bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol for a prospective observational cohort study collecting data on demographics, symptoms and biomarkers in people with mesothelioma (ASSESS-meso)
Authors: Conway Ruairi J H , Symonds Jenny , Walton Deborah , Probets Janet , Comins Charles , Stadon Louise , Harvey John E , Blyth Kevin G , Maskell Nick A , Bibby Anna C
Published: November 2022

Introduction

Mesothelioma is a heterogeneous disease that can be challenging to monitor and prognosticate. ASSESS-meso is a multicentre, prospective, longitudinal observational cohort study of patients with mesothelioma. The primary aim is to describe different clinical phenotypes and investigate predictive and prognostic factors, including biomarkers from blood and pleural fluid. The secondary aim is to provide a resource for future trials and substudies.

Methods and analysis

We aim to recruit 700 patients with a histological, cytological or clinicopathological diagnosis of mesothelioma, at any anatomical site (pleural, peritoneal, pericardial, etc). Longitudinal data will be collected, including clinical information, radiological investigations, blood tests and patient-reported outcome measures for breathlessness, chest pain and sweats. Preplanned analyses will use Cox proportional hazards method to evaluate factors associated with survival, linear and logistic regression models to investigate associations with symptoms, and analysis of variance modelling to explore changes in symptoms over time.

Ethics and dissemination

Ethical approval has been granted by the Research Ethics Committee South West—Central Bristol (17-SW-0019) and Health Research Authority (IRAS ID 220360). A study steering committee has been established and results will be published OpenAccess in peer-reviewed journals.

Trial registration number

ISRCTN: 61861764.
Cross-sectional survey of child weight management service provision by acute NHS trusts across England in 2020/2021
Authors: Mears Ruth , Leadbetter Sofia , Candler Toby , Sutton Hannah , Sharp Deborah , Shield Julian P H
Published: November 2022

Objective

With one in five children in England living with obesity, we mapped the geographical distribution and format of child weight management services provided by acute National Health Service (NHS) trusts across England, to identify breadth of service provision.

Design

A cross-sectional survey.

Setting

The survey was sent to acute NHS trusts (n=148) in England in 2020, via a freedom of information request.

Participants

Responses were received from 139 of 148 (94%) acute NHS trusts, between March 2020 to March 2021.

Outcome measures

The survey asked each acute NHS trust whether they provide a weight management service for children living with obesity. For those trusts providing a service, data were collected on eligibility criteria, funding source, personnel involved, number of new patients seen per year, intervention duration, follow-up length and outcome measures. Service characteristics were reported using descriptive statistics. Service provision was analysed in the context of ethnicity and Index of Multiple Deprivation score of the trust catchment area.

Results

From the 139 survey respondents, 23% stated that they provided a weight management service for children living with obesity. There were inequalities in the proportion of acute NHS trusts providing a service across the different regions of England, ranging from 4% (Midlands) to 36% (London). For trusts providing a service, there was variability in the number of new cases seen per year, eligibility criteria, funding source, intervention format and outcome measures collected. A multidisciplinary approach was not routinely provided, with only 41% of services reporting ≥3 different staff disciplines.

Conclusion

In 2020/2021, there were geographical inequalities in weight management service provision by acute NHS trusts for children living with obesity. Services provided lacked standardisation, did not routinely offer children multidisciplinary care and were insufficient in size to meet need.
Incidence of stroke, systemic embolism and bleeding events in patients without anticoagulation based on real-world data in Japan: a retrospective cohort study
Authors: Tanizawa Kimihiko , Nishimura Yuki , Sera Shoji , Yaguchi Daichi , Okada Akira , Nishikawa Masakatsu , Tamaru Satoshi , Nagai Naomi
Published: November 2022

Objectives

To examine the incidence of stroke or systemic embolic events (SSEs) and bleeding events in untreated patients with non-valvular atrial fibrillation (NVAF) after widespread use of direct oral anticoagulant agents (DOACs).

Design

Multicentre, non-interventional, observational, retrospective cohort study using real-world data in Japan (2016-2018).

Setting

The Mie, Musashino University study of NVAF, which used the Mie-Life Innovation Promotion Center Database. This is a regional clinical database involving one university hospital and eight general hospitals in Mie Prefecture in Japan.

Participants

Japanese patients with NVAF (n=7001).

Primary and secondary outcome

The incidence of SSEs and bleeding events.

Results

A total of 7001 patients with NAVF were registered, and 53.0% were treated with DOACs, 10.6% were treated with warfarin and 36.4% had no treatment. Additionally, 29.5% of patients with a CHADS2 (congestive heart failure, hypertension, age≥75 years, diabetes, previous stroke or transient ischemic attack) score of 3–6 were untreated. In the no treatment group, the SSE rates by the CHADS2 score (0, 1, 2 and 3–6) were 1.4%, 1.4%, 3.2% and 8.0%, respectively. The rates of bleeding events by the CHADS2 score (0, 1, 2 and 3–6) in the no treatment group were 0.7%, 1.0%, 1.2% and 2.9%, respectively. A multivariate analysis of SSEs in components of the CHADS2 showed that the adjusted HRs were 2.32 for heart failure, 1.66 for an age ≥75 years, 1.81 for diabetes mellitus and 5.84 for prior stroke or transient ischaemic attack.

Conclusions

Approximately one-third of the patients do not receive any anticoagulation in the modern DOAC era in Japan. The SSE rate increases by the CHADS2 score. The SSE rate is low in patients with a CHADS2 score <1, supporting no indication of anticoagulation in current guidelines. In patients with a CHADS2 score >1, the use of anticoagulant drug therapy is recommended because of a higher risk of stroke.
Relative vaccine effectiveness against Delta and Omicron COVID-19 after homologous inactivated vaccine boosting: a retrospective cohort study
Authors: Tang Lin , Zhang Yanyang , Wang Fuzhen , Wu Dan , Qian Zhao-Hui , Zhang Rui , Wang Ai-Bin , Huang Chang , Wang Haifeng , Ye Ying , Lu Mingxia , Wang Changshuang , Ma Ya-Ting , Pan Jingjing , Li Ya-fei , Lv Xiao-Ya , An Zhijie , Rodewald Lance , Wang Xuan-Yi , Shao Yi-Ming , Wu Zhi-Yin , Yin Zundong
Published: November 2022

Objective

Two COVID-19 outbreaks occurred in Henan province in early 2022—one was a Delta variant outbreak and the other was an Omicron variant outbreak. COVID-19 vaccines used at the time of the outbreak were inactivated, 91.8%; protein subunit, 7.5%; and adenovirus5-vectored, 0.7% vaccines. The outbreaks provided an opportunity to evaluate variant-specific breakthrough infection rates and relative protective effectiveness of homologous inactivated COVID-19 vaccine booster doses against symptomatic infection and pneumonia.

Design

Retrospective cohort study

Methods

We evaluated relative vaccine effectiveness (rVE) with a retrospective cohort study of close contacts of infected individuals using a time-dependent Cox regression model. Demographic and epidemiologic data were obtained from the local Centers for Disease Control and Prevention; clinical and laboratory data were obtained from COVID-19-designated hospitals. Vaccination histories were obtained from the national COVID-19 vaccination dataset. All data were linked by national identification number.

Results

Among 784 SARS-CoV-2 infections, 379 (48.3%) were caused by Delta and 405 (51.7%) were caused by Omicron, with breakthrough rates of 9.9% and 17.8%, respectively. Breakthrough rates among boosted individuals were 8.1% and 4.9%. Compared with subjects who received primary vaccination series ≥180 days before infection, Cox regression modelling showed that homologous inactivated booster vaccination was statistically significantly associated with protection from symptomatic infection caused by Omicron (rVE 59%; 95% CI 13% to 80%) and pneumonia caused by Delta (rVE 62%; 95% CI 34% to 77%) and Omicron (rVE 87%; 95% CI 3% to 98%).

Conclusions

COVID-19 vaccination in China provided good protection against symptomatic COVID-19 and COVID-19 pneumonia caused by Delta and Omicron variants. Protection declined 6 months after primary series vaccination but was restored by homologous inactivated booster doses given 6 months after the primary series.
Prevalence of undernourishment and associated factors among adults with major depressive disorder at two public hospitals in Northwest Ethiopia: a cross-sectional study
Authors: Tesfa Hiwot , Jara Dube , Woyiraw Wubetu , Bogale Eyob Ketema , Asrat Biksegn
Published: November 2022

Objective

Undernourishment is overlooked in people with major depressive disorder (MDD); however, it could have huge impacts on recovery, functioning and quality of life. This study aimed to assess the prevalence of undernourishment and associated factors among adults with MDD attending two public hospitals in Northwest Ethiopia.

Design

Institution-based cross-sectional study was used.

Setting

This study was conducted in two public hospitals—a tertiary-level specialised care hospital (Felege-Hiwot Comprehensive Specialized Hospital) and a secondary-level referral hospital (Debre Markos Referral Hospital). Both hospitals are located around 200 km apart and are the busiest hospitals in Western Amhara region.

Participants

A total of 396 participants were included in the study using a stratified sampling technique. The study participants were recruited from psychiatry units. Adults with MDD were recruited from both hospitals proportionally between September and November 2019.

Outcome measures

Undernourishment was assessed using a body mass index measurement. Data were collected using a structured questionnaire and anthropometric measurements, and analysed using a binary logistic regression model.

Results

The overall prevalence of undernourishment was 28.5% (95% CI: 23.7% to 33.4%) among adults with MDD attending psychiatric care in the two public hospitals in Northwest Ethiopia. Female gender (adjusted Odds Ratio (AOR)=2.18, 95% CI=1.20 to 3.96, p=0.01), rural residence (AOR=2.41, 95% CI=1.23 to 4.70, p=0.01), illiteracy (AOR=2.86, 95% CI=1.01 to 8.07, p=0.047), antidepressant side effects (AOR=2.04, 95% CI=1.08 to 3.88, p=0.028) and having HIV/AIDS (AOR=4.12, 95% CI=1.46 to 11.57, p=0.007) had a statistically significant association with undernourishment.

Conclusion

The prevalence of undernourishment was high among adults with MDD in Northwest Ethiopia. This study suggests the need to include nutritional interventions for people with MDD in psychiatric care facilities.
Longitudinal neighbourhood determinants with cognitive health and dementia disparities: protocol of the Multi-Ethnic Study of Atherosclerosis Neighborhoods and Aging prospective cohort study
Authors: Hirsch Jana A , Michael Yvonne L , Moore Kari A , Melly Steven , Hughes Timothy M , Hayden Kathleen , Luchsinger Jose A , Jimenez Marcia P , James Peter , Besser Lilah M , Sánchez Brisa , Diez Roux Ana V
Published: November 2022

Introduction

The burden of Alzheimer’s disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of—and disparities in—cognitive decline and dementia.

Methods and analyses

We describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing.

Ethics and dissemination

This project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.
INSTIs for the management of HIV-associated TB (INSIGHT study): a phase 2b study to evaluate the efficacy, safety and pharmacokinetics of a combination of bictegravir, emtricitabine and tenofovir alafenamide fumarate for the treatment of HIV-1 infection in patients with drug-susceptible tuberculosis on a rifampicin-based treatment regimen: a phase 2b open-label randomised controlled trial
Authors: Naidoo Anushka , Dooley Kelly E , Naidoo Kogieleum , Padayatchi Nesri , Yende-Zuma Nonhlanhla , Perumal Rubeshan , Dorse Gillian , Boodhram Resha , Osuala Emmanuella Chinonso
Published: November 2022

Introduction

Cotreatment of HIV and tuberculosis (TB) reduces morbidity and mortality in coinfected patients. Availability of antiretroviral treatment (ART) drug options, including within drug classes, is important, particularly in high HIV/TB burden low and middle-income countries.

Methods and analysis

This is a phase 2b, open-label, non-comparative randomised controlled trial to assess the antiretroviral activity of a fixed-drug, single tablet, combination of bictegravir (BIC) 50 mg/emtricitabine (FTC) 200 mg/tenofovir alafenamide (TAF) 25 mg (Biktarvy). The primary objective is to determine the efficacy, safety and pharmacokinetics of two times per day, coformulated BIC 50 mg/FTC 200 mg/TAF 25 mg in HIV-positive ART-naïve patients with TB who are receiving a rifampicin-based treatment regimen and to characterise viral suppression rates at week 24 through to week 48 in the BIC/FTC/TAF arm. We will enrol 120 patients randomised in a 2:1 ratio to the intervention or control arm of the study. A non-comparative contemporaneous control arm in which participants receive a dolutegravir-based regimen (standard of care) will also be enrolled.

Ethics and dissemination

The University of KwaZulu-Natal Biomedical Research Ethics Committee (BREC) and the South African Health Products Regulatory Authority (SAHPRA) have granted regulatory approval (trial reference numbers: BREC/00001300/2020 and SAHPRA 20200810). Trial results will be disseminated through conference presentations, peer-reviewed publications and the clinical trial registry.

Trial registration number

Clinicaltrials.gov; Trial registration number:NCT04734652; South African National Clinical Trials Register (SANCTR DOH-27-012021-6789)
Cyclizine pharmacovigilance in hospice/palliative care: net effects for nausea or vomiting
Authors: McNeill Richard , Prael Grace , Hunt Jane , Chang Sungwon , Wilcock Andrew , Dunwoodie David , Lau Corey , Morgan Nicola , Iupati Salina , Currow David C
Published: November 2022

Objectives

To describe the contemporary real-world use of cyclizine for nausea or vomiting, and the associated benefits and harms.

Methods

This was a prospective, consecutive case series of routine clinical use of cyclizine for nausea or vomiting in palliative care conducted across 19 sites in Australia, Aotearoa/New Zealand and the UK. Clinical outcomes were graded using the National Cancer Institute Common Terminology Criteria for Adverse Events at baseline and 72 hours after initiation of cyclizine. Ad hoc safety reporting continued for 2 weeks.

Results

Data were collected from 101 patients between May 2018 and December 2020. Cyclizine was mostly used in combination with another antiemetic. Overall, 79 patients benefited and 32 experienced harm (56 had benefit without harm; 9 had harm without benefit). The most common harms were constipation (13%), somnolence (9%) and confusion (7%), adding to the already high rates of these symptoms at baseline. For the four patients with serious harms (grade ≥3), these were exacerbations of existing symptoms. Nine patients stopped cyclizine at 72 hours and a further 20 patients within 2 weeks. The most common reasons for stopping were lack of benefit and symptom resolution; none stopped because of harms.

Conclusions

When used as described in a palliative care setting, cyclizine benefits about three-quarters of patients, with about one-third experiencing tolerable harms.
Anticholinergic drugs for death rattle in dying patients with cancer: multicentre prospective cohort study
Authors: Yamaguchi Takashi , Yokomichi Naosuke , Yamaguchi Takuhiro , Maeda Isseki , Matsunuma Ryo , Tanaka-Yagi Yukako , Akatani Asami , Suzuki Kozue , Kohara Hiroyuki , Taniyama Tomohiko , Matsuda Yosuke , Nakajima Nobuhisa , Morita Tatsuya , Tsuneto Satoru , Mori Masanori
Published: November 2022

Background

This study aimed to investigate the effectiveness of anticholinergics (AC) for death rattle in dying patients with cancer.

Methods

This is a prospective cohort study enrolled Terminally ill adult (20 years or older) patients with cancer who developed substantial death rattle (Back score ≥2) from 23 palliative care units in Japan. AC treatment for death rattle was prescribed according to primary physician’s decision. The primary outcome was the proportion of patients whose death rattle improved, which was defined as a Back score of ≤1. We compared the proportion of improved cases in patients treated with (AC group) and without (non-AC group) AC, controlling potential confounders by employing propensity score weighting.

Results

Of the 1896 patients enrolled, we included 196 who developed a substantial death rattle. Of these, 81 received AC. 56.8% in the AC group and 35.4% in the non-AC group had an improved death rattle at 8 hours after baseline. In the weighted analysis, AC group showed significant improvements in death rattle, with an adjusted OR of 4.47 (95% CI 2.04 to 9.78; p=0.0024). All sensitivity analyses achieved essentially the same results. In the subgroup analysis, ACs were strongly associated with death rattle improvement in men, patients with lung cancer, and type 1 death rattle (adjusted OR 5.81, 8.38 and 9.32, respectively).

Conclusions

In this propensity score-weighted analysis, ACs were associated with death rattle improvement in terminally ill patients with cancer who developed substantial death rattle.

Trial registration number

UMIN-CTR (UMIN00002545).
TeamSpiritous - A Retrospective Emotional Competence Development System for Video-Meetings
Authors: Benke Ivo , Schneider Maren , Liu Xuanhui , Maedche Alexander
Published: November 2022

Video-meetings essentially determine remote work life. However, video-meetings experience challenges originating from human emotions. Therefore, emotional competence, the ability to perceive, understand, and regulate emotions, is of the highest relevance. With limited transfer capacity of emotional information and various communication challenges, developing emotional competence, however, is complex. To overcome this complexity, we present TeamSpiritous, an individual, retrospective emotional competence development system for video-meetings. TeamSpiritous allows to upload and analyze recorded video-meetings on emotional processes and provides support for individual development of emotional competence.

We evaluated TeamSpiritous quantitatively and qualitatively in a six-week, longitudinal field study with 47 participants from China and Germany. Results of our study show that intra- and interpersonal emotional competence significantly increased over time for the whole sample. In particular, intrapersonal emotion regulation and interpersonal emotion perception and understanding improved. Since remote work video-meetings are often multicultural, we also investigated cultural differences and observed in our results that the effects of TeamSpiritous exist beyond cultural backgrounds (China, Germany). With our work, we contribute with the design of TeamSpiritous and understanding of its effects on emotional competence development.
A conversation with Heena Rathore
Authors: Anjum Bushra
Published: November 2022

Ubiquity's senior editor Dr. Bushra Anjum chats with Dr. Heena Rathore, assistant professor in the Computer Science Department at Texas State University, on how cyber-physical systems (CPS) are inherently similar to humans in their reliance upon sensing their environments and making decisions. They further discuss how this similarity motivates the exploration of novel AI algorithms inspired by the principles of cognition and neuroscience to ensure the security of critical CPS infrastructure, such as IoT networks, medical devices, and connected vehicles.
Radiative and MHD Effects on Time-Dependent Thermal-Material Transfer by Micropolar Binary Mixture
Authors: Mosharrof Hossain Md. , Nasrin R. , Hasanuzzaman Md.
Published: November 2022

Radiation is an important branch of thermal engineering which includes geophysical thermal insulation, ground water pollution, food processing, cooling of electronic components, oil recovery processes etc. An analysis of unsteady magneto-convective heat-mass transport by micropolar binary mixture of fluid passing a continuous permeable surface with thermal radiation effect has been introduced in this paper. The governing equations are transformed into coupled ordinary differential equations along with Boussinesq approximation by imposing the similarity analysis. Applying the shooting technique, the obtained non-linear coupled similarity equations are solved numerically with the help of “ODE45 MATLAB” software. The results of the numerical solutions to the problem involving velocity, temperature, concentration and micro-rotation are presented graphically for different dimensionless parameters and numbers encountered. With an increase of suction parameter, the velocity distributions very closed to the inclined permeable wall decrease slightly where

0
≤
η
≤
0.3

. But for the uplifting values of sunction, both micro-rotation profile and species concentration enhance through the boundary layer. The skin-friction coefficient increases about 61%, 13%, 27% for rising values of Prandtl number (0.71-7), radiation effect (0 - 1) and thermal Grashof number (5-10), respectively, but an adverse effect is observed for magnetic field (1 - 4), inclined angle

0

0

−

60

0

and Schmidt number (0.22 - 0.75). Heat transfer and mass transfer reduce about 82%, 53%, respectively, in increasing of Pr (0.71-1) and 36%, 11%, respectively, in increasing of thermal radiation (0 - 1). The surface couple stress increases about 26%, 49%, 64% and 30% with the increasing values of magnetic field (1-4), inclination angle

0

0

−

60

0

, suction (0-1) and Schmidt number (0.22-0.75), respectively. Finally, the present study has been compared with the earlier published results. It is observed that the comparison bears a good agreement.
A Study to Improve the Vitamin A and Iodine Status of Pregnant Women through a Multiple Micronutrient Fortified Salt
Authors: Vinod Kumar Malavika , Sankarapandian M. , Erhardt Juergen
Published: November 2022

Background. To study the efficacy of a multiple micronutrient fortified salt enriched with iron, iodine, vitamin A, vitamin B1, vitamin B2, vitamin B6, vitamin B12, niacin, and folic acid in improving serum retinol and iodine status of pregnant women. Methods. It was a randomized control trial in the antenatal clinic of a hospital. 151 women in the experimental group received a multiple micronutrient fortified salt to cook all their meals, and 150 women in the control group did not receive the fortified salt. Blood was collected in the three trimesters. Urine was collected in their first and third trimesters. Serum retinol, CRP (C-reactive protein), and AGP (Alpha glycoprotein) in blood were assessed, and iodine was assessed in urine. All the women were dewormed once. Results. The inflammation adjusted mean serum retinol in three trimesters in the experimental group was 24.51, 27.29, and 25.68 µg/dL, and it was 28.97, 27.63, and 22.72 µg/dL in the control group. Over the study period of 6 months, the increase in serum retinol in the experimental group was 1.17 µg/dL whereas in the control group serum retinol decreased by 6.25 µg/dL. The experimental group increase in serum retinol is significantly more (

p
=
0.0001

) than the changes in retinol in the control group. The prevalence of serum retinol deficiency in the three trimesters was 39.1%,25.8%, and 37.7% in the experimental group and 14%, 22.7%, and 39.3% in the control group, and the change in the experimental group was significant (

p
=
0.001

) compared to the control group by binary logistic regression. Over the study period of 6 months there is a significant increase in urinary iodine concentration in the experimental group (

p
=
0.030

), showing absorption of iodine from the fortified salt whereas there is a significant decline in the iodine values in the control group (

p
=
0.008

). At the end of the study, the urinary iodine concentration of the experimental group was significantly more (

p
=
0.0001

) than that of the control group. Conclusion. The fortified salt was able to improve serum retinol levels and urinary iodine levels in pregnant women. Trial Registration. This trial was registered retrospectively on 19/02/2022 in the ISRCTN registry with trial ID ISRCTN17782574.
The Prognostic Value of Echocardiographic Wall Motion Score Index in ST-Segment Elevation Myocardial Infarction
Authors: Savage Michael L. , Hay Karen , Anderson Bonita , Scalia Gregory , Burstow Darryl , Murdoch Dale , Ranasinghe Isuru , Raffel Owen Christopher
Published: November 2022

Background. When compared to left ventricular ejection fraction (LVEF), previous studies have suggested the superiority of wall motion score index (WMSI) in predicting cardiac events in patients who have suffered acute myocardial infarction. However, there are limited studies assessing WMSI and mortality in ST-segment elevation myocardial infarction (STEMI). We aimed to compare the prognostic value of WMSI in a cohort of STEMI patients treated with primary percutaneous coronary intervention (PCI). Methods. A comparison of WMSI, LVEF, and all-cause mortality in STEMI patients treated with primary PCI between January 2008 and December 2020 was performed. The prognostic value of WMSI, LVEF, and traditional risk scores (TIMI, GRACE) were compared using multivariable logistic regression modelling. Results. Among 1181 patients, 27 died within 30-days (2.3%) and 49 died within 12 months (4.2%). WMSI ≥1.8 was associated with poorer survival at 12-months (9.2% vs 1.5%;

p
<
0.001

). When used as the only classifier for predicting 12-month mortality, the discriminatory ability of WMSI (area under the curve (AUC): 0.77; 95% CI: 0.68–0.84) was significantly better than LVEF (AUC: 0.71; 95% CI: 0.61–0.79;

p
=
0.034

). After multivariable modelling, the AUC was comparable between models with either WMSI (AUC: 0.89; 95% CI: 0.85–0.94) or LVEF (AUC: 0.87; 95% CI: 0.83–0.92;

p
<
0.08

) yet performed significantly better than TIMI (AUC: 0.71; 95% CI: 0.62–0.79;

p
<
0.001

), or GRACE (AUC: 0.63; 95% CI: 0.54–0.71;

p
<
0.001

) risk scores. Conclusions. When examined individually, WMSI is a superior predictor of 12-month mortality over LVEF in STEMI patients treated with primary PCI. When examined in multivariable predictive models, WMSI and LVEF perform very well at predicting 12-month mortality, especially when compared to existing STEMI risk scores.
Molecular Characterization of Acquired Resistance to KRASG12C–EGFR Inhibition in Colorectal Cancer
Authors: Yaeger Rona , Mezzadra Riccardo , Sinopoli Jenna , Bian Yu , Marasco Michelangelo , Kaplun Esther , Gao Yijun , Zhao HuiYong , Paula Arnaud Da Cruz , Zhu Yingjie , Perez Almudena Chaves , Chadalavada Kalyani , Tse Edison , Chowdhry Sudhir , Bowker Sydney , Chang Qing , Qeriqi Besnik , Weigelt Britta , Nanjangud Gouri J. , Berger Michael F. , Der-Torossian Hirak , Anderes Kenna , Socci Nicholas D. , Shia Jinru , Riely Gregory J. , Murciano-Goroff Yonina R. , Li Bob T. , Christensen James G. , Reis-Filho Jorge S. , Solit David B. , de Stanchina Elisa , Lowe Scott W. , Rosen Neal , Misale Sandra
Published: November 2022

With the combination of KRASG12C and EGFR inhibitors, KRAS is becoming a druggable target in colorectal cancer. However, secondary resistance limits its efficacy. Using cell lines, patient-derived xenografts, and patient samples, we detected a heterogeneous pattern of putative resistance alterations expected primarily to prevent inhibition of ERK signaling by drugs at progression. Serial analysis of patient blood samples on treatment demonstrates that most of these alterations are detected at a low frequency except for KRASG12C amplification, a recurrent resistance mechanism that rises in step with clinical progression. Upon drug withdrawal, resistant cells with KRASG12C amplification undergo oncogene-induced senescence, and progressing patients experience a rapid fall in levels of this alteration in circulating DNA. In this new state, drug resumption is ineffective as mTOR signaling is elevated. However, our work exposes a potential therapeutic vulnerability, whereby therapies that target the senescence response may overcome acquired resistance.

Significance:

Clinical resistance to KRASG12C–EGFR inhibition primarily prevents suppression of ERK signaling. Most resistance mechanisms are subclonal, whereas KRASG12C amplification rises over time to drive a higher portion of resistance. This recurrent resistance mechanism leads to oncogene-induced senescence upon drug withdrawal and creates a potential vulnerability to senolytic approaches.

This article is highlighted in the In This Issue feature, p. 1
Pakistan sign language to Urdu translator using Kinect
Authors: Ahmed Saad , Shafiq Hasnain , Raheel Yamna , Chishti Noor , Asad Syed Muhammad
Published: November 2022

The lack of a standardized sign language, and the inability to communicate with the hearing community through sign language, are the two major issues confronting Pakistan's deaf and dumb society. In this research, we have proposed an approach to help eradicate one of the issues. Now, using the proposed framework, the deaf community can communicate with normal people. The purpose of this work is to reduce the struggles of hearing-impaired people in Pakistan. A Kinect-based Pakistan sign language (PSL) to Urdu language translator is being developed to accomplish this. The system’s dynamic sign language segment works in three phases: acquiring key points from the dataset, training a long short-term memory (LSTM) model, and making real-time predictions using sequences through openCV integrated with the Kinect device. The system’s static sign language segment works in three phases: acquiring an image-based dataset, training a model garden, and making real-time predictions using openCV integrated with the Kinect device. It also allows the hearing user to input Urdu audio to the Kinect microphone. The proposed sign language translator can detect and predict the PSL performed in front of the Kinect device and produce translations in Urdu.
Dissociable Neural Mechanisms for Human Inference Processing Predicted by Static and Contextual Language Models
Authors: Uchida Takahisa , Lair Nicolas , Ishiguro Hiroshi , Dominey Peter Ford
Published: November 2022

Language models (LMs) continue to reveal non-trivial relations to human language performance and the underlying neurophysiology. Recent research has characterized how word embeddings from an LM can be used to generate integrated discourse representations in order to perform inference on events. The current research investigates how such event knowledge may be coded in distinct manners in different classes of LMs and how this maps onto different forms of human inference processing. To do so, we investigate inference on events using two well-documented human experimental protocols from Metusalem et al. (2012) and McKoon and Ratcliff (1986), compared with two protocols for simpler semantic processing. Interestingly, this reveals a dissociation in the relation between local semantics versus event-inference depending on the LM. In a series of experiments, we observed that for the static LMs (word2vec/GloVe), there was a clear dissociation in the relation between semantics and inference for the two inference tasks. In contrast, for the contextual LMs (BERT/RoBERTa), we observed a correlation between semantic and inference processing for both inference tasks. The experimental results suggest that inference as measured by Metusalem and McKoon rely on dissociable processes. While the static models are able to perform Metusalem inference, only the contextual models succeed in McKoon inference. Interestingly, these dissociable processes may be linked to well-characterized automatic versus strategic inference processes in the psychological literature. This allows us to make predictions about dissociable neurophysiological markers that should be found during human inference processing with these tasks.
Senecio ×riloensis (Asteraceae), a new natural hybrid between S. hercynicus and S. transylvanicus from Bulgaria
Authors: SZELĄG ZBIGNIEW , VLADIMIROV VLADIMIR
Published: November 2022

The newly described Senecio ×riloensis combines the morphological features of S. hercynicus and S. transylvanicus, and grows in subalpine habitats in the Rila Mountains, Bulgaria. It is illustrated with photos of living plants in the locus classicus.
Evolutionary insights into the Andean genus Nicandra (Solanoideae, Solanaceae)
Authors: Seculin Glur JULIETA L. , GUTIÉRREZ NICOLÁS FÁTIMA , LEIVA GONZÁLEZ SEGUNDO , BARBOZA GLORIA E. , CARRIZO GARCÍA CAROLINA
Published: November 2022

Nicandra (Solanaceae) is a small Andean genus, historically considered monospecific, with N. physalodes as its only species. This species is native to the South American Andes but naturalized in many countries worldwide. Recently, N. john-tyleriana and N. yacheriana were described using morphological evidence, which are endemic to Peru. Sequence data from four DNA markers, the plastidial intergenic spacers trnL-trnF and ndhF-rpl32, and the nuclear ITS region and GBSSI (waxy) gene, were used to test the identity of the nominal species using genomic evidence, to reconstruct the genus phylogenetic history through Maximum Likelihood and Bayesian Inference, and to estimate divergence times within the genus. The three Nicandra species formed distinct partitions and monophyletic lineages. Nicandra physalodes, originated in the late Miocene (ca. 8 My), was resolved as the first splitting branch, sister to the siblings N. john-tyleriana and N. yacheriana, which were originated at the end of the Miocene (ca. 5 My). The crown ages for the three species were estimated from the early Pliocene (N. physalodes) to the mid-Pleistocene (N. john-tyleriana and N. yacheriana), which is consistent with hypotheses of Neotropical species diversification. Open questions remain about the biogeography of the genus.
Casearia seethalakshmiae (Samydoideae, Salicaceae), a new species from Palakkad Gap, Kerala (India)
Authors: AMBIKA VISWANATHANPILLAI , SOJAN JOSE , SURESH VEERANKUTTY
Published: November 2022

Casearia seethalakshmiae, a new species from India, is described and compared with the three other currently accepted Indian species namely C. graveolens, C. glomerata, and C. bourdillonii. The new species belongs to the Casearia sect. Casearia, and is confined to Palakkad, Kerala. Detailed description, distribution, phenology, photographs and a key to the species of Indian Casearia are provided.
Typification of two names in the genus Ranunculus (Ranunculaceae)
Authors: FERRER-GALLEGO P. PABLO , SÁEZ LLORENÇ
Published: November 2022

The typification of the names Ranunculus chaerophyllos var. balearicus and R. weyleri is discussed. These two names are lectotypified using specimens preserved at COI.
A new species of the genus Downsiomyia Vargas (Diptera: Culicidae) from Himachal Pradesh, India
Authors: NATARAJAN R. , GOPALAKRISHNAN S. , KUMAR PRADEEP , KUMAR ASHWANI
Published: November 2022

The adult, larval and pupal stages of Downsiomyia rajaveli, a new species (Diptera: Culicidae) from India, are described and illustrated, and the mitochondrial COI barcode is provided for the species. The morphological relationship of the new species to other members of the genus Downsiomyia is discussed.
The Tibetan Plateau’s Far-Reaching Impacts on Arctic and Antarctic Climate: Seasonality and Pathways
Authors: Wang Liping , Yang Haijun , Wen Qin , Liu Yimin , Wu Guoxiong
Published: November 2022

As the highest and most extensive plateau in the world, the Tibetan Plateau (TP) has remarkable effects on global climate. Through coupled model sensitivity experiments with and without the TP, we show that the TP can affect the Arctic directly via orography-forced stationary waves, and influence the Antarctic indirectly via stationary waves forced by sea surface temperature (SST) in the Indian Ocean. These far-reaching impacts occur mainly in wintertime. The fast atmospheric processes play an important role; particularly, the midlatitude westerly flow, which is stronger and closer to the equator in winter, provides a favorable condition for the eastward and poleward energy propagation of the forced waves. In the Northern Hemisphere, removing the TP causes a wave train traveling from the Asian continent to the North America–Atlantic Ocean region, resulting in intensified westerlies and thus an enhancement of stratospheric polar vortex and Arctic cooling. The pathways are northeastward directly in the upper level due to the background westerlies, while they are eastward and then northeastward in the lower level, modulated by the winter monsoon. To the south, the TP perturbation causes an anomalous cross-equatorial flow, leading to an anomalous SST dipole pattern in the Indian Ocean in the austral winter; this generates stationary waves propagating energy southeastward from the tropical Indian Ocean to the Antarctic, resulting in a Rossby wave train circulating around the Antarctic. Our study identifies the seasonality and pathways of the TP affecting the polar regions, which may help to understand the role of the TP in the future climate changes in polar regions.
Bayesian Meta-analysis of Direct Oral Anticoagulation Versus Vitamin K Antagonists With or Without Concomitant Antiplatelet After Transcatheter Aortic Valve Implantation in Patients With Anticoagulation Indication
Authors: Lee Gabriel Sheng Jie , Tay Hannah Si En , Teo Vanessa Xin Yi , Goh Rachel Sze Jen , Chong Bryan , Chan Siew Pang , Tay Edgar , Lim Yinghao , Yip James , Chew Nicholas W. S , Kuntjoro Ivandito
Published: November 2022

Patients undergoing transcatheter aortic valve implantation (TAVI) commonly have co-morbidities requiring anticoagulation. However, the optimal post-procedural anticoagulation regimen is not well-established. This meta-analysis investigates safety and efficacy outcomes of direct oral anticoagulants (DOACs) and Vitamin K Antagonist (VKA), with or without concomitant antiplatelet therapy. We searched EMBASE and MEDLINE for appropriate studies. Subgroup analyses were performed for anticoagulant monotherapy and combined therapy with antiplatelet agents. Eleven studies (6359 patients) were included. Overall, there were no differences between DOACs and VKA for all-cause mortality (Odds Ratio [OR]: .69; Credible Interval [CrI]: .40–1.06), cardiovascular-related mortality (OR: .76; Crl: .13–3.47), bleeding (OR: .95; CrI: .75–1.17), stroke (OR: 1.04; CrI: .65–1.63), myocardial infarction (OR: 1.51; CrI: .55–3.84), and valve thrombosis (OR: .29; CrI: .01–3.54). For DOACs vs VKA monotherapy subgroup, there were no differences in outcomes. For the combined therapy subgroup, there was decreased odds of all-cause mortality in the DOACs group compared with the VKA group (OR: .13; CrI: .02–.65), but no differences for bleeding and stroke. DOACs and VKA have similar safety and efficacy profiles for post-TAVI patients with anticoagulation indication. However, if concomitant antiplatelet therapy is required, DOACs were more favorable than VKA for all-cause mortality.
Bone Mineral Density and Serum 25OHD in Children and Adolescents With Juvenile Idiopathic Arthritis
Authors: Charuvanij Sirirat , Malakorn Hathaikan , Densupsoontorn Narumon , Nakavachara Pairunyar
Published: November 2022

Low bone mass is one of the complications of juvenile idiopathic arthritis (JIA). However, a study focusing on the low bone mass in children and adolescents with JIA in Southeast Asian countries is limited. This study aimed to evaluate the bone mineral density (BMD) of Thai patients with JIA and identify factors correlated with BMD. A cross-sectional study was conducted at a tertiary-care center. The BMD of the lumbar spines (BMDLS) and the total body (BMDTB) were measured by dual-energy X-ray absorptiometry. Thirty-eight patients were enrolled between July 2015 and January 2016. No patient had low BMDLS, and only 2 (5.3%) had low BMDTB. Serum 25-hydroxyvitamin D (25OHD) levels were significantly positively correlated with the BMDTB Z-score (coefficient: 0.047; 95% confidence interval = 0.011-0.082; P = .012). Our study demonstrated a very low prevalence of low bone mass. Optimization of the serum 25OHD level should be encouraged.
Hot Spots of Commercial Sex Activities in New York City Neighborhoods: Lessons Learned
Authors: Suh Brittany , Natarajan Mangai
Published: November 2022

Understanding the spatial distribution of commercial sex activities (CSA) in urban environments is important in addressing the harms against sex workers and identifying sex trafficking operations. Guided by crime pattern theory, using Census data and New York Police Department (NYPD) prostitution-related arrests data ( N = 29,075) from 2010 to 2019, this study examines the “hot spots” of CSA in New York City. Local Spatial Autocorrelation Analysis (LISA) identified distinctive spatial clusters of CSA, whereas logistic regression explained their significant congregation in immigrant and racial-ethnic enclaves. The heterogeneity of clusters by boroughs portrays the convergence of activity space of sex workers, patrons, and sex business opportunities reflecting the high-demand locations of CSA and human trafficking in NYC.
The impact of burnout on turnover intention among Chinese general practitioners: The mediating effect of job satisfaction and the moderating effect of professional identity
Authors: Feng Jing , Sang Wenyuan , Lei Zihui , Qu Ge , Li Xinyan , Ferrier Adamm , Jiang Heng , Pu Bo , Gan Yong
Published: November 2022

Background:

Turnover among general practitioners (GPs) has become a significant public health concern worldwide.

Aims:

This study aimed to investigate the interrelationships between job satisfaction, professional identity, burnout, and turnover intention among GPs in China and to assess the mediating effect of job satisfaction on the association between burnout and turnover intention and the moderating effect of professional identity on the association between burnout and job satisfaction.

Method:

A cross-sectional study was conducted to collect data from 3,236 GPs in eastern, central, and western China between October 2017 and February 2018 using a self-administered questionnaire. Pearson’s correlation analysis and hierarchical regression were used to identify the relationships between job satisfaction, professional identity, burnout, and turnover intention among Chinese GPs.

Results:

Among these respondents, 65.02% reported a medium or high level of emotional exhaustion (EE), 35.38% reported a moderate or high level of depersonalization (DP), and 62.05% reported reduced personal achievement (PA). Overall, 71.08% of GPs expressed a relatively high intention to seek another position (turnover intention). We found all 3 dimensions of burnout contributed to job dissatisfaction while turnover intention arising from burnout was associated with EE and DP. Job satisfaction had a direct negative impact on turnover intention and partially mediated the impact of EE and DP on turnover intention. Professional identity played a partial moderated role between EE and job satisfaction.

Conclusions:

The prevalence of burnout and turnover intention among GPs is high in China. The effect of EE and DP on turnover intention is mediated by job satisfaction, and the effect of EE on job satisfaction is moderated by professional identity.
Lived experiences of mental health conditions in Singapore: A constructivist grounded theory study
Authors: Kuek Jonathan Han Loong , Raeburn Toby , Chow Melissa Yan Zhi , Wand Timothy
Published: November 2022

Background:

Since the 1990s, the mental healthcare field has begun shifting to conceptualisations of personal mental health recovery, emphasising the heterogeneous nature of how people develop and overcome the difficulties associated with mental ill health. Despite three decades of research on the topic, most recovery-oriented studies have been conducted in predominantly Western cultures, lacking the necessary nuances when applied in Asian settings.

Aims:

We sought to contribute to a growing body of research to fill this gap by exploring the experiences of people who experience mental ill-health in Singapore.

Method:

We adopted a constructivist grounded theory approach and interviewed 21 people who had been diagnosed as experiencing a mental health condition.

Results:

The core category emerging from interview participant perspectives was a ‘roller coaster ride of confusion’. This overarching category was made up of the following four sub-categories – ‘not understanding what was happening’, ‘losing control over self’, ‘unpacking the root of challenges’ and ‘trying to make sense of the situation’.

Conclusions:

Taken together, the journey of a person experiencing mental health recovery in Singapore is filled with obstacles and uncertainty due to various social and cultural influences such as family pressures, the competitiveness of society and the high-pressure nature of Singapore’s educational system. Future research needs to better understand if these are generalisable experiences, and interventions to mitigate their impact need to be explored. Given the strong societal influences, change will take time. Still, this study gives a voice to the lived experiences of people who face mental health challenges in Singapore in the hope that their insights may assist future generations in developing a more mentally healthy society.