bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the STANDARD M10
C
.
difficile
, Xpert
C
.
difficile
, and BD MAX Cdiff assays as confirmatory tests in a two-step algorithm for diagnosing
Clostridioides difficile
infection
Authors: Choi Hyunseul , Kang Minhee , Yun Sun Ae , Yu Hui-Jin , Suh Eunsang , Kim Tae Yeul , Huh Hee Jae , Lee Nam Yong
Published: November 2024

Current guidelines recommend a two-step algorithm rather than relying solely on a single test for diagnosing
Clostridioides difficile
infection. This algorithm starts with enzyme immunoassay (EIA) for detecting glutamate dehydrogenase (GDH) and toxins A/B, followed by nucleic acid amplification test (NAAT) for GDH-positive but toxin-negative cases. This study compared the performance of three commercial NAATs: the STANDARD M10
C. difficile
, Xpert
C. difficile
, and BD MAX Cdiff assays, utilized as confirmatory testing of the two-step algorithm. Two hundred archived stool specimens, previously tested GDH-positive but toxin-negative by EIA, were analyzed in parallel with these NAATs and toxigenic culture, which served as the reference standard. Sensitivity, specificity, positive predictive value, and negative predictive value were 89.1%, 92.6%, 94.6%, and 85.2%, respectively, for the M10 assay; 95.8%, 86.4%, 91.2%, and 93.3%, respectively, for the Xpert assay; and 89.8%, 91.4%, 93.8%, and 86.0%, respectively, for the BD MAX assay. The rates of invalid results were 1.0%, 0.5%, and 1.0% for the M10, Xpert, and BD MAX assays, respectively. In conclusion, the M10 assay is a reliable diagnostic tool, performing comparably to the Xpert and BD MAX assays when used as confirmatory testing in the two-step algorithm.

IMPORTANCE

While numerous studies have assessed nucleic acid amplification tests (NAATs) as stand-alone tests for diagnosing
Clostridioides difficile
infection, limited research has compared their performance as confirmatory tests in a two-step algorithm. This study evaluated the performance of three commercial NAATs (M10, Xpert, and BD MAX assays) using 200 archived stool specimens initially tested as glutamate dehydrogenase (GDH)-positive but toxin-negative by GDH/toxin A/B enzyme immunoassay, the first step in the two-step algorithm. All three assays demonstrated high sensitivity (89.1% to 95.8%) and specificity (86.4% to 92.6%), with low rates of invalid results (≤1%). Our findings suggest that the M10 assay performs comparably to the Xpert and BD MAX assays when used as confirmatory testing in the two-step algorithm. Offering similar performance and turnaround time to these widely used assays at a slightly lower cost, the M10 assay serves as a practical alternative in this setting.
Transcriptome analysis reveals that PRV XJ delgE/gI/TK protects against intestinal damage in nose-dropping-infected mice by regulating ECM-ITGA/ITGB-P-FAK
Authors: Xu Tong , Zhang Yang , Tao Qian , Xu Lei , Lai Si-Yuan , Ai Yan-Ru , Huang Jian-Bo , Yang Ben-Lu , Zhu Ling , Xu Zhi-Wen
Published: November 2024

Pseudorabies virus (PRV) is an ideal model for mechanistic investigations into α-herpesvirus. The neurotropism and latent infection of PRV have been extensively studied. Apart from neurological symptoms, diarrhea caused by PRV infection is also an essential cause of mortality in newborn and weaned piglets. However, little research has been done on PRV invasion of the gut. To fill this gap, a nasal drip PRV-infection mouse model was developed, consisting of three groups: the challenged group (Group A), the immunization-challenged group (Group B), and a mock group (Group C). The results showed that immunization with PRV XJ delgE/gI/TK successfully prevented intestinal damage caused by PRV drop-nose infection. Subsequently, intestines were collected for transcriptional analysis. Differentially expressed genes analysis revealed that PRV XJ delgE/gI/TK was effective in reducing the organismal intestinal transcriptional activity caused by PRV. The Group A vs Group C and Group A vs Group B had similar Kyoto Encyclopedia of Genes and Genomes (KEGG)-enriched signaling pathways and the differentially expressed genes were primarily enriched in pathways, such as cell adhesion molecules, focal adhesion kinase, and actin cytoskeleton regulation. Notably, transcriptome analysis indicated that genes associated with the focal adhesion kinase (FAK) signaling pathway (ECM-ITGA/ITGB-p-FAK) were significantly more highly expressed in Group A than in Group B and Group C. The results of quantitative real-time PCR (RT-qPCR) and western blotting were consistent with KEGG analysis. Therefore, we hypothesized that PRV promotes self-infection through activation of the ECM-ITGA/ITGB-p-FAK signaling pathway and that PRV XJ delgE/gI/TK immunization could attenuate the intestinal damage caused by PRV by inhibiting the activation of this pathway.

IMPORTANCE

Pseudorabies virus (PRV) poses a significant threat to the swine industry and public health due to its ability to infect multiple species, including humans, leading to substantial economic losses and potential health risks. This study addresses a critical gap in understanding the impact of PRV infection on the gut, which has been less explored compared to its neurological effects. By developing a drip-nose PRV-infection mouse model, the research indicated that PRV might promote self-infection through activation of the ECM-ITGA/ITGB-p-FAK signaling pathway, and PRV XJ delgE/gI/TK immunization effectively prevents intestinal damage by significantly reducing the expression of genes in the ECM-ITGA/ITGB-p-FAK signaling pathway. The research has important implications for the swine industry and public health by contributing to the development of better vaccines and treatments, ultimately helping to control PRV and prevent its cross-species transmission.
Comparative evaluation of BacT/ALERT VIRTUO and BACTEC FX400 blood culture systems for the detection of bloodstream infections
Authors: Qin Yurong , Liao Yiwen , Zhou Jingfang , Liu Weijiang , Chen Huimin , Chen Xiaoli , Wang Weisha , Zhang Ni , Zhao Yunhu , Wang Liang , Gu Bing , Liu Suling
Published: November 2024

Bloodstream infections (BSI) pose significant threats to patient health, necessitating timely and accurate diagnostics to reduce mortality and morbidity. This study aimed to evaluate the clinical performance of the BacT/ALERT VIRTUO blood culture system with FANPlus bottles compared to the BACTEC FX400 system in detecting bloodstream pathogens. A total of 1,772 blood specimens were collected from various hospital wards. Specimen selection criteria were based on clinical suspicion of bloodstream infections, ensuring the inclusion of relevant and representative patient samples. These blood samples, collected from the same suspected sepsis patients, were cultured in parallel using both the BacT/ALERT VIRTUO and BACTEC FX400 systems. The diagnostic efficiency of both systems, including detection rates, time to detection (TTD), and sensitivity across different bacterial species, was assessed. In various application scenarios, the VIRTUO system demonstrates a higher positive detection rate, whether in the intensive care unit (ICU) (8.5% vs 6.4%,
P
= 0.028) or in general wards. Additionally, for different types of bacteria, the TVIRTUO system exhibits superior detection rates for anaerobic bacteria (5.9% vs 3.2%,
P
< 0.001) and aerobic bacteria (9.1% vs 7.2%,
P
= 0.043). Furthermore, it boasts a shorter median TTD of 14 hours compared to 16 hours, and a higher sensitivity for Gram-positive bacteria (2.8% vs 1.6%,
P
< 0.001). These findings emphasize VIRTUO’s effectiveness in enhancing diagnostic accuracy, achieving faster time to detection, and expanding the spectrum of detected organisms, thereby facilitating the quicker initiation of appropriate therapies, supporting precise clinical decision-making, and ultimately improving patient outcomes.

IMPORTANCE

Our study conducted a critical evaluation of advanced blood culture technologies for managing bloodstream infections (BSI). A distinctive strength of our research is the large sample size and the concurrent testing of the same patients with two systems, a methodology rarely achieved in other studies. BSIs present severe health threats, necessitating prompt and accurate diagnostics to mitigate morbidity and mortality. The BacT/ALERT VIRTUO system, in comparison to the BACTEC FX400 system, demonstrated superior detection capabilities, emphasizing the critical role of advanced diagnostics in clinical settings.
Supplemental Material: Establishing the modern-like differential climate of the Qaidam Basin, northeast Tibetan Plateau, since ca. 9 Ma: Implications of the effect of interactions between tectonics and atmospheric circles on paleoclimate
Authors: Lin Xiubin , al. et
Published: November 2024

Figure S1: The Sahu discriminant (Sahu, 1964) diagram for the Cenozoic samples of the Dahonggou Section along the northeastern Qaidam Basin. Figure S2: Plots of Mean Size (in Φ values) versus Sorting (e.g., Jiang and Ding, 2010) of samples from the Cenozoic strata of the Dahonggou Section for each stratigraphic formation. Table S1: Raw data of the grain-size analyses of the Cenozoic strata of the Dahonggou Section on the northeastern Qaidam Basin.
Predictors of upper limb motor recovery in stroke survivors: a pre–post test study design
Authors: Sikuka Hope Muwanei , Lupenga Joseph , Nkhata Loveness
Published: November 2024

Objectives

The study aimed to assess the predictors of upper limb motor recovery in stroke survivors.

Design

Pre–post test study design.

Setting

Conducted in two centres (First Level Hospital and University Teaching Hospital in Lusaka).

Participants

Patients living with stroke accessing physiotherapy services at the two public hospitals. A total of 52 patients were recruited at the start of the study, 6 were lost to follow-up and 46 completed the study.

Intervention

Conventional physiotherapy for 8 weeks (5 September 2022–28 October 2022).

Primary outcome

Motor function measured using a Fugl-Meyer assessment of the upper extremity.

Results

Analysis was conducted on 46 participants. A significant difference was observed between the level of motor function at baseline and after 8 weeks of treatment (p=0.0183). At baseline, 50% of participants had mild motor function, which improved after 8 weeks, with 69.6% having mild motor function. Stroke patients with severe motor function impairment at baseline were associated with 0.01 times likelihood of having mild motor function impairment after 8 weeks of physiotherapy treatment (AOR 0.01; 95 % CI 0.00 to 0.16; p=0.002).

Conclusion

The motor function of stroke patients continues to improve over time. This study demonstrated that initial upper limb motor function impairment could be used as a predictor for upper limb motor function.
Development, validation and economic evaluation of a machine learning algorithm for predicting the probability of kidney damage in patients with hyperuricaemia: protocol for a retrospective study
Authors: Hou Zhengyao , Yang Yong , Deng Bo , Gao Guangjie , Li Mengting , Liu Xinyu , Chang Huan , Shen Hao , Zou Linke , Li Jinqi , Wu Xingwei
Published: November 2024

Introduction

Accurate identification of the risk factors is essential for the effective prevention of hyperuricaemia (HUA)-related kidney damage. Previous studies have established the efficacy of machine learning (ML) methodologies in predicting kidney damage due to other chronic diseases. Nevertheless, a scarcity of precise and clinically applicable prediction models exists for assessing the risk of HUA-related kidney damage. This study aims to accurately predict the risk of developing HUA-related kidney damage using a ML algorithm, which is based on a retrospective database.

Methods and analysis

This retrospective study aims to collect clinical data on outpatients and inpatients from the Sichuan Provincial People’s Hospital, China, covering the period from 1 January 2018 to 31 December 2021 with a focus on patients diagnosed with ‘hyperuricaemia’ or ‘gout’. Predictive models will be constructed using techniques such as data imputation, sampling, feature selection and ML algorithms. This research will evaluate the predictive accuracy, interpretability and fairness of the developed models to determine their clinical applicability. The net benefit and net saving will be calculated to gauge the economic value of the model. The most effective model will then undergo external validation and be made available as an online predictive tool to facilitate user access.

Ethics and dissemination

The Ethics Review Committee at Sichuan Provincial People’s Hospital granted approval for the ethical review of this study without requiring informed consent. The findings of the study will be disseminated in a peer-reviewed journal.
Factors influencing postoperative urinary retention after radical hysterectomy for cervical cancer: development and validation of a predictive model in a prospective cohort study in Southwest China
Authors: Zuo Yan , Yang Kaixuan , Zhang Jianjun , Liu Xinru , Bai Zhilan , He Jingwen , Hu Xiaolin
Published: November 2024

Objectives

To explore influencing factors for postoperative urinary retention (POUR) in cervical cancer patients and construct and validate a POUR prediction model.

Design

A prospective cohort study.

Setting

A large tertiary hospital specialised in child and maternal healthcare in Southwest China.

Participants

1101 patients undergoing cervical cancer surgery at our hospital were enrolled in the analytic cohort between 1 July 2022 and 31 July 2023. Another 205 patients were enrolled in the external validation cohort between 1 August 2023 and 31 October 2023. Demographics and disease-related information were collected to construct a risk prediction model by logistic regression. Univariate analyses and a multivariate logistic regression analysis were conducted to determine possible influencing factors. The discrimination and accuracy of the model were assessed by the area under the curve (AUC) and the concordance index, respectively.

Results

Univariate analysis identified duration of surgery, intraoperative bleeding, presence of diabetes, hypertension, ureteral adhesion, wound healing classification, preoperative radio/chemotherapy, category of Body Mass Index, history of urinary diseases, history of caesarean section, postoperative urinary infection and use of analgesia pumps as potential influencing factors (p<0.05). Diabetes, wound healing classification, presurgery radio/chemotherapy, postoperative urinary infection, use of analgesia pumps and pain numerical rating score were founded to be significant factors influencing the occurrence of POUR in cervical cancer patients (p<0.05). A POUR prediction model constructed using the factors demonstrated excellent prediction power, with an AUC of 0.897 (95% CI, 0.877 to 0.916, p<0.001). The sensitivity of the model at the optimal threshold was 0.591, with specificity being 0.747. The receiver operating characteristic curve indicated a good performance of the model.

Conclusions

Presence of diabetes mellitus, wound healing classification, presurgery radio/chemotherapy, postoperative urinary infection, use of analgesia pumps and pain numerical rating score are factors influencing occurrence of POUR in cervical cancer patients. The POUR prediction model developed demonstrates good predictive power and is promising for clinical utility.
Prevalence and determinants of TB/HIV coinfection: the double tragedy of infectious disease burden – a 5-year retrospective study in a tertiary health facility in Enugu State, Nigeria
Authors: Nwoga Hope Obiageli , Igweagu Chukwuma Paulinus , Umeh Gabriel Chukwuemeka
Published: November 2024

Objective

To ascertain the prevalence and determinants of tuberculosis (TB)/HIV coinfection in Enugu State Nigeria.

Study design

A 5-year record-based retrospective study (2018–2022) conducted at a tertiary health facility to identify TB/HIV coinfections.

Setting

About 483 patients treated for TB at the centre were included in the study.

Primary outcome measure

The χ2test was used to test for association between the background characteristics of the patients (age, gender, place of residence, educational level, marital status, occupation, ethnicity and type of TB) and TB/HIV coinfection, while logistic regression was used to determine predictors of TB/HIV coinfection.

Results

Of the 483 patients with TB treated within the study period (2018–2022), all of them were screened for HIV and 29.0% of them had TB/HIV coinfection. The prevalence of TB/HIV coinfection was highest in 2021 (27.1%). On logistic regression, TB/HIV coinfection was more likely among traders (adjusted OR, AOR 4.932, 95% CI 1.364, 17.839) and students (AOR 2.772, 95% CI 1.014, 7.577). Those diagnosed in 2022 (AOR 0.514, 95% CI 0.272, 0.969) and those who reside in urban areas (AOR 0.594, 95% CI 0.372, 0.949) had lower odds of having TB/HIV coinfection.

Conclusion

Almost one-third of all the patients with TB (29.0%) treated at the health facility were HIV coinfected. Occupation of the patients was found to predict TB/HIV coinfection as traders had the highest odds of TB/HIV coinfection when compared with the other occupational groups. Targeted interventions should be geared towards these groups of persons for better prevention and control of both TB and HIV infections in the State.
Individual- and community-level risk factors for maternal morbidity and mortality among Native American women in the USA: a systematic review
Authors: Celaya Martín , Zahlan Alaa I , Rock Chelsea , Nathan Akshay , Acharya Aishwarya , Madhivanan Purnima , Ehiri John , Hu Chengcheng , Pettygrove Sydney D , Nuño Velia Leybas
Published: November 2024

Introduction and objective

Maternal morbidity and mortality (MMM) is a public health concern in the USA, with Native American women experiencing higher rates than non-Hispanic White women. Research on risk factors for MMM among Native American women is limited. This systematic review comprehensively synthesizes and critically appraises the literature on risk factors for MMM experienced by Native American women.

Methods and analysis

A systematic search was conducted on 10 October 2022 in PubMed, Embase, CINAHL and Scopus for articles published since 2012. Selection criteria included observational studies set in the USA, involving Native American women in the perinatal period, and examining the relationship between risk factors and MMM outcomes. Three reviewers screened and extracted data from the included studies, with risk of bias assessed using the National Institutes of Health Quality Assessment Tools. Data were analysed descriptively.

Results

15 studies were included. All studies used administrative databases, with settings, including nationwide (seven studies), statewide (four studies) and Indian reservations (four studies). The majority of studies focused on hypertensive disorders of pregnancy (eight studies) and severe maternal morbidity (SMM) (four studies). 26 risk factors were identified. Key risk factors included Native American race (six studies), rural maternal residency (four studies), overweight/obese body mass index (two studies), maternal age (two studies), nulliparity (two studies) and pre-existing medical conditions (one study).

Conclusion

This review identified risk factors associated with MMM among Native American women, including rural residency, overweight or obesity and advanced maternal age. However, the findings also reveal a scarcity of research specific to this population, limiting the ability to fully understand these risk factors and develop effective interventions. These results emphasise the need for further research and culturally relevant studies to inform public health and address disparities for Native American women, particularly those in rural areas.

PROSPERO registration number

CRD42022363405.
Psychometric properties and clinical utility of spinal health outcome measures in school-based interventions among children and adolescents: a systematic review protocol
Authors: Nkhata Loveness A , Human Anri , Louw Q A , Brink Yolandi
Published: November 2024

Introduction

Spinal health in children and adolescents has global implications, impacting school attendance, academic performance and physical activity. Effective school-based interventions are essential for promoting spinal health literacy, positive behaviours and academic success.

Objectives

This review aims to collect data on school-based interventions for spinal health in children and adolescents over the past two decades. It will examine interventions such as education, exercise and appropriate furniture, focusing on outcomes including musculoskeletal pain, posture, sedentary behaviour and academic performance. Additionally, the review will describe the psychometric properties and clinical utility of the outcome measures used in these studies.

Methods and analysis

The systematic review will adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, employing the PICO framework to define criteria for participants, interventions, comparisons, outcomes and study designs. Only English studies published between 2004 and 2024 will be included. Relevant databases will be searched using specific keywords derived from the PICO framework. The Critical Appraisal Tool and the COSMIN Risk of Bias tool will be used to evaluate the methodological quality and risk of bias in the selected studies. Review authors will independently assess articles, resolving discrepancies through consensus. Statistical analyses will be performed using CADIMA V.2.2.4.2 April 2023.

Results

Data will be collected based on various outcome measures, evaluated with an approved checklist and presented through descriptive narratives and tables. Findings will be disseminated via conference presentations, Faculty Research Day and publication in reputable journals.

Ethics and dissemination

The study will adhere to the ethical principles outlined in the Declaration of Helsinki, ensuring a rigorous approach to minimise bias and guarantee valid results. Studies will be selected based on predetermined criteria following a consistent protocol. The findings will be disseminated through presentations and publication in peer-reviewed journals.

PROSPERO registration number

The systematic review protocol is registered on PROSPERO (registration number CRD42024543258), with a planned date of commencement from August 2024 to November 2024.
Developing and testing a toolkit of interventions to improve adherence to non-invasive ventilation in children: the SPIRITUS study protocol
Authors: Russell Jessica , Chan Elaine Y , Davies Gwyneth , Gibson Faith , Harniess Philip , Rendle Garry , Wray Jo
Published: November 2024

Introduction

Non-invasive ventilation (NIV) is a known effective and safe treatment for children and young people with sleep disordered breathing (SDB). Adherence can be challenging and poor adherence risks undertreatment of SDB. While the risk factors for non-adherence have been widely reported, very few interventions have been tested in any capacity to address barriers to adherence.

Methods and analysis

We will conduct a mixed methods study over three phases. The aim is to identify the components of a toolkit of interventions to address some of the barriers to NIV usage in children and young people who have SDB. We will test these components for their feasibility and acceptability to families. We will also aim to identify health outcomes from NIV use that are important to families. Qualitative data will be managed using NVivo software and analysed using the Framework method. Quantitative data will be analysed using descriptive statistics.

Ethics and dissemination

The study will run from January 2023 to October 2025. This study has ethics and local site approval. Data will be stored and accessed only by the research team, stored on a secure server. Data will be pseudo-anonymised prior to analysis and presented in a way that no individual can be identified. We will disseminate widely to relevant stakeholders including peer-reviewed journals, presentations to academic and clinical audiences at conferences and meetings and a lay report.

Trial registration number

ISRCTN56845190.
Can we empirically derive a geographic definition of ‘coastal’ for use in cancer data reporting? An ecological modelling study using England’s national cancer registry
Authors: Welsh Claire , Welham Catherine , Anderson Jack , Green Mark Alan , Quinn Clarice , Lai Jennifer , Vernon Sally , Paley Lizz
Published: November 2024

Background

Reducing avoidable systematic differences in population health requires first understanding which populations are currently disadvantaged. Although the health of coastal communities in England has been of concern for some years, an operationalised definition of ‘coastal’ is lacking. This study aims to use national cancer statistics to define and validate a small area-level definition of ‘coastal’ that could be used to better report cancer-related health inequalities in England.

Methods

Information on the geography and demography of English populations at the Lower Super Output Area (LSOA) level were used to define a suite of candidate coastal variables that considered foreshore proximity, resident population location, rurality and deprivation. Adjusted linear models of LSOA-level statistics of cancer incidence, prevalence and mortality in England (2016 to 2020) were used to identify candidate coastal variable(s) that explained the greatest proportion of variation in cancer outcomes after adjustment.

Results

The candidate ‘G_25_5’ (LSOA’s designated as ‘coastal’ if 25% or more of postcodes were within 5 km of the coastline) was selected as the candidate that explained the most residual variation in cancer incidence and prevalence after adjustment. This variable would assign 7377 2011 LSOAs as coastal, whose populations summed to 12.3 million people (22% of England’s population, in 2016). This candidate variable was not significantly associated with cancer mortality.

Conclusions

The coastal variable that we identify can explain some of the ‘coastal excess’ in poor cancer outcomes. We propose that this variable is now embedded into health inequalities reporting and adopted as the working definition of ‘coastal’ implicated in NHS England’s ‘Core20PLUS5’ approach for use in cancer data reporting.
Associations of paternal age with offspring under-five mortality and perinatal outcomes: a cohort study using claims data in Taiwan
Authors: Wang Shi-Heng , Lee Jian-Te , Lin Mei-Chen , Wu Chi-Shin , Thompson Wesley K , Fan Chun-Chieh
Published: November 2024

Background

The causal relationship between advanced paternal age and offspring health is unclear, owing to familial confounders. This study examined the association of paternal age with offspring’s under-five mortality and perinatal outcomes, using sibling comparison analyses to account for familial confounding factors.

Methods

A nationwide birth cohort study was designed based on Taiwan’s single-payer compulsory National Health Insurance programme. Individuals born between 2001 and 2015 were included, resulting in 2454 104 live-born singletons. Among them, 1513 222 individuals had full sibling(s) who were included in the sibling-comparison analyses. Logistic regression analyses were used to evaluate the main study cohort whereas conditional logistic regressions were used in the sibling-comparison analyses.

Results

In the main cohort, paternal age categories showed a U-shaped relationship with offspring’s under-five mortality in the crude analysis, which attenuated towards the null hypothesis after accounting for the measured potential confounders. There was an increased risk of premature birth (gestational age <37 weeks), low birth weight (<2500 g), large for gestational age (90th percentile) and low 5 min Apgar Score (<7) in individuals with a paternal age of >35 years. Sibling-comparison analyses that accounted for unmeasured familial time-invariant confounders showed that younger siblings with older paternal age had a lower risk of under-five mortality, low birth weight, small for gestational age (10th percentile), congenital defects and low 5 min Apgar Score, and a higher risk of premature birth and large for gestational age.

Conclusions

Children with older fathers had lower risks of under-five mortality, low birth weight, small for gestational age, congenital defects and low 5 min Apgar Score.
Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study
Authors: Lin Shih-Chun , Chang Hsin-Yi , Huang Mei-Chih
Published: November 2024

Objective

This study compared the differences in the rates of maltreatment and homicide deaths between children and young adults with and without a life-limiting condition (LLC) and determined whether this affects the likelihood of receiving specialised palliative care (SPC) services before death.

Design

A nationwide retrospective observational study.

Setting

Taiwan.

Patients

Children and young adults aged 0–25 years with LLCs and maltreatment were identified within the Health and Welfare Data Science Centre by International Classification of Diseases codes. Deaths were included within the Multiple Causes of Death Data if they occurred between 2016 and 2017.

Main outcome measures

Rates of maltreatment, homicide deaths and SPC referrals.

Results

Children and young adults with underlying LLCs experienced a similar rate of maltreatment (2.2 per 10 000 vs 3.1 per 10 000) and had a 68% decrease in the odds of homicide death (19.7% vs 80.3%, OR, 0.32; 95% CI 0.18 to 0.56) than those without such conditions. Among those with LLCs who experienced maltreatment, 14.3% (2 out of 14) had received SPC at least 3 days before death. There was no significant difference in SPC referrals between those who experienced maltreatment and those who did not.

Conclusions

The likelihood of being referred to SPC was low with no significant statistical differences observed between children and young adults with maltreatment and without. These findings suggest a need for integrating SPC and child protection services to ensure human rights are upheld.
Circulating bone morphogenetic protein 10 as a novel marker of atrial stress and remodelling in heart failure
Authors: Ceelen Daan C H , Bracun Valentina , van Essen Bart J , Voors Adriaan A , de Boer Rudolf A , ter Maaten Jozine M , Masson Serge , Kastner Peter , Lang Chim C , Suthahar Navin
Published: November 2024

Background

We evaluated the potential of circulating bone morphogenetic protein 10 (BMP10) as a biomarker for atrial stress and remodelling in patients with heart failure (HF), in comparison to N-terminal pro-B-type natriuretic peptide (NT-proBNP). We also assessed the predictive value of BMP10 for adverse clinical outcomes.

Methods

BMP10 levels were quantified in 2085 chronic HF patients from the European BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT-CHF) cohort and in 1487 patients from the Scottish validation cohort. Multivariable linear regression identified independent associates of BMP10. Proteomic analysis of 6369 proteins with subsequent gene set enrichment analysis was used to explore biological pathways associated with elevated BMP10. Cox proportional hazards models adjusting for established risk factors were used to associate BMP10 levels with clinical outcomes, including all-cause mortality and HF hospitalisation.

Results

In a multivariable model including clinical and echocardiographic parameters, log-transformed and standardised BMP10 levels were significantly associated with a history of atrial fibrillation (Sβ=0.419; p<0.001), and with echocardiographic features reflecting atrial stress, such as increased left atrial diameter (Sβ=0.075; p=0.048). By contrast, these were not among the strongest associates of NT-proBNP levels. Gene set enrichment analysis showed significant overrepresentation in pathways of muscle contraction and extracellular matrix organisation. Higher log-transformed and standardised BMP10 levels predicted a combined outcome of 2-year all-cause mortality and HF rehospitalisation (HR=1.10, 95% CI=1.02–1.19), with the validation cohort yielding comparable results.

Conclusion

BMP10 emerges as a novel biomarker reflecting atrial stress and remodelling in chronic HF patients. Its additional predictive value for adverse outcomes underscores its potential utility in enhancing risk stratification and guiding therapeutic interventions in HF management.
Antecedent viral immunization and efficacy of immune checkpoint blockade: an extensive serum antibody profile to predict outcomes in non-small cell lung cancer
Authors: Dall’Olio Filippo G , Zrafi Wael Salem , Blampey Quentin , Danlos Francois-Xavier , Roulleaux-Dugage Matthieu , Roman Gabriel , Naltet Charles , Cournède Paul-Henry , Gautheret Daniel , Aldea Mihaela , Planchard David , Barlesi Fabrice , Marabelle Aurelien , Hulett Tyler , Chaput-Gras Nathalie , Besse Benjamin
Published: November 2024

Introduction

Immune checkpoint blockers (ICBs) revolutionized the treatment of patients with advanced non-small cell lung cancer (NSCLC) but only a fraction of them obtain a response, and clinical benefit from these treatments is often difficult to predict. The aim of our study is to unveil the potential implications of antibody response to previous viral infections in predicting response to ICBs in patients with NSCLC.

Methods

Sera from patients treated with ICBs alone, chemotherapy (CT) or a combination of CT-ICBs were analyzed with VirScan (CDI Labs, USA), a high-throughput method that comprehensively analyzes epitope-level antiviral IgG antibodies via programmable phage display and immunoprecipitation sequencing.

Total number of unique positive peptides (tUP) was defined as the total number of non-overlapping positive “is a hit” peptides for each patient.

Results

Overall, 387 patients were included. Of them, 129 were treated with ICBs alone, 66 with CT-ICBs and 195 with CT alone. 90 out of 129 patients treated with ICBs alone received ICBs as a subsequent line of treatment, while CT-ICBs and CT were administered as upfront therapies.

A higher tUP was correlated with improved overall survival in patients treated with ICBs, and confirmed in the multivariate model (HR 0.43, 95% CI 0.24, 0.79, p=0.006), while it was not in those treated with CT-ICBs (p=0.8) and CT alone (p=0.1).

tUP was not correlated with programmed death-ligand 1 (PD-L1) expression, while at the transcriptome level it was correlated with several immune-related pathways, particularly involving B cells.

Conclusion

A higher number of viral peptides recognized by serum antibodies might reflect increased immune fitness, resulting in improved outcomes in ICBs treated patients with NSCLC.
Marketing strategies in business-to-business advertisements for oral nicotine products
Authors: Sharma Akshika , Belton Amy , Ozga Jenny E , Ling Pamela , Hrywna Mary , Cornacchione Ross Jennifer , Ganz Ollie , Bold Krysten W , Stanton Cassandra
Published: November 2024

Introduction

Although the popularity of oral nicotine products (ONPs) such as ZYN and On! is growing globally, there is limited research on their marketing and advertising. This report describes recent ONP marketing communication to retailers. Promotion to retailers can provide insight into new product flavours and styles, as well as future marketing strategies targeting consumers.

Methods

We obtained all unique ONP print and online advertisements (ads) (N=50) targeted towards US businesses between January 2016 and August 2022 from Vivvix (formerly Numerator Ad Intel). Two independent reviewers coded for type of ONP, brand, nicotine strength(s), flavour(s), slogan(s), claim(s) and frequency of each component.

Results

Most ads featured nicotine pouches alone (52%), while 22% featured a mix of ONPs including pouches, tablets and lozenges. By brand, Rogue constituted 36% of ads, followed by Zyn and On! (16% each). Most (82%) ads featured at least one cooling flavour and 48% displayed at least one fruit flavour. Wintergreen flavour appeared most frequently (48%). Most (72%) ads contained a slogan, which frequently highlighted convenience of use (eg, ‘Chew on this Anywhere… Anytime’), bypassing current restrictions on other tobacco and nicotine products use (eg, ‘Laughs at no smoking signs’) and highlighting big profit margins from sales of ONPs for retailers (eg,‘small pouches big margins’).

Conclusion

This analysis provides insight into tobacco companies’ strategies for increasing ONP endorsement among retailers. Strategies include appealing to profitability, emphasising convenience of product use and primarily promoting non-tobacco flavours. These findings highlight new trends in ONP products and marketing tactics and identify important areas to monitor to inform tobacco marketing regulations.
Optimization of porous volcanic ash-based geopolymer for crystal violet adsorption using the Box-Behnken design
Authors: Lenou Idriss , Tchakounte Armand , Shikuku Victor , Kemdjien Ludovic , Valere Kuisseu , Dika Joseph , Kede Charles
Published: November 2024

Volcanic ash was used as a precursor for the synthesis of a geopolymer activated by sodium hydroxide and using hydrogen peroxide as a pore-forming agent. Factors controlling geopolymer synthesis such as sodium hydroxide concentration (6–12 mol/L), liquid/solid mass ratio (0.3–0.5), and H2O2 mass concentration (0%–2%) were optimized using the Box-Behnken design method. The chosen process variables were optimized to enhance both the geopolymer's porosity and its effectiveness in removing crystal violet. Sodium hydroxide concentration and H2O2 mass concentration had a significant effect on both responses. Under optimal conditions of 6 mol/L NaOH concentration, a 0.3 liquid/solid ratio, and 2% H2O2 mass concentration, the model-predicted and experimental values for both responses were highly comparable. Additionally, response surface methodology was used to assess the removal of crystal violet from an aqueous solution, employing the geopolymer produced under these optimal conditions as the adsorbent. Experiments were carried out according to the Box-Behnken statistical surface design with four input parameters, namely, contact time (A: 10–120 min), initial crystal violet concentration (B: 20–100 mg/L), adsorbent dose (C: 0.1–0.6 g), and pH (D: 3–9). Regression analysis indicated a strong fit of the experimental data to the second-order polynomial model, with a coefficient of determination ( R2) of 0.9864 and a Fisher's F value of 61.97. Optimization of the parameters A (35.415 mg/L), B (98.184 min), C (0.359 g), and pH (6.950) achieved a maximum crystal violet removal of 98.413% by the geopolymer.
Projected changes in risks of winter damage to fruit trees and plant hardiness zones in Canada
Authors: Qian Budong , Jing Qi , Bélanger Gilles , Jégo Guillaume , Smith Ward , VanderZaag Andy , Shang Jiali , Liu Jiangui , Grant Brian , Crépeau Marianne
Published: November 2024

Winter climate conditions, especially extremely low temperatures, constrain the production of fruit trees and other perennial crop species in Canada. Significant decreases in cold extremes under climate change may result in changes in plant hardiness zones and the distribution of crop species across the country. Climate warming might also bring changes to climate conditions that affect fall hardening, loss of cold hardiness due to winter thaws, and spring frost damages. Using the most up-to-date climate projections, we provide projected changes in the risks of damages to fruit trees during winter based on five agroclimatic indices and changes to the United States Department of Agriculture (USDA) plant hardiness zones based on long-term averages of annual extreme minimum air temperatures in the near-term (2030s, 2020–2049), mid-term (2050s, 2040–2069), and distant future (2070s, 2060–2089). Our results suggest that climate change might be beneficial for fruit trees across Canada with (1) improved fall hardening because of more time to acquire cold hardiness due to delayed first fall frost and (2) decreased winter coldness with increases in annual minimal temperatures and decreases in the accumulation of cold degree-days below –15 °C. The risks of loss of cold hardiness due to winter thaws will increase slightly while the risks of spring frost damages to buds will be largely unchanged. Under a warmer distant future, the USDA plant hardiness zones across Canada would increase by 1.5–2 “full” zones, which may lead to the introduction of new fruit tree species and opportunities for Canadian producers.
Productions of bottom and bottom-strange mesons in pion and kaon induced reactions
Authors: Liu Jing , Guo Quan-Yun , Wu Qi , He Jun , Chen Dian-Yong
Published: November 2024

In the present work, we propose to explore the productions of the bottom and bottom-strange mesons in the high-energy pion and kaon-induced reactions on a proton target. The cross sections are evaluated with an effective Lagrangian constructed by the heavy-quark limit and chiral symmetry. Our estimations show that at $$P_\pi =80$$

P
π

=
80

GeV, the cross sections for B(5279), $$B^*(5325)$$

B
∗

(
5325
)

, $$B_0^*(5722)$$

B
0
∗

(
5722
)

, $$B_1^\prime (5716)$$

B
1
′

(
5716
)

, $$B_1(5721)$$

B
1

(
5721
)

and $$B_2^*(5747)$$

B
2
∗

(
5747
)

production processes are estimated to be 3.19–86.26, 1.86–51.29, 0.88–24.33, 0.86–23.69, 162.35–4477.66, and 57.16–1604.43 nb, respectively, where uncertainties arise from the model parameter. In addition, the cross sections for the corresponding bottom-strange mesons production processes are very similar. From the heavy quark effective theory point of view, the ratios between the cross sections for bottom mesons and bottom-strange mesons should be similar and the present estimations are consistent with the expectation of heavy quark limit. In particular, the cross-section ratios related to the states in the same doublets are of order one. The cross sections related to the states in the T doublets are about two orders larger than those related to the states in the S doublets.
Phenomenology of extended multiHiggs doublet models with $$S_4$$ family symmetry
Authors: Hernández A. E. Cárcamo , Espinoza Catalina , Gómez-Izquierdo Juan Carlos , Marchant González Juan , Mondragón Myriam
Published: November 2024

We propose extended 3HDM and 4HDM models where the SM gauge symmetry is enlarged by the spontaneously broken $$S_4$$

S
4

group, the preserved $$Z_2$$

Z
2

and broken $$Z_4$$

Z
4

cyclic symmetries. Each model has three active SU(2) scalar doublets, in addition, the first one has an extra inert scalar singlet, whereas the second model has an inert scalar doublet. Furthermore, each model has several extra gauge singlet scalars, which are triplets under $$S_4$$

S
4

. Both models yield the same structure of the mass matrices for the fermion sector, where a radiative seesaw generates the tiny light active neutrino masses at one-loop level, through the $$S_4$$

S
4

triplets. The presence of flavor changing neutral currents mediated by heavy scalars allowed us to study the $$(K^0-\overline{K}^0)$$

(

K
0

-

K
¯

0

)

and $$(B_{d,s}^0-\overline{B}_{d,s}^0)$$

(

B

d
,
s

0

-

B
¯

d
,
s

0

)

meson mixings, in the parameter space that currently satisfies the experimental constraints. On the other hand, due to the preserved $$Z_2$$

Z
2

symmetry, our proposed models have stable scalar and fermionic dark matter candidates. Furthermore, these models are consistent with the current pattern of SM fermion masses and mixings, with the measured dark matter relic abundance and successfully accommodate the constraints arising from meson oscillations and oblique parameters. The extra scalars in our models provide radiative corrections to the oblique parameters, where due to the presence of the scalar inert doublet, renders the 4HDM less restrictive than the 3HDM one.
Impact of adding bismuth oxide nanoparticles functionalized with graphene oxide nanosheet on the polyvinyl chloride shielding properties
Authors: Salem Elsayeda F. , Khalil Waleed F. , Zaky Rasha S. , Kamel Fatma A.
Published: November 2024

This study investigates the enhancement of polyvinyl chloride (PVC) by incorporating Bi2O3-GO nanocomposites. We produced nanocomposites with varying concentrations (1, 2.5, 5, and 10 wt%). The prepared samples were characterized using scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). X-ray diffraction (XRD) and thermogravimetric analysis (TGA) were also used. As well as the shielding effectiveness against ultraviolet rays and gamma radiation from 137Cs and ⁶⁰Co sources at energies of 662, 1173, and 1275 keV. Results indicate that the addition of Bi2O3-GO significantly improves the thermal stability of PVC, as evidenced by higher decomposition temperatures from TGA. The absorption coefficient increases, while energy gap values decrease with increased nanofiller weight concentrations. The linear attenuation coefficient (LAC) also rises with increasing nanofiller content and decreases with higher gamma-ray energies. Results were consistent with Phy-X software simulations. The sample with 10% wt of Bi2O3-GO composite demonstrated a highly fast neutron removal cross section (FNRC) and reduced mean free path (MFP). This indicates strong potential for use as a safe, environmentally friendly alternative to lead-based shielding materials. These PVC/Bi2O3-GO nanocomposites could be effectively utilized in radiation barriers and protective screens in settings involving neutron and low-energy gamma radiation, such as in radiography and radioactive material management.
The Application of Computer Music Analysis Technique in the Characteristic Analysis of Vocal Music Works
Authors: Shen Tingting
Published: November 2024

In the current diversified music creation and consumption environment, the incubation of high-quality music is facing unprecedented challenges, partly due to the significant limitations of traditional beat tracking algorithms in dealing with complex and ever-changing music structures. Therefore, this paper innovatively proposes a real-time music beat tracking algorithm that integrates embedded neural network technology, aiming to break through technical bottlenecks and reshape the paradigm of music feature extraction and classification. The algorithm first conducted in-depth research on the feature extraction and classification technology model of music signals. By integrating embedded neural network technology, deep learning and precise capture of music features have been achieved, effectively overcoming the shortcomings of traditional methods in processing complex music features. On this basis, we further introduced embedded neural networks and utilized their powerful optimization search capabilities to intelligently adjust the data layout for music feature extraction and classification, thereby significantly improving the accuracy of feature extraction and the reliability of classification. To verify the effectiveness of the algorithm, we applied it to real-time detection of rhythm values and precise beat point positions in music. By comparing with international authoritative evaluation datasets such as MIREX2006, the significant improvement of this algorithm in time performance and accuracy was demonstrated.
Stock Market Investment Risk Measurement Method Based on Data Mining and Decision Trees
Authors: Youwen Wang
Published: November 2024

This study endeavors to introduce a method for measuring stock market investment risk, leveraging data mining techniques alongside decision trees (DTs). By harnessing extensive stock market data and integrating steps such as data cleaning, feature selection, and model construction within data mining technology, an effective risk measurement model is formulated. Specifically, DTs serve as the primary modeling tool, adept at capturing intricate relationships and nonlinear characteristics prevalent within the stock market, thereby facilitating precise measurement of investment risks. Through empirical analysis, the efficacy and viability of the proposed method in risk measurement are substantiated, furnishing investors with a pivotal decision-making reference. Overall, this study contributes to the ongoing discourse on stock market risk assessment by integrating advanced data mining methodologies, thereby enhancing the accuracy and reliability of risk evaluation in investment decision-making processes.