bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety and Efficacy of Anlotinib Hydrochloride Plus Temozolomide in Patients with Recurrent Glioblastoma
Authors: Xu Qingsheng , Huang Kaiyuan , Meng Xiangqi , Weng Yuxiang , Zhang Luyuan , Bu Linghao , Zheng Xiujue , Cai Jinquan , Zhan Renya , Chen Qun
Published: July 2023

Purpose:

Glioblastoma (GBM) is a highly vascularized tumor with few treatment options after disease recurrence. Here, we report the efficacy and safety of anlotinib hydrochloride plus temozolomide in patients with recurrent GBM.

Patients and Methods:

Patients with first definite postsurgical progression of histologically confirmed GBM preceded by standard radiotherapy and temozolomide chemotherapy were eligible for inclusion. All patients received temozolomide (150–200 mg/m2, orally, every day (QD) d1–5/4 wk) and anlotinib (10 mg, orally, QD, d1–14/3 wk) until disease progression or unacceptable toxicity. The primary endpoint was investigator-assessed 6-month progression-free survival (PFS) rate by the Response Assessment in Neuro-Oncology (RANO) criteria.

Results:

Twenty-one patients were enrolled between May 2020 and July 2021, with a median age of 55 (range 27–68) years old. According to the Response Assessment in Neuro-Oncology (RANO) criteria, tumor response occurred in 17 patients, of which 9 patients had a complete response, and the objective response rate was 81.0% [95% confidence interval (CI), 62.6–99.3]. The disease control rate was 95.2% (95% CI, 76.2–99.9), with three additional patients achieving a stable disease without tumor progression. The median PFS was 7.3 months (95% CI, 4.9–9.7), and the 6-month PFS rate was 61.9% (95% CI, 39.3–84.6). The median overall survival was 16.9 months (95% CI, 7.8–26.0). The most common adverse events were leukocytopenia (66.7%), thrombocytopenia (38.1%), and hypertriglyceridemia (38.1%). Five patients had nine grade 3 adverse events, with a 23.8% incidence rate. Two patients discontinued therapy due to ischemic stroke (grade 3) and wound dehiscence (grade 1), respectively. No grade 4 or treatment-related deaths occurred in this study.

Conclusions:

Anlotinib combined with temozolomide is efficacious and tolerated in patients with recurrent GBM.
Unique Spectrum of ActivatingBRAFAlterations in Prostate Cancer
Authors: Chehrazi-Raffle Alex , Tukachinsky Hanna , Toye Eamon , Sivakumar Smruthy , Schrock Alexa B. , Bergom Hannah E. , Ebrahimi Hedyeh , Pal Sumanta , Dorff Tanya , Agarwal Neeraj , Mahal Brandon A. , Oxnard Geoffrey R. , Hwang Justin , Antonarakis Emmanuel S.
Published: July 2023

Purpose:

Alterations in BRAF have been reported in 3% to 5% of prostate cancer, although further characterization is lacking. Here, we describe the nature of BRAF alterations in prostate cancer using a large cohort from commercially available tissue and liquid biopsies subjected to comprehensive genomic profiling (CGP).

Experimental Design:

Tissue and liquid biopsies from patients with prostate cancer were profiled using FoundationOne CDx and FoundationOne Liquid CDx CGP assays, respectively. Tissue biopsies from non–prostate cancer types were used for comparison (n = 275,151). Genetic ancestry was predicted using a single-nucleotide polymorphism (SNP) based approach.

Results:

Among 15,864 tissue biopsies, BRAF-activating alterations were detected in 520 cases (3.3%). The majority (463 samples, 2.9%) harbored class II alterations, including BRAF rearrangements (243 samples, 1.5%), K601E (101 samples, 0.6%), and G469A (58 samples, 0.4%). BRAF-altered prostate cancers were enriched for CDK12 mutations (OR, 1.87; 9.2% vs. 5.2%; P = 0.018), but depleted in TMPRSS2 fusions (OR, 0.25; 11% vs. 32%; P < 0.0001), PTEN alterations (OR, 0.47; 17% vs. 31%; P < 0.0001), and APC alterations (OR, 0.48; 4.4% vs. 8.9%; P = 0.018) relative to BRAF wild-type (WT) disease. Compared with patients of European ancestry, BRAF alterations were more common in tumors from patients of African ancestry (5.1% vs. 2.9%, P < 0.0001) and Asian ancestry (6.0% vs. 2.9%, P < 0.001).

Conclusions:

Activating BRAF alterations were detected in approximately 3% of prostate cancers, and most were class II mutations and rearrangements; BRAF V600 mutations were exceedingly rare. These findings suggest that BRAF activation in prostate cancer is unique from other cancers and supports further clinical investigation of therapeutics targeting the mitogen-activated protein kinase (MAPK) pathway.
Targeted Therapies in Pediatric and Adult Patients With Hypertrophic Heart Disease: From Molecular Pathophysiology to Personalized Medicine
Authors: Monda Emanuele , Bakalakos Athanasios , Rubino Marta , Verrillo Federica , Diana Gaetano , De Michele Gianantonio , Altobelli Ippolita , Lioncino Michele , Perna Alessia , Falco Luigi , Palmiero Giuseppe , Elliott Perry M. , Limongelli Giuseppe
Published: July 2023

Hypertrophic cardiomyopathy is a myocardial disease defined by an increased left ventricular wall thickness not solely explained by abnormal loading conditions. It is often genetically determined, with sarcomeric gene mutations accounting for around 50% of cases. Several conditions, including syndromic, metabolic, infiltrative, and neuromuscular diseases, may present with left ventricular hypertrophy, mimicking the hypertrophic cardiomyopathy phenotype but showing a different pathophysiology, clinical course, and outcome. Despite being rare, they are collectively responsible for a large proportion of patients presenting with hypertrophic heart disease, and their timely diagnosis can significantly impact patients’ management. The understanding of disease pathophysiology has advanced over the last few years, and several therapeutic targets have been identified, leading to a new era of tailored treatments applying to different etiologies associated with left ventricular hypertrophy. This review aims to provide an overview of the existing and emerging therapies for the principal causes of hypertrophic heart disease, discussing the potential impact on patients’ management and clinical outcome.
Syndromic Surveillance for COVID-19, Massachusetts, February 2020–November 2022: The Impact of Fever and Severity on Algorithm Performance
Authors: Cocoros Noelle M. , Willis Sarah J. , Eberhardt Karen , Morrison Monica , Randall Liisa M. , DeMaria Alfred , Brown Catherine M. , Madoff Lawrence C. , Zambarano Bob , Sljivo Selsebil , Nagavedu Kshema , Klompas Michael
Published: July 2023

Objectives:

Syndromic surveillance can help identify the onset, location, affected populations, and trends in infectious diseases quickly and efficiently. We developed an electronic medical record–based surveillance algorithm for COVID-19–like illness (CLI) and assessed its performance in 5 Massachusetts medical practice groups compared with statewide counts of confirmed cases.

Materials and Methods:

Using data from February 2020 through November 2022, the CLI algorithm was implemented in sites that provide ambulatory and inpatient care for about 25% of the state. The initial algorithm for CLI was modeled on influenza-like illness: an International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis code for COVID-19 and an ICD-10-CM diagnosis code suggesting severe lower respiratory tract infection or ≥1 ICD-10-CM diagnosis code for upper or lower respiratory tract infection plus fever. We generated weekly counts of CLI cases and patients with ≥1 clinical encounter and visually compared trends with those of statewide laboratory-confirmed cases.

Results:

The initial algorithm tracked well with the spring 2020 wave of COVID-19, but the components that required fever did not clearly detect the November 2020–January 2021 surge and identified <1% of weekly encounters as CLI. We revised the algorithm by adding more mild symptoms and removing the fever requirement; this revision improved alignment with statewide confirmed cases through spring 2022 and increased the proportion of encounters identified as CLI to about 2% to 6% weekly. Alignment between CLI trends and confirmed COVID-19 case counts diverged again in fall 2022, likely because of decreased COVID-19 testing and increases in other respiratory viruses.

Practice Implications:

Our work highlights the importance of using a broad definition for COVID-19 syndromic surveillance and the need for surveillance systems that are flexible and adaptable to changing trends and patterns in disease or care.
Performance of Soy Methyl Ester-Polystyrene as a Concrete Protectant: A State-of-the-Art Review
Authors: He Jialuo , Balapour Mohammad , Farnam Yaghoob
Published: July 2023

Freeze–thaw cycles, application of deicing salts, and rebar corrosion are becoming main sources of concrete deterioration in bridge decks and pavements. During the past few decades, concrete surface treatments have begun to receive wide acceptance because of their effectiveness in sealing the concrete. Surface treatments achieve this by limiting fluid ingress, thereby reducing damage associated with freeze–thaw cycles, deicing salt application, and rebar corrosion. Soy methyl ester-polystyrene blends (SME-PS) have been shown to be an innovative, promising method of topical sealing. SME-PS, which is a derivative of soybean oil and expanded polystyrene, has been continuously studied since 2008. In this context, a comprehensive literature review compared the performance of SME-PS with that of traditional concrete sealers, including organic, inorganic, hybrid, and biotic sealers. These sealers were reviewed for performance in reducing water absorption and chloride penetration and improving freeze–thaw durability of concrete. The reviewed papers indicate that SME-PS possesses superior performance as a concrete protectant for reducing water absorption, chloride penetration, and freeze–thaw damage. To further enhance the feasibility of SME-PS, future studies may include investigating the physical and chemical protecting mechanisms of SME-PS, understanding the factors that affect the penetration behavior of SME-PS in concrete, and evaluating the short and long-term effectiveness of SME-PS in concrete.
Comment les citoyens et les citoyennes s’informent ? Retour sur un dispositif d’enquête original à partir d’entretiens de couple
Authors: Dolez Charlotte
Published: July 2023

Cet article rend compte du dispositif méthodologique mis en place dans ma thèse, qui s’intéresse aux logiques d’exposition, d’attention et d’interprétation des informations. Dans cette optique, je propose de faire dialoguer une perspective de science politique avec les apports de la sociologie des médias pour comprendre le rapport aux informations et de saisir d’une manière qualitative les pratiques médiatiques des individus. J’ai ainsi construit un dispositif original et ludique à partir d’entretiens de couple, qui permet de répondre aux deux défis majeurs que pose le recueil des pratiques médiatiques : leur caractère routinier et quotidien ainsi que la norme civique qu’elles révèlent.
Mechanical influence of tissue scaffolding design with different geometries using finite element study
Authors: An Xinyi , Chong Perk Lin , Zohourkari Iman , Roy Sandipan , Merdji Ali , Linda Gnanasagaran Constance , Faraji Foad , Moey Lip Kean , Yazdi Mohammad Hossein
Published: July 2023

The mechanical properties of tissue scaffolds are essential in providing stability for tissue repair and growth. Thus, the ability of scaffolds to withstand specific loads is crucial for scaffold design. Most research on scaffold pores focuses on grids with pore size and gradient structure, and many research models are based on scaffolding with vertically arranged holes. However, little attention is paid to the influence of the distribution of holes on the mechanical properties of the scaffold. To address this gap, this research investigates the effect of pore distribution on the mechanical properties of tissue scaffolds. The study involves four types of scaffold designs with regular and staggered pore arrangements and porosity ranging from 30% to 80%. Finite element analysis (FEA) was used to compare the mechanical properties of different scaffold designs, with von-Mises stress distribution maps generated for each scaffold. The results show that scaffolds with regular vertical holes exhibit a more uniform stress distribution and better mechanical performance than those with irregular holes. In contrast, the scaffold with a staggered arrangement of holes had a higher probability of stress concentration. The study emphasized the importance of balancing porosity and strength in scaffold design.
How do Māori navigate advice about nutrition? A review that spans the mātauranga Māori, western science, and social media divides
Authors: Korohina Erina , Rolleston Anna , Wharemate Zirsha , Warbrick Isaac
Published: July 2023

Cardiovascular disease is one of the leading causes of death in Aotearoa (New Zealand). Life expectancy for Māori (Indigenous people of Aotearoa) is 7 years less than that for non-Māori. Maintaining a healthy nutrition lifestyle is vital to reduce cardiovascular disease risk and improve overall well-being. Though diet and nutrition campaigns are standard parts of health promotion and campaigns have been developed to target Māori, little is known about the way Māori navigate nutrition advice. This review explored mātauranga Māori (Māori knowledge) and western science as bodies of knowledge for nutrition advice and social media as a platform to disseminate nutrition information to understand how communities get their nutrition advice. The findings suggest that for Māori to navigate nutrition advice and messaging effectively, advice needs to be tailored in a way that is acceptable to a Māori worldview while working within the interface of mātauranga Māori, western science, and social media.
Challenges for music in initial teacher education and in schools: Perspectives from music teacher educators in Ireland and Northern Ireland
Authors: Moore Gwen , O’Flynn John , Burgess Frances , Moore Jayne
Published: July 2023

This article examines challenges for music in initial teacher education (ITE) and in schools from the perspectives of music teacher educators across two jurisdictions of Ireland and Northern Ireland. Spanning primary and secondary music ITE, 17 music teacher educators from across both jurisdictions met to share practice and concerns. Findings from three focus group discussions revealed concerns regarding musical provision within ITE institutions and on a wider systemic level, acknowledging the diminishing status of music in both policy and curricular discourse, and in schools. In terms of identity, a shared concept of the music teacher educator as both advocate and confidence builder emerged. As music teacher educators predominantly work in isolation within ITE institutions in Ireland and Northern Ireland, participants welcomed the opportunity to share knowledge and experience across jurisdictions. As such, we argue that emerging communities of music teacher education practice are of critical importance to combat the multiplicity of challenges that music teacher educators face at a time of turbulence in the status of music in state education systems.
Attitudes to Organ Donor Registration in England Under Opt-Out Legislation
Authors: Clark Natalie L. , Copping Lee , Swainston Katherine , McGeechan Grant J.
Published: July 2023

Introduction: In England, everyone is considered an organ donor unless they have registered for opt-out donation. Research Question: This study evaluated positive statements and negative affective attitudes against anticipated organ donor status and whether the order in the attitudes and statements presented impacted organ donor intention under an opt-out system. Design: A quasi-experimental mixed between-within design was employed with participants assigned to 1 of 2 conditions. Participants in the first condition received negative affective attitude statements followed by positive statements. This was reversed in the second condition to combat ordering effects. Participants ( N = 679) were asked about their donor status under an opt-out system. There were three groups: opt-in (actively), opt-out/not sure, and deemed consent (no objection). Organ donor intentions were measured at three intervals: baseline, post-positive statements, and post-negative attitudes. Results: Approximately 10% of participants would opt-out or were unsure of their intentions to be an organ donor under an opt-out system. Significant effects were found in both positive statements and negative affective attitudes. All groups expressed greater medical mistrust and were most influenced by cognitive attitudes. Conclusions: Under the opt-out system in England, it is anticipated that the majority would actively opt-in or have no objection to being automatically registered as an organ donor. Public health campaigns would benefit from promoting the most influential positive statements and refuting the most detrimental negative attitudes to increase intentions of those who plan to opt-out or are unsure.
Policy Analysis of Return to Learn After Sport and Recreational Related Concussion for Secondary Schools in New England: Relevance to School Nurses and Nursing Practice
Authors: Fetta Joseph M. , Starkweather Angela R. , Van Hoof Thomas , Huggins Robert , Casa Douglas , Gill Jessica
Published: July 2023

Return to learn (RTL) is the individualized process of coordinating cognitive care and reintegration for students into the academic setting after any sport and recreational-related concussion (SRRC). The guidelines for RTL are based on empirical evidence, however, implementation differs by institution. The purpose of the policy analysis is to evaluate RTL guidelines after SRRC of student-athletes in New England secondary school public school systems. A review of the six New England states’ policies surrounding RTL was conducted. The Comprehensive Analysis of Physical Activity Framework was referenced to identify the analytic components of existing legislation and because of the relatively new implementation of RTL-specific policy, a novel policy analysis tool was utilized. States with RTL-specific language scored on average 7.9 to 11.1 points higher when compared to states without RTL-specific language. This difference was associated with disparities in access to RTL resources for residents according to their geographic location. Lobbying efforts should be targeted toward states without RTL-specific language to provide equal care and opportunities for student-athletes to receive RTL services. RTL policy provides a responsibility to assist students who have suffered from an SRRC and can serve to improve health outcomes and academic achievement.
Work-Cognition and Subjective Well-being Among Female Professional Educators During the COVID-19 Pandemic: Moderating Role of Resilience
Authors: Patangia Bishal , Sathiyaseelan Anuradha , Balasundaram Sathiyaseelan , M. Ashwini , Chaudhury Soumonetra , Chaudhry Nirmay , Jaiprakash Radhika
Published: July 2023

Teaching demands educators to be both caretakers and educators, leading to significant cognitive and emotional strain. The pandemic has worsened these challenges, requiring teachers to seek psychological and professional support. Online teaching has added to these difficulties, with educators having to adapt to new technologies while managing virtual classrooms and addressing the unique needs of students in remote learning environments. This present study sought to understand the relationship between work cognition (WCog) and subjective well-being (SWB) among female professional educators during the COVID-19 pandemic. The study also examines the moderating effect of Resilience (RSL) on the association between WCog and SWB. Using a purposive sampling technique, data was collected through an online survey from 181 female professional educators in India. Female professional educators reported moderate levels of WCog, high levels of RSL, and high levels of SWB, which indicates that the female professional educators faced cognitive and emotional strain during online teaching but demonstrated resilience and maintained positive well-being. RSL moderated the relationship between WCog and SWB, highlighting its influence on educators’ cognitive management and well-being during online teaching. These insights have implications for support system to enhance the well-being of educators and promoting their professional development.
Tabulating and visualizing street-name data in the US and Europe
Authors: Carmona-Derqui Demetrio , Gutiérrez-Mora Dolores , Oto-Peralías Daniel
Published: July 2023

Street names constitute a rich source of data for quantitative analysis in social sciences. We gather and process street-name data from OpenStreetMap to create an accessible and readily analyzable street names database for the US and a large part of Europe. We also develop a web app to visualize the spatial distribution of street names and download the underlying data from users’ queries. These tools will continue to expand its geographic coverage by including additional countries.
Platelet count threshold for hemorrhage in patients with immune thrombocytopenia treated with antiplatelet agents
Authors: Ollier Natasha , Piel-Julian Marie-Léa , Mahévas Matthieu , Viallard Jean-François , Comont Thibault , Chèze Stéphane , Audia Sylvain , Ebbo Mikaël , Terriou Louis , Lega Jean-Christophe , Jeandel Pierre-Yves , Bonnotte Bernard , Michel Marc , Lapeyre-Mestre Maryse , Godeau Bertrand , Moulis Guillaume
Published: July 2023

A significant proportion of older patients with immune thrombocytopenia (ITP) also have clinical indications for treatment of cardiovascular disease with antiplatelet agents. Ollier and colleagues sought to determine the frequency of bleeding in patients with ITP on aspirin therapy, finding that the pattern of bleeding, segregated by platelet count, is similar to that observed in other adults with ITP not on aspirin. They show that a platelet count of <20 × 109/L is associated with most bleeding in ITP patients on antiplatelet agents.
Enhancing drug property prediction with dual-channel transfer learning based on molecular fragment
Authors: Wu Yue , Ni Xinran , Wang Zhihao , Feng Weike
Published: July 2023

Background

Accurate prediction of molecular property holds significance in contemporary drug discovery and medical research. Recent advances in AI-driven molecular property prediction have shown promising results. Due to the costly annotation of in vitro and in vivo experiments, transfer learning paradigm has been gaining momentum in extracting general self-supervised information to facilitate neural network learning. However, prior pretraining strategies have overlooked the necessity of explicitly incorporating domain knowledge, especially the molecular fragments, into model design, resulting in the under-exploration of the molecular semantic space.

Results

We propose an effective model with FRagment-based dual-channEL pretraining (). Equipped with molecular fragments, comprehensively employs masked autoencoder and contrastive learning to learn intra- and inter-molecule agreement, respectively. We further conduct extensive experiments on ten public datasets to demonstrate its superiority over state-of-the-art models. Further investigations and interpretations manifest the underlying relationship between molecular representations and molecular properties.

Conclusions

Our proposed model FREL achieves state-of-the-art performance on the benchmark datasets, emphasizing the importance of incorporating molecular fragments into model design. The expressiveness of learned molecular representations is also investigated by visualization and correlation analysis. Case studies indicate that the learned molecular representations better capture the drug property variation and fragment semantics.
Association between early blood urea nitrogen-to-albumin ratio and one-year post-hospital mortality in critically ill surgical patients: a propensity score-matched study
Authors: Nguyen Khoi Nguyen , Chuang Tzu-I , Wong Li-Ting , Chan Ming-Cheng , Chao Wen-Cheng
Published: July 2023

Background

Blood urea nitrogen to albumin ratio (BAR) is increasingly recognized as an early predictor for short-term outcomes in critically ill patients, but the association of BAR with long-term outcomes in critically ill surgical patients remains underexplored.

Methods

We enrolled consecutive patients who were admitted to surgical intensive care units (ICUs) at Taichung Veterans General Hospital between 2015 and 2020, and the dates of death were retrieved from Taiwan’s National Health Insurance Research Database. In addition to Cox regression, we also used propensity score matching to determine the hazard ratios (HRs) and 95% confidence intervals (CIs) for one-year post-hospital mortality of the variables.

Results

A total of 8,073 eligible subjects were included for analyses. We found that age, male gender, high Charlson Comorbidity Index, high Acute Physiology and Chronic Health Evaluation II score, positive microbial culture, and leukocytosis were predictors for mortality, whereas high body mass index, scheduled surgery, and high platelet counts were protective factors against long-term mortality. The high BAR was independently associated with increased post-hospital mortality after adjustment for the aforementioned covariates (adjHR 1.258, 95% CI, 1.127–1.405). Notably, the association tended to be stronger in females and patients with fewer comorbidities and lower disease severity of critical illness. The propensity score matching, dividing subjects by BAR higher or lower than 6, showed a consistent association between week-one BAR and post-hospital mortality (adjHR 1.503, 95% CI 1.247–1.811).

Conclusions

BAR is a newly identified predictor of short-term outcome, and we identified long-term outcome-relevant factors, including BAR, and the identified factors may be useful for risk stratification of long-term outcomes in patients discharged from surgical ICUs.
Pregnancy loss following miscarriage and termination of pregnancy for medical reasons during the COVID-19 pandemic: a thematic analysis of women’s experiences of healthcare on the island of Ireland
Authors: Heaney Suzanne , Galeotti Martina , Aventin Áine
Published: July 2023

Background

Losing a baby during pregnancy can be a devastating experience for expectant parents. Many report dedicated, compassionate healthcare provision as a facilitator of positive mental health outcomes, however, healthcare services have been severely impacted during the COVID-19 pandemic.

Aim

To explore women’s experiences of healthcare service provision for miscarriage and termination of pregnancy for medical reasons (TFMR) on the island of Ireland during the COVID-19 pandemic.

Methods

Findings combine data from elements of two separate studies. Study 1 used a mixed methods approach with women who experienced miscarriage and attended a hospital in Northern Ireland. Study 2 was qualitative and examined experiences of TFMR in Northern Ireland and Ireland. Data analysed for this paper includes open-ended responses from 145 women to one survey question from Study 1, and semi-structured interview data with 12 women from Study 2. Data were analysed separately using Thematic Analysis and combined for presentation in this paper.

Results

Combined analysis of results indicated three themes, (1) Lonely and anxiety-provoking experiences; (2) Waiting for inadequate healthcare; and (3) The comfort of compassionate healthcare professionals.

Conclusions

Women’s experiences of healthcare provision were negatively impacted by COVID-19, with the exclusion of their partner in hospital, and delayed services highlighted as particularly distressing. Limited in-person interactions with health professionals appeared to compound difficulties. The lived experience of service users will be helpful in developing policies, guidelines, and training that balance both the need to minimise the risk of infection spread, with the emotional, psychological, and physical needs and wishes of parents. Further research is needed to explore the long-term impact of pregnancy loss during a pandemic on both parents and health professionals delivering care.
“Figuring stuff out myself” – a qualitative study on maternal vaccination in socially and ethnically diverse areas in England
Authors: Berendes Sima , Mounier-Jack Sandra , Ojo-Aromokudu Oyinkansola , Ivory Alice , Tucker Joseph D. , Larson Heidi J. , Free Caroline
Published: July 2023

Background

Maternal vaccinations against Influenza, Pertussis, and Covid-19 are recommended in the UK, and vaccines against further infections may become available soon. However, many pregnant women, especially in socially and ethnically diverse areas, have low vaccine uptake. Qualitative studies on the reasons and possible solutions are needed that are inclusive of disadvantaged and minority ethnic groups. We therefore aimed to understand the complex interplay between structural and behavioural factors contributing to the low maternal vaccine uptake in socially and ethnically diverse areas in London in the Covid-19 context.

Methods

In 2022, we conducted semi-structured interviews and a focus group discussion among a purposive sample of 38 pregnant/recently pregnant women and 20 health service providers, including 12 midwives. Participants were recruited in ethnically diverse London boroughs. We followed a critical realist paradigm and used a thematic analysis approach.

Results

The sample included participants who took all, some or none of the maternal vaccines, with some participants unsure whether they had taken or been offered the vaccines. Decision-making was passive or active, with the expectation for pregnant women to do their 'own research'. Participants described various individual, social and contextual influences on their decision-making as they navigated the antenatal care system. Missing or conflicting information from providers meant knowledge gaps were sometimes filled with misinformation from unreliable sources that increased uncertainties and mistrust. Both pregnant women and providers described structural and organisational factors that hindered access to information and vaccinations, including lack of training, time and resources, and shortcomings of health information systems and apps. Some participants described factors that facilitated vaccination uptake and many made recommendations for improvements.

Conclusions

Our study showed how structural and organisational factors can compound uncertainties around maternal vaccination among socially and ethnically diverse populations. Results highlight the need for more reliable resources, streamlined workflows, improved electronic information systems and training in their use. Roles and responsibilities should be clarified with potential greater involvement of nurses and pharmacists in vaccine provision. Education and communication should consider individual (language/digital) skills and needs for information and reassurance. Further research is needed to co-produce solutions with service users and providers.
A scoping review on hyposalivation associated with systemic conditions: the role of physical stimulation in the treatment approaches
Authors: Melo Jéssica Luiza de Mendonça Albuquerq , Coelho Camila Pinho e Souza , Nunes Fernanda de Paula e Silva , Heller Debora , Grisi Daniela Corrêa , Guimarães Maria do Carmo Machado , Dame-Teixeira Naile
Published: July 2023

Background

Several systemic conditions can result in distinct degrees of salivary gland damage and consequent hypofunction. The development of successful management schemes is highly challenging due to the complexity of saliva. This study aimed to systematically map the literature on the physical stimulation of salivary glands for hyposalivation management and the response of individuals according to different systemic conditions causing salivary impairment.

Methods

A systematic search in the literature was performed. Two reviewers independently selected clinical trials, randomized or not, that used physical stimulation to treat hyposalivation caused by systemic conditions. Studies evaluating healthy subjects without hyposalivation were included as controls. Single-arm clinical studies or case series were also included for protocol mapping (PRISMA extension for scoping reviews).

Results

Out of 24 included studies, 10 evaluated healthy subjects, from which 9 tested transcutaneous electrical nerve stimulation (TENS) and 1 tested acupuncture and electroacupuncture. Fourteen studies evaluated individuals with hyposalivation: 6 applied TENS, 6 applied low-level laser therapy (LLLT), and 2 applied acupuncture, carried out in post-chemotherapy, medication use, postmenopausal women, hemodialysis patients, smokers, diabetics, Sjögren's syndrome (SS). All showed increased salivation after treatment, except for two LLLT studies in individuals with SS.

Conclusions

Among the different patient groups, individuals with Sjögren's syndrome (SS) exhibited the poorest responses, while those with medication-induced hyposalivation demonstrated the most favorable treatment outcomes, independently of the management strategy for saliva stimulation. It means that physical stimulation of salivary glands holds promise as an alternative for managing hyposalivation in cases of reversible gland damage. However, to make informed decisions in current practice, it is necessary to conduct new well-designed randomized clinical trials with appropriate methodologies.
An intelligent decision support system for acute postoperative endophthalmitis: design, development and evaluation of a smartphone application
Authors: Shaeri Mahdi , Shoeibi Nasser , Hosseini Seyedeh Maryam , Jeddi Fatemeh Rangraze , Farrahi Razieh , Nabovati Ehsan , Salehzadeh Azam
Published: July 2023

Background

Today, clinical decision support systems based on artificial intelligence can significantly help physicians in the correct diagnosis and quick rapid treatment of endophthalmitis as the most important cause of blindness in emergency diseases. This study aimed to design, develop, and evaluate an intelligent decision support system for acute postoperative endophthalmitis.

Methods

This study was conducted in 2020–2021 in three phases: analysis, design and development, and evaluation. The user needs and the features of the system were identified through interviews with end users. Data were analyzed using thematic analysis. The list of clinical signs of acute postoperative endophthalmitis was provided to ophthalmologists for prioritization. 4 algorithms support vector machine, decision tree classifier, k-nearest neighbors, and random forest were used in the design of the computing core of the system for disease diagnosis. The acute postoperative endophthalmitis diagnosis application was developed for using by physicians and patients. Based on the data of 60 acute postoperative endophthalmitis patients, 143 acute postoperative endophthalmitis records and 12 non-acute postoperative endophthalmitis records were identified. The learning process of the algorithm was performed on 70% of the data and 30% of the data was used for evaluation.

Results

The most important features of the application for physicians were selecting clinical signs and symptoms, predicting diagnosis based on artificial intelligence, physician–patient communication, selecting the appropriate treatment, and easy access to scientific resources. The results of the usability evaluation showed that the application was good with a mean (± SD) score of 7.73 ± 0.53 out of 10.

Conclusion

A decision support system with accuracy, precision, sensitivity and specificity, negative predictive values, F-measure and area under precision-recall curve 100% was created thanks to widespread participation, the use of clinical specialists' experiences and their awareness of patients' needs, as well as the availability of a comprehensive acute postoperative endophthalmitis clinical dataset.
Lipopolysaccharide-binding protein and future Parkinson’s disease risk: a European prospective cohort
Authors: Zhao Yujia , Walker Douglas I. , Lill Christina M. , Bloem Bastiaan R. , Darweesh Sirwan K. L. , Pinto-Pacheco Brismar , McNeil Brooklyn , Miller Gary W. , Heath Alicia K. , Frissen Myrthe , Petrova Dafina , Sánchez Maria-Jose , Chirlaque María-Dolores , Guevara Marcela , Zibetti Maurizio , Panico Salvatore , Middleton Lefkos , Katzke Verena , Kaaks Rudolf , Riboli Elio , Masala Giovanna , Sieri Sabina , Zamora-Ros Raul , Amiano Pilar , Jenab Mazda , Peters Susan , Vermeulen Roel
Published: July 2023

Introduction

Lipopolysaccharide (LPS) is the outer membrane component of Gram-negative bacteria. LPS-binding protein (LBP) is an acute-phase reactant that mediates immune responses triggered by LPS and has been used as a blood marker for LPS. LBP has recently been indicated to be associated with Parkinson’s disease (PD) in small-scale retrospective case–control studies. We aimed to investigate the association between LBP blood levels with PD risk in a nested case–control study within a large European prospective cohort.

Methods

A total of 352 incident PD cases (55% males) were identified and one control per case was selected, matched by age at recruitment, sex and study center. LBP levels in plasma collected at recruitment, which was on average 7.8 years before diagnosis of the cases, were analyzed by enzyme linked immunosorbent assay. Odds ratios (ORs) were estimated for one unit increase of the natural log of LBP levels and PD incidence by conditional logistic regression.

Results

Plasma LBP levels were higher in prospective PD cases compared to controls (median (interquartile range) 26.9 (18.1–41.0) vs. 24.7 (16.6–38.4) µg/ml). The OR for PD incidence per one unit increase of log LBP was elevated (1.46, 95% CI 0.98–2.19). This association was more pronounced among women (OR 2.68, 95% CI 1.40–5.13) and overweight/obese subjects (OR 1.54, 95% CI 1.09–2.18).

Conclusion

The findings suggest that higher plasma LBP levels may be associated with an increased risk of PD and may thus pinpoint to a potential role of endotoxemia in the pathogenesis of PD, particularly in women and overweight/obese individuals.
The European experience with testing and surveillance during the first phase of the COVID-19 pandemic
Authors: Stoto Michael A. , Reno Chiara , Tsolova Svetla , Fantini Maria Pia
Published: July 2023

Background

COVID-19 pandemic provides a unique opportunity to learn the challenges encountered by public health emergency preparedness systems, both in terms of problems encountered and adaptations during and after the first wave, as well as successful responses to them.

Results

This work draws on published literature, interviews with countries and institutional documents as part of a European Centre for Disease Prevention and Control project that aims to identify the implications for preparedness measurement derived from COVID-19 pandemic experience in order to advance future preparedness efforts in European Union member states. The analysis focused on testing and surveillance themes and five countries were considered, namely Italy, Germany, Finland, Spain and Croatia. Our analysis shown that a country’s ability to conduct testing at scale was critical, especially early in the pandemic, and the inability to scale up testing operations created critical issues for public health operations such as contact tracing. Countries were required to develop new strategies, approaches, and policies under pressure and to review and revise them as the pandemic evolved, also considering that public health systems operate at the national, regional, and local level with respect to testing, contact tracing, and surveillance, and involve both government agencies as well as private organizations. Therefore, communication among multiple public and private entities at all levels and coordination of the testing and surveillance activities was critical.

Conclusion

With regard to testing and surveillance, three capabilities that were essential to the COVID-19 response in the first phase, and presumably in other public health emergencies: the ability to scale-up testing, contact tracing, surveillance efforts; flexibility to develop new strategies, approaches, and policies under pressure and to review and revise them as the pandemic evolved; and the ability to coordinate and communicate in complex public health systems that operate at the national, regional, and local level with respect and involve multiple government agencies as well as private organizations.
Predicting disease severity in metachromatic leukodystrophy using protein activity and a patient phenotype matrix
Authors: Trinidad Marena , Hong Xinying , Froelich Steven , Daiker Jessica , Sacco James , Nguyen Hong Phuc , Campagna Madelynn , Suhr Dean , Suhr Teryn , LeBowitz Jonathan H. , Gelb Michael H. , Clark Wyatt T.
Published: July 2023

Background

Metachromatic leukodystrophy (MLD) is a lysosomal storage disorder caused by mutations in the arylsulfatase A gene (ARSA) and categorized into three subtypes according to age of onset. The functional effect of most ARSA mutants remains unknown; better understanding of the genotype–phenotype relationship is required to support newborn screening (NBS) and guide treatment.

Results

We collected a patient data set from the literature that relates disease severity to ARSA genotype in 489 individuals with MLD. Patient-based data were used to develop a phenotype matrix that predicts MLD phenotype given ARSA alleles in a patient’s genotype with 76% accuracy. We then employed a high-throughput enzyme activity assay using mass spectrometry to explore the function of ARSA variants from the curated patient data set and the Genome Aggregation Database (gnomAD). We observed evidence that 36% of variants of unknown significance (VUS) in ARSA may be pathogenic. By classifying functional effects for 251 VUS from gnomAD, we reduced the incidence of genotypes of unknown significance (GUS) by over 98.5% in the overall population.

Conclusions

These results provide an additional tool for clinicians to anticipate the disease course in MLD patients, identifying individuals at high risk of severe disease to support treatment access. Our results suggest that more than 1 in 3 VUS in ARSA may be pathogenic. We show that combining genetic and biochemical information increases diagnostic yield. Our strategy may apply to other recessive diseases, providing a tool to address the challenge of interpreting VUS within genotype–phenotype relationships and NBS.
Hyperactivity in patients with narcolepsy and idiopathic hypersomnia: an exploratory study
Authors: Dodson Caroline , Spruyt Karen , Considine Ciaran , Thompson Emily , Ipsiroglu Osman S. , Bagai Kanika , Silvestri Rosalia , Couvadelli Barbara , Walters Arthur S.
Published: July 2023

Introduction

Patients with either Idiopathic Hypersomnia or Narcolepsy demonstrate excessive daytime somnolence (EDS) with resultant inattention mimicking Attention Deficit Hyperactivity Disorder (ADHD). Patients with ADHD also often express sleep problems including EDS. Thus, patients with ADHD and patients with idiopathic hypersomnia or narcolepsy may share inattention and daytime drowsiness as common features. However, it is not known whether EDS patients with idiopathic hypersomnia or narcolepsy also have increased movement (hyperactivity) like ADHD patients, the determination of which is the purpose of this study.

Methods

We studied 12 patients (7 Narcolepsy type 2 and 5 Idiopathic Hypersomnia) with EDS as shown by Multiple Sleep Latency Test which served as the gold standard for entry into the study. Twelve subjects without symptoms of EDS served as the control group. None of the participants had a previous history of ADHD. Each participant underwent a one-hour session laying at 45 degrees with surveys about the need to move and actigraphy as an objective measure of movement.

Results

Sleep-disordered patients with EDS reported more symptoms of inattention and hyperactivity on the ADHD Self-Report Scale. At each of the time points patients with EDS had a clear trend to express the need to move more than controls on the Suggested Immobilization Test (SIT). For the total 60 min, a large effect size for the need to move during the SIT test was found between patients and controls (Cohen’s d = 0.61, p = 0.01). Patients with EDS did not express a need to move more to combat drowsiness than controls, nor did actigraphy show any difference in objective movement between patients and controls during the SIT.

Conclusion

Patients with EDS express inattention and a need to move more than controls. However, hyperactivity was not verified by objective measurement, nor did the EDS patients express a need to move to combat drowsiness more than controls. Thus, a hypothesis to be further tested, is whether narcolepsy and idiopathic hypersomnia may be more a model of the inattentive form of ADHD rather than the combined or inattentive/hyperactive form of ADHD. Further studies are needed to explore the relationship between EDS and hyperactivity.
Τοπικός πολιτισμός και διδασκαλία της ιστορίας στην πρωτοβάθμια εκπαίδευση
Authors: Θεοχάρης Θωμάς
Published: July 2023

Στην παρούσα μελέτη εξετάζεται η συμβολή του τοπικού πολιτισμού στη διδασκαλία της ιστορίας στην πρωτοβάθμια εκπαίδευση μέσα από την περίπτωση της Κέρκυρας. Αξιοποιείται το κοντινό και οικείο πολιτισμικό περιβάλλον των μαθητών, ώστε αυτοί να προσεγγίσουν δημιουργικά και κριτικά το παρελθόν. Στις επιμέρους ενότητες αναλύεται η έννοια του πολιτισμού, του τόπου, αλλά και της ιστορίας και της διδακτικής της. Τελικά μέσα από τη διεξαγωγή μίας έρευνας-δράσης διαπιστώνεται πως η συμβολή του τοπικού πολιτισμού στη διδασκαλία της ιστορίας οδηγεί στην υιοθέτηση της επιστημονικής μεθόδου από τους μαθητές, συμβάλλει στην αντικειμενική προσέγγιση του ιστορικού «άλλου» και μπορεί να γίνει αποδεκτή από την εκπαιδευτική κοινότητα. Επίσης, ως προς τον τρόπο αυτό προσέγγισης του παρελθόντος, εντοπίζονται στοιχεία της διδακτικής διαδικασίας που έχουν ιδιαίτερη σημασία και αποδεικνύεται πως η διδασκαλία της ιστορίας μετατρέπεται σε μία συνομιλία μεταξύ των μαθητών και του παρελθόντος, αντί των μαθητών και του διδάσκοντος, καθώς οι πηγές τοποθετούνται στο επίκεντρο της διδακτικής πράξης. Οι στερεοτυπικές αντιλήψεις τίθενται στο περιθώριο, δίνοντας τη θέση τους στην ανάπτυξη της ισότητας και της δημοκρατίας. Από τη μελέτη συμπεραίνεται πως η διδασκαλία της ιστορίας με την αξιοποίηση του τοπικού πολιτισμού οδηγεί στην ανάπτυξη της ιστορικής σκέψης από τους μαθητές της πρωτοβάθμιας εκπαίδευσης.
Broadband 1.5-2.1 µm emission in gallo-germanate dual-core optical fiber co-doped with Er3+ and Yb3+/Tm3+/Ho3+
Authors: Markiewicz Jakub , Kochanowicz Marcin , Ragiń Tomasz , Sadowska Karolina , Żmojda Jacek , Miluski Piotr , Dorosz Jan , Kuwik Marta , Pisarski Wojciech A. , Pisarska Joanna , Leśniak Magdalena , Dorosz Dominik
Published: July 2023

The near-infrared emission in fabricated low-phonon energy, gallo-germanate glass, and double-core optical fiber has been investigated. Broadband amplified spontaneous emission (ASE) was obtained in optical fiber with cores doped with: 1st - 0.2Er2O3 and 2nd - 0.5Yb2O3/0.4Tm2O3/0.05Ho2O3 as a result of the superposition of emission bands from both cores corresponding to the Er3+:4I13/2→4I15/2 (1st core) and Tm3+:3F4 → 3H6/Ho3+:5I7 → 5I8 (2nd core) transitions. The effect of fiber length and pump wavelength on the near-infrared amplified spontaneous emission (ASE) properties has been analyzed for 1 m and 5 m optical fiber. The widest emission bandwidth (355 nm - 3 dB level) was obtained for a 5 m length optical fiber pumped by a 940 nm laser.
Tellurium crystal pumped with ultrafast 10 µm pulses demonstrates a giant nonlinear optical response
Authors: Matteo Daniel , Tochitsky Sergei Ya. , Joshi Chan
Published: July 2023

The nonresonant nonlinear optical response of bulk tellurium (Te) is studied using 220 fs 10 µm laser pulses with photon energy roughly three times smaller than the band gap energy. The Kerr nonlinearity is found to be extremely large (n2,eff = 3.0-6.0 × 10−12 cm2/W), nearly 100 times larger than that of GaAs, depending on crystal orientation. Multiphoton absorption is observed at intensities >109 W/cm2 indicating the importance of free carriers to the overall nonlinear optical response. The large values of the nonlinear susceptibilities of Te open up possibilities of designing thin film elements for mid- and long-wavelength infrared nonlinear photonics.