bluuebunny/crossref_metadata_2025 huggingface dataset:
Host cell sensing and restoration of mitochondrial function and metabolism within
Helicobacter pylori
VacA intoxicated cells
Authors: Seeger Ami Y. , Zaidi Faisal , Alhayek Sammy , Jones Rachel M. , Zohair Huzaifa , Holland Robin L. , Kim Ik-Jung , Blanke Steven R.
Published: October 2023

Helicobacter pylori
vacuolating cytotoxin A (VacA) is an intracellular-acting protein exotoxin that induces mitochondrial dysfunction and energy depletion within host cells. Although exposure to VacA results in mitochondrial dysfunction, one recent study revealed that, following limited exposure to VacA, mitochondrial function and cellular ATP levels were restored in a time-dependent manner. Studies performed to address the mechanism by which host cells detect and respond to intracellular VacA identified the adenosine monophosphate (AMP)-activated protein kinase (AMPK) as a sensor of toxin-dependent alterations in cellular energy status. Activation of AMPK in response to VacA was demonstrated to orchestrate alterations in mitochondrial dynamics which resulted in restoration of mitochondrial function. Specifically, upregulation of dynamin-related protein 1 (Drp-1)-dependent mitochondrial fission resulted in reversible fragmentation of filamentous mitochondria and time-dependent reduction in mitochondrial-associated VacA, suggesting that fragmentation is important for removal of VacA from mitochondria. Cells with reduced levels of Drp-1 were more susceptible to VacA-dependent cell death, suggesting that mitochondrial dynamics is important for maintaining cell viability through the reduction in mitochondrial-associated toxin. Collectively, these studies support a model that cellular recovery and survival in response to VacA-dependent mitochondrial dysfunction is linked to host cell modulation of mitochondrial dynamics. This study provides new insights into cellular recognition and responses to intracellular-acting toxin modulation of host cell function, which could be relevant for the growing list of pathogenic microbes and viruses identified that target mitochondria as part of their virulence strategies.

IMPORTANCE

Persistent human gastric infection with
Helicobacter pylori
is the single most important risk factor for development of gastric malignancy, which is one of the leading causes of cancer-related deaths worldwide. An important virulence factor for
Hp
colonization and severity of gastric disease is the protein exotoxin VacA, which is secreted by the bacterium and modulates functional properties of gastric cells. VacA acts by damaging mitochondria, which impairs host cell metabolism through impairment of energy production. Here, we demonstrate that intoxicated cells have the capacity to detect VacA-mediated damage, and orchestrate the repair of mitochondrial function, thereby restoring cellular health and vitality. This study provides new insights into cellular recognition and responses to intracellular-acting toxin modulation of host cell function, which could be relevant for the growing list of pathogenic microbes and viruses identified that target mitochondria as part of their virulence strategies.
Living-donor lobar lung transplantation from a hepatitis B surface antigen-positive donor to a negative recipient
Authors: Yamaya Takafumi , Sato Masaaki , Konoeda Chihiro , Nakajima Jun
Published: October 2023

A man in his 40s was diagnosed with interstitial pneumonia at another hospital. He was referred to our hospital for lung transplantation. His lung function was rapidly declining, necessitating semiurgent living-donor lobar lung transplantation (LDLLT). Although he was negative for hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb), one of the candidate donors was proven HBsAg-positive. The risk of hepatitis B virus (HBV) infection at transplantation was considered high; however, after careful discussion about the safety of the recipient and donor, it was decided to conduct LDLLT. For prophylaxis, human anti-HBV surface immunoglobulin and entecavir were administered to the recipient. HBsAg and HBsAb were continuously monitored postoperatively and consistently negative, suggesting no signs of reactivation in the recipient, even after corticosteroid pulse treatment for acute cellular rejection. More than 6 months after LDLLT, there were no signs of HBV reactivation in either the recipient or donor.
Inequalities in adequate maternal healthcare opportunities: evidence from Bangladesh Demographic and Health Survey 2017–2018
Authors: Methun Md Injamul Haq , Ahinkorah Bright Opoku , Roy Sutopa , Okyere Joshua , Hossain Md Ismail , Haq Iqramul , Ume Shatabdi Shamrita , Kamrul Hasan Md
Published: October 2023

Objectives

This study investigated the inequalities in access to maternal healthcare services in Bangladesh.

Design and setting

This study used cross-sectional data from the nationally representative Bangladesh Demographic and Health Survey conducted in 2017–2018. The survey encompassed diverse regions and households across Bangladesh. The study used the Human Opportunity Index (HOI) and Shapley’s decomposition technique to measure the inequality in access to maternal healthcare opportunities.

Participants

This study included 20 127 women aged 15–49 years. Among them, 5012 women had live births in the preceding 3 years of the survey, forming the study sample.

Primary and secondary outcome measures

This study has no secondary outcome variable. The primary dependent variable is ‘adequate maternal healthcare’, a dichotomous variable.

Results

Household wealth status contributed the highest to inequality in accessing adequate maternal healthcare services (41.4%) such as receiving at least four antenatal care (ANC) visits (39.7%), access to proper ANC (50.7% and 44.0%) and health facility birth (43.4%). Maternal educational status contributes the second highest inequality among all factors in accessing adequate maternal healthcare (29.5%). Adequate maternal healthcare presented the lowest coverage rate and opportunity index among all (approximately 24% with HOI=17.2).

Conclusions

We found that attained adequate maternal healthcare had the lowest coverage and widest dissimilarity, while wealth index, education and place of residence are the major factors that contribute to inequalities in accessibility to maternal healthcare services in Bangladesh. These findings underscore a need for pro-poor interventions to narrow the economic inequalities between the poor and rich in terms of accessibility to maternal healthcare services. The results indicate the need for the Bangladeshi government and its health department to strengthen their commitment to improving female education. Investments should be made in initiatives that facilitate the proximity of maternal healthcare services to women in rural areas.
Content development of the VISION-Cog: a novel tool to assess cognitive impairment in visually impaired older adults in Singapore
Authors: Vu Tai Anh , Fenwick Eva , Doshi Kinjal , Gupta Preeti , Quek Shin Yi , Chen Christopher , Ting Simon , Ng Adeline S L , Yap Philip , Yeo Donald , Milea Dan , Lamoureux Ecosse Luc
Published: October 2023

Objectives

Current cognitive screening and diagnostic instruments rely on visually dependent tasks and are, therefore, not suitable to assess cognitive impairment (CI) in visually impaired older adults. We describe the content development of the VISually Independent test battery Of NeuroCOGnition (VISION-Cog)–a new diagnostic tool to evaluate CI in visually impaired older Singaporean adults.

Design

The content development phase consisted of two iterative stages: a neuropsychological consultation and literature review (stage 1) and an expert-panel discussion (stage 2). In stage 1, we investigated currently available neuropsychological test batteries for CI to inform constructions of our preliminary test battery. We then deliberated this battery during a consensus meeting using the Modified Nominal Group technique (stage 2) to decide, via agreement of five experts, the content of a pilot neuropsychological battery for the visually impaired.

Setting

Singapore Eye Research Institute.

Participants

Stakeholders included researchers, psychologists, neurologists, neuro-ophthalmologists, geriatricians and psychiatrists.

Outcome measure

pilot VISION-Cog.

Results

The two-stage process resulted in a pilot VISION-Cog consisting of nine vision-independent neuropsychological tests, including the modified spatial memory test, list learning, list recall and list recognition, adapted token test, semantic fluency, modified spatial analysis, verbal subtests of the frontal battery assessment, digit symbol, digit span forwards, and digit span backwards. These tests encompassed five cognitive domains–memory and learning, language, executive function, complex attention, and perceptual-motor abilities. The expert panel suggested improvements to the clarity of test instructions and culturally relevant test content. These suggestions were incorporated and iteratively pilot-tested by the study team until no further issues emerged.

Conclusions

We have developed a five-domain and nine-test VISION-Cog pilot instrument capable of replacing vision-dependent diagnostic batteries in aiding the clinician-based diagnosis of CI in visually impaired older adults. Subsequent phases will examine the VISION-Cog’s feasibility, comprehensibility and acceptability; and evaluate its diagnostic performance.
Diabetes care components effectively implemented in the ASEAN health systems: an umbrella review of systematic reviews
Authors: Te Vannarath , Ma Sokvy , Por Ir , Van Damme Wim , Wouters Edwin , van Olmen Josefien
Published: October 2023

Objectives

Association of Southeast Asian Nations (ASEAN) is among the hardest hit low-income and middle-income countries by diabetes. Innovative Care for Chronic Conditions (ICCC) framework has been adopted by the WHO for health system transformation towards better care for chronic conditions including diabetes. We conducted an umbrella review of systematic reviews on diabetes care components effectively implemented in the ASEAN health systems and map those effective care components into the ICCC framework.

Design

An umbrella review of systematic reviews and/or meta-analyses following JBI (Joanna Briggs Institute) guidelines.

Data sources

Health System Evidence, Health Evidence, PubMed and Ovid MEDLINE.

Eligibility criteria

We included systematic reviews and/or meta-analyses which focused on management of type 2 diabetes, reported improvements in measured outcomes and had at least one ASEAN member state in the study setting.

Data extraction and synthesis

Two reviewers independently extracted the data and mapped the included studies into the ICCC framework. A narrative synthesis method was used to summarise the findings. The included studies were assessed for methodological quality based on the JBI critical appraisal checklist for systematic reviews and research syntheses.

Results

479 records were found of which 36 studies were included for the analysis. A multidisciplinary healthcare team including pharmacists and nurses has been reported to effectively support patients in self-management of their conditions. This can be supported by effective use of digital health interventions. Community health workers either peers or lay people with necessary software (knowledge and skills) and hardware (medical equipment and supplies) can provide complementary care to that of the healthcare staff.

Conclusion

To meet challenges of the increased burden of chronic conditions including diabetes, health policy-makers in the ASEAN member states can consider a paradigm shift in human resources for health towards the multidisciplinary, inclusive, collaborative and complementary team.
Multimodal prehabilitation to improve the clinical outcomes of frail elderly patients with gastric cancer: a study protocol for a multicentre randomised controlled trial (GISSG+2201)
Authors: Sun Yuqi , Tian Yulong , Cao Shougen , Li Leping , Yu Wenbin , Ding Yinlu , Wang Xixun , Kong Ying , Wang Xinjian , Wang Hao , Hui Xizeng , Qu Jianjun , Wang HongBo , Duan Quanhong , Yang Daogui , Zhang Huanhu , Zhou Shaofei , Liu Xiaodong , Li Zequn , Meng Cheng , Kehlet Henrik , Zhou Yanbing
Published: October 2023

Introduction

Gastric cancer (GC) diagnosed in the elderly population has become a serious public health problem worldwide. Given the combined effects of frailty and the consequences of cancer treatment, older individuals with GC are more likely than young patients to suffer from postoperative complications and poor clinical outcomes. Nutrition, functional capacity and psychological state-based multimodal prehabilitation, which is dominated by Enhanced Recovery After Surgery (ERAS) pathway management, has been shown to reduce postoperative complications, promote functional recovery and decrease hospitalisation time in certain malignancies. However, no previous studies have investigated the clinical application of multimodal prehabilitation in frail older patients with GC.

Methods and analysis

The study is a prospective, multicentre randomised controlled trial in which a total of 368 participants who meet the inclusion criteria will be randomised into either a prehabilitation group or an ERAS group. The prehabilitation group will receive multimodal prehabilitation combined with ERAS at least 2 weeks before the gastrectomy is performed, including physical and respiratory training, nutritional support, and therapy and psychosocial treatment. The ERAS group patients will be treated according to the ERAS pathway. All interventions will be supervised by family members. The primary outcome measures are the incidence and severity of postoperative complications. Secondary outcomes include survival, functional capacity and other short-term postoperative outcomes. Overall, the multimodal prehabilitation protocol may improve functional capacity, reduce the surgical stress response and concomitant systemic inflammation, and potentially modulate the tumour microenvironment to improve short-term and long-term clinical outcomes and patients’ quality of life.

Ethics and dissemination

All procedures and participating centres of this study were approved by their respective ethics committees (QYFYKYLL 916111920). The final study results will be published separately in peer-reviewed journals.

Trial registration number

NCT05352802.
Ultrasound-guided anterior quadratus lumborum block at the L2 level for postsurgical analgesia in patients undergoing laparoscopic gynaecological surgery: a single-centre, randomised, double-blinded trial at a university-affiliated hospital in China
Authors: Huang Lvdan , Cai Yaoyao , Yang Lili , Liu Le , Wang Quanguang , Shi Kejian
Published: October 2023

Objective

This study aimed to investigate the analgesic effect of an ultrasound-guided anterior quadratus lumborum block (QLB) at the L2 level on postoperative pain after laparoscopic gynaecological surgery.

Design

Prospective single-centre randomised double-blind trial.

Setting

University-affiliated hospital.

Participants

Sixty patients aged between 18 and 65 years scheduled for laparoscopic gynaecological surgery.

Interventions

Before surgery, bilateral anterior QLB was performed with 20 mL of 0.375% ropivacaine injected on each side in the QLB group, whereas equal amount of saline was administered in the placebo group.

Primary and secondary outcome measures

The primary endpoint was the cumulative morphine dose in the first 24 hours, and the secondary endpoints were morphine consumption at each time interval, area under the curve (AUC) of the numeric rating scale (NRS) for pain, maximum pain intensity, incidence of moderate-to-severe pain (NRS>3), sedation score, adverse events, and time to home-readiness.

Results

Cumulative morphine consumption in the first 24 hours after surgery was significantly lower in the QLB group than in the placebo group (mean difference, 14.2; 95% CI 6.3 to 22.1; p<0.001). The AUCs of NRS pain intensity scores, including visceral and incisional pain at rest and on movement, were significantly lower in the QLB group than in the placebo group (all p<0.001). The time to home-readiness was significantly shorter in the QLB group than in the placebo group (p<0.05).

Conclusion

Ultrasound-guided anterior QLB at the L2 level significantly reduced morphine consumption and relieved visceral and incision pain intensity after laparoscopic gynaecological surgery, which was beneficial for enhanced recovery.

Trial registration number

Chinese Clinical Trial Registry (ChiCTR-IOR-17011960).
Efficacy of automated insulin delivery (AID) systems in type 1 diabetes: protocol of a systematic review and network meta-analysis of outpatient randomised controlled trials
Authors: Stahl-Pehe Anna , Schlesinger Sabrina , Kuss Oliver , Shokri-Mashhadi Nafiseh , Bächle Christina , Warz Klaus-D , Bürger-Büsing Jutta , Holl Reinhard , Spörkel Olaf , Rosenbauer Joachim
Published: October 2023

Introduction

Automated insulin delivery (AID), also known as artificial pancreas system or ‘closed-loop system’, represents a novel option for current treatments for type 1 diabetes (T1D). The objective of this systematic review and meta-analysis is to assess the efficacy of AID systems in comparison with current intensified insulin therapy for glycaemic control and patient-reported outcomes in individuals with T1D.

Methods and analysis

Studies will be eligible if they are randomised controlled trials (RCTs) in people with T1D of all ages, and if they compare an AID system for self-administration during the day and night period with any other type of insulin therapy for at least 3 weeks. The primary outcome will be time in the glucose target range of 70–180 mg/dL. A systematic review will be conducted in the MEDLINE, Embase, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov registries from their inception dates. Two authors will independently screen all references based on titles and abstracts against the eligibility criteria. For data extraction, standard forms will be developed and tested before extraction. All information will be assessed independently by at least two reviewers. The risk of bias of the included studies will be assessed using the Cochrane Risk of Bias 2 tool. The data synthesis will include a random-effects pairwise and network meta-analysis (NMA) in a frequentist framework. Where applicable and if sufficient RCTs are available, sensitivity analyses will be performed, and heterogeneity and publication bias will be assessed. The certainty of evidence from the NMA will be evaluated following the Grading of Recommendations Assessment, Development, and Evaluation working group guidance.

Ethics and dissemination

No ethical approval is needed. The results will be reported to the funder, presented in a peer-reviewed scientific journal and at conferences, and disseminated via press release, social media and public events.

PROSPERO registration number

CRD42023395492.
Improving the mental health and mental health support available to adolescents in out-of-home care via Adolescent-Focused Low-Intensity Life Story Work: a realist review
Authors: Hammond Simon P , Mickleburgh Ella , Duddy Claire , Hiller Rachel , Neil Elsbeth , Blackett Rosie , Williams Kevin , Wilson Jon , Wong Geoff
Published: October 2023

Objectives

Life Story Work (LSW) is used to promote the mental health and well-being of children and adolescents living in out-of-home care. LSW should be offered to all but is conventionally delivered in high-intensity ways. Low-intensity approaches are more accessible but there is significant variation and little guidance for supporting adolescents. We aimed to create guidance for Adolescent-Focused Low-Intensity LSW.

Design

Realist review.

Data sources

MEDLINE, Embase, PsycINFO, Sociology Collection (ProQuest), CINAHL, CDAS, Web of Science (SCIE, SSCI), Social Care Online and grey literature sources. Searches were performed between December 2021 and March 2022.

Eligibility criteria

Documents on children and adolescents in care, LSW and/or low-intensity interventions to improve mental health were included. Documents focusing on parenting style and contact with birth family were excluded.

Analysis

Documents were analysed using a realist logic of analysis. In consultation with Content Expert Groups (comprising professionals and care leavers), we developed an initial programme theory. Data relating to and challenging the initial programme theory were extracted and context-mechanism-outcome-configurations developed, critiqued and refined in an iterative fashion. Interpretations were drawn from context-mechanism-outcome-configurations to enhance the programme theory.

Results

75 documents contributed to the analysis. Generally, studies were small-scale and lacked in-depth methods and evaluation descriptions. Findings indicated important factors contribute to the development of high-quality Adolescent-Focused Low-Intensity LSW. Adolescent-Focused Low-Intensity LSW should be person-centred, begin in the now, involve co-construction, record everyday positive life events and be supported by trained carer(s). Context-mechanism-outcome-configurations relating to these themes are reported.

Conclusions

Using this knowledge we developed initial practice guidance to support social care to deliver better quality Adolescent-Focused Low-Intensity LSW more consistently. To address gaps in our knowledge about the impact of Adolescent-Focused Low-Intensity LSW, further primary research is needed to strengthen understandings of how this intervention works (or not) in different contexts.

PROSPERO registration number

CRD42021279816.
Factors affecting do-not-attempt-resuscitation (DNAR) decisions among adult patients in the emergency department of a general tertiary teaching hospital in China: a retrospective observational study
Authors: Wang Chao-Lan , Liu Yang , Gao Yu-Lei , Li Qing-Song , Liu Yan-Cun , Chai Yan-Fen
Published: October 2023

Objective

Do-not-attempt-resuscitation (DNAR) orders are designed to allow patients to opt out of receiving cardiopulmonary resuscitation in the event of a cardiac arrest. While DNAR has become a standard component of medical care, there is limited research available specifically focusing on DNAR orders in the context of emergency departments in China. This study aimed to fill that gap by examining the factors related to DNAR orders among patients in the emergency department of a general tertiary teaching hospital in China.

Design

Retrospective observational study.

Setting

Emergency department.

Participants

This study and analysis on adult patients with DNAR or no DNAR data between 1 January 2022 and 1 January 2023 in the emergency department of a large academic comprehensive tertiary teaching hospital. A total of 689 were included in our study.

Primary outcome measures

Whether the patient received DNAR was our dependent variable.

Results

Among the total patients, 365 individuals (53.0%) had DNAR orders. The following variables, including age, sex, age-adjusted Charlson comorbidity index (ACCI), primary diagnosis of cardiogenic or cancer related, history of neurological dysfunction or cancer, were independently associated with the difference between the DNAR group and the no DNAR group. Furthermore, there were significant statistical differences observed in the choice of DNAR among patients with different stages of cancer.

Conclusions

In comparison to the no DNAR group, patients with DNAR were characterised by being older, having a higher proportion of female patients, higher ACCI scores, a lower number of patients with a primary diagnosis of cardiogenic and a higher number of patients with a primary diagnosis of cancer related, history of neurological dysfunction or cancer.
Framework for maternal morbidity and mortality interventions in Ethiopia: a systematic review protocol
Authors: Tadesse Trhas , Regassa Nigatu , Kifle Dereje , Jara Dube , Abegaz Kedir Hussein
Published: October 2023

Background

Maternal morbidity and mortality remain critical public health challenges in Ethiopia with limited evidence on the effectiveness of interventions and health promotion strategies. A scoping review of the existing literature on maternal morbidity and mortality interventions and health promotion in Ethiopia can provide a comprehensive overview of the current evidence, identify research gaps and establish a framework for successful maternal morbidity and mortality interventions.

Objective

The systematic review seeks to assess the existing literature on maternal morbidity and mortality interventions in Ethiopia to develop an evidence-based framework for effective interventions.

Method

The methodology for this study adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines for systematic review protocol. A comprehensive search strategy will be devised, in compliance with the highly sensitive search guidelines of Cochrane, which will involve using both snowball methods to identify relevant articles and searching electronic databases using specific key search terms. The following databases will be searched for studies to be included in the systematic review: MEDLINE (via PubMed), Embase, Scopus, Google Scholar, Web of Science, Science Direct and African Journals Online (AJOL).

The search will be restricted to English language publications starting from January 2010 to May 2023. In a comprehensive review process, independent reviewers will meticulously assess titles, abstracts and full texts of studies, ensuring alignment with predetermined inclusion and exclusion criteria at each stage of selection.

Quality evaluation instruments appropriate for each research design will be used to assess the quality of the selected studies. The findings from the included studies will be analysed and summarised using a narrative synthesis approach.

Ethics and dissemination

Since this systematic review is based on the reviewing of existing literature and will not involve the collection of primary data, ethical approval is not required. The results will be disseminated through peer-reviewed publication and conference presentations.

PROSPERO registration number

CRD42023420990.
Barriers to and facilitators of advance care planning implementation for medical staff after the COVID-19 pandemic: an overview of reviews
Authors: Inokuchi Ryota , Hanari Kyoko , Shimada Kensuke , Iwagami Masao , Sakamoto Ayaka , Sun Yu , Mayers Thomas , Sugiyama Takehiro , Tamiya Nanako
Published: October 2023

Objective

The COVID-19 pandemic has impacted the capacity for advance care planning (ACP) among patients, families and healthcare teams. We sought to identify and review the barriers to and facilitators of ACP implementation for medical staff in different settings (eg, hospitals, outpatient palliative care, nursing and care homes) during the pandemic.

Design

This study employed an overview of reviews design. We searched the MEDLINE, CENTRAL, Web of Science and Embase databases for studies published between 8 December 2019 and 30 July 2023. We used AMSTAR 2 to assess the risk of bias.

Results

We included seven reviews. Common barriers to ACP implementation included visitation restrictions, limited resources and personnel and a lack of coordination among healthcare professionals. In care and nursing homes, barriers included a dearth of palliative care physicians and the psychological burden on facility staff. Using telemedicine for information sharing was a common facilitator across settings. In hospitals, facilitators included short-term training in palliative care and palliative care physicians joining the acute care team. In care and nursing homes, facilitators included ACP education and emotional support for staff.

Conclusions

Visitation restrictions and limited resources during the pandemic posed obstacles; however, the implementation of ACP was further hindered by insufficient staff education on ACP in hospitals and facilities, as well as a scarcity of information sharing at the community level. These pre-existing issues were magnified by the pandemic, drawing attention to their significance. Short-term staff training programmes and immediate information sharing could better enable ACP.

PROSPERO registration number

CRD42022351362.
Retinopathy among women with hypertensive disorders of pregnancy attending hospitals in Mbarara city, south-western Uganda: a cross-sectional study
Authors: Zamaladi Ibrahimu , Ruvuma Sam , Mceniery Carmel M , Kwaga Teddy , Wilkinson Ian B , Atwine Daniel , Lugobe Henry Mark
Published: October 2023

Objective

Retinopathy is one of the complications occurring among women with hypertensive disorders of pregnancy. We sought to determine the prevalence and factors associated with retinopathy among women with hypertensive disorders of pregnancy in southwestern Uganda.

Design

This was a hospital-based cross-sectional study from November 2019 to March 2020.

Setting

Three selected hospitals in Mbarara city, south-western Uganda.

Participants

The study included all pregnant women with hypertensive disorders of pregnancy.

Primary and secondary outcome measures

The participants were screened for retinopathy using a fundus camera. Data on participant’s sociodemographics, obstetrics and medical factors were collected. The prevalence of retinopathy was determined and multivariable logistic regression was used to determine the independent factors associated with retinopathy.

Results

A total of 216 women with hypertensive disorders of pregnancy were enrolled in this study. The prevalence of retinopathy was 60.2% (130/216). The most common retinal lesions were grade 1 retinopathy (narrowing of arterioles) accounting for 86.9% (113/130), grade 3 (retinal haemorrhages) was present in 10% (13/130) of women and grade 4 (papilloedema) in 3% (4/130). In an adjusted analysis, severe hypertension was significantly associated with retinopathy (aOR=2.8; 95% CI: 1.36 to 5.68). Grandmultigravida women were also associated with retinopathy (aOR=2.4; 95% CI: 0.99 to 5.72) with a tendency towards significancy, p=0.051.

Conclusions

In our study, retinopathy was common among women with hypertensive disorders of pregnancy. Women presenting with severe hypertension were likely to have retinopathy. There is a need to integrate screening for retinopathy in the care cascade of women with hypertensive disorders of pregnancy.
Prediction of recurrent ischaemic stroke using radiomics data and machine learning methods in patients with acute ischaemic stroke: protocol for a multicentre, large sample, prospective observational cohort study in China
Authors: Li Jingyi , Han Mengqi , Chen Yongsen , Wu Bin , Wu Yifan , Jia Weijie , Liu JianMo , Luo Haowen , Yu Pengfei , Tu Jianglong , Kuang Jie , Yi Yingping
Published: October 2023

Introduction

Stroke is a leading cause of mortality and disability worldwide. Recurrent strokes result in prolonged hospitalisation and worsened functional outcomes compared with the initial stroke. Thus, it is critical to identify patients who are at high risk of stroke recurrence. This study is positioned to develop and validate a prediction model using radiomics data and machine learning methods to identify the risk of stroke recurrence in patients with acute ischaemic stroke (AIS).

Methods and analysis

A total of 1957 patients with AIS will be needed. Enrolment at participating hospitals will continue until the required sample size is reached, and we will recruit as many participants as possible. Multiple indicators including basic clinical data, image data, laboratory data, CYP2C19 genotype and follow-up data will be assessed at various time points during the registry, including baseline, 24 hours, 7 days, 1 month, 3 months, 6 months, 9 months and 12 months. The primary outcome was stroke recurrence. The secondary outcomes were death events, prognosis scores and adverse events. Imaging images were processed using deep learning algorithms to construct a programme capable of automatically labelling the lesion area and extracting radiomics features. The machine learning algorithms will be applied to integrate cross-scale, multidimensional data for exploratory analysis. Then, an ischaemic stroke recurrence prediction model of the best performance for patients with AIS will be established. Calibration, receiver operating characteristic and decision curve analyses will be evaluated.

Ethics and dissemination

This study has received ethical approval from the Medical Ethics Committee of the Second Affiliated Hospital of Nanchang University (medical research review No.34/2021), and informed consent will be obtained voluntarily. The research findings will be disseminated through publication in journals and presented at conferences.

Trial registration number

ChiCTR2200055209.
Recurrence risk of myopic choroidal neovascularisation: a systematic review of current study
Authors: Victor Andi Arus , Andayani Gitalisa , Djatikusumo Ari , Yudantha Anggun Rama , Hutapea Mario Marbungaran , Ardhia Seruni Hanna , Suryoadji Kemal Akbar
Published: October 2023

Introduction

The rising prevalence of myopia is a concern in ophthalmology, with myopic choroidal neovascularisation (m-CNV) significantly affecting vision. However, long-term outcomes of m-CNV management have been unsatisfactory, leading to high recurrence rates. These studies aim to identify risk factors for m-CNV recurrence.

Methods

Comprehensive review followed a pre-registered plan in the International Prospective Register of Systematic Reviews (PROSPERO). The search strategy used various databases including PubMed, Cochrane Library, Embase, Scopus and ScienceDirect using the keywords ‘Myopic Choroidal Neovascularization’, ‘Recurrence’ and ‘Risk’. Eligible studies were identified and analysed based on predetermined criteria. This study was registered on PROSPERO (CRD4202343461).

Results

The systematic review included three retrospective studies investigating risk factors associated with m-CNV recurrence. These factors are: (1) requiring three or more injections for initial disease control, (2) older age, (3) larger myopic macular neovascularisation, (4) juxtafoveal CNV, (5) larger height of hyper-reflective foci (HRF) and (6) destruction or absence of the ellipsoid zone (EZ) and retinal pigment epithelium (RPE).

Conclusion

Risk factors for m-CNV recurrence include a greater number of required injections, older age, large macular CNV, juxtafoveal location, increased HRF height and changes in EZ and RPE structure. Understanding these factors can inform personalised treatment approaches and improve patient outcomes by identifying individuals at higher risk of recurrence and implementing proactive measures to mitigate the impact of m-CNV recurrence and progression. Further investigation is needed to enhance our understanding of the underlying mechanisms and develop innovative therapeutic approaches for effective m-CNV management.

PROSPERO registration number

CRD4202343461.
The use and timing of rehabilitation and palliative care to cancer patients, and the influence of social vulnerability – a population-based study
Authors: Møller Jens-Jakob Kjer , la Cour Karen , Pilegaard Marc Sampedro , Dalton Susanne Oksbjerg , Bidstrup Pernille , Möller Sören , Jarlbaek Lene
Published: October 2023

Objectives

To identify and investigate different cohorts of cancer patients’ use of physical rehabilitation and specialised palliative care (SPC) services, focusing on patients with incurable cancer and the impact of social vulnerability.

Methods

The sample originated from patients diagnosed during 2013–2018 and alive 1 January 2015. Use of physical rehabilitation and/or SPC units were identified from contacts registered in population-based administrative databases. Competing-risks regression models were applied to investigate disparities with regard to social vulnerability, disease duration, gender and age.

Results

A total of 101 268 patients with cancer were included and 60 125 survived longer than 3 years after their diagnosis. Among the 41 143 patients, who died from cancer, 66%, survived less than 1 year, 23% survived from 1 to 2 years and 11% survived from 2 to 3 years. Contacts regarding physical rehabilitation services appeared in the entire cancer trajectory, whereas contacts regarding SPC showed a steep increase as time drew closer to death. The largest disparity was related to disease duration. Socially vulnerable patients had less contact with SPC, while a larger proportion of the socially vulnerable cancer survivors used rehabilitation, compared with the non-vulnerable patients.

Conclusions

This study provides a previously unseen detailed overview of the use of physical rehabilitation and/or SPC among patients with incurable cancer. The services appeared to overlap at a group level in the cancer trajectory, emphasising the importance of awareness with regard to coordination and combination of the services. Disparities between socially vulnerable or non-vulnerable patients were identified.
Determinants of unmet physical and psychological supportive care needs among adult cancer patients in Southern Ethiopia
Authors: Amenu Asaye , Aynalem Amdehiwot , Borie Yacob Abraham , Jemebere Wegene , Molla Ezedin , Samuel Beniyam , Israel Eskinder , Yeheyis Tomas , Assefa Dawit Getachew , Gebrie Meless
Published: October 2023

Objective

The main objective of this study was to assess the prevalence of unmet physical and psychological supportive care needs and associated factors among adult patients with cancer in Southern Ethiopia.

Methods

A cross-sectional study was conducted among 321 patients with cancer from 20 June 2022 to 5 August 2022 at Hawassa University Comprehensive Specialized Hospital oncology centre. Simple random sampling technique was used to recruit participants. Data were entered into Epi-Data V.4.6 and were exported to SPSS V.26 for analysis. Logistic regression model was used to describe the association between dependent and independent variables.

Result

The mean age of the study participants was 45±14.27. The prevalence of unmet physical and psychological supportive care needs was 47.3% and 71.1%, respectively. Rural residence ((adjusted OR, AOR 2.73; 95% CI (1.27 to 5.83)) and late-stage cancer ((AOR 2.95; 95% CI 1.02 to 8.52) were factors significantly associated with unmet physical supportive care need. Coexisting illness was associated with both unmet physical and psychological supportive care needs (AOR 2.73; 95% CI 1.27 to 5.83) and (AOR 2.71; 95% CI 1.16 to 6.33), respectively.

Conclusion

Nearly half of the study participants had an unmet physical supportive care need while greater than two-thirds had unmet psychological supportive care need. Residence and late-stage cancer were factors significantly associated with physical unmet supportive care need while coexisting illness was associated with both unmet physical and psychological supportive care needs. Hence, supportive care for patients with cancer should be given an emphasis and incorporated into the cancer treatment protocol.
Mycoheterotrophic plants as indicators of post-agricultural forest regeneration: abundance of Hypopitys monotropa and Monotropa uniflora in post-agricultural forests changes through time
Authors: Holmes Marion Andrews
Published: October 2023

Herbaceous layers in second-growth forests are shaped by past land use. Disturbances such as agriculture may impact populations of mycoheterotrophs, non-photosynthetic mycorrhizal plants that obtain carbon from fungal networks by altering mycorrhizal communities or removing trees they derive carbon from. I tested the hypotheses that two mycoheterotrophic forest herbs increase in abundance during succession and become most common in older forests as plant communities reassemble through time. Distributions of Hypopitys monotropa and Monotropa uniflora were sampled in Athens County, Ohio, USA. I surveyed populations in a 40-site post-agricultural forest chronosequence with five upland and five valley sites in each of four age classes: 40–60, 61–80, 81–100, and >130 years since canopy closure. Aspect and elevation were measured to assess environmental influence. Both H. monotropa and M. uniflora were most common in older stands with EM tree-rich canopy composition and west- or south-facing aspects, indicating influence of historical, biotic, and edaphic factors. Hypopitys was exclusive to forests >80 years old, while M. uniflora was present in younger stands. Abundance of both species was also significantly predicted by Fagaceae basal area. Because EM trees were also most abundant in south- and west-facing uplands, environmental influence appears to be mediated through canopy composition.
Non-forward radiative corrections to electron-carbon scattering
Authors: Mihovilovič M. , Achenbach P. , Ayerbe-Gayoso C. , Bajec M. , Beranek T. , Beričič J. , Bernauer J. C. , Böhm R. , Bosnar D. , Cardinali M. , Correa L. , Debenjak L. , Denig A. , Distler M. O. , Esser A. , Bondy M. I. Ferretti , Fonvieille H. , Friedrich J. M. , Friščić I. , Griffioen K. , Hoek M. , Kegel S. , Stöttinger Y. , Merkel H. , Middleton D. G. , Müller U. , Nungesser L. , Pochodzalla J. , Rohrbeck M. , Majos S. Sánchez , Schlimme B. S. , Schoth M. , Schulz F. , Sfienti C. , Širca S. , Sobczyk J. E. , Štajner S. , Thiel M. , Tyukin A. , Vanderhaeghen M. , Weber A. B. , Weinriefer M.
Published: October 2023

Radiative corrections to elastic scattering represent an important part of the interpretation of electron-induced nuclear reactions at small energy transfers, where they represent a dominant part of the background. Here we present and validate a new event generator for simulating QED radiative processes in electron-carbon scattering that exactly calculates the coherent sum of the Bethe-Heitler amplitudes for the leading diagrams. We demonstrate that the generator describes the shape of the radiative tail of an elastic peak with a precision better than $$10\%$$

10
%

over the whole energy range of the scattered electrons and can thus be reliably employed in the analyses of electron scattering experiments for more precise extraction of inelastic cross-sections.
Isospin-violating dark matter at liquid noble detectors: new constraints, future projections, and an exploration of target complementarity
Authors: Cheek Andrew , Price Darren D. , Sandford Ellen M.
Published: October 2023

There is no known reason that dark matter interactions with the Standard Model should couple to neutrons and protons in the same way. This isospin violation can have large consequences, modifying the sensitivity of existing and future direct detection experimental constraints by orders of magnitude. Previous works in the literature have focused on the zero-momentum limit which has its limitations when extending the analysis to the Non-Relativistic Effective Field Theory basis (NREFT). In this paper, we study isospin violation in a detailed manner, paying specific attention to the experimental setups of liquid noble detectors. We analyse two effective Standard Model gauge invariant models as interesting case studies as well as the more model-independent NREFT operators. This work demonstrates the high degree of complementarity between the target nuclei xenon and argon. Most notably, we show that the Standard Model gauge-invariant formulation of the standard spin-dependent interaction often generates a sizeable response from argon, a target nuclei with zero spin. This work is meant as an update and a useful reference to model builders and experimentalists.
The spatial string tension from the field correlator method
Authors: Agasian N. O. , Khaidukov Z. V. , Simonov Yu. A.
Published: October 2023

The behaviour of spatial string tension $$\sigma _s(T)$$

σ
s

(
T
)

as a function of the temperature T is found in the framework of the Field Correlator Method (FCM). Here the string tension is calculated using the gluelump Green’s function, where gluons in the gluelump are interacting via the same spatial string tension. The resulting T-dependence was obtained without extra parameters in the region $$T_c< T < 5 T_c$$

T
c

<
T
<
5

T
c

using the formalism of elliptic functions $$\theta _3$$

θ
3

, demonstrating good agreement with available lattice data.
The role of the boundary term in f(Q, B) symmetric teleparallel gravity
Authors: Capozziello Salvatore , De Falco Vittorio , Ferrara Carmen
Published: October 2023

In the framework of metric-affine gravity, we consider the role of the boundary term in Symmetric Teleparallel Gravity assuming f(Q, B) models where f is a smooth function of the non-metricity scalar Q and the related boundary term B. Starting from a variational approach, we derive the field equations and compare them with respect to those of f(Q) gravity in the limit of $$B\rightarrow 0$$

B
→
0

. It is possible to show that $$f(Q,B)=f(Q-B)$$

f
(
Q
,
B
)
=
f
(
Q
-
B
)

models are dynamically equivalent to f(R) gravity as in the case of teleparallel $$f(\tilde{B}-T)$$

f
(

B
~

-
T
)

gravity (where $$B\ne \tilde{B}$$

B
≠

B
~

). Furthermore, conservation laws are derived. In this perspective, considering boundary terms in f(Q) gravity represents the last ingredient towards the Extended Geometric Trinity of Gravity, where f(R), $$f(T,\tilde{B})$$

f
(
T
,

B
~

)

, and f(Q, B) can be dealt under the same standard. In this perspective, we discuss also the Gibbons–Hawking–York boundary term of General Relativity comparing it with B in f(Q, B) gravity.
Terahertz photoconductive antennas based on silicon-doped GaAs (111)A
Authors: Klimov Evgeniy , Klochkov Aleksey , Solyankin Petr , Pushkarev Sergei , Galiev Galib , Yuzeeva Nataliya , Shkurinov Aleksandr
Published: October 2023

In this study we investigate a relatively new material for terahertz (THz) photoconductive antennas (PCAs): GaAs epitaxial films grown on (111)A-oriented semi-insulated GaAs substrates and doped with Si. GaAs:Si (111)A films with the required high resistance without postgrowth annealing have been grown by molecular-beam epitaxy. The Si doping of (111)A-oriented GaAs was expected to lead to the formation of acceptors that facilitate the activation of As[Formula: see text] traps. The relaxation times of nonequilibrium charge carriers in the films were measured in pump-probe experiment, and, finally, the electron mobility was estimated from the carrier lifetime and current–voltage characteristics measured under pulsed pumping by Ti:sapphire femtosecond laser. Dipole and bow-tie PCAs were fabricated, and the THz emission spectra and the total THz emission power were measured with varying applied voltage and optical excitation power. The properties of GaAs:Si (111)A films and the PCAs based on them are compared with LTG-GaAs (100) and (111)A-oriented films.
Analysis of pulsatile flow of Rabinowitsch fluid in the multi-stenosed inclined artery under the influence of external body acceleration
Authors: Akhtar Salman , Khan Muhammad Naveed , Sharaf Mohamed
Published: October 2023

The stenosis builds up and its progression in the artery causes serious damages, which may lead to death. This research aims to investigate the non-Newtonian properties of the pulsatile blood flow through the multi-stenotic inclined artery. The effect of external body acceleration is considered, and blood is taken as Rabinowitsch fluid in this work. The mathematical model representing the proposed problem is transformed into a dimensionless form by applying the assumption for mild stenosis. The dimensionless mathematical equations are solved using the perturbation method. The solutions of mathematical equations are investigated graphically to analyze the impacts of various physical constraints. We find that strong non-Newtonian effects lead to an increase in flow velocity and wall shear stress. The stenosis’s presence and progression in the artery reduces the flow velocity. The stenotic artery (diseased artery) is found to have less flow rate than the healthy artery. It is noted that the vertically held conduit effectively has a larger flow velocity and wall shear stress than the horizontal one. External body acceleration is noted to have an impact that raises velocity and wall shear stress.