bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and tribological properties of Ni/DLC multilayer film
Authors: Wu Yanxia , Qi Jiawei , Li Ke , Zhou Xiaoyan , Yu Shengwang , Zhang Caili , Liu Ying
Published: February 2024

Ni was selected as a transition layer and sublayer in the diamondlike carbon-based multilayered film with varied bilayer periods (from 228 to 970 nm) prepared by magnetron sputtering. The reaction between Ni- and C-containing particles was discussed, and the influences of bilayer periods on the structure and morphology, accompanied with the frictional behaviors at different loading forces (2 and 5 N), as well as the field emission properties were investigated. The results showed that Ni grew in the (111) plane, and there was no Ni–C bond or graphene formed in the film because of the relatively lower energy during deposition. Moreover, the content of sp2C in the film, the hardness, and the field emission performance exhibited an initial increase followed by a subsequent decrease with increasing bilayer periods. However, the frictional coefficient decreased owing to more graphitization with an increase of the applied load. Particularly noteworthy was that the film possessed a bilayer period of 710 nm, displayed a compact structure with a smaller grain size, and showed reduced sp2C content in the role of Ni. This resulted in sustained lower surface roughness, heightened hardness, decreased coefficient of friction, and a smaller opening electric field.
The Role of Imitation, Primitives, and Spatial Referent Coordinates in Motor Control: Implications for Writing and Reading
Authors: Guberman Shelia , Latash Mark L.
Published: February 2024

We review a body of literature related to the drawing and recognition of geometrical two-dimensional linear drawings including letters. Handwritten letters are viewed not as two-dimensional geometrical objects but as one-dimensional trajectories of the tip of the implement. Handwritten letters are viewed as composed of a small set of kinematic primitives. Recognition of objects is mediated by processes of their creation (actual or imagined)—the imitation principle, a particular example of action–perception coupling. The concept of spatial directional field guiding the trajectories is introduced and linked to neuronal population vectors. Further, we link the kinematic description to the theory of control with spatial referent coordinates. This framework allows interpreting a number of experimental observations and clinical cases of agnosia. It also allows formulating predictions for new experimental studies of writing.
A Matched-Pair Analysis of Gross Motor Skills of 3- to 5-Year-Old Children With and Without a Chronic Physical Illness
Authors: Bedard Chloe , King-Dowling Sara , Timmons Brian W. , Ferro Mark A.
Published: February 2024

Purpose: The purpose of this study was to compare the gross motor skills of children with a chronic physical illness with those of their healthy peers. Methods: Data for children with a chronic physical illness come from the Multimorbidity in Children and Youth Across the Life Course study, and data from children without a physical illness come from the Health Outcomes and Physical Activity in Preschoolers study. Multimorbidity in Children and Youth Across the Life Course and Health Outcomes and Physical Activity in Preschoolers included children ages 3–5 years and administered the Peabody Development Motor Scales-second edition. Participants were sex and age matched (20 male and 15 female pairs; Mage = 54.03 [9.5] mo). Results: Gross motor skills scores were “below average” for 47% of children with a physical illness compared with 9% of children without a physical illness (P = .003). Matched-paired t tests detected significant differences in total gross motor scores (dz = −0.35), locomotor (dz = −0.31), and object control (dz = −0.39) scores, with healthy children exhibiting better motor skills, and no significant difference in stationary scores (dz = −0.19). Conclusions: This skill gap may increase burden on children with physical illness and future research should assess gross motor skills longitudinally to establish whether the gap widens with age.
Global monitoring for biodiversity: Uncertainty, risk, and power analyses to support trend change detection
Authors: Leung Brian , Gonzalez Andrew
Published: February 2024

Global targets aim to reverse biodiversity declines by 2050 but require knowledge of current trends and future projections under policy intervention. First, given uncertainty in measurement of current trends, we propose a risk framework, considering probability and magnitude of decline. While only 11 of 198 systems analyzed (taxonomic groups by country from the Living Planet Database) showed declining abundance with high certainty, 20% of systems had a 70% chance of strong declines. Society needs to decide acceptable risks of biodiversity loss. Second, we calculated statistical power to detect trend change using ~12,000 populations from 62 systems currently showing strong declines. Current trend uncertainty hinders our ability to assess improvements. Trend change is detectable with high certainty in only 14 systems, even if thousands of populations are sampled, and conservation action reduces net declines to zero immediately, on average. We provide potential solutions to improve monitoring of progress toward biodiversity targets.
Functional metal-phenolic cortical cytoskeleton for artificial cells
Authors: Luo Zhen-Hong , Chen Chen , Zhao Qi-Hong , Deng Nan-Nan
Published: February 2024

Cortex-like cytoskeleton, a thin layer of cross-linked cytoplasmic proteins underlying the cell membrane, plays an essential role in modulating membrane behavior and cell surface properties. However, bottom-up construction of functional cortex-like cytoskeleton in artificial cells remains a challenge. Here, we present metal-phenolic networks as artificial cortical cytoskeletons in liposome-based artificial cells. The metal-phenolic cytoskeleton–reinforced artificial cells exhibit long-term stability, enhanced resistance to a variety of harsh environments, tunable permeability, and well-controlled morphologies. We anticipate that our stable artificial cell models will stride forward to practical applications of liposome-based microsystem.
Integration of population-level data sources into an individual-level clinical prediction model for dengue virus test positivity
Authors: Williams Robert J. , Brintz Ben J. , Ribeiro Dos Santos Gabriel , Huang Angkana T. , Buddhari Darunee , Kaewhiran Surachai , Iamsirithaworn Sopon , Rothman Alan L. , Thomas Stephen , Farmer Aaron , Fernandez Stefan , Cummings Derek A. T. , Anderson Kathryn B. , Salje Henrik , Leung Daniel T.
Published: February 2024

The differentiation of dengue virus (DENV) infection, a major cause of acute febrile illness in tropical regions, from other etiologies, may help prioritize laboratory testing and limit the inappropriate use of antibiotics. While traditional clinical prediction models focus on individual patient-level parameters, we hypothesize that for infectious diseases, population-level data sources may improve predictive ability. To create a clinical prediction model that integrates patient-extrinsic data for identifying DENV among febrile patients presenting to a hospital in Thailand, we fit random forest classifiers combining clinical data with climate and population-level epidemiologic data. In cross-validation, compared to a parsimonious model with the top clinical predictors, a model with the addition of climate data, reconstructed susceptibility estimates, force of infection estimates, and a recent case clustering metric significantly improved model performance.
Mechanistic insight into glioma through spatially multidimensional proteomics
Authors: Shen Lei , Zhang Zhourui , Wu Pengfei , Yang Jingyi , Cai Yuankun , Chen Keyu , Chai Songshan , Zhao Jingwei , Chen Hongyu , Dai Xuan , Yang Bangkun , Wei Wei , Dong Lixin , Chen Jincao , Jiang Pucha , Cao Changjun , Ma Chao , Xu Chengshi , Zou Yichun , Zhang Jibo , Xiong Wenping , Li Zhengwei , Xu Shuangxiang , Shu Bing , Wang Mengyang , Li Zejin , Wan Qiongqiong , Xiong Nanxiang , Chen Suming
Published: February 2024

Characterizing the tumor microenvironment at the molecular level is essential for understanding the mechanisms of tumorigenesis and evolution. However, the specificity of the blood proteome in localized region of the tumor and its linkages with other systems is difficult to investigate. Here, we propose a spatially multidimensional comparative proteomics strategy using glioma as an example. The blood proteome signature of tumor microenvironment was specifically identified by in situ collection of arterial and venous blood from the glioma region of the brain for comparison with peripheral blood. Also, by integrating with different dimensions of tissue and peripheral blood proteomics, the information on the genesis, migration, and exchange of glioma-associated proteins was revealed, which provided a powerful method for tumor mechanism research and biomarker discovery. The study recruited multidimensional clinical cohorts, allowing the proteomic results to corroborate each other, reliably revealing biological processes specific to gliomas, and identifying highly accurate biomarkers.
Bionic visual-audio photodetectors with in-sensor perception and preprocessing
Authors: Fu Jintao , Nie Changbin , Sun Feiying , Li Genglin , Shi Haofei , Wei Xingzhan
Published: February 2024

Serving as the “eyes” and “ears” of the Internet of Things, optical and acoustic sensors are the fundamental components in hardware systems. Nowadays, mainstream hardware systems, often comprising numerous discrete sensors, conversion modules, and processing units, tend to result in complex architectures that are less efficient compared to human sensory pathways. Here, a visual-audio photodetector inspired by the human perception system is proposed to enable all-in-one visual and acoustic signal detection with computing capability. This device not only captures light but also optically records sound waves, thus achieving “watching” and “listening” within a single unit. The gate-tunable positive, negative, and zero photoresponses lead to highly programmable responsivities. This programmability enables the execution of diverse functions, including visual feature extraction, object classification, and sound wave manipulation. These results showcase the potential of expanding perception approaches in neuromorphic devices, opening up new possibilities to craft intelligent and compact hardware systems.
T cell help shapes B cell tolerance
Authors: Akama-Garren Elliot H. , Yin Xihui , Prestwood Tyler R. , Ma Minghe , Utz Paul J. , Carroll Michael C.
Published: February 2024

T cell help is a crucial component of the normal humoral immune response, yet whether it promotes or restrains autoreactive B cell responses remains unclear. Here, we observe that autoreactive germinal centers require T cell help for their formation and persistence. Using retrogenic chimeras transduced with candidate TCRs, we demonstrate that a follicular T cell repertoire restricted to a single autoreactive TCR, but not a foreign antigen–specific TCR, is sufficient to initiate autoreactive germinal centers. Follicular T cell specificity influences the breadth of epitope spreading by regulating wild-type B cell entry into autoreactive germinal centers. These results demonstrate that TCR-dependent T cell help can promote loss of B cell tolerance and that epitope spreading is determined by TCR specificity.
Critical role of growth medium for detecting drug interactions in Gram-negative bacteria that model
in vivo
responses
Authors: Davis Kathleen P. , Morales Yoelkys , Ende Rachel J. , Peters Ryan , McCabe Anne L. , Mecsas Joan , Aldridge Bree B.
Published: February 2024

The rise in infections caused by multidrug-resistant (MDR) bacteria has necessitated a variety of clinical approaches, including the use of antibiotic combinations. Here, we tested the hypothesis that drug-drug interactions vary in different media, and determined which
in vitro
models best predict drug interactions in the lungs. We systematically studied pair-wise antibiotic interactions in three different media, CAMHB, (a rich lab medium standard for antibiotic susceptibility testing), a urine mimetic medium (UMM), and a minimal medium of M9 salts supplemented with glucose and iron (M9Glu) with three Gram-negative ESKAPE pathogens,
Acinetobacter baumannii
(Ab),
Klebsiella pneumoniae
(Kp), and
Pseudomonas aeruginosa
(Pa). There were pronounced differences in responses to antibiotic combinations between the three bacterial species grown in the same medium. However, within species, PaO1 responded to drug combinations similarly when grown in all three different media, whereas Ab17978 and other Ab clinical isolates responded similarly when grown in CAMHB and M9Glu medium. By contrast, drug interactions in Kp43816, and other Kp clinical isolates poorly correlated across different media. To assess whether any of these media were predictive of antibiotic interactions against Kp in the lungs of mice, we tested three antibiotic combination pairs.
In vitro
measurements in M9Glu, but not rich medium or UMM, predicted
in vivo
outcomes. This work demonstrates that antibiotic interactions are highly variable across three Gram-negative pathogens and highlights the importance of growth medium by showing a superior correlation between
in vitro
interactions in a minimal growth medium and
in vivo
outcomes.

IMPORTANCE

Drug-resistant bacterial infections are a growing concern and have only continued to increase during the SARS-CoV-2 pandemic. Though not routinely used for Gram-negative bacteria, drug combinations are sometimes used for serious infections and may become more widely used as the prevalence of extremely drug-resistant organisms increases. To date, reliable methods are not available for identifying beneficial drug combinations for a particular infection. Our study shows variability across strains in how drug interactions are impacted by growth conditions. It also demonstrates that testing drug combinations in tissue-relevant growth conditions for some strains better models what happens during infection and may better inform combination therapy selection.
Draft genome sequences of three rhodopsin possessing
Croceitalea
sp. strains, isolated from the sea surface microlayer in Japan
Authors: Takada Mako , Jiang Chunqi , Sugai Youta , Hasegawa-Takano Masumi , Fujiwara Takayoshi , Tsukamoto Yuya , Nakajima Yu , Nishimura Yosuke , Yoshizawa Susumu
Published: February 2024

Here, we present the draft genome sequences of three
Croceitalea
sp. strains containing microbial rhodopsins, isolated from the Japanese coastal sea surface microlayer, which is exposed to intense sunlight. This study will contribute to the understanding of the genus
Croceitalea
and the diversity of microbial rhodopsins.
Evaluation of CHROMagar
Candida
Plus for the detection of
C. auris
with a panel of 206 fungal isolates and 83 colonization screening skin-swabs
Authors: Bentz Meghan L. , Le Ngoc , Min Brian , Nunnally Natalie S. , Sullivan Vickie , Tran Mike , Lockhart Shawn R. , Litvintseva Ana , Berkow Elizabeth L. , Sexton D. Joseph
Published: February 2024

CHROMagar
Candida
Plus is a new formulation of chromogenic media designed for the detection and differentiation of major clinical
Candida
species, including
Candida auris
. The objective of this study is to evaluate CHROMagar
Candida
Plus when used according to manufacturer’s instructions with a panel of 206 fungal isolates and 83 skin-swab specimens originally collected for
C. auris
colonization screening. Of the 68
C
.
auris
isolates tested, 66/68 displayed the expected light-blue colony morphology and blue halo within 48 h. None of the remaining 138 non-
auris
isolates appeared similar to
C. auris
. CHROMagar
Candida
Plus was, therefore, inclusive to 97% of 68
C
.
auris
isolates tested and supported visual exclusion of 100% of the 138 non-
C
.
auris
isolates tested. For the 83 colonization screening specimens, direct plating onto CHROMagar
Candida
Plus was 60% sensitive and 100% specific when compared to the enrichment broth gold-standard reference method. In sum, these findings demonstrate the utility of this media when working with isolates but also notable limitations when working with primary skin-swabs specimens when competing yeast species are present.

IMPORTANCE

Candida auris
is an emerging fungal pathogen of public health concern. As it continues to spread, it is important to publish evaluations of new diagnostic tools. In this study, we share our experience with a new chromogenic media which can help distinguish
C. auris
from related species.
Assessing the medical reasoning skills of GPT-4 in complex ophthalmology cases
Authors: Milad Daniel , Antaki Fares , Milad Jason , Farah Andrew , Khairy Thomas , Mikhail David , Giguère Charles-Édouard , Touma Samir , Bernstein Allison , Szigiato Andrei-Alexandru , Nayman Taylor , Mullie Guillaume A , Duval Renaud
Published: February 2024

Background/aims

This study assesses the proficiency of Generative Pre-trained Transformer (GPT)-4 in answering questions about complex clinical ophthalmology cases.

Methods

We tested GPT-4 on 422Journal of the American Medical AssociationOphthalmology Clinical Challenges, and prompted the model to determine the diagnosis (open-ended question) and identify the next-step (multiple-choice question). We generated responses using two zero-shot prompting strategies, including zero-shot plan-and-solve+ (PS+), to improve the reasoning of the model. We compared the best-performing model to human graders in a benchmarking effort.

Results

Using PS+ prompting, GPT-4 achieved mean accuracies of 48.0% (95% CI (43.1% to 52.9%)) and 63.0% (95% CI (58.2% to 67.6%)) in diagnosis and next step, respectively. Next-step accuracy did not significantly differ by subspecialty (p=0.44). However, diagnostic accuracy in pathology and tumours was significantly higher than in uveitis (p=0.027). When the diagnosis was accurate, 75.2% (95% CI (68.6% to 80.9%)) of the next steps were correct. Conversely, when the diagnosis was incorrect, 50.2% (95% CI (43.8% to 56.6%)) of the next steps were accurate. The next step was three times more likely to be accurate when the initial diagnosis was correct (p<0.001). No significant differences were observed in diagnostic accuracy and decision-making between board-certified ophthalmologists and GPT-4. Among trainees, senior residents outperformed GPT-4 in diagnostic accuracy (p≤0.001 and 0.049) and in accuracy of next step (p=0.002 and 0.020).

Conclusion

Improved prompting enhances GPT-4’s performance in complex clinical situations, although it does not surpass ophthalmology trainees in our context. Specialised large language models hold promise for future assistance in medical decision-making and diagnosis.
Mpox (monkeypox) risk and mortality associated with HIV infection: a national case–control study in Nigeria
Authors: Yinka-Ogunleye Adesola , Dalhat Mahmood , Akinpelu Afolabi , Aruna Olusola , Garba Fatima , Ahmad Adama , Adeleye Adesola , Botson Iliya , Oluwafemi Bamidele , Ogunbode Oladipo , Amao Lateefat , Ekripo Udeme , Aliyu Gambo Gumel , Adetifa Ifedayo , Ihekweazu Chikwe , Abubakar Ibrahim
Published: February 2024

Introduction

Recent outbreaks of mpox are characterised by changes in the natural history of the disease, the demographic and clinical characteristics of the cases, and widening geographical distribution. We investigated the role of HIV and other sexually transmitted infections (STIs) coinfection among cases in the re-emergence of mpox to inform national and global response.

Methods

We conducted a national descriptive and case–control study on cases in the 2017–2019 Nigerian mpox outbreak. Mpox cases were age, sex and geographical area matched each with two randomly selected controls from a representative national HIV/AIDS survey. Logistic regression was used to investigate the association between HIV infection and the risk of mpox acquisition and death.

Results

Among 204 suspected mpox cases, 86 were confirmed (median age 31 years (IQR 27–38 years), mostly males (61 cases, 70.9%). Three-fifths of mpox cases had serological evidence of one or more STIs with 27.9% (24/86) coinfected with HIV. The case fatality rate was 9.4% (8/86) and 20.8% (5/24) overall and in HIV positive cases respectively. Mpox cases were more likely to have HIV coinfection compared with an age, gender and geography-matched control group drawn from the general population (OR 45 (95% CI 6.1 to 333.5, p=0.002) and when compared with non mpox rash cases (7.29 (95% CI 2.6 to 20.5, p<0.0001)). HIV coinfection and young age were associated with mortality among mpox cases (aOR 13.66 (95% CI 1.88 to 98.95, p=0.010) and aOR 0.90 (0.82–0.97, p=0.008), respectively).

Conclusion

HIV infection was associated with a higher risk of contracting and dying from mpox. Children are also at high risk of death. STIs in mpox cases may be suggestive of high-risk sexual behaviours among these individuals.
Age at menarche and risk of ovarian hyperstimulation syndrome in women undergoing IVF/ICSI cycles: a retrospective cohort study
Authors: Wang Qiaofeng , Tang Xiaojun , Lv Xingyu , Meng Xiangqian , Geng Lihong , Zhong Zhaohui , Ding Yubin , Li Tian , Wan Qi
Published: February 2024

Objectives

We aimed to explore the association between age at menarche (AAM) and ovarian hyperstimulation syndrome (OHSS) in fresh in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycles.

Design

A retrospective cohort study.

Setting

Data were collected from a large obstetrics and gynaecology hospital in Sichuan, China.

Participants

This study included 17 419 eligible women aged ≤40 years who underwent the first IVF/ICSI cycles from January 2015 to December 2021. Women were divided into three groups according to their AAM: ≤12 years (n=5781), 13–14 years (n=9469) and ≥15 years (n=2169).

Results

The means of age at recruitment and AAM were 30.4 years and 13.1 years, respectively. Restricted cubic spline models suggested that early menarche age increased the risk of OHSS. The multivariable logistic analysis showed that women with menarche age ≤12 years were more likely to suffer from OHSS (OR 1.321, 95% CI 1.113 to 1.567) compared with those aged 13–14 years among the whole cohort. This significant relationship remained in women administered with different ovarian stimulation protocols and gonadotrophin doses. When stratified by female age, this correlation was presented only in patients aged ≤30 years (OR 1.362, 95% CI 1.094 to 1.694). And the mediation analysis showed that the relationship between AAM and OHSS was totally mediated by antral follicle counts (AFC).

Conclusion

Menarche age earlier than 12 years may increase the OHSS risk in women aged ≤30 years through the mediation of AFC. More prospective studies are required to verify the results.
Quality of locally designed surveys in a quality improvement collaborative: review of survey validity and identification of common errors
Authors: Reed Julie E , Johnson Julie K , Zanni Robert , Messier Randy , Asfour Fadi , Godfrey Marjorie M
Published: February 2024

Objective

Surveys are a commonly used tool in quality improvement (QI) projects, but little is known about the standards to which they are designed and applied. We aimed to investigate the quality of surveys used within a QI collaborative, and to characterise the common errors made in survey design.

Methods

Five reviewers (two research methodology and QI, three clinical and QI experts) independently assessed 20 surveys, comprising 250 survey items, that were developed in a North American cystic fibrosis lung transplant transition collaborative. Content Validity Index (CVI) scores were calculated for each survey. Reviewer consensus discussions decided an overall quality assessment for each survey and survey item (analysed using descriptive statistics) and explored the rationale for scoring (using qualitative thematic analysis).

Results

3/20 surveys scored as high quality (CVI >80%). 19% (n=47) of survey items were recommended by the reviewers, with 35% (n=87) requiring improvements, and 46% (n=116) not recommended. Quality assessment criteria were agreed upon. Types of common errors identified included the ethics and appropriateness of questions and survey format; usefulness of survey items to inform learning or lead to action, and methodological issues with survey questions, survey response options; and overall survey design.

Conclusion

Survey development is a task that requires careful consideration, time and expertise. QI teams should consider whether a survey is the most appropriate form for capturing information during the improvement process. There is a need to educate and support QI teams to adhere to good practice and avoid common errors, thereby increasing the value of surveys for evaluation and QI. The methodology, quality assessment criteria and common errors described in this paper can provide a useful resource for this purpose.
Reducing use of seclusion on a male medium secure forensic ward
Authors: Rowsell Kathryn Amy , Akinbola Ayodele , Hancock Mark , Nyambayo Tsitsi , Jackson Zoe , Hunt David Francis
Published: February 2024

The reduction of restrictive practices is a priority for mental health inpatient services. Often such practices are considered to increase patients’ feelings of anger, loneliness, hopelessness and vulnerability. Moreover, such approaches are counterintuitive to both recovery-orientated and trauma-informed practice.

Our project, based in a male 15-bed secure forensic ward, aimed to reduce the duration (outcome measure) and frequency (balancing measure) of the use of seclusion by 10% over 6 months. Following the analysis of our local data systems and feedback from both patients and staff, we identified the high levels of use of seclusion, and reluctance to terminate it. These included a lack of awareness of the effective and appropriate use of such a facility, a hesitancy to use de-escalation techniques and an over-reliance on multidisciplinary team and consultant decision making.

We subsequently designed and implemented three tests of change which reviewed seclusion processes, enhanced de-escalation skills and improved decision making. Our tests of change were applied over a 6-month period. During this period, we surpassed our original target of a reduction of frequency and duration by 10% and achieved a 33% reduction overall. Patients reported feeling safer on the ward, and the team reported improvements in relationships with patients.

Our project highlights the importance of relational security within the secure setting and provides a template for other wards wishing to reduce the frequency and duration of seclusions.
Complaint behaviour among healthcare users: self-reported complaint experience and complaint proneness in adult men
Authors: Birkeland Søren , Bismark Marie , Barry Michael J , Möller Sören
Published: February 2024

Aims

When patients are harmed by, or dissatisfied with, healthcare, only a minority will lodge a complaint or file a claim for compensation. This survey aimed to investigate complaint behaviour and inequalities in complaints using self-reports and hypothetical case vignettes.

Methods

Cross-sectional, web-based survey among 6755 Danish men aged 45–70 years (response rate=30%). Participants reported their lifetime complaint experience and the likelihood that they would complain in response to hypothetical case vignettes.

Results

Overall, 4.8% of participants had complained about healthcare. Predictors were younger age (OR 2.08, 95% CI 1.32 to 3.27, p=0.002 45–50 years compared with 65–70 years), chronic illness (OR 1.49, 95% CI 1.12 to 1.98, p=0.006), rural residence (OR 2.11, 95% CI 1.20 to 3.73, p=0.010 comparing least and most populated areas), high healthcare utilisation (OR 1.55, 95% CI 1.18 to 2.03, p=0.002 primary care, and OR 1.97, 95% CI 1.52 to 2.55, p=0.000 hospital care) and decreased agreeableness on the 10-item Big Five personality inventory (OR 0.91, 95% CI 0.83 to 0.99, p=0.034). Complaint experience was associated with increased wish to complain about the treatment in the hypothetical vignettes (p=0.006).

Conclusions

Roughly 1 in 20 men reported having complained about healthcare. Complaints were more common among men who were younger, living in rural areas, diagnosed with chronic illness and high users of healthcare services. Prior complaint experience may be associated with a higher proclivity for complaining about future healthcare. Findings suggest differences in the way healthcare users respond to care experiences, pointing to the importance of aligning expectations and providing clear information about treatment options.
Social media as a public health tool during the UK mpox outbreak: a qualitative study of stakeholders’ experiences
Authors: Garcia-Iglesias Jaime , May Tom , Pickersgill Martyn , Williams Jeremy , Nagington Maurice , Buijsen Sophie , McHugh Ciara , Horwood Jeremy
Published: February 2024

Objectives

This rapid response research explored the experiences of key stakeholder groups during the 2022–2023 mpox outbreak in the UK, and in particular, the use of social media as a tool of health promotion. The project sought to identify key lessons learnt for future epidemic and pandemic preparedness.

Methods

The qualitative study employed online focus groups and interviews with key stakeholder communities, including activists, clinicians, policy actors and individuals with lived experience of mpox. N=29 stakeholders participated. Data were subject to framework analysis, with findings discussed and conclusions reached through a face-to-face analysis workshop.

Results

Participants emphasised the significant role of social media, particularly Twitter (now called X), in the response to the mpox outbreak. Several benefits were highlighted, including disseminating relevant information, tackling stigma and generating/advancing advocacy and collaboration. However, participants also pointed out challenges associated with social media; in particular, its reliance on pre-existing networks and associated dynamics of exclusion, and the presence of misinformation.

Conclusion

Social media played an important role in informal and purposive health promotion during the 2022–2023 mpox outbreak, while also presenting significant challenges regarding misinformation and exclusion. We recommend that preparedness for infectious disease outbreaks must consider the role of social media as key tools for not only the dissemination of health promotion messages, but also for real-time collaboration on message development. Special attention should be paid to ensuring collaboration and dissemination strategies are explicitly orientated towards promoting the inclusion of underserved groups.
Serum biomarker signature is predictive of the risk of hepatocellular cancer in patients with cirrhosis
Authors: El-Serag Hashem , Kanwal Fasiha , Ning Jing , Powell Hannah , Khaderi Saira , Singal Amit G , Asrani Sumeet , Marrero Jorge A , Amos Christopher I , Thrift Aaron P , Luster Michelle , Alsarraj Abeer , Olivares Luis , Skapura Darlene , Deng Jenny , Salem Emad , Najjar Omar , Yu Xian , Duong Hao , Scheurer Michael E , Ballantyne Christie M , Kaochar Salma
Published: February 2024

Background

Inflammatory and metabolic biomarkers have been associated with hepatocellular cancer (HCC) risk in phases I and II biomarker studies. We developed and internally validated a robust metabolic biomarker panel predictive of HCC in a longitudinal phase III study.

Methods

We used data and banked serum from a prospective cohort of 2266 adult patients with cirrhosis who were followed until the development of HCC (n=126). We custom designed a FirePlex immunoassay to measure baseline serum levels of 39 biomarkers and established a set of biomarkers with the highest discriminatory ability for HCC. We performed bootstrapping to evaluate the predictive performance using C-index and time-dependent area under the receiver operating characteristic curve (AUROC). We quantified the incremental predictive value of the biomarker panel when added to previously validated clinical models.

Results

We identified a nine-biomarker panel (P9) with a C-index of 0.67 (95% CI 0.66 to 0.67), including insulin growth factor-1, interleukin-10, transforming growth factor β1, adipsin, fetuin-A, interleukin-1 β, macrophage stimulating protein α chain, serum amyloid A and TNF-α. Adding P9 to our clinical model with 10 factors including AFP improved AUROC at 1 and 2 years by 4.8% and 2.7%, respectively. Adding P9 to aMAP score improved AUROC at 1 and 2 years by 14.2% and 7.6%, respectively. Adding AFP L-3 or DCP did not change the predictive ability of the P9 model.

Conclusions

We identified a panel of nine serum biomarkers that is independently associated with developing HCC in cirrhosis and that improved the predictive ability of risk stratification models containing clinical factors.
Clinical implications of discordance between anti-dsDNA antibodies by multiplex flow immunoassay andCrithidia luciliaeassay in a multiethnic racial cohort of patients with SLE
Authors: Zaminski Devyn , Saxena Amit , Izmirly Peter , Buyon Jill P , Belmont H Michael
Published: February 2024

Objective

Anti-dsDNA antibodies (anti-dsDNA) are a component of all classification schemes in SLE and comprise one of the domains in validated activity indices. Anti-dsDNA is frequently measured commercially by an enzyme immunoassay (EIA) orCrithidia luciliaeimmunofluorescence test (CLIFT). To address the clinical impact of measuring these antibodies by two different assays, this study leveraged a well-phenotyped multiethnic/racial cohort.

Methods

All patients fulfilled the classification criteria for SLE by at least one of the validated schemes: American College of Rheumatology, Systemic Lupus Erythematosus International Collaborating Clinics and/or American College of Rheumatology/European League Against Rheumatism classification criteria. Patients with one or more simultaneously paired anti-dsDNA by multiplex EIA and CLIFT were identified. Analysis of concordance or discordance, titre comparability of assays and association with hybrid SLE Disease Activity Index score, prevalence of lupus nephritis (LN), ability to predict a flare and classification criteria was performed.

Results

207 patients were simultaneously tested by EIA and CLIFT at least once for anti-dsDNA, generating 586 paired results. 377 pairs were concordant and 209 were discordant. 41 of 207 patients always had discordant paired results and 39 patients always had results with titre discordance. In 100 patients with LN, 60 were positive by EIA and 72 by CLIFT. Sensitivities and specificities for patients with LN versus patients without LN were EIA 60% and 47%, and CLIFT 72% and 37%, respectively. 42 patients had flare assessment within 90 days of their paired result. Six of seven patients with mild flares and all four patients with severe flares had concordant positive results.

Conclusion

Our data demonstrate that discordance of positivity between both assays for anti-dsDNA is relatively common, occurring in a fifth of patients overall and a third of visits. EIA positivity is associated with LN less often than CLIFT positivity. With the significant discordance of results between anti-dsDNA assays, obtaining both CLIFT and EIA assays may be beneficial for classification and routine monitoring of SLE.
Trends inChlamydia trachomatisIgG seroprevalence in the general population of the Netherlands over 20 years
Authors: Alexiou Zoïe Willemijn , van Aar Fleur , Hoenderboom Bernice Maria , Morre Servaas Antonie , Heijne Janneke Cornelia Maria
Published: February 2024

Objectives

To report sex and age-specificChlamydia trachomatis(Ct) seroprevalence estimates in the general population of the Netherlands between 1996 and 2017 and identify risk factors associated with Ct seropositivity.

Methods

Participants (n=5158, aged 15–59 years) were included from three independent nationwide population-based serosurveillance studies in 1996, 2007 and 2017. Participants completed a questionnaire on demographics and sexual behaviour. Serum antibodies were analysed using Medac Ct IgG ELISA test. Census weights were assigned to achieve seroprevalence estimates representative of the general Dutch population. Weighted seroprevalence estimates were stratified by gender, age and birth cohort. Trends and risk factors in men and women were identified using multivariable logistic regression.

Results

Weighted overall Ct seroprevalence was 10.5% (95% CI: 9.2% to 12.0%) in women and 5.8% (95% CI: 4.7% to 7.0%) in men. Among women <25 years, there was a non-significant increase in seroprevalence from 5.9% (95% CI 3.7% to 9.2%) in 1996, to 7.6% (95% CI 5.1% to 11.1%) in 2007 and 8.8% (95% CI 5.5% to 13.9%) in 2017. Among women ≥25 years, the seroprevalence significantly decreased from 15.6% (95% CI: 12.2% to 19.7%) in 1996 to 9.5% (95% CI: 7.2% to 12.4%) in 2007 but did not further drop (11.2% (95% CI 8.1% to 15.3%) in 2017). In men, we did not observe trends between study rounds. In both men and women, having a non-Western migration background was a risk factor for seropositivity. In women, having had a prior sexually transmitted infection and ≥2 recent sex partners were risk factors for seropositivity as well.

Conclusions

We have not found evidence for a decrease in population seroprevalence in those under 25 years old despite decades of intensified testing-and-treatment efforts in the Netherlands. This suggests further monitoring of Ct burden in the general population is needed. If serum banks are used for this, specifically individuals <25 years old and with diverse migration backgrounds should be included.
Prevalence, risk factors and prognostic value of atrial fibrillation detected after stroke after haemorrhagic versus ischaemic stroke
Authors: Guo Jiahuan , Li Zixiao , Gu Hongqiu , Yang Kaixuan , Liu Yanfang , Lu Jingjing , Wang Dandan , Jia Jiaokun , Zhang Jia , Wang Yongjun , Zhao Xingquan
Published: February 2024

Background and objectives

Prior evidence suggests that atrial fibrillation detected after stroke (AFDAS) is distinct from known atrial fibrillation (KAF), with particular clinical characteristics and impacts on outcomes in ischaemic stroke. However, the results remained inconsistent in ischaemic stroke, and the role of AFDAS in haemorrhagic stroke remains unclear. Therefore, we aimed to estimate the prevalence, risk factors and prognostic value of AFDAS in haemorrhagic stroke in comparison with ischaemic stroke.

Methods

This was a multicentre cohort study. Patients who had an ischaemic and haemorrhagic stroke hospitalised in the Chinese Stroke Center Alliance hospitals were enrolled and classified as AFDAS, KAF or sinus rhythm (SR) based on heart rhythm. Univariate and multivariate logistic regression analyses were used to assess the prevalence, characteristics, risk factors and outcomes of AFDAS, KAF and SR in different stroke subtypes.

Results

A total of 913 163 patients, including 818 799 with ischaemic stroke, 83 450 with intracerebral haemorrhage (ICH) and 10 914 with subarachnoid haemorrhage (SAH), were enrolled. AFDAS was the most common in ischaemic stroke. There were differences in the risk factor profile between stroke subtypes; older age is a common independent risk factor shared by ischaemic stroke (OR 1.06, 95% CI 1.06 to 1.06), ICH (OR 1.08, 95% CI 1.07 to 1.09) and SAH (OR 1.07, 95% CI 1.05 to 1.10). Similar to KAF, AFDAS was associated with an increased risk of in-hospital mortality compared with SR in both ischaemic stroke (OR 2.23, 95% CI 1.94 to 2.56) and ICH (OR 2.84, 95% CI 1.84 to 4.38).

Discussion

There are differences in the prevalence, characteristics and risk factors for AFDAS and KAF in different stroke subtypes. AFDAS was associated with an increased risk of mortality compared with SR in both ischaemic stroke and ICH. Rhythm monitoring and risk factor modification after both ischaemic and haemorrhagic stroke are essential in clinical practice. More emphasis and appropriate treatment should be given to AFDAS.
Invasive versus non-invasive paediatric home mechanical ventilation: review of the international evolution over the past 24 years
Authors: Toussaint Michel , van Hove Olivier , Leduc Dimitri , Ansay Lise , Deconinck Nicolas , Fauroux Brigitte , Khirani Sonia
Published: February 2024

Background

Home mechanical ventilation (HMV) is the treatment for chronic hypercapnic alveolar hypoventilation. The proportion and evolution of paediatric invasive (IMV) and non-invasive (NIV) HMV across the world is unknown, as well as the disorders and age of children using HMV.

Methods

Search of Medline/PubMed for publications of paediatric surveys on HMV from 2000 to 2023.

Results

Data from 32 international reports, representing 8815 children (59% boys) using HMV, were analysed. A substantial number of children had neuromuscular disorders (NMD; 37%), followed by cardiorespiratory (Cardio-Resp; 16%), central nervous system (CNS; 16%), upper airway (UA; 13%), other disorders (Others; 10%), central hypoventilation (4%), thoracic (3%) and genetic/congenital disorders (Gen/Cong; 1%). Mean age±SD (range) at HMV initiation was 6.7±3.7 (0.5–14.7) years. Age distribution was bimodal, with two peaks around 1–2 and 14–15 years. The number and proportion of children using NIV was significantly greater than that of children using IMV (n=6362 vs 2453, p=0.03; 72% vs 28%, p=0.048), with wide variations among countries, studies and disorders. NIV was used preferentially in the preponderance of children affected by UA, Gen/Cong, Thoracic, NMD and Cardio-Resp disorders. Children with NMD still receiving primary invasive HMV were mainly type I spinal muscular atrophy (SMA). Mean age±SD at initiation of IMV and NIV was 3.3±3.3 and 8.2±4.4 years (p<0.01), respectively. The rate of children receiving additional daytime HMV was higher with IMV as compared with NIV (69% vs 10%, p<0.001). The evolution of paediatric HMV over the last two decades consists of a growing number of children using HMV, in parallel to an increasing use of NIV in recent years (2020–2023). There is no clear trend in the profile of children over time (age at HMV). However, an increasing number of patients requiring HMV were observed in the Gen/Cong, CNS and Others groups. Finally, the estimated prevalence of paediatric HMV was calculated at 7.4/100 000 children.

Conclusions

Patients with NMD represent the largest group of children using HMV. NIV is increasingly favoured in recent years, but IMV is still a prevalent intervention in young children, particularly in countries indicating less experience with NIV.
CDC Esme oilseed flax
Authors: Tar'an Bunyamin , Booker Helen M. , House Megan A. , Jackle Kenneth I. , Kutcher H. Randy
Published: February 2024

CDC Esme, a high-yielding, late-maturing oilseed flax ( Linum usitatissimum L.) cultivar, was registered in 2023 by the Crop Development Centre, University of Saskatchewan, Saskatoon, Saskatchewan. CDC Esme had a superior yield (106%) compared to the check variety, CDC Glas, in all soil zones of the Northern Prairies. The yield of CDC Esme was 106%, 105%, and 105% of CDC Glas, in the long-season Black, Brown, and short-season Black and Grey soil zones of Western Canada, respectively. CDC Esme has larger seeds (thousand seed weight) than that of check cultivar, CDC Glas, with improved quality based on the iodine value of 192 and alpha-linolenic acid (ALA) content of 57.1%. This cultivar is immune to the North American rust (race 371) caused by Melampsora lini and moderately resistant to wilt caused by Fusarium oxysporum f. sp. lini.
Unifying supervised learning and VAEs: coverage, systematics and goodness-of-fit in normalizing-flow based neural network models for astro-particle reconstructions
Authors: Glüsenkamp Thorsten
Published: February 2024

Neural-network based predictions of event properties in astro-particle physics are getting more and more common. However, in many cases the result is just utilized as a point prediction. Statistical uncertainties, coverage, systematic uncertainties or a goodness-of-fit measure are often not calculated. Here we describe a certain choice of training and network architecture that allows to incorporate all these properties into a single network model. We show that a KL-divergence objective of the joint distribution of data and labels allows to unify supervised learning and variational autoencoders (VAEs) under one umbrella of stochastic variational inference. The unification motivates an extended supervised learning scheme which allows to calculate a goodness-of-fit p-value for the neural network model. Conditional normalizing flows amortized with a neural network are crucial in this construction. We discuss how to calculate coverage probabilities without numerical integration for specific “base-ordered” contours that are unique to normalizing flows. Furthermore we show how systematic uncertainties can be included via effective marginalization during training. The proposed extended supervised training incorporates (1) coverage calculation, (2) systematics and (3) a goodness-of-fit measure in a single machine-learning model. There are in principle no constraints on the shape of the involved distributions, in fact the machinery works with complex multi-modal distributions defined on product spaces like $${\mathbb {R}}^n \times {\mathbb {S}}^m$$

R

n

×

S

m

. The coverage calculation, however, requires care in its interpretation when the distributions are too degenerate. We see great potential for exploiting this per-event information in event selections or for fast astronomical alerts which require uncertainty guarantees.
Mixed-state entanglement and transport in Einstein–Maxwell–Axion–Horndeski theory
Authors: Li Mu-Jing , Chen Chong-Ye , Niu Chao , Zhang Cheng-Yong , Liu Peng
Published: February 2024

We present a comprehensive study exploring the relationship between transport properties and measures of quantum entanglement in the Einstein–Maxwell–Axion–Horndeski theory. By using holographic duality, we study the entanglement measures, holographic entanglement entropy (HEE) and entanglement wedge cross-section (EWCS), and transport coefficients, for this model and analyze their dependence on free parameters which we classify into action parameters, observable parameters and axion factor. We find contrasting behaviors between HEE and EWCS with respect to observable parameters (charge and temperature), and the axion factor, indicating that they capture different types of quantum correlations. We also find that HEE exhibits positive correlation with both charge and thermal excitations, whereas EWCS exhibits a negative correlation with charge-related conductivities and thermal fluctuations. Furthermore, we find that the Horndeski coupling term, as the modification to standard gravity theory, does not change the qualitative behaviors of the conductivities and the entanglement measures.