bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of exercise interventions on physical, psychological and social outcomes in frail older adults: An overview of systematic reviews
Authors: Kong Ling‐Na , Lyu Qiong , Liu Dun‐Xiu , Hu Ping
Published: May 2024

Aims

To comprehensively synthesise existing evidence from systematic reviews regarding the effects of exercise interventions on physical, psychological and social outcomes in frail older adults to provide reference for clinical practice.

Background

Frailty is highly prevalent in older adults and associated with increased adverse health outcomes. Some systematic reviews have assessed the effectiveness of exercise interventions in frail older adults with varied inclusion criteria, methodology quality, types of exercise and outcome measures.

Design

An overview of systematic reviews reported following the PRISMA checklist.

Methods

PubMed, Embase, CINAHL, Web of Science and Cochrane database were searched from inception until June 2023 to identify relevant systematic reviews with or without meta‐analysis of randomised controlled trails. Two reviewers independently selected articles, extracted data, assessed quality and summarised findings.

Results

A total of 17 systematic reviews were included, with methodology quality varying from moderate to critically low. The most frequent types of exercise were multicomponent exercise and resistance‐based exercise in community and long‐term care facilities, respectively. Exercise interventions had positive effects on most physical outcomes and depression, but inconsistent effects on cognitive function and quality of life. The quality of the evidence for most outcomes was low and very low.

Conclusions

This overview highlights the importance of exercise interventions to improve physical, psychological and social aspects in frail older adults and provides evidence on characteristics of exercise interventions for frailty in various settings.

Relevance to clinical practice

Multicomponent exercise and resistance‐based exercise should be recommended for frail older adults. There is a need of more well‐designed research with large sample size and validated definition of frailty. Long‐term effects, adherence during and after exercise interventions, adverse events and cost‐effectiveness should be emphasised in future studies.

Trial and Protocol Registration

The overview protocol was registered on the International Prospective Register of Systematic reviews (CRD 42021281327).

Patient or Public Contribution

No patient or public contribution.

Reporting Method

The Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) guidelines were applied to report the results.
Fracture load of chairside CAD‐CAM veneers fabricated with pre‐and fully crystalized lithium disilicate ceramics
Authors: Jurado Carlos A. , Yeh Jacquelyn S. , Vidal Cristina M. P. , Cho Seok‐Hwan , Abuhammoud Salahaldeen
Published: May 2024

Purpose

To evaluate the fracture load of chairside computer‐aided design and computer‐aided manufacturing (CAD‐CAM) veneers fabricated with two conventional pre‐crystallized and two fully crystallized lithium disilicate ceramic materials.

Materials and Methods

Seventy‐five chairside CAD‐CAM veneers (15 specimens/group) for maxillary right central incisors were fabricated with different lithium disilicate brands: (1) IPS e.max CAD; (2) Amber Mill; (3) Cerec Tessera; (4) n!ce Straumann; and (5) GC Initial LiSi Block. Restorations were cemented with resin luting cement (Variolink Esthetic, Ivoclar) to 3D‐printed resin dies. Bonded restorations received 5000 thermal cycles and then were loaded until fracture. Statistical analysis included One‐Way ANOVA.

Results

Conventional pre‐crystallized e.max CAD displayed the highest fracture load value (640 N), followed by fully‐crystallized n!ce Straumann (547 N), pre‐crystallized Cerec Tessera (503 N), pre‐crystallized Amber Mill (476 N), respectively; fully‐crystallized GC Initial LiSi Block (431 N) displayed the lowest values. When comparing the fracture load of recent lithium disilicate ceramic material to the e.max group, which acted as the control, significant differences were noted. The LiSi Block GC group, in particular, had considerably higher mean difference values (208.867, p < 0.001, 95% CI [89.63, 328.10]), as did the Amber Mill group (164.200, p = 0.002, 95% CI [44.96, 283.44]) and CEREC Tessera group (137.533, p = 0.016, 95% CI [18.30, 256.77]). The e.max and n!ce Straumann groups had no statistically significant differences in mean scores (92.933, p = 0.198, 95% CI [−26.30, 212.17]). These findings imply that the clinical performance of recent lithium disilicate veneers varies when compared to the e.max CAD group.

Conclusions

The fracture load of chairside CAD‐CAM lithium disilicate veneers for maxillary central incisors varies according to the type of ceramic brands. Conventional pre‐crystallized e.max CAD displayed higher fracture load than the recent pre‐ and fully‐crystallized lithium disilicate materials, emphasizing the significance of choosing the right product based on the desired clinical outcome.
Congenital erythropoietic porphyria
Authors: To‐Figueras Jordi , Erwin Angelika L. , Aguilera Paula , Millet Oscar , Desnick Robert J.
Published: May 2024

Congenital erythropoietic porphyria (CEP) is a rare autosomal recessive disease due to the deficient, but not absent, activity of uroporphyrinogen III synthase (UROS), the fourth enzyme in the heme biosynthesis pathway. Biallelic variants in the UROS gene result in decreased UROS enzymatic activity and the accumulation of non‐physiologic Type I porphyrins in cells and fluids. Overproduced uroporphyrins in haematopoietic cells are released into the circulation and distributed to tissues, inducing primarily hematologic and dermatologic symptoms. The clinical manifestations vary in severity ranging from non‐immune hydrops fetalis in utero to mild dermatologic manifestations in adults. Here, the biochemical, molecular and clinical features of CEP as well as current and new treatment options, including the rescue of UROS enzyme activity by chaperones, are presented.
The costs of Suaahara II, a complex scaled‐up multisectoral nutrition programme in Nepal
Authors: Choo Esther M. , Kemp Christopher G. , Sagun K. C. , Paudel Uttam , Wun Jolene , Cunningham Kenda , Acharya Pushpa , Rana Pooja Pandey , Levin Carol
Published: May 2024

Limited evidence exists on the costs of scaled‐up multisectoral nutrition programmes. Such evidence is crucial to assess intervention value and affordability. Evidence is also lacking on the opportunity costs of implementers and participants engaging in community‐level interventions. We help to fill this gap by estimating the full financial and economic costs of the United States Agency for International Development‐funded Suaahara II (SII) programme, a scaled‐up multisectoral nutrition programme in Nepal (2016–2023). We applied a standardized mixed methods costing approach to estimate total and unit costs over a 3.7‐year implementation period. Financial expenditure data from national and subnational levels were combined with economic cost estimates assessed using in‐depth interviews and focus group discussions with staff, volunteers, community members, and government partners in four representative districts. The average annual total cost was US$908,948 per district, with economic costs accounting for 47% of the costs. The annual unit cost was US$132 per programme participant (mother in the 1000‐day period between conception and a child's second birthday) reached. Annual costs ranged from US$152 (mountains) to US$118 (plains) per programme participant. Personnel (63%) were the largest input cost driver, followed by supplies (11%). Community events (29%) and household counselling visits (17%) were the largest activity cost drivers. Volunteer cadres contributed significant time to the programme, with female community health volunteers spending a substantial amount of time (27 h per month) on SII activities. Multisectoral nutrition programmes can be costly, especially when taking into consideration volunteer and participant opportunity costs. This study provides much‐needed evidence of the costs of scaled‐up multisectoral nutrition programmes for future comparison against benefits.
Knowing what to do
Authors: Jerzak Ethan , Kocurek Alexander W.
Published: May 2024

Much has been written on whether practical knowledge (knowledge‐how) reduces to propositional knowledge (knowledge‐that). Less attention has been paid to what we call deliberative knowledge (knowledge‐to), i.e., knowledge ascriptions embedding other infinitival questions, like where to meet, when to leave, and what to bring. We offer an analysis of knowledge‐to and argue on its basis that, regardless of whether knowledge‐how reduces to knowledge‐that, no such reduction of knowledge‐to is forthcoming. Knowledge‐to, unlike knowledge‐that and knowledge‐how, requires the agent to have formed certain conditional intentions. We discuss the philosophical implications for knowledge‐how, deliberative questions, and virtue.
Artificial intelligence as a prediction tool for orthognathic surgery assessment
Authors: de Oliveira Pedro Henrique José , Li Tengfei , Li Haoyue , Gonçalves João Roberto , Santos‐Pinto Ary , Gandini Junior Luiz Gonzaga , Cevidanes Lucia Soares , Toyama Claudia , Feltrin Guilherme Paladini , Campanha Antonio Augusto , de Oliveira Junior Melchiades Alves , Bianchi Jonas
Published: May 2024

Introduction

An ideal orthodontic treatment involves qualitative and quantitative measurements of dental and skeletal components to evaluate patients' discrepancies, such as facial, occlusal, and functional characteristics. Deciding between orthodontics and orthognathic surgery remains challenging, especially in borderline patients. Advances in technology are aiding clinical decisions in orthodontics. The increasing availability of data and the era of big data enable the use of artificial intelligence to guide clinicians' diagnoses. This study aims to test the capacity of different machine learning (ML) models to predict whether orthognathic surgery or orthodontics treatment is required, using soft and hard tissue cephalometric values.

Methods

A total of 920 lateral radiographs from patients previously treated with either conventional orthodontics or in combination with orthognathic surgery were used, comprising n = 558 Class II and n = 362 Class III patients, respectively. Thirty‐two measures were obtained from each cephalogram at the initial appointment. The subjects were randomly divided into training (n = 552), validation (n = 183), and test (n = 185) datasets, both as an entire sample and divided into Class II and Class III sub‐groups. The extracted data were evaluated using 10 machine learning models and by a four‐expert panel consisting of orthodontists (n = 2) and surgeons (n = 2).

Results

The combined prediction of 10 models showed top‐ranked performance in the testing dataset for accuracy, F1‐score, and AUC (entire sample: 0.707, 0.706, 0.791; Class II: 0.759, 0.758, 0.824; Class III: 0.822, 0.807, 0.89).

Conclusions

The proposed combined 10 ML approach model accurately predicted the need for orthognathic surgery, showing better performance in Class III patients.
The impact of performance information on citizen perceptions of school district efficiency, trust in government, and support for taxes
Authors: Brunner Eric J. , Kim Yusun , Robbins Mark D. , Simonsen Bill
Published: May 2024

We report the results of a random assignment experiment that examines the effect of revealing actual school district performance on three important outcomes: perceptions of efficiency, trust in government, and support for higher taxes for increased school spending. We randomly assign survey respondents to a control group or experimental condition that includes information about how their school district's test scores compare to their state average. Our study includes 2604 observations from an on‐line panel fielded in the United States from October through December, 2022 which allows us to precisely estimate the effect of performance information on outcomes. We find that providing high‐performance information has significant and substantial effects that improve efficiency perceptions, trust in the school district, and support for taxes.
Compliance and assessment outcomes in the personal property tax
Authors: Propheter Geoffrey
Published: May 2024

Personal property taxpayers must decide the sort and quality of property information to report to assessors. Differences in the extent of compliance across personal property owners may result in assessors over‐ or underassessing noncompliers relative to compliers, which has policy implications for assessment equity and noncompliance penalties. Using nonparametric matching on a panel of restaurants from Dallas County, Texas from 2008 through 2022, I find consistent evidence that noncompliers are underassessed relative to compliers. Results suggest that Texas's statutory penalty rate for noncompliance should be almost twice as much for the rational property owner to be indifferent to compliance.
Phytophthora and Phytopythium species associated with walnut dieback in plantations of northern Patagonia, Argentina
Authors: Marfetan Jorge A. , Fernández Diana , Gallo Ana L. , Vélez María L.
Published: May 2024

The walnut industry in Argentina has grown in recent years, especially in northern Patagonia. However, this expansion has also brought new challenges, including the emergence of diseases threatening the health and productivity of walnut plantations. One of the most important diseases affecting walnut crops worldwide is ‘ink disease’ or ‘walnut dieback'. The aim of this study was to characterize ink disease, identify the aetiological agents, and estimate its incidence in walnut orchards of northern Patagonia, Argentina. Symptomatic trees were observed in the seven surveyed walnut orchards, showing a range of symptoms, including chlorosis and wilting, stem cankers and desiccation. In vivo assay and molecular analyses revealed that not only Phytophthora (P.) but also Phytopythium (Ph.) species are the causal agents of the disease, with P. drechsleri, Ph. mercuriale and Ph. vexans  being the most virulent over the commonly used rootstock Juglans hindsii. Notably, Ph. vexans was the most frequently isolated pathogen, suggesting its prevalence and potential impact on the regional walnut industry. Overall, this study provides critical insights into the prevalence and impact of Phytophthora and Phytopythium species on walnut health in northern Patagonia. The presence of multiple pathogenic oomycete species raises concerns about the health of walnut orchards, as well as the potential risk of pathogen transmission to other fruit crops in the region. The findings will help growers to develop better cultural practices and implement measures to guarantee the sustainability of the walnut industry in Patagonia.
Process evaluation of the CO‐WORK‐CARE model: Collaboration and a person‐centred dialogue meeting for patients with common mental disorder in primary health care
Authors: Petersson Eva‐Lisa , Törnbom Karin , Björkelund Cecilia , Jerlock Margaretha , Hange Dominique , Udo Camilla , Svenningsson Irene
Published: May 2024

Rationale

To ensure optimal patient care based on evidence, it is crucial to understand how to implement new methods in practice. However, intervention studies often overlook parts of the implementation process. A comprehensive process evaluation is necessary to understand why interventions succeed or fail in specific contexts and to integrate new knowledge into daily practice. This evaluation examines the full implementation of the Co‐Work‐Care model in Swedish primary healthcare to identify strengths and weaknesses.

Aim

This study aimed to evaluate the process of implementing the CO‐WORK‐CARE model that focuses on close collaboration and the use of a person‐centred dialogue meeting in primary healthcare for patients on sick leave due to common mental disorders.

Method

The CO‐WORK‐CARE model emphasises collaboration among the GP, rehabilitation coordinator and care manager, along with person‐centred dialogue meetings involving employers. Following UK Medical Research Council guidelines, we conducted a process evaluation. Data from previous studies were reanalysed. We also analysed field notes and meeting notes using Malterud's qualitative method.

Results

The evaluation identified key facilitators for model implementation, including regular visits by facilitators and guidance from the research physician. Peer support meetings also bolstered implementation. However, challenges emerged due to conflicts with existing structures and limitations in person‐centred dialogue meetings.

Conclusion

Adapting the CO‐WORK‐CARE model to Swedish primary care is feasible and beneficial, with collaboration among the care manager, rehabilitation coordinator and GP and person‐centred dialogue meetings. Thorough preparations, ongoing facilitator and peer support and integrated information enhanced implementation efficiency, despite challenges posed by existing structures.
Work Stress Among Nigerian Electronic Technology Teachers: Exploring its Influence on Job Performance with Stress Beliefs as Moderator
Authors: Shodeinde Abidemi , Ogbuanya Theresa
Published: May 2024

Electronic technology teachers are among professionals who may face adverse effects of stress due to the nature of their job. This study explores the relationship between work stress and job performance among electronic technology teachers and investigates the role of stress beliefs in moderating this relationship. Purposive sampling was used to select 123 electronic technology teachers and 22 heads of departments in government-owned universities in Nigeria, who provided data for the study. Results indicate that work stress significantly predicts job performance among electronic technology teachers (β = .60, p < .001). Additionally, stress beliefs were found to be a significant predictor of job performance (β = .61, p < .001). Furthermore, stress beliefs were found to moderate the relationship between work stress and job performance. The findings suggest that teachers' job performance is influenced by both work stress and stress beliefs. Positive stress beliefs are associated with improved job performance, while negative stress beliefs may lead to decrements in performance. Understanding the interplay between work stress, stress beliefs, and job performance can inform interventions to improve the performance of electronic technology teachers and, subsequently, the skill acquisition of their students.
Developing Structural and Civil Engineering (SCE) Curriculum in sub-Sahara African Nations on the Foundation of the Developed Nations, in Training, Practices and Technology – Nigeria as Case Study
Authors: Fapohunda Christopher , Abioye Adekunle , Osanyinlokun Oluwatoyin
Published: May 2024

The training and practice of structural and civil engineering (SCE) education in developing nations, especially the sub-Sahara African nations, are not as robust and dynamic when compared to what are operating in the developed Nations of the World. Available resources in the public domain show strong evidence of a sustained fundamental link of SCE training and practice of the developed nations to the classical training of the ancient Caesar’s Rome. This paper looks into the training and practice of structural and civil engineering about 2000 years ago in the imperial Caesar’s Rome. The data used were collected from the information available from the public domain. The results showed that: (i) the curriculum for SCE education was very wide and deep and it is in partnership with the State (ii) the training together with the attendant skill development program/schemes began early at Roman home, (iii) SCE is deeply connected to Latin and Greek languages, and (iv) a heavy dependence on classical philosophical studies existed.  It is thus concluded that the curriculum for SCE engineering in developing nations be tied to these foundations.
Mathematical Competence of Practicing Engineers in Engineering Tasks
Authors: Sahroni Mohamad Norhakim , Mohd Puzi Nur Izrah Binti , Syed Yusof Sharifah Kamilah , Ismail Zaleha
Published: May 2024

Due to the complexity of the problems that engineers must solve; they must receive training in real-life problem-solving scenarios. The Engineering Accreditation Council (EAC) and Board of Engineering of Malaysia (BEM) place a significant emphasis on engineering competencies in Program Learning Outcome (PLO), including the ability to apply mathematical knowledge to engineering problems. However, students at universities face challenges in understanding engineering mathematics, as they are not typically taught by specialized instructors. Therefore, a phenomenological approach was utilized in this study to identify the mathematical competencies (MC) among practicing engineers in manufacturing workplaces. Three engineers were selected as potential respondents, but only one participated in the study. Data was collected through intensive interviews conducted in the workplace. The phenomenological reduction technique was employed, utilizing Epoche, Identification of significant statements, Meaning Units, Textural Description of the Experience, Structural Descriptions of the Experience, and Textural-Structural Synthesis phenomenology for data analysis. This method offers a logical, systematic, and coherent design that produces an essential description of the experience. The study's findings indicate that mathematical competencies frequently used by engineers include mathematical thinking, problem-solving skills, and mathematical communication. This study could inform instructors about developing mathematical competencies relevant to real-life problem-solving in engineering activities and academic programs at their institutions.
Integrated Mass and Energy Balance Course Project using Spreadsheet for a Chemical Engineering Degree Program
Authors: Mustaffa Azizul Azri , Jamaluddin Jamarosliza , Zubir Muhammad Afiq
Published: May 2024

In this innovation, team projects from two courses offered in different semesters are integrated. On top of that, students are trained to use a spreadsheet-based tool to solve the problem in the project. Those two courses are Mass Balance (SETK 1123) and Energy Balance (SETK 2133) offered to Chemical Engineering students in Universiti Teknologi Malaysia at their second and third semester. The main objective of the innovation is to scaffold the students’ understanding of the problems given to them in the projects. At the end of the project, they should be able to clearly see the overall processes in a typical chemical industry, starting from raw materials to the targeted products, by-products, and wastes produced. In addition to that, the projects also foster digital skills by enhancing the students’ skills to use the spreadsheet tools to solve Chemical Engineering problems. This is inline with their study as the students learnt about computer programming and spreadsheet tools in their first semester. From the students’ reflections, it can be concluded that this innovation are able to increase the comprehension of the students on the two courses, increase the skills in using spreadsheet tools for solving problems and also inculcate critical thinking and problem solving skills.
Selection of Phase Change Material for Latent Heat Thermal Energy Storage Using a Hairpin Heat Exchanger: Numerical Study
Authors: Kumari Pallavi , Raj Akash , Ghosh Debasree
Published: May 2024

Phase change materials (PCMs) are promising for storing thermal energy as latent heat, addressing power shortages. Growing demand for concentrated solar power systems has spurred the development of latent thermal energy storage, offering steady temperature release and compact heat exchanger designs. This study explores melting and solidification in a hairpin-type heat exchanger (HEX) using three PCMs (RT 50, RT 27, and RT 35). A 3D model of the HEX is drawn using Ansys-workbench. High-temperature fluid/low-temperature fluid (HTF/LTF) with Stefan numbers (0.44, 0.35, and 0.23) flows through the inner pipe to charge the outer pipe's PCM. The Enthalpy-porosity model is used to study the melting and solidification of various PCMs, and the results were compared. Also, individual thermophysical properties that affect the heat transfer during the melting and solidification process have been discussed. It is observed that low thermal conductivity material with high latent heat is preferred for cold climates. In this study, RT 27 excels in cold climates due to extended solidification time, while RT 50 is effective in tropical regions due to its high melting points and lower latent heat.
Integrated Performance of a Modular Biomass Boiler With a Combined Heat and Power Industrial Rankine Cycle and Supplementary sCO2 Brayton Cycle
Authors: Haffejee Rashid A. , Rousseau Pieter , Laubscher Ryno
Published: May 2024

In this paper, the integrated performance of a modular biomass boiler with an existing industrial Rankine steam heat and power cycle and a supplementary supercritical-carbon dioxide (sCO2) Brayton cycle is analyzed. The aim is to leverage the high efficiency supplementary sCO2 cycle to increase net generation and energy efficiency from the existing biomass boiler. Two sCO2 heater configurations situated within the flue gas flow path are investigated, namely a single convective-dominant heater, and a dual heater configuration with a radiative and a convective heater. A quasi-steady-state 1D model was developed to simulate the integrated cycle, including detailed component characteristics for the Rankine and Brayton cycles. The model solves the mass, energy, momentum, and species balance equations. The system is analyzed for three cases: (i) the existing Rankine cycle without the sCO2 integration, (ii) with the single convective-dominant sCO2 heater configuration, and (iii) the dual sCO2 heater configuration. The results show the required rate of overfiring for the sCO2 configurations, with a 15.3% increase in fuel flowrate resulting in an additional 21.2% in net power output. The model quantifies the impact of the sCO2 heaters, with reduced heat uptakes for downstream boiler heat exchangers. Furnace water wall heat uptake increased due to overfiring, offsetting the reduced heat uptakes at downstream evaporative heat exchangers. The dual configuration has more impact on Rankine cycle operation due to the radiative sCO2 heater placement in front of the second superheater, absorbing some of the direct radiation from the furnace.
Critical Tiriti Analysis of He Mata whāriki, he matawhānui
Authors: Came Heather Anne , Wilkinson Hana , Berghan Grant , Manson Leanne
Published: May 2024

Hapū are interested in local government due to their decision-making influence over the cultural, social, economic and environmental wellbeing of a district that can enable or restrict tino rangatiratanga. In Aotearoa, the debate about Indigenous engagement in local government is shaped by Te Tiriti o Waitangi responsibilities to protect and promote the interests of hapū. There is currently a major review of local government underway, which is providing a once-in- a-generation opportunity to have a courageous conversation about the future of this sector. This paper presents a Critical Tiriti Analysis (CTA) examining to what extent He mata whāriki, he matawhānui–the local government draft review report–has engaged with te Tiriti. It includes a postscript on the final report released while this paper was under review. In the draft report we found variable engagement. It was strongest regarding relationships and governance and weaker in relation to tino rangatiratanga, ōritetanga (equitable citizenship) and wairuatanga (spiritual domain). This review challenges local and regional government to lift their game in relation to their te Tiriti responsibilities and concludes that local Māori solutions, mātauranga Māori knowledge and leadership are required at all levels of local and regional government. National states of emergency and devastating disasters in the context of Cyclone Gabrielle will no longer wait for the bureaucracy of the local government.
Fast collective motions of backbone in transmembrane α helices are critical to water transfer of aquaporin
Authors: Tan Huan , Duan Mojie , Xie Huayong , Zhao Yongxiang , Liu Hui , Yang Minghui , Liu Maili , Yang Jun
Published: May 2024

Fast collective motions are widely present in biomolecules, but their functional relevance remains unclear. Herein, we reveal that fast collective motions of backbone are critical to the water transfer of aquaporin Z (AqpZ) by using solid-state nuclear magnetic resonance (ssNMR) spectroscopy and molecular dynamics (MD) simulations. A total of 212 residue site–specific dipolar order parameters and 158
15
N spin relaxation rates of the backbone are measured by combining the
13
C- and
1
H-detected multidimensional ssNMR spectra. Analysis of these experimental data by theoretic models suggests that the small-amplitude (~10°) collective motions of the transmembrane α helices on the nanosecond-to-microsecond timescales are dominant for the dynamics of AqpZ. The MD simulations demonstrate that these collective motions are critical to the water transfer efficiency of AqpZ by facilitating the opening of the channel and accelerating the water-residue hydrogen bonds renewing in the selectivity filter region.
Phenome-wide identification of therapeutic genetic targets, leveraging knowledge graphs, graph neural networks, and UK Biobank data
Authors: Middleton Lawrence , Melas Ioannis , Vasavda Chirag , Raies Arwa , Rozemberczki Benedek , Dhindsa Ryan S. , Dhindsa Justin S. , Weido Blake , Wang Quanli , Harper Andrew R. , Edwards Gavin , Petrovski Slavé , Vitsios Dimitrios
Published: May 2024

The ongoing expansion of human genomic datasets propels therapeutic target identification; however, extracting gene-disease associations from gene annotations remains challenging. Here, we introduce Mantis-ML 2.0, a framework integrating AstraZeneca’s Biological Insights Knowledge Graph and numerous tabular datasets, to assess gene-disease probabilities throughout the phenome. We use graph neural networks, capturing the graph’s holistic structure, and train them on hundreds of balanced datasets via a robust semi-supervised learning framework to provide gene-disease probabilities across the human exome. Mantis-ML 2.0 incorporates natural language processing to automate disease-relevant feature selection for thousands of diseases. The enhanced models demonstrate a 6.9% average classification power boost, achieving a median receiver operating characteristic (ROC) area under curve (AUC) score of 0.90 across 5220 diseases from Human Phenotype Ontology, OpenTargets, and Genomics England. Notably, Mantis-ML 2.0 prioritizes associations from an independent UK Biobank phenome-wide association study (PheWAS), providing a stronger form of triaging and mitigating against underpowered PheWAS associations. Results are exposed through an interactive web resource.
Speed-dependent bacterial surface swimming
Authors: Liu Qiuqian , Zhang Chi , Zhang Rongjing , Yuan Junhua
Published: May 2024

Solid surfaces submerged in liquid in natural environments alter bacterial swimming behavior and serve as platforms for bacteria to form biofilms. In the initial stage of biofilm formation, bacteria detect surfaces and increase the intracellular level of the second messenger c-di-GMP, leading to a reduction in swimming speed. The impact of this speed reduction on bacterial surface swimming remains unclear. In this study, we utilized advanced microscopy techniques to examine the effect of swimming speed on bacterial surface swimming behavior. We found that a decrease in swimming speed reduces the cell-surface distance and prolongs the surface trapping time. Both these effects would enhance bacterial surface sensing and increase the likelihood of cells adhering to the surface, thereby promoting biofilm formation. We also examined the surface-escaping behavior of wild-type
Escherichia coli
and
Pseudomonas aeruginosa
, noting distinct surface-escaping mechanisms between the two bacterial species.

IMPORTANCE

In the early phase of biofilm formation, bacteria identify surfaces and increase the intracellular level of the second messenger c-di-GMP, resulting in a decrease in swimming speed. Here, we utilized advanced microscopy techniques to investigate the impact of swimming speed on bacterial surface swimming, focusing on
Escherichia coli
and
Pseudomonas aeruginosa
. We found that an increase in swimming speed led to an increase in the radius of curvature and a decrease in surface detention time. These effects were explained through hydrodynamic modeling as a result of an increase in the cell-surface distance with increasing swimming speed. We also observed distinct surface-escaping mechanisms between the two bacterial species. Our study suggests that a decrease in swimming speed could enhance the likelihood of cells adhering to the surface, promoting biofilm formation. This sheds light on the role of reduced swimming speed in the transition from motile to sedentary bacterial lifestyles.
Answer to May 2024 Photo Quiz
Authors: Attaway Christopher C. , Tobin Erick , Rhoads Daniel D.
Published: May 2024

Read the full article for the answer.
Update on human herpesvirus 7 pathogenesis and clinical aspects as a roadmap for future research
Authors: Verbeek Rianne , Vandekerckhove Linos , Van Cleemput Jolien
Published: May 2024

Human herpesvirus 7 (HHV-7) is a common virus that is associated with various human diseases including febrile syndromes, dermatological lesions, neurological defects, and transplant complications. Still, HHV-7 remains one of the least studied members of all human betaherpesviruses. In addition, HHV-7-related research is mostly confined to case reports, while
in vitro
or
in vivo
studies unraveling basic virology, transmission mechanisms, and viral pathogenesis are sparse. Here, we discuss HHV-7-related literature linking clinical syndromes to the viral life cycle, epidemiology, and viral immunopathogenesis. Based on our review, we propose a hypothetical model of HHV-7 pathogenesis inside its host. Furthermore, we identify important knowledge gaps and recommendations for future research to better understand HHV-7 diseases and improve therapeutic interventions.
Initiation of the Shape Memory Effect by Fast Neutron Irradiation
Authors: Bobrovskii V. I. , Afanasyev S. V. , Voronin V. I. , Kazantsev V. A. , Kataeva N. V. , Parkhomenko V. D. , Proskurnina N. V. , Sagaradze V. V.
Published: May 2024

A sample made from a ribbon of austenitic-martensitic steel 0.3C–13Cr–10Mn–3Si–1V, pre-deformed in the shape of a circular arc with a deflection of 3 mm, was subjected to fast neutron irradiation with a fluence of 6 × 1019 cm–2 in the vertical wet channel of the IVV-2M reactor at a temperature of 80°C. This material belongs to the class of stainless manganese austenitic steels with the shape memory effect (SME). Initially, it was expected that irradiation would reduce the SME magnitude after subsequent heating of the studied sample in comparison with the reference one. But instead, the manifestation of SME was revealed already after irradiation, with a decrease in the deflection by approximately 21%. Control experiments confirmed that the lower temperature limit for the manifestation of the SME in this material lies at 120ºC and is absent at 80°C. This allows us to conclude that the effect observed is the result of neutron irradiation.
Acute ischaemic stroke and deep vein thrombosis following snakebite
Authors: Das Dhriti Sundar , Mohapatra Rakesh Kumar , Mohanty Rashmi Ranjan , Patel Ranjan Kumar
Published: May 2024

Snakebite envenomation remains a neglected tropical public health issue claiming thousands of lives every year. It is a common medical emergency and a threat to the impoverished populations of low-income and middle-income countries including India. A combination of ischaemic stroke and deep vein thrombosis is a devastating duo complication of snake bite, with no literature report to date. Here, the authors report an unusual case of a young woman developing ischaemic stroke and deep vein thrombosis following snakebite even after the use of antivenom. MRI brain showed right thalamic infarct with haemorrhagic transformation and, ultrasound Doppler revealed right lower limb deep vein thrombosis. The pathophysiology of deep vein thrombosis and ischaemic stroke is complex. It is believed that the activation of the coagulation cascade, complement system together with endothelial injury and immune activation leads to inflammation, thrombosis and occlusion of smaller and even larger vessels.
Medical education with large language models in ophthalmology: custom instructions and enhanced retrieval capabilities
Authors: Sevgi Mertcan , Antaki Fares , Keane Pearse A
Published: May 2024

Foundation models are the next generation of artificial intelligence that has the potential to provide novel use cases for healthcare. Large language models (LLMs), a type of foundation model, are capable of language comprehension and the ability to generate human-like text. Researchers and developers have been tuning LLMs to optimise their performance in specific tasks, such as medical challenge problems. Until recently, tuning required technical programming expertise, but the release of custom generative pre-trained transformers (GPTs) by OpenAI has allowed users to tune their own GPTs with natural language. This has the potential to democratise access to high-quality bespoke LLMs globally. In this review, we provide an overview of LLMs, how they are tuned and how custom GPTs work. We provide three use cases of custom GPTs in ophthalmology to demonstrate the versatility and effectiveness of these tools. First, we present ‘EyeTeacher’, an educational aid that generates questions from clinical guidelines to facilitate learning. Second, we built ‘EyeAssistant’, a clinical support tool that is tuned with clinical guidelines to respond to various physician queries. Lastly, we design ‘The GPT for GA’, which offers clinicians a comprehensive summary of emerging management strategies for geographic atrophy by analysing peer-reviewed documents. The review underscores the significance of custom instructions and information retrieval in tuning GPTs for specific tasks in ophthalmology. We also discuss the evaluation of LLM responses and address critical aspects such as privacy and accountability in their clinical application. Finally, we discuss their potential in ophthalmic education and clinical practice.
Efficiency assessment of follow-up methodology of patients with knee replacement to predict post-surgical functionality: a protocol for randomised control PROKnee trial
Authors: San Martín Valenzuela Constanza , Tabarés-Seisdedos Rafael , Payá Rubio Alfonso , Correa-Ghisays Patricia , Pedrero-Sánchez José-Francisco , Silvestre Muñoz Antonio
Published: May 2024

Introduction

Even when total knee arthroplasty (TKA) is an extended treatment, most patients experience a suboptimal evolution after TKA. The objectives of this study are the following: (1) to determine the effectiveness of two different prosthesis stabilisation systems on the functionality in activities of daily life, and (2) to determine prognostic biomarkers of knee prosthesis function based on radiological information, quantification of cytokines, intra-articular markers and biomechanical functional evaluation to predict successful evolution.

Methods and analysis

The PROKnee trial was designed as a randomised controlled patient-blinded trial with two parallel groups that are currently ongoing. The initial recruitment will be 99 patients scheduled for their first TKA, without previous prosthesis interventions in lower limbs, who will be randomly divided into two groups that differed in the stabilisation methodology incorporated in the knee prosthesis: the MEDIAL-pivot group and the CENTRAL-pivot group. The maximum walking speed will be reported as the primary outcome, and the secondary results will be patient-reported questionnaires related to physical status, cognitive and mental state, radiological test, laboratory analysis and biomechanical instrumented functional performance, such as the 6-minute walking test, timed up-and-go test, gait, sit-to-stand, step-over, and ability to step up and down stairs. All the results will be measured 1 week before TKA and at 1.5, 3, 6 and 12 months after surgery.

Ethics and dissemination

All procedures were approved by the Ethical Committee for Research with Medicines of the University Clinical Hospital of Valencia on 8 October 2020 (order no. 2020/181). Participants are required to provide informed consent for the study and for the surgical procedure. All the data collected will be treated confidentially since they will be blinded and encrypted. The results from the trial will be published in international peer-reviewed scientific journals, regardless of whether these results are negative or inconclusive.

Trial registration number

ClinicalTrials.gov Registry (NCT04850300).
Experiences of living with overweight/obesity and early type 2 diabetes in Singapore—a qualitative interview study
Authors: Lee Mary , Khoo Hwee Sing , Krishnasamy Charmaine , Loo May Eng , Wong S K W , Cheng San Chye , Bei Eileen , Tan Shu Yun , Xie Pauline , Lee Eng Sing , Tang Wern Ee
Published: May 2024

Objectives

To understand the lived experience of adults with overweight/obesity and early type 2 diabetes in a modern urban environment, and the interrelations among the various aspects of these experiences and participants’ attitudes to weight management.

Design

Qualitative inductive approach to analysing data thematically from semistructured interviews and interpreted from a socioecological perspective.

Setting

Primary care clinics located in northern and central Singapore.

Participants

21 patients between 29 and 59 years old who are living with overweight/obese (Body Mass Index of 25.3–44.0kg/m2) and type 2 diabetes for 6 years or less.

Results

The main themes–everyday life, people around me and within me–pointed to a combination of barriers to weight and health management for participants. These included environmental factors such as easy physical and digital access to unhealthy food, and high-stress work environments; social factors such as ambiguous family support and dietary practices of peers; and individual factors such as challenges with self-regulation, prioritising work, dealing with co-existing medical conditions and the emotional significance of food. While lack of motivation and cultural dietary practices are hard to change, a problem-solving attitude, and presence of role models, may enable behaviour change.

Conclusion

An exploration of the lifeworld of patients with overweight/obese and early type 2 diabetes revealed that work demands, dietary practices in the workplace and at home, and the easy availability of calorie-dense foods afforded by a technology-infused environment hindered the individual’s efforts at maintaining a healthy weight and lifestyle. Policy and initiatives promoting work-life balance as well as individualised interventions can support participants’ stress management, and problem-solving capability for behaviour change. These barriers stemmed from the various domains of the environmental, interpersonal and intrapersonal but were interrelated. They underscored the need for an integrated approach to weight and diabetes management.
Comprehensive observational study evaluating the enduring effectiveness of 4CMenB, the meningococcal B vaccine against gonococcal infections in the Northern Territory and South Australia, Australia: study protocol
Authors: Marshall Helen , Ward James , Wang Bing , Andraweera Prabha , McMillan Mark , Flood Louise , Bell Charlotte , Sisnowski Jana , Krause Vicki , Webby Rosalind , Childs Emma , Gunathilake Manoji , Egoroff Natasha , Leong Lex , Lawrence Andrew , Baird Rob , Freeman Kevin , Menouhos Dimitrios , Whiley David M , Karnon Jonathan , van Hal Sebastian , Lahra Monica M
Published: May 2024

Introduction

The effectiveness of antibiotics for treating gonococcal infections is compromised due to escalating antibiotic resistance; and the development of an effective gonococcal vaccine has been challenging. Emerging evidence suggests that the licensed meningococcal B (MenB) vaccine, 4CMenB is effective against gonococcal infections due to cross-reacting antibodies and 95% genetic homology between the two bacteria,Neisseria meningitidisandNeisseria gonorrhoeae,that cause the diseases. This project aims to undertake epidemiological and genomic surveillance to evaluate the long-term protection of the 4CMenB vaccine against gonococcal infections in the Northern Territory (NT) and South Australia (SA), and to determine the potential benefit of a booster vaccine doses to provide longer-term protection against gonococcal infections.

Methods and analyses

This observational study will provide long-term evaluation results of the effectiveness of the 4CMenB vaccine against gonococcal infections at 4–7 years post 4CMenB programme implementation. Routine notifiable disease notifications will be the basis for assessing the impact of the vaccine on gonococcal infections. Pathology laboratories will provide data on the number and percentage ofN. gonorrhoeaepositive tests relative to all tests administered and will coordinate molecular sequencing for isolates. Genome sequencing results will be provided by SA Pathology and Territory Pathology/New South Wales Health Pathology, and linked with notification data by SA Health and NT Health. There are limitations in observational studies including the potential for confounding. Confounders will be analysed separately for each outcome/comparison.

Ethics and dissemination

The protocol and all study documents have been reviewed and approved by the SA Department for Health and Well-being Human Research Ethics Committee (HREC/2022/HRE00308), and the evaluation will commence in the NT on receipt of approval from the NT Health and Menzies School of Health Research Human Research Ethics Committee. Results will be published in peer-reviewed journals and presented at scientific meetings and public forums.