bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment considerations in total anomalous pulmonary venous connection
Authors: Mulia Eka Prasetya Budi , Rahman Mahrus A.
Published: July 2023

Background

Total anomalous pulmonary venous connection (TAPVC) is a rare cyanotic abnormality that accounts for about 1%–3% of congenital heart disease malformations. TAPVC is a condition in which there is no direct connection between all four pulmonary veins and the left atrium but makes abnormal connections to the right atrium or systemic venous system. TAPVC caused a high mortality rate of 80% in the first year of life, and 50% of them die within 3 months after birth without intervention.

Objectives

The aim of this review is to elucidate the various treatment considerations of TAPVC.

Methods

A literature search was conducted on PubMed, ScienceDirect and Google Scholar using various combinations of keywords related to treatment of TAPVC. The citations from all selected articles were reviewed for additional studies.

Results and Conclusion

TAPVC intervention, including medical and surgical, is tailored to each type of TAPVC. Catheter-based interventions are frequently used to temporize neonates and provide time to optimize patients medically prior to definite repair. Corrective surgery is required for all patients with this condition. Several latest catheter-based or surgical intervention technique modifications have also been reported.
Investigating hybridity in artificial intelligence research
Authors: Williams Kate , Berman Glen , Michalska Sandra
Published: July 2023

Research in the global field of artificial intelligence is increasingly hybrid in orientation. Researchers are beholden to the requirements of multiple intersecting spheres, such as scholarly, public, and commercial, each with their own language and logic. Relatedly, collaboration across disciplinary, sector and national borders is increasingly expected, or required. Using a dataset of 93,482 artificial intelligence publications, this article operationalises scholarly, public, and commercial spheres through citations, news mentions, and patent mentions, respectively. High performing publications (99th percentile) for each metric were separated into eight categories of influence. These comprised four blended categories of influence (news, patents and citations; news and patents; news and citations; patents and citations) and three single categories of influence (citations; news; patents), in addition to the ‘Other’ category of non-high performing publications. The article develops and applies two components of a new hybridity lens: evaluative hybridity and generative hybridity. Using multinomial logistic regression, selected aspects of knowledge production – research context, focus, artefacts, and collaborative configurations – were examined. The results elucidate key characteristics of knowledge production in the artificial intelligence field and demonstrate the utility of the proposed lens.
Medical artificial intelligence ethics: A systematic review of empirical studies
Authors: Tang Lu , Li Jinxu , Fantus Sophia
Published: July 2023

Background

Artificial intelligence (AI) technologies are transforming medicine and healthcare. Scholars and practitioners have debated the philosophical, ethical, legal, and regulatory implications of medical AI, and empirical research on stakeholders’ knowledge, attitude, and practices has started to emerge. This study is a systematic review of published empirical studies of medical AI ethics with the goal of mapping the main approaches, findings, and limitations of scholarship to inform future practice considerations.

Methods

We searched seven databases for published peer-reviewed empirical studies on medical AI ethics and evaluated them in terms of types of technologies studied, geographic locations, stakeholders involved, research methods used, ethical principles studied, and major findings.

Findings

Thirty-six studies were included (published 2013-2022). They typically belonged to one of the three topics: exploratory studies of stakeholder knowledge and attitude toward medical AI, theory-building studies testing hypotheses regarding factors contributing to stakeholders’ acceptance of medical AI, and studies identifying and correcting bias in medical AI.

Interpretation

There is a disconnect between high-level ethical principles and guidelines developed by ethicists and empirical research on the topic and a need to embed ethicists in tandem with AI developers, clinicians, patients, and scholars of innovation and technology adoption in studying medical AI ethics.
Inpatient care of neuromyelitis optica spectrum disorder in Germany: Nationwide analysis from 2010 to 2021
Authors: Richter Daniel , Bartig Dirk , Tönges Lars , Kümpfel Tania , Schwake Carolin , Gold Ralf , Krogias Christos , Ayzenberg Ilya
Published: July 2023

Background

Despite tremendous development in the treatment of neuromyelitis optica spectrum disorder (NMOSD), less is known about the characteristics of hospitalized patients and inpatient care utilization.

Objective

To investigate the development of inpatient NMOSD case numbers and implemented immunotherapies in the last decade in Germany.

Methods

We conducted a nationwide retrospective study using an administrative database of all hospitalized NMOSD patients between 2010 and 2021. We evaluated yearly data on case numbers, demographics, treatment regimens, and seasonal variations of apheresis therapy as a surrogate marker of severe relapse incidence.

Results

During the observational period case number of inpatients substantially increased (2010: n = 463, 2021: n = 992). The mean age was 48.1 ± 2.5 years (74% females). The pooled yearly rate of plasmapheresis/immunoadsorption was 14% (95% CI [13–15%]), without seasonal variations. Its application peaked in 2013 (18%, 95% CI [15–21%]) with decreasing trend since. Predominant immunotherapy was rituximab (40%, 95% CI [34–45%]), followed by tocilizumab (4%, 95% CI [3–5%]) since 2013 and eculizumab (4%, 95% CI [3–5%]) since 2020. Inpatient mortality ranged between 0% and 1% per year.

Conclusions

Inpatient case numbers of NMOSD substantially increased during the past decade, probably reflecting improving disease awareness. In parallel with the administration of highly effective therapies rate of apheresis therapies decreased. A stable apheresis rate over the year makes seasonal variations of the steroid-refractive relapses unlikely.
Acceptability and Comfort Regarding Remotely Delivered PrEP Services in Mississippi
Authors: Giorlando Kayla K. , Arnold Trisha , Barnett Andrew P. , Leigland Avery , Whiteley Laura , Brock James B. , Brown Larry K.
Published: July 2023

Despite the prevalence of human immunodeficiency virus (HIV) in Mississippi, access to pre-exposure prophylaxis (PrEP) is mostly limited to urban areas. Remote PrEP care via telemedicine, HIV self-testing, and prescription mail delivery can improve care in underserved communities. This mixed methods study assessed the acceptability and feasibility of using remote PrEP care, compared to alternatives. This consisted of (1) a cross-sectional survey and (2) interviews. PrEP-eligible adults were recruited from community-based organizations across Mississippi while accessing HIV testing between December 2019 and May 2022. Those surveyed (n = 63) indicated the greatest comfort in receiving PrEP via mail delivery ( m = 5.14) and telemedicine ( m = 4.89) and least comfort at gyms ( m = 3.92). Comfort significantly differed between mail delivery and gyms ( F = 2.90; P < .01). Those interviewed (n = 26) expressed relatively high comfort with remote PrEP care citing enhanced accessibility, privacy, simplicity, and quality. Remote PrEP services were acceptable and feasible among our sample, thus, should be expanded in Mississippi to address unmet needs.
Probabilistic seismic damage and loss assessment methodology for wastewater network incorporating modeling uncertainty and damage correlations
Authors: Alam Mohammad S , Simpson Barbara G , Barbosa Andre R , Jung Jaehoon , Parulekar Nishant
Published: July 2023

Maintaining the functionality of wastewater networks is critical to individual well-being, business continuity, public health, and safety. However, seismic damage and loss assessments of wastewater networks traditionally use fragility functions based on median repair rates without considering relevant sources of uncertainty and correlations of damage when estimating potential damage states and pipe repairs. This study presents a probabilistic methodology to incorporate modeling uncertainty (e.g. model parameter and model class uncertainty) and spatial correlations (e.g. spatial auto- and cross-correlation) of pipe repairs. The methodology was applied to a case study backbone system of a wastewater network in Portland, OR, using the expected hazard intensity maps for multiple deterministic earthquake scenarios, including a moment magnitude M6.8 Portland Hills Fault and M8.1, M8.4, M8.7, and M9.0 Cascadia Subduction Zone (CSZ) events. As spatial-correlation models of pipeline damage were non-existent in the literature and local information on costs to repair the pipes was limited at the time of this study, correlation methods and repair costs were proposed to estimate lower and upper bounds of pipe damage and loss. The results show how the consideration of different levels of uncertainty and spatial correlation for pipe repair rate could lead to different probabilistic estimates of damage and loss at the system level of the wastewater network, even though the point estimates, such as the mean and median, remain essentially unaltered.
Molecular characterization and antifungal activity of lipopeptides produced from Bacillus subtilis against plant fungal pathogen Alternaria alternata
Authors: Harish B. N. , Nagesha S. N. , Ramesh B. N. , Shyamalamma S. , Nagaraj M. S. , Girish H. C. , Pradeep C. , Shiva Kumar K. S. , Tharun Kumar K. S. , Pavan S. N. , Kavan Kumar V.
Published: July 2023

Over 380 host plant species have been known to develop leaf spots as a result of the fungus Alternaria alternata. It is an aspiring pathogen that affects a variety of hosts and causes rots, blights, and leaf spots on different plant sections. In this investigation, the lipopeptides from the B. subtilis strains T3, T4, T5, and T6 were evaluated for their antifungal activities. In the genomic DNA, iturin, surfactin, and fengycin genes were found recovered from B. subtilis bacterium by PCR amplification. From different B. subtilis strains, antifungal Lipopeptides were extracted, identified by HPLC, and quantified with values for T3 (24 g/ml), T4 (32 g/ml), T5 (28 g/ml), and T6 (18 g/ml). To test the antifungal activity, the isolated lipopeptides from the B. subtilis T3, T4, T5, and T6 strains were applied to Alternaria alternata at a concentration of 10 g/ml. Lipopeptides were found to suppress Alternaria alternata at rates of T3 (75.14%), T4 (75.93%), T5 (80.40%), and T6 (85.88%). The T6 strain outperformed the other three by having the highest antifungal activity against Alternaria alternata (85.88%).
Genome-wide systematic characterization of the NRT2 gene family and its expression profile in wheat (Triticum aestivum L.) during plant growth and in response to nitrate deficiency
Authors: Deng Qing-Yan , Luo Jiang-Tao , Zheng Jian-Min , Tan Wen-Fang , Pu Zong-Jun , Wang Fang
Published: July 2023

Background

Wheat (Triticum aestivum L.) is a major cereal crop that is grown worldwide, and it is highly dependent on sufficient N supply. The molecular mechanisms associated with nitrate uptake and assimilation are still poorly understood in wheat. In plants, NRT2 family proteins play a crucial role in NO3– acquisition and translocation under nitrate limited conditions. However, the biological functions of these genes in wheat are still unclear, especially their roles in NO3– uptake and assimilation.

Results

In this study, a comprehensive analysis of wheat TaNRT2 genes was conducted using bioinformatics and molecular biology methods, and 49 TaNRT2 genes were identified. A phylogenetic analysis clustered the TaNRT2 genes into three clades. The genes that clustered on the same phylogenetic branch had similar gene structures and nitrate assimilation functions. The identified genes were further mapped onto the 13 wheat chromosomes, and the results showed that a large duplication event had occurred on chromosome 6. To explore the TaNRT2 gene expression profiles in wheat, we performed transcriptome sequencing after low nitrate treatment for three days. Transcriptome analysis revealed the expression levels of all TaNRT2 genes in shoots and roots, and based on the expression profiles, three highly expressed genes (TaNRT2-6A.2, TaNRT2-6A.6, and TaNRT2-6B.4) were selected for qPCR analysis in two different wheat cultivars (‘Mianmai367’ and ‘Nanmai660’) under nitrate-limited and normal conditions. All three genes were upregulated under nitrate-limited conditions and highly expressed in the high nitrogen use efficiency (NUE) wheat ‘Mianmai367’ under low nitrate conditions.

Conclusion

We systematically identified 49 NRT2 genes in wheat and analysed the transcript levels of all TaNRT2s under nitrate deficient conditions and over the whole growth period. The results suggest that these genes play important roles in nitrate absorption, distribution, and accumulation. This study provides valuable information and key candidate genes for further studies on the function of TaNRT2s in wheat.
Efficacy and safety of Cook staged Extubation Set in patients with difficult airway: a systematic review and meta-analysis
Authors: Lu Cheng , Li Jian , Zhao Shibing , Zhang Yajun
Published: July 2023

Background

Cook Stage extubation is a tool developed by Cook Medical for patients with difficult airways. Multiple clinical studies demonstrated the effectiveness and safety of Cook Stage extubation Set (CSES). Currently, no systematic review evidence has been published in this field. Therefore, this study aimed to review the clinical success rate, safety, and tolerability of CSES in patients with difficult airways.

Method

The inclusion criteria were based on the population, intervention, comparator, outcomes, and study designs. An electronic search was conducted, and the following databases were used: PubMed, EMBASE, Cochrane Library, and Web of Science. Search keywords included difficult airway and CSES. The primary outcome was the CSES clinical success rate.The Joanna Briggs Institute Critical Appraisal tools for Case Series were used to assess the risk of bias in the included studies. R studio, version 4.2.2. was used to perform the statistical analysis. The Cochrane Q and I2 statistics were used to test the heterogeneity among all studies. Details of the included case reports were summarized in the systematic review part.

Results

Five studies were eligible for meta-analysis, and 7 case reports were included for systematic review. The pooled overall CSES clinical success rate was 93% (95% CI: 85%, 97%). The CSES intolerable and complication incidence rates were 9% (95% CI: 5%, 18%) and 5% (95% CI: 2%, 12%), respectively. CSES clinical success rate was influenced by the study center and study design. The success rate of CSES was higher in multicenter and prospective design studies. Seven case reports have documented the successful operation of CSES intubation in obese, tall, oncologist, and pediatric patients.

Discussion

This meta-analysis suggested that CSES have achieved a high clinical success rate in adult and pediatric patients with different physical conditions and types of surgery. The results of all original studies and meta-analysis confirmed a remarkably high tolerance rate and low overall complication rate. However, regardless of the tools chosen, a personalized, safe intubation strategy and a highly qualified anesthesiologist should be considered as the fundamental guarantee of a high clinical success rate. Future studies should also focus on the success rate of reintubation using CSES in patients with airway difficulties.
Exploration on surgery of malignant glaucoma with prolonged absence of the anterior chamber: a retrospective consecutive case series
Authors: Liu Yan , Wang Tao
Published: July 2023

Objective

To evaluate the surgical outcomes of anterior chamber restoration in patients with malignant glaucoma and a prolonged absence of the anterior chamber.

Methods

Five patients with malignant glaucoma and a long-term absence of the anterior chamber underwent a combination of anterior pars plana vitrectomy (aPPV), phacoemulsification cataract excision, intraocular lens implantation, peripheral iridotomy (PI), goniosynechialysis (GSL) (referred to aPPV + P + I + PI + GSL) at Beijing Tongren Hospital from October 2018 to June 2021. The study compared the changes in their visual acuity, intraocular pressure (IOP) and medication requirements between the pre-surgery period and their most recent follow-up visit.

Results

The five patients did not report any discomfort, such as pain, tearing, swelling, etc., in their affected eyes, and maintained a stable restoration of the anterior chamber. Among the affected eyes, only one eye demonstrated improved vision during the follow-up visit, while the remaining four eyes did not show any significant improvement. One eye underwent transscleral cyclophotocoagulation as an additional procedure, while the other four eyes did not require any further surgical intervention. In all cases, the intraocular pressure (IOP) was successfully controlled below 30 mmHg. Post-surgery, four eyes still required cycloplegia treatment, and three eyes continued to rely on eye drops to manage their IOP.

Conclusion

Despite minimal improvement in vision, surgical intervention successfully restored the anterior chamber in malignant glaucoma patients with a prolonged absence of anterior chamber. This restoration contributed to alleviating subjective complaints of discomfort and delaying eyeball atrophy.
Exploring the use of social network interventions for adults with mental health difficulties: a systematic review and narrative synthesis
Authors: Brooks Helen , Devereux-Fitzgerald Angela , Richmond Laura , Caton Neil , Cherry Mary Gemma , Bee Penny , Lovell Karina , Downs James , Edwards Bethan Mair , Vassilev Ivaylo , Bush Laura , Rogers Anne
Published: July 2023

Background

People with mental health difficulties often experience social isolation. The importance of interventions to enhance social networks and reduce this isolation is increasingly being recognised. However, the literature has not yet been systematically reviewed with regards to how these are best used. This narrative synthesis aimed to investigate the role of social network interventions for people with mental health difficulties and identify barriers and facilitators to effective delivery. This was undertaken with a view to understanding how social network interventions might work best in the mental health field.

Methods

Systematic searches using combinations of synonyms for mental health difficulties and social network interventions were undertaken across 7 databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science) and 2 grey literature databases (EThoS and OpenGrey) from their inception to October 2021. We included studies reporting primary qualitative and quantitative data from all study types relating to the use of social network interventions for people with mental health difficulties. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Data were extracted and synthesised narratively.

Results

The review included 54 studies, reporting data from 6,249 participants. Social network interventions were generally beneficial for people with mental health difficulties but heterogeneity in intervention type, implementation and evaluation made it difficult to draw definitive conclusions. Interventions worked best when they (1) were personalised to individual needs, interests and health, (2) were delivered outside formal health services and (3) provided the opportunity to engage in authentic valued activities. Several barriers to access were identified which, without careful consideration could exacerbate existing health inequalities. Further research is required to fully understand condition-specific barriers which may limit access to, and efficacy of, interventions.

Conclusions

Strategies for improving social networks for people with mental health difficulties should focus on supporting engagement with personalised and supported social activities outside of formal mental health services. To optimise access and uptake, accessibility barriers should be carefully considered within implementation contexts and equality, diversity and inclusion should be prioritised in intervention design, delivery and evaluation and in future research.
Impact of caregiver’s eHealth literacy, financial well-being, and mental health on quality of life of pediatric patients with osteogenesis imperfecta
Authors: Xu Richard Huan , Zhu Liling , Sun Rongjia , Zou Sainan , Dong Dong
Published: July 2023

Objective

This study assesses the association between health-related quality of life (HRQoL) for pediatric patients with osteogenesis imperfecta (OI) and their caregivers’ eHealth literacy (eHL), financial well-being, and mental health along with the impact of eHealth literacy on the financial well-being and mental health of OI caregivers.

Methods

Participants were recruited from a member pool of two OI patient organizations in China. Information about patients’ HRQoL and their caregivers’ eHL, financial well-being, and mental health was collected. Structure equation modeling (SEM) was used to estimate the relationship between the measures. The robust weighted least square mean and variance adjusted estimator was used. Three criteria, the comparative fit index, the Tucker-Lewis index, and the root mean square error of approximation, were used to evaluate the goodness-of-fit of the model.

Results

A total of 166 caregivers completed the questionnaires. Around 28.3% indicated that pediatric OI patients experienced problems related to mobility, and 25.3% reported difficulty doing usual activities. Around 52.4% of caregivers reported that their care receivers have some emotional problems while 8.4% reported that their care receivers have “a lot of” emotional problems. ‘Some problems’ on all dimensions on EQ-5D-Y was the most frequently reported health state (13.9%), and around 10.0% have no problems on all dimensions on EQ-5D-Y. Caregivers tended to show a significantly high eHL, financial well-being, and mental health when their care receivers reported no problems with usual activities and emotions. The SEM demonstrated a significant and positive relationship between eHL, financial well-being, and mental health.

Conclusion

OI caregivers with high eHL reported satisfactory financial well-being and mental health; their care receivers rarely reported living with poor HRQoL. Providing multicomponent and easy-to-learn training to improve caregivers’ eHL should be highly encouraged.
Effectiveness of provider-initiated versus client-initiated HIV testing by different health facility departments in Northern Tanzania
Authors: Abdul Ramadhani , de Wit Tobias F. Rinke , Martelli Giulia , Costigan Kathleen , Katambi Patrobas , Mllacha Peter , Pozniak Anton , Maokola Werner , Mfinanga Sayoki , Hermans Sabine
Published: July 2023

Background

HIV prevalence in Tanzania is still high at 4.7% among adults. Regular HIV testing is consistently advocated in the country to increase the level of awareness of HIV status, thus contributing to national HIV prevention. We report findings from three years of implementation of an HIV Test and Treat project utilizing provider-initiated and client-initiated testing and counselling (PITC and CITC). This study compared the effectiveness of PITC versus CITC in HIV case detection by the different departments of health facilities.

Method

This retrospective cross-sectional study used health facility-based HIV testing data collected from adults aged 18 years and above between June 2017 – July 2019 in the Shinyanga region, Tanzania. Chi-square and logistic regression analysis were used to assess determinants of yield (HIV positivity).

Results

A total of 24,802 HIV tests were performed of which 15,814 (63.8%) were by PITC and 8,987 (36.2%) by CITC. Overall HIV positivity was 5.7%, higher among CITC at 6.6% than PITC at 5.2%. TB and IPD departments had the highest HIV positivity 11.8% and 7.8% respectively. Factors associated with a positive test were testing at a department in the facility compared to CITC, first-time test, and being or having been married compared to being single.

Conclusion

Success in identifying HIV + patients was highest among people visiting the clinic for HIV testing (CITC) and first-time testers. With PITC, HIV + patient detection differed between departments, suggesting divergent risk profiles of respective clients and/or divergent HIV alertness of staff. This underscores the importance of increased targeting for PITC to identify HIV + patients.
Comparison of cancer subtype identification methods combined with feature selection methods in omics data analysis
Authors: Park JiYoon , Lee Jae Won , Park Mira
Published: July 2023

Background

Cancer subtype identification is important for the early diagnosis of cancer and the provision of adequate treatment. Prior to identifying the subtype of cancer in a patient, feature selection is also crucial for reducing the dimensionality of the data by detecting genes that contain important information about the cancer subtype. Numerous cancer subtyping methods have been developed, and their performance has been compared. However, combinations of feature selection and subtype identification methods have rarely been considered. This study aimed to identify the best combination of variable selection and subtype identification methods in single omics data analysis.

Results

Combinations of six filter-based methods and six unsupervised subtype identification methods were investigated using The Cancer Genome Atlas (TCGA) datasets for four cancers. The number of features selected varied, and several evaluation metrics were used. Although no single combination was found to have a distinctively good performance, Consensus Clustering (CC) and Neighborhood-Based Multi-omics Clustering (NEMO) used with variance-based feature selection had a tendency to show lower p-values, and nonnegative matrix factorization (NMF) stably showed good performance in many cases unless the Dip test was used for feature selection. In terms of accuracy, the combination of NMF and similarity network fusion (SNF) with Monte Carlo Feature Selection (MCFS) and Minimum-Redundancy Maximum Relevance (mRMR) showed good overall performance. NMF always showed among the worst performances without feature selection in all datasets, but performed much better when used with various feature selection methods. iClusterBayes (ICB) had decent performance when used without feature selection.

Conclusions

Rather than a single method clearly emerging as optimal, the best methodology was different depending on the data used, the number of features selected, and the evaluation method. A guideline for choosing the best combination method under various situations is provided.
Long-term observation of estimated fluid volume reduction after the initiation of ipragliflozin in patients with type 2 diabetes mellitus: a sub-analysis from a randomized controlled trial (PROTECT)
Authors: Tanaka Atsushi , Imai Takumi , Toyoda Shigeru , Sugimoto Kazuhiro , Yoshida Ruka , Furuta Machi , Node Koichi ,   the PROTECT Investigators
Published: July 2023

Backgrounds/Aim

Recent studies have shown that the addition of sodium-glucose co-transporter 2 (SGLT2) inhibitors gradually reduces the estimated fluid volume parameters in a broad range of patient populations, suggesting that this mediates the clinical benefits of SGLT2 inhibitors in preventing heart failure. Here, we sought to examine the long-term (24 months) effect of the SGLT2 inhibitor ipragliflozin on the estimated fluid volume parameters in patients with type 2 diabetes mellitus (T2DM).

Methods

In this prespecified sub-analysis of the PROTECT (Prevention of Atherosclerosis by SGLT2 Inhibitor: Multicenter, Randomized Controlled Study) trial, which was an investigator-initiated, multicenter, prospective, randomized, open-label, clinical trial primarily designed to evaluate the effect of ipragliflozin treatment administered for 24 months on carotid atherosclerosis in patients with T2DM, we evaluated serial changes in estimated plasma volume (ePV, %) calculated using the Straus formula and estimated extracellular volume (eEV, mL) calculated by the body surface area by 24 months following the initiation of 50-mg ipragliflozin once daily and compared them with those following standard care for T2DM (non-SGLT2 inhibitor use).

Results

This sub-analysis included 464 patients (ipragliflozin,n = 232; control,n = 232), a full analysis set of the PROTECT trial. In an analysis using mixed-effects models for repeated measures, relative to the control group, ipragliflozin significantly reduced ePV by − 10.29% (95% confidence interval [CI]  − 12.47% to − 8.11%;P < 0.001) at 12 months and − 10.76% (95% CI − 12.86% to − 8.67%;P < 0.001) at 24 months. Additionally, ipragliflozin significantly reduced eEV by − 190.44 mL (95% CI − 249.09 to − 131.79 mL;P < 0.001) at 12 months and − 176.90 mL (95% CI  − 233.36 to − 120.44 mL;P < 0.001) at 24 months. The effects of ipragliflozin on these parameters over 24 months were mostly consistent across various patient clinical characteristics.

Conclusions

This prespecified sub-analysis from the PROTECT trial demonstrated that ipragliflozin treatment, compared with the standard care for T2DM, reduced two types of estimated fluid volume parameters in patients with T2DM, and the effect was maintained for 24 months. Our findings suggest that SGLT2 inhibitor treatment regulates clinical parameters incorporated into the calculating formulas analyzed and consequently fluid volume status for the long-term, and this may be at least partly associated with clinical benefits from chronic use of SGLT2 inhibitors.

Trial registrationJapan Registry of Clinical Trials, ID jRCT1071220089
Mobile health service as an alternative modality for hard-to-reach pastoralist communities of Afar and Somali regions in Ethiopia
Authors: Eba Kasahun , Gerbaba Mulusew J. , Abera Yared , Tadessse Derebe , Tsegaye Sentayehu , Abrar Moahmmed , Mohammed Abdella , Ibrahim Ahmed , Shekabdulahi Muktar , Zeleke Solomon , Medhin Girmay
Published: July 2023

Background

Mobile Health Service (MHS) has been introduced as an alternative strategy to make health care services easily accessible in the Somali and Afar regions of Ethiopia to reach the mobile and hard-to-reach communities. However, the implementation status and effectiveness of the MHS program are not evaluated. Thus, this study aimed at exploring the dynamics and causes of poor health care utilization and implementation barriers and facilitators of MHS in the two regions, i.e. Somali and Afar regions of Ethiopia.

Methods

This study employed the Reachness, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to understand the health care services utilization in pastoralist settings. Furthermore, the study demonstrates the proposed MHS programme components and their challenges encountered during the implementation phase. The researchers collected data from eighteen key informants and eight focused group discussions (FGDs). The data were categorized, coded, entered, and analysed using the NVIVO version 11 software.

Results

The results of this study revealed that health service coverage increased in the districts of Somali and Afar regions where MHS was implemented. According to the results of this study, MHS provision has also increased access to and utilization of health services in general and RMNCH services in particular. The study indicated that the MHS provided the following main health care services: family planning, nutrition supply, timely referral with free transportation, immunization, and treatment of malnourished children. The MHS programme is considered as an effective health service modality in pastoralist areas compared to other modalities. This is mainly because it provides health services following the footsteps of settlement and movement route of the community in search of grazing land and water. However, the study revealed that the MHS programme lacks guidelines for procedural adoption to implement it both at national and regional levels.

Conclusion

The Mobile Health Service has been a useful and effective mechanism to deliver Reproductive, Maternal, Newborn and Child Health (RMNCH) and family planning (FP). Hence, it also facilitates nutrition services to hard-to-reach communities with limited or no health facilities in the targeted woredas of the Somali and Afar regions. Based on the findings, the study recommends the MHS needs to be institutionalized and owned by the government as an alternative health care service delivery modality.
Advances in graft-versus-host disease prevention strategies: latest updates from the 2022 ASH annual meeting
Authors: Chen Yiyin , Xu Yang , Wu Depei
Published: July 2023

This review summarizes the significant advancements in prophylaxis against graft-versus-host disease (GvHD) presented at the 2022 ASH Annual Meeting. The use of innovative agents and regimens, along with the conventional prophylactic approach of combining post-transplant cyclophosphamide and anti-thymocyte globulin, were discussed. The innovative agents and regimens highlighted in this review include abatacept, the first FDA-approved drug for acute GvHD prophylaxis; RGI-2001, which promotes the expansion of regulatory T cells; and cell therapies such as Orca-T and Orca-Q. These advancements provide promising strategies and options for GvHD prevention, offering hope for improved post-transplant patient outcomes in terms of survival rates.
Cost of treatment support for multidrug-resistant tuberculosis using patient-centred approaches in Ethiopia: a model-based method
Authors: Rosu Laura , Morgan Lucy , Tomeny Ewan M. , Worthington Claire , Jin Mengdi , Nidoi Jasper , Worthington David
Published: July 2023

Background

Patient and health system costs for treating multidrug-resistant tuberculosis (MDR-TB) remain high even after treatment duration was shortened. Many patients do not finish treatment, contributing to increased transmission and antimicrobial resistance. A restructure of health services, that is more patient-centred has the potential to reduce costs and increase trust and patient satisfaction. The aim of the study is to investigate how costs would change in the delivery of MDR-TB care in Ethiopia under patient-centred and hybrid approaches compared to the current standard-of-care.

Methods

We used published data, collected from 2017 to 2020 as part of the Standard Treatment Regimen of Anti-Tuberculosis Drugs for Patients with MDR-TB (STREAM) trial, to populate a discrete event simulation (DES) model. The model was developed to represent the key characteristics of patients’ clinical pathways following each of the three treatment delivery strategies. To the pathways of 1000 patients generated by the DES model we applied relevant patient cost data derived from the STREAM trial. Costs are calculated for treating patients using a 9-month MDR-TB treatment and are presented in 2021 United States dollars (USD).

Results

The patient-centred and hybrid strategies are less costly than the standard-of-care, from both a health system (by USD 219 for patient-centred and USD 276 for the hybrid strategy) and patient perspective when patients do not have a guardian (by USD 389 for patient-centred and USD 152 for the hybrid strategy). Changes in indirect costs, staff costs, transport costs, inpatient stay costs or changes in directly-observed-treatment frequency or hospitalisation duration for standard-of-care did not change our results.

Conclusion

Our findings show that patient-centred and hybrid strategies for delivering MDR-TB treatment cost less than standard-of-care and provide critical evidence that there is scope for such strategies to be implemented in routine care. These results should be used inform country-level decisions on how MDR-TB is delivered and also the design of future implementation trials.

Graphical Abstract
CCNNet: a novel lightweight convolutional neural network and its application in traditional Chinese medicine recognition
Authors: Gang Hu , Guanglei Sheng , Xiaofeng Wang , Jinlin Jiang
Published: July 2023

With the development of computer vision technology, the demand for deploying vision inspection tasks on edge mobile devices is becoming increasingly widespread. To meet the requirements of application scenarios on edge devices with limited computational resources, many lightweight models have been proposed that achieves good performance with fewer parameters. In order to achieve higher model accuracy with fewer parameters, a novel lightweight convolutional neural network CCNNet is proposed. The proposed model compresses the modern CNN architecture with “bottleneck” architecture and gets multi-scale features with downsampling rate 3, adopts GCIR module stacking and MDCA attention mechanism to promote the model performance. Compares with several benchmark lightweight convolutional neural network models on CIFAR-10, CIFAR-100 and ImageNet-1 K, the proposed model outperforms them. In order to verify its generalization, a fine-grained dataset for traditional Chinese medicine recognition named “TCM-100” is created. The proposed model applies in the field of traditional Chinese medicine recognition and achieves good classification accuracy, which also demonstrates it generalizes well. The bottleneck framework of the proposed model has some reference values for the design of lightweight model. The proposed model has some promotion significance for classification or recognition applications in other fields.
Demonstration of position estimation for multiple construction vehicles of different models by using 3D LiDARs installed in the field
Authors: Inagawa Masahiro , Kawabe Tomohito , Takei Toshinobu , Nagatani Keiji
Published: July 2023

The construction industry faces a labor shortage problem, so construction vehicles need to be automated. For automation, a position estimation method is expected that is independent of the work environment and can accurately estimate the position of targets. This paper aims to develop a position estimation method for multiple construction vehicles using 3D LiDAR installed in a work environment. By focusing on the shape of construction vehicles, this method can estimate the location of construction vehicles in places where conventional methods cannot be used, such as valleys or roofs. Because the shape of the construction vehicle changes depending on the work equipment and steering operation, each joint angle was obtained, and the 3D model used for estimation was updated. As a result of the experiment, it was verified that the position and orientation of multiple construction vehicles can be estimated with an accuracy that satisfies the required accuracy.
Population genetics of the cereal cyst nematode Heterodera avenae reveal geographical segregation and host adaptation
Authors: Shao Hudie , Zhu Linfeng , Li Zhiqiang , Jiang Ru , Liu Shiming , Huang Wenkun , Li Chuanren , Kong Ling-an , Peng Deliang , Peng Huan
Published: July 2023

Cereal cyst nematodes (CCNs) lead to major losses in the cereal crop industry worldwide and have been reported in many provinces of China. However, this plant nematode’s distribution and genetic differences are not fully understood. In the present study, 821 soil and host root samples were collected from 16 provinces in 2019–2022 to investigate the distribution of the CCNs. Heterodera avenae was detected in 56.39% of the total samples, primarily in Hubei, Henan, Hebei, Shandong, Shanxi, Gansu, Beijing, Tianjin, Inner Mongolia, Ningxia, Xinjiang, Qinghai, Anhui, Shaanxi, and Jiangsu. H. filipjevi was present in 21 samples, with a detection rate of 2.60%, and it was found mainly in Henan, Anhui, Jiangsu, Shandong, Shanxi, and Qinghai. A phylogenetic analysis of the internal transcribed spacer (ITS) region of the rRNA gene indicated that significant evolutionary and genetic differences existed between the Chinese populations and populations from other countries. Our results indicate that ITS1 can be used as a phylogenetic analysis and genetic target for H. avenae populations. The haplotypes of the ITS1 sequences of H. avenae populations from 14 countries were analyzed, and we speculate that H. avenae originated in a Middle East hotspot, then spread westwards to Europe and the United States and eastwards to China and Australia. Genetic differences between Asian and European populations suggest that the Himalayas and Kunlun Mountains formed a barrier that resulted in the formation of a separate evolutionary group in China. The phylogenetic and haplotype analysis results from different hosts showed significant differences among populations isolated from different hosts, and those isolated from weeds were distinct from those from other hosts, indicating that the rich genetic diversity of H. avenae populations is related to the large number of available hosts. Above all, geographic barriers, time of origin, and host adaptation might explain the current known distribution patterns of Chinese H. avenae populations.
Recent application of Raman spectroscopy in tumor diagnosis: from conventional methods to artificial intelligence fusion
Authors: Qi Yafeng , Liu Yuhong , Luo Jianbin
Published: July 2023

Raman spectroscopy, as a label-free optical technology, has widely applied in tumor diagnosis. Relying on the different Raman technologies, conventional diagnostic methods can be used for the diagnosis of benign, malignant and subtypes of tumors. In the past 3 years, in addition to traditional diagnostic methods, the application of artificial intelligence (AI) in various technologies based on Raman technologies has been developing at an incredible speed. Based on this, three technical methods from single spot acquisition (conventional Raman spectroscopy, surface-enhanced Raman spectroscopy) to Raman imaging are respectively introduced and analyzed the diagnosis process of these technical methods. Meanwhile, the emerging AI applications of tumor diagnosis within these methods are highlighted and presented. Finally, the challenges and limitations of existing diagnostic methods, and the prospects of AI-enabled diagnostic methods are presented.
The impact of blockage on the performance of canal coverage structures
Authors: Abo-Sreeaa Doaa A. , AboulAtta Nahla M. , El-Molla Doaa A.
Published: July 2023

Despite the benefits of canal coverage structures, they may turn out to be a significant reason of decreasing canals conveyance efficiency if they are subject to blockage. The difficulty of removing wastes from closed canals further exaggerates the problem. This study investigates the effects of blockage in canal coverage structures, focusing on various cross-sectional shapes and blockage ratios. Seven coverage cross-section shapes, namely the square box, pipe, pipe arch, ellipse, arch, conspan arch, and rectangular box, were studied in combination with 10 different Froude numbers and 10 different blockage ratios. An experimental setup was used in the study along with the HEC-RAS 1D numerical model, which was evaluated through a series of comparative tests.

The study demonstrated that blockage in a canal coverage structure and its extent significantly impairs the structure’s hydraulic performance, leading to an increased head loss ratio and a reduced velocity ratio. The extent of this reduction varied with different coverage shapes, and the sensitivity to blockage was found to be the highest in the square box section, followed by the pipe section at the same design Froude number.

A crucial threshold was identified at a blockage ratio of 30% where the performance of coverage structures started to decline sharply, indicating a key maintenance point. Among the shapes studied, the pipe arch had the best performance in terms of head loss reduction, while a rectangular box with a height to width ratio of 2:3 was found to be a close second. Considering the construction complexities associated with the pipe arch, the rectangular box is recommended as the most practical and efficient option for canal coverage structure design. The findings from this study provide valuable insights for engineers and decision-makers involved in canal management and infrastructure planning.
Digital Psychoeducation for First Episode Psychosis
Authors: Ahmedani Iman , Lyle Holly , Lim Wei Han
Published: July 2023

Aims

Young people with their first episode of psychosis can feel lonely and isolated. Psychoeducation has been shown to increase patient insight, reduce the risk of relapse and forms part of the Quality Standards for Early Intervention in Psychosis Services. Our aim was to increase knowledge of psychosis in service users in an urban cohort by delivering psychoeducation in an interactive online format, due to the restrictions on socialising during the COVID-19 pandemic. We hoped this would serve to empower service users, allow them to connect with each other and offer hope through understanding.

Methods

Appropriate service users aged 18–35 years were recruited from the caseload with the support of care coordinators, with 28 participating overall over a period of ten months. One-hour Zoom sessions of 2–4 participants were facilitated by a junior doctor. Each session consisted of a mix of teaching about basic neuroscience, including brain structure and the dopamine hypothesis theory, interspersed with factual quiz questions and opportunities for free-form answers in ‘thought clouds’. These explored feelings and experiences associated with psychosis. Data were also collected quantitatively in the form of anonymous self-rated pre- and post- session questionnaires on a 10-point Likert scale. These included self-reported questions about the understanding of the brain, psychosis, symptoms, medications and fear associated with the illness. Engagement was increased through the creation of flyers and reminder messages.

Results

Thought clouds constructed during the sessions described feelings such as ‘panic’, ‘unease’, ‘dreamy’ and ‘broken reality’. On average over all sessions, there was an increase of 1.2 points in understanding of the brain, 2.6 points in understanding of ‘psychosis’, 2 points in understanding of how symptoms relate to the brain, 1.8 points in the belief that psychosis can be managed with therapy, 1.5 points in the belief that psychosis can be managed by medication, and unfortunately a 0.1 point increase in fear of the disease – perhaps associated with increased knowledge of the disease process. Encouragingly, 91% of final responses in the sessions were positive, demonstrating hopefulness.

Conclusion

We have demonstrated that innovative digital psychoeducation sessions provide a highly effective way to deliver information to young people with psychosis whilst also allowing connection with peers. This model represents a great learning opportunity for trainees, and could be easily replicated in other geographical locations, or mental health conditions. We have also invited and encouraged co-production with service users.