bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Pressure, Surface Characteristics, and Fluid Properties Effect on Pool Boiling Heat Transfer Over Plain and External Micro-Finned Cylindrical Surfaces
Authors: Shah Balkrushna A. , Patel Parth , Lakhera Vikas J.
Published: August 2023

Pool boiling is extensively used in high- and low-temperature heat exchangers as it results in a high heat transfer coefficient compared to natural and single-phase forced convection. Pool boiling experimental study conducted over a plain cylindrical surface (PS) and four external micro-finned cylindrical surfaces (MFCSs), with R123 and R141b at different pressures in the heat flux range 20–100 kW/m2, is presented in this paper. The objective of the present study is to explore the effect of pressure, surface characteristics, and fluid properties on pool boiling heat transfer over plain and micro-finned cylindrical surfaces. The boiling performance improved at a higher pressure, irrespective of the working fluid used for all the test surfaces. It was found that, with the rise in pressure, the boiling heat transfer coefficient (BHTC) for the MFCSs increases at a higher rate than the PS. In comparison with PS, the average rise in the BHTC with pressure, for the MFCS-1, MFCS-2, MFCS-3, and MFCS-4 with R123 were 69.3% to 84.3%, 3.3% to 9.9%, 16.9% to 22.4%, and 29.4% to 40.2%, respectively. The higher BHTC over micro-finned cylindrical surfaces results due to more nucleation site results from lower surface wettability and micro-finned geometry. It was observed that the pool boiling over the plain surface with R123 results in higher BHTC compared with R141b at all tested pressures, whereas the pool boiling characteristics over MFCSs varied based on the combined effect of micro-finned surface geometry, surface wettability, heat flux, pressure and fluid properties. The bubble departure diameters over all the surfaces were measured at 30 W, 60 W, and 90 W at different pressures, and a new model of bubble departure diameter was proposed based on dimensionless terms. The total mean absolute error (MAE) of the proposed bubble departure diameter model was about 6.79% for the whole range of data points.
Relative importance and interactions of parameters of finite-element models of human middle ear
Authors: Ebrahimian Arash , Mohammadi Hossein , Maftoon Nima
Published: August 2023

In the last decades, finite-element models of the middle ear have been widely used to predict the middle-ear vibration outputs. Even with the simplest linear assumption for material properties of the structures in the middle ear, these models need tens of parameters. Due to the complexities of measurements of material properties of these structures, accurate estimations of the values of most of these parameters are not possible. In this study, we benefited from the stochastic finite-element model of the middle ear we had developed in the past, to perform global sensitivity analysis. For this aim, we implemented Sobol′ sensitivity analysis which ranks the importance of all uncertain parameters and interactions among them at different frequencies. To decrease the computational costs, we found Sobol′ indices from surrogate models that we created using stochastic finite-element results and the polynomial chaos expansion method. Based on the results, the Young's modulus and thickness of the tympanic membrane, Young's modulus and damping of the stapedial annular ligaments, and the Young's modulus of ossicles are among the parameters with the greatest impacts on vibrations of the umbo and stapes footplate. Furthermore, the most significant interactions happen between the Young's modulus and thickness of the tympanic membrane.
Representations of fricatives in subcortical model responses: Comparisons with human consonant perception
Authors: Hamza Yasmeen , Farhadi Afagh , Schwarz Douglas M. , McDonough Joyce M. , Carney Laurel H.
Published: August 2023

Fricatives are obstruent sound contrasts made by airflow constrictions in the vocal tract that produce turbulence across the constriction or at a site downstream from the constriction. Fricatives exhibit significant intra/intersubject and contextual variability. Yet, fricatives are perceived with high accuracy. The current study investigated modeled neural responses to fricatives in the auditory nerve (AN) and inferior colliculus (IC) with the hypothesis that response profiles across populations of neurons provide robust correlates to consonant perception. Stimuli were 270 intervocalic fricatives (10 speakers × 9 fricatives × 3 utterances). Computational model response profiles had characteristic frequencies that were log-spaced from 125 Hz to 8 or 20 kHz to explore the impact of high-frequency responses. Confusion matrices generated by k-nearest-neighbor subspace classifiers were based on the profiles of average rates across characteristic frequencies as feature vectors. Model confusion matrices were compared with published behavioral data. The modeled AN and IC neural responses provided better predictions of behavioral accuracy than the stimulus spectra, and IC showed better accuracy than AN. Behavioral fricative accuracy was explained by modeled neural response profiles, whereas confusions were only partially explained. Extended frequencies improved accuracy based on the model IC, corroborating the importance of extended high frequencies in speech perception.
Efficacy of Resisted Sled Sprint Training Compared With Unresisted Sprint Training on Acceleration and Sprint Performance in Rugby Players: An 8-Week Randomized Controlled Trial
Authors: Panascì Marco , Di Gennaro Simone , Ferrando Vittoria , Filipas Luca , Ruggeri Piero , Faelli Emanuela
Published: August 2023

Purpose: To compare the effects between resisted sled sprint training (RSS) and unresisted sprint training (URS) on sprint and acceleration performance, vertical jump, and maximal strength during an 8-week period of preseason training. Methods: Twenty-six recreational active rugby players were randomly divided into either RSS or URS training groups and then performed 8 weeks of training, 2 sessions/wk of sprint-specific training program. The RSS group performed sprints by towing a sled overloaded with 12.6% of body mass for 2 of the 3 sets of 3 × 20-m sprints, plus one set was carried out with unresisted modality. The URS groups performed 3 sets of 3 × 20-m unresisted sprints. The measures of 10- and 30-m sprint times, vertical jump, and 3-repetition-maximum (3-RM) squat tests were performed at baseline and after 8 weeks. Results: Ten- and 30-m sprint times (P < .05 and ) improved significantly more in RSS than in URS. Both groups improved significantly in vertical jump and 3-RM squat tests; however, no significant differences (P > .1 and ) between groups were found. Conclusions: Our findings indicate that an 8-week program of RSS is more effective than URS for enhancing sprint time performance in male recreational active rugby players. In addition, these data suggest that a sled overload corresponding to 12.6% of body mass can induce positive effects on both acceleration and speed performance in recreational active rugby players.
Does Physical Fitness Relate to Academic Achievement in High School Students?
Authors: Santana Carla Caroliny de Almeida , Barros Mauro Virgilio Gomes de , Medeiros Flávio Roberto Carneiro de , Rangel Júnior João Francisco Lins Brayner , Cantieri Francys Paula , Alarcon Daniela , Prado Wagner Luiz do
Published: August 2023

Background: Academic achievement (AA) is an important issue not only during the school period since it is a strong predictor of long-term professional and social success. Physical fitness (PF) components are associated with AA, and previous studies were conducted with relatively small samples, lack of statistical power, and the conclusions are based on simple correlational analyses. The objective of this study was to analyze the association between PF (single and clustered) with AA in a large and representative sample of high school students. Methods: Cross-sectional design study conducted with 911 students, aged 13–15 years (38.52% boys) enrolled in the first year of high school. Cardiorespiratory fitness (20-m shuttle run test), muscular strength (dynamometer), and body composition (skinfolds) were measured. PF components were clustered (Z-cardiorespiratory fitness + Z-muscular strength – Z-body fatness). AA was analyzed through standard math tests. Hierarchical linear regression analysis was applied to verify the independent contribution of each single component and PF’s cluster on AA. Age, screen time, maternal education, race, and type of residence were used as covariates. Results: Among boys, cardiorespiratory fitness was negatively associated with AA (β = −0.137; P = .041), while strength was positively associated with AA (β = 0.188; P = .004). There was no association between clustered PF indicators and AA (β = 0.064; P = .297). There was a negative association between age and AA in girls (β = −0.151; P = .003) and in boys (β = −0.128; P = .045). Conclusions: These results support current literature, indicating an association between PF’s component, namely muscular strength and AA (mathematics) in adolescents, even when controlled for several covariates.
Accelerometry Measured Movement Behaviors in Middle-Aged and Older Adults: Cross-Sectional Analysis of the ELSA-Brasil Study
Authors: de Paula Danilo , Crochemore-Silva Inácio , Griep Rosane Harter , Duncan Bruce Bartholow , Schmidt Maria Inês
Published: August 2023

Background: Little investigation of accelerometry assessed movement behaviors and physical inactivity was carried out in middle-aged and older adults in low-middle-income countries. Objective: Describe accelerometry-measured movement behaviors and prevalence of physical inactivity in middle-aged and older adults. Methods: We collected raw accelerometry data during the third visit (2017–2019) of ELSA-Brasil, a large-scale multicenter Brazilian cohort. Participants wore an ActiGraph wGT3X-BT on the waist for 24 hours for 7 days and documented sleep in a diary. Results: Nine thousand two hundred and seventy-nine participants had valid data (73.4% of the eligible cohort). Overall activity was higher for men (11.82mg; 95% confidence interval [CI], 11.7 to 11.93) than women (10.69mg; 95% CI, 10.6 to 10.77) and lower in older groups—women (−0.12mg/y; 95% CI, −0.13 to −0.11), men (−0.16mg/y; 95% CI, −0.17 to −0.14). Participants were more active from noon to midnight. Distribution of movement behaviors varied with sex and age, and sleep duration was longer in older individuals. Overall, 14.4% (95% CI, 13.7 to 15.1) were inactive, with inactivity being more frequent in women (16.4%; 95% CI, 15.4 to 17.4) than men (12.2%; 95% CI, 11 to 13). Higher rates were observed in the oldest. Retirement was associated with a higher prevalence of physical inactivity in both sexes. Conclusion: Women were less active than men. Older individuals showed a high prevalence of physical inactivity, probably related to transition into retirement. These findings strengthen evidence for public policies promoting physical activity by emphasizing the need to target women, older individuals, and those transitioning to retirement to improve and/or maintain physical activity levels throughout the course of their lives.
Structural basis of γ chain family receptor sharing at the membrane level
Authors: Cai Tiantian , Lenoir Capello Rachel , Pi Xiong , Wu Hao , Chou James J.
Published: August 2023

Common γ chain (γc) cytokine receptors, including interleukin-2 (IL-2), IL-4, IL-7, IL-9, IL-15, and IL-21 receptors, are activated upon engagement with a common γc receptor (CD132) by concomitant binding of their ectodomains to an interleukin. In this work, we find that direct interactions between the transmembrane domains (TMDs) of both the γc and the interleukin receptors (ILRs) are also required for receptor activation. Moreover, the same γc TMD can specifically recognize multiple ILR TMDs of diverse sequences within the family. Heterodimer structures of γc TMD bound to IL-7 and IL-9 receptor TMDs—determined in a lipid bilayer–like environment by nuclear magnetic resonance spectroscopy—reveal a conserved knob-into-hole mechanism of recognition that mediates receptor sharing within the membrane. Thus, signaling in the γc receptor family requires specific heterotypic interactions of the TMDs.
CXCL9:SPP1
macrophage polarity identifies a network of cellular programs that control human cancers
Authors: Bill Ruben , Wirapati Pratyaksha , Messemaker Marius , Roh Whijae , Zitti Beatrice , Duval Florent , Kiss Máté , Park Jong Chul , Saal Talia M. , Hoelzl Jan , Tarussio David , Benedetti Fabrizio , Tissot Stéphanie , Kandalaft Lana , Varrone Marco , Ciriello Giovanni , McKee Thomas A. , Monnier Yan , Mermod Maxime , Blaum Emily M. , Gushterova Irena , Gonye Anna L. K. , Hacohen Nir , Getz Gad , Mempel Thorsten R. , Klein Allon M. , Weissleder Ralph , Faquin William C. , Sadow Peter M. , Lin Derrick , Pai Sara I. , Sade-Feldman Moshe , Pittet Mikael J.
Published: August 2023

Tumor microenvironments (TMEs) influence cancer progression but are complex and often differ between patients. Considering that microenvironment variations may reveal rules governing intratumoral cellular programs and disease outcome, we focused on tumor-to-tumor variation to examine 52 head and neck squamous cell carcinomas. We found that macrophage polarity—defined by
CXCL9
and
SPP1
(CS) expression but not by conventional M1 and M2 markers—had a noticeably strong prognostic association. CS macrophage polarity also identified a highly coordinated network of either pro- or antitumor variables, which involved each tumor-associated cell type and was spatially organized. We extended these findings to other cancer indications. Overall, these results suggest that, despite their complexity, TMEs coordinate coherent responses that control human cancers and for which CS macrophage polarity is a relevant yet simple variable.
A stable rhombohedral phase in ferroelectric Hf(Zr)
1+

x

O
2
capacitor with ultralow coercive field
Authors: Wang Yuan , Tao Lei , Guzman Roger , Luo Qing , Zhou Wu , Yang Yang , Wei Yingfen , Liu Yu , Jiang Pengfei , Chen Yuting , Lv Shuxian , Ding Yaxin , Wei Wei , Gong Tiancheng , Wang Yan , Liu Qi , Du Shixuan , Liu Ming
Published: August 2023

Hafnium oxide–based ferroelectric materials are promising candidates for next-generation nanoscale devices because of their ability to integrate into silicon electronics. However, the intrinsic high coercive field of the fluorite-structure oxide ferroelectric devices leads to incompatible operating voltage and limited endurance performance. We discovered a complementary metal-oxide semiconductor (CMOS)–compatible rhombohedral ferroelectric Hf(Zr)
1+

x

O
2
material rich in hafnium-zirconium [Hf(Zr)]. X-ray diffraction combined with scanning transmission electron microscopy reveals that the excess Hf(Zr) atoms intercalate within the hollow sites. We found that the intercalated atoms expand the lattice and increase the in-plane and out-of-plane stresses, which stabilize both the rhombohedral phase (r-phase) and its ferroelectric properties. Our ferroelectric devices, which are based on the r-phase Hf(Zr)
1+

x

O
2
, exhibit an ultralow coercive field (~0.65 megavolts per centimeter). Moreover, we achieved a high endurance of more than 10
12
cycles at saturation polarization. This material discovery may help to realize low-cost and long-life memory chips.
Intrinsically elastic polymer ferroelectric by precise slight cross-linking
Authors: Gao Liang , Hu Ben-Lin , Wang Linping , Cao Jinwei , He Ri , Zhang Fengyuan , Wang Zhiming , Xue Wuhong , Yang Huali , Li Run-Wei
Published: August 2023

Ferroelectrics are an integral component of the modern world and are of importance in electrics, electronics, and biomedicine. However, their usage in emerging wearable electronics is limited by inelastic deformation. We developed intrinsically elastic ferroelectrics by combining ferroelectric response and elastic resilience into one material by slight cross-linking of plastic ferroelectric polymers. The precise slight cross-linking can realize the complex balance between crystallinity and resilience. Thus, we obtained an elastic ferroelectric with a stable ferroelectric response under mechanical deformation up to 70% strain. This elastic ferroelectric exerts potentials in applications related to wearable electronics, such as elastic ferroelectric sensors, information storage, and energy transduction.
Diverse sleep strategies at sea
Authors: Rattenborg Niels C.
Published: August 2023

Findings in marine mammals and birds provide opportunities to explore sleep’s functions
Methods for assessing social and cultural losses
Authors: Gregory Robin , Halteman Philip , Kaechele Nicole , Satterfield Terre
Published: August 2023

Compensation for damages can and should address social and cultural impacts
Turning the tide on obesity?
Authors: Bulik Cynthia M. , Hardaway J. Andrew
Published: August 2023

Genetics, ultraprocessed foods, portion distortion, sweetened beverages, screen time, food addiction, intestinal microbiota, diet culture, weight stigma, food insecurity—all have been implicated in the “obesity epidemic.” More than a billion people worldwide have obesity, and many more are overweight. With the emergence of new, highly effective weight-loss drugs, might the “fat decades” become a closed chapter in the history of public health?
Forging connections
Authors: Curry Andrew
Published: August 2023

DNA from enslaved Black workers at a 19th century iron forge links them to living descendants. But the research swirls with ethical questions
Side effects loom over Alzheimer’s drugs
Authors: Couzin-Frankel Jennifer
Published: August 2023

Despite landmark antibody approval, research into brain swelling and bleeding lags
Structural and functional studies of PCNA from African swine fever virus
Authors: Shao Zhiwei , Yang Jie , Gao Yanqing , Zhang Yixi , Zhao Xin , Shao Qiyuan , Zhang Weizhen , Cao Chulei , Liu Hehua , Gan Jianhua
Published: August 2023

Proliferating cell nuclear antigen (PCNA) belongs to the DNA sliding clamp family. Via interacting with various partner proteins, PCNA plays critical roles in DNA replication, DNA repair, chromatin assembly, epigenetic inheritance, chromatin remodeling, and many other fundamental biological processes. Although PCNA and PCNA-interacting partner networks are conserved across species, PCNA of a given species is rarely functional in heterologous systems, emphasizing the importance of more representative PCNA studies. Here, we report two crystal structures of PCNA from African swine fever virus (ASFV), which is the only member of the
Asfarviridae
family. Compared to the eukaryotic and archaeal PCNAs and the sliding clamp structural homologs from other viruses,
Asfv
PCNA possesses unique sequences and/or conformations at several regions, such as the J-loop, interdomain-connecting loop (IDCL), P-loop, and C-tail, which are involved in partner recognition or modification of sliding clamps. In addition to double-stranded DNA binding, we also demonstrate that
Asfv
PCNA can modestly enhance the ligation activity of the
Asfv
LIG protein. The unique structural features of
Asfv
PCNA can serve as a potential target for the development of ASFV-specific inhibitors and help combat the deadly virus.

IMPORTANCE

Two high-resolution crystal structures of African swine fever virus proliferating cell nuclear antigen (
Asfv
PCNA) are presented here. Structural comparison revealed that
Asfv
PCNA is unique at several regions, such as the J-loop, the interdomain-connecting loop linker, and the P-loop, which may play important roles in ASFV-specific partner selection of
Asfv
PCNA. Unlike eukaryotic and archaeal PCNAs,
Asfv
PCNA possesses high double-stranded DNA-binding affinity. Besides DNA binding,
Asfv
PCNA can also modestly enhance the ligation activity of the
Asfv
LIG protein, which is essential for the replication and repair of ASFV genome. The unique structural features make
Asfv
PCNA a potential target for drug development, which will help combat the deadly virus.
Pancreatitis with infected pseudocyst presenting as a prevertebral abscess with spontaneous rupture into the oesophagus
Authors: Shivakumar Madan , Prakash Sagar , Shaikh Oseen Hajilal , Kumbhar Uday Shamrao
Published: August 2023

The development of a prevertebral abscess due to an infected pancreatic pseudocyst and its spontaneous rupture into the oesophagus is a rare complication. We report a man who presented with odynophagia, dyspnoea and abdominal pain. Contrast-enhanced CT showed evidence of pancreatitis and a prevertebral space abscess communicating with the pancreas through the oesophageal hiatus. The patient was diagnosed to have a prevertebral abscess with chronic pancreatitis. Surgical drainage was planned, but the patient died of spontaneous drainage of the prevertebral abscess into the oesophagus and aspiration of the collection into the lungs.
Prolonged febrile illness following first dose of ChAdOx1
Authors: Caruana Dingli Michael , Bugeja Luke , Camilleri Robert
Published: August 2023

A woman in her 40s, with a known history of fibromyalgia, presented with high-grade fever and constitutional symptoms occurring 5 days following vaccination with Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1). Her inflammatory markers and neutrophil count were found to be elevated and as such, she was started on antibiotics. Despite treatment, markers remained elevated and temperature spikes persisted for another 4 weeks before these symptoms subsided, and her blood tests normalised. All investigations taken in the interim were negative, with no source being identified for the fever. As a result, a positron emission tomography scan was performed to attempt to localise the source of these symptoms. This revealed low-to-moderate grade lymph node tracer uptake above and below the diaphragm most pervasive in the right axilla, with uptake in the right arm corresponding with the site of vaccination.
Optimal dose and type of physical activity to improve functional capacity and minimise adverse events in acutely hospitalised older adults: a systematic review with dose-response network meta-analysis of randomised controlled trials
Authors: Gallardo-Gómez Daniel , del Pozo-Cruz Jesús , Pedder Hugo , Alfonso-Rosa Rosa M , Álvarez-Barbosa Francisco , Noetel Michael , Jasper Unyime , Chastin Sebastien , Ramos-Munell Javier , del Pozo Cruz Borja
Published: August 2023

Objective

To identify the optimal dose and type of physical activity to improve functional capacity and reduce adverse events in acutely hospitalised older adults.

Design

Systematic review and Bayesian model-based network meta-analysis.

Data sources

Four databases were searched from inception to 20 June 2022.

Eligibility criteria for selecting studies

Randomised controlled trials that assessed the effectiveness of a physical activity-based intervention on at least one functional outcome in people aged ≥50 years hospitalised due to an acute medical condition were included. Pooled effect estimates (ie, standardised mean differences for functional capacity and the ratio of means for adverse events) were calculated using random treatment effects network meta-analysis models.

Results

Nineteen studies (3842 participants) met the inclusion criteria. Approximately 100 Metabolic Equivalents of Task per day (METs-min/day) (~40 min/day of light effort or ~25 min/day of moderate effort activities) was the minimal dose to improve the functional capacity of acute hospitalised older adults (standardised mean difference (SMD)=0.28, 95% credible interval (CrI) 0.01 to 0.55). The optimal dose was estimated at 159 METs-min/day (~70 min/day of light effort or ~40 min/day of moderate effort activities; SMD=0.41, 95% CrI 0.08 to 0.72). Ambulation was deemed the most efficient intervention, and the optimal dose was reached at 143 METs-min/day (~50 min/day of slow-paced walking; SMD=0.76, 95% CrI 0.35 to 1.16), showing a high evidential power (87.68%). The minimal effective ambulation dose was estimated at 74 METs-min/day (~25 min/day of slow-paced walking; SMD=0.25, 95% CrI 0.01 to 0.41). Physical activity interventions resulted in a decrease in the rate of adverse events compared with usual care at discharge (ratio of means=0.96, 95% CrI 0.95 to 0.97; median time 7 days).

Conclusions

This meta-analysis yielded low to moderate evidence supporting the use of in-hospital supervised physical activity programmes in acutely hospitalised older adults. As little as ~25 min/day of slow-paced walking is sufficient to improve functional capacity and minimise adverse events in this population.

Trial registration number

PROSPERO CRD42021271999.
Study profile: the Genetics of Glaucoma Study
Authors: Gharahkhani Puya , He Weixiong , Diaz Torres Santiago , Wu Yeda , Ingold Nathan , Yu Regina , Seviiri Mathias , Ong Jue-Sheng , Law Matthew H , Craig Jamie E , Mackey David A , Hewitt Alex W , MacGregor Stuart
Published: August 2023

Purpose

Glaucoma, a major cause of irreversible blindness, is a highly heritable human disease. Currently, the majority of the risk genes for glaucoma are unknown. We established the Genetics of Glaucoma Study (GOGS) to identify disease genes and improve genetic prediction of glaucoma risk and response to treatment.

Participants

More than 5700 participants with glaucoma or a family history of glaucoma were recruited through a media campaign and the Australian Government healthcare service provider, Services Australia, making GOGS one of the largest genetic studies of glaucoma globally. The mean age of the participants was 65.30±9.36 years, and 62% were female. Participants completed a questionnaire obtaining information about their glaucoma-related medical history such as family history, glaucoma status and subtypes, surgical procedures, and prescriptions. The questionnaire also obtained information about other eye and systemic diseases. Approximately 80% of the participants provided a DNA sample and ~70% consented to data linkage to their Australian Government Medicare and Pharmaceutical Benefits Scheme schedules.

Findings to date

4336 GOGS participants reported that an optometrist or ophthalmologist has diagnosed them with glaucoma and 3639 participants reported having a family history of glaucoma. The vast majority of the participants (N=4393) had used at least one glaucoma-related medication; latanoprost was the most commonly prescribed drug (54% of the participants who had a glaucoma prescription). A subset of the participants reported a surgical treatment for glaucoma including a laser surgery in 2008 participants and a non-laser operation in 803 participants. Several comorbid eye and systemic diseases were also observed; the most common reports were ocular hypertension (53% of the participants), cataract (48%), hypertension (40%), nearsightedness (31%), astigmatism (22%), farsightedness (16%), diabetes (12%), sleep apnoea (11%) and migraines (10%).

Future plans

GOGS will contribute to the global gene-mapping efforts as one of the largest genetic studies for glaucoma. We will also use GOGS to develop or validate genetic risk prediction models to stratify glaucoma risk, particularly in individuals with a family history of glaucoma, and to predict clinical outcomes (eg, which medication works better for an individual and whether glaucoma surgery is required). GOGS will also help us answer various research questions about genetic overlap and causal relationships between glaucoma and its comorbidities.
Assessing a nurse-assisted eHealth intervention posthospital discharge in adult patients with non-communicable diseases: a protocol for a feasibility study
Authors: Morken Ingvild Margreta , Wathne Hege Bjøkne , Karlsen Bjørg , Storm Marianne , Nordfonn Oda Karin , Gjeilo Kari Hanne , Urstad Kristin Hjorthaug , Søreide Jon Arne , Husebø Anne Marie
Published: August 2023

Introduction

A growing number of patients with non-communicable diseases (NCDs), such as heart failure (HF) and colorectal cancer (CRC), are prone to comorbidity, a high rate of readmissions and complex healthcare needs. An eHealth intervention, however, could potentially ameliorate the increasing burdens associated with NCDs by helping to smoothen patient transition from hospital to home and by reducing the number of readmissions. This feasibility study therefore aims to assess the feasibility of a nurse-assisted eHealth intervention posthospital discharge among patients with HF and CRC, while also examining the preliminary clinical and behavioural outcomes of the intervention before initiating a full-scale randomised controlled trial. The recruitment ended in January 2023.

Methods and analysis

Twenty adult patients with HF and 10 adult patients with CRC will be recruited from two university hospitals in Norway. Six hospital-based nurse navigators (NNs) will offer support during the transition phase from hospital to home by using a solution for digital remote care, Dignio Connected Care. The patients will use the MyDignio application uploaded to an iPad for 30 days postdischarge. The interactions between patients and NNs will then be assessed through direct observation and qualitative interviews in line with a think-aloud protocol. Following the intervention, semistructured interviews will be used to explore patients’ experiences of eHealth support and NNs’ experiences of eHealth delivery. The feasibility testing will also comprise a post-test of the Post-System Usability Questionnaire and pretesting of patient-reported outcomes questionnaires, as well as an inspection of user data collected from the software.

Ethics and dissemination

The study has been approved by the Norwegian Centre for Research Data (ID.NO: 523386). All participation is based on informed, written consent. The results of the study will be published in open-access, peer-reviewed journals and presented at international and national scientific conferences and meetings.
Identifying older adults at increased risk of medication-related readmission to hospital within 30 days of discharge: development and validation of a risk assessment tool
Authors: Glans Maria , Kempen Thomas Gerardus Hendrik , Jakobsson Ulf , Kragh Ekstam Annika , Bondesson Åsa , Midlöv Patrik
Published: August 2023

Objective

Developing and validating a risk assessment tool aiming to identify older adults (≥65 years) at increased risk of possibly medication-related readmission to hospital within 30 days of discharge.

Design

Retrospective cohort study.

Setting

The risk score was developed using data from a hospital in southern Sweden and validated using data from four hospitals in the mid-eastern part of Sweden.

Participants

The development cohort (n=720) was admitted to hospital during 2017, whereas the validation cohort (n=892) was admitted during 2017–2018.

Measures

The risk assessment tool aims to predict possibly medication-related readmission to hospital within 30 days of discharge. Variables known at first admission and individually associated with possibly medication-related readmission were used in development. The included variables were assigned points, and Youden’s index was used to decide a threshold score. The risk score was calculated for all individuals in both cohorts. Area under the receiver operating characteristic (ROC) curve (c-index) was used to measure the discrimination of the developed risk score. Sensitivity, specificity and positive and negative predictive values were calculated using cross-tabulation.

Results

The developed risk assessment tool, the Hospitalisations, Own home, Medications, and Emergency admission (HOME) Score, had a c-index of 0.69 in the development cohort and 0.65 in the validation cohort. It showed sensitivity 76%, specificity 54%, positive predictive value 29% and negative predictive value 90% at the threshold score in the development cohort.

Conclusion

The HOME Score can be used to identify older adults at increased risk of possibly medication-related readmission within 30 days of discharge. The tool is easy to use and includes variables available in electronic health records at admission, thus making it possible to implement risk-reducing activities during the hospital stay as well as at discharge and in transitions of care. Further studies are needed to investigate the clinical usefulness of the HOME Score as well as the benefits of implemented activities.
Depression, anxiety and quality of life of Afghan women living in urban areas under the Taliban government: a cross-sectional study
Authors: Neyazi Ahmad , Padhi Bijaya K , Mohammadi Ab Qadim , Ahmadi Mahsa , Erfan Adiba , Bashiri Bahara , Neyazi Mehrab , Ishaqzada Marjina , Noormohammadi Morteza , Griffiths Mark D
Published: August 2023

Objectives

According to the World Health Organization, depression is a common mental health illness that is characterised by a persistent feeling of sadness and loss of interest. The present study examined the association of two mental health variables (ie, depression, anxiety) with quality of life (QoL) and the sociodemographic characteristics of Afghan women living in urban areas under the rule of Taliban government in Afghanistan.

Design

Cross-sectional study administered between 10 November 2021 to 25 December 2021 among women.

Setting

Across major provinces of Afghanistan (Herat, Mazar-e-Sharif, Kabul and Samangan).

Measurements

Data were collected using a pretested structured questionnaire. Data entry was carried out using Microsoft Excel 2016. And then exported to IBM SPSS V.26 for Microsoft Windows. Logistic regression models were used to examine the association of depression, anxiety with QoL and sociodemographic characteristics among women (N=438).

Results

The prevalence of depression symptoms was 80.4%, and the prevalence of mild to extremely severe anxiety was 81.0%. Depression symptoms among Afghan women were associated with being older, having more children, lower education level, other individuals’ bad behaviour, bad events experienced in the past month, and feeling physically ill. Multiple regression analysis indicated that low monthly household income (adjusted OR, AOR 2.260; 95% CI 1.179 to 4.331, p=0.014) poor physical domain of QoL (AOR 4.436; 95% CI 1.748 to 11.256, p=0.002) and poor psychological domain of QoL (AOR 23.499; 95% CI 7.737 to 71.369, p<0.001) were significantly associated with depression.

Conclusion

The prevalence of depression was high among women living under the government of the Taliban in Afghanistan. Considering the high prevalence of depression, anxiety and their impact on QoL and the overall quality of healthcare services, international health organisations should implement programmes for regular screening of depression and anxiety, and there should be psychological counselling services available for vulnerable women living under the government of the Taliban.
Serological survey to estimate SARS-CoV-2 infection and antibody seroprevalence at a large public university: A cross-sectional study
Authors: Hou Ching-Wen , Williams Stacy , Taylor Kylee , Boyle Veronica , Bobbett Bradley , Kouvetakis Joseph , Nguyen Keana , McDonald Aaron , Harris Valerie , Nussle Benjamin , Scharf Phillip , Jehn Megan L , Lant Timothy , Magee Mitchell , Chung Yunro , LaBaer Joshua , Murugan Vel
Published: August 2023

Objective

This study investigated the seroprevalence of SARS-CoV-2 antibodies among adults over 18 years.

Design

Prospective cohort study.

Settings

A large public university.

Participants

This study took volunteers over 5 days and recruited 1064 adult participants.

Primary outcome measures

Seroprevalence of SARS-CoV-2-specific antibodies due to previous exposure to SARS-CoV-2 and/or vaccination.

Results

The seroprevalence of the antireceptor binding domain (RBD) antibody was 90% by a lateral flow assay and 88% by a semiquantitative chemiluminescent immunoassay. The seroprevalence for antinucleocapsid was 20%. In addition, individuals with previous natural COVID-19 infection plus vaccination had higher anti-RBD antibody levels compared with those who had vaccination only or infection only. Individuals who had a breakthrough infection had the highest anti-RBD antibody levels.

Conclusion

Accurate estimates of the cumulative incidence of SARS-CoV-2 infection can inform the development of university risk mitigation protocols such as encouraging booster shots, extending mask mandates or reverting to online classes. It could help us to have clear guidance to act at the first sign of the next surge as well, especially since there is a surge of COVID-19 subvariant infections.
Using community-based geographical information system (GIS) to recruit older Asian Americans in an Alzheimer’s disease study
Authors: Lee Haeok , Ha Hoehun , Yim Sejung , Yang Hyun-Sik , Lee Veronica , Hong Eunju , Chow Tiffany W , Park Van Ta , Wang Li-San , Jun Gyungah , Choi Yun-Beom
Published: August 2023

Objective

This study aims to show the usefulness of incorporating a community-based geographical information system (GIS) in recruiting research participants for the Asian Cohort for Alzheimer’s Disease (ACAD) study for using the subgroup of Korean American (KA) older adults. The ACAD study is the first large study in the USA and Canada focusing on the recruitment of Chinese, Korean and Vietnamese older adults to address the issues of under-representation of Asian Americans in clinical research.

Methods

To promote clinical research participation of racial/ethnic minority older adults with and without dementia, we used GIS by collaborating with community members to delineate boundaries for geographical clusters and enclaves of church and senior networks, and KA serving ethnic clinics. In addition, we used socioeconomic data identified as recruitment factors unique to KA older adults which was analysed for developing recruitment strategies.

Results

GIS maps show a visualisation of the heterogeneity of the sociodemographic characteristics and the resources of faith-based organisations and KA serving local clinics. We addressed these factors that disproportionately affect participation in clinical research and successfully recruited the intended participants (N=60) in the proposed period.

Discussion

Using GIS maps to locate KA provided innovative inroads to successful research outreach efforts for a pilot study that may be expanded to other underserved populations across the USA in the future. We will use this tool subsequently on a large-scale clinical genetic epidemiology study.

Policy implication

This approach responds to the call from the National Institute on Aging to develop strategies to improve the health status of older adults in diverse populations. Our study will offer a practical guidance to health researchers and policymakers in identifying understudied and hard-to-reach specific Asian American populations for clinical studies or initiatives. This would further contribute in reducing the health and research disparity gaps among older minority populations.
Pneumonia in newly diagnosed patients infected with the Omicron variant: a population-based study of Chinese patients in Chongqing
Authors: Wang Huyu , Chen Rouqian , Guo Jing , Shui Lili , Xiong Jian , Chen Yajuan
Published: August 2023

Background

Pneumonia is the main complication of the Omicron variant of SARS-CoV-2; however, the incidence proportions and prognostic factors for Omicron-associated pneumonia have not been established. We conducted this study to characterise the incidence proportions and influence of various factors on prognosis of Omicron-associated pneumonia.

Methods

We collected data from 714 patients infected with the Omicron variant in The First Affiliated Hospital of Chongqing Medical University (Chongqing, China) who were divided into different groups for analysis.

Results

We identified 313 patients with Omicron-associated pneumonia at the time of diagnosis of patients infected with the Omicron variant, representing 43.8% of the entire cohort. A total of 82 were 15–59 years old, 71 were 60–69 years old, 76 were 70–79 years old and 84 were >80 years old. 133 were female and 180 were male. Incidence proportions of pneumonia were highest among patients with cardiovascular (82.4% of the basic disease of the cardiovascular system subset) or kidney disease (92.3% of the kidney disease subset), whereas patients with lung cancer (35.7% of the lung cancer subset) had a lower incidence proportion. Several factors were associated with the prognosis of pneumonia in patients infected with the Omicron variant. Patients with a thrombosis or pleural effusion had a longer hospitalisation time. Paxlovid and immunoglobulins improved the prognosis of patients with severe pneumonia. The following measures were significantly different in patients as a function of disease severity: number of neutrophils and lymphocytes, partial oxygen pressure; and myoglobin, lactic dehydrogenase, aspartate transaminase and procalcitonin levels.

Conclusion

Patients infected with the Omicron variant with coexisting cardiovascular or kidney disease, but not respiratory disease, had a higher incidence proportion of pneumonia. Paxlovid and immunoglobulins can be used in patients with severe infections to improve prognosis.
Multiple TMA-aided CRISPR/Cas13a platform for highly sensitive detection of IL-15 to predict immunotherapeutic response in nasopharyngeal carcinoma
Authors: Wu Ya-Xian , Xing Shan , Wang Yu , Tian Bo-Yu , Wu Meng , Wang Xue-Ping , Huang Qi , He Xia , Chen Shu-Lin , Li Xiao-Hui , Zeng Mu-Sheng , Liu Wan-Li
Published: August 2023

Background

Immune checkpoint inhibitors (ICIs)-based treatments have been recommended as the first line for refractory recurrent and/or metastatic nasopharyngeal carcinoma (NPC) patients, yet responses vary, and predictive biomarkers are urgently needed. We selected serum interleukin-15 (sIL-15) out of four interleukins as a candidate biomarker, while most patients’ sIL-15 levels were too low to be detected by conventional methods, so it was necessary to construct a highly sensitive method to detect sIL-15 in order to select NPC patients who would benefit most or least from ICIs.

Methods

Combining a primer exchange reaction (PER), transcription-mediated amplification (TMA), and a immuno-PER-TMA-CRISPR/Cas13a system, we developed a novel multiple signal amplification platform with a detection limit of 32 fg/mL, making it 153-fold more sensitive than ELISA.

Results

This platform demonstrated high specificity, repeatability, and versatility. When applied to two independent cohorts of 130 NPC sera, the predictive value of sIL-15 was accurate in both cohorts (area under the curve: training, 0.882; validation, 0.898). Additionally, lower sIL-15 levels were correlated with poorer progression-free survival (training, HR: 0.080, p<0.0001; validation, HR: 0.053, p<0.0001).

Conclusion

This work proposes a simple and sensitive approach for sIL-15 detection to provide insights for personalized immunotherapy of NPC patients.
Transcutaneous auricular branch vagal nerve stimulation as a non-invasive add-on therapeutic approach for pain in systemic sclerosis
Authors: Bellocchi Chiara , Carandina Angelica , Della Torre Alice , Turzi Massimiliano , Arosio Beatrice , Marchini Maurizio , Vigone Barbara , Scatà Costanza , Beretta Lorenzo , Rodrigues Gabriel Dias , Tobaldini Eleonora , Montano Nicola
Published: August 2023

Objective

Systemic sclerosis (SSc) is an autoimmune disease with health-related quality of life (HRQoL) high impairment. Pain is of paramount importance to be targeted by therapeutical approaches. Our study aim was to perform an add-on device-based non-invasive neuromodulatory treatment through transcutaneous auricular vagal nerve stimulation (tVNS) in patients with SSc, assessing its effects on pain as primary endpoint and on inflammation, cardiovascular autonomic control and HRQoL.

Methods

Thirty-two patients with SSc were enrolled based on reported pain assessed through Numeric Rating Scale (NRS). Twenty-one (90% with limited cutaneous SSc) completed a randomised, cross-over, patient-blind trial, in which interventional and active control were used in random order for 4 weeks, interspersed with 4 weeks washout. NRS, Patient-Reported Outcomes Measurement Information System-29 (PROMIS-29) Item4 for pain interference, heart rate variability (HRV), serum cytokines and HRQoL questionnaires (Health Assessment Questionnaire, Patient Health Questionnaire-9, University of California, Los Angeles Gastrointestinal Tract, Pittsburgh Sleep Quality Index) were assessed at baseline, at T1 (after 1 month of tVNS or active control), at T2 (after washout) and at T3 (after 1 month of active control or tVNS). T-test for paired data and Wilcoxon signed-rank test for non-normally distributed parameters were performed to compare the effect of tVNS and active control.

Results

NRS pain was significantly reduced by tVNS and not by active control (Mean±SD: −27.7%±21.3% vs −7.7%±26.3%, p=0.002). Interleukin-6 was downregulated in tVNS versus active control (p=0.029). No significant differences were observed in tVNS versus active control for PROMIS-29 Item4, QoL scales and HRV with both spectral and symbolic analyses.

Conclusion

tVNS demonstrated to be a safe and non-invasive add-on tool to reduce pain in SSc.
Bigger, stronger and cheaper: growth in e-cigarette market driven by disposable devices with more e-liquid, higher nicotine concentration and declining prices
Authors: Diaz Megan C , Silver Nathan A , Bertrand Adrian , Schillo Barbara A
Published: August 2023

Objective

Given the evolving changes in the disposable e-cigarette market, we explore patterns of sales in the USA by e-liquid volume capacity, nicotine strength and real sales-weighted average prices by both e-cigarette unit and volume of e-liquid.

Methodology

We used NielsenIQ retail scanner data from January 2017 to September 2022 to examine changes over time for average product volume capacity in millilitres, nicotine strength (%) and both sales-weighted average price per disposable unit and per millilitre of e-liquid for each 4-week period.

Results

Among disposable e-cigarettes sold between January 2017 and September 2022, average volume capacity increased 518% from 1.1 mL to 5.7 mL and average nicotine strength increased 294% from 1.7% to 5%. Sales-weighted average price per disposable unit and millilitres of e-liquid both remained relatively constant until January 2020. From January 2020 through September 2022, average unit prices increased 165.7% from US$8.49 to US$14.07, while the average price of 1 mL of e-liquid decreased 69.2% from US$7.96 to US$2.45.

Conclusions

The current regulatory regime around e-cigarettes has resulted in disposable e-cigarette manufacturers providing consumers with bigger, cheaper disposable e-cigarettes that come in increasingly higher nicotine strengths. Tobacco policy recommendations such as restricting e-liquid capacity and minimum price laws as well as regulations on product characteristics that affect nicotine emissions and delivery such as nicotine strength, nicotine output, device power, and puff duration should be considered in regulating the e-cigarette market.