bluuebunny/crossref_metadata_2025 huggingface dataset:
Cor e som: interfaces significantes na obra de Sonia Coutinho
Authors: Silva Lilian Santana da
Published: December 2022

Este estudo tem como temática as relações interartísticas entre música, arte e literatura nos contos de Sonia Coutinho. Objetiva-se analisar a integração entre as construções verbal e musical, como um sistema complexo em que a estrutura melódica projeta e atua ao mesmo tempo na constituição e na representação das personagens na contística da autora baiana. A abordagem interpretativa dos contos permite a observação de relações significativas entre elementos discursivos e sonoros. As teorias sobre as relações entre literatura e música e a Crítica Literária Feminista forneceram a base teórica para o contexto histórico-social da análise. A atmosfera construída para os contos por meio de músicas de jazz e personagens sobrepostas às imagens de divas do cinema exemplificam o caráter de jogo intertextual produzido pela autora na sua ficção.
Eclipse do romance: autoconsciência narrativa e fatias de vida em Huxley, Döblin e Waugh
Authors: Mota Raphael Valim da
Published: December 2022

O presente artigo desenvolve uma análise comparada de três romances publicados na passagem da década de 1920 para a de 1930: Contraponto ([1928] 2014), de Aldous Huxley, Berlin Alexanderplatz ([1929] 2019a), de Alfred Döblin, e Vile Bodies ([1930] 2012), de Evelyn Waugh. A análise pauta-se no conceito de crise do romance para investigar como esses escritores responderam às crises estéticas, políticas e sociais da primeira metade do século XX, traçando novos caminhos para o gênero novelístico a partir de procedimentos que envolvem contenção e dispersão, variação de pontos de vista, polifonia e autorreflexividade formal. A abordagem comparatista, centrada em autores de diferentes nacionalidades (dois ingleses e um alemão), permite uma compreensão mais abrangente desse momento crucial para a história do mundo tal qual representado pela ficção. Para tanto, é preciso também levar em conta as relações entre literatura e outras artes: a música erudita, em Huxley, e o cinema, em Döblin e Waugh.
Édipo, G. H. e o drama da existência: o heroísmo na deseroização
Authors: Gouveia Luã Leal , Moraes Claudia Letícia Gonçalves
Published: December 2022

O presente estudo analisa os protagonistas das obras A paixão segundo G. H. (1964), da autora Clarice Lispector, e Édipo Rei, de Sófocles, discutindo a figura do herói trágico a partir de uma análise comparatista. Édipo, personagem trágico, está atravessado por ambiguidades e tensões da sua existência. Já no romance de Lispector, a personagem/narradora, identificada apenas pelas suas iniciais, atravessa o itinerário existencial, lançada no abismo do seu existir, e assiste a sua vida ruir. Para a análise, esta proposta centraliza sua discussão na figura dos personagens Édipo e G. H. como heróis trágicos, propondo uma leitura acerca da deseroização dos personagens e encarando-a como um ato de heroísmo, isto é, como a travessia pela existência, que despersonaliza os personagens e ilustra a virtude do herói trágico: a busca pelo eu.
Dependência de dispositivo auxiliar ventilatório em pacientes portadores de atrofia muscular espinhal
Authors: Santos Lethícia Silva , Ribeiro Thais Cristine Cardoso , Oliveira Raíssa Freitas de Paula , Borges Kissy Rodrigues , Medeiros Rodrigo Parente
Published: December 2022

A Atrofia Muscular Espinhal ou Amiotrofia Espinhal (AME) é caracterizada pela degeneração de neurônios motores na medula espinhal e tronco encefálico.
Telemonitoramento da incapacidade e participação de crianças com doença de Charcot-Marie-Tooth na pandemia Covid-19
Authors: Cruz Karoliny Lisandra Teixeira , Petian-Alonso Danila Cristina , Martins Emanuela Juvenal , Mattiello-Sverzut Ana Claudia
Published: December 2022

A pandemia do COVID-19 causada pelo coronavírus 2 da síndrome respiratória aguda grave (SARS-CoV-2) é considerada um dos maiores desafios sanitários globais, sendo a principal responsável pelo isolamento social.
Influência do sexo no pico de torque isométrico da flexo-extensão de cotovelo de indivíduos na puberdade
Authors: Ansanello Noemi Biziaki , Franco Camila Scarpino Barboza , Martins Emanuela Juvenal , Baptista Cyntia Rogean de Jesus Alves de , Mattiello-Sverzut Ana Claudia
Published: December 2022

A força muscular permite ao corpo mover-se, fixar-se ou estabilizar-se. A produção de força nos membros superiores e inferiores é influenciada por fatores como idade, altura, peso e maturidade sexual, sendo que essas variáveis se diferenciam entre os sexos e, principalmente, na puberdade.
Acompanhamento do uso das órteses de membro superior em um Centro de Reabilitação Física durante o período de pandemia Covid-19
Authors: Souza Tatiane Teixeira de Almeida e , Giacomazi Roberta , Jorge Vanessa , Matos Celso Vilella , Silva Elaine Cristina da
Published: December 2022

A Organização Mundial de Saúde (OMS) declarou Pandemia decorrente ao surto da Covid-19 no início de março de 2020 e rapidamente, a doença se espalhou pelo mundo.
Distrofia muscular de cinturas - doença rara desafiadora para o médico e para o paciente
Authors: Hora João Sergio Ignacio , Rangel Ivan Orlando Castellanos , Rodas Patrícia Alexandra Viteri , Pinheiro Guilherme de Lima
Published: December 2022

A distrofia muscular de cintura/Limb Girdle Muscular Distrophy (DMC/LGMD) é causada por mutações do gene CAPN3 que codifica a proteína Calpaína, que desempenha um papel na manutenção da integridade e função muscular.
Gameterapia na marcha e equilíbrio na distrofia miotônica tipo 1: relato de caso
Authors: Oliveira Maria Isabelle Neves de , Silva Natalia Cristina Picco da , Boaventura Luiz Carlos , Borges Heloise Cazangi
Published: December 2022

A Distrofia Miotônica de Steinert, também conhecida como distrofia miotônica tipo 1 (DM1), é o tipo de distrofia muscular mais comum em adultos.
Correlação entre a CMTPedS-Br e variáveis de força e fadiga em crianças e adolescentes com CMT1
Authors: Estevam Ester da Silva , Franco Camila Scarpino Barboza , Martins Emanuela Juvenal , Baptista Cyntia Rogean de Jesus Alves de , Mattiello-Sverzut Ana Claudia
Published: December 2022

A doença de Charcot-Marie-Tooth (CMT) é uma neuropatia hereditária que afeta os nervos periféricos.
Perfil de via alimentar em pacientes internados para reabilitação
Authors: Borges Kissy Rodrigues , Ribeiro Thaís Cristine Cardoso , Santos Lethícia Silva , Cintra Marianna Miotto , Medeiros Rodrigo Parente
Published: December 2022

A disfagia orofaríngea é causada pelo acometimento da região central da deglutição e/ou nervos periféricos. Caracteriza-se pela disfunção dos músculos e estruturas envolvidas no processo de deglutição.
A dictionary of abbreviations used in reptile descriptions
Authors: DARKO YAA ADARKWA , VOSS OLAF , UETZ PETER
Published: December 2022

Species are usually described by morphological terms. In order to simplify and shorten descriptions these are often abbreviated (e.g., SVL for snout-vent-length). However, there has been no systematic attempt to define and standardize such terms or their abbreviations. Here we present an initial list of 594 unique abbreviations from a total list of 1,223 abbreviations collected from >50 reptile species descriptions, resulting in a non-redundant list of 344 abbreviations. Most of these abbreviations describe either meristic characters such as scale counts (46%) or measurements such as SVL (snout-vent-length) (30%). The remainder describe presence/absence states, colors, or formulas such as ratios. We highlight the common problem of synonyms and homonyms, i.e., different terms and abbreviations for the same character or the same term for different characters. We propose to standardize definitions of terms and abbreviations in future species descriptions. In order to future-proof species descriptions for machine-readability such as text-mining, standardization is needed for all species descriptions in biology, not just reptiles.
Erythroid/megakaryocytic differentiation confers BCL-XL dependency and venetoclax resistance in acute myeloid leukemia
Authors: Kuusanmäki Heikki , Dufva Olli , Vähä-Koskela Markus , Leppä Aino-Maija , Huuhtanen Jani , Vänttinen Ida , Nygren Petra , Klievink Jay , Bouhlal Jonas , Pölönen Petri , Zhang Qi , Adnan-Awad Shady , Mancebo-Pérez Cristina , Saad Joseph , Miettinen Juho , Javarappa Komal K. , Aakko Sofia , Ruokoranta Tanja , Eldfors Samuli , Heinäniemi Merja , Theilgaard-Mönch Kim , Wartiovaara-Kautto Ulla , Keränen Mikko , Porkka Kimmo , Konopleva Marina , Wennerberg Krister , Kontro Mika , Heckman Caroline A. , Mustjoki Satu
Published: December 2022

Myeloid neoplasms with erythroid or megakaryocytic differentiation include pure erythroid leukemia, myelodysplastic syndrome with erythroid features, and acute megakaryoblastic leukemia (FAB M7) and are characterized by poor prognosis and limited treatment options. Here, we investigate the drug sensitivity landscape of these rare malignancies. We show that acute myeloid leukemia (AML) cells with erythroid or megakaryocytic differentiation depend on the antiapoptotic protein B-cell lymphoma (BCL)-XL, rather than BCL-2, using combined ex vivo drug sensitivity testing, genetic perturbation, and transcriptomic profiling. High-throughput screening of >500 compounds identified the BCL-XL–selective inhibitor A-1331852 and navitoclax as highly effective against erythroid/megakaryoblastic leukemia cell lines. In contrast, these AML subtypes were resistant to the BCL-2 inhibitor venetoclax, which is used clinically in the treatment of AML. Consistently, genome-scale CRISPR-Cas9 and RNAi screening data demonstrated the striking essentiality of BCL-XL-encoding BCL2L1 but not BCL2 or MCL1, for the survival of erythroid/megakaryoblastic leukemia cell lines. Single-cell and bulk transcriptomics of patient samples with erythroid and megakaryoblastic leukemias identified high BCL2L1 expression compared with other subtypes of AML and other hematological malignancies, where BCL2 and MCL1 were more prominent. BCL-XL inhibition effectively killed blasts in samples from patients with AML with erythroid or megakaryocytic differentiation ex vivo and reduced tumor burden in a mouse erythroleukemia xenograft model. Combining the BCL-XL inhibitor with the JAK inhibitor ruxolitinib showed synergistic and durable responses in cell lines. Our results suggest targeting BCL-XL as a potential therapy option in erythroid/megakaryoblastic leukemias and highlight an AML subgroup with potentially reduced sensitivity to venetoclax-based treatments.
scCapsNet-mask: an updated version of scCapsNet with extended applicability in functional analysis related to scRNA-seq data
Authors: Wang Lifei , Nie Rui , Zhang Jiang , Cai Jun
Published: December 2022

Background

With the rapid accumulation of scRNA-seq data, more and more automatic cell type identification methods have been developed, especially those based on deep learning. Although these methods have reached relatively high prediction accuracy, many issues still exist. One is the interpretability. The second is how to deal with the non-standard test samples that are not encountered in the training process.

Results

Here we introduce scCapsNet-mask, an updated version of scCapsNet. The scCapsNet-mask provides a reasonable solution to the issues of interpretability and non-standard test samples. Firstly, the scCapsNet-mask utilizes a mask to ease the task of model interpretation in the original scCapsNet. The results show that scCapsNet-mask could constrain the coupling coefficients, and make a one-to-one correspondence between the primary capsules and type capsules. Secondly, the scCapsNet-mask can process non-standard samples more reasonably. In one example, the scCapsNet-mask was trained on the committed cells, and then tested on less differentiated cells as the non-standard samples. It could not only estimate the lineage bias of less differentiated cells, but also distinguish the development stages more accurately than traditional machine learning models. Therefore, the pseudo-temporal order of cells for each lineage could be established. Following these pseudo-temporal order, lineage specific genes exhibit a gradual increase expression pattern and stem cell associated genes exhibit a gradual decrease expression pattern. In another example, the scCapsNet-mask was trained on scRNA-seq data, and then used to assign cell type in spatial transcriptomics that may contain non-standard sample of doublets. The results show that the scCapsNet-mask not only restored the spatial map but also identified several non-standard samples of doublet.

Conclusions

The scCapsNet-mask offers a suitable solution to the challenge of interpretability and non-standard test samples. By adding a mask, it has the advantages of automatic processing and easy interpretation compared with the original scCapsNet. In addition, the scCapsNet-mask could more accurately reflect the composition of non-standard test samples than traditional machine learning methods. Therefore, it can extend its applicability in functional analysis, such as fate bias prediction in less differentiated cells and cell type assignment in spatial transcriptomics.
Characterization of a novel theta-type replicon of indigenous plasmid pTE15 from Lactobacillus reuteri N16
Authors: Chen Po-Wen , Lin Chuen-Fu
Published: December 2022

Background

pTE15 is a ~ 15-kb narrow-host-range indigenous plasmid from Lactobacillus reuteri N16 that does not replicate in selected Bacillus spp., Staphylococcus spp., and other Lactobacillus spp.

Methods

Combined deletion analysis the minireplicon essential of pTE15 with replicon-probe vector pUE80 (−) to confirmed sufficient for replication and from the ssDNA intermediate detection, plasmid amplification tested by chloramphenicol treatment, and replication origin sequence analysis to delineated the novel theta-type replication of pTE15.

Results

Single-stranded intermediate of pTE15 DNA was not detected in L. reuteri, indicating that this plasmid does not replicate via a rolling circle mechanism. The replicon of pTE15 did not display the structural organization typical of rolling-circle plasmids, nor were they similar to known rolling-circle plasmids. We further provided evidence that this plasmid applied a new mode of theta-type replication mechanism: (1) the size of this plasmid was > 10-kb; (2) the minireplicon consisted of AT-rich (directed repeat, iteron) and DnaA sequences; (3) the minireplicon did not contain double-strand origin (DSO) and essential rep genes, and it also showed no single-strand origin (SSO) structure; (4) the intermediate single-stranded DNA products were not observed for pTE15 replication; (5) the minireplicon did not contain a typical essential replication protein, Rep, (6) its copy number was decreased by chloramphenicol treatment, and (7) genes in pTE15 replication region encoded truncated RepA (TRepA), RepB and RepC, which were replication-associated proteins, but they were not essential for pTE15 replication.

Conclusions

Collectively, our results strongly suggested that the indigenous plasmid pTE15 of L. reuteri N16 belongs to a new class of theta replicons.
Severe COVID-19-associated myocarditis with cardiogenic shock – management with assist devices – a case report & review
Authors: Noone Stephanie , Flinspach Armin N. , Fichtlscherer Stephan , Zacharowski Kai , Sonntagbauer Michael , Raimann Florian J.
Published: December 2022

Background

Primary viral myocarditis associated with severe acute respiratory syndrome coronavirus 2 (SARS-Cov2) infection is a rare diagnosis.

Case presentation

We report the case of an unvaccinated, healthy patient with cardiogenic shock in the context of a COVID-19-associated myocarditis and therapy with simultaneous veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and percutaneous left ventricular decompression therapy with an Impella. The aim of this review is to provide an overview of therapeutic options for patients with COVID-19-associated myocarditis.

Conclusions

The majority of patients required a combination of two assist devices to achieve sufficient cardiac output until recovery of left ventricular ejection fraction. Due to the rapid onset of this fulminant cardiogenic shock immediate invasive bridging therapy in a specialized center was lifesaving.
Sex-dependent associations between MAP3K1 gene polymorphisms and soy products with the gastric cancer risk in Korea: a case-control study
Authors: Kwak Jung Hyun , Eun Chang Soo , Han Dong Soo , Kim Yong Sung , Song Kyu Sang , Choi Bo Youl , Kim Hyun Ja
Published: December 2022

Background/Objectives

The hormone-dependent effect of MAP3K1 gene polymorphisms may explain sex-specific differences in gastric cancer (GC) risk. Phytoestrogens have been shown to interact with this genetic factor. Here, we investigated the association between MAP3K1 gene polymorphisms and GC risk by sex and whether these associations differ depending on soy products intake.

Methods

Participants aged 20–79 years were recruited from two hospitals between December 2002 and September 2006. In all, 440 cases and 485 controls were recruited, among, 246 pairs of cases and controls, matched by sex, age (± 5 years), study admission period (± 1 years), and hospital, were included for the analysis.

Results

In dominant model, men with the A allele of rs252902 showed significantly increased GC risk (odd ratio; OR=2.19, 95% confidence interval; CI=1.31–3.64) compared to GG homozygotes. When stratified by intake of soy products, men with the A allele of rs252902 and low intake of soy products showed significantly higher GC risk (OR=3.29, 95% CI=1.55–6.78) than that in GG homozygotes.

Conclusions

Men with the risk allele of MAP3K1 had a significantly increased GC risk compared to GG homozygotes; this trend was more pronounced in those with low intake of soy products.
Detecting low-intake dehydration using bioelectrical impedance analysis in older adults in acute care settings: a systematic review
Authors: Alsanie Saleh , Lim Stephen , Wootton Stephen A.
Published: December 2022

Background

Dehydration is a frequent cause of excess morbidity and poor health outcomes, particularly in older adults who have an increased risk of fluid loss due to renal senescence, comorbidities, and polypharmacy. Detecting dehydration is key to instigating treatment to resolve the problem and prevent further adverse consequences; however, current approaches to diagnosis are unreliable and, as a result, under-detection remains a widespread problem. This systematic review sought to explore the value of bioelectrical impedance in detecting low-intake dehydration among older adults admitted to acute care settings.

Methods

A literature search using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane Library was undertaken from inception till May 2022 and led to the eventual evaluation of four studies. Risk of bias was assessed using the Cochrane tool for observational studies; three studies had a high risk of bias, and one had a low risk. Data were extracted using systematic proofs. Due to insufficient reporting, the data were analysed using narrative synthesis.

Results

One study showed that the sensitivity and specificity of bioelectrical impedance in detecting low-intake dehydration varied considerably depending on the total body water percentage threshold used to ascertain dehydration status. Other included studies supported the technique's utility when compared to conventional measures of hydration status.

Conclusions

Given the scarcity of literature and inconsistency between findings, it is not possible to ascertain the value of bioelectrical impedance for detecting low-intake dehydration in older inpatients.
Human monkeypox: a comparison of the characteristics of the new epidemic to the endemic disease
Authors: Sukhdeo Sharon , Mishra Sharmistha , Walmsley Sharon
Published: December 2022

In May 2022, a new global outbreak of mpox (formerly, human monkeypox) emerged that was declared a public health emergency of international concern by the World Health Organization on July 23, 2022. With new patterns of person-to-person spread within sexual networks in nonendemic countries and several differences from the classic disease course, we performed a comprehensive review of existing literature on human monkeypox to discuss epidemiology, modes of transmission, clinical presentation and asymptomatic infection, diagnostics, therapeutics, and vaccines with the primary aim to identify important areas for future research of this new epidemic form of the disease. A comprehensive literature search was performed of all published literature to August 15, 2022. Historically, in regions of monkeypox virus endemicity, human outbreaks have occurred related to discrete zoonotic events. The animal reservoir is unknown, but the virus has been isolated from rodents. Traditionally, transmission occurred by direct or indirect contact with an infected animal. In nonendemic countries affected in the 2022 outbreak, almost exclusive person-to-person spread has been observed, and most cases are connected to sexual networks of gay, bisexual, and other men who have sex with men. After an incubation period of approximately 13 days, in traditional human cases affected persons developed a febrile prodrome preceding a rash that started on the face and body, spread centrifugally to the palms and soles and healed monomorphically over two to four weeks. However, in the 2022 outbreak, the febrile illness is often absent or occurs after the onset of the rash. The rash presents primarily in the anogenital region and face before disseminating throughout the body, with lesions displaying regional pleomorphism. There is a paucity of data for the role of antiviral agents or vaccines. The epidemiology and clinical course of mpox has changed in the 2022 epidemic from that observed with the endemic disease. There is an urgent need to establish rapid and collaborative research platforms to diagnose, treat and prevent disease and inform important public health and other strategies to stop the spread of disease.
Antidepressants Trial in Parkinson's Disease (ADepT-PD): protocol for a randomised placebo-controlled trial on the effectiveness of escitalopram and nortriptyline on depressive symptoms in Parkinson’s disease
Authors: Schrag A , Carroll C , Duncan G , Molloy S , Grover L , Hunter R , Brown R , Freemantle N , Whipps J , Serfaty M. A , Lewis G
Published: December 2022

Background

Depressive symptoms are common in patients with Parkinson’s disease and depression is a significant predictor of functional impairment, reduced quality of life and general well-being in Parkinson's disease. Despite the high prevalence of depression, evidence on the effectiveness and tolerability of antidepressants in this population is limited. The primary aim of this trial is to establish the clinical and cost effectiveness of escitalopram and nortriptyline for the treatment of depression in Parkinson’s disease.

Methods

This is a multi-centre, double-blind, randomised placebo-controlled trial in 408 people with Parkinson’s disease with subsyndromal depression, major depressive disorder or persistent depressive disorder and a Beck Depression Inventory-II (BDI-II) score of 14 or above. Participants will be randomised into one of three groups, receiving either escitalopram, nortriptyline or placebo for 12 months. Trial participation is face-to-face, hybrid or remote. The primary outcome measure is the BDI-II score following 8 weeks of treatment. Secondary outcomes will be collected at baseline, 8, 26 and 52 weeks and following withdrawal, including severity of anxiety and depression scores as well as Parkinson’s disease motor severity, and ratings of non-motor symptoms, cognitive function, health-related quality of life, levodopa-equivalence dose, changes in medication, overall clinical effectiveness, capability, health and social care resource use, carer health-related quality of life, adverse effects and number of dropouts.

Discussion

This trial aims to determine the effectiveness of escitalopram and nortriptyline for reducing depressive symptoms in Parkinson’s disease over 8 weeks, to provide information on the effect of these medications on anxiety and other non-motor symptoms in PD and on impact on patients and caregivers, and to examine their effect on change in motor severity.

Trial registration

ClinicalTrials.gov Identifier: NCT03652870

Date of registration – 29th August 2018
Validating the use of the Wijma Delivery Expectancy/Experience Questionnaire in Mainland China: a descriptive, cross-sectional study
Authors: Han Lu , Wu Jiaxin , Wu Hengchang , Liu Jun , Liu Yanqun , Zou Zhijie , Liu Juan , Bai Jinbing
Published: December 2022

Background

Fear of childbirth (FOC) is a common psychological problem in Chinese pregnant women. FOC can influence both maternal health and infants’ wellness. Special assessment tools for FOC in Mandarin Chinese are currently lacking. The aim of this study was to evaluate the psychometric properties of the Mandarin Chinese of the Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A).

Methods

We recruited 364 Chinese pregnant women from April 2021 to July 2021. Translation and cultural adaptation, as well as reliability and validity testing were conducted. Analyses included the content validity, structural validity, criterion-related validity, convergent validity and reliability. The content validity indices were used to assess the content validity of the tool. The structural validity was tested through exploratory factor analysis and confirmatory factor analysis. The Cronbach’s alpha coefficient was used to evaluate the reliability of the W-DEQ-A Chinese version.

Results

The Chinese translation showed excellent similarities and equivalence to the original version, with the satisfactory content validity. Factor analysis indicated 5 factors, accounting for 57% of the total variance. Both criterion-related validity and convergent validity proved to be acceptable. The reliability was tested with a Cronbach’s alpha coefficient of 0.911 for the total scale.

Conclusion

The W-DEQ-A Chinese version is a reliable and valid tool to identify FOC in Mandarin Chinese-speaking populations.
Renal and hepatic artery embolization with Pickering gel emulsion of lipiodol in rabbit
Authors: Zhang Hongsen , Ren Yanqiao , Li Han , Zheng Chuansheng , Qian Kun
Published: December 2022

Objective

This research aimed to evaluate the feasibility of a novel liquid embolic agent Pickering gel emulsion of lipiodol (PGEL) for renal and hepatic artery embolization in the rabbit experimental model.

Methods

Embolization was performed in the right renal artery of 24 adult New Zealand White rabbits and 24 VX2 tumors in the left liver lobe. The rabbits were randomly allocated to four treatment groups (n = 6 per group): (A) normal saline (NS), (B) lipiodol, (C) 180–300 μm polyvinyl alcohol (PVA), and (D) PGEL.

Results

Renal artery embolization in normal rabbits and transarterial embolization (TAE) in VX2 tumor-bearing rabbits indicated that PGEL achieved a better embolization effect for a longer time than lipiodol and PVA. The tumor growth ratio of the PGEL group was significantly lower than that of the NS, lipiodol, and PVA groups at 3 (P < 0.001) and 7 (P < 0.001) days after embolization. In addition, hematoxylin and eosin and immunohistochemical staining revealed that the tumor necrosis ratio was higher in the PGEL group than in the NS, lipiodol, and PVA groups (P < 0.01), and the expression levels of HIF-1α, VEGF, and CD31 decreased after PGEL embolization compared with the lipiodol and PVA treatments.

Conclusion

PGEL is an effective embolic material that provides immediate and total occlusion of the renal artery and may be a potential therapeutic embolic agent for TAE of HCC.
Application of a deep learning system in glaucoma screening and further classification with colour fundus photographs: a case control study
Authors: Hung Kuo-Hsuan , Kao Yu-Ching , Tang Yu-Hsuan , Chen Yi-Ting , Wang Chuen-Heng , Wang Yu-Chen , Lee Oscar Kuang-Sheng
Published: December 2022

Background

To verify efficacy of automatic screening and classification of glaucoma with deep learning system.

Methods

A cross-sectional, retrospective study in a tertiary referral hospital. Patients with healthy optic disc, high-tension, or normal-tension glaucoma were enrolled. Complicated non-glaucomatous optic neuropathy was excluded. Colour and red-free fundus images were collected for development of DLS and comparison of their efficacy. The convolutional neural network with the pre-trained EfficientNet-b0 model was selected for machine learning. Glaucoma screening (Binary) and ternary classification with or without additional demographics (age, gender, high myopia) were evaluated, followed by creating confusion matrix and heatmaps. Area under receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, and F1 score were viewed as main outcome measures.

Results

Two hundred and twenty-two cases (421 eyes) were enrolled, with 1851 images in total (1207 normal and 644 glaucomatous disc). Train set and test set were comprised of 1539 and 312 images, respectively. If demographics were not provided, AUC, accuracy, precision, sensitivity, F1 score, and specificity of our deep learning system in eye-based glaucoma screening were 0.98, 0.91, 0.86, 0.86, 0.86, and 0.94 in test set. Same outcome measures in eye-based ternary classification without demographic data were 0.94, 0.87, 0.87, 0.87, 0.87, and 0.94 in our test set, respectively. Adding demographics has no significant impact on efficacy, but establishing a linkage between eyes and images is helpful for a better performance. Confusion matrix and heatmaps suggested that retinal lesions and quality of photographs could affect classification. Colour fundus images play a major role in glaucoma classification, compared to red-free fundus images.

Conclusions

Promising results with high AUC and specificity were shown in distinguishing normal optic nerve from glaucomatous fundus images and doing further classification.
Towards more personalized digital health interventions: a clustering method of action and coping plans to promote physical activity
Authors: Schroé Helene , Carlier Stéphanie , Van Dyck Delfien , De Backere Femke , Crombez Geert
Published: December 2022

Background

Despite effectiveness of action and coping planning in digital health interventions to promote physical activity (PA), attrition rates remain high. Indeed, support to make plans is often abstract and similar for each individual. Nevertheless, people are different, and context varies. Tailored support at the content level, involving suggestions of specific plans that are personalized to the individual, may reduce attrition and improve outcomes in digital health interventions. The aim of this study was to investigate whether user information relates toward specific action and coping plans using a clustering method. In doing so, we demonstrate how knowledge can be acquired in order to develop a knowledge-base, which might provide personalized suggestions in a later phase.

Methods

To establish proof-of-concept for this approach, data of 65 healthy adults, including 222 action plans and 204 coping plans, were used and were collected as part of the digital health intervention MyPlan 2.0 to promote PA. As a first step, clusters of action plans, clusters of coping plans and clusters of combinations of action plans and barriers of coping plans were identified using hierarchical clustering. As a second step, relations with user information (i.e. gender, motivational stage, ...) were examined using anova’s and chi2–tests.

Results

First, three clusters of action plans, eight clusters of coping plans and eight clusters of the combination of action and coping plans were identified. Second, relating these clusters to user information was possible for action plans: 1) Users with a higher BMI related more to outdoor leisure activities (F = 13.40, P < .001), 2) Women, users that didn’t perform PA regularly yet, or users with a job related more to household activities (X2 = 16.92, P < .001; X2 = 20.34, P < .001; X2 = 10.79, P = .004; respectively), 3) Younger users related more to active transport and different sports activities (F = 14.40, P < .001). However, relating clusters to user information proved difficult for the coping plans and combination of action and coping plans.

Conclusions

The approach used in this study might be a feasible approach to acquire input for a knowledge-base, however more data (i.e. contextual and dynamic user information) from possible end users should be acquired in future research. This might result in a first type of context-aware personalized suggestions on the content level.

Trial registration

The digital health intervention MyPlan 2.0 was preregistered as a clinical trial (ID:NCT03274271). Release date: 6-September-2017.
Why do parents use packaged infant foods when starting complementary feeding? Findings from phase one of a longitudinal qualitative study
Authors: Isaacs Anna , Neve Kimberley , Hawkes Corinna
Published: December 2022

Background

The first 1000 days in a child’s life, from conception to age two, are a critical period for establishing a child’s health and development. One important element is the diet that children receive during this time. Dietary intake of infants in the UK has been shown to be high in sugar and salt, with overall energy intakes exceeding recommendations by the time they are two years of age. Commercial infant food, which forms approximately 40–60% of infants’ dietary intake, was identified in 2011 as the main contributor to sugar intake for infants aged 4–9 months in the United Kingdom. Further, evidence demonstrates inconsistencies between national recommendations on infant feeding and some of these products in terms of the type available, their nutritional value and product labelling and marketing. Given their role in infants’ diets, it is important to understand parental perceptions of these products and why they are chosen.

Methods

The study comprised the first phase of an in-depth, longitudinal qualitative study which explored parents’ experiences of introducing solid foods to their infants over the first year of feeding. 62 parents/ carers were recruited to this phase when their infants were four-six months old. Data collection involved semi-structured interviews and a photo-elicitation exercise. Data from interview transcripts which focused on the purchase and use of packaged purees and commercial snacks were analysed thematically.

Results

Parents/ carers drew on a range of reasons for buying both packaged purees and commercial snacks for their infants. These included anxiety over food preparation, food safety, convenience, cost effectiveness, the pull of brand eco-systems for packaged purees, and the way in which commercial snacks provide opportunities for safe development of motor skills, keep infants occupied, and allow them to take part in family rituals.

Conclusion

In considering the use of packaged products as a food source for infants in public health nutrition policy, it is important to understand the broad range of factors that shape parents decisions ranging from the way that products are advertised and perceived, to the non-nutritive roles that they play.
Investigating informed choice in screening programmes: a mixed methods analysis
Authors: Tyldesley-Marshall Natalie , Grove Amy , Ghosh Iman , Kudrna Laura , Ayorinde Abimbola , Singh Megha , Mehaan Edward , Clarke Aileen , Taylor-Phillips Sian , Al-Khudairy Lena
Published: December 2022

Background

Screening programmes aim to identify individuals at higher risk of developing a disease or condition. While globally, there is agreement that people who attend screening should be fully informed, there is no consensus about how this should be achieved. We conducted a mixed methods study across eight different countries to understand how countries address informed choice across two screening programmes: breast cancer and fetal trisomy anomaly screening.

Methods

Fourteen senior level employees from organisations who produce and deliver decision aids to assist informed choice were interviewed, and their decision aids (n = 15) were evaluated using documentary analysis.

Results

We discovered that attempts to achieve informed choice via decision aids generate two key tensions (i) between improving informed choice and increasing uptake and (ii) between improving informed choice and comprehensibility of the information presented. Comprehensibility is fundamentally at tension with an aim of being fully informed. These tensions emerged in both the interviews and documentary analysis.

Conclusion

We conclude that organisations need to decide whether their overarching aim is ensuring high levels of uptake or maximising informed choice to participate in screening programmes. Consideration must then be given to all levels of development and distribution of information produced to reflect each organisation’s aim. The comprehensibility of the DA must also be considered, as this may be reduced when informed choice is prioritised.
The predictive value of pulmonary function test before transplantation for chronic pulmonary graft-versus-host-disease after allogeneic hematopoietic stem cell transplantation
Authors: Yang Lingyi , Cheng Jia , Li Fei , Qian Ruiqi , Zhang Xiuqin , Jin Song , He Xuefeng , Xu Ting , Hu Xiaohui , Ma Xiao , Chen Jia , Zhu Yehan , Chen Feng
Published: December 2022

Background

Pulmonary chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a devastating complication and often diagnosed at a late stage when lung dysfunction is irreversible. Identifying patients before transplant who are at risk may offer improved strategies to decrease the mortality. Bronchiolitis obliterans syndrome (BOS) is the typical manifestation of pulmonary cGVHD, which is clinically diagnosed by pulmonary function test (PFT). This study aimed to evaluate the predictive value of PFT pre-HSCT for BOS.

Methods

A single center cohort of 923 allo-HSCT recipients was analyzed, including 15 patients who developed pulmonary cGVHD. Kaplan–Meier method was used to analyze the 3 year progression free survival and 3 year overall survival (OS). A Cox regression model was applied for univariate and multivariate models.

Results

The 3 year cumulative incidence of pulmonary cGVHD was 2.04% (95% CI 1.00–3.08%). According to the cut-off values determined by receiver operator characteristic curve, higher ratio of forced expiratory volume during one second to forced vital capacity (FEV1/FVC) pre-HSCT was correlated to a lower incidence of pulmonary cGVHD [0.91% (95% CI 0.01–1.81%) vs. 3.61% (95% CI 1.30–5.92%), P < 0.01], and so as peak expiratory flow to predictive value (PEF/pred) [0.72% (95% CI 0–1.54%) vs. 3.74% (95% CI 1.47–6.01%), P < 0.01]. Multivariate analysis showed that FEV1/FVC (HR = 3.383, P = 0.047) and PEF/pred (HR = 4.426, P = 0.027) were independent risk factors for onset of BOS. Higher FEV1/FVC and PEF/pred level were related to a significantly decreased 3 year non-relapse mortality. The 3 year OS was superior in patients with higher PEF/pred [78.17% (95% CI 74.50–81.84%) vs. 71.14% (95% CI 66.08–76.20%), P = 0.01], while FEV1/FVC did not show significance difference.

Conclusion

Our results suggested that PFT parameters such as PEF/pred and FEV1/FVC could be predictors for pulmonary cGVHD and even transplant outcomes before HSCT.
A comparison between ultrasound-guided AIIS injection and radiography in the diagnosis of subspine impingement in patients with FAI
Authors: He Zi-Yi , Liu Zi-Ming , Bi Gui-Juan , Zhang Xiao-Le , Wang Jian-Quan , Jiang Ling , Ju Xiao-Dong
Published: December 2022

Background

Subspine impingement (SSI) does not have effective diagnostic criteria, especially in patients who also have femoroacetabular impingement (FAI). The classification of anterior inferior iliac spine (AIIS) morphology via three-dimensional CT is controversial.

Purpose

To propose a method for ultrasound-guided AIIS injection as a way to diagnose SSI and evaluate the accuracy of radiography methods, including 3-D CT and MRI, as well as intraoperative findings.

Methods

Patients diagnosed with FAI between September 2020 and December 2021 were evaluated in this prospective study. Those who met the criteria were included in the ultrasound-guided AIIS injection test. Whether the pain was relieved after injection was recorded in the radiology report. Patients who experienced significant relief of the anterior groin pain (more than 50%) after the AIIS injection were considered positive responders. Among these patients, radiography materials, including AIIS morphology as measured by 3-D CT as well as superior capsular oedema on MRI, were compared. The presence of congestion or bruising on the capsule side of the labrum corresponding to the AIIS during hip arthroscopy was recorded.

Results

A total of 73 patients with FAI underwent the ultrasound-guided AIIS injection test. Prevalence rates of 13.70% (10/73), 58.90% (43/73), 23.29% (17/73) and 4.11% (3/73) were recorded for Type I, Type IIA, Type IIB and Type III AIISs, respectively. Thirty-six patients had positive responses to injection, and 37 patients had negative responses to injection. None of the patients with Type I, 23 (53.49%) patients with Type IIA, 11 (64.71%) patients with Type IIB and 2 (66.7%) patients with Type III AIISs had positive responses to the injection. A total of 57.14% of patients with Type II or Type III AIIS had positive responses to the injection. The proportions of patients with superior capsular oedema on MRI in the Type I, Type IIA, Type IIB, and Type III AIIS groups was 0, 30.23, 29.41 and 0%, respectively. Among non-Type I AIIS patients, those who reported positive responses to the injection had a higher incidence of superior capsular oedema (38.89% vs. 14.81%, P = 0.036), but they had no significant differences in the proportion of congestion or bruising of the labrum (47.22% vs. 37.04%, P = 0.419). The results showed that no pairs of methods—ultrasound-guided injection, MRI, and intraoperative findings—achieved good consistency (κ = 0.222, κ = 0.098 and κ = − 0.116).

Conclusions

Radiographic methods including 3-D CT and MRI as well as the intraoperative findings of the labrum cannot be considered an accurate and reliable basis for the diagnosis and treatment of SSI in FAI patients. It is suggested that ultrasound-guided AIIS injections be combined with radiography to better diagnose SSI.

Level of Evidence

IV, case series.
Knowing the ABCs: teaching the principles of radiology to medical students in Turkey
Authors: Altinmakas Emre , Dogru Omer Faruk , Yucel Umut , Ayas Görkem , Balcı Ayşe Sena , Duran Munevver , Doğan Hakan , Kamel Serageldin , Patel Parth , Elsayes Khaled M
Published: December 2022

Background

Radiology education in Turkey is mainly taught during clinical years of medical school and often lacks main principles. Exposure to the fundamentals of radiology at an early stage of medical education may drastically help students generate a better understanding of radiology and expand their interest in the specialty. With the Principles of Radiology Course that we provided, pre- and post-session tests, and assessment survey at the end of the course, we aimed to evaluate the effectiveness of such an online course among Turkish medical students.

Methods

A total of nine online sessions on imaging modalities principles was developed by radiology professors. Each session was given through Zoom by radiologists from different U.S.-institutions to Turkish medical students from state (n = 33) and private (n = 8) universities. Pretests and post-tests were given to participants via Qualtrics before and after each session, respectively. Paired two-sample t-tests were conducted to detect the variance and p=-.05 was used as the significance level. An evaluation survey was distributed at the end of the course to collect their feedback through SurveyMonkey.

Results

A total of 1,438 predominantly Turkish (99.32%) medical students engaged with this course. An average of 506 students completed both pre-test and post-test. There was a statistically significant (p < .001) increase in the scores in post-test (mean[range]:7.58[5.21–8.53]) relative to pre-test (mean[range]:5.10[3.52–8.53]). Four hundred and thirty-nine participants (F/M:63.33%/35.54%) completed the end-of-course survey. A total of 71% and 69.70% of the participants strongly agreed that the course would be useful in their clinical practice and had increased their understanding of radiology. They also reported that their level of confidence in the subjects had increased 68% and reached a weighted average of 3.09/4. The survey revealed that 396 (90.21%) of the participants strongly or somewhat agree that introductory principles and concepts should be presented in earlier years of medical education. Compared to in-person education, 358 (81.55%) found the course extremely or very convenient.

Conclusion

Online lecture series consisting of the principles of the radiological imaging modalities can be offered to Turkish medical students to enhance their grasp of the various imaging modalities and their correct clinical application.
Thermodynamics driving phytochemical self-assembly morphological change and efficacy enhancement originated from single and co-decoction of traditional chinese medicine
Authors: Huang Xuemei , Liu Xiaojing , Lin Xiaoyu , Yuan Zhihua , Zhang Yaozhi , Wang Zhijia , Pi Wenmin , Zhao Haoqiang , Lei Haimin , Wang Penglong
Published: December 2022

Through the self-assembled strategy to improve the clinical efficacy of the existing drugs is the focus of current research. Herbal formula granule is a kind of modern dosage form of traditional Chinese medicine (TCM) which has sprung up in recent decades. However, whether it is equivalent to the TCM decoction that has been used for thousands of years has always been a controversial issue. In this paper, taking the herb pair of Coptidis Rhizoma—Scutellariae Radix and its main component berberine—baicalin as examples, the differences and mechanisms of self-assemblies originated from the co-decoction and physical mixture were studied, respectively. Moreover, the relationship between the morphology and antibacterial effects of self-assemblies was illuminated via multi-technology. Our study revealed that the physical mixture’s morphology of both the herb pair and the phytochemicals was nanofibers (NFs), while their co-decoction’s morphology was nanospheres (NPs). We also found that the antibacterial activity was enhanced with the change of self-assemblies’ morphology after the driving by thermal energy. This might be attributed to that NPs could influence amino acid biosynthesis and metabolism in bacteria. Current study provides a basis that co-decoction maybe beneficial to enhance activity and reasonable use of herbal formula granule in clinic.