bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial intelligence in the autonomous navigation of endovascular interventions: a systematic review
Authors: Robertshaw Harry , Karstensen Lennart , Jackson Benjamin , Sadati Hadi , Rhode Kawal , Ourselin Sebastien , Granados Alejandro , Booth Thomas C. 
Published: August 2023

BackgroundAutonomous navigation of catheters and guidewires in endovascular interventional surgery can decrease operation times, improve decision-making during surgery, and reduce operator radiation exposure while increasing access to treatment.ObjectiveTo determine from recent literature, through a systematic review, the impact, challenges, and opportunities artificial intelligence (AI) has for the autonomous navigation of catheters and guidewires for endovascular interventions.MethodsPubMed and IEEEXplore databases were searched to identify reports of AI applied to autonomous navigation methods in endovascular interventional surgery. Eligibility criteria included studies investigating the use of AI in enabling the autonomous navigation of catheters/guidewires in endovascular interventions. Following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), articles were assessed using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). PROSPERO: CRD42023392259.ResultsFour hundred and sixty-two studies fulfilled the search criteria, of which 14 studies were included for analysis. Reinforcement learning (RL) (9/14, 64%) and learning from expert demonstration (7/14, 50%) were used as data-driven models for autonomous navigation. These studies evaluated models on physical phantoms (10/14, 71%) and in-silico (4/14, 29%) models. Experiments within or around the blood vessels of the heart were reported by the majority of studies (10/14, 71%), while non-anatomical vessel platforms “idealized” for simple navigation were used in three studies (3/14, 21%), and the porcine liver venous system in one study. We observed that risk of bias and poor generalizability were present across studies. No procedures were performed on patients in any of the studies reviewed. Moreover, all studies were limited due to the lack of patient selection criteria, reference standards, and reproducibility, which resulted in a low level of evidence for clinical translation.ConclusionDespite the potential benefits of AI applied to autonomous navigation of endovascular interventions, the field is in an experimental proof-of-concept stage, with a technology readiness level of 3. We highlight that reference standards with well-identified performance metrics are crucial to allow for comparisons of data-driven algorithms proposed in the years to come.Systematic review registrationidentifier: CRD42023392259.
Deep learning-based segmentation of brain parenchyma and ventricular system in CT scans in the presence of anomalies
Authors: Gerken Annika , Walluscheck Sina , Kohlmann Peter , Galinovic Ivana , Villringer Kersten , Fiebach Jochen B. , Klein Jan , Heldmann Stefan 
Published: August 2023

IntroductionThe automatic segmentation of brain parenchyma and cerebrospinal fluid-filled spaces such as the ventricular system is the first step for quantitative and qualitative analysis of brain CT data. For clinical practice and especially for diagnostics, it is crucial that such a method is robust to anatomical variability and pathological changes such as (hemorrhagic or neoplastic) lesions and chronic defects. This study investigates the increase in overall robustness of a deep learning algorithm that is gained by adding hemorrhage training data to an otherwise normal training cohort.MethodsA 2D U-Net is trained on subjects with normal appearing brain anatomy. In a second experiment the training data includes additional subjects with brain hemorrhage on image data of the RSNA Brain CT Hemorrhage Challenge with custom reference segmentations. The resulting networks are evaluated on normal and hemorrhage test casesseparately, and on an independent test set of patients with brain tumors of the publicly available GLIS-RT dataset.ResultsAdding data with hemorrhage to the training set significantly improves the segmentation performance over an algorithm trained exclusively on normally appearing data, not only in the hemorrhage test set but also in the tumor test set. The performance on normally appearing data is stable. Overall, the improved algorithm achieves median Dice scores of 0.98 (parenchyma), 0.91 (left ventricle), 0.90 (right ventricle), 0.81 (third ventricle), and 0.80 (fourth ventricle) on the hemorrhage test set. On the tumor test set, the median Dice scores are 0.96 (parenchyma), 0.90 (left ventricle), 0.90 (right ventricle), 0.75 (third ventricle), and 0.73 (fourth ventricle).ConclusionTraining on an extended data set that includes pathologies is crucial and significantly increases the overall robustness of a segmentation algorithm for brain parenchyma and ventricular system in CT data, also for anomalies completely unseen during training. Extension of the training set to include other diseases may further improve the generalizability of the algorithm.
Monoclonal antibodies binding to different epitopes of CD20 differentially sensitize DLBCL to different classes of chemotherapy
Authors: Lee Brian , Pierpont Tim , August Avery , Richards Kristy 
Published: August 2023

IntroductionRituximab (R), an anti-CD20 monoclonal antibody (mAb) and the world’s first approved antibody for oncology patients, was combined with the CHOP chemotherapy regimen and markedly improved the prognosis of all B- cell–derived lymphomas, the most common hematological malignancy worldwide. However, there is a 35% disease recurrence with no advancement in the first-line treatment since R was combined with the archetypal CHOP chemotherapy regimen nearly 30 years ago. There is evidence that R synergizes with chemotherapy, but the pharmacological interactions between R and CHOP or between newer anti-CD20 mAbs and CHOP remain largely unexplored.MethodsWe used in vitro models to score pharmacological interactions between R and CHOP across various lymphoma cell lines. We compared these pharmacological interactions to ofatumumab, a second-generation anti-CD20 mAb, and CHOP. Lastly, we used RNA-sequencing to characterize the transcriptional profiles induced by these two antibodies and potential molecular pathways that mediate their different effects.ResultsWe discovered vast heterogeneity in the pharmacological interactions between R and CHOP in a way not predicted by the current clinical classification. We then discovered that R and ofatumumab differentially synergize with the cytotoxic and cytostatic capabilities of CHOP in separate distinct subsets of B-cell lymphoma cell lines, thereby expanding favorable immunochemotherapy interactions across a greater range of cell lines beyond those induced by R-CHOP. Lastly, we discovered these two mAbs differentially modulate genes enriched in the JNK and p38 MAPK family, which regulates apoptosis and proliferation.DiscussionOur findings were completely unexpected because these mAbs were long considered to be biological and clinical equivalents but, in practice, may perform better than the other in a patient-specific manner. This finding may have immediate clinical significance because both immunochemotherapy combinations are already FDA-approved with no difference in toxicity across phase I, II, and III clinical trials. Therefore, this finding could inform a new precision medicine strategy to provide additional therapeutic benefit to patients with B-cell lymphoma using immunochemotherapy combinations that already meet the clinical standard of care.
“Waitlist mortality” is high for myeloma patients with limited access to BCMA therapy
Authors: Ahmed Nausheen , Wesson William , Mushtaq Muhammad Umair , Bansal Rajat , AbdelHakim Haitham , Bromert Sarah , Appenfeller Allison , Ghazal Batool Abu , Singh Anurag , Abhyankar Sunil , Ganguly Siddhartha , McGuirk Joseph , Abdallah Al-Ola , Shune Leyla 
Published: August 2023

BackgroundThe first-in-class approved BCMA CAR-T therapy was idecabtagene vicleucel (ide-cel), approved in March 2021, for RRMM patients who progressed after 4 or more lines of therapy. Despite the promising outcomes, there were limited apheresis/production slots for ide-cel. We report outcomes of patients at our institution who were on the “waitlist” to receive ide-cel in 2021 and who could not secure a slot.MethodsWe conducted a retrospective review of RRMM patients evaluated at the University of Kansas Cancer Center for ide-cel from 3/2021-7/2021. A retrospective chart review was performed to determine patient and disease characteristics. Descriptive statistics were reported using medians for continuous variables. Survival analysis from initial consult was performed using Kaplan-Meier Survival estimator.ResultsForty patients were eligible and were on the “waitlist” for CAR-T. The median follow-up was 14 months (2-25mo). Twenty-four patients (60%) secured a production slot and 16 (40%) did not. The median time from consult to collection was 38 days (8-703). The median time from collection to infusion was 42 days (34-132 days). The median overall survival was higher in the CAR-T group (NR vs 9 mo, p&lt;0.001).Conclusion(s)Many patients who were eligible for ide-cel were not able to secure a timely slot in 2021. Mortality was higher in this group, due to a lack of comparable alternatives. Increasing alternate options as well as improvement in manufacturing and access is an area of high importance to improve RRMM outcomes.
Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis
Authors: Lu Xikui , Zhang Lu , Huang Hangxing , Wu Xiangping , Wang Zhenting , Huang Ling , Li Jingyang , Yu Huimin , Zhang Hongyan , Xiao Jian 
Published: August 2023

Objective: To examine whether joint management of cancer pain by physicians and pharmacists in clinics provides economic advantages from the perspective of the Chinese healthcare system.Methods: From February 2018 to March 2020, 100 patients who visited the joint cancer pain clinic at the Xiangya Hospital of Central South University were included. These patients were randomly assigned to either the control or intervention groups. The control group received regular outpatient services from a physician, while the intervention group received regular outpatient services from a physician and medication education provided by a pharmacist. The study considered various direct costs, including drug expenses, physician-pharmacist outpatient services, adverse event management, consultations, examinations, and readmissions. The outcome indicators considered were the cancer pain control rate and the reduction in pain scores. Decision tree modeling, single-factor sensitivity analysis, and probabilistic sensitivity analysis were performed to evaluate the cost-effectiveness of joint physician-pharmacist outpatient services compared to physician-alone outpatient services.Results: The intervention group showed a significantly higher cancer pain control rate than the control group (0.69 vs. 0.39, p = 0.03). In the decision tree model, the intervention group had a significantly lower pain score than the control group (0.23 vs. 0.14). The cost per person in the intervention group was $165.39, while it was $191.1 per person in the control group. The univariate sensitivity analysis showed that the cost of self-management for patients in the control group was identified as the primary sensitivity factor. Probabilistic sensitivity analysis indicated that the joint clinic group had a favorable incremental cost-effectiveness compared to the physician clinic group. In addition, the probabilistic sensitivity analysis demonstrated an absolute advantage in the incremental cost-effectiveness of the joint clinic group over the outpatient physician group.Conclusion: The participation of pharmacists in joint cancer pain clinic services led to improved pain management for patients, demonstrating a clear advantage in terms of cost-effectiveness.
Tripterygium glycosides for safely controlling disease activity in systemic lupus erythematosus: a systematic review with meta-analysis and trial sequential analysis
Authors: Chen Yifan , Wang Liuding , Li Nannan , Zhou Caiyun 
Published: August 2023

Background: Tripterygium glycosides have been used to treat systemic lupus erythematosus (SLE) for a long time, showing the effects of immune regulation. We aimed to evaluate the benefits and risks of Tripterygium Glycosides Tablets (TGT) for patients with SLE.Methods: We searched electronic databases and clinical trial registries for relevant randomized controlled trials (RCTs). We identified eligible RCTs and assessed risk of bias. We conducted a meta-analysis to estimate the pooled effects. The Trial Sequential Analysis (TSA) 0.9.5.10 software was used to verify the reliability of the results.Results: Eight RCTs encompassing 538 patients with SLE were included. TGT combined with conventional treatments (CTs) was superior to CTs alone in reducing lupus activity (MD = −1.66, 95% CI = −2.07 to −1.26, p &lt; 0.00001, low-certainty evidence) and improving overall response rate (ORR) (RR = 1.21, 95% CI = 1.11 to 1.32, p &lt; 0.0001, moderate-certainty evidence). The robustness of the results was confirmed by TSA. Regarding safety, there was no statistical difference in the overall incidence of adverse reactions between the two groups.Conclusion: In patients with SLE, TGT might safely reduce disease activity. However, further high-quality studies are needed to firmly establish the clinical efficacy of TGT.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022300474; Identifier: CRD42022300474.
Subacute toxicity evaluations of LPM3480392 in rats, a full µ-opioid receptor biased agonist
Authors: Ye Liang , Li Chunmei , Jiang Wanglin , Yang Yifei , Wang Wenyan , Zhu Haibo , Hu Zhengping , Li Ning , Cen Xiaobo , Wang Hongbo , Tian Jingwei 
Published: August 2023

Opiates produce analgesia via G-protein signaling, and adverse effects, such as respiratory depression and decreased bowel motility, by β-arrestin pathway. Oliceridine, a G protein-biased MOR agonist, only presents modest safety advantages as compared to other opiates in clinical trials, possibly due to its limited bias. Our previous study shown that LPM3480392, a full MOR biased agonist, is selective for the Gi pathway over the β-arrestin-2. In the present article, we evaluated the subacute toxicity of LPM3480392 in rats. The rats were administered with control article or LPM3480392 0.6, 1.2 or 2.4 mg/kg/day for 4 consecutive weeks followed by a 4-week recovery phase. Intravenous infusion was conducted at tail vein at 0.2, 0.4 or 0.8 mg/kg/day with a dosing volume of 10 mL/kg and 5 min/rat/dose, three times a day with an interval of approximately 4 h. The concomitant toxicokinetics study was conducted. Two unscheduled rats at 2.4 mg/kg/day died with no clear cause. For the scheduled necropsy, the major effects were associated with the MOR agonist-related pharmacodynamic properties of LPM3480392 (e.g., increased activity, increased muscle tone; decreased food consumption and body weight gain; and clinical chemistry changes related with decreased food consumption) in three LPM3480392 groups. In addition, LPM3480392 at 2.4 mg/kg/day also induced deep respiration and histopathology changes in testis and epididymis in sporadic individual rats. However, different from other opiates, LPM3480392 presents weak/no immunosuppression and the decreased adrenal gland weight, which may be due to LPM3480392’ full MOR bias. At the end of recovery phase, all findings were recovered to some extent or completely. In the toxicokinetics study, the dose-dependent elevation of drug exposure was observed, which partly explained the toxicity of high dose. In summary, LPM3480392 has exhibited good safety characteristics in this subacute toxicity study in rats.
Sexual dimorphic gene expression profile of perirenal adipose tissue in ovine fetuses with growth restriction
Authors: Blomberg Jack , Luna Ramirez Rosa I. , Goyal Dipali , Limesand Sean W. , Goyal Ravi 
Published: August 2023

Worldwide, fetal growth restriction (FGR) affects 7%–10% of pregnancies, or roughly 20.5 million infants, each year. FGR increases not only neonatal mortality and morbidity but also the risk of obesity in later life. Currently, the molecular mechanisms by which FGR “programs” an obese phenotype are not well understood. Studies demonstrate that FGR females are more prone to obesity compared to males; however, the molecular mechanisms that lead to the sexually dimorphic programming of FGR are not known. Thus, we hypothesized that FGR leads to the sexually dimorphic programming of preadipocytes and reduces their ability to differentiate into mature adipocytes. To test the hypothesis, we utilized a maternal hyperthermia-induced placental insufficiency to restrict fetal growth in sheep. We collected perirenal adipose tissue from near-term (∼140 days gestation) male and female FGR and normal-weight fetal lambs (N = 4 to 5 in each group), examined the preadipocytes’ differentiation potential, and identified differential mRNA transcript expression in perirenal adipose tissue. Male FGR fetuses have a lower cellular density (nuclei number/unit area) compared to control male fetuses. However, no difference was observed in female FGR fetuses compared to control female fetuses. In addition, the ability of preadipocytes to differentiate into mature adipocytes with fat accumulation was impaired in male FGR fetuses, but this was not observed in female FGR fetuses. Finally, we examined the genes and pathways involved in the sexually dimorphic programming of obesity by FGR. On enrichment of differentially expressed genes in males compared to females, the Thermogenesis KEGG Pathway was downregulated, and the Metabolic and Steroid Biosynthesis KEGG pathways were upregulated. On enrichment of differentially expressed genes in male FGR compared to male control, the Steroid Biosynthesis KEGG Pathway was downregulated, and the PPAR Signaling KEGG pathway was upregulated. No pathways were altered in females in response to growth restriction in perirenal adipose tissue. Thus, the present study demonstrates a sexually dimorphic program in response to growth restriction in sheep fetal perirenal adipose tissue.
The influence of Big Five personality traits on college students’ key competencies: the mediating effect of psychological capital
Authors: Hu Anqi , Li Xueyan , Song Hongfeng 
Published: August 2023

BackgroundIn recent years, both society and employers have put forward higher requirements for the comprehensive quality of college students in the new era. Based on the conservation of resources theory and life-cycle approach, this study aimed to examine the relationship between the Big Five personality traits, the psychological capital, and the key competencies among college students and analyzed the mediating role of the psychological capital in this link.MethodsA total of 1,132 Chinese undergraduates (67.40% girls; 48.67% from key universities) participated. Participants completed self-report questionnaires that evaluated the five key characteristics of personality, psychological capital, and key competencies.ResultsThere were extremely significant university-type differences in key competencies of college students. And the mediating role of psychological capital in the link between Big Five personality traits and key competencies was validated according to PROCESS model 4. Psychological capital serves as a partial mediator in the relationships between neuroticism and critical thinking, openness and creativity, conscientiousness and creativity, openness and communication, conscientiousness and communication, extraversion and collaboration, as well as openness and collaboration. The proportion of mediating effects for the above models was 5.97, 10.89, 11.82, 12.24, 11.98, 12.39, and 22.72%, respectively.DiscussionThe findings provide a better understanding of the key competencies of college students from the perspectives of the Big Five personality traits and psychological capital and suggest a greater emphasis to focusing on personality and improving psychological capital.
Factors related to the quality of life of family cancer caregivers
Authors: Liu Zhenya , Chen Cancan , Hu Yanli 
Published: August 2023

BackgroundCancer caregivers directly affect patient health outcomes. To maintain the function and health of caregivers so that patients can receive efficient care, we must pay more attention to caregivers’ quality of life in the process of caring for patients. However, the factors influencing caregivers’ quality of life are complex.AimTo assess caregivers’ quality of life in the process of caring for cancer patients and to explore the factors associated with it.DesignThis was a descriptive correlational study. A self-report questionnaire was used to anonymously collect data from one Chinese cancer hospital. The Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp-12), General Self-efficacy Scale (GSES), Positive and Negative Affect Schedule (PANAS), Connor-Davidson Resilience Scale 10 (CD-RISC-10), 24-item Caregiver Burden Inventory (CBI) and Caregiver Evaluation Questionnaire were used to measure caregivers’ spiritual well-being, self-efficacy, affective well-being, resilience, caregiver burden and quality of life. One-way analysis of variance, the Kruskal–Wallis H test and multiple regression analysis were applied to measure the factors influencing caregivers’ situations.Setting and participantsA total of 315 caregivers of cancer patients were selected by convenience sampling. All participants were invited to complete the questionnaire through a one-on-one approach.ResultsThe mean score for caregiver quality of life was 204.62 ± 36.61. After controlling for demographic factors, self-efficacy (β’ = 0.265, p &lt; 0.01), resilience (β’ = 0.287, p &lt; 0.01) and positive affect (β’ = 0.103, p &lt; 0.01) were protective factors for caregivers’ quality of life. Negative affect (β’ = −0.217, p &lt; 0.01) and caregiver burden (β’ = −0.219, p &lt; 0.01) were negative factors. Notably, not all of these predictors can predict all dimensions of quality of life.ConclusionCaregivers’ quality of life needs to be further improved. The results of this study may provide clues to help identify factors influencing caregivers’ quality of life and implement targeted strategies to improve their quality of life.