bluuebunny/crossref_metadata_2025 huggingface dataset:
Bifurcation analysis and control of traffic flow model considering the impact of smart devices for drivers
Authors: Ai WenHuan , Zeng Jingming , Jianli Fu , Lei zhengqing
Published: February 2025

In this paper, a linear feedback controller is designed to analyze and control the hopf bifurcation in the traffic flow system based on an improved traffic flow model considering the influence of intelligent vehicle communication devices. A traffic flow stability model with suitable bifurcation analysis is established to transform the sudden change of traffic state into a system stability problem. From the macroscopic view, there is reflect the unstable phenomenon about traffic congestion and other sudden changes. Then bifurcationing analysis is carried out on the traffic flow stability model to study the behavior of congestion and stability mutation near the equilibrium point and bifurcation point of the highway traffic system. It analyze and predict the changes of the actual traffic state. Aiming at the unstable bifurcation points, control method are designed through Chebyshev polynomial approximation, stochastic feedback control and other methods to make the unstable bifurcation points delayed or disappeared and alleviate the traffic congestion. Finally, the hopf bifurcationing control set up on the model is simulated, and it is verified by the density waves and the phase plane diagram that the introduction of the bifurcation control theory into the traffic flow state control not only helps to improve the stability of the traffic flow and avoid traffic congestion, but also provides a theoretical basis for the prevention of traffic congestion. Numerical simulation results show that the improved model is good at explaining the formation of various blockage patterns in real traffic and its evolution mechanism.
Validating the Iowa Test of Consonant Perception in a large cohort of cochlear implant users
Authors: Smith Francis X. , Berger Joel I. , Gander Phillip E. , Schwalje Adam T. , Griffiths Timothy D. , McMurray Bob , Choi Inyong
Published: February 2025

The Iowa Test of Consonant Perception (ITCP) was designed to test word-initial phoneme perception by uniformly sampling frequently used phonemes as well as balancing feature overlap of response competitors. However, the task has only been validated in normal hearing listeners. In this study, a large cohort of cochlear implant users completed the ITCP and two commonly used clinical measures of speech recognition [AzBio sentences and consonant-nucleus-consonant (CNC) words]. At two different signal-to-noise ratios, the ITCP showed strong convergent validity with other speech recognition tasks and good test-retest reliability. The ITCP is a useful tool for both clinicians and experimental researchers.
Computational Bayesian inference for active sonar localization under uncertainty in sound speed profile
Authors: Barros Abner C. , Gendron Paul J.
Published: February 2025

A computational Bayesian approach is presented to address active sonar localization under the challenges of small receive aperture, uncertain sound speed profile (SSP), and limited coherence time. The approach draws inference on wavevectors associated with the closely spaced angle/Doppler spread arrivals, characterizing the scattered acoustic field. The wavevector posterior density is mapped to the scattering body's location and speed under an uncertain SSP using eigenray interpolation and marginalization. SSP uncertainty is captured by a multivariate Gaussian and a low-dimensional subspace mode representation. A case study using SSPs from the Mediterranean Sea demonstrates the efficacy of this approach.
Relationship Between Community Integration, Physical Activity, Pain Quality, and Quality of Life in Older Adults With Knee Osteoarthritis
Authors: Güneş Gencer Gökçe Yağmur , Temel Aksu Neriman , Teke Yeliz , Hekim Hanife Hale , Akdağ Ali
Published: February 2025

Objectives: This cross-sectional study investigated the relationship between community integration, physical activity, pain quality, and quality of life in older adults with knee osteoarthritis. Methods: It included 92 older adults aged 60 and over diagnosed with osteoarthritis of Stage 2 and above, according to the Kellgren–Lawrence classification. Participants were evaluated using the Community Integration Questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, International Physical Activity Questionnaire, Pain Quality Assessment Scale, and World Health Organization Quality of Life-old module Scales. Results: The mean age of 92 older adults included in the study was 67.5 ± 7.6 years. Specifically, for every 0.599 unit decrease in the Western Ontario and McMaster Universities Osteoarthritis Index physical function score (indicating an improvement in physical function), the community integration level increased by 0.196 units. Additionally, for every 0.380 unit increase in total physical activity level (measured in metabolic equivalent of task), the community integration level increased by 0.001 units. Also, community integration was negatively associated with pain intensity and positively associated with quality of life (p < .05). Conclusion: In the treatment of knee osteoarthritis, it is essential to provide intervention support to combat the symptoms of the disease, increase physical activity, and maintain community integration. Implications: In older adults diagnosed with knee osteoarthritis, community integration decreases as the severity of osteoarthritis increases with age. For older adults with knee osteoarthritis to have a better quality of life and active aging, it would be appropriate to add interventions to maintain and increase community integration in osteoarthritis treatment programs.
The Swaying Pendulum: Factors Influencing Physical Activity Participation in Women With Recurrent Ovarian Cancer
Authors: Gildea Gabrielle C. , Spence Rosalind R. , Jones Tamara L , Sandler Carolina X. , McDonald Nicole M. , Hayes Sandra C. , Plinsinga Melanie L.
Published: February 2025

Background: Physical activity levels decline following diagnosis of ovarian cancer, and there is limited research investigating the factors that influence participation across the cancer continuum. The objective of this study is to explore barriers, facilitators, perceptions, and preferences of physical activity for women with recurrent ovarian cancer and to explore whether these factors change across the cancer continuum. Methods: Women enrolled in the Exercise During Chemotherapy for Recurrent Ovarian Cancer trial were invited to participate. Semistructured interviews, guided by social cognitive theory, were conducted by 2 interviewers via video conferencing. All interviews were recorded and transcribed verbatim. Data were analyzed using an adaptive thematic approach. Results: An overarching theme, “The swaying pendulum,” emerged following 13 participant interviews, representing the instability of physical activity participation in women with recurrent ovarian cancer. Five themes captured factors swaying the “pendulum”: (1) the “priority ladder” of physical activity and the importance of social support and the physical environment, (2) the “hurdles” of treatment- and disease-related side effects, (3) the power of physical activity support and advice from health professionals in the face of uncertainty and fear, (4) a “yearning” for the outdoors, and (5) resorting to walking. Conclusions: Physical activity participation in women with recurrent ovarian cancer is swayed by a complex combination of internal and external factors, unique to each individual, and continually changing circumstances across the cancer continuum.
Age-Related Differences in Electromyographic Latencies of the Lower Limb Muscles in Standing Sprint Initiation in Boys During Childhood and Adolescence
Authors: Kitamura Mizuki , Isaka Tadao , Otsuka Mitsuo
Published: February 2025

Purpose: The aim of our study was to investigate age-related differences in childhood and adolescent boys’ performance, including initial reaction time and electromyographic (EMG) latencies of leg muscles during sprint start. Methods: Forty-six Japanese boys, aged 5–19 years, participated in this study. The participants performed 5 consecutive 2-m sprints, starting with the boys’ preferred split-stance starting posture. Ground reaction force data of the front and rear feet and surface EMG data of the rectus femoris, biceps femoris, and gastrocnemius muscles in both legs of all participants were measured using a wireless EMG system. Results: As chronological age increased, the initial reaction time was largely shortened until the breakpoint age of 8.6 years and was moderately shortened thereafter. The EMG latencies of the posterior thigh and shank muscles of the rear leg were also shortened largely long before reaching the adolescence; in contrast, those of the front leg muscles were largely shortened until adolescence. Conclusions: Reaction behavior with complex whole-body motion may develop long before the onset of adolescence. In particular, adjusting the rear leg motion may contribute to the rapid development of whole-body reaction maturation.
Generation of RNA aptamers against chikungunya virus E2 envelope protein
Authors: Goto Kaku , Amano Ryo , Ichinose Akiko , Michishita Akiya , Hamada Michiaki , Nakamura Yoshikazu , Takahashi Masaki
Published: February 2025

Nucleic acid aptamers are a promising drug modality, whereas the generation of virus-neutralizing aptamers has remained difficult due to the lack of a robust system for targeting the viral particles of interest. Here, we took advantage of our latest platform technology of Systematic Evolution of Ligands by EXponential enrichment (SELEX) with virus-like particles (VLPs) and targeted chikungunya virus (CHIKV) as a model, the pathogenic reemerging virus with an unmet need for control. The identified aptamer against CHIKV-VLPs, Apt#1, and its truncated derivatives showed neutralizing activity with nanomolar IC50 values in a cell-based assay system using a pseudoviral particle of CHIKV (CHIKVpp). An antiviral-based chemical genetics approach revealed significant competition of Apt#1 with suramin, a reported interactant with domain A of the E2 envelope protein (E2DA), in both CHIKVpp and surface plasmon resonance (SPR) analyses, predicting E2DA to be the Apt#1 interface. In addition, Apt#1 interfered with the attachment of CHIKVpp, collectively suggesting its property as an attachment inhibitor via E2DA of CHIKV. Thus, the generation of the VLP-targeted aptamers proved to contribute to anti-CHIKV strategies and confirmed the utility of the platform as a novel and viable option for the development of neutralizing agents against viral particles of interest.

IMPORTANCE

Our latest SELEX technology using VLPs has generated aptamers that bind the native conformation of the incorporated envelope protein and achieve the virus binding and neutralizing effects. Indeed, the aptamer-probed target E2DA is a representative neutralization site on the surface of the viral particle, validating the utility of the VLP-driven procedure. Simultaneously, the enhanced antiviral effects of the aptamer in combination with approved drugs using the CHIKVpp assay with human cells indicated potential therapeutic strategies that are expected to help address unmet needs in CHIKV control. The robust affinity of the aptamer to viral particles demonstrated by SPR analysis can also lead to conjugates with antivirals as guiding molecules and aptasensors for diagnostic tools. Overall, our VLP-based method provided anti-CHIKV as well as a versatile platform applicable to other emerging and reemerging viruses, in preparation for outbreaks with the need for rapid development of antiviral strategies as next-generation theranostics.
Why Do We Not See the Radiative Decays of $$D_{{s1}}^{ + }$$ (2536) Meson?
Authors: Bondar A.
Published: February 2025

The radiative decays of D

s1(2536)+ charmed-strange meson have not been observed. We employ the available Babar measurements to derive an upper bound for the D

s1(2536)+ →
$$D_{{s1}}^{ + }$$
γ decay width and discuss its implications for the quark structure of D

s1(2460)+.
Computational Identification of Four Promising Nonlinear Optical Materials for Near and Middle Ultraviolet Operation
Authors: Alkabakibi Y. , Barma D. D. , Rybkovskiy D. V. , Tudi A. , Xie C. , Oganov A. R.
Published: February 2025

We perform a computational search for promising nonlinear optical materials by screening crystal structure databases. We selected non-centrosymmetric, thermodynamically stable and low-energy metastable borates, with large expected band gaps. For these structures, we performed density functional computations of the gap values, birefringence and nonlinear susceptibilities. Our search revealed four potentially efficient nonlinear borate materials with large band gaps, moderate birefringence and high nonlinear coefficients: K3B6O10Cl, Ca5B3O9F, SrB4O7, Al4(B2O5)3.
Avoiding ‘second victims’ in healthcare: what support do staff want for coping with patient safety incidents, what do they get and is it effective? A systematic review
Authors: Simms-Ellis Ruth , Harrison Reema , Sattar Raabia , Sweeting Elizabeth , Hartley Hannah , Morys-Edge Matthew , Lawton Rebecca
Published: February 2025

Objectives

Incontrovertible evidence surrounds the need to support healthcare professionals after patient safety incidents (PSIs). However, what characterises effective organisational support is less clearly understood and defined. This review aims to determine what support healthcare professionals want for coping with PSIs, what support interventions/approaches are currently available and which have evidence for effectiveness.

Design

Systematic research review with narrative synthesis.

Data sources

Medline, Scopus, PubMed and Web of Science databases (from 2010 to mid-2021; updated December 2022), reference lists of eligible articles and Connected Papers software.

Eligibility criteria for selecting studies

Empirical studies (1) containing information about support frontline healthcare staff want before/after a PSI, OR addressing (2) support currently available, OR (3) the effectiveness of support to help prevent/alleviate consequences of a PSI. Study quality was appraised using the Quality Assessment for Diverse Studies tool.

Results

Ninety-nine studies were identified. Staff most wanted: peer support (n=28), practical support and guidance (n=27) and professional mental health support (n=21). They mostly received: peer support (n=46), managerial support (n=23) and some form of debrief (n=15). Reports of poor PSI support were common. Eleven studies examined intervention effectiveness. Evidence was positive for the effectiveness of preventive/preparatory interventions (n=3), but mixed for peer support programmes designed to alleviate harmful consequences after PSIs (n=8). Study quality varied.

Conclusions

Beyond peer support, organisational support for PSIs appears to be misaligned with staff desires. Gaps exist in providing preparatory/preventive interventions and practical support and guidance. Reliable effectiveness data are lacking. Very few studies incorporated comparison groups or randomisation; most used self-report measures. Despite inconclusive evidence, formal peer support programmes dominate. This review illustrates a critical need to fund robust PSI-related intervention effectiveness studies to provide organisations with the evidence they need to make informed decisions when building PSI support programmes.

PROSPERO registration number

CRD42022325796.
Low & Anaplastic Grade Glioma Umbrella Study of MOlecular Guided TherapieS (LUMOS-2): study protocol for a phase 2, prospective, multicentre, open-label, multiarm, biomarker-directed, signal-seeking, umbrella, clinical trial for recurrent IDH mutant, grade 2/3 glioma
Authors: McParland Kristen , Koh Eng-Siew , Kong Benjamin , Sim Hao-Wen , Thavaneswaran Subotheni , Yip Sonia , Barnes Elizabeth H , Ballinger Mandy L , Thomas David M , De Abreu Lourenco Richard , Simes John , Sebastian Lucille , Wheeler Patrick J , Spyridopoulos Desma , Hawkins Cynthia , Pitz Marshall , O'Callaghan Christopher , Gan Hui K
Published: February 2025

Introduction

All grade 2/3 gliomas are incurable and at the time of inevitable relapse, patients have significant unmet needs with few effective treatments. This study aims to improve outcomes by molecular profiling of patients at relapse, then matching them with the best available drug based on their molecular profile, maximising the chances of patient benefit while simultaneously testing multiple novel drugs.

Methods and analysis

Low & Anaplastic Grade Glioma Umbrella Study of MOlecular Guided TherapieS (LUMOS-2) will be an international, phase 2, multicentre, open-label, biomarker-directed, umbrella clinical trial for recurrent isocitrate dehydrogenase mutant, histologically grade 2/3 gliomas. Investigational treatment will be assigned based on molecular profiling of contemporaneous tissue obtained at disease relapse using next-generation sequencing. LUMOS-2 will begin with three therapeutic treatment arms: paxalisib, cadonilimab and selinexor. Patient molecular profiles will be assessed by an expert, multidisciplinary Molecular Tumour Advisory Panel. Patients whose molecular profile is considered suitable for a targeted agent like paxalisib will be allocated to that arm, others will be randomised to the available arms of the trial. The primary endpoint is progression-free survival at 6 months. Secondary objectives include assessment of overall survival, response rate, safety and quality of life measures. Two additional therapeutic arms are currently in development.

Ethics and dissemination

Central ethics approval was obtained from the Sydney Local Health District Ethics Review Committee, Royal Prince Alfred Hospital Zone, Sydney, Australia (Approval: 2022/ETH02230). Other clinical sites will provide oversight through local governance processes, including obtaining informed consent from suitable participants. A report describing the results of the study will be submitted to international meetings and peer-reviewed journals.

Trial registration number

ACTRN12623000096651.
Role of private providers in the implementation of the national health insurance scheme in Zambia: a qualitative study of perceptions and experiences
Authors: Simangolwa Warren Mukelabai , Sundewall Jesper
Published: February 2025

Introduction

An increasing number of sub-Saharan African countries are implementing national health insurance schemes (NHISs) to support the aspiration of universal health coverage (UHC). A growing body of literature recognises the private sector role in improving NHIS equity in service access, public provider complementarity and overall member satisfaction. Zambia has implemented the NHIS since 2019 as a priority health financing strategy to support UHC. This study provides the first examination of the private sector’s experiences implementing the Zambia NHIS.

Methods

The study uses a qualitative study design and inductively synthesises data from 30 in-depth interviews with the private sector accredited to the Zambia NHIS in one rural and one urban province.

Results

The private sector was motivated by profits and complementarity with public providers regarding service readiness and availability. Providers perceived the accreditation process and fees as standard and affordable. Providers reported increased service utilisation, mainly by the NHIS clients. Senior citizens and the informal sector constituted the majority of users. There were implementation challenges, including delays in preauthorisations, loss of member details and exclusion and restrictions of interventions in the benefits package. Private providers also experienced overcrowding and reduced service quality. Providers perceived the service reimbursement levels as relatively cost-reflective, but some providers shifted models to maximise profits, including inducing demand to defraud the fund. Generally, providers perceived payments as within the agreed timelines, especially for online claims.

Conclusion

The initial scepticism among private providers before the initiation of the NHIS has subsided. The private provider’s experiences with accreditation, service utilisation, claims and reimbursements have been overall positive.
Torque visuomotor feedback training versus standard eccentric exercise for the management of patellar tendinopathy: protocol for a randomised controlled trial
Authors: Selvamoorthy Ragul , Arvanitidis Michail , Negro Francesco , Pincheira Patricio , Evans David , Martinez-Valdes Eduardo
Published: February 2025

Introduction

Patellar tendinopathy (PT) rehabilitation programmes frequently incorporate eccentric exercise (EE), where participants have limited control over the range of motion, speed, force production and load. Newly developed training protocols that employ visual feedback with specialised devices offer controlled management of loads, speeds and forces across the full range of motion, potentially providing greater benefits.

Objective

This protocol outlines a randomised controlled trial designed to compare the effects of a visuomotor torque feedback (TF) protocol with a traditional EE protocol on the rehabilitation of PT over a 6-week period. Our primary objective is to evaluate whether the TF protocol reduces pain and disability more effectively than the EE protocol in individuals with PT. Secondary objectives include analysing structural and architectural changes in the patellar tendon and quadriceps femoris muscles, as well as examining motor unit discharge dynamics in response to EE and TF training. Lastly, we aim to compare these dynamics and structural changes between healthy controls and individuals with PT.

Methods

Thirty two individuals with PT and twenty six healthy controls will be recruited. The PT group will be subdivided into an EE group, and a TF group, with both groups undergoing a 6-week training programme. The EE group will perform their exercises two times per day, while the TF group will do so 2–3 times a week. In individuals with PT, the primary outcomes will be the Victorian Institute of Sport-Patella (VISA-P) questionnaire to measure disability/physical function, and pain with a Numerical Rating Scale (NRS). To gain insights on mechanisms of action for potential improvements, motor unit discharge characteristics of the quadriceps femoris muscles will be assessed with high-density surface electromyography. Additionally, we will measure structural/architectural changes to the patellar tendon and quadriceps femoris muscles using B-mode ultrasonography and shear-wave elastography.

Ethics and dissemination

This study was approved by the Science, Technology, Engineering and Mathematics Ethical Review Committee from the University of Birmingham (ERN_2257-Jun2024). The results of this study will be disseminated in peer-reviewed journals and at international conferences.

Trial registration number

ISRCTN15821610.
COVID-19 prevention strategies and compliance among postnatal adolescent mothers with postnatal depression and generalised anxiety in rural Malawi: a cross-sectional study
Authors: Tembo Chimwemwe Pindani , Burns Sharyn , Portsmouth Linda
Published: February 2025

Objectives

This study examines the relationship between adolescent mothers’ mental health problems (postnatal depression and generalised anxiety) and adherence to COVID-19 public health prevention strategies in rural Malawi. It is part of a larger previously published study investigating the impact of social and cultural factors on the mental health in adolescent mothers.

Design

A cross-sectional study was conducted from September 2021 to March 2022. The Edinburgh Postnatal Depression Scale (EPDS) and the Generalised Anxiety Disorder-7 (GAD-7) were used to identify the risk of postnatal depression (PND) and generalised anxiety disorder (GAD), respectively. Participants also responded to questions about their perception of COVID-19 and how they practiced the recommended COVID-19 prevention strategies.

Setting

The study was conducted at a rural hospital in Lilongwe, Malawi.

Participants

Adolescent postnatal mothers aged 19 years and below, with children aged less than 1 year, who understood the study and could consent.

Results

Adolescent mothers (n=395) completed the researcher-administered survey. The mean age was±17 (SD 1.157). Most participants had recently given birth to their first child (91%, n=358). Almost half (45%, n=113) of participants agreed with the COVID-19 prevention strategies recommended by the Malawian government. However, overall adherence to public health COVID-19 prevention strategies, including hand hygiene practices, was low among adolescent mothers. Participants with probable GAD and probable PND were more likely to practice COVID-19 prevention strategies than participants with low GAD-7 or EPDS scores, except for restrictions on religious gatherings.

Conclusions

Adolescent perception of the potential threats or risks of COVID-19 was low. However, adolescents with probable PND and probable GAD reported higher adherence to some COVID-19 prevention strategies than adolescents without PND and GAD. The findings support the need for policies that integrate mental health within the public health response due to the potential direct and indirect effects the pandemic might have on perinatal mothers’ mental health. Additionally, recommended pandemic responses should be appropriate and relevant to the social environment.
Economic and relationship-strengthening intervention to reduce alcohol use in couples living with HIV in Malawi: a study protocol for a randomised controlled trial of Mlambe
Authors: Mkandawire James , Ssewamala Fred M , Hahn Judith A , Mulauzi Nancy , Neilands Torsten B , Tebbetts Scott , Darbes Lynae A , Brown Derek S , Conroy Amy A
Published: February 2025

Introduction

Heavy alcohol use has the potential to derail progress towards UNAIDS 95-95-95 targets for countries in sub-Saharan Africa (SSA). Within couples, alcohol use is closely linked with factors such as intimate partner violence and economic insecurity and can result in poor adherence to antiretroviral therapy (ART) and HIV clinical outcomes. We hypothesise that a combined economic and relationship intervention for couples that builds on the prior success of standalone economic and relationship-strengthening interventions will be efficacious for improving HIV clinical outcomes and reducing alcohol use. The synergy of these interventions has not been assessed in SSA—specifically among people living with HIV who drink alcohol. To test this hypothesis, we will testMlambe,an economic and relationship-strengthening intervention, found to be feasible and acceptable in a pilot study in Malawi. We will conduct a full-scale, randomised controlled trial (RCT) to evaluate the efficacy and cost-effectiveness ofMlambe.

Methods and analysis

We will enrol 250 adult married couples having at least one partner living with HIV and reporting heavy alcohol use. There will be two arms:Mlambeor an enhanced usual care control arm. Couples in the Mlambe arm will receive incentivised matched savings accounts and monthly sessions on financial literacy, relationship skills, and alcohol reduction education and counselling. Participants will be assessed at baseline, 11 months, 15 months and 20 months to examine effects on heavy alcohol use, HIV viral suppression, ART adherence and couple relationship dynamics. Study hypotheses will be tested using multilevel regression models, considering time points and treatment arms. Programmatic costs will be ascertained throughout the study and incremental cost-effectiveness ratios will be computed for each arm.

Ethics and dissemination

The RCT has been approved by the University of California, San Francisco (UCSF) (Human Research Protection Program; Protocol Number 23-40642), and the study has been approved by the National Health Sciences Research Committee (NHSRC; Protocol Number 24/05/4431) in Malawi. Adverse events and remedial actions will be reported to authorities both in Malawi and at UCSF. Results will be disseminated to study participants, local health officials and HIV policy makers and through presentations at conferences and publications in peer-reviewed journals.

Trial registration number

ClinicalTrials.gov Protocol Registration;NCT06367348registered on 19 April 2024;https://register.clinicaltrials.gov/. Protocol Version 1.0: 22 October 2024.
Discrimination and calibration performances of non-laboratory-based and laboratory-based cardiovascular risk predictions: a systematic review
Authors: Alemu Yihun Mulugeta , Alemu Sisay Mulugeta , Bagheri Nasser , Wangdi Kinley , Chateau Dan
Published: February 2025

Background and objective

This review compares non-laboratory-based and laboratory-based cardiovascular disease (CVD) risk prediction equations in populations targeted for primary prevention.

Design

Systematic review.

Methods

We searched five databases until 12 March 2024 and used prediction study risk of bias assessment tool to assess bias. Data on hazard ratios (HRs), discrimination (paired c-statistics) and calibration were extracted. Differences in c-statistics and HRs were analysed. Protocol: PROSPERO (CRD42021291936).

Results

Nine studies (1 238 562 participants, 46 cohorts) identified six unique CVD risk equations. Laboratory predictors (eg, cholesterol and diabetes) had strong HRs, while body mass index in non-laboratory models showed limited effect. Median c-statistics were 0.74 for both models (IQR: lab 0.77–0.72; non-lab 0.76–0.70), with a median absolute difference of 0.01. Calibration measures between laboratory-based and non-laboratory-based equations were similar, although non-calibrated equations often overestimated risk.

Conclusion

The discrimination and calibration measures between laboratory-based and non-laboratory-based models show minimal differences, demonstrating the insensitivity of c-statistics and calibration metrics to the inclusion of additional predictors. However, in most reviewed studies, the HRs for these additional predictors were substantial, significantly altering predicted risk, particularly for individuals with higher or lower levels of these predictors compared with the average.
Anterior quadratus lumborum block in total hip arthroplasty: a two-center, randomized, placebo-controlled trial showing no additional benefit over multimodal analgesia
Authors: Rozier Romain , Loiseleur Anouk , Ciais Charlotte , Moulin Ophélie , Alais Baptiste , Marguerite Kewan , Badia Emmanuelle , Tran Laurie , Balbo Juliette , Maurice-Szamburski Axel
Published: February 2025

Background

Total hip arthroplasty (THA) frequently causes postoperative pain, hindering recovery and prolonging hospital stays. While multimodal analgesia aims to minimize opioid use and enhance outcomes, the optimal regional anesthesia technique is unclear due to the hip’s complex innervation.

Objective

This multicenter randomized placebo-controlled trial evaluated whether adding an anterior quadratus lumborum block (QLB) to multimodal analgesia with non-steroidal anti-inflammatory drugs (NSAIDs) reduces opioid consumption in THA patients.

Methods

60 adults undergoing primary unilateral THA were randomized to receive either anterior QLB with 20 mL of 0.2% ropivacaine (n = 30) or a placebo saline injection (n = 30). All participants received multimodal analgesia including NSAIDs. The primary outcome was cumulative opioid consumption in oral morphine equivalents (OMEs) within the first 24 postoperative hours. Secondary outcomes included patient experience assessed by the EVAN scale on postoperative day 1, elevated pain and opioid consumption on days 1 and 2, time to first standing, walking distance and quadriceps strength on day 1, as well as walking progression, return to sport activity and analgesic use at 3 months.

Results

No significant difference was found in 24-hour cumulative OME consumption between groups (median 40 mg (IQR 20–50 mg) vs 31 mg (IQR 20–45 mg); p = 0.6). Patient experience, pain scores and opioid consumption were similar. Rehabilitation outcomes at 3 months also did not differ.

Conclusion

Adding anterior QLB to multimodal analgesia did not reduce opioid consumption or enhance postoperative pain control and functional recovery in THA patients. Anterior QLB may not provide additional benefits when combined with multimodal analgesia with NSAID for THA.

Trial registration number

NCT04555291.
Inflammation in preschool cystic fibrosis is of mixed phenotype, extends beyond the lung and is differentially modified by CFTR modulators
Authors: Shanthikumar Shivanthan , Gubbels Liam , Wong Anson Tsz Chun , Walker Hannah , Ranganathan Sarath C , Neeland Melanie R
Published: February 2025

Background

Early-life inflammation has long been recognised as a key pathophysiological process in the evolution of cystic fibrosis (CF) lung disease. Despite this, no CF-specific anti-inflammatory treatments have been developed. This is crucial even in the era of highly effective modulator therapy as recent evidence suggests that modulators alter, but may not fully resolve, pulmonary inflammation.

Methods

In this study, we used clinical microbiology data, high-dimensional flow cytometry and multiplex immunoassays to compare pulmonary (bronchoalveolar lavage (BAL)) and systemic immunity in 70 preschool children with CF and a total of 32 age-matched preschool controls.

Results

We show that inflammation in the early-life CF lung is characterised by innate cell infiltration (neutrophils: 31.31 vs 1.8% of BAL in CF compared with controls, FDRp=0.0001; eosinophils: 0.55 vs 0.06%, FDRp=0.001, and monocytes: 1.91 vs 0.45%, FDRp=0.004) and widespread upregulation of both traditional and type 2 inflammatory soluble signatures (40 analytes significantly elevated in BAL of CF compared with controls, all FDRp<0.1). Key targetable features of this response included pulmonary interleukin (IL)-8 and IL-13 which were most significantly associated with neutrophilic and eosinophilic infiltration, respectively (IL-8 and neutrophils; Spearman rho=0.68, FDRp=0.002: IL-13 and eosinophils; Spearman rho=0.75, FDRp=0.01). Signatures of type 2 inflammation, as identified by REACTOME pathway analysis, including IL-4, IL-13 and FGF-2, were highly elevated in both the lungs and circulation in early CF. When exploring the efficacy of Cystic Fibrosis Transmembrane Conductance Regulator modulators to resolve pulmonary and systemic inflammation in early life, we showed that different classes of modulators have varying effects on inflammation, with ivacaftor showing a more significant effect in the lungs and circulation than lumacaftor/ivacaftor. Finally, we showed that CF children with pathogen colonisation had similar levels of pulmonary inflammation as CF children without pathogen colonisation (no significant differences), and that inflammation was evident during infancy even without evidence of colonisation (as observed by significant increases in levels of SDF-1alpha, M-CSF, IL-2, IL-9, IL-12p40, IL-17, MCP-1 and LIGHT/TNFSF14, all FDRp<0.1), highlighting a role for intrinsic dysregulation of inflammation that begins in early life.

Conclusions

We provide a rationale for targeted anti-inflammatory intervention in early-life CF.
Ceiba: An Efficient and Scalable DNN Scheduler for Spatial Accelerators
Authors: Wang Fuyu , Shen Minghua , Lu Yutong , Xiao Nong
Published: February 2025

Spatial accelerators are domain-specific architectures to elevate performance and energy efficiency for deep neural networks (DNNs). They also bring a large number of schedule parameters to determine computation and data movement patterns of DNNs. Previous works formulate the schedule problem as design space exploration or integer linear programming. However, these advanced techniques face the challenge of efficiency or scalability.

In this paper, we propose Ceiba, which is a deep reinforcement learning-based DNN scheduler for spatial accelerators. Ceiba observes the running DNN computation as well as the spatial architecture to make schedule decisions. Then, Ceiba receives a reward to learn and produce the best-fit policy. To provide efficient and scalable scheduling, Ceiba constructs a DNN-architecture-specific action space. It is defined by upper and lower bounds to exclude invalid and sub-optimal schedule candidates. Extensive experiments demonstrate that Ceiba generally provides better performance for spatial accelerators under a fixed number of searching steps or a fixed amount of time. Specifically, Ceiba achieves an average 2.2 × speedup for the Simba accelerator, compared with the state-of-the-art scheduler. When scaling the batch size and the hardware architecture up by 64 ×, the performance gains of Ceiba are 1.8 × and 1.2 × on average, respectively. Moreover, Ceiba exhibits better scalability for the Eyeriss accelerator.
Detection and Analysis of Cadmium Prevalence in Soil-Water Matrices of Industrial Settings of Delhi: Bioavailability and Geochemical Study
Authors: Sable Harsh , Singh Vandana , Khosla Ajit , Chaudhary Vishal
Published: February 2025

Cadmium (Cd) is a persistent, carcinogenic and toxic heavy metal possessing analogous physicochemical characteristics to calcium, can displace it in ecological systems, enabling it to infiltrate the food chain through contaminated soil/water. Since the irresponsible discharge of effluents through industries is prominent, it necessitates detecting the prevalence of Cd in such ecosystems. This study focuses on detecting Cd prevalence in industrial areas of New Delhi, India using geochemical and bioavailability analysis. Soil and effluent water samples from 12 industrial locations were analyzed using a sequential extraction approach for detecting Cd prevalence. The outcomes revealed the average Cd quantity surpasses the WHO recommended limit i.e. (1.1 ± 0.3 mg K−1g−1) and (2.1 ± 0.4 mg K−1g−1), (1.2 ± 0.3 mg K−1g−1) and (2.2 ± 0.7 mg K−1g−1), and (1.1 ± 0.2 mg K−1g−1) and (2.1 ± 0.4 mg K−1g−1) for soil and effluent in Bawana, Kasana and Okhla, respectively. The pollution index for Cd surpassed the maximum allowed level of 1 at all locations. Besides, the estimated contamination metrics, including the geo-accumulation index (>1), heavy metal pollution index (>13), contamination factor (>7), and degree of contamination index (>20), are highly alarming. These findings emphasize the critical necessity for targated remediation approaches and rigorous regulatory measures to address Cd contamination. Managing this issue is crucial for protecting the sustainability of the environment, minimizing human health risks, and maintaining the core the principles of the One Health framework, which highlights the interrelation of environmental, animal, and human health.
Microbiota protect against frailty and loss of skeletal muscle, and maintain inflammatory tone during aging in mice
Authors: Conn Meghan O. , DeJong Erica N. , Marko Daniel M. , Fayyazi Russta , Kukje Zada Dana , Foley Kevin P. , Barra Nicole G. , Bowdish Dawn M. E. , Schertzer Jonathan D.
Published: February 2025

Germ-free mice had increased frailty, lower muscle mass, and lower circulating inflammatory monocytes. Therefore, lower systemic inflammation coincided with worse frailty and muscle loss. Microbial colonization decreased frailty, restored muscle mass, and increased circulating inflammatory monocytes while lowering transcripts in inflammatory TNF and NF-κB pathways within muscle. Hence, microbiota can increase circulating inflammation but decrease muscle inflammation to protect against frailty. This microbiota-muscle axis should be investigated for therapeutic potential in muscle wasting and sarcopenia.
Long-lasting recombinant HEXA treatment improves hepatic steatosis and glycemic control in mild, but not severe, metabolic dysfunction-associated steatohepatitis
Authors: Lin Sihan , Dong Li , De Nardo William , Leeming Michael G. , Cheng Zhili , Williamson Nicholas A. , Watt Matthew J. , Montgomery Magdalene K.
Published: February 2025

The prevalence of metabolic dysfunction-associated steatohepatitis (MASH) and type 2 diabetes is increasing. Here, we show that chronic FC-HEXA recombinant protein treatment reduces hepatic lipid accumulation and improves blood glucose control in mice with mild MASH and insulin resistance.
Characteristics and Risk Factors of Immune Checkpoint Inhibitor-related Pneumonitis in Non-small Cell Lung Cancer: A Retrospective Study
Authors: Cui Linhong , Cheng Kunxiang , Cui Mingxin , Li Xiaomei
Published: February 2025

Introduction: Immune checkpoint inhibitor-related pneumonitis (ICI-P) is a life-threatening complication, limiting immune checkpoint inhibitors (ICIs) clinical application in non-small cell lung cancer (NSCLC). But risk factors for developing ICI-P have not been well defined.
Methods: This study employed a retrospective analysis method. Following approval from the Ethics Committee of Chinese PLA General Hospital, we retrieved patient information on NSCLC registered in the hospital’s PRIDE workstation, selecting patients who received treatment with ICIs from January 1, 2018 to September 30, 2023. Complete medical records of patients were collected and verified. Logistic regression analysis was used to identify independent high-risk factors for the occurrence of ICI-P.
Results: A total of 753 patients with NSCLC who received treatment with ICIs were included, with mean age of (63±9.5) years. 102 patients diagnosed with ICI-P were identified, resulting in an incidence rate of 13.5%. Development of ICI-P was independently associated with history of interstitial lung disease (ILD) (OR, 3.85; CI, 1.99-7.46; P<0.001), prior thoracic radiotherapy (OR, 2.65; CI, 1.56-4.48; P<0.001), concurrent thoracic radiotherapy (OR, 3.56; CI, 1.69-7.47; P<0.001) and treatment with programmed cell death 1 (PD-1) inhibitors compared with programmed death-ligand 1 (PD-L1) inhibitors (OR, 3.54; CI, 1.05-11.98; P=0.04).
Conclusion: Independent risk factors for ICI-P occurrence included the history of ILD, previous chest radiotherapy, concurrent chest radiotherapy, and the use of PD-1 inhibitors (compared to non-PD-1 inhibitors). Specialty assessment of ILD before treatment and cautious use of ICIs in radiotherapy patients, represent feasible strategies to prevent the occurrence of ICI-P.
Eight cases of Pediatric Acute Onset Neuropsychiatric Syndrome (PANS) with Inflammatory Bowel Disease (IBD): Immunologic Intersections
Authors: Tang Angela W. , Prieto Jimenez Paula M. , Miller Ian K.T. , Madan Juliette C. , Nguyen Jaden , Ma Meiqian , Silverman Melissa , Farhadian Bahare , Wilson Jenny , Goyal Alka , Manko Cindy , Davies Yinka , Rabizadeh Shervin , Frankovich Jennifer
Published: February 2025

Introduction: Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) is an immune-mediated disease characterized by abrupt onset neurobehavioral changes. Inflammatory bowel disease (IBD) includes ulcerative colitis (UC) and Crohn’s disease (CD), chronic conditions characterized by gastrointestinal inflammation. We describe eight individuals with both PANS and IBD.
Methods: All individuals with both IBD and PANS were identified from Stanford Immune Behavioral Health Clinic, Cedars-Sinai Medical Center Pediatric Inflammatory Bowel Disease Program, and Dartmouth Neuroimmune Psychiatric Disorders (NIPD) Clinic. Data was collected by chart review.
Results: Eight cases of PANS with IBD were identified. Five were male. Mean age of onset was 9.3 years for PANS and 15.6 years for IBD. PANS preceded development of IBD in 7 of 8 cases by a mean of 8.4 years. Seven patients (88%) had a first-degree relative with an immune-mediated disease, including 5 with psoriasis or psoriatic arthritis. Five patients themselves had arthralgias or arthritis (63%). All of the 5 cases where PANS preceded IBD treatment sufficiently for analysis were free of major behavioral relapses after IBD was managed.
Conclusion: The triad of PANS, joint complaints, and family history of autoimmunity, including psoriasis, may represent a subset of PANS at heightened risk for IBD and additional immune-mediated disorders. For children with this triad, clinicians should have a low threshold to evaluate for gastrointestinal inflammation with biomarkers like hemoglobin, CRP, fecal calprotectin and diagnostic endoscopy when indicated. PANS symptoms may improve with effective treatment of IBD. The high prevalence of joint complaints in our cohort and psoriasis in first-degree family members suggests this subset of PANS may share immune mechanisms with psoriasis and arthritis. Treatment strategies used in IBD and arthritis should be studied for potential application in PANS.
Additive predictive value of left ventricular end-diastolic volume index to the development of persistent atrial fibrillation in non-obstructive hypertrophic cardiomyopathy
Authors: Tang Yajie , Yang Pan , Xiao Minghu , Song Lei , Lu Minjie , Zheng Zhe
Published: February 2025

Objective To evaluate the association between left ventricular diastolic volume index (LVEDVi) and the risk of persistent or long-standing persistent atrial fibrillation (perAF) in non-obstructive hypertrophic cardiomyopathy (NOHCM) patients.
Methods Forty-nigh NOHCM patients with perAF were selected as the case group (NOHCMAF group). A control group comprised 98 NOHCM patients without atrial fibrillation (AF) history.
Results Compared to the control group, patients in the NOHCMAF group were associated with higher CHA2DS2-VASc score (3.0 ± 1.7 vs 2.2 ± 1.1, p=0.003), higher grade of diastolic dysfunction (II/III) (43.3% vs. 19.4%, p<0.001). Meanwhile, they were associated with a larger left atrial diameter (LAD) (46.8 ± 4.7 vs. 39.3 ± 4.5 mm, p<0.001) and a smaller LVEDVi (63.88 ± 15.07 ml/m² vs. 78.86 ± 12.26 ml/m², p<0.001). Multivariate logistic analysis indicated the independent predictive factor of LVEDVi (OR 0.908, CI 0.861 - 0.957, p<0.001). The multivariable models revealed the additive discrimination for perAF by the LVEDVi with a higher C-statistic of 0.945 in combination with age at diagnosis and LAD. The LVEDVi cutoff for predicting perAF was 71 ml/m².
Conclusions LVEDVi was independently associated with the occurrence of perAF in NOHCM patients, demonstrating an incremental value compared to conventional LA parameters. Increased cardiac rhythm monitoring is recommended for patients with LVEDVi ≤ 71 ml/m².
The impact of telehealth on glycemic control in people diagnosed with type 2 diabetes: A retrospective cohort study
Authors: Aman Allah Ahmed M. , Malibarey Waad M , Bin Baz Sarah S. , Alsalmi Hazim A. , Alkattan Abdullah N. , Attar Hanan K.
Published: February 2025

Objectives: Telehealth is a potential method for improving the quality of care for people diagnosed with type 2 diabetes (T2D). In Saudi Arabia, there is limited research on the effectiveness of telehealth for glycemic control compared with usual care. Thus, the aim of the current study was to determine the impact of telehealth on glycemic control in individuals diagnosed with T2D, with a specific focus on the examination of hemoglobin A1c (HbA1c) values.
Methods: A retrospective case-control cohort study was conducted between January and August 2024 on people diagnosed with T2D who were managed at different primary health care centers (PHCs) in Taif, Saudi Arabia. The cohort design of the current study consisted of two groups based on the type of clinical visit, including in-person (control group) and remote (study group) visits.
Results: Based on the inclusion criteria for each group, 118 patients who utilized telehealth for diabetic follow-up were included in the study group, whereas the remaining subjects (N=125) who attended PHCs for in-person diabetic follow-up were recruited into the control group. The differences in HbA1c values between the two visits (baseline and follow-up visits) in the study group and the control group were -0.52±1.35 and -0.12±1.10, respectively (P=0.012). However, logistic regression revealed no significant difference in HbA1c between telehealth use and in-person clinical visits (P=0.053).
Conclusions: Telehealth was not inferior to usual care for people diagnosed with T2D and may be associated with a major improvement in HbA1c levels. These findings contribute valuable insights to the literature, and future research endeavors can build upon this foundation to further enhance the use of telehealth in maintaining glycemic control.