bluuebunny/crossref_metadata_2025 huggingface dataset:
Mycobacterium tuberculosis
is less likely to acquire pathogenic mutations during latent infection than during active disease
Authors: Osugi Asami , Tamaru Aki , Yoshiyama Takashi , Iwamoto Tomotada , Mitarai Satoshi , Murase Yoshiro
Published: May 2024

Most people infected with
Mycobacterium tuberculosis
(
Mtb
) are believed to be in a state of latent tuberculosis (TB) infection (LTBI). Although LTBI is asymptomatic and not infectious, there is a risk of developing active disease even decades after infection. Here, to characterize mutations acquired during LTBI, we collected and analyzed
Mtb
genomes from seven Japanese patient pairs, each pair consisting of two active TB patients whose starting dates of developing active disease were >3 years apart; one had a high suspicion of LTBI before developing active disease, whereas the other did not. Thereafter, we compared these genomes with those of longitudinal sample pairs within a host of chronic active TB infections combined with public data. The bacterial populations in patients with LTBI were genetically more homogeneous and accumulated single nucleotide polymorphisms (SNPs) slower than those from active disease. Moreover, the lower proportion of nonsynonymous SNPs indicated weaker selective pressures during LTBI than active disease. Finally, the different mutation spectrums indicated different mutators between LTBI and active disease. These results suggest that the likelihood of the acquisition of mutations responsible for antibiotic resistance and increased virulence was lower in the
Mtb
population from LTBI than active disease.

IMPORTANCE

Controlling latent tuberculosis (TB) infection (LTBI) activation is an effective strategy for TB elimination, where understanding
Mycobacterium tuberculosis
(
Mtb
) dynamics within the host plays an important role. Previous studies on chronic active disease reported that
Mtb
accumulated genomic mutations within the host, possibly resulting in acquired drug resistance and increased virulence. However, several reports suggest that fewer mutations accumulate during LTBI than during the active disease, but the associated risk is largely unknown. Here, we analyzed the genomic dynamics of
Mtb
within the host during LTBI. Our results statistically suggest that
Mtb
accumulates mutations during LTBI, but most mutations are under low selective pressures, which induce mutations responsible for drug resistance and virulence. Thus, we propose that LTBI acts as a source for new TB disease rather than as a period for in-host genome evolution.
Pilot Study of the DRD3, GHRL, FTO, LEPR, INSIG2, GSTP1, and ABCB1 Gene Expression in Peripheral Blood Leukocytes in Schizophrenic Patients with Metabolic Syndrome
Authors: Boiko A. S. , Paderina D. Z. , Mikhalitskaya E. V. , Kornetova E. G. , Bokhan N. A. , Ivanova S. A.
Published: May 2024

Abstract—Many individuals with schizophrenia also suffer from metabolic syndrome (MetS), which is a major risk factor for the development of cardiovascular disroders associated with a heavy burden of disease, as well as with premature death of patients. This study investigated the expression of 7 genes potentially important for the development of metabolic syndrome. QuantiGene Plex 2.0 technology was used to measure how 7 studied genes (DRD3, GHRL, FTO, LEPR, INSIG2, GSTP1, and ABCB1 (MDR1)) were expressed in leukocytes in 60 recently admitted patients with schizophrenia who had been on treatment with antipsychotic drugs. The preliminary results of our study show a change in the expression of the FTO gene in schizophrenic males with metabolic disorders, however, further studies are needed to determine the role of disturbances in the expression of this gene in the development of the metabolic syndrome in patients with schizophrenia.
Clinical, endoscopic and therapeutic features of bleeding Dieulafoy’s lesions: case series and literature review
Authors: Aabdi Basma , Kharrasse Ghizlane , Zazour Abdelkrim , Koulali Hajar , Elmqaddem Ouiam , Zahi Ismaili
Published: May 2024

Objective

Dieulafoy’s lesions (DLs) are a rare but potentially life-threatening source of gastrointestinal (GI) haemorrhage. They are responsible for roughly 1%–6.5% of all cases of acute non-variceal GI bleeding.

Here, we describe retrospectively the clinical and endoscopic features, review the short-term and long-term outcomes of endoscopic management of bleeding DLs and we identify rate and risk factors, of recurrence and mortality in our endoscopic unit.

Design

Data were collected from patients presenting with GI haemorrhagic secondary to DLs between January 2018 and August 2023. Patients’ medical records as well as endoscopic databases were retrospectively reviewed. Demographic data, risk factors, bleeding site, outcomes of endoscopy techniques, recurrence and mortality rate were taken into account.

Results

Among 1170 cases of GI bleeding, we identified only seven cases involving DLs. Median age was 74 years, with a male-to-female ratio of 2.5. 75% of patients had significant comorbidities, mainly cardiovascular diseases. Only anticoagulant and antiplatelet agents were significantly associated with DLs. All patients were presented with GI bleeding as their initial symptom. The initial endoscopy led to a diagnosis in 85% of the cases. Initial haemostasis was obtained in all patients treated endoscopically. Nevertheless, the study revealed early recurrence in two out of three patients treated solely with epinephrine injection or argon plasma coagulation. In contrast, one of three patients who received combined therapy, experienced late recurrence (average follow-up of 1 year). Pathological diagnosis was necessary in one case. One patient (14%) died of haemorrhagic shock. Average length of hospital stay was 3 days.

Conclusion

Although rare, DLs may be responsible for active, recurrent and unexplained GI bleeding. Thanks to the emergence of endoscopic therapies, the recurrence rate has decreased and the prognosis has highly improved. Therefore, the endoscopic approach remains the first choice to manage bleeding DLs.
Adverse pregnancy outcomes in gestational diabetes mellitus: a systematic review and meta-analysis protocol
Authors: Chukwuemeka Scholarstica , Chivese Tawanda , Gopinath Aswathy , Obikeze Kenechukwu
Published: May 2024

Introduction

Gestational diabetes mellitus (GDM) is associated with adverse pregnancy outcomes, including adverse outcomes for both the mother and the fetus. Different diagnostic criteria are used for GDM, and it is not clear how these affect the reported prevalence of adverse pregnancy outcomes. This protocol is for a systematic review to describe and compare the prevalence of adverse pregnancy outcomes in GDM using the different diagnostic criteria applied in various countries/regions of the world.

Methods and analysis

A systematic review and meta-analysis will be carried out. A comprehensive search of observational studies that report the outcomes of interest to this review from 2010 to 2021 will be conducted. We will search the major electronic databases such as PubMed, Scopus, CINHAL and Google Scholar, and screen references of included studies for additional studies. Meta-analyses will be performed, if there is low heterogeneity, and pooled estimates per outcome reported. We will use the bias-adjusted inverse variance heterogeneity model and random effects models, depending on the heterogeneity observed, to pool prevalence estimates and perform subgroup analyses by region, by age group, by diagnostic criteria and by GDM screening method if sufficient data are available. We will also compare the prevalence of adverse outcomes by diagnostic method and report prevalence ratios. We will report 95% confidence estimates for all estimates.

Ethics and dissemination

Ethical approval is not required as the review uses published data. Findings will be published in peer-reviewed journals and presented at conferences.

PROSPERO registration number

CRD42020155061.
Population density and receipt of care for common mental disorders: a cross-sectional analysis of English household data from the 2014 Adult Psychiatric Morbidity Survey
Authors: Hiepko Alexander Thomas , Shoham Natalie , McManus Sally , Cooper Claudia
Published: May 2024

Objectives

People living in less urban areas in the UK may have reduced access to mental healthcare compared with people in urban areas. Although this was not reported in the 2000 Adult Psychiatric Morbidity Survey (APMS) data, subsequent changes to mental health provision and economic recession may have impacted care inequalities. We re-examined this, hypothesising that those living in less urban areas of England received less antidepressant medication and psychological interventions, compared with those living in urban areas, after adjusting for covariates including common mental disorders (CMDs) and socioeconomic status.

Design

National cross-sectional study.

Setting

Households in England.

Participants

We analysed data from 7455 participants aged 16 and above from the 2014 English APMS.

Exposures

Residence in an urban or less urban area.

Primary outcome

Current receipt of any antidepressant medication or any psychological intervention.

Results

Participants living in less urban areas were half as likely to be in receipt of any psychological intervention relative to those living in urban areas (adjusted OR (aOR) 0.49; 95% CI 0.30 to 0.79; p=0.004). There was no association between urbanisation and antidepressant receipt (aOR 1.01; 95% CI 0.81 to 1.25; p=0.944).

Conclusion

People living in less urban areas have a lower likelihood of being in receipt of psychological treatment for CMDs, which may indicate barriers to care access. Our findings differ from the results of a study using a comparable sample conducted 14 years previously. While Improving Access to Psychological Therapies services have increased therapy access nationwide, this may have had more impact in urban areas, potentially widening urban/rural inequalities. Further research is needed to understand how to address such geographical inequalities in access to mental healthcare.
Quality of aerobic training description and its relation to intervention efficacy in chronic obstructive pulmonary disease trials: study protocol for a systematic review, meta-analysis and meta-regression
Authors: Jakobsson Johan , Stoffels Anouk A F , van Hees Hieronymus W H , De Brandt Jana , Nyberg André , Klijn Peter
Published: May 2024

Introduction

Chronic obstructive pulmonary disease (COPD) is a major global health concern, characterised by ventilatory constraints, decreased cardiovascular fitness and reduced limb muscle function, profoundly affecting patients’ quality of life. Aerobic training plays a crucial role in the treatment of COPD, but the variability in methodologies and incomplete reporting of key components in aerobic training trials limits the assessment of their effectiveness. This systematic review aims to critically evaluate the application of training principles and reporting of key components in aerobic training trials in randomised controlled trials (RCTs) in the COPD literature.

Methods and analysis

The protocol adheres to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocol guidelines. The review will include RCTs utilising aerobic training in individuals with COPD. A comprehensive search, following a predefined search strategy will identify studies published from 2007 to 2024 in English from MEDLINE, Embase, CINAHL, CENTRAL and PEDro. Studies including people with COPD and any aerobic training intervention will be included. Two reviewers will independently screen abstracts and titles for inclusion. Two reviewers will independently conduct the screening of full-text documents and data extraction. Study quality will be assessed using the Tool for the assESsment of sTudy quality and bias in Exercise, specifically developed for exercise training studies. The certainty of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. A systematic synthesis will be provided, with meta-analyses and meta-regression when appropriate.

Ethics and dissemination

As this review will involve the analysis of published data, ethical approval is not required. The findings of this review will be disseminated through peer-reviewed publications and conference presentations.

PROSPERO registration number

CRD42021247343.
Modelling air, ground surface, and permafrost temperature variability across four dissimilar valleys, Yukon, Canada
Authors: Garibaldi Madeleine C. , Bonnaventure Philip P. , Noad Nick C. , Kochtitzky Will
Published: May 2024

Spatial maps of the air and ground thermal regime were generated for four Yukon valleys. The aim was to model air, ground surface, and ground temperature (at fine spatial resolution) using locally measured inverted surface lapse rates (SLR) to better predict temperature along an elevation gradient. These local models were then compared to a regional permafrost probability model, which utilized differing inversion assumptions, as well as circumpolar and national models generated without considering inversions. Overall, permafrost probability in the regional model matched well with the local models where assumptions of treeline and inverted SLRs held true. When normal SLRs were assumed, permafrost presence was overestimated in each valley. This discrepancy was greatest at high elevations where permafrost was predicted to be the coldest and most widespread. However, the difference between valleys was dependent on surface and subsurface characteristics such as higher snow cover, mature forest, or thick organic layers which show a greater disassociation from the air temperature overall. Appropriate characterization of the SLR is essential for accurate predictions of the ground thermal regime’s spatial distribution and permafrost presence. These models also provide a starting point for better predictions of warming in these valleys and other areas subject to inversions of similar magnitudes.
Mass, charge, and distance to Reissner–Nordström black hole in terms of directly measurable quantities
Authors: Morales-Herrera Gerardo , Ortega-Ruiz Pablo , Momennia Mehrab , Herrera-Aguilar Alfredo
Published: May 2024

In this paper, we employ a general relativistic formalism and develop new theoretical tools that allow us to analytically express the mass and electric charge of the Reissner–Nordström black hole as well as its distance to a distant observer in terms of few directly observable quantities, such as the total frequency shift, aperture angle of the telescope, and redshift rapidity. Our analytic and concise formulas are valid on the midline, and the redshift rapidity is a relativistic invariant observable that represents the evolution of the frequency shift with respect to the proper time in the Reissner–Nordström spacetime. This procedure is applicable for particles undergoing circular motion around a spherically symmetric and electrically charged black hole, which is the case for accretion disks orbiting supermassive black holes hosted at the core of active galactic nuclei. Although this type of black hole is expected to be electrically neutral, our results provide a novel method to measure the electric charge of the Reissner–Nordström black hole, hence can shed some light on this claim. Besides, these results allow us to measure the mass of the black hole and its distance from the Earth, and we can employ the general formulas in black hole parameter estimation studies.
Confidential Computing or Cryptographic Computing?
Authors: Popa Raluca Ada
Published: May 2024

Secure computation via MPC/homomorphic encryption versus hardware enclaves presents tradeoffs involving deployment, security, and performance. Regarding performance, it matters a lot which workload you have in mind. For simple workloads such as simple summations, low-degree polynomials, or simple machine-learning tasks, both approaches can be ready to use in practice, but for rich computations such as complex SQL analytics or training large machine-learning models, only the hardware enclave approach is at this moment practical enough for many real-world deployment scenarios.
IoT Video Delivery Optimization through Machine Learning-Based Frame Resolution Adjustment
Authors: Bandung Yoanes , Wicaksono Mokhamad Arfan , Pribadi Sean , Langi Armein Z. R. , Tanjung Dion
Published: May 2024

Providing acceptable video quality in the Internet of Things (IoT) implementation poses a significant challenge, mainly when the application is performed on low-cost and low-power devices. This research focuses on developing a frame resolution adjustment system that maintains the frame rate value of video delivery in wireless IoT environments with resource-constrained devices. Consistent frame rates prevent motion lag and data loss, improving user experience. The system works by predicting the upcoming throughput values using machine learning methods to adjust the sensing parameter, which is the resolution of the video frame to be captured by camera nodes. Hence, the proposed system is equipped with a file size estimator to estimate the size of the next video frame and then adjust the resolution in accordance with the throughput prediction. In this research, we conducted extensive experiments to evaluate the accuracy of the file size estimator and the throughput prediction. The experiment generated a dataset to evaluate throughput prediction and file size estimator model. The evaluation results for the file size estimator showed a mean absolute percentage error (MAPE) of 6.73% in the experiment using 317 frames with video resolutions between 72p and 720p. Experiments were also conducted to compare several machine learning methods for predicting throughput values. Compared to long short-term memory (LSTM) and autoregressive integrated moving average (ARIMA), simple exponential smoothing (SES) outperforms the others with the lowest root mean squared error (RMSE) and mean absolute error (MAE) values. Building upon these findings, we implemented the frame resolution adjustment system using SES as the method for predicting the upcoming throughput values. Finally, we demonstrated that the proposed system can maintain the frame rate according to the threshold set by the system while the resolution is being maximized, thereby addressing the challenges of maintaining video quality in resource-constrained IoT environments.
Distributed Multi-objective Optimization in Cyber-Physical Energy Systems
Authors: Stark Sanja , Frost Emilie , Nebel-Wenner Marvin
Published: May 2024

Managing complex Cyber-Physical Energy Systems (CPES) requires solving various optimization problems with multiple objectives and constraints. As distributed control architectures are becoming more popular in CPES for certain tasks due to their flexibility, robustness, and privacy protection, multi-objective optimization must also be distributed. For this purpose, we present MO-COHDA, a fully distributed, agent-based algorithm, for solving multi-objective optimization problems of CPES. MO-COHDA allows an easy and flexible adaptation to different use cases and integration of custom functionality. To evaluate the effectiveness of MO-COHDA, we compare it to a central NSGA-2 algorithm using multi-objective benchmark functions from the ZDT problem suite. The results show that MO-COHDA can approximate the reference front of the benchmark problems well and is suitable for solving multi-objective optimization problems. In addition, an example use case of scheduling a group of generation units while optimizing three different objectives was evaluated to show how MO-COHDA can be easily applied to real-world optimization problems in CPES.
Interaction of macro- and microvascular function underlies brachial artery flow-mediated dilation in humans
Authors: Thorn Clare E. , Gates Phillip E. , Casanova Francesco , Ramalli Alessandro , Tortoli Piero , Palombo Carlo , Shore Angela C. , Aizawa Kunihiko
Published: May 2024

Microvascular response to ischemia and subsequent reperfusion is diminished in older adults compared with the young. Furthermore, there appears to be a dissociation between the microvascular response to ischemia and brachial hyperemic WSR in older adults, which may further disturb the BAFMD process in this cohort. A reduced BAFMD in older adults may be a result of multiple alterations occurring both at macro- and microcirculation.
Design and Analysis of Digitally Tunable Transconductance Amplifier (DTTA) Using CNTFETs
Authors: Tripathi Shailendra Kumar , Hussain Sarfraz , Kumar Raj , Sahu Sourabh
Published: May 2024

Carbon nanotube-FETs (CNTFETs) have become a potential challenger because of their exceptional electrical properties and compatibility with conventional CMOS technology. The design and study of digitally tunable transconductance amplifiers (DTTAs) using CNTFETs are the main topics of this work. By utilizing the special characteristics of CNTFETs, the suggested DTTA design makes transconductance tunable, providing a versatile method of adjusting amplifier settings without requiring modifications to the hardware architecture. This study provides a complete description of the CNTFET modeling techniques utilized for realistic circuit simulations, along with a detailed analysis of the DTTA based on CNTFETs. The circuit is implemented using a 32 nm CNTFET model and verified results with HSPICE.
Intelligent Infrastructure for Traffic Monitoring Based on Deep Learning and Edge Computing
Authors: Villa Jaime , García Franz , Jover Rubén , Martínez Ventura , Armingol José M.
Published: May 2024

In the field of traffic management and control systems, we are witnessing a symbiotic evolution, where intelligent infrastructure is progressively collaborating with smart vehicles to produce benefits for traffic monitoring and security, by rapidly identifying hazardous behaviours. This exponential growth is due to the rapid development of deep learning in recent years, as well as the improvements in computer vision models. These technologies allow for monitoring tasks without the need to install numerous sensors or stop the traffic, using the extensive camera network of surveillance cameras already present in worldwide roads. This study proposes a computer vision‐based solution that allows for real‐time processing of video streams through edge computing devices, eliminating the need for Internet connectivity or dedicated sensors. The proposed system employs deep learning algorithms and vision techniques that perform vehicle detection, classification, tracking, speed estimation, and vehicle geolocation.
Mammographic Texture versus Conventional Cumulus Measure of Density in Breast Cancer Risk Prediction: A Literature Review
Authors: Ye Zhoufeng , Nguyen Tuong L. , Dite Gillian S. , MacInnis Robert J. , Hopper John L. , Li Shuai
Published: May 2024

Mammographic textures show promise as breast cancer risk predictors, distinct from mammographic density. Yet, there is a lack of comprehensive evidence to determine the relative strengths as risk predictor of textures and density and the reliability of texture-based measures. We searched the PubMed database for research published up to November 2023, which assessed breast cancer risk associations [odds ratios (OR)] with texture-based measures and percent mammographic density (PMD), and their discrimination [area under the receiver operating characteristics curve (AUC)], using same datasets. Of 11 publications, for textures, six found stronger associations (P < 0.05) with 11% to 508% increases on the log scale by study, and four found weaker associations (P < 0.05) with 14% to 100% decreases, compared with PMD. Risk associations remained significant when fitting textures and PMD together. Eleven of 17 publications found greater AUCs for textures than PMD (P < 0.05); increases were 0.04 to 0.25 by study. Discrimination from PMD and these textures jointly was significantly higher than from PMD alone (P < 0.05). Therefore, different textures could capture distinct breast cancer risk information, partially independent of mammographic density, suggesting their joint role in breast cancer risk prediction. Some textures could outperform mammographic density for predicting breast cancer risk. However, obtaining reliable texture-based measures necessitates addressing various issues. Collaboration of researchers from diverse fields could be beneficial for advancing this complex field.
History of Infertility and Risk of Colorectal Cancer
Authors: Farland Leslie V. , Lind Kimberly E. , Roe Denise J. , Saquib Nazmus , Strickler Howard D. , Qi Lihong , Thomson Cynthia A. , Harris Holly R.
Published: May 2024

Background:

There has been limited prior research on the association between infertility and risk of colorectal cancer.

Methods:

Data from postmenopausal women in the Women’s Health Initiative were used to estimate the association between self-reported infertility (12 months of trying to get pregnant without achieving a pregnancy) and the risk of colorectal cancer using Cox proportional hazard models.

Results:

No association was observed between infertility and risk of postmenopausal colorectal cancer [RR, 0.97; 95% confidence interval (CI), 0.87–1.08], invasive colorectal cancer (RR, 0.99; 95% CI, 0.88–1.10), or colorectal cancer mortality (RR, 0.89; 95% CI, 0.71–1.12).

Conclusions:

Infertility was not found to be associated with colorectal cancer risk among postmenopausal women. Risk did not vary by specific infertility diagnoses.

Impact:

Infertility may not be associated with colorectal cancer risk.
Kamebakaurin Suppresses Antigen-Induced Mast Cell Activation by Inhibition of FcεRI Signaling Pathway
Authors: Asai Haruka , Kato Koichi , Miyasaka Mayu , Hatsukawa Kaho , Murakami Nanami , Takeda Naoko , Abe Junna , Aoyagi Yutaka , Kohda Yuka , Gui Ming-Yu , Jin Yong-Ri , Li Xu-Wen , Hitotsuyanagi Yukio , Takeya Koichi , Andoh Tsugunobu , Kurosaki Hiromasa , Fukuishi Nobuyuki
Published: May 2024

Introduction: Kamebakaurin is an active constituent of both Rabdosia japonica and Rabdosia excisa, which are utilized in Chinese traditional medicine for improving symptoms in patients with allergies. We investigated the molecular mechanisms of the anti-allergic effects of kamebakaurin using BMMCs. Methods: The degranulation ratio, histamine release, and the interleukin (IL)-4, leukotriene B4 (LTB4), and cysteinyl leukotriene productions on antigen-triggered BMMC were investigated. Additionally, the effects of kamebakaurin on signal transduction proteins were examined by Western blot and binding to the Syk and Lyn kinase domain was calculated. The effects of kamebakaurin on antigen-induced hyperpermeability were investigated using mouse model. Results: At 10 μm, kamebakaurin partially inhibited degranulation, histamine release, and IL-4 production. At 30 μm, kamebakaurin partially reduced LTB4 and cysteinyl leukotriene productions and suppressed degranulation, histamine release, and IL-4 production. Phosphorylation of both Syk Y519/520 and its downstream protein, Gab2, was reduced by kamebakaurin, and complete inhibition was observed with 30 μm kamebakaurin. In contrast, phosphorylation of Erk was only partially inhibited, even in the presence of 30 μm kamebakaurin. Syk Y519/520 is known to be auto-phosphorylated via intramolecular ATP present in its own ATP-binding site, and this auto-phosphorylation triggers degranulation, histamine release, and IL-4 production. Docking simulation study indicated kamebakaurin blocked ATP binding to the ATP-binding site in Syk. Therefore, inhibition of Syk auto-phosphorylation by kamebakaurin binding to the Syk ATP-binding site appeared to cause a reduction of histamine release and IL-4 production. Kamebakaurin inhibited antigen-induced vascular hyperpermeability in a dose-dependent fashion but did not reduce histamine-induced vascular hyperpermeability. Conclusion: Kamebakaurin ameliorates allergic symptoms via inhibition of Syk phosphorylation; thus, kamebakaurin could be a lead compound for the new anti-allergic drug.
Como a pandemia da covid-19 levantou novas questões éticas e legais em relação à propriedade intelectual
Authors: Hellmann Fernando
Published: May 2024

The book “Saúde & propriedade intelectual”, edited by Marcos Wachowicz and Ângela Kretschmann, provides a comprehensive view of the complex ethical and legal issues related to the COVID-19 pandemic and intellectual property in the context of global health. It is a work that explores the critical intersection of intellectual property and public health, with a focus on the COVID-19 pandemic. The book examines ethical issues arising from the pandemic, particularly the conflict between private economic interests and the preservation of people’s lives. It emphasizes the need to rethink intellectual property in biotechnology, considering its social function and pointing to the necessity of balancing public and private interests within the patent system. The work also delves into the Brazilian National Public Health System and international negotiations regarding the intellectual protection of genetic resources, along with the challenges of patenting medicines in resource-constrained countries. Due to its wide coverage, this publication is essential reading for academics, public health experts, legal professionals, and anyone interested in the intersection of intellectual property and public health.
Impact of Elevated Gradients After Transcatheter Aortic Valve Implantation for Degenerated Surgical Aortic Valve Bioprostheses
Authors: Kherallah Riyad Yazan , Suffredini John M. , Rahman Faisal , Eng Marvin H. , Kleiman Neal , Manandhar Pratik , Kosinski Andrzej , Silva Guilherme , Kamat Ishan , Kapadia Samir , Vemulapalli Sreekanth , Jneid Hani
Published: May 2024

BACKGROUND:

Elevated aortic valve gradients are common after transcatheter aortic valve implantation for degenerated surgical aortic valve replacement bioprostheses, but their clinical impact is uncertain.

METHODS:

A total of 12 122 patients who underwent transcatheter aortic valve implantation-in-surgical aortic valve replacement from November 2011 to December 2019 in the Society of Thoracic Surgery/American College of Cardiology Transvalvular Therapeutics Registry were included. The primary outcome was a composite of 1-year all-cause mortality, stroke, myocardial infarction, or valve reintervention. Secondary outcomes included 1-year all-cause mortality, readmission, and change from baseline 12-question self-administered Kansas City Cardiomyopathy Questionnaire-Overall Summary Score. Due to nonlinearity observed with restricted cubic splines analysis, a Cox regression analysis with aortic valve mean gradient modeled as a spline-continuous variable (with 20 mm Hg as a cutoff) was used to study the 1-year composite outcome and mortality.

RESULTS:

The composite outcome occurred most frequently in patients with aortic valve mean gradient ≥30 and <10 mm Hg, as compared with those with 10 to 20 and 20 to 30 mm Hg ranges (unadjusted rates, 13.9%, 12.1%, 7.5%, and 6.5%, respectively;
P
=0.002). When the mean aortic valve gradient was ≥20 mm Hg, higher gradients were associated with greater risk of the 1-year composite outcome (adjusted hazard ratio, 1.02 [1.02–1.03] per mm Hg;
P
<0.001) and 1-year mortality (adjusted hazard ratio, 1.02 [1.00–1.03] per mm Hg;
P
=0.007). Whereas when the mean aortic valve gradient was <20 mm Hg, higher gradients were not significantly associated with the composite outcome (adjusted hazard ratio, 0.99 [0.98–1.003] per mm Hg;
P
=0.12) but were associated with lower 1-year mortality (adjusted hazard ratio, 0.98 [0.97–0.99] per mm Hg;
P
=0.007).

CONCLUSIONS:

The relationship between postprocedural aortic valve mean gradient after transcatheter aortic valve implantation-in-surgical aortic valve replacement and clinical outcomes is complex and nonlinear, with relatively greater adverse events occurring at low and high gradient extremes. Further study of factors mediating the relationship between postprocedural gradients and clinical outcomes, including low-flow states, is necessary.
Combining Early Ischemic Change and Collateral Extent for Functional Outcomes After Endovascular Therapy: An Analysis From AcT Trial
Authors: Tanaka Koji , Kaveeta Chitapa , Pensato Umberto , Zhang Jianhai , Bala Fouzi , Alhabli Ibrahim , Horn MacKenzie , Ademola Ayoola , Almekhlafi Mohammed , Ganesh Aravind , Buck Brian , Tkach Aleksander , Catanese Luciana , Dowlatshahi Dar , Shankar Jai , Poppe Alexandre Y. , Shamy Michel , Qiu Wu , Swartz Richard H. , Hill Michael D. , Sajobi Tolulope T. , Menon Bijoy K. , Demchuk Andrew M. , Singh Nishita
Published: May 2024

BACKGROUND:

Early ischemic change and collateral extent are colinear with ischemic core volume (ICV). We investigated the relationship between a combined score using the Alberta Stroke Program Early Computed Tomography Score and multiphase computed tomography angiography (mCTA) collateral extent, named mCTA-ACE score, on functional outcomes in endovascular therapy–treated patients.

METHODS:

We performed a post hoc analysis of a subset of endovascular therapy–treated patients from the Alteplase Compared to Tenecteplase trial which was conducted between December 2019 and January 2022 at 22 centers across Canada. Ten-point mCTA collateral corresponding to M2 to M6 regions of the Alberta Stroke Program Early Computed Tomography Score grid was evaluated as 0 (poor), 1 (moderate), or 2 (normal) and additively combined with the 10-point Alberta Stroke Program Early Computed Tomography Score to produce a 20-point mCTA-ACE score. We investigated the association of mCTA-ACE score with modified Rankin Scale score ≤2 and return to prestroke level of function at 90 to 120 days using mixed-effects logistic regression. In the subset of patients who underwent baseline computed tomography perfusion imaging, we compared the mCTA-ACE score and ICV for outcome prediction.

RESULTS:

Among 1577 intention-to-treat population in the trial, 368 (23%; 179 men; median age, 73 years) were included, with Alberta Stroke Program Early Computed Tomography Score, mCTA collateral, and combination of both (mCTA-ACE score: median [interquartile range], 8 [7–10], 9 [8–10], and 17 [16–19], respectively). The probability of modified Rankin Scale score ≤2 and return to prestroke level of function increased for each 1-point increase in mCTA-ACE score (odds ratio, 1.16 [95% CI, 1.06–1.28] and 1.22 [95% CI, 1.06–1.40], respectively). Among 173 patients in whom computed tomography perfusion data was assessable, the mCTA-ACE score was inversely correlated with ICV (ρ=−0.46;
P
<0.01). The mCTA-ACE score was comparable to ICV to predict a modified Rankin Scale score ≤2 and return to prestroke level of function (C statistics 0.71 versus 0.69 and 0.68 versus 0.64, respectively).

CONCLUSIONS:

The mCTA-ACE score had a significant positive association with functional outcomes after endovascular therapy and had a similar predictive performance as ICV.
Establishing Faith – The Close Relationships, the Early Influences and the Aspect of Integrity and Trust
Authors: Bjørntvedt Andreas
Published: May 2024

This study examines the establishment of Christian faith amongst Norwegians aged 30–40, with focus on the impact and nature of early religious influences. Employing an explanatory sequential mixed-methods design, the research synthesizes quantitative data from 585 participants, complemented by qualitative follow-ups with 10 respondents from the initial cohort. The tripartite investigation probes into the dynamics of Christian faith formation in this demographic. It particularly scrutinizes the synergy between personal relationships and engagement in Christian practices. The findings suggest a composite of activities that collectively underscore their significance. While youth ministry and parental influence during adolescence play notable roles, the qualities embodied in personal relationships – characterized by warmth, trustworthiness, and integrity – may be more crucial than the structural aspects of the relationships themselves. These insights contest conventional views of predominant influences on faith formation and religious acculturation, underscoring the salience of authentic interpersonal connections in navigating one’s spiritual trajectory.
Meta-Analysis in Surgical Research: Methodology and Statistical Application
Authors: Choi Jae Hwan , Grimsley Emily A. , Read Meagan D. , Rogers Michael P. , Bulard Blake , Kuo Paul C.
Published: May 2024

In evidence-based medicine, systematic review continues to carry the highest weight in terms of quality and reliability, synthesizing robust information from previously published cohort studies to provide a comprehensive overview of a topic. Meta-analysis provides further depth by allowing for comparative analysis between the studied intervention and the control group, providing the most up-to-date evidence on their characteristics and efficacy. We discuss the principles and methodology of meta-analysis, and its applicability to the field of surgical research. The clinical question is defined using PICO framework (Problem, Intervention, Comparison, Outcome). Then a systematic article search is performed across multiple medical databases using relevant search terms, which are then filtered out based on appropriate screening tools. Pertinent data from the selected articles are collected and undergo critical appraisal by at least two independent reviewers. Additional statistical tests may be performed to identify the presence of any significant bias. The data are then synthesized to perform comparative analysis between the intervention and comparison groups. In this article, we discuss specifically the usage of R software (R Foundation for Statistical Computing, Vienna, Austria) for data analysis and visualization. Meta-analysis results of the pooled data are presented using forest plots. Concerns for potential bias may be addressed through the creation of funnel plots. Meta-analysis is a powerful tool to provide highly reliable medical evidence. It may be readily performed by independent researchers with minimal need for funding or institutional approval. The ability to conduct such studies is an asset to budding medical scholars.
Effects of Speaking Rate Changes on Speech Motor Variability in Adults
Authors: Wang Emily W. , Grigos Maria I.
Published: May 2024

The relationship between speaking rate and speech motor variability was examined in three groups of neurotypical adults, n = 40; 15 young adults (18–30 years), 13 adults (31–40 years), and 12 middle-aged adults (41–50 years). Participants completed a connected speech task at three speaking rates (habitual, fast, and slow) where kinematic (lower lip movement) and acoustic data were obtained. Duration and variability were measured at each speaking rate. Findings revealed a complex relationship between speaking rate and variability. Adults from the middle age range (31–40 years) demonstrated shorter acoustic and kinematic durations compared with the oldest age group (41–50 years) during the habitual speaking rate condition. All adults demonstrated the greatest variability in the slow speaking rate condition, with no significant differences in variability between habitual and fast speaking rates. Interestingly, lip aperture variability was significantly lower in the youngest age group (18–30 years) compared with the two older groups during the fast speaking rate condition. Differences in measures of acoustic variability were not observed across the age levels. Strong negative correlations between kinematic/acoustic duration and lip aperture/acoustic variability in the youngest age group were revealed. Therefore, while a slow speaking rate does result in greater variability compared with habitual and fast speaking rates, longer durations of productions by the different age groups were not linked to higher spatiotemporal index (STI) values, suggesting that timing influences speech motor variability, but is not the sole contributor.
Reporting of Child Maltreatment During the COVID-19 Pandemic in a Southern State in the United States
Authors: Thome Julia C. , Gracey Kathy , Epstein Richard A. , Cull Michael J. , Kuhn Tarah , Raman Rameela
Published: May 2024

Objectives:

COVID-19–related stay-at-home orders (SAHOs) created an immediate physical barrier between children and professionals such as pediatricians and teachers, who are often first to identify and report signs of child maltreatment. Our objective was to determine how the SAHO in a southern state was associated with reports of child maltreatment and whether this association was modified by sociodemographic characteristics.

Methods:

We linked data on reports of child maltreatment from a southern state in the United States from October 1, 2018, through September 30, 2020, to data from the US Census Bureau to obtain data on county-level socioeconomic characteristics. We fit a segmented regression model to evaluate changes in reports before and after the SAHO, March 20, 2020. We evaluated potential disparities by child age, case and allegation severity, and socioeconomic characteristics.

Results:

Of 374 885 hotline calls, 276 878 (73.9%) were made before the SAHO and 98 007 (26.1%) after it. Although an immediate decrease in reports of child maltreatment occurred on the day of the SAHO, the rates of reporting within socioeconomic groups started increasing thereafter. While we found no significant change in the overall rate of change in hotline calls after versus before the SAHO (0.23; 95% CI, −0.11 to 0.58), stratified analyses indicate that the rates at which reporting increased varied by education level, health insurance coverage, median annual household income, and unemployment.

Conclusions:

Evaluating these trends is important for policy makers and practitioners to understand how policies enforced during the pandemic influence child maltreatment reporting and how these policies may affect reporting differently across socioeconomic groups.
Robust model-free adaptive iterative learning control for an autonomous bus trajectory tracking system
Authors: Liu Shida , Huang Wei , Ji Honghai , Wang Li
Published: May 2024

A robust model-free adaptive iterative learning control (R-MFAILC) algorithm is proposed in this work to address the issue of laterally controlling an autonomous bus. First, according to the periodic repetitive working characteristics of autonomous buses, a novel dynamic linearized method used in the iterative domain is utilized, and a time-varying data model with a pseudo gradient (PG) is given. Then, the R-MFAILC controller is designed with a proposed adaptive attenuation factor. The proposed algorithm's advantage lies in the R-MFAILC controller, which solely utilizes the input and output data of the regulated entity. Moreover, the R-MFAILC controller has strong robustness and can handle the nonlinear measurement disturbances of the system. In simulations based on the Truck-Sim simulation platform, the effectiveness of the proposed algorithm is verified. A rigorous mathematical analysis is employed to demonstrate the stability and convergence of the proposed algorithm.
Promoting reading, mathematics and science learning: the role of reading achievement and reading interest / Fomento del aprendizaje lector, matemático y científico: el papel del rendimiento lector y del interés por la lectura
Authors: Qin Kexin , Wang Yehui
Published: May 2024

Reading, mathematics and science are important subjects in the compulsory educational stage. Promoting students’ learning in these subjects has become a focus. Early reading achievement and reading interest may play a critical role. Using two waves of data collected from 2,722 Chinese students in Grade 4 and Grade 6, the study investigated the longitudinal within-domain relationship between reading achievement and reading interest, as well as their cross-domain effects on mathematics and science. The results of the structural equation model showed that reading achievement and reading interest were mutually reinforced over time. Except for the path from reading achievement to science interest, the two reading-related constructs in Grade 4 positively predicted achievement and interest in mathematics and science in Grade 6. The findings underline the significance for primary schools to cultivate proficient reading skills and positive reading attitudes in promoting students’ long-term learning in reading, mathematics and science.
Exploring the Use of the Therapist’s Self in Therapy: A Systematic Review
Authors: Alva Meera H. , Antony Sherin P. , Kataria Kanak
Published: May 2024

Purpose:

This systematic qualitative review explored how psychotherapists use their self in therapy within the psychotherapy literature. It sought to examine the key documented ways through which the therapist’s self is intentionally used in therapy and the process of using the therapist’s self.

Methods:

Following PRISMA guidelines, databases including PubMed, ProQuest, APA PsycArticles, and APA PsycINFO were searched. The review question “How do therapists use their self in therapy?” guided the search using derivative keywords. Of the 149 screened articles, 20 underwent full-text review, and only four studies met inclusion criteria.

Findings:

All studies that met the inclusion criteria were from the West. Therapeutic self-disclosure (TSD) emerged as the primary way through which therapists used their self in therapy—notably, the only way documented in the studies reviewed. Studies discussed the nature, rationale, influencing factors, and effectiveness of TSD. This article elaborates upon the themes from the reviewed studies. It critically examines existing literature, lists avenues for future research, and discusses implications for psychotherapy practice.

Conclusions:

The review underscores a significant gap in empirical qualitative research regarding therapists’ use of their self beyond TSD in therapy. There is an urgent need for further exploration in this domain.
Evaluation of pursuance intention among mechanical and manufacturing engineering students in the Philippines: A higher-order structural equation modeling approach
Authors: Ong Ardvin Kester S , Chu Timothy Scott , German Josephine D
Published: May 2024

Constant development in the fields of mechanical and manufacturing engineering has been observed since the pandemic due to the rise of technology, robotics, and connectivity. However, a decline in enrollees for these programs is evident. The main objective of this study was to assess the pursuance intention of students to take these programs among 337 enrolled students in the Philippines. The integrated self-determination theory (SDT) and theory of planned behavior underwent a higher-order partial least square structural equation modeling analysis to completely assess significant factors affecting pursuance intention. Results showed that the SDT domains presented the most significant effect, followed by student motivation, attitude, and control. Based on the results, it could be posited that students from the Philippines believe that there are ample opportunities and careers in this engineering field. They anticipate having a well-respected profession with significant societal impact and practical applications, along with challenging responsibilities, and both local and international opportunities both local and international opportunities. In addition, they foresee great mobility, job security, and professional establishment in the future. As the first study to consider this area of analysis, the framework and methodology could be further developed, extended, and applied in other educational studies worldwide.
Book review: Nasir Raza Khan, India and the Silk Road: Exploring Current Opportunities
Authors: Upadhyaya Manorama
Published: May 2024

Nasir Raza Khan, India and the Silk Road: Exploring Current Opportunities. Delhi: Primus Book, 2019, IX + 245 pp., ₹1,250, ISBN: 97893502907229 (Hardback).