bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of DNA Methylation in Zebrafish Models of CNS Diseases
Authors: Yushko L. V. , Shevlyakov A. D. , Romazeva M. A. , Apukhtin K. V. , Volgin A. D. , Abramov D. A. , Kotova M. M. , Kalueff A. V.
Published: June 2024

DNA methylation plays an important role in the regulation of gene expression. Its deficits in the brain cause various neurological diseases, including autism, schizophrenia and mood disorders. The zebrafish (Danio rerio) is a promising model organism in biomedicine. Given its high genetic and physiological homology with humans, studying genome methylation deficits in zebrafish can help elucidate the molecular processes underlying the etiology and pathogenesis of various neurological diseases, as well as develop novel therapies. Here, we discuss the mechanisms of DNA methylation in the brain and the diseases associated with its dysregulation in humans, as well as their genetic and pharmacological models in zebrafish. We also evaluate the limitations of zebrafish models and possible directions for further research in this field. Mounting evidence summarized here supports zebrafish as an effective model for elucidating the molecular mechanisms of brain pathologies associated with compromised DNA methylation.
Effect of probiotic supplementation on the gut microbiota in very preterm infants: a systematic review
Authors: Vievermanns Kayleigh , Dierikx Thomas H , Oldenburger Nathalie J , Jamaludin Faridi S , Niemarkt Hendrik J , de Meij Tim G J
Published: June 2024

Objective

There is increasing evidence that probiotic supplementation in very preterm infants decreases the risk of necrotising enterocolitis (NEC), sepsis and mortality. The underlying mechanisms, including effects on the gut microbiota, are largely unknown. We aimed to systematically review the available literature on the effects of probiotic supplementation in very preterm infants on gut microbiota development.

Design

A systematic review in Medline, Embase, Cochrane Library, CINAHL and Web of Science.

Setting

Neonatal intensive care unit.

Patients

Premature infants.

Intervention

Probiotic supplementation.

Main outcome measures

Gut microbiota.

Results

A total of 1046 articles were screened, of which 29 were included. There was a large heterogeneity in study design, dose and type of probiotic strains, timepoints of sample collection and analysing techniques. Bifidobacteria and lactobacilli were the most used probiotic strains. The effects of probiotics on alpha diversity were conflicting; however, beta diversity was significantly different between probiotic-supplemented infants and controls in the vast majority of studies. In most studies, probiotic supplementation led to increased relative abundance of the supplemented strains and decreased abundance of genera such asClostridium,Streptococcus,KlebsiellaandEscherichia.

Conclusions

Probiotic supplementation to preterm infants seems to increase the relative abundance of the supplemented strains with a concurrent decrease of potentially pathogenic species. These probiotic-induced microbial alterations may contribute to the decreased risk of health complications such as NEC. Future trials, including omics technologies to analyse both microbiota composition and function linked to health outcomes, are warranted to identify the optimal mixture and dosing of probiotic strains.

PROSPERO registration number

CRD42023385204.
General population screening for type 1 diabetes using islet autoantibodies at the preschool vaccination visit: a proof-of-concept study (the T1Early study)
Authors: Scudder Claire , Townson Julia , Bowen-Morris Jane , Gillespie Kathleen , Evans Philip , Jones Sarah , Thomas Nicholas P B , Stanford Jane , Fox Robin , Todd John A , Greenfield Sheila , Dayan Colin M , Besser Rachel E J
Published: June 2024

Objective

Type 1 diabetes (T1D) screening programmes testing islet autoantibodies (IAbs) in childhood can reduce life-threatening diabetic ketoacidosis. General population screening is required to detect the majority of children with T1D, since in >85% there is no family history. Age 3–5 years has been proposed as an optimal age for a single screen approach.

Design

Capillary samples were collected from children attending their preschool vaccination and analysed for IAbs to insulin, glutamic acid decarboxylase, islet antigen-2 and zinc transporter 8 using radiobinding/luciferase immunoprecipitation system assays. Acceptability was assessed using semistructured interviews and open-ended postcard questionnaires with parents.

Setting

Two primary care practices in Oxfordshire, UK.

Main outcome measures

The ability to collect capillary blood to test IAbs in children at the routine preschool vaccination (3.5–4 years).

Results

Of 134 parents invited, 66 (49%) were recruited (median age 3.5 years (IQR 3.4–3.6), 26 (39.4%) male); 63 provided a sample (97% successfully), and one participant was identified with a single positive IAb. Parents (n=15 interviews, n=29 postcards) were uniformly positive about screening aligned to vaccination and stated they would have been less likely to take part had screening been a separate visit. Themes identified included preparedness for T1D and the long-term benefit outweighing short-term upset. The perceived volume of the capillary sample was a potential concern and needs optimising.

Conclusions

Capillary IAb testing is a possible method to screen children for T1D. Aligning collection to the preschool vaccination visit can be convenient for families without the need for an additional visit.
Psychosocial predictors of doping intentions and use in sport and exercise: a systematic review and meta-analysis
Authors: Ntoumanis Nikos , Dølven Sigurd , Barkoukis Vassilis , Boardley Ian David , Hvidemose Johan S , Juhl Carsten B , Gucciardi Daniel F
Published: June 2024

Objective

To conduct a meta-analytic review of psychosocial predictors of doping intention, doping use and inadvertent doping in sport and exercise settings.

Design

Systematic review and meta-analysis.

Data sources

Scopus, Medline, Embase, PsychINFO, CINAHL Plus, ProQuest Dissertations/Theses and Open Grey.

Eligibility criteria

Studies (of any design) that measured the outcome variables of doping intention, doping use and/or inadvertent dopingandat least one psychosocial determinant of those three variables.

Results

We included studies from 25 experiments (N=13 586) and 186 observational samples (N=3 09 130). Experimental groups reported lower doping intentions (g=−0.21, 95% CI (−0.31 to –0.12)) and doping use (g=−0.08, 95% CI (−0.14 to –0.03), but not inadvertent doping (g=−0.70, 95% CI (−1.95 to 0.55)), relative to comparators. For observational studies, protective factors were inversely associated with doping intentions (z=−0.28, 95% CI −0.31 to –0.24), doping use (z=−0.09, 95% CI −0.13 to to –0.05) and inadvertent doping (z=−0.19, 95% CI −0.32 to –0.06). Risk factors were positively associated with doping intentions (z=0.29, 95% CI 0.26 to 0.32) and use (z=0.17, 95% CI 0.15 to 0.19), but not inadvertent doping (z=0.08, 95% CI −0.06 to 0.22). Risk factors for both doping intentions and use included prodoping norms and attitudes, supplement use, body dissatisfaction and ill-being. Protective factors for both doping intentions and use included self-efficacy and positive morality.

Conclusion

This study identified several protective and risk factors for doping intention and use that may be viable intervention targets for antidoping programmes. Protective factors were negatively associated with inadvertent doping; however, the empirical volume is limited to draw firm conclusions.
How race and socioeconomic status moderate the association between moderate-to-vigorous physical activity and depressive symptoms: a cross-sectional study with compositional data
Authors: Liu Yujie , Ge Xin , Wang Ying , Qiao Shan , Cai Yong
Published: June 2024

Objectives

This study explored how race and socioeconomic status (SES) moderated the association between moderate-to-vigorous physical activity (MVPA) and depressive symptoms with compositional data.

Methods

Participants were 2803 US adults from the 2005–2006 cycle of the National Health and Nutrition Examination Survey. Accelerometers were used to measure MVPA, light-intensity physical activity (LPA) and sedentary behaviours (SB). Participants self-reported sleep duration and depressive symptoms. SES was derived by latent class analysis using household income level, education attainment and occupation. The association between the relative time of MVPA and depressive symptoms and the moderating effects of race and SES were investigated through compositional data analysis. Isotemporal substitution analysis was employed to estimate the association of time reallocation from other movement behaviours to MVPA with depressive symptoms.

Results

Increased time spent in MVPA relative to time spent in LPA, SB and sleep was inversely associated with depressive symptoms (OR (95% CI)=0.679 (0.538–0.855)). The relative time of MVPA significantly interacted with race and SES for depressive symptoms (P for interaction <0.05). Reallocating 10–30 min from sleep, SB or LPA to MVPA was associated with lower odds of depressive symptoms solely among non-Hispanic white individuals and those with higher SES.

Conclusion

This study used compositional data to reveal a reverse association between MVPA and depressive symptoms among white individuals and those with higher SES. Our results provide evidence of how race and SES moderate the relationship between MVPA and depressive symptoms. Future research is needed to further explore these racial and socioeconomic differences.
Implementation of quality indicators for palliative care for patients with incurable cancer at palliative care units in Germany (Quincie): a study protocol for a mixed-methods study
Authors: van Baal Katharina , Ernst Alexandra , Schade Franziska , Stiel Stephanie
Published: June 2024

Introduction

Guidelines are important tools for supporting quality management in the care of patients with cancer. However, in clinical practice barriers exist to their implementation. Consequently, Quincie aims at: (1) gaining a comprehensive picture of the implementation of quality indicators from the national guideline on palliative care for patients with incurable cancer in palliative care units and (2) describing the factors that facilitate and hinder their implementation to develop recommendations.

Methods and analysis

The Quincie study follows a mixed-methods approach across two study phases. In phase 1, routinely collected data of 845 patients with incurable cancer from eight palliative care units in the commuting area of the Comprehensive Cancer Centre Lower Saxony will be analysed, regarding the implementation of 10 quality indicators from the national guideline on palliative care. Structural characteristics of the palliative care units will also be collected. In phase 2, recommendations for the practical implementation of the quality indicators, focusing on the achievement of the quality objectives identified in phase 1, will be developed in an implementation workshop. These recommendations will be subsequently agreed on via a Delphi survey.

Ethics and dissemination

Ethical approval has been given by the ethics committee of the Hannover Medical School (first vote, No. 10567_BO_K_2022) and other relevant institutions. The results will provide urgently needed insights on the implementation of the national guideline on palliative care in clinical care and on the factors that facilitate and hinder this implementation. The results are expected to promote better care for patients with incurable cancer. The results will be directly reported to the participating palliative care units and will be published in relevant peer-reviewed journals. They will also be presented at national conferences.

Trial registration number

German Clinical Trials Register (DRKS00029965).
Shared symptomatology between atopic dermatitis, ADHD and autism spectrum disorder: a protocol for a systematic scoping review
Authors: Nguyen N Tan , Ragamin Aviël , Rietman André B , Nijsten Tamar E C , Schappin Renske
Published: June 2024

Introduction

Children with atopic dermatitis (AD) are more at risk for the neurodevelopmental disorders attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) with parallel increases in global prevalences. Children afflicted with these conditions appear to share similar problems in sensory modulation but investigational studies on the underlying aetiology are scarce. This scoping review aims to find knowledge gaps, collate hypotheses and to summarise available evidence on the shared pathophysiology of AD, ADHD and ASD in children.

Methods and analysis

Our study will follow the methodological manual published by the Joanna Briggs Methodology for Scoping Reviews and will be reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews. The following electronic databases will be searched for studies focused on children with AD and symptoms of ADHD and/or ASD: Medline ALL via Ovid, Embase, Web of Science Core Collection and the Cochrane Central Register of Controlled Trials via Wiley.

Ethics and dissemination

This review does not require ethics approval as it will not be conducted with human participants. We will only use published data. Our dissemination strategy includes peer review publication and conference reports.
Prehabilitation in patients with cirrhosis awaiting liver transplantation: protocol of a feasibility study
Authors: Benmassaoud Amine , Gillis Chelsia , Geraci Olivia , Martel Myriam , Awasthi Rashami , Barkun Jeffrey , Chen Tianyan , Edgar Linda , Sebastiani Giada , Carli Francesco , Bessissow Amal
Published: June 2024

Introduction

Patients with cirrhosis awaiting liver transplantation (LT) are often frail, and malnourished. The period of time on the waitlist provides an opportunity to improve their physical fitness. Prehabilitation appears to improve the physical fitness of patients before major surgery. Little is known about prehabilitation in patients with cirrhosis. The aim of this feasibility study will be to investigate the feasibility, safety, and effectiveness of a multimodal prehabilitation programme in this patient population.

Methods and analysis

This is an open-label single-arm feasibility trial recruiting 25 consecutive adult patients with cirrhosis active on the LT waiting list of the McGill University Health Centre (MUHC). Individuals will be excluded based on criteria developed for the safe exercise training in patients with cirrhosis. Enrolled individuals will participate in a multimodal prehabilitation programme conducted at the PeriOperative Programme complex of the MUHC. It includes exercise training with a certified kinesiologist (aerobic and resistance training), nutritional optimisation with a registered dietician and psychological support with a nurse specialist. The exercise training programme is divided into an induction phase with three sessions per week for 4 weeks followed by a maintenance phase with one session every other week for 20 weeks. Aerobic training will be individualised based on result from cardiopulmonary exercise testing (CPET) and will include a high-intensity interval training on a cycle ergometer. Feasibility, adherence and acceptability of the intervention will be assessed. Adverse events will be reviewed before each visit. Changes in exercise capacity (6-minute walk test, CPET, liver frailty index), nutritional status and health-related quality of life will be assessed during the study. Post-transplantation outcomes will be recorded.

Ethics and dissemination

The research ethics board of the MUHC has approved this study (2021-7646). Our findings will be submitted for presentation at national and international conferences, and for peer-reviewed publication.

Trial registration number

NCT05237583.
Prevalence and determinants of suspected developmental delays among 12-month-old children in northeast of Iran: a large-scale population-based study
Authors: Kazemian Seyedeh Vajiheh , Farkhani Ehsan Mousa , Jarahi Lida
Published: June 2024

Background

Early identification of suspected developmental delays (SDDs) is crucial for planning early interventions. This study aimed to determine the prevalence of SDDs and the associated determinants in children aged 12 months in the northeast of Iran, using the Age and Stage Questionnaire-3 (ASQ-3) as the evaluative tool.

Methods

This study conducted an analytical cross-sectional design to investigate all children who had completed the ASQ-3 screening form at 12 months of age within the time frame of 2016–2023 in the northeast of Iran. The necessary data were extracted from the electronic health record database associated with Mashhad University of Medical Sciences. To examine the factors associated with SDDs within each domain of the ASQ-3, a multiple logistic regression model was employed, and the results were presented using ORs along with 95% CIs.

Results

Over 7 years, 236 476 children (96.74%) underwent routine ASQ-3 screening at 12 months. After excluding certain cases, 226 076 children (95.60%) were included. Among them, 51 593 children (22.82%) had a score below −1 SD, indicating SDD prevalence in at least one domain. The social–personal domain had the highest prevalence with 22 980 children (10.16%), while the gross motor domain had the lowest with 5650 children (2.50%). Logistic regression analysis identified strong predictors of SDDs, including hospitalisation at birth (OR=1.85, 95% CI:1.69 to 2.02), prematurity (OR=1.56, 95% CI: 1.37 to 1.79), urbanisation (OR=1.51, 95% CI: 1.45 to 1.57), boys (OR=1.36, 95% CI: 1.31 to 1.40) and lack of exclusive breast feeding until 6 months (OR=1.30, 95% CI: 1.25 to 1.34).

Conclusion

The prevalence of SDDs highlights the urgency for prompt action, while considering contributing factors. Policymakers can address modifiable risk factors associated with SDDs, including urbanisation risks, support programmes for immigrant families and the importance of exclusive breast feeding until 6 months. Additionally, it is recommended establishing gender-specific local standard cut-off points for the ASQ.
Intracoronary thrombolysis in ST-elevation myocardial infarction: a systematic review and meta-analysis
Authors: Rehan Rajan , Virk Sohaib , Wong Christopher C Y , Passam Freda , Layland Jamie , Keech Anthony , Yong Andy , White Harvey D , Fearon William , Ng Martin
Published: June 2024

Background

Despite restoration of epicardial blood flow in acute ST-elevation myocardial infarction (STEMI), inadequate microcirculatory perfusion is common and portends a poor prognosis. Intracoronary (IC) thrombolytic therapy can reduce microvascular thrombotic burden; however, contemporary studies have produced conflicting outcomes.

Objectives

This meta-analysis aims to evaluate the efficacy and safety of adjunctive IC thrombolytic therapy at the time of primary percutaneous coronary intervention (PCI) among patients with STEMI.

Methods

Comprehensive literature search of six electronic databases identified relevant randomised controlled trials. The primary outcome was major adverse cardiac events (MACE). The pooled risk ratio (RR) and weighted mean difference (WMD) with a 95% CI were calculated.

Results

12 studies with 1915 patients were included. IC thrombolysis was associated with a significantly lower incidence of MACE (RR=0.65, 95% CI 0.51 to 0.82, I
2
=0%, p<0.0004) and improved left ventricular ejection fraction (WMD=1.87; 95% CI 1.07 to 2.67; I
2
=25%; p<0.0001). Subgroup analysis demonstrated a significant reduction in MACE for trials using non-fibrin (RR=0.39, 95% CI 0.20 to 0.78, I
2
=0%, p=0.007) and moderately fibrin-specific thrombolytic agents (RR=0.62, 95% CI 0.47 to 0.83, I
2
=0%, p=0.001). No significant reduction was observed in studies using highly fibrin-specific thrombolytic agents (RR=1.10, 95% CI 0.62 to 1.96, I
2
=0%, p=0.75). Furthermore, there were no significant differences in mortality (RR=0.91; 95% CI 0.48 to 1.71; I
2
=0%; p=0.77) or bleeding events (major bleeding, RR=1.24; 95% CI 0.47 to 3.28; I
2
=0%; p=0.67; minor bleeding, RR=1.47; 95% CI 0.90 to 2.40; I
2
=0%; p=0.12).

Conclusion

Adjunctive IC thrombolysis at the time of primary PCI in patients with STEMI improves clinical and myocardial perfusion parameters without an increased rate of bleeding. Further research is needed to optimise the selection of thrombolytic agents and treatment protocols.
Reviewing past and present consent practices in unplanned obstetric interventions: an eye towards the future
Authors: Wilbourne Morganne , Hand Frances , McAllister Sophie , Print-Lyons Louise , Bhatia Meena
Published: June 2024

Many first-time mothers (primiparous) within UK National Health Service (NHS) settings require an obstetric intervention to deliver their babies safely. While the antepartum period allows time for conversations about consent for planned interventions, such as elective caesarean section, current practice is that, in emergencies, consent is addressed in the moments before the intervention takes place. This paper explores whether there are limitations on the validity of consent offered in time-pressured and emotionally charged circumstances, specifically concerning emergency obstetric interventions. Using the legal framework of the Mental Capacity Act,Montgomery v. Lanarkshire Health Board(2015) andMcCulloch v Forth Valley Health Board(2023), we argue that while women have the capacity to consent during labour, their autonomy is best supported by providing more information about instrumental delivery (ID) during the antepartum period. This conclusion is supported by some national guidelines, including those developed by the Royal College of Obstetricians and Gynaecologists, but not all. Further, we examine the extent to which these principles are upheld in modern-day practice. Data suggest there is relatively little antepartum information provision regarding ID within NHS settings, and that primiparous women do not report a thorough understanding of ID before labour. Based on these results, and bearing in mind the pressures under which NHS obstetric services currently operate, we recommend further research into patient and clinician perceptions of the consent process for ID. Pending these results, we discuss possible modes of information delivery in future practice.
First-ever seizure and eligibility for commercial motor vehicle driving
Authors: Lawn Nicholas , Lee Judy , Dunne John
Published: June 2024

Background

After a first-ever seizure, 6 months of seizure freedom is usually required before returning to driving a private motor vehicle, after which the annual risk of seizure recurrence has fallen to ≤20%. Stricter criteria apply for commercial driver’s licence (CDL) holders, and a longer period of seizure freedom sufficient for the annual risk of recurrence to be <2% is recommended. However, CDL guidelines are based on little data with few studies having long-term follow-up.

Methods

1714 patients with first-ever seizures were prospectively studied. Seizure recurrence was evaluated using survival analysis. The annual conditional risk of seizure recurrence was calculated for patients with first-ever unprovoked and acute symptomatic seizures, and according to the presence or absence of clinical, electroencephalogram (EEG) and neuroimaging risk factors for recurrence.

Results

The annual risk of recurrence for unprovoked first seizures did not fall below 2% until after 9 years of seizure freedom. The annual risk after 5 years of seizure freedom was still 3.9% (95% CI 1.8% to 6.1%) including for those without epileptiform abnormalities on EEG and with normal imaging. For acute symptomatic first seizures, the annual recurrence risk was 4.5% (95% CI 2.3% to 6.7%) after 1 year and fell below 2% only after 4 years of seizure freedom.

Conclusions

For unprovoked and acute symptomatic first-ever seizure and CDL, a higher-than-expected annual seizure risk persists beyond the currently recommended seizure-free periods, even in those without risk factors for recurrence. Our data can inform decisions regarding a return to driving for CDL holders after first-ever seizure.
Visuospatial dysfunction predicts dementia-first phenoconversion in isolated REM sleep behaviour disorder
Authors: Wang Jing , Huang Bei , Zhou Li , Tang Shi , Feng Hongliang , Chan Joey W Y , Chau Steven W H , Zhang Jihui , Li Shirley X , Mok Vincent , Wing Yun Kwok , Liu Yaping
Published: June 2024

Objective

While isolated rapid eye movement sleep behaviour disorder (iRBD) is known as a prodrome of α-synucleinopathies, the prediction for its future phenoconversion to parkinsonism-first or dementia-first subtype remains a challenge. This study aimed to investigate whether visuospatial dysfunction predicts dementia-first phenoconversion in iRBD.

Methods

Patients with iRBD and control subjects were enrolled in this prospective cohort study. Baseline neuropsychological assessment included the Unified Parkinson’s Disease Rating Scale part III, Montreal Cognitive Assessment (MoCA), Rey-Osterrieth complex figure (ROCF), Colour Trails test (CTT), Farnsworth-Munsell 100-hue test and Digit Span test. The anterior and posterior subscores of MoCA as well as their modified versions were explored. A composite score derived from ROCF and CTT was also explored. Regular follow-up was conducted to determine the phenoconversion status of iRBD patients.

Results

The study included 175 iRBD patients and 98 controls. During a mean follow-up of 5.1 years, 25.7% of patients experienced phenoconversion. Most of the neuropsychological tests could differentiate dementia-first but not parkinsonism-first convertors from non-convertors. The modified posterior subscore of MoCA, by integrating the Alternating Trail Making and Clock Drawing components into original the posterior subscore, which mainly reflects visuospatial function, was the strongest predictor for dementia-first phenoconversion (adjusted HR 5.48, 95% CI 1.67 to 17.98).

Conclusion

Visuospatial dysfunction, as reflected mainly by the modified posterior subscore of MoCA, is a predictive factor for dementia-first phenoconversion in iRBD, suggesting its potential for being a biomarker for clinical prognostic prediction and potential neuroprotective trials aiming to delay or prevent dementia.
Relationships between asbestos exposure and pleural plaques: dose and time effects using fractional polynomials
Authors: Menant Morgane , Benlala Ilyes , Thaon Isabelle , Andujar Pascal , Julia Benoist , Brochard Patrick , Chouaid Christos , Clin Bénédicte , Gislard Antoine , Gramond Celine , Paris Christophe , Pairon Jean-Claude , Delva Fleur
Published: June 2024

Objective

The aim of this study was to confirm the relationship between several parameters of exposure to asbestos and pleural plaques (PP) using data from a large cohort of retired workers occupationally exposed to asbestos in France.

Method

A large screening programme, including high-resolution CT (HRCT) examinations at inclusion and two other HRCT campaigns, was organised from 2003 to 2016 in four regions of France for voluntary, formerly asbestos-exposed workers. Exposure to asbestos has been evaluated by industrial hygienists based on the complete work history. The time since first exposure, the time since last exposure, Cumulative Exposure Index and maximum level of exposure to asbestos, were used in logistic regression using fractional polynomials to model the relationship with PP.

Results

The study included 5392 subjects with at least one HRCT available. There was a significant non-linear effect of time since first exposure, time since last exposure and Cumulative Exposure Index to asbestos on the presence of PP. The risk of PP increased with increasing Cumulative Exposure Index to asbestos adjusted for time since first exposure, age and smoking status. Models also show that PP odds rise with increasing time since first exposure adjusted for cumulative index exposure, age and smoking status. PP odds decrease when time since last exposure increases.

Conclusion

The study provides new data on the link between asbestos exposure and the presence of PP using fractional polynomials with non-linear relationships for time exposure parameters and asbestos exposure parameters.
Seroprevalence of immunity to hepatitis A and hepatitis B among gay, bisexual and other men who have sex with men (GBMSM) attending sexual health clinics in London and Leeds, England, 2017–2018
Authors: Roche Rachel , Simmons Ruth , Allen Hester , Glancy Megan , Balan Anca-Maria , Bolea Maria , Harris Ross , Desai Monica , Mohammed Hamish , Sabin Caroline , Ijaz Samreen , Mandal Sema
Published: June 2024

Objectives

Although hepatitis A virus (HAV) and hepatitis B virus (HBV) immunisation is recommended in the UK for gay, bisexual and other men who have sex with men (GBMSM), data on immunisation coverage are limited. We aimed to determine the seroprevalence of HAV and HBV immunity among a sample of GBMSM attending sexual health services (SHS) in England.

Methods

Residual serum samples from HIV/syphilis testing for adult GBMSM attending eight SHS in London and one in Leeds were tested for markers of HAV immunity (HAV IgG) and HBV immunity (anti-HBs) using an unlinked anonymous approach. We estimated seroprevalence of HAV and HBV immunity overall and stratified by individuals’ characteristics, which we obtained from the Genitourinary Medicine Clinic Activity Dataset Sexually Transmitted Infection (STI) Surveillance System. We used logistic regression to calculate crude and adjusted ORs between seropositivity and demographic and clinical characteristics.

Results

Seroprevalence of immunity to HAV (74.5% of 2577) and HBV (77.1% of 2551) was high. In adjusted analysis, HAV IgG seroprevalence varied by clinic and WHO region of birth (global p<0.001 for each), increased with older age (ORs of 1.50 (95% CI 1.18 to 1.86), 2.91 (2.17 to 3.90) and 3.40 (2.44 to 4.75) for ages 26–35, 36–45 and >46 vs 18–25 years (global p<0.001), was higher in those with an STI in the past year (1.58 (1.25 to 2.00); p<0.001) and those who were living with HIV (1.82 (1.25 to 2.64); p<0.001). Anti-HBs seroprevalence varied by clinic (global p<0.001), increased with older age (global p<0.001) and was higher in those with an STI in the past year (1.61 (1.27 to 2.05); p<0.001).

Conclusion

Our findings provide a baseline seroprevalence from which to monitor serial levels of immunity to HBV and HAV in GBMSM accessing SHS. Levels of immunity for both viruses are high, noting samples were taken after recent widespread outbreaks and vaccination campaigns. High vaccine coverage in all GBMSM should be maintained to prevent further outbreaks.
ChatGPT as a tool to improve access to knowledge on sexually transmitted infections
Authors: Koh Matthew Chung Yi , Ngiam Jinghao Nicholas , Tambyah Paul Anantharajah , Archuleta Sophia
Published: June 2024

Objectives

Specific to sexual health, individuals in need of information may be adolescents who have limited ability to formally access healthcare. These digital natives may turn to ChatGPT to address their concerns on sexually transmitted infections (STI). We sought to evaluate the veracity of ChatGPT’s responses to commonly asked questions on STIs.

Methods

We instructed ChatGPT (GPT 3.5) to answer STI questions from three domains, namely, (1) general risk factors for STIs, (2) access to care and diagnosis of STIs and (3) management of STIs and postexposure prophylaxis. The responses were recorded and checked against the US Centers for Disease Control and Prevention STI Treatment Guidelines 2021.

Results

Overall, the responses were concise and accurate. In terms of prevention, ChatGPT could also recommend measures like safe sex practices and human papillomavirus vaccination. However, it failed to recommend HIV pre-exposure prophylaxis. When an individual expressed a symptom that could potentially represent STI (eg, dyspareunia) ChatGPT appropriately provided reassurance that other possibilities exist, but advocated for testing. In terms of treatment, ChatGPT consistently communicated the importance of partner testing and follow-up testing, but at times, failed to highlight the importance of testing for other STIs. Overall, the advice given was not tailored to the specific individual’s circumstances.

Conclusions

ChatGPT can provide helpful information regarding STIs, but the advice lacks specificity and requires a human physician to fine-tune. Its ubiquity may make it a useful adjunct to sexual health clinics, to improve knowledge and access to care.
Healthy lifestyles are associated with alleviating the single-nucleotide polymorphism-based genetic risks of ischaemic stroke, intracerebral haemorrhage and myocardial infarction
Authors: Wang Jingru , Liu Zhenqiu , Hu Chengxin , Zhao Renjia , Zhu Dongliang , Xie Yijing , Zhang Pengyan , Cui Mei , Xu Kelin , Zhao Genming , Jin Li , Chen Xingdong , Suo Chen , Jiang Yanfeng
Published: June 2024

Background

Both genetic and lifestyle factors contribute to myocardial infarction (MI) and stroke, including ischaemic stroke (IS) and intracerebral haemorrhage (ICH). We explored how and the extent to which a healthy lifestyle, by considering a comprehensive list, could counteract the genetic risk of those diseases, respectively.

Methods

315 044 participants free of stroke and MI at baseline were identified from the UK Biobank. Genetic risk scores (GRS) for those diseases were constructed separately and categorised as low, intermediate and high by tertile. Lifestyle risk scores (LRS) were constructed separately using smoking, alcohol intake, physical activity, dietary patterns and sleep patterns. Similarly, participants were categorised into low, intermediate and high LRS. The data were analysed using Cox proportional hazard models.

Results

Over a median follow-up of 12.8 years, 4642, 1046 and 9485 participants developed IS, ICH and MI, respectively. Compared with participants with low levels of GRS and LRS, the HRs of those with high levels of GRS and LRS were 3.45 (95% CI 2.71 to 4.41), 2.32 (95% CI 1.40 to 3.85) and 4.89 (95% CI 4.16 to 5.75) for IS, ICH and MI, respectively. Moreover, among participants with high GRS, the standardised 14-year rates of IS events were 4.40% (95% CI 3.45% to 5.36%) among those with high LRS. In contrast, it is only 1.78% (95% CI 1.63% to 1.94%) among those with low LRS. Similarly for MI, the high LRS group had standardised rates of 8.60% (95% CI 7.38% to 9.81%), compared with 3.34% (95% CI 3.12% to 3.56%) in low LRS. Among the high genetic risk group of ICH, the rate is reduced by about half compared low LRS to high LRS, although the rate was low for both (0.36% (95% CI 0.31% to 0.42%) and 0.71% (95% CI 0.36% to 1.05%), respectively).

Conclusion

Healthy lifestyles were substantially associated with a reduction in the risk of IS, ICH and MI and attenuated the genetic risk of IS, ICH and MI by at least half, respectively.
Mortality burden from variation in provision of surgical care in emergency general surgery: a cohort study using the National Inpatient Sample
Authors: Ho Vanessa P , Towe Christopher W , Bensken Wyatt P , Pfoh Elizabeth , Dalton Jarrod , Connors Alfred F , Claridge Jeffrey A , Perzynski Adam T
Published: June 2024

Background

The decision to undertake a surgical intervention for an emergency general surgery (EGS) condition (appendicitis, diverticulitis, cholecystitis, hernia, peptic ulcer, bowel obstruction, ischemic bowel) involves a complex consideration of factors, particularly in older adults. We hypothesized that identifying variability in the application of operative management could highlight a potential pathway to improve patient survival and outcomes.

Methods

We included adults aged 65+ years with an EGS condition from the 2016–2017 National Inpatient Sample. Operative management was determined from procedure codes. Each patient was assigned a propensity score (PS) for the likelihood of undergoing an operation, modeled from patient and hospital factors: EGS diagnosis, age, gender, race, presence of shock, comorbidities, and hospital EGS volumes. Low and high probability for surgery was defined using a PS cut-off of 0.5. We identified two model-concordant groups (no surgery-low probability, surgery-high probability) and two model-discordant groups (no surgery-high probability, surgery-low probability). Logistic regression estimated the adjusted OR (AOR) of in-hospital mortality for each group.

Results

Of 375 546 admissions, 21.2% underwent surgery. Model-discordant care occurred in 14.6%; 5.9% had no surgery despite a high PS and 8.7% received surgery with low PS. In the adjusted regression, model-discordant care was associated with significantly increased mortality: no surgery-high probability AOR 2.06 (1.86 to 2.27), surgery-low probability AOR 1.57 (1.49 to 1.65). Model-concordant care showed a protective effect against mortality (AOR 0.83, 0.74 to 0.92).

Conclusions

Nearly one in seven EGS patients received model-discordant care, which was associated with higher mortality. Our study suggests that streamlined treatment protocols can be applied in EGS patients as a means to save lives.

Level of evidence

III.
Assessing the health-fitness dynamics of endangered mountain caribou and the influence of maternal penning
Authors: Lamb Clayton T. , Dubman E. , McNay R.S. , Giguere L. , Majchrzak Y. , Thacker C. , Slater O. , Macbeth B. , Owens-Beek N. , Muir B. , Ford A.T.
Published: June 2024

The health of wildlife plays a crucial role in population demography by connecting habitat and physiology. Southern mountain caribou, a population of woodland caribou ( Rangifer tarandus caribou (Gmelin, 1978)) found in the mountains of southwest Canada, are facing significant threats. We evaluated the health of the Klinse-Za subpopulation within the central group of southern mountain caribou, which is part of an Indigenous-led conservation initiative aimed at enhancing caribou population growth through seasonal maternal penning. We collected health metrics from 46 female Klinse-Za caribou between 2014 and 2021. The health metrics included trace minerals, cortisol, biomarkers for inflammation, and pathogen prevalence. We compared these health metrics between penned and non-penned animals, reproductive and non-reproductive females, and nearby subpopulations. We provide correlative evidence linking reproductive success to trace nutrients but find no evidence for relationships with stress, exposure to pathogens, or biomarkers of inflammation. Based on the health metrics considered, Klinse-Za caribou were generally healthy relative to neighboring subpopulations and repeat capture for penning did not appear to create accumulated health issues. Penned caribou had lower fecal cortisol levels and inflammation markers compared to free-ranging animals. This work provides a baseline assessment of southern mountain caribou health and provides guidance on maternal penning activities in support of caribou recovery.
Modifying a mini drone for remote drug delivery for wildlife medicine
Authors: Yindee Marnoch , Khumngoen Patcharapol , Manatchaiworakul Wallaya , Wongtawan Tuempong
Published: June 2024

Remote drug delivery is an essential tool for administering medication to wildlife. However, the conventional method, the dart gun, has limitations in terms of injection distance, posing risks for operators. This study aimed to modify a mini drone equipped with a dart syringe and delivery system for use with large wildlife. A commercial mini drone was modified to release a syringe dart using a vertical gravity-based delivery system. The performance of the drone and delivery system was evaluated based on accuracy to the target and penetration ability through pig skin. The evaluation compared a dart with or without a plastic shell, with tests conducted both indoors and outdoors. The results indicated that the higher the drone’s flight, the more the dart tended to deviate from the target. In outdoor tests, a syringe dart without a shell showed greater accuracy than a dart with a shell. Regarding penetration ability, only a dart without a shell had a 100% success rate at a maximum height of 5 m, with an overall statistical difference ( P = 0.01). In conclusion, this study represents the first scientific validation of using mini drones for remote drug injections that could be used in large wildlife medicine.
Analyzing user reactions using relevance between location information of tweets and news articles
Authors: Jin Yun-Tae , You JaeBeom , Wakamiya Shoko , Kwon Hyuk-Yoon
Published: June 2024

In this study, we analyze the extent of user reactions based on user’s tweets to news articles, demonstrating the potential for home location prediction. To achieve this, we quantify users’ reactions to specific news articles based on the textual similarity between tweets and news articles, showcasing that users’ reactions to news articles about their cities are significantly higher than those about other cities. To maximize the difference in reactions, we introduce the concept of News Distinctness, which highlights the news articles that affect a specific location. By incorporating News Distinctness with users’ reactions to the news, we magnify its effects. Through experiments conducted with tweets collected from users whose home locations are in five representative cities within the United States and news articles describing events occurring in those cities, we observed a 6.75% to 40% improvement in the reaction score when compared to the average reactions towards news for outside of home location, clearly predicting the home location. Furthermore, News Distinctness increases the difference in reaction score between news in the home location and the average of the news outside of the home location by 12% to 194%. These results demonstrate that our proposed idea can be utilized to predict the users’ location, potentially recommending meaningful information based on the users’ areas of interest.
Effective action approach to the dynamical map
Authors: Lewicki M. , Smaldone L.
Published: June 2024

The dynamical map represents a fundamental concept in quantum field theory, providing a solution of the field equations in the Fock space of asymptotic fields. In this paper, we show how to express the dynamical map of a scalar field in the language of quantum effective action. This grants us new insights into the study of topological defects in quantum field theory by showing a connection between the usual least-action principle and Umezawa’s boson transformation method.
Comment on: “Klein–Gordon oscillator under gravitational effects in a topologically charged Ellis–Bronnikov wormhole”
Authors: Fernández Francisco M.
Published: June 2024

In this paper, we analyze the results for the ground state of a Klein–Gordon oscillator under gravitational effects in a topologically charged Ellis–Bronnikov wormhole derived recently. We show that the authors failed to truncate a power-series and, consequently, could not obtain the desired solution to a differential equation. For this reason, their analytical expression for the ground-state eigenvalue is incorrect, a fact that affects all the conclusions drawn by the authors for the physical problem.
Identifying the Nonlinear Dynamics of Logistic Mapping Using the Modified 0–1 Test for Chaos
Authors: Zhang Xiaoxue , Yang Kai , Xu Wei , Xiao Qingtai , Wang Hua , Pan Jianxin
Published: June 2024

Chaos identification can not only promote the development and perfection of chaos theory, but also help to find the factors that produce chaos in the considered system, and control or anti-control it. The 0–1 test for chaos is an effective method to detect chaos. In order to simulate the noise contaminated through its production, Gaussian, Exponential, and Uniform noises are added to Logistic mapping to form a new hybrid time series, respectively. The effects of noise types and levels on the modified 0–1 test for chaos are studied. By studying the effect of different types of noises on chaos index [Formula: see text], [Formula: see text], and the change of [Formula: see text] with amplitude [Formula: see text], it can be seen that Uniform noise has the greatest effect on chaos identification. In addition, it is found that the effect of the noise types on chaos identification depends on the peak of the noisy time series, and the effect of the noise on chaos detection increases with the increase of the noisy time series peak. It is worth noting that the selection of amplitude [Formula: see text] can improve the noise resistance of chaos identification. The noise resistance of the modified 0–1 test for chaos can be improved by adjusting the amplitude [Formula: see text] of the parameters. With the continuous increase of noise contamination level, the effect on the modified 0–1 test for chaos detection results is gradually enhanced, so reducing the noise contamination level is the key to improving the accuracy of the modified 0–1 test for chaos. In addition, adjusting the amplitude [Formula: see text] can also play a certain noise immunity effect, and when [Formula: see text], the noise immunity is stronger on logistic mapping. Sample size [Formula: see text] up to [Formula: see text] is sufficient, but amplitude [Formula: see text] has little effect on chaos identification.
Research on the Evaluation System of Digital Management Process Improvement of Automobile Transaction Business Based on CMMI
Authors: Gu Nailin , Cai Zhiming , Zhao Shutong
Published: June 2024

With the rapid development of information technology, enterprise digitalization, and Internet + application, the digitalization and improvement of the used car trading business and its management process improvement are facing many challenges. This paper attempts to use the CMMI process improvement model to analyze the factors affecting the digital construction, business process optimization, and digital management process improvement of the used car market through research on the digital management process and the related theories of CMMI, such as talent training, application of information technology, immature business development, irregular business process, and industry policy restriction. The FAHP analysis method is used to establish a comparison matrix to explore the construction of an evaluation system model for the improvement of the digital management process of the used car trading market based on the CMMI model.