Initial Analysis Research Articles

Developing a multivariable prediction model of global health-related quality of life in patients treated for rectal cancer: a prospective study in five countries

PurposeRectal cancer and its treatment have a negative impact on health-related quality of life (HRQoL). If risk factors for sustained low HRQoL could be identified early, ideally before the start of treatment, individualised interventions could be identified and implemented to maintain or improve HRQoL. The study aimed to develop a multivariable prediction model for global HRQoL 12 months after rectal cancer treatment.MethodsWithin COLOR II, a randomised, multicentre, international trial of laparoscopic and open surgery for rectal cancer, a sub-study on HRQoL included 385 patients in 12 hospitals and five countries. The HRQoL study was optional for hospitals in the COLOR II trial. EORTC QLQ-C30 and EORTC QLQ-CR38 were analysed preoperatively and at 1 and 12 months postoperatively. In exploratory analyses, correlations between age, sex, fatigue, pain, ASA classification, complications, and symptoms after surgery to HRQoL were studied. Bivariate initial analyses were followed by multivariate regression models.ResultsPatient characteristics and clinical factors explained 4–10% of the variation in global HRQoL. The patient-reported outcomes from EORTC QLQ-C30 explained 55–65% of the variation in global HRQoL. The predominant predictors were fatigue and pain, which significantly impacted global HRQoL at all time points measured.ConclusionWe found that fatigue and pain were two significant factors associated with posttreatment global HRQoL in patients treated for rectal cancer T1-T3 Nx. Interventions to reduce fatigue and pain could enhance global HRQoL after rectal cancer treatment.Trial registrationThis trial is registered with ClinicalTrials.gov No. NCT00297791

Comparison of the out-of-pocket costs of Medicare-funded telepsychiatry and face-to-face consultations: A descriptive study.

Telepsychiatry items in the Australian Medicare Benefits Schedule (MBS) were expanded following the COVID-19 pandemic. However, their out-of-pocket costs have not been examined. We describe and compare patient out-of-pocket payments for face-to-face and telepsychiatry (videoconferencing and telephone) MBS items for outpatient psychiatric services to understand the differential out-of-pocket cost burden for patients across these modalities. out-of-pocket cost information was obtained from the Medical Costs Finder website, which extracted data from Services Australia's Medicare claims data in 2021-2022. Cost information for corresponding face-to-face, video, and telephone MBS items for outpatient psychiatric services was compared, including (1) Median specialist fees; (2) Median out-of-pocket payments; (3) Medicare reimbursement amounts; and (4) Proportions of patients subject to out-of-pocket fees. Medicare reimbursements are identical for all comparable face-to-face and telepsychiatry items. Specialist fees for comparable items varied across face-to-face to telehealth options, with resulting differences in out-of-pocket costs. For video items, higher proportions of patients were not bulk-billed, with greater out-of-pocket costs than face-to-face items. However, the opposite was true for telephone items compared with face-to-face items. Initial cost analyses of MBS telepsychiatry items indicate that telephone consultations incur the lowest out-of-pocket costs, followed by face-to-face and video consultations.

XPS study on passivation behavior of naturally formed oxide on AlFeCuCrMg1.5 high-entropy alloy

High-entropy alloys have exceptional oxidation resistance due to their passive oxide film. In this study, photoelectron spectroscopy was used in a modern atomic-scale in situ initial oxidation analysis process to determine the oxidation behavior and elemental variation on its breakdown. Furthermore, the behavior of natural oxide formed on the AlFeCuCrMg1.5 HEA after the exposure of the alloy to the atmosphere for one hour, one day, and seven days was investigated in detail. Through a survey scan, the elements present on the oxidized surface were determined and quantified. Additionally, the seven-day-exposed HEA was depth-profiled and discovered drastic modifications in the alloy.

Exploration of data for analysis using boundary line methodology

The boundary line model has been proposed for interpretation of the plot of a biological response (such as crop yield) against a potentially-limiting variable from observations in a large set of scenarios across which other factors show uncontrolled variation. Under this model the upper bound of the distribution of data represents the limiting effect of the potential factor on the response. Methods have been proposed to fit this model, but we propose that an initial exploratory data analysis step is needed to evaluate evidence that (i) the model is plausible and (ii) that any limiting upper bound is exhibited by the data set (which could, in principle, not include any cases where the factor is limiting). We propose a statistic based on the density of observations in upper sections of early convex hull peels of the data plot. We evaluate this approach using various data sets, some of which have been used for boundary line analysis in previous studies.

Pulmonary MRI with hyperpolarized xenon-129 demonstrates novel alterations in gas transfer across the air-blood barrier in asthma.

Individuals with asthma can vary widely in clinical presentation, severity, and pathobiology. Hyperpolarized xenon-129 (Xe129) MRI is a novel imaging method to provide 3-D mapping of both ventilation and gas exchange in the human lung. To evaluate the functional changes in adults with asthma as compared to healthy controls using Xe129 MRI. All subjects (20 controls and 20 asthmatics) underwent lung function measurements and Xe129 MRI on the same day. Outcome measures included the pulmonary ventilation defect and transfer of inspired Xe129 into two soluble compartments: tissue and blood. Ten asthmatics underwent Xe129 MRI before and after bronchodilator to test whether gas transfer measures change with bronchodilator effects. Initial analysis of the results revealed striking differences in gas transfer measures based on age, hence we compared outcomes in younger (n=24, ≤ 35 years) versus older (n=16,>45 years) asthmatics and controls. The younger asthmatics exhibited significantly lower Xe129 gas uptake by lung tissue (Asthmatic: 0.98%±0.24%, Control: 1.17%±0.12%, P=0.035), and higher Xe129 gas transfer from tissue to the blood (Asthmatic: 0.40±0.10, Control: 0.31%±0.03%, P=0.035) than the younger controls. No significant difference in Xe129 gas transfer was observed in the older group between asthmatics and controls (P>0.05). No significant change in Xe129 transfer was observed before and after bronchodilator treatment. By using Xe129 MRI, we discovered heterogeneous alterations of gas transfer that have associations with age. This finding suggests a heretofore unrecognized physiological derangement in the gas/tissue/blood interface in young adults with asthma that deserves further study.

Exploring roles in teacher–researcher collaboration: examples from a Swedish research–practice partnership in education

ABSTRACT Research – practice partnerships (RPPs) engage the diverse perspectives of researchers and teachers, transforming both educational research and practice. However, an increased understanding of the day-to-day activities of research conducted within RPPs, and of the role of teachers and researchers in this research, is needed. In this study, teachers and researchers involved in research projects framed by a Swedish RPP between a university and thirteen municipalities were interviewed. In total, we interviewed twelve teachers and researchers in a selection of four research projects in this RPP. We studied how teachers’ and researchers’ roles evolved over the phases of the research process and found that collaboration was more extensive during the data collection phase than during project initiation and data analysis and reporting. We also found that characteristics of the project’s initialising phase were consequential to the evolution of teachers’ and researchers’ roles in later phases. This study contributes to the literature on collaborative research by elaborating on teacher and researcher roles across the research process. This knowledge will assist the development of strategies for conducting collaborative research in education.

Benford’s law analysis to evaluate the quality data of COVID-19 epidemiological surveillance in Indonesia

Countries worldwide, including Indonesia, grappled with the unprecedented challenges brought about by the coronavirus disease (COVID-19) pandemic. Surveillance data vividly illustrates the profound effect of the COVID-19 pandemic in Indonesia. Both daily cases and deaths were raised, revealing the rapid transmission of the virus within communities. A quantitative study using a statistical approach was accomplished with secondary data to evaluate the quality of COVID-19 epidemiological surveillance data in Indonesia during the period between March 2020 to January 2021. The data was sourced from the World Health Organization (WHO) website using data reports on COVID-19 confirmed cases and deaths. A rapid tool called the first digit law or the fulfillment of Benford’s law was used to suggest good data quality for epidemiological surveillance. Data analysis used the Chi-squared test and the log-likelihood ratio test. Also, it displayed the difference in mean absolute deviation (MAD) to identify the proximity of the data and Benford’s law distribution. The results showed that both confirmed, and death case distributions were statistically non-conformity with Benford’s law distribution. In terms of quality data regarding the COVID-19 pandemic, the epidemiological surveillance system falls short of Benford’s law assumption. Benford's law has been acknowledged as an initial analysis that can expeditiously assess the performance of a surveillance system. The next phase of this study would be to conduct a complete evaluation suitably, especially in post-pandemic COVID-19.

Advancing Local US Transitional Justice Initiatives: A University Partnership Alongside Descendant Communities

ABSTRACT This article suggests that the ongoing denial by the USA federal government of historical human rights infractions against African Americans and people of African descent led to a proliferation of local transitional justice efforts. Drawing from a university-driven transitional justice project, this article offers an analysis of local initiatives and highlights one of its six transitional justice collaborations. The university project sought to decolonize its structure and approach, drawing on methods of cultural humility, desire-based research and deep listening. This article responds to the success and challenges of decolonizing a transitional justice project within academia. Findings suggested that local initiatives face obstacles due to enduring legacies of harms and silenced histories, necessitating communities to substantiate their claims. Capacity issues and funding are challenged due to centuries of disinvestment. The article offers lessons learned for potential ally organizations who seek to advance transitional justice where government-sponsored redress continues to be denied.

TRANSFORMATION OF THE ECONOMY IN THE DIGITAL ERA: EXPERIENCE OF UZBEKISTAN AND DEVELOPMENT STRATEGIES

This article examines the processes of transformation of the economy of Uzbekistan inthe context of the digital era. The main focus is on analyzing the country’s experience in the use of digital technologies and developing development strategies in a rapidly changing digital landscape. The study includes an analysis of key initiatives aimed at promoting digital transformation, such as developing digital infrastructure, introducing e-government, stimulating digital entrepreneurship and educational programs in the field of digital technologies. The author of the article also considers strategic directions of development, identifies successful practices and highlights the challenges facing Uzbekistan in the process of digital transformation, providing valuable recommendations for the further development of the economy in the digital age.

Abstract IA009: Racial disparities in high grade endometrial cancers

Abstract Endometrial cancer (EC) is the most common gynecological cancer in the United States, with approximately 66,200 cases diagnosed annually. Incidence rates have been increasing over the past two decades, especially in non-white and younger populations. Additionally, population-based studies have shown that the increases are greatest among the more aggressive histologic subtypes. In unadjusted analyses, incidence rates are highest among non-Hispanic white women (NHW); however, when the greater prevalence of hysterectomies in non-Hispanic black women (NHB) is accounted for, the incidence among NHB women exceeds that of other racial and ethnic groups. In addition, survival after an EC diagnosis is significantly lower for NHB women at every stage of diagnosis, and for all histologic subtypes. EC is currently the 6th leading cause of cancer-related deaths among women but will likely overtake ovarian cancer (the 5th leading cause) before the end of the decade—it has already done so for NHB women. Factors influencing survival exist across the cancer care spectrum, starting at diagnosis and continuing through treatment and beyond. A portion of the differences in EC survival can be explained by the histologic subtype of the tumor. Low grade endometrioid ECs are the most common histologic type and tend to have a good prognosis. High grade tumors, such as serous cancers, are more common among NHB women and have poorer prognosis. A better understanding of the molecular characteristics of these more aggressive tumors is warranted, as they are increasing in incidence and cause a disproportionate amount of morbidity and mortality. To date, most studies that have included molecular profiling do not have large enough numbers or participants from diverse populations to examine whether mutations that may be clinically significant differ by race and ethnicity in high grade endometrial cancers. In a population of women with high grade EC (endometrioid, serous, clear cell, mixed) identified from two academic hospitals in Detroit, Michigan, we performed whole exome sequencing on tumor and normal tissue from 285 women. We hypothesized that somatic mutations in specific genes may vary by race and ultimately contribute to the survival disparity consistently identified in population-based studies. We report findings from the two most common high grade histologic subtypes, endometrioid (n=51 NHB, n=60 NHW) and serous (n=85 NHB, n=37 NHW). Established and emerging therapeutic targets were selected as a priori for the initial analysis. Tumor mutational burden (TMB), microsatellite instability status (MSI), mutations in genes in the PIK3 pathway, POLE, ARID1A and p53 were all examined. Findings highlight the need to consider histologic subtype in conjunction with race and ethnicity, as failure to do so may erroneously confound the estimates. Larger studies in diverse populations will be critical to disentangle the contribution of ancestry, histology and somatic mutations to the survival disparities seen after an EC diagnosis. Citation Format: Michele L. Cote. Racial disparities in high grade endometrial cancers [abstract]. In: Proceedings of the AACR Special Conference on Endometrial Cancer: Transforming Care through Science; 2023 Nov 16-18; Boston, Massachusetts. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(5_Suppl):Abstract nr IA009.

Microplastic Pollution: The Real Potential Threats to Human Being

The emergence of microplastic pollution has become a significant environmental concern that has far-reaching consequences for ecosystems and human health on a global scale. Microplastics, which are defined as plastic particulates smaller than five millimeters, are pervasive in our surroundings and originate from a variety of sources, including industrial processes, plastic products, and the degradation of larger plastics. This article examines the tangible risks that microplastic pollution presents to human beings, encompassing its origins, distribution, health consequences, and contamination of soil, water, food, and air. Through an analysis of ongoing regulatory initiatives, mitigation tactics, and the necessity for additional investigation, our objective is to elucidate the intricacies of this matter and underscore the critical nature of confronting microplastic pollution in order to safeguard the environment and human health.

ИНИЦИАТИВЫ ВСЕМИРНОЙ ОРГАНИЗАЦИИ ЗДРАВООХРАНЕНИЯ В СФЕРЕ ПОВЫШЕНИЯ БЕЗОПАСНОСТИ ПАЦИЕНТОВ И ИХ РЕАЛИЗАЦИЯ В РОССИЙСКОЙ ФЕДЕРАЦИИ

Currently, patient safety is one of the most important areas of healthcare, and it requires global coordinated efforts. The term "patient safety" covers various aspects, including the prevention of errors and adverse events, minimising risks of infections associated with medical care, ensuring proper use of equipment and effective interaction between patients and medical staff. World Health Organization (WHO) as a specialized unit of the United Nations in the field of global health has a unique international position and authority. It collects and analyzes data from around the world, conducts research and consults member countries within its competence, including medical care safety. In the Russian Federation, the movement for patient safety is still in the process of formation, many medical organizations, when implementing modern principles of safe medical care, face a shortage of practical manuals and other methodological materials. This literature review is devoted to the analysis and systematization of WHO initiatives in the field of improving patient safety. The review pays special attention to WHO's practical recommendations for improving patient safety, which can be used in medical organizations. The review also provides an analytical assessment of the implementation of the main activities aimed to improve patient safety in the Russian Federation. Thus, this study will be interesting to a wide range of readers, especially health care managers and medical professionals who plan to implement the principles of safe medical care in their organizations.

Genetic analysis of translation initiation in bacteria: An initiator tRNA-centric view.

Translation of messenger RNA (mRNA) in bacteria occurs in the steps of initiation, elongation, termination, and ribosome recycling. The initiation step comprises multiple stages and uses a special transfer RNA (tRNA) called initiator tRNA (i-tRNA), which is first aminoacylated and then formylated using methionine and N10 -formyl-tetrahydrofolate (N10 -fTHF), respectively. Both methionine and N10 -fTHF are produced via one-carbon metabolism, linking translation initiation with active cellular metabolism. The fidelity of i-tRNA binding to the ribosomal peptidyl-site (P-site) is attributed to the structural features in its acceptor stem, and the highly conserved three consecutive G-C base pairs (3GC pairs) in the anticodon stem. The acceptor stem region is important in formylation of the amino acid attached to i-tRNA and in its initial binding to the P-site. And, the 3GC pairs are crucial in transiting the i-tRNA through various stages of initiation. We utilized the feature of 3GC pairs to investigate the nuanced layers of scrutiny that ensure fidelity of translation initiation through i-tRNA abundance and its interactions with the components of the translation apparatus. We discuss the importance of i-tRNA in the final stages of ribosome maturation, as also the roles of the Shine-Dalgarno sequence, ribosome heterogeneity, initiation factors, ribosome recycling factor, and coevolution of the translation apparatus in orchestrating a delicate balance between the fidelity of initiation and/or its leakiness to generate proteome plasticity in cells to confer growth fitness advantages in response to the dynamic nutritional states.

CrAss-Like Phages: From Discovery in Human Fecal Metagenome to Application as a Microbial Source Tracking Marker.

CrAss-like phages are a diverse group of bacteriophages genetically similar to the prototypical crAssphage (p-crAssphage), which was discovered in the human gut microbiome through a metagenomics approach. It was identified as a ubiquitous and highly abundant bacteriophage group in the gut microbiome. Initial co-occurrence analysis postulated Bacteroides spp. as the prospective bacterial host. Subsequent studies have confirmed multiple host species under Phylum Bacteroidetes and some Firmicutes. Detection of crAss-like phages in sewage-contaminated environmental water and robust correlation with enteric viruses and bacteria has culminated in their adoption as a microbial source tracking (MST) marker. Polymerase chain reaction (PCR) and real-time PCR assays have been developed utilizing the conserved genes in the p-crAssphage genome to detect human fecal contamination of different water sources, with high specificity. Numerous investigations have examined the implications of crAss-like phages in diverse disease conditions, including ulcerative colitis, obesity and metabolic syndrome, autism spectrum disorders, rheumatoid arthritis, atopic eczema, and other autoimmune disorders. These studies have unveiled associations between certain diseases and diminished abundance and diversity of crAss-like phages. This review offers insights into the diverse aspects of research on crAss-like phages, including their discovery, genomic characteristics, structure, taxonomy, isolation, molecular detection, application as an MST marker, and role as a gut microbiome modulator with consequential health implications.

Collective dynamics of fluctuating–damping coupled oscillators in network structures: Stability, synchronism, and resonant behaviors

The investigation of collective behaviors and synergies in coupled systems holds great significance in many fields. In this paper, we propose the coupled system of overdamped fluctuating–damping oscillators in a general network framework. Our initial theoretical analysis focuses on the system’s synchronization and stability, revealing that both the first and second moments of the mean field are asymptotic stability, and the system exhibits a property of stochastic asymptotic synchronization with the mean field, irrespective of coupled structures. Furthermore, we explore the system’s collective behaviors by analyzing the output amplitude amplification (OAA), where we observe the emergence of generalized stochastic resonance (GSR) phenomena. Finally, we numerically verify the influence of system parameters on stability and synchronization in different coupled structures by introducing the mean first stability time and mean first synchronization time in the simulations. Our findings indicate that the structure does not significantly influence the system stability, whereas it does play a synergistic role in influencing the synchronization. Moreover, we further extend the investigation in complex networks, and observe the non-monotonous phenomena of mean first synchronization time varying with the heterogeneity.

Action Segmentation Through Self-Supervised Video Features and Positional-Encoded Embeddings

Action segmentation consists of temporally segmenting a video and labeling each segmented interval with a specific action label. In this work, we propose a novel action segmentation method that requires no initial video analysis and no annotated data. Our proposal involves extracting features from videos using several pre-trained deep-learning models, including spatiotemporal and self-supervised methods. Data is then transformed using a positional encoder, and finally, a clustering algorithm is applied, where each produced cluster presumably corresponds to a different single and distinguishable action. For self-supervised features, we explored DINO, and for spatiotemporal features, we investigated I3D and SlowFast methods. Moreover, two different clustering algorithms (FINCH and KMeans) were investigated, and we also explored how varying the length of video snippets that generate the feature vectors affected the quality of the segmentation. Experiments show that our method produces competitive results on the Breakfast and INRIA Instructional Videos dataset benchmarks. Our best result was produced using a composition of self-supervised features generated by DINO, FINCH clustering, and positional encoding.

Classification of Belts Status Based on an Automatic Generator of Fuzzy Rules Base System

The automation of maintenance is a growing field and consequently, predictive maintenance is achieving more importance. The main objective is to predict a breakage before it happens. In order to reach this, it is necessary to have an intelligent classification technique that analyzes the state of the key breakage elements and evaluates whether a replacement is necessary or not. This work presents a study to classify belts according to their state of use. For training, vibration data have been collected on a test bench using new belts, belts with half use and belts near the breaking point. The processing of these vibrations allows for extracting the characteristic parameters that can be related to its state of use, and then, after the initial analysis, these values are used as inputs for training the intelligent system. In particular, the Genetic Neuro-Fuzzy (GNF) technique has been chosen and, with the proposed algorithm, more detailed Fuzzy rules are obtained. Once the algorithm has been trained, it is possible to establish a relationship between the vibration shown by the belt and its state of use. The achieved results show that a good classifier has been built.

Failure of trabecular bone: XFEM modelling of multiple crack growth

Trabecular bone plays an important role in structural integrity of bone tissues. Its complex microstructure characterised by high porosity and intricate composition with multiple trabeculae is a challenge for analysis of fracture initiation and propagation in it. This work investigates mechanical behaviour and failure of representative volume elements (RVEs) of porous structure of trabecular bone using numerical simulations. The extended finite-element method (XFEM) is used together with an original algorithm for the growth of multiple cracks in individual trabeculae of the structure. The obtained results are presented in comparison with the model of degradation of elastic properties. The effect of morphology on accumulation of damage and crack growth - both on the scale of a RVE and in individual ligaments - was investigated using the developed approach for estimation of a relative crack-surface area. The results are presented for five RVEs, obtained with high-resolution computed tomography of human trabecular bone, subjected to applied tensile and compressive loads.

Analysis of external personal dosimetry for external ex-posure to medical radiation workers in radiotherapy and nuclear medicine departments between 2019 and 2022

The National Cancer Institute from Chile possesses a wide variety of high-complexity equipment for cancer treatment and diagnosis that employs ionizing radiation with high and medium energy. Presently, the radiotherapy department is equipped with 5 clinical linear accelerators and one brachytherapy equipment, while the nuclear medicine department is equipped with a PET-CT, a single gamma camera, and a hospitalization room for betatherapy. A descriptive statistical analysis was conducted on the Personal Doses Equivalent Reports from medical radiation workers between 2019-2022. The analysis involved extracting Hp(10) and Hp(0.07) measurements from digital reports using the Python Pandas library, and a database was constructed. The annual set of data was selected for each department to describe their behavior concerning Hp(10) total since PD8 dosimeters had the highest circulation. Additionally, using the boxplot format for the Hp(10) and Hp(0.07) distributions, means, medians, minimums and maximums, interquartile ranges and outliers were analyzed. While Hp(10) measurements exhibited an increase, Hp(0.07) measurements remained constant or experienced a decrease. All reported measurements were less than international tolerances. Finally, this initial descriptive statistical analysis enables the radiation safety officers to evaluate the applicability of inferential statistical analysis with stronger evidence and in an objective manner.

Haplotype information of large neuromuscular disease genes provided by linked-read sequencing has a potential to increase diagnostic yield.

Rare or novel missense variants in large genes such as TTN and NEB are frequent in the general population, which hampers the interpretation of putative disease-causing biallelic variants in patients with sporadic neuromuscular disorders. Often, when the first initial genetic analysis is performed, the reconstructed haplotype, i.e. phasing information of the variants is missing. Segregation analysis increases the diagnostic turnaround time and is not always possible if samples from family members are lacking. To overcome this difficulty, we investigated how well the linked-read technology succeeded to phase variants in these large genes, and whether it improved the identification of structural variants. Linked-read sequencing data of nemaline myopathy, distal myopathy, and proximal myopathy patients were analyzed for phasing, single nucleotide variants, and structural variants. Variant phasing was successful in the large muscle genes studied. The longest continuous phase blocks were gained using high-quality DNA samples with long DNA fragments. Homozygosity increased the number of phase blocks, especially in exome sequencing samples lacking intronic variation. In our cohort, linked-read sequencing added more information about the structural variation but did not lead to a molecular genetic diagnosis. The linked-read technology can support the clinical diagnosis of neuromuscular and other genetic disorders.