bluuebunny/crossref_metadata_2025 huggingface dataset:
Cluster analysis of post-COVID-19 physical and mental health outcomes 3–6 months after SARS-CoV-2 infection: results of the French Prospective ALCOVID Cohort Study
Authors: Escoda Thomas , Chiche Laurent , Faralli Hervé , Cohen Frédéric , Halfon Philippe , Pegliasco Hervé , Rebaudet Stanislas
Published: February 2025

Objectives

This study aims to characterise the diversity of post-COVID-19 physical and mental health outcomes, known as the post-COVID-19 condition (PCC), and the determining factors 3–6 months after acute SARS-CoV-2 infection.

Design

This is a prospective cohort study.

Setting

This study took place at the European Hospital of Marseille, France.

Participants

Participants include patients with acute COVID-19 treated as inpatients or outpatients.

Interventions

Interventions include face-to-face assessment of physical and mental health symptoms.

Main outcome measures

Main outcome measures include symptom scores and scales, as well as paraclinical elements (thoracic CT scan, pulmonary functional tests). Multiple component analysis was used to identify clinical phenotypic clusters of PCC patients, as well as their initial comorbidity groups. A multinomial regression model was used to evaluate the association between the initial comorbidities and disease severity with PCC phenotype.

Results

A total of 210 patients agreed to participate, of which 157 (75%) reported at least one symptom at the 3–6 months visit; mostly asthenia, dyspnoea, psychiatric disorders such as anxiety, depression, post-traumatic stress disorder and cognitive disorders. Four PCC clusters were recognised: (1) paucisymptomatic PCC (n=82, 39%); (2) physical sequelae PCC (n=39, 18.6%), (3) pre-existing pulmonary comorbidities PCC (n=29, 13.8%); and (4) functional somatic and/or mental symptoms PCC (n=60, 28.6%). In addition to their PCC symptoms, the patients in these clusters differed in terms of their demographic characteristics (sex), comorbidities and severity of COVID-19.

Conclusions

The four identified PCC clusters corresponded to distinct and coherent clinical and paraclinical entities, making it possible to consider adapted and personalised prognosis and therapeutic interventions.
Protocol for a meta-review of interventions to prevent and manage ICU delirium
Authors: Jones Katherine Louise , Kundakci Burak , Booth Andrew , Pufulete Maria , Gibbison Ben
Published: February 2025

Introduction

Intensive care unit (ICU) delirium is an acute brain dysfunction that affects up to 7 out of 10 patients admitted to ICUs. Patients who develop ICU delirium cannot think clearly, have trouble paying attention, do not understand what is happening around them and may see or hear things that are not there. ICU delirium increases the time patients spend in ICUs and hospitals and therefore healthcare costs. ICU delirium is also associated with increased mortality and dementia in the longer term. ICU delirium prevention and management strategies are likely to include both pharmacological and non-pharmacological components as part of a complex intervention, but it is unclear which components should be included. The objective of this meta-review is to systematically map the quantity and certainty of the available evidence from reviews and meta-analyses of randomised controlled trials (RCTs) of pharmacological and non-pharmacological interventions, which will be used to design a multicomponent intervention to prevent and manage ICU delirium.

Methods and analysis

A systematic search strategy was performed in MEDLINE (Ovid), Embase (Elsevier), Cochrane Database of Systematic Reviews, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO and Web of Science (from inception to 26 September 2023), as well as Epistemonikos (from inception to 19 July 2023). We will include all critically ill adults (aged≥18 years) and any ICU delirium prevention or management intervention (pharmacological or non-pharmacological). For pharmacological interventions, we will include reviews of RCTs. For non-pharmacological interventions, we will consider reviews of RCTs, quasi-experimental and cohort studies. We will use the International Consensus Study (Del-COrS) core outcome set for research evaluating interventions to prevent or manage ICU delirium and synthesise our findings using quantitative data description methods. We will involve our Patient and Public Involvement group of people who experienced ICU delirium to develop and comment on such aspects as the research question, methodology and which outcomes are most important.

Ethics and dissemination

No ethical approval is required for this study. The results of this meta-review will be disseminated through peer-reviewed publications and conferences. They will also form part of an evidence map and logic model for the prevention and management of ICU delirium.

PROSPERO registration number

CRD42023473260
Supervised Injecting Room Cohort Study (SIRX): study protocol
Authors: Stewart Ashleigh C , Hickman Matthew , Agius Paul A , Scott Nick , Stone Jack , Roxburgh Amanda , O’Keefe Daniel , Higgs Peter , Kerr Thomas , Stoové Mark A , Thompson Alexander , Crawford Sione , Norman Josephine , Vella-Horne Dylan , Lloyd Zachary , Clark Nico , Maher Lisa , Dietze Paul
Published: February 2025

Background

Supervised injecting facilities (SIFs) are designed to reduce the harms associated with injecting drug use and improve access to health and support services for people who need them. The Supervised Injecting Room Cohort Study (SIRX) aims to provide evidence of the effects, including cost-effectiveness, of a SIF embedded within a community health service, the Melbourne Medically Supervised Injecting Room (MSIR), which has a range of integrated harm reduction, health and social support services on-site.

Methods and analysis

The SIRX study design involves two prospective cohort studies that collect behavioural data and retrospectively and prospectively linked administrative data for primary and tertiary health services, criminal justice records, and mortality. The two cohorts are: (1) participants drawn from the existing Melbourne Injecting Drug User Cohort Study (SuperMIX; established in 2008–ongoing) through which participants consent to annual behavioural surveys (including serological testing for HIV and hepatitis B and C viruses) and linkage to administrative data; and (2) the SIRX-Registration Cohort (SIRX-R; established in 2024) comprising registered MSIR clients who consent to a baseline behavioural survey and administrative data linkage including the frequency of SIF use, and the uptake of on-site services. Primary outcomes are aligned to the legislated aims of the Melbourne MSIR, including ambulance-attended non-fatal overdoses and all-cause and drug-related mortality. Using causal inference methods, analyses will estimate the effect of MSIR exposure (frequent use/infrequent use/no use) on these primary outcomes. The SIRX study also has a secondary focus on the effect of MSIR exposure on health service use and related outcomes.

Ethics and dissemination

SuperMIX Study (599/21) and SIRX-R Study (71/23) ethics approvals were obtained from Alfred Hospital Research Ethics Committee. Participants will be assessed for capacity to provide informed consent following a detailed explanation of the study. Participants are informed of their right to withdraw from the study at any time and that withdrawing does not impact their access to services. Aggregated research results will be disseminated via presentations at national and international scientific conferences and publications in peer-reviewed journals. Local-level reports and outputs will be distributed to key study stakeholders and policymakers. Summary findings via accessible outputs (eg, short infographic summaries) for participants will be displayed in relevant services including the Melbourne MSIR and the study van, and distributed via Harm Reduction Victoria.
Comprehensive coronary CT angiography in people living with HIV: a systematic review and meta-analysis
Authors: Phillips Tarin , Blake Gregory M , Aun Jonathan A , Conte Lisa M , Gadodia Ritika , Tuli Aakash , Nguyen Binh T , Robinson Sara L , Harrell Travis E , Murthy Venkatesh L , Hulten Edward
Published: February 2025

Objectives

People living with HIV (PLWH) were previously shown to have a higher prevalence of non-calcified coronary plaque with discrepant results for coronary stenosis and any plaque prevalence. This systematic review and meta-analysis summarise and estimate pooled effect sizes for observational studies among PLWH using comprehensive coronary CT angiography (CTA).

Design

Preferred Reporting Items for Systematic Review and Meta-analysis reporting guidelines were used.

Data sources

PubMed, Embase, Web of Science, CINAHL, Cochrane Clinical Trials and EBM were searched from inception to 23 February 2024.

Eligibility criteria

We included studies evaluating coronary atherosclerosis in adult PLWH with controls and CTA results for plaque prevalence, extent, severity and high-degree stenosis.

Data extraction and synthesis

Two independent reviewers used standardised methods to screen for relevance by title, abstract and full-text review. Two unblinded independent reviewers manually extracted data and rated study quality using the Newcastle-Ottawa Scale. Meta-analysis was conducted using random effects models. A sensitivity analysis was performed with a fixed effects model. Publication bias was assessed by visual inspection of funnel plots and formal testing by Egger’s and Begg’s tests. Segment scores were evaluated using the difference of medians.

Results

PLWH showed a significantly higher prevalence of non-calcified plaque (34% (95% CI: 15% to 53%)) compared with controls (22% (95% CI: 6% to 38%)) with an OR of 1.61 (1.13–2.30, p=0.009). There was no significant difference in partially calcified plaque prevalence (OR=1.20, 0.96–1.49), stenosis prevalence (OR=1.34, 0.92–1.96) and median difference in Segment Involvement Score (SIS; 0.39, –0.01 to 0.79) in PLWH compared with controls who have a non-significant difference in calcified plaque (OR=0.80, 0.61–1.04). The prevalence of any plaque (OR=1.22, 0.93–1.61) and difference in median Segment Stenosis Score (−0.12, –0.60 to 0.35) did not differ between groups.

Conclusion

This study demonstrates a greater prevalence of non-calcified plaque in PLWH than controls. Additional research is needed to assess quantitative CTA measurements. Increased power may reveal a difference in the prevalence of high-degree stenosis and median SIS score in PWLH, while controls may have a greater prevalence of calcified plaque.
Evaluation of quality policies and strategies in health systems: a scoping review
Authors: Pellense Márcia Cunha da Silva , Saturno Hernández Pedro Jesús , Caldas Anna Cláudia Sales Gomes , Gama Zenewton André da Silva
Published: February 2025

Objectives

Improving the quality of care requires specific, comprehensive and continuous attention from the administration of a health system. However, information on evaluations of national and subnational policies and strategies for quality is lacking. This study aims to map studies evaluating policies and strategies for quality in health systems around the world.

Design

This is a scoping review based on the guidelines of the Joanna Briggs Institute (JBI), guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR).

Data sources

The search for articles was carried out in the Embase, Medline/Pubmed, Scopus, Web of Science and Cumulative Index to Nursing and Allied Health Literature databases and in the grey literature in July 2024.

Eligibility criteria

Publications describing a tool for evaluating interventions for quality in the health system and studies containing at least one conceptual framework related to the evaluation of policies and strategies for quality in the health system, in any language, were included.

Data extraction and synthesis

Data selection was carried out independently by two reviewers, whose conflicts were resolved by consensus and the decision of a third reviewer. The findings were synthesised using a data extraction protocol adapted from two theoretical frameworks on National Quality Policies and Strategies proposed by the WHO.

Results

The data search resulted in 133 potentially eligible studies, of which 14 studies were included in the review. We found 27 countries that had evaluated their policies or strategies, most of them in Asia (11) and Africa (9). Six studies used instruments to evaluate interventions for quality at the health system level. An instrument used in Afghanistan, Armenia, Guatemala and Mexico proved to be potentially useful for dissemination in other countries. Among the elements recommended by the WHO for the implementation of strategic policies for quality, the most present were governance and organisational structure.

Conclusions

Although the evidence provides an indication of how countries have implemented their quality policies and strategies, we identified the need for tools to assess their impact on health systems.
Gender disparity in living organ donation: a qualitative analysis of experiences and perceptions of female donors in Pakistan
Authors: Iqbal Mahrukh , Saleem Javeria , Tehreem Abida , Asghar Raja Sajjad , Ishaq Muhammad , Shahzad Ruhma Binte , Touqeer Aleena , Bukkhari Gul Mehar Javaid
Published: February 2025

Objectives

This study aims to explore and analyse the interplay of sociocultural, psychological and institutional factors, gender roles and power dynamics in shaping the decision-making processes and experiences of living kidney and liver donors in Punjab, specifically focusing on women.

Design

This study employed a qualitative approach, using in-depth interviews to delve into the narratives and experiences of living kidney and liver donors in Punjab.

Setting

Punjab Human Organ Transplantation Authority (PHOTA), Lahore, Punjab, Pakistan.

Participants

17 participants registered at the PHOTA for kidney or liver donation.

Results

Interviews with living donors at PHOTA, Lahore, provided qualitative data, which was then systematically coded and analysed to identify recurring themes that explore the underlying social and cultural reasons for the observed gender disparity. The qualitative research yielded 17 interviews to include in the analysis, representing the voices of living kidney and liver donors. The study resulted in the following themes emerging: (1) female donation as a consequence of economic vulnerability; (2) comorbidities impacting donor eligibility; (3) altruism among female donors; (4) social and self-benefit of the donors and (5) social obligation on the female donors. These themes transcended the medical considerations and highlighted the interplay between social norms, family dynamics and gendered expectations surrounding caregiving and self-sacrifice.

Conclusion

The findings of this study underscore the significant relationship between gender roles, economic pressures and social expectations in the context of living organ donation. The study’s results highlight the urgent need for targeted interventions to address the gender gap in living kidney and liver donation. By acknowledging the influence of social and economic factors, strategies to create a more equitable landscape for living kidney and liver donors can be created.
Patterns and factors associated with healthcare utilisation in Cambodia: a cross-sectional study based on the World Health Survey Plus 2023
Authors: Chhim Srean , Kowal Paul , Ngor Chamnab , Long Sereyraksmey , Walton Poppy , Maung Khin Thiri , Marie Ku Grace , Klipstein-Grobusch Kerstin , Ng Nawi , Ir Por , Chhea Chhorvann , Sopheab Heng
Published: February 2025

Background

The Cambodian government aims to boost healthcare utilisation in public facilities and reduce the spending burden for disadvantaged households. This study aims to describe patterns of public and private outpatient and inpatient healthcare use and investigate the factors associated with public healthcare usage in Cambodia.

Method

A cross-sectional study was conducted in all provinces in Cambodia, including the capital, Phnom Penh. The analysis included 4603 individuals aged ≥18 who had received care within the last 12 months.

Results

Around 9% of outpatient and 50% of inpatient visits were made to public healthcare facilities. The number of outpatient visits made to public healthcare compared with private healthcare facilities was significantly higher in women (aOR 1.4, 95% CI 1.1, 1.8), living in rural settings (aOR 1.4, 95% CI 1.1, 1.7), those in the poorest (aOR 1.7, 95% CI 1.2, 2.3) and poor (aOR 1.5, 95% CI 1.1, 2.1) compared with the richest wealth quintiles, and respondents with insurance coverage (aOR 2.0, 95% CI 1.6, 2.5). The number of inpatient visits made to public healthcare compared with private healthcare facilities was significantly higher in the poorest (aOR 2.4, 95% CI 1.4, 3.9), poor (aOR 2.4, 95% CI 1.5, 4.0) and middle (aOR 2.5, 95% CI 1.5, 4.1) compared with those in the richest wealth quintiles and respondents with insurance coverage (aOR 2.1, 95% CI 1.5, 3.2).

Conclusion

Our study shows that private healthcare dominates outpatient services in Cambodia, while public healthcare is more significant for inpatient care. Individuals with low socioeconomic status and those with insurance showed higher public healthcare utilisation for outpatient and inpatient services, with women more likely to use public outpatient care. To progress towards universal health coverage, it is essential to improve public healthcare quality, especially in rural areas, expand service coverage and social health protection and develop strategies to engage the private sector.
Association between the number of social roles and self-rated health: mediation effect byikigaiand the size of close social networks
Authors: Suzuki Yuka , Honjo Kaori , Iso Hiroyasu , Yamagishi Kazumasa , Muraki Isao , Sakata Kiyomi , Tanno Kozo , Yasuda Nobufumi , Saito Isao , Kato Tadahiro , Arima Kazuhiko , Nakashima Hiroki , Yamaji Taiki , Iwasaki Motoki , Inoue Manami , Goto Atsushi , Sawada Norie , Tsugane Shoichiro
Published: February 2025

Background

Health effects of multiple role occupancy and their mechanism are not fully addressed. We examined (1) the association between the number of social roles and self-rated health (SRH) and (2) the mediation effects ofikigai(the sense of life worth living) and the size of close social networks to the association.

Methods

We analysed the cross-sectional baseline questionnaire data of the Japan Public Health Center-based Prospective Study for the Next Generation (JPHC-NEXT) of 22 180 men and 26 616 women in age 40–59 years. The independent variable was the number of social roles, counting five social roles as a spouse, parent, child, worker and a role in a community. The dependent variable was poor SRH. Logistic regression was used to estimate the ORs for poor SRH by the number of social roles and to test linear trends. Mediation analyses were conducted to estimate the proportion mediated byikigaiand the size of close social networks.

Results

Compared with people with 0–1 social role, those who had two or more roles had a lower OR of poor SRH in both men and women. There was a linear inverse trend in the association; people having the largest (5) versus lowest (0–1) number of social roles had the lowest ORs: 0.55 (95% CI 0.46 to 0.66) in men and 0.72 (95% CI 0.61 to 0.86) in women. The estimated proportion mediated byikigaiwas over 50%, whereas the size of close social networks mediated the association by approximately 20%.

Conclusion

An inverse association between the number of social roles and poor SRH and mediation effects ofikigaiand the size of close social networks were identified. Having even one more social role might benefit subjective health via increasedikigaiand the size of close social networks.
Association of race and ethnicity with mortality in adults with SLE: a systematic literature review and meta-analysis
Authors: Patel Samir , Yang Zijing , Nagra Deepak , Adas Maryam , Russell Mark , Norton Sam , Wincup Chris , Galloway James , Bramham Kate , Gordon Patrick
Published: February 2025

Objectives

Ethnicity and health outcomes are intrinsically interrelated, although mechanisms are complex. SLE is a disease with higher incidence in Asian, Black, Hispanic and Indigenous populations than in White populations. SLE is associated with premature mortality, but it is unclear if ethnicity impacts on health outcomes as studies are frequently underpowered. We aimed to describe the association between SLE and mortality across different racial and ethnic groups using meta-analysis.

Methods

We identified studies of adults with SLE that reported mortality, stratified by racial and ethnic group, through a systematic literature review. We used a pairwise meta-analysis to determine the pooled odds ratio (OR) of death for those from underserved groups compared with those of White race and ethnicity.

Results

Thirty-seven studies, comprising 85 578 patients with SLE, were included. Mortality was higher in Black patients (OR 1.30 (95% CI 1.16 to 1.46)) and Indigenous patients (OR 1.47 (95% CI 1.11 to 1.94)), while Asian and Hispanic patients showed no significant differences compared with White patients with SLE. Seventy per cent of included studies were conducted in the USA and when excluded, the significant difference in mortality between Black and White individuals with SLE was no longer seen (OR 0.84 (95% CI 0.54 to 1.31)).

Conclusion

Overall, patients with SLE from Black or Indigenous racial and ethnic groups had higher mortality than those of White race and ethnicity. We observed no significant association in the mortality of Black patients compared with White patients from non-USA cohorts, but a scarcity of data outside of the USA was highlighted. We promote caution in the use of race and ethnicity as a factor in determining mortality risk until more generalisable data are available.

PROSPERO registration number

CRD42023379034.
Rare and common single nucleotide variants in childhood-onset systemic lupus erythematosus
Authors: Sayadi Ahmed , Sandling Johanna K , Eloranta Maija-Leena ,   ImmunoArray Development Consortium,   DISSECT Consortium, Jönsen Andreas , Gunnarsson Iva , Rantapää-Dahlqvist Solbritt , Sjöwall Christopher , Bengtsson Anders A , Svenungsson Elisabet , Lindblad-Toh Kerstin , Leonard Dag , Rönnblom Lars
Published: February 2025

Background

SLE is a systemic autoimmune disease with a large number of common risk gene variants, but several rare gene variants can cause monogenic SLE. The relationship between common and rare variants in SLE is unclear. We therefore investigated the occurrence of rare deleterious variants in patients with childhood-onset SLE (cSLE) and adult-onset SLE (aSLE) and compared the frequency of these variants with their individual SLE polygenic risk score (PRS).

Materials and methods

Targeted sequencing of 1832 gene regions, including coding regions of 31 genes associated with monogenic SLE, was performed in 958 patients with SLE and 1026 healthy individuals. A total of 116 patients with SLE had disease onset before the age of 18 (cSLE). An SLE common variant PRS was created from 37 SLE genome-wide association study single nucleotide variants (SNVs).

Results

Rare coding deleterious SNVs (RD SNVs) were observed in 23 of the monogenic SLE-associated genes. Six per cent of patients with cSLE, compared with 3.2% of controls and 4.6% of patients with aSLE, carried rare deleterious alleles. In cSLE, RD SNVs were observed in theC1S,DDX58,IFIH1,IKZF1,RNASEH2AandC8Agenes. A PRS analysis showed that patients with cSLE with any of these gene variants had a similar average PRS as control individuals.

Conclusion

RD SNVs were observed in a small proportion of cSLE and carriers of these RD SNVs had a PRS similar to healthy individuals, suggesting the importance of rare coding heterozygous variants in driving disease risk in a subset of children with SLE.
Association of blood pressure and left ventricular mass with subclinical coronary atherosclerosis
Authors: Loh Enver De Wei , Huang Weiting , Sultana Rehena , Kong Siew Ching , Ng Chirk Jenn , Tan Swee Yaw , Chin Calvin , Yap Jonathan Jiunn Liang , Yeo Khung K
Published: February 2025

Background

Left ventricular (LV) mass is closely associated with atherosclerotic heart disease, but the mechanisms are not well defined. This study aimed to evaluate the risk factors associated with LV mass and subclinical coronary atherosclerosis, in an Asian population free of baseline cardiovascular disease.

Methods

The SingHEART study is a population-based cohort in which individuals underwent ambulatory blood pressure (BP) monitoring, cardiac MRI to measure indexed LV mass index (LVMI) and coronary artery calcium (CAC) scoring. Individuals were stratified based on LVMI and the presence of CAC, and intergroup differences in risk factors were analysed. Logistic regression models were used to assess the interaction of BP and LVMI on prevalent CAC.

Results

The study included 880 subjects (mean age 45.8±11.7 years, 51.4% women). Individuals with high LVMI had higher BP than those with normal LVMI. Across all LVMI groups, higher BP was associated with the presence of CAC. Compared with individuals with normotensive BP and normal LVMI, those with normotensive BP and high LVMI had no increased risk of prevalent CAC (p=0.530); however, risk was progressively higher in those with hypertensive BP and normal LVMI (risk ratio (RR) 1.47, 95% CI 1.13 to 1.91), or hypertensive BP and high LVMI (RR 1.72, 95% CI 1.26 to 2.36).

Conclusions

In this healthy asymptomatic population, hypertension was the strongest risk factor for high LVMI and prevalent CAC. LV hypertrophy was a risk modifier, and its prognostic significance in adults without hypertension requires further study.
Phase 1 study of novel anti-platelet agent to overcome pharmacogenomic limitations of clopidogrel
Authors: Pareek Anil , Chandurkar Nitin , Raut Vivek , Naidu Kumar
Published: February 2025

Aims

Clopidogrel is the most commonly prescribed thienopyridine as part of dual anti-platelet therapy for the treatment of cardiovascular diseases. However, clopidogrel responsiveness shows variability based on CYP2C19 polymorphism. Therefore, we planned a study with an objective of evaluating safety, tolerability, pharmacodynamics and pharmacokinetics of a novel thienopyridine antiplatelet agent AT-10 in healthy Indian subjects compared with standard dosage regimen of clopidogrel based on their CYP2C19 genotyping.

Methods

Two CYP2C19 genotype–based groups were identified, that is, poor metabolisers and extensive metabolisers, with 20 subjects in each group (n=40) for participating in a randomised, two-period, crossover study. Each study period lasted 6 days including administration of loading and maintenance doses of AT-10 (40 mg/10 mg) or clopidogrel (300 mg/75 mg). The pharmacokinetics and pharmacodynamics were assessed on day 1 and day 6 at several time intervals.

Results

Overall result of pharmacodynamic parameters showed that mean %inhibition of platelet aggregation between AT-10 and clopidogrel in all subjects at 6 hours postdose (loading dose) (AT-10: clopidogrel; 73.30% vs 18.53%) and 6 hours postdose on day 6 (maintenance dose) (AT-10: clopidogrel; 83.41% vs 51.19 %) obtained from the AT-10 group was significantly higher than the clopidogrel group. Further, %inhibition of platelet aggregation from AT-10 treatment in poor metaboliser group was significantly higher than the clopidogrel treatments in extensive metaboliser group.

Overall pharmacokinetic comparison in all subjects indicates that AT-10 gives greater exposure to active Metabolite H4 than clopidogrel.

Conclusion

AT-10 showed better inhibition of platelet aggregation in poor metabolizers as compared to Clopidogrel. AT-10 may emerge as a potential alternative to Clopidogrel as an anti-platelet drug. It can be further developed in clinical studies for the unmet medical needs in management of CVDs and overcome the pharmacogenomic limitations of Clopidogrel.

Trial registration number

Clinical Trial Registry-India URL:http://ctri.nic.in. Registration number: CTRI/2021/03/032206.
Incidence, mortality and oral cancer disability-adjusted life years in 204 countries and territories before and after the adoption of FCTC/WHO: interrupted time series study
Authors: Silva Bruna Machado da , Hagen Laila Menezes , Cunha Amanda Ramos da , Hugo Fernando Neves , Amenabar José Miguel
Published: February 2025

The development of oral cancer (OC) is strongly associated with tobacco products which is a significant risk factor. In 2003, the WHO recommended that countries adopt the Framework Convention on Tobacco Control (FCTC/WHO), an international treaty that includes a set of public policies for tobacco control. Studies show a reduction in the prevalence of tobacco product consumption in countries that have more strongly implemented WHO/FCTC actions. However, information on the relationship between these policies and the burden of neoplastic diseases, including OC, is still scarce. For this reason, the objective of this study was to analyse trends in incidence, mortality, and OC disability-adjusted life years (DALYs) in countries and territories that have joined FCTC/WHO. The analysis lasted from 1990 to 2019, and 2003 was the interruption year (FCTC/WHO implementation), characterising the interrupted time series. The control group (G1) was composed of the countries and territories that did not adhere to the FCTC/WHO; the countries and territories that joined FCTC/WHO were divided into two groups, according to their policy performance (G2A: lowest MPOWER score and G2B: highest MPOWER score). To analyse trends and slopes, generalised linear regression was used using the Prais-Winsten method, allowing the presentation by means of the annual percentage changes and their respective 95% CIs. The temporal pattern showed significant downward negative movements in the group of countries and territories with the highest performance of the policies established in the FCTC/WHO (G2B Group). The socioeconomic development of the countries and territories did not interfere with the impact on the OC rates. It is concluded that the effective implementation of public policies for tobacco control is capable of favourably modifying the trend of incidence, mortality and DALYs rates of OC.
Field study on intelligent compaction for compaction quality control of subgrade bases
Authors: Baek Sung-Ha , Cho Jin-Woo , Kim Jin-Young
Published: February 2025

To address the challenges in adopting IC as the primary method for compaction quality control, this study investigated methods for determining appropriate target intelligent compaction measurement values (ICMVs) for compaction quality control and strategies to manage compaction quality considering the ICMV variability. Field tests revealed that the mean compaction meter value (CMV) increased with the number of roller passes. However, a high coefficient of variation (COV) was observed across all roller passes, indicating significant local variability in compaction quality. A 5-m region of interest was determined optimal for correlating CMV with plate-load-test results and determining CMV for compaction quality management. Uniform compaction could not address localized variability in compaction quality. Detecting weak areas during the compaction process and concentrating efforts in these regions improved the uniformity of the compaction quality. This study provides valuable insights for ICMV-based compaction quality control, assisting construction supervisors in setting target ICMVs and developing effective strategies.
The Addictive Process of Opioids: Current and Novel Interventions in Opioid Use Disorder
Authors: Duerksen James , Ramjiawan Matthew , Witt Julia , Fitzpatrick-Wong Shirley , Tappia Paramjit S , Ramjiawan Bram , Mansouri Behzad , Sareen Jitender , Knight Erin
Published: February 2025

The growing epidemic of opioid misuse presents numerous challenges for healthcare practitioners and patients alike as friction exists between ease of use and efficacy, and potential for overuse and addiction. With over 82,000 deaths related to opioid overdose in North America in 2020, it is imperative to gain a better understanding of the underlying mechanisms behind the addiction process, as well as the current methods being used in the arsenal against this disease. The current best pharmacological approaches for mediating opioid use disorder are methadone, buprenorphine, naltrexone and naloxone, which act on opioid receptors to produce diverse effects based upon the patients’ needs. The variety of effects that these drugs produce, which include removing opioid withdrawal, reversing overdose effects and blocking opioid properties, makes this arsenal of therapeutics a global necessity in addressing the opioid use epidemic. Accordingly, this narrative review provides a summary of the available data regarding the physiological processes by which opioid addiction takes place and discusses the current and future potential of interventional methods used to mitigate opioid use disorder. The mechanisms of action and subsequent functional outcomes must be understood in order to reduce the number of opioid-related deaths worldwide.
Examining the Role of Household on Entrepreneurial Development in Rural India: A Resource-Based Approach
Authors: Pandey Shraddha , Mishra Sanjay , Lohani Vaniki Joshi , Pandey Hari Om
Published: February 2025

Drawing on the previous research on context and family involvement in entrepreneurial growth, this study examines the impact of households on the creation and growth of a rural enterprise. We aim to investigate how household strategies affect the development of new enterprise, how household dynamics influence enterprise growth strategy decisions, and how household manage and create business portfolios. To address these questions, we conducted comparative case studies utilising information from four business households situated in rural areas of Uttarakhand. In all four cases, a thematic interview approach was employed to explore consistent themes, such as business operations, household requirements, motivations for initiating and running a business, and community interactions. The findings illustrate how household contribute to the development and growth of rural enterprise, how these business change over time, the collaborative efforts of families in business venture and how they build and expand their business activities. The study identified three main themes: the close connection between household and business; how family and kinship act as valuable resources in enterprise growth; and how households effectively manage risk and uncertainty through entrepreneurial bricolage. These results highlight the role of households and household strategy in shaping enterprise growth, in contrast to earlier studies that focused on individual aspirations and business strategy. By focusing on farm family businesses and the resource-based view, this study offers valuable insights into the strategies employed by agripreneurial households to manage and leverage their resources effectively.
Aster: Enhancing LSM-structures for Scalable Graph Database
Authors: Mo Dingheng , Liu Junfeng , Wang Fan , Luo Siqiang
Published: February 2025

There is a proliferation of applications requiring the management of large-scale, evolving graphs under workloads with intensive graph updates and lookups. Driven by this challenge, we introduce
Poly-LSM
, a high-performance key-value storage engine for graphs with the following novel techniques: (1)
Poly-LSM
is embedded with a new design of graph-oriented LSM-tree structure that features a hybrid storage model for concisely and effectively storing graph data. (2)
Poly-LSM
utilizes an adaptive mechanism to handle edge insertions and deletions on graphs with optimized I/O efficiency. (3)
Poly-LSM
exploits the skewness of graph data to encode the key-value entries. Building upon this foundation, we further implement
Aster
, a robust and versatile graph database that supports Gremlin query language facilitating various graph applications. In our experiments, we compared
Aster
against several mainstream real-world graph databases. The results demonstrate that
Aster
outperforms all baseline graph databases, especially on large-scale graphs. Notably, on the billion-scale Twitter graph dataset,
Aster
achieves up to 17x throughput improvement compared to the best-performing baseline graph system.
Boosting OLTP Performance with Per-Page Logging on NVDIMM
Authors: Lee Bohyun , Moon Seongjae , Park Jonghyeok , Lee Sang-Won
Published: February 2025

When running OLTP workloads on flash SSDs, relational DBMSs still face the write durability overhead, severely limiting their performance. To address this challenge, we propose NV-PPL, a novel database architecture that leverages NVDIMM as a
durable log cache.
NV-PPL
captures per-page redo logs and retains them on NVDIMM to absorb writes from DRAM to SSD. Our
NV-PPL
prototype, deployed on an actual NVDIMM device, demonstrates superior transaction throughput, surpassing the
same-priced
Vanilla MySQL by at least 6.9× and NV-SQL, a page-grained NVDIMM caching scheme, by up to 1.5×. Beyond write reduction, the page-wise logs in NVDIMM enable novel approaches such as redo-less recovery and redo-based multi-versioning. Compared to Vanilla MySQL, redo-less recovery reduces recovery time by one-third, while redo-based multi-versioning enhances the latency of long-lived transactions in HTAP workloads by 3× to 18×.
Efficiently Processing Joins and Grouped Aggregations on GPUs
Authors: Wu Bowen , Koutsoukos Dimitrios , Alonso Gustavo
Published: February 2025

There is a growing interest in leveraging GPUs for tasks beyond ML, especially in database systems. Despite the existing extensive work on GPU-based database operators, several questions are still open. For instance, the performance of almost all operators suffers from random accesses, which can account for up to 75% of the runtime. In addition, the group-by operator which is widely used in combination with joins, has not been fully explored for GPU acceleration. Furthermore, existing work often uses limited and unrepresentative workloads for evaluation and does not explore the query optimization aspect, i.e., how to choose the most efficient implementation based on the workload. In this paper, we revisit the state-of-the-art GPU-based join and group-by implementations. We identify their inefficiencies and propose several optimizations. We introduce GFTR, a novel technique to reduce random accesses, leading to speedups of up to 2.3x. We further optimize existing hash-based and sort-based group-by implementations, achieving significant speedups (19.4x and 1.7x, respectively). We also present a new partition-based group-by algorithm ideal for high group cardinalities. We analyze the optimizations with cost models, allowing us to predict the speedup. Finally, we conduct a performance evaluation to analyze each implementation. We conclude by providing practical heuristics to guide query optimizers in selecting the most efficient implementation for a given workload.
Entity/Relationship Graphs: Principled Design, Modeling, and Data Integrity Management of Graph Databases
Authors: Skavantzos Philipp , Link Sebastian
Published: February 2025

Chen's Entity/Relationship (E/R) framework is a lingua franca for well-designed databases. We define E/R graphs as property graphs that are instances of E/R diagrams. As the latter are a subclass of PG-Schema, E/R modeling constitutes a methodology for designing graph databases that guarantee data integrity, the absence of data redundancy and update anomalies. In addition, E/R graphs provide the first graph semantics for E/R diagrams. Further to the unification of conceptual and graph data modeling, referential integrity for E/R graphs can be managed by directed edges, called E/R links, between nodes. As a consequence, redundancy and sources of potential inconsistency can be eliminated, minimizing update maintenance. This is achieved by E/R keys that use properties and E/R links to enforce entity integrity, in contrast to property keys that rely exclusively on properties to enforce entity integrity. We use the TPC-H benchmark as running example and for extensive experiments that quantify the effort for i) managing entity integrity using property keys or E/R keys, ii) managing referential integrity using property redundancy or E/R links, iii) query evaluation. In summary, E/R diagrams form a principled core of PG-Schema for well-designed property graphs, while E/R keys constitute an efficient core of PG-Key for data integrity management.
TGraph: A Tensor-centric Graph Processing Framework
Authors: Zhang Yongliang , Zhu Yuanyuan , Zhang Hao , Gao Congli , Wang Yuyang , Li Guojing , Xu Tianyang , Zhong Ming , Jiang Jiawei , Qian Tieyun , Zhang Chenyi , Yu Jeffrey Xu
Published: February 2025

Graph is ubiquitous in various real-world applications, and many graph processing systems have been developed. Recently, hardware accelerators have been exploited to speed up graph systems. However, such hardware-specific systems are hard to migrate across different hardware backends. In this paper, we propose the first tensor-based graph processing framework, Tgraph, which can be smoothly deployed and run on any powerful hardware accelerators (uniformly called XPU) that support Tensor Computation Runtimes (TCRs). TCRs, which are deep learning frameworks along with their runtimes and compilers, provide tensor-based interfaces to users to easily utilize specialized hardware accelerators without delving into the complex low-level programming details. However, building an efficient tensor-based graph processing framework is non-trivial. Thus, we make the following efforts: (1) propose a tensor-centric computation model for users to implement graph algorithms with easy-to-use programming interfaces; (2) provide a set of graph operators implemented by tensor to shield the computation model from the detailed tensor operators so that Tgraph can be easily migrated and deployed across different TCRs; (3) design a tensor-based graph compression and computation strategy and an out-of-XPU-memory computation strategy to handle large graphs. We conduct extensive experiments on multiple graph algorithms (BFS, WCC, SSSP, etc.), which validate that Tgraph not only outperforms seven state-of-the-art graph systems, but also can be smoothly deployed and run on multiple DL frameworks (PyTorch and TensorFlow) and hardware backends (Nvidia GPU, AMD GPU, and Apple MPS).
Hallucination Detection in Foundation Models for Decision-Making: A Flexible Definition and Review of the State of the Art
Authors: Chakraborty Neeloy , Ornik Melkior , Driggs-Campbell Katherine
Published: February 2025

Autonomous systems are soon to be ubiquitous, spanning manufacturing, agriculture, healthcare, entertainment, and other industries. Most of these systems are developed with modular sub-components for decision-making, planning, and control that may be hand-engineered or learning-based. While these approaches perform well under the situations they were specifically designed for, they can perform especially poorly in out-of-distribution scenarios that will undoubtedly arise at test-time. The rise of foundation models trained on multiple tasks with impressively large datasets has led researchers to believe that these models may provide “common sense” reasoning that existing planners are missing, bridging the gap between algorithm development and deployment. While researchers have shown promising results in deploying foundation models to decision-making tasks, these models are known to hallucinate and generate decisions that may sound reasonable, but are in fact poor. We argue there is a need to step back and simultaneously design systems that can quantify the certainty of a model’s decision, and detect when it may be hallucinating. In this work, we discuss the current use cases of foundation models for decision-making tasks, provide a general definition for hallucinations with examples, discuss existing approaches to hallucination detection and mitigation with a focus on decision problems, present guidelines, and explore areas for further research in this exciting field.
Thermal-Aware Chiplet Placement for 2.5D ICs with Sequence Pair Based Tree
Authors: Lee Yu-Min , Chiou Hong-Wen , Jiang Jia-Hao
Published: February 2025

This work develops an efficient thermal-aware chiplet placer with sequence-pair representation. It provides wirelength-driven placement and thermal-aware placement. Its wirelength-driven option combines the sequence-pair based tree, a parallel branch-and-bound method and advanced placement/pruning techniques to efficiently find the minimum-wirelength placement. The thermal-aware option incorporates the wirelength-driven option with a thermal-aware net weight decision method and a post chiplet placement procedure to effectively make a trade-off between wirelength and temperatures of chiplets. Compared with the state-of-the-art wirelength-driven chiplet placer, the developed wirelength-driven chiplet placer not only finds the same or less minimum wirelength placement but also speeds up at most two orders of magnitude. With considering thermal effect, Its thermal-aware option can reduce the maximum temperature up to 9.4 ℃ with an average 4.7% increase of wirelength, while ensuring that all cases meet thermal constraints. Compared to the state-of-the-art thermal-aware chiplet placer, the proposed thermal-aware placer not only takes shorter runtime but also provides less total wirelength placement.
Energy-Aware Drone Path Finding with a Fixed-Trajectory Ground Vehicle
Authors: Diller Jonathan , Han Qi
Published: February 2025

Rotary-wing Unmanned Aerial Vehicles (commonly referred to as drones) are versatile autonomous transportation platforms that can be used for a variety of data collection applications including emergency response, environmental monitoring, surveillance, and many others.

In this work, we investigate how to plan efficient paths that minimize mission completion time for drone data collection where the drone must rendezvous with a moving ground vehicle (GV) that cannot stop and wait for the drone. Moreover, we address the limited onboard energy storage issue by adapting drone speed.

We propose a mixed-integer nonlinear program (MINLP) solution to solve this problem to optimality and provide two heuristics-based alternative solutions (the
k
-TSP and
D
-TSP approaches) that are more computationally tractable.

We evaluate these approaches in extensive simulations using real drone characteristics to highlight their trade-offs. Our results show that the
k
-TSP algorithm performs well when data collection points are closer to the GV, averaging within 4.5% of the optimal solution, while the
D
-TSP approach is more versatile, finding solutions in situations where the
k
-TSP algorithm tends to fail. Furthermore, we show that adapting drone speed can improve solution quality by up to 47.1% compared to fixed-speed approaches. In summary, this article serves as an exploratory study in energy-aware planning and scheduling for drones and other autonomous transportation systems.
CONFERENCE REPORTS
Authors: Katoen Joost-Pieter
Published: February 2025

I hope you all enjoyed the conferences you attended in the last half year. I write this preamble while enjoying the PICS (Probability in Computer Science) Ph.D. school in Copenhagen that is possible thanks to the generous support by SIGLOG, SIGPLAN, ETAPS and EATCS. Next time, I'll report on the school and its lectures.
The 2024 ACM SIGEVO Outstanding Contribution Awardees
Authors: Auger Anne , Rothlauf Franz
Published: February 2025

The SIGEVO Outstanding Contribution Award recognizes remarkable contributions to Evolutionary Computation (EC) when evaluated over a sustained period of at least 15 years. These contributions can include technical innovations, publications, leadership, teaching, mentoring, and service to the EC community.