bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio, Platelet−to−Lymphocyte Ratio, or Monocyte-to-Lymphocyte Ratio in Endometrial Neoplasms: A Systematic Review and Meta−analysis
Authors: Leng Jiali , Wu Fei , Zhang Lihui
Published: May 2022

Aim

Neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), or monocyte–lymphocyte ratio (MLR) has been shown to be related to the poor prognosis of cervical cancer, ovarian cancer, breast cancer, and other malignant tumors, but their role in predicting the prognosis of endometrial cancer is still controversial. Therefore, we conducted this meta-analysis to evaluate the effectiveness of NLR more accurately, PLR, or MLR in predicting the prognosis of endometrial cancer (EC).

Methods

This review systematically searched for relevant publications in databases of the Cochrane Library, PubMed, EMBASE, CNKI, WanFang, VIP, and CBM. Pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were determined and used to explore the association between inflammatory biomarkers (NLR, PLR, and MLR) and overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) in a random-effects model. We also conducted subgroup analysis and publication bias in this meta-analysis. Stata 12.0 was used for statistical analysis.

Results

This meta-analysis contained 14 eligible studies including 5,274 patients. Our results showed that NLR or PLR was associated with OS [NLR: HR, 2.51; 95% CI, 1.70–3.71; p <0.001 in univariate analysis (Ua); HR, 1.87; 95% CI, 1.34–2.60; p <0.001 in multivariate analysis (Ma); PLR: HR, 2.50; 95% CI, 1.82–3.43; p <0.001 in Ua; HR, 1.86; 95% CI, 1.22–2.83; p = 0.004 in Ma], but MLR was not associated with OS (HR, 1.44; 95% CI, 0.70–2.95; p = 0.325 in Ua; HR, 1.01; 95% CI, 0.39–2.60; p =0.987 in Ma). A further subgroup analysis found that the correlations were not affected by race, cutoff value, sample size, or treatment. Our meta-analysis showed that NLR or PLR was associated with DFS (NLR: HR, 2.50; 95% CI, 1.38–4.56; p =0.003 in Ua; HR, 2.06; 95% CI, 1.26–3.37, P =0.004 in Ma; PLR: HR, 1.91; 95% CI, 1.30–2.81; p = 0.001 in Ua), and NLR was associated with PFS only in the univariate analysis (HR, 1.71; 95% CI, 1.04–2.81; p =0.035 in Ua; HR, 1.79; 95% CI, 0.65–4.89; P =0.257 in Ma), but MLR was not associated with DFS (HR, 0.36; 95% CI, 0.03–4.13; p =0.409 in Ua).

Conclusions

Our results indicated that pretreatment NLR and PLR were biomarkers of poor prognosis in patients with endometrial cancer. The results indicated that NLR or PLR was associated with OS and disease-free survival DFS, and NLR was associated with PFS only in univariate analysis, but MLR was not associated with OS or DFS.
A Novel Germline SDHA Gene Mutation and Co-Occurring Somatic KIT Activating Mutation in a Patient With Pediatric Central Nervous System Germ Cell Tumor: Case Report
Authors: Yue Xizan , Liu Bo , Han Tiantian , Luo Ningning , Lu Guanghua , Guo Didi , Bu Fanfeng , Wang Guangyu
Published: May 2022

Central nervous system germ cell tumors (CNS GCTs) are a heterogeneous group of primary CNS tumors. GCTs are more common and mostly observed in pediatric and young adult patients. CNS GCTs are divided into germinomas and non-germinomatous germ cell tumors (NGGCTs), with different therapeutic strategies depending on diagnosis. Herein, we report a patient with pediatric central nervous system germinoma harboring a somatic KIT p.Y823D and a heterozygous germline SDHA p. T396Nfs*14 mutation detected by next generation sequencing. After surgery, the patient received chemotherapy (temozolomide + nedaplatin + etoposide). This is the first report of a Chinese pediatric patient with CNS GCT harboring concurrent germline SDHA and somatic KIT mutation, which enriches molecular profiles of CNS GCTs and provides more molecular evidence of clinical diagnosis and potential targeted therapy in CNS GCTs.
Deep Learning-Based Protein Features Predict Overall Survival and Chemotherapy Benefit in Gastric Cancer
Authors: Zhao Xuefei , Xia Xia , Wang Xinyue , Bai Mingze , Zhan Dongdong , Shu Kunxian
Published: May 2022

Gastric cancer (GC) is one of the most common malignant tumors with a high mortality rate worldwide and lacks effective methods for prognosis prediction. Postoperative adjuvant chemotherapy is the first-line treatment for advanced gastric cancer, but only a subgroup of patients benefits from it. Here, we used 833 formalin-fixed, paraffin-embedded resected tumor samples from patients with TNM stage II/III GC and established a proteomic subtyping workflow using 100 deep-learned features. Two proteomic subtypes (S-I and S-II) with overall survival differences were identified. S-I has a better survival rate and is sensitive to chemotherapy. Patients in the S-I who received adjuvant chemotherapy had a significant improvement in the 5-year overall survival rate compared with patients who received surgery alone (65.3% vs 52.6%; log-rank P = 0.014), but no improvement was observed in the S-II (54% vs 51%; log-rank P = 0.96). These results were verified in an independent validation set. Furthermore, we also evaluated the superiority and scalability of the deep learning-based workflow in cancer molecular subtyping, exhibiting its great utility and potential in prognosis prediction and therapeutic decision-making.
Patterns and Trends of the Mortality From Bone Cancer in Pudong, Shanghai: A Population-Based Study
Authors: Ma Gui-Fen , Bao Qi-Yuan , Zhang Hong-Yue , Chen Yi-Chen , Zhang Yue , Jiang Zhao-Yong , Li Xiao-Pan , Zhang Ju-Hua
Published: May 2022

Introduction

The burden of cancer-related mortality of common malignancies has been reported worldwide. However, whether bone cancer (BC), as a highly aggressive and heterogeneous group of rare cancers, followed a similar or distinct epidemiological pattern during such process remains largely unknown. We aimed to analyze the mortality and the temporal trends of BC in relation to gender, age, and premature death in Shanghai, China.

Methods

We conducted a population-based analysis of the mortality data of BC in Shanghai Pudong New Area (PNA) from 2005 to 2020. The epidemiological characteristics and long-term trends in crude mortality rates (CMRs), age-standardized mortality rates worldwide (ASMRWs), and rate of years of life lost (YLL) was analyzed using the Joinpoint regression program. The demographic and non-demographic factors affecting the mortality rate were evaluated by the decomposition method.

Results

There are 519 BC-specific deaths accounting for 0.15% of all 336,823 deaths and 0.49% of cancer-specific death in PNA. The CMR and ASMRW of BC were 1.15/105 person-year and 0.61/105 person-year, respectively. The YLL due to premature death from BC was 6,539.39 years, with the age group of 60–69 years having the highest YLL of 1,440.79 years. The long-term trend of CMR, ASMRW, and YLL rate significantly decreased by −5.14%, −7.64%, and −7.27%, respectively, per year (all p < 0.05) in the past 16 years. However, the proportion of BC-specific death within the total cancer-specific death dropped to a plateau without further improvement since 2016, and a remarkable gender and age disparity was noticed in the observed reduction in mortality. Specifically, the elderly benefited less but accounted for a larger percentage of BC population in the last decades. Although the overall mortality of BC decreased, there was still a significant upward trend toward an increased mortality rate caused by the aging of the BC patients.

Conclusion

Our study provides novel insights on the epidemiological characteristics and longitudinal dynamics of BC in a fast urbanization and transitioning city. As a rare disease affecting all ages, the burden of BC among the elderly emerged to form an understudied and unmet medical need in an aging society.
CEUS and CT/MRI LI-RADS in Association With Serum Biomarkers for Differentiation of Combined Hepatocellular-Cholangiocarcinoma From Hepatocellular Carcinoma
Authors: Zhou Yan , Yin Shanshan , Zhao Lin , Zhang Xiang , Li Meng , Ding Jianmin , Yan Kun , Jing Xiang
Published: May 2022

Background

Combined Hepatocellular-cholangiocarcinoma (cHCC-CCAs) are with both unambiguously differentiated hepatocellular and biliary components. cHCC-CCAs show various imaging features similar to hepatocellular carcinoma (HCCs) and intrahepatic cholangiocarcinoma (ICCs), which makes the differential diagnosis between them challenging. The accurate diagnosis of cHCC-CCAs is of great importance in selecting treatment methods and performing patient management.

Purpose

To investigate the diagnostic efficacy of CEUS and CT/MRI LI-RADS in association with tumor biomarkers for differentiation of cHCC-CCAs from HCCs.

Methods

A total of 54 cHCC-CCAs and 55 HCCs in two centers were retrospectively collected. The diagnostic criteria for cHCC-CCAs if one or more of the following conditions were satisfied: (1) arterial phase hyperenhancement (APHE) on CEUS and LR-M on CT/MRI; (2) LR-5 on both CEUS and CT/MRI with elevated carbohydrate antigen 19-9 (CA19-9); (3) LR-M on both CEUS and CT/MRI with elevated alphafetoprotein (AFP). The sensitivity, specificity, accuracy and area under the receiver operating characteristic curve (AUC) were calculated.

Results

The rates of APHE and Rim-APHE on CEUS in cHCC-CCAs were 81.5% and 9.3%, respectively. The rate of early and marked washout on CEUS in cHCC-CCAs were 59.3% and 27.8%, respectively. 64.8% and 25.9% of cHCC-CCAs showed APHE and Rim-APHE on CT/MRI, respectively. 46.3% and 35.2% of cHCC-CCAs showed washout and delay enhancement on CT/MRI, respectively. The kappa value of LI-RADS categories of cHCC-CCAs on CEUS and CT/MRI was 0.319 (P=0.008). The sensitivity, specificity, accuracy and AUC of the aforementioned diagnostic criteria for cHCC-CCAs were 64.8%, 84.4%, 76.1% and 0.746, respectively.

Conclusion

The combination of the CEUS and CT/MRI LI-RADS with serum tumor markers shows promising diagnostic performance of cHCC-CCAs.
Cardiac Imaging in Patients After Fontan Palliation: Which Test and When?
Authors: Ciliberti Paolo , Ciancarella Paolo , Bruno Pasqualina , Curione Davide , Bordonaro Veronica , Lisignoli Veronica , Panebianco Mario , Chinali Marcello , Secinaro Aurelio , Galletti Lorenzo , Guccione Paolo
Published: May 2022

The Fontan operation represents the final stage of a series of palliative surgical procedures for children born with complex congenital heart disease, where a “usual” biventricular physiology cannot be restored. The palliation results in the direct connection of the systemic venous returns to the pulmonary arterial circulation without an interposed ventricle. In this unique physiology, systemic venous hypertension and intrathoracic pressures changes due to respiratory mechanics play the main role for propelling blood through the pulmonary vasculature. Although the Fontan operation has dramatically improved survival in patients with a single ventricle congenital heart disease, significant morbidity is still a concern. Patients with Fontan physiology are in fact suffering from a multitude of complications mainly due to the increased systemic venous pressure. Consequently, these patients need close clinical and imaging monitoring, where cardiac exams play a key role. In this article, we review the main cardiac imaging modalities available, summarizing their main strengths and limitations in this peculiar setting. The main purpose is to provide a practical approach for all clinicians involved in the care of these patients, even for those less experienced in cardiac imaging.
Local Investigators Significantly Overestimate Overall Response Rates Compared to Blinded Independent Central Reviews in Uncontrolled Oncology Trials: A Comprehensive Review of the Literature
Authors: Dello Russo Cinzia , Navarra Pierluigi
Published: May 2022

Several drugs gained market authorization based on the demonstration of improved progression-free survival (PFS), adopted as a primary endpoint in Phase 3 clinical trials. In addition, an increasing number of drugs have been granted accelerated approval, and sometimes regular approval, by the main regulatory agencies based on the evaluation of the overall response rate in Phase 1 and 2 clinical trials. However, while the overall survival is an unbiased measure of drug efficacy, these outcomes rely on the assessment of radiological images and patients’ categorization using standardized response criteria. The evaluation of these outcomes may be influenced by subjective factors, particularly when the analysis is performed locally. In fact, blinding of treatment is not always possible in modern oncology trials. Therefore, a blinded independent central review is often adopted to overcome the problem of expectation bias associated with local investigator assessments. In this regard, we have recently observed that local investigators tend to overestimate the overall response rate in comparison to central reviewers in Phase 2 clinical trials, whereas we did not find any significant evaluation bias between local investigators and central reviews when considering progression-free survival in both Phase 2 and 3 trials. In the present article, we have tried to understand the reasons behind this discrepancy by reviewing the available evidence in the literature. In addition, a further analysis of Phase 2 and 3 clinical trials that included the evaluation of both endpoints showed that local investigators significantly overestimate overall response rates compared to blinded independent central reviews in uncontrolled oncology trials.
Superoxide dismutase@zeolite Imidazolate Framework-8 Attenuates Noise-Induced Hearing Loss in Rats
Authors: Zhang Yan , Li Qing , Han Chengzhou , Geng Fang , Zhang Sen , Qu Yan , Tang Wenxue
Published: May 2022

Reactive oxygen species (ROS) and inflammation have been considered major contributors to noise-induced hearing loss (NIHL) that constituted a public health threat worldwide. Nanoantioxidants, with high antioxidant activity and good stability, have been extensively used in the study of ROS-related diseases. In this study, we constructed a superoxide dismutase (SOD)@zeolite imidazolate framework-8 (ZIF-8) nanoparticle based on biomimetic mineralization and applied it to a rat model of NIHL. Our results showed that SOD@ZIF-8 effectively protected the animals from hearing loss and hair cell loss caused by noise. ROS, oxidative damage, and inflammation of noise-damaged cochlea were attenuated considerably after SOD@ZIF-8 administration. Importantly, we found that SOD@ZIF-8 achieved nanotherapy for NIHL in rats via a primary effect on the Sirtuin-3 (SIRT3)/superoxide dismutase2 (SOD2) signaling pathway without obvious adverse side effects. Therefore, our study is expected to open up a new field for NIHL treatment, and lay a foundation for the application of nanomaterials in other ROS-related inner ear diseases.
Fisetin: An Integrated Approach to Identify a Strategy Promoting Osteogenesis
Authors: Dalle Carbonare Luca , Bertacco Jessica , Gaglio Salvatore Calogero , Minoia Arianna , Cominacini Mattia , Cheri Samuele , Deiana Michela , Marchetto Giulia , Bisognin Anna , Gandini Alberto , Antoniazzi Franco , Perduca Massimiliano , Mottes Monica , Valenti Maria Teresa
Published: May 2022

Flavonoids may modulate the bone formation process. Among flavonoids, fisetin is known to counteract tumor growth, osteoarthritis, and rheumatoid arthritis. In addition, fisetin prevents inflammation-induced bone loss. In order to evaluate its favorable use in osteogenesis, we assayed fisetin supplementation in both in vitro and in vivo models and gathered information on nanoparticle-mediated delivery of fisetin in vitro and in a microfluidic system. Real-time RT-PCR, Western blotting, and nanoparticle synthesis were performed to evaluate the effects of fisetin in vitro, in the zebrafish model, and in ex vivo samples. Our results demonstrated that fisetin at 2.5 µM concentration promotes bone formation in vitro and mineralization in the zebrafish model. In addition, we found that fisetin stimulates osteoblast maturation in cell cultures obtained from cleidocranial dysplasia patients. Remarkably, PLGA nanoparticles increased fisetin stability and, consequently, its stimulating effects on RUNX2 and its downstream gene SP7 expression. Therefore, our findings demonstrated the positive effects of fisetin on osteogenesis and suggest that patients affected by skeletal diseases, both of genetic and metabolic origins, may actually benefit from fisetin supplementation.
Superradiance of Spin Defects in Silicon Carbide for Maser Applications
Authors: Gottscholl Andreas , Wagenhöfer Maximilian , Klimmer Manuel , Scherbel Selina , Kasper Christian , Baianov Valentin , Astakhov Georgy V. , Dyakonov Vladimir , Sperlich Andreas
Published: May 2022

Masers as telecommunication amplifiers have been known for decades, yet their application is strongly limited due to extreme operating conditions requiring vacuum techniques and cryogenic temperatures. Recently, a new generation of masers has been invented based on optically pumped spin states in pentacene and diamond. In this study, we pave the way for masers based on spin S = 3/2 silicon vacancy (VSi) defects in silicon carbide (SiC) to overcome the microwave generation threshold and discuss the advantages of this highly developed spin hosting material. To achieve population inversion, we optically pump the VSi into their mS = ±1/2 spin sub-states and additionally tune the Zeeman energy splitting by applying an external magnetic field. In this way, the prerequisites for stimulated emission by means of resonant microwaves in the 10 GHz range are fulfilled. On the way to realising a maser, we were able to systematically solve a series of subtasks that improved the underlying relevant physical parameters of the SiC samples. Among others, we investigated the pump efficiency as a function of the optical excitation wavelength and the angle between the magnetic field and the defect symmetry axis in order to boost the population inversion factor, a key figure of merit for the targeted microwave oscillator. Furthermore, we developed a high-Q sapphire microwave resonator (Q ≈ 104–105) with which we find superradiant stimulated microwave emission. In summary, SiC with optimized spin defect density and thus spin relaxation rates is well on its way of becoming a suitable maser gain material with wide-ranging applications.
Serum Levels of Irisin Predict Cumulative Clinical Outcomes in Heart Failure Patients With Type 2 Diabetes Mellitus
Authors: Berezin Alexander A. , Lichtenauer Michael , Boxhammer Elke , Fushtey Ivan M. , Berezin Alexander E.
Published: May 2022

Background: The aim of this study was to investigate the role of serum irisin level in predicting clinical outcome in heart failure (HF) patients with type 2 diabetes mellitus (T2DM).

Methods: 153 T2DM patients with HF aged 41–62 years were prospectively recruited for the study. Serum levels of irisin and NT-proBNP were measured by ELISA. Laboratory tests including HbA1c, fasting glucose, blood creatinine, insulin, lipids and creatinine with estimation of GFR were performed along with echocardiography at baseline. The observation period was 56 weeks.

Results: We identified 76 composite cardiovascular (CV) outcomes, which included CV death and death from all causes, resuscitated cardiac death, non-fatal/fatal acute myocardial infarction or stroke, and HF hospitalization. Therefore, the entire patient cohort was divided into 2 groups with (n = 76) and without (n = 77) composite CV outcomes. We found that the concentrations of NT-proBNP were higher in HF patients with T2DM who had a CV composite outcome than in patients without CV composite outcome (p = 0.001). In contrast, the relationship was exactly reversed for irisin, as HF and T2DM patients with CV composite outcome had significantly lower irisin levels (p = 0.001). Unadjusted multivariate Cox regression analyses showed that LVEF < 40%, LAVI > 39 ml/m2, NT-proBNP > 2,250 pmol/ml, and irisin < 6.50 ng/ml were the strongest predictors of CV outcomes in HF patients with T2DM. After adjustment for LVEF, serum levels of NT-proBNP and irisin remained independent predictors of end points. Furthermore, divergence of Kaplan-Meier curves pointed out that patients with NT-proBNP > 2,250 pmol/ml and irisin < 6.50 ng/ml had worse prognosis than those with any other compartment of the bomarkers’ levels.

Conclusion: Adding irisin to NT-proBNP significantly improved discriminative value of the whole model. HF patients with T2DM had significantly worse clinical outcomes when showing the constellation NT-proBNP > 2,250 pmol/ml and irisin < 6.50 ng/ml, respectively, in comparison to patients with opposite trends for both biomarkers.
Application of Convolutional Neural Network-Based Detection Methods in Fresh Fruit Production: A Comprehensive Review
Authors: Wang Chenglin , Liu Suchun , Wang Yawei , Xiong Juntao , Zhang Zhaoguo , Zhao Bo , Luo Lufeng , Lin Guichao , He Peng
Published: May 2022

As one of the representative algorithms of deep learning, a convolutional neural network (CNN) with the advantage of local perception and parameter sharing has been rapidly developed. CNN-based detection technology has been widely used in computer vision, natural language processing, and other fields. Fresh fruit production is an important socioeconomic activity, where CNN-based deep learning detection technology has been successfully applied to its important links. To the best of our knowledge, this review is the first on the whole production process of fresh fruit. We first introduced the network architecture and implementation principle of CNN and described the training process of a CNN-based deep learning model in detail. A large number of articles were investigated, which have made breakthroughs in response to challenges using CNN-based deep learning detection technology in important links of fresh fruit production including fruit flower detection, fruit detection, fruit harvesting, and fruit grading. Object detection based on CNN deep learning was elaborated from data acquisition to model training, and different detection methods based on CNN deep learning were compared in each link of the fresh fruit production. The investigation results of this review show that improved CNN deep learning models can give full play to detection potential by combining with the characteristics of each link of fruit production. The investigation results also imply that CNN-based detection may penetrate the challenges created by environmental issues, new area exploration, and multiple task execution of fresh fruit production in the future.
Using Eye-Tracking to Investigate an Activation-Based Account of False Hearing in Younger and Older Adults
Authors: Failes Eric , Sommers Mitchell S.
Published: May 2022

Several recent studies have demonstrated context-based, high-confidence misperceptions in hearing, referred to as false hearing. These studies have unanimously found that older adults are more susceptible to false hearing than are younger adults, which the authors have attributed to an age-related decline in the ability to inhibit the activation of a contextually predicted (but incorrect) response. However, no published work has investigated this activation-based account of false hearing. In the present study, younger and older adults listened to sentences in which the semantic context provided by the sentence was either unpredictive, highly predictive and valid, or highly predictive and misleading with relation to a sentence-final word in noise. Participants were tasked with clicking on one of four images to indicate which image depicted the sentence-final word in noise. We used eye-tracking to investigate how activation, as revealed in patterns of fixations, of different response options changed in real-time over the course of sentences. We found that both younger and older adults exhibited anticipatory activation of the target word when highly predictive contextual cues were available. When these contextual cues were misleading, younger adults were able to suppress the activation of the contextually predicted word to a greater extent than older adults. These findings are interpreted as evidence for an activation-based model of speech perception and for the role of inhibitory control in false hearing.
Exploration of Digital Creativity: Construction of the Multiteam Digital Creativity Influencing Factor Model in the Action Phase
Authors: Zhang Jing , Chen Weilong , Xiao Yuchun , Wang Baohua
Published: May 2022

Based on multiteam system (MTS) theory and creativity theory, this study explores the influencing factor model of multiteam digital creativity (MTDC) in the action phase through two cross-validation studies, filling a theoretical gap and responding to the research call. Study 1 is a qualitative analysis method to fully explore the relevant influencing factors and enhance the theoretical saturation. Study 2 is an optimized DEMATEL method, known as the CL-WG DEMATEL analysis method, which cross-validates the new theoretical model and measures the centrality of the influencing factors. This study finds that the influence factor model of MTDC has eight major factors and distributes in four different levels. Further analysis shows that the three influences (team digital ability, multiteam digital sharing, and organizational digital resource matching) with the highest centrality of impact on MTDC all belong to the collective level, which indicates the uniqueness of the action phase of the performance episodes. The two cross-validation studies enhance the scientific validity of the new theoretical exploration. In addition, Theoretical and practical implications of the results are presented, and future directions for research are discussed.
Automated Progress-Monitoring for Literate Language Use in Narrative Assessment (LLUNA)
Authors: Fox Carly , Jones Sharad , Gillam Sandra Laing , Israelsen-Augenstein Megan , Schwartz Sarah , Gillam Ronald Bradley
Published: May 2022

Language sample analysis (LSA) is an important practice for providing a culturally sensitive and accurate assessment of a child's language abilities. A child's usage of literate language devices in narrative samples has been shown to be a critical target for evaluation. While automated scoring systems have begun to appear in the field, no such system exists for conducting progress-monitoring on literate language usage within narratives. The current study aimed to develop a hard-coded scoring system called the Literate Language Use in Narrative Assessment (LLUNA), to automatically evaluate six aspects of literate language in non-coded narrative transcripts. LLUNA was designed to individually score six literate language elements (e.g., coordinating and subordinating conjunctions, meta-linguistic and meta-cognitive verbs, adverbs, and elaborated noun phrases). The interrater reliability of LLUNA with an expert scorer, as well as its' reliability compared to certified undergraduate scorers was calculated using a quadratic weighted kappa (Kqw). Results indicated that LLUNA met strong levels of interrater reliability with an expert scorer on all six elements. LLUNA also surpassed the reliability levels of certified, but non-expert scorers on four of the six elements and came close to matching reliability levels on the remaining two. LLUNA shows promise as means for automating the scoring of literate language in LSA and narrative samples for the purpose of assessment and progress-monitoring.
Association of Insulin Resistance With Cardiovascular Risk Factors and Sleep Complaints: A 10-Year Follow-Up
Authors: Podlipskyte Aurelija , Kazukauskiene Nijole , Varoneckas Giedrius , Mickuviene Narseta
Published: May 2022

The aim of the study was to investigate the association of insulin resistance (IR) with cardiovascular risk factors and sleep complaints among citizens of Palanga over a 10-year follow-up period. This epidemiological longitudinal cohort study was performed with 835 subjects.

Methods

All participants were evaluated for sociodemographic, clinical and cardiovascular risk factors, behavioral factors, self-perceived health and biochemical analysis. IR was evaluated using the homeostasis model assessment of IR (HOMA-IR).

Results

All study participants were stratified into two groups, without IR (HOMA-IR ≤ 2.7) and with IR (HOMA-IR > 2.7). The analysis of parameters between the two study groups showed statistically significant relationships between IR, cardiovascular risk factors and sleep complaints within the 10-year period. After adjusting for a 10-year period, sex, age, body mass index, physical activity, education, systolic and diastolic blood pressures, presence of disease, total cholesterol, triglyceride levels, metabolic syndrome (MetS) and diabetes mellitus (DM), IR was statistically significantly more frequent in subjects with increased sleep latency [odds ratio (OR) 1.37, 95% CI 1.01–1.93; p = 0.043], snoring frequency (OR 1.37, 95% CI 1.05–1.79; p = 0.020) and very loud snoring (OR 1.34, 95% CI 1.04–1.74, p = 0.026).

Conclusions

The incidence of obesity, MetS, DM, elevated fasting glucose level, triglyceridemia and sleep complaints became more frequent after a 10-year period in subjects with IR. Over a 10-year period, IR was significantly associated with an increase in sleep complaints: sleep latency reflecting difficulty to fall asleep, snoring and very loud snoring.
Regional Effects of Maternal Mortality Determinants in Africa and the Middle East: How About Political Risks of Conflicts?
Authors: Mamkhezri Jamal , Razzaghi Somayeh , Khezri Mohsen , Heshmati Almas
Published: May 2022

Background

As per the United Nations Women data, the maternal mortality rate in war-affected countries is critical and more than 800 million people live in war-affected countries (ICRC). External and internal conflicts such as foreign pressure, war and cross-border, civil disorder, terrorism, and civil war, are characteristics of Middle Eastern and African countries. Therefore considering the rapid increment of political risks and internal and external conflicts in Africa and the Middle East during the last decade, and considering warfare as a key contributor to maternal mortality; This paper seeks to evaluate the factors that have caused significant rates of maternal mortality in Middle Eastern and African countries by emphasizing the contributions of a number of political risk aspects as Civil Disorder Index, Terrorism Index, Civil War Index, Foreign Pressures Index, Cross-Border Conflict Index, War Index along with other socio-economic factors.

Method

Data were collected from forty-six countries during 2011–2016 to explore the regional contributions of political risk aspects to the maternal mortality rate through spatial approaches.

Results

It was found that GDP per capita, energy intensity, and urbanization strongly impacted maternal mortality. Also, it was observed that natural resource rents and economic growth significantly influenced the reduction of mortality by expanding healthcare services. The urban expansion was found to have elevated maternal mortality. A majority of external and internal conflicts reduced the orientation of production toward healthcare services and thus raised maternal mortality. On the other hand, war and cross-border were found to pose opposite impacts.

Conclusion

The findings revealed that political risks arising from terrorism, foreign pressure, and war in the adjacent countries would elevate the rate of mortality in the original country. This implies the spillover impacts of regional conflicts on maternal mortality elevation at the regional scale.

JEL Classification Codes: C23; I10; I18; N37:
Clinical Analysis of the Discovery of Malignant Gynecological Tumors in the Diagnosis and Treatment of Pelvic Organ Prolapse
Authors: Niu Li-Na , Wang Jun-Xia , Li Xia , Xu Yong-Jun , Qiu Li-Rong , Guo Sheng , Zhang Li-Zhen , Shang Yun
Published: May 2022

Background

Clinically, malignant gynecological tumors found by chance during the diagnosis and treatment of pelvic organ prolapse (POP) are rare, and they are usually missed, leading to delayed diagnosis and treatment. The initial treatment of these tumors cannot be standardized, and, as a single surgical intervention may not be able to treat both the tumor and prolapse, secondary surgery is usually needed, affecting the quality of life of patients.

Case presentation

The present study retrospectively analyzed the data of three patients who were diagnosed with malignant gynecological tumors during the diagnosis and treatment of POP. These patients were among 215 patients with POP treated in Yuncheng Central Hospital of Shanxi Province between January 2011 and May 2020. The case characteristics, surgical interventions, postoperative treatments, and follow-ups were summarized, and the characteristics of diagnosis and treatment were analyzed in the context of relevant literature.

Conclusion

As long as clinicians operate in strict accordance with the standards of diagnosis and treatment, obtain a complete medical history, undertake a physical examination, and remain diligent in auxiliary examinations, following existing clinical methods and diagnosis and treatment processes, patients with POP complicated with malignant gynecological tumors can be clearly diagnosed before and during surgery. In this way, initial treatment can be standardized, and surgical methods can be selected that address both the tumor and prolapse, thereby avoiding secondary surgery and improving the patient’s quality of life.
Case Report: Clinical and Procedural Implications of Ommaya Reservoir Implantation in Cystic Brain Metastases Followed by Radiosurgery Treatment
Authors: Lv Junhui , Wu Zhuoxuan , Wang Kun , Wang Yirong , Yang ShuXu , Han Weidong
Published: May 2022

Background

Therapy for large or deep cystic brain metastases is a troublesome procedure in clinical departments. Stereotactic cyst aspiration, combined with Gamma Knife radiosurgery, can be an effective treatment for cystic brain metastases. However, there is still a possibility that a reaccumulation of cystic fluid may lead to poor efficacy or even reoperation.

Case presentation

We present a case of a 67-year-old man who was diagnosed with lung cancer brain metastasis. The intracranial lesion seen on imaging appeared to be cystic and located deep inside the brain with associated limb dysfunction. The patient did not respond well to chemotherapy and underwent cyst aspiration with Ommaya reservoir implantation under neuronavigation. Repeated cystic fluid reaccumulation and exacerbation of symptoms occurred during treatment. We performed repeated aspiration via the Ommaya reservoir to control the symptoms and combined it with radiotherapy. During the follow-up period of 14 months, the intracranial tumor was effectively and satisfactorily controlled.

Conclusions

We highlight that Ommaya reservoir implantation during stereotactic cyst aspiration is necessary to prevent fluid reaccumulation, thereby avoiding the need for a second surgical procedure.
Endoscopic Transnasal Approaches to Petrous Apex
Authors: Kovalev Alexander , Sufianov Rinat , Prevedello Daniel , Borba Luís , Mastronardi Luciano , Ilyasova Tatiana , Daniel Roy Thomas , Messerer Mahmoud , Rassi Marcio , Zhang Guang
Published: May 2022

Endoscopic extended transnasal approaches to the apex of the temporal bone pyramid are rapidly developing and are widely used in our time around the world. Despite this, the problem of choosing an approach remains relevant and open not only between the “open” and “endoscopic transnasal” access groups but also within the latter. In the article, we systematized all endoscopic approaches to the pyramid of the temporal bone and divided them into three large groups: medial, inferior, and superior—in accordance with the anatomical relationship with the internal carotid artery—and also presented their various, modern (later described), modifications that allow you to work more targeted, depending on the nature of the neoplasm and the goals of surgical intervention, which in turn allows you to complete the operation with minimal losses, and improve the quality of life of the patient in the early and late postoperative period. We described the indications and limitations for these accesses and the problems that arise in the way of their implementation, which in turn can theoretically allow us to obtain an algorithm for choosing access, as well as identify growth points.
Application of e-PTFE Frontalis Suspension in the Treatment of Congenital Ptosis in Children
Authors: Ma Ling , Zhang Lei , Liu Zhen , Wang Dandan , Li Yibao , Zhang Chengyue
Published: May 2022

Purpose

Analysis of the value of expanded polytetrafluoroethylene (e-PTFE) frontalis suspension applied to children with congenital ptosis.

Methods

Eighty clinical cases of children with congenital ptosis from October 2019 to October 2021 were randomly selected from our hospital. All children were divided into the observation group (n = 44) treated with e-PTFE frontalis suspension and the control group (n = 36) treated with frontalis flap suspension according to the treatment procedure. Comparison of eyelid condition [palpebral fissure height, margin reflex distance (MRD), eyelid closure time], ocular surface status [corneal fluorescein staining (CFS) score, tear film breakup time (TBUT), surgical eye lacrimal river height (LRH), sehirmer test I (STI)], frontal muscle strength of affected side, cosmetic results and complications in both groups at 1, 6 and 12 months postoperative follow-up.

Results

At 1, 6 and 12 months after surgery, there was no significant difference in terms of palpebral fissure height and MRD between both groups (p > 0.05); After surgery, the eyelid closure time was shorter in the observation group than in the control group (p < 0.05). At 1, 6 and 12 months after surgery, the CFS scores were lower in the observation group than in the control group (p < 0.05); At 6 and 12 months after surgery, the TBUT was longer and the surgical eye LRH was higher in the observation group than in the control group (p < 0.05); At 1, 6, and 12 months after surgery, there was no significant difference in STI between both groups (p < 0.05). At 1, 6 and 12 months after surgery, the frontal muscle strength of affected side was higher in the observation group than in the control group (p < 0.05). At 1, 6, and 12 months after surgery, there was no significant difference in cosmetic results between both groups (p > 0.05). The overall complication rate in the observation group (6.82%) was lower than that in the control group (25.00%) (p < 0.05).

Conclusion

The surgical and cosmetic results of e-PTFE frontalis suspension and frontalis flap suspension applied to congenital ptosis are comparable, but the former has the advantage of faster postoperative recovery, better ocular surface status, less frontali muscle strength damage and fewer complications.
Effects of an Intravenous Infusion of Emulsified Fish Oil Rich in Long-Chained Omega-3 Fatty Acids on Plasma Total Fatty Acids Profile, Metabolic Conditions, and Performances of Postpartum Dairy Cows During the Early Lactation
Authors: Mezzetti Matteo , Piccioli-Cappelli Fiorenzo , Minuti Andrea , Trevisi Erminio
Published: May 2022

A group of 10 multiparous Italian Holstein cows were housed in individual tied stalls and infused with 150 ml of saline (CTR; 5 cows), or of 10% solution rich in long-chained omega-3 fatty acids (n3FA; 5 cows) at 12, 24, and 48 h after calving. From −7 to 21 days from calving (DFC), the body condition score, body weight, dry matter intake (DMI), and milk yield were measured, blood samples were collected to assess the plasma fatty acids (FA) and metabolic profiles, and milk samples were collected to assess the milk composition. Data underwent a mixed model for repeated measurements, including the treatment and time and their interactions as fixed effects. Plasma FA profile from n3FA cows had lower myristic and higher myristoleic proportions, higher cis-11,14-eicosadienoic acid and monounsaturated FA proportions at 3 DFC, and lower cis-10-pentadecanoic proportion at 10 DFC. Besides these, n3FA cows had higher eicosapentaenoic (EPA) and docosahexaenoic (DHA) proportions (1.09 vs. 0.71 and 0.33 vs. 0.08 g/100 g), confirming the effectiveness of the infusion in elevating plasma availability of these FA. The plasma metabolic profile from n3FA cows revealed a tendency toward a lower concentration of reactive oxygen metabolites at 1 DFC and lower haptoglobin at 2 and 3 DFC, reflecting a mitigated inflammatory state. Furthermore, n3FA cows had a higher DMI during the first week of lactation. Higher DMI of n3FA could account for the changes detected on their plasma FAs, the higher milk yield they had at 1 and 2 DFC, the reduced lactose and urea nitrogen content in their milk. Higher DMI could also account for the lower plasma urea that n3FA cows had at 1 and 2 DFC, suggesting a lower amount of endogenous amino acids deserved to gluconeogenic fate. Milk from n3FA cows had lower rennet clotting time and higher curd firmness, which is probably driven by a higher EPA and DHA inclusion in the milk fat. Together, these outcomes suggest that the infusion exerts a short-term anti-inflammatory action on dairy cows at the onset of lactation.
Examining Intersectoral Action as an Approach to Implementing Multistakeholder Collaborations to Achieve the Sustainable Development Goals
Authors: Trowbridge Joslyn , Tan Julia Y. , Hussain Sameera , Osman Ahmed Esawi Babiker , Di Ruggiero Erica
Published: May 2022

Objectives: The Sustainable Development Goals (SDGs) re-orient action towards improving the social and ecological determinants of health and equity. SDG 17 calls for enhanced policy and institutional coherence and strong multi-stakeholder partnerships. Intersectoral action (IA) has a promising history in public health, including health promotion and global health. Some experts see IA as crucial to the SDGs. Yet less is known about how IA is conceptualized and what promising models exist with relevance to the SDGs. We sought to investigate how IA is understood conceptually and empirically.

Methods: We conducted a narrative review of global public health and political science literatures and grey literature on the SDGs to identify theoretical models, case studies and reviews of IA research.

Results: Multiple competing conceptualizations of IA exist. Research has focused on case studies in high-income countries. More conceptual clarity, analyses of applications in LMICs, and explorations of political and institutional factors affecting IA are needed, as is attention to power dynamics between sectors.

Conclusion: IA is required to collaborate on the SDGs and address equity. New models for successful implementation merit exploration.
Herbicide Tolerance Options for Weed Control in Lanza® Tedera
Authors: Real Daniel , Dhammu Harmohinder , Moore John , Clegg David , van Burgel Andrew
Published: May 2022

Tedera is a drought-tolerant perennial forage legume introduced in Australia in 2006. In October 2018, T15-1218 Lanza®, the world’s first tedera variety, was released by the Department of Primary Industries and Regional Development and Meat & Livestock Australia for commercial use. A key agronomic practise for the successful establishment and adoption of tedera is to have a robust herbicide package to control a range of grass and broadleaf weeds well tolerated by tedera. A total of 9 pre-emergent and 44 post-emergent herbicide treatments were evaluated in eight experiments from 2017 to 2021. To control grasses such as annual ryegrass (Lolium rigidum Gaud.), propyzamide and carbetamide can be recommended for pre- or post-emergent applications and butroxydim, clethodim, and haloxyfop for post-emergent applications. The broadleaf pre-emergent herbicides recommended are clopyralid to control emerged capeweed (Arctotheca calendula (L.) Levyns), fomesafen to control pre-emergent wild radish (Raphanus raphanistrum L.), and the double mix of fomesafen + diuron, flumetsulam + diuron, and the triple mix of fomesafen + diuron + flumetsulam to control pre-emergent capeweed, pre- and post-emergent wild radish, and other broadleaf weeds. The most consistently well tolerated post-emergent herbicides by tedera seedlings and adult plants were diflufenican, diuron, flumetsulam, fomesafen, and their two- or three-way mixes that will provide good control of capeweed and wild radish. Desiccants such as paraquat or diquat were also well tolerated by 1-year-old tedera plants that recovered after being desiccated.
Electrocardiographic Changes in a Horse with Induced Myocardial Infarction
Authors: Weis Rikke , Carstensen Helena , Sattler Stefan M. , Buhl Rikke , Hesselkilde Eva M.
Published: May 2022

During acute myocardial infarction (AMI), the ischemia and necrosis of the infarcted tissue result in local electrophysiological changes, which bring about deviations of the ST segment and T wave. In this case report, the aim was to investigate whether these changes could be detected with a 12-lead electrocardiogram (ECG) during acute occlusion of the coronary artery in a 15-year-old Standardbred mare (scheduled for euthanasia due to non-cardiac health problems). The left anterior descending (LAD) coronary artery was occluded using an angioplasty balloon catheter guided through the carotid artery. Two coronary occlusions of 30 min were induced, separated by a 10-min reperfusion phase. AMI led to ST deviations and T-wave amplitude changes (maximum ST deviation was 1.98 mV; T-wave amplitude increased from 6.58 to 9.25 mV). The ST segment almost returned to the baseline during the reperfusion phase. The ECG changes seen after the infarction were comparable to those reported in other species with AMI, suggesting that the 12-lead-ECG can potentially be used to detect signs of myocardial infarction in horses.
Multidisciplinary Approach in the Treatment of Descending Necrotizing Mediastinitis: Twenty-Year Single-Center Experience
Authors: De Palma Angela , Cantatore Mirko Girolamo , Di Gennaro Francesco , Signore Francesca , Panza Teodora , Brascia Debora , De Iaco Giulia , Sampietro Doroty , Quercia Rosatea , Genualdo Marcella , Pizzuto Ondina , Garofalo Giuseppe , Signorile Fabio , Bavaro Davide Fiore , Brindicci Gaetano , De Gennaro Nicolò , Saracino Annalisa , Quaranta Nicola Antonio Adolfo , Favia Gianfranco , Marulli Giuseppe
Published: May 2022

Descending necrotizing mediastinitis (DNM) is an acute, rare, severe condition with high mortality, but the optimal management protocol is still controversial. We retrospectively analyzed the results of multidisciplinary management in patients treated for DNM at our center over the last twenty years. Fifteen male patients, mean age 49.07 ± 14.92 years, were treated: 9 with cervico-pharyngeal etiopathogenesis, 3 peri-tonsillar/tonsillar, 2 odontogenic, 1 post-surgical; 6 with DNM type I, 6 with type IIA, and 3 with type IIB (Endo’s classification). Mean time between diagnosis and treatment was 2.24 ± 1.61 days. In all cases, mediastinum drainage via thoracotomy was performed after neck drainage via cervicotomy, associated with tooth treatment in two; one required re-operation; tracheostomy was necessary in 9, temporary intensive care unit stay in 4; 6 developed complications, without post-operative mortality. Main isolated germs were Staphylococci and Candida; 7 had polymicrobial infection. The most used antibiotics were meropenem, metronidazole, teicoplanin, third-generation cephalosporins and clyndamicin; anti-fungal drugs were fluconazole, caspofungin and anidulafungin. On multivariate analysis, presence of cardiovascular disease was statistically significantly associated with longer chest tube duration and hospital stay. DNM requires early diagnosis and treatment to reduce mortality and morbidity. The most effective treatment should provide a multidisciplinary approach, combining cervicotomy and thoracotomy to drain all infectious collections with administration and monitoring of the proper antimicrobial therapy.