bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting ocean pressure field with a physics-informed neural network
Authors: Yoon Seunghyun , Park Yongsung , Gerstoft Peter , Seong Woojae
Published: March 2024

Ocean sound pressure field prediction, based on partially measured pressure magnitudes at different range-depths, is presented. Our proposed machine learning strategy employs a trained neural network with range-depth as input and outputs complex acoustic pressure at the location. We utilize a physics-informed neural network (PINN), fitting sampled data while considering the additional information provided by the partial differential equation (PDE) governing the ocean sound pressure field. In vast ocean environments with kilometer-scale ranges, pressure fields exhibit rapidly fluctuating phases, even at frequencies below 100 Hz, posing a challenge for neural networks to converge to accurate solutions. To address this, we utilize the envelope function from the parabolic-equation technique, fundamental in ocean sound propagation modeling. The envelope function shows slower variations across ranges, enabling PINNs to predict sound pressure in an ocean waveguide more effectively. Additional PDE information allows PINNs to capture PDE solutions even with a limited amount of training data, distinguishing them from purely data-driven machine learning approaches that require extensive datasets. Our approach is validated through simulations and using data from the SWellEx-96 experiment.
Importance of the receiver's height for transmission studies in acoustic ecology
Authors: Iglesias-Merchan Carlos , Llusia Diego , Márquez Rafael
Published: March 2024

In animal communication, the sound pressure level (SPL) of the acoustic signals has been studied in relation to various biological functions. Previous research reported that senders and receivers benefit from being at elevated positions. However, sometimes, researchers find contradictory results. Using a transmission experiment, we measured SPL of two acoustic stimuli: (i) white noise, and (ii) advertisement calls of the Iberian tree frog (Hyla molleri) at two different heights above ground level (0.05 and 0.75 m) and from six distances (1, 2, 4, 8, 16, and 32 m) from a loudspeaker. Calls of the Iberian tree frog have two spectral peaks centred at the frequencies of ca. 1 and 2 kHz. As expected, SPL decreased with distance, but following a distinct attenuation pattern across height above the ground and frequency. Our findings show that the ground effect may critically alter frequency attenuation and, therefore, signal composition and discrimination at the listener's location, even at low heights above the ground. We suggest that recording devices should be positioned at the same height that natural listeners are usually located in nature, to facilitate the replication and comparison of experiments in the field of acoustic ecology and, also, bioacoustics.
Analysis of Changes in Physical Fitness in Children and Adolescents (11–15 Years) From Kraków (Poland) During COVID-19 Pandemic
Authors: Artymiak Paulina , Żegleń Magdalena , Kryst Łukasz
Published: March 2024

Background: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has posed a threat to society worldwide. The aim of the study was to analyze changes in the physical fitness of 11- to 15-year-olds during the COVID-19 pandemic. Methods: Cross-sectional research was conducted in randomly selected schools in Kraków (Poland) during the years 2020 and 2022. The study group included 1635 adolescents aged 11–15 years. The results of fitness tests such as flexibility, standing broad jump, handgrip strength, overhead medicine ball throw, shuttle run (10 × 5 m), and 30-second sit-ups were analyzed. Body height and weight measurements were also taken. The standing broad jump and handgrip strength were normalized. A statistical analysis was performed to compare the differences between groups using 2-way analysis of variance with the Tukey HSD post hoc test or Kruskal–Wallis test. Results: The test results revealed a deterioration decrease in sit-ups, standing broad jump, shuttle run, and normalized standing broad jump in both sexes. Furthermore, the test results among girls showed a decrease in overhead medicine ball throw and flexibility. An increase in test results of both sexes was noticed in handgrip strength of the right and left hand. Among boys in 2022, the results were better in the flexibility test and overhead medicine ball throw compared with their peers from 2020. Conclusion: This study indicates a decrease in overall physical fitness in adolescents. The observed results may be associated with a decrease in physical activity, changes in nutrition, and restrictions imposed during the COVID-19 pandemic.
Clonal dominance defines metastatic dissemination in pancreatic cancer
Authors: Ho I-Lin , Li Chieh-Yuan , Wang Fuchenchu , Zhao Li , Liu Jingjing , Yen Er-Yen , Dyke Charles A. , Shah Rutvi , Liu Zhaoliang , Çetin Ali Osman , Chu Yanshuo , Citron Francesca , Attanasio Sergio , Corti Denise , Darbaniyan Faezeh , Del Poggetto Edoardo , Loponte Sara , Liu Jintan , Soeung Melinda , Chen Ziheng , Jiang Shan , Jiang Hong , Inoue Akira , Gao Sisi , Deem Angela , Feng Ningping , Ying Haoqiang , Kim Michael , Giuliani Virginia , Genovese Giannicola , Zhang Jianhua , Futreal Andrew , Maitra Anirban , Heffernan Timothy , Wang Linghua , Do Kim-Anh , Gargiulo Gaetano , Draetta Giulio , Carugo Alessandro , Lin Ruitao , Viale Andrea
Published: March 2024

Tumors represent ecosystems where subclones compete during tumor growth. While extensively investigated, a comprehensive picture of the interplay of clonal lineages during dissemination is still lacking. Using patient-derived pancreatic cancer cells, we created orthotopically implanted clonal replica tumors to trace clonal dynamics of unperturbed tumor expansion and dissemination. This model revealed the multifaceted nature of tumor growth, with rapid changes in clonal fitness leading to continuous reshuffling of tumor architecture and alternating clonal dominance as a distinct feature of cancer growth. Regarding dissemination, a large fraction of tumor lineages could be found at secondary sites each having distinctive organ growth patterns as well as numerous undescribed behaviors such as abortive colonization. Paired analysis of primary and secondary sites revealed fitness as major contributor to dissemination. From the analysis of pro- and nonmetastatic isogenic subclones, we identified a transcriptomic signature able to identify metastatic cells in human tumors and predict patients’ survival.
The Effects of the Flint water crisis on the educational outcomes of school-age children
Authors: Trejo Sam , Yeomans-Maldonado Gloria , Jacob Brian
Published: March 2024

In 2014, the municipal water source in Flint, Michigan was switched, causing lead from aging pipes to leach into the city’s drinking water. While lead exposure in Flint children increased modestly on average, some children were exposed to high lead levels. Surveys of Flint residents show the water crisis was also associated with increased levels of stress, anxiety, and depression. We use Michigan’s administrative education data and utilize synthetic control methods to examine the impact of the crisis on Flint’s school-age children. We find decreases in math achievement and increases in special needs classification, even among children living in homes with copper (rather than lead) water service lines. Low socioeconomic status students and younger students experienced the largest effects on math achievement, and boys experienced the largest effects on special needs classification. Our results point toward the broad negative effects of the crisis on children and suggest that existing estimates may substantially underestimate the overall societal cost of the crisis.
Mechanosensing regulates tissue repair program in macrophages
Authors: Meizlish Matthew L. , Kimura Yoshitaka , Pope Scott D. , Matta Rita , Kim Catherine , Philip Naomi H. , Meyaard Linde , Gonzalez Anjelica , Medzhitov Ruslan
Published: March 2024

Tissue-resident macrophages play important roles in tissue homeostasis and repair. However, how macrophages monitor and maintain tissue integrity is not well understood. The extracellular matrix (ECM) is a key structural and organizational component of all tissues. Here, we find that macrophages sense the mechanical properties of the ECM to regulate a specific tissue repair program. We show that macrophage mechanosensing is mediated by cytoskeletal remodeling and can be performed in three-dimensional environments through a noncanonical, integrin-independent mechanism analogous to amoeboid migration. We find that these cytoskeletal dynamics also integrate biochemical signaling by colony-stimulating factor 1 and ultimately regulate chromatin accessibility to control the mechanosensitive gene expression program. This study identifies an “amoeboid” mode of ECM mechanosensing through which macrophages may regulate tissue repair and fibrosis.
The dissipative Talbot soliton fiber laser
Authors: Zhang Heze , Du Yueqing , Zeng Chao , Sun Zhipei , Zhang Yong , Zhao Jianlin , Mao Dong
Published: March 2024

Talbot effect, characterized by the replication of a periodic optical field in a specific plane, is governed by diffraction and dispersion in the spatial and temporal domains, respectively. In mode-locked lasers, Talbot effect is rarely linked with soliton dynamics since the longitudinal mode spacing and cavity dispersion are far away from the self-imaging condition. We report switchable breathing and stable dissipative Talbot solitons in a multicolor mode-locked fiber laser by manipulating the frequency difference of neighboring spectra. The temporal Talbot effect dominates the laser emission state—in the breathing state when the integer self-imaging distance deviates from the cavity length and in the steady state when it equals the cavity length. A refined Talbot theory including dispersion and nonlinearity is proposed to accurately depict this evolution behavior. These findings pave an effective way to control the operation in dissipative optical systems and open branches in the study of nonlinear physics.
Dense hydrated Mg-silicates in diamond: Implications for transport of H
2
O into the mantle
Authors: Carvalho Luísa D. V. , Stachel Thomas , Luth Robert W. , Locock Andrew J. , Pearson D. Graham , Steele-MacInnis Matthew , Stern Richard A. , Nestola Fabrizio , Scholz Ricardo , Jalowitzki Tiago , Fuck Reinhardt A.
Published: March 2024

Water in Earth’s upper mantle is a minor and yet critically important component that dictates mantle properties such as strength and melting behavior. Minerals with stoichiometric water, such as those of the humite group, are important yet poorly characterized potential reservoirs for volatiles in the upper mantle. Here, we report observation of hydroxyl members of the humite group as inclusions in mantle-derived diamond. Hydroxylchondrodite and hydroxylclinohumite were found coexisting with olivine, magnesiochromite, Mg-bearing calcite, dolomite, quartz, mica, and a djerfisherite-group mineral in a diamond from Brazil. The olivine is highly forsteritic (Mg# 97), with non–mantle-like oxygen isotope composition (δ
18
O +6.2‰), and is associated with fluid inclusions and hydrous minerals—features that could be inherited from a serpentinite protolith. Our results constitute direct evidence for the presence of deserpentinized peridotitic protoliths in subcratonic mantle keels, placing important constraints on the stability of hydrous phases in the mantle and the origin of diamond-forming fluids.
Diverse high-pressure chemistry in Y-NH
3
BH
3
and Y–paraffin oil systems
Authors: Aslandukova Alena , Aslandukov Andrey , Laniel Dominique , Yin Yuqing , Akbar Fariia Iasmin , Bykov Maxim , Fedotenko Timofey , Glazyrin Konstantin , Pakhomova Anna , Garbarino Gaston , Bright Eleanor Lawrence , Wright Jonathan , Hanfland Michael , Chariton Stella , Prakapenka Vitali , Dubrovinskaia Natalia , Dubrovinsky Leonid
Published: March 2024

The yttrium-hydrogen system has gained attention because of near-ambient temperature superconductivity reports in yttrium hydrides at high pressures. We conducted a study using synchrotron single-crystal x-ray diffraction (SCXRD) at 87 to 171 GPa, resulting in the discovery of known (two YH
3
phases) and five previously unknown yttrium hydrides. These were synthesized in diamond anvil cells by laser heating yttrium with hydrogen-rich precursors—ammonia borane or paraffin oil. The arrangements of yttrium atoms in the crystal structures of new phases were determined on the basis of SCXRD, and the hydrogen content estimations based on empirical relations and ab initio calculations revealed the following compounds: Y
3
H
11
, Y
2
H
9
, Y
4
H
23
, Y
13
H
75
, and Y
4
H
25
. The study also uncovered a carbide (YC
2
) and two yttrium allotropes. Complex phase diversity, variable hydrogen content in yttrium hydrides, and their metallic nature, as revealed by ab initio calculations, underline the challenges in identifying superconducting phases and understanding electronic transitions in high-pressure synthesized materials.
Harnessing regulatory T cells to establish immune tolerance
Authors: Ho Patrick , Cahir-McFarland Ellen , Fontenot Jason D. , Lodie Tracey , Nada Adel , Tang Qizhi , Turka Laurence A. , Bluestone Jeffrey A.
Published: March 2024

Engineered regulatory T (T
reg
) cells have emerged as precision therapeutics aimed at inducing immune tolerance while reducing the risks associated with generalized immunosuppression. This Viewpoint highlights the opportunities and challenges for engineered T
reg
cell therapies in treating autoimmune and other inflammatory diseases.
Answer to March 2024 Photo Quiz
Authors: Grams Tristan R. , Mathison Blaine A. , Roseberry Donald , Couturier Marc Roger
Published: March 2024

Read the full article for the answer.
Near-complete genome sequences of multiple genotype 1 African swine fever virus isolates from 2016 to 2018 in Cameroon
Authors: Spinard Edward , Wade Abel , Unger Hermann , Robert Nenkam , Mayega Francis J. , Sreenu Vattipally B. , Da Silva Filpe Ana , Mair Daniel , Borca Manuel V. , Gladue Douglas P. , Masembe Charles
Published: March 2024

African swine fever virus has been endemic in Cameroon since 1982. Here, we announce the sequences of Cameroon/2016/C1, Cameroon/2016/C5, Cameroon/2017/C-A2, Cameroon/2018/C02, and Cameroon/2018/CF3, five genotype 1 African swine fever virus genomes collected from domestic pigs between 2016 and 2018.
N-terminal proteomics of
Mycobacterium marinum
using bottom-up label-free quantitative analysis in data-dependent acquisition mode on a timsTOF Pro mass spectrometer
Authors: Hu Daniel D. , Weaver Simon D. , Collars Owen A. , Champion Patricia A. , Champion Matthew M.
Published: March 2024

N-terminal acetylation in
Mycobacterium tuberculosis
is correlated with pathogenic activity. We used genomics and bottom-up proteomics to identify protein Emp1 as the sole acetyltransferase responsible for acetylation of EsxA, a known virulence factor. Using custom data analysis, we screened the proteome to identify 22 additional putative substrates of Emp1.
Apple cider vinegar for weight management in Lebanese adolescents and young adults with overweight and obesity: a randomised, double-blind, placebo-controlled study
Authors: Abou-Khalil Rony , Andary Jeanne , El-Hayek Elissar
Published: March 2024

Background and aims

Obesity and overweight have become significant health concerns worldwide, leading to an increased interest in finding natural remedies for weight reduction. One such remedy that has gained popularity is apple cider vinegar (ACV).

Objective

To investigate the effects of ACV consumption on weight, blood glucose, triglyceride and cholesterol levels in a sample of the Lebanese population.

Materials and methods

120 overweight and obese individuals were recruited. Participants were randomly assigned to either an intervention group receiving 5, 10 or 15 mL of ACV or a control group receiving a placebo (group 4) over a 12-week period. Measurements of anthropometric parameters, fasting blood glucose, triglyceride and cholesterol levels were taken at weeks 0, 4, 8 and 12.

Results

Our findings showed that daily consumption of the three doses of ACV for a duration of between 4 and 12 weeks is associated with significant reductions in anthropometric variables (weight, body mass index, waist/hip circumferences and body fat ratio), blood glucose, triglyceride and cholesterol levels. No significant risk factors were observed during the 12 weeks of ACV intake.

Conclusion

Consumption of ACV in people with overweight and obesity led to an improvement in the anthropometric and metabolic parameters. ACV could be a promising antiobesity supplement that does not produce any side effects.
Adverse birth outcomes and childhood overweight at age of 3–8 years in a prospective cohort study in Tianjin, China
Authors: Zhang Rui , Gao Ming , Li Weiqin , Liu Hongyan , Wang Shuting , Wang Hui , Li Ninghua , Li Jing , Yu Zhijie , Hu Gang , Leng Junhong , Yang Xilin
Published: March 2024

Objectives

To explore associations between adverse birth outcomes and childhood overweight at 3–8 years of age.

Design

A prospective cohort study.

Setting

Six central urban districts of Tianjin, China.

Participants

1681 woman–child pairs.

Methods

1681 woman–child pairs were followed up for 8 years in Tianjin, China. Demographic and clinical information including birth outcomes was collected longitudinally, commencing from first antenatal care visit till postpartum period. Offspring height and weight were measured at 3–8 years of age. High and low weight/length ratios (WLR) at birth were, respectively, defined as ≥90th and ≤10th gestational week and sex-specific percentiles. Overweight for children at 3–5 and 6–8 years of age were, respectively, defined as body mass index (BMI)-for-age and -sex above the 2 z-score and 1 z-score curves of the WHO’s child growth standards. Binary logistic regression analysis was used to obtain ORs and 95% CI with a stepwise backward selection method to select independent predictors.

Primary outcomes measures

Childhood overweight.

Results

Of 1681 children, 10.7% (n=179) and 27.8% (n=468) developed overweight at 3–5 and 6–8 years of age, respectively. Large for gestational age (LGA) was associated with increased risk of overweight at 3–5 years of age (aOR: 1.86, 95% CI: 1.27 to 2.72) while high WLR at birth was associated with increased risk of overweight at 6–8 years of age (1.82, 1.41 to 2.34). Low WLR at birth was associated with decreased risk of overweight at 6–8 years of age (0.52, 0.30 to 0.90).

Conclusions

LGA and high WLR at birth predicted childhood overweight at 3–5 and 6–8 years of age, respectively. Low WLR at birth was associated with decreased risk of childhood overweight at 6–8 years of age.
Would’ve, could’ve, should’ve: a cross-sectional investigation of whether and how healthcare staff’s working conditions and mental health symptoms have changed throughout 3 pandemic years
Authors: Reiter Julia , Weibelzahl Stephan , Duden Gesa S
Published: March 2024

Objectives

Mental health and well-being of healthcare staff were majorly impacted by the COVID-19 pandemic. Little attention has been devoted to the role employers could choose to play in mitigating long-term negative consequences and how effective organisational measures taken were perceived by the individual healthcare workers. This study aims to investigate (1) whether and how healthcare professionals’ mental health has changed from the second to the third pandemic year, (2) whether differences between professional groups (physicians, nurses, paramedics) identified in previous studies persisted and (3) how job demands and resources, for example, work culture and employers’ measures, impacted this situation.

Design

The study employs an observational, cross-sectional design, using an online survey.

Setting and participants

The study was conducted online from mid-June to mid-August 2022 among healthcare staff in state-run and private healthcare facilities, such as doctor’s practices, hospitals and paramedic organisations, in Germany and Austria (n=421).

Outcome measures

We measured psychological strain using an ICD-10-based symptom checklist, as well as subjective strain and importance of stressors using self-report questions. The ICD-10 was the 10th version of the International Statistical Classification of Diseases and Related Health Problems, a widely used standardized diagnostic manual.

Results

Psychological strain stayed relatively consistent, with nursing staff suffering the most. While the job demands participants felt most affected by were structural issues (eg, staff shortages), employers were far more likely to be perceived as taking action against pandemic-specific job demands (eg, lack of protective gear). Psychological strain was lowest when staff perceived employers’ actions as effective. Only 60% of those with severe enough symptoms to require psychological help had intentions of seeking such help, which is in line with past studies. This help-seeking hesitancy was also dependent on different facets of perceived work culture.

Conclusions

Healthcare staff and nursing staff in particular continue to suffer in the aftermath of the COVID-19 pandemic. However, while employers were perceived as taking action against pandemic-specific job demands, pre-existing job demands causing stress and psychological strain for staff have remained uncombatted.
Association between socioeconomic status and hypertension among adults in Fujian province and the mediating effect of BMI and cooking salt intake: a cross-sectional study
Authors: Li Yuqing , Ge Wailiang , Wu Minxia , Gao Mengyang , Peng Zhongrui , Han Yaofeng , Hu Xiangju , Li Lei
Published: March 2024

Objectives

This study aimed to investigate the association between socioeconomic status (SES) and the prevalence of hypertension in Fujian province, China, and to evaluate the mediating effect of body mass index (BMI) and cooking salt intake between SES and hypertension.

Design

Community-based cross-sectional survey was conducted between June 2018 and December 2019.

Setting

Fujian province, China.

Participants

A total of 26 500 participants aged >18 years completed the survey.

Outcome measures

The primary outcome was the prevalence of hypertension. Education, income and occupation were used as SES indicators. Meanwhile, certain health behaviours and metabolic risk factors were used as secondary indicators of SES.

Results

The prevalence of hypertension was relatively high among participants who finished primary education (34.8%), had the lowest annual income (46.0%), were unemployed or retired (34.7%). Education and income levels were negatively associated with the prevalence of hypertension (p<0.05). Regular smoking, alcohol consumption, BMI and high cooking salt intake were also significantly associated with the prevalence of hypertension (p<0.05). Cooking salt intake was identified as a partial mediator between income and hypertension, mediating 3.45% of the association. Both BMI and cooking salt intake were partial mediators between education and hypertension, mediating 5.23% and 1.93% of the association, respectively.

Conclusions

SES was associated with the prevalence of hypertension among adults in Fujian province, China. BMI and cooking salt intake were partial mediators of the association between SES and hypertension.
Epidemiology of diabetes mellitus in Pakistan: a systematic review protocol
Authors: Hasan Syed Umar , Siddiqui M A Rehman
Published: March 2024

Introduction

Diabetes mellitus (DM) is a chronic metabolic disorder characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action or both. As a major global health concern, its prevalence has been steadily increasing. Pakistan, is no exception to this trend, facing a growing burden of non-communicable diseases including DM. This research aims to comprehensively assess the prevalence of DM, and disparities between rural and urban populations as well as between men and women in Pakistan.

Methods and analysis

The systematic review will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and will aim to assess DM prevalence in Pakistan. A comprehensive search strategy will be applied to databases like PubMed, Scopus, Cochrane, PakMediNet and CINAHL from inception up to 1st April 2024. We will include studies that focus on diabetes prevalence in the general population, employing WHO or American Diabetes Association criteria for diagnosis of DM. Cross-sectional studies, cohort studies and population-based surveys with a sample size ≥500, in English will be considered. Data extraction will be done as per a predefined proforma which will include study details such as demographics, prevalence data and methodology. A meta-analysis will be performed using a random effect model with an inverse variance weighted method. I2statistics will be used to examine heterogeneity, and subgroup analyses will be performed.

Ethics and dissemination

The findings from the systematic review will be shared by publishing them in a peer-reviewed journal and showcasing them at pertinent conferences. Our analysis will be based on aggregated data and will not involve individual patient information, thus eliminating the need for ethical clearance.

PROSPERO registration number

CRD42023453085.
Qualitative study of challenges with recruitment of hospitals into a cluster controlled trial of clinical decision support in Australia
Authors: Baysari Melissa T , Van Dort Bethany Annemarie , Stanceski Kristian , Hargreaves Andrew , Zheng Wu Yi , Moran Maria , Day Richard O , Li Ling , Westbrook Johanna , Hilmer Sarah N
Published: March 2024

Objective

To identify barriers to hospital participation in controlled cluster trials of clinical decision support (CDS) and potential strategies for addressing barriers.

Design

Qualitative descriptive design comprising semistructured interviews.

Setting

Five hospitals in New South Wales and one hospital in Queensland, Australia.

Participants

Senior hospital staff, including department directors, chief information officers and those working in health informatics teams.

Results

20 senior hospital staff took part. Barriers to hospital-level recruitment primarily related to perceptions of risk associated with not implementing CDS as a control site. Perceived risks included reductions in patient safety, reputational risk and increased likelihood that benefits would not be achieved following electronic medical record (EMR) implementation without CDS alerts in place. Senior staff recommended clear communication of trial information to all relevant stakeholders as a key strategy for boosting hospital-level participation in trials.

Conclusion

Hospital participation in controlled cluster trials of CDS is hindered by perceptions that adopting an EMR without CDS is risky for both patients and organisations. The improvements in safety expected to follow CDS implementation makes it challenging and counterintuitive for hospitals to implement EMR without incorporating CDS alerts for the purposes of a research trial. To counteract these barriers, clear communication regarding the evidence base and rationale for a controlled trial is needed.
Protocol: Prospective evaluation of feasibility, added value and satisfaction of remote digital self-assessment for mild cognitive impairment in routine care with the neotivCare app
Authors: Duzel Emrah , Schöttler Michael , Sommer Harriet , Griebe Martin
Published: March 2024

Introduction

Timely diagnosis of mild cognitive impairment (MCI) in Alzheimer’s disease is crucial for early interventions, but its implementation is often challenging due to the complexity and time burden of required cognitive assessments. To address these challenges, the usability of new unsupervised digital remote assessment tools needs to be validated in a care context.

Methods and analysis

This multicentric healthcare research evaluation survey, re.cogni.ze, aims to evaluate physician satisfaction with a remote digital assessment solution (neotivCare) in primary and specialised routine care in Germany. Over a period of 22 months, physicians in different regions of Germany will recommend the application (app) to approximately 1000 patients for a 12-week self-assessment of cognition. The primary endpoint is the evaluation of physicians’ and patients’ overall satisfaction with neotivCare and with neuropsychological questionnaires/standard procedures using a Likert scale, while secondary endpoints include user-friendliness, qualitative assessment of acceptance and potential improvements on medical routine services. The study also aims to evaluate the proportion of physicians or patients attributing added value to neotivCare compared with standard paper–pencil tests. The study results will provide insights into the feasibility, efficiency and acceptance of new digital tools for MCI diagnosis in routine care. The re.cogni.ze survey will thus provide proof-of-concept information for the implementation of remote digital cognitive assessment apps for MCI into medical routine care.

Ethics and dissemination

This study was approved by the ethics committee of the State Medical Association (Landesärztekammer) Baden-Württemberg, (F-2021-161) as the leading committee and nine ethics committees local to the participating healthcare professionals (Lower Saxony, North Rhine, Westphalia-Lippe, Hesse, Bremen, Berlin, University of Göttingen, Charite, University of Rostock). The results can be shared (upon reasonable quest) to improve routine clinical processes and holistic approaches.
Understanding and maximising the community impact of seasonal malaria chemoprevention in Burkina Faso (INDIE-SMC): study protocol for a cluster randomised evaluation trial
Authors: Moreno Marta , Barry Aissata , Gmeiner Markus , Yaro Jean Baptist , Sermé Samuel S , Byrne Isabel , Ramjith Jordache , Ouedraogo Alphonse , Soulama Issiaka , Grignard Lynn , Soremekun Seyi , Koele Simon , ter Heine Rob , Ouedraogo Amidou Z , Sawadogo Jean , Sanogo Edith , Ouedraogo Issa N , Hien Denise , Sirima Sodiomon Bienvenu , Bradley John , Bousema Teun , Drakeley Chris , Tiono Alfred B
Published: March 2024

Introduction

Seasonal malaria chemoprevention (SMC) involves repeated administrations of sulfadoxine-pyrimethamine plus amodiaquine to children below the age of 5 years during the peak transmission season in areas of seasonal malaria transmission. While highly impactful in reducingPlasmodium falciparummalaria burden in controlled research settings, the impact of SMC on infection prevalence is moderate in real-life settings. It remains unclear what drives this efficacy decay. Recently, the WHO widened the scope for SMC to target all vulnerable populations. The Ministry of Health (MoH) in Burkina Faso is considering extending SMC to children below 10 years old. We aim to assess the impact of SMC on clinical incidence and parasite prevalence and quantify the human infectious reservoir for malaria in this population.

Methods and analysis

We will perform a cluster randomised trial in Saponé Health District, Burkina Faso, with three study arms comprising 62 clusters of three compounds: arm 1 (control): SMC in under 5-year-old children, implemented by the MoH without directly observed treatment (DOT) for the full course of SMC; arm 2 (intervention): SMC in under 5-year-old children, with DOT for the full course of SMC; arm 3 (intervention): SMC in under 10-year-old children, with DOT for the full course of SMC. The primary endpoint is parasite prevalence at the end of the malaria transmission season. Secondary endpoints include the impact of SMC on clinical incidence. Factors affecting SMC uptake, treatment adherence, drug concentrations, parasite resistance markers and transmission of parasites will be determined.

Ethics and dissemination

The London School of Hygiene & Tropical Medicine’s Ethics Committee (29193) and the Burkina Faso National Medical Ethics Committee (Deliberation No 2023-05-104) approved this study. The findings will be presented to the community; disease occurrence data and study outcomes will also be shared with the Burkina Faso MoH. Findings will be published irrespective of their results.

Trial registration number

NCT05878366.
HFEgenotypes, haemochromatosis diagnosis and clinical outcomes at age 80 years: a prospective cohort study in the UK Biobank
Authors: Lucas Mitchell R , Atkins Janice L , Pilling Luke C , Shearman Jeremy D , Melzer David
Published: March 2024

Objectives

HFEhaemochromatosis genetic variants have an uncertain clinical penetrance, especially to older ages and in undiagnosed groups. We estimated p.C282Y and p.H63D variant cumulative incidence of multiple clinical outcomes in a large community cohort.

Design

Prospective cohort study.

Setting

22 assessment centres across England, Scotland, and Wales in the UK Biobank (2006–2010).

Participants

451 270 participants genetically similar to the 1000 Genomes European reference population, with a mean of 13.3-year follow-up through hospital inpatient, cancer registries and death certificate data.

Main outcome measures

Cox proportional HRs of incident clinical outcomes and mortality in those withHFEp.C282Y/p.H63D mutations compared with those with no variants, stratified by sex and adjusted for age, assessment centre and genetic stratification. Cumulative incidences were estimated from age 40 years to 80 years.

Results

12.1% of p.C282Y+/+ males had baseline (mean age 57 years) haemochromatosis diagnoses, with a cumulative incidence of 56.4% at age 80 years. 33.1% died vs 25.4% withoutHFEvariants (HR 1.29, 95% CI: 1.12 to 1.48, p=4.7×10-4); 27.9% vs 17.1% had joint replacements, 20.3% vs 8.3% had liver disease, and there were excess delirium, dementia, and Parkinson’s disease but not depression. Associations, including excess mortality, were similar in the group undiagnosed with haemochromatosis. 3.4% of women with p.C282Y+/+ had baseline haemochromatosis diagnoses, with a cumulative incidence of 40.5% at age 80 years. There were excess incident liver disease (8.9% vs 6.8%; HR 1.62, 95% CI: 1.27 to 2.05, p=7.8×10-5), joint replacements and delirium, with similar results in the undiagnosed. p.C282Y/p.H63D and p.H63D+/+ men or women had no statistically significant excess fatigue or depression at baseline and no excess incident outcomes.

Conclusions

Male and female p.C282Y homozygotes experienced greater excess morbidity than previously documented, including those undiagnosed with haemochromatosis in the community. As haemochromatosis diagnosis rates were low at baseline despite treatment being considered effective, trials of screening to identify people with p.C282Y homozygosity early appear justified.
Availability of caregiver-friendly workplace policies (CFWPs): an updated international scoping review protocol
Authors: Williams Allison , Ciarloni Reed
Published: March 2024

Background

This scoping review will provide an update on the availability of caregiver-friendly workplace policies (CFWPs) internationally. As the global population continues to age, there is a growing demand for unpaid care. Many individuals providing unpaid care remain in the workforce, increasing the number of carer-employees (CEs). The goal of this review is to determine how workplaces are supporting the growing number of CEs via CFWPs compared with 5 years ago, while identifying and prioritising actions that will improve workplace support for CEs. It is expected that this scoping review will provide: valuable insights on how broader social and cultural issues shape CFWPs; identification of leading workplaces that provide CFWPs, as well as; labour sectors that require improvement. Comparative analysis between the previous published scoping reviews will allow for further conclusions with respect to the changing landscape of CFWPs over time.

Methods

This scoping review will be conducted with methodological guidance from the Joanna Briggs Institute (JBI) Reviewers Manual, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines and checklist and the scoping review protocol checklist by JBI. As recommended by the JBI, this scoping review uses the Population/Context/Concept framework to identify main concepts and appropriate inclusionary/exclusionary criteria. This review will include literature (peer-reviewed and grey) published between 1 May 2019 and 31 May 2023, in the English language, that discuss the provision of unpaid care to older adults; workplaces deemed caregiver and/or family friendly related to CFWPs and explicit identification of the workplace/organisation by name. Results will be communicated via tables, diagrams and content analysis.

Ethics approval and dissemination

Ethics approval for this study is not applicable. The results of this study will be disseminated through peer-reviewed publication and conferences.
Varying circumstances surrounding opioid toxicity deaths across ethno-racial groups in Ontario, Canada: a population-based descriptive cross-sectional study
Authors: Campbell Tonya J , Kitchen Sophie A , Tadrous Mina , Damba Cynthia , Johnson Colin H , Smoke Ashley , Crichlow Frank , Gomes Tara
Published: March 2024

Introduction

The North American toxic drug crisis has been framed as an epidemic primarily affecting white people. However, evidence suggests that deaths are rising among racialised people. Accordingly, we sought to describe and compare characteristics and circumstances of opioid toxicity deaths across ethno-racial groups.

Methods

We conducted a population-based, descriptive cross-sectional study of all individuals who died of accidental opioid toxicity in Ontario, Canada between 1 July 2017 and 30 June 2021. Decedents were categorised as Asian, black, Latin American or white. We summarised decedents’ sociodemographic characteristics, circumstances surrounding death and patterns of healthcare utilisation preceding death by ethno-racial group, and used standardised differences (SDs) to draw comparisons.

Results

Overall, 6687 Ontarians died of opioid toxicity, of whom 275 were Asian (4.1%), 238 were black (3.6%), 53 were Latin American (0.8%), 5222 were white (78.1%) and 899 (13.4%) had an unknown ethno-racial identity. Black people (median age: 35 years; SD: 0.40) and Asian people (median age: 37 years; SD: 0.30) generally died younger than white people (median age: 40 years), and there was greater male predominance in deaths among Asian people (86.2%; SD: 0.30), Latin American people (83.0%; SD: 0.21) and black people (80.3%; SD: 0.14) relative to white people (74.6%). Cocaine contributed to more deaths among black people (55.9%; SD: 0.37) and Asian people (45.1%; SD: 0.15) compared with white people (37.6%). Racialised people had a lower prevalence of opioid agonist treatment in the 5 years preceding death (black people: 27.9%, SD: 0.73; Asian people: 51.1%, SD: 0.22; white people: 61.9%).

Conclusions

There are marked differences in the risk factors, context and patterns of drug involvement in opioid toxicity deaths across ethno-racial groups, and substantial disparities exist in access to harm reduction and treatment services. Prevention and response strategies must be tailored and targeted to racialised people.
Characteristics of pulse oximetry and arterial blood gas in patients with fibrotic interstitial lung disease
Authors: Donaldson Mira A , Donohoe Kathryn , Assayag Deborah , Durand Celine , Fisher Jolene H , Johannson Kerri , Kolb Martin , Lok Stacey D , Manganas Hélène , Marcoux Veronica , Min Bohyung , Morisset Julie , Marinescu Daniel-Costin , Ryerson Christopher J
Published: March 2024

Background

Fibrotic interstitial lung disease (ILD) is frequently associated with abnormal oxygenation; however, little is known about the accuracy of oxygen saturation by pulse oximetry (SpO2) compared with arterial blood gas (ABG) saturation (SaO2), the factors that influence the partial pressure of carbon dioxide (PaCO2) and the impact of PaCO2on outcomes in patients with fibrotic ILD.

Study design and methods

Patients with fibrotic ILD enrolled in a large prospective registry with a room air ABG were included. Prespecified analyses included testing the correlation between SaO2and SpO2, the difference between SaO2and SpO2, the association of baseline characteristics with both the difference between SaO2and SpO2and the PaCO2, the association of baseline characteristics with acid-base category, and the association of PaCO2and acid-base category with time to death or transplant.

Results

A total of 532 patients with fibrotic ILD were included. Mean resting SaO2was 92±4% and SpO2was 95±3%. Mean PaCO2was 38±6 mmHg, with 135 patients having PaCO2<35 mmHg and 62 having PaCO2>45 mmHg. Correlation between SaO2and SpO2was mild to moderate (r=0.39), with SpO2on average 3.0% higher than SaO2. No baseline characteristics were associated with the difference in SaO2and SpO2. Variables associated with either elevated or abnormal (elevated or low) PaCO2included higher smoking pack-years and lower baseline forced vital capacity (FVC). Lower baseline lung function was associated with an increased risk of chronic respiratory acidosis. PaCO2and acid-base status were not associated with time to death or transplant.

Interpretation

SaO2and SpO2are weakly-to-moderately correlated in fibrotic ILD, with limited ability to accurately predict this difference. Abnormal PaCO2was associated with baseline FVC but was not associated with outcomes.
Wrestling with a ghost: facing an opponent I can neither see nor clinch – the experience of professional wrestlers who have suffered an ACL injury
Authors: Piussi Ramana , Nilsson Elin , Karlsson Hannah , Hägglund Martin , Ivarsson Andreas , Samuelsson Kristian , Holmberg Hans-Christer , Hamrin Senorski Eric
Published: March 2024

This study explored professional wrestlers’ experiences of the consequences of an anterior cruciate ligament (ACL) injury and their perception of whether the ACL injury could have been prevented. We interviewed 10 professional wrestlers (60% women, age range 21–34) treated with ACL reconstruction with semistructured interviews. Transcripts were analysed using qualitative content analysis: One major theme, ‘Wrestling with a ghost: facing an opponent I can neither see nor clinch’, supported by five main categories, emerged from the collected data. The five main categories were: My ACL injury: bad luck or bad planning?; The way back: a fight to return to sport; Only performance counts; The injury’s impact on life: a wrestling with emotions; In hindsight, personal growth. Professional wrestlers who experienced an ACL injury expressed that not only the injury itself but also the subsequent recovery posed major challenges that they did not know how to deal with and that, in some cases, ended the athletes’ wrestling careers. Professional wrestlers attributed their ACL injuries to bad luck or large training loads and wished that they had more support from the wrestling community when injured.
The role of COVID-19 vaccines in preventing post-COVID-19 thromboembolic and cardiovascular complications
Authors: Mercadé-Besora Núria , Li Xintong , Kolde Raivo , Trinh Nhung TH , Sanchez-Santos Maria T , Man Wai Yi , Roel Elena , Reyes Carlen , Delmestri Antonella , Nordeng Hedvig M E , Uusküla Anneli , Duarte-Salles Talita , Prats Clara , Prieto-Alhambra Daniel , Jödicke Annika M , Català Martí
Published: March 2024

Objective

To study the association between COVID-19 vaccination and the risk of post-COVID-19 cardiac and thromboembolic complications.

Methods

We conducted a staggered cohort study based on national vaccination campaigns using electronic health records from the UK, Spain and Estonia. Vaccine rollout was grouped into four stages with predefined enrolment periods. Each stage included all individuals eligible for vaccination, with no previous SARS-CoV-2 infection or COVID-19 vaccine at the start date. Vaccination status was used as a time-varying exposure. Outcomes included heart failure (HF), venous thromboembolism (VTE) and arterial thrombosis/thromboembolism (ATE) recorded in four time windows after SARS-CoV-2 infection: 0–30, 31–90, 91–180 and 181–365 days. Propensity score overlap weighting and empirical calibration were used to minimise observed and unobserved confounding, respectively.

Fine-Gray models estimated subdistribution hazard ratios (sHR). Random effect meta-analyses were conducted across staggered cohorts and databases.

Results

The study included 10.17 million vaccinated and 10.39 million unvaccinated people. Vaccination was associated with reduced risks of acute (30-day) and post-acute COVID-19 VTE, ATE and HF: for example, meta-analytic sHR of 0.22 (95% CI 0.17 to 0.29), 0.53 (0.44 to 0.63) and 0.45 (0.38 to 0.53), respectively, for 0–30 days after SARS-CoV-2 infection, while in the 91–180 days sHR were 0.53 (0.40 to 0.70), 0.72 (0.58 to 0.88) and 0.61 (0.51 to 0.73), respectively.

Conclusions

COVID-19 vaccination reduced the risk of post-COVID-19 cardiac and thromboembolic outcomes. These effects were more pronounced for acute COVID-19 outcomes, consistent with known reductions in disease severity following breakthrough versus unvaccinated SARS-CoV-2 infection.
Posterior condylar canal dural arteriovenous fistula: anatomical, symptomatological, and therapeutic considerations in comparison with hypoglossal canal dural arteriovenous fistula
Authors: Maekawa Hidetsugu , Lindgren Antti , Krings Timo
Published: March 2024

Background

Posterior condylar canal dural arteriovenous fistulas (dAVFs) are extremely rare.

Methods

We report a case series and literature review of posterior condylar canal dAVFs and discuss similarities and differences between posterior condylar and hypoglossal canal dAVFs with respect to the related vascular anatomy, angioarchitecture of the fistula, presentation, and treatment.

Results

Four cases of posterior condylar canal dAVF were identified at our institutions and six cases were identified in the literature. Posterior condylar canal dAVFs were predominantly frequent in relatively young women. All patients presented with pulsatile tinnitus. There was no history of hemorrhage as there was no cortical venous reflux. This is different from hypoglossal canal dAVFs which can present with myelopathy or hemorrhage from cortical venous reflux. Transvenous embolization was safe and eliminated the symptoms. Palliative transarterial embolization can be an option to mitigate the symptoms, although there is a potential risk of cranial nerve palsy or lateral medullary stroke.

Conclusions

Posterior condylar canal dAVFs are generally benign lesions. However, intolerable tinnitus may require intervention. Transvenous embolization is effective and safe.