Federated learning enables big data for rare cancer boundary detection.

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing

Author Correction: Federated learning enables big data for rare cancer boundary detection.

10.1038/s41467-023-36188-7NATURE COMMUNICATIONS14

Federated Learning Enables Big Data for Rare Cancer Boundary Detection

Although machine learning (ML) has shown promise across disciplines, out-of-sample generalizability is concerning. This is currently addressed by sharing multi-site data, but such centralization is challenging/infeasible to scale due to various limitations. Federated ML (FL) provides an alternative paradigm for accurate and generalizable ML, by only sharing numerical model updates. Here we present the largest FL study to-date, involving data from 71 sites across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, reporting the largest such dataset in the literature (n = 6, 314). We demonstrate a 33% delineation improvement for the surgically targetable tumor, and 23% for the complete tumor extent, over a publicly trained model. We anticipate our study to: 1) enable more healthcare studies informed by large diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further analyses for glioblastoma by releasing our consensus model, and 3) demonstrate the FL effectiveness at such scale and task-complexity as a paradigm shift for multi-site collaborations, alleviating the need for data-sharing

Temporal changes (1989–1999) in deep-sea metazoan meiofaunal assemblages on the Porcupine Abyssal Plain, NE Atlantic

Trends among major metazoan meiofaunal taxa were investigated based on 56 deployments of a multicorer at 10 time points over a period of 11 years (1989–1999) at the Porcupine Abyssal Plain Sustained Observatory site (PAP-SO: 48°50?N 16°30?W, 4850 m depth). This area is characterised by a strong seasonality in the deposition of organic matter to the seafloor and by the massive increase in the density of holothurian species since 1996, the so-called ‘Amperima event’. Total meiofaunal densities ranged from 346 to 1074 ind.×10 cm?2 and showed a significant increase with time when time was represented by cruises, years and the ‘Amperima period’ (1996–1999) vs. the pre-Amperima period (1989–1994). This pattern was driven mainly by the nematodes, which were the dominant taxon (not, vert, similar90% of total abundance). The third most abundant group, the polychaetes, also increased significantly in abundance over the time series, while the ostracods showed a significant decrease. Most other taxa, including the second-ranked group, the copepods (harpacticoids and nauplii), did not exhibit significant temporal changes in abundance. Ordination of taxon composition showed a shift from the pre-Amperima to the Amperima periods, a trend supported by the significant correlation between the x-ordinate and time. The majority (52–75%) of meiofaunal animals inhabited the top 2 cm of the 5 cm sediment cores analysed. There were significant increases in the proportion of total meiofauna, nematodes and copepods (but not polychaetes) inhabiting the 0–1 cm layer over time (represented by cruises) and between the pre-Amperima and Amperima periods in the case of copepods and polychaetes. During the intensively sampled period (1996–1997), there were indications of seasonal changes in the vertical distribution patterns of total meiofauna and nematodes within the sediment. We discuss the potential link between temporal variations in organic matter flux to the seafloor and meiofaunal populations, considering both qualitative and quantitative changes in fluxes and how they may be linked to climate variations

Chronic acid-base perturbations in hemodialysis patients treated with sevelamer hydrochloride: A two-year follow-up study

Sevelamer hydrochloride (HCl) contains multiple amines that may cause a significant dietary acid load. To evaluate the impact of sevelamer on arterial blood gases, we followed two groups of stable hemodialysis patients for 24 months. The Sevelamer Group (n = 7) did not achieve the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) goals for phosporus and Ca x P product and was switched from a calcium-based to sevelamer-based regimen. The Calcium Group (n = 7) achieved those goals and remained on calcium salts. Following sevelamer administration, a deterioration of chronic metabolic acidosis was revealed, which lasted throughout the study. Sevelamer therapy was associated with reduced cholesterol levels, improved serum phosphate, and Ca x P product, which facilitated the management of secondary hyperparathyroidism. No significant changes in acid-base status or other parameter tested were found in the Control Group. In conclusion, sevelamer intake caused small but persistent acid-base disturbances, which did not neutralize sevelamer’s beneficial effects on mineral and lipid metabolism

Level of Awareness Regarding Cervical Cancer Among Female Syrian Refugees in Greece

Nowadays, prevention, control and treatment of cervical cancer are a worldwide public health priority. Primary objective of this study was to evaluate the level of awareness of female Syrian refugees who have recently settled in Greece regarding the warning signs and the risk factors of cervical cancer. This is a descriptive, cross-sectional study that was conducted in two facilities of the Hellenic Red Cross. The Cervical Cancer Awareness Measure questionnaire was addressed to 176 female Syrian refugees, aged between 18 and 50. Syrian women presented low awareness both for risk factors and warning signs. The most frequently identified warning signs were vaginal bleeding after menopause (44.3%), vaginal bleeding between menstruation (34.1%) and unexplained weight loss (32.4%). Regarding the risk factors’ recognition rates, 74.5% considered the existence of many sexual partners as a risk factor and 61.3% the existence of a sexual partner with many previous sexual partners. Older age, a higher level of education and confidence that any potential symptom would be identified were associated with increased awareness. Our findings confirm former published reports that indicate poor awareness regarding cervical cancer among refugee populations. Full compliance with the guidelines of the World Health Organization for a national cervical cancer screening programme is highly advised in Greece and should address the needs of both native and refugee populations. This research is the first one that underlines the need for raising awareness of cervical cancer among female Syrian refugees in Greece by developing health promotion strategies adjusted to their unique cultural needs. © 2020, American Association for Cancer Education

Multiresistant Pseudomonas aeruginosa serogroup O:11 outbreak in an intensive care unit

Objective: To determine whether 15 multiresistant Pseudomonas aeruginosa isolates from an intensive care unit (ICU) outbreak were related, were endemic, and belonged to the O:12 European clone. Methods: Forty-six P. aeruginosa isolates from a large hospital were investigated with respect to their antibiotic resistance profiles, serogroups, bacteriocin types and DNA fingerprints obtained by pulsed-field gel electrophoresis (PFGE) of genomic DNA digested with Xbal. Results: Fourteen of the ICU outbreak isolates were indeed identical with respect to their serogroup, O:11, pyocin type, 10/a, and PFGE type, A. Clone A was endemic and dominant throughout the hospital, even though, within the ICU, it underwent phenotypic alterations, such as loss of cell wall lipopolysaccharide side-chains, or acquisition of ceftazidime and imipenem resistance. Bacteriocin typing was more discriminatory than serotyping, but PFGE could differentiate further among phenotypically identical strains. It also allowed the tracking of an O:6 strain, as it was becoming gradually more resistant and undergoing a bacteriocin-type conversion while remaining genotypically unaltered. Conclusions: Using three typing methods, a nosocomial multiresistant strain distinct from the previously described dominant European O:12 clone was characterized, and the ability of PFGE to identify clonal isolates even when these appear phenotypically distinct was demonstrated