Search

The study examines how school-related factors influence the cognitive, psychological, and mental development of Vietnamese students. We randomly sent the questionnaires to more than 2000 students with different majors at five top universities in Vietnam based on the Ranking Web of Universities and conducted in-depth online interviews with respondents. Subsequently, we tested the correlation between student development and four school-related factors, including academic staff quality, school infrastructure, teaching curriculum, and school environment, using SPSS 22 and STATA version 2016. The findings suggest the significant role of staff quality in determining the level of student satisfaction. Specifically, students express their satisfaction and appreciation with their studies if their teachers have a solid academic platform. More importantly, infrastructure is positively correlated with three dependent variables, while teaching curriculum only influences cognitive development. The school environment positively affects psychological, mental, but not cognitive development. We also find that gender does not moderate students’ development but does influence student satisfaction.

RIG-I-like receptors (RLRs) are cytosolic RNA sensors critical for antiviral immunity. RLR activation is regulated by polyubiquitination and oligomerization following RNA binding. Yet, little is known about how RLRs exploit subcellular organelles to facilitate their posttranslational modifications and activation. Endosomal adaptor TAPE regulates the endosomal TLR and cytosolic RLR pathways. The potential interplay between RIG-I signaling and endosomes has been explored. Here, we report that endosomes act as platforms for facilitating RIG-I polyubiquitination and complex formation. RIG-I was translocated onto endosomes to form signaling complexes upon activation. Ablation of endosomes impaired RIG-I signaling to type I IFN activation. TAPE mediates the interaction and polyubiquitination of RIG-I and TRIM25. TAPE-deficient myeloid cells were defective in type I IFN activation upon RNA ligand and virus challenges. Myeloid TAPE deficiency increased the susceptibility to RNA virus infection in vivo. Our work reveals endosomes as signaling platforms for RIG-I activation and antiviral immunity.

Informal caregivers are crucial to the care of persons with dementia (PWD), but their role is often reported as challenging. This study aims to examine caregiver stress and depressive symptoms among informal caregivers of PWD using a modified transactional stress and coping model. Path analysis was conducted among a sample of informal caregivers of PWD in Singapore (n = 281) using information on functional dependence and memory and behavioral problems of PWD, and self-reported measurements on caregivers' knowledge of dementia, perceived positive aspects of caregiving, social support, coping patterns, caregiving self-efficacy, caregiving burden and depressive symptoms. The initial model reflecting our assumptions for the transactional stress and coping model showed a poor fit (model 1 - CFI = 0.858, TLI = 0.665, RMSEA = 0.118). Logical modifications were made until sufficient model fit was achieved (model 2 - CFI = 0.987, TLI = 0.955, RMSEA = 0.043). We then removed the insignificant paths in model 2 and obtained our final model (model 3 - CFI = 0.990, TLI = 0.974, RMSEA = 0.033). The final model supported our hypotheses, with some adjustments. This study advances our understanding of caregiver distress by modifying the transactional stress and coping model, including (1) the key role of caregiver self-efficacy in the primary appraisal process, (2) the dynamic assessment of coping resources across all stages of the model, and (3) the importance of coping patterns. Future studies could explore the generalizability of these findings., (© 2024. The Author(s).)

Background: This retrospective study compares the outcomes of trapeziectomy and Weilby suspensionplasty procedure versus implant arthroplasty using the TOUCH ® prosthesis for basilar thumb arthritis in an Asian population. Methods: A total of 15 consecutive thumbs in 13 patients were included in this study. Six patients (2 male, 4 female, mean age of 62 years old) underwent trapeziectomy and Weilby suspensionplasty procedure. Seven patients (4 male, 3 female, mean age 63 years old) underwent implant CMCJ arthroplasty using the TOUCH ® prosthesis. Data collected include demographics, severity of arthritis on plain radiographs of the thumb basilar joint, length of follow-up, pre- and postoperative pain levels, Kapandji thumb opposition score, grip and pinch strength and the time taken to return to work. Results: Patients in the trapeziectomy and Weilby suspensionplasty group had a mean follow-up of 4.5 months, while those in the TOUCH ® implant arthroplasty group had a mean follow-up of 14 months. TOUCH ® implant arthroplasty patients showed significantly higher grip strengths at 3 months post-surgery and a shorter return to work. There were no differences in pinch strength at 3 months, pinch or grip strength at 6 months or pain scores. Complications included prolonged scar hypersensitivity in two patients who underwent the Weilby suspensionplasty and a dislocated TOUCH ® implant cup in one patient. Conclusions: Our study suggests that in the short term, CMCJ implant arthroplasty with the TOUCH ® prosthesis produces results comparable to trapeziectomy and Weilby suspensionplasty. Level of Evidence: Level III (Therapeutic).

Background: Deformable registration is required to generate a time-integrated activity (TIA) map which is essential for voxel-based dosimetry. The conventional iterative registration algorithm using anatomical images (e.g., computed tomography (CT)) could result in registration errors in functional images (e.g., single photon emission computed tomography (SPECT) or positron emission tomography (PET)). Various deep learning-based registration tools have been proposed, but studies specifically focused on the registration of serial hybrid images were not found., Purpose: In this study, we introduce CoRX-NET, a novel unsupervised deep learning network designed for deformable registration of hybrid medical images. The CoRX-NET structure is based on the Swin-transformer (ST), allowing for the representation of complex spatial connections in images. Its self-attention mechanism aids in the effective exchange and integration of information across diverse image regions. To augment the amalgamation of SPECT and CT features, cross-stitch layers have been integrated into the network., Methods: Two different 177 Lu DOTATATE SPECT/CT datasets were acquired at different medical centers. 22 sets from Seoul National University and 14 sets from Sunway Medical Centre are used for training/internal validation and external validation respectively. The CoRX-NET architecture builds upon the ST, enabling the modeling of intricate spatial relationships within images. To further enhance the fusion of SPECT and CT features, cross-stitch layers have been incorporated within the network. The network takes a pair of SPECT/CT images (e.g., fixed and moving images) and generates a deformed SPECT/CT image. The performance of the network was compared with Elastix and TransMorph using L1 loss and structural similarity index measure (SSIM) of CT, SSIM of normalized SPECT, and local normalized cross correlation (LNCC) of SPECT as metrics. The voxel-wise root mean square errors (RMSE) of TIA were compared among the different methods., Results: The ablation study revealed that cross-stitch layers improved SPECT/CT registration performance. The cross-stitch layers notably enhance SSIM (internal validation: 0.9614 vs. 0.9653, external validation: 0.9159 vs. 0.9189) and LNCC of normalized SPECT images (internal validation: 0.7512 vs. 0.7670, external validation: 0.8027 vs. 0.8027). CoRX-NET with the cross-stitch layer achieved superior performance metrics compared to Elastix and TransMorph, except for CT SSIM in the external dataset. When qualitatively analyzed for both internal and external validation cases, CoRX-NET consistently demonstrated superior SPECT registration results. In addition, CoRX-NET accomplished SPECT/CT image registration in less than 6 s, whereas Elastix required approximately 50 s using the same PC's CPU. When employing CoRX-NET, it was observed that the voxel-wise RMSE values for TIA were approximately 27% lower for the kidney and 33% lower for the tumor, compared to when Elastix was used., Conclusion: This study represents a major advancement in achieving precise SPECT/CT registration using an unsupervised deep learning network. It outperforms conventional methods like Elastix and TransMorph, reducing uncertainties in TIA maps for more accurate dose assessments., (© 2024 The Author(s). Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

Studies of patients with castrate-resistant prostate cancer at high risk of developing overt metastases but with no current evidence of evaluable disease on computed tomography or bone scan non-metastatic castrate-resistant prostrate cancer have demonstrated increased metastasis-free survival and overall survival following treatment with the next-generation oral anti-androgen apalutamide (in addition to therapies that aim to lower testosterone to castrate levels) or luteinizing hormone-releasing hormone antagonist or surgical castration. Patients receiving apalutamide can be managed by medical oncologists, radiation oncologists, or urologists, preferably as part of a multidisciplinary team. However, the importance of additional safety monitoring for significant adverse effects and drug interactions should not be underestimated. The toxicities of apalutamide are manageable with experience and should be managed proactively to minimize their impact on patients. Monitoring of patients for apalutamide-specific toxicities, including skin rash, hypothyroidism, and QT prolongation should be carried out regularly, particularly in the first few months following initiation. Monitoring should continue alongside monitoring for toxicities of androgen deprivation, including cardiovascular risk, hot flashes, weight gain, bone health, muscle wasting, and diabetic risk. This review is a practical guide to the use of apalutamide describing the management of patients including dosing and administration, toxicities, potential drug interactions, and safety monitoring requirements., (© 2024 The Authors. Asia‐Pacific Journal of Clinical Oncology published by John Wiley & Sons Australia, Ltd.)

This paper proposes a novel approach to enhance the multichannel fiber optic sensing systems by integrating an Inverse Fast Fourier Transform-based Deep Neural Network (IFFT-DNN) to accurately predict sensor responses despite signals overlapping and crosstalk between sensors. The IFFT-DNN leverages both frequency and time domain information, enabling a comprehensive feature extraction which enhances the prediction accuracy and reliability performance. To investigate the IFFT-DNN's performance, we propose a multichannel water level sensing system based on Free Space Optics (FSO) to measure the water level at multiple points in remote areas. The experimental results demonstrate the system's high precision, with a Mean Absolute Error (MAE) of 0.07 cm, even in complex conditions. Hence, this system provides a cost-effective and reliable remote water level sensing solution, highlighting its practical applicability in various industrial settings.

Background: While the impact of telephone follow-up (TFU) for older emergency department (ED) patients is controversial, its effects on the Asian population remain uncertain. In this study, we evaluated the effectiveness of a novel computer assisted TFU model specifically for this demographic., Methods: At a Taiwanese tertiary medical center, we developed a TFU protocol that included a referral and case management system within the ED hospital information system. We provided TFU to older discharged patients between April 1, 2021, and May 31, 2021. We compared this cohort with a non-TFU cohort of older ED patients and analyzed demographic characteristics and post-ED discharge outcomes., Results: The TFU model was successfully implemented, with 395 patients receiving TFU and 191 without TFU. TFU patients (median age: 76 years, male proportion: 48.9%) differed from non-TFU patients (median age: 74 years, male proportion: 43.5%). Compared with the non-TFU cohort, the multivariate logistic regression analysis revealed that the TFU cohort had a lower total medical expenditure < 1 month (adjusted odds ratio [AOR]: 0.32; 95% CI: 0.21 - 0.47 for amounts exceeding 5,000 New Taiwan Dollars), and higher satisfaction (AOR: 2.80; 95% CI: 1.46 - 5.36 for scores > 3 on a five-point Likert Scale). However, the TFU cohort also had a higher risk of hospitalization < 1 month (AOR: 2.50; 95% CI: 1.31 - 4.77) compared to the non-TFU cohort., Conclusion: Computer-assisted TFU appears promising. Further research involving a larger number of patients and validation in other hospitals is necessary to bolster the evidence and extend the findings to a broader context., (© 2024. The Author(s).)

DUSP22, an atypical dual-specificity phosphatase enzyme, plays a significant role in regulating multiple kinase signaling pathways by dephosphorylation. Our study demonstrated that decreased DUSP22 expression is associated with shorter disease-free survival, advanced TNM (tumor, lymph nodes, and metastasis), cancer stage, and higher tumor grade in lung adenocarcinoma (LUAD) patients. Exogenous DUSP22 expression reduces the colony-forming capacity of lung cancer cells and inhibits xenograft tumor growth primarily by targeting EGFR and suppressing its activity through dephosphorylation. Knockdown of DUSP22 using shRNA enhances EGFR dependency in HCC827 lung cancer cells and increases sensitivity to gefitinib, an EGFR inhibitor. Consistently, genetic deletion of DUSP22 enhances EGFRdel (exon 19 deletion)-driven lung tumorigenesis and elevates EGFR activity. Pharmacological inhibition of DUSP22 activates EGFR, ERK1/2, and upregulates downstream PD-L1 expression. Additionally, lentiviral deletion of DUSP22 by shRNA enhances lung cancer cell migration through EGFR/c-Met and PD-L1-dependent pathways. Gefitinib, an EGFR inhibitor, mechanistically suppresses migration induced by DUSP22 deletion and inhibits c-Met activity. Furthermore, cabozantinib, a c-Met inhibitor, reduces migration and attenuates EGFR activation caused by DUSP22 deletion. Collectively, our findings support the hypothesis that loss of DUSP22 function in lung cancer cells confers a survival advantage by augmenting EGFR signaling, leading to increased activation of downstream c-Met, ERK1/2, and PD-L1 axis, ultimately contributing to the progression of advanced lung cancer., (© 2024. The Author(s).)

Non-Alcoholic Fatty Liver Disease (NAFLD) is characterized by the accumulation of excess fat in the liver. If left undiagnosed and untreated during the early stages, NAFLD can progress to more severe conditions such as inflammation, liver fibrosis, cirrhosis, and even liver failure. In this study, machine learning techniques were employed to predict NAFLD using affordable and accessible laboratory test data, while the conventional technique hepatic steatosis index (HSI)was calculated for comparison. Six algorithms (random forest, K-nearest Neighbors, Logistic Regression, Support Vector Machine, extreme gradient boosting, decision tree), along with an ensemble model, were utilized for dataset analysis. The objective was to develop a cost-effective tool for enabling early diagnosis, leading to better management of the condition. The issue of imbalanced data was addressed using the Synthetic Minority Oversampling Technique Edited Nearest Neighbors (SMOTEENN). Various evaluation metrics including the F1 score, precision, accuracy, recall, confusion matrix, the mean absolute error (MAE), receiver operating characteristics (ROC), and area under the curve (AUC) were employed to assess the suitability of each technique for disease prediction. Experimental results using the National Health and Nutrition Examination Survey (NHANES) dataset demonstrated that the ensemble model achieved the highest accuracy (0.99) and AUC (1.00) compared to the machine learning techniques that we used and HSI. These findings indicate that the ensemble model holds potential as a beneficial tool for healthcare professionals to predict NAFLD, leveraging accessible and cost-effective laboratory test data.

Inflammatory T cells contribute to the pathogenesis of autoimmune diseases such as systemic lupus erythematosus (SLE). Analysis of the T-cell transcriptomics data of two independent SLE patient cohorts by three machine learning models revealed the pseudogene UHRF1P as a novel SLE biomarker. The pseudogene-encoded UHRF1P protein was overexpressed in peripheral blood T cells of SLE patients. The UHRF1P protein lacks the amino-terminus of its parental UHRF1 protein, resulting in missing the proteasome-binding ubiquitin-like (Ubl) domain of UHRF1. T-cell-specific UHRF1P transgenic mice manifested the induction of IL-17A and autoimmune inflammation. Mechanistically, UHFR1P prevented UHRF1-induced Lys48-linked ubiquitination and degradation of MAP4K3 (GLK), which is a kinase known to induce IL-17A. Consistently, IL-17A induction and autoimmune phenotypes of UHRF1P transgenic mice were obliterated by MAP4K3 knockout. Collectively, UHRF1P overexpression in T cells inhibits the E3 ligase function of its parental UHRF1 and induces autoimmune diseases., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This case report presents an uncommon long-term complication of external fixator application to distal radius fracture. Despite an initial uneventful fracture healing, the patient presented with Brodie's abscess with Staphylococcus aureus osteomyelitis at the previous pin site 17 years later. A diagnosis of late-onset osteomyelitis, as a manifestation of quiescence chronic osteomyelitis, was made., (© 2024 Society for Indian Hand Surgery and Micro Surgeons. Published by Elsevier B.V. All rights reserved.)

Background: Enzalutamide and lutetium-177 [ 177 Lu]Lu-prostate-specific membrane antigen (PSMA)-617 both improve overall survival in patients with metastatic castration-resistant prostate cancer. Androgen and PSMA receptors have a close intracellular relationship, with data suggesting complementary benefit if targeted concurrently. In this study, we assessed the activity and safety of enzalutamide plus adaptive-dosed [ 177 Lu]Lu-PSMA-617 versus enzalutamide alone as first-line treatment for metastatic castration-resistant prostate cancer., Methods: ENZA-p was an open-label, randomised, controlled phase 2 trial done at 15 hospitals in Australia. Participants were men aged 18 years or older with metastatic castration-resistant prostate cancer not previously treated with docetaxel or androgen receptor pathway inhibitors for metastatic castration-resistant prostate cancer, gallium-68 [ 68 Ga]Ga-PSMA-PET-CT (PSMA-PET-CT) positive disease, Eastern Cooperative Oncology Group performance status of 0-2, and at least two risk factors for early progression on enzalutamide. Participants were randomly assigned (1:1) by a centralised, web-based system using minimisation with a random component to stratify for study site, disease burden, use of early docetaxel, and previous treatment with abiraterone acetate. Patients were either given oral enzalutamide 160 mg daily alone or with adaptive-dosed (two or four doses) intravenous 7·5 GBq [ 177 Lu]Lu-PSMA-617 every 6-8 weeks dependent on an interim PSMA-PET-CT (week 12). The primary endpoint was prostate-specific antigen (PSA) progression-free survival, defined as the interval from the date of randomisation to the date of first evidence of PSA progression, commencement of non-protocol anticancer therapy, or death. The analysis was done in the intention-to-treat population, using stratified Cox proportional hazards regression. This trial is registered with ClinicalTrials.gov, NCT04419402, and participant follow-up is ongoing., Findings: 162 participants were randomly assigned between Aug 17, 2020, and July 26, 2022. 83 men were assigned to the enzalutamide plus [ 177 Lu]Lu-PSMA-617 group, and 79 were assigned to the enzalutamide group. Median follow-up in this interim analysis was 20 months (IQR 18-21), with 32 (39%) of 83 patients in the enzalutamide plus [ 177 Lu]Lu-PSMA-617 group and 16 (20%) of 79 patients in the enzalutamide group remaining on treatment at the data cutoff date. Median age was 71 years (IQR 64-76). Median PSA progression-free survival was 13·0 months (95% CI 11·0-17·0) in the enzalutamide plus [ 177 Lu]Lu-PSMA-617 group and 7·8 months (95% CI 4·3-11·0) in the enzalutamide group (hazard ratio 0·43, 95% CI 0·29-0·63, p<0·0001). The most common adverse events (all grades) were fatigue (61 [75%] of 81 patients), nausea (38 [47%]), and dry mouth (32 [40%]) in the enzalutamide plus [ 177 Lu]Lu-PSMA-617 group and fatigue (55 [70%] of 79), nausea (21 [27%]), and constipation (18 [23%]) in the enzalutamide group. Grade 3-5 adverse events occurred in 32 (40%) of 81 patients in the enzalutamide plus [ 177 Lu]Lu-PSMA-617 group and 32 (41%) of 79 patients in the enzalutamide group. Grade 3 events that occurred only in the enzalutamide plus [ 177 Lu]Lu-PSMA-617 group included anaemia (three [4%] of 81 participants) and decreased platelet count (one [1%] participant). No grade 4 or 5 events were attributed to treatment on central review in either group., Interpretation: The addition of [ 177 Lu]Lu-PSMA-617 to enzalutamide improved PSA progression-free survival providing evidence of enhanced anticancer activity in patients with metastatic castration-resistant prostate cancer with risk factors for early progression on enzalutamide and warrants further evaluation of the combination more broadly in metastatic prostate cancer., Funding: Prostate Cancer Research Alliance (Movember and Australian Federal Government), St Vincent's Clinic Foundation, GenesisCare, Roy Morgan Research, and Endocyte (a Novartis company)., Competing Interests: Declaration of interests LE reports research grant support (to their institution) from Novartis and Clarity Pharma; consulting fees for lectures or advisory boards from Astellas, Janssen, AstraZeneca, Clarity, Novartis, and Telix in the past 5 years; and philanthropic grant support from the Prostate Cancer Foundation, St Vincent's Clinic Research Foundation, and Curran Foundation. SSa reports grants from Novartis/AAA, AstraZeneca, Merck Sharp & Dohme, Genentech, Pfizer, Amgen, and Senhwa to their institution; and personal fees from AstraZeneca, Merck Sharp & Dohme, Bristol Myers Squibb, and AstraZeneca to their institution, outside the submitted work. CG donated personal fees from Astellas, Janssen, AstraZeneca, Bristol Myers Squibb, Pfizer/EMD Serono, Ipsen, Astellas, and MSD, direct and complete, to a third party not-for-profit. CG declares consulting fees (unrelated to this work) from Novotech, Cadex Geonomics, and BCAL Diagnostics; and participation on an advisory board for Alloplex. MSH reports grants and receipt of equipment, materials, drugs, medical writing, gifts, or other services from the Prostate Cancer Foundation, National Health and Medical Research Council (NHRMC), Movember, US Department of Defense, Medical Research Future Fund, Bayer, Peter MacCallum Foundation, Isotopia, and the Australian Nuclear Science and Technology Organisation; consulting fees from Merck Sharp & Dohme and Novartis; honoraria from Janssen, Novartis, AstraZeneca, and Astellas; support for meetings from Merck Sharp & Dohme, Novartis, Janssen, AstraZeneca, and Astellas; leadership or fiduciary role in other board from Australian Friends of Sheba; and other financial or non-financial interests from Peter MacCallum Cancer Centre and the University of Melbourne. DAP reports personal fees from Ipsen and Eisai, all outside the submitted work. RJF reports institution funding and consulting fees from AIQ Solutions, outside the submitted work; and committee involvement in the Australasian Radiopharmaceutical Trials Network (unpaid). MRS reports grants to his institution from the Australian NHMRC, Cancer Australia, Astellas, Amgen, AstraZeneca, Bayer, Bionomics, Bristol Myers Squibb, Celgene, Medivation, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, and Tilray, all outside the submitted work. IDD reports grants from the NHMRC, during the conduct of the study; and institutional payments to support prostate cancer trials from Pfizer, ANZUP Cancer Trials Group, Bayer, Astellas, Janssen, Movember Foundation, and Merck Sharp & Dohme, outside the submitted work. IDD is unremunerated Chair of the ANZUP Cancer Trials Group and is supported in part by an Australian NHMRC Investigator Grant (grant number 2016274). AMJ reports consulting or advisory roles (to their institution) from Janssen Oncology, Pfizer, and Astellas Pharma; and research funding (to their institution) from Bristol Myers Squibb, Janssen Oncology, Merck Sharp & Dohme, Mayne Pharma, Roche/Genentech, Bayer, Lilly, Pfizer, and AstraZeneca. AW declares consulting fees from MSD, Eisai, Bristol Myers Squibb, and Astellas; honoraria from Eisai and MSD; and participation on an advisory board from Loxo-Lilly, MSD, and Astellas. DP declares support for travel from Astellas and participation on an advisory board from Astellas. MC reports advisory board fees from Astellas. MV reports personal fees from AstraZeneca and MSD. AYZ reports grants or contracts from Astellas, Amgen, AstraZeneca, Bionomics, Bristol Myers Squibb, Celgene, Medivation, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, and Tilray; consulting fees from Merck Sharpe & Dohme; honoraria from Merck Sharpe & Dohme, Astellas, Bayer, Pfizer, Merck, Mundipharma, Janssen, and AstraZeneca; and participation on a data safety monitoring board or advisory board from Merck, Merck Sharpe & Dohme, Astellas, and Bayer. JCG reports consulting fees from Bristol Myers Squibb, GlaxoSmithKline, and MSD; honoraria from Bayer, Ipsen, Eisai, Janssen, GlaxoSmithKline, and MSD; support to attend meetings from Bayer and BeiGene; and participation on a data safety monitoring board or advisory board from AstraZeneca. LH reports support for the present manuscript from Astellas; research funding from Astellas, Bayer, and Imagion; participation on advisory boards from Astellas, Bayer, Janssen, and MSD; payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing, or educational events from Astellas, Bayer, Janssen, and MSD; support for attending meetings from Bayer; a provisional patent (Australian number 2022902527, Prognostic Markers [plasma lipid prognostic signature in metastatic prostate cancer]; patent owned by the Chris O'Brien Lifehouse [their institution]); participation on a data safety monitoring board or advisory board from Astellas, Bayer, and Imagion; advisory board leadership role for ANZUP; and stock or stock options from Connected Medical Solutions. SY reports grants or contracts from NHMRC, Cancer Australia, Astellas, Amgen, AstraZeneca, Bionomics, Bristol Myers Squibb, Celgene, Medivation, Merck Sharp & Dohme, Pfizer, Roche, Sanofi, and Tilray; and support for attending meetings from Bayer. All other authors declare no competing interests., (Copyright © 2024. Published by Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Study Design: Single centre, cross-sectional study., Objectives: The objective is to report the prevalence of spondylolisthesis and retrolisthesis, analyse both conditions in terms of the affected levels and severity, as well as identify their risk factors., Methods: A review of clinical data and radiographic images of consecutive spine patients seen in outpatient clinics over a 1-month period is performed. Images are obtained using the EOS® technology under standardised protocol, and radiographic measurements were performed by 2 independent, blinded spine surgeons. The prevalence of both conditions were shown and categorised based on the spinal level involvement and severity. Associated risk factors were identified., Results: A total of 256 subjects (46.1% males) with 2304 discs from T9/10 to L5/S1 were studied. Their mean age was 52.2(± 18.7) years. The overall prevalence of spondylolisthesis and retrolisthesis was 25.9% and 17.1% respectively. Spondylolisthesis occurs frequently at L4/5(16.3%), and retrolisthesis at L3/4(6.8%). Majority of the patients with spondylolisthesis had a Grade I slip (84.3%), while those with retrolisthesis had a Grade I slip. The presence of spondylolisthesis was found associated with increased age ( P < .001), female gender (OR: 2.310; P = .005), predominantly sitting occupations (OR:2.421; P = .008), higher American Society of Anaesthesiology grades ( P = .001), and lower limb radiculopathy (OR: 2.175; P = .007). Patients with spondylolisthesis had larger Pelvic Incidence ( P < .001), Pelvic Tilt ( P < .001) and Knee alignment angle ( P = .011), but smaller Thoracolumbar junctional angle ( P = .008), Spinocoxa angle ( P = .007). Retrolisthesis was associated with a larger Thoracolumbar junctional angle ( P =.039)., Conclusion: This is the first study that details the prevalence of spondylolisthesis and retrolisthesis simultaneously, using the EOS technology and updated sagittal radiographic parameters. It allows better understanding of both conditions, their mutual relationship, and associated clinical and radiographic risk factors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Activity recognition is one of the significant technologies accompanying the development of the Internet of Things (IoT). It can help in recording daily life activities or reporting emergencies, thus improving the user's quality of life and safety, and even easing the workload of caregivers. This study proposes a human activity recognition (HAR) system based on activity data obtained via the micro-Doppler effect, combining a two-stream one-dimensional convolutional neural network (1D-CNN) with a bidirectional gated recurrent unit (BiGRU). Initially, radar sensor data are used to generate information related to time and frequency responses using short-time Fourier transform (STFT). Subsequently, the magnitudes and phase values are calculated and fed into the 1D-CNN and Bi-GRU models to extract spatial and temporal features for subsequent model training and activity recognition. Additionally, we propose a simple cross-channel operation (CCO) to facilitate the exchange of magnitude and phase features between parallel convolutional layers. An open dataset collected through radar, named Rad-HAR, is employed for model training and performance evaluation. Experimental results demonstrate that the proposed 1D-CNN+CCO-BiGRU model demonstrated superior performance, achieving an impressive accuracy rate of 98.2%. This outperformance of existing systems with the radar sensor underscores the proposed model's potential applicability in real-world scenarios, marking a significant advancement in the field of HAR within the IoT framework.

Objectives: To evaluate serial tissue Doppler cardiac imaging (TDI) in the evolution of bronchopulmonary dysplasia-associated pulmonary hypertension (BPD-PH) among extremely preterm infants., Design: Prospective observational study., Setting: Single-center, tertiary-level neonatal intensive care unit., Patients: Infant born <28 weeks gestation., Main Outcome Measures: Utility of TDI in the early diagnosis and prediction of BPD-PH and optimal timing for screening of BPD-PH., Results: A total of 79 infants were included. Of them, 17 (23%) had BPD-PH. The mean gestational age was 25.9 ± 1.1 weeks, and mean birth weight was 830 ± 174 g. The BPD-PH group had a high incidence of hemodynamically significant patent ductus arteriosus (83% vs. 56%, p  < 0.018), longer oxygen days (96.16 ± 68.09 vs. 59.35 ± 52.1, p  < 0.008), and prolonged hospital stay (133.8 ± 45.9 vs. 106.5 ± 37.9 days, p  < 0.005). The left ventricular eccentricity index (0.99 ± 0.1 vs. 1.1 ± 0.7, p  < 0.01) and the ratio of acceleration time to right ventricular ejection time showed a statistically significant trend from 33 weeks (0.24 ± 0.05 vs. 0.28 ± 0.05, p  < 0.05). At 33 weeks, the BPD-PH group showed prolonged isovolumetric contraction time (27.84 ± 5.5 vs. 22.77 ± 4, p  < 0.001), prolonged isovolumetric relaxation time (40.3 ± 7.1 vs. 34.9 ± 5.3, p  < 0.003), and abnormal myocardial performance index (0.39 ± 0.05 vs. 0.32 ± 0.03, p  < 0.001). These differences persisted at 36 weeks after conceptional gestational age., Conclusions: TDI parameters are sensitive in the early evolution of BPD-PH. Diagnostic accuracy can be increased by combining the TDI parameters with conventional echocardiographic parameters. BPD-PH can be recognizable as early as 33-34 weeks of gestation., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Gopagondanahalli, Abdul Haium, Vora, Sundararaghavan, Ng, Choo, Ang, Binte Mohamad Taib, Wijedasa, Rajadurai, Yeo and Tan.)

Study Design: Systematic review and meta-analysis., Objective: To report the ratio-of-differences between standing and sitting. To understand how sex and age influence these differences., Summary of Background Data: Currently, spinal deformity surgery aims to realign the sagittal profile of the spine with-reference-to the standing posture resulting in overcorrection. New studies report significant disparities between standing and sitting spinal alignment., Methods: A comprehensive search and review of the published literature was performed on 4 platforms in accordance with the PRISMA 2009 checklist by 2 authors independently., Results: From 753 abstracts extracted from the databases, 38 papers involving 5423 patients were identified. sagittal vertical axis was more positive in sitting, with a pooled mean difference of 29.5 mm (95% CI: 17.9-41.0). Pelvic tilt (PT) was larger in sitting, with a pooled mean difference of 16.7 degrees (95% CI: 12.5-20.9), and a pooled odds ratio of 1.2(95% CI:1.1-1.3. P =0.001). Sacral Slope (SS) was smaller and lumbar lordosis (LL) was less lordotic in sitting, with a pooled mean difference of 15.0 degrees (95% CI: 11.918.1) and 21.1 degrees (95% CI:14.5-27.8), respectively, and a pooled odds ratio of 0.7 (95% CI: 0.6-0.8. P <0.001) and 0.7 (95% CI:0.6-0.7, P <0.001), respectively. Pelvic incidence and thoracic kyphosis was similar in sitting. Subgroup meta-analysis comparing odd ratio of standing to sitting showed: Among younger patients (age younger than 50), the PT and LL pooled odds-ratios were 1.4 and 0.7, respectively. Among older patients (age older than or equal to 50), the PT and LL pooled odds-ratios were 1.1 and 0.8, respectively. Among female patients, the SS pooled odds ratio was 0.6. Among male patients, the SS pooled odds ratio was 0.7., Conclusion: When comparing sitting to standing, it gives a more positive sagittal vertical axis, a smaller SS and LL, and a larger PT. pelvic incidence and thoracic kyphosis remained similar. Younger and female patients have pronounced differences in SS, PT, and LL, suggesting the existence of age and sex variations, and its role to be considered when planning for spinal realignment surgeries. Clinical outcome studies are required to ascertain the impact of these findings., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: T cell receptor (TCR) signaling and T cell activation are tightly regulated by gatekeepers to maintain immune tolerance and avoid autoimmunity. The TRAIL receptor (TRAIL-R) is a TNF-family death receptor that transduces apoptotic signals to induce cell death. Recent studies have indicated that TRAIL-R regulates T cell-mediated immune responses by directly inhibiting T cell activation without inducing apoptosis; however, the distinct signaling pathway that regulates T cell activation remains unclear. In this study, we screened for intracellular TRAIL-R-binding proteins within T cells to explore the novel signaling pathway transduced by TRAIL-R that directly inhibits T cell activation., Methods: Whole-transcriptome RNA sequencing was used to identify gene expression signatures associated with TRAIL-R signaling during T cell activation. High-throughput screening with mass spectrometry was used to identify the novel TRAIL-R binding proteins within T cells. Co-immunoprecipitation, lipid raft isolation, and confocal microscopic analyses were conducted to verify the association between TRAIL-R and the identified binding proteins within T cells., Results: TRAIL engagement downregulated gene signatures in TCR signaling pathways and profoundly suppressed phosphorylation of TCR proximal tyrosine kinases without inducing cell death. The tyrosine phosphatase SHP-1 was identified as the major TRAIL-R binding protein within T cells, using high throughput mass spectrometry-based proteomics analysis. Furthermore, Lck was co-immunoprecipitated with the TRAIL-R/SHP-1 complex in the activated T cells. TRAIL engagement profoundly inhibited phosphorylation of Lck (Y394) and suppressed the recruitment of Lck into lipid rafts in the activated T cells, leading to the interruption of proximal TCR signaling and subsequent T cell activation., Conclusions: TRAIL-R associates with phosphatase SHP-1 and transduces a unique and distinct immune gatekeeper signal to repress TCR signaling and T cell activation via inactivating Lck. Thus, our results define TRAIL-R as a new class of immune checkpoint receptors for restraining T cell activation, and TRAIL-R/SHP-1 axis can serve as a potential therapeutic target for immune-mediated diseases., (© 2024. The Author(s).)

Importance: Survivors of head and neck cancers (HNC) have increased risk of stroke. A comprehensive report using standardized methods is warranted to characterize the risk and to inform on survivorship strategy., Objective: To determine the stroke risk in subpopulations of survivors of HNC in Singapore., Design, Setting, and Participants: This national, registry-based, cross-sectional study aimed to estimate stroke risk in subgroups of the HNC population between January 2005 and December 2020. Participants were identified from the Singapore Cancer Registry, the Singapore Stroke Registry, and the Registry of Birth and Deaths using relevant International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes. HNC subgroups were defined based on patient demographic, disease, and treatment factors. Data were analyzed from September 2022 to September 2023., Exposure: Diagnosis of HNC., Main Outcomes and Measures: Both ischemic and hemorrhagic stroke were studied. The age-standardized incidence rate ratio (SIRR) and age-standardized incidence rate difference (SIRD) were reported. The Singapore general population (approximately 4 million) served as the reference group for these estimations., Results: A total of 9803 survivors of HNC (median [IQR] age at diagnosis, 58 [49-68] years; 7166 [73.1%] male) were identified. The most common HNC subsites were nasopharynx (4680 individuals [47.7%]), larynx (1228 individuals [12.5%]), and tongue (1059 individuals [10.8%]). A total of 337 individuals (3.4%) developed stroke over a median (IQR) follow-up of 42.5 (15.0-94.5) months. The overall SIRR was 2.46 (95% CI, 2.21-2.74), and the overall SIRD was 4.11 (95% CI, 3.37-4.85) strokes per 1000 person-years (PY). The cumulative incidence of stroke was 3% at 5 years and 7% at 10 years after HNC diagnosis. The SIRR was highest among individuals diagnosed at younger than 40 years (SIRR, 30.55 [95% CI, 16.24-52.35]). All population subsets defined by age, sex, race and ethnicity, HNC subsites (except tongue), stage, histology, and treatment modalities had increased risk of stroke compared with the general population. The SIRR and SIRD were significantly higher among individuals who had a primary radiation treatment approach (SIRR, 3.01 [95% CI, 2.64-3.43]; SIRD, 5.12 [95% CI, 4.18-6.29] strokes per 1000 PY) compared with a primary surgery approach (SIRR, 1.64 [95% CI, 1.31-2.05]; SIRD, 1.84 [95% CI, 0.923.67] strokes per 1000 PY)., Conclusions and Relevance: In this cross-sectional study of survivors of HNC, elevated stroke risks were observed across different age, subsites, and treatment modalities, underscoring the importance of early screening and intervention.

DUSP22 is a dual-specificity phosphatase that inhibits T cell activation by inactivating the kinase Lck. Here we show that the E3 ubiquitin ligase UBR2 is a positive upstream regulator of Lck during T-cell activation. DUSP22 dephosphorylates UBR2 at specific Serine residues, leading to ubiquitin-mediated UBR2 degradation. UBR2 is also modified by the SCF E3 ubiquitin ligase complex via Lys48-linked ubiquitination at multiple Lysine residues. Single-cell RNA sequencing analysis and UBR2 loss of function experiments showed that UBR2 is a positive regulator of proinflammatory cytokine expression. Mechanistically, UBR2 induces Lys63-linked ubiquitination of Lck at Lys99 and Lys276 residues, followed by Lck Tyr394 phosphorylation and activation as part of TCR signalling. Inflammatory phenotypes induced by TCR-triggered Lck activation or knocking out DUSP22, are attenuated by genomic deletion of UBR2. UBR2-Lck interaction and Lck Lys63-linked ubiquitination are induced in the peripheral blood T cells of human SLE patients, which demonstrate the relevance of the UBR2-mediated regulation of inflammation to human pathology. In summary, we show here an important regulatory mechanism of T cell activation, which finetunes the balance between T cell response and aggravated inflammation., (© 2024. The Author(s).)

Background: Chronic lower back pain (CLBP) is one of the most common disorders worldwide. Flash cupping has the ability to relieve CLBP; nevertheless, its impact on CLBP and the likely mechanism of action have not been studied., Objective: The goal of this study was to assess the impact of a single, brief cupping session on CLBP and low back muscle activity using multichannel surface electromyography (sEMG)., Methods: In this randomized controlled trial, 24 patients with CLBP were enrolled and randomly assigned to the control group (treated by acupuncture) and cupping group (treated by acupuncture and flash cupping). Acupuncture was applied on the shen shu (BL23), dachang shu (BL25), and wei zhong (BL40) acupoints in both the groups. A brief cupping treatment was applied to the shen shu (BL23), qihai shu (BL24), dachang shu (BL25), guanyuan shu (BL26), and xiaochang shu (BL27) acupoints on both sides of the lower back in the cupping group. The numeric rating scale (NRS) was used to assess therapy efficacy for lower back pain (LBP) before and after treatment. Surface EMG data collected during symmetrical trunk flexion-extension movements were utilized to measure lower back muscle activity and the effectiveness of LBP therapy., Results: There was no statistically significant difference (P= 0.63) in pain intensity between the two groups before and after treatment. There was a statistically significant difference (P= 0.04) between the control group and the cupping group in the sEMG topographic map parameter CoGx-To-Midline., Conclusion: This study established a connection between the action mechanism of flash cupping and enhanced horizontal synchronization of lower back muscular activity.