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Prognostic analysis of nimotuzumab combined with concurrent chemoradiotherapy for locally advanced cervical cancer: a multicenter real-world study

Abstract Nimotuzumab is a monoclonal antibody against EGFR. The therapeutic efficacy of nimotuzumab in cervical cancer treatment remains inconclusive, with current evidence insufficient to establish a definitive clinical benefit. Therefore, this study compares the efficacy and safety of nimotuzumab combined with concurrent chemoradiotherapy (CCRT) and CCRT in locally advanced cervical cancer (LACC). Information on patients with stage IIB-IVA cervical cancer who received CCRT combined with nimotuzumab or CCRT alone at five cancer centers from January 2021 to December 2022 were collected. Propensity score (PS) matching analysis was used to compare nimotuzumab group and no-nimotuzumab group. Clinical outcomes were analyzed. There were 195 patients enrolled. The 2-year overall survival (OS) and progression-free survival (PFS) rates were 92.5% and 89.5%, respectively. The objective response rate (ORR) was 90.8%. There were 60 patients in the nimotuzumab group and 135 patients in the no-nimotuzumab group. The nimotuzumab group had a better CR rate (51.7% vs. 26.7%, P = 0.001) and ORR (98.3% vs. 87.4%, p = 0.015) compared to the no-nimotuzumab group. After PS matching, there were 54 patients in each group. There were no significant differences in 2-year OS rate and PFS rate between the two groups before and after matching. However, the nimotuzumab group had also a better CR rate and ORR compared to the no-nimotuzumab group after matching. The incidence of grade 3–4 anemia was relatively higher in nimotuzumab group than in no-nimotuzumab group after matching, while no difference was observed in other adverse events between the two groups. The combination of nimotuzumab and CCRT for LACC improved CR rate and ORR, without increasing side effects, which might become a potential treatment strategy for LACC patients.

Exploring barriers and facilitators in implementation fidelity of malaria screening intervention at Nepal-India border point-of-entry health desks-A mixed method study

Purpose This research aimed to identify the barriers and facilitators in implementation fidelity of malaria screening at Nepal-India border Point of Entry (POE) health desks. Method A mixed-method approach was used guided by an implementation fidelity framework. Epidemiological records of reported malaria cases at selected border posts of Sudurpaschim and Lumbini province were obtained, while observation of the malaria screening was done among them. Qualitative inquiries were done with the health workers working at selected POEs, health coordinators and development partners working at respective districts, including representatives from three tiers of government: local municipalities, provincial and federal government. The suspected and confirmed migrant population were also interviewed about their experience while seeking for screening facility provided at POEs. Descriptive and trend analysis was done for number of tests per month and total malaria cases identified at POEs, while thematic analysis was performed for qualitative data. Results There were fluctuating testing trends from March 2021 to December 2022, where malaria screening was peaked before and after rainy season and during festivities and showed its the decreased priorities with the decreasing COVID-19 cases. Over those two consecutive years, 10 malaria cases were identified at POE in two provinces. Adherence to the screening protocol was partially followed, as there were limited guidance for malaria testing protocols at POE, incomplete fulfillment of health declaration forms, non-compliance in providing counseling during testing. Reported unavailability of test kits, variation in eligibility criteria, porosity of border, inadequate health workers, inaccessible infrastructures, limited awareness activities, fear of losing belongings among migrants, and administrative barriers were hindering the screening process. In contrast, presence of well-equipped infrastructures, perceived risk among the migrant’s population and regular monitoring during the monthly review meetings at the local health institutions facilitated the health workers for conducting screening. Conclusion The study concluded that prioritizing malaria detection and addressing barriers to ensure fidelity of malaria screening intervention is crucial.

Potential shared neoantigens from pan-cancer transcript isoforms

Association between hypertension and self-perception of health status: Findings from a decade population-based survey in Spanish adults

Objective This study, conducted in the community setting, aimed to assess and discuss how a diagnosis of arterial hypertension affects self-perceived health status, examining the association with potential explanatory factors and comparing its impact with that of other chronic conditions. Methods Cross-sectional observational study using the 2011–2012 and 2017 Spanish National Health Surveys and the 2020 European Health Interview Survey for Spain as data sources. Health perception was categorised as very good, good, fair, bad, or very bad. The independent variables recorded demographic, social, clinical, and lifestyle information. The associations between variables were evaluated via a generalisation of an ordered logit model. Results A total of 66,168 subjects were included (21,007 in 2011, 23,089 in 2017, and 22,072 in 2020), 21.6% of whom were diagnosed with hypertension, 51.3% were women, and the average age was 48.24 (18.89) years. Around one in five people in the general population reported a “very good” health status. The probability of reporting a “very good” health condition decreased with a diagnosis of hypertension (6.2%; CI 95%: 3.1–9.3%) and hypertensive medication (4.5%; CI 95%: 1.8–7.3%). Such associations were independent of age, gender, social group, other chronic conditions or limitations, or various lifestyle habits. In contrast, no association was found with reporting a “bad” or “very bad” health status. Conclusion Being diagnosed with hypertension and prescription of antihypertensive medication are associated with a lower probability of reporting a “very good” health status, irrespective of other comorbidities or complications related to the diagnosis.

Geodemographic analysis of socioeconomic area disparities in tuberculosis incidence in Osaka City, Japan

Abstract Regional disparities in the incidence of tuberculosis (TB) pose several challenges to effective TB control. This study aimed to investigate such disparities in Osaka City, Japan, by analyzing the relationship between TB incidence and residents’ socioeconomic indicators. Using 42 indicators from the 2010 population census, the city was clustered into 15 social areas through a factor analysis, and TB incidence during 2012–2016 was compared across the areas in 4,852 cases. Two geographically adjacent areas (Area D and O) exhibited significantly higher TB rates, each with distinct social characteristics. Area D consisted of a high proportion of young, single individuals working in the service sector as well as foreigners. Area O included a high proportion of day laborers, secondary industry workers, and individuals with lower educational levels. TB occurred more frequently in foreign-born patients aged < 60 years, and it was detected during treatment for other diseases in Area D compared with other areas. However, a high proportion of retreated patients aged 40–79 years, with a shorter delay in TB detection, was observed in Area O. The variations in this study provide insights into the relationship between socioeconomic indicators and regional disparities in TB incidence in local settings.

Identification of stable reference genes for qRT-PCR in Stropharia rugosoannulata using mRNA-sequencing data

Quantitative real-time PCR (qRT-PCR) is a well-established and reliable technology utilized for the rapid and accurate quantification of gene expression changes. The selection of stable reference genes is necessary to analyse qRT-PCR data and ensure gene expression studies reliability. Stropharia rugosoannulata, commonly known as the wine-cap Stropharia mushroom, ranks among the top ten internationally traded mushrooms. In the present study, six novel candidate reference genes were selected from S. rugosoannulata transcriptome, alongside four traditional reference genes that displayed stable expression levels in S. rugosoannulata. Three widely used software (geNorm, NormFinder, and BestKeeper) were employed to analyse ten candidate reference genes, and the final ranking of reference genes was determined through RefFinder. The results indicated that UBP exhibited the highest stability across various developmental stages of red and yellow S. rugosoannulata, while RPB2 and GAPDH showed the least stability. These novel reference genes demonstrated significantly superior stability to other four traditional genes across nearly all developmental stages. In conclusion, Our findings provide robust guidelines for selecting suitable reference genes, thereby enhancing the reliability of qRT-PCR normalization in Stropharia rugosoannulata.

A discrete element simulation study of paver screed and hot mix asphalt interaction

Abstract Paving hot mix asphalt (HMA) using an asphalt paver is a complex process requiring precise adjustments of compaction units such as the tamper and vibration unit to suit varying conditions. Despite decades of advancements, the process remains largely dependent on operator experience, and scientifically validated guidelines for optimizing key parameters like tamper and vibration frequency, as well as paving speed, are lacking. Field tests are costly and limited in scope, while internal material movements during compaction are difficult to observe. This study addresses these challenges by employing a full-scale simulation using a calibrated Discrete Element Method (DEM) model to analyze HMA’s flow and pre-compaction behavior. Key findings include insights into the flow and distribution of asphalt material within the auger tunnel and under the screed. The study reveals that the tamper’s compaction force is primarily directed toward the chamfer and has a significant depth effect, achieving considerable pre-compaction of the material. The paving process generates distinct force distributions and particle rearrangements, with key zones of high wear impact identified, especially on the tamper chamfer. Pre-compaction due to the screed’s dead weight is limited, highlighting the tamper’s critical role in achieving optimal compaction. These insights suggest improvements for future paver design, including potential modifications to the screed’s geometry and the introduction of heating elements on the screed front wall to reduce the risk of material cooling and ensure more homogeneous paving. This research contributes to enhancing the understanding of machine-material interactions during asphalt paving, offering practical recommendations for improving paving efficiency and longevity of road surfaces.

Fibrinogen and colorectal cancer: A study of the Chinese population

Fibrinogen has been associated with a variety of malignancies, including colorectal cancer (CRC). However, there is no study on the relationship between fibrinogen and CRC specifically in the Chinese population. The objective of this study was to analyze the relationship between fibrinogen and CRC in the Chinese population. This study included consecutive inpatients undergoing colonoscopies (April 2015‒June 2022). A total of 3,595 individuals, comprising 468 CRCs and 3,127 controls, were included. Logistic regression models and restricted cubic spline analysis were employed to assess the association between fibrinogen and CRC. When fibrinogen levels were divided into quartiles, the ORs for CRC in Q2, Q3, and Q4 compared to Q1 were 2.72 (95% CI: 1.57–4.74), 4.84 (95% CI: 2.84–8.25), and 9.55 (95% CI: 5.55–16.43), respectively. Restricted cubic spline analysis identified a non-linear association between fibrinogen levels and CRC risk with a threshold of 3.794 (95% CI: 3.747–3.841) g/L. Below this threshold, the CRC risk significantly increased (OR 5.944, 95% CI 4.084–8.65, P < 0.001). These findings may offer new insights for the diagnosis and management of CRC.

EEG-based neurodegenerative disease diagnosis: comparative analysis of conventional methods and deep learning models

Abstract In the context of lifestyle changes, stress and other environmental factors have resulted in the sudden hike in dementia globally. This necessitates investigations with respect to every horizon of the due cause for it; further on, the diagnosis and treatments can be advanced with the aid of technology. This work attempts to conduct one such investigation on dementia diagnosis based on EEG signals. The implementation is carried out under three different verticals. Firstly, a conventional machine learning model was developed post-pre-processing, and feature extraction from the power spectral density was done using a Random Forest classifier. Second, 1D Convolutional Neural Networks models are developed, and pre-processed EEG signals are fed as input. Third, stacked spectrogram images are computed from decomposed EEG signals and are fed to 2D CNN models for classification. The investigations are performed on three different benchmark datasets. Across three datasets, the class labels include cognitively normal, frontotemporal dementia, mild cognitive impairment, and Alzheimer’s. The study offers a comparative evaluation across three distinct datasets, illustrating that deep learning models, particularly 1D and 2D CNNs, consistently outperform conventional methods in recognizing subtle EEG signal patterns linked to neurodegenerative conditions. For instance, in Dataset 1, the 2D CNN achieved the highest accuracy of 91.13%, surpassing the Random Forest model’s 84.78% accuracy. Nevertheless, the investigation also points out challenges in Dataset 3, indicating the necessity for further model optimization tailored to specific datasets. Statistical tests validate the findings. This study showcases a comparative investigation of the potential of deep learning models vs. conventional classifiers in clinical environments for the early diagnosis of dementia.

Deconstructing construction wastes: Exploring waste generation causes and their impact on project performances

The construction industry has long been struggling with excessive costs, delays, and compromised quality due to wasteful practices, particularly in developing nations. While international efforts have focused on identifying waste-related factors, there’s a research gap in pinpointing micro-level causes and analyzing their specific impacts on cost, quality, and time. This study delves into the prevalent and crucial causes of construction waste in Pakistan, evaluating their collective influence on project cost, schedule, quality, and material management. A mix of literature study findings, on-site inspections, and a survey from industry experts was used to determine the causes of non-value-adding/waste generation in construction. Using two rounds of questionnaire survey, 65 valid responses (48% of response rate) were obtained. Following the initial round, the most significant causes and their consequences on waste-related features were identified using the Relative Importance Index (RII) and mean value indexing. To confirm the influence of these waste-generating causes on Pakistani construction projects, assessments from 21 industrial experts were conducted in the second round. The data alignment between the two phases confirmed the impact of the indicated causes on waste. The study determined that inadequate worker training and awareness, planning long duration leading to material escalation, and poor workmanship are the main causes of construction waste in Pakistan. Insights from 21 construction industry experts were also acquired, offering helpful strategies to cut waste in these projects. The outcome of this study clarifies the main reasons for the negative effects of construction waste on the sector and offers recommendations for future steps to reduce their frequency.

Surgical treatment of distal tibia non-unions with a retrograde intramedullary nail as a therapy option to prevent amputation

Abstract Compared to other long bones, non-unions of the tibia after fractures are more likely. Due to surgical debridement, the residual bone stock in the distal part of the bone may be insufficient for adequate fixation of an implant. Thus, treatment with a retrograde nail with the additional performance of an arthrodesis of the hindfoot may be an alternative. The aim of this study was to examine the consolidation and reinfection rates of non-unions of the distal tibia treated with a retrograde arthrodesis nail. A total of 27 patients between 2010 and 2018 were included according to our inclusion criteria. The modified Lane Sandhu Score was used for the radiographic evaluation. The osseous consolidation was validated after 1 year as well as after 2 years. Furthermore, we investigated differences in surgical treatment and treatment-associated complications. One year after the initial therapy 48% of the patients showed osseous consolidation, 75% showed consolidation after two years. 14% underwent amputation later. The majority of the patients (77%) received the ETN PROtect (Expert Tibia Nail PROtect) retrogradely, while the rest were obtained with the HAN (Hindfoot Arthrodesis Nail). Major revision surgeries were required in 26% of patients, while minor revisions were necessary in 15% of patients. In conclusion, treatment with a retrograde nail is a safe treatment option for distal tibia non-unions with a satisfactory overall fusion rate. Therefore, it can be an effective option especially in cases, where the fixation of the implant is difficult, in order to prevent amputation.

Finding patterns in lung cancer protein sequences for drug repurposing

Proteins are fundamental biomolecules composed of one or more chains of amino acids. They are essential for all living organisms, contributing to various biological functions and regulatory processes. Alterations in protein structures and functions are closely linked to diseases, emphasizing the need for in-depth study. A thorough understanding of these associations is crucial for developing targeted and more effective therapeutic strategies.Computational analyses of biomedical data facilitate the identification of specific patterns in proteins associated with diseases, providing novel insights into their biological roles. This study introduces a computational approach designed to detect relevant sequence patterns within proteins. These patterns, characterized by specific amino acid arrangements, can be critical for protein functionality. The proposed methodology was applied to proteins targeted by drugs used in lung cancer treatment, a disease that remains the leading cause of cancer-related mortality worldwide. Given that non-small cell lung cancer represents 85–90% of all lung cancer cases, it was selected as the primary focus of this study.Significant sequence patterns were identified, establishing connections between drug-target proteins and proteins associated with lung cancer. Based on these findings, a novel computational framework was developed to extend this pattern-based analysis to proteins linked to other diseases. By employing this approach, relationships between lung cancer drug-target proteins and proteins associated with four additional cancer types were uncovered. These associations, characterized by shared amino acid sequence features, suggest potential opportunities for drug repurposing. Furthermore, validation through an extensive literature review confirmed biological links between lung cancer drug-target proteins and proteins related to other malignancies, reinforcing the potential of this methodology for identifying new therapeutic applications.

Study on the in-situ modified support method of roadway surrounding rock under vertical impact load

Cap-assisted 5-cm diameter cold snare treatment for phytobezoars: A retrospective study

Background and aims The current treatment options for phytobezoars include endoscopic therapy, chemical lysis, and surgical treatment. These methods are often less efficient or are associated with more adverse events in large-diameter phytobezoars. This study aimed to evaluate the feasibility, effectiveness, and safety of the cap-assisted 5-cm diameter cold snare technique for the treatment of huge phytobezoars. Methods This retrospective study enrolled 24 patients with huge phytobezoars treated with the cap-assisted 5-cm diameter cold snare technique in the Department of Gastroenterology, Nanchong Central Hospital, between December 25, 2022, and October 1, 2023. Patients' clinical characteristics and bezoar features were evaluated, the procedure was recorded, and patients were reviewed and followed with gastroscopy 1 day and 1 month after the procedure. Results Twenty-four patients with huge phytobezoars were treated with the cap-assisted 5-cm diameter cold snare technique during the study period. The median phytobezoar size, break-up time, and extraction time were 5 × 3 cm (range 4–10, 3–5), 10.08 minutes (range 3.31–31.48), and 9.63 minutes (range 6.5–35.71), respectively. All patients achieved satisfactory treatment results, with no residual phytobezoars or gastrointestinal injuries on gastroscopy review 1 day after the procedure, and no postoperative adverse events were found on gastroscopy follow-up 1 month after the procedure. Conclusions The results of this study indicated that the cap-assisted 5-cm diameter cold snare technique is safe, feasible, and effective for treating huge gastric bezoars, offering a new treatment method for this disease. Given the limitations inherent in the retrospective nature and relatively small sample size of this study, a prospective, multicenter, large-sample clinical trial is warranted to evaluate the efficacy and generalizability of this technique comprehensively.

Publisher Correction: The link between tinnitus and menstrual cycle disorders in premenopausal women

“Everybody’s problem but nobody’s problem”: Qualitative study on integrating smoking cessation and mental health services in Singapore

Background Although quitting smoking benefits mental health, people with mental health conditions tend to have higher smoking rates and more severe tobacco use disorders. Integration of smoking cessation into mental healthcare, or vice versa, could help to meet the needs of this population. While Singapore offers specialist smoking cessation and mental health services, it is unclear how these services address the needs of people with comorbid tobacco use and mental health issues. This study aimed to explore the integration of smoking cessation and mental health services in Singapore from the perspective of healthcare professionals. Methods We conducted one-on-one semi-structured interviews with 21 Singaporean health professionals with expertise in mental health (n = 5), smoking cessation (n = 5), primary healthcare (n = 3), specialist respiratory or emergency care (n = 3) or health systems and policy (n = 5). We recruited participants from the authors’ professional networks and subsequently via snowballing. We used inductive coding methods to identify themes that emerged from the data. Results Health professionals were divided on whether smoking and mental health are sufficiently interconnected to justify more integrated or tailored services. Smoking cessation and mental health were generally approached in a siloed manner, reflecting systemic barriers to integration as well as ranging levels of awareness among health professionals on the association between smoking and mental health. While some participants welcomed the integration of smoking cessation and mental health services as a more convenient, effective and equitable way to address the needs of this population, others deemed it unnecessary and viewed smoking as a lifestyle habit, distinct from other mental health issues. Implications There is a need to educate health professionals on smoking as a mental health issue and to consider more tailored programmes designed to address smoking cessation and mental health needs simultaneously.

Impact of pre-existing subclinical depressive symptoms on the mental health of older adults during the COVID-19-related confinements: assessment of moderating factors including meditation training

C16orf74 is a novel prognostic biomarker and associates with immune infiltration in head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSC) is a prevalent and aggressive malignancy with poor prognosis, underscoring the need for novel biomarkers and therapeutic strategies. This study investigates the role of C16orf74 as a potential diagnostic and prognostic biomarker in HNSC. Bioinformatics analyses revealed that C16orf74 is significantly overexpressed in HNSC and is associated with advanced disease stages, therapy resistance, and shorter overall and progression-free survival. A prognostic nomogram integrating C16orf74 expression with clinicopathological features demonstrated robust predictive performance. Functional enrichment and immune infiltration analyses suggest that high C16orf74 expression might contribute to an immunosuppressive tumor microenvironment by reducing key immune cell populations, such as B cells, T cells, and natural killer cells, which are critical for anti-tumor immunity. Moreover, C16orf74 expression was inversely associated with immune checkpoint expression and immunotherapy response, highlighting its potential as a predictive biomarker for immune checkpoint blockade (ICB) efficacy. Drug sensitivity analyses identified potential therapeutic agents, including arsenic trioxide, carmustine, vincristine, quercetin, and carboplatin for patients with high C16orf74 expression. These findings highlight the potential of C16orf74 as a biomarker and therapeutic target to improve HNSC management.

A cooperative intrusion detection system for internet of things using fuzzy logic and ensemble of convolutional neural networks

Multispecies allometric models for estimating aboveground biomass in plantation and natural dry Afromontane forests in northcentral Ethiopia

Dry Afromontane forests in Ethiopia are crucial for carbon sequestration; however, the absence of robust biomass and carbon stock estimation models hinders accurate assessment. This study addresses this limitation by developing and validating site-specific, multispecies biomass estimation models for Wof-Washa plantation and natural forests. Biometric data were collected from 127 harvested trees representing seven dominant species from both plantation and natural forests. Aboveground biomass (AGB) was regressed against diameter at breast height (DBH) as the sole predictor, with stepwise inclusion of total height (H), crown area (CA), and wood density (ρ). Weighted nonlinear least squares regression was performed to fit new models for each forest, their performance was evaluated using the root mean square error (rRMSE), pseudo-R2, and relative mean prediction error (rMPE %). The best-selected model using DBH and H explained 90% and 95% of the variation in the AGB of plantation and natural forests, respectively. This model produced the lowest bias (rMPE = 5.9% for plantation and 2.5% for natural forests) compared to pan-tropical models. Our findings demonstrated that our optimal model provides accurate AGB predictions at plot and landscape levels. This confirms that the models can provide sufficiently reliable estimations of carbon stocks, indicating the potential for national carbon accounting and thereby enhancing decision-making in the study forests. Therefore, the findings of this research contribute directly to enhancing the accuracy of carbon dynamic monitoring and supporting sustainable forest management, a crucial component in global efforts to combat climate change.