bluuebunny/crossref_metadata_2025 huggingface dataset:
Mortality and significant neurosensory impairment in preterm infants: an international comparison
Authors: Chevallier Marie , Debillon Thierry , Darlow Brian A , Synnes Anne R , Pierrat Véronique , Hurrion Elizabeth , Yang Junmin , Ego Anne , Ancel Pierre Yves , Lui Kei , Shah Prakeshkumar S , Luu Thuy Mai ,   Australian and New Zealand Neonatal Network (ANZNN),   Canadian Neonatal Network (CNN),   Canadian Neonatal Follow-Up Network (CNFUN)
Published: September 2021

Objective

To compare mortality and rates of significant neurosensory impairment (sNSI) at 18–36 months’ corrected age in infants born extremely preterm across three international cohorts.

Design

Retrospective analysis of prospectively collected neonatal and follow-up data.

Setting

Three population-based observational cohort studies: the Australian and New Zealand Neonatal Network (ANZNN), the Canadian Neonatal and Follow-up Networks (CNN/CNFUN) and the French cohort Etude (Epidémiologique sur les Petits Ages Gestationnels: EPIPAGE-2).

Patients

Extremely preterm neonates of <28 weeks’ gestation in year 2011.

Main outcome measures

Primary outcome was composite of mortality or sNSI defined by cerebral palsy with no independent walking, disabling hearing loss and bilateral blindness.

Results

Overall, 3055 infants (ANZNN n=960, CNN/CNFUN n=1019, EPIPAGE-2 n=1076) were included in the study. Primary composite outcome rates were 21.3%, 20.6% and 28.4%; mortality rates were 18.7%, 17.4% and 26.3%; and rates of sNSI among survivors were 4.3%, 5.3% and 3.3% for ANZNN, CNN/CNFUN and EPIPAGE-2, respectively. Adjusted for gestational age and multiple births, EPIPAGE-2 had higher odds of composite outcome compared with ANZNN (OR 1.71, 95% CI 1.38 to 2.13) and CNN/CNFUN (OR 1.72, 95% CI 1.39 to 2.12). EPIPAGE-2 did have a trend of lower odds of sNDI but far short of compensating for the significant increase in mortality odds. These differences may be related to variations in perinatal approach and practices (and not to differences in infants’ baseline characteristics).

Conclusions

Composite outcome of mortality or sNSI for extremely preterm infants differed across high-income countries with similar baseline characteristics and access to healthcare.
CYP1B1andMYOCvariants in neonatal-onset versus infantile-onset primary congenital glaucoma
Authors: Kaushik Sushmita , Luthra-Guptasarma Manni , Prasher Dimple , Dhingra Deepika , Singh Nirbhai , Kumar Aman , Sharma Surya Prakash , Kaur Harpreet , Snehi Sagarika , Thattaruthody Faisal , Pandav Surinder Singh
Published: September 2021

Objective

To compareCYP1B1andMYOCvariants in a cohort of neonatal-onset (NO) and infantile-onset (IO) primary congenital glaucoma (PCG).

Methods

This prospective observational study included 43 infants with PCG (14 NO and 29 IO) presenting between January 2017 and January 2019 with a minimum 1-year follow-up.CYP1B1andMYOCgenes were screened using Sanger sequencing with in-silico analysis of the variants using Polymorphism Phenotyping v.2 and Protein Variation Effect Analyser platforms. Allelic frequency was estimated using Genome Aggregation Database (gnomAd). Disease presentation and outcome were correlated to the genetic variants in both groups.

Results

Babies withCYP1B1mutations had more severe disease at presentation and worse outcomes. Six of 14 (42.8%) NO glaucoma and 5 of 29 (17.2%) IO harbouredCYP1B1mutations. Five of six babies in the NO group and three of five in the IO group harboured the variant c.1169G>A, [p.R390H]. They required more surgeries and had a poorer outcome. On in-silico analysis c.1169G>A, [p.R390H] scored very likely pathogenic. Two patients in the IO group who had the c.1294C>G, [p.L432V] variant had a good outcome. Five of 14 NO-PCG and 8 of 29 IO-PCG harboured the variant c.227G>A, [p.R76K] in theMYOCgene, which was scored benign by in-silico analysis, and was also found in 2 of 15 normal controls.

Conclusions

Patients withCYP1B1pathogenic variants had a poorer outcome than those without. We found more NO PCG babies withCYP1B1mutations compared with IO PCG. This may be one of the reasons for NO PCG having a poorer prognosis compared with IO PCG.
Derivation of the Buffalo Concussion Physical Examination risk of delayed recovery (RDR) score to identify children at risk for persistent postconcussive symptoms
Authors: Haider Mohammad Nadir , Cunningham Adam , Darling Scott , Suffoletto Heidi N , Freitas Michael S , Jain Rajiv K , Willer Barry , Leddy John J
Published: September 2021

Objective

The Buffalo Concussion Physical Examination (BCPE) is a brief, but pertinent physical examination designed for the subacute, outpatient assessment of concussion. The purpose of this study was to perform the BCPE on a larger sample and derive a scoring system to identify children at risk for Persistent Post-Concussive Symptoms (PPCS, recovery ≥30 days).

Methods

This prospective, observational cohort study from September 2016 to March 2019 was performed at three university-affiliated concussion clinics. Male and female children (n=270, 14.92±1.86 years, range 8–18, 38% female) were diagnosed with a concussion within 14 days of injury and followed-up until recovery. Logistic regression was used with history and physical examination variables to predict PPCS and a weighted scoring metric was derived.

Results

Out of 15 predictor variables, the main effects of 1 preinjury variable (≥3 previous concussions), 2 injury characteristic variables (days-since-injury and type-of-injury), 3 physical examination variables (orthostatic intolerance (OI), vestibulo-ocular reflex (VOR) and tandem gait) and 2 interaction terms (OI/VOR and tandem gait/type-of-injury) produced a score that was 85% accurate for identifying children with low-risk, medium-risk and high-risk for PPCS on cross-validation.

Conclusion

The Risk for Delayed Recovery (RDR)-Score allows physicians in an outpatient setting to more accurately predict which children are at greater risk for PPCS early after their injury, and who would benefit most from targeted therapies. The RDR-Score is intended to be used as part of a comprehensive assessment that should include validated symptom checklists, mental health history and adjunct testing (eg, cognitive or physical exertion) where clinically indicated.
Evaluating agreement between bodies of evidence from randomised controlled trials and cohort studies in nutrition research: meta-epidemiological study
Authors: Schwingshackl Lukas , Balduzzi Sara , Beyerbach Jessica , Bröckelmann Nils , Werner Sarah S , Zähringer Jasmin , Nagavci Blin , Meerpohl Joerg J
Published: September 2021

Objective

To evaluate the agreement between diet-disease effect estimates of bodies of evidence from randomised controlled trials and those from cohort studies in nutrition research, and to investigate potential factors for disagreement.

Design

Meta-epidemiological study.

Data sources

Cochrane Database of Systematic Reviews, and Medline.

Review methods

Population, intervention or exposure, comparator, outcome (PI/ECO) elements from a body of evidence from cohort studies (BoE(CS)) were matched with corresponding elements of a body of evidence from randomised controlled trials (BoE(RCT)). Pooled ratio of risk ratios or difference of mean differences across all diet-disease outcome pairs were calculated. Subgroup analyses were conducted to explore factors for disagreement. Heterogeneity was assessed through I
2
and τ
2
. Prediction intervals were calculated to assess the range of possible values for the difference in the results between evidence from randomised controlled trials and evidence from cohort studies in future comparisons.

Results

97 diet-disease outcome pairs (that is, matched BoE(RCT) and BoE(CS)) were identified overall. For binary outcomes, the pooled ratio of risk ratios comparing estimates from BoE(RCT) with BoE(CS) was 1.09 (95% confidence interval 1.04 to 1.14; I
2
=68%; τ
2
=0.021; 95% prediction interval 0.81 to 1.46). The prediction interval indicated that the difference could be much more substantial, in either direction. We further explored heterogeneity and found that PI/ECO dissimilarities, especially for the comparisons of dietary supplements in randomised controlled trials and nutrient status in cohort studies, explained most of the differences. When the type of intake or exposure between both types of evidence was identical, the estimates were similar. For continuous outcomes, small differences were observed between randomised controlled trials and cohort studies.

Conclusion

On average, the difference in pooled results between estimates from BoE(RCT) and BoE(CS) was small. But wide prediction intervals and some substantial statistical heterogeneity in cohort studies indicate that important differences or potential bias in individual comparisons or studies cannot be excluded. Observed differences were mainly driven by dissimilarities in population, intervention or exposure, comparator, and outcome. These findings could help researchers further understand the integration of such evidence into prospective nutrition evidence syntheses and improve evidence based dietary guidelines.
Residual C-peptide secretion and hypoglycemia awareness in people with type 1 diabetes
Authors: Wellens Martine J , Vollenbrock Charlotte E , Dekker Pim , Boesten Lianne S M , Geelhoed-Duijvestijn Petronella H , de Vries-Velraeds Martine M C , Nefs Giesje , Wolffenbuttel Bruce H R , Aanstoot Henk-Jan , van Dijk Peter R
Published: September 2021

Introduction

This study aimed to assess the association between fasting serum C-peptide levels and the presence of impaired awareness of hypoglycemia (IAH) in people with type 1 diabetes.

Research design and methods

We performed a cross-sectional study among 509 individuals with type 1 diabetes (diabetes duration 5–65 years). Extensive clinical data and fasting serum C-peptide concentrations were collected and related to the presence or absence of IAH, which was evaluated using the validated Dutch version of the Clarke questionnaire. A multivariable logistic regression model was constructed to investigate the association of C-peptide and other clinical variables with IAH.

Results

In 129 (25%) individuals, residual C-peptide secretion was detected, while 75 (15%) individuals reported IAH. The median (IQR) C-peptide concentration among all participants was 0.0 (0.0–3.9) pmol/L. The prevalence of severe hypoglycemia was lower in people with demonstrable C-peptide versus those with absent C-peptide (30% vs 41%, p=0.025). Individuals with IAH were older, had longer diabetes duration, more frequently had macrovascular and microvascular complications, and more often used antihypertensive drugs, antiplatelet agents and cholesterol-lowering medication. There was a strong association between IAH and having a severe hypoglycemia in the preceding year. In multivariable regression analysis, residual C-peptide, either continuously or dichotomous, was associated with lower prevalence of IAH (p=0.040–0.042), while age at diabetes onset (p=0.001), presence of microvascular complications (p=0.003) and body mass index (BMI) (p=0.003) were also independently associated with the presence of IAH.

Conclusions

Higher BMI, the presence of microvascular complications and higher age at diabetes onset were independent risk factors for IAH in people with type 1 diabetes, while residual C-peptide secretion was associated with lower risk of this complication.
Prognostic impact of cardiac surgery in left-sided infective endocarditis according to risk profile
Authors: Garcia Granja Pablo Elpidio , Lopez Javier , Vilacosta Isidre , Saéz Carmen , Cabezón Gonzalo , Olmos Carmen , Jerónimo Adrián , Pérez Javier B , De Stefano Salvatore , Maroto Luis , Carnero Manuel , Monguio Emilio , Pulido Paloma , de Miguel María , Gomez Salvador Itziar , Carrasco-Moraleja Manuel , San Román J Alberto
Published: September 2021

Objective

To evaluate the prognostic impact of urgent cardiac surgery on the prognosis of left-sided infective endocarditis (LSIE) and its relationship to the basal risk of the patient and to the surgical indication.

Methods

605 patients with LSIE and formal surgical indication were consecutively recruited between 2000 and 2020 among three tertiary centres: 405 underwent surgery during the active phase of the disease and 200 did not despite having indication. The prognostic impact of urgent surgery was evaluated by multivariable analysis and propensity score analysis. We studied the benefit of surgery according to baseline mortality risk defined by the ENDOVAL score and according to surgical indication.

Results

Surgery is an independent predictor of survival in LSIE with surgical indication both by multivariable analysis (OR 0.260, 95% CI 0.162 to 0.416) and propensity score (mortality 40% vs 66%, p<0.001). Its greatest prognostic benefit is seen in patients at highest risk (predicted mortality 80%–100%: OR 0.08, 95% CI 0.021 to 0.299). The benefit of surgery is especially remarkable for uncontrolled infection indication (OR 0.385, 95% CI 0.194 to 0.765), even in combination with heart failure (OR 0.220, 95% CI 0.077 to 0.632).

Conclusions

Surgery during active LSIE seems to significantly reduce in-hospital mortality. The higher the risk, the higher the improvement in outcome.
Early percutaneous mitral commissurotomy or conventional management for asymptomatic mitral stenosis: a randomised clinical trial
Authors: Kang Duk-Hyun , Park Sung-Ji , Lee Seung-Ah , Lee Sahmin , Kim Dae-Hee , Park Duk-Woo , Yun Sung-Cheol , Hong Geu-Ru , Song Jong-Min , Hong Myeong-Ki , Park Seung Woo , Park Seung-Jung
Published: September 2021

Objective

The decision to perform percutaneous mitral commissurotomy (PMC) on asymptomatic patients requires careful weighing of the potential benefits against the risks of PMC, and we conducted a multicentre, randomised trial to compare long-term outcomes of early PMC and conventional treatment in asymptomatic, severe mitral stenosis (MS).

Methods

We randomly assigned asymptomatic patients with severe MS (defined as mitral valve area between 1.0 and 1.5 cm2) to early PMC (84 patients) or to conventional treatment (83 patients). The primary endpoint was a composite of major cardiovascular events, including PMC-related complications, cardiovascular mortality, cerebral infarction and systemic thromboembolic events. The secondary endpoints were death from any cause and mitral valve (MV) replacement during follow-up.

Results

In the early PMC group, there were no PMC-related complications. During the median follow-up of 6.4 years, the composite primary endpoint occurred in seven patients in the early PMC group (8.3%) and in nine patients in the conventional treatment group (10.8%) (HR 0.77; 95% CI 0.29 to 2.07; p=0.61). Death from any cause occurred in four patients in the early PMC group (4.8%) and three patients in the conventional treatment group (3.6%) (HR 1.30; 95% CI 0.29 to 5.77). Ten patients (11.9%) in the early PMC group and 17 patients (20.5%) in the conventional treatment group underwent MV replacement (HR 0.59; 95% CI 0.27 to 1.29).

Conclusions

Compared with conventional treatment, early PMC did not significantly reduce the incidence of cardiovascular events among asymptomatic patients with severe MS during the median follow-up of 6 years.

Trial registration number

NCT01406353.
Prediction of dementia using diffusion tensor MRI measures: the OPTIMAL collaboration
Authors: Egle Marco , Hilal Saima , Tuladhar A M , Pirpamer Lukas , Hofer Edith , Duering Marco , Wason James , Morris Robin G , Dichgans Martin , Schmidt Reinhold , Tozer Daniel , Chen Christopher , de Leeuw Frank-Erik , Markus Hugh S
Published: September 2021

Objectives

It has been suggested that diffusion tensor imaging (DTI) measures sensitive to white matter (WM) damage may predict future dementia risk not only in cerebral small vessel disease (SVD), but also in mild cognitive impairment. To determine whether DTI measures were associated with cognition cross-sectionally and predicted future dementia risk across the full range of SVD severity, we established the International OPtimising mulTImodal MRI markers for use as surrogate markers in trials of Vascular Cognitive Impairment due to cerebrAl small vesseL disease collaboration which included six cohorts.

Methods

Among the six cohorts, prospective data with dementia incidences were available for three cohorts. The associations between six different DTI measures and cognition or dementia conversion were tested. The additional contribution to prediction of other MRI markers of SVD was also determined.

Results

The DTI measure mean diffusivity (MD) median correlated with cognition in all cohorts, demonstrating the contribution of WM damage to cognition. Adding MD median significantly improved the model fit compared to the clinical risk model alone and further increased in all single-centre SVD cohorts when adding conventional MRI measures. Baseline MD median predicted dementia conversion. In a study with severe SVD (SCANS) change in MD median also predicted dementia conversion. The area under the curve was best when employing a multimodal MRI model using both DTI measures and other MRI measures.

Conclusions

Our results support a central role for WM alterations in dementia pathogenesis in all cohorts. DTI measures such as MD median may be a useful clinical risk predictor. The contribution of other MRI markers varied according to disease severity.
Blood-based high sensitivity measurements of beta-amyloid and phosphorylated tau as biomarkers of Alzheimer’s disease: a focused review on recent advances
Authors: Chong Joyce R. , Ashton Nicholas J. , Karikari Thomas K. , Tanaka Tomotaka , Schöll Michael , Zetterberg Henrik , Blennow Kaj , Chen Christopher P. , Lai Mitchell K.P.
Published: September 2021

Discovery and development of clinically useful biomarkers for Alzheimer’s disease (AD) and related dementias have been the focus of recent research efforts. While cerebrospinal fluid and positron emission tomography or MRI-based neuroimaging markers have made the in vivo detection of AD pathology and its consequences possible, the high cost and invasiveness have limited their widespread use in the clinical setting. On the other hand, advances in potentially more accessible blood-based biomarkers had been impeded by lack of sensitivity in detecting changes in markers of the hallmarks of AD, including amyloid-β (Aβ) peptides and phosphorylated tau (P-tau). More recently, however, emerging technologies with superior sensitivity and specificity for measuring Aβ and P-tau have reported high concordances with AD severity. In this focused review, we describe several emerging technologies, including immunoprecipitation-mass spectrometry (IP-MS), single molecule array and Meso Scale Discovery immunoassay platforms, and appraise the current literature arising from their use to identify plaques, tangles and other AD-associated pathology. While there is potential clinical utility in adopting these technologies, we also highlight the further studies needed to establish Aβ and P-tau as blood-based biomarkers for AD, including validation with existing large sample sets, new independent cohorts from diverse backgrounds as well as population-based longitudinal studies. In conclusion, the availability of sensitive and reliable measurements of Aβ peptides and P-tau species in blood holds promise for the diagnosis, prognosis and outcome assessments in clinical trials for AD.
Infection hospitalisation in systemic lupus in Sweden
Authors: Simard Julia F , Rossides Marios , Gunnarsson Iva , Svenungsson Elisabet , Arkema Elizabeth V
Published: September 2021

Objective

Immune dysregulation in SLE and the corresponding immune-modulating and immunosuppressive nature of the treatments may play key roles in infection risk. We compared serious infection rates among individuals with incident SLE with the general population, and examined the role of treatment initiation in SLE.

Methods

Newly diagnosed patients with SLE (2006–2013) and general population comparators from the Swedish Lupus Linkage cohort were followed for serious infection through 2016. Adjusted Cox and frailty models estimated the relative risk of first and recurrent infections, respectively. Using a new-user design, rates of serious infections were compared between disease-modifying antirheumatic drugs (DMARDs) and hydroxychloroquine (HCQ) initiators. We then evaluated three DMARDs (azathioprine, mycophenolate mofetil and methotrexate) in multivariable-adjusted models.

Results

Individuals with SLE experienced more infections (22% vs 6%), especially during the first year of follow-up, and recurrent serious infections were also more common (HR=2.22, 95% CI 1.93 to 2.56). DMARDs were associated with a higher rate of serious infection versus HCQ (HR=1.82, 95% CI 1.27 to 2.60), which attenuated after multivariable-adjustment (HR=1.30, 95% CI 0.86 to 1.95). Among DMARDs, azathioprine was associated with infection (HR=2.19, 95% CI 1.14 to 4.21) and mycophenolate mofetil yielded an HR=1.39 (95% CI 0.65 to 2.96) in multivariable-adjusted models compared with methotrexate. Results were comparable across numerous sensitivity analyses.

Conclusion

Individuals with incident SLE were 2–4 times more likely to be hospitalised for infection and experienced more recurrent infections than the general population. Among DMARD initiators, azathioprine was associated with the highest rate.
Digital bioethics: introducing new methods for the study of bioethical issues
Authors: Schneider Manuel , Vayena Effy , Blasimme Alessandro
Published: September 2021

The online space has become a digital public square, where individuals interact and share ideas on the most trivial to the most serious of matters, including discussions of controversial ethical issues in science, technology and medicine. In the last decade, new disciplines like computational social science and social data science have created methods to collect and analyse such data that have considerably expanded the scope of social science research. Empirical bioethics can benefit from the integration of such digital methods to investigate novel digital phenomena and trace how bioethical issues take shape online.

Here, using concrete examples, we demonstrate how novel methods based on digital approaches in the social sciences can be used effectively in the domain of bioethics. We show that a digital turn in bioethics research aligns with the established aims of empirical bioethics, integrating with normative analysis and expanding the scope of the discipline, thus offering ways to reinforce the capacity of bioethics to tackle the increasing complexity of present-day ethical issues in science and technology. We propose to call this domain of research in bioethicsdigital bioethics.
Commercial DNA tests and police investigations: a broad bioethical perspective
Authors: de Groot Nina F , van Beers Britta C , Meynen Gerben
Published: September 2021

Over 30 million people worldwide have taken a commercial at-home DNA test, because they were interested in their genetic ancestry, disease predisposition or inherited traits. Yet, these consumer DNA data are also increasingly used for a very different purpose: to identify suspects in criminal investigations. By matching a suspect’s DNA with DNA from a suspect’s distant relatives who have taken a commercial at-home DNA test, law enforcement can zero in on a perpetrator. Such forensic use of consumer DNA data has been performed in over 200 criminal investigations. However, this practice of so-called investigative genetic genealogy (IGG) raises ethical concerns. In this paper, we aim to broaden the bioethical analysis on IGG by showing the limitations of an individual-based model. We discuss two concerns central in the debate: privacy and informed consent. However, we argue that IGG raises pressing ethical concerns that extend beyond these individual-focused issues. The very nature of the genetic information entails that relatives may also be affected by the individual customer’s choices. In this respect, we explore to what extent the ethical approach in the biomedical genetic context on consent and consequences for relatives can be helpful for the debate on IGG. We argue that an individual-based model has significant limitations in an IGG context. The ethical debate is further complicated by the international, transgenerational and commercial nature of IGG. We conclude that IGG should not only be approached as an individual but also—and perhaps primarily—as a collective issue.
Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001–2016
Authors: Webber Mayris P , Singh Ankura , Zeig-Owens Rachel , Salako Joke , Skerker Molly , Hall Charles B , Goldfarb David G , Jaber Nadia , Daniels Robert D , Prezant David J
Published: September 2021

Objective

To compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) cohort, and to compare rates from each firefighter cohort to rates in demographically similar US males.

Methods

FDNY (N=10 786) and CFHS (N=8813) cohorts included male firefighters who were active on 11 September 2001 (9/11) and were followed until death or 31 December 2016. Cases were identified from 15 state cancer registries. Poisson regression models assessed cancers in each group (FDNY and CFHS) versus US males, and associations between group and cancer rates; these models estimated standardised incidence ratios (SIRs) and adjusted relative rates (RRs), respectively. Secondary analyses assessed surveillance bias and smoking history.

Results

We identified 915 cancer cases in 841 FDNY firefighters and 1002 cases in 909 CFHS firefighters. FDNY had: higher rates for all cancers (RR=1.13; 95% CI 1.02 to 1.25), prostate (RR=1.39; 95% CI 1.19 to 1.63) and thyroid cancer (RR=2.53; 95% CI 1.37 to 4.70); younger median ages at diagnosis (55.6 vs 59.4; p<0.001, all cancers); and more cases with localised disease when compared with CFHS. Compared with US males, both firefighter cohorts had elevated SIRs for prostate cancer and melanoma. Control for surveillance bias in FDNY reduced most differences.

Conclusions

Excess cancers occurred in WTC-exposed firefighters relative to each comparison group, which may partially be explained by heightened surveillance. Two decades post-9/11, clearer understanding of WTC-related risk requires extended follow-up and modelling studies (laboratory or animal based) to identify workplace exposures in all firefighters.
Early detection of prostate cancer in firefighters: a register-based study of prognostic factors and survival
Authors: Jakobsen Jarle , Veierød Marit B , Grimsrud Tom K , Fosså Sophie Dorothea , Hammarström Bato , Kjærheim Kristina
Published: September 2021

Objectives

To examine age at diagnosis, prognostic factors and survival of prostate cancer (PCa) in Norwegian firefighters and three other occupations undergoing occupational health check-ups, and comparing with PCa cases in the general population.

Methods

All PCa cases diagnosed in 1960–2017 were extracted from the Cancer Registry of Norway. Firefighters, military employees, pilots and police officers were identified through occupational data from Statistics Norway. Age at diagnosis, clinical stage, prostate-specific antigen (PSA), Gleason score, performance status and overall survival and PCa-specific survival in cases in these occupations were compared with cases in the general population.

Results

Firefighters were significantly younger at PCa diagnosis than cases in the general population in 1960–1993 (mean difference: 2.1 years) and 2007–2017 (mean difference: 4.3 years). At diagnosis, firefighters had significantly lower PSA values, Gleason scores and performance status scores than the general population. Firefighters diagnosed in 2007–2017 had lower risk of all-cause death than the general population (crude HR 0.71 (0.53–0.95)). No difference remained after adjusting for age at diagnosis (HR 1.03 (0.77–1.37)). Firefighters were older at diagnosis in 1994–2006 (mean difference: 3.0 years), but showed no other significant differences in age at diagnosis, PSA values, Gleason scores or performance status compared with military employees, pilots and police officers.

Conclusions

Younger age and better prognostic factors at PCa diagnosis among firefighters and other occupations with requirements for health check-ups than cases in the general population may indicate an increased diagnostic intensity, likely contributing to elevated PCa incidence in such occupations.
Cerebral lipiodol embolisation
Authors: Batcheller Lisa , Thaller Mark , Wright Ben
Published: September 2021

Cerebral lipiodol embolisation is a rare but serious complication of lymphangiography. A man in his seventies had undergone lymphangiography for a refractory chyle leak following oesophagectomy. The day after lymphangiography, his conscious level dropped with bilaterally miotic pupils, increased muscle tone and double incontinence. CT scan of the head showed patchy high density throughout basal ganglia, cortex and cerebellum but no infarct, in keeping with lipiodol embolisation. He was managed initially in intensive care and subsequently underwent thoracoscopy with clipping and suturing of the left thoracic duct, and later a talc pleurodesis. At 3 months, he had some cognitive limitations and was walking with a stick.
Perceived efficacy of HIV treatment-as-prevention among university students in Johannesburg, South Africa
Authors: Bor Jacob , Musakwa Nozipho , Onoya Dorina , Evans Denise
Published: September 2021

Objective

Antiretroviral therapy (ART) nearly eliminates HIV transmission. Yet information on treatment as prevention (TasP) has been slow to diffuse in sub-Saharan Africa. We assessed TasP knowledge among university students in South Africa.

Methods

We conducted a cross-sectional survey of first-year university students at a large public university in Johannesburg, South Africa, all of whom would have recently completed secondary school HIV curricula. Respondents were asked to consider the likelihood of HIV transmission in a serodiscordant couple having condomless sex with and without virally suppressive ART. Beliefs were elicited using a 0–20 visual scale. Perceived TasP efficacy was computed as the relative reduction in risk associated with virally suppressive ART. We compared beliefs with estimates from the scientific literature and assessed associations with demographics, HIV testing history and qualitative measures of HIV knowledge and risk perception.

Results

The analysis included 365 university students ages 18-25 years (48% female, 56% from Gauteng Province). On average, perceived annual risk of HIV transmission with virally suppressive ART was 73%; the objective risk is <1%. On average, respondents perceived that virally suppressive ART reduced annual transmission risk by 17%; the objective reduction in risk is >96%. We observed no differences in perceived TasP efficacy by participant characteristics and testing history. Perceived TasP efficacy was correlated with the (correct) belief that HIV risk increases with sexual frequency.

Conclusions

University students in South Africa underestimated the prevention benefits of HIV treatment. Low knowledge of TasP could limit demand for HIV testing and treatment among young adults.
Gender-based differences in community-wide screening for pulmonary tuberculosis in Karachi, Pakistan: an observational study of 311 732 individuals undergoing screening
Authors: Habib Shifa Salman , Asad Zaidi Syed Mohammad , Jamal Wafa Zehra , Azeemi Kiran Sohail , Khan Salman , Khowaja Saira , Domki Abdul Khalique , Khan Aamir , Ahmad Khan Faiz
Published: September 2021

We describe gender-based differences in a community-wide TB screening programme in Karachi, Pakistan, in which 311 732 individuals were screened in mobile camps using symptom questionnaires and van-mounted digital chest X-ray, between 1 January 2018 and 31 December 2019. Only 22.4% (69 869) of camp attendees were women. Female attendees were less likely to have sputum collected and tested (31.5% (95% CI 30.4% to 32.7%) vs 38.5% (95% CI 37.6% to 39.1%)) or to initiate TB treatment (75.9% (95% CI 68.1% to 82.6%) vs 82.8% (95% CI 78.9% to 86.2%)), when indicated. Among the participants, the age-standardised prevalence of active TB was higher among women (prevalence ratio 1.4, 95% CI 1.1 to 1.7). These findings underscore the importance of integrating gender into the design and monitoring of TB screening programmes to ensure that women and men benefit equally from this important intervention.
Preliminary assessment of the conservation status of medicinal plant species in Canada
Authors: Erland Lauren A.E. , Turi Christina E. , Murch Susan J.
Published: September 2021

Natural health products in North America represent a $9.6 billion USD industry that has seen increased demands, particularly in products for immune support and in anti-viral supplements as a response to the COVID-19 pandemic. It has been estimated that approximately 40% of the plant raw materials used in natural health products are wild harvested each year, but exact data are missing for many species. Our data show that there are at least 1445 medicinal plant species harvested for commercial products in Canada, and 1217 of these are native species. Medicinal plants and non-timber forest crops are also increasingly impacted by climate change as suitable growing areas shift. To ensure long-term species survival in the wild, it is necessary to generate accurate information about the distribution of wild populations, the need for conservation, and the development of sustainable methods. Our objective was to provide a preliminary assessment of the conservation status of Canadian medicinal plants by analyzing the available data resources.
Life history contrasts in nutritional state and return probability of post-spawned Atlantic salmon
Authors: Bøe Kristin , Power Michael , Robertson Martha J. , Dempson J. Brian , Fleming Ian A.
Published: September 2021

Using nonlethal tissue biopsies, we investigated somatic energy, lipid composition, and condition in post-spawned Atlantic salmon (Salmo salar) (kelts, n = 69) returning to sea in the spring and explored contrasts as a function of previous migration and spawning history, length and sex. Using mark–recapture analysis, we also explored linkages between spawning history and probability of future repeat spawning. Lipid density was significantly higher in previously spawned individuals compared to first-time spawned fish and in females compared to males. Fatty acid composition differed significantly among spawning histories. Return rates to consecutive spawning the following year were consistent with spawning history-dependent differences in lipid density, as first-time spawned kelts had lower return rates compared to consecutive repeat spawned kelts. We suggest that spawning history related contrasts in nutritional state in post-spawned Atlantic salmon may be a carry-over effect of differences in the feeding habitat as affected by spawning-history-dependent migration strategies. Alternatively, it may represent an adaptive response to increased survival and recovery potential with age.
Paleolimnological evidence reveals climate-related preeminence of cyanobacteria in a temperate meromictic lake
Authors: Erratt Kevin , Creed Irena F. , Favot Elizabeth J. , Todoran Irina , Tai Vera , Smol John P. , Trick Charles G.
Published: September 2021

Meromictic lakes provide a physically stable environment in which proxies for potentially harmful cyanobacteria are exceptionally well-preserved in the sediments. In Sunfish Lake, a meromictic lake that has recently become the focus of citizen concern due to the apparent rise in cyanobacteria blooms, we used a multi-proxy paleolimnological approach pairing novel spectral (i.e., VNIRS) and molecular (i.e., qPCR) assessment tools to explore long-term cyanobacteria trends. We hypothesized that climate change over the past 50 years altered the Sunfish Lake environment to favour cyanobacteria dominance, resulting in an increased incidence of bloom events. Spectral and genetic results aligned to reveal an unprecedented abundance of cyanobacteria in modern times and coincided with warmer and wetter climatic conditions in the region. Our findings offer evidence for climate-driven shifts in cyanobacteria abundance and suggest that a shift towards warmer and wetter conditions supports the rise of cyanobacteria in lakes.
Microlitter in the water, sediments, and mussels of the Saint John River (Wolastoq) watershed, Atlantic Canada
Authors: Labaj Andrew L. , LeBlanc Amber D. , Doucet Casey V. , Tardif Christina E. , Kurek Joshua
Published: September 2021

Microlitter is a widespread contaminant with implications for aquatic health; however, knowledge of its distribution in fresh waters is limited. We examined microlitter in surface water, sediment, and mussels within the Saint John River and four major tributaries. Microlitter was present at all 89 sites, with concentrations in water equivalent to other Canadian watersheds. Microlitter concentrations likely reflected differences in land use and development. Comparisons between rivers generally revealed distinct water microlitter particle compositions, suggesting that input sources were specific to each river, while microlitter in sediments and mussels was largely homogeneous among rivers. There was little similarity in concentration and composition of microlitter among the three matrices sampled. Microlitter in sediments and mussels may not reliably track concentration and composition in aquatic environments. Microlitter concentration was not significantly greater downstream of wastewater treatment plants. Airborne microlitter transportation was evident, as remote sites in two tributary rivers demonstrated the highest concentrations of microlitter. Our data highlights the prevalence of microlitter in rural rivers, underscoring the ubiquity of this emerging contaminant and its integration into food webs.
Exotic diboson $$Z'$$ decays in the U$$\mu \nu $$SSM
Authors: Aguilar-Saavedra J. A. , Lara I. , López-Fogliani D. E. , Muñoz C.
Published: September 2021

Searches for new leptophobic resonances at high energy colliders usually target their decay modes into pairs of light quarks, top quarks, or standard model bosons. Additional decay modes may also be present, producing signatures to which current searches are not sensitive. We investigate the performance of generic searches that look for resonances decaying into two large-radius jets. As benchmark for our analysis we use a supersymmetric $$\text {U}(1)'$$

U

(
1
)

′

extension of the Standard Model, the so-called U$$\mu \nu $$

μ
ν

SSM, where all the SM decay modes of the $$Z'$$

Z
′

boson take place, plus additional (cascade) decays into new scalars. The generic searches use a generic multi-pronged jet tagger and take advantage of the presence of b quarks in the large-radius jets, and are sensitive to all these $$Z'$$

Z
′

decay modes (except into light quarks) at once. For couplings that are well below current experimental constraints, these generic searches are sensitive at the $$3\sigma -4\sigma $$

3
σ
-
4
σ

level with Run 2 LHC data.
A Sensitivity Controllable Thermopile Infrared Sensor by Monolithic Integration of a N-channel Metal Oxide Semiconductor
Authors: Li Hongbo , Xu Gaobo , Zhang Chenchen , Mao Haiyang , Zhou Na , Chen Dapeng
Published: September 2021

We report a sensitivity controllable infrared (IR) sensor composed of a thermopile and a n-channel metal oxide semiconductor (NMOS). In the sensor, the cathode of the thermopile is connected with the gate of NMOS. Such a sensor is fabricated by using a CMOS-compatible monolithic integration process. Compared with the separate thermopile IR sensor, sensitivity of the thermopile IR sensor integrated with NMOS can be remarkably enhanced by 357%. In addition, the drain bias voltage of the NMOS can be employed as a quick-response switch. The fabrication process of this device is quite simple and compatible with CMOS processes, thus such a thermopile IR sensor integrated with NMOS is low-cost and suitable for mass production. Moreover, the integration approach can be further applied to develop thermopile arrays for high-resolution imaging.
[Retracted] Effect of Basicity on the Microstructure of Sinter and Its Application Based on Deep Learning
Authors: Zhi Jian-Ming , Li Jie , Wang Jia-Hao , Jiang Tian-Yu , Hua Ze-Yi
Published: September 2021

The influence of the evolution rule of basicity (0.6∼2.4) on the mineral composition and microstructure of sinter is studied by using a polarizing microscope, and the comprehensive application analysis of the drum index, vertical sintering speed, and yield of sinter shows that, over the course of an increase in basicity (0.6∼1.0), the mineral structure changed from the original porphyritic‐granular structure to a porphyritic structure. At the same time, there was no calcium ferrite phase in the bonding phase at a basicity of less than 1.0; therefore, the downward trend of the three indicators is obvious. When the basicity was further increased to approximately 1.6, the main structure of the mineral phase changed from a corrosion structure to an interweaving corrosion structure. Because of the existence of a porphyritic‐granular structure, the structure of the mineral phase was extremely inhomogeneous and most complex near the basicity of 1.6; although a small amount of calcium ferrite displayed an acicular structure, the drum index appeared to show a very low value. With an increase in basicity to 2.0, the mineral phase structure was dominated by an interweaving corrosion structure with a uniform framework, and the content of calcium ferrite reached the highest value. Moreover, a clear acicular structure developed, and the drum index also increased to the highest value. At a basicity of more than 2.0, a mineral structure began to appear and the corrosion, porphyritic‐granular structure, and the drum index also showed a slightly declining trend. Therefore, in the actual production process, basicity should be avoided as far as possible at around 1.0 and 1.6 and it should be controlled at around 2.0. At the same time, based on the mineral facies data set of this paper, the convolutional neural network is used to carry out a simple prediction model experiment on the basicity corresponding to the mineral facies photos, and the effect is quite good, which provides a new idea and method for the follow‐up study of mineral facies.
Sensor Fault Diagnosis Method Based on α‐Grey Wolf Optimization‐Support Vector Machine
Authors: Cheng Xuezhen , Wang Dafei , Xu Chuannuo , Li Jiming
Published: September 2021

Aimed to address the low diagnostic accuracy caused by the similar data distribution of sensor partial faults, a sensor fault diagnosis method is proposed on the basis of α Grey Wolf Optimization Support Vector Machine (α‐GWO‐SVM) in this paper. Firstly, a fusion with Kernel Principal Component Analysis (KPCA) and time‐domain parameters is performed to carry out the feature extraction and dimensionality reduction for fault data. Then, an improved Grey Wolf Optimization (GWO) algorithm is applied to enhance its global search capability while speeding up the convergence, for the purpose of further optimizing the parameters of SVM. Finally, the experimental results are obtained to suggest that the proposed method performs better in optimization than the other intelligent diagnosis algorithms based on SVM, which improves the accuracy of fault diagnosis effectively.
Estimation of Chronic Illness Severity Based on Machine Learning Methods
Authors: Chang Yue , Chen Xudong
Published: September 2021

Chronic diseases are diseases that last one year or more and require a continuous medical care and monitoring. Based on this point, a dataset from an APP called Flaredown helps patients of chronic disease improve their symptoms and conditions. In this study, an illness severity‐level model was proposed to give the patient an alert to his or her health condition into three different levels according to their severity. Personal information, treatment conditions, and dietary conditions were analyzed by a statistical measure, TD‐IDF. Seven different machine learning models were used and compared to generate the illness severity‐level model. The results revealed that the XGBoost model with a F1 score of 0.85 and LightGBM model with a F1 score of 0.84 have the best performance. We also applied feature selection and parameter tuning for these two models to attain better performance, and the final best F1 scores achieved by the XGBoost model and LightGBM model were both 0.85. Sensitivity analysis has shown that the treatment feature and symptom feature have important effects on the classification of the illness severity‐level. Based on this, a fusion model was designed to study the data and the final accuracy of the fusion model was 93.3%. Thus, this study provides an effective illness severity‐level model for a reference and guidance for the management of high‐risk groups of chronic diseases. Patients may use this illness severity‐level model to self‐monitor their illness conditions and take proactive steps to avoid deterioration of their illness and take further medical care.
Simulation and Experimental Study on Rotor System Dynamic Analysis with the Blade‐Coating Rubbing Faults
Authors: Lu Xin , Tang Jie , Wang Liwen
Published: September 2021

In the modern turbo‐machinery, reducing the clearance between the blade tip and casing inner face is an effective method to improve the power performance, but the clearance reduction leads to increased risk of blade‐casing rubbing. In this paper, a blade‐coating rubbing force model which considered the abradable coating scraping is developed to simulate the rotor system dynamic characteristics at blade‐casing rubbing faults with abradable coating. An experimental tester is established to simulate the rotor system blade‐casing rubbing faults; the AlSi‐ployphenyl ester abradable coating is prepared and introduced into the blade‐casing experiment to verify the model. After the vibration and force analysis in simulation and experiment, the dynamic characteristics and the influence factors of blade‐casing rubbing rotor system are studied.
Some Variants of Krasnoselskii-Type Fixed Point Results for Equiexpansive Mappings with Applications
Authors: Ahmad Niaz , Mehmood Nayyar , Al-Rawashdeh Ahmed
Published: September 2021

In this paper, we investigate the Krasnoselskii-type fixed point results for the operator

F

of two variables by assuming that the family

F

x
,
.

:
x

is equiexpansive. The results may be considered as variants of the Krasnoselskii fixed point theorem in a general setting. We use our main results to obtain the existence of solutions of a fractional evolution differential equation. An example of a controlled system is given to illustrate the application.