bluuebunny/crossref_metadata_2025 huggingface dataset:
The Diagnostic Value of Ultrasound-Based Deep Learning in Differentiating Parotid Gland Tumors
Authors: Wang Yaoqin , Xie Wenting , Huang Shixin , Feng Ming , Ke Xiaohui , Zhong Zhaoming , Tang Lina
Published: May 2022

Objectives. Evidence suggests that about 80% of all salivary gland tumors involve the parotid glands, with approximately 20% of parotid gland tumors (PGTs) being malignant. Discriminating benign and malignant parotid gland lesions preoperatively is vital for selecting the appropriate treatment strategy. This study explored the diagnostic performance of deep learning system for discriminating benign and malignant PGTs in ultrasonography images and compared it with radiologists. Methods. A total of 251 consecutive patients with surgical resection and proven parotid gland malignant or benign tumors who underwent preoperative ultrasound examinations were enrolled in this study between January 2014 and November 2020. Next, we compared the diagnostic accuracy of deep learning methods (ViT-B\16, EfficientNetB3, DenseNet121, and ResNet50) and radiologists in parotid gland tumor. In addition, the area under the curve (AUC), specificity, sensitivity, positive predictive value, and negative predictive value were calculated. Results. Among the 251 patients, 176/251 were the training set, whereas 75/251 were the validation set. Results showed that 74/251 patients had malignant tumor. Deep learning models achieved good performance in differentiating benign from malignant tumors, with the diagnostic accuracy and AUCs of ViT-B\16, EfficientNetB3, DenseNet121, and ResNet50 model being 81% and 0.81, 80% and 0.82, 77% and 0.81, and 79% and 0.80, respectively. On the other hand, the diagnostic accuracy and AUCs of radiologists were 77%-81% and 0.68-0.75, respectively. It was evident that the diagnostic accuracy of deep learning methods was higher than that of inexperienced radiologists, but there was no significant difference between deep learning methods and experienced radiologists. Conclusions. This study shows that the deep learning system can be used for diagnosing parotid tumors. The findings also suggest that the deep learning system may improve the diagnosis performance of inexperienced radiologists.
Sports-Induced Fatigue Recovery of Competitive Aerobics Athletes Based on Health Monitoring
Authors: Wang Cuijuan
Published: May 2022

Exercise-induced fatigue refers to the symptom that the body cannot continue to maintain the original training volume after a certain period of continuous training. Competitive aerobics athletes have a large amount of daily training exercise, and their bodies are prone to exercise fatigue. The health monitoring technology can monitor the physical state in real time and diagnose and treat the diseases caused by the body in time. This article aims at applying the health monitoring technology to the research of sports fatigue recovery of competitive aerobics athletes. This article first briefly introduces the theoretical review of exercise-induced fatigue, and it includes the definition, classification, and determination methods of exercise-induced fatigue, and then uses the health monitoring system to describe it, and finally conducts an experiment in the diagnosis and rehabilitation of exercise-induced fatigue. The health monitoring technology was compared with traditional medical methods, and the four aspects of speed, accuracy, recovery rate, and athlete’s treatment satisfaction were tested. The experimental results show that the diagnostic accuracy based on health monitoring technology is the same as that of traditional manual medical diagnosis, reaching about 85%, which verifies its effectiveness.
A Prediction and Evaluation Model Analysis of Enterprise Economic Management Mode Based on Neural Network Strategy
Authors: Wang Zijin , Han Xiujuan
Published: May 2022

Intelligent finance is an inevitable product for continuous development of big data, which is also a weapon to improve the work efficiency of enterprise economic management. The significance and feasibility of an artificial intelligence technology in corporate management performance have been analyzed. Two types of neural networks are used, which one is the single BP neural network without LSTM and the other is a BP neural network with LSTM layer is used to capture corporate time characteristics of performance factors between cost-savings ratio and corporate performance factors. The results have shown that the two types of BP neural networks have good accuracy in predicting corporate performance and which the prediction errors are within 5%. And both training loss and test loss have good convergence for predicting corporate performance. However, the BP neural network with LSTM layer has better accuracy than a single BP neural network. The correlation coefficient reached 0.97, which shows that the BP neural network model established in this article has good accuracy in predicting corporate performance, which is sufficient for predicting corporate performance. The application prediction errors of BP neural network in enterprise performance are all within the acceptable range, and the maximum error is only 1.23%.
Lateral Ventricular Volume Asymmetry and Optic Nerve Sheath Diameter Predict Intracranial Pressure in Traumatic Brain Injury Patients
Authors: Wang Yang , Yuan Ziming , Zhang Zuoyan , Shang Jiawei , Li Mingna , Wang Wei
Published: May 2022

Background. Various noninvasive methods of intracranial pressure (ICP) measurement have been proposed. Each has unique advantages and limitations. This study was aimed at investigating the relationships between lateral ventricular asymmetry on admission computed tomography, optic nerve sheath diameter (ONSD), and ICP in traumatic brain injury (TBI) patients. Methods. A prospective observational study was conducted in the patients admitted to our department between October 2018 and October 2020. 20 patients with moderate-severe TBI with a Glasgow Coma Scale of 3–12 were enrolled. Lateral ventricle volume (LVV) value measurements were conducted using ITK-SNAP software. The lateral ventricular volume ratio (LVR) was quantified by dividing the larger LVV by the smaller. Results. ONSD and LVR had a good correlation with ICP. Admission LVR of >1.735 was shown to have a sensitivity of 90.9% and a specificity of 88.9% for prediction of ICP increase (

AUC
=
0.879

; standard

error
=
0.091

; 95%

CI
=
0.701

to 1.0; significance level

p
<
0.004

). Admission ONSD of >5.55 mm was shown to have a sensitivity of 81.8% and a specificity of 88.9% for prediction of ICP increase (

AUC
=
0.919

; standard

error
=
0.062

; 95%

CI
=
0.798

to 1.0; significance level

p
<
0.002

). Combining the ONSD and LVR, the sensitivity could be improved to 90.9% in parallel test, and the specificity could be improved to 100% in serial test. Conclusion. ONSD and LVR measurements can diagnose elevated ICP in traumatic brain injury patients. ONSD combining with LVR may further improve the diagnostic evaluation.
Putative Biomarkers of Clinical Benefit With Pembrolizumab in Advanced Urothelial Cancer: Results from the KEYNOTE-045 and KEYNOTE-052 Landmark Trials
Authors: Bellmunt Joaquim , de Wit Ronald , Fradet Yves , Climent Miguel A. , Petrylak Daniel P. , Lee Jae-Lyun , Fong Lawrence , Necchi Andrea , Sternberg Cora N. , O'Donnell Peter H. , Powles Thomas , Plimack Elizabeth R. , Bajorin Dean F. , Balar Arjun V. , Castellano Daniel , Choueiri Toni K. , Culine Stephane , Gerritsen Winald , Gurney Howard , Quinn David I. , Vuky Jacqueline , Vogelzang Nicholas J. , Cristescu Razvan , Lunceford Jared , Saadatpour Assieh , Loboda Andrey , Ma Junshui , Rajasagi Mohini , Godwin James Luke , Homet Moreno Blanca , Grivas Petros
Published: May 2022

Purpose:

In an exploratory analysis, we investigated the association between programmed death ligand 1 (PD-L1), tumor mutational burden (TMB), T-cell–inflamed gene expression profile (TcellinfGEP), and stromal signature with outcomes of pembrolizumab in urothelial carcinoma (UC).

Patients and Methods:

Patients with advanced UC received first-line pembrolizumab 200 mg every 3 weeks in the single-arm phase II KEYNOTE-052 trial (NCT02335424) and salvage pembrolizumab 200 mg every 3 weeks or chemotherapy (paclitaxel/docetaxel/vinflunine) in the randomized phase III KEYNOTE-045 trial (NCT02256436). The association of each biomarker (continuous variable) with objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) was evaluated using logistic regression (ORR) and Cox PH (PFS, OS), adjusted for ECOG PS; nominal P values were calculated without multiplicity adjustment (one-sided, pembrolizumab; two-sided, chemotherapy). Significance was prespecified at α = 0.05.

Results:

In KEYNOTE-052, PD-L1, TMB, and TcellinfGEP were significantly associated with improved outcomes; stromal signature was significantly associated with worse outcomes. In KEYNOTE-045, although findings for TMB and TcellinfGEP with pembrolizumab were consistent with those of KEYNOTE-052, PD-L1 was not significantly associated with improved outcomes, nor was stromal signature associated with worse outcomes with pembrolizumab; chemotherapy was not associated with outcomes in a consistent manner for any of the biomarkers. Hazard ratio (HR) estimates at prespecified cutoffs showed an advantage for pembrolizumab versus chemotherapy regardless of PD-L1 or TMB, with a trend toward lower HRs in the combined positive score ≥10 and the TMB ≥175 mutation/exome subgroup. For TcellinfGEP, PFS and OS HRs were lower in the TcellinfGEP-nonlow subgroup regardless of treatment.

Conclusions:

Multiple biomarkers characterizing the tumor microenvironment may help predict response to pembrolizumab monotherapy in UC, and potential clinical utility of these biomarkers may be context-dependent.
Circulating Tumor DNA Is Associated with Response and Survival in Patients with Advanced Leiomyosarcoma
Authors: Madanat-Harjuoja Laura M. , Klega Kelly , Lu Yao , Shulman David S. , Thorner Aaron R. , Nag Anwesha , Tap William D. , Reinke Denise K. , Diller Lisa , Ballman Karla V. , George Suzanne , Crompton Brian D.
Published: May 2022

Purpose:

We sought to determine whether the detection of circulating tumor DNA (ctDNA) in samples of patients undergoing chemotherapy for advanced leiomyosarcoma (LMS) is associated with objective response or survival.

Experimental Design:

Using ultra–low-passage whole-genome sequencing (ULP-WGS) of plasma cell-free DNA from patients treated on a prospective clinical trial, we tested whether detection of ctDNA evaluated prior to the start of therapy and after two cycles of chemotherapy was associated with treatment response and outcome. Associations between detection of ctDNA and pathologic measures of disease burden were evaluated.

Results:

We found that ctDNA was detectable by ULP-WGS in 49% patients prior to treatment and in 24.6% patients after two cycles of chemotherapy. Detection of pretreatment ctDNA was significantly associated with a lower overall survival [HR, 1.55; 95% confidence interval (CI), 1.03–2.31; P = 0.03] and a significantly lower likelihood of objective response [odds ratio (OR), 0.21; 95% CI, 0.06–0.59; P = 0.005]. After two cycles of chemotherapy, patients who continued to have detectable levels of ctDNA experienced a significantly worse overall survival (HR, 1.77; 95% CI, 1–3.14; P = 0.05) and were unlikely to experience an objective response (OR, 0.05; 95% CI, 0–0.39; P = 0.001).

Conclusions:

Our results demonstrate that detection of ctDNA is associated with outcome and objective response to chemotherapy in patients with advanced LMS. These results suggest that liquid biopsy assays could be used to inform treatment decisions by recognizing patients who are likely and unlikely to benefit from chemotherapy.

See related commentary by Kasper and Wilky, p. 2480
Revisiting Intracavitary Immunotherapy of Cancer
Authors: Aranda Fernando , Eguren-Santamaria Iñaki , Bella Ángela , Berraondo Pedro , Melero Ignacio
Published: May 2022

Ovarian cancer is often limited to the peritoneal cavity in the form of peritoneal carcinomatosis. Peritoneal spreading offers the opportunity for locoregional delivery of combinations of immunotherapy agents, maximizing bioavailability while potentially reducing systemic exposure and side effects.

See related article by Orr et al., p. 2038
Ceramide Kinase Inhibition Drives Ferroptosis and Sensitivity to Cisplatin in Mutant KRAS Lung Cancer by Dysregulating VDAC-Mediated Mitochondria Function
Authors: Vu Ngoc T. , Kim Minjung , Stephenson Daniel J. , MacKnight H. Patrick , Chalfant Charles E.
Published: May 2022

Ceramide kinase (CERK) is the mammalian lipid kinase from which the bioactive sphingolipid, ceramide-1-phosphate (C1P), is derived. CERK has been implicated in several promalignant phenotypes with little known as to mechanistic underpinnings. In this study, the mechanism of how CERK inhibition decreases cell survival in mutant (Mut) KRAS non–small cell lung cancer (NSCLC), a major lung cancer subtype, was revealed. Specifically, NSCLC cells possessing a KRAS mutation were more responsive to inhibition, downregulation, and genetic ablation of CERK compared with those with wild-type (WT) KRAS regarding a reduction in cell survival. Inhibition of CERK induced ferroptosis in Mut KRAS NSCLC cells, which required elevating VDAC-regulated mitochondria membrane potential (MMP) and the generation of cellular reactive oxygen species (ROS). Importantly, through modulation of VDAC, CERK inhibition synergized with the first-line NSCLC treatment, cisplatin, in reducing cell survival and in vivo tumor growth. Further mechanistic studies indicated that CERK inhibition affected MMP and cell survival by limiting AKT activation and translocation to mitochondria, and thus, blocking VDAC phosphorylation and tubulin recruitment.

Implications:

Our findings depict how CERK inhibition may serve as a new key point in combination therapeutic strategy for NSCLC, specifically precision therapeutics targeting NSCLC possessing a KRAS mutation.
Prostate Cancer Associated with Minimal Change Disease: A Case Report
Authors: Nakano Yuta , Yoshida Mariko , Muraki Naohiro , Sugita Kouhei , Ishihara Saori , Kumagai Jiro , Fujisawa Hajime
Published: May 2022

Introduction: Minimal change disease (MCD), a common cause of primary nephrotic syndrome that accounts for 10%–15% of all primary nephrotic syndrome cases in adults, is frequently associated with malignant lymphoma. However, studies on MCD associated with prostate cancer are scarce. Case Presentation: A 73-year-old male with prostate cancer was referred to our department with hypoalbuminemia and severe proteinuria while waiting for prostatectomy. We diagnosed the patient with nephrotic syndrome and performed a renal biopsy. Renal pathological findings were consistent with those of MCD. The clinical course suggested an association between prostate cancer and MCD as our patient achieved complete remission of MCD after receiving androgen deprivation and radiation therapy for prostate cancer without the use of glucocorticoids or other immunosuppressants. Discussion: Although MCD can be associated with solid tumors, MCD associated with prostate cancer is very rare. The current case is the first to directly raise the possibility that secondary MCD may develop due to prostate cancer in some patients.
Entre a favela e o castelo: infância, desigualdades sociais e escolares
Authors: Arenhart Deise , Silva Maurício Roberto da
Published: May 2022

Este texto se circunscreve na esteira das reflexões sobre as possíveis articulações entre a problemática das desigualdades sociais e as desigualdades escolares. Busca-se aqui colocar a infância no epicentro desse debate, pondo em cena as categorias analíticas que constroem a infância e a condição de desigualdade a ela associada: geração (diversidade) e classe (desigualdade social). Neste sentido, o texto, tendo como lócus uma escola de classe média (Castelo) e outra da classe empobrecida (Favela), tem como desafio, de um lado, debater, de forma articulada, os aspectos geracionais, tais como as questões de alteridade no âmbito das relações criança-adulto e, de outro lado, determinações de classe social que, por sua vez, terminam por estreitar as relações entre desigualdades sociais e escolares. As conclusões provisórias apontam para o fato de que a condição de desigualdade social também se reproduz na escola, por fatores estruturalmente políticos, econômicos e também pedagógicos. Nas manifestações das crianças, sobretudo as da favela as quais vivem essa dupla condição de desvantagem social (tanto a geracional como a de classe), evidenciamos pistas de como elas procuram driblar a condição do não direito para construir alternativas de fazer viver sua condição infantil no espaço escolar. As crianças reagem às condições de opressão (corpo oprimido) pela expressão de um corpo brincante e portador de resistências e transgressões. O texto conclui reiterando a necessidade de colocar a produção científica a favor de um projeto comprometido com a transformação social, na qual o direito à vida seja de fato para todos e todas e em todas as idades.
Uncanny Beauty: Aesthetics of Companionship, Love, and Sex Robots
Authors: Euron Paolo
Published: May 2022

In the last few years there has been a lively debate on humanoid robots interacting with humans in fields where human appearance and likeness may be essential. The debate has been bolstered by advancing AI technologies as well as increasing economic interest and public attention. The feasibility, inevitability, or ethical opportunity of companionship, love, and sex robots has been discussed. I propose a philosophical and cultural approach, applying the strategies of aesthetics and literary theory to the field of artificial beings, in order to understand reasons, use, limits, and possibilities expressed by the technology applied to companionship, love, and sex robots in the contemporary cultural and social context. In dealing with aesthetics, I will state how cognitive, biological, and ethical aspects are involved, how beauty is relatable to a robot’s physical appearance, and how the aesthetics of artificial beings may offer new existential experiences.
The Ocean Boundary Layer beneath Larsen C Ice Shelf: Insights from Large-Eddy Simulations with a Near-Wall Model
Authors: Vreugdenhil Catherine A. , Taylor John R. , Davis Peter E. D. , Nicholls Keith W. , Holland Paul R. , Jenkins Adrian
Published: May 2022

The melt rate of Antarctic ice shelves is of key importance for rising sea levels and future climate scenarios. Recent observations beneath Larsen C Ice Shelf revealed an ocean boundary layer that was highly turbulent and raised questions on the effect of these rich flow dynamics on the ocean heat transfer and the ice shelf melt rate. Directly motivated by the field observations, we have conducted large-eddy simulations (LES) to further examine the ocean boundary layer beneath Larsen C Ice Shelf. The LES was initialized with uniform temperature and salinity (T–S) and included a realistic tidal cycle and a small basal slope. A new parameterization based on previous work was applied at the top boundary to model near-wall turbulence and basal melting. The resulting vertical T–S profiles, melt rate, and friction velocity matched well with the Larsen C Ice Shelf observations. The instantaneous melt rate varied strongly with the tidal cycle, with faster flow increasing the turbulence and mixing of heat toward the ice base. An Ekman layer formed beneath the ice base and, due to the strong vertical shear of the current, Ekman rolls appeared in the mixed layer and stratified region (depth ≈ 20–60 m). In an additional high-resolution simulation (conducted with a smaller domain) the Ekman rolls were associated with increased turbulent kinetic energy, but a relatively small vertical heat flux. Our results will help with interpreting field observations and parameterizing the ocean-driven basal melting of ice shelves.
Creating a Communication Framework for FACETs: How Probabilistic Hazard Information Affected Warning Operations in NOAA’s Hazardous Weather Testbed
Authors: Trujillo-Falcón Joseph E. , Reedy Justin , Klockow-McClain Kimberly E. , Berry Kodi L. , Stumpf Gregory J. , Bates Alyssa V. , LaDue James G.
Published: May 2022

Scientists at NOAA are testing a new tool that allows forecasters to communicate estimated probabilities of severe hazards (tornadoes, severe wind, and hail) as part of the Forecasting a Continuum of Environmental Threats (FACETs) framework. In this study, we employ the embedded systems theory (EST)—a communication framework that analyzes small group workplace practices as products of group, organizational, and local dynamics—to understand how probabilistic hazard information (PHI) is produced and negotiated among multiple NWS weather forecast offices in an experimental setting. Gathering feedback from NWS meteorologists who participated in the 2020 Hazard Services (HS)-PHI Interoffice Collaboration experiment, we explored implications of local and interoffice collaboration while using this experimental tool. By using a qualitative thematic analysis, it was found that differing probability thresholds, forecasting styles, social dynamics, and workload will be social factors that developers should consider as they bring PHI toward operational readiness. Warning operations in this new paradigm were also implemented into the EST model to create a communication ecosystem for future weather hazard communication research.

Significance Statement

Meteorologists are currently exploring how to use probabilities to communicate life-saving information. From tornadoes to hail, a new type of probabilistic hazard information could fundamentally change the way that NWS meteorologists collaborate with one another when issuing weather products, especially near and along the boundaries of County Warning Areas. To explore potential collaboration challenges and solutions, we applied a communication framework and explored perceptions that NWS meteorologists had while using this new tool in an experimental setting. NWS meteorologists expressed that differing ways of communicating hazard information between each office, along with forecasting styles and workload, would change the way they go about producing critical hazard information to the public.
Evaluating real-world treatment patterns and outcomes of mantle cell lymphoma
Authors: Narkhede Mayur , Goyal Gaurav , Shea Lauren , Mehta Amit , Giri Smith
Published: May 2022

Mantle cell lymphoma (MCL) is considered incurable with the available chemoimmunotherapy approaches, and therefore, newer effective targeted therapies such as Bruton tyrosine kinase (BTK) inhibitors are increasingly used in MCL as chronic suppressive therapy, especially in the elderly. We aimed to describe the treatment patterns in MCL at different lines of therapy with a focus on BTK inhibitor use and compare outcomes with known prognostic factors using a nationwide Flatiron Health electronic health record–derived de-identified database. We analyzed patient-level data from the period of 2011 to 2021. In this study of 4336 patients with MCL, we found that bendamustine plus rituximab chemotherapy was the most commonly used frontline regimen (42%). Maintenance rituximab or consolidative autologous stem cell transplant (ASCT) was administered to 31% of all patients. Also, for patients who received ASCT as consolidation therapy, only 34% subsequently received rituximab maintenance. BTK inhibitors were the most preferred agents in second or later lines of therapy (n = 933, 57%), followed by bortezomib, lenalidomide, and venetoclax, respectively. Among patients treated with BTK inhibitors, the median real-world overall survival (rwOS) was 35 months (95% confidence interval [CI], 27-50), 24 months (95% CI, 22-30), and 18 months (95% CI, 14-21) for first line, second line, and third or later line of therapy, respectively. Patients with a deletion 17p/TP53 mutation and blastoid variant MCL had poor outcomes; however, BTK inhibitors appeared to mitigate the negative influence of del17p/TP53-mutated MCL with a hazard ratio of 1.17 (95% CI, 0.88-1.55) on multivariable analysis.
Quality of breeding value predictions from longitudinal analyses, with application to residual feed intake in pigs
Authors: David Ingrid , Ricard Anne , Huynh-Tran Van-Hung , Dekkers Jack C. M. , Gilbert Hélène
Published: May 2022

Background

An important goal in animal breeding is to improve longitudinal traits. The objective of this study was to explore for longitudinal residual feed intake (RFI) data, which estimated breeding value (EBV), or combination of EBV, to use in a breeding program. Linear combinations of EBV (summarized breeding values, SBV) or phenotypes (summarized phenotypes) derived from the eigenvectors of the genetic covariance matrix over time were considered, and the linear regression method (LR method) was used to facilitate the evaluation of their prediction accuracy.

Results

Weekly feed intake, average daily gain, metabolic body weight, and backfat thickness measured on 2435 growing French Large White pigs over a 10-week period were analysed using a random regression model. In this population, the 544 dams of the phenotyped animals were genotyped. These dams did not have own phenotypes. The quality of the predictions of SBV and breeding values from summarized phenotypes of these females was evaluated. On average, predictions of SBV at the time of selection were unbiased, slightly over-dispersed and less accurate than those obtained with additional phenotypic information. The use of genomic information did not improve the quality of predictions. The use of summarized instead of longitudinal phenotypes resulted in predictions of breeding values of similar quality.

Conclusions

For practical selection on longitudinal data, the results obtained with this specific design suggest that the use of summarized phenotypes could facilitate routine genetic evaluation of longitudinal traits.
CFVisual: an interactive desktop platform for drawing gene structure and protein architecture
Authors: Chen Huilong , Song Xiaoming , Shang Qian , Feng Shuyan , Ge Weina
Published: May 2022

Background

When researchers perform gene family analysis, they often analyze the structural characteristics of the gene, such as the distribution of introns and exons. At the same time, characteristic structural analysis of amino acid sequence is also essential, for example, motif and domain features. Researchers often integrate these analyses into one image to dig out more information, but the tools responsible for this integration are lacking.

Results

Here, we developed a tool (CFVisual) for drawing gene structure and protein architecture. CFVisual can draw the phylogenetic tree, gene structure, and protein architecture in one picture, and has rich interactive capabilities, which can meet the work needs of researchers. Furthermore, it also supports arbitrary stitching of the above analysis images. It has become a useful helper in gene family analysis. The CFVisual package was implemented in Python and is freely available from https://github.com/ChenHuilong1223/CFVisual/.

Conclusion

CFVisual has been used by some researchers and cited by some articles. In the future, CFVisual will continue to serve as a good helper for researchers in the study of gene structure and protein architecture.
Defining ICD-10 surrogate variables to estimate the modified frailty index: a Delphi-based approach
Authors: Subramaniam Ashwin , Ueno Ryo , Tiruvoipati Ravindranath , Darvall Jai , Srikanth Velandai , Bailey Michael , Pilcher David , Bellomo Rinaldo
Published: May 2022

Background

There are currently no validated globally and freely available tools to estimate the modified frailty index (mFI). The widely available and non-proprietary International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coding could be used as a surrogate for the mFI. We aimed to establish an appropriate set of the ICD-10 codes for comorbidities to be used to estimate the eleven-variable mFI.

Methods

A three-stage, web-based, Delphi consensus-building process among a panel of intensivists and geriatricians using iterative rounds of an online survey, was conducted between March and July 2021. The consensus was set a priori at 75% overall agreement. Additionally, we assessed if survey responses differed between intensivists and geriatricians. Finally, we ascertained the level of agreement.

Results

A total of 21 clinicians participated in all 3 Delphi surveys. Most (86%, 18/21) had more than 5-years’ experience as specialists. The agreement proportionately increased with every Delphi survey. After the third survey, the panel had reached 75% consensus in 87.5% (112/128) of ICD-10 codes. The initially included 128 ICD-10 variables were narrowed down to 54 at the end of the 3 surveys. The inter-rater agreements between intensivists and geriatricians were moderate for surveys 1 and 3 (κ = 0.728, κ = 0.780) respectively, and strong for survey 2 (κ = 0.811).

Conclusions

This quantitative Delphi survey of a panel of experienced intensivists and geriatricians achieved consensus for appropriate ICD-10 codes to estimate the mFI. Future studies should focus on validating the mFI estimated from these ICD-10 codes.

Trial registration

Not applicable.
Development and validation of an ensemble artificial intelligence model for comprehensive imaging quality check to classify body parts and contrast enhancement
Authors: Na Seongwon , Sung Yu Sub , Ko Yousun , Shin Youngbin , Lee Junghyun , Ha Jiyeon , Ham Su Jung , Yoon Kyoungro , Kim Kyung Won
Published: May 2022

Background

Despite the dramatic increase in the use of medical imaging in various therapeutic fields of clinical trials, the first step of image quality check (image QC), which aims to check whether images are uploaded appropriately according to the predefined rules, is still performed manually by image analysts, which requires a lot of manpower and time.

Methods

In this retrospective study, 1669 computed tomography (CT) images with five specific anatomical locations were collected from Asan Medical Center and Kangdong Sacred Heart Hospital. To generate the ground truth, two radiologists reviewed the anatomical locations and presence of contrast enhancement using the collected data. The individual deep learning model is developed through InceptionResNetv2 and transfer learning, and we propose Image Quality Check-Net (Image QC-Net), an ensemble AI model that utilizes it. To evaluate their clinical effectiveness, the overall accuracy and time spent on image quality check of a conventional model and ImageQC-net were compared.

Results

ImageQC-net body part classification showed excellent performance in both internal (precision, 100%; recall, 100% accuracy, 100%) and external verification sets (precision, 99.8%; recovery rate, 99.8%, accuracy, 99.8%). In addition, contrast enhancement classification performance achieved 100% precision, recall, and accuracy in the internal verification set and achieved (precision, 100%; recall, 100%; accuracy 100%) in the external dataset. In the case of clinical effects, the reduction of time by checking the quality of artificial intelligence (AI) support by analysts 1 and 2 (49.7% and 48.3%, respectively) was statistically significant (p < 0.001).

Conclusions

Comprehensive AI techniques to identify body parts and contrast enhancement on CT images are highly accurate and can significantly reduce the time spent on image quality checks.
Quantitative study of the changes in brain white matter before and after radiotherapy by applying multi-sequence MR radiomics
Authors: Chen Mingming , Wang Lizhen , Gong Guanzhong , Yin Yong , Wang Pengcheng
Published: May 2022

Purpose

To analyse the changes in brain white matter before and after radiotherapy (RT) by applying multisequence MR radiomics features and to establish a relationship between the changes in radiomics features and radiation dose.

Methods

Eighty-eight patients with brain tumours who had undergone RT were selected in this study, and MR images (T1, T1+C, T2FLAIR, T2, DWI, and ASL) before and after RT were obtained. The brain white matter was delineated as an ROI under dose gradients of 0–5 Gy, 5–10 Gy, 10–15 Gy, 15–20 Gy, 20–30 Gy, 30–40 Gy, and 40–50 Gy. The radiomics features of each ROI were extracted, and the changes in radiomics features before and after RT for different sequences under different dose gradients were compared.

Results

At each dose gradient, statistically significant features of different MR sequences were mainly concentrated in three dose gradients, 5–10 Gy, 20–30 Gy, and 30–40 Gy. The T1+C sequence held the most features (66) under the 20–30 Gy dose gradient. There were 20 general features at dose gradients of 20–30 Gy, 30–40 Gy, and 40–50 Gy, and the changes in features first decreased and then increased following dose escalation. With dose gradients of 5–10 Gy and 10–15 Gy, only T1 and T2FLAIR had general features, and the rates of change were − 24.57% and − 29.32% for T1 and − 3.08% and − 10.87% for T2FLAIR, respectively. The changes showed an upward trend with increasing doses. For different MR sequences that were analysed under the same dose gradient, all sequences with 5–10 Gy, 20–30 Gy and 30–40 Gy had general features, except the T2FLAIR sequence, which was concentrated in the FirstOrder category feature, and the changes in features of T1 and T1+C were more significant than those of the other sequences.

Conclusions

MR radiomics features revealed microscopic changes in brain white matter before and after RT, although there was no constant dose-effect relationship for each feature. The changes in radiomics features in different sequences could reveal the radiation response of brain white matter to different doses.
Preoperative diagnosis and prediction of microvascular invasion in hepatocellularcarcinoma by ultrasound elastography
Authors: Xu Chengchuan , Jiang Dong , Tan Bibo , Shen Cuiqin , Guo Jia
Published: May 2022

Background

To assess the values of two elastography techniques combined with serological examination and clinical features in preoperative diagnosis of microvascular invasion in HCC patients.

Methods

A total of 74 patients with single Hepatocellular carcinoma (HCC) were included in this study. Shear wave measurement and real-time tissue elastography were used to evaluate the hardness of tumor-adjacent tissues and tumor tissues, as well as the strain rate ratio per lesion before surgery. According to the pathological results, the ultrasound parameters and clinical laboratory indicators related to microvascular invasion were analyzed, and the effectiveness of each parameter in predicting the occurrence of microvascular invasion was compared.

Results

33/74 patients exhibited microvascular invasion. Univariate analysis showed that the hardness of tumor-adjacent tissues (P = 0.003), elastic strain rate ratio (P = 0.032), maximum tumor diameter (P < 0.001), and alpha-fetoprotein (AFP) level (P = 0.007) was significantly different in the patients with and without microvascular invasion. The binary logistic regression analysis showed that the maximum tumor diameter (P = 0.001) was an independent risk factor for predicting microvascular invasion, while the hardness of tumor-adjacent tissues (P = 0.028) was a protective factor. The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the hardness of tumor-adjacent tissues, the maximum diameter of the tumor, and the predictive model Logit(P) in predicting the occurrence of MVI was 0.718, 0.775 and 0.806, respectively.

Conclusion

The hardness of tumor-adjacent tissues, maximum tumor diameter, and the preoperative prediction model predict the occurrence of MVI in HCC patients.
Statins attenuate cholesterol-induced ROS via inhibiting NOX2/NOX4 and mitochondrial pathway in collecting ducts of the kidney
Authors: Wang Ani , Lin Yu , Liang Baien , Zhao Xiaoduo , Qiu Miaojuan , Huang Hui , Li Chunling , Wang Weidong , Kong Yonglun
Published: May 2022

Background

Statins therapy has been primarily recommended for the prevention of cardiovascular risk in patients with chronic kidney diseases. Statins has also been proved some benefits in lipid-induced kidney diseases. The current study aims to investigate the protection and underlying mechanisms of statins on renal tubular injuries induced by cholesterol overloaded.

Methods

We used tubular suspensions of inner medullary collecting duct (IMCD) cells from rat kidneys and mouse collecting duct cell line mpkCCD cells to investigate the effect of statins on reactive oxygen species (ROS) production induced by cholesterol. Protein and mRNA expression of NADPH oxidase 2 (NOX2) /NOX4 was examined by Western blot and RT-PCR in vitro studies and in rats with 5/6 nephrectomy and high-fat diet. Mitochondrial morphology and membrane potential was observed by Mito-tracker and JC-1.

Results

Statins treatment was associated with decreased NOX2 and NOX4 protein expression and mRNA levels in 5/6Nx rats with high-fat diet. Statins treatment markedly reduced the ROS production in IMCD suspensions and mpkCCD cells. Also, statins reduced NOX2 and NOX4 protein expression and mRNA levels in cholesterol overload mpkCCD cells and improved mitochondrial morphology and function.

Conclusion

Statins prevented ROS production induced by cholesterol in the kidney, likely through inhibiting NOXs protein expression and improving mitochondrial function. Statins may be a therapeutic option in treating obesity-associated kidney diseases.
Barriers to quality of life in patients with multiple sclerosis: a qualitative study
Authors: Hosseini Zahra , Homayuni Atefeh , Etemadifar Masoud
Published: May 2022

Background

Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system that affects the patients’ quality of life. This research was conducted with the aim of identifying the barriers of quality of life in patients with MS.

Methods

This qualitative study was conducted through a conventional content analysis approach. We used the purposeful sampling with maximum diversity in terms of gender, age, education, marital status and employment. Data were collected through semi-structured interviews with 18 patients with multiple sclerosis referred to the MS Association of Isfahan. Interviews were conducted to the point of information saturation.

Results

Through the content analysis of the interviews, we identified 2 main categories and 11 sub-categories. The main categories include intrapersonal problems (physical problems, psychological disorders, turbulent future, functional limitations, job loss and pennilessness), and environmental barriers (disease and treatment process, fatigue of caregivers, information deficiency about MS, family tensions, lack of social support and fun and entertainment).

Conclusions

In order to improve the quality of life in these patients, there is a need for attention and practical measures in the field of identified factors. By removing barriers such as providing educational and counseling services to the patients and their families, adapting the urban structure, providing financial support and adequate insurance coverage, the authorities can take measures to ensure patients’ health and improve their quality of life.
Risk of adverse fetal outcomes following nonobstetric surgery during gestation: a nationwide population-based analysis
Authors: Fu Pei-Han , Yu Chia-Hung , Chen Yi-Chen , Chu Chin-Chen , Chen Jen-Yin , Liang Fu-Wen
Published: May 2022

Background

Literature suggests that nonobstetric surgery during gestation is associated with a higher risk of spontaneous abortion, prematurity, and a higher cesarean section rate, but the direct impact on fetal outcomes is still unclear. In this study, we aimed to investigate whether nonobstetric surgery during pregnancy is associated with negative fetal outcomes by analysing a nation-wide database in Taiwan.

Methods

This population-based retrospective observational case–control study was based on the linkage of Taiwan’s National Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database between 2004 and 2014. For every pregnancy with nonobstetric surgery during gestation, four controls were randomly matched according to maternal age and delivery year. We estimated adjusted odds ratios (aOR) and 95% confidence intervals (CIs) of adverse fetal outcomes with the non-surgery group as the reference. The primary outcomes involved stillbirth, prematurity, low birth weight, low Apgar scores, and neonatal and infant death.

Results

Among 23,721 identified pregnancies, 4,747 underwent nonobstetric surgery. Pregnancies with nonobstetric surgery had significantly higher risks of prematurity (aOR: 1.46; 95% CI: 1.31–1.62), lower birth weight (aOR: 1.49; 95% CI: 1.33–1.67), Apgar scores < 7 (1 min, aOR: 1.58; 95% CI: 1.33–1.86; 5 min, aOR: 1.34; 95% CI: 1.03–1.74), neonatal death (aOR: 2.01; 95% CI: 1.18–3.42), and infant death (aOR: 1.69; 95% CI: 1.12–2.54) than those without nonobstetric surgery after adjustment for socioeconomic deprivation, hospital level, and other comorbidities. Surgery performed in the third trimester was associated with a significantly increased rate of prematurity (aOR: 1.38; 95% CI: 1.03–1.85), but lower rates of stillbirth (aOR: 0.1; 95% CI: 0.01–0.75) and Apgar score < 7 at the 5th minute (aOR: 0.2; 95% CI: 0.05–0.82), than surgery performed in the first trimester.

Conclusions

Pregnancies with nonobstetric surgery during gestation were associated with increased risks of prematurity, low birth weight, low Apgar scores, neonatal and infant death, longer admission, and higher medical expenses than those without surgery. Furthermore, surgery in the third trimester was associated with a higher rate of prematurity than surgery performed in the first trimester.

Trial registration

Not applicable.
Identification and validation of TNFRSF4 as a high-profile biomarker for prognosis and immunomodulation in endometrial carcinoma
Authors: Ma Heng , Feng Peng-hui , Yu Shuang-ni , Lu Zhao-hui , Yu Qi , Chen Jie
Published: May 2022

Background

The interaction between tumor microenvironment (TME) and tumors offers various targets in mounting anti-tumor immunotherapies. However, the prognostic biomarkers in endometrial carcinoma (EC) are still limited. Here, we aimed to analyze the TME features and identify novel prognostic biomarkers for EC.

Methods

ESTIMATE, CIBERSORT, protein-protein interaction (PPI) network, univariate and multivariate Cox regression, and functional enrichment analysis were performed to identify immune- and survival-related hub genes as well as possible molecular mechanisms. The limma package and deconvolution algorithm were adopted to estimate the abundance of tumor-infiltrating immune cells (TICs) and their relationship with the target gene. In the validation section, tissue microarrays (TMAs) of EC and multiplex immunohistochemistry (m-IHC) were evaluated to validate the expression of TNFRSF4, and its correlation with immune markers, including CD4, CD8, and FOXP3. Besides, the receiver operating characteristic (ROC) curve was plotted to determine the diagnostic performance of TNFRSF4, CD4, CD8, and FOXP3 in EC.

Results

Two genes, TNFRSF4 and S1PR4, were screened out from 386 intersection differential expression genes (DEGs) shared by ImmuneScore and StromalScore in EC. Highlighted by TNFRSF4, we found that it was not only positively correlated with the TICs (mainly CD4+ T cells, CD8+ T cells, and Tregs) but significantly related to the prognosis in patients of EC, both verified by data from The Cancer Genome Altas (TCGA)-EC database and clinical samples. At the same time, the expression trend of TNFRSF4 was further confirmed by an integrated meta-analysis based on six microarrays from the Gene Expression Omnibus database (GEO).

Conclusions

Collectively, TNFRSF4, a previously unrecognized key player in EC, could serve as a potential biomarker for prognosis prediction and immunomodulation of EC.
Prevalence and risk factors for non-collision injuries among bus commuters in Dar es Salaam, Tanzania
Authors: Lwanga Alan , Mwanga Hussein H. , Mrema Ezra J.
Published: May 2022

Background

Migration of people from rural to urban areas has led to the increase in demand for transportation services in the cities. However, authorities have failed to cope with this problem in a consistently manner. This has led to the increase in non-collision injuries among commuters. This study aimed at investigating the prevalence and risk factors for non-collision injuries among commuters using public transport in Dar es Salaam, Tanzania.

Methods

A cross sectional study was conducted in Dar es Salaam involving 290 commuters from 7 bus routes travelling to and from the city centre using public transport which are privately owned and commonly known as “daladala”. Stratified random sampling was used to sample buses based on the passenger carrying capacity (i.e. 15-24, 25-34 and 35-45 passengers). Systematic random sampling was used to get a total of three commuters from each bus for the interview.

Results

Lifetime prevalence of non-collision injuries was 71%, while these rates were 70 and 39% in the last 12 and 6 months, respectively. Commuters aged between 18 and 28 years experienced non-collision injuries the most (56%) in the last 12 months. Most non-collision injuries occurred on weekdays in the evening from 5:00 pm to 10:00 pm. Strong association was observed between the occurrence of non-collision injuries and commuting time between 5:00 pm to 10:00 pm (adjusted OR = 9.24; 95% CI: 2.68-19.54); boarding and disembarking (adjusted OR = 9.21; 95% CI: 3.77-25.11) and scrambling during boarding (adjusted OR = 5.03; 95% CI: 2.51-21.32). The lower limbs (adjusted OR = 8.64; 95% CI: 2.72-21.76) and the upper limbs (adjusted OR = 13.55; 95% CI: 5.32-33.21) were the most affected body parts.

Conclusions

This study has demonstrated high prevalence of non-collision injuries among commuters using public transport in Dar es Salaam. Travelling in the evening between 5:00 pm to 10:00 pm on the weekdays, boarding and disembarking especially when scrambling for the bus during boarding, overcrowding in the bus especially when the bus is already full with no seats available are the major risk factors for non-collision injuries.
Sexual behaviors at home and abroad: an online survey of Canadian young adult travelers
Authors: Gareau Emmanuelle , Phillips Karen P.
Published: May 2022

Background

For young adults, travel- an accessible and aspirational experience- may be accompanied by high-risk lifestyle behaviors abroad, which in turn, increases the risk of sexually transmitted and blood-borne infections (STBBI). This study aimed to examine sexual and risk behaviors of young Canadian adults both at-home and during international travel.

Methods

Sexually-active Canadians, aged 18-25 years (N = 646) who travelled abroad in 2016, completed an online, cross-sectional survey analyzed by descriptive statistics. Outcome measures included young Canadian adults’ lifestyle risk and sexual behaviors at-home and abroad.

Results

Sexual behaviors, both penetrative and non-penetrative activities, decreased significantly (p < 0.001; McNemar test) abroad compared to at-home. International travel elicited a statistically significant increase in alcohol consumption compared to at-home (Wilcoxon, z = − 11.341, p < 0.001). Partner type (new trip-acquired partner) abroad was associated with a greater number of travel-acquired sexual partners (Mann-Whitney, U = 4901, p < 0.001), inconsistent condom use during penetrative sex (U = 7215, p = 0.009), and sex under the influence of alcohol (Test of Two Proportions, p < 0.001).

Conclusions

Although many young Canadian respondents practiced abstinence in their 2016 travel, for sexually-active travelers, new partner-type was related to high risk sexual behaviors. Young Canadians exhibited sexual risk behaviors both at-home and while travelling; suggesting the need for both domestic and pre-travel sexual health interventions.