bluuebunny/crossref_metadata_2025 huggingface dataset:
The study of plain CT combined with contrast-enhanced CT-based models for predicting malignancy of solitary solid pulmonary nodules
Authors: Zhang Wenjia , Cui Xiaonan , Wang Jing , Cui Sha , Yang Jianghua , Meng Junjie , Zhu Weijie , Li Zhiqi , Niu Jinliang
Published: April 2024

Background: Tocompare the diagnostic performance between only plain CT based model and plain &contrast-enhanced CT based model in the classification of malignancy for solitary solid pulmonary nodules.
Methods: From January 2011 to July 2020, 527 patients with pathologically confirmed solitary solid pulmonary nodules collected at two centers with similar CT examinations and scanning parameters. Prior to surgery, all patients underwent both plain and contrast-enhanced chest CT scan. Two clinical characteristics, fifteen plain CT characteristics and four enhanced characteristics were used to develop logistic regression model with only plain CT and plain & contrast-enhanced CT. The diagnostic performance of the two models were assessed separately in the development and external validation cohorts using the AUC.
Results: 392patients from A center were included in the development cohort (median size, 20.0 [IQR, 15.0-24.0] mm; mean age, 55.8 [SD, 9.9] years; male 53.3%). 153 patients from B center were included in the external validation cohort (median size, 20.0 [IQR, 16.0-24.0] mm; mean age, 56.4 [SD, 9.6] years; man 51.9%).Preoperative patients with 201 malignant (adenocarcinoma, 148 [73.6%]; squamous cell carcinoma, 35 [17.4%]; large cell carcinoma,18 [9.0%]) and 326 benign (pulmonary hamartoma, 118[36.2%]; sclerosing pneumocytoma, 35 [10.7%]; tuberculosis, 104 [31.9%]; inflammatory pseudonodule, 69 [21.2%]) solitary solid pulmonary nodules were gathered from two independent centers.. The mean sensitivity, specificity, accuracy, PPV, NPV, and AUC (95%CI) of the only plain CT based model were 0.79, 0.78, 0.79, 0.67, 0.87, and 0.88 (95%CI, 0.82-0.93), the plain & contrast enhanced CT based model were 0.88, 0.91, 0.90, 0.84, 0.93, 0.93 (95%CI, 0.88-0.98) in external validation cohort, respectively.
Conclusions:A logistic regression model based on plain and contrast-enhanced CT characteristics showed exceptional performance in the evaluation of malignancy for solitary solid lung nodules. The utilization of this contrast-enhanced CT model would provide recommendations concerning follow-up or surgical intervention for preoperative patient presenting with solid lung nodules.
Impact of narrow-band imaging in prediction of histology of colorectal neoplasia: a prospective study
Authors: Grega Tomas , Kmochova Klara , Hejcmanova Katerina , Ngo Ondrej , Brodyuk Nadija , Majek Ondrej , Bures Jan , Urbanek Petr , Zavoral Miroslav , Suchanek Stepan
Published: April 2024

Aims: We assessed the diagnostic performance of the Narrow-Band Imaging (NBI) International Colorectal Endoscopic Classification (NICE) and the Japan NBI Expert Team classification (JNET) in predicting histological outcomes of colorectal lesions. We aimed to compare their accuracy, particularly in identifying high-grade colorectal lesions (including high-grade adenomas, intramucosal carcinomas, T1 and T2 carcinomas).
Methods: This was a prospective study involving 211 patients (130 men, mean age 60 years) who underwent colonoscopy with endoscopic resection of advanced colorectal neoplasia (lesions ≥ 10 mm). Lesions were classified using both NICE and JNET criteria, and final histopathological results were used for comparison.
Results: Of the 257 lesions analyzed, the NICE classification demonstrated higher accuracy, correctly classifying 93.8% of lesions compared to 77.4% with JNET. Specifically, the sensitivity and positive predictive value (PPV) of NICE 2 for high-grade lesions were 100% and 24.4%, respectively. In comparison, JNET 2B had a sensitivity of 54.5% and a PPV of 52.2% for high-grade lesions.
Conclusion: The NICE classification shows higher sensitivity for high-grade colorectal lesions (HGD adenomas, intramucosal carcinomas, T1 and T2 carcinomas), whereas the JNET classification, with a positive predictive value for high-grade lesions nearly double that of NICE, is more favourable for guiding therapy decisions.
Trial Registration
clinicaltrials.gov identifier: NCT05929365
Cichorium intybus Leaves Extract in Varying Solvent Systems for the Production of Platinum Nanoparticles: Design and Development of a Green Approach
Authors: Azad Aisha , Hussain Shoaib , Akram Hina , Fida Hina , Iqbal Muhammad Adnan , Butt Talib E.
Published: April 2024

The clinical medicine, also referred to as biomedicine, is being revolutionised by the growing usage of nanotechnology. Platinum nanoparticles (PtNPs), due to its stability and other properties, are found to be particularly more effective in biomedicine. However, the traditional chemical and physical methods of production of PtNPs have brought about some severe concerns to environmental and human health directly, or indirectly that mainly includes land and water pollution. There is need to overcome such concerns raised by replacing traditional methods by environment friendly ones. For this purpose, Cichorium intybus (C. Intybus) is a significant member of the Asteraceae family of medicinal plants, and has been used in traditional medicine for almost a century. In this research, for synthesis of nanoparticles via sustainable, green and environment friendly approach, C. Intybus leaves extract is used as a precursor. For this, leaves were extracted under five different solvent systems such as 80% methanol, 80% ethanol, methanol (absolute), ethanol (absolute), and de-ionized water. The phytochemical analysis reflected that the greatest extract yield (12.79 g/100 g DW) was obtained from leaves in an 80% methanolic solvent solution. The results indicated that the 80% methanolic leaf extract had the highest total phenolic content (93.24 mg GAE/g DW) and the maximum total flavonoid content (8.92 mg CE/g DW) of methanolic leaf extract. 2, 2-diphenyl-1-picrylhydrazyl (DDPH) radical scavenging activity and reducing power were used to determine antioxidant activity. The results revealed that 80% methanolic leaf extract showed the highest level of radical scavenging activity and reducing potential. In UV-visible spectroscopy, a colour change and a surface resonance plasmon band at 295 nm confirmed the production of PtNPs in the reaction mixture. The green methods of nanoparticles like the one presented in this study, have a promising potential to minimize negative impacts on the environmental health. This study paves a path for further research and development in this regard.
Colorimetric Evaluation of Cortisol Hormone and Stress Levels with Artificial Intelligence Assisted Image Processing
Authors: CAPAN ERTUGRUL , Çapan Ebru Cingöz , Öncel Hasan Uğur , Arıcan Ercan , Bulut Faruk
Published: April 2024

A novel approach utilizing Convolutional Neural Networks (CNN), Decision Trees, and Vector Regression methods, along with image processing techniques, has been developed to measure cortisol hormone levels through color change, one of the stress biomarkers. Visible color change of sweat samples obtained from users was achieved using the blue tetrazolium method, followed by analytical evaluation of this color change with the proposed system. Validated with ELISA references and a colorimeter device, the system reached a success rate of 98% in determining main reference values and 84.2% in determining users' cortisol values.
Additionally, participants (n=20) underwent the Copenhagen Psychosocial Risk Assessment and Perceived Stress Scale tests, and the correlation between evaluated cortisol levels and stress was examined. Emphasizing the importance of cortisol in stress assessment, an effective tool for rapid cortisol and stress level assessment is proposed.
Temperature-mediated growth of helical polymer and chevron-type graphene nanoribbon from internally fluorinated precursor on Au(111)
Authors: Li An-Ping , Teeter Jacob , Sarker Mamun , Lu Wenchang , Tao Chenggang , Baddorf Arthur , Huang Jingsong , Hong Kunlun , Bernholc Jerry , Sinitskii Alexander
Published: April 2024

Graphene nanoribbons (GNRs) of precise size and shape, critical for controlling electronic properties and future device applications, can be realized via precision synthesis on surfaces using rationally designed molecular precursors. Fluorine-bearing precursors have the potential to form GNRs on a nonmetallic substrate favorable for device fabrication. Here we investigate the temperature-mediated growth of a new fluorine-bearing precursor 6,11-diiodo-1,4-bis(2-fluorophenyl)-2,3-diphenyltriphenylene (C42H­24F2I2) into helical polymer intermediates and chevron-type GNRs on Au(111) by combining scanning tunneling microscopy, X-ray photoelectron spectroscopy, and ab initio density functional theory simulations. The fluorinated precursors do not adsorb on the Au(111) surface at lower temperatures, necessitating an optimum substrate temperature to achieve maximum possible polymer and GNR lengths. We compare the adsorption behavior with that of the pristine chevron precursors and discuss the effects of C-H and C-F bonds. The results will help elucidate the growth mechanism of GNRs with fluorine-bearing precursors and establish a foundation for future synthesis of GNRs on nonmetallic substrates.
Conserved effector families of Phytophthora species drive NLR-mediated nonhost resistance in plants
Authors: Choi Doil , Oh Soohyun , Kim Myung-Shin , Kang Hui Jeong , Kim Taewon , Kong Junhyeong
Published: April 2024

Nucleotide-binding leucine-rich repeat (NLR) receptor is suggested as a component of nonhost resistance (NHR). However, the evolutionary process of how plants develop receptors for recognizing wide range of non-adapted pathogens is still elusive.
We observed that multiple RxLR effector families including 12 reported avirulence effectors of Phytophthora infestans are broadly conserved across the Phytophthora species. We cloned 69 effectors distributed into 8 families from 6 Phytophthora species, and confirmed that 60.87% (42/69) of the tested effectors are recognized by the corresponding Solanum NLR (R1, R2, R3a, R8, Rpi-amr1, Rpi-blb1, Rpi-blb2, Rpi-vnt1). Notably, all the tested Solanum NLRs, except for Rpi-blb2, were able to recognize homologous effectors of multiple Phytophthora species. Furthermore, we also confirmed that expression of R1, R8, and Rpi-amr1 conferred broad-spectrum resistance against multiple Phytophthora species in Nicotiana benthamiana.
Combined results suggest that conserved effector families of Phytophthora species allow Solanaceae plants to recognize wide-range of pathogens by using NLRs that originally reported to recognize P. infestans, thus contribute to NLR-mediated NHR. Moreover, considering that resistance genes against most of Phytophthora species, except for P. infestans, have never been identified, our homology-based approach would provide a powerful strategy to identify functional NLRs against multiple pathogens threatening crop production.
Fire history in northern Sierra Nevada mixed conifer forests across a distinct gradient in productivity
Authors: Coppoletta Michelle , Knapp Eric E. , Collins Brandon M. , Abbott Celeste S. , Fertel Hannah , Stephens Scott L.
Published: April 2024

Background Understanding the role of fire in forested landscapes is fundamental to fire reintroduction efforts, yet few studies have examined how fire dynamics vary in response to interactions between local conditions, such as soil productivity, and more broadscale changes in climate. In this study we examined historical fire frequency, seasonality, and spatial patterning in mixed conifer forests across a distinct gradient of soil productivity in the northern Sierra Nevada. We cross-dated 46 different wood samples containing 377 fire scars from six paired sites, located on and off of ultramafic serpentine soils. Forests on serpentine-derived soils have slower growth rates, lower biomass accumulation, and patchier vegetation than adjacent, non-serpentine sites. Due to these differences, we hypothesized that historical fire frequency and spatial extent would be reduced in mixed conifer forests growing on serpentine soils.
Results Fire scars revealed a history of frequent fire at all of our sites (median composite interval: 6-22.5 years) despite clear differences in soil productivity. Fire frequency was slightly shorter in more productive non-serpentine sites, but this difference was not significant within any of our sample pairs. While fires were frequent, both on and off of serpentine, they were also highly asynchronous, and this was largely driven by differing climate-fire relationships. Fires in more productive sites were strongly associated with drought conditions in the year of the fire, while fires in less productive serpentine sites appeared to be more dependent on a cycle of wet and dry conditions in the years preceding the fire. Widespread fires that crossed the boundary between serpentine and non-serpentine were associated with drier than normal years.
Conclusions In our study, fine-scale variation in historical fire regime attributes was linked to both bottom-up and top-down controls. Understanding how these factors interact to create variation in fire frequency, timing, and spatial extent can help managers more effectively define desired conditions, develop management objectives, and identify management strategies for fire reintroduction and forest restoration projects.
Deep neural network-enhanced prediction and carbon footprint analysis of early-age high-performance manufactured sand concrete's stress-strain behavior
Authors: Han Lijuan , Pu Guangning , Guo Qi , Shi Donglei , Yuan Yangguang , Liu Bin
Published: April 2024

This study aims to investigate the stress–strain curve relationship and construction efficiency of manufactured sand concrete (MSC) at early ages thr ough uniaxial compression tests conducted on 216 specimens at ages of 2 d, 3 d, 4 d, 5 d, 6 d, 7 d, 14 d, and 28 d. The research examines the influence of age, water-cement ratio, and fly ash content on the peak stress and peak str ain of MSC. The results suggest that the variation pattern of characteristic poin ts on the stress-strain curve of MSC is influenced by the age. Within the 2-d to 4-d age range, the characteristic points on the stress-strain curve of MSC de monstrate the most prominent alterations. In the age range of 5 d to 7 d, the hydration reactions have already been completed, in contrast to the 2-d to 4-d age range. Consequently, the rate of change in characteristic points on the curv e becomes relatively gradual. During the extended period from 14 d to 28 d, t he rate of change in characteristic points on the curve exhibits no significant d ifference compared to other periods. This study evaluates the carbon emissions of MSC as a sustainable building material over its entire lifecycle and conclud es that the replacement of supplementary cementitious material (SCM) for ceme nt is essential for emission reduction. Furthermore, a deep neural network (DN N) model with four hidden layers and 100 neurons in each layer was develope d based on experimental results. The model was trained to predict the stress–st rain curves of MSC under varying water cement ratios, ages, and fly ash conte nt. DNN model was trained and validated through pre-processing and segmenti ng the original dataset using Pytorch deep learning (DL) libraries. DNN model accurately predicts stress–strain curves that closely align with MSC test curves.
The Assessment of Frailty in Adults Undergoing Allogeneic Hematopoietic Cell Transplantation Can Help to Improve Outcomes and Supportive Care. Study on Behalf of the Grupo Español de Trasplante Hematopoyético y Terapia Celular
Authors: Salas Maria , Solano María , Baile Mónica , Acera-Gómez Marina , Fox Laura , Pérez-Artigas María del Mar , López Ans Santamaría , Quintela-González María del Carmen , Sánchez Andrés , Salmerón-Camacho Joaquina , Illana-Álvaro Verónica , Abdallahi-Lefdil Zahra , Navascues Javier Cornago , Pardo Laura , Fernandez-Luis Sara , Suárez Leddy Patricia Vega , Villar Sara , Beorlegui-Murillo Patricia , Esqu Albert , Izquierdo-García Isabel , Rodriguez Sonia Gonzalez , Mussetti Alberto , Lavilla Esperanza , López-Marín Javier , Cedillo Ángel , Filaferro Silvia , Bento Leyre , Sureda Anna
Published: April 2024

This prospective and multicenter study implements the HCT Frailty Scale at first consultation and HCT admission in 384 consecutive adults undergoing allo-HCT at 15 HCT programs across Spain and investigates the applicability of evaluating frailty in allo-HCT. At first consultation, 102 (26.6%) patients were classified as fit, 233 (60.7%) as pre-frail and 49 (12.8%) as frail. During the study period, 61 (15.8%) patients joined a pre-habilitation program. From first consultation to HCT admission, among non-pre-habilitated patients (n=323), the proportion of fit patients decreased from 27.6% to 17.6%, while pre-frail and frail patients increased (from 59.8% to 63.7% and 12.7% to 19.2%, respectively). In contrast, among those in pre-habilitation (n=61), fit patients increased (from 21.3% to 42.6%), while the proportions of pre-frail and frail patients decreased (from 65.6% to 50.8% and 13.1% to 6.6%). Multivariate analysis including frailty information obtained at HCT admission confirmed lower OS (HR 3.02, P=0.004) and higher NRM (HR 2.79, P=0.03) in frail patients compared to fit ones, with pre-frail patients showing a tendency towards lower OS (HR 1.74, P=0.092). Results from this study confirm the predictive power of the HCT Frailty Scale for transplant outcomes, and reveal the dynamic nature of frailty in allo-HCT candidates.
Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study
Authors: Cai Yueju , Jiang Yongjiang , Wang Ping , Zhao Xiaopeng , Song Yanyan , Li Xiaolan
Published: April 2024

Background
This study aimed to explore the risk factors for early periventricular intraventricular hemorrhage (PIVH) in extremely low birth weight infants (ELBWIs), provide guidance for early intervention, and improve the survival rate and life expectancy of ELBWIs.
Methods
A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. The presence and severity of PIVH were assessed through standard head ultrasound screening (HUS) using the modified Papile classification on days 1–3 and 5–7 postbirth. The infants were categorized into either the PIVH group or the non-PIVH group based on the HUS findings. Univariate analysis and logistic regression were employed to identify the risk factors associated with PIVH. The efficacy of the model was evaluated using a receiver operating characteristic (ROC) curve.
Results
Among the 205 ELBWIs (97 males and 108 females) included in the study, 82 patients (40.0%) developed PIVH, 26 patients (12.7%) had severe PIVH, and 56 patients (27.3%) had mild PIVH. Of the 82 PIVH cases, 51 occurred within 3 days after birth. The incidence rates of severe PIVH in the 23+ 1-26-, 26+ 1-28-, and 28+ 1-32-week gestational age groups were 40.0% (16/40), 10.7% (10/93), and 1.4% (1/72), respectively (χ2 = 34.392, p = 0.000). Logistic regression analysis revealed that failure to withdraw invasive ventilators within 1 week (OR = 3.668, 95% CI = 1.557–8.641, p = 0.003) and the use of vasoactive drugs within 1 week (OR = 2.193, 95% CI = 1.033–4.658, p = 0.041) were independent risk factors for PIVH (sensitivity = 68.3%).The specificity was 81.3%, and the AUC was 0.792.
Conclusion
The incidence of PIVH in extremely low birth weight infants is relatively high, particularly within the first three days after birth. The use of vasoactive drugs and delayed removal of invasive ventilators may increase the risk.
Immune checkpoint blockade therapies efficacy and toxicity in patients with impaired renal function in metastatic bladder cancer
Authors: Tural¹ Deniz , Arslan Cagatay , Selcukbiricik Fatih , Olmez Omer Fatih , Akar¹ Emre , Erman Mustafa , Ürün Yüksel , Erdem Dilek , Kilickap Saadettin
Published: April 2024

Background
In this study, we reported the real-life results of data from impaired renal patients with urothelial carcinoma who were treated with ICTs.
Methods
The patients were categorized into 3 different groups GFR≥60mL/min (normal), 60–30mL/min (low), and less than 30 mL/min (very low) based on GFR. The primary endpoints were the overall response rate (ORR), overall survival (OS), duration of response with ICT, and safety. Median follow-up and OS were estimated by using the Kaplan-Meier method.
Results
One hundred-five( 60.3%) of patients were GFR normal, 26.4% were GFR low with 30–60 mL/min, and %13.2 were very low group.
ORR for GFR normal, low and very low groups were 36% (n=38), 26% (n=12) and %31 (7); p=0.2, respectively. The median duration of response for GFR normal, low and very low groups were 47.2 months (95% CI, 24.5–51.4), 33.1 months (95% CI, 26.9–47), and 23.5 months (95% CI, 12.2–43.7); p=0.01, respectively. The Median OS rate for GFR normal, low and very low groups were 11.9 (7.2–16.5) months, 4.7 (1.8–7.7) and 6.8 (1.1–13.6) months, p=0.015, respectively.
In addition, GFR <60 ml/min HR=1.6; 95% CI 1.12-1.80; p=0.02, maintained a significant association with OS in multivariate analysis
Conclusions
Long-term follow-up of real-world data confirms that the overall survival rate and durable response rate with ICT were higher in patients with GFR >60mL/min. On the other hand, we demonstrated that ICT was effective and a durable response seen in a group of patients with renal inpairement who did not have an effective systemic treatment option
Narrative Identity Alterations in Autism Spectrum Disorder: A Life Story Approach
Authors: Allé Mélissa C. , Schneider Priscille , Rigoulot Lyla , Gandolphe Marie-Charlotte , Danion Jean-Marie , Coutelle Romain , Berna Fabrice
Published: April 2024

Autism spectrum disorder (ASD) is characterized by an alteration of the sense of self, particularly self-continuity. While former studies focused on the recollection and narrative of single past events, the present study aimed to explore autistic individuals’ narrative identity by assessing for the first time their life story, described as the most integrated form of personal narrative and the closest to the self. A comparison of the narrative coherence of autistic individuals’ life stories (n = 22) with those of nonautistic participants (n = 22) revealed that global coherence, particularly causal-motivational coherence, was lower in the life narratives of autistic individuals. Additionally, typical narrative beginnings at birth and elaborated endings were less frequent in autistic individuals. In comparison with the nonautistic group, the ASD group included personal events in their life narratives that were self-rated as more negative and associated with negative feelings at retrieval, along with having lower life impacts. The present study provides evidence for an impaired narrative identity in ASD. We discussed how this effect could be related to a lower narrative coherence and an impaired temporal framework, possibly associated with a lack of others’ perspective-taking.
Clinical profile and treatment of patients with Vulvar Cancer: experience from a novice Gynecologic Oncology unit in Sub Saharan Africa
Authors: Birara Malede , Gudu Wondimu , Mekonen Tadios , Abdu Amani
Published: April 2024

Introduction
Vulvar cancer is rare accounting approximately for 4% of gynecologic malignancies. The prevalence of vulvar cancer rising in sub-Saharan Africa primarily attributed to high incidence of HIV infections. This study aims to explore clinic-pathologic profile and treatment of patients at a novice gynecologic oncology unit in Ethiopia.
Methodology
A descriptive cross-sectional study was conducted, among vulvar cancer patients treated at Saint Paul’s Hospital millennium medical college in Ethiopia, gynecology oncologic unit from 2016 to 2020. Data was collected from patients’ medical records and hospital registries using a simple data extraction format. Data was analyzed using IBM SPSS 23.1 computer statistical software.
Results
The magnitude of vulvar cancer was 3.6%, with mean age of patients being 42 years. Commonest symptoms were vulvar swelling, itching, and ulceration. The average duration of symptoms was 12 months and 66 percent of patients were HIV positive. The mean lesion size was 5 cm, with squamous cell carcinoma being the most prevalent (82%). Disease was early stage in 56% percent of patients. Fifty seven Percent were given treatment. Surgery was done to 37% of patients, postoperative wound complications rate being 30 percent. 43 percent had Postoperative follow-up and among those who adhered to follow-up, 85 individuals were disease-free at the last assessment, with only one case of recurrent disease.
Conclusions
Vulvar cancer is not uncommon being more prevalent among HIV patients. Early diagnosis and staging are crucial for improved patient outcomes. Interventions to raise awareness, implementing screening programs, and ensuring early referrals are imperative.
Characterization of Diabetic Kidney Disease in 235 Patients: Clinical and Pathological Insights with or without Concurrent Non-Diabetic Kidney Disease
Authors: Jiang Mengjie , Chen Hongyu , Luo Jing , Chen Jinhan , Gao Li , Zhu Qin
Published: April 2024

BACKGROUND This study aimed to explore the clinical and pathological features of patients with diabetic kidney disease (DKD), with and without non-diabetic kidney disease (NDKD), through a retrospective analysis. The objective was to provide clinical insights for accurate identification.METHODS A retrospective analysis of 235 patients admitted to the Department of Nephrology at Hangzhou Hospital of Traditional Chinese Medicine was conducted between July 2014 and December 2022. These patients underwent renal biopsy and received a pathology-based diagnosis of DKD. They were categorized into the DKD group (93 cases) and the DKD + NDKD group (142 cases).RESULTS In the DKD group, nodular diabetic glomerulosclerosis was the most prevalent, accounting for 63% of cases. In the DKD + NDKD group, the predominant pathological types were coupled with acute and chronic tubulointerstitial lesions, and IgA nephropathy, accounting for 40.14% and 35.21%, respectively. Clinical correlation analysis revealed associations between glomerular grading, tubulointerstitial lesions, renal arteriolar vitelliform lesions, renal vascular atherosclerosis, and clinical parameters such as 24-hour urine protein, hemoglobin, and urinary specific gravity. Multifactorial logistic regression analysis identified independent factors affecting DKD + NDKD, including body mass index, blood creatinine level, microscopic erythrocyte grade, urinary immunoglobulin G/creatinine ratio, and serum immunoglobulin A.CONCLUSION This study provides important insights into the pathological and clinical features of DKD and identifies independent factors associated with DKD + NDKD.
ENSO-Former: Spatiotemporal fusion network based on multivariate and dual-branch Transformer for ENSO prediction
Authors: Fang Wei , Sha Yu
Published: April 2024

El Niño Southern Oscillation (ENSO) is a natural climate phenomenon. Mainly characterized by the periodic variation of sea surface temperature anomalies in the eastern equatorial Pacific. It has significant impacts on global climate change. The traditional ENSO prediction methods rely on complex physical models and empirical rules, but these methods still have significant biases and uncertainties. We design a novel multi-head spatiotemporal convolutional attention module, TSCA Block. The module employs a dual-branch structure to fully exploit spatiotemporal features, where the spatiotemporal attention mechanism is used to capture long-term dependencies in time and space. Subsequent convolutional modules are used to locally enhance features. In addition, we also propose a spatiotemporal fusion prediction model based on multivariable and dual-branch Transformers, called ENSO-Former. By repeating basic building blocks at multiple stages and adopting long skip connections between shallow and deep layers, it captures multiscale features and dynamic changes of ENSO more effectively. We train using multiple meteorological factors, initially pre-training with various model-simulated data, followed by fine-tuning using transfer learning on reanalysis datasets. Experimental results show that the model achieves a correlation skill of 0.51 for predicting ENSO 20 months in advance during the period from 1983 to 2021. Compared to the current state-of-the-art deep learning model, the correlation skill is improved by 0.06. The source code will be available at https://github.com/shaxiaoyuyu/ensoformer.git.
The suture fixation of the levonorgestrel-releasing intrauterine device with hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion
Authors: Mao Min , Gou Yuanqin , Luo Zhigui , Li Yuanhong , Tong Yu
Published: April 2024

Background: This study aimed to investigate the safety and efficacy ofsuture fixation of the levonorgestrel-releasing intrauterine device (LNG-IUD) by hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion.
Methods: 21 patients with large symptomaticadenomyosis were sewed and fixed with the LNG-IUD in the uterus by hysteroscopy to prevent the device expulsion.
Results:In this prospective case series, all 21 patients were successfully sewed and fixed with the LNG-IUD in the uterus by hysteroscopy. The amount of menstruation was significantly decreased and dysmenorrhea was significantlyrelieved in 3, 6, and 12 months after surgery compared with before surgery. Only one patient underwent a laparoscopic hysterectomy due to dysmenorrhea which was not alleviated one month later. Serious IUD complications including expulsion and perforation were not observed. There was no development of new side effects than LNG-IUD insertion.
Conclusion: Suture fixation of the LNG-IUD by hysteroscope is a safe, effective, and minimally invasive surgical procedure to prevent the device expulsion. It is a good solution for the treatment of patients with large symptomatic adenomyosis.
Uncovering CARD14 features in cancer
Authors: Manils Joan , Bespalov Daniil , Pino Dayana , Vidal-Guirao Sonia , Franquesa Julia , Lopez-Ramajo Daniel , Filgaira Ingrid , Wan Li , O'Sullivan Paul A , Ley Steven C , Forcales Sonia Vanina , Rojas Juan Jose , Izquierdo-Serra Merce , Soler Concepcio
Published: April 2024

Aberrant caspase recruitment domain family member 14 (CARD14) signaling has been strongly associated with inflammatory skin conditions. CARD14 acts as a scaffold protein, ultimately activating the transcription factor NF-KB. Although primarily studied in the context of inflammation, recent research has suggested its potential implications in tumorigenesis. In this study, we gathered TCGA tumor data to gauge the involvement of CARD14 in cancer, including genetic alterations, expression patterns, survival correlations, immune cell infiltration and functional interactions across diverse cancer types. We found heightened CARD14 expression in different tumors, which was associated with patient outcomes; hence, CARD14 could be used as a prognostic biomarker in several cancers, highlighting its potential clinical relevance.
A scattered volume emitter micropixel architecture for ultraefficient light extraction from DUV LEDs
Authors: Fajri Faris Azim Ahmad , Mukherjee Anjan , Naskar Suraj , Noorden Ahmad Fakhrurrazi Ahmad , Abass Aimi
Published: April 2024

Deep ultraviolet light-emitting diodes (DUV LEDs) typically suffer from strong parasitic absorption in the p-epitaxial layer and rear metal contact/mirror. This problem is exacerbated by a significant portion of the multiquantum well (MQW) emissions having a strong out-of-plane dipole component, contributing to emission in widely oblique directions outside the exit cone of the emitting surface. Here, an architecture that exploits heavy oblique emission is proposed by using scattered volume emitter micropixels that are spaced apart and embedded in a low-index dielectric buffer film with a patterned top surface. This approach significantly increases the surface-to-volume ratio of the semiconductor and does not require a high-index (e.g., sapphire) substrate or a lens to achieve high extraction efficiency. Depending on the assumed epilayer absorption, the hybrid wave and ray optical simulations demonstrated a 3- to 6-fold increase in light extraction efficiency compared to that of a conventional planar design with a sapphire substrate reference. An extraction efficiency three times greater than that of a recent nanotextured DUV LED design was also demonstrated. This architecture paves the way for DUV LEDs to have a plug efficiency comparable to that of mercury lamps while still being significantly smaller.
MicroRNA-195-5p suppresses metastasis by targeting VEGFA in nasopharyngeal carcinoma
Authors: Li Xian , zhu Qin , Xie Liang , Liu Xiang-Lin , Hu Jing-Ye , Yi Wei
Published: April 2024

Background
MicroRNA (miRNA) plays an important role in nasopharyngeal carcinoma (NPC). We aimed to identify a microRNA that can help us understand the molecular mechanism and develop target therapy for NPC.
Methods:
MiRNA expression levels in 18 specimens of nasopharyngeal carcinoma were firstly analysed using quantitative real-time PCR (qRT-PCR). Then we further detected vascular endothelial growth factor A (VEGFA) protein with immunohistochemistry in 108 paraffin-embedded samples from the First Affiliated Hospital of Guangzhou Medical University (Guangzhou, China). The cell line Hone1, 5-8F, CNE1 and CNE2 were employed in transwell invasion assay, western blot, RT-PCR and dual luciferase assay.
Results:
We found miR-195-5p had a lower expression level in high metastasis potential NPC, compared with low metastasis potential NPC (p < 0.05). In in-vitro experiment, the over expressed miR-195-5p resulted in significant decrease in migration and invasion of NPC cells. In contrast, the down-regulation of miR-195-5p increased their migration and invasion. By using dual luciferase assay, we found a binding site between miR-195-5p and 3’-UTR of VEGFA. Through direct binding, miR-195-5p can suppress VEGFA in NPC cell. The results of immunohistochemistry showed that patients with high expression of VEGFA had a poor distance-metastasis free survival (p < 0.05).
Conclusions:
It was concluded that the expression level of miR-195-5p in patients with NPC was associated with metastasis by targeting VEGFA, which suggests that miR-195-5p is a potential biomarker of prognosis and molecular therapeutic target in NPC.
Hepatic Steatosis affects the Outcome of Anti- tuberculosis Treatment in Pulmonary Tuberculosis Patients
Authors: Du Zhi-xiang , Yang Yuan , Gong Yu-xiang , Liu Xing , Chen Miao-yang , Wang Li , Liu Hong-li , Zhang Yu , Hu Chun-mei , YANG Jiang-hua , Hao Ming-da , Li Yang , Yang Yong-feng
Published: April 2024

Background:
Pulmonary Tuberculosis (PTB) remains the leading cause of death from infectious diseases worldwide. Few studies have investigated hepatic steatosis's effect on PTB's progression and prognosis.
Methods: We selected 785 PTB patients in this study. And 174 PTB patients were enrolled in the statistical analysis. Patients with positive sputum smears for over eight weeks are clustered in the Extension Group. Conversely, the other patients are clustered in the Unextended Group. The clinical data were used to analyze the risk factors for the time of smear conversion.
Results:
Eleven different factors were obtained from the clinical data of PTB patients. According to clinical significance, correlation detection, collinearity diagnosis, and chest package score, six factors were enrolled into the model. The logistics regression analysis confirmed that Hepatic steatosis and IL-18 were positively correlated with the smear conversion (β= 2.401, OR =11.036, 95% CI = 2.489-48.934; β= 2.396, OR =10.984, 95% CI = 1.832-65.862). On the contrary, the T-SPOT was negatively correlated with the smear conversion (β= -4.199, OR =0.015, 95% CI = 0.001-0.172).
Conclusions:
Hepatic steatosis is confirmed as an independent risk factor affecting smear conversion time in PTB. The levels of serum cytokines, such as IL-6 and IL-18, are significantly related to the outcome of anti-tuberculosis treatment. Previous studies have confirmed that hepatic steatosis is associated with abnormal serum cytokines. Therefore, more attention is needed for the PTB patients with hepatic steatosis.
Derivation and Validation of Generalized Sepsis-induced Acute Respiratory Failure Phenotypes Among Critically Ill Patients: A Retrospective Study
Authors: Choudhary Tilendra , Upadhyaya Pulakesh , Davis Carolyn M. , Yang Philip , Tallowin Simon , Lisboa Felipe A. , Schobel Seth A. , Coopersmith Craig M. , Elster Eric A. , Buchman Timothy G. , Dente Christopher J. , Kamaleswaran Rishikesan
Published: April 2024

Background: Septic patients who develop acute respiratory failure (ARF) requiring mechanical ventilation represent a heterogenous subgroup of critically ill patients with widely variable clinical characteristics. Identifying distinct phenotypes of these patients may reveal insights about the broader heterogeneity in the clinical course of sepsis. We aimed to derive novel phenotypes of sepsis-induced ARF using observational clinical data and investigate their generalizability across multi-ICU specialties, considering multi-organ dynamics.
Methods: We performed a multi-center retrospective study of ICU patients with sepsis who required mechanical ventilation for ≥24 hours. Data from two different high-volume academic hospital systems were used as a derivation set with N=3,225 medical ICU (MICU) patients and a validation set with N=848 MICU patients. For the multi-ICU validation, we utilized retrospective data from two surgical ICUs at the same hospitals (N=1,577). Clinical data from 24 hours preceding intubation was used to derive distinct phenotypes using an explainable machine learning-based clustering model interpreted by clinical experts.
Results: Four distinct ARF phenotypes were identified: A (severe multi-organ dysfunction (MOD) with a high likelihood of kidney injury and heart failure), B (severe hypoxemic respiratory failure [median P/F=123]), C (mild hypoxia [median P/F=240]), and D (severe MOD with a high likelihood of hepatic injury, coagulopathy, and lactic acidosis). Patients in each phenotype showed differences in clinical course and mortality rates despite similarities in demographics and admission co-morbidities. The phenotypes were reproduced in external validation utilizing an external MICU from second hospital and SICUs from both centers. Kaplan-Meier analysis showed significant difference in 28-day mortality across the phenotypes (p<0.01) and consistent across both centers. The phenotypes demonstrated differences in treatment effects associated with high positive end-expiratory pressure (PEEP) strategy.
Conclusion: The phenotypes demonstrated unique patterns of organ injury and differences in clinical outcomes, which may help inform future research and clinical trial design for tailored management strategies.
Reducing adverse events associated with pediatric cardiac catheterization: A quality improvement project focusing on decreasing unnecessary blood transfusions
Authors: Wilhelm Michael , Torgeson Jenna , Cook Connor , Erdmann Alexandra , Boriosi Juan , Lamers Luke
Published: April 2024

Objective: To describe interventions and outcomes of a quality improvement (QI) project to reduce red blood cell transfusion (RBCT) within 72 hours of pediatric cardiac catheterization.
Methods: Using Plan-Do-Study-Act (PDSA) methodology we applied interventions including: 1. Intraprocedural - to reduce hemodilution, blood loss, and excessive anticoagulation, 2. Standardization of institutional transfusion criteria, and 3. “Hard stop” requiring QI team approval prior to elective RBCT. Primary outcome measures were frequency of RBCT from IMPACT quarterly reports and cases between transfusions (CBT). Length of stay (LOS) was a countermeasure. Characteristics of patients who did and did not receive RBCT were compared.
Results: 698 pediatric cardiac catheterizations occurred between 4/2017-8/2023. Intraprocedural interventions did not alter frequency of RBCT or CBT. Standardized transfusion guidelines followed by the “hard stop” decreased RBCT frequency from 10% to 1.9% and increased CBT without increasing LOS. Patients requiring RBCT were younger (medians 0.31 vs 2.4 years), smaller (5.2 vs 11.8 kg) and had longer procedures (2.24 vs 1.57 hours) all p<0.001. Single ventricle patients were more likely to have RBCT than simple biventricular patients (14.1% vs 3.1%; RR = 4.57, 95% CI: 2.29–10.4; p < 0.001). Procedure type (diagnostic vs. intervention) and starting hemoglobin concentration were comparable between groups.
Conclusion: Programmatic adherence to standardized peri-procedural transfusion guidelines successfully decreased RBCT without compromising patient care or increasing LOS. Younger age, lower weight, procedure length, and single ventricle physiology were all associated with RBCT risk.
Action Unit-Based 3D Face Reconstruction Using Transformers
Authors: Kim Hyeonjin , Wang Pei , Lee Hyukjoon
Published: April 2024

The reconstruction of 3D face shapes and expressions from single 2D images remains unconquered due to the lack of detailed modeling of human facial movements such as the correlation between the different parts of faces. Facial action units (AUs), which represent detailed taxonomy of the human facial movements based on observation of activation of muscles or muscle groups, can be used to model various facial expression types. We present a novel 3D face reconstruction framework called AU feature-based 3D FAce Reconstruction using Transformer (AUFART) that can generate a 3D face model that is responsive to AU activation given a single monocular 2D image to capture expressions. AUFART leverages AU-specific features as well as facial global features to achieve accurate 3D reconstruction of facial expressions using transformers. We also introduce a loss function which is to force the learning toward the minimal discrepancy in AU activations between the input and rendered reconstruction. The proposed framework achieves an average F1 score of 0.39, outperforming state-of-the-art methods.
Covid-19 Vaccination Uptake Among Remote Communities in Malaysia: A Cross-sectional Study
Authors: Mahjom Maznieda , Shukor Imanul Hassan Abdul , Arip Masita , Saupin Sahipudin , Mohamad Fitri Suraya , Deraman Nurul Fadzilah , Ismail Rohaida , Sa Dzarifah Hanis Md , Udin Nurul Shahira Asyikin Mohd Redda , Ghazali Mizanurfakhri
Published: April 2024

Intro: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for highly contagious respiratory infectious disease causing a pandemic in 2020. It used angiotensin-converting enzyme 2 (ACE2) receptor for permitting their entry into the human cells. Initially, COVID-19 was managed through secondary and tertiary prevention. Many countries began to implement lockdown and vaccination programmes after developing vaccines. Most COVID-19 vaccines aim to prevent uptake via the human ACE2 receptor by inducing neutralising antibodies against the viral spike (S) protein. Malaysia implemented the National COVID-19 Immunisation Programme (PICK) in February 2021, involving the government and society to vaccinate 80% of the population. The study aims to determine the uptake of COVID-19 vaccination among remote communities in Malaysia and its associated factors.
Method: It is a cross-sectional study conducted in two phases between September 2021 and April 2023 among the remote communities in Malaysia, with 1005 respondents. A two-stage stratified random sampling method was applied to collect data from heads of households (HHs) in each enumeration block given by the Department of Statistics Malaysia (DOSM). Data were analysed using the Statistical Package for Social Sciences (SPSS) version 28.
Result: The result revealed that 99% of remote communities were willing to receive COVID-19 vaccination. 99% of the participants had received the first dose of vaccination, while 92% had completed a series of vaccinations. Factors associated with vaccination uptake among remote communities were state location (2.01[1.62-2.80]), age (1.04[1.01-1.07]), and main transport to the workplace (0.45[0.26-0.78]).
Conclusion: Malaysia is more willing to take vaccination than Asian and European countries. Vaccination uptake among the remote communities in Malaysia is also higher than Thailand, Western Australia and South Africa. The contributing factors for the vaccination uptake and willingness were Whole-of-Government and Whole-of-Society approaches, no-cost for the vaccination to all residing in Malaysia, regardless of citizenship status and public area restriction if they did not have two doses of vaccination in their MySejahteraapplication.
Re-Irradiation of Anaplastic Meningioma: Higher dose and concomitant Bevacizumab may improve progression-free survival
Authors: Haisraely Ory , Taliansky Alicia , sivan Maayan , Lawernce Yaacov
Published: April 2024

Introduction: Anaplastic meningiomas, categorized as WHO grade 3 tumors, are rare and highly aggressive, accounting for 1%-2% of all meningioma cases. Despite aggressive treatment, including surgery and Radiation, they exhibit a high recurrence rate and poor survival outcomes. The aggressive histopathological features emphasize the urgent need for effective management strategies. Methods: A retrospective multi-institutional analysis was conducted on patients with recurrent anaplastic meningioma who underwent re-irradiation between 2017 and 2023. Clinical, dosimetric, and outcome data were collected and analyzed, focusing on local control, progression free survival and treatment-related adverse events. Results: Thirty-four cases were analyzed, with a median follow-up 11 months after re-irradiation. Progression-free survival at 12 months was 61.9%, with higher doses correlating with better outcomes. Concomitant Bevacizumab improves progression-free survival and reduces the risk of radiation necrosis. CDKN2A homozygote deletion correlated with a higher risk of local failure. Symptomatic radiation necrosis occurred in 20.5% of cases, but its incidence was lower with concomitant Bevacizumab treatment. Conclusion: Re-irradiation presents a viable option for recurrent anaplastic meningioma despite the associated risk of radiation necrosis. Higher doses with concomitant Bevacizumab improve clinical outcomes and reduce toxicity. Individualized treatment approaches are necessary, emphasizing the importance of further research to refine management strategies for this challenging disease.