to the TAUG. Randomized controlled trials on larger samples would be an important next step.

Trial registration

ISRCTN15684371
A randomized controlled trial of an app-based intervention on physical activity and glycemic control in people with type 2 diabetes
Authors: Kim Gyuri , Kim Seohyun , Lee You-Bin , Jin Sang-Man , Hur Kyu Yeon , Kim Jae Hyeon
Published: May 2024

Background

We investigated the effects of a physical activity encouragement intervention based on a smartphone personal health record (PHR) application (app) on step count increases, glycemic control, and body weight in patients with type 2 diabetes (T2D).

Methods

In this 12-week, single-center, randomized controlled, 12-week extension study, patients with T2D who were overweight or obese were randomized using ratio 1:2 to a group using a smartphone PHR app (control group) or group using the app and received individualized motivational text messages (intervention group) for 12 weeks. During the extension period, the sending of the encouraging text messages to the intervention group was discontinued. The primary outcome was a change in daily step count after 12 weeks and analyzed by independent t-test. The secondary outcomes included HbA1c, fasting glucose, and body weight analyzed by paired or independent t-test.

Results

Of 200 participants, 62 (93.9%) and 118 (88.1%) in the control and intervention group, respectively, completed the 12-week main study. The change in daily step count from baseline to week 12 was not significantly different between the two groups (P = 0.365). Among participants with baseline step counts < 7,500 steps per day, the change in the mean daily step count at week 12 in the intervention group (1,319 ± 3,020) was significantly larger than that in control group (-139 ± 2,309) (P = 0.009). At week 12, HbA1c in the intervention group (6.7 ± 0.5%) was significantly lower than that in control group (6.9 ± 0.6%, P = 0.041) and at week 24, changes in HbA1c from baseline were significant in both groups but, comparable between groups. Decrease in HbA1c from baseline to week 12 of intervention group was greater in participants with baseline HbA1c ≥ 7.5% (-0.81 ± 0.84%) compared with those with baseline HbA1c < 7.5% (-0.22 ± 0.39%) (P for interaction = 0.014). A significant reduction in body weight from baseline to week 24 was observed in both groups without significant between-group differences (P = 0.370).

Conclusions

App-based individualized motivational intervention for physical activity did not increase daily step count from baseline to week 12, and the changes in HbA1c levels from baseline to week 12 were comparable.

Trial registration

ClinicalTrials.gov (NCT03407222).
Campylobacter jejuni virulence factors: update on emerging issues and trends
Authors: Tikhomirova Alexandra , McNabb Emmylee R. , Petterlin Luca , Bellamy Georgia L. , Lin Kyaw H. , Santoso Christopher A. , Daye Ella S. , Alhaddad Fatimah M. , Lee Kah Peng , Roujeinikova Anna
Published: May 2024

Campylobacter jejuni is a very common cause of gastroenteritis, and is frequently transmitted to humans through contaminated food products or water. Importantly, C. jejuni infections have a range of short- and long-term sequelae such as irritable bowel syndrome and Guillain Barre syndrome. C. jejuni triggers disease by employing a range of molecular strategies which enable it to colonise the gut, invade the epithelium, persist intracellularly and avoid detection by the host immune response. The objective of this review is to explore and summarise recent advances in the understanding of the C. jejuni molecular factors involved in colonisation, invasion of cells, collective quorum sensing-mediated behaviours and persistence. Understanding the mechanisms that underpin the pathogenicity of C. jejuni will enable future development of effective preventative approaches and vaccines against this pathogen.
Health care: life stories by trans women in Colombia
Authors: Zapata Mayor Juan Carlos , Hoyos Hernández Paula Andrea
Published: May 2024

Background

In Colombia, health care for people with trans life experiences is characterised by countless barriers to health services and care. Commonly, trans people have experienced stigma and discrimination among health professionals, a lack of services and professionals specialized to guarantee affirmative processes from non-hegemonic gender perspectives, and there exists a marked pathologization and medicalization of services. Therefore, it is necessary to provide affirmative health services to improve health and well-being from the recognition of their needs and experiences. The article describes life narratives about health care for the gender transitions of trans women in Colombia.

Methods

A qualitative narrative study was conducted with 139 trans women in seven cities in Colombia. In-depth interviews and discussion groups were conducted between June 2019 and March 2020. Data were analyzed using thematic analysis and the Atlas Ti cloud program. National and international ethical guidelines were followed in the development of the research.

Results

This research provided an overview of the health experiences of Colombian trans women. They reported their experiences of pathologizing approaches to transgender healthcare, stigma, discrimination, and barriers to accessing preventive, specialized, and regular healthcare services. For this reason, they opted for self-medicated gender transition processes and self-management of health care. An important aspect to consider within healthcare is that not all women want binary gender transition processes.

Conclusion

Participants felt that in Colombia there is a lack of affirmative health care for transgender women and that there are many limitations to care related to the gender transition processes. This exposes them to more situations that violate their rights and influences their lack of confidence and their search for professional health care. In Colombia, it is important to develop strategies for education, information, and communication, as well as a handbook for health workers on specialized healthcare for trans women.
High prevalence of diabetes among young First Nations Peoples with metabolic dysfunction-associated steatotic liver disease: a population-based study in Australia
Authors: Valery Patricia C. , Roche Shruti , Brown Catherine , O’Beirne James , Hartel Gunter , Leggett Barbara , Skoien Richard , Powell Elizabeth E.
Published: May 2024

Background

Liver disease is an important contributor to the mortality gap between First Nations Peoples and non-Indigenous Australian adults. Despite a high burden of metabolic comorbidities among First Nations Peoples, data about the epidemiology of metabolic dysfunction-associated steatotic liver disease (MASLD) in this population is scarce.

Methods

A retrospective analysis of all adults hospitalized with MASLD or metabolic dysfunction-associated steatohepatitis (MASH) with/without cirrhosis during 2007–2019 in the state of Queensland was performed. Patients were followed from the first admission with MASLD/MASH (identified based on validated algorithms) to decompensated cirrhosis and overall mortality. We explored differences according to Indigenous status using Multivariable Cox regression.

Findings

439 First Nations Peoples and 7,547 non-Indigenous Australians were followed for a median of 4.6 years (interquartile range 2.7–7.2). Overall, women were overrepresented, but more so in the First Nations cohort (72.7% vs. 57.0%, p < 0.001). First Nations patients were younger, a higher proportion lived in remote and socioeconomic disadvantaged areas, and had higher comorbidity compared to non-Indigenous Australians (all p < 0.001). Diabetes, the most common comorbidity affecting both groups, was overrepresented in First Nations Peoples versus non-Indigenous Australians (43.5% vs. 30.8%, p < 0.001, respectively). Nineteen (4.3%) First Nations Peoples and 332 (4.4%) of non-Indigenous patients progressed to cirrhosis decompensation (9.0% [95%CI 4.5–17.7] vs. 7.7% [95%CI 6.6–8.9; p = 0.956] respectively within 10 years). In multivariable analysis, there was no association between Indigenous status and progression to decompensated cirrhosis (p = 0.759) and survival (p = 0.437).

Conclusions

This study provides the first population-based epidemiological data on MASLD in First Nations Australians. The high prevalence of diabetes (that is associated with advanced fibrosis and liver disease mortality) among young First Nations Peoples with MASLD raises concern about future risk of progressive liver disease in this patient population. These data highlight the importance of early identification of MASLD, and providing culturally appropriate intervention to reduce disease progression in parallel with the management of cardiometabolic comorbidities.
Measurable residual disease monitoring by ddPCR in the early posttransplant period complements the traditional MFC method to predict relapse after HSCT in AML/MDS: a multicenter retrospective study
Authors: Chen Weihao , Huang Jingtao , Zhao Yeqian , Huang Luo , Yuan Zhiyang , Gu Miner , Xu Xiaojun , Shi Jimin , Luo Yi , Yu Jian , Lai Xiaoyu , Liu Lizhen , Fu Huarui , Bao Chenhui , Huang Xin , Zheng Zhongzheng , Huang He , Hu Xiaoxia , Zhao Yanmin
Published: May 2024

Background

Droplet digital PCR (ddPCR) is widely applied to monitor measurable residual disease (MRD). However, there are limited studies on the feasibility of ddPCR-MRD monitoring after allogeneic hematopoietic stem cell transplantation (allo-HSCT), especially targeting multiple molecular markers simultaneously.

Methods

Our study collected samples from patients with acute myeloid leukemia (AML) or high-risk myelodysplastic syndrome (MDS) in complete remission after allo-HSCT between January 2018 and August 2021 to evaluate whether posttransplant ddPCR-MRD monitoring can identify patients at high risk of relapse.

Results

Of 152 patients, 58 (38.2%) were MRD positive by ddPCR within 4 months posttransplant, with a median variant allele frequency of 0.198%. The detectable DTA mutations (DNMT3A, TET2, and ASXL1 mutations) after allo-HSCT were not associated with an increased risk of relapse. After excluding DTA mutations, patients with ddPCR-MRD positivity had a significantly higher cumulative incidence of relapse (CIR, 38.7% vs. 9.7%, P < 0.001) and lower rates of relapse-free survival (RFS, 55.5% vs. 83.7%, P < 0.001) and overall survival (OS, 60.5% vs. 90.5%, P < 0.001). In multivariate analysis, ddPCR-MRD positivity of non-DTA genes was an independent adverse predictor for CIR (hazard ratio [HR], 4.02; P < 0.001), RFS (HR, 2.92; P = 0.002) and OS (HR, 3.12; P = 0.007). Moreover, the combination of ddPCR with multiparameter flow cytometry (MFC) can further accurately identify patients at high risk of relapse (F+/M+, HR, 22.44; P < 0.001, F+/M-, HR, 12.46; P < 0.001 and F-/M+, HR, 4.51; P = 0.003).

Conclusion

ddPCR-MRD is a feasible approach to predict relapse after allo-HSCT in AML/MDS patients with non-DTA genes and is more accurate when combined with MFC.

Trial registration

ClinicalTrials.gov identifier: NCT06000306. Registered 17 August 2023 –Retrospectively registered (https://clinicaltrials.gov/study/NCT06000306?term=NCT06000306&rank=1).
Type 2 diabetic mellitus related osteoporosis: focusing on ferroptosis
Authors: Chen Yili , Zhao Wen , Hu An , Lin Shi , Chen Ping , Yang Bing , Fan Zhirong , Qi Ji , Zhang Wenhui , Gao Huanhuan , Yu Xiubing , Chen Haiyun , Chen Luyuan , Wang Haizhou
Published: May 2024

With the aging global population, type 2 diabetes mellitus (T2DM) and osteoporosis(OP) are becoming increasingly prevalent. Diabetic osteoporosis (DOP) is a metabolic bone disorder characterized by abnormal bone tissue structure and reduced bone strength in patients with diabetes. Studies have revealed a close association among diabetes, increased fracture risk, and disturbances in iron metabolism. This review explores the concept of ferroptosis, a non-apoptotic cell death process dependent on intracellular iron, focusing on its role in DOP. Iron-dependent lipid peroxidation, particularly impacting pancreatic β-cells, osteoblasts (OBs) and osteoclasts (OCs), contributes to DOP. The intricate interplay between iron dysregulation, which comprises deficiency and overload, and DOP has been discussed, emphasizing how excessive iron accumulation triggers ferroptosis in DOP. This concise overview highlights the need to understand the complex relationship between T2DM and OP, particularly ferroptosis. This review aimed to elucidate the pathogenesis of ferroptosis in DOP and provide a prospective for future research targeting interventions in the field of ferroptosis.
Social difficulties and care burden of adult Duchenne muscular dystrophy in Japan: a questionnaire survey based on the Japanese Registry of Muscular Dystrophy (Remudy)
Authors: Mori-Yoshimura Madoka , Ishigaki Keiko , Shimizu-Motohashi Yuko , Ishihara Naoko , Unuma Atushi , Yoshida Sumiko , Nakamura Harumasa
Published: May 2024

Background

Little is known about the social difficulties and health care needs of adult Duchenne muscular dystrophy (DMD) patients in Japan, as well as the financial and physical stress experienced by their caregivers. This study aimed to clarify the social circumstances surrounding adult DMD patients and assess the degree of involvement of family members in their care and the associated economic burden of the disorder in Japan.

Methods

Adult DMD patients were identified through the Registry of Muscular Dystrophy (Remudy) in Japan and invited to complete a questionnaire together with a caregiver. Data on health care use, quality of life, work status, informal care, and household expenses were collected to estimate the costs associated with DMD from social and caregiver household perspectives.

Results

In total, 234 (63.7%) of 367 adult DMD patients (mean age, 27.4 ± 6.0; range, 20–48 years) completed the questionnaire. Of these, 38 (21%) had developmental disorders (mental retardation, autism, and learning disorders), 57 (33%) experienced bullying in school, and 44 (77%) indicated the reason for bullying to be their physical handicap. Employment histories were noted by 72 (31%), although 23 (10%) lost their jobs mainly due to physical difficulties. Of the 234 patients, 164 (74%) lived with their relatives, and 78% of care time was supplied by family members, in particular, their mothers. The mean rate of care work provided by family members was 81%. Household income of families with an adult DMD patient was lower, whereas the rate of living with parent(s) and grandparent(s) was higher, in comparison with the general Japanese population.

Conclusions

Adult DMD patients in Japan experience many social difficulties from childhood up to adulthood. As adults, many DMD patients experience bullying and workplace difficulties. Families were found to provide most of the care and financial support for DMD patients. Our results suggest the need to improve public patient care systems, including financial support, to address the physical and economic burdens of care for adult DMD patients in Japan.
Hepatitis B virus reactivation in hepatocellular carcinoma patients after hepatic arterial infusion chemotherapy combined with and without immunotherapy
Authors: Zhang Lijie , Liu Yiming , Song Songlin , Makamure Joyman , Shi Heshui , Zheng Chuansheng , Liang Bin
Published: May 2024

Background

Hepatitis B virus (HBV) reactivation (HBVr) is a major concern for hepatocellular carcinoma (HCC) patients undergoing hepatic arterial infusion chemotherapy (HAIC) using mFOLFOX6 regimen. There is insufficient evidence to support the routine use of HAIC combined with immunotherapy in HCC patients with HBVr. The aim of this study was to examine the adverse events (AEs) related to HBVr in HCC patients after HAIC, with or without immunotherapy, and to assess the effectiveness of antiviral prophylaxis for HBVr.

Methods

Medical records of HCC patients receiving HAIC combined with and without immunotherapy between January 2021 and June 2023 were reviewed. The patients were divided into two groups based on whether they received immunotherapy or not.

Results

Out of the 106 patients, 32 (30.2%) developed HBVr. Among these, 23 eligible patients with HBVr were included, with 14 patients (61%) receiving immunotherapy and nine patients (39%) not receiving immunotherapy. Prior to HAIC treatment, four patients in each group had detectable HBV DNA with median titre of 3.66 × 102 IU/ml (patients with immunotherapy) and 1.98 × 102 IU/ml (patients without immunotherapy), respectively. Fifteen patients did not show detectable HBV DNA. At HBVr occurrence, the median HBV DNA level was 6.95 × 102 IU/ml for all patients, 4.82 × 102 IU/ml in patients receiving immunotherapy and 1.3 × 103 IU/ml in patients not receiving immunotherapy. Grade 3 hepatitis developed in 12 cases of all patients (12/23, 48%), including five patients with immunotherapy (56%) and seven patients without immunotherapy (78%). At the 3-month follow-up, HBV DNA was detected in 10 patients, with a median HBV DNA level of 2.05 × 102 IU/ml (range, 1.5 × 102– 3.55 × 102 IU/ml) in patients (7/10) with immunotherapy and 4.28 × 102 IU/ml (range, 1.15 × 102– 5.88 × 102 IU/ml) in patients (3/10) without immunotherapy. Intensified antiviral treatment was administered to all patients. No HBVr-related fatal events occurred.

Conclusion

HBVr can occur after HAIC combined with or without immunotherapy. The degree of liver damage did not differ significantly in patients treated with or without immunotherapy. Intensified antiviral treatment was found to be crucial for HCC patients with HBVr.
ChatGPT’s ability to generate realistic experimental images poses a new challenge to academic integrity
Authors: Zhu Lingxuan , Lai Yancheng , Mou Weiming , Zhang Haoran , Lin Anqi , Qi Chang , Yang Tao , Xu Liling , Zhang Jian , Luo Peng
Published: May 2024

The rapid advancements in large language models (LLMs) such as ChatGPT have raised concerns about their potential impact on academic integrity. While initial concerns focused on ChatGPT’s writing capabilities, recent updates have integrated DALL-E 3’s image generation features, extending the risks to visual evidence in biomedical research. Our tests revealed ChatGPT’s nearly barrier-free image generation feature can be used to generate experimental result images, such as blood smears, Western Blot, immunofluorescence and so on. Although the current ability of ChatGPT to generate experimental images is limited, the risk of misuse is evident. This development underscores the need for immediate action. We suggest that AI providers restrict the generation of experimental image, develop tools to detect AI-generated images, and consider adding “invisible watermarks” to the generated images. By implementing these measures, we can better ensure the responsible use of AI technology in academic research and maintain the integrity of scientific evidence.
mi-Mic: a novel multi-layer statistical test for microbiota-disease associations
Authors: Shtossel Oshrit , Finkelstein Shani , Louzoun Yoram
Published: May 2024

mi-Mic, a novel approach for microbiome differential abundance analysis, tackles the key challenges of such statistical tests: a large number of tests, sparsity, varying abundance scales, and taxonomic relationships. mi-Mic first converts microbial counts to a cladogram of means. It then applies a priori tests on the upper levels of the cladogram to detect overall relationships. Finally, it performs a Mann-Whitney test on paths that are consistently significant along the cladogram or on the leaves. mi-Mic has much higher true to false positives ratios than existing tests, as measured by a new real-to-shuffle positive score.
When describing harms and benefits to potential trial participants, participant information leaflets are inadequate
Authors: Cuddihy Laura , Howick Jeremy , Murphy Ellen , Shiely Frances
Published: May 2024

Background

Providing informed consent for trials requires providing trial participants with comprehensive information about the trial, including information about potential risks and benefits. It is required by the ethical principle of respecting patient autonomy. Our study examines the variation in the way information about potential trial benefits and harms is shared in participant information leaflets (PILs).

Methods

A total of 214 PILs and informed consent forms from clinical trials units (CTUs) and Clinical Research Facilities (CRFs) in Ireland and the UK were assessed by two authors independently, to check the extent to which they adhered to seven recently developed principles. Discrepancies were resolved by a third.

Results

Usage of the seven principles varied widely between PILs regardless of the intended recipient or trial type. None of the PILs used more than four principles, and some (4%) used none. Twenty-seven per cent of PILs presented information about all known potential harms, whereas 45% presented information on all known potential benefits. Some PILs did not provide any potential harms or potential benefits (8%). There was variation in the information contained in adult and children PILs and across disease areas.

Conclusion

Significant variation exists in how potential trial benefits and harms are described to potential trial participants in PILs in our sample. Usage of the seven principles of good practice will promote consistency, ensure informed ethical decision-making and invoke trust and transparency. In the long term, a standardised PIL template is needed.
Medicinal Cannabis (MedCan 3): a randomised, multicentre, double-blind, placebo-controlled trial to assess THC/CBD (1:20) to relieve symptom burden in patients with cancer—a study protocol for a randomised controlled trial
Authors: Gurgenci Taylan , Hardy Janet , Huggett Georgie , Foster Karyn , Pelecanos Anita , Greer Ristan , Philip Jennifer , Haywood Alison , Mendis Ruwani , Yates Patsy , Good Phillip
Published: May 2024

Background

Distressing symptoms are common in advanced cancer. Medicinal cannabinoids are commonly prescribed for a variety of symptoms. There is little evidence to support their use for most indications in palliative care. This study aims to assess a 1:20 delta-9-tetrahydrocannabinol/cannabidiol (THC/CBD) cannabinoid preparation in the management of symptom distress in patients with advanced cancer undergoing palliative care.

Methods and design

One hundred and fifty participants will be recruited across multiple sites in Queensland, Australia. A teletrial model will facilitate the recruitment of patients outside of major metropolitan areas. The study is a pragmatic, multicenter, randomised, placebo-controlled, two-arm trial of escalating doses of an oral 1:20 THC/CBD medicinal cannabinoid preparation (10 mg THC:200 mg CBD/mL). It will compare the efficacy and safety outcomes of a titrated dose range of 2.5 mg THC/50mgCBD to 30 mg THC/600 mg CBD per day against a placebo. There is a 2-week patient-determined titration phase, to reach a dose that achieves symptom relief or intolerable side effects, with a further 2 weeks of assessment on the final dose.

The primary objective is to assess the effect of escalating doses of a 1:20 THC/CBD medicinal cannabinoid preparation against placebo on change in total symptom distress score, with secondary objectives including establishing a patient-determined effective dose, the effect on sleep quality and overall quality of life. Some patients will be enrolled in a sub-study which will more rigorously evaluate the effect on sleep.

Discussion

MedCan-3 is a high-quality, adequately powered, placebo-controlled trial which will help demonstrate the utility of a THC:CBD 1:20 oral medicinal cannabis product in reducing total symptom distress in this population. Secondary outcomes may lead to new hypotheses regarding medicinal cannabis’ role in particular symptoms or in particular cancers. The sleep sub-study will test the feasibility of using actigraphy and the Insomnia Severity Index (ISI) in this cohort. This will be the first large-scale palliative care randomised clinical trial to utilise the teletrial model in Australia. If successful, this will have significant implications for trial access for rural and remote patients in Australia and internationally.

Trial registration

ANZCTR ACTRN12622000083796. Protocol number 001/20. Registered on 21 January 2022. Recruitment started on 8 August 2022.
Pembrolizumab response in stage IV luminal-type breast cancer with high microsatellite instability: a case report
Authors: Inakami Keiko , Fujita Noriko , Iguchi Chikage , Enomoto Yukie , Minohata Junya , Sata Atsushi , Miyagawa Yoshimasa , Yanagisawa Tetsu , Saitoh Tomokazu , Nomura Takashi , Sawai Yuka , Takahara Keiko , Kasugai Tsutomu , Shiba Eiichi
Published: May 2024

Background

Pembrolizumab (PEM), an immune checkpoint inhibitor (ICI), is often used for triple-negative breast cancer, but can also be used to treat solid tumors that exhibit high microsatellite instability (MSI-High). However, patients with breast cancer rarely have MSI-High, the use of PEM in such cases in clinical practice is uncertain due to lack of sufficient supporting data. Here, we report the case of a premenopausal woman in who received PEM for MSI-High luminal-type breast cancer.

Case presentation

A 40-year-old premenopausal Asian woman was diagnosed with stage IIA (T2N0M0) breast cancer and had an Oncotype DX recurrence score of 38. After surgery, she received 4 courses of chemotherapy with docetaxel and cyclophosphamide. After 3 months of tamoxifen therapy, the patient complained of abdominal pain due to right iliac metastasis, and biopsy of the metastatic lesion showed of luminal type; she was sequentially treated with fulvestrant, a CDK4/6 inhibitor, and an anticancer drug (TS1), but over the next year, metastasis to the bone and para-aortic lymph nodes increased. Tumor was MSI-High; PEM was started, and after three courses, bone metastases were reduced, para-aortic lymph node metastases resolved, opioids were discontinued, and the patient returned to society; PEM was administered for 1 year with no worsening of bone metastases on imaging. Asymptomatic brain metastasis less than 1 cm was detected and gamma knife was performed. Six months after completion of PEM, the patient is working with no new lesions.

Conclusion

We report a case of luminal-type breast cancer with bone metastases and MSI-High, which was treated with PEM and showed a rapid therapeutic response.
Mycophenolate-induced colitis in a patient with lupus nephritis: a case report and review of the literature
Authors: Alakkas Ziyad , Gari Abdulaziz M. , Makhdoum Sara , AlSindi Eman A.
Published: May 2024

Background

Mycophenolate mofetil (MMF) is an immunosuppressive drug that is frequently prescribed to patients with rheumatological diseases. MMF’s side effects include abdominal discomfort, nausea, vomiting, and other gastro-intestinal side effects, which typically appear in the first few months of treatment. However, late-onset diarrhea does not rule out the presence of MMF-induced colitis, which can be misdiagnosed since it is linked to a broad range of histopathological characteristics, including alterations that resemble inflammatory bowel disease, graft-versus-host disease, and ischemia. The differences in treatment response may be explained by the complexity of the histopathologic characteristics.

Case presentation

Here we present a case of a 29-year-old Arabian female with lupus nephritis who started on MMF as induction therapy. In two months, the patient was presented to the Emergency Department with diarrhea and manifestations of severe dehydration. Infectious diseases and adverse drug events were suspected, so the patient was admitted for further workup, and MMF was stopped. The patient was diagnosed with MMF-induced colitis based on colonoscopy and histological findings. Fourteen days after stopping MMF, she was within her baseline.

Conclusion

The purpose of this paper is to report a case of early-onset MMF-induced colitis in a patient with lupus nephritis who had started MMF as induction therapy. A review of the available literature on this uncommon immunosuppressive effect is also presented.
Elucidating the semantics-topology trade-off for knowledge inference-based pharmacological discovery
Authors: Sosa Daniel N. , Neculae Georgiana , Fauqueur Julien , Altman Russ B.
Published: May 2024

Leveraging AI for synthesizing the deluge of biomedical knowledge has great potential for pharmacological discovery with applications including developing new therapeutics for untreated diseases and repurposing drugs as emergent pandemic treatments. Creating knowledge graph representations of interacting drugs, diseases, genes, and proteins enables discovery via embedding-based ML approaches and link prediction. Previously, it has been shown that these predictive methods are susceptible to biases from network structure, namely that they are driven not by discovering nuanced biological understanding of mechanisms, but based on high-degree hub nodes. In this work, we study the confounding effect of network topology on biological relation semantics by creating an experimental pipeline of knowledge graph semantic and topological perturbations. We show that the drop in drug repurposing performance from ablating meaningful semantics increases by 21% and 38% when mitigating topological bias in two networks. We demonstrate that new methods for representing knowledge and inferring new knowledge must be developed for making use of biomedical semantics for pharmacological innovation, and we suggest fruitful avenues for their development.
Detecting self-organising patterns in crowd motion: effect of optimisation algorithms
Authors: Worku Samson , Mullick Pratik
Published: May 2024

The escalating process of urbanization has raised concerns about incidents arising from overcrowding, necessitating a deep understanding of large human crowd behavior and the development of effective crowd management strategies. This study employs computational methods to analyze real-world crowd behaviors, emphasizing self-organizing patterns. Notably, the intersection of two streams of individuals triggers the spontaneous emergence of striped patterns, validated through both simulations and live human experiments. Addressing a gap in computational methods for studying these patterns, previous research utilized the pattern-matching technique, employing the Nelder-Mead Simplex algorithm for fitting a two-dimensional sinusoidal function to pedestrian coordinates. This paper advances the pattern-matching procedure by introducing Simulated Annealing as the optimization algorithm and employing a two-dimensional square wave for data fitting. The amalgamation of Simulated Annealing and the square wave significantly enhances pattern fitting quality, validated through statistical hypothesis tests. The study concludes by outlining potential applications of this method across diverse scenarios.
Robust point cloud registration for map-based autonomous robot navigation
Authors: Efraim Amit , Francos Joseph M.
Published: May 2024

Autonomous navigation in large-scale and complex environments in the absence of a GPS signal is a fundamental challenge encountered in a variety of applications. Since 3-D scans provide inherent robustness to ambient illumination changes and the type of the surface texture, we present Point Cloud Map-based Navigation (PCMN), a robust robot navigation system, based exclusively on 3-D point cloud registration between an acquired observation and a stored reference map. It provides a drift-free navigation solution, equipped with a failed registration detection capability. The backbone of the navigation system is a robust point cloud registration method, of the acquired observation to the stored reference map. The proposed registration algorithm follows a hypotheses generation and evaluation paradigm, where multiple statistically independent hypotheses are generated from local neighborhoods of putative matching points. Then, hypotheses are evaluated using a multiple consensus analysis that integrates evaluation of the point cloud feature correlation and a consensus test on the Special Euclidean Group SE(3) based on independent hypothesized estimates. The proposed PCMN is shown to achieve significantly better performance than state-of-the-art methods, both in terms of place recognition recall and localization accuracy, achieving submesh resolution accuracy, both for indoor and outdoor settings.
Prediction of soil organic carbon stock combining Sentinel-1 and Sentinel-2 images in the Zoige Plateau, the northeastern Qinghai-Tibet Plateau
Authors: Lei Junjie , Zeng Changli , Zhang Lv , Wang Xiaogang , Ma Chanhua , Zhou Tao , Laffitte Benjamin , Luo Ke , Yang Zhihan , Tang Xiaolu
Published: May 2024

Background

Soil organic carbon (SOC) is a critical component of the global carbon cycle, and an accurate estimate of regional SOC stock (SOCS) would significantly improve our understanding of SOC sequestration and cycles. Zoige Plateau, locating in the northeastern Qinghai-Tibet Plateau, has the largest alpine marsh wetland worldwide and exhibits a high sensitivity to climate fluctuations. Despite an increasing use of optical remote sensing in predicting regional SOCS, optical remote sensing has obvious limitations in the Zoige Plateau due to highly cloudy weather, and knowledge of on the spatial patterns of SOCS is limited. Therefore, in the current study, the spatial distributions of SOCS within 100 cm were predicted using an XGBoost model—a machine learning approach, by integrating Sentinel-1, Sentinel-2 and field observations in the Zoige Plateau.

Results

The results showed that SOC content exhibited vertical distribution patterns within 100 cm, with the highest SOC content in topsoil. The tenfold cross-validation approach showed that XGBoost model satisfactorily predicted the spatial patterns of SOCS with a model efficiency of 0.59 and a root mean standard error of 95.2 Mg ha−1. Predicted SOCS showed a distinct spatial heterogeneity in the Zoige Plateau, with an average of 355.7 ± 123.1 Mg ha−1 within 100 cm and totaled 0.27 × 109 Mg carbon.

Conclusions

High SOC content in topsoil highlights the high risks of significant carbon loss from topsoil due to human activities in the Zoige Plateau. Combining Sentinel-1 and Sentinel-2 satisfactorily predicted SOCS using the XGBoost model, which demonstrates the importance of selecting modeling approaches and satellite images to improve efficiency in predicting SOCS distribution at a fine spatial resolution of 10 m. Furthermore, the study emphasizes the potential of radar (Sentinel-1) in developing SOCS mapping, with the newly developed fine-resolution mapping having important applications in land management, ecological restoration, and protection efforts in the Zoige Plateau.
An acute phase reaction from zoledronate mimicking symptoms seen in opioid withdrawal: a case report
Authors: Acharya Pankti P. , Joseph Crystal
Published: May 2024

Background

Zoledronate, a bisphosphonate, is a potent first-line treatment for osteoporosis. It is also a preferred treatment for hypercalcemia especially when unresponsive to intravenous fluids. Bisphosphonates can cause acute phase reactions that mimic opioid withdrawal symptoms, which can confound provider decision-making. Our case highlights cognitive bias involving a patient with opioid use disorder who received zoledronate for hypercalcemia secondary to immobilization and significant bone infection.

Case presentation

A 41-year-old male is admitted with a past medical history of active intravenous opioid use complicated by group A streptococcal bacteremia with L5-S1 discitis and osteomyelitis, L2-L3 osteomyelitis, and left ankle abscess/septic arthritis status post left ankle washout. His pain was well-controlled by acute pain service with ketamine infusion (discontinued earlier), opioids, acetaminophen, buprenorphine-naloxone, cyclobenzaprine, gabapentin, and naproxen. Intravenous opioids were discontinued, slightly decreasing the opioid regimen. A day later, the patient reported tachycardia, diaphoresis, myalgias, and chills, which the primary team reconsulted acute pain service for opioid withdrawal. However, the patient received a zoledronate infusion for hypercalcemia, on the same day intravenous opioids were discontinued. He had no other medications known to cause withdrawal-like symptoms per chart review. Therefore, it was suspected that an acute phase reaction occurred, commonly seen within a few days of bisphosphonate use.

Conclusion

Zoledronate, well known for causing acute phase reactions, was likely the cause of withdrawal-like symptoms. Acute phase reactions with bisphosphonates mostly occur in the first infusion, and the incidence decreases with subsequent infusions. Symptoms typically occur 24–72 h post-infusion, and last at most for 72 h. Cognitive bias led the primary team to be concerned with opioid withdrawal rather than investigating other causes for the patient’s presentation. Therefore, providers should thoroughly investigate potential etiologies and rule them out accordingly to provide the best care. Health care providers should also be aware of the implicit biases that potentially impact the quality of care they provide to patients.
The application of omics technologies for understanding tropical plants-based bioactive compounds in ruminants: a review
Authors: Wanapat Metha , Dagaew Gamonmas , Sommai Sukruthai , Matra Maharach , Suriyapha Chaichana , Prachumchai Rittikeard , Muslykhah Uswatun , Phupaboon Srisan
Published: May 2024

Finding out how diet impacts health and metabolism while concentrating on the functional qualities and bioactive components of food is the crucial scientific objective of nutritional research. The complex relationship between metabolism and nutrition could be investigated with cutting-edge "omics" and bioinformatics techniques. This review paper provides an overview of the use of omics technologies in nutritional research, with a particular emphasis on the new applications of transcriptomics, proteomics, metabolomics, and genomes in functional and biological activity research on ruminant livestock and products in the tropical regions. A wealth of knowledge has been uncovered regarding the regulation and use of numerous physiological and pathological processes by gene, mRNA, protein, and metabolite expressions under various physiological situations and guidelines. In particular, the components of meat and milk were assessed using omics research utilizing the various methods of transcriptomics, proteomics, metabolomics, and genomes. The goal of this review is to use omics technologies—which have been steadily gaining popularity as technological tools—to develop new nutritional, genetic, and leadership strategies to improve animal products and their quality control. We also present an overview of the new applications of omics technologies in cattle production and employ nutriomics and foodomics technologies to investigate the microbes in the rumen ecology. Thus, the application of state-of-the-art omics technology may aid in our understanding of how species and/or breeds adapt, and the sustainability of tropical animal production, in the long run, is becoming increasingly important as a means of mitigating the consequences of climate change.
Illuminating the problem of blue verditer synthesis in the early modern English period: chemical characterisation and mechanistic understanding
Authors: Purdy Ellen H. , Critchley Sarah , Kirkham Andrea , Casford Michael
Published: May 2024

We present a study into early modern English production of blue verditer, an early synthetic copper-based blue pigment chemically analogous to azurite. Verditers have been identified in numerous wall and easel paintings. While initial documentation occurs in the mid 1500s and production recipes were documented by the 17th c., the synthesis was known to be unreliable. This study replicates historical and recent scientific work on blue verditer and represents a significant advance in our understanding of verditer production and its challenges. Procedures for verditer synthesis are drawn from both 17th c. documentation and 20th c. replication work. The effects of temperature, copper and carbonate sources, solution stirring, copper ion concentration, and atmospheric composition are studied in order to elucidate the mechanism of synthesis and explain its unreliability in early modern refineries. Products are characterised by polarised light microscopy, scanning electron microscopy, Raman spectroscopy, and powder X-Ray diffraction. Rouaite, a green basic copper nitrate, is for the first time confirmed as a product of the refiners’ synthesis and a precursor to blue verditer in laboratory syntheses. This result problematises the blanket identification of green verditer as basic copper carbonate and provides important clues to the mechanism for blue verditer synthesis. Solution chemistry and ion equilibria allow us to explain the route by which rouaite is first formed and then converted to blue verditer. Conditions favouring blue verditer production are also clarified further. Although it is commonly stated that low temperatures are required for blue verditer production, blue verditer is produced here at a range of ambient temperatures. The reaction is found instead to be controlled by solution equilibria and heavily favoured by high partial pressures of carbon dioxide. Alongside archival materials about refining and verditer production, these results are contextualised and explanations for the unreliability of historical synthesis are proposed.
A systematic review of factors impacting intraoral scanning accuracy in implant dentistry with emphasis on scan bodies
Authors: Gehrke Peter , Rashidpour Mahsa , Sader Robert , Weigl Paul
Published: May 2024

Purpose

The purpose of this systematic review was to explore and identify the factors that influence the accuracy of intraoral scanning in implant dentistry, with a specific focus on scan bodies (ISBs).

Methods

Following the PRISMA 2020 guidelines, this study conducted a thorough electronic search across MedLine, PubMed, and Scopus to identify relevant studies. Articles were screened based on titles, abstracts, and full texts for relevance. The Robins I tool assessed the risk of bias in various study types. Data extraction occurred based on predetermined parameters for studying specimens and assessing outcomes.

Results

16 studies met the specified criteria and were consequently included in the systematic review. Due to variations in variables and methods across the selected studies, statistical comparison of results was not feasible. Therefore, a descriptive review approach was chosen, acknowledging the substantial heterogeneity in the reviewed literature.

Conclusions

The precision of virtual scan results is contingent upon diverse characteristics of ISBs and implants. These factors encompass their placement within the dental arch, structural design, shape, material composition, color, and the manufacturing system, all of which contribute to scan accuracy. Additionally, considerations such as the intraoral scanner (IOS) type, scanning technique, use of scan aids, inter-implant distance, scan span, and the number of implants warrant evaluation. In the context of capturing implant positions, intraoral scanning with ISBs demonstrates comparable accuracy to traditional impression methods, particularly in single and short-span scenarios. However, the existing data lacks sufficient information on in vivo applications to formulate clinical recommendations.