bluuebunny/crossref_metadata_2025 huggingface dataset:
Accurate prediction of solvent flux in sub–1-nm slit-pore nanosheet membranes
Authors: Chen Xiaofang , Qin Yao , Zhu Yudan , Pan Xueling , Wang Yuqi , Ma Hongyu , Wang Ruoxin , Easton Christopher D. , Chen Yu , Tang Cheng , Du Aijun , Huang Aisheng , Xie Zongli , Zhang Xiwang , Simon George P. , Banaszak Holl Mark M. , Lu Xiaohua , Novoselov Kostya , Wang Huanting
Published: April 2024

Nanosheet-based membranes have shown enormous potential for energy-efficient molecular transport and separation applications, but designing these membranes for specific separations remains a great challenge due to the lack of good understanding of fluid transport mechanisms in complex nanochannels. We synthesized reduced MXene/graphene hetero-channel membranes with sub–1-nm pores for experimental measurements and theoretical modeling of their structures and fluid transport rates. Our experiments showed that upon complete rejection of salt and organic dyes, these membranes with subnanometer channels exhibit remarkably high solvent fluxes, and their solvent transport behavior is very different from their homo-structured counterparts. We proposed a subcontinuum flow model that enables accurate prediction of solvent flux in sub–1-nm slit-pore membranes by building a direct relationship between the solvent molecule–channel wall interaction and flux from the confined physical properties of a liquid and the structural parameters of the membranes. This work provides a basis for the rational design of nanosheet-based membranes for advanced separation and emerging nanofluidics.
Megathrust locking encoded in subduction landscapes
Authors: Oryan Bar , Olive Jean-Arthur , Jolivet Romain , Malatesta Luca C. , Gailleton Boris , Bruhat Lucile
Published: April 2024

Locked areas of subduction megathrusts are increasingly found to coincide with landscape features sculpted over hundreds of thousand years, yet the mechanisms that underlie such correlations remain elusive. We show that interseismic locking gradients induce increments of irreversible strain across the overriding plate manifested predominantly as distributed seismicity. Summing these increments over hundreds of earthquake cycles produces a spatially variable field of uplift representing the unbalance of co-, post-, and interseismic strain. This long-term uplift explains first-order geomorphological features of subduction zones such as the position of the continental erosive shelf break, the distribution of marine terraces and peninsulas, and the profile of forearc rivers. Inelastic yielding of the forearc thus encodes short-term locking patterns in subduction landscapes, hinting that megathrust locking is stable over multiple earthquake cycles and highlighting the role geomorphology can play in constraining Earth’s greatest source of seismic hazard.
Up-regulated PLA2G10 in cancer impairs T cell infiltration to dampen immunity
Authors: Zhang Tianxiang , Yu Weiwei , Cheng Xiaoxiao , Yeung Jacky , Ahumada Viviana , Norris Paul C. , Pearson Mackenzie J. , Yang Xuan , van Deursen Willemijn , Halcovich Christina , Nassar Ala , Vesely Matthew D. , Zhang Yu , Zhang Jian-Ping , Ji Lan , Flies Dallas B. , Liu Linda , Langermann Solomon , LaRochelle William J. , Humphrey Rachel , Zhao Dejian , Zhang Qiuyu , Zhang Jindong , Gu Runxia , Schalper Kurt A. , Sanmamed Miguel F. , Chen Lieping
Published: April 2024

T cells are often absent from human cancer tissues during both spontaneously induced immunity and therapeutic immunotherapy, even in the presence of a functional T cell–recruiting chemokine system, suggesting the existence of T cell exclusion mechanisms that impair infiltration. Using a genome-wide in vitro screening platform, we identified a role for phospholipase A2 group 10 (PLA2G10) protein in T cell exclusion. PLA2G10 up-regulation is widespread in human cancers and is associated with poor T cell infiltration in tumor tissues. PLA2G10 overexpression in immunogenic mouse tumors excluded T cells from infiltration, resulting in resistance to anti–PD-1 immunotherapy. PLA2G10 can hydrolyze phospholipids into small lipid metabolites, thus inhibiting chemokine-mediated T cell mobility. Ablation of PLA2G10’s enzymatic activity enhanced T cell infiltration and sensitized PLA2G10-overexpressing tumors to immunotherapies. Our study implicates a role for PLA2G10 in T cell exclusion from tumors and suggests a potential target for cancer immunotherapy.
Genetic basis of clarithromycin resistance in
Bacillus anthracis
Authors: Maxson Tucker , Overholt Will A. , Chivukula Vasanta , Caban-Figueroa Victoria , Kongphet-Tran Thiphasone , Medina Cordoba Luz K. , Cherney Blake , Rishishwar Lavanya , Conley Andrew , Sue David
Published: April 2024

The high-consequence pathogen
Bacillus anthracis
causes human anthrax and often results in lethal infections without the rapid administration of effective antimicrobial treatment. Antimicrobial resistance profiling is therefore critical to inform post-exposure prophylaxis and treatment decisions, especially during emergencies such as outbreaks or where intentional release is suspected. Whole-genome sequencing using a rapid long-read sequencer can uncover antimicrobial resistance patterns if genetic markers of resistance are known. To identify genomic markers associated with antimicrobial resistance, we isolated
B. anthracis
derived from the avirulent Sterne strain with elevated minimal inhibitory concentrations to clarithromycin. Mutants were characterized both phenotypically through broth microdilution susceptibility testing and observations during culturing, as well as genotypically with whole-genome sequencing. We identified two different in-frame insertions in the L22 ribosomal protein-encoding gene
rplV
, which were subsequently confirmed to be involved in clarithromycin resistance through the reversion of the mutant gene to the parent (drug-susceptible) sequence. Detection of the
rplV
insertions was possible with rapid long-read sequencing, with a time-to-answer within 3 h. The mutations associated with clarithromycin resistance described here will be used in conjunction with known genetic markers of resistance for other antimicrobials to strengthen the prediction of antimicrobial resistance in
B. anthracis
.

IMPORTANCE

The disease anthrax, caused by the pathogen
Bacillus anthracis
, is extremely deadly if not treated quickly and appropriately. Clarithromycin is an antibiotic recommended for the treatment and post-exposure prophylaxis of anthrax by the Centers for Disease Control and Prevention; however, little is known about the ability of
B. anthracis
to develop resistance to clarithromycin or the mechanism of that resistance. The characterization of clarithromycin-resistant isolates presented here provides valuable information for researchers and clinicians in the event of a release of the resistant strain. Additionally, knowledge of the genetic basis of resistance provides a foundation for susceptibility prediction through rapid genome sequencing to inform timely treatment decisions.
Big slow-movers, debris slides and flows, and mega-boulders of the Blue Ridge Escarpment, western North Carolina, USA
Authors: Hill§ Jesse , Wooten§ Richard , Cattanach§ Bart , Bauer§ Jennifer , Bozdog§ Nick , Douglas§ Tommy , Isard§ Sierra , Khashchevskaya§ Daria , Korte§ David , Kuhne§ Jody , Owen§ Lewis , Prince§ Philip , Scheip§ Corey , Waters-Tormey§ Cheryl , Wegmann§ and Karl
Published: April 2024

This one-day field trip will explore the geomorphology, landslide mapping, geochronology, tectonics, meteorology, and geoengineering related to the Blue Ridge Escarpment (BRE), North Carolina, USA. Our aim is to show why it has persisted in the landscape and how it influences landslide frequency and the lives of the western North Carolina people. Some of the work we highlight has been published and some we present for the first time. Landslides pose a frequent geologic hazard to the people of western North Carolina, and they cause losses of road access, property, or, in the worst scenarios, human lives. We will also discuss landslide disaster response and mitigation efforts that required the collaboration of state and local emergency managers with other local, state, and federal agencies and the public.

As we traverse the rugged terrain along the BRE in Polk and Rutherford counties, we will examine rockfalls, rockslides, debris flows, and debris slides occurring in late Proterozoic to early Paleozoic metasedimentary and meta-igneous rocks southeast of the Brevard fault zone. Our focus will be steep-walled, topographic reentrants where streams exploit brittle, post-orogenic bedrock structures, incise into the BRE, and produce landforms prone to debris flows and other types of mass wasting, often triggered by extreme rainfall events. The research we present on these extreme historical storms will help illustrate the scope and magnitude of the BRE’s influence on meteorological and hydrological events that lead to landslides and flooding.

In addition to ongoing countywide landslide hazard mapping, a complementary research objective is to better understand the influence brittle cross-structures and earlier ductile bedrock structures have on rock slope failures and debris flows in the North Pacolet River valley and Hickory Nut Gorge, two major structurally controlled topographic lineaments.
Bacterial magnetofossil evidence for enhanced Pacific Ocean respired carbon storage during buildup of Antarctic glaciation
Authors: Wang Dunfan , Chen Yihui , Liu Yan , Roberts Andrew P. , Rohling Eelco J. , Zhao Xiangyu , Zhang Xu , Li Jinhua , Yao Weiqi , Qu Xuejiao , Tan Xianfeng , Liu Qingsong
Published: April 2024

Global cooling with the onset of Antarctic glaciation ca. 34 Ma across the Eocene-Oligocene transition (EOT) terminated the early Cenozoic greenhouse climate state and marked the beginning of icehouse conditions. Although a pCO2 decline is considered to have been a major cause of this climate shift, the associated carbon-sequestration mechanism remains unclear. Here, we assessed ocean production and circulation changes across the EOT using numerical simulations combined with a novel proxy, namely, bacterial magnetofossils, the abundance and morphology of which are sensitive to sedimentary organic matter accumulation and oxygenation. We detected production and oxygenation declines in the equatorial Pacific Ocean coeval with increased biological production in the Southern Ocean after the EOT. Corroborated by simulation results and evidence from the Subantarctic region, we interpret this counterintuitive combination as a result of enhanced bottom-water formation and biological pump efficiency in the Southern Ocean due to Antarctic glacial buildup across the EOT. These results provide key evidence for deep Pacific Ocean deoxygenation and increased respired carbon concentrations, which amplified CO2 decline across the EOT.
Missing link: a qualitative analysis of community-based organisations’ contributions to partnered collaborative care to treat late-life depression
Authors: Gosdin Melissa M , Hoeft Theresa , Henderson Stuart , Wagner Jenny , Hinton Ladson
Published: April 2024

Objective

Extending collaborative care, a model integrating mental health services into primary care, to include community-based organisations (CBOs) may improve older patient health outcomes by increasing access to care and addressing patients’ social needs; however, little is known about how CBOs contribute to such partnered depression care. We explored how six primary care clinic and CBO partnerships came together to provide late-life depression care through the Care Partners funded in 2014.

Design

43 key informant interviews and 15 focus groups were conducted with care managers, administrators and primary care providers partnering to provide late-life depression care. Data were coded and analysed iteratively using qualitative thematic analysis.

Setting

Six primary care clinic–CBO sites across California.

Participants

Care managers, administrators and primary care providers participated in this study.

Results

Three unique contributions of CBOs to depression care in these clinic–CBO partnerships were identified: (1) CBOs added new services that focus on social needs and enhanced depression care; (2) CBOs strengthened core aspects of collaborative care for depression; (3) CBOs provided new avenues for building connections and trust with underserved patients.

Conclusions

CBOs, when partnered with clinics, enhanced both medical and social aspects of depression treatment for older adults. CBOs are well positioned to assist primary care clinics in treating the complex health needs of older adults by providing new and strengthening existing aspects of partnered depression care while building patient trust among culturally diverse populations.
Intersectional stigma and the non-communicable disease syndemic in the context of HIV: protocol for a multisite, observational study in the USA
Authors: Friedman M Reuel , Badri Sheila , Bowleg Lisa , Haberlen Sabina A , Jones Deborah L , Kempf Mirjam-Colette , Konkle-Parker Deborah , Kwait Jenn , Martinson Jeremy , Mimiaga Matthew J , Plankey Michael W , Stosor Valentina , Tsai Alexander C , Turan Janet M , Ware Deanna , Wu Katherine
Published: April 2024

Introduction

The increasing burden of non-communicable diseases, such as hypertension, diabetes and dyslipidaemia, presents key challenges to achieving optimal HIV care outcomes among ageing people living with HIV. These diseases are often comorbid and are exacerbated by psychosocial and structural inequities. This interaction among multiple health conditions and social factors is referred to as a syndemic. In the USA, there are substantial disparities by social position (ie, racial, ethnic and socioeconomic status) in the prevalence and/or control of non-communicable diseases and HIV. Intersecting stigmas, such as racism, classism and homophobia, may drive these health disparities by contributing to healthcare avoidance and by contributing to a psychosocial syndemic (stress, depression, violence victimisation and substance use), reducing success along the HIV and non-communicable disease continua of care. Our hypothesis is that marginalised populations experience disparities in non-communicable disease incidence, prevalence and control, mediated by intersectional stigma and the psychosocial syndemic.

Methods and analysis

Collecting data over a 4 year period, we will recruit sexual minority men (planned n=1800) enrolled in the MACS/WIHS Combined Cohort Study, a long-standing mixed-serostatus observational cohort in the USA, to investigate the following specific aims: (1) assess relationships between social position, intersectional stigma and the psychosocial syndemic among middle-aged and ageing sexual minority men, (2) assess relationships between social position and non-communicable disease incidence and prevalence and (3) assess relationships between social position and HIV and non-communicable disease continua of care outcomes, mediated by intersectional stigma and the psychosocial syndemic. Analyses will be conducted using generalised structural equation models using a cross-lagged panel model design.

Ethics and dissemination

This protocol is approved as a single-IRB study (Advarra Institutional Review Board: Protocol 00068335). We will disseminate results via peer-reviewed academic journals, scientific conferences, a dedicated website, site community advisory boards and forums hosted at participating sites.
Swissped-RECOVERY: masked independent adjudication for the interpretation of non-randomised treatment in a two-arm open-label randomised controlled trial (methylprednisolone vs immunoglobulins) in Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS) involving 10 secondary and tertiary paediatric hospitals in Switzerland
Authors: Schöbi Nina , Sanchez Carlos , Welzel Tatjana , Bamford Alasdair , Webb Kate , Rojo Pablo , Tremoulet Adriana , Atkinson Andrew , Schlapbach Luregn J , Bielicki Julia Anna
Published: April 2024

Objectives

In trials of acute severe infections or inflammations frequent administration of non-randomised treatment (ie, intercurrent event) in response to clinical events is expected. These events may affect the interpretation of trial findings. Swissped-RECOVERY was set up as one of the first randomised controlled trials worldwide, investigating the comparative effectiveness of anti-inflammatory treatment with intravenous methylprednisolone or intravenous immunoglobulins in children and adolescents with Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS). We present one approach towards improving the interpretation of non-randomised treatment in a randomised controlled trial.

Design

This is a pre-planned ancillary analysis of the Swissped-RECOVERY trial, a randomised multicentre open-label two-arm trial.

Setting

10 Swiss paediatric hospitals (secondary and tertiary care) participated.

Participants

Paediatric patients hospitalised with PIMS-TS.

Interventions

All patient-first intercurrent events, if applicable, were presented to an independent adjudication committee consisting of four international paediatric COVID-19 experts to provide independent clinical adjudication to a set of standardised questions relating to whether additional non-randomised treatments were clinically indicated and disease classification at the time of the intercurrent event.

Results

Of 41 treatments in 75 participants (24/41 (59%) and 17/41 (41%) in the intravenous methylprednisolone and immunoglobulin arms of the trial, respectively), two-thirds were considered indicated. The most common treatment (oral glucocorticoids, 14/41, 35%) was mostly considered not indicated (11/14, 79%), although in line with local guidelines. Intercurrent events among patients with Shock-like PIMS-TS at baseline were mostly considered indicated. A significant proportion of patients with undifferentiated PIMS-TS at baseline were not attributed to the same group at the time of the intercurrent event (6/12 unchanged, 4/12 Kawasaki disease-like, 2/12 Shock-like).

Conclusion

The masked adjudication of intercurrent events contributes to the interpretation of results in open-label trials and should be incorporated in the future.

Trial registration numbers

SNCTP000004720 and NCT 04826588.
Social care data and its fitness for integrated health and social care service governance: an exploratory qualitative analysis in the Dutch context
Authors: Bos Véronique LLC , Klazinga Niek S , Kringos Dionne S
Published: April 2024

Introduction

To date, little is known on how social care data could be used to inform performance-based governance to accelerate progress towards integrated health and social care.

Objectives and design

This study aims to perform a descriptive evaluation of available social care data in the Netherlands and its fitness for integrated health and social care service governance. An exploratory mixed-method qualitative study was undertaken based on desktop research (41 included indicators), semi-structured expert interviews (13 interviews including 18 experts) and a reflection session (10 experts).

Setting

The Netherlands; social care is care provided in accordance with the Social Support Act, the Participation Law and the Law for Municipal debt-counselling.

Results

This study found six current uses for social care data: (a) communication and accountability, (b) monitoring social care policy, (c) early warning systems, (d) controls and fraud detection, (e) outreaching efforts and (f) prioritisation. Further optimisation should be sought through: standardisation, management of data exchange across domains, awareness of the link between registration and financing, strengthening the overall trust in data sharing. The study found five ways the enhanced social care data could be used to improve the governance of integrated health and social care services: (a) cross-domain learning and cooperation (eg, through benchmarks), (b) preventative measures and early warning systems, (c) give insight regarding the quality and effectivity of social care in a broader perspective, (d) clearer accountability of social care towards contracting parties and policy, (e) enable cross-sector data-driven governance model.

Conclusion

Although there are several innovative initiatives for the optimisation of the use of social care data in the Netherlands, the current social care data landscape and management is not yet fit to support the new policy initiatives to strengthen integrated health and social care service governance. Directions for addressing the shortcomings are provided.
Value-based comparison of ambulatory children with respiratory diseases in an emergency department and a walk-in clinic: a retrospective cohort study in Québec, Canada
Authors: Marx Tania , Moore Lynne , Talbot Denis , Guertin Jason Robert , Lachapelle Philippe , Blais Sébastien , Singbo Narcisse , Simonyan David , Lavallée Jeanne , Zada Nawid , Shahrigharahkoshan Shaghayegh , Huard Benoit , Olivier Pascale , Mallet Myriam , Létourneau Mélanie , Lafrenière Michel , Archambault Patrick , Berthelot Simon
Published: April 2024

Objective

To compare health outcomes and costs given in the emergency department (ED) and walk-in clinics for ambulatory children presenting with acute respiratory diseases.

Design

A retrospective cohort study.

Setting

This study was conducted from April 2016 to March 2017 in one ED and one walk-in clinic. The ED is a paediatric tertiary care centre, and the clinic has access to lab tests and X-rays.

Participants

Inclusion criteria were children: (1) aged from 2 to 17 years old and (2) discharged home with a diagnosis of upper respiratory tract infection (URTI), pneumonia or acute asthma.

Main outcome measures

The primary outcome measure was the proportion of patients returning to any ED or clinic within 3 and 7 days of the index visit. The secondary outcome measures were the mean cost of care estimated using time-driven activity-based costing and the incidence of antibiotic prescription for URTI patients.

Results

We included 532 children seen in the ED and 201 seen in the walk-in clinic. The incidence of return visits at 3 and 7 days was 20.7% and 27.3% in the ED vs 6.5% and 11.4% in the clinic (adjusted relative risk at 3 days (aRR) (95% CI) 3.17 (1.77 to 5.66) and aRR at 7 days 2.24 (1.46 to 3.44)). The mean cost (95% CI) of care (CAD) at the index visit was $C96.68 (92.62 to 100.74) in the ED vs $C48.82 (45.47 to 52.16) in the clinic (mean difference (95% CI): 46.15 (41.29 to 51.02)). Antibiotic prescription for URTI was less common in the ED than in the clinic (1.5% vs 16.4%; aRR 0.10 (95% CI 0.03 to 0.32)).

Conclusions

The incidence of return visits and cost of care were significantly higher in the ED, while antibiotic use for URTI was more frequent in the walk-in clinic. These data may help determine which setting offers the highest value to ambulatory children with acute respiratory conditions.
Physical activity and mental health in individuals with multimorbidity during COVID-19: an explanatory sequential mixed-method study
Authors: Ambrosio Leire , Faulkner James , Morris Jacqui H , Stuart Beth , Lambrick Danielle , Compton Eric , Portillo Mari Carmen
Published: April 2024

Objective

To understand the physical activity and mental health of individuals living with long-term conditions during the COVID-19 pandemic.

Design

A sequential explanatory mixed-methods study with two phases: phase 1: quantitative survey and phase 2: qualitative follow-up interviews.

Setting

For the quantitative phase, an online survey was launched in March 2021, using Microsoft Forms. For the qualitative phase, in-depth semistructured interviews were conducted via online.

Participants

368 adults over 18 years old living in the UK with at least one long-term condition completed the survey. Interviews were conducted in a subsample of participants from the previous quantitative phase, with 26 people. Data were analysed using thematic analysis.

Results

Responses from the survey showed that people with one long-term condition were significantly more physically active and spent less time sitting, than those with two or more conditions, presenting with significantly higher well-being (p<0.0001), and lower levels of anxiety (p<0.01), and depression (p<0.0001). Interviews found that people developed a range of strategies to cope with the impact of changeability and the consequences of their long-term condition on their physical activity.

Conclusions

The number of long-term conditions influenced physical activity and how people coped with their condition during COVID-19. Findings will inform policy developments in preparation for future pandemics to support and remain people to remain physically active and mental health.
Remote ischaemic preconditioning for transcatheter aortic valve replacement: a protocol for a systematic review with meta-analysis and trial sequential analysis
Authors: Zhang Weiyi , Du Li , Chen Guo , Du Bin , Zhang Lu , Zheng Jianqiao
Published: April 2024

Introduction

Transcatheter aortic valve replacement (TAVR) has become an important treatment in patients with aortic valve disease with the continuous advancement of technology and the improvement of outcomes. However, TAVR-related complications still increase patient morbidity and mortality. Remote ischaemic preconditioning (RIPC) is a simple procedure that provides perioperative protection for many vital organs. However, the efficiency of RIPC on TAVR remains unclear based on inconsistent conclusions from different clinical studies. Therefore, we will perform a protocol for a systematic review and meta-analysis to identify the efficiency of RIPC on TAVR.

Methods and analysis

English databases (PubMed, Web of Science, Ovid Medline, Embase and Cochrane Library), Chinese electronic databases (Wanfang Database, VIP Database and China National Knowledge Infrastructure) and trial registry databases will be searched from inception to December 2023 to identify randomised controlled trials of RIPC on TAVR. We will calculate mean differences or standardised mean differences with 95% CIs for continuous data, and the risk ratio (RR) with 95% CIs for dichotomous data by Review Manager version 5.4. Fixed-effects model or random-effects model will be used according to the degree of statistical heterogeneity assessed by the I-square test. We will evaluate the risk of bias using the Cochrane risk-of-bias tool 2 and assess the evidence quality of each outcome by the Grading of Recommendations Assessment, Development and Evaluation. The robustness of outcomes will be evaluated by trial sequential analysis. In addition, we will evaluate the publication bias of outcomes by Funnel plots and Egger’s regression test.

Ethics and dissemination

Ethical approval was not required for this systematic review protocol. The results will be disseminated through peer-reviewed publications.

PROSPERO registration number

CRD42023462926
Community-Partnered Research appraisal tool for conducting, reporting and assessing community-based research
Authors: Park Avery , van Draanen Jenna
Published: April 2024

ObjectiveThe aim of this study was to develop an appraisal tool to support and promote clear, accurate and transparent standards and consistency when conducting, reporting and assessing community-based research.

DesignCurrent recommendations for developing reporting guidelines was used with three key differences: (1) an analysis of existing guides, principles and published literature about community engagement, involvement and participation in research using situational and relational maps; (2) feedback and pilot-testing by a community-based research team; and (3) testing the utility and usability of the appraisal tool.

ResultsAfter a series of iterative revisions, the resulting Community-Partnered Research (CPR) appraisal tool emerged into three products: an elaborate prospective format, a basic retrospective format, and a supplemental checklist format. All three versions of the CPR appraisal tool consist of 11 main question items with corresponding prompts aimed to facilitate awareness, accountability, and transparency about processes and practices employed by professional researchers and community co-researchers throughout four phases of research: (1) partnership and planning, (2) methods, (3) results and (4) sustainment.

ConclusionWe hope that introducing this tool will contribute to shifting individual and systematic processes and practices towards equitable partnerships, mutual trustworthiness and empowerment among professional researchers and community co-researchers and, in turn, improving the quality of co-created knowledge that benefits communities and creates social change.
Randomised controlled trial of population screening for atrial fibrillation in people aged 70 years and over to reduce stroke: protocol for the SAFER trial
Authors: Mant Jonathan , Modi Rakesh N , Dymond Andrew , Armstrong Natalie , Burt Jenni , Calvert Peter , Cowie Martin , Ding Wern Yew , Edwards Duncan , Freedman Ben , Griffin Simon J , Hoare Sarah , Hobbs F D Richard , Johnson Rachel , Kaptoge Stephen , Lip Gregory Y H , Lobban Trudie , Lown Mark , Lund Jenny , McManus Richard J , Mills Mark T , Morris Stephen , Powell Alison , Proietti Riccardo , Sutton Stephen , Sweeting Mike , Thom Howard , Williams Kate
Published: April 2024

Introduction

There is a lack of evidence that the benefits of screening for atrial fibrillation (AF) outweigh the harms. Following the completion of the Screening for Atrial Fibrillation with ECG to Reduce stroke (SAFER) pilot trial, the aim of the main SAFER trial is to establish whether population screening for AF reduces incidence of stroke risk.

Methods and analysis

Approximately 82 000 people aged 70 years and over and not on oral anticoagulation are being recruited from general practices in England. Patients on the palliative care register or residents in a nursing home are excluded. Eligible people are identified using electronic patient records from general practices and sent an invitation and consent form to participate by post. Consenting participants are randomised at a ratio of 2:1 (control:intervention) with clustering by household. Those randomised to the intervention arm are sent an information leaflet inviting them to participate in screening, which involves use of a handheld single-lead ECG four times a day for 3 weeks. ECG traces identified by an algorithm as possible AF are reviewed by cardiologists. Participants with AF are seen by a general practitioner for consideration of anticoagulation. The primary outcome is stroke. Major secondary outcomes are: death, major bleeding and cardiovascular events. Follow-up will be via electronic health records for an average of 4 years. The primary analysis will be by intention-to-treat using time-to-event modelling. Results from this trial will be combined with follow-up data from the cluster-randomised pilot trial by fixed-effects meta-analysis.

Ethics and dissemination

The London—Central National Health Service Research Ethics Committee (19/LO/1597) provided ethical approval. Dissemination will include public-friendly summaries, reports and engagement with the UK National Screening Committee.

Trial registration number

ISRCTN72104369.
Danish Diabetes Birth Registry 2: a study protocol of a national prospective cohort study to monitor outcomes of pregnancies of women with pre-existing diabetes
Authors: Knorr Sine , Aalders Jori , Overgaard Martin , Støvring Henrik , Mathiesen Elisabeth R , Damm Peter , Clausen Tine D , Bjerre-Christensen Ulla , Andersen Lise Lotte T , Vinter Christina , Kofoed-Enevoldsen Allan , Lauenborg Jeannet , Kampmann Ulla , Fuglsang Jens , Ovesen Per G , Christensen Trine T , Sørensen Anne , Ringholm Lene , Jensen Dorte M
Published: April 2024

Introduction

Despite technological developments and intensified care, pregnancies in women with pre-existing diabetes are still considered high-risk pregnancies. The rate of adverse outcomes in pregnancies affected by diabetes in Denmark is currently unknown, and there is a limited understanding of mechanisms contributing to this elevated risk. To address these gaps, the Danish Diabetes Birth Registry 2 (DDBR2) was established. The aims of this registry are to evaluate maternal and fetal-neonatal outcomes based on 5 years cohort data, and to identify pathophysiology and risk factors associated with short-term and long-term outcomes of pregnancies in women with pre-existing diabetes.

Methods and analysis

The DDBR2 registry is a nationwide 5-year prospective cohort with an inclusion period from February 2023 to February 2028 of pregnancies in women with all types of pre-existing diabetes and includes registry, clinical and questionnaire data and biological samples of mother–partner–child trios. Eligible families (parents age ≥18 years and sufficient proficiency in Danish or English) can participate by either (1) basic level data obtained from medical records (mother and child) and questionnaires (partner) or (2) basic level data and additional data which includes questionnaires (mother and partner) and blood samples (all). The primary maternal outcome is Hemoglobin A1c (HbA1c) levels at the end of pregnancy and the primary offspring endpoint is the birth weight SD score. The DDBR2 registry will be complemented by genetic, epigenetic and metabolomic data as well as a biobank for future research, and the cohort will be followed through data from national databases to illuminate possible mechanisms that link maternal diabetes and other parental factors to a possible increased risk of adverse long-term child outcomes.

Ethics and dissemination

Approval from the Ethical Committee is obtained (S-20220039). Findings will be sought published in international scientific journals and shared among the participating hospitals and policymakers.

Trial registration number

NCT05678543.
Relationship of domestic violence with pregnancy symptoms and pregnancy experience in Iranian pregnant women: a cross-sectional study
Authors: Aliasghari Fatemeh , Effati-Daryani Fatemeh , Mohammadi Azam , Mirghafourvand Mojgan
Published: April 2024

Objective

Violence has had adverse effects on the physical and psychological dimensions of pregnant women. This study was conducted with the aim of determining the relationship of domestic violence with pregnancy symptoms and pregnancy experience.

Design

In this cross-sectional study, pregnant women were selected through two-stage cluster sampling method. Data were collected using the domestic violence questionnaire of the WHO, pregnancy symptoms inventory (PSI) and pregnancy experience scale (PES). To determine the relationship between domestic violence with pregnancy symptoms and pregnancy experience, adjusted general linear model was used in multivariate analysis.

Setting

Health centres in Urmia—Iran in 2022.

Participants

415 pregnant women.

Results

The frequency of emotional, physical and sexual violence was 86.0%, 67.7% and 79.5%, respectively. The mean (SD) of PSI was 49.45 (14.38) with attainable score of 0–123 and PES including happiness and worry was 14.32 (6.48) and 16.21 (2.51) with attainable score of 0–30, respectively. Based on the adjusted general linear model, the mean score of PSI in women who experienced physical violence (mild (p<0.001) and moderate (p<0.001)); sexual violence (mild (p<0.001), moderate (p<0.001) and severe (p<0.001)); and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly higher than women without experiencing violence. The mean score of happiness during pregnancy in women who experienced physical violence (moderate (p=0.011)) and emotional violence (mild (p<0.001), moderate (p=0.002) and severe (p<0.001)) was significantly lower than women without experience of violence. Also, the mean score of worry scores in women with experience of sexual violence (mild (p=0.001) and moderate (p=0.012)) and emotional violence (mild (p<0.001), moderate (p<0.001)) and severe (p<0.001)) was significantly higher than women without experiencing violence.

Conclusion

Considering the relationship between violence and pregnancy symptoms and pregnancy experiences, it is necessary to use appropriate strategies to prevent violence in pregnant women.
Development and validation of a risk assessment tool for uncontrolled type 2 diabetes among patients in South Karnataka, India
Authors: Anil Deepak , Doddaiah Sunil Kumar , Shivaswamy Rajendra Prasad , Gopi Arun , Basheer Sayana , Narayana Murthy Mysore Ramakrishnaiah
Published: April 2024

Introduction

Diabetes is a chronic medical condition with severe complications mainly caused due to unhealthy lifestyles in genetically susceptible individuals. This study attempts to develop a non-invasive risk assessment tool to identify patients with uncontrolled type 2 diabetes mellitus (T2DM) in southern India.

Methodology

An exploratory study was conducted among 545 patients with T2DM in the Mysuru district, South India for 6 months. A prevalidated questionnaire was used to collect data. Univariate and multivariate logistic regression analysis was performed to develop the risk score. Receiver-operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the cut-off for the risk score. The risk score is specifically designed for the population of South Karnataka, India.

Results

Out of the 545 study participants, the prevalence of uncontrolled diabetes was 59.9%. Physical activity, duration of diabetes, diabetic diet, regular health check-ups, history of hypertension, smoking history and alcohol consumption were factors significantly associated with uncontrolled diabetes (p<0.05). For an optimum cut-off point of >13.50, the risk assessment model showed a moderate sensitivity of 71.3%, specificity of 61%, positive predictive value of 73.2% and negative predictive value of 58.3%. The ROC curve was plotted for the model with an AUC of 0.726 (95% CI 0.683 to 0.769).

Conclusion

This study developed ‘Diabetes Care’, a simple web-based, non-invasive and inexpensive tool for identifying individuals at risk of developing uncontrolled T2DM in the future.
Focused update to guidelines for endovascular therapy for emergent large vessel occlusion: basilar artery occlusion patients
Authors: Heit Jeremy Josef , Chaudhary Neeraj , Mascitelli Justin R , Al-Kawaz Mais , Baker Amanda , Bulsara Ketan R , Burkhardt Jan Karl , Marden Franklin A , Raper Daniel , Tjoumakaris Stavropoula I , Schirmer Clemens M , Hetts Steven W ,   SNIS Standards and Guidelines Committee
Published: April 2024

Background

Endovascular therapy (EVT) dramatically improves clinical outcomes for patients with anterior circulation emergent large vessel occlusion (ELVO) strokes. With recent publication of two randomized controlled trials in favor of EVT for basilar artery occlusions, the Society of NeuroInterventional Surgery (SNIS) Standards and Guidelines Committee provides this focused update for the existing SNIS guideline, ‘Current endovascular strategies for posterior circulation large vessel occlusion stroke.’

Methods

A structured literature review and analysis of studies related to posterior circulation large vessel occlusion (basilar or vertebral artery) strokes treated by EVT was performed. Based on the strength and quality of the evidence, recommendations were made by consensus of the writing committee, with additional input from the full SNIS Standards and Guidelines Committee and the SNIS Board of Directors.

Results

Based on the results of the most recent randomized, controlled trials on EVT for basilar or vertebral artery occlusion, the expert panel agreed on the following recommendations. For patients presenting with an acute ischemic stroke due to an acute basilar or vertebral artery occlusion confirmed on CT angiography, National Institutes of Health Stroke Scale (NIHSS) score of ≥6, posterior circulation Alberta Stroke Program Early CT Score (PC-ASPECTS) ≥6, and age 18–89 years: (1) thrombectomy is indicated within 12 hours since last known well (class I, level B-R); (2) thrombectomy is reasonable within 12–24 hours from the last known well (class IIa, level B-R); (3) thrombectomy may be considered on a case by case basis for patients presenting beyond 24 hours since last known well (class IIb, level C-EO). In addition, thrombectomy may be considered on a case by case basis for patients aged <18 years or >89 years on a case by case basis (class IIb, level C-EO).

Conclusions

The indications for EVT of ELVO strokes continue to expand and now include patients with basilar artery occlusion. Further prospective, randomized controlled trials are warranted to elucidate the efficacy and safety of EVT in populations not included in this set of recommendations, and to confirm long term outcomes.
Impacts of soil, water source, and agro-climatic conditions on exchangeable sodium in rice-cultivated lowland soils of Sri Lanka
Authors: Sugathas Sinthuja , Sirisena Dineratne , Nijamudeen Mohomad , Marambe Buddhi , Kadupitiya Harsha , Beneragama Chalinda , Chandrajith Rohana , Suriyagoda Lalith
Published: April 2024

Rice is sensitive to salt stress, commonly caused by high concentrations of sodium (Na) in soils. However, the concentration and spatial variability of exchangeable Na in lowland paddy fields of Sri Lanka are not known. This study examined the interactive effects of the agro-climatic zones (ACZs), soil orders, and water sources on exchangeable Na in lowland paddy fields in Sri Lanka using 8566 soil samples. Exchangeable Na was extracted using 0.01 mol/L CaCl2 solution and detected using inductively coupled plasma-mass spectrophotometry. Exchangeable-Na concentration ranged from 0.05 to 4814 mg kg−1 with a mean concentration of 140.7 mg kg−1, and these values were within the optimal range reported for tropical paddy soils. The distribution of exchangeable Na was right skewed with 44%, 35%, and 9.3% of samples falling into 0–100, 100–200, and 200–300 mg kg−1, respectively. Samples from the Low country Dry zone had the highest (157 mg kg−1) Na concentration while that in the Upcountry Intermediate zone was the lowest (13 mg kg−1) ( p < 0.05). Vertisols recorded the highest (255 mg kg−1) and Ultisols recorded the lowest (81 ± 5.0 mg kg−1) among soil orders. Soils receiving supplementary irrigation in Low country Dry zone had lower Na than that in rainfed systems. Exchangeable-Na concentration was positively correlated with soil pH ( p < 0.05). Even though the concentrations of Na in soil samples were within the optimal range, agronomic decisions based on ACZ, soil order, and water source need to be made to minimize the potential development of saline–sodic soils in the study areas.
Seizure Detection Based on Lightweight Inverted Residual Attention Network
Authors: Lv Hongbin , Zhang Yongfeng , Xiao Tiantian , Wang Ziwei , Wang Shuai , Feng Hailing , Zhao Xianxun , Zhao Yanna
Published: April 2024

Timely and accurately seizure detection is of great importance for the diagnosis and treatment of epilepsy patients. Existing seizure detection models are often complex and time-consuming, highlighting the urgent need for lightweight seizure detection. Additionally, existing methods often neglect the key characteristic channels and spatial regions of electroencephalography (EEG) signals. To solve these issues, we propose a lightweight EEG-based seizure detection model named lightweight inverted residual attention network (LRAN). Specifically, we employ a four-stage inverted residual mobile block (iRMB) to effectively extract the hierarchical features from EEG. The convolutional block attention module (CBAM) is introduced to make the model focus on important feature channels and spatial information, thereby enhancing the discrimination of the learned features. Finally, convolution operations are used to capture local information and spatial relationships between features. We conduct intra-subject and inter-subject experiments on a publicly available dataset. Intra-subject experiments obtain 99.25% accuracy in segment-based detection and 0.36/h false detection rate (FDR) in event-based detection, respectively. Inter-subject experiments obtain 84.32% accuracy. Both sets of experiments maintain high classification accuracy with a low number of parameters, where the multiply accumulate operations (MACs) are 25.86[Formula: see text]M and the number of parameters is 0.57[Formula: see text]M.
Evolution game simulation study on Asia–Europe grain trade cooperation network
Authors: Xie Zhidong , Ma Jinlong , Zhang Hongbin , Pang Huawei
Published: April 2024

There has unavoidably been a problem for international grain cooperation in the Asia–Europe region as a result of the Russian–Ukrainian conflict. Analysis of the impact of Russian–Ukrainian conflict on the evolution of grain trade cooperation, identifying key influencing factors and formulating corresponding measures are of practical value for safeguarding grain security in the Asia–Europe region. In this paper, a grain trade network is constructed according to grain trade data from the Asian–European grain trade cooperation countries. A grain trade network game (GTNG) model of grain trade cooperation is established in order to investigate the elements that influence trade cooperation. The reciprocal preference is introduced. Through simulation experiments, the effects of cooperation costs, neighboring countries’ incentives, and punitive pressures, the degree of goodwill perception, the types of game, and the proportion of initial cooperators on trade cooperation are examined. This study may give useful policy recommendations for promoting Asia–Europe grain trade cooperation under the influence of the Russian–Ukrainian conflict.
Simulating the spread of COVID-19 with cellular automata: A new approach
Authors: Chowdhury Sourav , Roychowdhury Suparna , Chaudhuri Indranath
Published: April 2024

Between the years 2020 and 2022, the world was hit by the pandemic of COVID-19 giving rise to an extremely grave situation. Many people suffered and died from this disease. Also, the global economy was badly hurt due to the consequences of various intervention strategies (like social distancing, lockdown) which were applied by different countries to control this pandemic. There are multiple speculations that humanity will again face such pandemics in the future. Thus, it is very important to learn and gain knowledge about the spread of such infectious diseases and the various factors which are responsible for it. In this study, we have extended our previous work [S. Chowdhury, S. Roychowdhury and I. Chaudhuri, Eur. Phys. J. Spec. Top. 231, 3619 (2022), doi:10.1140/epjs/s11734-022-00619-1] on the probabilistic cellular automata (CA) model to reproduce the spread of COVID-19 in several countries by modifying its earlier used neighborhood criteria. This modification gives us the liberty to adopt the effect of different restrictions like lockdown and social distancing in our model. We have done some theoretical analysis for initial infection and simulations to gain insights into our model. We have also studied the data from eight countries for COVID-19 in a window of 876 days and compared it with our model. We have developed a proper framework to fit our model on the data for confirmed cases of COVID-19 and have also re-checked the goodness of the fit with the data of the deceased cases for this pandemic. Our model is compared with other well-known CA models and the ODE-based SEIR model. This model fits well with different peaks of COVID-19 data for all the eight countries and can be possibly generalized for a global prediction. Our study shows that the rate of disease spread depends both on infectivity of a disease and social restrictions. Also, it shows an overall decrement in mortality rate with time due to COVID-19 as more and more people get infected as well as vaccinated. Our minimal model with modified neighborhood condition can easily quantify the degree of social restrictions. It is statistically concluded that the overall degree of social restrictions is above the mean when we considered all eight countries. Finally to conclude, this study has given us various important insights about this pandemic which can help in preparing for combating epidemics in future situations.