bluuebunny/crossref_metadata_2025 huggingface dataset:
Divergent selection for basal metabolic rate in mice affects the abundance of UCP1 protein: implications for translational studies
Authors: Brzęk Paweł , Selewestruk Piotr , Sadowska Julita , Gębczyński Andrzej K. , Książek Aneta , Kalinovich Anastasia , Nedergaard Jan , Konarzewski Marek
Published: December 2024

Low basal metabolic rate (BMR) is a risk factor for obesity, whereas elevation of non‐shivering thermogenesis (NST) is a promising means to combat obesity. Because heat generated by NST covers thermogenic needs not fulfilled by BMR, one can expect the presence of a negative relationship between both parameters. Understanding of the mechanisms underlying this relationship is therefore important for interpretation of the results of translational experiments and the development of anti‐obesity treatments. We studied two lines of laboratory mice divergently selected for high or low level of BMR, raised at 23°C and subsequently acclimated to different ambient temperatures (30, 23 and 4°C). Mice selected for low BMR accumulated more fat but simultaneously showed higher NST capacity and more uncoupling protein‐1 (UCP1) in interscapular brown adipose tissue (iBAT), to compensate for their lower heat production through BMR. The between‐line difference in UCP1 protein abundance was significant even in mice acclimated to 30°C when the level of UCP1 is very low. Differences in NST capacity between selected lines and acclimation temperatures were explained by UCP1 iBAT abundance. Our results reveal that BMR is inversely correlated with UCP1 protein abundance and NST, even after acclimation to thermoneutrality. Thus, low values of BMR can increase both obesity risk and the magnitude of NST, i.e. the process whose activation has been proposed to mitigate obesity risk. All these effects should be taken into account in the design and interpretation of translational studies on mice models of metabolic diseases.

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Key points

Basal metabolic rate (BMR) and non‐shivering thermogenesis (NST) based on the activity of uncoupling protein‐1 (UCP1) are two main sources of heat in laboratory mice.

Both BMR and UCP1 can affect obesity risk in laboratory rodents and humans.

Here we studied BMR, NST, and the abundance of UCP1 in laboratory mice selected divergently towards either high or low BMR.

We showed that BMR is negatively correlated with UCP1 abundance and this effect is not removed even after acclimation to thermoneutrality.

The pattern described reveals that BMR can affect not only obesity risk but also the magnitude of UCP1‐mediated NST. Since activation of NST was proposed to mitigate obesity risk, variation in BMR should be taken into account in translational studies of mouse models of metabolic diseases.
Computational modelling of cardiac control following myocardial infarction using an in silico patient cohort
Authors: Gee Michelle M. , Lenhoff Abraham M. , Schwaber James S. , Vadigepalli Rajanikanth
Published: December 2024

Loss of cardiac physiological function following myocardial infarction (MI) is accompanied by neural adaptations in the baroreflex that are compensatory in the short term, but then become associated with long‐term disease progression. One marker of these adaptations is decreased baroreflex sensitivity, a strong predictor of post‐MI mortality. The relative contributions of cardiac remodelling and neural adaptation in the sensory, central brainstem and peripheral ganglionic loci to baroreflex sensitivity changes remain underexplored. We used a computational model‐based approach that accounts for the short‐term dynamics of closed‐loop human cardiac control to integrate disparate experimental studies on neural adaptation following MI into a unified quantitative framework. We developed an ensemble of 59 distinct model parameterizations that account for the clinically observed heterogeneity of cardiac control in healthy individuals. We simulated an in silico cohort of 35,400 patients with MI, corresponding to six scenarios of one or more loci of neural adaptation coupled with cardiac remodelling. We evaluated the range of MI‐induced shifts in arterial pressure, heart rate and baroreflex curve responses. Our results show that adaptation in any single neural locus coupled with cardiac remodelling is sufficient to account for the MI‐induced haemodynamic and autonomic changes observed experimentally. Of the adaptation pathways, we found that individuals with central or peripheral vagal efferent adaptation and preserved baroreceptor gain could maintain high baroreflex sensitivity after ischaemic injury. These results suggest that there are a multitude of adaptive pathways for tuning the baroreflex circuit to shift cardiac control physiology, potentially explaining patient heterogeneity post‐MI.

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Key points

Baroreflex sensitivity is a strong indicator of post‐myocardial ischaemia survival and is variable among individuals.

We fine‐tuned a computational model ensemble based on physiological observations to develop an in silico patient cohort consistent with the range of baroreflex responses observed experimentally.

Simulation and analysis of the in silico cohort show that individuals with a functional afferent pathway and the ability to adapt along the vagal efferent pathway can maintain baroreflex sensitivity post‐cardiac ischaemia.
A Parameterized Prediction Method for Turbulent Jet Noise Based on Physics-Informed Neural Networks
Authors: Jiang Liang , Cheng Yuzhou , Luo Kun , Liu Kai , Cao Zhen , Fan Jianren
Published: December 2024

Turbulent noise prediction is integral to fluid equipment design, and multiple simulations or experiments are often required for noise distribution under varying operating conditions during the design optimization process, which could be expensive. Recently, the physics informed neural networks (PINNs) method has emerged as an efficient machine learning method for solving parameterized partial differential equations with geometric shapes, boundary conditions, and equation parameters as variable parameters through a single training session without data. In this study, a parameterized prediction method is developed to predict turbulent jet noise based on PINNs without any training datasets. Both 2D and 3D jet flow problems are solved. The 2D problem is solved with the Reynolds number as a variable parameter, and the 3D problem is solved with the Reynolds number and nozzle eccentricity as variable parameters. The predicted results are in good agreement with those from conventional computational fluid dynamics (CFD), with average errors of 3% and 6% for the 2D and 3D flow and acoustic power fields, respectively. In terms of computational efficiency, the time required by the method for the three-dimensional problem with two variable parameters is only one-seventh of that of the traditional CFD method. This study demonstrates that for engineering noise scenarios with varying parameters, the method based on PINNs offers a more efficient parameterized predicting approach and is promising for future applications.
Supporting Psychological Needs Online: Learning and Teaching Experiences of Physical Activity Educators
Authors: Yun Sanga , Park Junhyuk , Yli-Piipari Sami
Published: December 2024

Purpose: Online delivery of physical education and physical activity (PA) instruction has demonstrated effectiveness in improving adolescents’ fitness. However, improving learners’ motivation in online PA settings remains largely unexplored. This study aims to examine PA instructors’ experiences in implementing, learning, and evaluating need-supportive instructional strategies for teaching online PA lessons. Method: Eleven undergraduate college students who participated in need-supportive instructor training and completed teaching roles took part in this study. Data were collected through semistructured interviews, participant observations, and reflection papers, which were thematically analyzed. Results: While instructors initially found online need-supportive instruction challenging, they discovered its value of supporting and motivating adolescents to stay active. To overcome online barriers, instructors displayed creativity in developing and implementing need-supportive strategies to teach PA online. Discussion: A need for tailored training and instruction guidelines for online need-supportive teaching was suggested to better educate instructors and motivate students to participate in PA.
Optimization and analytical validation of the Allplex HPV28 genotyping assay for use in first-void urine samples
Authors: Bell Margo , Baussano Iacopo , Rol MaryLuz , Tenet Vanessa , Heideman Daniëlle A. M. , Gheit Tarik , Van Caesbroeck Anne , Vorsters Alex , Clifford Gary
Published: December 2024

Despite first-void urine (FVU) being increasingly recognized as a credible specimen for human papillomavirus (HPV) detection, there is a lack of well-validated testing methods providing full quantitative genotyping required for vaccine impact monitoring from FVU samples. The Allplex HPV28 assay, capable of individually detecting 28 HPV genotypes, presents a promising method. We aimed to evaluate its genotype-specific performance on FVU samples, following optimization of FVU preanalytics. We selected 701 FVU samples collected using a Colli-Pee device (20 mL, with UCM), enriched for HPV-positivity (
n
= 630) based on previous testing with GP5+/6+-PCR-based reverse line blot (GP5+/6+ RLB) and E7-MPG after Amicon filtration (AF). We first evaluated the comparability and agreement of Allplex HPV28 genotype-specific positivity according to different preanalytics. Subsequently, we conducted the genotype-specific comparison of Allplex HPV28 with GP5+/6+ RLB AF and E7-MPG AF. No significant differences in HPV positivity by Allplex HPV28 testing were observed when comparing pre-centrifuged versus non-centrifuged DNA extraction, nor when comparing manual versus automated DNA extraction. Good genotype-specific agreement was observed between Allplex HPV28 and GP5+/6+ RLB AF, with Allplex HPV28 being slightly more sensitive for all 28 HPV genotypes (average Allplex HPV28:GP5+/6+ RLB AF ratio 1.729). Compared to E7-MPG AF, Allplex HPV28 exhibited lower sensitivity for all 21 overlapping HPV genotypes (average Allplex HPV28:E7-MPG AF ratio 0.588). The findings of this study, combined with practical considerations for real-world implementation, support the use of Allplex HPV28 testing after automated or manual DNA extraction without the requirement for pre-centrifugation, for HPV studies based on FVU samples, most notably those for vaccine impact monitoring on HPV prevalence.

IMPORTANCE

This study provides the first analytical validation of the Allplex HPV28 genotyping assay for use in first-void urine samples, offering a reliable, non-invasive, and practical alternative to cervical samples for human papillomavirus (HPV) detection. It demonstrates a validated approach that supports the assay’s potential application in real-world settings, including low- and middle-income countries, where non-invasive and widely acceptable sampling methods are crucial for maximizing population coverage and representativity. Given the urgent need for accurate and practical tools to monitor HPV vaccination impact, these findings offer a timely and impactful contribution to the field.
Expecting the unexpected in obstetrics: shoulder dystocia causing humerus fracture in an average-weight fetus
Authors: Yaliwal Rajasri G , Biradar Aruna , G V Vinithira Sri
Published: December 2024

Shoulder dystocia is a critical obstetrical emergency that challenges even the most experienced practitioners. This case report details a patient at 40 weeks of gestation with no identified risk factors. Following the delivery of the head, the baby’s shoulders became lodged behind the maternal pubis and did not deliver despite gentle downward traction, raising suspicion of shoulder dystocia. Various manoeuvres were attempted, and ultimately, the posterior arm was delivered by sweeping through the corresponding antecubital fossa, resulting in the successful birth of a live 3.4 kg baby. However, the posterior arm’s humerus sustained a fracture during delivery. With appropriate treatment, the term neonate recovered fully, exhibiting a full range of movement in the affected limb, and the fracture healed within 3 weeks. Although shoulder dystocia is rare, it necessitates immediate and skilful intervention. Therefore, all obstetricians should undergo simulation training and master all relevant manoeuvres.
Sterile abscesses following administration of long-acting injectable rilpivirine for HIV
Authors: L'Etoile Nathan , Lowenthal Elizabeth
Published: December 2024

Long-acting injectable antiretroviral therapy for HIV has improved treatment satisfaction with mild injection site reactions reported. We describe a case of a young adult with sterile abscesses at the sites of two consecutive injections. This case describes a significant side effect noted during post-market roll-out.
Misplaced Ballerine intrauterine contraceptive device requiring operative removal
Authors: Worrall Amy P , Hunter Rebecca , Farah Nadine
Published: December 2024

A young woman in her 20s presented with a misplaced intrauterine ball Ballerine MIDI intrauterine copper coil device. Her general practitioner had referred her to a tertiary maternity and gynaecology unit after an outpatient pelvic ultrasound scan in the community reported the intrauterine contraceptive device to be ‘low in the cavity’. On review in our unit, a sterile speculum examination revealed the Ballerine coil strings coming out of the anterior lateral lip of the cervix (and not from the cervical os). A transvaginal ultrasound scan demonstrated that the Ballerine device was embedded in the muscle wall of the anterior outer lip of the cervix. A hysteroscopic examination and removal with a hysteroscopic toothed grasper were completed in the operation theatre under general anaesthesia, with minimal blood loss. The patient recovered well, and after review 6 weeks postoperatively, the patient was counselled on alternative forms of contraception.
Predictors of cytomegalovirus corneal endotheliitis postcorneal transplantation
Authors: Watanabe Mako , Kitazawa Koji , Fukuoka Hideki , Wakimasu Koichi , Inatomi Tsutomu , Yoshii Kengo , Koizumi Noriko , Kinoshita Shigeru , Sotozono Chie
Published: December 2024

Purpose

This study was designed to investigate risk factors for the development of cytomegalovirus (CMV) corneal endotheliitis following corneal transplantation.

Methods

We retrospectively analysed 1225 corneal transplants for bullous keratopathy between 2011 and 2021. 31 cases who were administered the treatment of CMV corneal endotheliitis preoperatively were excluded, and 1194 cases were analysed for risk factors for the development of CMV corneal endotheliitis following corneal transplantation.

Results

Among 1194 cases, 15 cases (1.26%) occurred CMV corneal endotheliitis after corneal transplantation. Coin-shaped lesion or keratoprecipitates were observed in 100% of cases. Postoperatively, the mean onset of CMV corneal endotheliitis was 9.9±12.2 months, with 12 eyes (80.0%) within the first 12 months. Multivariate analysis adjusted for potential confounding factors revealed a gender (male, OR (8.42, 95% CI: 2.19 to 56.00), the previous history of anterior uveitis (OR: 25.31, 95% CI: 8.22 to 95.19) and the previous history of glaucoma (OR: 6.25, 95% CI: 1.17 to 115.90) were significantly associated with the development of postoperative CMV corneal endotheliitis. The maternal proportion Ryan multiple comparison tests revealed that dual previous history with glaucoma and anterior uveitis significantly enhanced the development of postoperative CMV corneal endotheliitis (p<0.001).

Conclusions

CMV corneal endotheliitis developed postcorneal transplantation with coin-shaped lesions. Careful postoperative follow-up, especially within the first 12 months after surgery, is necessary for patients with a history of glaucoma or anterior uveitis.
Living with pain and Parkinson’s developing an understanding of the impact, trajectory and pain management needs: a qualitative interview study protocol
Authors: Naisby Jenni , Avery Leah , Baker Katherine , Parkinson Mark , Hand Annette , Rochester Lynn , Yarnall Alison , Walker Richard , Flynn Darren , Ryan Cormac , Finch Tracy
Published: December 2024

Introduction

Pain is reported as one of the most troubling symptoms for people with Parkinson’s (PwP); however, the literature exploring their lived experience of pain and how to manage it is limited. Pain affects PwP at all stages of their condition and can fluctuate and change over time. Therefore, it is pertinent to speak to PwP to understand their experiences of pain to inform the development of tailored behavioural interventions to manage pain. How pain interacts with other Parkinson’s symptoms lacks consensus. Gaining a better understanding of this from the perspective of PwP is important to inform interventions. Exploring the behavioural determinants, including the barriers and enablers to pain management from the perspective of PwP, the role of healthcare professionals and impact of other symptoms alongside pain will inform the development of a fit for purpose, pain management toolkit for PwP.

Methods and analysis

A longitudinal qualitative study using semi structured interviews at two time points within an 18-month period will be conducted. PwP living with pain will be purposefully sampled from four NHS sites in the North of England. Data will be thematically analysed with reference to the Theoretical Domains Framework.

Ethics and dissemination

A favourable ethical opinion has been granted by the National Health Service East Midlands-Derby Research Ethics Committee (22/EM/0176) and the NHS Health Research Authority (IRAS ID 316403). Findings will be disseminated via scientific conferences, academic journals, lay summaries and public engagement events.
Night shift work and prostate cancer: a large cohort study from UK Biobank and Mendelian randomisation study
Authors: Yang Guorong , Yang Yingzi , Lv Kaikai , Wu Yangyang , Song Tao , Yuan Qing
Published: December 2024

Objective

The global concern regarding the health implications of night shift work has escalated. Nevertheless, variations exist in the observed association between night shift work and prostate cancer (PCa). This study aims to systematically explore the association between night shift work and the risk of PCa.

Design

Cohort study and Mendelian randomisation (MR) study were used.

Setting

Cohort study data was from the UK Biobank (UKB). MR study using data was from the Finngen study and UKB through the Integrative Epidemiology Unit (IEU) Open Genome-Wide Association Study Project.

Participants

Participants without prior PCa in paid employment or self-employment were include in the current work schedule cohort, participants without PCa who provided employment history formed the lifetime night shift work cohort.

Main outcome measures

The outcome, incident PCa, was obtained from cancer register through linkage to national cancer databases. National cancer registries centralised information received from separate regional cancer centres around the UK.

Results

A total of 130 853 participants were included in the current work schedule cohort, while the lifetime night shift work cohort comprised 49 511 participants. Over a median follow-up duration of 13.9 years, the current work schedule cohort witnessed 4993 incident cases of PCa, while the lifetime night shift work cohort recorded 2022 PCa cases. In the analysis of the current work schedule, final model showed that no significant association was found between shift work and PCa risk, whether it involved shift but no night shifts (HR 0.96, 95% CI 0.85 to 1.08), some night shifts (HR 1.16, 95% CI 0.99 to 1.33) and usual night shifts (HR 1.01, 95% CI 0.85 to 1.19). In the analysis of the average frequency of night shift work, final model showed no significant impact of different night shift frequencies (<3/month: HR 0.97, 95% CI 0.73 to 1.29; 3–8/month: HR 0.99, 95% CI 0.83 to 1.19; >8/month: HR 0.89, 95% CI 0.73 to 1.07) on the risk of PCa. No significant association was found for either <10 years (HR 0.89, 95% CI 0.72 to 1.09) or ≥10 years (HR 1.00, 95% CI 0.86 to 1.16) of night shift work. Subsequent subgroup and sensitivity analyses demonstrated consistent results without significant alterations. Furthermore, in the two-sample MR analysis, no statistically significant causal relationship was identified between night shift work and the incidence of PCa.

Conclusion

In both the cohort studies and MR analysis, our investigation did not find any association between night shift work and PCa.
Efficacy in predicting mortality of patients with heart failure using heart rate before intensive care unit discharge: a retrospective cohort study from MIMIC-IV Database
Authors: Hsiao Chia-Ying , Su Min-I , Chang Yu-Cheng , Lee Ying-Hsiang , Lin Po-Lin , Chiou Wei-Ru
Published: December 2024

Objective

Heart rate serves as a critical prognostic factor in heart failure (HF) patients. We hypothesise that elevated heart rate in critically ill HF patients on discharge from the intensive care unit (ICU) could be linked to adverse outcomes.

Design

A single-centre retrospective cohort study.

Setting

This study used data collected between 2008 and 2019 from the Medical Information Mart for Intensive Care IV (V.2.0) Database.

Participants

From the 76 943 ICU stays, we enrolled 2365 patients in this study.

Primary and secondary outcome measures

We observed correlations between in-hospital mortality and ICU discharge heart rate of 83.56±15.81 beats per minute (bpm) (survivors) vs 93.84±17.28 bpm (non-survivors, p<0.001). Total mortality showed similar trends, with 83.67±15.36 bpm (survivors) vs 85.23±17.25 bpm (non-survivors, p=0.027), as did ICU readmissions at 83.55±15.77 bpm (non-readmitted) vs 88.64±17.49 bpm (readmitted, p<0.001).

Results

Given multivariate analysis, the ICU discharge heart rate strongly predicted in-hospital mortality (HR 1.032 (95% CI 1.022 to 1.041), p<0.001), total mortality (HR 1.008 (95% CI 1.004 to 1.013), p<0.001) and ICU readmission (HR 1.018 (95% CI 1.010 to 1.025), p<0.001). Patients with an ICU discharge heart rate>90 bpm demonstrated significantly higher in-hospital mortality (HR 2.639 (95% CI 1.898 to 3.669), p<0.001), total mortality (HR 1.342 (95% CI 1.163 to 1.550), p<0.001) and ICU readmission rates (HR 1.781 (95% CI 1.413 to 2.243), p<0.001).

Conclusion

The findings suggest that HF patients with an elevated heart rate (>90 bpm) at ICU discharge are more likely to experience increased in-hospital mortality, total mortality and ICU readmissions, indicating potential negative outcomes.
Implementation and impact of NHS-funded tobacco dependence services in England: a mixed-method evaluation protocol
Authors: Aquino Maria Raisa Jessica , Brennan-Tovey Kerry , Fong Mackenzie , Wearn Angela , Bigirumurame Theophile , Robinson Tomos , Trevor Miranda , Feeney Joanna , Rutter Ailsa , Sharrock Ruth , West Jane , Bridges Sally , Attwood Angela S , Jolly Kate , Damery Sarah , Flanagan Sarah , Armitage Chris , Russell Samantha , Strong Steve , Ramsay Sheena E , Kaner Eileen F S
Published: December 2024

Introduction

Tobacco smoking remains a leading cause of ill-health, premature mortality and a driver of health inequalities. To support smokers in England, a comprehensive approach to treating tobacco dependence is being implemented. This includes offering support to all people admitted to hospitals, as well as women and pregnant people within NHS settings. We aim to describe the protocol for an evaluation of this tobacco-dependence service.

Methods and analysis

This is a national evaluation across five regions in England (i.e., South West, West Midlands, Greater Manchester, North East and North Cumbria, Yorkshire and Humber) including 11 NHS Foundation Trusts. It is funded from September 2021 to September 2025. Evaluation settings are acute hospital, maternity and inpatient mental health.

Work package (WP) 1 involves qualitative key informant interviews to characterise the policy implementation context. WP 2 involves an online survey to assess the routinisation of the service in practice and staff attitudes regarding tobacco dependence, plus in-depth interviews with relevant practitioners to explore survey findings and interviews with smokers to investigate its usefulness and impact. WP 3 involves descriptive statistical analysis of routinely collected data to assess service uptake and impact on health and care outcomes (e.g., smoking status). WP 4 involves an economic analysis of routinely collected data to determine the financial impact of the service. Qualitative data (WP 1, WP 2) will be analysed using Thematic Analysis and Framework Analysis, respectively. WP 2 survey data will be analysed using descriptive statistics.

Ethics and dissemination

This evaluation received favourable ethical opinion from Newcastle University (17756/2021) and NHS Wales Research Ethics Committee (22/WA/0203). It has also received Confidentiality Advisory Group support (22CAG0103).
Derivation and validation of the simplified BleedingAudit Triage Trauma (sBATT) score: a simplified trauma score for major trauma patients injured in motor vehicle collisions
Authors: Nutbeam Tim , Stassen Willem , Foote Emily , Ageron Francois-Xavier
Published: December 2024

Objectives

To develop and validate a simplified Bleeding Audit Triage Trauma (sBATT) score for use by lay persons, or in areas and environments where physiological monitoring equipment may be unavailable or inappropriate.

Design

The sBATT was derived from the original BATT, which included prehospital systolic blood pressure (SBP), heart rate, respiratory rate, Glasgow Coma Scale (GCS), age and trauma mechanism. Variables suitable for lay interpretation without monitoring equipment were included (age, level of consciousness, absence of radial pulse, tachycardia and trapped status). The sBATT was validated using data from the UK Trauma Audit Research Network (TARN) registry.

Setting

Data sourced from prehospital observations from multiple trauma systems in the UK.

Participants

70 027 motor vehicle collision (MVC) patients from the TARN registry (2012–2019). Participants included were those involved in MVCs, with exclusion criteria being incomplete data or non-trauma-related admissions.

Interventions

Not applicable.

Primary and secondary outcome measures

Death within 24 hours of MVC. Secondary: need for trauma intervention.

Results

In a cohort of 70 027 MVC patients, 1976 (3%) died within 24 hours. The sBATT showed an area under receiver operating characteristic curve of 0.90 (95% CI: 0.90 to 0.91) for predicting 24-hour mortality, surpassing other trauma scores such as the Shock Index and Assessment of Blood Consumption score. Sensitivity was 96% and specificity 72%, with a negative likelihood ratio below 0.1, indicating strong rule-out capability. Sensitivity analyses confirmed consistent performance across varying SBP and GCS thresholds. The sBATT was equally effective across sexes with no significant predictive discrepancies.

Conclusions

The sBATT is a novel, simplified tool that performs well at predicting early death in the TARN dataset. It demonstrates high predictive accuracy for 24-hour mortality and need for trauma intervention. Further research should validate sBATT in diverse populations and real-world scenarios to confirm its utility and applicability.
“Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis
Authors: Calvo-Herrera Maria Alejandra , Serna-Campuzano Angelica Maria , Isaza-Lopez María Carolina , Villegas-Arbeláez Esteban , Rojas-Rosas Luisa Fernanda , Serna-Higuita Lina Maria , Ochoa-García Carolina Lucia
Published: December 2024

Background

Post-transplantation diabetes mellitus and carbohydrate intolerance (PTDM/iCHO) are complications following solid organ transplantation, which significantly increases the risk of graft loss and mortality. However, data concerning long-term outcomes in paediatric kidney transplant recipients with PTDM/iCHO are scarce. This study aimed to evaluate the risk of graft loss in paediatric kidney transplant recipients with PTDM or iCHO compared with non-PTDM/iCHO.

Methods

The study cohort included patients aged <18 who underwent a kidney transplant in a transplant centre from 2005 to 2022. The primary outcome was graft survival loss; secondary outcomes were acute rejection, renal function and mortality. Cumulative incidence of graft loss and acute rejection was estimated, considering death a competing risk. Fine and Gray’s proportional subdistribution hazard model was used to analyse the effect of PTDM/iCHO status on the event.

Results

Seventy-six paediatric kidney transplant recipients were included. The incidence of PTDM and iCHO was 6.6% and 9.2%, respectively. Patients with PTDM/iCHO had a significantly higher cumulative graft loss incidence than those without (34.4% vs 13.9% at 36 months, p<0.008). Multivariable analysis revealed a threefold increased risk of graft loss in patients with PTDM/iCHO (HRadjusted3.33, 95% CI 1.19 to 9.30, p=0.022). PTDM/iCHO was associated with a higher incidence of acute rejection (33.3% vs 14.5% at 1 year, p=0.025). Patients with PTDM/iCHO also exhibited significantly worse eGFR at all time points compared with patients without PTDM/iCHO (p=0.036)

Conclusion

Patients with PTDM and iCHO had a higher risk of graft loss and lower renal function in paediatric kidney transplant recipients. This justifies close monitoring of metabolic complications in these patients.
Impact of maternal antenatal nutrition and infection treatment interventions on Longitudinal Infant Development and Growth in rural Ethiopia: protocol of the LIDG child follow-up study
Authors: Workneh Firehiwot , Chin Theresa I , Yibeltal Kalkidan , Fasil Nebiyou , North Krysten , Jensen Sarah K G , Kidane Workagegnhu Tarekegn , Melese Mulatu , Tsegaye Sitota , Berhane Yoseph Yemane , Roy Paladhi Unmesha , Abate Betelhem Haimanot , Teklehaimanot Atsede , Melka Tizita Lemma , Pihl Stephen , An Winko W , Van Dyk Fred , Mullany Luke C , Folger Lian V , Cherkerzian Sara , Troller-Renfree Sonya V , Thomason Moriah E , Andersson Maria , Inder Terrie , Nelson Charles A , Grant P Ellen , Christian Parul , Worku Alemayehu , Berhane Yemane , Lee Anne CC
Published: December 2024

Introduction

Maternal undernutrition and inflammation in utero may significantly impact the neurodevelopmental potential of offspring. However, few studies have investigated the effects of pregnancy interventions on long-term child growth and development. This study will examine the effects of prenatal nutrition and infection management interventions on long-term growth and neurodevelopmental outcomes of offspring.

Methods

The Enhancing Nutrition and Antenatal Infection Treatment (‘ENAT’) study (ISRCTN15116516) was a pragmatic, open-label, 2×2 factorial, randomised clinical effectiveness study implemented in 12 rural health centres in Amhara, Ethiopia. The study enrolled 2399 pregnant women who were randomised to receive routine care, an enhanced nutrition package (iron and folic acid, monthly household supply of iodised salt, and micronutrient-fortified balanced energy protein supplement for undernourished women), an enhanced infection management package (genitourinary tract infection screening and treatment, and enhanced deworming), or both packages. In the present Longitudinal Infant Development and Growth study, a subset of 480 children of mothers from ENAT will be recruited equally from each of the four study arms and visited at 12, 18, and 24 months of postnatal age. We will evaluate a range of domains and deploy multiple measures to assess child neurodevelopment, including resting electroencephalography and visual evoked potentials, Hammersmith Infant Neurological Examination, eye-tracking, Bayley Scales of Infant and Toddler Development (Bayley-III), and Magnetic Resonance Imaging (MRI).

Discussion

This study will advance understanding of the impact of nutrition and inflammation in pregnancy on long-term offspring neurodevelopment. This study aims to fill a critical knowledge gap on the benefits of prenatal interventions to promote the health of mothers and their offspring.

Ethics and dissemination

This study was approved by the Institutional Review Boards of Addis Continental Institute of Public Health (ACIPH/IRB/002/2022) and Mass General Brigham (2023P000461). Results will be disseminated to local and international stakeholders.

Trial registration number

NCT06296238.
Effects of non-invasive brain stimulation on impulsivity in patients with mental disorders: a systematic review and meta-analysis of randomised clinical trials
Authors: Machado Yuri de Castro , Oliveira Mariana , Mundoca Mateus Pereira , Viana Bernardo , Marques de Miranda Debora , Romano-Silva Marco Aurélio
Published: December 2024

Background

Non-invasive brain stimulation (NIBS) techniques, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), may offer an alternative treatment strategy for impulsive behaviour. By modulating brain activity, these techniques could potentially enhance impulse control and mitigate impulsivity.

Aims

To provide a comprehensive analysis of the correlation between NIBS parameters, targeted brain regions and impulsivity.

Methods

We systematically searched PubMed, Scopus and Embase on 5 April 2023 for randomised controlled trials (RCTs) of NIBS on impulsivity. Unbiased Hedges’ g with 95% CIs was used to define the effect size. Cochran Q test and I² statistics were used to assess for heterogeneity; p values inferior to 0.10 and I²>25% were considered significant for heterogeneity. Publication bias was investigated by funnel plot analysis of point estimates according to study weights, by Egger’s regression test and by non-parametric rank correlation (Begg) test.

Results

A total of 18 studies were included, comprising 655 patients from 14 RCTs and four randomised crossover studies. The meta-analysis of effect sizes from 9 tDCS studies on impulsivity did not show a significant effect (g=−0.18; 95% CI −0.46 to 0.10; p=0.210) and from 9 repetitive TMS (rTMS) studies also did not yield a statistically significant effect (g=0.21; 95% CI −0.38 to 0.80; p=0.490). When analysing active tDCS using Barratt Impulsiveness Scale version 11, the scores showed a trend towards improvement with active tDCS over placebo (g=−0.54; 95% CI −0.97 to −0.12; p<0.05; I²=0%).

Conclusions

There is currently insufficient evidence to support the clinical use of rTMS or tDCS as a means of reducing impulsivity in individuals with mental disorders. The main limitations of this study are the lack of available patient-level data, a limited number of studies, the lack of consensus on the structure of impulsivity and variability in how impulsivity is measured and conceptualised.

PROSPERO registration number

CRD42023413684.
A worthwhile wager: the ethics of open-label placebo treatment in clinical practice
Authors: Hardman Doug , Miller Franklin
Published: December 2024

There is increasing evidence for the use of open-label placebo (OLP) as an effective and safe treatment for a range of chronic conditions. OLP is generally conceived as an ethical alternative to classic placebo treatment because patients know that they are taking a placebo and are hence not deceived. However, despite its potential benefits and lack of side effects, the paradoxical nature of OLP may make it difficult to propose as a treatment option in clinical practice. To mitigate this issue, we propose a practical way for clinicians and patients to conceive of OLP in clinical practice: namely, as a worthwhile wager.
Engineering organs, hopes and hybridity: considerations on the social potentialities of xenotransplantation
Authors: Kögel Johannes , Cook Peta S , Brown Nik , Clare Amy , Glick Megan H , Hansson Kristofer , Idvall Markus , Lundin Susanne , Michael Mike , á Rogvi Sofie , Sharp Lesley A
Published: December 2024

The development of replacing human organs with those from genetically modified pigs holds immense potential for alleviating the shortage of organs necessary for patients in need of transplants. This medical advancement is also accompanied by significant social changes, including the emergence of a bioeconomy, new modes of biotechnology governance, altered human-animal relations and increased public engagement. Some aspects, such as the impact on the transplant allocation system, effects on clinical practice and healthcare provision, global trajectories and most importantly the consequences for patients and their families remain unpredictable. Given that xenotransplantation occurs within a societal context and its success or failure will not be confined to technical feasibility alone, it is essential to engage a social sciences perspective to highlight the social implications and emphasise the importance of social research in accompanying future developments.
Timing of intravenous dexamethasone and analgesia after brachial plexus block: a randomized, double-blind, placebo-controlled trial
Authors: Grass Ariel , Chan Vincent , Short Anthony James , Busser Michael J , Chin Ki-Jinn , Chowdhury Jayanta , Huszti Ella , Li Qixuan , Perlas Anahi
Published: December 2024

Background

The addition of intravenous dexamethasone can significantly prolong analgesia and reduce opioid-related side effects after brachial plexus blockade, but the most effective administration time is yet unknown. The objective of this study is to determine if the timing of administration of dexamethasone affects the duration of analgesia after supraclavicular brachial plexus block.

Methods

This is a double-blind, placebo-controlled, randomized trial performed at a single-center, tertiary academic health sciences center. Patients were randomly assigned to one of four treatment groups to receive dexamethasone 8 mg intravenously (or normal saline infusions) at 1-hour preblock, at the time of the block, and 1 or 2 hours postblock.

Results

197 patients were randomized and received the intervention (in one of four treatment groups) between January 2018 and November 2023. 39 patients were excluded due to loss to follow-up and unavailability of primary outcome data. The remaining 158 patients have complete data sets and were analyzed. The time to first reported pain was not significantly different between groups (p=0.904). Secondary outcomes including pain scores and opioid consumption, recovery scores and block recovery time did not vary significantly among groups up to 48 hours. Adverse effects such as postoperative neurological symptoms and nausea were similar across groups up to 3 months postoperatively.

Conclusions and relevance

Our results suggest that perioperative administration of 8 mg of intravenous dexamethasone (from 1 hour prior and up to 2 hours postblock) provides similar duration of analgesia to administration at the time of brachial plexus block.

Trial registration number

NCT03394820.
Corticosteroid therapy for treating acute exacerbation of interstitial lung diseases: a systematic review
Authors: Srivali Narat , De Giacomi Federica , Moua Teng , Ryu Jay H
Published: December 2024

Introduction

Acute exacerbation of interstitial lung disease (AE-ILD) often results in death and poses significant challenges in clinical management. While corticosteroids are frequently employed, the optimal regimen and their clinical efficacy remain uncertain. To address this knowledge gap, we undertook a systematic review to evaluate the impact of steroid therapy on clinical outcomes in patients experiencing AE-ILD.

Method

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we systematically searched multiple databases, identifying 12 454 articles. After removing duplicates and screening titles and abstracts, 447 articles were selected for full-text review. Ultimately, nine studies met inclusion criteria, comparing high-dose corticosteroids with low-dose or non-steroidal interventions in treating AE-ILD. Key outcomes included in-hospital and long-term mortality, as well as AE recurrence.

Results

Analysis of nine studies (total n=18 509) revealed differential treatment effects based on the ILD subtype. In non-idiopathic pulmonary fibrosis (IPF) ILD, high-dose corticosteroid therapy (>1.0 mg/kg prednisolone) demonstrated improved survival (adjusted HR 0.221, 95% CI 0.102 to 0.480, p<0.001) and reduced 90-day mortality. Early tapering of high-dose corticosteroids (>10% reduction within 2 weeks) reduced in-hospital mortality (adjusted HR 0.37, 95% CI 0.14 to 0.99). Higher cumulative doses in the first 30 days (5185±2414 mg/month vs 3133±1990 mg/month) were associated with lower recurrence rates (adjusted HR 0.61, 95% CI 0.41 to 0.90, p=0.02). In IPF patients, however, high-dose therapy showed inconsistent benefits, with some studies reporting increased mortality risk (OR 1.075, 95% CI 1.044 to 1.107, p<0.001).

Conclusion

This review emphasises the potential benefits of individualised treatment approaches for AE-ILD but highlights the need for caution in making definitive recommendations. Although high-dose corticosteroids may show promise, particularly in non-IPF cases, the current evidence is inconsistent, and the lack of robust supporting literature makes it difficult to draw firm conclusions. Further research through randomised controlled trials is necessary to refine and optimise therapeutic strategies for AE-ILD.
Regular black holes from Kiselev anisotropic fluid
Authors: Santos L. C. N.
Published: December 2024

In this paper, we investigate a generalization of Kiselev black holes by introducing a varying equation-of-state parameter for the anisotropic fluid surrounding the black hole. We extend this model by allowing w in the expression

$$p_t(r)/\rho (r) = (3w + 1)/2$$

p
t

(
r
)

/
ρ

(
r
)

=

(
3
w
+
1
)

/
2

to vary as a function of the radial coordinate, and derive new solutions to the Einstein field equations for this configuration. In particular, we study solutions that describe regular black holes. By choosing specific forms of w(r), we obtain regular black hole solutions, and show that the matter surrounding the black hole can satisfy the weak and strong energy conditions under certain values of parameters analyzed. Due to the generality of this treatment, other categories of black holes can be obtained with particular choices of the equation-of-state parameter. Our analysis confirms that the curvature invariants associated with the regular black holes remain finite at the origin, indicating the absence of singularities. We also explore the physical properties of the matter associated with these solutions. Due to its versatility, we suggest the possibility of using this approach as a tool to construct new physical solutions associated with regular black holes or other geometries of interest.
Evaluation of College English Online Education Course Teaching Effectiveness Based on Deep Learning Algorithms
Authors: Jiao Zhao Hong
Published: December 2024

In the burgeoning landscape of higher education, the effective evaluation of online English teaching outcomes has become increasingly pivotal. This paper focuses on the benefits of employing long short-term memory (LSTM) networks for such evaluations, capitalizing on their strength in processing time-series data and identifying long-term learning patterns. We detail a structured approach using LSTM for assessing the quality of online English education, encompassing data collection, preprocessing, model training, and analysis. The innovative aspect of our methodology lies in its application of LSTM to interpret complex student interaction data, providing a more nuanced understanding of educational effectiveness. Experimental results affirm the LSTM model’s capability to offer accurate and meaningful insights into teaching effectiveness, marking a significant advancement in the application of deep learning techniques in educational assessment.
Accurate Tracking Method of Basketball Flight Trajectory Based on YOLO and Multi-level Data Association
Authors: Li Zhou
Published: December 2024

There are problems such as large tracking deviation in basketball flight trajectory tracking. To this end, this paper proposes an accurate tracking method of basketball flight trajectory based on YOLO and multi-level data association. Digital imaging equipment is used to collect basketball flight image video sequences, and the frame difference of the basketball flight image video sequence is defined. The spatial invariant feature decomposition method is used in the three-dimensional flight space to obtain the energy function of the binary multi-dimensional image and analyze the inherent mode function of the image. The visual feature extraction method is used to extract the basketball flight trajectory; the Gaussian kernel function is used to set the Gaussian distribution to approximate the two-dimensional convolution operator, and the weight of the product of each neighborhood pixel value and the weight is used as the pixel value of the pixel, and the size of the weight increases as the distance from the center point decreases. The image information is retained. The Gaussian proportion mixture model is used to extract the texture information and noise information existing in the image, and the Rudin–Osher–Fatemi model is used to eliminate the texture information existing in the image to achieve denoising processing of basketball images. The mining algorithm ML_T2 of multi-level association rules is used to mine multi-level data of basketball flight trajectory characteristics. Support and confidence are introduced to describe the importance of mining multi-level data of basketball flight trajectory characteristics. All frequent item sets are found. According to the obtained frequent items Set, generate corresponding strong association rules, set a minimum confidence threshold, and realize multi-level data mining of basketball flight trajectory characteristics. On this basis, build a network structure for basketball flight trajectory tracking and enhance basketball flight trajectory tracking image data. Set the loss function for basketball flight trajectory tracking, and integrate the multi-level data of basketball flight trajectory characteristics to build an accurate basketball flight trajectory tracking model based on YOLO and implement the research. The feasibility of this method was verified through experiments.
Digital Drive Method Based on Damped-Signal Tracking for Coriolis Mass Flowmeter
Authors: Peng Yuqin , Yang Huiyue , Tu Yaqing
Published: December 2024

Aiming at the problem that conventional digital driving methods cannot accurately track the natural frequency changes of flow tubes, we analyzed the sources of tracking errors in the natural frequency of flow tubes and proposed a new digital driving method. The method utilizes the amplitude of flow tube vibration to monitor changes in natural frequency, and tracks the natural frequency of the flow tube by estimating the frequency of the attenuation signal after stopping vibration. Then the hardware and software design and implementation of the Coriolis mass flowmeter (CMF) transmitter embedded with the proposed method was carried out, and experiments were conducted on the micro-flow differential CMF experimental platform. The experimental results illustrate that the proposed method can adjust the driving signal frequency timely when the natural frequency changes, improve the tracking accuracy of the digital driving natural frequency, and make the system have better driving performance; when the water temperature rises from [Formula: see text] to [Formula: see text], the measurement accuracy of the CMF embedded in the proposed digital driving method is improved by 37.87% compared to conventional digital drive.