bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral Doses Beyond Electron Applicators in Conventional C-Arm Linear Accelerators: A Systematic Literature Review
Authors: Maharaj Kapil Dev , Dass Joshua , Ibrahim Mounir , Mahmood Talat , Rowshanfarzad Pejman
Published: March 2024

Background: This review investigates peripheral dose levels in electron beam treatments, comparing different manufacturers including Varian, Elekta, and Siemens. Accurate measurement of peripheral dose is vital for patient safety and precise radiation delivery in radiation therapy. Methods: This review followed PRISMA standards, conducting a comprehensive literature search from 1978 to July 2023. Emphasis was on identifying studies analyzing peripheral doses related to various electron beam energies, beam angle, field sizes, cutouts, and applicator combinations. Three major databases including PubMed, Web of Science, and Scopus were searched. Results: A total of 7 articles were included in this review. Strategies such as bolus materials, personalized cutouts, and optimal treatment procedures have all been developed to reduce peripheral radiation exposure and enhance patient safety. Ongoing research in this field is focused on further minimizing the risks associated with out-of-field radiation by improving dose delivery systems. Conclusion: The literature emphasizes importance of precision in electron beam radiation therapy, highlighting the critical need for managing peripheral doses and optimizing hardware to ensure patient safety. It advocates for the use of advanced tools and protocols to maintain a balance between effective treatment while protecting healthy tissues. Continuous research, careful treatment planning, and effective management of peripheral doses are essential.
Youth Sport Specialization: Current Concepts and Clinical Guides
Authors: Sugimoto Dai , Whitney Kristin E. , d’Hemecourt Pierre A. , Stracciolini Andrea
Published: March 2024

The concept of youth sport specialization has evolved over the past decade, from a focus on the risk of overuse injury to a broader awareness of its effects on mental health, social well-being, quality of life, growth and maturation, sport performance, and long-term athletic success. This review article considers a recently revised definition of youth sport specialization, as well as guidelines and consensus statements from various sports medicine organizations, with practical applications for young athletes.
Safety and efficacy of early carotid artery stenting in patients with symptomatic stenosis
Authors: Rodríguez Isabel , Gramegna Laura Ludovica , Requena Manuel , Rizzuti Michele , Elosua Iker , Mayol Jordi , Olivé-Gadea Marta , Diana Francesco , Rodrigo-Gisbert Marc , Muchada Marián , Rivera Eila , García-Tornel Álvaro , Rizzo Federica , De Dios Marta , Rodríguez-Luna David , Piñana Carlos , Pagola Jorge , Hernández David , Juega Jesús , Rodríguez Noelia , Quintana Manuel , Molina Carlos , Ribo Marc , Tomasello Alejandro
Published: March 2024

Background

Symptomatic carotid artery stenosis is a significant contributor to ischemic strokes. Carotid artery stenting (CAS) is usually indicated for secondary stroke prevention. This study evaluates the safety and efficacy of CAS performed within a short time frame from symptom onset.

Methods

We conducted a single-center, retrospective study of consecutive patients who underwent CAS for symptomatic carotid stenosis within eight days of symptom onset from July 2019 to January 2022. Data on demographics, medical history, procedural details, and follow-up outcomes were analyzed. The primary outcome measure was the recurrence of the stroke within the first month post-procedure. Secondary outcomes included mortality, the rate of intra-procedural complications, and hyperperfusion syndrome.

Results

We included 93 patients with a mean age of 71.7 ± 11.7 years. The median time from symptom onset to CAS was 96 h. The rate of stroke recurrence was 5.4% in the first month, with a significant association between the number of stents used and increased recurrence risk. Mortality within the first month was 3.2%, with an overall mortality rate of 11.8% after a median follow-up of 19 months. Intra-procedural complications were present in five (5.4%) cases and were related to the number of stents used ( p = 0.002) and post-procedural angioplasty ( p = 0.045). Hyperperfusion syndrome occurred in 3.2% of cases.

Conclusion

Early CAS within the high-risk window post-symptom onset is a viable secondary stroke prevention strategy in patients with symptomatic carotid artery stenosis. The procedure rate of complication is acceptable, with a low recurrence of stroke. However, further careful selection of patients for this procedural strategy is crucial to optimize outcomes.
Middle meningeal artery embolization for the treatment of unilateral large chronic subdural hematoma patients with significant midline shift: A single-center experience
Authors: Niu Yin , Zhang Qiang , Jiang Zhouyang , Li Wenyan , Chen Zhi
Published: March 2024

Background

The amount of midline shift (MLS) considered safe for middle meningeal artery embolization (MMAE) in patients with chronic subdural hematoma (CSDH) has not been established. Whether MMAE could be used as upfront treatment for unilateral large CSDH patients with significant MLS (>1 cm) has not been reported.

Objective

To investigate the efficacy and safety of MMAE in unilateral large CSDH patients with MLS > 1 cm.

Methods

Eleven carefully selected CSDH patients with mild or moderate symptoms and significant MLS > 1 cm from 1 May 2021 to 31 August 2022 were included in the study. All patients were treated with MMAE using polyvinyl alcohol (PVA) particles. Outcomes were assessed clinically and with interval imaging studies at follow-up.

Results

All 19 MMAs (unilateral embolization in three patients and bilateral embolization in eight patients) were successfully embolized. All 11 patients were followed for subsequent months, and there was no recurrence and enlargement of CSDH. Procedural adverse events, mortality, or complications were not observed. The average time to achieve a 50% reduction in MLS was approximately four weeks, while it took approximately eight weeks to achieve a 50% reduction in maximal volume. All 11 patients showed improvement in their neurological symptoms at three days post-operation, including four hemiplegic patients.

Conclusions

MMAE may demonstrate safety in carefully selected CSDH patients with significant midline shift (MLS > 1 cm), particularly in those who are not suitable for surgery, thus providing a potential alternative approach.
Feasibility of ultrasound measurement of tracheal diameter in patients undergoing severe scoliosis orthopedic surgery: A randomized trial
Authors: Tian Ying , Yu Mingshuai , Zhang Ke , Chen Zuqi , Xiao Tianke
Published: March 2024

Objective

To explore the feasibility of ultrasound measurement of the transverse diameter of the cervical trachea at its narrowest point in patients undergoing severe scoliosis orthopedic surgery.

Methods

A total of 110 patients, aged 18-65, who scheduled for elective orthopedic surgery for severe scoliosis were included. Prior to surgery, all patients underwent two types of tracheal inner diameter measurements: (1) CT measurement of the anteroposterior diameter (Dmin,AP) and transverse diameter (Dmin,T) of the cervical trachea at its narrowest point; and (2) ultrasound measurement of Dmin,T. Based on the measurement results, the patients were randomly divided into two groups, the CT group ( n = 55) and the ultrasound group ( n = 55). We compared the Dmin,AP and Dmin,T measured by CT for all patients. Then, we compared CT and ultrasound measurements of Dmin,T. Furthermore, we conducted an analysis to determine the correlation and consistency between the two methods. Additionally, we examined the success rate of first-attempt tracheal intubation and the occurrence rate of tracheal tube being too wide or too narrow between the two groups, and assessed the occurrence of postoperative 24-h pharyngeal pain and hoarseness.

Results

When comparing the Dmin,AP and Dmin,T measured by CT in all patients, a statistically significant difference was observed ( p < .001). When comparing the measurements of Dmin,T between CT and ultrasound in all patients, no statistically significant differences were found ( p > .05). The correlation coefficient (r) between CT and ultrasound measurements of Dmin,T was 0.849 ( p < .001). The mean difference in Dmin,T was 0.19 mm, and the limits of agreement (LoA) were −2.24 mm to 2.62 mm.

Conclusions

Ultrasound measurement of Dmin,T in severe scoliosis patients is feasible and provides valuable guidance for the selection of endotracheal tube sizes. It serves as a non-invasive and bedside auxiliary examination method for perioperative airway assessment.
Challenges to Democratization from the Perspective of Political Inaction: Insights into Political Disempowerment and Citizenship in the Philippines
Authors: Borja Anthony Lawrence A. , Torneo Ador R. , Hecita Ian Jayson R.
Published: March 2024

Though scholarship on Philippine politics has focused on either structures or elites, political participation and inaction have become equally pertinent issues, especially in times of political change. The Philippines shows a curious juxtaposition between high levels of electoral participation in the general citizenry and mass political inaction among the majority of Filipinos outside the ballot. For this reason, we would try to make sense of this paradox by analyzing political disempowerment itself and how it is linked to political participation. Hence, we raise and address the question, what challenges do political disempowerment as political powerlessness and cynicism posit against democratization in the Philippines? The trends captured in the 2nd–5th waves of the Asia Barometer Survey suggest that political disempowerment is a vicious cycle driven by perceived dis/incentives to political participation without depoliticizing citizens. Political spectatorship is the key to understanding the virtuousness or viciousness of this cycle.
“I Need to Do Better”: The Promotion of Undergraduate Women's STEM Identity by Engineering Faculty
Authors: Peterson Elizabeth , Kulakowski Emily , Mendez Sylvia L.
Published: March 2024

The purpose of this intrinsic case study was to explore the conceptual knowledge of engineering faculty regarding STEM identity and how they promote undergraduate women's STEM identity in the classroom. Interviews with faculty were grounded in Collins’ contextual model of Black student STEM identity and were analyzed inductively and deductively. Three themes emerged: (1) faculty are aware of STEM identity but cannot define it; (2) faculty passively promotes STEM identity in the classroom; and (3) faculty actively promote STEM identity through research, service, and mentorship. These findings shed light on the general commitment of engineering faculty to broaden and diversify participation in their field as well as the need for a greater understanding of the role faculty can play in stimulating the STEM identity of undergraduate women in the classroom, efforts that may translate into more women earning baccalaureate degrees in engineering.
Ab Initio Conformational Analysis of 3,7-Diacetyl-3,7-Diazabicyclo[3.3.1]Nonanes
Authors: Pisarev Sergey A. , Golubeva Elena A. , Palyulin Vladimir A.
Published: March 2024

Introduction: The importance of the conformational behavior comprehension for proper prediction of properties for a certain compound or for a class of compounds is indisputable. For 3,7-diacylbispidines (3,7-diacyl-3,7-diazabicyclo[3.3.1]nonanes), only “double chair” (CC) conformers were prior found experimentally in the condensed phase, which differ only in the acyl groups relative orientation, “parallel,” pa or “antiparallel,” ap. However, 2 other conformer families, “boat-chair,” BC and “double twist,” TT, are known for other bicyclo[3.3.1]nonane derivatives. Features of these conformers would be useful for the accurate prediction of properties and activities of the compounds. Methods: Second-order perturbation theory ab initio techniques (MP2) in the triple-zeta correlation-consistent orbital basis set cc-pVTZ was employed to optimize the electronic energy for structures, to characterize the optimized structures as potential energy surface minima by energy hessian eigenvalue calculations and to calculate zero-point energy corrections for the minima using the “rigid rotor-harmonic oscillator” approximation to model the molecular ensemble thermodynamics. Additionally, the computational chemical thermodynamics benefits much from the concept of the molecular strain and its energy assessed successfully through the bond separation energy formalism. We combine both approaches in our investigation to find and consistently characterize the conformers previously unknown for the compounds under the studies. Results: Six possible conformers were found for the investigated 3,7-diacetyl-3,7-diazabicyclo[3.3.1]nonanes 1-4, formed by combining the skeletal conformation changes with the internal rotation of acyl substituents. The conformational behavior is quite similar for all investigated molecules. In all cases, the CC conformation is optimal for the bicyclic skeleton and ap orientation prevails over pa for 2 acetyl groups. This prevalence is 4-5 kcal mol−1 in CC and less than 1 kcal mol−1 in other skeletal forms, making rotation of 2 acyl groups in BC and TT almost independent. Concerning the skeletal conformations, the common energy sequence CC < BC < TT is found. While the relative BC energy is 6-7 kcal mol−1 over the optimal CC structure, TT forms are all strained by more than 12 kcal mol−1. Conclusions: For the first time, both BC and TT conformers of 3,7-diacetylbispidines were characterized by their strain and conformation energies together with known less strained CC forms. On the basis of our calculations, the relative energies of BC conformers are expected to be close to those of the CC acetyl amide bond rotamers found previously in experiment, therefore, their exclusion from the conformational behavior would look unjustified. On the contrary, TT conformers are found to be much more strained enough to be neglected in the conformational ensemble modeling.
Picnic methodology: rethinking multispecies relationships through alfresco meals
Authors: Koski Kaisu
Published: March 2024

This essay introduces a speculative “picnic methodology” emerging from site-specific performance art practice with a herd of reindeer. The practice expands from the justice-oriented picnic tradition and stages picnic as a space to envision nonhierarchical multispecies relationships. The picnic blanket is offered as a meeting place to appreciate more-than-human ways of being, thinking, and knowing, starting with our relative, the reindeer. The essay draws from the short film City Reindeer (2022), documenting the durational picnics in the wintery Arctic. The performance art practice forms here a contemplative and playful intervention to decenter the human and give the reindeer a voice, with an underlying commitment to promoting veganism.
Algorithmic management of platform workers: An examination of the Canadian and European approaches to regulation
Authors: Ogunde Fife
Published: March 2024

Algorithmic management, though less attention-grabbing than total job automation, is expected to become even more influential and powerful over time. The realities of algorithmic management have gained increasing scholarly attention over the last decade, particularly in the context of employment relationships in the platform economy. This article contributes to existing scholarship by comparing two important pieces of legislation impacting algorithmic management in the platform economy: Ontario's Digital Workers’ Rights Act 2022 (‘the Act’) and the Proposal for a Directive of the European Parliament and of the Council on Improving Conditions in Platform Work (‘the Directive’). The thrust of this article is that while the general tenor of the Act indicates a step in the right direction, its restrictive approach to information rights limits its overall effectiveness in regulating algorithmic management of platform workers.
Adapting player styles to enhance learning and retention in high school science education
Authors: Moradi Mahsa , Mahdavinasab Yousef , Mehrvarz Mahboobe
Published: March 2024

The impact of player styles in game-based learning on academic performance is a significant consideration, with the exploratory style being one of these styles. Despite the initial random sampling of 60 tenth-grade students to ensure unbiased representation, the sampling method became purposeful as students with the exploratory player style were selectively placed in the first experimental group. Pre-test data, collected using Bartle’s player styles questionnaire, informed the categorization of students into groups based on their styles, enhancing sampling accuracy. The Explorer player style students formed one group, while students with other styles constituted a separate group. All students completed the Player Styles questionnaire and a pre-learning test. Subsequently, an exploratory-style game was provided to all students, followed by learning and retention tests. The data analysis method employed for this study was MANCOVA. The outcomes of the multivariate analysis of covariance (MANCOVA) demonstrate a substantial multivariate F value of 7.075 (df = 2) with a significant level at p < .05. This outcome substantiates the existence of a notable distinction between the students belonging to the first group (exemplifying the explorer player style) and those in the second experimental group (encompassing the socializer, achiever, and killer player styles) concerning the dependent variables (learning and retention). The observed distinction is in favor of the first experimental group, underscoring the potential influence of player styles on the variables under consideration.
A Contrastive Study of Lexical Bundles Expressing Gratitude in Dissertation Acknowledgments Produced by Chinese and American PhD Students of Linguistics
Authors: Bao Kai , Liu Meihua
Published: March 2024

This study compared the five-word lexical bundles (LBs) expressing gratitude in acknowledgments of dissertations written by Chinese and American PhD students of linguistics. Two corpora were built: (1) The Chinese University Dissertation Acknowledgments Collection (CUC) which contained 700 acknowledgments with a total of 300,686 tokens, and (2) the American University Dissertation Acknowledgments Collection (AUC) which contained 700 acknowledgments with a total of 493,045 tokens. We then retrieved five-word LBs, of which LBs expressing gratitude in CUC and AUC were identified, categorized, and compared with respect to frequency, forms and structures. Major findings were: (1) the Chinese students used a substantially greater number of gratitude LBs than the American students, (2) the two groups used considerably different gratitude LBs, and (3) the two groups mainly relied on verb phrase-based LBs to express gratitude, but the Chinese students used a larger proportion of noun phrase- yet a smaller proportion of verb phrase-based items than the American students, and (4) the two groups used dissimilar structures and words to construct gratitude LBs. These findings enrich our knowledge of linguistic patterns in dissertation acknowledgments as a unique genre of academic prose, and provide corpus-based learning materials for students tasked with properly expressing gratitude in their theses or dissertations.
Revisiting the Andersen Model: Transnational Ties With the Home Country and Healthcare Utilization Among Chinese International Students in South Korea
Authors: Jang Sou Hyun , Yi Yong Jeong
Published: March 2024

The present study aimed to understand how Chinese international students perceived and experience healthcare utilization in Korea and to broaden Andersen’s framework in the age of globalization, allowing easier maintenance of transnational relationships with one’s native country. We analyzed the in-depth personal interviews with 31 Chinese international students. The grounded theory was employed to analyze the interview data. Among factors suggested by Andersen, predisposing (perceptions about the Korean healthcare system) and enabling (financial barriers, language barriers, and lack of social support) factors contributed to healthcare utilization among Chinese international students in Korea. Self-medication via broad medical transnational ties with the home country (bringing medications from home) impeded their healthcare utilization. We highlighted the roles of their campus health center to promote optimal healthcare utilization for Chinese international students. It is important to educate international students about the risks or negative effects of self-medication.
The Introduction of Modal Verbs in English Textbooks Across Levels in China
Authors: Gao Xia
Published: March 2024

The introduction of modal verbs in English textbooks across levels in China was surveyed and compared with Chinese learners’ use in writing to explore the potential impact of textbook introduction on learners’ real use. The results have revealed (1) divergences between the sequence of modal verb presentation in textbooks and their frequency order in native speakers’ use, the unusual lower coverage of WOULD and early introduction of SHALL in particular; (2) the imbalanced coverage of different forms and senses of modal verbs in textbooks, notwithstanding that learners deploy some senses or forms in writing even if these usages have not been introduced; and (3) the constrained way of introduction—English to Chinese translation in vocabulary, simple explanation and exemplification in sentence context. Core senses and fundamental forms introduced early in textbooks are used most frequently in learners’ writing. Modal verbs with the perfect aspect structure and their associated senses introduced in textbooks at university levels rarely occur in learners’ writing even at advanced levels. Limited agreement between textbook introduction and learners’ use has been detected.
Polling to vaccination stations: Brexit’s influence on immunisation uptake
Authors: Gallagher Mitchell
Published: March 2024

This study investigates political decisions and epidemiological developments. Employing a quantitative approach, this paper examines proportions of votes advocating Brexit with the proportional rates of Covid-19 vaccinations among individuals aged 18 years and above. A discernible pattern suggests a link between lower vaccination rates and pro-Brexit inclinations. This research finds a correlative relationship between political behaviour in voting for Brexit, and epidemiological outcomes measured by the uptake of vaccinations among various urban centres, towns, and local governmental jurisdictions within the United Kingdom. However, the results also show socioeconomic control variables are statistically more significant in predicting vaccination rates.
Orthopaedic Hand Patient Support Systems Have Valuable Insight to Patient Function and Pain
Authors: Washnock-Schmid E.A. , Livingston Nicholas , Latack Katie , Wrobel Nancy , Day Charles S.
Published: March 2024

Patient-reported outcome measures (PROs) are increasingly used in clinical assessment. Research on how patient support systems contribute to physician understanding of patient condition is limited. Thus, insights from significant others may provide value, especially when concerns exist regarding patient response validity. Patients recruited from the pre-operative environment undergoing orthopaedic hand procedures responded to PROMIS-Pain Interference (PI), PROMIS-Upper Extremity (UE), PROMIS-Depression (D), and QuickDASH. They then selected a significant other (SO) to do the same. Patients and SOs were also asked to complete the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) as a measure of support-related responses. Patient and SO responses were compared, and support-related responses were added in subsequent analyses to examine their effect on SO PRO assessment.
Patients’ Satisfaction With Physiotherapy Services of Red Cross Physical Rehabilitation Services and Related Factors: A Case Study of Afghanistan
Authors: Ghavami Vahid , Ghiyasi Khalil Ahmad , Kokabi-Saghi Fatemeh , Shabanikiya Hamidreza
Published: March 2024

Patient satisfaction is essential to the patient-centered approach in health services delivery, but little is known about satisfaction with physiotherapy services in Afghanistan. This study evaluated patients’ satisfaction with physiotherapy services and related factors in this country. This study was conducted on 420 recipients of a physiotherapy center in Afghanistan. A questionnaire was used to collect data that measured satisfaction in 4 dimensions: treatment process, logistics, organizational factors, and overall. The scale of the questionnaire was 5-point Likert. The highest possible score was 100. Statistics methods included Spearman's correlation coefficient, Mann-Whitney and Kruskal-Wallis tests for univariate analysis, and Linear Regression for multivariate analysis. The average overall satisfaction score was 84.82 ± 13.24. Among the demographic variables, the relationship between education level and overall satisfaction score was significant. The findings of the linear regression model showed that the 3 dimensions of satisfaction, including the treatment process, logistics, and organizational factors, had statistically significant relationships with overall satisfaction. The level of satisfaction was high in all dimensions. To maximize satisfaction, reducing waiting time and better communication with patients, as components of logistics and organizational factors, are suggested. Patients also need to receive feedback from physiotherapists that are an essential components of the treatment process dimension.
How Climate, Crops, and Health Concerns Are Scripting a Millet Revolution in India
Authors: Nanda Aradhana , Sharma Rekha
Published: March 2024

Millets are small grains, normally referred to as “inferior goods” in the classification of goods, under microeconomics. Across South East Asia and Africa, it has been a staple food for ages. In India, since ancient times, millets have been cultivated and consumed but are not as popular as rice and wheat. In April 2018, India declared 2018 as the National Year of Millets. The United Nations General Assembly at its 75th session in March 2021 declared 2023 as the International Year of Millets. India is already among the five largest economies in the world. India is predicted to be the third fastest-growing economy by 2030. As we embark on to 2024, India has to achieve the dream of a $5 trillion economy and ensure self-sufficiency in the production of food grains. Through the rapid pace of innovation and ideation, and by ensuring food availability, India can achieve a higher growth trajectory. The demographic dividend, digital prowess and the renewed focus on “Millets production” will help India to achieve the goals of “Viksit Bharat” by 2047. This article is an attempt to understand that “encouragement to millet production and consumption” can lead to multifarious gains. Hence, to achieve the goals of sustainable development, it is imperative that healthy and cost-effective crops are encouraged.
Spatial pattern of Olympic medals
Authors: Tóth Géza
Published: March 2024

Reviving the idea of the ancient Olympics, the modern Olympic Games were held in Athens in 1896 after 1503 years. The first Winter Olympics were organized in 1924 by the French town of Chamonix. In 2024, the 30th Summer Olympics will be held. On the occasion of this, I created my map, on which I depicted the countries of the world in terms of their medals won at the Summer and Winter Olympics.
Neighbourhood social capital and political participation in neighbourhood governance: The case of Beijing, China
Authors: Liu Zhilin , Yang Liangwei , Wang Xiaomeng
Published: March 2024

Determinants of individual participation in neighbourhood public affairs have been subject to growing scholarly interest. Urban scholars have adopted the social capital perspective to understanding both informal forms of civic engagement and formal participation in local politics. However, given the mixed findings from the existing literature, whether the social capital theory applies to understanding neighbourhood political participation in Chinese cities requires further investigation. This paper thus examines, in the context of housing marketization and neighbourhood governance reforms, the extent to which neighbourhood social capital promotes neighbourhood political participation among urban residents in China. Using data from a large-scale questionnaire survey conducted in 2017 in Beijing, China, we conducted statistical analysis and found an overall positive relationship between neighbourhood social capital and voting behaviour in neighbourhood elections. However, not all dimensions of social capital are significant, and the positive effects are more salient in newly-developed neighbourhoods of private governance, but not in traditional neighbourhoods in Beijing. These findings extend the international literature on the social capital theory of neighbourhood political participation with additional evidence from a developing country, while also contributing to an emerging line of inquiry on the determinants of civic engagement in neighbourhood governance in transitional urban China.
Genomic imbalance analysis provides new insight into prognostic factors in adult and pediatric T-ALL
Authors: Balducci Estelle , Simonin Mathieu , Duployez Nicolas , Steimlé Thomas , Dourthe Marie-Emilie , Villarese Patrick , Ducassou Stéphane , Arnoux Isabelle , Cayuela Jean-Michel , Balsat Marie , Courtois Lucien , Andrieu Guillaume , Touzart Aurore , Huguet Françoise , Petit Arnaud , Ifrah Norbert , Dombret Hervé , Baruchel André , Macintyre Elizabeth , Preudhomme Claude , Boissel Nicolas , Asnafi Vahid
Published: March 2024

Given the poor outcome of refractory and relapsing T-cell acute lymphoblastic leukemia (T-ALL), identifying prognostic markers is still challenging. Using single nucleotide polymorphism (SNP) array analysis, we provide a comprehensive analysis of genomic imbalances in a cohort of 317 newly diagnosed patients with T-ALL including 135 children and 182 adults with respect to clinical and biological features and outcomes. SNP array results identified at least 1 somatic genomic imbalance in virtually all patients with T-ALL (∼96%). Del(9)(p21) (∼70%) and UPD(9)p21)/CDKN2A/B (∼28%) were the most frequent genomic imbalances. Unexpectedly del(13)(q14)/RB1/DLEU1 (∼14%) was the second most frequent copy number variant followed by del(6)(q15)/CASP8AP2 (∼11%), del(1)(p33)/SIL-TAL1 (∼11%), del(12)(p13)ETV6/CDKN1B (∼9%), del(18)(p11)/PTPN2 (∼9%), del(1)(p36)/RPL22 (∼9%), and del(17)(q11)/NF1/SUZ12 (∼8%). SNP array also revealed distinct profiles of genomic imbalances according to age, immunophenotype, and oncogenetic subgroups. In particular, adult patients with T-ALL demonstrated a significantly higher incidence of del(1)(p36)/RPL22, and del(13)(q14)/RB1/DLEU1, and lower incidence of del(9)(p21) and UPD(9p21)/CDKN2A/B. We determined a threshold of 15 genomic imbalances to stratify patients into high- and low-risk groups of relapse. Survival analysis also revealed the poor outcome, despite the low number of affected cases, conferred by the presence of chromothripsis (n = 6, ∼2%), del(16)(p13)/CREBBP (n = 15, ∼5%) as well as the newly-identified recurrent gain at 6q27 involving MLLT4 (n = 10, ∼3%). Genomic complexity, del(16)(p13)/CREBBP and gain at 6q27 involving MLLT4, maintained their significance in multivariate analysis for survival outcome. Our study thus demonstrated that whole genome analysis of imbalances provides new insights to refine risk stratification in T-ALL. This trial was registered at www.ClinicalTrials.gov as #NCT00222027 and #NCT00327678, and as #FRALLE 2000T trial.
Identification of the estrogen-active compounds via integrating effect-directed analysis and non-target screening in soils of the northeastern China
Authors: Feng Qiang , Yang Li , Chen Jie , Li Fang , Fang Fang , Guo Jinsong , Chen Zhongli , Shao Ying
Published: March 2024

Background

The gaps between estrogenic effect and its effect-active compounds exist frequently due to a large number of compounds that have been reported to induce this effect and the occurrence of pollutants in environments as mixtures. Therefore, identifying the estrogen-active compounds is of importance for environmental management and pollution treatment. In the current study, the effect-directed analysis (EDA) and non-targeted screening (NTS) were integrated to identify the estrogen-active compounds in soils of the rural area with different socioeconomic types (industrial, farming and plantation village) in Northeast China.

Results

The cytotoxicity results indicated that the industrial and farming villages showed cytotoxic effects. The detection rates of estrogenic effects for samples of winter and summer were 100% and 87%, respectively. Of which, the effects were found to be stronger in summer than in winter, with significant difference observed from the farming village (0.1–11.3 EEQ μg/kg dry weight). A total of 159 chemicals were detected by NTS. By integrating EDA, triphenyl phosphate (TPhP) and indole were successfully identified from a raw sample and its fraction, explaining up to 19.31% of the estrogen activity.

Conclusions

The present study demonstrates that the successful identification of seven estrogen-active compounds in rural areas of northeastern China can be achieved through the combination of effect-directed analysis (EDA) and non-targeted screening (NTS). This finding is beneficial for risk monitoring and pollution management.
Improving somatic exome sequencing performance by biological replicates
Authors: Cebeci Yunus Emre , Erturk Rumeysa Aslihan , Ergun Mehmet Arif , Baysan Mehmet
Published: March 2024

Background

Next-generation sequencing (NGS) technologies offer fast and inexpensive identification of DNA sequences. Somatic sequencing is among the primary applications of NGS, where acquired (non-inherited) variants are based on comparing diseased and healthy tissues from the same individual. Somatic mutations in genetic diseases such as cancer are tightly associated with genomic instability. Genomic instability increases heterogenity, complicating sequencing efforts further, a task already challenged by the presence of short reads and repetitions in human DNA. This leads to low concordance among studies and limits reproducibility. This limitation is a significant problem since identified mutations in somatic sequencing are major biomarkers for diagnosis and the primary input of targeted therapies. Benchmarking studies were conducted to assess the error rates and increase reproducibility. Unfortunately, the number of somatic benchmarking sets is very limited due to difficulties in validating true somatic variants. Moreover, most NGS benchmarking studies are based on relatively simpler germline (inherited) sequencing. Recently, a comprehensive somatic sequencing benchmarking set was published by Sequencing Quality Control Phase 2 (SEQC2). We chose this dataset for our experiments because it is a well-validated, cancer-focused dataset that includes many tumor/normal biological replicates. Our study has two primary goals. First goal is to determine how replicate-based consensus approaches can improve the accuracy of somatic variant detection systems. Second goal is to develop highly predictive machine learning (ML) models by employing replicate-based consensus variants as labels during the training phase.

Results

Ensemble approaches that combine alternative algorithms are relatively common; here, as an alternative, we study the performance enhancement potential of biological replicates. We first developed replicate-based consensus approaches that utilize the biological replicates available in this study to improve variant calling performance. Subsequently, we trained ML models using these biological replicates and achieved performance comparable to optimal ML models, those trained using high-confidence variants identified in advance.

Conclusions

Our replicate-based consensus approach can be used to improve variant calling performance and develop efficient ML models. Given the relative ease of obtaining biological replicates, this strategy allows for the development of efficient ML models tailored to specific datasets or scenarios.
Predictive value of estimated plasma volume for postoperative hypotension in percutaneous intramyocardial septal radiofrequency ablation treating for hypertrophic obstructive cardiomyopathy
Authors: Shan Bo , Li Jing , Shi Zhangwei , Han Chao , Zhang Juan , Zhao Jia , Hu Rui , Liu Liwen , Ta Shengjun
Published: March 2024

Background

Estimated plasma volume status (ePVS) estimated by the Duarte formula is associated with clinical outcomes in patients with heart failure. It remains unclear the predictive value of the ePVS to the postoperative hypotension (POH) in percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) treating hypertrophic obstructive cardiomyopathy (HOCM).

Methods

Data of HOCM patients who underwent PIMSRA were retrospectively collected. Preoperative ePVS was calculated using the Duarte formulas which derived from hemoglobin and hematocrit ratios. Clinical variables including physical assessment, biological and echocardiographic parameters were recorded. Patients were labeled with or without POH according to the medical record in the hospital. Univariable and multivariable logistic regression were performed to evaluate the association between ePVS and POH. Using different thresholds derived from quartiles and the best cutoff value of the receiver operating characteristic curve, the diagnostic performance of ePVS was quantified.

Results

Among the 405 patients included in this study, 53 (13.1%) patients were observed with symptomatic POH. Median (IQR) of ePVS in overall patients was 3.77 (3.27~4.40) mL/g and in patients with POH were higher than those without POH. The ePVS was associated with POH, with the odds ratio of 1.669 (95% CI 1.299 ~ 2.144) per mL/g. After adjusted by potential confounders, ePVS remained independently associated with POH, with the approximate odds ratio in different models.

Conclusion

The preoperative ePVS derived from the Duarte formulas was independently associated with postoperative hypotension in HOCM patients who underwent PIMSRA and showed prognostic value to the risk stratification of postoperative management.

Trial registration

NCT06003478 (22/08/2023).
Translation and validation of menopause quick 6 (MQ6) into the Malay language
Authors: Manoharan Anusha , Harris Megat Muhammad , Chin Beh Hooi , Ming Koh Wen , Asmuee Zamzurina , Salamon Norafini , Pefer Jerampang , Radhiyah H. , Hamimmah M. Nadia , Goldstein Susan , Ramasamy Shamala , Sreeramareddy Chandrashekhar T.
Published: March 2024

Background

Inquiring conservative Asian women about their menopausal symptoms is often challenging in crowded primary healthcare clinics. Furthermore, the subject matter is culturally sensitive to most Malaysian women. Hence, the translation of the MQ6 into Malay is crucial to enable self-administration, eliminating the necessity for interviewers and mitigating potential respondent shyness.

Methods

The Menopause Quick 6 (MQ6) questionnaire was translated into the Malay language with an addition of an item, henceforth termed MQ6 (M). Forward and backward translation was performed. Face and content validity were conducted. MQ6 (M) was self-administered to 400 women aged between 40 and 60 attending six primary healthcare clinics in Malaysia. To ascertain the reliability for MQ6 (M), corrected Item-Total Correlation, Squared Multiple Correlation, Cronbach’s Alpha if the Item is Deleted, and Kuder-Richardson Reliability Coefficients (KR20). Exploratory factor analysis was done to determine its’ construct validity.

Results

The outcome of the validation was satisfactory. By the Lawshe method, the content validity ratios ranged from 0.6 to 1.0 and the content validity index was 0.914. The Internal consistency for the MQ6(M) Cronbach’s alpha was 0.711 while Kuder-Richardson Reliability Coefficients KR20 was 0.676. Factor loading of all four items is above 0.70, indicating a well-defined structure. Whereas factor loading for three items fell within the range of 0.50–0.69 indicating a practically significant threshold for a new questionnaire.

Conclusion

The MQ6 (M) has acceptable reliability and construct validity to be considered as a self-administered screening tool in primary care clinics in Malaysia.
Maternal performance after childbirth and its predictors: a cross sectional study
Authors: Choobdarnezhad Masoumeh , Amiri-Farahani Leila , Pezaro Sally
Published: March 2024

Background and Objectives

Birthing parents need to use specialized skills as the first caregiver of the newborn. Several factors may affect performance. Yet there is a paucity of research in this area, and evidence remains inconsistent. Consequently, this study aimed to determine maternal performance after childbirth and its predictors.

Methods

This cross-sectional study was conducted with those (n = 450) who had given birth (< two months) and been referred for the vaccination of their newborn. The multi-stage sampling method was carried out from April 2022 to February 2023. Participants who met the inclusion criteria completed a demographic and obstetric information questionnaire, along with the childbirth experience 2 (CEQ2), Barkin maternal performance and maternal self-efficacy scales. Multiple linear regression was used to investigate the predictive effect of the independent variables of childbirth experience, maternal self-efficacy, demographic and obstetric variables on the dependent variable of maternal performance.

Results

The mean age of the participants was 26.78 and the mean total score of maternal performance was 91.04 (0—120). The highest and lowest scores related to the ‘maternal competence’ and the ‘maternal needs’ domains, with mean score calculated at 77.51 and 72.81 respectively. ‘Childbirth experience’ and ‘maternal self-efficacy’ domains had a statistically significant relationship with maternal performance (P < 0.05). Among the predictive factors of maternal performance, the results of our linear regression demonstrated the variables of birth experience (B = 0.63), maternal self-efficacy (B = 1.53), spouse's employment status (B = 5.78 for worker level, B = 3.99 for employee level), the number of previous childbirth experiences (B = -8.46), frequency of receiving antenatal care (B = -6.68), length of stay in the birth suite (B = -2.22) and length of stay in the hospital (B = 2.84) remained in the model. 53.2% of changes in maternal performance can be explained by these independent variables.

Conclusion

The promotion of evidence-based, person-centered, and respectful perinatal care during pregnancy and childbirth are of paramount importance. Strategies to improve the experience of childbirth and self-efficacy are especially required to improve maternal performance in the postpartum period. Prenatal care aimed at improving maternal function after childbirth will be important in achieving this overall.
Diagnostic significance of cerebrospinal fluid flow cytometry in Chinese children with B lineage acute lymphoblastic leukemia
Authors: Tang Xue , Mai Huirong , Wang Lulu , Chen Shiyang , Chen Fen , Li Tonghui , Liu Yi , Zhou Guichi , Liu Shilin , Wang Ying , Liu Sixi , Fu Xiaoying , Wen Feiqiu
Published: March 2024

Background

Central nervous system leukemia (CNSL) is one of the major causes of the poor prognosis of childhood leukemia. We aimed to compare the sensitivity of cytomorphology (CM) and flow cytometry (FCM) in diagnosing CNSL, emphasizing the importance of FCM in the diagnosis process.

Methods

One-hundred-sixty-five children with newly diagnosed B-cell Acute Lymphoblastic Leukemia (B-cell ALL) were included in this study. Cerebrospinal fluid (CSF) samples were taken for routine CSF analysis, CM analysis, and FCM examination. Computed tomography scans and/or magnetic resonance imaging were performed at diagnosis. Patients with CNS2, CNS3, and traumatic lumbar puncture (TLP) at diagnosis received two additional courses of triple intrathecal injections during induction treatment. We compared the sensitivity of FCM and CM in the diagnosis of children with CNSL.

Results

One hundred and twenty-eight (77.58%) CSF samples were negative by either CM or FCM (CM−/FCM−), four (2.42%) were positive by both CM and FCM (CM+/FCM+), and thirty-three (20%) displayed a single positive finding by FCM (CM−/FCM+) (p = 0.044). By adding two intrathecal injections in the induction treatment, ten children with TLP+ had no CNS relapse, like those with TLP−. However, compared to CNS1 and TLP, the event-free survival (EFS) did not significantly improve in patients with CNS2 and CNS3. Moreover, CNSL status was associated with worse 3-year EFS (p < 0.05).

Conclusions

We have validated that FCM is more accurate in stratifying the status of the CNS compared to CM analysis. However, to improve the EFS rate of childhood leukemia, it is necessary to combine CM examination, FCM, and cranial imaging for the early diagnosis of CNSL.
Serum cholesterol level as a predictive biomarker for prognosis of Neuroblastoma
Authors: Min Jie , Wu Yi , Huang Shungen , Li Yanhong , Lv Xinjing , Tang Ruze , Zhao He , Wang Jian
Published: March 2024

Background

Neuroblastoma (NB), a type of solid tumor in children, has a poor prognosis. Few blood biomarkers can accurately predict the prognosis, including recurrence and survival, in children with NB. In this study, we found that the serum total cholesterol (Tchol) level was associated with the prognosis of patients through a retrospective study.

Methods

Multivariate Cox regression model was used to identify the independent risk factors in the children with NB. Kaplan–Meier method was used to analyze the correlation between the common biomarkers, including the serum Tchol level, and the prognosis of the patients. ROC curves were used to predict the accuracy of the International Neuroblastoma Staging System (INSS) stage and Children’s Oncology Group (COG) risk stratification after adding the serum Tchol level.

Results

Compared with the other patients, serum Tchol level was significantly increased in the relapsed and died patients (P < 0.05). Subsequently, serum Tchol level was found as an independent risk factor to affect the outcome of patients (P < 0.05). Finally, we added serum Tchol level into traditional stage and risk classification system to form the new INSS stage and COG risk classification system. It was found that the areas under the ROC curve (AUC) of recurrence-free survival in the new INSS stage and COG risk classification system were increased to 0.691 (95%CI: 0.535–0.847) and 0.748 (95%CI: 0.622–0.874), respectively. Moreover, the AUC areas of overall survival in the new INSS stage and COG risk classification system were increased to 0.722 (95%CI: 0.561–0.883) and 0.668 (95%CI: 0.496–0.819), respectively.

Conclusion

We found that serum Tchol level, a clinical biomarker, is a risk factor for recurrence and death among the children with NB. The serum Tchol level could significantly increase the accuracy of the prediction for NB prognosis.