bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a knowledge-attitude-practice model based narrative life education program for community-dwelling older adults: a mixed-methods feasibility study
Authors: Xie Xifeng , Zhou Li , Zhang Xiaoling , Zou Huina , Lu Yuanfeng , Xiao Huimin
Published: June 2024

Background

The global aging population presents challenges that are particularly acute in China. Older Chinese adults’ attitudes towards death significantly impact their quality of life. Death education is crucial for promoting positive perspectives on life and death. Narrative education offers a promising approach to facilitating death education. Integrating the Knowledge-Attitude-Practice (KAP) model into death education will enhance the feasibility and acceptability of death education programs.

Methods

This mixed-methods feasibility study included a quasi-experimental trial and semi-structured interviews. Older adults in the intervention group (N = 27) received a 6-week KAP-based narrative life education program in addition to standard community health education; participants in the control group (N = 20) received only the normal community health education. In both groups, attitudes toward death and the meaning of life were assessed at baseline and immediately after the intervention. A post-intervention semi-structured interview and satisfaction survey were also conducted for the intervention group.

Results

Forty out of 47 older adults completed the program for an 85.1% retention rate. All of the older adults in the experiment were very satisfied and satisfied with the life education program, and no adverse events were reported. Compared to the control group, participants in the intervention group had a significant decrease in the fear of death (P = 0.028), and substantial improvement in their value of life (P = 0.031), goal of life (P = 0.035), freedom of life (P = 0.003), and the total score for purpose in life (P = 0.017). The qualitative results yielded four themes: profound recognition of life and death, contradiction between thoughts and action, conflict between one’s acceptance and others’ avoidance, and evaluation of the life education program.

Conclusions

The KAP-based narrative life education program is feasible and acceptable for older Chinese community-dwelling adults. It is also potentially effective in improving attitudes toward death attitudes and the meaning of life in this cohort.

Trial registration

This study was retrospectively registered at China Clinical Trial Registry as ChiCTR2300069551 on 2023-03-20. URL of registration: https://www.chictr.org.cn/showproj.html?proj=183176.
An improved method for diagnosis of Parkinson’s disease using deep learning models enhanced with metaheuristic algorithm
Authors: Majhi Babita , Kashyap Aarti , Mohanty Siddhartha Suprasad , Dash Sujata , Mallik Saurav , Li Aimin , Zhao Zhongming
Published: June 2024

Parkinson's disease (PD) is challenging for clinicians to accurately diagnose in the early stages. Quantitative measures of brain health can be obtained safely and non-invasively using medical imaging techniques like magnetic resonance imaging (MRI) and single photon emission computed tomography (SPECT). For accurate diagnosis of PD, powerful machine learning and deep learning models as well as the effectiveness of medical imaging tools for assessing neurological health are required. This study proposes four deep learning models with a hybrid model for the early detection of PD. For the simulation study, two standard datasets are chosen. Further to improve the performance of the models, grey wolf optimization (GWO) is used to automatically fine-tune the hyperparameters of the models. The GWO-VGG16, GWO-DenseNet, GWO-DenseNet + LSTM, GWO-InceptionV3 and GWO-VGG16 + InceptionV3 are applied to the T1,T2-weighted and SPECT DaTscan datasets. All the models performed well and obtained near or above 99% accuracy. The highest accuracy of 99.94% and AUC of 99.99% is achieved by the hybrid model (GWO-VGG16 + InceptionV3) for T1,T2-weighted dataset and 100% accuracy and 99.92% AUC is recorded for GWO-VGG16 + InceptionV3 models using SPECT DaTscan dataset.
3D residual attention hierarchical fusion for real-time detection of the prostate capsule
Authors: Wu Shixiao , Guo Chengcheng , Litifu Ayixiamu , Wang Zhiwei
Published: June 2024

Background

For prostate electrosurgery, where real-time surveillance screens are relied upon for operations, manual identification of the prostate capsule remains the primary method. With the need for rapid and accurate detection becoming increasingly urgent, we set out to develop a deep learning approach for detecting the prostate capsule using endoscopic optical images.

Methods

Our method involves utilizing the Simple, Parameter-Free Attention Module(SimAM) residual attention fusion module to enhance the extraction of texture and detail information, enabling better feature extraction capabilities. This enhanced detail information is then hierarchically transferred from lower to higher levels to aid in the extraction of semantic information. By employing a forward feature-by-feature hierarchical fusion network based on the 3D residual attention mechanism, we have proposed an improved single-shot multibox detector model.

Results

Our proposed model achieves a detection precision of 83.12% and a speed of 0.014 ms on NVIDIA RTX 2060, demonstrating its effectiveness in rapid detection. Furthermore, when compared to various existing methods including Faster Region-based Convolutional Neural Network (Faster R-CNN), Single Shot Multibox Detector (SSD), EfficientDet and others, our method Attention based Feature Fusion Single Shot Multibox Detector (AFFSSD) stands out with the highest mean Average Precision (mAP) and faster speed, ranking only below You Only Look Once version 7 (YOLOv7).

Conclusions

This network excels in extracting regional features from images while retaining the spatial structure, facilitating the rapid detection of medical images.
Acute kidney injury in cancer patients receiving anti-vascular endothelial growth factor monoclonal antibody vs. immune checkpoint inhibitors: a retrospective real-world study
Authors: Zhu Jianfen , Ding Xiaokai , Zhang Jianna , Chen Bo , You Xiaohan , Chen Xinxin , Chen Tianxin
Published: June 2024

Background

Anti-vascular endothelial growth factor monoclonal antibody (anti-VEGF) or immune checkpoint inhibitors (ICIs) combined with chemotherapy are commonly administered to cancer patients. Although cancer patients receiving anti-VEGF or ICIs have been reported to experience an increased risk of acute kidney injury (AKI), comparative studies on the AKI incidence have not been evaluated.

Methods

Cancer patients receiving anti-VEGF or ICIs were retrospectively selected from the hospital information system of the First Affiliated Hospital of Wenzhou Medical University between Jan, 2020 and Dec, 2022 and were divided into two groups according to the treatment regimen: anti-VEGF group and ICIs group. The baseline characteristics were propensity-score matched. The primary outcome was sustained AKI. A comparison of cumulative incidence of sustained AKI was performed by Kaplan-Meier curves and log-rank test. Risks for outcomes were assessed using Cox proportional regression.

Results

A total of 1581 cancer patients receiving anti-VEGF (n = 696) or ICIs (n = 885) were included in the primary analysis. The ICIs group had a higher cumulative incidence of sustained AKI within one year than the anti-VEGF group (26.8% vs. 17.8%, P < 0.001). Among 1392 propensity score matched patients, ICIs therapy (n = 696) was associated with an increased risk of sustained AKI events in the entire population (HR 2.0; 95%CI 1.3 to 2.5; P = 0.001) and especially in those with genitourinary cancer (HR 4.2; 95%CI 1.3 to 13.2; P = 0.015). Baseline serum albumin level (> 35 g/l) was an important risk factor for a lower incidence of sustained AKI in the anti-VEGF group (HR 0.5; 95%CI 0.3 to 0.9; P = 0.027) and the ICIs group (HR 0.3; 95%CI 0.2 to 0.5; P < 0.001).

Conclusions

Among cancer patients in this real-world study, treatment with ICIs increased incidence of sustained AKI in one year. Baseline serum albumin level was an important risk factor for sustained AKI. The risk factors for sustained AKI differed between the anti-VEGF group and the ICIs group.

Trial Registration

The study has been registered at ClinicalTrials.gov (NCT06119347) on 11/06/2023.
Randomised study of the effects of sense of entitlement and conflict of interest contrarianism on researcher decision-making to work with the alcohol industry
Authors: McCambridge Jim , Kypri Kypros , Boehnke Jan R. , Bero Lisa , Bendtsen Marcus
Published: June 2024

Background

It is well established that the tobacco industry used research funding as a deliberate tactic to subvert science. There has been little wider attention to how researchers think about accepting industry funding. We developed, then tested, hypotheses about two psychological constructs, namely, entitlement and conflict of interest contrarianism (CoI-C) among alcohol researchers who had previously received industry funding.

Methods

A mixed-methods pilot study involved construct and instrument development, followed by an online survey and nested 3-arm randomised trial. We randomly allocated alcohol industry funding recipients to one of three conditions. In two experimental conditions we asked participants questions to remind them (and thus increase the salience) of their sense of entitlement or CoI-C. We compared these groups with a control group who did not receive any reminder. The outcome was a composite measure of openness to working with the alcohol industry.

Results

133 researchers were randomised of whom 79 completed the experiment. The posterior distribution over effect estimates revealed that there was a 94.8% probability that reminding researchers of their CoI-C led them to self-report being more receptive to industry funding, whereas the probability was 68.1% that reminding them of their sense of entitlement did so. Biomedical researchers reported being more open to working with industry than did psychosocial researchers.

Conclusion

Holding contrarian views on conflict of interest could make researchers more open to working with industry. This study shows how it is possible to study researcher decision-making using quantitative experimental methods.
The 2017 Women’s Health Initiative study and use of hormone therapy: an emulated repeated cross-sectional study
Authors: Chueh Chen-Han , Ho Pei-Kuan , Li Wai-Hou , Shiu Ming-Neng , Wang I.-Ting , Wen Yu-Wen , Tsai Yi-Wen
Published: June 2024

Background

Hormone therapy (HT) use among menopausal women declined after negative information from the 2002 Women’s Health Initiative (WHI) HT study. The 2017 post-intervention follow-up WHI study revealed that HT did not increase long-term mortality. However, studies on the effects of the updated WHI findings are lacking. Thus, we assessed the impact of the 2017 WHI findings on HT use in Taiwan.

Methods

We identified 1,869,050 women aged 50–60 years, between June and December 2017, from health insurance claims data to compare HT use in the 3 months preceding and following September 2017. To address the limitations associated with interval-censored data, we employed an emulated repeated cross-sectional design. Using logistic regression analysis, we evaluated the impact of the 2017 WHI study on menopausal symptom-related outpatient visits and HT use. In a scenario analysis, we examined the impact of the 2002 trial on HT use to validate our study design.

Results

Study participants’ baseline characteristics before and after the 2017 WHI study were not significantly different. Logistic regressions demonstrated that the 2017 study had no significant effect on outpatient visits for menopause-related symptoms or HT use among women with outpatient visits. The scenario analysis confirmed the negative impact of the 2002 WHI trial on HT use.

Conclusions

The 2017 WHI study did not demonstrate any impact on either menopause-related outpatient visits or HT use among middle-aged women in Taiwan. Our emulated cross-sectional study design may be employed in similar population-based policy intervention studies using interval-censored data.
“Well, what we can do is […] to organize data, to evaluate studies”—Self-images of public health academics in Germany during the COVID-19 pandemic: a qualitative study
Authors: Piel Julia , Prugger Julian , Meuche Anne , von Köppen Marilena , Rosendorfer Tizia , Apfelbacher Christian
Published: June 2024

Background

Despite the significant role of scientific knowledge pertaining to public health, the discipline of public health remained outside the centre stage within the pandemic discourse. Against this background, we investigated the role of German public health academics during the pandemic in our study, focusing on their orientations and associated values.

Methods

We interviewed 21 public health scholars from Germany and collected 36 documents published by public health scientific societies. We analyzed data by grounded theory and situational mapping.

Results

We identified five types of self-images identified among healthcare academics: the scientific study supplier, the expert facing political issues, the restrained scholar, the public informer and the changemaker. The typology yields insights into the multiple dimensions of public health and its role in times of crisis.

Conclusions

The findings provide implications to inter- and transdisciplinary interaction and to managing the expectations of public health professionals in relation to crisis management.
The association between smoking and smokeless tobacco use with dental caries among Pakistani patients
Authors: Khan Muhammad Azad , Vichayanrat Tippanart , Ngoenwiwatkul Yaowaluk
Published: June 2024

Background

Tobacco use is widely recognised as a significant risk factor for oral cancer and periodontal diseases. However, the relationship between various types of tobacco use and dental caries has been inconsistent. This study aimed to determine the association between smoking and smokeless tobacco and dental caries among patients in a tertiary care hospital in Quetta, Pakistan.

Methods

This cross-sectional study was conducted from November 2020 to March 2021 among patients in a tertiary care hospital in Quetta, Pakistan. Oral examinations and interviews were performed according to the WHO Oral Health Survey basic methods (5th edition) to determine dental caries status, tobacco use, and oral health behaviours. The odds ratio and binary logistic regression were analysed to assess the association between the types (smoking tobacco, smokeless tobacco, and use of both types), duration, and frequency of tobacco use and high caries level (DMFT ≥ 5).

Results

Four hundred participants aged 18–65 were included, and 67.8% were tobacco users. Use of both smoking and smokeless tobacco (aOR = 14.7, 95%CI = 1.87–115.96, p = 0.011), smokeless tobacco only (aOR = 5.90, 95%CI = 1.89–18.37, p = 0.002), and smoking only (aOR = 2.18, 95%CI = 1.23–3.88, p = 0.008) were associated with significantly increased risk of high caries. Using tobacco for longer periods and more frequently daily also significantly increases the risk of high caries.

Conclusion

Smoking and smokeless tobacco are significantly associated with high dental caries after adjusting for other factors. Due to the high severity of dental caries and the high prevalence of tobacco use among Pakistani patients in this study, it is highly recommended to strengthen policies aimed at reducing tobacco usage, including smokeless forms.
Sleep and liver function biomarkers in relation to risk of incident liver cancer: a nationwide prospective cohort study
Authors: Song Jiahao , Fan Lieyang , Shi Da , Lai Xuefeng , Wang Hao , Liu Wei , Yu Linling , Liang Ruyi , Zhang Yongfang , Wan Shuhui , Yang Yueru , Wang Bin
Published: June 2024

Background

To assess the largely undetermined separate and joint effects of sleep and liver function biomarkers on liver cancer.

Methods

Data of 356,894 participants without cancer at baseline in the UK Biobank were analyzed. Sleep score was evaluated using five sleep traits (sleep duration, chronotype, insomnia, snoring, and excessive daytime sleepiness) and dichotomized into healthy or unhealthy sleep. Circulating liver function biomarkers were measured. Cox proportional hazard model was performed to investigate the independent and joint associations of sleep and liver function biomarkers with liver cancer incidence.

Results

After a median follow-up time of 13.1 years, 394 cases of incident liver cancer were documented. The multivariable-adjusted hazard ratio (HR) for liver cancer was 1.46 (95% confidence interval: 1.15–1.85) associated with unhealthy sleep (vs. healthy sleep), and was 1.17 (1.15–1.20), 1.20 (1.18–1.22), 1.69 (1.47–1.93), 1.06 (1.06–1.07), 1.08 (1.07–1.09), 1.81 (1.37–2.39), or 0.29 (0.18–0.46) associated with each 10-unit increase in alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total protein (TP), or albumin (ALB), respectively. Individuals with unhealthy sleep and high (≥ median) ALT, AST, TBIL, GGT, ALP, or TP or low (< median) ALB level had the highest HR of 3.65 (2.43–5.48), 4.03 (2.69–6.03), 1.97 (1.40–2.77), 4.69 (2.98–7.37), 2.51 (1.75–3.59), 2.09 (1.51–2.89), or 2.22 (1.55–3.17) for liver cancer, respectively. Significant additive interaction of unhealthy sleep with high TP level on liver cancer was observed with relative excess risk due to an interaction of 0.80 (0.19–1.41).

Conclusions

Unhealthy sleep was associated with an increased risk of liver cancer, especially in participants with lower ALB levels or higher levels of ALT, AST, TBIL, GGT, ALP, or particularly TP.
Role of arachidonic acid in ischemic heart disease under different comorbidities: risk or protection?
Authors: Li Chengjia , Chen Huijun
Published: June 2024

In a translational study involving animal models and human subjects, Lv et al. demonstrate that arachidonic acid (AA) exhibits cardioprotective effects in diabetic myocardial ischemia, suggesting a departure from its known role in promoting ferroptosis—a form of cell death characterized by iron-dependent lipid peroxidation. However, the study does not address how underlying diabetic conditions might influence the metabolic pathways of AA, which are critical for fully understanding its impact on heart disease. Diabetes can significantly alter lipid metabolism, which in turn might affect the enzymatic processes involved in AA’s metabolism, leading to different outcomes in the disease process. Further examination of the role of diabetes in modulating AA’s effects could enhance the understanding of its protective mechanism in ischemic conditions. This could also lead to more targeted and effective therapeutic strategies for managing myocardial ischemia in diabetic patients, such as optimizing AA levels to prevent heart damage while avoiding exacerbating factors like ferroptosis.
Assessment of inbreeding depression on morphometric traits among North Indian population cohorts
Authors: Fatma Rafat , Chauhan Waseem , Afzal Mohammad
Published: June 2024

Aim

Inbreeding is thought to affect the morphometric parameters leading to lower health status among the progeny. The present study was aimed to investigate the repercussions of inbreeding on anthropometric traits, namely height, weight and body mass index (BMI).

Subjects and methods

The survey was conducted in two North Indian cities and total 813 individuals were randomly recruited from inbred and outbred families. The morphometric parameters of the subjects were measured using standard methods, BMI was calculated and categorized into underweight, normal weight and overweight. Family pedigrees were drawn and degree of inbreeding in terms of the inbreeding coefficient (F) was calculated.

Results

A significant decline in morphometric measures was observed among inbred individuals as compared to outbred ones. The mean differences (95% CI) were found significant for various inbred and first cousin categories as compared to outbred subjects (p < 0.05). We found the increased frequency of underweight individuals corresponding to the degree of inbreeding for different types of inbred categories (p = 2.086 × 10−9) and also for different subtypes of first cousin unions corresponding to their sex-linked inbreeding coefficients (p = 5.2 × 10−5). The regression slope and correlation coefficient revealed a fitness decline and depression in anthropometric measures (p < 0.05) with the increase in ‘F’ for all inbred groups and first cousin categories.

Conclusions

The present research confirms the adverse effects of inbreeding on morphometric parameters among inbred subjects. It has novelty in shedding light on the hitherto unreported differences in the consequences of inbreeding among different types of first cousin unions.
Changes in glucose metabolism, C-reactive protein, and liver enzymes following intake of NAD + precursor supplementation: a systematic review and meta‐regression analysis
Authors: Sohouli Mohammad Hassan , Tavakoli Sogand , Reis Marcela Gomes , Hekmatdoost Azita , Guimarães Nathalia Sernizon
Published: June 2024

Background

There are contradictory effects regarding the effect of NAD + precursor on glucose metabolism and liver enzymes. In order to obtain a better viewpoint from them, this study aimed to comprehensively investigate the effects of NAD + precursor supplementation on glucose metabolism, C-reactive protein (CRP), and liver enzymes.

Methods

PubMed/MEDLINE, Web of Science, SCOPUS, and Embase databases were searched using standard keywords to identify all controlled trials investigating the glucose metabolism, CRP, and liver enzymes effects of NAD + precursor. Pooled weighted mean difference (WMD) and 95% confidence intervals (95% CI) were achieved by random-effects model analysis for the best estimation of outcomes.

Results

Forty-five articles with 9256 participants’ were included in this article. The pooled findings showed that NAD + precursor supplementation had a significant increase in glucose (WMD: 2.17 mg/dL, 95% CI: 0.68, 3.66, P = 0.004) and HbA1c (WMD: 0.11, 95% CI: 0.06, 0.16, P < 0.001) as well as a significant decrease in CRP (WMD: -0.93 mg/l, 95% CI -1.47 to -0.40, P < 0.001) compared with control group, and was not statistically significant with respect to insulin and homeostasis model assessment of insulin resistance (HOMA-IR). However, we found no systemic changes in aspartate transaminase (AST), alanine transaminase (ALT), or alkaline phosphatase (ALP) levels after NAD + precursor supplementation. The results of the subgroup analysis showed that the intake of NAD + precursor during the intervention of more than 12 weeks caused a greater increase in the glucose level. Furthermore, Nicotinic acid supplementation (NA) causes a greater increase in glucose and HbA1c levels than nicotinamide (NE) supplementation.

Conclusions

Overall, these findings suggest that NAD + precursor supplementation might have an increase effect on glucose metabolism as well as a decrease in CRP.
Anti-acetylated-tau immunotherapy is neuroprotective in tauopathy and brain injury
Authors: Parra Bravo Celeste , Krukowski Karen , Barker Sarah , Wang Chao , Li Yaqiao , Fan Li , Vázquez-Rosa Edwin , Shin Min-Kyoo , Wong Man Ying , McCullough Louise D. , Kitagawa Ryan S. , Choi H. Alex , Cacace Angela , Sinha Subhash C. , Pieper Andrew A. , Rosi Susanna , Chen Xu , Gan Li
Published: June 2024

Background

Tau is aberrantly acetylated in various neurodegenerative conditions, including Alzheimer’s disease, frontotemporal lobar degeneration (FTLD), and traumatic brain injury (TBI). Previously, we reported that reducing acetylated tau by pharmacologically inhibiting p300-mediated tau acetylation at lysine 174 reduces tau pathology and improves cognitive function in animal models.

Methods

We investigated the therapeutic efficacy of two different antibodies that specifically target acetylated lysine 174 on tau (ac-tauK174). We treated PS19 mice, which harbor the P301S tauopathy mutation that causes FTLD, with anti-ac-tauK174 and measured effects on tau pathology, neurodegeneration, and neurobehavioral outcomes. Furthermore, PS19 mice received treatment post-TBI to evaluate the ability of the immunotherapy to prevent TBI-induced exacerbation of tauopathy phenotypes. Ac-tauK174 measurements in human plasma following TBI were also collected to establish a link between trauma and acetylated tau levels, and single nuclei RNA-sequencing of post-TBI brain tissues from treated mice provided insights into the molecular mechanisms underlying the observed treatment effects.

Results

Anti-ac-tauK174 treatment mitigates neurobehavioral impairment and reduces tau pathology in PS19 mice. Ac-tauK174 increases significantly in human plasma 24 h after TBI, and anti-ac-tauK174 treatment of PS19 mice blocked TBI-induced neurodegeneration and preserved memory functions. Anti-ac-tauK174 treatment rescues alterations of microglial and oligodendrocyte transcriptomic states following TBI in PS19 mice.

Conclusions

The ability of anti-ac-tauK174 treatment to rescue neurobehavioral impairment, reduce tau pathology, and rescue glial responses demonstrates that targeting tau acetylation at K174 is a promising neuroprotective therapeutic approach to human tauopathies resulting from TBI or genetic disease.
Individualized dynamic frailty-tailored therapy (DynaFiT) in elderly patients with newly diagnosed multiple myeloma: a prospective study
Authors: Zhang Yingjie , Liang Xinyue , Xu Weiling , Yi Xingcheng , Hu Rui , Ma Xintian , Yan Yurong , Zhang Nan , Wang Jingxuan , Sun Xiaoxiao , Zhu Yufeng , Tian Mengru , Lan Maozhuo , Long Mengtuan , Dai Yun , Jin Fengyan
Published: June 2024

It remains a substantial challenge to balance treatment efficacy and toxicity in geriatric patients with multiple myeloma (MM), primarily due to the dynamic nature of frailty. Here, we conducted a prospective study to evaluate the feasibility and benefits of dynamic frailty-tailored therapy (DynaFiT) in elderly patients. Patients with newly diagnosed MM (aged ≥ 65 years) received eight induction cycles of bortezomib, lenalidomide, and dexamethasone (daratumumab was recommended for frail patients), with treatment intensity adjusted according to longitudinal changes in the frailty category (IMWG-FI) at each cycle. Of 90 patients, 33 (37%), 16 (18%), and 41 (45%) were fit, intermediate fit, and frail at baseline, respectively. Of 75 patients who had geriatric assessment at least twice, 28 (37%) experienced frailty category changes at least once. At analysis, 15/26 (58%) frail patients improved (27% became fit and 31% became intermediate fit), 4/15 (27%) intermediate fit patients either improved or deteriorated (two for each), and 6/30 (20%) fit patients deteriorated. During induction, 34/90 (38%) patients discontinued treatment, including 10/33 (30%) fit, 4/16 (25%) intermediate fit, and 20/41 (49%) frail; 14/40 (35%) frail patients discontinued treatment within the first two cycles, mainly because of non-hematologic toxicity (mostly infections). For fit, intermediate-fit, and frail patients, the overall response rate was 100%, 93%, and 73%, respectively; one-year overall survival was 90%, 75%, and 54%, respectively. Therefore, the individualized DynaFiT is feasible and promising for heterogeneous elderly patients.
Silver diamine fluoride for the management of dental caries in children in primary dental care: protocol for a feasibility study
Authors: Timms Laura , Rodd Helen , Deery Chris , Brocklehurst Paul , Marshman Zoe
Published: June 2024

Background

Dental caries remains a significant problem in England, affecting 11% of 3-year-olds and 23% of 5-year-olds. While current approaches have been extensively investigated, their ability to (1) control pain and infection; (2) prevent hospital admissions, and (3) be implemented within the National Health Service (NHS) contractual arrangements, remains unsatisfactory. Silver diamine fluoride (SDF) is an alternative, non-invasive approach that has proven efficacy in arresting caries progression in primary teeth, principally from studies conducted outside of Europe. Its use in primary dental care in the UK is limited, despite the acknowledged need.

The clinical and cost-effectiveness of SDF has not been compared to usual care in the UK. Before a pragmatic randomised controlled trial (RCT) can be conducted to compare SDF to usual care for caries management in young children, there are several uncertainties that require investigation. This study aims to establish whether such an RCT is feasible.

Methods

This mixed-method parallel design study is a feasibility study with an embedded process evaluation, to compare SDF with usual treatment in primary dental care in the UK. It will be individually randomised, with 13 dentists and therapists, in 8 different dental primary care sites with a sample size of 80 child participants aged 1–8 years old. The aim will be to recruit ten participants per site with equal arm allocation. Follow-up will be for 1 year. The study will inform whether an RCT is feasible by resolving several key uncertainties. The acceptability and implementation of SDF and the research processes will be explored. Patient and Public Involvement and Engagement representatives will be involved throughout recruitment and retention strategies, participant documentation, analysis, engagement and dissemination.

Discussion

The ability to conduct an RCT will be evaluated. If feasible, this RCT has the potential to evaluate the effectiveness of a non-invasive approach for the management of untreated caries in young children. A feasibility study also offers the opportunity to consider factors associated with the implementation of SDF at an early stage through a process evaluation that will inform the definitive trial and an implementation strategy for SDF by identifying relevant barriers and facilitators.

Trial registration

ClinicalTrials.gov identifier: NCT06092151. Date: 19/10/2023.
Gender differences in survival across the ages of life: an introduction
Authors: Zarulli Virginia , Salinari Giambattista
Published: June 2024

This thematic series explores the complex nature of the survival gap between genders across the lifespan. It highlights how, although women generally have a longer life expectancy than men globally, the complexity of this advantage challenges simplistic explanations. The text emphasizes several areas of interest, such as mortality differences between genders at different life stages, the aging process, and epidemiological differences between the sexes. Additionally, it discusses the role of biological and socio-behavioral factors in explaining the female survival advantage and how this gap has evolved and been influenced by historical, behavioral, and lifestyle changes. With six compelling articles from diverse disciplinary angles, this series underscores the interdisciplinary approach essential for unraveling the intricacies of gender differences in survival across the lifespan.
Comparing machine learning algorithms to predict vegetation fire detections in Pakistan
Authors: Shahzad Fahad , Mehmood Kaleem , Hussain Khadim , Haidar Ijlal , Anees Shoaib Ahmad , Muhammad Sultan , Ali Jamshid , Adnan Muhammad , Wang Zhichao , Feng Zhongke
Published: June 2024

Vegetation fires have major impacts on the ecosystem and present a significant threat to human life. Vegetation fires consists of forest fires, cropland fires, and other vegetation fires in this study. Currently, there is a limited amount of research on the long-term prediction of vegetation fires in Pakistan. The exact effect of every factor on the frequency of vegetation fires remains unclear when using standard analysis. This research utilized the high proficiency of machine learning algorithms to combine data from several sources, including the MODIS Global Fire Atlas dataset, topographic, climatic conditions, and different vegetation types acquired between 2001 and 2022. We tested many algorithms and ultimately chose four models for formal data processing. Their selection was based on their performance metrics, such as accuracy, computational efficiency, and preliminary test results. The model’s logistic regression, a random forest, a support vector machine, and an eXtreme Gradient Boosting were used to identify and select the nine key factors of forest and cropland fires and, in the case of other vegetation, seven key factors that cause a fire in Pakistan. The findings indicated that the vegetation fire prediction models achieved prediction accuracies ranging from 78.7 to 87.5% for forest fires, 70.4 to 84.0% for cropland fires, and 66.6 to 83.1% for other vegetation. Additionally, the area under the curve (AUC) values ranged from 83.6 to 93.4% in forest fires, 72.6 to 90.6% in cropland fires, and 74.2 to 90.7% in other vegetation. The random forest model had the highest accuracy rate of 87.5% in forest fires, 84.0% in cropland fires, and 83.1% in other vegetation and also the highest AUC value of 93.4% in forest fires, 90.6% in cropland fires, and 90.7% in other vegetation, proving to be the most optimal performance model. The models provided predictive insights into specific conditions and regional susceptibilities to fire occurrences, adding significant value beyond the initial MODIS detection data. The maps generated to analyze Pakistan’s vegetation fire risk showed the geographical distribution of areas with high, moderate, and low vegetation fire risks, highlighting predictive risk assessments rather than historical fire detections.
High-precision services of BeiDou navigation satellite system (BDS): current state, achievements, and future directions
Authors: GAO Weiguang , Zhou Wei , Tang Chengpan , Li Xingxing , Yuan Yongqiang , Hu Xiaogong
Published: June 2024

With the rapid development of technologies such as autonomous driving and robotic navigation, the demand for accurate and reliable positioning results with BDS has increased. The current status and future development of BDS high precision services are reviewed. The operational PPP-B2b of BDS-3 achieves positioning accuracy at decimeter-level within 14 min and has the drawbacks in regional coverage and long convergence time compared with the international counterparts, such as CLAS of QZSS and HAS of Galileo. A development frame for multi-layer BDS high-precision services is proposed by considering its construction cost, compatibility of user terminal, operating maintenance burden, and service level. The global high-precision service with the improved orbit and clock accuracy enhanced with the inter-satellite link is taken as the most fundamental layer. By incorporating inter-satellite link observations, the orbit errors URE and clock errors are significantly reduced to approximately 0.05 m and 0.16 ns, respectively, which will expand PPP service to global. Based on this, the regional PPP-AR and PPP-RTK services with improved convergence performance are taken as the second layer. With PPP-AR, the convergence time drops to 10 min. With PPP-RTK, the convergence time would be further shortened to less than 3 min. The LEO enhanced PPP service is taken as the third layer which overcomes both drawbacks of the long convergence time of the inter-satellite link enhanced service (the first layer) and the regional coverage of the PPP-AR/PPP-RTK services (the second layer). The simulation results show that by introducing a LEO constellation of 288 satellites, the LEO enhanced PPP can achieve positioning accuracy better than 5 cm within approximately 1 min. In addition, the integration of LEO constellation and PPP-RTK is further proposed to enable instantaneous convergence. The implementation challenges are also presented.
Novel triplex nucleic acid lateral flow immunoassay for rapid detection of Nipah virus, Middle East respiratory syndrome coronavirus and Reston ebolavirus
Authors: Chingtham Santhalembi , Kulkarni Diwakar D. , Sivaraman Sumi , Mishra Anamika , Pateriya Atul K. , Singh Vijendra Pal , Raut Ashwin Ashok
Published: June 2024

We report the development of a triplex nucleic acid lateral flow immunoassay (NALFIA) for the detection of the genomes of Nipah virus (NiV), Middle East respiratory syndrome coronavirus (MERS-CoV) and Reston ebolavirus (REBOV), which are intended for screening bats as well as other hosts and reservoirs of these three viruses. Our triplex NALFIA is a two-step assay format: the target nucleic acid in the sample is first amplified using tagged primers, and the tagged dsDNA amplicons are captured by antibodies immobilized on the NALFIA device, resulting in signal development from the binding of a streptavidin-colloidal gold conjugate to a biotin tag on the captured amplicons. Triplex amplification of the N gene of NiV, the UpE gene of MERS-CoV, and the Vp40 gene of REBOV was optimized, and three compatible combinations of hapten labels and antibodies were identified for end point detection. The lowest RNA copy numbers detected by the triplex NALFIA were 8.21e4 for the NiV N target, 7.09e1 for the MERS-CoV UpE target, and 1.83e4 for the REBOV Vp40 target. Using simulated samples, the sensitivity and specificity for MERS-CoV and REBOV targets were estimated to be 100%, while the sensitivity and specificity for the NiV target were 91% and 93.3%, respectively. The compliance rate between triplex NALFIA and real-time RT‒PCR was 92% for the NiV N target and 100% for the MERS-CoV UpE and REBOV Vp40 targets.
Deep-learning optimization using the gradient of a custom objective function: A full-waveform inversion example study on the convolutional objective function
Authors: Fang Jinwei , Zhou Hui , Elita Li Yunyue , Shi Ying , Li Xu , Wang Enyuan
Published: June 2024

The integration of conventional high-performance full-waveform inversion (FWI) algorithms with deep-learning frameworks is an innovative and promising research direction with the potential to enhance and broaden the application prospects of this field significantly. Automatic differentiation with backpropagation techniques can derive the gradients of model parameters in an equivalent manner to that of adjoint methods; however, it requires a substantial amount of computer memory, particularly when considering the time-step layers. In addition, some excellent objective functions suitable for FWI are not available in deep-learning frameworks. In comparison, the adjoint method, based on effective boundary storage technology, offers greater practicality for calculating the gradients of various objective functions. Therefore, this paper develops a novel approach toward FWI that integrates deep-learning optimization with high-performance gradient computation. In particular, our method inputs model parameter gradients from a custom objective function into the deep-learning framework. Herein, we use the acoustic equation with variable density as an example to demonstrate how a convolutional objective function, along with its corresponding velocity and density gradients, can be used for optimized inversion, multiscale inversion, and deep network parameterization-based multiscale inversion within the deep-learning framework. This approach provides a paradigm for deep-learning-optimized FWI, which we apply to synthetic and field data scenarios.
Testosterone and Erythrocyte Lifespan
Authors: McMartin Melissa C , Savkovic Sasha , Romano Adelina , Lim Sarina , Muir Christopher A , Jayadev Veena , Conway Ann J , Seccombe Leigh , Handelsman David J
Published: June 2024

Context

Endogenous and exogenous androgens increase circulating erythrocytes and hemoglobin but their effects on erythrocyte lifespan is not known.

Objective

To investigate androgen effects on immature and mature erythrocyte lifespan in humans and mice using novel nonradioactive minimally invasive methods.

Design

Human erythrocyte lifespan was estimated using alveolar carbon monoxide concentration and blood hemoglobin in Levitt's formula in hypogonadal or transgender men before and up to 18 weeks after commencing testosterone (T) treatment. Erythrocyte lifespan was estimated in androgen receptor knockout and wild-type mice after T or DHT treatment of intact females or orchidectomized males using in vivo biotin labelling of erythrocyte surface epitopes for reticulocytes (Ter119+CD71+) and 2 markers of erythrocytes (CD45–, Ter119+CD71–) monitoring their blood disappearance rate by flow cytometry.

Results

Before treatment, hypogonadal and transgender men had marked reduction in erythrocyte lifespan compared with controls. T treatment increased erythrocyte lifespan at 6 weeks but returned to pretreatment levels at 18 weeks, whereas serum T and blood hemoglobin were increased by T treatment remaining elevated at 18 weeks. In mice, T and DHT treatment had higher erythrocyte (but not reticulocyte) lifespan but neither orchidectomy nor androgen receptor inactivation significantly influenced erythrocyte or reticulocyte lifespan.

Conclusion

We conclude that hypogonadal men have reduced erythrocyte lifespan and acute androgen-induced increase in circulating erythrocyte lifespan may contribute to the well-known erythropoietic effects of androgens, but longer term effects require further investigation to determine how much they contribute to androgen-induced increases in circulating hemoglobin.
Preliminary Notes toward a Destituent Art
Authors: Petrossiants Andreas
Published: June 2024

This article argues that, by looking to the generalization of a certain kind of artistic or creative character in paradigms of work, there is a view onto a different kind of relationship between culture and militant action and fugitivity. Here, the term destituent art is proposed to sketch out a form of cultural production that does or might lay waste not only to institutional targets of critique but also to the structurally immanent belief in institutional reform that underlies the aesthetics of that critique. It is an invitation to reconsider some key myths that structure art discourse (even if they appear as objects of critique) and an appeal to read that discursivity as not just productive but potentially destituent. To do so, the author reads operaismo's rereading of Marx against Marxism alongside theorizations of destituent insurrection through the subject of the artist. Some recent social movements in New York City targeting art institutions are analyzed to consider this connection. Like Colectivo Situaciones’ discussion of destituent insurrection as a grammar that unifies surplus populations through their expressions of refusal (the riot, the strike, the commune) that are simultaneously modes of reorganizing forms of life, a destituent art would not signal a turn to a productive pessimism—that all creative work is already subsumed—but that the cultivation of destituent power actualizes and is actualized by the aesthetic production of places of action.
Cardiorespiratory Fitness Is Associated with Decreased Platelet Reactivity
Authors: GRECH JOSEPH , NKAMBULE BONGANI BRIAN , THIBORD FLORIAN , CHAN MELISSA VICTORIA , LACHAPELLE AMBER ROSE , VASAN RAMACHANDRAN , SPARTANO NICOLE L , CHEN MING-HUEI , NAYOR MATT , LEWIS GREGORY DYER , JOHNSON ANDREW DANNER
Published: June 2024

Purpose

Platelets are key mediators in cardiovascular disease (CVD). Low cardiorespiratory fitness (CRF) is a risk factor for CVD. The purpose of our study was to assess if CRF associates with platelet function.

Methods

Platelet assays and cardiopulmonary exercise testing were conducted in the Framingham Heart Study (N = 3014). Linear mixed effects models estimated associations between CRF (assessed by peak oxygen uptake [V̇O2]) and multiple platelet reactivity assays. Models were adjusted for multiple medications, risk factors, relatedness, and prevalent CVD.

Results

Nineteen associations passed the significance threshold in the fully adjusted models, all indicating higher CRF associated with decreased platelet reactivity. Significant traits spanned multiple platelet agonists. Strongest associations were observed in multiplate whole blood testing after TRAP-6 (e.g., velocity, beta = −0.563, 95% CI = −0.735 to −0.391, P = 1.38E−10), ADP (e.g., velocity, beta = −0.514, 95% CI = −0.681 to −0348, P = 1.41E−09), collagen (e.g., velocity, beta = −0.387, 95% CI = −0.549 to −0.224, P = 3.01E−06), ristocetin (e.g., AUC, beta = −0.365, 95% CI = −0.522 to −0.208, P = 5.17E−06) and arachidonic acid stimulation of platelets (e.g., velocity, beta = −0.298, 95% CI = −0.435 to −0.162, P = 3.39E−04), and light transmission aggregometry (LTA) after ristocetin stimulation (e.g., max aggregation, beta = −0.362, 95% CI = −0.540 to −0.184, P = 6.64E−05). One trait passed significance threshold in the aspirin subsample (LTA ristocetin primary slope, beta = −0.733, 95% CI = −1.134 to −0.333, P = 3.30E−04) and another in a model including von Willebrand Factor levels as a covariate (U46619, a thromboxane receptor mimetic, AUC in the Optimul assay, beta = −0.36, 95% CI = −0.551 to −0.168, P = 2.35E−04). No strong interactions were observed between the associations and sex, age, or body mass index in formal interaction analyses.

Conclusions

Our findings build on past work that shows CRF to be associated with reduced CVD by suggesting decreased platelet reactivity may play a mechanistic role. We found significant associations with multiple platelet agonists, indicating higher CRF may globally inhibit platelets; however, given multiple strong associations after TRAP-6 and ADP stimulation, PAR-1 and purinergic signaling may be most heavily involved. This is notable because each of these receptor pathways are tied to anticoagulant (DOAC/thrombin inhibitors) and antiplatelet therapies (P2Y12/PAR1/PAR4 inhibitors) for CVD prevention.
Cohort profile: Improved Pregnancy Outcomes via Early Detection (IMPROvED), an International Multicentre Prospective Cohort
Authors: Maher Gillian M. , Kenny Louise C. , Navaratnam Kate , Alfirevic Zarko , Sheehan Darina , Baker Philip N. , Gluud Christian , Tuytten Robin , Kublickas Marius , Niklasson Boel , Duvekot Johannes J. , van den Berg Caroline B. , Wu Pensee , Kublickiene Karolina , McCarthy Fergus P. , Khashan Ali S.
Published: June 2024

Background Improved Pregnancy Outcomes via Early Detection (IMPROvED) is a multi-centre, European phase IIa clinical study. The primary aim of IMPROvED is to enable the assessment and refinement of innovative prototype preeclampsia risk assessment tests based on emerging biomarker technologies. Here we describe IMPROvED’s profile and invite researchers to collaborate. Methods A total of 4,038 low-risk nulliparous singleton pregnancies were recruited from maternity units in Ireland (N=1,501), United Kingdom (N=1,108), The Netherlands (N=810), and Sweden (N=619) between November 2013 to August 2017. Participants were interviewed by a research midwife at ~11 weeks (optional visit), ~15 weeks, ~20 weeks, ~34 weeks’ gestation (optional visit), and postpartum (within 72-hours following delivery). Findings to date Clinical data included information on maternal sociodemographic, medical history, and lifestyle factors collected at ~15 weeks’ gestation, and maternal measurements, collected at each study visit. Biobank samples included blood, urine, and hair collected at each study visit throughout pregnancy in all units plus umbilical cord/blood samples collected at birth in Ireland and Sweden. A total of 74.0% (N=2,922) had an uncomplicated pregnancy, 3.1% (N=122) developed preeclampsia, 3.6% (N=143) had a spontaneous preterm birth, and 10.5% (N=416) had a small for gestational age baby. We evaluated a panel of metabolite biomarkers and a panel of protein biomarkers at 15 weeks and 20 weeks’ gestation for preeclampsia risk assessment. Their translation into tests with clinical application, as conducted by commercial entities, was hampered by technical issues and changes in test requirements. Work on the panel of proteins was abandoned, while work on the use of metabolite biomarkers for preeclampsia risk assessment is ongoing. Future plans In accordance with the original goals of the IMPROvED study, the data and biobank are now available for international collaboration to conduct high quality research into the cause and prevention of adverse pregnancy outcomes.