bluuebunny/crossref_metadata_2025 huggingface dataset:
How older adults manage misinformation and information overload - A qualitative study
Authors: Vivion M. , Reid V. , Dubé E. , Coutant A. , Benoit A. , Tourigny A.
Published: March 2024

Background

The COVID-19 pandemic was characterized by an abundance of information, some of it reliable and some of it misinformation. Evidence-based data on the impact of misinformation on attitudes and behaviours remains limited. Studies indicate that older adults are more likely to embrace and disseminate misinformation than other population groups, making them vulnerable to misinformation. The purpose of this article is to explore the effects of misinformation and information overload on older adults, and to present the management strategies put in place to deal with such effects, in the context of COVID-19.

Methods

A qualitative exploratory approach was adopted to conduct this research. A total of 36 semi-structured interviews were conducted with older adults living in Quebec, Canada. The interviews were fully transcribed and subjected to a thematic content analysis.

Results

Participants said they could easily spot misinformation online. Despite this, misinformation and its treatment by the media could generate fear, stress and anxiety. Moreover, the polarization induced by misinformation resulted in tensions and even friendship breakdowns. Participants also denounced the information overload produced largely by the media. To this end, the participants set up information routines targeting the sources of information and the times at which they consulted the information.

Conclusions

This article questions the concept of vulnerability to misinformation by highlighting older adults’ agency in managing misinformation and information overload. Furthermore, this study invites us to rethink communication strategies by distinguishing between information overload and misinformation.
The validity of the Physical Literacy in Children Questionnaire in children aged 4 to 12
Authors: Diao Yucui , Wang Li , Chen Sitong , Barnett Lisa M. , Mazzoli Emiliano , Essiet Inimfon A. , Wang Xiaofen , Wang Lei , Zhao Yaping , Li Xuanxi , Li Jing
Published: March 2024

Background

Given the growing evidence on the health benefits associated with physical literacy (PL), it is necessary to develop sound measures to assess the levels of PL in children. The Physical Literacy in Children Questionnaire (PL-C Quest) is the first self-report pictorial-based scale to assess children’s perceived PL. It has good validity and reliability in Australian children aged 7 to 12 years, but little is known in younger children and in other cultural contexts. The aim of this study was to examine the validity and reliability in an expanded age range.

Methods

A total of 1,870 Chinese children (girls, n = 871; 46.6%), aged 4 to 12 years (M = 8.07 ± 2.42) participated in validity testing. Structural equation modeling with the Weighted Least Squares with Mean and Variance approach was used to assess construct validity. The hypothesized theoretical model used the 30 items and four hypothesized factors: physical, psychological, social and cognitive capabilities. Multigroup confirmatory factor analysis was used to assess sex and age group (4–6 years, 7–9 years and 10–12 years) measurement invariance. Internal consistency analyses were conducted using polychoric alpha. A random subsample (n = 262) was selected to determine test–retest reliability using Intra-Class Correlations (ICC).

Results

All items except one (moving with equipment–skateboarding) loaded on sub-domains with λ > 0.45. The hypothesized model had a good fit (CFI = 0.954, TLI = 0.950, RMSEA = 0.042), with measurement equivalence across sex and age groups separately. Internal consistency values were good to excellent (overall: α = 0.94; physical: α = 0.86; psychological: α = 0.83; social: α = 0.81; cognitive: α = 0.86). Test–retest reliability was adequate to excellent (overall: ICC = 0.90, physical: ICC = 0.86, psychological: ICC = 0.75, social: ICC = 0.71, cognitive: ICC = 0.72).

Conclusion

The Chinese version of the PL-C Quest is valid and reliable for testing the self-reported PL of Chinese children aged 4 to 12. This study provides the first evidence of validity for this tool in children aged 4–6 years and also evidence that the PL-C Quest would be a meaningful instrument to assess PL in Chinese children.
Stable elastic nail application with poller K-wire for Irreducible distal radius metaphyseal-diaphyseal Junction fractures in preadolescents: a new operative technique
Authors: Horoz Levent , Cakmak Mehmet Fevzi , Kircil Cihan
Published: March 2024

Background

Surgical treatment of irreducible distal radius diaphyseal- metaphyseal junction fractures involves difficulties as the fracture remains too proximal for K-wire fixation and too distal for the elastic stable intramedullary nail. Our study aims to present the clinical results of applying an elastic stable intramedullary nail with a poller K-wire to achieve both reduction and stable fixation.

Patients and methods

A retrospective analysis was performed on 26 patients who underwent ESIN with a poller K-wire for distal radius diaphyseal-metaphyseal region fracture. Reduction parameters such as residual angulation and alignment were evaluated on postoperative follow-up radiographs. Changes in angular and alignment parameters on follow-up radiographs were recorded. Wrist and forearm functions were evaluated at the last follow-up.

Result

There were 17 male and nine female patients with an average age of 10.9. The residual angulation in coronal and sagittal planes on immediate postoperative radiographs was 4.0 ± 1.62° and 3.0 ± 1.26°, respectively. The mean translation rate on immediate postoperative radiographs was 6.0 ± 1.98% and 5.0 ± 2.02% in the coronal and sagittal planes, respectively. No change was observed in translation rates in the last follow-ups. The mean angulation in the coronal and sagittal planes measured on 6th-week radiographs was 4.0 ± 1.72°and 3.0 ± 1.16°, respectively. No significant difference was observed in angular changes in the sagittal and coronal planes at the last follow-up (p > 0.05). No tendon injury or neurovascular injury was observed in any of the patients.

Conclusion

In the surgical treatment of pediatric DRDMJ fractures, applying ESIN with poller K-wire is an effective, safe, and novel method for achieving reduction and stable fixation.
Finite element analysis of stress distribution on residual root structure in socket shield procedure following immediate dental implant placement: an in vitro study
Authors: Shinde Aniket , Madhav V.N.V , Saini Ravinder S , Gurumurthy Vishwanath , Binduhayyim Rayan Ibrahim H , Mosaddad Seyed Ali , Heboyan Artak
Published: March 2024

Background

The success of implants in the socket shield technique relies on stress experienced by root fragments within the socket. Although there is no consensus on optimal root fragment thickness, varying thicknesses and dynamic implant placement induce stress in various directions and degrees. This study aimed to assess biomechanical response and stress distribution across different root fragment thicknesses in the socket shield procedure.

Methods

This in vitro study was conducted to assess and compare the stress distribution on residual root structures of varying thicknesses positioned within the labial aspect of the maxillary incisor socket during immediate implant placement of standard dimensions. The procedure involved applying an insertional torque of 40 Ncm, and the analysis was conducted using finite element analysis software.

Results

Utilizing the Numerical Technique with Abaqus software for explicit dynamics, von Mises stress and principal strain were analyzed on the root structure and bone under nonlinear contact conditions during implant torque application. For Model A, a loading torque of 40 Ncm was applied vertically on the implant, along with a horizontal force of 20 N on the root structure and bone. Results indicated maximum stress of 12.68 MPa on the root structure with a thickness of 0.5 mm and 5.61 MPa on the bone, with principal strains of 6.82E-03 and 4.10E-03, respectively. In Model B, with a root structure thickness of 1.0 mm, the maximum stress increased to 19.70 MPa, while the bone stress rose to 9.51 MPa, with principal strains of 1.03E-02 and 6.09E-03. Model C, with a root structure thickness of 1.5 mm, exhibited a maximum stress of 21.58 MPa on the root and 10.12 MPa on the bone, with principal strains of 1.16E-02 and 6.10E-03. Lastly, in Model D, with a root structure thickness of 2.0 mm, the maximum stress on the root structure and bone escalated to 28.74 MPa and 11.38 MPa, respectively, with principal strains of 1.55E-02 and 8.31E-03.

Conclusions

As the thickness of the shield increases (ranging from 0.5 to 2 mm) in socket shield procedures with immediate implant placement, both stress on the root fragment and bone and principal micro-strain escalate. However, employing a shield thickness within the range of 0.5 to 2 mm does not lead to any adverse stress generation on the residual root fragment. However, for enhanced safety, it is recommended to restrict the maximum diameter and extension of the root fragment to 1.5 mm when considering implant sizes and socket diameter for the socket shield technique.
Association of tet methylcytosine dioxygenase 2 and 5-hydroxymethylcytosine in endometrioid adenocarcinoma and its clinical significance
Authors: Kuang Lei , Zhang Jingbo , Li Yanyu , Wang Qing , Liu Jianwei , Zhang Bei
Published: March 2024

Background

Aberrant DNA methylation is a vital molecular alteration commonly detected in type I endometrial cancers (EC), and tet methylcytosine dioxygenase 2 (TET2) and 5-hydroxymethylcytosine (5hmC) play significant roles in DNA demethylation. However, little is known about the function and correlation of TET2 and 5hmC co-expressed in EC. This study intended to investigate the clinical significance of TET2 and 5hmC in EC.

Methods

The levels of TET2 and 5hmC were detected in 326 endometrial tissues by immumohistochemistry, and the correlation of their level was detected by Pearson analysis. The association between the levels of TET2 and 5hmC and clinicopathologic characteristics was analyzed. Prognostic value of TET2 and 5hmC was explored by Kaplan–Meier analysis. The Cox proportional hazard regression model was used for univariate and multivariate analyses.

Results

Based on the analysis results, TET2 protein level was positively correlated with 5hmC level in EC tissues (r = 0.801, P < 0.001). TET2+5hmC+ (high TET2 and high 5hmC) association was significantly associated with well differentiation, myometrial invasion, negative lymph node metastasis, and tumor stage in EC. Association of TET2 and 5hmC was confirmed as a prognostic factor (HR = 2.843, 95%CI = 1.226–3.605, P = 0.007) for EC patients, and EC patients with TET2−5hmC− level had poor overall survival.

Conclusions

In summary, the association of TET2 and 5hmC was downregulated in EC tissues, and may be a potential poor prognostic indicator for EC patients. Combined detection of TET2 and 5hmC may be valuable for the diagnosis and prognosis of EC.
An Effective Methodology for Scoring to Assist Emergency Physicians in Identifying Overcrowding in an Academic Emergency Department in Thailand
Authors: Nan Sukumpat Na , Wittayachamnankul Borwon , Wongtanasarasin Wachira , Tangsuwanaruk Theerapon , Sutham Krongkarn , Thinnukool Orawit
Published: March 2024

Background

Emergency Department (ED) overcrowding is a global concern, with tools like NEDOCS, READI, and Work Score used as predictors. These tools aid healthcare professionals in identifying overcrowding and preventing negative patient outcomes. However, there’s no agreed-upon method to define ED overcrowding. Most studies on this topic are U.S.-based, limiting their applicability in EDs without waiting rooms or ambulance diversion roles. Additionally, the intricate calculations required for these scores, with multiple variables, make them impractical for use in developing nations.

Objective

This study sought to examine the relationship between prevalent ED overcrowding scores such as EDWIN, occupancy rate, and Work Score, and a modified version of EDWIN newly introduced by the authors, in comparison to the real-time perspectives of emergency physicians. Additionally, the study explored the links between these overcrowding scores and adverse events related to ED code activations as secondary outcomes.

Method

The method described in the provided text is a correlational study. The study aims to examine the relationship between various Emergency Department (ED) overcrowding scores and the real-time perceptions of emergency physicians in every two-hour period. Additionally, it seeks to explore the associations between these scores and adverse events related to ED code activations.

Results

The study analyzed 459 periods, with 5.2% having Likert scores of 5–6. EDOR had the highest correlation coefficient (0.69, p < 0.001) and an AUC of 0.864. Only EDOR significantly correlated with adverse events (p = 0.033).

Conclusion

EDOR shows the most robust link with ‘emergency physicians’ views on overcrowding. Additionally, elevated EDOR scores correlate with a rise in adverse events. Emergency physicians’ perceptionof overcrowding could hint at possible adverse events. Notably, all overcrowding scores have high negative predictive values, efficiently negating the likelihood of adverse incidents.
Systems approaches to scaling up: a systematic review and narrative synthesis of evidence for physical activity and other behavioural non-communicable disease risk factors
Authors: Koorts Harriet , Ma Jiani , Swain Christopher T. V. , Rutter Harry , Salmon Jo , Bolton Kristy A.
Published: March 2024

Background

Non-communicable diseases (NCDs) are the leading causes of death worldwide. Systems approaches have potential for creating sustainable outcomes at scale but have rarely been used to support scale up in physical activity/nutrition promotion or NCD prevention more generally. This review aimed to: (i) synthesise evidence on the use of systems approaches in scaling up interventions targeting four behavioural risk factors for NCDs; and (ii) to explore how systems approaches have been conceptualised and used in intervention implementation and scale up.

Method

Seven electronic databases were searched for studies published 2016–2021. Eligible studies targeted at least one of four NCD behavioural risk factors (physical inactivity, tobacco use, alcohol consumption, diet), or described evaluation of an intervention planned for or scaled up. Studies were categorised as having a (i) high, (ii) moderate, or (iii) no use of a systems approach. A narrative synthesis of how systems approaches had been operationalised in scale up, following PRISMA guidelines.

Results

Twenty-one intervention studies were included. Only 19% (n = 4) of interventions explicitly used systems thinking to inform intervention design, implementation and scale up (targeting all four risk factors n = 2, diet n = 1, tobacco use n = 1). Five studies (‘high use’) planned and implemented scale up with an explicit focus on relations between system elements and used system changes to drive impact at scale. Seven studies (‘moderate use’) considered systems elements impacting scale-up processes or outcomes but did not require achieving system-level changes from the outset. Nine studies (‘no use’) were designed to work at multiple levels among multiple agencies in an intervention setting, but the complexity of the system and relations between system elements was not articulated. We synthesised reported barriers and facilitators to scaling up, and how studies within each group conceptualised and used systems approaches, and methods, frameworks and principles for scaling up.

Conclusion

In physical activity research, and NCD prevention more broadly, the use of systems approaches in scale up remains in its infancy. For researchers, practitioners and policymakers wishing to adopt systems approaches to intervention implementation at scale, guidance is needed on how to communicate and operationalise systems approaches in research and in practice.

Trial registration

PROSPERO (CRD42021287265).
Changes in the innate immune response to SARS-CoV-2 with advancing age in humans
Authors: Agrawal Sudhanshu , Tran Michelle Thu , Jennings Tara Sinta Kartika , Soliman Marlaine Maged Hosny , Heo Sally , Sasson Bobby , Rahmatpanah Farah , Agrawal Anshu
Published: March 2024

Background

Advancing age is a major risk factor for respiratory viral infections. The infections are often prolonged and difficult to resolve resulting hospitalizations and mortality. The recent COVID-19 pandemic has highlighted this as elderly subjects have emerged as vulnerable populations that display increased susceptibility and severity to SARS-CoV-2. There is an urgent need to identify the probable mechanisms underlying this to protect against future outbreaks of such nature. Innate immunity is the first line of defense against viruses and its decline impacts downstream immune responses. This is because dendritic cells (DCs) and macrophages are key cellular elements of the innate immune system that can sense and respond to viruses by producing inflammatory mediators and priming CD4 and CD8 T-cell responses.

Results

We investigated the changes in innate immune responses to SARS-CoV-2 as a function of age. Our results using human PBMCs from aged, middle-aged, and young subjects indicate that the activation of DCs and monocytes in response to SARS-CoV-2 is compromised with age. The impairment is most apparent in pDCs where both aged and middle-aged display reduced responses. The secretion of IL-29 that confers protection against respiratory viruses is also decreased in both aged and middle-aged subjects. In contrast, inflammatory mediators associated with severe COVID-19 including CXCL-8, TREM-1 are increased with age. This is also apparent in the gene expression data where pathways related host defense display an age dependent decrease with a concomitant increase in inflammatory pathways. Not only are the inflammatory pathways and mediators increased after stimulation with SARS-CoV-2 but also at homeostasis. In keeping with reduced DC activation, the induction of cytotoxic CD8 T cells is also impaired in aged subjects. However, the CD8 T cells from aged subjects display increased baseline activation in accordance with the enhanced baseline inflammation.

Conclusions

Our results demonstrate a decline in protective anti-viral immune responses and increase in damaging inflammatory responses with age indicating that dysregulated innate immune responses play a significant role in the increased susceptibility of aged subjects to COVID-19. Furthermore, the dysregulation in immune responses develops early on as middle-aged demonstrate several of these changes.

Graphical abstract
Hypermethylation of the glutathione peroxidase 4 gene promoter is associated with the occurrence of immune tolerance phase in chronic hepatitis B
Authors: Su Xing , Wang Zhaohui , Li Jihui , Gao Shuai , Fan Yuchen , Wang Kai
Published: March 2024

Background

Hepatitis B virus (HBV) infection is a public health problem that seriously threatens human health. This study aimed to investigate the clinical significance of glutathione peroxidase 4(GPX4) in the occurrence and development of chronic hepatitis B (CHB).

Methods

A total of 169 participants including 137 patients with CHB and 32 healthy controls (HCs) were recruited. We detected the expression of GPX4 and stimulator of interferon genes (STING) in peripheral blood mononuclear cells (PBMCs) by real-time quantitative polymerase chain reaction (RT-qPCR). The methylation level of GPX4 gene promoter in PBMCs was detected by TaqMan probe-based quantitative methylation-specific PCR (MethyLight). Enzyme-linked immunosorbent assay (ELISA) was performed to detect the serum levels of GPX4, IFN-β, oxidative stress (OS) related molecules, and pro-inflammatory cytokines.

Results

The expression levels of GPX4 in PBMCs and serum of CHB patients were lower than those of HCs, but the methylation levels of GPX4 promoter were higher than those of HCs, especially in patients at the immune tolerance phase. STING mRNA expression levels in PBMCs and serum IFN-β levels of patients at the immune activation phase and reactivation phase of CHB were higher than those at other clinical phases of CHB and HCs. GPX4 mRNA expression level and methylation level in PBMCs from patients with CHB had a certain correlation with STING and IFN-β expression levels. In addition, the methylation level of the GPX4 promoter in PBMCs from patients with CHB was correlated with molecules associated with OS and inflammation.

Conclusions

GPX4 may play an important role in the pathogenesis and immune tolerance of CHB, which may provide new ideas for the functional cure of CHB.
Multiply restimulated human cord blood-derived Tregs maintain stabilized phenotype and suppressive function and predict their therapeutic effects on autoimmune diabetes
Authors: Bi Yuanjie , Kong Ran , Peng Yani , Cai Donghua , Zhang Yu , Yang Fan , Li Xia , Deng Wen , Liu Fang , He Binbin , Cao Chuqing , Deng Chao , Tang Xiaohan , Fan Li , Yu Haibo , Zhou Zhiguang
Published: March 2024

Background

Regulatory T cells (Tregs) are involved in the maintenance of immune homeostasis and immune regulation. Clinical trials on the adoptive transfer of Tregs have been ongoing for > 10 years. However, many unresolved issues remain in the production of readymade Treg products and selection of patients. Hence, this study aimed to develop a method to expand off-the-shelf Tregs derived from umbilical cord blood (UCB-Tregs) in vitro without changing their phenotype and inhibitory function. In addition, the study intended to design an approach to precisely select patients who are more likely to benefit from the adoptive Treg transfer therapy.

Methods

UCB-Tregs were isolated and cultured in a medium containing human recombinant IL-2 and rapamycin and then multiply restimulated with human T-activator CD3/CD28 dynabeads. The phenotype and suppressive capacity of Tregs were assessed on days 18 and 42. The relationship between the suppressive function of UCB-Tregs in vitro and clinical indicators was analyzed, and the ability of the in vitro suppressive capacity to predict the in vivo therapeutic effects was evaluated.

Results

UCB-Tregs expanded 123-fold and 5,981-fold at 18 and 42 days, respectively. The suppressive function of UCB-Tregs on the proliferation of immune cells at 42 days was not significantly different compared with that of UCB-Tregs obtained at 18 days. The suppression rate of UCB-Tregs to PBMCs was negatively correlated with the course of diabetes. Moreover, the high-suppression group exhibited a better treatment response than the low-suppression group during the 12-month follow-up period.

Conclusions

Multiply restimulated UCB-Tregs expanded at a large scale without any alterations in their classical phenotypic features and inhibitory functions. The suppressive function of Tregs in vitro was negatively correlated with the disease duration. The present study revealed the possibility of predicting the in vivo therapeutic effects via the in vitro inhibition assay. Thus, these findings provided a method to obtain off-the-shelf Treg products and facilitated the selection of patients who are likely to respond to the treatment, thereby moving toward the goal of precision treatment.
Explicable prioritization of genetic variants by integration of rule-based and machine learning algorithms for diagnosis of rare Mendelian disorders
Authors: Kim Ho Heon , Kim Dong-Wook , Woo Junwoo , Lee Kyoungyeul
Published: March 2024

Background

In the process of finding the causative variant of rare diseases, accurate assessment and prioritization of genetic variants is essential. Previous variant prioritization tools mainly depend on the in-silico prediction of the pathogenicity of variants, which results in low sensitivity and difficulty in interpreting the prioritization result. In this study, we propose an explainable algorithm for variant prioritization, named 3ASC, with higher sensitivity and ability to annotate evidence used for prioritization. 3ASC annotates each variant with the 28 criteria defined by the ACMG/AMP genome interpretation guidelines and features related to the clinical interpretation of the variants. The system can explain the result based on annotated evidence and feature contributions.

Results

We trained various machine learning algorithms using in-house patient data. The performance of variant ranking was assessed using the recall rate of identifying causative variants in the top-ranked variants. The best practice model was a random forest classifier that showed top 1 recall of 85.6% and top 3 recall of 94.4%. The 3ASC annotates the ACMG/AMP criteria for each genetic variant of a patient so that clinical geneticists can interpret the result as in the CAGI6 SickKids challenge. In the challenge, 3ASC identified causal genes for 10 out of 14 patient cases, with evidence of decreased gene expression for 6 cases. Among them, two genes (HDAC8 and CASK) had decreased gene expression profiles confirmed by transcriptome data.

Conclusions

3ASC can prioritize genetic variants with higher sensitivity compared to previous methods by integrating various features related to clinical interpretation, including features related to false positive risk such as quality control and disease inheritance pattern. The system allows interpretation of each variant based on the ACMG/AMP criteria and feature contribution assessed using explainable AI techniques.
Mussel-inspired resilient hydrogels with strong skin adhesion and high-sensitivity for wearable device
Authors: Kondaveeti Stalin , Choi Geonjun , Veerla Sarath Chandra , Kim Somi , Kim Jaeil , Lee Hee Jin , Kuzhiumparambil Unnikrishnan , Ralph Peter J. , Yeo Junyeob , Jeong Hoon Eui
Published: March 2024

Stretchable and self-adhesive conductive hydrogels hold significant importance across a wide spectrum of applications, including human–machine interfaces, wearable devices, and soft robotics. However, integrating multiple properties, such as high stretchability, strong interfacial adhesion, self-healing capability, and sensitivity, into a single material poses significant technical challenges. Herein, we present a multifunctional conductive hydrogel based on poly(acrylic acid) (PAA), dopamine-functionalized pectin (PT-DA), polydopamine-coated reduction graphene oxide (rGO-PDA), and Fe3+ as an ionic cross-linker. This hydrogel exhibits a combination of high stretchability (2000%), rapid self-healing (~ 94% recovery in 5 s), and robust self-adhesion to various substrates. Notably, the hydrogel demonstrates a remarkable skin adhesion strength of 85 kPa, surpassing previous skin adhesive hydrogels. Furthermore, incorporating rGO within the hydrogel network creates electric pathways, ensuring excellent conductivity (0.56 S m–1). Consequently, these conductive hydrogels exhibit strain-sensing properties with a significant increase in gauge factor (GF) of 14.6, covering an extensive detection range of ~ 1000%, fast response (198 ms) and exceptional cycle stability. These multifunctional hydrogels can be seamlessly integrated into motion detection sensors capable of distinguishing between various strong or subtle movements of the human body.
Effectiveness and safety of biological and target synthetic drugs treatment for psoriatic arthritis: a systematic review with network meta-analysis
Authors: Montezuma Thais , Probst Livia Fernandes , Almeida Matheus Oliveira
Published: March 2024

Background

Psoriatic arthritis (PA) is a chronic inflammatory systemic arthritis that can result in loss of functional capacity and joint deformation. This systematic review assessed the effectiveness and safety of biological and target synthetic drugs for treating PA.

Methods

We searched for randomized clinical trials (RCTs) that evaluated the use of Adalimumab, Etanercept, Infliximab, Golimumab, Secukinumab, Certolizumab Pegol and Tofacitinib in the main general databases and clinical trial registers databases. The primary outcomes were ACR 50, PsARC, and serious adverse events. Two independent reviewers performed study selection and data extraction. Network meta-analyses were conducted using a random effects model and frequentist approach. The CINeMA software was used to assess the certainty of evidence.

Results

We included 33 RCTs (n = 11,034). The results from the network meta-analysis for the ACR 50 at 6-months follow-up showed that all drugs were superior to placebo, with Secukinumab (high certainty of evidence), Infliximab (very low certainty of evidence) and Adalimumab (high certainty of evidence) ranking the highest. Regarding the PsARC (at 6-months follow-up), all drugs, except for Golimumab (very low certainty of evidence), were superior to placebo, with Etanercept (low certainty of evidence), Infliximab (low certainty of evidence) and Certolizumab Pegol (low certainty of evidence) being the most effective drugs. There were no significant differences in the risk of serious adverse events between the drugs and placebo. Golimumab (very low certainty of evidence), Secukinumab (low certainty of evidence), and Adalimumab (very low certainty of evidence) ranked the highest for safety.

Conclusions

In conclusion, based on the balance between efficacy and safety, Secukinumab and Adalimumab may be the preferred options among the evaluated drugs for treating patients with PsA. However, caution is necessary when interpreting the safety findings, as they are supported by evidence of low to very low certainty. Consequently, the balance between benefits and potential risks may change as new safety evaluation studies become available.

Protocol registration

PROSPERO: CRD42022315577
Isolation and identification of associated endophytic bacteria from barely seeds harbour non-ribosomal peptides and enhance tolerance to salinity stress
Authors: Hussein Walaa , Ramadan Walaa A. , Ibrahim Hayam F.
Published: March 2024

Background

Barely Hordeum vulgare L. is considered one of the most important cereal crops with economic and industrial importance in the world, but its productivity is affected by climate change and abiotic stresses. One of the most recent and important microbiological promising aspects is the use of associated microorganisms, especially the endophytic bacteria producers for non-ribosomal peptides which play an important role in promoting plant growth, productivity, and tolerance to biotic and abiotic stresses. This work aims to identify vertically transferred or inherited endophytic bacterial communities in barely seeds, detect the presence of non-ribosomal peptides from these isolated endophytic strains and study their effect on protein patterns as a response to salinity stress.

Results

From two different tolerant (Giza 126) and sensitive (Giza 123) barely seeds cultivars, six different endophytic bacterial strains were isolated and identified using 16S rRNA. Bacterial strains belonged to Bacillus, Paenibacillus, Staphylococcus and Acinetobacter genera. Three of them have been isolated from both sensitive and tolerant barely cultivar (Uncultured Staphylococcus, Acinetobacter and Priestia endophytica or Bacillus endophyticus), while the other three endophytes have been isolated uniquely from the tolerant barely cultivar (Paenibacillus glucanolyticus, Bacillus cereus and Bacillus sp.). Non-ribosomal peptide synthetases genes NRPs of two lipopeptide families; surfactins and kurstakins have been detected using both bioinformatic analysis and degenerate primers. On the other hand, fragments similar to NRPs genes might be considered new NRPS molecules in Paenibacillus glucanolyticus, Acinetobacter and Priestia endophytica which have been detected using degenerate primers and required whole genome sequencing. The effect of soaking barely seeds exposed to 2.5% NaCl using SDS-PAGE electrophoresis revealed the presence of 24 bands, 10 of them were monomorphic with 41.5%, and 14 were polymorphic with 58.5% polymorphism.

Conclusion

The overnight soaking and co-cultivation of isolated endophytic strains with barely seeds before planting proved their capability in conferring salt stress tolerance to barely seedlings which appeared in protein patterns. We could consider these barely seeds endophytic among the PGPR strains promising to improve plant growth during abiotic stresses.
Performance analysis of deep learning-based object detection algorithms on COCO benchmark: a comparative study
Authors: Tian Jiya , Jin Qiangshan , Wang Yizong , Yang Jie , Zhang Shuping , Sun Dengxun
Published: March 2024

This paper thoroughly explores the role of object detection in smart cities, specifically focusing on advancements in deep learning-based methods. Deep learning models gain popularity for their autonomous feature learning, surpassing traditional approaches. Despite progress, challenges remain, such as achieving high accuracy in urban scenes and meeting real-time requirements. The study aims to contribute by analyzing state-of-the-art deep learning algorithms, identifying accurate models for smart cities, and evaluating real-time performance using the Average Precision at Medium Intersection over Union (IoU) metric. The reported results showcase various algorithms’ performance, with Dynamic Head (DyHead) emerging as the top scorer, excelling in accurately localizing and classifying objects. Its high precision and recall at medium IoU thresholds signify robustness. The paper suggests considering the mean Average Precision (mAP) metric for a comprehensive evaluation across IoU thresholds, if available. Despite this, DyHead stands out as the superior algorithm, particularly at medium IoU thresholds, making it suitable for precise object detection in smart city applications. The performance analysis using Average Precision at Medium IoU is reinforced by the Average Precision at Low IoU (APL), consistently depicting DyHead’s superiority. These findings provide valuable insights for researchers and practitioners, guiding them toward employing DyHead for tasks prioritizing accurate object localization and classification in smart cities. Overall, the paper navigates through the complexities of object detection in urban environments, presenting DyHead as a leading solution with robust performance metrics.
Increasing Annual Cancer Incidence in Patients Age 20-49 Years: A Real-Data Study
Authors: Ribelles Nuria , Pascual Javier , Galvez-Carvajal Laura , Ruiz-Medina Sofía , Garcia-Corbacho Javier , Benitez Jose Carlos , Dominguez-Recio Maria Emilia , Torres Esperanza , Oliva Lucia , Zalabardo Manuel , Rueda Antonio , Alba Emilio
Published: March 2024

PURPOSE

Data from population-based studies have shown an increased incidence of certain types of neoplasms in patients younger than 50 years (early-onset cancer [EOC]); however, little information is derived from other real-world data sources. In a nonpopulation registry, we analyzed changes in the incidence of several neoplasms in successive generations.

METHODS

This cross-sectional study included all patients with a cancer diagnosis registered in one university hospital in Málaga, Spain, between 1998 and 2021, and 18 neoplasms were analyzed. For each neoplasm, the proportion of patients younger than 50 years and age 50 years and older (late-onset cancer [LOC]) of the total number of patients diagnosed each year was determined. In addition, the age limit was lowered to 45-40 years. Changes in these proportions between each year and the following year were assessed by calculating the annual percentage change (APC), and a final assessment of these changes was performed by determining the average APC (AAPC).

RESULTS

Of the 24,596 patients, 5,466 (22.2%) had EOC, and 19,130 (77.8%) had LOC. The incidence of all tumors increased throughout the study period in both age groups. The AAPC increase was higher in patients with EOC than in those with LOC for the following neoplasms: head and neck (6.1% v 4.6%), colon (11.0% v 8.2%), testicular (16.3% v –13.1%), non-Hodgkin lymphoma (8.4% v 5.9%), rectum (16.1% v 6.8%), kidney (27.8% v 20.1%), and sarcoma (43.4% v 28.6%). This increase was confirmed in patients younger than 45 years and 40 years.

CONCLUSION

Our results are consistent with the data published for most tumor sites analyzed. This global public health problem requires the utmost attention to decrease excess cancer in young patients.
Human Papillomavirus–Attributable Head and Neck Cancers in India—A Systematic Review and Meta-Analysis
Authors: Vani Nandimandalam Venkata , Rama Ranganathan , Madhanagopal Rajendran , Vijayalakshmi Ramshankar , Swaminathan Rajaraman
Published: March 2024

PURPOSE

Head and neck cancer accounts for about one third of the global burden in India. Mucosal high-risk human papillomavirus (HPV) has been hypothesized as a contributory risk factor for head and neck cancer (HNC) but its prevalence in Indian patients is not well established. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of HPV in HNC in India and their attributable fraction by considering the biomarkers of carcinogenesis, p16, and HPV E6/E7 mRNA.

METHODS

A systematic literature search was done in Medline via PubMed, Embase, Scopus, ScienceDirect, ProQuest, and Cochrane to identify studies on HPV and HNC in the Indian population, published between January 1990 and October 2022. Fifty-four eligible studies were identified and relevant clinical information was collected. Meta-analysis was conducted to estimate the pooled prevalence of HPV DNA, p16INK4a, and E6/E7 mRNA percent positivity by random-effect logistic regression model using Metapreg, STATA 18.

RESULTS

Thirty-four high-quality studies were taken for meta-analysis. The pooled prevalence of HPV in HNC was 20% (95% CI, 12 to 32) with a high level of heterogeneity ( I2 = 90.79%). The proportion of HPV in oropharyngeal cancer (OPC; 22% [95% CI, 13 to 34]) and laryngeal cancer (LC; 29% [95% CI, 17 to 46]) was higher than in oral cancer (OC; 16% [95% CI, 8 to 30]). The HPV-attributable fraction of OPC, considering the E6/E7 mRNA and p16 positivity, was 12.54% and 9.68%, respectively, almost similar to LC (11.6% and 9.57%), while it was much lower in OC (3.36% and 4%).

CONCLUSION

The HPV-attributable fraction is considerably lower for OC, suggesting a negligible causative role of HPV in OC. A significant proportion of OPC and LC are attributed to HPV; however, their exact causative role is unclear because of the presence of other known risk factors.
High Concordance of Different Assays in the Determination of Homologous Recombination Deficiency–Associated Genomic Instability in Ovarian Cancer
Authors: Pfarr Nicole , von Schwarzenberg Karin , Zocholl Dario , Merkelbach-Bruse Sabine , Siemanowski Janna , Mayr Eva-Maria , Herold Sylvia , Kleo Karsten , Heukamp Lukas C. , Willing Eva-Maria , Menzel Michael , Lehmann Ulrich , Bartels Stephan , Chakraborty Shounak , Baretton Gustavo , Demes Melanie C. , Döring Claudia , Kazdal Daniel , Budczies Jan , Rad Roland , Wild Peter , Christinat Yann , McKee Thomas , Schirmacher Peter , Horst David , Büttner Reinhard , Stenzinger Albrecht , Sehouli Jalid , Vollbrecht Claudia , Hummel Michael , Braicu Elena I. , Weichert Wilko ,   on behalf of the German HRD assay Harmonization Consortium
Published: March 2024

PURPOSE

Poly(ADP-ribose) polymerase inhibitors (PARPi) have shown promising clinical results in the treatment of ovarian cancer. Analysis of biomarker subgroups consistently revealed higher benefits for patients with homologous recombination deficiency (HRD). The test that is most often used for the detection of HRD in clinical studies is the Myriad myChoice assay. However, other assays can also be used to assess biomarkers, which are indicative of HRD, genomic instability (GI), and BRCA1/ 2 mutation status. Many of these assays have high potential to be broadly applied in clinical routine diagnostics in a time-effective decentralized manner. Here, we compare the performance of a multitude of alternative assays in comparison with Myriad myChoice in high-grade serous ovarian cancer (HGSOC).

METHODS

DNA from HGSOC samples was extracted from formalin-fixed paraffin-embedded tissue blocks of cases previously run with the Myriad myChoice assay, and GI was measured by multiple molecular assays (CytoSNP, AmoyDx, Illumina TSO500 HRD, OncoScan, NOGGO GISv1, QIAseq HRD Panel and whole genome sequencing), applying different bioinformatics algorithms.

RESULTS

Application of different assays to assess GI, including Myriad myChoice, revealed high concordance of the generated scores ranging from very substantial to nearly perfect fit, depending on the assay and bioinformatics pipelines applied. Interlaboratory comparison of assays also showed high concordance of GI scores.

CONCLUSION

Assays for GI assessment not only show a high concordance with each other but also in correlation with Myriad myChoice. Thus, almost all of the assays included here can be used effectively to assess HRD-associated GI in the clinical setting. This is important as PARPi treatment on the basis of these tests is compliant with European Medicines Agency approvals, which are methodologically not test-bound.
Identifying Oncology Clinical Trial Candidates Using Artificial Intelligence Predictions of Treatment Change: A Pilot Implementation Study
Authors: Kehl Kenneth L. , Mazor Tali , Trukhanov Pavel , Lindsay James , Galvin Matthew R. , Farhat Karim S. , McClure Emily , Giordano Antonio , Gandhi Leena , Schrag Deborah , Hassett Michael J. , Cerami Ethan
Published: March 2024

PURPOSE

Precision oncology clinical trials often struggle to accrue, partly because it is difficult to find potentially eligible patients at moments when they need new treatment. We piloted deployment of artificial intelligence tools to identify such patients at a large academic cancer center.

PATIENTS AND METHODS

Neural networks that process radiology reports to identify patients likely to start new systemic therapy were applied prospectively for patients with solid tumors that had undergone next-generation sequencing at our center. Model output was linked to the MatchMiner tool, which matches patients to trials using tumor genomics. Reports listing genomically matched patients, sorted by probability of treatment change, were provided weekly to an oncology nurse navigator (ONN) coordinating recruitment to nine early-phase trials. The ONN contacted treating oncologists when patients likely to change treatment appeared potentially trial-eligible.

RESULTS

Within weekly reports to the ONN, 60,199 patient-trial matches were generated for 2,150 patients on the basis of genomics alone. Of these, 3,168 patient-trial matches (5%) corresponding to 525 patients were flagged for ONN review by our model, representing a 95% reduction in review compared with manual review of all patient-trial matches weekly. After ONN review for potential eligibility, treating oncologists for 74 patients were contacted. Common reasons for not contacting treating oncologists included cases where patients had already decided to continue current treatment (21%); the trial had no slots (14%); or the patient was ineligible on ONN review (12%). Of 74 patients whose oncologists were contacted, 10 (14%) had a consult regarding a trial and five (7%) enrolled.

CONCLUSION

This approach facilitated identification of potential patients for clinical trials in real time, but further work to improve accrual must address the many other barriers to trial enrollment in precision oncology research.
Transcranial Magnetic Stimulation–Based Machine Learning Prediction of Tumor Grading in Motor-Eloquent Gliomas
Authors: Lavrador José Pedro , Mirallave-Pescador Ana , Soumpasis Christos , Díaz Baamonde Alba , Aliaga-Arias Jahard , Baig Mirza Asfand , Patel Sabina , David Siado Mosquera José , Gullan Richard , Ashkan Keyoumars , Bhangoo Ranjeev , Vergani Francesco
Published: March 2024

BACKGROUND:

Navigated transcranial magnetic stimulation (nTMS) is a well-established preoperative mapping tool for motor-eloquent glioma surgery. Machine learning (ML) and nTMS may improve clinical outcome prediction and histological correlation.

METHODS:

This was a retrospective cohort study of patients who underwent surgery for motor-eloquent gliomas between 2018 and 2022. Ten healthy subjects were included. Preoperative nTMS-derived variables were collected: resting motor threshold (RMT), interhemispheric RMT ratio (iRMTr)—abnormal if above 10%—and cortical excitability score—number of abnormal iRMTrs. World Health Organization (WHO) grade and molecular profile were collected to characterize each tumor. ML models were fitted to the data after statistical feature selection to predict tumor grade.

RESULTS:

A total of 177 patients were recruited: WHO grade 2—32 patients, WHO grade 3—65 patients, and WHO grade 4—80 patients. For the upper limb, abnormal iRMTr were identified in 22.7% of WHO grade 2, 62.5% of WHO grade 3, and 75.4% of WHO grade 4 patients. For the lower limb, iRMTr was abnormal in 23.1% of WHO grade 2, 67.6% of WHO grade 3%, and 63.6% of WHO grade 4 patients. Cortical excitability score (P = .04) was statistically significantly related with WHO grading. Using these variables as predictors, the ML model had an accuracy of 0.57 to predict WHO grade 4 lesions. In subgroup analysis of high-grade gliomas vs low-grade gliomas, the accuracy for high-grade gliomas prediction increased to 0.83. The inclusion of molecular data into the model—IDH mutation and 1p19q codeletion status—increases the accuracy of the model in predicting tumor grading (0.95 and 0.74, respectively).

CONCLUSION:

ML algorithms based on nTMS-derived interhemispheric excitability assessment provide accurate predictions of HGGs affecting the motor pathway. Their accuracy is further increased when molecular data are fitted onto the model paving the way for a joint preoperative approach with radiogenomics.
Efficacy of Biportal Endoscopic Decompression for Lumbar Spinal Stenosis: A Meta-Analysis With Single-Arm Analysis and Comparative Analysis With Microscopic Decompression and Uniportal Endoscopic Decompression
Authors: Lv Shuangwen , Lv Haiwen , He Yupeng , Xia Xiansheng
Published: March 2024

BACKGROUND AND OBJECTIVE:

Biportal endoscopic decompression is a minimally invasive surgical technique for lumbar spinal stenosis (LSS). This meta-analysis aimed to evaluate the efficacy and safety of biportal endoscopic decompression through both a single-arm analysis and a comparative analysis.

METHODS:

A comprehensive literature search was conducted to identify eligible studies reporting the outcomes of biportal endoscopic decompression for LSS. Single-arm analysis and comparisons with microscopic and uniportal endoscopic decompression were performed. Evaluated outcomes included visual analog scale (VAS) scores for back pain and leg pain, Oswestry Disability Index (ODI) scores, operation time, estimated blood loss, duration of hospital stay, and adverse events.

RESULTS:

Single-arm analysis demonstrated significant improvements in VAS back pain, VAS leg pain, and ODI scores after biportal endoscopic decompression at postoperative 1-day to 36-month follow-up (all P < .001), compared with preoperative levels. The pooled mean single-level operation time was 71.44 min, and the pooled mean hospital stay was 3.63 days. The overall adverse event rate was 4.0%, with dural tear being the most common complication (3.0%). Compared with microscopic decompression, biportal endoscopic decompression showed significantly lower VAS back pain at 1-month (P < .001) and 6-month (P < .001) follow-up; lower VAS leg pain at 1-month (P = .045) follow-up; lower ODI scores at 3-month (P < .001), 12-month (P = .017), and >12-month (P = .007) follow-up; lower estimated blood loss (P = .003); and shorter hospital stay (P < .001). Adverse event rates did not differ between the techniques. No significant differences were observed between biportal endoscopic and uniportal endoscopic decompression groups for most efficacy and safety outcomes.

CONCLUSION:

Biportal endoscopic decompression emerges as a safe and effective alternative for LSS, presenting potential advantages over the microscopic technique and comparable efficacy with the uniportal endoscopic technique.