bluuebunny/crossref_metadata_2025 huggingface dataset:
Long Short-Term Memory Autoencoder for Anomaly Detection in Rails Using Laser Doppler Vibrometer Measurements
Authors: Yang Chi , Kaynardag Korkut , Lee Guan-Wei , Salamone Salvatore
Published: October 2024

This study presents an application of a long short-term memory autoencoder (LSTM AE) for the detection of broken rails based on laser Doppler vibrometer (LDV) measurements. This work is part of an ongoing project aimed at developing a noncontact damage detection system using LDV measurements. The damage detection system consists of two LDVs mounted on a moving rail car to measure vibrations induced on the rail head. Field tests were carried out at the Transportation Technology Center (TTC) in Pueblo, CO, to collect the vibrational data. This study focused on the detection of broken rails. To simulate the reflected and transmitted waves induced by the broken rail, a welded joint was used. The data were collected from moving LDV measurements, in which the train was operating at three different speeds: 16 km/h (10 mph), 32 km/h (20 mph), and 48 km/h (30 mph). After obtaining the data, filtering and signal processing were applied to obtain the signal features in time and frequency domains. Next, correlation analysis and principal component analysis were carried out for feature selection and dimension reduction to determine the input used to train and test the LSTM AE model. In this study, the LSTM AE models were trained based on different data sets for anomaly detection. Consequently, an automatic anomaly detection approach for anomaly detection based on the LSTM AE model was evaluated. The results show that the LSTM AE model can efficiently detect the anomaly based on the selected features at three different speeds.
Analysis of Production Decline Type Curves Considering Water Influx in Naturally Fractured Gas Reservoirs
Authors: Wei Mingqiang , Wang Hao , Yang Wenming , Tian Wenzhong , Yang Neng , Duan Yonggang
Published: October 2024

In the development of fractured gas reservoirs with edge and bottom water, water invasion is a pervasive issue. However, most production decline analysis models focus on primary depletion with closed boundaries rather than secondary depletion with water influx. Therefore, this article aims to develop decline type curves for analyzing and interpreting production data from existing natural water influx in fractured gas reservoirs. First, a transient dual porosity flow model is developed considering water influx in naturally fractured gas reservoirs, and the functions of Blasingame decline type curves are derived and obtained. Subsequently, the Blasingame production decline type curves of a vertical well in naturally fractured reservoirs experiencing natural water influx are plotted. These new type curves can estimate water invasion and dual-medium parameters, offering valuable insights for production decline analysis in fractured reservoirs with water influx. The Blasingame production decline curves are divided into six regimes based on characteristics. Then, the effects of various formation parameters and water invasion cases on the type curves are discussed and analyzed. Compared with Blasingame type curves without water influx at the external boundary, the behaviors of those presented in this article are quite different at the boundary responses. Finally, through the analysis of a case well, it is found that theoretical type curves considering dual-medium and water invasion are more consistent with actual production data. This suggests that these new type curves provide more accurate estimation for understanding and managing issues related to water invasion in fractured gas reservoirs.
Longitudinal Analysis of Race-Management Strategies in a World-Class 200-m Freestyle Swimmer: A Case Study
Authors: Loisel Camille , Pla Robin , Seifert Ludovic
Published: October 2024

Purpose: To investigate race-management strategies over a longitudinal case study of one of the world’s best female swimmers of the 200-m freestyle to understand if only 1 race-management strategy allowed her to succeed or whether several profiles have been used over the 8 years of analysis. Methods: Different race-management strategies within and between 50-m laps emerged from cluster analysis. To better explain race management, additional characteristics described the level of adversity, the level of competition, the performance outcome, and the type of race. Results: Two strategies of race management between laps have been used, and both allowed her to succeed in her career. The first was characterized by a fast start and a greater decrease of the speed between laps, whereas the second exhibited a more stable speed management. When those strategies were examined in relation to the level of competition and the level of adversity, it appeared that the first strategy was used more in international competitions and associated with higher time intervals between the studied swimmer and the direct rivals, while the second one was used more in national competitions and associated with lower time intervals. Conclusions: Findings suggested that this top elite swimmer did not adhere to a single “ideal” race-management strategy. Instead, she demonstrated flexibility and the ability to adapt her race management to contextual factors throughout her career, effectively controlling adversity. This highlights the importance of including adversity analysis in race-management studies.
The composite metamorphic sequence in the Jiajika gneiss dome, Songpan-Ganze orogenic belt, eastern Tibet: P-T-D-t evolution and implications for lithium mineralization
Authors: Zhu Junyue , Zhu Wenbin , Xu Zhiqin , Zheng Bihai , Li Guangwei , Lin Hefeng , Gao Jianguo
Published: October 2024

The metamorphic host rocks of pegmatites can help to decipher their geodynamic setting and emplacement conditions. The Jiajika lithium deposit, located in the Songpan-Ganze orogenic belt, eastern Tibet, is one of the largest hard-rock type lithium deposits in China. The lithium-enriched pegmatites in Jiajika are hosted in the amphibolite facies metasedimentary rocks in the mantle of the Jiajika gneiss dome. However, the metamorphic evolution of Jiajika is poorly constrained. In this study, we carried out detailed fieldwork, petrological observation, mineral chemical analysis, phase equilibria modeling, and geochronological studies on the Jiajika gneiss dome and the borehole JSD-1 (with a total depth of 3211 m) of the Jiajika Scientific Drilling Project (JSD). Structural data outlined two subdomes within the Jiajika gneiss dome. Two main stages of regional metamorphism and deformation are documented in Jiajika: an early Barrovian metamorphism (M1) in ca. 237–221 Ma caused by crustal thickening (D1), which has a peak condition of 6.7–8.3 kbar and 649–694 °C; a late Buchan metamorphism (M2) induced by the emplacement of granites and pegmatites during doming (D2) with a peak condition of 3.4–4.3 kbar and 570–612 °C at 210–206 Ma. The superimposition of the M2 isograds upon the M1 isograds resulted in a composite metamorphic sequence around the Jiajika gneiss dome. The overlapping of the Barrovian metamorphism and the Buchan metamorphism is related to crustal thickening during continental collision and later decompression through doming, which facilitated lithium mineralization.
Panniculitis with fever of unknown origin
Authors: Gnanendran Dhanushan , Alshamari Thamir , Muhammad Arif , Mack Kirsten
Published: October 2024

We present a case of a girl in her early childhood with a background of chromosomal deletion 10q21.2, hypothyroidism, second-degree atrioventricular block, developmental delay, gastroesophageal reflux disease, constipation and recurrent fevers. She had subcutaneous nodules, which represented panniculitis. Diagnosis of fever of unknown origin (FUO) associated with panniculitis was very challenging despite the involvement of geneticist, dermatologist, rheumatologist and paediatrician. To detect possible malignant cases and start treatment plans promptly, the case emphasises the need for a comprehensive diagnostic examination, which includes an early biopsy of nodular lesions. To maximise patient outcomes in complicated paediatric presentations, it emphasises the need for continual multidisciplinary teamwork and close monitoring. This case adds to the body of knowledge on the treatment of panniculitis and FUO in paediatric patients, highlighting the need of a comprehensive approach to treatment.
Correlation between ALK+ non-small cell lung cancer targeted therapy and thrombosis: a systematic review and network meta-analysis
Authors: Qi Yaopu , Wang Xiuhuan , Guo Tai , You Tiebin , Wang Ping
Published: October 2024

Objective

The main adjuvant therapies for anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer include ALK tyrosine kinase inhibitors (TKI) and chemotherapy. We aimed to compare differences in the incidence of thromboembolism (TE) among different treatment options.

Design

Using a systematic review and Bayesian network meta-analysis (NMA).

Data sources

We searched PubMed, Embase, Cochrane Library, ClinicalTrials.gov and Web of Science databases before 10 June 2023.

Eligibility criteria

We included published randomised controlled trials (RCT) involving comparisons of treatments between chemotherapy and ALK-TKI drugs.

Data extraction and synthesis

Assessed risk bias with Cochrane tool. Conducted NMA with GEMTC in R, we evaluate the model fit using the deviation information criteria. Estimated posterior distribution using Markov Chain Monte Carlo, 4 chains, 10 fine-tuned iterations, 10 000 iterations per chain, total 50 000 iterations. Monitored potential scale reduction factor for convergence. And checked convergence with Gelman-Rubin statistics and trace plot. Provided surface under the cumulative ranking, lower values indicate less TE event probability.

Results

Analysis of eight RCTs showed that, compared with that for crizotinib, there was a lower risk of total TE with chemotherapy (OR, 0.28; 95% credible intervals (CrI) 0.11 to 0.63), brigatinib (OR 0.31; 95% CrI 0.11 to 0.79) and ceritinib (OR 0.13; 95% CrI 0.03 to 0.45). In addition, analysis of venous TE (VTE) showed similar results, with a lower occurrence for chemotherapy (OR 0.27; 95% CrI 0.1 to 0.62), brigatinib (OR 0.18; 95% CrI 0.04 to 0.6) and ceritinib (OR 0.1; 95% CrI 0.02 to 0.43) compared with that for crizotinib. There were no significant differences in the occurrence of arterial TE among the different treatment options.

Conclusion

Compared with chemotherapy, alectinib, lorlatinib, brigatinib and ceritinib, crizotinib significantly increased the risk of TE and VTE.

PROSPERO registration number

CRD42023373307.
Mediating role of childbirth readiness in the relationship between social support and psychological birth trauma in primiparous women: a nationwide cross-sectional study in China
Authors: Ju Dandan , Zhang Ke , Yuan Mengmei , Li Bingbing , Zeng Tieying
Published: October 2024

Objective

To examine the relationship between social support and psychological birth trauma among Chinese primiparous women and the mediating effects of childbirth readiness.

Design

A cross-sectional study was conducted between November 2021 and March 2022.

Setting

10 general tertiary hospitals and 3 specialised maternity hospitals in 7 provinces in China.

Participants

A total of 751 primiparous women were recruited for this study.

Outcome measures

The questionnaires consisted of questions on demographic characteristics, the Birth Trauma Scale, the Chinese Mandarin version of the Medical Outcomes Study Social Support Survey and the Childbirth Readiness Scale. Hierarchical multiple regression was used to explore the associated factors and mediating role of childbirth readiness in the relationship between social support and psychological birth trauma. The mediating model was examined by the PROCESS macro for SPSS.

Results

After adjusting for demographic variables, social support was negatively associated with psychological birth trauma (r=−0.242, p<0.01). Childbirth readiness had a positive correlation with social support (r=0.206, p<0.01) and a negative correlation with psychological birth trauma (r=−0.351, p<0.01). The hierarchical multiple regression model indicated that social support and childbirth readiness explained 3.9% and 7.7% of the variance in psychological birth trauma, respectively. Childbirth readiness partly mediated the association between social support and psychological birth trauma for primiparas.

Conclusions

Childbirth readiness plays a mediating role between social support and psychological birth trauma among primiparas. Strategies and interventions to enhance childbirth readiness levels may be expected to improve the impact of social support on women’s psychological birth trauma.
Performance and safety of PowerPICC catheters and accessories: a prospective observational study
Authors: Troubil Martin , Capozzoli Giuseppe , Mussa Baudolino , Hodne Melinda , Hoerauf Klaus , Alsbrooks Kimberly
Published: October 2024

Objective

This study aimed to evaluate the safety and performance of PowerPICC catheters in a real-world setting.

Design

Prospective, observational, multicentre study.

Setting

Nine European countries, involving 14 centres.

Participants

General patient population.

Intervention

PowerPICC catheter inserted by the clinician as standard of care with routinely collected outcomes followed through device removal or 180 days postinsertion.

Primary and secondary outcomes measures

Safety and performance outcomes were assessed for PowerPICC, PowerPICC SOLO 2 and PowerGroshong PICC. The primary safety endpoint was the incidence of symptomatic venous thrombosis (VT), and secondary safety endpoints included phlebitis, extravasation, vessel laceration, vessel perforation local infection, accidental dislodgment and catheter-related bloodstream infection (CRBSI). The primary performance endpoint was the percentage of patients whose PowerPICC device remained in place through the completion of therapy. The secondary performance endpoints included catheter patency, placement success in a single attempt and usability.

Results

The enrolled patients (N=451) received either PowerPICC, PowerPICC SOLO 2 or PowerGroshong PICC catheters. Across all devices, 1.6% of patients developed symptomatic VT, and CRBSI occurred in 1.6% of patients. There were no cases of phlebitis or extravasation and only three cases of vein laceration or vein perforation. The catheters showed high success rates in completing therapy (81.8%), maintaining patency (93.9%) and achieving successful placement in a single attempt (90.4%). Clinicians overwhelmingly agreed that both the guidewire and stylet (93.3% and 94.4%, respectively) were easy or very easy to use.

Conclusions

This study demonstrates the safety and performance of PowerPICC catheters across diverse settings and patient cohorts in real-world hospital settings across Europe. The findings indicate that these catheters are safe and can be effectively used in the general patient setting and when inserted by a variety of clinicians. The low incidence of complications and high success rates further support the clinical utility of these catheters.

Trial registration number

NCT04263649.
Effectiveness of peritoneal lavage fluid circulating tumour cells and circulating tumour DNA in the prediction of metachronous peritoneal metastasis of gastric cancer (pT4NxM0/pT1-3N+M0) after radical resection: protocol of a prospective single-centre clinical study
Authors: Bai Long , Guan Yujing , Zhang Yeqian , Gu Jiayi , Ni Bo , Zhang Hao-yu , Aimaiti Muerzhate , Wang Shuchang , Yue Ben , Xia Xiang , Zhang Zizhen
Published: October 2024

Background

Gastric cancer (GC) is the fourth leading cause of cancer mortality worldwide. Peritoneal metastasis (PM) is a significant cause of death in patients with GC, and presents a major challenge in clinical diagnosis and treatment. Predicting the occurrence of PM in high-risk patients, and diagnosing and treating PM in advance to improve patient survival, remains an unsolved problem in clinical practice. Given the low positive rate of cytology and difficulty in diagnosing occult PM, new molecular markers and detection technologies for early diagnosis require urgent validation. The primary objective of this study is to observe and evaluate the predictive effect of intraoperative peritoneal lavage fluid (PLF) circulating tumour cells (CTC) and circulating tumour DNA (ctDNA) levels in patients with pT4NxM0/pT1-3N+M0 GC on metachronous PM after R0 resection.

Methods and analysis

This prospective single-centre clinical study is conducted at Renji Hospital, Shanghai Jiao Tong University School of Medicine. In this study, 200 cases of patients with pT4NxM0/pT1-3N+M0 gastric adenocarcinoma older than 18 years will be screened. Participants will undergo intraoperative PLF CTC and ctDNA testing and will be followed up for 2 years, with imaging assessments performed every 3–6 months until PM occurrs. The primary outcome is the incidence of PM 1 year after surgery, which will be estimated using Clopper-Pearson method, with 95% CIs calculated and compared between groups. Secondary outcome include the incidence of PM 2 years after surgery, overall survival and disease progression. Data will be analysed using the Kaplan-Meier method and the log-rank test.

Ethics and communication

Informed consent has been obtained from all subjects. This protocol has been approved by the Ethics Committee of Renji Hospital, Shanghai Jiao Tong University School of Medicine (LY2023-142-B). The findings will be disseminated through peer-reviewed manuscripts, reports and presentations.

Trial registration number

ChiCTR2300074910.
Characteristics and factors associated with psychotic-like experiences in remission: a cross-sectional study of 4208 college students in China
Authors: Yang Xin-Hu , Wang Rui , Li Yue , Zhou Hong-Ling , Zhou Liang , Sun Meng
Published: October 2024

Objectives

Previous research has extensively explored the factors associated with psychotic-like experiences (PLEs). However, the characteristics and associated factors of remitted PLEs, which refer to the absence of current PLEs following previous PLEs, remain unclear. Therefore, this study aims to describe the characteristics of adolescents who reported remitted PLEs.

Design

Cross-sectional study.

Setting

The survey was conducted from October to December 2020 in three colleges located in Guangzhou, China.

Participants

A total of 4208 college freshmen aged from 15 to 24 participated in our survey.

Primary and secondary outcome measures

The 15-item positive subscale of the Community Assessment of the Psychic Experience was used to assess both lifetime and current PLEs. Multivariate logistic regression models were used to examine the associations between remitted PLEs and a range of demographic factors, lifestyle, psychosocial factors, lifetime affective symptoms and sleep problems.

Results

Three groups of PLEs were observed: non-PLEs (47.27% of the sample), remitted PLEs (40.42%) and current PLEs (12.31%). Several factors have been identified as shared correlates of remission and absence of PLEs, including fewer recent adverse life events, greater resilience, fewer symptoms of depression and anxiety, and early waking. Furthermore, higher levels of social support (OR 1.48, 95% CI 1.01 to 2.17; OR 1.53, 95% CI 1.18 to 1.97) was a specific factor associated with the remission of PLEs. Compared with individuals without PLEs, those with remitted PLEs were more likely to be female (OR 1.50, 95% CI 1.28 to 1.75), less likely to be younger (OR 0.88, 95% CI 0.81 to 0.95) and prone to have more chronic physical illness (OR 1.67, 95% CI 1.29 to 2.16), habitual alcohol intake (OR 1.85, 95% CI 1.19 to 2.88), more childhood trauma (OR for low vs high=0.72, 95% CI 0.57 to 0.91) and the sleep problems of waking up easily (OR 1.36, 95% CI 1.12 to 1.65).

Conclusion

These findings suggest that remitted PLEs play a vital, unique role among three groups and provide preliminary targets for the intervention for adolescents at risk of mental health problems. Further investigation may shed light on the causality of the relationship between remitted PLEs and associated factors.
Dynamic Interplay of Online Risk and Resilience in Adolescence (DIORA): a protocol for a 12-month prospective observational study testing the associations among digital activity, affective and cognitive reactions and depression symptoms in a community sample of UK adolescents
Authors: Kostyrka-Allchorne Katarzyna , Stoilova Mariya , Bourgaize Jake , Murray Aja , Azeri Eliz , Hollis Chris , Townsend Ellen , Livingstone Sonia , Sonuga-Barke Edmund
Published: October 2024

Introduction

The impact of digital activity on adolescent mental health has been difficult to assess because of methodological limitations and a lack of strong theory.Dynamic Interplay of Online Risk and Resilience in Adolescence(DIORA) is a longitudinal study designed to address these core limitations and tease apart the reciprocal influences linking digital activity and depression symptoms (hereafter ‘depression’) over 12 months in middle adolescence. This study will examine whether negative affective and cognitive reactions evoked by risky digital activities increase depression. It will additionally examine whether protective characteristics (eg, self-efficacy) moderate the associations between digital activity and depression. DIORA will also explore the reverse pathways between digital activity and depression, namely whether depression exacerbates negative affective and cognitive reactions and, in turn, increase risky digital activities or, further, whether risks can be mitigated through active management of digital activity and/or reactions that it evokes. Finally, the study will examine whether the effects of digital activity observed for depression contrast with those observed for well-being.

Methods and analysis

This is a prospective observational study with three assessment points: baseline (T1), 6 months (T2) and 12 months (T3). We aim to recruit a minimum of 276 adolescents aged between 13 and 14 years from secondary schools in the UK and 1 parent/caregiver/guardian (hereafter, ‘parent’) for each adolescent. Study questionnaires will be completed online.

We will fit a range of models to examine the direct and indirect associations among digital activity, the reactions it evokes, depression and wellbeing, and individual and contextual mediators and moderators drawing on the structural equation modelling framework.

Ethics and dissemination

The study was approved by the London School of Economics and Political Science Research Ethics Committee, reference number 249287. The results will be published in peer-reviewed scientific journals and disseminated through presentations, posters and blogs.
Association of early statin initiation during COVID-19 admission with inpatient mortality at an academic health system in Illinois, March 2020 to September 2022: a target trial emulation using observational data
Authors: Rivera Adovich , Al-Heeti Omar , Feinstein Matthew J , Williams Janna , Taiwo Babafemi , Achenbach Chad , Petito Lucia
Published: October 2024

Objective

We assessed the association of early statin initiation with inpatient mortality among hospitalised COVID-19 patients.

Design, setting and participants

This observational study emulated a hypothetical target trial using electronic health records data from Northwestern Medicine Health System, Illinois, 2020–2022. We included patients who were ≥40 years, admitted ≥48 hours for COVID-19 from March 2020 to August 2022 and had no evidence of statin use before admission.

Interventions

Individuals who initiated any statins within 48 hours of admission were compared with individuals who did not initiate statins during this period.

Primary outcome measures

Inpatient mortality at hospital days 7, 14, 21 and 28 were determined using hospital records. Risk differences between exposure groups were calculated using augmented inverse propensity weighting (AIPW) with SuperLearner.

Results

A total of 8893 individuals (24.5% early statin initiators) were included. Early initiators tended to be older, male and have higher comorbidity burdens. Unadjusted day 28 mortality was higher in early initiators (6.0% vs 3.6%). Adjusted analysis showed slightly higher inpatient mortality risk at days 7 (RD: 0.5%, 95% CI: 0.2 to 0.8) and 21 (RD: 0.6%, 95% CI: 0.04 to 1.1), but not days 14 (RD: 0.4%, 95% CI: −0.03 to 0.9) and 28 (RD: 0.4%, 95% CI: −0.2 to 1.1). Sensitivity analyses using alternative modelling approaches showed no difference between groups.

Conclusions

Early statin initiation was not associated with lower mortality contrasting with findings of previous observational studies. Trial emulation helped in identifying and addressing sources of bias incompletely addressed by previous work. Statin use may be indicated for other conditions but not COVID-19.
Global mapping survey research on physiotherapeutic interventions for osteoarthritis: a scoping review protocol
Authors: Monteiro Nívea Renata Oliveira , dos Anjos Gabriely Cristina Sousa , Nunes Pinto Ana Carolina Pereira , Matos Areolino Pena
Published: October 2024

Introduction

Physiotherapists provide non-pharmacological conservative treatment for osteoarthritis (OA) using a wide spectrum of interventions. Previous surveys have identified global physiotherapy OA management practices. However, no review to date summarises the scope and findings of these studies. This article describes a scoping review protocol to map the surveys investigating physiotherapeutic interventions offered to patients with OA to identify the treatment interventions currently used for OA, the physiotherapists’ attributes and organisational practice factors potentially associated with the choice of these interventions and to detect knowledge-practice gaps in the provision of physiotherapeutic interventions in OA treatment, contributing to guiding future research on this topic.

Methods and analysis

This is a protocol for a scoping review that will be based on Arksey and O’Malley scoping review methodology and the methodological guidance for conducting scoping reviews published by the Joanna Briggs Institute (JBI). Relevant articles will be searched using the following databases: Medline (PubMed), Embase, Web of Science and Google Scholar. Surveys studies addressing physiotherapeutic interventions offered to patients with OA will be included. Study will be selected through title/abstract and full-text screening stages and data will be extracted using an instrument based on the model available in the JBI Manual. The findings will be summarised using descriptive statistics according to our research questions. This review will be reported in accordance with the Preferred Items for Systematic Reviews and Meta-Analyses for Scoping Reviews.

Ethics and dissemination

Ethical approval is not required for this scoping review. Review findings will be disseminated through peer-reviewed publications, scientific conference presentations and scientific meetings.

Study registration

This protocol has been registered with the Open Science Framework (DOI10.17605/OSF.IO/J3RBT).
Multicohort study testing the generalisability of the SASKit-ML stroke and PDAC prognostic model pipeline to other chronic diseases
Authors: Palmer Daniel , Henze Larissa , Murua Escobar Hugo , Walter Uwe , Kowald Axel , Fuellen Georg
Published: October 2024

Objectives

To validate and test the generalisability of the SASKit-ML pipeline, a prepublished feature selection and machine learning pipeline for the prediction of health deterioration after a stroke or pancreatic adenocarcinoma event, by using it to identify biomarkers of health deterioration in chronic disease.

Design

This is a validation study using a predefined protocol applied to multiple publicly available datasets, including longitudinal data from cohorts with type 2 diabetes (T2D), inflammatory bowel disease (IBD), rheumatoid arthritis (RA) and various cancers. The datasets were chosen to mimic as closely as possible the SASKit cohort, a prospective, longitudinal cohort study.

Data sources

Public data were used from the T2D (77 patients with potential pre-diabetes and 18 controls) and IBD (49 patients with IBD and 12 controls) branches of the Human Microbiome Project (HMP), RA Map (RA-MAP, 92 patients with RA, 22 controls) and The Cancer Genome Atlas (TCGA, 16 cancers).

Methods

Data integration steps were performed in accordance with the prepublished study protocol, generating features to predict disease outcomes using 10-fold cross-validated random survival forests.

Outcome measures

Health deterioration was assessed using disease-specific clinical markers and endpoints across different cohorts. In the HMP-T2D cohort, the worsening of glycated haemoglobin (HbA1c) levels (5.7% or more HbA1c in the blood), fasting plasma glucose (at least 100 mg/dL) and oral glucose tolerance test (at least 140) results were considered. For the HMP-IBD cohort, a worsening by at least 3 points of a disease-specific severity measure, the "Simple Clinical Colitis Activity Index" or "Harvey-Bradshaw Index" indicated an event. For the RA-MAP cohort, the outcome was defined as the worsening of the "Disease Activity Score 28" or "Simple Disease Activity Index" by at least five points, or the worsening of the "Health Assessment Questionnaire" score or an increase in the number of swollen/tender joints were evaluated. Finally, the outcome for all TCGA datasets was the progression-free interval.

Results

Models for the prediction of health deterioration in T2D, IBD, RA and 16 cancers were produced. The T2D (C-index of 0.633 and Integrated Brier Score (IBS) of 0.107) and the RA (C-index of 0.654 and IBS of 0.150) models were modestly predictive. The IBD model was uninformative. TCGA models tended towards modest predictive power.

Conclusions

The SASKit-ML pipeline produces informative and useful features with the power to predict health deterioration in a variety of diseases and cancers; however, this performance is disease-dependent.
Artificial intelligence-powered chatbots in search engines: a cross-sectional study on the quality and risks of drug information for patients
Authors: Andrikyan Wahram , Sametinger Sophie Marie , Kosfeld Frithjof , Jung-Poppe Lea , Fromm Martin F , Maas Renke , Nicolaus Hagen F
Published: October 2024

Background

Search engines often serve as a primary resource for patients to obtain drug information. However, the search engine market is rapidly changing due to the introduction of artificial intelligence (AI)-powered chatbots. The consequences for medication safety when patients interact with chatbots remain largely unexplored.

Objective

To explore the quality and potential safety concerns of answers provided by an AI-powered chatbot integrated within a search engine.

Methodology

Bing copilot was queried on 10 frequently asked patient questions regarding the 50 most prescribed drugs in the US outpatient market. Patient questions covered drug indications, mechanisms of action, instructions for use, adverse drug reactions and contraindications. Readability of chatbot answers was assessed using the Flesch Reading Ease Score. Completeness and accuracy were evaluated based on corresponding patient drug information in the pharmaceutical encyclopaedia drugs.com. On a preselected subset of inaccurate chatbot answers, healthcare professionals evaluated likelihood and extent of possible harm if patients follow the chatbot’s given recommendations.

Results

Of 500 generated chatbot answers, overall readability implied that responses were difficult to read according to the Flesch Reading Ease Score. Overall median completeness and accuracy of chatbot answers were 100.0% (IQR 50.0–100.0%) and 100.0% (IQR 88.1–100.0%), respectively. Of the subset of 20 chatbot answers, experts found 66% (95% CI 50% to 85%) to be potentially harmful. 42% (95% CI 25% to 60%) of these 20 chatbot answers were found to potentially cause moderate to mild harm, and 22% (95% CI 10% to 40%) to cause severe harm or even death if patients follow the chatbot’s advice.

Conclusions

AI-powered chatbots are capable of providing overall complete and accurate patient drug information. Yet, experts deemed a considerable number of answers incorrect or potentially harmful. Furthermore, complexity of chatbot answers may limit patient understanding. Hence, healthcare professionals should be cautious in recommending AI-powered search engines until more precise and reliable alternatives are available.
Evidence-based incorporation of key parameters into MELD score for acute-on-chronic liver failure
Authors: Yu Xia , Zhou Ruoqi , Tan Wenting , Wang Xiaobo , Zheng Xin , Huang Yan , Chen Jinjun , Li Beiling , Liu Xinxin , Li Zhiwei , Meng Zhongji , Gao Yanhang , Qian Zhiping , Liu Feng , Lu Xiaobo , Shang Jia , Yan Huadong , Zheng Yubao , Zhang Weituo , Yin Shan , Gu Wenyi , Deng Guohong , Xiang Xiaomei , Zhou Yi , Hou Yixin , Zhang Qun , Xiong Shue , Liu Jing , Chen Ruochan , Long Liyuan , Jiang Xiuhua , Luo Sen , Chen Yuanyuan , Jiang Chang , Zhao Jinming , Ji Liujuan , Mei Xue , Li Jing , Li Tao , Zheng Rongjiong , Zhou Xinyi , Cai Qun , Li Hai , Sheng Jifang , Shi Yu
Published: October 2024

Background

The model for end-stage liver disease (MELD) score is widely used for the prognostication in end-stage liver disease but has limited performance in acute-on-chronic liver failure (ACLF). In this study, we identified additional predictive parameters and reformed the MELD score to predict ACLF more accurately.

Methods

A meta-analysis was performed on relevant studies to identify the predictive factors of 28-day/90-day outcomes of ACLF, which were validated in two large prospective cohorts. A prognostic score was developed by incorporating predictive parameters into the MELD score. The model was evaluated with a focus on discrimination and calibration.

Results

The meta-analysis incorporated 32 cohort studies with a total of 13 939 patients, of which 13 risk factors were identified, and 3 risk factors (age, neutrophil count and hepatic encephalopathy (HE) grade) besides MELD score were validated in 751 patients with ACLF derived from two prospective cohorts. A new model (Chinese Acute-on-Chronic Liver Failure Consortium (CATCH-LIFE)-MELD score) was developed as follows: 0.028×age+0.3×HE grade+0.039×neutrophil count+0.079×MELD score. CATCH-LIFE-MELD score achieved a concordance index of 0.791/0.788 for 28-day/90-day outcomes, which is superior to other traditional scores. Other discrimination indices, including net reclassification improvement, integrated discrimination improvement and probability density function, and calibration including Nagelkerke’s R2and Brier scores confirmed its superiority. Moreover, the accuracy of CATCH-LIFE-MELD score remained stable. It was highest in patients with or without hepatitis B virus infection, cirrhosis, liver failure or under the Chinese Group on the Study of Severe Hepatitis B (COSSH) criteria or European Association for the Study of the Liver (EASL) criteria. All results were substantiated by an evaluation using an external cohort.

Conclusions

CATCH-LIFE-MELD score, a modified MELD score exhibited improved accuracy in predicting the short-term prognosis of ACLF than other traditional scores.
Dancing with disorder: chorea – an unusual and neglected manifestation of antiphospholipid syndrome
Authors: Hu Shikai , Zhou Yangzhong , Li Mengtao , Zeng Xiaofeng , Zhao Jiuliang
Published: October 2024

Objectives

Chorea, characterised by involuntary, irregular movements, is a rare neurological manifestation of antiphospholipid syndrome (APS). The specific clinical features remain unclear. This study aimed to summarise the available evidence on antiphospholipid antibody (aPL)-associated chorea.

Methods

We used a mixed-methods approach, combining data from patients with chorea with aPL positivity admitted to Peking Union Medical College Hospital (PUMCH) from 2014 to 2024, with cases identified in public databases since 1983. We collected and analysed clinical, laboratory, and imaging results, along with their treatments and outcomes.

Results

A total of 180 patients with incident aPL-associated chorea were included (13 from PUMCH and 167 from the literature). The majority (81.7%) were female, with a mean age of chorea onset 22.8 years (SD=16.0). Chorea was the initial symptom in 87.9% of cases and often occurred as a single episode (67%), involving bilateral limbs (58.8%) and both upper and lower limbs (87.2%). 43.3% met the 2023 American College of Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) APS classification criteria. Thrombocytopenia (30.0%) and arterial thrombosis (29.1%) were the most common manifestations. Lupus anticoagulant was positive in 84.2% of patients, anticardiolipin IgG in 70.8%, and anti-β2 glycoprotein I IgG in 52.9%. Among those who had results available for the three tests, 57.6% were triple-positive. ANAs were positive in 63.6%. MRI revealed basal ganglia lesions in only 14.8% of patients, whereas all positron emission tomography (PET) scans showed contralateral striatal hypermetabolism. Treatment varied, with most receiving combination therapies of neuroleptics, anticoagulants, antiplatelets, steroids and immunosuppressants. Chorea completely or partially improved in 95.5% of patients.

Conclusion

Chorea is a significant but under-recognised manifestation of APS, predominantly affecting young women and often presenting as the initial symptom. Characteristic PET findings of contralateral striatal hypermetabolism can assist in diagnosis. Treatments with glucocorticoids and immunosuppressive therapies appear beneficial. Further research is needed to understand the pathophysiology and optimise management strategies for aPL-associated chorea.
Reconstructive surgery for gunshot injuriesof the knee:experience from the Russo-Ukranian War 2022–2024
Authors: Klapchuk Yurii , Los D , Buryanov O , Yarmoliuk Y , Bazarov M , Bets I , Lyanskorunsky V , Vashkevych B , Ramasamy A
Published: October 2024

The invasion of Ukraine by the Russian Federation in February 2022 has witnessed the first peer-on-peer full-scale European conflict since World War 2. We have noted that the vast majority of injuries affect the extremities. Within that group, injuries to the joints pose a huge clinical challenge. Specifically, 17.1% of all gunshot injuries (GSWs) involved the joints, which represents 22.3% of all limb injuries. 55.6% of all GSW to the joints involved the knee; 10% had a concomitant vascular injury and 15%–20% had a nerve injury.

The surgical management of ballistic knee injuries includes initial damage control surgery with debridement of non-vitalised tissue, vascular reconstruction and fasciotomies where necessary, with stabilisation of bone injury with a spanning external fixator. Following repatriation to Role 4 facilities, staged reconstruction is performed with cement spacers followed by autograft, endoprosthesis or arthrodesis. Where reconstruction is not possible, above-knee amputation remains an option.

In this paper, based on the analysis of 33 cases, we describe the Ukrainian early experience of the management of gunshot wounds to the knee joint with three clinical case studies as representative examples.
Patient experiences in high-grade gliomas: from symptoms to radiotherapy
Authors: Chainey Jonathan , Kim Michael J , Chan Vivien Ka-Ying , Au Karolyn
Published: October 2024

Objectives

Little is known in the literature about felt experience and supportive care needs of patients with new diagnosis of adult-type diffuse gliomas Central Nervous System WHO grades 3 and 4. The purpose of this study is to influence clinicians’ attitudes and facilitate the referral process and the development of support services by better understanding the patient’s journey.

Methods

Adult patients with a new histopathological diagnosis of high-grade glioma, who underwent radiotherapy, participated in a semistructured, face-to-face interview. Different segments of the patient’s journey were explored focusing on patient’s emotions, interactions with healthcare providers, satisfaction during the process and access to supports. Descriptive thematic analysis in the tradition of grounded theory was performed.

Results

Fifteen patients were interviewed, and four themes were emerged from the analysis. First, information conveyed by the medical team was frequently disconnected from patients’ understanding regarding diagnosis and treatment. Second, specific events created a lasting impression that the medical system, and at times medical care providers, lacked empathy. Third, patients’ perceptions of shortcomings within the medical system led to decreased trust, particularly regarding the follow-up process. Finally, although respondents identified multiple inadequacies during their journey, they nonetheless acknowledged the great support and quality of services they received.

Conclusions

This study provides insight into patients’ experiences and perceived shortcomings of the medical system, from the time of presentation until the end of radiotherapy treatment in patients with new diagnosis of high-grade glioma. These findings should influence clinicians’ attitudes and guide systematic changes including delivery of information and the referral process.
Residue management and overwinter survival in winter canola (Brassica napus L.)
Authors: Page Eric R. , Meloche Sydney , Thibodeau Alyssa , Moran Meghan , Caldbeck Brian
Published: October 2024

Winter canola production in eastern Canada is a growing segment of the Canadian canola industry. Crop establishment and survival overwinter have been identified as two of the major challenges associated with the production of winter canola. Environmental conditions can interact with agronomic practices, including seeding date, plant population density, fertility, and residue management, to influence stand establishment in autumn and overwinter survival. The objective of the current research was to evaluate the impact and interaction of preceding crop residue and tillage practices on the establishment, overwinter survival, and yield of winter canola in southern Ontario. Winter canola was seeded following either winter wheat or soybean and using conventional, no-till, or strip-till practices. Over the course of the 3 years of study, the annual decline in winter canola plant population density was influenced by the type of tillage practice used but not by the preceding crop. The overwinter decrease in plant population density was largest in no-till, followed by strip-till, and finally conventional tillage. At physiological maturity, winter canola yields in reduced tillage practices (i.e., no-till and strip-till) were equivalent to those achieved utilizing conventional tillage practices. When grain yields were standardized as a function of the spring plant population density, the highest and lowest yield per plant coincided with the lowest and highest plant population densities and were observed in strip-till (14.2 g plant−1) and no-till (9.1 g plant−1), respectively. Results of this research have established that winter canola can be successfully produced in Ontario utilizing a range of tillage practices.
Cumulative effects assessment in community watersheds at different spatial scales: A review of indicators
Authors: Bristow Emmi , Mian Haroon R. , Chhipi-Shrestha Gyan K. , Hewage Kasun , Sadiq Rehan
Published: October 2024

Cumulative effect assessments (CEA) for water systems are becoming more necessary as pressures from multiple stressors impact communities, watersheds, and basins. CEA is an important tool for shifting from fragmented to holistic, integrated management as per the Integrated Water Resources Management paradigm. Through a review of scientific literature, this study analyzed the patterns and use of indicators for upstream–downstream linkages. This study found that five categories of spatial scale approaches are used: the national/regional scale, basin scale, watershed scale, local scale, and the specially defined multi-scale approach. It was found that CEA has been applied using a high-level, qualitative approach for national, regional, and multi-scale studies—these undertakings inform strategic planning and sustainable decision-making. Basin, watershed, and local scale CEA studies have focused on quantitative modelling of environmental and human systems. These assessments emphasized the interconnectedness of water systems, as well as the role of policy development and stakeholders in improving system outcomes. Four indicator categories were found to span all five spatial scales: water quality (occurred in 64% of the literature), water quantity (53%), land use (56%), and landscape characteristics (67%). These indicator categories provide a common foundation for understanding stressor interactions, impact response, and upstream–downstream linkages. However, further research is needed on temporal scales and the integration of time into CEA for watersheds. This review found that CEA, a tool which is useful for a variety of scales, can help find a balance between present and future needs and further community sustainability using a holistic and integrated approach.
Effects of dark matter on the spontaneous scalarization in neutron stars
Authors: Rahimi Fahimeh , Rezaei Zeinab
Published: October 2024

Dark matter, an important portion of compact objects, can influence different phenomena in neutron stars. The spontaneous scalarization in the scalar-tensor gravity has been proposed for neutron stars. Here, we investigate the spontaneous scalarization in dark matter admixed neutron stars. Applying the dark matter equations of state, we calculate the structure of scalarized neutron stars containing dark matter. The dark matter equations of state are based on observational data from the rotational curves of galaxies and the fermionic self-interacting dark matter. Our results verify that the spontaneous scalarization is affected by the dark matter pressure in neutron stars. Depending on the central density of scalarized dark matter admixed neutron stars, the dark matter pressure alters the central scalar field. The increase of dark matter pressure in low-density scalarized stars amplifies the central scalar field. However, the pressure of dark matter in high-density scalarized stars suppresses the central scalar field. Our calculations confirm that the stars in the merger event GW170817 and in the low-mass X-ray binary 4U 1820-30 can be scalarized dark matter admixed neutron stars.
MgO and ZnO nanofluids passive cooling effects on the electricity production of photovoltaic panels: a comparative study
Authors: Abdulhamid Muhammad Ibrahim , Aboul-Enein Saad , Ibrahim Ali
Published: October 2024

Overheating of solar panels stands as a pivotal factor that impacts their conversion efficiency. Therefore, implementing cooling for solar panels is a key strategy to enhance the electrical output; due to regulating their thermal properties. This study is set out to examine, experimentally, the back-passive cooling impact of MgO and ZnO water-based nanofluids at volume concentrations of 0.01%, 0.03%, and 0.05% on the thermal and electrical characteristics of polycrystalline silicon solar panels, compared with not cooled and water-cooled panels at the same time and under the same weather conditions. The system design is cost-effective and facilitates the direct contact between the cooling fluids and the photovoltaic system. The experimental results demonstrate that the application of MgO nanofluid introduces more improvement compared to the ZnO nanofluid and conventional water cooling. The electrical efficiency enhancement attains its maximum at a volume concentration of 0.05% with 20.90% and 21.65% for MgO and ZnO nanofluids, respectively, over the non-cooled panel. Simultaneously, at this concentration, the temperature reduction achieved by MgO nanofluid is 20.72%, surpassing the 15.80% reduction achieved by the ZnO nanofluid in comparison with the reference panel.