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Implementation of Point-of-Care PCR-testing for the diagnosis of respiratory infections in vulnerable patient populations
Background Point-of-Care (POC) PCR-testing provides accurate, and timely results in diagnosing respiratory viral infections. Despite these benefits, stakeholder perceptions and its potential for improving health outcomes remain insufficiently explored. Therefore, we aim to explore the acceptability and feasibility of POC PCR-testing implementation in settings attended by vulnerable populations. Methods We conducted semi-structured interviews with stakeholders from ambulatory settings, including decision makers, molecular diagnostics experts, healthcare workers, and patients. Study settings included two emergency departments (one adult, one pediatric), two oncology units, and two dialysis units, including both POC PCR implementors and non-implementors. We thematically analyzed our data, drawing on components of the Thematic Framework of Acceptability, the CFIR, and the Consolidated Framework for Sustainability Constructs in Healthcare. Results Stakeholders recognized COVID-19, influenza A&B, and RSV as significant healthcare challenges and generally viewed POC PCR-testing as fit to address them. Stakeholders exhibited varying levels of knowledge about POC PCR-testing, with lower levels among non-implementors. While perceived benefits included rapid results, accuracy, and automation, concerns regarding cost, workload, and device throughput remained. Stakeholders recognized testing’s clinical impact in terms of transmission prevention and patient management. Perceived infection risk, disease prevalence, governmental regulations, and funding availability further influenced implementation decisions. Implementation processes were deemed straightforward, but limited involvement in decision-making processes dissatisfied some healthcare providers. End-users valued POC PCR-devices’ ease-of-use, while molecular diagnostics experts stressed that testing should be performed by medical staff. Sustainability considerations emphasized the stepwise development of testing guidelines, adaptation to local workflows, and continuous evaluation and quality control. Conclusion POC PCR-testing for respiratory viral infections is generally accepted. Knowledge, cost, workload and perceived benefit of testing guide decisions, while testing upon suspicion is favored over screening strategies due to per-test-cost and low device throughput. Sustainability requires cost-efficiency through guidelines and outcome monitoring. While test accuracy and turnover-time are valued, clinical impact requires further investigation.
Effects of neoadjuvant immunotherapy on hearing in patients with head and neck squamous cell carcinoma
Abstract Immune checkpoint blockade (ICB) is a commonly used treatment modality for cancer with a growing list of oncologic indications. Ototoxicity is a potential immune-related adverse event of ICB treatment, but the risk of hearing loss after ICB remains unknown. This retrospective chart review sought to identify individuals who received ICB and had available audiometric data before and after treatment in order to identify clinically meaningful changes in hearing. This single center, institutional chart review examined hearing function data in patients who underwent audiometry before and after ICB treatment. Measures included pure tone thresholds, distortion product otoacoustic emissions (DPOAEs), tympanometry, and word recognition scores. Ototoxicity was assessed using the American Speech-Language-Hearing-Association (ASHA) and Common Terminology Criteria for Adverse Events (CTCAEv5.0) guidelines where applicable. We identified twelve individuals with newly diagnosed, advanced-stage Head and Neck Squamous Cell Carcinoma (HNSCC) who received neoadjuvant ICB on a clinical trial. Eleven of twelve (92%) patients (8 male, 4 female, age 41–79 years) did not meet criteria for hearing threshold changes. One patient demonstrated a 10 dB shift at two consecutive frequencies in one ear, meeting the minimum ASHA criteria for significant change. Speech audiometry and tympanometry identified no differences in speech understanding or middle ear function pre-and post-treatment. Variations in DPOAE amplitudes were noted, potentially indicating early outer hair cell damage despite stable audiometric thresholds. In this small data set of newly diagnosed advanced-stage HNSCC, there appears to be a low incidence of significant hearing changes following neoadjuvant ICB treatment. Larger, prospective studies with long-term follow-up are needed to evaluate late-onset ototoxicity. Cancer survivors treated with neoadjuvant immune checkpoint blockade for advanced-stage head and neck squamous cell carcinoma (HNSCC) appear to have a low risk of acute hearing loss based on this study. While significant changes in hearing thresholds were not observed, subtle alterations in cochlear outer hair cell function were detected, suggesting the importance of long-term monitoring to capture potential delayed effects on hearing. This insight helps reassure patients about the immediate ototoxic risks while highlighting the need for continued vigilance in hearing assessment during follow-up.
Molecular and morphological alterations in breast tissue of transgender patients undergoing dihydrotestosterone therapy
Many patients undergoing gender-affirming surgery (GAS) opt for reconstructive procedures rather than total mastectomy to achieve a more masculine chest contour. The impact of dihydrotestosterone (DHT) treatment on breast tissue remains unclear. This study evaluates the morphological changes and protein expression levels in breast tissue associated with hormonal and molecular pathways in patients receiving short-term or long-term DHT treatment before GAS. A total of 230 breast tissue samples were categorized into three groups: nontreatment, short-term treatment (STT, < 12 months), and long-term treatment (LTT, ≥ 12 months). Paired samples (n = 33) were stained for estrogen receptor (ER) and androgen receptor (AR). NanoString Digital Spatial Profiling (DSP) analysis was conducted on a subset (n = 17), including two incidental breast cancer (BC) cases. Among morphological parameters assessed, atrophy and secretory changes differed significantly among groups. In the LTT group, ER-alpha expression was elevated in lactiferous ducts, while AR H-scores were higher in both STT and LTT groups. ER and AR expression levels were strongly correlated in the STT and LTT groups (r = 0.93–0.99). DSP analysis revealed increased ER expression in the treated groups and higher AR expression in peripheral lobules of the LTT group (log2FC = 1.3, p = 0.03). Ki-67, CDK6, and CD45 levels decreased in the LTT group, while INPP4B and BCL6 increased. DHT treatment leads to significant morphological and molecular changes in both benign and cancerous breast tissue. Altered expression of biomarkers such as INPP4B and CD45 in the LTT group and breast cancer samples suggests a potential role in BC development, warranting further investigation.
An improved lightweight tongue segmentation model with self-attention parallel network and progressive upsampling
Identification of differentially expressed genes associated with ferroptosis in ulcerative colitis
Purpose To identify ferroptosis-related genes associated with the development of Ulcerative colitis (UC), through bioinformatics and basic experiments. Methods Ferroptosis-related genes were identified from UC microarray data extracted from the GEO database and FerrDb. GO and KEGG pathway enrichment analyses were performed. Hub genes were identified through PPI analysis, leading to TF-hub gene and miRNA-hub gene regulatory network, predicting potential drug candidates by DSigDB. RT-qPCR, WB and IHC were employed to validate hub gene expression in animal samples. Clinical samples were gathered from Normal examiners and UC patients and IHC was performed to verify SLC7A5. Results Eleven ferroptosis-related DEGs were identified (nine upregulated and two downregulated genes) in UC, with eight genes chosen from the PPI network. MCC algorithm demonstrated that SLC7A11, PSAT1, SLC7A5, ACSF2, and ACSL4 were hub genes, predicting TFs, miRNAs and drugs. RT-qPCR confirmed significant differential expression of SLC7A5, ACSL4, and ACSF2. WB and IHC of mouse samples, as well as IHC of clinical samples, revealed significantly elevated SLC7A5 expression in the UC group compared to controls. Conclusion SLC7A5 emerged as a potential focus for understanding UC pathogenesis, potentially influencing ferroptosis. FOXP3, STAT6, and hsa-miR-186-5p are implicated in UC and ferroptosis, with minocycline identified as a potential treatment by inhibiting ferroptosis.
A dual input dual spliced network with data augmentation for robust modulation recognition in communication countermeasures
A novel incision design for Vibrant SoundBridge®︎ implantation prior to auricular reconstruction for microtia
Objective This study aimed to present and evaluate a surgical approach for placing a Vibrant Soundbridge® (VSB) device prior to auricular reconstruction in patients with microtia atresia. The goal was to determine whether an incision line for VSB implantation, located sufficiently posterior to the planned area of auricular reconstruction, could prevent interference with subsequent auricular surgeries and ensure stable hearing outcomes. Methods We retrospectively examined four patients with unilateral microtia who underwent VSB implantation before auricular reconstruction. The incision line was placed approximately 5 cm posterior to the posterior edge of the temporomandibular joint, ensuring that it remained at least 2 cm away from the future area of auricular reconstruction. The VSB implantation procedure involved skin incision, subperiosteal dissection, mastoidectomy, and placement of the VSB implant, with a floating mass transducer attached to the head of the stapes. More than a year later, two-stage auricular reconstruction was performed. Results All patients underwent successful auricular reconstruction after VSB implantation. During the first stage of costal cartilage grafting, subcutaneous pockets were created without encountering congestion or compromised skin flaps, and the grafted cartilage maintained a good contour. In the second stage of auricular elevation, the mastoid fascial flap was elevated with adequate blood flow, and careful dissection prevented exposure or damage to the VSB device. Postoperatively, the reconstructed auricles exhibited stable contour. Audiometric evaluation revealed no deterioration in hearing outcomes, indicating that the VSB device worked well. Conclusion This method allows safe and effective VSB implantation prior to auricular reconstruction, without hindering subsequent procedures. By maintaining an appropriate distance between the incision line and planned area of reconstruction, early hearing rehabilitation and successful auricular reconstruction can be achieved. This approach may serve as a practical standard for treating patients with microtia atresia who require early hearing intervention.
Nutrient dynamics in the berry, bean, and husk of six Coffea canephora genotypes throughout fruit maturation
Evidence Based Gait Analysis Interpretation Tools (EB-GAIT) treatment recommendation and outcome prediction models to support decision-making based on clinical gait analysis data
Clinical gait analysis (CGA) has historically relied on clinician experience and judgment, leading to modest, stagnant, and unpredictable outcomes. This paper introduces Evidence-Based Gait Analysis Interpretation Tools (EB-GAIT), a novel framework leveraging machine learning to support treatment decisions. The core of EB-GAIT consists of two key components: (1) treatment recommendation models, which are models that estimate the probability of specific surgeries based on historical standard-of-practice (SOP), and (2) treatment outcome models, which predict changes in patient characteristics following treatment or natural history. Using Bayesian Additive Regression Trees (BART), we developed and validated treatment recommendation models for 12 common surgeries that account for more than 95% of the surgery recorded in our CGA center’s database. These models demonstrated high balanced accuracy, sensitivity, and specificity. We used Shapley values for the models to enhances interpretability and allow clinicians and patients to understand the factors driving treatment recommendations. We also developed treatment outcome models for over 20 common outcome measures. These models were found to be unbiased, with reliable prediction intervals and accuracy comparable to experimental measurement error. We illustrated the application of EB-GAIT through a case study, showcasing its utility in providing treatment recommendations and outcome predictions. We then use simulations to show that combining recommendation and outcome models offers the possibility to improve outcomes for treated limbs, maintain outcomes for untreated limbs, and reduce the number of surgeries performed. For example, under the counterfactual situation where femoral derotation osteotomies are administered only when they align with historical standard of practice (> 50% probability of surgery) and are predicted to improve the Gait Deviation Index (change > 7.5 points), the model predicts a 11 percentage point reduction in surgeries (26% limbs currently, 15% limbs simulated), a 6 point improvement in Gait Deviation Index among treated limbs (6 currently, 12 simulated), and no change in Gait Deviation Index for untreated limbs (2 currently, 2 simulated). EB-GAIT represents a significant step toward precision medicine in CGA, offering a promising tool to enhance treatment outcomes and patient care. The EB-GAIT approach addresses the limitations of the conventional CGA interpretation method, offering a more structured and data-driven decision-making process. EB-GAIT is not intended to replace clinical judgment but to supplement it, providing clinicians with a second opinion grounded in historical data and predictive analytics. While the models perform well, their effectiveness is constrained by historical variability in treatment decisions and the inherent complexity of patient outcomes. Future efforts should focus on refining model inputs, incorporating surgical details, and pooling data from multiple centers to improve generalizability.
In vitro haploid plantlet regeneration through anther culture in some local types of Syrian cauliflower (Brassica Oleracea var. botrytis L.)
Fractionation mechanisms of rare earth element speciation in granitic weathering profiles: Metallogenic implications for the kuanyu ion-adsorption REE deposit, dechang, SW China
The Kuanyu ion-adsorption rare earth element (REE) deposit, Sichuan’s first economically viable resource of its type, remains underexplored in terms of REE fractionation and enrichment mechanisms within its weathering profiles. This study systematically resolves REE speciation patterns and light-to-heavy REE (LREE/HREE) differentiation processes, advancing the metallogenic framework fo r such deposits. Analytical results demonstrate: (1) A vertically progressive enrichment of LREE-dominated REE concentrations from bedrock to topsoil, with the fully weathered layer serving as the primary enrichment zone; (2) Weathering of primary REE-bearing minerals and subsequent secondary mineral formation as drivers of elemental redistribution; (3) Contrasting controls by clay minerals, iron-manganese oxides, and humic acids—clay minerals preferentially adsorb LREEs, while iron-manganese oxides exhibit stronger HREE affinity through inner-sphere complexation, and humic acids enhance HREE mobility via stable complex formation. These findings establish iron-manganese oxides and organic ligands as dual regulators of REE fractionation, refining predictive models for ion-adsorption REE exploration in granitic weathering systems.
Intermittent fasting and a no-sugar diet for Long COVID symptoms: a randomized crossover trial
Age-dependent ACE2/TMPRSS2 expression and SARS-CoV-2 household transmission in Gran Canaria
Background This study aimed to assess whether the expression of ACE2 and TMPRSS2 is associated with susceptibility to and severity of COVID-19 across age groups. We also evaluated the role of children in household transmission of SARS-CoV-2. Methods We conducted a cross-sectional observational study including 258 households in Gran Canaria between March 10 and June 2, 2020. A total of 650 individuals (including 89 children under 18 years of age) were evaluated using a combined serological testing strategy to confirm past SARS-CoV-2 infection. Gene expression of ACE2 and TMPRSS2 was quantified from saliva samples. Demographic, clinical, and household exposure data were collected for analysis. Results The combined serological approach increased diagnostic sensitivity by 10%. Antibody levels decreased with age in children but increased with age and disease severity in adults. ACE2 expression was slightly elevated in younger children; however, after correction for multiple comparisons, there was no statistically significant association between ACE2 expression and age, antibody titers, or symptom severity.. TMPRSS2 expression did not correlate with any studied variable. Children were less frequently infected (OR = 0.56), and when infected, they experienced milder symptoms and reduced disease severity. Risk factors for transmission included older age and sharing a bedroom with the index case. In adults, risk increased with age; in children, younger age was associated with higher transmission risk. Conclusions Our findings do not support a strong relationship between ACE2 or TMPRSS2 expression levels and susceptibility to or severity of COVID-19. Children appear to be less susceptible to SARS-CoV-2 infection and tend to experience a milder disease course.
Unravelling the importance of spatial and temporal resolutions in modeling urban air pollution using a machine learning approach
Fault analysis and performance improvement of grid-connected doubly fed induction generator through an enhanced crowbar protection scheme
The main problem associated with a doubly fed induction generator (DFIG) during fault is large inrush currents induced in rotor winding, which has detrimental effects on the machine’s AC excitation converter. A simple conventional resistance inclusion (crowbar) is employed with a PI controller to protect a DFIG from transient current, but it is observed that this method is not enough to keep transient over-current to an admissible level. In this paper, an effective current limiting technique along with reactive power control is proposed in order to maintain stability, reduce transient current surge to an acceptable level, and enhance the Fault Ride Through capacity of DFIG. The proposed dynamic control technique not only limits the fault current during voltage dip to a permissible level but also controls the reactive power during fault. The behavior of a proposed technique is analyzed by introducing unsymmetrical faults in the MATLAB-based model of DFIG. An enhanced crowbar-based fault ride-through is employed for the rotor side controller to limit inrush current and control reactive power.
Thermodynamic, isotherm and kinetic studies lead ions adsorption onto Manihot esculenta chaff surface
Expression of Concern: Knowledge, attitude, and preventive practices towards COVID-19 and associated factors among adult hospital visitors in South Gondar Zone Hospitals, Northwest Ethiopia
Salinity stress amelioration through selenium and zinc oxide nanoparticles in rice
Abstract Salinity is one of the most dominant abiotic stresses limiting growth and productivity in rice (Oryza sativa L.), thereby posing a serious threat to global food security. To enhance plants’ tolerance to salinity stress, the application of green-synthesized nanoparticles presents a novel and eco-friendly approach. This research article investigates the ameliorative effects of selenium (Se-NPs) and zinc oxide (ZnO-NPs) nanoparticles, both individually and in combination, on rice plants under salinity stress. Our results revealed that salinity stress significantly impaired rice growth and productivity, reducing plant height, root length, and yield-related traits, including tiller count, number of grains per spike, and grain weight. Furthermore, it induced oxidative stress, as evidenced by elevated levels of malondialdehyde and proline. The elevated levels of reactive oxygen species were visibly confirmed through histochemical staining. However, treatment with Se-NPs and ZnO-NPs significantly alleviated these adverse effects by enhancing the plant’s antioxidant defense mechanism. Activities of key antioxidant enzymes such as superoxide dismutase (50.06%), catalase (59.92%), ascorbate (104.28%), and peroxidase (85%) were significantly elevated, contributing to efficient ROS scavenging and reduced lipid peroxidation. The combined nanoparticle application was particularly effective in restoring physiological and biochemical parameters to near-normal levels, with increases of 46.32% in plant height, 70.53% in root length, and 100.7% in grains per spike under salinity stress. Furthermore, the enhanced accumulation of minerals such as Zn (31.8 ppm), Se (0.57 ppm), and Fe (7.4 ppm) in rice grains was also observed, indicating a dual benefit of stress alleviation and nutritional enrichment. Green-synthesized Se-NPs and ZnO-NPs, particularly when combined, offer a promising strategy for mitigating salinity stress in rice. Beyond enhancing stress tolerance and growth, the nanoparticles also contribute to the biofortification of rice grains, thereby improving both crop resilience and nutritional value in saline environments.
RETRACTED: Physical fitness characteristics and comprehensive physical fitness evaluation model of basketball players based on association rule algorithm
Physical fitness refers to the health of all body functions, including cardiorespiratory endurance, muscle strength, flexibility, stamina, and body composition, which can help individuals effectively cope with daily activities and sports challenges. This paper explores the physical characteristics of basketball players, aiming to improve training effects through unique physical evaluation indicators and provide a theoretical framework for improving college basketball performance and training standards. The study adopted the Apriori association rule algorithm in data mining. First, the physical data of basketball players were collected and preprocessed. Then, frequent item sets were extracted through the association rule mining algorithm, association rules were generated, and the key factors affecting the physical performance of athletes were analyzed. The article’s results revealed the potential relationship between different physical characteristics and emphasized the application prospects of association rule mining in the physical evaluation of basketball players.