bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral simultaneous cataract surgery and intraocular lens implantation in an adult female chimpanzee (Pan troglodytes) inducing monovision
Authors: Notting F. , Cheng Y. , Marinkovic M. , van Bolhuis H. , Notting I.
Published: May 2023

Background

Cataract is the major cause of visual impairment in humans. Phacoemulsification with intraocular lens (IOL) implantation is the standard technique for cataract treatment with a high success rate. In a few cases, the surgical cataract procedure and lens implantation have been applied in non‐human primates.

Case Description

A +/− 40‐year‐old female chimpanzee (Pan troglodytes) in captivity was diagnosed with mature cataract optical density (OD) and posterior subcapsular cataract combined with cortical opacities OS after ophthalmic examination. To restore vision and facilitate far‐ and near sight, phacoemulsification OU with +22.5 diopter (D) IOL implantation OD and + 24 D OS were performed. Despite complicated surgery OD due to posterior capsular rupture, the outcome was successful during 1‐year follow‐up. The chimpanzee regained adequate vision, normal behavior, and was successfully re‐introduced to her group of chimpanzees.

Conclusion

This is the first case report of a simultaneous bilateral cataract surgery with IOL implantations in both eyes, targeting emmetropia OS and near vision OD resulting in monovision, in a chimpanzee. Vision was restored without postoperative complications.
Immune response after rabies pre‐exposure prophylaxis and a booster dose in Australian bat carers
Authors: Guo Yihan , Mills Deborah J. , Lau Colleen L. , Mills Christine , Furuya‐Kanamori Luis
Published: May 2023

Periodic vaccination against rabies is essential for individuals at continuing risk of rabies exposure. There is limited evidence on long‐term immunogenicity after a 3‐dose intramuscular (3IM) pre‐exposure prophylaxis (PrEP) and single IM booster dose, thus current guideline recommendations differ in the interval for serology tests following PrEP and boosters. This study investigated post‐PrEP and post‐booster persistence of antibodies in Australian bat carers. Bat carers who received 3IM PrEP/booster doses and had post‐PrEP/booster serology test results were included. The proportion of antibody‐negative (<0.5 EU/mL) individuals after PrEP/booster dose were examined. Three hundred and five participants (65.6% females, median age at PrEP 43.1 years) were included. The proportion who were antibody‐negative varied depending on the time between 3IM PrEP and the serology test: 8.0% <1 year, 29.8% 1–2 years, 21.2% 2–3 years and 7.7% >3 years. Ninety‐one participants receiving booster doses were further assessed. Only one participant was antibody‐negative at >3 years after receiving one IM booster dose. Our findings support that a serology test should be performed 1 year after 3IM PrEP, followed by first booster if required. Rabies antibodies persist for many years after receiving the booster doses. The interval between subsequent serology tests and the first booster dose should be no longer than 3 years. Future studies are required to provide more insight into the most appropriate timing of subsequent boosters.
Assessment of Newly-Designed Hybrid Nanofluid-Cooled Micro-Channeled Thermal Management System for Li-Ion Battery
Authors: Kumar Kartik , Sarkar Jahar , Mondal Swasti Sundar
Published: May 2023

Maintaining both maximum temperature and temperature uniformity within the desirable limit is a crucial issue for high C-rating Li-ion batteries of electric vehicles, which can be achieved by the properly designed battery thermal management system (BTMS). In this research, three new designs of liquid-cooled micro-channeled BTMS are suggested for cylindrical batteries to address the issue of temperature variations and uneven temperature distribution. Using 3D numerical simulation, we investigate the impacts of volume flowrate and the usage of mono/hybrid nanofluids with varying concentrations on the thermal performance of the battery pack at a high C-rate by utilizing a two-phase mixture model. Effects on maximum temperature, temperature uniformity, pumping power, and heat transfer coefficient to pressure drop ratio are investigated. Results demonstrate that the effectiveness of heat transmission and temperature uniformity of the battery pack are positively impacted by an increase in nanoparticle concentration in nanofluid and volume flow rate. Even at high C-rates (5 C), the proposed design can effectively reduce both cell temperature and thermal gradient of the 21700-type cylindrical cell. Design 3 is the most favorable BTMS for Li-ion cylindrical battery in terms of both maximum temperature and temperature uniformity (maximum temperature of 304.72 K and temperature difference of 4.7 K).
Deep Learning-Based Denoising of Acoustic Images Generated With Point Contact Method
Authors: Jadhav Suyog , Kuchibhotla Ravali , Agarwal Krishna , Habib Anowarul , Prasad Dilip K.
Published: May 2023

The versatile nature of ultrasound imaging finds applications in various fields. A point contact excitation and detection method is generally used for visualizing the acoustic waves in Lead Zirconate Titanate (PZT) ceramics. Such an excitation method with a delta pulse generates a broadband frequency spectrum and wide directional wave vector. The presence of noise in the ultrasonic signals severely degrades the resolution and image quality. Deep learning-based signal and image denoising have been demonstrated recently. This paper bench-marked and compared several state-of-the-art deep learning image denoising methods with the classical denoising methods. The best-performing deep learning models are observed to be performing at par or, in some cases, even better than the classical methods on ultrasonic images. We further demonstrate the effectiveness and versatility of the deep learning-based denoising model for the unexplored domain of ultrasound/ultrasonic data. We conclude with a discussion on selecting the best method for denoising ultrasonic images. The impact of this work may help ultrasound-based defects identification equipment manufacturers to adopt a deep learning-based denoising model for more wider and versatile use.
Influence of boron contents on mechanical properties and high-temperature tribological behavior in (AlCrNbTiB)N coatings
Authors: Chen Tzu-Ling , Hsu Sheng-Yu , Lai Yuan-Tai , Chang Shou-Yi , Hung Hsueh-Hsing , Tsai Su-Yueh , Duh Jenq-Gong
Published: May 2023

Various boron contents of AlCrNbTiBN coatings were prepared by radiofrequency reactive magnetron cosputtering on both 304 stainless steel and 100 silicon substrates. Boron-doped AlCrNbTiN coatings resulted in a dense structure and a decrease in the grain size. As compared to boron-free coatings, the hardness of AlCrNbTiBN coatings increased from 25.8 to 31.1 GPa at a boron content of 3.3 at. %. The AlCrNbTiBN coatings exhibited favorable hardness due to the increased dense structure, defect density, grain refinement, and solid solution strengthening. The wear test at 700 °C showed that coatings without boron reveal three times the wear rate than those coatings doped with boron. In this study, the multicomponent (AlCrNbTiBN) coating demonstrated favorable mechanical and tribological properties. This implies that AlCrNbTiBN coatings might provide promising applicability in the wear-resistant field at high temperatures. Furthermore, boron-doped multicomponent nitride coating appears to enhance coating’s mechanical properties and wear resistance, indicating potential development in the near future.
Comparison Between Cardiorespiratory Fitness and Functions of Cognitive Control in Adolescents: A Tracking Study of 3 Years
Authors: Weber Vinícius Muller Reis , Castro‐Piñero Jose , Cesar da Costa Julio , Fernandes Daniel Zanardini , Romanzini Marcelo , Ronque Enio Ricardo Vaz
Published: May 2023

Purpose: Compare tracking groups with cognitive control functions and plasma brain-derived neurotrophic factors concentrations from childhood to adolescence. Methods: This is a prospective study with 3 years of follow-up. At baseline, data from 394 individuals were collected (11.7 y), and data were obtained from 134 adolescents (14.9 y) at the 3-year follow-up. At both time points, anthropometric and maximal oxygen uptake data were collected. Cardiorespiratory fitness (CRF) groups were classified into high or low CRF. At follow-up, cognitive outcomes were collected via the Stroop and Corsi block test; plasma brain-derived neurotrophic factors concentrations were also analyzed. Results: Comparisons demonstrated that maintaining high CRF over 3 years results in shorter reaction time, better inhibitory control, and higher working memory values. Likewise, the group that moved from low to high CRF over 3 years presented better reaction time. Plasma brain-derived neurotrophic factors concentrations were higher for the group that increased its CRF over the 3 years in relation to the low–low group (90.58 pg·mL−1; P = .004). However, after scaling by an allometric approach, differences were only found for reaction time and working memory between high–high and high–low groups. Conclusion: Maintaining high CRF over 3 years was positively related to reaction time and working memory in relation to adolescents that decreased their levels of CRF.
Genetics of mirror movements identifies a multifunctional complex required for Netrin-1 guidance and lateralization of motor control
Authors: Schlienger Sabrina , Yam Patricia T. , Balekoglu Nursen , Ducuing Hugo , Michaud Jean-Francois , Makihara Shirin , Kramer Daniel K. , Chen Baoyu , Fasano Alfonso , Berardelli Alfredo , Hamdan Fadi F. , Rouleau Guy A. , Srour Myriam , Charron Frederic
Published: May 2023

Mirror movements (MM) disorder is characterized by involuntary movements on one side of the body that mirror intentional movements on the opposite side. We performed genetic characterization of a family with autosomal dominant MM and identified
ARHGEF7
, a RhoGEF, as a candidate MM gene. We found that Arhgef7 and its partner Git1 bind directly to Dcc. Dcc is the receptor for Netrin-1, an axon guidance cue that attracts commissural axons to the midline, promoting the midline crossing of axon tracts. We show that Arhgef7 and Git1 are required for Netrin-1–mediated axon guidance and act as a multifunctional effector complex. Arhgef7/Git1 activates Rac1 and Cdc42 and inhibits Arf1 downstream of Netrin-1. Furthermore, Arhgef7/Git1, via Arf1, mediates the Netrin-1–induced increase in cell surface Dcc. Mice heterozygous for
Arhgef7
have defects in commissural axon trajectories and increased symmetrical paw placements during skilled walking, a MM-like phenotype. Thus, we have delineated how
ARHGEF7
mutation causes MM.
Broad responses to chemical adducts shape the natural antibody repertoire in early infancy
Authors: Mashiko Shunya , Shihab Ronzon R. , See Sarah B. , Schahadat Luca G. Z. , Aguiar Talita F. M. , Roy Poulomi , Porcheray Fabrice , Zorn Emmanuel
Published: May 2023

Natural antibodies are an integral part of innate humoral immunity yet their development and polyreactive nature are still enigmatic. Here, we show that characteristic monoclonal natural antibodies recognize common chemical moieties or adducts, supporting the view that polyreactive antibodies may often correspond to anti-adduct antibodies. We next examined the development of immunoglobulin M (IgM) and IgG to 81 ubiquitous adducts from birth to old age. Newborn IgM only reacted to a limited number of consensus determinants. This highly restricted neonatal repertoire abruptly diversified around 6 months of age through the development of antibodies to environmental antigens and age-driven epigenetic modifications. In contrast, the IgG repertoire was diverse across the entire life span. Our studies reveal an unrecognized component of humoral immunity directed to common adducts. These findings set the ground for further investigations into the role of anti-adduct B cell responses in homeostatic functions and pathological conditions.
Retinal waves align the concentric orientation map in mouse superior colliculus to the center of vision
Authors: Teh Kai Lun , Sibille Jérémie , Gehr Carolin , Kremkow Jens
Published: May 2023

Neurons in the mouse superior colliculus (SC) are arranged in a concentric orientation map, which is aligned to the center of vision and the optic flow experienced by the mouse. The origin of this map remains unclear. Here, we propose that spontaneous retinal waves during development provide a scaffold to establish the concentric orientation map within the SC and its alignment to the optic flow. We test this hypothesis by modeling the orientation-tuned SC neurons that receive ON/OFF retinal inputs. Our model suggests that the propagation direction bias of stage III retinal waves, together with OFF-delayed responses, shapes the spatial organization of the orientation map. The OFF delay establishes orientation-tuned neurons by segregating their ON/OFF receptive subfields, the wave-like activities form the concentric pattern, and the direction biases align the map to the center of vision. Together, retinal waves may play an instructive role in establishing functional properties of single SC neurons and their spatial organization within maps.
Improving the stability and color purity of a BT.2020 blue multiresonance emitter by alleviating hydrogen repulsion
Authors: Wang Xiang , Wang Lu , Meng Guoyun , Zeng Xuan , Zhang Dongdong , Duan Lian
Published: May 2023

Stable deep blue multiresonance emitters with small full width at half maximum (FWHM) are attractive for wide color-gamut organic light-emitting diodes (OLEDs). However, the steric repulsion from the spatially close hydrogens would twist the multiresonance skeletons, causing spectral broadening and molecular instability issues. Here, we strategically introduce a mesitylboron locking unit into a carbazole-embedded multiresonance model emitter, alleviating the hydrogen repulsions and also strengthening the para-positioned weak carbon-nitrogen bond in anionic states. An emission peaking at 452 nm with an FWHM of merely 14 nm and nearly BT.2020 blue chromaticity coordinates are obtained in toluene, affording a high maximum external quantum efficiency of 33.9% in a sensitizing device. Moreover, an impressive LT97 (time to decay to 97% of the initial luminance) of 178 hours at a constant current density of 12 mA/cm
2
was achieved in a stable device with a small
y
coordinate of 0.057, nearly 20 times longer than the model emitter with even a substantially red-shifted emission.
Transcriptional programming of CD4
+
T
RM
differentiation in viral infection balances effector- and memory-associated gene expression
Authors: Nguyen Quynh P. , Takehara Kennidy K. , Deng Tianda Z. , O’Shea Shannon , Heeg Maximilian , Omilusik Kyla D. , Milner J. Justin , Quon Sara , Pipkin Matthew E. , Choi Jinyong , Crotty Shane , Goldrath Ananda W.
Published: May 2023

After resolution of infection, T cells differentiate into long-lived memory cells that recirculate through secondary lymphoid organs or establish residence in tissues. In contrast to CD8
+
tissue-resident memory T cells (T
RM
), the developmental origins and transcriptional regulation of CD4
+
T
RM
remain largely undefined. Here, we investigated the phenotypic, functional, and transcriptional profiles of CD4
+
T
RM
in the small intestine (SI) responding to acute viral infection, revealing a shared gene expression program and chromatin accessibility profile with circulating T
H
1 and the progressive acquisition of a mature T
RM
program. Single-cell RNA sequencing identified heterogeneity among established CD4
+
T
RM
, which were predominantly located in the lamina propria, and revealed a population of cells that coexpressed both effector- and memory-associated genes, including the transcriptional regulators Blimp1, Id2, and Bcl6. T
H
1-associated Blimp1 and Id2 and T
FH
-associated Bcl6 were required for early T
RM
formation and development of a mature T
RM
population in the SI. These results demonstrate a developmental relationship between T
H
1 effector cells and the establishment of early T
RM
, as well as highlighted differences in CD4
+
versus CD8
+
T
RM
populations, providing insights into the mechanisms underlying the origins, differentiation, and persistence of CD4
+
T
RM
in response to viral infection.
‘It’s just a finger isn’t it…’: patients’ perspectives of recovery following finger fractures and participation in surgical trials – a qualitative interview study
Authors: Mousoulis Christos , Karantana Alexia , Trickett Ryan W , Thomas Kim S , Leighton Paul
Published: May 2023

Objectives

To (1) generate detailed, person-centred data about the experience of finger injury and treatment and (2) understand the patients’ perspectives of research involvement with a view to informing better designed future studies in hand injury.

Design

Qualitative study using semistructured interviews and framework analysis.

Participants

19 participants who were part of the Cohort study of Patients’ Outcomes for Finger Fractures and Joint Injuries study in a single secondary care centre in the UK.

Results

The results of this study showed that although finger injuries are frequently seen as minor by patients and healthcare professionals, their effects on peoples’ lives are possibly greater than first anticipated. The relative importance of hand functioning means that the experience of treatment and recovery varies and is shaped by an individual’s age, job, lifestyle and hobbies. These factors will also inform an individual’s perspective on and willingness to participate in, hand research. Interviewees showed reluctance to accept randomisation in surgical trials. Interviewees would be more likely to participate in a study testing two variants of the same treatment modality (eg, surgery vs surgery), rather than two different modalities, (eg, surgery vs splint). The Patient-Reported Outcome Measure questionnaires that were used in this study were seen as less relevant by these patients. Pain, hand function and cosmetic appearance were considered important, meaningful outcomes.

Conclusions

Patients with finger injuries need more support from healthcare professionals as they may experience more problems than first anticipated. Good communication by clinicians and empathy can help patients engage with the treatment pathway. Perceptions of an ‘insignificant’ injury and/or need for quick functional recovery will influence recruitment to future hand research (both positively and negatively). Accessible information about the functional and clinical consequences of a hand injury will be important in enabling participants to make fully informed decisions about participation.
Use of global rating scales and checklists in clinical simulation-based assessments: a protocol for a scoping review
Authors: Henrico Karien , Makkink Andrew William
Published: May 2023

Introduction

Assessment in health sciences education remains a hotly debated topic, with measures of competency and how to determine them in simulation-based assessments enjoying much of the focus. Global rating scales (GRS) and checklists are widely used within simulation-based education but there is a question regarding how the two strategies are used within clinical simulation assessment. The aim of this proposed scoping review is to explore, map and summarise the nature, range and extent of published literature available relating to the use of GRS and checklists in clinical simulation-based assessment.

Methods

We will follow the methodological frameworks and updates described by Arksey and O’Malley, Levac, Colquhoun and O’Brien, and Peters, Marnie and Triccoet aland will report using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We will search PubMed, CINAHL, ERIC, Cochrane Library, Scopus, EBSCO, ScienceDirect, Web of Science, the DOAJ and several sources of grey literature. We will be including all identified sources published in English after 1 January 2010 that relate to the use of GRS and/or checklists in clinical simulation-based assessments. The planned search will be conducted from 6 February 2023 to 20 February 2023.

Ethics and dissemination

An ethical waiver was received from a registered research ethics committee and findings will be disseminated through publications. The overview of literature the produced will help to identify knowledge gaps and inform future research on the use of GRS and checklists in clinical simulation-based assessments. This information will be valuable and useful for all stakeholders that are interested in clinical simulation-based assessments.
Global burden of cardiovascular disease attributable to metabolic risk factors, 1990–2019: an analysis of observational data from a 2019 Global Burden of Disease study
Authors: Wu Shuyi , Xu Wenlin , Guan Chengfu , Lv Meina , Jiang Shaojun , Jinhua Zhang
Published: May 2023

Objectives

An up-to-date, detailed global analysis of the current status of the metabolic-attributed cardiovascular disease (CVD) burden has not been reported. Therefore, we investigated the global burden of metabolic-attributed CVD and its association with socioeconomic development status over the past 30 years.

Methods

Data on the burden of metabolic-attributed CVD were taken from the 2019 Global Burden of Disease (GBD) study. Metabolic risk factors of CVD included high fasting plasma glucose, high low-density lipoprotein cholesterol (LDL-c), high systolic blood pressure (SBP), high body mass index (BMI) and kidney dysfunction. Numbers and age-standardised rates (ASR) of disability-adjusted life-years (DALYs) and deaths were extracted and stratified by sex, age, Socio-demographic Index (SDI) level, country and region.

Results

The ASR of metabolic-attributed CVD DALYs and deaths decreased by 28.0% (95% UI 23.8% to 32.5%) and 30.4% (95% UI 26.6% to 34.5%), respectively, from 1990 to 2019. The highest burden of metabolic-attributed total CVD and intracerebral haemorrhage was mainly in low SDI locations, while the highest burden of ischaemic heart disease and IS was mainly in high SDI locations. The burden of DALYs and deaths in CVD was higher in men than women. In addition, the number and ASR of DALYs and deaths were highest in those over 80 years old.

Conclusion

Metabolic-attributed CVD threatens public health, especially in low-SDI locations and among the elderly. Low SDI location should strengthen the control of metabolic factors such as high SBP, high BMI, and high LDL-c and increase the knowledge of metabolic risk factors for CVD. Countries and regions should enhance screening and prevention of metabolic risk factors of CVD in the elderly. Policy-makers should use 2019 GBD data to guide cost-effective interventions and resource allocation.
Temporal trends in cardiovascular risk factors, lifestyle and secondary preventive medication for patients with myocardial infarction attending cardiac rehabilitation in Sweden 2006–2019: a registry-based cohort study
Authors: Leosdottir Margret , Hagstrom Emil , Hadziosmanovic Nermin , Norhammar Anna , Lindahl Bertil , Hambraeus Kristina , Jernberg Tomas , Bäck Maria
Published: May 2023

Objectives

Registries have been highlighted as means to improve quality of care. Here, we describe temporal trends in risk factors, lifestyle and preventive medication for patients after myocardial infarction (MI) registered in the quality registry Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART).

Design

A registry-based cohort study.

Setting

All coronary care units and cardiac rehabilitation (CR) centres in Sweden.

Participants

Patients attending a CR visit at 1-year post-MI 2006–2019 were included (n=81 363, 18–74 years, 74.7% men).

Outcome measures

Outcome measures at 1-year follow-up included blood pressure (BP) <140/90 mm Hg, low-density lipoprotein-cholesterol (LDL-C)<1.8 mmol/L, persistent smoking, overweight/obesity, central obesity, diabetes prevalence, inadequate physical activity, and prescription of secondary preventive medication. Descriptive statistics and testing for trends were applied.

Results

The proportion of patients attaining the targets for BP<140/90 mmHg increased from 65.2% (2006) to 86.0% (2019), and LDL-C<1.8 mmol/L from 29.8% (2006) to 66.9% (2019, p<0.0001 both). While smoking at the time of MI decreased (32.0% to 26.5%, p<0.0001), persistent smoking at 1 year was unchanged (42.8% to 43.2%, p=0.672) as was the prevalence of overweight/obesity (71.9% to 72.9%, p=0.559). Central obesity (50.5% to 57.0%), diabetes (18.2% to 27.2%) and patients reporting inadequate levels of physical activity (57.0% to 61.5%) increased (p<0.0001 for all). From 2007, >90.0% of patients were prescribed statins and approximately 98% antiplatelet and/or anticoagulant therapy. Angiotensin-converting enzyme inhibitor/angiotensin receptor blocker prescription increased from 68.7% (2006) to 80.2% (2019, p<0.0001).

Conclusions

While little change was observed for persistent smoking and overweight/obesity, large improvements were observed for LDL-C and BP target achievements and prescription of preventive medication for Swedish patients after MI 2006–2019. Compared with published results from patients with coronary artery disease in Europe during the same period, these improvements were considerably larger. Continuous auditing and open comparisons of CR outcomes might possibly explain some of the observed improvements and differences.
Point-of-care testing of HbA1c levels in community settings for people with established diabetes or people at risk of developing type 2 diabetes: a systematic review and meta-analysis protocol
Authors: Gourlay Anna , Sutherland Calum , Radley Andrew
Published: May 2023

Introduction

Diabetes mellitus has increased in prevalence worldwide and is causing an increasing burden on health services. The best patient outcomes occur with early diagnosis to prevent health complications. Glycated haemoglobin (HbA1c) is used to assess glycaemic control over 3–6 months and inform clinical management. Point-of-care (POC) HbA1c devices can be used in community settings, independent of clinical laboratories. This review aims to evaluate how these devices have been implemented in community settings and what patient outcomes have been documented.

Methods and analysis

This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis guidance. A systematic search was undertaken in October 2022, using the defined PICOS (population, intervention, comparison, outcomes, study type) statement to identify all relevant articles: CINAHL, Cochrane, PubMed, Scopus and Web of Science were searched (updated February 2023). Studies will be included if they report outcomes of community POC testing for HbA1c for people with diabetes or at risk of diabetes. We will review the PROSPERO database and trial registers.

Title, abstract screening and full-text review will be carried out by two reviewers. The Cochrane risk-of-bias tool will be used to assess randomised studies and the National Institutes of Health (NIH) Quality Assessment tool for observational cohort and cross-sectional studies. Publication bias will be assessed visually with a funnel plot and statistical approaches if necessary. If a group of sufficiently comparable studies are identified, we will perform a meta-analysis applying a fixed or random effects model as appropriate. We will investigate heterogeneity using visual inspection of forest plots along with review of evaluative approaches such as Χ2and the I2statistic. Strength of evidence will be assessed using Grading of Recommendations, Assessment, Development and Evaluation.

Ethics and dissemination

Ethics approval is not required for this literature review. The results will be disseminated through peer-reviewed publication and conference presentations. Furthermore, this systematic review will be used to inform the design of a community pharmacy-based prediabetes intervention.

PROSPERO registration number

CRD42023383784.
CT airway remodelling and chronic cough
Authors: Abozid Hazim , Kirby Miranda , Nasir Neha , Hartl Sylvia , Breyer-Kohansal Robab , Breyer Marie-Kathrin , Burghuber Otto C , Bourbeau Jean , Wouters Emiel F M , Tan Wan
Published: May 2023

Rationale

Structural airway changes related to chronic cough (CC) are described in the literature, but so far reported data are rare and non-conclusive. Furthermore, they derive mainly from cohorts with small sample sizes. Advanced CT imaging not only allows airway abnormalities to be quantified, but also to count the number of visible airways. The current study evaluates these airway abnormalities in CC and assesses the contribution of CC in addition to CT findings on the progression of airflow limitation, defined as a decline in forced expiratory volume in 1 s (FEV1) over time.

Methods

A total of 1183 males and females aged ≥40 years with thoracic CT scans and valid spirometry from Canadian Obstructive Lung Disease, a Canadian multicentre, population-based study has been included in this analysis. Participants were stratified into 286 never-smokers, 297 ever-smokers with normal lung function and 600 with chronic obstructive pulmonary disease (COPD) of different severity grades. Imaging parameters analyses included total airway count (TAC), airway wall thickness, emphysema as well as parameters for functional small airway disease quantification.

Results

Irrespective of COPD presence, CC was not related to specific airway and lung structure features. Independent of TAC and emphysema score, CC was highly associated with FEV1 decline over time in the entire study population, particularly in ever-smokers (p<0.0001).

Conclusion

The absence of specific structural CT features independently from COPD presence indicate that other underlying mechanisms are contributing to the symptomatology of CC. On top of derived CT parameters, CC seems to be independently associated with FEV1 decline.

Trial registration number

NCT00920348.
Comparison of intravenous paracetamol (acetaminophen) to intravenously or intramuscularly administered non-steroidal anti-inflammatory drugs (NSAIDs) or opioids for patients presenting with moderate to severe acute pain conditions to the ED: systematic review and meta-analysis
Authors: Qureshi Isma , Abdulrashid Khadiga , Thomas Stephen H , Abdel-Rahman Manar E , Pathan Sameer A , Harris Tim
Published: May 2023

Objective

Paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opiates/opioids, administered parenterally via intravenous or intramuscular route, are widely used to provide analgesia for patients with moderate to severe pain. This systematic review and meta-analysis evaluated the level of analgesia provided by intravenous paracetamol (IVP) alone compared with NSAIDs (intravenous or intramuscular), or opioids (intravenous) alone in adults attending the ED with acute pain.

Methods

Two authors independently searched PubMed (MEDLINE), Web of Science, Embase (OVID), Cochrane Library, SCOPUS and Google Scholar (3 March 2021–20 May 2022) for randomised trials without any language or date restriction. Clinical trials were evaluated using the Risk of Bias V.2 tool. The primary outcome was mean difference (MD) for pain reduction at 30 min (T30) post analgesia delivery. The secondary outcomes were MD in pain reduction at 60, 90 and 120 min; the need for rescue analgesia; and the occurrence of adverse events (AEs).

Results

Twenty-seven trials (5427 patients) were included in the systematic review and 25 trials (5006 patients) in the meta-analysis. There was no significant difference in pain reduction at T30 between the IVP group and opioids (MD −0.13, 95% CI −1.49 to 1.22) or IVP and NSAIDs (MD −0.27, 95% CI −1.0 to 1.54. There was also no difference at 60 min, IVP group versus opioid group (MD −0.09, 95% CI −2.69 to 2.52) or IVP versus NSAIDs (MD 0.51, 95% CI 0.11 to 0.91). The quality of the evidence using Grading of Recommendations, Assessments, Development and Evaluations methodology was low for MD in pain scores.

The need for rescue analgesia at T30 was significantly higher in the IVP group compared with the NSAID group (risk ratio (RR): 1.50, 95% CI 1.23 to 1.83), with no difference found between the IVP group and the opioid group (RR: 1.07, 95% CI 0.67 to 1.70). AEs were 50% lower in the IVP group compared with the opioid group (RR: 0.50, 95% CI 0.40 to 0.62), whereas no difference was observed in the IVP group compared with the NSAID group (RR: 1.30, 95% CI 0.78 to 2.15).

Conclusion

In patients presenting to the ED with a diverse range of pain conditions, IVP provides similar levels of pain relief compared with opiates/opioids or NSAIDs at T30 post administration. Patients treated with NSAIDs had lower risk of rescue analgesia, and opioids cause more AEs, suggesting NSAIDs as the first-choice analgesia and IVP as a suitable alternative.

PROSPERO registration number

CRD42021240099.
Answering calls for rigorous health equity research: a cross-sectional study leveraging electronic health records for data disaggregation in Latinos
Authors: Heintzman John , Dinh Dang , Lucas Jennifer A , Byhoff Elena , Crookes Danielle M , April-Sanders Ayana , Kaufmann Jorge , Boston Dave , Hsu Audree , Giebultowicz Sophia , Marino Miguel
Published: May 2023

Introduction

Country of birth/nativity information may be crucial to understanding health equity in Latino populations and is routinely called for in health services literature assessing cardiovascular disease and risk, but is not thought to co-occur with longitudinal, objective health information such as that found in electronic health records (EHRs).

Methods

We used a multistate network of community health centres to describe the extent to which country of birth is recorded in EHRs in Latinos, and to describe demographic features and cardiovascular risk profiles by country of birth. We compared geographical/demographic/clinical characteristics, from 2012 to 2020 (9 years of data), of 914 495 Latinos recorded as US-born, non-US-born and without a country of birth recorded. We also described the state in which these data were collected.

Results

Country of birth was collected for 127 138 Latinos in 782 clinics in 22 states. Compared with those with a country of birth recorded, Latinos without this record were more often uninsured and less often preferred Spanish. While covariate adjusted prevalence of heart disease and risk factors were similar between the three groups, when results were disaggregated to five specific Latin countries (Mexico, Guatemala, Dominican Republic, Cuba, El Salvador), significant variation was observed, especially in diabetes, hypertension and hyperlipidaemia.

Conclusions

In a multistate network, thousands of non-US-born, US-born and patients without a country of birth recorded had differing demographic characteristics, but clinical variation was not observed until data was disaggregated into specific country of origin. State policies that enhance the safety of immigrant populations may enhance the collection of health equity related data. Rigorous and effective health equity research using Latino country of birth information paired with longitudinal healthcare information found in EHRs might have significant potential for aiding clinical and public health practice, but it depends on increased, widespread and accurate availability of this information, co-occurring with other robust demographic and clinical data nativity.
Screening of normal endoscopic large bowel biopsies with interpretable graph learning: a retrospective study
Authors: Graham Simon , Minhas Fayyaz , Bilal Mohsin , Ali Mahmoud , Tsang Yee Wah , Eastwood Mark , Wahab Noorul , Jahanifar Mostafa , Hero Emily , Dodd Katherine , Sahota Harvir , Wu Shaobin , Lu Wenqi , Azam Ayesha , Benes Ksenija , Nimir Mohammed , Hewitt Katherine , Bhalerao Abhir , Robinson Andrew , Eldaly Hesham , Raza Shan E Ahmed , Gopalakrishnan Kishore , Snead David , Rajpoot Nasir
Published: May 2023

Objective

To develop an interpretable artificial intelligence algorithm to rule out normal large bowel endoscopic biopsies, saving pathologist resources and helping with early diagnosis.

Design

A graph neural network was developed incorporating pathologist domain knowledge to classify 6591 whole-slides images (WSIs) of endoscopic large bowel biopsies from 3291 patients (approximately 54% female, 46% male) as normal or abnormal (non-neoplastic and neoplastic) using clinically driven interpretable features. One UK National Health Service (NHS) site was used for model training and internal validation. External validation was conducted on data from two other NHS sites and one Portuguese site.

Results

Model training and internal validation were performed on 5054 WSIs of 2080 patients resulting in an area under the curve-receiver operating characteristic (AUC-ROC) of 0.98 (SD=0.004) and AUC-precision-recall (PR) of 0.98 (SD=0.003). The performance of the model, named Interpretable Gland-Graphs using a Neural Aggregator (IGUANA), was consistent in testing over 1537 WSIs of 1211 patients from three independent external datasets with mean AUC-ROC=0.97 (SD=0.007) and AUC-PR=0.97 (SD=0.005). At a high sensitivity threshold of 99%, the proposed model can reduce the number of normal slides to be reviewed by a pathologist by approximately 55%. IGUANA also provides an explainable output highlighting potential abnormalities in a WSI in the form of a heatmap as well as numerical values associating the model prediction with various histological features.

Conclusion

The model achieved consistently high accuracy showing its potential in optimising increasingly scarce pathologist resources. Explainable predictions can guide pathologists in their diagnostic decision-making and help boost their confidence in the algorithm, paving the way for its future clinical adoption.
Association of age and inflammatory disease activity in the pivotal natalizumab clinical trials in relapsing-remitting multiple sclerosis
Authors: Strijbis Eva M , Coerver Eline , Mostert Jop , van Kempen Zoé L E , Killestein Joep , Comtois Jacynthe , Repovic Pavle , Bowen James D , Cutter Gary , Koch Marcus
Published: May 2023

Background

Focal inflammatory disease activity in relapsing-remitting multiple sclerosis (RRMS) diminishes with increasing age. Here we use patient-level data from randomised controlled trials (RCTs) of natalizumab treatment in RRMS to investigate the association of age and inflammatory disease activity.

Methods

We used patient-level data from the AFFIRM (natalizumab vs placebo in relapsing-remitting MS,NCT00027300) and SENTINEL (natalizumab plus interferon beta vs interferon beta in relapsing remitting MS,NCT00030966) RCTs. We determined the proportion of participants developing new T2 lesions, contrast-enhancing lesions (CELs) and relapses over 2 years of follow-up as a function of age, and investigated the association of age with time to first relapse using time-to-event analyses.

Results

At baseline, there were no differences between age groups in T2 lesion volume and number of relapses in the year before inclusion. In SENTINEL, older participants had a significantly lower number of CELs. During both trials, the number of new CELs and the proportion of participants developing new CELs were significantly lower in older age groups. The number of new T2 lesions and the proportion of participants with any radiological disease activity during follow-up were also lower in older age groups, especially in the control arms.

Conclusions

Older age is associated with a lower prevalence and degree of focal inflammatory disease activity in treated and untreated RRMS. Our findings inform the design of RCTs, and suggest that patient age should be taken into consideration when deciding on immunomodulatory treatment in RRMS.
Efficient simulation of multielectron dynamics in molecules under intense laser pulses: implementation of the multiconfiguration time-dependent Hartree–Fock method based on the adaptive finite element method
Authors: Orimo Yuki , Sato Takeshi , Ishikawa Kenichi L.
Published: May 2023

We present an implementation of the multiconfiguration time-dependent Hartree–Fock method based on the adaptive finite element method for molecules under intense laser pulses. For efficient simulations, orbital functions are propagated by a stable propagator using the short iterative Arnoldi scheme and our implementation is parallelized for distributed memory computing. This is demonstrated by simulating high-harmonic generation from a water molecule and achieves a simulation of multielectron dynamics with overwhelmingly less computational time, compared to our previous work [Sawada, R. et al. Phys. Rev. A, 2016, 93, 023434].
The Environment Agency Chalk groundwater level monitoring network in England
Authors: Farrell Rolf Peter , Whiteman Mark
Published: May 2023

This paper reviews the Environment Agency chalk groundwater level monitoring network. The network has evolved over many years to enable management of the resource and to assess the impact of abstractions on the environment. The paper considers the strengths and weaknesses of the network, the use and accessibility of the data and how the network supports, and works with, the Environment Agency's regional groundwater models. It concludes with the suggestion that the network is suffering from a degree of lack of maintenance and that there is a disparity between the ambitions of the modelling programme with its Modflow6-driven shift to multi-layer conceptualization and a largely open-hole, single-layer monitoring installation.
Geological and chronostratigraphic overview of the Upper Triassic and Jurassic successions of the Junggar Basin, NW China
Authors: Sha Jingeng , Fang Yanan , Cheng Jinhui , Wang Yaqiong , Li Sha , Yang Xiaoju , Li Jiahao , Zhang Haichun
Published: May 2023

The vast, widely exposed terrestrial (lacustrine to fluvial) Upper Triassic–Jurassic (except Tithonian) successions of the Junggar Basin not only record most of the stratigraphic boundaries of the Upper Triassic and Jurassic, including the Triassic–Jurassic boundary and the Hettangian–Sinemurian, Sinemurian–Pliensbachian, Pliensbachian–Toarcian, Lower–Middle Jurassic, Middle–Upper Jurassic and Oxfordian–Kimmeridgian boundaries, but also record a range of geological, organic, palaeogeographic and palaeoclimatic events known to have happened globally in the Late Triassic and Jurassic. The Triassic–Jurassic boundary is placed in the stratigraphic interval of the first occurrence of
Retitriletes austroclavatidites
and
Callialasporites dampieri
and the last occurrence of
Lunatisporites rhaeticus
. The end-Triassic mass extinction is characterized by the disappearance of most of the sporomorph and macro-plant taxa. The end-Triassic mass extinction occurred before the first occurrence of the sporomorph
Cerebropollenites thiergartii
, and ended after its appearance when life began to revive. The Junggar Basin was situated at a high latitude during the Late Triassic–Early Jurassic Pliensbachian ‘hothouse’ and ‘greenhouse’ periods. The Late Triassic–Mid Jurassic Bajocian was humid and warm, and rich in coal swamps, except the Toarcian, which yields little coal because it was relatively warmer and drier. It became arid from the early Late Jurassic Oxfordian.
Late Devonian shear-zone reactivation in the Canadian Appalachian orogen
Authors: Piette-Lauzière Nicolas , Larson Kyle P. , Kellett Dawn A. , Rogers Neil , Powell Jeremy
Published: May 2023

Oblique accretion zones often display transpressive, strike-slip and transtensive structures of different orientations with respect to the convergence axis. The Late Devonian oblique collision of Meguma within the Canadian Appalachian orogen is often characterized as transpressive. However, the simultaneous opening of the Maritimes Basin indicates that the orogenesis also partitioned into an extensional component. In this context, few of the shear zones reactivated during this time period have been characterized while accounting for the possibility of strain partitioning. To do so, we characterize the kinematics and timing of deformation of the Eastern Highlands Shear Zone (EHSZ) and the Coinneach Brook Shear Zone (CBSZ) on Cape Breton Island, Nova Scotia, using a combination of U–Pb geochronology (zircon, monazite, xenotime and apatite) and
40
Ar/
39
Ar geochronology
in situ
and step-heating experiments (amphibole, muscovite and biotite). Results show that the Silurian EHSZ was reactivated at
c.
385–367 Ma and the CBSZ was formed at
c.
395–369 Ma, both yielding oblique kinematics. Together, these structures accommodated the rapid exhumation of the Cape Breton Highlands during the docking of the Meguma terrane. This study thus highlights the heterogeneous distribution of transtensive and transpressive deformation during the Neoacadian Orogeny.
CostCounter: A Better Method for Collision Mitigation in Cuckoo Hashing
Authors: Wu Haonan , Wang Shuxian , Jin Zhanfeng , Zhang Yuhang , Ma Ruyun , Fan Sijin , Chao Ruili
Published: May 2023

Hardware is often required to support fast search and high-throughput applications. Consequently, the performance of search algorithms is limited by storage bandwidth. Hence, the search algorithm must be optimized accordingly. We propose a CostCounter (CC) algorithm based on cuckoo hashing and an Improved CostCounter (ICC) algorithm. A better path can be selected when collisions occur using a cost counter to record the kick-out situation. Our simulation results indicate that the CC and ICC algorithms can achieve more significant performance improvements than Random Walk (RW), Breadth First Search (BFS), and MinCounter (MC). With two buckets and two slots per bucket, under the 95% memory load rate of the maximum load rate, CC and ICC are optimized on read-write times over 20% and 80% compared to MC and BFS, respectively. Furthermore, the CC and ICC algorithms achieve a slight improvement in storage efficiency compared with MC. In addition, we implement RW, MC, and the proposed algorithms using fine-grained locking to support a high throughput rate. From the test on field programmable gate arrays, we verify the simulation results and our algorithms optimize the maximum throughput over 23% compared to RW and 9% compared to MC under 95% of the memory capacity. The test results indicate that our CC and ICC algorithms can achieve better performance in terms of hardware bandwidth and memory load efficiency without incurring a significant resource cost.
Effect of Dispersion Method on Ink Rheology and Microstructure of Microporous Layer for PEMFCs
Authors: Chen Mengyan , Du Shaojie , Jung Joey Chung-Yen , Zhang Ruiming , Dong Zuomin , Djilali Ned , Sui Pang-Chieh
Published: May 2023

In the modern design of proton exchange membrane fuel cells (PEMFCs), a microporous layer (MPL) is often introduced between the gas diffusion layer and catalyst layer to facilitate water management and reduce contact resistance. In this study, an experimental investigation of MPL fabrication, particularly on ink preparation, is carried out to assess the relationship between ink properties and MPL’s microstructure. Two dispersion methods for ink preparation, i.e., sonication and ball-milling, are employed. Rheological and agglomerate size measurements of the inks are performed. Structural properties of the MPL are characterized by the Brunauer–Emmett–Teller method. The MPL inks prepared by ball-milling and sonication dispersion are found to have different rheological properties. The viscosity of ball-milled inks is around 20 mPa·s, whereas for sonicated inks it is about one order of magnitude lower. The surface cracks of the MPL by ball-milling appear to be more extensive and fewer in number than those by sonication. A distinct layer structure forms when the inks are dispersed by ball-milling, whereas sonicated inks penetrate the gas diffusion substrate. The MPL fabricated by a ball-milled ink for 2 h has the most uniform microstructural characteristics among the cases tested.