bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic performance of a 3D double-echo steady-state sequence at 3 T using radial reformats for detecting and grading rotator cuff tears: a pilot diagnostic accuracy study with magnetic resonance imaging and arthroscopic correlation
Authors: Osterholt Ann-Carolin , Link Tobias W , Abrar Daniel B , Mewes Alexander D , Hufeland Martin , Schleich Christoph , Bittersohl Bernd
Published: August 2023

Background

In diagnosing rotator cuff tears (RCTs), magnetic resonance imaging (MRI) is the imaging modality of choice, and its accuracy is improving constantly.

Purpose

To evaluate the diagnostic performance of a high-resolution 3D double-echo steady-state (DESS) sequence with radial and paracoronal 3-T MRI regarding the grading of RCTs in correlation with conventional 2D MRI and arthroscopic findings.

Material and Methods

We retrospectively compared arthroscopic findings of RCTs with preoperative MRI, including conventional 2D sequences and radial and paracoronal DESS images in 20 patients. Two observers evaluated supraspinatus (SSP), infraspinatus (ISP), and subscapularis (SSC) tendon tears using a grading system. For statistical analysis, arthroscopy was used as the reference standard.

Results

Inter-observer agreement for detecting and grading SSP, ISP, and SSC tendon tears on radial and paracoronal sliced 3D DESS MRI was excellent (intraclass-correlation [ICC] = 0.92–0.98; all P < 0.001). Regarding the detection of SSP lesions, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 93.8%, 50%, 88.2%, and 66.7% for both radial and paracoronal DESS imaging. A sensitivity of 100%, specificity of 61.1%, PPV of 22.2%, and NPV of 100% were noted for detecting ISP tendon tears using radially reformatted DESS images. Regarding detecting SSC tendon tears using radially reformatted DESS images, sensitivity, specificity, PPV, and NPV were 100%, 81.3%, 50%, and 100%, respectively. The results with standard 2D MRI were similar.

Conclusion

The DESS technique with radially reformatted images provided excellent sensitivity and high inter-observer agreement in detecting RCTs. It showed a moderate to high correlation between MRI and arthroscopy for diagnosing SSP and SSC tendon tears.
Clinical significance of serum S100 calcium-binding protein A12 concentrations in patients with community-acquired pneumonia
Authors: Wang Haoling , Li Dongqiong , Wang Youli , Mao Guangjian , Lu Guozhou , Lan Qiqin , Xiao Lianchun , Tang Wenjuan , Liu Yiqi
Published: August 2023

Objective

This study aimed to investigate the clinical significance of serum S100 calcium-binding protein A12 (S100A12) concentrations in patients with community-acquired pneumonia (CAP).

Methods

This was a case–control study. We selected 120 patients with CAP treated in Xichang People’s Hospital from January to June 2022 as the case group. Sixty healthy adults without a history of basic diseases were selected as the control group. The patients in the case group were divided into the low S100A12 and high S100A12 subgroups. Serum S100A12, C-reactive protein (CRP), and procalcitonin (PCT) concentrations, the leukocyte count, and other study parameters were compared.

Results

Serum S100A12, CRP, and PCT concentrations and the leukocyte count were higher in the case group than in the control group. The baseline confusion, urea, respiratory rate, blood pressure, and age ≥ 65 score, baseline pneumonia severity index score, and 30-day mortality rate were higher in the high S100A12 subgroup than in the low S100A12 subgroup. Serum CRP and PCT concentrations and the leukocyte count were higher in the high S100A12 subgroup than in the low S100A12 subgroup.

Conclusion

Patients with high serum S100A12 concentrations have more severe CAP, a more serious inflammatory reaction, and higher 30-day mortality.
Machinability improvement of titanium alloys in ultra-precision machining with micro-structured surface
Authors: Sujuan Wang , Liangbao Yu , Chao Qin , Zhanwen Sun
Published: August 2023

Titanium alloys get wider applications in different areas due to its excellent mechanical properties. However, poor thermal conductivity and low elastic module of titanium alloy induce high tool wear and make it being one of hard-to-machine materials; especially the segmented chip formation accelerates the diamond tool wear in ultra-precision machining (UPM) of precision parts. This study applies micro-structured surface to improve machinability of titanium alloys in UPM by reducing the chip segmentation induced cutting forces fluctuations. Finite element (FE) model is built to study chip formation mechanism and characterize geometries of segmented chips in orthogonal diamond cutting of Ti6Al4V alloy with the aims at the design of micro-structures array. Turning experiments are conducted to compare cutting force, surface roughness, and tool wear for diamond turning of Ti6Al4V alloy on smooth surface and micro-structured surface. The results show that the FE simulated saw chips agree well with the measured ones. Moreover, the micro-structured surface helps to decrease cutting force, reduce diamond tool wear, and improve surface quality for UPM of titanium alloy. Especially, the new method fabricates micro-grooves array on the machined surface in half-finishing process of UPM without the need of any material pre-processing and extra manufacturing equipment, which can also provide the guidance for efficient and sustainable UPM of titanium alloys parts with high surface quality.
Configuration of Agile Operant Resources in Family Firms Through Stakeholders Partnership
Authors: Waheed Mehreen , Kausar Abdul Rashid , Ali Syed Ahmad
Published: August 2023

Family firms are often recognized as wealthy in resources, especially in operant resources. These resources are hidden and play a phenomenal role in sustainable development. Fewer studies are available to spotlight the role of operant resources. This study aims to surface the magnificent hidden role of agile operant resources that facilitate the diverse needs of stakeholders in family firms. Data for this study were collected using in-depth interviews with complementary observations. Almost 29 interviews were considered with the owners of family firms from Pakistan. Interviews were translated and transcribed. Gioia Methodology is used to develop broader themes for discussion in terms of first-order concepts, themes and aggregate dimension that explained the mystical hidden role of agile operant resources in family firms. Research findings portrayed that Collaborative Capability, Reputational Resources, Religious Resources and Relationship Proneness are the agile operant resources which strengthen stakeholder’s partnership in family businesses. The authors proposed a conceptual model for highlighting the pertinent role of agile operant resources that facilitate stakeholder partnership in family-owned businesses (FOBs). Recent study provides the conceptual framework to academia for future research in the literature of family firms. FOBs may adopt all these agile operant resources to cater firm diverse stakeholder partnerships in today’s business world. It will open new avenues of growth and innovation for FOBs. This research can apply to all FOBs.
The Azalea Hypothesis of Alzheimer Disease: A Functional Iron Deficiency Promotes Neurodegeneration
Authors: LeVine Steven M.
Published: August 2023

Chlorosis in azaleas is characterized by an interveinal yellowing of leaves that is typically caused by a deficiency of iron. This condition is usually due to the inability of cells to properly acquire iron as a consequence of unfavorable conditions, such as an elevated pH, rather than insufficient iron levels. The causes and effects of chlorosis were found to have similarities with those pertaining to a recently presented hypothesis that describes a pathogenic process in Alzheimer disease. This hypothesis states that iron becomes sequestered (e.g., by amyloid β and tau), causing a functional deficiency of iron that disrupts biochemical processes leading to neurodegeneration. Additional mechanisms that contribute to iron becoming unavailable include iron-containing structures not undergoing proper recycling (e.g., disrupted mitophagy and altered ferritinophagy) and failure to successfully translocate iron from one compartment to another (e.g., due to impaired lysosomal acidification). Other contributors to a functional deficiency of iron in patients with Alzheimer disease include altered metabolism of heme or altered production of iron-containing proteins and their partners (e.g., subunits, upstream proteins). A review of the evidence supporting this hypothesis is presented. Also, parallels between the mechanisms underlying a functional iron-deficient state in Alzheimer disease and those occurring for chlorosis in plants are discussed. Finally, a model describing the generation of a functional iron deficiency in Alzheimer disease is put forward.
Modal participation ratio in damage identification of building structures: A numerical validation
Authors: Yilmaz Zafer , OKUR Fatih Yesevi , GÜNAYDIN Murat , ALTUNIŞIK Ahmet Can
Published: August 2023

In this paper, the aim is to detail the newly introduced method, which is based on the calculation of modal participation ratio, in damage detection and assessment. For this aim, a four-story reinforced concrete building model is employed for numerical application. The method is evaluated for two damage scenarios, namely, single story and cumulative. Damage to the building is employed as stiffness reduction of each story. Single story and cumulative damage scenarios are applied evaluating the utilization of modal participation ratio values in damage detection. Sixteen modal participation ratio values consisting of a combination of 4 modes and 4 degrees of freedom are evaluated. Single story damage scenarios vary from 1% to 40% for each story with a 1% increment. The cumulative damage scenarios include varying rates of different story damage to represent the earthquake damage. These scenarios provide a possibility to examine the correlation of damage location and severity with modal participation ratio variation. Based on correlation quality, the efficiency of the damage detection method is evaluated. It is found that all 16 ratios are overly sensitive to damage increase in both types of damage scenarios. There are also obvious signs for determining the location of single-story damage and good indicators for additional story damage in cumulative scenarios. It is concluded that the modal participation ratio variation can be used for detecting the presence, severity, and location of the damage.
Investigation of wear behavior of Al-B4C functionally graded materials synthesized using vibration-assisted casting methodology
Authors: Kumar Divyanand , Kumar Dinesh
Published: August 2023

This study investigates the dry sliding reciprocating wear behavior of Al-B4C continuous functionally graded materials at two different loads, 15 and 25 N, against a steel ball in a ball-on-flat configuration at a frequency of 5 Hz. Using sound wave-assisted vibrational casting, three samples with composition ratios of 2, 4, and 6 volume percentages in an aluminum matrix were produced, and a comparative analysis was conducted between them and their respective zones. Tribological properties and microstructure were examined for the inner (A), middle (B), and outer (C) regions of each sample, and subsequent analysis revealed that wear rate and friction coefficient increased with increasing applied load, but decreased with increasing sliding distance (100, 200, and 300 m). Also, as the concentration of B4C reinforcing particles increased, the wear rate and friction coefficient gradually decreased from the inner to the outer region of each sample. In comparison to the middle (B) and inner (A) regions, the outer (C) region of each sample exhibited superior wear properties. At high applied normal loads, the worn morphologies of wear tracks examined with a scanning electron microscope and an optical profilometer revealed extreme delamination wear and particle pull-out.
Simple Tool for Bleeding Control During Minimally Invasive and Robotic Cardiac Surgery
Authors: Özcan Zeynep Sıla , Arslanhan Gökhan , Senay Sahin , Koçyiğit Muharrem , Alhan Cem
Published: August 2023

Achievement of complete hemostasis is a key element to success in cardiac surgery. Bleeding control is of utmost importance in minimally invasive and robotic cardiac surgery to avoid conversion, as major bleeding is one of the most common indications for conversion to sternotomy. Bleeding control with surgical techniques can be technically more difficult in robotic and minimally invasive cardiac surgery as access to the bleeding area is limited and it is harder to intervene compared with open cardiac surgery with sternotomy. We present in this case the achievement of hemostasis in a minimally invasive robotic mitral repair, without the employment of surgical techniques and with the aid of a surgical sealant.
Stable gait generation method for lower-limb exoskeleton based on instrumented crutches
Authors: Zheng Tianjiao , Gao Jingsong , Zhao Sikai , Lai Mingzhu , Gao Yang , Zhao Jie , Zhu Yanhe
Published: August 2023

Lower-limb exoskeletons have attracted considerable interest because they can provide impaired individuals with the ability to walk upright. Trajectory generation of walking gait is a crucial issue for lower-limb exoskeletons that has not yet been satisfactorily solved. The purpose of this article is to study a stable gait generation method considering the subjective walking intention. Inspired by the motion synergy between crutches and lower limbs, a stable gait generation method for flat-ground walking was proposed for a lower-limb exoskeleton. The motion synergy in the sagittal plane between the crutch-pitch-angle and step length was validated using theoretical and experimental methods. The synergistic relationship between the maximum crutch-pitch-angle and step-length coefficient was established and optimized. Based on the synergistic relationship, the gait trajectory of the exoskeleton with variable step length can be instinctively generated with a crutch swing. The gait stability of the human-exoskeleton system was modeled and analyzed. Consecutive walking experiments were conducted on flat ground in which a compact lower-limb exoskeleton and pair of instrumented crutches were employed. The results demonstrate that gait based on the synergistic relationship is effective and stable, thereby verifying the feasibility of this human-in-the-loop gait generation method.
How to Prevent Wound Complications After Total Ankle Arthroplasty Through Anterior Approach: A Systematic Review on Current Treatment Options
Authors: Artioli Elena , Mazzotti Antonio , Arceri Alberto , Casadei Giacomo , Abdi Pejman , Geraci Giuseppe , Faldini Cesare
Published: August 2023

Introduction

Total ankle arthroplasty (TAA) through anterior approaches is a common treatment for end-stage tibiotalar arthritis. The occurrence of wound healing problems can lead to severe consequences. The aim of this systematic review is to summarize the available methods to minimize postoperative wound complications after TAA through standard anterior approaches.

Methods

Three databases were searched for original articles concerning methods to reduce anterior wound complications after TAA. Eligible articles were examined to extract studies’ characteristics, population data, type of intervention, and related wound complications. Study risk of bias assessment was conducted through the Newcastle-Ottawa Scale.

Results

Thirteen articles were included for analysis, investigating 8 types of intervention, which were grouped into 3 classes: biological, mechanical, and pharmacological methods. A significant decrease in wound complications was reported for negative pressure wound therapy (3% vs 24%, P = .014), soft tissue expansion strips (2% vs 12%, P = .04), and tranexamic acid (TXA) administration (9% vs 22%, P = .002).

Conclusion

Despite the limitations of the included studies, this review showed encouraging results for TXA administration. Good results were found for mechanical methods, despite each intervention being supported by only 1 comparative study. Careful selection of patients is recommended to identify potential benefits or contraindications to such interventions. Further prospective randomized studies would be helpful to confirm these results. Levels of Evidence: 3
Global Christian higher education from 1950 to 2020: An updated analysis
Authors: Glanzer Perry L.
Published: August 2023

A recent global reconnaissance of Christian higher education found a number of key themes that shaped current developments, such as the pressing challenges of secularization and nationalization but also the advantages of privatization and massification. This article provides an update to this older analysis by taking a birds-eye view of trends within the past 70 years of global Christian higher education. It reveals that privatization and massification trends do not predict new developments in countries and outliers always exist. Furthermore, it highlights some findings missed in previous analyses related to the importance of indigenous Christian groups and Christian general education.
Current Trends in Fixed Prosthodontics Education in Undergraduate Dental Colleges
Authors: Lone Muneeb Ahmed , Iqbal Uzma Anam , Lone Maham Muneeb , Adnan Samira , Heboyan Artak , Ahmed Naseer , Karobari Mohmed Isaqali , Marya Anand
Published: August 2023

OBJECTIVES

The objective of this study was to explore current trends in undergraduate fixed prosthodontics teaching at undergraduate dental level education.

METHODS

This cross-sectional descriptive study included close-ended questions to inquire about the teaching practices of fixed prosthodontics at Bachelor of Dental Surgery level education. Electronic copies of the survey forms were sent to the heads or directors of department of prosthodontics responsible for undergraduate dental students teaching and learning in various institutes of Sindh by the help of Google forms in December 2020. The form included questions on sociodemographic details and questions inquiring the theoretical and clinical teaching practices in undergraduate fixed prosthodontics course. Data was entered and analyzed using SPSS 25. Frequency distribution and percentages of categorical variables were recorded.

RESULTS

Out of total 18 dental institutes of Sindh, 15 returned the completely filled form, giving a response rate of 83.3%. Seven (46.7%) schools teach various fixed prosthesis in the preclinical years to their students. All 15 colleges carry out didactic teaching and provide exposure by live clinical demonstrations for various fixed prosthesis. Faculty of 12 (80%) dental colleges where fixed prostheses are being constructed in the dental outpatient department mentioned that their students observe or assist the clinical procedures during their clinical rotation; but none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years.

CONCLUSION

Didactic teaching and live clinical demonstrations of fixed prosthodontics is being carried out in all dental colleges of Sindh. Almost half of the dental schools teach crown preparation on phantom teeth during their preclinical course. Contrary to this, none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. As these procedures are not included in the current undergraduate curriculum, recommendations should be forwarded to governing educational body of the country to include cases of fixed prosthesis in their skill set prior to their graduation.
New town development and housing affordability: A case study in Hong Kong
Authors: Huang Yaoxuan , Li Victor Jing , Wang Daikun
Published: August 2023

New towns and housing affordability are the hot topics among city planners, urban researchers, policymakers, and economists in recent years. Yet, whether the existing new town development could mitigate the problem of housing affordability for low-income people is understudied. To fill this important knowledge blank and research gap, this study selects Hong Kong to conduct the empirical analysis. Through examining the data from multiple sources such as Census statistics from the Hong Kong government, market-rate housing transaction records, and private housing transactions from the property agents’ website, we found that new town development mitigates the problems of housing affordability in Hong Kong in general but not for low-income tenants in particular. The low-income people in new towns pay more for living in unsubsidized affordable housing/subdivided units as their last shelters. As more new towns will be developed in the upcoming years, the results also found that the announcement of new development areas increases the housing rent rate by 9.4% in the new development areas. We suggest that the priority of the newly built subsidized housing in the new development areas should be allocated to the local/indigenous low-income people; otherwise, the housing affordability of low-income people may repeat the same pattern associated with the past new towns’ development.
Theorizing a Dalit Language: The Parayans’ Language in Kerala, Some Ethnographic Observations
Authors: Sajeesh O. G. , Babu Abhilash
Published: August 2023

Language is a prerequisite for quotidian human life. For the most part, it plays an instrumental role in defining national, ethnocultural, and caste identifications in a polyglot society like India. Language shapes our views and bestows meanings to our thoughts. However, the analysis of language’s roles, functions, and usefulness, especially in studies grappling with Dalits life in Kerala, has been considerably overlooked by vernacular Dalit scholarship. Against this backdrop, the present article attempts to delve into one of the Dalit languages in Kerala, the Parayans’ language. Drawing insights from two-year-long ethnographic fieldwork, this article sheds light upon the unfolding of Parayans’ everyday life and the process of self-identification besides explicating the ontic properties of the Parayans’ language. In a subtle manner, the article adopts the methodology of ‘linguistic turn’ and urges Dalit scholarship to attune itself to afresh conceptual orientation so that it can bring the linguistic question as the central a priori of discussions in relation to life, identification, and subjectivity of Dalit beings.
The Relationship Between COVID-19 and the Development of Depression: Implications on Mental Health
Authors: Shetty Padmashri A , Ayari Lena , Madry Jessica , Betts Colton , Robinson Diana M , Kirmani Batool F
Published: August 2023

Initially, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease-2019 (COVID-19), was predominantly considered to primarily affect the respiratory system. However, later studies revealed that it also affects brain function through its ability to bind to the angiotensin-converting enzyme type 2 (ACE2) receptors expressed on neural cells. Our study involved a comprehensive review of literature aiming to investigate the relationship between COVID-19 and the development of depression. Our analysis shows a connection between these 2 conditions, as a consequence of the inflammatory response in the nervous system to the COVID-19 virus and the psychophysiological effects of the pandemic. In COVID-19 patients, depression can arise either due to the direct viral infection of the brain or as a result of an indirect immune response triggering neuroinflammation after a cytokine storm. The resulting depression can be treated with non-pharmacological therapies such as psychotherapy, antidepressant medications, or a combination of these treatments depending on the severity of the symptoms.
Impact of cumulative dose of brentuximab vedotin on outcomes of frontline therapy for advanced-stage Hodgkin lymphoma
Authors: Steiner Raphael E. , Hwang Steven R. , Khurana Arushi , Habermann Thomas M. , Epperla Narendranath , Annunzio Kaitlin , Allen Pamela Blair , Baird Katelin , Paulino Darina , Alderuccio Juan Pablo , Lossos Izidore S. , David Kevin , Evens Andrew M. , Pandya Karan , Bair Steven M. , Kamdar Manali , Ba Aqeel Sheeba , Torka Pallawi , Lynch Ryan , Smith Stephen , Feng Lei , Noorani Mansoor , Ahmed Sairah , Nair Ranjit , Vega Francisco , Wu Susan , Fang Penny , Pinnix Chelsea C. , Gunther Jillian R. , Dabaja Bouthaina S. , Lee Hun J.
Published: August 2023

In the pivotal study ECHELON-1, brentuximab vedotin (BV), doxorubicin, vinblastine, and dacarbazine (A + AVD) demonstrated superior efficacy compared with bleomycin + AVD for the treatment of advanced-stage classic Hodgkin lymphoma (cHL). However, there are minimal available data regarding the frequency of dose reductions or omission of BV during curative therapy and the potential impact on patient outcomes. In a real-world analysis, we retrospectively reviewed the characteristics and outcomes of 179 patients with stage III or IV cHL treated with frontline A + AVD from January 2010 to April 2022. Treatment consisted of up to 1.2 mg/kg of BV and standard dose AVD IV on days 1 and 15 of each 28-day cycle for up to 6 cycles. At the time of treatment, the median patient age was 37 years, and a high-risk International Prognostic Score was observed in 46% of patients. Overall, 91% of patients received 6 cycles of AVD; 55% of patients did not receive the intended cumulative dose of BV (CDB); 28% of patients received two-thirds or less than the planned CDB. At a median follow-up time of 27.4 months (95% confidence interval [CI], 24.8-29), the median progression-free survival (PFS) was not reached, and the 12-month PFS was 90.3% (95% CI, 85.9-95.0). The impact of CDB on PFS was not significant (P = .15), nor was high CDB significantly associated with increased adverse events. In real-world experience, A + AVD is a highly effective treatment for patients with advanced-stage cHL, including for patients with prominent dose reductions of BV.
D-galactose-induced mitochondrial oxidative damage and apoptosis in the cochlear stria vascularis of mice
Authors: Peng Zhe , Zhao Chunli , Yang Zijing , Gong Shusheng , Du Zhengde
Published: August 2023

Background

Age-related hearing loss, known as presbycusis, is the result of auditory system degeneration. Numerous studies have suggested that reactive oxygen species (ROS) and mitochondrial oxidative damage play important roles in the occurrence and progression of aging. The D-galactose (D-gal)-induced aging model is well known and widely utilized in aging research. Our previous studies demonstrate that administration of D-gal causes mitochondrial oxidative damage and causes subsequent dysfunction in the cochlear ribbon synapses, which in turn leads to hearing changes and early stage presbycusis. Stria vascularis (SV) cells are vital for hearing function. However, it is unclear to what extent D-gal induces oxidative damage and apoptosis in the cochlear SV of mice. In addition, the source of the causative ROS in the cochlear SV has not been fully investigated.

Methods

In this study, we investigated ROS generation in the cochlear SV of mice treated with D-gal. Hearing function was measured using the auditory brainstem response (ABR). Immunofluorescence was used to examine apoptosis and oxidative damage. Transmission electron microscopy was also used to investigate the mitochondrial ultrastructure. DNA fragmentation was determined using the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling (TUNEL) assay. Mitochondrial membrane potential (MMP) and ATP were also measured.

Results

We found that D-gal-treated mice exhibited a significant shift in the mean amplitude and latency of the ABR; a remarkable increase in the levels of NADPH oxidase (NOX-2), Uncoupling protein 2 (UCP2) and cleaved caspase-3 (c-Cas3) was observed, as well as an increase in the number of TUNEL-positive cells were observed in the SV of mice. Both the expression of the DNA oxidative damage biomarker 8-hydroxy-2-deoxyguanosine (8-OHdG) and a commonly occurring mitochondrial DNA deletion were markedly elevated in the SV of mice that had been treated with D-gal to induce aging. Conversely, the ATP level and MMP were significantly reduced in D-gal-induced aging mice. We also found alterations in the mitochondrial ultrastructure in the SV of aging mice, which include swollen and distorted mitochondrial shape, shortened and thickened microvilli, and the accumulation of lysosomes in the SV.

Conclusion

Our findings suggest that the impairment of cochlear SV during presbycusis may be caused by mitochondrial oxidative damage and subsequent apoptosis.
Genome-wide scan for runs of homozygosity in South American Camelids
Authors: Pallotti Stefano , Picciolini Matteo , Antonini Marco , Renieri Carlo , Napolioni Valerio
Published: August 2023

Background

Alpaca (Vicugna pacos), llama (Lama glama), vicugna (Vicugna vicugna) and guanaco (Lama guanicoe), are the camelid species distributed over the Andean high-altitude grasslands, the Altiplano, and the Patagonian arid steppes. Despite the wide interest on these animals, most of the loci under selection are still unknown. Using whole-genome sequencing (WGS) data we investigated the occurrence and the distribution of Runs Of Homozygosity (ROHs) across the South American Camelids (SACs) genome to identify the genetic relationship between the four species and the potential signatures of selection.

Results

A total of 37 WGS samples covering the four species was included in the final analysis. The multi-dimensional scaling approach showed a clear separation between the four species; however, admixture analysis suggested a strong genetic introgression from vicugna and llama to alpaca. Conversely, very low genetic admixture of the guanaco with the other SACs was found. The four species did not show significant differences in the number, length of ROHs (100-500 kb) and genomic inbreeding values. Longer ROHs (> 500 kb) were found almost exclusively in alpaca. Seven overlapping ROHs were shared by alpacas, encompassing nine loci (FGF5, LOC107034918, PRDM8, ANTXR2, LOC102534792, BSN, LOC116284892, DAG1andRIC8B) while nine overlapping ROHs were found in llama with twenty-five loci annotated (ERC2, FZD9, BAZ1B, BCL7B, LOC116284208, TBL2, MLXIPL, PHF20, TRNAD-AUC, LOC116284365, RBM39, ARFGEF2, DCAF5, EXD2, HSPB11, LRRC42, LDLRAD1, TMEM59, LOC107033213, TCEANC2, LOC102545169, LOC116278408, SMIM15, NDUFAF2andRCOR1). Four overlapping ROHs, with three annotated loci (DLG1, KAT6BandPDE4D) and three overlapping ROHs, with seven annotated genes (ATP6V1E1, BCL2L13, LOC116276952, BID, KAT6B, LOC116282667andLOC107034552), were detected for vicugna and guanaco, respectively.

Conclusions

The signatures of selection revealed genomic areas potentially selected for production traits as well as for natural adaptation to harsh environment. Alpaca and llama hint a selection driven by environment as well as by farming purpose while vicugna and guanaco showed selection signals for adaptation to harsh environment. Interesting, signatures of selection onKAT6Bgene were identified for both vicugna and guanaco, suggesting a positive effect on wild populations fitness. Such information may be of interest to further ecological and animal production studies.
A Bayesian latent class extension of naive Bayesian classifier and its application to the classification of gastric cancer patients
Authors: Gohari Kimiya , Kazemnejad Anoshirvan , Mohammadi Marjan , Eskandari Farzad , Saberi Samaneh , Esmaieli Maryam , Sheidaei Ali
Published: August 2023

Background

The Naive Bayes (NB) classifier is a powerful supervised algorithm widely used in Machine Learning (ML). However, its effectiveness relies on a strict assumption of conditional independence, which is often violated in real-world scenarios. To address this limitation, various studies have explored extensions of NB that tackle the issue of non-conditional independence in the data. These approaches can be broadly categorized into two main categories: feature selection and structure expansion.

In this particular study, we propose a novel approach to enhancing NB by introducing a latent variable as the parent of the attributes. We define this latent variable using a flexible technique called Bayesian Latent Class Analysis (BLCA). As a result, our final model combines the strengths of NB and BLCA, giving rise to what we refer to as NB-BLCA. By incorporating the latent variable, we aim to capture complex dependencies among the attributes and improve the overall performance of the classifier.

Methods

Both Expectation-Maximization (EM) algorithm and the Gibbs sampling approach were offered for parameter learning. A simulation study was conducted to evaluate the classification of the model in comparison with the ordinary NB model. In addition, real-world data related to 976 Gastric Cancer (GC) and 1189 Non-ulcer dyspepsia (NUD) patients was used to show the model's performance in an actual application. The validity of models was evaluated using the 10-fold cross-validation.

Results

The presented model was superior to ordinary NB in all the simulation scenarios according to higher classification sensitivity and specificity in test data. The NB-BLCA model using Gibbs sampling accuracy was 87.77 (95% CI: 84.87-90.29). This index was estimated at 77.22 (95% CI: 73.64-80.53) and 74.71 (95% CI: 71.02-78.15) for the NB-BLCA model using the EM algorithm and ordinary NB classifier, respectively.

Conclusions

When considering the modification of the NB classifier, incorporating a latent component into the model offers numerous advantages, particularly within medical and health-related contexts. By doing so, the researchers can bypass the extensive search algorithm and structure learning required in the local learning and structure extension approach. The inclusion of latent class variables allows for the integration of all attributes during model construction. Consequently, the NB-BLCA model serves as a suitable alternative to conventional NB classifiers when the assumption of independence is violated, especially in domains pertaining to health and medicine.
Associations of hospitalisation – admission, readmission and length to stay – with multimorbidity patterns by age and sex in adults and older adults: the ELSI-Brazil study
Authors: Rodrigues Luciana Pereira , França Diego Galdino , Vissoci João Ricardo Nickenig , Caruzzo Nayara Malheiros , Batista Sandro Rodrigues , de Oliveira Cesar , Nunes Bruno Pereira , Silveira Erika Aparecida
Published: August 2023

Background

Although the association between multimorbidity (MM) and hospitalisation is known, the different effects of MM patterns by age and sex in this outcome needs to be elucidated. Our study aimed to analyse the association of hospitalisations’ variables (occurrence, readmission, length of stay) and patterns of multimorbidity (MM) according to sex and age.

Methods

Data from 8.807 participants aged ≥ 50 years sourced from the baseline of the Brazilian Longitudinal Study of Ageing (ELSI-Brazil) were analysed. Multimorbidity was defined as ≥ 2 (MM2) and ≥ 3 (MM3) chronic conditions. Poisson regression was used to verify the association between the independent variables and hospitalisation according to sex and age group. Multiple linear regression models were constructed for the outcomes of readmission and length of stay. Ising models were used to estimate the networks of diseases and MM patterns.

Results

Regarding the risk of hospitalisation among those with MM2, we observed a positive association with male sex, age ≥ 75 years and women aged ≥ 75 years. For MM3, there was a positive association with hospitalisation among males. For the outcomes hospital readmission and length of stay, we observed a positive association with male sex and women aged ≥ 75 years. Network analysis identified two groups that are more strongly associated with occurrence of hospitalisation: the cardiovascular–cancer–glaucoma–cataract group stratified by sex and the neurodegenerative diseases–renal failure–haemorrhagic stroke group stratified by age group.

Conclusion

We conclude that the association between hospitalisation, readmission, length of stay, and MM changes when sex and age group are considered. Differences were identified in the MM patterns associated with hospitalisation according to sex and age group.
Emergency department visits and associated factors among people with dementia residing in nursing homes in Taiwan: a one-year cohort study
Authors: Wang Jiun-Yi , Yang Yu-Wan , Liu Chien-Hui , Chang Kun-Chia , Lin Yi-Ting , Liu Chih-Ching
Published: August 2023

Background

Residing in a nursing home (NH) may increase emergency department (ED) utilization in patients with dementia; however, evidence regarding the status of and predictors for ED utilization of NH residents with dementia remains unclear, especially in Asia. This study aimed to assess the incidence density of ED visits and associated factors for the risk of ED utilization among NH residents with dementia.

Methods

This one-year cohort study followed 6595 NH residents with dementia aged ≧ 40 years from Taiwan’s National Health Insurance Research Database between 2012 and 2014. The Andersen-Gill extension of Cox regression analysis with death as a competing risk was applied to investigate the association of the risk of all causes and the most common causes of ED utilization with the predisposing, enabling, and need factors as defined by the Andersen model.

Results

All participants encountered 9254 emergency visits in the 5371.49 person-years observed, representing incidence densities of ED visits of 1722.80 per 1000 person-years. Among them, respiratory disease was the most common cause of ED visits. The significant predictors for the risk of all-cause and respiratory-cause ED visits included: (1) predisposing factors (i.e., age and gender); (2) enabling factors (i.e., regional variables); and (3) need factors (i.e., prolonged ventilator dependence and comorbidity status).

Conclusions

Predisposing, enabling, and need factors could influence ED visits among studies patients. NH providers should consider these factors to develop strategies for reducing ED utilization.
Protocol of the RACB study: a multicenter, single-arm, prospective study to evaluate the efficacy of resection of initially unresectable hepatocellular carcinoma with atezolizumab combined with bevacizumab
Authors: Okuno Masayuki , Ishii Takamichi , Ichida Akihiko , Soyama Akihiko , Takemura Nobuyuki , Hirono Seiko , Eguchi Susumu , Hasegawa Kiyoshi , Sasaki Yasuharu , Uemura Kohei , Kokudo Norihiro , Hatano Etsuro
Published: August 2023

Background

Although the standard therapy for advanced-stage hepatocellular carcinoma (HCC) is systemic chemotherapy, the combination of atezolizumab and bevacizumab (atezo + bev) with a high objective response rate may lead to conversion to resection in patients with initially unresectable HCC. This study aims to evaluate the efficacy of atezo + bev in achieving conversion surgery and prolonged progression-free survival (PFS) for initially unresectable HCC.

Methods

The RACB study is a prospective, single-arm, multicenter, phase II trial evaluating the efficacy of combination therapy with atezo + bev for conversion surgery in patients with technically and/or oncologically unresectable HCC. The main eligibility criteria are as follows: (1) unresectable HCC without a history of systemic chemotherapy, (2) at least one target lesion based on RECIST ver. 1.1, and (3) a Child‒Pugh score of 5–6. The definition of unresectable tumors in this study includes macroscopic vascular invasion and/or extrahepatic metastasis and massive distribution of intrahepatic tumors. Patients will be treated with atezolizumab (1200 mg/body weight) and bevacizumab (15 mg/kg) every 3 weeks. If the patient is considered resectable on radiological assessment 12 weeks after initial chemotherapy, the patient will be treated with atezolizumab monotherapy 3 weeks after combination chemotherapy followed by surgery 3 weeks after atezolizumab monotherapy. If the patient is considered unresectable, the patient will continue with atezo + bev and undergo a radiological assessment every 9 weeks until resectable or until disease progression. The primary endpoint is PFS, and the secondary endpoints are the overall response rate, overall survival, resection rate, curative resection rate, on-protocol resection rate, and ICG retention rate at 15 min after atezo + bev therapy. The assessments of safety and quality of life during the treatment course will also be evaluated. The number of patients has been set at 50 based on the threshold and the expected PFS rate at 6 months after enrollment of 40% and 60%, respectively, with a one-sided alpha error of 0.05 and power of 0.80. The enrollment and follow-up periods will be 2 and 1.5 years, respectively.

Discussion

This study will elucidate the efficacy of conversion surgery with atezo + bev for initially unresectable HCC. In addition, the conversion rate, safety and quality of life during the treatment course will also be demonstrated.

Trial registration

This study is registered in the Japan Registry of Clinical Trials (jRCTs051210148, January 7, 2022).
Does previous asbestos exposure increase the risk of a post coronary artery bypass graft (CABG) pleural effusion – a routine data study?
Authors: Welch Hugh , Harris Jessica , Pufulete Maria , Dimagli Arnaldo , Benedetto Umberto , Maskell Nick
Published: August 2023

Background

Development of pleural effusion (PE) following CABG is common. Post-CABG PE are divided into early- (within 30 days of surgery) and delayed-onset (30 days–1 year) which are likely due to distinct pathological processes. Some experts suggest asbestos exposure may confer an independent risk for late-onset post-CABG PE, however no large studies have explored this potential association.

Research question

To explore possible association between asbestos exposure and post-CABG PE using routine data.

Methods

All patients who underwent CABG 01/04/2013–31/03/2018 were identified from the Hospital Episode Statistics (HES) Database. This England-wide population was evaluated for evidence of asbestos exposure, pleural plaques or asbestosis and a diagnosis of PE or PE-related procedure from 30 days to 1 year post-CABG. Patients with evidence of PE three months prior to CABG were excluded, as were patients with a new mesothelioma diagnosis.

Results

68,150 patients were identified, of whom 1,003 (1%) were asbestos exposed and 2,377 (3%) developed late-onset PE. After adjusting for demographic data, Index of Multiple Deprivation and Charlson Co-morbidity Index, asbestos exposed patients had increased odds of PE diagnosis or related procedure such as thoracentesis or drainage (OR 1.35, 95% CI 1.03–1.76, p = 0.04). In those with evidence of PE requiring procedure alone, the adjusted OR was 1.66 (95% CI 1.14–2.40, p = 0.01). Additional subgroup analysis of the 518 patients coded for pleural plaques and asbestosis alone revealed an adjusted OR of post-CABG PE requiring a procedure of 2.16 (95% CI 1.38–3.37, p = 0.002).

Interpretation

This large-scale study demonstrates prior asbestos exposure is associated with modestly increased risk of post-CABG PE development. The risk association appears higher in patients with assigned clinical codes indicative of radiological evidence of asbestos exposure (pleural plaques or asbestosis). This association may fit with a possible inflammatory co-pathogenesis, with asbestos exposure ‘priming’ the pleura resulting in greater propensity for PE evolution following the physiological insult of CABG surgery. Further work, including prospective studies and clinicopathological correlation are suggested to explore this further.
Growth differentiation factor-15 and circulating biomarkers as predictors of periodontal treatment effects in patients with periodontitis: a randomized-controlled clinical trial
Authors: Isola Gaetano , Tartaglia Gianluca Martino , Santonocito Simona , Chaurasia Akhilanand , Marya Anand , Lo Giudice Antonino
Published: August 2023

Background

During the last decades, in patients with periodontitis, periodontal treatment has been shown to reduce the potential release of local and systemic biomarkers linked to an early risk of systemic inflammatory disorders. This study evaluated the efficacy of non-surgical-periodontal treatment (NSPT) on growth differentiation factor 15 (GDF-15) and related circulating biomarkers such as glutathione peroxidase 1 (GPx-1), c-reactive protein (hs-CRP), and surfactant protein D (SP-D) in periodontal patients and explored whether subjects who had high GDF-15 levels at baseline showed increased clinical benefits following NSPT at 6-months follow-up.

Methods

For this two-arm, parallel randomized clinical trial, patients with periodontitis were randomly allocated to receive quadrant scaling and root-planing (Q-SRP, n = 23, median age 51 years old) or full-mouth disinfection (FMD, n = 23, median age 50 years old) treatment. Clinical and periodontal parameters were recorded in all enrolled patients. The primary outcome was to analyse serum concentrations changes of GDF-15 and of GPx-1, hs-CRP, and SP-D at baseline and at 30, 90, and 180-days follow-up after NSPT through enzyme-linked immunosorbent assay (ELISA) and nephelometric assay techniques.

Results

In comparison with FMD, patients of the Q-SRP group showed a significant improvement in clinical periodontal parameters (p < 0.05) and a reduction in the mean levels of GDF-15 (p = 0.005), hs-CRP (p < 0.001), and SP-D (p = 0.042) and an increase of GPx-1 (p = 0.025) concentrations after 6 months of treatment. At 6 months of treatment, there was a significant association between several periodontal parameters and the mean concentrations of GDF-15, GPx-1, hs-CRP, and SP-D (p < 0.05 for all parameters). Finally, the ANOVA analysis revealed that, at 6 months after treatment, the Q-SRP treatment significantly impacted the reduction of GDF-15 (p = 0.015), SP-D (p = 0.026) and the upregulation of GPx-1 (p = 0.045).

Conclusion

The results evidenced that, after 6 months of treatment, both NSPT protocols improved the periodontal parameters and analyzed biomarkers, but Q-SRP was more efficacious than the FMD approach. Moreover, patients who presented high baseline GDF-15 and SP-D levels benefited more from NSPT at 6-month follow-up.

Trial registration

NCT05720481.